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Find video protocols related to scientific articles indexed in Pubmed.
Single-Incision Laparoscopic Surgery Through an Ostomy Site: A Natural Approach By An Unnatural Orifice.
Surg Laparosc Endosc Percutan Tech
PUBLISHED: 04-19-2014
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Single-incision laparoscopic surgery (SILS) is gaining popularity for a wide variety of surgical operations and capitalizes on the benefits of traditional laparoscopic surgery without incurring multiple incision sites. Traditionally, SILS is performed by a midline periumbilical approach. However, such a minimally invasive approach may be utilized in patients who already have an abdominal incision. Our series retrospectively reviews 7 cases in which we utilized the fascial defect at the time of after ostomy reversal as our SILS incision site. In turn, we performed a variety of concurrent intra-abdominal procedures with excellent technical success and outcomes. Our study is the largest single-institution case series of this novel approach and suggests that utilizing an existing ostomy-site abdominal incision is a safe and effective location for SILS port placement and should be considered in patients undergoing concurrent procedures.
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An efficient risk adjustment model to predict inpatient adverse events after surgery.
World J Surg
PUBLISHED: 03-12-2014
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Risk adjustment is an important component of surgical outcomes and quality analyses. Current models include numerous preoperative variables; however, the relative contribution of these variables may be limited. This research seeks to identify a model with the fewest number of variables necessary to perform an adequate risk adjustment to predict any inpatient adverse event for use in resource-limited settings.
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Laparo-endoscopic transgastric resection of gastric submucosal tumors.
Surg Endosc
PUBLISHED: 03-03-2014
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Laparoscopic and endoluminal surgical techniques have evolved and allowed improvements in the methods for treating benign and malignant gastrointestinal diseases. To date, only case reports have been reported on the application of a laparo-endoscopic approach for resecting gastric submucosal tumors (SMT). In this study, we aimed to evaluate the efficacy, safety, and oncologic outcomes of a laparo-endoscopic transgastric approach to resect tumors that would traditionally require either a laparoscopic or open surgical approach. Herein, we present the largest single institution series utilizing this technique for the resection of gastric SMT in North America.
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Cholecystostomy offers no survival benefit in patients with acute acalculous cholecystitis and severe sepsis and shock.
J. Surg. Res.
PUBLISHED: 02-20-2014
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Acute acalculous cholecystitis is often managed with cholecystectomy or cholecystostomy, but data guiding surgical practice are lacking.
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Long-term mortality rates (>8-year) improve as compared to the general and obese population following bariatric surgery.
Surg Endosc
PUBLISHED: 02-19-2014
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Sparse data are available on long-term patient mortality following bariatric surgery as compared to the general population. The purpose of this study was to assess long-term mortality rates and identify risk factors for all-cause mortality following bariatric surgery.
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Hospital Admissions Greater Than 30 Days Following Bariatric Surgery: Patient and Procedure Matter.
Surg Endosc
PUBLISHED: 02-14-2014
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Assessment of hospital admission in the 30-day period following bariatric surgery likely underestimates true hospital utilization. The purpose of this study is to assess hospital admissions for 2 years following bariatric surgery to identify potential differences by patient and procedure.
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Reoperation rates after laparoscopic fundoplication.
Surg Endosc
PUBLISHED: 02-06-2014
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Current literature on redo antireflux surgery has limitations due to small sample size or single center experiences. This study aims to evaluate the reoperation rate of laparoscopic fundoplication in a large population database.
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Impact of a third-year surgical apprenticeship model: perceptions and attitudes compared with the traditional medical student clerkship experience.
J. Am. Coll. Surg.
PUBLISHED: 01-10-2014
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Current literature suggests that medical students may have negative misconceptions of a surgical career partly due to the traditional hierarchical structure of the surgical clerkship. We hypothesized that a novel medical student apprenticeship would result in positive changes in perceptions of both surgeons and surgical careers.
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Improved perioperative outcomes with minimally invasive distal pancreatectomy: results from a population-based analysis.
JAMA Surg
PUBLISHED: 01-10-2014
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Interest in minimally invasive distal pancreatectomy (MIDP) has grown in recent years, but currently available data are limited. Greater insight into application patterns and outcomes may be gained from a national database inquiry.
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Outcomes of robotic-assisted transhiatal esophagectomy for esophageal cancer after neoadjuvant chemoradiation.
