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Advanced laparoscopic surgery

Daniel Cherqui, Go Wakabayashi, David A Geller, Joseph F Buell, Ho-Seong Han, Olivier Soubrane, Nicholas O'Rourke
In this article, we present the rationale for creating a new society aiming at organizing laparoscopic liver surgery. It has been named International Laparoscopic Liver Society (ILLS). Its main mission is to facilitate the diffusion and education of laparoscopic liver resection for meaningful improvements in patient care. This will include organization of a biannual congress dedicated to laparoscopic liver resection, coordination of international registries, helping in the education of surgeons wishing to learn these techniques including travel grants, provide a website serving as a forum supporting collaboration between surgeons interested in the advancement of laparoscopic liver resection techniques (http://www...
October 21, 2016: Journal of Hepato-biliary-pancreatic Sciences
Yuichiro Miyake, Junichi Nishimura, Hidekazu Takahashi, Naotsugu Haraguchi, Taishi Hata, Ichiro Takemasa, Tsunekazu Mizushima, Hirofumi Yamamoto, Yuichiro Doki, Masaki Mori
PURPOSE: Laparoscopic surgery for locally advanced colorectal cancer suspected of direct invasion to adjacent organs or structures remains controversial because of its high conversion rate, inadequate oncologic clearance and surgical outcomes. This study retrospectively evaluated the short-term outcomes of laparoscopic multivisceral resection for colorectal cancer and investigated the factors influencing conversion to open surgery. METHODS: Between 2010 and 2015, 39 patients who underwent laparoscopic multivisceral resection for colorectal cancer intraoperatively suspected of direct invasion to adjacent organs or structures were included...
October 21, 2016: Surgery Today
Eva Carlsson, Jeanette Fingren, Anne-Marie Hallén, Charlotta Petersén, Elisabet Lindholm
Despite advancements in the creation and care of stomas, ostomy and peristomal skin complications are common immediately following surgery as well as in the months and years thereafter. A prospective study to determine the prevalence of ostomy and peristomal skin complications and the influence of ostomy configuration on such complications was conducted 1 year after ostomy surgery among all patients at a university hospital in Sweden. All participants received regular (10 to 14 days post discharge, 6 weeks, 3 months, 6 months, and 1 year post surgery) ostomy follow-up care by a wound ostomy continence (WOC) nurse...
October 2016: Ostomy/wound Management
A Buia, F Stockhausen, N Filmann, E Hanisch
PURPOSE: 3D imaging is an upcoming technology in laparoscopic surgery, and recent studies have shown that the modern 3D technique is superior in an experimental setting. METHODS: All 14 members of the Asklepios Klinik Langen Department of Visceral and Thoracic Surgery, as well as two gynaecologists, were asked to undertake 2D vs. 3D laparoscopic black box skill training. The black box training was adapted to the "fundamentals of laparoscopic surgery" programme provided by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)...
October 19, 2016: Langenbeck's Archives of Surgery
Amanda N Fader, Tim Xu, Brian J Dunkin, Martin A Makary
BACKGROUND: Surgery is one of the highest priced services in health care, and complications from surgery can be serious and costly. Recently, advances in surgical techniques have allowed surgeons to perform many common operations using minimally invasive methods that result in fewer complications. Despite this, the rates of open surgery remain high across multiple surgical disciplines. METHODS: This is an expert commentary and review of the contemporary literature regarding minimally invasive surgery practices nationwide, the benefits of less invasive approaches, and how minimally invasive compared with open procedures are differentially reimbursed in the United States...
October 17, 2016: Surgical Endoscopy
Mario Schootman, Samantha Hendren, Kendra Ratnapradipa, Lisa Stringer, Nick O Davidson
BACKGROUND: Debate exists regarding the role of robotic-assisted surgery in colorectal cancer. Robotic-assisted surgery has been promoted as a strategy to increase the availability of minimally invasive surgery, which is associated with improved short-term morbidity; however, robotic-assisted surgery is much more expensive than laparoscopic surgery. OBJECTIVE: We aimed to understand hospital and patient trends in the adoption of robotic-assisted surgery. DESIGN: The study used cross-sectional and longitudinal designs...
November 2016: Diseases of the Colon and Rectum
Sheng-Han Tsai, Chien-An Liu, Kuo-Hung Huang, Yuan-Tzu Lan, Ming-Huang Chen, Yee Chao, Su-Shun Lo, Anna Fen-Yau Li, Chew-Wun Wu, Shih-Hwa Chiou, Muh-Hwa Yang, Yi-Ming Shyr, Wen-Liang Fang
Robot-assisted gastrectomy has been reported to be a safe alternative to both conventional laparoscopy and the open approach for treating early gastric carcinoma. Currently, there are a limited number of published reports on this technique in the literature. We assessed the current status of robotic and laparoscopic surgery in the treatment of gastric cancer and compared the operative outcomes, learning curves, and oncological outcome of the two approaches. Robotic gastrectomy offers benefits that include increased ease of performing D2 lymph node dissection and reduced blood loss compared with laparoscopic gastrectomy...
