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Sample records for advanced minimally invasive

  1. Minimally Invasive Dentistry

    Science.gov (United States)

    ... to your desktop! more... What Is Minimally Invasive Dentistry? Article Chapters What Is Minimally Invasive Dentistry? Minimally ... techniques. Reviewed: January 2012 Related Articles: Minimally Invasive Dentistry Minimally Invasive Veneers Dramatically Change Smiles What Patients ...

  2. Workshop on Advances in NASA-Relevant, Minimally Invasive Instrumentation

    Science.gov (United States)

    1985-01-01

    The purpose of this meeting is to highlight those advances in instrumentation and methodology that can be applied to the medical problems that will be encountered as the duration of manned space missions is extended. Information on work that is presently being done by NASA as well as other approaches in which NASA is not participating will be exchanged. The NASA-sponsored efforts that will be discussed are part of the overall Space Medicine Program that has been undertaken by NASA to address the medical problems of manned spaceflight. These problems include those that have been observed in the past as well as those which are anticipated as missions become longer, traverse different orbits, or are in any way different. This conference is arranged in order to address the types of instrumentation that might be used in several major medical problem areas. Instrumentation that will help in the cardiovascular, musculoskeletal, and psychological areas, among others will be presented. Interest lies in identifying instrumentation which will help in learning more about ourselves through experiments performed directly on humans. Great emphasis is placed on non-invasive approaches, although every substantial program basic to animal research will be needed in the foreseeable future. Space Medicine is a rather small affair in what is primarily an engineering organization. Space Medicine is conducted throughout NASA by a very small skeleton staff at the headquarters office in Washington and by our various field centers. These centers include the Johnson Space Center in Houston, Texas, the Ames Research Center in Moffett Field, California, the Jet Propulsion Laboratory in Pasadena, California, the Kennedy Space Center in Florida, and the Langley Research Center in Hampton, Virginia. Throughout these various centers, work is conducted in-house by NASA's own staff scientists, physicians, and engineers. In addition, various universities, industries, and other government laboratories

  3. Esophagectomy - minimally invasive

    Science.gov (United States)

    Minimally invasive esophagectomy; Robotic esophagectomy; Removal of the esophagus - minimally invasive; Achalasia - esophagectomy; Barrett esophagus - esophagectomy; Esophageal cancer - esophagectomy - laparoscopic; Cancer of the ...

  4. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... minimally invasive approach in terms of, you know, effectiveness of treating lumbar herniations? 2 Well, the minimally ... think it’s important to stress here that the effectiveness of this procedure is about the same as ...

  5. [Are there technological advances in minimally invasive surgery and who will pay them?].

    Science.gov (United States)

    Feussner, H; Wilhelm, D; Härtl, F; Schneider, A; Siess, M

    2007-06-01

    The successful development of minimally invasive surgery would have been inconceivable without continuous advances in medical technology. The users, i.e. the surgeons, however, only accepted innovations with a clear-cut positive impact on clinical care. Accordingly, the expected exponential rise in costs could be avoided. The imbalance in cost/benefit aspects between the deliverers of medical care on one hand, and the patients, the insurance companies and the employers on the other is critical. In addition, further innovations are to be expected. This will not be possible without increasing costs, but there are good reasons to assume that expenses will rise only moderately. Each modern society is able (and obliged) to afford a certain amount of medical progress in order to maintain a high level of medical care and economic strength.

  6. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... called a “minimally invasive microscopic lumbar discectomy.” Now this is a patient who a 46-year-old ... L-5, S-1. So that’s why she’s having this procedure. The man who is doing the procedure ...

  7. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... part of the sciatic nerve. You know one good important thing to talk about is the concept of “I ... in the minimally invasive procedures? The most important thing is to have a good trusting relationship between your surgeon and yourself, and ...

  8. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... Miami’s Baptist Hospital. You’re going to be a seeing a procedure called a “minimally invasive microscopic lumbar discectomy.” Now this is a patient who a 46-year-old woman who ...

  9. Minimally Invasive Stomas

    OpenAIRE

    Hellinger, Michael D.; Al Haddad, Abdullah

    2008-01-01

    Traditionally, stoma creation and end stoma reversal have been performed via a laparotomy incision. However, in many situations, stoma construction may be safely performed in a minimally invasive nature. This may include a trephine, laparoscopic, or combined approach. Furthermore, Hartmann's colostomy reversal, a procedure traditionally associated with substantial morbidity, may also be performed laparoscopically. The authors briefly review patient selection, preparation, and indications, and...

  10. Minimally invasive periodontal therapy.

    Science.gov (United States)

    Dannan, Aous

    2011-10-01

    Minimally invasive dentistry is a concept that preserves dentition and supporting structures. However, minimally invasive procedures in periodontal treatment are supposed to be limited within periodontal surgery, the aim of which is to represent alternative approaches developed to allow less extensive manipulation of surrounding tissues than conventional procedures, while accomplishing the same objectives. In this review, the concept of minimally invasive periodontal surgery (MIPS) is firstly explained. An electronic search for all studies regarding efficacy and effectiveness of MIPS between 2001 and 2009 was conducted. For this purpose, suitable key words from Medical Subject Headings on PubMed were used to extract the required studies. All studies are demonstrated and important results are concluded. Preliminary data from case cohorts and from many studies reveal that the microsurgical access flap, in terms of MIPS, has a high potential to seal the healing wound from the contaminated oral environment by achieving and maintaining primary closure. Soft tissues are mostly preserved and minimal gingival recession is observed, an important feature to meet the demands of the patient and the clinician in the esthetic zone. However, although the potential efficacy of MIPS in the treatment of deep intrabony defects has been proved, larger studies are required to confirm and extend the reported positive preliminary outcomes.

  11. Minimally Invasive Thoracic Surgery

    OpenAIRE

    McFadden, P. Michael

    2000-01-01

    To reduce the risk, trauma, and expense of intrathoracic surgical treatments, minimally invasive procedures performed with the assistance of fiberoptic video technology have been developed for thoracic and bronchial surgeries. The surgical treatment of nearly every intrathoracic condition can benefit from a video-assisted approach performed through a few small incisions. Video-assisted thoracoscopic and rigid-bronchoscopic surgery have improved the results of thoracic procedures by decreasing...

  12. Heart bypass surgery - minimally invasive

    Science.gov (United States)

    Minimally invasive direct coronary artery bypass; MIDCAB; Robot assisted coronary artery bypass; RACAB; Keyhole heart surgery ... doctor may recommend a minimally invasive coronary artery bypass if you have a blockage in one or ...

  13. Minimally invasive mediastinal surgery.

    Science.gov (United States)

    Melfi, Franca M A; Fanucchi, Olivia; Mussi, Alfredo

    2016-01-01

    In the past, mediastinal surgery was associated with the necessity of a maximum exposure, which was accomplished through various approaches. In the early 1990s, many surgical fields, including thoracic surgery, observed the development of minimally invasive techniques. These included video-assisted thoracic surgery (VATS), which confers clear advantages over an open approach, such as less trauma, short hospital stay, increased cosmetic results and preservation of lung function. However, VATS is associated with several disadvantages. For this reason, it is not routinely performed for resection of mediastinal mass lesions, especially those located in the anterior mediastinum, a tiny and remote space that contains vital structures at risk of injury. Robotic systems can overcome the limits of VATS, offering three-dimensional (3D) vision and wristed instrumentations, and are being increasingly used. With regards to thymectomy for myasthenia gravis (MG), unilateral and bilateral VATS approaches have demonstrated good long-term neurologic results with low complication rates. Nevertheless, some authors still advocate the necessity of maximum exposure, especially when considering the distribution of normal and ectopic thymic tissue. In recent studies, the robotic approach has shown to provide similar neurological outcomes when compared to transsternal and VATS approaches, and is associated with a low morbidity. Importantly, through a unilateral robotic technique, it is possible to dissect and remove at least the same amount of mediastinal fat tissue. Preliminary results on early-stage thymomatous disease indicated that minimally invasive approaches are safe and feasible, with a low rate of pleural recurrence, underlining the necessity of a "no-touch" technique. However, especially for thymomatous disease characterized by an indolent nature, further studies with long follow-up period are necessary in order to assess oncologic and neurologic results through minimally invasive

  14. Advances in Haptics, Tactile Sensing, and Manipulation for Robot-Assisted Minimally Invasive Surgery, Noninvasive Surgery, and Diagnosis

    Directory of Open Access Journals (Sweden)

    Abbi Hamed

    2012-01-01

    Full Text Available The developments of medical practices and medical technologies have always progressed concurrently. The relatively recent developments in endoscopic technologies have allowed the realization of the “minimally invasive” form of surgeries. The advancements in robotics facilitate precise surgeries that are often integrated with medical image guidance capability. This in turn has driven the further development of technology to compensate for the unique complexities engendered by this new format and to improve the performance and broaden the scope of the procedures that can be performed. Medical robotics has been a central component of this development due to the highly suitable characteristics that a robotic system can purport, including highly optimizable mechanical conformation and the ability to program assistive functions in medical robots for surgeons to perform safe and accurate minimally invasive surgeries. In addition, combining the robot-assisted interventions with touch-sensing and medical imaging technologies can greatly improve the available information and thus help to ensure that minimally invasive surgeries continue to gain popularity and stay at the focus of modern medical technology development. This paper presents a state-of-the-art review of robotic systems for minimally invasive and noninvasive surgeries, precise surgeries, diagnoses, and their corresponding technologies.

  15. Future of Minimally Invasive Colorectal Surgery.

    Science.gov (United States)

    Whealon, Matthew; Vinci, Alessio; Pigazzi, Alessio

    2016-09-01

    Minimally invasive surgery is slowly taking over as the preferred operative approach for colorectal diseases. However, many of the procedures remain technically difficult. This article will give an overview of the state of minimally invasive surgery and the many advances that have been made over the last two decades. Specifically, we discuss the introduction of the robotic platform and some of its benefits and limitations. We also describe some newer techniques related to robotics. PMID:27582647

  16. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... during this non-invasive sort of approach. The word that we put in the operative record is ... compressed really are like cables, and there’s a short circuit in the cable of the nerve when ...

  17. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... invasive, very small, and patients have recuperated very well, and this patient will be very satisfied in about 45 minutes when the ... 45 minutes, once she she’s stable, she should be fine. Well if you want to have any consult with ...

  18. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... his choice. Tariq asks, can we see one day that minimally invasive techniques to replace conventional heart ... rarely need those pacemaker wires after the first day after surgery. Okay, we have another question from ...

  19. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... possible incision to minimize the injury to the tissues, particularly the muscles, the skin, and the ligaments, ... easier, and it limits the damage to the tissues around. So it’s a much safer procedure for ...

  20. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... approach. The word that we put in the operative record is minimal. We’re talking about maybe ... we’re looking at 20-times magnification. The operative area, the field that they’re working is ...

  1. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... with the smallest possible incision to minimize the injury to the tissues, particularly the muscles, the skin, ... the world. It’s one of the most common injuries and one of the most common causes of ...

  2. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... toll that it takes on people and the economy with lost workdays and also, needless to say, ... normal life. And thankfully with the advances in technology and diagnostics that we have available here at ...

  3. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... t get better with conservative treatment. She tried medicine and physical therapy. Her MRI revealed that he ... greatest advances, at least in my specialty in medicine, has been the ability to use surgical microscopes. ...

  4. Minimally Invasive Lumbar Discectomy

    Medline Plus

    Full Text Available ... normal life. And thankfully with the advances in technology and diagnostics that we have available here at ... of at a facility that has the latest technology available for the diagnostic, the treatment, and the ...

  5. Robotic assisted minimally invasive surgery

    Directory of Open Access Journals (Sweden)

    Palep Jaydeep

    2009-01-01

    Full Text Available The term "robot" was coined by the Czech playright Karel Capek in 1921 in his play Rossom′s Universal Robots. The word "robot" is from the check word robota which means forced labor.The era of robots in surgery commenced in 1994 when the first AESOP (voice controlled camera holder prototype robot was used clinically in 1993 and then marketed as the first surgical robot ever in 1994 by the US FDA. Since then many robot prototypes like the Endoassist (Armstrong Healthcare Ltd., High Wycombe, Buck, UK, FIPS endoarm (Karlsruhe Research Center, Karlsruhe, Germany have been developed to add to the functions of the robot and try and increase its utility. Integrated Surgical Systems (now Intuitive Surgery, Inc. redesigned the SRI Green Telepresence Surgery system and created the daVinci Surgical System ® classified as a master-slave surgical system. It uses true 3-D visualization and EndoWrist ® . It was approved by FDA in July 2000 for general laparoscopic surgery, in November 2002 for mitral valve repair surgery. The da Vinci robot is currently being used in various fields such as urology, general surgery, gynecology, cardio-thoracic, pediatric and ENT surgery. It provides several advantages to conventional laparoscopy such as 3D vision, motion scaling, intuitive movements, visual immersion and tremor filtration. The advent of robotics has increased the use of minimally invasive surgery among laparoscopically naοve surgeons and expanded the repertoire of experienced surgeons to include more advanced and complex reconstructions.

  6. What is minimally invasive dentistry?

    Science.gov (United States)

    Ericson, Dan

    2004-01-01

    Minimally Invasive Dentistry is the application of "a systematic respect for the original tissue." This implies that the dental profession recognizes that an artifact is of less biological value than the original healthy tissue. Minimally invasive dentistry is a concept that can embrace all aspects of the profession. The common delineator is tissue preservation, preferably by preventing disease from occurring and intercepting its progress, but also removing and replacing with as little tissue loss as possible. It does not suggest that we make small fillings to restore incipient lesions or surgically remove impacted third molars without symptoms as routine procedures. The introduction of predictable adhesive technologies has led to a giant leap in interest in minimally invasive dentistry. The concept bridges the traditional gap between prevention and surgical procedures, which is just what dentistry needs today. The evidence-base for survival of restorations clearly indicates that restoring teeth is a temporary palliative measure that is doomed to fail if the disease that caused the condition is not addressed properly. Today, the means, motives and opportunities for minimally invasive dentistry are at hand, but incentives are definitely lacking. Patients and third parties seem to be convinced that the only things that count are replacements. Namely, they are prepared to pay for a filling but not for a procedure that can help avoid having one.

  7. New trends in minimally invasive urological surgery

    Directory of Open Access Journals (Sweden)

    Prabhakar Rajan

    2009-10-01

    Full Text Available Purpose: The perceived benefits of minimally-invasive surgery include less postoperative pain, shorter hospitalization, reduced morbidity and better cosmesis while maintaining diagnostic accuracy and therapeutic outcome. We review the new trends in minimally-invasive urological surgery. Materials and method: We reviewed the English language literature using the National Library of Medicine database to identify the latest technological advances in minimally-invasive surgery with particular reference to urology. Results: Amongst other advances, studies incorporating needlescopic surgery, laparoendoscopic single-site surgery , magnetic anchoring and guidance systems, natural orifice transluminal endoscopic surgery and flexible robots were considered of interest. The results from initial animal and human studies are also outlined. Conclusion: Minimally-invasive surgery continues to evolve to meet the demands of the operators and patients. Many novel technologies are still in the testing phase, whilst others have entered clinical practice. Further evaluation is required to confirm the safety and efficacy of these techniques and validate the published reports.

  8. Minimally invasive surgery for Achilles tendon pathologies

    Directory of Open Access Journals (Sweden)

    Nicola Maffulli

    2010-07-01

    Full Text Available Nicola Maffulli1, Umile Giuseppe Longo2, Filippo Spiezia2, Vincenzo Denaro21Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, London, England; 2Department of Orthopedic and Trauma Surgery, Campus Bio-Medico University, Rome, ItalyAbstract: Minimally invasive trauma and orthopedic surgery is increasingly common, though technically demanding. Its use for pathologies of the Achilles tendon (AT hold the promise to allow faster recovery times, shorter hospital stays, and improved functional outcomes when compared to traditional open procedures, which can lead to difficulty with wound healing because of the tenuous blood supply and increased chance of wound breakdown and infection. We present the recent advances in the field of minimally invasive AT surgery for tendinopathy, acute ruptures, chronic tears, and chronic avulsions of the AT. In our hands, minimally invasive surgery has provided similar results to those obtained with open surgery, with decreased perioperative morbidity, decreased duration of hospital stay, and reduced costs. So far, the studies on minimally invasive orthopedic techniques are of moderate scientific quality with short follow-up periods. Multicenter studies with longer follow-up are needed to justify the long-term advantages of these techniques over traditional ones.Keywords: tendinopathy, rupture, percutanous repair, less invasive

  9. Minimally Invasive Posterior Hamstring Harvest

    OpenAIRE

    Wilson, Trent J.; Lubowitz, James H.

    2013-01-01

    Autogenous hamstring harvesting for knee ligament reconstruction is a well-established standard. Minimally invasive posterior hamstring harvest is a simple, efficient, reproducible technique for harvest of the semitendinosus or gracilis tendon or both medial hamstring tendons. A 2- to 3-cm longitudinal incision from the popliteal crease proximally, in line with the semitendinosus tendon, is sufficient. The deep fascia is bluntly penetrated, and the tendon or tendons are identified. Adhesions ...

  10. Minimally invasive procedures on the lumbar spine

    Science.gov (United States)

    Skovrlj, Branko; Gilligan, Jeffrey; Cutler, Holt S; Qureshi, Sheeraz A

    2015-01-01

    Degenerative disease of the lumbar spine is a common and increasingly prevalent condition that is often implicated as the primary reason for chronic low back pain and the leading cause of disability in the western world. Surgical management of lumbar degenerative disease has historically been approached by way of open surgical procedures aimed at decompressing and/or stabilizing the lumbar spine. Advances in technology and surgical instrumentation have led to minimally invasive surgical techniques being developed and increasingly used in the treatment of lumbar degenerative disease. Compared to the traditional open spine surgery, minimally invasive techniques require smaller incisions and decrease approach-related morbidity by avoiding muscle crush injury by self-retaining retractors, preventing the disruption of tendon attachment sites of important muscles at the spinous processes, using known anatomic neurovascular and muscle planes, and minimizing collateral soft-tissue injury by limiting the width of the surgical corridor. The theoretical benefits of minimally invasive surgery over traditional open surgery include reduced blood loss, decreased postoperative pain and narcotics use, shorter hospital length of stay, faster recover and quicker return to work and normal activity. This paper describes the different minimally invasive techniques that are currently available for the treatment of degenerative disease of the lumbar spine. PMID:25610845

  11. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

    Medline Plus

    Full Text Available ... evening to the viewer, by the way. The concept of minimally invasive neurosurgery is based on a ... illness. Minimally invasive neurosurgery is based on the concept of reducing tissue injury while maximizing efficacy of ...

  12. Minimally Invasive Surgical Therapies for Atrial Fibrillation

    OpenAIRE

    Chu, Michael W.A.; Yoshitsugu Nakamura; Bob Kiaii

    2012-01-01

    Atrial fibrillation is the most common sustained arrhythmia and is associated with significant risks of thromboembolism, stroke, congestive heart failure, and death. There have been major advances in the management of atrial fibrillation including pharmacologic therapies, antithrombotic therapies, and ablation techniques. Surgery for atrial fibrillation, including both concomitant and stand-alone interventions, is an effective therapy to restore sinus rhythm. Minimally invasive surgical ablat...

  13. Esophageal surgery in minimally invasive era

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    The widespread popularity of new surgical technologiessuch as laparoscopy, thoracoscopy and robotics has ledmany surgeons to treat esophageal diseases with thesemethods. The expected benefits of minimally invasive surgery (MIS) mainly include reductions of postoperativecomplications, length of hospital stay, and pain andbetter cosmetic results. All of these benefits couldpotentially be of great interest when dealing with theesophagus due to the potentially severe complicationsthat can occur after conventional surgery. Moreover,robotic platforms are expected to reduce many of thedifficulties encountered during advanced laparoscopicand thoracoscopic procedures such as anastomoticreconstructions,accurate lymphadenectomies, andvascular sutures. Almost all esophageal diseases areapproachable in a minimally invasive way, includingdiverticula, gastro-esophageal reflux disease, achalasia,perforations and cancer. Nevertheless, while the limitsof MIS for benign esophageal diseases are mainlytechnical issues and costs, oncologic outcomes remainthe cornerstone of any procedure to cure malignancies,for which the long-term results are critical. Furthermore,many of the minimally invasive esophageal operationsshould be compared to pharmacologic interventionsand advanced pure endoscopic procedures; such acomparison requires a difficult literature analysis andleads to some confounding results of clinical trials. Thisreview aims to examine the evidence for the use of MISin both malignancies and more common benign diseaseof the esophagus, with a particular emphasis on futuredevelopments and ongoing areas of research.

  14. [MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT].

    Science.gov (United States)

    Tabata, Minoru

    2016-03-01

    Minimally invasive aortic valve replacement (MIAVR) is defined as aortic valve replacement avoiding full sternotomy. Common approaches include a partial sternotomy right thoracotomy, and a parasternal approach. MIAVR has been shown to have advantages over conventional AVR such as shorter length of stay and smaller amount of blood transfusion and better cosmesis. However, it is also known to have disadvantages such as longer cardiopulmonary bypass and aortic cross-clamp times and potential complications related to peripheral cannulation. Appropriate patient selection is very important. Since the procedure is more complex than conventional AVR, more intensive teamwork in the operating room is essential. Additionally, a team approach during postoperative management is critical to maximize the benefits of MIAVR. PMID:27295772

  15. A minimally invasive smile enhancement.

    Science.gov (United States)

    Peck, Fred H

    2014-01-01

    Minimally invasive dentistry refers to a wide variety of dental treatments. On the restorative aspect of dental procedures, direct resin bonding can be a very conservative treatment option for the patient. When tooth structure does not need to be removed, the patient benefits. Proper treatment planning is essential to determine how conservative the restorative treatment will be. This article describes the diagnosis, treatment options, and procedural techniques in the restoration of 4 maxillary anterior teeth with direct composite resin. The procedural steps are reviewed with regard to placing the composite and the variety of colors needed to ensure a natural result. Finishing and polishing of the composite are critical to ending with a natural looking dentition that the patient will be pleased with for many years.

  16. [MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT].

    Science.gov (United States)

    Tabata, Minoru

    2016-03-01

    Minimally invasive aortic valve replacement (MIAVR) is defined as aortic valve replacement avoiding full sternotomy. Common approaches include a partial sternotomy right thoracotomy, and a parasternal approach. MIAVR has been shown to have advantages over conventional AVR such as shorter length of stay and smaller amount of blood transfusion and better cosmesis. However, it is also known to have disadvantages such as longer cardiopulmonary bypass and aortic cross-clamp times and potential complications related to peripheral cannulation. Appropriate patient selection is very important. Since the procedure is more complex than conventional AVR, more intensive teamwork in the operating room is essential. Additionally, a team approach during postoperative management is critical to maximize the benefits of MIAVR.

  17. Minimally invasive aortic valve replacement

    DEFF Research Database (Denmark)

    Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K

    2009-01-01

    In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy...... operations were completed as mini-sternotomies, 4 died later of noncardiac causes. The aortic cross-clamp and perfusion times were significantly different across all groups (P valve replacement...... is an excellent operation in selected patients, but its true advantages over conventional aortic valve replacement (other than a smaller scar) await evaluation by means of randomized clinical trial. The "extended mini-aortic valve replacement" operation, on the other hand, is a risky procedure that should...

  18. Minimally invasive posterior hamstring harvest.

    Science.gov (United States)

    Wilson, Trent J; Lubowitz, James H

    2013-01-01

    Autogenous hamstring harvesting for knee ligament reconstruction is a well-established standard. Minimally invasive posterior hamstring harvest is a simple, efficient, reproducible technique for harvest of the semitendinosus or gracilis tendon or both medial hamstring tendons. A 2- to 3-cm longitudinal incision from the popliteal crease proximally, in line with the semitendinosus tendon, is sufficient. The deep fascia is bluntly penetrated, and the tendon or tendons are identified. Adhesions are dissected. Then, an open tendon stripper is used to release the tendon or tendons proximally; a closed, sharp tendon stripper is used to release the tendon or tendons from the pes. Layered, absorbable skin closure is performed, and the skin is covered with a skin sealant, bolster dressing, and plastic adhesive bandage for 2 weeks. PMID:24266003

  19. Laparoscopic total pelvic exenteration using transanal minimal invasive surgery technique with en bloc bilateral lymph node dissection for advanced rectal cancer.

    Science.gov (United States)

    Hayashi, Kengo; Kotake, Masanori; Kakiuchi, Daiki; Yamada, Sho; Hada, Masahiro; Kato, Yosuke; Hiranuma, Chikashi; Oyama, Kaeko; Hara, Takuo

    2016-12-01

    A 59-year-old man presenting with fecal occult blood visited our hospital. He was diagnosed with advanced lower rectal cancer, which was contiguous with the prostate and the left seminal vesicle. There were no metastatic lesions with lymph nodes or other organs. We performed laparoscopic total pelvic exenteration (LTPE) using transanal minimal invasive surgery technique with bilateral en bloc lateral lymph node dissection for advanced primary rectal cancer after neoadjuvant chemoradiotherapy. The total operative time was 760 min, and the estimated blood loss was 200 ml. LTPE is not well established technically, but it has many advantages including good visibility of the surgical field, less blood loss, and smaller wounds. A laparoscopic approach may be an appropriate choice for treating locally advanced lower rectal cancer, which requires TPE. PMID:27460130

  20. Advances in bio-tactile sensors for minimally invasive surgery using the fibre Bragg grating force sensor technique: a survey.

    Science.gov (United States)

    Abushagur, Abdulfatah A G; Arsad, Norhana; Reaz, Mamun Ibne; Bakar, A Ashrif A

    2014-04-09

    The large interest in utilising fibre Bragg grating (FBG) strain sensors for minimally invasive surgery (MIS) applications to replace conventional electrical tactile sensors has grown in the past few years. FBG strain sensors offer the advantages of optical fibre sensors, such as high sensitivity, immunity to electromagnetic noise, electrical passivity and chemical inertness, but are not limited by phase discontinuity or intensity fluctuations. FBG sensors feature a wavelength-encoding sensing signal that enables distributed sensing that utilises fewer connections. In addition, their flexibility and lightness allow easy insertion into needles and catheters, thus enabling localised measurements inside tissues and blood. Two types of FBG tactile sensors have been emphasised in the literature: single-point and array FBG tactile sensors. This paper describes the current design, development and research of the optical fibre tactile techniques that are based on FBGs to enhance the performance of MIS procedures in general. Providing MIS or microsurgery surgeons with accurate and precise measurements and control of the contact forces during tissues manipulation will benefit both surgeons and patients.

  1. Minimally invasive pediatric surgery: Our experience

    Directory of Open Access Journals (Sweden)

    Saravanan K

    2008-01-01

    Full Text Available Aim: Departmental survey of the pediatric laparoscopic and thoracoscopic procedures. Materials and Methods: It is a retrospective study from January 1999 to December 2007. The various types of surgeries, number of patients, complications and conversions of laparoscopic and thoracoscopic procedures were analyzed. Results: The number of minimally invasive procedures that had been performed over the past 9 years is 734, out of which thoracoscopic procedures alone were 48. The majority of the surgeries were appendicectomy (31%, orchiopexy (19% and diagnostic laparoscopy (16%. The other advanced procedures include laparoscopic-assisted anorectoplasty, surgery for Hirschprung′s disease, thoracosocpic decortication, congenital diaphragmatic hernia repair, nephrectomy, fundoplication, etc. Our complications are postoperative fever, bleeding, bile leak following choledochal cyst excision and pneumothorax following bronchogenic cyst excision. A case of empyema thorax following thoracoscopic decortication succumbed due to disseminated tuberculosis. Our conversion rate was around 5% in the years 1999 to 2001, which has come down to 3% over the past few years. Conversions were for sliding hiatus hernia, nephrectomy, perforated adherent appendicitis, Meckel′s diverticulum, thoracoscopic decortication and ileal perforation. Conclusion: The minimally invasive pediatric surgical technique is increasingly accepted world wide and the need for laparoscopic training has become essential in every teaching hospital. It has a lot of advantages, such as less pain, early return to school and scarlessness. Our conversion rate has come down from 5% to 3% with experience and now we do more advanced procedures with a lower complication rate.

  2. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... screen and open the door to informed medical care. Good afternoon and welcome to the Heart Institute ... be progressive and less invasive in how we care for our patients. 8 Here's one from one ...

  3. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... echocardiography is? Echocardiography is the use of ultrasound technology. Ultrasound technology is a form of the same kind of ... want to embrace less invasive or more progressive technology, you want to make sure that it's not ...

  4. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... the heart easily. This can lead to some clinical symptoms, which we'll talk about in a ... I'm not sure is there from a clinical perspective. There certainly is benefit to less invasive ...

  5. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... for patients who would not tolerate well a traditional open operation or a less invasive operation, as ... physical reserve. So Barbara Bush recently had a traditional aortic valve replacement surgery. What makes a patient ...

  6. Economic impact of minimally invasive lumbar surgery

    Science.gov (United States)

    Hofstetter, Christoph P; Hofer, Anna S; Wang, Michael Y

    2015-01-01

    Cost effectiveness has been demonstrated for traditional lumbar discectomy, lumbar laminectomy as well as for instrumented and noninstrumented arthrodesis. While emerging evidence suggests that minimally invasive spine surgery reduces morbidity, duration of hospitalization, and accelerates return to activites of daily living, data regarding cost effectiveness of these novel techniques is limited. The current study analyzes all available data on minimally invasive techniques for lumbar discectomy, decompression, short-segment fusion and deformity surgery. In general, minimally invasive spine procedures appear to hold promise in quicker patient recovery times and earlier return to work. Thus, minimally invasive lumbar spine surgery appears to have the potential to be a cost-effective intervention. Moreover, novel less invasive procedures are less destabilizing and may therefore be utilized in certain indications that traditionally required arthrodesis procedures. However, there is a lack of studies analyzing the economic impact of minimally invasive spine surgery. Future studies are necessary to confirm the durability and further define indications for minimally invasive lumbar spine procedures. PMID:25793159

  7. Danish surgeons' views on minimally invasive surgery

    DEFF Research Database (Denmark)

    Edwards, Hellen; Jørgensen, Lars Nannestad

    2014-01-01

    BACKGROUND AND AIM: Advancements in minimally invasive surgery have led to increases in popularity of single-incision laparoscopic surgery (SILS) and natural orifice translumenal surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American...... Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) due to their postulated benefits of better cosmesis, less pain, and quicker recovery. This questionnaire-based study investigated Danish surgeons' attitudes toward these new procedures. SUBJECTS AND METHODS: A 26-item questionnaire was developed...... become standard techniques for cholecystectomy within 6 years. CONCLUSIONS: The importance of risk of complications has not surprisingly a high priority among surgeons in this questionnaire. Why this is has to be investigated further before implementing SILS and NOTES as standard of care....

  8. Minimally Invasive Aortic Valve Replacement

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    Full Text Available ... more likely we see aortic stenosis. Again, patient education is part of the evaluation and management of ... want to embrace less invasive or more progressive technology, you want to make ... with that information and certainly shouldn't be insulted by that. ...

  9. Minimally Invasive Treatment for Lung Cancer

    Medline Plus

    Full Text Available Minimally Invasive Treatment for Lung Cancer June 15, 2009 Welcome to this “OR-Live” webcast presentation, premiering from Beth Israel Medical Center in New York City. During ...

  10. Minimally Invasive Treatment for Lung Cancer

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    Full Text Available ... kinds of impossible crevices, and it’s really a big advantage to have these flexible instruments versus some ... cannot tolerate, you know, large incisions, you know, big lobes being removed. And using the minimally invasive ...

  11. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

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    Full Text Available ... that the viewers will more greatly appreciate the quality of the image that you actually get through ... that the viewer really appreciates the minimally invasive quality of this actual procedure so they’ll get ...

  12. Minimally Invasive Aortic Valve Replacement

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    Full Text Available ... to minimize their symptoms, but that doesn't impact the course of the disease itself. When I' ... more likely we see aortic stenosis. Again, patient education is part of the evaluation and management of ...

  13. Minimally Invasive Aortic Valve Replacement

    Medline Plus

    Full Text Available ... to minimize their symptoms, but that doesn't impact the course of the disease itself. When I' ... echocardiography is? Echocardiography is the use of ultrasound technology. Ultrasound technology is a form of the same ...

  14. Minimally invasive treatment of infected pancreatic necrosis

    OpenAIRE

    Wroński, Marek; Cebulski, Włodzimierz; Słodkowski, Maciej; Krasnodębski, Ireneusz W.

    2014-01-01

    Infected pancreatic necrosis is a challenging complication that worsens prognosis in acute pancreatitis. For years, open necrosectomy has been the mainstay treatment option in infected pancreatic necrosis, although surgical debridement still results in high morbidity and mortality rates. Recently, many reports on minimally invasive treatment in infected pancreatic necrosis have been published. This paper presents a review of minimally invasive techniques and attempts to define their role in t...

  15. The advantages of minimally invasive dentistry.

    Science.gov (United States)

    Christensen, Gordon J

    2005-11-01

    Minimally invasive dentistry, in cases in which it is appropriate, is a concept that preserves dentitions and supporting structures. In this column, I have discussed several examples of minimally invasive dental techniques. This type of dentistry is gratifying for dentists and appreciated by patients. If more dentists would practice it, the dental profession could enhance the public's perception of its honesty and increase its professionalism as well.

  16. [EVOLUTION OF MINIMALLY INVASIVE CARDIAC SURGERY].

    Science.gov (United States)

    Fujita, Tomoyuki; Kobayashi, Junjiro

    2016-03-01

    Minimally invasive surgery is an attractive choice for patients undergoing major cardiac surgery. We review the history of minimally invasive valve surgery in this article. Due to many innovations in surgical tools, cardiopulmonary bypass systems, visualization systems, and robotic systems as well as surgical techniques, minimally invasive cardiac surgery has become standard care for valve lesion repair. In particular, aortic cross-clamp techniques and methods for cardioplegia using the Chitwood clamp and root cannula or endoballoon catheter in combination with femoro-femoral bypass systems have made such procedures safer and more practical. On the other hand, robotically assisted surgery has not become standard due to the cost and slow learning curve. However, along with the development of robotics, this less-invasive technique may provide another choice for patients in the near future. PMID:27295770

  17. Minimal Invasive Urologic Surgery and Postoperative Ileus

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-07-01

    Full Text Available Postoperative ileus (POI is the most common cause of prolonged length of hospital stays (LOS and associated healthcare costs. The advent of minimal invasive technique was a major breakthrough in the urologic landscape with great potential to progress in the future. In the field of gastrointestinal surgery, several studies had reported lower incidence rates for POI following minimal invasive surgery compared to conventional open procedures. In contrast, little is known about the effect of minimal invasive approach on the recovery of bowel motility after urologic surgery. We performed an overview of the potential benefit of minimal invasive approach on POI for urologic procedures. The mechanisms and risk factors responsible for the onset of POI are discussed with emphasis on the advantages of minimal invasive approach. In the urologic field, POI is the main complication following radical cystectomy but it is rarely of clinical significance for other minimal invasive interventions. Laparoscopy or robotic assisted laparoscopic techniques when studied individually may reduce to their own the duration and prevent the onset of POI in a subset of procedures. The potential influence of age and urinary diversion type on postoperative ileus is contradictory in the literature. There is some evidence suggesting that BMI, blood loss, urinary extravasation, existence of a major complication, bowel resection, operative time and transperitoneal approach are independent risk factors for POI. Treatment of POI remains elusive. One of the most important and effective management strategies for patients undergoing radical cystectomy has been the development and use of enhanced recovery programs. An optimal rational strategy to shorten the duration of POI should incorporate minimal invasive approach when appropriate into multimodal fast track programs designed to reduce POI and shorten LOS.

  18. Minimally invasive surgical approach to pancreatic malignancies.

    Science.gov (United States)

    Bencini, Lapo; Annecchiarico, Mario; Farsi, Marco; Bartolini, Ilenia; Mirasolo, Vita; Guerra, Francesco; Coratti, Andrea

    2015-12-15

    Pancreatic surgery for malignancy is recognized as challenging for the surgeons and risky for the patients due to consistent perioperative morbidity and mortality. Furthermore, the oncological long-term results are largely disappointing, even for those patients who experience an uneventfully hospital stay. Nevertheless, surgery still remains the cornerstone of a multidisciplinary treatment for pancreatic cancer. In order to maximize the benefits of surgery, the advent of both laparoscopy and robotics has led many surgeons to treat pancreatic cancers with these new methodologies. The reduction of postoperative complications, length of hospital stay and pain, together with a shorter interval between surgery and the beginning of adjuvant chemotherapy, represent the potential advantages over conventional surgery. Lastly, a better cosmetic result, although not crucial in any cancerous patient, could also play a role by improving overall well-being and patient self-perception. The laparoscopic approach to pancreatic surgery is, however, difficult in inexperienced hands and requires a dedicated training in both advanced laparoscopy and pancreatic surgery. The recent large diffusion of the da Vinci(®) robotic platform seems to facilitate many of the technical maneuvers, such as anastomotic biliary and pancreatic reconstructions, accurate lymphadenectomy, and vascular sutures. The two main pancreatic operations, distal pancreatectomy and pancreaticoduodenectomy, are approachable by a minimally invasive path, but more limited interventions such as enucleation are also feasible. Nevertheless, a word of caution should be taken into account when considering the increasing costs of these newest technologies because the main concerns regarding these are the maintenance of all oncological standards and the lack of long-term follow-up. The purpose of this review is to examine the evidence for the use of minimally invasive surgery in pancreatic cancer (and less aggressive tumors

  19. Minimally invasive surgical approach to pancreatic malignancies

    Institute of Scientific and Technical Information of China (English)

    Lapo; Bencini; Mario; Annecchiarico; Marco; Farsi; Ilenia; Bartolini; Vita; Mirasolo; Francesco; Guerra; Andrea; Coratti

    2015-01-01

    Pancreatic surgery for malignancy is recognized as challenging for the surgeons and risky for the patientsdue to consistent perioperative morbidity and mortality. Furthermore, the oncological long-term results are largely disappointing, even for those patients who experience an uneventfully hospital stay. Nevertheless, surgery still remains the cornerstone of a multidisciplinary treatment for pancreatic cancer. In order to maximize the benefits of surgery, the advent of both laparoscopy and robotics has led many surgeons to treat pancreatic cancers with these new methodologies. The reduction of postoperative complications, length of hospital stay and pain, together with a shorter interval between surgery and the beginning of adjuvant chemotherapy, represent the potential advantages over conventional surgery. Lastly, a better cosmetic result, although not crucial in any cancerous patient, could also play a role by improving overall well-being and patient self-perception. The laparoscopic approach to pancreatic surgery is, however, difficult in inexperienced hands and requires a dedicated training in both advanced laparoscopy and pancreatic surgery. The recent large diffusion of the da Vinci?? robotic platform seems to facilitate many of the technical maneuvers, such as anastomotic biliary and pancreatic reconstructions, accurate lymphadenectomy, and vascular sutures. The two main pancreatic operations, distal pancreatectomy and pancreaticoduodenectomy, are approachable by a minimally invasive path, but more limited interventions such as enucleation are also feasible. Nevertheless, a word of caution should be taken into account when considering the increasing costs of these newest technologies because the main concerns regarding these are the maintenance of all oncological standards and the lack of long-term follow-up. The purpose of this review is to examine the evidence for the use of minimally invasive surgery in pancreatic cancer(and less aggressive tumors), with

  20. [Minimally invasive cardiac surgery for aortic valve disease].

    Science.gov (United States)

    Fujimura, Y; Katoh, T; Hamano, K; Gohra, H; Tsuboi, H; Esato, K

    1998-12-01

    Recent surgical advances leading to good operative results have contributed to the trend to useminimally invasive approaches, even in cardiac surgery. Smaller incisions are clearly more cosmetically acceptable to patients. When using a minimally invasive approach, it is most important to maintain surgical quality without jeopardizing patients. A good operative visual field leads to good surgical results. In the parasternal approach, we use a retractor to harvest an internal thoracic artery in coronary artery bypass surgery. Retracting the sternum upward allows for a good surgical view and permits the use of an arch cannula rather than femoral cannulation. When reoperating for aortic valve repair, the j-sternotomy approach requires less adhesiolysis compared with the traditional full sternotomy. No special technique is necessary to perform aortic valve surgery using the j-sternotomy approach. However, meticulous attention must be paid to avoiding left ventricular air embolisms to prevent postoperative stroke or neurocognitive deficits, especially when utilizing a minimally invasive approach. Transesophageal echo is useful not only for monitoring cardiac function but also for monitoring the persence of air in the left ventricle and atrium. This paper compare as the degree of invasion of minimally invasive cardiac surgery and the traditional full sternotomy. No differences were found in the occurrence of systemic inflammatory response syndrome between patients undergoing minimally invasive cardiac surgery and the traditional technique. Therefore it is concluded that minimally invasive surgery for patients with aortic valve disease may become the standard approach in the near future.

  1. Minimally invasive restorative dentistry: a biomimetic approach.

    Science.gov (United States)

    Malterud, Mark I

    2006-08-01

    When providing dental treatment for a given patient, the practitioner should use a minimally invasive technique that conserves sound tooth structure as a clinical imperative. Biomimetics is a tenet that guides the author's practice and is generally described as the mimicking of natural life. This can be accomplished in many cases using contemporary composite resins and adhesive dental procedures. Both provide clinical benefits and support the biomimetic philosophy for treatment. This article illustrates a minimally invasive approach for the restoration of carious cervical defects created by poor hygiene exacerbated by the presence of orthodontic brackets.

  2. Minimally invasive (robotic assisted thoracic surgery and video-assisted thoracic surgery) lobectomy for the treatment of locally advanced non-small cell lung cancer

    Science.gov (United States)

    Yang, Hao-Xian; Woo, Kaitlin M.; Sima, Camelia S.

    2016-01-01

    Background Insufficient data exist on the results of minimally invasive surgery (MIS) for locally advanced non-small cell lung cancer (NSCLC) traditionally approached by thoracotomy. The use of telerobotic surgical systems may allow for greater utilization of MIS approaches to locally advanced disease. We will review the existing literature on MIS for locally advanced disease and briefly report on the results of a recent study conducted at our institution. Methods We performed a retrospective review of a prospective single institution database to identify patients with clinical stage II and IIIA NSCLC who underwent lobectomy following induction chemotherapy. The patients were classified into two groups (MIS and thoracotomy) and were compared for differences in outcomes and survival. Results From January 2002 to December 2013, 428 patients {397 thoracotomy, 31 MIS [17 robotic and 14 video-assisted thoracic surgery (VATS)]} underwent induction chemotherapy followed by lobectomy. The conversion rate in the MIS group was 26% (8/31) The R0 resection rate was similar between the groups (97% for MIS vs. 94% for thoracotomy; P=0.71), as was postoperative morbidity (32% for MIS vs. 33% for thoracotomy; P=0.99). The median length of hospital stay was shorter in the MIS group (4 vs. 5 days; P<0.001). The 3-year overall survival (OS) was 48.3% in the MIS group and 56.6% in the thoracotomy group (P=0.84); the corresponding 3-year DFS were 49.0% and 42.1% (P=0.19). Conclusions In appropriately selected patients with NSCLC, MIS approaches to lobectomy following induction therapy are feasible and associated with similar disease-free and OS to those following thoracotomy. PMID:27195138

  3. Minimally Invasive Treatment for Lung Cancer

    Medline Plus

    Full Text Available Minimally Invasive Treatment for Lung Cancer June 15, 2009 Welcome to this “OR-Live” webcast presentation, premiering from Beth Israel Medical ... when detected, you know, and when patients get treatment. Okay. So it’s very important, you know, to ...

  4. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

    Medline Plus

    Full Text Available ... you this evening about minimally invasive endoscopic intraventricular neurosurgery. Now that’s a mouthful that we're going ... York Presbyterian. He is the Director of Pediatric Neurosurgery at Komansky Center for Children’s Health at Weill ...

  5. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

    Medline Plus

    Full Text Available ... the age of one don't respond as well. While it an be used in certain circumstances, the success rate is ... of information on minimally invasive endoscopic neurosurgery as well ... Web site that can be visited for more information. And again, the source ...

  6. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

    Medline Plus

    Full Text Available Minimally Invasive Treatment of Hydrocephalus February 11, 2009 Welcome to this OR Live Webcast presentation. Live from the Phyllis and David ... to focus the application of endoscopes in the treatment of hydrocephalus. Perhaps you could talk about, you ...

  7. [Minimally Invasive Open Surgery for Lung Cancer].

    Science.gov (United States)

    Nakagawa, Kazuo; Watanabe, Shunichi

    2016-07-01

    Significant efforts have been made to reduce the invasiveness of surgical procedures by surgeons for a long time. Surgeons always keep it in mind that the basic principle performing less invasive surgical procedures for malignant tumors is to decrease the invasiveness for patients without compromising oncological curability and surgical safety. Video-assisted thoracic surgery (VATS) has been used increasingly as a minimally invasive approach to lung cancer surgery. Whereas, whether VATS lobectomy is a less invasive procedure and has equivalent or better clinical effect compared with open lobectomy for patients with lung cancer remains controversial because of the absence of randomized prospective studies. The degree of difficulty for anatomical lung resection depends on the degree of the fissure development, mobility of hilar lymph nodes, and the degree of pleural adhesions. During pulmonary surgery, thoracic surgeons always have to deal with not only these difficulties but other unexpected events such as intraoperative bleeding. Recently, we perform pulmonary resection for lung cancer with minimally invasive open surgery (MIOS) approach. In this article, we introduce the surgical procedure of MIOS and demonstrate short-term results. Off course, the efficacy of MIOS needs to be further evaluated with long-term results. PMID:27440030

  8. Minimally invasive follicular thyroid carcinomas: prognostic factors.

    Science.gov (United States)

    Stenson, Gustav; Nilsson, Inga-Lena; Mu, Ninni; Larsson, Catharina; Lundgren, Catharina Ihre; Juhlin, C Christofer; Höög, Anders; Zedenius, Jan

    2016-08-01

    Although minimally invasive follicular thyroid carcinoma (MI-FTC) is regarded as an indolent tumour, treatment strategies remain controversial. Our aim was to investigate the outcome for patients with MI-FTC and to identify prognostic parameters to facilitate adequate treatment and follow-up. This retrospective follow-up study involved all cases of MI-FTC operated at the Karolinska University Hospital between 1986 and 2009. Outcome was analysed using death from MI-FTC as endpoint. Fifty-eight patients (41 women and 17 men) with MI-FTC were identified. The median follow-up time was 140 (range 21-308) months. Vascular invasion was observed in 36 cases and was associated with larger tumour size [median 40 (20-76) compared with 24 (10-80) mm for patients with capsular invasion only (P = 0.001)] and older patients [54 (20-92) vs. 44 (11-77) years; P = 0.019]. Patients with vascular invasion were more often treated with thyroidectomy (21/36 compared to 7/22 with capsular invasion only; P = 0.045). Five patients died from metastatic disease of FTC after a median follow-up of 114 (range 41-193) months; all were older than 50 years (51-72) at the time of the initial surgery; vascular invasion was present in all tumours and all but one were treated with thyroidectomy. Univariate analysis identified combined capsular and vascular invasion (P = 0.034), age at surgery ≥50 years (P = 0.023) and male gender (P = 0.005) as related to risk of death from MI-FTC. MI-FTC should not be considered a purely indolent disease. Age at diagnosis and the existence of combined capsular and vascular invasion were identified as important prognostic factors. PMID:26858184

  9. Navigated minimally invasive unicompartmental knee arthroplasty.

    Science.gov (United States)

    Jenny, Jean-Yves; Müller, Peter E; Weyer, R; John, Michael; Weber, Patrick; Ciobanu, Eugène; Schmitz, Andreas; Bacher, Thomas; Neumann, Wolfram; Jansson, Volkmar

    2006-10-01

    Unicompartmental knee arthroplasty (UKA) is an alternative procedure to high tibial osteotomy. This study assessed the procedure using computer navigation to improve implantation accuracy and presents early radiological results of a group of patients implanted with the univation UKA (B. Braun Aesculap, Tuttlingen, Germany) with navigation instrumentation and a minimally invasive approach. The authors concluded that navigated implantation of a UKA using a nonimage-based system improved radiologic accuracy implantation without significant inconvenience and minimal change in the conventional operating technique. PMID:17407935

  10. The concept of minimally invasive dentistry.

    Science.gov (United States)

    Ericson, Dan

    2007-01-01

    This paper reviews Minimally Invasive Dentistry (MID) from a day-to-day dentistry perspective, focusing mostly on cariology and restorative dentistry, even though it embraces many aspects of dentistry. The concept of MID supports a systematic respect for the original tissue, including diagnosis, risk assessment, preventive treatment, and minimal tissue removal upon restoration. The motivation for MID emerges from the fact that fillings are not permanent and that the main reasons for failure are secondary caries and filling fracture. To address these flaws, there is a need for economical re-routing so that practices can survive on maintaining dental health and not only by operative procedures.

  11. Mechatronic Feasibility of Minimally Invasive, Atraumatic Cochleostomy

    Directory of Open Access Journals (Sweden)

    Tom Williamson

    2014-01-01

    Full Text Available Robotic assistance in the context of lateral skull base surgery, particularly during cochlear implantation procedures, has been the subject of considerable research over the last decade. The use of robotics during these procedures has the potential to provide significant benefits to the patient by reducing invasiveness when gaining access to the cochlea, as well as reducing intracochlear trauma when performing a cochleostomy. Presented herein is preliminary work on the combination of two robotic systems for reducing invasiveness and trauma in cochlear implantation procedures. A robotic system for minimally invasive inner ear access was combined with a smart drilling tool for robust and safe cochleostomy; evaluation was completed on a single human cadaver specimen. Access to the middle ear was successfully achieved through the facial recess without damage to surrounding anatomical structures; cochleostomy was completed at the planned position with the endosteum remaining intact after drilling as confirmed by microscope evaluation.

  12. Minimally invasive local therapies for liver cancer

    International Nuclear Information System (INIS)

    Primary and metastatic liver tumors are an increasing global health problem, with hepatocellular carcinoma (HCC) now being the third leading cause of cancer-related mortality worldwide. Systemic treatment options for HCC remain limited, with Sorafenib as the only prospectively validated agent shown to increase overall survival. Surgical resection and/or transplantation, locally ablative therapies and regional or locoregional therapies have filled the gap in liver tumor treatments, providing improved survival outcomes for both primary and metastatic tumors. Minimally invasive local therapies have an increasing role in the treatment of both primary and metastatic liver tumors. For patients with low volume disease, these therapies have now been established into consensus practice guidelines. This review highlights technical aspects and outcomes of commonly utilized, minimally invasive local therapies including laparoscopic liver resection (LLR), radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and stereotactic body radiation therapy (SBRT). In addition, the role of combination treatment strategies utilizing these minimally invasive techniques is reviewed

  13. Minimally invasive local therapies for liver cancer

    Institute of Scientific and Technical Information of China (English)

    David Li; Josephine Kang; Benjamin J Golas; Vincent W Yeung; David C Madoff

    2014-01-01

    Primary and metastatic liver tumors are an increasing global health problem, with hepatocellular carcinoma (HCC) now being the third leading cause of cancer-related mortality worldwide. Systemic treatment options for HCC remain limited, with Sorafenib as the only prospectively validated agent shown to increase overall survival. Surgical resection and/or transplantation, locally ablative therapies and regional or locoregional therapies have iflled the gap in liver tumor treatments, providing improved survival outcomes for both primary and metastatic tumors. Minimally invasive local therapies have an increasing role in the treatment of both primary and metastatic liver tumors. For patients with low volume disease, these therapies have now been established into consensus practice guidelines. This review highlights technical aspects and outcomes of commonly utilized, minimally invasive local therapies including laparoscopic liver resection (LLR), radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), irreversible electroporation (IRE), and stereotactic body radiation therapy (SBRT). In addition, the role of combination treatment strategies utilizing these minimally invasive techniques is reviewed.

  14. Minimally invasive dentistry: a review and update.

    Science.gov (United States)

    Brostek, Andrew M; Bochenek, Andrew J; Walsh, Laurence J

    2006-06-01

    The term "Minimal Invasive (MI) Dentistry" can best be defined as the management of caries with a biological approach, rather than with a traditional (surgical) operative dentistry approach. Where operative dentistry is required, this is now carried out in the most conservative manner with minimal destruction of tooth structure. This new approach to caries management changes the emphasis from diagnosing carious lesions as cavities (and a repeating cycle of restorations), to one of diagnosing the oral ecological imbalance and effecting biological changes in the biofilm. The goal of MI is to stop the disease process and then to restore lost tooth structure and function, maximizing the healing potential of the tooth. The thought process which underpins this new minimal invasive approach can be organized into three main categories: (1) Recognize, which means identify patient caries risk, (2) Remineralize, which means prevent caries and reverse non-cavitated caries, and (3) Repair, which means control caries activity, maximize healing and repair the damage. The disease of dental caries is not just demineralization, but a process of repeated demineralization cycles caused by an imbalance in the ecological and chemical equilibrium of the biofilm /tooth interface (the ecological plaque hypothesis). Dietary and lifestyle patterns, especially carbohydrate frequency, water intake and smoking, play an important role in changing the biofilm ecology and pathogenicity. Tools for chairside assessment of saliva and plaque, allow risk to be assessed and patient compliance monitored. The remineralizing properties of saliva can be enhanced using materials which release biologically available calcium, phosphate and fluoride ions (CPP-ACP and CPP-ACFP). Use of biocides can also alter the pathogenic properties of plaque. Use of these MI treatment protocols, can repair early lesions and improve patient understanding and compliance. This review article introduces some of the key concepts

  15. Multiexpandable cage for minimally invasive posterior lumbar interbody fusion

    Science.gov (United States)

    Coe, Jeffrey D; Zucherman, James F; Kucharzyk, Donald W; Poelstra, Kornelis A; Miller, Larry E; Kunwar, Sandeep

    2016-01-01

    The increasing adoption of minimally invasive techniques for spine surgery in recent years has led to significant advancements in instrumentation for lumbar interbody fusion. Percutaneous pedicle screw fixation is now a mature technology, but the role of expandable cages is still evolving. The capability to deliver a multiexpandable interbody cage with a large footprint through a narrow surgical cannula represents a significant advancement in spinal surgery technology. The purpose of this report is to describe a multiexpandable lumbar interbody fusion cage, including implant characteristics, intended use, surgical technique, preclinical testing, and early clinical experience. Results to date suggest that the multiexpandable cage allows a less invasive approach to posterior/transforaminal lumbar interbody fusion surgery by minimizing iatrogenic risks associated with static or vertically expanding interbody prostheses while providing immediate vertebral height restoration, restoration of anatomic alignment, and excellent early-term clinical results. PMID:27729817

  16. Robot-Assisted Minimally Invasive Coronary Artery Bypass Surgery Operation

    Science.gov (United States)

    ROBOT-ASSISTED MINIMALLY INVASIVE CORONARY ARTERY BYPASS SURGERY OPERATION PINNACLEHEALTH HARRISBURG HOSPITAL HARRISBURG, PA 00:00:08 ... Hospital campus. We are going to witness a robot-assisted minimally invasive coronary artery bypass surgery operation. ...

  17. Robot-Assisted Minimally Invasive Coronary Artery Bypass Surgery Operation

    Medline Plus

    Full Text Available ROBOT-ASSISTED MINIMALLY INVASIVE CORONARY ARTERY BYPASS SURGERY OPERATION PINNACLEHEALTH HARRISBURG HOSPITAL HARRISBURG, PA 00:00:08 ... Hospital campus. We are going to witness a robot-assisted minimally invasive coronary artery bypass surgery operation. ...

  18. Minimally invasive surgery for atrial fibrillation.

    Science.gov (United States)

    Zembala, Michael O; Suwalski, Piotr

    2013-11-01

    Atrial fibrillation (AF) remains the most common cardiac arrhythmia, affecting nearly 2% of the general population worldwide. Minimally invasive surgical ablation remains one of the most dynamically evolving fields of modern cardiac surgery. While there are more than a dozen issues driving this development, two seem to play the most important role: first, there is lack of evidence supporting percutaneous catheter based approach to treat patients with persistent and long-standing persistent AF. Paucity of this data offers surgical community unparalleled opportunity to challenge guidelines and change indications for surgical intervention. Large, multicenter prospective clinical studies are therefore of utmost importance, as well as honest, clear data reporting. Second, a collaborative methodology started a long-awaited debate on a Heart Team approach to AF, similar to the debate on coronary artery disease and transcatheter valves. Appropriate patient selection and tailored treatment options will most certainly result in better outcomes and patient satisfaction, coupled with appropriate use of always-limited institutional resources. The aim of this review, unlike other reviews of minimally invasive surgical ablation, is to present medical professionals with two distinctly different, approaches. The first one is purely surgical, Standalone surgical isolation of the pulmonary veins using bipolar energy source with concomitant amputation of the left atrial appendage-a method of choice in one of the most important clinical trials on AF-The Atrial Fibrillation Catheter Ablation Versus Surgical Ablation Treatment (FAST) Trial. The second one represents the most complex approach to this problem: a multidisciplinary, combined effort of a cardiac surgeon and electrophysiologist. The Convergent Procedure, which includes both endocardial and epicardial unipolar ablation bonds together minimally invasive endoscopic surgery with electroanatomical mapping, to deliver best of the

  19. Minimal Invasive Surgery for Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    A.H.Hoelscher; Ch.Gutschow

    2004-01-01

    Thoracoscopic esophagectomy is only established in some centers and affords a cervical anastomosis because intrathoracic anastomosis as a routine is technically too difficult. Laparoscopic mobilisation of the stomach (gastrolysis) is an important contribution for minimal invasive surgery of esophageal cancer.This procedure reduces the stress of the two cavity operation for the patient and allows the construction of a comparable gastric conduit like by open surgery. The technique of laparoscopic gastrolysis as preparation for transthoracic en bloc esophagectomy is described in detail and preliminary results are briefly mentioned.

  20. Minimally Invasive Colorectal Cancer Surgery in Europe

    OpenAIRE

    Babaei, Masoud; Balavarca, Yesilda; Jansen, Lina; Gondos, Adam; Lemmens, Valery; Sjövall, Annika; B⊘rge Johannesen, Tom; Moreau, Michel; Gabriel, Liberale; Gonçalves, Ana Filipa; Bento, Maria José; van de Velde, Tony; Kempfer, Lana Raffaela; Becker, Nikolaus; Ulrich, Alexis

    2016-01-01

    Abstract Minimally invasive surgery (MIS) of colorectal cancer (CRC) was first introduced over 20 years ago and recently has gained increasing acceptance and usage beyond clinical trials. However, data on dissemination of the method across countries and on long-term outcomes are still sparse. In the context of a European collaborative study, a total of 112,023 CRC cases from 3 population-based (N = 109,695) and 4 institute-based clinical cancer registries (N = 2328) were studied and compared ...

  1. Resin composites in minimally invasive dentistry.

    Science.gov (United States)

    Jacobsen, Thomas

    2004-01-01

    The concept of minimally invasive dentistry will provide favorable conditions for the use of composite resin. However, a number of factors must be considered when placing composite resins in conservatively prepared cavities, including: aspects on the adaptation of the composite resin to the cavity walls; the use of adhesives; and techniques for obtaining adequate proximal contacts. The clinician must also adopt an equally conservative approach when treating failed restorations. The quality of the composite resin restoration will not only be affected by the outline form of the preparation but also by the clinician's technique and understanding of the materials.

  2. Minimal Invasive Decompression for Lumbar Spinal Stenosis

    Directory of Open Access Journals (Sweden)

    Victor Popov

    2012-01-01

    Full Text Available Lumbar spinal stenosis is a common condition in elderly patients and may lead to progressive back and leg pain, muscular weakness, sensory disturbance, and/or problems with ambulation. Multiple studies suggest that surgical decompression is an effective therapy for patients with symptomatic lumbar stenosis. Although traditional lumbar decompression is a time-honored procedure, minimally invasive procedures are now available which can achieve the goals of decompression with less bleeding, smaller incisions, and quicker patient recovery. This paper will review the technique of performing ipsilateral and bilateral decompressions using a tubular retractor system and microscope.

  3. Minimally invasive coronary artery bypass grafting: initial Connecticut experience.

    Science.gov (United States)

    Tellides, G; Maragh, M R; Smith, J M; Kopf, G S; Ezekowitz, M; Remetz, M; Elefteriades, J A

    1997-03-01

    We report the initial Connecticut experience with minimally invasive coronary artery bypass grafting. This procedure allows bypass grafting to the left anterior descending coronary artery utilizing the internal mammary artery as the conduit. The procedure is minimally invasive because it is performed through a mini-thoracotomy incision in the fourth anterior intercostal space and it is conducted without the use of cardiopulmonary bypass. The procedure has been applied to 13 patients operated between February and October 1996. All but one patient selected were poor candidates for conventional coronary artery bypass surgery because of advanced age (6), chronic renal failure/dialysis/kidney transplant (4), redo status with vulnerable grafts (1), severe peripheral vascular disease (6), severe chronic obstructive pulmonary disease (4). All patients survived operation and were discharged in good condition. Mean postoperative intubation time was seven hours and mean hospital stay was 4.5 days despite the very high pre-existing comorbidity of these patients. All patients are alive at the current follow-up time. Two patients required a conventional bypass procedure for occlusion of the minimally invasive graft, the first because of diffuse disease in the target artery and the second attributable to the technical limitations of minimally invasive coronary artery bypass grafting; both tolerated the subsequent procedure well. All patients are now angina-free. All four grafts studied by routine postoperative angiography were widely patent. Routine post-operative exercise nuclear imaging was normal in an additional patient. This procedure of minimally invasive coronary artery bypass grafting offers significant advantages compared to the conventional bypass procedure (short hospital stay, quick recovery, and, especially, avoidance of cerebrovascular accidents caused by the heart-lung machine). This minimally invasive procedure is expected to apply to a growing percentage of

  4. Minimally invasive parathyroidectomy under local anesthesia

    Directory of Open Access Journals (Sweden)

    Ö Karahan

    2013-01-01

    Full Text Available Background: More than 85% of primary hyperparathyroidism (PHPT cases are due to solitary, benign parathyroid adenomas. Recently, the success rate of Tc99m sestamibi scintigraphy in localization has made minimally invasive parathyroidectomy (MIP more prominent. MIP is as effective as conventional bilateral neck exploration. Moreover, it offers lower morbidity, cost effectiveness, and better cosmetics effects. Aim: We aimed to evaluate the success of MIP, which happens only under local anesthesia, in this study. Materials and Methods: Total of 63 patients were operated for PHPT, of which 54 had solitary adenoma. Five patients underwent bilateral neck exploration under general anesthesia for thyroid nodules or unlocalizated adenomas. A total of 49 patients underwent MIP under local anesthesia without any sedation. During MIP, gamma probe was used for all patients. The patients were followed for parathyroid functions. Results: The mean age of 49 patients with MIP (5 male, 44 female was 59 years. The mean follow-up time was 16.4 (±10.1 months (range: 2-36 months. Of the 49 patients, 47 (96% were totally cured. In 2 patients, the procedure was switched to conventional bilateral neck exploration. Temporary hypocalcaemia was noted in 4 patients. Conclusions: If the adenoma is localizated, MIP under only local anesthesia can be performed with a high success rate. Gamma probe-guided MIP under local anesthesia is an effective and safe method. It has the advantage of being minimally invasive and, therefore, it should be preferred over the conventional method.

