DOZ047.82: Outcome of thoracoscopic repair of type C esophageal atresia: single-center experience from North Africa

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
M Elbarbary ◽  
A Shalaby ◽  
M Elseoudi ◽  
M Ragab ◽  
A E Fares ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Esophageal Atresia ◽  
Operative Time ◽  
Primary Anastomosis ◽  
Single Center Experience ◽  
Resource Setting ◽  
Thoracoscopic Repair ◽  
Type C ◽  
The Mean ◽  
A Prospective Study

Abstract Background and Aim Thoracoscopic repair of esophageal atresia is gaining popularity worldwide owing to the availability of and advances in minimally invasive instruments. This report presents our early experience of thoracoscopic esophageal atresia repair (EA/TEF) in a single institute. Methods A prospective study on short-gap type C EA/TEF was conducted at Cairo University Specialized Pediatric Hospital from April 2016. The technique was standardized in all cases: patients placed in the fully prone position, and using a 5 mm 30° scope with 3 mm instruments and carried out by four experts in minimally invasive surgery. Data was collected to include patient demographics and operative time. The main outcome was survival. Secondary outcomes were leak rate and postoperative stricture. Results Over a period of 24 months (April 2016–April 2018) 136 cases of EA/TEF were admitted. Thoracoscopy was attempted in 76 cases. Thirty cases with pure atresia or long-gap anomaly were excluded from this study for gap length, leaving 46 (60%) nonconsecutive neonates who underwent thoracoscopic repair of their short-gap EA/TEF. Five cases (10.8%) were converted to open surgery via right thoracotomy. A primary anastomosis was possible in all cases, leaving the azygos intact. The mean age at operation was 8.7 days (range 2–32), the mean weight was 2.6 kg (range 1.8–3.6), and the mean operative time was 108.3 minutes (range 80–180). In the fully thoracoscopic patients the survival was 85.4% (n = 35). An anastomotic leak occurred in 17% (n = 7); it was managed conservatively in 2 and with esophagostomy and gastrostomy in 5 cases. Followup was at one week, one and three months postdischarge. A stricture developed in 5 (16.6%) of the 30 surviving patients who kept their native esophagus. Conclusions Thoracoscopic repair is a feasible alternative even in a low-resource setting. The better outcome compared to traditional open repair in our center may be due to patient selection bias.

Outcome of thoracoscopic repair of type-C esophageal atresia: a single-center experience from North Africa

2020 ◽  
Vol 33 (7) ◽  
Author(s):  
Mohamed M Elbarbary ◽  
Aly Shalaby ◽  
Mohamed Elseoudi ◽  
Hamed M Seleim ◽  
Moutaz Ragab ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Anastomotic Leakage ◽  
Esophageal Atresia ◽  
Operative Time ◽  
Anastomotic Stricture ◽  
Primary Anastomosis ◽  
Tertiary Care ◽  
Thoracoscopic Approach ◽  
Thoracoscopic Repair ◽  
Type C

Summary Thoracoscopic repair of esophageal atresia is gaining popularity worldwide attributable to availability and advances in minimally invasive instruments. In this report, we presented our experience with thoracoscopic esophageal atresia/tracheoesophageal fistula (EA/TEF) repair in our tertiary care institute. A prospective study on short-gap type-C EA/TEF was conducted at Cairo University Specialized Pediatric Hospital between April 2016 and 2018. Excluded were cases with birth weight < 1500 gm, inability to stabilize physiologic parameters, or major cardiac anomalies. The technique was standardized in all cases and was carried out by operating team concerned with minimally invasive surgery at our facility. Primary outcome evaluated was successful primary anastomosis. Secondary outcomes included operative time, conversion rate, anastomotic leakage, recurrent fistula, postoperative stricture, and time till discharge. Over the inclusion period of this study, 136 cases of EA/TEF were admitted at our surgical NICU. Thoracoscopic repair was attempted in 76 cases. In total, 30 cases were pure atresia/long gap type-C atresia and were excluded from the study. Remaining 46 cases met the inclusion criteria and were enrolled in the study. Mean age at operation was 8.7 days (range 2–32), and mean weight was 2.6 Kg (range 1.8–3.6). Apart from five cases (10.8%) converted to thoracotomy, the mean operative time was 108.3 minutes (range 80–122 minute). A tension-free primary anastomosis was possible in all thoracoscopically managed cases (n = 41) cases. Survival rate was 85.4% (n = 35). Anastomotic leakage occurred in seven patients (17%). Conservative management was successful in two cases, while esophagostomy and gastrostomy were judged necessary in the other for five. Anastomotic stricture developed in five cases (16.6%) of the 30 surviving patients who kept their native esophagus. Despite the fact that good mid-term presented results may be due to patient selection bias, thoracoscopic approach proved to be feasible for management of short-gap EA/TEF. Authors of this report believe that thoracoscopy should gain wider acceptance and pediatric surgeons should strive to adopt this procedure.

