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Necrosectomy laparoscope procedure

G Alsfasser, S Hermeneit, B M Rau, E Klar
Laparoscopic procedures have advanced to represent the new gold standard in many surgical fields. Although application in pancreatic surgery is hampered by the friable nature of the gland and the difficulty of its exposure, advanced technology and surgeons' experience are leading to an expansion of minimally invasive pancreatic surgery. Addressing the whole range of main operative procedures, this review analyzes the literature data so far to give an overview about the current status of minimally invasive pancreatic surgery, its indications and limitations...
2016: Digestive Surgery
A B Cresswell, H Nageswaran, A Belgaumkar, R Kumar, N Menezes, A Riga, T R Worthington, N D Karanjia
INTRODUCTION: Despite advances in surgery and critical care, severe pancreatitis continues to be associated with a high rate of mortality, which is increased significantly in the presence of infected pancreatic necrosis. Controversy persists around the optimal treatment for such cases, with specialist units variously advocating open necrosectomy, simple percutaneous drainage or one of several minimal access approaches. We describe our technique and outcomes with a two-port laparoscopic retroperitoneal necrosectomy (2P-LRN)...
July 2015: Annals of the Royal College of Surgeons of England
Mohammad Khreiss, Mazen Zenati, Amber Clifford, Kenneth K Lee, Melissa E Hogg, Adam Slivka, Jennifer Chennat, Andres Gelrud, Herbert J Zeh, Georgios I Papachristou, Amer H Zureikat
INTRODUCTION: Walled-off pancreatic necrosis (WON) is a sequela of acute necrotizing pancreatitis in 15-40% of cases. We sought to compare the outcomes of minimally invasive surgical and endoscopic cyst gastrostomy (CG) and necrosectomy for the management for sterile WON at a tertiary care high-volume pancreas center. METHOD: This is a retrospective review of patients who underwent minimally invasive surgical or endoscopic CG and necrosectomy for clinically sterile WON between 2008 and 2013...
August 2015: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
R Kostka, J Havlůj
INTRODUCTION: Treatment of necrotizing pancreatitis continues to evolve. The standard therapeutic method for infected pancreatic necrosis and its subsequent septic complications is open surgical drainage. The advances in radiological imaging and interventional radiology have enabled the development of minimally invasive procedures, i.e. percutaneous drainage (PCD) under CT/USG control, endoscopic transgastric necrosectomy (ENE), laparoscopic transperitoneal necrosectomy (LNE) and retroperitoneal access to pancreatic necrosis (RENE)...
April 2015: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Hubertus Feussner, Valentin Becker, Margit Bauer, Michael Kranzfelder, Rebekka Schirren, Tim Lüth, Alexander Meining, Dirk Wilhelm
Flexible endoscopy is increasingly developing into a therapeutic instead of a purely diagnostic discipline. Improved visualization makes early lesions easily detectable and allows us to decide ad hoc on the required treatment. Deep enteroscopy allows the exploration of even the small bowel - for long a "white spot" for gastrointestinal endoscopy - and to perform direct treatment. Endoscopic submucosal dissection is a considerable step forward in oncologically correct endoscopic treatment of (early) malignant lesions...
2015: Clinical and Experimental Gastroenterology
Yu-Chung Chang
In 1886, Senn stated that removing necrotic pancreatic and peripancreatic tissue would benefit patients with severe acute pancreatitis. Since then, necrosectomy has been a mainstay of surgical procedures for infected necrotizing pancreatitis (NP). No published report has successfully questioned the role of necrosectomy. Recently, however, increasing evidence shows good outcomes when treating walled-off necrotizing pancreatitis without a necrosectomy. The literature concerning NP published primarily after 2000 was reviewed; it demonstrates the feasibility of a paradigm shift...
