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1

Understanding the pelvic anatomy.  

PubMed

The pelvic anatomy is constant, with few variations. It has a distinct appearance when observed using the 2-dimensional laparoscope. Thus it is important to master the laparoscopic anatomy and use this knowledge to perform better surgery. The laparoscope offers better vision in a narrow space and thus helps better understanding of the anatomy than what can be seen during open surgery. The objectives of this video are to enable the observer to become familiar with the surgical anatomy, to apply anatomical knowledge to develop fine surgical skills, and to address the myths of open surgical anatomy. The lucid graphics, images, and commentary will enable easy understanding of the pelvic anatomy. PMID:24140861

Puntambekar, Shailesh P; Desai, Riddhi; Puntambekar, Seema S; Galagali, Amit; Kenawadekar, Rahul; Joshi, Saurabh; Joshi, Geetanjali Agarwal; Lawande, Akhil

2014-01-01

2

Demonstration of Pelvic Anatomy by Modified Midline Transection that Maintains Intact Internal Pelvic Organs  

ERIC Educational Resources Information Center

Gross dissection for demonstrating anatomy of the human pelvis has traditionally involved one of two approaches, each with advantages and disadvantages. Classic hemisection in the median plane through the pelvic ring transects the visceral organs but maintains two symmetric pelvic halves. An alternative paramedial transection compromises one side…

Steinke, Hanno; Saito, Toshiyuki; Herrmann, Gudrun; Miyaki, Takayoshi; Hammer, Niels; Sandrock, Mara; Itoh, Masahiro; Spanel-Borowski, Katharina

2010-01-01

3

[Functional anatomy of the pelvic floor].  

PubMed

The pelvic floor is the support of the pelvic viscera. The levator ani muscle (LA) with its two bundles (pubo- and iliococcygeus) is the major component of this pelvic floor. LA is formed essentially by type I fibers (slow twitch, with high oxidative capability and presence of slow myosin) as in postural muscles. The aerobic metabolism makes LA fragile to excentric contraction and to mitochondrial dysfunction. The innervation of the pelvic floor comes from the 2nd, 3rd, 4th anterior sacral roots; denervation affects pelvic dynamism. Perineum includes the musculofascial structures under the LA: ventrally the striated sphincter of urethra and the ischiocavernosus and bulbospongiosus, caudally the fatty tissue filling the ischioanal fossa. Pelvic fascia covers the muscles ; it presents reinforcements : the uterosacral and cardinal ligaments, the arcus tendineus fascia pelvis (ATFP) and the arcus tendineus levator ani (ATLA). The pelvis statics is supported by the combined action of all this anatomical structures anteriorly forming the perineal "hammock," medially the uterosacral and cardinal ligaments, posteriorly the rectovaginal fascia and the perineal body. The angles formed by the pelvic viscera with their evacuation ducts participate to the pelvic statics. During the pelvic dynamics the modification of these angles expresses the action of the musculofascial structures. PMID:24260836

Yiou, René; Delmas, Vincent

2013-01-01

4

Laparoscopic Inguinal Exploration and Mesh Placement for Chronic Pelvic Pain  

PubMed Central

Background and Objective: Chronic pelvic pain affects 15% of women. Our objective was to evaluate empiric laparoscopic inguinal exploration and mesh placement in this population. Methods: Retrospective cohort with follow-up questionnaire of women with lateralizing chronic pelvic pain (right or left), ipsilateral inguinal tenderness on pelvic examination, no clinical hernia on abdominal examination, and ipsilateral empiric laparoscopic inguinal exploration with mesh placement (2003–2009). Primary outcome was pain level at the last postoperative visit. Secondary outcomes were pain level and SF-36 scores from the follow-up questionnaire. Results: Forty-eight cases met the study criteria. Surgery was done empirically for all patients, with only 7 patients (15%) found to have an ipsilateral patent processus vaginalis (shallow peritoneal dimple or a deeper defect (occult hernia)). Of 43 cases informative for the primary outcome, there was pain improvement in 15 patients (35%); pain improvement then return of the pain in 18 patients (42%); and pain unchanged in 9 patients (21%) and worse in 1 patient (2%). Improvement in pain was associated with a positive Carnett's test in the ipsilateral abdominal lower quadrant (P = .024). Thirteen patients returned the questionnaire (27%), and the pain was now described as improved in 9 patients (69%), unchanged in 4 patients (31%), and worse in none. Three SF-36 subscales showed improvement (physical functioning, social functioning, and pain). Conclusion: In select women with chronic pelvic pain, empiric laparoscopic inguinal exploration and mesh placement results in moderate improvement in outcome. A positive Carnett's test in the ipsilateral abdominal lower quadrant is a predictor of better outcome. PMID:23743375

Williams, Christina; Allaire, Catherine

2013-01-01

5

Laparoscopy for pelvic floor disorders.  

PubMed

Surgical treatment of pelvic floor disorders has significantly evolved during the last decade, with increasing understanding of anatomy, pathophysiology and the minimally-invasive 'revolution' of laparoscopic surgery. Laparoscopic pelvic floor repair requires a thorough knowledge of pelvic floor anatomy and its supportive components before repair of defective anatomy is possible. Several surgical procedures have been introduced and applied to treat rectal prolapse syndromes. Transabdominal procedures include a variety of rectopexies with the use of sutures or prosthesis and with or without resection of redundant sigmoid colon. Unfortunately there is lack of one generally accepted standard treatment technique. This article will focus on recent advances in the management of pelvic floor disorders affecting defecation, with a brief overview of contemporary concepts in pelvic floor anatomy and different laparoscopic treatment options. PMID:24485256

Van Geluwe, B; Wolthuis, A; D'Hoore, A

2014-02-01

6

Laparoscopic removal of a pelvic cyst associated with obstructed megaureter and dysplastic renal remnant.  

PubMed

We report a case of a 41-year-old man with a solitary functioning left kidney and history of chronic pelvic discomfort associated with lower urinary tract symptoms. Imaging revealed a large cystic structure in the pelvis attached to a dilated tortuous ureter on the right with congenital absence of the right kidney. The patient underwent laparoscopic removal of the pelvic cyst and dilated right ureter. Pathological assessment revealed mesonephric remnants representing dysplastic renal tissue attached to a dilated and obstructed megaureter, extending into the bladder wall and forming a large pelvic cyst. The patient's symptoms resolved. A laparoscopic approach represents an excellent surgical option for pelvic pathology. PMID:19424474

Pianezza, Michael L; Estey, Eric P

2009-04-01

7

Laparoscopic removal of a pelvic cyst associated with obstructed megaureter and dysplastic renal remnant  

PubMed Central

We report a case of a 41-year-old man with a solitary functioning left kidney and history of chronic pelvic discomfort associated with lower urinary tract symptoms. Imaging revealed a large cystic structure in the pelvis attached to a dilated tortuous ureter on the right with congenital absence of the right kidney. The patient underwent laparoscopic removal of the pelvic cyst and dilated right ureter. Pathological assessment revealed mesonephric remnants representing dysplastic renal tissue attached to a dilated and obstructed megaureter, extending into the bladder wall and forming a large pelvic cyst. The patient’s symptoms resolved. A laparoscopic approach represents an excellent surgical option for pelvic pathology. PMID:19424474

Pianezza, Michael L.; Estey, Eric P.

2009-01-01

8

Pelvic peritonization after laparoscopic abdominoperineal resection for low-rectal carcinoma treatment: surgical technique.  

PubMed

Abdominoperineal resection is a standard method of low-rectum carcinoma treatment. It is associated with significant morbidity and mortality rates, which decreased with the development of preoperative diagnostic procedures, new surgical techniques and new surgical instruments. In this article, laparoscopic pelvic peritonization was used after laparoscopic rectum amputation for low-rectum carcinoma treatment. Pelvic peritonization is performed after laparoscopic recto-sigmoid extirpation, using the extended absorbable intracorporeal suture with titanic clip application after every second suture. The role of titanic clip is to grasp the extended suture and to mark the postoperative irradiation field. Laparoscopic pelvic peritonization after laparoscopic abdominoperineal rectum amputation is a simple procedure with clinical importance in possible adhesion and postirradiatic enteritis prevention. This procedure can satisfy all oncological requirements and minimally invasive surgery principles and is acceptable for every patient in which rectum amputation is indicated. PMID:19760934

Druzijani?, Nikica; Perko, Zdravko; Srsen, Darko; Pogoreli?, Zenon; Schwarz, Dragan; Jurici?, Josko

2009-01-01

9

Muscle architecture and functional anatomy of the pelvic limb of the ostrich (Struthio camelus)  

Microsoft Academic Search

The functional anatomy of the pelvic limb of the ostrich ( Struthio camelus ) was investigated in order to assess musculoskeletal specialization related to locomotor performance. The pelvic limbs of ten ostriches were dissected and detailed measurements of all muscle tendon units of the pelvic limb were made, including muscle mass, muscle length, fascicle length, pennation angle, tendon mass and

N. C. Smith; A. M. Wilson; K. J. Jespers; R. C. Payne

2006-01-01

10

A novel technique of uterine manipulation in laparoscopic pelvic oncosurgical procedures: "the uterine hitch technique".  

PubMed

Aim. To describe a new technique of uterine manipulation in laparoscopic management of pelvic cancers. Material and Methods. We used a novel uterine hitch technique in 23 patients from May 2008 to October 2008. These patients underwent pelvic oncologic surgery including laparoscopic radical hysterectomy (n = 7), laparoscopic anterior resection (n = 4), laparoscopic abdominoperineal resection (n = 3), laparoscopic posterior exenteration (n = 4), or laparoscopic anterior exenteration (n = 5). The uterus was hitched to the anterior abdominal.wall by either a single suture in the fundus or by sutures through the round ligaments. Results. The uterine hitch technique was successfully accomplished in all procedures. It was performed in less than 5 minutes in all cases. It obviated the need for vaginal manipulation. An extra port for retraction could be avoided. There were no intraoperative complications. Conclusion. A practical, cheap and reproducible method for uterine manipulation, during pelvic oncologic surgery is described. It improves the stability of the uterus and also obviates the need for keeping an additional assistant for vaginal manipulation in any of the procedures. PMID:22091356

Puntambekar, S P; Patil, A M; Rayate, N V; Puntambekar, S S; Sathe, R M; Kulkarni, M A

2010-01-01

11

Laparoscopic Pyeloplasty for Ureteropelvic Junction Obstruction in Crossed Fused Ectopic Pelvic Kidney  

PubMed Central

Crossed fused renal ectopia is a rare anomaly and may be associated with pelvic ureteric junction obstruction (PUJO). The L-shaped fusion variety is even rarer. We report such a case with a crossed fused ectopic pelvic kidney (L-type) with PUJO and its successful laparoscopic management. Through this report we emphasize the importance of adequate preoperative imaging and intraoperative details to avoid mishaps.

Muruganandham, Kalyaperumal; Kumar, Santosh

2014-01-01

12

Laparoscopic removal of a pelvic cyst associated with obstructed megaureter and dysplastic renal remnant  

Microsoft Academic Search

We report a case of a 41-year-old man with a solitary function- ing left kidney and history of chronic pelvic discomfort associ- ated with lower urinary tract symptoms. Imaging revealed a large cystic structure in the pelvis attached to a dilated tortuous ureter on the right with congenital absence of the right kidney. The patient underwent laparoscopic removal of the

Michael L. Pianezza; Eric P. Estey

2009-01-01

13

Advances in laparoscopic techniques in pelvic reconstructive surgery for prolapse and incontinence.  

PubMed

Advances in minimally invasive surgery have led to an increasing adoption of laparoscopic techniques in pelvic reconstructive surgery and treatment of urinary incontinence. Our review of recent developments aims to identify and evaluate the evidence for use of these procedures. Recent literature continues to support the use of laparoscopy for colposuspension and sacrocolpopexy, as an effective alternative to open surgery. However, with the advent of retropubic mid-urethral slings for stress urinary incontinence, laparoscopic Burch colposuspension has now become obsolete. There are relatively few reports on other laparoscopic prolapse procedures, such as uterosacral ligament vault suspension, uterine suspension, paravaginal defect repair and rectocele repair. In conclusion, several short-term studies support the use of laparoscopy in pelvic reconstructive surgery and urogynaecology but longer-term investigations are needed to confirm their findings. PMID:19231115

Price, Natalia; Jackson, Simon R

2009-03-20

14

Laparoscopic Sacrocolpopexy with Two Separate Meshes along the Anterior and Posterior Vaginal Walls for Multicompartment Pelvic Organ Prolapse  

Microsoft Academic Search

Study ObjectiveTo assess the feasibility and results of laparoscopic sacrocolpopexy (LSC) with two separate meshes along the anterior and posterior vaginal walls in correcting multicompartment pelvic organ prolapse (POP).

Pierre Gadonneix; Alfredo Ercoli; Delphine Salet-Lizée; Odile Cotelle; Brigitte Bolner; Michel Van Den Akker; Richard Villet

2004-01-01

15

Anatomy of the pelvic floor for translevatoric-transsphincteric operations.  

PubMed

The parasacral transsphincteric-translevatoric approach has proved of great interest in surgery of the lower rectum and urogenital organs. Due to this experience, anatomic specimens of the pelvic floor and pelvic organs were prepared in order to perfect the operative technique. The anatomic specimens show the pelvic floor and sphincter muscles and the blood supply by the pudendal vessels and nerve, as well as the topography of pelvic organs and fascias from the view of a surgeon performing parasacral surgery. The clinical experience with 118 cases of parasacral translevatoric-transsphincteric interventions at the Departments of Surgery of the University Hospital, Basel, and the Canton Hospital, Luzern, Switzerland, is presented. The results were mainly good. The operation technique is illustrated with selected cases of rectum resection, procedures for treatment of urethrorectal fistulas, reconstruction of pelvic floor for malformations, and reconstruction of injured urethra. PMID:3579034

Huber, A; von Hochstetter, A; Allgöwer, M

1987-05-01

16

Extraperitoneal Pelvic laparoscopic disconnection of accessory urethra from normal urethra in a case of urethral duplication.  

PubMed

We report an extraperitoneal pelvic laparoscopic approach to disconnect accessory urethra from normal urethra in complete urethral duplication. First stage consisted of chordee correction, partial excision of the accessory urethra and glansplasty. In the second stage the remaining accessory urethra was disconnected from the normal urethra through a pre-peritoneal minimal access approach to the retropubic space. The remaining distal mucosa was ablated using monopolar cautery. PMID:24741219

Pant, Nitin; Aggarwal, Satish Kumar

2014-04-01

17

[Laparoscopic [corrected] Hartmann's reversal procedure and posterior pelvic exenteration for rectal carcinoma].  

PubMed

Hartmann's Reversal procedure is a major surgical procedure and high morbidity rates has been reported. Many institutions has begun to apply the this procedure by laparoscopy achieving low morbidity rates, due to less eventrations, wound infections and less days of hospitalization, among others. We present a case of locally advance rectal cancer that was formerly submitted to a posterior radical pelvic exenteration that received postoperative chemoradiation, followed by a laparoscopic Hartmann reversal without any complications. PMID:18641784

Pilco Castañeda, Paul

2008-01-01

18

Laparoscopic Reconstructive Surgery is Superior to Vaginal Reconstruction in the Pelvic Organ Prolapse  

PubMed Central

Background: Our purpose was to provide the clinical advantages of the laparoscopic approach compare to the vaginal approach in correcting uterine and vaginal vault prolapse. Methods: Between June 2007 and June 2011, 174 women were admitted to HUMC (Hallym University Medical Center) and underwent pelvic reconstructive surgery for prolapsed vaginal vault and uterus. Upon retrospective review of the medical records, 174 of the patients who had symptoms of pelvic organ prolapsed and Baden-Walker prolapse grade ? 2 were selected and divided into two groups as follows: vaginal approach group (n=120) and laparoscopic approach group (n=54). We compared the results of clinical outcome by analyzing Student's t-test and ?2-test or the Fisher exact test as appropriate. Results: There were significant difference in success rates without reoperation for recurrence as 91.7% (vaginal approach group, n=110) vs 100% (laparoscopic approach group, n=54), p=0.032. Mean follow-up duration was 31.3 ± 7.6 months for vaginal approach group and 29.7 ± 9.7 months for laparoscopic approach group. The Foley catheter indwelling duration (4.7± 1.9 vs 3.4±2.1 days, p< 0.001) and the length of postoperative hospitalization (6.4 ± 2.1 vs 5.0 ± 1.9 days, p <0.001) were significantly longer in vaginal approach group, whereas the operative time was significantly longer (108.2 ± 38.6 vs 168.3 ± 69.7 minutes, p <0.001) in laparoscopic approach group. Conclusions: Our result suggest there is significantly lower recurrence rate requiring reoperation and less catheterization time but increased operative time for laparascopic sacrocolpopexy.

Park, Young-Han; Yang, Seong Cheon; Park, Sung Taek; Park, Sung Ho; Kim, Hong Bae

2014-01-01

19

Functional specialisation of pelvic limb anatomy in horses (Equus caballus)  

Microsoft Academic Search

We provide quantitative anatomical data on the muscle-tendon units of the equine pelvic limb. Specifically, we recorded muscle mass, fascicle length, pennation angle, tendon mass and tendon rest length. Physiological cross sectional area was then determined and maximum isometric force estimated. There was proximal-to-distal reduc- tion in muscle volume and fascicle length. Proximal limb tendons were few and, where present,

R. C. Payne; J. R. Hutchinson; J. J. Robilliard; N. C. Smith; A. M. Wilson

2005-01-01

20

Robot-assisted laparoscopic sacrouteropexy for pelvic organ prolapse in classical bladder exstrophy.  

PubMed

Classical bladder exstrophy is a rare congenital anomaly with male predominance. When occurring in women, the accompanying anatomical and functional abnormalities, including pelvic organ prolapse (POP), may cause significant problems in both pediatric and adult patients. The robotic surgical approach to POP has not been described for bladder exstrophy as it has been in otherwise normal women. We report our technique with the first robot-assisted laparoscopic sacrouteropexy for Baden-Walker grade-four POP in an 18-year-old classical bladder exstrophy patient. At 12 months of follow-up, there were no issues or symptoms/evidence of recurrence of POP. To our knowledge, this is the first reported robot-assisted laparoscopic sacrouteropexy for POP in a previously repaired bladder exstrophy case. This procedure may be a viable option in selected patients. PMID:20423288

Benson, Aaron D; Kramer, Brandan A; McKenna, Patrick H; Schwartz, Bradley F

2010-04-01

21

Surgical excision of umbilical endometriotic lesions with laparoscopic pelvic observation is the way to treat umbilical endometriosis.  

PubMed

Primary umbilical endometriosis is extremely rare, although cases secondary to previous surgery have occasionally been reported. Here, we report three cases of umbilical endometriosis: two cases with previous cesarean section and one case of primary umbilical endometriosis. The treatment of choice for umbilical endometriosis is the excision of the lesions, and we believe laparoscopic pelvic observation is a beneficial addition, as 13%-15% of umbilical endometriosis cases are accompanied by pelvic endometriosis. PMID:25354378

Chikazawa, Kenro; Mitsushita, Junji; Netsu, Sachiho; Konno, Ryo

2014-11-01

22

Robot-assisted laparoscopic prostatectomy in a 68-year-old patient with previous heart transplantation and pelvic irradiation  

Microsoft Academic Search

We report the case of a 68-year-old man who had previously undergone heart transplantation and pelvic irradiation for Hodgkin’s\\u000a lymphoma and who was under active surveillance for prostate cancer. In response to his increased prostate-specific antigen\\u000a levels and elevated Gleason score, he was offered robot-assisted laparoscopic prostatectomy.

Karol Axcrona; Ljiljana Vlatkovic; Jarl Hovland; Bjørn Brennhovd; Ulf Kongsgaard; Karl-Erik Giercksky

23

[Robotic assisted laparoscopic colposacropexy in the treatment of pelvic organ prolapse].  

PubMed

Laparoscopic colposacropexy has become a substitute for open surgery in the treatment of pelvic organ prolapse. In the same way, robotic assisted surgery is a new step in the evolution of the procedure. In this paper we intend to show our surgical technique and preliminary results. From November 2006 to date, 10 patients have undergone this procedure at the Hospital Clinico San Carlos. The main indication for the operation was existence of symptomatic pelvic prolapse. Both patients with or without hysterectomy have been operated, without making significant differences between them. Preoperative evaluation workout included: cystogram, urinary tract ultrasound and urodynamics in all cases; urinary tract MRI was performed only in selected cases. All patients underwent surgery under general anesthesia, with at least three robotic trocars (8 mm) and one conventional trocar for the assistant; 2 accessory trocars were necessary in some cases, mainly at the beginning of the series. Most procedures in our series were associated with a transobturator suburethral sling for the treatment of stress urinary incontinence or prevention of its appearance after prolapse repair. Our results are comparable to those reported in other larger series in terms of operative time, hospital stay and early or late complications. Pending an evaluation on the long term with larger series, we can include robot assisted colposacropexy among the therapeutic options for symptomatic pelvic floor prolapse repair. PMID:17626540

Moreno Sierra, Jesús; Galante Romo, Isabel; Ortiz Oshiro, Elena; Núñez Mora, Carlos; Silmi Moyano, Angel

2007-05-01

24

Comparative study of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in the management of large renal pelvic stones  

PubMed Central

Background The aim of the study is to investigate whether laparoscopic pyelolithotomy (LPL) could be used to manage large renal pelvic stones, generally considered excellent indications for percutaneous nephrolithotomy (PNL). Methods: This study was performed from May 2009 to March 2012 at Al-Azhar University Hospitals (Assiut and Cairo), Egypt. It included two groups of patients with large renal pelvic stones; only patients with stones 2.5 cm2 or greater were included. Group 1 included 40 patients treated by PNL and Group 2 included 10 patients treated by LPL. The differences between the two procedures were compared and analyzed. Results: There was no difference between the two groups regarding patient demographics and stone size. There was a statistically significant difference between the groups regarding mean estimated blood loss (65 ± 12.25 [range: 52.75–77.25] vs. 180 ± 20.74 [range: 159.26–200.74] mL, p ? 0001), mean hospital stay (2.3 ± 0.64 [range: 1.66–2.94] vs. 3.7 ± 1.4 [range: 2.3–5.1] days, p ? 0.006), rate of postoperative blood transfusion (0% vs. 4.8%, p ? 0.0024), and stone-free rate (80% vs. 78.6%, p ? 0.23). The mean operative time was significantly longer in Group 2 (LPL) (131 ± 22.11 [range: 108.89–153.11) vs. 51.19 ± 24.39 [range: 26.8–75.58] min, p ? 0001), respectively. Conclusion: Although PNL is the standard treatment in most cases of renal pelvic stones, LPL is another feasible surgical technique for patients with large renal pelvic stones. PMID:23589752

Haggag, Yasser M.; Morsy, Gamal; Badr, Magdy M.; Al Emam, Abdel Baset A.; Farid, Mourad; Etafy, Mohamed

2013-01-01

25

Prostate position relative to pelvic bony anatomy based on intraprostatic gold markers and electronic portal imaging  

SciTech Connect

Purpose: To describe the relative positions and motions of the prostate, pelvic bony anatomy, and intraprostatic gold fiducial markers during daily electronic portal localization of the prostate. Methods and Materials: Twenty prostate cancer patients were treated supine with definitive external radiotherapy according to an on-line target localization protocol using three or four intraprostatic gold fiducial markers and an electronic portal imaging device. Daily pretherapy and through-treatment electronic portal images (EPIs) were obtained for each of four treatment fields. The patients' pelvic bony anatomy, intraprostatic gold markers, and a best visual match to the target (i.e., prostate) were identified on simulation digitally reconstructed radiographs and during daily treatment setup and delivery. These data provided quantitative inter- and intrafractional analysis of prostate motion, its position relative to the bony anatomy, and the individual intraprostatic fiducial markers. Treatment planning margins, with and without on-line localization, were subsequently compared. Results: A total of 22,266 data points were obtained from daily pretherapy and through-treatment EPIs. The pretherapy three-dimensional (3D) average displacement of the fiducial markers, as a surrogate for the prostate, was 5.6 mm, which improved to 2.8 mm after use of the localization protocol. The bony anatomy 3D average displacement was 4.4 mm both before and after localization to the prostate (p = 0.46). Along the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) axes, the average prostate displacement improved from 2.5, 3.7, and 1.9 mm, respectively, before localization to 1.4, 1.6, and 1.1 mm after (all p < 0.001). The pretherapy to through-treatment position of the bony landmarks worsened from 1.7 to 2.5 mm (p < 0.001) in the SI axis, remained statistically unchanged at 2.8 mm (p = 0.39) in the AP axis, and improved from 2.0 to 1.2 mm in the RL axis (p < 0.001). There was no significant intrafractional displacement of prostate position or bony anatomic landmarks. An intermarker distance was identified for all fiducial markers, and 96 were followed daily. Seventy-nine percent had a standard deviation of <1 mm, and 96% were <1.5 mm. Margins were 5.1, 7.3, and 5.0 mm in the SI, AP, and RL axes, respectively, before localization and 2.7, 2.9, and 2.8 mm after localization. Conclusions: Significant interfractional motion exists for patients' prostate and pelvic bony anatomy. However, these move independently, so the pelvic bony anatomy should not be used as a surrogate for prostate motion. Fiducial markers are stable within the prostate and allow significant margin reduction when used for on-line localization of the prostate.

Schallenkamp, John M. [Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States); Herman, Michael G. [Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States)]. E-mail: herman.michael@mayo.edu; Kruse, Jon J. [Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States); Pisansky, Thomas M. [Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States)

2005-11-01

26

Long-term experience on laparoscopic incontinent urinary diversion unrelated to cystectomy in radiated or recurrent pelvic malignancies  

PubMed Central

BACKGROUND: There are few reports describing series of cases about development on laparoscopic urinary diversions no related to cystectomy. The aim of this paper is to show the experience of our reference institutions for treatment of pelvic malignancies when laparoscopic techniques were applied to perform only urinary diversion without cystectomy or pelvic exenteration. MATERIALS AND METHODS: We included retrospectively 12 cases of cutaneous ureterostomy and 21 cases with a reservoir (16 ileal conduits, 2 colonic conduits and 3 wet colostomies) treated in our institute from 2004 to 2010. It was evaluated operative time, blood loss, intraoperative complications, conversion rate, length of large incision, post operative complications, analgesic consumption, time to food intake, hospital stay, time to recovery to normal activities. Mean time to follow-up was 3(2-7) years. RESULTS: All procedures were completed without conversions. In the cutaneous ureterostomy group the mean surgical time. PMID:23626412

Tobias-Machado, Marcos; Lopes, Leonardo S; de Araujo, Felipe Brandao Correa; Starling, Eduardo S; Pompeo, Antonio Carlos Lima

2013-01-01

27

Robotic Radical Hysterectomy Versus Total Laparoscopic Radical Hysterectomy With Pelvic Lymphadenectomy for Treatment of Early Cervical Cancer  

PubMed Central

Background and Objectives: To compare intraoperative, pathologic and postoperative outcomes of robotic radical hysterectomy (RRH) to total laparoscopic radical hysterectomy (TLRH) in patients with early stage cervical carcinoma. Methods: We prospectively analyzed cases of TLRH or RRH with pelvic lymphadenectomy performed for treatment of early cervical cancer between 2000 and 2008. Results: Thirty patients underwent TLRH and pelvic lymph-adenectomy for cervical cancer from August 2000 to June 2006. Thirteen patients underwent RRH and pelvic lymph-adenectomy for cervical cancer from April 2006 to January 2008. There were no differences between groups for age, tumor histology, stage, lymphovascular space involvement or nodal status. No statistical differences were observed regarding operative time (323 vs 318 min), estimated blood loss (157 vs 200 mL), or hospital stay (2.7 vs 3.8 days). Mean pelvic lymph node count was similar in the two groups (25 vs 31). None of the robotic or laparoscopic procedures required conversion to laparotomy. The differences in major operative and postoperative complications between the two groups were not significant. All patients in both groups are alive and free of disease at the time of last follow up. Conclusion: Based on our experience, robotic radical hysterectomy appears to be equivalent to total laparoscopic radical hysterectomy with respect to operative time, blood loss, hospital stay, and oncological outcome. We feel the intuitive nature of the robotic approach, magnification, dexterity, and flexibility combined with significant reduction in surgeon's fatigue offered by the robotic system will allow more surgeons to use a minimally invasive approach to radical hysterectomy. PMID:18765043

Datta, M. Shoma; Liu, Connie; Chuang, Linus; Zakashansky, Konstantin

2008-01-01

28

Total laparoscopic hysterectomy: a tried and tested technique.  

PubMed

Gynecologists are increasingly adopting total laparoscopic hysterectomy as their preferred method for performing a hysterectomy. The laparoscopic approach offers a superior view of the anatomy, facilitates meticulous hemostasis, enables the surgeon to perform adnexal surgery and pelvic reconstructive surgery, and reduces morbidity associated with large abdominal incisions. During the last 10 years, the surgeons at the Sydney Women's Endosurgery Centre (SWEC) have developed a laparoscopic technique using the same well-known steps as in the open abdominal approach. The ovarian pedicles are ligated, the uterine pedicles and vaginal vault are sutured laparoscopically, and some novel time-saving maneuvers are adopted. PMID:15922986

Elkington, Nicholas; Cario, Gregory; Rosen, David; Carlton, Mark; Chou, Danny

2005-01-01

29

Laparoscopic diagnosis and treatment of pelvic benign multicystic mesothelioma associated with high CA19.9 serum concentration.  

PubMed

We report a case of benign multicystic mesothelioma in a 20-year-old woman referred because of amenorrhea. She underwent pelvic transabdominal ultrasound, which disclosed a micropolycystic appearance of the ovaries and a fluid collection in the pouch of Douglas. Tumor serum markers revealed an increase in CA19.9. Abdominal and pelvic computed tomography scans confirmed the presence of ascites. Laparoscopy disclosed small, thin-walled, translucent cysts in the Douglas cavity. The cysts were free-floating in a yellowish, sticky, gelatinous material. Microscopically, cystic lesions showed mesothelium-lined cystic spaces surrounded by a delicate thin fibrovascular wall. With immunohistochemistry, the tumor cells were strongly positive for cytokeratin and calretinin. These aspects were suggestive of benign multicystic mesothelioma. Electron microscopy confirmed the mesothelial nature of this tumor. Serial evaluation of the CA19.9 concentration showed a progressive decrease in the serum marker in the normal range. The patient is now well and symptom-free with no recurrence 24 months after surgery. The association between benign multicystic mesothelioma and increased CA19.9 serum concentration has been described only once, in a man. To our knowledge, this is the second case of benign multicystic mesothelioma associated with increased CA19.9 serum concentration and the first diagnosed in a woman. In the present case, a minimally invasive laparoscopic approach enabled not only histologic diagnosis of benign multicystic mesothelioma but also its surgical treatment. Although benign multicystic mesothelioma is a rare pathologic entity, it is important that sonologists include it in the differential diagnosis of diseases that manifest with ascites. Furthermore, all surgeons should be aware of the macroscopic and laparoscopic appearance of the lesion, and its generally benign course. PMID:20226419

Pinto, Vincenzo; Rossi, Angela Cristina; Fiore, Maria Grazia; D'Addario, Vincenzo; Cicinelli, Ettore

2010-01-01

30

Mapping of nodal disease in locally advanced prostate cancer: Rethinking the clinical target volume for pelvic nodal irradiation based on vascular rather than bony anatomy  

SciTech Connect

Purpose: Toxicity from pelvic irradiation could be reduced if fields were limited to likely areas of nodal involvement rather than using the standard 'four-field box.' We employed a novel magnetic resonance lymphangiographic technique to highlight the likely sites of occult nodal metastasis from prostate cancer. Methods and Materials: Eighteen prostate cancer patients with pathologically confirmed node-positive disease had a total of 69 pathologic nodes identifiable by lymphotropic nanoparticle-enhanced MRI and semiquantitative nodal analysis. Fourteen of these nodes were in the para-aortic region, and 55 were in the pelvis. The position of each of these malignant nodes was mapped to a common template based on its relation to skeletal or vascular anatomy. Results: Relative to skeletal anatomy, nodes covered a diffuse volume from the mid lumbar spine to the superior pubic ramus and along the sacrum and pelvic side walls. In contrast, the nodal metastases mapped much more tightly relative to the large pelvic vessels. A proposed pelvic clinical target volume to encompass the region at greatest risk of containing occult nodal metastases would include a 2.0-cm radial expansion volume around the distal common iliac and proximal external and internal iliac vessels that would encompass 94.5% of the pelvic nodes at risk as defined by our node-positive prostate cancer patient cohort. Conclusions: Nodal metastases from prostate cancer are largely localized along the major pelvic vasculature. Defining nodal radiation treatment portals based on vascular rather than bony anatomy may allow for a significant decrease in normal pelvic tissue irradiation and its associated toxicities.

Shih, Helen A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States) and Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital, Boston, MA (United States)]. E-mail: hshih@partners.org; Harisinghani, Mukesh [Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Wolfgang, John A. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Saksena, Mansi [Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital, Boston, MA (United States); Weissleder, Ralph [Center for Molecular Imaging Research, Department of Radiology, Massachusetts General Hospital, Boston, MA (United States)

2005-11-15

31

A Cone Beam CT-Based Study for Clinical Target Definition Using Pelvic Anatomy During Postprostatectomy Radiotherapy  

SciTech Connect

Purpose: There are no accepted guidelines for target volume definition for online image-guided radiation therapy (IGRT) after radical prostatectomy (RP). This study used cone beam CT (CBCT) imaging to generate information for use in post-RP IGRT. Methods and Materials: The pelvic anatomy of 10 prostate cancer patients undergoing post-RP radiation therapy (RT) to 68.4 Gy was studied using CBCT images obtained immediately before treatment. Contoured bladder and rectal volumes on CBCT images were compared with planning CT (CT{sub ref}) volumes from seminal vesicle stump (SVS) to bladder-urethral junction. This region was chosen to approximate the prostatic fossa (PF) during a course of post-RP RT. Anterior and posterior planning target volume margins were calculated using ICRU report 71 guidelines, accounting for systematic and random error based on bladder and rectal motion, respectively. Results: A total of 176 CBCT study sets obtained 2 to 5 times weekly were analyzed. The rectal and bladder borders were reliably identified in 166 of 176 (94%) of CBCT images. Relative to CT{sub ref}, mean posterior bladder wall position was anterior by 0.1 to 1.5 mm, and mean anterior rectum wall position was posterior by 1.6 to 2.7 mm. Calculated anterior margin as derived from bladder motion ranged from 5.9 to 7.1 mm. Calculated posterior margin as derived from rectal motion ranged from 8.6 to 10.2 mm. Conclusions: Normal tissue anatomy was definable by CBCT imaging throughout the course of post-RP RT, and the interfraction anteroposterior motion of the bladder and rectum was studied. This information should be considered in devising post-RP RT techniques using image guidance.

Showalter, Timothy N.; Nawaz, A. Omer; Xiao Ying; Galvin, James M. [Department of Radiation Oncology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States); Valicenti, Richard K. [Department of Radiation Oncology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States)], E-mail: richard.valicenti@mail.tju.edu

2008-02-01

32

The Functional Anatomy of the Female Pelvic Floor and Stress Continence Control System  

PubMed Central

This paper provides an overview of the functional anatomy of the structures responsible for controlling urinary continence under stress. The stress continence control system can be divided into two parts: the system responsible for bladder neck support, and the system responsible for sphincteric closure. Age- and injury-related changes in each of these systems are discussed. Understanding the pathophysiology of incontinence on the anatomical level will help to lead to identification of specific defects, thereby allowing better individualized treatment for the incontinent patient. PMID:11409608

Ashton-Miller, James A.; Howard, Denise; DeLancey, John O. L.

2005-01-01

33

Esophageal Anatomy and Function in Laparoscopic Gastric Restrictive Bariatric Surgery: Implications for Patient Selection  

Microsoft Academic Search

Background: The purpose of this study was to assess factors of clinical importance in morbidly obese patients having a laparoscopically\\u000a adjustable gastric band (LAP-BAND?) implanted in order to achieve weight loss. Methods: Preoperative evaluation of hiatus\\u000a hernia and esophageal (dys)motility were compared with the need for reoperation. Results are presented for the first 50 consecutive\\u000a patients entered. Results: Nine of

Robert J Greenstein; A. Nissan; B Jaffin

1998-01-01

34

A new order of D2 lymphadenectomy in laparoscopic gastrectomy for cancer: live anatomy-based dissection.  

PubMed

It was the aim of this study to develop a methodology for dissection in laparoscopic distal gastrectomy with D2 lymphadenectomy (D2 LDG) for gastric cancer. One-hundred and thirty-two patients with distal gastric cancer underwent D2 LDG with a novel sequence of lymph node dissection between August 2004 and June 2008. Live anatomy in each step was observed simultaneously to ensure and confirm the newly developed methodology. Dissections in LDG were standardized as sequential steps: Dividing the gastrocolic ligament and getting access to the prepancreatic space--lymph node dissection in the lower left area--lymph node dissection in the lower right area--lymph node dissection in the upper right area--lymph nodes dissection centrally--lymph node dissection between liver and stomach. All dissections were successfully performed in peripancreatic spaces and their extensions. Gastric vessels were located by special landmarks, traced along vascular trunks and bifurcations, and identified by fine dissection technique in vaginavasorum. Sequential dissection around the pancreas was an effective method for D2 LDG. It was ensured by anatomical knowledge in each step: Vessels and fascial spaces around a central landmark, the pancreas. PMID:21091070

Li, Guo-Xin; Zhang, Ce; Yu, Jiang; Wang, Ya-Nan; Hu, Yan-Feng

2010-12-01

35

Total laparoscopic posterior pelvic exenteration: a case report of low anterior resection with en bloc partial vaginectomy with sphincter preservation and handsewn coloanal anastomosis for locoregionally advanced carcinoma of rectum invading female genital tract.  

PubMed

Posterior pelvic exenteration (PPE) has been used as modality of treatment for recurrent or primary cancer of rectum that has invaded into the female genital tract. We report a case of PPE performed for locoregionally advanced carcinoma of rectum invading the uterus; which was performed in a totally laparoscopic manner. The handsewn coloanal anastomosis was performed transrectally thus obviating the need for even a minilaparotomy for abdominal access for specimen retrieval or anastomotic stapler application. This is a first reported case in the literature where a total laparoscopic PPE was performed with successful outcome and oncological adequacy and safety. PMID:23386166

Puntambekar, Shailesh P; Kumthekar, Parag; Agarwal-Joshi, Geetanjali; Joshi, Saurabh; Nadkarni, Akshay

2013-02-01

36

Robotics for Pelvic Reconstruction  

PubMed Central

Robotic-assisted laparoscopy is increasingly used in female pelvic reconstructive surgery to combine the benefits of abdominally placed mesh for prolapse outcomes with the quicker recovery time associated with minimally invasive procedures. Level III data suggest that early outcomes of robotic sacrocolpopexy are similar to those of open sacrocolpopexy. A single randomized trial has provided level I evidence that robotic and laparoscopic approaches to sacrocolpopexy have similar short-term anatomic outcomes, although operating times, postoperative pain, and cost are increased with robotics. Patient satisfaction and long-term outcomes of both robotic and laparoscopic sacrocolpopexy are insufficiently studied despite their widespread use in the treatment of prolapse. Given the high reoperative rates for prolapse repairs, long-term follow-up is essential, and well-designed comparative effectiveness research is needed to evaluate pelvic floor surgery adequately. PMID:21874147

Ramm, Olga; Kenton, Kimberly

2011-01-01

37

Learning curve for laparoscopic totally extraperitoneal repair of inguinal hernia  

PubMed Central

Background Laparoscopic totally extraperitoneal (TEP) repair has been accepted as a popular procedure for inguinal hernia repair, but surgeons still encounter technical difficulties owing to unfamiliar pelvic anatomy and limited working space. We sought to estimate the learning curve for laparoscopic TEP repair without supervision. Methods We retrospectively analyzed the medical records of patients scheduled for laparoscopic TEP repair of an inguinal hernia from December 2000 to October 2007. Results We reviewed medical records for 700 patients. The cases were divided into 8 groups: 20 patients each in groups I–V and 200 patients each in groups VI–VIII. No significant difference in demographic characteristics was identified among the groups. The mean duration of surgery significantly decreased (p < 0.001) in relation to experience; it reached a plateau of less than 30 minutes (mean 28 min) after 60 cases. The mean length of stay in hospital was 0.97 days, reaching a plateau after 20 cases. Six patients were converted to other techniques: 1 patient each in groups III and VIII and 4 patients in group VII. Three recurrences were detected; however, 2 were excluded because the patient had bilateral inguinal hernias. Conclusion We estimate the learning curve for laparoscopic TEP repair is 60 cases for a beginner surgeon. The presence of an experienced supervisor during the first 60 cases can help prevent unnecessary complications and shorten the duration of surgery. PMID:22269299

Choi, Yoon Young; Kim, Zisun; Hur, Kyung Yul

2012-01-01

38

Surgical Treatment for Chronic Pelvic Pain  

PubMed Central

The source of chronic pelvic pain may be reproductive organ, urological, musculoskeletal - neurological, gastrointestinal, or myofascial. A psychological component almost always is a factor, whether as an antecedent event or presenting as depression as result of the pain. Surgical interventions for chronic pelvic pain include: 1) resection or vaporization of vulvar/vestibular tissue for human papillion virus (HPV) induced or chronic vulvodynia/vestibulitis; 2) cervical dilation for cervix stenosis; 3) hysteroscopic resection for intracavitary or submucous myomas or intracavitary polyps; 4) myomectomy or myolysis for symptomatic intramural, subserosal or pedunculated myomas; 5) adhesiolysis for peritubular and periovarian adhesions, and enterolysis for bowel adhesions, adhesiolysis for all thick adhesions in areas of pain as well as thin ahesions affecting critical structures such as ovaries and tubes; 6) salpingectomy or neosalpingostomy for symptomatic hydrosalpinx; 7) ovarian treatment for symptomatic ovarian pain; 8) uterosacral nerve vaporization for dysmenorrhea; 9) presacral neurectomy for disabling central pain primarily of uterine but also of bladder origin; 10) resection of endometriosis from all surfaces including removal from bladder and bowel as well as from the rectovaginal septal space. Complete resection of all disease in a debulking operation is essential; 11) appendectomy for symptoms of chronic appendicitis, and chronic right lower quadrant pain; 12) uterine suspension for symptoms of collision dyspareunia, pelvic congestion, severe dysmenorrhea, cul-desac endometriosis; 13) repair of all hernia defects whether sciatic, inguinal, femoral, Spigelian, ventral or incisional; 14) hysterectomy if relief has not been achieved by organ-preserving surgery such as resection of all endometriosis and presacral neurectomy, or the central pain continues to be disabling. Before such a radical step is taken, MRI of the uterus to confirm presence of adenomyosis may be helpful; 15) trigger point injection therapy for myofascial pain and dysfunction in pelvic and abdominal muscles. With application of all currently available laparoscopic modalities, 80% of women with chronic pelvic pain will report a decrease of pain to tolerable levels, a significant average reduction which is maintained in 3-year follow-up. Individual factors contributing to pain cannot be determined, although the frequency of endometriosis dictates that its complete treatment be attempted. The beneficial effect of uterosacral nerve ablation may be as much due to treatment of occult endometriosis in the uterosacral ligaments as to transection of the nerve fibers themselves. The benefit of the presacral neurectomy appears to be definite but strictly limited to midline pain. Appendectomy, herniorraphy, and even hysterectomy are all appropriate therapies for patients with chronic pelvic pain. Even with all laparoscopic procedures employed, fully 20% of patients experience unsatisfactory results. In addition, these patients are often depressed. Whether the pain contributes to the depression or the depression to the pain is irrelevant to them. Selected referrals to an integrated pain center with psychologic assistance together with judicious prescription of antidepressant drugs will likely benefit both women who respond to surgical intervention and those who do not. A maximum surgical effort must be expended to resect all endometriosis, restore normal pelvic anatomy, resect nerve fibers, and treat surgically accessible disease. In addition, it is important to provide patients with chronic pelvic pain sufficient psychologic support to overcome the effects of the condition, and to assist them with underlying psychologic disorders. PMID:9876726

1998-01-01

39

Predicting the pathological features of the mesorectum before the laparoscopic approach to rectal cancer.  

PubMed

Pelvic anatomy and tumour features play a role in the difficulty of the laparoscopic approach to total mesorectal excision in rectal cancer. The aim of the study was to analyse whether these characteristics also influence the quality of the surgical specimen. We performed a prospective study in consecutive patients with rectal cancer located less than 12 cm from the anal verge who underwent laparoscopic surgery between January 2010 and July 2013. Exclusion criteria were T1 and T4 tumours, abdominoperineal resections, obstructive and perforated tumours, or any major contraindication for laparoscopic surgery. Dependent variables were the circumferential resection margin (CMR) and the quality of the mesorectum. Sixty-four patients underwent laparoscopic sphincter-preserving total mesorectal excision. Resection was complete in 79.1 % of specimens and CMR was positive in 9.7 %. Univariate analysis showed tumour depth (T status) (P = 0.04) and promontorium-subsacrum angle (P = 0.02) independently predicted CRM (circumferential resection margin) positivity. Tumour depth (P < 0.05) and promontorium-subsacrum axis (P < 0.05) independently predicted mesorectum quality. Multivariate analysis identified the promontorium-subsacrum angle (P = 0.012) as the only independent predictor of CRM. Bony pelvis dimensions influenced the quality of the specimen obtained by laparoscopy. These measurements may be useful to predict which patients will benefit most from laparoscopic surgery and also to select patients in accordance with the learning curve of trainee surgeons. PMID:24950725

Fernández Ananín, Sonia; Targarona, Eduardo M; Martinez, Carmen; Pernas, Juan Carlos; Hernández, Diana; Gich, Ignasi; Sancho, Francesc J; Trias, Manuel

2014-12-01

40

[Laparoscopic reconstruction of the diaphragm].  

PubMed

The authors report the case of a 63-year-old patient who was polytraumatized in a motor vehicle accident and suffered multiple traumatic injuries. Chest and pelvic fractures as well as left-sided diaphragmatic rupture with associated omentum herniation were diagnosed on CT scan. None of the injuries required urgent surgical intervention. After 10 days supportive therapy, elective laparoscopic reconstruction of the diaphragmatic hernia was performed. The authors discuss the role of laparoscopic diaphragm reconstruction. PMID:25327405

Halvax, Péter; Légner, András; Paál, Balázs; Somogyi, Rózsa; Ukös, Mária; Altorjay, Aron

2014-10-01

41

LAPAROSCOPIC ASSISTED RADICAL CYSTECTOMY WITH ILEAL NEOBLADDER: A COMPARISON WITH THE OPEN APPROACH  

Microsoft Academic Search

Purpose:To date, there have been only a few reports regarding the feasibility of the laparoscopic approach to radical cystectomy. In none of these cases has the laparoscopic approach been contrasted with a contemporary cohort of open cystectomy and diversion. Recently, we initiated laparoscopic assisted radical cystoprostatectomy and ileal neobladder (LACINB) wherein the cystoprostatectomy and pelvic lymph node dissections are performed

JAY B. BASILLOTE; COROLLOS ABDELSHEHID; THOMAS E. AHLERING; ALLAN M. SHANBERG

2004-01-01

42

Laparoscopic assisted vaginal radical hysterectomy - evolution of a concept  

Microsoft Academic Search

The evolution of the laparoscopic techniques for the treatment of patients with early cervical cancer is presen- ted. The laparoscopic assistance makes the pelvic lymphade- nectomy and the removal of the lateral portion of the para- metrium feasible during radical vaginal hysterectomy without the need for the muscle-cutting vulvovaginal incision. The technique is also applicable to patients with early cervical

DANIEL DARGENT

43

Pelvic incidentalomas  

PubMed Central

Abstract Recent advances in multi-detector computed tomography, magnetic resonance imaging, and ultrasound have led to the detection of incidental ovarian, uterine, vascular and pelvic nodal abnormalities in both the oncology and non-oncology patient population that in the past remained undiscovered. These incidental pelvic lesions have created a management dilemma for both clinicians and radiologists. Depending on the clinical setting, these lesions may require no further evaluation, additional immediate or serial follow-up imaging, or surgical intervention. In this review, guidelines concerning the diagnosis and management of some of the more common pelvic incidentalomas are presented. PMID:20880789

Newmark, G.M.; Thakrar, K.H.; Mehta, U.K.; Berlin, J.W.

2010-01-01

44

[Laparoscopic appendectomy. Our experience].  

