This is an open access book. Colorectal surgery is one of the most performed procedures in dedicated colorectal and general surgery units worldwide. In the last two decades, the minimally invasive ...laparoscopic approach has become very popular worldwide, attracting great interest among patients (lower risk of infection, less pain, and faster recovery) and demonstrating excellent oncological results. Technology is improving rapidly, offering revolutionary innovations, particularly with the advent of robotic surgery, which offers important advantages over laparoscopy for both surgeons and patients: improved ergonomics, wristed instruments, and a better vision. These advantages may be particularly useful for more complex and challenging situations (complete mesocolic excision, low rectal cancer, one-stage treatment of colorectal and liver metastases, etc.), translating into potential improved surgical and oncological results. Although several books have been published on the subject, the great interest in robotic surgery makes it mandatory, in our opinion, to have a general update in view of the latest technical innovations and the results of the most relevant and recent literature. The book is divided into chapters dealing with the different colorectal segments with their robotic surgical operations and specific technical variants. The new frontiers of benign and emergency colorectal diseases are also considered, as well as the new robotic platforms recently introduced in the healthcare market. Some of them, such as the da Vinci SP single port device, may represent a revolutionary approach for this surgery. Training and cost aspects were also considered.
This is an open access book. The book focuses mainly on the surgical technique, OR setup, equipments and devices necessary in minimally invasive surgery (MIS). It serves as a compendium of ...endolaparoscopic surgical procedures. It is an official publication of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA). The book includes various sections covering basic skills set, devices, equipments, OR setup, procedures by area. Each chapter cover introduction, indications and contraindications, pre-operative patient’s assessment and preparation, OT setup (instrumentation required, patient’s position, etc.), step by step description of surgical procedures, management of complications, post-operative care. It includes original illustrations for better understanding and visualization of specific procedures. The book serves as a practical guide for surgical residents, surgical trainees, surgical fellows, junior surgeons, surgical consultants and anyone interested in MIS. It covers most of the basic and advanced laparoscopic and thoracoscopic surgery procedures meeting the curriculum and examination requirements of the residents.
Computer-assisted techniques in the surgery of the facial skeleton including the skull base are depicted for the very first time in this atlas of navigational surgery. Experienced surgeons as well as ...trainees will benefit from the detailed and well-illustrated information on the use of computer technology in clinical routine, accompanied by the experimental basis of intraoperative accuracy. The authors` inventions in the field of non-invasive registration have led to widespread use of computer-assisted simulation and navigational surgery in this field, so the time is right for a comprehensive publication on the topic. The interdisciplinary approach brings together maxillofacial surgeons, plastic surgeons, ENT surgeons, and neurosurgeons. New methods of non-invasive referencing and the use of virtual models in the field of oral and cranio-maxillofacial surgery are demonstrated. Clinical cases illustrate the practical use of this new technique.
BACKGROUND:The efficacy of autologous fat transplantation is reduced by fat absorption and fibrosis that are closely related to unsatisfactory vascularization. Extracellular vesicles are key ...components of the cell secretome, which can mirror the functional and molecular characteristics of their parental cells. Growing evidence has revealed that adipose-derived mesenchymal stem cells have the ability to enhance vascularization, which is partly ascribed to extracellular vesicles. The authors evaluated whether adipose-derived mesenchymal stem cell–derived extracellular vesicles improved vascularization of fat grafts and increased their retention rate.
METHODS:To test the angiogenesis ability of adipose-derived mesenchymal stem cell–derived extracellular vesicles, they were isolated from the supernatant of cultured human adipose-derived mesenchymal stem cells and incubated with human umbilical vein endothelial cells in vitro. Then, the vesicles were co-transplanted with fat into nude mice subcutaneously. Three months after transplantation, the retention rate and inflammatory reaction of the grafts were analyzed by histologic assay.
RESULTS:The experimental group could significantly promote migration and tube formation at the concentration of 20 μg/ml. At 3 months after transplantation, the volume of the experimental group (0.12 ± 0.03 mm) was larger compared with the blank group (0.05 ± 0.01 mm). Histology and immunohistology results demonstrated significantly fewer cysts and vacuoles, less fibrosis, and more neovessels in the extracelluar vesicle group.
CONCLUSIONS:The authors co-transplanted adipose-derived mesenchymal stem cell–derived extracellular vesicles with fat into a nude mouse model and found that the vesicles improved volume retention by enhancing vascularization and regulating the inflammatory response.
Purpose Three-dimensional (3D) analysis and planning are powerful tools in craniofacial and reconstructive surgery. The elements include 1) analysis, 2) planning, 3) virtual surgery, 4) 3D printouts ...of guides or implants, and 5) verification of actual to planned results. The purpose of this article is to review different applications of 3D planning in craniomaxillofacial surgery. Materials and Methods Case examples involving 3D analysis and planning were reviewed. Common threads pertaining to all types of reconstruction are highlighted and contrasted with unique aspects specific to new applications in craniomaxillofacial surgery. Results Six examples of 3D planning are described: 1) cranial reconstruction, 2) craniosynostosis, 3) midface advancement, 4) mandibular distraction, 5) mandibular reconstruction, and 6) orthognathic surgery. Conclusions Planning in craniomaxillofacial surgery is useful and has applicability across different procedures and reconstructions. Three-dimensional planning and virtual surgery enhance efficiency, accuracy, creativity, and reproducibility in craniomaxillofacial surgery.
