scholarly journals Contemporary Management of Benign Parapharyngeal Lesions Using Minimally Invasive Techniques: Case Discussion and Review of the Literature

2020 ◽  
Vol 5 (3) ◽  
pp. 1-9
Author(s):  
Tiffany Peng Hwa ◽  
Michael Cheng ◽  
Babak Sadoughi
Keyword(s):  
Minimally Invasive ◽  
Retropharyngeal Space ◽  
Ktp Laser ◽  
Open Approach ◽  
Contemporary Management ◽  
The Right ◽  
Invasive Techniques ◽  
Total Parotidectomy ◽  
Severe Airway Obstruction ◽  
Branchial Anomalies

Branchial anomalies can present in the parapharyngeal space, creating unique challenges in management. Historically, this approach warranted an open approach, including transcervical, transparotid with total parotidectomy and retromandibular dissection, or transmandibular dissection with mandibulotomy. However, the advent of minimally invasive transoral techniques and laser resection have allowed for successful resection of masses in this anatomical region without an external approach. We illustrate these advancements with the case of a 30-year-old man with globus sensation and throat discomfort, found to have a mass of the right posterolateral oropharynx causing severe airway obstruction. Imaging showed a parapharyngeal mass with extension to the carotid sheath and retropharyngeal space, which was successfully resected with potassium-titanyl-phosphate (KTP) laser using a minimally invasive transoral approach with no major complications. Transoral excision offers decreased morbidity and a cosmetically favorable outcome compared to transcervical excision. KTP laser may be safely used for transoral excision of a benign parapharyngeal mass.

scholarly journals Minimally Invasive Techniques for Iliac Bolt Placement: 2-Dimensional Operative Video

2021 ◽  
Vol 20 (4) ◽  
pp. E292-E292
Author(s):  
Travis Hamilton ◽  
Mohamed Macki ◽  
Thomas M Zervos ◽  
Victor Chang
Keyword(s):  
Minimally Invasive ◽  
Imaging System ◽  
Pedicle Screws ◽  
Vertical Axis ◽  
Spinal Diseases ◽  
Open Approach ◽  
Sagittal Vertical Axis ◽  
Pelvic Fixation ◽  
Iliac Screws ◽  
Invasive Techniques

Abstract As the popularity of minimally invasive surgery (MIS) continues to grow, novel techniques are needed to meet the demands of multisegment fixation for advanced spinal diseases. In one such example, iliac bolts are often required to anchor large fusion constructs, but MIS technical notes are missing from the literature.  A 67-yr-old female presented with a symptomatic coronal deformity: preoperative pelvic incidence = 47°, pelvic tilt = 19°, and lumbar lordosis = 29°, sagittal vertical axis = +5.4 cm with 30° of scoliosis. The operative plan included T10-ilium fusion with transforaminal interbody grafts at L2-3, L3-4, L4-5, and L5-S1. The intraoperative video is of minimally invasive placement of iliac bolts using the O-Arm Surgical Imaging System (Medtronic®). The patient consented to the procedure.  A mini-open exposure that remains above the fascial planes allows for multilevel instrumentation with appropriate decompression at the interbody segments. After the placement of the pedicle screws under image-guidance, the direction is turned to the minimally invasive iliac bolts. Following the trajectory described in the standard open approach,1 the posterior superior iliac spine (PSIS) is identified with the navigation probe, which will guide the Bovie cautery through the fascia. This opening assists in the trajectory of the navigated-awl tap toward the anterior superior iliac spine (ASIS). Next, 8.5 mm x 90 mm iliac screws were placed in the cannulated bone under navigation. After intraoperative image confirmation of screw placement, the contoured rods are threaded under the fascia. The setscrews lock the rod in position. MIS approaches obviate cross-linking the rods, rendering pelvic fixation more facile.  This technique allows for minimal dissection of the posterior pelvic soft tissue while maintaining adequate fixation.

scholarly journals Variation in medical management and neurosurgical treatment of patients with supratentorial spontaneous intracerebral haemorrhage

2021 ◽  
pp. 239698732110059
Author(s):  
Lotte Sondag ◽  
Floor AE Jacobs ◽  
Floris HBM Schreuder ◽  
Jeroen D Boogaarts ◽  
W Peter Vandertop ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Intracerebral Haemorrhage ◽  
Online Survey ◽  
Treatment Decisions ◽  
Neurosurgical Treatment ◽  
The Right ◽  
Invasive Techniques ◽  
Spontaneous Intracerebral Haemorrhage

