Video-Assisted Jejunostomy Tube Placement With Two Portals: Surgical Technique in Ten Steps

2021 ◽  
pp. 155335062098432
Author(s):  
Phillipe Abreu ◽  
Raphaella Ferreira ◽  
Victor Mineli ◽  
Danilo S. Bussyguin ◽  
Luiz B. Dantas ◽  
...  
Keyword(s):  
Operative Time ◽  
Tube Placement ◽  
Laparoscopic Technique ◽  
Limited Capacity ◽  
Gastric Cavity ◽  
Jejunostomy Tube ◽  
Video Assisted ◽  
Endoscopic Gastrostomy ◽  
Incision Size ◽  
Esophageal Tumors

Objectives. Endoscopic gastrostomy occasionally presents limitations such as costs, availability of equipment and special materials, and difficult access to the gastric cavity in the setting of obstructive esophageal tumors. Open jejunostomies present high rates of postoperative complications and limited capacity for abdominal evaluation due to reduced incision size. Thus, to reduce procedure-related complications and overall costs and provide a thorough intraoperative evaluation of the peritoneal cavity, we present the following simplified technique. Methods. Video-assisted jejunostomy in ten steps. Results. The use of this Video-assisted laparoscopic technique proves to be a safe, viable alternative, with cost reduction, decreased use of disposable materials, shortened operative time, and accelerated recovery, in addition to increased technical ease and wide applicability across a variety of hospital settings.

Endoscopic and Surgical Gastrostomy and Jejunostomy Tube Placement

2018 ◽  
Vol 02 (01) ◽  
pp. 053-061
Author(s):  
Kevin El-Hayek ◽  
Marita Bauman
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Jejunostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Surgical Gastrostomy ◽  
Tools And Techniques ◽  
Invasive Techniques

AbstractEnteral access is a common request for consulting surgeons and interventionists. Prior to the 1980s, such a consultation often necessitated open surgical intervention whereas today, enteral access is often performed via several minimally invasive methods. Tools and techniques for minimally invasive enteral access have changed drastically due to advancements in the fields of endoscopy, laparoscopy, and interventional radiology. Percutaneous endoscopic gastrostomy tube placement is one such advancement. Since its first development, its basic principles have been applied to other minimally invasive techniques, which have resulted in an expansion of techniques for establishment of enteral access. In this article, we outline various endoscopic and surgical techniques for gastric and jejunal access.

Subxiphoid versus intercostal uniportal video-assisted thoracoscopic surgery for bilateral lung resections: a single-institution experience

2019 ◽  
Author(s):  
Haomin Cai ◽  
Dong Xie ◽  
Samer Al Sawalhi ◽  
Lei Jiang ◽  
Yuming Zhu ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Blood Loss ◽  
Operative Time ◽  
Thoracoscopic Surgery ◽  
Tube Placement ◽  
Lung Lesions ◽  
Video Assisted ◽  
Bilateral Lung ◽  
Lung Resections ◽  
Video Assisted Thoracoscopic Surgery

Abstract OBJECTIVES Subxiphoid uniportal video-assisted thoracoscopic surgery (SUVATS) is a technically difficult and challenging operation that can help decrease pain around the incision after traditional intercostal uniportal video-assisted thoracoscopic surgery (IUVATS), and can also treat bilateral lesions through the same incision. We aimed to compare perioperative outcomes and pain scores after SUVATS and IUVATS in patients receiving synchronous treatment of bilateral lung lesions. METHODS Patients who received SUVATS and IUVATS bilateral lung resections from September 2014 to February 2018 were analysed. Ultimately a total of 381 cases were analysed after using one-to-one propensity score matching to match baseline characteristics between the 2 groups. RESULTS The 381 patients included 56 with SUVATS and 325 with IUVATS. After matching, 54 SUVATS and 54 IUVATS cases were analysed. The 2 groups had similar preoperative factors and did not differ with respect to duration of chest tube placement, length of stay in hospital and incidence of postoperative complications. SUVATS was associated with a significantly longer operative time (212.3 vs 154.6 min, P < 0.001) and more blood loss (190.9 vs 72.7 ml, P < 0.001), lower pain score on the first day after operation (2.6 vs 3.0, P = 0.03) and before discharge (0.8 vs 1.4, P < 0.001). Furthermore, less patients in group SUVATS requested for additional analgesic therapy (P = 0.03). CONCLUSIONS Compared with IUVATS, despite the longer operative time and greater blood loss, SUVATS for bilateral lung lesions is a safe surgical procedure associated with significantly less postoperative pain and a similar incidence of postoperative complications in selected patients.

