scholarly journals Minimally Invasive Surgery in Emergency Surgery: A WSES Survey

2021 ◽  
Author(s):  
Marco Ceresoli ◽  
Michele Pisano ◽  
Fikri Abu-Zidan ◽  
Niccolò Allievi ◽  
Kurinchi Gurusamy ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Emergency Surgery ◽  
Elective Surgery ◽  
Personal Characteristics ◽  
Ordinal Regression ◽  
Emergency Setting ◽  
Minimally Invasive Techniques ◽  
Invasive Techniques

Abstract Background: The diffusion of minimally invasive surgery in emergency surgery still represents a developing challenge. Evidence about the use of minimally invasive surgery shows its feasibility and safety, however the diffusion of these techniques is still poor. The aims of the present survey were to explore the diffusion and variations in the use of minimally invasive surgery among surgeons in the emergency setting.Methods: This is a web-based survey administered to all the WSES members investigating the diffusion of minimally invasive surgery in emergency. The survey investigated personal characteristics of participants, hospital characteristics, personal confidence in the use of minimally invasive surgery in emergency, limitations in the use of it and limitations to prosecute minimally invasive surgery in emergency surgery. Characteristics related to the use of minimally invasive surgery were studied with a multivariate ordinal regression.Results: The survey collected a total of 415 answers; 42.2% of participants declared a working experience >15 years and 69.4% of responders worked in tertiary level centre or academic hospital. In primary emergencies only28,7% of participants declared the use of laparoscopy in more than 50% of times. Personal confidence with minimally invasive techniques was the highest for appendectomy and cholecystectomy. At multivariate ordinal regression a longer professional experience, the use of laparoscopy in major elective surgery and bariatric surgery expertise were related to a higher use of laparoscopy in emergency surgery.Conclusions: The survey shows that minimally invasive techniques in emergency surgery are still underutilized. Greater focus should be placed on the development of dedicated training in laparoscopy among emergency surgeons.

scholarly journals Minimally Invasive Approaches in the Thoracic Surgery

2021 ◽  
Author(s):  
Güntuğ Batıhan ◽  
Kenan Can Ceylan
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Thoracic Surgery ◽  
Invasive Surgery ◽  
Minimally Invasive Techniques ◽  
The Past ◽  
Minimally Invasive Surgical ◽  
First Choice ◽  
Surgical Methods ◽  
Invasive Techniques

Minimally invasive techniques in thoracic surgery have made great progress over the past 20 years and are still evolving. Many surgical procedures performed with large thoracotomy incisions in the past can now be performed with much smaller incisions. With many studies, the advantages of minimally invasive surgery have been clearly seen, and thus its use has become widespread worldwide. Today, minimally invasive surgical methods have become the first choice in the diagnosis and treatment of lung, pleural and mediastinal pathologies. Minimally invasive approaches in thoracic surgery include many different techniques and applications. In this chapter, current minimally invasive techniques in thoracic surgery are discussed and important points are emphasized in the light of the current literature.

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 From the Idea to Its Realization: The Evolution of Minimally Invasive Techniques in Neurosurgery

2013 ◽  
Vol 2013 ◽  
pp. 1-18 ◽  
Author(s):  
P. Grunert
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Pituitary Surgery ◽  
General Concept ◽  
Modern Technology ◽  
Minimally Invasive Techniques ◽  
Technical Developments ◽  
Transsphenoidal Pituitary Surgery ◽  
Invasive Techniques

Minimally invasive techniques in neurosurgery evolved in two steps. Many minimally invasive concepts like neuronavigation, endoscopy, or frame based stereotaxy were developed by the pioneers of neurosurgery, but it took decades till further technical developments made the realization and broad clinical application of these early ideas safe and possible. This thesis will be demonstrated by giving examples of the evolution of four minimally invasive techiques: neuronavigation, transsphenoidal pituitary surgery, neuroendoscopy and stereotaxy. The reasons for their early failure and also the crucial steps for the rediscovery of these minimally invasive techniques will be analysed. In the 80th of the 20th century endoscopy became increasingly applied in different surgical fields. The abdominal surgeons coined as first for their endoscopic procedures the term minimally invasive surgery in contrast to open surgery. In neurrosurgery the term minimally invasive surgery stood not in opposiotion to open procedures but was understood as a general concept and philosophy using the modern technology such as neuronavigation, endoscopy and planing computer workstations with the aim to make the procedures less traumatic.

