scholarly journals Clinical effect of minimally invasive surgery for inguinal cryptorchidism

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yunjin Wang ◽  
Liu Chen ◽  
Xu Cui ◽  
Chaoming Zhou ◽  
Qing Zhou ◽  
...  

Abstract Background The purpose of this study was to investigate the clinical effect of minimally invasive surgery for inguinal cryptorchidism. Methods The patients were divided into the minimally invasive surgery group (n = 100) and the traditional surgery group (n = 58). In the minimally invasive surgery group, patients with low inguinal cryptorchidism (n = 54) underwent surgery with a transscrotal incision, and patients with high inguinal cryptorchidism (n = 46) underwent laparoscopic surgery. Results There was no difference in the hospital stay duration or cost between the minimally invasive surgery group and the traditional surgery group (P > 0.05). As for the operative time, minimally invasive surgery of low inguinal cryptorchidism was shorter than traditional surgery (P = 0.033), while minimally invasive surgery of high inguinal cryptorchidism was comparable to traditional surgery (P = 0.658). Additionally, there were no cases of testicular atrophy, testicular retraction, inguinal hernia or hydrocele in either group. There was no significant difference in the incidence of poor wound healing between the two groups (P > 0.05). Although there was no significant difference in the incidence of scrotal hematoma between the two groups (P > 0.05), the incidence in the minimally invasive surgery group was higher than that in the traditional surgery group. Conclusions Minimally invasive surgery including a transscrotal incision for low inguinal cryptorchidism and laparoscopic surgery for high inguinal cryptorchidism is as safe and effective as traditional surgery, and could also provide a good cosmetic effect for children.

2020 ◽  
Author(s):  
Yunjin Wang ◽  
Liu Chen ◽  
Xu Cui ◽  
Chaoming Zhou ◽  
Qing Zhou ◽  
...  

Abstract Background: The purpose of this study was to investigate the clinical effect of minimally invasive surgery for inguinal cryptorchidism.Methods: The patients were divided into the minimally invasive surgery group (n=100) and the traditional surgery group (n=58). In the minimally invasive surgery group, patients with low inguinal cryptorchidism (n=54) underwent surgery with a transscrotal incision, and patients with high inguinal cryptorchidism (n=46) underwent laparoscopic surgery. Results: There was no difference in the hospital stay duration or cost between the minimally invasive surgery group and the traditional surgery group (P>0.05). As for the operative time, minimally invasive surgery of low inguinal cryptorchidism was shorter than traditional surgery (P=0.033), while minimally invasive surgery of high inguinal cryptorchidism was comparable to traditional surgery (P=0.658). Additionally, there were no cases of testicular atrophy, testicular retraction, inguinal hernia or hydrocele in either group. There was no significant difference in the incidence of poor wound healing between the two groups (P>0.05). Although there was no significant difference in the incidence of scrotal hematoma between the two groups (P>0.05), the incidence in the minimally invasive surgery group was higher than that in the traditional surgery group. Conclusions: Minimally invasive surgery including a transscrotal incision for low inguinal cryptorchidism and laparoscopic surgery for high inguinal cryptorchidism is as safe and effective as traditional surgery, and could also provide a good cosmetic effect for children.


2020 ◽  
Author(s):  
Yunjin Wang ◽  
Liu Chen ◽  
Xu Cui ◽  
Chaoming Zhou ◽  
Qing Zhou ◽  
...  

Abstract Background: The purpose of this study was to investigate the clinical effect of minimally invasive surgery for inguinal cryptorchidism. Methods: The patients were divided into the minimally invasive surgery group (n=100) and the traditional surgery group (n=58). In the minimally invasive surgery group, patients with low inguinal cryptorchidism (n=54) underwent surgery with a transscrotal incision, and patients with high inguinal cryptorchidism (n=46) underwent laparoscopic surgery. Results: There was no difference in the hospital stay duration or cost between the minimally invasive surgery group and the traditional surgery group (P>0.05). As for the operative time, minimally invasive surgery of low inguinal cryptorchidism was shorter than traditional surgery (P=0.033), while minimally invasive surgery of high inguinal cryptorchidism was comparable to traditional surgery (P=0.658). Additionally, there were no cases of testicular atrophy, testicular retraction, inguinal hernia or hydrocele in either group. There was no significant difference in the incidence of poor wound healing between the two groups (P>0.05). Although there was no significant difference in the incidence of scrotal hematoma between the two groups (P>0.05), the incidence in the minimally invasive surgery group was higher than that in the traditional surgery group. Conclusions: Minimally invasive surgery including a transscrotal incision for low inguinal cryptorchidism and laparoscopic surgery for high inguinal cryptorchidism is as safe and effective as traditional surgery, and could also provide a good cosmetic effect for children.


