Avoiding pullout complications in external ventricular drains: technical note

2017 ◽  
Vol 126 (3) ◽  
pp. 1003-1005 ◽  
Author(s):  
Carlos Velásquez ◽  
Mónica Rivero-Garvía ◽  
Maria Jose Mayorga-Buiza ◽  
María de los Ángeles Cañizares-Méndez ◽  
Manuel E. Jiménez-Mejías ◽  
...  
Keyword(s):  
Complication Rate ◽  
Operative Technique ◽  
Operative Time ◽  
Simple Technique ◽  
Technical Note ◽  
Single Institution ◽  
Fixation Technique ◽  
Reliable Procedure ◽  
Time Required ◽  
Median Operative Time

This report describes a reliable and simple technique for securing external ventricular drains (EVDs) to the scalp and avoiding pullout complications. The operative technique consists of fixing the drain between 2 hydrocolloid dressings and securing it with staples. A 10-year retrospective analysis of EVD pullout complications was performed in a series of 435 consecutive patients who were treated at a single institution. The EVD pullout complication rate was 0.4%. No complications related to the fixation technique were found. The median operative time required to fix the drain was 60 seconds. The technique presented here is a simple and reliable procedure to fix the EVD to the scalp, preventing pullout complications and thus reducing the morbidity of EVD reimplantation.

How feasible and practical is it to introduce the Endometriosis Phenome and Biobanking Harmonisation Project (EPHect) standard surgical form into clinical practice?

2018 ◽  
Vol 10 (4) ◽  
pp. 193-197
Author(s):  
Valerie To ◽  
Alan Lam ◽  
Akshara Shyamsunder ◽  
Neil Johnson
Keyword(s):  
Clinical Practice ◽  
Operative Time ◽  
Routine Clinical Practice ◽  
Deep Endometriosis ◽  
Web Based ◽  
Fertility Index ◽  
American Society ◽  
Set Up ◽  
Time Required ◽  
Median Operative Time

Background: The Endometriosis Phenome and Biobanking Harmonisation Project has been set up to facilitate and advance global endometriosis research. Aim: To test the feasibility and practicality of using the Endometriosis Phenome and Biobanking Harmonisation Project standard surgical form in routine clinical practice. Materials and methods: Standard surgical form was filled out using a web-based application for 225 consecutive women who underwent surgery for suspected or known endometriosis. Results: Median age was 37 years. Half (49.8%) of the women had a previous surgical diagnosis of endometriosis. Endometriosis was found in 91.5% of patients in this cohort. Median operative time was 101 min. Operative photographs substantially assisted completion of the standard surgical form post-operatively. The median time required to fill out the questionnaire was 8 min (range, 2–17 min). This was mostly dependent on the severity and distribution of endometriosis lesions. The standard surgical form is very comprehensive and has the advantage of including both the American Society of Reproductive Medicine classification and the Endometriosis Fertility Index; however, characterisation of deep endometriosis is insufficient for some women. In addition, some sections such as the descriptive endometriosis table (section IX) remain subjective. Conclusion: Using the Endometriosis Phenome and Biobanking Harmonisation Project standard surgical form to collect research data is feasible, especially when using an electronic database entry tool. It is also practically manageable, although the time taken is more than originally estimated by the Endometriosis Phenome and Biobanking Harmonisation Project standard surgical form authors. Even though some sections of the standard surgical form may be subjective, it is comprehensive and we would recommend its adoption into routine clinical practice for endometriosis research.

scholarly journals Retroperitoneal endoscopic adrenalectomy vs. Conventional adrenalectomy in treatment of benign adrenal lesions: Comparative analysis

2007 ◽  
Vol 54 (2) ◽  
pp. 45-48 ◽  
Author(s):  
G. Todorov ◽  
Tc. Lukanova
Keyword(s):  
Minimally Invasive ◽  
Hospital Stay ◽  
Complication Rate ◽  
Operative Time ◽  
Standard Of Care ◽  
Postoperative Hospital Stay ◽  
Adrenal Tumors ◽  
Endoscopic Adrenalectomy ◽  
Significant Difference ◽  
Median Operative Time

