Minimally invasive preparation

BACKGROUND: The utilization of robot-assisted approaches to surgery has increased significantly over the last two decades. This has introduced novel complexities into the operating room environment, requiring management of new challenges and workflow adaptation. This study aimed to analyze challenges in the surgical setup for complex upper gastrointestinal robot-assisted surgery (UGI-RAS) and identify opportunities for solutions. METHODS: Direct observations of surgical setup processes for UGI-RAS were performed by a trained Human Factors researcher at a non-profit academic medical center in Southern California...

BACKGROUND AND OBJECTIVE: EBUS-TBNA has emerged as an important minimally invasive procedure for the diagnosis and staging of lung cancer. Our objective was to evaluate the effect of different specimen preparation from aspirates on the diagnosis of lung cancer. METHODS: 181 consecutive patients with known or suspected lung cancer accompanied by hilar / mediastinal lymphadenopathy underwent EBUS-TBNA from January 2019 to December 2022. Specimens obtained by EBUS-TBNA were processed by three methods: Traditional smear cytology of aspirates (TSC), liquid-based cytology of aspirates (LBC) and histopathology of core biopsies...

INTRODUCTION: There has been an increase in endoscopic and bronchoscopic biopsies as minimally invasive methods to obtain specimens from gastrointestinal (GI) or pancreatobiliary lesions and thoracic or mediastinal lesions, respectively. As hospitals undertake more of these procedures, it is important to consider the staffing implications that this has on cytopathology laboratories with respect to support for rapid on-site evaluation (ROSE). MATERIALS AND METHODS: Volume and time data from endoscopic ultrasound and bronchoscopic procedures (including endobronchial ultrasound-guided transbronchial needle aspirations and small biopsies with touch preparation) in the GI suite, bronchoscopy suite, or operating room were reviewed for 2 months at 2 different medical centers with ROSE services provided by cytologists or fellows physically present at the procedure and cytopathologists located remotely using telecytology...

With the transition of the medical model from the traditional biomedical model to the biopsychosocial one, there is a growing trend and requirement for oral operations that prioritize comfort, pain management, minimally invasive techniques, and visualization. Consequently, demands for comfortable dental treatments among individuals are increasing. However, initial periodontal therapy is often accompanied by pain, and patients' reactions to pain range from nervousness to dental fear, such as irritability, hyperventilation, even nausea, vomiting, and refusal to cooperate, which make the implementation of initial periodontal therapy difficult or even impossible...

BACKGROUND: Hepatic artery infusion pump (HAIP) with floxuridine/dexamethasone and systemic chemotherapy is an established treatment regimen, which had been reported about converting 47% of patients with stage 4 colorectal liver metastasis from unresectable to resectable.1,2 To this effect, HAIP chemotherapy contributes to prolonged survival of many patients, which otherwise may not have other treatment options. Biliary sclerosis, however, is a known complication of the HAIP treatment, which occurs in approximately 5...

A novel approach was devised to address the challenges in delivering cisplatin (CIS) for lung cancer treatment. This involved the development of a non-invasive hydrogel delivery system, aiming to minimize side effects associated with its administration. Using carbopol 971 (CP) and chitosan (CH) at varying ratios, the hydrogels were prepared and loaded with eco-friendly iron oxide nanoparticles (IONPs) conjugated to CIS. The physical properties, yield, drug loading, and cytotoxicity against lung cancer cell lines (A549) were assessed, along with hydrogel rheological properties and in vitro drug diffusion...

OBJECTIVES: The distribution characteristics of intrathecal drugs and the limitation of current catheterization techniques make traditional intrathecal analgesic treatment nearly useless for refractory craniofacial pain, such as trigemina neuralgia. This technical guideline aims to promote the widespread and standardize the application of intra-prepontine cisternal drug delivery via spinal puncture and catheterization. METHODS: A modified Delphi approach was used to work for this guideline...

OBJECTIVE: The aim was to determine whether preclinical medical students can develop their illness scripts to a level comparable to that of clerkship students through test-only learning using repeated formative online testlets. METHODS: In this experimental study, participants were 52 preclinical and 53 clinical medical students. The intervention group consisted of preclinical medical students, and the control group consisted of clinical medical students. The intervention group responded to online testlets containing feedback, an innovative formative assessment method called ContExtended Questions, on general surgery for 8 days by spending no more than 30 minutes each day...

INTRODUCTION: In vitro fracture resistance of extracted mandibular molars treated with various access cavity designs, including traditional endodontic cavity (TradAC), conservative/contracted endodontic cavity (ConsAC), ninja endodontic cavity (UltraAC), truss endodontic cavity (TrussAC), caries-driven access cavity (CariesAC), and intact teeth, is the focus of this study. MATERIALS AND METHODS: Six groups of 20 mandibular molars, totaling 120, were used in the investigation...

