scholarly journals Comparative Assessment of Original vs. Standard Surgery Techniques in Treatment for Purulent Pyelonephritis

2021 ◽  
Vol 11 (4) ◽  
pp. 288-292
Author(s):  
V. A. Ananev ◽  
V. N. Pavlov ◽  
A. M. Pushkarev
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Cortical Layer ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Intraarterial Infusion ◽  
Minimally Invasive Surgical ◽  
Destructive Processes ◽  
Laparoscopic Techniques

Background. Modern minimally invasive surgical techniques reduce traumatism of operative interventions and aggressive anaesthesia, which accordingly shortens the patient’s hospital stay and rehabilitation period.Aim. An improvement of surgical outcomes in patients with purulent pyelonephritis via introduction of laparoscopic techniques.Materials and methods. Th e study included 80 purulent pyelonephritis patients operated at the Territorial Clinical Hospital during 2006—2018. Th e patients were divided between two cohorts. Cohort 1 included 40 (50 %) patients operated with standard techniques (ST), cohort 2 — 40 (50 %) patients having surgery by an original minimally invasive technique (OT). Kidney decapsulation was found to outcome in parenchymal decompression and blood circulation restore in cortical layer. Intraarterial infusion of alprostadil prevents further spread of purulent-destructive processes in kidney.Results and discussion. In patients with the minimally invasive technique, postoperative period proceeded at no complications. On day 1, the patients reported reduced pain syndrome in the surgical area. Contrasted renal MSCT before and aft er surgery showed the recovery of renal blood flow and significant diminishing of destruction foci in short term. Nephrectomy was not performed as no-indication.Conclusion. The treatment outcomes in 40 patients having the new surgical technique demonstrate its efficacy and applicability in clinical practice.

scholarly journals Description of a minimally invasive technique with a modified instrument for the osteosynthesis of proximal femoral fractures using the standard DHS and case series

2020 ◽  
Vol 47 ◽  
Author(s):  
RICARDO RAMON CAMACHO IRIGOYEN ◽  
RAFAEL DE LUCA DE-LUCENA ◽  
JEAN KLAY SANTOS MACHADO ◽  
GABRIEL SEVERO DA-SILVA ◽  
CARLOS ROBERTO SCHWARTSMANN ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Case Series ◽  
Femoral Fractures ◽  
Soft Tissue Injuries ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Trochanteric Fractures ◽  
Clinical Complications ◽  
Minimally Invasive Surgical

ABSTRACT Introduction: the number of hip fractures is estimated to increase from 1.66 million in 1990 to 6.26 million by 2050. Internal fixation is the most common surgical treatment for intertrochanteric fractures. Objectives: the objective of the present research is to describe a minimally invasive technique with a modified instrument for the treatment of stable proximal femoral trochanteric fractures using the standard DHS, classified as Tronzo types 1 and 2 (AO 31A1.2), and presenting a case series. Methods: a case was selected to present the technique. Patients operated by this technique undergo a clinical evaluation and preoperative preparation as routine. The criteria for inclusion in the study were the presence of stable fracture of the proximal femur verified by two hip specialist orthopedists, and operated by the minimally invasive technique with a modified instrument using a standard DHS. Exclusion criteria were cases of patients operated for unstable fractures, and the use of other surgical techniques. A case series of 98 patients was performed and discussed. Results: minimally invasive technique with a modified instrument using the standard DHS device can reduce bleeding, it decreases soft tissue injuries, surgical time, and hospital stay, as any other MIPO procedures. Ninety-eight patients underwent the operation (Tronzo types I and II), 59 female and 39 male, ages from 50 to 85 years old. Immediate post-operative complications were shortening of the lower limb, loss of fracture reduction, and death by clinical complications. Conclusion: the present study describes a minimally invasive surgical technique using a modified instrument to perform proximal femoral osteosynthesis for stable trochanteric fractures, using the standard DHS.

scholarly journals Optimization of Surgical Care and Anesthesia in the Treatment of Multilevel Degenerative Diseases of the Lumbar Spine in Patients with Overweight and Obesity