J Laparoendosc Adv Surg Tech A
PUBLISHED: 01-08-2014
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We previously reported our experience performing robotic-assisted transhiatal esophagectomy (RATE) in patients with early-stage esophageal cancer who had had no preoperative treatment. The purpose of this report was to determine if RATE could be performed safely with good outcomes for esophageal cancer in a more recent series of patients, the majority of whom were treated with neoadjuvant chemoradiation.
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Transanal minimally invasive surgery for benign and malignant rectal neoplasia.
Am. J. Surg.
PUBLISHED: 01-05-2014
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Transanal minimally invasive surgery (TAMIS), an alternative technique to transanal endoscopic microsurgery, was developed in 2009. Herein, we describe our initial experience using TAMIS for benign and malignant rectal neoplasia.
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Long-term outcomes of patients with nonsurgically managed uncomplicated appendicitis.
J. Am. Coll. Surg.
PUBLISHED: 01-03-2014
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Emerging literature has supported the safety of nonoperative management of uncomplicated appendicitis.
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Gross-total resection outcomes in an elderly population with glioblastoma: a SEER-based analysis.
J. Neurosurg.
PUBLISHED: 11-08-2013
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Object There is limited information on the relationship between patient age and the clinical benefit of resection in patients with glioblastoma. The purpose of this study was to use a population-based database to determine whether patient age influences the frequency that gross-total resection (GTR) is performed, and also whether GTR is associated with survival difference in different age groups. Methods The authors identified 20,705 adult patients with glioblastoma in the Surveillance, Epidemiology, and End Results (SEER) registry (1998-2009). Surgical practice patterns were defined by the categories of no surgery, subtotal resection (STR), and GTR. Kaplan-Meier and multivariate Cox regression analyses were used to assess the pattern of surgical practice and overall survival. Results The frequency that GTR was achieved in patients with glioblastoma decreased in a stepwise manner as a function of patient age (from 36% [age 18-44 years] to 24% [age ? 75]; p < 0.001). For all age groups, glioblastoma patients who were selected for and underwent GTR showed a 2- to 3-month improvement in overall survival (p < 0.001) relative to those who underwent STR. These trends remained true after a multivariate analysis that incorporated variables including ethnicity, sex, year of diagnosis, tumor size, tumor location, and radiotherapy status. Conclusions Gross-total resection is associated with improved overall survival, even in elderly patients with glioblastoma. As such, surgical decisions should be individually tailored to the patient rather than an adherence to age as the sole clinical determinant.
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Outcomes of isolated basilar skull fracture: readmission, meningitis, and cerebrospinal fluid leak.
Otolaryngol Head Neck Surg
PUBLISHED: 10-17-2013
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Objective To determine rates of cerebrospinal fluid (CSF) leak, meningitis, and readmission in pediatric and adult patients with isolated basilar skull fracture. Study Design Cross-sectional analysis of a statewide database. Subjects Patients with isolated basilar skull fracture (1995-2010). Methods Patients were identified within the California Office of Statewide Health Planning and Development database using ICD-9 diagnosis codes. Results A total of 3563 pediatric and 10,761 adult patients met inclusion criteria. In-hospital rates of meningitis (0.48% and 0.64%, P = .3360) and CSF leak (2.33% and 1.75%, P = .0270) were similar among children and adults, respectively. Rates of 90-day meningitis (0.17% and 0.37%, P = .0714) and CSF leak (0.40% and 0.40%, P = .9823) were also similar. Thirty-day readmission was 4.6% for children compared with 12.4% for adults (P < .001). For both pediatric and adult patients, extra-axial hematoma (odds ratio [OR] [confidence interval {CI}] 1.65 [1.05-2.59] and 1.61 [1.34-1.95]) and comorbidities (OR [CI] 2.19 [1.11-4.34] and 1.28 [1.04-1.59]) were associated with significant increases in 30-day readmission. Loss of consciousness greater than 1 hour (OR, 3.05; 95% CI, 1.53-6.08) and CSF leak (OR, 3.28; 95% CI, 1.41-7.64) increased the likelihood of pediatric readmissions. Lack of insurance (OR, 0.67; 95% CI, 0.50-0.90) and female gender (OR 0.83; 95% CI, 0.70-0.99) reduced the likelihood of adult readmission. Conclusion Meningitis and CSF leak following isolated basilar skull fractures are uncommon. Readmission within 30 days was more common in adults than in children. CSF leak, hematoma, and prolonged loss of consciousness increased the likelihood of readmission in children. Intracranial injury, male gender, having insurance, and comorbidities increased the likelihood of readmission in adults.
