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O'Toole, John E., Kurt M. Eichholz, and Richard G. Fessler. "Surgical site infection rates after minimally invasive spinal surgery." Journal of Neurosurgery: Spine 11, no. 4 (October 2009): 471–76. http://dx.doi.org/10.3171/2009.5.spine08633.
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Object Postoperative surgical site infections (SSIs) have been reported after 2–6% of spinal surgeries in most large series. The incidence of SSI can be < 1% after decompressive procedures and > 10% after instrumented fusions. Anecdotal evidence has suggested that there is a lower rate of SSI when minimally invasive techniques are used. Methods A retrospective review of prospectively collected databases of consecutive patients who underwent minimally invasive spinal surgery was performed. Minimally invasive spinal surgery was defined as any spinal procedure performed through a tubular retractor system. All surgeries were performed under standard sterile conditions with preoperative antibiotic prophylaxis. The databases were reviewed for any infectious complications. Cases of SSI were identified and reviewed for clinically relevant details. The incidence of postoperative SSIs was then calculated for the entire cohort as well as for subgroups based on the type of procedure performed, and then compared with an analogous series selected from an extensive literature review. Results The authors performed 1338 minimally invasive spinal surgeries in 1274 patients of average age 55.5 years. The primary diagnosis was degenerative in nature in 93% of cases. A single minimally invasive spinal surgery procedure was undertaken in 1213 patients, 2 procedures in 58, and 3 procedures in 3 patients. The region of surgery was lumbar in 85%, cervical in 12%, and thoracic in 3%. Simple decompressive procedures comprised 78%, instrumented arthrodeses 20%, and minimally invasive intradural procedures 2% of the collected cases. Three postoperative SSIs were detected, 2 were superficial and 1 deep. The procedural rate of SSI for simple decompression was 0.10%, and for minimally invasive fusion/fixation was 0.74%. The total SSI rate for the entire group was only 0.22%. Conclusions Minimally invasive spinal surgery techniques may reduce postoperative wound infections as much as 10-fold compared with other large, modern series of open spinal surgery published in the literature.
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Ulmer, Brenda C. "Best Practices for Minimally Invasive Procedures." AORN Journal 91, no. 5 (May 2010): 558–75. http://dx.doi.org/10.1016/j.aorn.2009.12.028.
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McLoitghlin, Thomas M. "Complications of Minimally Invasive Cardiac Surgical Procedures." Seminars in Cardiothoracic and Vascular Anesthesia 3, no. 2 (July 1999): 136–42. http://dx.doi.org/10.1177/108925329900300209.
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del Nido, Pedro J. "Minimally Invasive Cardiac Surgical Procedures in Children." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 15, no. 2 (March 2020): 95–98. http://dx.doi.org/10.1177/1556984520914283.
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Kotov, S. V., R. I. Guspanov, and A. K. Zhuravleva. "Clip migration after minimally-invasive surgical procedures." Urology Herald 11, no. 3 (October 5, 2023): 156–61. http://dx.doi.org/10.21886/2308-6424-2023-11-3-156-161.
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Introduction. Today absorbable suture material as well as plastic nonabsorbable clips are widely used for surgical haemostasis and stabilisation of sutures during minimally invasive operations, however, they are capable of potential and spontaneous migration into the lower and upper urinary tract.Objective. In this paper, we present clinical cases of clip migration after radical prostatectomy and renal resection.Clinical cases. Clinical cases of spontaneous clip migration after the two most common minimally invasive interventions: kidney resection with subsequent removal of a foreign body after the use of lithokinetic therapy and a case of hemostatic material migration after robot-assisted radical prostatectomy. The literature review is also available.Conclusion. Excessive use of non-absorbable plastic clips around their close contact with the kidney cavity or the bladder wall should be avoided to achieve adequate hemostasis during minimally invasive methods of treating patients.
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Bjelovic, Milos, Dejan Stojakov, Bratislav Spica, Dejan Velickovic, Dragan Gunjic, Ognjen Skrobic, Ljubomir Djurasic, Danko Grujic, and Predrag Pesko. "Minimally invasive esophagectomy in the treatment of esophageal cancer." Acta chirurgica Iugoslavica 58, no. 4 (2011): 27–30. http://dx.doi.org/10.2298/aci1104027b.
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In the Western countries, the incidence of esophageal carcinoma is 3-6 cases per 100.000 persons. Despite tremendous success of other therapeutic options, surgical treatment still represents the best therapeutic option whenever possible. For the long period, debate has centered on which of the available surgical procedures is superior - transhiatal or transthoracic esophagectomy. Minimally invasive esophagectomy (MIE) could offer both minimally invasive approach and proper mediastinal lymph node dissection. Minimally invasive esophagectomy is safe and adequate, but time consuming and technically demanding procedure. It is procedure reserved for the surgeons experienced in open esophagectomy for cancer, and specially trained in advanced minimally invasive procedures. Even in that case, learning curve is steep.
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Nebbia, Martina, Paulo Gustavo Kotze, and Antonino Spinelli. "Training on Minimally Invasive Colorectal Surgery during Surgical Residency: Integrating Surgical Education and Advanced Techniques." Clinics in Colon and Rectal Surgery 34, no. 03 (March 29, 2021): 194–200. http://dx.doi.org/10.1055/s-0041-1722843.
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AbstractSurgery is an ever-evolving discipline and continually incorporates new technologies that have improved the ability of the operating room surgeon to perform. The next generation of minimally invasive surgery includes laparoscopic and robotic-assisted procedures. Graduating residents may be expected to have the skills to perform common colorectal procedures using these technologies, and residency programs are developing curriculums to teach these skills. Minimally invasive techniques are challenging and learning only by observation and practice alone is difficult. This requires dedicated training and mentoring.New simulation methods have been conceived specifically for minimally invasive procedures, and these embrace a combination of virtual reality simulators and box trainers, with animal and human tissue, as well as synthetic materials. The aim of this review is to provide an overview of training in minimally invasive colorectal surgery with a focus on different types of simulators that build the basis to develop and include a multistep training approach in a structured training curriculum for minimally invasive colorectal procedures.
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Subhas, Gokulakkrishna, and Vijay K. Mittal. "Minimally Invasive Training During Surgical Residency." American Surgeon 77, no. 7 (July 2011): 902–6. http://dx.doi.org/10.1177/000313481107700728.
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The field of postgraduate minimally invasive surgery training has undergone substantial growth and change. A survey was sent to all program directors in surgery. Minimally invasive training patterns, facilities, their views, and performance of residents were examined. Ninety-five directors (38%) responded to the questionnaire. Of these, 51 per cent (n = 48) had a program size of three to four residents and 33 per cent (n = 31) had a program size of five to six residents. In 3 per cent of programs (n = 3), residents could not achieve the minimum Accreditation Council for Graduate Medical Education required numbers for advanced laparoscopic cases. Only 47 per cent of programs (n = 45) had dedicated rotations in minimally invasive surgery, ranging from 2 to 11 months. Up to 10 per cent (n = 9) of program directors felt that the current training in minimally invasive surgery was insufficient. Fifty-five per cent (n = 52) felt that laparoscopic adhesiolysis was an advanced laparoscopic procedure, and 33 per cent (n = 31) felt that there should be a separate minimum requirement for each of the commonly performed basic and advanced laparoscopic cases by Accreditation Council for Graduate Medical Education. Fifty-six per cent (n = 53) of programs were performing robotic surgery. Minimally invasive surgery training for surgical residents needs to increase opportunities so that they are able to perform laparoscopic procedures with confidence. There should be specific number requirements in each category of individual basic and advanced laparoscopic procedures.
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Oppenheimer, Jeffrey H., Igor DeCastro, and Dennis E. McDonnell. "Minimally invasive spine technology and minimally invasive spine surgery: a historical review." Neurosurgical Focus 27, no. 3 (September 2009): E9. http://dx.doi.org/10.3171/2009.7.focus09121.
