Journal of laparoendoscopic & advanced surgical techniques. Part A最新文献

{"title":"Rapid Adoption of an Interdisciplinary Care Team Model for Surgical Residents Managing Coronavirus Disease-19.","authors":"Aaron W Kangas-Dick,&nbsp;J Rodrigo Diaz-Siso,&nbsp;Alexa Griffiths,&nbsp;Asha Khachane,&nbsp;Nicole Bilbro,&nbsp;Regina Hwang,&nbsp;Christopher Prien,&nbsp;Paul Chandler,&nbsp;Zoe Berman,&nbsp;Antony Dellituri,&nbsp;Inna Gelfand,&nbsp;Victor Roszokha,&nbsp;Patrick I Borgen,&nbsp;Ory Wiesel,&nbsp;Anne Mongiu,&nbsp;Kyle J Glithero,&nbsp;Rebecca J Rhee","doi":"10.1089/lap.2021.0120","DOIUrl":"https://doi.org/10.1089/lap.2021.0120","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Patients infected with SARS-Cov-2, the causative virus behind the coronavirus disease-19 (COVID-19) pandemic, have been increasing rapidly in New York City. New York City has the highest incidence in the United States and fully 45% of all deaths from COVID-19. Our medical center is located within a high-density region of cases in south Brooklyn and, in fact, three of our neighborhood zip codes are in the top seven in New York in incidence. As a result, our center has experienced a dramatic increase in hospitalizations, particularly respiratory distress secondary to COVID-19, which rapidly exceeded the capacity of our internal medicine service. This necessitated the formation of new COVID-19 units throughout the hospital, replacing all former service lines. These units employed management teams composed of residents from many medical and surgical disciplines, including general surgery residents. <b><i>Methods:</i></b> Our general surgery residency program established a surgical COVID-19 (SCOVID) management team. Initially, 4 surgical residents (2 senior and 2 junior), 1 attending surgeon, and 1 attending internal medicine physician were allocated to the initial SCOVID team. On day 3 of implementation, to achieve more rapid competence in the complex management of these patients, a senior medicine resident with direct experience in the care of COVID-19 patients was added in an advisory capacity. <b><i>Results:</i></b> The addition of an experienced senior medical resident and attending allowed for the quick adoption of uniform management protocols by surgical residents and attendings. <b><i>Discussion:</i></b> We describe a protocol for the establishment of COVID-19 management teams staffed with general surgical residents, as well as a strategy for the achievement of rapid increases in competency. The addition of a senior internal medicine resident and attending to our SCOVID team allowed for rapid achievement of competency in the care of COVID-19 patients in our large institution at the epicenter of the COVID-19 pandemic.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"541-545"},"PeriodicalIF":1.3,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25583764","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":"Hybrid Robotic Hernia Repair for Incisional Hernias: Perioperative and Patient-Reported Outcomes.","authors":"Omar Yusef Kudsi,&nbsp;Karen Chang,&nbsp;Naseem Bou-Ayash,&nbsp;Fahri Gokcal","doi":"10.1089/lap.2020.0657","DOIUrl":"https://doi.org/10.1089/lap.2020.0657","url":null,"abstract":"<p><p><b><i>Background:</i></b> Minimally invasive abdominal wall reconstruction, utilizing transversus abdominis release (TAR), has been described and shown to be beneficial for ventral hernia repair (VHR). Limited literature is available surrounding the hybrid robotic TAR (h-rTAR) approach, which combines robotic dissection and component separation with open fascial defect closure and mesh deployment. In this study, we describe our h-rTAR technique and present our center's postoperative and patient-reported outcomes (PROs). <b><i>Methods:</i></b> h-rTAR VHRs performed between 2013 and 2018 were examined. The h-rTAR technique was described. Patient characteristics and operative variables were analyzed. Perioperative results were presented according to European Hernia Society (EHS) classifications. Pre- and post-operative hernia-specific quality-of-life (QoL) assessments were conducted. <b><i>Results:</i></b> Twenty patients who underwent an h-rTAR were included in this study. All hernias were incisional. A bilateral TAR needed in 90% of patients. The average hospital stay was 1.8 days. Two patients experienced medical complications and 5 patients experienced surgical site events. None of the patients experienced a hernia recurrence throughout a mean postoperative follow-up period of 319 days. PROs showed improvement in all domains, especially cosmetic. <b><i>Conclusion:</i></b> The h-rTAR technique combines the benefits of robotic and open techniques when used for large incisional VHR with improvement in patient-reported QoL.