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Surgical Endoscopy

The current status of robotic pelvic surgery: results of a multinational interdisciplinary consensus conference
Thu, 27 Nov 2008 09:39:38 -0000
Abstract Background  Despite the significant benefits of laparoscopic surgery, limitations still exist. One of these limitations is the loss of several degrees of freedom. Robotic surgery has allowed surgeons to regain the two lost degrees of freedom by introducing wristed laparoscopic instruments. Methods  At the first Pelvic Surgery Meeting held in Brescia in June 2007, the participants focused on the role of robotic surgery in pelvic operations surgery for malignancy including prostate, rectal, uterine, and cervical carcinoma. All members of the interdisciplinary panel were asked to define the role of robotic surgery in prostate, rectal, and uterine carcinoma. All key statements were reformulated until a consensus within the group was achieved (Murphy et al., Health Technol Assess 2(i–v):1–88, 1998). For the systematic review, a comprehensive literature search was performed in Medline and the Cochrane Library from January 1997 to June 2007. The keywords used were Da Vinci®, telemonitoring, laparoscopy, neoplasms for urology, colorectal, gynecology, visceral surgery, and minimally invasive surgery. The pelvic surgery meeting was supported by Olympus Medical Systems Europa. Results  As of December 31, 2007, there were 795 unit shipments worldwide of the Da Vinci®: 595 in North America, 136 in Europe, and 64 in the rest of the world (http://investor.intuitivesurgical.com/phoenix.zhtml?c=122359&p=irol-faq#22324). It was estimated that, during 2007, approximately 50,000 radical prostatectomies were performed with the Da Vinci® robot system in the USA, reflecting market penetration of 60% of radical prostatectomies in the USA. This utilization represents 50% growth as in 2006 only 42% of all radical prostatectomies performed in the USA employed robotics. Conclusion  While robotic prostatectomy has become the most widely accepted method of prostatectomy, robotic hysterectomy and proctectomy remain far less widely accepted. The theoretical benefits of the increased degrees of freedom and three-dimensional visualization may be outweighed in these areas by the loss of haptic feedback, increased operative times, and increased cost. Content Type Journal ArticleCategory Consensus StatementDOI 10.1007/s00464-008-0202-8Authors Steven D. Wexner, Cleveland Clinic Florida Department of Colorectal Surgery 2950 Cleveland Clinic Blvd Weston FL 33331 USARoberto Bergamaschi, State University of New York Division of Colorectal Surgery Stony Brook NY USAAntonio Lacy, Hospital Clinic i Provincial de Barcelona Calle Villarroel, 170 08036 Barcelona SpainJonas Udo, Hannover Medical School Department of Urology Carl Neuberg Str. 1 30625 Hannover GermanyHans Brölmann, VU University Medical Center Department of Obstetrics and Gynaecology De Boelelaan 1117 1181HV Amsterdam The NetherlandsRobin H. Kennedy, Northwick St Mark’s Hospital Department of Surgery Park Watford Road, Harrow, Middlesex HA1 3UJ London UKHubert John, Zentrum für Urologie Facharzt FMH für Urologie, spez. operative Urologie, Klinik Hirslanden Witellikerstrasse 40 8008 Zürich Switzerland Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
The Dutch multicenter experience of the Endo-Sponge treatment for anastomotic leakage after colorectal surgery
Thu, 27 Nov 2008 09:39:37 -0000
Abstract Background  Anastomotic leakage is a feared complication following colorectal surgery and is associated with early and long-term morbidity and mortality. The presacral cavity as the result of leakage can be treated with an endo-sponge (B-Braun Medical). The aim of this study was to assess the effectiveness of endo-sponge treatment of the presacral cavity as the result of anastomotic leakage in the Netherlands. Methods  Between July 2006 and April 2008, 16 patients (M/F = 9:7) with median age 64 years (range 19–78 years) who underwent surgery for rectal cancer (n = 13) or ulcerative colitis (n = 3) were treated with the endo-sponge treatment after anastomotic leakage. Results  Of the 16 patients, eight patients started with the endo-sponge treatment within 6 weeks after the initial surgery. In these patients the endo-sponge was placed after a median of 24 days (range 13–39 days) following surgery. In the remaining eight patients the endo-sponge treatment was started later than 6 weeks after the initial surgery. In this group there was a median of 74 days (range 43–1,602 days) between surgery and the start of endo-sponge placement. There was closure in six out of eight patients (75%) in the group that started with the endo-sponge treatment within 6 weeks of surgery compared with three out of eight patients (38%) in the group that started later (p = 0.315). Closure was achieved in a median of 40 (range 28–90) days with a median number of 13 sponge replacements (range 8–17). Conclusions  Endo-sponge placement can be helpful in the treatment for anastomotic leakage after colorectal surgery and might prevent a chronic presacral sinus. However, it is not yet clear if this new treatment modality results in quicker healing. Content Type Journal ArticleDOI 10.1007/s00464-008-0186-4Authors P. J. van Koperen, Academic Medical Center Department of Surgery P.O. Box 22660 1100 A2 DD Amsterdam The NetherlandsM. I. van Berge Henegouwen, Academic Medical Center Department of Surgery P.O. Box 22660 1100 A2 DD Amsterdam The NetherlandsC. Rosman, Canisius Wilhelmina Hospital Department of Surgery Nijmegen The NetherlandsC. M. Bakker, Atrium Medical Center Department of Gastroenterology Heerlen The NetherlandsP. Heres, Waterland Hospital Department of Surgery Purmerend The NetherlandsJ. F. M. Slors, Academic Medical Center Department of Surgery P.O. Box 22660 1100 A2 DD Amsterdam The NetherlandsW. A. Bemelman, Academic Medical Center Department of Surgery P.O. Box 22660 1100 A2 DD Amsterdam The Netherlands Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Unrecognized adrenal insufficiency in patients undergoing laparoscopic adrenalectomy
