scholarly journals Multifunctional surface probe for less invasive stimulation of sacral somatic and autonomic outflow under EMG feedback control

2017 ◽  
Vol 3 (2) ◽  
pp. 265-268
Author(s):  
Daniel W. Kauff ◽  
Tomasz Moszkowski ◽  
Roman Ruff ◽  
Werner Kneist
Keyword(s):  
Feedback Control ◽  
Autonomic Nerve ◽  
Nerve Sparing ◽  
Direct Stimulation ◽  
Invasive Approach ◽  
Less Invasive ◽  
Surface Probe ◽  
Emg Feedback ◽  
Less Invasive Approach ◽  
Stimulation Of

AbstractInvasive electric stimulation of sacral somatic and autonomic outflow is used for treatment of urinary and anorectal functional disturbances and selective monitoring of the autonomic nerve-sparing technique in pelvic surgery, the so called pelvic intraoperative neuromonitoring. The aim of this experimental study was to investigate a less invasive approach for simultaneous stimulation of sacral somatic and autonomic outflow and concomitant recording of feedback.A newly developed multifunctional surface probe for simultaneous transrectal stimulation and electromyography (EMG) of external (EAS) and internal anal sphincter (IAS) was investigated in a consecutive series of six male pigs. The probe (cathode) was designed for intra-anal/-rectal application. An additional surface anode was placed on the animals´ back at the level of the sacrum. Each animal underwent autonomic nerve-sparing low anterior rectal resection. The transrectal stimulations followed a standardized protocol. Further direct stimulation of the surgically exposed pelvic autonomic nerves was carried out with a hand-guided bipolar microfork probe.In all six experiments, the transrectal stimulation resulted in significantly increased EMG signals of the somatically innervated EAS (21.0 μV (interquartile range (IQR): 17.8; 64.4) before stimulation vs. 375.8 μV (IQR: 103.4; 895.9) during stimulation, p = 0.004) and autonomically innervated IAS (35.1 μV (IQR: 27.9; 41.7) before stimulation vs. 1115.7 μV (IQR: 420.1; 2920.3) during stimulation, p = 0.008). Subgroup analysis of the observed IAS EMG signals under transrectal stimulation and hand guided direct stimulation revealed no significant differences between both methods (70.5 μV (IQR: 31.5; 322.7) vs. 320.3 μV (IQR: 204.0; 358.0), p = 0.109).The newly developed multifunctional surface probe enabled successful transrectal stimulation of sacral somatic and autonomic outflow under EMG feedback control. The clinical value of this less invasive approach for the treatment of functional disturbances needs further investigations.

scholarly journals Triple valve surgery through a less invasive approach: early and mid-term results

2017 ◽  
pp. ivw430
Author(s):  
Petar Risteski ◽  
Nadejda Monsefi ◽  
Aleksandra Miskovic ◽  
Tanja Josic ◽  
Sherife Bala ◽  
...  
Keyword(s):  
Valve Surgery ◽  
Invasive Approach ◽  
Less Invasive ◽  
Less Invasive Approach ◽  
Triple Valve ◽  
Mid Term Results

scholarly journals Less Invasive Approach to Pancoast Tumor in a Partitioned Incision

2017 ◽  
Vol 23 (3) ◽  
pp. 161-163
Author(s):  
Norikazu Kawai ◽  
Takeshi Kawaguchi ◽  
Motoaki Yasukawa ◽  
Takashi Watanabe ◽  
Takashi Tojo
Keyword(s):  
Pancoast Tumor ◽  
Invasive Approach ◽  
Less Invasive ◽  
Less Invasive Approach

scholarly journals Less Invasive Approach to the Assessment of Coronary Artery Disease

2011 ◽  
Vol 75 (7) ◽  
pp. 1573-1574 ◽  
Author(s):  
Naoya Matsumoto ◽  
Yasuyuki Suzuki ◽  
Ken Nagao ◽  
Atsushi Hirayama ◽  
Yuichi Sato
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Invasive Approach ◽  
Less Invasive ◽  
Less Invasive Approach ◽  
Artery Disease

Resection of Pulmonary Metastases From Sarcoma: Can Some Patients Benefit From a Less Invasive Approach?

2009 ◽  
Vol 87 (1) ◽  
pp. 238-243 ◽  
Author(s):  
Dominique Gossot ◽  
Costin Radu ◽  
Philippe Girard ◽  
Axel Le Cesne ◽  
Sylvie Bonvalot ◽  
...  
Keyword(s):  
Pulmonary Metastases ◽  
Invasive Approach ◽  
Less Invasive ◽  
Less Invasive Approach

scholarly journals Minimally Invasive Endoscopic Approach to the Cervicothoracic Junction for Vertebral Osteomyelitis

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Tadatsugu Morimoto ◽  
Masatsugu Tsukamoto ◽  
Tomohito Yoshihara ◽  
Motoki Sonohata ◽  
Masaaki Mawatari
Keyword(s):  
Posterior Approach ◽  
Vertebral Osteomyelitis ◽  
Perioperative Period ◽  
Lateral Approach ◽  
Cervicothoracic Junction ◽  
Invasive Approach ◽  
Less Invasive ◽  
Good View ◽  
Thoracic Level ◽  
Less Invasive Approach

The selection of an anterior, lateral, or posterior approach to the cervicothoracic junction for surgical treatment of vertebral osteomyelitis is still a matter of debate. These ordinary approaches generally require an extensile exposure. This article describes a less invasive approach case of a vertebral osteomyelitis of T2/3 using a video-assisted operating technique of thoracic surgery (VATS). A 78-year-old female underwent anterior debridement and interbody fusion with bone graft at T2/3 using a lateral surgical approach through a right thoracotomy with VATS. The VATS through two small skin incisions in the axillary region provides a good view without requiring elevation of the scapula with extensile muscle dissection and rib resection. There was no complication without partial lobectomy due to pleural adhesion during the perioperative period. Currently, at 1 year after operation, the patient has no back pain with neurologically normal findings and no inflammation findings (CRP was 0.01 mg/dl). Although the operating field of the upper thoracic level in the lateral approach is generally deep and narrow, the VATS provides a good view and allows us to perform adequate debridement and bone fusion at the T2/3 level with a less invasive approach than those previously described anterior or laterally or posterior approach.

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