scholarly journals Experience of application of 3D-visualization in laparoscopic operations

2020 ◽  
Vol 87 (1-2) ◽  
pp. 35-38
Author(s):  
V. M. Zaporozhan ◽  
A. V. Malynovskyi
Keyword(s):  
3D Visualization ◽  
Abdominal Muscles ◽  
Hernia Defect ◽  
3D Laparoscopy ◽  
Transabdominal Preperitoneal ◽  
Inguinal Hernias ◽  
First Results ◽  
Dor’S Fundoplication ◽  
Ventral Hernias

Objective. Studying of first results of application of 3D visualization in various laparoscopic interventions. Materials and methods. There were performed 169 operations: 27 transabdominal preperitoneal plasties of inguinal hernias, 19 intraperitoneal alloplasties of umbilical and postoperative ventral hernias with suturing of hernia defect, 1 retromuscular alloplasty of umbilical hernia, 6 reconstructions of anterior abdominal wall for dyastasis of rectal abdominal muscles, 103 plasties of hiatal hernias with fundoplications, 7 Heller’s cardiomyotomies and Dor’s fundoplication, 1 subtotal, 3 atypical gastric resections and 2 sleeve gastric resections for obesity. Results. 3D laparoscopy have simplified and accelerated the parietal peritoneum suturing in conduction of transabdominal preperitoneal plasties of inguinal hernias, as well as while performance of intraperitoneal alloplasties of umbilical and postoperative ventral hernias – the hernia defect suturing. While doing the hiatal hernia plasty, fundoplication with crurorrhaphy 3D laparoscopy have provided the additional advantages of manipulations improvement in special anatomic zones. Analogous advantages were shown in gastric operations, using 3D visualization. Intra- and postoperative complications were absent, as well as the hernias recurrence in the 6 mo-1.5 yr follow-up. Conclusion. The 3D visualization guarantees a rapid and highly-precision performance of complex manipulations in technically hard anatomical zones. Further accumulation of the material and comparison of results of 3D and 2D laparoscopy in prospective investigations, using objective parameters, as well as studying of expediency for 3D visualization selective application, for instance while performance of the most complicated operative stages are necessary.

scholarly journals P139 LAPAROSCOPIC TRANSABDOMINAL PREPERITONEAL REPAIR FOR SMALL AND MEDIUM PRIMARY UMBILICAL AND MIDLINE HERNIAS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Kryspin Mitura
Keyword(s):  
Mesh Repair ◽  
Laparoscopic Approach ◽  
Mesh Size ◽  
Complication Rates ◽  
Linea Alba ◽  
Hernia Defect ◽  
Transabdominal Preperitoneal ◽  
Open Mesh Repair ◽  
Onlay Mesh

Abstract Aim Complications of open mesh repair for primary umbilical and midline hernias (PUMH) may lead to significant re-admissions and follow-up costs. Although laparoscopic intraperitoneal onlay mesh repair reduces infection rates, especially in overweight patients, it’s controversial in these hernias, mainly due to potential adhesions’ formation. Laparoscopic transabdominal preperitoneal technique (lap-TAPP) may address these issues, as it combines advantages of both open and laparoscopic approaches. The aim of this study is to present the initial results of lap-TAPP for PUMH in regard to its feasibility and complication rates. Material and Methods We evaluated 25 consecutive cases of lap-TAPP repair for PUMH. Patients’s characteristics, intraoperative findings, and postoperative complications after 30-days follow-up were analyzed. Results 21 male and 4 female patients were included in analysis (mean BMI 29.8 kg/m2). Surgery time was 82 minutes (55-120). We found 20 umbilical and 11 epigastric linea alba hernias. Mesh size was 144cm2 (120-225); mean hernia defect width was 25mm (10-40). In 9 patients (36%) the peritoneal rents were created which were easily closed with sutures. All patients were discharged on 1 POD with no complications. After 30-days we found no recurrences or bulging, no pain complaints. We found one subcutaneous small hematoma with no need for intervention. Conclusions Laparoscopic TAPP for small and medium PUMH is a safe and feasible technique with low complication rate. However, this method is technically demanding and time consuming while performed with laparoscopic approach as it requires precise and subtle plane dissection, and non-ergonomic closure hernia defect.

