Advances in proctology

Nowa Medycyna ◽  
2019 ◽  
Vol 26 (3) ◽  
Author(s):  
Małgorzata Kołodziejczak ◽  
Przemysław Ciesielski
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Ultrasound Images ◽  
Stool Incontinence ◽  
Haemorrhoidal Disease ◽  
Current State ◽  
Anorectal Region ◽  
Healing Wounds ◽  
Anorectal Ultrasonography ◽  
Invasive Techniques

In recent years there has been progress in proctological diagnostics and minimally invasive procedures. We present the latest diagnostic options in proctology, including dynamic 3D anorectal ultrasonography technique, the so-called echodefecography, as well as volume render mode, a technique based on computer processing of ultrasound images. The current state of knowledge on the treatment of the most common proctological diseases: haemorrhoidal disease, anal fistula, anal fissure, stool incontinence, rectal prolapse and pilonidal sinus, was also presented. According to the available analyses, patients are most interested in maintaining full postoperative gas and stool continence, while the effectiveness of the surgery comes second. Modern surgery meets these expectations by developing preoperative diagnosis and minimally invasive techniques which do not cause sphincter damage. Indications for the use of these methods, their limitations, and possible postoperative complications were discussed. There is still some room for classical surgical techniques, which have been enriched with methods supporting the healing of difficult healing wounds and inflammation of the anorectal region: negative pressure wound therapy systems and hyperbaric chambers.

scholarly journals Revisional Techniques for Secondary Cleft Lip Deformities

2021 ◽  
Vol 35 (02) ◽  
pp. 065-071
Author(s):  
Shayan M. Sarrami ◽  
Anna J. Skochdopole ◽  
Andrew M. Ferry ◽  
Edward P. Buchanan ◽  
Larry H. Hollier ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Early Life ◽  
Cleft Lip ◽  
Primary Repair ◽  
Surgical Techniques ◽  
Minimally Invasive Techniques ◽  
Adjacent Tissue ◽  
Tissue Transfer ◽  
Invasive Techniques

AbstractSecondary deformities of repaired cleft lips are an unfortunate complication despite the meticulous approach of modern primary procedures. Most of these surgeries take place in the patient's early life and must be strategically planned to provide optimal cosmesis with minimal interventions. Depending on the level of severity, treatment of the secondary deformities ranges from noninvasive or minimally invasive techniques to complete revision cheiloplasty. Many novel topical, injectable, and laser therapies have allotted physicians more technical flexibility in treating superficial distortions. Nonetheless, surgical techniques such as diamond excision and adjacent tissue transfer remain popular and useful reconstructive modalities. Deformities involving the orbicularis oris must be completely taken down to allow full access to the muscle. Complete revision cheiloplasty requires recreation of the cleft defect and reconstruction similar to the primary repair. Due to the myriad of presentations of these secondary deformities, familiarity with the various treatments available is imperative for any cleft surgeon.

scholarly journals P.104 Peri-cavity atrophy after minimally invasive evacuation of intracerebral hemorrhage

2018 ◽  
Vol 45 (s2) ◽  
pp. S43-S44
Author(s):  
S Ahmed ◽  
J Scaggiante ◽  
J Mocco ◽  
C Kellner
Keyword(s):  
Minimally Invasive ◽  
Intracerebral Hemorrhage ◽  
Surgical Techniques ◽  
Ct Scans ◽  
Cavity Volume ◽  
Cavity Size ◽  
Hematoma Evacuation ◽  
Endoscopic Evacuation ◽  
Invasive Techniques

Background: Intracerebral hemorrhage (ICH) remains a significant cause of morbidity and mortality. While traditional surgical techniques have shown marginal clinical benefit of ICH evacuation, minimally invasive techniques have shown some promise. Endoscopic evacuation of the hemorrhage may reduce the peri-hematoma edema and subsequent atrophy around the hemorrhage cavity. This study aims to quantify the changes in cavity volume following hematoma evacuation. Methods: Patients from the INVEST registry of minimally invasive ICH evacuation were included retrospectively if follow-up computed tomography (CT) scans were available for analysis. Hematoma cavity volumes were calculated from the immediate post-procedural and three-month follow-up CT scans using the Analyze Pro software. Results: Twenty patients had follow-up CT scans at a mean time of 93 days from hematoma evacuation. The average cavity size at follow-up was 11938.12 mm3 (SD: 6996.49). The change in cavity size compared to the prior CT was 6396.74 mm3 (median 2542; range: -1030-27543; SD: 8472.45). This represented mean growth in cavity volume of 54%. Conclusions: This study provides preliminary data describing increase in cavity size after endoscopic minimally invasive evacuation of ICH. Comparison to atrophy in conservatively-managed patients is a further planned avenue of research.

scholarly journals Advances in Minimally Invasive Surgery for Lung Cancer

2020 ◽  
Author(s):  
Rachit Shah ◽  
Nils-Tomas Delagar McBride
Keyword(s):  
Lung Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Wedge Resection ◽  
Surgical Techniques ◽  
Robotic Assisted ◽  
Current State ◽  
Chest Disease ◽  
History Of ◽  
Vats Wedge Resection

Over the last 25 years, improvement in instrumentation and surgical techniques has led to widespread adaptation of thoracoscopic (VATS) surgery in the field of thoracic oncology. What once was a niche operation like VATS wedge resection to now hybrid VATS chest wall resections, and advanced surgeries like bronchoplasty and sleeve resections are done with VATS. This has led to improved surgical outcomes for our patients and increased use of surgery in the treatment of chest disease. We review the history of VATS and its current state with most recent changes and upgrades in the technique in this chapter. We review the advancement in uniportal VATS, robotic assisted resection, complex VATS resection, and awake lung surgery with VATS.

