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endoluminal surgery

Paul Castellanos, Manjunath Mk, Ihab Atallah
The management of tracheobronchomalacia is a very challenging problem with few treatment options. This study aims to evaluate the outcomes of a novel surgical treatment for membranous tracheobronchomalacia. A consecutive series of patients with tracheobronchomalacia were treated with two to three holmium laser scarring surgeries of the hyperdynamic tracheal and bronchial walls for the purpose of stiffening them through fibrosis. Patients filled out a Dyspnea Index questionnaire before and after treatment. Ten patients were treated for their tracheobronchomalacia with a mean age of 54 years...
October 20, 2016: European Archives of Oto-rhino-laryngology
K Krajinovic, S Reimer, T Kudlich, C T Germer, A Wiegering
BACKGROUND: Anastomotic leakage (AL) is one of the most common and serious complications following visceral surgery. In recent years, endoluminal vacuum therapy has dramatically changed therapeutic options for AL, but its use has been limited to areas easily accessible by endoscope. CASE PRESENTATION: We describe the first use of endoluminal vacuum therapy in the small intestine employing a combined surgical and endoscopic "rendezvous technique" in which the surgeon assists the endoscopic placement of an endoluminal vacuum therapy sponge in the jejunum by means of a pullback string...
December 2016: Surgical Case Reports
Antonio Biondi, Marco Vacante, Immacolata Ambrosino, Erika Cristaldi, Giuseppe Pietrapertosa, Francesco Basile
The prevalence of subjects with colorectal cancer is expected to grow in the next future decades and surgery represents the most successful treatment modality for these patients. Anyway, currently elderly subjects undergo less elective surgical procedures than younger patients mainly due to the high rates of postoperative morbidity and mortality. Some authors suggest extensive surgery, including multistage procedures, as carried out in younger patients while others promote less aggressive surgery. In older patients, laparoscopic-assisted colectomy showed a number of advantages compared to conventional open surgery that include lower stress, higher rate of independency after surgery, quicker return to prior activities and a decrease in costs...
September 27, 2016: World Journal of Gastrointestinal Surgery
Nhan Huynh, Joshua D Rouch, Andrew Scott, Elvin Chiang, Benjamin M Wu, Shant Shekherdimian, James Cy Dunn
PURPOSE: Distraction enterogenesis has been investigated as a novel treatment for patients with short bowel syndrome (SBS) but has been limited by loss of intestinal length during restoration and need for multiple bowel surgeries. The feasibility of in-continuity, spring-mediated intestinal lengthening has yet to be demonstrated. METHODS: Juvenile mini-Yucatan pigs underwent in-continuity placement of polycaprolactone (PCL) degradable springs within jejunum. Methods used to anchor the spring ends to the intestine included full-thickness sutures and a high-friction surface spring...
September 15, 2016: Journal of Pediatric Surgery
Astrid Balança
OBJECTIVE: We report an emphysematous cystitis in a diabetic patient complicated by peritonitis. OBSERVATIONS: A 66-year-old male presented to the emergency with septic shock. Patient's history: poorly controlled diabetes and prostate adenoma. Clinical examination revealed a surgical abdomen and signs of shock. Blood sugar was 6g/L. CRP 274mg/L. The abdomino-pelvic CT scan showed a perforated bladder with emphysema of the bladder wall and endoluminal air bubbles...
September 2016: Annals of Physical and Rehabilitation Medicine
Mena Boules, Julietta Chang, Ivy N Haskins, Gautam Sharma, Dvir Froylich, Kevin El-Hayek, John Rodriguez, Matthew Kroh
Understanding the technical constructs of bariatric surgery is important to the treating endoscopist to maximize effective endoluminal therapy. Post-operative complication rates vary widely based on the complication of interest, and have been reported to be as high as 68% following adjustable gastric banding. Similarly, there is a wide range of presenting symptoms for post-operative bariatric complications, including abdominal pain, nausea and vomiting, dysphagia, gastrointestinal hemorrhage, and weight regain, all of which may provoke an endoscopic assessment...
September 16, 2016: World Journal of Gastrointestinal Endoscopy
Bryan W Tillman, Jeremy Kelly, Tara D Richards, Alex F Chen, Albert D Donnenberg, Vera S Donnenberg, Edith Tzeng
OBJECTIVE: Vascular restenosis remains a major obstacle to long-term success after vascular intervention. Circulating progenitor cells have been implicated in restenosis, and yet it has remained unclear if these cells, particularly nonendothelial progenitors, have an active role in this pathologic process. We hypothesized that circulating CD34(+)/c-kit(+) progenitors would increase after vascular injury, mirrored by changes in the injury signal, stromal cell-derived factor 1α (sdf1α)...