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The comparative effectiveness of surgeons over interventionalists in endovascular repairs of abdominal aortic aneurysm.
Ann. Surg.
PUBLISHED: 09-12-2013
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Comparative effectiveness research has mostly been focused on comparison of treatment techniques. The goal of the present study was to extend the research to physician specialty.
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Fluorescently labeled chimeric anti-CEA antibody improves detection and resection of human colon cancer in a patient-derived orthotopic xenograft (PDOX) nude mouse model.
J Surg Oncol
PUBLISHED: 07-06-2013
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The aim of this study was to evaluate a new fluorescently labeled chimeric anti-CEA antibody for improved detection and resection of colon cancer.
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Transvaginal organ extraction: potential for broad clinical application.
Surg Endosc
PUBLISHED: 04-21-2013
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Natural orifice transluminal endoscopic surgery procedures have evolved over the past few years. A transvaginal approach is a promising alternative for intraperitoneal procedures. Our objective was to evaluate the safety and feasibility of transvaginal organ extraction.
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Older age increases short-term surgical complications after primary knee arthroplasty.
Clin. Orthop. Relat. Res.
PUBLISHED: 04-04-2013
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Age is a known risk factor for complications after knee arthroplasty; however, age-related risks for a variety of complications of total and partial knee arthroplasties have not been well quantified.
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Transesophageal endoscopic myotomy (TEEM) for the treatment of achalasia: the United States human experience.
Surg Endosc
PUBLISHED: 03-23-2013
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From our early experience with NOTES, our group has acquired familiarity with transesophageal submucosal dissection and myotomy in swine model, which allowed us to perfect a model to perform purely endoscopic transesophageal myotomy (TEEM) for the treatment of achalasia and apply it into clinical practice. This study was designed to assess the safety, feasibility, and efficacy of TEEM in a series of patients with achalasia.
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Broad clinical utilization of NOTES: is it safe?
Surg Endosc
PUBLISHED: 03-12-2013
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Natural orifice transluminal endoscopic surgery (NOTES) has been the focus of several studies as a less invasive alternative to conventional laparoscopy to access and treat intracavitary organs. For the last 5 years, much has been accomplished with animal studies, yet the clinical utilization of this novel technique is still modest. After 2 years of experience in the laboratory, we started our clinical experience. We report our experience with clinical utilization of NOTES procedures from 2007 to 2010.
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A nationwide examination of outcomes of percutaneous cholecystostomy compared with cholecystectomy for acute cholecystitis, 1998-2010.
Surg Endosc
PUBLISHED: 02-26-2013
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Improvements in percutaneous drainage techniques combined with the recognized advantages of avoiding surgery in critically ill patients have rendered cholecystostomy an attractive treatment option, particularly in those patients with acute acalculus cholecystitis. However, robust data to guide surgeons in choosing cholecystostomy versus cholecystectomy have been lacking.
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TAMIS-assisted laparoscopic low anterior resection with total mesorectal excision in a cadaveric series.
Surg Endosc
PUBLISHED: 02-11-2013
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To demonstrate the feasibility of an innovative technique for the surgical management of rectal cancer, we performed transanal minimally invasive surgery assisted low anterior resection with total mesorectal excision (TAMIS-assisted LAR with TME) in a cadaver model. Transanal LAR via natural orifice transluminal endoscopic surgery has been reported in cadaveric series using rigid transanal platforms. This procedure has not been described using a combination of a single incision laparoscopy and TAMIS transanal endoscopic platform. We describe the first cadaveric series of TAMIS-assisted LAR with TME.
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Robotic-assisted laparoscopic stage II restorative proctectomy for toxic ulcerative colitis.
Int J Med Robot
PUBLISHED: 09-16-2011
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There is a paucity of literature reporting minimally invasive proctectomy for ulcerative colitis (UC). We report a novel application of a robotic system to perform restorative proctectomy in patients with toxic UC.
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Submillimeter-resolution fluorescence laparoscopy of pancreatic cancer in a carcinomatosis mouse model visualizes metastases not seen with standard laparoscopy.
J Laparoendosc Adv Surg Tech A
PUBLISHED: 06-23-2011
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Staging laparoscopy can visualize peritoneal and liver metastases in pancreatic cancer otherwise undetectable by preoperative imaging. However, false-negative rates may be as high as 18%-26%. The aim of the present study was to improve detection of metastatic pancreatic cancer with the use of fluorescence laparoscopy (FL) in a nude-mouse model with the tumors expressing green fluorescent protein (GFP).
