发布求助
文献互助 智能选刊 最新文献

Endoscopic surgery and allied technologies最新文献

筛选
英文 中文
The optical "Veress-needle"--initial puncture with a minioptic. 光学"维瑞斯针"用微型光学仪器进行初始穿刺。
Endoscopic surgery and allied technologies Pub Date : 1995-02-01
G Schaller, M Kuenkel, B C Manegold
{"title":"The optical \"Veress-needle\"--initial puncture with a minioptic.","authors":"G Schaller,&nbsp;M Kuenkel,&nbsp;B C Manegold","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Laparoscopic access is a necessary part of minimally invasive surgery. The double blind puncture with Veress-needle and trocar can cause lethal complications such as bowel injury, bleeding and gas-embolisation. Some authors have reported alternative techniques for laparoscopic abdominal access. Because no blind procedure can absolutely prevent injury, permanent visual control of perforated tissue layers as in open surgery should be achieved to prevent possible injury at an early stage. Previously described procedures could not fulfil all requirements to comply with this ideal, i.e. permanent visual control of abdominal wall penetration prior to establishment of pneumoperitoneum and trocar insertion without further possible damage. We designed a 2 mm fibreglass optic 250 mm in length that is inserted into a suitable cannula. Special construction allows rinsing through the cannula to clear the vision and to open spaces in the puncture track by water dissection. After incision of the skin, all layers of the abdominal wall can be visualised, including blood vessels and internal surfaces. Once the abdominal cavity is reached, the needle tip is retracted and a two-step dilation allows the trocar to be introduced via the puncture track. Only then does insufflation begin. The fibreglass optic-equipped safety needle was used for visually controlled access in 184 laparoscopic surgical procedures. After a period of training, all layers of the abdominal wall could be recognised exactly. In two patients with dense adhesions, perforation of the small bowel was diagnosed immediately by endoscopic viewing. The small injury needed no treatment, and the intended procedure was completed laparoscopically.(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1995-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18758217","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}
引用次数: 0
Image-guided access techniques. 图像引导访问技术。
Endoscopic surgery and allied technologies Pub Date : 1995-02-01
D H Groenemeyer, R M Seibel, A Melzer, A Schmidt
{"title":"Image-guided access techniques.","authors":"D H Groenemeyer,&nbsp;R M Seibel,&nbsp;A Melzer,&nbsp;A Schmidt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>For increasing safety in access and guidance of endoscopes and instruments, fast real-time radiologic imaging should be integrated. Open designed Magnetic Resonance Imaging (MRI), Computer Tomography (CT), and Electron Beam Tomography (EBT) scanners permit adequate transparency of the operative field. CT and EBT as hybrid scanners can be combined with fluoroscopy. MRI avoids X-ray exposure and entails the possibility of 3D localisation, while open access and keyhole imaging allows nearly real-time guidance of instruments. EBT has the largest gantry (90 cm) for using long instruments, and the image acquisition requires only 50 msec (34 images/sec at 8 levels). However, computed reconstruction of the data takes about 3 times longer than conventional CT. Until EBT can be accelerated, CT will be the golden standard of guidance-techniques in high risk areas, because the tips of the instruments can be precisely visualised within +/- 0.5 mm (MRI: 3.5 mm). MRI-guidance can be used for low risk access techniques. This safe interactive transparent guidance technique has the potential to reduce complications, and it adds significant advantages to micro-invasive operative procedures such as percutaneous diskectomies, pain and cancer therapy with ethanol, or gene-technology implants in the new field of \"surgical tomography\".</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1995-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18758220","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}
引用次数: 0
Cutting versus conical tip designs. 切割与锥形尖端设计。
Endoscopic surgery and allied technologies Pub Date : 1995-02-01
K Semm
{"title":"Cutting versus conical tip designs.","authors":"K Semm","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The history of development in laparoscopy shows that the dilemma involving blind insertion of the trocar has not changed in over 100 years. Perforation of the abdominal wall with the cutting trocar is no longer necessary with today's anatomical and technical possibilities. The cutting trocar with its four cutting surfaces has a great disadvantage compared to the conical trocar with regard to safety. The linea alba should not be disrupted, and perforation of the abdominal wall should be performed in an area where the fascia is weaker and muscle is more abundant. The \"z\"-track method of trocar insertion prevents intestinal or omental herniation. For perforation and stretching of the muscle, a conical trocar with a blunt tip is recommended. After inserting the conical trocar down to the layer of subcutaneous fat or muscle, further advancement is performed under visual control using a normal straight endoscope and by rotating the bevelled end of the trocar sheath. Perforation of the abdominal wall with a conical trocar using the \"z\"-track incision under endoscopic control prevents incisional herniation of intestine or omentum.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1995-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18758214","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}