2020 ◽  
Author(s):  
Yunjin Wang ◽  
Liu Chen ◽  
Xu Cui ◽  
Chaoming Zhou ◽  
Qing Zhou ◽  
...  

Abstract Background: The purpose of this study was to investigate the clinical effect of minimally invasive surgery for inguinal cryptorchidism.Methods: The patients were divided into the minimally invasive surgery group (n=100) and the traditional surgery group (n=58). In the minimally invasive surgery group, patients with low inguinal cryptorchidism (n=54) underwent surgery with a transscrotal incision, and patients with high inguinal cryptorchidism (n=46) underwent laparoscopic surgery.Results: For low inguinal cryptorchidism, the operative duration in the minimally invasive surgery group was significantly shorter than that in the traditional surgery group (P<0.05). For high inguinal cryptorchidism, there was no difference in the operative duration, the postoperative hospital stay duration or hospital costs between the two groups (P>0.05). Additionally, there were no cases of testicular atrophy, testicular retraction, inguinal hernia or hydrocele in either group. There was no significant difference in the incidence of poor wound healing between the two groups (P>0.05). Although there was no significant difference in the incidence of scrotal hematoma between the two groups (P>0.05), the incidence in the minimally invasive surgery group was higher than that in the traditional surgery group.Conclusions: Minimally invasive surgery including a transscrotal incision for low inguinal cryptorchidism and laparoscopic surgery for high inguinal cryptorchidism is as safe and effective as traditional surgery, and could also provide a good cosmetic effect for children.


2020 ◽  
Vol 3 (68) ◽  
pp. 116
Author(s):  
Cătălin Bogdan Coroleucă ◽  
Manu Andrei ◽  
Alexandra Bauşic ◽  
Ana-Maria Rădulescu ◽  
Ciprian Andrei  Coroleucă ◽  
...  

2020 ◽  
Vol 30 (9) ◽  
pp. 1269-1277 ◽  
Author(s):  
Luis Chiva ◽  
Vanna Zanagnolo ◽  
Denis Querleu ◽  
Nerea Martin-Calvo ◽  
Juan Arévalo-Serrano ◽  
...  

BackgroundMinimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse.MethodsWe obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group.ResultsMean age was 48.3 years (range; 23–83) while the mean BMI was 25.7 kg/m2 (range; 15–49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07; 95% CI, 1.35 to 3.15; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76; 95% CI, 1.75 to 4.33; P<0.001) and those without the use of a uterine manipulator had similar disease-free-survival to the open surgery group (HR, 1.58; 95% CI, 0.79 to 3.15; P=0.20). Moreover, patients that underwent minimally invasive surgery with protective vaginal closure had similar rates of relapse to those who underwent open surgery (HR, 0.63; 95% CI, 0.15 to 2.59; P<0.52).ConclusionsMinimally invasive surgery in cervical cancer increased the risk of relapse and death compared with open surgery. In this study, avoiding the uterine manipulator and using maneuvers to avoid tumor spread at the time of colpotomy in minimally invasive surgery was associated with similar outcomes to open surgery. Further prospective studies are warranted.


2019 ◽  
Vol 10 (1) ◽  
pp. 30-43 ◽  
Author(s):  
Fanny Ficuciello ◽  
Guglielmo Tamburrini ◽  
Alberto Arezzo ◽  
Luigi Villani ◽  
Bruno Siciliano

AbstractThis article focuses on ethical issues raised by increasing levels of autonomy for surgical robots. These ethical issues are explored mainly by reference to state-ofart case studies and imminent advances in Minimally Invasive Surgery (MIS) and Microsurgery. In both area, surgicalworkspace is limited and the required precision is high. For this reason, increasing levels of robotic autonomy can make a significant difference there, and ethically justified control sharing between humans and robots must be introduced. In particular, from a responsibility and accountability perspective suitable policies for theMeaningfulHuman Control (MHC) of increasingly autonomous surgical robots are proposed. It is highlighted how MHC should be modulated in accordance with various levels of autonomy for MIS and Microsurgery robots. Moreover, finer MHC distinctions are introduced to deal with contextual conditions concerning e.g. soft or rigid anatomical environments.


