Was bringt die Minimalisierung des Zugangstraumas für den Patienten

Hildebrand, P.; Roblick, U. J.; Keller, R.; Kleemann, Markus; Mirow, Lutz; Bruch, Hans–Peter

doi:10.1007/s00104-007-1348-y

Cited by 9 publications

(4 citation statements)

References 37 publications

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“…The concept of natural orifice surgery (NOS) has changed the surgeon’s perspective; natural openings of the body are used by interdisciplinary teams to reach the target region directly, thereby causing minimal tissue trauma. The aim is to reduce collateral damage and complications and to fasten recovery of the patient [17, 26]. In our opinion, a true NOS procedure is a pure endoscopic approach through natural orifices of the body without any additional skin incisions.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Minimally Invasive Thyroidectomy (eMIT): A Prospective Proof‐of‐Concept Study in Humans

Wilhelm¹,

Metzig²

2010

World j. surg.

182

120

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The experimental development of the eMIT technique has led to its first clinical application in humans. In this prospective proof-of-concept study in humans, the thyroid gland was reached via the transoral endoscopic approach in an anatomically defined layer without any relevant damage to vessels. Limitations to this technique are determined by specimen volume (up to 30 ml) and nodule size (up to 20 mm).

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Section: Discussionmentioning

confidence: 99%

Endoscopic Minimally Invasive Thyroidectomy (eMIT): A Prospective Proof‐of‐Concept Study in Humans

Wilhelm¹,

Metzig²

2010

World j. surg.

182

120

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“…Morbidity and mortality rates following several surgical and oncological procedures have significantly improved during the last decades due to the advancement of surgical techniques. Especially the introduction of minimally invasive techniques resulted in many advantages for the patients, i.e., a lesser operative trauma, faster recovery, less pain, and a reduction of the ICU and hospital length of stay [ 7 ]. A randomized controlled trial (TIME trial) also confirmed the superiority of the minimally invasive approach in complex esophageal resections.…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted transthoracic hybrid esophagectomy versus open and laparoscopic hybrid esophagectomy: propensity score matched analysis of short-term outcome

Reinstaller

Adolf

Lorenz

et al. 2022

Langenbecks Arch Surg

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Purpose Minimally invasive en-bloc esophagectomy is associated with a reduction of postoperative morbidity. This was demonstrated for both total minimally invasive and hybrid esophagectomy. However, little is known about any benefits of robotic assistance compared to the conventional minimally invasive technique, especially in hybrid procedures. Methods For this retrospective study, all consecutive patients who had undergone elective esophagectomy with circular stapled intrathoracic anastomosis using the open and the minimally invasive hybrid technique at the University Hospital Magdeburg, from January 2010 to March 2021 were considered for analysis. Results In total, 137 patients (60.4%) had undergone open esophagectomy. In 45 patients (19.8%), the laparoscopic hybrid technique and in 45 patients (19.8%), the robot-assisted hybrid technique were applied. In propensity score matching analysis comparing the open with the robotic hybrid technique, significant differences were found in favor of the robotic technique (postoperative morbidity, p < 0.01; hospital length of stay, p < 0.01; number of lymph nodes retrieved, p = 0.048). In propensity score matching analysis comparing the laparoscopic with the robotic hybrid technique, a significant reduction of the rate of postoperative delayed gastric emptying (p = 0.02) was found for patients who had undergone robotic esophagectomy. However, the operation time was significantly longer (p < 0.01). Conclusions En-bloc esophagectomy using the robotic hybrid technique is associated with a significant reduction of postoperative morbidity and of the hospital length of stay when compared to the open approach. However, when compared to the laparoscopic hybrid technique, only few advantages could be demonstrated.

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“… 11 – 13 Downsizing of incisions, trocar size, and trocar number can help decrease postoperative pain and increase postoperative quality of life. 14 Data from large case series and case registries suggest that TV hybrid NOTES cholecystectomy is safe when performed by surgeons well trained in minimally invasive techniques. 15 – 17 A recent systematic review and meta-analysis of TV hybrid NOTES cholecystectomy 18 supports those findings.…”

mentioning

confidence: 99%

Feasibility and Technique for Transvaginal Natural Orifice Transluminal Endoscopic Surgery Liver Resection: A Porcine Model

Katagiri

Otsuka

Horgan

et al. 2017

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Introduction:Natural orifice transluminal endoscopic surgery (NOTES) is a challenging minimally invasive procedure. Although laparoscopic techniques for liver resection are gaining acceptance worldwide, few studies have investigated NOTES liver resection. We used a porcine model to assess the feasibility and safety of transvaginal NOTES liver resection (TV NOTES LR).Materials and Methods:Nine female pigs underwent TV NOTES LR. A nonsurvival acute porcine model with general anesthesia was used in all cases. Using hybrid NOTES technique, we placed only 1 umbilical 12-mm umbilical trocar in the abdominal wall, which was used to create pneumoperitoneum. A laparoscope was then advanced to obtain intra-abdominal visualization. A 15-mm vaginal trocar was inserted under direct laparoscopic vision, and a flexible endoscope was introduced through the vaginal trocar. A long, flexible grasper and endocavity retractor were used to stably retract the liver. The liver edge was partially transected using energy devices inserted through the umbilical trocar. To transect the left lateral lobe, a flexible linear stapler was inserted alongside the vaginal trocar. A specimen extraction bag was deployed and extracted transvaginally. Blood loss, bile leakage, operative time, and specimen size were evaluated. Necropsy studies were performed after the procedures.Results:Eighteen transvaginal NOTES partial liver resections and 4 transvaginal NOTES left lateral lobectomies were successfully performed on 9 pigs. Mean operative time was 165.8 minutes, and mean estimated blood loss was 76.6 mL. All TV NOTES LRs were performed without complications or deaths. Necropsy showed no bile leakage from remnant liver.Conclusions:Our porcine model suggests that TV NOTES LR is technically feasible and safe and has the potential for clinical use as a minimally invasive alternative to conventional laparoscopic liver resection.

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Was bringt die Minimalisierung des Zugangstraumas für den Patienten

Cited by 9 publications

References 37 publications

Endoscopic Minimally Invasive Thyroidectomy (eMIT): A Prospective Proof‐of‐Concept Study in Humans

Endoscopic Minimally Invasive Thyroidectomy (eMIT): A Prospective Proof‐of‐Concept Study in Humans

Robot-assisted transthoracic hybrid esophagectomy versus open and laparoscopic hybrid esophagectomy: propensity score matched analysis of short-term outcome

Feasibility and Technique for Transvaginal Natural Orifice Transluminal Endoscopic Surgery Liver Resection: A Porcine Model

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