PubMed

The advantages and applications of the videolaparoscopic technique (VL) versus open surgery in the treatment of acute and complicated appendicitis are not well defined. Our study examined 150 patients, 67 males and 83 females. They underwent surgery for acute appendicitis in emergency. The choice between open or laparoscopic tecnique was due to patient's clinical conditions and surgeon's experience. Two of these patients had no infiammatory process. Eleven patients were affected by gynaecological diseases. The last 137 patients underwent surgery for acute appendicitis and the diagnosis was confirmed. Among them, 35 (25%) were affected by a complicated appendicitis with diffuse or clearly defined peritonitis. In 134 patients the surgery was completed laparoscopically. The conversion rate was 2%. Morbility rate was 3%, due to intra abdominal abscesses secondary to acute complicated appendicitis. The mean operative time was 76 min and the mean hospital stay was 4.8 days. The death rate was 0%. In our experience, laparoscopic appendectomy has significant advantages over traditional open surgery in both acute and complicated appendicitis, especially in young women. In this way, we can diagnose pelvic disease that could be characterized by the same symptoms of acute appendicitis, then we suggest laparoscopic appendectomy even just to complete the diagnostic iter. Laparoscopy is useful in terms of convalescence, postoperative pain, hospital stay, aesthetic outcome and an easier exploration of the peritoneal cavity. PMID:22595725

Pezzolla, Angela; Milella, Marialessia; Lattarulo, Serafina; Barile, Graziana; Pascazio, Bianca; Ialongo, Paolo; Fabiano, Gennaro; Palasciano, Nicola

2012-01-01

45

Pelvic Exam  

MedlinePLUS

... Home About My Pictures Browse Search Quick Search Image Details Pelvic Exam View/Download: Small: 719x590 View ... Added: 2/22/2010 Reuse Restrictions: Yes - This image is copyright protected. Any use of this image ...

46

Present status of endoscopic surgery in Japan: laparoscopic surgery and laparoscopic assisted surgery for gastric cancer  

NASA Astrophysics Data System (ADS)

In this report, I would like to explain the latest data from the 7th National Survey 2004, by the Japan Society for Endoscopic Surgery (1). Next, I will explain you the comment on laparoscopic gastric cancer operation, in particular. We perform the following 3 surgical procedures. (1) Intragastric method (2) Laparoscopic lesion lifting method (3) Laparoscopic assisted gastric resection Mastery of basic techniques and thorough understanding of topographic anatomy are the most important (2). Furthermore, it is necessary for a surgeon with experience of at least 50 cases of laparoscopic surgery to be involved in surgery as an assistant.

Hiki, Yoshiki; Kitano, Seigo

2005-07-01

47

Pelvic organ prolapse.  

PubMed

Pelvic organ prolapse, including anterior and posterior vaginal prolapse, uterine prolapse, and enterocele, is a common group of clinical conditions affecting millions of American women. This article, designed for the practicing clinician, highlights the clinical importance of prolapse, its pathophysiology, and approaches to diagnosis and therapy. Prolapse encompasses a range of disorders, from asymptomatic altered vaginal anatomy to complete vaginal eversion associated with severe urinary, defecatory, and sexual dysfunction. The pathophysiology of prolapse is multifactorial and may operate under a "multiple-hit" process in which genetically susceptible women are exposed to life events that ultimately result in the development of clinically important prolapse. The evaluation of women with prolapse requires a comprehensive approach, with attention to function in all pelvic compartments based on a detailed patient history, physical examination, and limited testing. Although prolapse is associated with many symptoms, few are specific for prolapse; it is often challenging for the clinician to determine which symptoms are attributable to the prolapse itself and will therefore improve or resolve once the prolapse is treated. When treatment is warranted based on specific symptoms, prolapse management choices fall into 2 broad categories: nonsurgical, which includes pelvic floor muscle training and pessary use; and surgical, which can be reconstructive (eg, sacral colpopexy) or obliterative (eg, colpocleisis). Concomitant symptoms require additional management. Virtually all women with prolapse can be treated and their symptoms improved, even if not completely resolved. PMID:16135597

Weber, Anne M; Richter, Holly E

2005-09-01

48

Stress response to laparoscopic liver resection  

PubMed Central

Background: The magnitude of the systemic response is proportional to the degree of surgical trauma. Much has been reported in the literature comparing metabolic and immune responses, analgesia use, or length of hospital stay between laparoscopic and open procedures. In particular, metabolic and immune responses are represented by measuring various chemical mediators as stress responses. Laparoscopic procedures are associated with reduced operative trauma compared with open procedures, resulting in lower systemic response. As a result, laparoscopic procedures are now well accepted for both benign and malignant processes. Laparoscopic liver resection, specifically, is employed for symptomatic and some malignant tumors, following improvements in diagnostic accuracy, laparoscopic devices, and techniques. However, laparoscopic liver resection is still controversial in malignant disease because of complex anatomy, the technical difficulty of the procedure, and questionable indications. There are few reports describing the stress responses associated with laparoscopic liver resection, even though many studies reviewing stress responses have been performed recently in both humans and animal models comparing laparoscopic to conventional open surgery. Although this review examines stress response after laparoscopic liver resection in both an animal and human clinical model, further controlled randomized studies with additional investigations of immunologic parameters are needed to demonstrate the consequences of either minimally invasive surgery or open procedures on perioperative or postoperative stress responses for laparoscopic liver resection. PMID:18333082

Ueda, Kazuki; Turner, Patricia

2004-01-01

49

REAL-TIME TRANSRECTAL ULTRASONOGRAPHY DURING LAPAROSCOPIC RADICAL PROSTATECTOMY  

Microsoft Academic Search

Purpose:We describe the technical aspects of real-time transrectal ultrasound (TRUS) monitoring and guidance during laparoscopic radical prostatectomy (LRP). Furthermore, we describe the TRUS visualized anatomy of periprostatic structures during LRP.

OSAMU UKIMURA; INDERBIR S. GILL; MIHIR M. DESAI; ANDREW P. STEINBERG; METE KILCILER; CHRISTOPHER S. NG; SIDNEY C. ABREU; MASSIMILIANO SPALIVIERO; ANUP P. RAMANI; JIHAD H. KAOUK; AKIHIRO KAWAUCHI; TSUNEHARU MIKI

2004-01-01

50

Laparoscopic inguinal herniorrhaphy.  

PubMed

Between Mar. 13 and Sept. 16, 1991, the authors performed 10 inguinal herniorrhaphies laparoscopically. Two patients with a type II hernia (indirect with dilated internal ring but intact posterior inguinal wall) had laparoscopic preperitoneal closure of the internal ring with interrupted 0-Prolene. Seven patients had a type IIIA hernia (direct), and one patient had a large type IIIB hernia (indirect with dilated internal ring and medial encroachment or destruction of transversalis fascia of Hesselbach triangle). They all underwent laparoscopic preperitoneal placement of Prolene mesh, which was fixed in place with interrupted 0-Prolene sutures. All patients recovered promptly, with less pain and minimal limping, resulting in high patient acceptance of the procedure. There were no complications. Although no recurrence was noted and the technique appears sound, it is too early to predict its long-term success. At present, the preperitoneal approach is difficult to perform because of lack of appropriate instrumentation. The surgeon who plans to perform such a procedure must be familiar with the anatomy. We suggest that every potential candidate for laparoscopic inguinal hernia repair should be apprised of the advantages and disadvantages of this approach. A research consent form should be read and signed by every patient. PMID:1532920

Dion, Y M; Morin, J

1992-04-01

51

Female Anatomy Lecture outline Human Reproduc.ve  

E-print Network

9/9/12 1 Female Anatomy Lecture outline Human Reproduc.ve Anatomy A. Pelvic Female Anatomy A. External Genitalia B. Uterus, Ovaries & Oviducts C. Breasts #12 to outside Internal organs associated with female system: #12;9/9/12 6 Vagina- more a potential space than

Dever, Jennifer A.

52

Laparoscopic urology: Past, present, and future  

Microsoft Academic Search

Laparoscopy has begun to have a significant impact on the management of urologic problems. Although initially limited to diagnostic pediatric problems, it has more recently been used to resolve myriad adult urologic conditions. Indeed, during the past year laparoscopic urology has moved well beyond the diagnosis of the undescended testicle and has been successfully used for pelvic lymphadenectomy, varicocelectomy, ureterolysis,

Ralph V. Clayman; Louis R. Kavoussi

1993-01-01

53

Laparoscopic Treatment of Intrauterine Fallopian Tube Incarceration  

PubMed Central

Herniation of the pelvic structures into the uterine cavity (appendix vermiformis, small bowel, omentum, or fallopian tube) may occur after uterine perforation. In this paper, we describe one case of intrauterine fallopian tube incarceration treated by means of laparoscopic surgery. PMID:23738168

Kondo, William; Bruns, Rafael Frederico; Nicola, Marcelo Chemin; Ribeiro, Reitan; Trippia, Carlos Henrique; Zomer, Monica Tessmann

2013-01-01

54

Pelvic Pain  

MedlinePLUS

Pelvic pain occurs mostly in the lower abdomen area. The pain might be steady, or it might come and go. If the pain is severe, it might get in the way ... re a woman, you might feel a dull pain during your period. It could also happen during ...

55

[Pelvic exenteration].  

PubMed

Pelvic exenteresis (total, anterior and posterior) is operative procedure reserved for the local advanced malignancies of the pelvis. In the period 1995-2001, we have treated 54 patients (20 male, 34 female) by this procedures. By anterior pelvic exenteresis we have treated 6 females for: Ca vesicae urinary (4 pts). Ca PVU after irradiation therapy (1 patient), Ca urethrae (1 patient). By posterior pelvic exenteresis we have treated 2 females for primary advanced Ca of the rectum. By total pelvic exenteresis we have treated 46 pts (20 male, 26 female): Ca PVU after irradiation therapy (10 females), recidivant Ca PVU (8 females), primary advanced Ca of the rectum (7 male, 1 female), recidivant Ca of the rectum (10 male, 7 female), recidivant Schwanoma (1 male), recidivant Sa stromae endometrii (1 female), recidivant Ca vesicae urinary (1 female). The median survival time of all 54 patients was 24 months. Early postoperative mortality was 18% (10 pts). Twenty patients died with median survival of 18 months (range 4-48 months). Twenty one patients are alive without evidence of disease with median follow up period of 41 months (range 6-60 months). Three patients were lost from follow up. Exenteresis pelvis is very complicate operative procedure and it should be limited to perform only in couple surgical centers. PMID:11889986

Kecmanovi?, D; Pavlov, M; Kovacevi?, P; Cerani?, M

2001-01-01

56

Laparoscopic Hysterectomy and Prolapse: A Multiprocedural Concept  

PubMed Central

Background and Objectives: Today, laparoscopic intrafascial hysterectomy and laparoscopic supracervical hysterectomy are well-accepted techniques. With our multimodal concept of laparoscopic hysterectomy for benign indications, preservation of the pelvic floor as well as reconstruction of pelvic floor structures and pre-existing prolapse situations can be achieved. Methods: The multimodal concept consists of 3 steps: Intrafascial hysterectomy with preservation of existing structures Technique 1: Primary uterine artery ligationTechnique 2: Classic intrafascial hysterectomyA technique for the stable fixation of the vaginal or cervical stumpA new method of pectopexy to correct a pre-existing descensus situation Results and Conclustion: This well-balanced concept can be used by advanced endoscopic gynecologic surgeons as well as by novices in our field. PMID:24680150

Mettler, Liselotte; Peters, Goentje; Noe, Gunter; Holthaus, Bernd; Jonat, Walter; Schollmeyer, Thoralf

2014-01-01

57

Pelvic Exenteration: Surgical Approaches  

PubMed Central

Although the incidence of local recurrence after curative resection of rectal cancer has decreased due to the understanding of the anatomy of pelvic structures and the adoption of total mesorectal excision, local recurrence in the pelvis still remains a significant and troublesome complication. While surgery for recurrent rectal cancer may offer a chance for a cure, conservative management, including radiation and chemotherapy, remain widely accepted courses of treatment. Recent improvement in imaging modalities, perioperative care, and surgical techniques, including bone resection and wound coverage, have allowed for reductions in operative mortality, though postoperative morbidity still remains high. In this review, the techniques, including surgical approaches, employed for management of locally recurrent rectal cancer are highlighted. PMID:23346506

2012-01-01

58

Chronic Pelvic Pain  

MedlinePLUS

... Family > Conditions & Treatments > Pain Disorders > Chronic Pelvic Pain Chronic Pelvic Pain Page Content Pelvic pain is an uncommon but ... and can be injured or weakened causing pain Chronic pain can continue long after tissue injury has healed, ...

59

Pelvic Inflammatory Disease (PID)  

MedlinePLUS

... Pelvic Inflammatory Disease (PID) - CDC Fact Sheet Untreated sexually transmitted diseases (STDs) can cause pelvic inflammatory disease (PID), a ... plain language for individuals with general questions about sexually transmitted diseases. What is PID? Pelvic inflammatory disease is an ...

60

Laparoscopic radical cystoprostatectomy with ileal conduit performed completely intracorporeally: the initial 2 cases  

Microsoft Academic Search

Objectives. To present the initial 2 patients who underwent laparoscopic radical cystoprostatectomy, bilateral pelvic lymphadenectomy, and ileal conduit urinary diversion, with the entire procedure performed exclusively by intracorporeal laparoscopic techniques.Methods. Two male patients, 78 and 70 years old, with muscle-invasive, organ-confined, transitional cell carcinoma of the urinary bladder underwent the procedure. The entire procedure, including radical cystoprostatectomy, pelvic node dissection,

Inderbir S Gill; Amr Fergany; Eric A Klein; Jihad H Kaouk; Gyung Tak Sung; Anoop M Meraney; Stephen J Savage; James C Ulchaker; Andrew C Novick

2000-01-01

61

Prevention and management of pelvic organ prolapse  

PubMed Central

Pelvic organ prolapse is a highly prevalent condition in the female population, which impairs the health-related quality of life of affected individuals. Despite the lack of robust evidence, selective modification of obstetric events or other risk factors could play a central role in the prevention of prolapse. While the value of pelvic floor muscle training as a preventive treatment remains uncertain, it has an essential role in the conservative management of prolapse. Surgical trends are currently changing due to the controversial issues surrounding the use of mesh and the increasing demand for uterine preservation. The evolution of laparoscopic and robotic surgery has increased the use of these techniques in pelvic floor surgery. PMID:25343034

Giarenis, Ilias

2014-01-01

62

Anatomy Corner  

NSDL National Science Digital Library

This fascinating and informative website was created by a high school teacher in Granite City, Missouri. It brings together a wide range of resources designed to help students learn about anatomy. The materials are divided into three sections: Anatomy Galleries, Anatomy Topics, and Virtual Cat Dissection. The Anatomy Galleries area provides slides, photos, and illustrative materials related to eye dissection, sheep heart dissection, and cat muscles. The Anatomy Topics area includes overviews of the major body systems, including the nervous, circulatory, and endocrine systems. The site also includes a Virtual Cat Dissection, which walks interested parties through this process.

2013-01-01

63

[Robotics-assisted laparoscopic colorectal resection].  

PubMed

The value of laparoscopic surgery for rectal cancer is still controversially discussed. Robotics offers the opportunity to leave the limitations of conventional laparoscopy behind us. The three-dimensional visualization and the superior dexterity by wristed instruments should be particularly helpful in complex laparoscopic procedures in confined spaces such as the small pelvis. Colorectal resections using the Da Vinci® system are well established and becoming increasingly more standard procedures. Nerve-sparing total mesorectal excision in patients with rectal cancer, total mesocolic excision in patients with right-sided colon cancer and rectopexy in patients with pelvic floor insufficiency are the most promising indications. The prospective randomized ROLARR study has been evaluating the application of the Da Vinci® system in laparoscopic rectal cancer surgery since 2011. Besides the currently available clinical data the perioperative and intraoperative logistics and strategy will be presented in detail. PMID:23942962

Mann, B; Virakas, G; Blase, M; Soenmez, M

2013-08-01

64

Pelvic floor muscle training exercises  

MedlinePLUS

Pelvic floor muscle training exercises are a series of exercises designed to strengthen the muscles of the pelvic floor. ... Pelvic floor muscle training exercises are recommended for: Women ... have fecal incontinence Pelvic floor muscle training exercises ...

65

Laparoscopic appendectomy  

NASA Astrophysics Data System (ADS)

The accurate and timely diagnosis of acute appendicitis remains a difficult clinical dilemma. Misdiagnosis rates of up to 40% are not unusual. Laparoscopic appendectomy provides a definitive diagnosis and an excellent method for routine removal of the appendix with very low morbidity and patient discomfort.

Richards, Kent F.; Christensen, Brent J.

1991-07-01

66

The role of biologics in pelvic floor surgery.  

PubMed

The advent of laparoscopic surgery and with it Laparoscopic Ventral Mesh Rectopexy (LVMR) has revolutionised the management of internal/external rectal and vaginal vault prolapse. These procedures have traditionally been performed with synthetic meshes. Biologics have gained a prominent role over the last decade in LVMR as well as perineal procedures for rectocoele and cystocoele repair. We examine the existing literature on the use of biologics in pelvic floor surgery comparing this with literature on synthetic mesh for the key outcomes of infection rates, bowel/sexual function and recurrence. PMID:23136820

Ahmad, M; Sileri, P; Franceschilli, L; Mercer-Jones, M

2012-12-01

67

Pelvic Inflammatory Disease (PID)  

MedlinePLUS

... Pelvic Inflammatory Disease (PID) - CDC Fact Sheet Untreated sexually transmitted diseases (STDs) can cause pelvic inflammatory disease (PID), a serious ... It is a complication often caused by some STDs, like chlamydia and gonorrhea. Other infections that are ...

68

Pelvic Organ Prolapse  

MedlinePLUS

... and layers of connective tissue, which are called fascia, become weakened, stretched, or are torn the pelvic ... delivery) can cause injury to the muscles or fascia of the pelvic floor. The increased pressure of ...

69

Pathways of extrapelvic spread of pelvic disease: imaging findings.  

PubMed

The complex extraperitoneal anatomy of the pelvis includes various outlets for the transit of organs and neurovascular structures to the rest of the body. These outlets include the greater sciatic foramen, lesser sciatic foramen, inguinal canal, femoral triangle, obturator canal, anal and genitourinary hiatuses of the pelvic floor, prevesical space, and iliopsoas compartment. All of these structures serve as conduits for the dissemination of malignant and benign inflammatory diseases from the pelvic cavity and into the soft-tissue structures of the abdominal wall, buttocks, and upper thigh. Knowledge of the pelvic anatomy is crucial to understand these patterns of disease spread. Cross-sectional imaging provides important anatomic information and depicts the extent of disease and its involvement of surrounding extrapelvic structures, information that is important for planning surgery and radiation therapy. PMID:21257938

Tan, Cher Heng; Vikram, Raghunandan; Boonsirikamchai, Piyaporn; Faria, Silvana C; Charnsangavej, Chusilp; Bhosale, Priya R

2011-01-01

70

MR imaging-based assessment of the female pelvic floor.  

PubMed

Pelvic floor weakness is a functional condition that affects the anatomic structures supporting the pelvic organs: fasciae, ligaments, and muscles. It is a prevalent disorder among people older than 50 years, especially women, and may substantially diminish their quality of life. Many complex causes of pelvic floor weakness have been described, but the greatest risk factors are aging and female sex. Pelvic floor weakness can provoke a wide range of symptoms, including pain, urinary and fecal incontinence, constipation, difficulty in voiding, a sense of pressure, and sexual dysfunction. When the condition is diagnosed solely on the basis of physical and clinical examination, the compartments involved and the site of prolapse are frequently misidentified. Such errors contribute to a high number of failed interventions. Magnetic resonance (MR) imaging, which allows visualization of all three compartments, has proved a reliable technique for accurate diagnosis, especially when involvement of multiple compartments is suspected. MR imaging allows precise evaluation of ligaments, muscles, and pelvic organs and provides accurate information for appropriate surgical treatment. Moreover, dynamic MR imaging with steady-state sequences enables the evaluation of functional disorders of the pelvic floor. The authors review the pelvic floor anatomy, describe the MR imaging protocol used in their institutions, survey common MR imaging findings in the presence of pelvic floor weakness, and highlight key details that radiologists should provide surgeons to ensure effective treatment and improved outcomes. PMID:25208288

García del Salto, Laura; de Miguel Criado, Jaime; Aguilera del Hoyo, Luis Felipe; Gutiérrez Velasco, Leticia; Fraga Rivas, Patricia; Manzano Paradela, Marcos; Díez Pérez de las Vacas, María Isabel; Marco Sanz, Ana Gloria; Fraile Moreno, Eduardo

2014-01-01

71

Pelvic Floor Magnetic Resonance Imaging after Neonatal Single Stage Reconstruction in Male Patients With Classic Bladder Exstrophy  

Microsoft Academic Search

PurposeWe evaluate a magnetic resonance imaging (MRI) protocol used to study the pelvic floor anatomy in male patients following neonatal single stage complete bladder exstrophy and epispadias repair with osteotomies.

SAREL HALACHMI; WALID FARHAT; OSNAT KONEN; AZRA KHAN; JOHN HODAPP; DARIUS J. BAGLI; GORDON A. McLORIE; ANTOINE E. KHOURY

2003-01-01

72

Human Anatomy  

NSDL National Science Digital Library

Please find links below: Human Anatomy Human Anatomy Online Human Body - Gray s Anatomy - Digestive Aparatus MEDtropolis - Virtual Body - can be viewed in English or Spanish. Contains tours of the Human Brain, Skeleton, Human Heart, and Digestive Tract. Respiratory System National Heart, Lung, and Blood Institute HealthTalk COPD (chronic obstructive pulmonary disease) American Lung Association - Disease Finder Association of Legal Aid Attorneys/UAW 2325 Canadian Lung Association Kids Health Family Living and Personal Living - Ms. Schultz added this link because on this page there is CDC, American ...

Schultz, Ms.

2007-11-09

73

Haemodynamically unstable pelvic fractures.  

PubMed

Bleeding pelvic fractures that result in haemodynamic instability have a reported mortality rate as high as 40%. Because of the extreme force needed to disrupt the pelvic ring, associated injuries are common and mortality is usually from uncontrolled haemorrhage from extra-pelvic sources. Identifying and controlling all sources of bleeding is a complex challenge and is best managed by a multi-disciplinary team, which include trauma surgeons, orthopaedic surgeons and interventional radiologists. Once the pelvis is identified as the major source of haemorrhage, component therapy reconstituting whole blood should be used and the pelvic region wrapped circumferentially with a sheet or pelvic binder. Patients at risk for arterial bleeding who continue to show haemodynamic instability despite resuscitative efforts should undergo immediate arteriography and embolisation of bleeding pelvic vessels. If this is unavailable or delayed, or the patient has other injuries (i.e., head, chest, intra-abdominal, long bone), external fixation and pelvic packing, performed concomitantly with other life-saving procedures, may be used to further reduce pelvic venous bleeding. If however, the patient remains haemodynamically labile without apparent source of blood loss, transcatheter angiographic embolisation should be attempted to locate and stop pelvic arterial bleeding. Institutional practice guidelines have been shown to reduce mortality and should be developed by all centres treating pelvic fractures. PMID:19371871

White, Christopher E; Hsu, Joseph R; Holcomb, John B

2009-10-01

74

Sexual selection targets cetacean pelvic bones.  

PubMed

Male genitalia evolve rapidly, probably as a result of sexual selection. Whether this pattern extends to the internal infrastructure that influences genital movements remains unknown. Cetaceans (whales and dolphins) offer a unique opportunity to test this hypothesis: since evolving from land-dwelling ancestors, they lost external hind limbs and evolved a highly reduced pelvis that seems to serve no other function except to anchor muscles that maneuver the penis. Here, we create a novel morphometric pipeline to analyze the size and shape evolution of pelvic bones from 130 individuals (29 species) in the context of inferred mating system. We present two main findings: (1) males from species with relatively intense sexual selection (inferred by relative testes size) tend to evolve larger penises and pelvic bones compared to their body length, and (2) pelvic bone shape has diverged more in species pairs that have diverged in inferred mating system. Neither pattern was observed in the anterior-most pair of vertebral ribs, which served as a negative control. This study provides evidence that sexual selection can affect internal anatomy that controls male genitalia. These important functions may explain why cetacean pelvic bones have not been lost through evolutionary time. PMID:25186496

Dines, James P; Otárola-Castillo, Erik; Ralph, Peter; Alas, Jesse; Daley, Timothy; Smith, Andrew D; Dean, Matthew D

2014-11-01

75

Mesh-Based Transperineal Repair of a Perineal Hernia After a Laparoscopic Abdominoperineal Resection  

PubMed Central

A perineal hernia (PH) is formed by a protrusion of intra-abdominal viscera through a defect in the pelvic floor. This is a rare complication after a conventional abdominoperineal resection (APR). However, the risk of a PH may be increased after a laparoscopic resection because this technique can cause fewer postoperative adhesions, predisposing the small bowel to sliding down toward the pelvis. However, only a few case reports describe the transperineal approach for the repair of a PH after a laparoscopic APR. We present a case of a PH after a laparoscopic APR; the PH was repaired with synthetic mesh by using a transperineal approach. A transperineal approach using a mesh to reconstruct the pelvic floor is less invasive and more effective. We suggest that this technique should probably be the first choice for treating an uncomplicated PH that occurs after a laparoscopic APR.

Lee, Taek-Gu

2014-01-01

76

Fluorescent imaging of the biliary tract during laparoscopic cholecystectomy  

PubMed Central

The introduction of laparoscopic cholecystectomy was associated with increased incidences of bile duct injury. The primary cause appears to be misidentification of the biliary anatomy. Routine intra-operative cholangiography has been recommended to reduce accidental duct injury, although in practice it is more often reserved for selected cases. There has been interest in the use of fluorescent agents excreted via the biliary system to enable real-time intra-operative imaging, to aid the laparoscopic surgeon in correctly interpreting the anatomy. The primary aim of this review is to evaluate the ability of fluorescent cholangiography to identify important biliary anatomy intra-operatively. Secondary aims are to investigate its ability to detect important intra-operative pathology such as bile leaks, identify potential alternative fluorophores, and evaluate the evidence regarding patient outcomes. PMID:25317203

2014-01-01

77

Effect of Human Immunodeficiency Virus Type 1 Infection upon Acute Salpingitis: A Laparoscopic Study  

Microsoft Academic Search

To determine the effect of human immunodeficiency virus type 1 (HIV-1) infection upon pelvic inflammatory disease (PID), a laparoscopic study of acute PID was conducted in Nai- robi, Kenya. Subjects underwent diagnostic laparoscopy, HIV-1 serology, and testing for sex- ually transmitted diseases. Of the 133 women with laparoscopically verified salpingitis, 52 (39%) were HIV-1-seropositive. Tubo-ovarian abscesses (TOA) were found in

Samuel Sinei; Marie Reilly; Elizabeth Bukusi; David Eschenbach; Job Bwayo; Verena Grieco; Walter Stamm; Joseph Karanja; Joan Kreiss

1998-01-01

78

Laparoscopic gastric banding  

MedlinePLUS

Lap-Band; LAGB; Laparoscopic adjustable gastric banding; Bariatric surgery - laparoscopic gastric banding ... J, Welch G, Zagarins S, Kuhn J, Romanelli J. Bariatric surgery for the treatment of morbid obesity: a meta- ...

79

Human Anatomy  

NSDL National Science Digital Library

The EMuseum at the University of Minnesota-Mankato provides this educational site on human anatomy. Although some parts of the site are still under construction, the Introduction to the Skeletal System section offers a straightforward introduction to the topic, complete with black-and-white skeletal photographs. Topics in this section include skeletal functions, axial and appendicular divisions, types of bone, bone composition, and a brief list of anatomical terms. For educators of introductory human anatomy, this site should provide interesting supplemental information.

80

Laparoscopic Radical Nephrectomy  

Microsoft Academic Search

Laparoscopic radical nephrectomy has gained in popularity as an accepted treatment modality for localized renal cell carcinoma at many centers worldwide. Laparoscopic radical nephrectomy may be performed via a transperitoneal or retroperitoneal approach. Mostly, the transperitoneal approach is used. Current indications for laparoscopic radical nephrectomy include patients with T1–T3aN0M0 renal tumors. Herein, transperitoneal as well as retroperitoneal laparoscopic approaches are

James D. D. Allan; David A. Tolley; Jihad H. Kaouk; Andrew C. Novick; Inderbir S. Gill

2001-01-01

81

Giant gallstone performed by emergency laparoscopic cholecystectomy?  

PubMed Central

INTRODUCTION Gallstone disease is very common, but the gallstone bigger than 5 cm in diameter is very rare. It is very challenging to be removed by laparoscopic cholecystectomy (LC) and poses extra difficulty in emergency. PRESENTATION OF CASE A 70-year-old man complained of abdominal pain in the right upper quadrant with fever of 38 °C for two days. Abdominal ultrasound indicated acute cholecystitis and a single, extremely large gallstone (95 mm × 60 mm × 45 mm). Emergency laparoscopic cholecystectomy was performed successfully. DISCUSSION Gallstone over 5 cm in diameter is very rare. LC will be very difficult for these cases, especially for the emergency cases. Emergency laparoscopic cholecystectomy can be successfully performed with clear exposure of the anatomy of the Calot's triangle. To the best of our knowledge, such giant gallstone has been rarely reported. CONCLUSION We have proven that for the rare giant gallstone about 10 cm in size, LC is a feasible option if the anatomy of the Calot's triangle can be clearly exposed; otherwise, open cholecystectomy is a safe choice.

Xu, Xiequn; Hong, Tao; Zheng, Chaoji

2013-01-01

82

JOURNAL OF MORPHOLOGY 211:63-72 (1992) Comparative Anatomy and Phylogenyof the Cloacae of  

E-print Network

JOURNAL OF MORPHOLOGY 211:63-72 (1992) Comparative Anatomy and Phylogenyof the Cloacae (lateral pelvic glands, posterior ventral glands), resulting in the most plesiomorphic cloacal anatomy) described the gross anat- omy of the cloacae of male and femaleAmph- iuma means and was the first to provide

Sever, David M.

83

Rectal mesh exposure after laparoscopic sacrocolpopexy.  

PubMed

Herein we report the case of a 68-year-old woman who had rectal bleeding 13 days after laparoscopic sacrocolpopexy. Clinical examination and rectoscopy revealed rectal exposure of the posterior polyester mesh placed during the surgery. Endorectal surgery was performed to remove the exposed mesh and repair the rectal erosion. No further complications occurred during follow-up. Although vaginal erosions are a well-known complication of synthetic implants after surgery to repair pelvic organ prolapse, one must keep in mind the possibility of more uncommon types of mesh exposure. PMID:24075836

Ferry, Philippe; Sedille, Lucie; Roncheau, Valérie

2014-01-01

84

Migraine in women with chronic pelvic pain with and without endometriosis  

PubMed Central

Objective To examine the prevalence of migraine in women with chronic pelvic pain with and without endometriosis. Design Prospective study of headache, pelvic pain, and quality of life before laparoscopic surgery for pelvic pain. Endometriosis was diagnosed pathologically. Headaches were classified as migraine or non-migraine using International Headache Society criteria. Setting Clinical research hospital. Patient(s) 108 women in a clinical trial for chronic pelvic pain (NCT00001848). Intervention(s) Laparoscopy to diagnose endometriosis, assessment by neurologist to assess headaches. Main Outcome Measure(s) Prevalence of migraine and other headaches in women with chronic pelvic pain with or without endometriosis. Headache frequency, severity and relationship to pelvic pain and endometriosis. Result(s) Lifetime prevalence of definite or possible migraine was 67% of women with chronic pelvic pain. An additional 8% met criteria for possible migraine. Migraine was no more likely in women with endometriosis than those without. Women with the most severe headaches had a lower quality of life compared with those with pelvic pain alone. Conclusion(s) Migraine headache is common in women with chronic pelvic pain, regardless of endometriosis, and contributes to disability in those with both conditions. The strong association suggests a common pathophysiology. PMID:21145540

Karp, Barbara Illowsky; Sinaii, Ninet; Nieman, Lynnette K.; Silberstein, Stephen D.; Stratton, Pamela

2012-01-01

85

Prospective Comparison of 3Dimensional Volume Rendered Computerized Tomography and Conventional Renal Arteriography for Surgical Planning in Patients Undergoing Laparoscopic Donor Nephrectomy  

Microsoft Academic Search

PurposeWe prospectively assessed the accuracy of 3-dimensional (3-D) volume rendered computerized tomography (CT) and conventional renal arteriography to visualize renovascular anatomy in patients undergoing laparoscopic donor nephrectomy.

HAZEM ABOU EL FETTOUH; BRIAN R. HERTS; TONI NIMEH; SUSAN L. WIRTH; AUDREY CAPLIN; MARK SANDS; ANUP P. RAMANI; JIHAD KAOUK; DAVID A. GOLDFARB; INDERBIR S. GILL

2003-01-01

86

Pelvic Support Problems  

MedlinePLUS

... the pelvic floor . Layers of connective tissue called fascia also provide support. These supporting muscles and fascia ... intestine into the upper part of the vagina. Fascia: Tissue that supports the organs and muscles of ...

87

Pelvic Floor Dyssynergia  

MedlinePLUS

... abnormal increase of pelvic floor muscle activity with defecation, rather than the normal decrease in muscle activity that is necessary in order to have a normal bowel movement. This condition can contribute to some forms of ...

88

Pelvic Floor Dysfunction  

MedlinePLUS

... pelvic floor dysfunction? For most people, having a bowel movement is a seemingly automatic function. For some individuals, ... incomplete emptying of the rectum when having a bowel movement. Incomplete emptying may result in the individual feeling ...

89

Pelvic Radiation in Women  

Microsoft Academic Search

\\u000a Pelvic radiation represents a major therapeutic strategy, either as adjuvant or primary treatment in the management of cancer\\u000a in women. This mainly concerns women with gynaecological malignancies: endometrial, cervical, vaginal, and vulva cancer; intestinal\\u000a malignancies: rectal and anal cancer, and bladder cancer. Further, long-term breast cancer survivors may experience similar\\u000a adverse effects after ovarian ablation accomplished by pelvic radiation. Finally,

Pernille T. Jensen

90

Life-threatening rupture of an external iliac artery pseudoaneurysm caused by necrotizing fasciitis following laparoscopic radical cystectomy: a case report  

PubMed Central

Background Pseudoaneurysms are caused by trauma, tumors, infections, vasculitis, atherosclerosis and iatrogenic complications. In this paper, we report about a patient with rupture of an external iliac artery pseudoaneurysm, which lead to hemorrhagic shock, after undergoing laparoscopic radical cystectomy and extended pelvic lymphadenectomy. Case presentation The patient was a 68-year-old Japanese male diagnosed with invasive bladder cancer. Laparoscopic radical cystectomy and extended pelvic lymphadenectomy were performed. On postoperative day 12, he developed a high fever and an acute inflammatory response with redness and swelling in the right inguinal region. He was diagnosed with necrotizing fasciitis and underwent debridement. On postoperative day 42, a sudden hemorrhage developed from the open wound in the right inguinal region. He was diagnosed with external iliac artery pseudoaneurysm rupture by computed tomography. Conclusion These complications occur extremely rarely after cystectomy with pelvic lymphadenectomy. There are no reports to date on these complications following laparoscopic cystectomy with pelvic lymphadenectomy. PMID:24885366

2014-01-01

91

Gynecologic Pelvic Pain  

PubMed Central

The family physician dealing with gynecologic pelvic pain (acute or chronic) enters at the beginning of the problem as diagnostician, refers the patient to a specialist in the interim, and resumes care in the follow-up period. Patients with chronic pelvic pain (pelvic pain that has lasted for at least six months) can be difficult to treat because they often have a history of dysfunctional family life, sexual and marital problems, and often a hidden history of sexual molestation or incest. The family physician can best care for the patient with empathy, a long ventilated history, complete physical and pelvic examination, and pelvic ultrasonograpy if necessary. Laparoscopy normally shows pelvic adhesions in one third of these patients, minimal endometriosis in one third, and a normal pelvis in the final third. The family physician should specifically reassure patients with normal results that they do not have cancer. The ideal therapy combines both stimulation-produced analgesia and treatment of the psychological, emotional, sociological, and environmental aspects of the disease. PMID:21248970

Kinch, Robert A.H.

1989-01-01

92

[Pelvic floor and pregnancy].  

PubMed

Congenital factor, obesity, aging, pregnancy and childbirth are the main risk factors for female pelvic floor disorders (urinary incontinence, anal incontinence, pelvic organ prolapse, dyspareunia). Vaginal delivery may cause injury to the pudendal nerve, the anal sphincter, or the anal sphincter. However the link between these injuries and pelvic floor symptoms is not always determined and we still ignore what might be the ways of prevention. Of the many obstetrical methods proposed to prevent postpartum symptoms, episiotomy, delivery in vertical position, delayed pushing, perineal massage, warm pack, pelvic floor rehabilitation, results are disappointing or limited. Caesarean section is followed by less postnatal urinary incontinence than vaginal childbirth. However this difference tends to disappear with time and following childbirth. Limit the number of instrumental extractions and prefer the vacuum to forceps could reduce pelvic floor disorders after childbirth. Ultrasound examination of the anal sphincter after a second-degree perineal tear is useful to detect and repair infra-clinic anal sphincter lesions. Scientific data is insufficient to justify an elective cesarean section in order to avoid pelvic floor symptoms in a woman without previous disorders. PMID:20456995

Fritel, X

2010-05-01

93

Pelvic exenteration and reconstruction.  

PubMed

For the past six decades, pelvic extenteration has been utilized in the treatment of localized central pelvic recurrences after chemo/radiotherapy. The radicality of the procedure that includes resection of the bladder, vulva/vagina, and rectum, although with curative intent, results in comprehensive changes for the patient. For this reason, all patients should undergo extensive psychosocial counseling to prepare them for the changes in body image and lifestyle. Extirpation of the pelvic viscera has undergone a number of modifications since Brunschwig first described it in 1948 to maximize survivability and minimized anatomical distortion. Most of the advancements have been focused on the reconstructive phase after pelvic exenteration. A few select patients can be free of any external appliances such as a colostomy bag with utilization of a low colorectal anastomosis, and can maintain sexual intimacy with creation of a neovagina. In addition, reconstruction of the pelvic floor with omental flaps, dura mater grafts and myocutaneous flaps have decreased postoperative morbidity. In this article, we provide a review of pelvic exenteration in gynecologic oncology, emphasizing preoperative evaluation, surgical techniques and their postoperative management. PMID:14690317

Salom, Emery M; Penalver, Manuel A

2003-01-01

94

Web Anatomy  

NSDL National Science Digital Library

The College of Education and Human Development at the University of Minnesota has created this interactive and engaging set of resources designed to help college students learn about anatomy and physiology. Along with the learning modules, visitors can also take part in the rather fun "Anatomy Bowl". Here visitors can take on topics like biochemistry, the heart, and the reproductive system in a format that is quite similar to a certain popular television game show. Moving along, there's the "Self Test" section. Here visitors can take quizzes of varying lengths designed to test their knowledge of fifteen different subjects, including the endocrine system and the lymphatic system. The site also contains a "Timed Tests" area and a more comprehensive "Quiz Bowl" which allows visitors the opportunity to answer seventeen questions across a myriad of topics.

Jensen, Murray

2011-12-14

95

Dream Anatomy  

NSDL National Science Digital Library

For centuries, artists and physicians have rendered the human body and its anatomy in a myriad of ways, and with the invention of the printing press in the 15th century, the number of anatomical drawings and their like multiplied. Drawing on the collections contained within the National Library of Medicine, this revealing digital exhibit explores some of the ways in which human anatomy has been imagined and represented over the past five centuries or so. These images are divided into a number of thematic sections, including "Anatomical Dreamtime", "Getting Real", and "Visionary & Visible". Visitors to the site can also view the winners in a related contest which asked children to draw what they thought the body looked like "under the skin".

2007-05-25

96

COMPARATIVE OUTCOMES OF OPEN VERSUS LAPAROSCOPIC SACROCOLPOPEXY AMONG MEDICARE BENEFICIARIES  

PubMed Central

Introduction Since the first reported laparoscopic sacrocolpopexy in 1991, a limited number of single-center studies have attempted to assess the procedure’s effectiveness and safety. Therefore, we analyzed a national Medicare database to compare real-world short-term outcomes of open and laparoscopic-assisted (including robotic) sacrocolpopexy on a United States sample of patients. Methods Public Use File data for a 5% random national sample of all Medicare beneficiaries age 65 and older were obtained from the Centers for Medicare and Medicaid Services for years 2004–2008. Women with pelvic organ prolapse were identified using ICD-9 diagnosis codes. CPT-4 procedure codes were used to identify women who underwent open (code 57280) or laparoscopic (code 57425) sacrocolpopexy. Individual subjects were followed for one year post-operatively. Outcomes measured, using ICD-9 and CPT-4 codes, included medical and surgical complications and re-treatment rates. Results 794 women underwent open and 176 underwent laparoscopic sacrocolpopexy. Laparoscopic sacrocolpopexy was associated with a significantly increased rate of re-operation for anterior vaginal wall prolapse (3.4% vs. 1.0%, p = 0.018). However, more medical (primarily cardiopulmonary) complications occurred post-operatively in the open group (31.5% vs. 22.7%, p = 0.023). When sacrocolpopexy was performed with concomitant hysterectomy, mesh-related complications were significantly higher in the laparoscopic group (5.4% vs. 0%, p = 0.026). Conclusion Laparoscopic sacrocolpopexy resulted in increased rate of reoperation for prolapse in anterior compartment. When hysterectomy was performed at the time of sacrocolpopexy, the laparoscopic approach was associated with an increased risk of mesh-related complications. PMID:23652338

Khan, Aqsa; Alperin, Marianna; Wu, Ning; Clemens, J. Quentin; Dubina, Emily; Pashos, Chris L.; Anger, Jennifer T.

2014-01-01

97

Early Pregnancy Loss Following Laparoscopic Management of Ovarian Abscess Secondary to Oocyte Retrieval  

PubMed Central

Severe pelvic infections following ultrasound-guided transvaginal oocyte retrieval (TVOR) are rare but challenging. Ovarian abscess formation is one of the consequences and management of such cases as highly debated in pregnant patients. In this case report, an early fetal loss following laparoscopic management of ovarian abscess is described and possible etiologies are discussed. PMID:25379164

Pabuccu, Emre Goksan; Taskin, Salih; Atabekoglu, Cem; Sonmezer, Murat

2014-01-01

98

Normal Pancreas Anatomy  

MedlinePLUS

... Pictures Browse Search Quick Search Image Details Normal Pancreas Anatomy View/Download: Small: 761x736 View Download Add to My Pictures Title: Normal Pancreas Anatomy Description: Anatomy of the pancreas; drawing shows ...

99

AAA: Anatomy Textbook Reviews  

NSDL National Science Digital Library

This link on the American Anatomists Association (AAA) provides students and teachers with a one stop site for review of anatomy textbook and education resources (ex: flash cards and atlases). Textbooks include clinical anatomy, human anatomy and specialized regions.

2011-12-23

100

The anatomy of learning anatomy  

Microsoft Academic Search

The experience of clinical teachers as well as research results about senior medical students’ understanding of basic science\\u000a concepts has much been debated. To gain a better understanding about how this knowledge-transformation is managed by medical\\u000a students, this work aims at investigating their ways of setting about learning anatomy. Second-year medical students were\\u000a interviewed with a focus on their approach

Niklas Wilhelmsson; Lars Owe Dahlgren; Håkan Hult; Max Scheja; Kirsti Lonka; Anna Josephson

2010-01-01

101

Report of Laparoscopic Cholecystectomy in Two Patients with Left-Sided Gallbladders  

PubMed Central

Laparoscopic cholecystectomy has been widely performed since its introduction in 1987 by Mouret. However, conversion to open cholecystectomy is common when the surgeon encounters variant anatomy. We report 2 cases of cholecystitis and cholelithiasis in patients with left-sided gallbladders that were treated with laparoscopic cholecystectomy by the same surgeon at this institution. The patient in the first case had the condition of situs inversus totalis, and the gallbladder of the second patient was located to the left of the round ligament. In both instances, successful laparoscopic cholecystectomy was performed, and the patients recovered uneventfully. PMID:11303995

Donthi, Ramamurthy; Thomas, David J.; DO; Sanders, David

2001-01-01

102

Report of laparoscopic cholecystectomy in two patients with left-sided gallbladders.  

PubMed

Laparoscopic cholecystectomy has been widely performed since its introduction in 1987 by Mouret. However, conversion to open cholecystectomy is common when the surgeon encounters variant anatomy. We report 2 cases of cholecystitis and cholelithiasis in patients with left-sided gallbladders that were treated with laparoscopic cholecystectomy by the same surgeon at this institution. The patient in the first case had the condition of situs inversus totalis, and the gallbladder of the second patient was located to the left of the round ligament. In both instances, successful laparoscopic cholecystectomy was performed, and the patients recovered uneventfully. PMID:11303995

Donthi, R; Thomas, D J; Sanders, D; Schmidt, S P

2001-01-01

103

LAPAROSCOPIC RETROPUBIC SIMPLE PROSTATECTOMY  

Microsoft Academic Search

Purpose:Open retropubic simple prostatectomy is occasionally performed for symptomatic, large volume benign prostatic hyperplasia. We describe the technique of laparoscopic simple retropubic prostatectomy.

RENÉ SOTELO; MASSIMILIANO SPALIVIERO; ALEJANDRO GARCIA-SEGUI; WALEED HASAN; JOHN NOVOA; MIHIR M. DESAI; JIHAD H. KAOUK; INDERBIR S. GILL

2005-01-01

104

Pelvic resection: current concepts.  

PubMed

Pelvic resection is a technique that involves surgical resection of portions of the pelvic girdle. Historically, this procedure was known as internal hemipelvectomy. Hemipelvectomy is a resection that includes the ipsilateral limb. The main indication for these procedures is primary malignant tumors of the pelvis, but in rare cases they are indicated for metastatic lesions, infection, or trauma. Reconstruction is dictated by the extent of the resection and the remaining structures. Surgical technique is dictated by histology of the tumor and location of the lesion. A multidisciplinary team is required. The patient and family should undergo counseling preoperatively to discuss morbidity and mortality, the extensive rehabilitation process, and life expectancy. PMID:24668351

Mayerson, Joel L; Wooldridge, Adam N; Scharschmidt, Thomas J

2014-04-01

105

Successful laparoscopic management of an incarcerated obturator hernia  

PubMed Central

Obturator hernia is a rare pelvic hernia that occurs primarily in multiparous, elderly (>70 years of age), thin females. This case highlights the successful laparoscopic mesh repair of an incarcerated obturator hernia in an octogenarian. The authors report a case of an incarcerated obturator hernia in an elderly female with subsequent high-grade small bowel and its successful laparoscopic operative management. A review of the relevant literature was also performed following a search on the online literature databases such as PUBMED and EMBASE. Laparoscopic mesh repair of the incarcerated obturator hernia and an ipsilateral femoral hernia found incidentally was successfully performed. A review of the literature showed a significant burden of morbidity and mortality associated with obturator hernias. Laparoscopic mesh repair has been previously shown to be a safe therapeutic modality. Small bowel obstruction and leg pain in a thin elderly lady should arouse suspicion for an incarcerated obturator hernia. Laparoscopic management of an incarcerated obturator hernia is a feasible and safe therapeutic option. PMID:24964456

Lynch, Noel P.; Corrigan, Mark A.; Kearney, David E.; Andrews, Emmet J.

2013-01-01

106

[Optimization of surgical treatment of pelvic prolapse in women].  

PubMed

The study was aimed to improving the efficiency and reducing the incidence of complications after transvaginal pelvic reconstructive surgery with the installation of synthetic mesh prosthesis for pelvic organ prolapse. The study involved 228 patients with II-IV stage pelvic prolapse, of which 144 (63.2%) underwent surgery by the TVM (Tension-free Vaginal Mesh) method, and 84 (36.8 %)--by the original method with the installation of patented mesh implant. In the group of patients who underwent reconstruction of the pelvic floor with the implantation of mesh prosthesis, original in form and method of installation, in the postoperative period significantly less stress urinary incontinence was detected, better functional results have been found, and significantly fewer intra- and postoperative complications were diagnosed. Transvaginal pelvic floor reconstruction with the use of technology to minimize operational approaches when setting the original mesh implant allows to effectively restoring the normal anatomy of the vagina, and characterized by high safety and good functional results. PMID:24649760

Tarasov, N I; Mironov, V N

2013-01-01

107

12) Anatomy Course Outline  

E-print Network

12) Anatomy Course Outline 0) Introduction and Course Overview (week 1) 1) Scheme Crash Course (week 1,2) 2) Anatomy of a Language Definition (week 3) 3) Environments and Scope (week 4, 5, 6) 4-Oriented Programming (week 11, 12) 7) Aspect-Oriented Programming (week 13) 22) Anatomy 2) Anatomy of a Language

De Volder, Kris

108

Teaching instrument: a laparoscopic training model.  

