Endoscopic Surgery in Rectal Cancer- A Review

Colorectal cancer is one of the leading causes of cancer-related deaths worldwide. Total mesorectal excision (TME) remains the gold standard treatment for any stage of rectal cancer, especially in more advanced disease, as it effectively treats the mesorectal lymph nodes and reduces recurrence [1]. Minimally invasive abdominal approach has been established to be oncologically safe, feasible and associated with all the advantages of minimal access surgery, however, it has not had a measurable impact on the incidence of postoperative complications, sexual and urinary dysfunction, or quality of life. TME performed either via open, laparoscopic or robotic approach is accompanied by significant morbidity and mortality [2]. In addition, widespread adoption of laparoscopic techniques in colorectal surgery has been limited by the technical complexity and steep learning curve. In an effort to harness the advantages of a minimally invasive approach to beneﬁt patients with colorectal pathology, trans anal natural oriﬁce transluminal endoscopic surgery (NOTES) has been explored, with promising preliminary results, particularly when used for rectal cancer and other benign lesions. NOTES in Rectal lesions can be carried out using Transanal Endoscopic Microsurgery (TEMS) and Transanal Minimal Invasive Surgery (TAMIS), which can be together termed as Transanal endoscopic surgery. JMS 2018;21(1):3-10

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Endoscopic Surgery of Congenital Cholesteatoma in the Anterior Epitympanic Recess: A Case Report of a Rare Location

Ear Nose & Throat Journal ◽

10.1177/0145561320969249 ◽

2020 ◽

pp. 014556132096924

Author(s):

Hong Chan Kim ◽

Hyung Chae Yang ◽

Hyong-Ho Cho

Keyword(s):

Case Report ◽

Minimally Invasive ◽

Middle Ear ◽

Endoscopic Surgery ◽

Minimally Invasive Approach ◽

Ear Surgery ◽

Invasive Approach ◽

Congenital Cholesteatoma ◽

Rare Location ◽

Histopathological Type

Congenital cholesteatoma is a whitish mass in the middle ear medial to an intact tympanic membrane. It is often without symptoms and therefore incidentally diagnosed. Pediatric congenital cholesteatoma generally starts as a small pearl-like mass in the middle ear cavity that eventually expands to involve the ossicles, epitympanum, and mastoid. The location, size, histopathological type, and extent of the mass must be evaluated to select the appropriate surgical method. Although microscopic ear surgery has traditionally been performed to remove congenital cholesteatoma, a recently introduced alternative is endoscopic surgery, which allows a minimally invasive approach and has better visualization. Here, we report the first known case of a patient with congenital cholesteatoma in the anterior epitympanic recess and discuss the utility of an endoscopic approach in the removal of a congenital cholesteatoma in the hidden area within the middle ear.

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OPTIMIZATION OF SURGICAL TREATMENT OF PATIENTS WITH ACUTE PANCREATITIS USING MINIINVASIVE TECHNIQUES

Kharkiv Surgical School ◽

10.37699/2308-7005.3.2020.03 ◽

2020 ◽

pp. 16-18

Author(s):

A. G. Drozdova

Keyword(s):

Acute Pancreatitis ◽

Surgical Treatment ◽

Minimally Invasive ◽

Pancreatic Necrosis ◽

Minimal Invasive ◽

Hospital Treatment ◽

Bed Days ◽

Minimal Invasive Techniques ◽

Invasive Techniques

Summary. The aim of the study. To improve the results of surgical treatment of patients with acute pancreatitis using minimal invasive techniques. Matherials and Methods of the study. The results of surgical treatment of 75 patients with different forms of acute pancreatitis were analyzed. All patients were examined and operated on. Results of the study. Minimally invasive interventions were performed in 92 % of the analyzed patients. Intraoperatively acute pancreatic edema was observed in 43 % of patients, hemorrhagic pancreatic necrosis – in 24 %, infected pancreatic necrosis – in 33 %. The postoperative period was complicated by 13.3 %, the mortality rate was 9.3 %. Conclusions. The use of minimally invasive techniques for treating acute pancreatitis can significantly improve the results of surgical treatment of patients with this pathology. The frequency of complications and lethality decreases. Also, it is possible to significantly reduce operational trauma, and hence the number of bed-days of stay in hospital treatment. This contributes to reducing the financial cost of treatment in patients with acute pancreatitis, as well as improving the quality of life of this category of patients.

