Minimal invasive procedures in pancreatic surgery – Are they a good option for cystic neoplasms?

Pancreatology ◽  
2012 ◽  
Vol 12 (6) ◽  
pp. 564
Author(s):  
M. Nowak-Niezgoda ◽  
M. Durlik
Keyword(s):  
Pancreatic Surgery ◽  
Minimal Invasive ◽  
Good Option ◽  
Invasive Procedures ◽  
Cystic Neoplasms

Transgastric gastro-jejunal anastomosis with flexible endoscope on a biosynthetic model

2007 ◽  
Vol 148 (4) ◽  
pp. 161-164 ◽  
Author(s):  
Péter Lukovich ◽  
Balázs Kádár ◽  
Attila Jónás ◽  
Mehdi Sadatakhavi ◽  
Gábor Váradi ◽  
...  
Keyword(s):  
Porcine Model ◽  
Single Channel ◽  
Rapid Development ◽  
Abdominal Cavity ◽  
Gastric Wall ◽  
Minimal Invasive ◽  
Invasive Procedures ◽  
Plastic Frame ◽  
Human Use ◽  
Needle Knife

Introduction: In the last few years the rapid development of flexible endoscopies has opened new possibilities in minimal invasive procedures. With the help of these techniques the exposure, the risk of complications and the healing period of the patient might be reduced. One of these procedures is the transgastric intervention. Through an incision on the wall of the stomach, the endoscope could be led into the abdominal cavity, where several interventions can be performed. The aim of the study was to examine the technical feasibility and the success of the formation of gastro-jejunal anastomosis. Meanwhile the difficulties of the method could be explored in order to introduce this method in human use. Method: A lifelike biosynthetic model was made from a slaughtered domestic pig’s gastrointestinal tract (stomach and the first few jejunum loops) which was fixed onto a plastic frame. Two single-channel gastroscopes were inserted into the stomach. On the wall of the stomach an approximately 2 centimetres wide incision was made by the electrocoagulator with a needle-knife. Through it the first jejunum loop was grasped by a foreign-body forceps and then was retracted into the stomach. Subsequently the jejunum loop was held safely with the first endoscope. Parallel to it an incision was made on the jejunum by the electrocoagulator. The authors managed to securely unite the open edges of the gastric wall and the jejunum with endoclips. Result: The model was good for practising. The anastomosis is technically feasible and was successfully made on biosynthetic porcine model using the transgastric route. Although the incisions both on the gastric wall and on the jejunum loop were made easily, the fixing of the anastomosis might be questionable. Conclusion: It was revealed that more experiments and the development of new, special instruments are needed in order to conduct the anastomosis safely.

scholarly journals Minimal invasive procedures for the treatment of genitourinary syndrome of menopause (GSM). Un update

2020 ◽  
Vol 19 (1) ◽  
pp. 35-44
Author(s):  
Dimitrios Zacharakis ◽  
Eleni Pitsouni ◽  
Themos Grigoriadis ◽  
Christos Kalantzis ◽  
Dimitrios Loutradis ◽  
...  
Keyword(s):  
High Intensity ◽  
Electromagnetic Waves ◽  
Platelet Rich Plasma ◽  
Vaginal Wall ◽  
Minimal Invasive ◽  
Long Term Results ◽  
Invasive Procedures ◽  
Genitourinary Syndrome Of Menopause ◽  
Age Related ◽  
Genitourinary Syndrome

Genitourinary syndrome of menopause (GSM) is a new term for a condition more renowned as atrophic vaginitis. It is used to describe a variety of menopausal symptoms and signs that are related to the physical changes of the vulva, vagina and lower urinary tract. The etiology of GSM is secondary to decreased levels of endogenous estrogens and represents a common but underreported condition. In this update we present novel minimal invasive procedures that may benefit GSM symptoms making particular focus on platelet-rich plasma (PRP) treatment, hyaluronic acid (HA) treatment and energy-based devices (CO2 laser, YAG laser, radiofrequency device and high intensity focused ultrasounds). Currently, PRP has becoming popular as a non-operative treatment option for GSM symptoms. The principle underlying PRP treatment has to do with its ability to reproduce natural mechanisms of cell regeneration through the sequential secretion of numerous growth factors. Moreover, HA has been widely used as an important ingredient in topical hydrating and lubricating gels or injected for conditions such as dyspareunia. Lately, it has also been used as a new tool to treat age-related fat lysis of the female genitalia and especially the labia majora. Τhe Energy based devices have been recently suggested for the management of GSM. They utilize technologies such as laser, electromagnetic waves and high intensity focused ultrasounds to focus energy in the vaginal wall heating the targeted tissue at various depths without causing any pain or needing a recovery time. These minimal invasive procedures appear to be promising options for the treatment of GSM symptoms. However, further studies are necessary to evaluate more thoroughly the effectiveness and safety of these procedure and assess medium and long term results.