PubMed

A laparoscopic training model with female surface anatomy has been developed. This training model is made of a plastic boutique-showing model that is equivalent to normal-size female anatomy from the neck to the upper thigh. Four holes were made on the model's abdominal wall as puncture-sites to enter the cavity, the first is 80-mm diameter at the umbilical area, and the other three 38-mm diameter holes are located on both sides of the lower abdomen and suprapubic area. The umbilical hole can be covered with a simulated abdominal wall made from 6.5-mm insulation sheet, fixed to the model using a rubber band. The other three puncture-sites were plugged with a flexible rubber diaphragm as working ports. When used as video-laparoscopy, the auto-focus camcorder is used as a telescope and is connected to a regular television set as a monitor. This model can be used for training of abdominal entry by Veress needle or trocar, laparoscopic tubal ligation (LTL), and video-eye-hand co-ordination. This model has been a training medium in our Department for 1 year and was included in the OSCE for the Board Examination of the Royal Thai College of Obstetricians and Gynecologists in the year 2000 to assess the process of Veress needle insertion. PMID:11853305

Tintara, H; Choobun, T

2001-11-01

109

Laparoscopic total abdominal colectomy  

Microsoft Academic Search

The aim of this study was to prospectively assess the impact of laparoscopy upon the outcome of total abdominal colectomy (TAC). Specifically, patients underwent standard laparotomy with TAC and ileoproctostomy (TAC + IP), TAC and ileoanal reservoir (TAC + IAR), laparoscopically assisted TAC + IP (L-TAC + IP), or laparoscopically assisted TAC + IAR (L-TAC + IAR). Parameters studied included

Steven D. Wexner; Olaf B. Johansen; Juan J. Nogueras; David G. Jagelman

1992-01-01

110

Laparoscopic splenectomy in children  

Microsoft Academic Search

To determine the safety and efficiacy of laparoscopic splenectomy (LS) in children, a retrospective review of our preliminary experience using LS was compared to results in patients who previously underwent open splenectomy (OS). From July 1993 to January 1995, we performed eight LS procedures in six children with hereditary spherocytosis (HS) and two with immune thrombocytopenic purpura (ITP). Laparoscopic cholecystectomy

K. Yoshida; Y. Yamazaki; R. Mizuno; H. Yamadera; A. Hara; J. Yoshizawa; M. Kanai

1995-01-01

111

Laparoscopic and robotic surgical training in urology.  

PubMed

The most important change in urology during the past decade was the development of minimally invasive surgery, particularly laparoscopy. However, the main drawback of laparoscopy is a steep learning curve, which results from the significant changes in the surgical environment. Although laparoscopy can provide important advantages for the patient, including decreased length of hospitalization, decreased analgesic requirement, and a shortened postoperative convalescence, one concern has been whether laparoscopic techniques should be learned solely in the operating room. For example, sports, music, and aviation are practiced before an actual performance is ever undertaken. In this review, the advantages and limitations of all available training modalities in minimally invasive surgery are described. Testing basic laparoscopic skills on inanimate models, becoming familiar with the principles of dissection and hemostasis on living animals, and studying surgical anatomy on cadavers should be considered as indispensable and complementary elements for laparoscopic training in the future. In addition, telementoring with the help of modern image processing and virtual reality eventually may become the basis of tomorrow's surgical instruction. PMID:12648430

Hoznek, András; Katz, Ran; Gettman, Matthew; Salomon, Laurent; Antiphon, Patrick; de la Taille, Alexandre; Yiou, René; Chopin, Dominique; Abbou, Clément-Claude

2003-04-01

112

Human Anatomy  

NSDL National Science Digital Library

This website, crafted by the State University of New York-Upstate Medical University, brings together key resources for students and others interested in human anatomy. These materials were designed with first year medical students in mind, but they will also be of use to individuals taking biology and other science-related courses. On the site, visitors can make their way through six sections ranging from extremities to the head and neck. Each area contains a variety of detailed anatomical charts, glossaries, and images. Radiology resources are also prominently featured within each section, providing students with a different perspective of the human body through x-rays, CT scans, and MRIs. Other helpful resources include fact sheets, quizzes, teaching materials, and other freely available course materials offered from other medical schools.

113

Anatomy Arcade  

NSDL National Science Digital Library

Anatomy truly gets interactive via these collection of fun and engaging games, videos, and other multimedia excursions. The site was created by Ben Crossett, a science teacher in Australia. Several years ago, he decided to craft some new resources like "Poke a Muscle" and "Whack-A-Bone" that would be both entertaining and educational. Visitors can look at the Games By Body System to get started, or they can also look over the Games By Type area. The types of games here include jigsaw puzzles, crosswords, word searches, and the nice catch all Just For Fun. The activities are also made interesting by the mere fact that they contain catchy visuals and jaunty tunes. The site also includes a place where teachers can offer feedback and an area just for students.

Crossett, Ben

114

Gray's Anatomy  

NSDL National Science Digital Library

Bartelby.com (last reviewed in the May 12, 2000 Scout Report) has placed yet another classic reference work online. This time, it's the 20th edition (1918) of Henry Gray's Anatomy of the Human Body. At Bartleby, the classic is given a new feel, with its 1,247 illustrations ("many in color and unchanged since the first edition of 1859") rendered in multiple resolutions, and its 13,000 entries presented in an encyclopedic subject index with hyperlinks to their respective pages and illustrations in the text. As with other Bartleby texts, access is free and the electronic book is searchable by keyword or browseable via the table of contents. The illustrations may also be accessed directly and browsed by thumbnail.

115

A Three-Dimensional Reconstructive Study of Pelvic Cavity in the New Zealand Rabbit (Oryctolagus cuniculus)  

PubMed Central

The present study has been performed to reveal biometrical aspects and diameter-related differences in terms of sexes regarding pelvic cavity via three-dimensional (3D) reconstruction by using multidetector computed tomography (MDCT) images of pelvic cavity of the New Zealand rabbit. A total of 16 adult New Zealand rabbits, including 8 males and 8 females, were used in this study. Under anesthesia, the images obtained from MDCT were stacked and overlaid to reconstruct the 3D model of the pelvic cavity using 3D modeling software (Mimics 13.1). Measurements, such as the conjugate, transverse, and vertical diameters of the pelvic cavity, and the pelvic inclination were calculated and analyzed statistically. Biometrical differences of the pelvic diameters in New Zealand rabbits of both sexes were shown clearly. It was concluded that the pelvic diameters revealed by 3D modeling techniques can shed light on medical students who take both anatomy training and gynecological applications. The authors hope that the synchronization of medical approaches may give rise to novel diagnostic and therapeutic developments related to pelvic cavity. PMID:25379534

Eken, Emrullah; Kalayc?, Ibrahim

2014-01-01

116

Laparoscopic distal gastrectomy with D2 dissection for advanced gastric cancer.  

PubMed

The successful application of the laparoscopic distal gastrectomy with D2 dissection for gastric cancer requires adequate understanding of the anatomic characteristics of peripancreatic and intrathecal spaces, the role of pancreas and vascular bifurcation as the surgical landmarks, as well as the variations of gastric vascular anatomy. The standardized surgical procedures based on distribution of regional lymph node should be clarified. PMID:23997541

Yu, Jiang; Hu, Yanfeng; Chen, Tao; Mou, Tingyu; Cheng, Xia; Li, Guoxin

2013-08-01

117

Laparoscopic distal gastrectomy with D2 dissection for advanced gastric cancer  

PubMed Central

The successful application of the laparoscopic distal gastrectomy with D2 dissection for gastric cancer requires adequate understanding of the anatomic characteristics of peripancreatic and intrathecal spaces, the role of pancreas and vascular bifurcation as the surgical landmarks, as well as the variations of gastric vascular anatomy. The standardized surgical procedures based on distribution of regional lymph node should be clarified. PMID:23997541

Yu, Jiang; Hu, Yanfeng; Chen, Tao; Mou, Tingyu; Cheng, Xia

2013-01-01

118

Fecundity and morbidity following acute pelvic inflammatory disease treated with doxycycline and metronidazole  

Microsoft Academic Search

.  \\u000a We studied fecundity and late sequelae of 39 women who had laparoscopic and microbiological sampling-proven acute pelvic inflammatory\\u000a disease (PID) treated with the same antimicrobial regimen. The grade and etiology of index PID were classified using laparoscopy,\\u000a endometrial biopsy and microbiological cultures from the cervix, endometrium and tubes: 20 had mild and 19 severe PID. The\\u000a mean (SD) follow-up

Pentti K. Heinonen; Maarit Leinonen

2003-01-01

119

Raising the thinker: new concept for dissecting the cystic pedicle during laparoscopic cholecystectomy.  

PubMed

Imprecise dissection due to poor visualization of anatomic structures is among the major causes of biliary injuries during laparoscopic cholecystectomy. Developing new illustrational and rendering techniques represents an important part in decreasing visual deception and subsequent bile duct injuries. We use the model of one of the most well-known pieces of art, Rodin's The Thinker, to visualize the gallbladder and cystic pedicle structures. This minimizes visual deception before dissection, especially in cases with obscured structures. Our method, raising The Thinker, is based on the remarkable similarity between the sculpture and the topographic anatomy of the gallbladder. The method can be used not only for better orientation and visualization during laparoscopic cholecystectomy but also as a tool to complement the teaching of laparoscopic biliary anatomy to surgical residents and medical students. PMID:22184309

Neychev, Vladimir; Saldinger, Pierre F

2011-12-01

120

The First Laparoscopic Cholecystectomy  

PubMed Central

Prof Dr Med Erich Mühe of Böblingen, Germany, performed the first laparoscopic cholecystectomy on September 12, 1985. The German Surgical Society rejected Mühe in 1986 after he reported that he had performed the first laparoscopic cholecystectomy, yet in 1992 he received their highest award, the German Surgical Society Anniversary Award. In 1990 in Atlanta, at the Society of American Gastrointestinal Surgeons (SAGES) Convention, Perissat, Berci, Cuschieri, Dubois, and Mouret were recognized by SAGES for performing early laparoscopic cholecystectomies, but Mühe was not. However, in 1999 he was recognized by SAGES for having performed the first laparoscopic cholecystectomy–sAGES invited Mühe to present the Storz Lecture. In Mühe's presentation, titled “The First Laparoscopic Cholecystectomy,” which he gave in March 1999 in San Antonio, Texas, he described the first procedure. Finally, Mühe had received the worldwide acclaim that he deserved for his pioneering work. One purpose of this article is to trace the development of the basic instruments used in laparoscopic cholecystectomy. The other purpose is to give Mühe the recognition he deserves for being the developer of the laparoscopic cholecystectomy procedure. PMID:11304004

2001-01-01

121

Pelvic support, pelvic symptoms, and patient satisfaction after colpocleisis  

PubMed Central

The objective was to study the effect of colpocleisis on pelvic support, symptoms, and quality of life and report-associated morbidity and postoperative satisfaction. Women undergoing colpocleisis for treatment of pelvic organ prolapse (POP) were recruited at six centers. Baseline measures included physical examination, responses to the Pelvic Floor Distress Inventory, and Pelvic Floor Impact Questionnaire. Three and 12 months after surgery we repeated baseline measures. Of 152 patients with mean age 79 (±6) years, 132 (87%) completed 1 year follow-up. Three and 12 months after surgery, 90/110 (82%) and 75/103 (73%) patients following up had POP stage ?1. All pelvic symptom scores and related bother significantly improved at 3 and 12 months, and 125 (95%) patients said they were either ‘very satisfied’ or ‘satisfied’ with the outcome of their surgery. Colpocleisis was effective in resolving prolapse and pelvic symptoms and was associated with high patient satisfaction. PMID:18690402

Richter, H. E.; Bradley, C. S.; Ye, W.; Visco, A. C.; Cundiff, G. W.; Zyczynski, H. M.; Fine, P.; Weber, A. M.

2013-01-01

122

Pelvic support, pelvic symptoms, and patient satisfaction after colpocleisis.  

PubMed

The objective was to study the effect of colpocleisis on pelvic support, symptoms, and quality of life and report-associated morbidity and postoperative satisfaction. Women undergoing colpocleisis for treatment of pelvic organ prolapse (POP) were recruited at six centers. Baseline measures included physical examination, responses to the Pelvic Floor Distress Inventory, and Pelvic Floor Impact Questionnaire. Three and 12 months after surgery we repeated baseline measures. Of 152 patients with mean age 79 (+/-6) years, 132 (87%) completed 1 year follow-up. Three and 12 months after surgery, 90/110 (82%) and 75/103 (73%) patients following up had POP stage < or = 1. All pelvic symptom scores and related bother significantly improved at 3 and 12 months, and 125 (95%) patients said they were either 'very satisfied' or 'satisfied' with the outcome of their surgery. Colpocleisis was effective in resolving prolapse and pelvic symptoms and was associated with high patient satisfaction. PMID:18690402

Fitzgerald, M P; Richter, H E; Bradley, C S; Ye, W; Visco, A C; Cundiff, G W; Zyczynski, H M; Fine, P; Weber, A M

2008-12-01

123

Various types of total laparoscopic nerve-sparing radical hysterectomies and their effects on bladder function  

PubMed Central

Objective This study was conducted to ascertain the correlation between preserved pelvic nerve networks and bladder function after laparoscopic nerve-sparing radical hysterectomy. Methods Between 2009 and 2011, 53 patients underwent total laparoscopic radical hysterectomies. They were categorized into groups A, B, and C based on the status of preserved pelvic nerve networks: complete preservation of the pelvic nerve plexus (group A, 27 cases); partial preservation (group B, 13 cases); and complete sacrifice (group C, 13 cases). To evaluate bladder function, urodynamic studies were conducted preoperatively and postoperatively at 1, 3, 6, and 12 months after surgery. Results No significant difference in sensory function was found between groups A and B. However, the sensory function of group C was significantly lower than that of the other groups. Group A had significantly better motor function than groups B and C. No significant difference in motor function was found between groups B and C. Results showed that the sensory nerve is distributed predominantly at the dorsal half of the pelvic nerve networks, but the motor nerve is predominantly distributed at the ventral half. Conclusion Various types of total laparoscopic nerve-sparing radical hysterectomies can be tailored to patients with cervical carcinomas. PMID:25045432

Fujiwara, Kazuko; Ebisawa, Keiko; Hada, Tomonori; Ota, Yoshiaki; Andou, Masaaki

2014-01-01

124

Robotic radical anterior pelvic exenteration: the UCI experience.  

PubMed

Robotic technology may be a promising tool in reduction of morbidity in radical anterior pelvic exenteration for invasive bladder cancer. We report our initial experience with robotic-assisted radical anterior pelvic exenteration in females in an attempt to evaluate the technique's feasibility and outcomes. A retrospective review of our bladder cancer database was performed. Twelve women that underwent robotic-assisted radical anterior pelvic exenteration, bilateral pelvic lymphadenectomy, and urinary diversion for clinically localized urothelial carcinoma of the bladder between 2004 and 2008 were included in this retrospective study. Median age was 73.0 +/- 9.6 years and median body mass index (BMI) was 23.5 +/- 5.0 kg/m2. Ten patients underwent ileal conduit diversion, one had an orthotopic neobladder and one an Indiana pouch. Median total operating time was 6.4 +/- 1.5 hours with median console and diversion times of 4.7 +/- 0.9 and 2.5 +/- 1.5 hours respectively. Median blood loss was 275.0 +/- 165.8 ml. Median length of stay was 8.0 +/- 1.6 days. Four patients were T2N0 or less, five T3N0, one T3N1 and two patients T4N0. There was one patient with positive surgical margins. Median number of lymph nodes removed was 23.0 +/- 11.4. Median follow-up of 9.0 +/- 6.0 months was available for ten patients. One had a recurrent ureteroenteric stricture, one had colpocleisis for vault prolapse, and three had metastatic disease. Robotic-assisted laparoscopic anterior pelvic exenteration appears to be a favorable surgical option with acceptable operative, pathological, and short-term clinical outcomes. According to the UCI experience, robotic anterior exenteration appears to achieve the clinical and oncologic goals for the surgical treatment of bladder cancer. PMID:21142832

Kaufmann, Oskar G; Young, Jennifer L; Sountoulides, Petros; Kaplan, Adam G; Dash, Atreya; Ornstein, David K

2011-07-01

125

Pelvic, Hip, and Thigh Injuries  

Microsoft Academic Search

\\u000a Pelvic, hip, and thigh injuries are relatively rare in the young athlete (1). The young athlete with pelvic or hip pain may present with an acute injury necessitating immediate treatment. An acute\\u000a injury may cause pain in the pelvic, hip, thigh, or even knee region. More commonly, the young athlete will have a chronic\\u000a injury that will limit activities during

Jason H. Nielson

126

Gallbladder Removal: Laparoscopic Method  

MedlinePLUS

... complications? Complications are rare but may include bleeding, infection and injury to the duct (tube) that carries bile from your gallbladder to your stomach. Also, during laparoscopic cholecystectomy, the intestines or major blood vessels may be ...

127

Laparoscopic Ureterocalicostomy: Initial Experience  

Microsoft Academic Search

PurposeUreterocalicostomy is a reconstructive option in the rare patient with surgically failed or difficult ureteropelvic junction (UPJ) obstruction with fibrosis and significant hydronephrosis. We introduce the technique of laparoscopic ureterocalicostomy.

INDERBIR S. GILL; EDWARD E. CHERULLO; ANDREW P. STEINBERG; MIHIR M. DESAI; SIDNEY C. ABREU; CHRISTOPHER NG; JIHAD H. KAOUK

2004-01-01

128

Randomized comparison of laparoscopic and open lymphadenectomy in pigs 1 1 Funded in part by an educational grant from Ethicon-Endosurgery, Inc  

Microsoft Academic Search

Objective: To compare the efficacy of open and laparoscopic lymphadenectomy and validate an objective model of lymph node retrieval using lymphangiography in pigs.Methods: Twenty-five pigs weighing 54–75 lbs were randomly assigned by side to open or laparoscopic pelvic and paraaortic lymphadenectomy. Lymph node yield, quantified by a masked pathologist, operative time, complications, blood loss, and other variables were recorded. Lymphangiography

Thomas J Herzog; Justin S Wu; David M Hovsepian; Donna Luttman; Alaa Elbendary

1999-01-01

129

Anatomy of the Eye  

MedlinePLUS

External (Extraocular) Anatomy Extraocular Muscles: There are six muscles that are present in the orbit (eye socket) that attach to the ... on which contact lenses are placed. Internal (Intraocular)Anatomy Anterior chamber: The anterior chamber is a fluid ( ...

130

Anatomy of the Brain  

MedlinePLUS

Donate Donate One Time Monthly Event Tribute For brain tumor information and support Call: 800-886-ABTA (2282) or Email: ABTAcares@abta.org Donate Now Menu Brain Tumor Information Brain Anatomy Brain Structure Neuron Anatomy Brain ...

131

Neurobiological Mechanisms of Pelvic Pain  

PubMed Central

Pelvic pain is a common condition which significantly deteriorates health-related quality of life. The most commonly identified causes of pain in the pelvic region are gynaecologic, urologic, gastrointestinal, neurological, and musculoskeletal. However, in up to 33% of patients the source of this symptom is not identified, frustrating both patients and health-care professionals. Pelvic pain may involve both the somatic and visceral systems, making the differential diagnosing challenging. This paper aimed to review the mechanisms involved in pelvic pain perception by analyzing the neural plasticity and molecules which are involved in these complex circuits. PMID:25110704

Leone Roberti Maggiore, Umberto; Candiani, Massimo

2014-01-01

132

Laparoscopic refundoplication in children  

Microsoft Academic Search

Background: Gastroesophageal fundoplication currently is one of the three most common major operations performed on infants and children\\u000a by pediatric surgeons in the United States. With the advent of laparoscopic surgery, the number of gastroesophageal fundoplications\\u000a has virtually exploded. Morbidity always was substantial with this operation, and laparoscopy has not changed this. We describe\\u000a our results with laparoscopic refundoplication in

D. C. van der Zee; N. M. A. Bax; B. M. Ure

2000-01-01

133

Pregnancy After a Laparoscopic Sacrohysteropexy: a Case Report  

PubMed Central

Pelvic Organ Prolapse (POP) is a rare condition during pregnancy. If all conservative treatments fail, the surgical approach has proven to be in non-pregnant women a very good option due to high efficacy and a very low morbidity and mortality rate. We are reporting on the clinical results of a 33-year-old pregnant woman with a past history of laparoscopic sacrohysteropexy who delivered by caesarean section due to a foetal breech presentation. There are only a handful of cases reporting the outcome “pregnancy” after a laparoscopic sacrohysteropexy. Nevertheless, this appears to be a useful intervention for women with a POP unresponsive to conservative treatment and open family planning. Further studies with long-term follow-ups are required to confirm this.

Albowitz, M.; Schyrba, V.; Bolla, D.; Schoning, A.; Hornung, R.

2014-01-01

134

Robotic-assisted laparoscopic adrenalectomy  

Microsoft Academic Search

IntroductionRemote robotic telemanipulators have been recently used in performing laparoscopic urologic procedures, both in the laboratory and in clinical practice. We present, to our knowledge, the initial 2 cases of robotic-assisted laparoscopic adrenalectomy in humans.

Mihir M Desai; Inderbir S Gill; Jihad H Kaouk; Surena F Matin; Gyung Tak Sung; Emmanuel L Bravo

2002-01-01

135

Pelvic floor physical therapy in urogynecologic disorders.  

PubMed

Physical therapists are uniquely qualified to treat pelvic floor dysfunction with conservative management techniques. Techniques associated with incontinence and support functions of the pelvic floor include bladder training and pelvic floor rehabilitation: pelvic floor exercises, biofeedback therapy, and pelvic floor electrical stimulation. Pain associated with mechanical pelvic floor dysfunction can be treated by physical therapists utilizing various manual techniques and modalities. Research documents that conservative management is effective in treating many conditions associated with pelvic floor dysfunction. Research should be conducted to determine if addressing diastasis recti and contracture of the pelvic floor musculature should be a component of the standard physical therapy protocol. PMID:12844459

Kotarinos, Rhonda K

2003-08-01

136

Laparoscopic repair for groin hernias  

Microsoft Academic Search

Laparoscopic inguinal herniorrhaphy was first described by Ger, Schultz, Corbitt, and Filipi in the early 1990s (1-4) and burst upon the surgical scene just after laparoscopic cholecystectomy. It rapidly became popular, and many different techniques for repair were developed. Over the last decade much good work has been done to find which type of laparoscopic repair is best, to determine

Chad J. Davis; Maurice E. Arregui

137

Recovery after uncomplicated laparoscopic cholecystectomy  

Microsoft Academic Search

Background. After laparoscopic cholecystectomy, the duration of convalescence is 2 to 3 weeks with an unclear pathogenesis. This study was undertaken to analyze postoperative recovery after uncomplicated elective laparoscopic cholecystectomy. Methods. Twenty-four consecutive unselected employed patients were followed up prospectively from 1 week before to 1 week after outpatient laparoscopic cholecystectomy. Daily computerized monitoring of physical motor activity and sleep

Thue Bisgaard; Birthe Klarskov; Henrik Kehlet; Jacob Rosenberg

2002-01-01

138

Measurement of beliefs about effectiveness of laparoscopic uterosacral nerve ablation.  

PubMed

To explore gynaecologists' 'prior' beliefs on effectiveness of laparoscopic uterosacral nerve ablation (LUNA), a structured survey was used to gather information on the distribution of their prior beliefs regarding the effects of LUNA on pelvic pain, both numerically [on a 10-point visual analogue scale] and by responses to a questionnaire. None of the 25 gynaecologists responding to the questionnaire stated that LUNA would increase pain, while two of the 25 gave numerical answers suggesting they believed that the intervention would worsen the pain. The most widely held 'prior belief', reflected in both questionnaire and numerical responses, was that LUNA would have a small beneficial effect on pain. PMID:15663592

Latthe, Pallavi M; Braunholtz, David A; Hills, Robert K; Khan, Khalid S; Lilford, Richard

2005-02-01

139

Single-port access laparoscopic staging operation for a borderline ovarian tumor  

PubMed Central

Minimally invasive surgery is widely used in benign gynecologic diseases and may be used in malignancies. We performed a single-port access laparoscopy staging - bilateral salpingo-oophorectomy, laparoscopy-assisted vaginal hysterectomy, bilateral pelvic lymphadenectomy, infracolic omentectomy, and washing cytology - in a borderline ovarian tumor. The number of harvested pelvic lymph nodes were twenty-three and there were no intraoperative or postoperative complications. Single-port access laparoscopic staging may be performed in selected patients. The efficacy, safety, and potential benefits of this technique should be evaluated in further trials. PMID:21860739

Yoon, Aera; Kim, Tae-Joong; Lee, Woo Seok; Kim, Byoung-Gie

2011-01-01

140

A minimally invasive approach to undergraduate anatomy teaching  

NSDL National Science Digital Library

Anatomy is one of the cornerstones of medical education. Unfortunately, sufficient evidence has accumulated to suggest a worldwide decline in the resources and time allocated to its teaching. Integration of anatomy with clinical medicine has been frequently advocated as the solution to this academic crisis. Consequently, new ways of harnessing clinical relevance to the teaching of anatomy must be sought to make it applicable to contemporary clinical practice. Human cadavers have been used to teach laparoscopic skills to surgical trainees for some time. More recently, centers in the United States have piloted the use of minimally invasive techniques in the teaching of anatomy to undergraduates. We believe that the use of laparoscopy on human cadavers may also be used to complement the teaching of anatomy to United Kingdom and European medical students. This would not only familiarize students with the topography and morphology of human anatomy, but also with the concept of manipulating anatomical structures to achieve a clinical outcome. Other benefits include improved three-dimensional orientation, increased dexterity, and development team-working skills amongst students. A UK feasibility study is currently underway.

Dr. Petrut Gogalniceanu (University College London)

2007-12-07

141

Epidemiology of pelvic floor dysfunction.  

PubMed

The epidemiology of female pelvic floor disorders, including urinary incontinence, pelvic organ prolapse, anal incontinence, and interstitial cystitis/painful bladder syndrome is reviewed. The natural history, prevalence, incidence, remission, risk factors, and potential areas for prevention are considered. PMID:19932408

Sung, Vivian W; Hampton, Brittany Star

2009-09-01

142

Entomology 201 Lab 3 Anatomy and  

E-print Network

Entomology 201 Lab 3 Anatomy and Metamorphosis #12;External Anatomy head #12;External Anatomy thorax #12;External Anatomy abdomen #12;External Anatomy abdomen #12;External Anatomy abdomen #12;External Anatomy abdomen #12;External Anatomy abdomen #12;External Anatomy abdomen ovipositor #12;External

Eubanks, Micky

143

The International Pelvic Pain Society  

NSDL National Science Digital Library

The International Pelvic Pain Society (IPPS) was founded in 1996 by health professionals as a forum for public and professional education regarding chronic pelvic pain. One of the primary objectives of the IPPS is to "educate health care professionals how to diagnose and manage chronic pelvic pain, thereby changing the lives of patients worldwide." The IPPS is especially focused on addressing the pelvic health needs of women. For health care providers, the IPPS website offers a number of helpful resources such as downloadable articles and Powerpoint presentations concerning Endoscopy, Vulvodunia, Pelvic Congestion, and Physical Therapy, to name a few. The site also offers a collection of Featured Scientific Articles, downloadable IPPS newsletters (current and past), an assemblage of annotated links to related organizations, and more. Offerings for patients include a downloadable Patient Education Booklet, Patient Testimonials, and a service for locating nearby health care providers.

144

Mechanisms of gastric and esophageal perforations during laparoscopic Nissen fundoplication.  

PubMed Central

OBJECTIVE: The purpose of this study was to determine possible mechanisms of 17 gastric and esophageal perforations that occurred during laparoscopic Nissen fundoplication. METHODS: Specific details of each perforation relating to mechanism of injury, surgeon experience, diagnosis, treatment, and outcome were obtained. For each perforation, an attempt was made to accurately determine the mechanism of perforation. RESULTS: Three mechanisms accounted for the 17 perforations, the majority of which occurred within the first ten laparoscopic Nissen fundoplications performed by the surgeon. Ten perforations resulted from injuries related to improper retroesophageal dissection, five occurred during passage of the bougie dilator or nasogastric tube, and two occurred after surgery secondary to suture pullthrough. Six patients received a delayed diagnosis, which adversely affected outcome. Most of the perforations were successfully managed by primary closure and wrap to include the repair. Morbidity was significantly increased for perforations recognized late. One death, attributed to sepsis, occurred in association with a delay in diagnosis. CONCLUSIONS: Gastric and esophageal perforations are serious complications of the new laparoscopic method of Nissen fundoplication. The mechanisms of these complications are specifically related to limitations of the laparoscopic technique. Prevention of these potentially lethal complications requires a full understanding of the detailed anatomy of the gastroesophageal region and awareness of the recognized mechanisms of perforation. Images Figure 2. PMID:8554418

Schauer, P R; Meyers, W C; Eubanks, S; Norem, R F; Franklin, M; Pappas, T N

1996-01-01

145

Anatomy Atlases - A Digital Library of Anatomy Information  

NSDL National Science Digital Library

This website provides a collection of anatomy atlases and encyclopedias including: Atlas of Human Anatomy, Atlas in Human Anatomy in Cross Section, Illustrated Encyclopedia of Human Anatomic Variation, Atlas of Microscopic Anatomy - A Functional Approach, and Anatomy of First Aid. Within each resource, images, original plates, and descriptions relevant to the image are provided.

PhD Ronald A Bergman (University of Iowa Carver College of Medicine)

2011-08-31

146

Laparoscopic Management of a Cystic Duct Cyst  

PubMed Central

Background: Choledochal cysts are rare cystic dilatations of the biliary tree. Though their cause is uncertain, these cysts are usually referred for surgical resection because of their association with developing malignancy. Traditionally, choledochal cysts have been classified under 5 main types. Not included in this classification are cysts of the cystic duct, a condition that is even rarer, with only 14 cases reported in the literature to date. We describe one such rare case of a cyst of the cystic duct that we successfully treated via laparoscopic resection. Methods and Results: A 41-year-old male was found to have a biliary abnormality on a routine follow-up computed tomography (CT) scan for an unrelated medical condition. Further magnetic resonance cholangiopancreatography (MRCP) imaging identified a cystic dilation consistent with a Type II choledochal cyst. Laparoscopic resection was performed using a total of 5 trocars, at which time a cyst of the cystic duct was found instead of the expected Type II choledochal cyst. Intraoperative cholangiography was used as a surgical adjunct to confirm the anatomy, and resection of the cyst was completed without complications. Conclusions: Our case adds to the body of reports showing that cysts of the cystic duct, while extremely rare, do occur and need to be recognized. Given the preoperative similarity between cystic duct cysts and other choledochal cysts, proposal for a new “Type VI” category for choledochal cysts may be considered so that clinicians can be prepared for this variation. Once recognized, cysts of the cystic duct can be safely and effectively removed by laparoscopic excision, as we have demonstrated. PMID:19793491

Chan, Edward S.; Auyang, Edward D.

2009-01-01

147

[Laparoscopic adrenalectomy: our experience].  

PubMed

Since 2002 19 laparoscopic adrenalectomies with a lateral transperitoneal access have been performed at our Division of Surgery. Three patients had Conn's syndrome, 8 incidentaloma, 4 pheochromocytoma, 2 Cushing's syndrome, 1 metastases from a contralateral renal cancer and 1 metastases from lung cancer. The parameters considered for data analysis were: intra- and postoperative hypertensive crises, haemorrhage, subcutaneous emphysema, conversions, dura- tion of surgery, hospital stay, postoperative comfort, and canalisation and mobilisation times. The results obtained in our experience were comparable to those reported in the literature, confirming the reproducibility and feasibility of this type of surgical procedure. Comparison of the data obtained with laparoscopic, surgery and those obtained with traditional surgical treatment suggest that it is reasonable to claim that the laparoscopic approach is today the gold standard for adrenal surgery. PMID:17663364

Pantuso, Gianni; Grassi, Nello; Bottino, Alessandro; Cipolla, Calogero; Lo Iacono, Angelo; Cacace, Ermenegilda; Rizzo, Marta; Farinella, Eleonora

2007-01-01

148

[Key point and skill of assistant cooperation in laparoscopic gastrectomy for gastric cancer].  

PubMed

A good team work including an excellent assistant is very important for laparoscopic radical gastrectomy, because of the complex anatomy around the stomach and the difficulty of extra-gastric lymphadenectomy. An assistant with expert cooperation can shorten the operation time, decrease bleeding, increase the smoothness of the operation, improve the quality of surgery. Growth of assistants requires time and case accumulation. Firstly they should understand their own tasks, perfect themselves in the use of laparoscopic instruments and operating skills. A good assistant should follow the lead of the surgeon and maintain good cooperation, and keep on learning in order to shorten the learning curve. PMID:25164890

Zheng, Chaohui; Huang, Changming

2014-08-25

149

Laparoscopic Total Mesorectal Excision in a Rectal Cancer Patient with Situs Inversus Totalis  

PubMed Central

Situs inversus totalis is a rare anomaly in which the abdominal and thoracic cavity structures are opposite their usual positions. A 41-yr-old woman, who had an ulcerating cancer on the rectum, was found as a case of situs inversus totalis. We present an overview of the operative technique for the first documented laparoscopic total mesorectal excision of a rectal cancer in the patient with situs inversus totalis. Careful consideration of the mirror-image anatomy permitted a safe operation using techniques not otherwise different from those used for the general population. Therefore, curative laparoscopic surgery for rectal cancer in this patient is feasible and safe. PMID:20436720

Huh, Jung Wook; Cho, Sang Hyuk; Kim, Choong Young; Kim, Hoon Jin; Joo, Jae Kyoon; Kim, Young Jin

2010-01-01

150

Laparoscopic repair of gastro-duodenal fistula secondary to band erosion  

PubMed Central

Laparoscopic gastric banding is one of the most common surgical treatments for morbid obesity performed worldwide. The procedure, however, has many well-documented risks and complications, including band erosion. We present here a gastric banding patient who was referred to our tertiary care centre after secondarily forming an entero-enteric fistula with complaints of pain, nausea, vomiting and severe reflux. She was successfully treated with laparoscopic dissection and due to her existing anatomy, and the patient's desire for continued weight loss, she was converted to Roux-en-Y gastric bypass.

Patel, Kunal J.; Byrne, T. Karl; Pullatt, Rana C.

2014-01-01

151

Laparoscopic repair of gastro-duodenal fistula secondary to band erosion.  

PubMed

Laparoscopic gastric banding is one of the most common surgical treatments for morbid obesity performed worldwide. The procedure, however, has many well-documented risks and complications, including band erosion. We present here a gastric banding patient who was referred to our tertiary care centre after secondarily forming an entero-enteric fistula with complaints of pain, nausea, vomiting and severe reflux. She was successfully treated with laparoscopic dissection and due to her existing anatomy, and the patient's desire for continued weight loss, she was converted to Roux-en-Y gastric bypass. PMID:25336826

Patel, Kunal J; Byrne, T Karl; Pullatt, Rana C

2014-10-01

152

Pelvic lipomatosis: Bladder sparing extirpation of pelvic mass to relieve bladder storage dysfunction symptoms and pelvic pain  

PubMed Central

Pelvic lipomatosis is a rare benign disease, associated with overgrowth of fat in the perivesical and perirectal area. It is of unknown etiology. We describe a 45–year–old male with pelvic lipomatosis causing bladder storage dysfunction symptoms and pelvic pain that affected his quality of life. Surgical excision of the pelvic mass with bladder preservation was performed. After surgery, the patient had a marked improvement in his quality of life, with resolution of bladder storage dysfunction symptoms and pelvic pain.

Ali, Ahmed; Swain, Sanjaya

2014-01-01

153

Pelvic injuries in child abuse.  

PubMed

Three cases of child abuse are described in which pelvic injuries were prominent findings on radiologic examination: Two patients had pelvic fractures, and one was found to have heterotopic ossification of the soft tissues of the pelvis and thighs corresponding to extensive bruising in the pubic, genital, buttock, and thigh areas, resulting from physical and sexual abuse. These represent uncommon radiographic findings. Skeletal survey in cases of suspected child abuse should include the entire pelvis, and special attention should be paid to the ischiopubic rami the most common site of these rare pelvic injuries. PMID:1437374

Ablin, D S; Greenspan, A; Reinhart, M A

1992-01-01

154

Robotic-Assisted Laparoscopic Treatment of Bowel, Bladder, and Ureteral Endometriosis  

PubMed Central

Background: Endometriosis commonly affects the pelvic organs but can also affect organs outside the pelvis and is then termed extragenital endometriosis. Cases: Successful robotically assisted laparoscopic management of extragenital endometriosis, specifically, endometriosis of the bowel, bladder, and ureter in 5 patients. Conclusion: A substantial body of evidence supports the laparoscopic approach as the preferred method for many procedures; yet, a majority of procedures today still are performed by laparotomy. This preference for open procedures is likely due to the lack of trained endoscopic surgeons, the difficulty in obtaining proper instruments, and the long learning curve of operative laparoscopy. The recent advent of computer-enhanced technology may provide the bridge necessary for more surgeons to incorporate laparoscopic surgery in the treatment of complex cases. PMID:21985730

Hajhosseini, Babak; King, Louise P.

2011-01-01

155

The sacroiliac joint: an overview of its anatomy, function and potential clinical implications  

PubMed Central

This article focuses on the (functional) anatomy and biomechanics of the pelvic girdle and specifically the sacroiliac joints (SIJs). The SIJs are essential for effective load transfer between the spine and legs. The sacrum, pelvis and spine, and the connections to the arms, legs and head, are functionally interrelated through muscular, fascial and ligamentous interconnections. A historical overview is presented on pelvic and especially SIJ research, followed by a general functional anatomical overview of the pelvis. In specific sections, the development and maturation of the SIJ is discussed, and a description of the bony anatomy and sexual morphism of the pelvis and SIJ is debated. The literature on the SIJ ligaments and innervation is discussed, followed by a section on the pathology of the SIJ. Pelvic movement studies are investigated and biomechanical models for SIJ stability analyzed, including examples of insufficient versus excessive sacroiliac force closure. PMID:22994881

Vleeming, A; Schuenke, M D; Masi, A T; Carreiro, J E; Danneels, L; Willard, F H

2012-01-01

156

University of Portland Summer Courses- Anatomy & Anatomy Lab  

NSDL National Science Digital Library

This website provides course information for intensive course study during summer school at the University of Portland. The courses available include: Anatomy, Anatomy Lab, Physiology and Physiology Lab.

University of Portland (University of Portland)

2012-07-24

157

HUMAN GROSS ANATOMY ANTH 695  

E-print Network

1 HUMAN GROSS ANATOMY ANTH 695 THE UNIVERSITY OF TENNESSEE Instructor lectures: 33 ALUMNI MEMORIAL BUILDING Course description: Human Gross Anatomy knowledge) is also stressed. Course textbooks: Human gross anatomy uses four

Auerbach, Benjamin M.

158

Pelvic Inflammatory Disease (PID) Statistics  

MedlinePLUS

... Table 45 Pelvic Inflammatory Disease—Hospitalizations of Women Aged 15–44 Years, United States, 1998–2010 Click ... Disease—Initial Visits to Physicians’ Offices by Women Aged 15–44 Years, United States, 2003–2012 Click ...

159

Laparoscopic intussuscepting pancreaticojejunostomy.  

PubMed

Perhaps the greatest barrier to adoption of laparoscopic pancreaticoduodenectomy by experienced pancreatic surgeons is the technical challenge of constructing the pancreaticojejunostomy (PJ). The authors present a less demanding PJ technique they have developed that creates an end-to-end intussuscepting anastomosis using a running monofilament suture. This method reduces technical complexity and operative time while producing acceptably comparable outcomes. PMID:23929187

Hughes, S J; Neichoy, B; Behrns, K E

2014-01-01

160

Laparoscopic Reconstructive Urology  

Microsoft Academic Search

PurposeAlthough laparoscopy has emerged as a feasible and effective alternative for a majority of open ablative abdominopelvic urological procedures, minimally invasive reconstruction has come to the forefront only recently. We present the current state of the art of laparoscopic reconstructive urology.

JIHAD H. KAOUK; INDERBIR S. GILL

2003-01-01

161

Laparoscopic retroperitoneal partial nephrectomy.  

PubMed

To our knowledge we report the initial case of laparoscopic partial nephrectomy performed completely via the retroperitoneal approach. The retroperitoneal space was developed by inflating a balloon. Renal parenchymal hemostasis was obtained by a newly designed double loop apparatus and the argon beam coagulator. Convalescence was rapid and no complications have been noted during a followup of 7 months. PMID:7933195

Gill, I S; Delworth, M G; Munch, L C

1994-11-01

162

Pediatric Laparoscopic Dismembered Pyeloplasty  

Microsoft Academic Search

We performed laparoscopic dismembered pyeloplasty in a boy with right ureteropelvic junction obstruction using 4 cannula sites, and a dismembering and reanastomosis technique identical to that used in open pyeloplasty. Interrupted sutures were placed and tied intracorporeally. A nephrostomy tube was placed under direct vision for drainage but no ureteral stent was used. Total operating time was 5 hours. The

Craig A. Peters; Richard N. Schlussel; Alan B. Retik

1995-01-01

163

Laparoscopic surgery in pregnancy  

Microsoft Academic Search

A 32-year-old white lady suffering from tubal infertility was referred to our institution in November 1992 because of low abdominal pain due to a heterotopic pregnancy (one intrauterine sac and the other in the right tube). The patient had undergone, 8 weeks before, her second successful attempt at in vitro fertilization and embryo transfer. We decided to perform a laparoscopic

V. Remorgida; C. Carrer; A. Ferraiolo; M. Natucci; P. Anserini

1995-01-01

164

Laparoscopic vs . Hand-Assisted Laparoscopic Sigmoidectomy for Diverticulitis  

Microsoft Academic Search

Introduction Sigmoid colectomy for diverticulitis can be technically challenging because of severe inflammation in the left-lower quadrant and pelvis. We hypothesized that hand-assisted laparoscopic technique may facilitate laparoscopic completion of this surgery while retaining the short-term benefits associated with “pure” laparoscopic surgery, in which an incision is made only for extracting the specimen. This study was designed to compare the

Sang W. Lee; James Yoo; Nadav Dujovny; Toyooki Sonoda; Jeffrey W. Milsom

2006-01-01

165

Laparoscopic cholecystectomy for a left-sided gallbladder  

PubMed Central

Cholecystectomy is a common procedure. Abnormalities in the anatomy of the biliary system are common but an abnormal location of the gallbladder is much rarer. Despite frequent pre-operative imaging, the aberrant location of the gallbladder is commonly discovered at surgery. This article presents a case of a patient with the gallbladder located to the left of the falciform ligament in the absence of situs inversus totalis that presented with right upper quadrant pain. A laparoscopic cholecystectomy was performed and it was noted that the cystic duct originated from the right side. The presence of a left sided gall bladder is often associated with various biliary, portal venous and other anomalies that might lead to intra-operative injuries. The spectrum of unusual positions and anatomical gallbladder abnormalities is reviewed in order to facilitate elective and emergent cholecystectomy as well as other hepatobiliary procedures. With proper identification of the anatomy, minimally invasive approaches are still considered safe. PMID:24124340

Iskandar, Mazen E; Radzio, Agnes; Krikhely, Merab; Leitman, I Michael

2013-01-01

166

Insulation failure in laparoscopic instruments  

Microsoft Academic Search

Background  Electrosurgery is used in virtually every laparoscopic operation. In the early days of laparoscopic surgery, capacitive coupling,\\u000a associated with hybrid trocars, was thought to be the major cause of laparoscopic electrosurgery injuries. Modern laparoscopy\\u000a has reduced capacitive coupling, and now insulation failure is thought to be the main cause of electrosurgical complications.\\u000a The aim of this study was (1) to

Paul N. Montero; Thomas N. Robinson; John S. Weaver; Greg V. Stiegmann

2010-01-01

167

Laparoscopic Management of Large Myomas  

PubMed Central

The objective of this article is to review the different techniques that have been adopted for removal of large myomas laparoscopically. We have also quoted literature about the impact of myomas on Pregnancy and obstetrical outcome and the effect of laparoscopic myomectomy on the same. Technical modifications to remove large myomas have been described along with methods to reduce intraoperative bleeding. This comprehensive review describes all possibilities of laparoscopic myomectomy irrespective of size, site and number. PMID:22442517

Sinha, Rakesh; Sundaram, Meenakshi

2009-01-01

168

Anatomy comic strips.  

PubMed

Comics are powerful visual messages that convey immediate visceral meaning in ways that conventional texts often cannot. This article's authors created comic strips to teach anatomy more interestingly and effectively. Four-frame comic strips were conceptualized from a set of anatomy-related humorous stories gathered from the authors' collective imagination. The comics were drawn on paper and then recreated with digital graphics software. More than 500 comic strips have been drawn and labeled in Korean language, and some of them have been translated into English. All comic strips can be viewed on the Department of Anatomy homepage at the Ajou University School of Medicine, Suwon, Republic of Korea. The comic strips were written and drawn by experienced anatomists, and responses from viewers have generally been favorable. These anatomy comic strips, designed to help students learn the complexities of anatomy in a straightforward and humorous way, are expected to be improved further by the authors and other interested anatomists. PMID:21634024

Park, Jin Seo; Kim, Dae Hyun; Chung, Min Suk

2011-01-01

169

Laparoscopic en bloc kidney transplantation  

PubMed Central

Laparoscopic donor nephrectomy is well establish procedure and having advantages over open donor nephrectomy in terms of having less pain, early ambulation and rapid post operative recovery. To extend the advantages of laparoscopic surgery to the recipient, recently we have performed laparoscopic kidney transplantations when kidney was procured from deceased donors. As a further extension of the procedure, here we present a case of laparoscopic en bloc kidney transplantation in obese diabetic recipient who received kidneys from 70 year old non-heart beating donor. PMID:23204675

Modi, Pranjal; Thyagaraj, Krishnaprasad; Rizvi, Syed Jamal; Vyas, Jigish; Padhi, Sukant; Shah, Kamlesh; Patel, Ram

2012-01-01

170

Anatomy 199 Basic Human Anatomy Course Syllabus  

NSDL National Science Digital Library

This Word document contains the course syllabus (with schedule) for a one-quarter (i.e. 10 week), five-credit undergraduate human anatomy course, which serves health science majors from multiple areas. This course was designed to either meet for lecture three days a week (1.5 hour lectures; the posted syllabus is based on three lectures per week) or five days a week (50 minute lectures), along with laboratory once a week (2 hour lab). The laboratory portion of the course uses prosected cadavers, bones, and models. This basic human anatomy course normally has between 200-450 students registered per quarter.

Dr. Jennifer M Burgoon (The Ohio State University Division of Anatomy)

2011-03-25

171

Successful laparoscopic reversal of gastric bypass in a patient with malnutrition  

PubMed Central

Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed bariatric procedures around the world. Although RYGB is the gold standard for treating morbid obesity, it carries the risk of rare but serious long-term complications from malnutrition. We report a case of laparoscopic reversal of RYGB. A female patient reported prolonged incapacitating postprandial pain that consequently made her avoid proper oral intake. Therefore, she became seriously malnourished at 30 months after RYGB and requested reversal of RYGB into normal anatomy. The operation was successfully performed via laparoscopy. Operating time was 120 minutes, and intraoperative blood loss was 20 mL. The patient was discharged without any complications directly related to surgical procedures, although her hospital stay was prolonged by the treatment of asymptomatic septicemia of unknown origin. Laparoscopic reversal of RYGB into normal anatomy is technically feasible and might be performed safely after thorough preoperative evaluation in carefully selected patients.

Park, Ji Yeon

2014-01-01

172

Successful laparoscopic reversal of gastric bypass in a patient with malnutrition.  

PubMed

Roux-en-Y gastric bypass (RYGB) is one of the most commonly performed bariatric procedures around the world. Although RYGB is the gold standard for treating morbid obesity, it carries the risk of rare but serious long-term complications from malnutrition. We report a case of laparoscopic reversal of RYGB. A female patient reported prolonged incapacitating postprandial pain that consequently made her avoid proper oral intake. Therefore, she became seriously malnourished at 30 months after RYGB and requested reversal of RYGB into normal anatomy. The operation was successfully performed via laparoscopy. Operating time was 120 minutes, and intraoperative blood loss was 20 mL. The patient was discharged without any complications directly related to surgical procedures, although her hospital stay was prolonged by the treatment of asymptomatic septicemia of unknown origin. Laparoscopic reversal of RYGB into normal anatomy is technically feasible and might be performed safely after thorough preoperative evaluation in carefully selected patients. PMID:25317419

Park, Ji Yeon; Kim, Yong Jin

2014-10-01

173

Laparoscopic hemicolectomy in a patient with situs inversus totalis after open distal gastrectomy  

PubMed Central

Situs inversus totalis (SIT) is a rare anomaly in which the abdominal and thoracic cavity structures are opposite their usual positions. Occasionally, a few patients with a combination of this condition and malignant tumors have been encountered. Recently, several laparoscopic operations have been reported in patients with SIT. We report a case of an 83-year-old man with situs inversus totalis who developed colon cancer after open distal gastrectomy. Laparoscopic hemicolectomy with radical lymphadenectomy in such a patient was successfully performed by careful consideration of the mirror-image anatomy. Techniques themselves was not different from those in ordinary cases. Thus, curative laparoscopic surgery for colon cancer in the presence of situs inversus totalis is feasible and safe. PMID:23515492

Sumi, Yasuo; Tomono, Ayako; Suzuki, Satoshi; Kuroda, Daisuke; Kakeji, Yoshihiro

2013-01-01

174

Laparoscopic hemicolectomy in a patient with situs inversus totalis after open distal gastrectomy.  

