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Endoscopic Surgery (endoscopic + surgery)

Distribution by Scientific Domains
Medical Sciences94%
Life Sciences5%
Distribution within Medical Sciences
Surgery & Surgical Specialties58%
Urology18%
6 Other Subdomains24%

Kinds of Endoscopic Surgery

  • natural orifice transluminal endoscopic surgery
  • orifice transluminal endoscopic surgery
    		•
  • translumenal endoscopic surgery
  • transluminal endoscopic surgery
    		•

    Selected Abstracts

    THE EMERGING FIELDS OF LAPAROENDOSCOPIC SINGLE-SITE SURGERY (LESS) AND NATURAL ORIFICE TRANSLUMINAL ENDOSCOPIC SURGERY (NOTES)

    BJU INTERNATIONAL, Issue 6 2010
    Article first published online: 18 DEC 200
    No abstract is available for this article. [source]

    MINIMALLY INVASIVE SURGERY IN UROLOGY: IS THE WINNER NATURAL-ORIFICE TRANSLUMENAL ENDOSCOPIC SURGERY OR LAPAROENDOSCOPIC SINGLE-SITE SURGERY?

    BJU INTERNATIONAL, Issue 1 2010
    Abhay Rane
    No abstract is available for this article. [source]

    Plenary Lecture: Broadening of the Indications for Endoscopic Surgery: Upper Gastrointestinal Tract

    DIGESTIVE ENDOSCOPY, Issue 2000
    Shuji Inatsuchi
    First page of article [source]

    Endoscopic Surgery of the Anterior Skull Base,

    THE LARYNGOSCOPE, Issue 1 2005
    John D. Casler MD
    Abstract Objectives/Hypothesis: Traditional surgical approaches to the anterior skull base often involve craniotomy, facial incisions, disruption of skeletal framework, tracheotomy, and an extended hospital stay. As experience with endoscopic sinus surgery has grown, the techniques and equipment have been found to be adaptable to treatment of lesions of the anterior and central skull base. A minimally invasive endoscopic approach theoretically offers the advantages of avoiding facial incisions, osteotomies, and tracheotomy; surgery should be less painful, recovery quicker, and hospital stays should be shorter. The study attempted to assess endoscopic approaches to the anterior and central skull base for its ability to achieve those goals. Study Design: Retrospective review of 72 cases performed at a single institution from November 1996 to July 2003. A subgroup of 15 patients who underwent endoscopic approach to their pituitary tumors was compared with a similar group of 15 patients who underwent traditional open trans-sphenoidal surgery for their pituitary tumors. Methods: Patient records were analyzed and information tabulated for age, sex, disease, location of lesion, operative time, use of image-guided surgical systems, blood loss, length of intensive care unit stay, duration of operative pain, length of postoperative hospitalization, complications, and completeness of resection. Results: Of the cases, 86.1% were performed exclusively endoscopically, and 13.9% used a combination of endoscopic and open techniques. An image-guided surgical system was used in 83% of cases. Hospital length of stay was 2.3 days for the exclusively endoscopic group as opposed to 8 days for the combined group. With the patients with pituitary tumors, operative times were similar between the two groups (255.13 vs. 245.73 min), blood loss was less in the endoscopic group (125.33 vs. 243.33 mL), pain duration was shorter in the endoscopic group (10 of 15 patients pain free on postoperative day 1 vs. 2 of 15 patients pain free in the open group), and intensive care unit stay and hospital length of stay were both shorter in the endoscopic group. Complication rates and completeness of resection was similar in both groups, although the open group had a higher rate of complications related to the approach to the sella. Conclusion: The study demonstrated the safety and efficacy of judicious endoscopic approaches to anterior skull base lesions. An outcomes assessment in pituitary surgery demonstrates advantages of an endoscopic approach in appropriate cases. [source]

