Minimally invasive technique for insertion of ventriculopleural shunt catheters

2013 ◽  
Vol 12 (5) ◽  
pp. 501-504 ◽  
Author(s):  
Marlin Dustin Richardson ◽  
Michael H. Handler

Object Cerebrospinal fluid diversion to the pleural space has employed various methods to insert the distal catheter into the pleural space. The authors report on a minimally invasive method of pleural catheter insertion that they have developed and have used safely in a small series of patients. Methods Pleural shunt catheters were inserted using a split trochar into the pleural space (technique described in further detail in the article). All cases over the previous 10 years in which this technique was employed were reviewed from the existing electronic medical records. Patient age at insertion, sex, reason for hydrocephalus, early and late complications, valve type, and follow-up were recorded. Results Fourteen shunt procedures performed in 10 patients were identified. Two small pneumothoraces were detected on routine postoperative imaging and required no intervention. There were 3 late mechanical complications, including migration of a catheter out of the pleural space, catheter fracture at the insertion point, and the need for a longer catheter due to the patient's growth. Conclusions The authors describe a safe, minimally invasive method for insertion of pleural shunt catheters along with a series of patients who have undergone placement of a pleural shunt catheter using this method without complication directly attributable to the use of this technique.

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Mireia Musquera ◽  
Lluis Peri ◽  
Tarek Ajami ◽  
Ignacio Revuelta ◽  
Laura Izquierdo ◽  
...  

Introduction. Nowadays, minimally invasive surgery in kidney transplantation is a reality thanks to robotic assistance. In this paper, we describe our experience, how we developed the robotic assisted Kidney transplantation (RAKT) technique, and analyze our results. Material and Methods. This is a retrospective study of all RAKTs performed at our center between July 2015 and March 2020. We describe the donor selection, surgical technique, and analyze the surgical results and complications. A comparison between the first 20 cases and the following ones is performed. Results. During the aforementioned period, 82 living donor RAKTs were performed. The mean age was 47.4±13.4 and 50 (61%) were male. Mean body mass index was 25±4.7 and preemptive in 63.7% of cases. Right kidneys and multiple arteries were seen in 14.6% and 12.2%, respectively. Mean operative and rewarming time was 197±42 and 47±9.6 minutes, respectively. Five cases required conversion to open surgery because of abnormal kidney vascularization. Two patients required embolization for subcapsular and hypogastric artery bleeding without repercussion. Three kidneys were lost, two of them due to acute rejection and one because venous thrombosis. Late complications requiring surgery included one kidney artery stenosis, one ureteral stenosis, two lymphoceles, and three hernia repairs. We noticed a significant reduction in time between the first 20 cases and the following ones from 248.25±38.1 to 189.75±25.3 (p<0.05). With a mean follow-up time of 1.8 years (SD 1.3), the mean creatinine was 1.52 (SD 0.7) and RAKT graft survival was 98%. Conclusions. The robotic approach is an attractive, minimally invasive method for kidney transplantation, yielding good results. Further studies are needed to consider it a standard approach.


1992 ◽  
Vol 72 (3) ◽  
pp. 851-857 ◽  
Author(s):  
V. C. Broaddus ◽  
M. Araya

To obtain continuous access to the pleural space without causing injury, we tested a new transdiaphragmatic pleural catheter for its ability 1) to drain the pleural space without injury and 2) to drain liquid at a rate equal to normal pleural liquid production. In 13 anesthetized rabbits, we opened the abdomen and dissected through the diaphragm to insert a flared-tip catheter into the ventral pleural space on one side and then turned the rabbit prone. In 10 of the rabbits (8 for 6 h, 2 for 24 h), we continuously collected draining pleural liquid, and in 3 rabbits (6 h), we did not open the catheter. We injected radiolabeled albumin intravenously as a protein marker. Terminally, we collected pleural liquid from both pleural spaces and lavaged for total radioactivity. In 14 awake control rabbits without catheters, we measured normal pleural liquid production by the rate of equilibration of radiolabeled albumin from plasma to pleural liquid. We found that, although the percentage of neutrophils was increased on the side with the catheter (54 vs. 1% in control rabbits), the pleural liquid volume, protein concentration, specific activity of albumin, and total radioactivity in the pleural space were the same on the side with the catheter as on the opposite side and in the control rabbits. The liquid flow rate through the catheter over 6 h was 53 +/- 23 microliters/h [0.017 +/- 0.008 (SD) ml.kg-1.h-1], which was not significantly different from the computed rate of normal pleural liquid production in the control rabbits, 49 +/- 14 microliters/h (0.016 +/- 0.004 ml.kg-1.h-1).(ABSTRACT TRUNCATED AT 250 WORDS)


2021 ◽  
Vol 11 (6) ◽  
pp. 2766
Author(s):  
Yerko Leighton ◽  
Javier Miranda ◽  
Raphael Freitas de Souza ◽  
Benjamin Weber ◽  
Eduardo Borie

