scholarly journals First Canadian experience with robotic single-incision pyeloplasty: Comparison with multi-incision technique

2016 ◽  
Vol 10 (3-4) ◽  
pp. 83 ◽  
Author(s):  
Jeffrey Law ◽  
Neal Rowe ◽  
Jason Archambault ◽  
Sofia Nastis ◽  
Alp Sener ◽  
...  
Keyword(s):  
Single Incision ◽  
Single Port ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Success Rates ◽  
Access Port ◽  
Significant Difference ◽  
Site Access ◽  
Da Vinci Robotic System ◽  
Incision Technique

<p><strong>Introduction:</strong> We compared the outcomes of single-incision, robotassisted laparoscopic pyeloplasty vs. multiple-incision pyeloplasty using the da Vinci robotic system.</p><p><strong>Methods:</strong> We reviewed all consecutive robotic pyeloplasties by a single surgeon from January 2011 to August 2015. A total of 30 procedures were performed (16 single:14 multi-port). Two different single-port devices were compared: the GelPort (Applied Medical, Rancho Santa Margarita, CA) and the Intuitive single-site access port (Intuitive Surgical, Sunnyvale, CA).</p><p><strong>Results:</strong> Patient demographics were similar between the two groups. Mean operating time was similar among the single and multi-port groups (225.2 min vs. 198.9 minutes [p=0.33]). There was no significant difference in length of hospital stay in either group (86.2 hr vs. 93.2 hr [p=0.76]). There was no difference in success rates or postoperative complications among groups.</p><p><strong>Conclusions:</strong> Single-port robotic pyeloplasty is non-inferior to multiple-incision robotic surgery in terms of operative times, hospitalization time, success rates, and complications. Verifying these results with larger cohorts is required prior to the wide adoption of this technique. Ongoing objective measurements of cosmesis and patient satisfaction are being evaluated.</p><p> </p>

scholarly journals Placement of Totally Implantable Venous Access Ports Using the Single-Incision Technique: Outcomes and Complications

2020 ◽  
Vol 17 (3) ◽  
Author(s):  
Seo Jin Jang ◽  
Jae Hyun Kwon ◽  
Yoon Ki Cha ◽  
Do Yeun Kim
Keyword(s):  
Single Incision ◽  
Clinical Success ◽  
Wound Dehiscence ◽  
Venous Access ◽  
Complication Rates ◽  
Axillary Vein ◽  
Success Rates ◽  
Access Port ◽  
Incision Technique ◽  
Subcutaneous Tunneling

Background: A totally implantable venous access port (TIVAP) is an essential component of care for oncology patients. Conventional placement of the TIVAP is performed through the internal jugular vein or the subclavian vein using a tunneled catheter, which involves creating two incisions. However, the conventional technique has several potential limitations. To address these limitations, a single-incision technique without a second incision or subcutaneous tunneling has been extensively tested since first being introduced by Glenn in 2007. Objectives: The purpose of this study was to evaluate the technical success, clinical outcomes, and complications of the single-incision technique for the placement of TIVAPs. Patients and Methods: Between January 2013 and June 2017, 182 TIVAPs were placed by a single-incision technique in 175 patients, including 79 men and 96 women (mean age, 62.4 years; range: 20 - 88 years). Electronic medical records were retrospectively reviewed to obtain patient data, outcomes, and complication rates. Results: A total of 40,594 catheter maintenance days (median, 221.9 days; range, 1 - 889 days) were recorded for 182 TIVAPs in 176 patients. Technical and clinical success rates were both 100%. A total of 25 complications (complication rate, 13.74%) occurred, including catheter occlusion (5.49%), catheter-related infection (5.49%), wound dehiscence (1.10%), catheter kinking (0.55%), venous thrombosis (0.55%), and extravasation during infusion (0.55%). Conclusion: The single-incision technique for TIVAP via the axillary vein was safe and efficient with high technical and clinical success rates. This new technique may be a good alternative to conventional techniques.

