Surgery and endovenous techniques for the treatment of small saphenous varicose veins: a review of the literature

In 15% of all patients, varicosis is caused by insufficiency of the small saphenous vein (SSV). In the past it was common to entirely remove the SSV by surgical procedure; however, recently minimally invasive techniques have taken over a significant number of varicose vein treatments. The aim of this paper is a review of the literature of all treatment modalities of the insufficient SSV. The search aimed to identify all papers published describing one or more treatments for SSV insufficiency. International literature databases were searched through for articles eligible for this review. Articles describing one or more treatment techniques for SSV insufficiency were eligible for this review. Also studies describing SSV as well as greater saphenous vein were included as long as they made a clear distinction in their results between the two groups. Studies were excluded if they did not use ultrasound examination to qualify outcome, as this is the golden standard to evaluate venous insufficiency. Seventeen articles were included in this review. Five articles on surgical treatment showed success rates varying from 24% to 100% (follow-up 1.5–60 months). Ten articles on endovenous laser ablation (EVLA) showed success rates varying from 91% to 100% (follow-up 1.5–36 months). Two articles on ultrasound-guided foam sclerotherapy (UGFS) showed success rates varying from 82% to 100% (follow-up 1.5–11 months). Statistical analysis showed a significant difference ( P < 0.05) in success rate of 47.8% versus 94.9% for surgery and EVLA/UGFS, respectively. Most complications for all treatment techniques were mild and self-limiting. Rates of deep venous thrombosis were not described often and in the articles that mentioned it, varied from 1.8% to 3.5% (surgery) and 2.5–5.7% for EVLA. In the absence of large, comparative randomized clinical trials, minimally invasive techniques appear to have a tendency towards better results than surgery, in the treatment of the insufficient SSV.

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Buschke-Löwenstein Tumour: Successful Treatment with Minimally Invasive Techniques

Case Reports in Dermatological Medicine ◽

10.1155/2015/651703 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

Estefânia Correia ◽

António Santos

Keyword(s):

Minimally Invasive ◽

Cost Effective ◽

Functional Results ◽

Moderate Degree ◽

Minimally Invasive Techniques ◽

Secondary Intention ◽

History Of ◽

Full Thickness Excision ◽

Invasive Techniques

We report a case of an 80-year-old female who presented with a four-year history of a growing mass in the perianal area with pain and bleeding during defaecation. Clinical examination revealed a locally destructive, cauliflower-like, verrucous mass measuring 10×12 cm in diameter. Histologic findings revealed a moderate degree of dysplasia of the epithelium with koilocytosis atypia, acanthosis, and parakeratosis, features that are consistent with Buschke-Löwenstein tumour. Polymerase-chain-reaction assay for human papillomavirus (HPV) showed an infection with HPV type 11. Full-thickness excision of involved skin was undertaken by cryotherapy and electrocautery over five months. The entire wound was left open to heal by secondary intention. After 3 years of follow-up, the patient has not experienced a recurrence, with excellent functional results, but the cosmetic results were satisfactory. These minimally invasive techniques can be safer and more cost-effective than surgery and the General Practitioner can play a key role in diagnosis.

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Surgical Treatment of Brainstem Cavernous Malformations with Three Basic Skull Base Approaches and Minimally Invasive Techniques: Observations in 20 Patients

Translational Neuroscience and Clinics ◽

10.18679/cn11-6030_r.2017.019 ◽

2017 ◽

Vol 3 (2) ◽

pp. 74-83

Author(s):

Wen Yin ◽

Jianrong Ma ◽

Yiwei Liao

Keyword(s):

