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1

Laparoscopically guided bilateral pelvic lymphadenectomy  

NASA Astrophysics Data System (ADS)

Pelvic node dissection has gained widespread acceptance as the final staging procedure in patients with normal acid phospatase and bone scan free of metastatic disease prior to definitive therapy for cure. However, the procedure has had a high morbidity (20-34%) and a major economic impact on the patient due to lengthy hospitalization and recuperative time. The development of laparoscopic biopsy techniques suggests that the need for open surgical lymphadenectomy may be reduced by a laparoscopically performed lymphadenectomy. The goal of this report is to investigate the possibility of laparoscopic pelvic lymphadenectomy in an animal model. Our interest in laparoscopy is based on the ability of this technique to permit tissue removal without the need for major incisions. In laparoscopic cholecystectomy and laparoscopic appendectomy, the surgical procedure is essentially unaltered. The diseased organ is removed and there is no need for a large abdominal incision.

Gershman, Alex; Danoff, Dudley; Chandra, Mudjianto; Grundfest, Warren S.

1991-07-01

2

Laparoscopic resection of a retroperitoneal pelvic schwannoma  

PubMed Central

Schwannomas are rarely located in the pelvis. A 54-year-old woman was found incidentally to have a tumor in the abdomen. Abdominal computed tomography and magnetic resonance imaging revealed a well-defined, heterogeneous tumor, 5 cm in diameter, in the pelvic cavity. With a diagnosis of a mesenteric tumor, a laparoscopic procedure was performed. Intra-operatively, an elastic tumor was identified in the pelvis adjacent to the right internal iliac vein and ureter. The tumor was dissected free from adjacent structures using Liga-Sure and blunt maneuvers. A complete laparoscopic excision was performed. Histopathological examination revealed a benign schwannoma. The patient had an uneventful post-operative course, and was discharged on the fourth post-operative day. Laparoscopic treatment is useful and feasible for retroperitoneal pelvic schwannoma, with minimal invasiveness and an early post-operative recovery. Thus, this procedure may be the first-choice surgical procedure for retroperitoneal pelvic schwannomas. PMID:24876325

Okuyama, Takashi; Tagaya, Nobumi; Saito, Kazuyuki; Takahashi, Shuhei; Shibusawa, Hiroyuki; Oya, Masatoshi

2014-01-01

3

Cutaneous Metastasis Following Laparoscopic Pelvic Lymphadenectomy for Prostatic Carcinoma  

Microsoft Academic Search

A case of implantation metastasis in the abdominal wall following transabdominal laparoscopic pelvic lymphadenectomy is reported. A cutaneous nodule was palpated at 1 of the laparoscopic ports 6 months after laparoscopic lymphadenectomy in a 66-year-old patient with stage T3pN1M0, grade 2 adenocarcinoma of the prostate. Aspiration cytology confirmed metastatic adenocarcinoma.

Chr H. Bangma; W. J. Kirkels; S. Chadha; F. H. Schroder

1995-01-01

4

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

5

[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

6

Normal Vulvovaginal, Perineal, and Pelvic Anatomy with Reconstructive Considerations  

PubMed Central

A thorough insight into the female genital anatomy is crucial for understanding and performing pelvic reconstructive procedures. The intimate relationship between the genitalia and the muscles, ligaments, and fascia that provide support is complex, but critical to restore during surgery for correction of prolapse or aesthetic reasons. The external female genitalia include the mons pubis, labia majora and minora, clitoris, vestibule with glands, perineal body, and the muscles and fascia surrounding these structures. Through the perineal membrane and the perineal body, these superficial vulvar structures are structurally related to the deep pelvic muscle levator ani with its fascia. The levator ani forms the pelvic floor with the coccygeus muscle and provides vital support to all the pelvic organs and stability to the perineum. The internal female genital organs include the vagina, cervix, uterus, tubes, and ovaries with their visceral fascia. The visceral fascia also called the endopelvic fascia, surrounds the pelvic organs and connects them to the pelvic walls. It is continuous with the paraurethral and paravaginal fascia, which is attached to the perineal membrane. Thus, the internal and external genitalia are closely related to the muscles and fascia, and work as one functioning unit. PMID:22547969