    NOTES: past, present and future

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 3 2010
    B Dallemagne MD
    Abstract Once in a few decades in science or medicine, an idea emerges that is so powerful that it changes forever how we think about that field. Natural Orifices Translumenal Endoscopic Surgery (NOTES) has the potential to break the physical barrier between bodily trauma and surgery. At the dawn of surgery, excellence was associated with big incisions: "big scar - big surgeon". In the 80s, minimally invasive surgery was born representing one of the greatest surgical evolutions of the 20th century. After Kalloo's first report in 2004 on transgastric peritoneoscopy in a porcine model, the interest in natural orifice transluminal endoscopic surgery (NOTES) has blossomed. Theoretically the same operation performed laparoscopically could be carried out through natural orifices without any abdominal incision avoiding pain and scarring. The lesson learned from the advent of laparoscopic surgery, thought us that we could be witnessing the birth of another surgical revolution. Since 2004 many abdominal procedures that use a NOTES approach have been successfully performed in animal models. However, the initial excitement for NOTES has been somewhat tempered by the reality that a NOTES procedure in human without laparoscopic assistance has not been performed by most groups. Indeed, a major issue is the lack of stable operative platform and flexible instruments that allow retraction and exposure of the organs, such as appendix or gallbladder. Will this issue change the future of NOTES? [source]

    Endoscopic surgical skill qualification system in Japan: Five years of experience in the gastrointestinal field

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 2 2010
    T Kimura
    Abstract Introduction: To reduce the complications of endoscopic surgery, the Japan Society for Endoscopic Surgery formed a committee that established the Endoscopic Surgical Skill Qualification System (ESSQS). Here we report on the methods employed and results obtained with the ESSQS over five years in the field of gastrointestinal surgery. Methods: The first ESSQS review was performed in 2004, and examinations have been conducted once a year since then. Applicants must submit a list of patients on whom they have performed surgery (including complications) and an unedited video showing one of the relevant surgical procedures. To assess the applicants' videos, the judging committee prepared "common criteria" (60 points) and "procedure-specific criteria" (40 points). Assessment of videos was done independently by two judges, and the applicant passed the test if both judges assigned a score of 70 points or more. Results: There have been 1369 applicants, and 641 (46.8%) have been successful. The main problem with this system has been a relatively low rate of agreement between the two judges (, value: 0.29,0.40). However, the incidence of complications is significantly lower in patients treated by successful applicants (4.3±6.8%) than in those treated by failed applicants (5.6±8.4%) (P=0.0096). Conclusion: Although the ESSQS could be further improved, this system promotes training and decreases complications. [source]

    11th World Congress of Endoscopic Surgery, September 2,5, 2008, Yokohama, Japan: Workshop

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 3 2009
    Article first published online: 18 NOV 200
    [source]

    11th World Congress of Endoscopic Surgery, September 2,5, 2008, Yokohama, Japan: Poster Session

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 3 2009
    Article first published online: 18 NOV 200
    [source]

    Laparoscopic colorectal cancer surgery: Japanese experience

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 2 2009
    F Konishi
    Abstract In Japan, laparoscopic colectomy for cancer started in 1992. A national survey has revealed that, since that time, the number of cases that have undergone this procedure has steadily increased, and by 2007, there were over 9000 cases. This figure includes an increase in the percentage of more advanced cases, which has occurred due to technical improvements in lymph node dissection. A Japanese randomized controlled trial comparing laparoscopic to open surgery started in November 2004, with enrollment ending in April 2009 with 1050 cases. For this study, preoperative stage T3 and T4 cases were selected for inclusion, and D3 dissection was required. To assess the technical skill of surgeons, the Japan Society of Endoscopic Surgery established the Endoscopic Surgical Skill Qualification System to encourage high-level surgical techniques. Assessment is conducted by reviewing unedited videos. The success rate for colon and rectal surgeries has ranged between 37%,40%. The Endoscopic Surgical Skill Qualification System has contributed to the establishment of standard technical skills in laparoscopic surgery, the development of an educational system for laparoscopic surgeons, and a reduction in the number complications. Technical difficulties still exist in laparoscopic rectal cancer surgery, but with the technical progress in laparoscopic colorectal surgery, the number of laparoscopic rectal cancer surgeries has been gradually increasing in number. A multicentric phase II study on the feasibility and long-term outcome for stage I and II rectal cancer started in 2008. In this study, the short-term outcomes including anastomotic leakage rate and long-term survival, will be clarified. Combined with continuously improved technologies, training techniques and surgical standards, laparoscopic colorectal surgery is steadily progressing in Japan. [source]

