scholarly journals Minimally Invasive Video-assisted Thyroidectomy vs Conventional Open Hemithyroidectomy in Asian Patients

2016 ◽  
Vol 8 (3) ◽  
pp. 189-192
Author(s):  
Reyaz M Singaporewalla ◽  
Anil D Rao ◽  
Arunesh Majumder
Keyword(s):  
Postoperative Pain ◽  
Minimally Invasive ◽  
Pain Score ◽  
Open Surgery ◽  
Operating Time ◽  
Incision Length ◽  
Video Assisted ◽  
Asian Patients ◽  
Significant Difference ◽  
Conventional Open Surgery

ABSTRACT Introduction Although the technique of minimally invasive video assisted thyroidectomy (MIVAT) is well established in continental Europe, data on it's role in Asian patients is limited. We compared the results of MIVAT with conventional open hemithyroidectomy in Asian patients. Materials and methods Over a 1-year period, patients undergoing hemithyroidectomy for benign symptomatic goiters were selected. Inclusion criteria for MIVAT were benign colloid goiters, recurrent cysts or follicular lesions and neoplasms with lobe volume of less than 40 cc or nodule diameter less than 35 mm. Larger goiters underwent conventional open surgery. Patients with previous neck surgery and proven malignancy were excluded. Operative time, complications, postoperative pain score, incision length and cosmetic satisfaction at 6 months were recorded. Results Thirty-six patients (MIVAT-21, Conventional-15) were included. Both groups were comparable in terms of demographic profile and co-morbidities. The mean operating time for both groups showed no significant difference (MIVAT = 111.67 ± 19.4 min, Conventional = 112.40 ± 25.06 min; p = 0.925). Minimally invasive video assisted thyroidectomy patients had significantly less pain in the immediate postoperative period (mean pain score 2.38 vs 4.8, p < 0.001). Mean incision length at end of surgery was significantly smaller in the MIVAT group (2.58 vs 6.3 cm; p < 0.001). Neck scar satisfaction at 6 months was excellent in 71.4% of MIVAT cases vs 26.6% of conventional hemithyroidectomy cases. There were no complications in any of the treatment groups. Conclusion In selected cases, MIVAT is as safe as conventional open surgery with distinct advantages of better postoperative pain control and cosmesis. How to cite this article Rao AD, Singaporewalla RM, Majumder A. Minimally Invasive Video-assisted Thyroidectomy vs Conventional Open Hemithyroidectomy in Asian Patients. World J Endoc Surg 2016;8(3):189-192.

Efficacy of Perioperative Administration of Intravenous Parecoxib on Postoperative Morphine Consumption after Video-Assisted Thoracoscopic Surgery

2021 ◽  
Vol 104 (11) ◽  
pp. 1836-1842
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Rating Scale ◽  
Thoracoscopic Surgery ◽  
Morphine Consumption ◽  
High Dose ◽  
Video Assisted ◽  
Significant Difference ◽  
Postoperative Morphine ◽  
Video Assisted Thoracoscopic Surgery

Background: Morphine is commonly used to relief pain after video-assisted thoracoscopic surgery (VATS), however high dose morphine is usually related with many complications. Parecoxib is a potent cyclo-oxygenase inhibitor for parenteral administration that has a role in acute pain management addition to opioid protocol. Objective: To investigate the potential benefits of intravenous parecoxib for relieving postoperative pain after VATS. Materials and Methods: The present study was a randomized controlled trial that assigned 22 patients undergoing VATS into two groups to received either parecoxib 40 mg as P group with 11 patients, or placebo using 2 mL of Normal Saline Solution as C group with 11 patients with an intravenous administration at 30 minutes prior to surgery and then 12 hours later. In the postoperative period, all patients received intravenous patient-controlled analgesia (PCA) with morphine. The primary outcome was the total morphine consumption for 24 hours postoperatively. The secondary outcomes were pain score at 2, 6, 12, and 24 hours postoperatively, using a numeric rating scale (NRS, 0 to 10) and the incidence of side effects. Results: The total morphine consumption was significantly lower in P group (26.64±4.41 mg) than C group (39.82±3.87 mg) at 24 hours postoperatively (p<0.001). The NRS pain score at rest and on coughing at 24 hours postoperatively between P group compared with C group were 1.09±1.04 versus 4.45±0.69 (p<0.001) and 2.91±0.83 versus 5.36±0.81 (p<0.001), respectively. The incidences of nausea and vomiting were found in both groups at 2, 6, and 12 hours, postoperatively, but there was no statistically significant difference between both groups (p>0.05). Other adverse events such as sedation, pruritus, dyspepsia, headache, hypotension, and respiratory depression were not found. Conclusion: Perioperative administration of parecoxib was safe and effectively decrease postoperative morphine consumption and pain score at rest and on coughing within 24 hours postoperatively after VATS. Keywords: Intravenous parecoxib; Video-assisted thoracoscopic surgery; Acute postoperative pain