Yavagal, Sujata; de Farias, Thais F.; Medina, Carlos A.; Takacs, Peter

2011-01-01

7

SIMPLE Technique of Laparoscopic Nephrectomy for Ectopic Nonfunctioning Pelvic Kidney Secondary to Pelviureteric Junction Obstruction: A Feasible and Safe Technique  

PubMed Central

Ectopic kidneys are rare developmental anomalies. Anomalous blood supply of the pelvic ectopic kidneys poses a problem for a minimally invasive surgery. Although laparoscopic nephrectomies have been described for symptomatic nonfunctioning pelvic ectopic kidney, this is the first case report that highlights the safety and feasibility of SIMPLE technique of laparoscopic nephrectomy in a pelvic kidney. PMID:25140271

Parmar, Kalpesh Mahesh; Shankaregowda Ajjoor, Sriharsha; Jayant, Kumar; Singh, Shrawan Kumar

2014-01-01

8

Laparoscopic pyeloplasty for ureteropelvic junction obstruction in crossed fused ectopic pelvic kidney.  

PubMed

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. PMID:25405020

Muruganandham, Kalyaperumal; Kumar, Avijit; Kumar, Santosh

2014-11-01

9

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. PMID:25405020

Muruganandham, Kalyaperumal; Kumar, Santosh

2014-01-01

10

Laparoscopic bilateral pelvic and paraaortic lymph node sampoing: An evolving technique  

Microsoft Academic Search

OBJECTIVE: Reports describing laparoscopic lymph node sampling in patients with gynecologic malignancies have yet to describe a method to sample left-sided aortic lymph nodes that has been successful in a large series of patients. We submit our experience with evolving techniques that allow for excellent visualization and resection of both left and right aortic and pelvic lymph nodes.STUDY DESIGN: Forty

Nick M. Spirtos; John B. Schlaerth; Tanya W. Spirtos; Alan C. Schlaerth; Paul D. Indman; Ronald E. Kimball

1995-01-01

11

Total laparoscopic radical hysterectomy with pelvic lymphadenectomy using the argon-beam coagulator: pilot data and comparison to laparotomy  

Microsoft Academic Search

ObjectivesThe aim of this study was to describe the feasibility and outcome of total laparoscopic radical hysterectomy with pelvic lymphadenectomy for stage I cervical cancer using the argon-beam coagulator.

Nadeem R Abu-Rustum; Mary L Gemignani; Kathleen Moore; Yukio Sonoda; Ennapadam Venkatraman; Carol Brown; Elizabeth Poynor; Dennis S Chi; Richard R Barakat

2003-01-01

12

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

PubMed Central

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

2014-01-01

13

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

PubMed Central

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 reduction in muscle volume and fascicle length. Proximal limb tendons were few and, where present, were relatively short. By contrast, distal limb tendons were numerous and long in comparison to mean muscle fascicle length, increasing potential for elastic energy storage. When compared with published data on thoracic limb muscles, proximal pelvic limb muscles were larger in volume and had shorter fascicles. Distal limb muscle architecture was similar in thoracic and pelvic limbs with the exception of flexor digitorum lateralis (lateral head of the deep digital flexor), the architecture of which was similar to that of the pelvic and thoracic limb superficial digital flexors, suggesting a functional similarity. PMID:15960766

Payne, RC; Hutchinson, JR; Robilliard, JJ; Smith, NC; Wilson, AM

2005-01-01

14

Efficacy of Laparoscopic Sacrocervicopexy for Apical Support of Pelvic Organ Prolapse  

PubMed Central

Background and Objectives: To evaluate the efficacy of laparoscopic sacrocervicopexy for apical support in sexually active patients with pelvic organ prolapse. Methods: One-hundred thirty-five women with symptomatic prolapse of the central compartment (Pelvic Organ Prolapse Quantitative [POP-Q] stage 2) underwent laparoscopic sacrocervicopexy. The operating physicians used synthetic mesh to attach the anterior endopelvic fascia to the anterior longitudinal ligament of the sacral promontory with subtotal hysterectomy. Anterior and posterior colporrhaphy was performed when necessary. The patients returned for follow-up examinations 1 month after surgery and then over subsequent years. On follow-up a physician evaluated each patient for the recurrence of genital prolapse and for recurrent or de novo development of urinary or bowel symptoms. We define “surgical failure” as any grade of recurrent prolapse of stage II or more of the POP-Q test. Patients also gave feedback about their satisfaction with the procedure. Results: The mean follow-up period was 33 months. The success rate was 98.4% for the central compartment, 94.2% for the anterior compartment, and 99.2% for the posterior compartment. Postoperatively, the percentage of asymptomatic patients (51.6%) increased significantly (P < .01), and we observed a statistically significant reduction (P < .05) of urinary urge incontinence, recurrent cystitis, pelvic pain, dyspareunia, and discomfort. The present study showed 70.5% of patients stated they were very satisfied with the operation and 18.8% stated high satisfaction. Conclusion: Laparoscopic sacrocervicopexy is an effective option for sexually active women with pelvic organ prolapse. PMID:23925017

