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Cm Incision (cm + incision)
Selected AbstractsHand-assisted retroperitoneoscopic radical nephrectomy: Initial experienceINTERNATIONAL JOURNAL OF UROLOGY, Issue 9 2002AKIHIRO KAWAUCHI Abstract Objectives: To report our initial experience of hand-assisted retroperitoneoscopic radical nephrectomy for stage T1 renal tumors. Methods: The clinical data on 22 consecutive patients who had undergone hand-assisted retroperitoneoscopic radical nephrectomy and 22 who had undergone open radical nephrectomy were reviewed. The operation was performed with a hand placed retroperitoneally through a pararectal longitudal 7,7.5 cm incision using a LAP DISC. Results: The total operating time was between 2.3 and 5.8 h (mean: 3.4 h). The estimated blood loss was between 15 and 650 mL (mean: 170 mL). The complication rate was 9% (2/22). No conversions to open procedure occurred. In comparison to open radical nephrectomy, the operating time was similar (3.4 vs 3.9 h) whereas the estimated blood loss was significantly less in this procedure (170 vs 495 mL). During the convalescence period the patients revealed significantly less postoperative pain, shorter intervals to resuming oral intake and more rapid return to normal activities compared to the open radical nephrectomy patients. Conclusion: Hand-assisted retroperitoneoscopic radical nephrectomy is an effective and safe procedure for T1 renal tumors. [source] Robotic-assisted single-incision laparoscopic partial cecectomyTHE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 3 2010Madhu Ragupathi Abstract Background Single-incision laparoscopic surgery is an emerging approach in the field of minimally invasive colon and rectal surgery. This modality utilizes a ,scarless' incision concealed within the umbilicus, and results in improved cosmesis with the potential for reduced trauma, pain and length of hospital stay. However, unique technical challenges have curbed its adaptation. Robotic-assisted technique may help overcome these limitations when applied to the single-incision approach. Methods A robotic-assisted single-incision laparoscopic partial cecectomy was performed using the da Vinci® robot and the GelPOINTÔ access device. Modifications of the robotic set-up were utilized to optimize the technique. The robotic instruments were crossed below the abdominal wall to minimize internal conflict and maximize range of motion. Control of the robotic arms was reassigned on the robotic console to create a more intuitive surgical approach. The robotic camera was rotated and positioned vertically to reduce external conflict and enhance visualization. Results Robotic-assisted single-incision laparoscopic partial cecectomy was performed in a 53 year-old male without complication or need for conversion. The procedure required 120 min with an estimated blood loss of < 50 ml. Pathology revealed a sessile tubular adenoma of the cecum. The length of hospital stay was 2 days and no complications were encountered. The patient returned with a well-healed 2.5 cm incision and no postoperative complications at 6 weeks follow-up. Conclusions With appropriate modifications, robotic-assisted single-incision laparoscopic surgery may be applicable as a minimally invasive modality for partial colectomy. Further studies are warranted to establish the safety, efficacy, benefits, and limits of this technique. Copyright © 2010 John Wiley & Sons, Ltd. [source] Robotic-assisted single-incision right colectomy: early experienceTHE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 4 2009Matthew B. Ostrowitz Abstract Background Application of laparoendoscopic single-site surgery (LESS) is increasing across surgical disciplines. In addition to the possibility of decreased postoperative pain, LESS offers better cosmesis with virtually ,scarless' surgeries, while avoiding the increased costs and complexity of natural orifice surgery. Instrument conflict minimization often requires the crossing of articulating instruments, which we believe can be more intuitively facilitated using the daVinci-S® robotic system. We describe our early experience with three robotic single-incision right hemicolectomies. Methods Three robotic single-incision right hemicolectomies were performed using the daVinci-S robotic system, utilizing a single 4 cm incision through or around the umbilicus. The procedure was performed using three robotic arms, a 12 mm camera and two 8 mm robotic ports. A medial to lateral approach was used and an extracorporeal resection and anastomosis was performed after undocking the robot. Results There were no intraoperative or postoperative complications. Average operative time was 152 min. The first case was converted to non-robotic single-incision right hemicolectomy during mobilization of the ascending colon, due to uncontrollable air leakage around the ports. The second and third cases were successfully completed without air loss by purse-stringing sutures around each individual port and the use of the SILSÔ port, respectively. Conclusions Robotic-assisted single-incision right hemicolectomy can be successfully and safely performed using the daVinci-S robotic system. Several techniques may be employed to prevent the loss of pneumoperitoneum. We believe right hemicolectomy lends itself to single-site surgery because specimen extraction requires a 4 cm incision and may confer patient benefit, with decreased postoperative pain and improved cosmesis. By crossing the robotic instruments and reassigning control of the arms, the robot represents a means to help perform these procedures safely by allowing them to be performed in a more intuitive fashion. Copyright © 2009 John Wiley & Sons, Ltd. [source] A biodegradable copolymer for the slow release of growth hormone expedites scarring in diabetic ratsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2007Francisco García-Esteo Abstract In many diseases wound healing is impaired. This study was designed to establish whether the healing process in diabetes could be improved using a site-specific polymer delivery system containing hGH. The system was first optimized in in vitro experiments performed on cultured fibroblasts taken from healthy and diabetic rats and then tested in an incisional wound model created in the diabetic Wistar rat. In the in vitro experiments using cultured fibroblasts, cell viability, growth, and proliferation were determined, along with polymer degradation, hormone release rates and the expression of TGF,1 in the culture medium. For the in vivo experiments, polymer discs with/without GH were inserted through 3 cm incisions made on the backs of the animals. Wound specimens were obtained 7 and 30 days after surgery to evaluate inflammatory/apoptotic cells, metalloprotease expression and neoangiogenesis using microscopy and immunohistochemical techniques. The local administration of GH using a polymer delivery system did not affect the normal wound healing process. Conversely, when used in diabetic animals, epidermal and dermal repair was expedited. Our findings indicate that GH induces cell proliferation, enhances CD4+ infiltration; increases extracellular matrix protein deposition; stimulates angiogenesis; and diminishes apoptosis at the diabetic wound site. These effects give rise to a comparable wound healing process to that observed in healthy animals. © 2006 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2006 [source] | ||||||||||