Measurement of Intraoperative Blood Loss in Minimally Invasive Neurosurgery

Surgeries that take place in medicine and dentistry or during any form of childbirth results in a significant amount of blood loss. The prevalent measurement methods that surgeons and anesthesiologists utilize as the “gold - standard” has several drawbacks. There are numerous other methods to measure blood loss, which, however, due to their impracticality and limitations, are not ideal either. This paper focuses on minimally invasive neurosurgery in particular, by taking into account a surgical technique known as Endoscopic Endonasal Transphenoidal surgery (EETS), which is used to treat pituitary tumors and adenomas. Along with the review of the existing literature pertaining to blood loss management, this paper proposes a modified electrode probe method along with the concept of usage, computer interface, and the system of integration. The probe is intended to measure the hematocrit count from the collected blood under all circumstances, such that the medical practitioner is assisted to improve the blood loss management technique for better patient recovery.

Download Full-text

Comparative analysis of safety and effect of minimally invasive esophageal cancer radical resection and conventional thoracotomy for esophageal cancer

Proceedings of Anticancer Research ◽

10.26689/par.v2i6.724 ◽

2018 ◽

Vol 2 (6) ◽

Author(s):

Ke Du ◽

Zhenxing Wang

Keyword(s):

Esophageal Cancer ◽

Blood Loss ◽

Minimally Invasive ◽

Lymph Nodes ◽

Radical Surgery ◽

Radical Resection ◽

Control Group ◽

Clinical Effects ◽

Intraoperative Blood Loss ◽

Experimental Group

ã€Abstractã€‘Objective: To compare the clinical effects of minimally invasive esophageal cancer radical resection and traditional esophageal cancer radical resection.Methods: 200 cases of esophageal cancer radical resection were performed from July 2014 to July 2017 in our hospital.The cases were divided into experimental group and control group, 82 cases in the experimental group and 118 cases in the control group.The experimental group was treated with minimally invasive esophageal cancer radical surgery, and the control group was treated with conventional thoracotomy.Record the comparison between the two groups (1) surgical conditions, including the time of surgery, intraoperative blood loss, hospitalization time; (2) the number of lymph nodes cleaned; (3) the postoperative control group used conventional thoracotomy, including lung lesions, anastomotic fistula / narrow.RESULTS: The parameters of operation time, intraoperative blood loss, hospitalization time, and number of lymph nodes cleaned in the experimental group were lower than those in the control group, and the difference was statistically significant (p<0.05). In addition to pulmonary infection (p<0.05), There was no significant difference in the incidence of other complications between the experimental group and the control group (p>0.05).Conclusion: Minimally invasive esophageal cancer radical resection and conventional thoracotomy have good clinical effects in the treatment of esophageal cancer. Minimally invasive esophageal cancer radical surgery can effectively reduce intraoperative trauma and postoperative reaction, which is worthy of popularization and application.

Download Full-text

Clinical Application of a Neurosurgical Robot in Intracranial Ommaya Reservoir Implantation

Frontiers in Neurorobotics ◽

10.3389/fnbot.2021.638633 ◽

2021 ◽

Vol 15 ◽

Author(s):

Huan-Guang Liu ◽

De-Feng Liu ◽

Kai Zhang ◽

Fan-Gang Meng ◽

An-Chao Yang ◽

...

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Operation Time ◽

Hole Diameter ◽

Drainage Tube ◽

Ommaya Reservoir ◽

Implantation Technique ◽

Intraoperative Blood Loss ◽

Robot Assisted ◽

Robot Assisted Surgery

Background: The Ommaya reservoir implantation technique allows for bypass of the blood-brain barrier. It can be continuously administered locally and be used to repeatedly flush the intracranial cavity to achieve the purpose of treatment. Accurate, fast, and minimally invasive placement of the drainage tube is essential during the Ommaya reservoir implantation technique, which can be achieved with the assistance of robots.Methods: We retrospectively analyzed a total of 100 patients undergoing Ommaya reservoir implantation, of which 50 were implanted using a robot, and the remaining 50 were implanted using conventional surgical methods. We then compared the data related to surgery between the two groups and calculated the accuracy of the drainage tube of the robot-assisted group.Results: The average operation time of robot-assisted surgery groups was 41.17 ± 11.09 min, the bone hole diameter was 4.1 ± 0.5 mm, the intraoperative blood loss was 11.1 ± 3.08 ml, and the average hospitalization time was 3.9 ± 1.2 days. All of the Ommaya reservoirs were successful in one pass, and there were no complications such as infection or incorrect placement of the tube. In the conventional Ommaya reservoir implantation group, the average operation time was 65 ± 14.32 min, the bone hole diameter was 11.3 ± 0.3 mm, the intraoperative blood loss was 19.9 ± 3.98 ml, and the average hospitalization time was 4.1 ± 0.5 days. In the robot-assisted surgery group, the radial error was 2.14 ± 0.99 mm and the axial error was 1.69 ± 1.24 mm.Conclusions: Robot-assisted stereotactic Ommaya reservoir implantation is quick, effective, and minimally invasive. The technique effectively negates the inefficiencies of craniotomy and provides a novel treatment for intracranial lesions.

