scholarly journals Endoscopy-guided diode laser-assisted transcaruncular StopLoss Jones tube implantation for canalicular obstructions in primary surgery

2020 ◽  
Vol 258 (12) ◽  
pp. 2809-2817
Author(s):  
Yongwei Guo ◽  
Alexander C. Rokohl ◽  
Katharina Kroth ◽  
Senmao Li ◽  
Ming Lin ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Diode Laser ◽  
Postoperative Bleeding ◽  
Primary Treatment ◽  
Implantation Technique ◽  
Success Rates ◽  
Secondary Surgery ◽  
Invasive Approach ◽  
Primary Surgery ◽  
Tube Malposition

Abstract Purpose To introduce and evaluate a minimally-invasive endoscopy-guided transcaruncular laser-assisted StopLoss Jones tube (SLJT) implantation technique for severe canalicular obstructions in primary surgeries. Methods We retrospectively identified 12 adult patients (12 eyes) with severe epiphora secondary to long-segment canalicular obstructions. All the 12 eyes underwent an endoscopy-guided transcaruncular SLJT implantation with an 810-nm diode laser’s assistance as the primary surgical approach. Surgical and functional success rates, intraoperative and postoperative complications, as well as the need for secondary surgery, are evaluated. Results Primary surgical success was achieved in 11 of the 12 cases (92%); one patient (8%) required secondary surgery to replace an SLJT with a shorter one. Ultimately, all cases showed well-placed functioning tubes. Three of the 12 cases (25%) presented conjunctival scarring, conjunctival granulation tissue, with or without tube-associated irritation of the ocular surface. We observed no sink-in, extrusion, nor crack of the tube. Complete functional success was achieved in 83%, and moderate functional success in 17% of all patients. The functionally unsuccessful outcome was not present in this study. Conclusion Endoscopy-guided transcaruncular diode laser-assisted SLJT implantation seems to be a promising minimally invasive approach for primary treatment of severe canalicular dacryostenosis. This novel technique shows high functional success rates. It seems to avoid the risk of tube malposition and extrusion, septal and turbinate injury, nasal adhesion, drainage failure, ethmoiditis, postoperative bleeding, and cutaneous scars.

Analysis of Minimally Invasive Left Thoracotomy HVAD Implantation – A Single-Center Experience

2018 ◽  
Vol 67 (03) ◽  
pp. 170-175 ◽  
Author(s):  
D. Reichart ◽  
C.F. Brand ◽  
A.M. Bernhardt ◽  
S. Schmidt ◽  
A. Schaefer ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Ventricular Assist Device ◽  
Median Sternotomy ◽  
Left Ventricular ◽  
Implantation Technique ◽  
Assist Device ◽  
Ventricular Assist ◽  
Invasive Approach ◽  
Left Thoracotomy ◽  
Bridge To Transplant

Background Minimally invasive left ventricular assist device (LVAD) implantation may reduce peri-/postoperative complications and risks associated with resternotomies. In this study, we describe our first results using a minimally invasive LVAD implantation technique (lateral thoracotomy [LT] group). These results were compared with LVAD implantations done via full median sternotomy (STX group). Methods HVAD (HeartWare, Framingham, Massachusetts, United States) implantations in 70 patients (LT group n = 22, 52 ± 15 years old; STX group n = 48, 59 ± 11 years old) were retrospectively analyzed. Minimally invasive access via left thoracotomy was feasible in 22 patients. Peri- and postoperative analyses of survival and adverse events were performed. Results No survival differences were observed between the LT and STX group (p = 0.43). LT patients without temporary right ventricular assist device (tRVAD) showed a significantly better survival rate compared to LT patients with concomitant tRVAD implantation (p = 0.02), which could not be demonstrated in the STX group (p = 0.11). Two LT and four STX patients were successfully bridged to heart transplantation and three STX patients were successfully weaned with subsequent LVAD explantations. LVAD-related infections (n = 4 LT group vs n = 20 STX group, p = 0.04) were less likely in the LT group. No wound dehiscence occurred in the LT group, whereas five were observed in the STX group (p = 0.17). The amount of perioperative blood transfusions (within the first 7 postoperative days) did not differ in both study groups (p = 0.48). Conclusion The minimally invasive approach is a viable alternative with the possibility to reduce complications and should be particularly considered for bridge-to-transplant patients.

scholarly journals Comparing Robot-Assisted Laparoscopic Pyeloplasty vs. Laparoscopic Pyeloplasty in Infants Aged 12 Months or Less

2021 ◽  
Vol 9 ◽  
Author(s):  
Yuenshan Sammi Wong ◽  
Kristine Kit Yi Pang ◽  
Yuk Him Tam
Keyword(s):  
Minimally Invasive ◽  
Intraoperative Complications ◽  
Linear Regression Analysis ◽  
Hospital Length Of Stay ◽  
Success Rates ◽  
Laparoscopic Pyeloplasty ◽  
Minimally Invasive Approach ◽  
Robot Assisted ◽  
Analgesic Requirement ◽  
Invasive Approach