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The trend of using smaller operative corridors is seen in various surgical specialties. Neurosurgery has also recently embraced minimal access spine technique, and it has rapidly evolved over the past 2 decades. There has been a progression from needle access, small incisions with adaptation of the microscope, and automated percutaneous procedures to endoscopically and laparoscopically assisted procedures. More recently, new muscle-sparing technology has come into use with tubular access. This has now been adapted to the percutaneous placement of spinal instrumentation, including intervertebral spacers, rods, pedicle screws, facet screws, nucleus replacement devices, and artificial discs. New technologies involving hybrid procedures for the treatment of complex spine trauma are now on the horizon. Surgical corridors have been developed utilizing the interspinous space for X-STOP placement to treat lumbar stenosis in a minimally invasive fashion. The direct lateral retroperitoneal corridor has allowed for minimally invasive access to the anterior spine. In this report the authors present a chronological, historical perspective of minimal access spine technique and minimally invasive technologies in the lumbar, thoracic, and cervical spine from 1967 through 2009. Due to a low rate of complications, minimal soft tissue trauma, and reduced blood loss, more spine procedures are being performed in this manner. Spine surgery now entails shorter hospital stays and often is carried out on an outpatient basis. With education, training, and further research, more of our traditional open surgical management will be augmented or replaced by these technologies and approaches in the future.
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Murthy, Raghav A., Nicholas S. Clarke, and Kemp H. Kernstine. "Minimally Invasive and Robotic Esophagectomy." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 13, no. 6 (November 2018): 391–403. http://dx.doi.org/10.1097/imi.0000000000000572.
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Great advances have been made in the surgical management of esophageal disease since the first description of esophageal resection in 1913. We are in the era of minimally invasive esophagectomy. The current three main approaches to an esophagectomy are the Ivor Lewis technique, McKeown technique, and the transhiatal approach to esophagectomy. These operations were associated with a high morbidity and mortality. The recent advances in minimally invasive surgical techniques have greatly improved the outcomes of these surgical procedures. This article reviews the literature and describes the various techniques available for performing minimally invasive esophagectomy and robot-assisted esophagectomies, the history behind the development of these techniques, the variations, and the contemporary outcomes after such procedures.
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Speth, Jennifer. "Guidelines in Practice: Minimally Invasive Surgery." AORN Journal 118, no. 4 (September 26, 2023): 250–57. http://dx.doi.org/10.1002/aorn.14001.
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ABSTRACTDuring minimally invasive surgery (MIS), surgeons create small and percutaneous incisions to access internal structures without open surgical incisions. Some MIS equipment is complex and challenging for perioperative nurses to manage. Patients also can experience life‐threatening complications during MIS procedures. The updated AORN “Guideline for minimally invasive surgery” provides recommendations that perioperative nurses can use when caring for patients undergoing MIS procedures. This article provides an overview of the guideline and discusses several recommendations, including creating a safe environment in which to perform MIS procedures; using gas distension media, irrigation and fluid distension media, and computer‐assisted navigation and robotics; and performing intraoperative magnetic resonance imaging in a hybrid OR. It also includes a scenario describing care of a patient undergoing a hysteroscopy. Perioperative nurses who care for patients undergoing MIS procedures should review the guideline in its entirety and apply the recommendations as applicable in their practice.
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Johnson, J. Patrick, Samuel S. Ahn, William C. Choi, Jeffery E. Masciopinto, Kee D. Kim, Aaron G. Filler, and Antonio A. F. DeSalles. "Thoracoscopic sympathectomy: techniques and outcomes." Neurosurgical Focus 4, no. 2 (February 1998): E6. http://dx.doi.org/10.3171/foc.1998.4.2.7.
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Thoracic sympathectomy is an important option in the treatment of palmar hyperhidrosis and pain disorders. Earlier surgical procedures were highly invasive with known morbidity, acceptable outcome, and established recurrence rates that were the limitations to considering surgical treatment. Thoracoscopic sympathectomy is a minimally invasive procedure that allows detailed visualization of the sympathetic ganglia and minimal postoperative morbidity; however, outcome studies of this technique have been limited. The authors treated 39 patients with 60 thoracoscopic procedures, and the outcomes in this small series were equivalent to previously established open surgical techniques; however, operative moribidity rates, hospital stay, and time of return to normal activity were substantially reduced. Complications and recurrence of symptoms were also comparable to previous reports. Overall patient satisfaction and willingness to repeat the operative procedure ranged from 66 to 96% in all patients. Patients and physicians can consider minimally invasive thoracoscopic sympathectomy procedures as an option to treat sympathetically mediated disorders because of the procedure's reduced morbidity and at least equivalent outcome rates in comparison to other treatments.
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Cicekoglu, Ferit, Seyhan Babaroglu, Onur Hanedan, Murat Songur, Garip Altintas, and Kerem Yay. "Minimally invasive cardiac surgical procedures in female population." Journal-Cardiovascular Surgery 2, no. 2 (2014): 25. http://dx.doi.org/10.5455/jcvs.2014223.
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Maršálková, Kristýna. "Balloon vaginoplasty as a minimally invasive method in the management of vaginal aplasia." Česká gynekologie 87, no. 3 (June 27, 2022): 206–10. http://dx.doi.org/10.48095/cccg2022206.
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Objective: The aim of this article is to describe the management of vaginal aplasia and to introduce minimally invasive surgical procedures for neovagina formation. Methodology: Literature review obtained from studies and papers dealing with the management of congenital vaginal aplasia. Conclusion: Vaginal aplasia is a rare congenital anomaly, often in coincidence with congenital defects of the uropoietic system. Management nowadays favors non-surgical or minimally invasive surgical methods for neovagina formation. Saman et al introduced a new method of neovagina formation, namely balloon vaginoplasty. The advantage of the surgical procedure is traction using a soft Foley balloon, determining both the length and width of the neovagina. The method uses the expansion of the natural vaginal mucosa without the need for dissection of the vesicorectal space. The soft Foley balloon does not cause erosion of the vaginal mucosa. Key words: vaginal aplasia – Mayer-Rokitanský-Küster-Hauser syndrome – minimally invasive surgical method of neovagina formation – laparoscopically assisted balloon vaginoplasty – retropubic balloon vaginoplasty
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Kaneko, Tsuyoshi, and Sary F. Aranki. "Hybrid Surgical and Catheter Treatment for Atrial Fibrillation." ISRN Cardiology 2013 (December 16, 2013): 1–5. http://dx.doi.org/10.1155/2013/920635.
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Advances in surgery for atrial fibrillation from cut and sew technique to thoracoscopy and new energy source have enabled minimally invasive approach which avoids median sternotomy and cardiopulmonary bypass. However, minimally invasive approach is unable to match the outcome of classic surgical technique due to difficulty in creating some of linear ablation lines. Hybrid procedure using catheter mapping and ablation in addition to minimally invasive surgical ablation has gained interest to combine the advantages of both procedures. No large study has been conducted to date comparing this new technique to other existing treatments. The aim of this paper is to review the data on hybrid procedure for atrial fibrillation and assess its early outcome and efficacy.
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Ruhotina, Nedim, Julien Dagenais, Giorgio Gandaglia, Akshay Sood, Firas Abdollah, Steven L. Chang, Jeffrey J. Leow, et al. "The impact of resident involvement in minimally-invasive urologic oncology procedures." Canadian Urological Association Journal 8, no. 9-10 (October 13, 2014): 334. http://dx.doi.org/10.5489/cuaj.2170.
