Pleuroskopi Sebagai Tindakan Diagnostik pada Paru

Pleuroscopy, also known as medical thoracoscopy, is a minimally invasive procedure that is used to examine and biopsy the pleural cavity as well as to perform therapeutic interventions. This procedure has a near-perfect diagnostic accuracy in malignant pleural effusions and tuberculosis. With a mortality rate of 0.1%, the complication rate is low (2% - 5%) and usually mild (subcutaneous emphysema, bleeding, infection). Objective : Increase knowledge of pleuroscopy as a diagnostic and therapeutic tool in lung disease. Method : This paper is based on a review of the literature on pleuroscopy. Conclusion : Pleuroscopy is a minimally invasive procedure that can be used to examine and biopsy the pleural cavity, as well as for therapeutic intervention. Complications are uncommon and usually minor. Sugestion : Other articles are required to increase knowledge about pleuroscopy in order to obtain more knowledge.

Combined underwater endoscopic and microscopic surgery for external auditory canal cholesteatoma: A case report

Transcanal endoscopic ear surgery is a minimally invasive procedure that allows a clear visualization of the middle ear. Recently, indications for endoscopic surgery have been expanding. We performed combined underwater endoscopic and microscopic surgery for external auditory canal cholesteatoma, the computer tomography of which indicates the possibility of cholesteatoma not only in the canal wall but also in the mastoid. The 30° endoscope and underwater technique makes the surgical view clear, and we could remove the cholesteatoma without canalplasty. To the best of our knowledge, no case of external auditory canal cholesteatoma treated with underwater endoscopic and microscopic surgery has been previously reported. This case indicates that the procedure could be a good indication for external auditory canal cholesteatoma.

Bilateral Synchronous 3-port Transperitoneal Laparoscopic Ureterolithotomy: A Case Report

Transperitoneal laparoscopic ureterolithotomy is a well-established minimally invasive procedure for management of large impacted ureteric stones since the last 3 decades. We present a case of a 51 years old gentleman, who presented with bilateral large upper ureteric calculi with obstructive uropathy and azotemia, managed successfully with bilateral synchronous 3-port transperitoneal laparoscopic ureterolithotomy, and to our knowledge is the first such case to be reported in literature.

Laparoscopic repair of retro-caval ureter: report of two cases

Retrocaval ureter is a rare congenital disorder and surgery is necessary when the patient is symptomatic or having significant functional obstructions. The two cases referred to our center with severe hydronephrosis on their right sides. In both cases further evaluation with CT scan showed the diagnosis of retrocaval ureter. The retrocaval segment of the both ureters were isolated and after the excision of the narrow segments, end to end anastomosis have been done with transperitoneal laparoscopic technique. The laparoscopic ureteroureterostomy is a safe, effective and minimally invasive procedure and should be considered as a standard treatment for retrocaval ureter.

Hydro-dissection of Dorsal Scapular Nerve for Neuropathy Post Radical Neck Dissection and Radiation: A Case Report

Neuropathy of dorsal scapular nerve (DSN) following neck dissections or radiotherapy has not been reported so far nor has its treatment in the form of hydro-dissection. Hydro-dissection of nerve under ultrasound guidance has been receiving more attention in the recent past and it is a minimally invasive procedure. We report here a case of neuropathy of DSN following radiotherapy in a patient for whom we could at least provide pain relief as a palliative measure during his past 6 months of life.

Evaluation of the efficacy of homologous autoinoculation therapy in treatment of multiple recalcitrant warts

Background Warts are infections caused by human papillomavirus (HPV). There are new trends towards the use of immunotherapy in treatment of warts. Homologous autoinoculation is a minimally invasive procedure, which treats warts by stimulating a specific immune response against HPV Objective To evaluate the efficacy of autoinoculation therapy in treatment of multiple recalcitrant warts. Methods Under local anesthesia and aseptic condition, inoculum was collected by paring a wart by scalpel and by pressing it between two sterile glass slides. After making a subcutaneous Pocket in non-dominant forearm, the inoculum was introduced in the subcutaneous pocket with forceps and dressed. Follow up for 1,2,12 and 16 weeks was done. Results Fourty patients were included. At 12 weeks of therapy 42.5% showed complete clearance, 27.5% showed moderate clearance, 15% showed mild clearance and 12.5% showed treatment failure. No significant complication was documented after 1 and 2 weeks of follow up except in 3 patients in form of mild inflammation and mild pain. There was no recurrence at16 weeks follow up session. Conclusion Autoinoculation is simple and effective method in treatment of different types of warts including genital wart. It also prevents recurrence.

