scholarly journals Minimally Invasive Approach to Gastric GISTs: Analysis of a Multicenter Robotic and Laparoscopic Experience with Literature Review

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4351
Author(s):  
Graziano Ceccarelli ◽  
Gianluca Costa ◽  
Michele De Rosa ◽  
Massimo Codacci Pisanelli ◽  
Barbara Frezza ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Multidisciplinary Approach ◽  
Gastric Resection ◽  
Therapeutic Option ◽  
Minimal Invasive ◽  
Invasive Approach ◽  
Gastric Gists ◽  
Surgical Units ◽  
Laparoscopic Experience ◽  
Average Tumor Size

Background: Gastrointestinal stromal tumors (GISTs) are most frequently located in the stomach. In the setting of a multidisciplinary approach, surgery represents the best therapeutic option, consisting mainly in a wedge gastric resection. (1) Materials and methods: Between January 2010 to September 2020, 105 patients with a primary gastrointestinal stromal tumor (GISTs) located in the stomach, underwent surgery at three surgical units. (2) Results: A multi-institutional analysis of minimally invasive series including 81 cases (36 laparoscopic and 45 robotic) from 3 referral centers was performed. Males were 35 (43.2%), the average age was 66.64 years old. ASA score ≥3 was 6 (13.3%) in the RS and 4 (11.1%) in the LS and the average tumor size was 4.4 cm. Most of the procedures were wedge resections (N = 76; 93.8%) and the main operative time was 151 min in the RS and 97 min in the LS. Conversion was necessary in five cases (6.2%). (3) Conclusions: Minimal invasive approaches for gastric GISTs performed in selected patients and experienced centers are safe. A robotic approach represents a useful option, especially for GISTs that are more than 5 cm, even located in unfavorable places.

Minimally invasive repair of spontaneous intracranial hypotension

2011 ◽  
Vol 114 (2) ◽  
pp. 505-509 ◽  
Author(s):  
Hamad I. Farhat ◽  
Brian Hood ◽  
Steven Vanni ◽  
Allan D. Levi
Keyword(s):  
Minimally Invasive ◽  
Intracranial Hypotension ◽  
Therapeutic Option ◽  
Treatment Options ◽  
Spontaneous Intracranial Hypotension ◽  
Surgical Correction ◽  
Invasive Approach ◽  
Epidural Blood Patching ◽  
Csf Leakage ◽  
Cerebrospinal Fluid Leaks

Spontaneous spinal CSF leakage with the development of intracranial hypotension is a well-described entity. Cerebrospinal fluid leaks, mostly from the thoracic spine, are the major cause of spontaneous intracranial hypotension (SIH). Conservative treatment options include hydration, oral caffeine, and epidural blood patching. Alternatively, open surgical correction of meningeal diverticula is a therapeutic option. The authors describe 4 cases of spontaneous spinal CSF leakage producing symptoms of intracranial hypotension. All patients had multiple spinal diverticula with an identified leaking level. The patients were treated using a minimally invasive approach via surgical correction of the meningeal diverticulum.

scholarly journals Minimally invasive esophagectomy in the treatment of esophageal cancer

2011 ◽  
Vol 58 (4) ◽  
pp. 27-30 ◽  
Author(s):  
Milos Bjelovic ◽  
Dejan Stojakov ◽  
Bratislav Spica ◽  
Dejan Velickovic ◽  
Dragan Gunjic ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Mediastinal Lymph Node ◽  
Therapeutic Option ◽  
Minimally Invasive Esophagectomy ◽  
Invasive Procedures ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Invasive Esophagectomy ◽  
Open Esophagectomy ◽  
Esophagectomy For Cancer