Download Full-text

Human-Robot Interfaces of the NeuRoboScope: A Minimally Invasive Endoscopic Pituitary Tumor Surgery Robotic Assistance System

Journal of Medical Devices ◽

10.1115/1.4049394 ◽

2020 ◽

Author(s):

Mehmet Ismet Can Dede ◽

Gokhan Kiper ◽

Tolga Ayav ◽

Barbaros Özdemirel ◽

Enver Tatlicioglu ◽

...

Keyword(s):

Minimally Invasive ◽

Interaction Design ◽

User Study ◽

Pituitary Tumors ◽

Human Robot Interaction ◽

Ease Of Use ◽

Physical Interaction ◽

Endoscopic Endonasal ◽

Wide Range ◽

Human Robot Interfaces

Abstract Endoscopic endonasal surgery is a commonly practiced minimally invasive neurosurgical operation for the treatment of a wide range of skull base pathologies including pituitary tumors. A common shortcoming of this surgery is the necessity of a third hand when the endoscope has to be handled to allow active use of both hands of the main surgeon. The robot surgery assistant NeuRoboScope system has been developed to take over the endoscope from the main surgeon's hand while providing the surgeon with the necessary means of controlling the location and direction of the endoscope. One of the main novelties of the NeuRoboScope system is its human-robot interface designs which regulate and facilitate the interaction between the surgeon and the robot assistant. The human-robot interaction design of the NeuRoboScope system is investigated in two domains: direct physical interaction and master-slave teleoperation. The user study indicating the learning curve and ease of use of the master-slave teleoperation is given and this paper is concluded via providing the reader with an outlook of possible new human-robot interfaces for the robot assisted surgery systems.

Download Full-text

Minimally invasive subtalar arthrodesis for traumatic subtalar arthritis

Journal of International Medical Research ◽

10.1177/0300060519847814 ◽

2019 ◽

Vol 47 (12) ◽

pp. 6129-6138 ◽

Cited By ~ 1

Author(s):

Lei Sun ◽

Zhigang Kong ◽

Ming Xu

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Bone Graft ◽

Iliac Crest ◽

Operation Time ◽

Iliac Crest Bone Graft ◽

Intraoperative Blood Loss ◽

Subtalar Arthrodesis ◽

Subtalar Arthritis ◽

The Mean

Objective This study was performed to introduce a new method of minimally invasive subtalar arthrodesis (MISA) and assess its clinical effects on traumatic subtalar arthritis (TSA). Methods Fifteen patients (8 male and 7 female; age range, 36–56 years; mean age, 48.67 years) with TSA who underwent MISA were included. All patients were treated using a series instrument. The intraoperative and postoperative indexes were recorded. Results Among all patients, the mean operation time was 59.67 ± 16.31 minutes and the mean intraoperative blood loss was 43.33 ± 52.87 mL. Four patients underwent iliac crest bone graft surgery, and one patient developed a complication involving fat liquefaction of the iliac crest wound. The mean bony fusion time among all patients was 3.5 months. According to the American Orthopaedic Foot and Ankle Society standard, an excellent outcome was obtained in eight patients and a good outcome was obtained in seven patients. The operation time and intraoperative blood loss were significantly different between patients who did and did not undergo iliac crest bone graft surgery. Conclusion MISA is a simple and effective method for the treatment of TSA.

Download Full-text

Minimally invasive microendoscopy-assisted transforaminal lumbar interbody fusion with instrumentation

Journal of Neurosurgery Spine ◽

10.3171/spi.2005.3.2.0098 ◽

2005 ◽

Vol 3 (2) ◽

pp. 98-105 ◽

Cited By ~ 198

Author(s):

Robert E. Isaacs ◽

Vinod K. Podichetty ◽

Paul Santiago ◽

Faheem A. Sandhu ◽

John Spears ◽

...

