scholarly journals Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus weighing ≥1 kg

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaojuan Wang ◽  
Junwei Li ◽  
Keqin Hua ◽  
Yisong Chen
Keyword(s):  
Endoscopic Surgery ◽  
Operating Time ◽  
Ureteral Injury ◽  
Indications For Surgery ◽  
Natural Orifice ◽  
Invasive Approach ◽  
Minimal Invasive Approach ◽  
Estimated Blood Loss ◽  
Large Uterus ◽  
The Mean

Abstract Background The transvaginal natural orifice transluminal endoscopic surgery (vNOTES) applied in gynecology has been developed recent years and been evolving. In this study, we aimed to evaluate the feasibility and effect of the vNOTES hysterectomy for uterus ≥1 kilogram (kg). Methods From January 2019 to March 2020, patients with benign indications in cases of uterus weighing ≥1 kg, underwent vNOTES hysterectomy were studied retrospectively. The patients’ demographics, indications for surgery, operation outcomes and follow-up details were recorded. Results 39 patients were performed vNOTES hysterectomy for large uterus (mean weight 1141.8 gram, range from 1000 to 1720), indications for surgery included bulky uterine myomas or adenomysosis. The mean age was 48 years (range 42–66) and mean BMI was 24 kg/m2 (range 18.4–38). Mean operating time was 123.3 min (rang 40–400) and the mean estimated blood loss was 206.7 milliliters  (range 10–1300). The mean pain assessment was 2.1 (range 0–5). The mean length of stay was 2.4 nights (1–11). 1 patient experienced ureteral injury and was performed ureteral anastomosis. 3 patients were converted to vaginal-assisted trans-umbilicus single-port laparoscopy. The learning curve was analyzed to show that 20 cases were needed to achieve proficiency in vNOTES hysterectomy for large uterus ≥1 kg. Conclusion Our preliminary experience suggested that vNOTES hysterectomy for large uterus weighing ≥1 kg was feasible and safe, meanwhile this procedure had the advantages of all the minimal invasive approach such as fast recovery and aesthetic advantage.

scholarly journals Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus weighing ≥ 1kg

2020 ◽  
Author(s):  
Xiaojuan Wang ◽  
Junwei LI ◽  
Keqin Hua ◽  
Yisong Chen
Keyword(s):  
Endoscopic Surgery ◽  
Operating Time ◽  
Ureteral Injury ◽  
Indications For Surgery ◽  
Natural Orifice ◽  
Invasive Approach ◽  
Minimal Invasive Approach ◽  
Estimated Blood Loss ◽  
Large Uterus ◽  
The Mean

Abstract Background: The transvaginal natural orifice transluminal endoscopic surgery (vNOTES) applied in gynecology has been developed recent years and been evolving. In this study, we aimed to evaluate the feasibility and effect of the vNOTES hysterectomy for uterus ≥ 1 kilogram (kg).Methods: From January 2019 to March 2020, patients with benign indications in cases of uterus weighing ≥ 1kg, underwent vNOTES hysterectomy were studied retrospectively. The patients’ demographics, indications for surgery, operation outcomes and follow-up details were recorded. Results: 39 patients were performed vNOTES hysterectomy for large uterus (mean weight 1141.8 gram, range from 1000 to 1720), indications for surgery included bulky uterine myomas or adenomysosis. The mean age was 48 years (range 42-66) and mean BMI was 24 kg/m2 (range 18.4-38). Mean operating time was 123.3 minutes (rang 40-400) and the mean estimated blood loss was 206.7 milliliters (range 10-1300). The mean pain assessment was 2.1 (range 0-5). The mean length of stay was 2.4 nights (1-11). 1 patient experienced ureteral injury and was performed ureteral anastomosis. 3 patients were converted to vaginal-assisted trans-umbilicus single-port laparoscopy. The learning curve was analyzed to show that 20 cases were needed to achieve proficiency in vNOTES hysterectomy for large uterus ≥ 1 kg.Conclusion: Our preliminary experience suggested that vNOTES hysterectomy for large uterus weighing ≥ 1kg was feasible and safe, meanwhile this procedure had the advantages of all the minimal invasive approach such as fast recovery and aesthetic advantage.