Objective: To investigate the outcomes of minimally invasive approach to infants with ureteropelvic junction (UPJ) obstruction by comparing the two surgical modalities of robot-assisted laparoscopic pyeloplasty (RALP) and laparoscopic pyeloplasty (LP).Methods: We conducted a retrospective review of all consecutive infants aged ≤12 months who underwent either LP or RALP in a single institution over the period of 2008–Jul 2020. We included primary pyeloplasty cases that were performed by or under the supervision of the same surgeon.Results: Forty-six infants (LP = 22; RALP = 24) were included with medians of age and body weight at 6 months (2–12months) and 8.0 kg (5.4–10 kg), respectively. There was no difference between the two groups in the patients' demographics and pre-operative characteristics. All infants underwent LP or RALP successfully without conversion to open surgery. None had intraoperative complications. Operative time (OT) was 242 min (SD = 59) in LP, compared with 225 min (SD = 39) of RALP (p = 0.25). Linear regression analysis showed a significant trend of decrease in OT with increasing case experience of RALP(p = 0.005). No difference was noted in the post-operative analgesic requirement. RALP was associated with a shorter hospital length of stay than LP (3 vs. 3.8 days; p = 0.009). 4/22(18%) LP and 3/24(13%) RALP developed post-operative complications (p = 0.59), mostly minor and stent-related. The success rates were 20/22 (91%) in LP and 23/24 (96%) in RALP (p = 0.49).Conclusions: Pyeloplasty by minimally invasive approach is safe and effective in the infant population. RALP may have superiority over LP in infants with its faster recovery and a more manageable learning curve to acquire the skills.

scholarly journals Penetration into free abdominal cavity during transanal endoscopic rectal resection for adenoma

2021 ◽  
Vol 2 (1) ◽  
pp. 43-49
Author(s):  
Yu. A. Gevorkyan ◽  
N. V. Soldatkina ◽  
V. E. Kolesnikov ◽  
D. A. Kharagezov ◽  
A. V. Dashkov ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Endoscopic Resection ◽  
Malignant Tumors ◽  
Rectal Resection ◽  
Abdominal Cavity ◽  
Postoperative Bleeding ◽  
Functional Results ◽  
Rectal Tumors ◽  
Invasive Approach ◽  
Technical Advances

Benign and malignant tumors are the most common diseases of the rectum and tend to grow. Various techniques have been developed for the treatment of rectal tumors: endoscopic electroexcision through a colonoscope, transanal removal of tumors, and transabdominal removal. The use of all these methods made it possible to determine their advantages and indications, as well as limitations and disadvantages. Technical advances in modern oncology resulted in developing a method for transanal tumor removal with a number of advantages: radical surgery, adequacy, and functionality. This technique can be used in benign and malignant rectal tumors. One of its main advantages involves a small number of postoperative complications, while intra- operative complications such as penetration into the free abdominal cavity during transanal endoscopic resection of the rectum are quite rare. It is also important that the method of transanal endoscopic resection of the rectum also has good oncological and functional results (according to various studies). We present a clinical case of penetration into the free abdominal cavity during transanal endoscopic rectal resection for adenoma. This case is also interesting in that the patient also had another complication – postoperative bleeding from the rectum, which required surgical intervention, also with the use of a minimally invasive approach.This clinical observation demonstrates successful suturing of penetrating openings into the abdominal cavity arising during transanal endoscopic removal of rectal tumors with the upper pole located above the pelvic peritoneum and effective minimally invasive tactics in the development of postoperative bleeding.

Minimally Invasive Approach for Wilms Tumor Treatment in a Small Child - A Case Report

Urology ◽  
2020 ◽  
Author(s):  
Alexandre Azevedo Ziomkowski ◽  
João Rafael Silva Simões Estrela ◽  
Nilo Jorge Carvalho Leão Barretto ◽  
Nilo César Leão Barretto
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Wilms Tumor ◽  
Small Child ◽  
Tumor Treatment ◽  
Minimally Invasive Approach ◽  
Invasive Approach

A Minimally Invasive Approach for Treatment of Cholesterol Granuloma of the Petrous Apex

2019 ◽  
Author(s):  
Brandon Lucke-Wold ◽  
Maya Fleseriu ◽  
Haley Calcagno ◽  
Timothy Smith ◽  
Joshua Levy ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Petrous Apex ◽  
Cholesterol Granuloma ◽  
Minimally Invasive Approach ◽  
Invasive Approach

Surgical Technique: Papillary Muscle Sling for Functional Mitral Regurgitation during Minimally Invasive Valve Surgery

2013 ◽  
Vol 16 (5) ◽  
pp. E295-E297 ◽  
Author(s):  
Joseph Lamelas ◽  
Christos Mihos ◽  
Orlando Santana
Keyword(s):  
Mitral Regurgitation ◽  
Minimally Invasive ◽  
Median Sternotomy ◽  
Rational Approach ◽  
Functional Mitral Regurgitation ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Mitral Annuloplasty ◽  
Technical Details ◽  
Mitral Apparatus

In patients with functional mitral regurgitation, the placement of a sling encircling both papillary muscles in conjunction with mitral annuloplasty appears to be a rational approach for surgical correction, because it addresses both the mitral valve and the deformities of the subvalvular mitral apparatus. Reports in the literature that describe the utilization of this technique are few, and mainly involve a median sternotomy approach. The purpose of this communication is to describe the technical details of performing this procedure via a minimally invasive approach.

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