Natural Orifice Transluminal Endoscopic Surgery-Assisted Laparoscopic Transvesical Bladder Diverticulectomy: Feasibility Study, Points of Technique, and Case Series with Medium-Term Follow-Up

2016 ◽  
Vol 30 (5) ◽  
pp. 526-531 ◽  
Author(s):  
Ahmed Magdy ◽  
Martin Drerup ◽  
Sophina Bauer ◽  
Daniela Colleselli ◽  
Stephan Hruby ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Endoscopic Surgery ◽  
Case Series ◽  
Natural Orifice ◽  
Medium Term ◽  
Bladder Diverticulectomy

scholarly journals Repeat Vaginal Natural Orifice Transluminal Endoscopic Surgery: A First Feasibility Study

2021 ◽  
pp. 1-6
Author(s):  
Katrien Nulens ◽  
Ilse Van Genechten ◽  
Jan Baekelandt
Keyword(s):  
Peritoneal Cavity ◽  
Endoscopic Surgery ◽  
Large Scale ◽  
Case Series ◽  
Small Sample ◽  
Invasive Technique ◽  
Natural Orifice ◽  
Adnexal Surgery

<b><i>Objectives:</i></b> Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is an emerging minimally invasive technique in benign gynaecologic surgery whereby surgical access to the peritoneal cavity is achieved through natural orifices, namely through a vaginal colpotomy. Experience in repeat vNOTES cases is limited and so far, repeat vNOTES cases have not been described in the literature. The purpose of this study was to demonstrate the feasibility of vNOTES hysterectomy in women with a history of previous vNOTES adnexal surgery. <b><i>Design:</i></b> We performed a retrospective cohort study of the first 11 repeat vNOTES cases in our centre. All vNOTES procedures, primary adnexal surgery as well as repeat vNOTES hysterectomy, were performed by one surgeon (J.B.). <b><i>Materials, Setting, Methods:</i></b> Between March 2016 and May 2020, 11 patients underwent a vNOTES hysterectomy after prior vNOTES adnexectomy or cystectomy in Imelda Hospital, Bonheiden, Belgium. Relevant patient characteristics and outcome data were collected after written informed consent. <b><i>Results:</i></b> Median age was 49 years (range 44–65) at the moment of the first vNOTES procedure. Two patients had one or more caesarean sections in history, and 2 women were nulliparous. Median interval between primary and repeat vNOTES procedure was 15 months (range 0.8–37 months). All patients underwent a vaginally assisted NOTES hysterectomy (VANH) as repeat vNOTES procedure. Performing a colpotomy and entering the peritoneal cavity after prior vNOTES was technically feasible in all cases. All VANHs were successfully performed. There were 3 minor complications after repeat vNOTES, of which one was anaesthesia-related. The 2 complications associated with the surgical procedure were both cystitis. In one of these 2 patients, there were high post-void residues, which were easily managed by bladder training. There were no conversions to laparoscopy or laparotomy, neither serious nor life-threatening complications. No ureteric, bladder, or intestinal injuries have occurred. <b><i>Limitations:</i></b> The retrospective design and small sample size are the main limitations of this study. Moreover, the follow-up period of the most recently operated patients was too short to draw conclusions on long-term outcomes, including sexual function. <b><i>Conclusions:</i></b> In all patients in this case series, vNOTES hysterectomy after prior vNOTES adnexal surgery was successfully performed. Large-scale prospective trials with long-term follow-up are needed to evaluate the safety and feasibility of multiple consecutive vNOTES procedures in 1 patient.

scholarly journals Surgical outcome of isolated congenital supravalvular pulmonary stenosis: a case series

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Vikas Kumar ◽  
Sachin Mahajan ◽  
Vivek Jaswal ◽  
Shyam Kumar Singh Thingnam
Keyword(s):  
Pulmonary Stenosis ◽  
Main Pulmonary Artery ◽  
Tertiary Care ◽  
Case Series ◽  
Surgical Correction ◽  
Medium Term ◽  
Constriction Band ◽  
Supravalvular Stenosis ◽  
Mid Term Results

Abstract Background Supravalvular stenosis of main pulmonary artery is a rare anomaly characterized by the presence of constriction band just above the pulmonary valve. It is mostly acquired after intervention on the pulmonary trunk or less commonly is congenital in origin associated with complex congenital cardiac malformations and very rarely can present as an isolated native congenital supravalvular pulmonary stenosis (SPS). Case summary We present a series of four cases of isolated congenital SPS who underwent surgical correction at our tertiary care institute over 8 years. Mean age of the patients was 2.25 ± 0.96 years with all of them being males. Mean peak systolic gradient across the stenosis was 82 ± 21.48 mmHg ranging from 60 mmHg to 110 mmHg. There was no early and medium-term mortality with 100% survival at mean follow-up of 31 months (range 7–85 months). Discussion Surgical correction of congenital SPS carries excellent early and mid-term results with almost no mortality and very low risk of re-intervention for restenosis.

