1,721,055 research outputs found
Primary hyperparathyroidism: successful parathyroidectomy and persistently elevated intact PTH.
No full textMinimally Invasive Video-Assisted Parathyroidectomy
No full textThe great improvement of preoperative studies able to correctly localize an affected parathyroid in cases of primary hyperparathyroidism, and the increased availability of intraoperative PTH, have led to a different surgical approach to hyperparathyroidism. The surgical strategy has moved from the bilateral exploration of the parathyroids to a “focused” parathyroidectomy, indicated for the majority of cases, that allows to limit the surgical dissection, the time of the procedure, and the morbidity. Among all the minimally invasive techniques conceived to this purpose, the Minimally Invasive Video-Assisted Parathyroidectomy (MIVAP) was designed and described in Pisa, in 1997.
The technique relies on principles that are different from those of the totally endoscopic techniques: the access is a single central 1.5 cm incision performed in the anterior part of the neck (thus allowing an approach to both sides of the neck), the CO2 insufflation is not used since the surgical field is maintained by external retraction, but the endoscope is still used to explore the anatomical region. The purposely designed surgical instruments and the endoscope are all inserted from the incision, allowing to perform a thorough exploration of the neck, with the great advantage of the endoscopic vision, and an oncologically correct dissection and removal of the parathyroid tissue.
The significant advantages of the MIVAP over other techniques might be summarized in: the same outcomes of the traditional surgery, obtained with a better cosmetic result and postoperative course, and the possibility of performing a bilateral exploration when necessary, theoretically allowing to avoid preoperative localizing studies and the use of intraoperative PTH
How to Use Energy Devices and their Potential Hazards
No full textModern thyroid surgery has been substantially modified by the impact of devices/instruments that, using different forms of energy (mainly radiofrequency and harmonic technology), allow a bloodless dissection of the surgical field. Among many advantages, these instruments are responsible, for example, for the significant reduction of the incision size, which may be one of the main concerns of patients undergoing thyroid surgery. Nevertheless, even if they are sa-fer than the common monopolar electrocautery, to be properly used all these instruments have a learning curve necessary to avoid damage that may affect the patient's quality of life. This chapter analyses the technology behind the more commonly used devices, and discusses the results and advantages obtained when using them to perform a thyroidectomy. © 2013 John Wiley & Sons, Ltd
Minimally Invasive Video-assisted Thyroidectomy
No full textThe minimally invasive video-assisted thyroidectomy (MIVAT) was developed in Pisa in 1998, and described in 1999. It has now become the most widespread minimally invasive technique for thyroidectomy throughout the world. This technique cannot be applied to every patient undergoing thyroid surgery but has precise indications, mainly in terms of size of the thyroid gland and nature of the thyroid disease. Only low and intermediate differentiated thyroid cancers under 2cm should be selected for MIVAT. © 2013 John Wiley & Sons, Ltd
Minimally Invasive Techniques Performed Through the Neck Access
No full textMinimally invasive video-assisted thyroidectomy currently represents the most widely performed technique for minimally invasive thyroidectomy in western countries. The particular complications of the minimally invasive video-assisted thyroidectomy technique will be discussed. We will focus specifically on the relevant aspects and management of well-known complications (e.g. postoperative bleeding) during and after this minimally invasive procedure, and on how to avoid them. © 2013 John Wiley & Sons, Ltd
Thyroid surgery before the technological revolution: From Samuel Gross' "torrents of blood" to Paolo Miccoli's video-assisted thyroidectomy
No full text"Can the thyroid gland... be removed with a reasonable hope of saving the patient?... If a surgeon should be so foolhardy as to undertake it... every step he takes will be followed by a torrent of blood, and lucky will it be for him if his victim live long enough to enable him to finish his horrid butchery... no honest and sensible surgeon would ever engage in it". With this renowned posthumous declaration, in 1886, Samuel D. Gross proposed that thyroid surgery should have been abandoned by surgeons. Despite this, subsequent improvements in anesthesiology, antisepsis strategies and better surgical instruments allowed to significantly decrease the mortality rates of this surgery to nearly zero percent, as is the case now. This paper aims at highlighting the most important steps and Mentors that led thyroid surgery to become one of the safest and most widespread surgical procedures
Scritture di immagini. Arti verbovisuali, dal secondo Novecento a oggi. Avanguardia, neoavanguardia, comunicazione di massa / Image Writing. Verbo-Visual Arts from the Late Twentieth Century to Today. Avant-Garde, Neo-Avant-Garde, Mass Communication
Full text linkEditoriale / Editorial. Scritture di immagini. Arti verbovisuali, dal secondo Novecento a oggi. Avanguardia, neoavanguardia, comunicazione di massa / Image Writing. Verbo-Visual Arts from the Late Twentieth Century to Today. Avant-Garde, Neo-Avant-Garde, Mass Communication
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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