scholarly journals Surgery Averted Using a Novel, Minimally Invasive Approach to Treat Very Severe Radial Artery Spasm

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Anthony A. Cochet ◽  
Daniel A. Bellin
Keyword(s):  
Minimally Invasive ◽  
Radial Artery ◽  
Conscious Sedation ◽  
Surgical Intervention ◽  
Axillary Nerve ◽  
Invasive Technique ◽  
Invasive Approach ◽  
St Elevation ◽  
The Right ◽  
Axillary Nerve Block

A 42-year-old male admitted with a non-ST elevation myocardial infarction was referred for invasive angiographic assessment. Based on preprocedural assessment, the right radial artery approach was selected. Despite possessing none of the consensus risk factors for radial artery spasm, in addition to receiving standard arterial spasm prophylaxis and conscious sedation, the patient suffered very severe radial artery spasm with initial catheter placement, resulting in entrapment of a 5 Fr pigtail catheter within the left ventricle. After exhausting traditional methods for resolution of radial artery spasm, surgical intervention appeared to be the only remaining option for removal of the entrapped catheter. Prior to committing to surgery, use of an axillary nerve block to hinder sympathetic vascular tone was suggested and attempted. This intervention resulted in atraumatic catheter removal. We present a case of very severe radial artery spasm refractory to customary interventions, alleviated with a novel, minimally invasive technique, which spared surgical intervention.

A Minimally Invasive Approach for Placing Sew-On Epicardial Leads in the Child

2018 ◽  
Vol 13 (6) ◽  
pp. 455-457 ◽  
Author(s):  
Joseph R. Nellis ◽  
Zachary W. Fitch ◽  
Ashley Y. Choi ◽  
James M. Meza ◽  
Zebulon Z. Spector ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Patient Population ◽  
Pediatric Patients ◽  
Single Case ◽  
Invasive Technique ◽  
Invasive Approach ◽  
Epicardial Lead ◽  
Lead Placement ◽  
Pacemaker Syndrome ◽  
The Right

Traditionally, pacing leads are placed transvenously, although smaller pediatric patients who require permanent pacemakers may benefit from delaying tranvenous lead placement until they are larger. Alternative, minimally invasive atrioventricular pacing options have not previously existed for this patient population, leaving many of these children with large sternotomies or thoracotomies. Using three port sites and an adjustable shaft dual-needle suturing device, we placed a steroid-eluting, sew-on epicardial lead on the right atrium of a 9-year-old patient. This is one of the earliest reported cases of a minimally invasive technique for sew-on epicardial lead placement on the atrium of a child. Although based on a single case, we believe that this approach is safe, reliable, and reproducible and that it can be used to place leads on any aspect of the heart. Adoption of this technique will allow for earlier atrioventricular pacing, which may decrease the incidence of pacemaker syndrome, and thus improve overall outcomes in this patient population.

Minimally invasive permanent pacemaker implantation immediately after birth: from delivery room to heart surgery

2021 ◽  
pp. 1-3
Author(s):  
Mehmet Taşar ◽  
Nur Dikmen Yaman ◽  
Burcu Arıcı ◽  
Ömer Nuri Aksoy ◽  
Huseyin Dursin ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Atrioventricular Block ◽  
Heart Surgery ◽  
Pacemaker Implantation ◽  
Skin Incision ◽  
Permanent Pacemaker ◽  
Invasive Technique ◽  
Permanent Pacemaker Implantation ◽  
Congenital Atrioventricular Block ◽  
The Right

Abstract Introduction: Congenital atrioventricular block is diagnosed in uterine life, at birth, or early in life. Atrioventricular blocks can be life threatening immediately at birth so urgent pacemaker implantation techniques are requested. Reasons can be cardiac or non-cardiac, but regardless of the reason, operations are challenging. We aimed to present technical procedure and operative results of pacemaker implantation in neonates. Materials and methods: Between June 2014 and February 2021, 10 neonates who had congenital atrioventricular block underwent surgical operation to implant permanent epicardial pacemaker by using minimally invasive technique. Six of the patients were female and four of them were male. Mean age was 4.3 days (0–11), while three of them were operated on the day of birth. Mean weight was 2533 g (1200–3300). Results: Operations were achieved through subxiphoidal minimally skin incision. Epicardial 25 mm length dual leads were implanted on right ventricular surface and generators were fixed on the right (seven patients) or left (three patients) diaphragmatic surface by incising pleura. There were no complication, morbidity, and mortality related to surgery. Conclusion: Few studies have characterised the surgical outcomes following epicardial permanent pacemaker implantation in neonates. The surgical approach is attractive and compelling among professionals so we aimed to present the techniques and results in patients who required permanent pacemaker implantation in the first month of life.