scholarly journals Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus weighing ≥ 1kg

2020 ◽  
Author(s):  
Xiaojuan Wang ◽  
Junwei LI ◽  
Keqin Hua ◽  
Yisong Chen
Keyword(s):  
Endoscopic Surgery ◽  
Operating Time ◽  
Ureteral Injury ◽  
Indications For Surgery ◽  
Natural Orifice ◽  
Invasive Approach ◽  
Minimal Invasive Approach ◽  
Estimated Blood Loss ◽  
Large Uterus ◽  
The Mean

Abstract Background: The transvaginal natural orifice transluminal endoscopic surgery (vNOTES) applied in gynecology has been developed recent years and been evolving. In this study, we aimed to evaluate the feasibility and effect of the vNOTES hysterectomy for uterus ≥ 1 kilogram (kg).Methods: From January 2019 to March 2020, patients with benign indications in cases of uterus weighing ≥ 1kg, underwent vNOTES hysterectomy were studied retrospectively. The patients’ demographics, indications for surgery, operation outcomes and follow-up details were recorded. Results: 39 patients were performed vNOTES hysterectomy for large uterus (mean weight 1141.8 gram, range from 1000 to 1720), indications for surgery included bulky uterine myomas or adenomysosis. The mean age was 48 years (range 42-66) and mean BMI was 24 kg/m2 (range 18.4-38). Mean operating time was 123.3 minutes (rang 40-400) and the mean estimated blood loss was 206.7 milliliters (range 10-1300). The mean pain assessment was 2.1 (range 0-5). The mean length of stay was 2.4 nights (1-11). 1 patient experienced ureteral injury and was performed ureteral anastomosis. 3 patients were converted to vaginal-assisted trans-umbilicus single-port laparoscopy. The learning curve was analyzed to show that 20 cases were needed to achieve proficiency in vNOTES hysterectomy for large uterus ≥ 1 kg.Conclusion: Our preliminary experience suggested that vNOTES hysterectomy for large uterus weighing ≥ 1kg was feasible and safe, meanwhile this procedure had the advantages of all the minimal invasive approach such as fast recovery and aesthetic advantage.

scholarly journals Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus weighing ≥ 1kg

2020 ◽  
Author(s):  
Xiaojuan Wang ◽  
Junwei LI ◽  
Keqin Hua ◽  
Yisong Chen
Keyword(s):  
Endoscopic Surgery ◽  
Operating Time ◽  
Ureteral Injury ◽  
Minimal Invasive ◽  
Natural Orifice ◽  
Invasive Approach ◽  
Minimal Invasive Approach ◽  
Estimated Blood Loss ◽  
Large Uterus ◽  
The Mean

Abstract Background: The transvaginal natural orifice transluminal endoscopic surgery (vNOTES) applied in gynecology has been developed recent years and been evolving. In this study, we aimed to evaluate the feasibility and effect of the transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus ≥ 1 kilogram (kg). Methods: From January 2019 to March 2020, 39 patients with benign indications in cases of uterus weighing ≥ 1kg, underwent vNOTES hysterectomy were studied retrospectively. The patient demographics, indications for surgery, operation outcomes and patient follow-up details were recorded.Results: The mean age was 48 years (range 42-66); the mean BMI was 24 kg/m 2 (range 18.4-38); the mean operating time was 123.3 minutes (rang 40-400), mean estimated blood loss was 206.7 milliliters (range 10-1300); the mean uterus weight was 1141.8 gram (g) (range 1000-1720). The mean pain assessment was 2.1 (range 0-5). The mean length of stay was 2.4 nights (1-11). 1 patient experienced ureteral injury and was performed ureteral anastomosis. 3 patients were converted to vaginal-assisted trans-umbilicus single-port laparoscopy. The learning curve was analyzed to show that 20 cases were needed to achieve proficiency in vNOTES hysterectomy for large uterus ≥ 1 kg. Conclusion: Our preliminary experience suggested that vNOTES hysterectomy for large uterus weighing ≥ 1kg was feasible and safe, meanwhile this procedure had the advantages of all the minimal invasive approach such as fast recovery and aesthetic advantage.

