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Surgical Innovation

Hiroaki Matsumoto, Hiroaki Minami, Hiroaki Hanayama, Yasuhisa Yoshida
AIM: Endoscopic surgery for acute subdural hematoma (ASDH) has recently been performed in elderly patients. Unlike other reported procedures, we used the endoscope's fixation device to ensure hemostasis because the surgeon can then use a surgical instrument with each hand. To date, there have no reports that prove lesser invasiveness or noninferiority of endoscopic surgery based on direct comparison with a large craniotomy. In this study, we investigated whether our endoscopic procedure was effective and safe...
July 1, 2018: Surgical Innovation
Wen-Song Liu, Yong Jiang, Dong Zhang, Long-Qing Shi, Dong-Lin Sun
PURPOSE: Laparoscopic common bile duct exploration (LCBDE) has been widely used to remove common bile duct (CBD) stones. However, surgery is not considered as the first treatment choice for elderly patients with CBD stones because of the potential risk of postoperative complications. This study aims to evaluate the safety and efficiency of LCBDE for elderly patients. METHODS: From April 2011 to October 2016, 265 consecutive patients underwent LCBDE. We performed a retrospective study and divided these patients into 2 groups...
July 1, 2018: Surgical Innovation
Auriane De Neef, Guy-Bernard Cadière, Pierre Bourgeois, Romain Barbieux, Giovanni Dapri, Maxime Fastrez
BACKGROUND: The standard treatment of rectovaginal deep infiltrating endometriosis nodules (RVDIEN) consists in their surgical removal. RVDIEN are anatomically neovascularized. Indocyanine green (ICG) reveals vascularized structures when becoming fluorescent after exposure to near-infrared (NIR) light. This study aims to evaluate if fluorescence-guided surgery can improve the laparoscopic resection of RVDIEN, thus avoiding a rectal perforation. MATERIALS AND METHODS: Patients with a symptomatic RVDIEN, scheduled for a laparoscopic rectal shaving, were enrolled in the study...
July 1, 2018: Surgical Innovation
Daisuke Taniguchi, Keitaro Matsumoto, Yoshihiro Kondo, Koichiro Shimoyama, Yasumasa Hashimoto, Abdelmotagaly Elgalad, Tomohiro Obata, Takuro Miyazaki, Tomoshi Tsuchiya, Naoto Matsuo, Murray John Lawn, Naoya Yamasaki, Ikuo Yamamoto, Takeshi Nagayasu
OBJECTIVES: In recent years, video-assisted thoracoscopic surgery (VATS) has increasingly become the preferred technique for thoracic surgery. However, the inherent characteristics of the lungs as large, soft, slippery, and delicate creates difficulties for pulmonary surgery. In this article, we outline the development and assessment of a balloon-based organ retractor for VATS via collaboration between medical and engineering personnel. METHODS: A dry lab trial and accompanying questionnaire assessment were performed by a group of thoracic surgeons...
June 1, 2018: Surgical Innovation
Nava Aghdasi, Mark Whipple, Ian M Humphreys, Kris S Moe, Blake Hannaford, Randall A Bly
Successful multidisciplinary treatment of skull base pathology requires precise preoperative planning. Current surgical approach (pathway) selection for these complex procedures depends on an individual surgeon's experiences and background training. Because of anatomical variation in both normal tissue and pathology (eg, tumor), a successful surgical pathway used on one patient is not necessarily the best approach on another patient. The question is how to define and obtain optimized patient-specific surgical approach pathways? In this article, we demonstrate that the surgeon's knowledge and decision making in preoperative planning can be modeled by a multiobjective cost function in a retrospective analysis of actual complex skull base cases...
June 1, 2018: Surgical Innovation
Jason M Ali, Kyle Lam, Aman S Coonar
INTRODUCTION: Minimally invasive techniques have become the standard for a variety of procedures across all surgical specialties. There has been a recent move to integrate robotic technology into standard laparoscopic and thoracoscopic surgery with the aim of improving stability of the visual field with the use of robotic camera assistance. The aim of this study was to report on and examine the use of a headset-controlled robotic camera holder, FreeHand. METHODS: Between May 2013 and Dec 2016, 105 procedures were observed where the FreeHand robotic camera assistant was used...
