scholarly journals Blood patch treatment of chylothorax following transthoracic oesophagogastrectomy: a novel technique to aid surgical management

2010 ◽  
Vol 92 (4) ◽  
pp. e10-e11 ◽  
Author(s):  
RAJ Windhaber ◽  
AG Holbrook ◽  
RJ Krysztopik
Keyword(s):  
Mortality Rate ◽  
Minimally Invasive ◽  
Surgical Management ◽  
Chyle Leak ◽  
Novel Technique ◽  
Blood Patch

Chylothorax is a well-recognised complication of oesophagectomy, occurring in around 3% of cases. If managed conservatively, the mortality rate can be over 50%. We describe our experience of managing a patient with a chylothorax following oesophagectomy, and the use of a blood patch (a novel technique) to overcome persistent leakage following re-operation. The authors feel that this technique has the potential for a wider application in the treatment of chyle leak, especially if combined with minimally invasive or radiological techniques.

Proctorship in Minimally Invasive Colorectal Surgery

2021 ◽  
Vol 34 (03) ◽  
pp. 186-193
Author(s):  
Assad Zahid ◽  
Danilo Miskovic
Keyword(s):  
Quality Control ◽  
Colorectal Surgery ◽  
Minimally Invasive ◽  
Emerging Technology ◽  
Specific Technique ◽  
Novel Technique ◽  
The Past ◽  
Or Groups ◽  
Minimally Invasive Colorectal Surgery ◽  
Teaching Programs

AbstractTeaching an established surgeon in a novel technique by a colleague who has acquired a level of expertise is often referred to as “proctoring” or “precepting.” Surgical preceptorships can be defined as supervised teaching programs, whereby individual or groups of surgeons (proctors) experienced in a certain technique support a colleague who wants to adopt this technique (sometimes referred to as “delegates” or “preceptees”). Preceptorship programs really focus on a specific technique, technology, or skill which is required to broaden, complement, or transform an established surgeon's practice.Within colorectal surgery, in the past 30 years, there is been an evolution of interventional options including open, laparoscopic, robotic, and endoscopic procedures. With each new emerging technology and technique, safe and effective uptake by established surgeons is best been attained by a period of proctorship by an experienced colleague. Formalizing this has been facilitated largely through industry support. There, however, remains a considerable chasm when it comes to standardization, quality control, and jurisprudence.This article aims to describe the requirements for a contemporary proctorship program, to examine instruments of quality control, and how to improve effectiveness.

Minimally invasive implantation of epidural spinal cord neurostimulator electrodes by using a tubular retractor system

2004 ◽  
Vol 100 (6) ◽  
pp. 1119-1121 ◽  
Author(s):  
Matthew R. Johnson ◽  
Daniel J. Tomes ◽  
John S. Treves ◽  
Lyal G. Leibrock
Keyword(s):  
Spinal Cord ◽  
Postoperative Pain ◽  
Minimally Invasive ◽  
Intractable Pain ◽  
Tubular Retractor ◽  
Content Type ◽  
Novel Technique ◽  
Pain Syndromes ◽  
Hospital Stays ◽  
Fine Print

✓ The authors describe a novel technique for the implantation of multipolar epidural spinal cord neurostimulator electrodes with the aid of a tubular retractor system. Spinal cord neurostimulation is used as a neuroaugmentive tool for treating chronic intractable pain syndromes. Minimally invasive placement of the multipolar neurostimulator electrodes may allow for shorter hospital stays and less postoperative pain associated with the incision.

scholarly journals Anesthetic and critical care challenges in massive chyle leak following robotic surgery: a special case report

2015 ◽  
Vol 2 (2) ◽  
pp. 73-76
Author(s):  
Uma Hariharan ◽  
Itee Choudhary ◽  
Ajay Kumar Bhargava
Keyword(s):  
Critical Care ◽  
Case Report ◽  
Lymph Node ◽  
Robotic Surgery ◽  
Minimally Invasive ◽  
Germ Cell ◽  
Retroperitoneal Lymph Node Dissection ◽  
Node Dissection ◽  
Retroperitoneal Lymph Node ◽  
Chyle Leak

A unique case report is hereby presented which entails the multi-modality management of a very rare complication of modern minimally-invasive robotic surgery. Chyle leak can be an extremely challenging problem following certain surgeries, especially in cancer patients. Medical, nutritional and/or surgical management is required to control the leak. Prolonged massive chyle leaks which do not respond to conservative management require surgical intervention. Retroperitoneal lymph node dissection is a complex procedure undertaken for lymph node clearance in germ cell tumors after primary radical surgery. Robotic surgeries have revolutionized the field of minimally invasive operations. A patient who underwent robotic nerve sparing retroperitoneal lymph node dissection for non-seminomatous germ cell tumor of the right testis, post-chemotherapy, developed a continuous large volume chylous ascites, presenting with electrolyte imbalances and hypotension. Exploratory laparotomy in the operation theatre was required for sealing the chyle leak after failure of medical and nutritional management in the intensive care unit. The main take-away message is that refractory chyle leak can occur in retroperitoneal surgeries requiring multidisciplinary management. Careful coordinated action between critical care, oncological, anesthesia and surgical teams is mandatory for a favourable outcome. Familiarity with the nuances of robotic surgery and eternal vigilance are the keys to successful conduction of complex robotic procedures.Journal of Society of Anesthesiologists of Nepal 2015; 2(2): 73-76

Classifications of acute pancreatitis: to Atlanta and beyond

Open Medicine ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. 543-549
Author(s):  
Anna Pallisera ◽  
Farah Adel ◽  
Jose Ramia
Keyword(s):  
Acute Pancreatitis ◽  
Minimally Invasive ◽  
Surgical Management ◽  
Historical Review ◽  
Diagnostic Methods ◽  
Local Complications ◽  
Made In

AbstractUntil Atlanta Classification (AC) made in 1992, there was not any classification of acute pancreatitis (AP). Last twenty years AC let us compare results and papers. But the increasing understanding of the pathophysiology of AP, improvements in diagnostic methods and the development of minimally invasive tools for radiological, endoscopic and surgical management of local complications, several authors have called for the AC to be reviewed. Last months, two new classifications of AP have been published. We made a historical review of AC, the two new classifications and a comparison between them.

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