scholarly journals Method of forming a pancreatogastric anastomosis after pancreatoduodenal resection

2021 ◽  
Vol 26 (4) ◽  
pp. 97-104
Author(s):  
V. Ya. Lishchishin ◽  
A. G. Barishev ◽  
A. N. Petrovsky ◽  
A. N. Lishchenko ◽  
A. Y. Popov ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Open Surgery ◽  
Surgical Approaches ◽  
Open Approach ◽  
Malignant Tumours ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Pancreatic Fistulas

Aim. To evaluate the reproducibility and safety of the developed pancreatogastric anastomosis with various surgical approaches during pancreatoduodenectomy.Materials and methods. The experience of surgical treatment of 47 patients with malignant tumours of the periampullary zone, who underwent pancreatoduodenectomy, was considered. The proposed variant of anastomose was performed to 14 (29.8%) patients: in 7 cases with a minimally invasive approach to perform pancreatoduodenectomy; and in 7 cases with an open approach. To compare retrospectively 33 (70.2%) patients who underwent pancreatogastric anastomosis according to the Bassi technique: 9 – with minimally invasive surgery, 24 – with open surgery. The frequency of pancreatic fistulas, the number of repeated interferences, and hospital mortality were taken into account.Results. A significant advantage of the new method of forming an anastomosis in the duration of the operation was noted in comparison with the Bassi technique. There were no statistically significant differences in blood loss while various types of anastomoses (p > 0.05). When using the proposed technique, the formation of pancreatic fistulas was not revealed. The development of pancreatic fistula was observed in 4 (16.7%) patients after open surgery and in 7 (77.8%) patients after minimally invasive Bassi anastomose formation. Reoperations were performed after open surgery in 3 (12.5%) cases and in 4 (44.4%) cases of minimally invasive surgery according to the Bassi technique. There were 2 (22.2%) deaths in the minimally invasive group.Conclusion. The proposed pancreatogastric anastomosis is applicable in clinical practice. This method allows to create relatively fast and less challenging anastomosis, including with a minimally invasive approach. The use of this technique makes it possible to reduce mortality and postoperative complications in patients with a “complex” pancreas.

Minimally invasive cervical microendoscopic laminoforaminotomy

2008 ◽  
Vol 25 (2) ◽  
pp. E2 ◽  
Author(s):  
Domagoj Coric ◽  
Tim Adamson
Keyword(s):  
Minimally Invasive Surgery ◽  
Surgical Technique ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Cost Effective ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Disc Herniations ◽  
The Ideal

Spine surgery has seen parallel interest and development in the areas of motion preservation and minimally invasive surgery. Posterior microendoscopic laminoforaminotomy (MELF) allows for neural decompression while maintaining motion via a minimally invasive approach. This technique shares the advantage of maintenance of motion with arthroplasty, but without the need for instrumentation. Therefore, the procedure is motion preserving, minimally invasive and cost-effective. The ideal indications for posterior MELF include unilateral radiculopathy secondary to “hard disc” or spondylosis, as well as soft disc herniations. The authors present a modified surgical technique for posterior MELF as well as a case study illustrating its synergy with anterior arthroplasty.

Safety and Efficacy of Intradural Extramedullary Spinal Tumor Removal Using a Minimally Invasive Approach

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons208-ons216 ◽  
Author(s):  
Richard J. Mannion ◽  
Adrian M. Nowitzke ◽  
Johnny Efendy ◽  
Martin J. Wood
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Spinous Process ◽  
Tumor Resection ◽  
Minimally Invasive Techniques ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Intradural Extramedullary ◽  
Invasive Techniques

Abstract BACKGROUND: Although minimally invasive surgery for intradural tumors offers the potential benefits of less postoperative pain, a quicker recovery, and the avoidance of long-term instability from multilevel laminectomy, there are concerns over whether one can safely and effectively remove intradural extramedullary tumors in a fashion comparable to open techniques and whether the advantages of minimally invasive surgery are clinically significant. OBJECTIVE: To review our early experience with minimally invasive techniques for intradural extramedullary tumors of the spine. METHODS: Thirteen intradural tumors (1 cervical, 6 thoracic, 6 lumbar) in 11 patients were operated on using a muscle-splitting, tube-assisted paramedian oblique approach with hemilaminectomy to access the spinal canal while preserving the spinous process and ligaments. Fluoroscopy and navigation were used to determine the surgical level in all thoracic and lumbar cases. RESULTS: Satisfactory tumor resection using standard microsurgical techniques was achieved in all but 1 case using a minimally invasive approach. Surgical time and intraoperative blood loss were favorable compared with our open technique cases. There was no postoperative morbidity with the minimally invasive approach, although in 2 patients with tumors in the mid- and upper thoracic spine, the surgical incision was inaccurately placed by 1 level. In 1 case, the approach was converted to open when the tumor could not be found, and postoperatively there was a cerebrospinal fluid leak with infection that required readmission. CONCLUSION: Intradural extramedullary tumors can be safely and effectively removed using minimally invasive techniques. The pros and cons of minimally invasive vs open surgery are discussed.

scholarly journals Minimally Invasive Surgery in Pediatric Surgical Oncology

Children ◽  
2018 ◽  
Vol 5 (12) ◽  
pp. 158 ◽  
Author(s):  
Hannah Phelps ◽  
Harold Lovvorn, III
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Surgical Site Infections ◽  
Surgical Oncology ◽  
Current Evidence ◽  
Invasive Approach ◽  
Treatment Regimens ◽  
Pediatric Solid Tumors ◽  
Oncologic Resection

The application of minimally invasive surgery (MIS) to resect pediatric solid tumors offers the potential for reduced postoperative morbidity with smaller wounds, less pain, fewer surgical site infections, decreased blood loss, shorter hospital stays, and less disruption to treatment regimens. However, significant controversy surrounds the question of whether a high-fidelity oncologic resection of childhood cancers can be achieved through MIS. This review outlines the diverse applications of MIS to treat pediatric malignancies, up to and including definitive resection. This work further summarizes the current evidence supporting the efficacy of MIS to accomplish a definitive, oncologic resection as well as appropriate patient selection criteria for the minimally invasive approach.

scholarly journals Minimally invasive surgery versus open surgery for the treatment of solid abdominal and thoracic neoplasms in children

2012 ◽  
Author(s):  
Manou S de Lijster ◽  
Rosemarijn M Bergevoet ◽  
Elvira C van Dalen ◽  
Erna MC Michiels ◽  
Huib N Caron ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Open Surgery ◽  
Thoracic Neoplasms

scholarly journals SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer

2020 ◽  
Vol 30 (9) ◽  
pp. 1269-1277 ◽  
Author(s):  
Luis Chiva ◽  
Vanna Zanagnolo ◽  
Denis Querleu ◽  
Nerea Martin-Calvo ◽  
Juan Arévalo-Serrano ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Open Surgery ◽  
Disease Free Survival ◽  
Free Survival ◽  
Uterine Manipulator ◽  
Surgery Group ◽  
Disease Free

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.

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