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Minu Bajpai
OBJECTIVE: Objective of this study is to present our experience by harmonic scalpel enabled, single external port appendicectomy using extracorporeally inserted 'pick and fix' stitch in three cases. MATERIALS AND METHODS: Of the eighteen appendicectomies performed with only the use of harmonic scalpel in the last 11 months, the last three were performed using a single external port with the second port accessed under the subcutaneous tissues. The procedure consists of anchoring the mesoappendix to anterior abdominal wall by an extracorporeally inserted 'pick and fix' stitch followed by dissection and division of mesoappendix and appendix only with harmonic scalpel...
January 2014: Journal of Indian Association of Pediatric Surgeons
Luca Milone, Despoina Daskalaki, Eduardo Fernandes, Isacco Damoli, Pier Cristoforo Giulianotti
Hepatobiliary (HB) surgery is a challenging surgical subspecialty that requires highly specialized training and an adequate level of experience in order to be performed safely. As a result, minimally invasive HB surgery has been met with slower acceptance as compared to other subspecialties, with many surgeons in the field still reluctant to adopt the approach. Recently development of the robotic platform has provided a tool that can overcome many of the limitations of conventional laparoscopic HB surgery. Augmented dexterity enabled by the endowristed movements, software filtration of the surgeon's movements, and high-definition three-dimensional vision provided by the stereoscopic camera combine to allow steady and careful dissection of the liver hilum structures, as well as prompt and precise endosuturing in cases of intraoperative bleeding...
December 2013: World Journal of Surgery
L Milone, A Coratti, D Daskalaki, E Fernandes, P C Giulianotti
Hepatobiliary surgery is a challenging surgical subspecialty that requires highly specialized training and an adequate level of experience in order to be performed safely. As a result, minimally invasive hepatobiliary surgery has been met with slower acceptance as compared to other subspecialties, with many surgeons in the field still reluctant about the approach. On the other hand, gastric surgery is a very popular field of surgery with an extensive amount of literature especially regarding open and laparoscopic surgery but not much about the robotic approach especially for oncological disease...
August 2013: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Samik Kumar Bandyopadhyay, Shashi Khanna, Bimalendu Sen, Om Tantia
UNLABELLED: Laparoscopic common bile duct exploration (LCBDE) has been found to be a safe, efficient and cost-effective treatment for choledocholithiasis. Following LCBDE, the clearance may be ascertained by a cholangiogram or choledochoscopy. The common bile duct (CBD) may be closed primarily with or without a stent in situ or may be drained by means of a T-tube or a biliary enteric anastomosis. MATERIALS AND METHODS: In our series of 464 patients of choledocholithiasis, 100 patients underwent closure of the CBD with an indwelling antegrade stent following LCBDE...
January 2007: Journal of Minimal Access Surgery
Eyvind J Paulssen, Rolv-Ole Lindsetmo
OBJECTIVE: Endoluminal gastroplication has been used with limited success for the treatment of gastro-oesophageal reflux disease (GORD). This method was used in 119 patients with GORD, and the results from short-term and long-term followup of symptoms and the use of acid suppression medication are reported. The purpose of this study was also to report on the effect of a second procedure on selected patients. MATERIAL AND METHODS: The Bard EndoCinch endosuturing system was used for all procedures...
January 2008: Scandinavian Journal of Gastroenterology
Bing Hu, S C Sydney Chung, Lawrence C L Sun, Koichi Kawashima, Tetsuya Yamamoto, Peter B Cotton, Christopher J Gostout, Robert H Hawes, Anthony N Kalloo, Sergey V Kantsevoy, Pankaj J Pasricha
BACKGROUND: Control of bleeding from major arteries in the upper-GI tract remains difficult with currently available endoscopic devices. We designed an endosuture device that uses a curved needle and extracorporeal knotting, and assessed the device in stopping arterial bleeding in a bench model. METHODS: Harvested porcine splenic arteries (2-mm diameter) were tunneled submucosally in pig stomach with the open end protruding into an artificially created mucosal defect...