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[Surgery without incisions--the third generation of surgery].
Harefuah
PUBLISHED: 04-01-2011
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In the past, abdominal surgery mandated a large abdominal wall incision. The minimal invasive surgery techniques including Laparoscopy, created an option for performing intraabdominal surgery through small incisions. In this article, the authors present new surgical techniques: the natural orifice trans-luminal endoscopic surgery (NOTES], and the singLe incision laparoscopic surgery (SILS). It seems that these evolving techniques are the third generation of surgery.
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NSQIP reveals significant incidence of death following discharge.
J. Surg. Res.
PUBLISHED: 03-15-2011
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The rates of post-discharge deaths after surgical procedures are unknown and may represent areas of quality improvement. The NSQIP database captures 30-d outcomes not included within normal administrative databases, and can thus differentiate between in-hospital and post-discharge deaths.
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Human experience with an endoluminal, endoscopic, gastrojejunal bypass sleeve.
Surg Endosc
PUBLISHED: 03-11-2011
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This report describes the authors experience with a unique endoluminal, endoscopically delivered and retrieved gastroduodenojejunal bypass sleeve, including short-term weight loss and changes in comorbidities.
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Transrectal hybrid natural orifice transluminal endoscopic surgery (NOTES) nephrectomy in a porcine model.
Urology
PUBLISHED: 03-08-2011
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To examine feasibility of transrectal hybrid natural orifice translumenal endoscopic surgery (NOTES) nephrectomy in the porcine model. NOTES uses ports of entry to the peritoneal cavity instead of abdominal wall incisions, thereby eliminating visible scar and also potentially reducing postoperative pain.
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A review for clinical outcomes research: hypothesis generation, data strategy, and hypothesis-driven statistical analysis.
Surg Endosc
PUBLISHED: 02-27-2011
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In recent years, more and more large, population-level databases have become available for clinical research. The size and complexity of these databases often present a methodological challenge for investigators. We propose that a "protocol" may facilitate the research process using these databases. In addition, much like the structured History and Physical (H&P) helps the audience appreciate the details of a patient case more systematically, a formal outcomes research protocol can also help in the systematic evaluation of an outcomes research manuscript.
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Density of surgeons is significantly associated with reduced risk of deaths from motor vehicle crashes in US counties.
J. Am. Coll. Surg.
PUBLISHED: 01-21-2011
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The concept of surgery and public health has been introduced in recent years, highlighting the impact of surgeons on improving public health outcomes, a relationship that has traditionally been ascribed to general practitioners. The purpose of this study is to quantify the effect of surgeon availability on deaths from motor vehicle crashes (MVC).
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Robotic single-incision transabdominal and transvaginal surgery: initial experience with intersecting robotic arms.
Int J Med Robot
PUBLISHED: 09-03-2010
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Single-incision laparoscopic and natural orifice translumenal endoscopic surgery (NOTES) are technically challenging methods. Robotics might have the potential to overcome such hurdles with computer technology.
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Fluidic lens laparoscopic zoom camera for minimally invasive surgery.
J Biomed Opt
PUBLISHED: 07-10-2010
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This work reports a miniaturized laparoscopic zoom camera that can significantly improve vision for minimally invasive surgery (MIS), also known as laparoscopic surgery. The laparoscopic zoom camera contains bioinspired fluidic lenses that can change curvature and focal length in a manner similar to the crystalline lenses in human eyes. The traditional laparoscope is long, rigid, and made of fixed glass lenses with a fixed field of view. The constricted vision of a laparoscope is often an inconvenience and plays a role in many surgical injuries. To further advance MIS technology, we developed a new type of laparoscopic camera that has a total length of less than 17 mm, greater than 4x optical zoom, and 100 times higher sensitivity than todays laparoscope allowing it to work under illumination as low as 300 lux. All these unique features are enabled by the technology of bioinspired fluidic lenses having a dynamic range over 100 diopters and being convertible between a convex and concave shape.
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Tumor necrosis factor expression is ameliorated after exposure to an acidic environment.
J. Surg. Res.
PUBLISHED: 06-30-2010
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It has been well established that laparoscopic surgery presents several clinical benefits, including reduced pain and a shorter hospital stay. These effects have been associated with a decrease in the inflammatory response. Previous studies have demonstrated that reduced inflammation after laparoscopic surgery is the product of carbon dioxide insufflation, which decreases peritoneal pH. The objective of this study was to investigate the cellular and molecular mechanisms responsible for the reduced response after exposure to acidic environments.
