scholarly journals Endoscopic extraperitoneal access to the prostate in the presence of cystostomy fistula: methodology and first results

2020 ◽  
Vol 13 (5) ◽  
pp. 46-50
Author(s):  
I.E. Mamaev ◽  
◽  
V.V. Solovyev ◽  
M.B. Popova ◽  
R.I. Guspanov ◽  
...  
Keyword(s):  
Abdominal Cavity ◽  
Prostate Gland ◽  
Negative Effects ◽  
Working Space ◽  
Surgical Access ◽  
Abdominal Organs ◽  
First Results ◽  
Surgical Field ◽  
The Creation ◽  
Natural Separation

Introduction. The advantages of extraperitoneal laparoscopic access to the prostate are well known - this is an opportunity to avoid the negative effects of pneumoperitoneum and the natural separation of the abdominal cavity from the surgical field. One of the drawbacks is the need to create an artifical cavity. Presence of a cystostomy fistula can significantly complicate the formation of the preperitoneal cavity. The aim of this research is to analyze our experience in creating extraperitoneoscopic access to the prostate gland in patients with cystostomy fistula. Materials and methods. From 2015 to 2019, we operated on 153 patients using extraperitoneal access to the prostate gland. Of these, 13 had a cystostomy fistula at the time of the surgery. The formation of the space was carried out according to the original technique without spacemaker balloon. After isolation of the fistulous passage, the latter intersected with suturing on the bladder side with 8-shaped (2–0 vicril). Results. In all cases, we were able to form a working space sufficient for surgical intervention. In 10 (76,93%) cases, access was created without opening the abdominal cavity, in 3 cases (23,07%) the abdominal cavity was unintentionally opened. There were no complications associated with the creation of a pre-abdominal space. Discussion. Extraperitoneal access to the prostate reduces the likelihood of damage to the abdominal organs, reduces the angle of inclination of the patient in the Trendelenburg position, does not require the creation of a pneumoperitoneum, with its adverse effect on the cardiovascular system, and also preserves the natural barriers between the surgical area and the abdominal cavity. The presence of a cystostomy in a patient is not an obstacle to this surgical access, the technical feasibility and safety of which was demonstrated in our study. Conclusion. Thus, extraperitoneal access to the prostate gland in the presence of a cystostomy fistula can be safely created in most cases.

scholarly journals Influence of anesthesia methods on the immune system of patients with oncological diseases of the abdominal organs

2020 ◽  
Vol 14 (4) ◽  
pp. 185-192
Author(s):  
M. I. Neimark ◽  
Sayat Z. Tanatarov
Keyword(s):  
Immune System ◽  
Abdominal Cavity ◽  
Nitrogen Monoxide ◽  
Halogenated Hydrocarbons ◽  
Malignant Neoplasms ◽  
Negative Effects ◽  
Epidural Blockade ◽  
Abdominal Organs ◽  
Cytokine Balance ◽  
Oncological Diseases

Modern anesthesia, based on the use of halogenated hydrocarbons, nitrogen monoxide, or xenon, cannot fully ensure the interruption of nociceptive impulses at the level of the stem and spinal and subcortical formations, which caused vegetative and metabolic signs related to pain. To prevent the negative effects of pain, additional methods are used, including intraoperative analgesia and regional blockades. This study was conducted to assess the effects of various types of anesthesia, including epidural blockade, on the parameters of the immune system in patients with cancer. A total of 438 patients with malignant neoplasms of the abdominal organs were examined. In these patients, levels of cytokines (such as tumor necrosis-alpha and interleukin-6) and T-lymphocytes of various clusters of differentiation in the blood were measured. Impaired cytokine balance in patients with oncological diseases of the abdominal cavity was accompanied by the formation of suppression of cellular immunity in the postoperative period. Measurements revealed immunosuppression that was largely dependent on the type of anesthesia used. Cellular parameters with the greatest relationship with immunity were preserved during combined anesthesia, including epidural blockade.