Introduction The role of surgery in spontaneous intracerebral haemorrhage (sICH) remains controversial. This leads to variation in the percentage of patients who are treated with surgery between countries. Patients and methods We sent an online survey to all neurosurgeons (n = 140) and to a sample of neurologists (n = 378) in Dutch hospitals, with questions on management in supratentorial sICH in general, and on treatment in six patients, to explore current variation in medical and neurosurgical management. We assessed patient and haemorrhage characteristics influencing treatment decisions. Results Twenty-nine (21%) neurosurgeons and 92 (24%) neurologists responded. Prior to surgery, neurosurgeons would more frequently administer platelet-transfusion in patients on clopidogrel (64% versus 13%; p = 0.000) or acetylsalicylic acid (61% versus 11%; p = 0.000) than neurologists. In the cases, neurosurgeons and neurologists were similar in their choice for surgery as initial treatment (24% and 31%; p = 0.12), however variation existed amongst physicians in specific cases. Neurosurgeons preferred craniotomy with haematoma evacuation (74%) above minimally-invasive techniques (5%). Age, Glasgow Coma Scale score and ICH location were important factors influencing decisions on treatment for neurosurgeons and neurologists. 69% of neurosurgeons and 80% of neurologists would randomise patients in a trial evaluating the effect of minimally-invasive surgery on functional outcome. Discussion Our results reflect the lack of evidence about the right treatment strategy in patients with sICH. Conclusion New high quality evidence is needed to guide treatment decisions for patients with ICH. The willingness to randomise patients into a clinical trial on minimally-invasive surgery, contributes to the feasibility of such studies in the future.

Right Anterior Mini-Incision Approach to Anomalous Right Coronary Artery Repair

2020 ◽  
Vol 11 (2) ◽  
pp. 215-216 ◽  
Author(s):  
Zoe W. Hinton ◽  
James M. Meza ◽  
Alyssa C. Habermann ◽  
Nicholas D. Andersen ◽  
Mani A. Daneshmand ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Minimally Invasive ◽  
Right Coronary Artery ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
The Right ◽  
Invasive Techniques ◽  
Mini Incision

The right anterior mini-incision has emerged as an effective minimally invasive approach for adult aortic root and valve operations. However, adoption of minimally invasive techniques has been limited in congenital heart surgery. We report a case of anomalous aortic origin of the right coronary artery repair performed through this approach. Following successful right coronary artery unroofing, the patient had an uncomplicated postoperative hospitalization.

scholarly journals The Role of Minimally Invasive Techniques in Scoliosis Correction Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Michael B. Cloney ◽  
Jack A. Goergen ◽  
Angela M. Bohnen ◽  
Zachary A. Smith ◽  
Tyler Koski ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Selection Effect ◽  
Treatment Modalities ◽  
Open Approach ◽  
Icu Admission ◽  
Lengths Of Stay ◽  
Scoliosis Correction ◽  
Multivariable Regression ◽  
Correction Surgery ◽  
Invasive Techniques

Objective. Recently, minimally invasive surgery (MIS) has been included among the treatment modalities for scoliosis. However, literature comparing MIS to open surgery for scoliosis correction is limited. The objective of this study was to compare outcomes for scoliosis correction patients undergoing MIS versus open approach. Methods. We retrospectively collected data on demographics, procedure characteristics, and outcomes for 207 consecutive scoliosis correction surgeries at our institution between 2009 and 2015. Results. MIS patients had lower number of levels fused (p<0.0001), shorter surgeries (p=0.0023), and shorter overall lengths of stay (p<0.0001), were less likely to be admitted to the ICU (p<0.0001), and had shorter ICU stays (p=0.0015). On multivariable regression, number of levels fused predicted selection for MIS procedure (p=0.004), and multiple other variables showed trends toward significance. Age predicted ICU admission and VTE. BMI predicted any VTE, and DVT specifically. Comorbid disease burden predicted readmission, need for transfusion, and ICU admission. Number of levels fused predicted prolonged surgery, need for transfusion, and ICU admission. Conclusions. Patients undergoing MIS correction had shorter surgeries, shorter lengths of stay, and shorter and fewer ICU stays, but there was a significant selection effect. Accounting for other variables, MIS did not independently predict any of the outcomes.

scholarly journals Selection of the Method and Analysis of the Results of the Application of Minimally Invasive Methods of Treatment of Hydatidous Liver Echinococcosis