Minimally Invasive ◽

Skull Base ◽

Surgical Approach ◽

Cavernous Malformation ◽

Minimally Invasive Techniques ◽

Cavernous Malformations ◽

Bleeding Episodes ◽

Surgical Treatments ◽

Invasive Techniques

Objective Brainstem cavernous malformation (BSCM) is extremely challenging for neurosurgeons in terms of surgical approach choices. In this article, we summarized our experience in skull base approaches of BSCM, and elucidated the advance of surgical treatments of brain stem cavernous malformation through reviewing recent relevant articles. Methods We retrospectively reviewed 20 consecutive patients who underwent resection between May 1, 2014 and April 30, 2016. Only midline suboccipital, subtemporal approach and retrosigmoid approach were used in this series. The diagnoses of all patients were confirmed by radiological and histological examination. Results All 20 patients were completely extirpated without surgical-related mortality. The mean follow-up period was 9.5 months (range, 2-20 months). Of the 20 patients, 80% symptomatic patients underwent surgery after first bleeding episode within 3 months, 20% after two or more bleeding episodes by magnetic resonance imaging. After resection and during follow-up, 75% of patients had an improvement in their modified Rankin scale (mRS) scores, whereas 10% were worse compared with their preoperative presentation; 15% were unchanged. Conclusion Appropriate basic surgical approach and minimally invasive techniques are necessary in preventing impairment of neurologic function. The three common basic skull base approaches, combined with minimally invasive techniques can handle most of BSCMs with good surgical results.

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Single-stage minimally invasive nephroureterectomy for upper tract urothelial carcinoma: Perioperative and early oncological outcomes

Journal of Clinical Urology ◽

10.1177/2051415820913449 ◽

2020 ◽

Vol 13 (5) ◽

pp. 332-338

Author(s):

PC Ryan ◽

UM Haroon ◽

RA Keenan ◽

PJ O’Donoghue ◽

M Hegazy ◽

...

Keyword(s):

Minimally Invasive ◽

Urothelial Carcinoma ◽

Single Stage ◽

Upper Tract Urothelial Carcinoma ◽

Perioperative Outcomes ◽

Minimally Invasive Techniques ◽

Upper Tract ◽

Oncological Outcomes ◽

Invasive Techniques

Objective: The purpose of this article is to present our minimally-invasive techniques for upper tract urothelial carcinoma and review the perioperative and early oncological outcomes at our centre. Materials and methods: A retrospective review of all patients undergoing minimally-invasive surgery for upper tract urothelial carcinoma over a 3-year period following institutional approval was performed. Perioperative and early oncological outcomes were assessed. Results: Twenty-three cases of minimally-invasive single-stage nephroureterectomy were performed with a mean patient age of 69.45 years. Twelve (52%) of these cases were for high-grade disease and six (27%) had received neo-adjuvant chemotherapy. There were no intraoperative complications, no positive surgical margins and four (17.4%) of patients had a post-operative complication. Mean length of stay was 5.5 days and there was one readmission within 30 days of surgery. Seven patients (30%) experienced either local or distant recurrences with a median time to recurrence of 6 months. Recurrence free survival was 69.6%. Two patients died during the follow-up period. Conclusion: Our minimally-invasive techniques provides a safe and reproducible approach for upper tract urothelial carcinoma. Our perioperative outcomes and oncological are comparable to similar studies, but more long-term follow-up and larger patient numbers are required to validate oncological efficacy. Level of evidence: 4.

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16-month outcomes following hybrid ablation for long-standing persistent atrial fibrillation in patients with dilated atria

European Heart Journal ◽

10.1093/ehjci/ehaa946.0629 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

R.A Kaba ◽

A Ashry ◽

A Elbadri ◽

P Gukop ◽

A Li ◽

...