PubMed

Situs inversus totalis (SIT) is a rare anomaly in which the abdominal and thoracic cavity structures are opposite their usual positions. Occasionally, a few patients with a combination of this condition and malignant tumors have been encountered. Recently, several laparoscopic operations have been reported in patients with SIT. We report a case of an 83-year-old man with situs inversus totalis who developed colon cancer after open distal gastrectomy. Laparoscopic hemicolectomy with radical lymphadenectomy in such a patient was successfully performed by careful consideration of the mirror-image anatomy. Techniques themselves was not different from those in ordinary cases. Thus, curative laparoscopic surgery for colon cancer in the presence of situs inversus totalis is feasible and safe. PMID:23515492

Sumi, Yasuo; Tomono, Ayako; Suzuki, Satoshi; Kuroda, Daisuke; Kakeji, Yoshihiro

2013-02-27

175

Managing chronic pelvic pain following reconstructive pelvic surgery with transvaginal mesh.  

PubMed

In 2001, the US Food and Drug Administration (FDA) approved the first transvaginal mesh kit to treat pelvic organ prolapse (POP). Since the introduction of vaginal mesh kits, some vaginal meshes have been associated with chronic pelvic pain after reconstructive pelvic floor surgery. Pelvic pain results in between 0 % and 30 % of patients following transvaginal mesh placement. Common causes of chronic pelvic pain include pelvic floor muscle spasm, pudendal neuralgia, and infection. Paucity of data exists on the effective management of chronic pelvic pain after pelvic reconstructive surgery with mesh. We outline the management of chronic pelvic pain after transvaginal mesh placement for reconstructive pelvic floor repair based on our clinical experience and adaptation of data used in other aspects of managing chronic pelvic pain conditions. PMID:24217793

Gyang, Anthony N; Feranec, Jessica B; Patel, Rakesh C; Lamvu, Georgine M

2014-03-01

176

Laparoscopic Surgery in Elderly Patients Aged 65 Years and Older with Gynecologic Disease  

PubMed Central

Objectives. The study was conducted to characterize the use of the laparoscopic surgery in elderly patients. Methods. The medical records of elderly patients aged ?65 years who underwent laparoscopic surgery were retrospectively reviewed for diseases, surgical procedures, histological diagnosis, intraoperative and postoperative complications, and reasons for presentation. Results. Of the 405 patients who underwent laparoscopic surgery between January 2005 and March 2012, 41 (10.1%) were aged ?65 years. The most common disease treated by surgery was ovarian tumor, followed by uterine prolapse. Histological diagnosis of ovarian tumor specimens obtained from 23 patients included serous cystadenoma (44.0%), mature cystic teratoma (20.0%), mucinous cystadenoma (20.0%), and endometrioma (4%). In contrast, in the non-elderly group, the most common histological diagnosis was endometrioma (42.9%), followed in order by mature cystic teratoma (28.3%), serous cystadenoma (18.0%), and mucinous cystadenoma (4.7%). While 23.7% of the non-elderly patients required emergency laparoscopic surgery, none of the elderly patients required emergency surgery. Only 1 of 27 patients who underwent surgery for an ovarian or adnexal mass presented with abdominal pain. No one developed serious intraoperative or postoperative complications. Conclusion. Laparoscopic surgery can be safely performed in elderly patients. It should be noted, however, that few elderly patients with benign pelvic mass manifest symptoms before undergoing surgery. PMID:23227353

Kanasaki, Haruhiko; Oride, Aki; Miyazaki, Kohji

2012-01-01

177

Laparoscopic Versus Open Colorectal Surgery  

PubMed Central

Objective The primary endpoint was to compare the impact of laparoscopic and open colorectal surgery on 30-day postoperative morbidity. Lymphocyte proliferation to mitogens and gut oxygen tension were surrogate endpoints. Summary Background Data Evidence-based proof of the effect of laparoscopic colorectal surgery on immunometabolic response and clinically relevant outcome variables is scanty. Further randomized trials are desirable before proposing laparoscopy as a superior technique. Methods Two hundred sixty-nine patients with colorectal disease were randomly assigned to laparoscopic (n = 136) or open (n = 133) colorectal resection. Four trained members of the surgical staff who were not involved in the study registered postoperative complications. Lymphocyte proliferation to Candida albicans and phytohemagglutinin was evaluated before and 3 and 15 days after surgery. Operative gut oxygen tension was monitored continuously by a polarographic microprobe. Results In the laparoscopic group the conversion rate was 5.1%. The overall morbidity rate was 20.6% in the laparoscopic group and 38.3% in the open group. Postoperative infections occurred in 15 of the 136 patients in the laparoscopic group and 31 of the 133 patients in the open group. The mean length of hospital stay was 10.4 ± 2.9 days in the laparoscopic group and 12.5 ± 4.1 days in the open group. On postoperative day 3, lymphocyte proliferation was impaired in both groups. Fifteen days after surgery, the proliferation index returned to baseline values only in the laparoscopic group. Intraoperative gut oxygen tension was higher in the laparoscopic than in the open group. Conclusions Laparoscopic colorectal surgery resulted in a significant reduction of 30-day postoperative morbidity. Lymphocyte proliferation and gut oxygen tension were better preserved in the laparoscopic group than in the open group. PMID:12454514

Braga, Marco; Vignali, Andrea; Gianotti, Luca; Zuliani, Walter; Radaelli, Giovanni; Gruarin, Paola; Dellabona, Paolo; Di Carlo, Valerio

2002-01-01

178

Laparoscopic and thoracoscopic esophagectomy.  

PubMed

Over the past decade, our technique of MIE has evolved considerably. In the incipient phase of our experience, we used a totally laparoscopic approach similar to that described in the initial reports from DePaula and colleagues and Swanstrom and Hansen. However, it was soon apparent that there were several critical disadvantages to a purely laparoscopic approach. Laparoscopic transhiatal mobilization of the esophagus offers suboptimal visualization of important periesophageal structures, including the inferior pulmonary vein and the left mainstem bronchus. Moreover, decreased visibility hindered hemostatic division of periesophageal vessels and negatively impacted the completeness of the mediastinal lymph node dissection. These problems are further exacerbated in taller patients. In light of these considerations, we soon transitioned to a laparoscopic-thoracoscopic McKeown approach (thoracoscopic mobilization of the intrathoracic esophagus, laparoscopic gastric tube creation, cervical anastomosis). To this date, the great majority of our minimally invasive esophagectomies (>500 cases) have been performed with this 3-field technique. Indeed, the procedure has been the mainstay of our experience in the past 10 years with reduced perioperative morbidity and mortality compared with many other open series. In our experience, perhaps the most significant technical concern with this operation is the cervical dissection. Recurrent laryngeal nerve injuries, perturbations in pharyngeal transit, and swallowing dysfunction even in the absence of recurrent nerve injury are not infrequent. Moreover, as described in open series using a cervical anastomosis, anastomotic stricture and leak have been shown to occur with increased frequency [35]. In short, there is a significant learning curve with the cervical dissection. Out of these concerns emerged our more recent experience with completely thoracoscopic-laparoscopic Ivor Lewis esophagectomy. However, we did first evolve through a transition phase whereby a mini-thoracotomy (hybrid approach) was performed for creation of the intrathoracic anastomosis. We believe that the experience with totally thoracoscopic-laparoscopic Ivor Lewis esophagectomy will ultimately reproduce the low morbidity and mortality we have previously published with our established MIE technique. The omission of a cervical dissection has reduced our recurrent nerve injury rate to zero. From a theoretical standpoint, one would presume that pharyngeal transit problems and oropharyngeal swallowing dysfunction should be reduced as well with a chest anastomosis. It should be emphasized that there is a steep operator learning curve associated with this approach. Indeed, thoracoscopic port placement is critical, as poorly positioned trocars can result in difficulty maneuvering instruments through the rigid chest wall. Additionally, both blood and lung can obscure visualization of the esophagus, which lies at the dependent aspect of the operative field. Prone positioning has been described as an alternative approach that may facilitate operative exposure and address such technical concerns. Low rates of anastomotic leak (3%), low mortality (1.5%), and equivalent stage-specific survival compared with open series have been shown with this thoracoscopic prone approach [36]. In conclusion, our technique of MIE has evolved such that laparoscopic-thoracoscopic Ivor Lewis esophagectomy has become our preferred approach. Although somewhat early in our experience, we are convinced that this operative technique is feasible with reproducible results. Perioperative morbidity and mortality are comparable with our previously established MIE with cervical anastomosis while essentially eliminating recurrent nerve injury, limiting the length of the gastric conduit required, and allowing a more aggressive gastric resection margin. Recent data from other publications also suggests that lymph node yields may be improved, although insufficient data exist at this time to comment on oncologic results or outcomes with this technique. PMID:20919

Levy, Ryan M; Wizorek, Joseph; Shende, Manisha; Luketich, James D

2010-01-01

179

Total Laparoscopic Pancreaticoduodenectomy  

PubMed Central

Introduction: Total laparoscopic pancreaticoduodenectomy (TLPD) remains one of the most advanced laparoscopic procedures. Owing to the evolution in laparoscopic technology and instrumentation within the past decade, laparoscopic pancreaticoduodenectomy is beginning to gain wider acceptance. Methods: Data were collected for all patients who underwent a TLPD at our institution. Preoperative evaluation consisted of computed tomography scan with pancreatic protocol and selective use of magnetic resonance imaging and/or endoscopic ultrasonography. The TLPD was done with 6 ports on 3 patients and 5 ports in 2 patients and included a celiac, periportal, peripancreatic, and periduodenal lymphadenectomy. Pancreatic stents were used in all 5 cases, and intestinal continuity was re-established by intracorporeal anastomoses. Results: Five patients underwent a TLPD for suspicion of a periampullary tumor. There were 3 women and 2 men with a mean age of 60 years and a mean body mass index of 32.8. Intraoperatively, the mean operative time was 9 hours 48 minutes, with a mean blood loss of 136 mL. Postoperatively, there were no complications and a mean length of stay of 6.6 days. There was no lymph node involvement in 4 out of 5 specimens. The pathological results included intraductal papillary mucinous neoplasm in 2 patients, pancreatic adenocarcinoma in 1 patient (R0 resection), benign 4-cm periampullary adenoma in 1 patient, and a somatostatin neuroendocrine carcinoma in 1 patient (R0, N1). Conclusion: TLPD is a viable alternative to the standard Whipple procedure. Our early experience suggests decreased length of stay, quicker recovery, and improved quality of life. Complication rates appear to be improved or equivalent. PMID:23925010

Kamyab, Armin

2013-01-01

180

Laparoscopic surgery for diverticulitis  

Microsoft Academic Search

Background: Resection of diverticular disease may be quite challenging; the acute inflammatory process, thick sigmoid mesentery, and\\u000a any associated fistula or abscess can make this procedure technically demanding. The aim of this study was to compare the\\u000a results between laparoscopic and laparotomy-type resections stratified by disease severity and thereby predict outcome and\\u000a possibly a subset of patients who may benefit

M. E. Sher; F. Agachan; M. Bortul; J. J. Nogueras; E. G. Weiss; S. D. Wexner

1997-01-01

181

Laparoscopic pancreatic necrosectomy.  

PubMed

We describe a patient with infected pancreatic necrosis who was treated successfully with minimally invasive surgery. Five weeks after an episode of acute uncomplicated pancreatitis, he was found to have infected pancreatic necrosis and splenic vein thrombosis. The patient underwent a laparoscopic pancreatic necrosectomy, splenectomy, and cholecystectomy. Seven days after surgery, the patient was discharged and continued to be asymptomatic for the 6 months of follow-up. PMID:10794217

Hamad, G G; Broderick, T J

2000-04-01

182

Management of Pelvic Organ Prolapse  

PubMed Central

Quality of life is adversely affected by pelvic organ prolapse, the prevalence of which is increasing because of the persistently growing older population. Today, the tension-free vaginal mesh kit has grown in popularity owing to its comparable cure rate to traditional reconstructive surgery and the feasibility of an early return to normal life. However, significant debate remains over the long-term cure rate and the safety of tension-free vaginal mesh in the United States. The U.S. Food and Drug Administration recommends obtaining informed consent about the safety and cure rate when the patient chooses surgery using the tension-free vaginal mesh kit or meshes before surgery. The goal of surgery for pelvic organ prolapse is the restoration of anatomic defects. This review article provides an overview of basic surgical techniques and the results, advantages, and disadvantages of surgery for pelvic organ prolapse.

Choi, Kyung Hwa

2014-01-01

183

Laparoscopic surgery—anesthetic implications  

Microsoft Academic Search

Laparoscopic cholecystectomy is a relatively new surgical procedure which is enjoying everincreasing popularity and presenting new anesthetic challenges. The advantages of shorter hospital stay and more rapid return to normal activities are combined with less pain associated with the small limited incisions and less postoperative ileus compared with the traditional open cholecystectomy. The efficacy of laparoscopic appendectomy and hemicolectomy has

A. J. Cunningham

1994-01-01

184

Laparoscopic pylorus-preserving pancreatoduodenectomy  

Microsoft Academic Search

A case of chronic pancreatitis localized in the head of the pancreas with pancreas divisum was treated by laparoscopic pylorus-preserving pancreatoduodenectomy. The laparoscopic technique of resection and reconstruction with a gastrojejunostomy, hepaticojejunostomy, and pancreaticojejunostomy is described. The postoperative period was complicated by a jejunal ulcer and delayed gastric emptying necessitating a prolonged hospitalization and intravenous hyperalimentation. No fistulas occurred, a

M. Gagner; A. Pomp

1994-01-01

185

Neurobiology & AnatomyNeurobiology & Anatomy Welcome and Introduction to the Neurobiology & Anatomy Department  

E-print Network

Neurobiology & AnatomyNeurobiology & Anatomy Welcome and Introduction to the Neurobiology & Anatomy Department Hello, Welcome to the Neurobiology & Anatomy Department. Below you will find helpful information be found at the University of Utah Human Resources web site. Go to Human Resources Training and Development

Alvarado, Alejandro Sánchez

186

Single-Incision Laparoscopic Cholecystectomy in Situs Inversus Totalis  

PubMed Central

Background and Objectives: Situs inversus totalis (SIT) is a rare congenital anomaly that can cause difficulties during standard laparoscopic cholecystectomy due to its mirror-image anatomy. These cases require more technically demanding procedures, and handedness of the surgeon may influence performance of these operations. Single-incision laparoscopic surgery (SILS) has been proposed as a less-invasive alternative to conventional laparoscopic surgery. We report the first case of successful SILS cholecystectomy in a patient with SIT and discuss technical aspects of the operation related to the handedness of the surgeon. Case: A 49-year-old man who was known to have situs inversus totalis presented with symptomatic cholelithiasis. This patient was operated on by a right-handed surgeon. The surgeon and camera assistant were positioned on the right and left side respectively with the video monitor above the patient's left shoulder. The SILS port (Covidien), which has 3 operating channels, was placed in the abdomen via a 2-cm intraumbilical incision. SILS cholecystectomy was performed successfully. Dissection of Calot's triangle and the gallbladder bed was performed using a dissector and hook in the right hand without any technical problems. Conclusion: SIT may confer an advantage over the orthotopic position for right-handed surgeons. SILS cholecystectomy can be performed safely in SIT. PMID:21902984

Yetkin, Gurkan; Kartal, Abdulcabbar

2011-01-01

187

Anatomy and Physiology Everyday  

NSDL National Science Digital Library

Students use information from newspaper articles to write a paper or presentation on the correlation of information from the article and their understanding of it using knowledge gained in anatomy and physiology class.

Teresa Alvarez (St. Louis Community College Forest Park AHNS)

2008-08-22

188

Anatomy and art.  

PubMed

Leonardo da Vinci, Jean Falcon, Andreas Vesalius, Henry Gray, Henry Vandyke Carter and Frank Netter created some of the best atlases of anatomy. Their works constitute not only scientific medical projects but also masterpieces of art. PMID:24640589

Laios, Konstantinos; Tsoukalas, Gregory; Karamanou, Marianna; Androutsos, George

2013-01-01

189

Dream Anatomy Learning Station  

NSDL National Science Digital Library

This Web site contains the educational materials for Dream Anatomy, a new exhibit at the National Library of Medicine. Viewable online, the exhibit offers a somewhat macabre but undeniably fascinating survey of changes in anatomical representation over the last five centuries. Recently added to the main Dream Anatomy Web site, Learning Station provides lesson plans and activities intended for 6-12 graders. The material can be used exhibit or its online version. The lesson plans titled Beginnings of Anatomical Illustrations (grades 6-12) and Anatomical Metaphors (grades 7-8) have especially strong life sciences applications. Other online activities offer "fun ways for high school and older students to explore the content of Dream Anatomy." Altogether, Dream Anatomy Learning Station offers students a unique look at the intersection of art, science, and the imagination.

2008-09-08

190

Atlas of Plant Anatomy  

NSDL National Science Digital Library

The Atlas of Plant Anatomy comes courtesy of Paul J. Schulte, plant physiologist at the University of Nevada, who created the Web site for his plant anatomy course. The Atlas contains microscope photos of different plant structures in cross section, including cell tissues, reproductive structures, roots, stems, apical meristems, and leaves. Each image comes with an informative description, and smaller structures are helpfully labeled. Some of the photos -- like the one of a pine bud in longitudinal section -- are quite eye-catching.

Schulte, Paul J.

2007-06-21

191

Pelvic Inflammatory Disease (For Parents)  

MedlinePLUS

Pelvic inflammatory disease (PID) is a serious infection of the female reproductive system that can develop from an untreated sexually transmitted disease (STD) . In most cases, it occurs when bacteria from the STD in the vagina or cervix move into the uterus and upper genital ...

192

The female orgasm: Pelvic contractions  

Microsoft Academic Search

Eleven nulliparous women manually self-stimulated to orgasm, each on three separate occasions. Pelvic contraction pressure was measured by an anal probe and a vaginal probe simultaneously. Near the perceived start of orgasm, a series of regular contractions began in nine of the women. Anal and vaginal contraction waveforms were synchronized with each other, and the same number of orgasmic contractions

Joseph G. Bohlen; James P. Held; Margaret Olwen Sanderson; Andrew Ahlgren

1982-01-01

193

Pelvic floor disorders: Case study  

PubMed Central

Interactive case study discussions were an integral part of the program at the 3rd Annual Canadian Urology Forum (2013). The following is a summary of discussions pertaining to a case illustrating the difficulties in the management of pelvic floor disorders. PMID:24523847

Flood, Catherine

2013-01-01

194

Clinical and Functional Anatomy of the Urethral Sphincter  

PubMed Central

Continence and micturition involve urethral closure. Especially, insufficient strength of the pelvic floor muscles including the urethral sphincter muscles causes urinary incontinence (UI). Thus, it is most important to understand the main mechanism causing UI and the relationship of UI with the urethral sphincter. Functionally and anatomically, the urethral sphincter is made up of the internal and the external sphincter. We highlight the basic and clinical anatomy of the internal and the external sphincter and their clinical meaning. Understanding these relationships may provide a novel view in identifying the main mechanism causing UI and surgical techniques for UI. PMID:23094214

Ahn, Hyo Kwang; Huh, Youngbuhm

2012-01-01

195

Laparoscopic anatomic liver resection  

PubMed Central

Background Liver resection is reputed to be one of the most difficult procedures embraced in laparoscopy. This report shows that with adequate training, anatomical liver resection including major hepatectomies can be performed. Methods This is a retrospective study. Results From 1995 to 2004, among 84 laparoscopic liver resections, 46 (54%) anatomical laparoscopic hepatectomies were performed in our institution by laparoscopy. Nine (20%) patients had benign disease while 37 (80%) had malignant lesions. Among those with malignant lesions, 14 patients had hepatocellular carcinoma (HCC), 18 had colorectal metastasis (CRM), while 5 had miscellaneous tumours. For benign disease, minor (two Couinaud's segments or less) and major anatomic hepatectomies were performed in five and four patients, respectively. For malignant lesions, minor and major anatomic hepatectomies were performed in 15 and 22 patients, respectively. Overall, conversion to laparotomy was necessary in 7 (15%) patients. Blood transfusion was required in five (10%) patients. One patient died of cerebral infarction 8 days after a massive peroperative haemorrhage. The overall morbidity rate was 34% whatever the type of resection. Three patients required reoperation, either for haemorrhage (n=1) and/or biliary leak (n=2). For CRM (n=18), overall and disease-free survival at 24 months (mean follow-up of 17 months) were 100% and 56%, respectively. For HCC (n=14), overall and disease-free survival at 36 months (mean follow-up of 29 months) were 91% and 65%, respectively. No port site metastasis occurred in patients with malignancy. Conclusions After a long training with limited liver resection in superficial segments, laparoscopic anatomical minor and major resections are feasible. Short-term carcinological results seem to be similar to those obtained with laparotomy. PMID:18333079

Vibert, Eric; Kouider, Ali

2004-01-01

196

[Radical laparoscopic nephroureterectomy].  

PubMed

As with the increasingly common presence of laparoscopic surgery in renal adenocarcinoma, the same situation is also occurring with radical management of tumours of the upper urothelium. In this type of clinical condition, it is important to emphasize the different ways to mobilise the distal ureter (with transuretral resection or unroofing, pure laparoscopy, or open), and to take into account that this tumour has the highest risk of implantation at the ports of entry. Here, we conduct a literature review and up-date of the different approaches to the distal urethra. PMID:16884102

Fariña Pérez, L A

2006-05-01

197

Laparoscopic Duodenal Switch  

Microsoft Academic Search

Laparoscopic biliopancreatic diversion with duodenal switch (BPD-DS) is one of the most effective weight loss procedures currently\\u000a available. Both short- and long-term weight loss exceed that of any other bariatric operation. BPD-DS involves a 150- to 200-cc\\u000a sleeve or vertical gastrectomy, a duodenoileal anastomosis, and a long Roux-en-Y with a 150-cm alimentary limb and a 100-cm\\u000a common channel (Fig. 14.1).

Manish Parikh; Michel Gagner; Alfons Pomp

198

Outcomes after laparoscopic adrenalectomy  

Microsoft Academic Search

Background  Laparoscopic adrenalectomy (LA) has become the standard of care for many conditions requiring removal of the adrenal gland.\\u000a Previous studies on outcomes after LA have had limitations. This report describes the 30-day morbidity and mortality rates\\u000a after LA and analyzes factors affecting operative time, hospital length of stay (LOS), and postoperative morbidity.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Patients undergoing LA in 2007and 2008 were identified

Prateek K. Gupta; Bala Natarajan; Pradeep K. Pallati; Himani Gupta; Jyothsna Sainath; Robert J. Fitzgibbons

2011-01-01

199

[Radical prostatectomy - pro laparoscopic].  

PubMed

Recent publications have failed to demonstrate significant differences in perioperative oncological and functional outcomes between laparoscopic radical prostatectomy (LRPE) and R-LRPE. Reports suggesting better functional results, in particular better potency rates for R-LRPE, are rare. However, to date no large prospective, randomized, multicenter studies have compared the two methods. With an experienced operator both methods produce comparably good results. The monopoly of the intuitive system with extremely high cost of purchase and maintenance are the major disadvantages of R-LRPE. PMID:22526174

Do, H M; Holze, S; Qazi, H; Dietel, A; Häfner, T; Liatsikos, E; Stolzenburg, J-U

2012-05-01

200

The Anatomy of Self-Defense  

NSDL National Science Digital Library

This article describes a teaching method that incorporates real world application of anatomy. To apply student's anatomy skills, anatomy students were educated on self defense moves and the anatomy involved to make each action occur.

Dr. Pamela S Stein (University of Kentucky College of Medicine Anatomy and Neurobiology); Dr. April D Richardson (University of Kentucky College of Medicine Anatomy and Neurobiology); Dr. Sandra D Challman (University of Kentucky College of Dentistry Instructional Technology Center)

2008-05-01

201

Feasibility of single-incision laparoscopic surgery for appendicitis in abnormal anatomical locations: A single surgeon's initial experience  

PubMed Central

BACKGROUND: Single-incision laparoscopic surgery is considered as a more technically demanding procedure than the standard laparoscopic surgery. Based on an initial and early experience, single-incision laparoscopic appendectomy (LA) was found to be technically advantageous for dealing with appendicitis in unusual anatomical locations. This study aims to highlight the technical advantages of single-incision laparoscopic surgery in dealing with the abnormally located appendixes and furthermore report a case of acute appendicitis occurring in a sub-gastric position, which is probably the first such case to be reported in English literature. MATERIALS AND METHODS: A retrospective analysis of the first 10 cases of single-incision LA which were performed by a single surgeon is presented here. RESULTS: There were seven females and three males. The mean age of the patients was 30.6 (range 18–52) years, mean BMI was 22.7 (range 17–28) kg/m2 and the mean operative time was 85.5 (range 45–150) min. The mean postoperative stay was 3.6 (range 1–7) days. The commonest position of the appendix was retro-caecal (50%) followed by pelvic (30%). In three cases the appendix was found to be in abnormal locations namely sub-hepatic, sub-gastric and deep pelvic or para-vesical or para-rectal. All these cases could be managed with this technique without any conversions CONCLUSION: Single-incision laparoscopic surgery appears to be a feasible and safe technique for dealing with appendicitis in rare anatomical locations. Appendectomy may be a suitable procedure for the initial training in single-incision laparoscopic surgery. PMID:23626414

Zachariah, Sanoop K

2013-01-01

202

Goldfish external anatomy  

NSDL National Science Digital Library

Goldfish live in the water. They use their gills to breathe. Goldfish swim in water to move around. This goldfish has pectoral fins, pelvic fins, anal fins, and dorsal fins that it uses to swim. The tail is used to steer the goldfish wherever it is going.

N/A N/A (U.S. National Oceanic and Atmospheric Administration;)

2005-05-12

203

The Anatomy of Anatomy: A Review for its Modernization  

NSDL National Science Digital Library

This article describes the struggles anatomy education in the United Kingdom is facing, in particular available time and quality instruction for dissection labs. Described are the historical and modern teaching strategies used in anatomy and highlights of the positives and negatives of each. The focus of the author's statement is to highlight the need for a focus in anatomy pedagogy research and anatomy instructor programs.

Kapil Sugand (Imperial College London School of Medicine); Ashish Khurana (University Hospital of Wale Orthopedics)

2010-03-04

204

Role of drains in laparoscopic appendectomy for complicated appendicitis at a busy county hospital.  

PubMed

Laparoscopic appendectomy (LA) has become the treatment of choice for acute appendicitis with equal or better outcomes than traditional open appendectomy (OA). LA in patients with a gangrenous or perforated appendicitis carries increased rate of pelvic abscess formation when compared with OA. We hypothesized routine placement of pelvic drains in gangrenous or perforated appendicitis decreases pelvic abscess formation after LA. Three hundred thirty-one patients undergoing LA between January 2007 and June 2011 were reviewed. Patients with perforated or gangrenous appendicitis were included. Group I had a Jackson-Pratt (JP) drain(s) placed and Group II had no JP drain. Data included patient demographics, emergency department laboratory values and vital signs, and computed axial tomography scan findings, intra-abdominal or pelvic abscess postoperatively, interventional radiology drainage, and length of stay. Clinic follow-up notes were reviewed. One hundred forty-eight patients were identified. Forty-three patients had placement of JP drains (Group I) and 105 patients had no JP drain (Group II). Three patients (three of 43 [6%]) in Group I developed pelvic abscess and 21 of 105 (20%) patients in Group II developed pelvic abscesses requiring subsequent drainage. This was statistically significant. Patient demographics, temperature, and mean white blood count before surgery were similar. Presurgery computed tomography (CT) with appendicolith and CT with abscess were more prevalent in Group I. The use of JP drainage in patients with perforated or gangrenous appendicitis during LA has decreased rates of pelvic abscess. This was demonstrated despite the drain group having appendicolith or abscess on preoperative CT. PMID:25264664

Pakula, Andrea M; Skinner, Ruby; Jones, Amber; Chung, Ray; Martin, Maureen

2014-10-01

205

A randomized prospective trial of the postoperative quality of life between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy for the treatment of symptomatic uterine fibroids: clinical trial design  

Microsoft Academic Search

BACKGROUND: Laparoscopy-assisted vaginal hysterectomy is one of the definite methods for the treatment of symptomatic uterine fibroids with lesser intraoperative bleeding and shorter hospitalization compared with abdominal hysterectomy. However, laparoscopy-assisted vaginal hysterectomy cannot preserve uterus and can show postoperative complications by the change of pelvic structure. Thus, laparoscopic uterine artery ligation has been introduced for relieving the symptoms caused by

Hee Seung Kim; Jae Weon Kim; Mi-Kyung Kim; Hyun Hoon Chung; Taek Sang Lee; Yong-Tark Jeon; Yong Beom Kim; Hye Won Jeon; Young Ho Yun; Noh Hyun Park; Yong Sang Song; Soon-Beom Kang

2009-01-01

206

Mesh fistulation into the rectum after laparoscopic ventral mesh rectopexy?  

PubMed Central

INTRODUCTION Laparoscopic ventral mesh rectopexy (LVMR) is an effective method of management of functional disorders of the rectum including symptomatic rectal intussusception, and obstructed defaecation. Despite the technical demands of the procedure and common use of foreign body (mesh), the incidence of mesh related severe complications of the rectum is very low. PRESENTATION OF CASE A 63 year old woman presented with recurrent pelvic sepsis following a mesh rectopexy. Investigations revealed fistulation of the mesh into the rectum. She was treated with an anterior resection. DISCUSSION The intraoperative findings and management of the complication are described. Risk factors for mesh attrition and fistulation are also discussed. CONCLUSION Chronic sepsis may lead to ‘late’ fistulation after mesh rectopexy. PMID:24566425

Adeyemo, Dayo

2013-01-01

207

Radiology Anatomy Teaching Modules  

NSDL National Science Digital Library

As more and more individuals elect to enter the various health science professions, there is an increased demand for teaching resources designed to keep students aware of basic skills and techniques. Created by the University of Washington, these radiology anatomy teaching modules are designed to supplement regular instruction and to serve as a reference resource for medical educators and students. Along the left side of the site visitors will find a muscle atlas, an online radiology guide, and the "Teaching Files" area. Further down the homepage, visitors will find the "Anatomy Teaching Modules" section. Here visitors can take advantage of modules that cover the basic radiographic anatomy of selected parts of the skeleton and related resources.

2007-01-01

208

Veterinary Anatomy Instruction  

NSDL National Science Digital Library

With one of the most well regarded veterinary schools in the United States, the University of Minnesota continues to break new ground in the training of new veterinarians on a regular basis. Of course, more and more of these training materials are finding their way to the web, and this site will be quite helpful to those persons with an interest in this particular field. Created by different faculty members, the materials here are categorized by the course they are most commonly associated with, such as gross anatomy or neurobiology. In the gross anatomy section, visitors will find materials that include a glossary of terms related to veterinary anatomy and dissections, animations that illustrate the major gaits of various quadrupeds, and the nervous system pathways of canines. The neurobiology section contains instructional materials that include information about brain dissection neuroanatomy and neurohistology.

2006-10-30

209

Laparoscopic Surgery - What Is It?  

MedlinePLUS

... cavity to high-resolution video monitors in the operating room. During the operation the surgeon watches detailed images ... past there had been concern raised about the safety of laparoscopic surgery for cancer operations. Recently several ...

210

LAPAROSCOPIC HEMINEPHROURETERECTOMY IN PEDIATRIC PATIENTS  

Microsoft Academic Search

PurposeAn increasing number of operative procedures in pediatric urology can be performed by laparoscopy. We report our experience with laparoscopic heminephroureterectomy, which is a typical operation in pediatric patients.

Gunter Janetschek; Jorg Seibold; Christian Radmayr; Georg Bartsch

1997-01-01

211

Laparoscopic treatment of perforated appendicitis  

PubMed Central

The use of laparoscopy has been established in improving perioperative and postoperative outcomes for patients with simple appendicitis. Laparoscopic appendectomy is associated with less wound pain, less wound infection, a shorter hospital stay, and faster overall recovery when compared to the open appendectomy for uncomplicated cases. In the past two decades, the use of laparoscopy for the treatment of perforated appendicitis to take the advantages of minimally invasiveness has increased. This article reviewed the prevalence, approaches, safety disclaimers, perioperative and postoperative outcomes of the laparoscopic appendectomy in the treatment of patients with perforated appendicitis. Special issues including the conversion, interval appendectomy, laparoscopic approach for elderly or obese patient are also discussed to define the role of laparoscopic treatment for patients with perforated appendicitis. PMID:25339821

Lin, Heng-Fu; Lai, Hong-Shiee; Lai, I-Rue

2014-01-01

212

Laparoscopic salpingostomy versus laparoscopic local methotrexate injection in the management of unruptured ectopic gestation  

Microsoft Academic Search

OBJECTIVE: Our goal was to determine whether laparoscopic salpingostomy is preferable to laparoscopic methotrexate injection in the management of unruptured tubal gestation. STUDY DESIGN: Forty-eight patients with unruptured tubal pregnancy were prospectively randomized to either laparoscopic salpingostomy or laparoscopic local methotrexate injection in a university medical center. Operation time, duration of hospital stay, decrease in levels of ?-human chorionic gonadotropin,

Zilber; Pansky; Bukovsky; Golan

1996-01-01

213

The Drosophila anatomy ontology  

PubMed Central

Background Anatomy ontologies are query-able classifications of anatomical structures. They provide a widely-used means for standardising the annotation of phenotypes and expression in both human-readable and programmatically accessible forms. They are also frequently used to group annotations in biologically meaningful ways. Accurate annotation requires clear textual definitions for terms, ideally accompanied by images. Accurate grouping and fruitful programmatic usage requires high-quality formal definitions that can be used to automate classification and check for errors. The Drosophila anatomy ontology (DAO) consists of over 8000 classes with broad coverage of Drosophila anatomy. It has been used extensively for annotation by a range of resources, but until recently it was poorly formalised and had few textual definitions. Results We have transformed the DAO into an ontology rich in formal and textual definitions in which the majority of classifications are automated and extensive error checking ensures quality. Here we present an overview of the content of the DAO, the patterns used in its formalisation, and the various uses it has been put to. Conclusions As a result of the work described here, the DAO provides a high-quality, queryable reference for the wild-type anatomy of Drosophila melanogaster and a set of terms to annotate data related to that anatomy. Extensive, well referenced textual definitions make it both a reliable and useful reference and ensure accurate use in annotation. Wide use of formal axioms allows a large proportion of classification to be automated and the use of consistency checking to eliminate errors. This increased formalisation has resulted in significant improvements to the completeness and accuracy of classification. The broad use of both formal and informal definitions make further development of the ontology sustainable and scalable. The patterns of formalisation used in the DAO are likely to be useful to developers of other anatomy ontologies. PMID:24139062

2013-01-01

214

Simulation of Laparoscopic Surgery Lab  

NSDL National Science Digital Library

This simulation of laparoscopic surgery enables learners to practice and to learn this modern surgical technique. Learners discover how to manipulate a variety of instruments while watching a TV monitor, thereby learning to compensate while going from a 3-D situation to a 2-D situation. Learners also analyze the pros and cons of the procedure. Note: Laparoscopic instruments are needed for this activity; adult supervision and safety demonstration recommended. A/V equipment is also required.

Robitaille, Phyllis

2009-01-01

215

Laparoscopic colorectal resection for diverticulitis  

Microsoft Academic Search

This study evaluated outcome in patients undergoing laparoscopically assisted sigmoid resection for diverticular disease.\\u000a A total of 29 consecutive patients were treated surgically for colonic diverticulitis; in 27 of these laparoscopy was performed.\\u000a The review of medical records from a control group of 34 patients undergoing open resection were used for comparison. The\\u000a conversion rate was 7.5%. Using the laparoscopic

L. Köhler; D. Rixen; H. Troidl

1998-01-01

216

Rhabdomyolysis after Laparoscopic Bariatric Surgery  

Microsoft Academic Search

Background: Postoperative rhabdomyolysis is an uncommon event. The aim of this study was to determine the incidence of rhabdomyolysis\\u000a following laparoscopic obesity surgery. Methods: Rhabdomyolysis was studied prospectively. Over a 6-month period, 66 consecutive\\u000a patients underwent bariatric surgery (gastric banding (n=50) and gastric bypass (n=16)). All patients underwent laparoscopic\\u000a procedures. A range of blood tests, including serum creatine phosphokinase (CPK)

Philippe Mognol; Stéphane Vignes; Denis Chosidow; Jean-Pierre Marmuse

2004-01-01

217

DEPARTMENT OF ANATOMY AND NEUROBIOLOGY  

E-print Network

CREDIT-HOURS: 32 (33) First Year: 21 Credit-Hours ANAT 8501 Human Gross Anatomy 8 ANAT 8503 Human Embryology 2 ANAT 8504 Human Cell Biology and Microscopic Anatomy 4 ANAT 8505 Human Neuroanatomy WITH SPECIALTY IN ANATOMY (Ph.D.) TOTAL CREDIT-HOURS: 63 (65) First Year: 21 Credit-Hours ANAT 8501 Human Gross

Quirk, Gregory J.

218

GENERAL ANATOMY Introductory remarks. _... . __ ____ 65  

E-print Network

CHAPTER IV GENERAL ANATOMY Page Introductory remarks.· _·.·..·· · . ·__ ·· ·__·__ 65 Methods the arrangement and topography of the various systems of organs. The anatomy of edible oysters is described of the anatomy of C. virginica. The structure of the European oyster, O. edulis, is described by Orton (1937

219

Learning Anatomy Enhances Spatial Ability  

ERIC Educational Resources Information Center

Spatial ability is an important factor in learning anatomy. Students with high scores on a mental rotation test (MRT) systematically score higher on anatomy examinations. This study aims to investigate if learning anatomy also oppositely improves the MRT-score. Five hundred first year students of medicine ("n" = 242, intervention) and…

Vorstenbosch, Marc A. T. M.; Klaassen, Tim P. F. M.; Donders, A. R. T.; Kooloos, Jan G. M.; Bolhuis, Sanneke M.; Laan, Roland F. J. M.

2013-01-01

220

Computational Anatomy: An Emerging Discipline  

Microsoft Academic Search

This paper studies mathematical methods in the emerging new discipline of Computational Anatomy. Herein we formalize the Brown\\/Washington University model of anatomy following the global pattern theory introduced in [1, 2], in which anatomies are represented as deformable templates, collections of 0; 1; 2; 3 dimensional manifolds. Typical structure is carried by the template with the variabilities accommodated via the

Ulf Grenander; Michael I. Miller

1998-01-01

221

Pelvic inflammatory disease in adolescents.  

PubMed

Clinical, laboratory, and sonographic data were collected prospectively from 100 female adolescents hospitalized with acute pelvic inflammatory disease (PID). The endocervical isolation rates for Chlamydia trachomatis and Neisseria gonorrhoeae were 44.7% and 36.4%, respectively. In comparison with adolescents with chlamydia-associated PID, those with gonococcus-associated PID had a shorter duration of pain before admission (p less than 0.05), higher mean maximum temperatures (p less than 0.01), and higher leukocyte counts (p less than 0.01). Pelvic ultrasound studies showed adnexal enlargement or tubo-ovarian abscess (TOA) in 85.2% of the patients. Of the 88 adolescents in whom adequate sonograms were obtained, 17 (19.3%) had TOA. In 12 of the 17 adolescents, the abscesses were identified sonographically before being diagnosed clinically. With clinical criteria alone, only the leukocyte count and prior history of PID differed significantly between those with TOA and those with uncomplicated PID. These findings support a more liberal use of pelvic ultrasound studies in teenagers with PID. Our high detection rate of C. trachomatis and the difficulty in predicting the cause of the infection in an individual patient support treating all adolescents with PID with agents effective against both C. trachomatis and N. gonorrhoeae. PMID:2642549

Golden, N; Neuhoff, S; Cohen, H

1989-01-01

222

Allograft AlloDerm® tissue for laparoscopic transabdominal preperitoneal groin hernia repair: A case report  

PubMed Central

INTRODUCTION Synthetic mesh is the prosthetic material used for most inguinal hernioplasties. However, when left in contact with intra-abdominal viscera, it often becomes associated with infection and migration, particularly in irradiated tissues, contaminated fields, immunosuppressed individuals, and patients with intestinal obstruction or fistula. AlloDerm® Regenerative Tissue Matrix (LifeCell Corporation, Branchburg, NJ) is derived from human cadaver skin and may be associated with fewer visceral adhesions and more durability in infected fields than synthetic mesh. PRESENTATION OF CASE We report the first case in which AlloDerm was used in a laparoscopic transabdominal preperitoneal repair of a multiple recurrent right inguinal hernia, a left femoral hernia, and an umbilical hernia in the same patient. Use of AlloDerm greatly enhanced the maneuverability during laparoscopic hernia repair due to its pliability and strength and eliminated the need to cover the prosthetic with peritoneum. DISCUSSION Previous pelvic radiation and multiple previous groin repairs can render the peritoneum friable, resulting in obstacles to successful closure. AlloDerm is a reasonable choice for groin hernia repairs when such factors are present. CONCLUSION The long-term durability of AlloDerm for laparoscopic groin hernia repairs is yet to be determined, but based on current data it seems prudent to use this technique in laparoscopic repair of complex groin hernias where infection is suspected or inadequate prosthetic coverage with peritoneum is anticipated. PMID:24780773

Amirlak, Bardia; Gerdes, Jodi; Puri, Varun; Fitzgibbons, Robert J.

2014-01-01

223

Sentinel node mapping in high risk endometrial cancer after laparoscopic supracervical hysterectomy with morcellation?  

PubMed Central

INTRODUCTION Occult endometrial cancer after supracervical hysterectomy is very uncommon. Even if optimal management of those rare cases is still unproven, to guide the need for further therapies, restaging should be recommended in this situation. PRESENTATION OF CASE We report of a 60-year old woman with occult high risk endometrial cancer after supracervical hysterectomy with morcellation. We describe the feasibility of laparoscopic intraoperative sentinel node identification with cervical stump removing to restage the suspicious early stage high risk endometrial cancer. DISCUSSION In high risk endometrial cancer surgical restaging is important, considering that 10–35% of cases can present pelvic nodal metastasis. To reduce the treatment related morbidity maintaining the benefit of surgical staging, with a negative preoperative PET/CT, we performed a laparoscopic SN mapping with cervical stump removing. CONCLUSION This report highlight the fact that SN mapping with cervical injection is a feasible and safe technique also without the uterine corpus after supracervical hysterectomy with morcellation. PMID:23959405

Buda, Alessandro; Marco, Cuzzocrea; Dolci, Carlotta; Elisei, Federica; Baldo, Romina; Locatelli, Luca; Milani, Rodolfo; Messa, Cristina

2013-01-01

224

LAPAROSCOPIC PARTIAL NEPHRECTOMY FOR HILAR TUMORS  

Microsoft Academic Search

PurposePartial nephrectomy for hilar tumors represents a technical challenge not only for laparoscopic, but also for open surgeons. We report the technical feasibility and perioperative outcomes of laparoscopic partial nephrectomy (LPN) for hilar tumors.

INDERBIR S. GILL; JOSE R. COLOMBO; IGOR FRANK; ALIREZA MOINZADEH; JIHAD KAOUK; MIHIR DESAI

2005-01-01

225

Design of a pressure sensing laparoscopic grasper  

E-print Network

With smaller incisions, laparoscopic, or minimally invasive, surgery is considered safer for patients than open surgery. However, the safety of current laparoscopic grasping instruments can still be improved. Current devices ...

Reyda, Caitlin J. (Caitlin Jilaine)

2011-01-01

226

Approach to Carcinoma Cervix with Pelvic Kidney  

Microsoft Academic Search

To study the management of carcinoma cervix when the patient has an associated pelvic kidney. The simultaneous occurrence\\u000a of carcinoma cervix and pelvic kidney is rare. It is an interesting scenario where surgery is technically challenging and\\u000a radiation is difficult since the pelvic kidney lies within the field of radiation. In our department, we treated three cases\\u000a of cervical carcinoma

Rajaraman Ramamurthy; Vimalakannan Muthusamy; Syed Afroze Hussain

2010-01-01

227

Complete laparoscopic removal of a gastric trichobezoar  

PubMed Central

Trichobezoars are seen usually in adolescent girls and laparotomy is required to remove them, though recently laparoscopic assisted and laparoscopic removal have been reported in adults and older children. We report this 4-year-old boy who underwent complete laparoscopic removal of a gastric trichobezoar, both for its rarity in such young boys and also because he is the youngest reported patient to undergo complete laparoscopic removal of a gastric trichobezoar. PMID:25013333

Vepakomma, Deepti; Alladi, Anand

2014-01-01

228

Complete laparoscopic removal of a gastric trichobezoar.  

PubMed

Trichobezoars are seen usually in adolescent girls and laparotomy is required to remove them, though recently laparoscopic assisted and laparoscopic removal have been reported in adults and older children. We report this 4-year-old boy who underwent complete laparoscopic removal of a gastric trichobezoar, both for its rarity in such young boys and also because he is the youngest reported patient to undergo complete laparoscopic removal of a gastric trichobezoar. PMID:25013333

Vepakomma, Deepti; Alladi, Anand

2014-07-01

229

Laparoscopic Roux-en-Y gastric bypass  

Microsoft Academic Search

  Background: Increasing numbers of laparoscopic surgeons are performing laparoscopic Roux-en-Y gastric bypass (LGB). Our aim\\u000a was to determine the length of the learning curve for a skilled laparoscopic surgeon. Methods: The study population consisted\\u000a of the first 225 consecutive LGB procedures attempted by one laparoscopic surgeon (HJS). Outcome parameters included mortality,\\u000a morbidity, operative time, and conversion to an open procedure.

D. Oliak; G. H. Ballantyne; P. Weber; A. Wasielewski; R. J. Davies; H. J. Schmidt

2003-01-01

230

External Anatomy Lab  

NSDL National Science Digital Library

Interactive grasshopper anatomy lessons. Mouthparts, legs, abdomen, various sutures are all featured, as well as well as more general discussions about the types of insect antennae,wings, legs, and mouthparts. An excellent flash demonstration of mouthpart modifications is also featured.

0002-11-30

231

Clinical Topographic Anatomy  

NSDL National Science Digital Library

This website created by faculty at the University of Zurich and University of Australia provides mini-lectures on regional anatomy. The lectures are broken up by the head, neck & trunk, upper limb, lower Limb, thorax, abdomen, and pelvis. Quizzes for each region are also available.

2010-01-01

232

The Anatomy Puzzle Book.  

ERIC Educational Resources Information Center

This document features review questions, crossword puzzles, and word search puzzles on human anatomy. Topics include: (1) Anatomical Terminology; (2) The Skeletal System and Joints; (3) The Muscular System; (4) The Nervous System; (5) The Eye and Ear; (6) The Circulatory System and Blood; (7) The Respiratory System; (8) The Urinary System; (9) The…

Jacob, Willis H.; Carter, Robert, III

233

Laparoscopic Radical Prostatectomy: An Approach in Evolution  

Microsoft Academic Search

Laparoscopic radical prostatectomy has become an attractive and exciting approach for the surgical treatment of localized prostate cancer. Two main routes are mainly used, namely the transperitoneal and the extraperitoneal approach. Minimal bleeding, shorter hospitalization and recovery time are unquestionable advantages for laparoscopic procedures. Oncological and functional results of laparoscopic prostatectomies today are comparable to those of the open retropubic

Hubert John

2005-01-01

234

Application of Augmented Reality to Laparoscopic Surgery  

E-print Network

Application of Augmented Reality to Laparoscopic Surgery by Jeremy D. Ackerman A Dissertation to Laparoscopic Surgery. (Under the direction of Henry Fuchs, Ph. D..) ABSTRACT The usefulness and feasibility of an augmented reality visualization system for laparoscopic surgery is examined. This technology could enable

Whitton, Mary C.