scholarly journals THE FIRST RESULTS OF LAPAROSCOPIC INTRAPERITONEAL ALLOPLASTY OF UMBILICAL AND POSTOPERATIVE VENTRAL HERNIAS WITH CLOSURE OF THE HERNIAL DEFECT USING 3D LAPAROSCOPY

2019 ◽  
pp. 56-58
Author(s):  
A. V. Malinovsky ◽  
S. Y. Badion
Keyword(s):  
Main Group ◽  
Control Group ◽  
Average Volume ◽  
3D Laparoscopy ◽  
First Results ◽  
Ventral Hernias

Abstract. The aim of the study was to analyze the first results of laparoscopic alloplasty of the umbilical and postoperative ventral hernias with suturing the hernial defect using 3D laparoscopy. During the period from September 2018 to April 2019, we performed 12 intraperitoneal alloplastic umbilical and postoperative hernias of medium and large sizes. The main group consisted of 7 patients who underwent intraperitoneal alloplasty with closure of the hernial defect and sac. 3D laparoscopy was used in some patients, (Epic HD system, Richard Wolf). The control group consisted of 5 patients who underwent intraperitoneal alloplasty without suturing the hernial defect and sac. Seromes in the main group were in 3 cases, the average volume was 2 ml (from 0.5 to 3 ml), in the control group seromes were also in 3 cases, the average volume was 2.8 ml (from 1 to 5.5 ml). The immediate results, tracked from 1 to 6 months, showed no recurrence in both groups.

The transabdominal preperitoneal aloplasty optimization for recurrent inguinal hernias after liechtenstein surgery

2019 ◽  
Vol 0 (2) ◽  
pp. 30-33
Author(s):  
Ya. P. Feleshtynskyi ◽  
A. A. Shtaier ◽  
M. O. Yosypenko
Keyword(s):  
Transabdominal Preperitoneal ◽  
Inguinal Hernias

Creation of physiologic rhythm by closed loop stimulation in heart failure patients with severe chronotropic incompetence: worldwide first results of a pilot study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Proff ◽  
B Merkely ◽  
R Papp ◽  
C Lenz ◽  
P.J Nordbeck ◽  
...  
Keyword(s):  
Heart Rate ◽  
Closed Loop ◽  
Funding Source ◽  
Chronotropic Incompetence ◽  
First Results ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background The prevalence of chronotropic incompetence (CI) in heart failure (HF) population is high and negatively impacts prognosis. In HF patients with an implanted cardiac resynchronisation therapy (CRT) device and severe CI, the effect of rate adaptive pacing on patient outcomes is unclear. Closed loop stimulation (CLS) based on cardiac impedance measurement may be an optimal method of heart rate adaptation according to metabolic need in HF patients with severe CI. Purpose This is the first study evaluating the effect of CLS on the established prognostic parameters assessed by the cardio-pulmonary exercise (CPX) testing and on quality of life (QoL) of the patients. Methods A randomised, controlled, double-blind and crossover pilot study has been performed in CRT patients with severe CI defined as the inability to achieve 70% of the age-predicted maximum heart rate (APMHR). After baseline assessment, patients were randomised to either DDD-CLS pacing (group 1) or DDD pacing at 40 bpm (group 2) for a 1-month period, followed by crossover for another month. At baseline and at 1- and 2-month follow-ups, a CPX was performed and QoL was assessed using the EQ-5D-5L questionnaire. The main endpoints were the effect of CLS on ventilatory efficiency (VE) slope (evaluated by an independent CPX expert), the responder rate defined as an improvement (decrease) of the VE slope by at least 5%, percentage of maximal predicted heart rate reserve (HRR) achieved, and QoL. Results Of the 36 patients enrolled in the study, 20 fulfilled the criterion for severe CI and entered the study follow-up (mean age 68.9±7.4 years, 70% men, LVEF=41.8±9.3%, 40%/60% NYHA class II/III). Full baseline and follow-up datasets were obtained in 17 patients. The mean VE slope and HRR at baseline were 34.4±4.4 and 49.6±23.8%, respectively, in group 1 (n=7) and 34.5±12.2 and 54.2±16.1% in group 2 (n=10). After completing the 2-month CPX, the mean difference between DDD-CLS and DDD-40 modes was −2.4±8.3 (group 1) and −1.2±3.5 (group 2) for VE slope, and 17.1±15.5% (group 1) and 8.7±18.8% (group 2) for HRR. Altogether, VE slope improved by −1.8±2.95 (p=0.31) in DDD-CLS versus DDD-40, and HRR improved by 12.9±8.8% (p=0.01). The VE slope decreased by ≥5% in 47% of patients (“responders to CLS”). The mean difference in the QoL between DDD-CLS and DDD-40 was 0.16±0.25 in group 1 and −0.01±0.05 in group 2, resulting in an overall increase by 0.08±0.08 in the DDD-CLS mode (p=0.13). Conclusion First results of the evaluation of the effectiveness of CLS in CRT patients with severe CI revealed that CLS generated an overall positive effect on well-established surrogate parameters for prognosis. About one half of the patients showed CLS response in terms of improved VE slope. In addition, CLS improved quality of life. Further clinical research is needed to identify predictors that can increase the responder rate and to confirm improvement in clinical outcomes. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Biotronik SE & Co. KG

