submit url • add directory • Physician Assistant jobs ♦ Nurse Practitioner jobs
Today's News:
Surgical Endoscopy (Online First™)
Training in laparoscopic colorectal surgery: a new educational model using specially embalmed human anatomical specimen
Sat, 28 Jan 2012 06:43:05 -0000
Abstract Background With an increasing percentage of colorectal resections performed laparoscopically nowadays, there is more emphasis on training “before the job” on operative skills, including the comprehension of specific laparoscopic surgical anatomy. As integration of technical skills with correct interpretation of the anatomical image must be incorporated in laparoscopic training, a human specimen training model with special emphasis on surgical anatomy was developed. Methods The new embalming method Anubifix™ combines long-term high-quality embalming of human bodies with almost normal flexibility and plasticity, and the body can be kept operational as long as conventionally embalmed human specimens. A colorectal training model was created in a specimen in which anatomical landmarks of colorectal anatomy were permanently colored to explore laparoscopic colorectal anatomy in a skills training setting. Airtight closure of the abdominal wall permits the creation of pneumoperitoneum. Residents were asked to test the model by mobilizing the small and large bowels and expose the central vessels and ureters. Afterward they were asked to fill out an eight-item questionnaire about the model. Results Eleven surgical residents in their first and second year of training participated. Responses to the questionnaire showed that a majority of residents considered the model to be representative of the real situation and superior to animal models or virtual reality simulators, and helped to improve the knowledge of three-dimensional anatomy and laparoscopic skills. Conclusion The new training model for laparoscopic colorectal surgery proved to be a high-quality tool, concentrating on laparoscopic colorectal anatomy in a skills training setting. We believe it may be a valuable adjunct to residency training programs based on the principle of “training before the job.” Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-012-2158-yAuthors Juliette C. Slieker, Department of Surgery, Erasmus University Medical Center, Rotterdam, The NetherlandsHilco P. Theeuwes, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The NetherlandsGöran L. van Rooijen, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The NetherlandsJohan F. Lange, Department of Surgery, Erasmus University Medical Center, Rotterdam, The NetherlandsGert-Jan Kleinrensink, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The Netherlands Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Educational and training aspects of new surgical techniques: experience with the endoscopic–laparoscopic interdisciplinary training entity (ELITE) model in training for a natural orifice translumenal endoscopic surgery (NOTES) approach to appendectomy
Sat, 28 Jan 2012 06:43:05 -0000
Abstract Background Natural orifice translumenal endoscopic surgery (NOTES) is a new surgical concept that requires training before it is introduced into clinical practice. The endoscopic–laparoscopic interdisciplinary training entity (ELITE) is a training model for NOTES interventions. The latest research has concentrated on new materials for organs with realistic optical and haptic characteristics and the possibility of high-frequency dissection. This study aimed to assess both the ELITE model in a surgical training course and the construct validity of a newly developed NOTES appendectomy scenario. Methods The 70 attendees of the 2010 Practical Course for Visceral Surgery (Warnemuende, Germany) took part in the study and performed a NOTES appendectomy via a transsigmoidal access. The primary end point was the total time required for the appendectomy, including retrieval of the appendix. Subjective evaluation of the model was performed using a questionnaire. Subgroups were analyzed according to laparoscopic and endoscopic experience. Results The participants with endoscopic or laparoscopic experience completed the task significantly faster than the inexperienced participants (p = 0.009 and 0.019, respectively). Endoscopic experience was the strongest influencing factor, whereas laparoscopic experience had limited impact on the participants with previous endoscopic experience. As shown by the findings, 87.3% of the participants stated that the ELITE model was suitable for the NOTES training scenario, and 88.7% found the newly developed model anatomically realistic. Conclusions This study was able to establish face and construct validity for the ELITE model with a large group of surgeons. The ELITE model seems to be well suited for the training of NOTES as a new surgical technique in an established gastrointestinal surgery skills course. Content Type Journal ArticleCategory Endoluminal SurgeryPages 1-7DOI 10.1007/s00464-012-2165-zAuthors Sonja Gillen, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyJörn Gröne, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyFritz Knödgen, Research Group MITI, Minimally Invasive Therapy and Intervention, Munich, GermanyPetra Wolf, Institute of Medical Statistics and Epidemiology, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyMichael Meyer, Research Institute of Leather and Plastic Sheeting, FILK, Freiberg, GermanyHelmut Friess, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyHeinz-Johannes Buhr, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyJörg-Peter Ritz, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyHubertus Feussner, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyKai S. Lehmann, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, Germany Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Endoscopic treatment of large colorectal tumors: comparison of endoscopic mucosal resection, endoscopic mucosal resection–precutting, and endoscopic submucosal dissection