2018 ◽  
Vol 73 (6) ◽  
pp. 401-410 ◽  
Author(s):  
Vadim A. Byvaltsev ◽  
Andrey A. Kalinin ◽  
Victoria Yu. Goloborodko
Keyword(s):  
Lumbar Spine ◽  
Minimally Invasive ◽  
Surgical Procedures ◽  
Surgical Techniques ◽  
Surgical Care ◽  
Pain Syndrome ◽  
Overweight And Obesity ◽  
Degenerative Diseases ◽  
Minimally Invasive Surgical ◽  
Paravertebral Muscles

Background: The provision of surgical care in the treatment of degenerative diseases of the lumbar spine in patients with obesity and obesity is associated with significant risks of anesthesia and the development of perioperative complications. Aims: to analyze the results of the introduction of a combination of surgical procedures and anesthesia in the treatment of multilevel degenerative diseases of the lumbar spine in patients with excessive body weight and obesity.Materials and methods: The results of surgical treatment of 86 patients were studied, 2 groups were identified. In the study group (SG, n=37), minimally invasive surgical techniques and original surgical approach, paravertebral musculature infiltration with bupivacaine with epinephrine, and multimodal anesthesia with dexmedetomidine were used. The comparison group (CG, n=49) consisted of patients who used the technique of traditional open transpedicular fixation in combination with the posterior interbody fusion without the above combination of surgical procedures and anesthesia. Observation and clinical evaluation was performed in the early (during hospitalization) and in the distant (on average 36 months) postoperative periods.Results: In SG there were no changes in hemodynamics and better results were obtained on the speed of recovery of psychomotor functions. The use of local anesthetics significantly reduced the local pain syndrome (p0.05) and the need for analgesics (p=0.002). Comparative analysis in the main group revealed significantly better results in indices of the duration of the operation [SG 145 (105; 155) min, CG 185 (100; 205) min; p=0.02], the volume of blood loss [SG 110 (90; 140) ml, CG 510 (390; 640) ml; p0.001], the activation time [SG 1 (1; 2) days, CG 3 (3; 4) days; p=0.01], the length of hospitalization [SG 10 (9; 11) days, CG 13 (12; 15) days; p=0,03], remote clinical parameters of the pain syndrome level from the visual analogue scale in the lower extremities [SG 3 (1; 4) mm, CG 9 (6; 14) mm; p=0.006] and the lumbar spine [SG 6 (4; 9) mm, CG 16 (11; 21) mm; p=0.001], functional state according to ODI [SG 8 (6; 10) points, CG 16 (12; 24) points; p=0.008], subjective satisfaction with the operation performed on the Macnab scale (p=0.01). The number of postoperative complications in SG was 8%, in CG ― 18% (p=0.006).Conclusions: Analysis of the results of the introduction of a combination of surgical and anesthetic support methods in the treatment of multilevel degenerative diseases of the lumbar spine in patients with overweight and obesity, including minimally invasive surgical techniques, infiltration of paravertebral muscles with bupivacaine and epinephrine, multimodal anesthesia with dexmedetomidine showed its high perioperative safety, low number of complications, as well as better and clinical outcomes in the early and late postoperative periods.

A Novel Minimally Invasive Technique for Spinal Cord Untethering

2007 ◽  
Vol 60 (suppl_2) ◽  
pp. ONS-70-ONS-74 ◽  
Author(s):  
Trent L. Tredway ◽  
Wael Musleh ◽  
Sean D. Christie ◽  
Yevginy Khavkin ◽  
Richard G. Fessler ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Back Pain ◽  
Minimally Invasive ◽  
Tissue Injury ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Filum Terminale ◽  
Minimally Invasive Surgical