Rosati, Maurizio; Bracale, Umberto; Pignata, Giusto; Azioni, Guglielmo

2013-01-01

15

Risk factors for laparoscopically confirmed pelvic inflammatory disease: findings from Mumbai (Bombay), India  

PubMed Central

OBJECTIVES: Sexually transmitted diseases (STDs) are an important cause of pelvic inflammatory disease (PID) but have often not been detected in microbiological studies of Indian women admitted to hospital gynaecology wards or private clinics. In this cross sectional study, women living in the inner city of Mumbai (Bombay) were investigated for socioeconomic, clinical, and microbiological risk factors for PID. METHODS: Microbiological tests and laparoscopic examination were carried out on 2736 women aged < or = 35 years who came to a health facility with suspected acute salpingitis or infertility or for laparoscopic sterilisation. 86 women with a clinical diagnosis of PID were not referred for laparoscopy although their characteristics are described. Associations between various risk factors and PID status were investigated and logistic regression performed on all factors that remained significant. RESULTS: Of women with a laparoscopically confirmed evaluation, 26 women had acute and 48 chronic pelvic infection. Independent risk factors for PID were later age at menarche (> or = 14 years), a history of stillbirth and no previous pregnancy, history of tuberculosis, STD, dilatation and curettage or previous laparoscopy, and presence of Gardnerella vaginalis. CONCLUSIONS: It is concluded that STD related risk factors applied to only a small proportion of PID cases and that other determinants of PID are important, including obstetric complications, invasive surgical procedures such as laparoscopy, and tuberculosis. ????? PMID:10195052

Gogate, A.; Brabin, L.; Nicholas, S.; Gogate, S.; Gaonkar, T.; Naidu, A.; Divekar, A.; Karande, A.; Hart, C. A.

1998-01-01

16

Ovarian remnant syndrome after laparoscopic hysterectomy and bilateral salpingo-oophorectomy for severe pelvic endometriosis.  

PubMed

Ovarian remnant syndrome is a rare complication of total abdominal hysterectomy and bilateral salpingo-oophorectomy (BSO). Ovarian enlargement and dense periovarian adhesions are the predisposing factors. Recurrent ovarian remnant syndrome was associated with recurrence of symptomatic endometriosis in a woman who underwent laparoscopic supracervical hysterectomy and BSO for severe endometriosis and extensive pelvic adhesions. After primary surgery she required five additional procedures for complete resection of all ovarian remnants. Definitive surgery for advanced endometriosis with extensive periovarian adhesions may be complicated by ovarian remnant syndrome and reactivation of the disease. Careful retroperitoneal resection of all ovarian tissue is of paramount importance in preventing the syndrome. This, however, may be a limitation of laparoscopic surgery. The choice between laparoscopy and laparotomy in such cases should be individualized and based on the degree of surgical difficulty and the surgeon's level of experience. PMID:9050667

Rana, N; Rotman, C; Hasson, H M; Redwine, D B; Dmowski, W P

1996-05-01

17

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

18

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

PubMed Central

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 tendon length. From these measurements other muscle properties such as muscle volume, physiological cross-sectional area (PCSA), tendon cross-sectional area, maximum isometric muscle force and tendon stress were derived, using standard relationships and published muscle data. Larger muscles tended to be located more proximally and had longer fascicle lengths and lower pennation angles. This led to an expected proximal to distal reduction in total muscle mass. An exception to this trend was the gastrocnemius muscle, which was found to have the largest volume and PCSA and also had the highest capacity for both force and power production. Generally high-power muscles were located more proximally in the limb, while some small distal muscles (tibialis cranialis and flexor perforatus digiti III), with short fibres, were found to have very high force generation capacities. The greatest proportion of pelvic muscle volume was for the hip extensors, while the highest capacity for force generation was observed in the extensors of the ankle, many of which were also in series with long tendons and thus were functionally suited to elastic energy storage. PMID:17118064

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

2006-01-01

19

Real-time Cadaveric Laparoscopy and Laparoscopic Video Demonstrations in Gross Anatomy: An Observation of Impact on Learning and Career Choice.  

