Minimal access and open surgery

1997 ◽  
Vol 11 (11) ◽  
pp. 1063-1064 ◽  
Author(s):  
K.A. Forde
Keyword(s):  
Open Surgery ◽  
Minimal Access

scholarly journals Minimal-access colorectal surgery is associated with fewer adhesion-related admissions than open surgery

2012 ◽  
Vol 100 (1) ◽  
pp. 152-159 ◽  
Author(s):  
E. M. Burns ◽  
A. Currie ◽  
A. Bottle ◽  
P. Aylin ◽  
A. Darzi ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Open Surgery ◽  
Minimal Access

scholarly journals Interim safety analysis of the first-in-human clinical trial of the Versius surgical system, a new robot-assisted device for use in minimal access surgery

2020 ◽  
Author(s):  
Dhananjay Kelkar ◽  
Mahindra A. Borse ◽  
Girish P. Godbole ◽  
Utkrant Kurlekar ◽  
Mark Slack
Keyword(s):  
Clinical Trial ◽  
Surgical Procedures ◽  
Open Surgery ◽  
Safety Analysis ◽  
Minimal Access Surgery ◽  
Minimal Access ◽  
Robot Assisted ◽  
Post Surgery ◽  
Access Surgery ◽  
Surgical System

Abstract Objective The aim of this study was to provide an interim safety analysis of the first 30 surgical procedures performed using the Versius Surgical System. Background Robot-assisted laparoscopy has been developed to overcome some of the important limitations of conventional laparoscopy. The new system is currently undergoing a first-in-human prospective clinical trial to confirm the safety and effectiveness of the device when performing minimal access surgery (MAS). Methods Procedures were performed using Versius by a lead surgeon supported by an operating room (OR) team. Male or female patients aged between 18 and 65 years old and requiring elective minor or intermediate gynaecological or general surgical procedures were enrolled. The primary endpoint was the rate of unplanned conversion of procedures to other MAS or open surgery. Results The procedures included nine cholecystectomies, six robot-assisted total laparoscopic hysterectomies, four appendectomies, five diagnostic laparoscopy cases, two oophorectomies, two fallopian tube recanalisation procedures, an ovarian cystectomy and a salpingo-oophorectomy procedure. All procedures were completed successfully without the need for conversion to MAS or open surgery. No patient returned to the OR within 24 h of surgery and readmittance rate at 30 and 90 days post-surgery was 1/30 (3.3%) and 2/30 (6.7%), respectively. Conclusions This first-in-human interim safety analysis demonstrates that the Versius Surgical System is safe and can be used to successfully perform minor or intermediate gynaecological and general surgery procedures. The cases presented here provide evidence that the Versius clinical trial can continue to extend recruitment and begin to include major procedures, in alignment with the IDEAL-D Framework Stage 2b: Exploration.

scholarly journals Surgery in the Treatment of Acute Pancreatitis Minimal Access Pancreatic Necrosectomy

2005 ◽  
Vol 94 (2) ◽  
pp. 135-142 ◽  
Author(s):  
S. Connor ◽  
M. G. T. Raraty ◽  
N. Howes ◽  
J. Evans ◽  
P. Ghaneh ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Mortality Rate ◽  
Open Surgery ◽  
Pancreatic Necrosis ◽  
Statistical Significance ◽  
Infected Pancreatic Necrosis ◽  
Current Evidence ◽  
Minimal Access ◽  
Randomised Controlled ◽  
Invasive Techniques

Between 5% and 10% of patients with acute pancreatitis will develop infected pancreatic necrosis. Traditional open surgery for this condition carries a mortality rate of up to 50%, and therefore a number of less invasive techniques have been developed, including radiological drainage and a minimal access retroperitoneal approach. No randomised controlled trials have been published which compare these techniques. Indications for minimal access surgery are the same as for open surgery, i.e. infected pancreatic necrosis or failure to improve with extensive sterile necrosis. Access is obtained to the pancreatic necrosis via the left loin and necrosectomy performed using an operating nephroscope, and this often requires several procedures to remove all necrotic tissue. The cavity is continuously irrigated on the ward in between procedures. The results of this approach are encouraging, with less systemic upset to the patient, a lower incidence of post-operative organ failure when compared with open surgery, and a reduced requirement for ITU support. There is also a trend towards a lower mortality rate, although this does not reach statistical significance on the data published so far. Current evidence suggests that a minimal access approach to pancreatic necrosis is feasible, well tolerated and beneficial for the patient when compared with open surgery.

