scholarly journals Transoral Robotic Surgery: Step-by-Step Radical Tonsillectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Jose Granell ◽  
Ivan Mendez-Benegassi ◽  
Teresa Millas ◽  
Laura Garrido ◽  
Raimundo Gutierrez-Fonseca
Keyword(s):  
Robotic Surgery ◽  
Minimally Invasive ◽  
Surgical Procedure ◽  
Feeding Tube ◽  
Transoral Robotic Surgery ◽  
Surgical Reconstruction ◽  
Case Presentation ◽  
Minimally Invasive Surgical Procedure ◽  
Patients With Cancer ◽  
Minimally Invasive Surgical

Introduction. Transoral robotic surgery (TORS) radical tonsillectomy is an emerging minimally invasive surgical procedure for the treatment of cancer of the tonsil. The detailed surgical technique and claims for its reproducibility have been previously published.Case Presentation. We present a patient with a T2N2bM0 epidermoid carcinoma of the tonsil to illustrate step by step the surgical procedure for TORS radical tonsillectomy. Neck dissection and TORS were staged. No surgical reconstruction of the defect was required. No tracheostomy was necessary. The patient could eat without any feeding tube and was on full oral diet on the fifth postoperative day.Discussion. The transoral approach offers the benefits of minimally invasive surgery to patients with cancer of the tonsil. The excellent exposure and high precision provided by robotic instrumentation allow the surgeon to closely follow and accomplish the surgical steps, which is the best warranty for safety and effectiveness.

Uniportal thoracoscopic right anterior basal (S8) segmentectomy using unidirectional dissection

2021 ◽  
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedure ◽  
Lower Lobe ◽  
Lung Parenchyma ◽  
Surgical Instruments ◽  
Thoracoscopic Approach ◽  
Minimally Invasive Surgical Procedure ◽  
Small Incision ◽  
Minimally Invasive Surgical ◽  
The Right

Anterior basal (S8) segmentectomy is one of the most challenging procedures among the uncommon pulmonary segmentectomies because the surgeon has to identify dominant pulmonary vein branches located deep in the lung parenchyma. Moreover, with the uniportal thoracoscopic approach, the angulation of inserted surgical instruments via a single small incision is extremely limited, which causes technical difficulties. However, adoption of a suitable procedure such as unidirectional dissection enables us to perform this type of minimally invasive surgical procedure. We describe the successful results of a patient undergoing uniportal thoracoscopic S8 segmentectomy of the right lower lobe and explain the nuances of performing it.

COMBINED USE OF CALCIUM INFUSION LOCALIZATION AND A MINIMALLY INVASIVE SURGICAL PROCEDURE IN THE MANAGEMENT OF INSULINOMA

2002 ◽  
Vol 8 (5) ◽  
pp. 329-334 ◽  
Author(s):  
L. Raymond Reynolds, MD, FACP ◽  
Adrian E. Park, MD ◽  
Ralph E. Miller, MD ◽  
Dennis G. Karounos, MD
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedure ◽  
Minimally Invasive Surgical Procedure ◽  
Minimally Invasive Surgical ◽  
Combined Use ◽  
Calcium Infusion

scholarly journals Cost-utility of two minimally-invasive surgical techniques for operable oropharyngeal cancer: transoral robotic surgery versus transoral laser microsurgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Enea Parimbelli ◽  
Federico Soldati ◽  
Lorry Duchoud ◽  
Gian Luca Armas ◽  
John de Almeida ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Minimally Invasive ◽  
Endoscopic Surgery ◽  
Surgical Techniques ◽  
Cost Effective ◽  
Cost Utility ◽  
Transoral Robotic Surgery ◽  
Transoral Laser Microsurgery ◽  
Adjuvant Chemoradiation ◽  
Minimally Invasive Surgical