Thu, 27 Nov 2008 09:39:37 -0000
Abstract Background  Subclinical Cushing’s syndrome (SCS) is a well-described phenomenon where abnormalities of the hypothalamic–pituitary–adrenal axis exist in the absence of overt signs and symptoms of classic Cushing’s syndrome. While this has been shown to exist in 5–20% of patients with adrenal lesions, no standardized biochemical regimen exists to screen for SCS. Consequently, many of these patients may not be diagnosed prior to adrenalectomy with the risk of postoperative adrenal insufficiency. We began checking morning (a.m.) serum cortisol levels on postoperative day 1 (POD1) following unilateral adrenalectomy for nonfunctioning adrenal lesions to determine the incidence of unrecognized adrenal insufficiency (AI) in these patients. Methods  One hundred and five patients undergoing adrenalectomy at a tertiary care center from 1999 to 2007 were retrospectively evaluated. Patients with Cushing’s syndrome, conditions associate with bilateral disease, and those receiving perioperative steroids were excluded, leaving 41 patients for analysis. A.m. serum cortisol levels were obtained in all patients POD1. Multiple factors were analyzed as possible predictors of AI. Analysis of variance (ANOVA), t-test, and chi-square test were used to determine statistical significance. Results  The 41 patients’ diagnoses included 13 pheochromocytomas, 15 nonsecreting adenomas, 5 aldosteronomas, 5 metastatic lesions, 1 adrenocortical carcinoma, and 2 other benign lesions. Three groups were identified based on POD1, a.m. cortisol levels: sufficient (>10 μg/dl; n = 25, 61%), low-normal (3.4–10 μg/dl; n = 7, 17%), and insufficient (<3.4 μg/dl; n = 9, 22%). Tumor size and presence of diabetes, hypertension, and obesity were predictive of postoperative AI (p < 0.05). Conclusions  AI after unilateral adrenalectomy without evidence of cortisol hypersecretion on preoperative screening was present in a significant number of patients in our series. Patients with diabetes, hypertension, obesity, and larger tumors may be at higher risk for postoperative AI. More thorough screening for cortisol hypersecretion may be warranted in patients with these characteristics, and obtaining routine postoperative cortisol levels may avoid potentially dangerous unrecognized adrenal insufficiency following adrenalectomy. Content Type Journal ArticleDOI 10.1007/s00464-008-0189-1Authors Jamie Mitchell, The Cleveland Clinic Endocrinology and Metabolism Institute, Section of Endocrine Surgery A-80 9500 Euclid Avenue Cleveland OH 44195 USAGerman Barbosa, The Cleveland Clinic Endocrinology and Metabolism Institute, Section of Endocrine Surgery A-80 9500 Euclid Avenue Cleveland OH 44195 USAMichael Tsinberg, The Cleveland Clinic Endocrinology and Metabolism Institute, Section of Endocrine Surgery A-80 9500 Euclid Avenue Cleveland OH 44195 USAMira Milas, The Cleveland Clinic Endocrinology and Metabolism Institute, Section of Endocrine Surgery A-80 9500 Euclid Avenue Cleveland OH 44195 USAAllan Siperstein, The Cleveland Clinic Endocrinology and Metabolism Institute, Section of Endocrine Surgery A-80 9500 Euclid Avenue Cleveland OH 44195 USAEren Berber, The Cleveland Clinic Endocrinology and Metabolism Institute, Section of Endocrine Surgery A-80 9500 Euclid Avenue Cleveland OH 44195 USA Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
A self-tailored hernia mesh using lightweight material: a cautionary note
Thu, 27 Nov 2008 09:39:37 -0000
A self-tailored hernia mesh using lightweight material: a cautionary note Content Type Journal ArticleCategory LetterDOI 10.1007/s00464-008-0200-xAuthors W. T. Ng, Yan Chai Hospital Department of Surgery 7-11, Yan Chai Street Tsuen Wan Hong KongY. K. Lee, Yan Chai Hospital Department of Surgery 7-11, Yan Chai Street Tsuen Wan Hong Kong Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Routine laparoscopic single-stitch omental patch repair for perforated peptic ulcer: experience from 338 cases
Thu, 27 Nov 2008 09:39:36 -0000
Routine laparoscopic single-stitch omental patch repair for perforated peptic ulcer: experience from 338 cases Content Type Journal ArticleCategory LetterDOI 10.1007/s00464-008-0215-3Authors D. C. T. Wong, Pamela Youde Nethersole Eastern Hospital Department of Surgery Hong Kong Hong KongW. T. Siu, Prince of Wales Hospital Department of Surgery Shatin Hong KongS. K. H. Wong, Prince of Wales Hospital Department of Surgery Shatin Hong KongY. P. Tai, Pamela Youde Nethersole Eastern Hospital Department of Surgery Hong Kong Hong KongM. K. W. Li, Pamela Youde Nethersole Eastern Hospital Department of Surgery Hong Kong Hong Kong Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Colorectal resection, both open and laparoscopic-assisted, in patients with benign indications is associated with proangiogenic changes in plasma angiopoietin 1 and 2 levels
Thu, 27 Nov 2008 09:39:36 -0000
Colorectal resection, both open and laparoscopic-assisted, in patients with benign indications is associated with proangiogenic changes in plasma angiopoietin 1 and 2 levels Content Type Journal ArticleCategory ErratumDOI 10.1007/s00464-008-0212-6Authors H. M. C. Shantha Kumara, Columbia University College of Physicians & Surgeons Section of Colon & Rectal Surgery New York USAA. Hoffman, Columbia University College of Physicians & Surgeons Section of Colon & Rectal Surgery New York USAI. Y. Kim, Yonsei University Department of Surgery, The Wonju College of Medicine Wonju South KoreaD. Feingold, Columbia University College of Physicians & Surgeons Section of Colon & Rectal Surgery New York USAN. Dujovny, Ferguson Clinic Division of Colon and Rectal Surgery Grand Rapids MI USAM. Kalady, Cleveland Clinic Department of Colon & Rectal Surgery Cleveland OH USAM. Luchtefeld, Ferguson Clinic Division of Colon and Rectal Surgery Grand Rapids MI USAR. L. Whelan, Columbia University College of Physicians & Surgeons Section of Colon & Rectal Surgery New York USA Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques - Current Table Of Contents

