Minimally Invasive Technique for PMMA Augmentation of Fenestrated Screws.
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ABSTRACT:
SUBMITTER: Klingler JH
PROVIDER: S-EPMC4446514 | biostudies-other | 2015
REPOSITORIES: biostudies-other
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Project description:BackgroundCervical radiculopathy is a common pathological entity encountered by spine surgeons. Many surgical options have been described including anterior cervical discectomy with or without fusion to arthroplasty and posterior cervical laminoforaminotomy. Being a motion-preserving procedure, posterior cervical laminoforaminotomy is an excellent treatment for patients with unilateral radiculopathy secondary to a laterally located herniated disc or foraminal stenosis. With the advent of minimally invasive techniques, this procedure has regained popularity.ObjectivesAlthough there is enough evidence in the literature highlighting the benefits, safety, and efficacy of minimally invasive versus conventional techniques, a detailed technical report along with long-term surgical outcomes is lacking.MethodsThe authors present their experience in minimally invasive cervical laminoforaminotomy (MIS-CLF) over a 7-year period (2013-2020) along with a technical note. Clinical evaluation was performed both before and after surgery, using the Visual Analog Scale (VAS) pain scores. Patient functional outcome was measured using the modified Odom's criteria.ResultsThere were no major perioperative complications. No patient required surgery for the same level during the follow-up period which ranged from 1 to 3 years. Statistically significant results were obtained in all cases, reflected by an improvement in VAS for neck/arm pain.ConclusionMIS-CLF is an effective technique for treatment of radiculopathy due to cervical disc herniation in a carefully selected subgroup of patients with good medium- to long-term outcomes. A larger study would possibly highlight the effectiveness of this procedure.
| S-EPMC8740814 | biostudies-literature
Project description:Hybrid minimally invasive esophagectomy (HMIE) has been proven to be superior when compared with open esophagectomy, with a significant reduction of postoperative morbidity. In HMIE, the laparotomy is replaced by a minimally invasive laparoscopic approach. The radical mediastinal resection plus reconstruction is performed by a thoracic approach through a muscle-sparing thoracotomy. In this instructional article, we describe the surgical technique of HMIE in detail in order to facilitate possible adoption of the procedure by other surgeons. In addition, we give the monocentric results of our own practice. Between 2013 and 2018, HMIE was performed in 157 patients. The morbidity and mortality data of the procedure is shown in a retrospective monocentric analysis. Overall, 54% of patients had at least one perioperative complication. Anastomotic leak was evident in 1.9%, and a single patient had focal conduit necrosis of the gastric pull-up. Postoperative pulmonary morbidity was 31%. Pneumonia was found in 17%. The 90 day mortality was 2.5%. Wound infection rate was 3%, and delayed gastric emptying occurred in 17% of patients. In follow up, 12.7% presented with diaphragmatic herniation of the bowel, requiring laparoscopic hernia reduction and hiatal reconstruction and colopexy several months after surgery. HMIE is a highly reliable technique, not only for the resection part but especially in terms of safety in reconstruction and anastomosis. For esophageal surgeons with experience in minimally invasive anti-reflux procedures and obesity surgery, HMIE is easy and fast to learn and adopt.
| S-EPMC6678699 | biostudies-literature
Project description:The Cox-Maze procedure (CMP) for the surgical treatment of atrial fibrillation (AF) traditionally has required a median sternotomy and cardiopulmonary bypass. This study describes a method using ablation technologies to create the full Cox-Maze lesion set through a 5- to 6-cm right minithoracotomy.Twenty-two consecutive patients underwent a CMP through a right mini-thoracotomy and cardiopulmonary bypass. All patients were followed prospectively with electrocardiogram and 24-hour Holter monitoring at 3, 6, and 12 months. The CMP lesion set was created using bipolar radiofrequency energy and cryotherapy.There was no operative mortality or major complications.Two patients required a permanent pacemaker. Five patients (23%) had early atrial tachyarrhythmias. At last follow-up(mean, 18 ± 12 months), all the patients (n=22) were free from atrial dysrhythmias. At 3 months (n=19), 84% of patients were off antiarrhythmic drugs. At 6 months (n=18), 94% of patients were free from AF and off antiarrhythmic medications. At 12 months (n=16), 81% of patients were free from AF and off antiarrhythmic drugs and three patients remained on warfarin for a mechanical mitral valve.A full CMP can be performed through a right mini-thoracotomy with outstanding short-term results. This less invasive procedure can be offered to patients without compromising efficacy.
| S-EPMC2967773 | biostudies-other
Project description:Here we present the development of a novel minimally invasive sample preparation technique for application in the mass spectrometric analysis of bioarchaeological materials. The extraction protocol was developed by applying commercially available, dermatology grade skin sampling strips to modern skin surfaces as a surrogate, and then applied to cranial and bone fragments belonging to a 26th Dynasty Egyptian mummified individual from the coffin of a woman named Mer-Neith-it-es. Extracted proteins were subjected to electrophoretic separation and proteolytic digestion, resulting in peptides that were separated, fragmented and identified using nanoflow liquid chromatography - high resolution tandem mass spectrometry. We have identified a number of ancient brain and intracellular proteins on the surfaces of the various cranial and bone fragments, without causing any significant damage to these valuable remains.
