scholarly journals Minimal Invasive Anterior Decompression in Tuberculosis of Thoracolumbar Junction of the Spine – Experience With SynFrame

2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Navin Kumar Karn ◽  
B S Rao ◽  
M M Prabhakar

Introduction: This study assesses the role of new retractor system SynFrame for anteriordecompression of tuberculosis of thoracolumbar junction of the spine.Methods: This study includes fi ve consecutive patients with tuberculosis of thoracolumbar junctiontreated with minimal invasive anterior decompression using a new table mounted retractor systemSynFrame (Stratec Medical, Switzerland). The thoracolumbar junction was approached by a left sidedthoracotomy. Short construct pedicle screw stabilization was done in all cases before decompression.The anterior column was reconstructed using expandable cage (n=3) and autologous tricortical graft(n=2).Results: The mean operating time was 100 minutes (range 90-120). Mean overall blood loss was 400ml. No operation had to change into an open procedure. There were neither intra nor postoperativecomplications related to minimal access in particular, nor visceral/vascular complications.Conclusions: The ring retractor system allows minimal open surgery to the spine by carryingdifferent devices as well as endoscope, providing an excellent visualization of the operating fi eld,and is safe and easy to use. The only disadvantage is its high cost.Key Words: anterior decompression, minimal invasive spine surgery, SynFrame

2011 ◽  
Vol 8 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Manish N. Shah ◽  
Alex A. Kane ◽  
J. Dayne Petersen ◽  
Albert S. Woo ◽  
Sybill D. Naidoo ◽  
...  

Object This study investigated the differences in effectiveness and morbidity between endoscopically assisted wide-vertex strip craniectomy with barrel-stave osteotomies and postoperative helmet therapy versus open calvarial vault reconstruction without helmet therapy for sagittal craniosynostosis. Methods Between 2003 and 2010, the authors prospectively observed 89 children less than 12 months old who were surgically treated for a diagnosis of isolated sagittal synostosis. The endoscopic procedure was offered starting in 2006. The data associated with length of stay, blood loss, transfusion rates, operating times, and cephalic indices were reviewed. Results There were 47 endoscopically treated patients with a mean age at surgery of 3.6 months and 42 patients with open-vault reconstruction whose mean age at surgery was 6.8 months. The mean follow-up time was 13 months for endoscopic versus 25 months for open procedures. The mean operating time for the endoscopic procedure was 88 minutes, versus 179 minutes for the open surgery. The mean blood loss was 29 ml for endoscopic versus 218 ml for open procedures. Three endoscopically treated cases (6.4%) underwent transfusion, whereas all patients with open procedures underwent transfusion, with a mean of 1.6 transfusions per patient. The mean length of stay was 1.2 days for endoscopic and 3.9 days for open procedures. Of endoscopically treated patients completing helmet therapy, the mean duration for helmet therapy was 8.7 months. The mean pre- and postoperative cephalic indices for endoscopic procedures were 68% and 76% at 13 months postoperatively, versus 68% and 77% at 25 months postoperatively for open surgery. Conclusions Endoscopically assisted strip craniectomy offers a safe and effective treatment for sagittal craniosynostosis that is comparable in outcome to calvarial vault reconstruction, with no increase in morbidity and a shorter length of stay.


2019 ◽  
Vol 16 (01) ◽  
pp. 33-37 ◽  
Author(s):  
Kanwaljeet Garg ◽  
Deepak Agrawal

AbstractThoracolumbar burst fractures are one of the most common traumatic fractures seen. Management options vary from nonoperative to operative. Among the operative approaches, minimal invasive approaches are gaining popularity. However, all the cases are not suitable for minimal invasive approaches. We discuss the various minimal invasive approaches and their role in the management of thoracolumbar burst fractures.


