Innovations in Surgery and Interventional Medicine最新文献

{"title":"Multimodality Echocardiographic Imaging for a Novel Transcatheter Native Mitral Valve Replacement Procedure","authors":"D. Galzerano, B. Alamro, A. Moreo, Edoardo Bossone, O. Vriz, A. Alenazy, Ahmed M Alshehri, M. Al Amri, A. Alhamshari, Hani Al sergani","doi":"10.36401/isim-22-02","DOIUrl":"https://doi.org/10.36401/isim-22-02","url":null,"abstract":"\u0000 Transcatheter native mitral valve replacement (TMVR) is a novel procedure that has the potential to overcome some of the current limitations associated with the transcatheter edge-to-edge mitral valve (MV) repair technique. The aim of this study was to describe the key steps in periprocedural echocardiographic guidance of TMVR with the Tendyne system, emphasizing potential caveats and areas of difficulty. The imaging pathway can be schematized in four fundamental steps: baseline evaluation of mitral regurgitation (MR), preprocedural screening and planning, intraprocedural guidance, and follow-up. Baseline evaluation of MR in TMVR includes the guidelines-recommended imaging pathway of MR assessment. A dedicated preprocedure cardiac multimodality imaging screening and planning for TMVR is able to determine patient eligibility according to the anatomic characteristics and measurements, provide information for appropriate valve sizing, and detect features that can predispose to potential hazard or complications. Cardiac computed tomography and two-dimensional (2D) and three-dimensional (3D) transesophageal echocardiography (TEE) are the main actors in this phase. The road map for intraprocedural TMVR guidance includes the following: (1) apical access assessment: 2D TEE assessment of the site for optimal left ventricular apical access as planned by the preprocedural computed tomography; (2) support for catheter and sheath localization, trajectory, and positioning; and (3) valve positioning and radial orientation. Thereafter, the prosthesis is withdrawn toward the left ventricle and deployed intra-annularly. Post-deployment includes assessment for correct clocking and hemodynamics, perivalvular leakage, and left ventricular outflow tract obstruction. Two-dimensional and 3D TEE and fluoroscopy provide intraprocedural guidance. The follow-up of the Tendyne device includes the guidelines-recommended imaging pathway of bioprosthesis. Knowledge of multimodality imaging use is key for the interventional imagers and crucial in the success of the procedure.","PeriodicalId":392717,"journal":{"name":"Innovations in Surgery and Interventional Medicine","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130110263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indocyanine Green-enhanced Fluorescence to Assess Bowel Perfusion During Robotic-assisted Rectal Surgery","authors":"H. Alawfi, Seung Yoon Yang, M. Alessa, H. Helmi, A. Sakr, N. Kim","doi":"10.36401/isim-23-01","DOIUrl":"https://doi.org/10.36401/isim-23-01","url":null,"abstract":"\u0000 \u0000 \u0000 Anastomotic leakage following rectal surgery is a major complication, which may occur due to insufficient vascular supply. We aimed to evaluate the efficacy of using indocyanine green fluorescence angiography for intraoperative assessment of vascular anastomotic perfusion in robotic low anterior resection.\u0000 \u0000 \u0000 \u0000 This was a retrospective cohort study that included consecutive patients undergoing robotic low anterior resection for rectal cancer between March 2017 and February 2019. Intraoperative use of indocyanine green fluorescence for assessment of bowel perfusion was performed in patients operated after April 2018. Those who underwent the surgery before that comprised the control group. The primary outcome was the occurrence of anastomotic leakage between the two groups.\u0000 \u0000 \u0000 \u0000 Each group included 48 patients. There were no significant differences between the two groups in terms of demographic data or tumor characteristics. The planned anastomotic site was revised in 1 of 48 patients who received indocyanine green fluorescence based on the surgeon's subjective finding of a hypo-perfused distal segment. Postoperative anastomotic leakage was confirmed clinically and radiologically in one patient (2.8%) in the indocyanine green group compared with two patients (4.16%) in the control group.\u0000 \u0000 \u0000 \u0000 Indocyanine green fluorescence may be considered a useful intraoperative tool for assessment of vascular perfusion of bowel during robotic rectal surgery. Change in the site of resection and/or anastomosis may be indicated, possibly affecting the incidence of anastomotic leakage.\u0000","PeriodicalId":392717,"journal":{"name":"Innovations in Surgery and Interventional Medicine","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127453136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Rib Avascular Necrosis Complicated by Osteomyelitis in a Patient With Sickle Cell Anemia","authors":"Ibrahem Albalkhi, Tariq Saleh, Jibran A. Khan, W. Saleh","doi":"10.36401/isim-22-04","DOIUrl":"https://doi.org/10.36401/isim-22-04","url":null,"abstract":"\u0000 \u0000 \u0000 Avascular necrosis of the rib is a rare presentation of sickle cell anemia's vaso-occlusive crisis. This report describes the case of a 45-year-old man known to have sickle cell anemia presenting with rib avascular necrosis complicated by osteomyelitis. The patient came to the outpatient department with left lateral chest wall pain. Antibiotics produced no improvement. A computed tomography scan of the chest revealed a left sixth rib fracture with a thick fluid collection consistent with pus. The patient was taken to surgery and underwent necrotic bone debridement and pus drainage. The patient showed improvement and became afebrile after the surgery.