Giant Bochdalek Hernia: A Minimally Invasive Transabdominal Approach

Abstract Objective: To describe a minimally invasive comprehensive treatment for granulomatous lobular mastitis (GLM) and compare its effect with the existing methods, particularly in terms of its recurrence rate and esthetic outcomes. Methods: This retrospective study reviewed 69 GLM patients receiving the minimally invasive comprehensive treatment. Patients’ information, including age, clinical features, image characteristics, histopathological findings, mastitis history, treatment process, operative technique, recurrence, and esthetic effect, was evaluated. Results: All patients were female with a median age of 32 (range 17 - 55) years. Hospital stays ranged from 2 to 34 days, with a median of 6 days. The shortest time for complete rehabilitation was 2 days and the longest time was 365 days, with a median of 30 days. After a median follow-up of 391 days (range 162 - 690), 7 patients (10.14%) relapsed. The average cosmetic score was 2.62 ± 0.57 points and was mainly related to the past treatment, especially the surgical history. Conclusion: Minimally invasive comprehensive treatment is a new method for the treatment of GLM, ensuring a therapeutic effect while maintaining breast beauty.

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Minimálisan invazív, endoszkóppal asszisztált, transcribriform reszekció a koponyaalap rosszindulatú daganatainak sebészetében

Orvosi Hetilap ◽

10.1556/650.2019.31473 ◽

2019 ◽

Vol 160 (40) ◽

pp. 1584-1590

Author(s):

Zalán Piski ◽

András Büki ◽

Imre Gerlinger ◽

István Tóth ◽

Nelli Nepp ◽

...

Keyword(s):

Minimally Invasive ◽

Skull Base ◽

Intraoperative Complications ◽

Anterior Skull Base ◽

Open Approach ◽

Malignant Tumours ◽

Recurrent Tumour ◽

Intestinal Type Adenocarcinoma ◽

The Mean

Abstract: Introduction: Malignant tumours of the sinonasal region – including those with invasion of the skull base – necessitate surgical resection. The majority of the cases give an opportunity to perform the procedure via minimally invasive, endoscopic approach, without external, craniofacial surgery. Aim: To assess our clinical experience in treating anterior skull base malignancies, performing minimally invasive endoscopic transcribriform resection. Method: Between February 2015 and July 2017, four male and one female patient underwent minimally invasive, endoscopic skull base procedure. The mean age was 64.6 years (59–70, median: 66). Every surgery was performed via transnasal, endoscopic transcribriform approach. In two cases Kadish C esthesioneuroblastomas, while in one case a T3N0 sinonasal non-differentiated carcinoma, a T1N0 intestinal type adenocarcinoma and a T4N0 squamous cell carcinoma was the indication of surgery, respectively. Results: The mean follow-up time was 22.8 months, between 14 and 46 months. Intraoperative complications did not occur during the procedures. Regarding the postoperative period, liquorrhoea and pneumocephalus occurred in one case. Complications were solved with lumbar drainage. During follow-up, neither residual nor recurrent tumour was observed in our patients. Conclusion: Endoscopic transcribriform resection of the skull base malignancies is a safe and viable alternative to the traditional open approach. Orv Hetil. 2019; 160(40): 1584–1590.

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Minimally invasive scoliosis surgery assisted by O-arm navigation for Lenke Type 5C adolescent idiopathic scoliosis: a comparison with standard open approach spinal instrumentation

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.11.peds16412 ◽

2017 ◽

Vol 19 (4) ◽

pp. 472-478 ◽

Cited By ~ 18

Author(s):

Weiguo Zhu ◽

Weixiang Sun ◽

Leilei Xu ◽

Xu Sun ◽

Zhen Liu ◽

...

