Minimally-Invasive Resection of a Racemose Neurocysticercal Cyst.
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ABSTRACT:
SUBMITTER: Trubin PA
PROVIDER: S-EPMC9294708 | biostudies-literature | 2022 May
REPOSITORIES: biostudies-literature
Publications
Minimally-Invasive Resection of a Racemose Neurocysticercal Cyst.
Trubin Paul Albert PA Omay Sacit Bulent SB Ko Albert I AI
The American journal of tropical medicine and hygiene 20220523
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| S-EPMC9735424 | biostudies-literature
Project description:BackgroundPancreatic resections are among the most technically demanding procedures, including a high risk of potentially life-threatening complications and outcomes strongly correlated to hospital volume and individual surgeon experience. Minimally invasive pancreatic resections (MIPRs) have become a part of standard surgical practice worldwide over the last decade; however, in comparison with other surgical procedures, the implementation of minimally invasive approaches into clinical practice has been rather slow.ObjectiveThe aim of this study was to highlight and summarize the available randomized controlled trials (RCTs) evaluating the role of minimally invasive approaches in pancreatic surgery.MethodsA WHO trial registry and Pubmed database literature search was performed to identify all RCTs comparing MIPRs (robot-assisted and/or laparoscopic distal pancreatectomy [DP] or pancreatoduodenectomy [PD]) with open pancreatic resections (OPRs).ResultsOverall, five RCTs on MIPR versus OPR have been published and seven RCTs are currently recruiting. For DP, the results of two RCTs were in favor of minimally invasive distal pancreatectomy (MIDP) in terms of shorter hospital stay and less intraoperative blood loss, with comparable morbidity and mortality. Regarding PD, two RCTs showed similar advantages for MIPD. However, concerns were raised after the early termination of the third multicenter RCT on MIPD versus open PD due to higher complication-related mortality in the laparoscopic group and no clear other demonstrable advantages. No RCTs on robot-assisted pancreatic procedures are available as yet.ConclusionAt the current level of evidence, MIDP is thought to be safe and feasible, although oncological safety should be further evaluated. Based on the results of the RCTs conducted for PD, MIPD cannot be proclaimed as the superior alternative to open PD, although promising outcomes have been demonstrated by experienced centers. Future studies should provide answers to the role of robotic approaches in pancreatic surgery and aim to identity the subgroups of patients or indications with the greatest benefit of MIPRs.
| S-EPMC7892688 | biostudies-literature
Project description:Primary cardiac tumours for which surgical resection is the main stay of treatment are rare and present both diagnostic and management challenges. The majority of patients are asymptomatic and one third of those who have symptoms present with vague constitutional symptoms which further complicates the process of early diagnosis. The current state-of-the art multi-modality imaging, routine use of intra-operative transoesophageal echocardiogram (TOE) in most cardiac centres and the tremendous advances of endoscopic adjuncts greatly enhances both the diagnosis and management of those group of patients. The surgical burden of median sternotomy and the contemporary trend towards less invasive surgery urged the necessity for adopting minimally invasive surgery in general and cardiac tumours are no exception. Despite the rarity of theses tumours, minimally invasive resection is successful in the hands of experienced minimally invasive surgeons who employ the same minimal access valve surgery platform to access the tumours in various cardiac chambers and valves with no compromise to the oncological clearance and hence achieve the benefits of minimally invasive surgery without compromising long term outcomes.
| S-EPMC8024814 | biostudies-literature
Project description:Intracranial dermoid cysts are benign lesions that may be diagnosed incidentally or present symptomatically due to mass effect-focal neurological deficits, seizures and/or hydrocephalus-or chemical meningitis secondary to spontaneous rupture. The use of tubular retractors in minimally invasive parafascicular surgery (tsMIPS) has been described extensively as a technique to preserve neurological function whilst safely maximizing the extent of resection. The authors present the first use of the tsMIPS approach for removal of a dermoid cyst in a 68-year-old female who presented with abulia and seizures due to a large Sylvian fissure dermoid cyst. This approach minimized trauma to surrounding cortical-subcortical structures, as supported by connectome analyses, without sacrificing visualization of the operative field. Additionally, itavoided manipulation of the lenticulostriate arteries attached to the walls of the dermoid cyst. The use of an endoscope ensured complete drainage of the cyst components and therefore the effectiveness of the procedure.
| S-EPMC11837332 | biostudies-literature
Project description:ObjectiveTo present the treatment algorithm, surgical technique, and results of a series of patients with spinal synovial cysts operated with minimally invasive techniques (MIS).IntroductionSpinal synovial cysts originate from the dilation and potential rupture of the synovial sheath of a facet joint. Surgical resection is considered the treatment of choice in symptomatic patients. The use of MIS techniques could reduce the disruption of the facet joint involved, reducing the risk of postoperative instability.Materials and methodsWe retrospectively evaluated 21 patients with spinal synovial cysts operated by MIS approach and decompression. We analyzed the signs, symptoms, surgical time, hospital stay, evolution, and complications. The visual analog scale (VAS) was used to evaluate pain and the Weiner scale and the modified Macnab criteria to measure the patient's postoperative satisfaction.ResultsA total of 21 patients were surgically treated with MIS technique; 76.2% (n = 16) did not require arthrodesis, the remaining 23.8% (n = 5) were fused. We performed 13 (61.9%) contralateral hemilaminectomies, 7 ipsilateral hemilaminectomies (33.3%), and 1 laminectomy in S1-S2. The average follow-up was 26 months; surgical time was 150.33 ± 63.31 min, with a hospital stay of 2.5 ± 1.78 days. The VAS decreased from 8.3 preoperatively to 2.3 postoperatively. Sixteen patients reported excellent results, four good and one regular in the scale of Macnab. 95.2% of patients perceived that the procedure was very/quite successful according to the Weiner scale.ConclusionThe minimally invasive approach is a safe and effective procedure for the complete resection of spinal synovial cysts. It provides excellent clinical-functional results by preserving muscles, ligaments, and joint facets.