Are Surgisis Biomeshes Effective in Reducing Recurrences After Laparoscopic Repair of Large Hiatal Hernias?
Page: 433DOI: 10.1097/SLE.0b013e3181802ca7Authors: Fumagalli, Uberto MD *; Bona, Stefano MD *; Caputo, Maria MD *; Elmore, Ugo MD *; Battafarano, Francesco MD *; Pestalozza, Alessandra MD +; Rosati, Riccardo MD, FACS *
Effects of Pneumoperitoneum and Positioning on Respiratory Mechanics in Chronic Obstructive Pulmonary Disease Patients During Nissen Fundoplication.
Page: 437DOI: 10.1097/SLE.0b013e31817f9878Authors: Salihoglu, Ziya MD; Demiroluk, Sener MD; Baca, Bilgi MD; Ayan, Fadl MD [latin dotless i]; Kara, Halil MD
Endoscopic Treatment of Bleeding Gastric Varices Using Large Amount of N-Butyl-2-Cyanoacrylate Under Fluoroscopic Guidance.
Page: 441DOI: 10.1097/SLE.0b013e31817b8f0cAuthors: Linhares, Marcelo Moura MD, PhD *; Matone, Jacques MD *; Matos, Delcio MD, PhD *; Sakamoto, Flavio Issao MD +; Caetano, Elesiario Marques Jr MD *; Sato, Nelson Yokishito MD *; Filho, Benedito Herani MD, PhD *; Aramayo, Ana Leticia MD *; Goldenberg, Alberto MD, PhD *; Lopes-Filho, Gaspar De Jesus MD, PhD *
Treatment of Recurrent Bile Duct Stricture After Primary Reconstruction for Laparoscopic Cholecystectomy-induced Injury.
Page: 445DOI: 10.1097/SLE.0b013e31817a7e47Authors: Hwang, Shin MD; Lee, Sung-Gyu MD; Lee, Young-Joo MD; Ahn, Chul-Soo MD; Kim, Ki-Hun MD; Moon, Deok-Bog MD; Ha, Tae-Yong MD
Editorial Commentary.
Page: 449DOI: 10.1097/SLE.0b013e31817a7e5fAuthors: Lillemoe, Keith D. MD, FACS
Laparoscopic Enterolithotomy for Gallstone Ileus.
Page: 450DOI: 10.1097/SLE.0b013e318180570fAuthors: Owera, Anas MD, MRCS; Low, Jee MB ChB, FRCS; Ammori, Basil J. MB ChB, FRCS, MD

