PS01.241: HYBRID MINIMALLY INVASIVE TECHNIQUE OF OESOPHAGECTOMY FOR OESOPHAGEAL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 118-118
Author(s):  
Satpal Virk ◽  
Saurabh Singla
Keyword(s):  
Postoperative Complications ◽  
Minimally Invasive ◽  
Oesophageal Cancer ◽  
Gastric Tube ◽  
Operative Time ◽  
Laparoscopic Group ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Open Technique ◽  
Open Procedure

Abstract Background Oesophagectomy is challenging procedure involving multiple body cavities. The traditional open procedure being either transthoracic or transhiatal, carries significant morbidity and mortality. There is continuing debate between the two approaches. Minimally invasive oesophagectomy has swung the pendulum towards transthoracic procedure, though it remains a complex and technically demanding procedure. This study was done to assess the feasibility, and benefit of hybrid minimally invasive technique over open technique. Methods Patients of oesophageal cancer were selected from January 2005 to December 20,017. After 2012 open technique was replaced with minimally invasive technique. Open technique included Ivor Lewis, McKeown's or transhiatal. Hybrid minimally invasive technique included laparoscopic gastric mobilisation and thoracic part using small thoracotomy. Anastomosis was done using hand sewn technique. The short term outcome, including postoperative complications were analysed from prospectively collected data. Results One hundred sixty three patients underwent open procedure and 103 patients underwent hybrid minimally invasive esophagectomy. Total operative time was shorter in laparoscopic group (325.6 minutes vs 232.6 minutes, P < 0.05). The number of transfused patients were significantly smaller in laparoscopic group (40.75% vs 13.6%, P < 0.05). The postoperative course without complication was observed in 68.1% and 79.3% in open vs laparoscopic group respectively. Serious complications included myocardial infarction and gastric tube necrosis and bleed. There was no anastomotic leak in chest anastomosis but there was overall 17.3% leak in neck anastomosis, higher in open group 20.8% vs 16.6% in minimally invasive group. Mortality was higher ion open group (5.5% vs 2%, P < 0.05). On multivariate analysis, age more than 60 years, chest complications and cardiovascular comorbidity were associated with increased mortality. Conclusion Hybrid minimally invasive procedure is feasible and safe procedure for patients with oesophageal cancer. it is associated with shorter operative time and less postoperative complications. Even laparoscopic gastric tube mobilisation alone adds to in decreasing the morbidity in esophagectomy. Disclosure All authors have declared no conflicts of interest.

The Emerging Role of Robotic Single-site Approach for Myomectomy: A Systematic Review of the Literature

2021 ◽  
pp. 155335062098822
Author(s):  
Eirini Giovannopoulou ◽  
Anastasia Prodromidou ◽  
Nikolaos Blontzos ◽  
Christos Iavazzo
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Complication Rate ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Single Site ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Robotic Myomectomy ◽  
The Mean

Objective. To review the existing studies on single-site robotic myomectomy and test the safety and feasibility of this innovative minimally invasive technique. Data Sources. PubMed, Scopus, Google Scholar (from their inception to October 2019), as well as Clinicaltrials.gov databases up to April 2020. Methods of Study Selection. Clinical trials (prospective or retrospective) that reported the outcomes of single-site robotic myomectomy, with a sample of at least 20 patients were considered eligible for the review. Results. The present review was performed in accordance with the guidelines for Systematic Reviews and Meta-Analyses (PRISMA). Four (4) studies met the inclusion criteria, and a total of 267 patients were included with a mean age from 37.1 to 39.1 years and BMI from 21.6 to 29.4 kg/m2. The mean operative time ranged from 131.4 to 154.2 min, the mean docking time from 5.1 to 5.45 min, and the mean blood loss from 57.9 to 182.62 ml. No intraoperative complications were observed, and a conversion rate of 3.8% was reported by a sole study. The overall postoperative complication rate was estimated at 2.2%, and the mean hospital stay ranged from 0.57 to 4.7 days. No significant differences were detected when single-site robotic myomectomy was compared to the multiport technique concerning operative time, blood loss, and total complication rate. Conclusion. Our findings support the safety of single-site robotic myomectomy and its equivalency with the multiport technique on the most studied outcomes. Further studies are needed to conclude on the optimal minimally invasive technique for myomectomy.

scholarly journals A randomised controlled techniques saphenous vein harvest; morbidity lowering with minimally invasive technique

2018 ◽  
Vol 5 (8) ◽  
pp. 2727
Author(s):  
Sudheendra Tekalkote ◽  
Sartaj B. Hussein
Keyword(s):  
Minimally Invasive ◽  
Saphenous Vein ◽  
Minimally Invasive Technique ◽  
Controlled Study ◽  
Invasive Technique ◽  
Organ Bath ◽  
Open Technique ◽  
Long Saphenous Vein ◽  
Group A ◽  
Vein Harvesting