    11th World Congress of Endoscopic Surgery

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 2 2009
    Article first published online: 10 AUG 200
    [source]

    Current trends of laparoscopic gastrectomy for gastric cancer in Japan

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 1 2009
    T Etoh
    Abstract Laparoscopic gastrectomy with lymph node dissection, such as laparoscopy-assisted distal gastrectomy (LADG), is widely accepted for the treatment of early gastric cancer with a risk of lymph node metastasis. In Japan, a nationwide survey conducted by the Japan Society of Endoscopic Surgery has shown that the number of laparoscopic gastrectomies is gradually increasing. So far, the following advantages of laparoscopic surgery for the treatment of gastric cancer have been well documented: favorable clinical course after operation, pulmonary function and immune response. A retrospective multicenter study in Japan has shown that the short-term outcomes of laparoscopic gastrectomy are beneficial and that the long-term outcomes are the same as those for open surgery. Recently, the Gastric Cancer Surgical Study Group of the Japan Clinical Oncology Group conducted a multi-institutional, phase II trial (JCOG0703) to evaluate the safety of LADG for clinical stage I gastric cancer. In the future, laparoscopic surgeons will need to design and implement education and training systems for standard laparoscopic procedures, evaluate clinical outcomes through multicenter randomized controlled trials and clarify the oncological aspects of laparoscopic surgery in basic studies. [source]

    11th World Congress of Endoscopic Surgery: Special Session

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 1 2009
    Article first published online: 17 APR 200
    [source]

    11th World Congress of Endoscopic Surgery: Symposium

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 1 2009
    Article first published online: 17 APR 200
    [source]

    Current status and activity regarding natural orifice translumenal endoscopic surgery (NOTES) in Japan

    ASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 1 2008
    Seigo Kitano M.D
    Abstract: Natural orifice translumenal endoscopic surgery (NOTES) is a new, minimally invasive technique in the field of gastroenterological surgery. Research on NOTES has rapidly progressed all over the world. A joint committee on NOTES organized by the Japan Society for Endoscopic Surgery (JSES) and the Japan Gastroenterological Endoscopy Society (JGES) established Japan NOTES to encourage the responsible development and safe adoption of NOTES into clinical practice. This paper provides an overview of the current activity in regard to NOTES in Japan. [source]

    Psychosocial and marketing challenges for Natural Orifice Transluminal Endoscopic Surgery and Laparoendoscopic Single-site Surgery

    BJU INTERNATIONAL, Issue 6b 2010
    Sashi S. Kommu
    First page of article [source]

    Operative Endoscopy and Endoscopic Surgery in Infants and Children.

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 5 2006

    No abstract is available for this article. [source]

    Treatment of early stage squamous-cell carcinoma of the glottic larynx: Endoscopic surgery or cricohyoidoepiglottopexy versus radiotherapy