235

Laparoscopic subtotal cholecystectomy for severe cholecystitis  

Microsoft Academic Search

Background: In severe cholecystitis, laparoscopic cholecystectomy can be technically difficult, and is associated with an increased rate of procedure conversions and common bile duct lesions. Methods: We investigated the safety and complications of laparoscopic subtotal cholecystectomy for severe cholecystitis in a medium- to long-term follow-up evaluation. Laparoscopic cholecystectomy was performed in 345 patients during a period of 64 months. In

G. Beldi; A. Glättli

2003-01-01

236

Laparoscopic pyloromyotomy for infantile hypertrophic pyloric stenosis  

Microsoft Academic Search

Although great advances in laparoscopic techniques have been made in the field of adult surgery, its application in infants and young children has been limited. We present a technique of laparoscopic pyloromyotomy that has been successfully used in two babies, employing specially made instruments. Laparoscopic surgery deserves further consideration in this age group.

H. L. Tan; A. Najmaldin

1993-01-01

237

Complex organ injuries after mid-trimester termination of pregnancy: pushing boundaries in laparoscopic management.  

PubMed

Surgical termination of pregnancy is one of the most often performed gynecologic procedures in the United Kingdom and worldwide. Although complications are rare, they can be devastating because they include hemorrhage and pelvic organ damage often necessitating hysterectomy. Traditionally, these complications have been managed via laparotomy; however, with increasing technological advances and surgical expertise, it is now possible to manage extreme complications of these procedures via operative laparoscopy. Herein is reported successful laparoscopic management of 3 cases of complex uterine perforation in young women after mid-trimester surgical termination of pregnancy. PMID:24183279

Lawin-O'Brien, Anna; Olowu, Ola; Shahid, Anupama; Odejinmi, Funlayo

2013-01-01

238

Robotic-assisted laparoscopic excision of gossypiboma simulating bladder wall mass after 35 years of appendectomy  

PubMed Central

Gossypiboma or textiloma are terms commonly used to describe a retained sponge in the body that is composed of sponge invested within a layer of foreign body reaction in the form of an abscess or an aseptic fibrotic reaction. These cases are rarely reported despite an incidence of 1:1,000-1,500 of abdominal or pelvic surgery. We report a patient who presented with an incidental supravesical mass discovered upon work up for frequency and suprapubic pain. He had appendectomy 35 years ago. The mass was excised by robotic-assisted laparoscopic technique. The pathologic evaluation came as gossypiboma. PMID:24833833

Rajih, Emad Sabri; Al-Khudair, Waleed Khalid; Al-Hussain, Turky; Al-Otaibi, Mohammed Faihan

2014-01-01

239

The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction  

Microsoft Academic Search

This article presents a standard system of terminology recently approved by the International Continence Society, the American Urogynecologic Society, and the Society of Gynecologic Surgeons for the description of female pelvic organ prolapse and pelvic floor dysfunction. An objective site-specific system for describing, quantitating, and staging pelvic support in women is included. It has been developed to enhance both clinical

Richard C. Bump; Anders Mattiasson; Kari Bø; Linda P. Brubaker; John O. L. DeLancey; Peter Klarskov; Bob L. Shull; Anthony R. B. Smith

1996-01-01

240

Recognizing Myofascial Pelvic Pain in the Female Patient with Chronic Pelvic Pain  

PubMed Central

Myofascial pelvic pain (MFPP) is a major component of chronic pelvic pain (CPP) and often is not properly identified by healthcare providers. The hallmark diagnostic indicator of MFPP is myofascial trigger points in the pelvic floor musculature that refer pain to adjacent sites. Effective treatments are available to reduce MFPP, including myofascial trigger point release, PMID:22862153

Pastore, Elizabeth Anne; Katzman, Wendy B.

2012-01-01

241

Retrospective review of pelvic malignancies undergoing total pelvic exenteration  

PubMed Central

Background In patients with locally advanced or recurrent pelvic malignancies, total pelvic exenteration (TPE) may be necessary for curative treatment. Despite improvements in mortality rates since TPE was first described, morbidity rates remain high due to the extensive resection and the aggressiveness of these tumors. We have studied the outcomes of TPE surgery performed at our institution. Methods Fifty-three patients with various pelvic pathologies underwent TPE between 2004 and 2010. Patients were divided into two groups based on pathology: colorectal (n?=?36) versus non-colorectal (n?=?17) malignancies. Demographics, operative reports, pathology reports, periprocedural events, and outcomes were analyzed. Comparison of the two groups was performed using student’s?t-test and Fisher’s exact test. Survival curves were constructed using the Kaplan–Meier method and compared using the log rank test. Results The colorectal and non-colorectal groups were similar in demographics, operative times, length of stay, estimated blood loss, and rates of preoperative and intraoperative radiation use. Chemotherapy use was increased in the colorectal group compared with the non-colorectal group (55.6% vs. 23.5%, P?=?0.04). Complication rates were similar: 86% in the colorectal group and 76% in the non-colorectal group. In the colorectal group, 27.8% of patients developed perineal abscesses, whereas no patients developed these complications in the non-colorectal group (P?=?0.02). No survival difference was seen in primary versus recurrent colorectal tumors; however, within the colorectal group there was a survival advantage when comparing R0 resection to R1 and R2 resection combined. Median survival rates were 27.3?months for R0 resection and 10.7?months for R1 and R2 resection combined. The median survival was 21.4?months for the colorectal group and 6.9?months for the non-colorectal group (P?=?0.002). Conclusions Patients undergoing TPE for colorectal tumors have improved survival when compared with patients undergoing exenteration for pelvic malignancies of other origins. Within the colorectal group, the extent of resection demonstrated a significant survival benefit of an R0 resection compared with R1 and R2 resections. Despite TPE carrying a high morbidity rate, mortality rates have improved and careful patient selection can optimize outcomes. PMID:22703863

2012-01-01

242

Pelvic radiculopathies, lumbosacral plexopathies, and neuropathies in oncologic disease: a multidisciplinary approach to a diagnostic challenge  

PubMed Central

Abstract The purpose of this article is to familiarize the reader with the anatomy of the major pelvic nerves and the clinical features of associated lumbosacral plexopathies. To demonstrate this we illustrate several cases of malignant lumbosacral plexopathy on computed tomography, magnetic resonance imaging, and positron emission tomography/computed tomography. A new lumbosacral plexopathy in a patient with a prior history of abdominal or pelvic malignancy is usually of malignant etiology. Biopsies may be required to definitively differentiate tumour from posttreatment fibrosis, and in cases of inconclusive sampling or where biopsies are not possible, follow-up imaging may be necessary. In view of the complexity of clinical findings often confounded by a history of prior surgery and/or radiotherapy, a multidisciplinary approach between oncologists, neurologists, and radiologists is often required for what can be a diagnostic challenge. PMID:24433993

Berry, Jonathan; Nisbet, Angus; Bloomfield, David; Burkill, Guy

2013-01-01

243

Toward a highly-detailed 3D pelvic model: approaching an ultra-specific level for surgical simulation and anatomical education.  

PubMed

The surgical anatomy of the pelvis is highly complex. Anorectal and urogenital dysfunctions occur frequently after pelvic oncological surgery and are mainly caused by surgical damage of the autonomic nerves. A highly-detailed 3D pelvic model could increase the anatomical knowledge and form a solid basis for a surgical simulation system. Currently, pelvic surgeons still rely on the preoperative interpretation of 2D diagnostic images. With a 3D simulation system, pelvic surgeons could simulate and train different scenes to enhance their preoperative knowledge and improve surgical outcome. To substantially enrich pelvic surgery and anatomical education, such a system must provide insight into the relation between the autonomic network, the lymphatic system, and endopelvic fasciae. Besides CT and MR images, Visible Human Datasets (VHDs) are widely used for 3D modeling, due to the high degree of anatomical detail represented in the cryosectional images. However, key surgical structures cannot be fully identified using VHDs and radiologic imaging techniques alone. Several unsolved anatomical problems must be elucidated as well. Therefore, adequate analysis on a microscopic level is inevitable. The development of a comprehensive anatomical atlas of the pelvis is no straightforward task. Such an endeavor involves several anatomical and technical challenges. This article surveys all existing 3D pelvic models, focusing on the level of anatomical detail. The use of VHDs in the 3D reconstruction of a highly-detailed pelvic model and the accompanying anatomical challenges will be discussed. PMID:23255348

Kraima, A C; Smit, N N; Jansma, D; Wallner, C; Bleys, R L A W; van de Velde, C J H; Botha, C P; DeRuiter, M C

2013-04-01

244

Laparoscopic Adrenalectomy for Adrenal Tumors  

PubMed Central

Objective. To evaluate the indication and the clinical value of laparoscopic adrenalectomy of different types of adrenal tumor. Methods. From 2009 to 2014, a total of 110 patients were diagnosed with adrenal benign tumor by CT scan and we performed laparoscopic adrenalectomy. The laparoscopic approach has been the procedure of choice for surgery of benign adrenal tumors, and the upper limit of tumor size was thought to be 6?cm. Results. 109 of 110 cases were successful; only one was converted to open surgery due to bleeding. The average operating time and intraoperative blood loss of pheochromocytoma were significantly more than the benign tumors (P < 0.05). After 3 months of follow-up, the preoperative symptoms were relieved and there was no recurrence. Conclusions. Laparoscopic adrenalectomy has the advantages of minimal invasion, less blood loss, fewer complications, quicker recovery, and shorter hospital stay. The full preparation before operation can decrease the average operating time and intraoperative blood loss of pheochromocytomas. Laparoscopic adrenalectomy should be considered as the first choice treatment for the resection of adrenal benign tumor. PMID:25132851

Chuan-yu, Sun; Yat-faat, Ho; Wei-hong, Ding; Yuan-cheng, Gou; Qing-feng, Hu; Ke, Xu; Bin, Gu; Guo-wei, Xia

2014-01-01

245

Totally retroperitoneal laparoscopic aortobifemoral bypass.  

PubMed

The classic procedure for aortobifemoral bypass is open surgery. Since the first totally laparoscopic aortobifemoral bypass reported in 1997 by Yves-Marie Dion, laparoscopy has been accepted by several authors as a possible minimally invasive alternative for aorto-iliac occlusive disease. The transperitoneal left retrocolic and retrorenal ways are generally used. The totally retroperitoneal laparoscopic procedure has been described as an alternative to the transperitoneal approach. We report here a totally laparoscopic retroperitoneal approach to performing aortobifemoral bypass. This approach was proposed to a 51-year-old man with aorto-iliac occlusive disease. There was no indication for endovascular revascularization. The patient suffered from 10 metres of bilateral intermittent claudication and lower limb ulcers. During the surgical procedure our patient was placed in a 30-degree right lateral decubitus position. The optical system was first placed in an intra-abdominal position to check the positioning of the trocars in the left retroperitoneal space. The dissection of the retroperitoneal space was performed by CO2 insufflation and by blunt dissection using laparoscopic forceps. The infrarenal aorta was exposed and clamped by laparoscopic clamps. A bifurcated graft was sutured on the left-hand side of the aorta by a running suture. Both prosthetic limbs were tunnelized retroperitoneally to the groin under optical control. The femoral anastomoses were performed by classic open surgery. PMID:18074917

Segers, B; Lemaitre, J; Bosschaerts, Th; Guntz, E; Roman, A; Jozsa, B; Hazane, E; Horn, D; Pastijn, I; Barroy, J P

2007-01-01

246

Entry Complications in Laparoscopic Surgery  

PubMed Central

To review the complications associated with laparoscopic surgery and provide clinical direction regarding the best practice based on the best available evidence. The laparoscopic entry techniques and technologies reviewed include the classic pneumoperitoneum (Veress/trocar), the open (Hasson), the direct trocar insertion, the use of disposable shielded trocars, radially expanding trocars and visual entry systems. Medline, Pubmed and Cochrane Databases were searched for English language articles published before December 2008. It is an evidence based fact that minimal access surgery is superior to conventional open surgery since this is beneficial to the women, community and the healthcare system.Over the past 50 years, many techniques, technologies and guidelines have been introduced to eliminate the risks associated with laparoscopic entry. No single technique or instrument has been proved to eliminate laparoscopic entry associated injury. Proper evaluation of the women, supported by surgical skills and good knowledge of the technology and instrumentation is the keystone to safe access and prevention of complications during laparoscopic surgery. PMID:22442503

Krishnakumar, S; Tambe, P

2009-01-01

247

Development of virtual environments for training skills and reducing errors in laparoscopic surgery  

NASA Astrophysics Data System (ADS)

In every surgical procedure there are key steps and skills that, if performed incorrectly, can lead to complications. In conjunction with efforts, based on task and error analysis, in the Videoscopic Training Center at UCSF to identify these key elements in laparoscopic surgical procedures, the authors are developing virtual environments and modeling methods to train the elements. Laparoscopic surgery is particularly demanding of the surgeon's spatial skills, requiring the ability to create 3D mental models and plans while viewing a 2D image. For example, operating a laparoscope with the objective lens angled from the scope axis is a skill that some surgeons have difficulty mastering, even after using the instrument in many procedures. Virtual environments are a promising medium for teaching spatial skills. A kinematically accurate model of an angled laparoscope in an environment of simple targets is being tested in courses for novice and experienced surgeons. Errors in surgery are often due to a misinterpretation of local anatomy compounded with inadequate procedural knowledge. Methods to avoid bile duct injuries in cholecystectomy are being integrated into a deformable environment consisting of the liver, gallbladder, and biliary tree. Novel deformable tissue modeling algorithms based on finite element methods will be used to improve the response of the anatomical models.

Tendick, Frank; Downes, Michael S.; Cavusoglu, Murat C.; Gantert, Walter A.; Way, Lawrence W.

1998-06-01

248

Laparoscopic liver resection: Wedge resections to living donor hepatectomy, are we heading in the right direction?  

PubMed Central

Despite inception over 15 years ago and over 3000 completed procedures, laparoscopic liver resection has remained mainly in the domain of selected centers and enthusiasts. Requirement of extensive open liver resection (OLR) experience, in-depth understanding of anatomy and considerable laparoscopic technical expertise may have delayed wide application. However healthy scepticism of its actual benefits and presence of a potential publication bias; concern about its safety and technical learning curve, are probably equally responsible. Given that a large proportion of our work, at least in transplantation is still OLR, we have attempted to provide an entirely unbiased, mature opinion of its pros and cons in the current invited review. We have divided this review into two sections as we believe they merit separate attention on technical and ethical grounds. The first part deals with laparoscopic liver resection (LLR) in patients who present with benign or malignant liver pathology, wherein we have discussed its overall outcomes; its feasibility based on type of pathology and type of resection and included a small section on application of LLR in special scenarios like cirrhosis. The second part deals with the laparoscopic living donor hepatectomy (LDH) experience to date, including its potential impact on transplantation in general. Donor safety, graft outcomes after LDH and criterion to select ideal donors for LLR are discussed. Within each section we have provided practical points to improve safety in LLR and attempted to reach reasonable recommendations on the utilization of LLR for units that wish to develop such a service. PMID:25309070

Cherian, P Thomas; Mishra, Ashish Kumar; Kumar, Palaniappen; Sachan, Vijayant Kumar; Bharathan, Anand; Srikanth, Gadiyaram; Senadhipan, Baiju; Rela, Mohamad S

2014-01-01

249

Urogenital disorders after pelvic ring injuries  

PubMed Central

Introduction The close anatomical relationship between the skeletal and connective systems of the pelvis, neurological, and vascular structures and pelvic organs are predisposing factors for structural and functional damages of the urogenital system. Materials and methods We performed PUBMED and MEDLINE search using terms “pelvic ring trauma/disruption, bladder injury, urethral injury, sexual dysfunction”. Results The probability of damage of the pelvic organs increases along with the degree of disturbance of integrity of the pelvic ring. The most important risk factor of urogenital injuries is the rupture of the symphyseal joint. Patients with lesions of the urogenital system have a higher risk of mortality compared with patients without lesions of the urogenital system. Sexual dysfunctions along with urinary incontinence are a common consequence of the pelvic fracture in men and women. Conclusions Injuries of the urogenital organs during pelvic ring fractures have an important negative prognostic value in terms of morbidity and quality of life. A prerequisite for a successful therapeutic outcome in case of pelvic fractures with disturbance of pelvic ring integrity is cooperation of orthopedists and urologists, with possible early diagnosis and treatment of injuries of the urogenital organs. PMID:24707384

Ter-Grigorian, Atom A.; Pushkar, Dmitry Y.

2013-01-01

250

Pelvic-floor exercises for incontinence  

Microsoft Academic Search

Most women have little or no idea of where their pelvic-floor muscles are, what they do or how they can be exercised. Assessment and instruction by a specialist physiotherapist should be the first line of treatment for women with stress or urge incontinence or genital prolapse. Without expert instruction a woman may exercise conscientiously but entirely ineffectually. Correct pelvic-floor exercise

Georgina Evans

2005-01-01

251

Pelvic neuroblastoma: Low mortality and high morbidity  

Microsoft Academic Search

Background\\/Purpose: Cervical, thoracic, and pelvic neuroblastomas are regarded as having a better outcome than abdominal primaries. The aim of the study was to analyze the results of treatment of pelvic neuroblastomas in our institution. Methods: The authors reviewed the records of 284 patients with neuroblastoma treated in our hospital during the period 1983 through 1998 and identified 17 (6%) with

A Cruccetti; E. M Kiely; L Spitz; D. P Drake; J Pritchard; A Pierro

2000-01-01

252

Transcatheter embolization for massive posttraumatic pelvic hemorrhage  

Microsoft Academic Search

The purpose of this study was a retrospective review of patients treated by transcatheter embolization for management of life-treatening pelvic hemorrhage due to trauma. Sixty-one patients with suspected significant pelvic hemorrhage from trauma were referred for arteriography and consideration of embolization. The etiology was blunt trauma in 56 patients (92%) and gunshot wound in 5 patients (8%). Embolization followed selective

Stephen H. Smyth; Christopher J. Bosarge; Donald J. Roach; Mark S. Asay; Gerald D. Pond

1997-01-01

253

38 CFR 4.67 - Pelvic bones.  

...Relief 1 2014-07-01 2014-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans...Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of residuals following these fractures...

2014-07-01

254

38 CFR 4.67 - Pelvic bones.  

Code of Federal Regulations, 2011 CFR

...Relief 1 2011-07-01 2011-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans...Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of residuals following these fractures...

2011-07-01

255

38 CFR 4.67 - Pelvic bones.  

Code of Federal Regulations, 2013 CFR

...Relief 1 2013-07-01 2013-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans...Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of residuals following these fractures...

2013-07-01

256

38 CFR 4.67 - Pelvic bones.  

Code of Federal Regulations, 2010 CFR

...Relief 1 2010-07-01 2010-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans...Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of residuals following these fractures...

2010-07-01

257

38 CFR 4.67 - Pelvic bones.  

Code of Federal Regulations, 2012 CFR

...Relief 1 2012-07-01 2012-07-01 false Pelvic bones. 4.67 Section 4.67 Pensions, Bonuses, and Veterans...Disability Ratings The Musculoskeletal System § 4.67 Pelvic bones. The variability of residuals following these fractures...

2012-07-01

258

Determinants and Management Outcomes of Pelvic Organ Prolapse in a Low Resource Setting  

PubMed Central

Background: The last decade has seen significant progress in understanding of the pathophysiology, anatomy and management modalities of pelvic organ prolapse. A review of the way we manage this entity in a low resource setting has become necessary. Aim: The aim of the study is to determine the incidence, risk factors and management modalities of pelvic organ prolapse. Materials and Methods: A 5-year cross-sectional study with retrospective data collection of women who attended the gynecologic clinic in Nnamdi Azikiwe University Teaching Hospital, Nnewi, south-east Nigeria and were diagnosed of pelvic organ prolapse was made. Proforma was initially used for data collection before transfer to Epi-info 2008 (v 3.5.1; Epi Info, Centers for Disease Control and Prevention, Atlanta, GA) software. Results: There were 199 cases of pelvic organ prolapse, out of a total gynecologic clinic attendance of 3082, thus giving an incidence of 6.5%. The mean age was 55.5 (15.9) years with a significant association between prolapse and advanced age (P < 0.001). The age range was 22-80 years. The leading determinants were menopause, advanced age, multiparity, chronic increase in intra-abdominal pressure (IAP) and prolonged labor. Out of the 147 patients with uterine prolapse, majority, 60.5% (89/147) had third degree prolapse. Vaginal hysterectomy with pelvic floor repair was the most common surgery performed. The average duration of hospital stay following surgery was 6.8 (2.9) days and the most common complication was urinary tract infection, 13.5% (27/199). The recurrence rate was 13.5% (27/199). Most of the patients who presented initially with pelvic organ prolapse were lost to follow-up. Conclusion: The incidence of pelvic organ prolapse in this study was 6.5% and the leading determinants of pelvic organ prolapse were - multiparity, menopause, chronic increase in IAP and advanced age. Most were lost to follow-up and a lesser proportion was offered conservative management. Early presentation of women is necessary so that conservative management could be offered if feasible. PMID:25328796

Eleje, GU; Udegbunam, OI; Ofojebe, CJ; Adichie, CV

2014-01-01

259

Syllabus Human Anatomy and Human Anatomy Laboratory -Biol 350 Spring 2014 page 1 of 10  

E-print Network

Syllabus Human Anatomy and Human Anatomy Laboratory - Biol 350 Spring 2014 page 1 of 10 Welcome to Human Anatomy! Except for those destined for medical or dental school, it is assumed that students Anatomy and Human Anatomy Laboratory - Biol 350 Spring 2014 page 2 of 10 #12;Syllabus Human Anatomy

Houde, Peter

260

Laparoscopic repair of recurrent hernias.  

PubMed

The purpose of this study was to evaluate the results of a laparoscopic approach to recurrent inguinal hernia repair which dissected the entire inguinal floor and repaired all potential areas of recurrence without producing tension. Both a transabdominal preperitoneal and a totally extraperitoneal laparoscopic approach were utilized. Ninety recurrent hernias were repaired in 81 patients. The patients had 26 indirect, 36 direct, and 26 pantaloon recurrent hernias of which eight had a femoral component. In all but one patient the primary operations were open anterior repairs. The median follow-up was 14 months, ranging from 1 to 28 months. Patients returned to normal activities in an average of 1 week. The only recurrence observed was in the one patient whose primary repair was laparoscopic. When the entire inguinal floor of the recurrent hernia was redissected and buttressed with mesh, early recurrence was eliminated and recovery was shortened. PMID:7597580

Felix, E L; Michas, C A; McKnight, R L

1995-02-01

261

[Laparoscopic evaluation of the appendix].  

PubMed

In the Netherlands every year about 16,000 appendectomies are carried out. Despite the increase in preoperative radiological evaluation of the appendix, the negative appendectomy rate is still around 16%, with a morbidity of approximately 5%. The Dutch practice guideline on appendicitis states that a normal appendix should not be removed, although laparoscopic criteria to establish appendicitis are lacking. Retrospective analysis of negative appendectomies shows that in 51% of cases the surgeon was convinced the appendix was inflamed. Furthermore, in an online survey, 78% of responding Dutch surgeons stated that if good and reproducible criteria for identifying appendicitis during laparoscopy were available they would use them. In conclusion, laparoscopic evaluation of the appendix is not always easy and use of the laparoscopic appendicitis score (LAPP) might lead to fewer negative appendectomies with their associated morbidity. Surgeons should be more aware of the morbidity associated with a negative appendectomy. PMID:23548189

Hamminga, Jenneke T H; Hofker, H Sijbrand; Haveman, Jan Willem

2013-01-01

262

Multidisciplinary Management of Blunt Pelvic Trauma  

PubMed Central

Pelvic fractures account for ?3% of all fractures and usually occur in patients with polytrauma. Pelvic fractures usually indicate high energy transfer and a significant mechanism of injury, and they can involve massive hemorrhage. For this reason, mortality from pelvic trauma is high, ranging from 40% to 60% among patients in shock, and up to 90% in patients considered to be in extremis. Multidisciplinary approaches in the treatment of patients with pelvic fractures have resulted in improved outcomes for these complex and challenging injuries. In this article, we describe a case of a pediatric patient who suffered severe pelvic fracture with massive hemorrhage, requiring a multidisciplinary approach for control of hemorrhage and definitive repair of injuries. PMID:23997410

Khanna, Pavan; Phan, Ho; Hardy, Andrew Hal; Nolan, Timothy; Dong, Paul

2012-01-01

263

Laparoscopic renal cryoablation.  

PubMed

In light of evidence linking radical nephrectomy and consequent suboptimal renal function to adverse cardiovascular events and increased mortality, research into nephron-sparing techniques for renal masses widely expanded in the past two decades. The American Urological Association (AUA) guidelines now explicitly list partial nephrectomy as the standard of care for the management of T1a renal tumors. Because of the increasing utilization of cross-sectional imaging, up to 70% of newly detected renal masses are stage T1a, making them more amenable to minimally invasive nephron-sparing therapies including laparoscopic and robotic partial nephrectomy and ablative therapies. Cryosurgery has emerged as a leading option for renal ablation, and compared with surgical techniques it offers benefits in preserving renal function with fewer complications, shorter hospitalization times, and allows for quicker convalescence. A mature dataset exists at this time, with intermediate and long-term follow-up data available. Cryosurgical recommendations as a first-line therapy are made at this time in limited populations, including elderly patients, patients with multiple comorbidities, and those with a solitary kidney. As more data emerge on oncologic efficacy, and technical experience and the technology continue to improve, the application of this modality will likely be extended in future treatment guidelines. PMID:24596441

Schiffman, Marc; Moshfegh, Amiel; Talenfeld, Adam; Del Pizzo, Joseph J

2014-03-01

264

Lateral canthal anatomy: a review.  

PubMed

The anatomy of the lateral canthus is analogous to that of the medial canthus, but with a less defined structure. Although the lateral canthal tendon occupies the major part of the lateral canthal anatomy, the lateral rectus capsulopalpebral fascia and other structures also play a significant role. Appropriate comprehension and consideration of the lateral canthal anatomy enable safe and effective performance in the lateral canthal surgeries. In this review, we present the lateral canthal anatomy along with updated topics. We discuss the lateral canthal tendon, lateral orbital thickening, lateral palpebral raphe, lateral canthal muscle, lateral rectus capsulopalpebral fascia, lateral check ligament, lateral retinaculum, and orbitomalar ligament. PMID:22690873

Kang, Hyera; Takahashi, Yasuhiro; Ichinose, Akihiro; Nakano, Takashi; Asamoto, Ken; Ikeda, Hiroshi; Iwaki, Masayoshi; Kakizaki, Hirohiko

2012-08-01

265

University of Oregon Human Anatomy I  

E-print Network

University of Oregon Human Anatomy I HPHY 321 Fall 2013 Monday learning opportunity occurs if students choose to take HPHY 321 (Anatomy I Resources: 1. Anatomy & Physiology Revealed 3.0, Web-Based Program. This is a great

Lockery, Shawn

266

HUMAN GROSS ANATOMY ANTH 695 SPRING 2014  

E-print Network

1 HUMAN GROSS ANATOMY ANTH 695 � SPRING 2014 THE UNIVERSITY OF TENNESSEE description: Human Gross Anatomy provides advanced graduate students with in in Anatomy Lecture Series Fridays: 12:20 PM � 1:10 PM * All

Auerbach, Benjamin M.

267

Anatomy Adventure: A Board Game for Enhancing Understanding of Anatomy  

ERIC Educational Resources Information Center

Certain negative factors such as fear, loss of concentration and interest in the course, lack of confidence, and undue stress have been associated with the study of anatomy. These are factors most often provoked by the unusually large curriculum, nature of the course, and the psychosocial impact of dissection. As a palliative measure, Anatomy

Anyanwu, Emeka G.

2014-01-01

268

SKELETAL ANATOMY The Anatomy of Sea Turtles 53  

E-print Network

become more pronounced as the turtles age. Figs. 107a and 107b. The pelvis of the leatherback is composedSKELETAL ANATOMY The Anatomy of Sea Turtles 53 intermedium centrale humerus lateral process distal of a leatherback flipper. ba Fig. 101. The cheloniid humerus is distinctive in its form with a slight- ly offset

269

Magnetic resonance nephrography for planning of laparoscopic partial nephrectomy in a pediatric case of ureteral triplication.  

PubMed

We present the case of ureteral triplication with vesicoureteral reflux into the lowest and middle pole in a 5-year-old girl. Magnetic resonance (MR) nephrography depicted loss of function of the lowest pole, which could not be assessed through MAG3 renal scan. Morphologic analyses revealed organ structure and vascular anatomy in superior quality. A laparoscopic partial nephroureterectomy of the lower pole was performed. Intraoperative findings correlated exactly with morphologic data obtained through MR nephrography. Dynamic MR nephrography should be considered as diagnostic tool of choice for selected kidney anomalies before surgery. PMID:20920729

Flechsig, Henrike; Fuchs, Joerg; Warmann, Steven W; Schaefer, Juergen F

2010-10-01

270

Laparoscopic right hemicolectomy with complete mesocolic excision provides acceptable perioperative outcomes but is lengthy -- analysis of learning curves for a novice minimally invasive surgeon  

PubMed Central

Background Associated with reduced trauma, laparoscopic colon surgery is an alternative to open surgery. Furthermore, complete mesocolic excision (CME) has been shown to provide superior nodal yield and offers the prospect of better oncological outcomes. Methods All oncologic laparoscopic right colon resections with CME performed by a single surgeon since the beginning of his surgical practice were retrospectively analyzed for operative duration and perioperative outcomes. Results The study included 81 patients. The average duration of surgery was 220.0 (range 206–233) minutes. The initial durations of about 250 minutes gradually decreased to less than 200 minutes in an inverse linear relationship (y = ?0.58x × 248). The major complication rate was 3.6% ± 4.2% and the average nodal yield was 31.3 ± 4.1. CumulativeSum analysis showed acceptable complication rates and oncological results from the beginning of surgeon’s laparoscopic career. Conclusion Developing laparoscopic skills can provide acceptable outcomes in advanced right hemicolectomy for a surgeon who primarily trained in open colorectal surgery. Operative duration is nearly triple that reported for conventional laparoscopic right hemicolectomy. The slow operative duration learning curve without a plateau reflects complex anatomy and the need for careful dissection around critical structures. Should one wish to adopt this strategy either based on some available evidence of superiority or with intention to participate in research, one has to change the view of right hemicolectomy being a rather simple case to being a complex, lengthy laparoscopic surgery. PMID:25265107

Melich, George; Jeong, Duck Hyoun; Hur, Hyuk; Baik, Seung Hyuk; Faria, Julio; Kim, Nam Kyu; Min, Byung Soh

2014-01-01

271

Laparoscopic colectomy: A critical appraisal  

Microsoft Academic Search

A multicenter retrospective study was undertaken to assess the efficacy and safety of laparoscopy in colon and rectal surgery. To minimize potential bias in interpretation of the results, all data were registered with an independent observer, who did not participate in any of the surgical procedures. Sixty-six patients underwent a laparoscopic procedure. Operations performed included sigmoid colectomy (19), right hemicolectomy

P. M. Falk; R. W. Beart; S. D. Wexner; A. G. Thorson; D. G. Jagelman; I. C. Lavery; O. B. Johansen; R. J. Fitzgibbons

1993-01-01

272

Robot-assisted laparoscopic choledochojejunostomy  

Microsoft Academic Search

Background: Endoscopic stenting is the treatment of choice for palliative relief of biliary obstruction by a periampullary tumor. If treated surgically, a choledochojejunostomy and Roux-en-Y diversion is still performed by laparotomy in a large number of cases due to technical challenges of the biliodigestive anastomosis in the laparoscopic approach. Robotic systems may enhance dexterity and vision and might therefore support

J. P. Ruurda; K. W. van Dongen; J. Dries; I. H. M. Borel Rinkes; I. A. M. J. Broeders

2003-01-01

273

Stump Appendicitis following Laparoscopic Appendectomy  

PubMed Central

Stump appendicitis (SA) is a rare clinicopathologic entity characterised by inflammation of the appendiceal remnant after incomplete appendectomy. The diagnosis is not routinely suspected in patients who have previously undergone appendectomy. We report a case of SA in an adolescent boy who had previously undergone laparoscopic appendectomy. The case necessitated surgical completion of the appendectomy. PMID:21509217

Parameshwarappa, Suresh; Rodrigues, Gabriel; Prabhu, Raghunath; Sambhaji, Charudutt

2011-01-01

274

Laparoscopic management of appendicular mass  

PubMed Central

BACKGROUND: Laparoscopic appendectomy is becoming the preferred technique for treating acute appendicitis. However, its role in the treatment of complicated appendicitis is controversial. This study was undertaken to assess the feasibility of laparoscopic appendectomy for appendicular mass. MATERIALS AND METHODS: A retrospective review was performed of all the patients who were treated laparoscopically for appendicular mass from March 2007 to October 2009. Setting: Tertiary care hospital. RESULTS: A total of 120 patients were treated for appendicitis. A retrospective review of the patients’ records demonstrated that 19 patients (15.8%) had appendicular mass at the time of admission. The average operative time was 95 minutes (range 45-140 minutes). Pathological evidence of appendicitis was present in all the patients. The average length of hospital stay was six days (rang 6-9 days). Three patients (15.7%) had post- operative complications. Two patients developed wound infections and one patient was re-admitted with pain and a lump below the umbilical port. CONCLUSION: The findings suggest that laparoscopic appendectomy is feasible in patients with appendicular mass. The authors propose a prospective, randomized trial to verify this finding. PMID:21523236

Shindholimath, Vishwanath V; Thinakaran, K; Rao, T Narayana; Veerappa, Yenni Veerabhadrappa

2011-01-01

275

[Conversion in laparoscopic cholecystectomy].  

PubMed

Laparoscopic cholecystectomy (LC) has become the gold standard in the treatment of symptomatic cholelithiasis. Some patients require conversion to open surgery and several preoperative variables have been identified as risk factors that are helpful in predicting the probability of conversion. The aim of this study was to analyze the factors that make LC difficult and determine conversion to open approach: Our study includes: 6985 cases which underwent LC and 1430 cases with open cholecystectomy, between March 1993 and April 2005 in our clinic of general surgery. The overall conversion rate was 5.1% (deliberate conversion--299 cases, conversion of necessity--62 cases). The conversion rate has decreased from 17.5% in 1993 to 3.2% in recent years. The most conversion happen after a simple inspection or a minimal dissection caused by the existence of perforation (105 cases), the discovery of a difficult anatomic situation (63 cases) or of another pathology (14 cases); more rarely, the conversion was necessary in the principal time, doing to hemorrhage (26 cases), impossible dissection (41 cases), visceral injury (1 case) or even at the end of the operation, doing to hemorrhage, loss piece or stone (10 cases), and other situations (101 cases). Significant predictors of conversion were acute cholecystitis , choledocholithiasis, past history of acute cholecystitis, male gender, gall bladder wall thickness exceeding 6 mm. In conclusion, based on our experience, we suggest limiting OC to patients with proven contraindications to LC (i.e., Mirizzi syndrome or systemic illness incompatible with general anesthesia or pneumoperitoneum), attempting LC in all other cases. Decision to convert to open approach is a proven of surgical maturity. Conversion must be decided from the beginning, in the moment of the recognition of a difficult situation and not after the occurrence of a complication. PMID:16372669

Târcoveanu, E; Niculescu, D; Georgescu, St; Epure, Oana; Bradea, C

2005-01-01

276

PROSPECTIVE, RANDOMIZED COMPARISON OF TRANSPERITONEAL VERSUS RETROPERITONEAL LAPAROSCOPIC ADRENALECTOMY  

Microsoft Academic Search

PurposeWe report a prospective, randomized comparison of transperitoneal laparoscopic adrenalectomy (TLA) vs retroperitoneal laparoscopic adrenalectomy (RLA) for adrenal lesions with long-term followup.

MAURICIO RUBINSTEIN; INDERBIR S. GILL; MONISH ARON; METE KILCILER; ANOOP M. MERANEY; ANTONIO FINELLI; ALI MOINZADEH; OSAMU UKIMURA; MIHIR M. DESAI; JIHAD KAOUK; EMMANUEL BRAVO

2005-01-01

277

[Celioscopic pelvic and para-aortic lymphadenectomy].  

PubMed

Because small volume lymph node metastases are difficult to recognize despite modern imaging techniques and since staging laparoscopy is costly and leads to important patient discomfort, pelvic then para-aortic lymph node endoscopic dissection has been introduced for staging gynaecological cancers. Since 1988, we have performed 110 pelvic and 17 para-aortic lymph node dissections using this technique. Pava-aortic endoscopic biopsy is indicated for advanced cancer of the cervix and subrenal biopsy for cancer of the ovary. Pelvic node dissection alone is useful in early stage cancers of the uterus and in cancers of the endometrium as well as in urological indications. PMID:7805478

Querleu, D; Leblanc, E; Castelain, B; Elhage, A

278

Wiley Anatomy Website  

NSDL National Science Digital Library

Wiley InterScience (described in the October 3, 1997 Scout Report) is the online journal service for John Wiley & Sons. As part of their contribution to the information highway, InterScience offers three separate Internet resource centers featuring anatomy, neuroscience, and genetics. Each Website is intended as a gateway for researchers and educators in relevant disciplines, and includes discussion about and links to Wiley publications (journals). While access to all Wiley publications is not free, several sample articles are provided for each journal.

279

Cancer Genome Anatomy Project  

NSDL National Science Digital Library

The National Cancer Institute has launched the Cancer Genome Anatomy Project to "achieve a comprehensive molecular characterization of normal, precancerous, and malignant cells." Sequenced genes are held as library entries in a database and are available for downloading (fasta format). Each cDNA library entry may include biological source, number of sequences, and library construction detail information. Thousands of gene sequences are available for over 15 cancers, including breast, colon, and prostrate. Contact information for donating or obtaining tissue samples for research purposes is provided.

1997-01-01

280

Anatomy of Criticism: Four Essays  

E-print Network

Anatomy of Criticism: Four Essays Northrop Frye Here is a book fundamental enough to be entitled theorists of the twen- tieth century,and Anatomy of Criticism is his magnum opus.More than any other North American critic, Frye paved the way for the explosion of interest in literary theory that took hold

Landweber, Laura

281

Laparoscopic cholecystectomy in the new millennium  

Microsoft Academic Search

Background  Laparoscopic cholecystectomy has become the gold standard for the treatment of symptomatic cholelithiasis. Many authors—including\\u000a investigators at our institution, who reported one of the initial experiences with laparoscopic cholecystectomy in July 1992—have\\u000a documented a definite learning curve associated with this procedure. We present a follow-up study of our experience with laparoscopic\\u000a cholecystectomy and compare these data to an earlier study

J. B. Lichten; J. J. Reid; M. P. Zahalsky; R. L. Friedman

2001-01-01

282

The quail anatomy portal.  

PubMed

The Japanese quail is a widely used model organism for the study of embryonic development; however, anatomical resources are lacking. The Quail Anatomy Portal (QAP) provides 22 detailed three-dimensional (3D) models of quail embryos during development from embryonic day (E)1 to E15 generated using optical projection tomography. The 3D models provided can be virtually sectioned to investigate anatomy. Furthermore, using the 3D nature of the models, we have generated a tool to assist in the staging of quail samples. Volume renderings of each stage are provided and can be rotated to allow visualization from multiple angles allowing easy comparison of features both between stages in the database and between images or samples in the laboratory. The use of JavaScript, PHP and HTML ensure the database is accessible to users across different operating systems, including mobile devices, facilitating its use in the laboratory.The QAP provides a unique resource for researchers using the quail model. The ability to virtually section anatomical models throughout development provides the opportunity for researchers to virtually dissect the quail and also provides a valuable tool for the education of students and researchers new to the field. DATABASE URL: http://quail.anatomyportal.org (For review username: demo, password: quail123). PMID:24715219

Ruparelia, Avnika A; Simkin, Johanna E; Salgado, David; Newgreen, Donald F; Martins, Gabriel G; Bryson-Richardson, Robert J

2014-01-01

283

Use of Neutral Argon Plasma in the Laparoscopic Treatment of Endometriosis  

PubMed Central

Background and Objectives: To report the feasibility and safety of the use of a novel energy source that uses an electrically neutral beam of pure argon plasma for the laparoscopic management of endometriosis. Methods: In this prospective pilot study, 20 patients undergoing laparoscopic treatment of endometriosis were included. Characteristic endometriotic lesions throughout the pelvis were vaporized or resected using neutral argon plasma. Specimens were evaluated for the presence of endometriosis and thermal effects on tissue. The bases of the treated lesions were biopsied to determine whether residual endometriosis was present. Results: Neutral argon plasma was used in 18 of the 20 patients for laparoscopic treatment of pelvic endometriosis. All biopsies confirmed complete vaporization or re-section with no residual endometriosis at the base. Endometriosis was identified on pathology in all lesions excised. Thermal effects did not interfere with histologic analysis in any of the lesions. No complications occurred. Conclusion: Neutral argon plasma can be utilized as a multi-functional device that has vaporization, coagulation, and superficial cutting capacities with minimal thermal spread and acceptable outcomes. The use of neutral argon plasma appears to be efficacious and safe for the complete treatment of endometriotic implants. PMID:20202387

Kho, Kimberly A.; Morozov, Vadim

2009-01-01

284

Major pelvic injuries in equestrian sports  

PubMed Central

A series of pelvic and acetabular injuries caused by horse riding accidents is reported. The importance of wearing appropriate protective clothing when riding is emphasised. ImagesFigure 1Figure 2Figure 3Figure 4 PMID:9298563

O'Farrell, D A; Irshad, F; Thorns, B S; McElwain, J P

1997-01-01

285

Intra operative lesion of the pelvic ureter solved in a minimally invasive manner.  

PubMed

Ureteral lesions during open hysterectomy, vaginal hysterectomy or laparoscopic hysterectomy have a rate of 0.2% up to 6%. Multiple complications may occur if the lesion is not recognised intra operatively: hydronephrosis, anuria (bilateral lesion), ureterovaginal fistula, ileus, peritonitis. The rate of recognition of an intra operative ureter lesion is 30% and it could rise up to 90% when cystoscopy with ureteroscopy is used at the end of the intervention. The article presents the case of a 46-year-old patient with uterine fibromatosis, whose pelvic ureter was sectioned during surgery. The lesion was recognised during surgery because, at the end of each intervention, the diuresis was stimulated by injecting Furosemide in order to detect the lesions of the ureters and urinary bladder. PMID:25408763

Stoica, Ra; Enache, T; Iordache, N

2014-09-15

286

Intra operative lesion of the pelvic ureter solved in a minimally invasive manner  

PubMed Central

Abstract Ureteral lesions during open hysterectomy, vaginal hysterectomy or laparoscopic hysterectomy have a rate of 0.2% up to 6%. Multiple complications may occur if the lesion is not recognised intra operatively: hydronephrosis, anuria (bilateral lesion), ureterovaginal fistula, ileus, peritonitis. The rate of recognition of an intra operative ureter lesion is 30% and it could rise up to 90% when cystoscopy with ureteroscopy is used at the end of the intervention. The article presents the case of a 46-year-old patient with uterine fibromatosis, whose pelvic ureter was sectioned during surgery. The lesion was recognised during surgery because, at the end of each intervention, the diuresis was stimulated by injecting Furosemide in order to detect the lesions of the ureters and urinary bladder.

Stoica, RA; Enache, T; Iordache, N

2014-01-01

287

Laparoscopic management of gastric gastrointestinal stromal tumors.  

PubMed

Gastrointestinal stromal tumors (GISTs) are the most frequent gastrointestinal tumors of mesodermal origin. Gastric GISTs represent approximately 70% of all gastrointestinal GISTs. The only curative option is surgical resection. Many surgical groups have shown good results with the laparoscopic approach. There have not been any randomized controlled trials comparing the open vs laparoscopic approach, and all recommendations have been based on observational studies. The experience obtained from gastric laparoscopic surgery during recent decades and the development of specific devices have allowed the treatment of most gastric GISTs through the laparoscopic approach. PMID:25031788

Correa-Cote, Juan; Morales-Uribe, Carlos; Sanabria, Alvaro

2014-07-16

288

Laparoscopic management of gastric gastrointestinal stromal tumors  

PubMed Central

Gastrointestinal stromal tumors (GISTs) are the most frequent gastrointestinal tumors of mesodermal origin. Gastric GISTs represent approximately 70% of all gastrointestinal GISTs. The only curative option is surgical resection. Many surgical groups have shown good results with the laparoscopic approach. There have not been any randomized controlled trials comparing the open vs laparoscopic approach, and all recommendations have been based on observational studies. The experience obtained from gastric laparoscopic surgery during recent decades and the development of specific devices have allowed the treatment of most gastric GISTs through the laparoscopic approach. PMID:25031788

Correa-Cote, Juan; Morales-Uribe, Carlos; Sanabria, Alvaro

2014-01-01

289

Low-energy osteoporotic pelvic fractures  

Microsoft Academic Search

The vast majority of pelvic fractures in geriatric patients are classified as stable injuries. The current treatment strategies\\u000a of these fractures involve pain management and mobilization. Pain-related immobility may pose a serious hazard to patients\\u000a with severe preexisting comorbidities. There is paucity of literature on the outcome and mortality after osteoporotic pelvic\\u000a fractures in the elderly. This review aims to

Dietmar Krappinger; Christian Kammerlander; David J. Hak; Michael Blauth

2010-01-01

290

Pelvic floor and sexual male dysfunction.  

PubMed

The pelvic floor is a complex multifunctional structure that corresponds to the genito-urinary-anal area and consists of muscle and connective tissue. It supports the urinary, fecal, sexual and reproductive functions and pelvic statics. The symptoms caused by pelvic floor dysfunction often affect the quality of life of those who are afflicted, worsening significantly more aspects of daily life. In fact, in addition to providing support to the pelvic organs, the deep floor muscles support urinary continence and intestinal emptying whereas the superficial floor muscles are involved in the mechanism of erection and ejaculation. So, conditions of muscle hypotonia or hypertonicity may affect the efficiency of the pelvic floor, altering both the functionality of the deep and superficial floor muscles. In this evolution of knowledge it is possible imagine how the rehabilitation techniques of pelvic floor muscles, if altered and able to support a voiding or evacuative or sexual dysfunction, may have a role in improving the health and the quality of life. PMID:23695397

Pischedda, Antonella; Fusco, Ferdinando; Curreli, Andrea; Grimaldi, Giovanni; Pirozzi Farina, Furio

2013-03-01

291

Laparoscopic management of a strangulated internal hernia underneath the left external iliac artery?  

PubMed Central

INTRODUCTION Internal herniation of a small bowel behind pelvic vessels is a rare complication seen after pelvic lymphadenectomy. PRESENTATION OF CASE A 56-year-old woman was operated due to a gynecological cancer. 4 years thereafter she presented with a 2 days history of abdominal pain and vomiting. Clinical and radiological findings indicated a small bowel obstruction. A loop of small bowel had herniated behind the left external iliac artery. Using laparoscopic technique the herniated bowel was reduced. Due to limited peritoneum around the area and skeletonized vessel, we decided not to do any repair of the hernia orifice. The postoperative recovery was uneventful, bowel activity returned to normal and she was discharged the next day. Follow-up was done at 1 month and the latest at 10 months. She didn’t experience pain or discomfort after the operation. DISCUSSION Due to limited peritoneum around the skeletonized vessel, we decided to leave the hernia orifice unrepaired. We found it hazardous to do any direct suture of the orifice or use a free peritoneal graft to repair the defect as the fibrosis and inflammatory process might have compromised the artery or the vein. A longer follow-up of the patient is needed to clearly conclude if this simple procedure has been sufficient. We agreed that if the patient would experience any sign of recurrence and need another operation we would close the defect at that time. CONCLUSION 4 years after pelvic lymphadenectomy a small bowel herniation behind an external iliac artery occurred. The patient was successfully treated with reduction of the small bowel using laparoscopic technique. A quick recovery with minimal discomfort and no sign of recurrence after 10 months made our approach an acceptable surgical option. PMID:24121051

Dumont, Karl-Andreas; Wexels, Jan Cyril

2013-01-01

292

Syllabus Human Anatomy and Human Anatomy Laboratory -Biol 350 Fall 2014 page 1 of 10  

E-print Network

Syllabus Human Anatomy and Human Anatomy Laboratory - Biol 350 Fall 2014 page 1 of 10 Welcome to Human Anatomy! Except for those destined for medical or dental school, it is assumed that students with practice as a medical professional. #12;Syllabus Human Anatomy and Human Anatomy Laboratory - Biol 350 Fall

Houde, Peter

293

College of Medicine ANATOMY AND CELL BIOLOGY  

E-print Network

of the following: Tissue Biology, Neuroanatomy, or one section of Gross Human Anatomy. InterdepartmentalCollege of Medicine ANATOMY AND CELL BIOLOGY Mailing Address: Department of Anatomy and Cell Studies: Conwell Anderson The Department of Anatomy and Cell Biology offers work leading to degrees

Illinois at Chicago, University of

294

Intrinsic and Extrinsic Analysis on Computational Anatomy  

E-print Network

Intrinsic and Extrinsic Analysis on Computational Anatomy Anqi Qiu1 , Laurent Younes1 , Michael I Computational Anatomy (CA) [1] is a discipline which is evolving rapidly world- wide. The three major areas in the anatomy. 68 Mathematical Foundations of Computational Anatomy (MFCA'06) inria-00635889,version1-26Oct2011

Paris-Sud XI, Université de

295

BIM Anatomy An investigation into implementation prerequisites  

E-print Network

BIM Anatomy An investigation into implementation prerequisites Martin Hooper #12;BIM Anatomy Title: BIM Anatomy An investigation into implementation prerequisites Published: 2012 Design SE221 00 Lund Sweden Tel: +46 (0)46 222 48 63 #12;BIM Anatomy: An investigation

296

Radiological evaluation by magnetic resonance of the 'new anatomy' of transsexual patients undergoing male to female sex reassignment surgery.  

