The Role of Laparoscopy in Anorectal Malformations

AbstractThe use of laparoscopy in the minimally invasive management of anorectal malformations (ARMs) continues to evolve, although the principles guiding the anatomic surgical repair and clinical follow-up remain unchanged. In this review, we detail the advantages, indications, contraindications, complications, and issues unique to the minimally invasive approach to ARM. A comprehensive search of the PubMed and Embase databases was performed (2014–2018). Full-text screening, data abstraction, and quality appraisal were performed of articles describing the use of laparoscopy in ARM and cloaca. While new developments and approaches to ARM utilizing minimally invasive techniques and timing for surgical approach have been detailed, a unique complication profile involving greater risk of rectal prolapse and retention of a remnant of the original fistula are still consistently reported. Analysis of perioperative complications and long-term functional outcomes, including rates of fecal and urinary continence, are lacking. It is clear that patient selection for the choice of surgical approach based on precise preoperative delineation of the anatomy is the key. Adherence to the principles of ARM repair as well as application of operative/imaging adjuncts will yield the best technically safe minimally invasive approach to ARM. Continued efforts for standardized reporting and long-term follow-up are required.

Download Full-text

Impact of biomineralization on resin/biomineralized dentin bond longevity in a minimally invasive approach: An “in vitro” 18-month follow-up

Dental Materials ◽

10.1016/j.dental.2021.01.021 ◽

2021 ◽

Vol 37 (5) ◽

pp. e276-e289

Author(s):

Kelly Maria Moreira ◽

Luiz Eduardo Bertassoni ◽

Robert Phill Davies ◽

Felipe Joia ◽

José Francisco Höfling ◽

...

Keyword(s):

Minimally Invasive ◽

Minimally Invasive Approach ◽

Invasive Approach

Download Full-text

Long-term follow-up results of multimodal treatment with initial surgical approach for acromegaly in a single center

Acta Neurologica Belgica ◽

10.1007/s13760-012-0128-8 ◽

2012 ◽

Vol 113 (1) ◽

pp. 49-54 ◽

Cited By ~ 2

Author(s):

Katrijn Van Rompaey ◽

David Unuane ◽

Maarten Moens ◽

Johnny Duerinck ◽

Kris Poppe ◽

...

Keyword(s):

Surgical Approach ◽

Multimodal Treatment ◽

Single Center ◽

Long Term Follow Up

Download Full-text

Tubularized proximally-incised plate in distal/midshaft hypospadias repair

La Pediatria Medica e Chirurgica ◽

10.4081/pmc.2017.151 ◽

2017 ◽

Vol 39 (2) ◽

Author(s):

Antonio Marte ◽

Lucia Pintozzi

Keyword(s):

Perioperative Complications ◽

Foley Catheter ◽

Case Series ◽

Functional Results ◽

Inclusion Criteria ◽

Urethral Plate ◽

Age At Surgery ◽

Long Term Follow Up

The aim of this study was to verify the validity, feasibility, and the functional results, by uroflowmetry, of Tubularized proximallyincised plate technique in selected case of distal/midshaft hypospadias. Out of 120 patients scheduled to undergo TIP (or Snodgrass) procedure, 23 were selected between January 2013 and January 2016 (19.1%). This case series comprised 16 patients with distal and 7 with midshaft hypospadias. Mean age at surgery was 2.9 years. The inclusion criteria were a deep and wide glandular groove and a proximal narrow urethral plate. The procedure was carried out as described by Snodgrass but the incision of the urethral plate, including the mucosal and submucosal tissue, was made only proximally, between the original meatus and the glandular groove in no case extending to the entire length of the plate. Postoperatively a foley catheter was left in place from 4 to 7 days. Uroflowmetry was performed when the patients age ranged from 2.5 to 5.7 years (mean age 3.11 years and mean follow-up 1.8 years, body surface 2). No patient presented fistulas nor perioperative complications. At uroflowmetry, eighteen patients presented values above the 25<sup>th</sup> percentile and 5 showed a borderline flow. All patients in this group remained stable without urinary symptoms. In selected cases, the tubularized proximally-incised plate yields satisfactory cosmetic and functional results for the treatment of midshaft proximal hypospadias. A long-term follow-up study is needed for further evaluation. Patient selection is crucial for the success of this technique.

Download Full-text

Sutureless Aortic Valve Implantation through an Upper V-Type Ministernotomy: An Innovative Approach in High-Risk Patients

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e31828d6b03 ◽

2013 ◽

Vol 8 (1) ◽

pp. 23-28 ◽

Cited By ~ 8

Author(s):

Giovanni Concistrè ◽

Antonio Miceli ◽

Francesca Chiaramonti ◽

Pierandrea Farneti ◽

Stefano Bevilacqua ◽

...