 
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Carpal Tunnel Syndrome: The Southern California Orthopedic Institute (SCOI) - serving the Los Angeles and San Fernando Valley California in orthopedic surgery, sports medicine, knee and shoulder surgery, joint replacement, MRI, and physical rehabilitation.

Duke US Surgical Endosurgery Center: The Center was established for the purpose of improving endosurgical education, advancing endosurgery through research and technical developments, and assessing the appropriate applications of endosurgical techniques.

Endius: endoscopic spinal surgery - Endius Incorporated

Gastrointestinal Endoscopy: Explains how the stomach and intestines can be examined using endoscopes, without surgery.

Laparoscopic Surgery: RSAPC1.com provides information about a broad spectrum of procedures including minimally invasive surgery, colo-rectal , breast and hernia surgery with special interest in advanced laparoscopic procedures including surgical weight loss, esophagus, stomach, liver, gallbladder, colon small intestin...

Laparoscopy Hospital: Laparoscopy Hospital is super specialized institute for laparoscopic treatment training and research

MicroSpine - Minimally Invasive Spinal Surgery Specialists: Endoscopic Laser Spine Surgery

Neurosurgeon and Pain Management Specialist: Dr. Ramsis F. Ghaly is a Neurosurgeon who is uniquely specialized in the latest endoscopic surgical techniques. Dr. Ghaly also specializes in Pain Management by using techniques that alleviate refractory pain sufferers. He also specializes in Anesthesiology and Intensive Care Management.

Plastic Surgery Performed Using Endoscopes: Provides explanations of various procedures (browlifts, facelifts) that can be performed endoscopically. Compares conventional and endoscopic procedures.

San Diego Shoulder Arthroscopy: An on-line library of tips, techniques, and procedures.

Society of American Gastrointestinal Endoscopic Surgeons: The leading professional society and CME meeting, representing more than 5000 board certified surgeons who use endoscopy and laparoscopy as an integral part of their treatment of patients

The Belgian Group for Endoscopic Surgery: An association of endoscopic surgeons in Belgium.

TMJ (Temporomandibular Joint) Disorders: The temporomandibular joint, anatomy, disorders, surgery. Includes a brief discussion of TMJ arthroscopy.

University of Massachusetts EndoSurgery Center: Laparoscopic surgical techniques, online courses and educational resources for minimally invasive and hand-assisted laparoscopic surgery. Watch videos and learn the essentials of laparoscopy, including cholecystectomy, hernia repair, Nissen and Toupet fundoplication for GERD.

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