Background: The long incision is associated with significant intra-operative and postoperative complications. The use of minimal invasive saphenous vein harvesting has been advocated in an effort to minimize such wound related problems. The objective of this study was to compare the morbidity associated with long saphenous vein harvesting using the traditional open technique (A) against a minimally invasive technique using the Mayo vein stripper (B) that involves multiple short incisions.Methods: Authors conducted a prospective randomized controlled study in 80 patients undergoing first time coronary artery bypass grafting. Pain and healing was assessed on each postoperative day. Rings of long saphenous vein were subjected to organ-bath evaluation of endothelium-dependent and endothelium-independent relaxation. Three patients were excluded from the study, leaving 38 patients in Group A and 39 in Group B.Results: With respect to operative procedure, Group A had a greater length of vein harvested than Group B. There was no statistical difference in pain scores and endothelium-dependent or endothelium-independent relaxation between the two groups. However, there were significantly more infections in Group A compared with Group B.Conclusions: Harvesting vein through multiple incisions using the Mayo vein stripper is quicker, results in fewer infections and has no deleterious effect on endothelial function compared to open technique.

scholarly journals Comparison between the open and minimally invasive repair technique in acute Achilles tendon injuries

2018 ◽  
Vol 12 (4) ◽  
pp. 265-70 ◽  
Author(s):  
João Paulo Primo de Araujo ◽  
Marcus Vinicius Mota Garcia Moreno ◽  
Janice De Souza Guimarães ◽  
Marilton Jorge Torres Gomes ◽  
Túlio Eduardo Marçal Vieira ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Functional Results ◽  
Tendon Injuries ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Flexor Hallucis Longus ◽  
Repair System ◽  
Open Technique

Objective: To compare the functional results of patients submitted to open repair of the Achilles tendon in relation to those treated with the minimally invasive technique using PARS, with a minimum period of 1 year, as well as the complication index of the two techniques. Methods: Between 2011 and 2016, 31 patients were reviewed, including 20 cases (10 PARS X 10 Open technique). Patients with chronic Achilles tendon rupture, insertional or bilaterial, patients with a history of surgery or previous ankle pathology that could mask the functional results were excluded. The open technique was performed through a posteromedial incision to the ankle, repairing the tendon associated with the myotendinous transfer of the flexor hallucis longus, which was fixed with a biotenodetic screw. The minimally invasive technique was performed with the PARS (percutaneous Achilles repair system) of the company Arthrex, through a small transverse incision on the site of rupture of the Achilles tendon. Functional outcomes and complications were collected after at least 1 year of follow-up. Results: Both groups presented similar AOFAS scores (PARS: 95.3 ± 5.1, Open: 96.5 ± 5.1, P=0.604), showing similar functional results. Regarding the complications, the PARS obtained a greater number of complications in relation to the Open technique (PARS: 20% X Open: 10%), but without statistical relevance (P=0.383). Conclusion: We conclude that for the treatment of acute Achilles tendon injuries, the PARS and Aberta techniques have similar functional results after 1 year of follow-up. Level of Evidence IV; Therapeutic Studies; Cases Series.

scholarly journals OPEN SURGICAL VS. MINIMALLY INVASIVE TREATMENT OF THORACOLUMBAR AO FRACTURES TYPE A AND B1 IN A REFERENCE HOSPITAL

2017 ◽  
Vol 16 (2) ◽  
pp. 133-136 ◽  
Author(s):  
José Enrique Salcedo Oviedo ◽  
Luis Muñiz Luna ◽  
Marco Antonio Marbán Heredia ◽  
Jorge Salvador De la Cruz Álvarez ◽  
Hugo Vilchis Sámano ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Minimally Invasive ◽  
Analogue Scale ◽  
Statistical Significance ◽  
Pedicle Screws ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Open Technique ◽  
Surgical Time ◽  
Invasive Group

ABSTRACT Objective: The thoracolumbar spine trauma represents 30% of spinal diseases. To compare the minimally invasive technique with the open technique in lumbar fractures. Method: A prospective, cross-sectional, comparative observational study, which evaluated the following variables: surgery time, length of hospital stay, transoperative bleeding, postoperative pain, analyzed by SPSS software using Student's t test with statistical significance of p ≥ 0.05, with 24 patients with single-level thoracolumbar fractures, randomly treated with percutaneous pedicle screws and by open technique with a transpedicular system. Results: The surgery time was 90 minutes for the minimally invasive technique and 60 minutes for the open technique, the bleeding was on average 50 cm3 vs. 400 cm3. The mean visual analogue scale for pain at 24 hours of surgery was 5 for the minimally invasive group vs. 8 for the open group. The number of fluoroscopic projections of pedicle screws was 220 in the minimally invasive technique vs. 100 in the traditional technique. Quantified bleeding was minimal for percutaneous access vs. 340 cm3 for the traditional system. The hospital discharge for the minimally invasive group was at 24 hours and at 72 hours for those treated with open surgery. Conclusions: It is a technique that requires longer surgical time, with reports of less bleeding, less postoperative pain and less time for hospital discharge, reasons why it is supposed to be a procedure that requires a learning curve, statistical significance with respect to bleeding, visual analogue scale for pain and showed no significant difference in the variables of surgical time.

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