scholarly journals Left liver anatomical resection via the left vertical groove and intraoperative antegrade cholangioscopy in patients with left-sided hepatolithiasis and previous biliary tract surgery

2019 ◽  
Vol 47 (10) ◽  
pp. 4872-4877
Author(s):  
Yong Zhou ◽  
Guo-qin Jiang ◽  
Ren-Gen Fan ◽  
Wen-Zhang Zha ◽  
Xu-dong Wu
Keyword(s):  
Biliary Tract ◽  
Operative Time ◽  
Hepatic Duct ◽  
Intraoperative Complications ◽  
Tube Placement ◽  
Anatomical Resection ◽  
Left Liver ◽  
Biliary Tract Surgery ◽  
The Mean ◽  
Residual Stones

Objective This study aimed to assess the safety and efficacy of left liver anatomical resection via the left vertical groove following intraoperative antegrade cholangioscopy (biliary exploration through the left hepatic duct orifice) in patients with left-sided hepatolithiasis (LSH) and previous biliary tract surgery. Methods Between January 2012 and January 2016, eligible patients with LSH (n = 28) who underwent left liver anatomical resection via the left vertical groove followed by intraoperative antegrade cholangioscopy, were referred to our hospital. Clinical results, such as the overall operative time, length of hospital stay, intraoperative complications, residual stones and postoperative bile leaks, were recorded and analyzed. Results No residual stones and bile leakage occurred in the patients. No patients experienced intraoperative complications or T-tube placement. The mean operative time was 135.1 ± 18.9 minutes. The mean postoperative duration of hospitalization was 7.8 ± 1.8 days. Conclusions Left liver anatomical resection via the left vertical groove combined with intraoperative antegrade cholangioscopy is a safe and useful method for patients with LSH and previous biliary tract surgery. This technique simplifies the operative procedure by avoiding dissection of the porta hepatis and subsequent choledochotomy.

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 VP019 TESAR - TOTALLY ENDOSCOPIC SUBLAY ANTERIOR REPAIR - IN MIDLINE DEFECTS REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Federico Fiori ◽  
Feancesco Ferrara ◽  
Daniele Gentile ◽  
Paolo Boati ◽  
Matteo Calì
Keyword(s):  
Operative Time ◽  
Intraoperative Complications ◽  
Endoscopic Approach ◽  
Anterior Repair ◽  
Exclusion Criteria ◽  
Diastasis Recti ◽  
Midline Defects ◽  
Previously Treated ◽  
The Mean ◽  
Invasive Techniques

Abstract Aim In recent years, many minimally invasive techniques have been presented in abdominall wall repair. Since 2018 we have been using TESAR techinque, an anterior endoscopic approach with mesh sublay, published in 2019 from our group. Material and Methods From May 2018 to May 2021 58 Patients referred to our Unit for clinical and radiological diagnosis of ventral defect (Midline hernia, Incisional hernia, Diastasis Recti>5 cm). Exclusion criteria were: maximum defeact width 8 cm, and contraindications to general anesthesia Results All the patients underwent midline repair with TESAR technique. Three TAR were performed, with defect of 8 cm width previously treated with botox. No conversion to laparotomy occured, no intraoperative complications were registered. Total mean operative time was 156 +- 21,5 min. No postoperative major complications, 3 subcoutaneous seromas occurred ,all treated conservatively. The mean Hospital stay was 2.7 + 0.8 days. Conclusions TESAR is a feasible technique for extraperitoneal repair of midline defects with a totally endoscopic approach, allowing a safe repair with good outcomes in terms of resolutions of symtoms and postoperative complications. The video shows the main steps of the technique in diastasis recti and complicated ventral hernia repair.