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Interbody Fusion ◽

Pedicle Screws ◽

Transforaminal Lumbar Interbody Fusion ◽

Hospital Length Of Stay ◽

Lumbar Interbody Fusion ◽

Intraoperative Blood Loss ◽

Disc Space ◽

Single Level

Object The authors have developed a novel technique for percutaneous fusion in which standard microendoscopic discectomy is modified. Based on data obtained in their cadaveric studies they considered that this minimally invasive interbody fusion could be safely implemented clinically. The authors describe their initial experience with a microendoscopic transforaminal lumbar interbody fusion (METLIF) technique, with regard to safety in the placement of percutaneous instrumentation, perioperative morbidity, and early postoperative results. Methods The METLIF procedure was performed unilaterally in 20 patients with single-level lumbar spondylolisthesis or pure mechanical back pain with endoscopic assistance, hemilaminectomy, unilateral facetectomy, and microdiscectomy. Two interbody grafts were placed via the lateral exposure of the disc space. Bilateral percutaneous pedicle screws were then inserted. Compared with patients who had undergone single-level posterior LIF at the same institutions, intraoperative blood loss, hospital length of stay (LOS), and postoperative narcotic agent use were significantly lower in the METLIF group. The mean LOS for the percutaneous fusion group was 3.4 days (5.1 days in those who underwent PLIF; p < 0.02). There have been no procedure-related complications in this series to date. Conclusions The METLIF technique provided an option for percutaneous interbody fusion similar to that in open surgery while minimizing destruction to adjacent tissues. This technique was safe and exhibited a trend toward decreased intraoperative blood loss, postoperative pain, total narcotic use, and the risk of transfusion.

Download Full-text

A Novel Closed Reduction Technique for Treating Femoral Shaft Fractures With Intramedullary Nails, Haemostatic Forceps and the Lever Principal

10.21203/rs.3.rs-113768/v1 ◽

2020 ◽

Author(s):

Wei Shui ◽

Youyin Yang ◽

Xinling Pi ◽

Gang Luo ◽

Bo Qiao ◽

...

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Intramedullary Nail ◽

Operative Time ◽

Femoral Shaft ◽

Intraoperative Blood Loss ◽

Femoral Shaft Fractures ◽

Shaft Fractures ◽

Fracture Table ◽

Minimally Invasive Reduction

Abstract Background: Faster, easier, more economical and more effective versions of the minimally invasive reduction procedure for femoral shaft fractures need to be developed for use by orthopaedic surgeons. In this study, a fracture table was used to restore limb length, and long, curved haemostatic forceps and the lever principle were utilized to achieve minimally invasive reduction and intramedullary nail fixation of femoral shaft fractures.Methods: A retrospective analysis involving 20 patients with femoral shaft fractures reduced with a fracture table; long, curved haemostatic forceps; and the lever principle was conducted. The operative effect was evaluated on the basis of the operative time, reduction time, fluoroscopy time, and intraoperative blood loss.Results: All 20 cases were reduced in a closed fashion, and no conversions to open reduction were needed. The average operative time and fracture reduction time for all patients were 69.1±13.5 minutes (range, 50–100 minutes) and 6.7±1.9 minutes (range, 3–10 minutes). The fluoroscopy exposure time during the reduction process was 5–15 seconds, with an average time of 8.7±2.7 seconds. The average intraoperative blood loss was 73.5±22.5 mL (range, 50–150 mL). The patients exhibited excellent alignment in the injured limb after intramedullary nailing. Seventeen patients successfully completed a follow-up after fracture healing. The healing time ranged from 4 to 6 months.Conclusions: Displaced femoral shaft fractures in adults can be treated by a labour-saving lever technique involving fragments, 2 haemostatic forceps and soft tissue envelope-assisted closed reduction and intramedullary nail fixation. This technique is easy to perform; reduces blood loss, the fluoroscopy time and the surgical time for intraoperative reduction; and leads to excellent fracture healing.

Download Full-text

Surgical Challenges in Multi-Vessel Minimally Invasive Coronary Artery Bypass Grafting

Journal of Interventional Cardiology ◽

10.1155/2021/1195613 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Jia-Ji Liu ◽