Evaluation of Postoperative Pain after Sinonasal Surgery

2005 ◽  
Vol 19 (5) ◽  
pp. 471-477 ◽  
Author(s):  
Sarah K. Wise ◽  
Justin C. Wise ◽  
John M. DelGaudio
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Postoperative Period ◽  
Repeated Measures ◽  
Medication Use ◽  
Pain Rating ◽  
Pain Location ◽  
Significant Difference ◽  
Chi Square Analysis ◽  
Analgesic Use

Background Pain after sinonasal surgery concerns both patients and surgeons. Factors affecting sinonasal postoperative pain have not been examined extensively. Methods Using a prospective survey design, sinonasal surgery patients evaluated postoperative pain (on a scale of 0–10), pain location, and medication use. Results One hundred twenty-seven patients consented to participate. One hundred fifteen patients returned surveys, with 100 patients appropriate for analysis over the 6-day postoperative period. Pain score and medication use were evaluated with respect to sex, primary/revision case, nasal packing, and other factors. Repeated measures analysis of variance and chi-square analysis were conducted (p < 0.05). Pain ratings and analgesic use declined significantly over the postoperative period (p < 0.05). Mean pain score on postoperative day (POD) 1 was 3.61 and on POD 6 was 1.72. Mean medication use was 1.37 tablets on POD 1 and 0.55 tablets on POD 6. Additionally, a significant interaction existed, such that narcotic medication use declined from 1.91 tablets on POD 1 to 0.52 tablets on POD 6, whereas nonnarcotic medication use remained steady (p < 0.05). Periorbital pain was most frequent (46.3%), with unilateral facial pain reported least (4.1%). A significant difference existed for distribution of pain location (p < 0.05). Finally, the difference in pain rating between primary and revision procedure for women (0.65) was less than for men (1.12); this interaction was significant (p < 0.05). Conclusion Multiple patient and operative factors affect pain rating and medication use after sinonasal surgery. Generally, pain level should be low with little analgesic use postoperatively.

Frameless Stereotactic Brain Biopsies: Comparison of Minimally Invasive Robot-Guided and Manual Arm-Based Technique

2020 ◽  
Vol 19 (3) ◽  
pp. 292-301
Author(s):  
Georgi Minchev ◽  
Gernot Kronreif ◽  
Wolfgang Ptacek ◽  
Joachim Kettenbach ◽  
Alexander Micko ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Diagnostic Yield ◽  
Operating Time ◽  
Point Group ◽  
Skin Incision ◽  
Target Point ◽  
Incision Length ◽  
Biopsy Technique ◽  
Lower Accuracy ◽  
Stereotactic Biopsies

Abstract BACKGROUND Most brain biopsies are still performed with the aid of a navigation-guided mechanical arm. Due to the manual trajectory alignment without rigid skull contact, frameless aiming devices are prone to considerably lower accuracy. OBJECTIVE To compare a novel minimally invasive robot-guided biopsy technique with rigid skull fixation to a standard frameless manual arm biopsy procedure. METHODS Accuracy, procedural duration, diagnostic yield, complication rate, and cosmetic result were retrospectively assessed in 40 consecutive cases of frameless stereotactic biopsies and compared between a minimally invasive robotic technique using the iSYS1 guidance device (iSYS Medizintechnik GmbH) (robot-guided group [ROB], n = 20) and a manual arm-based technique (group MAN, n = 20). RESULTS Application of the robotic technique resulted in significantly higher accuracy at entry point (group ROB median 1.5 mm [0.4-3.2 mm] vs manual arm-based group (MAN) 2.2 mm [0.2-5.2 mm], P = .019) and at target point (group ROB 1.5 mm [0.4-2.8 mm] vs group MAN 2.8 mm [1.4-4.9 mm], P = .001), without increasing incision to suture time (group ROB 30.0 min [20-45 min vs group MAN 32.5 min [range 20-60 min], P = .09) and significantly shorter skin incision length (group ROB 16.3 mm [12.7-23.4 mm] vs group MAN 24.2 mm [18.0-37.0 mm], P = .008). CONCLUSION According to our data, the proposed technique of minimally invasive robot-guided brain biopsies can improve accuracy without increasing operating time while being equally safe and effective compared to a standard frameless arm-based manual biopsy technique.