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Minimally Invasive Separation Surgery for Metastases in the Vertebral Column: A Technical Report

Operative Neurosurgery ◽

10.1093/ons/opz233 ◽

2019 ◽

Vol 18 (6) ◽

pp. 606-613

Author(s):

Rafael A Vega ◽

Jeffrey I Traylor ◽

Ahmed Habib ◽

Laurence D Rhines ◽

Claudio E Tatsui ◽

...

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Minimally Invasive ◽

Definitive Treatment ◽

Invasive Technique ◽

Thoracic Vertebrae ◽

Minimally Invasive Techniques ◽

Invasive Approach ◽

Invasive Techniques

Abstract BACKGROUND Epidural spinal cord compression (ESCC) is a common and severe cause of morbidity in cancer patients. Minimally invasive surgical techniques may be utilized to preserve neurological function and permit the use of radiation to maximize local control. Minimally invasive techniques are associated with lower morbidity. OBJECTIVE To describe a novel, minimally invasive operative technique for the management of metastatic ESCC. METHODS A minimally invasive approach was used to cannulate the pedicles of the thoracic vertebrae, which were then held in place by Kirschner wires (K-wires). Following open decompression of the spinal cord, cannulated screws were placed percutaneously with stereotactic guidance through the pedicles followed by cement induction. Stereotactic radiosurgery is performed in the postoperative period for residual metastatic disease in the vertebral body. RESULTS The minimally invasive technique used in this case reduced tissue damage and optimized subsequent recovery without compromising the quality of decompression or the extent of metastatic tumor resection. Development of more minimally invasive techniques for the management of metastatic ESCC has the potential to facilitate healing and preserve quality of life in patients with systemic malignancy. CONCLUSION ESCC from vertebral metastases poses a challenge to treat in the context of minimizing potential risks to preserve quality of life. Percutaneous pedicle screw fixation with cement augmentation provides a minimally invasive alternative for definitive treatment of these patients.

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Anesthetic Implications of Natural Orifice Translumenal Endoscopic Surgery (NOTES) and Single-Incision Laparoscopic Surgery (SILS)

10.1093/med/9780190495756.003.0021 ◽

2018 ◽

Author(s):

Mark A. Gromski ◽

Kai Matthes

Keyword(s):

Laparoscopic Surgery ◽

Minimally Invasive ◽

Endoscopic Surgery ◽

Single Incision ◽

Single Incision Laparoscopic Surgery ◽

Natural Orifice ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Current State ◽

Field Notes

This chapter introduces the concepts of natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS). The field of NOTES has evolved over the past decade, and this developmental framework is also outlined to help better understand the current state of the field. NOTES describes a minimally invasive approach to surgical diseases in which instruments are passed transluminally to achieve access to the desired body. SILS is a minimally invasive approach carried out as an extension of traditional laparoscopic surgery. The anesthetic implications of NOTES and SILS are explained, including potential complications that are unique to each. Finally, future directions in developmental endoscopy are discussed to give a sense of what types of procedures may become available or commonplace in the coming decade.

