Safety and Error Issues in Minimally Invasive Surgery
Marilyn Sue Bogner in Misadventures in Health Care, 2003
Minimally Invasive Surgery (MIS), also referred to as minimal access surgery, endoscopic surgery, or keyhole surgery, is a relatively new surgical area. Surgery, the work of the surgeon’s hand, has been revolutionized by the introduction of the endoscope, an instrument with a tiny video camera on the end, that enables surgeons to view inside a body cavity. Depending on which internal cavity is being viewed, the surgery is named accordingly; for example, laparoscopic for abdominal, thoracoscopic for chest, arthroscopic for joint surgery. Initially, endoscopes were used to see inside the body for exploratory and diagnostic purposes only. Eventually, surgeons were able to manipulate target tissues in the internal cavities to achieve surgical goals with specialized laparoscopic instruments. Thus, the purpose of such minimally invasive surgeries evolved from diagnostic to therapeutic. Although the focus of this discussion is primarily on laparoscopic procedures (see also Scott-Conner, 1999), many of the factors discussed also apply to other endoscopic surgical specialties.
The Respiratory System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
The fiberoptic bronchoscope is an instrument utilized for visual examination of the bronchi through the procedure of bronchoscopy and may be used to obtain bronchial brushings and biopsies. Mediastinoscopy is the examination of the mediastinum and its lymph nodes, particularly in suspected malignancy. Use of an endoscope to inspect the larynx is laryngoscopy. Thoracoscopy denotes examination of the pleural cavity. Fluoroscopy is a type of radiographic technique that allows visualization of the thoracic contents In a dynamic manner and provides a range of views.
Endoscopic Lysis of Lumbar Epidural Adhesions
Mark V. Boswell, B. Eliot Cole in Weiner's Pain Management, 2005
Medical literature has described various types of endoscopes for 60 years.21 Integration of fiber-optic technology with computer-enhanced imaging provided a new medium for viewing the central nervous system.21 Burman22 first described the possibility of direct visualization of the spinal canal and its contents in 1931. However, direct visualization of spinal contents could not be achieved until the advent of flexible fiber-optic light sources and optics.23 Burman22 concluded that myeloscopy was limited by the available technology, but with higher quality instrumentation, he felt that the ability to visualize the contents of the spinal canal might be especially important in establishing a diagnosis of tumor or inflammation. Stern,24 in 1936, described a spinascope, which was specifically designed for the in vivo examination of the spinal canal contents during spinal anesthesia.
An extraction free modified o-phthalaldehyde assay for quantifying residual protein and microbial biofilms on surfaces
Published in Biofouling, 2018
Allan Guan, Yi Wang, K. Scott Phillips
Considering the regularity of Gram-negative antibiotic resistant outbreaks that are associated with the use of reprocessed devices, the lack of suitable cleaning verification methods is a significant gap in efforts to protect patients and the public health. Herein is demonstrated an extraction-free protein quantitation assay to overcome limitations of current practices for monitoring and verifying cleaning. The assay capitalizes on the common use of OPA as both a fluorescent derivative for protein and a common disinfectant for reprocessed medical devices. The risk profile for OPA in reprocessing is well known and the assay uses a concentration >500-fold lower than in disinfection. While OPA is normally reacted with extracted protein, here the amount of protein on equipment surfaces is quantified by measuring the amount of OPA consumed (Figure 1). It is also shown how this approach can be used as an indicator for total biofilm biomass. Characterization of the assay response, optimization using an endoscope surrogate, and figures of merit are reported for protein and S. epidermidis biofilm analytes. Real-world application to clinically used endoscopes is demonstrated.
Comparison of anterior and posterior tympanomeatal flap elevations in endoscopic transcanal tympanoplasty
Published in Acta Oto-Laryngologica, 2019
Arin Ozturk, Murat Benzer, Isa Kaya, Sercan Gode, Cem Bilgen, Tayfun Kirazli
Endoscopic transcanal surgery without the necessity of posterior auricular incision is the main factor that reduces the postoperative morbidity [1–3]. With the help of technology, endoscopes presented a broader and detailed visualization of external auditory canal and TM without the need of canaloplasty or postauricular incision. Therefore, surgeons can perform many different surgical steps during the surgery with endoscopes. Endoscopes can provide more detailed and broader surgical view compared to microscopes in the cases with the anterior wall overhang [5]. In a recent study, we have described limited tympanomeatal incision on the posterior side of the external auditory canal for all types of perforations with successful hearing results and graft healing rate [6]. We assumed that protecting the main vascular supply of TM in the mallear region and inferior side was crucial for successful graft healing.
Preliminary experience and feasibility test using a novel 3D virtual-reality microscope for otologic surgical procedures
Published in Acta Oto-Laryngologica, 2021
Merlin Schär, Christof Röösli, Alexander Huber
Alternatives to the conventional surgical microscope have been developed to address some of these limitations. Endoscopes offer a wider field of view and provide advantages for select procedures, e.g. in cholesteatoma surgery [2]. Although strategies to reduce fogging and to eliminate the need for prolonged holding of the endoscope have been proposed [3], repositioning of the endoscope requires manual control. As a third option, exoscopes have been applied to otologic procedures [4]. Exoscopes rely on an extracorporeal telescope to image the surgical field at a larger working distance while the image is shown on a screen. The systems were limited to 2D-views but have recently been upgraded to 3D-viewing capabilities. Exoscopes provide better viewing angles than conventional microscopes but are bound to manual adjustments and may offer subpar illumination in narrow surgical corridors [5].
Related Knowledge Centers
- Anesthesia
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- Gastrointestinal Tract
- Vomiting
- Nausea
- Endoscope
- Medical Imaging
- Surgeon
- Borescope