scholarly journals Plasma Radiofrequency Ablation for Scar Treatment

2021 ◽  
Vol 11 (1) ◽  
pp. 140
Author(s):  
Adone Baroni ◽  
Pasquale Verolino
Keyword(s):  
Radiofrequency Ablation ◽  
Carbon Dioxide Laser ◽  
Surgical Techniques ◽  
Psychosocial Problems ◽  
Minimal Invasive ◽  
Novel Therapy ◽  
Autologous Fat Transfer ◽  
Plasma Energy ◽  
Collateral Effects ◽  
Negative Effect

Scars are a common disfiguring sequela of various events such as acne, hidradenitis suppurativa, surgery, trauma, and burns, which can lead to serious psychosocial problems with a negative effect on the quality of life. Many conventional approaches have been proposed for the treatment of scars, including surgical techniques, dermabrasion, chemical peels, topical silicone gel, 5-fluorouracile and dermal fillers injection or autologous fat transfer for atrophic scars, and corticosteroids injection for hypertrophic and keloid scars; however, they have sporadic effects. Ablative lasers, such as carbon dioxide laser or Erbium Yag laser, are associated with many collateral effects limiting their application. Non-ablative laser treatments have been shown to be safer and to have fewer side effects, but they have a reduction of clinical efficacy compared to ablative lasers and a minimal improvement of scars. The demand for minimal invasive and safe technology for the treatment of a scars has stimulated the search for more effective novel therapy with fewer collateral effects. Plasma radiofrequency ablation is a new technique consisting of the generation of plasma energy through the production of ionized energy, which thermally heats tissue in a uniform and controlled manner, through a plasma radiofrequency device, inducing a sublimation of the tissue. The aim of this study is to evaluate the effectiveness of P-RF ablation in the treatment of scars performed with D.A.S. Medical device (Technolux, Italia), which is a tool working with the long-wave plasma radiofrequency principle.

scholarly journals Radiofrequency Ablation of Hepatocellular Carcinoma: A Literature Review

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Yasunori Minami ◽  
Masatoshi Kudo
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Safety Margin ◽  
Surgical Techniques ◽  
Evidence Base ◽  
Current Status ◽  
Probe Design ◽  
Curative Therapy ◽  
Management Of Complications ◽  
Liver Cancers

Radiofrequency ablation (RFA) of liver cancers can be performed safely using percutaneous, laparoscopic, or open surgical techniques, and much of the impetus for the use of RFA has come from cohort series that have provided an evidence base for this technique. Here, we give an overview of the current status of radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC), including its physical properties, to assess the characteristics that make this technique applicable in clinical practice. We review the technical development of probe design and summarize current indications and outcomes of reported clinical use. An accurate evaluation of treatment response is very important to secure successful RFA therapy since a sufficient safety margin (at least 0.5 cm) can prevent local tumor recurrences. We also provide a profile of side effects and information on the integration of this technique into the general management of patients with HCC. To minimize complications of RFA, physicians should be familiar with each feature of complication. Appropriate management of complications is essential for successful RFA treatment. Moreover, adjuvant therapy, such as molecular targeted therapies following curative therapy, is expected to further improve survival after RFA.

Treatment of vulvar and vaginal dysplasia: plasma energy ablation versus carbon dioxide laser ablation

2021 ◽  
pp. ijgc-2021-002913
Author(s):  
Anna Beavis ◽  
Omar Najjar ◽  
Tricia Murdock ◽  
Ashley Abing ◽  
Amanda Fader ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laser Ablation ◽  
Carbon Dioxide Laser ◽  
Group Versus ◽  
Demographic Factors ◽  
Cox Proportional Hazards ◽  
Complication Rates ◽  
Recurrence Rates ◽  
Plasma Energy ◽  
Plasma Ablation