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Morbid obesity with achalasia: a surgical challenge.
Obes Surg
PUBLISHED: 04-08-2010
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Achalasia is a relatively rare medical condition that is classically not associated with obesity. The surgical treatment of a simultaneous occurrence of these two diseases requires careful consideration, and only a few reports can be found in the literature combining a Heller myotomy with gastric bypass, duodenal switch, or gastric banding. We report the case of a 69-year-old female patient with early achalasia and obesity who underwent simultaneous laparoscopic gastric sleeve resection and robotic Heller myotomy. No intra- or postoperative complications occurred. A follow-up at 6 weeks showed a significant weight loss and resolved symptoms of achalasia. The case illustrates that a simultaneous gastric sleeve resection and robotic Heller myotomy might be an option for the treatment of concurrent obesity and achalasia.
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Video. Magnetic retraction for NOTES transvaginal cholecystectomy.
Surg Endosc
PUBLISHED: 02-23-2010
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Natural orifice translumenal endoscopic surgery (NOTES) has the potential to decrease the burden of an operation on a patient. Limitations of the endoscopic platform require innovative solutions to provide retraction and create an operation comparable with the gold standard, laparoscopic cholecystectomy.
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Clinical experience with a multifunctional, flexible surgery system for endolumenal, single-port, and NOTES procedures.
Surg Endosc
PUBLISHED: 01-20-2010
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Single-port and incisionless surgical approaches hold the promise of fewer complications, reduced pain, faster recovery, and improved cosmesis compared with traditional open or laparoscopic approaches. The ability to select an access approach (i.e., endolumenal, single-port, transvaginal, or transgastric) with one platform may be important to optimization of individual patient results. The authors report their results using these four separate surgical approaches tailored to three different therapeutic procedures, all with the use of a single flexible platform, the Incisionless Operating Platform (IOP).
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Fluorescence laparoscopy imaging of pancreatic tumor progression in an orthotopic mouse model.
Surg Endosc
PUBLISHED: 01-10-2010
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The use of fluorescent proteins to label tumors is revolutionizing cancer research, enabling imaging of both primary and metastatic lesions, which is important for diagnosis, staging, and therapy. This report describes the use of fluorescence laparoscopy to image green fluorescent protein (GFP)-expressing tumors in an orthotopic mouse model of human pancreatic cancer.
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Womens positive perception of transvaginal NOTES surgery.
Surg Endosc
PUBLISHED: 10-07-2009
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Two decades ago, minimally invasive surgery (MIS) was introduced and led to a revolution in modern surgery. Currently MIS procedures are the standard of care for many surgical interventions and patients often seek out surgeons with special training in MIS. Today, natural orifice transluminal endoscopic surgery (NOTES) appears to be on the threshold of another such revolution. We surmise that its advantages are similar to those of other MIS procedures, but there are no associated abdominal wall complications as there are no abdominal incisions. To date, there is no data evaluating womens perceptions of such a procedure and their willingness to consent to this type of surgical approach.
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Transrectal endoscopic retrorectal access (TERA): a novel NOTES approach to the peritoneal cavity.
J Laparoendosc Adv Surg Tech A
PUBLISHED: 09-01-2009
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As the field of natural orifice translumenal endoscopic surgery (NOTES) expands, new access sites are being investigated. One access site to the peritoneal cavity, which has not been the subject of much investigation, is transrectal access. The aim of this article is to describe a new method to peritoneal access: transrectal endoscopic retrorectal access (TERA).
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Upregulation of thrombospondin-1 and angiogenesis in an aggressive human pancreatic cancer cell line selected for high metastasis.
Mol. Cancer Ther.
PUBLISHED: 07-07-2009
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Pancreatic cancer remains a leading cause of death despite its relatively low incidence. As in many other solid tumors, angiogenesis is critical to the growth and metastasis of this cancer. Through serial in vivo passages in mice, we have developed a highly aggressive variant of human pancreatic cancer cell line XPA-1 which shows more rapid primary tumor growth, faster time to metastasis, and more rapid lethality than the parental cell line. The high-metastatic variant developed a much denser tumor vasculature early during growth within the pancreas. Interestingly, examination of the in vitro growth of this aggressive variant yielded no significant difference from the parental cell line. Real-time PCR evaluation of genes involved in angiogenesis revealed a 24-fold increase in Thrombospondin-1 expression in cells derived from the high-metastatic variant when compared with the parental cell line. These findings provide direct evidence that elevated capability for angiogenesis, mediated by specific changes in gene expression, can lead to a large increase in cancer aggressiveness and resulting metastasis. These findings have important implications for the treatment of metastatic disease.