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2001
    Lue P. Bron MD
    Abstract Background Both surgery and radiotherapy are recognized treatments of T1-T2 squamous cell carcinoma of the larynx. We retrospectively analyze and compare the oncological outcome of patients treated in a single institution, either by endoscopic surgery or partial supracricoid laryngectomy versus radiation therapy. Methods The medical records of 156 patients treated between 1983 and 1996 with either surgery (n = 75) or radiotherapy (n = 81) were reviewed. Male to female ratio, median age, and T-stage distribution were comparable. Results With a median follow-up time of 59 months, the 5-year cause-specific survival rate of 93% was identical for both groups. The actuarial incidence of metachronous second primaries was 7% at 5 years. Local control at 5 years remained 84% after surgery and 77% after radiotherapy. Anterior commissure infiltration was shown to represent a negative predictive factor of local control for radiotherapy (p = .01). Salvage treatment brought ultimate local control to 96% of patients after surgery and 94% after radiation therapy with long-term laryngeal preservation rate altered significantly (p = .05) in the group of patients who received radiotherapy (90.1% vs 97.4%). Conclusion The treatment of laryngeal cancer is always a compromise between oncological efficiency and preservation of function. Our data suggest that, assuming proper selection of patients, radiation therapy and surgery yield similar local control and survival rates. The functional disadvantages after surgery are moderate and clearly counterbalanced by a significant decrease in long-term laryngeal preservation rate after radiotherapeutic treatment. © 2001 John Wiley & Sons, Inc. Head Neck 23: 823,829, 2001. [source]

    Fungus ball of the paranasal sinuses: Experience in 160 patients treated with endoscopic surgery

    THE LARYNGOSCOPE, Issue 11 2009
    Piero Nicolai MD
    Abstract Objectives/Hypothesis: Herein we present our experience in the management of fungus ball (FB) of the paranasal sinuses. Preoperative imaging strategy and findings, surgical technique, and pathologic and microbiologic results are discussed. Study Design: Retrospective chart review of patients with FB of the paranasal sinuses who underwent endoscopic surgery at the Department of Otorhinolaryngology of the University of Brescia, Italy. Methods: From January 1990 to December 2006, 160 patients with sinonasal fungus ball were treated with a purely endoscopic approach. All patients underwent preoperative computed tomography (CT) and/or magnetic resonance (MR) imaging; an endo-oral dental x-ray or orthopantomography and odontological evaluation were also performed in patients with maxillary sinus localization. All removed material was sent for pathologic and microbiologic evaluation. All patients were prospectively followed with endoscopic control every 2 months during the first postoperative year and subsequently every 6 months. Results: The patient cohort included 118 females and 42 males, with an age from 19 to 85 years (mean, 52.7 years). FB was located in the maxillary sinus in 135 (84.4%) patients; in two cases both sinuses were affected. Sphenoid and ethmoid involvement was observed in 23 (14.4%) and 1 (0.6%) patients, respectively. Simultaneous ethmoid and sphenoid involvement was found in one (0.6%) case. In all patients complete removal of fungal debris was obtained through wide sinusotomy. No recurrence was observed. Conclusions: Endoscopic surgery is a safe and effective treatment for paranasal sinuses FB. A proper imaging study by MR and/or CT can address diagnosis, which is based upon detection of fungal hyphae at histology. Laryngoscope, 2009 [source]

    Endoscopic surgery for female infertility: A review of current management

    AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2009
    Tamara HUNTER
    First page of article [source]

    Outcome of sinonasal melanoma: Clinical experience and review of the literature,

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2010
    Thomas N. Roth MD
    Abstract Background. Primary sinonasal malignant melanoma (SNMM) is a rare clinical entity. There is neither a classification nor a staging system nor an evidence-based treatment concept established. Our objective was to find potential risk factors predicting the outcome. Methods. Twenty-five patients with histologically confirmed SNMM were consecutively included and retrospectively analyzed. Staging methods were nasal endoscopy, CT, MRI, and positron emission tomography (PET) scan. Patients were selected for a curative or palliative concept. All patients had postoperative follow-up with control-MRI at 3 and 6 months. Restaging was performed when local recurrence occurred. Results. Nineteen patients underwent primary surgery with curative intention; in 16 cases with tumor free margins. Thirteen patients (68%) had transnasal endoscopic surgery, 4 lateral rhinotomy, and 2 transfacial approach with orbital exenteration. Six patients (32%) had palliative therapy and 7 patients (37%) had adjuvant radiotherapy. Despite radical operations, 6 patients (37%) showed local recurrence and 8 patients (50%) developed distant metastasis. In 2 patients with incomplete surgery, regional metastasis was noted. The median disease-free interval was 18 months, and the median overall survival rate was 23 months. Conclusion. SNMMs of the ethmoid and maxillary sinuses have a worse prognosis than other localizations in the nasal cavity; infiltration into the skull base, orbit, or facial soft tissue correlates with a very poor outcome corresponding to the palliative situations. Furthermore, local recurrence insinuates aggressive disease with short survival rate. A main difference from its cutaneous counterpart seems to be a primary tendency to hematogenic spread. Further research is needed to confirm these findings. © 2010 Wiley Periodicals, Inc. Head Neck, 2010 [source]