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Transorbital Endoscopic Surgery for Sphenoid Wing Meningioma: Long-Term Outcomes and Surgical Technique

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0040-1713854 ◽

2020 ◽

Vol 81 (04) ◽

pp. 357-368

Author(s):

N. Goncalves ◽

D.E. Lubbe

Keyword(s):

Minimally Invasive ◽

Endoscopic Surgery ◽

Case Series ◽

Surgical Approaches ◽

Benign Tumors ◽

Long Term Outcomes ◽

Invasive Approach ◽

Visual Outcomes ◽

Presenting Symptoms

AbstractSphenoid wing meningiomas are benign tumors that can result in proptosis, visual impairment, and pain. Traditional open surgical approaches are associated with significant morbidity. Transorbital endoscopic surgery has been developed as a minimally invasive approach to gain access to these tumors and address the main presenting symptoms. Case series reporting transorbital endoscopic resection of sphenoid wing meningiomas using combined endonasal, pre-caruncular, and extended superior eyelid approaches have demonstrated stable and/or improved short- and medium-term visual outcomes. Earlier medial optic nerve decompression appears to result in more favorable long-term visual outcomes. Transorbital endoscopic surgery therefore represents an emerging minimally invasive alternative to deal with these challenging lesions.

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Full-endoscopic surgery for gunshot penetrating wound of the lumbar spine (literature review and clinical case)

Russian journal of neurosurgery ◽

10.17650/1683-3295-2018-20-2-66-73 ◽

2018 ◽

Vol 20 (2) ◽

pp. 66-73

Author(s):

M. N. Kravtsov ◽

S. A. Landik ◽

A. А. Dubinin ◽

K. S. Azatyan ◽

В. V. Gaidar ◽

...

Keyword(s):

Lumbar Spine ◽

Endoscopic Surgery ◽

Spinal Canal ◽

Gunshot Wound ◽

Clinical Case ◽

Gunshot Wounds ◽

Minimal Invasive ◽

Study Objective ◽

Invasive Approach ◽

Minimal Invasive Approach

The study objectiveis to determine the feasibility and effectiveness evaluation of full-endoscopic surgery in gunshot wound of the lumbar spine.Materials and methods.A clinical case of a 24-year-old male who received a gunshot wound to the lumbar spine is described. The patient underwent a full-endoscopic intervention aimed at extracting a bullet from the spinal canal.Results.Minimal-invasive approach to spinal canal with the possibility to extract a bullet, decompression of nerve roots, defect closure of the dura mater is demonstrated.Conclusion.Good clinical outcome allows to recommend the full-endoscopic surgery with similar gunshot wounds of the lumbar spine at the stage of specialized care.

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Minimally Invasive Surgery of Rectal Cancer: Current Evidence and Options

American Society of Clinical Oncology Educational Book ◽

10.14694/edbook_am.2012.32.41 ◽

2012 ◽

pp. 214-218 ◽

Cited By ~ 2

Author(s):

Atthaphorn Trakarnsanga ◽

Martin R. Weiser

Keyword(s):

Rectal Cancer ◽

Colon Cancer ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Oncologic Outcomes ◽

Current Status ◽

Current Evidence ◽

Short Term ◽

Invasive Approach

Overview: Minimally invasive surgery (MIS) of colorectal cancer has become more popular in the past two decades. Laparoscopic colectomy has been accepted as an alternative standard approach in colon cancer, with comparable oncologic outcomes and several better short-term outcomes compared to open surgery. Unlike the treatment for colon cancer, however, the minimally invasive approach in rectal cancer has not been established. In this article, we summarize the current status of MIS for rectal cancer and explore the various technical options.

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Incidence of minimally invasive colorectal cancer (CRC) surgery in patients treated at NCCN institutions

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.6575 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 6575-6575

Author(s):

M. Weiser ◽

D. Romanus ◽

A. terVeer ◽

A. Rajput ◽

J. Skibber ◽

...

