scholarly journals OV03 TEP IN COLORS: ANATOMICAL VIEW USING ARTICULATED FORCEPS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Claudio Antonio Guariglia ◽  
Rafael Diaz del Gobbo ◽  
Raquel Sanchez ◽  
Lorena Sanchon ◽  
Alexander Osorio ◽  
...  
Keyword(s):  
Laparoscopic Approach ◽  
Anatomical Study ◽  
Postoperative Recovery ◽  
Educational Video ◽  
Direct Visualization ◽  
Anatomical Structures ◽  
Myopectineal Orifice ◽  
Novel Approach ◽  
Preperitoneal Approach ◽  
Good Resource

Abstract Aim Present through an illustrative and educational video, an anatomical and colorful vision of the totally extraperitoneal laparoscopic approach (TEP) of inguinofemoral hernias, with the aim of favoring the learning process of this technique, facilitating the identification of the main anatomical structures, ensuring a safe and effective approach. Material and Methods In this video we show the laparoscopic approach to inguinofemoral hernias via TEP, highlighting the most important anatomical structures with different colors. Additionally, the surgical technique of this approach using articulated forceps is shown, which we consider to be a good resource for dissection in a space as small as the preperitoneal one. Results The anatomical study of the inguinofemoral area constitutes the basis of a correct preperitoneal approach, especially in PET, where the most difficult is probably the space location and the identification of the structures. Conclusions The preperitoneal PET route is a relatively novel approach for inguinofemoral hernia repair. Its benefits are based on the ability to identify all the anatomical structures of the myopectineal orifice from a preperitoneal view without the need to access the peritoneal cavity. The knowledge of preperitoneal anatomy is the cornerstone for learning the TEP approach, and we consider that anatomical videos of real surgeries are good strategies to shorten the learning curve. Mastering the preperitoneal anatomy ensures obtaining the benefits inherent to the TEP approach, such as bilateral exploration of the myopectineal orifice, direct visualization of the pain and doom triangles, tension-free repair with mesh of all possible defects and faster postoperative recovery.

scholarly journals OV15 EMERGENCY SURGERY OF OBSTRUCTED VENTRAL HERNIA USING TAPP TECHNIQUE: A SAFE AND FEASIBLE APPROACH

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Victor Vaello ◽  
Angela Santana ◽  
Diego Oto ◽  
Luz Juez ◽  
Raquel Arranz ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Intestinal Resection ◽  
Laparoscopic Approach ◽  
Right Hemicolectomy ◽  
Postoperative Recovery ◽  
Preperitoneal Space ◽  
Open Approach ◽  
Emergency Procedures ◽  
Peritoneal Flap ◽  
Ventral Incisional Hernia

Abstract Aim to explain and show the feasibility of laparoscopic TAPP technique in emergency procedures Material and Methods we present a 71-year-old female with personal history of obesity (BMI 32) and a laparoscopic right hemicolectomy performed in 2018, presenting at the ER with a 24-hour intestinal obstruction due to incarcerated ventral incisional hernia. Results laparoscopic reduction of the hernia contents was achieved without need of intestinal resection, prior to access to the preperitoneal space, creating a peritoneal flap that was dissected around the hernia. Following closure of the hernia defect, a polypropylene mesh was placed and the peritoneal flap closed. There were no intraoperative or postoperative events and patient was discharged on 3rd POD. Conclusions laparoscopic approach to emergency hernias in selected patients doesn’t differ from elective surgery, and offers great advantages in terms of evaluation of the incarcerated elements, and postoperative recovery, especially in obese patients where a conventional open approach has higher morbidity.