June 1, 2018: Surgical Innovation
Yanxiong Chen, Haofeng Zheng, Zhijun Zang, Xiaobin Hong, Weizhong Cai, Youqiang Fang
OBJECTIVES: To assess the feasibility and utility of a newly developed wireless portable ultrasound "UProbe- 2" for puncture guidance in percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: The UProbe-2 consists of a probe with integrated ultrasound circuit boards inside, an intelligent terminal that installed specific ultrasound software, and a puncture trestle. The probe can connect to an intelligent terminal via WI-FI. It was used to guide puncture in PCNL in 31 patients who suffered kidney stones or large impacted proximal upper ureteral stones with hydronephrosis from June 2016 to July 2017...
June 1, 2018: Surgical Innovation
Valérie N E Schuermans, Ziyu Li, Audrey C H M Jongen, Zhouqiao Wu, Jinyao Shi, Jiafu Ji, Nicole D Bouvy
The aim of this pilot study is to investigate the ability of an electronic nose (e-nose) to distinguish malignant gastric histology from healthy controls in exhaled breath. In a period of 3 weeks, all preoperative gastric carcinoma (GC) patients (n = 16) in the Beijing Oncology Hospital were asked to participate in the study. The control group (n = 28) consisted of family members screened by endoscopy and healthy volunteers. The e-nose consists of 3 sensors with which volatile organic compounds in the exhaled air react...
June 1, 2018: Surgical Innovation
Konstantinos Laios
Professor William Wayne Babcock (1872-1963) is considered as a leading figure of American surgery during early 20th century. He introduced many innovative surgical techniques such as Babcock operation for the treatment of varicose veins, the Babcock-Bacon operation for the treatment of cancer of the rectum and sigmoid colon preserving anal sphincters, the "soup bone" cranioplasty technique, and the nerve disassociation technique for the relief of certain forms of paralysis or parasthesia due to injury or inflammation...
June 1, 2018: Surgical Innovation
Rebecca Zener, Lee L Swanström, Eran Shlomovitz
OBJECTIVE: To assess the prevalence of patients whose anatomy would be potentially amenable to percutaneous cholecystoenteric lumen-apposing metallic stents (LAMS) insertion from a population of acute cholecystitis patients. METHODS: Contrast-enhanced abdominal computed tomography images in 100 consecutive adult patients with acute cholecystitis were reviewed retrospectively. Feasibility of LAMS placement percutaneously or with endoscopic ultrasound guidance was defined as the presence of a straight and unobstructed trajectory from the skin to the gallbladder, and between the gallbladder and the gastric antrum, or the proximal duodenum, measuring ≤2 cm, respectively...
June 1, 2018: Surgical Innovation
Tao Shen, Dietric Hennings, Carl A Nelson, Dmitry Oleynikov
Natural orifice transluminal endoscopic surgery (NOTES) has gained attention as a revolutionary technique with its potential advantages in eliminating skin incisions, shortening recovery time, and decreasing postoperative complications; however, its practical application is still constrained by the complexity of navigation through the surgical field and paucity of available instruments. Current progress on NOTES focuses on designing flexible articulated robots or fully inserted bimanual robots to address the limitations...
June 1, 2018: Surgical Innovation
Rui Tang, Longfei Ma, Ang Li, Lihan Yu, Zhixia Rong, Xinjing Zhang, Canhong Xiang, Hongen Liao, Jiahong Dong
BACKGROUND: We applied augmented reality (AR) techniques to flexible choledochoscopy examinations. METHODS: Enhanced computed tomography data of a patient with intrahepatic and extrahepatic biliary duct dilatation were collected to generate a hollow, 3-dimensional (3D) model of the biliary tree by 3D printing. The 3D printed model was placed in an opaque box. An electromagnetic (EM) sensor was internally installed in the choledochoscope instrument channel for tracking its movements through the passages of the 3D printed model, and an AR navigation platform was built using image overlay display...
June 1, 2018: Surgical Innovation
F Borja de Lacy, Sami A Chadi, Mariana Berho, Richard J Heald, Jim Khan, Brendan Moran, Yves Panis, Rodrigo Perez, Paris Tekkis, Neil J Mortensen, Antonio M Lacy, Steven D Wexner, Manish Chand
Surgery remains the mainstay of curative treatment for primary rectal cancer. For mid and low rectal tumors, optimal oncologic surgery requires total mesorectal excision (TME) to ensure the tumor and locoregional lymph nodes are removed. Adequacy of surgery is directly linked to survival outcomes and, in particular, local recurrence. From a technical perspective, the more distal the tumor, the more challenging the surgery and consequently, the risk for oncologically incomplete surgery is higher. TME can be performed by an open, laparoscopic, robotic or transanal approach...