October 17, 2016: Pathology Oncology Research: POR
Yusuke Watanabe, Amin Madani, Elif Bilgic, Katherine M McKendy, Gada Enani, Iman Ghaderi, Gerald M Fried, Liane S Feldman, Melina C Vassiliou
BACKGROUND: General surgery residency may not adequately prepare residents for independent practice. It is unclear; however, if non-ACGME-accredited fellowships are better meeting training needs. The purpose of this mixed-method study was to determine perceived preparedness for practice and to identify gaps in fellowship training. METHODS: A survey was developed using an iterative qualitative methodology based on interviews and focus groups of graduated fellows and program directors...
October 14, 2016: Surgical Endoscopy
Eden C Payabyab, Sanjeeve Balasubramaniam, Maureen Edgerly, Margarita Velarde, Maria J Merino, Aradhana M Venkatesan, Harshraj Leuva, Thomas Litman, Susan E Bates, Tito Fojo
The development of new therapies has lagged behind for rare cancers without defined therapeutic targets. Adrenocortical cancer is no exception. Mitotane, an older agent considered "adrenolytic," is used both to control symptoms in advanced disease and as adjuvant therapy after surgical resection. Molecular characterization of adrenocortical cancer has deepened our understanding of this genetically complex disease while identifying subgroups whose importance remains to be determined. Unfortunately, such studies have yet to demonstrate a therapeutic target for drug development, and to date, no targeted therapy has achieved meaningful outcomes...
October 15, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Atsushi Ogura, Takashi Akiyoshi, Toshiya Nagasaki, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Yosuke Fukunaga, Masashi Ueno, Hiroya Kuroyanagi
BACKGROUND: The feasibility of additional lateral pelvic lymph node dissection (LPLND) compared with total mesorectal excision (TME) alone in patients treated with preoperative chemoradiotherapy (CRT) is controversial, especially in laparoscopic surgery. This study was performed to evaluate the feasibility of adding laparoscopic LPLND to TME in patients with advanced lower rectal cancer and swollen LPLNs treated with preoperative CRT. METHODS: We reviewed 327 patients with lower rectal cancer without distant metastasis who underwent preoperative CRT followed by laparoscopic TME...
October 11, 2016: World Journal of Surgery
Pablo Achurra, Antonia Lagos, Ruben Avila, Rodrigo Tejos, Erwin Buckel, Juan Alvarado, Camilo Boza, Nicolas Jarufe, Julian Varas
Introduction Simulated laparoscopy training is limited by its low-quality image. A high-definition (HD) laparoscopic training box was developed under the present necessity of simulating advanced surgery. Objective To describe and test a new HD laparoscopic training box for advanced simulation training. Methods We describe the features and image quality of the new training box. The simulator was tested and then evaluated by a group of 76 expert surgeons using a 4-item questionnaire. To assess the effectiveness of training using this simulation box, 15 general surgery residents were trained to perform a laparoscopic jejuno-jejunostomy in a validated simulation program...
October 10, 2016: Surgical Innovation
Antonio Biondi, Marco Vacante, Immacolata Ambrosino, Erika Cristaldi, Giuseppe Pietrapertosa, Francesco Basile
The prevalence of subjects with colorectal cancer is expected to grow in the next future decades and surgery represents the most successful treatment modality for these patients. Anyway, currently elderly subjects undergo less elective surgical procedures than younger patients mainly due to the high rates of postoperative morbidity and mortality. Some authors suggest extensive surgery, including multistage procedures, as carried out in younger patients while others promote less aggressive surgery. In older patients, laparoscopic-assisted colectomy showed a number of advantages compared to conventional open surgery that include lower stress, higher rate of independency after surgery, quicker return to prior activities and a decrease in costs...
September 27, 2016: World Journal of Gastrointestinal Surgery
Rachel E Andrew, Evangelos Messaris
Acute severe ulcerative colitis (UC) is a highly morbid condition that requires both medical and surgical management through the collaboration of gastroenterologists and colorectal surgeons. First line treatment for patients presenting with acute severe UC consists of intravenous steroids, but those who do not respond require escalation of therapy or emergent colectomy. The mortality of emergent colectomy has declined significantly in recent decades, but due to the morbidity of this procedure, second line agents such as cyclosporine and infliximab have been used as salvage therapy in an attempt to avoid emergent surgery...
