Applicability of the new ITKA GSD Basic 250 electrosurgical unit to urologic endoscopic surgery, laparoscopic surgery and urologic open surgery

1998 ◽  
Vol 22 (6) ◽  
pp. 270-273
Author(s):  
Olavi Lukkarinen And ◽  
Pekka Tuuttila
Keyword(s):  
Laparoscopic Surgery ◽  
Endoscopic Surgery ◽  
Open Surgery ◽  
Electrosurgical Unit

Synthesis and Workspace Study of Endoscopic Extenders With Flexible Stem

1997 ◽  
Vol 119 (3) ◽  
pp. 412-414 ◽  
Author(s):  
A. Faraz ◽  
S. Payandeh
Keyword(s):  
Laparoscopic Surgery ◽  
Endoscopic Surgery ◽  
Open Surgery ◽  
Hand Movement ◽  
Type Synthesis ◽  
Specific Design ◽  
Invasive Method ◽  
Flexible Stem ◽  
Haptic Sensation ◽  
Systematic Synthesis

Endoscopic surgery is a less invasive method of surgery as compared to open surgery. However, indirect vision, limited hand movement and lack of haptic sensation, combined with the tiring posture of holding long tools makes it a very difficult task for the surgeon to perform (Tendick, 93; Faraz, June, 95). Consequently, the surgeon has a fraction of the dexterity and sensing of that of open surgery. This is specially the case in laparoscopic surgery which is a specific branch of endoscopic surgery, and is performed on the abdomen. The dexterity problem associated with laparoscopic surgery arises from the fact that the present rigid stem extenders can approach the surgical site with some fix orientation (determined by the connecting line between the position of surgical site and the port of entry). Lack of 2 DOF at the stem, to orient the tool’s tip to the desired orientation near the surgical site, prevents the surgeon from having the required dexterity and agility. By adding revolute/spherical joints on the stem, the required internal capability in orienting the tool can be achieved, and hence provide more dexterity for the surgeon. Although, there has been some publication in the literature about different design possibilities (e.g., Rinninsland, 93; Melzer, 93; Neisius, 94), as well as U.S. patents (Matsumaru, 92; Heimberger, 94), they are all dealing with special designs with specific design focus. There is a lack of general study of flexible endoscopic extenders with wider design objectives. For example, such objectives can be: (a) general type synthesis of the joint design, (b) formulation of workspace requirements of laparoscopic extenders, and (c) comparative study of different designs in search of the optimal design(s). The objective of this report is to have a systematic synthesis of the joints, as well as formulate the dexterous workspace for laparoscopic extenders with flexible stem, in order to find the optimum design.

FACTORS INFLUENCING THE OPERATION TECHNIQUE OF PEFORATED DUODENAL ULCER REPAIR BY SINGLEPORT LAPAROSCOPIC SURGERY

2016 ◽  
pp. 99-105
Author(s):  
Huu Tri Nguyen ◽  
Loc Le ◽  
Doàn Van Phu Nguyen ◽  
Nhu Thanh Dang ◽  
Thanh Phuc Nguyen
Keyword(s):  
Duodenal Ulcer ◽  
Laparoscopic Surgery ◽  
Correlation Coefficient ◽  
Open Surgery ◽  
Operative Time ◽  
Single Port ◽  
Time Correlation ◽  
Patch Repair ◽  
Perforated Duodenal Ulcer ◽  
Conversion To Open Surgery

Background: Single-port laparoscopic surgery (SPLS) is increasingly used in surgery and in the treatment of perforated duodenal ulcer. The aim of this study was to evaluate technical factors for perforated duodenal ulcer repair by SPLS. Methods: A prospective study on 42 consecutive patients diagnosed with perforated duodenal ulcer and treated with SPLS at Hue university of medicine and pharmacy hospital and Hue central hospital from January 2012 to February 2015. Results: The mean age was 48.1 ± 14.2 (17 - 79) years. 40 patients were treated with suture of the perforation by pure SPLS. There was one case (2.4%) in which one additional trocar was required. Conversion to open surgery was necessary in one patient (2.4%) in which the perforation was situated on the posterior duodenal wall. Two patients (4.8%) with history of abdominal surgery were successfully treated by pure SPLS. The size of perforation was correlated with suturing time (correlation coefficient r = 0.459) and operative time (correlation coefficient r = 0.528). Considering suture type, X stitches were used in 95.5% cases, simple stitches were used in one case (2.4%) while Graham patch repair technique was utilized in one case (2.4%) with large perforation. Most cases (95.1%) required only simple suture without omental patch. Peritoneal drainage was spared in most cases (90.2%). Conclusions: SPLS is a safe method for the treatment of perforated duodenal ulcer. Posterior duodenal location is the main cause of conversion to open surgery. Factor related to operative time is perforation size. Key words: perforated duodenal ulcer, single port laparoscopic repair, single port laparoscopy

Assessment of Circumferential Resection Margins (CRM) clearance in Conventional open Versus Laparoscopic Cancer Rectum Resection

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ibrahim H Bayan ◽  
Ahmed Abdelaziz ◽  
Tarek Youssef Ahmed ◽  
Mohamed Magdy
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Abdominal Surgery ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Resection Margins ◽  
Laparoscopy Group ◽  
Surgery Group ◽  
Colon And Rectal Cancer ◽  
Significant Difference