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"570-578"},"PeriodicalIF":1.3,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/lap.2020.0657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38565833","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":"Simulation for Colorectal Surgery.","authors":"Ganesh Sankaranarayanan, Lisa Parker, Suvranu De, Muneera Kapadia, Alessandro Fichera","doi":"10.1089/lap.2021.0096","DOIUrl":"10.1089/lap.2021.0096","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Colorectal surgery is a highly specialized field in surgery that deals with the surgical intervention of disease processes of the colon, rectum, and anus. Gaining proficiency in this field requires training both inside and outside of the operating room. Simulation plays a key role in training surgeons in colorectal surgery. The goal of this study is to review the currently available simulators for training in the field of colorectal surgery. <b><i>Methods:</i></b> A review of the literature was conducted to identify simulators that are both physical such as benchtop, live animal, and cadaver, as wells as virtual reality (VR) simulators. Any reported validity evidence for these simulators were also presented. <b><i>Results:</i></b> There are several benchtop physical models made of silicone for training in basic colorectal tasks, such as hand-sewn and stapled anastomosis. To improve realism, explanted animal and cadaveric specimens were also used for training. To improve repeatability, objective assessment, both commercial and VR simulators also exist for training in both open and laparoscopic colorectal surgery and emerging areas such as endoscopic submucosal dissection. <b><i>Conclusion:</i></b> Simulation-based training in colorectal surgery is here to stay and is going to play a significant role in training, credentialing, and quality improvements.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"566-569"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8126420/pdf/lap.2021.0096.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38835364","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":"Commentary: Evaluation of Anterior Phrenoesophageal Ligament Preservation During Hiatus Hernia Repair in Laparoscopic Sleeve Gastrectomy as an Anti-Reflux Measure by Elmaleh <i>et al.</i>","authors":"Luigi Bonavina","doi":"10.1089/lap.2021.29036.lb","DOIUrl":"https://doi.org/10.1089/lap.2021.29036.lb","url":null,"abstract":"","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"515-516"},"PeriodicalIF":1.3,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25521057","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":"Comparison of Laparoscopic Orchiopexy and Traditional Inguinal Incision Orchiopexy for Palpable Undescended Testes in Cryptorchidism.","authors":"Shaodong Gu,&nbsp;Yingxun Wang,&nbsp;Hong Luo","doi":"10.1089/lap.2020.0832","DOIUrl":"https://doi.org/10.1089/lap.2020.0832","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic orchiopexy (LO) has become a standard procedure for the treatment of nonpalpable undescended testes (UDT). LO for palpable UDT is still controversial. The aim of this study is to explore the method and effect of LO procedure for palpable UDT in children suffering from cryptorchidism. <b><i>Methods:</i></b> A retrospective study was performed for LO and traditional inguinal incision orchiopexy (TIO) for palpable UDT. A total of 291 children were enrolled, and they were aged 9-96 months with either left- or right-side palpable inguinal canalicular testes. Patients with testes that were nonpalpable, ectopic, and retractable were excluded. One hundred seventy patients received LO and 121 patients received TIO. Patient age, operative time, and clinical outcomes were reviewed. Independent <i>t</i>-test and Fisher's exact test were performed by SPSS 25.0 software. <b><i>Results:</i></b> The mean operative time (30.77 ± 6.02 minutes versus 44.76 ± 6.70 minutes) and postoperative normal activity time (1.25 ± 0.43 days versus 2.48 ± 0.68 days) of LO were significantly shorter than those of TIO group (<i>P</i> < .05). Forty-seven of 49 cases (95.9%) aged <1 year successfully achieved LO. <b><i>Conclusion:</i></b> LO is an appropriate choice for palpable UDT, especially in younger children aged <2 years. The success rate of LO decreased with age.