\u0000 \u0000 \u0000 \u0000 The lack of distinct clinical indicators and low occurrence of rib avascular necrosis can lead to misdiagnosis and mismanagement of the disease.\u0000","PeriodicalId":392717,"journal":{"name":"Innovations in Surgery and Interventional Medicine","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115834343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheal Resection Anastomosis: A Retrospective Analysis of 33 Cases","authors":"Abdullah Al Shammari, Ghadi Askar, Talal Al Masri, M. Shoukri, M. Ishaq, W. Saleh","doi":"10.36401/isim-22-01","DOIUrl":"https://doi.org/10.36401/isim-22-01","url":null,"abstract":"\u0000 \u0000 \u0000 Laryngotracheal stenosis (LS) is most commonly caused by iatrogenic injury, namely, tracheal intubation. The goal of treatment is the maintenance of a patent airway, which is mostly achieved by surgical intervention. Our objective was to study the effect of perioperative variables on tracheal resection anastomosis (TRA)/cricotracheal resection anastomosis (CTRA) surgical outcomes by identifying statistically significant factors associated with postoperative complications and failure of surgery, i.e., restenosis.\u0000 \u0000 \u0000 \u0000 Data from the medical records of 33 patients who underwent TRA/CTRA was analyzed by univariate and multivariate logistic regression. The data included perioperative variables such as the etiology of stenosis, comorbidities, and postoperative or long-term complications.\u0000 \u0000 \u0000 \u0000 The study included nine females and 24 males, and most (29, 87.88%) were intubated prior to surgery. Nineteen patients (57.57%) developed one or more postoperative complications, including, but not limited to, surgical site infection and hematoma. Of all patients, six (18.18%) developed long-term restenosis. Multiple factors were significantly associated with the development of postoperative complications. Univariate analysis revealed the following factors as statistically significant: age (p = 0.05), diabetes (p = 0.00001), hypertension (p = 0.00001), and myocardial infarction (p = 0.03). Multivariate analysis showed that age (p = 0.046) and myocardial infarction (p = 0.00001) were independent factors. The study had an overall survival of 97%.\u0000 \u0000 \u0000 \u0000 TRA/CTRA is a complex surgical procedure, and its outcomes can be affected by many factors. More studies with bigger sample sizes are needed to better understand contributing factors and to confirm the already established associations.\u0000","PeriodicalId":392717,"journal":{"name":"Innovations in Surgery and Interventional Medicine","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116218279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution of Fetal Procedures","authors":"Abeer Alsaigh, W. Kurdi","doi":"10.36401/isim-22-x1","DOIUrl":"https://doi.org/10.36401/isim-22-x1","url":null,"abstract":"","PeriodicalId":392717,"journal":{"name":"Innovations in Surgery and Interventional Medicine","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128896980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Utero Intervention for Isolated Fetal Pleural Effusion: A Case Report","authors":"W. Kurdi, L. Ibrahim","doi":"10.36401/isim-22-03","DOIUrl":"https://doi.org/10.36401/isim-22-03","url":null,"abstract":"\u0000 Fetal pleural effusion is a rare condition easily diagnosed by antenatal ultrasound. It can be classified into two categories: primary and secondary. Primary pleural effusion is mainly attributed to defective lymphatic drainage in the fetus. Secondary pleural effusion can be caused by conditions that affect the fetal cardiac function, fetal anemia, fetal infections, chromosomal aberrations, genetic diseases, or congenital malformations that disrupt the lungs and mediastinal architecture. The clinical course is variable depending on the severity, underlying cause, gestational age at diagnosis, and the presence or absence of other congenital abnormalities. We present a case of isolated fetal pleural effusion where in utero therapy included thoracocentesis followed by the insertion of a thoracoamniotic shunt.","PeriodicalId":392717,"journal":{"name":"Innovations in Surgery and Interventional Medicine","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121175408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching Undergraduate Otolaryngology During the COVID-19 Pandemic: A Cross-Sectional Questionnaire Study","authors":"H. Alsheikh, A. Zahlan, Fawziah AlMana, R. Almutairi, Hawazen Alqahtani, M. A. Al Doumani, Esam Albawardi, K. Alkattan, N. Alotaibi","doi":"10.36401/isim-21-04","DOIUrl":"https://doi.org/10.36401/isim-21-04","url":null,"abstract":"\u0000 \u0000 \u0000 Live teaching via online platforms during the COVID-19 pandemic has proved to be an innovative solution during the crisis, yet limitations were still observed. Teaching challenges during the pandemic must be accurately studied to come up with evidence-based solutions. We aimed to assess the effectiveness of virtual or online teaching in delivering educational objectives to otorhinolaryngology, head and neck surgery (ORL-HNS) clerkship students (undergraduate medical students) during the COVID-19 pandemic.