August 2005: Gastrointestinal Endoscopy
Sandro Mattioli, Maria Luisa Lugaresi, Massimo Pierluigi Di Simone, Franco D'Ovidio, Vladimiro Pilotti, Alberto Ruffato
The aim of this paper is to illustrate a laparoscopic-thoracoscopic technique for the surgical management of foreshortened esophagus in patients affected by severe gastro-esophageal reflux disease. The patient is placed on the operating table with the left chest and arm lifted to perform a thoracostomy in theV-VI space, posterior to the axillary line. The hiatus is opened and the distal esophagus is mobilized. With intraoperative endoscopy the position of the gastroesophageal junction in relationship to the hiatus is determined in order to decide whether to perform a standard procedure for reflux or to lengthen the esophagus...
March 2005: Chirurgia Italiana
B Hu, S C Chung, L C Sun, K Kawashima, T Yamamoto, P B Cotton, C J Gostout, R H Hawes, A N Kalloo, S V Kantsevoy, P J Pasricha
BACKGROUND AND STUDY AIMS: Surgical creation of a small gastric pouch with a restricted outlet is a well-established option for the treatment of morbid obesity. This report describes initial experience with endoscopic transoral stomach partition using a newly designed suturing apparatus. MATERIALS AND METHODS: A fresh porcine stomach was placed in the Erlangen model. A prototype suture device, incorporating a curved needle and an intracorporeal tightening mechanism, was used in this procedure...
May 2005: Endoscopy
Yu-Jen Cheng, Eing-Long Kao
OBJECTIVE: Direct management of ruptured pulmonary blebs remains the definitive treatment for spontaneous pneumothorax. We compared endosuturing and endostapling performed via thoracoscopy to determine if suture closure of the blebs without resection was sufficient to treat primary spontaneous pneumothorax. METHODS: Nine female and forty-nine male prospective patients were prospectively enrolled into two groups between July 1999 and May 2003. The patients in the suturing group were treated with an endoscopic suturing technique to close existing blebs...
October 2004: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Yu-Jen Cheng, Shah-Hwa Chou, Eing-Long Kao
BACKGROUND AND OBJECTIVES: If surgery is indicated for primary spontaneous pneumothorax (PSP), video-assisted thoracoscopic surgery (VATS) using an endoscopic linear cutter to resect the involved blebs is the most popular treatment. We tried to determine whether closure of the blebs with sutures without resection is also efficacious enough to treat PSP. METHODS: We prospectively analyzed 22 episodes of PSP in 21 patients from January 2001 to April 2002. We endosutured the blebs, without removing them, no matter what the size and the number of the blebs were...
January 2004: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Arnaldo B Feitoza, Christopher J Gostout, Elizabeth Rajan, Rory L Smoot, Lawrence J Burgart, Cathy Schleck, Alan R Zinsmeister
BACKGROUND: Endoluminal gastroplication is used to treat GERD, with modest results. Little is known of the histologic reaction to endosutures. Thus, the histologic response to intraluminal plications at different penetration depths within the gastric wall was studied in an animal model. METHODS: Intraluminal gastroplications were performed through a laparotomy in 18 New Zealand rabbits. Three sets of everted plications were placed at different penetration depths in each stomach: submucosa (SMpl), muscularis propria (Mpl), and serosa (Spl)...
June 2003: Gastrointestinal Endoscopy
C S Ramachandran, D Goel, Vijay Arora, Mandhir Kumar
Once pancreatic pseudocysts become persistent, unresolving, and symptomatic, surgical drainage is mandatory. Between January 1998 and December 2001, we performed five laparoscopic cystogastrostomies for such pseudocysts with the simultaneous use of the gastroendoscope. The mean cyst diameter was 20 cm (range, 18.5-24). In the first four cases, the anterior wall of the stomach was entered through two 10-mm balloon cannulae under gastroscopic guidance. By introducing the laparoscope through one port and a harmonic scalpel through the other, a wide cystogastrostomy was performed...
December 2002: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Rolv-Ole Lindsetmo, Eyvind J Paulssen
BACKGROUND: Gastrooesophageal reflux disease is a common disorder, its most significant pathophysiological mechanism being a dysfunction of the lower oesophageal sphincter. MATERIALS AND METHODS: On the basis of our own experience and relevant literature, we present a novel method of treating this disease by means of strengthening the lower oesophageal sphincter by endoscopic suture. RESULTS AND INTERPRETATION: The commercially available Bard EndoCinch endosuture device was attached to a normal gastroscope and was used to fasten a Prolene thread in a fold of the gastric mucosa approximately one centimetre below the lower oesophageal sphincter...