Speculation on the Neuropsychology of Teleoperation: Implications for Presence Research and Minimally Invasive Surgery

2008 ◽  
Vol 17 (2) ◽  
pp. 199-211 ◽  
Author(s):  
Andrew N. Healey
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Interface Design ◽  
New Technology ◽  
Human Action ◽  
Task Demands ◽  
Neural Basis ◽  
Invasive Techniques ◽  
Brain Processing

Teleoperation is now common in high-risk work domains, particularly in surgery with the extensive use of remote, minimally invasive techniques. While this new technology affords a novel means by which to control human action for surgical intervention, interface design often constrains the operator in unorthodox ways, requiring considerable adaptation and raising patient safety concerns. There is a need to objectively measure operator adaptation, evaluate varying teleoperator interface designs and assess the efficacy of the virtual reality trainers that simulate teleoperation. This paper highlights the potential for a neuroergonomic approach to these problems. It first delineates some of the task demands unique to teleoperation in minimally invasive surgery and then speculates on the neural basis of those tasks with reference to select neuropsychological literature. The integration of this literature serves to indicate that teleoperation may engage a unique pattern of brain processing and that neuropsychological measurement may therefore be useful in evaluating the design of the teleoperation interface and teleoperator adaptation.

scholarly journals Variation in medical management and neurosurgical treatment of patients with supratentorial spontaneous intracerebral haemorrhage

2021 ◽  
pp. 239698732110059
Author(s):  
Lotte Sondag ◽  
Floor AE Jacobs ◽  
Floris HBM Schreuder ◽  
Jeroen D Boogaarts ◽  
W Peter Vandertop ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Intracerebral Haemorrhage ◽  
Online Survey ◽  
Treatment Decisions ◽  
Neurosurgical Treatment ◽  
The Right ◽  
Invasive Techniques ◽  
Spontaneous Intracerebral Haemorrhage

Introduction The role of surgery in spontaneous intracerebral haemorrhage (sICH) remains controversial. This leads to variation in the percentage of patients who are treated with surgery between countries. Patients and methods We sent an online survey to all neurosurgeons (n = 140) and to a sample of neurologists (n = 378) in Dutch hospitals, with questions on management in supratentorial sICH in general, and on treatment in six patients, to explore current variation in medical and neurosurgical management. We assessed patient and haemorrhage characteristics influencing treatment decisions. Results Twenty-nine (21%) neurosurgeons and 92 (24%) neurologists responded. Prior to surgery, neurosurgeons would more frequently administer platelet-transfusion in patients on clopidogrel (64% versus 13%; p = 0.000) or acetylsalicylic acid (61% versus 11%; p = 0.000) than neurologists. In the cases, neurosurgeons and neurologists were similar in their choice for surgery as initial treatment (24% and 31%; p = 0.12), however variation existed amongst physicians in specific cases. Neurosurgeons preferred craniotomy with haematoma evacuation (74%) above minimally-invasive techniques (5%). Age, Glasgow Coma Scale score and ICH location were important factors influencing decisions on treatment for neurosurgeons and neurologists. 69% of neurosurgeons and 80% of neurologists would randomise patients in a trial evaluating the effect of minimally-invasive surgery on functional outcome. Discussion Our results reflect the lack of evidence about the right treatment strategy in patients with sICH. Conclusion New high quality evidence is needed to guide treatment decisions for patients with ICH. The willingness to randomise patients into a clinical trial on minimally-invasive surgery, contributes to the feasibility of such studies in the future.