    Role of endoscopic surgery in the management of selected malignant epithelial neoplasms of the naso-ethmoidal complex

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 12 2007
    Piero Nicolai MD
    Abstract Background. This study reviews the outcome of patients with adenocarcinoma (AC) and squamous cell carcinoma (SCC) of the naso-ethmoidal complex treated by endoscopic surgery. Methods. Sixteen patients underwent a purely endoscopic excision of AC (n = 12) or SCC (n = 4) at 2 university hospitals. All patients were prospectively followed by endoscopic and MRI evaluations. Results. The tumor originated from the ethmoid in 13 cases and the nasal fossa in 3. Lesions were staged as follows: 5 T1, 10 T2, and 1 T3. Adjuvant radiotherapy was delivered in 7 cases. Follow-up (range, 28,70 months; mean, 47.25) was available for all patients. One patient died for brain metastases 28 months after surgery. Another patient required salvage craniofacial resection and radiotherapy for recurrent AC. Five-year disease-specific and disease-free survival rates were 93.3% and 87.0%, respectively. Conclusions. In selected T1-T2 lesions of the naso-ethmoidal complex, endoscopic surgery seems to offer a satisfactory alternative to external procedures. © 2007 Wiley Periodicals, Inc. Head Neck, 2007 [source]

    Endo-robotic resection of the submandibular gland in a cadaver model,

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 11 2005
    David J. Terris MD
    Abstract Background. By means of a prospective, nonrandomized investigation, we evaluated the feasibility of performing endo-robotic resection of the submandibular gland in a cadaver model and compared the results of robotically enhanced endoscopic surgery with those from a conventional endoscopic technique. Methods. Procedural times were recorded in a consecutive series of 11 endoscopic submandibular gland resections using the daVinci Surgical System (Intuitive Surgical, Sunnyvale, CA) and a modified endoscopic surgical approach previously developed in a porcine model. The presence of neurovascular injury was assessed postoperatively, and the specimens were examined histologically. Results. Eleven endo-robotic submandibular gland resections were successfully performed in six cadavers (no conversions to open resection were necessary). The median duration of the procedures was 48 minutes (range, 33,82 minutes). Creation of the operative pocket took an average (±SD) of 12.2 ± 5.3 minutes, assembly of the robot required 9.3 ± 4.1 minutes, and the mean time for submandibular gland resection was 29.4 ± 8.9 minutes. The time required for robotic assembly was offset by the reduced operative time necessary compared with conventional endoscopic resection. Histologic examination confirmed the presence of normal glandular architecture, without evidence of excessive mechanical or thermal injury. There were no cases of apparent neurovascular injury. Conclusions. Robotically enhanced endoscopic surgery in the neck is feasible and offers a number of compelling advantages over conventional endoscopic neck surgery. Clinical trials will be necessary to determine whether these advantages can be achieved in clinical practice. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source]