A study of intradermotherapy with needles in facial rejuvenation

Background: Intradermotherapy is considered a minimally invasive procedure, which works through applications of diluted pharmacological drugs, resulting in facial rejuvenation. Methods: 18 women were divided equally into two groups and evaluated before and after treatment (at 45 and 90 days). Four applications were made to the facial region at 15-day intervals; for group 1, traditional injections were given to introduce the anti-ageing substance, and, for group 2, a placebo intervention (0.9% saline application) was given. Results: In the analysis of the group 1 photos, greater filling of the nasogenian groove was observed after two sessions, and the presence of less deep wrinkles in the perioral area was also observed after four treatment sessions. Subjects in both groups complained of pain during the application, even with the use of anaesthetic. Most of the volunteers in group 1 said that the texture of the skin seemed much firmer and classified the therapy as an ‘excellent treatment’. Conclusion: Intradermotherapy shows favourable results in the treatment of facial rejuvenation in women, which is more evident 90 days after the initial application.

Accuracy of intraoperative neuromonitoring during percutaneous cement discoplasty

Introduction: Percutaneous cement discoplasty is a minimally invasive procedure to treat low back pain due to advanced degenerative disc disease in elderly patients. Complications of this procedure has been described such as infection, vertebral fracture, cement leakage and nerve injury. Intraoperative neuromonitoring is used to detect the latter. The objective of this study was to assess the usefulness of neuromonitoring during discoplasty to detect new neurological compromise. Methods: 100 consecutive patients were included in this retrospective study, (30 males and 70 females, mean age of 76.3 ± 5.71 years) with mechanical low back pain who underwent percutaneous cement discoplasty. Results: Sensitivity to detect neurological injury was 82% (CI 95% 66-98), specificity was of 99% (CI 95%98-100) with a positive predictive value of 0.95 (CI 95% 85-100) and a negative predictive value of 0.97 (CI 95% 95-99). In 5 patients neurological compromise was not detected by neuromonitoring. Discussion: Our study showed high sensitivity and specificity of neuromonitoring to detect neurological irritation during percutaneous discoplasty. Intraoperative neuromonitoring resulted an effective assistance during this minimally invasive procedure.

Five-Level Unilateral Laminectomy Bilateral Decompression (ULBD) by Two-Stage Unilateral Biportal Endoscopy (UBE)

Background Unilateral biportal endoscopy (UBE) is a relatively new yet common minimally invasive procedure in spine surgery, capable of achieving adequate decompression for lumbar spinal stenosis through unilateral laminectomy bilateral decompression (ULBD). Neither additional fusion nor rigid fixation is required, as UBE-ULBD rarely causes iatrogenic lumbar instability. However, to our knowledge, five-level ULBD via two-stage UBE without lumbar fusion has been yet to be reported in the treatment of multilevel lumbar spinal stenosis.Case description We present a case of an 80-year-old female patient who developed progressive paralysis of the lower extremities. Radiographic examinations showed multilevel degenerative lumbar spinal stenosis and extensive compression of the dural sac and nerve roots from L1-2 to L5-S1. The patient underwent five-level ULBD through two-stage UBE without lumbar fusion or fixation. One week after the final procedure, the patient could ambulate with walking aids and braces. Moreover, no back pain or limited lumbar motion was observed at the 6-month follow-up.Conclusions Multilevel ULBD through UBE may provide elderly patients with an alternative, minimally invasive procedure for treating spinal stenosis. This procedure could be achieved by staging surgeries. In this case, we reported complaints of little back pain, despite not needing to perform lumbar fusion or fixation.