scholarly journals Analysis of Port Site Complications & Measures to Prevent them

2021 ◽  
Vol 07 (3&4) ◽  
pp. 1-5
Author(s):  
Arun Kumar Tiwary ◽  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Port Site ◽  
Site Infection ◽  
Common Complication ◽  
Port Site Metastasis ◽  
Visceral Injury ◽  
Port Site Hernia ◽  
Minimal Complication

Background: Port site complications following elective laparoscopic surgeries are rare. Port site infection is the most common complication. Objectives: The study was conducted to analyze port site complications occurring in the patients undergoing laparoscopic surgeries and measures to prevent them. Patients and Methods: Total 408 patients who underwent various laparoscopic surgeries were included in the study. Follow up was done for 3 months postoperatively. Port site was examined for any complication. Result: Out of 408 patients 24 patients (5.88%) developed port site complications. 14 patients developed post site infection, 4 patients had port site discharge with sinus formation, 4 patients developed port site bleeding and 2 patients had port site hernia. No case of port site metastasis or visceral injury while port insertion were found. No patient had port site omental entrapment. Conclusion: Minimally invasive surgery is a safe and effective with minimal complication.

scholarly journals Assessment of Port Site Complication in Laparoscopic Abdominal Surgery

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K H Gad ◽  
A M M Elhefny ◽  
W B Gerges ◽  
M S A Sebaie
Keyword(s):  
Abdominal Surgery ◽  
Air Embolism ◽  
Port Site ◽  
Rapid Expansion ◽  
Port Site Metastasis ◽  
University Hospitals ◽  
Visceral Injury ◽  
Specialized Hospital ◽  
Vessel Injury ◽  
Port Site Hernia

Abstract Background Rapid expansion in the volume and complexities of laparoscopic surgeries has been accompanied by complications, many of which can be directly attributed to abdominal access with laparoscopic trocars including visceral injury, vascular injuries, air embolism, subcutaneous emphysema, port site infections, incisional hernia and metastasis occurred post operatively. Objectives This study aimed to detect the different port site complications encountered in laparoscopic abdominal surgery in terms of incidence and management. Patients and Methods This study was conducted in the surgical operating theatre of Ain-Shams University Hospitals (Demerdash and Ain Shams University Specialized Hospital), Cairo, Egypt, from January 2018 till July 2018. Results In this study complications occurred in 37 cases out of the 400 cases (Study subjects). The incidence of port site complications in our study was 9.25%. Vessel injury occurred in 19 out of the 400 cases with incidence 4.75%. Port site infection occurred in 11 out of the 400 cases with incidence 2.75%. Visceral injury occurred in 4 out of the 400 cases with incidence 1%. Port site hernia occurred in 3 out of the 400 case with incidence 0.75%. Conclusion Study incorporated 400 subjects operated for different indications laparoscopically and patients developing any kind of complications were recorded and analyzed. The results showed 3(0.75%) port site hernias, 11(2.75%) port site infections,19 (4.75%) vessel injury, 4 (1%) visceral injury and no port site metastasis was detected.

Video Tutorials Increase Precision in Minimally Invasive Surgery Training – a Prospective Randomised Trial and Follow-up Study

2018 ◽  
Vol 144 (02) ◽  
pp. 153-162
Author(s):  
Michael Thomaschewski ◽  
Hamed Esnaashari ◽  
Anna Höfer ◽  
Lotta Renner ◽  
Claudia Benecke ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Randomised Trial ◽  
Prospective Randomised Trial ◽  
Simulation Based ◽  
Video Tutorials ◽  
Group A ◽  
Group B

