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Liver training surgery

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https://www.readbyqxmd.com/read/29164509/evolution-and-standardisation-of-techniques-in-single-incision-laparoscopic-bariatric-surgery
#1
P Praveen Raj, Siddhartha Bhattacharya, R Parthasarathi, P Senthilnathan, S Rajapandian, S Saravana Kumar, C Palanivelu
Bariatric surgery has proven benefits for morbid obesity and its associated comorbidities. Laparoscopic approach is well established for bariatric surgery. Single-incision laparoscopic surgery (SILS) offers even more minimally invasive approach for the same with the added advantage of better cosmesis. We have developed and standardised the SILS approach at our institute. We share our experience and technical "tips" and modifications which we have learnt over the years. Technical details of performing sleeve gastrectomy and Roux-en-Y gastric bypass with special attention to liver retraction, techniques of dissection in difficult areas, creation of anastomoses and suturing have all been described...
November 21, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29150779/perioperative-transesophageal-echocardiography-for-non-cardiac-surgery
#2
REVIEW
Ashraf Fayad, Sasha K Shillcutt
PURPOSE: The use of transesophageal echocardiography (TEE) has evolved to include patients undergoing high-risk non-cardiac procedures and patients with significant cardiac disease undergoing non-cardiac surgery. Implementation of basic TEE education in training programs has increased across a broad spectrum of procedures in the perioperative arena. This paper describes the use of perioperative TEE in non-cardiac surgery and provides an overview of the basic TEE examination. PRINCIPAL FINDINGS: Perioperative TEE is used to monitor hemodynamic parameters in non-cardiac procedures where there is a high risk of hemodynamic instability...
November 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29117471/tumor-adjacent-tissue-co-expression-profile-analysis-reveals-pro-oncogenic-ribosomal-gene-signature-for-prognosis-of-resectable-hepatocellular-carcinoma
#3
O V Grinchuk, S P Yenamandra, R Iyer, M Singh, H K Lee, K H Lim, P K H Chow, V A Kuznetsov
Currently, molecular markers are not used whilst determining the prognosis and treatment strategy for patients with hepatocellular carcinoma (HCC). Here, we proposed that the identification of common pro-oncogenic pathways in primary tumors (PT), and adjacent non-malignant tissues (AT), that typically used to predict HCC patient risks may result in HCC biomarker discovery. We examined the genome-wide mRNA expression profiles of paired PT and AT samples from 321 HCC patients. The workflow integrated differentially expressed gene selection, gene ontology enrichment, computational classification, survival predictions, image analysis and experimental validation methods...
November 8, 2017: Molecular Oncology
https://www.readbyqxmd.com/read/28981738/factors-influencing-the-operating-time-for-single-port-laparoscopic-radical-nephrectomy-focus-on-the-anatomy-and-distribution-of-the-renal-artery-and-vein
#4
Kazuhiro Matsumoto, Akira Miyajima, Keishiro Fukumoto, Akari Komatsuda, Naoya Niwa, Seiya Hattori, Toshikazu Takeda, Eiji Kikuchi, Hiroshi Asanuma, Mototsugu Oya
Objective: It is considered that laparoscopic single-site surgery should be performed by specially trained surgeons because of the technical difficulty in using special instruments through limited access. We investigated suitable patients for single-port laparoscopic radical nephrectomy, focusing on the anatomy and distribution of the renal artery and vein. Methods: This retrospective study was conducted in 52 consecutive patients who underwent single-port radical nephrectomy by the transperitoneal approach...
October 1, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28980424/development-and-validation-of-a-nomogram-predicting-the-overall-survival-of-stage-iv-breast-cancer-patients
#5
Shunrong Li, Jianli Zhao, Liling Zhu, Fengxi Su, Kai Chen
This study aimed to develop a nomogram to predict the overall survival (OS) of stage IV breast cancer patients. We searched the National Cancer Database (NCDB) for stage IV breast cancer patients diagnosed between 2010 and 2013. Predictors of OS were identified and a nomogram was developed and validated using concordance index (C-index), calibration plots, and risk group stratifications. A total of 7199 patients from the NCDB were included in the study. With a median follow-up of 25.7 months, the 1-year and 3-year OS rates were 80...
