scholarly journals Population perception of surgical approach in minimally invasive surgery

2015 ◽  
Vol 9 (1-2) ◽  
pp. 1 ◽  
Author(s):  
Shogo Inoue ◽  
Mitsuru Kajiwara ◽  
Jun Teishima ◽  
Akio Matsubara
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Surgical Approach ◽  
Young Female ◽  
Surgical Approaches ◽  
Paramedical Staff ◽  
The Impact

Introduction: The aim of this study was to better understand the impact that public opinion might have on surgical approaches in urologic minimally invasive surgery (MIS).Methods: We collected surveys from 400 participants, including the general population (n = 220) and paramedical staff (n = 180). Participants were anonymous. The survey included 16 questions on the characteristics and preference for the surgical approach if a urologic MIS were performed on them.Results: The responders preferred the transumbilical approach (57.0%) to the subcostal approach (43.0%). In particular, the preference for a transumbilical approach was significantly higher in females (65.1% vs. 49.3%, p = 0.0014). Similarly, when participants were divided into two groups (<50 years and >50 years), the preference for the transumbilical approach was significantly higher in the younger group (60.8% vs. 48.0%, p = 0.0187). Logistic regression analysis revealed that preference for this approach was about 2 times more likely to rise in the females (p = 0.032).Conclusions: Preference for the transumbilical approach was significantly higher young female respondents. This patient subset most values the cosmetic benefits of transumbilical approach in urologic MIS.

scholarly journals The impact of surgeon-based ultrasonography for parathyroid disease on a British endocrine surgical practice

2012 ◽  
Vol 94 (1) ◽  
pp. 17-23 ◽  
Author(s):  
SR Aspinall ◽  
S Nicholson ◽  
RD Bliss ◽  
TWJ Lennard
Keyword(s):  
Minimally Invasive Surgery ◽  
Primary Hyperparathyroidism ◽  
Minimally Invasive ◽  
Negative Predictive Value ◽  
Invasive Surgery ◽  
Predictive Value ◽  
Surgical Practice ◽  
Parathyroid Disease ◽  
Operative Findings ◽  
The Impact

INTRODUCTION Surgeon-based ultrasonography (SUS) for parathyroid disease has not been widely adopted by British endocrine surgeons despite reports worldwide of accuracy in parathyroid localisation equivalent or superior to radiology-based ultrasonography (RUS). The aim of this study was to determine whether SUS might benefit parathyroid surgical practice in a British endocrine unit. METHODS Following an audit to establish the accuracy of RUS and technetium sestamibi (MIBI) in 54 patients, the accuracy of parathyroid localisation by SUS and RUS was compared prospectively with operative findings in 65 patients undergoing surgery for primary hyperparathyroidism (pHPT). RESULTS The sensitivity of RUS (40%) was below and MIBI (57%) was within the range of published results in the audit phase. The sensitivity (64%), negative predictive value (86%) and accuracy (86%) of SUS were significantly greater than RUS (37%, 77% and 78% respectively). SUS significantly increased the concordance of parathyroid localisation with MIBI (58% versus 32% with RUS). CONCLUSIONS SUS improves parathyroid localisation in a British endocrine surgical practice. It is a useful adjunct to parathyroid practice, particularly in centres without a dedicated parathyroid radiologist, and enables more patients with pHPT to benefit from minimally invasive surgery.

scholarly journals Initial CT blend sign is not associated with poor outcome in patients following stereotactic minimally invasive surgery

2021 ◽  
Author(s):  
Xu Yang ◽  
Yan Zhu ◽  
Linshan Zhang ◽  
Likun Wang ◽  
Yuanhong Mao ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Cardiac Complications ◽  
Control Group ◽  
Haematoma Expansion ◽  
Poor Outcomes ◽  
The Impact ◽  
The Relationship

Abstract Background: The initial computed tomography (CT) blend sign has been used as an imaging marker to predict haematoma expansion and poor outcomes in patients with a small volume intracerebral haemorrhage (ICH). However, the relationship between the blend sign and outcomes remains elusive. The present study aimed to retrospectively measure the impact of initial CT blend signs on short-term outcomes in patients with hypertensive ICH who underwent stereotactic minimally invasive surgery (sMIS). Methods: We enrolled 242 patients with spontaneous ICH. Based on the initial CT features, the patients were assigned to a blend sign group (91 patients) or a nonblend sign (control) group (151 patients). The NIHSS, GCS and mRS were used to measure the effects of sMIS. The rates of severe pulmonary infection and cardiac complications were also compared between the two groups. Results: No significant differences in NIHSS and GCS scores were observed between the two groups. The proportion of patients with good outcomes during follow-up was not different between the two groups. The rate of rehaemorrhaging increased in the blend sign group. No significant differences in severe pulmonary infections and cardiac complications were noted between the two groups. Conclusions: The initial CT blend sign was not associated with poor outcomes in patients with hypertensive ICH who underwent sMIS. ICH patients with CT blend signs should undergo sMIS if they are suitable candidates for surgery.