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Introduction: Robotic and laparoscopic surgical training is an integral part of resident education in urology, yet the effect of resident involvement on outcomes of minimally-invasive urologic procedures remains largely unknown. We assess the impact of resident participation on surgical outcomes using a large multi-institutional prospective database.Methods: Relying on the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Participant User Files (2005-2011), we abstracted the 3 most frequently performed minimally-invasive urologic oncology procedures. These included radical prostatectomy, radical nephrectomy and partial nephrectomy. Multivariable logistic regression models were constructed to assess the impact of trainee involvement (PGY 1-2: junior, PGY 3-4: senior, PGY ≥5: chief) versus attending-only on operative time, length-of-stay, 30-day complication, reoperation and readmission rates.Results: A total of 5459 minimally-invasive radical prostatectomies,1740 minimally-invasive radical nephrectomies and 786 minimally-invasive partial nephrectomies were performed during the study period, for which data on resident surgeon involvement was available. In multivariable analyses, resident involvement was not associated with increased odds of overall complications, reoperation, or readmission rates for minimally-invasive prostatectomy, radical and partial nephrectomy. However, operative time was prolonged when residents were involved irrespective of the type of procedure. Length-of-stay was decreased with senior resident involvement in minimally-invasive partial nephrectomies (odds ratio [OR] 0.49, p = 0.04) and prostatectomies (OR 0.68, p = 0.01). The major limitations of this study include its retrospective observational design, inability to adjust for the case complexity and surgeon/hospital characteristics, and the lack of information regarding the minimally-invasive approach utilized (whether robotic or laparoscopic).Conclusions: Resident involvement is associated with increased operative time in minimally-invasive urologic oncology procedures. However, it does not adversely affect the complication, reoperation or readmission rates, as well as length-of-stay.
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Stadie, Axel Thomas, Ralf Alfons Kockro, Robert Reisch, Andrei Tropine, Stephan Boor, Peter Stoeter, and Axel Perneczky. "Virtual reality system for planning minimally invasive neurosurgery." Journal of Neurosurgery 108, no. 2 (February 2008): 382–94. http://dx.doi.org/10.3171/jns/2008/108/2/0382.
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Object The authors report on their experience with a 3D virtual reality system for planning minimally invasive neurosurgical procedures. Methods Between October 2002 and April 2006, the authors used the Dextroscope (Volume Interactions, Ltd.) to plan neurosurgical procedures in 106 patients, including 100 with intracranial and 6 with spinal lesions. The planning was performed 1 to 3 days preoperatively, and in 12 cases, 3D prints of the planning procedure were taken into the operating room. A questionnaire was completed by the neurosurgeon after the planning procedure. Results After a short period of acclimatization, the system proved easy to operate and is currently used routinely for preoperative planning of difficult cases at the authors' institution. It was felt that working with a virtual reality multimodal model of the patient significantly improved surgical planning. The pathoanatomy in individual patients could easily be understood in great detail, enabling the authors to determine the surgical trajectory precisely and in the most minimally invasive way. Conclusions The authors found the preoperative 3D model to be in high concordance with intraoperative conditions; the resulting intraoperative “déjà-vu” feeling enhanced surgical confidence. In all procedures planned with the Dextroscope, the chosen surgical strategy proved to be the correct choice. Three-dimensional virtual reality models of a patient allow quick and easy understanding of complex intracranial lesions.
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Fík, Zdeněk, Jaromír Astl, Michal Zábrodský, Petr Lukeš, Ilja Merunka, Jan Betka, and Martin Chovanec. "Minimally Invasive Video-Assisted versus Minimally Invasive Nonendoscopic Thyroidectomy." BioMed Research International 2014 (2014): 1–7. http://dx.doi.org/10.1155/2014/450170.
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Minimally invasive video-assisted thyroidectomy (MIVAT) and minimally invasive nonendoscopic thyroidectomy (MINET) represent well accepted and reproducible techniques developed with the main goal to improve cosmetic outcome, accelerate healing, and increase patient’s comfort following thyroid surgery. Between 2007 and 2011, a prospective nonrandomized study of patients undergoing minimally invasive thyroid surgery was performed to compare advantages and disadvantages of the two different techniques. There were no significant differences in the length of incision to perform surgical procedures. Mean duration of hemithyroidectomy was comparable in both groups, but it was more time consuming to perform total thyroidectomy by MIVAT. There were more patients undergoing MIVAT procedures without active drainage in the postoperative course and we also could see a trend for less pain in the same group. This was paralleled by statistically significant decreased administration of both opiates and nonopiate analgesics. We encountered two cases of recurrent laryngeal nerve palsies in the MIVAT group only. MIVAT and MINET represent safe and feasible alternative to conventional thyroid surgery in selected cases and this prospective study has shown minimal differences between these two techniques.
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Mátrai, Zoltán, Gusztáv Gulyás, Csaba Kunos, Ákos Sávolt, Emil Farkas, András Szollár, and Miklós Kásler. "Minimally invasive breast surgery." Orvosi Hetilap 155, no. 5 (February 2014): 162–69. http://dx.doi.org/10.1556/oh.2014.29783.
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Due to the development in medical science and industrial technology, minimally invasive procedures have appeared in the surgery of benign and malignant breast diseases. In general , such interventions result in significantly reduced breast and chest wall scars, shorter hospitalization and less pain, but they require specific, expensive devices, longer surgical time compared to open surgery. Furthermore, indications or oncological safety have not been established yet. It is quite likely, that minimally invasive surgical procedures with high-tech devices – similar to other surgical subspecialties –, will gradually become popular and it may form part of routine breast surgery even. Vacuum-assisted core biopsy with a therapeutic indication is suitable for the removal of benign fibroadenomas leaving behind an almost invisible scar, while endoscopically assisted skin-sparing and nipple-sparing mastectomy, axillary staging and reconstruction with latissimus dorsi muscle flap are all feasible through the same short axillary incision. Endoscopic techniques are also suitable for the diagnostics and treatment of intracapsular complications of implant-based breast reconstructions (intracapsular fluid, implant rupture, capsular contracture) and for the biopsy of intracapsular lesions with uncertain pathology. Perception of the role of radiofrequency ablation of breast tumors requires further hands-on experience, but it is likely that it can serve as a replacement of surgical removal in a portion of primary tumors in the future due to the development in functional imaging and anticancer drugs. With the reduction of the price of ductoscopes routine examination of the ductal branch system, guided microdochectomy and targeted surgical removal of terminal ducto-lobular units or a „sick lobe” as an anatomical unit may become feasible. The paper presents the experience of the authors and provides a literature review, for the first time in Hungarian language on the subject. Orv. Hetil., 2014, 155(5), 162–169.
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Roumm, Adam R., Laura Pizzi, Neil I. Goldfarb, and Herbert Cohn. "Minimally Invasive: Minimally Reimbursed? An Examination of Six Laparoscopic Surgical Procedures." Surgical Innovation 12, no. 3 (September 2005): 261–87. http://dx.doi.org/10.1177/155335060501200313.
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Rothrock, Robert J., Alexander G. Chartrain, Jacopo Scaggiante, Jonathan Pan, Rui Song, Danny Hom, Adam C. Lieber, Joshua B. Bederson, J. Mocco, and Christopher P. Kellner. "Advanced Techniques for Endoscopic Intracerebral Hemorrhage Evacuation: A Technical Report With Case Examples." Operative Neurosurgery 20, no. 1 (April 22, 2020): 119–29. http://dx.doi.org/10.1093/ons/opaa089.
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Abstract BACKGROUND Multiple surgical techniques to perform minimally invasive intracerebral hemorrhage (ICH) evacuation are currently under investigation. The use of an adjunctive aspiration device permits controlled suction through an endoscope, minimizing collateral damage from the access tract. As with increased experience with any new procedure, performance of endoscopic minimally invasive ICH evacuation requires development of a unique set of operative tenets and techniques. OBJECTIVE To describe operative nuances of endoscopic minimally invasive ICH evacuation developed at a single center over an experience of 80 procedures. METHODS Endoscopic minimally invasive ICH evacuation was performed on 79 consecutive eligible patients who presented a single Health System between March 2016 and May 2018. We summarize 4 core operative tenets and 4 main techniques used in 80 procedures. RESULTS A total of 80 endoscopic minimally invasive ICH evacuations were performed utilizing the described surgical techniques. The average preoperative and postoperative volumes were 49.5 mL (standard deviation [SD] 31.1 mL, interquartile range [IQR] 30.2) and 5.4 mL (SD 9.6, mL IQR 5.1), respectively, with an average evacuation rate of 88.7%. All cause 30-d mortality was 8.9%. CONCLUSION As experience builds with endoscopic minimally invasive ICH evacuation, academic discussion of specific surgical techniques will be critical to maximizing its safety and efficacy.