    CO2 laser surgery in the treatment of glottic cancer

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2005
    Giovanni Motta MD
    Abstract Background. The aim of the study was to assess the effectiveness of CO2 laser endoscopic surgery in the treatment of glottic carcinoma limited to the true vocal cords or involving the adjacent regions. Methods. Seven hundred nineteen patients (687 men and 32 women; mean age, 60.4 years; range, 33,86 years) with glottic carcinoma (432 T1N0M0, 236 T2N0M0, 51 T3N0M0) underwent CO2 laser surgery (mean follow-up, 5 years; range, 2,17 years). Statistical comparison was carried out with Wilcoxon test, considering p < .05 the minimum significance value. Results. Overall actuarial survival, adjusted actuarial survival, and percentage of patients with no evidence of disease at 5 years were 85%, 97%, and 85%, respectively, in patients with T1a disease; 84%, 96%, and 83% in those with T1b disease; 77%, 86%, and 61% in those with T2 unilateral tumors; 77%, 88%, and 55% in those with T2 bilateral tumors; and 64%, 72%, and 60% in those with T3 disease. The statistical analysis showed the following: significant differences in the comparison of T1 versus T2 and T2 versus T3 tumors (p < .01), with the exception of no evidence of disease in the comparison of T2 versus T3 (p > .05); and no significant differences in the comparison of unilateral and bilateral tumors (p > .05). Actuarial local control, actuarial nodal control, and actuarial distant metastasis control at 5 years were 85%, 98%, and 99%, respectively, in patients with T1 disease; and 66%, 82%, and 91% in patients with T2 disease; and 66%, 83%, and 95% in patients with T3 disease. The laryngeal preservation rate was 97.3% in the T1 group, 82.5% in the T2 group, and 80.5% in T3 group. Conclusions. CO2 laser endoscopic surgery is effective in the treatment of glottic carcinoma not infiltrating the cartilaginous skeleton; the results achieved are competitive with those of open conservative operations, if we take into account the possibilities afforded by salvage surgery and the rate of laryngeal preservation achieved in the study patients. © 2004 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source]

    Treatment of early stage squamous-cell carcinoma of the glottic larynx: Endoscopic surgery or cricohyoidoepiglottopexy versus radiotherapy

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2001
    Lue P. Bron MD
    Abstract Background Both surgery and radiotherapy are recognized treatments of T1-T2 squamous cell carcinoma of the larynx. We retrospectively analyze and compare the oncological outcome of patients treated in a single institution, either by endoscopic surgery or partial supracricoid laryngectomy versus radiation therapy. Methods The medical records of 156 patients treated between 1983 and 1996 with either surgery (n = 75) or radiotherapy (n = 81) were reviewed. Male to female ratio, median age, and T-stage distribution were comparable. Results With a median follow-up time of 59 months, the 5-year cause-specific survival rate of 93% was identical for both groups. The actuarial incidence of metachronous second primaries was 7% at 5 years. Local control at 5 years remained 84% after surgery and 77% after radiotherapy. Anterior commissure infiltration was shown to represent a negative predictive factor of local control for radiotherapy (p = .01). Salvage treatment brought ultimate local control to 96% of patients after surgery and 94% after radiation therapy with long-term laryngeal preservation rate altered significantly (p = .05) in the group of patients who received radiotherapy (90.1% vs 97.4%). Conclusion The treatment of laryngeal cancer is always a compromise between oncological efficiency and preservation of function. Our data suggest that, assuming proper selection of patients, radiation therapy and surgery yield similar local control and survival rates. The functional disadvantages after surgery are moderate and clearly counterbalanced by a significant decrease in long-term laryngeal preservation rate after radiotherapeutic treatment. © 2001 John Wiley & Sons, Inc. Head Neck 23: 823,829, 2001. [source]

    Endonasal Endoscopic Management of Contact Point Headache and Diagnostic Criteria