| S-EPMC6416767 | biostudies-literature
Project description:Most simple renal cysts rarely require therapy. When it grows to such a large size, regardless of the presence of symptomatology, surgical intervention is required. In this study, we explored a new approach called percutaneous ureteroscopy laser unroofing for treatment renal cysts and evaluated its safety and efficacy. 71 simple renal cyst patients with surgical indications were enrolled, including 6 patients with a peripelvic cyst and 5 patients coexisting ipsilateral calculi. Under ultrasound guidance, an eighteen-gauge needle was placed inside the cyst cavity, and a guidewire was introduced followed by sequential dilation up to 28 F. The extra-parenchymal portion of cyst wall was dissociated and incised using either a Thulium or Holmium laser, and a pathological examination was performed. Renal calculi were treated simultaneously. For peripelvic cyst patients, one end of a double-J stent was inserted into the cyst cavity to prevent auto-closure. Mean of 11.7 months follow-up, the results showed that the cyst was completely resolved in 53 patients, its size was reduced to less than 50% in 15 patients, and treatment failed in only 3 anterior cyst patients, suggesting that percutaneous ureteroscopy laser unroofing is an effective and less invasive alternative for treatment of renal cysts in selected patients.
| S-EPMC5663957 | biostudies-literature
Project description:BackgroundWhile keyhole neurosurgery is increasingly utilized in the operating room, there are few reports regarding the use of keyhole techniques to resect giant intracranial tumors. The feasibility and technique of that were discussed in this paper.MethodsWe retrospectively reviewed 95 consecutive patients who were admitted to our service between February 2012 and September 2017 with a maximum intracranial tumor diameter >5 cm. Keyhole approaches were used to resect these tumors in each case, including supraorbital, subtemporal, suboccipital, retromastoid, frontal, temporal, occipital, parietal, pterional, a combined temporo-parietal keyhole approach, and an approach via the longitudinal fissure.ResultsWe achieved gross total resection in 68/95 cases (71.6%) and subtotal resection in 27/95 cases (28.4%). No surgical death or severe disabilities such as coma and limb dyskinesia occurred following surgery. At the time of discharge, 8 patients had complications related to impaired cranial nerve function. In addition, 2 patients developed hydrocephalus requiring ventriculo-peritoneal shunt placement, and 4 patients developed a postoperative CSF leak requiring surgical intervention.ConclusionWith meticulous design and reasonable selection, resection of giant intracranial tumors utilizing minimally invasive keyhole approaches can be done safely with satisfactory surgical outcomes.
| S-EPMC9354442 | biostudies-literature
Project description: Not available
| S-EPMC9579481 | biostudies-literature
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| S-EPMC11336546 | biostudies-literature
Project description:BackgroundSubtalar arthrodesis is a commonly performed procedure for the treatment of posttraumatic or primary osteoarthritis and several hindfoot deformities. The primary objective of this study is to evaluate the efficacy and safety of a minimally invasive technique for cartilage removal of the subtalar joint using a modified sinus tarsi approach.MethodsAn anatomical study was performed on 8 pairs of fresh frozen cadaveric feet. A modified 2.5-cm sinus tarsi approach was used to access the subtalar joint. Cartilage removal was performed in 2 groups using either a 13-mm Shannon burr (GB) or a curette (GC) with subsequent systematic dissection. Standardized scaled photographs of the resected articular surfaces were analyzed in ImageJ software to quantify cartilage removal. Nearby vulnerable anatomical structures such as the intermediate and lateral dorsal cutaneous nerves, peroneal, tibialis posterior, flexor digitorum longus, and flexor hallucis longus tendons were assessed for injury.ResultsThe area of completely removed cartilage in GC was median 79.7% talar and 76.6% calcaneal. In GB, median 67.8% of the talar cartilage and 76.8% of the calcaneal cartilage was removed. The overall mean of cartilage resection was 73% (±7.7). There was no statistically significant difference between the groups. Anatomical structures at risk were not inadvertently injured.ConclusionSubtalar cartilage resection can be performed safely using a minimally invasive modified sinus tarsi approach and either a Shannon burr or curettes. The amount of cartilage resection is less than that reported in the literature for open cartilage resection, but may be beneficial in select patient populations at increased risk for wound healing compromise and infection.Level of evidenceLevel III, comparative cadaver study.
| S-EPMC11924069 | biostudies-literature