September 27, 2016: World Journal of Gastrointestinal Surgery
Ting-Chia Yeh
BACKGROUND: Duodenum diverticulum is the most common site for diverticular disease of small intestine. Most of duodenal diverticulum are asymptomatic, but complicated or perforated duodenal diverticulum is rare. Nonoperative management is attractive in selected patients, because of higher surgical complications. We suggest the use of a minimally invasive operative method as an alternative approach for the management of complicated duodenal diverticulum, especially when conservative treatment has failed...
October 5, 2016: International Journal of Surgery Case Reports
Yanling Feng, Tiefeng Cao, Yin Wang, He Huang, Yujie Xie, Jihong Liu
The average age when cervical cancer is diagnosed is decreasing, resulting in a larger proportion of patients seeking fertility preservation. Therefore, a less radical approach that aims to preserve the potential for fertility during the treatment of cervical carcinoma is crucial. The present study reported a case of a patient with stage IB2 cervical cancer who exhibited pathological complete regression to neoadjuvant chemotherapy (NACT). This patient underwent deep cervical conization and laparoscopic lymphadenectomy to preserve her fertility...
October 2016: Molecular and Clinical Oncology
Takeshi Nishikawa, Soichiro Ishihara, Tetsuo Ushiku, Keisuke Hata, Kazuhito Sasaki, Koji Murono, Koji Yasuda, Kensuke Otani, Toshiaki Tanaka, Tomomichi Kiyomatsu, Kazushige Kawai, Hiroaki Nozawa, Toshiaki Watanabe
The metastasis of rectal cancer to the anus is rare. Here, we report a case of advanced rectal cancer, which had a diffuse venous invasion with anal metastasis and multiple lymph node and liver metastases. The patient was a 72-year-old woman who complained of perianal pain and fresh blood in the stools for 6 months. She had neither history of fistula-in-ano nor anal surgery. Digital examination revealed a 2-cm tumor at the 7 o'clock position, and the barium enema and colonoscopy confirmed advanced rectal cancer...
October 1, 2016: Clinical Journal of Gastroenterology
Giovanni Fantola, Laurent Brunaud, Phi-Linh Nguyen-Thi, Adeline Germain, Ahmet Ayav, Laurent Bresler
The feasibility and safety of robotically assisted procedures in general surgery have been reported from various groups worldwide. Because postoperative complications may lead to longer hospital stays and higher costs overall, analysis of risk factors for postoperative surgical complications in this subset of patients is clinically relevant. The goal of this study was to identify risk factors for postoperative morbidity after robotic surgical procedures in general surgery. We performed an observational monocentric retrospective study...
September 30, 2016: Updates in Surgery
Marta Penna, Nicolas C Buchs, Alexander L Bloemendaal, Roel Hompes
The surgical approach to total mesorectal excision (TME) for rectal cancer has undergone a substantial evolution with the adoption of more minimally invasive procedures. Transanal TME (taTME) is the latest advanced technique pioneered to tackle difficult pelvic dissections. Areas covered: The evolution of TME surgery from open to laparoscopic, robotic and transanal techniques was explored in this review. The outcomes to date on the latest approach, taTME, are reviewed and the future direction of rectal cancer surgery proposed...
October 3, 2016: Expert Review of Anticancer Therapy
Akira Umemura, Hiroyuki Nitta, Takeshi Takahara, Yasushi Hasegawa, Akira Sasaki
This review describes the recent advances in, and current status of, minimally invasive pancreatic surgery (MIPS). Typical MIPS procedures are laparoscopic pancreaticoduodenectomy (LPD), laparoscopic distal pancreatectomy (LDP), laparoscopic central pancreatectomy (LCP), and laparoscopic total pancreatectomy (LTP). Some retrospective studies comparing LPD or LDP and open procedures have demonstrated the safety and feasibility as well as the intraoperative outcomes and postoperative recovery of these procedures...
September 26, 2016: Asian Journal of Surgery
J X Lin, C M Huang, C H Zheng, P Li, J W Xie, J B Wang, J Lu, Q Y Chen, L L Cao, M Lin
Objective: To investigate the surgical outcomes after the laparoscopy-assisted distal gastrectomy (LADG) for patients with advanced gastric cancer. Methods: The data of 213 patients who underwent LADG and 213 treated by open distal gastrectomy (ODG) were selected using the propensity score matching method from a prospectively constructed database of 641 patients who underwent radical distal gastrectomy between January 2005 and June 2012 in Department of Gastric Surgery, Fujian Medical University Union Hospital...
October 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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