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"598-603"},"PeriodicalIF":1.3,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25375921","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":"Improving Exposure Using Thoracoscopy for Apical Thoracic Neuroblastoma Encasing the Subclavian Vessels.","authors":"Abdelhafeez H Abdelhafeez,&nbsp;Sara Mansfield,&nbsp;Lindsay Talbot,&nbsp;Andrew J Murphy,&nbsp;Andrew M Davidoff","doi":"10.1089/lap.2020.0850","DOIUrl":"https://doi.org/10.1089/lap.2020.0850","url":null,"abstract":"<p><p><b><i>Background:</i></b> Posterolateral thoracotomy provides limited access to the thoracic apex that can result in poor visualization of subclavian vessels, their branches, and the brachial plexus. A thoracoscopic approach may overcome these limitations. <b><i>Purpose:</i></b> We report a thoracoscopic approach and associated technical challenges in resecting apical thoracic neuroblastoma encasing the subclavian artery. <b><i>Methods:</i></b> A single-institution retrospective chart review was performed (2018-2020) for patients undergoing thoracoscopic resection of apical neuroblastoma encasing the subclavian artery. Patient demographics, imaging, and hospital course were reviewed. Operative video recordings were assessed for exposure quality, technical challenges, and percentage of tumor resection. Patients were placed laterally, with three 5-mm ports triangulated to the apex. Dissection started at the tumor edge and followed along the vessel and branches. <b><i>Results:</i></b> Four patients (median age 2.7 years) underwent thoracoscopic apical neuroblastoma resection. Median length of stay was 2.5 days. One low-risk patient underwent resection for tumor growth during observation. One intermediate and 2 high-risk patients received neoadjuvant chemotherapy. Two patients continued having persistent vascular encasement, whereas in 1 patient the mass decreased in size and only abutted the subclavian and vertebral arteries. In 1 patient, tumor involved the brachial plexus, which was freed and preserved thoracoscopically. All cases had substantial tumor-feeding vessels branching from the subclavian artery. There was one conversion to open thoracotomy due to dense tumor adherence to the subclavian artery and vein. More than 95% resection was achieved in all cases. All patients had baseline Horner syndrome. No complications were reported. <b><i>Conclusion:</i></b> The thoracoscopic approach for resecting apical neuroblastoma provides optimal exposure and safe access in selected patients.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"589-593"},"PeriodicalIF":1.3,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25379407","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":"Commentary: Application of Indocyanine Green Fluorescence as an Adjuvant to Laparoscopic Ultrasound in Minimally Invasive Liver Resection by Piccolo <i>et al.</i>","authors":"Jessica E Wahi,&nbsp;Kfir Ben-David","doi":"10.1089/lap.2021.29035.kbd","DOIUrl":"https://doi.org/10.1089/lap.2021.29035.kbd","url":null,"abstract":"","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"524-525"},"PeriodicalIF":1.3,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25539022","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 Role of Simulation in Attaining Proficiency in Minimally Invasive Hepatopancreatobiliary Surgery.","authors":"Cameron Schlegel,&nbsp;Amer H Zureikat","doi":"10.1089/lap.2021.0083","DOIUrl":"https://doi.org/10.1089/lap.2021.0083","url":null,"abstract":"<p><p>The implementation of robotic surgery in the field of hepato-pancreato-biliary (HPB) has been a slow but significant process. HPB procedures offer a unique challenge when for new technologies, as the surgeries themselves are complex, with long learning curves. Yet the benefits of the robotic approach for this patient population are notable: decreased length of stay, blood loss, postoperative complications, and improving quality of life. The use of robotic simulation focused curriculum plays a crucial role in mentoring experienced surgeons and surgical trainees. Although further study remains, early studies suggest a structured simulation curriculum decreases time, technical errors, and improves proficiency, ultimately leading to a more expedited and safe implementation of robotic techniques in the HPB field.