ObjectivePlasma energy ablation vaporizes tissues similar to carbon dioxide laser ablation, but is not hindered by the unique hazards and regulation of laser technology. We aimed to evaluate the complication rate and effectiveness of plasma versus laser ablation in the treatment of vulvovaginal high-grade squamous intra-epithelial lesions (HSIL).MethodsWe performed a retrospective cohort study of women treated with plasma or carbon dioxide laser ablation for histologically proven HSIL of the vulva or vagina from January 2014 to October 2019 at a single institution. Demographic factors, surgical characteristics, and complications were compared by ablation type using Fisher’s exact tests. Recurrence-free survival was evaluated by ablation type using Kaplan–Meier curves, weighted log-rank tests, and Cox proportional hazards ratio estimates.ResultsForty-two women were included; 50% underwent plasma and 50% underwent carbon dioxide laser ablation. Demographic factors were similar between the groups. 50% (n=21) were immunosuppressed, 45.2% (n=19) had prior vulvovaginal HSIL treatment, and 35.7% (n=15) were current smokers. Most women (n=25, 59.5%) were treated for vulvar HSIL, 38.1% (n=16) for vaginal HSIL. Complication rates did not differ by treatment: 9.5% (n=2) for laser ablation versus 4.8% (n=1) for plasma ablation (p=1.0). Over a median follow-up time of 29.3 months (IQR 11.0–45.0 months), recurrence rates were similar: 28.6% in the laser ablation group versus 33.3% in the plasma ablation group (weighted log rank p=0.43; 24-month HR 0.54, 95% CI 0.15 to 2.01).ConclusionPlasma energy ablation of vulvovaginal HSIL has similar complication rates and recurrence risk to carbon dioxide laser ablation. This technique could be considered as an alternative treatment modality for vulvovaginal HSIL and warrants further investigation.

scholarly journals Minimally-invasive technologies in the treatment of choledocholithiasis complicated by biliary pancreatitis

2021 ◽  
Vol 11 (3) ◽  
pp. 294-309
Author(s):  
I. Deikalo ◽  
D. Osadchuk ◽  
O. Karel ◽  
M. Handzhalas
Keyword(s):  
High Efficiency ◽  
Surgical Techniques ◽  
Liver Parenchyma ◽  
Minimal Invasive ◽  
Biliary Pancreatitis ◽  
Satisfactory Condition ◽  
Biliary Sepsis ◽  
Extrahepatic Bile Ducts ◽  
Group 3 ◽  
Sepsis And Septic Shock

Minimal invasive endoscopic technologies are used in the treatment of patients with biliary pancreatitis with complicated cholangitis and biliary sepsis. 56 patients were treated for the period 2014 - 2018, aged 65.5 ± 15.18 years. ERCP was performed in 31 (55,3%) patients, in 13 (23,2%) - surgical intervention was performed without contrast of extrahepatic bile ducts. Papillotomy in 52 cases (96,4%) was performed by string papilloma and in 4 (7,1%) - by needle. In all cases, subtotal papilloprotectomy was performed [1], supplemented by balloon sphincteroplasty. In the I group, the patients included patients with biliary pancreatitis clinic, in group II patients with clinic of biliary sepsis, in the III group patients with purulent cholangitis clinic, biliary sepsis and septic shock. In the 1st and 2nd groups of patients, mortality was not observed. In the 3rd group, 3 patients died (37,5%). The rest of the patients are discharged from the hospital in a satisfactory condition. A decrease in the level of markers of hepatitis cytolysis (AlAT, AsAT, GGTP, L-FABP) was observed during surgical procedures without ERCP, indicating the toxic effect of contrast on the liver parenchyma. L-FABP is a highly informative marker for hepatocyte cytolysis and can be used as a criterion for hepatic insufficiency and prognosis of biliary sepsis. The high efficiency of transpacillary endoscopic surgical techniques in the treatment of biliary pancreatitis and biliary sepsis was noted.

Total Cervical Tracheal Stenosis: Treatment by Laser, Dilation, and Stenting

1989 ◽  
Vol 98 (11) ◽  
pp. 890-895 ◽  
Author(s):  
Stanley M. Shapshay ◽  
John F. Beamis ◽  
Jean-Francois Dumon
Keyword(s):  
Tracheal Stenosis ◽  
Carbon Dioxide Laser ◽  
Average Duration ◽  
Surgical Techniques ◽  
Initial Therapy ◽  
Tube Placement ◽  
T Tube ◽  
Endoscopic Laser ◽  
Laser Excision

Twelve patients with total cervical tracheal stenosis were treated by endoscopic laser excision (neodymium:yttrium aluminum garnet or carbon dioxide laser), bronchoscopic dilation, and prolonged stenting with a silicone T-tube. All patients had previous traumatic or prolonged endotracheal intubation requiring a tracheotomy and presented with aphonia as the major complaint. Multiple laser and dilation treatments were necessary in ten patients. Average duration of T-tube placement was 6 months. Excellent results (decannulation and good voice) were achieved in eight patients with a follow-up of 9 months to 6 years. Persistent granulation tissue and some degree of fibrosis were the most common complications (eight of 12 patients). Two patients died of medical complications. A high success rate with this endoscopic technique justifies this approach as our initial therapy, with open surgical techniques reserved for failure.