Comparing Outcomes of the Standard Technique of Endoscopic DCR with Its Modifications: A Retrospective Analysis

2018 ◽  
Vol 160 (2) ◽  
pp. 347-354 ◽  
Author(s):  
Subodh Kumar ◽  
Awadhesh Kumar Mishra ◽  
Ashwani Sethi ◽  
Ajay Mallick ◽  
Nidhi Maggon ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Preoperative Evaluation ◽  
Tertiary Care ◽  
Operating Time ◽  
Standard Technique ◽  
Success Rates ◽  
Retrospective Case ◽  
Case Record ◽  
Significant Difference ◽  
Endoscopic Dcr

Objective To compare the outcomes of various techniques of endoscopic dacryocystorhinostomy (DCR). Study Design Retrospective case record analysis. Settings Tertiary care referral center. Subject and Methods Retrospective analysis of case records was carried out pertaining to the period from January 1996 to September 2017 with respect to patients who had undergone endoscopic DCR with either the standard technique or one of its modifications. Case notes showing well-documented preoperative evaluation, operative details, postoperative assessment, and minimum 6-month follow-up were considered. The outcomes were measured on the basis of patients’ postoperative symptoms, clinical examination, and sac-syringing results. Results A total of 423 patients were included in the study. Of these, 169 underwent standard endoscopic DCR; 87, endoscopic DCR with stent; 19, endoscopic DCR with mitomycin C; 62, powered DCR; 29, laser-assisted DCR; and 57, balloon DCR. There was no statistically significant difference in success rates, recurrences, or complications of various techniques at 3 or 6 months. Mean operating time was lowest for balloon DCR (mean ± SD, 27.1 ± 3.1 minutes), followed by standard endoscopic DCR (38.2 ± 3.6 minutes; P = .001). Conclusion Standard endoscopic DCR and its more sophisticated modifications were equally effective and safe in managing distal nasolacrimal drainage obstruction. Balloon DCR, followed by standard endoscopic DCR, was significantly faster than other techniques.

scholarly journals Single Port Laparoscopic Liver Resection for Hepatocellular Carcinoma: A Preliminary Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Stephen Kin Yong Chang ◽  
Maria Mayasari ◽  
Iyer Shridhar Ganpathi ◽  
Victor Lee Tswen Wen ◽  
Krishnakumar Madhavan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Laparoscopic Surgery ◽  
Liver Resection ◽  
Blood Loss ◽  
Hospital Stay ◽  
Laparoscopic Liver Resection ◽  
Preliminary Report ◽  
Single Port ◽  
Operating Time ◽  
Length Of Hospital Stay

Single port laparoscopic surgery is an emerging technique, now commonly used in cholecystectomy. The experience of using this technique in liver resection for hepatocellular carcinoma is described in a series of 3 cases with single port laparoscopic liver resection performed during 2010. All patients were male aged 61 to 70 years, with several comorbidities. There were no complications in this early series. The length of hospital stay was 3–5 days. The blood loss was 200–450 mL, with operating time between 142 and 171 minutes. We conclude that this technique is feasible and safe to perform in experienced centers.

RETROPERITONEALS SINGLE INCISION LAPAROSCOPIC NEPHRECTOMY: MINI-INVASIVE TECHNICAL, SAFETY AND COSMETIC

2018 ◽  
Vol 8 (6) ◽  
pp. 23-26
Author(s):  
Liem Ngo Thanh ◽  
Hung Nguyen Khoa ◽  
Tung Hoang Van
Keyword(s):  
Single Incision ◽  
Single Port ◽  
Operating Time ◽  
Laparoscopic Nephrectomy ◽  
Central Hospital ◽  
Hospital Patients ◽  
Sils Port ◽  
A Prospective Study ◽  
Objective Outcome ◽  
Technical Safety

Objective: Outcome of 45 retroperitoneal single incision laparoscopic nephrectomy of benigns nonfunction kidneys at Hue Central Hospital. Patients and method: A prospective study was perform on 45 patients with benign nonfuncion kidney, treated by retroperitoneal single incision laparoscopic nephrectomy at Department of General Surgery - Hue Central Hospital from May 2015 to August 2018. Results: Success: 42/45 patients. Mean operating time 87.5mins (50 - 155 mins), postoperative hospital stay 5-7 days. SILS Port of Covidien was inserted by 2.5 cm skin transverse incision, standard straight laparoscopic instruments were used instead of roticular instruments. Conclusion: This is a mini-invasive technical, safety and cosmetic Keywords: retroperitoneal single incision laparoscopic nephrectomy, single port nephrectomy.

