Journal of visualized surgery最新文献

{"title":"Uniportal video-assisted thoracic surgery treatment of intra-operative complications.","authors":"Vasilios Tentzeris,&nbsp;Kostas Papagiannopoulos","doi":"10.21037/jovs.2018.04.10","DOIUrl":"https://doi.org/10.21037/jovs.2018.04.10","url":null,"abstract":"<p><strong>Background: </strong>The uniportal video-assisted thoracic surgery (U-VATS) approach is rapidly gaining attention. Still there is lack of gross engagement to this technique, even within the VATS surgeons. We believe that the uniportal approach needs the same attention as any newly introduced skill; it would be a great mistake to be considered as a simple variation of the standardised multi-portal VATS.</p><p><strong>Methods: </strong>We have evaluated personal and institutional experience, supported by international bibliography. Factors that could influence complications have been searched. Factors have been split to operator-related and patient-related.</p><p><strong>Results: </strong>We have identified a series of preventable complications. The operator-related ones, need addressing prior to engagement to surgery. A well-structured team led by the surgeon functions in benefit of the patient. A wise and skilled surgeon in synergy with the surgical team can be prepared to resolve the most common presented challenges.</p><p><strong>Conclusions: </strong>Our collected experience may be a guide to facilitate the U-VATS journey.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"74"},"PeriodicalIF":0.0,"publicationDate":"2018-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.04.10","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36115212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coarctation repair-redo challenges in the adults: what to do?","authors":"Erik Beckmann,&nbsp;Arminder S Jassar","doi":"10.21037/jovs.2018.04.07","DOIUrl":"https://doi.org/10.21037/jovs.2018.04.07","url":null,"abstract":"<p><p>Aortic coarctation is one of the most common congenital cardiac pathologies. Repair of native aortic coarctation is nowadays a common and safe procedure. However, late complications, including re-coarctation and aneurysm formation, are not uncommon. The incidence of these complications is dependent on the type of the initial operation. Both endovascular and conventional open repair play important roles in the treatment of late complications after previous coarctation repair. This article will review the incidence of late complications after coarctation repair and will discuss the treatment options for redo coarctation repair in adult patients.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"76"},"PeriodicalIF":0.0,"publicationDate":"2018-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.04.07","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36115646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why to be cautious with the use of the frozen elephant trunk in acute type A aortic dissection.","authors":"William J Morshuis","doi":"10.21037/jovs.2018.03.21","DOIUrl":"https://doi.org/10.21037/jovs.2018.03.21","url":null,"abstract":"Already at the second meeting Aortic meeting in Bologna, I showed a slide confirming that type A dissection is a life-threatening disease with high rate of early mortality. What threatens the patients is blood in the pericardium causing tamponade. In Germany and The Netherlands patients are operated on within hours.","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"73"},"PeriodicalIF":0.0,"publicationDate":"2018-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.03.21","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36115211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic pancreas drainage procedure for chronic pancreatitis: robotic lateral pancreaticojejunostomy (Puestow procedure).","authors":"Adeel S Khan, Imran Siddiqui, Dionisios Vrochides, John B Martinie","doi":"10.21037/jovs.2017.10.10","DOIUrl":"10.21037/jovs.2017.10.10","url":null,"abstract":"<p><p>Lateral pancreaticojejunostomy (LPJ), also known as the Puestow procedure, is a complex surgical procedure reserved for patients with refractory chronic pancreatitis (CP) and a dilated pancreatic duct. Traditionally, this operation is performed through an open incision, however, recent advancements in minimally invasive techniques have made it possible to perform the surgery using laparoscopic and robotic techniques with comparable safety. Though we do not have enough data yet to prove superiority of one over the other, the robotic approach appears to have an advantage over the laparoscopic technique in better visualization through 3-dimensional (3D) imaging and availability of wristed instruments for more precise actions, which may translate into superior outcomes. This paper is a description of our technique for robotic LPJ in patients with refractory CP. Important principles of patient selection, preoperative workup, surgical technique and post-operative management are discussed. A short video with a case presentation and highlights of the important steps of the surgery is included.