Keyword(s):

High Risk ◽

Aortic Valve ◽

Minimally Invasive ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

High Risk Patients ◽

Risk Patients ◽

The Mean ◽

Valve Implantation

Objective Aortic valve replacement in minimally invasive approach has shown to improve clinical outcomes even with a prolonged cardiopulmonary bypass and aortic cross-clamp (ACC) time. Sutureless aortic valve implantation may ideally shorten operative time. We describe our initial experience with the sutureless 3f Enable (Medtronic, Inc, ATS Medical, Minneapolis, MN USA) aortic bioprosthesis implanted in minimally invasive approach in high-risk patients. Methods Between May 2010 and May 2011, thirteen patients with severe aortic stenosis underwent aortic valve replacement with the 3f Enable bioprosthesis through an upper V-type ministernotomy interrupted at the second intercostal space. The mean ± SD age was 77 ± 3.9 years (range, 72–83 years), 10 patients were women, and the mean ± SD logistic EuroSCORE was 15% ± 13.5%. Echocardiography was performed preoperatively, at postoperative day 1, at discharge, and at follow-up. Clinical data, adverse events, and patient outcomes were recorded retrospectively. The median follow-up time was 4 months (interquartile range, 2–10 months). Results Most of the implanted valves were 21 mm in diameter (19–25 mm). The CPB and ACC times were 100.2 ± 25.3 and 66.4 ± 18.6 minutes. At short-term follow-up, the mean ± SD pressure gradient was 14 ± 4.9 mm Hg; one patient showed trivial paravalvular leakage. No patients died during hospital stay or at follow-up. Conclusions The 3f Enable sutureless bioprosthesis implanted in minimally invasive approach through an upper V-type ministernotomy is a feasible, safe, and reproducible procedure. Hemodynamic and clinical data are promising. This innovative approach might be considered as an alternative in high-risk patients. Reduction of CPB and ACC time is possible with increasing of experience and sutureless evolution of actual technology.

Download Full-text

Long term follow-up and transition of care in anorectal malformations: An international survey

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2016.03.011 ◽

2016 ◽

Vol 51 (9) ◽

pp. 1450-1457 ◽

Cited By ~ 12

Author(s):

Stefano Giuliani ◽

Emily Decker ◽

Ernesto Leva ◽

Giovanna Riccipetitoni ◽

Pietro Bagolan

Keyword(s):

Anorectal Malformations ◽

Transition Of Care ◽

International Survey ◽

Long Term Follow Up

Download Full-text

A Simplified Technique for Correcting Mitral Valve Regurgitation via Minimally Invasive Approach

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0000000000000497 ◽

2018 ◽

Vol 13 (3) ◽

pp. 236-238

Author(s):

Giuseppe Speziale ◽

Marco Moscarelli

Keyword(s):

Cardiopulmonary Bypass ◽

Mitral Valve ◽

Mitral Regurgitation ◽

Minimally Invasive ◽

Mitral Valve Regurgitation ◽

Valve Regurgitation ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Repair Techniques

Mitral valve regurgitation may require complex repair techniques that are challenging in minimally invasive and may expose patients to prolonged cardiopulmonary bypass and cross-clamp times. Here, we present a stepwise operative approach that may facilitate the repair of the mitral valve in a minimally invasive fashion and may be carried out even when multiple posterior segments are involved. This how-to-do article presents a method that was performed in 148 patients that were referred to our institution for severe organic mitral regurgitation between 2008 and 2016. At mean ± SD follow-up of 45.5 ± 27 months, freedom from recurrent of mitral regurgitation 2+ or greater and reoperation was 95.2%.

Download Full-text

Neoglottis Reconstruction Following Total Laryngectomy: The Emory Experience

Otolaryngology ◽

10.1177/019459988209000509 ◽

1982 ◽

Vol 90 (5) ◽

pp. 569-575 ◽

Cited By ~ 8

Author(s):

Fred M.S. McConnel ◽

John Teichgraeber

Keyword(s):

Medical School ◽

Revision Surgery ◽

Total Laryngectomy ◽

Perioperative Complications ◽

Vocal Rehabilitation ◽

Early Results ◽

Emory University ◽

Long Term Follow Up

A number of studies over the last decade have reported on a viability of the primary neoglottis reconstruction after total laryngectomy. Early results have been encouraging, although operative and perioperative complications are higher than with a classic laryngectomy. This article reports on a series of 13 neoglottis reconstructions performed at Emory University Medical School using the techniques developed by Mario Staffiert, MD. During the course of the study, the overall success rate has fallen from 80% at three years to 54% at five years. With each succeeding year there has been an increasing need for revision surgery. The series emphasizes the need for long-term follow-up in any vocal rehabilitation procedure.

Download Full-text