2022-04-06 | PXD029003 | Pride
Project description:BackgroundMinimally invasive endoscopic hematoma evacuation is widely used in the treatment of intracerebral hemorrhage. However, this technique still has room for improvement. The intra-neuroendoscopic technique (INET) is a modified minimally invasive technique, and we report its safety and efficacy in evacuating brain parenchyma hematomas by comparing it with cranial puncture and drainage operation (CPDO).MethodsThe frontal, temporal, or occipital approaches were used according to the site of bleeding. The preoperative and postoperative hematoma volumes, Glasgow Coma Scale (GCS) score, Cerebral State Index (CSI), hematoma evacuation rate, operation time, complications, and 30-day mortality and Glasgow Outcome Scale (GOS) were retrospectively compared between the two groups.ResultsA total of 98 patients were enrolled. The evacuation rate (84 ± 7.1% versus 51.0 ± 8.4%, p = 0.00), 7-day GCS (11.8 ± 1.2 versus 10.4 ± 1.5, p = 0.01), and CSI (87.1 ± 8.7 versus 80.6 ± 10.2, p = 0.02) were higher, and the 30-day mortality rate (1.9% versus 15.6%, p = 0.036) was lower in the INET group. However, the operation time was longer in the INET group than in the control group (65.2 ± 12.5 min versus 45.6 ± 10.9 min, p = 0.000). Multivariable logistic regression showed that a good medium-term outcome (GOS scores 4-5) was significantly associated with INET (odds ratio (OR) 3.514, 95% confidence interval (CI) 1.463-8.440, p = 0.005), age under 65 years (OR 1.402, 95% CI, 1.041-1.888, p = 0.026), and hematoma volume less than 50 ml (OR 1.974, 95% CI 1.302-2.993, p = 0.001).ConclusionsINET surgery for brain parenchyma hematoma evacuation is a safe and efficient modified technique. This technique is minimally invasive, has less complications, and may be helpful in providing optimal outcomes for selected patients.Trial registrationClinicalTrials.gov, NCT02515903. Registered on 5 August 2015.
| S-EPMC6503359 | biostudies-literature
Project description:Introduction:The standard open technique for carpal tunnel surgery has wound problems and complications significantly more than minimally invasive surgery using the Wongsiri technique with MiniSURE Kit® (Surgical Innovation Healthcare Co., Ltd, Bangkok, Thailand) and in particular, the open technique surgery requires a longer time for return to work. CTR surgery with endoscopic devices improves the results with fewer wound problems when compared with the commonly used open technique; however, nerve complications and injury are more prevalent with endoscopic surgery than with the open technique. The Wongsiri technique produces good results with new medical devices such as the MiniSURE View, for improved vision and line-of-sight, and the MiniSURE Cut for improved and complete cutting via the supraretinacular technique that may reduce the nerve problems associated with endoscopic tooling in the carpal tunnel. Purpose:To evaluate the results of the operation and postoperative outcomes of the Wongsiri technique with a MiniSURE Kit®. Methods:20 patients underwent carpal tunnel release using the Wongsiri technique and a MiniSURE Kit® with a five-step surgery: MIS starts when the surgeon makes a 1.5-1.8?cm incision, creates a working space, inserts the visual tube of MiniSURE View, inserts the freer, and then cuts the transverse carpal ligament by using the MiniSURE Cut. Results:All 20 successes of the Wongsiri technique and MiniSURE Kit® surgery occurred within 6.8 minutes operative time and a 12?mm wound size. A single outlier, in one case (6.7%), the patient experienced pillar pain which abated within one month. Patients can return to work in 7.3 days. Conclusions:The Wongsiri technique with the MiniSURE Kit® demonstrated good outcomes similar to the endoscope. By contrast with the endoscopic surgery, the Wongsiri technique with the MiniSURE Kit® reduced preop, operating, and postop time, many resources, and significant costs and resulted in no nerve problems or complications.
