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The history of lymphatic mapping: a gynecologic perspective
Published in Charles F. Levenback, Ate G.J. van der Zee, Robert L. Coleman, Clinical Lymphatic Mapping in Gynecologic Cancers, 2022
During the same period of the development of sentinel lymph node biopsy, health care leaders have observed industries such as commercial aviation and nuclear energy that are ultrasafe and still provide high satisfaction to consumers. High-reliability organizations (HROs) operate in high-risk environments by being highly sensitive to operations, deferring to expertise, and not trying to simplify complex operations, in addition to a preoccupation with failure and a commitment to resilience. The lessons of HROs are being applied in health care, especially in surgery and anesthesiology. For example, the World Health Organization Surgical Safety Checklist has transformed how surgical procedures are conducted. Risk-adjusted data, such as the National Surgical Quality Improvement Database (NSQIP), allow accurate measurement of new protocols to reduce surgical site infections. Minimally invasive surgery and enhanced recovery protocols have reduced the surgical length of stay dramatically. Low-risk anesthesia for outpatient procedures is ultrasafe.
Bariatric surgery
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Lindel C.K. Dewberry, Thomas H. Inge
Bariatric programs for adolescents should include expertise in adolescent obesity, nutrition, diet, and behavioral management. It is critical that thorough investigations be conducted to discover unrecognized coexisting obesity-related medical conditions. Minimally invasive surgery has significant advantages over open surgery, including a reduction in both length of hospitalization and operative morbidity. Minimally invasive bariatric surgery is one of the most technically difficult operations to perform. Laparoscopic skills utilized in foregut surgery are not directly transferable to bariatric surgery. Expertise in minimally invasive surgery may not confer the same level of expertise in performing minimally invasive bariatric surgery. Surgeons performing bariatric procedures must be well trained, as suggested by the American Society for Bariatric Surgery, the American College of Surgeons, and the Society of American Gastrointestinal Endoscopic Surgeons. Prior to performing laparoscopic bariatric operations, surgeons must meet all local credentialing requirements for the performance of open bariatric procedures and advanced laparoscopic operations. Given the controversy centered on adolescent bariatric surgery, the aspiring adolescent bariatric surgeon, at a minimum, should take a course in bariatric surgery and perform his or her first five to ten procedures proctored by an experienced laparoscopic bariatric surgeon.
Volumetric Approach to Lower Facial Rejuvenation
Published in Neil S. Sadick, Illustrated Manual of Injectable Fillers, 2020
Robert A. Glasgold, Justin C. Cohen, Mark J. Glasgold, Sachin M. Shridharani, Jason D. Meier
Utilizing a volumetric approach for lower facial rejuvenation, soft tissue fillers provide long-lasting excellent results with minimal downtime. Each lower facial region has specific techniques and products, which have demonstrated long-lasting and good results. With appropriate expectations, patients can have a high degree of satisfaction with soft tissue fillers. These minimally invasive procedures are an excellent alternative or can be used in conjunction with surgical treatment.
Complete Laparoscopic Interval Debulking Surgery for Advanced Ovarian Cancer Achieves Similar Survival Outcomes to Open Approach: A Propensity-Matched Study
Published in Journal of Investigative Surgery, 2022
Lise Lecointre, Madeleine Pellerin, Aïna Venkatasamy, Thibaut Fabacher, Lauriane Eberst, Justine Gantzer, Floriane Jochum, Émilie Faller, Thomas Boisramé, Denis Querleu, Chérif Akladios
IDS is achievable by laparoscopy for low residual tumor burden, with a low risk of conversion, reduced morbidity, shorter hospital stay, fewer postoperative complications and similar surgery time (5.2 h ± 1.6 with laparoscopy vs 4.9 h ± 1.5 with laparotomy, p = 0.47). Only one conversion to laparotomy was observed, which is consistent with other studies (“Mission” study conversion rate 3.9% out of 98 procedures; Melamed et al. 5–20%) [11–12]. Similarly, Corrado et al. described 6.6% of postoperative complication with laparoscopy, similar to the 4.7% rate of Fagotti et al. [11,31]. The higher postoperative complication rate in our study (21% for laparoscopy vs 62.5% for laparotomy) can be explained because we strictly followed the Dindo Clavien classification and included parental nutrition, urinary tract infections, post-operative fever and diarrhea, as significant post-operative complications. Additionally, the lower psychological distress associated with laparoscopy is relevant for patients experiencing a difficult life event [32]. The importance of the patients’ quality of life could be also one of the explanations for our results in favor of laparoscopy. Indeed, minimally invasive surgery involves less intra- and post-operative morbidity and probably leads to improved quality of life, playing a role in patients’ survival.
A comparative study of the acute and long-term prognosis for mouse models undergoing laparoscopic surgery under continuous intra-abdominal perfusion with either CO2 gas or saline
Published in Cogent Medicine, 2018
Hisayo Jin, Takuro Ishii, Shiroh Isono, Tatsuo Igarashi, Tomohiko Aoe
Minimally invasive surgical techniques are an essential component of enhanced recovery after surgery (ERAS). Endoscopic surgery is a potent tool that reduces postoperative complications and pain while providing the additional advantages of a small incision size, a minimally invasive approach, and reduced hospital stays. Conventional laparoscopic surgery and robot-assisted surgery routinely apply carbon dioxide (CO2) gas to widen the body cavity and obtain an adequate surgical field. Although both CO2 insufflation and liquid irrigation may have some adverse effects, liquid irrigation would provide us with the opportunity to perform lavage that would help to maintain an appropriate local/body temperature, avoid the desiccation of organs, and would allow us to use a favorable navigation system that permits simultaneous monitoring by both ultrasonography and laparoscopic imaging. Laparoscopic surgery under continuous intra-abdominal perfusion may be a possible alternative method for minimally invasive surgical techniques.
Should minimally invasive approaches in rectal surgery be regarded as a key element of modern enhanced recovery perioperative care?
Published in Acta Chirurgica Belgica, 2023
Petr Kocián, Filip Pazdírek, Petr Přikryl, Tomáš Vymazal, Jiří Hoch, Adam Whitley
One of the potential limitations of the study is the selection of procedures for minimally invasive surgery. When we began with laparoscopic and robotic surgery we preferentially selected patients with smaller tumours, with normal BMIs, without a history of major abdominal surgery and patient who had not received neoadjuvant therapy. As we became more experienced with these procedures, we began to indicate more complicated cases and currently with the exception of multi-visceral resections, which were all excluded from this analysis, all rectal resections are performed laparoscopically or robotically. Although it did not reach statistical significance there were noticeable differences in tumour stage and neoadjuvant therapy between the groups.