scholarly journals Airway management in a patient with an intratracheal tumor near the carina by a two-stage operation

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110145
Author(s):  
Chaerim Oh ◽  
Hyun Joo Kim
Keyword(s):  
Mechanical Ventilation ◽  
Airway Management ◽  
General Anesthesia ◽  
Distal Part ◽  
High Flow ◽  
Tracheal Resection ◽  
Two Stage ◽  
Partial Obstruction ◽  
Surgical Access ◽  
Surgical Field

In patients with intratracheal tumors, airway management while maintaining oxygenation and providing surgical access to the airway can be challenging. Here, we present a case of a two-stage operation to remove an intratracheal tumor causing partial obstruction near the carina. In the otorhinolaryngology department, a biopsy was performed during apnea under high-flow nasal oxygenation support. A few days later, a thoracic surgeon performed tracheal resection after sternotomy under general anesthesia. Mechanical ventilation was performed by inserting a sterile endotracheal tube in the resected distal part of the trachea in the surgical field for tracheal end-to-end anastomosis. Airway was successfully secured through close communication between teams of anesthesiologists and surgeons.

Advantages and disadvantages of main surgical approaches for robot-assisted radical prostatectomy

2020 ◽  
Vol 10 (4) ◽  
pp. 347-354
Author(s):  
Dmitriy M. Il’in ◽  
Vladimir A. Makeev
Keyword(s):  
Radical Prostatectomy ◽  
Abdominal Cavity ◽  
Prostate Gland ◽  
Clinical Situation ◽  
Surgical Approaches ◽  
Robot Assisted ◽  
Scientific Databases ◽  
Advantages And Disadvantages ◽  
Robotic Assisted Surgery ◽  
History Of

The introduction of robotic-assisted surgery into clinical practice has opened up new possibilities for the surgical treatment of urological patients. Robot-assisted radical prostatectomy (RARP) is one of the most commonly performed robot-assisted surgery. The review is devoted to the main surgical approaches for RARP. An analysis of publications on this topic was carried out using the search engines of the scientific databases PubMed, Medscape, Google Scholar, eLibrary when writing the article The article presents an overview of the advantages and disadvantages of the existing four access options for RARP: anterior, perineal, lateral and posterior, as well as oncological and functional outcomes of operations. It has been shown that a surgeon with different approaches can choose the most suitable one for a given clinical situation, focusing on the stage of the disease, the patients age, anatomical features of the prostate gland, the state of the patients erectile function, and the history of operations on the abdominal cavity and pelvic organs.

scholarly journals ROLE OF ACCESS OSTEOTOMY IN HEAD AND NECK LESIONS – A REVIEW

2021 ◽  
pp. 25-30
Author(s):  
BHARATHI K ◽  
MANOJ CHANDRASEKAR ◽  
KAPIL DEV KUMAR S ◽  
BALA JAGANNATH GUPTA B
Keyword(s):  
Head And Neck ◽  
Surgical Resection ◽  
Hand Search ◽  
Surgical Access ◽  
Operative Care ◽  
Specific Tumor ◽  
Surgical Field ◽  
Tumor Types ◽  
Neurovascular Structures

The surgical resection of the head and neck lesions summarizes the principles, classifications, applications, complications, and post-operative care of osteotomy with the standard protocols performed safely. It often poses a great surgical challenge due to the anatomical complexity, difficulty in accessibility, and proximity of vital structures. A multidisciplinary approach is often required in these situations for their better exposure to provide surgical access. Access osteotomy is the choice and type for these head and neck lesions, which are most often based on the anatomic extent of the lesion, vascularity of the lesion, and involvement of neurovascular structures in and around it. The literature search using Medline from the year 1986 to 2019 were performed and textbooks were also collected by hand search from the same period. The role of aggressive surgical resection has not been established for malignant head and neck lesions with the technical feasibility and its efficacy for specific tumor types must be defined by the future studies. Thus, we would like to conclude that access osteotomy allows the surgeon a better view and an access of the surgical field to resect the tumor completely with safer margins, preserving the vital structures, pre-operative functions, and reducing post-operative complications.

