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A preliminary report on endoscopic transanal resection of the rectum. 内镜下经肛门直肠切除术的初步报道。
Endoscopic surgery and allied technologies Pub Date : 1994-10-01
G Fischer
{"title":"A preliminary report on endoscopic transanal resection of the rectum.","authors":"G Fischer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Since 1986 we have performed 62 endoscopic transanal resections (TAR) on 43 patients with malignant or benign tumours. Initially a transurethral resectoscope was used, and later the recently developed rectal resectoscope was introduced, enabling diathermy resection of a rectal lesion growing into the lumen of the rectum and making it possible to take the resection level up to or below the level of the muscularis propria. The wound is left to epithelialise spontaneously. 32 patients with malignant lesions of the rectum underwent TAR. The aim was to palliate symptoms and avoid colostomy. 11 patients with benign tumours (8 adenomas, 2 polyps, 1 stricture) also underwent TAR. No patient died within 25 days of operation. TAR is a minimally invasive procedure. It is quick, safe and effective if performed caudal to the peritoneal reflection fold.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":"2 5","pages":"261-4"},"PeriodicalIF":0.0,"publicationDate":"1994-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18865244","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
Experience with TEM in Germany. 有德国TEM工作经验。
Endoscopic surgery and allied technologies Pub Date : 1994-10-01
R Salm, H Lampe, A Bustos, U Matern
{"title":"Experience with TEM in Germany.","authors":"R Salm,&nbsp;H Lampe,&nbsp;A Bustos,&nbsp;U Matern","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Transanal endoscopic microsurgery (TEM) presents a minimally invasive procedure for local removal of large adenomas as well as early carcinomas of the rectum. 57 surgical departments/clinics, which practice this method in Germany were asked about their experience. 44 questionnaires were evaluated. Indications for the 1,900 recorded operations were 1,411 adenomas, 433 carcinomas (curative intention: 286; palliative intention: 147), and 56 other procedures. The conversion rate to laparotomy was dependent on the experience with this surgical method (1.2%-11.6%). A radical rectal resection as a second step was performed in 5.7% of patients in the case of advanced carcinoma in the histologic examination of the specimen. Complications appeared in 120 patients (6.3%), 77 patients (4.0%) recovered with conservative treatment, and 43 (2.3%) had to undergo surgery. The mortality rate was 0.2% (3/1,900 pts).</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":"2 5","pages":"251-4"},"PeriodicalIF":0.0,"publicationDate":"1994-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18865241","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
Transanal endoscopic microsurgery in Italy. 意大利经肛门内窥镜显微手术。
Endoscopic surgery and allied technologies Pub Date : 1994-10-01
M M Lirici, L Chiavellati, E Lezoche, S Martelli, G Melotti, M Morino, M Guerrieri, I Selmi, S Stipa, L Angelini
{"title":"Transanal endoscopic microsurgery in Italy.","authors":"M M Lirici,&nbsp;L Chiavellati,&nbsp;E Lezoche,&nbsp;S Martelli,&nbsp;G Melotti,&nbsp;M Morino,&nbsp;M Guerrieri,&nbsp;I Selmi,&nbsp;S Stipa,&nbsp;L Angelini","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Italian experience with Transanal Endoscopic Microsurgery (TEM) started in 1991. Until April, 1994, 122 patients were operated on by such a technique in six centres. The surgical protocol in the 66 patients with benign lesions was similar to that described by Buess. In contrast to the German experience, the indications of TEM for cancer have been extended to more advanced tumours and in 22 out of 56 patients with rectal carcinoma adjuvant radiation- or radiation-chemotherapy have been applied according to various protocols. In 88% of TEM for rectal tumours the operation has been carried out according to a full-thickness technique, with or without perirectal fat excision. Postoperative morbidity of TEM for adenoma was 15.8% and that of TEM for carcinoma 29.6%. There was no postoperative mortality. Local recurrence rate after TEM for adenoma was 10.5%, while that after TEM for cancer was 9.25%. No local recurrence has been reported among patients treated with a combination of TEM and adjuvant radiation treatments. The median follow-up in the 6 centres ranged between 7 and 16 months. A randomised prospective clinical trial has been planned in order to evaluate the role of transanal endoscopic microsurgery in the treatment of locally advanced rectal cancer.