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Keyhole surgery

Omar E Aly, Douglas H Black, Haroon Rehman, Irfan Ahmed
BACKGROUND: Appendicectomy is a well-established surgical procedure used in the management of acute appendicitis. The operation can be performed with minimally invasive surgery or as an open procedure. A further development in the minimally invasive appendicectomy technique has been the introduction of single incision laparoscopic surgery (SILA). AIM: To ascertain any differences in outcomes from available trials comparing SILA with conventional multi-incision laparoscopic appendicectomy (CLA)...
October 2, 2016: International Journal of Surgery
Ziyu Zhao, Hongying Wang, Zhong Li, Xiaoxi Wang, Wei Zhang, Kang Feng, Jingchun Fan
BACKGROUND: Hypertension is the most common cause of intracerebral haemorrhages (ICHs), yet the short-term impact factors associated with hypertensive intracerebral haemorrhages (HICHs) in patients who undergo different surgical treatments are still unknown. MATERIALS AND METHODS: All consecutive patients with acute HICHs admitted to our hospital from January 2012 to March 2015 were enrolled in the study. Patients were either randomly divided or assigned according to their family's preference into three groups (those undergoing minimally invasive aspiration, keyhole craniotomy or haematoma aspiration with extended pterional and decompressive craniotomy)...
November 2016: Clinical Neurology and Neurosurgery
Fuminari Komatsu, Masaaki Imai, Akihiro Hirayama, Kazuko Hotta, Naokazu Hayashi, Shinri Oda, Masami Shimoda, Mitsunori Matsumae
Background Endoscopic microvascular decompression (MVD) offers reliable identification of neurovascular conflicts under superb illumination, and it provides minimally invasive surgery for trigeminal neuralgia and hemifacial spasm. Transposition techniques have been reported as a decompression method to prevent adhesion and granuloma formation around decompression sites, providing better surgical outcomes. The feasibility and effects of transposition under endoscopic MVD were evaluated. Material and Methods Fully endoscopic MVD was performed using 4-mm 0- and 30-degree endoscopes...
September 5, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Abdulfettah Tümtürk, Ahmet Küçük, Ahmet Menkü, Rahmi Kemal Koç
AIM: We have aimed to evaluate the clinical success of the en bloc laminoplasty and impact of the arcocristectomy on postoperative axial pain of the patients with cervical spondylotic myelopathy (CSM). MATERIAL AND METHODS: A retrospective review of 81 patients with CSM who underwent an en bloc cervical laminoplasty with preserving posterior structure of the cervical spine during the period from 2007 to 2014 was performed. Arcocristectomy was performed if C6-7 level included to surgery...
March 28, 2016: Turkish Neurosurgery
Ali Fahir Ozer, Salim Senturk, Mert Ciplak, Tunc Oktenoglu, Mehdi Sasani, Emrah Egemen, Onur Yaman, Tuncer Suzer
The technique we describe was developed for cervical foraminal stenosis for cases in which a keyhole foraminotomy would not be effective. Many cervical stenosis cases are so severe that keyhole foraminotomy is not successful. However, the technique outlined in this study provides adequate enlargement of an entire cervical foraminal diameter. This study reports on a novel foraminal expansion technique. Linear drilling was performed in the middle of the facet joint. A small bone graft was placed between the divided lateral masses after distraction...
August 2016: Asian Spine Journal
L H Chen, Y Yang, Q Wei, Y J Li, W D Li, J B Gao, B Yu, H Zhao, R X Xu
OBJECTIVE: With the development of modern skull base minimally invasive technology mature and neural radio surgery techniques, it is necessary to re-examine the therapeutic strategy for the treatment of petroclival meningiomas. To sum up the operative experience and methods in microsurgical resection of petroclival meningiomas by the combining trans-subtemporal and suboccipital retrosigmoid keyhole approach. To explore the minimally invasive operation approach of petroclival meningiomas, to raise the removal degree and to improve the postoperative result using this approach...
February 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Raghav Gupta, Nimer Adeeb, Christoph J Griessenauer, Justin M Moore, Apar S Patel, Ajith J Thomas, Christopher S Ogilvy
INTRODUCTION: Titanium fixation plates are routinely used for rigid fixation of bone flaps after craniotomy. In craniofacial surgery or after craniotomy involving orbitozygomatic osteotomies, these plates are occasionally removed because of infection, pain, protrusion, soft tissue erosion, and plate malfunction. However, plate removal because of pain and protrusion after craniotomy without orbitozygomatic osteotomy has rarely been reported. METHODS: A retrospective analysis of all patients who underwent removal of cranial fixation plates after craniotomy, performed by the senior authors at one institution between 2014 and 2016, was conducted...