scholarly journals Development of detection method for automatic hemostasis using machine learning with abdominal cavity irrigation

2020 ◽  
Vol 7 (7) ◽  
pp. 2103
Author(s):  
Yoshihisa Matsunaga ◽  
Ryoichi Nakamura
Keyword(s):  
Machine Learning ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Real Time ◽  
Invasive Surgery ◽  
Abdominal Cavity ◽  
Training Dataset ◽  
Support Vector ◽  
Processing Cost ◽  
Surgical Field

Background: Abdominal cavity irrigation is a more minimally invasive surgery than that using a gas. Minimally invasive surgery improves the quality of life of patients; however, it demands higher skills from the doctors. Therefore, the study aimed to reduce the burden by assisting and automating the hemostatic procedure a highly frequent procedure by taking advantage of the clearness of the endoscopic images and continuous bleeding point observations in the liquid. We aimed to construct a method for detecting organs, bleeding sites, and hemostasis regions.Methods: We developed a method to perform real-time detection based on machine learning using laparoscopic videos. Our training dataset was prepared from three experiments in pigs. Linear support vector machine was applied using new color feature descriptors. In the verification of the accuracy of the classifier, we performed five-part cross-validation. Classification processing time was measured to verify the real-time property. Furthermore, we visualized the time series class change of the surgical field during the hemostatic procedure.Results: The accuracy of our classifier was 98.3% and the processing cost to perform real-time was enough. Furthermore, it was conceivable to quantitatively indicate the completion of the hemostatic procedure based on the changes in the bleeding region by ablation and the hemostasis regions by tissue coagulation.Conclusions: The organs, bleeding sites, and hemostasis regions classification was useful for assisting and automating the hemostatic procedure in the liquid. Our method can be adapted to more hemostatic procedures. 

scholarly journals CLINICAL AND EPIDEMIOLOGICAL ANALYSIS OF MALIGNANT NEOPLASMS OF THE ABDOMINAL ORGANS

2021 ◽  
Vol 19 (4) ◽  
Author(s):  
I.A. Malishevsky
Keyword(s):  
Developmental Stages ◽  
Abdominal Cavity ◽  
Malignant Neoplasms ◽  
Newly Diagnosed ◽  
Epidemiological Analysis ◽  
Software Packages ◽  
Abdominal Organs ◽  
Microsoft Office ◽  
Epidemiological Characteristics ◽  
Epidemiological Parameters

Purpose – to determine the statistical and epidemiological parameters of malignantneoplasms of the abdominal cavity organs.Material and methods. The study was carried out on the basis of the Chernivtsi RegionalClinical Oncological Dispensary and covers observation materials during 2019 andstatistical reporting concerning 21259 patients with tumors of various localization. The calculation of indices was carried out using software packages MS Access and MS Excelbased on the Microsoft Office medium.Results. Neoplasms of the abdominal organs account for 32.4%-37.1% of the totalnumber of neoplasms of various localization. The distribution of patients with malignantdiseases of the abdominal organs by developmental stages is relatively uniform, despitesignificant differences in various localizations of neoplasmsConclusions. Malignant neoplasms of the abdominal organs account for 32.4%(registered) and 37.1% of the newly diagnosed of the total number of tumors of variouslocalization, indicating the importance of further research. A significant part of tumors ofthe abdominal cavity organs are diagnosed in the late (III-IV) stages of the pathologicalprocess development (up to 94.7% in the liver and intrahepatic biliary tract). Therevealed significant differences in clinical and epidemiological characteristics requirefurther research.

scholarly journals Organisation design and the role of ICT: Negative effects of working from home during the coronavirus pandemic

2021 ◽  
Vol 16 (1) ◽  
pp. 1-12
Author(s):  
Ernad Kahrović ◽  
Emina Kahrović
Keyword(s):  
Dominant Role ◽  
Organization Design ◽  
Negative Effects ◽  
Work From Home ◽  
Working From Home ◽  
New Organizational Forms ◽  
The Creation ◽  
Impact Of Technology ◽  
The Impact