Endoscopic and Surgical Gastrostomy and Jejunostomy Tube Placement

2018 ◽  
Vol 02 (01) ◽  
pp. 053-061
Author(s):  
Kevin El-Hayek ◽  
Marita Bauman
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Tube Placement ◽  
Percutaneous Endoscopic Gastrostomy Tube ◽  
Jejunostomy Tube ◽  
Endoscopic Gastrostomy ◽  
Enteral Access ◽  
Surgical Gastrostomy ◽  
Tools And Techniques ◽  
Invasive Techniques

AbstractEnteral access is a common request for consulting surgeons and interventionists. Prior to the 1980s, such a consultation often necessitated open surgical intervention whereas today, enteral access is often performed via several minimally invasive methods. Tools and techniques for minimally invasive enteral access have changed drastically due to advancements in the fields of endoscopy, laparoscopy, and interventional radiology. Percutaneous endoscopic gastrostomy tube placement is one such advancement. Since its first development, its basic principles have been applied to other minimally invasive techniques, which have resulted in an expansion of techniques for establishment of enteral access. In this article, we outline various endoscopic and surgical techniques for gastric and jejunal access.

Minimally invasive lumbar intradural extramedullary tumor resection

2012 ◽  
Vol 33 (Suppl1) ◽  
pp. 1 ◽  
Author(s):  
Brian Lee ◽  
Patrick C. Hsieh
Keyword(s):  
Minimally Invasive ◽  
Tumor Resection ◽  
Surgical Techniques ◽  
Csf Leak ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Extramedullary Tumor ◽  
Intradural Extramedullary ◽  
Dural Opening ◽  
Invasive Techniques

Intradural, extramedullary schwannomas have long been treated with open midline incision, laminectomy, and dural opening to expose and resect the lesion. While this technique is well established, today new surgical techniques can be utilized to perform the same procedure while minimizing pain, size of incision, and trauma to adjacent tissues. In cases of intradural surgery, minimally invasive surgery limits the degree of soft tissue disruption. As a result, there is significant decreased dead space within the surgical cavity that may decrease the rate of CSF leak complications. Minimally invasive techniques have continuously improved over the years and have reached a point where they can be used for intradural surgeries. In this case presentation, we demonstrate a minimally invasive approach to the lumbar spine with resection of an intradural schwannoma. Surgical techniques and the nuances of the minimally invasive approach to intradural tumors compared to the standard open procedure will be discussed. The video can be found here: http://youtu.be/XXrvAIq_H48.

scholarly journals Minimally invasive approach: is this the future of aortic surgery?

2021 ◽  
Author(s):  
Paolo Berretta ◽  
Michele Galeazzi ◽  
Mariano Cefarelli ◽  
Jacopo Alfonsi ◽  
Veronica De Angelis ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Aortic Surgery ◽  
Median Sternotomy ◽  
Surgical Techniques ◽  
Current Evidence ◽  
Invasive Approach ◽  
Less Invasive ◽  
First Choice ◽  
Aortic Interventions ◽  
Invasive Techniques

AbstractMedian sternotomy incision has shown to be a safe and efficacious approach in patients who require thoracic aortic interventions and still represents the gold-standard access. Nevertheless, over the last decade, less invasive techniques have gained wider clinical application in cardiac surgery becoming the first-choice approach to treat heart valve diseases, in experienced centers. The popularization of less invasive techniques coupled with an increased patient demand for less invasive therapies has motivated aortic surgeons to apply minimally invasive approaches to more challenging procedures, such as aortic root replacement and arch repair. However, technical demands and the paucity of available clinical data have still limited the widespread adoption of minimally invasive thoracic aortic interventions. This review aimed to assess and comment on the surgical techniques and the current evidence on mini thoracic aortic surgery.

scholarly journals Minimally invasive techniques for epilepsy surgery: stereotactic radiosurgery and other technologies

2014 ◽  
Vol 121 (Suppl_2) ◽  
pp. 232-240 ◽  
Author(s):  
Mark Quigg ◽  
Cynthia Harden
Keyword(s):  
Minimally Invasive ◽  
Stereotactic Radiosurgery ◽  
Epilepsy Surgery ◽  
Focused Ultrasound ◽  
Surgical Techniques ◽  
Intractable Epilepsy ◽  
Patient Acceptance ◽  
Minimally Invasive Techniques ◽  
Minimally Invasive Surgical ◽  
Invasive Techniques

Minimally invasive surgical techniques for the treatment of medically intractable epilepsy, which have been developed by neurosurgeons and epileptologists almost simultaneously with standard open epilepsy surgery, provide benefits in the traditional realms of safety and efficacy and the more recently appreciated realms of patient acceptance and costs. In this review, the authors discuss the shortcomings of the gold standard of open epilepsy surgery and summarize the techniques developed to provide minimally invasive alternatives. These minimally invasive techniques include stereotactic radiosurgery using the Gamma Knife, stereotactic radiofrequency thermocoagulation, laser-induced thermal therapy, and MRI-guided focused ultrasound ablation.