  5. Minimally invasive treatment of pancreatic necrosis

    Institute of Scientific and Technical Information of China (English)

    Brian Bello; Jeffrey B Matthews

    2012-01-01

    AIM:To systematically review these minimally invasive approaches to infected pancreatic necrosis.METHODS:We used the MEDLINE database to investigate studies between 1996 and 2010 with greater than 10 patients that examined these techniques.Using a combination of Boolean operators,reports were retrieved addressing percutaneous therapy (341 studies),endoscopic necrosectomy (574 studies),laparoscopic necrosectomy via a transperitoneal approach (148 studies),and retroperitoneal necrosectomy (194 studies).Only cohorts with at least 10 or more patients were included.Non-English papers,letters,animal studies,duplicate series and reviews without original data were excluded,leaving a total of 27 studies for analysis.RESULTS:Twenty-seven studies with 947 patients total were examined (eight studies on percutaneous approach; ten studies on endoscopic necrosectomy;two studies on laparoscopic necrosectomy via a transperitoneal approach; five studies on retroperitoneal necrosectomy; and two studies on a combined percutaneous-retroperitoneal approach).Success rate,complications,mortality,and number of procedures were outcomes that were included in the review.We found that most published reports were retrospective in nature,and thus,susceptible to selection and publication bias.Few reports examined these techniques in a comparative,prospective manner.CONCLUSION:Each minimally invasive approach though was found to be safe and feasible in multiple reports.With these new techniques,treatment of infected pancreatic necrosis remains a challenge.We advocate a multidisciplinary approach to this complex problem with treatment individualized to each patient.

  6. [Theory and practice of minimally invasive endodontics].

    Science.gov (United States)

    Jiang, H W

    2016-08-01

    The primary goal of modern endodontic therapy is to achieve the long-term retention of a functional tooth by preventing or treating pulpitis or apical periodontitis is. The long-term retention of endodontically treated tooth is correlated with the remaining amount of tooth tissue and the quality of the restoration after root canal filling. In recent years, there has been rapid progress and development in the basic research of endodontic biology, instrument and applied materials, making treatment procedures safer, more accurate, and more efficient. Thus, minimally invasive endodontics(MIE)has received increasing attention at present. MIE aims to preserve the maximum of tooth structure during root canal therapy, and the concept covers the whole process of diagnosis and treatment of teeth. This review article focuses on describing the minimally invasive concepts and operating essentials in endodontics, from diagnosis and treatment planning to the access opening, pulp cavity finishing, root canal cleaning and shaping, 3-dimensional root canal filling and restoration after root canal treatment. PMID:27511034

  7. Minimally invasive treatment options in fixed prosthodontics.

    Science.gov (United States)

    Edelhoff, Daniel; Liebermann, Anja; Beuer, Florian; Stimmelmayr, Michael; Güth, Jan-Frederik

    2016-03-01

    Minimally invasive treatment options have become increasingly feasible in restorative dentistry, due to the introduction of the adhesive technique in combination with restorative materials featuring translucent properties similar to those of natural teeth. Mechanical anchoring of restorations via conventional cementation represents a predominantly subtractive treatment approach that is gradually being superseded by a primarily defect-oriented additive method in prosthodontics. Modifications of conventional treatment procedures have led to the development of an economical approach to the removal of healthy tooth structure. This is possible because the planned treatment outcome is defined in a wax-up before the treatment is commenced and this wax-up is subsequently used as a reference during tooth preparation. Similarly, resin- bonded FDPs and implants have made it possible to preserve the natural tooth structure of potential abutment teeth. This report describes a number of clinical cases to demonstrate the principles of modern prosthetic treatment strategies and discusses these approaches in the context of minimally invasive prosthetic dentistry.

  8. Minimally invasive surgery for esophageal cancer.

    Science.gov (United States)

    Santillan, Alfredo A; Farma, Jeffrey M; Meredith, Kenneth L; Shah, Nilay R; Kelley, Scott T

    2008-10-01

    Esophageal cancer represents a major public health problem worldwide. Several minimally invasive esophagectomy (MIE) techniques have been described and represent a safe alternative for the surgical management of esophageal cancer in selected centers with high volume and expertise in them. This article reviews the most recent and largest series evaluating MIE techniques. Recent larger series have shown MIE to be equivalent in postoperative morbidity and mortality rates to conventional surgery. MIE has been associated with less blood loss, less postoperative pain, and decreased intensive care unit and hospital length of stay compared with conventional surgery. Despite limited data, conventional surgery and MIE have shown no significant difference in survival, stage for stage. The myriad of MIE techniques complicates the debate of defining the optimal surgical approach for treating esophageal cancer. Randomized controlled trials comparing MIE with conventional open esophagectomy are needed to clarify the ideal procedure with the lowest postoperative morbidity, best quality of life after surgery, and long-term survival.

  9. Surgeons' musculoskeletal pain in minimally invasive surgery

    DEFF Research Database (Denmark)

    Dalager, Tina; Søgaard, Karen; Bech, Katrine Tholstrup;

    Background: A large proportion of surgeons performing minimally invasive surgery (MIS) experience musculoskeletal pain in the upper body possibly due to awkward and long-term static positions. This can be detrimental for workability and health. The objective of the present review is to sum up...... in surgeons performing MIS is high and derives mainly from static postures. Positioning of monitor, adjustment of table height and instrument design also contribute substantially. Robotic assisted laparoscopy seems less physically demanding for the surgeon compared with conventional laparoscopy. However, some...... alongside patient safety. The present literature study supports the need for a randomized controlled trial evaluating the effect of an individually designed training program for surgeons performing MIS....

  10. Comparison of laparoscopy-assisted and open radical gastrectomy for advanced gastric cancer: A retrospective study in a single minimally invasive surgery center.

    Science.gov (United States)

    Hao, Yingxue; Yu, Peiwu; Qian, Feng; Zhao, Yongliang; Shi, Yan; Tang, Bo; Zeng, Dongzhu; Zhang, Chao

    2016-06-01

    Laparoscopy-assisted gastrectomy (LAG) has gained international acceptance for the treatment of early gastric cancer (EGC). However, the use of laparoscopic surgery in the management of advanced gastric cancer (AGC) has not attained widespread acceptance. This retrospective large-scale patient study in a single center for minimally invasive surgery assessed the feasibility and safety of LAG for T2 and T3 stage AGC. A total of 628 patients underwent LAG and 579 patients underwent open gastrectomy (OG) from Jan 2004 to Dec 2011. All cases underwent radical lymph node (LN) dissection from D1 to D2+. This study compared short- and long-term results between the 2 groups after stratifying by pTNM stages, including the mean operation time, volume of blood loss, number of harvested LNs, average days of postoperative hospital stay, mean gastrointestinal function recovery time, intra- and post-operative complications, recurrence rate, recurrence site, and 5-year survival curve. Thirty-five patients (5.57%) converted to open procedures in the LAG group. There were no significant differences in retrieved LN number (30.4 ± 13.4 vs 28.1 ± 17.2, P = 0.43), proximal resection margin (PRM) (6.15 ± 1.63 vs 6.09 ± 1.91, P = 0.56), or distal resection margin (DRM) (5.46 ± 1.74 vs 5.40 ± 1.95, P = 0.57) between the LAG and OG groups, respectively. The mean volume of blood loss (154.5 ± 102.6 vs 311.2 ± 118.9 mL, P < 0.001), mean postoperative hospital stay (7.6 ± 2.5 vs 10.7 ± 3.6 days, P < 0.001), mean time for gastrointestinal function recovery (3.3 ± 1.4 vs 3.9 ± 1.5 days, P < 0.001), and postoperative complications rate (6.4% vs 10.5%, P = 0.01) were clearly lower in the LAG group compared to the OG group. However, the recurrence pattern and site were not different between the 2 groups, even they were stratified by the TNM stage. The 5-year overall survival (OS) rates were 85.38%, 79.70%, 57

  11. Innovations in minimally invasive mitral valve pair.

    Science.gov (United States)

    Sündermann, Simon H; Seeburger, Joerg; Scherman, Jacques; Mohr, Friedrich Wilhelm; Falk, Volkmar

    2012-12-01

    Mitral valve (MV) insufficiency is the second most common heart valve disease represented in cardiac surgery. The gold standard therapy is surgical repair of the valve. Today, most centers prefer a minimally invasive approach through a right-sided mini-thoracotomy. Despite the small access, there is still the need to use cardiopulmonary bypass (CPB), and the operation has to be performed on the arrested heart. New devices have been developed to optimize the results of surgical repair by implementing mechanisms for post-implantation adjustment on the beating heart or the avoidance of CPB. Early attempts with adjustable mitral annuloplasty rings go back to the early 1990s. Only a few devices are available on the market. Recently, a mitral valve adjustable annuloplasty ring was CE-marked and is under further clinical investigation. In addition, a sutureless annuloplasty band to be implanted on the beating heart is under preclinical and initial clinical investigation for transatrial and transfemoral transcatheter implantation. Furthermore, new neochord systems are being developed, which allow for functional length adjustment on the beating heart after implantation. Some devices were developed for percutaneous MV repair implanted into the coronary sinus to reshape the posterior MV annulus. Other percutaneous devices are directly fixed to the posterior annulus to alter its shape. Several disadvantages have been observed preventing a broad clinical use of some of these devices. There is a continuous effort to develop innovative techniques to optimize MV repair and to decrease invasiveness. PMID:23315719

  12. Prevailing Trends in Haptic Feedback Simulation for Minimally Invasive Surgery.

    Science.gov (United States)

    Pinzon, David; Byrns, Simon; Zheng, Bin

    2016-08-01

    Background The amount of direct hand-tool-tissue interaction and feedback in minimally invasive surgery varies from being attenuated in laparoscopy to being completely absent in robotic minimally invasive surgery. The role of haptic feedback during surgical skill acquisition and its emphasis in training have been a constant source of controversy. This review discusses the major developments in haptic simulation as they relate to surgical performance and the current research questions that remain unanswered. Search Strategy An in-depth review of the literature was performed using PubMed. Results A total of 198 abstracts were returned based on our search criteria. Three major areas of research were identified, including advancements in 1 of the 4 components of haptic systems, evaluating the effectiveness of haptic integration in simulators, and improvements to haptic feedback in robotic surgery. Conclusions Force feedback is the best method for tissue identification in minimally invasive surgery and haptic feedback provides the greatest benefit to surgical novices in the early stages of their training. New technology has improved our ability to capture, playback and enhance to utility of haptic cues in simulated surgery. Future research should focus on deciphering how haptic training in surgical education can increase performance, safety, and improve training efficiency. PMID:26839212

  13. The theoretical basis of minimally-invasive and non-invasive medicine: Treatments--Minimize harm to patients.

    Science.gov (United States)

    Wang, Zhibiao

    2015-11-01

    This perspective, for the first time, proposed the theoretical basis for the minimally-invasive and non-invasive medicine. It sets the goal of medical treatment that is to minimize harm to patients and to maximize the natural self-healing power for fighting against the disease. It took a historical review on the technological developments shaped by the minimally-invasive and non-invasive ideology with a focus on the course of research, development and clinical deployment of the high-intensity focused ultrasound (HIFU) ablation therapy by the Chinese research team. It also summarized the highlights of the "1st Yangtze International Summit of Minimally-invasive and Non-invasive Medicine 2013" and the mandate of the newly inaugurated International Society of the Minimally-invasive and Noninvasive Medicine (ISMINIM). It provides a perspective on the future development of this emerging field and its impact on human civilization. PMID:26074209

  14. Minimally invasive cardiac surgery and transesophageal echocardiography

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Jha

    2014-01-01

    Full Text Available Improved cosmetic appearance, reduced pain and duration of post-operative stay have intensified the popularity of minimally invasive cardiac surgery (MICS; however, the increased risk of stroke remains a concern. In conventional cardiac surgery, surgeons can visualize and feel the cardiac structures directly, which is not possible with MICS. Transesophageal echocardiography (TEE is essential during MICS in detecting problems that require immediate correction. Comprehensive evaluation of the cardiac structures and function helps in the confirmation of not only the definitive diagnosis, but also the success of surgical treatment. Venous and aortic cannulations are not under the direct vision of the surgeon and appropriate positioning of the cannulae is not possible during MICS without the aid of TEE. Intra-operative TEE helps in the navigation of the guide wire and correct placement of the cannulae and allows real-time assessment of valvular pathologies, ventricular filling, ventricular function, intracardiac air, weaning from cardiopulmonary bypass and adequacy of the surgical procedure. Early detection of perioperative complications by TEE potentially enhances the post-operative outcome of patients managed with MICS.

  15. Minimally invasive dentistry and the dental enterprise.

    Science.gov (United States)

    Rossomando, Edward F

    2007-03-01

    Improvements in understanding the process of remineralization have resulted in a reappraisal of repair of damaged tooth structure and call into question the principles of cavity preparation of GV Black and his principle of "extension for prevention." From this reappraisal has emerged the idea of minimally invasive dentistry (MID). The goal of MID is to remove as little of the sound tooth structure during the restoration phase as possible. This goal is in our reach in part because of availability of products that promote mineralization and of dental excavation instruments, like the dental laser, that can be managed to remove only damaged tooth structure. It is critical that the leaders of the dental enterprise endorse MID. Delay could allow new products to move from the dental profession to other health care providers. For example, a caries vaccine will soon enter the market place. Will dentists expand the scope of their practices to include the application of this vaccine, or will they ignore this new product and allow the new technology to enter the scope of practice of other health providers?

  16. Process optimized minimally invasive total hip replacement

    Directory of Open Access Journals (Sweden)

    Philipp Gebel

    2012-02-01

    Full Text Available The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA in total hip replacement (THR in combination with the leg positioner (Rotex- Table and a modified retractor system (Condor. We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS. All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years, with a mean BMI of 26.5 (17 to 43. The mean time of surgery was 80 min. (55 to 130 min. The blood loss showed an average of 511.5 mL (200 to 1000 mL. No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/- 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved.

  17. Radiofrequency Ablation: A Minimally Invasive Approach in Kidney Tumor Management

    Energy Technology Data Exchange (ETDEWEB)

    Salagierski, Maciej, E-mail: maciej.salagierski@umed.lodz.pl [I Urology Department, Medical University of Lodz (Poland); Salagierski, Marek S. [II Urology Department, Medical University of Lodz (Poland)

    2010-11-17

    The management and diagnosis of renal tumors have changed significantly over the last decade. Due to advances in imaging techniques, more than 50% of kidney tumors are discovered incidentally and many of them represent an early stage lesion. This has stimulated the development of nephron-sparing surgery and of the minimally invasive treatment options including ablative techniques, i.e., radiofrequency ablation (RFA) and cryoablation. The objective of the minimally invasive approach is to preserve the renal function and to lower the perioperative morbidity. RFA involves inducing the coagulative necrosis of tumor tissue. Being probably one of the least invasive procedures in kidney tumor management, RFA may be performed percutaneously under ultrasound (US), computed tomography (CT) or magnetic resonance (MR) guidance. Most of the studies show that the RFA procedure is efficient, safe and has a low complication rate. Due to the still limited data on the oncological outcome of RFA, the indication for this intervention remains limited to selected patients with small organ-confined renal tumors and contraindication to surgery or who have a solitary kidney. The aim of our study is to review the literature on RFA of kidney tumors.

  18. Multiexpandable cage for minimally invasive posterior lumbar interbody fusion

    Directory of Open Access Journals (Sweden)

    Coe JD

    2016-09-01

    Full Text Available Jeffrey D Coe,1 James F Zucherman,2 Donald W Kucharzyk,3 Kornelis A Poelstra,4 Larry E Miller,5 Sandeep Kunwar,6 1Silicon Valley Spine Institute, Campbell, 2San Francisco Orthopaedic Surgeons, San Francisco, CA, 3Orthopaedic Pediatric and Spine, Crown Point, IN, 4Department of Surgery, Sacred Heart Hospital on the Emerald Coast, Miramar Beach, FL, 5Miller Scientific Consulting, Inc., Asheville, NC, 6Bell Neuroscience Institute, Washington Hospital Healthcare System, Fremont, CA, USA Abstract: The increasing adoption of minimally invasive techniques for spine surgery in recent years has led to significant advancements in instrumentation for lumbar interbody fusion. Percutaneous pedicle screw fixation is now a mature technology, but the role of expandable cages is still evolving. The capability to deliver a multiexpandable interbody cage with a large footprint through a narrow surgical cannula represents a significant advancement in spinal surgery technology. The purpose of this report is to describe a multiexpandable lumbar interbody fusion cage, including implant characteristics, intended use, surgical technique, preclinical testing, and early clinical experience. Results to date suggest that the multiexpandable cage allows a less invasive approach to posterior/transforaminal lumbar interbody fusion surgery by minimizing iatrogenic risks associated with static or vertically expanding interbody prostheses while providing immediate vertebral height restoration, restoration of anatomic alignment, and excellent early-term clinical results. Keywords: degenerative disc disease, expandable, low back pain, Luna

  19. Minimally invasive surgery colloidal cystic thyroid nodules

    Directory of Open Access Journals (Sweden)

    V G Petrov

    2013-12-01

    Full Text Available An analysis of the use of minimally invasive interventions - laser-induced thermotherapy (LITT, ethanol destruction (ED under ultrasound guidance, a combination of these methods in the treatment of сystic-col- loidal nodes (CCN of thyroid nodules in 120 patients. ED carried out in 31 patients with cystic destruction of a site of more than 70%. Marked decrease in the average volume with 4.68 ± 2.25 cm3 to 1.15 ± 0.9 cm3. In 4 patients remained cystic cavity of small size, which required a combination of LITT (CombiLITT. Nine patients underwent LITT solid residue of more than 1 cm3. The average size of nodules within 6 months after the primary surgery was 0.9 ± 0.3 cm3. СombiLITT performed in 42 patients with cystic cavity from 20 to 70%. The volume of units decreased from 7.98 ± 4.56 to 1.87 ± 0.9 cm3. After 3 months, 11 patients with the size of a solid residue of more than 1 cm3 held LITT. All of them when viewed after 3 months observed decrease of more than 50%. LITT performed 23 patients with major nodes and cystic cavities less than 20% of the node. Marked decrease in the amount of nodes with 2.89 ± 1.25 cm3 to 1.42 ± 0.8 cm3. Retesting LITT took 2 patients. After 6 months, the average amount of units was 0.7 ± 0.2 cm3 LITT conducted in 24 patients with small cystic nodes to 1 cm3. Marked decrease in size from 0.69 ± 0.23 cm3 to 0.29 ± 0.12 cm3. Varied selection of minimally inva- sive treatment of CCN is effective and in most cases, to achieve reduction of the size of nodes.

  20. Endoscopic Cystogastrostomy: Minimally Invasive Approach for Pancreatic Pseudocyst

    Directory of Open Access Journals (Sweden)

    Gull-Zareen Khan Sial

    2014-12-01

    Full Text Available Pancreatic pseudocysts in children are not uncommon. Non-resolving pseudocysts often require surgical intervention. Endoscopic cystogastrostomy is a minimally invasive procedure which is recommended for this condition. We report a large pancreatic pseudocyst in a 4-year old child, which developed following therapy with PEG-Asparaginase for acute lymphoblastic leukemia. It was managed with minimally invasive procedure.

  1. Next step in minimally invasive surgery: hybrid image-guided surgery.

    Science.gov (United States)

    Marescaux, Jacques; Diana, Michele

    2015-01-01

    Surgery, interventional radiology, and advanced endoscopy have all developed minimally invasive techniques to effectively treat a variety of diseases with positive impact on patients' postoperative outcomes. However, those techniques are challenging and require extensive training. Robotics and computer sciences can help facilitate minimally invasive approaches. Furthermore, surgery, advanced endoscopy, and interventional radiology could converge towards a new hybrid specialty, hybrid image-guided minimally invasive therapies, in which the three fundamental disciplines could complement one another to maximize the positive effects and reduce the iatrogenic footprint on patients. The present manuscript describes the fundamental steps of this new paradigm shift in surgical therapies that, in our opinion, will be the next revolutionary step in minimally invasive approaches. PMID:25598089

  2. Minimally Invasive Colorectal Cancer Surgery in Europe

    Science.gov (United States)

    Babaei, Masoud; Balavarca, Yesilda; Jansen, Lina; Gondos, Adam; Lemmens, Valery; Sjövall, Annika; B⊘rge Johannesen, Tom; Moreau, Michel; Gabriel, Liberale; Gonçalves, Ana Filipa; Bento, Maria José; van de Velde, Tony; Kempfer, Lana Raffaela; Becker, Nikolaus; Ulrich, Alexis; Ulrich, Cornelia M.; Schrotz-King, Petra; Brenner, Hermann

    2016-01-01

    Abstract Minimally invasive surgery (MIS) of colorectal cancer (CRC) was first introduced over 20 years ago and recently has gained increasing acceptance and usage beyond clinical trials. However, data on dissemination of the method across countries and on long-term outcomes are still sparse. In the context of a European collaborative study, a total of 112,023 CRC cases from 3 population-based (N = 109,695) and 4 institute-based clinical cancer registries (N = 2328) were studied and compared on the utilization of MIS versus open surgery. Cox regression models were applied to study associations between surgery type and survival of patients from the population-based registries. The study considered adjustment for potential confounders. The percentage of CRC patients undergoing MIS differed substantially between centers and generally increased over time. MIS was significantly less often used in stage II to IV colon cancer compared with stage I in most centers. MIS tended to be less often used in older (70+) than in younger colon cancer patients. MIS tended to be more often used in women than in men with rectal cancer. MIS was associated with significantly reduced mortality among colon cancer patients in the Netherlands (hazard ratio [HR] 0.66, 95% confidence interval [CI] (0.63–0.69), Sweden (HR 0.68, 95% CI 0.60–0.76), and Norway (HR 0.73, 95% CI 0.67–0.79). Likewise, MIS was associated with reduced mortality of rectal cancer patients in the Netherlands (HR 0.74, 95% CI 0.68–0.80) and Sweden (HR 0.77, 95% CI 0.66–0.90). Utilization of MIS in CRC resection is increasing, but large variation between European countries and clinical centers prevails. Our results support association of MIS with substantially enhanced survival among colon cancer patients. Further studies controlling for selection bias and residual confounding are needed to establish role of MIS in survival of patients. PMID:27258522

  3. Minimally invasive medicine:a new theoretical system of medicine

    Institute of Scientific and Technical Information of China (English)

    王永光; 裘法祖; 何兴图

    2004-01-01

    @@ For many diseases and surgical procedures, the method of choice has shifted from traditional means, or open surgery, to the use of less invasive means in the last few decades. These minimally invasive alternatives, such as laparoscopic, endoscopic, and interventional ultrasound procedures, usually result in less pain, scarring, recovery time and complication, as well as shorter hospitalization and reduced health-care costs. The trend is predicted to continue with these minimally invasive alternatives being used in clinics widely. In addition, these less invasive means will become one of the most important areas in the future of 21st century medicine.

  4. Chances of cryosurgery in the minimal invasive therapy; Chancen der Kryochirurgie in der Minimal Invasiven Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Haensgen, H. [Institut fuer Luft- und Kaeltetechnik GmbH, Dresden (Germany). Fachbereich Klimatechnik; Binneberg, A. [Institut fuer Luft- und Kaeltetechnik GmbH, Dresden (Germany). Fachbereich Klimatechnik; Herzog, R. [Institut fuer Luft- und Kaeltetechnik GmbH, Dresden (Germany). Fachbereich Klimatechnik; Schumann, B. [Institut fuer Luft- und Kaeltetechnik GmbH, Dresden (Germany). Fachbereich Klimatechnik

    1995-01-01

    Object in view of the minimal invasive therapy is to substitute the traditional open and therefore invasive surgically interventions through fewer invasive surgery. Additional to preponderantly in MIT used microsurgery and laser-therapy also cryotherapy may be used. Clinical results in therapy of trigeminalneuralgia are present. Application of endoscopic cryotip are possible. (orig.)

  5. Minimally invasive lumbar decompression-the surgical learning curve.

    Science.gov (United States)

    Kim, Choll W

    2016-08-01

    Commentary On: Ahn J, Iqbal A, Manning BT, Leblang S, Bohl DD, Mayo BC, et al. Minimally invasive lumbar decompression-the surgical learning curve. Spine J 2016:16:909-16. (in this issue). PMID:27545398

  6. Robot-Assisted Minimally Invasive Coronary Artery Bypass Surgery Operation

    Medline Plus

    Full Text Available ... Harrisburg Hospital campus. We are going to witness a robot-assisted minimally invasive coronary artery bypass surgery ... you're starting to do and maybe give a little background on the patient's condition? 00:00: ...

  7. Minimally Invasive Treatment for Lung Cancer

    Medline Plus

    Full Text Available ... rigid instruments that are applicable in an earlier generation of thoracic and thoracoscopic devices and definitely better ... therapy is is the use of high-energy X-rays that preferentially kill cancer cells with minimal ...

  8. Minimally Invasive Treatment for Lung Cancer

    Medline Plus

    Full Text Available ... an oropharyngeal cancer, the cancer of the upper airway here in the throat. And during the workup ... room and performed a thoracoscopic lobectomy because we wanted to minimize the effects of surgery, major lung ...

  9. Minimally Invasive Treatment for Lung Cancer

    Medline Plus

    Full Text Available ... in between the ribs. We divide just the soft tissue of the thorax, the chest wall. And, ... therapy is is the use of high-energy X-rays that preferentially kill cancer cells with minimal damage ...

  10. Minimally invasive retroperitoneal necrosectomy in management of acute necrotizing pancreatitis

    OpenAIRE

    Šileikis, Audrius; Beiša, Virgilijus; Beiša, Augustas; Samuilis, Artūras; Šerpytis, Mindaugas; Strupas, Kęstutis

    2012-01-01

    Introduction One of the most important requirements in treatment of acute necrotizing pancreatitis is minimized invasion. Aim We are presenting experience in treatment of acute necrotizing pancreatitis by an original minimally invasive retroperitoneal necrosectomy technique, comparing our results to other studies, evaluating feasibility and safety, discussing advantages and disadvantages of this method. Material and methods We performed a retrospective analysis of 13 patients who had acute ne...

  11. A minimally invasive approach for a compromised treatment plan.

    Science.gov (United States)

    Maibaum, Wayne W

    2016-01-01

    A primary goal in dentistry is the execution of appropriate treatment plans that are minimally invasive and maintainable. However, it is sometimes necessary to repair existing dental restorations or revise treatment plans to accommodate changes in a patient's condition. In the present case, a patient who was satisfied with a removable partial overdenture lost a critical abutment tooth. A creative, minimally invasive approach enabled the patient to keep his existing partial prosthesis and avoid the need for a full reconstruction or complete denture.

  12. Complications of minimally invasive cosmetic procedures: Prevention and management

    OpenAIRE

    Levy, Lauren L; Emer, Jason J.

    2012-01-01

    Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT), soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability ...

  13. Minimal Invasive Percutaneous Fixation of Thoracic and Lumbar Spine Fractures

    Directory of Open Access Journals (Sweden)

    Federico De Iure

    2012-01-01

    Full Text Available We studied 122 patients with 163 fractures of the thoracic and lumbar spine undergoing the surgical treatment by percutaneous transpedicular fixation and stabilization with minimally invasive technique. Patient followup ranged from 6 to 72 months (mean 38 months, and the patients were assessed by clinical and radiographic evaluation. The results show that percutaneous transpedicular fixation and stabilization with minimally invasive technique is an adequate and satisfactory procedure to be used in specific type of the thoracolumbar and lumbar spine fractures.

  14. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

    Medline Plus

    Full Text Available ... he’s the product, he’s the beneficiary of the advances of this technology. Yeah he is. And it’s ... 8 revisions truly appreciates the gravity of that advance. There you can see the actual surgical site ...

  15. Minimally Invasive Treatment for Lung Cancer

    Medline Plus

    Full Text Available ... glucose into the patient’s body and the cancer cells, you know, take up glucose more than the regular cells in the body, and it will give us ... high-energy X-rays that preferentially kill cancer cells with minimal damage overall to the normal surrounding ...

  16. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

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    Full Text Available ... well as hydrocephalus and its treatment. The Hydrocephalus Research Association is very valid Web site that can ... this very new innovative technology. It’s a superb technology, minimally ... the “Request Information” button on your Webcast screen and open the ...

  17. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

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    Full Text Available ... Presbyterian Hospital invest a lot of time in education: yearly courses, CME courses, on the teaching of ... this very new innovative technology. It’s a superb technology, minimally ... the “Request Information” button on your Webcast screen and open the ...

  18. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

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    Full Text Available ... holds particular interest from the standpoint of the history of neurosurgery at the institution by which you ... this very new innovative technology. It’s a superb technology, minimally ... the “Request Information” button on your Webcast screen and open the ...

  19. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

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    Full Text Available ... shunt complications and 8 revisions truly appreciates the gravity of that advance. There you can see the ... endoscopic third ventriculostomy, it starts with a good definition of what type of hydrocephalus it is. If ...

  20. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

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    Full Text Available ... the Komansky Center for Children’s Health allows medical care to be more accessible, advanced and supportive of ... irrigation that we're utilizing right now takes care of the great majority of that. It cleanses ...

  1. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

    Medline Plus

    Full Text Available ... Health at New York Presbyterian Hospital Weill Cornell Medical Center. Serving pediatric patients from around the world, the Komansky Center for Children’s Health allows medical care to be more accessible, advanced and supportive ...

  2. Minimally Invasive Treatment for Lung Cancer

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    Full Text Available ... 2009 is very sophisticated. We have very advanced computer modeling, and we work very closely with our ... door to informed medical care. “OR-Live,” the vision of improving health. 11

  3. ACTIVE ROBOTIC ENDOSCOPE FOR MINIMALLY INVASIVE SURGERY

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    A robotic endoscope is mainly composed of a tactile array sensor, soft mobile mechanism for earthworm locomotion and turning mechanism based on shape memory effect. The tactile array sensor can provide the information about magnitude and orientation of interacting forces between the robotic endoscope and the wall of gastrointestinal tracts. The soft mobile mechanism contacts gastrointestinal tracts with air-in inflatable balloons, so it has better soft and non-invasive properties. The turning mechanism can be actively bent by shape memory alloy components and conform to the complex shape of gastrointestinal tracts. The working principle of robotic endoscope is dealt with.

  4. Dens in dente: A minimally invasive nonsurgical approach!

    Science.gov (United States)

    Hegde, Vivek; Morawala, Abdul; Gupta, Abhilasha; Khandwawala, Naqiyaa

    2016-01-01

    Dens invaginatus, also known as dens in dente, is a rare anomaly affecting human dentition. The condition results in invagination of an amelodental structure within the pulp. This case report discusses the current management protocol of dens invaginatus using a minimally invasive and nonsurgical treatment option. As with most conditions, early diagnosis and preventive measures help minimize complications in dens invaginatus cases. PMID:27656073

  5. The material science of minimally invasive esthetic restorations.

    Science.gov (United States)

    Nový, Brian B; Fuller, Cameron E

    2008-01-01

    The term esthetic dentistry usually conjures up mental images of porcelain crowns and veneers. To some dentists, the term minimally invasive dentistry evokes thoughts of observing early lesions, and postponing treatment until lesions are closer to the pulp. (The World Congress of Minimally Invasive Dentistry defines minimally invasive dentistry as those techniques which respect health, function, and esthetics of oral tissue by preventing disease from occurring, or intercepting its progress with minimal tissue loss.) It would seem these two niches within dentistry are on opposite ends of the spectrum; however, composite resin and glass ionomer restorative materials unite these two ideologies. Understanding the limitations, benefits, and science behind each material allows clinicians to produce highly esthetic restorations that can resist future decay, internally remineralize the tooth, and help protect adjacent teeth from cariogenic attack.

  6. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

    Medline Plus

    Full Text Available ... around the world, the Komansky Center for Children’s Health allows medical care to be more accessible, advanced and supportive of ... screen and open the door to informed medical care. OR Live, the vision of improving health. 20

  7. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

    Medline Plus

    Full Text Available ... the Komansky Center for Children’s Health allows medical care to be more accessible, advanced and supportive of the needs of these patients and their families. The focus on children’s health is critical, emphasizing health maintenance and prevention. The experience and ...

  8. Minimally Invasive-Endoscopic Intraventricular Neurosurgery

    Medline Plus

    Full Text Available ... the Phyllis and David Komansky Center for Children’s Health at New York Presbyterian Hospital Weill Cornell Medical ... around the world, the Komansky Center for Children’s Health allows medical care to be more accessible, advanced ...

  9. Coronary optical coherence tomography: minimally invasive virtual histology as part of targeted post-mortem computed tomography angiography.

    Science.gov (United States)

    Adlam, David; Joseph, Shiju; Robinson, Claire; Rousseau, Clement; Barber, Jade; Biggs, Mike; Morgan, Bruno; Rutty, Guy

    2013-09-01

    Social, cultural and practical barriers to conventional invasive autopsy have led to considerable interest in the development of minimally invasive radiological techniques as an alternative to the invasive autopsy for determining the cause of death. Critical to accurate diagnosis in this context is detailed examination of coronary anatomy and pathology. Current computed tomography and magnetic resonance imaging approaches have significantly advanced minimally invasive autopsy practice but have limited spatial resolution. This prohibits assessment at a microscopic level, meaning that histological assessment is still required for detailed analysis of, for example, coronary plaque rupture or dissection. Coronary optical coherence tomography (OCT) is used in the living during percutaneous coronary interventions to provide high-resolution coronary imaging, but this technique for obtaining virtual histology has not, to date, been translated into minimally invasive autopsy practice. We present a first description of minimally invasive post-mortem coronary OCT and discuss the potential for this technique to advance current practice. PMID:23455719

  10. Minimally Invasive Cardiac Surgery: Transapical Aortic Valve Replacement

    Directory of Open Access Journals (Sweden)

    Ming Li

    2012-01-01

    Full Text Available Minimally invasive cardiac surgery is less traumatic and therefore leads to quicker recovery. With the assistance of engineering technologies on devices, imaging, and robotics, in conjunction with surgical technique, minimally invasive cardiac surgery will improve clinical outcomes and expand the cohort of patients that can be treated. We used transapical aortic valve implantation as an example to demonstrate that minimally invasive cardiac surgery can be implemented with the integration of surgical techniques and engineering technologies. Feasibility studies and long-term evaluation results prove that transapical aortic valve implantation under MRI guidance is feasible and practical. We are investigating an MRI compatible robotic surgical system to further assist the surgeon to precisely deliver aortic valve prostheses via a transapical approach. Ex vivo experimentation results indicate that a robotic system can also be employed in in vivo models.

  11. Minimally Invasive Spinal Surgery with Intraoperative Image-Guided Navigation

    Directory of Open Access Journals (Sweden)

    Terrence T. Kim

    2016-01-01

    Full Text Available We present our perioperative minimally invasive spine surgery technique using intraoperative computed tomography image-guided navigation for the treatment of various lumbar spine pathologies. We present an illustrative case of a patient undergoing minimally invasive percutaneous posterior spinal fusion assisted by the O-arm system with navigation. We discuss the literature and the advantages of the technique over fluoroscopic imaging methods: lower occupational radiation exposure for operative room personnel, reduced need for postoperative imaging, and decreased revision rates. Most importantly, we demonstrate that use of intraoperative cone beam CT image-guided navigation has been reported to increase accuracy.

  12. [Antibiotic-prophylaxis in the minimally invasive pain surgical procedures].

    Science.gov (United States)

    Mastronicola, Cristina; Rocco, Marzia; Maltoni, Susanna; Marata, Annamaria; Bedini, Andrea; Sarti, Mario; Ungheri, Mirella

    2010-09-01

    The minimally invasive pain surgical procedures are more and more frequently used in the treatment and management of the chronic pain. The patients will often have recourse to a higher infection's risk during the proceedings for acquired general conditions (like enterotomy, skin ulcers, bladder catheter).The analysis literature doesn't produce specific treatment guidelines about antibiotic prophylaxis in pain therapy. This document, drawn up with multidisciplinary approach, correspond to rational, efficacy and functional guide about the choice and management of the antibiotic prophylaxis during the minimally invasive pain surgical procedures. PMID:21268371

  13. Minimally Invasive Esophagectomy for Cancer -Short Up-to-Date

    Directory of Open Access Journals (Sweden)

    Radu Mircea Neagoe

    2014-07-01

    Full Text Available Surgery remains the main treatment for localized resectable esophageal cancer. Open esophagectomy is still the standard surgical approach for esophageal cancer but it has a lower patient satisfaction when compared with other treatment options. In the era of “key-hole” surgeries, minimally invasive esophagectomy (MIE stands as a solution to improve the results after standard open esophagectomies. The aim of the present paper is to provide a short update regarding the minimally invasive esophagectomy, with special emphasis on its indications, results and current controversies.

  14. [Robot-assisted minimally invasive esophagectomy. German version].

    Science.gov (United States)

    van Hillegersberg, R; Seesing, M F J; Brenkman, H J F; Ruurda, J P

    2016-08-01

    Esophagolymphadenectomy is the cornerstone of multimodality treatment for resectable esophageal cancer. The preferred surgical approach is transthoracic, with a two-field lymph node dissection and gastric conduit reconstruction. A minimally invasive approach has been shown to reduce postoperative complications and increase quality of life. Robot-assisted minimally invasive esophagectomy (RAMIE) was developed to facilitate this complex thoracoscopic procedure. RAMIE has been shown to be safe with good oncologic results and reduced morbidity. The use of RAMIE opens new indications for curative surgery in patients with T4b tumors, high mediastinal tumors, and lymph node metastases after neoadjuvant treatment. PMID:27484825

  15. [Minimally invasive direct cardiac surgery with the jakoscope retractor].

    Science.gov (United States)

    Galajda, Zoltán; Jakó, Géza; von Jakó, Ronald; Péterffy, Arpád

    2008-01-20

    The authors present a surgical retractor named jakoscope, useful in the field of abdominal, urological, vascular, thoracic and cardiac surgery procedures. This multifunctional device offers the possibility to utilize Minimally Invasive Direct Access Surgical Technology (MIDAST) in the above mentioned surgical specialties. In their department the authors use the jakoscope retractor for aortic valve replacement, off-pump coronary bypass operations and radiofrequency pulmonary vein ablation by mini-thoracotomy approach. In this report they published for the first time their experience with jakoscope device in the field of cardiac surgery. In these operations the device assured adequate minimally invasive direct access, without complications.

  16. Minimally invasive and surgical management strategies tailored to the severity of acute diverticulitis.

    LENUS (Irish Health Repository)

    McDermott, F D

    2014-01-01

    The severity of acute diverticulitis ranges from mild, simple inflammation to pericolic abscesses, or perforation with faeculent peritonitis. Treatment of diverticulitis has evolved towards more conservative and minimally invasive strategies. The aim of this review is to highlight recent concepts and advances in management.

  17. A Brief History of Minimally Invasive Plastic Surgery

    OpenAIRE

    Hallock, Geoffrey G.

    2008-01-01

    It could be argued that a basic principle establishing plastic surgery as a distinct specialty always has been minimal invasive surgery. Although perhaps lagging behind the other surgical specialties specifically in adopting the surgical endoscope, this merely is a new tool to better achieve just that objective. Outcome enhancements initially predominated in aesthetic applications, but widespread use also in reconstructive endeavors has proved that there is indeed today a broad role for minim...

  18. Ultra-minimally invasive cardiac surgery: robotic surgery and awake CABG.

    Science.gov (United States)

    Ishikawa, Norihiko; Watanabe, Go

    2015-01-01

    The recognition of the significant advantages of minimizing surgical trauma has resulted in the development of minimally invasive surgical procedures. Endoscopic surgery confers the benefits of minimally invasive surgery upon patients, and surgical robots have enhanced the ability and precision of surgeons. Consequently, technological advances have facilitated totally endoscopic robotic cardiac surgery, which has allowed surgeons to operate endoscopically, rather than through a median sternotomy, during cardiac surgery. Thus, repairs for structural heart conditions, including mitral valve plasty, atrial septal defect closure, multivessel minimally invasive direct coronary artery bypass grafting and totally endoscopic coronary artery bypass graft surgery (CABG), can be totally endoscopic. On the other hand, general anesthesia remains a risk in patients who have severe carotid artery stenosis before surgery, as well as in those with a history of severe cerebral infarction or respiratory failure. In this study, the potential of a new awake CABG protocol using only epidural anesthesia was investigated for realizing day surgery and was found to be a promising modality for ultra-minimally invasive cardiac surgery. We herein review robot-assisted cardiac surgery and awake off-pump coronary artery bypass grafting as ultra-minimally invasive cardiac surgeries. PMID:25274467

  19. Interstitial laser coagulation of benign prostatic hyperplasia: a minimally invasive treatment alternative

    Science.gov (United States)

    Ordonez, Robert F.; Mittemeyer, Bernhard T.; Aronoff, David R.; de Riese, Werner T. W.

    2003-06-01

    The use of minimally invasive treatments for benign prostatic hyperplasia (BPH) have been introduced into the medical community. Over the last decade several minimally invasive treatment techniques have been approved for use. In particular, interstitial laser coagulation (ILC) has shown pomise as an alternative to the current gold standard, transurethral resection of prostate (TURP). Studies show ILC to have equal efficacy as TURP while causing less side effects. Future technical advances as well as increased physician experience with ILC could lead to the replacement of TURP as the gold standard in trestment of BPH.

  20. Manual Control for Medical Instruments in Minimally Invasive Surgery

    NARCIS (Netherlands)

    Fan, C.

    2014-01-01

    With the introduction of new technologies, surgical procedures have been varying from free access in open surgery towards limited access in minimal invasive surgery. During such procedures, surgeons have to manoeuver the instruments from outside the patient while looking at the monitor. Long and sle

  1. Update in minimal invasive therapy in benign prostatic hyperplasia.

    NARCIS (Netherlands)

    Hest, P.J. van; Ancona, F.C.H. d'

    2009-01-01

    Last decade several new treatment modalities for minimal invasive therapy of benign prostatic hyperplasia have been developed, both ablative and non-ablative. In this review the authors describe the different techniques and clinical studies of bipolar transurethral resection of the prostate (TURP),

  2. Diagnosis and minimally invasive treatment of early stage breast carcinoma

    NARCIS (Netherlands)

    van Esser, S.

    1979-01-01

    In this thesis the diagnostic work up and minimally invasive surgical treatment of early stage breast carcinoma is studied. Although the surgical treatment of breast carcinoma has improved significantly over the past decades, there is still room for improvement. On the one hand the focus is on early

  3. Minimally Invasive Surgical Treatments for Benign Prostatic Hyperplasia

    NARCIS (Netherlands)

    V. Tzortzis; S. Gravas; J.J.M.C.H. de la Rosette

    2009-01-01

    Although transurethral resection of the prostate (TURP) is considered to be the reference standard for minimally invasive surgical treatment (MIST) of lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO), it is associated with a noteworthy rate of complication. Transurethral

  4. Perspectives of Nanotechnology in Minimally Invasive Therapy of Breast Cancer

    Directory of Open Access Journals (Sweden)

    Yamin Yang

    2013-01-01

    Full Text Available Breast cancer, the most common type of cancer among women in the western world, affects approximately one out of every eight women over their lifetime. In recognition of the high invasiveness of surgical excision and severe side effects of chemical and radiation therapies, increasing efforts are made to seek minimally invasive modalities with fewer side effects. Nanoparticles (<100 nm in size have shown promising capabilities for delivering targeted therapeutic drugs to cancer cells and confining the treatment mainly within tumors. Additionally, some nanoparticles exhibit distinct properties, such as conversion of photonic energy into heat, and these properties enable eradication of cancer cells. In this review, current utilization of nanostructures for cancer therapy, especially in minimally invasive therapy, is summarized with a particular interest in breast cancer.

  5. Minimally invasive surgery of the anterior skull base: transorbital approaches

    Science.gov (United States)

    Gassner, Holger G.; Schwan, Franziska; Schebesch, Karl-Michael

    2016-01-01

    Minimally invasive approaches are becoming increasingly popular to access the anterior skull base. With interdisciplinary cooperation, in particular endonasal endoscopic approaches have seen an impressive expansion of indications over the past decades. The more recently described transorbital approaches represent minimally invasive alternatives with a differing spectrum of access corridors. The purpose of the present paper is to discuss transorbital approaches to the anterior skull base in the light of the current literature. The transorbital approaches allow excellent exposure of areas that are difficult to reach like the anterior and posterior wall of the frontal sinus; working angles may be more favorable and the paranasal sinus system can be preserved while exposing the skull base. Because of their minimal morbidity and the cosmetically excellent results, the transorbital approaches represent an important addition to established endonasal endoscopic and open approaches to the anterior skull base. Their execution requires an interdisciplinary team approach. PMID:27453759

  6. MINIMALLY INVASIVE SURGERY FOR GASTRIC CANCER: TIME TO CHANGE THE PARADIGM

    Science.gov (United States)

    BARCHI, Leandro Cardoso; JACOB, Carlos Eduardos; BRESCIANI, Cláudio José Caldas; YAGI, Osmar Kenji; MUCERINO, Donato Roberto; LOPASSO, Fábio Pinatel; MESTER, Marcelo; RIBEIRO-JÚNIOR, Ulysses; DIAS, André Roncon; RAMOS, Marcus Fernando Kodama Pertille; CECCONELLO, Ivan; ZILBERSTEIN, Bruno

    2016-01-01

    ABSTRACT Introduction: Minimally invasive surgery widely used to treat benign disorders of the digestive system, has become the focus of intense study in recent years in the field of surgical oncology. Since then, the experience with this kind of approach has grown, aiming to provide the same oncological outcomes and survival to conventional surgery. Regarding gastric cancer, surgery is still considered the only curative treatment, considering the extent of resection and lymphadenectomy performed. Conventional surgery remains the main modality performed worldwide. Notwithstanding, the role of the minimally invasive access is yet to be clarified. Objective: To evaluate and summarize the current status of minimally invasive resection of gastric cancer. Methods: A literature review was performed using Medline/PubMed, Cochrane Library and SciELO with the following headings: gastric cancer, minimally invasive surgery, robotic gastrectomy, laparoscopic gastrectomy, stomach cancer. The language used for the research was English. Results: 28 articles were considered, including randomized controlled trials, meta-analyzes, prospective and retrospective cohort studies. Conclusion: Minimally invasive gastrectomy may be considered as a technical option in the treatment of early gastric cancer. As for advanced cancer, recent studies have demonstrated the safety and feasibility of the laparoscopic approach. Robotic gastrectomy will probably improve outcomes obtained with laparoscopy. However, high cost is still a barrier to its use on a large scale. PMID:27438040

  7. Minimally invasive plate osteosynthesis in metaphyseal fractures of tibia

    Directory of Open Access Journals (Sweden)

    K Ramesh Krishna

    2015-01-01

    Full Text Available Introduction: Treating tibial metaphyseal fractures is still great challenge. However, two of most used techniques are locked intramedullary nail and minimally-invasive bridge plate. Minimally invasive plate osteosynthesis (MIPO offers biological advantages. Reduced soft tissue dissection and exposition results in low surgical trauma and preservation of blood supply. Aim of study was to evaluate results of MIPO in treatment of metaphyseal fractures of tibia and to compare efficacy in treating metaphyseal fractures of tibia with other similar studies. Materials and Methods: This study was performed with 30 metaphyseal fractures of tibia with MIPO in hospitals attached to BMCRI. All cases were fresh fractures and traumatic. There were 12 proximal tibial and 18 distal tibial fractures. Temporary joint spanning external fixation was used for severe soft tissue injuries in 6 patients. All the fractures were stabilized by minimally invasive plating. Cases were followed up for an average of 14.1 months. Results: All fractures united. Proximal and disal tibia fractures united after an average of 6.3 and 6.6 months respectively. In proximal and distal tibia fractures, average range of motion achieved was 81.75° and 48.8° respectively. One patient with distal tibia fracture had a malunion with valgus alignment of more than 5°. Conclusion: Minimally invasive percutaneous plating facilitates in early mobilization of the patient which helps in healing of the fracture and prevents joint stiffness. It promotes early union as it does not disturb anatomy and physiology of vascularity at fracture site. There is minimal risk of infection and minimal blood loss.

  8. Force Feedback Control of Robotic Forceps for Minimally Invasive Surgery

    Science.gov (United States)

    Ishii, Chiharu; Kamei, Yusuke

    2008-06-01

    Recently, the robotic surgical support systems are in clinical use for minimally invasive surgery. For improvement in operativity and safety of minimally invasive surgery, the development of haptic forceps manipulator is in demand to help surgeon's immersion and dexterity. We have developed a multi-DOF robotic forceps manipulator using a novel omni-directional bending mechanism, so far. In this paper, in order to control the developed robotic forceps as a slave manipulator, joy-stick type master manipulator with force feedback mechanism for remote control is designed and built, and force feedback bilateral control system was constructed for grasping and bending motions of the robotic forceps. Experimental works were carried out and experimental results showed the effectiveness of the proposed control system.

  9. MINIMALLY INVASIVE LOW-COLLAR INCISION IN THYROID LOBECTOMY

    Institute of Scientific and Technical Information of China (English)

    刘宝国; 王成学; 张乃嵩

    2003-01-01

    Objective: To report the development of a technique for minimally invasive thyroid lobectomy. Method: The procedure was accepted by 200 patients with a nodule of the lobe of the thyroid. We performed hemithyroidectomys through a 2-4 cm low-collar horizontal skin incision by conventional instrumentation. Results: The recurrent laryngeal nerve and the parathyroid glands were easily identified and preserved. The amount of bleeding ranged from 5 to 50 ml (mean 15 ml). Mean Operation time was 52.2 minutes (ranged 32 to 80 minutes). No complication occurred. Mean postoperative stay was 5.5 days (ranged 4 to 7 days). The incision provided excellent cometic results because the small and lower incisions were completely hidden by clothing collar. Conclusion: The above technique is feasible, safe, minimally invasive, less time and cost consuming and cosmetical.

  10. Current status of minimally invasive endoscopicmanagement for Zenker diverticulum

    Institute of Scientific and Technical Information of China (English)

    Alberto Aiolfi; Federica Scolari; Greta Saino; Luigi Bonavina

    2015-01-01

    Surgical resection has been the mainstay of treatment ofpharyngoesophageal (Zenker) diverticula over the pastcentury. Developments in minimally invasive surgeryand new endoscopic devices have led to a paradigmchange. The concept of dividing the septum betweenthe esophagus and the pouch rather than resecting thepouch itself has been revisited during the last threedecades and new technologies have been investigatedto make the transoral operation safe and effective. Theinternal pharyngoesophageal myotomy accomplished through the transoral stapling approach has been shown to effectively relieve outflow obstruction and restore physiological bolus transit in patients with medium size diverticula. Transoral techniques, either through a rigid device or by flexible endoscopy, are gaining popularity over the open surgical approach due the low morbidity, the fast recovery time and the fact that the procedure can be safely repeated. We provide an analysis of the the current status of minimally invasive endoscopic management of Zenker diverticulum.

  11. Application of minimally invasive surgery in traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Liu Baiyun

    2014-12-01

    Full Text Available This article aims to expound the essence of minimally invasive surgery as well as when and how to use it in craniocerebral trauma surgery according to the characteristics of the disease. In neurosurgery, the importance of tissue protection should be from the inside to the outside, i.e. brain→dura→skull→scalp. In this article, I want to share my opinion and our team’s experience in terms of selecting surgical approaches and incision, surgical treatment of the skull, dura handling, intracranial operation and placement of drainage based on the above theory. I hope this will be helpful for trauma surgeons. Key words: Traumatic brain injuries; Large craniectomy; Surgical procedures, minimally invasive

  12. Minimally invasive plate internal fixation for calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    SHAN Shu-lan; XU Jun-ling; YAO Shu-zhang; YU Guo-sheng; LIU Yu-qin

    2010-01-01

    Objective: To assess the clinical efficacy of minimally invasive plate internal fixation for the treatment of calcaneal fractures.Methods: Manual reduction, rectification of deformity,and cold compress with traditional Chinese medicine were used preoperatively to relieve swelling and pain. A small incision was made to expose the articular facet and to perform anatomic reduction and plate fixation. Self-made traditional Chinese pharmaceutics were applied postoperatively on the surface of the wound to accelerate bony union.Results: All the 40 patients were followed up for at least 1 year postoperatively. According to the Maryland scoring system, the excellent and good rate was 87.5%.Conclusion: Minimally invasive plate internal fixation has the advantages of relatively mild injury, reliable fixation,good recovery, and rare complications in the treatment of intraarticular fractures.

  13. MICROSURGICAL LANDMARKS IN MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION

    Directory of Open Access Journals (Sweden)

    Javier Quillo-Olvera

    2015-12-01

    Full Text Available Microsurgical landmarks of the facet joint complex were defined to provide guidance and security within the tubular retractor during transforaminal surgery. A retrospective observational study was performed in segments L4-L5 by the left side approach. Microsurgical relevant photos, anatomical models and drawing were used to expose the suggested landmarks. The MI-TLIF technique has advantages compared with conventional open TLIF technique, however minimally invasive technique implies lack of security for the surgeon due to the lack of defined microanatomical landmarks compared to open spine surgery, and disorientation within the tubular retractor, the reason why to have precise microsurgical references and its recognition within the surgical field provide speed and safety when performing minimally invasive technique.

  14. Recent advancement or less invasive treatment of percutaneous nephrolithotomy.

    Science.gov (United States)

    Kim, Bum Soo

    2015-09-01

    Since its initial introduction in 1976, percutaneous nephrolithotomy (PCNL) has been widely performed for the management of large renal stones and currently is recommended for staghorn calculi, kidney stones larger than 2 cm, and shock wave lithotripsy-resistant lower pole stones greater than 1 cm. However, except for open and laparoscopic surgery, PCNL is the most invasive of the minimally invasive stone surgery techniques. Over the years, technical and instrumental advances have been made in PCNL to reduce morbidity and improve effectiveness. A thorough review of the recent literature identified five major areas of progress for the advancement of PCNL: patient positioning, method of percutaneous access, development of lithotriptors, miniaturized access tracts, and postoperative nephrostomy tube management. This review provides an overview of recent advancements in PCNL and the outcomes of each area of progress and notes how much we achieve with less invasive PCNL. This information may allow us to consider the future role and future developments of PCNL. PMID:26366273

  15. Minimally invasive approaches for the treatment of inflammatory bowel disease

    OpenAIRE

    Zoccali, Marco; Fichera, Alessandro

    2012-01-01

    Despite significant improvements in medical management of inflammatory bowel disease, many of these patients still require surgery at some point in the course of their disease. Their young age and poor general conditions, worsened by the aggressive medical treatments, make minimally invasive approaches particularly enticing to this patient population. However, the typical inflammatory changes that characterize these diseases have hindered wide diffusion of laparoscopy in this setting, current...

  16. A Biomimetic steering robot for Minimally invasive surgery application

    OpenAIRE

    Chen, G.; M. T. Pham; Maalej, T.; Fourati, H.; Moreau, R.; Sesmat, S.

    2010-01-01

    Minimally Invasive Surgery represents the future of many types of medical inter- ventions such as keyhole neurosurgey or transluminal endoscopic surgery. These procedures involve insertion of surgical instruments such as needles and endoscopes into human body through small incision/ body cavity for biopsy and drug delivery. However, nearly all surgical instruments for these procedures are inserted manually and there is a long learning curve for surgeons to use them properly. Many research eff...

  17. Postoperative metabolic acidosis following the minimally invasive radiofrequency maze procedure

    OpenAIRE

    Raymond Patrick Hom; Anna Dubovoy; Elizabeth Jewell; Milo Engoren

    2016-01-01

    Purpose: Atrial fibrillation (AF) is the most common arrhythmia treated in the world. While medical treatment with antiarrhythmic drugs remains the primary treatment modality, symptomatic refractory AF often requires treatment with a catheter or surgical ablation. One minimally invasive therapy is the Mini-Maze procedure, which utilizes epicardial radiofrequency ablation via a subxiphoid approach to rid the heart of arrhythmogenic atrial foci without a median sternotomy or cardiopulmonary byp...

  18. Standardized definitions and policies of minimally invasive thymoma resection

    OpenAIRE

    Toker, Alper

    2015-01-01

    A wide range of technical approaches for the minimally invasive resection of thymus have been described. Most of the time, the benefits are superior cosmetic outcome and shorter duration of postoperative stay. Other demonstrable differences that have been reported include shorter duration of surgery, less intraoperative blood loss and less postoperative pleural drainage. Robotic surgery and video-assisted surgery (VATS) may become routinely used procedures in the treatment of stage I and II t...

  19. Minimally Invasive Approach to Eliminate Pyogenic Granuloma: A Case Report

    OpenAIRE

    Chandrashekar, B.

    2012-01-01

    Pyogenic granuloma is one of the inflammatory hyperplasia seen in the oral cavity. The term is a misnomer because it is not related to infection and arises in response to various stimuli such as low-grade local irritation, traumatic injury, or hormonal factors. It is most commonly seen in females in their second decade of life due to vascular effects of hormones. Although excisional surgery is the treatment of choice for it, this paper presents the safest and most minimally invasive procedure...

  20. Minimally invasive dentistry: paradigm shifts in preparation design.

    Science.gov (United States)

    LeSage, Brian P

    2009-01-01

    While the concept of minimally invasive dentistry has long been considered a rational, viable approach to restorative care, preparation design, material science, and long-term evidentiary support have only recently begun to provide the foundation necessary to support such treatment in the everyday practice. This article reviews the fundamental paradigm shift evidenced in contemporary prosthodontics as required to facilitate the emerging interest in delivering conservative restorative alternatives.

  1. Advances of imaging-guided interventional minimally invasive techniques for the treatment of lumbar disc herniation%影像导引腰椎间盘突出症微创治疗技术进展

    Institute of Scientific and Technical Information of China (English)

    李福元; 许文哲

    2012-01-01

    Lumbar disc herniation (LDH) is a common disease, which leads to the most common cause of low back pain. Imaging-guided interventional minimally invasive treatment of lumbar disc herniation. which was performed with minimal invasion, less pain, quicker recovery and less complications, has been widely used in clinic, and become the preferred method for the treatment of mild to moderate lumbar disc herniation.%腰椎间盘突出症(lumbar disc herniation,LDH)是一种常见病、多发病,是导致腰腿痛最常见的原因.影像导引微创治疗腰椎间盘突出症创伤小、痛苦少、恢复快、并发症少现已广泛应用于临床,成为治疗轻、中度腰椎间盘突出症的首选方法.

  2. Minimally invasive approaches for the treatment of inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Marco Zoccali; Alessandro Fichera

    2012-01-01

    Despite significant improvements in medical management of inflammatory bowel disease,many of these patients still require surgery at some point in the course of their disease.Their young age and poor general conditions,worsened by the aggressive medical treatments,make minimally invasive approaches particularly enticing to this patient population.However,the typical inflammatory changes that characterize these diseases have hindered wide diffusion of laparoscopy in this setting,currently mostly pursued in high-volume referral centers,despite accumulating evidences in the literature supporting the benefits of minimally invasive surgery.The largest body of evidence currently available for terminal ileal Crohn's disease shows improved short term outcomes after laparoscopic surgery,with prolonged operative times.For Crohn's colitis,high quality evidence supporting laparoscopic surgery is lacking.Encouraging preliminary results have been obtained with the adoption of laparoscopic restorative total proctocolectomy for the treatment of ulcerative colitis.A consensus about patients' selection and the need for staging has not been reached yet.Despite the lack of conclusive evidence,a wave of enthusiasm is pushing towards less invasive strategies,to further minimize surgical trauma,with single incision laparoscopic surgery being the most realistic future development.

  3. Complications of minimally invasive cosmetic procedures: Prevention and management

    Directory of Open Access Journals (Sweden)

    Lauren L Levy

    2012-01-01

    Full Text Available Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT, soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care.

  4. Minimally Invasive Dentistry--concepts and techniques in cariology.

    Science.gov (United States)

    Ericson, Dan; Kidd, Edwina; McComb, Dorothy; Mjör, Ivar; Noack, Michael J

    2003-01-01

    The concept 'Minimally Invasive Dentistry' can be defined as maximal preservation of healthy dental structures. Within cariology, this concept includes the use of all available information and techniques ranging from accurate diagnosis of caries, caries risk assessment and prevention, to technical procedures in repairing restorations. Dentists are currently spending more than half their time replacing old restorations. The main reasons for restoration failures are secondary caries and fractures, factors that are generally not addressed in the technical process of replacing a restoration. Prevailing concepts on minimally invasive dentistry seem to be 'product or technique-motivated', challenging one technique or product with another, rather than focusing on a general concept. New knowledge of caries progression rates has also led to substantial modification of restorative intervention thresholds and further handling of the disease. New diagnostic tools for caries lesion detection, caries risk assessment and focused preventive treatments have decreased the need for early restorative interventions. In parallel to this, new techniques for cutting teeth and removing decay have evolved. This paper focuses on describing minimally invasive dentistry in cariology from a conceptual perspective, relating to clinical caries diagnosis, restorative intervention thresholds and operative procedures, with special reference to survival of tunnel and slot restorations and to repair vs. replacement of defective restorations.

  5. [Minimally invasive hemodynamic monitoring with esophageal echoDoppler].

    Science.gov (United States)

    Monge, M I; Estella, A; Díaz, J C; Gil, A

    2008-01-01

    Hemodynamic monitoring is a key element in the care of the critical patients, providing an unquestionable aid in the attendance to diagnosis and the choice of the adequate treatment. Minimally invasive devices have been emerging over the past few years as an effective alternative to classic monitoring tools. The esophageal echoDoppler is among these. It makes it possible to obtain continuous and minimally invasive monitoring of the cardiac output in addition to other useful parameters by measuring the blood flow rate and the diameter of the thoracic descending aorta, which provides a sufficiently extensive view of the hemodynamic state of the patient and facilitates early detection of the changes produced by a sudden clinical derangement. Although several studies have demonstrated the usefulness of the esophageal Doppler in the surgical scene, there is scarce and dispersed evidence in the literature on its benefits in critical patients. Nevertheless, its advantages make it an attractive element to take into account within the diagnostic arsenal in the intensive care. The purpose of the following article is to describe how it works, its degree of validation with other monitoring methods and the role of esophageal echoDoppler as a minimally invasive monitoring tool for measuring cardiac output in the daily clinical practice, contributing with our own experience in the critical patient. PMID:18221711

  6. CHANGES IN RADIOGRAPHIC PARAMETERS AFTER MINIMALLY INVASIVE LUMBAR INTERBODY FUSION

    Directory of Open Access Journals (Sweden)

    Emiliano Vialle

    2015-12-01

    Full Text Available Objective : This study aims to evaluate changes in lumbosacral parameters after minimally invasive lumbar interbody fusion. The secondary aim was to evaluate whether interbody cage shape (crescent shaped or rectangular would influence the results. Method : Retrospective analysis of 70 patients who underwent one or two level lumbar interbody fusion through a minimally invasive posterolateral approach. This included midline preservation and unilateral facetectomy. Pre- and postoperative (three to six months postoperative radiographs were used for measuring lumbar lordosis (LL, segmental lordosis (SL at the level of interbody fusion, and sacral slope (SS. Further analyses divided the patients into Roussouly lumbar subgroups. Results : LL was significantly reduced after surgery (59o:39o, p=0.001 as well as the SS (33.8o:31.2o, p=0.05. SL did not change significantly (11.4:11.06, p=0.85. There were no significant differences when comparing patients who received crescent shaped cage (n=27 and rectangular cage (n=43. Hypolordotic patients (Roussouly types 1 and 2 had radiographic improvement in comparison to normolordotic and hyperlordotic groups (types 3 and 4. Conclusion : Minimally invasive lumbar interbody fusion caused reduction in lumbosacral parameters. Cage shape had no influence on the results.