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Schwartz-Filho, Humberto Osvaldo, William Cunha Brandt, and Caio Vinicius Gonçalves Roman-Torres. "Minimally Traumatic Surgical Procedures in Periodontics: a Review." Journal of Health Sciences 17, no. 1 (July 1, 2015): 60. http://dx.doi.org/10.17921/2447-8938.2015v17n1p60-63.
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<p>The concept of minimally invasive procedures can be extended to all fields of dentistry. Periodontics, in particular, has been reported as one of the areas with great benefits. This review aims to describe the use of minimally invasive procedures in periodontal surgery, its concepts, applications, and possible benefits from its use. For that, 682 articles published between 1950 and 2012 focused on minimally invasive periodontal surgery were evaluated. Of them, 669 studies did not describe clearly the procedures, and did not attend the inclusion criteria. The results showed that proper lighting promotes increased visual acuity during surgical procedures, favoring the precision associated with<br />microsurgical instruments specifically designed, allowing a more accurate manipulation of the soft and hard tissues. Surgical access avoids unnecessary tissues removal, optimizing the debridement, improving vascularisation, and therefore the possibility of obtaining primary healing of surgical wounds. The microsurgical approach can improve the predictability of different periodontal procedures, providing better results and cause less postoperative discomfort. However, few controlled methodologies on the use of instruments to promote minimally invasive procedures in periodontics have been found in literature. Therefore, studies are needed to determine whether microsurgical techniques can lead to a significant difference in the successful outcome. Most of the studies are based on observations and experiences of the authors, which clearly<br />show that there are advantages in having better lighting, better vision, and a more controlled and less traumatic technique.</p>
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Abdullah, Walid Ahmed, Hesham S. Khalil, Maryam M. Alhindi, and Hamdy Marzook. "Modifying Gummy Smile: A Minimally Invasive Approach." Journal of Contemporary Dental Practice 15, no. 6 (2014): 821–26. http://dx.doi.org/10.5005/jp-journals-10024-1625.
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ABSTRACT Aim Excessive gingival display is a problem that can be managed by variety of procedures. These procedures include non-surgical and surgical methods. The underlying cause of gummy smile can affect the type of procedure to be selected. Most patients prefer minimally invasive procedures with outstanding results. The authors describe a minimally invasive lip repositioning technique for management of gummy smile. Materials and methods Twelve patients (10 females, 2 males) with gingival display of 4 mm or more were operated under local anesthesia using a modified lip repositioning technique. Patients were followed up for 1, 3, 6 and 12 months and gingival display was measured at each follow up visit. The gingival mucosa was dissected and levator labii superioris and depressor septi muscles were freed and repositioned in a lower position. The levator labii superioris muscles were pulled in a lower position using circumdental sutures for 10 days. Both surgeon's and patient's satisfaction of surgical outcome was recorded at each follow-up visit. Results At early stage of follow-up the main complaints of patients were the feeling of tension in the upper lip and circum oral area, mild pain which was managed with analgesics. One month postoperatively, the gingival display in all patients was recorded to be between 2 and 4 mm with a mean of (2.6 mm). Patient satisfaction records after 1 month showed that 10 patients were satisfied with the results. Three months postoperatively, the gingival display in all patients was recorded and found to be between 2 and 5 mm with a mean of 3 mm. Patient satisfaction records showed that 8 patients were satisfied with the results as they gave scores between. Surgeon's satisfaction at three months follow up showed that the surgeons were satisfied in 8 patients. The same results were found in the 6 and 12 months follow-up periods without any changes. Complete relapse was recorded only in one case at the third postoperative month. Conclusion This study showed that the proposed lip repositioning technique is an acceptable minimally invasive procedure in managing gummy smile. Clinical significance A non-invasive procedure to avoid other complicated surgical procedures. How to cite this article Abdullah WA, Khalil HS, Alhindi MM, Marzook H. Modifying Gummy Smile: A Minimally Invasive Approach. J Contemp Dent Pract 2014;15(6):821-826.
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Hussain, Namath S., and Mick J. Perez-Cruet. "Complication management with minimally invasive spine procedures." Neurosurgical Focus 31, no. 4 (October 2011): E2. http://dx.doi.org/10.3171/2011.8.focus11165.
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Spine surgery as we know it has changed dramatically over the past 2 decades. More patients are undergoing minimally invasive procedures. Surgeons are becoming more comfortable with these procedures, and changes in technology have led to several new approaches and products to make surgery safer for patients and improve patient outcomes. As more patients undergo minimally invasive spine surgery, more long-term outcome and complications data have been collected. The authors describe the common complications associated with these minimally invasive surgical procedures and delineate management options for the spine surgeon.
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Smith, Justin S., Alfred T. Ogden, and Richard G. Fessler. "Minimally invasive posterior thoracic fusion." Neurosurgical Focus 25, no. 2 (August 2008): E9. http://dx.doi.org/10.3171/foc/2008/25/8/e9.
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Thoracic spine fusion may be indicated in the surgical treatment of a wide range of pathologies, including trauma, deformity, tumor, and infection. Conventional open procedures for surgical treatment of thoracic spine disease can be associated with significant approach-related morbidity, which has motivated the development of minimally invasive approaches. Thoracoscopy and, later, video-assisted thoracoscopic surgery were developed to address diseases of the thoracic cavity and subsequently adapted for thoracic spine surgery. Although video-assisted thoracoscopic surgery has been used to treat a variety of thoracic spine diseases, its relatively steep learning curve and high rate of pulmonary complications have limited its widespread use. These limitations have motivated the development of minimally invasive posterior approaches to address thoracic spine pathology without the added risk of morbidity involved in surgically entering the chest. Many of these advances are ongoing and represent the forefront of minimally invasive spine surgery. As these techniques are developed and applied, it will be important to assess their equivalence or superiority in comparison with standard open techniques using prospective trials. In this paper the authors focus on minimally invasive posterior thoracic procedures that include fusion, and provide a review of the current literature, a discussion of future pathways for development, and case examples. The topic is divided by pathology into sections including trauma, deformity, spinal column tumors, and osteomyelitis.
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Wolfe, J. Alan, S. Chris Malaisrie, R. Saeid Farivar, Junaid H. Khan, W. Clark Hargrove, Michael G. Moront, William H. Ryan, et al. "Minimally Invasive Mitral Valve Surgery II Surgical Technique and Postoperative Management." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 11, no. 4 (July 2016): 251–59. http://dx.doi.org/10.1097/imi.0000000000000300.
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Techniques for minimally invasive mitral valve repair and replacement continue to evolve. This expert opinion, the second of a 3-part series, outlines current best practices for nonrobotic, minimally invasive mitral valve procedures, and for postoperative care after minimally invasive mitral valve surgery.
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Nakagawa, Kazuo, and Hisao Asamura. "Limited resection for early-stage thymoma: minimally invasive resection does not mean limited resection." Japanese Journal of Clinical Oncology 51, no. 8 (July 2, 2021): 1197–203. http://dx.doi.org/10.1093/jjco/hyab102.
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Abstract Standard resection for patients with thymoma is resection of thymoma with total thymectomy (TTx) via median sternotomy. Hence, limited resection for thymoma means a lesser extent of resection of normal thymus compared with a standard procedure, i.e. resection of thymoma with partial thymectomy (PTx). In contrast, minimally invasive resection has been defined as resection of thymoma with TTx via a less-invasive approach. However, to date, few studies have precisely evaluated the differences in surgical and oncological outcomes among these three procedures. This report summarizes the differences among these three procedures with a review of studies (January 2000 to December 2020) focusing on the difference in surgical and oncological outcomes and presents current issues in the surgical management of thymoma. In this report, 16 studies were identified; 5 compared standard resection to limited resection, 9 compared standard resection to minimally invasive resection and 2 compared limited resection to minimally invasive resection. Most studies reported that the surgical and oncological outcomes of limited resection or minimally invasive resection were similar to those of standard resection in patients with early-stage thymoma. However, they did not include a sufficient follow-up period. Both limited resection and minimally invasive resection for early-stage thymoma might be reasonable treatment options. However, they are still promising modes of resection. Further studies with a long follow-up period are needed.