| S-EPMC6969642 | biostudies-literature
Project description:Hamstring tendon harvest, especially semitendinosus harvest, has been widely used in anterior cruciate ligament reconstruction for many years. However, donor site morbidity has been described regarding the infrapatellar branch of the saphenous nerve. Minimally invasive anterior semitendinosus harvest is a simple, safe, reproducible, and elegant technique. A 2-cm vertical incision above the pes anserinus is performed 2 cm medial to the tibial anterior tubercle. The fascia superficialis is opened with a horizontal incision, and the gracilis is isolated using a retractor. The semitendinosus is grabbed with a probe, and the vincula are hooked one by one. The tendon is harvested with a closed stripper. The expansions are cut, and the tendon is detached from the bone with part of the periosteum.
| S-EPMC4885910 | biostudies-literature
Project description:BackgroundThis study aimed to assess the feasibility, efficacy and safety of McKeown surgery with vagal-sparing using minimally invasive esophagectomy (MIE).MethodsMcKeown surgery with vagal-sparing technique using MIE was adopted on patients diagnosed with resectable esophageal cancer. From June 2020 to January 2021, a total of 20 patients from the Department of Thoracic Surgery of the National Clinical Research Center for Cancer were enrolled.ResultsThe study group included 17 (85%) males and 3 (15%) females, with an average age of 62.6 (±7.1) years. The most common tumor location was lower thoracic esophagus (n=9, 45%), followed by middle thoracic esophagus (n=8, 40%) and upper thoracic esophagus (n=3, 15%). Nine (45%) patients had T1b disease, followed by T2 (n=8, 40%), T1a (n=2, 10%), and Tis (n=1, 5%). The average operation time was 221.5 (±61.2) minutes. Postoperative complications were as follow: 2 (10%) with hoarseness, 2 (10%) with pulmonary infection, 1 (5%) with arrhythmia, 1 (5%) with anastomotic leakage, 1 (5%) with delayed gastric emptying, 1 (5%) with pleural effusion, and 1 (5%) with diarrhea. Dumping syndrome, cholestasis, and chylothorax were not observed, and there was no perioperative death.ConclusionsMIE with vagus nerve preservation is a feasible and safe technique, with the possibility to be an alternative for esophageal carcinoma. Further study is needed to explore the functional outcome of preserving vagus nerve.
| S-EPMC9011232 | biostudies-literature
Project description:Background. Minimally invasive esophagectomy (MIE) techniques offer similar oncological and surgical outcomes to open methods. The effects of MIE on hospital costs are not well documented. Methods. We reviewed the electronic records of patients who underwent esophagectomy at a single academic institution between January 2012 and December 2014. Esophagectomy techniques were grouped into open, hybrid, MIE, and transhiatal (THE) esophagectomy. Univariate and multivariate analyses were performed to assess the impact of surgery on total hospital cost after esophagectomy. Results. 80 patients were identified: 11 THE, 11 open, 41 hybrid, and 17 MIE. Median total cost of the hospitalization was $31,375 and was similar between surgical technique groups. MIE was associated with higher intraoperative costs, but not total hospital cost. Multivariable analysis revealed that the presence of a complication, increased age, American Society of Anesthesiologists class IV (ASA4), and preoperative coronary artery disease (CAD) were associated with significantly increased cost. Conclusions. Despite the association of MIE with higher operation costs, the total hospital cost was not different between surgical technique groups. Postoperative complications and severe preoperative comorbidities are significant drivers of hospital cost associated with esophagectomy. Surgeons should choose technique based on clinical factors, rather than cost implications.
| S-EPMC5178372 | biostudies-literature
Project description:Parchment is an ancient writing support formed from dehaired animal skins. Its manufacture comprises a series of liming and scraping steps before being stretched and dried under tension. Historical parchment represents a valuable source of cultural heritage which, until now, has limited investigations to noninvasive analyses to infer ink composition, degradation, or physical changes over time. We highlight the prospect of the molecular and isotope compositions of animal lipids from parchment as an untapped record of its production and the animal's diet and environment. We report a minimally invasive, total lipid extraction aided by a vacuum for historical parchments. The quantitative and qualitative compositions of lipid extracts obtained using this method are compared with those obtained using invasive sampling for nine sacrificial membranes dated 1765-1825 CE. This extraction method is then applied to membranes from the Chancery Parliament Rolls (1814-1820 CE) held by The National Archives, UK to obtain lipids and derive taxonomic and dietary information using their stable carbon isotope compositions. This novel vacuum-aided extraction allows, for the first time, animal lipids to be obtained from parchment minimally invasively, paving the way for dietary and paleoclimate studies using this well-dated and common material.
| S-EPMC11359388 | biostudies-literature