In the Western countries, the incidence of esophageal carcinoma is 3-6 cases per 100.000 persons. Despite tremendous success of other therapeutic options, surgical treatment still represents the best therapeutic option whenever possible. For the long period, debate has centered on which of the available surgical procedures is superior - transhiatal or transthoracic esophagectomy. Minimally invasive esophagectomy (MIE) could offer both minimally invasive approach and proper mediastinal lymph node dissection. Minimally invasive esophagectomy is safe and adequate, but time consuming and technically demanding procedure. It is procedure reserved for the surgeons experienced in open esophagectomy for cancer, and specially trained in advanced minimally invasive procedures. Even in that case, learning curve is steep.

scholarly journals Completion total gastrectomy with intracorporeal robot-sewn esophago-jejunal anastomosis

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Francesco Carafa ◽  
Immacolata Della Valle ◽  
Riccardo Memeo ◽  
Giorgio Palazzini ◽  
Domenico Di Nardo
Keyword(s):  
Minimally Invasive ◽  
Gastric Resection ◽  
Partial Gastrectomy ◽  
Anastomotic Site ◽  
Gastric Stump ◽  
Minimally Invasive Approach ◽  
Benign Diseases ◽  
Invasive Approach ◽  
Gastric Stump Cancer ◽  
Previous Laparotomy

Many technical reports concern minimally invasive surgery for stomach cancer; however, there is poor evidence about employing this approach for gastric stump cancer, which can arise at the anastomotic site in patients who have undergone previous partial gastrectomy for benign diseases such as gastric ulcer. Such surgery was quite common before the introduction of proton pump inhibitors (PPIs), and so today, according to different statistics, gastric stump cancer can be revealed in up to 8% of these patients. This report seeks to highlight the possibility of employing a minimally invasive approach in patients who already had an operation for gastric resection. The video shows technical notes about the hybrid laparoscopic-robotic approach performed in a patient who previously underwent open distal gastrectomy. Is the previous laparotomy an absolute or relative counterindication to reperform a surgery through a minimally invasive approach?

scholarly journals Factors for a Successful Laparoscopic Hysterectomy in Very Large Uteri

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Harald Krentel ◽  
Rudy Leon De Wilde
Keyword(s):  
Minimally Invasive ◽  
Vaginal Hysterectomy ◽  
Standard Procedure ◽  
Laparoscopic Hysterectomy ◽  
Cost Effective ◽  
Abdominal Hysterectomy ◽  
Minimal Invasive ◽  
Invasive Approach ◽  
Minimal Invasive Approach ◽  
Laparoscopic Subtotal Hysterectomy

Minimally invasive hysterectomy is a standard procedure. Different approaches, as laparoscopically assisted vaginal hysterectomy, vaginal hysterectomy, and subtotal and total laparoscopic hysterectomy, have been described and evaluated by various investigations as safe and cost-effective methods. In particular, in comparison to abdominal hysterectomy, the minimally invasive methods have undoubted advantages for the patients. The main reason for a primary abdominal hysterectomy or conversion to abdominal hysterectomy during a minimal invasive approach is the uterine size. We describe our course of action in the retrospective analysis of five cases of total minimal-access hysterectomy, combining the laparoscopic subtotal hysterectomy and the vaginal extirpation of the cervix in uterine myomatosis with a uterine weight of more than 1000 grams, and discuss the factors that limit the use of laparoscopy in the treatment of big uteri. Trail Registration. The case report is registered in Research Registry under the UIN researchregistry743.

scholarly journals Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Macroadenoma as Minimal Invasive Approach: Case Report

2019 ◽  
Vol 3 (1) ◽  
pp. 1
Author(s):  
Febyan Febyan ◽  
Handrianto Setiajaya
Keyword(s):  
Minimally Invasive ◽  
Transsphenoidal Surgery ◽  
Clinical Symptoms ◽  
Minimal Invasive ◽  
Invasive Technique ◽  
Endoscopic Endonasal ◽  
Invasive Approach ◽  
Minimal Invasive Approach ◽  
Endoscopic Endonasal Transsphenoidal Surgery ◽  
Visual Disturbances