PubMed

Magnetic resonance (MR) is the best way to assess the new anatomy of the pelvis after male to female (MtF) sex reassignment surgery. The aim of the study was to evaluate the radiological appearance of the small pelvis after MtF surgery and to compare it with the normal women's anatomy. Fifteen patients who underwent MtF surgery were subjected to pelvic MR at least 6 months after surgery. The anthropometric parameters of the small pelvis were measured and compared with those of ten healthy women (control group). Our personal technique (creation of the mons Veneris under the pubic skin) was performed in all patients. In patients who underwent MtF surgery, the mean neovaginal depth was slightly superior than in women (P=0.009). The length of the inferior pelvic aperture and of the inlet of pelvis was higher in the control group (P<0.005). The inclination between the axis of the neovagina and the inferior pelvis aperture, the thickness of the mons Veneris and the thickness of the rectovaginal septum were comparable between the two study groups. MR consents a detailed assessment of the new pelvic anatomy after MtF surgery. The anthropometric parameters measured in our patients were comparable with those of women. PMID:22673584

Brunocilla, E; Soli, M; Franceschelli, A; Schiavina, R; Borghesi, M; Gentile, G; Pultrone, C V; Martorana, G; Orrei, M G; Colombo, F

2012-09-01

297

Simultaneous laparoscopic adrenalectomy and laparoscopic nephron-sparing surgery – new experience with port placement  

PubMed Central

The aim of the study was to describe simultaneous laparoscopic adrenalectomy and laparoscopic nephron-sparing surgery, to discuss the details of a convenient laparoscopic approach and the way of port placement, as well as to present a review of the literature concerning combined laparoscopic procedures. A 72-year-old woman was admitted to our department because of a tumor of the right adrenal gland and a small tumor of the right kidney. The patient underwent simultaneous laparoscopic adrenalectomy and laparoscopic nephron-sparing surgery. The postoperative period was uncomplicated. The patient was discharged from the hospital on the 4th postoperative day. We believe that the proposed way of trocar placement would help to avoid a ‘rollover’ problem between the laparoscope and a Satinsky clamp or a ‘crossing swords’ problem between a Satinsky clamp and manipulators. PMID:24501608

Panek, Wojciech; Lewandowski, Jaroslaw; Tuchendler, Tomasz; Urba?czyk, Grzegorz; Litarski, Adam; Apozna?ski, Wojciech

2013-01-01

298

Electrodermal Measures of Jing-Well Points and Their Clinical Relevance in Endometriosis-Related Chronic Pelvic Pain  

PubMed Central

Abstract Objectives To determine whether electrodermal measures at Jing-Well acupuncture points, “indicator” points located at the tips of fingers and toes are associated with clinical measures in adolescent women with chronic pelvic pain. Design The design of this study was a randomized sham-controlled trial. Analyses of electrodermal measures were based on longitudinal, multivariable analyses using generalized estimating equations. Subjects and setting The subjects were 14 young women (ages 14–22) with laparoscopically diagnosed endometriosis and chronic pelvic pain. Subjects were randomized to sham acupuncture or Japanese-style active acupuncture. Sixteen (16) treatments were administered over 8 weeks. Outcome measures Using a Hibiki-7 device, electrodermal impedance measures were obtained at all 24 Jing-Well points for each treatment visit. From these readings, measures of “imbalance” were determined by calculating statistical dispersion (statistical deviation and Gini coefficient) and level of asymmetry (left–right, top–bottom, and yin–yang). Clinical outcome measures were obtained at baseline, week 4, and week 8 and included level of pelvic pain, Endometriosis Health Profile, Pediatric Quality of Life, perceived stress, and inflammatory cytokine levels (interleukin-6 and tumor necrosis factor-?). Results Participants designated to the acupuncture group had, on average, a substantial decrease in statistical dispersion and asymmetry of Hibiki-7 values over the course of treatment compared to the sham group. Electrodermal asymmetry variables, specifically either yin–yang or left–right measure, were significantly associated with pelvic pain, Endometriosis Health Profile, Pediatric Quality of Life, and Perceived Stress even after adjusting for treatment designation. No associations between electrodermal balance measures and inflammatory cytokines were found. Conclusions Electrodermal measures may be significantly associated with clinical outcome and acupuncture treatments in adolescent women with chronic pelvic pain. PMID:19958132

Schnyer, Rosa; Conboy, Lisa; Laufer, Marc R.; Wayne, Peter M.

2009-01-01

299

Two-layer laparoscopic repair of intraperitoneal bladder rupture in blunt abdominal trauma: a case report with literature review.  

PubMed

Bladder injuries are usually reported after blunt trauma to lower abdomen. The pelvic fracture is associated in >80% of the cases. All intraperitoneal bladder tear are managed surgically with open exploration and repair. In stable patients, with no other intra-abdominal injury, laparoscopy acts both as a diagnostic and therapeutic tool. It results in faster recovery, early discharge from the hospital with good cosmetic outcome. We describe a similar case of intraperitoneal bladder rupture managed laparoscopically replicating the open technique of double-layer repair. PMID:22874700

Kapoor, Rahul

2012-08-01

300

WebAnatomy.net  

NSDL National Science Digital Library

With a longtime presence on the web, Professor Jim Swan of the University of New Mexico has created a fine set of online anatomy and physiology resources that he uses in his courses on a regular basis. Students of the human body will also want to avail themselves of these materials, which include sets of pathology images and slides that cover such conditions as coronary artery thrombosis, atherosclerosis, and so on. One rather handy section includes weblab modules that introduce acolytes to the world of the heart, the lungs, and the digestive system through slides and interactive photos. The site is rounded out by the �Virtual Microscope� area, which includes detailed slides and explanations of cartilage, bone, blood, and muscular tissue.

Swan, Jim

2007-02-18

301

WebAnatomy.net  

NSDL National Science Digital Library

With a longtime presence on the web, Professor Jim Swan of the University of New Mexico has created a fine set of online anatomy and physiology resources that he uses in his courses on a regular basis. Students of the human body will also want to avail themselves of these materials, which include sets of pathology images and slides that cover such conditions as coronary artery thrombosis, atherosclerosis, and so on. One rather handy section includes weblab modules that introduce acolytes to the world of the heart, the lungs, and the digestive system through slides and interactive photos. The site is rounded out by the "Virtual Microscope" area, which includes detailed slides and explanations of cartilage, bone, blood, and muscular tissue.

Swan, Jim

302

Laparoscopic left pancreatectomy: current concepts.  

PubMed

The minimally invasive approach has been slow to gain acceptance in the field of pancreatic surgery even though its advantages over the open approach have been extensively documented in the medical literature. The reasons for the reluctant use of the technique are manifold. Laparoscopic distal or left sided pancreatic resections have slowly become the standard approach to lesions of the pancreatic body and tail as a result of evolution in technology and experience. A number of studies have shown the potential advantages of the technique in terms of safety, blood loss, oncological and economic feasibility, hospital stay and time to recovery from surgery. This review aims to provide an overview of the recent advances in the field of laparoscopic left pancreatectomy (LLP) and discuss potential future developments. PMID:23890145

Abu Hilal, Mohammad; Takhar, Arjun S

2013-01-01

303

Diagnosis of Pelvic Fractures in Patients with Acute Pelvic Trauma: Efficacy of Plain Radiographs  

Microsoft Academic Search

Although CT is widely recognized as an important adjunct to plain films in the evaluation of patients with acute pelvic trauma, accurate diagnosis of orthopedic injuries with plain films alone is often important to determine if immediate external fixation is necessary. The purpose of this study was to determine the efficacy of plain radiographs in the detection of pelvic fractures

Charles S. Resnik; Daniel J. Stackhouse; Kathirkamanathan Shanmuganathan; Jeremy W. R. Young

304

Update: What Is Left for Laparoscopic Hernia Repair?  

Microsoft Academic Search

The risks, benefits and costs of laparoscopic hernia repair are still being debated. According to a current survey on the situation of hernia surgery in Germany in 1996, laparoscopic hernioplasty was done in about 60% of the answering hospitals; about a quarter of all hernia repairs are done laparoscopically. Since April 1993, about 2,700 laparoscopic hernia repairs were done at

R. Bittner; B. Leibl; K. Kraft; J. Schwarz; C.-G. Schmedt

1998-01-01

305

Robotic-assisted laparoscopic radical prostatectomy: the Frankfurt technique  

Microsoft Academic Search

The robotic technique, which was first introduced in laparoscopic heart surgery, has revolutionized laparoscopic surgery over the last 5 years. In May 2000, our department accomplished the first robot assisted laparoscopic radical prostatectomy. Since that time we have performed more than 118 such procedures and several other laparoscopic operations using the robotic technique. We here summarize our experience in robot assisted

M. Wolfram; R. Bräutigam; T. Engl; W. Bentas; S. Heitkamp; M. Ostwald; W. Kramer; J. Binder; R. Blaheta; D. Jonas; W.-D. Beecken

2003-01-01

306

Laparoscopic resection of sigmoid diverticulitis  

Microsoft Academic Search

Background: In the large bowel, resection of the sigmoid colon is the most commonly performed laparoscopic intervention because large\\u000a bowel lesions often are located in this part of the bowel and the procedure technically is the most favorable one. A number\\u000a of publications involving case series or the results of highly experienced individual surgeons already have confirmed the\\u000a feasibility of

F. Köckerling; C. Schneider; M. A. Reymond; H. Scheuerlein; J. Konradt; H. P. Bruch; C. Zornig; L. Köhler; E. Bärlehner; A. Kuthe; G. Szinicz; H. A. Richter; W. Hohenberger

1999-01-01

307

Multimodal Interfaces for Laparoscopic Training  

Microsoft Academic Search

Multimodal interfaces are providing promising simulation solutions for training different practitioners as surgeons. These\\u000a environments present visual and haptic interaction to the trainee, as in a real intervention. They offer numerous advantages\\u000a over the traditional learning process, like the possibility of monitoring the skills and delivering constructive feedback.\\u000a This chapter presents a multimodal interface for laparoscopic training describing the functionality

Pablo Lamata; Carlos Alberola; Francisco Sánchez-Margallo; Miguel Ángel Florido; Enrique J. Gómez

308

Laparoscopic hernia repair in 2000  

Microsoft Academic Search

The 1994 meeting of the European Association for Endoscopic Surgery (E.A.E.S.) in Madrid highlighted a consensus-developing conference on the then new laparoscopic procedure for hernia repair. The conference was chaired by A. Paul from Cologne, Germany, and A. Fingerhut, from Poissy, France. The other members of the jury were B. Millat (France), L. Nyhus (USA), J. Himpens (Belgium), J.-L. Dulucq

A. Fingerhut; B. Millat; N. Bataille; E. Yachouchi; C. Dziri; M.-J. Boudet; A. Paul

2001-01-01

309

Laparoscopic cholecystectomy after bariatric surgery  

Microsoft Academic Search

Background: This prospective study determines the value of laparoscopic cholecystectomy (LC) in patients with cholelithiasis after bariatric surgery. Methods: Eighty-four consecutive patients who underwent bariatric surgery without concomitant cholecystectomy were studied. Patients were divided in two groups; group A including 50 patients (59.5%) without gallbladder disease, and group B included 34 patients (40.5%) with symptomatic cholelithiasis within 2 years postoperatively.

S. Papavramidis; N. Deligianidis; T. Papavramidis; K. Sapalidis; M. Katsamakas; O. Gamvros

2003-01-01

310

Laparoscopic pancreatectomy: Indications and outcomes  

PubMed Central

The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (LDP) is feasible and safe, and many of them show that compared to open distal pancreatectomy, LDP has decreased blood loss and length of hospital stay, and equivalent post-operative complication rates and short-term oncologic outcomes. LDP is becoming the procedure of choice for benign or small low-grade malignant lesions in the distal pancreas. Minimally invasive pancreaticoduodenectomy (MIPD) has not yet been widely adopted. There is no clear evidence in favor of MIPD over open pancreaticoduodenectomy in operative time, blood loss, length of stay or rate of complications. Robotic surgery has recently been applied to pancreatectomy, and many of the advantages of laparoscopy over open surgery have been observed in robotic surgery. Laparoscopic enucleation is considered safe for patients with small, benign or low-grade malignant lesions of the pancreas that is amenable to parenchyma-preserving procedure. As surgeons’ experience with advanced laparoscopic and robotic skills has been growing around the world, new innovations and breakthrough in minimally invasive pancreatic procedures will evolve. PMID:25339811

Liang, Shuyin; Hameed, Usmaan; Jayaraman, Shiva

2014-01-01

311

[Laparoscopic appendectomy. The new standard?].  

PubMed

Since the introduction of laparoscopic appendectomy by Semm in 1983, the role of this minimally invasive surgical technique has been the focus of controversial discussion. Meta-analyses have identified its advantages as having significantly lower wound infection rates, less postoperative pain and earlier resumption of normal everyday activities. The disadvantages are higher rates of intra-abdominal abscesses, longer operating times and higher inpatient treatment costs. However, some of the advantages identified by meta-analyses have been called into question by the results obtained from research into aspects of care. These discrepancies are attributable to the different surgeons involved in the various studies. The results are greatly influenced by the qualifications and experience of the surgeons. Therefore conventional appendectomy using a right lower lateral McBurney incision should continue to be the gold standard. Surgeons who have extensive experience in the field of laparoscopic surgery can achieve better results with minimally invasive appendectomy than with open surgery. This also holds true for specific situations such as complicated appendicitis and for morbidly obese patients. However, the operating costs incurred for laparoscopic appendectomy are higher because it has been shown that removal of the appendix with a linear stapler is the most reliable method. PMID:19455285

Köckerling, F; Schug-Pass, C; Grund, S

2009-07-01

312

Laparoscopic Prostatectomy: Where Do We Stand?  

PubMed Central

Laparoscopic radical prostatectomy is an effective treatment for localized prostate cancer. This cost-intensive and technically demanding operation currently takes longer than the standard open procedures, but with increasing experience, it is eventually associated with lower costs and is nearly as fast. As more urologists gain such experience, the laparoscopic approach may challenge the standard approaches. PMID:16985647

Remzi, Mesut; Djavan, Bob

2002-01-01

313

Laparoscopic versus open left lateral segmentectomy  

Microsoft Academic Search

BACKGROUND: Laparoscopic liver surgery is becoming increasingly common. This cohort study was designed to directly compare perioperative outcomes of the left lateral segmentectomy via laparoscopic and open approach. METHODS: Between 2002 and 2006 43 left lateral segmentectomies were performed at King's College Hospital. Those excluded from analysis included previous liver resections, polycystic liver disease, liver cirrhosis and synchronous operations. Of

Kirstin A Carswell; Filippos G Sagias; Beth Murgatroyd; Mohamed Rela; Nigel Heaton; Ameet G Patel

2009-01-01

314

Hand-assisted laparoscopic sigmoidectomy for diverticulitis  

Microsoft Academic Search

BACKGROUND: Sigmoid colectomy for diverticular disease, a routine procedure when performed using standard open methods, can prove much more challenging using minimum access techniques. Hand-assisted laparoscopic colectomy is a new technique that reportedly has a minimum learning curve, yet retains the benefits of a laparoscopic procedure. The purpose of this study was to perform and then prospectively to evaluate the

Michael J. Mooney; Patrick L. Elliott; Derrick B. Galapon; Linda K. James; Laura J. Lilac; Michael J. O'Reilly

1998-01-01

315

Laparoscopic excision of hepatoduodenal ligament cyst  

PubMed Central

Hepatoduodenal ligament cysts are rare. These may be confused with hepatic cysts even on advanced investigative modalities like Computerized tomography scanning or Magnetic Resonance Imaging. Diagnosis is often an intraoperative surprise. Laparoscopic treatment of such hepatoduodenal cysts is not described in available medical literature. We report one such case treated laparoscopically PMID:22837598

Deshpande, Aparna; Dalvi, Abhay N; Thanky, Harsh B; Khobragade, Krunal

2012-01-01

316

Laparoscopic adrenalectomy: a report on 50 operations  

Microsoft Academic Search

Objective: To investigate the feasibility, safety and results of laparoscopic transperitoneal adrenalec- tomies performed with the patient supine, in patients affected by secreting and silent adrenal lesions. Methods: Exclusion criteria were suspected adrenal primary malignancies. Fifty patients (33 women and 17 men; mean age 49.6 years, range 19-75 years) underwent 51 laparoscopic adrenalectomies (one bilateral). After complete endocrinological evaluation, computed

Silvia Filipponi; Mario Guerrieri; Giorgio Arnaldi; Marilena Giovagnetti; Ana M Masini; Emanuele Lezoche; Franco Mantero

1998-01-01

317

Laparoscopic cholecystectomy in the scarred abdomen  

Microsoft Academic Search

Summary  Laparoscopic cholecystectomy is rapidly becoming the definitive method for treating symptomatic gallbladder stones. Previous\\u000a upper abdominal surgery is a relative contraindication to this technique. We describe a method for safely placing the trocars\\u000a in a scarred abdomen, thus facilitating laparoscopic cholecystectomy in a wider group of patients.

P. A. Grace; A. Leahy; G. McEntee; D. Bouchier-Hayes

1991-01-01

318

Laparoscopic Surgery for Inflammatory Bowel Disease  

Microsoft Academic Search

Laparoscopic surgery has recently been gaining acceptance as an alternative approach for patients with inflammatory bowel disease. There is increasing evidence demonstrating the multiple potential benefits of laparoscopy including faster recovery, reduced costs, and lower morbidity. For patients with acute colitis, a laparoscopic subtotal colectomy and end ileostomy have been shown to be feasible and safe in experienced hands. When

Sergio Casillas; Conor P. Delaney

2005-01-01

319

Cicatrical Cecal Volvulus Following Laparoscopic Cholecystectomy  

PubMed Central

Laparoscopic cholecystectomy is the procedure of choice for the treatment of symptomatic biliary disease. There is currently no agreement on the management of spilled gallstones, which commonly occurs during laparoscopic cholecystectomy and may produce significant morbidity. We present a case of spilled gallstones causing cicatrical cecal volvulus and also provide a review of pertinent literature. PMID:23925032

Morris, Michael W.; Barker, Andrea K.; Harrison, James M.; Anderson, Andrew J.

2013-01-01

320

[Laparoscopic partial nephrectomy: technique and outcomes].  

PubMed

The indication of laparoscopic partial nephrectomy (LPN) has evolved considerably, and the technique is approaching established status at our institution. Over the past 5 years, the senior author has performed more than 450 laparoscopic partial nephrectomies at the Cleveland Clinic. Herein we present our current technique, review contemporary data and oncological outcomes of LPN. PMID:16884101

Colombo, J R; Gill, I S

2006-05-01

321

Understanding Perceptual Boundaries in Laparoscopic Surgery  

Microsoft Academic Search

Human perceptual capabilities related to the laparoscopic interaction paradigm are not well known. Its study is important for the design of virtual reality simulators, and for the specification of augmented reality applications that overcome current limitations and provide a supersensing to the surgeon. As part of this work, this article addresses the study of laparoscopic pulling forces. Two definitions are

Pablo Lamata; Enrique J. Gómez; Félix Lamata Hernández; Alfonso Oltra Pastor; Francisco Miguel Sanchez-Margallo; Francisco del Pozo Guerrero

2008-01-01

322

Dropped Gallstones During Laparoscopic Cholesystectomy: The Consequences  

Microsoft Academic Search

During laparoscopic cholecystectomy, gallbladder perforation has been reported, leading to bile leak and spillage of gallstones into the peritoneum. Because the consequences can be dangerous, conversion to laparotomy as an instant management for gallstone spillage is one of the topics of current discussion in laparoscopic cholesystectomy. In this article, we discussed the option of not converting to laparotomy after intraperitoneal

Ali Riza Tumer; Yunus Nadi Yüksek; Ahmet Cinar Yasti; Ugur Gözalan; Nuri Aydin Kama

2005-01-01

323

Laparoscopic Era of Operations for Morbid Obesity  

Microsoft Academic Search

he goal of this article is to review the status of the emerging field of laparoscopic bariat- ric surgery, to discuss developmental issues regarding technique and training, and fi- nally, to summarize the present and future roles of laparoscopic bariatric surgery. We reviewed all published literature from 1992 to the present on MEDLINE. Articles were excludedforanalysesthatwerecasereportsorarticlesontechnicalaspectsofgivenprocedures.Lap- aroscopic vertical banded gastroplasty

Daniel R. Cottam; Samer G. Mattar; Philip R. Schauer

2003-01-01

324

Symptomatic internal hernias after laparoscopic bariatric surgery  

Microsoft Academic Search

Background: The aim of this study was to describe the occurrence and clinical characteristics of symptomatic internal hernias (IH) after laparoscopic bariatric procedures. Methods: We conducted a retrospective review of cases of IH after 1,064 laparoscopic gastric bypasses (LGB) and biliopancreatic diversions with duodenal switch (LBPD-DS) performed from September 1998 to August 2002. Results: We documented 35 cases of IH

E. Comeau; M. Gagner; W. B. Inabnet; D. M. Herron; T. M. Quinn; A. Pomp

2005-01-01

325

OLFACTION: ANATOMY, PHYSIOLOGY AND BEHAVIOR  

EPA Science Inventory

The anatomy, physiology and function of the olfactory system are reviewed, as are the normal effects of olfactory stimulation. It is speculated that olfaction may have important but unobtrusive effects on human behavior....

326

Hitching the gallbladder in laparoscopic-assisted cholecysto-cholangiography: a simple technique.  

PubMed

Neonatal cholestatic disorder in the late neonatal period requires often cholangiography to differentiate between biliary atresia and other causes of prolonged neonatal jaundice. A simplified method of a laparoscopic-assisted cholecysto-cholangiography is presented. Retrospective chart review was conducted of all patients who from May 2002 to April 2012 underwent a laparoscopic-assisted cholecysto-cholangiography with routine fixation of the fundus of the gallbladder to the lateral aspect of the abdominal wall. A total of 18 infants (8 boys) aged 41-104 (median 64) days underwent laparoscopic-assisted cholecysto-cholangiography for prolonged jaundice. The technique identified ten cases of a patent bile duct system and eight biliary atresias. (Thirty-two cases of suspected biliary atresia were confirmed by laparoscopy alone.) Two cases required suturing of a bile leak at the puncture site. Hitching the gallbladder to the lateral abdominal wall is a simple method allowing an optimal radiographic assessment of the extra- and intra-hepatic bile duct anatomy. PMID:23857561

Houben, C H; Wong, H Y; Mou, W C; Chan, K W; Tam, Y H; Lee, K H

2013-09-01

327

Technical difficulties and its remedies in laparoscopic cholecystectomy in situs inversus totalis: A rare case report  

PubMed Central

INTRODUCTION Laparoscopic cholecystectomy is considered to be the gold standard surgical procedure for cholelithiasis and is one of the commonest surgical procedures in the world today. However, in rare cases of previously undiagnosed situs inversus totalis (with dextrocardia), the presentation of the cholecystitis, its diagnosis and the operative procedure can pose problems. We present here one such case and discuss how the diagnosis was made and difficulties encountered during surgery and how they were coped with. PRESENTATION OF CASE A 35 year old female presented with left hypochondrium pain and dyspepsia, for 2 years. A diagnosis of cholelithiasis with situs inversus was confirmed after thorough clinical examination, abdominal and chest X-rays and ultrasonography of the abdomen. Laparoscopic cholecystectomy, which is the standard treatment, was performed with numerous modifications in the positioning of the monitor, insufflator, ports and the position of the members of the surgical team and the laparoscopic instruments. The patient had an uneventful recovery. DISCUSSION Situs inversus totalis is itself a rare condition and when associated with cholelithiasis poses a challenge in the management of the condition. We must appreciate the necessity of setting up the operating theatre, the positioning of the ports, the surgical team and the instruments. CONCLUSION Therefore, it becomes important for the right handed surgeons to modify their techniques and establish a proper hand eye coordination to adapt to the mirror image anatomy of the Calot's triangle in a patient of situs inversus totalis. PMID:23816750

Arya, S.V.; Das, Anupam; Singh, Sunil; Kalwaniya, Dheer Singh; Sharma, Ashok; Thukral, B.B.

2013-01-01

328

Simultaneous laparoscopic management of ureteropelvic junction obstruction and renal lithiasis: the combined experience of two academic centers and review of the literature  

PubMed Central

Introduction Approximately one out of five patients with ureteropelvic junction obstruction (UPJO) present lithiasis in the same setting. We present our outcomes of simultaneous laparoscopic management of UPJO and pelvic or calyceal lithiasis and review the current literature. Methods Thirteen patients, with a mean age of 42.8±13.3 years were diagnosed with UPJO and pelvic or calyceal lithiasis. All patients were subjected to laparoscopic dismembered Hynes–Anderson pyeloplasty along with removal of single or multiple stones, using a combination of laparoscopic graspers, irrigation, and flexible nephroscopy with nitinol baskets. Results The mean operative time was 218.8±66 minutes. In two cases, transposition of the ureter due to crossing vessels was performed. The mean diameter of the largest stone was 0.87±0.25 cm and the mean number of stones retrieved was 8.2 (1–32). Eleven out of 13 patients (84.6%) were rendered stone-free. Complications included prolonged urine output from the drain in one case (Clavien grade I) and urinoma formation requiring drainage in another case (Clavien grade IIIa). The mean postoperative follow-up was 30.2 (7–51) months. No patient has experienced stone or UPJO recurrence. Conclusion Laparoscopy for the management of UPJO along with renal stone removal seems a very appealing treatment, with all the advantages of minimally invasive surgery. Concomitant renal stones do not affect the outcome of laparoscopic pyeloplasty, at least in the midterm. According to our results and the latest literature data, we advocate laparoscopic management as the treatment of choice for these cases. PMID:24892032

Stravodimos, Konstantinos G; Giannakopoulos, Stilianos; Tyritzis, Stavros I; Alevizopoulos, Aristeides; Papadoukakis, Stefanos; Touloupidis, Stavros; Constantinides, Constantinos A

2014-01-01

329

Evaluation of the levator ani and pelvic wall muscles in levator ani syndrome.  

PubMed

Chronic pelvic pain is a difficult problem to evaluate and treat. Knowledge of the pelvic floor and pelvic wall muscles may enable the provider to identify levator ani spasm syndrome, a possible cause of chronic pelvic pain. PMID:19718937

Hull, Margaret; Corton, Marlene M

2009-01-01

330

Accuracy of delivered dose in pelvic irradiation  

SciTech Connect

The accuracy of dose delivered to the pelvis in patients undergoing radiation therapy for various pelvic malignancies was checked by the placement of thermoluminescent dosimeters (TLD) in either the rectum or the vagina. The probes were left in place for an entire treatment. Eighty-two measurements in 37 patients were evaluated. The ratio of the TLD measured dose to the calculated dose, D/sub TLD//D/sub calc/, was obtained for each measurement. A perfect match would give a ratio of 1.000. The average dose ratio for the measurements was 1.012, indicating an average accuracy of within 2%. No correlation could be shown between the dose radio and obesity or quantity of pelvic bowel gas. We conclude that pelvic irradiation can be delivered with good precision, and that TLD's are useful in monitoring treatment dose.

Graham, W.J.; Anderson, D.W.; Landry, D.J.

1981-08-01

331

Testing of the Anorectal and Pelvic Floor Area  

MedlinePLUS

... Disorders of the Small Intestine Disorders of the Large Intestine Disorders of the Pelvic Floor Motility Testing Personal ... Disorders of the Small Intestine Disorders of the Large Intestine Disorders of the Pelvic Floor Motility Testing Esophagus ...

332

Chronic Pelvic Pain in Women (Beyond the Basics)  

MedlinePLUS

... Searches Chronic pelvic pain Patient information Patient information: Chronic pelvic pain in women (Beyond the Basics) Author Fred Howard, ... pain and is not a common cause of chronic pain. (See "Patient information: Diverticular disease (Beyond the Basics)" .) ...

333

Redo Ileal pouch-anal anastomosis combined with anti-TNF-? maintenance therapy for Crohn's disease with pelvic fistula: report of two cases.  

PubMed

Pouch failure has been reported to occur after ileal pouch-anal anastomosis for Crohn's disease. We report two cases of patients with Crohn's disease, who underwent redo ileal pouch-anal anastomosis (redo-IPAA) combined with anti-TNF-? maintenance therapy, with good functional results. The first patient, a man with presumed ulcerative colitis, suffered pelvic fistula recurrence and anastomotic dehiscence. He underwent redo-IPAA, at which time longitudinal ulcers were found. Infliximab was started 4 days postoperatively and continued. The second patient, a woman treated for ulcerative colitis, underwent laparoscopic IPAA 8 years later. After the development of a pelvic fistula, twisted mesentery of the ileal pouch was found intraoperatively and Crohn's disease was diagnosed. Adalimumab therapy resulted in fistula closure. Redo-IPAA was performed to normalize the twisted mesentery of the ileal pouch. No complications have been observed in either patient, both of whom have experienced good functional results after closure of the covering stomas. PMID:24442570

Araki, Toshimitsu; Okita, Yoshiki; Fujikawa, Hiroyuki; Ohi, Masaki; Tanaka, Koji; Inoue, Yasuhiro; Uchida, Keiichi; Mohri, Yasuhiko; Kusunoki, Masato

2014-10-01

334

Obliterative procedures for pelvic organ prolapse.  

PubMed

Colpocleisis is an effective surgical treatment for pelvic organ prolapse in elderly women who do not wish to preserve the vagina for sexual intercourse. Colpocleisis provides good relief of pelvic floor symptoms without significant morbidity. The morbidity and mortality associated with the surgery is largely related to the health status of this elderly segment of the population. Stress incontinence can be addressed with a concomitant procedure such as a midurethral synthetic sling. Overall patient satisfaction with this obliterative procedure is greater than 90%. As the population ages, this procedure stands to become an increasingly popular treatment option. PMID:20142646

Abbasy, Shameem; Kenton, Kimberly

2010-03-01

335

Total Pelvic Exenteration for Gynecologic Malignancies  

PubMed Central

Total pelvic exenteration (PE) is a radical operation, involving en bloc resection of pelvic organs, including reproductive structures, bladder, and rectosigmoid. In gynecologic oncology, it is most commonly indicated for the treatment of advanced primary or locally recurrent cancer. Careful patient selection and counseling are of paramount importance when considering someone for PE. Part of the evaluation process includes comprehensive assessment to exclude unresectable or metastatic disease. PE can be curative for carefully selected patients with gynecologic cancers. Major complications can be seen in as many as 50% of patients undergoing PE, underscoring the need to carefully discuss risks and benefits of this procedure with patients considering exenterative surgery. PMID:22720150

Diver, Elisabeth J.; Rauh-Hain, J. Alejandro; del Carmen, Marcela G.

2012-01-01

336

Sexual function in women after surgery for pelvic organ prolapse  

Microsoft Academic Search

Our objective was to evaluate the effect of surgical repair of pelvic organ prolapse on female sexual function. Sixty seven\\u000a women with pelvic organ prolapse were recruited in the study. Degree of pelvic organ prolapse was assessed using pelvic organ\\u000a prolapse quantitation (POPQ) staging system. Female sexual function index (FSFI) questionnaire was used to assess sexual function\\u000a of the cases

Mahyar Azar; Sima Noohi; Shokoufeh Radfar; Mohammad Hadi Radfar

2008-01-01

337

The place of surface anatomy in the medical literature and undergraduate anatomy textbooks.  

PubMed

The aims of this review were to examine the place of surface anatomy in the medical literature, particularly the methods and approaches used in teaching surface and living anatomy and assess commonly used anatomy textbooks in regard to their surface anatomy contents. PubMed and MEDLINE databases were searched using the following keywords "surface anatomy," "living anatomy," "teaching surface anatomy," "bony landmarks," "peer examination" and "dermatomes". The percentage of pages covering surface anatomy in each textbook was calculated as well as the number of images covering surface anatomy. Clarity, quality and adequacy of surface anatomy contents was also examined. The search identified 22 research papers addressing methods used in teaching surface anatomy, 31 papers that can help in the improvement of surface anatomy curriculum, and 12 anatomy textbooks. These teaching methods included: body painting, peer volunteer surface anatomy, use of a living anatomy model, real time ultrasound, virtual (visible) human dissector (VHD), full body digital x-ray of cadavers (Lodox(®) Statscan(®) images) combined with palpating landmarks on peers and the cadaver, as well as the use of collaborative, contextual and self-directed learning. Nineteen of these studies were published in the period from 2006 to 2013. The 31 papers covered evidence-based and clinically-applied surface anatomy. The percentage of surface anatomy in textbooks' contents ranged from 0 to 6.2 with an average of 3.4%. The number of medical illustrations on surface anatomy varied from 0 to 135. In conclusion, although there has been a progressive increase in publications addressing methods used in teaching surface anatomy over the last six to seven years, most anatomy textbooks do not provide students with adequate information about surface anatomy. Only three textbooks provided a solid explanation and foundation of understanding surface anatomy. PMID:23650274

Azer, Samy A

2013-01-01

338

Laparoscopic versus open left lateral segmentectomy  

PubMed Central

Background Laparoscopic liver surgery is becoming increasingly common. This cohort study was designed to directly compare perioperative outcomes of the left lateral segmentectomy via laparoscopic and open approach. Methods Between 2002 and 2006 43 left lateral segmentectomies were performed at King's College Hospital. Those excluded from analysis included previous liver resections, polycystic liver disease, liver cirrhosis and synchronous operations. Of 20 patients analysed, laparoscopic (n = 10) were compared with open left lateral segmentectomy (n = 10). Both groups had similar patient characteristics. Results Morbidity rates were similar with no wound or chest infection in either group. The conversion rate was 10% (1/10). There was no difference in operating time between the groups (median time 220 minutes versus 179 minutes, p = 0.315). Surgical margins for all lesions were clear. Less postoperative opiate analgesics were required in the laparoscopic group (median 2 days versus 5 days, p = 0.005). The median postoperative in-hospital stay was less in the laparoscopic group (6 days vs 9 days, p = 0.005). There was no mortality. Conclusion Laparoscopic left lateral segmentectomy is safe and feasible. Laparoscopic patients may benefit from requiring less postoperative opiate analgesia and a shorter post-operative in-hospital stay. PMID:19735573

Carswell, Kirstin A; Sagias, Filippos G; Murgatroyd, Beth; Rela, Mohamed; Heaton, Nigel; Patel, Ameet G

2009-01-01

339

[The importance and role of laparoscopic appendectomy].  

PubMed

Inspite of earlier beginning the laparoscopic appendectomy is in the shadow of laparoscopic cholecystectomy. In connection with laparoscopic appendectomy some problems are discussed--his significance or substantiality, techniques, advantages or disadvantages in contrast to classical appendectomy. The authors discussed these questions on the base of their own experiences with 56 laparoscopic appendectomies. These were done from 21. October 1992 to 7. February 1994. Known advantages of laparoscopic procedures are expressed--shorter hospital stay after the operation (in average 2.3 days), better view in the operating field with possibility of the treatment of gynecological pathology. Technical aspects are also discussed. The equipment with staplers according their opinion is needed. The time of the operations--average 44 minutes--is acceptable. The complication and conversion rate, which were noted in 3.6% resp. 5.3%, is quite good. There is a possibility to lower these numbers with increasing experience. The possibility for training in the laparoscopic field is great opportunity especially for young surgeons. In the end there is stated, that the authors consider laparoscopic appendectomy as an important step to the advanced procedures. The broad acceptance is recommended. PMID:7940038

Holéczy, P; Novák, P; Malina, J

1994-07-01

340

Outcomes after Combined Laparoscopic Gastrectomy and Laparoscopic Cholecystectomy in Gastric Cancer Patients  

Microsoft Academic Search

Background\\/Aims: The purpose of this study was to determine the effect of performing laparoscopic cholecystectomy on patients undergoing laparoscopic-assisted gastrectomy for gastric cancer. Methods: This single center study involved a retrospective review of a database of 400 patients who underwent consecutive laparoscopic-assisted gastrectomy for early gastric cancer from June 2003 to July 2007. Outcomes in 26 patients who underwent both

I. H. Jeong; S. U. Choi; S. R. Lee; J. H. Kim; J. M. Park; S. H. Jin; E. K. Choi; Y. K. Cho; S. U. Han

2009-01-01

341

Pelvic floor muscle training in males: practical applications.  

PubMed

The pelvic floor muscles are vital to male genitourinary health. Pelvic floor muscle training may prove helpful in a variety of clinical circumstances: stress urinary incontinence that follows prostate surgery, overactive bladder, postvoid dribbling, erectile dysfunction, ejaculation issues including premature ejaculation, and pelvic pain due to levator muscle spasm. PMID:24821468

Siegel, Andrew L

2014-07-01

342

Hand-assisted laparoscopic surgery using Gelport  

PubMed Central

Introduction: Minimally invasive surgery has revolutionized general surgery during the past 10 years. However, for more advanced surgical procedures, the acceptance of the minimally invasive approach has been slower than expected. Advanced laparoscopic surgery is complex and time-consuming. The major drawbacks of laparoscopic surgery are two-dimensional view, lack of depth perception and loss of tactile sensation. This has led to the innovation of hand-assisted laparoscopic surgery (HALS). The objective of the present study was to determine that safety of HALS. Materials and Methods: We preformed 18 HALS procedures in our department between July 2003 and January 2005 on patients who had given their informed consent for the use of Gelport. Out of these, 15 were colectomy, 2 nephrectomy and 1 splenectomy. Out of the 18 patients, 13 were males and 5 were females with the age group ranging from 44 to 72 years. Results: Hand-assisted laparoscopic surgery could be completed in 17 patients maintaining all the oncological principals of surgery. The mean operating times were 120 min for right haemicolectomy, 135 min for left colectomy, 150 min for splenectomy, and 150 min for nephrectomy. The patient undergoing radical nephrectomy by HALS had to be converted to open surgery. As the tumour was large and adherent to the spleen and posterior peritoneal wall. Postoperative recovery was excellent with an average hospital stay of 5 days. Histopathology report showed wide clearance and till date we have a good follow up of 30–380 days. Conclusion: Hand-assisted laparoscopic surgery allows tactile sensation and depth perception thereby may simplify the complex procedures. This may result in reduction of operating time and conversion rates at the same time maintaining all the oncological principles. Hand-assisted laparoscopic surgery strikes a perfect balance between an extended open laparotomy incision and an excessively tedious laparoscopic exercise. Hand assistance is an initial tool for the trainee laparoscopic surgeon or a last resort for the experienced laparoscopic surgeon. PMID:21188007

Gupta, Puneet; Bhartia, V K

2005-01-01

343

Laparoscopic cholecystectomy utilizing two ports.  

PubMed

Laparoscopic cholecystectomy is usually performed via four to five cannulas; a few surgeons employing only three. A technique utilizing two entry ports, an infraumbilical Hasson 10 mm and a medial subcostal 5 mm, is described. The operation was feasible in six of seven patients. In the seventh, a third cannula was placed to allow traction on a floppy gallbladder. No complications ensued and all patients went home the day following operation. While cosmesis was impressive, the patients appeared to experience pain similar to that of patients in whom more cannulas were employed. PMID:8694956

Laws, H L

1996-08-01

344

Laparoscopic colectomy for colonic polyps  

Microsoft Academic Search

Background  Benign colonic polyps not amenable to colonoscopic resection or those containing carcinoma require surgical excision. Traditionally,\\u000a formal colectomy with clearance of the lymphatic basin has been performed. The aim of this study was to review our experience\\u000a with the laparoscopic approach for retrieval of colonic polyps with specific emphasis on safety, feasibility, and tumor localization.\\u000a \\u000a \\u000a \\u000a Methods  Retrospective chart review of all

Oded Zmora; Barak Benjamin; Avi Reshef; David Neufeld; Danny Rosin; Ehud Klein; Amram Ayalon; Baruch Shpitz

2009-01-01

345

Laparoscopic versus open approach for solitary insulinoma  

Microsoft Academic Search

Background  In recent years, advances in laparoscopic techniques have allowed surgeons to treat pancreatic lesions laparoscopically. Insulinoma,\\u000a the most prevalent pancreatic endocrine tumor, is mostly benign and curable with surgical resection. This study aimed to assess\\u000a the results from laparoscopic resection (LG) of insulinomas and to compare them with the results from open surgery (OG).\\u000a \\u000a \\u000a \\u000a Methods  From September 1999 to December 2005,

Antonio Sa Cunha; Cedric Beau; Alexandre Rault; Bogdan Catargi; Denis Collet; Bernard Masson

2007-01-01

346

Laparoscopic transperitoneal bladder diverticulectomy: surgical technique.  

PubMed

A large bladder diverticulum causing poor emptying in an 84-year-old man was removed laparoscopically in a 6.5-h operation. The patient was discharged from the hospital on the third postoperative day, having had minimal analgesic requirements. A Council catheter and stylet in the diverticulum greatly facilitated identification of the sac with the laparoscope. Difficulties with intracorporeal knot tying were avoided by using the Lapra-Ty system. Experienced laparoscopic surgeons may find this method of diverticulectomy valuable. With experience, the operating time should be reduced. PMID:7612940

Jarrett, T W; Pardalidis, N P; Sweetser, P; Badlani, G H; Smith, A D

1995-04-01

347

Pelvic haemophilic pseudotumour: a case report.  

PubMed

We report on a 30-year-old haemophilic man with a pelvic pseudotumour compressing adjacent structures causing pain and swelling and destruction of surrounding soft tissues and bones. He underwent evacuation of the pseudotumour, acetabular reconstruction using the Harrington procedure, and total hip arthroplasty. PMID:25163970

Kamal, Achmad Fauzi; Sukrisman, Lugyanti; Dilogo, Ismail Hadisoebroto; Priyamurti, Heka; Qomaruzzaman, Muhammad Nurul

2014-08-01

348

Kegel Exercises for Your Pelvic Muscles  

MedlinePLUS

... 10 seconds. Do sets of 10 to 20 contractions per day. Be patient and continue to exercise. It takes time to strengthen the pelvic muscles, just like it takes time to improve the muscles in your arms, legs or abdomen. You may not notice any change ...

349

The Neurobiology of Chronic Pelvic Pain  

Microsoft Academic Search

Chronic pelvic pain is a response of the nervous system to somatic and visceral pathology. Involving multiple pain pathways,\\u000a it is unlikely to be confined to one organ system or to one mechanism. An understanding of the complex neuroanatomy and pathophysiologic\\u000a mechanisms is essential to the treatment of patients presenting with this disorder.

Jennifer Gunter

350

Magnetic resonance imaging of pelvic bone tumors.  

PubMed

The aim of our study was to determine the value of magnetic resonance (MR) imaging in the diagnostic workup of pelvic bone tumors. We retrospectively evaluated the MR findings in 60 pelvic bone tumors. Owing to its high contrast resolution and multiplanar imaging capabilities, MR offers a clear depiction of cortical, medullar or soft tissue involvement, intratumoral necrosis, and relationship to neurovascular structures, and may be considered as the modality of choice for the staging of pelvic bone tumors. Since grading of bone tumors reaches a high accuracy on conventional radiography (CR), the value of MR imaging is rather complementary. Although the role of MR imaging in tissue characterization is mostly limited to recognition of tumoral components, accurate tissue characterization if often possible (e.g. in low-grade chondrosarcoma, eosinophilic granuloma, aneurysmal bone cyst, giant cell tumor, and chordoma). MR imaging in osteochondromas, metastases, and fibrous dysplasia remains of limited value since most of these lesions are well recognized on CR and/or CT. CR remains the first choice examination in diagnosis and grading of bone tumors, but MR imaging has significantly improved staging and tissue characterization in bone tumor imaging. The aim of our study is to determine the value of magnetic resonance (MR) imaging in the diagnostic workup of pelvic bone tumors, i.e. in staging, in differentiating benign from malignant tumors (grading), and in further characterization of tumors or tumoral components. PMID:8647781

De Beuckeleer, L H; De Schepper, A M; Ramon, F

1996-02-01

351

PRIMARY HUMAN ANATOMY: BIOL20600 SPRING 2014  

E-print Network

1 PRIMARY HUMAN ANATOMY: BIOL20600 SPRING 2014 Instructors: Kit Muma, Rm. 158 CNS, (607) 274 in 118 Willams Hall Required Texts: McKinley, M. and V. O'Loughlin. 2012. Human Anatomy 3rd ed. McGraw-Hill Anatomy and Physiology Revealed 3.0 available at bookstore or on-line at http://www.mhhe.com/sem/apr3

352

A COMPARATIVE PRIMATE ANATOMY Dissection Manual  

E-print Network

is used as a reference species against which we compared the anatomy of the non-human primates. It alsoA COMPARATIVE PRIMATE ANATOMY Dissection Manual Edited by: Rebecca Rogers Ackermann Version 1 Anatomy taught jointly by Professors J Cheverud, G Conroy, and J Phillips-Conroy, at Washington University

Ackermann, Rebecca Rogers

353

College of Medicine ANA Anatomy and Neurobiology  

E-print Network

completion of ANA 109. ANA 209 PRINCIPLES OF HUMAN ANATOMY. (3-basedundergraduateanatomyandregionally-basedmedicalprofessional anatomy. The human body will be taught in an online format, including modules for independent study.Prereq:Anintroductorycourse in biology, zoology, or botany and consent of instructor. ANA 511 INTRODUCTION TO HUMAN ANATOMY. (5

MacAdam, Keith

354

COMPUTATIONAL ANATOMY: AN EMERGING Ulf Grenandery  

E-print Network

COMPUTATIONAL ANATOMY: AN EMERGING DISCIPLINE Ulf Grenandery and Michael I. Millerz June 25, 1998 Abstract This paper studies mathematical methods in the emerging new discipline of Computational Anatomy. Herein we formalize the Brown/Washington University model of anatomy following the global pattern theory

355

NEW CO-CHAIRS FOR ANATOMY &  

E-print Network

#12;2 NEW CO-CHAIRS FOR ANATOMY & STRUCTURAL BIOLOGY Drs. John Condeelis and Robert Singer have been named co-chairs of the Department of Anatomy & Structural Biology. They had been serving jointly of anatomy in 1977. Appointed profes- sor in 1987, he currently serves as sci- entific director

Yates, Andrew

356

Anatomy Department Act of Remembrance and Thanksgiving  

E-print Network

Anatomy Department Act of Remembrance and Thanksgiving ON Wednesday 6th March 2013 AT 5.15pm with the staff and students from the Anatomy Department have an opportunity to show their appreciation readings, singing, and music which is performed by the Chapel Choir and students from the Anatomy Dept

O'Mahony, Donal E.

357

Uterine arteriovenous malformation caused by intrauterine instrumentation for laparoscopic surgery due to left tubal pregnancy.  

PubMed

Uterine arteriovenous malformation (AVM) is a rare entity in gynecology with fewer than 100 cases reported in the literature. Due to abnormal connection between arteries and veins without an intervening capillary system, recurrent and profuse vaginal bleeding is the most common symptom which can be potentially life-threatening. Uterine AVM can be either congenital or acquired. Acquired AVM is reported as a consequence of previous uterine trauma such as curettage procedures, caesarean section or pelvic surgery. It is also associated with infection, retained product of conception, gestational trophoblastic disease, malignancy and exposure to diethlystilboestrol. We herein report a case of acquired uterine AVM located on the right lateral wall after intrauterine instrumentation for laparoscopic left salpingectomy due to left tubal pregnancy. The patient was successfully treated with embolization. PMID:25264537

Chang, Kylie Hae-Jin; Park, Jong-Kyu; Park, Sung-Ho; Kim, Hong-Bae; Park, Sung-Taek

2014-09-01

358

Uterine arteriovenous malformation caused by intrauterine instrumentation for laparoscopic surgery due to left tubal pregnancy  

PubMed Central

Uterine arteriovenous malformation (AVM) is a rare entity in gynecology with fewer than 100 cases reported in the literature. Due to abnormal connection between arteries and veins without an intervening capillary system, recurrent and profuse vaginal bleeding is the most common symptom which can be potentially life-threatening. Uterine AVM can be either congenital or acquired. Acquired AVM is reported as a consequence of previous uterine trauma such as curettage procedures, caesarean section or pelvic surgery. It is also associated with infection, retained product of conception, gestational trophoblastic disease, malignancy and exposure to diethlystilboestrol. We herein report a case of acquired uterine AVM located on the right lateral wall after intrauterine instrumentation for laparoscopic left salpingectomy due to left tubal pregnancy. The patient was successfully treated with embolization.