2019 ◽  
Vol 12 (4) ◽  
pp. 222-229
Author(s):  
Konstantin Arkad'evich Panfilov ◽  
Sergey Anatol'evich Ivanov ◽  
Evgeniy Anatol'evich Korymasov ◽  
Vladimir Evgen'evich Bogdanov
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Main Group ◽  
Invasive Treatment ◽  
Clinical Observations ◽  
Choice Of Treatment ◽  
Laparoscopic Intervention ◽  
Surgical Tactics ◽  
The Right ◽  
Invasive Techniques

Objective. To analyze minimally invasive treatment methods (puncture-draining intervention and laparoscopic) of liver echinococcosis and to develop an optimal treatment algorithm.Methods. The results of 120 clinical observations of patients with liver echinococcosis who were treated from 2002 to 2018 are presented. based on SOKB them. V.D. Seredavina (Samara). The comparison group (n = 68) consisted of patients with PDV and laparoscopic intervention in the period from 2002 to 2008, the main group (n = 52) - patients with PDV and laparoscopic intervention in the period from 2009 to 2018.Results. The starting points of the choice of treatment for echinococcosis in patients of the main group were the stage of life and the diameter of the hydatid cyst. Evaluation of the results of surgical treatment was carried out on the basis of a list of criteria that were assigned the values ​​of "good", "satisfactory", "unsatisfactory". With the right choice of surgical treatment tactics, as well as the priority of echinococcectomy in patients of the main group, 94% of clinical observations (n ​​= 52) achieved positive results.Conclusion. The proposed differential algorithm of surgical tactics of echinococcosis using minimally invasive techniques answers questions regarding the choice of access and method of surgical treatment based on the size of cysts, their number and localization, as well as the period of the parasite's vital activity.

MINIMALLY INVASIVE POSTERIOR FIXATION

Neurosurgery ◽  
2008 ◽  
Vol 63 (suppl_3) ◽  
pp. A197-A203 ◽  
Author(s):  
Michael Y. Wang ◽  
D. Greg Anderson ◽  
Kornelis A. Poelstra ◽  
Steven C. Ludwig
Keyword(s):  
Minimally Invasive ◽  
Axial Skeleton ◽  
Posterior Fixation ◽  
Complication Rates ◽  
Spinal Deformities ◽  
Tissue Destruction ◽  
Fixation Techniques ◽  
Contemporary Management ◽  
Prolonged Immobilization ◽  
Invasive Techniques

ABSTRACT SIGNIFICANT ADVANCES HAVE been made in the contemporary management of thoracolumbar spinal deformities, including improved segmental bony fixation, techniques for osteotomy, and mechanically powerful reduction maneuvers, which now allow the spinal surgeon to correct severe, complex, and rigid spinal deformities. However, one of the major limitations of surgical intervention has been the high complication rates associated with these surgical endeavors. Much of the morbidity associated with posterior deformity surgery relates to the extensive soft tissue destruction necessary to gain access to multiple segments of the axial skeleton. The open exposures for long-segment fixation result in additional blood loss, increased rates of infection, and prolonged immobilization caused by postoperative pain. Minimally invasive techniques attempt to overcome these drawbacks of the open exposures, and this report reviews preliminary experience in treating spinal deformities with long-segment minimally invasive internal fixation.

Minimally Invasive Technique for Closure of Atrial Septal Defect

1998 ◽  
Vol 6 (2) ◽  
pp. 88-90 ◽  
Author(s):  
Jacques AM van Son ◽  
Anno Diegeler ◽  
Eugene KW Sim ◽  
Rüdiger Autschbach ◽  
Friedrich W Mohr
Keyword(s):  
Minimally Invasive ◽  
Atrial Septal Defect ◽  
Iliac Artery ◽  
Septal Defect ◽  
External Iliac Artery ◽  
Invasive Technique ◽  
Minimally Invasive Techniques ◽  
The Mean ◽  
The Right ◽  
Invasive Techniques

Minimally invasive techniques for repair of extracardiac anomalies in congenital heart disease have evolved over the last 5 years and laid the foundation for the next phase: the repair of intracardiac defects. Fifteen patients (9 females and 6 males) with a median age of 9.8 years (range, 5.2 to 54 years) underwent closure of a secundum atrial septal defect through a small right anterior thoracotomy. The right external iliac artery was cannulated through a small groin incision and the atrial septal defect was repaired during hypothermic fibrillatory arrest for a mean period of 14 ± 5 minutes. The mean length of the thoracotomy was 4.9 ± 0.8 cm (range, 4.5 to 8.8 cm) while the mean length of the groin incision was 3.9 ± 0.5 cm (range, 2.9 to 5.3 cm). In the 3 youngest patients, the external iliac artery was cannulated with an 8F arterial cannula. Direct closure of the atrial septal defect was possible in all patients. The mean operative time was 109 ± 39 minutes. There was no perioperative or late mortality and no morbidity except for a tear in the right femoral artery of a 19-year-old girl. No residual atrial septal defect was observed in any of the patients. Although minimally invasive techniques for repair of intracardiac defects are not fully developed with regard to indications, the procedure described here provided secure closure of the defects with excellent cosmetic results.