Keyword(s):

Minimally Invasive ◽

Posterior Wall ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Success Rates ◽

Ablation Therapy ◽

Significant Difference ◽

Hybrid Ablation ◽

Stage 1

Abstract Introduction Although catheter ablation therapy is a well-established treatment for cardiac dysrhythmias, the success rates for longstanding, persistent AF with dilated atria remain unsatisfactory. The minimally invasive hybrid technology is a novel form of therapy. Methods A prospective, single-center UK study to evaluate the hybrid ablation technique for patients with longstanding (>1 year) persistent AF and dilated atria. Stage 1 was a minimally invasive epicardial approach for ablation of the posterior wall of left atrium (LA) and pulmonary veins (PVs). Stage 2 was a transcatheter approach via the femoral veins to isolate the endocardial aspect of the PVs +/− posterior wall. Occasionally, the sequence of the stages was reversed. Results Forty-one patients were enrolled for the study with a mean follow-up for 16±9 months. Mean age was 65±9 years and the mean BMI was 32±7. Males constituted 75% of the study cohort. Mean LA size was 48±7 mm and mean left ventricular ejection fraction (LVEF) was 51.9%, although 51.6% of patients had impaired LVSF (LVEF below 55%). 87.8% CI (0.7–0.9) of patients remained in sinus rhythm (SR) without repeat ablation, whereas only 12.2% CI (0.04–0.02) had redeveloped persistent AF. Although numerically different, there was no statistically significant difference in maintaining SR between patients with severely dilated LA (>50 mm) and those without (70% vs. 90%, respectively; z=−1.39, p=0.165). Major perioperative complications during stage 1 ablation were low, with IVC injury in 1 patient and a mild stroke in 1 patient. Median LOS was 1 day (1–4 days) and there was no 30-day mortality after stage 1. Conclusions The hybrid ablation therapy has a conversion rate from longstanding persistent AF to SR of 87.8% at a mean follow-up of 16±9 months, without repeat ablation. LOS was short, with very few complications and no peri-operative mortality. The hybrid approach appears to be very encouraging for a condition with otherwise low success rates by conventional endocardial techniques alone. Funding Acknowledgement Type of funding source: None

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Minimally Invasive Techniques for Management of Salivary Gland Pathology

Journal of Diagnostics and Treatment of Oral and Maxillofacial Pathology ◽

10.23999/j.dtomp.2017.1.2 ◽

2017 ◽

Vol 1 (1) ◽

pp. 11-14

Author(s):

Rui Fernandes ◽

Salam Salman ◽

Anastasiya Quimby

Keyword(s):

Salivary Gland ◽

Minimally Invasive ◽

Surgical Approach ◽

Standard Of Care ◽

Invasive Technique ◽

Minimally Invasive Techniques ◽

Success Rates ◽

Operator Experience ◽

Invasive Techniques ◽

Open Surgical Approach

Purpose. The goal of this article is to describe the technique used at our institution and highlight potential pitfalls during sialendoscopy. Discussion. Indication for sialendoscopy, sialendoscopy technique are discussed. Results. Despite the high reported success rates with sialendoscopy, the procedure is deemed to be technically challenging and correlation between success rates and operator experience has been shown. Conclusion. Sialendoscopy is a minimally invasive technique that is gradually replacing the classic open surgical approach to the treatment of obstructive salivary gland diseases as the standard of care.

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Functional properties of the saphenous vein harvested by minimally invasive techniques

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(99)01571-4 ◽

2000 ◽

Vol 69 (4) ◽

pp. 1116-1120 ◽

Cited By ~ 13

Author(s):

Myra Rinia-Feenstra ◽

Wim Stooker ◽

Ruud de Graaf ◽

Jaap J Kloek ◽

Martin Pfaffendorf ◽

...

Keyword(s):

Minimally Invasive ◽

Functional Properties ◽

Saphenous Vein ◽

Minimally Invasive Techniques ◽

Invasive Techniques

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Outcomes of Minimally Invasive Thyroid Surgery – A Systematic Review and Meta-Analysis

Frontiers in Endocrinology ◽

10.3389/fendo.2021.719397 ◽

2021 ◽

Vol 12 ◽

Author(s):

Lisa H. de Vries ◽

Dilay Aykan ◽

Lutske Lodewijk ◽

Johanna A. A. Damen ◽

Inne H. M. Borel Rinkes ◽

...