November 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28915538/long-term-t3-and-t4-treatment-as-an-alternative-to-aerobic-exercise-training-in-improving-cardiac-function-post-myocardial-infarction
#6
Rayane Brinck Teixeira, Alexsandra Zimmer, Alexandre Luz de Castro, Bruna Gazzi de Lima-Seolin, Patrick Türck, Rafaela Siqueira, Adriane Belló-Klein, Pawan K Singal, Alex Sander da Rosa Araujo
Here we aimed to compare the beneficial effects of T3 and T4 hormone treatment to those provided by aerobic exercise training in Wistar rats post-myocardial infarction (MI). Rats in one group were SHAM-operated and in the other group were subjected to MI surgery. One week after surgery, the MI group animals either received T3 and T4 hormones by gavage or underwent a low intensity aerobic exercise training protocol on a treadmill, and both treatments lasted until 10 weeks after MI. Untreated SHAM-operated and MI groups were also followed for the same duration...
November 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28822540/life-threatening-complications-and-mortality-of-minimally-invasive-pectus-surgery
#7
André Hebra, Robert E Kelly, Marcelo M Ferro, Mustafa Yüksel, Jose Ribas M Campos, Donald Nuss
The prevalence and type of life-threatening complications related to the minimally invasive repair of pectus excavatum (MIRPE) and bar removal are unknown and underreported. The purpose of this communication is to make surgeons aware of the risk of these life threatening complications as well as the modifications which have been developed to prevent them. METHODS: Data related to life-threatening complications of Pectus Excavatum (PE) patients was obtained from four sources: 1. A survey of Chest Wall International Group (CWIG) surgeons who specialize in repairing congenital chest wall malformations, 2...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28822392/optimal-modified-frailty-index-cutoff-in-older-gastrointestinal-cancer-patients
#8
Mary Garland, Fang-Chi Hsu, Perry Shen, Clancy J Clark
The newly characterized modified frailty index (mFI) is a robust predictor of postoperative outcomes for surgical patients. The present study investigates the optimal cutoff for mFI specifically in older gastrointestinal (GI) cancer patients undergoing surgery. All patients more than 60 years old who underwent surgery for a GI malignancy (esophagus, stomach, colon, rectum, pancreas, liver, and bile duct) were identified in the 2005 to 2012 National Surgical Quality Improvement Program, Participant Use Data File (NSQIP PUF)...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28771975/intraoperative-ultrasound-for-the-colorectal-surgeon-current-trends-and-barriers
#9
REVIEW
Thomas L J Walker, Richard Bamford, Margaret Finch-Jones
Up to two thirds of patients diagnosed with colorectal cancer (CRC) develop colorectal liver metastases (CRLMs) and one quarter of patients present with synchronous metastases. Early detection of CRLM widens the scope of potential treatment. Surgery for CRLM offers the best chance of a cure. Current preoperative staging of CRC relies on computerized tomography and magnetic resonance imaging. Intraoperative ultrasound (IOUS) scans and contrast-enhanced IOUS (CE-IOUS) have been demonstrated to detect additional metastases not seen on routine preoperative imaging...