October 2016: Acta Neurochirurgica
Hakan Yilmaz, Ali Rıza Ertürk, Ayşe Karataş, İbrahim Burak Atci, Alaettin Yurt
BACKGROUND/AIM: Posterior cervical laminoforaminotomy is an effective surgical treatment in selected cases of cervical radiculopathy caused by posterolateral herniated discs or foraminal stenosis. The aim of the present study was to evaluate the surgical techniques, rates of complications, long-term outcomes, advantages, and disadvantages of keyhole foraminotomy retrospectively. MATERIALS AND METHODS: Keyhole foraminotomy was performed in 83 patients. In 51 patients (61...
2016: Turkish Journal of Medical Sciences
R S Dzhindzhikhadze, O N Dreval', V A Lazarev, R L Kambiev
UNLABELLED: Progress in microneurosurgical techniques, neuroanesthesiology, and intraoperative imaging enables surgery using small incisions and craniotomy, in accordance with the keyhole surgery concept. Supraorbital craniotomy is the most widespread minimally invasive approach. There are a number of supraorbital craniotomy modifications, regarding different soft tissue incisions and the extent of craniotomy. We present the first results of using mini-orbitozygomatic craniotomy for aneurysms of the anterior circle of Willis and space-occupying lesions of the anterior and middle cranial fossae performed through an eyebrow incision...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Michael E Sughrue, Jad Othman, Steven A Mills, Phillip A Bonney, Adrian J Maurer, Charles Teo
AIM: Insular gliomas have traditionally been approached through variations of large frontotemporal craniotomies exposing much of the Sylvian fissure. Due to the importance of many structures exposed by such an approach, a less-invasive approach to these lesions is a viable alternative for resection. We present the technique and results of our keyhole transsylvian approach to remove infiltrating insular tumors. MATERIAL AND METHODS: A small linear incision and keyhole craniotomy is planned under image guidance to open a transsylvian window...
2016: Turkish Neurosurgery
Frederik Helgstrand
Ventral hernia repairs are among the most frequently performed surgical procedures. The variations of repair techniques are multiple and outcome has been unacceptable. Despite the high volume, it has been difficult to obtain sufficient data to provide evidence for best practice. In order to monitor national surgical quality and provide the warranted high volume data, the first national ventral hernia register (The Danish Ventral Hernia Database) was established in 2007 in Denmark. The present study series show that data from a well-established database supported by clinical examinations, patient files, questionnaires, and administrative data makes it possible to obtain nationwide high volume data and to achieve evidence for better outcome in a complex surgical condition as ventral hernia...
July 2016: Danish Medical Journal
Yuping Peng, Jun Fan, Yu Li, Mingxin Qiu, Songtao Qi
OBJECTIVE: To evaluate the feasibility of the supraorbital keyhole approach for suprasellar or intrasuprasellar Rathke cleft cysts (RCCs) under pure endoscopic visualization. METHODS: Thirteen surgically treated patients with symptomatic RCCs were analyzed retrospectively. Preoperative manifestations included headache (77%), visual impairment (38%), polyuria (31%), and pituitary dysfunction (15%). The maximal cyst diameter averaged 29.3 mm (23-46 mm). Eight patients (62%) had a purely suprasellar lesion, and 5 (38%) had a sellar lesion with suprasellar extension...
August 2016: World Neurosurgery
Joshua W Lucas, Gabriel Zada
The resection of anterior skull base meningiomas has traditionally been performed via pterional or unilateral/bilateral subfrontal craniotomies. The supraorbital keyhole approach and the endoscopic endonasal approach, techniques in which the endoscope is used to aid visualization, were developed to provide alternative, less-invasive approaches to aid the resection of these tumors. The individual characteristics of each tumor, such as location and size, are the main determinants guiding the choice of approach...
