• Title/Summary/Keyword: minimally invasive surgery

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Impact of conversion at time of minimally invasive pancreaticoduodenectomy on perioperative and long-term outcomes: Review of the National Cancer Database

  • Jennifer Palacio;Daisy Sanchez;Shenae Samuels;Bar Y. Ainuz;Raelynn M. Vigue;Waleem E. Hernandez;Christopher J. Gannon;Omar H. Llaguna
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.3
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    • pp.292-300
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    • 2023
  • Backgrounds/Aims: Current literature presents limited data regarding outcomes following conversion at the time of minimally invasive pancreaticoduodenectomy (MI-PD). Methods: The National Cancer Database was queried for patients who underwent pancreaticoduodenectomy. Patients were stratified into three groups: MI-PD, converted to open pancreaticoduodenectomy (CO-PD), and open pancreaticoduodenectomy (O-PD). Multivariable modeling was applied to compare outcomes of MI-PD and CO-PD to those of O-PD. Results: Of 17,570 patients identified, 12.5%, 4.2%, and 83.4% underwent MI-PD, CO-PD, and O-PD, respectively. Robotic pancreaticoduodenectomy (R-PD) resulted in a higher lymph node yield (n = 23.2 ± 12.2) even when requiring conversion (n = 22.4 ± 13.2, p < 0.001). Margin positivity was higher in the CO-PD group (26.6%) than in the MI-PD group (21.3%) and the O-PD (22.6%) group (p = 0.017). Length of stay was shorter in the MI-PD group (laparoscopic pancreaticoduodenectomy 10.4 ± 8.6, R-PD 10.6 ± 8.8) and the robotic converted to open group (10.7 ± 6.4) than in the laparoscopic converted to open group (11.2 ± 9) and the O-PD group (11.5 ± 8.9) (p < 0.001). After adjusting for patient and tumor characteristics, both MI-PD (odds ratio = 1.40; p < 0.001) and CO-PD (odds ratio = 1.24; p = 0.020) were significantly associated with an increased likelihood of long-term survival. Conclusions: CO-PD does not negatively impact perioperative or oncologic outcomes.

Axillocoronary Bypass as Coronary Reoperation via Minimally Invasive Procedure-A Report of One Case- (관상동맥 재수술로서의 최소 침습 수기를 통한 액와 -관상동맥 우회술 -1례 보고-)

  • 백완기;윤용한;김정택;김광호;임현경
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.399-402
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    • 2001
  • 최근 심폐기를 사용하지 않는 최소침습성 직접 관상동맥우회술(MIDCAB procedure)은 심장수술 분야에서 급속도로 발전을 거듭하고 있다. 금번 저자들은 전에 만들어 준 좌전하행지 이식편이 막혀 관상동맥 재수술을 필요로 하였으나 좌내 유동맥의 혈류량의 불충분하였다고 생각되었다. 1례에서 최소 침습 수기를 통한 액와-관상동맥 우회술을 시행하여 만족스러운 결과를 얻었기에 문헌고찰과 함께 보고하고자 한다.

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Robot-Assisted Thoracoscopic Esophagectomy and Lymph Node Dissection (수술로봇을 이용한 식도절제 및 종격동림프절 박리술)

  • Kim, Dae Joon
    • Korean Journal of Bronchoesophagology
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    • v.17 no.2
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    • pp.89-91
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    • 2011
  • Robotic surgery have been increasingly applied in the past several years to assist in a variety of operations. Some applications, such as in prostatectomy, have been widely adopted and have largely supplanted the alternative minimally invasive or open techniques. However, the use of surgical robots in esophagectomy has not been as common. Although a limited number of case reports demonstrated the feasibility of robotic esophagectomy, no large series of patients has been reported to date. The data on robotic-assisted esophagectomy suggest that the procedure is safe, feasible, and associated with perioperative outcomes similar to open and minimally invasive esophagectomy. Benefits of robotic system could be maximized when we do a extensive total mediastinal lymphadenectomy. For this procedure to gain widespread acceptance, identifiable benefit relative should be demonstrated in near future.