SP3.1.13 Does Single-port laparoscopic appendicectomy provide better outcomes compared to conventional (three-ports) laparoscopic appendicectomy?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ali Yasen Y Mohamedahmed ◽  
Shafquat Zaman ◽  
Stephen Stonelake ◽  
Shahin Hajibandeh
Keyword(s):  
Subgroup Analysis ◽  
Operative Time ◽  
Single Port ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Laparoscopic Appendicectomy ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Randomised Controlled ◽  
Additional Port

Abstract Aims To evaluate comparative outcomes of single port laparoscopic appendicectomy (SPLA) and conventional three-port laparoscopic appendicectomy (CLA) in the management of acute appendicitis. Methods A comprehensive systematic review of randomised controlled trials (RCTs) with subsequent meta-analysis of outcomes were conducted following PRISMA standards. Post-operative pain, cosmesis, need for an additional port(s), operative time, Post-operative complications, length of hospital stay(LOS), readmission, and reoperation were the evaluated outcome parameters. Results Sixteen RCTs reporting a total number of 2017 patients who underwent SPLA(n = 1009) or CLA(n = 1008) were included. SPLA showed higher cosmetic score (Mean Difference (MD) 1.11,P= 0.03) but significantly longer operative time (MD 7.08, P = 0.00001) compared to CLA. However, there was no significant difference between SPLA and CLA group in the postoperative pain score at 12 hours (MD -0.13,P=0.69), need for additional port(s) (Risk Ratio (RR)0.03, P = 0.07), postoperative ileus (RR 0.74,P=0.51), SSI ( RR 1.38, P = 0.28), Post-operative intra-abdominal collection (RR 0.00,P=0.62), LOS ( MD -2.41, P = 0.16), readmission to the hospital ( RR 0.45,P=0.22), and return to theatre (RR -0.00, P = 0.49). Subgroup analysis showed that operative time was comparable in adults only subgroup (P = 0.18) while it was significantly loner in paediatrics only subgroup(P = 0.00001). Moreover, LOS was shorter in adults only subgroup (P = 0.003) and no difference observed in paediatrics only subgroup (P = 0.93). Conclusion SPLA is associated with a slightly longer operative time; however, its efficacy and safety are comparable to CLA. Subgroup analysis showed that SPLA has better outcome in adults than paediatrics. Additionally, SPLA offers better post-operative cosmesis.

scholarly journals Percutaneous Radiofrequency Facet Rhizotomy – Experience with 118 Procedures and Reappraisal of its Value

2000 ◽  
Vol 27 (2) ◽  
pp. 125-130 ◽  
Author(s):  
Wen-Ching Tzaan ◽  
Ronald R. Tasker
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Operating Time ◽  
Spinal Pain ◽  
Outcome Data ◽  
Sensory Loss ◽  
Success Rates ◽  
Preoperative Pain ◽  
Significant Difference ◽  
Facet Denervation

