scholarly journals Minimally invasive approach to low-velocity penetrating extraperitoneal rectal trauma

2020 ◽  
Vol 5 (1) ◽  
pp. e000396
Author(s):  
Megan Melland-Smith ◽  
Tyler R Chesney ◽  
Shady Ashamalla ◽  
Fred Brenneman
Keyword(s):  
Minimally Invasive ◽  
New Technologies ◽  
Primary Repair ◽  
Standard Of Care ◽  
Rectal Disease ◽  
Low Velocity ◽  
Invasive Approach ◽  
Rectal Trauma ◽  
Rectal Injuries ◽  
Diverting Colostomy

Unlike intraperitoneal colorectal injuries, the standard of care for extraperitoneal rectal trauma includes a diverting colostomy due to relative inaccessibility of these injuries for primary repair. New technologies to enhance access to the extraperitoneal rectum have gained increasing use in benign and malignant rectal disease. We present two cases of low-velocity penetrating extraperitoneal rectal trauma. In both cases, a transanal minimally invasive surgery (TAMIS) approach was used to access, and primarily repair, full-thickness rectal lacerations. These patients were successfully managed without a colostomy and without complication. TAMIS enables access to distal rectal injuries, facilitating primary repair and bringing the management of extraperitoneal rectal injuries in line with intraperitoneal injuries, with the potential to avoid fecal diversion.

scholarly journals Evolution of Transanal Total Mesorectal Excision

2020 ◽  
Vol 33 (03) ◽  
pp. 113-127
Author(s):  
Heather Carmichael ◽  
Patricia Sylla
Keyword(s):  
Minimally Invasive ◽  
Total Mesorectal Excision ◽  
Surgical Techniques ◽  
Colorectal Disease ◽  
Surgical Approaches ◽  
Transanal Total Mesorectal Excision ◽  
Rectal Disease ◽  
Mesorectal Excision ◽  
Invasive Approach ◽  
Transanal Approach

AbstractMinimally invasive techniques continue to transform the field of colorectal surgery. Because traditional surgical approaches for rectal cancer are associated with significant mortality and morbidity, developing less invasive approaches to this disease is paramount. Natural orifice transluminal endoscopic surgery (NOTES), commonly known as “no incision surgery,” represents the ultimate minimally invasive approach to disease. Although transgastric and transvaginal approaches for NOTES surgery were the initially explored, a transrectal approach for colorectal disease is intuitive given that it makes use of the resected organ for transluminal access. Furthermore, the transanal approach allows for improved, precise visualization of the presacral mesorectal plane compared with an abdominal viewpoint, particularly in the narrow, male pelvis. Finally, experience with existing transanal platforms that have been used for decades for local excision of rectal disease made the development of a transanal approach to total mesorectal excision (TME) feasible. Here, we will review the evolution of minimally invasive and transanal surgical techniques that allowed for the development of transanal TME and its introduction into clinical practice.

Endoscopic transnasal odontoidectomy combined with posterior reduction to treat basilar invagination

2013 ◽  
Vol 19 (5) ◽  
pp. 637-643 ◽  
Author(s):  
Yong Yu ◽  
Fan Hu ◽  
Xiaobiao Zhang ◽  
Junqi Ge ◽  
Chongjing Sun
Keyword(s):  
Minimally Invasive ◽  
New Technologies ◽  
Standard Procedure ◽  
Treatment Algorithm ◽  
Ventral Side ◽  
Basilar Invagination ◽  
Invasive Approach ◽  
Cervicomedullary Junction ◽  
Recovery From Anesthesia ◽  
Minimally Invasive Access

Object Transoral microscopic odontoidectomy has been accepted as a standard procedure to treat basilar invagination over the past several decades. In recent years the emergence of new technologies, including endoscopic odontoidectomy and posterior reduction, has presented a challenge to the traditional treatment algorithm. In this article, the authors describe 1 patient with basilar invagination who was successfully treated with endoscopic transnasal odontoidectomy combined with posterior reduction. The purpose of this report is to validate the effectiveness of this treatment algorithm in selected cases and describe several operative nuances and pearls based on the authors' experience. Methods One patient with basilar invagination caused by a congenital osseous malformation underwent endoscopic transnasal odontoidectomy combined with posterior reduction in a single operative setting. The purely endoscopic transnasal odontoidectomy was first conducted with the patient supine. The favorable anatomical reduction was then achieved through a posterior approach after the patient was moved prone. Results The patient was extubated after recovery from anesthesia and allowed oral food intake the next day. No complications were noted, and the patient was discharged 4 days after the operation. Postoperative imaging demonstrated excellent decompression of the anterior cervicomedullary junction pathology. The patient was followed up for 12 months and remarkable neurological recovery was observed. Conclusions The endoscopic transnasal odontoidectomy is a better minimally invasive approach for anterior decompression and can make the posterior reduction easier because the anterior resistant force is eliminated. The subsequent posterior reduction can make decompression of the ventral side of the cervicomedullary junction more effective because the C-2 vertebral body is pushed forward. A combination of these 2 approaches has the advantages of minimally invasive access and a faster patient recovery, and thus is a valid alternative in selected cases.