  7. Primary Dural Repair in Minimally Invasive Spine Surgery

    Directory of Open Access Journals (Sweden)

    Raqeeb M. Haque

    2013-01-01

    Full Text Available We describe an effective surgical technique in primary repair of the spinal dura during minimally invasive spine surgery (MISS. Objective. Minimally invasive spine surgery includes the treatment of intradural lesions, and proper closure of the dura is necessary. However, primary dural closure can be difficult due to the restricted space of MIS retractors and the availability of appropriate surgical instrumentation. Methods. We describe the use of a needle already used in the pediatric neurosurgical arena that can facilitate easier and safer closure of spinal dura through MISS retractors in two illustrative intradural cases. Results and Discussion. The primary dural closure technique is described and patient demographics are included. The instruments specifically used for the intradural closure through MIS retractor systems include (1 4-0 Surgilon braided nylon (Covidien, Dublin, Ireland with a CV-20 taper 1/2 circle, 10 mm diameter needle; (2 Scanlan (Saint Paul, MN, USA dura closure set. Conclusion. Successful primary dural repair can be performed on primary and incidental durotomies during minimally invasive spinal surgery. We describe the novel use of a 10 mm diameter needle to help surgeons safely and efficiently close the dura with more ease than previously described.

  8. Minimally invasive scoliosis treatment with a Ho:YAG laser

    Science.gov (United States)

    Rumpf, Christian G.; Lang, Robert D.; Goetz, Marcus H.

    2000-11-01

    Today most surgical treatment of spinal deformations is concentrated on invasive mechanical techniques with long operation times and major effects on the patient's mobility. The proposed minimally invasive technique using laser light for tissue ablation offers a possibility of gentle scoliosis treatment. It is thought that an early removal of the epiphysial growth zone on the convex side over several vertebrae results in a straightening of the spine. In a first evaluation, four different laser systems including argon ion, Nd:YAG (Q-switched), Nd:YAG (cw), and Ho:YAG laser were compared with respect to thermal damage to adjacent tissue, ablation rates, efficiency and laser handling. For in-vivo investigation, fresh lamb spine was used. Comparison showed that the Ho:YAG laser is the most appropriate laser for the given goal, providing efficient photoablation with moderate thermal effects on the adjacent tissue. In a second step the proposed minimally invasive operation technique was performed in in-vivo experiments on young foxhounds using 3D- thoracoscopic operation techniques. During these operations temperature mapping was done using fiber-optic fluorescent probes. After 12 months of normal growth the animals were sacrificed and x-ray as well as MRI was performed on the spine. First results show a positive effect of scoliotic growth in two cases. Being able to produce a scoliosis by hemiepiphysiodesis on the vertebra, It is thought that this technique is successful for a straightening of the spine on patients with scoliosis.

  9. Minimally invasive cardiac surgery-coronary artery bypass graft.

    Science.gov (United States)

    Lemma, Massimo; Atanasiou, Thanos; Contino, Monica

    2013-01-01

    Coronary artery bypass graft (CABG) is among the most common operations performed in the world. Different surgical strategies can be used with different invasiveness. This paper describes a recent development of the technique that merges the advantages resulting from both the adoption of an 'off-pump no-touch aorta operation' and a 'complete arterial revascularization through a left minithoracotomy' in a single procedure. This operation is currently known with the acronym MICS (minimally invasive cardiac surgery)-CABG (minimally invasive cardiac surgery). It is an off-pump operation performed through a minithoracotomy in the fourth or fifth left intercostal space across the midclavicular line. The left internal thoracic artery (LITA) is harvested under direct vision using a special rib-retractor with multiple interchangeable thoracotomy blades, including blades to use with lift systems for proximal artery harvesting, while the right radial artery (RA) is harvested endoscopically. A Y-connection is made between the two arteries. The LITA is used to bypass the left anterior descending coronary artery, while the right RA is used on the obtuse marginal branches and/or the posterior descending coronary artery. A special coronary stabilizer and a heart positioner with a shaft for remote thoracic insertion are needed.

  10. Conventional Minimally Invasive Parathyroidectomy for Single Parathyroid Adenoma

    Directory of Open Access Journals (Sweden)

    Cristian Velicescu

    2015-04-01

    Full Text Available Background: Minimally invasive parathyroidectomy is actually the gold standard in the treatment of primary hyperparathyroidism (PHPT due to parathyroid adenoma (PA. Material and Methods: A clinical retrospective study was performed on a series of 40 cases operated for pHPT by single PA from January 2013 to March 2015, in the surgical department of the “St. Spiridon” Hospital of Iasi, a refferal center for endocrine surgery. Biochemical markers achieved the diagnosis of PHPT and PA was localized using cervical US and MIBI scintigraphy. Conventional minimally invasive parathyroidectomy (C-MIP was performed in all cases where PA was accurately localised by preoperative imaging, whereas conventional cervical exploration was necessary in cases with concomitant thyroid pathology. Results: Preoperative localisation findings were concordant with the intraoperative findings, except for one case when conversion to bilateral exploration was deemed and the PA was identified on the other side. In 8 cases, additional thyroid pathology – uni/multinodular goiter and a papillary microcarcinoma imposed a conventional PT adenomectomy and concomitant lobectomy/total thyroidectomy. The values of calcemia and PTH decreased significantly postoperatively and reached normal range in all cases. With the exception of a transient reccurrent nerve paresis (in a patient with total thyroidectomy, no postoperative morbidity and mortality was encountered. Conclusion: Conventional mini-incision parathyroidectomy (C-MIP has an excellent cure rate and minimal morbidity, with a reduced hospital stay and cost compared with the conventional extensive approach.

  11. Minimally Invasive Surgery for Pectus Excavatum: Park Technique

    Directory of Open Access Journals (Sweden)

    Hyung Park

    2011-09-01

    Full Text Available Pectus excavatum (PE is the most commonly encountered chest wall deformity which comprises one out of 1,000 live births. Depression of the anterior chest wall due to posterior angulation of the sternum and costal cartilages results in compression of internal thoracic organs as well as aesthetically unpleasant appearance. Multiple surgical techniques have been developed to correct this condition. Ravitch procedure, the technique including the excision of all deformed costal cartilages, division of intercostals bundles from the sternum, and transverse sternal osteotomy, was proposed in 1949 and most widely applied until recently. The Wada technique, principally sternal turnover, has been an alternative procedure. Those invasive techniques involve tedious and bloody operations resulted in a permanent defect of costal cartilages or contracture of the chest wall. Most importantly, a large, unsightly operative scar at the anterior chest is aesthetically dissatisfying. In this study “Minimally Invasive Surgery for Pectus Excavatum: Park Technique” was explained.

  12. Past, Present, and Future of Minimally Invasive Abdominal Surgery.

    Science.gov (United States)

    Antoniou, Stavros A; Antoniou, George A; Antoniou, Athanasios I; Granderath, Frank-Alexander

    2015-01-01

    Laparoscopic surgery has generated a revolution in operative medicine during the past few decades. Although strongly criticized during its early years, minimization of surgical trauma and the benefits of minimization to the patient have been brought to our attention through the efforts and vision of a few pioneers in the recent history of medicine. The German gynecologist Kurt Semm (1927-2003) transformed the use of laparoscopy for diagnostic purposes into a modern therapeutic surgical concept, having performed the first laparoscopic appendectomy, inspiring Erich Mühe and many other surgeons around the world to perform a wide spectrum of procedures by minimally invasive means. Laparoscopic cholecystectomy soon became the gold standard, and various laparoscopic procedures are now preferred over open approaches, in the light of emerging evidence that demonstrates less operative stress, reduced pain, and shorter convalescence. Natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS) may be considered further steps toward minimization of surgical trauma, although these methods have not yet been standardized. Laparoscopic surgery with the use of a robotic platform constitutes a promising field of investigation. New technologies are to be considered under the prism of the history of surgery; they seem to be a step toward further minimization of surgical trauma, but not definite therapeutic modalities. Patient safety and medical ethics must be the cornerstone of future investigation and implementation of new techniques. PMID:26508823

  13. Minimally invasive prostate cancer detection test using FISH probes

    Directory of Open Access Journals (Sweden)

    Tinawi-Aljundi R

    2016-07-01

    Full Text Available Rima Tinawi-Aljundi,1 Shannon T Knuth,2 Michael Gildea,2 Joshua Khal,2 Jason Hafron,1 Kenneth Kernen,1 Robert Di Loreto,1 Joan Aurich-Costa2 1Pathology and Research Department, Michigan Institute of Urology, St Clair Shores, MI, USA; 2Research and Development, Cellay, Inc., Cambridge, MA, USA Purpose: The ability to test for and detect prostate cancer with minimal invasiveness has the potential to reduce unnecessary prostate biopsies. This study was conducted as part of a clinical investigation for the development of an OligoFISH® probe panel for more accurate detection of prostate cancer.Materials and methods: One hundred eligible male patients undergoing transrectal ultrasound biopsies were enrolled in the study. After undergoing digital rectal examination with pressure, voided urine was collected in sufficient volume to prepare at least two slides using ThinPrep. Probe panels were tested on the slides, and 500 cells were scored when possible. From the 100 patients recruited, 85 had more than 300 cells scored and were included in the clinical performance calculations.Results: Chromosomes Y, 7, 10, 20, 6, 8, 16, and 18 were polysomic in most prostate carcinoma cases. Of these eight chromosomes, chromosomes 7, 16, 18, and 20 were identified as having the highest clinical performance as a fluorescence in situ hybridization test and used to manufacture the fluorescence in situ hybridization probe panels. The OligoFISH® probes performed with 100% analytical specificity. When the OligoFISH® probes were compared with the biopsy results for each individual, the test results highly correlated with positive and negative prostate biopsy pathology findings, supporting their high specificity and accuracy. Probes for chromosomes 7, 16, 18, and 20 showed in the receiver operator characteristics analysis an area under the curve of 0.83, with an accuracy of 81% in predicting the biopsy result.Conclusion: This investigation demonstrates the ease of use

  14. Cost-effectiveness of minimally invasive sacroiliac joint fusion

    Directory of Open Access Journals (Sweden)

    Cher DJ

    2015-12-01

    Full Text Available Daniel J Cher,1 Melissa A Frasco,2 Renée JG Arnold,2,3 David W Polly4,5 1Clinical Affairs, SI-BONE, Inc., San Jose, CA, USA; 2Division of Health Economics and Outcomes Research, Quorum Consulting, Inc., San Francisco, CA, USA; 3Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 4Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA; 5Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA Background: Sacroiliac joint (SIJ disorders are common in patients with chronic lower back pain. Minimally invasive surgical options have been shown to be effective for the treatment of chronic SIJ dysfunction. Objective: To determine the cost-effectiveness of minimally invasive SIJ fusion. Methods: Data from two prospective, multicenter, clinical trials were used to inform a Markov process cost-utility model to evaluate cumulative 5-year health quality and costs after minimally invasive SIJ fusion using triangular titanium implants or non-surgical treatment. The analysis was performed from a third-party perspective. The model specifically incorporated variation in resource utilization observed in the randomized trial. Multiple one-way and probabilistic sensitivity analyses were performed. Results: SIJ fusion was associated with a gain of approximately 0.74 quality-adjusted life years (QALYs at a cost of US$13,313 per QALY gained. In multiple one-way sensitivity analyses all scenarios resulted in an incremental cost-effectiveness ratio (ICER <$26,000/QALY. Probabilistic analyses showed a high degree of certainty that the maximum ICER for SIJ fusion was less than commonly selected thresholds for acceptability (mean ICER =$13,687, 95% confidence interval $5,162–$28,085. SIJ fusion provided potential cost savings per QALY gained compared to non-surgical treatment after a treatment horizon of greater than 13 years. Conclusion: Compared to traditional non-surgical treatments

  15. Minimally Invasive Approach to Eliminate Pyogenic Granuloma: A Case Report

    Directory of Open Access Journals (Sweden)

    B. Chandrashekar

    2012-01-01

    Full Text Available Pyogenic granuloma is one of the inflammatory hyperplasia seen in the oral cavity. The term is a misnomer because it is not related to infection and arises in response to various stimuli such as low-grade local irritation, traumatic injury, or hormonal factors. It is most commonly seen in females in their second decade of life due to vascular effects of hormones. Although excisional surgery is the treatment of choice for it, this paper presents the safest and most minimally invasive procedure for the regression of pyogenic granuloma.

  16. Minimally invasive approach to eliminate pyogenic granuloma: a case report.

    Science.gov (United States)

    Chandrashekar, B

    2012-01-01

    Pyogenic granuloma is one of the inflammatory hyperplasia seen in the oral cavity. The term is a misnomer because it is not related to infection and arises in response to various stimuli such as low-grade local irritation, traumatic injury, or hormonal factors. It is most commonly seen in females in their second decade of life due to vascular effects of hormones. Although excisional surgery is the treatment of choice for it, this paper presents the safest and most minimally invasive procedure for the regression of pyogenic granuloma. PMID:22567459

  17. Anaesthesia for minimally invasive gastric and bowel surgery

    DEFF Research Database (Denmark)

    Lund, Claus

    2002-01-01

    It is of great importance that anaesthetic regimens match surgical procedures in regard to surgical time, in reducing organ dysfunction elicited by the anaesthesia and surgical trauma and by providing optimal post-operative pain treatment, leaving the possibility of early mobilization. New, rapidly...... eliminated anaesthetic drugs are, by virtue of their pharmacodynamic and pharmacokinetic profiles, optimal for use; combined with continuous thoracic epidurals with local anaesthetics and low-dose opioids, these drugs may permit reduction of various post-operative complications. Minimally invasive surgical...

  18. Ergonomic T-Handle for Minimally Invasive Surgical Instruments.

    Science.gov (United States)

    Parekh, J; Shepherd, Det; Hukins, Dwl; Maffulli, N

    2016-05-01

    A T-handle has been designed to be used for minimally invasive implantation of a dynamic hip screw to repair fractures of the proximal femur. It is capable of being used in two actions: (i) push and hold (while using an angle guide) and (ii) application of torque when using the insertion wrench and lag screw tap. The T-handle can be held in a power or precision grip. It is suitable for either single (sterilised by γ-irradiation) or multiple (sterilised by autoclaving) use. The principles developed here are applicable to handles for a wide range of surgical instruments. PMID:27326394

  19. A Computational Investigation Of Minimal Invasive Spine Surgery

    DEFF Research Database (Denmark)

    Rasmussen, Sten; Rasmussen, John

    invasive insertion systems are designed to minimize the approach-related morbidity of traditional lumbar pedicle fixation. A major part of reducing morbidity might be the preservation of the tendon attachment of the muscle. Objectives: The aim of the study was to investigate the implication of preserving......4S1TOSS. This is because both procedures sacrifice muscles spanning L5S1 but only the L4S1 procedure provides force and moment stabilization of L5S1by fusion. Conclusions: The model indicates that the muscle preservation obtained by MISS leaves the patient with significantly better muscular...

  20. Removal of Invisalign retention attachments: a new minimally invasive method.

    Science.gov (United States)

    Ruiz, Jose Luis; Finger, Werner J; Sasazaki, Hiromi; Komatsu, Masahi

    2009-01-01

    Removal of Invisalign resin retention buttons without damaging underlying enamel is a major challenge. To date, the use of tungsten carbide burs is the most common and fastest--yet a risky-ablation method. Stainbuster, a fiber-reinforced resin bur, has been introduced for removal of surface stains and resin remnants from tooth surfaces. This comparative in vitro and in vivo study proved that a combined technique, using multifluted tungsten carbide burs for fast removal of the bulk of resin followed by Stainbuster grinding for gentle removal of the final resin layer, is a safe and minimally invasive procedure for removing composite buttons from enamel.

  1. Minimally invasive neurosurgery: the technical platform for translational medicine

    Institute of Scientific and Technical Information of China (English)

    ZHAO Ji-zong

    2009-01-01

    @@ Translational medicine, normally refers to a process for transitioning from the initial lab discovery to the patient's bedside with minimal disconnect and offers a comprehensive review of statistical design and methodology. It has been advocated repeatedly by worldwide medical scientists as the new prospect highlighting the transition for scientific achievements from laboratory results to clinical application in recent years. As for neurosurgery, it is generally acknowledged that it has been improving in basic research and clinical practice by bounds and leaps; however, the achievements in basic and clinical neurosurgical studies seem to be parallel with no intersection for mutual interaction.Minimally invasive neurosurgery is aimed at serving as the intersection platform for translational medicine.

  2. Bioinspired Nanoparticulate Medical Glues for Minimally Invasive Tissue Repair.

    Science.gov (United States)

    Lee, Yuhan; Xu, Chenjie; Sebastin, Monisha; Lee, Albert; Holwell, Nathan; Xu, Calvin; Miranda Nieves, David; Mu, Luye; Langer, Robert S; Lin, Charles; Karp, Jeffrey M

    2015-11-18

    Delivery of tissue glues through small-bore needles or trocars is critical for sealing holes, affixing medical devices, or attaching tissues together during minimally invasive surgeries. Inspired by the granule-packaged glue delivery system of sandcastle worms, a nanoparticulate formulation of a viscous hydrophobic light-activated adhesive based on poly(glycerol sebacate)-acrylate is developed. Negatively charged alginate is used to stabilize the nanoparticulate surface to significantly reduce its viscosity and to maximize injectability through small-bore needles. The nanoparticulate glues can be concentrated to ≈30 w/v% dispersions in water that remain localized following injection. With the trigger of a positively charged polymer (e.g., protamine), the nanoparticulate glues can quickly assemble into a viscous glue that exhibits rheological, mechanical, and adhesive properties resembling the native poly(glycerol sebacate)-acrylate based glues. This platform should be useful to enable the delivery of viscous glues to augment or replace sutures and staples during minimally invasive procedures.

  3. Intraoperative augmented reality for minimally invasive liver interventions

    Science.gov (United States)

    Scheuering, Michael; Schenk, Andrea; Schneider, Armin; Preim, Bernhard; Greiner, Guenther

    2003-05-01

    Minimally invasive liver interventions demand a lot of experience due to the limited access to the field of operation. In particular, the correct placement of the trocar and the navigation within the patient's body are hampered. In this work, we present an intraoperative augmented reality system (IARS) that directly projects preoperatively planned information and structures extracted from CT data, onto the real laparoscopic video images. Our system consists of a preoperative planning tool for liver surgery and an intraoperative real time visualization component. The planning software takes into account the individual anatomy of the intrahepatic vessels and determines the vascular territories. Methods for fast segmentation of the liver parenchyma, of the intrahepatic vessels and of liver lesions are provided. In addition, very efficient algorithms for skeletonization and vascular analysis allowing the approximation of patient-individual liver vascular territories are included. The intraoperative visualization is based on a standard graphics adapter for hardware accelerated high performance direct volume rendering. The preoperative CT data is rigidly registered to the patient position by the use of fiducials that are attached to the patient's body, and anatomical landmarks in combination with an electro-magnetic navigation system. Our system was evaluated in vivo during a minimally invasive intervention simulation in a swine under anesthesia.

  4. Minimal Invasive Circumferential Management of Thoracolumbar Spine Fractures

    Directory of Open Access Journals (Sweden)

    S. Pesenti

    2015-01-01

    Full Text Available Introduction. While thoracolumbar fractures are common lesions, no strong consensus is available at the moment. Objectives. The aim of this study was to evaluate the results of a minimal invasive strategy using percutaneous instrumentation and anterior approach in the management of thoracolumbar unstable fractures. Methods. 39 patients were included in this retrospective study. Radiologic evaluation was based on vertebral and regional kyphosis, vertebral body height restoration, and fusion rate. Clinical evaluation was based on Visual Analogic Score (VAS. All evaluations were done preoperatively and at 1-year follow-up. Results. Both vertebral and regional kyphoses were significantly improved on postoperative evaluation (13° and 7° versus −1° and −9°  P<0.05, resp. as well as vertebral body height (0.92 versus 1.16, P<0.05. At 1-year follow-up, mean loss of correction was 1°. A solid fusion was visible in all the cases, and mean VAS was significantly reduced form 8/10 preoperatively to 1/10 at the last follow-up. Conclusion. Management of thoracolumbar fractures using percutaneous osteosynthesis and minimal invasive anterior approach (telescopic vertebral body prosthesis is a valuable strategy. Results of this strategy offer satisfactory and stable results in time.

  5. THE ALGORITM OF MINIMAL INVASIVE TREATMENT OF HYDATIC CYST

    Directory of Open Access Journals (Sweden)

    L. Dubei

    2010-02-01

    Full Text Available Hydatid cyst is a parasitosis caused by Taenia Echinococcus. In the last 15 years, new methods of treatment of the hydatid cyst have been proposed. This article is one revue about the modalities of treatment hydatid cyst (HC, especially by a minimally invasive approach. The modalities of approach is the percutaneous and videoscopic technique. The abidance by rules of techniques is the key of the success. The videoscopic approach is conditioned by the existing of the personal calified in this method. The PAIR technique is the recently and modern approach a HHC and the protocol of this technique is very good established. This protocol can be aplied in laparoscopic approach. The open surgical approach of HHC is highly expensive in the postoperative period, therefore a laparoscopic approach may be advocated. The minimally invasive method shortens the postoperative hospitalization period, reduces the number of complications as well as the overall hospitalization expenses and facilitates a rapid social recovery. All these are solid arguments for me to recommend the laparoscopic approach as a standard procedure for hepatic hydatid disease.

  6. Minimally invasive ventriculo-atrial shunt for hydrocephalus

    Institute of Scientific and Technical Information of China (English)

    李江山; 江勇豪; 程成; 张世凯

    2005-01-01

    Objective: To study the therapeutic effect of mini-traumatic ventriculo-atrial shunt on hydrocephalus. Methods: Seventeen patients were treated with right internal jugular venepuncture intubation to finish minimally invasive ventriculo-atrial shunt for hydrocephalus. The patients were evaluated by CT/MRI. The catheters were deployed at the proper position in the right atrium under X-ray fluoroscopy.Results: The hydrocephalus in all the 17 patients eliminated with this surgical procedure with a 100% success rate technically. The operational duration ranged from 0.75 to 1.5 h (average: 1 h). Mistaken puncture into the internal carotid artery as a complication occurred on 1 case.Conclusions: The mini-traumatic ventriculo-atrial shunt, as a novel minimal invasion technique, has the advantages of small trauma, no influence on local blood circulation, short time and simplicity at operation, rapid healing, and good short-term effect. Moreover, it is suitable for those patients with organic dysfunction.

  7. Miniature fibre optic probe for minimally invasive photoacoustic sensing

    Science.gov (United States)

    Mathews, Sunish J.; Zhang, Edward Z.; Desjardins, Adrien E.; Beard, Paul C.

    2016-03-01

    A miniature (175 μm) all-optical photoacoustic probe has been developed for minimally invasive sensing and imaging applications. The probe comprises a single optical fibre which delivers the excitation light and a broadband 50 MHz Fabry-Pérot (F-P) ultrasound sensor at the distal end for detecting the photoacoustic waves. A graded index lens proximal to the F-P sensor is used to reduce beam walk-off and thus increase sensitivity as well as confine the excitation beam in order to increase lateral spatial resolution. The probe was evaluated in non-scattering media and found to provide lateral and axial resolutions of blood vessel mimicking phantom at distances up to 7 mm from the tip was demonstrated in order to illustrate its potential suitability for needle guidance applications.

  8. Acute Lumbar Burst Fracture Treated by Minimally Invasive Lateral Corpectomy

    Directory of Open Access Journals (Sweden)

    Rodrigo Amaral

    2013-01-01

    Full Text Available Burst fractures in acute spinal traumas are a difficult problem to solve. Different approaches and techniques have been utilized, but with high incidence of morbidity and mortality, besides unsatisfactory clinical and radiological results. Mini-open approaches recently emerged and have been shown to be safe and effective in the treatment of several spinal conditions. Here we report a case of acute lumbar burst fracture at L2 treated by minimally invasive true lateral approach posteriorly instrumented with percutaneous pedicle screws. The minimum disruptive access in addition to a rigid construction allowed a lumbar corpectomy without the morbidity of standard open approaches, lowering surgery costs and accelerating the patient recovery with successfully clinical and radiological results.

  9. Minimally invasive percutaneous plate fixation of distal tibia fractures.

    LENUS (Irish Health Repository)

    Bahari, Syah

    2007-10-01

    We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.4 weeks. All fractures united with acceptable alignment and angulation. Two cases of superficial infection were noted, with one case of deep infection. Mean SF36 score was 85 and mean AOFAS score was 90 at a mean of 19 months follow-up. We report satisfactory outcomes with the use of the AO distal tibia locking plate in treatment of unstable distal tibial fractures. Eighty-nine percent of the patients felt that they were back to their pre injury status and 95% back to their previous employment.

  10. Endoskopie, minimal invasive chirurgische und navigierte Verfahren in der Urologie

    Science.gov (United States)

    Grosse, Joachim; von Walter, Matthias; Jakse, Gerhard

    Betrachtet man die letzten 100 Jahre der Urologie in Deutschland seit Gründung ihrer Fachgesellschaft 1906 in Stuttgart, so sind sicherlich die letzten 25 Jahre von umfassenden Entwicklungen mit z. T. vollständigen Umwälzungen bisheriger Therapien und Methoden auf urologischen Fachgebiet gekennzeichnet. In erster Linie handelte es sich dabei um minimal invasive endoskopische Techniken wie perkutane Nierenchirurgie, Ureterorenoskopie, videoendoskopisch unterstütze transurethrale Elektroresektionen der Prostata und von Blasentumore sowie die Laparoskopie. Sie führten zu besseren operativen Ergebnissen und einer deutlichen Senkung der Morbidität der entsprechenden Behandlung urologischer Krankheitsbilder, mit der Konsequenz, dass einige bisher als Standard gültige offene Operationsverfahren abgelöst wurden.

  11. Interventional MRI of the breast: minimally invasive therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hall-Craggs, M.A. [MR Unit, Middlesex Hospital, London (United Kingdom)

    2000-01-01

    In recent years a variety of minimally invasive therapies have been applied to the treatment of breast lesions. These therapies include thermal treatments (interstitial laser coagulation, focused ultrasound, radiofrequency and cryotherapy), percutaneous excision, and interstitial radiotherapy. Magnetic resonance has been used in these treatments to visualize lesions before, during and after therapy and to guide interventions. ''Temperature-sensitive'' sequences have shown changes with thermal ablation which broadly correlate with areas of tumour necrosis. Consequently, MR has the potential to monitor treatment at the time of therapy. To date, experience in the treatment of breast cancer has been restricted to small studies. Large controlled studies are required to validate the efficacy and safety of these therapies in malignant disease. (orig.)

  12. [Minimally Invasive Mitral Valve Plasty;My Technique].

    Science.gov (United States)

    Ito, Toshiaki

    2016-07-01

    We perform minimally invasive mitral valve plasty under totally endoscopic view. Skin incisions are composed of a 3 to 5 cm of main wound along the right 4th intercostal space, 1 trocar port in the 3rd intercostal space, and a camera port in the 5th intercostal space. Matal rib spreader is not used. A 3-dimensional endoscope was recently introduced. Forceps controlled by the left hand are inserted through the independent trocar port in the 3rd intercostal space. Left atrial retractor, aortic clamp, and all the cannulae are inserted through the main incision. Cardio-pulmonary bypass is established through the right femoral artery and vein cannulation. No additional venous cannula through the right jugular vein is used. Posterior leaflet lesions are repaired by resection and suture technique. Anterior leaflet prolapse is repaired mainly using the loop technique. Bleeding from the chest wall is meticulously checked before closing the chest.

  13. Impact of minimally invasive surgery on the pediatric surgical profession.

    Science.gov (United States)

    Jones, Vinci S; Biesheuvel, Cornelis J; Cohen, Ralph C

    2008-12-01

    We conducted a survey among pediatric surgeons to examine the impact of the advent of minimally invasive surgery (MIS) on the pediatric surgical profession with respect to job satisfaction and training challenges. An invitation to participate in a web-based questionnaire was sent out to 306 pediatric surgeons. Apart from demographic details and training recommendations, parameters relevant to job satisfaction, including patient interaction, peer pressure, ethical considerations, academic progress, ability to train residents, and financial remuneration, were studied. The response rate was 38.2%. Working in a unit performing MIS was identified by 71% of respondents as the most effective and feasible modality of training in MIS. Inability to get away from a busy practice was the most common reason cited for inability to acquire MIS training. The overall responses to the job satisfaction parameters showed a positive trend in the current MIS era for patient interaction, ethical considerations, academic progress, and training residents, with a negative trend for peer pressure and financial remuneration. The enthusiastic minimally invasive surgeons (EMIS) were defined as those having more than 5 years of MIS experience and also performing more than 10% of their work using MIS. Of the 113 responses analyzed, 67 belonged to the EMIS category. Those belonging to the EMIS group were less likely to feel inadequate in training their residents, in meeting the felt needs of the patients, or to complain about peer pressure. They were more likely to consider MIS to be as relevant and beneficial in children as in adults. Embracing MIS, as represented by the EMIS group, correlated with an overall greater job satisfaction. PMID:19105675

  14. New minimally invasive approaches for cholecystectomy: Review of literature

    Institute of Scientific and Technical Information of China (English)

    Martin; Gaillard; Hadrien; Tranchart; Panagiotis; Lainas; Ibrahim; Dagher

    2015-01-01

    Laparoscopic cholecystectomy is the most commonlyperformed abdominal intervention in Western countries. In an attempt to reduce the invasiveness of the procedure, surgeons have developed single-incision laparoscopic cholecystectomy(SILC), minilaparoscopic cholecystectomy(MLC) and natural orifice transluminal endoscopic surgery(NOTES). The aim of this review was to determine the role of these new minimally invasive approaches for elective laparoscopic cholecystectomy in the treatment of gallstone related disease. Current literature remains insufficient for the correct assessment of emerging techniques for laparoscopic cholecystectomy. None of these procedures has demonstrated clear benefits over conventional laparoscopic cholecystectomy. SILC cannot be currently recommended as it can be associated with an increased risk of bile duct injury and incisional hernia incidence. NOTES cholecystectomy is still experimental, although hybrid transvaginal cholecystectomy is gaining popularity in clinical practice. As it is standardized and almost identical to the standard laparoscopic technique, MLC could lead to limited benefits without exposing patients to increased postoperative complications, being therefore adoptable for routine elective cholecystectomy. Technical challenges of SILC and NOTES cholecystectomy could be addressed with the evolution of new surgical tools that need to catch up with the innovative minds of surgeons. Regardless the place of these approaches in the future, robotization may be necessary to impose them as standard treatment.

  15. Crystalloid-based cardioplegia for minimally invasive cardiac surgery.

    Science.gov (United States)

    Misfeld, Martin; Davierwala, Piroze

    2012-01-01

    With the ever-increasing popularity of minimally invasive (MI) cardiac surgery, procedures like aortic valve replacement, with or without concomitant aortic surgery, and mitral and tricuspid valve procedures are now routinely performed through a minimal-access partial upper sternotomy and right anterolateral small thoracotomy, respectively, in our institution. To have optimal visualization through a small incision, it is extremely important to reduce the number of instruments, retractors, and cannulae passing through the incision to a bare minimum and to avoid repeated manipulation of the operative field. Repeated use of blood cardioplegia to maintain myocardial protection can sometimes prevent the surgeon from executing the aforementioned measures. However, if adequate myocardial protection can be achieved and maintained by administering a single dose of crystalloid cardioplegia, it would help expedite the operation with greater ease. At our institution, myocardial protection during aortic valve surgery is achieved using either blood or crystalloid cardioplegia according to surgeon preference. However, crystalloid cardioplegia has become the standard myocardial protection strategy for performing MI mitral valve surgery. Our experience with crystalloid cardioplegia for MI mitral valve surgery is the focus of this article.

  16. Craniocervical junction diseases treatment with a minimally invasive approach

    Directory of Open Access Journals (Sweden)

    Roberto Carlos Díaz

    2014-01-01

    Full Text Available Objective: To introduce a new minimally invasive surgical approach to anterior and lateral craniocervical junction diseases, preserving the midline posterior cervical spine stabilizing elements and reducing the inherent morbidity risk associated with traditional approaches. Methods: We describe a novel surgical technique in four cases of extra-medullary anterolateral compressive lesions located in the occipito-cervical junction, including infections and intra- and/or extradural tumor lesions. We used a paramedian trasmuscular approach through an anatomical muscle corridor using a micro MaXcess(r surgical expandable retractor, with the purpose of reducing morbidity and preserving the posterior muscle and ligamentous tension band. Results: This type of surgical approach provides adequate visualization and microsurgical resection of lesions and reduces muscle manipulation and devascularisation, preserving the tension of the ligament complex. There was minimal blood loss and a decrease in postoperative pain, with rapid start of rehabilitation and shorter hospitalization times. There were no intraoperative complications, and all patients recovered from their pre-operative symptoms. Conclusions: This novel surgical technique is feasible and adequate for the occipito-atlanto-axial complex, with better results than traditional procedures.

  17. Is Circumferential Minimally Invasive Surgery Effective in the Treatment of Moderate Adult Idiopathic Scoliosis?

    OpenAIRE

    Anand, Neel; Baron, Eli M.; Khandehroo, Babak

    2014-01-01

    Background Outcomes for minimally invasive scoliosis correction surgery have been reported for mild adult scoliosis. Larger curves historically have been treated with open surgical procedures including facet resections or posterior column osteotomies, which have been associated with high-volume blood loss. Further, minimally invasive techniques have been largely reported in the setting of degenerative scoliosis. Questions/purposes We describe the effects of circumferential minimally invasive ...

  18. Minimally invasive approaches in pancreatic pseudocyst: a Case report

    Directory of Open Access Journals (Sweden)

    Rohollah Y

    2009-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: According to importance of post operative period, admission duration, post operative pain, and acceptable rate of complications, minimally invasive approaches with endoscope in pancreatic pseudocyst management becomes more popular, but the best choice of procedure and patient selection is currently not completely established. During past decade endoscopic procedures are become first choice in most authors' therapeutic plans, however, open surgery remains gold standard in pancreatic pseudocyst treatment."n"nMethods: we present here a patient with pancreatic pseudocyst unresponsive to conservative management that is intervened endoscopically before 6th week, and review current literatures to depict a schema to management navigation."n"nResults: A 16 year old male patient presented with two episodes of acute pancreatitis with abdominal pain, nausea and vomiting. Hyperamilasemia, pancreatic ascites and a pseudocyst were found in our preliminary investigation. Despite optimal conservative management, including NPO (nil per os and total parentral nutrition, after four weeks, clinical and para-clinical findings deteriorated. Therefore, ERCP and trans-papillary cannulation with placement of 7Fr stent was

  19. Minimally invasive tethered cord release in children: A technical note

    Directory of Open Access Journals (Sweden)

    S. Kağan Başarslan

    2014-03-01

    Full Text Available Tethered cord release is commonly performed in pediatric neurosurgery. Nowadays, minimally invasive procedures are created growing interest due to its highly tolerable nature for surgery. It has been main purpose a minimal damaging on access route and maximum protection of normal structures in surgery. We present a surgical treatment of tethered cord syndrome, by which is provided the cord releasing unlike the many methods being applied with tissue removal. The main advantage of performing this surgery through 2 cm hole is to avoid removing ligamentum flavum and bony structure like lamina in addition to reduce the length of the incision and the related scar tissue. J Clin Exp Invest 2014; 5 (1: 115-117 Technical note: the patient was taken on the operating table in the sitting-prone position, and L5-S1 distance was determined by fluoroscopy. The skin and subcutaneous tissues was passed via a 2 cm vertical incision settled in 0.5 cm laterally from midline. L5-S1 distance and its covering ligamentum flavum are displayed by the guidance of L5 lamina. Williams’s retractor was placed in the distance after fetching microscope. The foregoing procedures are the same with microdiscectomic surgery. By a vertical incision made on the flavum, its both layer was lifted up and hanged with simple suture on the back tissue for a comfortable exposure of the Dura. Thecal sac was opened by 0.5 cm long vertical incision on the Dura after obtaining secure CSF drainage with the help of yellow-tipped syringe needle. With finding by a nerve hook, the phylum was burned and released securely. Then the Dura was sutured primarily for the closure by means of microsurgery instruments, and flavum was laid on it again.

  20. Design of Micro Robot for Minimally Invasive Surgery

    Directory of Open Access Journals (Sweden)

    Deiva Ganesh A

    2012-09-01

    Full Text Available Micro robots for medical applications need to be compatible with human body, remotely controllable, smooth in movement, less painful to the patients and capable of performing the designated functions. In this paper, state of the art in the design, fabrication and control of micro robots are presented. First the benefits of micro robots in medical applications are listed out. Second, the predominantly used micro robot designs are discussed. Third, the various fabrication process used in micro robot construction are presented. Fourth, the different approaches used for its operation and control in micro robot technology are narrated. Next based on the review we have designed a swimming micro robot driven by external magnetic fields for minimally invasive surgery. The advantage of EMA is that it can generate a wireless driving force. Then, the locomotive mechanism of the micro robot using EMA is presented. Using the EMA system setup various experiments have been conducted. Finally, the performance of the swimming micro robot is evaluated.  

  1. Minimally invasive glaucoma surgery: current status and future prospects

    Directory of Open Access Journals (Sweden)

    Richter GM

    2016-01-01

    Full Text Available Grace M Richter,1,2 Anne L Coleman11UCLA Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles, CA, USA; 2USC Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USAAbstract: Minimally invasive glaucoma surgery aims to provide a medication-sparing, conjunctival-sparing, ab interno approach to intraocular pressure reduction for patients with mild-to-moderate glaucoma that is safer than traditional incisional glaucoma surgery. The current approaches include: increasing trabecular outflow (Trabectome, iStent, Hydrus stent, gonioscopy-assisted transluminal trabeculotomy, excimer laser trabeculotomy; suprachoroidal shunts (Cypass micro-stent; reducing aqueous production (endocyclophotocoagulation; and subconjunctival filtration (XEN gel stent. The data on each surgical procedure for each of these approaches are reviewed in this article, patient selection pearls learned to date are discussed, and expectations for the future are examined. Keywords: MIGS, microincisional glaucoma surgery, trabecular stent, Schlemm’s canal, suprachoroidal shunt, ab interno

  2. Minimally invasive percutaneous endoscopic discectomy and drainage for infectious spondylodiscitis

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    Tsai-Sheng Fu

    2013-08-01

    Full Text Available The primary goals for treating infectious spondylodiscitis are to make an accurate diagnosis, isolate the causative organism, and prescribe effective antibiotic therapy based on the culture data. A positive culture of the responsible organism is not required for diagnosis, although it is extremely important for successful treatment and prevention of further morbidity. Surgical intervention is usually reserved for cases that are unresponsive to antibiotic therapy and for patients who have developed progressive spinal deformity or instability, epidural abscesses, or neurological impairment. However, the incidence of perioperative morbidity is particularly increased in elderly patients or in those with poor general condition. With improved endoscopic instruments and techniques, our clinical experiences demonstrate that spinal infections can be successfully treated by minimally invasive percutaneous endoscopic debridement. Direct endoscopic observation and collection of sufficient quantities of samples for microbiological examinations from the infected region are usually possible. This article summarizes the diagnostic and therapeutic values of percutaneous endoscopic discectomy and drainage (PEDD used to treat patients with spondylodiscitis. Our clinical evidence-based survey suggests that PEDD can provide adequate retrieval of specimens and has high diagnostic efficacy, thereby enabling prompt and sensitive antibiotic therapy to the offending pathogens. We propose that PEDD is an effective alternative for treating infectious spondylodiscitis and should be considered prior to extensive anterior surgery in selected cases. This method is particularly suitable for patients with early-stage spinal infection or serious medical conditions.

  3. Multiple video sequences synchronization during minimally invasive surgery

    Science.gov (United States)

    Belhaoua, Abdelkrim; Moreau, Johan; Krebs, Alexandre; Waechter, Julien; Radoux, Jean-Pierre; Marescaux, Jacques

    2016-03-01

    Hybrid operating rooms are an important development in the medical ecosystem. They allow integrating, in the same procedure, the advantages of radiological imaging and surgical tools. However, one of the challenges faced by clinical engineers is to support the connectivity and interoperability of medical-electrical point-of-care devices. A system that could enable plug-and-play connectivity and interoperability for medical devices would improve patient safety, save hospitals time and money, and provide data for electronic medical records. In this paper, we propose a hardware platform dedicated to collect and synchronize multiple videos captured from medical equipment in real-time. The final objective is to integrate augmented reality technology into an operation room (OR) in order to assist the surgeon during a minimally invasive operation. To the best of our knowledge, there is no prior work dealing with hardware based video synchronization for augmented reality applications on OR. Whilst hardware synchronization methods can embed temporal value, so called timestamp, into each sequence on-the-y and require no post-processing, they require specialized hardware. However the design of our hardware is simple and generic. This approach was adopted and implemented in this work and its performance is evaluated by comparison to the start-of-the-art methods.

  4. Practical pathology perspectives for minimally invasive hyperthermic medical devices

    Science.gov (United States)

    Coad, James E.

    2011-03-01

    Currently, hyperthermic-based minimally invasive medical devices are available for the treatment of dysfunctional and neoplastic tissues in a variety of organ systems. These therapies employ a spectrum of modalities for delivering heat energy to the targeted tissue, including radiofrequency/microwave, high intensity focused ultrasound, conductive/convective sources and others. While differences in energy transfer and organ systems exist, hyperthermic treatment sites show a spectrum of changes that intimately correlate with the thermal history generated in the tissue (temperature-time dependence). As a result, these hyperthermic medical technologies can be viewed using a "gradient" approach. First, the thermal applications themselves can be globally categorized along a high-dose ablation to low-dose ablation to lowdose non-ablative rejuvenating slope. Second, the resultant tissue changes can be viewed along a decreasing thermal dose gradient from thermally/heat-fixed tissue necrosis to coagulative tissue necrosis to partial tissue necrosis (transition zone) to subtle non-necrotizing tissue changes. Finally, a gradient of cellular and structural protein denaturation is present, especially within the transition zone and adjacent viable tissue region. A hyperthermic treatment's location along these gradients depends more on the overall thermal history it generates than the amount of energy it deposits into the tissue. The features of these gradients are highlighted to provide a better understanding of hyperthermic device associated tissue changes and their associated healing responses.

  5. Minimally-invasive transepidermal potentiometry with microneedle salt bridge.

    Science.gov (United States)

    Abe, Yuina; Nagamine, Kuniaki; Nakabayashi, Mayu; Kai, Hiroyuki; Kaji, Hirokazu; Yamauchi, Takeshi; Yamasaki, Kenshi; Nishizawa, Matsuhiko

    2016-08-01

    A commercial painless microneedle was filled with physiological saline agar, and this needle-based salt bridge was inserted into the skin (a piece of porcine skin and a flank skin of a live mouse) to make an electrical contact with its subepidermal region. The transepidermal potential (TEP), the potential difference between the skin surface and the subepidermal region, was measured using this inner electrode and a conventional agar electrode on the surface of the skin. Control of penetration depth of the inner electrode with a spacer and hydrophilic pretreatment with ozone plasma were found to be necessary for stable measurement. The TEP was reduced upon damages on the skin surface by tape stripping and acetone defatting, which indicated the fabricated needle electrode is useful for the minimally-invasive measurement of TEP and evaluation of skin barrier functions. Furthermore, we showed that the device integrating two electrodes into a single compact probe was useful to evaluate the local barrier functions and their mapping on a skin. This device could be a personal diagnostic tool in the fields of medicine and cosmetics in future.

  6. Percutaneous Iliac Screws for Minimally Invasive Spinal Deformity Surgery

    Directory of Open Access Journals (Sweden)

    Michael Y. Wang

    2012-01-01

    Full Text Available Introduction. Adult spinal deformity (ASD surgeries carry significant morbidity, and this has led many surgeons to apply minimally invasive surgery (MIS techniques to reduce the blood loss, infections, and other peri-operative complications. A spectrum of techniques for MIS correction of ASD has thus evolved, most recently the application of percutaneous iliac screws. Methods. Over an 18 months 10 patients with thoracolumbar scoliosis underwent MIS surgery. The mean age was 73 years (70% females. Patients were treated with multi-level facet osteotomies and interbody fusion using expandable cages followed by percutaneous screw fixation. Percutaneous iliac screws were placed bilaterally using the obturator outlet view to target the ischial body. Results. All patients were successfully instrumented without conversion to an open technique. Mean operative time was 302 minutes and the mean blood loss was 480 cc, with no intraoperative complications. A total of 20 screws were placed successfully as judged by CT scanning to confirm no bony violations. Complications included: two asymptomatic medial breaches at T10 and L5, and one patient requiring delayed epidural hematoma evacuation. Conclusions. Percutaneous iliac screws can be placed safely in patients with ASD. This MIS technique allows for successful caudal anchoring to stress-shield the sacrum and L5-S1 fusion site in long-segment constructs.

  7. Evaluation of robotic minimally invasive surgical skills using motion studies.

    Science.gov (United States)

    Jun, Seung-Kook; Sathia Narayanan, Madusudanan; Singhal, Pankaj; Garimella, Sudha; Krovi, Venkat

    2013-09-01

    Robotic Minimally Invasive Surgery, and the engendered computer-integration, offers unique opportunities for quantitative computer-based surgical-performance evaluation. In this work, we examine extension of traditional manipulative skill assessment, having deep roots in performance evaluation in manufacturing industries, for applicability to robotic surgical skill evaluation. This method relies on: defining task-level segmentation of modular sub-tasks/micro-motions called 'Therbligs' that can be combined to perform a given task; and analyzing intra- and inter-user performance variance by studying surgeons' performance over each 'Therbligs'. Any of the performance metrics of macro-motions-from motion-economy, tool motion measurements to handed-symmetry-can now be extended over the micro-motion temporal segments. Evaluation studies were based on video recordings of surgical tasks in two settings: first, we examined performance of two representative manipulation exercises (peg board and pick-and-place) on a da Vinci surgical SKILLS simulator. This affords a relatively-controlled and standardized test-scenarios for surgeons with varied experience-levels. Second, task-sequences from real surgical videos were analyzed with a list of predefined 'Therbligs' in order to investigate its overall usefulness. PMID:27000920

  8. Canaloplasty: A Minimally Invasive and Maximally Effective Glaucoma Treatment

    Directory of Open Access Journals (Sweden)

    Mahmoud A. Khaimi

    2015-01-01

    Full Text Available Canaloplasty is a highly effective, minimally invasive, surgical technique indicated for the treatment of open-angle glaucoma that works by restoring the function of the eye’s natural outflow system. The procedure’s excellent safety profile and long-term efficacy make it a viable option for the majority of glaucoma patient types. It can be used in conjunction with existing drug based glaucoma treatments, after laser or other types of incisional surgery, and does not preclude or affect the outcome of future surgery. Numerous scientific studies have shown Canaloplasty to be safe and effective in lowering IOP whilst reducing medication dependence. A recent refinement of Canaloplasty, known as ab-interno Canaloplasty (ABiC, maintains the IOP-lowering and safety benefits of traditional (ab-externo Canaloplasty using a more efficient, simplified surgical approach. This paper presents a review of Canaloplasty indications, clinical data, and complications, as well as comparisons with traditional incisional glaucoma techniques. It also addresses the early clinical evidence for ABiC.

  9. MINIMALLY INVASIVE OPEN THYROIDECTOMY IN THYROID CANCER WITH COEXISTENT HASHIMOTO THYROIDITIS

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    Rumen Nenkov

    2013-06-01

    Full Text Available One of the minimally invasive thyroidectomy challenges is the application of this technique in the surgical treatment of thyroid cancer. The use of minimally invasive open approach in co-existence of thyroid cancer with Hashimoto thyroiditis is well known provocation to the skills of the surgeon working in the field of thyroid surgery.Aim: To report our results and to present the possibilities of minimally invasive open approach in the surgical treatment of thyroid carcinoma and coexistent Hashimoto thyroiditis. Patients and methods: For the period from 2008 to 2011, 641 patients were operated on in our clinic using minimally invasive open approach. In 32 of these patients presence of Hashimoto thyroiditis was found in combination with thyroid cancer. All patients were females, 26 to 46 years age. Patients were selected according to designed and accepted for our institution criteria. The procedures were performed using ultrasound (harmonic shears (Harmonic Focus® and Harmonic Ace®, Ethicon Endo-Surgery. The operative time, incidence, type and severity of complications, length of hospital stay, safety and reliability of the surgical procedure were analyzed. Results: The operative incision length in all cases was between 2.0-2.5 cm. In 27 patients papillary thyroid carcinoma and in 5 patients – follicular variant of the neoplasm were found. The tumor size ranged between 0.5 and 1.5 cm. In all patients total thyroidectomy using harmonic scalpel was performed. Lymph node metastases in the central neck compartment were not found in any of the cases. The rate, type and severity of complications did not exceed those for patients who underwent conventional thyroidectomy. All patients leaved the hospital in the first 24 postoperative hours. The follow-up did not reveal remnant thyroid tissue in thyroid gland bed or recurrence of the disease.Conclusions: Our results demonstrate the feasibility and reliability of minimally invasive open approach with

  10. Development of magnetic anchoring and guidance systems for minimally invasive surgery.

    Science.gov (United States)

    Best, Sara L; Cadeddu, Jeffery A

    2010-07-01

    Recent advances in urology have included natural orifice translumenal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). These techniques seek to minimize morbidity by reducing the number of transabdominal port sites, but this comes at a cost of decreased instrument agility and other technical challenges that have prevented LESS and NOTES from entering mainstream urologic practice. Magnetic anchoring and guidance systems (MAGS) consist of instruments that are inserted laparoscopically through an entry in the peritoneal cavity at one point and then driven into position elsewhere and controlled with magnets. These instruments improve the ergonomics of minimally invasive surgery and may help make LESS and NOTES more accessible to urologists across experience levels.

  11. Comparative effectiveness of open versus minimally invasive sacroiliac joint fusion

    Directory of Open Access Journals (Sweden)

    Ledonio CGT

    2014-06-01

    Full Text Available Charles GT Ledonio,1 David W Polly Jr,1 Marc F Swiontkowski,1 John T Cummings Jr2 1Department of Orthopaedic Surgery, University of Minnesota, Twin Cities, MN, 2Community Neurosurgical Care, Indianapolis, IN, USA Background: The mainstay of sacroiliac joint disruption/degenerative sacroiliitis therapy has been nonoperative management. This nonoperative management often includes a regimen of physical therapy, chiropractic treatment, therapeutic injections, and possibly radiofrequency ablation at the discretion of the treating physician. When these clinical treatments fail, sacroiliac joint fusion has been recommended as the standard treatment. Open and minimally invasive (MIS surgical techniques are typical procedures. This study aims to compare the perioperative measures and Oswestry Disability Index (ODI outcomes associated with each of these techniques. Methods: A comparative retrospective chart review of patients with sacroiliac joint fusion and a minimum of 1 year of follow-up was performed. Perioperative measures and ODI scores were compared using the Fisher's exact test and two nonparametric tests, ie, the Mann–Whitney U test and the Wilcoxon signed-rank test. The results are presented as percent or median with range, as appropriate. Results: Forty-nine patients from two institutions underwent sacroiliac joint fusion between 2006 and 2012. Ten patients were excluded because of incomplete data, leaving 39 evaluable patients, of whom 22 underwent open and 17 underwent MIS sacroiliac joint fusion. The MIS group was significantly older (median age 66 [39–82] years than the open group (median age 51 [34–74] years. Surgical time and hospital stay were significantly shorter in the MIS group than in the open group. Preoperative ODI was significantly greater in the open group (median 64 [44–78] than in the MIS group (median 53 [14–84]. Postoperative improvement in ODI was statistically significant within and between groups, with MIS

  12. Reversal of Hartmann's procedure through the stomal side: A new even more minimal invasive technique

    NARCIS (Netherlands)

    J. Vermeulen (Jan); W.W. Vrijland (Wietske); G.H.H. Mannaerts (Guido)

    2008-01-01

    textabstractBackground: Several minimal invasive, mainly laparoscopic-assisted, techniques for reversal of Hartmann's procedure (HP) have been published. The purpose of this pilot study was to assess a minimal invasive procedure through the stomal site that may compare favorably with open or laparos

  13. Minimally invasive pediatric surgery : Increasing implementation in daily practice and resident's training

    NARCIS (Netherlands)

    Velde, E. A. te; Bax, N. M. A.; Tytgat, S. H. A. J.; de Jong, J. R.; Travassos, D. Vieira; Kramer, W. L. M.; van der Zee, D. C.

    2008-01-01

    Background: In 1998, the one-year experience in minimally invasive abdominal surgery in children at a pediatric training center was assessed. Seven years later, we determined the current status of pediatric minimally invasive surgery in daily practice and surgical training. Methods: A retrospective

  14. Nonablative minimally invasive thermal therapies in the treatment of symptomatic benign prostatic hyperplasia.

    NARCIS (Netherlands)

    Ancona, F.C.H. d'

    2008-01-01

    PURPOSE OF REVIEW: As all new treatment modalities nonablative thermal therapy for minimal invasive treatment of benign prostatic hyperplasia should be critically analyzed. This review discusses the literature to identify the merits of these so-called minimally invasive treatments and the place they

  15. Medicolegal Corner: When minimally invasive thoracic surgery leads to paraplegia.

    Science.gov (United States)

    Epstein, Nancy E

    2014-01-01

    A patient with mild cervical myelopathy due to multilevel ossification of the posterior longitudinal ligament (OPLL) initially underwent a cervical C3-T1 laminectomy with C2-T2 fusion utilizing lateral mass screws. The patient's new postoperative right upper extremity paresis largely resolved within several postoperative months. However, approximately 6 months later, the patient developed increased paraparesis attributed to thoracic OPLL and Ossification of the yellow ligament (OYL) at the T2-T5 and T10-T11 levels. The patient underwent simultaneous minimally invasive (MIS) unilateral MetRx approaches to both regions. Postoperatively, the patient was paraplegic and never recovered function. Multiple mistakes led to permanent paraplegia due to MIS MetRx decompressions for T2-T5 and T10-11 OPLL/OYL in this patient. First, both thoracic procedures should have been performed "open" utilizing a full laminectomy rather than MIS; adequate visualization would have likely averted inadvertent cord injury, and the resultant CSF leak. Second, the surgeon should have used an operating microscope. Third, the operation should have been monitored with somatosensory evoked potentials (SEP), motor evoked potentials (MEP), and EMG (electromyography). Fourth, preoperatively the patient should have received a 1-gram dose of Solumedrol for cord "protection". Fifth, applying Gelfoam as part of the CSF leak repair is contraindicated (e.g. due to swelling in confined spaces- see insert). Sixth, if the patient had not stopped Excedrin prior to the surgery, the surgery should have been delayed to avoid the increased perioperative risk of bleeding/hematoma. PMID:24843811

  16. PARASURG hybrid parallel robot for minimally invasive surgery.

    Science.gov (United States)

    Pisla, D; Gherman, B; Plitea, N; Gyurka, B; Vaida, C; Vlad, L; Graur, F; Radu, C; Suciu, M; Szilaghi, A; Stoica, A

    2011-01-01

    This paper presents the parallel hybrid robot, PARASURG 9M, for robotically assisted surgery, a robot which was entirely designed and produced in Romania. It is a versatile robot, being composed of a positioning and orientation module, PARASURG 5M with five degrees of freedom, having the possibility of attaching at its end either a laparoscope or an active surgical instrument for cutting/grasping, PARASIM, with four degrees of freedom. Based on its mathematical modelling, the first low-cost experimental model of the surgical robot has been built. The robot is part of the surgical robotic system, PARAMIS, with three arms, one used as a laparoscope holder, and other two for manipulating active instruments. When it is used as a manipulator of the camera, the user has the possibility to give commands in a large area for the positioning of the laparoscope using different interfaces: joystick, microphone, keyboard & mouse and haptic device. If the active surgical instrument, PARASIM, is attached, the robot commands are given through a haptic device. The main features that make the PARASURG 9M surgical robot suited for minimally invasive surgery are: precision, the elimination of the natural tremor of the surgeon, direct control over a smooth, precise, stable view of the internal surgical field for the surgeon. It also eliminates the need of a second surgeon to be present for the entire procedure (in the case of using the robot as a camera holder). In addition, there is improvement of surgeon dexterity in the case of using the PARASIM active instrument and better ergonomics in using the robot (in the case of the classic laparoscopy, the surgeon must adopt a difficult position for a long period of time, while the robot never gets tired). Having a relatively easy to understand, intuitive commanding system, the surgeons can rapidly adapt to the use of the PARASURG 9M robot in surgical procedures. PMID:22165061

  17. Minimally invasive plate osteosynthesis for distal radius fractures

    Directory of Open Access Journals (Sweden)

    Xu-ming Wei

    2014-01-01

    Full Text Available Background: Fractures of distal radius are common injury in all age groups. Cast treatment with or without close reduction is a viable option. However, the results are often unsatisfactory with restricted function. The open reduction and internal fixation often results in extensive soft tissue dissection and associated high rates of infection and delayed/nonunion. The distractor/external fixator have reported good functional and anatomical results but the incidence of pin traction infection nerve injury and cosmedic deformity are high. We introduced a modified operative technique for minimally invasive plate osteosynthesis (MIPO for distal radial fracture and evaluated the functional outcomes and complications. Materials and Methods: 22 distal radial fractures (10 left, 12 right were treated using the MIPO technique and two small incisions with a palmar locking plate from August 2009 to August 2010. The wrist function was assessed according to Dienst wrist rating system, and postoperative complications were recorded. Results: According to Dienst wrist rating system, 13 patients showed excellent results, 6 cases showed good results and 3 patients had moderate results. No patient had poor results. Thus, the excellent and good rate was 86.4%. One patient had anesthesia in the thenar eminence and this symptom disappeared after 3 months. One patient had delayed healing in the proximal wrist crease. Two patients had mild pain on the ulnar side of the wrist and two patients had limited wrist joint function. Conclusion: The MIPO technique by using two small palmar incisions is safe and effective for treatment of distal radial fractures.

  18. Minimally invasive or noninvasive cardiac output measurement: an update.

    Science.gov (United States)

    Sangkum, Lisa; Liu, Geoffrey L; Yu, Ling; Yan, Hong; Kaye, Alan D; Liu, Henry

    2016-06-01

    Although cardiac output (CO) by pulmonary artery catheterization (PAC) has been an important guideline in clinical management for more than four decades, some studies have questioned the clinical efficacy of CO in certain patient populations. Further, the use of CO by PAC has been linked to numerous complications including dysrhythmia, infection, rupture of pulmonary artery, injury to adjacent arteries, embolization, pulmonary infarction, cardiac valvular damage, pericardial effusion, and intracardiac catheter knotting. The use of PAC has been steadily declining over the past two decades. Minimally invasive and noninvasive CO monitoring have been studied in the past two decades with some evidence of efficacy. Several different devices based on pulse contour analysis are available currently, including the uncalibrated FloTrac/Vigileo system and the calibrated PiCCO and LiDCO systems. The pressure-recording analytical method (PRAM) system requires only an arterial line and is commercially available as the MostCare system. Transesophageal echocardiography (TEE) can measure CO by non-Doppler- or Doppler-based methods. The partial CO2 rebreathing technique, another method to measure CO, is marketed by Novametrix Medical Systems as the NICO system. Thoracic electrical bioimpedance (TEB) and electric bioreactance (EB) are totally noninvasive CO monitoring. Nexfin HD and the newer ClearSight systems are examples of noninvasive CO monitoring devices currently being marketed by Edwards Lifesciences. The developing focus in CO monitoring devices appears to be shifting to tissue perfusion and microcirculatory flow and aimed more at markers that indicate the effectiveness of circulatory and microcirculatory resuscitations. PMID:26961819

  19. Medicolegal Corner: When minimally invasive thoracic surgery leads to paraplegia

    Directory of Open Access Journals (Sweden)

    Nancy E Epstein

    2014-01-01

    Full Text Available A patient with mild cervical myelopathy due to multilevel ossification of the posterior longitudinal ligament (OPLL initially underwent a cervical C3-T1 laminectomy with C2-T2 fusion utilizing lateral mass screws. The patient′s new postoperative right upper extremity paresis largely resolved within several postoperative months. However, approximately 6 months later, the patient developed increased paraparesis attributed to thoracic OPLL and Ossification of the yellow ligament (OYL at the T2-T5 and T10-T11 levels. The patient underwent simultaneous minimally invasive (MIS unilateral MetRx approaches to both regions. Postoperatively, the patient was paraplegic and never recovered function. Multiple mistakes led to permanent paraplegia due to MIS MetRx decompressions for T2-T5 and T10-11 OPLL/OYL in this patient. First, both thoracic procedures should have been performed "open" utilizing a full laminectomy rather than MIS; adequate visualization would have likely averted inadvertent cord injury, and the resultant CSF leak. Second, the surgeon should have used an operating microscope. Third, the operation should have been monitored with somatosensory evoked potentials (SEP, motor evoked potentials (MEP, and EMG (electromyography. Fourth, preoperatively the patient should have received a 1-gram dose of Solumedrol for cord "protection". Fifth, applying Gelfoam as part of the CSF leak repair is contraindicated (e.g. due to swelling in confined spaces- see insert. Sixth, if the patient had not stopped Excedrin prior to the surgery, the surgery should have been delayed to avoid the increased perioperative risk of bleeding/hematoma.

  20. Postoperative metabolic acidosis following the minimally invasive radiofrequency maze procedure

    Directory of Open Access Journals (Sweden)

    Raymond Patrick Hom

    2016-01-01

    Full Text Available Purpose: Atrial fibrillation (AF is the most common arrhythmia treated in the world. While medical treatment with antiarrhythmic drugs remains the primary treatment modality, symptomatic refractory AF often requires treatment with a catheter or surgical ablation. One minimally invasive therapy is the Mini-Maze procedure, which utilizes epicardial radiofrequency ablation via a subxiphoid approach to rid the heart of arrhythmogenic atrial foci without a median sternotomy or cardiopulmonary bypass. The goal of this retrospective cohort study was to identify clinical factors associated with metabolic acidosis following the Mini-Maze procedure. Materials and Methods: After Institutional Review Board approval, we studied patients undergoing the Mini-Maze procedure, off-pump coronary artery bypass grafting or patients conventional Cox-Maze on cardiopulmonary bypass. The first base deficit value obtained in the Intensive Care Unit was used as a measure of metabolic acidosis. Using logistic regression with Akaike information criteria, we analyzed preoperative, intraoperative, and postoperative data to determine the factors associated with changes in base deficit. Results: A multivariable model using stepwise selection demonstrated that diabetes mellitus and weight were associated with a decrease in the base deficit by 2.87 mEq/L (95% CI: −5.55-−0.19 and 0.04 mEq/L (95%CI: −0.08, 0.004, respectively. Furthermore, creatinine was associated with a 1.57 mEq/L (95% CI: 0.14, 2.99 increase in the base deficit. Conclusion: The Mini-Maze procedure was not associated with postoperative metabolic acidosis. Instead, nondiabetic patients and patients with higher creatinine were associated with greater base deficits after undergoing cardiac surgery.

  1. Comparison of minimally invasive parathyroidectomy under local anaesthesia and minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism: a cost analysis

    Science.gov (United States)

    MELFA, G.I.; RASPANTI, C.; ATTARD, M.; COCORULLO, G.; ATTARD, A.; MAZZOLA, S.; SALAMONE, G.; GULOTTA, G.; SCERRINO, G.

