scholarly journals Commentary: Do we have the right combatants? Should it be minimally invasive surgery versus therapy that removes no lymph nodes?

2019 ◽  
Vol 158 (5) ◽  
pp. 1467-1468
Author(s):  
Robert J. Cerfolio
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Lymph Nodes ◽  
Invasive Surgery ◽  
The Right

scholarly journals Variation in medical management and neurosurgical treatment of patients with supratentorial spontaneous intracerebral haemorrhage

2021 ◽  
pp. 239698732110059
Author(s):  
Lotte Sondag ◽  
Floor AE Jacobs ◽  
Floris HBM Schreuder ◽  
Jeroen D Boogaarts ◽  
W Peter Vandertop ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Intracerebral Haemorrhage ◽  
Online Survey ◽  
Treatment Decisions ◽  
Neurosurgical Treatment ◽  
The Right ◽  
Invasive Techniques ◽  
Spontaneous Intracerebral Haemorrhage

Introduction The role of surgery in spontaneous intracerebral haemorrhage (sICH) remains controversial. This leads to variation in the percentage of patients who are treated with surgery between countries. Patients and methods We sent an online survey to all neurosurgeons (n = 140) and to a sample of neurologists (n = 378) in Dutch hospitals, with questions on management in supratentorial sICH in general, and on treatment in six patients, to explore current variation in medical and neurosurgical management. We assessed patient and haemorrhage characteristics influencing treatment decisions. Results Twenty-nine (21%) neurosurgeons and 92 (24%) neurologists responded. Prior to surgery, neurosurgeons would more frequently administer platelet-transfusion in patients on clopidogrel (64% versus 13%; p = 0.000) or acetylsalicylic acid (61% versus 11%; p = 0.000) than neurologists. In the cases, neurosurgeons and neurologists were similar in their choice for surgery as initial treatment (24% and 31%; p = 0.12), however variation existed amongst physicians in specific cases. Neurosurgeons preferred craniotomy with haematoma evacuation (74%) above minimally-invasive techniques (5%). Age, Glasgow Coma Scale score and ICH location were important factors influencing decisions on treatment for neurosurgeons and neurologists. 69% of neurosurgeons and 80% of neurologists would randomise patients in a trial evaluating the effect of minimally-invasive surgery on functional outcome. Discussion Our results reflect the lack of evidence about the right treatment strategy in patients with sICH. Conclusion New high quality evidence is needed to guide treatment decisions for patients with ICH. The willingness to randomise patients into a clinical trial on minimally-invasive surgery, contributes to the feasibility of such studies in the future.

scholarly journals A case of maxillary bone metastasis from lung cancer

2015 ◽  
Vol 5 (4) ◽  
Author(s):  
Takeshi Kusunoki ◽  
Hirotomo Homma ◽  
Yoshinobu Kidokoro ◽  
Aya Yanai ◽  
Katsuhisa Ikeda ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Minimally Invasive Surgery ◽  
Bone Metastasis ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Maxillary Bone ◽  
Old Japanese ◽  
History Of ◽  
The Right ◽  
End Stage

We experienced a very rare case of maxillary bone metastasis from lung cancer. The patient was a 77-year-old Japanese man with 1-month history of right alar swelling with hard pain as his chief complaint. Computed tomography scan showed a 1 cm length round lesion in the right nasal vestibule close to the pyriform fossa edge of the right maxillary bone. He had severe pulmonary dysfunction due to recurrent end stage lung cancer and diabetes. The expected remainder of his life would be half a year. Therefore, his very poor condition precluded general anesthesia. To relieve the nasal pain, shorten the stay in the hospital and improve the quality of life (QOL), we performed minimally invasive surgery under local anesthesia. Our minimally invasive surgery could improve QOL by relieving the hard nasal pain until the recurrence of cancer and enable the patient to live at home.

scholarly journals Is minimally invasive surgery of lesions in the right superior segments of the liver justified? A multi‐institutional study of 245 patients

2020 ◽  
Vol 122 (7) ◽  
pp. 1428-1434
Author(s):  
Sepideh Gholami ◽  
Sean J. Judge ◽  
Ser‐Yee Lee ◽  
Kiarash Mashayekhi ◽  
Brian K. P. Goh ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
The Right

Steerable Surgical Instrument for Conventional and Single-Site Minimally Invasive Surgery

2021 ◽  
pp. 155335062110370
Author(s):  
Victor Gabriel Hernández-Valderrama ◽  
Ricardo Manuel Ordorica-Flores ◽  
Salvador Montoya-Alvarez ◽  
Daniel Haro-Mendoza ◽  
Luis Ochoa-Toledo ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Degrees Of Freedom ◽  
Single Site ◽  
Ball Joint ◽  
Surgical Instrument ◽  
Joint Mechanism ◽  
Application Fields ◽  
The Right