scholarly journals Managing Benign and Malignant Oral Lesions with Carbon Dioxide Laser: Indications, Techniques, and Outcomes for Outpatient Surgery

2019 ◽  
Vol 05 (03) ◽  
pp. e69-e75
Author(s):  
Alberto Maria Saibene ◽  
Cecilia Rosso ◽  
Paolo Castellarin ◽  
Federica Vultaggio ◽  
Carlotta Pipolo ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Co2 Laser ◽  
Laser Surgery ◽  
Carbon Dioxide Laser ◽  
Outpatient Surgery ◽  
Surgical Techniques ◽  
Systematic Evaluation ◽  
Oral Lesions ◽  
Wide Range ◽  
Malignant Lesions

Purpose Because of its affinity for water-based tissues, carbon dioxide (CO2) laser has become an instrument of choice for treating oral mucosa conditions, ranging from inflammatory to malignant lesions. The aim of this work is to systematically evaluate the outcomes of laser surgery over a wide range of lesions, while providing a solid and reproducible protocol for CO2 laser surgery in the outpatient management of oral lesion. Methods Seventy-eight patients underwent 92 laser outpatient procedures for treatment of a wide range of benign and malignant lesions. We performed 60 removals, 11 exeretic biopsies, 15 vaporizations, and 3 vaporization/removal combined. We analyzed laser parameters applied for each technique and provided a systematic evaluation of surgical results. Results No problems occurred intraoperatively in any of the patients. Five patients complained marginal pain, while 3 patients had postsurgery bleeding. All treatments were successful, with the notable exception of 3 relapsing verrucous proliferative leukoplakias and an infiltrating squamous cell carcinoma of the tongue requiring radicalization. We did not record any adverse reactions to drugs or lesions due to laser action. Concordance between clinical diagnosis and pathology results was at 94.8%. Conclusions Our data indicate that CO2 laser is a solid choice for outpatient treatment of oral lesions. This technique grants painless and almost bloodless treatment, with negligible recurrence rates. Providing a solid reference for laser settings and operative techniques could provide a foundation for further exploring this tool while offering the basis for a positive comparison between different surgical techniques and options.

scholarly journals Surgery in the Treatment of Acute Pancreatitis — Open Pancreatic Necrosectomy

2005 ◽  
Vol 94 (2) ◽  
pp. 130-134 ◽  
Author(s):  
J. Werner ◽  
W. Hartwig ◽  
T. Hackert ◽  
M. W. Büchler
Keyword(s):  
Acute Pancreatitis ◽  
Late Phase ◽  
Necrotizing Pancreatitis ◽  
Surgical Techniques ◽  
Interventional Therapy ◽  
Minimal Invasive ◽  
Infected Necrosis ◽  
Early Management ◽  
Pancreatic Infection ◽  
The Past

Management of acute necrotizing pancreatitis has changed significantly over the past years. Early management is non-surgically and solely supportive. Today, more patients survive the early phase of severe pancreatitis due to improvements of intensive-care-medicine. Pancreatic infection is the major risk factor with regard to morbidity and mortality in the late phase of severe acute pancreatitis. Whereas early surgery and surgery for sterile necrosis can only be recommended in selected cases, pancreatic infection is a well accepted indication for surgical treatment. Surgery should ideally be postponed until four weeks after the onset of symptoms as necrosis is well demarcated at that time. Four surgical techniques can be performed with comparable results regarding mortality: necrosectomy combined with (1) open packing, (2) planned staged relaparotomies with repeated lavage, (3) closed continuous lavage of the retroperitoneum, and (4) closed packing. However, closed continuous lavage of the retroperitoneum, and closed packing seem to be associated with a lower morbidity compared to the other two approaches. Advances in radiologic imaging, new developments of interventional radiology and other minimal access interventions have revolutionized the management of many surgical conditions over the past decades. However, minimal invasive surgery and interventional therapy for infected necrosis should be limited to specific indications in patients who are critically ill and otherwise unfit for conventional surgery. Open surgical debridement is the “gold standard” for treatment of infected pancreatic and peripancreatic necrosis.

scholarly journals A Rare Complication of Radiofrequency Tonsil Ablation: Horner Syndrome