Indications for Minimally Invasive Surgery for Ovarian Cancer

2011 ◽  
Vol 9 (1) ◽  
pp. 126-132 ◽  
Author(s):  
Ernest S. Han ◽  
Mark Wakabayashi
Keyword(s):  
Ovarian Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Early Stage ◽  
Surgical Debulking ◽  
Advanced Stages ◽  
Cancer Laparoscopy ◽  
Invasive Techniques ◽  
Early Stage Ovarian Cancer

Epithelial ovarian cancer is often diagnosed in advanced stages and typically managed with surgical debulking followed by chemotherapy. For patients with presumed early-stage ovarian cancer, comprehensive surgical staging is essential for management, because 31% are upstaged. Over the past 15 years, minimally invasive techniques have improved and are increasingly being used to treat patients with ovarian cancer. Currently, only retrospective data support laparoscopic staging of patients with a suspicious adnexal mass or those surgically diagnosed with presumed early-stage ovarian cancer. Laparoscopy is also used in patients undergoing second-look procedures and to help evaluate whether patients should undergo optimal tumor debulking procedures or be initially managed with neoadjuvant chemotherapy. Randomized clinical studies are needed to further support the role of minimally invasive surgery in the treatment of ovarian cancer.

scholarly journals Minimally invasive surgery in the treatment of acute pancreatitis

2020 ◽  
Vol 11 (4) ◽  
pp. 75-80
Author(s):  
Eldar E. Topuzov ◽  
Bella G. Tsatinyan ◽  
Eskender G. Topuzov ◽  
Vyacheslav K. Balashov ◽  
Esma A. Arshba ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Medical Records ◽  
Pancreatic Necrosis ◽  
Surgical Intervention ◽  
Minimally Invasive Techniques ◽  
Severe Degree ◽  
Invasive Techniques ◽  
Positive Effect

Background. In recent years, the lethality from acute pancreatitis in Russia has not undergone significant changes and according to various data is from 15% to 25%. Purpose. The evaluation of the performing minimally invasive interventions in the treatment of patients with moderate to severe acute pancreatitis. Materials and methods. The authors retrospectively analyzed the medical records of 169 patients, the structure of mortality and complications depending on the choice of surgical intervention for the patients with acute pancreatitis of moderate and severe degree. Results. Lethal outcomes in the group of patients using minimally invasive interventions amounted to 11.5%, in the group of patients using traditional operations 37.5%, p 0.05. Laparoscopic interventions were effective in 88.8% of the cases, and drug therapy had a positive effect in 81.2% of the cases, p 0.05. Conclusion. It is shown that the use of minimally invasive techniques in the treatment of pancreatic necrosis significantly reduces the levels of mortality, postoperative complications, which improves the overall results of acute pancreatitis treatment.

scholarly journals Teaching Training and Surgical Education in Minimally Invasive Surgery (MIS) of the Spine: What Are the Best Teaching and Learning Strategies for MIS? Do We Have Any Experience and Data?

2020 ◽  
Vol 10 (2_suppl) ◽  
pp. 126S-129S
Author(s):  
Asdrubal Falavigna ◽  
Alfredo Guiroy ◽  
Néstor Taboada
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Learning Strategies ◽  
Invasive Surgery ◽  
Teaching And Learning ◽  
New Technologies ◽  
Ex Vivo ◽  
Morbidity Rate ◽  
Invasive Techniques

Study Design: Literature review and transversal study. Objective: Advances in new technologies give the surgeons confidence to manage complex spine conditions with a lower morbidity rate. This has changed the expectations of patients and medical payers and foreshadows the shift now underway: the use of minimally invasive techniques. The ethical considerations of learning directly on patients require a change in the education and training programs. Methods: The education paradigm has changed, and surgical training on minimally invasive surgery of the spine (MISS) techniques should follow a “curriculum.” The assessment of skill proficiency while learning the MISS techniques must be measurable to objectively show the performance gained over time and the changes that should be performed during training. Different strategies include “ex vivo” and “in vivo” training. Results: We have worked on a curriculum in which the participants can perceive the growth in their knowledge through the different educational opportunities. There are 3 levels: basic, advanced, and masters. Conclusions: We developed an educational curriculum for MISS rationale and techniques, that showed to be effective and interesting in our region.

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