April 2016: Neurosurgery Clinics of North America
Qing Lan, Qing Zhu, Ailin Chen, Ju Yu, Shihai Liu
OBJECTIVE: Modify the pterional approach for intracranial aneurysms clipping with minimally invasive concept to reduce the risk of iatrogenic surgical trauma. METHODS: A 4.0 cm skin incision was made along the temporal hairline and centered on the pterion, temporal muscle was incised along the sylvian fissure.A bone flap with 2.0 to 2.5 cm in diameter was milled after a bone hole was drilled just on the sphenoid ridge, which was drilled off as needed then.Aneurysms were exposed after dissection of sylvian fissure and cistern, as well as cerebrospinal fluid releasing...
October 20, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Yi Feng, Jianqing He, Bin Liu, Likun Yang, Yuhai Wang
AIM: Hypertensive cerebral hemorrhage (HCH) is a potentially life-threatening cerebrovascular disease with high mortality. In case of a massive hematoma, surgical drainage is a crucial treatment. The aim of the present study was to assess the efficacy of the endoscope-assisted keyhole technique in elderly patients with intracerebral hematoma who needed a flap craniotomy as traditional treatment. MATERIAL AND METHODS: One hundred-eighty-four elderly patients with HCH, who had craniotomy indications after conservative treatment for 6-24 hours after onset, were randomly divided into two groups...
2016: Turkish Neurosurgery
Bhawani S Sharma, Amandeep Kumar, Duttaraj Sawarkar
INTRODUCTION: Surgical clipping is the most definite treatment for intracranial aneurysms. Its aim is to achieve complete aneurysmal occlusion without compromising the lumen of a parent vessel or perforators, and with minimal brain tissue trauma. OBJECTIVE: To evaluate the role of endoscopic controlled keyhole approach in clipping of anterior circulation aneurysms. MATERIALS AND METHODS: In this retrospective study, all consecutive patients undergoing endoscopic controlled clipping via the keyhole approach by the senior author during the last 1 year were included...
November 2015: Neurology India
Daniel F Kelly, Chester F Griffiths, Yuki Takasumi, John Rhee, Garni Barkhoudarian, Howard R Krauss
Significant advances over the last 2 decades in imaging technology, instrumentation, anatomical knowledge, and reconstructive techniques have resulted in the endonasal endoscopic approach becoming an integral part of modern skull base surgery. With growing use and greater experience, surgical outcomes continue to incrementally improve across many skull base pathologies, including those tumors that impact vision and ocular motility. The importance of the learning curve and use of a multi-disciplinary approach is critical to maximizing success, minimizing complications, and enhancing quality of life in these patients...
December 2015: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Carlos B Dabdoub, Gueider Salas, Elisabeth do N Silveira, Carlos F Dabdoub
BACKGROUND: Pneumocephalus (PNC) is the presence of air in the intracranial cavity. The most frequent cause is trauma, but there are many other etiological factors, such as surgical procedures. PNC with compression of frontal lobes and the widening of the interhemispheric space between the tips of the frontal lobes is a characteristic radiological finding of the "Mount Fuji sign." In addition to presenting our own case, we reviewed the most relevant clinical features, diagnostic methods, and conservative management for this condition...
2015: Surgical Neurology International
H Isaac Chen, Leif-Erik Bohman, Lyndsey Emery, Maria Martinez-Lage, Andrew G Richardson, Kathryn A Davis, John R Pollard, Brian Litt, Roberta E Gausas, Timothy H Lucas
BACKGROUND/AIMS: Transorbital approaches traditionally have focused on skull base and cavernous sinus lesions medial to the globe. Lateral orbital approaches to the temporal lobe have not been widely explored despite several theoretical advantages compared to open craniotomy. Recently, we demonstrated the feasibility of the lateral transorbital technique in cadaveric specimens with endoscopic visualization. We describe our initial clinical experience with the endoscope-assisted lateral transorbital approach to lesions in the temporal lobe...
2015: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Marcin Kaczmarczyk, Przemysław Szałański, Michał Zembala, Krzysztof Filipiak, Wojciech Karolak, Jacek Wojarski, Marcin Garbacz, Aleksandra Kaczmarczyk, Anna Kwiecień, Marian Zembala
Over the last twenty years, minimally invasive aortic valve replacement (MIAVR) has evolved into a safe, well-tolerated and efficient surgical treatment option for aortic valve disease. It has been shown to reduce postoperative morbidity, providing faster recovery and rehabilitation, shorter hospital stay and better cosmetic results compared with conventional surgery. A variety of minimally invasive accesses have been developed and utilized to date. This concise review demonstrates and discusses surgical techniques used in contemporary approaches to MIAVR and presents the most important results of MIAVR procedures...
June 2015: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
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