Laparoscopic Hepatectomy for Liver Cancer

2015 ◽  
Vol 33 (5) ◽  
pp. 691-698 ◽  
Author(s):  
Akishige Kanazawa ◽  
Tadashi Tsukamoto ◽  
Sadatoshi Shimizu ◽  
Satoshi Yamamoto ◽  
Akihiro Murata ◽  
...  
Keyword(s):  
Liver Cancer ◽  
Standard Procedure ◽  
Laparoscopic Hepatectomy ◽  
Surgical Techniques ◽  
Laparoscopic Approach ◽  
Technological Innovations ◽  
Rapid Progress ◽  
Hepatic Surgery ◽  
Novel Approach ◽  
Near Future

This chapter covers a range of important topics of laparoscopic hepatectomy as a novel approach toward treatment of liver cancer. Although laparoscopic hepatectomy was performed in a limited number of centers in the 1990s, technological innovations, improvements in surgical techniques and accumulation of experience by surgeons have led to more rapid progress in laparoscopic hepatectomy in the late 2000s for minimally invasive hepatic surgery. Currently, laparoscopic hepatectomy can be performed for all tumor locations and several diseases via several approaches. The laparoscopic approach can be applied to several types of resection, not only for tumors but also for liver transplantation, with equivalent or better results compared with those obtained with open surgery. Therefore, laparoscopic hepatectomy will become a standard procedure for treatment of liver cancer in the near future.

Pregnancy-Preserving Laparoscopic Treatment of Acute Hemoperitoneum Following Lutein Cyst Rupture in Early Gestation

2019 ◽  
Vol 223 (02) ◽  
pp. 109-112
Author(s):  
Rafał Watrowski
Keyword(s):  
Case Report ◽  
Laparoscopic Approach ◽  
Postoperative Recovery ◽  
Absorbable Suture ◽  
Laparoscopic Treatment ◽  
Healthy Baby ◽  
Early Gestation ◽  
Cyst Rupture ◽  
Hemoglobin Drop ◽  
In Pregnancy

AbstractAcute hemoperitoneum (AHP) in early gestation is commonly treated via laparotomy. A ruptured corpus luteum (CL) cyst is a rare cause of AHP in pregnancy. This case report describes a 33-year-old, hemodynamically stable G2/P1 who presented at 5+5 gestational weeks with an acute abdomen due to ruptured CL cyst (7 cm). Emergent laparoscopy was performed. After evacuation of 1 L of hemoperitoneum, an atraumatic hemostasis was obtained without diathermy by use of hemostatic matrix (Floseal®). The ovary was reformed with an absorbable suture under preservation of CL. The postoperative recovery was uncomplicated. The hemoglobin drop was 2.8 g/dl. Further pregnancy course was uneventful. A healthy baby (2860 g) was delivered vaginally at 38+3 weeks of gestation. Conclusion Laparoscopic approach to AHP in early pregnancy is suitable. CL preservation is feasible by use of atraumatic hemostatics.

scholarly journals Should the laparoscopic approach be the norm for appendicectomy in the third trimester of pregnancy?

2019 ◽  
Vol 12 (4) ◽  
pp. e228192
Author(s):  
Hashviniya Sekar ◽  
Nisha Rajesh Thamaran ◽  
David Stoker ◽  
Sayantana Das ◽  
Wai Yoong
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Approach ◽  
Postoperative Recovery ◽  
Laparoscopic Appendicectomy ◽  
Third Trimester ◽  
Invasive Approach ◽  
Suspected Appendicitis ◽  
The Third ◽  
Trocar Placement ◽  
Theoretical Risk

Our case describes a pregnant woman with acute appendicitis who presented in the third trimester and underwent a laparoscopic appendicectomy. She made a rapid postoperative recovery and the pregnancy was otherwise uncomplicated, ending with a spontaneous vaginal birth at 41 weeks. The diagnosis of acute appendicitis can be unclear in pregnancy. Difficulty in establishing diagnosis due to atypical presentation often leads to delay in surgery, resulting in significant maternal and fetal morbidity and mortality. Surgical intervention should be prompt in cases of suspected appendicitis and the laparoscopic approach is advocated in the first two trimesters. In the third trimester (after 28 weeks), laparotomy is often performed due to the size of the uterus and the theoretical risk of inadvertent perforation with trocar placement. More recently, several authors have described successful outcomes following laparoscopic appendicectomy after 28 weeks and with increasing reassuring data, we suggest that this minimally invasive approach should be considered in managing appendicitis in the third trimester.

scholarly journals Transtentorial transcollateral sulcus approach to the ventricular atrium: an endoscope-assisted anatomical study

