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.

Surgical outcomes of hysterectomy for endometriosis: Benefits of a minimally invasive approach

2021 ◽  
pp. 228402652098571
Author(s):  
Olga Mutter ◽  
Sarah Ackroyd ◽  
George A Taylor ◽  
Juan Diaz
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Surgical Outcomes ◽  
Abdominal Hysterectomy ◽  
Pelvic Surgery ◽  
Complication Rates ◽  
Minimally Invasive Approach ◽  
Improvement Program ◽  
Invasive Approach ◽  
Abdominal Approach

Introduction: We aimed to evaluate surgical outcomes of hysterectomy for endometriosis performed by general obstetricians and gynecologists (OB/GYNs) based on surgical approach. Methods: Using the 2016–2018 National Surgical Quality Improvement Program (NSQIP) database, we examined surgical outcomes including 30-day complication rates based on surgical approach in patients who underwent a hysterectomy for endometriosis by OB/GYNs. Results: From 2016 to 2018, 3641 hysterectomies were performed by OB/GYNs for endometriosis. 86.0% were performed via a minimally invasive (MIS) approach, with 2882 (79.2%) via a laparoscopic and 247 (6.8%) via a vaginal approach. Compared to MIS hysterectomies, those who underwent an abdominal hysterectomy included a higher proportion of African American and a lower proportion of non-Hispanic white patients, had heavier uteri, lower parity, and were more likely obese (all p < 0.05). There were no differences in age, American Society of Anesthesiologists class, comorbidities other than obesity, or a history of prior abdominal or pelvic surgery (all p > 0.05). Women undergoing hysterectomy for endometriosis experienced an overall 9.8% complication rate. Compared to abdominal approaches, MIS had a lower rate of overall complications (8.5% vs 17.8%) including wound (2.7% vs 7.2%) and major (4.4% vs 8.8%) complications (all p < 0.001). MIS had shorter operative time (129.2 ± 60.9 vs 143.8 ± 71.9), shorter length of stay (0.9 ± 1.6 vs 2.4 ± 1.8), and fewer readmissions (2.8% vs 5.5%) (all p < 0.001). Conclusion: While hysterectomy for endometriosis is a challenging procedure to perform, OB/GYNs are performing this procedure predominantly via a minimally invasive approach with fewer complications and more favorable surgical outcomes than an abdominal approach.

scholarly journals A Single Centre Retrospective Evaluation of Laparoscopic Rectal Resection with TME for Rectal Cancer: 5-Year Cancer-Specific Survival

2011 ◽  
Vol 2011 ◽  
pp. 1-5
Author(s):  
Raoul Quarati ◽  
Massimo Summa ◽  
Fabio Priora ◽  
Valeria Maglione ◽  
Ferruccio Ravazzoni ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Survival Rate ◽  
Minimally Invasive ◽  
Rectal Resection ◽  
Minimally Invasive Approach ◽  
Single Centre ◽  
Term Survival ◽  
Invasive Approach ◽  
Anterior Rectal Resection

Laparoscopic colon resection has established its role as a minimally invasive approach to colorectal diseases. Better long-term survival rate is suggested to be achievable with this approach in colon cancer patients, whereas some doubts were raised about its safety in rectal cancer. Here we report on our single centre experience of rectal laparoscopic resections for cancer focusing on short- and long-term oncological outcomes. In the last 13 years, 248 patients underwent minimally invasive approach for rectal cancer at our centre. We focused on 99 stage I, II, and III patients with a minimum follow-up period of 5 years. Of them 43 had a middle and 56 lower rectal tumor. Laparoscopic anterior rectal resection was performed in 71 patients whereas laparoscopic abdomino-perineal resection in 28. The overall mortality rate was 1%; the overall morbidity rate was 29%. The 5-year disease-free survival rate was 69.7%, The 5-year overall survival rate was 78.8%.

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.

A novel minimally‐invasive approach for metal tattoo removal with Er: YAG laser

2021 ◽  
Author(s):  
Risako Mikami ◽  
Koji Mizutani ◽  
Shigeyuki Nagai ◽  
Verica Pavlic ◽  
Takanori Iwata ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Yag Laser ◽  
Tattoo Removal
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