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Flexible tactile sensor for minimally invasive surgery (최소 침습 수술을 위한 유연한 촉각 센서)

  • Lee, Junwoo;Yoo, Yong Kyoung;Han, Sung Il;Kim, Cheon Jing;Lee, Jeong Hoon
    • Proceedings of the KIEE Conference
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    • 2015.07a
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    • pp.1229-1230
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    • 2015
  • Monitoring of mechanical properties of tissues as well as direction/quantities of forces is considered as an essential way for disease diagnosis and haptic feedback systems. There are extensively increasing interests for measuring normal/shear force and touch feelings, especially for surgery systems. Highly sensitive and flexible tactile sensor is needed in palpation for detecting cancer cyst as well as real time pressure monitoring in minimally invasive surgery (MIS). Importantly, MEMS technique with miniaturized fabrication technique is essential for the on-chip integration with biopsy and biomedical grasper. Here, we propose the flexible tactile sensor with high sensitivity based on piezoresistive effect. We analyzed the sensitivity according to the pressure and directions and showed the ability of discrimination of the different materials surfaces, illustrating the feasibility of the flexible tactile sensor for biomedical grasper by mimicking human skin.

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Minimally-invasive Percutaneous Screw Fixation of Displaced Intra-articular Calcaneal Fractures (최소 침습적 경피적 나사못 고정 방법을 이용한 전위된 관절내 종골 골절 치료)

  • Chae, Soo-Uk;Yang, Jung-Hwan
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.73-78
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    • 2010
  • Purpose: The purpose of this study is to analyze the clinical and radiological results of minimally invasive percutaneous screw fixation in intra-articular calcaneal fractures and its complications. Materials and Methods: This study is based on 30 intra-articular calcaneal fractures that treated by index operation from June 2005 to November 2006 with at least 6 months follow-up. We assessed the clinical and radiological outcomes and complications. Results: According to Sanders classification, there were 8 in type IIA, 7 in type IIB, 3 in type IIIAB, 6 in type IIIBC, 6 in type IV. And according to Essex-Lopresti classification, there were 9 in the tongue type, 21 in the joint depression type. Average follow-up period was 14.6 months (range: 6-23 months). Average interval between from injury to operation was 2.3 days. Average AOFAS score was 87.7 (range: 52-92). Satisfactory results were obtained in 22 cases (73.3%) by AOFAS score and in 20 cases (66.7%) by VAS score (mean: 3.4). Radiological results improved from 8.7 to 20.3 degrees in the Bohler angle and from 40.2 mm to 52.1 mm in calcaneal height. Postoperative complications were 2 skin and soft tissue problems and 1 sural neuropathy. Conclusion: Minimally invasive percutaneous screw fixation may be useful alternative surgical method in the management of Sanders type II and III calcaneal fractures, which is possible to achieves the anatomical restoration and minimizes postoperative complication in patients with high risks of soft tissue compromise and allows relatively early operation.

Current Status of Robotic-assisted Surgery in Gastric Cancer

  • Eli Kakiashvili
    • Journal of Digestive Cancer Research
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    • v.4 no.2
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    • pp.99-106
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    • 2016
  • Minimally invasive surgery for gastric cancer has increased in popularity during the last two decades mainly in the Asia for patients with early-stage cancer. Nevertheless, the development of laparoscopic surgery for gastric cancers in the Western world has been slow because of the advanced stage at diagnosis for which LG is not yet considered an acceptable alternative to standard open surgery. RAG has been reported as a safe alternative to conventional surgery for treating of early gastric carcinoma. We assess the current status of robotic surgery in the treatment of gastric cancer focusing on the technical details, postoperative outcome, oncological considerations and future perspectives. In gastrectomy the biggest advantage of the robotic approach is the ease and reproducibility of lymphadenectomy. Reports also show that even the intra corporeal digestive restoration is facilitated by use of the robotic approach, particularly following TG. Additionally, the accuracy of robotic dissection is confirmed by decreased blood loss in comparison to conventional laparoscopy. The learning curve and technical reproducibility also appear to be shorter with robotic surgery and, consequently, robotics can help to standardize and diffuse minimally invasive surgery in the treatment of gastric cancer. While published reports have shown no significant differences in surgical morbidity, mortality, or oncological adequacy between robot-assisted and conventional gastrectomy. There are some advantages in terms of postoperative recovery of patients after robotic surgery. More studies are needed to assess the true indications and oncological effectiveness of robotic use in the treatment of gastric carcinoma.

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