    2016-01-01

    Background Primary hyperparathyroidism (PHPT) origins from a solitary adenoma in 70–95% of cases. Moreover, the advances in methods for localizing an abnormal parathyroid gland made minimally invasive techniques more prominent. This study presents a micro-cost analysis of two parathyroidectomy techniques. Patients and methods 72 consecutive patients who underwent minimally invasive parathyroidectomy, video-assisted (MIVAP, group A, 52 patients) or “open” under local anaesthesia (OMIP, group B, 20 patients) for PHPT were reviewed. Operating room, consumable, anaesthesia, maintenance costs, equipment depreciation and surgeons/anaesthesiologists fees were evaluated. The patient’s satisfaction and the rate of conversion to conventional parathyroidectomy were investigated. T-Student’s, Kolmogorov-Smirnov tests and Odds Ratio were used for statistical analysis. Results 1 patient of the group A and 2 of the group B were excluded from the cost analysis because of the conversion to the conventional technique. Concerning the remnant patients, the overall average costs were: for Operative Room, 1186,69 € for the MIVAP group (51 patients) and 836,11 € for the OMIP group (p<0,001); for the Team, 122,93 € (group A) and 90,02 € (group B) (p<0,001); the other operative costs were 1388,32 € (group A) and 928,23 € (group B) (p<0,001). The patient’s satisfaction was very strongly in favour of the group B (Odds Ratio 20,5 with a 95% confidence interval). Conclusions MIVAP is more expensive compared to the “open” parathyroidectomy under local anaesthesia due to the costs of general anaesthesia and the longer operative time. Moreover, the patients generally prefer the local anaesthesia. Nevertheless, the rate of conversion to the conventional parathyroidectomy was relevant in the group of the local anaesthesia compared to the MIVAP, since the latter allows a four-gland exploration. PMID:27381690

  2. Minimally Invasive Procedures - Direct and Video-Assisted Forms in the Treatment of Heart Diseases

    Energy Technology Data Exchange (ETDEWEB)

    Castro, Josué Viana Neto, E-mail: jvcn@uol.com.br [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil); Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Melo, Emanuel Carvalho; Silva, Juliana Fernandes [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil); Rebouças, Leonardo Lemos; Corrêa, Larissa Chagas; Germano, Amanda de Queiroz [Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Machado, João José Aquino [Instituto do Coração do Nordeste (INCONE), Fortaleza, CE (Brazil)

    2014-03-15

    Minimally invasive cardiovascular procedures have been progressively used in heart surgery. To describe the techniques and immediate results of minimally invasive procedures in 5 years. Prospective and descriptive study in which 102 patients were submitted to minimally invasive procedures in direct and video-assisted forms. Clinical and surgical variables were evaluated as well as the in hospital follow-up of the patients. Fourteen patients were operated through the direct form and 88 through the video-assisted form. Between minimally invasive procedures in direct form, 13 had aortic valve disease. Between minimally invasive procedures in video-assisted forms, 43 had mitral valve disease, 41 atrial septal defect and four tumors. In relation to mitral valve disease, we replaced 26 and reconstructed 17 valves. Aortic clamp, extracorporeal and procedure times were, respectively, 91,6 ± 21,8, 112,7 ± 27,9 e 247,1 ± 20,3 minutes in minimally invasive procedures in direct form. Between minimally invasive procedures in video-assisted forms, 71,6 ± 29, 99,7 ± 32,6 e 226,1 ± 42,7 minutes. Considering intensive care and hospitalization times, these were 41,1 ± 14,7 hours and 4,6 ± 2 days in minimally invasive procedures in direct and 36,8 ± 16,3 hours and 4,3 ± 1,9 days in minimally invasive procedures in video-assisted forms procedures. Minimally invasive procedures were used in two forms - direct and video-assisted - with safety in the surgical treatment of video-assisted, atrial septal defect and tumors of the heart. These procedures seem to result in longer surgical variables. However, hospital recuperation was faster, independent of the access or pathology.

  3. Minimally Invasive Procedures - Direct and Video-Assisted Forms in the Treatment of Heart Diseases

    International Nuclear Information System (INIS)

    Minimally invasive cardiovascular procedures have been progressively used in heart surgery. To describe the techniques and immediate results of minimally invasive procedures in 5 years. Prospective and descriptive study in which 102 patients were submitted to minimally invasive procedures in direct and video-assisted forms. Clinical and surgical variables were evaluated as well as the in hospital follow-up of the patients. Fourteen patients were operated through the direct form and 88 through the video-assisted form. Between minimally invasive procedures in direct form, 13 had aortic valve disease. Between minimally invasive procedures in video-assisted forms, 43 had mitral valve disease, 41 atrial septal defect and four tumors. In relation to mitral valve disease, we replaced 26 and reconstructed 17 valves. Aortic clamp, extracorporeal and procedure times were, respectively, 91,6 ± 21,8, 112,7 ± 27,9 e 247,1 ± 20,3 minutes in minimally invasive procedures in direct form. Between minimally invasive procedures in video-assisted forms, 71,6 ± 29, 99,7 ± 32,6 e 226,1 ± 42,7 minutes. Considering intensive care and hospitalization times, these were 41,1 ± 14,7 hours and 4,6 ± 2 days in minimally invasive procedures in direct and 36,8 ± 16,3 hours and 4,3 ± 1,9 days in minimally invasive procedures in video-assisted forms procedures. Minimally invasive procedures were used in two forms - direct and video-assisted - with safety in the surgical treatment of video-assisted, atrial septal defect and tumors of the heart. These procedures seem to result in longer surgical variables. However, hospital recuperation was faster, independent of the access or pathology

  4. Minimal intervention dentistry: part 7. Minimally invasive operative caries management: rationale and techniques.

    Science.gov (United States)

    Banerjee, A

    2013-02-01

    When patients present with cavities causing pain, poor aesthetics and/or functional problems restorations will need to be placed. Minimally invasive caries excavation strategies can be deployed depending on the patient's caries risk, lesion-pulp proximity and vitality, the extent of remaining supra-gingival tooth structure and clinical factors (for example, moisture control, access). Excavation instruments, including burs/handpieces, hand excavators, chemo-mechanical agents and/or air-abrasives limiting caries removal selectively to the more superficial caries-infected dentine and partial removal of caries-affected dentine when required, help create smaller cavities with healthy enamel/dentine margins. Using adhesive restorative materials the operator can, if handling with care, optimise the histological substrate coupled with the applied chemistry of the material so helping to form a durable peripheral seal and bond to aid retention of the restoration as well as arresting the carious process within the remaining tooth structure. Achieving a smooth tooth-restoration interface clinically to aid the cooperative, motivated patient in biofilm removal is an essential pre-requisite to prevent further secondary caries.

  5. Minimally invasive plate osteosynthesis for humerus diaphyseal fractures

    Directory of Open Access Journals (Sweden)

    M Shantharam Shetty

    2011-01-01

    Full Text Available Background: Minimally invasive plate osteosynthesis (MIPO technique is reported as a satisfactory procedure for the treatment of humeral shaft fractures by the anterior approach by several authors. However, none of the published reports had a significant follow-up nor have they reported patient outcomes. We evaluated the clinical, radiographic, and functional outcome over a minimum follow-up of 2 years using the same MIPO technique to humeral shaft fracture. Materials and Methods: 32 adult patients with diaphyseal fractures of the humerus treated with MIPO between June 2007 and October 2008 were included in the study. Patients with metabolic bone disease, polytrauma, and Gustilo and Anderson type 3 open fractures with injury severity score >16 were excluded from the study. All cases were treated with closed indirect reduction and locking plate fixation using the MIPO technique. The surgery time, radiation exposure, and time for union was noted. The shoulder and elbow function was assessed using the UCLA shoulder and Mayo elbow performance scores, respectively. Results: Of the 32 patients in the study, 19 were males and 13 were females. The mean age was 39 years (range: 22-70 years. Twenty-seven of the thirty-two patients (84.3% had the dominant side fractured. We had eight cases of C2 type; five cases of C1 and A2 type; four cases of B2 type; three cases each of B3, B1, and A1 type; and one case of A3 type of fracture. The mean surgical time was 91.5 minutes (range: 70-120 minutes and mean radiation exposure was 160.3 seconds (range: 100-220 seconds. The mean radiological fracture union time was 12.9 weeks (range: 10-20 weeks. Shoulder function was excellent in 27 cases (84.3% and good in remaining 5 cases (15.6% on the UCLA score. Elbow function was excellent in 26 cases (81.2%, good in 5 cases (15.6%, and fair in 1 case (3.1% who had an associated olecranon fracture that was fixed by tension band wire in the same sitting. Conclusion: MIPO of

  6. Minimally invasive approaches for histological diagnosis of anterior mediastinal masses

    Institute of Scientific and Technical Information of China (English)

    FANG Wen-tao; XU Mei-ying; CHEN Gang; CHEN Yong; CHEN Wen-hu

    2007-01-01

    diagnostic yield in mediastinal mass is rather low. Superior to core needle biopsy, biopsy through a mini-mediastinotomy under local anesthesia is highly effective in the histological diagnosis of anterior mediastinal mass, and has a satisfactory diagnostic yield. The method is safe, minimally invasive, cost-effective, and useful in therapeutic decision making for anterior mediastinal masses.

  7. Validation of a New Minimally Invasive Intracranial Pressure Monitoring Method by Direct Comparison with an Invasive Technique.

    Science.gov (United States)

    Vilela, Gustavo Henrique Frigieri; Cabella, Brenno; Mascarenhas, Sérgio; Czosnyka, Marek; Smielewski, Peter; Dias, Celeste; Cardim, Danilo Augusto; Mascarenhas, Yvonne Maria; Wang, Charles Chenwei; Andrade, Rodrigo; Tanaka, Koji; Lopes, Luiza Silva; Colli, Benedicto Oscar

    2016-01-01

    In this chapter we present in vivo experiments with a new minimally invasive method of monitoring intracranial pressure (ICP). Strain gauge deformation sensors are externally glued onto the exposed skull. The signal from these sensors is amplified, filtered, and sent to a computer with appropriate software for analysis and data storage. Saline infusions into the spinal channel of rats were performed to produce ICP changes, and minimally invasive ICP and direct Codman intraparenchymal ICP were simultaneously acquired in six animals. The similarity between the invasive and minimally invasive methods in response to ICP increase was assessed using Pearson's correlation coefficient. It demonstrated good agreement between the two measures  = 0.8 ± 0.2, with a range of 0.31-0.99. PMID:27165885

  8. New real-time MR image-guided surgical robotic system for minimally invasive precision surgery

    Energy Technology Data Exchange (ETDEWEB)

    Hashizume, M.; Yasunaga, T.; Konishi, K. [Kyushu University, Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Fukuoka (Japan); Tanoue, K.; Ieiri, S. [Kyushu University Hospital, Department of Advanced Medicine and Innovative Technology, Fukuoka (Japan); Kishi, K. [Hitachi Ltd, Mechanical Engineering Research Laboratory, Hitachinaka-Shi, Ibaraki (Japan); Nakamoto, H. [Hitachi Medical Corporation, Application Development Office, Kashiwa-Shi, Chiba (Japan); Ikeda, D. [Mizuho Ikakogyo Co. Ltd, Tokyo (Japan); Sakuma, I. [The University of Tokyo, Graduate School of Engineering, Bunkyo-Ku, Tokyo (Japan); Fujie, M. [Waseda University, Graduate School of Science and Engineering, Shinjuku-Ku, Tokyo (Japan); Dohi, T. [The University of Tokyo, Graduate School of Information Science and Technology, Bunkyo-Ku, Tokyo (Japan)

    2008-04-15

    To investigate the usefulness of a newly developed magnetic resonance (MR) image-guided surgical robotic system for minimally invasive laparoscopic surgery. The system consists of MR image guidance [interactive scan control (ISC) imaging, three-dimensional (3-D) navigation, and preoperative planning], an MR-compatible operating table, and an MR-compatible master-slave surgical manipulator that can enter the MR gantry. Using this system, we performed in vivo experiments with MR image-guided laparoscopic puncture on three pigs. We used a mimic tumor made of agarose gel and with a diameter of approximately 2 cm. All procedures were successfully performed. The operator only advanced the probe along the guidance device of the manipulator, which was adjusted on the basis of the preoperative plan, and punctured the target while maintaining the operative field using robotic forceps. The position of the probe was monitored continuously with 3-D navigation and 2-D ISC images, as well as the MR-compatible laparoscope. The ISC image was updated every 4 s; no artifact was detected. A newly developed MR image-guided surgical robotic system is feasible for an operator to perform safe and precise minimally invasive procedures. (orig.)

  9. Robust model-based 3d/3D fusion using sparse matching for minimally invasive surgery.

    Science.gov (United States)

    Neumann, Dominik; Grbic, Sasa; John, Matthias; Navab, Nassir; Hornegger, Joachim; Ionasec, Razvan

    2013-01-01

    Classical surgery is being disrupted by minimally invasive and transcatheter procedures. As there is no direct view or access to the affected anatomy, advanced imaging techniques such as 3D C-arm CT and C-arm fluoroscopy are routinely used for intra-operative guidance. However, intra-operative modalities have limited image quality of the soft tissue and a reliable assessment of the cardiac anatomy can only be made by injecting contrast agent, which is harmful to the patient and requires complex acquisition protocols. We propose a novel sparse matching approach for fusing high quality pre-operative CT and non-contrasted, non-gated intra-operative C-arm CT by utilizing robust machine learning and numerical optimization techniques. Thus, high-quality patient-specific models can be extracted from the pre-operative CT and mapped to the intra-operative imaging environment to guide minimally invasive procedures. Extensive quantitative experiments demonstrate that our model-based fusion approach has an average execution time of 2.9 s, while the accuracy lies within expert user confidence intervals. PMID:24505663

  10. Neuroendocrine tumors (carcinoids of the stomach and intestines - early diagnosis and minimally invasive endoscopic procedures

    Directory of Open Access Journals (Sweden)

    Kuryk O.G.

    2014-03-01

    Full Text Available Background. Neuroendocrine tumors of the stomach and intestines are rare diseases. Increasing incidence and complexity of diagnosis of these diseases cause acuteness of the problem. Objective. To evaluate the effectiveness of morphological examination of endoscopic biopsy material for diagnostics of neuroendocrine tumors and for evaluation of completeness of minimally invasive endoscopic surgical interventions (endoscopic mucosal resection and endoscopic submucosal dissection at neuroendocrine tumors. Methods. On the basis of Medical center "Oberig" in 2009 - 2013 in eight cases neuroendocrine tumors were diagnosed: 2 (25 % in the stomach, 2 (25% – in the duodenum, 2 (25% - in the small intestine, 1 (12.5 % - in the ascending colon, 1 (12.5% - in the rectum. Neuroendocrine tumors of stomach and ileum were removed by endoscopic mucosal resection, duodenal bulb and rectum neuroendocrine tumors – by endoscopic submucosal dissection, papillary duodenum, colon and jejunum neuroendocrine tumors – by surgical resection. Results. It was shown, that morphological evaluation of endoscopic mucosal biopsies is effective way to diagnose the neuroendocrine tumors. Conclusion. Endoscopic mucosal resection and endoscopic submucosal dissection allows to get advanced material for morphological diagnosis of neuroendocrine tumors and an adequate method of their removing Citation: Kuryk OG, Yakovenko VO, Bazdyrev VV, Bodnar LV. [Neuroendocrine tumors (carcinoids of the stomach and intestines - early diagnosis and minimally invasive endoscopic procedures]. Morphologia. 2014;8(1:58-64. Ukrainian.

  11. Minimally invasive treatment of peristomal metastases from gastric cancer at an ileostomy site by electrochemotherapy

    International Nuclear Information System (INIS)

    Peristomal metastases are rare, but potentially associated with relevant morbidity. Surgical resection, followed by stoma relocation, represent the gold standard in most patients. We describe electrochemotherapy (ECT), a minimally invasive method for locally-enhancing drug delivery by means of electric pulses, as an alternative approach. A 49-year-old man with advanced gastric cancer developed skin metastases around an ileostomy site. The ulcerated and oozing tumor growth impaired patient’s quality of life due to continuous trouble in fitting the ostomy appliance, its poor adherence and consequent stools spillage. ECT consisted of a 20-minute course under mild general sedation. A bleomycin bolus of 15 000 IU/m2 was followed by the percutaneous application of multiple, 1.5 ms -long electric pulses by means of a needle electrode. Post ECT course was uneventful and the patient was discharged on the same day. After one week, tumor nodules were flattened and partial tumor regression was appreciable at one-month follow-up. More importantly, peristomal skin conditions significantly improved, thus allowing for an effective application of the ostomy appliance during the following moths, until patient’s death. This report suggests the feasibility of ECT as a minimally invasive approach for peristomal tumors. In selected cases, ECT, by achieving a rapid tumor control, may ensure effective ostomy management and preserve patients’ quality of life

  12. Esthetic Smile Design: Limited Orthodontic Therapy to Position Teeth for Minimally Invasive Veneer Preparation.

    Science.gov (United States)

    Miro, Andi-Jean; Shalman, Alex; Morales, Ramiro; Giannuzzi, Nicholas J

    2015-07-01

    The standards of dentistry are being elevated, with a greater emphasis being placed on esthetics along with functionality. Minimally invasive dentistry has become an essential component in creating restorations that are functional and have increased longevity. In the case discussed in this article, the patient underwent 9 months of orthodontic therapy to correct her improper overbite and overjet, and the spacing of her dentition so the teeth could be positioned for future minimally invasive restorations. Orthodontic therapy was paramount in positioning the teeth so that the future restorations would have ideal axial inclinations and be as minimally invasive as possible.

  13. Open radical retropubic prostatectomy 2007: the true minimally invasive surgery for localized prostate cancer?

    Science.gov (United States)

    Nosnik, Israel P; Gan, Tong J; Moul, Judd W

    2007-09-01

    The introduction of robotic laparoscopic assisted prostatectomy at our institution and nationwide has been a great advancement and has caused us to focus and fine-tune our goal for improvements in prostate cancer outcomes whether the patient elects for robotic laparoscopic assisted prostatectomy or open minimally invasive radical retropubic prostatectomy. While these authors favor the open technique performed by highly skilled urologic surgical oncologists, the lessons we have learned to date suggest that it is the skill of the surgeon that determines outcome, regardless of whether or not the operation is performed by an open or robotic laparoscopic technique. The concepts we have articulated here are related to resection and avoidance of positive margins, limited intraoperative blood loss and pain control, which allow equivalence in these outcome areas, regardless of technique.

  14. Steering and Harvesting Technology for Minimally Invasive Biopsy

    NARCIS (Netherlands)

    Jelínek, F.

    2015-01-01

    Contemporary medical imaging technologies, such as computed tomography or magnetic resonance imaging, play a pivotal role in medical diagnosis, allowing for a relatively fast and non-invasive examination of the human body. In the field of cancer surgery they allow for preoperative detection of tumor

  15. Minimally invasive transforaminal lumbar interbody fusion Results of 23 consecutive cases

    Directory of Open Access Journals (Sweden)

    Amit Jhala

    2014-01-01

    Conclusion: The study demonstrates a good clinicoradiological outcome of minimally invasive TLIF. It is also superior in terms of postoperative back pain, blood loss, hospital stay, recovery time as well as medication use.

  16. Minimally Invasive Hip Surgery Isn't Always the Right Choice

    Science.gov (United States)

    ... Minimally Invasive Hip Surgery Isn't Always the Right Choice One-third of older patients may need ... hip arthroscopy for a labral tear in the right patient is an "excellent" surgery. It helps accommodate ...

  17. Comparative Review of Endoscopic Devices Articulations Technologies Developed for Minimally Invasive Medical Procedures

    Directory of Open Access Journals (Sweden)

    Julien Catherine

    2011-01-01

    Full Text Available This study introduces a comparative performance analysis of the technological solutions that have been used to build distal active articulations for minimally invasive medical procedures. The aim is to provide a practical and concise database and classification tool for anyone that wants to learn more about the technologies involved in minimally invasive medical devices, or for any designer interested in further improving these devices. A review of the different articulations developed in this field is therefore performed and organized by both actuation technology and structural architecture. Details are presented concerning the mechanical structures as well as the actuation and the mechanical transmission technologies available. The solutions are evaluated keeping as a reference some chosen required performances and characteristics for minimally invasive surgical procedures. Finally, a quantified comparison chart of these devices is given regarding selected criteria of interest for minimally invasive surgical application.

  18. Minimally invasive is the future of left ventricular assist device implantation.

    Science.gov (United States)

    Makdisi, George; Wang, I-Wen

    2015-09-01

    There have been many factors that have allowed for progressive improvement in outcomes and lower complication rates. These include the improvement in left ventricular assist device (LVAD) technologies, combined with better understanding of patient management, all these. Nowadays the numbers of LVAD implantations exceed the number of annual heart transplants worldwide. Minimally invasive procedures are shown to improve the surgical outcome in both LVAD insertion and replacement. These minimally invasive techniques can be grouped grossly into shifting from on-pump to off-pump implantation, alternative access for implantation other than sternotomy, and a combination of both, which should be the ultimate aim of minimally invasive LVAD implantation. Here we describe the alternative techniques and configurations of minimally invasive and sites of implantation. PMID:26543617

  19. Minimally invasive is the future of left ventricular assist device implantation

    Science.gov (United States)

    Makdisi, George

    2015-01-01

    There have been many factors that have allowed for progressive improvement in outcomes and lower complication rates. These include the improvement in left ventricular assist device (LVAD) technologies, combined with better understanding of patient management, all these. Nowadays the numbers of LVAD implantations exceed the number of annual heart transplants worldwide. Minimally invasive procedures are shown to improve the surgical outcome in both LVAD insertion and replacement. These minimally invasive techniques can be grouped grossly into shifting from on-pump to off-pump implantation, alternative access for implantation other than sternotomy, and a combination of both, which should be the ultimate aim of minimally invasive LVAD implantation. Here we describe the alternative techniques and configurations of minimally invasive and sites of implantation. PMID:26543617

  20. Minimally invasive transforaminal lumbar interbody fusion—indications and clinical experience

    Directory of Open Access Journals (Sweden)

    Akshay Hari

    2016-01-01

    Conclusions: Our clinical experience along with a review of the medical literature indicates that TLIF can be effectively and safely performed in a minimally invasive fashion for a wide variety of indications.

  1. Past, Present, and Future of Minimally Invasive Abdominal Surgery

    OpenAIRE

    Antoniou, Stavros A.; Antoniou, George A.; Antoniou, Athanasios I.; Granderath, Frank-Alexander

    2015-01-01

    Laparoscopic surgery has generated a revolution in operative medicine during the past few decades. Although strongly criticized during its early years, minimization of surgical trauma and the benefits of minimization to the patient have been brought to our attention through the efforts and vision of a few pioneers in the recent history of medicine. The German gynecologist Kurt Semm (1927–2003) transformed the use of laparoscopy for diagnostic purposes into a modern therapeutic surgical concep...

  2. Minimizing Risks of Invasive Alien Plant Species in Tropical Production Forest Management

    Directory of Open Access Journals (Sweden)

    Michael Padmanaba

    2014-08-01

    Full Text Available Timber production is the most pervasive human impact on tropical forests, but studies of logging impacts have largely focused on timber species and vertebrates. This review focuses on the risk from invasive alien plant species, which has been frequently neglected in production forest management in the tropics. Our literature search resulted in 114 publications with relevant information, including books, book chapters, reports and papers. Examples of both invasions by aliens into tropical production forests and plantation forests as sources of invasions are presented. We discuss species traits and processes affecting spread and invasion, and silvicultural practices that favor invasions. We also highlight potential impacts of invasive plant species and discuss options for managing them in production forests. We suggest that future forestry practices need to reduce the risks of plant invasions by conducting surveillance for invasive species; minimizing canopy opening during harvesting; encouraging rapid canopy closure in plantations; minimizing the width of access roads; and ensuring that vehicles and other equipment are not transporting seeds of invasive species. Potential invasive species should not be planted within dispersal range of production forests. In invasive species management, forewarned is forearmed.

  3. Anterior Spinal Artery Syndrome: Reversible Paraplegia after Minimally Invasive Spine Surgery

    OpenAIRE

    Bredow, J.; Oppermann, J.; Keller, K.; F. Beyer; Boese, C. K.; Zarghooni, K.; Sobottke, R.; Eysel, P.; Siewe, J.

    2014-01-01

    Background Context. Percutaneous balloon kyphoplasty is an established minimally invasive technique to treat painful vertebral compression fractures, especially in the context of osteoporosis with a minor complication rate. Purpose. To describe the heparin anticoagulation treatment of paraplegia following balloon kyphoplasty. Study Design. We report the first case of an anterior spinal artery syndrome with a postoperative reversible paraplegia following a minimally invasive spine surgery (bal...

  4. Minimally invasive video-assisted thyroidectomy: experience of 200 cases in a single center

    OpenAIRE

    Haitao, Zheng; Jie, Xu; Lixin, Jiang

    2014-01-01

    Introduction Minimally invasive techniques in thyroid surgery including video-assisted technique originally described by Miccoli have been accepted in several continents for more than 10 years. Aim To analyze our preliminary results from minimally invasive video-assisted thyroidectomy (MIVAT) and to evaluate the feasibility and effects of this method in a general department over a 4-year period. Material and methods Initial experience was presented based on a series of 200 patients selected f...

  5. Minimally invasive scoliosis surgery: an innovative technique in patients with adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Gambassi Melanie

    2011-08-01

    Full Text Available Abstract Minimally invasive spine surgery is becoming more common in the treatment of adult lumbar degenerative disorders. Minimally invasive techniques have been utilized for multilevel pathology, including adult lumbar degenerative scoliosis. The next logical step is to apply minimally invasive surgical techniques to the treatment of adolescent idiopathic scoliosis (AIS. However, there are significant technical challenges of performing minimally invasive surgery on this patient population. For more than two years, we have been utilizing minimally invasive spine surgery techniques in patients with adolescent idiopathic scoliosis. We have developed the present technique to allow for utilization of all standard reduction maneuvers through three small midline skin incisions. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, and allows adequate facet osteotomy to enable fusion. There are multiple potential advantages of this technique, including: less blood loss, shorter hospital stay, earlier mobilization, and relatively less pain and need for pain medication. The operative time needed to complete this surgery is longer. We feel that a minimally invasive approach, although technically challenging, is a feasible option in patients with adolescent idiopathic scoliosis. Although there are multiple perceived benefits, long term data is needed before it can be recommended for routine use.

  6. Conceptual frameworks and methods for advancing invasion ecology.

    Science.gov (United States)

    Heger, Tina; Pahl, Anna T; Botta-Dukát, Zoltan; Gherardi, Francesca; Hoppe, Christina; Hoste, Ivan; Jax, Kurt; Lindström, Leena; Boets, Pieter; Haider, Sylvia; Kollmann, Johannes; Wittmann, Meike J; Jeschke, Jonathan M

    2013-09-01

    Invasion ecology has much advanced since its early beginnings. Nevertheless, explanation, prediction, and management of biological invasions remain difficult. We argue that progress in invasion research can be accelerated by, first, pointing out difficulties this field is currently facing and, second, looking for measures to overcome them. We see basic and applied research in invasion ecology confronted with difficulties arising from (A) societal issues, e.g., disparate perceptions of invasive species; (B) the peculiarity of the invasion process, e.g., its complexity and context dependency; and (C) the scientific methodology, e.g., imprecise hypotheses. To overcome these difficulties, we propose three key measures: (1) a checklist for definitions to encourage explicit definitions; (2) implementation of a hierarchy of hypotheses (HoH), where general hypotheses branch into specific and precisely testable hypotheses; and (3) platforms for improved communication. These measures may significantly increase conceptual clarity and enhance communication, thus advancing invasion ecology.

  7. [Planning and simulation of minimally-invasive robotic heart surgery].

    Science.gov (United States)

    Coste-Manière, Eve; Adhami, Louaï; Severac-Bastide, Renault; Boissonnat, Jean-Daniel; Carpentier, Alain

    2002-04-01

    Due to their numerous advantages, mainly in terms of patient benefit, mini-invasive robotically assisted interventions are gaining in importance in various surgical fields. However, this conversion has its own challenges that stem from both its novelty and complexity. In this paper we propose to accompany the surgeons in their transition, by offering an integrated environment that enables them to make better use of this new technology. The proposed system is patient-dependent, and enables the planning, validation, simulation, teaching and archiving of robotically assisted interventions. The approach is illustrated for a coronary bypass graft using the daVinci tele-operated robot. PMID:12161911

  8. Is minimally invasive parathyroid surgery an option for patients with gestational primary hyperparathyroidism?

    OpenAIRE

    Bendinelli, Cino; Nebauer, Shane; Quach, Tuan; McGrath, Shaun; Acharya, Shamasunder

    2013-01-01

    Background Gestational primary hyperparathyroidism is associated with serious maternal and neonatal complications, which require prompt surgical treatment. Minimally invasive parathyroidectomy reduces pain, improves cosmesis and may achieve cure rates comparable to traditional open bilateral neck exploration. We report the clinical course of a woman with newly diagnosed gestational primary hyperparathyroidism and discuss the decision making behind the choice of video-assisted minimally invasi...

  9. Resection of an Occipital-Cervical Junction Schwannoma through a modified minimally invasive approach: Technical Note

    Directory of Open Access Journals (Sweden)

    Michael Feldman

    2015-01-01

    Conclusion: In properly selected patients, minimally invasive approaches to the OCJ for resection of mass lesions are feasible, provide adequate visualization of tumor and surrounding structures, and may even be preferable given the lower morbidity of a smaller incision and minimal soft tissue dissection.

  10. Minimally invasive cosmetic dentistry: smile reconstruction using direct resin bonding.

    Science.gov (United States)

    Prieto, Lucia Trazzi; Araujo, Cintia Tereza Pimenta; de Oliveira, Dayane Carvalho Ramos Salles; de Azevedo Vaz, Sergio Lins; D'Arce, Maria Beatriz Freitas; Paulillo, Luis Alexandre Maffei Sartini

    2014-01-01

    Discrepancies in tooth size and shape can interfere with smile harmony. Composite resin can be used to improve the esthetics of the smile at a low cost while offering good clinical performance. This article presents an approach for restoring and correcting functional, anatomic, and esthetic discrepancies with minimal intervention, using composites and a direct adhesive technique. This conservative restorative procedure provided the patient with maximum personal esthetic satisfaction.

  11. Minimally Invasive Cardiac Surgery Using a 3D High-Definition Endoscopic System.

    Science.gov (United States)

    Ruttkay, Tamas; Götte, Julia; Walle, Ulrike; Doll, Nicolas

    2015-01-01

    We describe a minimally invasive heart surgery application of the EinsteinVision 2.0 3D high-definition endoscopic system (Aesculap AG, Tuttlingen, Germany) in an 81-year-old man with severe tricuspid valve insufficiency. Fourteen years ago, he underwent a Ross procedure followed by a DDD pacemaker implantation 4 years later for tachy-brady-syndrome. His biventricular function was normal. We recommended minimally invasive tricuspid valve repair. The application of the aformentioned endoscopic system was simple, and the impressive 3D depth view offered an easy and precise manipulation through a minimal thoracotomy incision, avoiding the need for a rib spreading retractor.

  12. Probabilistic sparse matching for robust 3D/3D fusion in minimally invasive surgery.

    Science.gov (United States)

    Neumann, Dominik; Grbic, Sasa; John, Matthias; Navab, Nassir; Hornegger, Joachim; Ionasec, Razvan

    2015-01-01

    Classical surgery is being overtaken by minimally invasive and transcatheter procedures. As there is no direct view or access to the affected anatomy, advanced imaging techniques such as 3D C-arm computed tomography (CT) and C-arm fluoroscopy are routinely used in clinical practice for intraoperative guidance. However, due to constraints regarding acquisition time and device configuration, intraoperative modalities have limited soft tissue image quality and reliable assessment of the cardiac anatomy typically requires contrast agent, which is harmful to the patient and requires complex acquisition protocols. We propose a probabilistic sparse matching approach to fuse high-quality preoperative CT images and nongated, noncontrast intraoperative C-arm CT images by utilizing robust machine learning and numerical optimization techniques. Thus, high-quality patient-specific models can be extracted from the preoperative CT and mapped to the intraoperative imaging environment to guide minimally invasive procedures. Extensive quantitative experiments on 95 clinical datasets demonstrate that our model-based fusion approach has an average execution time of 1.56 s, while the accuracy of 5.48 mm between the anchor anatomy in both images lies within expert user confidence intervals. In direct comparison with image-to-image registration based on an open-source state-of-the-art medical imaging library and a recently proposed quasi-global, knowledge-driven multi-modal fusion approach for thoracic-abdominal images, our model-based method exhibits superior performance in terms of registration accuracy and robustness with respect to both target anatomy and anchor anatomy alignment errors. PMID:25095250

  13. Total abdominal hysterectomy versus minimal-invasive hysterectomy: a systemic review and meta-analysis

    International Nuclear Information System (INIS)

    INTRODUCTION. At the present time three types of hysterectomies are used: the vaginal hysterectomy and the minimal-invasive hysterectomy (MIH). The objective of present research was to compare the MIH and the total abdominal hysterectomy (TAH) in women presenting with benign uterine diseases. METHODS. A systemic review was made and a meta-analysis from the following databases: MEDLINE, EBSCO HOST AND The Cochrane Central Register of Controlled Trials. Only the controlled and randomized studies were selected. The data of all studies were combined and also the relative risk (RR) with a 95% CI was used with the Mantel-Haenszel method as an effect measure for dichotomy variables. For the analysis of continuing variables the mean difference was used. In all the comparisons performed the results were obtained with the fix effect and randomized forms. RESULTS. A total of 53 transoperative complications were registered in the MIH hysterectomy versus 17 in the TAH group (RR: 1,78; 95% CI: 1,04-3.05). Postoperative complications evolved in a similar way in both groups without significant differences from the statistical point of view. The blood losses, the hospital stay and the patient's reincorporation to usual and work activities were lesser in the laparoscopy group; however, the operative time is higher when it is compared with TAH (mean difference: 37,36; 95% CI: 34,36-39,93). CONCLUSIONS. Both techniques have advantages and disadvantages. The indication of MIH must to be individualized according to the clinical situation of each patient and these not to be performed in those centers without a properly trained surgical staff and with experience in advanced minimal invasive surgery. (author)

  14. ENDOSCOPIC SLEEVE GASTROPLASTY - MINIMALLY INVASIVE THERAPY FOR PRIMARY OBESITY TREATMENT

    Science.gov (United States)

    GALVÃO-NETO, Manoel dos Passos; GRECCO, Eduardo; de SOUZA, Thiago Ferreira; de QUADROS, Luiz Gustavo; SILVA, Lyz Bezerra; CAMPOS, Josemberg Marins

    2016-01-01

    ABSTRACT Background: Less invasive and complex procedures have been developed to treat obesity. The successful use of Endoscopic Sleeve Gastroplasty using OverStitch(r) (Apollo Endosurgery, Austin, Texas, USA) has been reported in the literature. Aim: Present technical details of the procedure and its surgical/ endoscopic preliminary outcome. Method: The device was used to perform plications along the greater curvature of the stomach, creating a tubulization similar to a sleeve gastrectomy. Result: A male patient with a BMI of 35.17 kg/m2 underwent the procedure, with successful achievement of four plications, and preservation of gastric fundus. The procedure was successfully performed in 50 minutes, time without bleeding or other complications. The patient presented mild abdominal pain and good acceptance of liquid diet. Conclusions: The endoscopic gastroplasty procedure was safe, with acceptable technical viability, short in duration and without early complications. PMID:27683786

  15. Minimally invasive surgical method to detect sound processing in the cochlear apex by optical coherence tomography

    Science.gov (United States)

    Ramamoorthy, Sripriya; Zhang, Yuan; Petrie, Tracy; Fridberger, Anders; Ren, Tianying; Wang, Ruikang; Jacques, Steven L.; Nuttall, Alfred L.

    2016-02-01

    Sound processing in the inner ear involves separation of the constituent frequencies along the length of the cochlea. Frequencies relevant to human speech (100 to 500 Hz) are processed in the apex region. Among mammals, the guinea pig cochlear apex processes similar frequencies and is thus relevant for the study of speech processing in the cochlea. However, the requirement for extensive surgery has challenged the optical accessibility of this area to investigate cochlear processing of signals without significant intrusion. A simple method is developed to provide optical access to the guinea pig cochlear apex in two directions with minimal surgery. Furthermore, all prior vibration measurements in the guinea pig apex involved opening an observation hole in the otic capsule, which has been questioned on the basis of the resulting changes to cochlear hydrodynamics. Here, this limitation is overcome by measuring the vibrations through the unopened otic capsule using phase-sensitive Fourier domain optical coherence tomography. The optically and surgically advanced method described here lays the foundation to perform minimally invasive investigation of speech-related signal processing in the cochlea.

  16. Minimally invasive surgery for live kidney donors: techniques and challenges.

    Science.gov (United States)

    Brook, Nicholas R; Nicholson, Michael L

    2005-09-01

    Live kidney donation is assuming an increasingly prominent role in kidney transplantation programs. The traditional operative approach has been through an incision in the upper quadrant of the abdomen or in the loin, with the attendant potential postoperative complications associated with a large surgical wound. These problems may act as disincentives to prospective donors. The introduction of laparoscopic donor surgery in 1995 heralded a new era offering reduced post-operative pain and improved cosmetic result. It is hoped that these benefits may counter some disincentives and thereby increase donation rates. Three minimal-access approaches and their advantages and disadvantages are described: classical laparoscopic, hand-assisted laparoscopic, and retroperitoneoscopic surgery. Published reports indicate extensive experience with the first 2 of these approaches and less experience with the latter. All 3 approaches present technical, physiological, and anatomical challenges in the context of retrieving an organ that is fit for transplantation. For minimal-access surgery to be accepted as the procedure of choice for live kidney donors, it must be demonstrated that morbidity is not transferred from donor to recipient when these techniques are used. Some concerns about these procedures are addressed. High-level evidence in the form of randomized controlled trials is generally lacking, but experiences of surgeons and patients suggest that, with appropriate modifications, these techniques are safe for both donors and allografts and also benefit donors' recovery. PMID:16252632

  17. Hepatic artery pseudoaneurysm after surgical treatment for pancreatic cancer: Minimally invasive angiographic techniques as the preferred treatment

    Directory of Open Access Journals (Sweden)

    Sucandy Iswanto

    2014-01-01

    Full Text Available Background: Delayed intra-abdominal bleeding related to hepatic artery pseudoaneurysm is a potentially lethal complication after pancreaticoduodenectomy for pancreatic cancer. Locally advanced tumors, which result in vessel erosion or extensive operative skeletonization, may contribute to weakness of the arterial wall. Reoperation is often technically difficult with high rate of mortality; therefore, alternative less invasive options are ideal. Aims: The study was to present an alternative endovascular treatment of a large hepatic artery pseudoaneurysm after pancreatic resection for locally advanced multicystic adenocarcinoma. Materials and Methods: Transcatheteric mesenteric angiography with deployment of detachable coils in the pseudoaneurysm sac was utilized to manage the hepatic artery pseudoaneurysm. Results: Completion angiography confirmed cessation of contrast enhancement in the pseudoaneurysm sac with preservation of normal antegrade hepatic artery flow. Conclusion: Minimally invasive angiographic technique is the preferred treatment for hepatic artery pseudoaneurysm after pancreatic resections.

  18. PORCELAIN LAMINATE VENEERS: A MINIMALLY INVASIVE ESTHETIC PROCEDURE

    OpenAIRE

    Tajammul

    2013-01-01

    ABSTRACT: With the advancement in the area of cosmetic dentistry, the dental profession has been offered new opportunities in conservative and esthetic restorative procedures. Multiple options are available to treat problems arising in the zone of high esthetic sensitivity. The use of porcelain laminate veneers to solve esthetic and/or functional problems has shown to be a valid treatment option especially in the anterior esthetic zone. The techniques and the materials em...

  19. Contemporary minimally invasive therapeutics in the management of tissue pathologies

    OpenAIRE

    Jerjes, W

    2015-01-01

    The aim of this thesis was to investigate and evaluate the effect of photodynamic therapy (PDT) in the management of tissue pathologies as well as the advances in photodynamic applications. Firstly, 5-ALA-PDT and mTHPC-PDT were applied in the management of superficial tissue disease. This includes oral dysplasia (147 patients), early stage oral squamous cell carcinoma (38 patients), actinic keratosis (62 patients), basal cell carcinoma (148 patients) and cutaneous squamous cell carcinoma (22 ...

  20. Minimally invasive technique for curettage of chondroblastoma using endoscopic technique.

    Science.gov (United States)

    Errani, C; Traina, F; Chehrassan, M; Donati, D; Faldini, C

    2014-11-01

    Chondroblastoma is a rare benign bone tumor. The treatment for chondroblastoma usually consists of curettage of the lesion and packing the tumor cavity with bone grafts or bone cement. However, chondroblastomas are known to recur in 10% to 20% of cases after excision, possibly because the incomplete removal of pathological tissue at surgery. We present a case of chondroblastoma in the distal femur treated by endoscopic curettage, which allowed a complete resection of tumor tissue and a minimal damage of the bone. The patient had relief of symptoms, rapid function restoration and no local recurrence. Endoscopic curettage is a promising new treatment for chondroblastoma. In fact, the extra-articular technique enters the tumor cavity via a tunnel drilled through the medullary canal, allowing to visualize possible residual tumor tissue or defects of the articular surface, without violating the joint and without taking away a much bigger cortical window.

  1. Minimally invasive technique for curettage of chondroblastoma using endoscopic technique.

    Science.gov (United States)

    Errani, C; Traina, F; Chehrassan, M; Donati, D; Faldini, C

    2014-11-01

    Chondroblastoma is a rare benign bone tumor. The treatment for chondroblastoma usually consists of curettage of the lesion and packing the tumor cavity with bone grafts or bone cement. However, chondroblastomas are known to recur in 10% to 20% of cases after excision, possibly because the incomplete removal of pathological tissue at surgery. We present a case of chondroblastoma in the distal femur treated by endoscopic curettage, which allowed a complete resection of tumor tissue and a minimal damage of the bone. The patient had relief of symptoms, rapid function restoration and no local recurrence. Endoscopic curettage is a promising new treatment for chondroblastoma. In fact, the extra-articular technique enters the tumor cavity via a tunnel drilled through the medullary canal, allowing to visualize possible residual tumor tissue or defects of the articular surface, without violating the joint and without taking away a much bigger cortical window. PMID:25491613

  2. PORCELAIN LAMINATE VENEERS: A MINIMALLY INVASIVE ESTHETIC PROCEDURE

    Directory of Open Access Journals (Sweden)

    Tajammul

    2013-11-01

    Full Text Available ABSTRACT: With the advancement in the area of cosmetic dentistry, the dental profession has been offered new opportunities in conservative and esthetic restorative procedures. Multiple options are available to treat problems arising in the zone of high esthetic sensitivity. The use of porcelain laminate veneers to solve esthetic and/or functional problems has shown to be a valid treatment option especially in the anterior esthetic zone. The techniques and the materials employed to fabricate porcelain laminate veneers offer satisfactory, predictable and lasting results. The current porcelain veneers are esthetically superior, conservative and durable treatment modality

  3. 妇科医师的微创理念与技艺%Gynaecologists Minimally Invasive Concept and Skills

    Institute of Scientific and Technical Information of China (English)

    凌斌

    2013-01-01

    The concept of minimally invasive belongs to the category of philosophy.It is the essence of advanced active subjective thought,embodies the integrity,loyalty and kindness to patients and medicine.Minimally invasive technology is the original passive clinical technological means,requires highly skilled and wonderful artistry excelling nature.Minimally invasive concept determines minimally invasive techniques,predicts the future of clinical medicine,accepts critical thinking,challenges traditional medicine behavior and promotes accurate treatment.Minimally invasive concept advocated to retain organs and functions,both to resist excessive treatment,also don't agree with insufficient treatment.Clinical minimally invasive wise decision lies in the proper definition of degree of removal of organs.In the face of the change of disease,if taking constant strategy of treatments for various diseases,the degree of treatment is unavoidably biased.%微创理念属于哲学范畴,是先进主动的主观思想的精髓,体现对医学与患者的忠诚、笃信和仁爱;微创技术是原始被动使用的临床手段,要求技艺精湛,巧夺天工.微创理念决定微创技术,促进建立批判性思维,挑战传统医学行为,推崇精准化治疗,预示临床医学的未来.微创理念倡导保留器官和功能,既抵触过度治疗,也不苟同治疗不足,临床微创决策在于恰到好处地界定器官取舍之度,面对复杂多变之病,秉承以不变应万变之策,治疗之度则难免有失偏颇.

  4. Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal-Repair Modification: Functional Evaluation and Safety Assessment of a New Minimally Invasive Method of Treatment of Advanced Hemorrhoidal Disease

    Directory of Open Access Journals (Sweden)

    Piotr Walega

    2012-01-01

    Full Text Available Purpose: We present 12-month followup results of functional evaluation and safety assessment of a modification of hemorrhoidal artery ligation (DGHAL called Recto-Anal-Repair (RAR in treatment of advanced hemorrhoidal disease (HD. Methods: Patients with grade III and IV HD underwent the RAR procedure (DGHAL combined with restoration of prolapsed hemorrhoids to their anatomical position with longitudinal sutures. Each patient had rectal examination, anorectal manometry, and QoL questionnaire performed before 3 months, and 12 months after RAR procedure. Results: 20 patients completed 12-month followup. There were no major complications. 3 months after RAR, 5 cases of residual mucosal prolapse were detected (25%, while only 3 patients (15% reported persistence of symptoms. 12 months after RAR, another 3 HD recurrences were detected, to a total of 8 patients (40% with HD recurrence. Anal pressures after RAR were significantly lower than before (P<0.05, and the effect was persistent 12 months after RAR. One patient (5% reported occasional soiling 3 months after RAR. Conclusions: RAR seems to be a safe method of treatment of advanced HD with no major complications. The procedure has a significant influence on anal pressures, with no evidence of risk of fecal incontinence after the operation.

  5. Humane accomplishment of physicians and the philosophy of minimally-invasive and noninvasive medicine: A perspective.

    Science.gov (United States)

    Ling, Bin; Lang, Jinghe

    2015-11-01

    The highest realm in clinical medicine is the harmonious unity of medical sciences and the humanistic spirit. Given that the beauty of human nature resides in humanity, a competent medical practitioner should be a sage that personifies the rigorous scientific spirit and the humanity. It is essential for a medical practitioner to learn to seek answers to medical inquiries at the philosophical level. Important as it is to study the organs, the cells and the functions of the body, medical practitioners need to be well-versed in the utmost beauty of mankind. The central tenet of minimally-invasive therapeutic medicine is to minimize harm to patients while effectively managing the lesion. The radical changes brought about by minimally-invasive technologies, exemplified by the non-invasive high intensity focused ultrasound (HIFU) surgery, are to change the face of traditional surgery.

  6. Minimally-invasive treatment of high velocity intra-articular fractures of the distal tibia.

    LENUS (Irish Health Repository)

    Leonard, M

    2012-02-01

    The pilon fracture is a complex injury. The purpose of this study was to evaluate the outcome of minimally invasive techniques in management of these injuries. This was a prospective study of closed AO type C2 and C3 fractures managed by early (<36 hours) minimally invasive surgical intervention and physiotherapist led rehabilitation. Thirty patients with 32 intra-articular distal tibial fractures were treated by the senior surgeon (GK). Our aim was to record the outcome and all complications with a minimum two year follow-up. There were two superficial wound infections. One patient developed a non-union which required a formal open procedure. Another patient was symptomatic from a palpable plate inferiorly. An excellent AOFAS result was obtained in 83% (20\\/24) of the patients. Early minimally invasive reduction and fixation of complex high velocity pilon fractures gave very satisfactory results at a minimum of two years follow-up.

  7. Concurrent Minimally Invasive Carpal Tunnel Release Techniques in Distal Radius Open Reduction Internal Fixation.

    Science.gov (United States)

    Low, O-Wern; Cheah, Andre E J

    2016-02-01

    Carpal tunnel syndrome is a common complication associated with distal radius fractures. Open carpal tunnel release in the same setting as open reduction and internal fixation of distal radius fractures is widely accepted. In this paper, we describe the technical details of a minimally invasive carpal tunnel release in the same setting as the fixation of a distal radius fracture via the same incision. Two options of minimally invasive techniques are described: The Knifelight® (Stryker, Kalamazoo, Michigan, USA) instrument and the single portal carpal tunnel release system (Agee, 3M Healthcare, St Paul, Minnesota, USA). Being well known and accepted techniques of carpal tunnel release, we believe that the techniques described in this paper provide a viable alternative for carpal tunnel release in the setting of distal radius fracture fixation; with the added advantages of the original minimally invasive techniques. PMID:27454517

  8. Intra-operative tumour localisation in robot-assisted minimally invasive surgery: A review.

    Science.gov (United States)

    Li, Min; Liu, Hongbin; Jiang, Allen; Seneviratne, Lakmal D; Dasgupta, Prokar; Althoefer, Kaspar; Wurdemann, Helge

    2014-05-01

    Robot-assisted minimally invasive surgery has many advantages compared to conventional open surgery and also certain drawbacks: it causes less operative trauma and faster recovery times but does not allow for direct tumour palpation as is the case in open surgery. This article reviews state-of-the-art intra-operative tumour localisation methods used in robot-assisted minimally invasive surgery and in particular methods that employ force-based sensing, tactile-based sensing, and medical imaging techniques. The limitations and challenges of these methods are discussed and future research directions are proposed.

  9. Developing neonatal minimally invasive surgery: Innovation, techniques, and helping an industry to change.

    Science.gov (United States)

    Rothenberg, Steven S

    2015-02-01

    The field of minimally invasive surgery (MIS) in neonates and infants is a relatively new field, evolving over the last 20years. This has required the development of not only new techniques but new instruments. The process has resulted in a unique partnership between pediatric minimally invasive surgeons and industry, as both groups have struggled to find the right mix of need, technical viability, and economic sustainability. The results have spawned a new generation of MIS instrumentation that not only enables the neonatal MIS surgeon but also leads the way in the field of mini-laparoscopy in children and adults.

  10. Complications of Minimally Invasive, Tubular Access Surgery for Cervical, Thoracic, and Lumbar Surgery

    OpenAIRE

    Ross, Donald A.

    2014-01-01

    The object of the study was to review the author's large series of minimally invasive spine surgeries for complication rates. The author reviewed a personal operative database for minimally access spine surgeries done through nonexpandable tubular retractors for extradural, nonfusion procedures. Consecutive cases (n = 1231) were reviewed for complications. There were no wound infections. Durotomy occurred in 33 cases (2.7% overall or 3.4% of lumbar cases). There were no external or symptomati...

  11. Making minimally invasive THR safe: conclusions from biomechanical simulation and analysis

    OpenAIRE

    Noble, P. C.; Johnston, J D; Alexander, J. A.; Thompson, M. T.; Usrey, M. M.; Heinrich, E. M.; Landon, G. C.; Mathis, K. B.

    2007-01-01

    The use of smaller surgical incisions has become popularized for total hip arthroplasty (THR) because of the potential benefits of shorter recovery and improved cosmetic appearance. However, an increased incidence of serious complications has been reported. To minimize the risks of minimally invasive approaches to THR, we have developed an experimental approach which enables us to evaluate risk factors in these procedures through cadaveric simulations performed within the laboratory. During c...

  12. Full Mouth Rehabilitation by Minimally Invasive Cosmetic Dentistry Coupled with Computer Guided Occlusal Analysis: A Case Report.

    Science.gov (United States)

    Sarita; Thumati, Prafulla

    2014-12-01

    Evidence of dentistry dates back to 7000 B.C. and since then has come, indeed a long sophisticated way in treatment management of our dental patients. There have been admirable advances in the field of prosthodontics by the way of techniques and materials; enabling production of artificial teeth that feel, function and appear nothing but natural. The following case report describes the management of maxillary edentulousness with removable complete denture and mandibular attrition and missing teeth with onlays and FPD by the concept of minimally invasive cosmetic dentistry. Computer guided occlusal analysis was used to guide sequential occlusal adjustments to obtain measurable bilateral occlusal contacts simultaneously.

  13. Minimally Invasive Video-Assisted Thyroidectomy and Parathyroidectomy with Intraoperative Recurrent Laryngeal Nerve Monitoring

    Directory of Open Access Journals (Sweden)

    Emad Kandil

    2009-01-01

    Full Text Available Objective. Our goal is to study the feasibility of using intraoperative neuromonitoring (IONM in minimally invasive video-assisted thyroidectomy and parathyroidectomy (MIVAT/P with emphasis given to the identification of recurrent laryngeal nerve (RLN. Methods. Consecutive series of forty-seven patients with seventy-seven recurrent laryngeal nerves at risk undergoing both MIVAT/P and IONM were enrolled in this retrospective, nonrandomized analysis study. All operations were performed by the same surgeon within an academic institution setting. All patients underwent vocal cord evaluation postoperatively. Demographics and intraoperative and postoperative complications following surgery were collected. Results. Out of seventy-seven RLNs, there was one permanent unilateral RLN injury (1.29% in a patient with advanced papillary thyroid cancer, managed by cord injection. There was another transient RLN paresis that resolved spontaneously (1.29%. There were no instances of equipment malfunction or interference. Conclusions. To our knowledge, this is the first reported MIVAT/P series from the United States of America with a standardized IONM technique. The technical feasibility of IONM seems acceptable and may serve as a meaningful adjunct to the visual identification of nerves. Neuromonitoring during MIVAT/P is effective in providing identification of laryngeal nerves and enables surgeons to feel more comfortable with MIVAT/P. Comparative series are needed for further evaluation.

  14. Anesthetic challenges in minimally invasive cardiac surgery: Are we moving in a right direction?

    Science.gov (United States)

    Malik, Vishwas; Jha, Ajay Kumar; Kapoor, Poonam Malhotra

    2016-01-01

    Continuously growing patient's demand, technological innovation, and surgical expertise have led to the widespread popularity of minimally invasive cardiac surgery (MICS). Patient's demand is being driven by less surgical trauma, reduced scarring, lesser pain, substantially lesser duration of hospital stay, and early return to normal activity. In addition, MICS decreases the incidence of postoperative respiratory dysfunction, chronic pain, chest instability, deep sternal wound infection, bleeding, and atrial fibrillation. Widespread media coverage, competition among surgeons and hospitals, and their associated brand values have further contributed in raising awareness among patients. In this process, surgeons and anesthesiologist have moved from the comfort of traditional wide incision surgeries to more challenging and intensively skilled MICS. A wide variety of cardiac lesions, techniques, and approaches coupled with a significant learning curve have made the anesthesiologist's job a challenging one. Anesthesiologists facilitate in providing optimal surgical settings beginning with lung isolation, confirmation of diagnosis, cannula placement, and cardioplegia delivery. However, the concern remains and it mainly relates to patient safety, prolonged intraoperative duration, and reduced surgical exposure leading to suboptimal treatment. The risk of neurological complications, aortic injury, phrenic nerve palsy, and peripheral vascular thromboembolism can be reduced by proper preoperative evaluation and patient selection. Nevertheless, advancement in surgical instruments, perfusion practices, increasing use of transesophageal echocardiography, and accumulating experience of surgeons and anesthesiologist have somewhat helped in amelioration of these valid concerns. A patient-centric approach and clear communication between the surgeon, anesthesiologist, and perfusionist are vital for the success of MICS.

  15. Anesthetic challenges in minimally invasive cardiac surgery: Are we moving in a right direction?

    Science.gov (United States)

    Malik, Vishwas; Jha, Ajay Kumar; Kapoor, Poonam Malhotra

    2016-01-01

    Continuously growing patient's demand, technological innovation, and surgical expertise have led to the widespread popularity of minimally invasive cardiac surgery (MICS). Patient's demand is being driven by less surgical trauma, reduced scarring, lesser pain, substantially lesser duration of hospital stay, and early return to normal activity. In addition, MICS decreases the incidence of postoperative respiratory dysfunction, chronic pain, chest instability, deep sternal wound infection, bleeding, and atrial fibrillation. Widespread media coverage, competition among surgeons and hospitals, and their associated brand values have further contributed in raising awareness among patients. In this process, surgeons and anesthesiologist have moved from the comfort of traditional wide incision surgeries to more challenging and intensively skilled MICS. A wide variety of cardiac lesions, techniques, and approaches coupled with a significant learning curve have made the anesthesiologist's job a challenging one. Anesthesiologists facilitate in providing optimal surgical settings beginning with lung isolation, confirmation of diagnosis, cannula placement, and cardioplegia delivery. However, the concern remains and it mainly relates to patient safety, prolonged intraoperative duration, and reduced surgical exposure leading to suboptimal treatment. The risk of neurological complications, aortic injury, phrenic nerve palsy, and peripheral vascular thromboembolism can be reduced by proper preoperative evaluation and patient selection. Nevertheless, advancement in surgical instruments, perfusion practices, increasing use of transesophageal echocardiography, and accumulating experience of surgeons and anesthesiologist have somewhat helped in amelioration of these valid concerns. A patient-centric approach and clear communication between the surgeon, anesthesiologist, and perfusionist are vital for the success of MICS. PMID:27397454

  16. Single-port access laparoscopic hysterectomy: a new dimension of minimally invasive surgery.

    Science.gov (United States)

    Liliana, Mereu; Alessandro, Pontis; Giada, Carri; Luca, Mencaglia

    2011-01-01

    The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. This review summarizes the history of SPAL hysterectomy (single-port access laparoscopy), and emphasizes nomenclature, surgical technique, instrumentation, and perioperative outcomes. Specific gynecological applications of single-port hysterectomy to date are summarized. Using the PubMed database, the English-language literature was reviewed for the past 40 years. Keyword searches included scarless, scar free, single-port/trocar/incision, single-port access laparoscopic hysterectomy. Within the bibliography of selected references, additional sources were retrieved. The purpose of the present article was to review the development and current status of SPAL hysterectomy and highlight important advances associated with this innovative approach. PMID:22442528

  17. A Parametric Study Delineating Irreversible Electroporation from Thermal Damage Based on a Minimally Invasive Intracranial Procedure

    OpenAIRE

    Ellis Thomas L; Neal Robert E; Rossmeisl John H; Garcia Paulo A; Davalos Rafael V

    2011-01-01

    Abstract Background Irreversible electroporation (IRE) is a new minimally invasive technique to kill undesirable tissue in a non-thermal manner. In order to maximize the benefits from an IRE procedure, the pulse parameters and electrode configuration must be optimized to achieve complete coverage of the targeted tissue while preventing thermal damage due to excessive Joule heating. M...

  18. Minimally Invasive Techniques to Accelerate the Orthodontic Tooth Movement: A Systematic Review of Animal Studies

    Directory of Open Access Journals (Sweden)

    Irfan Qamruddin

    2015-01-01

    Full Text Available Objective. To evaluate various noninvasive and minimally invasive procedures for the enhancement of orthodontic tooth movement in animals. Materials and Methods. Literature was searched using NCBI (PubMed, PubMed Central, and PubMed Health, MedPilot (Medline, Catalogue ZB MED, Catalogue Medicine Health, and Excerpta Medica Database (EMBASE, and Google Scholar from January 2009 till 31 December 2014. We included original articles related to noninvasive and minimally invasive procedures to enhance orthodontic tooth movement in animals. Extraction of data and quality assessments were carried out by two observers independently. Results. The total number of hits was 9195 out of which just 11 fulfilled the inclusion criteria. Nine articles were good and 5 articles were moderate in quality. Low level laser therapy (LLLT was among the most common noninvasive techniques whereas flapless corticision using various instruments was among the commonest minimally invasive procedures to enhance velocity of tooth movement. Conclusions. LLLT, low intensity pulsed ultrasound (LIPUS, mechanical vibration, and flapless corticision are emerging noninvasive and minimally invasive techniques which need further researches to establish protocols to use them clinically with conviction.

  19. Minimally invasive diagnosis of sarcoidosis by EBUS when conventional diagnostics fail

    DEFF Research Database (Denmark)

    Eckardt, J; Olsen, K E; Jørgensen, O D;

    2010-01-01

    Endobronchial ultrasound-guided transbronchial fine-needle aspiration (EBUS) is a minimally invasive method used routinely for mediastinal staging of patients with lung cancer. EBUS has also proved to be a valuable diagnostic tool for patients with different intrathoracic lesions who remain...... undiagnosed despite bronchoscopy and CT-guided fine-needle aspiration....

  20. Perioperative outcomes in minimally invasive lumbar spine surgery: A systematic review

    OpenAIRE

    Skovrlj, Branko; Belton, Patrick; Zarzour, Hekmat; Qureshi, Sheeraz A.

    2015-01-01

    AIM: To compare minimally invasive (MIS) and open techniques for MIS lumbar laminectomy, direct lateral and transforaminal lumbar interbody fusion (TLIF) surgeries with respect to length of surgery, estimated blood loss (EBL), neurologic complications, perioperative transfusion, postoperative pain, postoperative narcotic use, and length of stay (LOS).

  1. Minimally invasive non-thermal laser technology using laser-induced optical breakdown for skin rejuvenation

    NARCIS (Netherlands)

    Habbema, L.; Verhagen, R.; Van Hal, R.; Liu, Y.; Varghese, B.

    2011-01-01

    We describe a novel, minimally invasive laser technology for skin rejuvenation by creating isolated microscopic lesions within tissue below the epidermis using laser induced optical breakdown. Using an in-house built prototype device, tightly focused near-infrared laser pulses are used to create opt

  2. Implementation of simulation in surgical practice : Minimally invasive surgery has taken the lead: The Dutch experience

    NARCIS (Netherlands)

    Schreuder, Henk W. R.; Oei, Guid; Maas, Mario; Borleffs, Jan C. C.; Schijven, Marlies P.

    2011-01-01

    Minimal invasive techniques are rapidly becoming standard surgical techniques for many surgical procedures. To develop the skills necessary to apply these techniques, box trainers and/or inanimate models may be used, but these trainers lack the possibility of inherent objective classification of res

  3. Implementation of simulation in surgical practice: Minimally invasive surgery has taken the lead: The Dutch experience

    NARCIS (Netherlands)

    H.W.R. Schreuder; G. Oei; M. Maas; J.C.C. Borleffs; M.P. Schijven

    2011-01-01

    Minimal invasive techniques are rapidly becoming standard surgical techniques for many surgical procedures. To develop the skills necessary to apply these techniques, box trainers and/or inanimate models may be used, but these trainers lack the possibility of inherent objective classification of res

  4. Degradable Magnetic Composites for Minimally Invasive Interventions: Device Fabrication, Targeted Drug Delivery, and Cytotoxicity Tests.

