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minimal access surgery

Gretchen Stern, Jessica Rimsans, Arman Qamar, Muthiah Vaduganathan, Deepak L Bhatt
AIMS: Oral antiplatelet therapy may require interruption soon after percutaneous coronary intervention (PCI) or acute coronary syndrome. The optimal parenteral antiplatelet bridge strategy with glycoprotein IIb/IIIa inhibitors or cangrelor, a P2Y12 inhibitor, is unclear. We explore real-world use of cangrelor or eptifibatide for antiplatelet bridging at a large tertiary-care center. METHODS AND RESULTS: Thirty-one patients (9 eptifibatide, 20 cangrelor, and 2 both) received bridge therapy from October 2015 to June 2017...
March 13, 2018: EuroIntervention
Miriam Elisabeth Uhlmann, Corinna Walter, Fadi Taher, Markus Plimon, Jürgen Falkensammer, Afshin Assadian
OBJECTIVE: Because of its minimally invasive nature, percutaneous femoral access for endovascular aneurysm repair (pEVAR) is currently undergoing rapid popularization. Compared with surgical cutdown for femoral access (cEVAR), it offers the advantage of faster recovery after surgery as well as a reduction in wound complications. Despite proposed advantages, the method is largely considered uneconomical because of its reliance on costly closure devices. METHODS: There were 50 patients undergoing EVAR who were enrolled in this randomized prospective single-center trial...
March 8, 2018: Journal of Vascular Surgery
Andreas Lorenz, Pamela Kogler, Marcus Huth, Reinhold Kafka-Ritsch, Dietmar Öfner, Alexander Perathoner
PURPOSE: Resection of a long rectal stump after previous colectomy or Hartmann procedure often requires a combined transperitoneal and transperineal approach because of limited access through a perineal incision alone. Risks associated with this procedure include iatrogenic injury to bowels, nerves, ureters, vessels and sexual organs. This study reports on the feasibility and safety of perianal minimally invasive surgery (PAMIS) for the resection of long rectal stumps that would otherwise require a combined transperitoneal and perianal approach...
March 10, 2018: International Journal of Colorectal Disease
Bin Tang, Limin Xiao, Shenhao Xie, Guanlin Huang, Zhigang Wang, Dongwei Zhou, Erming Zeng, Tao Hong
OBJECTIVES: Removal of recurrent or residual symptomatic craniopharyngiomas is more challenging than the primary surgery. The extended endoscopic endonasal (EEE) approach has been proposed an alternative surgical route for removal of various suprasellar tumors including craniopharyngiomas currently. In this study, we summarized the operative experience and described the feasibility and advantages of this technique in recurrent or residual symptomatic craniopharyngiomas. PATIENTS AND METHODS: A retrospective review of 15 patients (9 males and 6 females) whom underwent EEE approach between April 2012 and February 2017, were included in this study...
February 6, 2018: Clinical Neurology and Neurosurgery
Razan A Basonbul, Michael S Cohen
Tympanic membrane perforationsoccur frequently in children, and can result in hearing loss, otorrhea, pain, and cholesteatoma. Due to the narrower ear canal in children, a postauricular incision is often needed to access the tympanic membrane for surgical repair. Endoscopic approaches are increasingly being used for tympanic membrane repair, reducing the need for postauricular incisions. As the need for a postauricular incision decreases, the demand for non-autologous grafting material has increased. Acellular porcine small intestinal submucosa (SIS) has been described in the literature as an alternative to commonly used autologous grafts, and is well suited for use with transcanal endoscopic ear surgery as a minimally invasive approach...
September 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
Stefan H E M Clermonts, Yu-Ting van Loon, Dareczka K Wasowicz, Barbara S Langenhoff, David D E Zimmerman
BACKGROUND: Transanal minimally invasive surgery (TAMIS) is considered the successor of transanal endoscopic microsurgery (TEMS). It makes use of more readily available laparoscopic instruments and single-port access platforms with similar perioperative, clinical and oncological outcomes. Little is known about quality of life (QoL) outcomes after the use of TAMIS. The aim of this study was to assess QoL after TAMIS in our patients and compare this with QoL in the healthy Dutch population...
March 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Johannes Fauser, Georgios Sakas, Anirban Mukhopadhyay
PURPOSE: Interventions at the otobasis operate in the narrow region of the temporal bone where several highly sensitive organs define obstacles with minimal clearance for surgical instruments. Nonlinear trajectories for potential minimally invasive interventions can provide larger distances to risk structures and optimized orientations of surgical instruments, thus improving clinical outcomes when compared to existing linear approaches. In this paper, we present fast and accurate planning methods for such nonlinear access paths...
