Retrieval of retained Jamshidi needle fragments during minimally invasive surgery

2011 ◽  
Vol 14 (5) ◽  
pp. 681-684 ◽  
Author(s):  
Michael Y. Wang ◽  
Spencer Block

As surgical techniques evolve, new intraoperative complications are prone to occur. With percutaneous spinal fixation, the control of implants and instruments can be a challenge when compared with open surgery, particularly if unintended instruments are retained or difficult to retrieve. In this report, the authors describe a case in which Jamshidi needle fragments broke within the vertebral body. Extraction of the fragments was accomplished using a small pedicle screw tap to first engage the retained metal and then to loosen the surrounding bone to allow retrieval and preservation of the anatomical structures needed to complete the intended operation. This technique may prove useful for the retrieval of deformable, cannulated metal pieces in minimally invasive surgery.

Author(s):  
Manou S de Lijster ◽  
Rosemarijn M Bergevoet ◽  
Elvira C van Dalen ◽  
Erna MC Michiels ◽  
Huib N Caron ◽  
...  

2020 ◽  
Vol 30 (9) ◽  
pp. 1269-1277 ◽  
Author(s):  
Luis Chiva ◽  
Vanna Zanagnolo ◽  
Denis Querleu ◽  
Nerea Martin-Calvo ◽  
Juan Arévalo-Serrano ◽  
...  

BackgroundMinimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse.MethodsWe obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group.ResultsMean age was 48.3 years (range; 23–83) while the mean BMI was 25.7 kg/m2 (range; 15–49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07; 95% CI, 1.35 to 3.15; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76; 95% CI, 1.75 to 4.33; P<0.001) and those without the use of a uterine manipulator had similar disease-free-survival to the open surgery group (HR, 1.58; 95% CI, 0.79 to 3.15; P=0.20). Moreover, patients that underwent minimally invasive surgery with protective vaginal closure had similar rates of relapse to those who underwent open surgery (HR, 0.63; 95% CI, 0.15 to 2.59; P<0.52).ConclusionsMinimally invasive surgery in cervical cancer increased the risk of relapse and death compared with open surgery. In this study, avoiding the uterine manipulator and using maneuvers to avoid tumor spread at the time of colpotomy in minimally invasive surgery was associated with similar outcomes to open surgery. Further prospective studies are warranted.


2013 ◽  
Vol 95 (6) ◽  
pp. 386-389 ◽  
Author(s):  
MS Ibrahim ◽  
S Alazzawi ◽  
I Nizam ◽  
FS Haddad

Introduction Total knee replacement (TKR) is a very common surgical procedure. Improved pain management techniques, surgical practices and the introduction of novel interventions have enhanced the patient’s postoperative experience after TKR. Safe, efficient pathways are needed to address the increasing need for knee arthroplasty in the UK. Enhanced recovery programmes can help to reduce hospital stays following knee replacements while maintaining patient safety and satisfaction. This review outlines common evidence-based pre, intra and postoperative interventions in use in enhanced recovery protocols following TKR. Methods A thorough literature search of the electronic healthcare databases (MEDLINE®, Embase™ and the Cochrane Library) was conducted to identify articles and studies concerned with enhanced recovery and fast track pathways for TKR. Results A literature review revealed several non-operative and operative interventions that are effective in enhanced recovery following TKR including preoperative patient education, pre-emptive and local infiltration analgesia, preoperative nutrition, neuromuscular electrical stimulation, pulsed electromagnetic fields, perioperative rehabilitation, modern wound dressings, different standard surgical techniques, minimally invasive surgery and computer assisted surgery. Conclusions Enhanced recovery programmes require a multidisciplinary team of dedicated professionals, principally involving preoperative education, multimodal pain control and accelerated rehabilitation; this will be boosted if combined with minimally invasive surgery. The current economic climate and restricted healthcare budget further necessitate brief hospitalisation while minimising costs. These non-operative interventions are the way forward to achieve such requirements.


2000 ◽  
Vol 6 (2_suppl) ◽  
pp. 88-89 ◽  
Author(s):  
V Masero ◽  
F M Sanchez ◽  
J Uson

We have developed a telemedicine project called Telesurgex, which is an integrated information system designed for several hospitals as well as the Minimally Invasive Surgery Centre. The project researches and develops telemedicine systems (both hardware and software) and their contents, ensuring that they are really useful and not just a videoconference with medical topics. Another aim of the project is the improvement of teleteaching systems as applied to medicine, mainly teleteaching of minimally invasive surgical techniques.


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