引用次数: 0
The valve design of disposable and reusable trocars. 一次性和可重复使用套管针的阀门设计。
Endoscopic surgery and allied technologies Pub Date : 1995-02-01
N A O'Rourke
{"title":"The valve design of disposable and reusable trocars.","authors":"N A O'Rourke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The advent of video-laparoscopy has led to many recent improvements in the design of both disposable and reusable trocars and cannulae. This paper discusses the various types of trocar sheath valve mechanisms available to the laparoscopic surgeon. For reusable cannulae it is suggested that controllable flap valves are close to ideal, whilst for disposable cannulae controllable flap valves or silicone leaflet valves allow easy access and retrieval of instruments with minimal loss of pneumo-peritoneum.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1995-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18758215","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}
引用次数: 0
Endoscopically controlled trocar and cannula insertion. 内窥镜控制套管针和套管插入。
Endoscopic surgery and allied technologies Pub Date : 1995-02-01
A Melzer, S Riek, K Roth, G Buess
{"title":"Endoscopically controlled trocar and cannula insertion.","authors":"A Melzer,&nbsp;S Riek,&nbsp;K Roth,&nbsp;G Buess","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>One of the keys to safe laparoscopic or thoracoscopic surgery is an expeditious and reliable access to the region of interest. To minimise the risk of accidental injury to major vessels, lung, intestine and other important structures the principle of controlled visualised access has been advocated. This has led to several developments in the field of trocars, cannulae and puncture techniques. Examples are the insertion of a needle scope into a Veress needle, complex access cannulae and our new principle of using an \"optical scalpel\". The direct visualisation of an active, controllable penetration of the abdominal wall is expected to become indispensable. A selected variety of endoscopically assisted trocar and cannula systems such as the \"windowed trocar\", the \"optical trocar\", the \"Visiport\" and the \"optical scalpel\" are described.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1995-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18758219","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}
引用次数: 0
Access with flexible cannulae. 可弯曲插管。
Endoscopic surgery and allied technologies Pub Date : 1995-02-01
S M Shimi
{"title":"Access with flexible cannulae.","authors":"S M Shimi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Flexible access cannulae maintain a readily accessible tract for the efficient introduction and withdrawal of both straight and curved endoscopic instruments from skin to the parietes. Their main advantage is their capacity to deform, allowing the passage of curved instruments. Several designs of flexible access cannulae are currently available. The most practical design makes use of tightly coiled springs as tubes with or without silicone coating. A modification of this design uses wire woven into a tubular form and coated with silicone. Gas seal valves for these cannulae are currently primitive. The capacity of flexible access cannulae for deformation along the longitudinal and transverse axes could potentially be exploited for retrieval of small organs. Clinically, flexible cannulae have been used whenever curved instruments were needed. Coaxial curved and bayonet instruments have been used extensively in both thoracoscopic and laparoscopic operations. These instruments will allow an additional degree of freedom, that of the pre-formed curve of the instrument. In clinical terms this will facilitate the dissection, retraction and encirclement of tubular structures. In addition, the creation of intra-corporeal surgical knots is more efficient using curved needle holders.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1995-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18758216","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}
引用次数: 0
The gasless laparoscopic cholecystectomy. 无气腹腔镜胆囊切除术。
Endoscopic surgery and allied technologies Pub Date : 1995-02-01
V Paolucci, B Schaeff, C N Gutt, A Encke