Background. This article aims to present an innovative design of a steerable surgical instrument for conventional and single-site minimally invasive surgery (MIS), which improves the dexterity and maneuverability of the surgeon while offering a solution to the limitations of current tools. Methods. The steerable MIS instrument consists of a deflection structure with a curved sliding joints design that articulates the distal tip in two additional degrees of freedom (DoFs), relative to the instrument shaft, using transmission by cables. A passive ball-joint mechanism articulates the handle relative to the instrument shaft, improves wrist posture, and prevents collision of instrument handles during single-site MIS procedures. The two additional DoFs of the articulating tip are activated by a thumb-controlled device, using a joystick design mounted on the handle. This steerable MIS instrument was developed by additive manufacturing in a 3D printer using PLA polymer. Results. Prototype testing showed a maximum tip deflection of 60° in the left and right directions, with a total deflection of 120°. With the passive ball-joint fully offset, the steerable tip achieved a deflection of 90° for the right and 40° for the left direction, with a total deflection of 130°. Furthermore, the passive ball-joint mechanism in the handle obtained a maximum range of motion of 60°. Conclusions. This steerable MIS instrument concept offers an alternative to enhance the application fields of conventional and single-site MIS, increasing manual dexterity of the surgeon and the ability to reach narrow anatomies from other directions.

scholarly journals P124 RECURRENCE OF SPIEGEL'S HERNIA POST-IPOM IN AN ELDERLY PATIENT, HOW TO DEAL WITH IT?

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Roser Farré ◽  
Rafael Gerardo Díaz Del Gobbo ◽  
Lorena Sanchon Fructuoso ◽  
Alexander Osorio Ramos ◽  
Claudio Antonio Guariglia ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Ct Scan ◽  
Invasive Surgery ◽  
Surgical Planning ◽  
Barbed Suture ◽  
3D Technology ◽  
Invasive Approach ◽  
Previously Treated ◽  
The Right

Abstract Aim To demonstrate how minimally invasive surgery of the abdominal wall allows us to rescue patients with recurrent hernias previously treated with other laparoscopic techniques. Material and Methods An 83-year-old woman with moderate comorbidities, ASA III and obese was operated for bilateral Spiegel’s hernia by laparoscopic IPOM. 21 months later, a symptomatic recurrence of the right hernia was diagnosed. The physical examination was difficult due to obesity and the CT scan showed a right hernia recurrence. This CT scan was used for 3D Planning of the surgery, showing the right Spiegel’s hernia with 5-6 cm of diameter with a bowel loop inside. Results Given the age of the patient and comorbidities, it was decided to perform a laparoscopic repair using the IPOM + technique, closing the defect with barbed suture and placing a wide visceral contact mesh fixed with absorbable tackers. She was discharged 24 hours after surgery without complications, providing the patient with the benefits of minimally invasive surgery. Conclusions Laparoscopic surgery allows us to treat hernia recurrences even in cases previously treated by minimally invasive approach. An individualized treatment adjusted to the age and characteristics of each patient should be carried out. 3D Technology and reconstruction is very useful for pre-surgical Planning, allowing a personalized pre-operative assessment of each patient. The use of 3D Technology is a great teaching tool with great potential for surgical planning.

scholarly journals Individualized strategy of minimally invasive cardiac surgery in congenital cardiac septal defects

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Jiaquan Zhu ◽  
Yunjiao Zhang ◽  
Chunrong Bao ◽  
Fangbao Ding ◽  
Ju Mei
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Septal Defect ◽  
Median Sternotomy ◽  
Right Ventricular Outflow Tract ◽  
Anterolateral Thoracotomy ◽  
Septal Defects ◽  
The Right ◽  
Residual Lesions

Abstract Background Intracardiac septal defect is repaired using median sternotomy in most centers; however, there are several reports using minimally invasive surgery in both children and adults. This study summarized our strategy of minimally invasive therapy using various lateral mini-thoracotomies in patients with congenital septal defect. Methods In this study, 472 patients who underwent minimally invasive repair of intracardiac septal defects (atrial septal defect, (ASD), ventricular septal defect, (VSD), and atrioventricular septal defect, (AVSD)) from January 2012 to June 2020 were retrospectively reviewed. Those who underwent device closure were excluded. The minimally invasive strategy included three groups: the right sub-axillary vertical incision (RSAVI) group (N = 335, including192 ASDs, 135 VSDs and 8 AVSDs); the right anterolateral thoracotomy (RALT) group (N = 132, including 77 ASDs, 51 VSDs and 4 AVSDs); and the left anterolateral thoracotomy (LALT) group (N = 5, all subpulmonary VSDs). Results Concomitant surgeries included nine cases of right ventricular outflow tract obstruction relief, nine cases of mitral repairs and 37 cases of tricuspid repairs. There was one transition from thoracotomy to sternotomy. Three patients required second pump run for residual lesions (two residual VSD shunts and one mitral regurgitation). The age and body weight of the RSAVI group were significantly lower than those of the RALT and LALT groups (all P < 0.01). No postoperative death was observed. Postoperative complications included one case of chest exploration for bleeding, one case of reoperation due to patch dehiscence during the same admission, one case of transient neural dysfunction, three cases of diaphragmatic paresis and 13 cases of atelectasis. The median stay in the intensive care unit was two days, while the median postoperative hospitalization duration was six days. The echocardiography results before discharge indicated no significant residual lesions. No reoperation, no new onset of chest deformities and no sclerosis were observed during the follow-up. Conclusions Intracardiac septal defects can be safely and effectively repaired by minimally invasive surgery with good cosmetic results. RSAVI is suitable in infants and children, while RALT is more commonly used in adolescents and adults. LALT is an alternative incision to repair subpulmonary VSD.

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