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"72"},"PeriodicalIF":0.0,"publicationDate":"2018-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5945911/pdf/jovs-04-2017.10.10.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36115210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic internal mammary lymphadenectomy: another possible minimally invasive approach to sampling lymph nodes in breast cancer patients.","authors":"Alessandro Pardolesi,&nbsp;Luca Bertolaccini,&nbsp;Jury Brandolini,&nbsp;Piergiorgio Solli","doi":"10.21037/jovs.2018.03.06","DOIUrl":"https://doi.org/10.21037/jovs.2018.03.06","url":null,"abstract":"Internal mammary lymphadenopathy may develop in breast cancer patients with silicone implants. Differential diagnosis includes malignant recurrence, infections, inflammations and granulomatous deposit. We report a case of internal mammary lymphadenopathy, in a patient with the previous history of breast cancer, requiring a tissue diagnosis. We performed a Robotic lymph nodes dissection of the left internal mammary. Final pathology diagnosis was positive for silicone granulomatous lymphadenitis secondary to silicone breast implants inserted after mastectomy for breast cancer.","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"71"},"PeriodicalIF":0.0,"publicationDate":"2018-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.03.06","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36115209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commissural repositioning in bicuspid aortic valve repair with Valsalva graft.","authors":"Monica Contino,&nbsp;Andrea Mangini,&nbsp;Claudia Romagnoni,&nbsp;Carlo Antona","doi":"10.21037/jovs.2018.03.18","DOIUrl":"https://doi.org/10.21037/jovs.2018.03.18","url":null,"abstract":"Bicuspid aortic valve (BAV) is the most common congenital cardiac defect, with an estimated prevalence between 0.5% and 2% (1); this pathology is often associated with aortic root and ascending aorta dilation due to structural abnormalities such as decreased fibrillin, elastin fragmentation and apoptosis (1,2).","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"70"},"PeriodicalIF":0.0,"publicationDate":"2018-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.03.18","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36115208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular treatment of acute Type A aortic dissection-the Endo Bentall approach.","authors":"Maximilian Kreibich,&nbsp;Bartosz Rylski,&nbsp;Stoyan Kondov,&nbsp;Julia Morlock,&nbsp;Johannes Scheumann,&nbsp;Fabian A Kari,&nbsp;Holger Schröfel,&nbsp;Matthias Siepe,&nbsp;Friedhelm Beyersdorf,&nbsp;Martin Czerny","doi":"10.21037/jovs.2018.03.14","DOIUrl":"https://doi.org/10.21037/jovs.2018.03.14","url":null,"abstract":"<p><p>Outcome after classical surgical repair of acute Type A aortic dissection has steadily improved over the years and several modifications in cannulation and perfusion added to this achievement. However, subgroups remain where results of classical surgical repair still have room for improvement, particularly patients with severe preoperative malperfusion as well as elderly patients with a limited physiological reserve. So far, only small case series or case reports have been published on the endovascular treatment of dissected ascending aortas. However, a tube alone is not sufficient to fix the entire complex underlying problem in the vast majority of patients with acute Type A aortic dissection. In addition, these published reports are either due to a favorable anatomy or due to very localized disease processes, which are the exception and not the rule. The concept of an endovascular valve-carrying conduit may significantly increase the number of patients suitable for endovascular therapy and it may soon be common practice.