\u0000 \u0000 \u0000 \u0000 This was a cross-sectional questionnaire study with a survey designed to evaluate undergraduate medical students' responses toward online ORL-HNS classes. The same set of questions was sent to two different groups who were in ORL-HNS clerkship rotation under different quarantine restrictions levels during the pandemic.\u0000 \u0000 \u0000 \u0000 In total, 95 responses were analyzed; 32 responses were collected from the first group of students who were in the clinical rotation exclusively through online means under strict lockdown measurements. The remaining 63 responses were from the second group of students who were in the rotation after modifications to the COVID-19 lockdown protocols; the modifications allowed more in-person meetings under social distancing measures. The overall feedback about the scientific benefit of the ORL-HNS clerkship course was positive, with the majority of students agreeing that they felt prepared for future examinations, but not as much for clinical practice. In addition, students reported that lab skills sessions held after quarantine protocol modifications helped enhance their knowledge and better prepare them for future clinical practice and exams.\u0000 \u0000 \u0000 \u0000 Online teaching technologies might be able to compete with conventional teaching methods, but further improvements must take place to close the gaps between traditional and online classrooms. We believe advanced methods and simulation techniques can be implemented to aid in teaching complex topics in medicine, especially in otorhinolaryngology.\u0000","PeriodicalId":392717,"journal":{"name":"Innovations in Surgery and Interventional Medicine","volume":"57 28","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120935077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients With Prior Gastric Bypass Surgery: A Case Series of Technical Challenges","authors":"Abdulrahman Aloun, Fahad Al Abeidi, Ali Alzahrani, A. Swied","doi":"10.36401/ISIM-20-04","DOIUrl":"https://doi.org/10.36401/ISIM-20-04","url":null,"abstract":"\u0000 Accessing the biliary ducts for performing endoscopic retrograde cholangiopancreatography (ERCP) and relevant interventional procedures after gastric bypass surgery is technically difficult and frequently unsuccessful due to anatomical alterations. To overcome such technical challenges, laparoscopic-assisted ERCP (LA-ERCP) is used to approach the biliary ducts via nonperoral reliable access for performing different endoscopic biliary interventions. In this case series, we report a total of three patients with different anatomical alterations who underwent LA-ERCP.","PeriodicalId":392717,"journal":{"name":"Innovations in Surgery and Interventional Medicine","volume":"105 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122631961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an Otolaryngology Head and Neck Surgery Residents' Induction “Boot Camp” in Saudi Arabia","authors":"Muataz H Alhashem, N. Alotaibi, Eulaf H. Alaadah, Ibrahim S. Alnoury, A. Jebreel, F. Jabri, Fazal Hussain, M. Rajab","doi":"10.36401/isim-21-02","DOIUrl":"https://doi.org/10.36401/isim-21-02","url":null,"abstract":"\u0000 \u0000 \u0000 The otolaryngology (ORL) boot camp was designed to onboard ORL residents through a curriculum focusing on their needs as novice otolaryngologists. This boot camp provided systematic, specialty-wide training in core elements of knowledge, procedural skills, professionalism, supervision, and communications for residents entering ORL. The present study aimed to assess the effectiveness of an ORL resident induction “boot camp” in the Kingdom of Saudi Arabia.\u0000 \u0000 \u0000 \u0000 This was a cross-sectional (multicenter) study encompassing data collection through an online voluntary questionnaire. Participants were new ORL residents in the Saudi residency training program.\u0000 \u0000 \u0000 \u0000 Fifty responses were returned, with a completion rate of 88%. Sixty-four percent of the respondents were male. Most of the respondents were aged from 26 to 27 years. Respondents were from different cities. Most participants agreed that the scientific value of the course was beneficial (agree, 40%; strongly agree, 44%) and they felt better prepared for their residency training after this boot camp (agree, 44%; strongly agree, 28%).\u0000 \u0000 \u0000 \u0000 Boot camp in ORL is an additional important activity during the early years of training. It provides significant effects in terms of knowledge readiness at the beginning of specialty training. We believe that boot camp should include other dimensions of training, including surgical, communication, and judgmental skills, not only for the early years of training but also during the remaining period until training completion.\u0000","PeriodicalId":392717,"journal":{"name":"Innovations in Surgery and Interventional Medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133828086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Is the Value of Artificial Intelligence in Radiology?","authors":"Mashael Alrujaib, D. Bakheet","doi":"10.36401/isim-21-03","DOIUrl":"https://doi.org/10.36401/isim-21-03","url":null,"abstract":"The promise of artificial intelligence in medicine is to provide composite, panoramic views of individuals’ medical data; to improve decision making; to avoid errors such as misdiagnosis and unnecessary procedures; to help in the ordering and interpretation of appropriate tests; and to recommend treat-ment .","PeriodicalId":392717,"journal":{"name":"Innovations in Surgery and Interventional Medicine","volume":"886 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127384894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}