2020 ◽  
Author(s):  
Xiaojuan Wang ◽  
Junwei LI ◽  
Keqin Hua ◽  
Yisong Chen

Abstract Background: The transvaginal natural orifice transluminal endoscopic surgery (vNOTES) applied in gynecology has been developed recent years and been evolving. In this study, we aimed to evaluate the feasibility and effect of the transvaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy for uterus ≥ 1 kilogram (kg). Methods: From January 2019 to March 2020, 39 patients with benign indications in cases of uterus weighing ≥ 1kg, underwent vNOTES hysterectomy were studied retrospectively. The patient demographics, indications for surgery, operation outcomes and patient follow-up details were recorded.Results: The mean age was 48 years (range 42-66); the mean BMI was 24 kg/m 2 (range 18.4-38); the mean operating time was 123.3 minutes (rang 40-400), mean estimated blood loss was 206.7 milliliters (range 10-1300); the mean uterus weight was 1141.8 gram (g) (range 1000-1720). The mean pain assessment was 2.1 (range 0-5). The mean length of stay was 2.4 nights (1-11). 1 patient experienced ureteral injury and was performed ureteral anastomosis. 3 patients were converted to vaginal-assisted trans-umbilicus single-port laparoscopy. The learning curve was analyzed to show that 20 cases were needed to achieve proficiency in vNOTES hysterectomy for large uterus ≥ 1 kg. Conclusion: Our preliminary experience suggested that vNOTES hysterectomy for large uterus weighing ≥ 1kg was feasible and safe, meanwhile this procedure had the advantages of all the minimal invasive approach such as fast recovery and aesthetic advantage.


2017 ◽  
pp. 107-112
Author(s):  
Duc Minh Hoang ◽  
khoa Hung Nguyen ◽  
Vinh Quy Truong ◽  
Van Binh Nguyen ◽  
Hong Duong Nguyen ◽  
...  

Purpose: To assess results of retroperitoneoscopy nephrectomy for benign non-function kidneys from June 2013 to June 2017 at Quang Tri General Hospital. Materials and Methods: The study comprised 43 patients who underwent retroperitoneoscopic nephrectomy during a 4 years period beginning from June 2013. Results: Mean age of surgery was 52.6 years (28-72 years). 23 males and 20 females. 25 patients underwent left nephrectomy; 18 underwent right nephrectomy. Retroperitoneoscopic nephrectomy were completed successfully in 38 patients (88.4%). There was 5 patients required conversion to open surgery (11.6%), all cases by poor progression. The mean operating time was 112.7 minutes (range 70 to 210), mean blood loss was 45.7 ml (range 15 to 170 ml), and mean post-operation hospital stay was 4.3 days (range 3 to 9). A total of 21.1% complications (8/38 cases), no severe complications occurred. No re-intervention was needed. No case was mortality. The indications for surgery included hydronephrosis in 19/38 cases (50.0%), atrophic kidney in 13/38 cases (34.2%) and multicystic kidney in 6/38 cases (15.8%). Conclusions: Retroperitoneoscopic nephrectomy can be performed safely and successfully with obvious advantages for benign nonfunctioning kidneys regardless of the etiology or pathogenesis. Key words: nephrectomy, kidney, benign, retroperitoneoscopy


2017 ◽  
Vol 29 (02) ◽  
pp. 173-178 ◽  
Author(s):  
Laurent Fourcade ◽  
Sarah Amar ◽  
Khalid Alzahrani ◽  
Ann-Rose Cook ◽  
Karim Braïk ◽  
...  

Introduction Laparoscopic fundoplicature for gastroesophageal reflux disease has become the gold standard because of the improvement of postoperative rehabilitation compared with the open procedure. The robot-assisted surgery has brought new advantages for the patient and the surgeon compared with laparoscopy. We studied this new approach and the learning curve. Materials and Methods Sixty robot-assisted fundoplicatures were performed in two university pediatric surgery centers. Data of the patients were recorded, including peroperative data (operation length and complications), postoperative recoveries, and clinical evolution. The learning curve was evaluated retrospectively and each variable was compared along this learning curve. Results We observed a flattening of the learning curve after the 20th case for one surgeon. The mean operative time decreased significantly to 80 ± 10 minutes after 20 cases. There were no conversions to an open procedure. A revision surgery was indicated for 4.7% of the patients by a surgical robot-assisted laparoscopic approach. Conclusion The robotic system appears to add many advantages for surgical ergonomic procedures. There is a potential benefit in operating time with a short technical apprenticeship period. The setting up system is easy with a short docking time.