ABSTRACT:Background:There have been many reports of percutaneous radiofrequency facet rhizotomy, perhaps better referred to as facet denervation, usually performed under general anaesthesia, with inconsistent success rates.Objectives:To report the authors' outcome data using both general and local anaesthesia and to reassess the value of this controversial procedure.Methods:Our experience with 118 consecutive percutaneous radiofrequency facet rhizotomies performed on 90 patients in the Toronto Western Hospital was analyzed. Sixty percent of the procedures were performed under general anaesthesia, 40% under local anaesthesia. All patients had been temporarily virtually relieved of pain after local anaesthetic blockade of the subject facets by an independent radiologist.Results:The patients were monitored from 1 - 33 (mean 5.6) months after surgery, with complete elimination or a greater than 50% subjective reduction of pain considered the criteria for success. For the first or only procedure this was 41% overall, 37% in cases done under local anaesthesia, 46% in cases done under general anaesthesia (difference not statistically significant p=0.52). There was no statistically significant difference in success rates for procedures performed in the cervical, thoracic or lumbosacral facets, with unilateral versus bilateral denervations, when two to three as compared with more than three facets were denervated, nor for operations done in patients who had had previous spinal surgery compared with those who had not. Results were not better regardless of whether hyperextension of the spine aggravated the patient's preoperative pain or not, and when the procedures were repeated in the same patient outcomes tended to be consistent, arguing against repetition of failed facet denervations. The morbidity was low, the chief problem being sensory loss and transient neuropathic pain in the distribution of cutaneous branches of posterior rami in the cervical and thoracic areas; mortality was zero.Conclusions:Percutaneous radiofrequency facet denervation is simple and safe, still worth considering in patients with disabling spinal pain that fails to respond to conservative treatment. The use of general anaesthesia shortens the operating time and the patient's discomfort without impairing success rate.

scholarly journals Single-port laparoscopic hysterectomy: preliminary results

2015 ◽  
Vol 61 (5) ◽  
pp. 446-451 ◽  
Author(s):  
Renata Assef Tormena ◽  
Sérgio Conti Ribeiro ◽  
Gustavo Arantes Maciel ◽  
Edmund Chada Baracat
Keyword(s):  
Blood Loss ◽  
Single Port ◽  
Medical Center ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Total Abdominal Hysterectomy ◽  
Uterine Disease ◽  
Access Methods ◽  
Port Access

Summary Objective: to describe the initial results of a laparoscopic single port access hysterectomy and also to evaluate the feasibility and safety of this access. Methods: a prospective study was performed at a tertiary university medical center (Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo) between March 2013 and June 2014. A total of 20 women, referred for hysterectomy due to benign uterine disease, were included in the study after they had signed an informed consent. Outcome measures, including operating time, blood loss, rate of complications, febrile morbidity, visual analogical pain score and length of hospital stay were registered. Results: mean patient age and body mass index (BMI) were 47.8 years and 27.15 kg/m2, respectively. Mean operating time was 165.5 min. Blood loss was minimal, with no blood transfusion. All procedures but one were successfully performed via a single incision and no post-operative complications occurred. We experienced one conversion to multiport laparoscopic hysterectomy due to extensive pelvic adhesions. There was no conversion to “open” total abdominal hysterectomy. None of the patients required narcotics or NSAD post-operatively. Conclusion: single-port hysterectomy is a feasible and safe technique, with no major complications.

scholarly journals Comparison of the methods of fibrinolysis by tube thoracostomy and thoracoscopic decortication in children with stage II and III empyema: a prospective randomized study

2011 ◽  
Vol 3 (4) ◽  
pp. 29 ◽  
Author(s):  
Ufuk Cobanoglu ◽  
Fuat Sayir ◽  
Salim Bilici ◽  
Mehmet Melek
Keyword(s):  
Low Cost ◽  
Treatment Options ◽  
Randomized Study ◽  
Bronchopleural Fistula ◽  
Length Of Hospital Stay ◽  
Pleural Empyema ◽  
Stage Ii ◽  
Success Rates ◽  
Fibrinolytic Agent ◽  
Significant Difference

