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Minimally invasive

Jesse C Selber
Over the past 10 years, robotic technology has had a significant impact on minimally invasive surgery. Because plastic surgery is rooted in "open" techniques, robotic applications in the specialty have been slow to emerge. That said, robotic technology possesses superhuman precision and high-definition, three-dimensional optics that are promising attributes in the hands of the plastic surgeon. In this article, the author explores three applications in robotic plastic surgery: (1) transoral robotic reconstructive surgery for head and neck reconstruction, permitting complex oropharyngeal reconstruction without dividing the lip or mandible; (2) robotic muscle harvest, permitting minimally invasive harvest of the latissimus dorsi and rectus abdominis muscle; and (3) robotic microanastomoses, extending the capabilities of the human hand in microvascular and microlymphatic surgery...
March 2017: Plastic and Reconstructive Surgery
Daniel D Bohl, Ankur S Narain, Fady Y Hijji, Junyoung Ahn, Benjamin C Mayo, Dustin H Massel, William W Long, Krishna D Modi, Kern Singh
STUDY DESIGN/SETTING: This is a retrospective analysis of a prospectively maintained surgical registry. OBJECTIVE: To characterize postoperative narcotic consumption in patients undergoing either an anterior lumbar interbody fusion (ALIF) or a lateral lumbar interbody fusion (LLIF). BACKGROUND CONTEXT: There is substantial interest in evaluating the safety, efficacy, and outcomes following minimally invasive techniques for lumbar fusion procedures...
February 23, 2017: Clinical Spine Surgery
Ivo Peto, Christian Scheiwe, Evangelos Kogias, Ulrich Hubbe
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Assessment of outcome after minimally invasive posterior cervical foraminotomy (MI-PCF). SUMMARY OF BACKGROUND DATA: Surgical management of cervical radiculopathy represents a controversial area in spinal surgery. Preferred approaches include both anterior cervical discectomy and posterior cervical foraminotomy (PCF). Numerous studies showed comparable results. Employing PCF eliminates risks associated with anterior approach...
February 23, 2017: Clinical Spine Surgery
Katie L Losenno, Philip M Jones, Matthew Valdis, Stephanie A Fox, Bob Kiaii, Michael W A Chu
BACKGROUND: Reoperative mitral valve (MV) surgery is associated with significant morbidity and mortality; however, endoscopic minimally invasive surgical techniques may preserve the surgical benefits of conventional mitral operations while potentially reducing perioperative risk and length of stay (LOS) in hospital. METHODS: We compared the outcomes of consecutive patients who underwent reoperative MV surgery between 2000 and 2014 using a minimally invasive endoscopic approach (MINI) with those of patients who underwent a conventional sternotomy (STERN)...
December 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
C L Wilde, S G Naylor, Z Varga, A Morrell, J L Ball
PurposeTo evaluate the safety and efficacy of implanted Kerarings in patients with mild, moderate, and severe keratoconus.Patients and methodsA 12-month retrospective case series of 70 eyes of 70 patients who underwent Keraring implantation with the Zeiss Visumax femtosecond laser. Patients were stratified into three groups according to their topography as mild (mean K <48 D) moderate (48-55 D) or severe (>55 D). Main outcome measures were visual acuity, manifest refraction, and corneal topography...
February 24, 2017: Eye
Ivy N Haskins, Jeremy Holzmacher, Vincent Obias, Samir Agarwal
Transanal hemorrhoidal dearterialization (THD) is a relatively new, minimally invasive approach for the treatment of hemorrhoid disease. Despite increasing use of this procedure, there remains scarce United States-based data on the perioperative variables affected by this surgical technique. This article details the experience with THD at a single institution. This is a single-institution study that includes consecutive patients that underwent THD at George Washington University from November 2011 to April 2014...