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":"2 5","pages":"255-8"},"PeriodicalIF":0.0,"publicationDate":"1994-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18865242","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
Technique and results using the glass-rectoscope for tumour resection. 玻璃直肠镜用于肿瘤切除术的技术与结果。
Endoscopic surgery and allied technologies Pub Date : 1994-10-01
W Seifart
{"title":"Technique and results using the glass-rectoscope for tumour resection.","authors":"W Seifart","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The glass-rectoscope, developed by P. Dewey is a cylinder speculum with a closed end and a working window at the side. This is a cheap instrument and method for transanal approach to the lower rectum. After preparation of the patient by saline lavage the day before operation and one dose antibiotic preoperatively, the operation is performed under general or epidural anesthesia. The digital slow dilatation of the anal sphincter is followed by introduction of the instrument, of which several versions are available. After focusing the lesion in the working window, diathermy-excision of the mucosa or of the total rectal wall is performed. Bleeding is controlled by electrocoagulation or by continuous suture of the resulting defect in the rectal wall. In 34 patients treated by transanal tumour resection, there was one local infection and four postoperative haemorrhages required operative revision by resuture. The method is suitable for removing lesions of the lower rectum up to the diameter of 2 cm and for stage T1N0 malignant lesions.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":"2 5","pages":"265-8"},"PeriodicalIF":0.0,"publicationDate":"1994-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18865245","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
Estimated worldwide total of surgeons using minimally invasive surgery (MIS). 估计全世界外科医生使用微创手术(MIS)的总数。
Endoscopic surgery and allied technologies Pub Date : 1994-10-01
{"title":"Estimated worldwide total of surgeons using minimally invasive surgery (MIS).","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":"2 5","pages":"269-70"},"PeriodicalIF":0.0,"publicationDate":"1994-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18865246","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
Preparation of instruments used in minimally invasive surgery in a washer-disinfector. 在清洗消毒器中制备微创手术用器械。
Endoscopic surgery and allied technologies Pub Date : 1994-10-01
W Michels
{"title":"Preparation of instruments used in minimally invasive surgery in a washer-disinfector.","authors":"W Michels","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The safe sterilisation of surgical instruments presumes that one is dealing with small amounts of standardised residual contamination and in particular, that the cleaning process adheres to good manufacturing practices, taking into account the protection of the personnel. Only mechanical processes can be standardised and are suitable for the preparation of surgical instruments. The development process which the instruments used in minimally invasive surgery have undergone, along with improvements in the field of cleaning technology and disinfection, now means that preparation of instruments of this nature can be entrusted to an automatic washer/disinfector. New cleaning and disinfection methods allow the complete array of instruments, including fibreoptic light guides and lenses, to be cleaned and disinfected in one procedure.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":"2 5","pages":"272-5"},"PeriodicalIF":0.0,"publicationDate":"1994-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18865248","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
New sterilisation technologies--are they applicable for endoscopic surgical instruments? 新的灭菌技术——是否适用于内窥镜手术器械?