INTRODUCTION: Patient-specific instrumentation (PSI) systems are used to conduct total knee arthroplasty. PSI reduces operative time, is less invasive and easier to use, and minimizes the risk of errors by providing precise measurements and reducing operating room turnover time. However, a study on the accuracy of Prophecy Evolution PSI (Microport Inc., Arlington, TN, USA) reported that 94% were below the error margin of 1.5 mm and 90% had error margins of 1 mm. This study aimed to evaluate the accuracy of the Prophecy Evolution PSI system in terms of the thickness of "total" bony resection required to achieve adequate extension/flexion gaps and the component match ratio between preoperative planning and actual component size inserted...

Microneedles offer minimally invasive, user-friendly, and subcutaneously accessible transdermal drug delivery and have been widely investigated as an effective transdermal delivery system. Ibuprofen is a common anti-inflammatory drug to treat chronic inflammation. It is crucial to develop microneedle patches capable of efficiently delivering ibuprofen through the skin for the effective treatment of arthritis patients requiring repeated medication. In this study, the mechanical properties of a new type of polymer microneedle were studied by finite element analysis, and the experimental results showed that the microneedle could effectively deliver drugs through the skin...

BACKGROUND: Temporomandibular disorder (TMD) encompasses a range of conditions affecting the temporomandibular joint (TMJ) and associated structures, with TMJ pain being a prevalent symptom. Conventional management strategies have limitations, which require the exploration of innovative interventions. Platelet-rich plasma (PRP), known for its regenerative properties, presents a potential therapeutic avenue. This study aims to investigate the effectiveness of PRP in reducing the pain associated with mild TMJ in young adults...

Vaginal microbiota transplantation (VMT) is a cutting-edge treatment modality that has the potential to revolutionize the management of vaginal disorders. The human vagina is a complex and dynamic ecosystem home to a diverse community of microorganisms. These microorganisms play a crucial role in maintaining the health and well-being of the female reproductive system. However, when the balance of this ecosystem is disrupted, it can lead to the development of various vaginal disorders. Conventional treatments, such as antibiotics and antifungal medications, can temporarily relieve the symptoms of vaginal disorders...

BACKGROUND AND OBJECTIVE: Data regarding open conversion (OC) during minimally invasive surgery (MIS) for renal tumors are reported from big databases, without precise description of the reason and management of OC. The objective of this study was to describe the rate, reasons, and perioperative outcomes of OC in a cohort of patients who underwent MIS for renal tumor initially. The secondary objective was to find the factors associated with OC. METHODS: Between 2008 and 2022, of the 8566 patients included in the UroCCR project prospective database (NCT03293563), who underwent laparoscopic or robot-assisted minimally invasive partial (MIPN) or radical (MIRN) nephrectomy, 163 experienced OC...

BACKGROUND: In this study, we investigated the area that can be addressed with an approach in which the skin incision is made directly above the dorsal column with Thiel cadaveric specimens. METHODS: Six Thiel cadaveric specimens were prepared. A skin incision was made directly above the dorsal column. The accessible proximal end from the proximal part of the greater sciatic notch to the gluteal ridge and the accessible distal end of the ischium were marked with a flat chisel...

Microneedle (MN)-assisted drug delivery technology has gained increasing attention over the past two decades. Its advantages of self-management and being minimally invasive could allow this technology to be an alternative to hypodermic needles. MNs can penetrate the stratum corneum and deliver active ingredients to the body through the dermal tissue in a controlled and sustained release. Long-acting polymeric MNs can reduce administration frequency to improve patient compliance and therapeutic outcomes, especially in the management of chronic diseases...

Congenital protein C (PC) deficiency is one type of hereditary thrombosis. Patients with hereditary thrombosis are at high risk for thrombosis in the perioperative period, but a standard management strategy has not been established. Here we report a case of perioperative management of a fracture in a child with homozygous congenital PC deficiency. The patient was a 3-year-old boy who was diagnosed with congenital PC deficiency at birth. He sustained a traumatic supracondylar fracture of the right humerus and underwent emergency surgery...

Extracellular RNA (cell-free RNA; exRNA) from blood-derived liquid biopsies is an appealing, minimally invasive source of disease biomarkers. As pre-analytical variables strongly influence exRNA measurements, their reporting is essential for meaningful interpretation and replication of results. The aim of this review was to chart to what extent pre-analytical variables are documented, to pinpoint shortcomings and to improve future reporting. In total, 200 blood plasma exRNA studies published in 2018 or 2023 were reviewed for annotation of 22 variables associated with blood collection, plasma preparation, and RNA purification...

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of transorbital neuroendoscopic surgery (TONES) in the management of sphenoid wing meningiomas (SWMs) with cavernous sinus and orbital invasion. METHODS: The authors conducted a retrospective review of 32 patients with SWMs treated at Gazi University using TONES from October 2019 to May 2023. The study includes clinical applications to elucidate the endoscopic transorbital approach. Surgical techniques focused on safe subtotal resection, aiming to minimize residual tumor volume for subsequent radiosurgery...

The use of robotic surgery in transplantation is increasing, however, robotic liver transplant (RLT) remains a challenging undertaking. This is a report of the first RLT in North America and the first robotic LT using a whole graft from a deceased donor in the world. This paper describes the preparation leading to the RLT and the surgical technique of the operation. The operation was performed in a 62-year old male with hepatitis C cirrhosis and hepatocellular carcinoma (HCC) with a native MELD score of 10...