Background: pituitary tumor accounted for 15% of benign intracranial tumors. Clinical symptoms found in the form of visual disturbances, and hormonal manifestations, surgery is one of the main managements. Endoscopic endonasal transsphenoidal surgery (EETS) is a minimally invasive approach for this case. The advantages of EETS is better efficacy than traditional technique, and shorter hospital stays, less mean blood loss, and earlier return to daily activities. Case: we reported a rare example of a male patient aged 37 years old with the main clinical features were visual disturbances, sexual malfunction and bitemporal hemianopsia on physical examination. Magnetic resonance imaging (MRI) showed macroadenoma pituitary, the size 2.41 x 2.98 x 3.20 cm. We explained about minimally invasive surgery such as EETS and the patient was agreed to performed EETS. Conclusion: endoscopic endonasal transsphenoidal surgery is a minimally invasive technique for tumor pituitary cases and safe when compared to traditional medicine.

scholarly journals Minimally invasive lumbar foraminotomy

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video7
Author(s):  
Harel Deutsch
Keyword(s):  
Minimally Invasive ◽  
Nerve Root ◽  
Minimal Invasive ◽  
Nerve Root Compression ◽  
Lumbar Radiculopathy ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Link Type ◽  
Lumbar Nerve Root

Lumbar radiculopathy is a common problem. Nerve root compression can occur at different places along a nerve root's course including in the foramina. Minimal invasive approaches allow easier exposure of the lateral foramina and decompression of the nerve root in the foramina. This video demonstrates a minimally invasive approach to decompress the lumbar nerve root in the foramina with a lateral to medial decompression.The video can be found here: http://youtu.be/jqa61HSpzIA.

Irreversible electroporation of the bile duct in swine: A pilot study.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 541-541
Author(s):  
Sang Hyun Kim ◽  
Jae Min Lee ◽  
Kang Won Lee ◽  
Sang Hoon Kim ◽  
Se Hyun Jang ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Minimally Invasive ◽  
Biliary Tract ◽  
Therapeutic Option ◽  
Irreversible Electroporation ◽  
Therapeutic Modality ◽  
Biliary Disease ◽  
Invasive Approach ◽  
Experimental Parameters

541 Background: Irreversible electroporation (IRE) is a relatively new ablative method. However, the application of IRE ablation has not been attempted for the treatment of biliary disease. Minimally invasive approach using endoscopic retrograde cholangio-pancreatography (ERCP) can be a novel therapeutic modality for IRE ablation. In this study, we investigated the feasibility and effect of endoscopic IRE for biliary tract in animal model. Methods: A new catheter electrode was developed for endoscopic IRE ablation of biliary tract. The electrode for IRE ablation has two band-shaped electrodes on catheter tip. We performed ERCP and endoscopic IRE ablations on normal common bile duct in 6 Yorkshire pigs. Experimental parameters of IRE were 500V/cm, 1000V/cm and 2000V/cm (under 50 pulses, 100 µs length). Animals were sacrificed after 24 hours and ablated bile duct were collected. H & E stain, immunohistochemistry and western blot were performed. Results: Well-demarcated focal color changes were observed on the mucosa of the common bile duct under all experimental parameters. After IRE ablation, bile duct epithelium was disappeared around ablated area and it showed fibrotic change in H&E stain. Depth of change after IRE was different between each experimental parameters. Apoptotic change of bile duct was localized around mucosa in 500V. Diffuse transmural fibrosis of bile duct was shown after IRE ablation with 2000V. TUNEL immunohistochemistry showed the cell death of bile duct mucosa and submucosa along the electrode. Within 24 hours, no complication was observed in pigs after endoscopic IRE ablation. Conclusions: Endoscopic IRE ablation using ERCP was successfully performed on common bile duct by using catheter-shaped electrode. It can be a potential therapeutic option as minimally invasive ablation for treatment of biliary tumors.