2019 ◽  
Vol 26 (2) ◽  
pp. 89-94
Author(s):  
Prisca Yeung ◽  
Lok Pong Man ◽  
Wing Hang Angela Ho

Introduction: Minimal invasive Achilles tendon repair is becoming more and more popular recently. We have evaluated our results in Achilles tendon repair using minimally invasive method by a suture-guiding device. Methods: This is a retrospective review of patients with acute Achilles tendon rupture, which was repaired using minimally invasive method namely the suture-guiding device, that was performed during 2003 to 2015 in our department. Outcome parameters were the incidence of re-rupture, other complications, and the functional outcome. Results: There were 36 men (90%) and 4 women (10%) in this study. Mechanisms of injury were basketball (28%), football (15%), squash (15%), and trauma (13%). The mean operating time was 59 min (range 30–90 min). The mean follow-up time was 8 months (range 3–35 months). The mean duration with casting was 7 weeks. The mean range of movement at 3 months was 8° dorsiflexion and 33° plantar flexion. There was no major complication necessitating surgical re-interventions such as re-ruptures and infections. No patient suffered from dysfunction of the sural nerve or delay wound healing. Conclusion: Minimally invasive Achilles tendon repair using suture-guiding device is a safe and quick procedure with a low rate of re-rupture and a satisfactory short-term and long-term recovery. Level of evidence: IV.


2019 ◽  
Vol 6 (6) ◽  
pp. 2159
Author(s):  
Raj N. Gajbhiye ◽  
Hemant Bhanarkar ◽  
Vikrant V. Akulwar ◽  
Bhupesh Tirpude ◽  
Niketan Jambhulkar ◽  
...  

Background: Myasthenia gravis (MG) is an autoimmune disease affecting acetylcholine postsynaptic receptor of voluntary muscles. Thymectomy is a mainstay in the treatment for myasthenia gravis with or without thymoma. For many years transsternal and transcervical thymectomy had been the most common approaches used, video assisted thoracoscopic thymectomy is still not accepted as approach of choice. We intend to study the role of Video assisted thoracoscopic thymectomy for myasthenia gravis in central Indian population.Methods: Study was conducted in single tertiary care institute from January 2015 to November 2018. It is a prospective study. Aims of the study were to evaluate the safety and feasibility of video assisted thoracoscopic thymectomy for patients of myasthenia gravis. All patients of myasthenia gravis who underwent underwent video assisted thoracoscopic thymectomy (VATS) were included in the study. Intraoperative and postoperative details were studied to assess the safety and feasibility of VATS for treatment of myasthenia gravis.Results: 16 patients including 7 men and 9 women with the mean age of 35.5 years were investigated. All patients had myasthenia gravis, 12 pts had thymoma while remaining 4 pts had normal thymus. Mean operating time was 104 mins, Mean intraoperative blood loss was 45 ml (range 20 to 60 ml). There was no major intraoperative or postoperative complication or mortality. Mean ICU stay and hospital stay was 33 hrs and 4.25 days respectively.Conclusions: VATS thymectomy is safe and effective approach for the treatment of MG with or without thymoma. MG treated by VATS resulted in comparable neurological outcomes to those associated with the transsternal approach.


2010 ◽  
Vol 2010 ◽  
pp. 1-6 ◽  
Author(s):  
Thierry A. Folliguet ◽  
Alain Dibie ◽  
François Philippe ◽  
Fabrice Larrazet ◽  
Michel S. Slama ◽  
...  

