Minimally Invasive Surgical Treatment of Lumbar Synovial Cysts

Neurosurgery ◽  
2004 ◽  
Vol 54 (1) ◽  
pp. 107-112 ◽  
Author(s):  
Faheem A. Sandhu ◽  
Paul Santiago ◽  
Richard G. Fessler ◽  
Sylvain Palmer
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Surgical Techniques ◽  
Synovial Cyst ◽  
Complete Excision ◽  
Tubular Retractor ◽  
Minimally Invasive Surgical ◽  
Average Patient ◽  
Synovial Cysts

Abstract OBJECTIVE Synovial cysts are a rare cause of lumbar radiculopathy and back pain. Surgical treatment is directed at complete excision of the cyst. We used minimally invasive surgical techniques for a series of patients, to assess the effectiveness of this approach for resection of synovial cysts. METHODS Seventeen patients (10 female and 7 male patients) with presumed synovial cysts, as indicated on magnetic resonance imaging scans, underwent surgical resection with the 18-mm METRx tubular retractor system (Medtronic Sofamor Danek, Memphis, TN). A unilateral approach was used, with either an operating microscope (13 cases) or a magnifying endoscope (4 cases), depending on the preference of the surgeon. Outcomes were reported by using modified MacNab criteria. RESULTS The average patient age was 64 years (range, 46–82 yr). The L4–L5 level was most commonly affected (82% of cases). Grade 1 spondylolisthesis at the level harboring the synovial cyst was observed for 47% of the patients; all cases of spondylolisthesis involved the L4–L5 level. The mean operative time was 97 minutes, and the average blood loss was 35 ml. Excellent or good results were achieved for 94% of the patients. A dural tear that did not violate the arachnoid membrane occurred during surgery for one patient but did not require further treatment. CONCLUSION Synovial cysts can be effectively treated with a tubular retractor system in conjunction with an endoscope or microscope. Use of the tubular retractor minimizes soft-tissue trauma, incision length, blood loss, and disruption of ligamentous and bony structures. This may be particularly significant when synovial cysts are associated with spondylolisthesis, minimizing the risk of progressive instability and the need for fusion.

Laparoscopic resections in the treatment of children with liver tumors: the first experience

2021 ◽  
Vol 61 (3) ◽  
pp. 27-30
Author(s):  
A. B. Riabov ◽  
M. S. Kubirov ◽  
A. V. Khizhnikov ◽  
M. Yu. Rykov
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Laparoscopic Resection ◽  
Liver Tumors ◽  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Minimally Invasive Surgical ◽  
Laparoscopic Techniques ◽  
Resection Volume ◽  
Selection Of

Relevance: Surgery is one of the main methods of treating patients with liver neoplasms. At that, minimally invasive surgical techniques facilitate the course of the postoperative period and rehabilitation. The purpose of the study was the selection of optimal surgical treatment for children with liver tumors. Results: In 2014-2020, five patients aged 3-9 years with liver tumors underwent laparoscopic resection at the Morozovskaya Children’s City Clinical Hospital (Moscow, Russia). Out of 3 patients with hepatoblastomas, two patients had stage PRETEXT I, one – stage II. All patients underwent radical surgical treatment (R0); in one child (4%), the resection volume was R1. The duration of operations did not exceed 60 minutes; intraoperative blood loss was within 10 ml/kg; no intraoperative complications were registered. Conclusion: Laparoscopic techniques reduce surgery time and blood loss, prevent intraoperative and postoperative complications, shorten the hospital stay, decrease enteral and drug burden, and the need for chemotherapy. They also facilitate radical surgery and early patient mobilization.

scholarly journals Tubular microdiscectomy: techniques, complication avoidance, and review of the literature

2017 ◽  
Vol 43 (2) ◽  
pp. E7 ◽  
Author(s):  
Aaron J. Clark ◽  
Michael M. Safaee ◽  
Nickalus R. Khan ◽  
Matthew T. Brown ◽  
Kevin T. Foley
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Surgical Techniques ◽  
Small Diameter ◽  
Skin Incision ◽  
Operating Table ◽  
Level Of Evidence ◽  
Tubular Retractor ◽  
Lower Blood ◽  
Level I

