86,591 research outputs found
Right Colectomy with Complete Mesocolic Excision: Four-arm Technique
No full textMinimally invasive surgery is gaining worldwide acceptance in the treatment of colonic cancer and the advantages over the traditional open approach are well known [1–3]. Unfortunately, during recent decades, the outcomes of patients after colon cancer resection have not improved to the same degree as for rectal cancer, whose treatment with total mesorectal excision (TME) is universally accepted as the standard of care. The complete mesocolic excision (CME), first reported by Hohenberger and colleagues in 2008 [4], seems to produce better long-term outcomes when compared to standard lymphadenectomy by following the same embryological-based principles introduced by Heald for rectal cancer more than 20 years ago [5]. However, well-conducted randomized studies are needed to confirm its efficacy
History of Robotic Surgery
No full textThe history of telerobotic surgery involves a revolutionary approach to minimally-invasive surgery. The concept of “telemanipulation” or “telepresence” emerged in the 1940s and was first used to describe the sensation that a person is in one location willIe being in another. It was driven by the need for certain complex tasks to be perfoffiled by machines in hazardous and unhealthy environment for human beings, such as the bottom of the ocean or in outer space. In Robert Heinlein’s 1942 science fiction , entitled “Waldo”, the lead character, Waldo Farthingwaite-Jones, was bom frail and unable to lift his own body weight. Heilnlein describes a glove and hamess device that allowed Waldo to control a powerful mechanical arm by simply moving his hand and fingers
Single-SiteTM Surgery
No full textThe Single-SiteTM platform was primarily designed to work in a narrow operative field and with a specific anatomical target. To date, the most consistent published experiences are regarding the use of this technology to perform cholecystectomy [1–9] but, recently, it has been applied in other fields of general surgery [10–12]. This chapter will focus on its current application in performing cholecystectomy and right colectomy
ICG Fluorescence: Current and Future Applications
No full textThe imaging technique based on indocyanine green (ICG) fluorescence has been widely used for more than forty years, especially to study blood flow and microcirculation. This method was first applied in general surgery to perform sentinel lymph node (SLN) biopsies in patients affected by breast and colorectal cancer. In 2010, a near-infrared (NIR) laser light system was integrated with the da Vinci® SiTM HD robotic system (Intuitive Surgical Inc., Sunnyvale, CA, USA). This imaging system is able to provide both white light and near-infrared light images through dedicated endoscopic illuminators and filters by simply pressing a pedal on the surgical console, thus allowing real-time fluorescence-guided surgery
EVALUATION OF THE EFFECTIVENESS OF METAXODINE IN THE HEPATIC TOXICITY DUE TO METHOTREXATE IN PATIENTS WITH RHEUMATOID ARTHRITIS
No full textHypothalamic-pituitary dysfunction in growth hormone-deficient patients with pituitary abnormalities.
No full textRobotic Right Colectomy with Modified Complete Mesocolic Excision: Long-Term Oncologic Outcomes
No full textBACKGROUND: A modified complete mesocolic excision (mCME) technique for the treatment of right-sided colon cancer recently was shown by Hohenberger and colleagues to provide impressive long-term oncologic outcomes. This report aims to describe the authors' experience with robotic right colectomy using mCME. The safety, feasibility, and efficacy of this procedure are measured by complications, conversion rates, and 4-year oncologic outcomes.
METHODS: A retrospective study analyzed 100 consecutive patients who underwent robotic right colectomy with mCME and intracorporeal anastomosis at the authors' institution between November 2005 and November 2013. Intra- and postoperative clinical outcomes, pathologic data, and survival were analyzed.
RESULTS: Robotic right colectomy with mCME was successfully performed for all the patients. No conversions or intraoperative complications occurred. The major complication rate (Dindo 3 or 4) was 4 %. During a median follow-up period of 48.5 months (range 24-114 months), the survival rates were 94.5 % for disease-specific survival, 91.4 % for disease-free survival, and 90.3 % for overall survival.
CONCLUSIONS: The authors' experience confirms the feasibility and safety of mCME for the treatment of right-sided colon cancer. This technique provided satisfying short-term outcomes with promising 4-year oncologic results. However, the real benefits of the CME technique should be evaluated further by well-conducted randomized studies before its adoption in routine practice is recommended
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