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Providing more through less: current methods of retraction in SIMIS and NOTES cholecystectomy.
Surg Endosc
PUBLISHED: 07-03-2009
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As the field of minimally invasive surgery continues to develop, surgeons are confronted with the challenge of performing conventional laparoscopic surgeries through fewer incisions while maintaining the same degree of safety and surgical efficiency. Most of these methods involve elimination of the ports previously designated for retraction. As a result, minimally invasive surgeons have been forced to develop minimally invasive and ingenious methods for providing adequate retraction for these procedures. Herein we present our experience using endoloops and internal retractors to provide retraction during Single Incision Minimally Invasive Surgery (SIMIS) and Natural Orifice Transluminal Endoscopic Surgery (NOTES) cholecystectomy. We also present a review of the alternative retraction methods currently being employed for these surgeries.
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The inflammatory response in transgastric surgery: gastric content leak leads to localized inflammatory response and higher adhesive disease.
Surg Endosc
PUBLISHED: 06-20-2009
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Risk of gastric spillage during transgastric surgery is a potential complication of NOTES procedures. The aim of this study was to determine risk outcomes from gastric spillage in a rat survival model by measuring local and systemic inflammatory markers, adhesive disease, and morbidity.
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Supra-pubic single incision cholecystectomy.
J. Gastrointest. Surg.
PUBLISHED: 06-08-2009
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Surgery is moving towards less invasive and cosmetically superior approaches such as single incision laparoscopy (SIL). While trans-umbilical SIL is gaining popularity, incisions may lead to post-operative deformations of the umbilicus and the possibility of an increased rate of incisional hernias. Access within the pubic hairline allows preservation of the umbilicus and results in a scar which is concealed within the pubic hair.
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The impact of proton-pump inhibitors on intraperitoneal sepsis: a word of caution for transgastric NOTES procedures.
Surg Endosc
PUBLISHED: 05-01-2009
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During transgastric natural orifice transluminal endoscopic surgery (NOTES), there is an iatrogenic perforation of the gastric wall with leakage of gastric contents into the peritoneal cavity. The aim of this study is to determine the effect of proton-pump inhibitors (PPI) and alterations of gastric pH on infection during transgastric surgery.
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Video. NOTES: transvaginal cholecystectomy with assisting articulating instruments.
Surg Endosc
PUBLISHED: 03-13-2009
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Transvaginal cholecystectomy has been performed at several institutions using hybrid natural orifice translumenal endoscopic surgery (NOTES) techniques.
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Natural orifice surgery: initial clinical experience.
Surg Endosc
PUBLISHED: 02-11-2009
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Natural orifice translumenal endoscopic surgery (NOTES) has moved quickly from preclinical investigation to clinical implementation. However, several major technical problems limit clinical NOTES including safe access, retraction and dissection of the gallbladder, and clipping of key structures. This study aimed to identify challenges and develop solutions for NOTES during the initial clinical experience.
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Initial experience with an innovative endoscopic clipping system.
Surg Technol Int
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There are few options for the treatment of fistulas, leaks, and perforations endoscopically. Here we describe our experience with an endoscopic clipping system. A retrospective review of all cases using the Over-The-Scope-Clip system (Ovesco Endoscopy AG, Tuebingen, Germany) was performed. The system was utilized in ten patients with gastrointestinal surgical complications. Four patients had gastric leaks following sleeve gastrectomy, one had a post-operative colonic leak, two had gastro-gastric fistulas following gastric bypass, and three had esophageal perforations. Two leak patients had complete resolution, one had a contained leak following clip placement that was clinically insignificant, and the fourth patient had a persistent leak despite two clipping procedures. Two patients had gastro-gastric fistulas following roux-en-y gastric bypass surgery and, while they both had initial success, the fistulas recurred. One patient presented with anastomotic leak following colon resection but the system was unable to reach the treatment site. Three patients were successfully treated for esophageal perforation. There were no complications. This over-the-scope endoscopic clip system is simple to use, safe, and successful in approximating tissue to treat traditionally difficult surgical complications. Further experience and longer follow-up are needed to assess its indications as related to defect size and location.