March 3, 2018: International Journal of Computer Assisted Radiology and Surgery
Tyler J Beute, Matthew D Orem, Timothy M Schiller, Matthew Goehler, Jessica Parker, Charles L Willekes, Tomasz Timek
BACKGROUND: Minimally invasive aortic valve replacement (mAVR) is gaining clinical acceptance, however, it is associated with increased operative times due to limited surgical field and access. The Cor-Knot is an automated fastening device designed to facilitate suture fastening, but clinical data in mAVR are lacking. METHODS: From May 2014 to February 2017, 92 patients underwent mAVR at our center with 39 valves secured with manually-tied (MT) sutures and 53 valves entirely secured with the Cor-Knot (CK)...
March 1, 2018: Annals of Thoracic Surgery
Ancuta Muntean, Ionica Stoica, Amulya K Saxena
BACKGROUND: After minimally invasive repair for pectus excavatum (MIRPE), similar procedures for pectus carinatum were developed. This study aimed to analyse the various published techniques of minimal access repair for pectus carinatum (MARPC) and compare the outcomes. DATA SOURCES: Literature was reviewed on PubMed with the terms "pectus carinatum", "minimal access repair", "thoracoscopy" and "children". RESULTS: Twelve MARPC techniques that included 13 articles and 140 patients with mean age 15...
March 2, 2018: World Journal of Pediatrics: WJP
A A Shetty, S J Kim, S Ahmed, S Trattnig, S A Kim, H J Jang
Introduction The morbidity and significant health economic impact associated with the chondral lesion has led to a large number of strategies for therapeutic neochondrogenesis. The challenge has been to develop techniques that are cost effective single-stage procedures with minimal surgical trauma that have undergone rigorous preclinical scrutiny and robust reproducible assessment of effectiveness. A biological repair requires the generation of a cellular and matrix composite with appropriate signalling for chondrogenic differentiation...
March 2018: Annals of the Royal College of Surgeons of England
Jawad Salman, Felix Fleißner, Jamshid Naqizadah, Murat Avsar, Malakh Shrestha, Gregor Warnecke, Issam Ismail, Stefan Rümke, Serghei Cebotari, Axel Haverich, Igor Tudorache
BACKGROUND:  Minimally invasive mitral valve surgery (MIMVS) is superior to "classical" mitral valve surgery via a sternotomy regarding wound healing and postoperative pain. It is however a more challenging procedure. Patients' preference is leading clearly toward minimally invasive approaches, and surgeons are driven by upcoming new technologies in interventional procedures such as the MitraClip. Especially in re-do cases, the access via right mini-thoracotomy, as previously non-operated situs, is a possible advantage over a re-sternotomy...
February 28, 2018: Thoracic and Cardiovascular Surgeon
Xunming Wang, Shihao Li, Zhiquan Huang, Qian Cai, Zixian Huang, Weiliang Chen
Minimally invasive endoscopic surgery has been developed for various indications in the craniomaxillofacial area. The case report presented in this article is focused on the possibility of removing the residual roots displaced into the maxillary sinus by means of an endoscopic technique. When planning endoscopic surgery to access the residual roots displaced in the maxillary sinus, we performed 2 different approaches into the maxillary sinus, a transnasal approach through the middle or inferior turbinate and transoral approach via the anterior maxillary sinus wall...
February 23, 2018: Journal of Craniofacial Surgery
Willian Ricardo Pires, Igor de Oliveira Puttini, André Hergesel de Oliva, Ricardo Garcia Mureb Jacob, Heldo Cesar Figueira Júnior, Celso Koogi Sonoda, André Luis da Silva Fabris, Leonardo Perez Faverani, Francisley Ávila Souza, Idelmo Rangel Garcia Júnior
The frontal bone fractures occur very often in service units in oral and maxillofacial surgery. Bicoronal access is the most common for the surgical treatment of frontal bone fractures. However, patients are surprised when they receive notice that such invasive access will be made. This approach allows adequate visualization of the fracture site, but may be associated with complications, which can be avoided by the use of less invasive techniques. We describe an alternative approach that aims to minimize the complications of a coronal incision...
February 23, 2018: Journal of Craniofacial Surgery
Aurélien Binet, Quentin Ballouhey, Yann Chaussy, Guénolée de Lambert, Karim Braïk, Thierry Villemagne, François Becmeur, Laurent Fourcade, Hubert Lardy
From classical surgery to Robotic Assisted Surgery, there is a long way allowed by Minimal Invasive Surgery' improvements. The last three decades have witnessed a prodigious development of minimally invasive surgery (MIS) and especially in the field of laparoscopic pediatric surgery but there are several limitations in the use of conventional laparoscopic surgery and Robotic Assisted Surgery was developed to relieve these drawbacks. This new technology enables today the performance of a wide variety of procedures in children with a minimally invasive approach...