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"561-564"},"PeriodicalIF":1.3,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38982481","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":"Robotic LINX Placement: Is it Worth It?","authors":"Jessica Emilia Wahi,&nbsp;Christopher Le,&nbsp;Michael Yousef,&nbsp;Ethling Hernandez,&nbsp;Margie Goralski Stickles,&nbsp;Kfir Ben-David","doi":"10.1089/lap.2021.0103","DOIUrl":"https://doi.org/10.1089/lap.2021.0103","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic Nissen fundoplication is considered the current gold standard of surgical treatment of gastroesophageal reflux disease. Magnetic sphincter augmentation with the LINX^® device was developed as a less technically challenging alternative that has proven to be a safe and effective surgical antireflux procedure. Despite rapid adoption of the robotic platform in many areas of general surgery, no studies have compared laparoscopic and robotic approaches to placement of the LINX device. This retrospective study is the first to compare the robotic platform with the laparoscopic approach for minimally invasive LINX placement. <b><i>Methods:</i></b> We conducted a retrospective review of a total cohort of 20 patients who underwent LINX placement with hiatal hernia repair at our institution. Half of the patients underwent surgery using laparoscopy and the other half with robotic technology. Patient characteristics, surgical outcomes, and charge differences were analyzed. <b><i>Results:</i></b> We found that there were no significant differences in hospital length of stay, surgical outcomes, use of proton pump inhibitors (PPIs) postoperatively, or postoperative dysphagia. Patients undergoing robotic surgery had longer operative time (139 ± 25 minutes versus 81 ± 14 minutes, <i>P</i> < .01), higher intraoperative charges ($8980 ± 275 versus $7239 ± 355, <i>P</i> < .01), and higher charges associated with their hospital stay ($45,037 ± 4112.41 versus $39,565 ± 3731.64, <i>P</i> < .01). <b><i>Conclusions:</i></b> In comparison with laparoscopic LINX procedures, robotic LINX does not offer superior surgical outcomes in terms of postoperative PPI use, dysphagia, or hospital length of stay. Robotic LINX procedures are associated with increased operative time and overall charges.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"526-529"},"PeriodicalIF":1.3,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25531432","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":"Creation of Virtual Three-Dimensional Animation Using Computer Graphic Technology for Videoscopic Transcervical Upper Mediastinal Esophageal Dissection.","authors":"Yoshinori Ishida,&nbsp;Tsutomu Kumamoto,&nbsp;Hibiki Watanabe,&nbsp;Yasunori Kurahashi,&nbsp;Hirotaka Niwa,&nbsp;Yasutaka Nakanishi,&nbsp;Koichi Okumura,&nbsp;Rie Ozawa,&nbsp;Koya Mizuno,&nbsp;Ichiro Uyama,&nbsp;Hisashi Shinohara","doi":"10.1089/lap.2018.0717","DOIUrl":"https://doi.org/10.1089/lap.2018.0717","url":null,"abstract":"<p><p><b><i>Background:</i></b> Videoscopic transcervical mediastinal lymphadenectomy has been attempted to reduce thoracotomy-related complications of surgical treatment for esophageal cancer. However, many surgeons would hesitate to attempt this procedure because of the difficulty in understanding the anatomical orientation. In this study, we aimed to create a three-dimensional computer graphic (3D CG) animation and compare it with the real-life operation. <b><i>Materials and Methods:</i></b> LightWave 3D^® version 7 was used as a rendering software to create the 3D CG. The 3D CG images were superimposed to generate an animation using AfterEffects CC^®. <b><i>Results:</i></b> The 3D CG animation for videoscopic transcervical upper mediastinal esophageal dissection was successfully created; it dynamically shows the scene, especially the separation between the esophagus and trachea, and enables surgeons to easily understand the anatomical orientation when using transcervical approach. This 3D CG animation was of high quality and similar to the real-life operation. <b><i>Conclusions:</i></b> We created a virtual 3D CG animation for the transcervical approach, which will contribute to understanding this procedure for esophageal cancer preoperatively.</p>","PeriodicalId":508448,"journal":{"name":"Journal of laparoendoscopic & advanced surgical techniques. Part A","volume":" ","pages":"304-307"},"PeriodicalIF":1.3,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/lap.2018.0717","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40452907","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}