The goal of the paper is to point to the role and importance of organization design as a tool for strategy implementation, together with a dominant, role of technology in shaping the design. Namely, the development, of modern information and communication technology (ICT) is accompanied by the creation of new organizational forms, which enable the management, and employees to carry out, a significant, portion of work from home. The central focus of this paper is the impact, of technology on the creation of new forms of design, with a virtual organization taking up a particularly prominent, position. We underline the fact, that, among many changes that, the coronavirus pandemic has produced in everyday life, working from home can be considered as the most, drastic one; hence, its harmful effects are underscored, such as those relating to negative psychological effects, anxiety disorders, health issues, job loss, decreased efficiency and reduced satisfaction of the employees.

Commercial Cities

2013 ◽  
Author(s):  
Oscar Gelderblom
Keyword(s):  
International Trade ◽  
Institutional Arrangements ◽  
Institutional Framework ◽  
Central Position ◽  
Negative Effects ◽  
The Creation ◽  
Treat All ◽  
Merchant Community

This chapter examines how the competition between neighboring ports led Bruges, Antwerp, and Amsterdam to adapt institutional arrangements to the needs of international traders. It considers how Bruges, Antwerp, and Amsterdam were able to overcome the negative effects of urban competition and develop an institutional framework conducive to the growth of trade. It explores what the three commercial cities did to secure a central position in domestic and international trade during the period, focusing on the important role played by the urban magistrates. The chapter shows that the creation of more inclusive commercial regimes allowed Bruges, Antwerp, and particularly Amsterdam to treat all merchants equally by means of a commercial infrastructure that served the merchant community at large.

Visual Plan Construct Language (VPCL)

2015 ◽  
pp. 326-343 ◽  
Author(s):  
Alireza Ebrahimi
Keyword(s):  
Problem Solving ◽  
Teaching And Learning ◽  
Observation Phase ◽  
Working Space ◽  
Observation Plan ◽  
The Creation ◽  
Teaching Learning ◽  
Learning Programming ◽  
Teaching And Learning Programming ◽  
The Web

Teaching and learning programming can be enhanced by the incorporation of visualization. A system and method that the author created, known as Visual Plan Construct Language (VPCL), incorporates programming visualization for teaching, learning programming, and problem solving. VPCL contains a Plan Library that is accessible through the Web. A user can create and establish a working space and environment on the system to examine VPCL plan library and develop one's own plan library. VPCL consists of three phases: Plan Observation, Plan Integration, and Plan Creation. The observation phase rehearses how a program is broken down into smaller components with their integration relationship. The integration phase concentrates on how two plans are related to each other in building a program. The methods of integration are known as appended, interleaved, branched, and embedded. The creation phase concentrates on how a new plan is built using the existing plans from the plan library.

scholarly journals Limb Body Wall Complex: A Rare Anomaly

2018 ◽  
Vol 16 (2) ◽  
pp. 56-58
Author(s):  
Unan Sultana ◽  
Md Qumrul Ahsan
Keyword(s):  
Early Diagnosis ◽  
Abdominal Wall ◽  
Umbilical Cord ◽  
Early Pregnancy ◽  
Body Wall ◽  
Abdominal Cavity ◽  
Abdominal Wall Defects ◽  
Proper Management ◽  
Vascular Disruption ◽  
Abdominal Organs

Body stalk anomalies are a group of massively disfiguring abdominal wall defects in which the abdominal organs lie outside of the abdominal cavity in a sac of amnioperitoneum with absence of or very small umbilical cord. Various hypotheses proposed to explain the pathogenesis of limb body wall complex include early amnion disruptions, embryonic dysplasia, and vascular disruption in early pregnancy. Body stalk anomaly is an accepted fatal anomaly and, hence, its early diagnosis aids in proper management of the patient. We present a case of LBWC, exhibiting combined cranial, abdominal & limb features.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 56-58

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