scholarly journals P050 INTRODUCTION OF MINIMAL INVASIVE PROCEDURES WITH EXTRAPERITONEAL MESH PLACEMENT MAY REDUCE MORBIDITY AND LENGTH OF HOSPITAL STAY IN PATIENTS WITH INCISIONAL HERNIA - A SINGLE CENTER'S EXPERIENCE

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Lena Kundel ◽  
Christian Gröger ◽  
Ulrich Adam ◽  
Hartwig Riediger
Keyword(s):  
Incisional Hernia ◽  
Hospital Stay ◽  
Open Surgery ◽  
Length Of Hospital Stay ◽  
Minimal Invasive ◽  
Wound Complications ◽  
Invasive Procedures ◽  
Hernia Surgery ◽  
Mesh Placement ◽  
Duration Of Surgery

Abstract Aim “Sublay mesh placement is the gold standard in the treatment of incisional hernias. In open surgery, high rates of wound complications are reported. Various minimal invasive procedures with extraperitoneal mesh placement (MIPEX) are currently under evaluation in order to improve the clinical results. We report our experience with an increased use of MIPEX techniques” Material and Methods “The perioperative results of all consecutive patients from 1/2018 to 4/2021with incisional hernia surgery were reviewed. For the purpose of this study, the results of patients with MIPEX were compared to STANDARD treatment (open surgery and/or intraperitoneal mesh). All patient data were registered prospectively in the Herniamed database. ” Results “103 out of 170 patients were treated with MIPEX and 67 with STANDARD. MIPEX were MILOS/E-MILOS (n = 48), TAPP (n = 15), laparoscopic sublay (n = 5), ETEP (n = 17) and other (n = 18) with additional TAR in (n = 16). Five procedures were performed robotically. Mean duration of surgery (DOS) was 150 minutes in MIPEX and 116 minutes in STANDARD (n.s.). Morbidity was 7% in MIPEX and 19% in Standard (p < 0.5). Mean length of hospital stay (LHS) was 4 days in MIPEX and 8 days in STANDARD (p < 0.5). In subgroup analysis of patients with large hernias (EHS-3, n = 31), DOS was 320 minutes (MIPEX) vs. 159 minutes (STANDARD); p < 0.01 and LHS was 8 days (MIPEX) vs. 12 days (STANDARD), p < 0.01.” Conclusions “MIPEX included a broad spectrum of procedures. With the implementation of MIPEX, DOS increased significantly in large hernias. Morbidity and LHS were significantly reduced in all patients.”

scholarly journals Robot-assisted pancreatic surgery—optimized operating procedures: set-up, port placement, surgical steps

2021 ◽  
Author(s):  
Matthäus Felsenstein ◽  
Karl H. Hillebrandt ◽  
Lea Timmermann ◽  
Mathilde Feist ◽  
Christian Benzing ◽  
...  
Keyword(s):  
Pancreatic Surgery ◽  
High Volume ◽  
Minimal Invasive ◽  
Learning Curves ◽  
High Morbidity ◽  
Port Placement ◽  
Robotic Assisted ◽  
Post Marketing ◽  
Set Up ◽  
The One

AbstractEven in most complex surgical settings, recent advances in minimal-invasive technologies have made the application of robotic-assisted devices more viable. Due to ever increasing experience and expertise, many large international centers now offer robotic-assisted pancreatic surgery as a preferred alternative. In general however, pancreatic operations are still associated with high morbidity and mortality, while robotic-assisted techniques still require significant learning curves. As a prospective post-marketing trial, we have established optimized operating procedures at our clinic. This manuscript intends to publicize our standardized methodology, including pre-operative preparation, surgical set-up as well as the surgeons’ step-by-step actions when using pancreatic-assisted robotic surgery. This manuscript is based on our institutional experience as a high-volume pancreas operating center. We introduce novel concepts that should standardize, facilitate and economize the surgical steps in all types of robotic-assisted pancreatic surgery. The “One Fits All” principle enables single port placement irrespective of the pancreatic procedure, while the “Reversed 6-to-6 Approach” offers an optimized manual for pancreatic surgeons using the robotic console. Novel and standardized surgical concepts could guide new centers to establish a robust, efficient and safe robotic-assisted pancreatic surgery program.

scholarly journals Parenchymal Sparing Resection: Options in Duodenal and Pancreatic Surgery

2021 ◽  
Vol 10 (7) ◽  
pp. 1479
Author(s):  
Ugo Marchese ◽  
Stylianos Tzedakis ◽  
Einas Abou Ali ◽  
Olivier Turrini ◽  
Jean-Robert Delpero ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Mortality ◽  
Pancreatic Resection ◽  
Pancreatic Surgery ◽  
Good Option ◽  
Tips And Tricks ◽  
Review Of Literature ◽  
Early Postoperative Complications

Parenchymal sparing duodenal and pancreatic resection are safe procedures in selected patients with the aim to reduce endocrine and exocrine long-term dysfunction. When the tumor is benign or borderline malignant, this appears to be a good option for the surgeon, associated with low rates of severe surgery-related early postoperative complications and low in-hospital mortality. This mini review offers comments, tips and tricks, and a review of literature concerning those different options with specific illustrations in order to clarify their indication.

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