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Minimally Invasive ◽

Idiopathic Scoliosis ◽

Spinal Instrumentation ◽

Deformity Correction ◽

Scoliosis Surgery ◽

Open Approach ◽

Additional Surgery ◽

Estimated Blood Loss

OBJECTIVE Recently, minimally invasive scoliosis surgery (MISS) was introduced for the correction of adult scoliosis. Multiple benefits including a good deformity correction rate and fewer complications have been demonstrated. However, few studies have reported on the use of MISS for the management of adolescent idiopathic scoliosis (AIS). The purpose of this study was to investigate the outcome of posterior MISS assisted by O-arm navigation for the correction of Lenke Type 5C AIS. METHODS The authors searched a database for all patients with AIS who had been treated with either MISS or PSF between November 2012 and January 2014. Levels of fusion, density of implants, operation time, and estimated blood loss (EBL) were recorded. Coronal and sagittal parameters were evaluated before surgery, immediately after surgery, and at the last follow-up. The accuracy of pedicle screw placement was assessed according to postoperative axial CT images in both groups. The 22-item Scoliosis Research Society questionnaire (SRS-22) results and complications were collected during follow-up. RESULTS The authors retrospectively reviewed the records of 45 patients with Lenke Type 5C AIS, 15 who underwent posterior MISS under O-arm navigation and 30 who underwent posterior spinal fusion (PSF). The 2 treatment groups were matched in terms of baseline characteristics. Comparison of radiographic parameters revealed no obvious difference between the 2 groups immediately after surgery or at the final follow-up; however, the MISS patients had significantly less EBL (p < 0.001) and longer operation times (p = 0.002). The evaluation of pain and self-image using the SRS-22 showed significantly higher scores in the MISS group (p = 0.013 and 0.046, respectively) than in the PSF group. Postoperative CT showed high accuracy in pedicle placement in both groups. No deep wound infection, pseudarthrosis, additional surgery, implant failure, or neurological complications were recorded in either group. CONCLUSIONS Minimally invasive scoliosis surgery is an effective and safe alternative to open surgery for patients with Lenke Type 5C AIS. Compared with results of the open approach, the outcomes of MISS are promising, with reduced morbidity. Before the routine use of MISS, however, long-term data are needed.

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Minimally Invasive Dorsal Cheilectomy and Hallux Metatarsal Phalangeal Joint Arthroscopy for the Treatment of Hallux Rigidus

Foot & Ankle Orthopaedics ◽

10.1177/2473011421993103 ◽

2021 ◽

Vol 6 (1) ◽

pp. 247301142199310

Author(s):

Rachel L. Glenn ◽

Tyler A. Gonzalez ◽

Alexander B. Peterson ◽

Jonathan Kaplan

Keyword(s):

Minimally Invasive ◽

Range Of Motion ◽

Hallux Rigidus ◽

Wound Complications ◽

Common Source ◽

Open Approach ◽

Loose Bodies ◽

Case Series Study ◽

Articular Pathology

Background: Hallux rigidus (HR) is a common source of forefoot pain and disability. For those who fail nonoperative treatment, minimally invasive dorsal cheilectomy (MIDC) is an increasingly popular alternative to the open approach with early positive results. Early failures may be due to lose bone debris from the MIDC as well as other intra-articular pathology that cannot be addressed with MIDC alone. Metatarsophalangeal (MTP) arthroscopy can be used in addition to MIDC to assess the joint after MIDC and address any intra-articular pathology while still maintaining the benefits of minimally invasive surgery. We report our clinical outcomes following MIDC combined with MTP arthroscopy. Methods: From November 2017 to July 2020, a retrospective analysis of all MIDC cheilectomies with MTP arthroscopy performed by the 2 senior authors was done. Wound complications, infections, revision rates, need for future surgery, conversion to fusion rates, pre- and postoperative range of motion, visual analog scale (VAS) scores, time to return to normal shoe, intraoperative arthroscopic findings, and operative time were collected. Follow-up average was 16.5 months (range 3-33 months). Results: A total of 20 patients were included with an average follow-up of 16.5 months. The average VAS score improved from 7.05 preoperatively to 0.75 postoperatively ( P < .05). Average range of motion in dorsiflexion increased from 32 to 48 degrees ( P < .05) and plantarflexion increased from 15 to 19 degrees plantarflexion ( P < .05). All patients were weightbearing as tolerated immediately after surgery in a postoperative shoe and transitioned to a regular shoe at average of 2.1 weeks. We had no wound infections, wound complications, revision surgeries, tendon injuries or nerve damage. One patient required conversion to a fusion 3 years after the index procedure. Average tourniquet time was 30.39 minutes (range 17-60 minutes) and total average operating room time was 59.7 minutes (range 40-87 minutes). On arthroscopic evaluation of the MTP joint after MIDC, 100% of patients had bone debris, 100% had synovitis, 10% had loose bodies, and 30% had large cartilage flaps within the joint. Conclusion: MIDC and first MTP joint arthroscopy for treatment of hallux rigidus provide improved pain relief with minimal complications while still maintaining the benefits touted for minimally invasive operative procedures. Additionally, we have shown a high rate of intra-articular debris along with intra-articular pathology such as synovitis, loose chondral flaps, and loose bodies that exist after MIDC. This combined procedure has the potential for improving patient outcomes and may minimize risk of future revision surgeries compared with MIDC alone. Level of Evidence: Level IV, case series study.