Chang, Kylie Hae-Jin; Park, Jong-Kyu; Park, Sung-Ho; Kim, Hong-Bae

2014-01-01

359

Minimizing knot tying during reconstructive laparoscopic urology  

Microsoft Academic Search

ObjectivesIntracorporeal knot tying during urologic reconstructive surgery is one of the most technically challenging skills of laparoscopic surgery. We describe our experience using the Lapra-Ty clip to substitute for knot tying.

Arieh L. Shalhav; Marcelo A. Orvieto; Gary W. Chien; Albert A. Mikhail; Gregory P. Zagaja; Kevin C. Zorn

2006-01-01

360

Should all distal pancreatectomies be performed laparoscopically?  

PubMed

Despite the relatively slow start of laparoscopic pancreatectomy relative to other laparoscopic resections, an increasing number of these procedures are being performed around the world. Operations that were once considered impossible to perform laparoscopically, such as pancreaticoduodenectomy and central pancreatectomy are gaining momentum. Technology continues to improve, as does surgical experience and prowess. There are both enough experience and data (though retrospective) to confirm that LDP with or without spleen preservation appears to be a safe treatment for benign or noninvasive lesions of the pancreas. Based on the fact that LDP can be performed with similar or shorter operative times, blood loss, complication rates, and length of hospital stay than ODP, it can be recommended as the treatment of choice for benign and noninvasive lesions in experienced hands when clinically indicated. It is very difficult to make clear recommendations with regard to laparoscopic resection of malignant pancreatic tumors due to the lack of conclusive data. As long as margins are negative and lymph node clearance is within accepted standards, LDP appears to have no untoward oncologic effects on outcome. Certainly more data, preferably in the manner of a randomized clinical trial, are needed before additional recommendations can be made. Potential benefits of laparoscopic resection for cancer include the ability to inspect the abdomen and abort the procedure with minimal damage if occult metastases are identified. This does not delay the onset of palliative chemotherapy, which would be the primary treatment in that circumstance. In fact, there is evidence to suggest that there is a greater likelihood of receiving systemic therapy if a laparotomy is avoided in patients who have radiologically occult metastases. Patients may also undergo palliative laparoscopic gastric and biliary bypass if indicated. Faster wound healing may also translate into a shorter waiting time before initiating adjuvant chemotherapy and/or radiation therapy. If the patient develops a wound infection, the infection should be more readily manageable with smaller incisions. Although not proven clinically relevant in humans, the reduction in perioperative stress associated with laparoscopic resection may translate to a cancer benefit for some patients. One report compared markers of systemic inflammatory response in 15 subjects undergoing left pancreatectomy. Eight had hand-access laparoscopic procedures and the rest had standard open surgery. The subjects in the laparoscopic group had statistically lower C-reactive protein levels than the open group on postoperative days one (5.5 mg/dL versus 9.7 mg/dL, P = .006) and three (8.5 mg/dL versus 17.7 mg/dL, P = .003), suggesting that the laparoscopic approach to left pancreatectomy is associated with less inflammation. While this report is underpowered, it supports the notion that MIS cancer surgery may induce less of a systemic insult to the body than standard open cancer surgery. More work in this area is necessary before any firm conclusions can be drawn. An important issue to consider is that of training surgeons to perform these complex procedures laparoscopically. Not all pancreatectomies are amenable to the laparoscopic approach, even in the most skilled hands. As such, only a percentage of cases will be performed this way and expectations to educate surgeons adequately to perform advanced laparoscopic procedures can be unrealistic, resulting in more "on-the-job" training. Another aspect that draws some controversy is that of the totally laparoscopic procedure versus the hand-access approach. No laparoscopic instrument provides the tactile feedback possible to obtain with the hand. The HALS approach allows for this, and the opportunity to control bleeding during the procedure. HALS also provides a way to improve confidence during the learning-curve phase of these operations. Finally, it is important to remember that if the procedure is failing to progress laparoscopically, or if cancer surgery princ

Merchant, Nipun B; Parikh, Alexander A; Kooby, David A

2009-01-01

361

Laparoscopic Marsupialization of Symptomatic Polycystic Kidney Disease  

Microsoft Academic Search

PurposeAlthough laparoscopic unroofing of simple renal cysts has proved to be an effective form of therapy, its use for treatment of multiple renal cysts or symptomatic autosomal dominant polycystic kidney disease only recently has been investigated.

James A. Brown; Vicente E. Torres; Bernard F. King; Joseph W. Segura

1996-01-01

362

LAPAROSCOPIC RADICAL CYSTECTOMY IN THE FEMALE  

Microsoft Academic Search

Purpose:We detail the technique of completely intracorporeal laparoscopic radical cystectomy in the female patient, which has previously not been well described in the literature. Additionally, perioperative and short-term oncological outcome data are presented.

ALIREZA MOINZADEH; INDERBIR S. GILL; MIHIR DESAI; ANTONIO FINELLI; TOMMASO FALCONE; JIHAD KAOUK

2005-01-01

363

Equipment for preventing and treating pelvic organ prolapse  

US Patent & Trademark Office Database

It is intended to prevent a pelvic organ from slipping out of the body by pushing up the organ having slipped out or just before slipping out. A device for preventing and treating pelvic organ prolapse characterized by comprising a convex push-up member which is made of a flexible material showing a pressing force toward a pelvic organ prolapse site of a wearer and in which the surface to be in contact with the pelvic organ is coated with a coating sheet, or a concave member which is made of a flexible material receiving the pelvic organ prolapse site and in which the surface to be in contact with the pelvic organ is coated with a coating sheet, and a means of holding the convex push-up member or the concave member for tightly pressing the convex push-up member or the concave member to the pelvic organ prolapse site of the wearer as described above.

2013-02-05

364

Prevention of childbirth injuries to the pelvic floor.  

PubMed

The majority of childbirth injuries to the pelvic floor occur after the first vaginal delivery. Cesarean sections performed after the onset of labor may not protect the pelvic floor. Elective cesarean section is the only true primary prevention strategy for childbirth injuries to the pelvic floor. Alternative primary prevention strategies include elective cesarean section for women with nonmodifiable risks for childbirth injuries to the pelvic floor, antepartum pelvic floor exercises, or intrapartum pudendal nerve monitoring. Secondary prevention strategies must focus on modifying obstetric practices that predispose women to pelvic floor injury. These factors are best delineated for anal incontinence and include restrictive use of episiotomy, mediolateral episiotomy when necessary, spontaneous over forceps-assisted vaginal delivery, vacuum extraction over forceps delivery, and antepartum perineal massage. Finally, tertiary prevention strategies should address the mode of delivery made for women with childbirth injuries to the pelvic floor who desire future fertility. PMID:12112955

Heit, M; Mudd, K; Culligan, P

2001-08-01

365

Infected Aortic Pseudoaneurysm following Laparoscopic Cholecystectomy  

Microsoft Academic Search

A 38-year-old hemodialysis-dependent diabetic female patient underwent a laparoscopic cholecystectomy for symptomatic cholelithiasis. Postoperatively, she developed chronic back pain. Eight months following laparoscopic cholecystectomy, she developed fevers and recurrent bacteremia with methicillin-resistant Staphylococcus aureus, despite removal of all indwelling intravenous dialysis access. An abdominal CT scan demonstrated a 7-cm pseudoaneurysm extending from the right anterolateral lower abdominal aorta. Following resection

Mark M. Levy

2001-01-01

366

Laparoscopic cholecystectomy as an outpatient procedure  

Microsoft Academic Search

Background:Laparoscopic cholecystectomy is still done mainly on an inpatient basis at hospitals or on an outpatient basis at ambulatory care departments inside hospitals.Study Design:We reviewed 213 cases in which outpatient laparoscopic cholecystectomy was done at an ambulatory surgical center not associated with a hospital physically or administratively. Patients were selected solely on the basis of medical history and physical examination

David Lam; Rodrigo Miranda; Shirley J Hom

1997-01-01

367

Laparoscopic-assisted surgery for constipation  

Microsoft Academic Search

:   The aim of this study was to evaluate the safety, outcome and disability of various forms of laparoscopic-assisted colectomy\\u000a for constipation. Between August 1991 and February 1995, 14 patients with constipation who underwent laparoscopic assisted\\u000a total abdominal colectomy with ileorectal anastomosis (TAC + IR) or sigmoidectomy with colorectal anastomosis (SC + CR) with\\u000a or without rectopexy were analyzed. Parameters

O. Alabaz; A. Nessim; A. Iroatulam; S. D. Wexner

1999-01-01

368

Laparoscopic vs open approach for Nissen fundoplication  

Microsoft Academic Search

  Background: Several studies, most of them nonrandomized, have shown similar functional results for both laparoscopic and open\\u000a Nissen fundoplication, the operation of choice for the treatment of gastroesophageal reflux disease (GERD). Methods: A total\\u000a of 106 patients with documented GERD were randomized to receive either a laparoscopic or an open Nissen fundoplication. Preoperative\\u000a and postoperative investigations included clinical assessment, esophagogram,

E. Chrysos; J. Tsiaoussis; E. Athanasakis; O. Zoras; J. S. Vassilakis; E. Xynos

2002-01-01

369

Laparoscopic management of recurrent vesicovaginal fistula.  

PubMed

Vesicovaginal fistula repair is most commonly undertaken via a transvaginal approach. We report a recurrent case of vesicovaginal fistula which was ultimately repaired using a laparoscopic approach. The fistula followed a hysterectomy and persisted despite two operations using the Latzko partial colpocleisis and prolonged catheterization. The fistulous tract was ultimately repaired by closing the vagina and bladder with an interposing omental flap utilizing a laparoscopic approach. PMID:10384974

Miklos, J R; Sobolewski, C; Lucente, V

1999-01-01

370

Laparoscopic ventral hernia repair during pregnancy  

Microsoft Academic Search

Background  Laparoscopic ventral hernia repair in comparison to open herniorrhaphy results in reduced length of stay, less post-operative\\u000a pain, earlier return to work, and reduced complications for the repair of complex ventral hernias. The laparoscopic approach\\u000a has been the standard of care for complex or large ventral hernias for non-pregnant patients over the past decade. Despite\\u000a evidence that demonstrates that laparoscopy

P. Y. Wai; J. A. Ruby; K. A. Davis; A. C. Roberts; K. E. Roberts

2009-01-01

371

Functional results two years after laparoscopic rectopexy  

Microsoft Academic Search

Background: Rectopexy is one of the accepted treatment options for full-thickness rectal prolapse, but the details of the technique remain controversial. This unit has adopted a laparoscopic approach as an alternative to open surgery, and has used three techniques: mesh, suture, and resection. This retrospective study compares the long-term outcome.Methods: From 1993 to 1995, 14 patients underwent a laparoscopic posterior

Stéphane Benoist; Nick Taffinder; Stuart Gould; Avril Chang; Ara Darzi

2001-01-01

372

Postoperative complications after laparoscopic incisional hernia repair  

Microsoft Academic Search

  Background: The popularity of laparoscopic repair of incisional hernias is increasing due to the apparent advantages of laparoscopy.\\u000a Patients and methods: A group of 150 consecutive patients with incisional hernias were treated by laparoscopic IPOM technique\\u000a with a Goretex Dualmesh between September 1999 and September 2001 and subsequently followed up. Some minor and major complications\\u000a could clearly identify advantages as

D. Berger; M. Bientzle; A. Müller

2002-01-01

373

Laparoscopic-assisted abdominal aortic aneurysmectomy  

Microsoft Academic Search

Purpose: The technical elements and early results of laparoscopic-assisted abdominal aortic aneurysmectomy are described. Methods: From February 1997 to May 1999, 60 patients underwent elective laparoscopic surgery for infrarenal abdominal aortic aneurysm. Patients ranged in age from 53 to 87 years (mean age, 70.6 years). The mean aneurysm size was 5.7 cm (range, 4.4-8.0 cm). All patients underwent aortography and

John J. Castronuovo; Kevin V. James; Michael Resnikoff; Edward R. McLean; John K. Edoga

2000-01-01

374

Pelvic actinomycosis presenting as a malignant pelvic mass: a case report  

PubMed Central

Abstract Introduction Pelvic actinomycosis constitutes 3% of all human actinomycosis infections. It is usually insidious, and is often mistaken for other conditions such as diverticulitis, abscesses, inflammatory bowel disease and malignant tumors, presenting a diagnostic challenge pre-operatively; it is identified post-operatively in most cases. Here we present a case that presented as pelvic malignancy and was diagnosed as pelvic actinomycosis post-operatively. Case presentation A 48-year-old Caucasian Turkish woman presented to our clinic with a three-month history of abdominal pain, weight loss and difficulty in defecation. She had used an intra-uterine device for 16 years, however it had recently been removed. The rectosigmoidoscopy revealed narrowing of the lumen at 12 cm due to a mass lesion either in the wall or due to an extrinsic lesion that prevented the passage of the endoscope. On examination, there was no gynecological pathology. Magnetic resonance imaging showed a mass, measuring 5.5 × 4 cm attached to the rectum posterior to the uterus. The ureter on that side was dilated. Surgically there was a pelvic mass adhered to the rectum and uterine adnexes, measuring 10 × 12 cm. It originated from uterine adnexes, particularly ones from the left side and formed a conglomerated mass with the uterus and nearby organs; the left ureter was also dilated due to the pelvic mass. Because of concomitant tubal abscess formation and difficulty in dissection planes, total abdominal hysterectomy and bilateral salphingo-oophorectomy was performed (our patient was 48 years old and had completed her childbearing period). The cytology revealed inflammatory cells with aggregates of Actinomyces. Penicillin therapy was given for six months without any complication. Conclusions Pelvic actinomycosis should always be considered in patients with a pelvic mass especially in ones using intra-uterine devices, and who have a history of appendectomy, tonsillectomy or dental infection. Surgeons should be aware of this infection in order to avoid excessive surgical procedures. PMID:21272333

2011-01-01

375

Pelvic Insufficiency Fracture After Pelvic Radiotherapy for Cervical Cancer: Analysis of Risk Factors  

SciTech Connect

Purpose: To investigate the incidence, clinical characteristics, and risk factors of pelvic insufficiency fracture (PIF) after pelvic radiotherapy (RT) in cervical cancer. Methods and Materials: Medical records and imaging studies, including bone scintigraphy, CT, and MRI of 557 patients with cervical cancer who received whole-pelvic RT between January 1998 and August 2005 were reviewed. Results: Eighty-three patients were diagnosed as having PIF after pelvic RT. The 5-year cumulative incidence of PIF was 19.7%. The most commonly involved site was the sacroiliac joint. Pelvic pain developed in 48 patients (57.8%) at diagnosis. Eleven patients (13.3%) needed admission or narcotics because of severe pain, and others had good relief of symptoms with conservative management. In univariate analysis, age {>=}55 years (p < 0.001), anteroposterior/posteroanterior parallel opposing technique (p = 0.001), curative treatment (p < 0.001), and radiation dose {>=}50.4 Gy (p = 0.005) were the predisposing factors for development of PIF. Concurrent chemotherapy (p = 0.78) was not significant. Multivariate analysis showed that age {>=}55 years (p < 0.001), body weight <55 kg (p = 0.02), curative treatment (p = 0.03), and radiation dose {>=}50.4 Gy (p = 0.04) were significant predisposing factors for development of PIF. Conclusion: The development of PIF is not rare after pelvic RT. The use of multibeam arrangements to reduce the volume and dose of irradiated pelvic bone can be helpful to minimize the risk of fracture, especially in elderly women with low body weight.

Oh, Dongryul [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Huh, Seung Jae [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)], E-mail: Sj5201.huh@samsung.com; Nam, Heerim; Park, Won; Han, Youngyih; Lim, Do Hoon; Ahn, Yong Chan [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Jeong Won; Kim, Byoung Gie; Bae, Duk Soo; Lee, Je Ho [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2008-03-15

376

Lab 2: Anatomy of Coral  

NSDL National Science Digital Library

In this activity, students examine hydra, a fresh-water relative of coral, under a microscope to observe feeding behavior and identify stinging cells that are characteristic of corals. They also learn more about the individual animals that make up coral reefs and construct simple models of coral polyp anatomy and feeding behavior.

377

Anatomy of the Bee's Sting  

Microsoft Academic Search

DURING a recent inquiry into the existing knowledge of the chemistry of bee poison, I examined also the anatomy of the bee's sting, a subject to which I venture to direct attention. It is stated, and the evidence seems to be undeniable, that the sting of the worker bee is the insect's ovipositor metamorphosed into an efficient weapon of attack.

Percy E. Spielmann

1912-01-01

378

ELECTRONIC SUPPLEMENTARY INFORMATION (a) ANATOMY  

E-print Network

ELECTRONIC SUPPLEMENTARY INFORMATION (a) ANATOMY Very few teeth of DORCM G 13,675 were found. The remains were sufficient to show that, in this specimen, as in most large Kimmeridgian forms, teeth were and compare anatomical information and bite force for many extant and extinct taxa such as crocodilians

Benton, Michael

379

The Anatomy of Health Insurance  

Microsoft Academic Search

This article describes the anatomy of health insurance. It begins by considering the optimal design of health insurance policies. Such policies must make tradeoffs appropriately between risk sharing on the one hand and agency problems such as moral hazard (the incentive of people to seek more care when they are insured) and supplier-induced demand (the incentive of physicians to provide

David M. Cutler; Richard J. Zeckhauser

1999-01-01

380

Human Anatomy II: Circulatory System  

E-print Network

1 Human Anatomy II: Circulatory System The Cardiovascular System Major functions include) Maintenance of fluid balance Protection against invading organisms Circulatory systems may be open or closed Open circulatory systems allow circulatory fluid to empty out of vessels Closed circulatory systems

Brown, Christopher A.

381

On the anatomy of understanding  

Microsoft Academic Search

In search for the nature of understanding of basic science in a clinical context, eight medical students were interviewed, with a focus on their view of the discipline of anatomy, in their fourth year of study. Interviews were semi?structured and took place just after the students had finished their surgery rotations. Phenomenographic analysis was used to explore how the students

Niklas Wilhelmsson; Lars Owe Dahlgren; Håkan Hult; Anna Josephson

2011-01-01

382

Dosimetric intercomparison for multicenter clinical trials using a patient-based anatomic pelvic phantom  

SciTech Connect

Purpose: To assess dose delivery accuracy to clinically significant points in a realistic patient geometry for two separate pelvic radiotherapy scenarios. Methods: An inhomogeneous pelvic phantom was transported to 36 radiotherapy centers in Australia and New Zealand. The phantom was treated according to Phase III rectal and prostate trial protocols. Point dose measurements were made with thermoluminescent dosimeters (TLDs) and an ionisation chamber. Comprehensive site-demographic, treatment planning, and physical data were collected for correlation with measurement outcomes. Results: Dose delivery to the prescription point for the rectal treatment was consistent with planned dose (mean difference between planned and measured dose - 0.1 {+-} 0.3% std err). Dose delivery in the region of the sacral hollow was consistently higher than planned (+1.2 {+-} 0.2%). For the prostate treatment, dose delivery to the prostate volume was consistent with planned doses (-0.49 {+-} 0.2%) and planned dose uniformity, though with a tendency to underdose the PTV at the prostate-rectal border. Measured out-of-field doses were significantly higher than planned. Conclusions: A phantom based on realistic anatomy and heterogeneity can be used to comprehensively assess the influence of multiple aspects of the radiotherapy treatment process on dose delivery. The ability to verify dose delivery for two trials with a single phantom was advantageous.

Ebert, M. A.; Harrison, K. M.; Howlett, S. J.; Cornes, D.; Bulsara, M.; Hamilton, C. S.; Kron, T.; Joseph, D. J.; Denham, J. W. [Department of Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia 6009, Australia and School of Physics, University of Western Australia, 6009 Australia (Australia); Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales 2298 (Australia); Australasian College of Physical Scientists and Engineers in Medicine, Mascot, New South Wales 2020 (Australia); Trans-Tasman Radiation Oncology Group, Calvary Mater Newcastle, New South Wales 2298 (Australia); Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia 6160 (Australia); Heidelberg Repatriation Hospital, Victoria 3084 (Australia); Department of Physical Sciences, Peter MacCallum Cancer Centre, Victoria 3002 (Australia); Department of Radiation Oncology, Sir Charles Gairdner Hospital, Western Australia 6009, Australia and School of Surgery, University of Western Australia, Western Australia 6009 (Australia); Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales 2298, Australia and School of Medicine and Population Health, University of Newcastle, New South Wales 2308 (Australia)

2011-09-15

383

Automated Instrument Tracking in Robotically-Assisted Laparoscopic Surgery  

E-print Network

Automated Instrument Tracking in Robotically-Assisted Laparoscopic Surgery Darrin R. Uecker automated instrument localization and scope maneuvering in robotically-assisted laparoscopic surgery efficient in performing surgery without requiring additional use of the hands. Key Words: Laparoscopy

Wang, Yuan-Fang

384

LAPAROSCOPIC RADICAL ADRENALECTOMY FOR MALIGNANCY IN 31 PATIENTS  

Microsoft Academic Search

Purpose:Laparoscopic adrenalectomy for malignancy is controversial. We analyzed our experience with laparoscopic radical adrenalectomy for cancer with an emphasis on predictors of surgical outcome and oncological followup data.

ALIREZA MOINZADEH; INDERBIR S. GILL

2005-01-01

385

Laparoscopic-Assisted Staging Surgery for Korean Women With Endometrial Cancer  

PubMed Central

Background and Objective: In recent years, the incidence of endometrial cancer has gradually increased in Korea, and the use of laparoscopically assisted staging surgery (LASS) is increasing in this field. We conducted this study to evaluate the feasibility of LASS in Korean women with endometrial cancer. Methods: We conducted a retrospective review of 35 Korean women with endometrial cancer who were managed laparoscopically. Results: The median age and BMI were 57 years (range, 28 to 81) and 25.8 kg/m2 (range, 20.9 to 37.2), respectively. The median operating time, estimated blood loss, and length of hospital stay were, respectively, 150 minutes (range, 95 to 410), 250 mL (range, 50 to 1000), and 8 days (range, 3 to 20). No conversion to laparotomy was noted. The median number of harvested lymph nodes was 22 (range, 10 to 41) in pelvic lymph nodes and 7 (range, 2 to 21) in paraaortic lymph nodes. No vault recurrence or port-site metastasis was noted until the last follow-up. Conclusions: LASS can be performed without additional morbidity and complications, and might be feasible in Korean women with endometrial cancer. PMID:18435887

Lee, Jung Hun; Jung, Un Suk; Kyung, Min Sun

2008-01-01

386

Postural mechatronic assistant for laparoscopic solo surgery (PMASS)  

Microsoft Academic Search

Background and purpose  Laparoscopes used in laparoscopic surgery are manipulated by human means, passive systems or robotic systems. All three methods\\u000a accumulate downtime when the laparoscope is cleaned and the optical perspective is adjusted. This work proposes a new navigation\\u000a system that autonomously handles the laparoscope, with a view to reducing latency, and that allows real-time adjustment of\\u000a the visual perspective.

Arturo Minor Martinez; Jesús Villalobos Gomez; Ricardo Ordorica Flores; Daniel Lorias Espinoza

2009-01-01

387

Pathophysiology of pelvic adhesions. Modern trends in preventing infertility.  

PubMed

Infertility is secondary to pelvic adhesions in 15-20% of cases. Pelvic adhesions result from pelvic inflammatory disease, previous pelvic surgery, foreign bodies and previous appendicitis with pelvic abscess. As a result of the insult to the peritoneal surfaces of the pelvic organs, the concentrations of peritoneal fluid leukotriene, B4 and prostaglandin E2 are increased. Also, there is a decrease in plasminogen activity. The end result will be the formation of fibrin deposits, which will end in the formation of pelvic adhesions. The diagnosis of adhesions can be achieved by a high index of suspicion in patients with a history of pelvic infections or surgery. A pelvic examination with fixation of the uterus and/or adnexa is also highly suggestive. A hysterosalpingogram might lead to a suspicion of the presence of pelvic adhesions; however, there is some degree of false-positive and -negative results. The definitive diagnosis depends on laparoscopy. The use of an internationally accepted classification, such as that of the American Fertility Society, allows investigators to compare the results of treatment. Various adjuvants have been used following lysis of adhesions to prevent their recurrence; they yield various results. The most significant recommendation is to prevent the occurrence of adhesions by following the principles of microsurgical technique during every surgical procedure. PMID:1371547

Drollette, C M; Badawy, S Z

1992-02-01

388

The bikini area and bikini line as a location for anterior subcutaneous pelvic fixation: an anatomic and clinical investigation.  

PubMed

Anterior external fixation for pelvic fractures has been the standard for acute stabilization but definitive treatment often leads to pin tract infection, is uncomfortable, and limits patient mobility. We recently developed a subcutaneous anterior pelvic fixator which addresses these issues (INFIX). The objective of this study is to introduce the Bikini Area and Bikini Line as the subcutaneous anatomical location where this apparatus is placed. A study was preformed on eight cadaveric specimens to define the location of the subcutaneous device with respect to anatomic structures. We examined 23 people of various body mass indexes to examine the anterior pelvic anatomy. This was followed by implantation on 42 individuals in whom we reviewed CT scans to assess the location of the implant. We asked these same 42 individuals whether they could sit, stand, and lie on their sides and if they had any discomfort. We measured the dimensions of 26 retrieved rods to approximate the curve of the Bikini Line. Finally in 14 individuals we performed vascular ultrasound to assess the flow in the iliac and femoral vessels with the implant in place in the sitting and standing position. Neurovascular structures are not affected by placing the INFIX device at the Bikini Line, patients are comfortable, mobile and complications are minimized by this procedure. A rod placed on the Bikini Line which connects screws inserted into the anterior inferior iliac spine on each side does not interfere with sitting, standing, or the neurovascular structures. PMID:22927118

Vaidya, R; Oliphant, B; Jain, R; Nasr, K; Siwiec, R; Onwudiwe, N; Sethi, A

2013-04-01

389

Laparoscopic assisted resection of a ilio-sacral chondrosarcoma: A single case report  

PubMed Central

INTRODUCTION Sacral tumor often involves en bloc surgical resection with tumor-free margins and functional reconstruction challenges. Such a management is challenging because of difficulties in accessing the lesion, risks for damages of neighboring organs, and risks for massive blood loss. In posterior approach, because first elevation of the sacrum allows dissection of presacral structures, such risks for damages intrapelvic structures and hemorrhage are especially high. PRESENTATION OF CASE We report here about a laparoscopic assisted posterior resection of a ilio-sacral chondrosarcoma in a women, 6 weeks after vaginal delivery. Primary laparoscopic approach consisted in dissection of the ureter and of the colon with control to the pelvic vessels and nerves and determination of limits of the resection. The iliac osteotomy was performed from posterior approach with saw and osteotomes at the predetermined extralesional level. The defect was replaced with a structural fresh frozen femoral allograft and stabilization performed by lumbo-ischial screw/rod fixation. DISCUSSION Surgical time was about 360 min. No intra-postoperative complications occurred. Blood loss was estimated to about 1000 cm3. Histologic examination of the specimen showed tumor-free margins. At 8 months follow-up, the patient appears to be without recurrence. Because of the denervation of the nerve root L5 and below, she mostly uses two canes, but she has a functioning quadriceps. Continence and voiding functions for urine and stool have fully recovered. CONCLUSION Primary laparoscopic approach appeared to be a good way for preparation orthopedics sacroiliac resection to reduce postoperative morbidity, intraoperative blood loss and better assure macroscopic tumor-free margins. PMID:24862027

Possover, Marc; Uehlinger, Kurt; Ulrich Exner, G.

2014-01-01

390

Laparoscopic splenectomy using conventional instruments  

PubMed Central

Introduction: Laparoscopic splenectomy (LS) is an accepted procedure for elective splenectomy. Advancement in technology has extended the possibility of LS in massive splenomegaly [Choy et al., J Laparoendosc Adv Surg Tech A 14(4), 197–200 (2004)], trauma [Ren et al., Surg Endosc 15(3), 324 (2001); Mostafa et al., Surg Laparosc Endosc Percutan Tech 12(4), 283–286 (2002)], and cirrhosis with portal hypertension [Hashizume et al., Hepatogastroenterology 49(45), 847–852 (2002)]. In a developing country, these advanced gadgets may not be always available. We performed LS using conventional and reusable instruments in a public teaching the hospital without the use of the advanced technology. The technique of LS and the outcome in these patients is reported. Materials and Methods: Patients undergoing LS for various hematological disorders from 1998 to 2004 were included. Electrocoagulation, clips, and intracorporeal knotting were the techniques used for tackling short-gastric vessels and splenic pedicle. Specimen was delivered through a Pfannensteil incision. Results: A total of 26 patients underwent LS. Twenty-two (85%) of patients had spleen size more than 500 g (average weight being 942.55 g). Mean operative time was 214 min (45–390 min). The conversion rate was 11.5% (n = 3). Average duration of stay was 5.65 days (3–30 days). Accessory spleen was detected and successfully removed in two patients. One patient developed subphrenic abscess. There was no mortality. There was no recurrence of hematological disease. Conclusion: Laparoscopic splenectomy using conventional equipment and instruments is safe and effective. Advanced technology has a definite advantage but is not a deterrent to the practice of LS. PMID:21206648

Dalvi, A. N.; Thapar, P. M.; Deshpande, A. A.; Rege, S. A.; Prabhu, R. Y.; Supe, A. N.; Kamble, R. S.

2005-01-01

391

Single-Incision Laparoscopic Splenectomy  

PubMed Central

Background and Objectives: The single-incision approach in laparoscopic surgery is a relatively new concept. This systematic review of the literature was performed to appraise the existing clinical evidence concerning the use of the single-incision technique for spleen resection. Methods: We performed a systematic search of the PubMed and Scopus databases, and the studies retrieved were included in our review. The references of the included studies were also hand searched. Results: Thirty-one relevant studies were found in the field including 81 patients with an age range from 0.6 to 90 years and a body mass index range from 18 to 36.7 kg/m2. Splenomegaly (44.6%), idiopathic thrombocytopenic purpura (31%), and immune thrombocytopenic purpura (6.8%) were the most common indications for the procedure. Concerning the applied port system, multiple single ports (5 to 12 mm) were used in 54.4% of patients, the SILS port (Covidien, Mansfield, Massachusetts) was used in 26.6%, the TriPort (Advanced Surgical Concepts, Wicklow, Ireland) was used in 7.6%, glove ports were used in 6.3%, and the GelPort (Applied Medical, Rancho Santa Margarita, California) was used in 5.1%. The median operative time was 125 minutes (range, 45–420 minutes), and the median quantity of blood loss was 50 mL (range, 10–450 mL). No conversion to open surgery and no transfusion were needed. The length of hospital stay was between 1 and 9 days. Low rates of complications and no patient deaths were found. The existing evidence on cosmesis is limited. Conclusion: Single-site/single-port laparoscopic surgery is a minimally invasive procedure that seems to be a challenging alternative in the management of spleen resection.

Mourtarakos, Sarantis; Iavazzo, Christos

2014-01-01

392

Prostatitis versus pelvic pain syndrome: Immunologic studies  

Microsoft Academic Search

The pathogenesis of chronic pelvic pain syndrome continues to be an enigma. The observation of inflammatory cells in urine,\\u000a ejaculate, prostate fluid, and prostate tissue combined with changed local expressions of cytokines, immunoglobulins, complement,\\u000a and other inflammatory markers led to the hypothesis of an involvement of the immune system in this clinical entity. This\\u000a review presents a survey of the

Caroline Maake; Hubert John

2003-01-01

393

Functional MRI of the Pelvic Floor  

Microsoft Academic Search

Taking all the above-mentioned into account, indications for functional cine MRI still remain controversial. The method itself\\u000a is not yet standardized, and so far only a 2D approach for functional imaging of the pelvic floor exists. With the advance\\u000a of fast “parallel imaging” a stack of two to three slices within the same acquisition time seems possible.\\u000a \\u000a In patients with

Tanja Fischer; Andreas Lienemann

394

[Primary pelvic hydatid cyst: a case report].  

PubMed

The purpose of this report is to describe a case of primary pelvic hydatid cyst in a 30-year-old man who presented with abdominal symptoms related to compression of the rectum and urinary tract. This unusual location was initially considered as a tumour process. Proper diagnosis can sometimes be based on ultrasound and computerised tomography. However in some cases such as ours surgical exploration may be necessary for definitive diagnosis. PMID:16924823

Bounaim, A; Sakit, F; Janati, I M

2006-06-01

395

SMA Syndrome Treated by Single Incision Laparoscopic Duodenojejunostomy  

PubMed Central

Superior mesenteric artery (SMA) syndrome is a mechanical duodenal obstruction by the SMA. The traditional approach to SMA syndrome was open bypass surgery. Nowadays, a conventional approach has been replaced by laparoscopic surgery. But single incision laparoscopic approach for SMA syndrome is rare. Herein, we report the first case of SMA syndrome patient who was treated by single incision laparoscopic duodenojejunostomy. PMID:25210483

Kim, Sungsoo; Kim, Yoo Seok; Min, Young-Don

2014-01-01

396

Laparoscopic Colectomy vs. Open Colectomy For Sigmoid Diverticular Disease  

Microsoft Academic Search

PURPOSE: The feasibility of laparoscopic colectomy for colon surgery has now been well established. Most of the studies on laparoscopic colectomies include all types of colonic pathologies without discrimination. Our goal was to compare laparoscopic sigmoid colectomy vs. open sigmoid colectomy for simple sigmoid diverticular disease, to assess whether it can be done safely and whether the proposed advantages could

Amit Dwivedi; Fadi Chahin; Sunita Agrawal; W. Y. Chau; A. Tootla; F. Tootla; Yvan J. Silva

2002-01-01

397

Laparoscopic splenectomy in the elderly: a morbid procedure?  

Microsoft Academic Search

Background: Laparoscopic splenectomy has emerged as the gold standard for elective splenectomy. Few reports have critically evaluated the results of laparoscopic splenectomy in elderly patients. Methods: All laparoscopic splenectomies performed between August 19, 1998 and June 8, 2004 were reviewed retrospectively. Results: Of 235 splenectomies, 188 were performed for patients younger than age 65 years (group 1), and 45 were

S. M. Kavic; R. D. Segan; A. E. Park

2005-01-01

398

Enhancing cosmesis in laparoscopic colon and rectal surgery  

Microsoft Academic Search

PURPOSE: The only unanimously accepted advantage of laparoscopic colon and rectal surgery, at present, is cosmesis. Techniques to enhance cosmesis in laparoscopic surgery are presented. METHOD: Careful and meticulous placement of laparoscopic ports and incisions enhance the cosmetic effect of the procedure. Determination of port sites is aided, in part, by preoperative assessment of natural skin folds and creases by

Tiong-Ann Teoh; Petachia Reissman; Eric G. Weiss; Roberto Verzaro; Steven D. Wexner

1995-01-01

399

Pelvic position and movement during hip replacement.  

PubMed

The orientation of the acetabular component is influenced not only by the orientation at which the surgeon implants the component, but also the orientation of the pelvis at the time of implantation. Hence, the orientation of the pelvis at set-up and its movement during the operation, are important. During 67 hip replacements, using a validated photogrammetric technique, we measured how three surgeons orientated the patient's pelvis, how much the pelvis moved during surgery, and what effect these had on the final orientation of the acetabular component. Pelvic orientation at set-up, varied widely (mean (± 2, standard deviation (sd))): tilt 8° (2sd ± 32), obliquity -4° (2sd ± 12), rotation -8° (2sd ± 14). Significant differences in pelvic positioning were detected between surgeons (p < 0.001). The mean angular movement of the pelvis between set-up and component implantation was 9° (sd 6). Factors influencing pelvic movement included surgeon, approach (posterior > lateral), procedure (hip resurfacing > total hip replacement) and type of support (p < 0.001). Although, on average, surgeons achieved their desired acetabular component orientation, there was considerable variability (2sd ± 16) in component orientation. We conclude that inconsistency in positioning the patient at set-up and movement of the pelvis during the operation account for much of the variation in acetabular component orientation. Improved methods of positioning and holding the pelvis are required. PMID:24986939

Grammatopoulos, G; Pandit, H G; da Assunção, R; Taylor, A; McLardy-Smith, P; De Smet, K A; Murray, D W; Gill, H S

2014-07-01

400

Laparoscopic Sigmoidectomy for Diverticulitis: a Prospective Study  

PubMed Central

Background: Surgical treatment of complicated colonic diverticular disease is still debatable. The aim of this prospective study was to evaluate the outcome of laparoscopic sigmoid colectomy in patients with diverticulitis. Patients offered laparoscopic surgery presented with acute complicated diverticulitis (Hinchey type I, II, III), chronically recurrent diverticulitis, bleeding, or sigmoid stenosis caused by chronic diverticulitis. Method: All patients who underwent laparoscopic colectomy within a 12-year period were prospectively entered into a database registry. One-stage laparoscopic resection and primary anastomosis constituted the planned procedure. A 4-trocar approach with suprapubic minilaparotomy was performed. Main data recorded were age, sex, postoperative pain, return of bowel function, operation time, duration of hospital stay, and early and late complications. Results: During the study period, 260 sigmoid colectomies were performed for diverticulitis. The cohort included 104 male and 156 female patients; M to F ratio was 4:6. Postoperative pain was controlled by NSAIDs or weak opioid analgesia. Fifteen patients (5.7%) required conversion from laparoscopic to open colectomy. The most common reasons for conversion were directly related to the inflammatory process, abscess, and peritonitis. Mean operative time was 130±54. Average postoperative hospital stay was 10±3 days. A longer hospital stay was recorded for Hinchey type IIb patients. Complications were recorded in 30 patients (11.5%). The most common complications that required reoperation were hemorrhage in 2 patients (0.76) and anastomotic leak in 5 patients (only 3 of them required reoperation). The mortality among them was 2 patients (0.76%). Conclusions: Laparoscopic surgery for diverticular disease is safe, feasible, and effective. Therefore, laparoscopic colectomy has replaced open resection as standard surgery for recurrent and complicated diverticulitis at our institution. PMID:21605507

Baca, Ivo; Grzybowski, Leszek; Jaacks, Armin

2010-01-01

401

Anatomy adventure: a board game for enhancing understanding of anatomy.  

PubMed

Certain negative factors such as fear, loss of concentration and interest in the course, lack of confidence, and undue stress have been associated with the study of anatomy. These are factors most often provoked by the unusually large curriculum, nature of the course, and the psychosocial impact of dissection. As a palliative measure, Anatomy Adventure, a board game on anatomy was designed to reduce some of these pressures, emphasize student centered and collaborative learning styles, and add fun to the process of learning while promoting understanding and retention of the subject. To assess these objectives, 95 out of over 150 medical and dental students who expressed willingness to be part of the study were recruited and divided into a Game group and a Non-game group. A pretest written examination was given to both groups, participants in the Game group were allowed to play the game for ten days, after which a post-test examination was also given. A 20-item questionnaire rated on a three-point scale to access student's perception of the game was given to the game group. The post-test scores of the game group were significantly higher (P?anatomy. PMID:23878076

Anyanwu, Emeka G

2014-01-01

402

The impact of a laparoscopic colorectal surgeon on the laparoscopic colectomy experience of a single academic center  

Microsoft Academic Search

Background: The objective of this study was to evaluate the impact of a laparoscopic colorectal surgeon (LCRS) on the laparoscopic colectomy experience of a single academic center. Methods: We performed a retrospective review of case complexity, patient characteristics, operative and preparation time, and trends over time for the LCRS compared to two veteran laparoscopic surgeons (VLS). Results: The LCRS performed

M. T. Austin; I. D. Feurer; M. D. Holzman; W. O. Richards; C. W. Pinson; A. J. Herline

2005-01-01

403

Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction  

PubMed Central

Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and anal sphincters. These symptoms may adversely affect quality of life. Focus on the global symptom complex, rather than the individual symptoms, may help the clinician identify the condition. The primary care provider is in a position to intervene early, efficiently, and effectively by (1) recognizing the range of symptoms that might suggest nonrelaxing pelvic floor dysfunction, (2) educating patients, (3) performing selective tests when needed to confirm the diagnosis, and (4) providing early referral for physical therapy. PMID:22305030

Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

2012-01-01

404

Bile Duct Injury During Laparoscopic Cholecystectomy  

PubMed Central

Objective To determine whether surgical residency training has influenced the occurrence of common bile duct injuries during laparoscopic cholecystectomy, and to asses the anatomic and technical details of bile duct injuries from the practices of surgeons trained in laparoscopic cholecystectomy after residency versus surgeons trained in laparoscopic cholecystectomy during residency. Summary Background Data Shortly after the introduction of laparoscopic cholecystectomy, the rate of injury to the common bile duct increased to 0.5%, and injuries were more commonly reported early in each surgeon’s experience. It is not known whether learning laparoscopic cholecystectomy during surgery residency influences this pattern. Methods An anonymous questionnaire was mailed to 3,657 surgeons across the United States who completed an Accreditation Council for Graduate Medical Education (ACGME)-approved residency between 1980 and 1990 (group A) or 1992 and 1998 (group B). All surgeons in group A learned laparoscopic cholecystectomy after residency, and all those in group B learned laparoscopic cholecystectomy during residency. Information obtained included practice description, number of laparoscopic cholecystectomies completed since residency, postgraduate training in laparoscopy, and annual volume of laparoscopic cholecystectomy in the surgeon’s hospital. In addition, technical details queried included the completion of a cholangiogram, the interval between injury and identification, the method of repair, and the site of definitive treatment. The primary endpoint was the occurrence of a major bile duct injury during laparoscopic cholecystectomy (bile leaks without a major bile duct injury were not tabulated). Results Forty-five percent (n = 1,661) of the questionnaires were completed and returned. Mean practice experience was 13.6 years for group A and 5.4 years for group B. At least one injury occurrence was reported by 422 surgeons (37.6%) in group A and 143 surgeons (26.5%) in group B. Forty percent of the injuries in group A occurred during the first 50 cases compared with 22% in group B. Thirty percent of bile duct injuries in group A and 32.9% of all injuries in group B occurred after a surgeon had performed more than 200 laparoscopic cholecystectomies. Independent of the number of laparoscopic cholecystectomies completed since residency, group A surgeons were 39% more likely to report one or more biliary injuries and 58% more likely to report two or more injuries than their counterparts in group B. Bile duct injuries were more likely to be discovered during surgery if a cholangiogram was completed than if cholangiography was omitted (80.9% vs. 45.1%). Sixty-four percent of all major bile duct injuries required biliary reconstruction, and most injuries were definitively treated at the hospital where the injury occurred. Only 14.7% of injuries were referred to another center for repair. Conclusions Accepting that the survey bias underestimates the true frequency of bile duct injuries, residency training decreases the likelihood of injuring a bile duct, but only by decreasing the frequency of early “learning curve” injuries. If one accepts a liberal definition of the learning curve (200 cases), it appears that at least one third of injuries are not related to inexperience but may reflect fundamental errors in the technique of laparoscopic cholecystectomy as practiced by a broad population of surgeons in the United States. Intraoperative cholangiography is helpful for intraoperative discovery of injuries when they occur. Most injuries are repaired in the hospital where they occur and are not universally referred to tertiary care centers. PMID:11573048

Archer, Stephen B.; Brown, David W.; Smith, C. Daniel; Branum, Gene D.; Hunter, John G.

2001-01-01

405

Minimally Invasive Therapies for Chronic Pelvic Pain Syndrome  

Microsoft Academic Search

Chronic pelvic pain syndrome (CPPS) is a common problem among men and women worldwide. It is a symptoms-complex term for interstitial\\u000a cystitis\\/painful bladder syndrome in women and chronic prostatitis\\/chronic pelvic pain syndrome in men. Patients often present\\u000a with a combination of lower urinary tract symptoms with pelvic pain and sexual dysfunction. No gold standard exists for diagnosis\\u000a or treatment of

Salim A. Wehbe; Jennifer Y. Fariello; Kristene Whitmore

2010-01-01

406

Sexual function in women with pelvic floor disorders  

PubMed Central

Pelvic floor disorders (PFDs) can impact sexual function. This summary provides an overview of the impact of stress urinary incontinence and pelvic organ prolapse and their treatments on sexual function. In general, interventions that successfully address PFDs will generally improve sexual function as well. However, there are patients whose sexual function will remain unchanged despite treatment, and a small but significant minority who will report worsened sexual function following treatment for their pelvic floor dysfunction. PMID:24523846

Rogers, Rebecca G.

2013-01-01

407

Assessment of Women With Defecatory Dysfunction and Manual Splinting Using Dynamic Pelvic Floor Magnetic Resonance Imaging  

PubMed Central

Objective This study aimed to describe magnetic resonance imaging (MRI) findings in women with defecatory dysfunction who perform manual splinting. Methods This is a retrospective study of 29 patients from a single urogynecology center who presented with complaints of defecatory dysfunction and who reported manual splinting to assist with bowel movements. Patients were scheduled for an MRI study with a novel “splinting” protocol to evaluate the effects of their manual splinting on the pelvic floor. The protocol involved asking patients to splint during the MRI, as they normally would when trying to defecate. The goal was to evaluate any change in pelvic anatomy and compensation for an anatomic defect that could potentially lead to their defecatory dysfunction. Magnetic resonance images of the pelvis were obtained at rest, with pelvic floor contraction, with Valsalva, and during manual splinting. These images were then reviewed by radiologists who evaluated various parameters, including anorectal angle, levator ani muscle integrity, and the presence of rectocele, cystocele, apical prolapse, and enterocele. The external and internal anal sphincters were also evaluated for continuity. Results From September 2008 to October 2010, 29 women reported defecatory dysfunction and the need for manual splinting. Their mean (SD) age was 55.2 (10.5) years. Magnetic resonance images showed a rectocele in 86.2% of the study group, cystocele in 75.9%, enterocele in 10.3%, and a defect of the levator ani muscles in 17.2%. Twentyone (72.4%) women had more than 1 of these defects. In addition, 27.6% had an anorectal angle less than 90 degrees or greater than 105 degrees. Patients in the study group splinted in the vagina (58.6%), on the perineum (31.0%), or on the buttock (10.3%). In all but 1 woman (96.6%), splinting improved or completely corrected the identified defect(s) as evidenced with MRI. Among those who used vaginal splinting, 52.9% of defects were corrected and 47.1% were improved. Perineal splinting corrected 55.6% and improved 33.3% of cases and was ineffective in 11.1% of cases, whereas buttock splinting corrected 33.3% and improved 66.7% of cases. Conclusions Most women in our study group who used manual splinting to assist in defecation are compensating for a pelvic floor defect that can be detected on MRI. Magnetic resonance imaging of the pelvis may help elucidate the etiology of the defecatory dysfunction in some women and may assist pelvic reconstructive surgeons in planning surgical correction of pelvic floor defects. Magnetic resonance imaging may also identify defects in the pelvic floor that are, at the present time, not amenable to surgical correction. PMID:22453259

Apostolis, Costas; Wallace, Karen; Sasson, Pierre; Hacker, Michele R.; Elkadry, Eman; Rosenblatt, Peter L.

2013-01-01

408

Improved Understanding of Human Anatomy through Self-guided  

E-print Network

Improved Understanding of Human Anatomy through Self-guided Radiological Anatomy Modules Andrew W: To quantifiably measure the impact of self-instructed radiological anatomy modules on anatomy comprehen- sion was created for each module of the first year medical anatomy course and incorporated as an optional course

409

Laparoscopic cholecystectomy. Experience with 375 consecutive patients.  