    Science.gov (United States)

    Peters, Christian; Hoop, Marcus; Pané, Salvador; Nelson, Bradley J; Hierold, Christofer

    2016-01-20

    Superparamagnetic nanoparticles and a functional, degradable polymer matrix based on poly(ethylene glycol) are combined to enable fully degradable magnetic microdevices for minimally invasive biomedical applications. A bioinspired helical microrobot platform mimicking Escherichia coli bacteria is fabricated and actuated using weak rotating magnetic fields. Locomotion based on corkscrew propulsion, targeted drug delivery, and low-degradation-product cytotoxicity are demonstrated. PMID:26603856

  5. Accurate and efficient fiber optical shape sensor for MRI compatible minimally invasive instruments

    NARCIS (Netherlands)

    Heiden, M.S. van der; Henken, K.R.; Cheng, L.K.; Bosch, B.G. van den; Braber, R. van den; Dankelman, J.; Dobbelsteen, J.J. van den

    2012-01-01

    Background: The mechanical properties of small minimally invasive instruments are limited and thus must be treated as flexible instruments. Proper functional behavior of these instruments can be significantly enhanced when the instrument is equipped with a shape sensor to track the path of the flexi

  6. Minimally Invasive Techniques to Accelerate the Orthodontic Tooth Movement: A Systematic Review of Animal Studies

    Science.gov (United States)

    Qamruddin, Irfan; Alam, Mohammad Khursheed; Khamis, Mohd Fadhli; Husein, Adam

    2015-01-01

    Objective. To evaluate various noninvasive and minimally invasive procedures for the enhancement of orthodontic tooth movement in animals. Materials and Methods. Literature was searched using NCBI (PubMed, PubMed Central, and PubMed Health), MedPilot (Medline, Catalogue ZB MED, Catalogue Medicine Health, and Excerpta Medica Database (EMBASE)), and Google Scholar from January 2009 till 31 December 2014. We included original articles related to noninvasive and minimally invasive procedures to enhance orthodontic tooth movement in animals. Extraction of data and quality assessments were carried out by two observers independently. Results. The total number of hits was 9195 out of which just 11 fulfilled the inclusion criteria. Nine articles were good and 5 articles were moderate in quality. Low level laser therapy (LLLT) was among the most common noninvasive techniques whereas flapless corticision using various instruments was among the commonest minimally invasive procedures to enhance velocity of tooth movement. Conclusions. LLLT, low intensity pulsed ultrasound (LIPUS), mechanical vibration, and flapless corticision are emerging noninvasive and minimally invasive techniques which need further researches to establish protocols to use them clinically with conviction. PMID:26881201

  7. Endotracheal suctioning versus minimally invasive airway suctioning in intubated patients : a prospective randomised controlled trial

    NARCIS (Netherlands)

    Van de Leur, JP; Zwaveling, JH; Loef, BG; Van der Schans, CP

    2003-01-01

    Study objective: Endotracheal suctioning in intubated patients is routinely applied in most ICUs but may have negative side effects. We hypothesised that on-demand minimally invasive suctioning would have fewer side effects than routine deep endotracheal suctioning, and would be comparable in durati

  8. Application of the Flexible CO2 Laser in Minimally Invasive Laminectomies: Technical Note

    Science.gov (United States)

    Perez-Cruet, Mick

    2016-01-01

    Background Minimally invasive laminectomy is a very effective surgical method for treating lumbar stenosis. However, this technique can be technically difficult, especially in patients suffering from severe stenosis. The contralateral decompression from a unilateral approach can result in durotomy during removal of the hypertrophied ligamentum flavum. This complication can be difficult to treat through a small working channel. Objective To detail our group’s operative experience with the CO2 laser and discuss our results and previous studies in the literature reporting results.  Methods The CO2 laser (Omniguide, Boston, MA) was investigated in the surgical ablation of the contralateral ligamentum flavum during minimally invasive laminectomies. Forty levels have been investigated thus far. The amount of voltage needed to adequately desiccate and remove the ligamentum flavum safely as well as the effectiveness of this technique were investigated. Results The contralateral ligamentum flavum could be removed effectively using the 9 to 11 watt continuous wavelength (10,600 nanometer) power setting on the CO2 laser. Shrinkage of the contralateral ligamentum flavum facilitated its removal using a number 2 Kerrison Punch. No durotomies occurred, and the use of the laser did not significantly lengthen operative times.  Conclusions The CO2 laser appears to be a useful tool in the armamentarium of instruments available to the minimally invasive spine surgeon and may help to reduce the incidence of durotomies when performing minimally invasive laminectomies. PMID:27433407

  9. Minimally invasive posterior cervical decompression using tubular retractor: The technical note and early clinical outcome

    Directory of Open Access Journals (Sweden)

    Jung-Woo Hur

    2014-01-01

    Full Text Available Background: The aim of this work is to present a novel decompression technique that approaches cervical spine posteriorly, but through minimal invasive method using tubular retractor avoiding detachment of posterior musculature. Methods: Six patients underwent minimally invasive posterior cervical decompression using the tubular retractor system and surgical microscope. Minimally invasive access to the posterior cervical spine was performed with exposure through a paramedian muscle-splitting approach. With the assistance of a specialized tubular retraction system and deep soft tissue expansion mechanism, multilevel posterior cervical decompression could be accomplished. This approach also allows safe docking of the retractor system on the lateral mass, thus avoiding the cervical spinal canal during exposure. A standard operating microscope was used with ×10 magnification and 400 mm focal length. The hospital charts, magnetic resonance imaging studies, and follow-up records of all the patients were reviewed. Outcome was assessed by neurological status and visual analog scale (VAS for neck and arm pain. Results: There was no significant complication related to operation. The follow-up time was 4-12 months (mean, 9 months. Muscle weakness improved in all patients; sensory deficits resolved in four patients and improved in two patients. Analysis of the mean VAS for radicular pain and VAS for neck pain showed significant improvement. Conclusions: The preliminary experiences with good clinical outcome seem to promise that this minimally invasive technique is a valid alternative option for the treatment of cervical spondylotic myelopathy.

  10. Reduction of the inflammatory response in patients undergoing minimally invasive coronary artery bypass grafting

    NARCIS (Netherlands)

    Gu, YJ; Mariani, MA; van Oeveren, W; Grandjean, JG; Boonstra, PW

    1998-01-01

    Background. The aim of this prospective study was to determine whether the inflammation-associated clinical morbidity as well as the subclinical markers of the inflammatory response are reduced in patients who undergo minimally invasive coronary artery bypass grafting without cardiopulmonary bypass.

  11. Effects of Camera Arrangement on Perceptual-Motor Performance in Minimally Invasive Surgery

    Science.gov (United States)

    Delucia, Patricia R.; Griswold, John A.

    2011-01-01

    Minimally invasive surgery (MIS) is performed for a growing number of treatments. Whereas open surgery requires large incisions, MIS relies on small incisions through which instruments are inserted and tissues are visualized with a camera. MIS results in benefits for patients compared with open surgery, but degrades the surgeon's perceptual-motor…

  12. Minimally invasive esophagectomy for cancer: Single center experience after 44 consecutive cases

    Directory of Open Access Journals (Sweden)

    Bjelović Miloš

    2015-01-01

    Full Text Available Introduction. At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE has been a standard of care for patients with resectable esophageal cancer since 2009. As a next and final step in the change management, from January 2015 we utilized total minimally invasive esophagectomy (tMIE as a standard of care. Objective. The aim of the study was to report initial experiences in hMIE (laparoscopic approach for cancer and analyze surgical technique, major morbidity and 30-day mortality. Methods. A retrospective cohort study included 44 patients who underwent elective hMIE for esophageal cancer at the Department for Minimally Invasive Upper Digestive Surgery, Hospital for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2009 to December 2014. Results. There were 16 (36% middle thoracic esophagus tumors and 28 (64% tumors of distal thoracic esophagus. Mean duration of the operation was 319 minutes (approximately five hours and 20 minutes. The average blood loss was 173.6 ml. A total of 12 (27% of patients had postoperative complications and mean intensive care unit stay was 2.8 days. Mean hospital stay after surgery was 16 days. The average number of harvested lymph nodes during surgery was 31.9. The overall 30-day mortality rate within 30 days after surgery was 2%. Conclusion. As long as MIE is an oncological equivalent to open esophagectomy (OE, better relation between cost savings and potentially increased effectiveness will make MIE the preferred approach in high-volume esophageal centers that are experienced in minimally invasive procedures.

  13. Ho: Yag laser-assisted lumbar disc decompression: A minimally invasive procedure under local anesthesia

    Directory of Open Access Journals (Sweden)

    Agarwal S

    2003-01-01

    Full Text Available The morbidity associated with open procedures for lumbar intervertebral disc prolapse has led to the development of minimally invasive techniques. Ho: LADD (Laser-assisted disc decompression is a very cost-effective minimally invasive procedure. The procedure is carried out under local anesthesia The patient can be mobilized immediately after the surgery. The study involved 36 cases treated with Ho: LADD for contained lumbar intervertebral disc prolapse. 35 cases were available for follow-up. There was a 91.5% success rate and a minimal complication rate. All cases adhered to strict inclusion and exclusion criteria and were evaluated with the modified Macnab criteria for the assessment of postoperative results.

  14. Recent advances in minimally invasive colorectal cancer surgery

    OpenAIRE

    Wichmann, Mathias W.; Meyer, G.; Angele, M. K.; Schildberg, Friedrich Wilhelm; Rau, H G

    2002-01-01

    Laparoscopy has improved surgical treatment of various diseases due to its limited surgical trauma and has developed as an interesting therapeutic alternative for the resection of colorectal cancer. Despite numerous clinical advantages (faster recovery, less pain, fewer wound and systemic complications, faster return to work) the laparoscopic approach to colorectal cancer therapy has also resulted in unusual complications, i.e. ureteral and bladder injury which are rarely observed with open l...

  15. A predictive model of suitability for minimally invasive parathyroid surgery in the treatment of primary hyperparathyroidism [corrected].

    LENUS (Irish Health Repository)

    Kavanagh, Dara O

    2012-05-01

    Improved preoperative localizing studies have facilitated minimally invasive approaches in the treatment of primary hyperparathyroidism (PHPT). Success depends on the ability to reliably select patients who have PHPT due to single-gland disease. We propose a model encompassing preoperative clinical, biochemical, and imaging studies to predict a patient\\'s suitability for minimally invasive surgery.

  16. Complications of Minimally Invasive, Tubular Access Surgery for Cervical, Thoracic, and Lumbar Surgery

    Directory of Open Access Journals (Sweden)

    Donald A. Ross

    2014-01-01

    Full Text Available The object of the study was to review the author’s large series of minimally invasive spine surgeries for complication rates. The author reviewed a personal operative database for minimally access spine surgeries done through nonexpandable tubular retractors for extradural, nonfusion procedures. Consecutive cases (n=1231 were reviewed for complications. There were no wound infections. Durotomy occurred in 33 cases (2.7% overall or 3.4% of lumbar cases. There were no external or symptomatic internal cerebrospinal fluid leaks or pseudomeningoceles requiring additional treatment. The only motor injuries were 3 C5 root palsies, 2 of which resolved. Minimally invasive spine surgery performed through tubular retractors can result in a low wound infection rate when compared to open surgery. Durotomy is no more common than open procedures and does not often result in the need for secondary procedures. New neurologic deficits are uncommon, with most observed at the C5 root. Minimally invasive spine surgery, even without benefits such as less pain or shorter hospital stays, can result in considerably lower complication rates than open surgery.

  17. Endoscopic-assisted minimally invasive resection of a papillary muscle blood cyst in an adult patient.

    Science.gov (United States)

    Okamoto, Kazuma; Kudo, Mikihiko; Hayashi, Kanako; Shimizu, Hideyuki

    2016-02-01

    We describe endoscopic-assisted minimally invasive resection of a blood cyst originating from the papillary muscle that caused severe mitral regurgitation and necessitated mitral valve replacement in an active adult woman, as well as a review of the relevant literature. An endoscopic view increases the visibility of the surgical target and facilitates a precise observation of the tumour and dissection at the appropriate layer. The On-X mechanical valve was chosen for mitral valve repair to minimize thromboembolic risk. This patient additionally benefited from endoscopic-assisted right minithoracotomy in terms of both cosmetic and functional aspects. PMID:26586675

  18. Minimally invasive porcelain veneers: indications for a conservative esthetic dentistry treatment modality.

    Science.gov (United States)

    Strassler, Howard E

    2007-11-01

    Patients have many restorative options for changing the appearance of their teeth. The most conservative restorative treatments for changing the appearance of teeth include tooth bleaching, direct composite resin veneers, and porcelain veneers. Patients seeking esthetic treatment should undergo a comprehensive clinical examination that includes an esthetic evaluation. When selecting a conservative treatment modality, the use of minimally invasive or no-preparation porcelain veneers should be considered. As with any treatment decision, the indications and contraindications must be considered before a definitive treatment plan is made. Long-term research has demonstrated a 94% survival rate for minimally invasive porcelain veneers. While conservation of tooth structure is important, so is selecting the right treatment modality for each patient based on clinical findings.

  19. Esthetic rehabilitation of a worn dentition with a minimally invasive prosthetic procedure (MIPP).

    Science.gov (United States)

    Fradeani, Mauro; Barducci, Giancarlo; Bacherini, Leonardo

    2016-01-01

    A minimally invasive prosthetic procedure (MIPP) for the esthetic rehabilitation of the complete arch advocates the preservation of enamel to optimize the adhesive bond of the luting agent to both the tooth surface and the etchable ceramic restoration. When esthetic rehabilitation of a worn dentition is required, a MIPP can be selected to reduce the biological cost of removing additional enamel tooth structure. The fundamental steps to achieve this goal are to: (1) increase the vertical dimension of occlusion (VDO); (2) reduce the thickness of the monolithic ceramic material; (3) preserve the enamel during tooth preparation; and (4) adhesively bond the etchable ceramic restorations. This article presents a comprehensive, minimally invasive prosthetic treatment approach for the esthetic rehabilitation of a severely worn dentition using a lithium disilicate all-ceramic material with partial and complete coverage restorations.

  20. Minimally Invasive Long-Term Management of Direct Restorations: the '5 Rs'.

    Science.gov (United States)

    Green, David; Mackenzie, Louis; Banerjee, Avijit

    2015-06-01

    The assessment and operative long-term management of direct restorations is a complex and controversial subject in conservative dentistry. Employing a minimally invasive (MI) approach helps preserve natural tooth structure and maintain endodontic health for as long as possible during the restorative cycle. This paper discusses how minimally invasive techniques may be applied practically to reviewing, resealing, refurbishing, repairing or replacing deteriorating/failed direct coronal restorations (the'5 Rs') and provides an update of contemporary MI clinical procedures. CPD/CLINICAL RELEVANCE: The assessment and long-term clinical management of deteriorating/failing direct restorations is a major component of the general dental practice workload and NHS UK budget expenditure for operative dentistry.

  1. Novel Wireless-Communicating Textiles Made from Multi-Material and Minimally-Invasive Fibers

    Directory of Open Access Journals (Sweden)

    Stepan Gorgutsa

    2014-10-01

    Full Text Available The ability to integrate multiple materials into miniaturized fiber structures enables the realization of novel biomedical textile devices with higher-level functionalities and minimally-invasive attributes. In this work, we present novel textile fabrics integrating unobtrusive multi-material fibers that communicate through 2.4 GHz wireless networks with excellent signal quality. The conductor elements of the textiles are embedded within the fibers themselves, providing electrical and chemical shielding against the environment, while preserving the mechanical and cosmetic properties of the garments. These multi-material fibers combine insulating and conducting materials into a well-defined geometry, and represent a cost-effective and minimally-invasive approach to sensor fabrics and bio-sensing textiles connected in real time to mobile communications infrastructures, suitable for a variety of health and life science applications.

  2. Minimally-invasive elimination of iatrogenic intravenous foreign bodies: initial experience in five cases

    International Nuclear Information System (INIS)

    Objective: To investigate the effectiveness, technical points and complications of the minimally-invasive treatment for iatrogenic intravenous foreign bodies. Methods: Five patients with iatrogenic intravenous foreign bodies due to the fracture or shift of venous catheter were enrolled in this study. By using grasping device, which was inserted into the target vein via right femoral vein, the foreign bodies within the venous system were successfully eliminated. Results: The vascular foreign bodies were successfully removed in all five patients, with a success rate of 100%. No operation-related complications, such as vascular rupture, pulmonary embolism, etc. occurred. Conclusion: As a minimally-invasive technique, the use grasping device for removing the iatrogenic vascular foreign bodies has higher success rate; thus, major surgical procedures can be avoided. (authors)

  3. Biostatistical analysis of treatment results of bacterial liver abscesses using minimally invasive techniques and open surgery

    Directory of Open Access Journals (Sweden)

    Кipshidze A.A.

    2013-12-01

    Full Text Available Today bacterial abscesses remain one of the most difficult complications in surgical hepatology, both traditional and minimally invasive methods of their treatment are used. Bio-statistical analysis is used due to the fact that strong evidences are required for the effectiveness of one or another method of surgical intervention. The estimation of statistical significance of differences between the control and the main group of patients with liver abscesses is given in this paper. Depending on the treatment method patients were divided into two groups: 1 - minimally invasive surgery (89 cases; 2 – laporatomy surgery (74 patients. Data compa¬ri¬son was performed by means of Stjudent's criterion. The effectiveness of method of abscesses drainage using inter¬ventional sonography, outer nazobiliar drainage with reorganization of ductal liver system and abscess cavity with the help of modern antiseptics was considered. The percentage of cured patients was also estimated.

  4. Minimally invasive surgical procedures for the treatment of lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Raspe, Heiner

    2005-11-01

    Full Text Available Introduction: In up to 30% of patients undergoing lumbar disc surgery for herniated or protruded discs outcomes are judged unfavourable. Over the last decades this problem has stimulated the development of a number of minimally-invasive operative procedures. The aim is to relieve pressure from compromised nerve roots by mechanically removing, dissolving or evaporating disc material while leaving bony structures and surrounding tissues as intact as possible. In Germany, there is hardly any utilisation data for these new procedures – data files from the statutory health insurances demonstrate that about 5% of all lumbar disc surgeries are performed using minimally-invasive techniques. Their real proportion is thought to be much higher because many procedures are offered by private hospitals and surgeries and are paid by private health insurers or patients themselves. So far no comprehensive assessment comparing efficacy, safety, effectiveness and cost-effectiveness of minimally-invasive lumbar disc surgery to standard procedures (microdiscectomy, open discectomy which could serve as a basis for coverage decisions, has been published in Germany. Objective: Against this background the aim of the following assessment is: * Based on published scientific literature assess safety, efficacy and effectiveness of minimally-invasive lumbar disc surgery compared to standard procedures. * To identify and critically appraise studies comparing costs and cost-effectiveness of minimally-invasive procedures to that of standard procedures. * If necessary identify research and evaluation needs and point out regulative needs within the German health care system. The assessment focusses on procedures that are used in elective lumbar disc surgery as alternative treatment options to microdiscectomy or open discectomy. Chemonucleolysis, percutaneous manual discectomy, automated percutaneous lumbar discectomy, laserdiscectomy and endoscopic procedures accessing the disc

  5. Virtual and augmented medical imaging environments: enabling technology for minimally invasive cardiac interventional guidance.

    Science.gov (United States)

    Linte, Cristian A; White, James; Eagleson, Roy; Guiraudon, Gérard M; Peters, Terry M

    2010-01-01

    Virtual and augmented reality environments have been adopted in medicine as a means to enhance the clinician's view of the anatomy and facilitate the performance of minimally invasive procedures. Their value is truly appreciated during interventions where the surgeon cannot directly visualize the targets to be treated, such as during cardiac procedures performed on the beating heart. These environments must accurately represent the real surgical field and require seamless integration of pre- and intra-operative imaging, surgical tracking, and visualization technology in a common framework centered around the patient. This review begins with an overview of minimally invasive cardiac interventions, describes the architecture of a typical surgical guidance platform including imaging, tracking, registration and visualization, highlights both clinical and engineering accuracy limitations in cardiac image guidance, and discusses the translation of the work from the laboratory into the operating room together with typically encountered challenges. PMID:22275200

  6. Anesthetic challenges in minimally invasive cardiac surgery: Are we moving in a right direction?

    Directory of Open Access Journals (Sweden)

    Vishwas Malik

    2016-01-01

    Full Text Available Continuously growing patient′s demand, technological innovation, and surgical expertise have led to the widespread popularity of minimally invasive cardiac surgery (MICS. Patient′s demand is being driven by less surgical trauma, reduced scarring, lesser pain, substantially lesser duration of hospital stay, and early return to normal activity. In addition, MICS decreases the incidence of postoperative respiratory dysfunction, chronic pain, chest instability, deep sternal wound infection, bleeding, and atrial fibrillation. Widespread media coverage, competition among surgeons and hospitals, and their associated brand values have further contributed in raising awareness among patients. In this process, surgeons and anesthesiologist have moved from the comfort of traditional wide incision surgeries to more challenging and intensively skilled MICS. A wide variety of cardiac lesions, techniques, and approaches coupled with a significant learning curve have made the anesthesiologist′s job a challenging one. Anesthesiologists facilitate in providing optimal surgical settings beginning with lung isolation, confirmation of diagnosis, cannula placement, and cardioplegia delivery. However, the concern remains and it mainly relates to patient safety, prolonged intraoperative duration, and reduced surgical exposure leading to suboptimal treatment. The risk of neurological complications, aortic injury, phrenic nerve palsy, and peripheral vascular thromboembolism can be reduced by proper preoperative evaluation and patient selection. Nevertheless, advancement in surgical instruments, perfusion practices, increasing use of transesophageal echocardiography, and accumulating experience of surgeons and anesthesiologist have somewhat helped in amelioration of these valid concerns. A patient-centric approach and clear communication between the surgeon, anesthesiologist, and perfusionist are vital for the success of MICS.

  7. 3T MR-guided minimally-invasive penile fracture repair.

    Science.gov (United States)

    Rosi, Giovanni; Fontanella, Paolo; Venzi, Giordano; Jermini, Fernando; Del Grande, Filippo

    2016-03-01

    We present the case of a 21 year old patient with an incomplete tear of the tunica albuginea occurred after violent masturbation. The diagnostic assessment was performed first clinically, then with ultrasound and with 3 Tesla MRI. 3 Tesla MRI, owing to its high resolution, allowed to exactly detect the tear location leading to precise preoperative planning. After adequate diagnosis through imaging and proper planning, we were able to perform a selective minimally invasive surgical approach to repair the lesion. PMID:27072182

  8. 3T MR-guided minimally-invasive penile fracture repair

    OpenAIRE

    Giovanni Rosi; Paolo Fontanella; Giordano Venzi; Fernando Jermini; Filippo Del Grande

    2016-01-01

    We present the case of a 21 year old patient with an incomplete tear of the tunica albuginea occurred after violent masturbation. The diagnostic assessment was performed first clinically, then with ultrasound and with 3 Tesla MRI. 3 Tesla MRI, owing to its high resolution, allowed to exactly detect the tear location leading to precise preoperative planning. After adequate diagnosis through imaging and proper planning, we were able to perform a selective minimally invasive surgical approach to...

  9. Minimally Invasive Video-Assisted Thyroidectomy and Parathyroidectomy with Intraoperative Recurrent Laryngeal Nerve Monitoring

    OpenAIRE

    Emad Kandil; Shafik N. Wassef; Haytham Alabbas; Paul L. Freidlander

    2009-01-01

    Objective. Our goal is to study the feasibility of using intraoperative neuromonitoring (IONM) in minimally invasive video-assisted thyroidectomy and parathyroidectomy (MIVAT/P) with emphasis given to the identification of recurrent laryngeal nerve (RLN). Methods. Consecutive series of forty-seven patients with seventy-seven recurrent laryngeal nerves at risk undergoing both MIVAT/P and IONM were enrolled in this retrospective, nonrandomized analysis study. All operations were performed by th...

  10. Skills training in minimally invasive surgery in Dutch obstetrics and gynecology residency curriculum

    OpenAIRE

    Hiemstra, Ellen; Kolkman, Wendela; Jansen, Frank Willem

    2008-01-01

    The complexity of acquiring minimally invasive surgical (MIS) skills, combined with smaller case volumes for residents have pushed the development of skills training facilities on simulators outside the operating room (OR). Medico-legal and financial constraints have stimulated this development even more. However, the implementation of simulator training into a residency curriculum is shown to be troublesome. MIS skills training is organized in a uniform and easily applicable way in the Dutch...

  11. Rolled-up magnetic microdrillers: towards remotely controlled minimally invasive surgery.

    Science.gov (United States)

    Xi, Wang; Solovev, Alexander A; Ananth, Adithya N; Gracias, David H; Sanchez, Samuel; Schmidt, Oliver G

    2013-02-21

    Self-folded magnetic microtools with sharp ends are directed at enabling drilling and related incision operations of tissues, ex vivo, in a fluid with a viscosity similar to that of blood. These microtools change their rotation from a horizontal to a vertical one when they are immersed into a rotational magnetic field. Novel self-assembly paradigms with magnetic materials can enable the creation of remotely controlled and mass-produced tools for potential applications in minimally invasive surgery. PMID:23154823

  12. Dionis: A novel remote-center-of-motion parallel manipulator for Minimally Invasive Surgery

    OpenAIRE

    R. Beira; L. Santos-Carreras; Rognini, G.; Bleuler, H.; Clavel, R

    2011-01-01

    The large volume and reduced dexterity of current surgical robotic systems are factors that restrict their effective performance. To improve the usefulness of surgical robots in minimally invasive surgery (MIS), a compact and accurate positioning mechanism, named Dionis, is proposed in this paper. This spatial hybrid mechanism based on a novel parallel kinematics is able to provide three rotations and one translation for single port procedures. The corresponding axes intersect at a remote cen...

  13. 3T MR-guided minimally-invasive penile fracture repair

    Directory of Open Access Journals (Sweden)

    Giovanni Rosi

    2016-03-01

    Full Text Available We present the case of a 21 year old patient with an incomplete tear of the tunica albuginea occurred after violent masturbation. The diagnostic assessment was performed first clinically, then with ultrasound and with 3 Tesla MRI. 3 Tesla MRI, owing to its high resolution, allowed to exactly detect the tear location leading to precise preoperative planning. After adequate diagnosis through imaging and proper planning, we were able to perform a selective minimally invasive surgical approach to repair the lesion.

  14. "NIMS technique" for minimally invasive spinal fixation using non-fenestrated pedicle screws: A technical note

    Directory of Open Access Journals (Sweden)

    Alugolu Rajesh

    2015-01-01

    Full Text Available Study Design: Case series. Objective: To reduce the cost of minimally invasive spinal fixation. Background: Minimally invasive spine (MIS surgery is an upcoming modality of managing a multitude of spinal pathologies. However, in a resource-limited situations, using fenestrated screws (FSs may prove very costly for patients with poor affordability. We here in describe the Nizam′s Institute of Medical Sciences (NIMS experience of using routine non-FSs (NFSs for transpedicular fixation by the minimally invasive way to bridge the economic gap. Materials and Methods: A total of 7 patients underwent NFS-minimally invasive spine (MIS surgery. Male to female distribution was 6:1. The average blood loss was 50 ml and the mean operating time was 2 and 1/2 h. All patients were mobilized the very next day after confirming the position of implants on X-ray/computed tomography. Results: All 7 patients are doing well in follow-up with no complaints of a backache or fresh neurological deficits. There was no case with pedicle breach or screw pullout. The average cost of a single level fixation by FS and NFS was `1, 30,000/patient and `32,000/patient respectively ($2166 and $530, respectively. At the end of 1-year follow-up, we had two cases of screw cap loosening and with a displacement of the rod cranio-caudally in one case which was revised through the same incisions. Conclusions: Transpedicular fixation by using NFS for thoracolumbar spinal pathologies is a cost-effective extension of MIS surgery. This may extend the benefits to a lower socioeconomic group who cannot afford the cost of fenestrated screw (FS.

  15. Abducens nerve palsy as a postoperative complication of minimally invasive thoracic spine surgery: a case report

    OpenAIRE

    Sandon, Luiz Henrique Dias; Choi, Gun; Park, EunSoo; Lee, Hyung-Chang

    2016-01-01

    Background Thoracic disc surgeries make up only a small number of all spine surgeries performed, but they can have a considerable number of postoperative complications. Numerous approaches have been developed and studied in an attempt to reduce the morbidity associated with the procedure; however, we still encounter cases that develop serious and unexpected outcomes. Case Presentation This case report presents a patient with abducens nerve palsy after minimally invasive surgery for thoracic d...

  16. Minimally invasive reconstruction of lateral tibial plateau fractures using the jail technique: a biomechanical study

    OpenAIRE

    Weimann, A; Heinkele, T; Herbort, M. (Mirco); Schliemann, B. (Benedikt); Petersen, W.; Raschke, M. J.

    2013-01-01

    Background: This study described a novel, minimally invasive reconstruction technique of lateral tibial plateau fractures using a three-screw jail technique and compared it to a conventional two-screw osteosynthesis technique. The benefit of an additional screw implanted in the proximal tibia from the anterior at an angle of 90° below the conventional two-screw reconstruction after lateral tibial plateau fracture was evaluated. This new method was called the jail technique. Methods: The two r...

  17. Minimally Invasive Reconstruction of the Medial Patellofemoral Ligament Using Quadriceps Tendon

    OpenAIRE

    Fink, Christian; Veselko, Matjaz; Herbort, Mirco; Hoser, Christian

    2014-01-01

    Reconstruction of the medial patellofemoral ligament (MPFL) for the treatment of patellar instability has received increased attention over the past few years. Most operative techniques use hamstring grafts fixed with bone tunnels and/or anchors on the patella. Despite good clinical results using these techniques, complications such as implant breakage, patellar fractures through bone tunnels, and loss of knee motion have occurred. We present a minimally invasive technique for MPFL reconstruc...

  18. Design of a Multitasking Robotic Platform with Flexible Arms and Articulated Head for Minimally Invasive Surgery

    OpenAIRE

    Shang, Jianzhong; Payne, Christopher J.; Clark, James; Noonan, David P.; Kwok, Ka-Wai; Darzi, Ara; Yang, Guang-Zhong

    2012-01-01

    This paper describes a multitasking robotic platform for Minimally Invasive Surgery (MIS). The device is designed to be introduced through a standard trocar port. Once the device is inserted to the desired surgical site, it can be reconfigured by lifting an articulated section, and protruding two tendon driven flexible arms. Each of the arms holds an interchangeable surgical instrument. The articulated section features a 2 Degrees-of-Freedom (DoF) universal joint followed by a single DoF yaw ...

  19. Design and Integration of a Telerobotic System for Minimally Invasive Surgery of the Throat

    OpenAIRE

    Simaan, Nabil; Xu, Kai; Kapoor, Ankur; Wei, Wei; Kazanzides, Peter; Flint, Paul; Taylor, Russell

    2009-01-01

    This paper presents the clinical motivation, design specifications, kinematics, statics, and actuation compensation for a newly constructed telerobotic system for Minimally Invasive Surgery (MIS) of the throat. A hybrid dual-arm telesurgical slave, with twenty joint-space Degrees of Freedom (DoF), is used in this telerobotic system to provide the necessary dexterity in deep surgical fields such as the throat. The telerobotic slave uses novel continuum robots that use multiple super-elastic ba...

  20. Complex esthetic and functional rehabilitation with an additive, minimally invasive restorative approach.

    Science.gov (United States)

    Ho, Christopher Ck

    2014-06-01

    Historically, the management of patients presenting with extensive tooth wear comprised the use of conventional fixed prosthodontics, an approach that often entailed invasive dentistry and increased biomechanical risk. With the development of adhesive bonding, a dentition can be restored in a much more conservative manner using an additive approach. This case report describes the concepts employed in a complex rehabilitation involving tooth erosion, applying both direct and indirect restorations with minimal biological risk to the patient.

  1. Minimally invasive dentistry combining orthodontic therapy and single-unit restoration.

    Science.gov (United States)

    Lowe, Edward; Rego, Juan; Rego, Nelson

    2008-06-01

    Today's restorative materials enable dental professionals to deliver predictable aesthetic enhancement, particularly for compromised teeth in the anterior region. Treating a single compromised tooth, however, requires a thorough understanding of the restorative material's optical properties, experience in its clinical performance, and awareness of therapeutic modalities that conserve sound tooth structure. In this presentation, the authors demonstrate the use of orthodontic therapy and careful treatment planning to restore a single central incisor using a minimally invasive approach.

  2. Inadvertent subclavian artery cannulation with a central venous catheter; successful retrieval using a minimally invasive technique.

    Science.gov (United States)

    Redmond, C E; O'Donohoe, R; Breslin, D; Brophy, D P

    2014-10-01

    A 48-year-old lady was referred to our department as an emergency following an unsuccessful attempt at central venous catheter insertion, resulting in cannulation of the subclavian artery. She underwent angiography with removal of the catheter and closure of the arteriotomy using an Angio-Seal device. While the optimal management of this scenario has yet to be defined, the use of this minimally invasive technique warrants consideration. PMID:25507120

  3. Single-Port Access Laparoscopic Hysterectomy: A New Dimension of Minimally Invasive Surgery

    OpenAIRE

    Liliana, Mereu; Alessandro, Pontis; Giada, Carri; Luca, Mencaglia

    2011-01-01

    The fundamental idea is to have all of the laparoscopic working ports entering the abdominal wall through the same incision. Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus and reduces morbidity of minimally invasive surgery. The advantages of single-access laparoscopic surgery may include less bleeding, ...

  4. Minimally invasive plate osteosynthesis for humeral shaft fractures: are results reproducible?

    OpenAIRE

    Concha, Juan M.; Sandoval, Alejandro; Philipp N Streubel

    2009-01-01

    Minimally invasive plate osteosynthesis (MIPO) has been advocated as a safe approach to humeral shaft fracture management. We evaluated the reproducibility of this technique in a regional hospital. Thirty-five patients underwent MIPO of humerus shaft fractures. Fifteen patients had an open fracture, six a preoperative radial nerve palsy, and nine a concomitant thoracic, musculoskeletal or vascular injury. At an average 12-month follow-up, 91% of fractures healed after a mean of 12 weeks (rang...

  5. Minimal Invasive Percutaneous Osteosynthesis for Elderly Valgus Impacted Proximal Humeral Fractures with the PHILOS

    OpenAIRE

    Hang Chen; Xiaochuan Hu; Haochen Tang; Guoyong Yang; Ming Xiang

    2015-01-01

    There is a growing concern about elderly valgus impacted proximal humeral fractures. The aim of this study was to evaluate the treatment and clinical outcomes following minimal invasive percutaneous plate osteosynthesis (MIPPO) with the proximal humeral internal locking system (PHILOS) for the treatment of elderly valgus impacted proximal humeral fracture. Between May 2008 and May 2012, 27 patients (average age 67.3, range 61–74) with valgus impacted proximal humeral fractures were enrolled i...

  6. Minimally invasive video-assisted thyroidectomy: seven-year experience with 240 cases

    OpenAIRE

    Barczyński, Marcin; Konturek, Aleksander; Stopa, Małgorzata; Papier, Aleksandra; Nowak, Wojciech

    2012-01-01

    Introduction Minimally invasive video-assisted thyroidectomy (MIVAT) has gained acceptance in recent years as an alternative to conventional thyroid surgery. Aim Assessment of our 7-year experience with MIVAT. Material and methods A retrospective study of 240 consecutive patients who underwent MIVAT at our institution between 01/2004 and 05/2011 was conducted. The inclusion criterion was a single thyroid nodule below 30 mm in diameter within the thyroid of 25 ml or less in volume. The exclusi...

  7. Natural orifice transluminal endoscopic surgery: New minimally invasive surgery come of age

    OpenAIRE

    Huang, Chen; Huang, Ren-Xiang; Qiu, Zheng-Jun

    2011-01-01

    Although in the past two decades, laparoscopic surgery, considered as a great revolution in the minimally invasive surgery field, has undergone major development worldwide, another dramatic surgical revolution has quietly appeared in recent years. Ever since Kalloo’s first report on transgastric peritoneoscopy in a porcine model in 2004, interest in a new surgical procedure named natural orifice transluminal endoscopic surgery (NOTES) has blossomed worldwide. Considering that a NOTES procedur...

  8. Minimally invasive is the future of left ventricular assist device implantation

    OpenAIRE

    Makdisi, George; Wang, I-Wen

    2015-01-01

    There have been many factors that have allowed for progressive improvement in outcomes and lower complication rates. These include the improvement in left ventricular assist device (LVAD) technologies, combined with better understanding of patient management, all these. Nowadays the numbers of LVAD implantations exceed the number of annual heart transplants worldwide. Minimally invasive procedures are shown to improve the surgical outcome in both LVAD insertion and replacement. These minimall...

  9. Minimally invasive intervention in a case of a noncarious lesion and severe loss of tooth structure.

    Science.gov (United States)

    Reston, Eduardo G; Corba, Vanessa D; Broliato, Gustavo; Saldini, Bruno P; Stefanello Busato, Adair L

    2012-01-01

    The present article describes a minimally invasive technique used for the restoration of loss of tooth structure caused by erosion of intrinsic etiology. First, the cause of erosion was treated and controlled. Subsequently, taking into consideration patient characteristics, especially a young age, a more conservative technique was chosen for dental rehabilitation with the use of composite resin. The advantages and disadvantages of the technique employed are discussed.

  10. Anastomosis in minimally invasive Ivor lewis esophagectomy via two ports provides equivalent perioperative outcomes to open

    Directory of Open Access Journals (Sweden)

    Y Zhao

    2014-01-01

    Full Text Available Objective: Minimally invasive esophagectomy (MIE is becoming a selective treatment of esophageal cancer; however, it′s a complex and technically demanding surgical operation. MIE can be performed in high volume centers in a variety of ways using different techniques. Transthoracic staplers have traditionally been used in open transthoracic Ivor Lewis Esophagectomy (ILE with good success. An investigation of the safety and utility of transthoracic stapler via two ports on thorax for esophageal anastomosis in minimally invasive ILE is reviewed. Methods: Patients of esophageal cancer were selected between November 2012 and July 2014. All the patients received minimally invasive (MIE or open transthoracic ILE. Transthoracic stapler for MIE anastomosis was performed through the major port located at subaxillary region. Patients′ demographics, indications for esophagectomy, perioperative treatments, intraoperative data, postoperative complications, hospital length of stay, 7 and in-hospital mortality were evaluated. Results: Totally, 63 consecutive patients underwent MIE or ILE. All the patients were Han with a mean age of 60 years (52-74. The indication of surgery is esophageal cancer, and squamous cell carcinoma was defined by pathologist before operation. None of the patients had neoadjuvant chemotherapy or radiation. All the MIE patients were no conversions to open thoracotomy or laparotomy. Mean operative time was 4.5 h. One patient (3.03% suffered postoperative pneumonia, no leak from the gastric conduit staple line or esophageal anastomoses, no postoperative complication required surgical intervention was observed. The median hospital length of stay was 13 days (range 7-18. There were no in-hospital mortalities. Conclusions: In our study, transthoracic stapler through the major port at subaxillary seems technically feasible and safe for minimally invasive ILE with comparable morbidity and oncologic data to open.

  11. Rhabdomyolysis and acute renal failure following minimally invasive spine surgery: report of 5 cases.

    Science.gov (United States)

    Dakwar, Elias; Rifkin, Stephen I; Volcan, Ildemaro J; Goodrich, J Allan; Uribe, Juan S

    2011-06-01

    Minimally invasive spine surgery is increasingly used to treat various spinal pathologies with the goal of minimizing destruction of the surrounding tissues. Rhabdomyolysis (RM) is a rare but known complication of spine surgery, and acute renal failure (ARF) is in turn a potential complication of severe RM. The authors report the first known case series of RM and ARF following minimally invasive lateral spine surgery. The authors retrospectively reviewed data in all consecutive patients who underwent a minimally invasive lateral transpsoas approach for interbody fusion with the subsequent development of RM and ARF at 2 institutions between 2006 and 2009. Demographic variables, patient home medications, preoperative laboratory values, and anesthetic used during the procedure were reviewed. All patient data were recorded including the operative procedure, patient positioning, postoperative hospital course, operative time, blood loss, creatine phosphokinase (CPK), creatinine, duration of hospital stay, and complications. Five of 315 consecutive patients were identified with RM and ARF after undergoing minimally invasive lateral transpsoas spine surgery. There were 4 men and 1 woman with a mean age of 66 years (range 60-71 years). The mean body mass index was 31 kg/m2 and ranged from 25 to 40 kg/m2. Nineteen interbody levels had been fused, with a range of 3-6 levels per patient. The mean operative time was 420 minutes and ranged from 315 to 600 minutes. The CPK ranged from 5000 to 56,000 U/L, with a mean of 25,861 U/L. Two of the 5 patients required temporary hemodialysis, while 3 required only aggressive fluid resuscitation. The mean duration of the hospital stay was 12 days, with a range of 3-25 days. Rhabdomyolysis is a rare but known potential complication of spine surgery. The authors describe the first case series associated with the minimally invasive lateral approach. Surgeons must be aware of the possibility of postoperative RM and ARF, particularly in

  12. Application of Minimally Invasive Treatment of Locking Compression Plate in SchatzkerⅠ~Ⅲ Tibial Plateau Fracture

    Institute of Scientific and Technical Information of China (English)

    Zhao Guohui

    2014-01-01

    Objective:To investigate the clinical effect of minimally invasive treatment of locking compression plate (LCP) in SchatzkerⅠ~Ⅲ tibial plateau fracture. Methods: Thirty-eight patients with SchatzkerⅠ~Ⅲtibial plateau fracture in our hospital were given minimally invasive treatment of LCP, and the artificial bone was transplanted to the depressed bone. Adverse responses, wound healing time and clinical efifcacy were observed. Results:All patients were followed-up for 14~20 months, and the mean duration was 16 months. Within 1 week after operation, 1 patient suffered from short-term rejection reaction to artiifcial bone, but he healed after corresponding measures were taken. There were no complications like skin necrosis and externally-exposed steel plate among the patients. In addition, all fractures were recovered, and the recovery time was 2.6~4.1 months, with the mean duration being 3.4 months. The recovery of knee function was favorable, in which 20 cases were excellent, 14 were good, and 4 were general. The excellent and good rate was 89.5%. Conclusion: Minimally invasive treatment of LCP for SchatzkerⅠ~Ⅲ tibial plateau fracture can reduce the postoperative relocation loss, and has small trauma and stable ifxation.

  13. Minimally invasive strategies and options for far-lateral Iumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yue; ZHANG Chao; WANG Jian; CHU Tong-wei; LI Chang-qing; ZHANG Zheng-feng; ZHENG wen-jie

    2008-01-01

    Objective: To investigate the surgical procedlures,options and surgical indications for far-lateral lumbar disc herniation between three different minimally invasive procedures.Methods: From January 2000 to October 2006, 52 patients with far-lateral lumbar disc herniation (29 males and 23 females, with the average age of 41.5 years) were treated with minimally invasive procedures. All the patients were assessed by X-ray and CT. Some were given additional myeography, discography, Computerized tomography myelography (CTM) and MRI examination. Yeung Endoscopy Spine System (YESS), METRx and X-tube procedures were performed in 25, 13 and 14 cases, respectively. All patients were followed up for a mean period of 13.5 months. Clinical outcomes were assessed by visual analog score (VAS) and Nakai criteria. Results: The results indicated that the three procedures could significantly improve the radiating leg symptoms (PO.05). The YESS procedure had several advantages including shortest operation time, simplest anesthesia and least trauma as compared with the other two procedures, especially for simple type I far-lateral lumbar disc herniation. METRx procedure was specially suitable for simple type II. And the procedure of posterior endoscopic facetectomy, posterior lumbar interbody fusion and unilateral pedicle screw instrumentation with X-tube was designed for far-lateral disc herniation combined with degenerative lumbar instability. Conclusion: Minimally invasive strategies and options should be determined by different types of far-lateral lumbar disc herniation.

  14. Quality assurance of multiport image-guided minimally invasive surgery at the lateral skull base.

    Science.gov (United States)

    Nau-Hermes, Maria; Schmitt, Robert; Becker, Meike; El-Hakimi, Wissam; Hansen, Stefan; Klenzner, Thomas; Schipper, Jörg

    2014-01-01

    For multiport image-guided minimally invasive surgery at the lateral skull base a quality management is necessary to avoid the damage of closely spaced critical neurovascular structures. So far there is no standardized method applicable independently from the surgery. Therefore, we adapt a quality management method, the quality gates (QG), which is well established in, for example, the automotive industry and apply it to multiport image-guided minimally invasive surgery. QG divide a process into different sections. Passing between sections can only be achieved if previously defined requirements are fulfilled which secures the process chain. An interdisciplinary team of otosurgeons, computer scientists, and engineers has worked together to define the quality gates and the corresponding criteria that need to be fulfilled before passing each quality gate. In order to evaluate the defined QG and their criteria, the new surgery method was applied with a first prototype at a human skull cadaver model. We show that the QG method can ensure a safe multiport minimally invasive surgical process at the lateral skull base. Therewith, we present an approach towards the standardization of quality assurance of surgical processes. PMID:25105146

  15. Natural and Controlled Demineralization for Study Purposes in Minimally Invasive Dentistry.

    Science.gov (United States)

    Skucha-Nowak, Małgorzata; Gibas, Mirosław; Tanasiewicz, Marta; Twardawa, Henryk; Szklarski, Tomasz

    2015-01-01

    Artificially induced demineralization of enamel is frequently used during laboratory tests, particularly in minimally invasive dentistry. The aim of this study was to analyze demineralization techniques of hard tooth tissue applicable in the research of materials in minimally invasive dentistry. The most important factor taken into consideration when designing a method is to make a model as closely similar to the natural environment of the human oral cavity as it is possible. In vitro models allow us to maintain stability and control over the environment and guarantee repeatability of the results. There are main models to produce dental caries outside of the body. The first model is chemical and it uses acids. It is simplified and reflects the actual environment of the oral cavity to a lesser degree. The second model is biological and it is more accurate as it uses microorganisms which build the dental plaque. Among in vitro protocols are also used pH-cycling models. Based on the available literature, it was found that bovine teeth and human teeth with demineralization diagnosed while still inside the oral cavity are the most frequently used kind of specimens in research conducted with use of the chemical model. Not a single case of use of the biological and pH-cycling models were found in the available literature related to the research of infiltrants in minimally invasive dentistry. PMID:26768642

  16. Minimally invasive osteosynthesis of distal tibial fractures using anterolateral locking plate: Evaluation of results and complications

    Institute of Scientific and Technical Information of China (English)

    Devendra Lakhotia; Gaurav Sharma; Kavin Khatri; G.N.Kiran Kumar; Vijay Sharma; Kamran Farooque

    2016-01-01

    Purpose:Soft tissue healing is of paramount importance in distal tibial fractures for a successful outcome.There is an increasing trend of using anterolateral plate due to an adequate soft tissue cover on anterolateral distal tibia.The aim of this study was to evaluate the results and complications of minimally invasive anterolateral locking plate in distal tibial fractures.Methods:This is a retrospective study of 42 patients with distal tibial fractures treated with minimally invasive anterolateral tibial plating.This study evaluates the bone and soft tissue healing along with emphasis on complications related to bone and soft tissue healing.Results:Full weight bearing was allowed in mean time period of 4.95 months (3-12 months).A major local complication of a wound which required revision surgery was seen in one case.Minor complications were identified in 9 cases which comprised 4 cases of marginal necrosis of the surgical wound,1 case of superficial infection,1 case of sensory disturbance over the anterolateral foot,1 case of muscle hernia and 2 cases of delayed union.Mean distance between the posterolateral and anterolateral incision was 5.7 cm (4.5-8 cm).Conclusion:The minimally invasive distal tibial fixation with anterolateral plating is a safe method of stabilization.Distance between anterolateral and posterolateral incision can be placed less than 7 cm apart depending on fracture pattern with proper surgical timing and technique.

  17. Natural and Controlled Demineralization for Study Purposes in Minimally Invasive Dentistry.

    Science.gov (United States)

    Skucha-Nowak, Małgorzata; Gibas, Mirosław; Tanasiewicz, Marta; Twardawa, Henryk; Szklarski, Tomasz

    2015-01-01

    Artificially induced demineralization of enamel is frequently used during laboratory tests, particularly in minimally invasive dentistry. The aim of this study was to analyze demineralization techniques of hard tooth tissue applicable in the research of materials in minimally invasive dentistry. The most important factor taken into consideration when designing a method is to make a model as closely similar to the natural environment of the human oral cavity as it is possible. In vitro models allow us to maintain stability and control over the environment and guarantee repeatability of the results. There are main models to produce dental caries outside of the body. The first model is chemical and it uses acids. It is simplified and reflects the actual environment of the oral cavity to a lesser degree. The second model is biological and it is more accurate as it uses microorganisms which build the dental plaque. Among in vitro protocols are also used pH-cycling models. Based on the available literature, it was found that bovine teeth and human teeth with demineralization diagnosed while still inside the oral cavity are the most frequently used kind of specimens in research conducted with use of the chemical model. Not a single case of use of the biological and pH-cycling models were found in the available literature related to the research of infiltrants in minimally invasive dentistry.

  18. [Research on minimally invasive release treatment of stenosing tenosynovitis of flexor digitorum].

    Science.gov (United States)

    Luo, Tao; Liu, Jing

    2013-05-01

    The minimally invasive release treatment of TCM Small Needle-Knife for the stenosing tenosynovitis of flexor digtorum-"trigger finger" has a more satisfied efficacy. In recent years, many clinicians use self-made small sharp scalpels, iris knives, small sickles, push shear knives, and other improved alternatives to instead of the traditional small needle-knives. Changing the original small needle-knife vertical stabbed cutting method, take a mini-incision, along the traveling direction of flexor tendon make a vertical hook cut, pick cut, straight push cut and any other cuts, completely cut the stenosis of the tendon sheath pulley, to achieve the release therapeutic purposes. The experience of most scholars is: Detailed and thorough understanding refers to the anatomical level of the flexor tendon and surrounding tissue, the structural relationship; Strictly adhere to the indications of minimally invasive release therapy; Proficiency in a dedicated minimally invasive release needle-knives, scalpels, and standardized methods of operation; Accurate positioning before surgery, in surgery traveling direction along flexor tendon, continuous incision to release the middle along the tendon. It can achieve the same or even higher incision release efficacy than the traditional treatment, at the same time also avoids common adverse complications. PMID:23937042

  19. Lumbar Spinal Stenosis Minimally Invasive Treatment with Bilateral Transpedicular Facet Augmentation System

    Energy Technology Data Exchange (ETDEWEB)

    Masala, Salvatore, E-mail: salva.masala@tiscali.it [Interventional Radiology and Radiotherapy, University of Rome ' Tor Vergata' , Department of Diagnostic and Molecular Imaging (Italy); Tarantino, Umberto [University of Rome ' Tor Vergata' , Department of Orthopaedics and Traumatology (Italy); Nano, Giovanni, E-mail: gionano@gmail.com [Interventional Radiology and Radiotherapy, University of Rome ' Tor Vergata' , Department of Diagnostic and Molecular Imaging (Italy); Iundusi, Riccardo [University of Rome ' Tor Vergata' , Department of Orthopaedics and Traumatology (Italy); Fiori, Roberto, E-mail: fiori.r@libero.it; Da Ros, Valerio, E-mail: valeriodaros@hotmail.com; Simonetti, Giovanni [Interventional Radiology and Radiotherapy, University of Rome ' Tor Vergata' , Department of Diagnostic and Molecular Imaging (Italy)

    2013-06-15

    Purpose. The purpose of this study was to evaluate the effectiveness of a new pedicle screw-based posterior dynamic stabilization device PDS Percudyn System Trade-Mark-Sign Anchor and Stabilizer (Interventional Spine Inc., Irvine, CA) as alternative minimally invasive treatment for patients with lumbar spine stenosis. Methods. Twenty-four consecutive patients (8 women, 16 men; mean age 61.8 yr) with lumbar spinal stenosis underwent implantation of the minimally invasive pedicle screw-based device for posterior dynamic stabilization. Inclusion criteria were lumbar stenosis without signs of instability, resistant to conservative treatment, and eligible to traditional surgical posterior decompression. Results. Twenty patients (83 %) progressively improved during the 1-year follow-up. Four (17 %) patients did not show any improvement and opted for surgical posterior decompression. For both responder and nonresponder patients, no device-related complications were reported. Conclusions. Minimally invasive PDS Percudyn System Trade-Mark-Sign has effectively improved the clinical setting of 83 % of highly selected patients treated, delaying the need for traditional surgical therapy.

  20. Minimally invasive surgical treatment for unstable fractures of the proximal phalanx: intramedullary screw☆

    Science.gov (United States)

    Aita, Marcio Aurélio; Mos, Paulo Augusto Castro; de Paula Cardoso Marques Leite, Gisele; Alves, Rafael Saleme; Credídio, Marcos Vinicius; da Costa, Eduardo Fernandes

    2015-01-01

    Objective To analyze the clinical-functional parameters and quality of life of patients undergoing minimally invasive surgical treatment for extra-articular fractures of the proximal phalanx, using an intramedullary screw (Acutrak®). Methods Between January 2011 and September 2014, a prospective study was conducted on 41 patients (48 fingers) with unstable extra-articular fractures of the proximal phalanx, who underwent minimally invasive surgical treatment using an intramedullary screw (Acutrak®). These patients were evaluated 12 months after the surgery by means of the DASH quality-of-life questionnaire, VAS pain scale, measurement of range of motion (ROM, in degrees) and radiographic assessment. Results All the patients achieved adequate reduction and consolidation of their fractures. There were statistically significant improvements in quality of life on the DASH scale, pain on the VAS scale and range of motion. Conclusion The minimally invasive technique for treating unstable extra-articular fractures of the proximal phalanx using an intramedullary screw (Acutrak®) is effective and safe, and it presents satisfactory clinical-functional results. PMID:26962488

  1. Intrathoracic migration of a breast implant after minimally invasive cardiac surgery.

    Science.gov (United States)

    Songcharoen, Somjade Jay; McClure, Michael; Aru, Roberto G; Songcharoen, Somprasong

    2015-03-01

    The aging population, in combination with the popularity of breast augmentation with implants, presents surgeons with a growing number of cases involving women undergoing minimally invasive cardiac surgery (MICS) who have breast implants. We present an unusual complication involving the delayed migration of a subpectoral implant into the chest cavity through an iatrogenic defect after a minimally invasive mitral valve repair. This chest wall defect was ultimately repaired with a latissimus dorsi flap. Although MICS has been described in women with breast implants, the documented experience remains limited. Most authors classically recommend explantation of the prosthesis to provide access to the chest wall; however, some have later suggested preserving the implant capsule in situ while performing the cardiac procedure with gentle retraction. From our literature review and experience, we recommend that the posterior capsule should remain intact. If this is not possible, then the chest wall closure should be reinforced with either mesh, soft tissue, or both. Soft tissue options include the conversion from a subpectoral to a subglandular position to use the pectoralis major, or a latissimus dorsi muscle flap. With the increasing number of these cases along with the complexities of minimally invasive procedures, close communication and planning should be undertaken between both cardiothoracic and plastic surgeons when taking care of these patients. Above all, when faced with postoperative complications after MICS, the plastic surgeon must maintain a high index of clinical suspicion and consider the possibility of intrathoracic migration of an implant so that proper workup and planning may be initiated.

  2. Minimally invasive neurosurgery with interventional magnetic resonance. Its present and future

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Takuo [Jikei Univ., Tokyo (Japan). School of Medicine

    2000-01-01

    We have used X-ray fluoroscopy, ultrasonography, and computed tomography in treatment. However, these methods do not provide precise image. Since magnetic resonance (MR) provides high-resolution images, it is more suitable in treatment. Recently open-type MR has been introduced for clinical diagnosis and treatment. Interventional MR provides a real-time images, high-resolutional images, and thermal distribution. Open MR can be used for minimally invasive neurosurgery. Interventional MR (I-MR) can be used in treatment and is extremely useful for minimally invasive surgery of the brain and spinal cord. We have used an open-type permanent MR scanner (Airis, Hitachi), for minimally invasive neurosurgery. Stereotactic brain tumor biopsy, aspiration of intracerebral hematoma, and percutaneous laser disc hernia ablation under MR guidance has been performed in our department. I-MR provided precise, and less-invasive treatment. Stereotactic biopsy was done in 12 patients with brain tumors. Precise, accurate biopsy is possible with MR fluoroscopic guidance. Hematomas were also aspirated safely and precisely by monitoring real-time image. Percutaneous laser disc hernia ablation (PLDA) was done in 201 patients with lumbar disc herniation (127 at L4/5 and 48 at L5/S1). Patients ranged in age from 17 to 72 years. A MR-compatible 18-gauge 15-cm-long titanium needle was clearly visualized and safety and accurately inserted into the disc herniation from multiple directions. Laser ablation was done (mean, 1,000 J). Signs and symptoms improved immediately after ablation. The overall success rate was 90.5% (MacNab's criteria). Two patients (1.0%) had discitis after PLDA. I-MR and fluoroscopy provide near-real-time images for treatment of brain tumors and hematoma. Precise treatment can be performed with the Patil MR-compatible stereotactic system. PLDA was performed safety and accurately with I-MR. The results were satisfactory. I-MR-PLDA is a safe, precise, and minimally

  3. Minimally invasive treatment of the thoracic spine disease: completely percutaneous and hybrid approaches.

    Science.gov (United States)

    Tamburrelli, Francesco Ciro; Francesco Ciro, Tamburrelli; Scaramuzzo, Laura; Laura, Scaramuzzo; Genitiempo, Maurizio; Maurizio, Genitiempo; Proietti, Luca; Luca, Proietti

    2013-01-01

    The aim of the study was to evaluate the feasibility of a limited invasive approach for the treatment of upper thoracic spine disease. Seven patients with type-A thoracic fractures and three with tumors underwent long thoracic stabilization through a minimally invasive approach. Four patients underwent a completely percutaneous approach while the other three underwent a modified hybrid technique, a combination of percutaneous and open approach. The hybrid constructs were realized using a percutaneous approach to the spine distally to the spinal lesion and by open approach proximally. In two patients, the stabilization was extended proximally up to the cervical spine. Clinical and radiographic assessment was performed during the first year after the operation at 3, 6, and 12 months. No technically related complications were seen. The postoperative recovery was rapid even in the tumor patients with neurologic impairment. Blood loss was irrelevant. At one-year follow-up there was no loosening or breakage of the screws or failure of the implants. When technically feasible a completely percutaneous approach has to be taken in consideration; otherwise, a combined open-percutaneous approach could be planned to minimize the invasivity of a completely open approach to the thoracic spine.

  4. Anterior Spinal Artery Syndrome: Reversible Paraplegia after Minimally Invasive Spine Surgery

    Directory of Open Access Journals (Sweden)

    J. Bredow

    2014-01-01

    Full Text Available Background Context. Percutaneous balloon kyphoplasty is an established minimally invasive technique to treat painful vertebral compression fractures, especially in the context of osteoporosis with a minor complication rate. Purpose. To describe the heparin anticoagulation treatment of paraplegia following balloon kyphoplasty. Study Design. We report the first case of an anterior spinal artery syndrome with a postoperative reversible paraplegia following a minimally invasive spine surgery (balloon kyphoplasty without cement leakage. Methods. A 75-year-old female patient underwent balloon kyphoplasty for a fresh fracture of the first vertebra. Results. Postoperatively, the patient developed an acute anterior spinal artery syndrome with motor paraplegia of the lower extremities as well as loss of pain and temperature sensation with retained proprioception and vibratory sensation. Complete recovery occurred six hours after bolus therapy with 15.000 IU low-molecular heparin. Conclusion. Spine surgeons should consider vascular complications in patients with incomplete spinal cord syndromes after balloon kyphoplasty, not only after more invasive spine surgery. High-dose low-molecular heparin might help to reperfuse the Adamkiewicz artery.

  5. A Potential Solution to Minimally Invasive Device for Oral Surgery: Evaluation of Surgical Outcomes in Rat

    Directory of Open Access Journals (Sweden)

    Keng-Liang Ou

    2015-01-01

    Full Text Available The objective of the present research was to investigate the thermal injury in the brain after minimally invasive electrosurgery using instruments with copper-doped diamond-like carbon (DLC-Cu surface coating. The surface morphologies of DLC-Cu thin films were characterized using scanning electron microscopy and atomic force microscopy. Three-dimensional brain models were reconstructed using magnetic resonance imaging to simulate the electrosurgical operation. In adult rats, a monopolar electrosurgical instrument coated with the DLC-Cu thin film was used to generate lesions in the brain. Animals were sacrificed for evaluations on postoperative days 0, 2, 7, and 28. Data indicated that the temperature decreased significantly when minimally invasive electrosurgical instruments with nanostructure DLC-Cu thin films were used and continued to decrease with increasing film thickness. On the other hand, the DLC-Cu-treated device created a relatively small thermal injury area and lateral thermal effect in the brain tissues. These results indicated that the DLC-Cu thin film minimized excessive thermal injury and uniformly distributed the temperature in the brain. Taken together, our study results suggest that the DLC-Cu film on copper electrode substrates is an effective means for improving the performance of electrosurgical instruments.

  6. Minimal invasive stabilization of osteoporotic vertebral compression fractures. Methods and preinterventional diagnostics; Minimal-invasive Stabilisierung osteoporotischer Wirbelkoerpereinbrueche. Methodik und praeinterventionelle Diagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Grohs, J.G.; Krepler, P. [Orthopaedische Klinik, Universitaet Wien (Austria)

    2004-03-01

    Minimal invasive stabilizations represent a new alternative for the treatment of osteoporotic compression fractures. Vertebroplasty and balloon kyphoplasty are two methods to enhance the strength of osteoporotic vertebral bodies by the means of cement application. Vertebroplasty is the older and technically easier method. The balloon kyphoplasty is the newer and more expensive method which does not only improve pain but also restores the sagittal profile of the spine. By balloon kyphoplasty the height of 101 fractured vertebral bodies could be increased up to 90% and the wedge decreased from 12 to 7 degrees. Pain was reduced from 7,2 to 2,5 points. The Oswestry disability index decreased from 60 to 26 points. This effects persisted over a period of two years. Cement leakage occurred in only 2% of vertebral bodies. Fractures of adjacent vertebral bodies were found in 11%. Good preinterventional diagnostics and intraoperative imaging are necessary to make the balloon kyphoplasty a successful application. (orig.) [German] Minimal-invasive Stabilisierungen stellen eine Alternative zur bisherigen Behandlung osteoporotischer Wirbelfrakturen dar. Die Vertebroplastie und die Ballonkyphoplastik sind 2 Verfahren, um die Festigkeit der Wirbelkoerper nach osteoporotischen Kompressionsfrakturen durch Einbringen von Knochenzement wieder herzustellen. Die Vertebroplastie ist die aeltere, technisch einfachere und kostenguenstigere Technik, geht allerdings regelmaessig mit Zementaustritt einher. Die Ballonkyphoplastik ist die neuere kostenintensivere Technologie, mit der abgesehen von der Schmerzreduktion auch die Wiederherstellung des sagittalen Profils der Wirbelsaeule angestrebt werden kann. Mit der Ballonkyphoplastik konnten bei 101 frakturierten Wirbelkoerpern die Hoehe auf fast 90% des Sollwertes angehoben und die lokale Kyphose von 12 auf 7 vermindert werden. Die Schmerzen wurden - gemessen anhand einer 10-teiligen Skala - von 7,2 auf 2,5 reduziert. Der Oswestry disability

  7. To ventilate or not after minimally invasive direct coronary artery bypass surgery : The role of epidural anesthesia

    NARCIS (Netherlands)

    de Vries, AJ; Mariani, MA; van der Maaten, JMAA; Loef, BG; Lip, H

    2002-01-01

    Objective: To evaluate the effect of immediate postoperative extubation and postoperative ventilation after minimally invasive direct coronary artery bypass (MIDCAB) surgery and to assess the role of epidural anesthesia. Design: Randomized prospective study. Setting: University hospital, single inst

  8. Mast Quadrant-assisted Minimally Invasive Modified Transforaminal Lumbar Interbody Fusion: Single Incision Versus Double Incision

    Directory of Open Access Journals (Sweden)

    Xin-Lei Xia

    2015-01-01

    Full Text Available Background: The concept of minimally invasive techniques is to make every effort to reduce tissue damage. Certainly, reducing skin incision is an important part of these techniques. This study aimed to investigate the clinical feasibility of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF with a small single posterior median incision. Methods: During the period of March 2011 to March 2012, 34 patients with single-segment degenerative lumbar disease underwent the minimally invasive modified TLIF assisted by Mast Quadrant with a small single posterior median incision (single incision group. The cases in this group were compared to 37 patients with single-segment degenerative lumbar disease in the double incision group. The perioperative conditions of patients in these two groups were statistically analyzed and compared. The Oswestry Disability Index (ODI scores, Visual Analog Scale (VAS scores, and sacrospinalis muscle damage evaluation indicators before operation and 3, 12 months postoperation were compared. Results: A total of 31 and 35 cases in the single incision and double incision groups, respectively, completed at least 12 months of systemic follow-up. The differences in perioperative conditions between the two groups were not statistically significant. The incision length of the single incision group was significantly shorter than that of the double incision group (P < 0.01. The ODI and VAS scores of patients in both groups improved significantly at 3 and 12 months postoperation. However, these two indicators at 3 and 12 months postoperation and the sacrospinalis muscle damage evaluation indicators at 3 months postoperation did not differ significantly between the two groups (P ≥ 0.05. Conclusions: Mast Quadrant-assisted modified TLIF with a small single posterior median incision has excellent clinical feasibility compared to minimally invasive TLIF with a double paramedian incision.