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Hiemstra, Ellen, Wendela Kolkman, Saskia le Cessie, and Frank Willem Jansen. "Are Minimally Invasive Procedures Harder to Acquire than Conventional Surgical Procedures?" Gynecologic and Obstetric Investigation 71, no. 4 (2011): 268–73. http://dx.doi.org/10.1159/000321796.
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Rhee, Ben S., John Pham, Joshua R. Tanzer, Jodi S. Charvis, and Lauren O. Roussel. "Using Microeconomic Spending Traits to Inform Trends in Utilization of Cosmetic Procedures by Race and Ethnicity." Plastic and Reconstructive Surgery - Global Open 12, no. 7 (July 2024): e5963. http://dx.doi.org/10.1097/gox.0000000000005963.
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Background: Cosmetic plastic surgery in the United States is underutilized by African American and Hispanic populations compared with their White and Asian counterparts. This study evaluated whether microeconomic spending traits as a representation of financial stability can inform trends in cosmetic procedure volumes by racial group. Methods: Annual volumes for the top five cosmetic surgical and cosmetic minimally invasive procedures by racial/ethnic group from 2012 to 2020 were collected from the American Society of Plastic Surgeons’ annual reports. Factor analysis was used to calculate inflexible and flexible consumer spending by racial/ethnic groupings from the US Bureau of Labor Statistics’ consumer expenditure data. All four factors were calculated across US Bureau of Labor Statistics–defined racial/ethnic groupings and standardized so they could be interpreted relative to each other. Results: Compared with the other groupings, the White/Asian/other grouping spent significantly more on average for inflexible consumer spending (P = 0.0097), flexible consumer spending (P < 0.0001), cosmetic surgical procedures (P < 0.0001), and cosmetic minimally invasive procedures (P = 0.0006). In contrast, African American people spent significantly less on average for all four factors (all P < 0.01). For Hispanic people, values were significantly less on average for flexible consumer spending (P = 0.0023), cosmetic surgical procedures (P < 0.0001), and cosmetic minimally invasive procedures (P = 0.0002). Conclusions: This study demonstrates that inflexible and flexible consumer spending follow trends in utilization of cosmetic surgical and minimally invasive procedures by racial/ethnic groups. These microeconomic spending inequities may help further contextualize the racial/ethnic variation in access to cosmetic surgery.
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Lungu, Daniel Adrian, Elisa Foresi, Paolo Belardi, Sabina Nuti, Andrea Giannini, and Tommaso Simoncini. "The Impact of New Surgical Techniques on Geographical Unwarranted Variation: The Case of Benign Hysterectomy." International Journal of Environmental Research and Public Health 18, no. 13 (June 22, 2021): 6722. http://dx.doi.org/10.3390/ijerph18136722.
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Since the 1980s, the international literature has reported variations for healthcare services, especially for elective ones. Variations are positive if they reflect patient preferences, while if they do not, they are unwarranted, and thus avoidable. Benign hysterectomy is among the most frequent elective surgical procedures in developed countries, and, in recent years, it has been increasingly delivered through minimally invasive surgical techniques, namely laparoscopic or robotic. The question therefore arises over what the impact of these new surgical techniques on avoidable variation is. In this study we analyze the extent of unwarranted geographical variation of treatment rates and of the adoption of minimally invasive procedures for benign hysterectomy in an Italian regional healthcare system. We assess the impact of the surgical approach on the provision of benign hysterectomy, in terms of efficiency (by measuring the average length of stay) and efficacy (by measuring the post-operative complications). Geographical variation was observed among regional health districts for treatment rates and waiting times. At a provider level, we found differences for the minimally invasive approach. We found a positive and significant association between rates and the percentage of minimally invasive procedures. Providers that frequently adopt minimally invasive procedures have shorter average length of stay, and when they also perform open hysterectomies, fewer complications.
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Arts, Sebastian, Hans Delye, and Erik J. van Lindert. "Intraoperative and postoperative complications in the surgical treatment of craniosynostosis: minimally invasive versus open surgical procedures." Journal of Neurosurgery: Pediatrics 21, no. 2 (February 2018): 112–18. http://dx.doi.org/10.3171/2017.7.peds17155.
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OBJECTIVETo compare minimally invasive endoscopic and open surgical procedures, to improve informed consent of parents, and to establish a baseline for further targeted improvement of surgical care, this study evaluated the complication rate and blood transfusion rate of craniosynostosis surgery in our department.METHODSA prospective complication registration database that contains a consecutive cohort of all pediatric neurosurgical procedures in the authors’ neurosurgical department was used. All pediatric patients who underwent neurosurgical treatment for craniosynostosis between February 2004 and December 2014 were included. In total, 187 procedures were performed, of which 121 were endoscopically assisted minimally invasive procedures (65%). Ninety-three patients were diagnosed with scaphocephaly, 50 with trigonocephaly, 26 with plagiocephaly, 3 with brachycephaly, 9 with a craniosynostosis syndrome, and 6 patients were suffering from nonsyndromic multisutural craniosynostosis.RESULTSA total of 18 complications occurred in 187 procedures (9.6%, 95% CI 6.2–15), of which 5.3% (n = 10, 95% CI 2.9–10) occurred intraoperatively and 4.2% (n = 8, 95% CI 2.2–8.2) occurred postoperatively. In the open surgical procedure group, 9 complications occurred: 6 intraoperatively and 3 postoperatively. In the endoscopically assisted procedure group, 9 complications occurred: 4 intraoperatively and 5 postoperatively. Blood transfusion was needed in 100% (n = 66) of the open surgical procedures but in only 21% (n = 26, 95% CI 15–30) of the endoscopic procedures. One patient suffered a transfusion reaction, and 6 patients suffered infections, only one of which was a surgical site infection. A dural tear was the most common intraoperative complication that occurred (n = 8), but it never led to postoperative sequelae. Intraoperative bleeding from a sagittal sinus occurred in one patient with only minimal blood loss. There were no deaths, permanent morbidity, or neurological sequelae.CONCLUSIONSComplications during craniosynostosis surgery were relatively few and minor and were without permanent sequelae in open and in minimally invasive procedures. The blood transfusion rate was significantly reduced in endoscopic procedures compared with open procedures.
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Blikkendaal, Mathijs D., Sara R. C. Driessen, Sharon P. Rodrigues, Johann P. T. Rhemrev, Maddy J. G. H. Smeets, Jenny Dankelman, John J. van den Dobbelsteen, and Frank Willem Jansen. "Measuring surgical safety during minimally invasive surgical procedures: a validation study." Surgical Endoscopy 32, no. 7 (January 19, 2018): 3087–95. http://dx.doi.org/10.1007/s00464-018-6021-7.
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Okumura, Meinoshin, Yasushi Shintani, Mitsunori Ohta, Yoshihisa Kadota, Masayoshi Inoue, and Hiroyuki Shiono. "Minimally invasive surgical procedures for thymic disease in Asia." Journal of Visualized Surgery 3 (July 27, 2017): 96. http://dx.doi.org/10.21037/jovs.2017.06.03.
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&NA;. "Specially Designed Surgical Tools Could Improve Minimally Invasive Procedures." Journal of Clinical Engineering 34, no. 4 (October 2009): 192–93. http://dx.doi.org/10.1097/01.jce.0000337822.00014.d1.
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Han, Ernest S., and Mark Wakabayashi. "Indications for Minimally Invasive Surgery for Ovarian Cancer." Journal of the National Comprehensive Cancer Network 9, no. 1 (January 2011): 126–32. http://dx.doi.org/10.6004/jnccn.2011.0011.