    HEADACHE, Issue 2 2010
    Alireza Mohebbi MD
    (Headache 2010;50:242-248) Background., Some types of headaches with sinonasal origin may be present in the absence of inflammation and infection. The contact points between the lateral nasal wall and the septum could be the cause of triggering and sustained pain via trigeminovascular system. Objective., The aim of this study was to evaluate the feasibility and effectiveness of endoscopic surgery in the sinonasal region for treatment of headache with special attention paid to specific diagnostic methods and patient selection. Methods., This was a prospective, non-randomized and semi-quasi experimental research study. Thirty-six patients with chronic headaches who had not previously responded to conventional treatments were evaluated by rhinoscopy and/or endoscopy, local anesthetic tests and computed tomography scans as diagnostic criteria. These patients were divided into 4 groups based on the diagnostic methods utilized. The intensity of headaches pre- and post-operatively were recorded by utilizing the visual analog scale scale and performing analysis with analysis of variance test comparison and Statistical Package for Social Sciences. Average follow-up was 30 months. Results., Our overall success rate approximated 83% while the complete cure rate was 11%. Patients in group 4 achieved the best results. In this group all diagnostic criteria were positive. In addition, patient responses were statistically significant in groups with more than one positive criteria compared with group 1 who only had positive examination. The positive response of 14 migrainous patients diagnosed with migraine prior to treatment was 64%. Conclusion., Surgery in specific cases of headaches with more positive evidence of contact point could be successful, particularly if medical therapy has failed. [source]

    Original Article: Prospective comparative study of single dose versus 3-day administration of antimicrobial prophylaxis in minimum incision endoscopic radical prostatectomy

    INTERNATIONAL JOURNAL OF UROLOGY, Issue 4 2008
    Mizuaki Sakura
    Objective: From the critical stand point against the overuse of antimicrobial agents, appropriate reduction of antimicrobial prophylaxis (AMP) should be considered. We have prospectively reduced AMP and evaluated the occurrence of surgical site infection (SSI) following radical retropubic prostatectomy (RRP) by minimum incision endoscopic surgery (MIES). Methods: A total of 101 consecutive patients who underwent MIES-RRP for prostate carcinoma were classified into two groups according to AMP dose. The 3-day group of 52 patients received tazobactam sodium/piperacillin sodium (TAZ/PIPC) 2.5 g intravenously before the operation and continued twice daily until postoperative day 2, and the single dose group of 49 patients received TAZ/PIPC 2.5 g intravenously only once before the operation. Additional antimicrobial agents were given only when SSI occurred. The occurrence of SSI and remote infection (RI) were analyzed. Results: There was no significant difference in the rate of SSI occurrence between the 3-day group (3.8%) and single dose group (6.1%) (P = 0.6). RI did not increase in the single dose group. Conclusion: Antimicrobial prophylaxis dose was successfully reduced without increasing SSI or RI. A single dose of AMP is feasible to prevent SSI and RI and would be a standard regimen in MIES-RRP. Active surveillance of postoperative infection is mandatory to promptly administer antimicrobial treatment as the need arises. [source]

    Portless endoscopic adrenalectomy via a single minimal incision using a retroperitoneal approach: Experience with initial 30 cases

    INTERNATIONAL JOURNAL OF UROLOGY, Issue 9 2004
    YUKIO KAGEYAMA
    Abstract Aim: To assess the feasibility of portless endoscopic adrenalectomy via a single minimum incision that narrowly permits extraction of the specimen. Methods: For, 30 cases of adrenal tumor, portless endoscopic surgery through a single flank incision (3,9 cm; mean, 5.6 cm) was performed without gas inflation or trocar port placement. All of the instruments used during surgery were reusable. The cases included primary aldosteronism (12), Cushing's syndrome (6), preclinical Cushing's syndrome (3), pheochromocytoma (1), non-functioning cortical adenoma (6), adrenocortical carcinoma (1) and adrenocortical hemorrhage (1). Results: Resection of the tumor was successfully completed, without complications, in all of the cases. Operative time was between 83 and 240 min (mean, 147 min). Estimated blood loss was 5,470 mL (mean, 139 mL). None of the patients required blood transfusion. Postoperative course was uneventful. Wound pain was mild and walking and full oral feeding were resumed on the first and second postoperative day, respectively, in the majority of cases. Conclusions: Adrenal tumors are good candidates for portless endoscopic surgery, which is safe, cost-effective, minimally invasive and matches favorably with laparoscopic surgery. [source]

    Assessment of a protocol for prophylactic antibiotics to prevent perioperative infection in urological surgery: A preliminary study