  9. Mast Quadrant-assisted Minimally Invasive Modified Transforaminal Lumbar Interbody Fusion: Single Incision Versus Double Incision

    Institute of Scientific and Technical Information of China (English)

    Xin-Lei Xia; Hong-Li Wang; Fei-Zhou Lyu; Li-Xun Wang; Xiao-Sheng Ma; Jian-Yuan Jiang

    2015-01-01

    Background:The concept of minimally invasive techniques is to make every effort to reduce tissue damage.Certainly,reducing skin incision is an important part of these techniques.This study aimed to investigate the clinical feasibility of Mast Quadrant-assisted modified transforaminal lumbar interbody fusion (TLIF) with a small single posterior median incision.Methods:During the period of March 2011 to March 2012,34 patients with single-segment degenerative lumbar disease underwent the minimally invasive modified TLIF assisted by Mast Quadrant with a small single posterior median incision (single incision group).The cases in this group were compared to 37 patients with single-segment degenerative lumbar disease in the double incision group.The perioperative conditions of patients in these two groups were statistically analyzed and compared.The Oswestry Disability Index (ODI) scores,Visual Analog Scale (VAS) scores,and sacrospinalis muscle damage evaluation indicators before operation and 3,12 months postoperation were compared.Results:A total of 31 and 35 cases in the single incision and double incision groups,respectively,completed at least 12 months of systemic follow-up.The differences in perioperative conditions between the two groups were not statistically significant.The incision length of the single incision group was significantly shorter than that of the double incision group (P < 0.01).The ODI and VAS scores of patients in both groups improved significantly at 3 and 12 months postoperation.However,these two indicators at 3 and 12 months postoperation and the sacrospinalis muscle damage evaluation indicators at 3 months postoperation did not differ significantly between the two groups (P ≥ 0.05).Conclusions:Mast Quadrant-assisted modified TLIF with a small single posterior median incision has excellent clinical feasibility compared to minimally invasive TLIF with a double paramedian incision.

  10. Minimally-invasive posterior lumbar stabilization for degenerative low back pain and sciatica. A review

    International Nuclear Information System (INIS)

    The most diffused surgical techniques for stabilization of the painful degenerated and instable lumbar spine, represented by transpedicular screws and rods instrumentation with or without interbody cages or disk replacements, require widely open and/or difficult and poorly anatomical accesses. However, such surgical techniques and approaches, although still considered “standard of care”, are burdened by high costs, long recovery times and several potential complications. Hence the effort to open new minimally-invasive surgical approaches to eliminate painful abnormal motion. The surgical and radiological communities are exploring, since more than a decade, alternative, minimally-invasive or even percutaneous techniques to fuse and lock an instable lumbar segment. Another promising line of research is represented by the so-called dynamic stabilization (non-fusion or motion preservation back surgery), which aims to provide stabilization to the lumbar spinal units (SUs), while maintaining their mobility and function. Risk of potential complications of traditional fusion methods (infection, CSF leaks, harvest site pain, instrumentation failure) are reduced, particularly transitional disease (i.e., the biomechanical stresses imposed on the adjacent segments, resulting in delayed degenerative changes in adjacent facet joints and discs). Dynamic stabilization modifies the distribution of loads within the SU, moving them away from sensitive (painful) areas of the SU. Basic biomechanics of the SU will be discussed, to clarify the mode of action of the different posterior stabilization devices. Most devices are minimally invasive or percutaneous, thus accessible to radiologists’ interventional practice. Devices will be described, together with indications for patient selection, surgical approaches and possible complications

  11. Minimally invasive keyhole approaches for removal of tumors of the third ventricle

    Institute of Scientific and Technical Information of China (English)

    LAN Qing; DONG Jun; HUANG Qiang

    2006-01-01

    Background In recent years, keyhole microsurgery has become an important subject of modem minimally invasive neurosurgery. In this study, minimally invasive techniques avoiding unnecessary tissue injuries were applied to refine traditional approaches for the removal of third ventricular tumors within a limited operative filed.Methods Individualized keyhole approaches were designed according to the characteristics of third ventricular tumors and their growth patterns. A series of keyhole approaches such as supraorbital subfrontal approach,infratentorial supracerebellar approach, interhemispheric transcallosal approach, pterional approach were taken to enter the third ventricle anteriorly, posteriorly, superiorly or laterally, respectively. A total of 34 removed tumors in or extended into the third ventricle included 11 craniopharyngiomas, 10 pituitary adenomas, 2 pinealomas, 1cholesteatoma, 3 germinomas, and 7 gliomas.Results Total tumor resection was done in 27 (79.4%) of the patients, and subtotal resection in 7 patients (20.6%). Residual tumor was due to tight adherence of germinoma to the vein of Galen (1 patient),craniopharyngioma to the pituitary stalk (3), supratentorial extension of pineal region gliomas (1), suprasellar extension of gliomas (1) and giant pituitary adenoma (1). Complications such as brain contusion, postoperative hemorrhage and infection were not associated with keyhole approaches. Extended incision or enlarged bone flap was not made because of episode during operation or inadequate exposure.Conclusions Keyhole approaches are safe, effective and minimally invasive in the surgical treatment of tumors deeply seated in the third ventricle. Individualized keyhole approach ensures a successful treatment. Tumors in the upper middle part of the third ventricle can be exposed by the interhemispheric transcallosal keyhole approach. Tumors of the posterior third ventricle may be well exposed by the infratentorial supracerebellar keyhole approach

  12. Minimally invasive treatment of the KobyGard system for plantar fasciitis:a retrospective study

    Institute of Scientific and Technical Information of China (English)

    XU Hai-lin; XU Lei; ZHANG Dian-ying; FU Zhong-guo; WANG Tian-bing; ZHANG Pei-xun; JIANG Bao-guo

    2012-01-01

    Background Calcodynia is a persistent condition that podiatric surgeons frequently see among their patients,and plantar fasciitis is the main reason for pain.When systematic conservative treatments fail to alleviate these conditions,it requires surgical intervention,mainly plantar fascia release surgery,which used to be an open heel release surgery.This study aimed to investigate whether minimally invasive treatment of the KobyGard system is more safe and effective for plantar fasciitis.Methods From May 2009 to May 2012,a total of nine patients,three males and six females with plantar fasciitis,were treated in the Peking University People's Hospital with minimally invasive instruments,the KobyGard system,for the release of plantar fascia.Three patients,experiencing bilateral calcaneodynia,underwent bilateral surgery.One patient had bilateral calcaneodynia with enthesiopathy of Achilles tendon,and underwent Achilles tendon surgery.Preoperative and postoperative Visual Analogue Scale(VAS),American Orthopaedic Foot and Ankle Society(AOFAS)ankle and hindfoot scores,Roles and Maudsley scores and SF-36 questionnaires were evaluated.Results The nine patients were successfully followed up.The average postoperative follow-up time was 13.2 months and it varied from 2.0 months to 21.0 months.Pre-and postoperative average scores of VAS was 9.3 and 1.9(P<0.001),respectively.Pre-and postoperative average scores of AOFAS hind foot was 36.0 and 82.0(P<0.001),respectively.There was also a statistically significant amelioration in SF-36 scores and the Roles and Maudlesy scores.Eight patients were satisfied with the surgery outcome.Conclusion Minimally invasive surgery treatment of the KobyGard system for plantar fasciitis has the advantages of shorter operation time,ease of operation,and similar satisfaction rates with open surgery,but with smaller surgical incision.

  13. Minimally-invasive posterior lumbar stabilization for degenerative low back pain and sciatica. A review.

    Science.gov (United States)

    Bonaldi, G; Brembilla, C; Cianfoni, A

    2015-05-01

    The most diffused surgical techniques for stabilization of the painful degenerated and instable lumbar spine, represented by transpedicular screws and rods instrumentation with or without interbody cages or disk replacements, require widely open and/or difficult and poorly anatomical accesses. However, such surgical techniques and approaches, although still considered "standard of care", are burdened by high costs, long recovery times and several potential complications. Hence the effort to open new minimally-invasive surgical approaches to eliminate painful abnormal motion. The surgical and radiological communities are exploring, since more than a decade, alternative, minimally-invasive or even percutaneous techniques to fuse and lock an instable lumbar segment. Another promising line of research is represented by the so-called dynamic stabilization (non-fusion or motion preservation back surgery), which aims to provide stabilization to the lumbar spinal units (SUs), while maintaining their mobility and function. Risk of potential complications of traditional fusion methods (infection, CSF leaks, harvest site pain, instrumentation failure) are reduced, particularly transitional disease (i.e., the biomechanical stresses imposed on the adjacent segments, resulting in delayed degenerative changes in adjacent facet joints and discs). Dynamic stabilization modifies the distribution of loads within the SU, moving them away from sensitive (painful) areas of the SU. Basic biomechanics of the SU will be discussed, to clarify the mode of action of the different posterior stabilization devices. Most devices are minimally invasive or percutaneous, thus accessible to radiologists' interventional practice. Devices will be described, together with indications for patient selection, surgical approaches and possible complications.

  14. Minimally-invasive posterior lumbar stabilization for degenerative low back pain and sciatica. A review

    Energy Technology Data Exchange (ETDEWEB)

    Bonaldi, G., E-mail: bbonaldi@yahoo.com [Neuroradiology Department, Ospedale Papa Giovanni XXIII, Bergamo (Italy); Brembilla, C. [Department of neurosurgery, Ospedale Papa Giovanni XXIII, Bergamo (Italy); Cianfoni, A. [Neuroradiology of Neurocenter of Italian Switzerland, Lugano, CH (Switzerland)

    2015-05-15

    The most diffused surgical techniques for stabilization of the painful degenerated and instable lumbar spine, represented by transpedicular screws and rods instrumentation with or without interbody cages or disk replacements, require widely open and/or difficult and poorly anatomical accesses. However, such surgical techniques and approaches, although still considered “standard of care”, are burdened by high costs, long recovery times and several potential complications. Hence the effort to open new minimally-invasive surgical approaches to eliminate painful abnormal motion. The surgical and radiological communities are exploring, since more than a decade, alternative, minimally-invasive or even percutaneous techniques to fuse and lock an instable lumbar segment. Another promising line of research is represented by the so-called dynamic stabilization (non-fusion or motion preservation back surgery), which aims to provide stabilization to the lumbar spinal units (SUs), while maintaining their mobility and function. Risk of potential complications of traditional fusion methods (infection, CSF leaks, harvest site pain, instrumentation failure) are reduced, particularly transitional disease (i.e., the biomechanical stresses imposed on the adjacent segments, resulting in delayed degenerative changes in adjacent facet joints and discs). Dynamic stabilization modifies the distribution of loads within the SU, moving them away from sensitive (painful) areas of the SU. Basic biomechanics of the SU will be discussed, to clarify the mode of action of the different posterior stabilization devices. Most devices are minimally invasive or percutaneous, thus accessible to radiologists’ interventional practice. Devices will be described, together with indications for patient selection, surgical approaches and possible complications.

  15. Clinical efficacy of three different minimally invasive procedures for far lateral lumbar disc herniation

    Institute of Scientific and Technical Information of China (English)

    LIU Tao; ZHOU Yue; WANG Jian; CHU Tong-wei; LI Chang-qing; ZHANG Zheng-feng; ZHANG Chad; ZHENG Wen-jie

    2012-01-01

    Background Far lateral lumbar disc hemiation (FLLDH) accounts for 2.6% to 11.7% of all lumbar herniated discs.Numerous surgical approaches have been described for treating this condition.The purpose of this study was to evaluate minimally invasive surgical techniques for the treatment of FLLDH.Methoda From June 2000 to March 2006,52 patients with FLLDH were treated with minimally invasive procedures.All patients were assessed by anteroposterior and lateral roentgenography and computed tomography (CT).Some patients underwent myelography,discography,and magnetic resonance imaging.Procedures performed included Yeung Endoscopy Spine System (YESS) (n=25),METRx MicroDiscectomy System (n=13),and X-tube (n=14).Patients were followed up for a mean of 13.5 months.Clinical outcomes were assessed using a visual analog scale (VAS) and Nakai criteria.Results All 3 procedures significantly improved radiating leg symptoms (P <0.005).After surgery,84.0%,84.6%,and 92.8% of patients in the YESS,METRx,and X-tube groups had excellent or good outcomes.There were no statistically significant differences of VAS scores between the groups.The YESS procedure was associated with the shortest operation time,simplest anesthesia,and least trauma compared with the other 2 procedures,especially for type Ⅰherniations.The METRx procedure was the most suitable for type Ⅱ herniations and posterior endoscopic facetectomy.Posterior lumbar interbody fusion and unilateral pedicle screw instrumentation with X-tube was the most suitable for herniations combined with degenerative lumbar instability (type Ⅲ).Conclusion Minimally invasive strategies and options should be determined with reference to the type of FLLDH.

  16. Additional right-sided upper “Half-Mini-Thoracotomy” for aortocoronary bypass grafting during minimally invasive multivessel revascularization

    OpenAIRE

    Aubin, Hug; Akhyari, Payam; Lichtenberg, Artur; Albert, Alexander

    2015-01-01

    Background Although minimally invasive coronary artery bypass grafting (MICS-CABG) has been shown to result in excellent clinical outcomes overall adoption rates still remain low. Traditional strategies for minimally invasive multivessel revascularization - usually performed through single-thoracotomy – have to deal with restricted grafting possibilities and possible increased susceptibility of arterial grafts to competitive flow, restraining their applicability to very specific indications o...

  17. Early functional results after Hemiarthroplasty for femoral neck fracture: a randomized comparison between a minimal invasive and a conventional approach

    OpenAIRE

    Renken Felix; Renken Svenja; Paech Andreas; Wenzl Michael; Unger Andreas; Schulz Arndt P

    2012-01-01

    Abstract Background A minimal invasive approach for elective hip surgery has been implemented in our institution in the past. It is widely hypothesized that implanting artificial hips in a minimal invasive fashion decreases surgical trauma and is helpful in the rehabilitation process in elective hip surgery. Thereby geriatric patients requiring emergency hip surgery also could theoretically benefit from a procedure that involves less tissue trauma. Methods Sixty patients who sustained a fract...

  18. How I do it: self-retaining atrial retractors for robotic and minimally invasive mitral valve surgery.

    Science.gov (United States)

    Ishikawa, Norihiko; Sun, You Su; Nifong, L Wiley; Watanabe, Go; Chitwood, W Randolph

    2007-01-01

    Successful surgery, particularly on the heart valves, is dependent on excellent and consistent exposure of the operative field. In this report, we describe 2 types of new atrial retractors designed for robotic and minimally invasive mitral valve surgery. These simple and easy-to-handle atrial retractors provide exceptional and consistent exposure of the left atrium in robotic and minimally invasive mitral valve surgery and prevent traumatic injury.

  19. Minimally invasive management of metastases from gastrointestinal stromal tumors; Minimalinvasive Therapieoptionen bei Metastasen gastrointestinaler Stromatumoren

    Energy Technology Data Exchange (ETDEWEB)

    Kamusella, P.C.; Bethke, A.; Platzek, I.; Wiggermann, P.; Wissgott, C.; Stroszczynski, C. [Universitaetsklinikum Dresden, Radiologisches Institut, Dresden (Germany)

    2009-12-15

    Minimally invasive radiological procedures can lead to an improvement in the prognosis and the clinical symptoms in cases of metastases of gastro-intestinal stromal tumors (GIST) in the context of multimodal therapy concepts. In the context of interdisciplinary therapy decision-making radiofrequency ablation (RFA) and transarterial tumor embolization should be considered. (orig.) [German] Minimalinvasive radiologische Verfahren koennen bei Metastasierung eines gastrointestinalen Stromatumors (GIST) im Rahmen multimodaler Therapiekonzepte zu einer Verbesserung der Prognose und klinischen Symptomatik fuehren. Im Rahmen des interdisziplinaeren Therapienentscheids sollten die Radiofrequenzablation (RFA) und die transarterielle Tumorembolisation in Betracht gezogen werden. (orig.)

  20. Real-time stereo generation for surgical vision during minimal invasive robotic surgery

    Science.gov (United States)

    Laddi, Amit; Bhardwaj, Vijay; Mahapatra, Prasant; Pankaj, Dinesh; Kumar, Amod

    2016-03-01

    This paper proposes a framework for 3D surgical vision for minimal invasive robotic surgery. It presents an approach for generating the three dimensional view of the in-vivo live surgical procedures from two images captured by very small sized, full resolution camera sensor rig. A pre-processing scheme is employed to enhance the image quality and equalizing the color profile of two images. Polarized Projection using interlacing two images give a smooth and strain free three dimensional view. The algorithm runs in real time with good speed at full HD resolution.

  1. Optimization Algorithm for Operation Comfortability of Master Manipulator of Minimally Invasive Surgery Robot

    Institute of Scientific and Technical Information of China (English)

    李进华; 王雪生; 邢元; 王树新; 李建民; 梁科

    2016-01-01

    To evaluate the operation comfortability in the master-slave robotic minimally invasive surgery (MIS), an optimal function was built with two operation comfortability decided indices, i.e., the center distance and volume contact ratio. Two verifying experiments on Phantom Desktop and MicroHand S were conducted. Experimental results show that the operation effect at the optimal relative location is better than that at the random location, which means that the optimal function constructed in this paper is effective in optimizing the operation comfortability.

  2. A Proposed Staging Classification for Minimally Invasive Management of Haglund's Syndrome with Percutaneous and Endoscopic Surgery.

    Science.gov (United States)

    Syed, Turab Arshad; Perera, Anthony

    2016-09-01

    Haglund's syndrome encompasses several different pathologies, including Haglund's deformity, insertional Achilles tendonopathy, retrocalcaneal bursitis, and superficial bursitis. Traditionally treated with open surgery, there is increasing interest in a more minimally invasive approach to this difficult region to reduce complications and improve the rate and ease of recovery. We review the evidence available for 2 of these techniques: the endoscopic calcaneoplasty and percutaneous Zadek's calcaneal osteotomy (also known as Keck and Kelly's osteotomy). The senior author's classification for management of the condition is presented as well as describing his operative technique for these procedures. PMID:27524710

  3. Minimally invasive transforaminal lumbar interbody fusion with percutaneous navigated guidewireless lumbosacral pedicle screw fixation.

    Science.gov (United States)

    Chen, Kevin S; Park, Paul

    2016-07-01

    This video details the minimally invasive approach for treatment of a symptomatic Grade II lytic spondylolisthesis with high-grade foraminal stenosis. In this procedure, the use of a navigated, guidewireless technique for percutaneous pedicle screw placement at the lumbosacral junction is highlighted following initial decompression and transforaminal interbody fusion. Key steps of the procedure are delineated that include positioning, exposure, technique for interbody fusion, intraoperative image acquisition, and use of a concise 2-step process for navigated screw placement without using guidewires. The video can be found here: https://youtu.be/2u6H4Pc_8To . PMID:27364422

  4. Role of minimally invasive surgery for adult spinal deformity in preventing complications.

    Science.gov (United States)

    Yen, Chun-Po; Mosley, Yusef I; Uribe, Juan S

    2016-09-01

    With the aging population, there is a rising prevalence of degenerative spinal deformity and need of surgical care for these patients. Surgical treatment for adult spinal deformity (ASD) is often fraught with a high rate of complications. Minimally invasive surgery (MIS) has for the past decade been adopted by spine surgeons to treat ASD in the hopes of reducing access-related morbidity and perioperative complications. The benefits of MIS approach in general and recent development of MIS techniques to avoid long-term complications such as pseudoarthrosis or proximal junctional kyphosis are reviewed. PMID:27411527

  5. Minimally invasive keyhole approaches in spinal intradural tumor surgery: report of two cases and conceptual considerations.

    Science.gov (United States)

    Reisch, Robert; Koechlin, Nicolas O; Marcus, Hani J

    2016-09-01

    Despite their predominantly histologically benign nature, intradural tumors may become symptomatic by virtue of their space-occupying effect, causing severe neurological deficits. The gold standard treatment is total excision of the lesion; however, extended dorsal and dorsolateral approaches may cause late complications due to iatrogenic destruction of the posterolateral elements of the spine. In this article, we describe our concept of minimally invasive spinal tumor surgery. Two illustrative cases demonstrate the feasibility and safety of keyhole fenestrations exposing the spinal canal. PMID:25336048

  6. 食管癌的微创术%Minimal Invasive Surgery for Esophageal Cancer

    Institute of Scientific and Technical Information of China (English)

    A.H.H(o)lscher; Ch.Gutschow

    2004-01-01

    Thoracoscopic esophagectomy is only established in some centers and affords a cervical anastomosis because intrathoracic anastomosis as a routine is technically too difficult. Laparoscopic mobilisation of the stomach (gastrolysis) is an important contribution for minimal invasive surgery of esophageal cancer.This procedure reduces the stress of the two cavity operation for the patient and allows the construction of a comparable gastric conduit like by open surgery. The technique of laparoscopic gastrolysis as preparation for transthoracic en bloc esophagectomy is described in detail and preliminary results are briefly mentioned.

  7. Minimal-invasive posterior approach for total hip arthroplasty versus standard lateral approach.

    Science.gov (United States)

    Schleicher, Iris; Haas, Holger; Adams, Tim S; Szalay, Gabor; Klein, Heiko; Kordelle, Jens

    2011-08-01

    In this prospective study we compared clinical and radiological results and rehabilitation progress of 64 patients who underwent total hip arthroplasty using the standard lateral approach with 64 patients operated with a minimal-invasive (MIS) posterior approach. The outcome of our study did not show any significant differences with regard to patient's safety such as complication rate and radiological assessment of the cup position. There was no difference in the duration of surgery, blood loss, hospital stay and postoperative leg length discrepancy. Rehabilitation milestones were achieved earlier by MIS patients and three and six months postoperatively, the Harris Hip Score of the MIS group was significantly higher.

  8. Occlusion of atrial septal defect utilizing occluder devise via minimally invasive right chest approach

    Institute of Scientific and Technical Information of China (English)

    励峰; 李伟; 康宁; 龚宝生; 吴东进; 徐方杰; 邱兆昆; 吴卫华

    2011-01-01

    Objective To evaluate atrial septal defect (ASD) occlusion employing a small right anterior thoracotomy approach. Methods A total of 21 patients with ASD underwent general anesthesia and 2 -3 cm incision was made in the fourth right intercostal space. Utilizing transesophageal or transthoracic echocardiography, the occluder was released using a monotube unit. Results All patients were occluded successfully. No patient required open surgery utilizing extracorporeal circulation. There were no major complications and no evidence of residual atrial shunt. Conclusion ASD occlusion via a minimal surgical incision is safe, less invasive, and has excellent outcomes.

  9. Minimally invasive procedures for the management of vertebral bone pain due to cancer

    DEFF Research Database (Denmark)

    Mercadante, Sebastiano; Klepstad, Pål; Kurita, Geana Paula;

    2016-01-01

    BACKGROUND: Image-guided percutaneous ablation methods have proved effective for treatment of benign bone tumors and for palliation of metastases involving the bone. However, the role of these techniques is controversial and has to be better defined in the setting of palliative care. METHODS......: A systematic review of the existing data regarding minimally invasive techniques for the pain management of vertebral bone metastases was performed by experts of the European Palliative Care Research Network. RESULTS: Only five papers were taken into consideration after performing rigorous screening according...

  10. Incorporating Minimally Invasive Procedures into an Aesthetic Surgery Practice.

    Science.gov (United States)

    Matarasso, Alan; Nikfarjam, Jeremy; Abramowitz, Lauren

    2016-07-01

    Minimally invasive procedures in an aesthetic practice have grown over the past decade. Plastic surgery practices are embracing the incorporation of injectables and lasers as adjuncts to their surgical procedures. The use of botulinum toxin, hyaluronic acid fillers, and lasers has made a significant impact on the authors' practice. The authors describe the important considerations, consultation goals, and procedural steps with injectables and fillers. The novel use of deoxycholic acid injections is also described. The authors strongly think that as options continue to expand, plastic surgeons will benefit from taking an active role in adopting these new innovations. PMID:27363759

  11. Implementation of minimally invasive and objective humane endpoints in the study of murine Plasmodium infections

    DEFF Research Database (Denmark)

    Dellavalle, B; Kirchhoff, J; Maretty, L;

    2014-01-01

    anaemia (SMA). Furthermore, we investigate the potential of a minimally invasive, non-contact infrared thermometer for repeated BT measurement. ECM was induced with Plasmodium berghei ANKA infection in C57Bl/6 mice. SMA was induced with Plasmodium chabaudi AS infection in A/J mice. Our previous published...... endpoint was applied in ECM and 30 °C was pre-determined as the lowest permitted limit for termination in SMA according to consultation with the Danish Animal Inspectorate. Infrared thermometer was compared with the rectal probe after cervical dislocation, ECM and SMA. Linear regression analysis of rectal...

  12. Comparative study between open and minimally invasive approach in the surgical management of esophageal leiomyoma

    Directory of Open Access Journals (Sweden)

    Diego Ramos

    2016-01-01

    Full Text Available Introduction: Leiomyomas are the most common benign tumors of the esophagus. Although classically surgical enucleation through thoracotomy or laparotomy has been widely accepted as treatment of choice, development of endoscopic and minimally invasive procedures has completely changed the surgical management of these tumors. Material and methods: We performed a retrospective review of all esophageal leiomyoma operated at Hospital Universitario Ramón y Cajal (Madrid, Spain between January 1986 and December 2014, analyzing patients' demographic data, symptomatology, tumor size and location, diagnostic tests, surgical data, complications and postoperative stay. Results: Thirteen patients were found within that period, 8 men and 5 women, with a mean age of 53.62 years (range 35-70 years. Surgical enucleation was achieved in all patients. In 8 cases (61.54% a thoracic approach was performed (4 thoracotomies and 4 thoracoscopies, and in 5 cases (38.56% an abdominal approach was performed (3 laparotomies and 2 laparoscopies; enucleation was carried out through a minimally invasive approach in 6 patients (46.15%. There were no cases of endoscopic resection alone. Surgery mean length was 174.38 minutes (range 70-270 minutes and median postoperative stay was 6.5 days (range 2-27 days. There was neither mortality nor cases of intraoperative complications were described. No postoperative major complications were reported; however one patient presented important pain in his right hemithorax that required management and long term follow-up by the Pain Management Unit. With a mean follow-up of 165.57 months (median 170; range 29-336 months no recurrences were reported. Conclusion: Enucleation is the treatment of choice for the majority of esophageal leiomyomas. In our experience, duration of the surgical procedure through minimally invasive approach was longer than surgery through open approach; however, postoperative stay was shorter in the first group

  13. Minimal invasive transforaminal lumbar interbody fusion versus open transforaminal lumbar interbody fusion

    Directory of Open Access Journals (Sweden)

    Arvind G Kulkarni

    2016-01-01

    Conclusion: The results in MI TLIF are comparable with O-TLIF in terms of outcomes. The advantages of MI-TLIF are lesser blood loss, shorter hospital stay, lesser tissue trauma, and early mobilization. The challenges of MI-TLIF lie in the steep learning curve and significant radiation exposure. The ultimate success of TLIF lies in the execution of the procedure, and in this respect the ability to achieve similar results using a minimally invasive technique makes MI-TLIF an attractive alternative.

  14. Minimally invasive L5-S1 oblique lumbar interbody fusion with anterior plate.

    Science.gov (United States)

    Pham, Martin H; Jakoi, Andre M; Hsieh, Patrick C

    2016-07-01

    Lumbar interbody fusion is an important technique for the treatment of degenerative disc disease and degenerative scoliosis. The oblique lumbar interbody fusion (OLIF) establishes a minimally invasive retroperitoneal exposure anterior to the psoas and lumbar plexus. In this video case presentation, the authors demonstrate the techniques of the OLIF at L5-S1 performed on a 69-year-old female with degenerative scoliosis as one component of an overall strategy for her deformity correction. The video can be found here: https://youtu.be/VMUYWKLAl0g . PMID:27364428

  15. Minimally invasive blood sampling method for genetic studies on Gopherus tortoises

    Directory of Open Access Journals (Sweden)

    García–Feria, L. M.

    2015-04-01

    Full Text Available Obtaining good quality tissue samples is the first hurdle in any molecular study. This is especially true for studies involving management and conservation of wild fauna. In the case of tortoises, the most common sources of DNA are blood samples. However, only a minimal amount of blood is required for PCR assays. Samples are obtained mainly from the brachial and jugular vein after restraining the animal chemically, or from conscious individuals by severe handling methods and clamping. Herein, we present a minimally invasive technique that has proven effective for extracting small quantities of blood, suitable for genetic analyses. Furthermore, the samples obtained yielded better DNA amplification than other cell sources, such as cloacal epithelium cells. After two years of use on wild tortoises, this technique has shown to be harmless. We suggest that sampling a small amount of blood could also be useful for other types of analyses, such as physiologic and medical monitoring.

  16. Urolift: a New Face of Minimally Invasive Surgical Technique for Benign Prostatic Hyperplasia?

    Science.gov (United States)

    Tsui, Johnson F; Dixon, Christopher M

    2016-09-01

    The management of clinical benign prostatic hyperplasia (BPH) remains a common problem in daily urologic practice. Recently, a new minimally invasive procedure for BPH, the Urolift System, has been introduced. This article reviews the current literature discussing the technique, efficacy, adverse events, limitations, and possible concerns. The existing data which includes a 3-month, sham-controlled multicenter trial with a subsequent 3-year follow-up indicates significant improvements in the outcome measures in particular urinary symptoms. The adverse event profile and reoperation rates are acceptable. A particular benefit includes the lack of negative effects on erectile or ejaculatory function. The procedure can be performed with minimal anesthesia, but is limited to lateral lobe enlargement as it is unsuitable for median lobe or central zone obstruction. Another potential drawback is the placement of permanent implants into the prostatic urethra. The adoption of this procedure will ultimately be determined by multiple factors including ease of use, patient satisfaction, durability, and reimbursement. PMID:27432380

  17. Central acetabular fracture with dislocation treated by minimally invasive plate osteosynthesis.

    Science.gov (United States)

    2015-06-01

    Central acetabular fractures with dislocation are usually the result of high-energy trauma, resulting in joint incongruity, and are frequently associated with other injuries. Open reduction and internal fixation has been the standard treatment for acetabular fractures, but it is associated with extensive surgical trauma, and complications such as haematoma formation, iatrogenic nerve injury, and heterotopic ossification. We present the case of a 63-year-old female who sustained a central acetabular fracture of the hip with dislocation as a result of an automobile collision. Closed reduction of the dislocation was performed, and the fracture was managed by minimally invasive plate osteosynthesis using a specially prepared plate. At 01 year postoperatively, radiographs showed the fracture to have been well-healed with good congruity of the joint. However, heterotopic ossification of the joint was noted. The technique allowed reduction of the fracture with minimal surgical trauma.

  18. Minimally Invasive Direct Repair of Bilateral Lumbar Spine Pars Defects in Athletes

    Directory of Open Access Journals (Sweden)

    Gabriel A. Widi

    2013-01-01

    Full Text Available Spondylolysis of the lumbar spine has traditionally been treated using a variety of techniques ranging from conservative care to fusion. Direct repair of the defect may be utilized in young adult patients without significant disc degeneration and lumbar instability. We used minimally invasive techniques to place pars interarticularis screws with the use of an intraoperative CT scanner in three young adults, including two athletes. This technique is a modification of the original procedure in 1970 by Buck, and it offers the advantage of minimal muscle dissection and optimal screw trajectory. There were no intra- or postoperative complications. The detailed operative procedure and the postoperative course along with a brief review of pars interarticularis defect treatment are discussed.

  19. Differentiating pre- and minimally invasive from invasive adenocarcinoma using CT-features in persistent pulmonary part-solid nodules in Caucasian patients

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, Julien G., E-mail: JCohen@chu-grenoble.fr [Clinique Universitaire de Radiologie et Imagerie Médicale (CURIM), Université Joseph Fourier, Centre Hospitalier Universitaire de Grenoble, CS 10217, 38043 Grenoble Cedex 9 (France); Reymond, Emilie [Clinique Universitaire de Radiologie et Imagerie Médicale (CURIM), Université Joseph Fourier, Centre Hospitalier Universitaire de Grenoble, CS 10217, 38043 Grenoble Cedex 9 (France); Lederlin, Mathieu [Service de Radiologie, Université Segalen Bordeaux, Centre Hospitalier Universitaire de Bordeaux, 12 rue Dubernat, 33404 Bordeaux Cedex (France); Medici, Maud [Centre d’Investigation Clinique – Innovation Technologique (CIC-IT), Pavillon Taillefer, 38706 La Tronche Cedex (France); Lantuejoul, Sylvie [Departement d’Anatomie et Cytologie Pathologique (DACP), Université Joseph Fourier, Centre Hospitalier Universitaire de Grenoble, CS 10217, 38043 Grenoble Cedex 9 (France); Laurent, François [Service de Radiologie, Université Segalen Bordeaux, Centre Hospitalier Universitaire de Bordeaux, 12 rue Dubernat, 33404 Bordeaux Cedex (France); Arbib, François [Departement de Pneumologie, Université Joseph Fourier, Centre Hospitalier Universitaire de Grenoble, CS 10217, 38043 Grenoble Cedex 9 (France); Jankowski, Adrien [Clinique Universitaire de Radiologie et Imagerie Médicale (CURIM), Université Joseph Fourier, Centre Hospitalier Universitaire de Grenoble, CS 10217, 38043 Grenoble Cedex 9 (France); and others

    2015-04-15

    Highlights: •We analyzed CT-features of part-solid ground glass nodules in Caucasians. •These CT-features were compared to pathology on full resection specimen. •Several CT-features can help differentiating invasive adenocarcinoma. •A solid component larger than 5 mm had 100% sensitivity for invasive adenocarcinoma. -- Abstract: Objective: To retrospectively investigate the diagnostic value of pre-operative CT-features between pre/minimally invasive and invasive lesions in part-solid persistent pulmonary ground glass nodules in a Caucasian population. Materials and methods: Retrospective review of two pre-operative CTs for 31 nodules in 30 patients. There were 10 adenocarcinomas in situ, 1 minimally invasive adenocarcinoma, 20 invasive adenocarcinomas. We analyzed the correlation between histopathology and the following CT-features: maximal axial diameter, maximal orthogonal axial diameter, height, density, size of solid component, air bronchogram, pleural retraction, nodule mass, disappearance rate and their evolution during follow-up. Results: In univariate analysis, invasive adenocarcinomas had a higher maximal height, density, solid component size, mass, a lower disappearance rate and presented more often with pleural retraction (p < 0.05). After logistic regression performed with the uncorrelated parameters using a method of selection of variables, only the size of solid component remained significant, with 100% sensitivity for invasive adenocarcinoma when larger than 5 mm. Conclusion: Preoperative CT-features can help differentiating in situ and minimally invasive adenocarcinomas from invasive adenocarcinomas in Caucasian patients. A solid component larger than 5 mm in diameter had 100% sensitivity for the diagnosis of invasive adenocarcinoma.

  20. An augmented reality platform for planning of minimally invasive cardiac surgeries

    Science.gov (United States)

    Chen, Elvis C. S.; Sarkar, Kripasindhu; Baxter, John S. H.; Moore, John; Wedlake, Chris; Peters, Terry M.

    2012-02-01

    One of the fundamental components in all Image Guided Surgery (IGS) applications is a method for presenting information to the surgeon in a simple, effective manner. This paper describes the first steps in our new Augmented Reality (AR) information delivery program. The system makes use of new "off the shelf" AR glasses that are both light-weight and unobtrusive, with adequate resolution for many IGS applications. Our first application is perioperative planning of minimally invasive robot-assisted cardiac surgery. In this procedure, a combination of tracking technologies and intraoperative ultrasound is used to map the migration of cardiac targets prior to selection of port locations for trocars that enter the chest. The AR glasses will then be used to present this heart migration data to the surgeon, overlaid onto the patients chest. The current paper describes the calibration process for the AR glasses, their integration into our IGS framework for minimally invasive robotic cardiac surgery, and preliminary validation of the system. Validation results indicate a mean 3D triangulation error of 2.9 +/- 3.3mm, 2D projection error of 2.1 +/- 2.1 pixels, and Normalized Stereo Calibration Error of 3.3.

  1. Kinematic, workspace and singularity analysis of a new parallel robot used in minimally invasive surgery

    Science.gov (United States)

    Stoica, Alin; Pisla, Doina; Andras, Szilaghyi; Gherman, Bogdan; Gyurka, Bela-Zoltan; Plitea, Nicolae

    2013-03-01

    In the last ten years, due to development in robotic assisted surgery, the minimally invasive surgery has greatly changed. Until now, the vast majority of robots used in surgery, have serial structures. Due to the orientation parallel module, the structure is able to reduce the pressure exerted on the entrance point in the patient's abdominal wall. The parallel robot can also handle both a laparoscope as well an active instrument for different surgical procedures. The advantage of this parallel structure is that the geometric model has been obtained through an analytical approach. The kinematic modelling of a new parallel architecture, the inverse and direct geometric model and the inverse and direct kinematic models for velocities and accelerations are being determined. The paper will demonstrate that with this parallel structure, one can obtain the necessary workspace required for a minimally invasive operation. The robot workspace was generated using the inverse geometric model. An indepth study of different types of singularity is performed, allowing the development of safe control algorithms of the experimental model. Some kinematic simulation results and the experimental model of the robot are presented in the paper.

  2. Optical design of a robotic TV camera probe for minimally invasive abdominal surgery

    Science.gov (United States)

    Todaro, Susanna; He, Weiyi; Killinger, Dennis

    2011-03-01

    Minimally invasive techniques are a promising new field of surgery; however, they limit the surgeon's access points and maneuverability. In order to increase the number of access points in minimally invasive abdominal surgery, a proposed implantable medical probe braces to the abdominal wall and provides illumination and video signal. The probe is cylindrical, about 25 mm long and 10 mm in diameter. A ring of LEDs on the end of the probe illuminates the tissue, and the resulting image is focused onto an HD video detector. It was necessary to apply beam-shaping reflectors to collimate the light onto a small target area, to avoid illuminating areas not picked up by the video. These reflectors were designed and simulated using the optical ray tracing software TracePro. Two LED chip geometries and three types of reflector geometries were analyzed, and the parameters for each geometry were optimized. For the straight-edged reflectors, the intensity patterns and optimization were compared to experimental results. Although parabolic reflectors produced the best collimation, cone reflectors with a 20-degree half-angle produced significant collimation at a much cheaper price. This work was supported by NSF REU program (award No DMR-1004873).

  3. EXPERIENCE OF MINIMALLY INVASIVE TREATMENT IN 520 PATIENTS WITH INTRACRANIAL ANEURYSMS

    Institute of Scientific and Technical Information of China (English)

    丁育基; 李慎茂; 段安安; 于小千; 华杨; 柳江; 王建生; 曹家康; 赵瑞林; 徐庚; 谷春; 王仲朴

    2002-01-01

    Objective.To summarize the experience of minimally invasive treatment in 520 patients with intracranial aneurysms on a retrospective study.Methods.The measures used in the treatment of 520 patients were reviewed in terms of timing of surgery,induced hypotensive anesthesia,brain protection combined with temporal occlusion of the feeding artery,external drainage of CSF,dynamic monitoring of intracranial pressure,blood flow velocity,serum osmolality and CT scanning,anti vasospasm therapy as well as selected interventional endovascular embolization of aneurysms.Results.Of the 520 patients,485 were treated with either direct clipping or endovascular embolization and 35 patients were treated non surgically.In 449 patients undergoing direct clipping and 36 undergoing endovascular embolization,intraoperative rupture of aneurysm occurred in 27 (6.0%) and 0%,respectively.Death occurred in 13 (2.6%),hemiplegia in 8 (1.6%),and vegetative state in 2 (0.4%).The operative mortality of direct clipping was 3.8% in 210 patients before 1990 and 1.8% in 275 patients after 1990 (36 patients undergoing endovascular embolization,the operative mortality was 0%).Conclusion.The outcome of patients with intracranial aneurysms can be markedly improved and the operative mortality can be lowered by minimally invasive treatment.

  4. Productivity benefits of minimally invasive surgery in patients with chronic sacroiliac joint dysfunction

    Directory of Open Access Journals (Sweden)

    Saavoss JD

    2016-04-01

    Full Text Available Josh D Saavoss,1 Lane Koenig,1 Daniel J Cher2 1KNG Health Consulting, LLC, Rockville, MD, 2SI-BONE, Inc., San Jose, CA, USA Introduction: Sacroiliac joint (SIJ dysfunction is associated with a marked decrease in quality of life. Increasing evidence supports minimally invasive SIJ fusion as a safe and effective procedure for the treatment of chronic SIJ dysfunction. The impact of SIJ fusion on worker productivity is not known. Methods: Regression modeling using data from the National Health Interview Survey was applied to determine the relationship between responses to selected interview questions related to function and economic outcomes. Regression coefficients were then applied to prospectively collected, individual patient data in a randomized trial of SIJ fusion (INSITE, NCT01681004 to estimate expected differences in economic outcomes across treatments. Results: Patients who receive SIJ fusion using iFuse Implant System® have an expected increase in the probability of working of 16% (95% confidence interval [CI] 11%–21% relative to nonsurgical patients. The expected change in earnings across groups was US $3,128 (not statistically significant. Combining the two metrics, the annual increase in worker productivity given surgical vs nonsurgical care was $6,924 (95% CI $1,890–$11,945. Conclusion: For employees with chronic, severe SIJ dysfunction, minimally invasive SIJ fusion may improve worker productivity compared to nonsurgical treatment. Keywords: sacroiliac joint fusion, low back pain, sacroiliac joint pain, clinical trial, health care costs, indirect costs

  5. A Novel Technique for Transvaginal Retrieval of Enlarged Pelvic Viscera during Minimally Invasive Surgery

    Directory of Open Access Journals (Sweden)

    Allison Wyman

    2012-01-01

    Full Text Available Introduction. With the widespread adoption of laparoscopic and robotic surgery, more and more women are undergoing minimally invasive surgery for complex gynecological procedures. The rate-limiting step is often the delivery of an intact uterus or an unruptured adnexal mass. To avoid conversion to a minilaparotomy for specimen retrieval, we describe a novel technique using an Anchor Tissue Retrieval System bag in conjunction with a pneumo-occluder to easily retrieve large specimens through a colpotomy incision. Surgical Technique. After completion of the robotic-assisted hysterectomy, the uterus, fallopian tubes, and ovaries were too large to be retrieved intact despite multiple attempts of delivery through the colpotomy incision. Prior to resorting to a minilaparotomy or morcellation of the specimen, a 15 mm anchor retrieval bag with a pneumo-occluder was placed through the vagina and the intact specimen was easily placed inside the bag under direct visualization and removed through the colpotomy incision intact. Conclusion. We routinely utilize this technique to retrieve hysterectomy specimens that are not readily delivered through the colpotomy incision and find this technique to be safe, highly efficient, and cost effective when there is a need to remove large intact specimens during minimally invasive surgery.

  6. Circulating microRNAs as minimally invasive biomarkers for cancer theragnosis and prognosis

    Directory of Open Access Journals (Sweden)

    William C. S. Cho

    2011-02-01

    Full Text Available Novel cancer biomarker discovery is urgently needed for cancer theragnosis and prognosis, and among the many possible types of samples, blood is regarded to be ideal for this discovery as it can be collected easily in a minimally invasive manner. Results of the last few years have ascertained the quantification of microRNA (miRNA as a promising approach for the detection and prognostication of cancer. Indeed, an increasing number of studies have shown that circulating cancer-associated miRNAs are readily measured in plasma or serum and they can robustly discriminate cancer patients from healthy controls, as well as distinguishing between good-prognosis and poor-prognosis patients. Furthermore, recent findings also suggest the potential of circulating miRNAs in the screening, monitoring, and treatment of cancer. This article summarizes the most significant and latest discoveries of original researches on circulating miRNAs involvement in cancer, focusing on the potential of circulating miRNAs as minimally invasive biomarkers for cancer theragnosis and prognosis.

  7. Anorectal function and outcomes after transanal minimally invasive surgery for rectal tumors

    Directory of Open Access Journals (Sweden)

    Feza Y Karakayali

    2015-01-01

    Full Text Available Background: Transanal endoscopic microsurgery is a minimally invasive technique that allows full-thickness resection and suture closure of the defect for large rectal adenomas, selected low-risk rectal cancers, or small cancers in patients who have a high risk for major surgery. Our aim, in the given prospective study was to report our initial clinical experience with TAMIS, and to evaluate its effects on postoperative anorectal functions. Materials and Methods: In 10 patients treated with TAMIS for benign and malignant rectal tumors, preoperative and postoperative anorectal function was evaluated with anorectal manometry and Cleveland Clinic Incontinence Score. Results: The mean distance of the tumors from the anal verge was 5.6 cm, and mean tumor diameter was 2.6 cm. All resection margins were tumor free. There was no difference in preoperative and 3-week postoperative anorectalmanometry findings; only mean minimum rectal sensory volume was lower at 3 weeks after surgery. The Cleveland Clinic Incontinence Score was normal in all patients except one which resolved by 6 weeks after surgery.The mean postoperative follow-up was 28 weeks without any recurrences. Conclusion: Transanal minimally invasive surgery is a safe and effective procedure for treatment of rectal tumors and can be performed without impairing anorectal functions.

  8. Preoperative Parathyroid Needle Localization: A Minimally Invasive Novel Technique in Reoperative Settings

    Directory of Open Access Journals (Sweden)

    Ryan Winters

    2011-01-01

    Full Text Available Background. Reoperative parathyroid surgery for primary hyperparathyroidism can be challenging. Numerous preoperative localization techniques have been employed to facilitate a more focused surgical exploration. This paper describes a novel, minimally invasive, and highly successful method of parathyroid localization. Methods. Patients with recurrent or persistent primary hyperparathyroidism underwent parathyroidectomy following CT scan or ultrasound-guided wire localization of the parathyroid. Accurate placement was confirmed by fine-needle aspiration with immunocytochemistry or PTH washout. The guide wire was left in situ to guide surgical excision of the gland. Curative resection was established by monitoring intact serum PTH levels after excision of the adenoma. Results. All ten patients underwent successful redo-targeted parathyroidectomy. Nine of the ten patients were discharged on the day of surgery. One patient was observed overnight due to transient postoperative hypocalcemia, which resolved with calcium supplementation. Conclusion. Placement of a localization wire via preoperative high-resolution ultrasound or CT can expedite reoperative parathyroid surgery. It allows identification of parathyroid adenoma via a minimally invasive approach, especially in cases where a sestamibi scan is inconclusive.

  9. Minimally invasive soft tissue release of foot and ankle contracture secondary to stroke.

    Science.gov (United States)

    Boffeli, Troy J; Collier, Rachel C

    2014-01-01

    Lower extremity contracture associated with stroke commonly results in a nonreducible, spastic equinovarus deformity of the foot and ankle. Rigid contracture deformity leads to gait instability, pain, bracing difficulties, and ulcerations. The classic surgical approach for stroke-related contracture of the foot and ankle has been combinations of tendon lengthening, tendon transfer, osteotomy, and joint fusion procedures. Recovery after traditional foot and ankle reconstructive surgery requires a period of non-weightbearing that is not typically practical for these patients. Little focus has been given in published studies on minimally invasive soft tissue release of contracture. We present the case of a 61-year-old female with an equinovarus foot contracture deformity secondary to stroke. The patient underwent Achilles tendon lengthening, posterior tibial tendon Z lengthening, and digital flexor tenotomy of each toe with immediate weightbearing in a walking boot, followed by transition to an ankle-foot orthosis. The surgical principles and technique tips are presented to demonstrate our minimally invasive approach to release of foot and ankle contracture secondary to stroke. The main goal of this approach is to improve foot and ankle alignment for ease of bracing, which, in turn, will improve gait, reduce the risk of falls, decrease pain, and avoid the development of pressure sores. PMID:23890795

  10. Hydrogel-forming microneedle arrays: Potential for use in minimally-invasive lithium monitoring.

    Science.gov (United States)

    Eltayib, Eyman; Brady, Aaron J; Caffarel-Salvador, Ester; Gonzalez-Vazquez, Patricia; Zaid Alkilani, Ahlam; McCarthy, Helen O; McElnay, James C; Donnelly, Ryan F

    2016-05-01

    We describe, for the first time, hydrogel-forming microneedle (s) (MN) arrays for minimally-invasive extraction and quantification of lithium in vitro and in vivo. MN arrays, prepared from aqueous blends of hydrolysed poly(methyl-vinylether-co-maleic anhydride) and crosslinked by poly(ethyleneglycol), imbibed interstitial fluid (ISF) upon skin insertion. Such MN were always removed intact. In vitro, mean detected lithium concentrations showed no significant difference following 30min MN application to excised neonatal porcine skin for lithium citrate concentrations of 0.9 and 2mmol/l. However, after 1h application, the mean lithium concentrations extracted were significantly different, being appropriately concentration-dependent. In vivo, rats were orally dosed with lithium citrate equivalent to 15mg/kg and 30mg/kg lithium carbonate, respectively. MN arrays were applied 1h after dosing and removed 1h later. The two groups, having received different doses, showed no significant difference between lithium concentrations in serum or MN. However, the higher dosed rats demonstrated a lithium concentration extracted from MN arrays equivalent to a mean increase of 22.5% compared to rats which received the lower dose. Hydrogel-forming MN clearly have potential as a minimally-invasive tool for lithium monitoring in outpatient settings. We will now focus on correlation between serum and MN lithium concentrations. PMID:26969262

  11. Modified minimally invasive two-incision total hip arthroplasty using large diameter femoral head

    Directory of Open Access Journals (Sweden)

    Kyung Soon Park

    2012-01-01

    Full Text Available Background: Minimally invasive (MI total hip arthroplasty (THA is an alternative to standard THA, but has created much controversy among orthopedic surgeons. The authors modified the original minimally invasive two-incision THA technique and used large-diameter (32 mm, 36 mm ceramic-on-ceramic articulation. Materials and Methods: One hundred and seventy patients that underwent unilateral MI two-incision THA were retrospectively reviewed, and surgical morbidity, functional recovery, radiological properties, and complications were assessed. Results: Mean Harris hip score (HHS improved from 41.8 to 96.1 at last followup, and mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC score from 66.2 to 26.9. The mean lateral opening angle of the acetabular component was 38.2° and the mean stem position was valgus 1.9°. There was an intraoperative femur fracture and one revision surgery due to stem subsidence. No patient had dislocation. Conclusions: Our data suggest that this modified technique combined with large ceramic femoral head is safe and reproducible in terms of achieving proper implant positioning and early functional recovery.

  12. Long-term professional performance of minimally invasive surgery post-graduates

    Directory of Open Access Journals (Sweden)

    Marcelo de Paula Loureiro

    2015-04-01

    Full Text Available OBJECTIVE: to evaluate the contribution of a post-graduation program in surgeons professional careers. METHODS: participants were asked to answer a questionnaire with questions related to possible changes in their professional performance after the end of the course. RESULTS: forty-three (76.7% of the 56 participants eligible for the study responded to the questionnaires. Most participants, 32 (74.4%, had previous contact with laparoscopic surgery; however, only 14 (32.5% reported the experience as primary surgeon. The expectations on the course were reached or exceeded for 36 (83.7% participants. Thirty-seven (86% incorporated minimally invasive procedures in their daily surgical practice, 37 (86% reported improvements in their income above 10% and 12% reported income increase of over 100%, directly related to their increase of laparoscopic activity. CONCLUSION: the program in minimally invasive surgery provides a high level of satisfaction to its participants, enables them to perform more complex technical procedures, such as sutures, and improves their professional economic performance.

  13. Effectiveness of treatment of transtrochanteric fractures with Dynamic Hip Screws using minimally invasive access☆

    Science.gov (United States)

    de Abreu, Eduardo Lima; Sena, Caroline Brum; Saldanha Rodrigues Filho, Sergio Antonio

    2016-01-01

    Objective To analyze the short-term results from treating unstable intertrochanteric fractures with Dynamic Hip Screws (DHS), using a minimally invasive route, focusing on the functional aspects and complication and mortality rates of the method. Methods This was a prospective longitudinal study on 140 patients who underwent fixation of transtrochanteric fractures with the DHS system with a lateral minimally invasive access in the hip, between January and December 2013. The patients were evaluated pre and postoperatively (after six months of follow-up) by means of the Parker and Palmer mobility score. Women comprised 65.7% of the sample, and 54.3% of the fractures were on the right side. The patients’ mean age was 80 years, ranging from 60 to 93 years. Results We observed an overall decrease in the mobility score and an increase in the degree of dependence over the short term. However, we encountered only two deaths in the study sample and there were no cases of infection or nonunion. Conclusion Despite the efficacy of the treatment with DHS, with high rates of fracture consolidation and a low mortality rate, we noted that the patients still showed significant functional limitation at the follow-up six months after the operation. PMID:27069880

  14. Minimally invasive devices for treating lower urinary tract symptoms in benign prostate hyperplasia: technology update

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    Aoun F

    2015-08-01

    Full Text Available Fouad Aoun1, Quentin Marcelis,1,2 Thierry Roumeguère,2 1Department of Urology, Jules Bordet Institute, 2Department of Urology, Erasme Hospital, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium Abstract: Benign prostatic hyperplasia (BPH represents a spectrum of related lower urinary tract symptoms (LUTS. The cost of currently recommended medications and the discontinuation rate due to side effects are significant drawbacks limiting their long-term use in clinical practice. Interventional procedures, considered as the definitive treatment for BPH, carry a significant risk of treatment-related complications in frail patients. These issues have contributed to the emergence of new approaches as alternative options to standard therapies. This paper reviews the recent literature regarding the experimental treatments under investigation and presents the currently available experimental devices and techniques used under local anesthesia for the treatment of LUTS/BPH in the vast majority of cases. Devices for delivery of thermal treatment (microwaves, radiofrequency, high-intensity focused ultrasound, and the Rezum system, mechanical devices (prostatic stent and urethral lift, fractionation of prostatic tissue (histotripsy and aquablation, prostate artery embolization, and intraprostatic drugs are discussed. Evidence for the safety, tolerability, and efficacy of these “minimally invasive procedures” is analyzed. Keywords: lower urinary tract symptoms (LUTS, benign prostatic hyperplasia (BPH, minimally invasive therapies, new approaches, experimental therapy

  15. Minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal shunt

    Institute of Scientific and Technical Information of China (English)

    Lu JIA; Guo-ping LI; Zhong-xin ZHAO; Chao YOU; Jia-gang LIU; Si-qing HUANG; Min HE; Pei-gang JI; Jie DUAN; Yi-jun ZENG

    2011-01-01

    Objective: To investigate the clinical value of a minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal (LP) shunt. Method: The clinical and long-term follow-up data of 256 patients suffering from communicating hydrocephalus and undergoing percutaneous LP shunt during 1998 to 2008 were retrospectively analyzed. Results: After the follow-up, which lasted 6 months to 10 years, 219 cases of communicating hydrocephalus recovered well (ventricular size returned to normal and symptoms completely disappeared),25 cases were brought under control (ventricle size reduced by 50% and symptoms partially abated), and 12 cases showed no obvious changes. Fifteen obese subjects needed modifications of the shunt due to the obstruction of the abdominal end following wrapping, and one subject underwent extubation as the subject was unable to tolerate stimulation of the cauda equina. The effectiveness of shunting was 91.40% and the probability of shunt-tube obstruction, which occurs predominantly in the abdominal end, was only 5.85%, far lower than that of ventriculoperitoneal (VP)shunt. Three subjects had a history of infection following VP shunting. Conclusion: LP shunting is minimally invasive and effective in treating communicating hydrocephalus, with fewer complications.

  16. Minimally invasive aortic banding in mice: effects of altered cardiomyocyte insulin signaling during pressure overload.

    Science.gov (United States)

    Hu, Ping; Zhang, Dongfang; Swenson, LeAnne; Chakrabarti, Gopa; Abel, E Dale; Litwin, Sheldon E

    2003-09-01

    We developed a minimally invasive method for producing left ventricular (LV) pressure overload in mice. With the use of this technique, we quickly and reproducibly banded the transverse aorta with low surgical morbidity and mortality. Minimally invasive transverse aortic banding (MTAB) acutely and chronically increased LV systolic pressure, increased heart weight-to-body weight ratio, and induced myocardial fibrosis. We used this technique to determine whether reduced insulin signaling in the heart altered the cardiac response to pressure overload. Mice with cardiac myocyte-restricted knockout of the insulin receptor (CIRKO) have smaller hearts than wild-type (WT) controls. Four weeks after MTAB, WT and CIRKO mice had comparably increased LV systolic pressure, increased cardiac mass, and induction of mRNA for beta-myosin heavy chain and atrial natriuretic factor. However, CIRKO hearts were more dilated, had depressed LV systolic function by echocardiography, and had greater interstitial fibrosis than WT mice. Expression of connective tissue growth factor was increased in banded CIRKO hearts compared with WT hearts. Thus lack of insulin signaling in the heart accelerates the transition to a more decompensated state during cardiac pressure overload. The use of the MTAB approach should facilitate the study of the pathophysiology and treatment of pressure-overload hypertrophy. PMID:12738623

  17. Results of kyphoplasty in the minimally invasive treatment of vertebral metastasis

    Directory of Open Access Journals (Sweden)

    Carlos Fernando Pereira da Silva Herrero

    2014-09-01

    Full Text Available OBJECTIVE: To evaluate the clinical and radiological outcome of minimally invasive surgical treatment of vertebral metastases using the technique of kyphoplasty. METHODS: This was a prospective observational study of patients with the diagnosis of spinal metastasis who underwent minimally invasive surgical treatment by filling the vertebral body with balloon kyphoplasty technique. Clinical evaluation included patient age at surgery, diagnosis of the tumor, biopsy results, data of the surgical procedure performed, visual pain scale (VAS and complications related to surgery. Radiological evaluation involved the study of radiographic procedures in the anteroposterior and lateral incidences, with the analysis of vertebral body kyphosis and the occurrence of extravasation of cement. RESULTS: 22 patients with spinal metastases who were treated by balloon kyphoplasty, 8 (36% males and 14 (64% females were studied. The average age was 56.05 years and the mean follow-up was 8.5 months. The mean preoperative VAS was 8.73, 1.73 in the initial postoperative period, and 1.92 in the late postoperative period. CONCLUSION: Kyphoplasty proved to be a safe and effective technique for symptomatic treatment of vertebral metastases.

  18. Minimally Invasive Subcortical Parafascicular Transsulcal Access for Clot Evacuation (Mi SPACE for Intracerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Benjamin Ritsma

    2014-01-01

    Full Text Available Background. Spontaneous intracerebral hemorrhage (ICH is common and causes significant mortality and morbidity. To date, optimal medical and surgical intervention remains uncertain. A lack of definitive benefit for operative management may be attributable to adverse surgical effect, collateral tissue injury. This is particularly relevant for ICH in dominant, eloquent cortex. Minimally invasive surgery (MIS offers the potential advantage of reduced collateral damage. MIS utilizing a parafascicular approach has demonstrated such benefit for intracranial tumor resection. Methods. We present a case of dominant hemisphere spontaneous ICH evacuated via the minimally invasive subcortical parafascicular transsulcal access clot evacuation (Mi SPACE model. We use this report to introduce Mi SPACE and to examine the application of this novel MIS paradigm. Case Presentation. The featured patient presented with a left temporal ICH and severe global aphasia. The hematoma was evacuated via the Mi SPACE approach. Postoperative reassessments showed significant improvement. At two months, bedside language testing was normal. MRI tractography confirmed limited collateral injury. Conclusions. This case illustrates successful application of the Mi SPACE model to ICH in dominant, eloquent cortex and subcortical regions. MRI tractography illustrates collateral tissue preservation. Safety and feasibility studies are required to further assess this promising new therapeutic paradigm.

  19. Lateral Interbody Fusion for Treatment of Discogenic Low Back Pain: Minimally Invasive Surgical Techniques

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    Luis Marchi

    2012-01-01

    Full Text Available Low back pain is one of the most common ailments in the general population, which tends to increase in severity along with aging. While few patients have severe enough symptoms or underlying pathology to warrant surgical intervention, in those select cases treatment choices remain controversial and reimbursement is a substancial barrier to surgery. The object of this study was to examine outcomes of discogenic back pain without radiculopathy following minimally-invasive lateral interbody fusion. Twenty-two patients were treated at either one or two levels (28 total between L2 and 5. Discectomy and interbody fusion were performed using a minimallyinvasive retroperitoneal lateral transpsoas approach. Clinical and radiographic parameters were analyzed at standard pre- and postoperative intervals up to 24 months. Mean surgical duration was 72.1 minutes. Three patients underwent supplemental percutaneous pedicle screw instrumentation. Four (14.3% stand-alone levels experienced cage subsidence. Pain (VAS and disability (ODI improved markedly postoperatively and were maintained through 24 months. Segmental lordosis increased significantly and fusion was achieved in 93% of levels. In this series, isolated axial low back pain arising from degenerative disc disease was treated with minimally-invasive lateral interbody fusion in significant radiographic and clinical improvements, which were maintained through 24 months.

  20. MANAGEMENT OF COMMINUTED FRACTURES OF LOWER EXTREMITY WITH MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS

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    Kapil A

    2015-07-01

    Full Text Available Comminuted multi fragmentary periarticular fractures are always a challenge to manage even today. Results of conservative management and ORIF by traditional methods are associated with number of complications. This study evaluate the role of minimally invasive plate osteosynthesis in management of such fractures. Seventeen (17 multi fragmentary fractures of long bones of lower extremity (in 15 patients were treated in t he present prospective study using the technique of minimally invasive plate osteosynthesis (MIPO. There were 11 cases of supracondylar fracture femur, two intra articular, 3 cases of proximal tibial fractures, 2 cases of tibial shaft fractures and 1 cases of subtrochanteric fracture. Mean age of the patients was 45.6 years with 13 male and 2 female patients. Most fractures were caused by high velocity road traffic accidents. Average injury surgery interval was 8.64 days. Average operative time was 67.35 mi nutes. Average period of union was 19.17 weeks and average period for full weight bearing was 15 weeks. Average hospital stay was 18.41 days. All fractures went on to union. Incidence of complications was low. Range of motion at the proximal and distal joi nts was excellent. Overall 93.33% (16 of 17 cases had excellent to good results.

