scholarly journals Esophageal atresia — state of the art (review of literature on the PUBMED base)

2020 ◽  
Vol 10 (3) ◽  
pp. 327-338
Author(s):  
Steven Rothenberg ◽  
Yury А. Kozlov

Esophageal atresia is fundamentally important in pediatric surgery, as its treatment results create an accurate portrait of the standards of surgical care, which is provided by any medical institution. Cameron Haight performed the first successful reconstruction of the esophagus malformation relatively recently just over 70 years ago. Advances in neonatal surgery, technology and advances in neonatal intensive care have dramatically improved treatment outcomes for this disease. Current mortality from this developmental abnormality has become minimal, despite its frequent association with other malformations. A revolutionary approach to the treatment of esophageal atresia was developed by Steven Rothenberg in 1999, the pioneer and legend of pediatric minimally invasive surgery. In 1999, he revolutionized esophageal anastomosis by thoracoscopy. The innovative concept of the minimally invasive approach ensured minimal trauma to patients, thereby providing the possibility of rapid postoperative recovery of patients and reducing the length of their surgical hospital stay. This literature review raises the main controversy in the surgical treatment of esophageal atresia in the 21st century. Emphasis is placed on the study of the role of minimally invasive surgery and the treatment of concomitant abnormalities associated with gastroesophageal reflux and tracheomalacia. As part of the study, a description of all the latest technologies, advances in technical and scientific terms, solutions, exceptional experience, and competence in developing and implementing minimally invasive operations in young children. These developments changed the direction of pediatric surgery and improved the quality of surgical care for children with congenital malformation of the esophagus and how they were performed.

Children ◽  
2018 ◽  
Vol 5 (12) ◽  
pp. 158 ◽  
Author(s):  
Hannah Phelps ◽  
Harold Lovvorn, III

The application of minimally invasive surgery (MIS) to resect pediatric solid tumors offers the potential for reduced postoperative morbidity with smaller wounds, less pain, fewer surgical site infections, decreased blood loss, shorter hospital stays, and less disruption to treatment regimens. However, significant controversy surrounds the question of whether a high-fidelity oncologic resection of childhood cancers can be achieved through MIS. This review outlines the diverse applications of MIS to treat pediatric malignancies, up to and including definitive resection. This work further summarizes the current evidence supporting the efficacy of MIS to accomplish a definitive, oncologic resection as well as appropriate patient selection criteria for the minimally invasive approach.


2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tianhui Liu ◽  
Xiaoying Gao ◽  
Jianmin Cui

Objective: To study and evaluate the incidence of pain and complications in patients with spinal trauma after minimally invasive treatment. Methods: The research period was selected from January 2018 to December 2020, and 40 patients with spinal trauma were selected. According to the random number table scheme, they were divided into the study group and the control group. The treatment scheme of the control group was traditional surgery, and the treatment scheme of the study group was minimally invasive surgery. The indicators of the two groups were compared and analyzed. Results: Compared with the two groups of surgery and postoperative recovery related indicators, the study group had more advantages (P<0.05); Compared two groups of postoperative NRS score, VAS score and the incidence of complications, the study group had more advantages(P<0.05). Conclusion: Minimally invasive treatment of spinal trauma has significant clinical effect, which can effectively relieve postoperative pain and reduce the incidence of various complications.


2019 ◽  
Vol 30 (05) ◽  
pp. 420-428 ◽  
Author(s):  
Joachim F. Kuebler ◽  
Jens Dingemann ◽  
Benno M. Ure ◽  
Nagoud Schukfeh

Abstract Introduction In the last three decades, minimally invasive surgery (MIS) has been widely used in pediatric surgery. Meta-analyses (MAs) showed that studies comparing minimally invasive with the corresponding open operations are available only for selected procedures. We evaluated all available MAs comparing MIS with the corresponding open procedure in pediatric surgery. Materials and Methods A literature search was performed on all MAs listed on PubMed. All analyses published in English, comparing pediatric minimally invasive with the corresponding open procedures, were included. End points were advantages and disadvantages of MIS. Results of 43 manuscripts were included. MAs evaluating the minimally invasive with the corresponding open procedures were available for 11 visceral, 4 urologic, and 3 thoracoscopic types of procedures. Studies included 34 randomized controlled trials. In 77% of MAs, at least one advantage of MIS was identified. The most common advantages of MIS were a shorter hospital stay in 20, a shorter time to feeding in 11, and a lower complication rate in 7 MAs. In 53% of MAs, at least one disadvantage of MIS was found. The most common disadvantages were longer operation duration in 16, a higher recurrence rate of diaphragmatic hernia in 4, and gastroesophageal reflux in 2 MAs. A lower native liver survival rate after laparoscopic Kasai-portoenterostomy was reported in one MA. Conclusion In the available MAs, the advantages of MIS seem to outnumber the disadvantages. However, for some types of procedures, MIS may have considerable disadvantages. More randomized controlled trials are required to confirm the advantage of MIS for most procedures.


Author(s):  
Atthaphorn Trakarnsanga ◽  
Martin R. Weiser

Overview: Minimally invasive surgery (MIS) of colorectal cancer has become more popular in the past two decades. Laparoscopic colectomy has been accepted as an alternative standard approach in colon cancer, with comparable oncologic outcomes and several better short-term outcomes compared to open surgery. Unlike the treatment for colon cancer, however, the minimally invasive approach in rectal cancer has not been established. In this article, we summarize the current status of MIS for rectal cancer and explore the various technical options.