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Minimally invasive comprehensive treatment for granulomatous lobular mastitis

10.21203/rs.2.16905/v3 ◽

2020 ◽

Author(s):

Yaohuai Wang ◽

Junlong Song ◽

Yi Tu ◽

Chuang Chen ◽

Shengrong Sun

Keyword(s):

Retrospective Study ◽

Minimally Invasive ◽

Operative Technique ◽

Treatment Process ◽

Comprehensive Treatment ◽

The Past ◽

Image Characteristics ◽

Surgical History ◽

Hospital Stays

Abstract Objective: To describe a minimally invasive comprehensive treatment for granulomatous lobular mastitis (GLM) and compare its effect with the existing methods, particularly in terms of its recurrence rate and esthetic outcomes. Methods: This retrospective study reviewed 69 GLM patients receiving the minimally invasive comprehensive treatment. Patients’ information, including age, clinical features, image characteristics, histopathological findings, mastitis history, treatment process, operative technique, recurrence, and esthetic effect, was evaluated. Results: All patients were female with a median age of 32 (range 17 - 55) years. Hospital stays ranged from 2 to 34 days, with a median of 6 days. The shortest time for complete rehabilitation was 2 days and the longest time was 365 days, with a median of 30 days. After a median follow-up of 391 days (range 162 - 690), 7 patients (10.14%) relapsed. The average cosmetic score was 2.62 ± 0.57 points and was mainly related to the past treatment, especially the surgical history. Conclusion: Minimally invasive comprehensive treatment is a new method for the treatment of GLM, ensuring a therapeutic effect while maintaining breast beauty.

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Surgical Approach to Frontal Sinus Osteoma: A Systematic Review

American Journal of Rhinology and Allergy ◽

10.1177/1945892419839895 ◽

2019 ◽

Vol 33 (5) ◽

pp. 462-469 ◽

Cited By ~ 3

Author(s):

Duncan C. Watley ◽

Eric R. Mong ◽

Nikunj A. Rana ◽

Elisa A. Illing ◽

Mohamad R. Chaaban

Keyword(s):