December 1, 2016: American Surgeon
Ik Yong Kim, Bo Ra Kim, Young Wan Kim
To evaluate the influence of timing of open conversion on short-term and oncologic outcomes after minimally invasive surgery for colorectal cancer. Six hundred forty-six consecutive patients were enrolled. All patients converted to open surgery were classified into early (n = 10) or late (n = 67) groups based on conversion timing using a 60-minute cutoff. A comparison of early conversion and nonconverted groups showed that history of prior abdominal surgery and pT4 tumor was more common in the early conversion group...
January 1, 2017: American Surgeon
Marco Oderda, Sergio Lacquaniti, Flavio Fraire, Jacopo Antolini, Marco Camilli, Roberto Mandras, Luca Puccetti, Francesco Varvello, Giuseppe Fasolis
OBJECTIVE: The aim of this study was to present a novel approach for complete and permanent ureteral occlusion using a percutaneous injection of Ifabond cyanoacrylate glue. METHODS: We describe in detail all the steps of our surgery, performed on a 79-year-old patient with urinary leakage from ureteral stump following radical cystectomy. N-hexyl-cyanoacrylate glue (Ifabond) was used to occlude the distal ureter and solve the leakage. RESULTS: Our approach was successful, sparing our already frail patient further surgical procedures...
February 22, 2017: Urologia
Jichun Li, Hongbin Liu, Matthew Brown, Pardeep Kumar, Benjamin J Challacombe, Ashish Chandra, Giles Rottenberg, Lakmal D Seneviratne, Kaspar Althoefer, Prokar Dasgupta
Rolling mechanical imaging (RMI) is a novel technique towards the detection and quantification of malignant tissue in locations that are inaccessible to palpation during robotic minimally invasive surgery (MIS); the approach is shown to achieve results of higher precision than is possible using the human hand. Using a passive robotic manipulator, a lightweight and force sensitive wheeled probe is driven across the surface of tissue samples to collect continuous measurements of wheel-tissue dynamics. A color-coded map is then generated to visualize the stiffness distribution within the internal tissue structure...
February 20, 2017: Medical Engineering & Physics
Sylwester Fabian, Dominik Spinczyk
Precise positioning of the target point during minimally invasive procedures is a major challenge associated with the use of image-based navigation systems. No significant dependence between fiducial registration error (FRE) and target registration error (TRE) was found. However, this investigation demonstrated the utility of using thin plate splines (TPS) and marker observation to monitor FRE during respiration to estimate target position based on the deformation field for minimally invasive procedures in deformable regions...
February 8, 2017: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
Jason E Michaud, Ardavan Akhavan
PURPOSE OF REVIEW: Ureteral duplication and ectopic upper pole ureters are commonly associated with renal pathology, including vesicoureteral reflux, obstruction, infection, and renal function loss. There remains no consensus on the most appropriate management of these complex patients. In this review, we sought to compare existing data on upper pole heminephrectomy with ipsilateral ureteroureterostomy. RECENT FINDINGS: Application of magnetic resonance imaging and minimally invasive techniques have led to changes in the diagnosis and treatment of ectopic upper pole ureters...
March 2017: Current Urology Reports
Helen N Schwerdt, Min Jung Kim, Satoko Amemori, Daigo Homma, Tomoko Yoshida, Hideki Shimazu, Harshita Yerramreddy, Ekin Karasan, Robert Langer, Ann M Graybiel, Michael J Cima
Dysregulation of neurochemicals, in particular, dopamine, is epitomized in numerous debilitating disorders that impair normal movement and mood aspects of our everyday behavior. Neurochemical transmission is a neuron-specific process, and further exhibits region-specific signaling in the brain. Tools are needed to monitor the heterogeneous spatiotemporal dynamics of dopamine neurotransmission without compromising the physiological processes of the neuronal environment. We developed neurochemical probes that are ten times smaller than any existing dopamine sensor, based on the size of the entire implanted shaft and its sensing tip...
February 24, 2017: Lab on a Chip
Roberta Rehder, Alan R Cohen
BACKGROUND: Refinements in optics and instrumentation have enabled surgeons to approach deep-seated intracranial pathologies with reduced exposure and brain retraction. The anterior subtemporal keyhole approach is a minimally invasive route to the posterolateral aspect of the suprasellar area and petroclival region. OBJECTIVE: In this cadaveric study, we demonstrate the benefits of endoscope-assisted microsurgical techniques in the anterior subtemporal keyhole approach...