Abstract Background In the past few decades, a re-evaluation of treatment paradigms of head and neck cancers with a desire to spare patients the treatment-related toxicities of open surgery, has led to the development of new minimally invasive surgical techniques to improve outcomes. Besides Transoral Laser Microsurgery (TLM), a new robotic surgical technique namely Transoral Robotic Surgery (TORS) emerged for the first time as one of the two most prominent and widely used minimally invasive surgical approaches particularly for the treatment of oropharyngeal cancer, a sub-entity of head and neck cancers. Recent population-level data suggest equivalent tumor control, but different total costs, and need for adjuvant chemoradiation. A comparative analysis of these two techniques is therefore warranted from the cost-utility (C/U) point of view. Methods A cost-utility analysis for comparing TORS and TLM was performed using a decision-analytical model. The analyses adopted the perspective of a Swiss hospital. Two tertiary referral centers in Lausanne and Zurich provided data for model quantificantion. Results In the base case analysis TLM dominates TORS. This advantage remains robust, even if the costs for TORS reduce by up to 25%. TORS begins to dominate TLM, if less than 59,7% patients require adjuvant treatment, whereby in an interval between 55 and 62% cost effectiveness of TORS is sensitive to the prescription of adjuvant chemoradiation therapy (CRT). Exceeding 29% of TLM patients requiring a revision of surgical margins renders TORS more cost-effective. Conclusion Non-robotic endoscopic surgery (TLM) is more cost-effective than robotic endoscopic surgery (TORS) for the treatment of oropharyngeal cancers. However, this advantage is sensitive to various parameters, i.e.to the number of re-operations and adjuvant treatment.

scholarly journals Optimal minimally invasive surgical procedure for gastric submucosal tumors

2017 ◽  
Vol 21 (3) ◽  
pp. 508-515 ◽  
Author(s):  
Yoshiaki Shoji ◽  
Hiroya Takeuchi ◽  
Osamu Goto ◽  
Kazunori Tokizawa ◽  
Rieko Nakamura ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedure ◽  
Minimally Invasive Surgical Procedure ◽  
Submucosal Tumors ◽  
Minimally Invasive Surgical ◽  
Gastric Submucosal Tumors

PP59 Evaluating Reimbursement Applications With Decision-Oriented Evidence

2018 ◽  
Vol 34 (S1) ◽  
pp. 89-90
Author(s):  
Thomas Vreugdenburg ◽  
Alun Cameron ◽  
Guy Maddern ◽  
Ning Ma ◽  
Anje Scarfe ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedure ◽  
Selection Criteria ◽  
Cochrane Library ◽  
Pain Patient ◽  
Sample Population ◽  
Single Trial ◽  
Minimally Invasive Surgical Procedure ◽  
Minimally Invasive Surgical ◽  
Patient Reported

Introduction:Our research group recently evaluated a minimally invasive surgical procedure in order to inform a reimbursement decision. The application for funding was designed around the study selection criteria from a single pivotal randomized controlled trial (RCT). The aim of this study review was to evaluate the safety and effectiveness of this minimally invasive surgical procedure, and document challenges faced in evaluating a technology based on a highly targeted population.Methods:A systematic literature search of four biomedical databases was conducted (PubMed, Embase, Cochrane library, York CRD) up to 8 August 2017. Specific elements related to the population were patient age, together with level and duration of pain. Primary effectiveness outcomes included pain, patient reported quality of life, mortality and adverse events. The included RCTs were critically appraised against the Cochrane risk of bias tool. Meta-analysis was not possible due to the limited availability of evidence with consistent outcomes.Results:From 4,718 search results, only one pivotal RCT specifically met the inclusion criteria, which demonstrated favorable safety and effectiveness of the procedure; however, the sample population in the trial had limited external validity to the proposed reimbursement population and follow-up was limited to six months. As a result, the selection criteria were broadened to better reflect the manner in which the service may be provided in clinical practice, and capture longer-term safety concerns. Four additional RCTs were included, which provided contradictory results.Conclusions:The results of this review identified two important issues in evaluating a health technology where the assessment has been focused to the results of a single trial. In particular, the generalizability of a trial is defined by the demographic distribution of the sample, not the selection criteria. Designing the review selection criteria around the selection criteria for a single trial can have consequences for a funding decision.

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