Proper Surgical Treatment of Small and Medium Size Umbilical Hernias. A Single Surgeon Experience

2020 ◽  
Vol 5 (2) ◽  
pp. 56-63
Author(s):  
Etele Élthes ◽  
Daniela Sala ◽  
Radu Mircea Neagoe ◽  
János Székely ◽  
Márton Dénes
Keyword(s):  
Minimally Invasive ◽  
Therapeutic Option ◽  
Minimal Invasive ◽  
Medium Size ◽  
Open Approach ◽  
Invasive Treatment ◽  
Minimally Invasive Surgical ◽  
Surgeon Experience ◽  
Group B

AbstractIntroduction: Minimally invasive surgical procedures have become routine interventions nowadays and represent an effective therapeutic option even for small umbilical hernias, providing favorable postoperative and aesthetic results.Aim of study: To determine the most appropriate minimally invasive treatment option for small and medium size umbilical hernias.Materials and methods: We conducted a prospective study on 50 patients with small or medium umbilical hernia (<4 cm). All patients benefited of minimal invasive surgery with mesh implantation. Depending on the surgical procedure, two major groups were defined: group A – patients with open surgical approach (n = 24) and group B – patients undergoing laparoscopic surgery (n = 26). Clinical, surgical, postoperative, and follow-up data were analyzed.Results: Mesh replacement via open approach through the umbilicus was associated with significantly reduced surgical time (p = 0.0359), administration of painkillers (p = 0.0461), and use of anticoagulants (p = 0.0404). Hospital stays (p = 0.0001) and costs (p = 0.0005) were also significantly lower in this group. After 6 months of follow-up, no recurrence was observed, and no significant differences were detected regarding postoperative pain and the patients’ professional reintegration. Patient satisfaction regarding postoperative scar was superior in the open group.Conclusion: The present study indicates that the ventral patch technique is a safe and effective method for the treatment of small and medium size umbilical hernias.

Endoscopic Surgery in Rectal Cancer- A Review

JMS SKIMS ◽  
2018 ◽  
Vol 21 (1) ◽  
pp. 3-10
Author(s):  
Rauf Ahmad Wani ◽  
Asif Mehraj
Keyword(s):  
Rectal Cancer ◽  
Minimally Invasive ◽  
Endoscopic Surgery ◽  
Minimal Invasive ◽  
Invasive Approach ◽  
Abdominal Approach ◽  
Endoscopic Microsurgery ◽  
Sexual And Urinary Dysfunction ◽  
Laparoscopic Techniques

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

scholarly journals Treatment for radicular compression experience of 926 cases in Bolivia [abstract]

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Ramiro Alvarado-Reyes
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Minimal Invasive ◽  
Motor Dysfunction ◽  
Ozone Therapy ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Lumbar Level ◽  
Invasive Method ◽  
Radicular Compression

PURPOSE: The present study aims to demonstrate the advantage of treating the radicular compression with the minimally invasive approach such as the discolysis with Ozone Therapy, rather than the surgical approach that we know has complications such as the spine fail back syndrome. This study shows the experience in Bolivia shows from August 2004 to August 2016. MATERIAL AND METHODS: Were treated 926 patients with radicular compression at cervical, thoracic and lumbar level 569 males and 357 females First were performed intra discal injections, the discolysis, of ozone at 30 mcgr/mL followed by 15 or 20 paravertebral injections at 20 mcgr/mL. RESULTS: Among the 926 patients with radicular compression were observed that sensory and motor dysfunction were completely abolished in 611 patients (66%) improved in 176 patients (19%) and with poor results and the dysfunction remained unchanged in 139 patients 15% some of them underwent surgical treatment. DISCUSSION: The discolysis with Ozone is a minimally invasive approach is atraumatic and safety and with this method avoids complications such as spine fail back syndrome, which in USA statistics are reported in 15% to 20%. CONCLUSION: With the treatment of ozone therapy is possible to obtain excellent and good results in 85 % of the cases. Ozone is a useful alternative the effectiveness using this minimal invasive method can avoid complications like spine fail back syndrome.

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