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Cuneyt Kucur ◽  
Isa Ozbay ◽  
Fatih Oghan ◽  
Nadir Yildirim ◽  
Zuhal Zeybek Sivas ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Present Report ◽  
Rare Complication ◽  
Surgical Techniques ◽  
Early Postoperative Period ◽  
Common Disease ◽  
Limited Data ◽  
Horner Syndrome ◽  
Tonsil Surgery ◽  
The Right

Chronic tonsillitis is a common disease, and several different surgical techniques are used to treat this condition. In recent years, techniques such as radiofrequency ablation and coblation have been commonly used for tonsil surgery. In this report, we present the cases of two pediatric patients who developed ptosis, miosis, and enophthalmos (Horner syndrome) after radiofrequency ablation for tonsil reduction and discuss the technique of radiofrequency ablation of the tonsils. In the early postoperative period, miosis and ptosis were observed on the right side in one patient and on the left side in the other patient. Both patients were treated with 1 mg/kg/day methylprednisolone, which were tapered by halving the dose every 3 days. Miosis and ptosis improved after treatment in both patients. Along with the case presentation, we discuss the effectiveness and complications of radiofrequency ablation of the tonsils. These unusual complications of tonsil ablation may help ENT physicians who do not yet have a preferred surgical technique for tonsillectomy to make an informed decision. Limited data are available about the possible complications of radiofrequency ablation of the tonsils. The present report contributes to the literature on this topic.

scholarly journals Transvaginal Appendectomy: A Systematic Review

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Mehmet Ali Yagci ◽  
Cuneyt Kayaalp
Keyword(s):  
Comparative Studies ◽  
Operating Time ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Minimal Invasive ◽  
Morbidly Obese ◽  
Complication Rates ◽  
Study Selection ◽  
History Of ◽  
Patient Selection Criteria

Background. Natural orifice transluminal endoscopic surgery (NOTES) is a new approach that allows minimal invasive surgery through the mouth, anus, or vagina.Objective. To summarize the recent clinical appraisal, feasibility, complications, and limitations of transvaginal appendectomy for humans and outline the techniques.Data Sources. PubMed/MEDLINE, Cochrane, Google-Scholar, EBSCO, clinicaltrials.gov and congress abstracts, were searched.Study Selection. All related reports were included, irrespective of age, region, race, obesity, comorbidities or history of previous surgery. No restrictions were made in terms of language, country or journal.Main Outcome Measures. Patient selection criteria, surgical techniques, and results.Results. There were total 112 transvaginal appendectomies. All the selected patients had uncomplicated appendicitis and there were no morbidly obese patients. There was no standard surgical technique for transvaginal appendectomy. Mean operating time was 53.3 minutes (25–130 minutes). Conversion and complication rates were 3.6% and 8.2%, respectively. Mean length of hospital stay was 1.9 days.Limitations.There are a limited number of comparative studies and an absence of randomized studies.Conclusions. For now, nonmorbidly obese females with noncomplicated appendicitis can be a candidate for transvaginal appendectomy. It may decrease postoperative pain and enable the return to normal life and work off time. More comparative studies including subgroups are necessary.

Treatment of incompetent perforating veins using the radiofrequency ablation stylet: a pilot study

2009 ◽  
Vol 24 (5) ◽  
pp. 208-212 ◽  
Author(s):  
R R van den Bos ◽  
T Wentel ◽  
M H A Neumann ◽  
T Nijsten
Keyword(s):  
Radiofrequency Ablation ◽  
Pilot Study ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Minimal Invasive ◽  
Perforating Veins ◽  
Minimal Invasive Techniques ◽  
Invasive Techniques ◽  
Anatomical Success

Background Although the role of incompetent perforating veins (IPV) in chronic venous insufficiency remains controversial, they are often treated by surgical or by minimal invasive techniques. Objectives To describe the procedure of radiofrequency ablation (RFA) of IPV and to evaluate its short-term effectiveness and safety. Methods In a clinical pilot study, 14 IPV in 12 patients were treated with a radiofrequency stylet. After three months, ultrasound (US) examination was used to assess anatomical success rate and exclude deep venous thrombosis. Also, self-reported side-effects were investigated. Results Of the 14 treated IPV, nine (64%) were obliterated on US examination and the others showed remaining reflux. Two patients reported localized paresthesia, but no deep venous thrombosis was recorded. Conclusion RFA of IPV may be a promising procedure, but patient and incompetent perforator vein selection is important and further standardization of the procedure is required. Comparative clinical trials between RFA and other therapies are warranted.

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