scholarly journals Minimally Invasive Plate Osteosynthesis for a Distal Radius Fracture with Forearm Skin Problem

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Kiyohito Naito ◽  
Yoichi Sugiyama ◽  
Mayuko Kinoshita ◽  
Ahmed Zemirline ◽  
Chihab Taleb ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Distal Radius ◽  
Skin Disorder ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Volar Locking Plate ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Locking Plate Osteosynthesis ◽  
The Right

In this study, we performed osteosynthesis for a distal radius fracture using a minimally invasive approach for a patient with skin disorder of the forearm and obtained favorable results. This case report may provide new findings confirming the usefulness of this surgical approach for distal radius fractures. Blister formation on the right forearm was observed in a 53-year-old female who was diagnosed with a distal fracture of the right radius and underwent splinting in a local hospital, and she was referred to our hospital 2 days after the injury. Minimally invasive locking plate osteosynthesis was performed, and there was no skin lesion at this incision site. Postoperatively, there were no complications in soft tissues and the operative scar was almost unrecognizable. We reported volar locking plate osteosynthesis using the minimally invasive approach in a patient with skin disorder of the forearm. Such patients are rarely encountered. However, this minimally invasive approach is extremely useful for utilizing the advantages of volar locking plate fixation without being affected by the soft tissue environment.

scholarly journals The double tunnels technique: an alternative minimally invasive approach for carpal tunnel syndrome

2015 ◽  
Vol 123 (5) ◽  
pp. 1230-1237 ◽  
Author(s):  
Daniele Vanni ◽  
Francesco Saverio Sirabella ◽  
Renato Galzio ◽  
Vincenzo Salini ◽  
Vincenzo Magliani
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Minimally Invasive ◽  
Carpal Tunnel ◽  
Secondary Outcome ◽  
Invasive Technique ◽  
Control Group ◽  
P Value ◽  
Invasive Approach ◽  
Group A ◽  
Tunnel Syndrome

OBJECT The purpose of this study was to assess the effectiveness and safety of an alternative minimally invasive technique for the treatment of carpal tunnel syndrome (CTS). METHODS This was designed as a prospective, randomized, open-label, blinded end point evaluation (PROBE) study. The active comparison was double tunnels technique (DTT) (Group A, 110 patients) versus standard open decompression of the median nerve (control [Group B], 110 patients). Patient recruitment started in January 2011. The primary outcomes were the functional Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) scores and visual analog scale (VAS) scores for pain (pVAS) at Weeks 2 and 4, and at Months 3, 6, and 12. The secondary outcome was the aesthetics (aVAS) score at Weeks 2 and 4, and at Months 3, 6, and 12. RESULTS The Student t-test and ANOVA were used, and the results were considered statistically significant if the p value was ≤ 0.05 for continuous variables. The DTT is a tissue-sparing approach that allows the surgeon to limit the length of the incision (0.6 ± 0.05 cm) and to respect the palmar fascia and the subcutaneous tissue. Recovery from wrist pain, night pain, numbness, stiffness, and weakness was achieved more effectively and quickly compared with the standard approach. Better BCTSQ, pVAS, and aVAS scores were observed in Group A. CONCLUSIONS The DTT is a safe and effective approach for the treatment of CTS. This technique entails faster recovery times, better aesthetic outcomes, and lower risks of complications.

Minimally Invasive Separation Surgery for Metastases in the Vertebral Column: A Technical Report

2019 ◽  
Vol 18 (6) ◽  
pp. 606-613
Author(s):  
Rafael A Vega ◽  
Jeffrey I Traylor ◽  
Ahmed Habib ◽  
Laurence D Rhines ◽  
Claudio E Tatsui ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Minimally Invasive ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Thoracic Vertebrae ◽  
Minimally Invasive Techniques ◽  
Invasive Approach ◽  
Invasive Techniques

Abstract BACKGROUND Epidural spinal cord compression (ESCC) is a common and severe cause of morbidity in cancer patients. Minimally invasive surgical techniques may be utilized to preserve neurological function and permit the use of radiation to maximize local control. Minimally invasive techniques are associated with lower morbidity. OBJECTIVE To describe a novel, minimally invasive operative technique for the management of metastatic ESCC. METHODS A minimally invasive approach was used to cannulate the pedicles of the thoracic vertebrae, which were then held in place by Kirschner wires (K-wires). Following open decompression of the spinal cord, cannulated screws were placed percutaneously with stereotactic guidance through the pedicles followed by cement induction. Stereotactic radiosurgery is performed in the postoperative period for residual metastatic disease in the vertebral body. RESULTS The minimally invasive technique used in this case reduced tissue damage and optimized subsequent recovery without compromising the quality of decompression or the extent of metastatic tumor resection. Development of more minimally invasive techniques for the management of metastatic ESCC has the potential to facilitate healing and preserve quality of life in patients with systemic malignancy. CONCLUSION ESCC from vertebral metastases poses a challenge to treat in the context of minimizing potential risks to preserve quality of life. Percutaneous pedicle screw fixation with cement augmentation provides a minimally invasive alternative for definitive treatment of these patients.