2015 ◽  
Vol 23 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Osa Emohare ◽  
Molly Stapleton ◽  
Alejandro Mendez

Resection of large presacral schwannomas can present a challenge. The posterior approach is commonly associated with coccygeal disarticulation, partial sacral resection, and muscular disarticulation, which can all result in significant morbidity. Minimally invasive surgery may obviate some of the morbidity traditionally associated with this approach. The authors present the case of a morbidly obese 49-year-old man with an enlarging presacral schwannoma. The patient refused laparoscopic resection because of the morbidity he had experienced with a previous laparoscopic surgery. The tumor was resected using a minimally invasive paracoccygeal approach, which affords improved access with minimal morbidity.


2021 ◽  
Vol 11 ◽  
Author(s):  
Ying Yang ◽  
Yue Huang ◽  
Zhengyu Li

PurposeTo compare the clinical outcomes of patients with early-stage cervical cancer who underwent minimally invasive surgery (MIS) by surgeons in different phases and evaluate whether the proficiency of surgeons affects the survival outcomes.Materials and MethodsA total of 851 patients with early-stage cervical cancer who underwent radical hysterectomy between January 2008 and June 2018 (every year from January to June) at a tertiary hospital were retrospectively analyzed. We categorized patients into four phases according to their sequence (phase one, 1-10 cases; phase two: 11-20 cases; phase three: 21-30 cases; phase four: &gt; 30 cases). Demographics and clinical and pathological data were collected and analyzed.ResultsThere were no statistical differences between the open surgery and MIS groups regarding three- and five-year overall survival (OS) and disease-free survival (DFS). The OS and DFS of patients in the MIS group in phase one were significantly lower than those in later phases and those in the open surgery group after adjustment (OS, P = 0.009; HR, 2.896; 95%CI, 1.303-6.435; DFS, P = 0.009; HR, 2.712; 95%CI, 1.289-5.706). Survival outcomes were not statistically significant when comparing different surgeons.ConclusionThe phase one cases of MIS had lower OS and DFS than those in later phases and those in the open surgery group. Thus, we suggest that the proficiency of surgeons is associated with survival outcomes of MIS. Favorable outcomes can be obtained after a certain number of MIS cases.


2008 ◽  
Vol 90 (2) ◽  
pp. 48-49
Author(s):  
Mark Coleman

Over the last two decades, minimally invasive surgery (MIS) has become the mainstream method for the treatment of many abdominal diseases previously treated by open surgery. It has resulted in improvements in many outcomes during and after surgery. The Royal College of Surgeons of England has always played an active role in training both consultant surgeons and trainees in minimally invasive surgery with courses such as the Intercollegiate Basic Surgical Skills Courses (BSS) and laparoscopic cholecystectomy courses run in the College itself and in regional units. Laparoscopic surgery itself presents unique challenges that demand that courses be designed specifically with these in mind.


2020 ◽  
Vol 5 (1) ◽  
pp. 916-920
Author(s):  
Mona Priyadarshini ◽  
Rani Akhil Bhat

Introduction: Endometrial carcinoma is one of the commonest gynaecological cancer in developed countries as well as developing countries. The mainstay of initial treatment of endometrial carcinoma is surgical staging which may be performed by either the conventional abdominal approach or by minimally invasive route i.e. laparoscopic or robotic. Objectives: The purpose of this study was to compare and evaluate the surgical staging, safety and clinical benefits of minimally invasive surgeries versus. laparotomy in patients with endometrial cancer. Methodology: We retrospectively analyzed 105 patients with endometrial cancer over a period of five years and compared the outcome of total hysterectomy with pelvic and para-aortic lymphadenectomy by abdominal, laparoscopic approach or robotic-assisted surgery. Comparison was done with respect to operative time, blood loss, number of lymph nodes retrieved, length of hospital stay, intraoperative and postoperative complications. The data were analyzed using paired “t”- test / Wilcoxon signed rank test ,χ2 - test, Pearson correlation coefficient “r” whenever found suitable. P value of less than 0.05 was considered as statistically significant. Result: There was no statistically significant difference seen in the baseline characteristics like age and BMI between the two groups. The laparotomies were done in a shorter time than the minimally invasive approach (p<0.001). The amount of blood loss (p=0.002), and the duration of hospital stay (p<0.001) was significantly less in the minimally invasive surgery group than the laparotomies. Not much difference in the lymph node retrieval was observed between the two arms (p=0.614). The number of complications were almost similar in both the groups. Conclusion: Minimally invasive surgery for surgical staging of endometrial carcinoma is feasible and effective than laparotomy. The amount of blood loss and duration of hospital stay is seen much lesser with MIS than laparotomy.


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