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Advanced laparoscopy

Sheng-Han Tsai, Chien-An Liu, Kuo-Hung Huang, Yuan-Tzu Lan, Ming-Huang Chen, Yee Chao, Su-Shun Lo, Anna Fen-Yau Li, Chew-Wun Wu, Shih-Hwa Chiou, Muh-Hwa Yang, Yi-Ming Shyr, Wen-Liang Fang
Robot-assisted gastrectomy has been reported to be a safe alternative to both conventional laparoscopy and the open approach for treating early gastric carcinoma. Currently, there are a limited number of published reports on this technique in the literature. We assessed the current status of robotic and laparoscopic surgery in the treatment of gastric cancer and compared the operative outcomes, learning curves, and oncological outcome of the two approaches. Robotic gastrectomy offers benefits that include increased ease of performing D2 lymph node dissection and reduced blood loss compared with laparoscopic gastrectomy...
October 17, 2016: Pathology Oncology Research: POR
Eden C Payabyab, Sanjeeve Balasubramaniam, Maureen Edgerly, Margarita Velarde, Maria J Merino, Aradhana M Venkatesan, Harshraj Leuva, Thomas Litman, Susan E Bates, Tito Fojo
The development of new therapies has lagged behind for rare cancers without defined therapeutic targets. Adrenocortical cancer is no exception. Mitotane, an older agent considered "adrenolytic," is used both to control symptoms in advanced disease and as adjuvant therapy after surgical resection. Molecular characterization of adrenocortical cancer has deepened our understanding of this genetically complex disease while identifying subgroups whose importance remains to be determined. Unfortunately, such studies have yet to demonstrate a therapeutic target for drug development, and to date, no targeted therapy has achieved meaningful outcomes...
October 15, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Pablo Achurra, Antonia Lagos, Ruben Avila, Rodrigo Tejos, Erwin Buckel, Juan Alvarado, Camilo Boza, Nicolas Jarufe, Julian Varas
Introduction Simulated laparoscopy training is limited by its low-quality image. A high-definition (HD) laparoscopic training box was developed under the present necessity of simulating advanced surgery. Objective To describe and test a new HD laparoscopic training box for advanced simulation training. Methods We describe the features and image quality of the new training box. The simulator was tested and then evaluated by a group of 76 expert surgeons using a 4-item questionnaire. To assess the effectiveness of training using this simulation box, 15 general surgery residents were trained to perform a laparoscopic jejuno-jejunostomy in a validated simulation program...
October 10, 2016: Surgical Innovation
A L P Nunes, A Maciel, L T Cavazzola, M Walter
While improved visual realism is known to enhance training effectiveness in virtual surgery simulators, the advances on realistic rendering for these simulators is slower than similar simulations for man-made scenes. One of the main reasons for this is that in vivo data is hard to gather and process. In this paper, we propose the analysis of videolaparoscopy data to compute the Bidirectional Reflectance Distribution Function (BRDF) of living organs as an input to physically based rendering algorithms. From the interplay between light and organic matter recorded in video images, we propose the definition of a process capable of establishing the BRDF for inside-the-body organic surfaces...
September 29, 2016: Medical Image Analysis
Patrick B Murphy, Kerollos Wanis, Christopher M Schlachta, Nawar A Alkhamesi
: INTRODUCTION; Surgical management of external rectal prolapse (ERP) remains a challenge with the breadth of choices available and varies on the international, national, regional and locoregional level. Significant innovation has led to new techniques to manage ERP including changes to both abdominal and perineal approaches. EVIDENCE ACQUISITION; A systematic, English-language search of major databases was conducted from 2006-2016. From 636 papers two reviewers identified 24 studies which compared two or more surgical techniques in adult patients with rectal prolapse and reported on complications, quality of life or recurrence...
October 6, 2016: Minerva Chirurgica
Eugen Zizer, Johanna Backhus, Stephan Bohl, Anette Braun, Irina Baturina, Dietmar Klass, Nektarios Dikopoulos, Thomas Seufferlein, Matthias Dollinger
BACKGROUND/AIM: The assessment of advanced chronic liver disease (ACLD) is a prerequisite for therapy and surveillance in patients with chronic hepatitis C infection. Mini-laparoscopy-assisted liver biopsies facilitate both histological and macroscopical evaluation of liver fibrosis. This study is aimed at investigating the prognostic significance of the laparoscopic assessment for the cumulative incidence of ACLD-related events. PATIENTS AND METHODS: We performed a single center, retrospective analysis of 94 patients with either macroscopically or/and microscopically assessed advanced fibrosis/cirrhosis caused by chronic hepatitis C infection...