Author(s):  
V. Ya. Lishchishin ◽  
A. G. Barishev ◽  
A. N. Petrovsky ◽  
A. N. Lishchenko ◽  
A. Y. Popov ◽  
...  

Aim. To evaluate the reproducibility and safety of the developed pancreatogastric anastomosis with various surgical approaches during pancreatoduodenectomy.Materials and methods. The experience of surgical treatment of 47 patients with malignant tumours of the periampullary zone, who underwent pancreatoduodenectomy, was considered. The proposed variant of anastomose was performed to 14 (29.8%) patients: in 7 cases with a minimally invasive approach to perform pancreatoduodenectomy; and in 7 cases with an open approach. To compare retrospectively 33 (70.2%) patients who underwent pancreatogastric anastomosis according to the Bassi technique: 9 – with minimally invasive surgery, 24 – with open surgery. The frequency of pancreatic fistulas, the number of repeated interferences, and hospital mortality were taken into account.Results. A significant advantage of the new method of forming an anastomosis in the duration of the operation was noted in comparison with the Bassi technique. There were no statistically significant differences in blood loss while various types of anastomoses (p > 0.05). When using the proposed technique, the formation of pancreatic fistulas was not revealed. The development of pancreatic fistula was observed in 4 (16.7%) patients after open surgery and in 7 (77.8%) patients after minimally invasive Bassi anastomose formation. Reoperations were performed after open surgery in 3 (12.5%) cases and in 4 (44.4%) cases of minimally invasive surgery according to the Bassi technique. There were 2 (22.2%) deaths in the minimally invasive group.Conclusion. The proposed pancreatogastric anastomosis is applicable in clinical practice. This method allows to create relatively fast and less challenging anastomosis, including with a minimally invasive approach. The use of this technique makes it possible to reduce mortality and postoperative complications in patients with a “complex” pancreas.


2018 ◽  
Vol 4 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Eike Smolinski ◽  
Alexander Benkmann ◽  
Wolfgang Drewelow ◽  
Torsten Jeinsch ◽  
Hans-Joachim Cappius

AbstractDue to its advantages like minimal trauma and a low risk of infections, the minimally invasive surgery (MIS) has become the standard operation technique for many surgical procedures. During this type of intervention, one of the main tasks from a technical point of view is the control of the pressure in the operation area in order to give the surgeon sufficient space to perform his actions. Because no invasive measurements are available, an extended Kalman filter incorporating the peristaltic behavior of the used medical device was developed to estimate the pressure in the operation area. This contribution focuses on the observer design while a separately designed PI controller using loop shaping was employed for validation. The proposed observer-based control structure was tested with a simulator deploying the principle of physical equivalence.


2006 ◽  
Vol 18 (3) ◽  
pp. 249-256 ◽  
Author(s):  
Makoto Jinno ◽  
◽  
Takamitsu Sunaoshi ◽  
Toyomi Miyagawa ◽  
Takehiro Hato ◽  
...  

Minimally invasive surgery accelerates postoperative recovery, but can only be applied by surgeons having advanced conduct skills. We developed a master-slave manipulator, i.e., robotic forceps for laparoscopic surgery that enhances surgical skill. Robotic forceps consists of a master-slave manipulator, a support component, a controller, an operating conditions display, and a foot switch for changing operating conditions. This paper details specifications and components of robotic forceps and evaluates conductance, such as measurement of the slave hand’s grip and suturing and ligaturing, conducted on a sponge stomach model. A comparison of support function in experiments demonstrates their effectiveness.


2010 ◽  
Vol 57 (3) ◽  
pp. 29-35 ◽  
Author(s):  
I. Popescu ◽  
C. Vasilescu ◽  
V. Tomulescu ◽  
S. Vasile ◽  
O. Sgarbura

Background: Robotic approach for rectal cancer competes with laparoscopy in centers dedicated to minimally invasive surgery (MIS) due to the technologic advantage. This is a report of our experience with MIS for rectal cancer. Methods: A series of 84 consecutive patients with laparoscopic resection (between 1995-2010) and 38 consecutive patients with robotic resection (between 2008-2010) for primary rectal cancer were analyzed. Hartmann's procedures were excluded. Clinical and pathologic outcomes were reviewed retrospectively. Results: In the laparoscopic group (LG), 50 anterior rectal resections (ARR), 34 abdominal perineal resections (APR) were performed while in the robotic group(RG) there were 30 ARR and 8 APR. The median operative time was 182 min (140-220 min) in LG and 208 min (180- 300 min) in RG (p=0.0002). No statistically significant difference was noticed between the groups in terms of conversion, morbidity, anastomotic leak and postoperative stay rates. Margin clearance was obtained in all patients and the median number of removed lymph nodes was similar: 11.37 in RG vs 11.07 in the LG (p=0.65) with a higher rate of metastatic lymph node involvement in laparoscopy (p=0.0012). Blood loss was higher in LG (150 ml vs. 100 ml; p=0.0001). There were 5 (5.9%) local recurrences in the LG at a median follow- up of 27.5 months and 2 (5.2%) in the RG at a median follow-up of 13 months (p=0.43). Conclusions: Minimally invasive surgery for rectal cancer proved to be safe and efficient with similar results in the two groups. Technological advances of robotic approach compared to laparoscopy allowed better ergonomics, more refined dissection, easier preserving of hypogastric nerves and less blood loss. Long term outcomes are to be assessed in prospective randomized studies.


1998 ◽  
Vol 186 (5) ◽  
pp. 542-544 ◽  
Author(s):  
Anthony M Firilas ◽  
Richard J Jackson ◽  
Samuel D Smith

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