Systematic Review ◽

Surgical Approach ◽

Frontal Sinus ◽

Clinical Presentation ◽

Sagittal Plane ◽

Residual Disease ◽

Complete Removal ◽

Open Approach ◽

The Past

Background Osteoma of the paranasal sinuses are benign bony masses most commonly found in the frontal sinus. In the past, due to the anatomical complexity of the frontal sinus, these often required an open approach, but with the invention of angled tools and endoscopes, many rhinologists are now attempting endoscopic or combined resections. No large systematic reviews currently exist that describe the surgical management of frontal sinus osteoma. Objective To perform a systematic review detailing the surgical resection of frontal sinus osteoma. Review Methods: A systematic literature review was performed using PubMed, Embase, and Ovid databases. Data extracted included demographics, clinical presentation, radiologic, histologic findings, surgical approach, and recurrence. Results A total of 32 studies, with 477 surgically resected tumors, were included in the analysis. Sex data were available for 179 patients (M:F, 93:86), with a mean age of 43.2 years. All resected tumors presented symptomatically: facial pain/headache (80.2%), recurrent sinusitis (30.5%), mucocele (4.3%), cosmetic deformity other than proptosis (12.8%), and proptosis (5.5%). Transnasal endoscopic surgery alone was the most common surgical approach utilized (44.9%), followed by open osteoplastic flaps (36.9%) and endoscopic assisted (18.2%). Osteoma with anterior (79%) and posterior (73%) attachments were treated statistically more often with endoscopic approach compared with floor (42%) and extrasinus (50%) attachment ( P < .0005). There was no statistical difference in approach to masses that crossed the sagittal plane extending from the lamina papyracea (63% endoscopic, 29% endoscopic assisted, 8% open, P = .21). Mean follow-up was 29.7 months, with recurrence or persistent residual disease occurring in 12 patients. Conclusion Despite the increasing use of endoscopic alone procedures for expanding indications, patients may still require an open or endoscopic assisted approach for complete removal.

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Endoscopy-assisted Approaches for Anterior Column Reconstruction after Pedicle Screw Fixation of Acute Traumatic Thoracic and Lumbar Fractures

Operative Neurosurgery ◽

10.1227/01.neu.0000326033.69961.c1 ◽

2008 ◽

Vol 62 (suppl_5) ◽

pp. ONS445-ONS453 ◽

Cited By ~ 11

Author(s):

Florian Ringel ◽

Michael Stoffel ◽

Carsten Stüer ◽

Silke Totzek ◽

Bernhard Meyer

Keyword(s):

Minimally Invasive ◽

Pedicle Screw ◽

Screw Fixation ◽

Pedicle Screw Fixation ◽

Anterior Column ◽

Open Approach ◽

Surgical Data ◽

Lumbar Fractures ◽

Anterior Column Reconstruction

Abstract Objective: Surgical treatment of thoracic and lumbar vertebral body fractures combines instrumentation to stabilize the fracture and an anterior reconstruction to promote fusion of the fractured spine. The aim of the present study was to show that minimally invasive thoracoscopic or endoscopy-assisted approaches to the thoracic and lumbar spine are feasible for anterior column reconstruction. Methods: This prospective, single-center study included 83 consecutive patients harboring 100 acute thoracic and lumbar vertebral fractures. Patients' neurological status; preoperative, postoperative, and follow-up radiographic data; and surgical data were obtained. Results: Fractures ranged from T5 to L5. All fractures underwent posterior pedicle screw fixation followed by a thoracoscopic or endoscopy-assisted anterior approach for anterior column reconstruction to promote fusion. Ventral graft position was correct in 45 patients and acceptable in 37 patients; one patient required a surgical repositioning. Initial correction of kyphosis was 9 degrees; during follow-up (23 ± 11 mo), the mean loss of correction was 6 degrees. In 84 minimally invasive approaches, five conversions to an open approach were necessary. Complications included one case of L1 nerve root injury, two cases of transient neurological worsening, one case of posterior wound infection, and one case of pleural empyema. Conclusion: The minimally invasive endoscopic approach for anterior column reconstruction is a feasible strategy in the treatment of unstable thoracic and lumbar fractures. Fracture type and the material of the anterior graft can affect long-term maintenance of correction.

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Proper Surgical Treatment of Small and Medium Size Umbilical Hernias. A Single Surgeon Experience

Journal of Interdisciplinary Medicine ◽

10.2478/jim-2020-0007 ◽

2020 ◽

Vol 5 (2) ◽

pp. 56-63

Author(s):

Etele Élthes ◽

Daniela Sala ◽

Radu Mircea Neagoe ◽

János Székely ◽

Márton Dénes

Keyword(s):