Abstract Background Colon and rectal cancer represent the fourth commonest malignancy worldwide. Globally, colon and rectal cancer make up 9.4% and 10.1% in men and women of all cancers, respectively. Colon and rectal tumors are the third most common malignancy after breast and lung cancer, respectively. The main management of rectal cancer involves a multi-disciplinary team approach and an individually tailored treatment routine. Operative surgery remains the primary and definitive treatment for locally confined rectal adenocarcinoma and is the only historical and current treatment which allows for cure. Resection of the colon and rectal cancer can be done either by open surgical excision or laparoscopically. Aim of the work The objective is to compare the radicality of total mesorectal excision for rectal cancer in both open and laparoscopic surgery through the pathology report. Methods In this multicentric, prospective, comparative study, we included the pathologically established rectal cancer patients from 2 hospitals in Cairo, Egypt, Ain Shams University Hospitals and Maadi Military Hospital, Egypt between 2013 and 2016. The sample size was 40 patients divided into two groups; 20 patients for laparoscopic arm and 20 patients for the open trans-abdominal surgery. Inclusion criteria: histopathology confirmed rectal cancer, patients fit for operative resection, and with T1- T3 grades according to the preoperative evaluation. The exclusion criteria: Patients with T4 stage tumor, patients present as emergency cases and patients present with recurrence of the tumor and synchronous colonic tumors. Results The circumferential resection margins (CRM) of the mesorectum when examined pathologically after resection showed no difference between the two arms of the study with laparoscopic group specimens 3.18±1.16 mm mean, (SD) compared to 3.50±0.45 mm mean, (SD) in the open surgery group with no statistically significant difference. The longitudinal resection margins (LRM) was (5.50±1.98 mean, SD) in the laparoscopic group compared to (5.20±2.28 mean, SD) in the open conventional surgery group with no significant difference found between the two groups. Total operative time was significantly shorter in the trans-abdominal surgery group, while the hospital stay period was significantly shorter in the laparoscopy group. Laparoscopy group also showed significantly time before flatus passage, and the patients in the laparoscopy group started oral intake faster than open surgery group. Conclusion In our study, the radicality of the rectal cancer excision in both laparoscopic and traditional open surgery, showed non inferiority of the laparoscopic technique over open surgery Long-term clinical outcomes of overall survival and recurrence is the foremost parameters which should be taken in consideration for decision for laparoscopic surgery for rectal cancer. Additional follow-up results from the current trial are presently being developed, beside with records on other secondary end points, like cost effectiveness and quality of life.

scholarly journals Current status of residency training in laparoscopic surgery in Brazil: a critical review

2015 ◽  
Vol 28 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Miguel Prestes NÁCUL ◽  
Leandro Totti CAVAZZOLA ◽  
Marco Cezário de MELO
Keyword(s):  
Laparoscopic Surgery ◽  
Endoscopic Surgery ◽  
Surgical Simulation ◽  
Internship And Residency ◽  
Current Status ◽  
Professional Activity ◽  
Medical Residency ◽  
Psychomotor Skills ◽  
Residency Programs ◽  
Education Medical

INTRODUCTION: The surgeon's formation process has changed in recent decades. The increase in medical schools, new specialties and modern technologies induce an overhaul of medical education. Medical residency in surgery has established itself as a key step in the formation of the surgeon, and represents the ideal and natural way for teaching laparoscopy. However, the introduction of laparoscopic surgery in the medical residency programs in surgical specialties is insufficient, creating the need for additional training after its termination. OBJECTIVE: To review the surgical teaching ways used in services that published their results. METHODS: Survey of relevant publications in books, internet and databases in PubMed, Lilacs and Scielo through july 2014 using the headings: laparoscopy; simulation; education, medical; learning; internship and residency. RESULTS: The training method for medical residency in surgery focused on surgical procedures in patients under supervision, has proven successful in the era of open surgery. However, conceptually turns as a process of experimentation in humans. Psychomotor learning must not be developed directly to the patient. Training in laparoscopic surgery requires the acquisition of psychomotor skills through training conducted initially with surgical simulation. Platforms based teaching problem solving as the Fundamentals of Laparoscopic Surgery, developed by the American Society of Gastrointestinal Endoscopic Surgery and the Laparoscopic Surgical Skills proposed by the European Society of Endoscopic Surgery has been widely used both for education and for the accreditation of surgeons worldwide. CONCLUSION: The establishment of a more appropriate pedagogical process for teaching laparoscopic surgery in the medical residency programs is mandatory in order to give a solid surgical education and to determine a structured and safe professional activity.

scholarly journals Impact of SupervIsed TraInIng on the AcquIsItIon of SImulated LaparoscopIc SkIlls

2013 ◽  
Vol 95 (6) ◽  
pp. 1-6 ◽  
Author(s):  
NA Healy ◽  
KH Chang ◽  
JB Conneely ◽  
C Malone ◽  
MJ Kerin
Keyword(s):  
Minimally Invasive Surgery ◽  
Laparoscopic Surgery ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Alternative Methods ◽  
Time Constraints ◽  
Laparoscopic Skills ◽  
Supervised Training ◽  
Initial Learning ◽  
Safety Considerations

Laparoscopy or minimally invasive surgery requires surgeons to attain proficiency in skills that are fundamentally different to those required for open surgery. As a result, it both challenges junior trainees and surgeons who are experienced in open surgery. Not surprisingly, the initial learning phase of laparoscopy has been associated with an increased incidence of serious complications. Owing to time constraints and the ethical and safety considerations of allowing novices to perform laparoscopic surgery on patients, alternative methods have been sought to train junior surgeons on the basics of laparoscopic surgery.

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