October 6, 2016: Digestion
Marta Penna, Nicolas C Buchs, Alexander L Bloemendaal, Roel Hompes
The surgical approach to total mesorectal excision (TME) for rectal cancer has undergone a substantial evolution with the adoption of more minimally invasive procedures. Transanal TME (taTME) is the latest advanced technique pioneered to tackle difficult pelvic dissections. Areas covered: The evolution of TME surgery from open to laparoscopic, robotic and transanal techniques was explored in this review. The outcomes to date on the latest approach, taTME, are reviewed and the future direction of rectal cancer surgery proposed...
October 3, 2016: Expert Review of Anticancer Therapy
J X Lin, C M Huang, C H Zheng, P Li, J W Xie, J B Wang, J Lu, Q Y Chen, L L Cao, M Lin
Objective: To investigate the surgical outcomes after the laparoscopy-assisted distal gastrectomy (LADG) for patients with advanced gastric cancer. Methods: The data of 213 patients who underwent LADG and 213 treated by open distal gastrectomy (ODG) were selected using the propensity score matching method from a prospectively constructed database of 641 patients who underwent radical distal gastrectomy between January 2005 and June 2012 in Department of Gastric Surgery, Fujian Medical University Union Hospital...
October 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Yi Lu, Baocheng Jiang, Tao Liu
PURPOSE: Laparoscopic total gastrectomy for advanced proximal gastric carcinoma is a complex and challenging procedure, limited to a few expert centers. This study analyzed the short- and long-term outcomes of laparoscopic total gastrectomy for advanced proximal gastric carcinoma compared with open gastrectomy. METHODS: From January 2008 to January 2015, 61 patients underwent laparoscopic total gastrectomy for advanced proximal gastric carcinoma. They were matched and compared to 61 patients who underwent a conventional open operation...
July 2016: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Lars Nelson, Rena C Moon, Andre F Teixeira, Manoel Galvão, Almino Ramos, Muhammad A Jawad
Background: Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was introduced into bariatric surgery by Sanchez-Pernaute et al. as an advancement of the biliopancreatic diversion with duodenal switch. Aim: To evaluate the SADI-S procedure with regard to weight loss, comorbidity resolution, and complication rate in the super obese population. Methods: A retrospective chart review was performed on initial 72 patients who underwent laparoscopic or robot-assisted laparoscopic SADI-S between December 17th, 2013 and July 29th, 2015...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Victor E Corona Montes, Antonio L Pastore, Louis Gausa, Oscar Rodríguez-Faba, Alberto Breda, Joan Palou
BACKGROUND: Today, access to technology through robotic surgery has allowed urologists to have a valuable tool in order to perform various robot - assisted laparoscopic procedures. Robotic surgery allows reproducing complex techniques such as retroperitoneal or extended pelvic lymphadenectomy. The aim of the study was to report our series of robot assisted retroperitoneal lymphadenectomy and to demonstrate its technical and oncological feasibility. METHODS: A retrospective analysis on 7 patients (four cases of testicular tumors, one prostate adenocarcinoma, and two bladder urothelial carcinomas), who underwent retroperitoneal para-aortic, interaorto-cava and extended pelvic lymphadenectomy by robot assisted laparoscopic surgery, was conducted...
September 28, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Ramy Girshally, Cedric Demtröder, Nurettin Albayrak, Jürgen Zieren, Clemens Tempfer, Marc A Reymond
BACKGROUND: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a novel drug delivery system able to induce regression of peritoneal metastasis (PM) in the salvage situation. The aim of this study was to determine the clinical characteristics, tumor histology, and extent of disease of the patients having undergone cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) after "neoadjuvant" PIPAC. METHODS: This study was performed at a single institution, tertiary center...
September 27, 2016: World Journal of Surgical Oncology
N Katic, G Dupré
Although endoscopic surgery entered its "golden era" in the mid-1980s, it is still advancing at a tremendous pace. Novel surgical techniques and devices are continuously developed and applied, and new indications (and/or contraindications) for the use of endoscopic surgery are routinely reported in the literature and subjected to systematic assessments. Although endoscopic surgery (laparoscopy in particular) has already become established as the gold standard in human medicine, it has yet to be proven as a viable alternative to open surgery in the field of veterinary medicine...