February 20, 2017: World Neurosurgery
Kojo R Rawish, Mohamed M Desouki, Oluwole Fadare
The 2014 World Health Organization classification calls for endometrial mucinous proliferations that display "confluent or cribriform architecture with even minimal atypia" in sampling specimens to be classified as carcinoma, and others whose features are not diagnostic of carcinoma to be categorized as atypical mucinous glandular proliferations (AMGP). Herein, we evaluate follow-up findings in 41 cases that were classified as AMGP from our files. The average patient age was 46years (range 37-59). Post-biopsy follow-up duration ranged from 15-109weeks (mean 40)...
February 20, 2017: Human Pathology
Paul A Brunton, Amna Ghazali, Zahidah H Tarif, Carolina Loch, Christopher Lynch, Nairn Wilson, Igor R Blum
OBJECTIVES: To evaluate the teaching and operative techniques for the repair and/or replacement of direct resin-based composite restorations (DCRs) in dental schools in Oceania. METHODS: A 14-item questionnaire was mailed to the heads of operative dentistry in 16 dental schools in Oceania (Australia, New Zealand, Fiji and Papua New Guinea). The survey asked whether the repair of DCRs was taught within the curriculum; the rationale behind the teaching; how techniques were taught, indications for repair, operative techniques, materials used, patient acceptability, expected longevity and recall systems...
February 20, 2017: Journal of Dentistry
A Lorenzo-Almorós, J Tuñón, M Orejas, M Cortés, J Egido, Ó Lorenzo
Diabetic cardiomyopathy (DCM) is a cardiac dysfunction which affects approximately 12% of diabetic patients, leading to overt heart failure and death. However, there is not an efficient and specific methodology for DCM diagnosis, possibly because molecular mechanisms are not fully elucidated, and it remains asymptomatic for many years. Also, DCM frequently coexists with other comorbidities such as hypertension, obesity, dyslipidemia, and vasculopathies. Thus, human DCM is not specifically identified after heart failure is established...
February 23, 2017: Cardiovascular Diabetology
Bogdan Silviu Ungureanu, Ştefan Pătraşcu, Valeriu Şurlin, Adrian Săftoiu
BACKGROUND: Obesity treatment options are of great interest worldwide with major developments in the past 20 years. From general surgery to natural orifice transluminal endoscopic surgery intervention nowadays, obesity surgical therapies have surely developed and are now offering a variety of possibilities. AREAS OF UNCERTAINTY: Although surgery is the only proven approach for weight loss, a joint decision between the physician and patient is required before proceeding to such a procedure...
February 3, 2017: American Journal of Therapeutics
Yu Bai, Yi Zhou, Xi Hua Lu
OBJECTIVE: The aim of this study was to observe the efficacy and safety of single-lumen tracheal ventilation for esophageal cancer surgery. METHODS: Thirty-eight patients with esophageal carcinoma who prepared for minimally invasive esophagectomy were included in this study. All of the included 38 patients were received single-lumen tracheal ventilation. The arterial blood gas index was monitored through the operation procedure and recorded at four-time points: before induction (T0), at the end of chest operation (T1), at the end of the abdominal operation (T2), and 30 min after extubation (T3)...
December 2016: Journal of Cancer Research and Therapeutics
Bin Li, Zhiwei Wang, Kang Zhou, Qinzong Gao, Xiaoguang Li
CONTEXT: Minimally invasive interventional therapy is now the more effective treatment strategy for organ-confined malignancy in patients who are poor candidates for surgery. Microwave ablation (MWA) in lung malignancy has been receiving much attention as an effective minimally invasive approach. AIMS: The aim of this study is to evaluate the safety and feasibility within 24 h of discharge of patients treated with percutaneous MWA for inoperable malignant lung nodules, and elucidate the factors predisposing to hospital readmission...
December 2016: Journal of Cancer Research and Therapeutics
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