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Endoscopic mucosal resection (EMR) is a useful therapeutic technique for colorectal tumors. However, for tumors larger than 20 mm, the chance of piecemeal resection is high. Recently introduced endoscopic submucosal dissection (ESD) enables en bloc resection regardless of the tumor size. This study aimed to compare the effectiveness and outcomes of EMR, EMR-precutting (EMR-P), and ESD in the treatment of colorectal tumors 20 mm in size or larger. Methods This study reviewed 523 nonpedunculated colorectal tumors (499 patients) 20 mm or larger that received endoscopic treatment (EMR in 140 cases, EMR-P in 69 cases, and ESD in 314 cases) from January 2004 to November 2009. Results The mean sizes of the tumors were 21.7 ± 3.5 mm (EMR), 23.5 ± 5.6 mm (EMR-P), and 28.9 ± 12.7 mm (ESD). The ratios of adenocarcinomas were 15.7% (EMR), 29% (EMR-P), and 37.9% (ESD). The en bloc resection rates were 42.9% (EMR), 65.2% (EMR-P), and 92.7% (ESD), and the complete resection rates were 32.9% (EMR), 59.4% (EMR-P), and 87.6% (ESD). Perforation occurred in 2.9% of the EMR-P cases and 8% of the ESD cases. The recurrence rates were 25.9% (EMR; median follow-up period, 26 months), 3.2% (EMR-P; median follow-up period, 16 months), and 0.8% (ESD; median follow-up period, 17 months). Conclusion For the treatment of large, nonpedunculated colorectal tumors, ESD is more effective than either EMR or EMR-P. Although ESD is technically demanding, it has clinical significance by overcoming the limitations of both EMR and EMR-P. Content Type Journal ArticlePages 1-11DOI 10.1007/s00464-012-2164-0Authors Eun-Jung Lee, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 KoreaJae Bum Lee, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 KoreaSuk Hee Lee, Department of Pathology, Daehang Hospital, Seoul, KoreaEui Gon Youk, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 Korea Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Laparoscopic splenectomy and azygoportal disconnection with intraoperative splenic blood salvage
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Intraoperative blood salvage can reduce or avoid perioperative allogeneic blood transfusion. Salvaging the blood in the portal hypertension-induced enlarged spleen becomes an issue of concern during devascularization surgery because an enlarged spleen accommodates a large red cell pool. We report 20 cases of laparoscopic splenectomy and azygoportal disconnection and present the advantages of the use of intraoperative splenic blood salvage during the procedure. Methods A total of 20 cirrhotic patients with esophagogastric variceal bleeding refractory to treatment with β-blockers and endoscopic therapy were studied. Laparoscopic splenectomy with azygoportal disconnection was performed. During the procedure, an intraoperative autologous blood salvage device recovered the splenic blood. The perioperative data were recorded from various viewpoints. Results The operative time was 3.1 ± 0.3 h and the blood loss was 70.5 ± 32.5 ml. The weight of the excised and morcellated spleen was 826.0 ± 155.1 g. The volume of autotransfused blood was 541.0 ± 150.4 ml. No patient received a perioperative allogeneic blood transfusion. There were no significant complications either intraoperatively or postoperatively. The hemoglobin value increased from 9.3 ± 0.8 to 11.5 ± 1.1 g/dl at postoperative day 1 (p < 0.01). During a postoperative follow-up period of 18.0 ± 9.0 months for 18 patients, neither esophageal variceal bleeding nor encephalopathy recurred. Conclusion Laparoscopic splenectomy with azygoportal disconnection is a feasible, effective, and safe surgical method for the treatment of bleeding portal hypertension. Intraoperative splenic blood salvage can avoid the risk associated with allogeneic transfusion during the procedure, with an advantage of significantly increased postoperative hemoglobin levels. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-012-2159-xAuthors Yuedong Wang, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaYun Ji, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaYangwen Zhu, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaZhijie Xie, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaXiaoli Zhan, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 China Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Nerve-sparing laparoscopic eradication of deep endometriosis with segmental rectal and parametrial resection: the Negrar method. A single-center, prospective, clinical trial
