Editorial Comment to Management of major venous bleeding during minimally invasive pelvic surgery: A proposed protocol for “What should we do next?”

2021 ◽  
Author(s):  
Takashi Kobayashi
Keyword(s):  
Editorial Comment ◽  
Minimally Invasive ◽  
Pelvic Surgery ◽  
Venous Bleeding

scholarly journals Editorial Comment: Minimally Invasive Spine Surgery

2014 ◽  
Vol 472 (6) ◽  
pp. 1709-1710 ◽  
Author(s):  
Ahmad Nassr ◽  
Bradford L. Currier ◽  
Steven R. Garfin
Keyword(s):  
Editorial Comment ◽  
Minimally Invasive ◽  
Spine Surgery ◽  
Minimally Invasive Spine Surgery ◽  
Minimally Invasive Spine

scholarly journals Fluorescence Imaging of the Ureter in Minimally Invasive Pelvic Surgery

2020 ◽  
Author(s):  
Warner K. Huh ◽  
John L. Johnson ◽  
Emily Elliott ◽  
Jonathan D. Boone ◽  
Charles A. Leath ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Fluorescence Imaging ◽  
Pelvic Surgery

Surface Electromyography Reliably Records Electrophysiologically Evoked Internal Anal Sphincter Activity: A More Minimally Invasive Approach for Monitoring Extrinsic Innervation

2016 ◽  
Vol 57 (1-2) ◽  
pp. 81-88 ◽  
Author(s):  
Daniel W. Kauff ◽  
Nicolas Wachter ◽  
Axel Heimann ◽  
Thilo B. Krüger ◽  
Klaus-Peter Hoffmann ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Anal Sphincter ◽  
Internal Anal Sphincter ◽  
Autonomic Nerve ◽  
Pelvic Surgery ◽  
Transanal Total Mesorectal Excision ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Anterior Rectal Resection ◽  
Extrinsic Innervation

Background: Even in the case of minimally invasive pelvic surgery, sparing of the autonomic nerve supply is a prerequisite for maintaining anal sphincter function. Internal anal sphincter (IAS) innervation could be electrophysiologically identified based on processed electromyographic (EMG) recordings with conventional bipolar needle electrodes (NE). This experimental study aimed for the development of a minimally invasive approach via intra-anal surface EMG for recordings of evoked IAS activity. Methods: Six male pigs underwent nerve-sparing low anterior rectal resection. Electric autonomic nerve stimulations were performed under online-processed EMG of the IAS. EMG recordings were simultaneously carried out with conventional bipolar NE as the reference method and newly developed intra-anal surface electrodes (SE) in different designs. Results: In all experiments, the IAS activity could be continuously visualized via EMG recordings based on NE and SE. The median number of bipolar electric stimulations per animal was 27 (range 5-52). The neurostimulations resulted in significant EMG amplitude increases for both recording types [NE: median 3.0 µV (interquartile range, IQR 2.8-3.5) before stimulation vs. 7.1 µV (IQR 3.9-13.8) during stimulation, p < 0.001; SE: median 3.6 µV (IQR 3.1-4.3) before stimulation vs. 6.8 µV (IQR 4.8-10.3) during stimulation, p < 0.001]. Conclusions: Intra-anal SE enabled reliable EMG of electrophysiologically evoked IAS activity similar to the conventional recording via NE. The transfer of the method to access platforms for transanal total mesorectal excision or robotics may offer a practical more minimally invasive approach for monitoring extrinsic innervation.

scholarly journals New method of stopping bleeding from the presacral venous plexus during the rectal cancer operation: a case report

2018 ◽  
Vol 8 (3) ◽  
pp. 42-45
Author(s):  
E. M. Parfir’eva ◽  
A. O. Ivchenko ◽  
O. A. Ivchenko
Keyword(s):  
Rectal Cancer ◽  
Case Report ◽  
Pore Size ◽  
Reliable Method ◽  
Pelvic Surgery ◽  
Bleeding Control ◽  
Venous Plexus ◽  
Fatal Complication ◽  
Rectal Cancer Operation ◽  
Venous Bleeding

Presacral venous bleeding is a rare but potentially fatal complication in pelvic surgery. This type of bleeding is difficult to control. Existing methods are not without shortcomings, therefore, the search for a more reliable method. We are present a case of successful bleeding control using by plates of medium-porous nitinol (pore size of 300–450 μm, permeability of 12 × 10–9). Hemostasis was carried out by pressing  a plate to the bleeding zone for 4 minutes.

Use of video endoscopic inguinal lymphadenectomy (VEIL) in patients with urogenital malignancies: An observational study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15101-e15101
Author(s):  
Raghunath S K ◽  
Sudhir Rawal ◽  
Samir Khanna
Keyword(s):  
Minimally Invasive ◽  
Skin Flap ◽  
Surgical Morbidity ◽  
Operative Morbidity ◽  
Conversion To Open Surgery ◽  
Inguinal Lymphadenectomy ◽  
Randomized Controlled Studies ◽  
Venous Bleeding ◽  
The Mean ◽  
Skin Flap Necrosis

e15101 Background: Surgical morbidity especially skin related necrosis is seen in 50% of patients following open radical inguinal lymphadenectomy in patients with urogenital malignancies. Inguinal lymphadenectomy helps in local control of disease and survival but had significant associated morbidity. We evaluated the post operative morbidity associated with minimally invasive video endoscopic Inguinal Lymphadenectomy (VEIL). Methods: Twenty two patients with urogenital malignancies who underwent thirty nine VEIL surgeries were evaluated for postoperative outcomes and morbidity. None of the patients required conversion to open surgery. Results: The mean operative time was 125 min, drain retention was 5.4 days, mean duration of postoperative stay was 3 days and a mean of 10.5 nodes were removed. 4.5% (1/22) developed skin flap necrosis, 4.5% (1/22) developed post operative venous bleeding that was controlled with dressing, 18.1% (4/22) developed lymphocoele that was resolved within 1-3 weeks with aspirations. Persistent drain output >50ml/day was observed in 18.1 % (4/22) that was resolved by readjusting the drain. Histologically positive nodes were seen in 40.9% (9/22) of patients. Conclusions: These observations offer further support for using minimally invasive VEIL surgeries over open radical inguinal lymphadenectomy in patients with urogenital malignancies in reducing both surgical and skin related morbidity. Further randomized controlled studies are needed to validate these findings.

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