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"69"},"PeriodicalIF":0.0,"publicationDate":"2018-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.03.14","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36115207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel reconstruction of a vascular aneurysm in Marfan syndrome.","authors":"Xun Yuan,&nbsp;Andreas Mitsis,&nbsp;Christoph A Nienaber","doi":"10.21037/jovs.2018.03.12","DOIUrl":"https://doi.org/10.21037/jovs.2018.03.12","url":null,"abstract":"The role of endovascular procedures in Marfan syndrome (MFS) remains an issue of debate. In principle, endovascular techniques are not intended for the treatment of aortic or vascular conditions in patients with genetic connective tissue disease.","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"67"},"PeriodicalIF":0.0,"publicationDate":"2018-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.03.12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36115205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can genetic diagnosis inform the decision of when to operate?","authors":"Maral Ouzounian,&nbsp;Scott A LeMaire","doi":"10.21037/jovs.2018.03.08","DOIUrl":"https://doi.org/10.21037/jovs.2018.03.08","url":null,"abstract":"<p><p>Genetic discovery for heritable thoracic aortic disease (HTAD) has been progressing at a brisk pace. Surgical management of thoracic aortic aneurysms and dissections has become more personalized, with genetic factors increasingly informing the decision of when to operate on patients. An improved understanding of genotype-phenotype correlations in patients with HTAD will ultimately lead to gene- and mutation-specific recommendations for surgical repair. Until more robust data from larger cohorts can inform our decisions, patients with HTAD should be seen by an aortic specialist for a tailored approach to elective surgical repair.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"68"},"PeriodicalIF":0.0,"publicationDate":"2018-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.03.08","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36115206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advantages of wound retractor device versus rigid trocar at camera port in video-assisted thoracic surgery-a single institution experience.","authors":"Federico Raveglia,&nbsp;Ugo Cioffi,&nbsp;Matilde De Simone,&nbsp;Alessandro Rizzi,&nbsp;Andrea Leporati,&nbsp;Carmine Tinelli,&nbsp;Marco Chiarelli,&nbsp;Alessandro Baisi","doi":"10.21037/jovs.2018.03.15","DOIUrl":"https://doi.org/10.21037/jovs.2018.03.15","url":null,"abstract":"<p><strong>Background: </strong>rigid trocars are widely adopted in video-assisted thoracic surgery (VATS), despite some disadvantages: (I) cannula strong pressure on intercostal nerve stimulating postoperative pain; (II) limited movement of thoracoscopic devices on their fulcrum when extreme acute angles with the chest wall are needed. Wound retractor (WR) device, designed for laparoscopic surgery, it is also used in VATS, but to protect mini-thoracotomy. We compared the use of extra-small WR versus rigid trocar at camera port that is the most painful thoracostomy. The aim was to determine if WR is associated with less postoperative pain and better scope maneuverability.</p><p><strong>Methods: </strong>This is a single institution prospective study recorded and approved by ethics committee at our hospital. From October 2016 to June 2017, we enrolled 40 patients (statistical power 88%), randomized into two different groups. Group A (20 patients) underwent VATS lung resection using WR at camera port, group B (20 patients) using rigid trocar. Intra-operative data collected were maximum acute angle obtained between the camera and chest wall and chest wall thickness. Pain was measured by numerical analog scales (NAS) at 6, 12, 24, 48 and 72 hours after surgery. We also measured total morphine consumption at 72 h administered by patient controlled analgesia (PCA) system.</p><p><strong>Results: </strong>No statistical significance was found in the demographic traits of the two groups (P=1). Statistically significant differences were found in favor of group A for both pain control, morphine consumption (P<0.001) and camera maneuverability (described as maximum acute angle obtained/chest wall thickness) (P<0.001).</p><p><strong>Conclusions: </strong>patients who had WR showed less postoperative pain. Moreover, WR presented other advantages: camera protection by small bleeding from chest wall, adaptability with every chest wall thickness, absence of skin injury around the port. We suggest its use instead of rigid trocar.</p>","PeriodicalId":17587,"journal":{"name":"Journal of visualized surgery","volume":"4 ","pages":"66"},"PeriodicalIF":0.0,"publicationDate":"2018-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/jovs.2018.03.15","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36115204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}