Abstract Background Simulation-based practice has become increasingly important in minimally invasive surgery (MIS) training. Nevertheless, personnel resources for demonstration and mentoring simulation-based practice are limited. Video tutorials could be a useful tool to overcome this dilemma. However, the effect of video tutorials on MIS training and improvement of MIS skills is unclear. Methods A prospective randomised trial (n = 24 MIS novices) was conducted. A video-trainer with three different tasks (#1 – 3) was used for standardised goal-directed MIS training. The subjects were randomised to two groups with standard instructional videos (group A, n = 12) versus comprehensive video tutorials for each training task watched at specific times of repetition (group B, n = 12). Performance was analysed using the MISTELS score. At the beginning and following the curriculum, an MIS cholecystectomy (CHE) was performed on a porcine organ model and analysed using the GOALS score. After 18 weeks, participants performed 10 repetitions of tasks #1 – 3 for follow-up analysis. Results More participants completed tasks #1 and #2 in group B (83.3 and 75%) than in group A (66.7 and 50%, ns). For task #2, there was a significant improvement in precision in group B (p < 0.001). For the entire cohort, the GOALS-Scores were 12.9 before and 18.9 after the curriculum (p < 0.001), with no significant difference between groups. Upon follow-up, 84.2% (task#1), 26.3% (task#2) and 100% (task#3) of MIS novices were able to reach the defined goals (A vs. B ns). There was a trend for a better MISTELS score in group B upon follow-up. Conclusions Standardised comprehensive video tutorials watched frequently throughout practice can significantly improve precision in MIC training. This aspect should be incorporated in MIS training.

scholarly journals Initial CT blend sign is not associated with poor outcome in patients following stereotactic minimally invasive surgery

2021 ◽  
Author(s):  
Xu Yang ◽  
Yan Zhu ◽  
Linshan Zhang ◽  
Likun Wang ◽  
Yuanhong Mao ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Cardiac Complications ◽  
Control Group ◽  
Haematoma Expansion ◽  
Poor Outcomes ◽  
The Impact ◽  
The Relationship

Abstract Background: The initial computed tomography (CT) blend sign has been used as an imaging marker to predict haematoma expansion and poor outcomes in patients with a small volume intracerebral haemorrhage (ICH). However, the relationship between the blend sign and outcomes remains elusive. The present study aimed to retrospectively measure the impact of initial CT blend signs on short-term outcomes in patients with hypertensive ICH who underwent stereotactic minimally invasive surgery (sMIS). Methods: We enrolled 242 patients with spontaneous ICH. Based on the initial CT features, the patients were assigned to a blend sign group (91 patients) or a nonblend sign (control) group (151 patients). The NIHSS, GCS and mRS were used to measure the effects of sMIS. The rates of severe pulmonary infection and cardiac complications were also compared between the two groups. Results: No significant differences in NIHSS and GCS scores were observed between the two groups. The proportion of patients with good outcomes during follow-up was not different between the two groups. The rate of rehaemorrhaging increased in the blend sign group. No significant differences in severe pulmonary infections and cardiac complications were noted between the two groups. Conclusions: The initial CT blend sign was not associated with poor outcomes in patients with hypertensive ICH who underwent sMIS. ICH patients with CT blend signs should undergo sMIS if they are suitable candidates for surgery.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: Outcome of adrenal sparing surgery in heritable pheochromocytoma

2016 ◽  
Vol 174 (1) ◽  
pp. R9-R18 ◽  
Author(s):  
F Castinetti ◽  
D Taieb ◽  
J F Henry ◽  
M Walz ◽  
C Guerin ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Cortical Tissue ◽  
Adrenal Surgery ◽  
Endocrine Disease ◽  
Von Hippel Lindau ◽  
Glucocorticoid Replacement Therapy ◽  
Hereditary Pheochromocytoma ◽  
Insight Into

The management of hereditary pheochromocytoma has drastically evolved in the last 20 years. Bilateral pheochromocytoma does not increase mortality in MEN2 or von Hippel-Lindau (VHL) mutation carriers who are followed regularly, but these mutations induce major morbidities if total bilateral adrenalectomy is performed. Cortical sparing adrenal surgery may be proposed to avoid definitive adrenal insufficiency. The surgical goal is to leave sufficient cortical tissue to avoid glucocorticoid replacement therapy. This approach was achieved by the progressive experience of minimally invasive surgery via the transperitoneal or retroperitoneal route. Cortical sparing adrenal surgery exhibits <5% significant recurrence after 10 years of follow-up and normal glucocorticoid function in more than 50% of the cases. Therefore, cortical sparing adrenal surgery should be systematically considered in the management of all patients with MEN2 or VHL hereditary pheochromocytoma. Hereditary pheochromocytoma is a rare disease, and a randomized trial comparing cortical sparing vs classical adrenalectomy is probably not possible. This lack of data most likely explains why cortical sparing surgery has not been adopted in most expert centers that perform at least 20 procedures per year for the treatment of this disease. This review examined recent data to provide insight into the technique, its indications, and the results and subsequent follow-up in the management of patients with hereditary pheochromocytoma with a special emphasis on MEN2.