Impact of surgical approach on prevalence of positive peritoneal cytology and lymph-vascular invasion in patients with early-stage endometrial carcinoma: a National Cancer Database study

2021 ◽  
pp. ijgc-2021-002445
Author(s):  
Dimitrios Nasioudis ◽  
Emily M Ko ◽  
Lori Cory ◽  
Nawar Latif
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Endometrial Carcinoma ◽  
Invasive Surgery ◽  
Surgical Approach ◽  
Vascular Invasion ◽  
Early Stage ◽  
Tumor Grade ◽  
Peritoneal Cytology ◽  
Positive Peritoneal Cytology

ObjectiveTo investigate the prevalence of positive peritoneal cytology and lymph-vascular invasion by surgical approach among patients with early stage endometrioid endometrial carcinoma undergoing hysterectomy.MethodsThe National Cancer Database was accessed and patients with FIGO stage I endometrioid endometrial carcinoma (with no history of another tumor diagnosed) who underwent simple hysterectomy (open or minimally invasive) between January 2010 and December 2015 and had available data on the presence of lymph-vascular invasion and/or status of peritoneal cytology were selected for further analysis. The impact of a surgical approach on the odds of lymph-vascular invasion and positive peritoneal cytology was calculated after controlling for tumor grade, size, and depth of myometrial invasion.ResultsA total of 74 732 patients who met the inclusion criteria were identified. The rate of minimally invasive hysterectomy was 75.7%. Data on peritoneal cytology status and lymph-vascular invasion were available for 50 185 and 71 641 patients, respectively. A higher proportion of patients who had minimally invasive hysterectomy had positive peritoneal cytology (4.4% vs 2.3%, p<0.001), and presence of lymph-vascular invasion (10.4% vs 9.2%, p<0.001). After controlling for tumor size, tumor grade, and disease substage, the performance of minimally invasive surgery was associated with higher odds of positive peritoneal cytology (OR 2.08, 95% CI 1.83 to 2.37) and presence of lymph-vascular invasion (OR 1.33, 95% CI 1.25 to 1.41). After controlling for confounders there was no difference in survival between open and minimally invasive surgery groups (HR 0.93, 95% CI 0.85 to 1.004).ConclusionsMinimally invasive surgery may be associated with a higher incidence of positive peritoneal cytology and lymph-vascular invasion among patients with early stage endometrioid endometrial cancer. There was no difference in overall survival between patients who had laparotomy or minimally invasive surgery.

scholarly journals Quality and Safety of Minimally Invasive Surgery: Past, Present, and Future

2014 ◽  
Vol 6 ◽  
pp. BECB.S10967 ◽  
Author(s):  
Bernadette McCrory ◽  
Chad A. LaGrange ◽  
M.S. Hallbeck
Keyword(s):  
Minimally Invasive Surgery ◽  
Adverse Events ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Human Performance ◽  
Motor Vehicle ◽  
The United States ◽  
Quality And Safety ◽  
Surgical Errors ◽  
The Impact

Adverse events because of medical errors are a leading cause of death in the United States (US) exceeding the mortality rates of motor vehicle accidents, breast cancer, and AIDS. Improvements can and should be made to reduce the rates of preventable surgical errors because they account for nearly half of all adverse events within hospitals. Although minimally invasive surgery (MIS) has proven patient benefits such as reduced postoperative pain and hospital stay, its operative environment imposes substantial physical and cognitive strain on the surgeon increasing the risk of error. To mitigate errors and protect patients, a multidisciplinary approach is needed to improve MIS. Clinical human factors, and biomedical engineering principles and methodologies can be used to develop and assess laparoscopic surgery instrumentation, practices, and procedures. First, the foundational understanding and the imperative to transform health care into a high-quality and safe system is discussed. Next, a generalized perspective is presented on the impact of the design and redesign of surgical technologies and processes on human performance. Finally, the future of this field and the research needed to further improve the quality and safety of MIS is discussed.

scholarly journals Clinical and Operative Determinants of Acute Kidney Injury after Cardiac Surgery

2020 ◽  
Vol 10 (5) ◽  
pp. 340-352
Author(s):  
Faeq Husain-Syed ◽  
Maria Giovanna Quattrone ◽  
Fiorenza Ferrari ◽  
Pércia Bezerra ◽  
Salvador Lopez-Giacoman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Minimally Invasive Surgery ◽  
Cardiopulmonary Bypass ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Fluid Balance ◽  
Kidney Injury ◽  
Baseline Serum

Introduction: Cardiac surgery-associated acute kidney injury (CSA-AKI) is associated with increased morbidity and mortality. Objectives: We aimed to identify potentially modifiable risk factors for CSA-AKI. Methods: This was asingle-center retrospective cohort study of 495 adult patients undergoing cardiac surgery. AKI was diagnosed and staged using full KDIGO criteria incorporating baseline serum creatinine (SC) levels and correction of postoperative SC levels for fluid balance. We examined the association of routinely available clinical and laboratory data with AKI using multivariate logistic regression modeling. Results: A total of 103 (20.8%) patients developed AKI: 16 (15.5%) patients were diagnosed with AKI upon hospital admission, and 87 (84.5%) patients were diagnosed with CSA-AKI. Correction of SC levels for fluid balance increased the number of AKI cases to 104 (21.0%), with 6 patients categorized to different AKI stages. Univariate logistic regression analysis identified five preoperative (age, sex, diabetes mellitus, preoperative systolic pulmonary arterial pressure [PSPAP], acute decompensated heart failure) and five intraoperative predictors of AKI (age, sex, red blood cell [RBC] volume transfused, use of minimally invasive surgery, duration of cardiopulmonary bypass). When all preoperative and intraoperative variables were incorporated into one model, six predictors remained significant (age, sex, use of minimally invasive surgery, RBC volume transfused, PSPAP, duration of cardiopulmonary bypass). Model discrimination performance showed an area under the curve of 0.69 for the model including only preoperative variables, 0.76 for the model including only intraoperative variables, and 0.77 for the model including all preoperative and intraoperative variables. Conclusions: Use of minimally invasive surgery and therapies mitigating PSPAP and intraoperative blood loss may offer protection against CSA-AKI.

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