OBJECTIVEMicroendoscopic discectomy is a minimally invasive surgery technique that was initially described in 1997. It allows surgeons to work with 2 hands through a small-diameter, operating table–mounted tubular retractor, and to apply standard microsurgical techniques in which a small skin incision and minimal muscle dissection are used. Whether the surgeon chooses to use an endoscope or a microscope for visualization, the technique uses the same type of retractor and is thus called tubular microdiscectomy. The goal in this study was to review the current literature, examine the level of evidence supporting tubular microdiscectomy, and describe surgical techniques for complication avoidance.METHODSThe authors performed a systematic PubMed review using the terms “microdiscectomy trial,” “tubular and open microdiscectomy,” “microendoscopic open discectomy,” and “minimally invasive open microdiscectomy OR microdiskectomy.” Of 317 references, 10 manuscripts were included for analysis based on study design, relevance, and appropriate comparison of open to tubular discectomy.RESULTSSimilar and very favorable clinical outcomes can be expected from tubular and standard microdiscectomy. Studies have demonstrated equivalent operating times for both procedures, with lower blood loss and shorter hospital stays associated with tubular microdiscectomy. Furthermore, postoperative analgesic usage has been shown to be significantly lower after tubular microdiscectomy. Overall rates of complications are no different for tubular and standard microdiscectomy.CONCLUSIONSProspective randomized trials have been used to evaluate outcomes of common minimally invasive lumbar spine procedures. For lumbar discectomy, Level I evidence supports equivalently good outcomes for tubular microdiscectomy compared with standard microdiscectomy. Likewise, Level I data indicate similar safety profiles and may indicate lower blood loss for tubular microdiscectomy. Future studies should examine the comparative value of these procedures.

scholarly journals Treatment of lumbar synovial cysts using minimally invasive surgical techniques

2006 ◽  
Vol 20 (3) ◽  
pp. 1-6 ◽  
Author(s):  
Nouzhan Sehati ◽  
Larry T. Khoo ◽  
Langston T. Holly
Keyword(s):  
Back Pain ◽  
Minimally Invasive ◽  
Surgical Techniques ◽  
Definitive Treatment ◽  
Surgical Approaches ◽  
Lower Extremity Weakness ◽  
Minimally Invasive Surgical ◽  
Synovial Cysts ◽  
The Mean

Object Lumbar synovial cysts are a potential cause of radiculopathy and back pain, and the definitive treatment is the complete excision of the cyst. This report summarizes the authors' preliminary clinical experience with the minimally invasive resection of lumbar synovial cysts. Methods Nineteen patients (nine men and 10 women) with symptomatic synovial cysts underwent minimally invasive resection. The mean patient age was 64 years of age (range 43–80 years). The presenting symptom was radiculopathy in 16 patients, low-back pain in two, and lower-extremity weakness in one. There were 16 cases of a cyst located at the L4–5 level, two at L3–4, and one at L5–S1. The mean cyst diameter was 13.7 mm (range 3–30 mm). The mean follow-up time was 16 months (range 4–29 months). Clinical outcomes were graded, based on the Macnab modified criteria, as excellent, good, fair, or poor. Eighteen patients (95% of cases) reported either excellent (10 patients) or good (eight patients) results, and a fair result was reported by one patient (5% of cases). The mean operative time was 158 minutes (range 75–270 minutes), and the average intraoperative blood loss was 31 ml (range 10–100 ml). Two patients had intraoperative dural tears that resulted in cerebrospinal fluid leaks that resolved following primary closure. Conclusions Synovial cysts can be safely and effectively treated using minimally invasive surgical techniques. Long-term follow up is required to determine whether this approach results in less need for fusion than conventional surgical approaches.

scholarly journals Laparoscopic resections in the treatment of children with liver tumors: the first experience

2021 ◽  
Vol 61 (3) ◽  
pp. 27-30
Author(s):  
A. B. Riabov ◽  
M. S. Kubirov ◽  
A. V. Khizhnikov ◽  
M. Yu. Rykov
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Laparoscopic Resection ◽  
Liver Tumors ◽  
Intraoperative Complications ◽  
Surgical Techniques ◽  
Minimally Invasive Surgical ◽  
Laparoscopic Techniques ◽  
Resection Volume ◽  
Selection Of

Relevance: Surgery is one of the main methods of treating patients with liver neoplasms. At that, minimally invasive surgical techniques facilitate the course of the postoperative period and rehabilitation. The purpose of the study was the selection of optimal surgical treatment for children with liver tumors. Results: In 2014-2020, five patients aged 3-9 years with liver tumors underwent laparoscopic resection at the Morozovskaya Children’s City Clinical Hospital (Moscow, Russia). Out of 3 patients with hepatoblastomas, two patients had stage PRETEXT I, one – stage II. All patients underwent radical surgical treatment (R0); in one child(4%), the resection volume was R1. The duration of operations did not exceed 60 minutes; intraoperative blood loss was within 10 ml/kg; no intraoperative complications were registered. Conclusion: Laparoscopic techniques reduce surgery time and blood loss, prevent intraoperative and postoperative complications, shorten the hospital stay, decrease enteral and drug burden, and the need for chemotherapy. They also facilitate radical surgery and early patient mobilization.