scholarly journals Laparoscopic management of Hydatid cyst

2016 ◽  
Vol 18 (3) ◽  
pp. 42
Author(s):  
Anang Pangeni ◽  
Vikal Chandra Shakya
Keyword(s):  
Minimally Invasive ◽  
Prospective Study ◽  
Hydatid Cyst ◽  
Operative Time ◽  
Energy Sources ◽  
Hydatid Cysts ◽  
Laparoscopic Management ◽  
The Mean ◽  
A Prospective Study ◽  
Surgery Department

Introduction and Objective: Hydatid cyst of the liver is a fairly common parasitic condition. We present here a series of 9 patients with hydatid cyst of the liver managed by minimally invasive surgeryMaterials and Methods: It was a prospective study in patients presenting with hydatid cyst of the liver to Surgery Department who were managed laparoscopically from January 2013 to November 2015.Result: There were 9 patients (5 males and 4 females). The mean operative time was 124+32 minutes. One patient developed mild allergy in the form of skin rashes on 3rd postoperative day, and another patient developed cholangitis which resolved on conservative management. There was no conversion.Conclusion: Laparoscopic management of hydatid cysts is possible, and looks promising provided we have advanced energy sources.

scholarly journals Safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy in the management of renal stones ≤ 2 cm: a single-center experience

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Elsayed M. Salih ◽  
Ibrahim Elsotohi ◽  
Hisham Elhelaly ◽  
Mohamed Elsalhy ◽  
Mourad M. Mourad
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Renal Stones ◽  
Stone Size ◽  
Intraoperative Complication ◽  
Safety And Efficacy ◽  
Single Center Experience ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
The Mean

Abstract Background The goal for using smaller caliber instruments in PNL was to reduce the access-related complications and to decrease morbidity. The objective of this study was to evaluate the safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy (MIPNL) in the treatment of renal stones ≤ 20 mm. Results Sixty-seven patients completed the study protocol. The mean age was 41.10 ± 13.99 years (range 18–68 years). There were 43 (64%) male and 24 (36%) females. The mean stone size was ranged from 78.5 to 439.6 mm2 (mean ± SD 172.48 ± 69.54 mm2). The overall SFR was (82%). Twelve (18%) needed post-MIPNL auxiliary procedure, in the form of second MIPNL in 3 (4.5%) cases, SWL in 7 (10%), and RIRS in 2 (3%) cases. The intraoperative complication was present in four patients (5%) include bleeding necessitate blood transfusion in one patient (1.5%) and renal collecting system perforation 3 (4.5%). The postoperative complication was urine leakage 5 (7.5) and fever in 6 (9%) of patients. Conclusion Chinese MIPNL is safe and effective method for treatment of renal stone ≤ 20 mm size with satisfactory SFR and low complication rate when SWL failed or contraindicated. It is considered a feasible treatment alternative to standard PNL, in the absence of flexible URS or miniature nephroscope.