December 7, 2014: World Journal of Gastroenterology: WJG
David J Worhunsky, Motaz Qadan, Monica M Dua, Walter G Park, George A Poultsides, Jeffrey A Norton, Brendan C Visser
BACKGROUND: Traditional open necrosectomy for pancreatic necrosis is associated with significant morbidity and mortality. Although minimally invasive techniques have been described and offer some promise, each has considerable limitations. This study assesses the safety and effectiveness of laparoscopic transgastric necrosectomy (LTN), a novel technique for the management of necrotizing pancreatitis. STUDY DESIGN: Between 2009 and 2013, patients with retrogastric pancreatic necrosis requiring debridement were evaluated for LTN...
October 2014: Journal of the American College of Surgeons
Jacek Szeliga, Marek Jackowski
INTRODUCTION: Acute pancreatitis (AP) consists of an extremely varied complex of pathological symptoms and clinical conditions, ranging from mild gastric complaints to multi-organ failure resulting in death. AIM: To present the authors' own experience regarding surgical treatment for pancreatic necrosis complicated by infection using different methods, including classic and laparoscopic methods as well as those combined with percutaneous techniques. MATERIAL AND METHODS: In the period 2007-2010, 34 patients with the diagnosis of severe AP were treated at the Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University...
June 2014: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Mittu John Mathew, Amit Kumar Parmar, Diwakar Sahu, Prasanna Kumar Reddy
CONTEXT: Pancreatic necrosis is a local complication of acute pancreatitis. The development of secondary infection in pancreatic necrosis is associated with increased mortality. Pancreatic necrosectomy is the mainstay of invasive management. AIMS: Surgical approach has significantly changed in the last several years with the advent of enhanced imaging techniques and minimally invasive surgery. However, there have been only a few case series related to laparoscopic approach, reported in literature to date...
July 2014: Journal of Minimal Access Surgery
Andrew A Gumbs, Roland Croner, Angel Rodriguez, Noah Zuker, Aristoteles Perrakis, Brice Gayet
INTRODUCTION: Because of the potential benefit of robotics in pancreatic surgery, we review our experience at two minimally invasive pancreatic surgery centers that utilize a robotically controlled laparoscope holder to see if smaller robots that enable the operating surgeon to maintain contact with the patient may have a role in the treatment of pancreatic disease. METHODS: From March 1994 to June 2011, a total of 200 laparoscopic pancreatic procedures utilizing a robotically controlled laparoscope holder were performed...
October 2013: Surgical Endoscopy
Brian Bello, Jeffrey B Matthews
AIM: To systematically review these minimally invasive approaches to infected pancreatic necrosis. METHODS: We used the MEDLINE database to investigate studies between 1996 and 2010 with greater than 10 patients that examined these techniques. Using a combination of Boolean operators, reports were retrieved addressing percutaneous therapy (341 studies), endoscopic necrosectomy (574 studies), laparoscopic necrosectomy via a transperitoneal approach (148 studies), and retroperitoneal necrosectomy (194 studies)...
December 14, 2012: World Journal of Gastroenterology: WJG
Gregorio Castellanos, Antonio Piñero, Laura A Doig, Andrés Serrano, Matilde Fuster, Vicente Bixquert
BACKGROUND: This study was designed to provide our experience in the management of infected and drained pancreatic necrosis using the retroperitoneal approach. METHODS: This was a prospective observational study in a tertiary care university hospital. Thirty-two patients with confirmed infected pancreatic necrosis were studied. Superficial necrosectomy was performed with lavage and aspiration of debris. This was achieved though a retroperitoneal approach of the pancreatic area and under the direct vision of a flexible endoscope...
February 2013: Surgical Endoscopy
JingWang Tan, Huamin Tan, Benshun Hu, Chen Ke, XiangMin Ding, Fei Chen, JianJun Leng, JiaHong Dong
BACKGROUND: Laparoscopic surgery for confirmed infected pancreatic necrosis (IPN) represents a relatively new solution. There are no studies comparing the outcomes of laparoscopic and open surgery for patients with IPN. The aims of this study were to investigate the feasibility of laparoscopic management for patients with IPN and to compare the outcomes of laparoscopic and open surgery. METHODS: Seventy-six patients with IPN who underwent open surgery (Open-group) or laparoscopic surgery (Lap-group) were retrospectively reviewed...