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Epithelial ovarian cancer is often diagnosed in advanced stages and typically managed with surgical debulking followed by chemotherapy. For patients with presumed early-stage ovarian cancer, comprehensive surgical staging is essential for management, because 31% are upstaged. Over the past 15 years, minimally invasive techniques have improved and are increasingly being used to treat patients with ovarian cancer. Currently, only retrospective data support laparoscopic staging of patients with a suspicious adnexal mass or those surgically diagnosed with presumed early-stage ovarian cancer. Laparoscopy is also used in patients undergoing second-look procedures and to help evaluate whether patients should undergo optimal tumor debulking procedures or be initially managed with neoadjuvant chemotherapy. Randomized clinical studies are needed to further support the role of minimally invasive surgery in the treatment of ovarian cancer.
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Sparic, Radmila, Rajka Argirovic, Snezana Buzadzic, and Milica Berisavac. "Paravesical haematoma following placement of an isolated anterior mesh for cystocele repair." Vojnosanitetski pregled 70, no. 7 (2013): 697–99. http://dx.doi.org/10.2298/vsp1307699s.
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Introduction. Pelvic organ prolapse is a substantial health problem for women around the world. Given the limitations of traditional surgery in the reconstruction of normal vaginal anatomy and function in genitourinary prolapse, various synthetic implants have been developed for surgical repair. Mesh procedures are gaining in popularity, encouraged by preliminary data. Although minimally invasive and relatively safe, serious complications following these procedures have been described. Case report. We presented a patient who had underwent an isolated anterior mesh procedure and developed postoperative haematoma which required surgical intervention. Conclusion. This report suggests that minimally invasive urogynecological procedures could result in significant complications. Thus, surgeons should be familiar with effective interventions in order to manage them.
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Horgan, Santiago, Robert A. Berger, Enrique F. Elli, and N. Joseph Espat. "Robotic-Assisted Minimally Invasive Transhiatal Esophagectomy." American Surgeon 69, no. 7 (July 2003): 624–26. http://dx.doi.org/10.1177/000313480306900716.
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Minimally invasive surgery has been increasing in its adaptability to a wide range of procedures. Initially used in general surgery for cholecystectomy its use has now expanded to include Nissen fundoplications, Heller myotomies, donor nephrectomies, and total esophagectomies. Technological advancements have evolved to include robotic systems for performance of complex surgical procedures. We report on our experience of using robotic-assisted technology to perform a transhiatal total esophagectomy.
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Uecker, Marie, Joachim F. Kuebler, Benno M. Ure, and Nagoud Schukfeh. "Minimally Invasive Pediatric Surgery: The Learning Curve." European Journal of Pediatric Surgery 30, no. 02 (March 8, 2020): 172–80. http://dx.doi.org/10.1055/s-0040-1703011.
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AbstractThe use of minimally invasive surgery (MIS) in pediatric patients has increased over the past decades. The process of mastering a new procedure is termed the learning curve, during which the ability to operate increases but poorer outcomes are produced. We aim to analyze the current evidence on learning curves in pediatric MIS and evaluate its impact on patient's clinical outcomes. A systematic literature search was performed for studies listed on PubMed that reported on the learning curve for MIS surgical procedures. Studies were included if they stated the number of procedures required to reach a consistency in outcomes or if they compared outcomes between early and late period of MIS experience regarding the endpoints operative time, conversions, and intra-/postoperative complications. A total of 22 articles reporting on 11 surgical procedures were included in the study. Most authors reported a significant decrease in operative time as well as peri- and postoperative complications with increasing experience of the surgeon. Complications ranged from minor to major, the latter being especially severe for patients receiving pyloromyotomy (5–7% higher risk of mucosal perforation), esophageal atresia repair (15% higher leakage rate and 19–77% higher stenosis rate), or Kasai portoenterostomy (26–35% more liver transplants in the first year after surgery) during the learning curve period. Pediatric MIS comes with a considerable learning curve that may have a significant impact on the patient's clinical outcomes. Efforts should be made to minimize the effect of the learning curve on the patients.
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Fatehi Hassanabad, Ali, Jimmy Kang, Andrew Maitland, Corey Adams, and William D. T. Kent. "Review of Contemporary Techniques for Minimally Invasive Coronary Revascularization." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 16, no. 3 (May 2021): 231–43. http://dx.doi.org/10.1177/15569845211010767.
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Minimally invasive coronary revascularization techniques aim to avoid median sternotomy with its associated complications, while facilitating recovery and maintaining the benefits of surgical revascularization. The 3 most common procedures are minimally invasive coronary artery bypass grafting, totally endoscopic coronary artery bypass, and hybrid coronary revascularization. For a variety of reasons, including cost and technical difficulty, not many centers are routinely performing minimally invasive coronary revascularization. Nevertheless, many studies have assessed the safety and efficacy of each of these procedures in different clinical contexts. Thus far results have been promising, and with the evolution of procedural techniques, these approaches have the potential to redefine coronary revascularization in the future. This review highlights the current state of minimally invasive coronary revascularization techniques by exploring their benefits, identifying barriers to their adoption, and discussing future potential paradigms.
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Catherine, Julien, Christine Rotinat-Libersa, and Alain Micaelli. "Comparative Review of Endoscopic Devices Articulations Technologies Developed for Minimally Invasive Medical Procedures." Applied Bionics and Biomechanics 8, no. 2 (2011): 151–71. http://dx.doi.org/10.1155/2011/581061.
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This study introduces a comparative performance analysis of the technological solutions that have been used to build distal active articulations for minimally invasive medical procedures. The aim is to provide a practical and concise database and classification tool for anyone that wants to learn more about the technologies involved in minimally invasive medical devices, or for any designer interested in further improving these devices. A review of the different articulations developed in this field is therefore performed and organized by both actuation technology and structural architecture. Details are presented concerning the mechanical structures as well as the actuation and the mechanical transmission technologies available. The solutions are evaluated keeping as a reference some chosen required performances and characteristics for minimally invasive surgical procedures. Finally, a quantified comparison chart of these devices is given regarding selected criteria of interest for minimally invasive surgical application.
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Shinde, Pranil S., Pankaj Gharde, Rushikesh Shukla, Janhavi Sabnis, and Kanchan H. Morey. "Minimally Invasive Approaches for Cholecystectomy." Journal of Datta Meghe Institute of Medical Sciences University 18, no. 4 (2023): 821–26. http://dx.doi.org/10.4103/jdmimsu.jdmimsu_153_23.
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Abstract Surgical removal of the gallbladder is cholecystectomy. In Western countries, laparoscopic cholecystectomy (LC) is widely used procedure. Single-incision LC (SILC), mini LC (MLC) these surgeries developed by doctors, also natural orifice transluminal endoscopic surgery to lessen the invasiveness of the treatment. The goal of this study was to see how effective these novel less invasive techniques for LC are in treating gallstone disease. The current literature is inadequate for a proper management of new LC procedures. None of these methods have shown to be superior to traditional LC. SILC is now not recommended since it is linked to the predominance of bile duct damage also incisional hernia. Even though hybrid transvaginal cholecystectomy is becoming more popular in objective practice, cholecystectomies are still experimental. As a result of the fact that it is standardized, because MLC is standardized and nearly identical to traditional laparoscopic surgery, it may provide limited benefits without increasing postoperative problems, making it suitable for routine elective cholecystectomy. The technological issues could be addressed by modifying new surgical equipment that needs to grow with the nuances of SILC and cholecystectomy. Regardless of where these treatments may be used in the upcoming days, robotization may be required to make them the standard of care.
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Perez-Cruet, Mick J., Richard G. Fessler, and Noel I. Perin. "Review: Complications of Minimally Invasive Spinal Surgery." Neurosurgery 51, suppl_2 (November 1, 2002): S2–26—S2–36. http://dx.doi.org/10.1097/00006123-200211002-00005.