Laparoscopic Versus Open Appendectomy for the Treatment of Complicated Acute Appendicitis

2020 ◽  
Vol 8 (1) ◽  
pp. 15
Author(s):  
Alireza Barband ◽  
Amir Mangouri ◽  
Changiz Gholipouri ◽  
Abasad Gharedaghi
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Treatment ◽  
Postoperative Pain ◽  
Acute Appendicitis ◽  
Open Surgery ◽  
Surgery Group ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Duration Of Hospitalization ◽  
Complicated Acute Appendicitis

Background and Objective: Acute appendicitis is one of the most common and at the same time lethal if not treated promptly. Failure to treat this medical condition in a timely manner then it can lead to major complications that endanger the patient’s health. In these cases, surgical treatment can be done in an open or laparoscopic method. Despite some limited studies comparing the results of these two therapies, there is still insufficient information in patients with this complicated situation. The aim of this study was to evaluate the results of these two therapies in patients with complicated acute appendicitis. Materials and Methods: In this randomized controlled clinical trial, 52 patients with complicated acute appendicitis in the laparoscopic surgery group and 56 patients in the open surgery group were studied. Primary outcomes in this study were duration of surgery and secondary outcomes including wound infection, intra-abdominal abscess, postoperative pain, miscarriage, hospitalization, and need for re-surgery that were compared between the two groups. Results: Both groups were matched for age (mean 31.0 years in laparoscopic surgery group, 30.5 years in open surgery group, p = 0.81) and gender (28 men in laparoscopic surgery group, 32 men in surgical group, p = 0.73). The mean duration of surgery in the laparoscopic group was significantly longer (mean 66.8 vs. 55.1 min, p <0.001). In contrast, mean duration of hospitalization (85.2 vs 98.6 hours, p <0.001) and mean postoperative pain severity (6.3 vs 7.2, p <0.001) was more significant high in open surgery group. In other cases there was no significant difference between the two groups. Conclusion: Although in surgical treatment of complicated acute appendicitis the duration of laparoscopic surgery is longer than the open method, but the duration of hospitalization and pain intensity in laparoscopic method is significantly reduced.

scholarly journals Minimally Invasive Surgery for Colorectal Cancer: Past, Present, and Future

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
J. Holder-Murray ◽  
E. J. Dozois
Keyword(s):  
Colorectal Cancer ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Oncologic Outcomes ◽  
Rapid Progression ◽  
Barriers To Adoption ◽  
Colorectal Cancer Surgery ◽  
Conventional Open Surgery ◽  
Invasive Techniques ◽  
Innovative Techniques

A rapid progression from conventional open surgery to minimally invasive approaches in the surgical management of colorectal cancer has occurred over the last 2 decades. Initial concerns that this new approach was oncologically inferior to open surgery were ultimately refuted when several prospective randomized trials concluded that laparoscopic colectomy could achieve similar oncologic outcomes to open surgery. On the contrary, level 1 data has not yet matured regarding the oncologic safety of minimally invasive approaches for rectal cancer. We review the published literature pertaining to the evolution of minimally invasive techniques used to treat colorectal cancer surgery, including barriers to adoption, and the prospects for future advances related to innovative techniques.

scholarly journals Minimally invasive, video-assisted thyroidectomy: first experience from the United Kingdom

2010 ◽  
Vol 92 (5) ◽  
pp. 379-384 ◽  
Author(s):  
AK Samy ◽  
D Ridgway ◽  
A Orabi ◽  
A Suppiah
Keyword(s):  
Minimally Invasive ◽  
Objective Assessment ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Operating Time ◽  
Rapid Improvement ◽  
Voice Change ◽  
Video Assisted ◽  
Surgeon Experience ◽  
First Results ◽  
The Uk