The Near-Earth Objects Follow-Up Program: First Results

Icarus ◽  
1995 ◽  
Vol 117 (1) ◽  
pp. 62-70 ◽  
Author(s):  
S Mottola
Keyword(s):  
First Results ◽  
Near Earth Objects

scholarly journals A Randomized, Controlled Trial Comparing Autologous Matrix-Induced Chondrogenesis (AMIC®) to Microfracture: Analysis of 1- and 2-Year Follow-Up Data of 2 Centers

2013 ◽  
Vol 7 (1) ◽  
pp. 133-143 ◽  
Author(s):  
Sven Anders ◽  
Martin Volz ◽  
Hubert Frick ◽  
Jörg Gellissen
Keyword(s):  
Randomized Controlled Trial ◽  
Clinical Outcomes ◽  
Controlled Trial ◽  
Collagen Type I ◽  
Cartilage Defects ◽  
Type I ◽  
Randomized Controlled ◽  
First Results ◽  
Post Operation

Microfracture (MFx) is currently the recommended option for the treatment of small cartilage defects but is not regarded as suitable for the treatment of defects larger than 2.5 cm2. To extent its applicability to medium-sized defects MFx has been combined with a collagen type I/III matrix (Chondro-Gide®). This technique is called Autologous Matrix-Induced Chondrogenesis (AMIC®) and meanwhile a clinically established treatment option for localized full-thickness small- to medium-sized cartilage defects. Despite its more spreading clinical use, clinical data published so far are limited to mainly case report series.In this study, we report the first results of a randomized, controlled trial assessing the efficacy and safety of AMIC®versus MFx. Patients enrolled in 2 centers were included in this analysis. 38 patients (aged 21-50 years, mean defect size 3.4 cm2) were randomized and treated either with MFx, with sutured AMIC®or glued AMIC®. Clinical outcomes (modified Cincinnati and ICRS score) could be assessed in 30 patients at 1-year and 27 patients at 2-years post-operation. Improvements in both scores were seen at 1-and 2-years post-operation, irrespective of the technique used. MRI assessment revealed a satisfactory and homogenous defect filling in the majority of patients. No treatment-related adverse events were reported.This interim analysis confirms the mid-term results for AMIC®reported in literature. It demonstrates clearly that clinical outcomes at 1-year post-operation are maintained at 2-years. Therefore we consider enhancing MFx with Chondro-Gide®is a valid and safe cartilage repair option for small- to medium-sized cartilage defects of the knee.

Sign in / Sign up

Export Citation Format

Share Document