Today, in spite of the developments in imaging methods and antibiotherapy, childhood pleural empyema is a prominent cause of morbidity and mortality. In recent years, it has been shown that there has been an increase in the frequency of pleural empyema in children, and antibiotic resistance in microorganisms causing pleural empyema has made treatment difficult. Despite the many studies investigating thoracoscopic debridement and fibrinolytic treatment separately in the management of this disease, there is are not enough studies comparing these two treatments. The aim of this study was to prospectively compare the efficacy of two different treatment methods in stage II and III empyema cases and to present a perspective for treatment options. We excluded from the study cases with: i) thoracoscopic intervention and fibrinolytic agent were contraindicated; ii) immunosuppression or additional infection focus; iii) concomitant diseases, those with bronchopleural fistula diagnosed radiologically, and Stage I cases. This gave a total of 54 cases: 23 (42.6%) in stage II, and 31 (57.4%) cases in stage III. These patients were randomized into two groups of 27 cases each for debridement or fibrinolytic agent application by video-assisted thoracoscopic decortication (VATS). The continuity of symptoms after the operation, duration of thoracic tube in situ, and the length of hospital stay in the VATS group were of significantly shorter duration than in the streptokinase applications (P=0.0001). In 19 of 27 cases (70.37%) in which fibrinolytic treatment was applied and in 21 cases of 27 (77.77%) in which VATS was applied, the lung was fully expanded and the procedure was considered successful. There was no significant difference with respect to success rates between the two groups (P=0.533). The complication rate in our cases was 12.96% and no mortality was observed. Similar success rates in thoracoscopic drainage and enzymatic debridement, and the low cost of enzymatic drainage both served to highlight intrapleural streptokinase treatment as a reliable method in reducing the need for surgery in complicated empyema.

Outcome and relative cost of transoral removal of submandibular calculi

2011 ◽  
Vol 125 (4) ◽  
pp. 386-389 ◽  
Author(s):  
S Shashinder ◽  
R P Morton ◽  
Z Ahmad
Keyword(s):  
Operating Time ◽  
Length Of Hospital Stay ◽  
Relative Cost ◽  
Submandibular Duct ◽  
Treatment Techniques ◽  
Significant Difference ◽  
The Mean ◽  
Preservation Rate ◽  
Submandibular Gland Excision

AbstractObjective:To examine the outcomes and treatment cost of transoral removal of submandibular calculi, and to compare the outcomes and costs of other reported techniques.Method:Retrospective review of 60 consecutive patients undergoing transoral removal of submandibular calculi. All clinical, operative, post-operative and follow-up data were collated and outcomes analysed.Results:A total of 61 submandibular glands were treated by the transoral approach. Patients with multiple stones (p = 0.034) and stones in the proximal submandibular duct (p = 0.0028) were at greater risk of requiring submandibular gland excision, compared with patients with single stones and stones in the distal duct, respectively. There was a significant difference between the gland preservation rate during the first versus the second half of the study (p = 0.028). Larger calculi were significantly more likely to be seen in the proximal duct (p < 0.001). The mean operating time (28 minutes) and length of hospital stay for transoral removal of submandibular calculi was much less than those for other treatment techniques.

scholarly journals Transperitoneal Laparoscopic Adrenalectomy: Assessment of the Surgical Learning Curve

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Lukas Meier ◽  
Henryk Zulewski ◽  
Daniel Oertli
Keyword(s):  
Blood Loss ◽  
Learning Curve ◽  
Hospital Stay ◽  
Laparoscopic Adrenalectomy ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Maximum Diameter ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Loss Maximum

Background. We report a single surgeon’s experience of 52 transperitoneal laparoscopic adrenalectomies (LAs) performed between 2001 and 2010. In addition, we compared this series with our first published series of LAs performed between 1994 and 2001. Methods. Our series includes 24 left, 20 right, and 4 bilateral LAs performed in 48 patients. To estimate the learning curve, we chronologically divided the sample of unilateral LAs into two groups of 22 patients and compared the operating time, estimated blood loss, maximum diameter of the lesion, complications, and length of hospital stay. Results. Mean operating time was significantly lower (94 versus 78 min, ) and mean intraoperative blood loss was significantly lower (156 versus 60 mL, ) after more experience had been gained. Additionally, a trend towards removing larger lesions was observed. There was no significant difference in terms of hospital stay. Conclusions. Observing a single surgeon’s experience of nine years in laparoscopic adrenalectomy, this study indicates that it takes approximately 20–25 procedures to flatten the learning curve. Thus, for single centers with a volume of approximately five LAs performed per year, we suggest a selection of a few experienced surgeons to perform LAs in order to improve outcomes.

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