Glissonean pedicle approach using Takasaki method in liver resection at Hue Central Hospital

2019 ◽  
pp. 8-11
Author(s):  
Van Linh Ho
Keyword(s):  
Operative Time ◽  
Hepatic Duct ◽  
Postoperative Mortality ◽  
Descriptive Study ◽  
Common Hepatic Duct ◽  
Effective Technique ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Glissonean Pedicle ◽  
The Mean

Objective: To apply hepatectomy using Takasaki procedure to control Glissonean pedicle. Methods: A prospective, descriptive study on 31 patients undergoing hepatectomy using Takasaki Glissonean pedicle approach. Results: The mean age was 55 ± 11.7 (39 – 73 years), male/female ratio was 7.3. The mean operative time was 115 ± 37 minutes. The mean blood loss was 271 ± 119 ml. There was one case of common hepatic duct injury (3.6%). Postoperative complications occurred in 7(22.4%) patients. There was no postoperative mortality. Conclusions: Hepatectomy using Takasaki Glissonean pedicle approach was safe and effective technique. Keywords: Glissonean pedicle approach, hepatectomy

Endoscopy-assisted wide-vertex craniectomy, “barrel-stave” osteotomies, and postoperative helmet molding therapy in the early management of sagittal suture craniosynostosis

2000 ◽  
Vol 9 (3) ◽  
pp. 1-6 ◽  
Author(s):  
David F. Jimenez ◽  
Constance M. Barone
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Hospital Length Of Stay ◽  
Hospital Charges ◽  
Sagittal Suture ◽  
Reconstructive Procedures ◽  
Early Management ◽  
Custom Made ◽  
The Mean

Object The purpose of this study was to assess the efficacy, safety, associated complications, and outcome in patients with sagittal suture craniosynostosis in whom endoscopy-assisted wide-vertex craniotomy and “barrel-stave” osteotomy were performed. Methods During a 4-year period, 59 patients with sagittal suture synostosis underwent endoscopy-assisted wide-vertex craniectomies, barrel stave–like osteotomies, and postoperatively were fitted with custom-made molding helmets. Data on operative time, blood loss, transfusion rates, hospital length of stay, complications, and hospital charges were collected prospectively. The mean patient age at the time of surgery was 3.7 months. The average blood loss was 31.8 ml; and only one patient required an intraoperative blood transfusion. Nine patients received transfusions of donor blood postoperatively. The mean operative time was 50 minutes, and all but three patients were discharged from the hospital the morning following surgery. There were no intraoperative complications. Normocephaly as well as normal cephalic indices were observed at latest follow up. Conclusions The authors conclude that early treatment of infants with sagittal suture craniosynostosis by using minimally invasive, endoscopy-assisted wide-vertex craniectomies provides excellent results and a significantly lower morbidity rate than traditional calvarial vault reconstructive procedures.

Short-term Results Of Sclerotherapy With 3% Polidocanol Foam For Symptomatic Second- And Third-degree Haemorrhoidal Disease

2019 ◽  
Author(s):  
Pierluigi Lobascio ◽  
Rita Laforgia ◽  
Eugenio Novelli Novelli ◽  
Fabrizio Perrone ◽  
Maria Di Salvo ◽  
...  
Keyword(s):  
Operative Time ◽  
Intraoperative Complications ◽  
Cost Effective ◽  
Daily Activities ◽  
Anal Continence ◽  
Short Term ◽  
Haemorrhoidal Disease ◽  
Post Operative Pain ◽  
Symptom Scores ◽  
The Mean

Abstract Background.Haemorrhoidal disease (HD) is defined as the symptomatic enlargement and/or distal displacement of anal cushions and is one of the most common proctological diseases. Sclerotherapy (ST) with 3% polidocanol foam induces an inflammatory reaction with sclerosis of the submucosal tissue and consequent suspension of the haemorrhoidal tissue. The aim of this study was to evaluate the short-term effectiveness and safety of ST with 3% polidocanol foam for the treatment of symptomatic second- and third-degree HD. Methods.A total of 66 patients with symptomatic second- and third-degree HD underwent a single ST session between March 2017 and July 2018. A visual analogue scale score was used to assess post-operative pain and patient satisfaction. The symptoms severity and anal continence were investigated through a self-reported questionnaire and Vaizey score, respectively, at baseline, at 4 weeks and after 1 year. Results. Fifty-seven out of 66 patients were male (86.3%), and the mean age was 52 (29-75; SD ± 12) years. The mean operative time was 4.5 (2-6; SD ± 1.23) minutes. No intraoperative complications and no drug-related side effects occurred. The overall success rate was 78.8% (52/66 patients) after a single ST session and 86% after two ST sessions (57/66 patients). The mean treatment effect, obtained comparing preoperative and T5 symptom scores in each patient, showed a mean change of 7.88 (p<0.001). All patients resumed their normal daily activities the day after the procedures. Conclusions.ST with 3% polidocanol foam is a safe, cost-effective and repeatable conservative treatment.