Abstract Objective: Minimally invasive surgical techniques have been described for the treatment of spinal pathology. Tethered cord syndrome is an under-diagnosed condition of abnormally rigid fixation of the spinal cord that results in spinal cord tension leading to ischemia. It can be the cause of incontinence, scoliosis, and chronic back and leg pain. In situations of spinal cord tether owing to fatty filum or tight filum terminale, the symptoms can be relieved by sectioning of the filum. We present a novel, minimally invasive technique for surgical untethering of the spinal cord by filum sectioning. The patho-physiology of tethered spinal cord and the advantages of minimally invasive surgical management of this entity are discussed. Methods: Three patients (ages 14, 35, and 46 yr) presented with long-standing leg and back pain and neuroradiological features of tethered cord syndrome and thickened, fatty filum terminale. Two patients presented with scoliosis and, upon further history, had subclinical incontinence; one of these patients had abnormal urodynamic studies. Results: All three patients underwent a minimally invasive approach to the L4/L5 level using the X-tube (Medtronic, Inc., Memphis, TN). A laminotomy was performed and the dura exposed. The dura was then opened and intradural microdissection delivered the fatty filum into the durotomy. Electrical stimulation was performed while the lower extremities and the anal sphincter were monitored for electromyographic activity. After acquisition of positive controls, the filum was identified by the lack of sphincter and lower extremity electromyographic responses and was then cauterized and cut. Dura was repaired with the use of endoscopic instrumentation. All patients had significant improvement of their leg and back pain, and one patient had resolution of the abnormal urodynamics. Conclusion: Tethered spinal cords can be safely and effectively untethered using minimally invasive surgery. This technique provides the advantage of reduced soft tissue injury, less postoperative pain, minimal blood loss, a smaller incision, and a shorter hospitalization. The minimal amount of tissue injury generated by this technique may also provide the added advantage of reduced scar formation and risk of retethering.

scholarly journals TULAA: A Minimally Invasive Appendicectomy Technique for the Paediatric Patient

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Giordano Perin ◽  
Maria Grazia Scarpa
Keyword(s):  
Paediatric Patient ◽  
Minimally Invasive ◽  
Peritoneal Cavity ◽  
Surgical Approach ◽  
Surgical Outcomes ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Minimally Invasive Surgical ◽  
Invasive Surgical Approach ◽  
Laparoscopic Assisted

TULAA or Transumbilical Laparoscopic Assisted Appendicectomy is a minimally invasive technique described by Pelosi in 1992 for the removal of the inflamed appendix. Its main advantage is the possibility of exploring the peritoneal cavity and performing a simple and safe extracorporeal appendicectomy. Since its first description, different authors reported their experience with such technique. The aim of this review is to summarise the surgical outcomes currently reported in the literature for this minimally invasive surgical approach and compare it with standard open and laparoscopic appendicectomy.

Minimally Invasive Surgical Techniques to Treat Spine Infection S

1996 ◽  
Vol 27 (1) ◽  
pp. 183-199 ◽  
Author(s):  
Larry M. Parker ◽  
Paul C. McAfee ◽  
Ira L. Fedder ◽  
James C. Weis ◽  
W. Peter Geis
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Spine Infection ◽  
Minimally Invasive Surgical

The Emerging Role of Robotic Single-site Approach for Myomectomy: A Systematic Review of the Literature

2021 ◽  
pp. 155335062098822
Author(s):  
Eirini Giovannopoulou ◽  
Anastasia Prodromidou ◽  
Nikolaos Blontzos ◽  
Christos Iavazzo
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Complication Rate ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Single Site ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Robotic Myomectomy ◽  
The Mean

Objective. To review the existing studies on single-site robotic myomectomy and test the safety and feasibility of this innovative minimally invasive technique. Data Sources. PubMed, Scopus, Google Scholar (from their inception to October 2019), as well as Clinicaltrials.gov databases up to April 2020. Methods of Study Selection. Clinical trials (prospective or retrospective) that reported the outcomes of single-site robotic myomectomy, with a sample of at least 20 patients were considered eligible for the review. Results. The present review was performed in accordance with the guidelines for Systematic Reviews and Meta-Analyses (PRISMA). Four (4) studies met the inclusion criteria, and a total of 267 patients were included with a mean age from 37.1 to 39.1 years and BMI from 21.6 to 29.4 kg/m2. The mean operative time ranged from 131.4 to 154.2 min, the mean docking time from 5.1 to 5.45 min, and the mean blood loss from 57.9 to 182.62 ml. No intraoperative complications were observed, and a conversion rate of 3.8% was reported by a sole study. The overall postoperative complication rate was estimated at 2.2%, and the mean hospital stay ranged from 0.57 to 4.7 days. No significant differences were detected when single-site robotic myomectomy was compared to the multiport technique concerning operative time, blood loss, and total complication rate. Conclusion. Our findings support the safety of single-site robotic myomectomy and its equivalency with the multiport technique on the most studied outcomes. Further studies are needed to conclude on the optimal minimally invasive technique for myomectomy.

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