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Abstract COMPLICATIONS OF MINIMALLY invasive spinal surgery can be related to anesthesia, patient positioning, and surgical technique. The performance of successful minimally invasive spinal surgery is beset with several technical challenges, including the limited tactile feedback, two-dimensional video image quality of three-dimensional anatomy, and the manual dexterity needed to manipulate instruments through small working channels, which all account for a very steep learning curve. Knowledge of possible complications associated with particular minimally invasive spinal procedures can aid in their avoidance. This article reviews complications associated with minimally invasive spinal surgery in the cervical, thoracic, and lumbar spine by reviewing reported data of sufficient detail or with sufficient numbers of patients. In addition, possible complications associated with anesthesia use, patient positioning, and surgical techniques during thoracoscopic and laparoscopic spinal procedures are reviewed.
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Dai, Jian S. "Surgical robotics and its development and progress." Robotica 28, no. 2 (January 27, 2010): 161. http://dx.doi.org/10.1017/s0263574709990877.
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Surgical robotics is the study and application of advanced robotic technology to diverse surgical procedures, particularly to minimally invasive surgery. The advanced robotic technology in minimally invasive surgery leads to momentous change in and generates a tremendous impact on surgery, resulting in less pain and scarring, reduced blood loss and transfusions, lower risk of complication, shorter hospital stays and faster recovery periods.
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Kuvendjiska, Jasmina, Goran Marjanovic, Torben Glatz, Birte Kulemann, and Jens Hoeppner. "Hybrid Minimally Invasive Esophagectomy–Surgical Technique and Results." Journal of Clinical Medicine 8, no. 7 (July 5, 2019): 978. http://dx.doi.org/10.3390/jcm8070978.
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Background: Hybrid minimally invasive esophagectomy (HMIE) has been proven to be superior when compared with open esophagectomy, with a significant reduction of postoperative morbidity. In HMIE, the laparotomy is replaced by a minimally invasive laparoscopic approach. The radical mediastinal resection plus reconstruction is performed by a thoracic approach through a muscle-sparing thoracotomy. In this instructional article, we describe the surgical technique of HMIE in detail in order to facilitate possible adoption of the procedure by other surgeons. In addition, we give the monocentric results of our own practice. Methods: Between 2013 and 2018, HMIE was performed in 157 patients. The morbidity and mortality data of the procedure is shown in a retrospective monocentric analysis. Results: Overall, 54% of patients had at least one perioperative complication. Anastomotic leak was evident in 1.9%, and a single patient had focal conduit necrosis of the gastric pull-up. Postoperative pulmonary morbidity was 31%. Pneumonia was found in 17%. The 90 day mortality was 2.5%. Wound infection rate was 3%, and delayed gastric emptying occurred in 17% of patients. In follow up, 12.7% presented with diaphragmatic herniation of the bowel, requiring laparoscopic hernia reduction and hiatal reconstruction and colopexy several months after surgery. Conclusion: HMIE is a highly reliable technique, not only for the resection part but especially in terms of safety in reconstruction and anastomosis. For esophageal surgeons with experience in minimally invasive anti-reflux procedures and obesity surgery, HMIE is easy and fast to learn and adopt.
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Neufeld, Steven K., Daniel Dean, and Syed Hussaini. "Outcomes and Surgical Strategies of Minimally Invasive Chevron/Akin Procedures." Foot & Ankle International 42, no. 6 (January 27, 2021): 676–88. http://dx.doi.org/10.1177/1071100720982967.
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Background: Minimally invasive surgery (MIS) is increasingly being used for bunion correction, but limited patient outcome data have been reported for third-generation minimally invasive chevron/Akin (MICA) techniques. The aim of this study was to report on radiographic outcomes, pain control, satisfaction, learning curve, and complication rates in a consecutive series of 94 patients undergoing MICA procedures for hallux valgus. It also describes strategies for avoiding perioperative complications that may arise with MIS bunionectomies. Methods: The treating surgeon’s first 94 MICA procedures were included in the study. Radiographs were reviewed to measure pre- and postoperative intermetatarsal angles (IMAs), hallux valgus angles (HVAs), and soft tissue/bony foot width. Outcome measures, including visual analog scale (VAS) scores and Coughlin satisfaction scores, were obtained. Complication rates were retrospectively assessed though chart review. Statistical analysis was performed using Student t test for continuous variables and χ2 test for categorical variables. Average patient follow-up was 11.2 months. Results: VAS scores dropped 1 week postoperatively, from 5.2 preoperatively to 2.4 ( P < .001). IMA improved from 12.6 degrees to 5.7 degrees at final follow-up ( P < .001), while HVA improved from 26.8 degrees to 10.3 degrees ( P < .001). Bony foot width improved from 92.4 mm to 87.2 mm ( P < .001), and soft tissue foot width improved from 104.1 mm to 100.1 mm ( P < .001). The reoperation rate was 5%, including 3 hardware removals, 1 irrigation and debridement, and 1 neurolysis. Ninety-four percent of patients reported good or excellent satisfaction with the procedure. Complication rates and patient satisfaction scores were similar between the first and second half of patients ( P > .05), suggesting the learning curve was not a factor. Conclusion: In our experience, the MICA osteotomy was a safe and reproducible technique, associated with rapid improvement in pain scores, early weightbearing, significant deformity correction, high patient satisfaction, and low frequency of complications. In addition, the learning curve for the procedure was not as steep as previously reported. Level of Evidence: Level III, retrospective comparative series.
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Yoshimoto, Mitsunori, Noriyuki Iesato, Yoshinori Terashima, Tsuneo Takebayashi, Toshihiko Yamashita, and Ryunosuke Fukushi. "Short-term Results of Microendoscopic Muscle-preserving Interlaminar Decompression versus Spinal Process Splitting Laminectomy." Journal of Neurological Surgery Part A: Central European Neurosurgery 79, no. 06 (January 2, 2018): 511–17. http://dx.doi.org/10.1055/s-0037-1608871.
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Study Design A retrospective comparative study. Objective To compare retrospectively the clinical results and surgical invasiveness of two different types of minimally invasive surgery for lumbar spinal canal stenosis: microendoscopic muscle-preserving interlaminar decompression (ME-MILD) and spinal process splitting laminectomy (SPSL). Summary of Background Data ME-MILD and SPSL are minimally invasive procedures. However, the two procedures have not been compared in the literature. Materials and Methods We retrospectively enrolled patients who underwent ME-MILD or SPSL from 2011 to 2015. The surgical invasiveness of each technique was determined by evaluating the time required for the surgical procedure, amount of blood loss, serum creatine kinase (CK) levels on postoperative day (POD) 1, C-reactive protein (CRP) levels on POD 3 and 7, and the hospitalization. The clinical results were evaluated using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire score, the Short Form (36) Health Survey patient-reported outcome score, the visual analog scale for pain, a patient satisfaction score, and the incidence of surgical complications. Results A total of 97 patients were evaluated: 58 patients underwent ME-MILD, and 39 patients underwent SPSL. No significant differences were observed in the clinical results between the two groups. Regarding surgical invasiveness, no significant difference was found in the amount of blood loss, levels of CK, hospitalization, or time required for the procedure. However, CRP levels were significantly lower in the ME-MILD group. Conclusions ME-MILD and SPSL are both minimally invasive procedures. In a comparison of these two procedures, CRP was significantly lower in the ME-MILD group.
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Sobczak, Jarosław, Przemysław Przewratil, and Janusz Piotr Sikora. "Advantages and disadvantages of laparoscopic procedures in relation to the open method in pediatric surgery." Emergency Medical Service 10, no. 3 (2023): 183 191. http://dx.doi.org/10.36740/emems202303108.