Minimally invasive adrenalectomy is considered to be the standard of care for the surgical treatment of the adrenal gland? s pathology. Since the initial report of laparoscopic adrenalectomy in 1992 and of retroperitoneal endoscopic adrenalectomy in 1994, it has evolved into a feasible and safe minimally invasive procedure for benign adrenal tumors. Clinical characteristics and outcomes of 63 retroperitoneal endoscopic adrenalectomies (REAs) and 45 conventional adrenalectomies (CAs) from 1996 to 2004 were evaluated. 61 patients underwent 63 REAs. Tumor size varied from 2 to 8 cm. Median age was 48.6 years. Median operative time was 135 min (45-240), median intraoperative blood loss - 85 ml (30- 550). The complication rate was 17.77%. Median postoperative hospital stay was 5 days (2-10). 44 patients underwent 45 conventional adenalectomies. Median age was 44.5 years (16-71). Intraoperative complication rate was 17.77%, postoperative - 22.22 %, Median operative time was 120 min (75 -240). Median postoperative hospital stay was 10 days (6-21). No statistically significant difference was established between median operative times of REA- and CA-groups (p=0.91). Conventional adrenalectomy was associated with a significantly increased complication rate (p= 0.009). Hospitalization was also longer after the open technique (d). Introduced in 1994 and displaying all advantages of minimal access surgery REA has become the standard of care for benign adrenal tumors. .

scholarly journals A comparison of the Thunderbeat and standard electrocautery devices in head and neck surgery: a prospective randomized controlled trial

2021 ◽  
Author(s):  
N. C. Kuipers ◽  
B. J. de Kleijn ◽  
J. Wedman ◽  
B. F. A. M. van der Laan ◽  
B. E. C. Plaat ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Loss ◽  
Head And Neck ◽  
Complication Rate ◽  
Operative Time ◽  
Controlled Trial ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Randomized Controlled ◽  
Standard Instrumentation

Abstract Purpose New energy-based sutureless vessel ligation devices, such as the Thunderbeat (Olympus Medical Systems Corp., Tokyo, Japan), could reduce operative time and limit blood loss in head and neck surgery; however, efficacy and safety in major head and neck surgery have not been investigated in a prospective, randomized study. Methods This prospective, double-arm, randomized controlled trial consisted of two parts: total laryngectomy (TL) and neck dissection (ND). Thirty patients planned for TL were randomized in two groups. For the ND part, forty-two operative sides were likewise randomized. In both parts, Thunderbeat was used in addition to the standard instrumentation in the intervention groups, while only standard instrumentation was used in the control groups. Primary outcome values were blood loss, operative time and complication rate. Results For the TL part there was no difference in mean blood loss (p = 0.062), operative time (p = 0.512) and complications (p = 0.662) between both hemostatic techniques. For the neck dissection part, there was a reduction in blood loss (mean 210 mL versus 431 mL, p = 0.046) and in operative time (median 101 (IQR 85–130) minutes versus 150 (IQR 130–199) minutes, p = 0.014) when Thunderbeat was used. There was no difference in complication rate between both hemostatic systems (p = 0.261). Conclusion The Thunderbeat hemostatic device significantly reduces operative blood loss and operative time for neck dissections, without increase in complications. In TL, blood loss using Thunderbeat was comparable with the standard technique, but the operative time tended to be shorter. Trial registration UMCG Research Register, Reg. no. 201700041, date of registration: 18/1/2017

The Emerging Role of Robotic Single-site Approach for Myomectomy: A Systematic Review of the Literature

2021 ◽  
pp. 155335062098822
Author(s):  
Eirini Giovannopoulou ◽  
Anastasia Prodromidou ◽  
Nikolaos Blontzos ◽  
Christos Iavazzo
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Complication Rate ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Single Site ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Robotic Myomectomy ◽  
The Mean

Objective. To review the existing studies on single-site robotic myomectomy and test the safety and feasibility of this innovative minimally invasive technique. Data Sources. PubMed, Scopus, Google Scholar (from their inception to October 2019), as well as Clinicaltrials.gov databases up to April 2020. Methods of Study Selection. Clinical trials (prospective or retrospective) that reported the outcomes of single-site robotic myomectomy, with a sample of at least 20 patients were considered eligible for the review. Results. The present review was performed in accordance with the guidelines for Systematic Reviews and Meta-Analyses (PRISMA). Four (4) studies met the inclusion criteria, and a total of 267 patients were included with a mean age from 37.1 to 39.1 years and BMI from 21.6 to 29.4 kg/m2. The mean operative time ranged from 131.4 to 154.2 min, the mean docking time from 5.1 to 5.45 min, and the mean blood loss from 57.9 to 182.62 ml. No intraoperative complications were observed, and a conversion rate of 3.8% was reported by a sole study. The overall postoperative complication rate was estimated at 2.2%, and the mean hospital stay ranged from 0.57 to 4.7 days. No significant differences were detected when single-site robotic myomectomy was compared to the multiport technique concerning operative time, blood loss, and total complication rate. Conclusion. Our findings support the safety of single-site robotic myomectomy and its equivalency with the multiport technique on the most studied outcomes. Further studies are needed to conclude on the optimal minimally invasive technique for myomectomy.