PubMed Central

Three hundred seventy-five consecutive patients underwent laparoscopic cholecystectomy from September 1989 to January 1991. Three hundred forty-one (91%) presented on an elective basis, and the remaining 34 patients (9%) were admitted for acute cholecystitis (24), gallstone pancreatitis (9), and cholangitis (1). Of the 375 patients, 20 were converted to laparotomy and cholecystectomy, for an overall success rate of 95% for patients undergoing laparoscopic cholecystectomy. Three hundred nineteen patients (90%) were discharged within 24 hours of surgery. Operative cholangiography was completed in 141 patients, showing choledocholithiasis in five (managed by postoperative endoscopic retrograde cholangiopancreatography [ERCP] in 4, common bile duct exploration [CBDE] in 1). Two retained stones (0.9%) were detected in 214 patients not undergoing cholangiography. Three patients (0.8%) were reoperated on because of perioperative complications. Overall morbidity for patients undergoing laparoscopic cholecystectomy was 3.5%. Major complications (0.6%) included a single common hepatic duct injury and a delayed cystic duct leak at 10 days. Minor complications occurred in 11 patients (2.9%). The single perioperative death (0.3%) was due to a myocardial infarction on postoperative day 3, after an otherwise uncomplicated laparoscopic procedure. Laparoscopic cholecystectomy appears to offer significant advantages to patient recovery, and these data suggest that it can be performed with an efficacy, morbidity rate, and mortality rate similar to those of open cholecystectomy. Images Fig. 4. Fig. 5. Fig. 2. Fig. 3. Fig. 6. PMID:1835346

Bailey, R W; Zucker, K A; Flowers, J L; Scovill, W A; Graham, S M; Imbembo, A L

1991-01-01

410

Controlling the vocabulary for anatomy.  

PubMed Central

When confronted with the representation of human anatomy, natural language processing (NLP) system designers are facing an unsolved and frequent problem: the lack of a suitable global reference. The available sources in electronic format are numerous, but none fits adequately all the constraints and needs of language analysis. These sources are usually incomplete, difficult to use or tailored to specific needs. The anatomist's or ontologist's view does not necessarily match that of the linguist. The purpose of this paper is to review most recognized sources of knowledge in anatomy usable for linguistic analysis. Their potential and limits are emphasized according to this point of view. Focus is given on the role of the consensus work of the International Federation of Associations of Anatomists (IFAA) giving the Terminologia Anatomica. PMID:12463780

Baud, R. H.; Lovis, C.; Rassinoux, A. M.; Ruch, P.; Geissbuhler, A.

2002-01-01

411

Urodynamic evaluation of the bladder and pelvic floor.  

PubMed

Pelvic floor disorders including lower urinary tract dysfunction are common, and may be evaluated by urodynamic tests, such as cystometry, uroflowmetry, pressure flow studies, electromyography, and video-urodynamics. These urodynamic tests provide objective information regarding the normal and abnormal function of the urinary tract and pelvic floor, and provide a better understanding of the pathophysiologic processes that cause lower urinary tract symptoms. This article describes typical urodynamic studies and their roles in the evaluation of common pelvic floor disorders, including stress urinary incontinence, overactive bladder, and pelvic organ prolapse. PMID:18793995

Bradley, Catherine S; Smith, Karen E; Kreder, Karl J

2008-09-01

412

Parallel genetic origins of pelvic reduction in vertebrates  

PubMed Central

Despite longstanding interest in parallel evolution, little is known about the genes that control similar traits in different lineages of vertebrates. Pelvic reduction in stickleback fish (family Gasterosteidae) provides a striking example of parallel evolution in a genetically tractable system. Previous studies suggest that cis-acting regulatory changes at the Pitx1 locus control pelvic reduction in a population of threespine sticklebacks (Gasterosteus aculeatus). In this study, progeny from intergeneric crosses between pelvic-reduced threespine and ninespine (Pungitius pungitius) sticklebacks also showed severe pelvic reduction, implicating a similar genetic origin for this trait in both genera. Comparative sequencing studies in complete and pelvic-reduced Pungitius revealed no differences in the Pitx1 coding sequences, but Pitx1 expression was absent from the prospective pelvic region of larvae from pelvic-reduced parents. A much more phylogenetically distant example of pelvic reduction, loss of hindlimbs in manatees, shows a similar left–right size bias that is a morphological signature of Pitx1-mediated pelvic reduction in both sticklebacks and mice. These multiple lines of evidence suggest that changes in Pitx1 may represent a key mechanism of morphological evolution in multiple populations, species, and genera of sticklebacks, as well as in distantly related vertebrate lineages. PMID:16945911

Shapiro, Michael D.; Bell, Michael A.; Kingsley, David M.

2006-01-01

413

Laparoscopic Assistance After Vaginal Hysterectomy and Unsuccessful Access to the Ovaries or Failed Uterine Mobilization: Changing Trends  

PubMed Central

Objectives: We conducted retrospective and prospective clinical studies at the Columbus Hospital of Rome to point out changes in choosing the route for performing hysterectomy; to evaluate the feasibility of vaginal hysterectomy (VH) and oophorectomy, even in commonly considered contraindications to the vaginal route; to describe a method of laparoscopic oophorectomy following vaginal hysterectomy; and laparoscopic assistance in impossible vaginal hysterectomies. Methods: From November 1999 to November 2001, 226 patients (age 46.1±4.6 years, range 35 to 58) underwent hysterectomy for benign pathologies: 22 (9.7%) underwent total laparoscopic hysterectomy for the presence of severe endometriosis, limited access to the fornices, or immobile uterus with no lateral mobilization; 204 (90.3%) underwent vaginal hysterectomy. Patients with uterine prolapse were excluded. Uterine size, previous cesarean deliveries, pelvic surgeries and the requirement of prophylactic oophorectomy were not considered contraindications to the vaginal approach. We retrospectively analyzed 509 hysterectomies performed in the previous 2 years from 1997 through 1998. Results: During vaginal hysterectomy, adnexectomy was possible in 90.6% of the cases in which it was indicated (unilateral in 21.8% because of adnexal pathology) and was technically impossible in 9.3%. In 4 patients (1.9%), it was not possible to complete a vaginal hysterectomy, owing to the presence of thick adhesions obliterating the cul-de-sac, to severe endometriosis, or to other unforeseen circumstances. In these few patients with difficult access to the ovaries (2.9% of all VH) or with difficulties in mobilizing the uterus, we resorted to laparoscopy. The pneumoperitoneum was achieved with an insufflation tube inserted via the vagina into the abdominal cavity and packing the vagina. Thus, the risks associated with the insertion of the Veress needle were avoided. In all but 2 patients in whom conversion to laparotomy was necessary, laparoscopy was successfully completed. No major complications occurred. In the retrospective analysis of 509 hysterectomies, we determined that 29% were vaginal, 43% abdominal, and 28% laparoscopic (mostly LAVH). In the following years, LAVH allowed the conversion of a significant number of abdominal or laparoscopic hysterectomies to a vaginal route, showing that the vaginal approach was possible in most of cases. Conclusions: The vaginal approach is feasible in more than 90% of cases even if oophorectomy is required. In the few cases with difficult access to ovaries or difficulties in mobilizing the uterus, the laparoscopic route can easily be adapted by packing the vagina and obtaining a pneumoperitoneum without the risk and loss of time of the insertion of the Veress needle. In this way, it is possible to avoid a great number of LAVH, reducing operating time and the risks of a concomitant procedure. PMID:15554277

Paparella, Pierluigi; Bonito, Claudio; Paparella, Raffaele; Rossetti, Alfonso

2004-01-01

414

Anatomy of the infant head  

SciTech Connect

This text is mainly an atlas of illustration representing the dissection of the head and upper neck of the infant. It was prepared by the author over a 20-year period. The commentary compares the anatomy of the near-term infant with that of a younger fetus, child, and adult. As the author indicates, the dearth of anatomic information about postnatal anatomic changes represents a considerable handicap to those imaging infants. In part 1 of the book, anatomy is related to physiologic performance involving the pharynx, larynx, and mouth. Sequential topics involve the regional anatomy of the head (excluding the brain), the skeleton of the cranium, the nose, orbit, mouth, larynx, pharynx, and ear. To facilitate use of this text as a reference, the illustrations and text on individual organs are considered separately (i.e., the nose, the orbit, the eye, the mouth, the larynx, the pharynx, and the ear). Each part concerned with a separate organ includes materials from the regional illustrations contained in part 2 and from the skeleton, which is treated in part 3. Also included in a summary of the embryologic and fetal development of the organ.

Bosma, J.F.

1986-01-01

415

Observations by a University Anatomy Teacher and a Suggestion for Curricular Change: Integrative anatomy for undergraduates  

NSDL National Science Digital Library

This article describes the need, purpose, and establishment of an undergraduate integrative anatomy course. The article also explains a survey conducted to evaluate the number of anatomy programs in undergraduate institutes in Washington.

David Darda (Central Washington University Biological Sciences)

2010-01-18

416

Fluidic lens laparoscopic zoom camera for minimally invasive surgery  

NASA Astrophysics Data System (ADS)

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 4× optical zoom, and 100 times higher sensitivity than today's 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.

Tsai, Frank S.; Johnson, Daniel; Francis, Cameron S.; Cho, Sung Hwan; Qiao, Wen; Arianpour, Ashkan; Mintz, Yoav; Horgan, Santiago; Talamini, Mark; Lo, Yu-Hwa

2010-05-01

417

Anatomy Resources Provided by MCW Libraries Acland's Video Atlas of Human Anatomy, ClinicalKey, LWW Health Library Premium  

E-print Network

Anatomy Resources Provided by MCW Libraries Acland's Video Atlas of Human Anatomy, ClinicalKey, LWW the library proxy server. Acland's Video Atlas of Human Anatomy Web-based product featuring freshly dissected such as Atlas of Human Anatomy (Netter) and over 20 additional Netter titles, Gray's Anatomy for Students

418

Treating Chronic Pelvic Pain: A Review of the Research for Women  

MedlinePLUS

... Women" /> Consumer Summary – Apr. 16, 2012 Treating Chronic Pelvic Pain: A Review of the Research for Women Formats ... or physician assistant. Understanding Your Condition What is chronic pelvic pain? Chronic pelvic pain (CPP) is ongoing pain in ...

419

A randomized prospective trial of the postoperative quality of life between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy for the treatment of symptomatic uterine fibroids: clinical trial design  

PubMed Central

Background Laparoscopy-assisted vaginal hysterectomy is one of the definite methods for the treatment of symptomatic uterine fibroids with lesser intraoperative bleeding and shorter hospitalization compared with abdominal hysterectomy. However, laparoscopy-assisted vaginal hysterectomy cannot preserve uterus and can show postoperative complications by the change of pelvic structure. Thus, laparoscopic uterine artery ligation has been introduced for relieving the symptoms caused by uterine fibroids in place of hysterectomy. The current study was designed to compare postoperative quality of life between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy, and to evaluate the efficacy of laparoscopic uterine artery ligation which can treat symptomatic uterine fibroids with the preservation of uterus. Methods and design Patients enrolled the current study are randomized to laparoscopic uterine artery ligation or laparoscopy-assisted vaginal hysterectomy. The primary outcome is to compare postoperative quality of life between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Cancer patients version 3.0. Secondary outcomes are to evaluate the volume reduction of uterus, uterine fibroids and ovaries by the 2 treatments, to compare the improvement of subjective symptoms using 11-point symptom score and postoperative clinical outcomes between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy, and to investigate the improvement of postoperative vaginal bleeding by laparoscopic uterine artery ligation. Discussion Among treatment methods for symptomatic uterine fibroids with the preservation of uterus, laparoscopic uterine artery ligation is expected to have the efficacy like uterine artery embolization, which appeared to be safe for routine use with symptomatic relief. The current study fully recruited in June 2008 and the results will be available in June 2009. If there is no difference of postoperative QOL between laparoscopic uterine artery ligation and laparoscopy-assisted vaginal hysterectomy for the treatment of symptomatic uterine fibroids, the comparison of quality of life between laparoscopic uterine artery ligation and uterine artery embolization will be also needed as a surgical treatment for preserving uterus. Trial registration Current Controlled Trials ISRCTN76790866 PMID:19178748

Kim, Hee Seung; Kim, Jae Weon; Kim, Mi-Kyung; Chung, Hyun Hoon; Lee, Taek Sang; Jeon, Yong-Tark; Kim, Yong Beom; Jeon, Hye Won; Yun, Young Ho; Park, Noh Hyun; Song, Yong Sang; Kang, Soon-Beom

2009-01-01

420

The first total laparoscopic pancreatoduodenectomy in Poland  

PubMed Central

We present a case of a 55-year-old female patient with pancreatic head cancer who was treated with total laparoscopic pylorus-preserving pancreatoduodenectomy (TLPD) on 13.12.2013. The procedure as well as the postoperative course was uncomplicated. The patient was mobilized on the day of surgery; a liquid diet was introduced on day 1 and a full hospital diet on day 2 postoperatively. Drains were removed on the 3rd day after the procedure. Length of hospital stay was 6 days. The final pathology report confirmed the diagnosis of cancer. According to our knowledge this is the first report on total laparoscopic pancreatoduodenectomy in Poland performed by an entirely Polish team of surgeons. In our opinion, TLPD is feasible and similarly to other laparoscopic operations may improve postoperative recovery. PMID:25337173

Budzynski, Andrzej; Zub-Pokrowiecka, Anna; Zychowicz, Anna; Wierdak, Mateusz; Matlok, Maciej; Zajac, Malgorzata

2014-01-01

421

Laparoscopic Resection of an Adrenal Schwannoma  

PubMed Central

Background and Objectives: Schwannomas are tumors originating from Schwann cells of the peripheral nerve sheath (neurilemma) of the neuroectoderm. Rarely, schwannomas can arise from the retroperitoneum and adrenal medulla. We describe a case of a 71-y-old woman who presented with an incidentally discovered adrenal tumor. Methods: Ultrasound and computed tomography scans revealed a lesion with solid and cystic areas originating from the left adrenal gland. The patient underwent complete laparoscopic resection of the tumor and the left adrenal gland. Results: Histopathological examination and immunohistochemical staining of the excised specimen revealed a benign schwannoma measuring 5.5×5×3.7 cm. To our knowledge, few other cases of laparoscopic resection of adrenal schwannomas have been reported. Conclusion: Because preoperative diagnosis of adrenal tumors is inconclusive, complete laparoscopic excision allows for definitive diagnosis with histological evaluation and represents the treatment of choice. PMID:23484583

Konstantinos, Toutouzas G.; Panagiotis, Kekis B.; Nikolaos, Michalopoulos V.; Ioannis, Flessas; Andreas, Manouras; Geogrios, Zografos

2012-01-01

422

Journal of Anatomy JournalofAnatomyVolume211,Issue1,Pages1148,July2007  

E-print Network

e-mail alerts. Volume 211, Issue 1, Pages 1­148, July 2007 AnatomyDevelopment,EvolutionJournal of Anatomy JournalofAnatomyVolume211,Issue1,Pages1­148,July2007 Contents Obituary i Charles Philippe Leblond, 1910­2007 G. W. Laurie Original Articles 1 An immunohistochemical study of the triangular

Frangi, Alejandro

423

Dynamic Magnetic Resonance Imaging Demonstrates the Integrity of Perineal Reconstruction following Cylindrical Abdominoperineal Excision with Reconstruction of the Pelvic Floor Using Porcine Collagen  

PubMed Central

A 72-year-old female presented with a six-month history of increased frequency of defecation, rectal bleeding, and severe rectal pain. Digital rectal examination and endoscopy revealed a low rectal lesion lying anteriorly. This was confirmed histologically as adenocarcinoma. Radiological staging was consistent with a T3N2 rectal tumour. Following long-course chemoradiotherapy repeat staging did not identify any metastatic disease. She underwent a laparoscopic cylindrical abdominoperineal excision with en bloc resection of the coccyx and posterior wall of the vagina with a negative circumferential resection margin. The perineal defect was reconstructed with Permacol (biological implant, Covidien) mesh. She had no clinical evidence of a perineal hernia at serial followup. Dynamic MRI images of the pelvic floor obtained during valsalva at 10 months revealed an intact pelvic floor. A control case that had undergone a conventional abdominoperineal excision with primary perineal closure without clinical evidence of herniation was also imaged. This confirmed subclinical perineal herniation with significant downward migration of the bowel and bladder below the pubococcygeal line. We eagerly await further evidence supporting a role for dynamic MR imaging in assessing the integrity of a reconstructed pelvic floor following cylindrical abdominoperineal excision. PMID:22312372

Kavanagh, D. O.; Imran, H.; Almoudaris, A.; Ziprin, P.; Faiz, O.

2012-01-01

424

Brachial plexus anatomy: normal and variant.  

PubMed

Effective brachial plexus blockade requires a thorough understanding of the anatomy of the plexus, as well as an appreciation of anatomic variations that may occur. This review summarizes relevant anatomy of the plexus, along with variations and anomalies that may affect nerve blocks conducted at these levels. The Medline, Cochrane Library, and PubMed electronic databases were searched in order to compile reports related to the anatomy of the brachial plexus using the following free terms: "brachial plexus", "median nerve", "ulnar nerve", "radial nerve", "axillary nerve", and "musculocutanous nerve". Each of these was then paired with the MESH terms "anatomy", "nerve block", "anomaly", "variation", and "ultrasound". Resulting articles were hand searched for additional relevant literature. A total of 68 searches were conducted, with a total of 377 possible articles for inclusion. Of these, 57 were found to provide substantive information for this review. The normal anatomy of the brachial plexus is briefly reviewed, with an emphasis on those features revealed by use of imaging technologies. Anomalies of the anatomy that might affect the conduct of the various brachial plexus blocks are noted. Brachial plexus blockade has been effectively utilized as a component of anesthesia for upper extremity surgery for a century. Over that period, our understanding of anatomy and its variations has improved significantly. The ability to explore anatomy at the bedside, with real-time ultrasonography, has improved our appreciation of brachial plexus anatomy as well. PMID:19412559

Orebaugh, Steven L; Williams, Brian A

2009-01-01

425

Hindawi Publishing Corporation Anatomy Research International  

E-print Network

Hindawi Publishing Corporation Anatomy Research International Volume 2011, Article ID 287860, 17, and destructive to gross morphological features. Consequently, there is a great value in bringing these two

Kruggel, Frithjof

426

Rehabilitation of the short pelvic floor. II: Treatment of the patient with the short pelvic floor  

Microsoft Academic Search

Several urogynecologic syndromes are associated with the clinical finding of a short, painful, tender and weak pelvic floor and a variety of connective tissue abnormalities. Techniques for rehabilitation include the avoidance of perpetuating factors, rehabilitation of extrapelvic musculoskeletal abnormalities, the use of manual techniques and needling to promote resolution of connective tissue problems, closure of any diastasis recti, and transvaginal\\/transrectal

M. P. FitzGerald; R. Kotarinos

2003-01-01

427

Risk Factors for Pelvic Floor Repair After Hysterectomy  

PubMed Central

Objective Having demonstrated that prior history of prolapse was a risk factor for pelvic floor repair procedures after hysterectomy, the objective of this study was to assess medical risk factors for pelvic floor repair after hysterectomy. Methods Using the Rochester Epidemiology Project database of 8,220 Olmsted County, Minnesota women who had hysterectomy for benign indications in 1965-2002, we conducted a nested case-control study in 144 pairs, comparing women who underwent pelvic floor repair after hysterectomy (cases) to controls matched for known risk factors (ie, age, pelvic floor disorders at baseline, year and type of hysterectomy, and pelvic floor repair during hysterectomy). Results The median duration between hysterectomy and pelvic floor repair was 13 years. Chronic pulmonary disease (odds ratio [OR] 14.3; 95% CI 1.2 to 178) but not obstetric history, obesity, indication for hysterectomy, or chronic constipation was associated with an increased risk of pelvic floor repair after hysterectomy. Between the hysterectomy and subsequent pelvic floor repair, overall pelvic organ prolapse severity changed by 1 grade or less in 54 cases (38%, Group A) but increased by 2 or more grades in 72 cases (50%, Group B). In Group A, but not Group B, uterine prolapse (OR 25; 95% CI 2.1 to 300) and chronic pulmonary disease (OR 22; 95% CI 1.5 to 328) at baseline remained risk factors for pelvic floor repair after hysterectomy. Conclusion In this matched case-control study, chronic pulmonary disease was the only risk factor for pelvic floor repair after hysterectomy for benign indications, underscoring the need to address pulmonary status prior to surgery. PMID:19300323

Blandon, Roberta E.; Bharucha, Adil E.; Melton, L. Joseph; Schleck, Cathy D.; Zinsmeister, Alan R.; Gebhart, John B.

2009-01-01

428

Laparoscopic revolution in bariatric surgery  

PubMed Central

The history of bariatric surgery is investigational. Dedicated surgeons have continuously sought for an ideal procedure to relieve morbidly obese patients from their burden of comorbid conditions, reduced life expectancy and low quality of life. The ideal procedure must have low complication risk, both in short- and long term, as well as minimal impact on daily life. The revolution of laparoscopic techniques in bariatric surgery is described in this summary. Advances in minimal invasive techniques have contributed to reduced operative time, length of stay, and complications. The development in bariatric surgery has been exceptional, resulting in a dramatic increase of the number of procedures performed world wide during the last decades. Although, a complex bariatric procedure can be performed with operative mortality no greater than cholecystectomy, specific procedure-related complications and other drawbacks must be taken into account. The evolution of laparoscopy will be the legacy of the 21st century and at present, day-care surgery and further reduction of the operative trauma is in focus. The impressive effects on comorbid conditions have prompted the adoption of minimal invasive bariatric procedures into the field of metabolic surgery. PMID:25386062

Sundbom, Magnus

2014-01-01

429

Laparoscopic colectomy vs traditional colectomy for diverticulitis  

Microsoft Academic Search

Background  The aim of this study was to evaluate the outcome of patients undergoing laparoscopic colectomy for diverticulitis.\\u000a \\u000a \\u000a \\u000a Methods  Fourteen consecutive patients undergoing laparoscopic sigmoid colectomy (LSC) for diverticulitis were evaluated. Medical records\\u000a from a control group of 14 matched patients undergoing traditional open sigmoid colectomy (OSC) for diverticulitis were reviewed\\u000a for comparison.\\u000a \\u000a \\u000a \\u000a Results  Mean age, operative time, morbidity, and mortality of the

M. A. Liberman; E. H. Phillips; B. J. Carroll; M. Fallas; R. Rosenthal

1996-01-01

430

Laparoscopic Fertility Sparing Management of Cervical Cancer  

PubMed Central

Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery is a minimally invasive approach associated with less pain and faster recovery, feasible even in obese women. PMID:24696772

Facchini, Chiara; Rapacchia, Giuseppina; Montanari, Giulia; Casadio, Paolo; Pilu, Gianluigi; Seracchioli, Renato

2014-01-01

431

Ectopic gallbladder revisited, laparoscopically: a case report  

PubMed Central

A case of the rare congenital anomaly ectopic gallbladder is presented. A 16-year-old girl suffered attacks of epigastric pain unrelated to eating. On abdominal ultrasonography, the gallbladder could not be found in its usual position. Endoscopic retrograde cholangiography demonstrated the gallbladder on the left side of the common duct and the cystic duct arising from the right hepatic duct. Laparoscopic cholecystectomy was done without complication. This appears to be the first reported case of laparoscopic removal of an ectopic gallbladder. The importance of preoperative cholangiography is emphasized for accurate diagnosis and preoperative location of the gallbladder. PMID:9416258

Chung, C.C.; Leung, K.L.; Lau, W.Y.; Li, Arthur K.C.

1997-01-01

432

Laparoscopic fertility sparing management of cervical cancer.  

PubMed

Fertility can be preserved after conservative cervical surgery. We report on a 29-year-old woman who was obese, para 0, and diagnosed with cervical insufficiency at the first trimester of current pregnancy due to a previous trachelectomy. She underwent laparoscopic transabdominal cervical cerclage (LTCC) for cervical cancer. The surgery was successful and she was discharged two days later. The patient underwent a caesarean section at 38 weeks of gestation. Laparoscopic surgery is a minimally invasive approach associated with less pain and faster recovery, feasible even in obese women. PMID:24696772

Facchini, Chiara; Rapacchia, Giuseppina; Montanari, Giulia; Casadio, Paolo; Pilu, Gianluigi; Seracchioli, Renato

2014-04-01

433

Single-port access in laparoscopic cholecystectomy  

Microsoft Academic Search

Background  Single-port access cholecystectomy is a new laparoscopic procedure using only one, transumbilical-placed port. The method\\u000a has been denominated by some authors as “scarless.” We report one of the initial clinical experiences in Europe with this\\u000a new technique.\\u000a \\u000a \\u000a \\u000a Methods  Fourteen patients underwent laparoscopic cholecystectomy using the ASC TriPort. In all cases, a small transumbilical incision\\u000a was used to insert two 5-mm rigid

Thomas E. Langwieler; Thomas Nimmesgern; Melanie Back

2009-01-01

434

Complications of laparoscopic antireflux surgery in childhood  

Microsoft Academic Search

Background: The aim of this study was to assess the complications associated with the laparoscopic treatment of gastroesophageal reflux\\u000a disease (GERD) in children.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Methods: From March 1992 to March 1998, we used the laparoscopic approach to treat 289 children affected by gastroesophageal reflux\\u000a disease. The patients' ages ranged between 4 months and 17 years (median, 4.3 years), and their body

C. Esposito; P. Montupet; G. Amici; P. Desruelle

2000-01-01

435

Laparoscopic resection of pancreatic neuroendocrine tumors  

PubMed Central

Pancreatic neuroendocrine tumors (PNETs) are a rare heterogeneous group of endocrine neoplasms. Surgery remains the best curative option for this type of tumor. Over the past two decades, with the development of laparoscopic pancreatic surgery, an increasingly larger number of PNET resections are being performed by these minimally-invasive techniques. In this review article, the various laparoscopic surgical options for the excision of PNETs are discussed. In addition, a summary of the literature describing the outcome of these treatment modalities is presented. PMID:24803802

Al-Kurd, Abbas; Chapchay, Katya; Grozinsky-Glasberg, Simona; Mazeh, Haggi

2014-01-01

436

Laparoscopic repair of a Morgagni hernia  

PubMed Central

We report a case of laparoscopic repair of symptomatic Morgagni hernia (MH) in an adult. A tension-free closure of the defect was carried out using a polypropylene mesh. The recovery was quick and uneventful. Two years after surgery, the patient is doing well. A search of the English-language surgical literature revealed a total of 55 cases of laparoscopic repair of MH reported: 40 in adults and 15 in children. The various modalities of diagnosis, operative techniques, and disease presentation are discussed. PMID:21206651

Sherigar, J. M.; Dalal, A. D.; Patel, J. R.

2005-01-01

437

Laparoscopic repair of ventral / incisional hernias  

PubMed Central

Despite its significant prevalence, there is little in the way of evidence-based guidelines regarding the timing and method of repair of incisional hernias. To add to the above is the formidable rate of recurrence that has been seen with conventional tissue repairs of these hernias. With introduction of different prosthetic materials and laparoscopic technique, it was hoped that an improvement in the recurrence and complication rates would be realized. The increasing application of the laparoscopic technique across the world indicates that these goals might indeed be achieved. PMID:21187995

Chowbey, Pradeep K; Sharma, Anil; Mehrotra, Magan; Khullar, Rajesh; Soni, Vandana; Baijal, Manish

2006-01-01

438

Laparoscopic total extraperitoneal repair of lumbar hernia  

PubMed Central

Lumbar hernia is a rare surgical entity without a standard method of repair. With advancements in laparoscopic techniques, successful lumbar herniorrhaphy can be achieved by the creation of a completely extraperitoneal working space and secure fixation of a wide posterior mesh. We present a total extraperitoneal laparoendoscopic repair of lumbar hernia, which allowed for minimal invasiveness while providing excellent anatomical identification, easy mobilization of contents and wide secure mesh fixation. A total extraperitoneal method of lumbar hernia repair by laparoscopic approach is feasible and may be an ideal option. PMID:22111086

Lim, Man Sup; Lee, Hae Wan; Yu, Chang Hee

2011-01-01

439

Resolving gastroesophageal reflux with laparoscopic fundoplication  

Microsoft Academic Search

Background: The purpose of this study was to evaluate the results of 138 cases of gastroesophageal reflux disease resolved laparoscopically\\u000a with the Rossetti modification of the Nissen fundoplication and to compare them with findings from other studies in an effort\\u000a to evaluate the procedure's ability to transfer from an academic setting to a community hospital setting.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: We performed laparoscopic

P. L. Leggett; R. Churchman-Winn; C. Ahn

1998-01-01

440

[Pelvic arteriovenous malformation : a case report].  

PubMed

A 70-year-old male presented with intermittent macroscopic hematuria. There was no history of previous trauma or pelvic operation. At first, we were unable to clarify the origin of the hematuria, but 3D computed tomography revealed an arteriovenous malformation (AVM) consisting of multiple feeding vessels arising from the bilateral, especially right, internal iliac artery. Treatment with transcatheter arterial embolization (TAE) with a combination of lipiodol and N-butyl-2-cyanoacrylate twice was effective. He needs to be followed up carefully for recurrence of AVM. PMID:23945325

Suzuki, Kotaro; Kusuda, Yuji; Yamada, Yuji; Nose, Ryuichiro; Matsui, Takashi; Sanda, Yuki; Mori, Takeki; Sugimoto, Koji

2013-07-01

441

Pathology Case Study: Progressive Abdominal / Pelvic Pain  

NSDL National Science Digital Library

This is a case study presented by the University of Pittsburgh Department of Pathology in which a woman presented with progressively worsening abdominal/pelvic pain over a period of 6 weeks. She experienced minor intermittent pain. Visitors can view both gross and microscopic descriptions, including images, and have the opportunity to diagnose the patient. This is an excellent resource for students in the health sciences to familiarize themselves with using patient history and laboratory results to diagnose disease. It is also a helpful site for educators to introduce or test students of pathology.

Mcfadden, Kathryn

2009-03-06

442

Hemorrhage Associated with Pelvic Fractures: Causes, Diagnosis, and Emergent Management  

Microsoft Academic Search

The high risk of exsanguinating hemorrhage in patients with pelvic ring disruption demands aggressive, yet balanced or- thopedic and angiographic management as soon as patients are admitted to the emergency department. We present a perspective of our experience in two trauma centers and propose a logical approach to early prediction, diagnosis, and management of hemorrhage associated with pelvic fractures. Our

Yoram Ben-Menachem; Douglas M. ColdweII; Jeremy W. R. Young; Andrew R. Burgess

443

Curative Surgery for Local Pelvic Recurrence of Rectal Cancer  

Microsoft Academic Search

Background\\/Aims: Local pelvic recurrence of rectal cancer after radical resection has been associated with morbidity and cancer-related death. This study retrospectively evaluated outcome following curative resection for rectal cancer recurring after surgery on the basis of prognosis, type of procedure and perioperative morbidity. Methods: A total of 85 consecutive patients with local pelvic recurrence of rectal cancer were evaluated. Of

Norio Saito; Keiji Koda; Nobuhiro Takiguchi; Kenji Oda; Masato Ono; Masanori Sugito; Kiyotaka Kawashima; Masaaki Ito

2003-01-01

444

Genetic and developmental basis of evolutionary pelvic reduction  

E-print Network

of the variation in pelvic size. Pelvic-reduced fish show the same left­right asymmetry seen in Pitx1 knockout mice processes. Vertebrate limb structures exhibit extensive structural variation in animals adapted to different that these animals evolved from four-limbed ancestors through extensive modification of pre-existing skeletal

Shapiro, Mike

445

Postnatal sonographic spectrum of prenatally detected abdominal and pelvic cysts.  

PubMed

OBJECTIVE. The purpose of this article is to illustrate the sonographic findings of a spectrum of neonatal abdominal and pelvic cystic lesions. CONCLUSION. Neonatal abdominal and pelvic cystic lesions can arise from many organs, and they have a broad differential diagnosis. Distinctive sonographic findings may be present and can help establish the correct cause and guide proper management. PMID:25415735

Silva, Cicero T; Engel, Caroline; Cross, Sarah N; Copel, Joshua E; Morotti, Raffaella A; Baker, Kenneth E; Goodman, Thomas R

2014-12-01

446

AUTOMATIC ANATOMY RECOGNITION VIA FUZZY OBJECT Jayaram K. Udupaa  

E-print Network

AUTOMATIC ANATOMY RECOGNITION VIA FUZZY OBJECT MODELS Jayaram K. Udupaa , Dewey Odhnera , Alexandre radiological practice, computerized automatic anatomy recognition (AAR) during radiological image reading

Ciesielski, Krzysztof Chris

447

Treatment of Acute Pelvic Inflammatory Disease  

PubMed Central

Pelvic inflammatory disease (PID), one of the most common infections in nonpregnant women of reproductive age, remains an important public health problem. It is associated with major long-term sequelae, including tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. In addition, treatment of acute PID and its complications incurs substantial health care costs. Prevention of these long-term sequelae is dependent upon development of treatment strategies based on knowledge of the microbiologic etiology of acute PID. It is well accepted that acute PID is a polymicrobic infection. The sexually transmitted organisms, Neisseria gonorrhoeae and Chlamydia trachomatis, are present in many cases, and microorganisms comprising the endogenous vaginal and cervical flora are frequently associated with PID. This includes anaerobic and facultative bacteria, similar to those associated with bacterial vaginosis. Genital tract mycoplasmas, most importantly Mycoplasma genitalium, have recently also been implicated as a cause of acute PID. As a consequence, treatment regimens for acute PID should provide broad spectrum coverage that is effective against these microorganisms. PMID:22228985

Sweet, Richard L.

2011-01-01

448

Chronic Pelvic Pain in Endometriosis: An Overview  

PubMed Central

Chronic pelvic pain (CPP) could be considered nowadays a deep health problem that challenges physicians all over the world. This because its aetiology is still unclear, the course of the disease could vary a lot among different patients and through time in the same patient, and the response to treatments is not every time successful. Among women who underwent laparoscopy for CPP, endometriosis is found in about 1/3 of the cases, while only 25% of women with histological confirmed endometriosis are asymptomatic. A wide range of variables may exert their influence on the resulting pain syndrome in endometriosis; for example, score according to American society for reproductive medicine (rASRM), size of the sub-peritoneal and pelvic wall implants, Douglas obliteration, previous surgery. It is widely accepted nowadays that central nervous system (CNS) and peripheral nervous system (PNS) seems to influence each other and this interconnection play a key role in pain modulation. Moreover, the phenomena induced by endometriosis in the pelvis, including the breakdown of peritoneal homeostasis and the induction of the production of proinflammatory and proangiogenic cytokines, are responsible of altered innervations and modulation of pain pathways in these patients. There are many proposed medical and surgical approach to treat this painful syndrome, although there is necessity of more efforts to create new non-invasive strategies that set a more accurate diagnosis of the causes of endometriotic-related CPP, and therefore facilitate its eradication. PMID:23671540

Triolo, Onofrio; Lagana, Antonio Simone; Sturlese, Emanuele

2013-01-01

449

Small bowel obstruction in percutaneous fixation of traumatic pelvic fractures  

PubMed Central

The use of external fixation for the initial treatment of unstable, complex pelvic injuries with hemodynamic instability remains an effective treatment for multiply injured patients. Bowel entrapment within a pelvic fracture is a rarely reported, potentially fatal complication. Here, we report a polytrauma patient with pelvic fractures who developed an intestinal obstruction after an external fixation. At an explorative laparotomy, we found an ileum segment trapped in the sacral fracture. Reported cases of bowel entrapment in pelvic fractures, especially in sacral fractures, are exceedingly rare. The diagnosis is often delayed due to difficulty distinguishing entrapment from the more common adynamic ileus. In conclusion, clinicians and radiologists should be aware of this potentially lethal complication of pelvic fractures treatment. To exclude bowel entrapment, patients with persistent ileus or sepsis should undergo early investigations. PMID:23960383

Bini, Roberto; Quiriconi, Fabrizio; Viora, Tiziana; Leli, Renzo

2013-01-01

450

Surgical anatomy of the shoulder.  

PubMed

The glenohumeral articulation is a versatile joint that requires a complex integration of bony ligamentous, musculotendinous, and neurovascular structures for proper function. Injuries resulting from dysfunction are common and potentially debilitating. Many of these injuries can be managed nonsurgically; however, if surgical treatment is indicated, a thorough knowledge of the anatomy of the shoulder girdle is critical. It is important for the surgeon to be aware of commonly used arthroscopic and surgical approaches to the glenohumeral joint along with anatomic structures at risk with each surgical approach and methods of avoiding injury. PMID:22301224

Millett, Peter J; van der Meijden, Olivier A J; Gaskill, Trevor

2012-01-01

451

Historical Anatomies on the Web  

NSDL National Science Digital Library

Historical Anatomies on the Web is a digital project of the National Library of Medicine offering selected images from illustrated anatomical atlases spanning the 15th to 20th centuries. The atlases represented in this collection were chosen primarily for their historical and artistic significance, but anyone with an interest in medicine or the history of medical science should find this Web site appealing. All images may be downloaded free of charge, and new items will continue to be added to the online collection.

452

Human Anatomy Label Me! Printouts  

NSDL National Science Digital Library

This Web site from Enchanted Learning (last mentioned in the June 28, 2002 Scout Report) contains elementary-level human anatomy diagrams, which may be printed out and labeled for practice. The diagrams come with a word bank, complete with definitions printed on the same page. Many of the diagrams lend themselves to coloring-in. A number of diagrams are available, including the human eye, ear, brain, skeleton, teeth, and more. Some of the diagrams are also available in French, German, Italian, or Spanish, and would be an interesting addition to language classes at any grade level.

2001-01-01

453

Functional anatomy of the nose.  

PubMed

The human nose is a very complex entity with a great amount of variation among and within different human populations. Even though the morphology of the nasal pyramid and its soft tissue coverage is principally known, a standardized nomenclature does not yet exist. The past two decades have witnessed a considerable increase of new studies on the functional morphology of the external nasal anatomy. Detailed anatomic and clinical knowledge about the external nose is a prerequisite for successful rhinosurgery, thus this report deals with the basic structures necessary for functional and aesthetic rhinoplasty. PMID:21404156

Koppe, Thomas; Giotakis, Evangelos I; Heppt, Werner

2011-04-01

454

Shark Attack! Sinking Your Teeth into Anatomy.  

ERIC Educational Resources Information Center

Presents a real life shark attack story and studies arm reattachment surgery to teach human anatomy. Discusses how knowledge of anatomy can be put to use in the real world and how the arm functions. Includes teaching notes and suggestions for classroom management. (YDS)

House, Herbert

2002-01-01

455

Design Projects in Human Anatomy & Physiology  

ERIC Educational Resources Information Center

Very often, some type of writing assignment is required in college entry-level Human Anatomy and Physiology courses. This assignment can be anything from an essay to a research paper on the literature, focusing on a faculty-approved topic of interest to the student. As educators who teach Human Anatomy and Physiology at an urban community college,…

Polizzotto, Kristin; Ortiz, Mary T.

2008-01-01

456

Human Anatomy ÃÂ SUNY Upstate Medical University  

NSDL National Science Digital Library

This website is a course site for a first year anatomy course developed by State University of New York (SUNY) Upstate Medical University. The course is a gross anatomy course and the page includes links to images, tutorials, videos, glossaries, and exam questions. The site is divided up by anatomical region including: thorax, abdomen & pelvis, extremities, and head & neck.

Dr. Barry Berg (SUNY Upstate Medical University Anatomy)

2011-03-03

457

The humanities and gross anatomy: Forgotten alternatives  

Microsoft Academic Search

Researchers in medical education have extensively studied negative reactions to gross anatomy, sometimes grouped under the term “the cadaver experience.” Although there has been disagreement about the extent and importance of such phenomena, several attempts at curricular reform have been designed to “humanize” the student-cadaver encounter. However, some obvious sources linking gross anatomy and the humanities have been consistently overlooked.

James S. Terry

1985-01-01

458

Laparoscopic and Open Cholecystectomy in Surgical Training  

Microsoft Academic Search

Background: Open cholecystectomy (OC) may still be necessary in surgical training to perform safe conversions of laparoscopic cholecystectomy (LC). Our aim was to study the outcome of LCs and OCs performed by surgical trainees. Methods: All consecutive cholecystectomies (1,581 LCs and 984 OCs) were retrospectively analyzed from 1995 until 2008. Operative complications were compared between the cholecystectomies performed by 20

Satu Suuronen; Anu Koski; Pia Nordstrom; Pekka Miettinen; Hannu Paajanen

2010-01-01

459

Laparoscopic left colon resection for diverticular disease  

Microsoft Academic Search

Background: The aim of this study was to review our experience with laparoscopic sigmoid colectomy for diverticular disease. Methods: All patients presenting with acute or chronic diverticulitis, obstruction, abscess, or fistula were included. Symptomatic diverticular disease was the main surgical indication (95%). Results: Between March 1992 and August 1999 170 consecutive patients underwent surgery. Of these, 21 patients (12%) had

G. Trebuchet; D. Lechaux; J. L. Lecalve

2002-01-01

460

Significant weight loss after laparoscopic Nissen fundoplication  

Microsoft Academic Search

Background: Laparoscopic Nissen fundoplication (LNF) has evolved as a gold standard in antireflux surgery. However, the association between body weight and gastroesophageal reflux disease (GERD) is still unclear, and no data are available concerning the effect of fundoplication on body weight. We present the first report elucidating the impact of LNF on body weight in GERD patients with special emphasis

C. Neumayer; R. Ciovica; M. Gadenstätter; G. Erd; S. Leidl; S. Lehr; G. Schwab

2005-01-01

461

Laparoscopic Management of Huge Ovarian Cysts  

PubMed Central

Objectives. Huge ovarian cysts are conventionally managed by laparotomy. We present 5 cases with huge ovarian cysts managed by laparoscopic endoscopic surgery without any complications. Materials and Methods. We describe five patients who had their surgeries conducted in a tertiary care center in Riyadh, Saudi Arabia (King Fahad Medical City). Results. Patients age ranged between 19 and 69 years. Tumor markers were normal for all patients. The maximum diameter of all cysts ranged between 18 and 42?cm as measured by ultrasound. The cysts were unilocular; in some patients, there were fine septations. All patients had open-entry laparoscopy. After evaluation of the cyst capsule, the cysts were drained under laparoscopic guidance, 1–12 liters were drained from the cysts (mean 5.2?L), and then laparoscopic oophorectomy was done. The final histopathology reports confirmed benign serous cystadenoma in four patients and one patient had a benign mucinous cystadenoma. There was minimal blood loss during surgeries and with no complications for all patients. Conclusion. There is still no consensus for the size limitation of ovarian cysts decided to be a contraindication for laparoscopic management. With advancing techniques, proper patients selection, and availability of experts in gynecologic endoscopy, it is possible to remove giant cyst by laparoscopy. PMID:23766763

Alobaid, A.; Memon, A.; Alobaid, S.; Aldakhil, L.

2013-01-01

462

Antimicrobial Prophylaxis in Laparoscopic and Conventional Cholecystectomy  

Microsoft Academic Search

Background: Postoperative infection following cholecystectomy poses a significant threat to recovery, with major cost repercussions. Though antimicrobial prophylaxis is commonly practiced, its value – particularly in laparoscopic cholecystectomy – has not yet been adequately documented. Method: In a prospective multicenter quality assurance study in 28 German hospitals, an analysis of data collected on 4,477 patients undergoing conventional (n = 1,349)

H. Lippert; J. Gastinger

1998-01-01

463

Laparoscopic Appendectomy in a Nigerian Teaching Hospital  

PubMed Central

Objective: Laparoscopic appendectomy in a setting where resources are poor is still controversial. This study evaluates the impact of laparoscopy on the early outcome of acute appendicitis in a developing country. Methods: All patients who underwent appendectomy from January 2010 through June 2011 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria were recruited for this study. Results: Of the 139 patients with acute appendicitis within the study period, 83 (59.7%) had open appendectomy (OA), 19 (13.7%) whose clinical and radiological findings suggested complicated appendicitis at presentation had laparotomy, while 37 (26.6%) had laparoscopic procedures. In the laparoscopy group, initial diagnostic laparoscopy in 4 (10.8%) patients revealed a normal appendix along with other findings that precluded appendectomy. Laparoscopic appendectomy (LA) was then performed in 33 (23.7%) patients with 2 of these (6.1%) requiring conversion to open laparotomy. Mean time for the LA procedure was higher than that observed for OA (56.2 vs 38.9 min). Patients in the LA group had a shorter mean postoperative stay (1.8 vs 3.0). Wound infection occurred in 2 (6.5%) patients from the LA group and 8 (9.6%) from OA. Conclusion: Laparoscopic appendectomy reduced the rate of unnecessary appendectomy and postoperative hospital stay in our patients, potentially reducing crowding in our surgical wards. We advocate increased use of laparoscopy especially in young women. PMID:23484567

Alatise, Olusegun I.; Arowolo, Olukayode A.; Lawal, Oladejo O.

2012-01-01

464

Laparoscopic splenectomy for atraumatic splenic rupture.  

PubMed

A traumatic splenic rupture (ASR) is a rare clinical entity. Several underlying benign and malignant conditions have been described as a leading cause. We report on a case of ASR in a 41-year-old man treated with laparoscopic splenectomy. Considering ASR as a life-threatening condition, a prompt diagnosis can be life saving. PMID:21675627

Grossi, Ugo; Crucitti, Antonio; D'Amato, Gerardo; Mazzari, Andrea; Tomaiuolo, Pasquina M C; Cavicchioni, Camillo; Bellantone, Rocco

2011-01-01

465

Increased transperitoneal bacterial translocation in laparoscopic surgery  

Microsoft Academic Search

Background: The indications for laparoscopic surgery have expanded to include diseases possibly associated with peritonitis such as appendicitis, perforated peptic ulcers, and diverticulitis. The safety of carbon dioxide (CO 2) pneumoperitoneum in the presence of peritonitis has not been proved. Our previous investigations demonstrated increased bacteremia associated with CO 2 insufflation. In effort to clarify the relative effects of intraabdominal

M. C. Horattas; N. Haller; D. Ricchiutti

2003-01-01

466

Ambidexterity in laparoscopic surgical skills training.  

PubMed

Understanding the way in which specialized medical skills are acquired is critical for developing effective training curricula, as well as effective metrics and methodologies for assessing skill acquisition, proficiency, and retention. Currently, a need exists for novel, objective metrics to support training and assessment of specialized surgical skills, such as those involved in laparoscopy, and to support a deeper understanding of the way in which these skills are acquired and decay during periods of nonuse. Ambidexterity has been identified by expert surgeons as a critical factor in the achievement of laparoscopic psychomotor surgical skill proficiency; however, the current standardized training and assessment protocols do not measure or account for differential performance between the dominant and non-dominant hands. Two experiments compared performance with the left and right hands during training of laparoscopic psychomotor surgical skills using the Fundamentals of Laparoscopic Surgery (FLS) platform, examining the role of ambidexterity in skill acquisition and proficiency. The results of these investigations indicate that degree of ambidexterity in task performance increases with overall task performance improvement and may be related to achievement of task proficiency. Measures that account for degree of task-related ambidexterity may provide useful metrics for assessing laparoscopic surgical skill acquisition, proficiency, and decay. PMID:23400194

Skinner, Anna; Auner, Gregory; Meadors, Margaret; Sebrechts, Marc

2013-01-01

467

Laparoscopic adrenalectomy: pathologic features determine outcome  

PubMed Central

Introduction The differential outcomes of laparoscopic adrenalectomy are not well described. Therefore, we evaluated these outcomes in the 3 groups most often seen clinically: bilateral adrenalectomy for Cushing's disease (group 1), pheochromocytoma (group 2) and unilateral adrenalectomy for non-pheochromocytoma (group 3). Methods We reviewed a longitudinal database of 72 consecutive cases of laparoscopic adrenalectomy carried out between 1997 and 2001 at the Centre for Minimally Invasive Surgery, University of Toronto. Results Patients in group 1 tended to be older (median 49 yr) and heavier (median 87 kg). They had a longer operating time (median 255 min), more postoperative complications (15%) and a longer median postoperative stay (4 d). Patients in group 2 had intermediate outcomes: a median operating time of 198 minutes, complication rate of 8.3% and a median postoperative hospital stay of 3 days. However, they had more intraoperative blood loss (median 150 mL). Group 3 patients had the best outcomes with the shortest median operating time (125 min), least blood loss (median 50 mL), fewer complications (6%) and shortest hospital stay (median 2 d). Conclusions Although the outcomes of laparoscopic adrenalectomy are uniformly good, on the basis of the underlying pathologic characteristics, patients can be divided into groups that have different expected outcomes. Patients requiring a unilateral adrenalectomy except for pheochromocytoma have the best recorded outcomes. Surgeons transferring to laparoscopic adrenalectomy would benefit from selecting patients in this group during their learning curve. PMID:14577705

Poulin, Eric C.; Schlachta, Christopher M.; Burpee, Stephen E.; Pace, Kenneth T.; Mamazza, Joseph

2003-01-01

468

Parameter evaluation for virtual Laparoscopic simulation  

Microsoft Academic Search

Virtual Reality based surgical simulators have become quite common for training of surgeons for different surgical skills. Simulators have been widely used particularly in minimal invasive surgery. In this paper we find parameters that would be required to create a real time working simulation for exercises given in the Fundamentals of Laparoscopic Surgery curriculum. We use peg transfer exercise as

Shamyl Bin Mansoor; Zaheer Mukhtar; Muddassir Malik; Zohaib Amjad; Hammad Qureshi

2011-01-01