2017 ◽  
Vol 126 (4) ◽  
pp. 1246-1252 ◽  
Author(s):  
Yasser Jeelani ◽  
Abdulkerim Gokoglu ◽  
Tomer Anor ◽  
Ossama Al-Mefty ◽  
Alan R. Cohen
Keyword(s):  
Cortical Thickness ◽  
Lateral Ventricle ◽  
Tracking System ◽  
Anatomical Study ◽  
Parahippocampal Gyrus ◽  
Lingual Gyrus ◽  
Novel Approach ◽  
Collateral Sulcus ◽  
Brain Retraction ◽  
Formalin Fixed

OBJECTIVE Conventional approaches to the atrium of the lateral ventricle may be associated with complications related to direct cortical injury or brain retraction. The authors describe a novel approach to the atrium through a retrosigmoid transtentorial transcollateral sulcus corridor. METHODS Bilateral retrosigmoid craniotomies were performed on 4 formalin-fixed, colored latex–injected human cadaver heads (a total of 8 approaches). Microsurgical dissections were performed under 3× to 24× magnification, and endoscopic visualization was provided by 0° and 30° rigid endoscope lens systems. Image guidance was provided by coupling an electromagnetic tracking system with an open source software platform. Objective measurements on cortical thickness traversed and total depth of exposure were recorded. Additionally, the basal occipitotemporal surfaces of 10 separate cerebral hemisphere specimens were examined to define the surface topography of sulci and gyri, with attention to the appearance and anatomical patterns and variations of the collateral sulcus and the surrounding gyri. RESULTS The retrosigmoid approach allowed for clear visualization of the basal occipitotemporal surface. The collateral sulcus was identified and permitted easy endoscopic access to the ventricular atrium. The conical corridor thus obtained provided an average base working area of 3.9 cm2 at an average depth of 4.5 cm. The mean cortical thickness traversed to enter the ventricle was 1.4 cm. The intraventricular anatomy of the ipsilateral ventricle was defined clearly in all 8 exposures in this manner. The anatomy of the basal occipitotemporal surface, observed in a total of 18 hemispheres, showed a consistent pattern, with the collateral sulcus abutted by the parahippocampal gyrus medially, and the fusiform and lingual gyrus laterally. The collateral sulcus was found to be caudally bifurcated in 14 of the 18 specimens. CONCLUSIONS The retrosigmoid supracerebellar transtentorial transcollateral sulcus approach is technically feasible. This approach has the potential advantage of providing a short and direct path to the atrium, hence avoiding violation of deep neurovascular structures and preserving eloquent areas. Although this approach appears unconventional, it may provide a minimally invasive option for the surgical management of selected lesions within the atrium of the lateral ventricle.

Surgical anatomy of the C-2 pedicle

2001 ◽  
Vol 95 (1) ◽  
pp. 88-92 ◽  
Author(s):  
Jay U. Howington ◽  
John J. Kruse ◽  
Deepak Awasthi
Keyword(s):  
Sagittal Plane ◽  
Pedicle Screws ◽  
Anatomical Study ◽  
Ct Scanning ◽  
Surgical Anatomy ◽  
Screw Placement ◽  
Preoperative Imaging ◽  
Direct Visualization ◽  
Content Type ◽  
Fine Print

Object. The goal of this anatomical study was to investigate the surgical and radiographic anatomy of the C-2 pedicle in relation to transpedicular screw placement in occipitocervical stabilization and to establish anatomical guidelines for the placement of C-2 pedicle screws. Methods. The C-2 pedicles in 10 cadaveric spines were evaluated using both computerized tomography (CT) scanning and manual measurements. The specimens were scanned; the mediolateral and rostrocaudal angulations of each pedicle were measured, with the midline sagittal plane and the inferior endplate of the C-2 facet, respectively, as references, and values were recorded in 1° increments by using a digital goniometer. The height, width, and length of the pedicles were also measured on the CT scans. Based on these measurements in conjunction with direct visualization of the C-2 pedicle through the C1–2 interlaminar space pedicle screws were then placed. The distances from the screw entry point to the midline, C2–3 joint line, and the medial aspect of the vertebral artery were also measured. Repeated CT scanning was then performed to assess screw placement. The average pedicle height, width, and length measured 9.1 mm, 7.9 mm, and 16.6 mm, respectively, and the medial inclination and rostrocaudal angulation averaged 35.2° and 38.8°, respectively. The cortex of the pedicle was not violated in any of the 20 cadaveric specimens. Conclusions. Adequate preoperative imaging studies in conjunction with direct visualization of the C-2 pedicle make transpedicular fixation safe and effective.