This practice-based study presents the clinical outcomes of a minimally invasive method for retrieving failed dental implants from elderly patients. Traditional removal methods for failed dental implants include trephination and other invasive procedures. That can be a special concern for the elderly, since aging exacerbates oral surgery-related morbidity and anxiety. This retrospective cohort study gathers data from 150 patients seen in a private clinic. Their implants (n = 199) failed due to biological, mechanical, or iatrogenic causes, and were removed as part of their treatment plan. Collected data included: (1) implant location (maxilla/mandible, anterior/posterior region), (2) reasons for implant retrieval, (3) connection type, (4) removal torque, and (5) operatory procedure—flapless and using a counter-torque removal kit, whenever possible. Flapless/minimally invasive retrieval was successful for 193 implants (97%). The remaining six implants demanded trephination (open-flap). The most common reasons for implant retrieval (81%) involved biological aspects, whereas iatrogenic (12%) and biomechanical (7%) reasons were less common. The surgical technique used was not associated to connection types or removal torque. Authors conclude that a counter-torque ratchet system is a minimally invasive technique with a high success rate in retrieving implants from elderly patients. Present findings support its use as a first-line approach for implant retrieval in that population.


2021 ◽  
pp. 112067212110481
Author(s):  
Syeed Mehbub Ul Kadir ◽  
Md. Hasanuzzaman ◽  
Yvette Marie Santiago-Gatmaitan ◽  
Vanessa Naseem Mansurali ◽  
Mukti Rani Mitra ◽  
...  

Purpose: To describe a minimally invasive technique of harvesting fascia lata, and also to analyze the clinical uses and the outcome of fascia lata in Ophthalmic Plastic and Reconstructive surgery. Methods: This interventional study was done in three tertiary care eye hospitals in Bangladesh from July 2014 to June 2020. We obtained autologous fascia lata for the correction of congenital ptosis with poor levator function (⩽4 mm), covering the ciliary staphyloma, repair of the extruded implant following anophthalmic socket surgery, and was also used to wrap the orbital implant after enucleation. Preserved FL was used only for children before 6 years of age for the treatment of congenital ptosis. Results: Out of 60 subjects, 38 (63.3%) were male and 22 (36.7%) were female. Autogenous fascia lata was used for frontalis brow suspension (FBS) in 25 (41.67%) patients of congenital ptosis with poor levator function, as patch graft in ciliary staphyloma (11 cases, 18.3%), to wrap orbital implant following enucleation in intraocular malignancies (nine cases, 15%), to repair of implant extrusion following evisceration (five cases, 8.3%), and as fascial sling to correct recurrent paralytic ectropion (one case, 1.67%). Allogeneic or preserved fascia lata was used to correct congenital ptosis in patients less than 6 years of age (nine cases, 15%). Mean follow-up time was 5.32 months. Conclusion: Fascia lata (autogenous and allogeneic preserved) has varied uses in ophthalmic plastic surgery. Harvesting fascia lata (FL) using with minimally invasive method was successful with the least scar on the thigh to correct congenital ptosis, ciliary staphyloma, repair of extruded implant, and in wrapping implant after enucleation to get better cosmesis and motility.


2012 ◽  
Vol 3 (1) ◽  
pp. 20-22
Author(s):  
Dr. Dhaval J Patel ◽  
◽  
Dr. Bipin B Chhajed ◽  
Dr. Dhaval R Modi ◽  
Dr. Nirav P Trivedi ◽  
...  

Author(s):  
Anton Yarikov ◽  
Maxim Shpagin ◽  
Iliya Nazmeev ◽  
Sergey Gorelov ◽  
Olga Perlmutter

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.


Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.


Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2541
Author(s):  
Giuseppe Massimo Sangiorgi ◽  
Alberto Cereda ◽  
Nicola Porchetta ◽  
Daniela Benedetto ◽  
Andrea Matteucci ◽  
...  

Nowadays, obesity represents one of the most unresolved global pandemics, posing a critical health issue in developed countries. According to the World Health Organization, its prevalence has tripled since 1975, reaching a prevalence of 13% of the world population in 2016. Indeed, as obesity increases worldwide, novel strategies to fight this condition are of the utmost importance to reduce obese-related morbidity and overall mortality related to its complications. Early experimental and initial clinical data have suggested that endovascular bariatric surgery (EBS) may be a promising technique to reduce weight and hormonal imbalance in the obese population. Compared to open bariatric surgery and minimally invasive surgery (MIS), EBS is much less invasive, well tolerated, with a shorter recovery time, and is probably cost-saving. However, there are still several technical aspects to investigate before EBS can be routinely offered to all obese patients. Further prospective studies and eventually a randomized trial comparing open bariatric surgery vs. EBS are needed, powered for clinically relevant outcomes, and with adequate follow-up. Yet, EBS may already appear as an appealing alternative treatment for weight management and cardiovascular prevention in morbidly obese patients at high surgical risk.


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