Laparoscopic Radical Nephrectomy: A Single Center Experience

2005 ◽  
Vol 72 (2) ◽  
pp. 238-242
Author(s):  
O. Sicuro ◽  
P. Veneziano ◽  
V. Sidari ◽  
L. Arcudi ◽  
L. Carbone ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Operating Time ◽  
Laparoscopic Approach ◽  
Laparoscopic Technique ◽  
Invasive Approach ◽  
Minimal Invasive Approach ◽  
The Mean ◽  
Stage T1

Renal cell carcinoma has become one of the most important indications for urological laparoscopic surgery. The laparoscopic technique combines the benefits of a minimal invasive approach with basic surgical principles. We report our experience with 52 procedures. Materials and methods Between June 2000 and December 2003 we performed 52 transperitoneal laparoscopic radical nephrectomies for clinical stage T1-T2 renal cell carcinoma. Median age of patients was 59 yrs (range 31–77 yrs). The mean tumor size was 5.4 cm (range 3–12 cm). Results In three patients (5.7%) conversion to open surgery was necessary. The mean operating time was 215 min (150–305 min). Post-operative hospitalization was 5.1 days (3–11 days). Median follow-up was 19.5 months (3–36 months). No cases of local recurrence or port metastasis occurred during observation. Conclusions In our center, a transperitoneal laparoscopic approach with the removal of intact specimens in endobags has become the standard treatment for stage T1-T2 N0 M0 renal cell carcinoma.

Advantages and limitations of the endoscopic tympanoscopy a prospective study

2020 ◽  
Vol 1 (1) ◽  
pp. 012-017
Author(s):  
Najib Zouhair ◽  
Anass Chaouki ◽  
Amine M’khatri ◽  
Youssef Oukessou ◽  
Sami Rouadi ◽  
...  
Keyword(s):  
Middle Ear ◽  
Operating Time ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Invasive Approach ◽  
Intraoperative Bleeding ◽  
Advantages And Disadvantages ◽  
Early Return ◽  
The Mean ◽  
Endoscopic Tympanoplasty

Tympanoplasty is one of the most performed procedures in ENT. The aggressiveness of its microscopic approach has led otologists to adopt the endoscopic approach as a less invasive alternative. The purpose of this work is to appreciate the advantages and disadvantages of this surgical technique. We conducted a prospective descriptive cross-sectional study on 20 interventions within the ENT department of August the 20th 1953 Hospital of Casablanca from April 2019 to June 2019. The average age of operated patients was 36.3 years. Perforations were unilateral in (71%) of the cases with a predominance of the anterior (29%) and subtotal (36%) locations. The tympanoplasties were performed by 3 different senior otologic surgeons, and were left in (57%). The mean operating time was (59.5 min) and the mean anesthesia duration was 75.1 min. Intraoperative vision allowed us to fully visualize the margins of all perforations (100%) and anatomical structures of the middle ear in almost all interventions. The first procedures carried out were filled with difficulties whose management of intraoperative bleeding was the main one in (42.8%) of the cases. (57%) procedures were described as easy. No complication was detected intraoperatively or immediately postoperatively. Endoscopic tympanoplasty has several advantages, including: Minimally invasive approach to the middle ear; panoramic perioperative vision; Gain of operating time; decrease in the duration of anesthesia; Valuable educational tool; postoperative comfort; Decrease in hospital stay and early return to daily activities; Better aesthetic rendering; cost and transportability. However, we also note a number of disadvantages of endoscopic tympanoplasty, particularly: performing the procedure with one hand; difficulty passing through the EAC; 2D vision that alters the perception of depth; management of intraoperative bleeding; fogging; learning curve.