Sacroiliac Joint Fusion: Percutaneous and Open

2018 ◽  
Author(s):  
Daraspreet Singh Kainth ◽  
Karanpal Singh Dhaliwal ◽  
David W. Polly
Keyword(s):  
Back Pain ◽  
Minimally Invasive ◽  
Sacroiliac Joint ◽  
Surgical Techniques ◽  
Nonoperative Treatment ◽  
Minimally Invasive Surgical ◽  
Joint Fusion ◽  
Sacroiliac Joint Fusion ◽  
Invasive Techniques

Sacroiliac joint (SIJ) pain is the source of back pain in up to 25% of patients presenting with back pain. There is significant individual variation in the anatomy of the sacrum and the lumbosacral junction. SIJ pain is diagnosed with the history and physical examination. SIJ injection of a local anesthetic along with steroids is often used to confirm the diagnosis. Nonoperative treatment includes nonsteroidal anti-inflammatories, physical therapy, joint manipulation therapies, and SIJ injections. SIJ pain can also be successfully treated with radiofrequency ablation in some patients. Surgical treatment includes the open anterior sacroiliac joint fusion technique and minimally invasive techniques. The benefits of minimally invasive SIJ fusion versus open surgery include less blood loss, decreased surgical time, and shorter hospital stay. Further studies are needed to determine the long-term durability of the minimally invasive surgical techniques.

scholarly journals The role of robotic technology in cardiac surgery

2019 ◽  
Vol 87 (2) ◽  
pp. 40-42 ◽  
Author(s):  
Elise Quint ◽  
Gayathri Sivakumar
Keyword(s):  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Artery Bypass ◽  
Surgical Techniques ◽  
Robotic Technology ◽  
Minimally Invasive Surgical ◽  
Robotic Cardiac Surgery ◽  
The Cost ◽  
Invasive Techniques

Minimally invasive surgical techniques have been developed in order to improve patient outcomes and satisfaction. These minimally invasive techniques have been applied to numerous fields, including cardiac surgery. Currently, mitral valve repair and coronary artery bypass grafting are the most common procedures performed robotically. Numerous studies have shown that robotic technology provides similar outcomes to traditional surgery, which is much more invasive. However, there are numerous barriers to performing robotic surgery, including the cost of robotic systems and the steep learning curve associated with these systems. It is predicted that the indications for robotic cardiac surgery will increase as these limitations are addressed.

scholarly journals Minimally invasive treatment for Hirschsprung disease

2015 ◽  
Vol 62 (3) ◽  
pp. 289-293
Author(s):  
Simona-Gabriela Tudorache ◽  
◽  
Felix Negoiţescu ◽  
Laura Niculescu ◽  
◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Hirschsprung Disease ◽  
Minimally Invasive Techniques ◽  
Minimally Invasive Approach ◽  
Invasive Treatment ◽  
Invasive Approach ◽  
Duhamel Procedure ◽  
Pull Through ◽  
Invasive Techniques

Introduction. Harold Hirschsprung, a physician at Queen Louise Children’s Hospital of Copenhagen, first described the disease that now bears his name, at the Pediatric Congress of Berlin in 1886. Since then there have been countless debates on the optimal surgical approach. This paper aims both to recap the main classical surgical techniques: Swenson, Duhamel and Soave, but the main focus is on minimally invasive techniques. Surgical techniques. In the last 25 years, the treatment for Hirschsprung disease has progressed. If classically the preferred treatment was in 2-3 stages, now the definitive intervention is per primam in most cases, thus avoiding the morbidity associated with stomas. In 1995, Georgeson describes the minimally invasive approach using laparoscopy, and then in 1998, De la Torre et al, describes the first transanal endorectal pull-through (TERPT), unattended laparoscopically. Discussions. The initial discussions were linked to comparing processes in a single stage with ones in 2 or 3 stages, finding similar results, it is now a question of comparing open techniques with minimally invasive and even minimally invasive techniques with each other, endeavoring to establish whether laparoscopically assisted approach is needed or if the transanal one is enough. Conclusion. Usually shorter forms of Hirschsprung disease are treated strictly using the transanal technique, for the forms involving the left and transverse colon laparoscopically assisted transanal pull-through is used, while for the ascending colon and for the total aganglionosis the laparoscopically assisted Duhamel procedure is preferred.

Sign in / Sign up

Export Citation Format

Share Document