A simple technique to prevent and correct graft vessel kinking in the subcutaneous tunnel: Technical note

2011 ◽  
Vol 113 (10) ◽  
pp. 835-838 ◽  
Author(s):  
Yasuo Murai ◽  
Takayuki Mizunari ◽  
Katusya Umeoka ◽  
Kojiro Tateyama ◽  
Shiro Kobayashi ◽  
...  
Keyword(s):  
Simple Technique ◽  
Technical Note ◽  
Subcutaneous Tunnel

scholarly journals Laparoscopic Sleeve Gastrectomy versus Laparoscopic Banded Sleeve Gastrectomy: First Prospective Pilot Randomized Study

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Valeria Tognoni ◽  
Domenico Benavoli ◽  
Emanuela Bianciardi ◽  
Federico Perrone ◽  
Simona Ippoliti ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Randomized Study ◽  
Control Group ◽  
Bodyweight Loss ◽  
Relevant Difference ◽  
Banded Sleeve Gastrectomy ◽  
Time Required

Introduction. The placement of ring or band around the gastric tube might prevent the dilation after Laparoscopic Sleeve Gastrectomy (LSG). We describe the first randomized study comparing LSG and Laparoscopic Banded Sleeve Gastrectomy (LBSG).Material and Method. Fifty obese patients were enrolled in the study between January 2014 and January 2015. We analysed differences in operative time, complication rate, mortality, and BMI between the two groups over a period of 12 months.Results. Twenty-five patients received LSG (group A) and 25 LBSG (group B). The mean preoperative BMI was47.3±6.58 kg/m2and44.95±5.85 kg/m2, respectively, in the two groups. There was no statistical relevant difference in operative time. No intraoperative complications occurred. Mean BMI registered after 3, 6, and 12 months in groups A and B, respectively, were37.86±5.72 kg/m2and37.58±6.21 kg/m2(p=0.869),33.64±6.08 kg/m2and32.03±5.24 kg/m2(p=0.325), and29.72±4.40 kg/m2and27.42±4.47 kg/m2(p=0.186); no statistical relevant difference was registered between the two groups.Conclusion. LBSG is a safe and feasible procedure. The time required for the device positioning did not influence significantly the surgical time. The results of bodyweight loss did not document any statistically significant differences among the two groups, even though LBSG group showed a mean BMI slightly lower than that of the control group.

Segment IV Approach is Useful for Whole-Layer Laparoscopic Cholecystectomy for Gallbladder Polyps

2021 ◽  
Author(s):  
Yoshiaki Tanji ◽  
Shuichi Fujioka ◽  
Hironori Shiozaki ◽  
Yuki Takano ◽  
Naoto Takahashi ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Malignant Neoplasms ◽  
Pathological Findings ◽  
Gallbladder Polyps ◽  
Cystic Plate ◽  
Potentially Malignant ◽  
Proof Procedure ◽  
Median Operative Time

Abstract Background Whole-layer laparoscopic cholecystectomy (W-LC) has recently been advocated as a total biopsy for potentially malignant neoplasms of the gallbladder; however, it is not an injury-proof procedure. This study reports W-LC using the segment IV approach (technique for securing the whole-layer gallbladder at the medial origin of the cystic plate).MethodsTwenty among twenty-five patients diagnosed with potentially malignant gallbladder polyps underwent this technique.ResultsMostly, W-LC was performed successfully (median operative time 135 min) without intraoperative and postoperative complications. Pathological findings indicated that cholesteric polyps was the most common type (n=13), followed by adenomatous polyps (25%) and carcinoma in situ (5%).ConclusionsWe conclude that the segment IV approach is appropriate for performing total biopsy in patients diagnosed with potentially malignant gallbladder polyps.

DOZ047.36: Thoracoscopic esophageal internal axial traction for long- gap esophageal atresia

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
M Juricic ◽  
N Panait ◽  
G Podevin ◽  
A Bonnard ◽  
P Lopez ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Operative Time ◽  
Median Number ◽  
Ethical Review ◽  
Multicenter Observational Study ◽  
Long Gap ◽  
Esophageal Anastomosis ◽  
Long Gap Esophageal Atresia ◽  
Axial Traction ◽  
Median Operative Time