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background The weight of surgical radicality, together with a lack of anatomical theoretical basis for surgery and inappropriate practical skills, can lead to serious impairments to bladder, rectal, and sexual functions after laparoscopic excision of deep infiltrating endometriosis. Although the “classical” laparoscopic technique for endometriosis excision involving segmental bowel resection has proven to relieve symptoms successfully, it is hampered by several postoperative long-term and/or definitive pelvic dysfunctions. Methods In this prospective cohort study, we compare the laparoscopic nerve-sparing approach to the classical laparoscopic procedure in a series of 126 cases. Satisfactory data for bowel, bladder, and sexual function were considered as primary endpoints. Results A total of 126 patients were considered for analysis: 61 treated with nerve-sparing radical excision of pelvic endometriosis with segmental bowel resection (group B), and 65 treated with the classical technique (group A). Intraoperative, perioperative, and postoperative complications were similar between the two groups. Mean days of self-catheterization were significantly lower in the nerve-sparing group (39.8 days) compared with the non-nerve-sparing group (121.1 days; p < 0.001). The relapse rate within 12 months after surgery was comparable between the two groups. Patients of group A suffered from urinary retention more frequently between 1 and 6 months (p = 0.035) compared with group B and did not experience any improvement between 6 months and 1 year (p = 0.018). Overall detection of severe bladder/rectal/sexual dysfunctions was significantly different between the two groups, and 56 patients of group A (86.2%) reported a significantly higher rate of severe neurologic pelvic dysfunctions vs. 1 patient (1.6%) of group B (p < 0.001). Conclusions Our technique appears to be feasible and offers good results in terms of reduced bladder morbidity and apparently higher satisfaction than the classical technique. Considering that this kind of surgery requires uncommon surgical skills and anatomical knowledge, we believe that it should be performed only in selected reference centers. Content Type Journal ArticlePages 1-17DOI 10.1007/s00464-012-2153-3Authors Marcello Ceccaroni, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyRoberto Clarizia, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyFrancesco Bruni, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyElisabetta D’Urso, Department of Obstetrics and Gynecology, European Gynecology Endoscopy School, Sacred Heart Hospital, Negrar, VR, ItalyMaria Lucia Gagliardi, Department of Obstetrics and Gynecology, A. Gemelli University Hospital, Catholic University of Sacred Heart, Rome, ItalyGiovanni Roviglione, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyLuca Minelli, Department of Obstetrics and Gynecology, European Gynecology Endoscopy School, Sacred Heart Hospital, Negrar, VR, ItalyGiacomo Ruffo, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, Italy Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Use of fibrin sealant (Tisseel/Tissucol) in hernia repair: a systematic review
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Abdominal wall and inguinal hernia repair are the most frequently performed surgical procedures in the United States and Europe. However, traditional methods of mesh fixation are associated with a number of problems including substantial risks of recurrence and of postoperative and chronic pain. The aim of this systematic review is to summarize the clinical safety and efficacy of Tisseel/Tissucol fibrin sealant for hernia mesh fixation. Methods A PubMed title/abstract search was conducted u
Subscribe to Endoscopic RSS feed 
Training in laparoscopic colorectal surgery: a new educational model using specially embalmed human anatomical specimen
Sat, 28 Jan 2012 06:43:05 -0000
Abstract Background With an increasing percentage of colorectal resections performed laparoscopically nowadays, there is more emphasis on training “before the job” on operative skills, including the comprehension of specific laparoscopic surgical anatomy. As integration of technical skills with correct interpretation of the anatomical image must be incorporated in laparoscopic training, a human specimen training model with special emphasis on surgical anatomy was developed. Methods The new embalming method Anubifix™ combines long-term high-quality embalming of human bodies with almost normal flexibility and plasticity, and the body can be kept operational as long as conventionally embalmed human specimens. A colorectal training model was created in a specimen in which anatomical landmarks of colorectal anatomy were permanently colored to explore laparoscopic colorectal anatomy in a skills training setting. Airtight closure of the abdominal wall permits the creation of pneumoperitoneum. Residents were asked to test the model by mobilizing the small and large bowels and expose the central vessels and ureters. Afterward they were asked to fill out an eight-item questionnaire about the model. Results Eleven surgical residents in their first and second year of training participated. Responses to the questionnaire showed that a majority of residents considered the model to be representative of the real situation and superior to animal models or virtual reality simulators, and helped to improve the knowledge of three-dimensional anatomy and laparoscopic skills. Conclusion The new training model for laparoscopic colorectal surgery proved to be a high-quality tool, concentrating on laparoscopic colorectal anatomy in a skills training setting. We believe it may be a valuable adjunct to residency training programs based on the principle of “training before the job.” Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-012-2158-yAuthors Juliette C. Slieker, Department of Surgery, Erasmus University Medical Center, Rotterdam, The NetherlandsHilco P. Theeuwes, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The NetherlandsGöran L. van Rooijen, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The NetherlandsJohan F. Lange, Department of Surgery, Erasmus University Medical Center, Rotterdam, The NetherlandsGert-Jan Kleinrensink, Department of Anatomy and Neurosciences, Erasmus University Medical Center, Rotterdam, The Netherlands Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Educational and training aspects of new surgical techniques: experience with the endoscopic–laparoscopic interdisciplinary training entity (ELITE) model in training for a natural orifice translumenal endoscopic surgery (NOTES) approach to appendectomy
Sat, 28 Jan 2012 06:43:05 -0000
Abstract Background Natural orifice translumenal endoscopic surgery (NOTES) is a new surgical concept that requires training before it is introduced into clinical practice. The endoscopic–laparoscopic interdisciplinary training entity (ELITE) is a training model for NOTES interventions. The latest research has concentrated on new materials for organs with realistic optical and haptic characteristics and the possibility of high-frequency dissection. This study aimed to assess both the ELITE model in a surgical training course and the construct validity of a newly developed NOTES appendectomy scenario. Methods The 70 attendees of the 2010 Practical Course for Visceral Surgery (Warnemuende, Germany) took part in the study and performed a NOTES appendectomy via a transsigmoidal access. The primary end point was the total time required for the appendectomy, including retrieval of the appendix. Subjective evaluation of the model was performed using a questionnaire. Subgroups were analyzed according to laparoscopic and endoscopic experience. Results The participants with endoscopic or laparoscopic experience completed the task significantly faster than the inexperienced participants (p = 0.009 and 0.019, respectively). Endoscopic experience was the strongest influencing factor, whereas laparoscopic experience had limited impact on the participants with previous endoscopic experience. As shown by the findings, 87.3% of the participants stated that the ELITE model was suitable for the NOTES training scenario, and 88.7% found the newly developed model anatomically realistic. Conclusions This study was able to establish face and construct validity for the ELITE model with a large group of surgeons. The ELITE model seems to be well suited for the training of NOTES as a new surgical technique in an established gastrointestinal surgery skills course. Content Type Journal ArticleCategory Endoluminal SurgeryPages 1-7DOI 10.1007/s00464-012-2165-zAuthors Sonja Gillen, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyJörn Gröne, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyFritz Knödgen, Research Group MITI, Minimally Invasive Therapy and Intervention, Munich, GermanyPetra Wolf, Institute of Medical Statistics and Epidemiology, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyMichael Meyer, Research Institute of Leather and Plastic Sheeting, FILK, Freiberg, GermanyHelmut Friess, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyHeinz-Johannes Buhr, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyJörg-Peter Ritz, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, GermanyHubertus Feussner, Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strässe 22, 81675 München, GermanyKai S. Lehmann, Department of Surgery, Charité–Campus Benjamin Franklin, Berlin, Germany Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Endoscopic treatment of large colorectal tumors: comparison of endoscopic mucosal resection, endoscopic mucosal resection–precutting, and endoscopic submucosal dissection