scholarly journals Minimally invasive resection of lumbar intraspinal synovial cysts via a contralateral approach: review of 13 cases

2015 ◽  
Vol 23 (4) ◽  
pp. 444-450 ◽  
Author(s):  
Hamdi G. Sukkarieh ◽  
Patrick W. Hitchon ◽  
Olatilewa Awe ◽  
Jennifer Noeller
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Operative Time ◽  
Synovial Cyst ◽  
Contralateral Approach ◽  
Estimated Blood Loss ◽  
Synovial Cysts ◽  
The Mean

OBJECT The authors sought to determine patient-related outcomes after minimally invasive surgical (MIS) lumbar intraspinal synovial cyst excision via a tubular working channel and a contralateral facet-sparing approach. METHODS All the patients with a symptomatic lumbar intraspinal synovial cyst who underwent surgery at the University of Iowa Hospitals and Clinics with an MIS excision via a contralateral approach were treated between July 2010 and August 2014. There was a total of 13 cases. Each patient was evaluated with preoperative neurological examinations, lumbar spine radiography, MRI, and visual analog scale (VAS) scores. The patients were evaluated postoperatively with neurological examinations and VAS and Macnab scores. The primary outcomes were improvement in VAS and Macnab scores. Secondary outcomes were average blood loss, hospital stay duration, and operative times. RESULTS There were 5 males and 8 females. The mean age was 66 years, and the mean body mass index was 28.5 kg/m2. Sixty-nine percent (9 of 13) of the cysts were at L4–5. Most patients had low-back pain and radicular pain, and one-third of them had Grade 1 spondylolisthesis. The mean (± SD) follow-up duration was 20.8 ± 16.9 months. The mean Macnab score was 3.4 ± 1.0, and the VAS score decreased from 7.8 preoperatively to 2.9 postoperatively. The mean operative time was 123 ± 30 minutes, with a mean estimated blood loss of 44 ± 29 ml. Hospital stay averaged 1.5 ± 0.7 days. There were no complications noted in this series. CONCLUSIONS The MIS excision of lumbar intraspinal synovial cysts via a contralateral approach offers excellent exposure to the cyst and spares the facet joint at the involved level, thus minimizing risk of instability, blood loss, operative time, and hospital stay. Prospective randomized trials with longer follow-up times and larger cohorts are needed to conclusively determine the superiority of the contralateral MIS approach over others, including open or ipsilateral minimally invasive surgery.

scholarly journals The choice of surgical treatment in patients with infected pancreonecrosis

2018 ◽  
Vol 177 (6) ◽  
pp. 20-26
Author(s):  
E. A. Tseimakh ◽  
V. A. Bombizo ◽  
P. N. Buldakov ◽  
A. A. Averkina ◽  
D. N. Ustinov ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Inpatient Treatment ◽  
Surgical Techniques ◽  
Postoperative Mortality ◽  
Group Comparison ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Minimally Invasive Surgical

The objectiveis to study the results of different methods of surgical treatment of patients with infected pancreonecrosis and to conduct a comparative analysis of minimally invasive and traditional surgical interventions.Material and methods.The results of treatment of 206 patients with infected pancreonecrosis were analyzed. In accordance with the used method of surgical treatment, the patients were divided into 2 groups: 105 (51.0%) patients with “traditional” open interventions were included in the first group (comparison), and 101 (49.0%) patients treated with various miniinvasive technologies, or a combination of minimally invasive and “open” interventions were included in the second group.Results.It was found that the mortality rate in the second group was less than in the first group by 12.8% (p<0.05).Conclusion.Minimally invasive surgical techniques are the method of choice for delimited pancreatogenic ulcers. The use of combined surgical interventions leads to a significant reduction of postoperative mortality and duration of inpatient treatment.

Minimally Invasive Surgical Techniques in Management of Intra-articular Fracture Calcaneus

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
sami sadek ◽  
khalid Abd Elrahman ◽  
Yousuf Khira ◽  
el sayed soudy
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Articular Fracture ◽  
Minimally Invasive Surgical

Minimally Invasive Surgical Techniques to Treat Spine Infection S

1996 ◽  
Vol 27 (1) ◽  
pp. 183-199 ◽  
Author(s):  
Larry M. Parker ◽  
Paul C. McAfee ◽  
Ira L. Fedder ◽  
James C. Weis ◽  
W. Peter Geis
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Spine Infection ◽  
Minimally Invasive Surgical
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