scholarly journals Comparative Study between Complications of Abdominoplasty after Weight Loss by Bariatric Surgeries versus Weight Loss by Non Surgical Methods

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A Aamer ◽  
M S Eskandaros ◽  
M A N Metwali
Keyword(s):  
Weight Loss ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Skin Flap ◽  
Leading Role ◽  
Drain Removal ◽  
Surgical Methods ◽  
The Mean ◽  
The Individual ◽  
Surgical Group

Abstract Background The abdomen plays a leading role in the aesthetic image of the human body, and is of prime importance in defining the overall contour of the individual. The abdomen is cited as the location with the most severe deformities after weight loss and the deformities are highly variable. Objectives The aim of this study is to compare between complications of abdominoplasty after weight loss by bariatric surgeries versus weight loss by non surgical methods according to operative time, intraoperative complications: bleeding, postoperative complications: seroma, hematoma, infection, wound-healing problems, and skin flap necrosis and final aesthetic outcome. Patients and Methods This study includes forty patients with abdominal wall redundancy after bariatric surgeries and non surgical methods. All the patients will be examined as regards age, sex, weight, height, BMI, general examination, co-morbidities & associated ventral hernia. This study was conducted in 6 months between April 2017 and October 2017 on patients who were admitted to El Demerdash hospital or authorized medical institutions under supervision of thesis supervisors. Results In this study the mean age of the post bariatric group was 44 years and the non surgical group was 42.4 years. The mean BMI of the post bariatric group was 29.9, a little higher than the non surgical group which was 28. The Pre - loss BMI of the post bariatric group was higher than the non surgical group. The ideal lost weight, actual lost weight and percent of lost weight of the post bariatric group was higher than the non surgical group. The resection weight and the operative time of the post bariatric group were higher than the non surgical group. The amount of drain day1, total amount of drain l& drain removal day of the post bariatric group was higher than the non surgical group. Conclusion To conclude, abdominoplasty after weight loss by bariatric surgeries has higher risk of complications more than abdominoplasty after non surgical methods.

Microdebrider-Assisted Supraglottoplasty for Laryngomalacia

2009 ◽  
Vol 118 (8) ◽  
pp. 592-597 ◽  
Author(s):  
Jan C. Groblewski ◽  
Rahul K. Shah ◽  
George H. Zalzal
Keyword(s):  
Surgical Treatment ◽  
Gastroesophageal Reflux ◽  
Outcome Measures ◽  
Revision Surgery ◽  
Retrospective Review ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Age At Diagnosis ◽  
Average Operative Time ◽  
The Mean

Objectives We describe our series in the surgical treatment of laryngomalacia using a microdebrider. Methods We performed a retrospective review of patients who underwent microdebrider-assisted supraglottoplasty for laryngomalacia between October 2004 and February 2008. Patients with neurologic conditions and secondary airway lesions were excluded. The main outcome measures included complications, pain, resolution of stridor, presence of aspiration, and need for revision surgery. Results Twenty-eight patients underwent microdebrider-assisted supraglottoplasty. The mean age at diagnosis was 109 days, and the mean age at the time of the procedure was 182 days. Nineteen patients (68%) had gastroesophageal reflux at diagnosis. The average operative time was 35.7 minutes (range, 11 to 65 minutes). No intraoperative complications or device problems occurred. Two patients remained intubated after the procedure. One patient required a tracheotomy, and 1 patient underwent revision supraglottoplasty. Three patients had aspiration that resolved. There was negligible pain from the procedure, as all patients immediately resumed a diet. All patients had immediate or eventual resolution of stridor. Conclusions This is the largest series of patients who underwent microdebrider-assisted supraglottoplasty for laryngomalacia. This procedure is relatively safe, with minimal pain, and effective in patients with laryngomalacia. Microdebrider-assisted supraglottoplasty is the method of choice for supraglottoplasty in our institution.