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eTAMIS: endoscopic visualization for transanal minimally invasive surgery.
Surg Endosc
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Transanal endoscopic microsurgical (TEM) resection is associated with improved outcomes compared to transanal excision of rectal lesions. However, TEM equipment requires additional operative setup time, and tumor location dictates patient positioning. In 2010, Drs. Attallah, Albert, and Larach developed an alternative technique, transanal minimally invasive surgery (TAMIS). Herein, we describe our novel experience using endoscopic visualization to perform TAMIS (eTAMIS) to remove a large rectal polyp.
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Brief tool to measure risk-adjusted surgical outcomes in resource-limited hospitals.
Arch Surg
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To develop and validate a risk-adjusted tool with fewer than 10 variables to measure surgical outcomes in resource-limited hospitals.
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Examining a common disease with unknown etiology: trends in epidemiology and surgical management of appendicitis in California, 1995-2009.
World J Surg
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The study was designed to examine the epidemiology of appendicitis and risk factors of perforation and appendectomy.
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Demystifying sample-size calculation for clinical trials and comparative effectiveness research: the impact of low-event frequency in surgical clinical research.
Surg Endosc
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Type II error, or not meeting sample-size requirement, has been identified as an issue in the surgical literature. The root of this problem is the low frequency of events in the majority of surgical clinical research. This exponentially increases the sample size needed to achieve statistical significance.
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Feasibility of transrectal hybrid natural orifice transluminal endoscopic surgery (NOTES) nephrectomy in the cadaveric model.
Urology
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To examine feasibility of transrectal hybrid natural orifice transluminal endoscopic surgery (NOTES) nephrectomy in human cadavers in the evolution of this technique, as transrectal hybrid NOTES nephrectomy has been demonstrated in the porcine model.
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Ulcerative colitis.
Lancet
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Ulcerative colitis is an idiopathic, chronic inflammatory disorder of the colonic mucosa, which starts in the rectum and generally extends proximally in a continuous manner through part of, or the entire, colon; however, some patients with proctitis or left-sided colitis might have a caecal patch of inflammation. Bloody diarrhoea is the characteristic symptom of the disease. The clinical course is unpredictable, marked by alternating periods of exacerbation and remission. In this Seminar we discuss the epidemiology, pathophysiology, diagnostic approach, natural history, medical and surgical management, and main disease-related complications of ulcerative colitis, and briefly outline novel treatment options. Enhanced understanding of how the interaction between environmental factors, genetics, and the immune system results in mucosal inflammation has increased knowledge of disease pathophysiology. We provide practical therapeutic algorithms that are easily applicable in daily clinical practice, emphasising present controversies in treatment management and novel therapies.
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Multiview glasses-free 3-D laparoscopy.
IEEE Trans Biomed Eng
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Numerous attempts have been made to introduce three-dimensional (3-D) video systems into clinical routine, particularly for surgeries. The drawback with all of them thus far has been the fact that they require users to wear cumbersome glasses in order to receive the advantage of stereoscopy. In this study, we present, to our best knowledge, the worlds very first laparoscopic surgical system that delivers glasses-free multiview 3-D in high-definition (HD) resolution. In addition to quantitative evaluations of the individual video processing components in our previous studies, we perform an initial subjective study with laparoscopically experienced surgeons, yielding very promising results. This study is still preliminary and requires further evaluation before the system may be introduced into standard surgical routine. Yet, we have developed a fully functioning prototype and successfully demonstrated its potential to numerous surgeons.
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Surgical management trends for cholangiocarcinoma in the USA 1998-2009.
J. Gastrointest. Surg.
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Surgical advancements have improved outcomes for cholangiocarcinoma (CCA) patients, but this expertise is not uniformly available. This research examines CCA surgical treatment patterns.
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Strategies for the care of adults hospitalized for active ulcerative colitis.
Clin. Gastroenterol. Hepatol.
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Ulcerative colitis is a chronic inflammatory disease of the colon; as many as 25% of patients with this disease require hospitalization. The goals of hospitalization are to assess disease severity, exclude infection, administer rapidly acting and highly effective medication regimens, and determine response. During hospitalization, patients should be given venous thromboembolism prophylaxis and monitored for the development of toxic megacolon. Patients who do not respond to intravenous corticosteroids should be considered for rescue therapy with infliximab or cyclosporine. Patients who are refractory to medical therapies or who develop toxic megacolon should be evaluated promptly for colectomy. Patients who do respond to medical therapies should be discharged on an appropriate maintenance regimen when they meet discharge criteria. We review practical evidence-based management principles and propose a day-by-day algorithm for managing patients hospitalized for ulcerative colitis.