Minimally Invasive ◽

Therapeutic Option ◽

Minimal Invasive ◽

Medium Size ◽

Open Approach ◽

Invasive Treatment ◽

Minimally Invasive Surgical ◽

Surgeon Experience ◽

Group B

AbstractIntroduction: Minimally invasive surgical procedures have become routine interventions nowadays and represent an effective therapeutic option even for small umbilical hernias, providing favorable postoperative and aesthetic results.Aim of study: To determine the most appropriate minimally invasive treatment option for small and medium size umbilical hernias.Materials and methods: We conducted a prospective study on 50 patients with small or medium umbilical hernia (<4 cm). All patients benefited of minimal invasive surgery with mesh implantation. Depending on the surgical procedure, two major groups were defined: group A – patients with open surgical approach (n = 24) and group B – patients undergoing laparoscopic surgery (n = 26). Clinical, surgical, postoperative, and follow-up data were analyzed.Results: Mesh replacement via open approach through the umbilicus was associated with significantly reduced surgical time (p = 0.0359), administration of painkillers (p = 0.0461), and use of anticoagulants (p = 0.0404). Hospital stays (p = 0.0001) and costs (p = 0.0005) were also significantly lower in this group. After 6 months of follow-up, no recurrence was observed, and no significant differences were detected regarding postoperative pain and the patients’ professional reintegration. Patient satisfaction regarding postoperative scar was superior in the open group.Conclusion: The present study indicates that the ventral patch technique is a safe and effective method for the treatment of small and medium size umbilical hernias.

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Clinical outcomes of minimally invasive versus open approach for one-level transforaminal lumbar interbody fusion at the 3- to 4-year follow-up

European Spine Journal ◽

10.1007/s00586-013-2853-y ◽

2013 ◽

Vol 22 (12) ◽

pp. 2857-2863 ◽

Cited By ~ 39

Author(s):

Javier Rodríguez-Vela ◽

Antonio Lobo-Escolar ◽

Eduardo Joven ◽

Javier Muñoz-Marín ◽

Antonio Herrera ◽

...

Keyword(s):

Minimally Invasive ◽

Clinical Outcomes ◽

Interbody Fusion ◽

Transforaminal Lumbar Interbody Fusion ◽

Open Approach ◽

Lumbar Interbody Fusion

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Clinical and Radiological Outcomes of Subtalar Arthroereisis for Management of Planovalgus Foot in Children With Cerebral Palsy: 3-Year Follow-up

Foot & Ankle Specialist ◽

10.1177/1938640020980911 ◽

2020 ◽

pp. 193864002098091

Author(s):

Hasan Magdi Elbarbary ◽

Amr Said Arafa ◽

Abo Bakr Zein Said ◽

Mohamed Hegazy ◽

Mina Waheeb Reiad ◽

...

Keyword(s):

Cerebral Palsy ◽

Minimally Invasive ◽

Prospective Study ◽

Good Alternative ◽

Therapeutic Level ◽

The Past ◽

Children With Cerebral Palsy ◽

Subtalar Arthroereisis ◽

A Prospective Study

Background Planovalgus deformity of the foot is common among cerebral palsy (CP) patients. It is an upcoming topic with debate and controversy that require further studies. Many clinical studies involving arthroereisis have shown acceptable results in short- and mid-term follow-up. The aim of this work was to evaluate the outcome of arthroereisis using a conventional screw placed percutaneously across the talocalcaneal articulation for the treatment of moderate planovalgus deformity in children with CP. Methods Between 2015 and 2018, a prospective study was conducted including 23 CP patients with bilateral flexible planovalgus deformity with follow-up period ranging from 24 to 40 months (mean of 36.7 months). The radiological and clinical outcomes were assessed. The patient/parent outcome was evaluated using the Oxford Ankle Foot Questionnaire for Children (OxAFQ-C). Results The results showed statistically significant improvement in both radiological and clinical data as well as patient’s symptoms and parent’s satisfaction. Conclusion Results obtained from literature from the past decades after arthroereisis for the correction of moderate planovalgus deformity in CP patients are promising. The few studies reported on that procedure shared the same harmony with our study giving a chance to be a good alternative to joint destructive procedures. Our technique is simple, effective, economical, and minimally invasive if used in selected pediatric CP patients. Levels of Evidence Therapeutic, Level IV

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