February 23, 2018: Minerva Pediatrica
Elaine C McKevitt, Carol K Dingee, Sher-Ping Leung, Carl J Brown, Nancy Y Van Laeken, Richard Lee, Urve Kuusk
Introduction Diagnostic delays for breast problems is a current concern in British Columbia and diagnostic pathways for breast cancer are currently under review. Breast centres have been introduced in Europe and reported to facilitate diagnosis and treatment. Guidelines for breast centers are outlined by the European Society for Mastology (EUSOMA). A Rapid Access Breast Clinic (RABC) was developed at our hospital applying the concept of triple evaluation for all patients and navigation between clinicians and radiologists...
December 7, 2017: Curēus
Ali Cevat Kutluk, Celalettin Ibrahim Kocaturk, Hasan Akin, Sertan Erdogan, Salih Bilen, Kemal Karapinar, Celal Bugra Sezen, Ozkan Saydam
OBJECTIVE:  Video-assisted thoracoscopic surgery (VATS) has become the standard treatment method for primary spontaneous pneumothorax. Concerns about lesser pain and better cosmesis led to the evolution of uniportal access. This study prospectively compared the results of the uniportal, two-port, and three-port thoracoscopic surgery. MATERIAL AND METHODS:  One hundred and thirty-five patients were randomized into three groups according to the port numbers. The groups were compared regarding the operation time, hospital stay, amount of drainage, area of pleurectomy, complications, recurrences, and pain scores...
February 20, 2018: Thoracic and Cardiovascular Surgeon
Johan van der Merwe, Frank Van Praet, Bernard Stockman, Ivan Degrieck, Yvette Vermeulen, Filip Casselman
OBJECTIVES: This study reports the factors that contribute to sternotomy conversions (SCs) and adverse intraoperative events in minimally invasive aortic valve surgery (MI-AVS) and minimally invasive Endoscopic Port Access™ atrioventricular valve surgery (MI-PAS). METHODS: In total, 3780 consecutive patients with either aortic valve disease or atrioventricular valve disease underwent minimally invasive valve surgery (MIVS) at our institution between 1 February 1997 and 31 March 2016...
February 14, 2018: European Journal of Cardio-thoracic Surgery
Gyan Chand, Goonj Johri, S K Mishra
Endoscopic surgery is now standard of care for different Endocrine Disorders; the endoscopic thyroid surgery is becoming more popular and different approaches has been practice by many thyroid surgeon worldwide. Trans-orovestibular approach, based on the principle of natural orifice transluminal surgery is truly scar free thyroid surgery and has minimal dissection. We are presenting here three cases of benign solitary thyroid nodule operated endoscopically through trans-oro-vestibular approach in one male and two female patients...
March 2018: Indian Journal of Otolaryngology and Head and Neck Surgery
G Naldini, A Sturiale, B Fabiani, I Giani, C Menconi
BACKGROUND: The aim of the present study was to evaluate the safety and efficacy of autologous, micro-fragmented and minimally manipulated adipose tissue injection associated closure of the internal opening in promoting healing of complex anal fistula. METHODS: A pilot study was conducted on patients referred to our center with anal fistula, from April 2015-December 2016. Inclusion criteria were age over 16 years old and a diagnosis of complex anal fistula according to the American Gastroenterological Association classification The patients were divided into 2 groups; the "first time group" (Group I) in which micro-fragmented adipose tissue injection with closure of the internal opening was the first sphincter-saving procedure, and the "recurrent group" (Group II) consisting of patients who had failed prior sphincter-saving procedures...
February 16, 2018: Techniques in Coloproctology
Sivashanmugam Dhandapani, Madhivanan Karthigeyan
BACKGROUND: Endoscopy is increasingly being used for minimal invasiveness and panoramic visualization, with unclear efficacy and safety among spinal intradural lesions. OBJECTIVE: To compare micro-endoscopic and pure-endoscopic surgery for spinal intradural lesions. METHODS: Spinal intradural lesions operated by us using endoscopic/access ports were categorized 'micro-endoscopic' (predominant microscope use), or 'pure-endoscopic' (standalone endoscopy) surgery, and studied with respect to clinico-radiological features, techniques, peri-operative course, histopathology, clinical and radiological outcome at minimum of 3 months...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
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