Minimally invasive approach and application of new technologies in bariatric and metabolic surgery

2019 ◽  
Vol 30 (4) ◽  
pp. 494-500
Author(s):  
S Morales Conde ◽  
F López Bernal ◽  
I Alarcón del Agua ◽  
E Licardie Bolaños ◽  
A Barranco Moreno ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Metabolic Surgery ◽  
New Technologies ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Nuevas Tecnologías

Resumen El abordaje mínimamente invasivo en cirugía bariátrica es una realidad, no existiendo duda actualmente que su aplicación debe ser prácticamente en todos los procedimientos, incluso en cirugía de revisión de cirugía previa laparotómica. Ante este escenario, si hablamos de aplicación de las nuevas técnicas y la tecnología en cirugía bariátrica debemos enfocar el tema a tres aspectos fundamentalmente: las vías actuales para realizar la cirugía de forma más segura apoyadas en las nuevas tecnologías, tales como: la mejora del material quirúrgico, la robótica, la cirugía con sistemas 3D o el potencial que tiene la cirugía guiada por la imagen. Por otro lado, se tiende a mejorar las ventajas del acceso a la cavidad mediante: la miniaturización de los trocares, es decir la minilaparoscopia, la reducción de su número o la cirugía por acceso único. Por último, el control del proceso asistencial del paciente avanza hacia la innovación mediante el uso de la telemonitorización gracias a la aplicación de las nuevas tecnologías. Estos aspectos son claves en el presente y el futuro de la cirugía bariátrica y metabólica y sin duda son el punto de desarrollo innovador y de la nueva visión asociada a este tipo de procedimientos.

scholarly journals Access for Laparoendoscopic Single Site Surgery

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Sharona B. Ross ◽  
C. Whalen Clark ◽  
Connor A. Morton ◽  
Alexander S. Rosemurgy
Keyword(s):  
Laparoscopic Surgery ◽  
Minimally Invasive ◽  
Peritoneal Cavity ◽  
Standard Of Care ◽  
Single Site ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Laparoendoscopic Single Site Surgery ◽  
Key Techniques ◽  
Single Site Surgery

Laparoscopic surgery is the standard of care for many abdominal and pelvic operations and is widely applied today. LESS (Laparo-Endoscopic Single Site) surgery, originally attempted in the 1990s, is an advanced minimally invasive approach that allows laparoscopic operations to be undertaken through a small (<15 mm) incision in the umbilicus, a preexisting scar. The presence of a preexisting scar allows LESS surgery to be essentially scarless, which is the key benefit to LESS operations. Herein, we review our experience with over 500 LESS operations and discuss the key techniques to establishing access to the peritoneal cavity. We review the options for obtaining access, available instrumentation, common challenges and solutions for access. We conclude that LESS surgery is safe and provides outcomes with superior cosmesis relative to conventional laparoscopy. LESS surgery should be embraced, as patient demand is rapidly increasing.

Minimally Invasive Approach for Wilms Tumor Treatment in a Small Child - A Case Report

Urology ◽  
2020 ◽  
Author(s):  
Alexandre Azevedo Ziomkowski ◽  
João Rafael Silva Simões Estrela ◽  
Nilo Jorge Carvalho Leão Barretto ◽  
Nilo César Leão Barretto
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Wilms Tumor ◽  
Small Child ◽  
Tumor Treatment ◽  
Minimally Invasive Approach ◽  
Invasive Approach

A Minimally Invasive Approach for Treatment of Cholesterol Granuloma of the Petrous Apex

2019 ◽  
Author(s):  
Brandon Lucke-Wold ◽  
Maya Fleseriu ◽  
Haley Calcagno ◽  
Timothy Smith ◽  
Joshua Levy ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Petrous Apex ◽  
Cholesterol Granuloma ◽  
Minimally Invasive Approach ◽  
Invasive Approach

Surgical Technique: Papillary Muscle Sling for Functional Mitral Regurgitation during Minimally Invasive Valve Surgery

2013 ◽  
Vol 16 (5) ◽  
pp. E295-E297 ◽  
Author(s):  
Joseph Lamelas ◽  
Christos Mihos ◽  
Orlando Santana
Keyword(s):  
Mitral Regurgitation ◽  
Minimally Invasive ◽  
Median Sternotomy ◽  
Rational Approach ◽  
Functional Mitral Regurgitation ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Mitral Annuloplasty ◽  
Technical Details ◽  
Mitral Apparatus

In patients with functional mitral regurgitation, the placement of a sling encircling both papillary muscles in conjunction with mitral annuloplasty appears to be a rational approach for surgical correction, because it addresses both the mitral valve and the deformities of the subvalvular mitral apparatus. Reports in the literature that describe the utilization of this technique are few, and mainly involve a median sternotomy approach. The purpose of this communication is to describe the technical details of performing this procedure via a minimally invasive approach.

Sign in / Sign up

Export Citation Format

Share Document