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 Comparative study between minimally invasive supraorbital craniotomy and pterional craniotomy for treating anterior circulation cerebral aneurysms in a low-resource setting

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ricardo Brandão Fonseca ◽  
Alyne Oliveira Correia ◽  
Raysa Siqueira Vieira ◽  
José Erivaldo Fonseca dos Santos ◽  
Heverty Rocha Alves-Neto ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Operative Time ◽  
Operating Time ◽  
Cerebral Aneurysms ◽  
Length Of Hospital Stay ◽  
Neurological Status ◽  
Aneurysm Rupture ◽  
Anterior Circulation ◽  
Pterional Craniotomy ◽  
Resource Setting

AbstractThe challenges encountered in performing minimally invasive approaches, such as supraorbital minicraniotomy (SOMC), in services without adequate equipment are rarely reported in the literature. This study analyzes the viability of SOMC in the treatment of cerebral aneurysms, using exactly the same resources as pterional craniotomy (PC). The results of these two techniques are compared. 35 patients underwent SOMC, compared to 50 patients underwent CP (100 aneurysms in total), using the same microsurgical instruments. The following variables were compared: operative time, angiographic cure, length of intensive care unit stay during the post-operative period, surgical complications, length of hospital stay after surgery until hospital discharge, intraoperative aneurysm rupture, aesthetic satisfaction with the scar, and neurological status at discharge. SOMC had a significantly shorter operative time in relation to PC (213.9 ± 11.09 min and 268.6 ± 15.44 min, respectively) (p = 0.0081).With respect to the cosmetic parameters assessed by the Visual Analog Scale, the average for SOMC was 94.12 ± 1.92 points, and the average for PC was 83.57 ± 4.75 points (p = 0.036). SOMC was as effective as PC in relation to successful aneurysm clipping (p = 0.77). The SOMC technique did not show advantages over PC in any other variable. Even in a general neurosurgery service lacking a specific structure for minimally invasive surgeries, SOMC was feasible and effective for treating intracranial aneurysms, using the same set of microsurgical instruments used for PC, obtaining better results in operating time and cosmetic satisfaction.

scholarly journals MINILAPAROSCOPIC APPENDECTOMY

2016 ◽  
Vol 29 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Lúcio Américo Della COLETTA ◽  
Bruno Ziade GIL ◽  
Renato Morato ZANATTO
Keyword(s):  
Acute Appendicitis ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Operative Time ◽  
Treatment Method ◽  
Public Health Services ◽  
Surgical Time ◽  
Aesthetic Result ◽  
The Mean ◽  
The Aesthetic

Background: Minilaparoscopy is considered one of the minimally invasive options available for acute appendicitis treatment, although not always employed in less complexity public health services. Aim: Report surgical outcomes of minilaparoscopy use in acute appendicitis treatment. Method : The study included 21 patients undergoing minilaparoscopic appendectomy with instrumental of 3 mm. The following variables were analyzed: sex, age, body mass index, stage of appendicitis, surgical time, hospital stay, surgical complications, conversion rate to conventional laparoscopy or laparotomy, pain after surgery and aesthetic result. Results: Twelve men and nine women underwent minilaparoscopic appendectomy. The average age was 27,8 years, the mean BMI was 24,8 kg/m2. The operative time ranged from 33 to 160 min and the average of hospital stay was three days. Among the 21 patients, 20 reported mild pain or no pain in the first postoperative day. The aesthetic result was considered "satisfactory" and "very satisfactory" by 95% of the patients. Conclusions: The minilaparoscopy is viable technique for treating acute appendicitis with a satisfactory recovery. It combines the benefits of minimally invasive procedures with results similar to conventional techniques.

A Single-Center Experience with Minimally Invasive Transgastric ERCP in Patients with Previous Gastric Bypass: Lessons Learned and Technical Considerations

2020 ◽  
Vol 86 (4) ◽  
pp. 300-307
Author(s):  
Maria Baimas-George ◽  
Michael J. Passeri ◽  
William B. Lyman ◽  
Andrew Dries ◽  
Tarun Narang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Biliary Obstruction ◽  
Operative Time ◽  
Lessons Learned ◽  
High Rate ◽  
Single Center Experience ◽  
Estimated Blood Loss ◽  
Chart Abstraction ◽  
Feasible Alternative ◽  
Median Operative Time