Single-position prone lateral transpsoas approach: early experience and outcomes

2021 ◽  
pp. 1-8
Author(s):  
S. Harrison Farber ◽  
Komal Naeem ◽  
Malika Bhargava ◽  
Randall W. Porter
Keyword(s):  
Case Series ◽  
Leg Pain ◽  
Consecutive Case ◽  
Intraoperative Radiation ◽  
Invasive Approach ◽  
Transpsoas Approach ◽  
Estimated Blood Loss ◽  
The Mean ◽  
Level Fusion

OBJECTIVE Lateral lumbar interbody fusion (LLIF) via a transpsoas approach is a workhorse minimally invasive approach for lumbar arthrodesis that is often combined with posterior pedicle screw fixation. There has been increasing interest in performing single-position surgery, allowing access to the anterolateral and posterior spine without requiring patient repositioning. The feasibility of the transpsoas approach in patients in the prone position has been reported. Herein, the authors present a consecutive case series of all patients who underwent single-position prone transpsoas LLIF performed by an individual surgeon since adopting this approach. METHODS A retrospective review was performed of a consecutive case series of adult patients (≥ 18 years old) who underwent single-position prone LLIF for any indication between October 2019 and November 2020. Pertinent operative details (levels, cage use, surgery duration, estimated blood loss, complications) and 3-month clinical outcomes were recorded. Intraoperative and 3-month postoperative radiographs were reviewed to assess for interbody subsidence. RESULTS Twenty-eight of 29 patients (97%) underwent successful treatment with the prone lateral approach over the study interval; the approach was aborted in 1 patient, whose data were excluded. The mean (SD) age of patients was 67.9 (9.3) years; 75% (21) were women. Thirty-nine levels were treated: 18 patients (64%) had single-level fusion, 9 (32%) had 2-level fusion, and 1 (4%) had 3-level fusion. The most commonly treated levels were L3–4 (n = 15), L2–3 (n = 12), and L4–5 (n = 11). L1–2 was fused in 1 patient. The mean operative time was 286.5 (100.6) minutes, and the mean retractor time was 29.2 (13.5) minutes per level. The mean fluoroscopy duration was 215.5 (99.6) seconds, and the mean intraoperative radiation dose was 170.1 (94.8) mGy. Intraoperative subsidence was noted in 1 patient (4% of patients, 3% of levels). Intraoperative lateral access complications occurred in 11% of patients (1 cage repositioning, 2 inadvertent ruptures of anterior longitudinal ligament). Subsidence occurred in 5 of 22 patients (23%) with radiographic follow-up, affecting 6 of 33 levels (18%). Postoperative functional testing (Oswestry Disability Index, SF-36, visual analog scale–back and leg pain) identified significant improvement. CONCLUSIONS This single-surgeon consecutive case series demonstrates that this novel technique is well tolerated and has acceptable clinical and radiographic outcomes. Larger patient series with longer follow-up are needed to further elucidate the safety profile and long-term outcomes of single-position prone LLIF.

Anesthetic Implications of Natural Orifice Translumenal Endoscopic Surgery (NOTES) and Single-Incision Laparoscopic Surgery (SILS)

2018 ◽  
Author(s):  
Mark A. Gromski ◽  
Kai Matthes
Keyword(s):  
Laparoscopic Surgery ◽  
Minimally Invasive ◽  
Endoscopic Surgery ◽  
Single Incision ◽  
Single Incision Laparoscopic Surgery ◽  
Natural Orifice ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Current State ◽  
Field Notes

This chapter introduces the concepts of natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS). The field of NOTES has evolved over the past decade, and this developmental framework is also outlined to help better understand the current state of the field. NOTES describes a minimally invasive approach to surgical diseases in which instruments are passed transluminally to achieve access to the desired body. SILS is a minimally invasive approach carried out as an extension of traditional laparoscopic surgery. The anesthetic implications of NOTES and SILS are explained, including potential complications that are unique to each. Finally, future directions in developmental endoscopy are discussed to give a sense of what types of procedures may become available or commonplace in the coming decade.