    INTERNATIONAL JOURNAL OF UROLOGY, Issue 6 2004
    SOJUN KANAMARU
    Abstract Background: The aim of the present study was to assess the usability and efficacy of our new protocol of prophylactic antibiotic use to prevent perioperative infection in urological surgery. Methods: We prospectively investigated 339 cases of typical urological surgery in our department between April 2001 and March 2002 (group I). We classified surgical procedures into four categories by invasiveness and contamination levels: category A, clean less invasive or endoscopic surgery; category B, clean invasive or clean contaminated surgery; category C, urinary tract diversion using the intestine; and category D, infected surgery. Antibiotics were administrated intravenously according to our protocol: category A, first or second generation cephems or penicillins during the operative day only; category B, first and second generation cephems or penicillins for 3 days; and category C, second or third generation cephems for 4 days. Category D was excluded from the analysis. To judge perioperative infections, the wound condition and general conditions were evaluated in terms of the surgical site infection (SSI) as well as remote infection (RI) up to postoperative day (POD) 14. We retrospectively reviewed 308 patients who underwent urological surgery between April 2000 and March 2001 (group II) as reference cases that were administered antibiotics without any restriction. Results: Perioperative infection rates (SSI + RI) in group I and group II were 25 of 339 (7.4%) and 35 of 308 (11.4%), respectively. Surgical site infection rates of categories A, B, and C in group I were 1.8%, 7.6%, and 30.0%, respectively, while those in group II were 2.0%, 7.4%, and 46.2%, respectively. There was no significant difference in infection rates in terms of RI and SSI between group I and group II. The amounts, as well as the prices, for intravenously administrated antibiotics and oral antibiotics decreased to approximately half and one-fifth, respectively. Conclusion: Our protocol effectively decreased the amount of antibiotics used without increasing perioperative infection rates. Thus, our protocol of prophylactic antibiotic therapy would be recommended as an appropriate method for preventing perioperative infection in urological surgery. [source]

    Thoracoscopic cell sheet transplantation with a novel device

    JOURNAL OF TISSUE ENGINEERING AND REGENERATIVE MEDICINE, Issue 4 2009
    Masanori Maeda
    Abstract Regenerative medicine with transplantable cell sheets fabricated on temperature-responsive culture surfaces has been successfully achieved in clinical applications, including skin and cornea treatment. Previously, we reported that transplantation of fibroblast cell sheets to wounded lung had big advantages for sealing intraoperative air leaks compared with conventional materials. Here, we report a novel device for minimally invasive transplantation of cell sheets in endoscopic surgery, such as video-assisted thoracoscopic surgery (VATS). The novel device was designed with a computer-aided design (CAD) system, and the three-dimensional (3D) data were transferred to a 3D printer. With this rapid prototyping system, the cell sheet transplantation device was fabricated using a commercially available photopolymer approved for clinical use. Square cell sheets (24 × 24 mm) were successfully transplanted onto wound sites of porcine lung placed in a human body model, with the device inserted through a 12 mm port. Such a device would enable less invasive transplantation of cell sheets onto a wide variety of internal organs. Copyright © 2009 John Wiley & Sons, Ltd. [source]

    Cardiac liposarcoma and bilateral ovarian mature teratoma in a patient with congenital heart disease and f-anisosplenia

    PEDIATRIC BLOOD & CANCER, Issue 2 2008
    Daniel G. Pollono MD
    Abstract A 10-year-old female with atrial septal defect presented with bilateral ovarian mature cystic teratomas. Three spleniculi adjacent to the main spleen were noticed while the endoscopic surgery. Two years later a heart tumor was discovered which led to death. Pathologic examination of samples of the mass proved it to be a liposarcoma. The unusual combination of atrial septal defect, f-anisosplenia (female, congenital heart disease, multiple unevenly-sized spleens, left lung type pulmonary isomerism), bilateral ovarian mature cystic teratomas and liposarcoma of the heart appears to be a unique presentation. Pediatr Blood Cancer 2008;51:304,305. © 2008 Wiley-Liss, Inc. [source]