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Endoscopic mucosal resection (EMR) is a useful therapeutic technique for colorectal tumors. However, for tumors larger than 20 mm, the chance of piecemeal resection is high. Recently introduced endoscopic submucosal dissection (ESD) enables en bloc resection regardless of the tumor size. This study aimed to compare the effectiveness and outcomes of EMR, EMR-precutting (EMR-P), and ESD in the treatment of colorectal tumors 20 mm in size or larger. Methods This study reviewed 523 nonpedunculated colorectal tumors (499 patients) 20 mm or larger that received endoscopic treatment (EMR in 140 cases, EMR-P in 69 cases, and ESD in 314 cases) from January 2004 to November 2009. Results The mean sizes of the tumors were 21.7 ± 3.5 mm (EMR), 23.5 ± 5.6 mm (EMR-P), and 28.9 ± 12.7 mm (ESD). The ratios of adenocarcinomas were 15.7% (EMR), 29% (EMR-P), and 37.9% (ESD). The en bloc resection rates were 42.9% (EMR), 65.2% (EMR-P), and 92.7% (ESD), and the complete resection rates were 32.9% (EMR), 59.4% (EMR-P), and 87.6% (ESD). Perforation occurred in 2.9% of the EMR-P cases and 8% of the ESD cases. The recurrence rates were 25.9% (EMR; median follow-up period, 26 months), 3.2% (EMR-P; median follow-up period, 16 months), and 0.8% (ESD; median follow-up period, 17 months). Conclusion For the treatment of large, nonpedunculated colorectal tumors, ESD is more effective than either EMR or EMR-P. Although ESD is technically demanding, it has clinical significance by overcoming the limitations of both EMR and EMR-P. Content Type Journal ArticlePages 1-11DOI 10.1007/s00464-012-2164-0Authors Eun-Jung Lee, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 KoreaJae Bum Lee, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 KoreaSuk Hee Lee, Department of Pathology, Daehang Hospital, Seoul, KoreaEui Gon Youk, Department of Surgery, Daehang Hospital, 481-10 Bangbae Seocho, Seoul, 137-820 Korea Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Laparoscopic splenectomy and azygoportal disconnection with intraoperative splenic blood salvage
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Intraoperative blood salvage can reduce or avoid perioperative allogeneic blood transfusion. Salvaging the blood in the portal hypertension-induced enlarged spleen becomes an issue of concern during devascularization surgery because an enlarged spleen accommodates a large red cell pool. We report 20 cases of laparoscopic splenectomy and azygoportal disconnection and present the advantages of the use of intraoperative splenic blood salvage during the procedure. Methods A total of 20 cirrhotic patients with esophagogastric variceal bleeding refractory to treatment with β-blockers and endoscopic therapy were studied. Laparoscopic splenectomy with azygoportal disconnection was performed. During the procedure, an intraoperative autologous blood salvage device recovered the splenic blood. The perioperative data were recorded from various viewpoints. Results The operative time was 3.1 ± 0.3 h and the blood loss was 70.5 ± 32.5 ml. The weight of the excised and morcellated spleen was 826.0 ± 155.1 g. The volume of autotransfused blood was 541.0 ± 150.4 ml. No patient received a perioperative allogeneic blood transfusion. There were no significant complications either intraoperatively or postoperatively. The hemoglobin value increased from 9.3 ± 0.8 to 11.5 ± 1.1 g/dl at postoperative day 1 (p < 0.01). During a postoperative follow-up period of 18.0 ± 9.0 months for 18 patients, neither esophageal variceal bleeding nor encephalopathy recurred. Conclusion Laparoscopic splenectomy with azygoportal disconnection is a feasible, effective, and safe surgical method for the treatment of bleeding portal hypertension. Intraoperative splenic blood salvage can avoid the risk associated with allogeneic transfusion during the procedure, with an advantage of significantly increased postoperative hemoglobin levels. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-012-2159-xAuthors Yuedong Wang, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaYun Ji, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaYangwen Zhu, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaZhijie Xie, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 ChinaXiaoli Zhan, Department of General Surgery, Zhejiang Provincial People’s Hospital, 158 Shangtang Rd, Hangzhou, 310014 China Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Nerve-sparing laparoscopic eradication of deep endometriosis with segmental rectal and parametrial resection: the Negrar method. A single-center, prospective, clinical trial
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background The weight of surgical radicality, together with a lack of anatomical theoretical basis for surgery and inappropriate practical skills, can lead to serious impairments to bladder, rectal, and sexual functions after laparoscopic excision of deep infiltrating endometriosis. Although the “classical” laparoscopic technique for endometriosis excision involving segmental bowel resection has proven to relieve symptoms successfully, it is hampered by several postoperative long-term and/or definitive pelvic dysfunctions. Methods In this prospective cohort study, we compare the laparoscopic nerve-sparing approach to the classical laparoscopic procedure in a series of 126 cases. Satisfactory data for bowel, bladder, and sexual function were considered as primary endpoints. Results A total of 126 patients were considered for analysis: 61 treated with nerve-sparing radical excision of pelvic endometriosis with segmental bowel resection (group B), and 65 treated with the classical technique (group A). Intraoperative, perioperative, and postoperative complications were similar between the two groups. Mean days of self-catheterization were significantly lower in the nerve-sparing