October 2016: Journal of Vascular Surgery
A Miernik, S Hein, F Adams, J Halbritter, M Schoenthaler
Urological and surgical treatment of urinary stones are highly technological and technology-driven disciplines in present-day surgery. German medical engineering has always been recognized for its technical innovations in endoscopic surgery. Current and future trends are indicative of further miniaturization and automation of surgical instruments and assist systems to facilitate endourological procedures as well as improvements in the quality of results and ergonomics. These technologies include, e. g. 3D-tracking to facilitate access to the pelvicaliceal system for percutaneous nephrolithotomy (PNL) or robotic master-slave systems for endourology...
October 2016: Der Urologe. Ausg. A
B Stratmann, Y Krepak, E Schiffer, I Jarick, M Hauber, Y H Lee-Barkey, M Fischer, D Tschoepe
Implantation of a duodenal-jejunal endoluminal bypass liner (DJBL) has shown to induce weight loss and to improve metabolic parameters. DJBL is a reversible endoduodenal sleeve mimicking duodenal bypass while lacking risks and limitations of bariatric surgery.Effects on metabolic control, body mass parameters, appetite regulation, glucose tolerance, organ health, and lipid profile were determined in 16 morbidly overweight patients with type 2 diabetes mellitus. In addition, relevant hormones (leptin, ghrelin, gastric inhibitory peptide, glucagon-like peptide, and insulin) were measured by enzyme-linked immunosorbent assay (ELISA) and chemiluminescent microparticle immunoassay (CMIA) at 0, 1, 32, and 52 weeks post-implant following a mixed meal tolerance test...
September 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Katherine A Kelley, V Liana Tsikitis
Appropriate endoscopic resection for colorectal polyps can present a challenge to endoscopists, as these lesions may harbor malignancy. With recent advances in endoscopy, however, we are now entering an exciting frontier of endoscopic therapy for gastrointestinal lesions. These techniques include endoluminal mucosal resection and endoscopic submucosal dissection, which may be utilized on several colonic lesions. This article will discuss these principle endoscopic techniques, their outcomes, and briefly highlight their influence on endoscopic interventions, including transanal endoscopic microsurgery and natural orifice transluminal endoscopic surgery...
September 2016: Clinics in Colon and Rectal Surgery
Nobuyoshi Takeshita, Khek Yu Ho
Full-thickness gastrointestinal defects such as perforation, anastomotic leak, and fistula are severe conditions caused by various types of pathologies. They are more likely to require intensive care and a long hospital stay and have high rates of morbidity and mortality. After intentional full-thickness opening of hollow organs for natural orifice transluminal endoscopic surgery, safe and secure closure is urgently required. The currently available advanced endoscopic closing techniques have a major role in the treatment of full-thickness gastrointestinal defects...
September 2016: Clinical Endoscopy
Stacy A Brethauer, Julietta Chang, Manoel Galvao Neto, Jan Willem Greve
BACKGROUND: Obesity and type 2 diabetes (T2D) continue to be growing epidemics worldwide. Although bariatric surgery remains the most effective and durable treatment for both of these chronic diseases, there is a need for therapies with risk and benefit profiles between medication and standard surgical procedures. Currently there are several endoscopic and minimally invasive therapies available worldwide to treat T2D. OBJECTIVE: To review the current evidence regarding the safety and efficacy of medical devices to treat T2D...
July 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Vincent Huberty, Mostafa Ibrahim, Martin Hiernaux, Alexandre Chau, Sonia Dugardeyn, Jacques Deviere
BACKGROUND AND AIMS: Obesity is a major pandemic disease. Surgical therapy is highly effective, but its availability will likely be overwhelmed by the burden of the disease. Endoscopic technologies that could reproduce some of the clinical effects of surgery may become part of the treatment armamentarium. A simple transoral restrictive procedure could play a role in first-line surgical management. METHODS: We evaluated the safety and feasibility of transmural suturing using a simple triangulation platform for gastric volume reduction through the creation of multiple double plicatures...
August 22, 2016: Gastrointestinal Endoscopy
Pietro Riva, Silvana Perretta, Lee Swanstrom
BACKGROUND: Obesity is a leading cause of morbidity and healthcare utilization. At the moment, the best treatment for obesity has shown to be laparoscopic gastric bypass. However, about a quarter of the patients experience substantial weight regain, which is difficult to treat, as revision surgery has higher risks than primary procedures. Endoscopic procedures, such as endoscopic suturing, are effective, safe and less invasive in addressing weight regain. METHODS: We conducted a retrospective analysis on 22 consecutive patients operated between 2011 and 2013 who had a significant weight regain after RYGB (mean follow-up 22 months), in order to evaluate the long-term outcomes of endoscopic gastro-jejunal revision after weight regain post-bypass surgery...