September 2016: Reproduction in Domestic Animals, Zuchthygiene
Sung Yoon Lim, Joon Yong Lee, Ji Hyun Yang, Young Joo Na, Myung-Gyu Kim, Sang-Kyung Jo, Won Yong Cho
BACKGROUND: Despite major advance in surgical techniques from open surgery to robot-assisted surgery, acute kidney injury (AKI) is still major postoperative complication in rectal surgery. The purpose of this study is to compare the incidence of postoperative AKI according to different surgical techniques and also the risk factors, outcomes of AKI in patients undergoing rectal cancer surgery. METHODS: A retrospective medical chart review was done in a total of 288 patients who received proctectomy because of rectal cancer from 2011 to 2013...
September 2016: Kidney Research and Clinical Practice
Yudai Fukui, Junichi Shindoh, Shuichiro Matoba, Kenji Tomizawa, Yutaka Hanaoka, Shigeo Toda, Jin Moriyama, Hiroya Kuroyanagi
A 53-year-old man was readmitted with abdominal distention 2 weeks after undergoing laparoscopic low anterior resection with para-aortic lymphadenectomy for advanced rectal cancer (T4aN1M0, Stage IIIb). Ultrasound revealed massive ascites, and paracentesis revealed chylous fluid with a markedly elevated triglyceride level (1762 mg/dL). Despite conservative management, the fistula remained on postoperative day 120. On percutaneous lymphangiography, the chylous leakage point was clearly visualized at the para-aortic site, and surgical intervention was planned...
September 26, 2016: Asian Journal of Endoscopic Surgery
A Venara, M Neunlist, K Slim, J Barbieux, P A Colas, A Hamy, G Meurette
Postoperative ileus (POI) is a major focus of concern for surgeons because it increases duration of hospitalization, cost of care, and postoperative morbidity. The definition of POI is relatively consensual albeit with a variable definition of interval to resolution ranging from 2 to 7 days for different authors. This variation, however, leads to non-reproducibility of studies and difficulties in interpreting the results. Certain risk factors for POI, such as male gender, advanced age and major blood loss, have been repeatedly described in the literature...
September 22, 2016: Journal of Visceral Surgery
Nicola Di Lorenzo, Livia Cenci, Massimiliano Simi, Claudio Arcudi, Valeria Tognoni, Achille Lucio Gaspari, Pietro Valdastri
BACKGROUND: Minimally invasive surgery (MIS) is rising in popularity generating a revolution in operative medicine during the past few decades. Although laparoscopic techniques have not significantly changed in the last 10 years, several advances have been made in visualization devices and instrumentation. METHODS: Our team, composed of surgeons and biomedical engineers, developed a magnetic levitation camera (MLC) with a magnetic internal mechanism dedicated to MIS...
September 22, 2016: Surgical Endoscopy
Yunhong Tian, Lei Liu, Ninad V Yeolkar, Feng Shen, Jun Li, Zhenxing He
BACKGROUND: Accurate preoperative radiological staging of biliary cancers remains difficult. Despite the improvement in imaging techniques, a number of patients with biliary cancers who undergo laparotomy are ultimately found to have unresectable diseases. The goals of staging laparoscopy (SL) are to rule out metastatic and locally advanced unresectable diseases and better define locally advanced unresectable diseases. This study evaluates the efficiency of SL in ruling out unresectable disease in a subset of biliary cancers...
September 20, 2016: ANZ Journal of Surgery
Jack S Elder
Undescended testis (UDT) is the most common disorder of sexual development in boys and affects 3.5% of male newborns. Although approximately half of newborn UDTs descend spontaneously, some boys develop an ascending testis later in childhood. Recent guideline recommendations advocate orchiopexy by 18 months of age to maximize potential for fertility and perhaps reduce the risk for testicular carcinoma in the future. For palpable testes, a standard inguinal approach is appropriate. However, the prescrotal approach is often effective for low inguinal testes and reduces surgical time and patient discomfort with an equivalent success rate in boys with an ascending testis...
October 2016: European Journal of Pediatric Surgery
Lin-Yong Zhao, Wei-Han Zhang, Yan Sun, Xin-Zu Chen, Kun Yang, Kai Liu, Xiao-Long Chen, Yi-Gao Wang, Xiao-Hai Song, Lian Xue, Zong-Guang Zhou, Jian-Kun Hu
Laparoscopy-assisted distal gastrectomy (LADG) is widely used for gastric cancer (GC) patients nowadays. This study aimed to investigate the time trend of outcomes so as to describe the learning curve for GC patients with LADG at a single medical institution in western China over a 6-year period.A total of 246 consecutive GC patients with LADG were divided into 5 groups (group A: 46 patients from 2006 to 2007; group B: 47 patients in 2008; group C: 49 patients in 2009; group D: 73 patients in 2010; and group E: 31 patients in 2011)...
September 2016: Medicine (Baltimore)
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