scholarly journals Thoracoscopic recurrent tracheo-oesophageal fistula repair with mini endostapler: promising solution

2019 ◽  
Vol 12 (5) ◽  
pp. e229365
Author(s):  
Indalecio Cano Novillo ◽  
Belén Aneiros Castro ◽  
Araceli García Vázquez ◽  
Mónica De Miguel Moya
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Oesophageal Atresia ◽  
High Rate ◽  
Common Complication ◽  
Fistula Repair ◽  
Safe Alternative ◽  
Endoscopic Techniques ◽  
Promising Solution

Recurrent tracheo-oesophageal fistula (TOF) is a common complication in children who underwent oesophageal atresia repair. The traditional surgical approach performed either by thoracotomy or cervicotomy is associated with a high rate of morbidity, mortality and new recurrence. In the last decades, endoscopic techniques have emerged as the minimally invasive alternative. However, it seems that the optimal treatment is still unknown. We present a patient with a recurrent TOF who underwent thoracoscopic closure using a 5.8 mm endostapler. The patient was extubated at the end of the procedure, and he started feeding the day after surgery. At 15 months of follow-up, he is asymptomatic. Thoracoscopic closure of TOF using endostaplers seems to be a safe alternative with some possible benefits compared with traditional and endoscopic approach.

Minimally invasive surgery for simple bone cysts using hydroxyapatite cannulated pin: A long-term follow-up.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. e21501-e21501
Author(s):  
Takashi Higuchi ◽  
Norio Yamamoto ◽  
Hideji Nishida ◽  
Hiroaki Kimura ◽  
Akihiko Takeuchi ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Bone Cysts ◽  
Long Term Follow Up

Minimally invasive surgery for thoracolumbar spinal deformity: initial clinical experience with clinical and radiographic outcomes

2010 ◽  
Vol 28 (3) ◽  
pp. E9 ◽  
Author(s):  
Michael Y. Wang ◽  
Praveen V. Mummaneni
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Interbody Fusion ◽  
Complication Rates ◽  
Surgical Morbidity ◽  
Minimally Invasive Surgical ◽  
Csf Leakage ◽  
The Mean

Object Adult degenerative scoliosis can be a cause of intractable pain, decreased mobility, and reduced quality of life. Surgical correction of this problem frequently leads to substantial clinical improvement, but advanced age, medical comorbidities, osteoporosis, and the rigidity of the spine result in high surgical complication rates. Minimally invasive surgery is being applied to this patient population in an effort to reduce the high complication rates associated with adult deformity surgery. Methods A retrospective study of 23 patients was undertaken to assess the clinical and radiographic results with minimally invasive surgery for adult thoracolumbar deformity surgery. All patients underwent a lateral interbody fusion followed by posterior percutaneous screw fixation and possible minimally invasive surgical transforaminal lumbar interbody fusion if fusion near the lumbosacral junction was necessary. A mean of 3.7 intersegmental levels were treated (range 2–7 levels). The mean follow-up was 13.4 months. Results The mean preoperative Cobb angle was 31.4°, and it was corrected to 11.5° at follow-up. The mean blood loss was 477 ml, and the operative time was 401 minutes. The mean visual analog scale score improvement for axial pain was 3.96. Clear evidence of fusion was seen on radiographs at 84 of 86 treated levels, with no interbody pseudarthroses. Complications included 2 returns to the operating room, one for CSF leakage and the other for hardware pullout. There were no wound infections, pneumonia, deep venous thrombosis, or new neurological deficits. However, of all patients, 30.4% experienced new thigh numbness, dysesthesias, pain, or weakness, and in one patient these new symptoms were persistent. Conclusions The minimally invasive surgical treatment of adult deformities is a promising method for reducing surgical morbidity. Numerous challenges exist, as the surgical technique does not yet allow for all correction maneuvers used in open surgery. However, as the techniques are advanced, the applicability of minimally invasive surgery for this population will likely be expanded and will afford the opportunity for reduced complications.

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