INTRODUCTION Minimally-invasive, video-assisted thyroidectomy (MIVAT) was developed to reduce scarring/trauma associated with cervical incisions used in open thyroidectomy. Results from various centres have been published internationally but none from the UK. This study reports the first results from the UK and compares them with other centres. We also aim to compare the results of a single-surgeon experience in a small/moderately-sized hospital to those of larger tertiary centres. PATIENTS AND METHODS Retrospective analysis of a single surgeon experience in a district general hospital RESULTS The cohort was 55 patients (52 female, 3 male), mean age 48 years (range, 21-77 years) who had 64 MIVAT procedures. There were 49 hemithyroidectomies (HTs), 2 isthmusectomy, 4 total thyroidectomies (TTs) and 9 completion thyroidec-tomies (CTs) with median operating time of 86 min (IQR 66-110 min). Individual operating times were HT 85 min (IQR 60-110 min); TT 130 min (IQR 100-140 min) and CT 77 min (IQR 70-98 min). Median operating time was shorter in the second half of this series (76 min vs 92 min; P < 0.001). Length of stay was < 1 day in 92%. Conversions occurred in 6.3% with no haematoma or re-operation. Transient voice change was present in 7 (11%), permanent unilateral recurrent laryngeal nerve palsy in 2 (3%), and transient hypocalcaemia in 2 (3%). CONCLUSIONS The first results from the UK are similar to those of other international centres. A single-surgeon practice can obtain results comparable to larger tertiary centres provided there is sufficient case-load. MIVAT is safe and effective, but has a steep learning curve with rapid improvement observed within first 30 cases. Future studies should focus on objective assessment of scar/cosmesis and cost-effectiveness. MIVAT is an acceptable alternative to open surgery in highly selected patients.

Intraoperative haemodynamic stability in patients with phaeochromocytoma ? minimally invasive vs conventional open surgery

2006 ◽  
Vol 65 (3) ◽  
pp. 352-358 ◽  
Author(s):  
Dirk Weismann ◽  
Martin Fassnacht ◽  
Fabian Weinberger ◽  
Wulf Hamelmann ◽  
Saskia Diehl ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Open Surgery ◽  
Haemodynamic Stability ◽  
Conventional Open Surgery

scholarly journals Using intravenous acetaminophen in the reduction of opioids in spinal cord surgeries by patient-controlled analgesia

2018 ◽  
Vol 5 (12) ◽  
pp. 3883
Author(s):  
Vadoud Nourouzi ◽  
Ali Mohammadian ◽  
Khatereh Isazadehfar ◽  
Sona Rasouli
Keyword(s):  
Spinal Cord ◽  
Placebo Group ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Pain Score ◽  
Postoperative Recovery ◽  
Opioid Use ◽  
Hospitalization Period ◽  
Significant Difference ◽  
Pain Pump

Background: Proper management of postoperative pain results in improved quality of patient's' life, early postoperative recovery, reduced hospitalization period and decreased treatment costs. Regarding significant efficacy and higher pain relief functions, opioids are amongst the best pain relief drugs. However, use of theses narcotics as pain killers is somehow controversial. Current study investigated the effects of IV acetaminophen in reduced use of opioids in surgeries of spinal cord by PCA method.Methods: Current double blinded clinical trial study performed upon 86 patients of 20-70 years of age who candidate for spinal CD implant with ASA class I or II. Patients randomly divided into two groups of IV Acetaminophen therapy (N=43) and placebo group (N=43) and each group were put equally under general anesthesia in which both received pain pump containing Fentanyl during recovery. Patients were examined regarding pain score, amount of opioid use and request for extra narcotics and the related complications including nausea, vomiting, dizziness, allergy, gastrointestinal bleeding and Ileus every 6 hours for 24 hours and the obtained results were recorded.Results: Regarding VAS, pain was significantly lower during 24 hours of study in IV Acetaminophen group (p<0.05). Mean use of opioid via pain pump was significantly lower in IV Acetaminophen group compared with placebo group (p=0.00). Request for extra doses of narcotics was higher in placebo group while regarding demand for extra pain relief, there was no significant difference between both groups. Regarding other results, no significant difference observed between both study groups.Conclusions: Results of the study indicated that use of a combination of IV acetaminophen along with opioids would be much more effective than use of narcotics alone in postoperative pain control of CD implant surgery of spinal cord and that leads to lower pain score and decreased use of opioids and its related complications.

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