As bariatric surgery increases, there is a growing population of patients with biliary obstruction and anatomy which precludes transoral access through endoscopic retrograde cholangiopancreatography (ERCP). Minimally invasive transgastric ERCP (TG-ERCP) offers a feasible alternative for the treatment. A retrospective review was performed of all patients who underwent laparoscopic or robotic-assisted TG-ERCP between 2010 and 2017. Chart abstraction collected demographics, procedural details, success rate, and postoperative outcomes. Forty patients were identified, of which 38 cases were performed laparoscopically and two robotically. Median operative time was 163 minutes, with an estimated blood loss of 50 cc. TG-ERCP was performed successfully in 36 cases (90%); sphincterotomy was completed in 35 patients (97%). Sixty per cent already had a cholecystectomy; in the remaining patients, it was performed concurrently. Major complications included stomach perforation (n = 1), pancreatitis (n = 3), and anemia requiring transfusion (n = 2). In patients with biliary obstruction and anatomy not suitable for ERCP, TG-ERCP can be performed in a minimally invasive fashion, with a high rate of technical success and low morbidity. We describe a stepwise, reproducible technique because it is an essential tool for the shared armamentarium of endoscopists and surgeons.

scholarly journals Ultrasonography-Guided Percutaneous Nephrolithotomy for the Treatment of Urolithiasis in Patients with Scoliosis

2012 ◽  
Vol 97 (2) ◽  
pp. 182-188 ◽  
Author(s):  
Hongyan Li ◽  
Zhuo Zhang ◽  
Hai Li ◽  
Yuanyuan Xing ◽  
Gang Zhang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Single Session ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
The Mean ◽  
Ultrasonographic Guidance ◽  
Mean Time ◽  
Treatment Of Urolithiasis

Abstract We examined the surgical outcomes of minimally invasive percutaneous nephrolithotomy (MPCNL) in scoliotic patients with complicating urolithiasis. Two patients with scoliosis were hospitalized for MPNCL due to upper tract urolithiasis. Calyx puncture was performed in the prone position under ultrasonographic guidance. The renal access route was established using a set of 8F to 16F dilators, and a transpyelic ballistic lithotriptor was used to fragment the calculi. The stone burdens in the 2 patients were 410 mm2 and 500 mm2. The entire operative time was 40 to 70 minutes, and the mean time of establishing percutaneous access was 20 minutes. The calculi were completely removed by single-session pneumatic lithotripsy. The 2 patients recovered from MPCNL uneventfully, and the follow-up radiologic examinations identified no stone residual or recurrence. MPCNL is a minimally invasive modality that is effective and safe for the treatment of urolithiasis in patients with scoliosis.

scholarly journals Clinical Comparison Between Thoracoscopic and Thoracotomy Repair of Gross Type C Esophageal Atresia

2021 ◽  
Author(s):  
Shen Yang ◽  
Peize Wang ◽  
Zhi Yang ◽  
Siqi Li ◽  
Junmin Liao ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Anastomotic Leakage ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Operative Time ◽  
Anastomotic Stricture ◽  
Surgical Approaches ◽  
Invasive Technique ◽  
Thoracoscopic Approach ◽  
Type C

Abstract Background To compare the clinical outcomes between thoracoscopic approach and thoracotomy surgery in patients with Gross type C Esophageal atresia (EA) and tracheoesophageal fistula (TEF). Methods Patients with Gross type C EA/TEF who underwent surgery from January 2007 to January 2020 at Beijing Children’s Hospital were retrospectively analyzed. The patients were divided into 2 groups according to surgical approaches. The perioperative factors and postoperative complications were compared among the 2 groups. Results One hundred and ninety patients (132 boys and 58 girls) with a median birth weight of 2975 (2600, 3200) g were included. The primary operations were performed via thoracoscopic (n = 62) and thoracotomy (n = 128) approach. After comparison of clinical characteristics between the 2 groups, we found that there were statistically significant differences in associated anomalies, method of fistula closure, duration of mechanical ventilation after surgery, feeding option before discharge, management of pneumothorax, and prognosis (all P < 0.05). To a certain extent, thoracoscopic surgery reduced the incidence of anastomotic leakage and increased the incidence of anastomotic stricture in this study. However, there were no statistically significant differences between the 2 groups in terms of operative time, postoperative pneumothorax, anastomotic leakage, anastomotic stricture, and recurrent tracheoesophageal fistula (all P > 0.05). Conclusions Thoracoscopy surgery for Gross type C EA/TEF is a safe and effective, minimally invasive technique with comparable operative time and incidence of postoperative complications.

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