MINIMAL ACCESS NERVE SURGERY AND INTERVENTIONAL MAGNETIC RESONANCE IMAGING

Neurosurgery ◽  
2009 ◽  
Vol 65 (suppl_4) ◽  
pp. A212-A221 ◽  
Author(s):  
Aaron Filler
Keyword(s):  
Magnetic Resonance Imaging ◽  
Operating Room ◽  
Cycle Time ◽  
Open Surgery ◽  
Minimal Access ◽  
Resonance Imaging ◽  
Surgical Time ◽  
Percutaneous Procedures ◽  
Standard Operating ◽  
Open Configuration

Abstract OBJECTIVE Develop and assess the utility of novel minimal access techniques including percutaneous open-configuration interventional magnetic resonance imaging (iMRI), open surgery using open or closed/cylindrical iMRI systems, and minimal access open surgery with electromyographic guidance in a standard operating room. METHODS For more than 2500 percutaneous open iMRI procedures, 25 incisional surgery open iMRI cases, 3 incisional surgery closed/cylindrical iMRI cases, 25 computed tomography–guided percutaneous procedures, and more than 1000 minimal access incisional surgery cases in the standard operating room with electromyographic guidance, cycle time for intraoperative data collection and numbers of guidance events per case were assessed. RESULTS Cycle time varied greatly. The minimum was for open surgery in the standard operating room with direct nerve stimulation for electromyography, requiring 10 to 15 seconds, which was applicable for dozens of assessments during the surgery and had negligible effects on total surgical time. Percutaneous procedures in the open iMRI environment allowed for 20 or 30 imaging events during a procedure, with cycle times of between 10 and 20 seconds. Incisional surgery in the open iMRI system had a cycle time of about 1 to 5 minutes for “in-magnet” procedures and about 5 to 10 minutes for “magnet-adjacent” procedures. Incisional surgery in closed/cylindrical iMRI procedures had a cycle time of 45 to 60 minutes, and the technique proved awkward to use more than once or twice per surgical case. CONCLUSION Percutaneous open-configuration iMRI provides clear benefits over computed tomography or ultrasound. Minimal access surgery and incisional open-configuration iMRI are useful and effective in some situations. Closed/cylindrical iMRI systems pose challenges for patient safety, add greatly to surgical time, and provide limited useful intraoperative benefits.

scholarly journals Minimal Invasive Anterior Decompression in Tuberculosis of Thoracolumbar Junction of the Spine – Experience With SynFrame

2009 ◽  
Vol 48 (175) ◽  
Author(s):  
Navin Kumar Karn ◽  
B S Rao ◽  
M M Prabhakar
Keyword(s):  
Open Surgery ◽  
Operating Time ◽  
Minimal Invasive ◽  
Thoracolumbar Junction ◽  
Minimal Access ◽  
Anterior Decompression ◽  
Open Procedure ◽  
The Mean ◽  
Minimal Invasive Spine Surgery

Introduction: This study assesses the role of new retractor system SynFrame for anteriordecompression of tuberculosis of thoracolumbar junction of the spine.Methods: This study includes fi ve consecutive patients with tuberculosis of thoracolumbar junctiontreated with minimal invasive anterior decompression using a new table mounted retractor systemSynFrame (Stratec Medical, Switzerland). The thoracolumbar junction was approached by a left sidedthoracotomy. Short construct pedicle screw stabilization was done in all cases before decompression.The anterior column was reconstructed using expandable cage (n=3) and autologous tricortical graft(n=2).Results: The mean operating time was 100 minutes (range 90-120). Mean overall blood loss was 400ml. No operation had to change into an open procedure. There were neither intra nor postoperativecomplications related to minimal access in particular, nor visceral/vascular complications.Conclusions: The ring retractor system allows minimal open surgery to the spine by carryingdifferent devices as well as endoscope, providing an excellent visualization of the operating fi eld,and is safe and easy to use. The only disadvantage is its high cost.Key Words: anterior decompression, minimal invasive spine surgery, SynFrame

Minimally invasive repair of acquired benign thoracic tracheoesophageal fistula

2019 ◽  
Vol 91 (3) ◽  
pp. 1-4
Author(s):  
Jayant Banerjee ◽  
Ramanathan Saranga Bharathi
Keyword(s):  
Minimally Invasive ◽  
Open Surgery ◽  
Tracheoesophageal Fistula ◽  
Minimal Access ◽  
Esophageal Fistula ◽  
Upper Thoracic

Background: Repair of large, upper thoracic, cuff induced, trachea-esophageal fistula (TEF) is technically demanding and is conventionally performed by open surgery. Minimal access approach is, hitherto, unreported. Technique & Case: Minimally invasive repair of TEF involving fistula isolation- by thoracoscopic oesophageal exclusion, and simultaneous establishment of alimentary continuity- by laparoscopy assisted sub-sternal colonic transposition, is described. The technique was successfully employed in repairing a large (4.5 centimetres), cuff induced, upper thoracic TEF, in a 25 years old lady. The rationale behind the technique, its pros & cons are analysed and contrasted against conventional techniques of TEF repair. Conclusion: Large upper thoracic, cuff induced TEF can be successfully repaired employing minimal access.

scholarly journals Mast (Minimal Access Spinal Technologies) Versus Open Surgery: Cost Analysis From Hospital Perspective

2014 ◽  
Vol 17 (7) ◽  
pp. A375-A376
Author(s):  
V. Lukyanov ◽  
D. Melik-Gusseinov ◽  
B. Borgman ◽  
D. Demourenko ◽  
S. Mlyavykh
Keyword(s):  
Cost Analysis ◽  
Open Surgery ◽  
Minimal Access ◽  
Hospital Perspective
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