August 3, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28767807/model-of-a-training-program-in-robotic-surgery-and-its-initial-results
#10
Fernando Athayde Veloso Madureira, José Luís Souza Varela, Delta Madureira, Luis Alfredo Vieira D'Almeida, Fábio Athayde Veloso Madureira, Alexandre Miranda Duarte, Otávio Pires Vaz, José Reinan Ramos
Objective: to describe the implementation of a training program in robotic surgery and to point the General Surgery procedures that can be performed with advantages using the robotic platform. Methods: we conducted a retrospective analysis of data collected prospectively from the robotic surgery group in General and Colo-Retal Surgery at the Samaritan Hospital (Rio de Janeiro, Brazil), from October 2012 to December 2015. We describe the training stages and particularities...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28733731/novel-laparoscopic-training-system-with-continuously-perfused-ex-vivo-porcine-liver-for-hepatobiliary-surgery
#11
Wenyan Liu, Xinglong Zheng, Rongqian Wu, Yinbin Jin, Shu Kong, Jianpeng Li, Jianwen Lu, Huan Yang, Xianghua Xu, Yi Lv, Xiaogang Zhang
OBJECTIVE: To introduce a novel laparoscopic training system with a continuously perfused ex-vivo porcine liver for hepatobiliary surgery. BACKGROUND: Existing models for laparoscopic training, such as box trainers and virtual reality simulators, often fail to provide holistic training and real haptic feedback. We have formulated a new training system that addresses these problems. METHODS: Real-Liver Laptrainer consists of a porcine liver, customized mannequin, ex-vivo machine perfusion system, and monitoring software...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28727633/is-the-use-of-a-robotic-camera-holder-economically-viable-a-cost-comparison-of-surgical-assistant-versus-the-use-of-a-robotic-camera-holder-in-laparoscopic-liver-resections
#12
Martyn C Stott, Jenifer Barrie, Domnic Sebastien, Christa Hammill, Daren A Subar
The laparoscopic approach has gained acceptance in the field of hepatopancreaticobiliary surgery. It offers several advantages including reduced blood loss, reduced postoperative pain, and shorter length of stay. However, long operating times can be associated with surgeon and assistant fatigue and image tremor. Robotic camera holders have been designed to overcome these drawbacks but may come with significant costs. The aim of this study was to economically evaluate their use compared with standard assistants using a single surgeon consecutive series of laparoscopic liver resections from January 2014 to May 2015...
July 19, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28698017/stepwise-introduction-of-laparoscopic-liver-surgery-validation-of-guideline-recommendations
#13
Marcel J van der Poel, Floor Huisman, Olivier R Busch, Mohammad Abu Hilal, Thomas M van Gulik, Pieter J Tanis, Marc G Besselink
BACKGROUND: Uncontrolled introduction of laparoscopic liver surgery (LLS) could compromise postoperative outcomes. A stepwise introduction of LLS combined with structured training is advised. This study aimed to evaluate the impact of such a stepwise introduction. METHODS: A retrospective, single-center case series assessing short term outcomes of all consecutive LLS in the period November 2006-January 2017. The technique was implemented in a stepwise fashion. To evaluate the impact of this stepwise approach combined with structured training, outcomes of LLS before and after a laparoscopic HPB fellowship were compared...
July 8, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28635403/psychomotor-skills-assessment-by-motion-analysis-in-minimally-invasive-surgery-on-an-animal-organ
#14
Erlend Fagertun Hofstad, Cecilie Våpenstad, Lars Eirik Bø, Thomas Langø, Esther Kuhry, Ronald Mårvik
BACKGROUND: A high level of psychomotor skills is required to perform minimally invasive surgery (MIS) safely. To be able to measure these skills is important in the assessment of surgeons, as it enables constructive feedback during training. The aim of this study was to test the validity of an objective and automatic assessment method using motion analysis during a laparoscopic procedure on an animal organ. MATERIAL AND METHODS: Experienced surgeons in laparoscopy (experts) and medical students (novices) performed a cholecystectomy on a porcine liver box model...
August 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#15
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
August 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28537779/simulation-model-for-laparoscopic-foregut-surgery-the-university-of-north-carolina-foregut-model
#16
Francisco Schlottmann, Neal S Murty, Marco G Patti
BACKGROUND: A significant gap presently exists between box-lap and virtual-reality simulators and live surgery. Live animal and cadaver use has significant downsides. We have developed a high fidelity, real tissue simulator that allows training in laparoscopic foregut operations. METHODS: Our foregut surgery model is based on porcine tissue blocks that include lungs, heart, aorta, esophagus, diaphragm, stomach, duodenum, liver, and spleen. The tissue block is mounted in a human mannequin and perfused with artificial blood...