Objectives. Robotic surgery enables to perform coronary surgery totally endoscopically. This report describes our experience using the da Vinci system for coronary artery bypass surgery.Methods. Patients requiring single-or-double vessel revascularization were eligible. The procedure was performed without cardiopulmonary bypass on a beating heart.Results. From April 2004 to May 2008, fifty-six patients were enrolled in the study. Twenty-four patients underwent robotic harvesting of the mammary conduit followed by minimal invasive direct coronary artery bypass (MIDCAB), and twenty-three patients had a totally endoscopic coronary artery bypass (TECAB) grafting. Nine patients (16%) were converted to open techniques. The mean total operating time for TECAB was minutes and for MIDCAB was minutes. Followup was complete for all patients up to one year. There was one hospital death following MIDCAB and two deaths at follow up. Forty-eight patients had an angiogram or CT scan revealing occlusion or anastomotic stenoses (>50%) in 6 patients. Overall permeability was 92%.Conclusions. Robotic surgery can be performed with promising results.


2018 ◽  
Vol 3 (3) ◽  
pp. 181-185
Author(s):  
Előd Etele Élthes ◽  
Alexandra Lavinia Cozlea ◽  
Márton Dénes ◽  
Cristian Borz ◽  
Kálmán Sárdi ◽  
...  

Abstract Objective: To evaluate and compare laparoscopic and conventional open procedures for bilateral inguinal hernia surgical repair, using clinical, intraoperative, and postoperative criteria. Methods: Forty-three patients with bilateral inguinal hernia were included in a retrospective study, between 2014–2017. All patients underwent conventional open or laparoscopic bilateral hernioplasty, and were divided into two groups: a conventional open group (COG) and a laparoscopy group (LG). Clinical, intraoperative, and postoperative outcomes were reviewed. Results: In the laparoscopic hernioplasty group, there was a significantly shorter hospitalization period (p = 0.026), less postoperative pain (p = 0.03), and a prompt return to work (p = 0.043) compared to the conventional open procedure. On the other hand, patients who underwent hernioplasty with the Progrip-type synthetic mesh developed a lower pain score, an earlier return to work, and a quick start to normal physical activities in comparison with other mesh types used for the treatment of bilateral inguinal hernias. For patients who underwent conventional open procedure, there was a significantly shorter operating time (p = 0.042). Conclusion: Laparoscopic bilateral inguinal hernioplasty is a time-consuming and technically demanding procedure. However, the current study underlines the benefits of this type of surgery. This technique presents comparable clinical, intraoperative, and postoperative results with the conventional open surgery.


2020 ◽  
Vol 1 (1) ◽  
pp. 012-017
Author(s):  
Najib Zouhair ◽  
Anass Chaouki ◽  
Amine M’khatri ◽  
Youssef Oukessou ◽  
Sami Rouadi ◽  
...  

Tympanoplasty is one of the most performed procedures in ENT. The aggressiveness of its microscopic approach has led otologists to adopt the endoscopic approach as a less invasive alternative. The purpose of this work is to appreciate the advantages and disadvantages of this surgical technique. We conducted a prospective descriptive cross-sectional study on 20 interventions within the ENT department of August the 20th 1953 Hospital of Casablanca from April 2019 to June 2019. The average age of operated patients was 36.3 years. Perforations were unilateral in (71%) of the cases with a predominance of the anterior (29%) and subtotal (36%) locations. The tympanoplasties were performed by 3 different senior otologic surgeons, and were left in (57%). The mean operating time was (59.5 min) and the mean anesthesia duration was 75.1 min. Intraoperative vision allowed us to fully visualize the margins of all perforations (100%) and anatomical structures of the middle ear in almost all interventions. The first procedures carried out were filled with difficulties whose management of intraoperative bleeding was the main one in (42.8%) of the cases. (57%) procedures were described as easy. No complication was detected intraoperatively or immediately postoperatively. Endoscopic tympanoplasty has several advantages, including: Minimally invasive approach to the middle ear; panoramic perioperative vision; Gain of operating time; decrease in the duration of anesthesia; Valuable educational tool; postoperative comfort; Decrease in hospital stay and early return to daily activities; Better aesthetic rendering; cost and transportability. However, we also note a number of disadvantages of endoscopic tympanoplasty, particularly: performing the procedure with one hand; difficulty passing through the EAC; 2D vision that alters the perception of depth; management of intraoperative bleeding; fogging; learning curve.


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