Qing-Yu Kong ◽

Bin You ◽

Lin Liang ◽

Wei Xiao ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Blood Loss ◽

Minimally Invasive ◽

Clinical Outcomes ◽

Artery Bypass ◽

Bypass Grafting ◽

Intraoperative Blood Loss ◽

Operative Duration ◽

Early Clinical Outcomes

Objectives. Minimally invasive coronary artery bypass grafting (MICS CABG) has emerged as an alternative treatment for patients with multi-vessel coronary artery disease, but there are certain surgical challenges inherent in the adoption of this approach. The present study was conducted to provide insight regarding the outcomes associated with our first 118 cases, to discuss the surgical difficulties encountered in these patients, and to outline the potential countermeasures. Methods. Between January 2017 and January 2020, 118 patients underwent multi-vessel MICS CABG. These patients were stratified into two groups based upon whether they did or did not experience surgical challenges, and early clinical outcomes were compared between these groups to assess the incidence of technical difficulties and associated factors. Results. Surgical challenges arose in 38 of the 118 cases in this study, including 13 cases of exposure-related difficulties, 11 cases of proximal anastomosis-related difficulties, 15 cases of distal anastomosis-related difficulties, 4 cases of LITA-related difficulties, and 3 cases of lung-related difficulties. Relative to the other 80 patients, those patients for whom intraoperative technical challenges arose experience significant increases in operative duration (4.94 ± 0.89 vs. 5.59 ± 1.11 h, P = 0.001 ), intraoperative blood loss (667 ± 313 vs. 892 ± 532 mL, P = 0.005 ), length of the ICU admission (17.59 ± 3.51 vs. 22.59 ± 17.31 h, P = 0.015 ), and the duration of postoperative hospitalization (5.96 ± 1.23 vs. 6.71 ± 1.92 days, P = 0.012 ). There were no significant differences between these groups with respect to the mean graft number, major complications such as stroke or organ dysfunction, or one-year graft patency. Conclusions. There is a substantial learning curve associated with performing off-pump MICS CABG to treat multi-vessel disease. Surgical challenges encountered during this procedure may increase the operative duration, intraoperative blood loss, ICU admission, and the duration of postoperative hospitalization. However, these issues do not appear to compromise the efficacy of complete revascularization, and early clinical outcomes associated with this procedure remain acceptable.

Download Full-text

Comparison of Curative Complications between Mammotome-Assisted Minimally Invasive Resection and Conventional Open Resection for Breast Neoplasm: A Retrospective Clinical Study

BioMed Research International ◽

10.1155/2021/7739628 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Rui Li ◽

Jingyan Li ◽

Shanzheng Chen ◽

Binglan Xiao ◽

Lihua Liu ◽

...

Keyword(s):

Clinical Study ◽

Postoperative Complications ◽

Blood Loss ◽

Minimally Invasive ◽

Breast Neoplasm ◽

Operative Time ◽

Intraoperative Blood Loss ◽

Open Resection ◽

Surgical Scar ◽

Retrospective Clinical Study

Background. To know the clinical value of mammotome-assisted minimally invasive resection (MAMIR) in the treatment of patients with breast neoplasm, we performed a retrospective clinical study for the patients treated with the MAMIR and conventional open resection (COR). Methods. Postoperative complications were compared between 40 patients treated with the MAMIR and 40 patients treated with the COR. The postoperative complications mainly included intraoperative blood loss, hospitalization days, operative time, surgical scar, and incidence of postoperative complications. Results. We found that the amount of intraoperative blood loss, hospitalization days, operative time, surgical scar, and incidence of postoperative complications in the MAMIR group were significantly lower than those of patients in the COR group. Conclusion. Our results indicated that patients with breast neoplasm treated with the MAMIR had better outcomes, which reinforced the advantage of this approach.

Download Full-text

Laparoscopic transperitoneal adrenalectomy v.s. posterior retroperitoneal adrenalectomy in the aspect of complete blood count

Polish Journal of Surgery ◽

10.5604/01.3001.0013.2093 ◽

2019 ◽

Vol 91 (Suplement 1) ◽

pp. 17-21

Author(s):

Tomasz Kozłowski ◽

Barbara Choromańska ◽

Piotr Wojskowicz ◽

Kamil Astapczyk ◽

Robert Milewski ◽

...