Oncologic outcomes for node-positive patients undergoing robotic radical cystectomy.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 290-290
Author(s):  
C. Mmeje ◽  
R. Nunez-Nateras ◽  
R. Pruthi ◽  
M. E. Nielsen ◽  
E. Wallen ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Case Series ◽  
Oncologic Outcomes ◽  
Perioperative Outcomes ◽  
High Risk Population ◽  
Medium Term ◽  
Node Positive ◽  
Time To Recurrence ◽  
Open Radical Cystectomy

290 Background: Previous studies have shown robot assisted radical cystectomy (RARC) to have equivalent perioperative outcomes to open radical cystectomy. There are few reports that have examined the oncologic results of RARC specifically with respect to node-positive patients. We report the outcomes of node-positive patients who have undergone RARC with medium-term (at least 1 year) follow-up. Methods: A total of 275 patients underwent RARC at two institutions for invasive bladder cancer between 2005-present. We examined the 50 patients with node-positive disease that had a minimum of one year follow-up. Oncologic outcomes, recurrence free survival (RFS), and disease specific survival (DSS) were analyzed and compared to the open literature. Results: Mean clinical follow up in this case series was 29 months (range 12–64 months). The mean number of lymph nodes removed was 18 (range 5–35), and mean number of positive LNs was 3.1 (range 1–12). Overall rate of LN positivity was 26%. Mean LN density was 18%. Seventeen (34%) patients had ≤ pT2 disease and 33 (66%) pT3/T4 disease. At this follow-up, 29 patients have recurred, 21 patients died of disease, giving a RFS and DSS of 42% and 58%, respectively. Mean (median) time to recurrence was 10.2 months (9 months). A total of 60% of patients received peri-operative chemotherapy in this cohort. These findings are consistent with prior reports of such oncologic outcomes in node-positive patients in open series. Conclusions: The oncologic follow-up of patients undergoing RARC with LN positive disease appears to have acceptable outcomes during medium term (mean 29 months) follow-up. As our follow-up increases, we expect to continue to accurately define the long-term clinical suitability and oncologic success of this procedure in this high-risk population. No significant financial relationships to disclose.

scholarly journals The Effectiveness of Prolotherapy for Recalcitrant Medial Tibial Stress Syndrome: a Prospective Consecutive Case Series.

2021 ◽  
Author(s):  
Nat Padhiar ◽  
Mark Curtin ◽  
Osama Aweid ◽  
Bashaar Awied ◽  
Dylan Morrissey ◽  
...  
Keyword(s):  
Case Series ◽  
Lower Leg ◽  
Consecutive Case ◽  
Ultrasound Guided ◽  
Medium Term ◽  
Leg Injuries ◽  
Long Term Follow Up ◽  
Return To Activity

Abstract Background: Medial tibial stress syndrome (MTSS) is one of the most common lower leg injuries in sporting populations. It accounts for between 6%-16% of all running injuries, and up to 53% of lower leg injuries in military recruits. Various treatment modalities are available with varying degrees of success. In recalcitrant cases, surgery is often the only option.Objective: To evaluate whether ultrasound-guided injection of 15% dextrose for treatment of recalcitrant MTSS decreases pain and facilitates a return to desired activity levels for those who may otherwise be considering surgery or giving up the sport.Method: The study design was a prospective consecutive case series involving eighteen patients: fifteen male and three female; (mean age=31.2 years) with recalcitrant MTSS. They were referred from sports injury clinics across the UK, having failed all available conservative treatment.Intervention: An ultrasound-guided sub-periosteal injection of 15% dextrose was administered by the same clinician (NP) along the length of the symptomatic area. Typically, 1 mL of solution was injected per cm of the symptomatic area. Main Outcome Measures: Pain was assessed using a 10-cm visual analog scale (VAS) at baseline, short-term, medium-term (mean 18 weeks), and long-term (mean 52 weeks) follow-up. Symptom resolution and return to activity were measured using a Likert scale at medium and long-term follow-up. Statistical analyses were performed using SPSS for Mac version 19.0.0 (IBM, New York, NY, US). The Shapiro-Wilk test was used to evaluate the normality of the distribution of data. Friedman's non-parametric test was used to compare the within-patient treatment response over time. Post-hoc Wilcoxon signed-rank tests with Bonferroni corrections were performed to determine VAS average pain response to treatment over five paired periods.Results: Patients reported a significant (p<0.01) reduction in median VAS pain score at medium and long-term follow-up compared to baseline. Median improvement per patient was 4.5/10. Patients rated their condition as 'much improved' at medium-term follow-up and the median return to sports score was 'returned to desired but not pre-injury level' at medium-term and long-term follow-up. No adverse events were reported.Conclusions: Ultrasound-guided 15% dextrose prolotherapy injection has a significant medium-term effect on pain in MTSS. This benefit may be maintained long-term; however, more robust trials are required to validate these findings in the absence of controls.Clinical Relevance: Clinicians should consider the use of ultrasound-guided injection of 15% dextrose as a viable treatment option to reduce pain and aid return to activity for patients with recalcitrant MTSS.

Transureteral Natural Orifice Translumenal Endoscopic Surgery Nephrectomy: A Feasibility Study in the Porcine Model

Videourology ◽  
2011 ◽  
Vol 25 (3) ◽  
Author(s):  
D. Duane Baldwin ◽  
Gene Huang ◽  
Christopher Tenggardjaja ◽  
Gideon Richards ◽  
Ryan Bowman ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Endoscopic Surgery ◽  
Porcine Model ◽  
Natural Orifice

Oophorectomy by natural orifice transluminal endoscopic surgery: feasibility study in dogs

2009 ◽  
Vol 69 (7) ◽  
pp. 1321-1332 ◽  
Author(s):  
Lynetta J. Freeman ◽  
Emad Y. Rahmani ◽  
Stuart Sherman ◽  
Michael V. Chiorean ◽  
Don J. Selzer ◽  
...  
Keyword(s):  
Feasibility Study ◽  
Endoscopic Surgery ◽  
Natural Orifice
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