scholarly journals Minimally invasive management of dorsiflexion contracture at the metatarsophalangeal joint and plantarflexion contracture at the proximal interphalangeal joint of the fifth toe

2011 ◽  
Vol 1 (2) ◽  
pp. 27
Author(s):  
Mariano De Prado ◽  
Pedro-Luis Ripoll ◽  
Pau Golanó ◽  
Javier Vaquero ◽  
Nicola Maffulli
Keyword(s):  
Minimally Invasive ◽  
Proximal Phalanx ◽  
Metatarsophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Invasive Technique ◽  
Wedge Osteotomy ◽  
Invasive Approach ◽  
Fifth Toe ◽  
Toe Deformity

Several surgical options have been described to manage persistent dorsiflexion contracture at the metatarsophalangeal joint and plantarflexion contracture at the proximal interphalangeal joint of the fifth toe. We describe a minimally invasive technique for the management of this deformity. We perform a plantar closing wedge osteotomy of the 5th toe at the base of its proximal phalanx associated with a lateral condylectomy of the head of the proximal phalanx and at the base of the middle phalanx. Lastly, a complete tenotomy of the deep and superficial flexor tendons and of the tendon of the extensor digitorum longus is undertaken. Correction of cock-up fifth toe deformity is achieved using a minimally invasive approach.

Achieving Aesthetic Results by Using Laser in Minimally Invasive Dentistry Approach

2017 ◽  
Vol 34 (3) ◽  
pp. 123-128
Author(s):  
Natalia Elson ◽  
Irene Brandes
Keyword(s):  
Minimally Invasive ◽  
Cosmetic Surgery ◽  
Surgical Intervention ◽  
Thermal Stimulus ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Technology Application ◽  
Laser Technology ◽  
Minimally Invasive Dentistry ◽  
Caries Management

The preservation of healthy human body and function for every patient should be the goal of all health practitioners. Dentistry is not an exception to this philosophy. In past few decades, the improvements of scientific method and technology has led to a better understanding of oral microflora and dental materials resulted in the shifting of caries management method from G. V. Black’s “extension for prevention” to the modern “minimally invasive” approach in dentistry. The minimally invasive approach to dental caries establishes a proper doctor-patient relationship, thus empowering and educating the patient to take responsibility for their own dental health. The proper sequence of caries management should be the introduction of preventive strategies such as oral hygiene instructions, reminialization regiments, and risk assessments followed by minimal surgical interventions. Using the laser technology in the aspect of surgical intervention has many clinical advantages. Some of the clinical benefits include its selectivity for carious tissue, reduction of needs for local anesthesia, decontamination effect of preparation surfaces, minimal thermal stimulus to pulp chamber, increase in surface adhesion for composite materials, and other soft tissue applications. The combination of caries prevention program, disease control, risk assessment, and laser technology application on the surgical intervention significantly reduces the long-term restorative needs and thus preserves more healthy natural tooth structures, which complement the concept of minimally invasive dentistry. In cosmetic surgery, the same rules apply. The same laser types are used as well.

PS01.219: SINGLE-PORT THORACOSCOPIC MINIMALLY INVASIVE ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 112-112
Author(s):  
Yong Yuan
Keyword(s):  
Minimally Invasive ◽  
Conflicts Of Interest ◽  
Single Port ◽  
Minimally Invasive Esophagectomy ◽  
Operation Time ◽  
Surgical Instruments ◽  
Thoracoscopic Esophagectomy ◽  
Invasive Technique ◽  
Invasive Approach ◽  
Invasive Esophagectomy