scholarly journals Functional Principles of Morphological and Anatomical Structures in Pinecones

Plants ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 1343
Author(s):  
Haejin Bae ◽  
Jinhee Kim
Keyword(s):  
Structural Characteristics ◽  
Complex Structure ◽  
External Environment ◽  
Image Data ◽  
Anatomical Study ◽  
Morphological Properties ◽  
Cross Sectional ◽  
Anatomical Structures ◽  
Complex Cone ◽  
Scientific System

In order to better understand the functions of plants, it is important to analyze the internal structure of plants with a complex structure, as well as to efficiently monitor the morphology of plants altered by their external environment. This anatomical study investigated structural characteristics of pinecones to provide detailed descriptions of morphological specifications of complex cone scales. We analyzed cross-sectional image data and internal movement patterns in the opening and closing motions of pinecones, which change according to the moisture content of its external environment. It is possible to propose a scientific system for the deformation of complex pinecone for the variable structures due to changes in relative humidity, as well as the application of technology. This study provided a functional principle for a multidisciplinary approach by exploring the morphological properties and anatomical structures of pinecones. Therefore, the results suggest a potential application for use in energy-efficient materials by incorporating hygroscopic principles into engineering technology and also providing basic data for biomimicry research.

Arthroscopy of the Elbow in Clinically Normal Dog Using the Caudal Portals

2000 ◽  
Vol 13 (02) ◽  
pp. 87-91 ◽  
Author(s):  
J.F. Bartlet
Keyword(s):  
At Risk ◽  
Elbow Joint ◽  
Direct Visualization ◽  
Anatomical Structures ◽  
Clinically Normal

The technique of arthroscopy of the elbow joint using the caudal portals is described. It was developed on six cadavers and six experimental dogs and allows a direct visualization of the olecranon fossa, caudolateral, caudo-medial and cranial compartments of the elbow joint. Arthroscopy of the caudal aspect of the elbow joint appears safe and reliable. None of anatomical structures are at risk on the caudal aspect of the elbow joint.

scholarly journals The flattened and needlelike leaves of the pine family (Pinaceae) share a conserved genetic network for adaxial-abaxial polarity but have diverged for photosynthetic adaptation

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hong Du ◽  
Jin-Hua Ran ◽  
Yuan-Yuan Feng ◽  
Xiao-Quan Wang
Keyword(s):  
Expression Patterns ◽  
Anatomical Study ◽  
Genetic Network ◽  
Spatial Patterning ◽  
Anatomical Structures ◽  
Adaptive Mechanisms ◽  
Genetic Module ◽  
History Of ◽  
Length Width ◽  
Photosynthetic Adaptation

Abstract Background Leaves have highly diverse morphologies. However, with an evolutionary history of approximately 200 million years, leaves of the pine family are relatively monotonous and often collectively called “needles”, although they vary in length, width and cross-section shapes. It would be of great interest to determine whether Pinaceae leaves share similar morpho-physiological features and even consistent developmental and adaptive mechanisms. Results Based on a detailed morpho-anatomical study of leaves from all 11 Pinaceae genera, we particularly investigated the expression patterns of adaxial-abaxial polarity genes in two types of leaves (needlelike and flattened) and compared their photosynthetic capacities. We found that the two types of leaves share conserved spatial patterning of vasculatures and genetic networks for adaxial-abaxial polarity, although they display different anatomical structures in the mesophyll tissue differentiation and distribution direction. In addition, the species with needlelike leaves exhibited better photosynthetic capacity than the species with flattened leaves. Conclusions Our study provides the first evidence for the existence of a conserved genetic module controlling adaxial-abaxial polarity in the development of different Pinaceae leaves.

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