scholarly journals Retroperitoneal Laparoscopic Ureterolithotomy for Proximal Ureteral Calculi in Selected Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Qingfeng Hu ◽  
Weihong Ding ◽  
Yuancheng Gou ◽  
Yatfaat Ho ◽  
Ke Xu ◽  
...  
Keyword(s):  
Operating Time ◽  
High Volume ◽  
Primary Treatment ◽  
Ureteral Calculi ◽  
Ureteral Stricture ◽  
Urine Leak ◽  
Estimated Blood Loss ◽  
Retroperitoneal Laparoscopic Ureterolithotomy ◽  
The Mean ◽  
Reasonable Choice

Objectives. To summarize our experience of retroperitoneal laparoscopic ureterolithotomy for ureteral calculi and evaluate the safety and efficiency of this procedure.Methods. We conducted a retrospective analysis of 197 patients with proximal ureteral calculi who accepted retroperitoneal laparoscopic ureterolithotomy from June 2005 to June 2014.Results. All procedures were performed successfully and the mean operating time and estimated blood loss were 87 min and 64 mL. The clearance rate was 98.5% and the rates of urine leak and ureteral stricture were 2.5% and 1.0%.Conclusions. Retroperitoneal laparoscopic ureterolithotomy is a safe and effective procedure for patients with complex stones or anatomic abnormalities, and, with experience of high volume series, it is also a reasonable choice as the primary treatment for such selected patients.

A New Minimal Approach in Cochlear Implant Surgery: The Colombian Experience

2005 ◽  
Vol 133 (1) ◽  
pp. 147-149 ◽  
Author(s):  
Jorge E. Almario ◽  
Jose G. Lora ◽  
Jose A. Prieto
Keyword(s):  
Cochlear Implant ◽  
Surgical Approach ◽  
Minimal Invasive ◽  
Surgical Trauma ◽  
Invasive Approach ◽  
Implant Surgery ◽  
Minimal Invasive Approach ◽  
Cochlear Implant Surgery ◽  
The Mean ◽  
Age Range

OBJECTIVES: To implement a minimal invasive approach in cochlear implant surgery for children and adults. In order to decrease surgical complications and morbidity with the surgery. SUBJECTS AND METHODS: During a 1-year period, 12 consecutive patients (5 female and 7 male; age range, 1.5 to 78 years; mean age, 14.5 years), who had cochlear implantation (1 Nucleus and 11 Clarion) through a new surgical approach, were prospectively evaluated. RESULTS: The surgical approach was accomplished in all the patients with no major complications. The mean surgical time was 3.2 hours and the mean time between surgery and process of programming was 2.7 weeks. CONCLUSION: The surgical trauma and postoperatory edema was decreased and allowed programming of the implant in a shorter period of time.

Full-endoscopic surgery for gunshot penetrating wound of the lumbar spine (literature review and clinical case)

2018 ◽  
Vol 20 (2) ◽  
pp. 66-73
Author(s):  
M. N. Kravtsov ◽  
S. A. Landik ◽  
A. А. Dubinin ◽  
K. S. Azatyan ◽  
В. V. Gaidar ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Endoscopic Surgery ◽  
Spinal Canal ◽  
Gunshot Wound ◽  
Clinical Case ◽  
Gunshot Wounds ◽  
Minimal Invasive ◽  
Study Objective ◽  
Invasive Approach ◽  
Minimal Invasive Approach

The study objectiveis to determine the feasibility and effectiveness evaluation of full-endoscopic surgery in gunshot wound of the lumbar spine.Materials and methods.A clinical case of a 24-year-old male who received a gunshot wound to the lumbar spine is described. The patient underwent a full-endoscopic intervention aimed at extracting a bullet from the spinal canal.Results.Minimal-invasive approach to spinal canal with the possibility to extract a bullet, decompression of nerve roots, defect closure of the dura mater is demonstrated.Conclusion.Good clinical outcome allows to recommend the full-endoscopic surgery with similar gunshot wounds of the lumbar spine at the stage of specialized care.

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