{"title":"The gasless laparoscopic cholecystectomy.","authors":"V Paolucci,&nbsp;B Schaeff,&nbsp;C N Gutt,&nbsp;A Encke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The pneumoperitoneum, generally used for all laparoscopic procedures, can lead to specific disadvantages and result in complications, and it furthermore represents a restriction of the surgeon's freedom of movement. In July, 1993 we started doing laparoscopic surgery without the pneumoperitoneum. Under direct vision and digital control, a fan-shaped wall retractor, which is attached to an electric lift arm, is introduced into the abdominal cavity. After raising the abdominal wall, the scope is introduced through the same access and the laparoscopic procedure can be started without the technical and pathophysiological problems which may occur when using a pneumoperitoneum. In this gasless laparoscopic procedure, simple valveless trocars and instruments can be used. During anaesthesia, neither an increased ventilation nor an enlarged ventilation pressure is necessary in this way we performed gasless laparoscopic cholecystectomy in 50 patients. We observed 5 wound infections as related complications. We had to change the surgical procedure seven times. The retraction technique creates a sufficient but not optimal exposure to the gallbladder. Intraoperative changes of the instruments, suction and specimen removal appeared easier. Both conventional and laparoscopic surgical instruments were introduced through the valveless trocars. Our experience demonstrates the practicability of this technique and potential advantages.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1995-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18758221","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}
引用次数: 0
Experimental retroperitoneal endoscopic surgery. 实验性腹膜后内镜手术。
Endoscopic surgery and allied technologies Pub Date : 1995-02-01
J J Bannenberg, K C Hodde, P Hourlay, D W Meijer
{"title":"Experimental retroperitoneal endoscopic surgery.","authors":"J J Bannenberg,&nbsp;K C Hodde,&nbsp;P Hourlay,&nbsp;D W Meijer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Techniques for retroperitoneal endoscopic procedures with the patient in prone position were evaluated in experimental studies in the pig. Nephrectomy, para-aortic lymph node dissection, lumbar sympathectomy and assisted aorto-femoral bypass were performed and the experience is reported herein. The prone position contributes to the creation of the retroperitoneal working space and eliminates the need for extensive retraction and thus for additional ports. The modified open Hasson technique was found to be the preferred retroperitoneal access procedure.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1995-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18759671","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}
引用次数: 0
Alternative techniques for laparoscopic tissue anastomosis in the retroperitoneum. 腹腔镜腹膜后组织吻合的替代技术。
Endoscopic surgery and allied technologies Pub Date : 1995-02-01
C G Eden
{"title":"Alternative techniques for laparoscopic tissue anastomosis in the retroperitoneum.","authors":"C G Eden","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The scope of reconstructive laparoscopy is currently limited by the difficult and time-consuming nature of laparoscopic suturing. Alternative methods to suturing, such as the use of biocompatible glues and laser tissue welding, have the potential to produce anastomoses which are immediately water-tight, achieved with less tissue trauma and reduce operating times.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1995-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18759672","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}
引用次数: 0
Retroperitoneal surgery of the kidney, ureter and adrenal gland. 肾、输尿管及肾上腺的腹膜后手术。
Endoscopic surgery and allied technologies Pub Date : 1995-02-01
D D Gaur
{"title":"Retroperitoneal surgery of the kidney, ureter and adrenal gland.","authors":"D D Gaur","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Seventy-one retroperitoneal endoscopic procedures on the kidney, ureter and adrenal gland were performed in 69 patients, using the balloon technique of retroperitoneoscopy. There were 9 failures in this series, all of which were converted into an open procedure. The balloon satisfactorily dissected the kidney and the ureter in 59 patients (85%). There were no major complications and the minor complication rate was 20%. Forty-nine patients were discharged the next day, while 20 were kept in hospital for 2 to 5 days. The balloon technique of retroperitoneoscopy is safe, simple and reliable for exposing the kidney, ureter and the adrenal gland.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1995-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18759674","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}
引用次数: 0
首页 上一页 下一页 尾页
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整，为了账户安全，请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们：info@booksci.cn Book学术提供免费学术资源搜索服务，方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号：481959085
Book学术官方微信