group (39.8 days) compared with the non-nerve-sparing group (121.1 days; p < 0.001). The relapse rate within 12 months after surgery was comparable between the two groups. Patients of group A suffered from urinary retention more frequently between 1 and 6 months (p = 0.035) compared with group B and did not experience any improvement between 6 months and 1 year (p = 0.018). Overall detection of severe bladder/rectal/sexual dysfunctions was significantly different between the two groups, and 56 patients of group A (86.2%) reported a significantly higher rate of severe neurologic pelvic dysfunctions vs. 1 patient (1.6%) of group B (p < 0.001). Conclusions Our technique appears to be feasible and offers good results in terms of reduced bladder morbidity and apparently higher satisfaction than the classical technique. Considering that this kind of surgery requires uncommon surgical skills and anatomical knowledge, we believe that it should be performed only in selected reference centers. Content Type Journal ArticlePages 1-17DOI 10.1007/s00464-012-2153-3Authors Marcello Ceccaroni, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyRoberto Clarizia, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyFrancesco Bruni, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyElisabetta D’Urso, Department of Obstetrics and Gynecology, European Gynecology Endoscopy School, Sacred Heart Hospital, Negrar, VR, ItalyMaria Lucia Gagliardi, Department of Obstetrics and Gynecology, A. Gemelli University Hospital, Catholic University of Sacred Heart, Rome, ItalyGiovanni Roviglione, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyLuca Minelli, Department of Obstetrics and Gynecology, European Gynecology Endoscopy School, Sacred Heart Hospital, Negrar, VR, ItalyGiacomo Ruffo, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, Italy Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Use of fibrin sealant (Tisseel/Tissucol) in hernia repair: a systematic review
Thu, 26 Jan 2012 06:55:34 -0000
Abstract Background Abdominal wall and inguinal hernia repair are the most frequently performed surgical procedures in the United States and Europe. However, traditional methods of mesh fixation are associated with a number of problems including substantial risks of recurrence and of postoperative and chronic pain. The aim of this systematic review is to summarize the clinical safety and efficacy of Tisseel/Tissucol fibrin sealant for hernia mesh fixation. Methods A PubMed title/abstract search was conducted u
Sites:
Carpal Tunnel Syndrome: The Southern California Orthopedic Institute (SCOI) - serving the Los Angeles and San Fernando Valley California in orthopedic surgery, sports medicine, knee and shoulder surgery, joint replacement, MRI, and physical rehabilitation.Duke US Surgical Endosurgery Center: The Center was established for the purpose of improving endosurgical education, advancing endosurgery through research and technical developments, and assessing the appropriate applications of endosurgical techniques.
Endius: endoscopic spinal surgery - Endius Incorporated
Gastrointestinal Endoscopy: Explains how the stomach and intestines can be examined using endoscopes, without surgery.
Laparoscopic Surgery: RSAPC1.com provides information about a broad spectrum of procedures including minimally invasive surgery, colo-rectal , breast and hernia surgery with special interest in advanced laparoscopic procedures including surgical weight loss, esophagus, stomach, liver, gallbladder, colon small intestin...
Laparoscopy Hospital: Laparoscopy Hospital is super specialized institute for laparoscopic treatment training and research
MicroSpine - Minimally Invasive Spinal Surgery Specialists: Endoscopic Laser Spine Surgery
Neurosurgeon and Pain Management Specialist: Dr. Ramsis F. Ghaly is a Neurosurgeon who is uniquely specialized in the latest endoscopic surgical techniques. Dr. Ghaly also specializes in Pain Management by using techniques that alleviate refractory pain sufferers. He also specializes in Anesthesiology and Intensive Care Management.
Plastic Surgery Performed Using Endoscopes: Provides explanations of various procedures (browlifts, facelifts) that can be performed endoscopically. Compares conventional and endoscopic procedures.
San Diego Shoulder Arthroscopy: An on-line library of tips, techniques, and procedures.
Society of American Gastrointestinal Endoscopic Surgeons: The leading professional society and CME meeting, representing more than 5000 board certified surgeons who use endoscopy and laparoscopy as an integral part of their treatment of patients
The Belgian Group for Endoscopic Surgery: An association of endoscopic surgeons in Belgium.
TMJ (Temporomandibular Joint) Disorders: The temporomandibular joint, anatomy, disorders, surgery. Includes a brief discussion of TMJ arthroscopy.
University of Massachusetts EndoSurgery Center: Laparoscopic surgical techniques, online courses and educational resources for minimally invasive and hand-assisted laparoscopic surgery. Watch videos and learn the essentials of laparoscopy, including cholecystectomy, hernia repair, Nissen and Toupet fundoplication for GERD.
This directory is based on the Open Directory and may have been modified