Nonintubated Uniportal Thoracoscopic Thymectomy with Laryngeal Mask

2019 ◽  
Vol 68 (05) ◽  
pp. 450-456 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang ◽  
Yang Sun
Keyword(s):  
Thoracoscopic Surgery ◽  
Anterior Mediastinum ◽  
Laryngeal Mask ◽  
Double Lumen Tube ◽  
Perioperative Outcomes ◽  
Video Assisted ◽  
Incision Size ◽  
The Mean ◽  
End Tidal ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objective To investigate whether laryngeal mask anesthesia had more favorable postoperative outcomes than double-lumen tube intubation anesthesia in uniportal thoracoscopic thymectomy. Methods Data were collected retrospectively from December 2013 to December 2017. A total of 96 patients with anterior mediastinum mass underwent nonintubated uniportal video-assisted thoracoscopic thymectomy with laryngeal mask, and 129 patients underwent intubated uniportal video-assisted thoracoscopic thymectomy. A single incision of ∼3 cm was made in an intercostal space along the anterior axillary line. Perioperative outcomes between nonintubated uniportal video-assisted thoracoscopic surgery (NU-VATS) and intubated uniportal video-assisted thoracoscopic surgery (IU-VATS) were compared. Results In both groups, incision size was kept to a minimum, with a median of 3 cm, and complete thymectomy was performed in all patients. Mean operative time was 61 minutes. The mean lowest SpO2 during operation was not significantly different. However, the mean peak end-tidal carbon dioxide in the NU-VATS group was higher than in the IU-VATS group. Mean chest tube duration in NU-VATS group was 1.9 days. Mean postoperative hospital stay was 2.5 days, with a range of 1 to 4 days. Time to oral fluid intake in the NU-VATS group was significantly less than in the IU-VATS group (p < 0.01). Several complications were significantly less in the NU-VATS group than in the IU-VATS group, including sore throat, nausea, irritable cough, and urinary retention. Conclusion Compared with intubated approach, nonintubated uniportal thoracoscopic thymectomy with laryngeal mask is feasible for anterior mediastinum lesion, and patients recovered faster with less complications.

scholarly journals Comparison of non-intubated and intubated video-assisted thoracoscopic surgeries of major pulmonary resections for lung cancer—a meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wenfei Xue ◽  
Guochen Duan ◽  
Xiaopeng Zhang ◽  
Hua Zhang ◽  
Qingtao Zhao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracic Surgery ◽  
Postoperative Complication ◽  
Complication Rate ◽  
Chest Tube ◽  
Meta Analysis ◽  
Tube Placement ◽  
Postoperative Complication Rate ◽  
Chest Tube Placement ◽  
Video Assisted

Abstract Objective The aim of this study was to compare the safety feasibility and safety feasibility of non-intubated (NIVATS) and intubated video-assisted thoracoscopic surgeries (IVATS) during major pulmonary resections. Methods A meta-analysis of eight studies was conducted to compare the real effects of two lobectomy or segmentectomy approaches during major pulmonary resections. Results Results showed that the patients using NIVATS had a greatly shorter hospital stay and chest-tube placement time (weighted mean difference (WMD): − 1.04 days; 95% CI − 1.50 to − 0.58; P < 0.01) WMD − 0.71 days; 95% confidence interval (CI), − 1.08 to − 0.34; P < 0.01, respectively) while compared to those with IVATS. There were no significant differences in postoperative complication rate, surgical duration, and the number of dissected lymph nodes. However, through the analysis of highly selected patients with lung cancer in early stage, the rate of postoperative complication in the NIVATS group was lower than that in the IVATS group [odds ratio (OR) 0.44; 95% CI 0.21–0.92; P = 0.03, I2 = 0%]. Conclusions Although the comparable postoperative complication rate was observed for major thoracic surgery in two surgical procedures, the NIVATS method could significantly shorten the hospitalized stay and chest-tube placement time compared with IVATS. Therefore, for highly selected patients, NIVATS is regarded as a safe and technically feasible procedure for major thoracic surgery. The assessment of the safety and feasibility for patients undergoing NIVATS needs further multi-center prospective clinical trials.

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