June 1, 2018: Surgical Innovation
Antonino Granata, Marco Bisello, Fabio Cipolletta, Dario Ligresti, Mario Traina
No abstract text is available yet for this article.
June 1, 2018: Surgical Innovation
Shouyi Yan, Wenxin Zhao, Bo Wang, Liyong Zhang
OBJECTIVE: The study aims to evaluate the clinic feasibility of rapid parathyroid hormone (PTH) detection and nano-carbon technology in preoperative diagnosis and localization of parathyroid adenoma. METHODS: With the guidance of ultrasound, the operator performed the parathyroid puncture and tested the PTH value by using a PTH test kit, and then injected nano-carbon into parathyroid adenoma as a marker to observe whether the parathyroid adenoma was stained black during the final operation...
June 1, 2018: Surgical Innovation
Gustavo A Alonso-Silverio, Fernando Pérez-Escamirosa, Raúl Bruno-Sanchez, José L Ortiz-Simon, Roberto Muñoz-Guerrero, Arturo Minor-Martinez, Antonio Alarcón-Paredes
BACKGROUND: A trainer for online laparoscopic surgical skills assessment based on the performance of experts and nonexperts is presented. The system uses computer vision, augmented reality, and artificial intelligence algorithms, implemented into a Raspberry Pi board with Python programming language. METHODS: Two training tasks were evaluated by the laparoscopic system: transferring and pattern cutting. Computer vision libraries were used to obtain the number of transferred points and simulated pattern cutting trace by means of tracking of the laparoscopic instrument...
May 1, 2018: Surgical Innovation
Raghu Prasad, Manivannan Muniyandi, Govindan Manoharan, Servarayan M Chandramohan
BACKGROUND: The purpose of this study was to examine the face and construct validity of a custom-developed bimanual laparoscopic force-skills trainer with haptics feedback. The study also examined the effect of handedness on fundamental and complex tasks. METHODS: Residents (n = 25) and surgeons (n = 25) performed virtual reality-based bimanual fundamental and complex tasks. Tool-tissue reaction forces were summed, recorded, and analysed. Seven different force-based measures and a 1-time measure were used as metrics...
May 1, 2018: Surgical Innovation
Zachary Sanford, Adam S Weltz, Jermaine Brown Ba, Nicole Shockcor, Nan Wu, Adrian E Park
Anteromedial subcostosternal defects, also known as a diaphragmatic hernia of Morgagni (MH), allow potentially life-threatening herniation of the abdominal organs into the thorax. Constituting only a small fraction of all types of congenital diaphragmatic hernias, correct diagnosis of MH is often delayed, owing in large part to nonspecific associated respiratory and gastrointestinal complaints. Once identified, the primary management for both symptomatic and incidentally discovered asymptomatic cases of MH are surgical correction because the herniated contents present increasing risk for strangulation...
May 1, 2018: Surgical Innovation
Konstantinos Markatos, Georgios Karaoglanis, Christos Damaskos, Nikolaos Garmpis, Gerasimos Tsourouflis, Konstantinos Laios, Gregory Tsoucalas
The purpose of this article is to summarize the work and pioneering achievements in the field of orthopedic surgery of the German orthopedic surgeon Karl Ludloff. Ludloff had an impact in the diagnostics, physical examination, orthopedic imaging, and orthopedic surgical technique of his era. He was a pioneer in the surgical treatment of dysplastic hip, anterior cruciate ligament reconstruction, and hallux valgus. His surgical technique for the correction of hallux valgus, initially stabilized with plaster of Paris, remained unpopular among other orthopedic surgeons for decades...
May 1, 2018: Surgical Innovation
Gabriela Batista Rodríguez, Andrea Balla, Sonia Fernández-Ananín, Carmen Balagué, Eduard M Targarona
BACKGROUND: The term big data refers to databases that include large amounts of information used in various areas of knowledge. Currently, there are large databases that allow the evaluation of postoperative evolution, such as the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS), and the National Cancer Database (NCDB). The aim of this review was to evaluate the clinical impact of information obtained from these registries regarding gastroesophageal surgery...
May 1, 2018: Surgical Innovation
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