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Background: The number of patients demanding endoscopic neck surgery is rising. The access trauma of the axillary, breast and chest approaches is bigger than in open or video assisted surgery. We tested the feasibility of he sublingual transoral access which is in our opinion the only real minimally...-invasive extracollar endoscopic access to the thyroid gland Methods: We performed an experimental investigation in a porcine model. In 10 pigs we made 10 endoscopic transoral thyroidectomys with a modified axilloscope with the help of ultrasonic scissors and a neuro-monitoring system for identification of the recurrent laryngeal nerve. Results: The average operation time from the introduction to the removal of the obturator just above the larynx was 57 seconds. The mean operation time was 43 minutes. With the help of the neuro-monitoring system we proved in all cases the function of the recurrent laryngeal nerve on both sides. The pigs were observed for another two hours after operation. During and after the operation no complications appeared. Conclusions: We could show that the endoscopic transoral thyroid resection in pigs is possible and save. Our results might be useful for using this access for endoscopic thyroid resection in humans.
Robotic surgery was developed to facilitate endoscopic surgery and overcome its disadvantage. Thus, we performed robotic Total Mesorectal Excison (TME) in patient with rectal cancer by using the Intuitive Surgical® da Vinci surgicalTM system (Intuitive Surgical®, Sunnyvale, CA). To our knowledge, ...this is the first robotic low anterior resection base on standard TME principle with pelvic autonomic preservation. In conclusion, Robotic system is the best operative instrument for performing the standard TME procedure in rectal cancer patients.
Natural Orifice Endoscopic Transgastric Distal Pancreatectomy, A Prospective Randomized Controlled Trial. Natural orifice surgery may represent a paradigm shift in the area of minimally invasive surgery and therapeutic endoscopy. However, studies to date have been limited primarily to small ca...se series with small sample sizes. There has been no large rigorous randomized controlled trial of natural orifice surgery to date. Early work on procedures such as peritoneoscopy, oophorectomy and tubal ligation, while pioneering, have reproduced laparoscopic procedures with minimal morbidity and mortality. In contrast, distal pancreatectomy has a post-operative morbidity of more than 50% even in high volume tertiary care centers. As a highly morbid surgery, the post-operative event rate would allow for a significant difference to be seen in a trial of conventional versus NOTES distal pancreatectomy. We have recently completed a prospective randomized controlled trial of NOTES versus laparoscopic distal pancreatectomy in a swine model which builds on our earlier non-survival work. This video focuses on the endoscopic technique.
The Mini Gastric Bypass (MGB) is a short, simple, successful and inexpensive laparoscopic gastric bypass weight loss surgery. The operation usually takes only 30 min., hospitalization less than 24 hours. The Mini Gastric Bypass is low risk, has excellent long term weight loss, minimal pain and can b...e easily reversed or revised.
Repair techniques for various types of asymmetric pectus excavatum are illustrated. Morphology-tailored bar shaping and selecting the hinge points are key elements of the technique. Repair of two cases on an eccentric type and unbalanced type according to "Park Classification" was demonstrated.