August 23, 2016: Surgical Endoscopy
S G Shapoval'yants, R V Plakhov, A I Mikhalev, E D Fedorov, L M Mikhaleva, Z V Galkova, E E Ernazarov, E V Gorbachev
AIM: to evaluate objectively the effectiveness of currently used diagnostic and curative approaches to gastrointestinal stromal tumors (GIST). MATERIAL AND METHODS: Early and remote results of treatment of 49 patients with gastric GISTs were presented. Herewith in 20 (40.8%) patients the disease was complicated by gastrointestinal bleeding. 43 (87.7%) of 49 patients with gastric GIST were operated. Conventional surgery was performed in 24 (55.8%) cases, laparoscopic interventions - in 12 (28%) cases, endoscopic endoluminal - in 7 (16...
2016: Khirurgiia
W A A Borstlap, P J Tanis, T W A Koedam, C A M Marijnen, C Cunningham, E Dekker, M E van Leerdam, G Meijer, N van Grieken, I D Nagtegaal, C J A Punt, M G W Dijkgraaf, J H De Wilt, G Beets, E J de Graaf, A A W van Geloven, M F Gerhards, H L van Westreenen, A W H van de Ven, P van Duijvendijk, I H J T de Hingh, J W A Leijtens, C Sietses, E J Spillenaar-Bilgen, R J C L M Vuylsteke, C Hoff, J W A Burger, W M U van Grevenstein, A Pronk, R J I Bosker, H Prins, A B Smits, S Bruin, D D Zimmerman, L P S Stassen, M S Dunker, M Westerterp, P P Coene, J Stoot, W A Bemelman, J B Tuynman
BACKGROUND: Rectal cancer surgery is accompanied with high morbidity and poor long term functional outcome. Screening programs have shown a shift towards more early staged cancers. Patients with early rectal cancer can potentially benefit significantly from rectal preserving therapy. For the earliest stage cancers, local excision is sufficient when the risk of lymph node disease and subsequent recurrence is below 5 %. However, the majority of early cancers are associated with an intermediate risk of lymph node involvement (5-20 %) suggesting that local excision alone is not sufficient, while completion radical surgery, which is currently standard of care, could be a substantial overtreatment for this group of patients...
2016: BMC Cancer
Francis J DeAsis, Woody Denham, John G Linn, Stephen P Haggerty, Michael B Ujiki
INTRODUCTION: Primary obesity surgery, endoluminal (POSE) is a promising procedure for weight loss surgery because it is outpatient, is incisionless and has short recovery time. We demonstrate the POSE procedure as a potential option for the bariatric patient. MATERIALS AND METHODS: Using an endoluminal camera, we videotaped one of our surgeons performing the POSE procedure. With rows of sutures in the fundus and antrum, the stomach's volume is reduced. RESULTS: We demonstrate a successful POSE procedure in its entirety...
June 20, 2016: Surgical Endoscopy
Christine Stier, Sonja Chiappetta
Dumping syndrome is a long-term postoperative complication of Roux-en-Y gastric bypass procedures. Morphologically, dumping syndrome usually correlates with a dilatation of the gastroenterostomy with accelerated pouch emptying. Conservative therapy includes diet changes, complementary pharmacotherapy and, if symptoms persist, surgical revision. Surgical options include endoscopic, endoluminal surgery to constrict the gastrojejunostomy using a novel endoscopic suturing device (OverStitch(TM), Apollo). In our study, we aimed to assess the viability, safety and efficacy of this procedure in patients with late dumping; 14 patients who had developed late dumping syndrome underwent surgery using an endoscopic suturing technique (OverStitch(TM), Apollo)...
August 2016: Obesity Surgery
Carmine Guarino, Gennaro Mazzarella, Nicolina De Rosa, Cristiano Cesaro, Giuseppe La Cerra, Edoardo Grella, Fabio Perrotta, Carlo Curcio, Germano Guerra, Andrea Bianco
Carcinoids are tumors that originate from diffuse neuroendocrine system cells (APUD cells) and represent 1-2% of all pulmonary tumors. Although surgical resection remains the mainstay of treatment, bronchoscopic radical resection of typical carcinoids in selected cases exhibiting endoluminal growth and small implant base has also been explored. Bronchoscopic removal of endobronchial lesions may also reduce the risk of post-obstructive infections and improve pulmonary function, allowing the patient to undergo surgery in better clinical and respiratory state...
September 2016: International Journal of Surgery
Eiji Kanehira, Takashi Tanida, Aya Kamei, Masafumi Nakagi, Tomohiko Yoshida, Sachiko Touma
BACKGROUND: Intragastric surgery is a percutaneous endoluminal surgery in the stomach aimed at resection of tumors located at the esophagogastric junction (EGJ). We developed needlescopic intragastric surgery performed via 2 mm, 2 mm, and 5 mm ports (PEIGS-225). MATERIAL AND METHODS: In cooperation with Niti-On Co., Ltd. we developed a series of 2 mm instruments including grasping forceps, a cannula, a laparoscope, an electrocautery, scissors, and a needle holder...
August 2016: Minimally Invasive Therapy & Allied Technologies: MITAT
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