May 20, 2002: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
P Bartos, Z Zelenka
UNLABELLED: The Burch procedure has enjoyed in the last decade a favourable status among open surgical repairs for stress urinary incontinence. In the last few years this technique was adapted for endoscopic application. This results in decreased recovery time and diminished postoperative patients discomfort. This endoscopic procedure was further simplified by means of extraperitoneal approach and through the use of Mesh & Tacker technique. This enables a high quality durable colposuspension in significantly shortened operational time...
September 1999: Ceská Gynekologie
Gasless laparoscopy is an evolving technique which can offer significant advantages to both patient and surgeon. A variety of major laparoscopic operations can be performed with gasless surgery including oophorectomy, myomectomy, and hysterectomy. The use of conventional instrumentation and open ports significantly improves the ease of surgery and greatly facilitates techniques such as endosuturing. For those patients with a contraindication, or a fear of general anesthesia, gasless laparoscopy under a regional anesthetic is now a reasonable alternative...
August 1994: Journal of the American Association of Gynecologic Laparoscopists
D Falk, C Hildebolt, M Vannier
The relationship between the squamosal suture and asterion was quantified in 15 hemispheres of eight chimpanzee endocasts that were aligned in the conventional lateral view (i.e., with frontal pole [FP]-occipital pole [OP] horizontal). Using a three-dimensional digitizer, x, y, and z coordinates were collected for the highest and lowest points of the squamosal suture, and the most rostral point of the suture approximate to the coronal suture. Our results were compared to a similar study of the squamosal suture on the external surfaces of chimpanzee skulls that were oriented in the Frankfurt horizontal (Holloway and Shapiro, 1992)...
April 1994: American Journal of Physical Anthropology
D Falk, L Konigsberg, R C Helmkamp, J Cheverud, M Vannier, C Hildebolt
Endocasts from skulls of 330 rhesus monkeys (Macaca mulatta) of known age are scored for closure of nine bilateral and three unilateral sutures or segments of sutures. A variety of tests reveals a strong relationship between age and stages of suture closure, although increasingly broad confidence intervals prevent sutures from being very useful for precisely aging older macaques. The order in which endosutures begin to close, as well as that in which closure is finally achieved, is determined for macaques, and these sequences compared to those for endosutures of humans (Todd and Lyon, 1924)...
December 1989: American Journal of Physical Anthropology
J G Valdivia Uría, A Viloria González, M D Santamarta Charte, J A López López, J Rodríguez Gómez, M J Martínez Sañudo, I Bonafonte Zaragozano
Urological surgery is rapidly developing towards less invasive and more conservative approaches without detriment to its proven efficacy. The authors, who perform endourologic surgery in 60% of the cases, have sought to enhance endoscopic suture techniques in the bladder using the triangulation procedure. Investigation was undertaken in experimental animals (large breed of female dogs) to assess various endosuture techniques and to develop the most appropriate instrument for this purpose. Following completion of the project's first phase, the authors claim that reconstructive endoscopic surgery of the bladder is already a reality and mechanical endoscopic suture of the bladder is forthcoming...
January 1990: Archivos Españoles de Urología
S T Ko, M C Airan
With the introduction of the technique of Interventional laparoscopy, a new era of minimally invasive general surgery has begun. The well-established principles of general surgical technique have not been altered by this new technology. As the new laparoscopic technology has become available, intraabdominal laparoscopic suturing and ligating techniques have been developed. The authors have attempted to elucidate the techniques of endoligation, "Endoloop" application, endosuture placement, sling suture placement, and continuous suture placement in laparoscopic surgery...
January 1992: Surgical Endoscopy
L Mettler, K Semm
About 15-20% of the time uterine surgery via laparotomy is replaced in our department by operative pelviscopy. Of these, in reference to myoma surgery, about 70% were tackled with operative pelviscopy and a laparotomy was avoided. This allows the preservation of the uterus, especially for those women who desire to bear children in the future. Organ-preserving, minimally invasive surgery is the current accepted operative ideal. Postoperative sequelae like adhesion formation, subacute intestinal obstruction, and chronic abdominal pain are thus decreased...
January 1992: Surgical Endoscopy
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