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Red Blood Cells ◽

Blood Cells ◽

Blood Count ◽

Complete Blood Count ◽

Tumour Size ◽

Surgical Approaches ◽

Intraoperative Blood Loss ◽

Retroperitoneal Adrenalectomy

Introduction: Minimally invasive surgery is the gold standard for treatment of benign adrenal tumours up to 7–8 cm in diameter. Nowadays, two surgical approaches are performed routinely – lateral transperitoneal adrenalectomy (LTA) and posterior retroperitoneal adrenalectomy (PRA). Both methods are recognized as safe and beneficial for a patient, what can also prove the statistical analysis in the perioperative period. Aim: The aim of our work was to compare lateral transperitoneal adrenalectomy with posterior retroperitoneal adrenalectomy in the aspect of complete blood count. M aterial and Methods: Patients, who underwent videoscopic adrenalectomy in our Department from 02.2015 to 06.2018, were prospectively included to the study. The inclusion criteria was the tumour size smaller than 8cm in abdominal CT. Primary neoplasms were excluded from the study. All surgieres were carried out by one surgeon. Patients were randomized to PRA or LTA. The blood samples were collected - a day before the surgery, and a day, a week, and a month after the surgery. We assessed the rate of leucocytes, red blood cells, hemoglobin and platelets in the peripheral blood. Additionally, the volume of intraoperative blood loss was measured. Results: 77 videoscopic adrenalectomies were carried out, 33 (42,9%) – LTA, 44 (57,1%) – PRA. The average age of the patients constituted- LTA – 61.2± 8.3, PRA – 59.3±10.2. Tumour size in LTA – 4 cm, in PRA – 4.1 cm. Adrenal gland adenomas, basing on postoperative histopathological findings, were most commonly removed tumours in our study: LTA – 82%, PRA – 70%. Intraoperative blood loss was not significant in both groups. We found differences in red blood cells, leucocytes, hemoglobin and platelets rates in each group, without statistically siginificant difference in both groups. Conclusion: Basing on our work, both minimally invasive adrenalectomies are not only effective but also safe. There were not any significant differences in both groups in the aspect of complete blood count. Both approaches – PRA and LTA can be routinely performed as a treatment of benign adrenal lesions and the choice of the approach depends on surgeon’s experience.

Download Full-text

Comparison of Minimally Invasive Reduction Combined With Medial and External Fixation in the Treatment of Intra-articular Calcaneal Fractures

10.21203/rs.3.rs-112214/v1 ◽

2020 ◽

Author(s):

wang jianchuan ◽

Liu jibin ◽

wang zongpu

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

External Fixation ◽

Operation Time ◽

Intraoperative Blood Loss ◽

Efficacy Evaluation ◽

Sf 36 ◽

Length Width ◽

Minimally Invasive Reduction

Abstract BackgroundComparison of percutaneous minimally invasive replacement joint inside external fixation technique and tarsal sinus approach to treat Sanders Ⅱ and Ⅲ clinical effect of intra-articular calcaneal fractures.MethodsThe clinical data of 64 cases of calcaneal fracture admitted to our hospital from January 2010 to January 2016 were retrospectively analyzed.According to different surgical methods,they were divided into the percutaneous minimally invasive reduction and internal and external fixation group (30 cases) and the tarsal sinus approach (34 cases).Comparison of two groups of patients with operation time,intraoperative blood loss,hospital stay, postoperative complications and radiographic evaluation including heel bone length,width,height,Bohler Angle,Angle of Gissane,calcaneal varus Angle,clinical efficacy evaluation including the American Orthopaedic Foot and Ankle Society (AOFAS),the visual analogue score for pain(VAS) score,health survey profiles (SF - 36) score and score Maryland ankle function.ResultsPatients in both groups were followed up for 12 to 50 months,an average of 24.8 months.All fractures obtained bone union.The waiting time,hospital stay,intraoperative blood loss and incision complications in the percutaneous minimally invasive medial and external fixation group were lower than those in the tarsal sinus group,and the differences were statistically significant (P<0.01).At the last follow-up,the length,width,height,Angle of Bohler,Angle of Gissane,and Angle of calcaneal varus were significantly increased in both groups (P<0.01),the calcaneal width was significantly lower than that before surgery (P<0.01),and the difference between the two groups was not statistically significant (P > 0.05).Clinical efficacy evaluation The AOFAS,VAS,SF-36 and Maryland scores were (85.28±8.21),(0.84±1.21),(82.95±3.25) and (83.56±3.32) at the last follow-up in the percutaneous minimally invasive medial and external fixation group.The AOFAS, VAS, SF-36 and Maryland scores of the tarsal sinus group were (83.32 ± 7.69),(1.85 ± 1.32),(80.71 ± 5.42),(81.85 ± 2.41) points,and there was no significant difference between the two groups (P > 0.05).ConclusionUnder the condition of having a good command of surgical indications and surgical skills,the use of calcaneoplastic forceps for percutaneous minimally invasive reduction combined with medial and external fixation for treatment of intra-articular calcaneoplasty fractures can achieve similar clinical effects as the tarsal sinus approach.However,the use of calcaneoplastic forceps for percutaneous minimally invasive reduction combined with internal and external fixation has advantages such as fewer complications, less blood loss,and shorter operation time,etc,which is of good safety and worthy of clinical promotion.

Download Full-text