Keyword(s):

Rectal Cancer ◽

Minimally Invasive ◽

Open Surgery ◽

Early Stage ◽

Oncologic Outcome ◽

Stage I ◽

Invasive Approach ◽

Conversion To Open Surgery ◽

The North ◽

Minimally Invasive Surgical

6575 Background: In May 2004 the Clinical Outcomes of Surgical Therapy Study Group published the results of the North American randomized trial demonstrating that oncologic outcome is similar for laparoscopic assisted and open surgery for CRC. This and other studies have shown quicker recovery with laparoscopic CRC surgery including earlier resolution of postoperative ileus, less discomfort, and earlier discharge from the hospital. The extent to which surgeons have adopted the minimally invasive surgical (MIS) approach in CRC is unknown. Methods: Using the NCCN Colon/Rectal Cancer Outcomes Project Database, 715 patients were identified who underwent CRC resection in 2005–6. The distribution of lesions included right colon (39%), left colon (31%), and rectum (30%). The incidence of MIS for CRC and clinicopathologic features associated with this approach were analyzed by logistic regression; results are reported as odd ratio (OR) with 95% confidence intervals (CI), and significance defined at p<0.05 level. Results: A total of 167 (23%) patients underwent MIS colorectal surgery (laparoscopy in 98% and robotic in 2%). Conversion to open surgery was noted in 33 cases (20%). Surgery was performed in outside institutions in 21% of cases prior to patients presenting to NCCN institutions for further treatment. The MIS approach was more common in colon than rectal cancer (30% vs.12%, OR 2.96, CI 1.94–4.51, p<0.0001). Within the colon cancer cohort, right sided lesions were more likely to be approached with MIS techniques rather than left sided lesions (32% vs. 25%; OR 1.42, CI 1.96–2.21, p<0.0001). Stage I tumors were also more likely to be managed with the less invasive approach: Stage I-41%; II-20%; III-21%; IV-19% (Stage I vs. IV, OR=3.00, CI 1.74–5.16 p<0.0001). No differences in surgical approach were noted based on age, gender, race, Charlson comorbidity score, insurance type, or location of surgery (NCCN vs outside facility). Conclusion: The majority of CRC surgery for patients presenting to NCCN institutions is performed by open techniques. Right sided and early stage CRCs were more likely treated with MIS, possibly related to the less demanding nature of the procedure. The adoption of MIS is expected to rise as surgeons become trained in MIS techniques for CRC. No significant financial relationships to disclose.

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Minimally invasive treatment of peristomal metastases from gastric cancer at an ileostomy site by electrochemotherapy

Radiology and Oncology ◽

10.2478/raon-2013-0051 ◽

2013 ◽

Vol 47 (4) ◽

pp. 370-375 ◽

Cited By ~ 7

Author(s):

Luca G. Campana ◽

Marco Scarpa ◽

Antonio Sommariva ◽

Elena Bonandini ◽

Sara Valpione ◽

...

Keyword(s):

Quality Of Life ◽

Gastric Cancer ◽

Minimally Invasive ◽

Tumor Regression ◽

Tumor Control ◽

Invasive Treatment ◽

Invasive Approach ◽

Electric Pulses ◽

Skin Conditions

Abstract Background. Peristomal metastases are rare, but potentially associated with relevant morbidity. Surgical resection, followed by stoma relocation, represent the gold standard in most patients. We describe electrochemotherapy (ECT), a minimally invasive method for locally-enhancing drug delivery by means of electric pulses, as an alternative approach. Patient and methods. A 49-year-old man with advanced gastric cancer developed skin metastases around an ileostomy site. The ulcerated and oozing tumor growth impaired patient’s quality of life due to continuous trouble in fitting the ostomy appliance, its poor adherence and consequent stools spillage. ECT consisted of a 20-minute course under mild general sedation. A bleomycin bolus of 15 000 IU/m2 was followed by the percutaneous application of multiple, 1.5 ms -long electric pulses by means of a needle electrode. Results. Post ECT course was uneventful and the patient was discharged on the same day. After one week, tumor nodules were flattened and partial tumor regression was appreciable at one-month follow-up. More importantly, peristomal skin conditions significantly improved, thus allowing for an effective application of the ostomy appliance during the following moths, until patient’s death. Conclusions. This report suggests the feasibility of ECT as a minimally invasive approach for peristomal tumors. In selected cases, ECT, by achieving a rapid tumor control, may ensure effective ostomy management and preserve patients’ quality of life.

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