Abstract Background This study was conducted to optimize the surgical procedures for single-port thoracoscopic esophagectomy, and to explore its potential advantages over multi-port minimally invasive esophagectomy. Methods For single-port thoracoscopic esophagectomy, the patient was placed in left lateral-prone position and a 4-cm incision through the 4th-5th intercostal space was taken on the postaxillary line. The 10-mm camera and two or three surgical instruments were used for the VATS esophagectomy and radical mediastinal lymph node dissection. The camera position was different for the upper and lower mediastinal regions. Mobilization of stomach was conducted via multiple-port laparoscopic approach. Cervical end-to-side anastomosis was completed by hand-sewn procedures.A propensity-matched comparison was made between the single-port and four-port thoracoscopic esophagectomy groups. Results From 2014 to 2016, 56 matched patients were analyzed. There was no conversion to open surgery or operative mortality. The use of single-port thoracoscopic esophagectomy increased the length of operation time in comparison with using multiple-port minimally invasive technique (mean, 257 vs. 216 min, P = 0.026). The time taken for thoracic procedure in the single-port group was significant longer that in the multi-port group (mean, 126 vs. 84 min, P < 0.001). There were no significant differences between groups in the number of lymph nodes dissected, blood loss, complications or hospital stay (P > 0.05). In single-port thoracoscopic group, the pain in the abdomen was more severe than that in the chest (P = 0.042). The pain scores for postoperative day 1 and day 7 were significantly lower in the single-port group as compared with multiple-port group (P = 0.038 and P < 0.001), a similar trend could be seen for the pain score on postoperative day 3 (P = 0.058). Conclusion Single-port thoracoscopic esophagectomy contributes to reducing postoperative pain with an acceptable increase of operation time, which does not compromise surgical radicality and has similar short-term postoperative outcomes when compared with multiple-port minimally invasive approach. Disclosure All authors have declared no conflicts of interest.

scholarly journals Transapical septal myectomy in the beating heart via a minimally invasive approach: a feasibility study in swine

2019 ◽  
Author(s):  
Jing Fang ◽  
Rui Wang ◽  
Hongyun Liu ◽  
Yunshu Su ◽  
Jun Chen ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
Beating Heart ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Aortic Cusp ◽  
Septal Myectomy ◽  
Custom Made ◽  
The Right

Abstract OBJECTIVES The aim of this study was to establish an original transapical septal myectomy procedure that can be performed in the beating heart via a minimally invasive approach for the treatment of hypertrophic obstructive cardiomyopathy. METHODS We designed an original intracardiac septum resection device to conduct off-pump septal myectomy in swine. A subxiphoid minithoracotomy was performed to access the apex of the heart. This resection device was inserted into the left ventricular outflow tract of the heart via the apex. The basal anteroseptal myocardium beneath the right aortic cusp was identified using a combination of transoesophageal and transthoracic echocardiography and then resected and collected by the device. RESULTS Six consecutive operations were successfully and accurately performed using the custom-made device under echocardiographic guidance. All pigs survived and appeared to be normal until planned euthanasia 1 week after operation. A 300–700 mg portion of the septal myocardium was resected from the normal swine heart. Echocardiography and electrocardiogram revealed no abnormalities after resection. One exception was the fifth pig, in which mild annular regurgitation of the aortic valve occurred after repetitive resection. Postmortem necropsy demonstrated that all resections were correctly located at the basal anteroseptal septum beneath the right aortic cusp. CONCLUSIONS Our study provides the first proof-of-concept evidence for a novel beating heart transapical septal myectomy procedure, which showed promising translational potential for the treatment of hypertrophic obstructive cardiomyopathy. This procedure would probably reduce operative risks and improve outcomes and reduce the demanding expertise required to perform conventional surgical myectomy.

scholarly journals Bilateral tubular minimally invasive approach for decompression, reduction and fixation in lumbosacral lythic spondylolisthesis

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video9 ◽  
Author(s):  
Giuseppe M.V. Barbagallo ◽  
Francesco Certo ◽  
Giovanni Sciacca ◽  
Vincenzo Albanese
Keyword(s):  
Minimally Invasive ◽  
Postoperative Recovery ◽  
Pedicle Screw Fixation ◽  
Invasive Technique ◽  
Surgical Morbidity ◽  
Nerve Roots ◽  
Invasive Approach ◽  
Minimally Invasive Surgical ◽  
Pull Out ◽  
Mini Open

This video demonstrates the minimally invasive surgical technique used in a 56-year-old woman suffering from L-5 spondylolysis and grade 2 L5–S1 spondylolisthesis. The first author used expandable tubular retractors bilaterally to perform neural decompression, mini-open TLIF, spondylolysthesis reduction and L5–S1 pedicle screw fixation. L-5 cement augmentation was performed through cannulated and fenestrated screws to enhance resistance to screw pull-out secondary to reduction maneuvers.Sequential surgical steps related to microsurgery, spondylolysthesis reduction and instrumentation are shown and commented.We submit that in cases of lythic spondylolisthesis a bilateral traversing and exiting nerve roots decompression is a safer option prior to performing the deformity reduction and fixation; the proposed minimally invasive technique may help in reducing surgical morbidity and improving postoperative recovery.The video can be found here: http://youtu.be/G4Qdg-A-Y3M.

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