  1. Role of early minimal-invasive spine fixation in acute thoracic and lumbar spine trauma

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    Schmidt Oliver

    2007-01-01

    Full Text Available Polytraumatized patients following a severe trauma suffer from substantial disturbances of the immune system. Secondary organ dysfunction syndromes due to early hyperinflammation and late immunparalysis contribute to adverse outcome. Consequently the principle of damage control surgery / orthopedics developed in the last two decades to limit secondary iatrogenic insult in these patients. New percutaneous internal fixators provide implants for a damage control approach of spinal trauma in polytraumatized patients. The goal of this study is to evaluate the feasibility of minimal-invasive instrumentation in the setting of minor and major trauma and to discuss the potential benefits and drawbacks of this procedure. Materials and Methods: The present study is a prospective analysis of 76 consecutive patients (mean age 53.3 years with thoracolumbar spine fractures following major or minor trauma from August 2003 to January 2007 who were subjected to minimal-invasive dorsal instrumentation using CD Horizon ® Sextant TM Rod Insertion System and Longitude TM Rod Insertion System (Medtronic ® Sofamor Danek. Perioperative and postoperative outcome measures including e.g. local and systemic complications were assessed and discussed. Results: Forty-nine patients (64.5% suffered from minor trauma (Injury Severity Score < 16. Polytraumatized patients (n=27; 35.5% had associated chest (n=20 and traumatic brain injuries (n=22. For mono- and bisegmental dorsal instrumentation the Sextant TM was used in 60 patients, whereas in 16 longer ranging instrumentations the (prototype Longitude TM system was implanted. Operation time was substantially lower than in conventional approach at minimum 22.5 min for Sextant and 36.2 min for Longitude TM , respectively. Geriatric patients with high perioperative risk according to ASA classification benefited from the less invasive approach and lack of approach-related complications including no substantial blood loss

  2. MR monitoring of minimally invasive delivery of mesenchymal stem cells into the porcine intervertebral disc.

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    Monika Barczewska

    Full Text Available PURPOSE: Bone marrow stem cell therapy is a new, attractive therapeutic approach for treatment of intervertebral disc (IVD degeneration; however, leakage and backflow of transplanted cells into the structures surrounding the disc may lead to the formation of undesirable osteophytes. The purpose of this study was to develop a technique for minimally invasive and accurate delivery of stem cells. METHODS: Porcine mesenchymal stem cells (MSCs were labeled with superparamagnetic iron oxide nanoparticles (SPIO, Molday ION rhodamine and first injected into the explanted swine lumbar IVD, followed by ex vivo 3T MRI. After having determined sufficient sensitivity, IVD degeneration was then induced in swine (n=3 by laser-evaporation. 3 x 10(6 SPIO-labeled cells embedded within hydrogel were injected in 2 doses using a transcutaneous cannula and an epidural anesthesia catheter. T2-weighted MR images were obtained at 3T before and immediately after cell infusion. Two weeks after injection, histological examination was performed for detection of transplanted cells. RESULTS: MSCs were efficiently labeled with Molday ION rhodamine. Cells could be readily detected in the injected vertebral tissue explants as distinct hypointensities with sufficient sensitivity. MR monitoring indicated that the MSCs were successfully delivered into the IVD in vivo, which was confirmed by iron-positive Prussian Blue staining of the tissue within the IVD. CONCLUSION: We have developed a technique for non-invasive monitoring of minimally invasive stem delivery into the IVD at 3T. By using a large animal model mimicking the anatomy of IVD in humans, the present results indicate that this procedure may be clinically feasible.

  3. Minimal invasive long PHILOS®-plate osteosynthesis in metadiaphyseal fractures of the proximal humerus.

    Science.gov (United States)

    Rancan, Mario; Dietrich, Michael; Lamdark, Tenzin; Can, Uenal; Platz, Andreas

    2010-12-01

    Minimal invasive plate osteosynthesis (MIPO) not only meets the criteria of a "biological" osteosynthesis by minimising invasivity as well as iatrogenic soft tissue damage, but can also provide adequate stability for fracture healing and early functional aftertreatment. Up to date, only few publications report on MIPO of humeral shaft fractures mainly using the anterolateral deltopectoral approach for proximal plate insertion. Objective of the present study was to assess the feasibility and clinical outcome of MIPO for metadiaphyseal fractures of the proximal humerus through a lateral approach using angular stable long PHILOS(®)-plates. We retrospectively evaluated 29 patients (mean age 77 years, range 48-95 years) with displaced metadiaphyseal fractures of the proximal humerus treated with MIPO technique. For the first time, an angular stable long PHILOS(®)-plate through a lateral deltoid-split approach proximally and a brachialis/brachioradialis intermuscular approach with exposure of the radial nerve distally, were used. There were no infections and no iatrogenic injuries to the axillary and radial nerve. One patient showed subacromial impingement and one patient had to be reoperated for redislocation of the distal fragment with screw breakage, which was most likely due to incorrect screw placement. This patient was successfully operated using the same method and implant. Besides one patient who refused further follow-up, 28 patients could be followed up to a mean of 8 months (range 3-12 months) each with an entirely healed fracture. Furthermore, patient's quality of life was documented using the SF-36 questionnaire. Comparison with published United States normative data showed no significant deficits in the physical as well as in the mental domains 8 months after MIPO. Minimal invasive long PHILOS(®)-plate osteosynthesis using a combined lateral deltoid-split and brachialis/brachioradialis intermuscular approach proved to be a safe procedure for the

  4. Design method of a foldable ventricular assist device for minimally invasive implantation.

    Science.gov (United States)

    Hsu, Po-Lin; Wang, Yaxin; Amaral, Felipe; Parker, Jack; Schmitz-Rode, Thomas; Autschbach, Rüdiger; Steinseifer, Ulrich

    2014-04-01

    To date, ventricular assist devices (VADs) have become accepted as a therapeutic solution for end-stage heart failure patients when a donor heart is not available. Newer generation VADs allow for a significant reduction in size and an improvement in reliability. However, the invasive implantation still limits this technology to critically ill patients. Recently, expandable/deployable devices have been investigated as a potential solution for minimally invasive insertion. Such a device can be inserted percutaneously via peripheral vessels in a collapsed form and operated in an expanded form at the desired location. A common structure of such foldable pumps comprises a memory alloy skeleton covered by flexible polyurethane material. The material properties allow elastic deformation to achieve the folded position and withstand the hydrodynamic forces during operation; however, determining the optimal geometry for such a structure is a complex challenge. The numerical finite element method (FEM) is widely used and provides accurate structural analysis, but computation time is considerably high during the initial design stage where various geometries need to be examined. This article details a simplified two-dimensional analytical method to estimate the mechanical stress and deformation of memory alloy skeletons. The method was applied in design examples including two popular types of blade skeletons of a foldable VAD. Furthermore, three force distributions were simulated to evaluate the strength of the structures under different loading conditions experienced during pump operation. The results were verified with FEM simulations. The proposed two-dimensional method gives a close stress and deformation estimation compared with three-dimensional FEM simulations. The results confirm the feasibility of such a simplified analytical approach to reveal priorities for structural optimization before time-consuming FEM simulations, providing an effective tool in the initial

  5. Comparative study on early period of recovery between minimally invasive surgery total knee arthroplasty and minimally invasive surgery-quadriceps sparing total knee arthroplasty in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    YU Jia-kuo; YU Chang-long; AO Ying-fang; GONG Xi; WANG Yong-jian; WANG Shu; XING Xie; CHEN Lian-xu; JU Xiao-dong

    2008-01-01

    Background Different kinds of minimally invasive surgery (MIS) procedures have now been used in total knee arthroplasty (TKA). Compared with traditional TKA procedure with a long skin incision, clinical studies showed MIS procedures had some advantages. Quadriceps sparing (QS) procedures are the most minimally invasive MIS procedure until now. This study was aimed to find the insertion types for Chinese patients' vastus medialis and if the QS procedure had some advantages in patients' early recovery.Methods Between February 2006 and May 2007, 120 consecutive patients underwent unilateral primary TKA under general anesthesia, among whom 14 patients were lost to follow-up, the remaining 106 cases were enrolled in this study. Among the 106 cases there were 85 right knees, 21 left knees (15 men and 91 women, with a mean age of 65.1±7.4 years); osteoarthritis in 97 patients (91.5%) and rheumatoid arthritis in 9 patients (8.5%). MIS TKA was performed in 49 cases (MIS TKA group), while MIS-QS TKA in 57 cases (MIS-QS TKA group). During the operation, the type Ⅰ, Ⅱ and Ⅲ insertions of the vastus medialis for all patients were recorded. Each knee was rated post-operatively according to the Hospital of Special Surgery (HSS) scoring system. Clinical follow-up was undertaken at 1 week, 2, 6, 12 and 24 weeks. Operating time and complications were recorded.Results There was no statistically significant difference between the two groups for gender distribution, age, left or right knee incidence, pre-operative diagnosis, incidence of varus or valgus deformity. Of the 106 cases there was 1 (0.9%) case with a type Ⅰ insertion of the vastus medialis, 4 (3.8%) cases with type Ⅱ insertions, 101 (95.3%) cases with type Ⅲ insertions. The HSS scoring was significantly different between the MIS-QS TKA group and MIS TKA group within the first two weeks post operation. From 2 weeks later to 24 weeks, no significant difference was found. The average operating time was (53.3±12

  6. Model-based cone-beam CT reconstruction for image-guided minimally invasive treatment of hip osteolysis

    Science.gov (United States)

    Otake, Yoshito; Stayman, J. W.; Zbijewski, W.; Murphy, R. J.; Kutzer, M. D.; Taylor, R. H.; Siewerdsen, J. H.; Armand, M.

    2013-03-01

    Purpose: Accurate assessment of the size and location of osteolytic regions is essential in minimally invasive hip revision surgery. Moreover, image-guided robotic intervention for osteolysis treatment requires precise localization of implant components. However, high density metallic implants in proximity to the hip make assessment by either 2D or 3D x-ray imaging difficult. This paper details the initial implementation and evaluation of an advanced model-based conebeam CT (CBCT) reconstruction algorithm to improve guidance and assessment of hip osteolysis treatment. Method: A model-based reconstruction approach called Known Component Reconstruction (KCR) was employed to obtain high-quality reconstruction of regions neighboring metallic implants. KCR incorporates knowledge about the implant shape and material to precisely reconstruct surrounding anatomy while simultaneously estimating implant position. A simulation study involving a phantom generated from a CBCT scan of a cadaveric hip was performed. Registration accuracy in KCR iterations was evaluated as translational and rotational error from the true registration. Improvement in image quality was evaluated using normalized cross correlation (NCC) in two regions of interest (ROIs) about the femoral and acetabular components. Result: The study showed significant improvement in image quality over conventional filtered backprojection (FBP) and penalized-likelihood (PL) reconstruction. The NCC in the two ROIs improved from 0.74 and 0.81 (FBP) to 0.98 and 0.86 (PL) and >0.99 for KCR. The registration error was 0.01 mm in translation (0.02° in rotation) for the acetabular component and 0.01 mm (0.01° rotation) for the femoral component. Conclusions: Application of KCR to imaging hip osteolysis in the presence of the implant offers a promising step toward quantitative assessment in minimally invasive image-guided osteolysis treatment. The method improves image quality (metal artifact reduction), yields a precise

  7. Minimalism

    CERN Document Server

    Obendorf, Hartmut

    2009-01-01

    The notion of Minimalism is proposed as a theoretical tool supporting a more differentiated understanding of reduction and thus forms a standpoint that allows definition of aspects of simplicity. This book traces the development of minimalism, defines the four types of minimalism in interaction design, and looks at how to apply it.

  8. ”No-preparation” and Minimally Invasive Veneers in Clinical Practice: Part 1

    Directory of Open Access Journals (Sweden)

    Beata Smielak

    2015-03-01

    Full Text Available Objectives: “No preparation” veneers and veneers requiring minimal preparation of dental enamel are steadily increasing in popularity among today’s dental practitioners but they are suitable for selected individual cases. Overview: The present study discusses the indications for, and limitations to, the use of ultra-thin veneers, their drawbacks and advantages. It also describes the veneer placement procedure, taking into account the issues of proper diagnostics and treatment planning. Clinical significance: “No preparation” veneers and veneers requiring minimal preparation should always be recommended whenever the clinical and laboratory conditions allow it. Their greatest advantage lies in the fact that they save healthy dental tissue and thus offer an excellent alternative to traditional veneers and crowns. On the other hand, “no-preparation” and minimally invasive veneers that are poorly designed and fabricated, heavy or chunky in appearance, and overcontoured can negatively influence the shape of a patient’s teeth and lead to periodontal problems.

  9. Minimally Invasive Spine Metastatic Tumor Resection and Stabilization: New Technology Yield Improved Outcome.

    Science.gov (United States)

    Harel, Ran; Doron, Omer; Knoller, Nachshon

    2015-01-01

    Spinal metastases compressing the spinal cord are a medical emergency and should be operated on if possible; however, patients' medical condition is often poor and surgical complications are common. Minimizing surgical extant, operative time, and blood loss can potentially reduce postoperative complications. This is a retrospective study describing the patients operated on in our department utilizing a minimally invasive surgery (MIS) approach to decompress and instrument the spine from November 2013 to November 2014. Five patients were operated on for thoracic or lumbar metastases. In all cases a unilateral decompression with expandable tubular retractor was followed by instrumentation of one level above and below the index level and additional screw at the index level contralateral to the decompression side. Cannulated fenestrated screws were used (Longitude FNS) and cement was injected to increase pullout resistance. Mean operative time was 134 minutes and estimated blood loss was minimal in all cases. Improvement was noticeable in neurological status, function, and pain scores. No complications were observed. Technological improvements in spinal instruments facilitate shorter and safer surgeries in oncologic patient population and thus reduce the complication rate. These technologies improve patients' quality of life and enable the treatment of patients with comorbidities.

  10. Minimally Invasive Spine Metastatic Tumor Resection and Stabilization: New Technology Yield Improved Outcome

    Directory of Open Access Journals (Sweden)

    Ran Harel

    2015-01-01

    Full Text Available Spinal metastases compressing the spinal cord are a medical emergency and should be operated on if possible; however, patients’ medical condition is often poor and surgical complications are common. Minimizing surgical extant, operative time, and blood loss can potentially reduce postoperative complications. This is a retrospective study describing the patients operated on in our department utilizing a minimally invasive surgery (MIS approach to decompress and instrument the spine from November 2013 to November 2014. Five patients were operated on for thoracic or lumbar metastases. In all cases a unilateral decompression with expandable tubular retractor was followed by instrumentation of one level above and below the index level and additional screw at the index level contralateral to the decompression side. Cannulated fenestrated screws were used (Longitude FNS and cement was injected to increase pullout resistance. Mean operative time was 134 minutes and estimated blood loss was minimal in all cases. Improvement was noticeable in neurological status, function, and pain scores. No complications were observed. Technological improvements in spinal instruments facilitate shorter and safer surgeries in oncologic patient population and thus reduce the complication rate. These technologies improve patients’ quality of life and enable the treatment of patients with comorbidities.

  11. Minimally Invasive Posterior Stabilization Improved Ambulation and Pain Scores in Patients with Plasmacytomas and/or Metastases of the Spine

    Directory of Open Access Journals (Sweden)

    Joseph H. Schwab

    2011-01-01

    Full Text Available Background. The incidence of spine metastasis is expected to increase as the population ages, and so is the number of palliative spinal procedures. Minimally invasive procedures are attractive options in that they offer the theoretical advantage of less morbidity. Purpose. The purpose of our study was to evaluate whether minimally invasive posterior spinal instrumentation provided significant pain relief and improved function. Study Design. We compared pre- and postoperative pain scores as well as ambulatory status in a population of patients suffering from oncologic conditions in the spine. Patient Sample. A consecutive series of patients with spine tumors treated minimally invasively with stabilization were reviewed. Outcome Measures. Visual analog pain scale as well as pre- and postoperative ambulatory status were used as outcome measures. Methods. Twenty-four patients who underwent minimally invasive posterior spinal instrumentation for metastasis were retrospectively reviewed. Results. Seven (29% patients were unable to ambulate secondary to pain and instability prior to surgery. All patients were ambulating within 2 to 3 days after having surgery (=0.01. The mean visual analog scale value for the preoperative patients was 2.8, and the mean postoperative value was 1.0 (=0.001. Conclusion. Minimally invasive posterior spinal instrumentation significantly improved pain and ambulatory status in this series.

  12. Minimally invasive corticotomy in orthodontics: a new technique using a CAD/CAM surgical template.

    Science.gov (United States)

    Cassetta, M; Pandolfi, S; Giansanti, M

    2015-07-01

    Accelerating orthodontic tooth movement is a topical issue. Despite the different techniques described in the literature, the corticotomy is the only effective and safe means of accelerating orthodontic tooth movement. Although effective, the corticotomy presents significant postoperative discomfort. The aggressive nature of these particular methods, related to the elevation of mucoperiosteal flaps and to the length of the surgery, has resulted in reluctance to proceed with this technique among both patients and the dental community. To overcome the disadvantages of the corticotomy, this technical note describes an innovative, minimally invasive, flapless procedure combining piezoelectric surgical cortical micro-incisions with the use of a 3D Printed CAD/CAM surgical guide. PMID:25840860

  13. Gaze-contingent motor channelling and haptic constraints for minimally invasive robotic surgery.

    Science.gov (United States)

    Mylonas, George P; Kwok, Ka-Wai; Darzi, Ara; Yang, Guang-Zhong

    2008-01-01

    The use of master-slave surgical robots for Minimally Invasive Surgery (MIS) has created a physical separation between the surgeon and the patient. Reconnecting the essential visuomotor sensory feedback is important for the safe practice of robotic assisted MIS procedures. This paper introduces a novel gaze contingent framework with real-time haptic feedback by transforming visual sensory information into physical constraints that can interact with the motor sensory channel. We demonstrate how motor tracking of deforming tissue can be made more effective and accurate through the concept of gaze-contingent motor channelling. The method also uses 3D eye gaze to dynamically prescribe and update safety boundaries during robotic assisted MIS without prior knowledge of the soft-tissue morphology. Initial validation results on both simulated and robotic assisted phantom procedures demonstrate the potential clinical value of the technique. PMID:18982663

  14. The Role of Minimally Invasive Enucleation in the Treatment of Pancreatic Tumors

    Directory of Open Access Journals (Sweden)

    Lea Matsuoka

    2016-02-01

    Full Text Available Pancreatic enucleation has been performed for small, benign or premalignant lesions of the pancreas. The goal of this parenchymapreserving strategy is to reduce the risk of exocrine and endocrine insufficiency and potentially the risks associated with pancreatic and biliary anastomoses. Studies have shown open pancreatic enucleation to be a viable option for patients, with a debatable increased risk of pancreatic fistula. With the advent of minimally invasive techniques and increasing experience, centers have started to perform laparoscopic pancreatic enucleation. Small studies have been performed demonstrating the safety and feasibility of laparoscopic pancreatic enucleation, with patient positioning and port placement dependent upon the location of the lesion. Laparoscopic intraoperative ultrasound plays an important role in the localization of these tumors and their proximity to the pancreatic duct and vascular structures, which helps to determine appropriateness for enucleation.

  15. Natural orifice transluminal endoscopic surgery: New minimally invasive surgery come of age

    Institute of Scientific and Technical Information of China (English)

    Chen Huang; Ren-Xiang Huang; Zheng-Jun Qiu

    2011-01-01

    Although in the past two decades, laparoscopic surgery, considered as a great revolution in the minimally invasive surgery field, has undergone major development worldwide, another dramatic surgical revolution has quietly appeared in recent years. Ever since Kalloo's first report on transgastric peritoneoscopy in a porcine model in 2004, interest in a new surgical procedure named natural orifice transluminal endoscopic surgery (NOTES) has blossomed worldwide. Considering that a NOTES procedure could theoretically avoid any abdominal incision, operation-related pain and scarring, many surgeons and endoscopists have been enthusiastic in their study of this new technique. In recent years, several NOTES studies have been carried out on porcine models and even on humans, including transvaginal cholecystectomy, transgastric appendectomy, transvaginal appendectomy, and transvesical peritoneoscopy. So what is the current situation of NOTES and how many challenges do we still face? This review discusses the current research progress in NOTES.

  16. Go-Smart: Web-based Computational Modeling of Minimally Invasive Cancer Treatments

    CERN Document Server

    Weir, Phil; Ellerweg, Roland; Alhonnoro, Tuomas; Pollari, Mika; Voglreiter, Philip; Mariappan, Panchatcharam; Flanagan, Ronan; Park, Chang Sub; Payne, Stephen; Staerk, Elmar; Voigt, Peter; Moche, Michael; Kolesnik, Marina

    2015-01-01

    The web-based Go-Smart environment is a scalable system that allows the prediction of minimally invasive cancer treatment. Interventional radiologists create a patient-specific 3D model by semi-automatic segmentation and registration of pre-interventional CT (Computed Tomography) and/or MRI (Magnetic Resonance Imaging) images in a 2D/3D browser environment. This model is used to compare patient-specific treatment plans and device performance via built-in simulation tools. Go-Smart includes evaluation techniques for comparing simulated treatment with real ablation lesions segmented from follow-up scans. The framework is highly extensible, allowing manufacturers and researchers to incorporate new ablation devices, mathematical models and physical parameters.

  17. Minimally invasive direct coronary artery bypass plus coronary stent for acute coronary syndrome: a case report

    Institute of Scientific and Technical Information of China (English)

    Caiyi Lu; Gang Wang; Qi Zhou; Jinwen Tian; Lei Gao; Shenhua Zhou; Jinyue Zhai; Rui Chen; Zhongren Zhao; Cangqing Gao; Shiwen Wang; Yuxiao Zhang; Ming Yang; Qiao Xue; Cangsong Xiao; Wei Gao; Yang Wu

    2008-01-01

    A 69-year old female patient was admitted because of 3 days of worsened chest pain.Coronary angiography showed60% stenosis of distal left main stem,chronic total occlusion of left anterior descending (LAD),70% stenosis at the ostium of a smallleft circumflex,70-90%stenosis at the paroxysmal and middle part of a dominant fight coronary artery (RCA),and a normal left internalmammary artery (LIMA) with normal origination and orientation.Percutaneous intervention was attempted but failed on the occludedlesion of LAD.The patient received minimally invasive direct coronary artery bypass (MIDCAB) with left LIMA isolation by Davincirobot.Eleven days later,the RCA lesion was treated by Sirolimus Rapamicin eluting stents implantation percutaneously.Then thepatient was discharged uneventfully after 3 days hospitalization.Our experience suggests that two stop shops of hybrid technique befeasible and safe in the treatment of elderly patient with multiple coronary diseases.

  18. MEMS-based ZnO Piezoelectric Tactile Sensor for Minimally Invasive Surgery

    Institute of Scientific and Technical Information of China (English)

    Minrui Wang; Jing Wang; Yan Cui; Liding Wang

    2006-01-01

    This paper reports the design and fabrication of a MEMS-based ZnO piezoelectric tactile sensor, which can be integrated on to the endoscopic grasper used in minimally invasive surgery (MIS). The sensor includes a silicon substrate,platinum bottom electrode, platinum top electrode, and a ZnO piezoelectric thin film, which is sandwiched between the two-electrode layers. The sensitivity of the micro-force sensor is analyzed in theory and the sensor exhibits high sensitivity about 7 pc/uN. The application of this tactile sensor to MIS will allow the surgeon feeling the touch force between the endoscopic grasper and tissue in real-time, and manipulating the tissue safely.

  19. Minimally Invasive Anterolateral Ligament Reconstruction in the Setting of Anterior Cruciate Ligament Injury.

    Science.gov (United States)

    Sonnery-Cottet, Bertrand; Barbosa, Nuno Camelo; Tuteja, Sanesh; Daggett, Matt; Kajetanek, Charles; Thaunat, Mathieu

    2016-02-01

    Recent evidence on the anatomy, function, and biomechanical properties of the anterolateral ligament has led to the recognition of the importance of this structure in the rotational control of the knee. This article describes a technique that allows for minimally invasive anterolateral ligament reconstruction as a complement to most techniques of anterior cruciate ligament reconstruction. A gracilis tendon autograft is harvested and prepared in a double-strand, inverted V-shaped graft. The graft is percutaneously placed through a femoral stab incision, and each strand is then passed deep to the iliotibial band, emerging through each tibial stab incision. After the femoral-end loop graft is fixed, the tibial fixation of each strand is performed in full extension for optimal isometry. PMID:27274456

  20. Minimally invasive harvest of a quadriceps tendon graft with or without a bone block.

    Science.gov (United States)

    Fink, Christian; Herbort, Mirco; Abermann, Elisabeth; Hoser, Christian

    2014-08-01

    The quadriceps tendon (QT) as a graft source for anterior cruciate ligament (ACL) and posterior cruciate ligament reconstruction has recently achieved increased attention. Although many knee surgeons have been using the QT as a graft for ACL revision surgery, it has never gained universal acceptance for primary ACL reconstruction. The QT is a very versatile graft that can be harvested in different widths, thicknesses, and lengths. Conventionally, the QT graft is harvested by an open technique, requiring a 6 to 8 cm longitudinal incision, which often leads to unpleasant scars. We describe a new, minimally invasive, standardized approach in which the QT graft can be harvested through a 2- to 3-cm skin incision and a new option of using the graft without a bone block. PMID:25264512

  1. Gaze-contingent soft tissue deformation tracking for minimally invasive robotic surgery.

    Science.gov (United States)

    Mylonas, George P; Stoyanov, Danail; Deligianni, Fani; Darzi, Ara; Yang, Guang-Zhong

    2005-01-01

    The introduction of surgical robots in Minimally Invasive Surgery (MIS) has allowed enhanced manual dexterity through the use of microprocessor controlled mechanical wrists. Although fully autonomous robots are attractive, both ethical and legal barriers can prohibit their practical use in surgery. The purpose of this paper is to demonstrate that it is possible to use real-time binocular eye tracking for empowering robots with human vision by using knowledge acquired in situ. By utilizing the close relationship between the horizontal disparity and the depth perception varying with the viewing distance, it is possible to use ocular vergence for recovering 3D motion and deformation of the soft tissue during MIS procedures. Both phantom and in vivo experiments were carried out to assess the potential frequency limit of the system and its intrinsic depth recovery accuracy. The potential applications of the technique include motion stabilization and intra-operative planning in the presence of large tissue deformation. PMID:16685925

  2. Secondary Radial Nerve Palsy after Minimally Invasive Plate Osteosynthesis of a Distal Humeral Shaft Fracture

    Directory of Open Access Journals (Sweden)

    Ursina Bichsel

    2015-01-01

    Full Text Available Minimally invasive plate osteosynthesis is a widely used procedure for the treatment of fractures of the femur and the tibia. For a short time it is also used for the treatment of humeral shaft fractures. Among other advantages, the ambassadors of this technique emphasize the lower risk of nerve injuries when compared to open reduction and internal fixation. We report the case of secondary radial nerve palsy caused by percutaneous fixation of a plate above the antecubital fold. The nerve did not recover and the patient needed a tendon transfer to regain active extension of the fingers. This case points to the importance of adequate exposure of the bone and plate if a humeral shaft fracture extends far distally.

  3. Stricture caused by a plastic vascular clip used during an operation of minimally invasive esophagectomy.

    Science.gov (United States)

    Wójcik, Janusz; Grodzki, Tomasz; Kubisa, Bartosz; Pieróg, Jaroslaw

    2011-10-01

    This article describes the case of a 62-year-old female who had had minimally invasive esophagectomy (Ivor-Lewis) for squamous cell carcinoma of the distal third of the esophagus. The anastomotic stenosis was accompanied by solid food dysphagia and the presence of a foreign body in the esophagus. The foreign body was fixed to the esophageal wall and could not be removed endoscopically. The patient was reoperated on through a 8 cm right thoracotomy. The anastomosis was reached via a gastrotomy, and the large-size plastic vascular clip was removed. The clip was primarily used to close the transsected azygos vein, it was then incorporated into the esophageal anastomotic region and subsequently partially protruded into the lumen of the gastrointestinal tract. After removal of the clip, backward dilatation of the anastomosis was performed by Savary-Gilliard dilators, with restoration of its proper diameter. PMID:21798890

  4. Safety and 6-month effectiveness of minimally invasive sacroiliac joint fusion: a prospective study

    Directory of Open Access Journals (Sweden)

    Duhon BS

    2013-12-01

    Full Text Available Bradley S Duhon,1 Daniel J Cher,2 Kathryn D Wine,2 Harry Lockstadt,3 Don Kovalsky,4 Cheng-Lun Soo5On behalf of the SIFI Study Group1Neurosurgical and Spine Specialists, Parker, CO, 2SI-BONE, Inc, San Jose, CA, 3Bluegrass Orthopaedics and Hand Care, Lexington, KY, 4Orthopaedic Center of Southern Illinois, Mount Vernon, IL, 5Health Research Institute, Oklahoma City, OK, USABackground: Sacroiliac (SI joint pain is an often overlooked cause of low back pain. SI joint arthrodesis has been reported to relieve pain and improve quality of life in patients suffering from degeneration or disruption of the SI joint who have failed non-surgical care. We report herein early results of a multicenter prospective single-arm cohort of patients with SI joint degeneration or disruption who underwent minimally invasive fusion using the iFuse Implant System®.Methods: The safety cohort includes 94 subjects at 23 sites with chronic SI joint pain who met study eligibility criteria and underwent minimally invasive SI joint fusion with the iFuse Implant System® between August 2012 and September 2013. Subjects underwent structured assessments preoperatively, immediately postoperatively, and at 1, 3, and 6 months postoperatively, including SI joint and back pain visual analog scale (VAS, Oswestry Disability Index (ODI, Short Form-36 (SF-36, and EuroQoL-5D (EQ-5D. Patient satisfaction with surgery was assessed at 6 months. The effectiveness cohort includes the 32 subjects who have had 6-month follow-up to date.Results: Mean subject age was 51 years (n=94, safety cohort and 66% of patients were women. Subjects were highly debilitated at baseline (mean VAS pain score 78, mean ODI score 54. Three implants were used in 80% of patients; two patients underwent staged bilateral implants. Twenty-three adverse events occurred within 1 month of surgery and 29 additional events occurred between 30 days and latest follow-up. Six adverse events were severe but none were device

  5. Routine use of minimally invasive surgery for pectus excavatum in adults

    DEFF Research Database (Denmark)

    Pilegaard, Hans K; Licht, Peter B

    2008-01-01

    operation was a patient-described disabling cosmetic appearance. We modified the operation by using a shorter pectus bar, which appears to be more stable. All patient records were available and analyzed retrospectively. RESULTS: Operations for pectus excavatum were done in 475 patients (89% men) at Aarhus...... University Hospital. 180 patients (38%) were aged 18 years or older, median patient age was 22 years (range, 18 to 43 years). All but one patient achieved an excellent cosmetic result. Two pectus bars were required in 57 patients (32%), and 2 patients required 3 pectus bars. The median duration of the...... during follow-up. CONCLUSIONS: Minimally invasive repair for pectus excavatum can be performed safely in adults, with excellent immediate cosmetic results. Adults often require more than 1 pectus bar. From the results of this large series, we conclude that patients aged younger than 50 years are eligible...

  6. Early Clinical and Radiographic Results of Minimally Invasive Anterior Approach Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Tamara Alexandrov

    2014-01-01

    consecutive patients with 43 total hip arthroplasties performed through an anterior muscle sparing minimally invasive approach. We found the early complication rates and radiographic outcomes comparable to those reported from arthroplasties performed via traditional approaches. Complications included dislocation (2%, femur fracture (2%, greater trochanteric fracture (12%, postoperative periprosthetic intertrochanteric fracture (2%, femoral nerve palsy (5%, hematoma (2%, and postoperative iliopsoas avulsion (2%. Radiographic analysis revealed average cup anteversion of 19.6°±6.6, average cup abduction angle of 48.4°±7, stem varus of 0.9°±2, and a mean leg length discrepancy of 0.7 mm. The anterior approach to the hip is an attractive alternative to the more traditional approaches. Acceptable component placement with comparable complication rates is possible using a muscle sparing technique which may lead to faster overall recovery.

  7. CAD/CAM Solutions for Minimally Invasive All-Ceramic Rehabilitation of Extended Erosive Lesions.

    Science.gov (United States)

    Guess Gierthmuehlen, Petra C; Steger, Enrico

    2016-05-01

    Dental erosion is a global oral health problem that can lead to significant functional and esthetic impairments of the affected patients. Treatment of severe cases with augmented loss of the vertical dimension of occlusion (VDO) represents a challenge for both the dental team and the patient. CAD/CAM technology was used in the presented case to analyze the interocclusal space. Based on a virtual wax-up of the final restorations, CAD/CAM-fabricated preparation splints served as a guide and ensured a most minimally invasive preparation design. Milled polymer provisionals enabled the patient to visualize the final treatment outcome and served as a fracture-resistant temporary restoration to test the increased VDO. Monolithic lithium-disilicate ceramic, defect-oriented restorations with reduced ceramic thickness enabled a functional and reliable reconstruction of the severely compromised dentition. This case report documents a practical, digital approach and discusses the advantages related to treatment time, ease of treatment, and predictability. PMID:27419357

  8. Towards a minimally invasive sampling tool for high resolution tissue analytical mapping

    Science.gov (United States)

    Gottardi, R.

    2015-09-01

    Multiple spatial mapping techniques of biological tissues have been proposed over the years, but all present limitations either in terms of resolution, analytical capacity or invasiveness. Ren et al (2015 Nanotechnology 26 284001) propose in their most recent work the use of a picosecond infrared laser (PIRL) under conditions of ultrafast desorption by impulsive vibrational excitation (DIVE) to extract small amounts of cellular and molecular components, conserving their viability, structure and activity. The PIRL DIVE technique would then work as a nanobiopsy with minimal damage to the surrounding tissues, which could potentially be applied for high resolution local structural characterization of tissues in health and disease with the spatial limit determined by the laser focus.

  9. Natural orifice transluminal endoscopic surgery: new minimally invasive surgery come of age.

    Science.gov (United States)

    Huang, Chen; Huang, Ren-Xiang; Qiu, Zheng-Jun

    2011-10-21

    Although in the past two decades, laparoscopic surgery, considered as a great revolution in the minimally invasive surgery field, has undergone major development worldwide, another dramatic surgical revolution has quietly appeared in recent years. Ever since Kalloo's first report on transgastric peritoneoscopy in a porcine model in 2004, interest in a new surgical procedure named natural orifice transluminal endoscopic surgery (NOTES) has blossomed worldwide. Considering that a NOTES procedure could theoretically avoid any abdominal incision, operation-related pain and scarring, many surgeons and endoscopists have been enthusiastic in their study of this new technique. In recent years, several NOTES studies have been carried out on porcine models and even on humans, including transvaginal cholecystectomy, transgastric appendectomy, transvaginal appendectomy, and transvesical peritoneoscopy. So what is the current situation of NOTES and how many challenges do we still face? This review discusses the current research progress in NOTES. PMID:22110263

  10. Penile prosthesis implant for erectile dysfunction: A new minimally invasive infrapubic surgical technique

    Directory of Open Access Journals (Sweden)

    Gabriele Antonini

    2016-01-01

    Full Text Available Erectile dysfunction, the most common male sexual disorder after premature ejaculation, with its important impact on man and partner’s sexuality and quality of life is a persistent inability to obtain and maintain an erection sufficient to permit satisfactory sexual performance. Non-surgical treatments with controversial results are usually applyed before surgical treatment that has reached high levels of satisfaction. We describe a new surgical technique to implant three-pieces penile prosthesis in patients suffering from erectile dysfunction (ED not responding to conventional medical therapy or reporting side effects with such a therapy. Implantation of an inflatable prosthesis, for treatment of ED, is a safe and efficacious approach with high satisfaction reported by patients and partners. Surgical technique should be minimally invasive and latest technology equipment should be implanted in order to decrease common complications and to obtain a better aesthetic result.

  11. Penile prosthesis implant for erectile dysfunction: A new minimally invasive infrapubic surgical technique.

    Science.gov (United States)

    Antonini, Gabriele; Busetto, Gian Maria; De Berardinis, Ettore; Giovannone, Riccardo; Vicini, Patrizio; Gentile, Vincenzo; Perito, Paul E

    2015-12-01

    Erectile dysfunction, the most common male sexual disorder after premature ejaculation, with its important impact on man and partner's sexuality and quality of life is a persistent inability to obtain and maintain an erection sufficient to permit satisfactory sexual performance. Non-surgical treatments with controversial results are usually applyed before surgical treatment that has reached high levels of satisfaction. We describe a new surgical technique to implant three-pieces penile prosthesis in patients suffering from erectile dysfunction (ED) not responding to conventional medical therapy or reporting side effects with such a therapy. Implantation of an inflatable prosthesis, for treatment of ED, is a safe and efficacious approach with high satisfaction reported by patients and partners. Surgical technique should be minimally invasive and latest technology equipment should be implanted in order to decrease common complications and to obtain a better aesthetic result. PMID:26766806

  12. Video-atlas on minimally invasive mitral valve surgery-The David Adams technique.

    Science.gov (United States)

    Castillo, Javier G; Milla, Federico; Anyanwu, Anelechi C; Adams, David H

    2013-11-01

    Median sternotomy has unquestionably evolved over recent decades. Modern sternotomy involves a 7-8 cm lower midline skin incision, tunneling of the subcutaneous tissues with subsequent creation of myocutaneous flaps, full sternotomy, and standard cardiopulmonary bypass techniques with central cannulation. In experienced centers, modern sternotomy may achieve all the goals of minimally invasive surgery, including excellent cosmesis, excellent postoperative pain control, low rates of bleeding and transfusion (our re-exploration rate for bleeding is <1%), and the ability to perform any reconstructive technique that would be used in a standard sternotomy, with very high repair rates (our most recent series documented a repair rate exceeding 99% in an all-comers population of degenerative disease regardless of complexity).

  13. Minimally invasive cardiac surgery in the adult: surgical instruments, equipment, and techniques.

    Science.gov (United States)

    Kitamura, M; Uwabe, K; Hirota, J; Kawai, A; Endo, M; Koyanagi, H

    1998-09-01

    To clarify the special instruments and equipment used for minimally invasive cardiac surgery (MICS), we examined the initial experiences with MICS operations with ministernotomy or minithoracotomy at our institution. Fifty adult patients with congenital, valvular, and/or ischemic heart diseases underwent MICS operations, and all surgical procedures were completed without conversion to full sternotomy. The length of the skin incision was about 10 cm or less in all patients. Postoperative recovery was favorable, and the majority of the patients were discharged from the hospital around the end of the second postoperative week. In this series of patients, an oscillating bone saw, lifting type retractor, 2 blade spreader, cannula with a balloon, and right-angled aortic clamp among other items, were very useful for successfully performing various operations with MICS approaches and techniques. The associated results suggest that MICS with ministernotomy or minithoracotomy was feasible using special instruments and equipment and could be encouraged for adult patients with various cardiovascular diseases.

  14. Gaze-contingent soft tissue deformation tracking for minimally invasive robotic surgery.

    Science.gov (United States)

    Mylonas, George P; Stoyanov, Danail; Deligianni, Fani; Darzi, Ara; Yang, Guang-Zhong

    2005-01-01

    The introduction of surgical robots in Minimally Invasive Surgery (MIS) has allowed enhanced manual dexterity through the use of microprocessor controlled mechanical wrists. Although fully autonomous robots are attractive, both ethical and legal barriers can prohibit their practical use in surgery. The purpose of this paper is to demonstrate that it is possible to use real-time binocular eye tracking for empowering robots with human vision by using knowledge acquired in situ. By utilizing the close relationship between the horizontal disparity and the depth perception varying with the viewing distance, it is possible to use ocular vergence for recovering 3D motion and deformation of the soft tissue during MIS procedures. Both phantom and in vivo experiments were carried out to assess the potential frequency limit of the system and its intrinsic depth recovery accuracy. The potential applications of the technique include motion stabilization and intra-operative planning in the presence of large tissue deformation.

  15. Minimally Invasive Treatment of Pelvic Fractures%骨盆骨折的微创治疗

    Institute of Scientific and Technical Information of China (English)

    闫双根

    2013-01-01

    不稳定性骨盆骨折多因巨大暴力直接作用于骨盆所致,常合并有休克、腹盆腔脏器及泌尿生殖道损伤.采取非手术疗法治疗的并发症较多,而开放内固定手术又存在创伤大、出血多、风险高等缺点.随着影像学设备的发展和骨科手术技术的不断改进,采用微创技术治疗骨盆骨折已逐渐应用于临床,如经皮采用外固定支架、骶髂螺钉或钢板等微创内固定方法治疗不同类型骨盆骨折的临床疗效已渐显优势.%Unstable pelvic fractures are mostly caused by the enormous violence which act directly on the pelvis,often associated with shock,abdominal and pelvic organs,and genitourinary tract injury. Non-surgical treatment will cause more complications, while open internal fixation has the demerits of maximal trauma, much bleeding and high-risk. With continuous improvement of imaging and orthopedic operation technology, minimally invasive surgery has been gradually applied to treat pelvic fracture. To different types of pelvic fracture , the advantages in clinical efficacy of the corresponding minimally invasive fixations have been gradually shown,such as percutaneous frame of external fixation,sacroiliac screw or steel plate etc..

  16. Laparoscopic endoscopic cooperative surgery as a minimally invasive treatment for gastric submucosal tumor

    Institute of Scientific and Technical Information of China (English)

    Tsutomu; Namikawa; Kazuhiro; Hanazaki

    2015-01-01

    Laparoscopic wedge resection is a useful procedure fortreating patients with submucosal tumor(SMT) including gastrointestinal stromal tumor(GIST) of the stomach. However, resection of intragastric-type SMTs can be problematic due to the difficulty in accurately judging the location of endoluminal tumor growth, and often excessive amounts of healthy mucosa are removed; thus, full-thickness local excision using laparoscopic and endoscopic cooperative surgery(LECS) is a promising procedure for these cases. Our experience with LECS has confirmed this procedure to be a safe, feasible, and minimally invasive treatment method for gastric GISTs less than 5 cm in diameter, with outcomes similar to conventional laparoscopic wedge resection. The important advantage of LECS is the reduction in the resected area of the gastric wall compared to that in conventional laparoscopic wedge resection using a linear stapler. Early gastric cancer fits the criteria for endoscopic resection; however, if performing endoscopic submucosal dissection is difficult, the LECS procedure might be a good alternative. In the future, LECS is also likely to be indicated for duodenal tumors, as well as gastric tumors. Furthermore, developments in endoscopic and laparoscopic technology have generated various modified LECS techniques, leading to even less invasive surgery.

  17. Manual of extravascular minimally invasive interventional procedures of the liver and biliary tract

    International Nuclear Information System (INIS)

    The use of interventional radiology and image-guided surgery has increased. Interventional radiologists are involved in patient treatment, well as in the diagnosis of the disease carrying his knowledge to the tumor treatment and procedures more invasive. Large amount of didactic material there are available, but the country lacks a manual to standardize interventional radiological techniques carried out. Also, those that could be instituted and adapted effectively in the management of hepatobiliary pathology of the Sistema de Salud Publica in Costa Rica, that covers the main procedures and adopt guidelines in a standardized way. A manual of procedures minimally invasive radiologic extravascular of the liver and biliary tract, is presented with broad bibliographic support that directs, standardizes and is adaptable to the needs and own resources of Costa Rica. Interventional radiology has been a non surgical alternative of a low index of complications, useful for the management of some health problems, avoids surgery and certainly lower costs. An alternative to surgical treatment of many conditions is offered, thereby reducing complications (morbidity) and can eliminate the need for hospitalization, in some cases. The development of new materials has allowed the most common working tools of the medical field are improved and become increasingly more efficient in the diagnosis and treatment of diseases, improving the training of radiologists in the interventional field. (author)

  18. Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures

    Directory of Open Access Journals (Sweden)

    TONG Da-ke

    2012-02-01

    Full Text Available 【Abstract】Objective: To investigate the efficacy of the locking internal fixator (LIF, which includes the locking compression plate (LCP and the less invasive stable system (LISS, in the proximal and distal tibial fractures. Methods: We did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the opera- tion with LIF by the minimally invasive plate osteosynthesis (MIPO technique. The data consisted of 43 proximal tibial fractures (type AO41C3 and 55 distal tibial fractures (type AO43C3. Results: No complications were observed in all patients after operation. The mean healing time was 8.4 months (range 5-14 months. Only two cases of delayed union occurred at postoperative 10 months. No infections were reported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at postoperative 6 to 9 months and regained the normal functions of knee and ankle joints. Conclusion: Using LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing. Key words: Internal fixator; Tibial fractures; Fracture fixation, intramedullary; Bone plates

  19. Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures

    Institute of Scientific and Technical Information of China (English)

    TONG Da-ke; JI Fang; CAI Xiao-bing

    2011-01-01

    Objective: To investigate the efficacy of the locking internal fixator (LIF), which includes the locking compression plate (LCP) and the less invasive stable system (LISS), in the proximal and distal tibial fractures. Methods: We did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the operation with LIF by the minimally invasive plate osteosynthesis (MIPO) technique. The data consisted of 43 proximal tibial fractures (type AO41C3) and 55 distal tibial fractures (type AO43C3). Results: No complications were observed in all patients after operation. The mean healing time was 8.4 months (range 5-14 months). Only two cases of delayed union occurred at postoperative 10 months. No infections were reported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at postoperative 6 to 9 months and regained the normal functions of knee and ankle joints. Conclusion: Using LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing.

  20. Minimally invasive liver resection to obtain tumor-infiltrating lymphocytes for adoptive cell therapy in patients with metastatic melanoma

    Directory of Open Access Journals (Sweden)

    Alvarez-Downing Melissa M

    2012-06-01

    Full Text Available Abstract Background Adoptive cell therapy (ACT with tumor-infiltrating lymphocytes (TIL in patients with metastatic melanoma has been reported to have a 56% overall response rate with 20% complete responders. To increase the availability of this promising therapy in patients with advanced melanoma, a minimally invasive approach to procure tumor for TIL generation is warranted. Methods A feasibility study was performed to determine the safety and efficacy of laparoscopic liver resection to generate TIL for ACT. Retrospective review of a prospectively maintained database identified 22 patients with advanced melanoma and visceral metastasis (AJCC Stage M1c who underwent laparoscopic liver resection between 1 October 2005 and 31 July 2011. The indication for resection in all patients was to receive postoperative ACT with TIL. Results Twenty patients (91% underwent resection utilizing a closed laparoscopic technique, one required hand-assistance and another required conversion to open resection. Median intraoperative blood loss was 100 mL with most cases performed without a Pringle maneuver. Median hospital stay was 3 days. Three (14% patients experienced a complication from resection with no mortality. TIL were generated from 18 of 22 (82% patients. Twelve of 15 (80% TIL tested were found to have in vitro tumor reactivity. Eleven patients (50% received the intended ACT. Two patients were rendered no evidence of disease after surgical resection, with one undergoing delayed ACT with generated TIL after relapse. Objective tumor response was seen in 5 of 11 patients (45% who received TIL, with one patient experiencing an ongoing complete response (32+ months. Conclusions Laparoscopic liver resection can be performed with minimal morbidity and serve as an effective means to procure tumor to generate therapeutic TIL for ACT to patients with metastatic melanoma.

  1. Hybrid technique of cortical bone trajectory and pedicle screwing for minimally invasive spine reconstruction surgery : A technical note

    OpenAIRE

    Takata, Yoichiro; Matsuura, Tetsuya; Higashino, Kosaku; Sakai, Toshinori; Mishiro, Takuya; Suzue, Naoto; Kosaka, Hirofumi; Hamada, Daisuke; Goto, Tomohiro; Nishisho, Toshihiko; Goda, Yuichiro; Sato, Ryosuke(Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Oho, Tsukuba, 305-0801, Japan); Tsutsui, Takahiko; Tonogai, Ichiro; Tezuka, Fumitake

    2014-01-01

    The pedicle screw (PS) system is widely used for spinal reconstruction. Recently, screw insertion using the cortical bone trajectory (CBT) technique has been reported to provide increased holding strength of the vertebra, even in an osteoporotic spine. CBT is also beneficial due to its low invasiveness. We have been performing hybrid reconstruction with CBT at the cranial level and PS at the caudal level based on the concept of minimal invasiveness. We applied this hybrid technique to 6 cases...

  2. Minimally invasive surgery for superior mesenteric artery syndrome: A case report.

    Science.gov (United States)

    Yao, Si-Yuan; Mikami, Ryuichi; Mikami, Sakae

    2015-12-01

    Superior mesenteric artery (SMA) syndrome is defined as a compression of the third portion of the duodenum by the abdominal aorta and the overlying SMA. SMA syndrome associated with anorexia nervosa has been recognized, mainly among young female patients. The excessive weight loss owing to the eating disorder sometimes results in a reduced aorto-mesenteric angle and causes duodenal obstruction. Conservative treatment, including psychiatric and nutritional management, is recommended as initial therapy. If conservative treatment fails, surgery is often required. Currently, traditional open bypass surgery has been replaced by laparoscopic duodenojejunostomy as a curative surgical approach. However, single incision laparoscopic approach is rarely performed. A 20-year-old female patient with a diagnosis of anorexia nervosa and SMA syndrome was prepared for surgery after failed conservative management. As the patient had body image concerns, a single incision laparoscopic duodenojejunostomy was performed to achieve minimal scarring. As a result, good perioperative outcomes and cosmetic results were achieved. We show the first case of a young patient with SMA syndrome who was successfully treated by single incision laparoscopic duodenojejunostomy. This minimal invasive surgery would be beneficial for other patients with SMA syndrome associated with anorexia nervosa, in terms of both surgical and cosmetic outcomes. PMID:26668518

  3. Neurological complications using a novel retractor system for direct lateral minimally invasive lumbar interbody fusion.

    Science.gov (United States)

    Sedra, Fady; Lee, Robert; Dominguez, Ignacio; Wilson, Lester

    2016-09-01

    We describe our experience using the RAVINE retractor (K2M, Leesburg, VA, USA) to gain access to the lateral aspect of the lumbar spine through a retroperitoneal approach. Postoperative neurological adverse events, utilising the mentioned retractor system, were recorded and analysed. We included 140 patients who underwent minimally invasive lateral lumbar interbody fusion (MI-LLIF) for degenerative spinal conditions between 2011 and 2015 at two major spinal centres. A total of 228 levels were treated, 35% one level, 40% two level, 20% three level and 5% 4 level surgeries. The L4/5 level was instrumented in 28% of cases. 12/140 patients had postoperative neurological complications. Immediately after surgery, 5% of patients (7/140) had transient symptoms in the thigh ranging from sensory loss, pain and paraesthesia, all of which recovered within 12weeks following surgery. There were five cases of femoral nerve palsy (3.6% - two ipsilateral and three contralateral), all of which recovered completely with no residual sensory or motor deficit within 6months. MI-LLIF done with help of the described retractor system has proved a safe and efficient way to achieve interbody fusion with minimal complications, mainly nerve related, that recovered quickly. Judicious use of the technique to access the L4/5 level is advised. PMID:27349467

  4. Evaluation of a novel tool for bone graft delivery in minimally invasive transforaminal lumbar interbody fusion

    Directory of Open Access Journals (Sweden)

    Kleiner JB

    2016-05-01

    Full Text Available Jeffrey B Kleiner, Hannah M Kleiner, E John Grimberg Jr, Stefanie J Throlson The Spine Center of Innovation, The Medical Center of Aurora, Aurora, CO, USA Study design: Disk material removed (DMR during L4-5 and L5-S1 transforaminal lumbar interbody fusion (T-LIF surgery was compared to the corresponding bone graft (BG volumes inserted at the time of fusion. A novel BG delivery tool (BGDT was used to apply the BG. In order to establish the percentage of DMR during T-LIF, it was compared to DMR during anterior diskectomy (AD. This study was performed prospectively. Summary of background data: Minimal information is available as to the volume of DMR during a T-LIF procedure, and the relationship between DMR and BG delivered is unknown. BG insertion has been empiric and technically challenging. Since the volume of BG applied to the prepared disk space likely impacts the probability of arthrodesis, an investigation is justified. Methods: A total of 65 patients with pathology at L4-5 and/or L5-S1 necessitating fusion were treated with a minimally invasive T-LIF procedure. DMR was volumetrically measured during disk space preparation. BG material consisting of local autograft, BG extender, and bone marrow aspirate were mixed to form a slurry. BG slurry was injected into the disk space using a novel BGDT and measured volumetrically. An additional 29 patients who were treated with L5-S1 AD were compared to L5-S1 T-LIF DMR to determine the percent of T-LIF DMR relative to AD. Results: DMR volumes averaged 3.6±2.2 mL. This represented 34% of the disk space relative to AD. The amount of BG delivered to the disk spaces was 9.3±3.2 mL, which is 2.6±2.2 times the amount of DMR. The BGDT allowed uncomplicated filling of the disk space in <1 minute. Conclusion: The volume of DMR during T-LIF allows for a predictable volume of BG delivery. The BGDT allowed complete filling of the entire prepared disk space. The T-LIF diskectomy debrides 34% of the disk

  5. Ultrafast mid-IR laser scalpel: protein signals of the fundamental limits to minimally invasive surgery.

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    Saeid Amini-Nik

    Full Text Available Lasers have in principle the capability to cut at the level of a single cell, the fundamental limit to minimally invasive procedures and restructuring biological tissues. To date, this limit has not been achieved due to collateral damage on the macroscale that arises from thermal and shock wave induced collateral damage of surrounding tissue. Here, we report on a novel concept using a specifically designed Picosecond IR Laser (PIRL that selectively energizes water molecules in the tissue to drive ablation or cutting process faster than thermal exchange of energy and shock wave propagation, without plasma formation or ionizing radiation effects. The targeted laser process imparts the least amount of energy in the remaining tissue without any of the deleterious photochemical or photothermal effects that accompanies other laser wavelengths and pulse parameters. Full thickness incisional and excisional wounds were generated in CD1 mice using the Picosecond IR Laser, a conventional surgical laser (DELight Er:YAG or mechanical surgical tools. Transmission and scanning electron microscopy showed that the PIRL laser produced minimal tissue ablation with less damage of surrounding tissues than wounds formed using the other modalities. The width of scars formed by wounds made by the PIRL laser were half that of the scars produced using either a conventional surgical laser or a scalpel. Aniline blue staining showed higher levels of collagen in the early stage of the wounds produced using the PIRL laser, suggesting that these wounds mature faster. There were more viable cells extracted from skin using the PIRL laser, suggesting less cellular damage. β-catenin and TGF-β signalling, which are activated during the proliferative phase of wound healing, and whose level of activation correlates with the size of wounds was lower in wounds generated by the PIRL system. Wounds created with the PIRL systsem also showed a lower rate of cell proliferation. Direct

  6. Ultrafast mid-IR laser scalpel: protein signals of the fundamental limits to minimally invasive surgery.

    Science.gov (United States)

    Amini-Nik, Saeid; Kraemer, Darren; Cowan, Michael L; Gunaratne, Keith; Nadesan, Puviindran; Alman, Benjamin A; Miller, R J Dwayne

    2010-01-01

    Lasers have in principle the capability to cut at the level of a single cell, the fundamental limit to minimally invasive procedures and restructuring biological tissues. To date, this limit has not been achieved due to collateral damage on the macroscale that arises from thermal and shock wave induced collateral damage of surrounding tissue. Here, we report on a novel concept using a specifically designed Picosecond IR Laser (PIRL) that selectively energizes water molecules in the tissue to drive ablation or cutting process faster than thermal exchange of energy and shock wave propagation, without plasma formation or ionizing radiation effects. The targeted laser process imparts the least amount of energy in the remaining tissue without any of the deleterious photochemical or photothermal effects that accompanies other laser wavelengths and pulse parameters. Full thickness incisional and excisional wounds were generated in CD1 mice using the Picosecond IR Laser, a conventional surgical laser (DELight Er:YAG) or mechanical surgical tools. Transmission and scanning electron microscopy showed that the PIRL laser produced minimal tissue ablation with less damage of surrounding tissues than wounds formed using the other modalities. The width of scars formed by wounds made by the PIRL laser were half that of the scars produced using either a conventional surgical laser or a scalpel. Aniline blue staining showed higher levels of collagen in the early stage of the wounds produced using the PIRL laser, suggesting that these wounds mature faster. There were more viable cells extracted from skin using the PIRL laser, suggesting less cellular damage. β-catenin and TGF-β signalling, which are activated during the proliferative phase of wound healing, and whose level of activation correlates with the size of wounds was lower in wounds generated by the PIRL system. Wounds created with the PIRL systsem also showed a lower rate of cell proliferation. Direct comparison of wound

  7. Development of a quantum dot mediated thermometry for minimally invasive thermal therapy

    Science.gov (United States)

    Hanson, Willard L.

    Thermally-related, minimally invasive therapies are designed to treat tumors while minimizing damage to the surrounding tissues. Adjacent tissues become susceptible to thermal injury to ensure the cancer is completely destroyed. Destroying tumor cells, while minimizing collateral damage to the surrounding tissue, requires the capacity to control and monitor tissue temperatures both spatially and temporally. Current devices measure the tumor's tissue temperature at a specific location leaving the majority unmonitored. A point-wise application can not substantiate complete tumor destruction. This type of surgery would be more effective if volumetric tissue temperature measurement were available. On this premise, the feasibility of a quantum dot (QD) assembly to measure the tissue temperature volumetrically was tested in the experiments described in this dissertation. QDs are fluorescence semiconductor nanoparticles having various superior optical properties. This new QD-mediated thermometry is capable of monitoring the thermal features of tissues non-invasively by measuring the aggregate fluorescence intensity of the QDs accumulated at the target tissues prior to and during the surgical procedure. Thus, such a modality would allow evaluation of tissue destruction by measuring the fluorescence intensity of the QD as a function of temperature. The present study also quantified the photoluminescence intensity and attenuation of the QD as a function of depth and wavelength using a tissue phantom. A prototype system was developed to measure the illumination through a tissue phantom as a proof of concept of the feasibility of a noninvasive thermal therapy. This prototype includes experimental hardware, software and working methods to perform image acquisition, and data reduction strategic to quantify the intensity and transport characteristics of the QD. The significance of this work is that real-time volumetric temperature information will prove a more robust tool for use

  8. Parathyroid scintigraphy in preoperative detection of parathyroid adenomas and use of gama probe in minimal invasive surgery

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    Mustafa Köroğlu

    2011-06-01

    Full Text Available Clinical or subclinical hyperparathyroidism is one of the most common endocrine disorders. Excessive secretion of parathyroid hormone is most frequently caused by an adenoma of a parathyroid gland or glands. The conventional surgical approach is bilateral neck exploration, whereas minimally invasive parathyroidectomy has been made possible by the introduction of 99mTc-sestamibi scintigraphy for preoperative localization of parathyroid adenomas. Especially in ectopic localizations of parathyroid gland and its lesions preoperative localization have undeniable value. In minimally invasive technique the incision is small, dissection is minimal, postoperative pain is less, and hospital stay is shorter. Minimally invasive technique is easy, safe, with a low morbidity rate and has better cosmetic results lower overall cost than conventional bilateral neck exploration. In this technique greatly aided by intraoperative guidence with a gamma probe, based on in vivo radioactivity counting after administrating 99mTc-MIBI. In pres¬ent article, we reviewed actual literature on the preoperative localization of parathyroid adenomas and radioguided minimal invasive surgery. J Clin Exp Invest 2011;2(2:238-43

  9. Precise minimally invasive surgery of lower lumbar spine%下腰椎精准微创技术的现状及展望

    Institute of Scientific and Technical Information of China (English)

    潘志敏; 程细高; 高贵程; 程联智

    2014-01-01

    近些年,显微内镜技术和微创器械的更新、计算机技术与影像医学的发展以及医学人文理念的进步等共同促进了微创脊柱外科快速发展。微创理念已渗透脊柱外科各领域,微创脊柱外科正向损伤小、并发症少为特点的精准靶点治疗发展。本文就有代表意义的经皮穿刺及髓核成形术、脊柱内镜及内窥镜技术、计算机导航系统精准定位脊柱外科手术、机器人操作腰椎手术等相关技术作一简介。%The fast development of minimally invasive spine surgery in recent years is based on the advance of endoscopic microsurgery techniques, computer science and medical imaging, as well as the growing concerning of medical humanities.The concept of minimally invasive and precise targeting therapy has been penetrating into various areas of surgery, and minimal tissue damage and fewer complications are the new directions of minimally invasive spine surgery.In this article we review some advances in precise spinal surgery including percutaneous lumbar discectomy, microendoscopic discectomy, computer-assisted orthopedic surgery and robot surgery.

  10. Small right vertical infra-axillary incision for minimally invasive port-access cardiac surgery: a moving window method

    OpenAIRE

    Kaneda, Toshio; Nishino, Takako; Saga, Toshihiko; Nakamoto, Susumu; Ogawa, Tatsuya; Satsu, Takuma

    2013-01-01

    Port-access cardiac surgery has been developed to minimize skin incision and improve cosmetic outcomes. Using this method, a skin incision is generally made just above where the thoracotomy will be placed, horizontally along the intercostal space at the anterolateral submammary position. However, this type of incision can affect the frontal view and shape of the breast. Here, we report our experience with minimally invasive cardiac surgery using a port-access approach via a small vertical rig...