January 2012: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Juan-Carlos Pattillo, Ricardo Funke
Acute pancreatitis (AP) in children usually follows a mild course but occasionally may be severally problematic. We report the case of a 12-year-old boy with severe AP who was managed with repeated laparoscopic pancreatic necrosectomy. Three weeks later he represented with a pancreatic pseudocyst that was treated with endoscopic gastrocystotomy. His abdominal pain persisted and a subsequent magnetic resonance cholangiopancreatogram showed multiple gallbladder and common bile duct (CBD) stones that were missed on previous imaging investigations...
January 2012: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Jordan R Stem, Jeffrey B Matthews
No abstract text is available yet for this article.
2011: Advances in Surgery
R R Watson, C C Thompson
Natural orifice transluminal endoscopic surgery (NOTES) has ushered in a new era in flexible endoscopy. Over the past decade, modest advances have been made in addressing the fundamental challenges of NOTES surgery including transluminal access and closure techniques, and advancement of NOTES-specific technology. Despite these encouraging initial efforts significant obstacles to widespread acceptance of NOTES as a surgical option persist. Moreover, due to the well-documented safety and efficacy of laparoscopic techniques, the question remains as to the best candidate NOTES procedure...
June 2011: Minerva Gastroenterologica e Dietologica
Sachin V Wani, Roy V Patankar, S K Mathur
BACKGROUND: Conventional open surgery for infected pancreatic necrosis is associated with significant surgical morbidity, that is, wound complications, facial dehiscence, and intestinal fistulae. In recent years, there has been interest in attempting to reduce this surgical morbidity by adopting a number of minimally invasive approaches. METHODS: Fifteen patients with pancreatic necrosis underwent pancreatic necrosectomy by minimally invasive surgery (11 men, 4 women; age group: 25-64 years, mean age: 46 years)...
March 2011: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Ratnakishore Pallapothu, David B Earle, David J Desilets, John R Romanelli
BACKGROUND: Traditional approach for surgical management of mature pancreatic pseudocysts is by internal surgical drainage. Endoscopic drainage procedures have also been described. We describe Natural Orifice Translumenal Endoscopic Surgery (NOTES(®)) stapled cystgastrostomy as a less invasive surgical procedure. STUDY DESIGN: Case series. METHODS: NOTES(®) cystgastrostomy was performed in six patients with mature pseudocysts from June 2007 to July 2009 under institutional review board (IRB) protocol...
March 2011: Surgical Endoscopy
Benoy I Babu, Aali J Sheen, Stephen H Lee, Sarah O'Shea, Jane M Eddleston, Ajith K Siriwardena
OBJECTIVE: To examine clinical outcome in a consecutive cohort of patients undergoing open necrosectomy for postinflammatory necrosis. BACKGROUND INFORMATION: The last decade has witnessed major developments in the surgical management of pancreatic necrosis. Minimally invasive approaches have become established. However, there are limited data from contemporary open necrosectomy, in particular where multidisciplinary care and aggressive interventional radiology are used...
May 2010: Annals of Surgery
Udayakumar Navaneethan, Santhi Swaroop Vege, Suresh T Chari, Todd H Baron
Traditional open surgical necrosectomy for treatment of infected pancreatic necrosis is associated with high morbidity and mortality, leading to a shift toward minimally invasive endoscopic, radiologic, and laparoscopic approaches. Percutaneous drainage is useful as a temporizing method to control sepsis and as an adjunctive treatment to surgical intervention. It is limited because of the requirement for frequent catheter care and the need for repeated procedures. Endoscopic transgastric or transduodenal therapies with endoscopic debridement/necrosectomy have recently been described and are highly successful in carefully selected patients...
November 2009: Pancreas
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