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Transgastric large-organ extraction: the initial human experience.
Surg Endosc
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In laparoscopy, it often is the case that port sites are enlarged for specimen extraction. This leads to higher risk of trocar site complications, such as infection or incisional hernia. Natural orifice surgery (NOTES) is beneficial for minimizing these complications, and this is emphasized when the extracted specimen is of large volume. We have been using transgastric technique for appendectomy, cholecystectomy, and laparoscopic sleeve gastrectomy (LSG). Of these transgastric operations, we focus on the one with relatively large-organ extraction: LSG with transoral remnant extraction (TORE). We describe the details and feasibility of this procedure and compare the outcomes to conventional LSG.
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NOTES transvaginal hybrid cholecystectomy: the United States human experience.
Surg Endosc
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"Pure" NOTES and "hybrid" NOTES procedures have gained popularity during the past few years. However, most of these published series have been documented outside the United States.
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Technical aspects of robotic proctectomy.
Surg Laparosc Endosc Percutan Tech
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Robotic proctectomy is at the forefront of surgical innovation, and interest in this technique is rapidly increasing. The advantages of robotic techniques, such as enhanced visualization and improved dexterity along with tireless retraction and the addition of a "fourth arm" are reported to confer an advantage in the pelvis. It is unknown what long-term outcomes may emerge from ongoing clinical trials; however, early studies suggest improved perioperative and oncologic outcomes. Proponents of robotics suggest that robot-assisted procedures are associated with decreased complication rates and fewer conversions to open. This article reviews the pertinent literature on robotic total mesorectal excision and the early reported outcomes. The 3-arm, 4-arm laparoscopic-assisted, and the 4-arm totally robotic techniques for performing robotic proctectomy are described in detail, including port placement and patient position as well as robot docking.
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Surgical malpractice in the United States, 1990-2006.
J. Am. Coll. Surg.
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Information about national trends and predictors of malpractice payments can constructively add to the hotly debated topic of medical malpractice. We sought to evaluate predictors of surgical malpractice payments and to explore national trends.
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Fluorescence-guided surgery allows for more complete resection of pancreatic cancer, resulting in longer disease-free survival compared with standard surgery in orthotopic mouse models.
J. Am. Coll. Surg.
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Negative surgical margins are vital to achieve cure and prolong survival in patients with pancreatic cancer. We inquired if fluorescence-guided surgery (FGS) could improve surgical outcomes and reduce recurrence rates in orthotopic mouse models of human pancreatic cancer.
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Can hospitals "game the system" by avoiding high-risk patients?
J. Am. Coll. Surg.
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It has been suggested that implementation of quality-improvement benchmarking programs can lead to risk-avoidance behaviors in some physicians and hospitals in an attempt to improve their rankings, potentially denying patients needed treatment. We hypothesize that avoidance of high-risk patients will not change risk-adjusted rankings.
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Prophylactic surgery prior to extended-duration space flight: is the benefit worth the risk?
Can J Surg
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This article explores the potential benefits and defined risks associated with prophylactic surgical procedures for astronauts before extended-duration space flight. This includes, but is not limited to, appendectomy and cholecystesctomy. Furthermore, discussion of treatment during space flight, potential impact of an acute illness on a defined mission and the ethical issues surrounding this concept are debated in detail.
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The first national examination of outcomes and trends in robotic surgery in the United States.
J. Am. Coll. Surg.
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There are few population-based data describing outcomes of robotic-assisted surgery. We compared outcomes of robotic-assisted, laparoscopic, and open surgery in a nationally representative population database.
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An LED light source and novel fluorophore combinations improve fluorescence laparoscopic detection of metastatic pancreatic cancer in orthotopic mouse models.
J. Am. Coll. Surg.
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The aim of this study was to improve fluorescence laparoscopy of pancreatic cancer in an orthotopic mouse model with the use of a light-emitting diode (LED) light source and optimal fluorophore combinations.
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Tumor-specific fluorescence antibody imaging enables accurate staging laparoscopy in an orthotopic model of pancreatic cancer.
Hepatogastroenterology
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Laparoscopy is important in staging pancreatic cancer, but false negatives remain problematic. Making tumors fluorescent has the potential to improve the accuracy of staging laparoscopy.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.