scholarly journals Minimally Invasive Approach for Improving Anterior Dental Aesthetics: Case Report with 1-Year Follow-Up

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
H. Sevilay Bahadır ◽  
Gökhan Karadağ ◽  
Yusuf Bayraktar
Keyword(s):  
Minimally Invasive ◽  
Canine Tooth ◽  
Invasive Approach ◽  
Resin Infiltration ◽  
Anterior Teeth ◽  
Dental Aesthetics ◽  
Infiltration Technique ◽  
The Right ◽  
Invasive Techniques

Dental aesthetics have become highly important in recent years. Treating aesthetic demands with noninvasive or minimally invasive techniques can preserve the natural tissues. A 20-year-old female patient presented to the clinic with aesthetic concerns. After the clinical and radiographic examinations, hypomineralization was identified in the maxillary anterior teeth except the maxillary right canine. An external discoloration was also identified in the maxillary left canine tooth. Moreover, the right canine tooth was identified as a Turner’s tooth according to the patient’s anamnesis. The resin infiltration technique was applied to the maxillary anterior teeth except the maxillary right canine. The bleaching treatment was applied to the maxillary left canine tooth. Then, a laminate veneer restoration was applied to the upper right canine tooth with Turner’s hypoplasia. Following the treatment, a satisfactory aesthetic restoration was achieved. After 1-year examination, no clinical failures were observed.

scholarly journals Update of Radiofrequency Ablation for Treating Benign and Malignant Thyroid Nodules. The Future Is Now

2021 ◽  
Vol 12 ◽  
Author(s):  
Ralph P. Tufano ◽  
Pia Pace-Asciak ◽  
Jonathon O. Russell ◽  
Carlos Suárez ◽  
Gregory W. Randolph ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Radiofrequency Ablation ◽  
Minimally Invasive ◽  
Thyroid Nodules ◽  
Standard Of Care ◽  
Low Risk ◽  
Autonomously Functioning Thyroid Nodules ◽  
Ablative Techniques ◽  
The Right ◽  
Invasive Techniques

Thermal and chemical ablation are minimally invasive procedures that avoid removal of the thyroid gland and target symptomatic nodules directly. Internationally, Radiofrequency ablation (RFA) is among one of the most widely used thermal ablative techniques, and is gaining traction in North America. Surgery remains the standard of care for most thyroid cancer, and in the right clinical setting, Active Surveillance (AS) can be a reasonable option for low risk disease. Minimally invasive techniques have emerged as an alternative option for patients deemed high risk for surgery, or for those patients who wish to receive a more active treatment approach compared to AS. Herein, we review the literature on the safety and efficacy of RFA for treating benign non-functioning thyroid nodules, autonomously functioning thyroid nodules, primary small low risk thyroid cancer (namely papillary thyroid cancer) as well as recurrent thyroid cancer.

Considerations in Dysphagia Management Following Esophagectomy

2016 ◽  
Vol 1 (13) ◽  
pp. 169-176
Author(s):  
Lisa M. Evangelista ◽  
James L. Coyle
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Surgical Procedures ◽  
Esophageal Resection ◽  
Minimally Invasive Surgical ◽  
Operative Complications ◽  
Swallowing Difficulties ◽  
Epidemiological Impact ◽  
Invasive Techniques ◽  
Management Of Dysphagia

Esophageal cancer is the sixth leading cause of death from cancer worldwide. Esophageal resection is the mainstay treatment for cancers of the esophagus. While curative, surgical resection may result in swallowing difficulties that require intervention from speech-language pathologists (SLPs). Minimally invasive surgical procedures for esophageal resection have aimed to reduce morbidity and mortality associated with more invasive techniques. Both intra-operative and post-operative complications, regardless of the surgical approach, can result in dysphagia. This article will review the epidemiological impact of esophageal cancers, operative complications resulting in dysphagia, and clinical assessment and management of dysphagia pertinent to esophageal resection.

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