Endoscopic surgery and allied technologies Pub Date : 1994-10-01
H K Geiss
{"title":"New sterilisation technologies--are they applicable for endoscopic surgical instruments?","authors":"H K Geiss","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It has been well established that instruments for minimally invasive surgery (MIS) must be treated like ordinary surgical instruments when they are intended for use within sterile areas of the human body. Due to the special design of most MIS instruments autoclaving (i.e. application of heat) may damage these delicate items. Therefore, low temperature sterilisation processes are essential. Gas sterilisation with ethylene oxide and formaldehyde may pose significant health hazards to workers exposed to these gases and to patients due to residues remaining on the surface of the instruments. Their general use in hospitals is more and more discouraged. However, with the advent of hydrogen peroxide gas plasma sterilisation there is a true alternative available for the sterilisation of MIS instruments. In contrast, the use of immersion sterilants such as liquid glutaraldehyde or peracetic acid cannot be considered as adequate because it is almost impossible to keep the processed instruments sterile until their intended use.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":"2 5","pages":"276-8"},"PeriodicalIF":0.0,"publicationDate":"1994-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18865249","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
Automated processing of endoscopic surgical instruments. 内窥镜手术器械的自动处理。
Endoscopic surgery and allied technologies Pub Date : 1994-10-01
K Roth, J P Sieber, H Schrimm, P Heeg, G Buess
{"title":"Automated processing of endoscopic surgical instruments.","authors":"K Roth,&nbsp;J P Sieber,&nbsp;H Schrimm,&nbsp;P Heeg,&nbsp;G Buess","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper deals with the requirements for automated processing of endoscopic surgical instruments. After a brief analysis of the current problems, solutions are discussed. Test-procedures have been developed to validate the automated processing, so that the cleaning results are guaranteed and reproducable. Also a device for testing and cleaning was designed together with Netzsch Newamatic and PCI, called TC-MIC, to automate processing and reduce manual work.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":"2 5","pages":"279-81"},"PeriodicalIF":0.0,"publicationDate":"1994-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18865840","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
Staging, grading and related histopathological techniques in local therapy of rectal tumours. 直肠肿瘤局部治疗的分期、分级及相关组织病理学技术。
Endoscopic surgery and allied technologies Pub Date : 1994-10-01
M Wehrmann, A Greschniok, S Offenhaeuser, B Bueltmann
{"title":"Staging, grading and related histopathological techniques in local therapy of rectal tumours.","authors":"M Wehrmann,&nbsp;A Greschniok,&nbsp;S Offenhaeuser,&nbsp;B Bueltmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Today, local therapy is an established alternative to radical resection for the treatment of rectal tumours. Selection of the operative technique requires an exact perioperative estimation of risks, with both clinical and histopathological examination. Of crucial importance in making a decision to perform a local resection is exact and meticulous histopathological preparation of the tissue. The most important criterion is the estimation of risk of lymph node metastases. This risk is assessed on the basis of the depth of invasion of the tumour, the histological grade of differentiation and the presence or absence of invasion of lymphatic vessels.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":"2 5","pages":"237-40"},"PeriodicalIF":0.0,"publicationDate":"1994-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18867292","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
Transanal endoscopic anorectal mucosectomy with ileal pouch anal anastomosis for familial adenomatous polyposis. A case report. 经肛门内镜肛肠粘膜切除术及回肠袋肛管吻合术治疗家族性腺瘤性息肉病。一份病例报告。
Endoscopic surgery and allied technologies Pub Date : 1994-10-01
L Chiavellati, F Stipa, G C Cassi, G D'Elia, R Tersigni
{"title":"Transanal endoscopic anorectal mucosectomy with ileal pouch anal anastomosis for familial adenomatous polyposis. A case report.","authors":"L Chiavellati,&nbsp;F Stipa,&nbsp;G C Cassi,&nbsp;G D'Elia,&nbsp;R Tersigni","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In patients with familial adenomatous polyposis (FAP) who are undergoing ileal pouch-anal anastomosis (IPAA), transanal mucosectomy can be performed without excessive anal dilatation and manipulation using the operative proctoscope introduced by Buess. In this way, mucosectomy under a direct three-dimensional six-fold magnified view is accurate and bloodless.</p>","PeriodicalId":79337,"journal":{"name":"Endoscopic surgery and allied technologies","volume":"2 5","pages":"259-60"},"PeriodicalIF":0.0,"publicationDate":"1994-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"18865243","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
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