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Laparoscopic surgery and imaging-directed surgery for anorectal malformation
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Matthew W. Ralls, Marcus D. Jarboe
The rectum is then reflected cephalad and the pelvic floor is examined. If image-guided surgery technique is used, the previously placed MRI guided needle is identified at this point. The perineal portion is performed. In short, an incision in the marked and confirmed center of the subcutaneous sphincter complex is made through the dermis. The anal canal is created with Seldinger technique with a radially dilating trocar. The previously transected fistula is brought down and the neoanus is sewn into place (Video 45.2).
Central Nervous System
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Image-guided surgery is an accepted method to facilitate tumor removal. However, powerful new techniques are now available to assist the surgeon in achieving MSR. Intra-operative MRI is available in many units and has been shown to lead to more complete resections. Direct demonstration of improved patient outcome is awaited.25 5-Aminolaevulinic acid (5-ALA) is a prodrug of a fluorescent porphyrin that accumulates preferentially in malignant glioma cells after intravenous injection. Using a modified neurosurgical microscope, these cells can be intra-operatively visualized and selectively removed. The rationale that this technique leads to more complete resections and longer progression-free survival compared with standard image-guided surgery was proved in a randomized trial.26 Improvements in intra-operative technology and neuro-anesthesia have led to the increasing popularity of awake craniotomy and cortical mapping as an aid to tumor surgery. The technique has been shown to decrease iatrogenic neurological deficits and permit earlier discharge as well as improving the extent of resection.27
Recent Developments in Bioresponsive Drug Delivery Systems
Published in Deepa H. Patel, Bioresponsive Polymers, 2020
Drashti Pathak, Deepa H. Patel
Molecular imaging is a powerful tool to visualize and characterize biological processes at the cellular and molecular level in vivo. Molecular imaging involves the noninvasive visualization and quantitative detection of biomolecules in vivo by means of target-specific probes [38–41]. Valuable applications of molecular imaging are accurate disease detection, phenotyping, and staging by gathering information on molecular pathways underlying biological and cellular processes in the diseased tissue. Hence, molecular imaging is likely to play a pivotal role in the stratification of patients for personalized treatment. Furthermore, molecular imaging is clinically relevant in the discovery and development of drugs and for the real-time assessment of the efficacy of drug therapy [42, 43]. Further, it can contribute to improved interventions by image-guided drug delivery and image-guided surgery [44–47].
Augmented reality in dentistry: a current perspective
Published in Acta Odontologica Scandinavica, 2018
Ho-Beom Kwon, Young-Seok Park, Jung-Suk Han
In contrast to conventional image-guided surgery, where a surgeon must look away from the operative field to view the informative data, AR guidance systems provide real-time intraoperative information with real surgical fields [39]. It is ideal to offer three-dimensional presentations on the patient’s body rather than a separate screen because perception of the real body is more intuitive and avoids confusion [13,40]. Since the display type dominates the perception location, head-mounted displays or microscopic eyepieces are typically recommended, mimicking Google Glass [41]. Generally, computer-generated additional information is overlaid onto a real surgical field and thus resides between the patient’s body and the surgeon’s eye.
The age of robotic surgery – Is laparoscopy dead?
Published in Arab Journal of Urology, 2018
Hartwig Schwaibold, Felix Wiesend, Christian Bach
With the most recent dVSS generation, the da Vinci® Xi, the system has become much simpler and versatile: simple docking, chip-on-tip camera, autofocus, overhead instrument arm architecture that facilitates access from virtually any position, the ability to attach the endoscope to any arm, tighter port placement than with the older systems, Bluetooth connection between patient cart and surgeon console, and the ability to reposition the patient without undocking. However, the advantage of image-guided surgery has been implemented only marginally to date [48].
Cysteine cathepsins as therapeutic targets in inflammatory diseases
Published in Expert Opinion on Therapeutic Targets, 2020
Matej Vizovišek, Eva Vidak, Urban Javoršek, Georgy Mikhaylov, Andreja Bratovš, Boris Turk
In parallel to the development of cathepsin inhibitors, other options for therapeutic targeting of cathepsins have started by exploiting their overexpression for diagnostic imaging and targeted drug delivery. In the future, we expect that the field will spread even more in this direction since the high cathepsin overexpression associated with local inflammation and secretion from various infiltrated immune cells results in a very high signal-to-noise ratio in diagnostic imaging. In particular, this is true for cathepsins B and S, because cathepsin B has generally high expression and secretion from a number of cells including immune cells whereas cathepsin S is almost exclusively secreted from immune cells. However, fluorescence imaging, which is currently most commonly used, has limited usability in human diagnostics primarily due to light scattering and poor light penetration to deep tissues. Anyhow, the field has found its niche in image-guided surgery and is successfully progressing although no agents are in clinical use as yet [24,183]. Because of the limitations, we expect the field to shift to different imaging modalities, in particular PET, CT and MRI, where some development has already been seen. Another breakthrough was made recently with targeting cathepsins for drug delivery in oncology using cathepsin B as a target [177]. A switch between diagnostic imaging and targeted delivery is possible, and we can expect further development in this area. Finally, intracellular cathepsins have also been established as prodrug and ADC-processing enzymes with one ADC already being used in clinics (Brentuximab vedotin; ADCETRIS®) and more being currently developed. Additionally, we believe that the research focus will also include cathepsins as exposers of disease-specific molecular features, but the clinical potential of this concept remains to be validated.