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There are many studies which present advantages and disadvantages of the use of both minimally invasive and open method procedures in pediatric sur¬gery. This paper highlights the advantages of minimally invasive surgery and the resulting conclusions for use in clinical practice (e.g. the use of laparoscopy in children is associated with significantly less postoperative stress). The disadvantages of the described surgical techniques and other possible complica¬tions observed after the use of laparoscopic techniques and the open method are also presented. It was emphasized that surgical trauma, regardless of the surgical method used, causes not only a post-traumatic immune-inflammatory response of the body, but is often associated with the risk of developing infections (local or generalized) and the occurrence of recurrences. The study focuses on summarizing the current state of knowledge on minimally invasive pediatric surgery, in particular on the effectiveness of laparoscopic appendectomy, laparoscopic inguinal hernia repair and laparoscopic procedures used in pediatric oncology, taking into account postoperative immune response disorders. Moreover, progress was analyzed in the use of minimally invasive robotic surgery, which becomes an increasingly common method of treatment of many typical surgical diseases in children.
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Stevens, Richard, Matthew Bursnall, Carolyn Chadwick, Howard Davies, Mark Flowers, Christopher Blundell, and Mark Davies. "Comparison of Complication and Reoperation Rates for Minimally Invasive Versus Open Cheilectomy of the First Metatarsophalangeal Joint." Foot & Ankle International 41, no. 1 (September 6, 2019): 31–36. http://dx.doi.org/10.1177/1071100719873846.
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Background: Dorsal cheilectomy of the first metatarsophalangeal joint is an accepted treatment to alleviate dorsal impingement, pain, and reduced dorsiflexion in hallux rigidus. Traditionally performed via an open incision, this procedure has more recently been performed using minimally invasive techniques despite limited supportive published evidence. Methods: From December 2012 through December 2017, a retrospective analysis of all cheilectomies performed in our institution was done. The surgical technique was recorded along with any subsequent procedures performed for either persistent or recurrent pain, and complications were also noted. A comparison between open and minimally invasive outcomes was performed. In total, 171 cheilectomies were performed during this period. There were 38 open and 133 minimally invasive procedures. Results: At a mean 3-year follow-up, the reoperation rates of the 2 groups were different with only 1 (2.6%) of the open group requiring a fusion, while 17 (12.8%) of the minimally invasive surgical (MIS) group required further surgery (relative risk, 4.86; P = .059). In the open group, there was 1 (2.6%) complication, compared with 15 (11.3%) in the minimally invasive group (relative risk, 4.29; P = .076). Conclusion: While patients may opt for MIS cheilectomy with a proposed faster recovery time and better cosmesis, they should be counseled about the risks and benefits of both methods, and that the technique of MIS cheilectomy utilized in this study appears to have an increased relative risk of requiring a further procedure. Level of Evidence: Level III, retrospective comparative series.
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Hurst, Rachel Alpha Johnston. "Collapsing the Surfaces of Skin and Photograph in Cosmetic Minimally-Invasive Procedures." Body & Society 24, no. 1-2 (April 5, 2018): 175–92. http://dx.doi.org/10.1177/1357034x18766289.
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This article proposes that cosmetic minimally-invasive procedures – Botox injections, soft-tissue fillers, microdermabrasion, chemical peels and laser treatments – are an under-researched area and provide a number of promising paths for skin studies research. I argue that cosmetic minimally-invasive procedures collapse the difference between the surfaces of the photograph and the skin – the primary surfaces of cosmetic surgery – more successfully than cosmetic surgical procedures. More precisely, I maintain that the difference between photograph and skin is collapsed in two ways: first, through narrating the transformation of the skin’s surface in a way that more closely matches the photographic promises of the cosmetic surgery industry; and, second, by depicting the surgical penetration of the skin through advertising photography. The article concludes by suggesting that further investigation into cosmetic minimally-invasive procedures could offer a new way to think about relationships between ‘normative’ and ‘non-normative’ skin modification practices.
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Шахрай, С. В., М. Ю. Гаин, and Ю. М. Гаин. "Minimally Invasive Laser Procedures for Surgical Treatment of Pilonidal Cyst." Хирургия. Восточная Европа, no. 1 (March 28, 2022): 42–56. http://dx.doi.org/10.34883/pi.2022.11.1.004.
Full textAbstract:
Цель. Изучить послеоперационные результаты малоинвазивных лазерных операций при пилонидальных кистах и провести их сравнительную оценку с результатами традиционных хирургических методов лечения.Материалы и методы. В исследование вошли 106 пациентов с хроническим и 60 пациентов с острым воспалением пилонидальной кисты, которые были слепо распределены – по две равные группы методом простой рандомизации. Пациентам группы А выполняли лазерную коагуляцию и кюретаж пилонидальной кисты, в группе B – иссечение кисты, в группе С – чрезраневую лазерную коагуляцию, в группе D – простую санацию абсцесса. Применялось лазерное излучение диодного аппарата с длиной волны 1,56 мкм, мощностью 10–15 Вт.Результаты. Вероятность рецидива заболевания через 1 год после лазерной коагуляции и кюретажа пилонидальной кисты – 5,67%. Достоверные преимущества перед методом иссечения кисты были выявлены по показателям уровня болевого синдрома, частоты раневой инфекции, длительности лечения, срокам эпителизации послеоперационных ран (p<0,05, Mann – Whitney U-test, Chi-Square). При эхоскопии через год после малоинвазивных операций достоверно реже наблюдались инфильтративные изменения мягких тканей в зоне послеоперационного рубца, а также рубцовые деформации межъягодичной складки (Chi-Square (df=1) p=0,00001, p=0,0062).Средние сроки заживления ран в группах С и D оказались сопоставимы (p=0,8054, z=–0,3458 Mann – Whitney U-test). У 10% пациентов в группе D через месяц выявлен вторичный свищ, что позднее потребовало иссечения кисты. Выявлены преимущества чрезраневой лазерной коагуляции по частоте ремиссии заболевания через 1 год после начала лечения (p=0,0122, Chi-square с поправкой Yates). При морфометрии, эхоскопии через год наличие инфильтрата без жидкостных структур и воспаления в группе С было выявлено в 6,67% наблюдений, в группе D – в 22,5%.Заключение. Методы лазерной коагуляции с кюретажем пилонидальной кисты и чрезраневой лазерной коагуляции обладают рядом преимуществ по сравнению с традиционными вмешательствами. Они могут стать альтернативными вариантами лечения хронического и острого воспаления пилонидальной кисты в условиях «хирургии одного дня». Purpose. To study the postoperative results of minimally invasive laser operations in pilonidal cysts and conduct its comparative assessment with the results of traditional surgical treatments.Materials and methods. The study included 106 patients with chronic and 60 patients with acute inflammation of pilonidal sinus who were blindly distributed – into two equal groups by simple randomization. Patients of group A underwent laser coagulation and curettage of the pilonidal sinus, in group B – sinus excision, in group C – laser coagulation through a wound, in group D – simple incision of the abscess. Laser radiation of a diode apparatus with a wavelength of 1.56 microns with a power of 10–15 W was used.Results. The recurrence rate of the disease 1 year follow-up after laser coagulation and curettage of the pilonidal sinus is 5.67%. Significant advantages over the method of sinus excision were revealed by indicators of the level of pain syndrome, the frequency of wound infection, the duration of treatment, the timing of postoperative wounds healing (p<0.05, Mann – Whitney U-test, Chi-Square). During ultrasound, a year after minimally invasive operations, infiltrative changes of tissues in the postoperative zone were significantly less common, as well as scar deformities of the intergluteal area (Chi-Square (df=1) p=0.00001, p=0.0062).Median wound healing times in groups C and D were comparable (p=0.8054, z=–0.3458 Mann – Whitney U-test). In 10% of patients in group D, a secondary fistula was detected after a month, which later required a sinus excision. The benefits of laser coagulation through a wound by disease remission rate 1 year after start of treatment (p=0.0122, Yates corrected Chi-square) were identified. In dimension measurement, ultrasound after a year, the presence of infiltrate without fluid structures and inflammation in group C was detected in 6.67% of patients, in group D – in 22.5%.Сonclusion. The laser coagulation with pilonidal sinus curettage method and laser coagulation through a wound has a number of advantages over the traditional operations. The methods can become one of the alternative options for treating chronic and acute pilonidal sinus in regimen of "one-day surgery".