  11. SECOND AND THIRD DEGREE HAEMORRHOIDS: MANAGEMENT WITH MINIMALLY INVASIVE PROCEDURE FOR HAEMORRHOID (MIPH AND OUTCOME

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    Rajesh Kumar

    2014-12-01

    Full Text Available The present study was carried out to study the management of second and third degree haemorrhoids with Minimally Invasive Procedure for Haemorrhoid (MIPH and its outcome. Twenty five cases were included in the study. The major aims of the study were to evaluate the merits and demerits of Minimal Invasive Procedure for management of second and third degree haemorrhoids by using haemorrhoidal set and to study the efficacy of MIPH ( S tapled haemorrho idopexy in terms of duration of surgery , early complications , time of ambulation , mean hospital stay , time of rejoin to work and late complications. The study was carried out in MB Government Hospital associated with R.N.T. Medical C ollege , Udaipur. Patients admitted in different s urgical wards were taken for study. Material and method used in this study include various laboratory investigations including CBC , BT , CT , Blood Sugar , S - urea , S - creatinine , HIV , HBsAg , Urine complete , X - Ray Chest and ECG. Special Investigation including Per rectal examination for anal sphincter tone , pain , any rectal growth , prolapse , bleeding , discharge and Proctoscopy to evaluate positions and grades of piles. Statistical analysis of various data done and maximum incidence thirty six percent of second and third degree haemorrhiods was found in 31 - 40 year age group. Males were predominantly affected as compared to females. Patients with second and third degree of haemorrhoids mostly visited hospital for bleeding pe r rectum and prolapse . Other symptoms about which patient were concerned were pain , itching and discharge and about half of the patients had associated history of constipation. Most of patients seek surgeons attention after a period of about one month. Twe nty percent patients had positive family history of haemorrhoid. Eighty eight percent patients had taken some treatment in the form of laxative and ointment. Eight percent patients had undergone sclerotherapy and twelve percent

  12. The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review.

    Science.gov (United States)

    Bemelman, Michael; van Baal, Mark; Yuan, Jian Zhang; Leenen, Luke

    2016-02-01

    More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950's, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has become available suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

  13. 3. Early outcomes of minimally invasive versus conventional mitral valve surgery in mitral valve diseases. A single institutional experience

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    E. Nourelden

    2016-07-01

    Full Text Available Minimally invasive techniques in cardiac surgery gained popularity due to many advantages like less postoperative pain, minimal blood loss, less hospital stay, less cost. Minimally invasive mitral valve surgery through right anterolateral mini thoracotomy became safe technique. In our study we compared mini-MV surgery with conventional technique regarding cross clamp time, bypass time, total blood loss, reopening for bleeding, and hospital and ICU length of stay. In our institution between 2010 and 2015, 147patients underwent minimally invasive mitral surgery through right lateral minithoracotomy 8 cm incision and 118 patient underwent conventional mitral valve surgery through median sternotomy in minimally invasive technique: mean age was 38 ± 20 vs 59 ± 21, 70.7% were female (n = 104 vs 39.8% (n = 47, 23.8% were associated with tricuspid valve regurgitation (n = 33 vs 55% in conventional technique (n = 65, 0.08% were able to use endovascular clamp (n = 12, mean Euroscore predected risk of mortality 14.7 ± 13.6% vs 8.7 ± 10.9%. Minimally invasive mitral valve repair surgery was accomplished in 77.5% (n = 114 vs 46.15% (n = 55 and replacement of mitral valve in 22.4% (n = 30 vs 53.8% (n = 64 , concomitant procedures consists of tricuspid valve surgery in 23.8% (n = 35 vs 55% (n = 65, primary mitral valve repair included implantation of rigid annuloplasty ring in 79.6% vs 38.9% (n = 46, duration of cardiopulmonary bypass in minimally invasive surgery was 123 ± 64 min vs 116 ± 62 min, cross clamp time was 64 ± 27 min vs 59 ± 23 min, postoperative mechanical ventilation time 4 ± 1.5 h vs 6.5 ± 2 h, ICU lenght of stay (LOS was 48 ± 12 h vs 3 ± 1 days. Minimally invasive mitral surgery can be performed very safely with excellent early results. mini-MV surgery can be performed with a reasonable operative time, good perioperative course with decrease in postoperative ICU and hospital

  14. Minimal invasive transforaminal lumbar interbody fusion versus open transforaminal lumbar interbody fusion

    Science.gov (United States)

    Kulkarni, Arvind G; Bohra, Hussain; Dhruv, Abhilash; Sarraf, Abhishek; Bassi, Anupreet; Patil, Vishwanath M

    2016-01-01

    Background: The aim of the present prospective study is to evaluate whether the touted advantages of minimal invasive-transforaminal lumbar interbody fusion (MI-TLIF) translate into superior, equal, or inferior outcomes as compared to open-transforaminal lumbar interbody fusion (O-TLIF). This is the first study from the Indian subcontinent prospectively comparing the outcomes of MI-TLIF and O-TLIF. Materials and Methods: All consecutive cases of open and MI-TLIF were prospectively followed up. Single-level TLIF procedures for spondylolytic and degenerative conditions (degenerative spondylolisthesis, central disc herniations) operated between January 2011 and January 2013 were included. The pre and postoperative Oswestry Disability Index (ODI) and visual analog scale (VAS) for back pain and leg pain, length of hospital stay, operative time, radiation exposure, quantitative C-reactive protein (QCRP), and blood loss were compared between the two groups. The parameters were statistically analyzed (using IBM® SPSS® Statistics version 17). Results: 129 patients underwent TLIF procedure during the study period of which, 71 patients (46 MI-TLIF and 25 O-TLIF) fulfilled the inclusion criteria. Of these, a further 10 patients were excluded on account of insufficient data and/or no followup. The mean followup was 36.5 months (range 18-54 months). The duration of hospital stay (O-TLIF 5.84 days + 2.249, MI-TLIF 4.11 days + 1.8, P blood loss (open 358.8 ml, MI 111.81 ml, P group. On an average, 57.77 fluoroscopic exposures were required in MI-TLIF which was significantly higher than in O-TLIF (8.2). There was no statistically significant difference in the improvement in ODI and VAS scores in MI-TLIF and O-TLIF groups. The change in QCRP values preoperative and postoperative was significantly lower (P group than in O-TLIF group, indicating lesser tissue trauma. Conclusion: The results in MI TLIF are comparable with O-TLIF in terms of outcomes. The advantages of MI-TLIF are

  15. A novel, minimally invasive rat model of normothermic cardiopulmonary bypass model without blood priming

    Institute of Scientific and Technical Information of China (English)

    Zhu Yaobin; Liu Donghai; Li Xiaofeng; Liu Aijun; Wang Qiang; Qiao Chenhui; Zhang Jing

    2014-01-01

    Background Cardiopulmonary bypass (CPB) has been shown to be associated with systemic inflammatory response leading to postoperative organ dysfunction.Elucidating the underlying mechanisms and developing protective strategies for the pathophysiological consequences of CPB have been hampered due to the absence of a satisfactory recovery animal model.The purpose of this study was to establish a novel,minimally invasive rat model of normothermic CPB model without blood priming.Methods Twenty adult male Sprague-Dawley rats weighing 450-560 g were randomly divided into CPB group (n=10) and control group (n=10).All rats were anaesthetized and mechanically ventilated.The carotid artery and jugular vein were cannulated.The blood was drained from the right atrium via the right jugular and further transferred by a miniaturized roller pump to a hollow fiber oxygenator and back to the rat via the left carotid artery.The volume of the priming solution,composed of 6% HES130/0.4 and 125 IU heparin,was less than 12 ml.The surface of the hollow fiber oxygenator was 0.075 m2.CPB was conducted for 60 minutes at a flow rat of 100-120 ml· kg-1· min-1 in CPB group.Oxygen flow/perfusion flow was 0.8 to 1.0,and the mean arterial pressure remained 60-80 mmHg.Results All CPB processes were successfully achieved.Blood gas analysis and hemodynamic parameters of each time point were in accordance with normal ranges.The vital signs of all rats were stable.Conclusions The establishment of CPB without blood priming in rats can be achieved successfully.The nontransthoracic model should facilitate the investigation of pathophysiological processes concerning CPB-related multiple organ dysfunction and possible protective interventions.This novel,recovery,and reproducible minimally invasive CPB model may open the field for various studies on the pathophysiological process of CPB and systemic ischemia-reperfusion injury in vivo.

  16. Minimally invasive treatment of lumbar spinal stenosis with a novel interspinous spacer

    Directory of Open Access Journals (Sweden)

    Shabat S

    2011-09-01

    Full Text Available Shay Shabat1, Larry E Miller2,3, Jon E Block3, Reuven Gepstein11Spinal Care Unit, Sapir Medical Center, Kfar Saba, Israel; 2Miller Scientific Consulting, Inc, Biltmore Lake, NC, USA; 3Jon E Block, PhD, Inc, San Francisco, CA, USAPurpose: To assess the safety and effectiveness of a novel, minimally invasive interspinous spacer in patients with moderate lumbar spinal stenosis (LSS.Methods: A total of 53 patients (mean age, 70 ± 11 years; 45% female with intermittent neurogenic claudication secondary to moderate LSS, confirmed on imaging studies, were treated with the Superion® Interspinous Spacer (VertiFlex, Inc, San Clemente, CA and returned for follow-up visits at 6 weeks, 1 year, and 2 years. Study endpoints included axial and extremity pain severity with an 11-point numeric scale, Zurich Claudication Questionnaire (ZCQ, back function with the Oswestry Disability Index (ODI, health-related quality of life with the Physical Component Summary (PCS and Mental Component Summary (MCS scores from the SF-12, and adverse events.Results: Axial and extremity pain each decreased 54% (both P < 0.001 over the 2-year follow-up period. ZCQ symptom severity scores improved 43% (P < 0.001 and ZCQ physical function improved 44% (P < 0.001 from pre-treatment to 2 years post-treatment. A statistically significant 50% improvement (P < 0.001 also was noted in back function. PCS and MCS each improved 40% (both P < 0.001 from pre-treatment to 2 years. Clinical success rates at 2 years were 83%–89% for ZCQ subscores, 75% for ODI, 78% for PCS, and 80% for MCS. No device infection, implant breakage, migration, or pull-out was observed, although two (3.8% patients underwent explant with subsequent laminectomy.Conclusion: Moderate LSS can be effectively treated with a minimally invasive interspinous spacer. This device is appropriate for select patients who have failed nonoperative treatment measures for LSS and meet strict anatomical criteria.Keywords: Superion, axial

  17. Modulation of Neural Network Activity through Single Cell Ablation: An in Vitro Model of Minimally Invasive Neurosurgery.

    Science.gov (United States)

    Soloperto, Alessandro; Bisio, Marta; Palazzolo, Gemma; Chiappalone, Michela; Bonifazi, Paolo; Difato, Francesco

    2016-01-01

    The technological advancement of optical approaches, and the growth of their applications in neuroscience, has allowed investigations of the physio-pathology of neural networks at a single cell level. Therefore, better understanding the role of single neurons in the onset and progression of neurodegenerative conditions has resulted in a strong demand for surgical tools operating with single cell resolution. Optical systems already provide subcellular resolution to monitor and manipulate living tissues, and thus allow understanding the potentiality of surgery actuated at single cell level. In the present work, we report an in vitro experimental model of minimally invasive surgery applied on neuronal cultures expressing a genetically encoded calcium sensor. The experimental protocol entails the continuous monitoring of the network activity before and after the ablation of a single neuron, to provide a robust evaluation of the induced changes in the network activity. We report that in subpopulations of about 1000 neurons, even the ablation of a single unit produces a reduction of the overall network activity. The reported protocol represents a simple and cost effective model to study the efficacy of single-cell surgery, and it could represent a test-bed to study surgical procedures circumventing the abrupt and complete tissue removal in pathological conditions.

  18. Modulation of Neural Network Activity through Single Cell Ablation: An in Vitro Model of Minimally Invasive Neurosurgery.

    Science.gov (United States)

    Soloperto, Alessandro; Bisio, Marta; Palazzolo, Gemma; Chiappalone, Michela; Bonifazi, Paolo; Difato, Francesco

    2016-01-01

    The technological advancement of optical approaches, and the growth of their applications in neuroscience, has allowed investigations of the physio-pathology of neural networks at a single cell level. Therefore, better understanding the role of single neurons in the onset and progression of neurodegenerative conditions has resulted in a strong demand for surgical tools operating with single cell resolution. Optical systems already provide subcellular resolution to monitor and manipulate living tissues, and thus allow understanding the potentiality of surgery actuated at single cell level. In the present work, we report an in vitro experimental model of minimally invasive surgery applied on neuronal cultures expressing a genetically encoded calcium sensor. The experimental protocol entails the continuous monitoring of the network activity before and after the ablation of a single neuron, to provide a robust evaluation of the induced changes in the network activity. We report that in subpopulations of about 1000 neurons, even the ablation of a single unit produces a reduction of the overall network activity. The reported protocol represents a simple and cost effective model to study the efficacy of single-cell surgery, and it could represent a test-bed to study surgical procedures circumventing the abrupt and complete tissue removal in pathological conditions. PMID:27527143

  19. Correlative analysis of MRI-evident abductor hip muscle degeneration and power after minimally invasive versus conventional unilateral cementless THA.

    Science.gov (United States)

    Vasilakis, Ioannis; Solomou, Ekaterini; Vitsas, Vasilis; Fennema, Peter; Korovessis, Panagiotis; Siamblis, Dimitrios K

    2012-12-01

    The 2 main null hypotheses of this study were: (1) the 4-year surgical trauma-related degeneration within the hip abductor muscles after a minimally invasive approach to total hip arthroplasty would be similar to that following a conventional approach; and (2) no differences in perioperative blood loss or postoperative hip pain would be observed between the minimally invasive and conventional approaches.In 40 consecutive randomly selected adult patients with unilateral primary hip osteoarthritis, a cementless Zweymüller-Plus THA (Smith & Nephew Orthopaedics, Baar, Switzerland) was implanted by a single surgeon in 1 institution during the same period. Twenty patients underwent a minimally invasive approach (group A), and 20 patients underwent a conventional anterolateral approach (group B). Four years postoperatively, the operated and contralateral nonoperated hips of 37 available patients from both groups were examined with magnetic resonance imaging to show any changes in the gluteus medius and tensor fascia latae. Simultaneously, hip abductor power was measured bilaterally in both groups. Anthropometric data, blood loss, Short Form 36 self-assessment questionnaire, visual analog pain score, and walking distance were also analyzed.The reliability of magnetic resonance imaging and hip abductor power measurements was high. No difference was found in hip abductor power on the operated side between the 2 groups, whereas hip abductor power on the nonoperated side was significantly higher in both groups. This study revealed no mechanical and functional benefits in favor of patients undergoing minimally invasive vs conventional total hip arthroplasty.

  20. Simple Tools for Surgeons: Design and Evaluation of mechanical alternatives for robotic instruments for Minimally Invasive Surgery

    NARCIS (Netherlands)

    Jaspers, J.E.N.

    2006-01-01

    Performing complex tasks in Minimally Invasive Surgery (MIS) is demanding due to a disturbed hand-eye co-ordination, the application of non-ergonomic instruments with limited number of degrees of freedom (DOFs) and the two-dimensional (2D) view controlled by the surgical assistance. Robotic camera h

  1. A fluoroscopy-based planning and guidance software tool for minimally invasive hip refixation by cement injection

    NARCIS (Netherlands)

    Malan, D.F.; Van der Walt, S.J.; Raidou, R.G.; Van den Berg, B.; Stoel, B.C.; Botha, C.P.; Nelissen, R.G.H.H.; Valstar, E.R.

    2015-01-01

    Purpose In orthopaedics, minimally invasive injection of bone cement is an established technique. We present HipRFX, a software tool for planning and guiding a cement injection procedure for stabilizing a loosening hip prosthesis. HipRFX works by analysing a pre-operative CT and intraoperative C-arm

  2. Four-dimensional modeling of the heart for image guidance of minimally invasive cardiac surgeries

    Science.gov (United States)

    Wierzbicki, Marcin; Drangova, Maria; Guiraudon, Gerard; Peters, Terry

    2004-05-01

    Minimally invasive surgery of the beating heart can be associated with two major limitations: selecting port locations for optimal target coverage from x-rays and angiograms, and navigating instruments in a dynamic and confined 3D environment using only an endoscope. To supplement the current surgery planning and guidance strategies, we continue developing VCSP - a virtual reality, patient-specific, thoracic cavity model derived from 3D pre-procedural images. In this work, we apply elastic image registration to 4D cardiac images to model the dynamic heart. Our method is validated on two image modalities, and for different parts of the cardiac anatomy. In a helical CT dataset of an excised heart phantom, we found that the artificial motion of the epicardial surface can be extracted to within 0.93 +/- 0.33 mm. For an MR dataset of a human volunteer, the error for different heart structures such as the myocardium, right and left atria, right ventricle, aorta, vena cava, and pulmonary artery, ranged from 1.08 +/- 0.18 mm to 1.14 +/- 0.22 mm. These results indicate that our method of modeling the motion of the heart is not only easily adaptable but also sufficiently accurate to meet the requirements for reliable cardiac surgery training, planning, and guidance.

  3. Minimally invasive corticotomy in orthodontics using a three-dimensional printed CAD/CAM surgical guide.

    Science.gov (United States)

    Cassetta, M; Giansanti, M; Di Mambro, A; Calasso, S; Barbato, E

    2016-09-01

    The aim of this prospective study was to evaluate the effectiveness of an innovative, minimally invasive, flapless corticotomy procedure in orthodontics. The STROBE guidelines were followed. Ten patients with severe dental crowding and a class I molar relationship were selected to receive orthodontic treatment with clear aligners and corticotomy-facilitated orthodontics. The mean age of these patients was 21 years (range 17-28, standard deviation 6.08 years); the male to female ratio was 2:1. The main outcome was a reduction in the total treatment time to correct dental crowding. The secondary outcomes were periodontal index changes, the degree of root resorption, and patient perceptions of the method used, assessed using the short-form Oral Health Impact Profile (OHIP-14). The occurrence of early surgical complications or unexpected events was also recorded. All patients completed the treatment to correct dental crowding. The average treatment time was reduced by two-thirds. The procedure did not significantly modify the periodontal indices or oral health-related quality of life. No early surgical complications or unexpected events were observed. In short, the results indicate that this new procedure is safe and accelerates tooth movement without periodontal complications or discomfort. However, the efficacy of this procedure must be confirmed in controlled clinical trials. PMID:27178968

  4. The design of the robot assisted magnetic resonance imaging guidance for minimally invasive surgery system

    Institute of Scientific and Technical Information of China (English)

    Shao Bing; Sun Lining; Du Zhijiang; Fu Lixin

    2005-01-01

    Robot assisted Minimally Invasive Surgery (MIS) is one of the rapidestdeveloping directions in the current surgical realm. Magnetic Resonance Imaging(MRI) is an optimal imaging modality which was applied in MIS in recent years. By combination of precise positioning to the target by intra-operative MRI guided surgery and dexterous motion by the robot, safe and smooth operation is expected to be performed. An overview of the MRI-guided robotic system for MIS is offered. The design of the intra-operative MR scanner system is described. The MR-compatible robotic system is carefully designed for safety and sterilization issues. This system unifies image information from open MRI, an optical endoscope and conventional vital-sign detectors. It helps and guides the surgeon and other medical staffs so they can make the right decisions. The high-performance manipulator can mimic the movement of the urgeon's hand precisely. And the analysis for active and passive interventional surgical instrument tracking is provided.

  5. Design and fabrication of an IPMC-embedded tube for minimally invasive surgery applications

    Science.gov (United States)

    Liu, Jiayu; Wang, Yanjie; Zhao, Dongxu; Zhang, Chi; Chen, Hualing; Li, Dichen

    2014-03-01

    Minimally Invasive Surgery (MIS) is receiving much attention for a number of reasons, including less trauma, faster recovery and enhanced precision. The traditional robotic actuators do not have the capabilities required to fulfill the demand for new applications in MIS. Ionic Polymer-Metal Composite (IPMC), one of the most promising smart materials, has extensive desirable characteristics such as low actuation voltage, large bending deformation and high functionality. Compared with traditional actuators, IPMCs can mimic biological muscle and are highly promising for actuation in robotic surgery. In this paper, a new approach which involves molding and integrating IPMC actuators into a soft silicone tube to create an active actuating tube capable of multi-degree-of-freedom motion is presented. First, according to the structure and performance requirements of the actuating tube, the biaxial bending IPMC actuators fabricated by using solution casting method have been implemented. The silicone was cured at a suitable temperature to form a flexible tube using molds fabricated by 3D Printing technology. Then an assembly based fabrication process was used to mold or integrate biaxial bending IPMC actuators into the soft silicone material to create an active control tube. The IPMC-embedded tube can generate multi-degree-of-freedom motions by controlling each IPMC actuator. Furthermore, the basic performance of the actuators was analyzed, including the displacement and the response speed. Experimental results indicate that IPMC-embedded tubes are promising for applications in MIS.

  6. Validation of four-dimensional ultrasound for targeting in minimally-invasive beating-heart surgery

    Science.gov (United States)

    Pace, Danielle F.; Wiles, Andrew D.; Moore, John; Wedlake, Chris; Gobbi, David G.; Peters, Terry M.

    2009-02-01

    Ultrasound is garnering significant interest as an imaging modality for surgical guidance, due to its affordability, real-time temporal resolution and ease of integration into the operating room. Minimally-invasive intracardiac surgery performed on the beating-heart prevents direct vision of the surgical target, and procedures such as mitral valve replacement and atrial septal defect closure would benefit from intraoperative ultrasound imaging. We propose that placing 4D ultrasound within an augmented reality environment, along with a patient-specific cardiac model and virtual representations of tracked surgical tools, will create a visually intuitive platform with sufficient image information to safely and accurately repair tissue within the beating heart. However, the quality of the imaging parameters, spatial calibration, temporal calibration and ECG-gating must be well characterized before any 4D ultrasound system can be used clinically to guide the treatment of moving structures. In this paper, we describe a comprehensive accuracy assessment framework that can be used to evaluate the performance of 4D ultrasound systems while imaging moving targets. We image a dynamic phantom that is comprised of a simple robot and a tracked phantom to which point-source, distance and spherical objects of known construction can be attached. We also follow our protocol to evaluate 4D ultrasound images generated in real-time by reconstructing ECG-gated 2D ultrasound images acquired from a tracked multiplanar transesophageal probe. Likewise, our evaluation framework allows any type of 4D ultrasound to be quantitatively assessed.

  7. A review of medical robotics for minimally invasive soft tissue surgery.

    Science.gov (United States)

    Dogangil, G; Davies, B L; Rodriguez y Baena, F

    2010-01-01

    This paper provides an overview of recent trends and developments in medical robotics for minimally invasive soft tissue surgery, with a view to highlight some of the issues posed and solutions proposed in the literature. The paper includes a thorough review of the literature, which focuses on soft tissue surgical robots developed and published in the last five years (between 2004 and 2008) in indexed journals and conference proceedings. Only surgical systems were considered; imaging and diagnostic devices were excluded from the review. The systems included in this paper are classified according to the following surgical specialties: neurosurgery; eye surgery and ear, nose, and throat (ENT); general, thoracic, and cardiac surgery; gastrointestinal and colorectal surgery; and urologic surgery. The systems are also cross-classified according to their engineering design and robotics technology, which is included in tabular form at the end of the paper. The review concludes with an overview of the field, along with some statistical considerations about the size, geographical spread, and impact of medical robotics for soft tissue surgery today. PMID:20718269

  8. A robotic indenter for minimally invasive measurement and characterization of soft tissue response.

    Science.gov (United States)

    Samur, Evren; Sedef, Mert; Basdogan, Cagatay; Avtan, Levent; Duzgun, Oktay

    2007-08-01

    The lack of experimental data in current literature on material properties of soft tissues in living condition has been a significant obstacle in the development of realistic soft tissue models for virtual reality based surgical simulators used in medical training. A robotic indenter was developed for minimally invasive measurement of soft tissue properties in abdominal region during a laparoscopic surgery. Using the robotic indenter, force versus displacement and force versus time responses of pig liver under static and dynamic loading conditions were successfully measured to characterize its material properties in three consecutive steps. First, the effective elastic modulus of pig liver was estimated as 10-15 kPa from the force versus displacement data of static indentations based on the small deformation assumption. Then, the stress relaxation function, relating the variation of stress with respect to time, was determined from the force versus time response data via curve fitting. Finally, an inverse finite element solution was developed using ANSYS finite element package to estimate the optimum values of viscoelastic and nonlinear hyperelastic material properties of pig liver through iterations. The initial estimates of the material properties for the iterations were extracted from the experimental data for faster convergence of the solutions. PMID:17509927

  9. Secondhand Tobacco Smoke Exposure and Lung Adenocarcinoma In Situ/Minimally Invasive Adenocarcinoma (AIS/MIA).

    Science.gov (United States)

    Kim, Claire H; Lee, Yuan-Chin Amy; Hung, Rayjean J; Boffetta, Paolo; Xie, Dong; Wampfler, Jason A; Cote, Michele L; Chang, Shen-Chih; Ugolini, Donatella; Neri, Monica; Le Marchand, Loic; Schwartz, Ann G; Morgenstern, Hal; Christiani, David C; Yang, Ping; Zhang, Zuo-Feng

    2015-12-01

    The aim of this study was to estimate the effect of exposure to secondhand tobacco smoke on the incidence of lung adenocarcinoma in situ/minimally invasive adenocarcinoma (AIS/MIA). Data from seven case-control studies participating in the International Lung Cancer Consortium (ILCCO) were pooled, resulting in 625 cases of AIS/MIA and 7,403 controls, of whom 170 cases and 3,035 controls were never smokers. Unconditional logistic regression was used to estimate adjusted ORs (ORadj) and 95% confidence intervals (CI), controlling for age, sex, race, smoking status (ever/never), and pack-years of smoking. Study center was included in the models as a random-effects intercept term. Ever versus never exposure to secondhand tobacco smoke was positively associated with AIS/MIA incidence in all subjects (ORadj = 1.48; 95% CI, 1.14-1.93) and in never smokers (ORadj = 1.45; 95% CI, 1.00-2.12). There was, however, appreciable heterogeneity of ORadj across studies (P = 0.01), and the pooled estimates were largely influenced by one large study (40% of all cases and 30% of all controls). These findings provide weak evidence for an effect of secondhand tobacco smoke exposure on AIS/MIA incidence. Further studies are needed to assess the impact of secondhand tobacco smoke exposure using the newly recommended classification of subtypes of lung adenocarcinoma.

  10. Simultaneous stereoscope localization and soft-tissue mapping for minimal invasive surgery.

    Science.gov (United States)

    Mountney, Peter; Stoyanov, Danail; Davison, Andrew; Yang, Guang-Zhong

    2006-01-01

    Minimally Invasive Surgery (MIS) has recognized benefits of reduced patient trauma and recovery time. In practice, MIS procedures present a number of challenges due to the loss of 3D vision and the narrow field-of-view provided by the camera. The restricted vision can make navigation and localization within the human body a challenging task. This paper presents a robust technique for building a repeatable long term 3D map of the scene whilst recovering the camera movement based on Simultaneous Localization and Mapping (SLAM). A sequential vision only approach is adopted which provides 6 DOF camera movement that exploits the available textured surfaces and reduces reliance on strong planar structures required for range finders. The method has been validated with a simulated data set using real MIS textures, as well as in vivo MIS video sequences. The results indicate the strength of the proposed algorithm under the complex reflectance properties of the scene, and the potential for real-time application for integrating with the existing MIS hardware. PMID:17354909

  11. Rectification and Robust Matching Using Oriented Image Triplets for Minimally Invasive Surgery

    Science.gov (United States)

    Conen, N.; Jepping, C.; Luhmann, T.; Maas, H.-G.

    2016-06-01

    Stereo endoscopes for minimally invasive surgery have been available on the market for several years and are well established in some areas. In practice, they offer a stereoscopic view to the surgeon but are not yet intended for 3D measurements. However, using current knowledge about the camera system and the difficult conditions in object space, it is possible to reconstruct a highly accurate surface model of the current endoscopic view. In particular for medical interventions, a highly reliable point cloud and real-time computation are required. To obtain good reliability, a miniaturised trinocular camera system is introduced that reduces the amount of outliers. To reduce computation time, an approach for generation of rectified image triplets and their corresponding interior and exterior camera parameters has been developed. With these modified and parameterised images it is possible to directly process 3D measurements in object space. Accordingly, an efficient semi-global optimisation is implemented by the authors. In this paper the special camera system, the rectification approach and the applied methodology of matching in rectified image triplets are explained. Finally, first results are presented. In conclusion, the trinocular camera system provides more reliable point clouds than a binocular one, especially for areas with repetitive or poor texture. Currently, the benefit of the third camera is not as great as desired.

  12. Shaeer’s Technique: A Minimally Invasive Procedure for Monsplasty and Revealing the Concealed Penis

    Science.gov (United States)

    2016-01-01

    Background: A concealed penis is a condition where part of the penis is invisible below the surface of the prepubic skin. Dermolipectomy can correct this condition, although it involves a long abdominal crease incision, or infrapubic incision around the base of the penis, and a possibility for genital lymphedema. This study describes Shaeer’s technique, a minimally invasive method for revealing the concealed penis. Methods: A 1- to 2-cm-long incision was cut over the anterior superior iliac spine (ASIS) on either side. A long curved blunt forceps was inserted from one incision, down to the base of the penis and then up to the contralateral ASIS. A 5-mm wide nonabsorbable tape was picked up by the forceps from 1 incision and pulled through to emerge from the other. Pulling on the tape cephalad pulled the mons pubis and revealed the penis. The tape was sutured to the periosteum overlying the ASIS on either side. Patients were followed up for 18 months for penile length, complications, and overall satisfaction. Results: Twenty patients were operated upon. Preoperatively, flaccid visible length was 3 ± 0.9 cm, and erect visible length was 8 ± 4.6 cm. Postoperatively, the flaccid visible length was 7.1 ± 2.1 cm, with a 57.9% improvement in length (P penis. PMID:27622092

  13. MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION IN DEGENERATIVE LUMBAR SPINE DISEASE

    Directory of Open Access Journals (Sweden)

    Pankaj

    2015-12-01

    Full Text Available OBJECTIVE To assess the clinical and radiological outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion (MI-TLIF and to analyze the surgical outcome for degenerative lumbar spine disease. METHODS A multicenter retrospective analysis of 20 patients who underwent a MI-TLIF by image guidance from 1 January 2012 to April 2015. The study included 13 males and 7 females (Mean age 53 year. CT scan of operating area was done to evaluate the pedicle screw, cage placement and fusion at 6 months post operatively. Oswestry Disability Index (ODI scores and Visual Analogue Scale (VAS were recorded pre-operatively and at 6-month followup. RESULTS Eighteen (90% patients had evidence of fusion at 6 months post operatively with a mean improvement of 34 on the ODI score. Mean length of hospital stay was 4 days. The mean operative time was 170min. One patient developed transient nerve root pain in the postoperative period which was managed conservatively and one patient developed superficial wound infection. There was no case of CSF leak. CONCLUSION MI-TLIF is a safe and effective surgical procedure for management of degenerative lumbar spine disease.

  14. Dionis: A Novel Remote-Center-of-Motion Parallel Manipulator for Minimally Invasive Surgery

    Directory of Open Access Journals (Sweden)

    R. Beira

    2011-01-01

    Full Text Available The large volume and reduced dexterity of current surgical robotic systems are factors that restrict their effective performance. To improve the usefulness of surgical robots in minimally invasive surgery (MIS, a compact and accurate positioning mechanism, named Dionis, is proposed in this paper. This spatial hybrid mechanism based on a novel parallel kinematics is able to provide three rotations and one translation for single port procedures. The corresponding axes intersect at a remote center of rotation (RCM that is the MIS entry port. Another important feature of the proposed positioning manipulator is that it can be placed below the operating table plane, allowing a quick and direct access to the patient, without removing the robotic system. This, besides saving precious space in the operating room, may improve safety over existing solutions. The conceptual design of Dionis is presented in this paper. Solutions for the inverse and direct kinematics are developed, as well as the analytical workspace and singularity analysis. Due to its unique design and kinematics, the proposed mechanism is highly compact, stiff and its dexterity fullfils the workspace specifications for MIS procedures.

  15. A Miniature Robot for Retraction Tasks under Vision Assistance in Minimally Invasive Surgery

    Directory of Open Access Journals (Sweden)

    Giuseppe Tortora

    2014-03-01

    Full Text Available Minimally Invasive Surgery (MIS is one of the main aims of modern medicine. It enables surgery to be performed with a lower number and severity of incisions. Medical robots have been developed worldwide to offer a robotic alternative to traditional medical procedures. New approaches aimed at a substantial decrease of visible scars have been explored, such as Natural Orifice Transluminal Endoscopic Surgery (NOTES. Simple surgical tasks such as the retraction of an organ can be a challenge when performed from narrow access ports. For this reason, there is a continuous need to develop new robotic tools for performing dedicated tasks. This article illustrates the design and testing of a new robotic tool for retraction tasks under vision assistance for NOTES. The retraction robots integrate brushless motors to enable additional degrees of freedom to that provided by magnetic anchoring, thus improving the dexterity of the overall platform. The retraction robot can be easily controlled to reach the target organ and apply a retraction force of up to 1.53 N. Additional degrees of freedom can be used for smooth manipulation and grasping of the organ.

  16. Total 3D Airo® Navigation for Minimally Invasive Transforaminal Lumbar Interbody Fusion

    Science.gov (United States)

    Lian, Xiaofeng; Berlin, Connor; Moriguchi, Yu; Zhang, Qiwei; Härtl, Roger

    2016-01-01

    Introduction. A new generation of iCT scanner, Airo®, has been introduced. The purpose of this study is to describe how Airo facilitates minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Method. We used the latest generation of portable iCT in all cases without the assistance of K-wires. We recorded the operation time, number of scans, and pedicle screw accuracy. Results. From January 2015 to December 2015, 33 consecutive patients consisting of 17 men and 16 women underwent single-level or two-level MIS-TLIF operations in our institution. The ages ranged from 23 years to 86 years (mean, 66.6 years). We treated all the cases in MIS fashion. In four cases, a tubular laminectomy at L1/2 was performed at the same time. The average operation time was 192.8 minutes and average time of placement per screw was 2.6 minutes. No additional fluoroscopy was used. Our screw accuracy rate was 98.6%. No complications were encountered. Conclusions. Airo iCT MIS-TLIF can be used for initial planning of the skin incision, precise screw, and cage placement, without the need for fluoroscopy. “Total navigation” (complete intraoperative 3D navigation without fluoroscopy) can be achieved by combining Airo navigation with navigated guide tubes for screw placement. PMID:27529069

  17. Total 3D Airo® Navigation for Minimally Invasive Transforaminal Lumbar Interbody Fusion.

    Science.gov (United States)

    Lian, Xiaofeng; Navarro-Ramirez, Rodrigo; Berlin, Connor; Jada, Ajit; Moriguchi, Yu; Zhang, Qiwei; Härtl, Roger

    2016-01-01

    Introduction. A new generation of iCT scanner, Airo®, has been introduced. The purpose of this study is to describe how Airo facilitates minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Method. We used the latest generation of portable iCT in all cases without the assistance of K-wires. We recorded the operation time, number of scans, and pedicle screw accuracy. Results. From January 2015 to December 2015, 33 consecutive patients consisting of 17 men and 16 women underwent single-level or two-level MIS-TLIF operations in our institution. The ages ranged from 23 years to 86 years (mean, 66.6 years). We treated all the cases in MIS fashion. In four cases, a tubular laminectomy at L1/2 was performed at the same time. The average operation time was 192.8 minutes and average time of placement per screw was 2.6 minutes. No additional fluoroscopy was used. Our screw accuracy rate was 98.6%. No complications were encountered. Conclusions. Airo iCT MIS-TLIF can be used for initial planning of the skin incision, precise screw, and cage placement, without the need for fluoroscopy. "Total navigation" (complete intraoperative 3D navigation without fluoroscopy) can be achieved by combining Airo navigation with navigated guide tubes for screw placement. PMID:27529069

  18. Minimally invasive reconstruction of the medial patellofemoral ligament using quadriceps tendon.

    Science.gov (United States)

    Fink, Christian; Veselko, Matjaz; Herbort, Mirco; Hoser, Christian

    2014-06-01

    Reconstruction of the medial patellofemoral ligament (MPFL) for the treatment of patellar instability has received increased attention over the past few years. Most operative techniques use hamstring grafts fixed with bone tunnels and/or anchors on the patella. Despite good clinical results using these techniques, complications such as implant breakage, patellar fractures through bone tunnels, and loss of knee motion have occurred. We present a minimally invasive technique for MPFL reconstruction using a strip of quadriceps tendon. With the use of specially designed instruments, the graft is harvested through a 3-cm transverse incision at the proximal pole of the patella. The tendon strip is then dissected distally on the patella, left attached, and diverged 90° medially underneath the medial prepatellar tissue. The graft is fixed on the femur in 20° of knee flexion in a bone tunnel with a bioabsorbable interference screw (adults) or a bone anchor (children). We think that this technique presents a valuable alternative to common hamstring techniques for primary MPFL reconstruction in children and adults, as well as for MPFL revision surgery. PMID:25126496

  19. Laser scoop desobliteration: a method for minimally invasive remote recanalization of chronically occluded superficial femoral arteries

    Science.gov (United States)

    Heneweer, Carola; Siggelkow, Markus; Helle, Michael; Petzina, Rainer; Wulff, Asmus; Schaefer, Joost P.; Berndt, Rouven; Rusch, Rene; Wedel, Thilo; Klaws, Guenther; Müller-Gerbl, Magdalena; Röcken, Christoph; Jansen, Olav; Lutter, Georg; Cremer, Joachim; Groß, Justus

    2015-02-01

    Stenosis and occlusion of the superficial femoral artery (SFA) are most common in arterial occlusive disease. There are numerous interventional, surgical, and combined approaches to reconstitute maximum blood supply to the lower limb; however, despite intense clinical research, the long-term success rates are still poor. We present the first results with a catheter prototype for laser-based minimal invasive endarterectomy, called laser scoop desobliteration (LSD). The tip of a glass fiber containing a catheter was modified with a spatula head design and connected to an ultraviolet laser. It was tested in cadavers fixed with the Thiel embalming technique preserving tissue consistency, flexibility, and plasticity. After longitudinal arteriotomy of the SFA, a circular dissection between media and adventitia was performed. Then the LSD catheter was inserted and propagated with a progress of 1 mm/s. Afterward, the atheroma core, which showed a plain surface without substantial attaching tissue debris, was removed. Histological examination of the vessel wall showed that the dissection was performed at the media/adventitia interface. In summary, the constructed LSD catheter allowed a rapid and easy way to perform an endarterectomy, thereby offering an innovative approach in the treatment of chronic occluded SFA.

  20. Experimental test of MR fluid based tactile device for minimally invasive surgery

    Science.gov (United States)

    Oh, Jong-Seok; Kim, Jin-Kyu; Choi, Seung-Bok

    2013-04-01

    Recently, it is very popular in modern medical industry to adopt robotic technology such as robotic minimally invasive surgery (RMIS). Compared with open surgery, the RMIS needs the robot to perform surgery through the usage of long surgical instruments that are inserted through incision points. This causes the surgeon not to feel viscosity and stiffness of the tissue or organ. So, for the tactile recognition of human organ in RMIS, this work proposes a novel tactile device that incorporates with magnetorheological (MR) fluid. The MR fluid is fully contained by diaphragm and several pins. By applying different magnetic field, the operator can feel different force from the proposed tactile device. In order to generate required force from the device, the repulsive force of human body is firstly measured as reference data and an appropriate size of tactile device is designed. Pins attached with the diaphragm are controlled by shape-memory-alloy (SMA). Thus, the proposed tactile device can realize repulsive force and shape of organ. It has been demonstrated via experiment whether the measured force can be achieved by applying proper control input current. In addition, psychophysical experiments are conducted to evaluate performance on the tactile rendering of the proposed tactile device. From these results, the practical feasibility of the tactile device is verified.

  1. Minimally invasive injectable short nanofibers of poly(glycerol sebacate) for cardiac tissue engineering

    Science.gov (United States)

    Ravichandran, Rajeswari; Reddy Venugopal, Jayarama; Sundarrajan, Subramanian; Mukherjee, Shayanti; Sridhar, Radhakrishnan; Ramakrishna, Seeram

    2012-09-01

    Myocardial tissue lacks the ability to appreciably regenerate itself following myocardial infarction (MI) which ultimately results in heart failure. Current therapies can only retard the progression of disease and hence tissue engineering strategies are required to facilitate the engineering of a suitable biomaterial to repair MI. The aim of this study was to investigate the in vitro properties of an injectable biomaterial for the regeneration of infarcted myocardium. Fabrication of core/shell fibers was by co-axial electrospinning, with poly(glycerol sebacate) (PGS) as core material and poly-l-lactic acid (PLLA) as shell material. The PLLA was removed by treatment of the PGS/PLLA core/shell fibers with DCM:hexane (2:1) to obtain PGS short fibers. These PGS short fibers offer the advantage of providing a minimally invasive injectable technique for the regeneration of infarcted myocardium. The scaffolds were characterized by SEM, FTIR and contact angle and cell-scaffold interactions using cardiomyocytes. The results showed that the cardiac marker proteins actinin, troponin, myosin heavy chain and connexin 43 were expressed more on short PGS fibers compared to PLLA nanofibers. We hypothesized that the injection of cells along with short PGS fibers would increase cell transplant retention and survival within the infarct, compared to the standard cell injection system.

  2. A novel linear elastic actuator for minimally invasive surgery: development of a surgical gripper

    Science.gov (United States)

    Gerboni, G.; Brancadoro, M.; Tortora, G.; Diodato, A.; Cianchetti, M.; Menciassi, A.

    2016-10-01

    Minimally invasive surgery (MIS) applications require lightweight actuators that can generate a high force in a limited volume. Among pressure driven actuators, fluid elastic actuators demonstrate high potential for use in the medical field. They are characterized by nearly no friction and wear and they can be made of low-cost biocompatible elastomers. However, when compared to traditional piston-cylinder fluid actuators, fluid elastic actuators often result in smaller output forces as well as weaker return forces. This work is about the design of a linear elastic actuator (LEA) which is able to develop relevant pulling-pushing force in one direction. The LEA is composed of entirely disposable materials and it requires a simple manufacturing process. Thanks to its design, the LEA can be compared to traditional piston-cylinders actuators in terms of output forces (up to 7 N) with the advantage of using relative low working pressures (0, 2 MPa). The actuator has been used for the actuation of a gripper for MIS, as a case study. The whole range of gripping forces developed by the tool actated by the LEA has been evaluated, thus verifying that the gripping device, is able to meet the force requirements for accomplishing typical surgical tasks.

  3. Total 3D Airo® Navigation for Minimally Invasive Transforaminal Lumbar Interbody Fusion

    Directory of Open Access Journals (Sweden)

    Xiaofeng Lian

    2016-01-01

    Full Text Available Introduction. A new generation of iCT scanner, Airo®, has been introduced. The purpose of this study is to describe how Airo facilitates minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF. Method. We used the latest generation of portable iCT in all cases without the assistance of K-wires. We recorded the operation time, number of scans, and pedicle screw accuracy. Results. From January 2015 to December 2015, 33 consecutive patients consisting of 17 men and 16 women underwent single-level or two-level MIS-TLIF operations in our institution. The ages ranged from 23 years to 86 years (mean, 66.6 years. We treated all the cases in MIS fashion. In four cases, a tubular laminectomy at L1/2 was performed at the same time. The average operation time was 192.8 minutes and average time of placement per screw was 2.6 minutes. No additional fluoroscopy was used. Our screw accuracy rate was 98.6%. No complications were encountered. Conclusions. Airo iCT MIS-TLIF can be used for initial planning of the skin incision, precise screw, and cage placement, without the need for fluoroscopy. “Total navigation” (complete intraoperative 3D navigation without fluoroscopy can be achieved by combining Airo navigation with navigated guide tubes for screw placement.

  4. The Minimally Invasive Plate Osteosynthesis (MIPO Technique with a Locking Compression Plate for Femoral Lengthening

    Directory of Open Access Journals (Sweden)

    Tetsunaga,Tomonori

    2008-10-01

    Full Text Available A minimally invasive plate osteosynthesis technique using a locking compression plate (LCP has been used widely in trauma cases. Its advantages are that the MIPO technique does not interfere with the fracture site and thus provides improved biological healing, and that the LCP has excellent angular stability. Its use in bone lengthening, however, has not been established. In such cases, it is desirable to shorten the external skeletal fixation period as much as possible. Here, the MIPO technique using an LCP was applied to femoral distraction osteogenesis in an attempt to shorten the external skeletal fixation period. For femoral lengthening, the MIPO technique was performed in 2 stages. Orthofix external fixators (Orthofix, England were used to insert screws from the anterolateral side rather than from the lateral side of the femur for bone lengthening. When sufficient callus formation was detected postoperatively at the site of bone lengthening, and the absence of infection was ensured, limb draping was performed, including a whole external fixator, and then the MIPO technique was applied with an LCP. In 3 cases (5 limbs, the average duration of external skeletal fixation was 134days, the average external-fixation index was 24days/cm, and the average consolidation index was 22days/cm. The MIPO technique using an LCP made it possible to shorten the external skeletal fixation-wearing period in femoral lengthening.

  5. Visualizing transplanted muscle flaps using minimally invasive multi-electrode bioimpedance spectroscopy

    Science.gov (United States)

    Gordon, R.; Zorkova, V.; Min, M.; Rätsep, I.

    2010-04-01

    We describe here an imaging system that uses bioimpedance spectroscopy with multi-electrode array to indicate the state of muscle flap regions under the array. The system is able to differentiate between different health states in the tissue and give early information about the location and size of ischemic sub-regions. The array will be 4*8 electrodes with the spacing of 5mm between the electrodes (the number of electrodes and the spacing may vary). The electrodes are minimally invasive short stainless steel needles, that penetrate 0.3 mm into the tissue with the goal of achieving a wet electric contact. We combine 32 configurations of 4-electrode multi-frequency impedance measurements to derive a health-state map for the transplanted flap. The imaging method is tested on a model consisting of 2 tissues and FEM software (Finite Element Method -COMSOL Multiphysics based) is used to conduct the measurements virtually. Dedicated multichannel bioimpedance measurement equipment has already been developed and tested, that cover the frequency range from 100 Hz to 1 MHz.

  6. Accuracy of implant positioning for minimally invasive total knee arthroplasty in patients with severe varus deformity.

    Science.gov (United States)

    Niki, Yasuo; Matsumoto, Hideo; Otani, Toshiro; Enomoto, Hiroyuki; Toyama, Yoshiaki; Suda, Yasunori

    2010-04-01

    Minimally invasive surgery (MIS) in total knee arthroplasty (TKA) reportedly yields decreased patient morbidity and a rapid return of function, but how much deformity can be accepted for MIS-TKA remains unclear. This study investigated 238 knees from 218 consecutive patients who underwent MIS-TKA. Patients were divided into groups with tibiofemoral mechanical axis (TFM) 195 degrees or greater and TFM less than 195 degrees, then clinical and radiographic results were compared. Similar improvements in knee score at 3 months postoperatively were obtained in the both groups, whereas radiographic accuracy of the coronal alignment in the TFM >or=195 degrees group was inferior to that in TFM angle of the femoral shaft (LBFS) 4 degrees or greater, and 53% of patients in the TFM >or=195 degrees group displayed LBFS 4 degrees or greater, explaining the inferior radiographic accuracy in this group compared with the TFM <195 degrees group. These results indicate that use of MIS techniques decreases radiographic accuracy, particularly in patients with severe genu varum and increased LBFS. PMID:20347714

  7. Minimally Invasive Drainage of a Post-Laminectomy Subfascial Seroma with Cervical Spinal Cord Compression.

    Science.gov (United States)

    Kitshoff, Adriaan Mynhardt; Van Goethem, Bart; Cornelis, Ine; Combes, Anais; Dvm, Ingeborgh Polis; Gielen, Ingrid; Vandekerckhove, Peter; de Rooster, Hilde

    2016-01-01

    A 14 mo old female neutered Doberman pinscher was evaluated for difficulty in rising, a wide based stance, pelvic limb gait abnormalities, and cervical pain of 2 mo duration. Neurologic examination revealed pelvic limb ataxia and cervical spinal hyperesthesia. Spinal reflexes and cranial nerve examination were normal. The pathology was localized to the C1-C5 or C6-T2 spinal cord segments. Computed tomography (CT) findings indicated bony proliferation of the caudal articular processes of C6 and the cranial articular processes of C7, resulting in bilateral dorsolateral spinal cord compression that was more pronounced on the left side. A limited dorsal laminectomy was performed at C6-C7. Due to progressive neurological deterioration, follow-up CT examination was performed 4 days postoperatively. At the level of the laminectomy defect, a subfacial seroma had developed, entering the spinal canal and causing significant spinal cord compression. Under ultrasonographic guidance a closed-suction wound catheter was placed. Drainage of the seroma successfully relieved its compressive effects on the spinal cord and the patient's neurological status improved. CT was a valuable tool in assessing spinal cord compression as a result of a postoperative subfascial seroma. Minimally invasive application of a wound catheter can be successfully used to manage this condition.

  8. Minimally invasive endoscopic resection of benign tumours of the accessory parotid gland: an updated approach.

    Science.gov (United States)

    Li, Biao; Zhang, Lei; Zhao, Zeliang; Shen, Guofang; Wang, Xudong

    2013-06-01

    The most common conventional approaches for the resection of benign tumours in the accessory parotid gland are a standard parotidectomy incision, a modified standard parotidectomy incision, or a face-lift incision. The resulting scars may severely affect the patient's postoperative appearance. The previously reported endoscopically assisted approach offers a less aesthetically invasive technique, but it may still leave a visible preauricular scar 4-5 cm long. We have used a modified endoscopic approach with minimal, and concealed, incisions for the resection of benign tumours in the accessory parotid gland. Five patients were diagnosed by physical examination, imaging, and preoperative fine-needle aspiration biopsy. They had endoscopically assisted resections using our modified approach, and we evaluated its feasibility. All the resections were successful. The mean operating time was 108 min (range 90-130). The postoperative scars were concealed and aesthetically satisfactory. There were no facial paralyses, salivary fistulas, or recurrences in the short term. Using endoscopically assisted resection we completely removed benign tumours from the accessory parotid gland and obtained good aesthetic results. Our updated endoscopic approach for these resections is successful with shorter, concealed incisions. It is a viable alternative to conventional approaches.

  9. From the ground up: building a minimally invasive aortic valve surgery program.

    Science.gov (United States)

    Nguyen, Tom C; Lamelas, Joseph

    2015-03-01

    Minimally invasive aortic valve replacement (MIAVR) is associated with numerous advantages including improved patient satisfaction, cosmesis, decreased transfusion requirements, and cost-effectiveness. Despite these advantages, little information exists on how to build a MIAVR program from the ground up. The steps to build a MIAVR program include compiling a multi-disciplinary team composed of surgeons, cardiologists, anesthesiologists, perfusionists, operating room (OR) technicians, and nurses. Once assembled, this team can then approach hospital administrators to present a cost-benefit analysis of MIAVR, emphasizing the importance of reduced resource utilization in the long-term to offset the initial financial investment that will be required. With hospital approval, training can commence to provide surgeons and other staff with the necessary knowledge and skills in MIAVR procedures and outcomes. Marketing and advertising of the program through the use of social media, educational conferences, grand rounds, and printed media will attract the initial patients. A dedicated website for the program can function as a "virtual lobby" for patients wanting to learn more. Initially, conservative selection criteria of cases that qualify for MIAVR will set the program up for success by avoiding complex co-morbidities and surgical techniques. During the learning curve phase of the program, patient safety should be a priority. PMID:25870815

  10. A new visual feedback-based magnetorheological haptic master for robot-assisted minimally invasive surgery

    Science.gov (United States)

    Choi, Seung-Hyun; Kim, Soomin; Kim, Pyunghwa; Park, Jinhyuk; Choi, Seung-Bok

    2015-06-01

    In this study, we developed a novel four-degrees-of-freedom haptic master using controllable magnetorheological (MR) fluid. We also integrated the haptic master with a vision device with image processing for robot-assisted minimally invasive surgery (RMIS). The proposed master can be used in RMIS as a haptic interface to provide the surgeon with a sense of touch by using both kinetic and kinesthetic information. The slave robot, which is manipulated with a proportional-integrative-derivative controller, uses a force sensor to obtain the desired forces from tissue contact, and these desired repulsive forces are then embodied through the MR haptic master. To verify the effectiveness of the haptic master, the desired force and actual force are compared in the time domain. In addition, a visual feedback system is implemented in the RMIS experiment to distinguish between the tumor and organ more clearly and provide better visibility to the operator. The hue-saturation-value color space is adopted for the image processing since it is often more intuitive than other color spaces. The image processing and haptic feedback are realized on surgery performance. In this work, tumor-cutting experiments are conducted under four different operating conditions: haptic feedback on, haptic feedback off, image processing on, and image processing off. The experimental realization shows that the performance index, which is a function of pixels, is different in the four operating conditions.

  11. Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis

    Science.gov (United States)

    Sarwahi, Vishal; Amaral, Terry; Wendolowski, Stephen; Gecelter, Rachel; Gambassi, Melanie; Plakas, Christos; Liao, Benita; Kalantre, Sarika; Katyal, Chhavi

    2015-01-01

    Minimally invasive surgery (MIS) has been described in the treatment of adolescent idiopathic scoliosis (AIS) and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented in our neuromuscular patients. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, partial/complete facet resection, and all standard reduction maneuvers. Operative time needed to complete this surgery is comparable to the standard procedure and the majority of our patients have been extubated at the end of procedure, spending 1 day in the PICU and 5-6 days in the hospital. We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis. Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations. PMID:26649305

  12. Minimal Invasive Management of Small Renal Masses: State of Art and New Trends

    Directory of Open Access Journals (Sweden)

    Senol Tonyali

    2016-04-01

    Full Text Available With the widespread use of abdominal imaging modalities such as ultrasound (US, computerized tomography (CT and magnetic resonance imaging (MRI, there has been a pronounced increase in the incidence of renal tumors especially clinically localized, small < 2 cm ones. Moreover the final pathology of these lesions is benign up to 30%. The development of ablation techniques (radiofrequency ablation, cryoablation, high-intensity focused ultrasound and microwave ablation with continuous innovations such as refinement of probes and real-time imaging capabilities has pioneered the great interest in these techniques, especially for the treatment of T1 renal malignancies. RFA and CA have similar cancer specific survival, disease-free survival, recurrence free survival and overall survival rates compared to nephrectomy. MWA and HIFU remain still experimental due to low patient volume and insufficient clinical experience. Minimal invasive techniques can be a feasible treatment alternative for patients who have high surgical and anesthetic risk with multiple comorbidities, have multiple tumors due to a systemic disease like VHL or do not want to undergo extirpative surgery. Especially elderly patients can be good candidates for these procedures with their relatively short life expectance and impaired performance status.

  13. Treatment of Humeral Shaft Fractures: Minimally Invasive Plate Osteosynthesis Versus Open Reduction and Internal Fixation

    Science.gov (United States)

    Esmailiejah, Ali Akbar; Abbasian, Mohammad Reza; Safdari, Farshad; Ashoori, Keyqobad

    2015-01-01

    Background: The optimal technique for operative fixation of humeral shaft fractures remains controversial and warrants research. Objectives: The purpose of the current study was to compare the functional and clinical outcomes of conventional open reduction and internal fixation (ORIF) with minimally invasive plate osteosynthesis (MIPO) in patients with fractures in two-third distal humeral shaft. Patients and Methods: In the current prospective case-control study, 65 patients with humeral shaft fractures were treated using ORIF (33 patients) or MIPO (32 patients). Time of surgery, time of union, incidence of varus deformity and complications were compared between the two groups. Also, the university of California-Los Angeles (UCLA) shoulder rating scale and Mayo Elbow performance score (MEPS) were used to compare the functional outcomes between the two groups. Results: The median of union time was shorter in the MIPO group (4 months versus 5 months). The time of surgery and functional outcomes based on the UCLA and MEPS scores were the same. The incidence of varus deformity was more than 5° and was higher and the incidence of nonunion, infection and iatrogenic radial nerve injury were lower in the MIPO group; however, the differences were not significant. Conclusions: Due to the shorter union time, to some extent less complication rate and comparable functional and clinical results, the authors recommend to use the MIPO technique in treating the mid-distal humeral shaft fracture. PMID:26543844

  14. Treatment feasibility study of osteoporosis using minimal invasive laser needle system

    Science.gov (United States)

    Kang, Dongyeon; Ko, Chang-Yong; Ryu, Yeon-Hang; Park, Sunwook; Kim, Han-Sung; Jung, Byungjo

    2010-02-01

    Although the mechanism of laser stimulation effect in bone has not completely understood, laser stimulation is recommended in the treatment of osteoporosis due to positive treatment efficacy. In this study, a minimal invasive laser needle system (MILNS) was developed using a fine hollow needle in order to stimulate directly bone site by guiding an optical fiber. In order to evaluate the MILNS as a treatment method, in-vivo animal experiment study was performed using osteopenic mice. Twelve virginal ICR mice were employed and divided two groups: SHAM-group and LASERgroup. SHARM-group was stimulated by only fine hollow needle and LASER-group by fine hollow needle combined with laser stimulation. All mice were served in-vivo micro-CT images before and after treatment. Three dimensional (3D) structural parameters and vBMD (volume bone mineral density, g/cm3) in the trabecular bone were measured. After 2 weeks of stimulation, the vBMD, BV/TV, Tb.Th and Tb.N in LASER-group were significantly higher than those in SHAM-group (p<0.05). Potentially, this study suggested that the MILNS might prevent the bone loss and maintains the bone mineral density of osteopenic mice.

  15. Minimally Invasive Drainage of a Post-Laminectomy Subfascial Seroma with Cervical Spinal Cord Compression.

    Science.gov (United States)

    Kitshoff, Adriaan Mynhardt; Van Goethem, Bart; Cornelis, Ine; Combes, Anais; Dvm, Ingeborgh Polis; Gielen, Ingrid; Vandekerckhove, Peter; de Rooster, Hilde

    2016-01-01

    A 14 mo old female neutered Doberman pinscher was evaluated for difficulty in rising, a wide based stance, pelvic limb gait abnormalities, and cervical pain of 2 mo duration. Neurologic examination revealed pelvic limb ataxia and cervical spinal hyperesthesia. Spinal reflexes and cranial nerve examination were normal. The pathology was localized to the C1-C5 or C6-T2 spinal cord segments. Computed tomography (CT) findings indicated bony proliferation of the caudal articular processes of C6 and the cranial articular processes of C7, resulting in bilateral dorsolateral spinal cord compression that was more pronounced on the left side. A limited dorsal laminectomy was performed at C6-C7. Due to progressive neurological deterioration, follow-up CT examination was performed 4 days postoperatively. At the level of the laminectomy defect, a subfacial seroma had developed, entering the spinal canal and causing significant spinal cord compression. Under ultrasonographic guidance a closed-suction wound catheter was placed. Drainage of the seroma successfully relieved its compressive effects on the spinal cord and the patient's neurological status improved. CT was a valuable tool in assessing spinal cord compression as a result of a postoperative subfascial seroma. Minimally invasive application of a wound catheter can be successfully used to manage this condition. PMID:27008321

  16. Design and control of MR haptic master/slave robot system for minimally invasive surgery

    Science.gov (United States)

    Uhm, Chang-Ho; Nguyen, Phoung Bac; Choi, Seung-Bok

    2013-04-01

    In this work, magnetorheological (MR) haptic master and slave robot for minimally invasive surgery (MIS) have been designed and tested. The proposed haptic master consists of four actuators; three MR brakes featuring gimbal structure for 3-DOF rotation motion(X, Y and Z axes) and one MR linear actuator for 1-DOF translational motion. The proposed slave robot which is connected with the haptic master has vertically multi- joints, and it consists of four DC servomotors; three for positioning endoscope and one for spinning motion. We added a fixed bar with a ball joint on the base of the slave for the endoscope position at the patient's abdomen to maintain safety. A gimbal structure at the end of the slave robotic arm for the last joint rotates freely with respect to the pivot point of the fixed bar. This master-slave system runs as if a teleoperation system through TCP/IP connection, programmed by LabVIEW. In order to achieve the desired position trajectory, a proportional-integral-derivative (PID) controller is designed and implemented. It has been demonstrated that the effective tracking control performances for the desired motion are well achieved and presented in time domain. At last, an experiment in virtual environments is undertaken to investigate the effectiveness of the MR haptic master device for MIS system.

  17. Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis

    Directory of Open Access Journals (Sweden)

    Vishal Sarwahi

    2015-01-01

    Full Text Available Minimally invasive surgery (MIS has been described in the treatment of adolescent idiopathic scoliosis (AIS and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented in our neuromuscular patients. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, partial/complete facet resection, and all standard reduction maneuvers. Operative time needed to complete this surgery is comparable to the standard procedure and the majority of our patients have been extubated at the end of procedure, spending 1 day in the PICU and 5-6 days in the hospital. We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis. Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations.

  18. A Parametric Study Delineating Irreversible Electroporation from Thermal Damage Based on a Minimally Invasive Intracranial Procedure

    Directory of Open Access Journals (Sweden)

    Ellis Thomas L

    2011-04-01

    Full Text Available Abstract Background Irreversible electroporation (IRE is a new minimally invasive technique to kill undesirable tissue in a non-thermal manner. In order to maximize the benefits from an IRE procedure, the pulse parameters and electrode configuration must be optimized to achieve complete coverage of the targeted tissue while preventing thermal damage due to excessive Joule heating. Methods We developed numerical simulations of typical protocols based on a previously published computed tomographic (CT guided in vivo procedure. These models were adapted to assess the effects of temperature, electroporation, pulse duration, and repetition rate on the volumes of tissue undergoing IRE alone or in superposition with thermal damage. Results Nine different combinations of voltage and pulse frequency were investigated, five of which resulted in IRE alone while four produced IRE in superposition with thermal damage. Conclusions The parametric study evaluated the influence of pulse frequency and applied voltage on treatment volumes, and refined a proposed method to delineate IRE from thermal damage. We confirm that determining an IRE treatment protocol requires incorporating all the physical effects of electroporation, and that these effects may have significant implications in treatment planning and outcome assessment. The goal of the manuscript is to provide the reader with the numerical methods to assess multiple-pulse electroporation treatment protocols in order to isolate IRE from thermal damage and capitalize on the benefits of a non-thermal mode of tissue ablation.

  19. New minimally invasive option for the treatment of gluteal muscle contracture.

    Science.gov (United States)

    Ye, Bin; Zhou, Panyu; Xia, Yan; Chen, Youyan; Yu, Jun; Xu, Shuogui

    2012-12-01

    Gluteal muscle contracture is a clinical syndrome that involves contracture and distortion of the gluteal muscles and fascia fibers due to multiple causes. Physical examination demonstrates a characteristic gait due to hip adduction and internal thigh rotation. This study introduces a new minimally invasive method for surgical release of gluteal muscle contracture. Patients with gluteal muscle contracture were assigned to 4 categories: type A, contracture occurred mainly in the iliotibial tract; type B, contracture occurred in the Iliotibial tract and gluteus maximus; type C1, movement of the contraction band was palpable and a snapping sound was audible during squatting; and type C2, movement of the contraction band was not palpable or almost absent and a snapping sound was audible during squatting. This classification method allowed prediction of the anatomic location of these pathological contractures and determination of the type of surgery required. Four critical points were used to define the operative field and served as points to mark a surgical incision smaller than 4 mm. The contracture was easily released in this carefully marked operative field without causing significant neurovascular damage. Over a period of 5 years, between March 2003 and June 2008, the authors treated 1059 patients with this method and achieved excellent outcomes. Most patients were fully active within 12 weeks, with the assistance of an early postoperative rehabilitation program. The most significant complication was a postoperative periarticular hematoma, which occurred in 3 patients within 10 days postoperatively and required surgical ligation of the bleeding vessel. PMID:23218623

  20. Prediction of Muscle Fatigue during Minimally Invasive Surgery Using Recurrence Quantification Analysis

    Science.gov (United States)

    Keshavarz Panahi, Ali; Cho, Sohyung

    2016-01-01

    Due to its inherent complexity such as limited work volume and degree of freedom, minimally invasive surgery (MIS) is ergonomically challenging to surgeons compared to traditional open surgery. Specifically, MIS can expose performing surgeons to excessive ergonomic risks including muscle fatigue that may lead to critical errors in surgical procedures. Therefore, detecting the vulnerable muscles and time-to-fatigue during MIS is of great importance in order to prevent these errors. The main goal of this study is to propose and test a novel measure that can be efficiently used to detect muscle fatigue. In this study, surface electromyography was used to record muscle activations of five subjects while they performed fifteen various laparoscopic operations. The muscle activation data was then reconstructed using recurrence quantification analysis (RQA) to detect possible signs of muscle fatigue on eight muscle groups (bicep, triceps, deltoid, and trapezius). The results showed that RQA detects the fatigue sign on bilateral trapezius at 47.5 minutes (average) and bilateral deltoid at 57.5 minutes after the start of operations. No sign of fatigue was detected for bicep and triceps muscles of any subject. According to the results, the proposed novel measure can be efficiently used to detect muscle fatigue and eventually improve the quality of MIS procedures with reducing errors that may result from overlooked muscle fatigue. PMID:27313884