Abstract Aim of the Study Long-gap esophageal atresia (LGEA) remains a surgical challenge. This study aimed to report the results of thoracoscopic esophageal axial internal traction in LGEA. Methods This multicenter observational study included retrospectively neonates who underwent primary thoracoscopic esophageal axial internal traction for LGEA between June 2017 and July 2018. LGEA was defined as the technical impossibility to perform a primary esophageal anastomosis. The Ethical Review Board of our institution approved the study. Main Results Eight neonates were included with a median gestational age at birth of 35 weeks [25; 37] and a median birth weight of 2266 g [890; 3800], 6 types I and 2 types II according to Ladd's classification. Initial median gap between 2 esophageal ends was 5 vertebral bodies [4.5; 7]. Internal traction was performed at a median age of 5 weeks of life [1; 17] with a median operative time of 87 minutes. Four patients required at least 2 internal traction procedures. After a mean traction time of 1.5 weeks [1; 13.5], esophageal anastomosis was successfully performed in 7 patients (5 thoracoscopies, 2 thoracotomies) with a median operative time of 165 minutes. One patient needed a colonic interposition. Five of these 7 patients required an esophageal endoscopic dilatation (median number: 4 [2; 6]). Median follow-up was 9.75 months [3; 16]. Conclusions Thoracoscopic esophageal axial internal traction for LGEA was a safe and feasible procedure that allowed an esophageal anastomosis in 7 of the 8 patients. Improvement of the procedure requires setting a common protocol concerning the timing of the first internal axial traction and the duration of traction before considering esophageal anastomosis.

PS01.070: EVALUATION OF THE EFFECTIVENESS OF ROBOTIC FUNDOPLICATIONS IN THE TREATMENT OF GERD

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 69-69
Author(s):  
Mikhail Koshkin ◽  
Oleg Vasnev ◽  
Alexandr Belousov ◽  
Mikhail Mikhnevich ◽  
Magomet Baychorov ◽  
...  
Keyword(s):  
Operative Time ◽  
Conflicts Of Interest ◽  
Nissen Fundoplication ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Short Term ◽  
Antireflux Operations ◽  
Davinci System ◽  
Invasive Techniques ◽  
Median Operative Time

Abstract Background Surgical treatment is one of the most effective options for treatment of gastroesofageal reflux disease. Laparoscopic approach became is a ‘gold standard’ over the time demonstrating all advantages of minimally invasive techniques over the open procedures. However the utility of robotic antireflux operations still remains controversial. Methods Since the January till the December of 2017 thirty operations were operated on. Mean age was 57,2 (35–76), among them 21 (70%) were female and 9 (30%) were males. Mean BMI was 29,4 (24,1–41,0). Laparoscopic procedures were performed in15 patients (1st group), robotic procedures with DaVinci system were performed in 15 patients of the second group. Chernousov modified Nissen fundoplication was performed in 25 patients, Toupet fundoplication was used for 4 patients, Nissen type was performed in 4 cases. Results The median operative time in laparoscopic group was 125 min (80–200 min), in robotic group - 124 min (90–210 min). There were no statistical differences between two groups (P = 0,93).Blood loss was minimal in both groups. Mean postoperative hospital stay was 4 days (2–7 days) in the 1st group and 4 days (2–6 days) in the second. There were no statistical differences between two groups (P = 0,19). Postoperative course was uneventful in all patients of both groups. Conclusion Robotic antireflux operations are safe and effective in treatment of patients with reflux-esophagitis. There were no statistically significant differences in short-term results of laparoscopic and robotic operations. Disclosure All authors have declared no conflicts of interest.

A Single-Center Experience with Minimally Invasive Transgastric ERCP in Patients with Previous Gastric Bypass: Lessons Learned and Technical Considerations

2020 ◽  
Vol 86 (4) ◽  
pp. 300-307
Author(s):  
Maria Baimas-George ◽  
Michael J. Passeri ◽  
William B. Lyman ◽  
Andrew Dries ◽  
Tarun Narang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Biliary Obstruction ◽  
Operative Time ◽  
Lessons Learned ◽  
High Rate ◽  
Single Center Experience ◽  
Estimated Blood Loss ◽  
Chart Abstraction ◽  
Feasible Alternative ◽  
Median Operative Time

As bariatric surgery increases, there is a growing population of patients with biliary obstruction and anatomy which precludes transoral access through endoscopic retrograde cholangiopancreatography (ERCP). Minimally invasive transgastric ERCP (TG-ERCP) offers a feasible alternative for the treatment. A retrospective review was performed of all patients who underwent laparoscopic or robotic-assisted TG-ERCP between 2010 and 2017. Chart abstraction collected demographics, procedural details, success rate, and postoperative outcomes. Forty patients were identified, of which 38 cases were performed laparoscopically and two robotically. Median operative time was 163 minutes, with an estimated blood loss of 50 cc. TG-ERCP was performed successfully in 36 cases (90%); sphincterotomy was completed in 35 patients (97%). Sixty per cent already had a cholecystectomy; in the remaining patients, it was performed concurrently. Major complications included stomach perforation (n = 1), pancreatitis (n = 3), and anemia requiring transfusion (n = 2). In patients with biliary obstruction and anatomy not suitable for ERCP, TG-ERCP can be performed in a minimally invasive fashion, with a high rate of technical success and low morbidity. We describe a stepwise, reproducible technique because it is an essential tool for the shared armamentarium of endoscopists and surgeons.

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