July 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28415702/overexpression-of-cxcr2-predicts-poor-prognosis-in-patients-with-colorectal-cancer
#17
Jingkun Zhao, Baochi Ou, Hao Feng, Puxiongzhi Wang, Shuai Yin, Congcong Zhu, Shenjie Wang, Chun Chen, Minhua Zheng, Yaping Zong, Jing Sun, Aiguo Lu
Colorectal cancer is a heterogeneous disease. Although many risk factors are used to predict colorectal cancer patients' prognosis after surgical resection, new prognostic factors are still needed to be defined to promote predictive efficacy of prognosis and further guide therapies. Herein, we identified the prognostic significance of CXCR2 in colorectal cancer patients. We retrospectively analysed 134 patients with colorectal cancer who underwent minimally invasive surgery between 2010 and 2011. The overall cohort was divided into a training set (n = 78) and a validation set (n = 56)...
April 25, 2017: Oncotarget
https://www.readbyqxmd.com/read/28408311/validation-of-a-difficulty-scoring-system-for-laparoscopic-liver-resection-a-multicenter-analysis-by-the-endoscopic-liver-surgery-study-group-in-japan
#18
MULTICENTER STUDY
Shogo Tanaka, Shoji Kubo, Akishige Kanazawa, Yutaka Takeda, Fumitoshi Hirokawa, Hiroyuki Nitta, Takayoshi Nakajima, Takashi Kaizu, Hironori Kaneko, Go Wakabayashi
BACKGROUND: Laparoscopic liver resection (LLR) is widely used for hepatic disease treatment. Preoperative prediction of operative difficulty can be beneficial as a roadmap for surgeons advancing from simple to highly technical LLR. We performed a multicenter analysis to investigate a "difficulty scoring system" for predicting the difficulty of LLR. STUDY DESIGN: The proposed "difficulty scoring system" includes 3 difficulty levels based on 5 factors. The system was validated in a cohort of 2,199 patients who underwent LLR at 74 Japanese centers between 2010 and 2014; the difficulty level was rated as low (n = 965), intermediate (n = 891), and high (n = 343)...
August 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28357490/annexin-a10-optimally-differentiates-between-intrahepatic-cholangiocarcinoma-and-hepatic-metastases-of-pancreatic-ductal-adenocarcinoma-a-comparative-study-of-immunohistochemical-markers-and-panels
#19
COMPARATIVE STUDY
Julia Kälsch, Juliet Padden, Stefanie Bertram, Leona L Pott, Henning Reis, Daniela Westerwick, Christoph M Schaefer, Jan-P Sowa, Dorothe Möllmann, Christian Fingas, Alexander Dechȇne, Barbara Sitek, Martin Eisenacher, Ali Canbay, Maike Ahrens, Hideo A Baba
Discriminating intrahepatic cholangiocarcinoma (ICC) from hepatic metastases of pancreatic ductal adenocarcinoma (mPDAC) can be challenging. While pathologists might depend on clinical information regarding a primary tumor, their diagnosis will lead the patient either to potentially curative surgery (for ICC) or to palliation (for mPDAC). Beyond the validation of recently published potential biomarkers for PDAC (primary or metastatic) in a large cohort, we assessed diagnostic performance of the most promising candidates in the challenging task of discriminating metastatic PDAC (mPDAC) from ICC...
May 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28338152/-development-and-future-of-minimally-invasive-surgery-in-western-china
#20
Peiwu Yu, Yingxue Hao
There are vast land and lots of people in western China, but the economy developing is relatively slow. However, the minimally invasive surgery was carried out firstly in China. Moreover, the type, number and difficulty of the minimally invasive surgery increased year by year. Especially, in the western area of China, Dr Zhou Zongguang, Yu Peiwu and Zheng Shuguo et al. have performed much pioneering work in laparoscopic surgery for rectal cancer, gastric cancer and laparoscopic liver resection. They led the standard development of minimally invasive in China...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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