scholarly journals Short-term Results Of Sclerotherapy With 3% Polidocanol Foam For Symptomatic Second- And Third-degree Haemorrhoidal Disease

2019 ◽  
Author(s):  
Pierluigi Lobascio ◽  
Rita Laforgia ◽  
Eugenio Novelli Novelli ◽  
Fabrizio Perrone ◽  
Maria Di Salvo ◽  
...  
Keyword(s):  
Operative Time ◽  
Intraoperative Complications ◽  
Cost Effective ◽  
Daily Activities ◽  
Anal Continence ◽  
Short Term ◽  
Haemorrhoidal Disease ◽  
Post Operative Pain ◽  
Symptom Scores ◽  
The Mean

Abstract Background . Haemorrhoidal disease (HD) is defined as the symptomatic enlargement and/or distal displacement of anal cushions and is one of the most common proctological diseases. Sclerotherapy (ST) with 3% polidocanol foam induces an inflammatory reaction with sclerosis of the submucosal tissue and consequent suspension of the haemorrhoidal tissue. The aim of this study was to evaluate the short-term effectiveness and safety of ST with 3% polidocanol foam for the treatment of symptomatic second- and third-degree HD. Methods . A total of 66 patients with symptomatic second- and third-degree HD underwent a single ST session between March 2017 and July 2018. A visual analogue scale score was used to assess post-operative pain and patient satisfaction. The symptoms severity and anal continence were investigated through the Hemorrhoid Severity Score (HSS) and Vaizey score, respectively, at baseline, at 4 weeks and after 1 year. Results . Fifty-seven out of 66 patients were male (86.3%), and the mean age was 52 (29-75; SD ± 12) years. The mean operative time was 4.5 (2-6; SD ± 1.23) minutes. No intraoperative complications and no drug-related side effects occurred. The overall success rate was 78.8% (52/66 patients) after a single ST session and 86% after two ST sessions (57/66 patients). The mean treatment effect, obtained comparing preoperative and T5 symptom scores in each patient, showed a mean change of 7.88 (p<0.001). All patients resumed their normal daily activities the day after the procedures. Conclusions . ST with 3% polidocanol foam is a safe, cost-effective and repeatable conservative treatment.

scholarly journals C2 quad-screws facilitate 4-rod fixation across the cervico-thoracic junction

2021 ◽  
Vol 12 ◽  
pp. 40
Author(s):  
Clarke I. Cady-McCrea ◽  
Michael A. Galgano
Keyword(s):  
Thoracic Spine ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Spine Deformity ◽  
Cervicothoracic Junction ◽  
Fusion Technique ◽  
Estimated Blood Loss ◽  
The Mean ◽  
Spine Fixation

Background: Cervical spine deformity is a potentially devitalizing problem. Contemporary techniques for repair and reconstruction include fusion using rods of tapered diameter alone, or quadruple-rod constructs in which primary rods are joined to floating accessory rods by connectors. Here, we present how we utilized a quadruple-rod construct to perform five C2 to thoracic spine fusions. Methods: Our hospital electronic medical record revealed five patients who underwent the four rod C2-thoracic spine fixation. Patients ranged in age from 14-years-old to 78-years-old. The mean operative time was 715.8 min (range 549–987 min), and average estimated blood loss was 878 cc (range 40–1800 cc). Results: None of the five patients sustained any intraoperative complications, and none demonstrated progressive kyphotic deformity over the average follow-up interval of 8 months. Conclusion: We successfully treated five patients with degenerative or oncologic cervical pathology requiring fixation across the cervicothoracic junction utilizing a 4-rod C2-cervicothoracic fusion technique.

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