Keyword(s):

Systematic Review ◽

Minimally Invasive ◽

Hospital Stay ◽

Meta Analysis ◽

Endoscopic Thyroidectomy ◽

Standard Of Care ◽

Minimally Invasive Techniques ◽

Conventional Thyroidectomy ◽

Significant Difference ◽

Invasive Techniques

PurposeConventional thyroidectomy has been standard of care for surgical thyroid nodules. For cosmetic purposes different minimally invasive and remote-access surgical approaches have been developed. At present, the most used robotic and endoscopic thyroidectomy approaches are minimally invasive video assisted thyroidectomy (MIVAT), bilateral axillo-breast approach endoscopic thyroidectomy (BABA-ET), bilateral axillo-breast approach robotic thyroidectomy (BABA-RT), transoral endoscopic thyroidectomy via vestibular approach (TOETVA), retro-auricular endoscopic thyroidectomy (RA-ET), retro-auricular robotic thyroidectomy (RA-RT), gasless transaxillary endoscopic thyroidectomy (GTET) and robot assisted transaxillary surgery (RATS). The purpose of this systematic review was to evaluate whether minimally invasive techniques are not inferior to conventional thyroidectomy.MethodsA systematic search was conducted in Medline, Embase and Web of Science to identify original articles investigating operating time, length of hospital stay and complication rates regarding recurrent laryngeal nerve injury and hypocalcemia, of the different minimally invasive techniques.ResultsOut of 569 identified manuscripts, 98 studies met the inclusion criteria. Most studies were retrospective in nature. The results of the systematic review varied. Thirty-one articles were included in the meta-analysis. Compared to the standard of care, the meta-analysis showed no significant difference in length of hospital stay, except a longer stay after BABA-ET. No significant difference in incidence of recurrent laryngeal nerve injury and hypocalcemia was seen. As expected, operating time was significantly longer for most minimally invasive techniques.ConclusionsThis is the first comprehensive systematic review and meta-analysis comparing the eight most commonly used minimally invasive thyroid surgeries individually with standard of care. It can be concluded that minimally invasive techniques do not lead to more complications or longer hospital stay and are, therefore, not inferior to conventional thyroidectomy.

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Frontal Keyhole Craniotomy for Resection of Low- and High-Grade Gliomas

Neurosurgery ◽

10.1093/neuros/nyx213 ◽

2017 ◽

Vol 82 (3) ◽

pp. 388-396 ◽

Cited By ~ 4

Author(s):

Joshua D Burks ◽

Andrew K Conner ◽

Phillip A Bonney ◽

Chad A Glenn ◽

Adam D Smitherman ◽

...

Keyword(s):

Minimally Invasive ◽

Senior Author ◽

Brain Lesions ◽

Minimally Invasive Techniques ◽

Who Grade ◽

Prior Surgery ◽

Grade Ii ◽

Keyhole Craniotomy ◽

Invasive Techniques

Abstract BACKGROUND Minimally invasive techniques are increasingly being used to access intra-axial brain lesions. OBJECTIVE To describe a method of resecting frontal gliomas through a keyhole craniotomy and share the results with these techniques. METHODS We performed a retrospective review of data obtained on all patients undergoing resection of frontal gliomas by the senior author between 2012 and 2015. We describe our technique for resecting dominant and nondominant gliomas utilizing both awake and asleep keyhole craniotomy techniques. RESULTS After excluding 1 patient who received a biopsy only, 48 patients were included in the study. Twenty-nine patients (60%) had not received prior surgery. Twenty-six patients (54%) were diagnosed with WHO grade II/III tumors, and 22 patients (46%) were diagnosed with glioblastoma. Twenty-five cases (52%) were performed awake. At least 90% of the tumor was resected in 35 cases (73%). Three of 43 patients with clinical follow-up experienced permanent deficits. CONCLUSION We provide our experience in using keyhole craniotomies for resecting frontal gliomas. Our data demonstrate the feasibility of using minimally invasive techniques to safely and aggressively treat these tumors.

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