The traditional boundaries of the transsphenoidal approach may be expanded to include the region from the cribriform plate of the anterior cranial base to the inferior clivus in the anteroposterior ...plane, and laterally to expose the cavernous cranial nerves and the optic canal. We review our combined experience with these variations on the transsphenoidal approach to various lesions of the sellar and parasellar region.
From 1982 to 2003, we used the extended and parasellar transsphenoidal approaches in 105 patients presenting with a variety of lesions of the parasellar region. This study specifically reviews the breadth of pathological lesions operated and the complications associated with the approaches.
Variations of the standard transsphenoidal approach have been used in the following series: 30 cases of pituitary adenomas extending laterally to involve the cavernous sinus, 27 craniopharyngiomas, 11 tuberculum/diaphragma sellae meningiomas, 10 sphenoid sinus mucoceles, 18 clivus chordomas, 4 cases of carcinoma of the sphenoid sinus, 2 cases of breast carcinoma metastatic to the sella, and 3 cases of monostotic fibrous dysplasia involving the clivus. There was no mortality in the series. Permanent neurological complications included one case of monocular blindness, one case of permanent diabetes insipidus, and two permanent cavernous cranial neuropathies. There were four cases of internal carotid artery hemorrhage, one of which required ligation of the cervical internal carotid artery and resulted in hemiparesis. The incidence of postoperative cerebrospinal fluid fistulae was 6% (6 of 105 cases).
These modifications of the standard transsphenoidal approach are useful for lesions within the boundaries noted above, they offer excellent alternatives to transcranial approaches for these lesions, and they avoid prolonged exposure time and brain retraction. Technical details are discussed and illustrative cases presented.
We present an overview of the history, development, technological advancements, current application, and future trends of cranial endoscopy. Neuroendoscopy provides a safe and effective management ...modality for the treatment of a variety of intracranial disorders, either tumoral or non-tumoral, congenital, developmental, and degenerative, and its knowledge, indications, and limits are fundamental for the armamentarium of the modern neurosurgeon.
The fourth edition of Implant Restorations: A Step-by-Step Guide provides a wealth of updated and expanded coverage on detailed procedures for restoring dental implants. Focusing on the most common ...treatment scenarios, it offers concise literature reviews for each chapter abd easy-to-follow descriptions of the techniques, along with high-quality clinical photographs demonstrating each step. Comprehensive throughout, this practical guide begins with introductory information on incorporating implant restorative dentistry in clinical practice. It covers diagnosis and treatment planning and digital dentistry, and addresses advances in cone beam computerized tomography (CBCT), treatment planning software, computer generated surgical guides, rapid prototype printing and impression-less implant restorative treatments, intra-oral scanning, laser sintering, and printing/milling polymer materials. Record- keeping, patient compliance, hygiene regimes, and follow-up are also covered. * Provides an accessible step-by-step guide to commonly encountered treatment scenarios, describing procedures and techniques in an easy-to-follow, highly illustrated format * Offers new chapters on diagnosis and treatment planning and digital dentistry * Covers advances in cone beam computerized tomography (CBCT), computer generated surgical guides, intra-oral scanning, laser sintering, and more An excellent and accessible guide on a burgeoning subject in modern dental practice by one of its most experienced clinicians, Implant Restorations: A Step-by-Step Guide, Fourth Edition will appeal to prosthodontists, general dentists, implant surgeons, dental students, dental assistants, hygienists, and dental laboratory technicians.
Background
Damage control surgery is a management sequence initiated to reduce the risk of death in severely injured patients presenting with physiological derangement. Damage control principles have ...emerged as an approach in non‐trauma abdominal emergencies in order to reduce mortality compared with primary definitive surgery.
Methods
A PubMed/MEDLINE literature review was conducted of data available over the past decade (up to August 2013) to gain information on current understanding of damage control surgery for abdominal surgical emergencies. Future directions for research are discussed.
Results
Damage control surgery facilitates a strategy for life‐saving intervention for critically ill patients by abbreviated laparotomy with subsequent reoperation for delayed definitive repair after physiological resuscitation. The six‐phase strategy (including damage control resuscitation in phase 0) is similar to that for severely injured patients, although non‐trauma indications include shock from uncontrolled haemorrhage or sepsis. Minimal evidence exists to validate the benefit of damage control surgery in general surgical abdominal emergencies. The collective published experience over the past decade is limited to 16 studies including a total of 455 (range 3–99) patients, of which the majority are retrospective case series. However, the concept has widespread acceptance by emergency surgeons, and appears a logical extension from pathophysiological principles in trauma to haemorrhage and sepsis. The benefits of this strategy depend on careful patient selection. Damage control surgery has been performed for a wide range of indications, but most frequently for uncontrolled bleeding during elective surgery, haemorrhage from complicated gastroduodenal ulcer disease, generalized peritonitis, acute mesenteric ischaemia and other sources of intra‐abdominal sepsis.
Conclusion
Damage control surgery is employed in a wide range of abdominal emergencies and is an increasingly recognized life‐saving tactic in emergency surgery performed on physiologically deranged patients.
Bail‐out option when patient in extremis
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