PubMed

Medical curricula are continually evolving and increasing clinical relevance. Gross anatomy educators have tested innovations to improve the clinical potency of anatomic dissection and found that clinical correlations are an effective method to accomplish this goal. Recently, surgical educators defined a role for laparoscopy in teaching anatomy. We aimed to expand this role by using surgical educators to create clinical correlates between gross anatomy and clinical surgery. We held supplements to traditional anatomy open dissection for medical students, including viewing prerecorded operative footage and live laparoscopic dissection performed on cadavers. The main outcome measures were assessed through pre- and postsession surveys. Greater than 75 per cent of students found the demonstrations highly valuable, and students perceived a significant increase in their understanding of abdominopelvic anatomy (P < 0.01). Additionally, 62 per cent of students with previous interest in surgery and 10 per cent of students without previous interest in surgery reported increased interest in pursuing surgical careers. Our demonstrations advance the use of minimally invasive surgical technology to teach gross anatomy. Live laparoscopic demonstrations augment traditional anatomic instruction by reinforcing the clinical relevance of abdominopelvic anatomy. Additionally, laparoscopic demonstrations generate interest in surgery that would otherwise be absent in the preclinical years. PMID:25569073

Saberski, Ean R; Orenstein, Sean B; Matheson, Dale; Novitsky, Yuri W

2015-01-01

20

Laparoscopic surgery in endometriosis.  

PubMed

Endometriosis (the presence of endometrial glands and stroma outside of the uterine cavity) is a common gynecologic problem affecting 10% of women in the general population, 40% of women with infertility and 60% of women with chronic pelvic pain. Laparoscopy has revolutionized management of women with endometriosis. Diagnosis of endometriosis depends on visualization of endometriotic lesions and histologic confirmation. Endometriotic implants have a multitude of appearances: powder burns, red, blue-black, yellow, white, clear vesicular and peritoneal windows. Diagnostic laparoscopy is often combined with operative procedures to treat manifestations and symptoms of endometriosis. This often includes removal or laser vaporization of endometriotic implants, lysis of adhesions, restoration of normal anatomy and removal or fulguration of ovarian endometriomas (conservative surgery). Severe incapacitating endometriosis, recurrent endometriosis following conservative surgery and symptomatic endometriosis in women not desiring more children is often treated by laparoscopic unilateral or bilateral salpingo-oophorectomy or laparoscopically-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy (radical surgery). Endometriosis affecting the appendix, ureters, bladder wall and rectosigmoid colon could be treated with laparoscopic appendectomy, excision of endometriotic implants or laparoscopic colectomy and anastomosis, respectively. Hydrodis-section and use of CO2 super pulsed laser aid in removal of adherent endometriotic implants without damage to normal underlying structures. Robotic-assisted laparoscopic surgery promises to provide advantages in the management of women with severe endometriosis secondary to 3-dimensional visualization, decreasing surgeon's fatigue and hand tremors and improving surgical precision. PMID:18560348

Eltabbakh, G H; Bower, N A

2008-08-01

21

Importance of Adequate Gross Anatomy Education: The Impact of a Structured Pelvic Anatomy Course during Gynecology Fellowship  

ERIC Educational Resources Information Center

Medical education underwent standardization at the turn of the 20th century and remained fairly consistent until recently. Incorporation of a patient-centered or case-based curriculum is believed to reinforce basic science concepts. One negative aspect is a reduction in hours spent with cadaveric dissection in the gross anatomy laboratory. For…

Heisler, Christine Aminda

2011-01-01

22

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

23

Single-incision plus one-port laparoscopic abdominoperineal resection with bilateral pelvic lymph node dissection for advanced rectal cancer: a case report.  

PubMed

With regard to laparoscopic and robotic abdominoperineal resection (APR) for primary rectal malignancies, limited data have been published in the literature. Single-incision laparoscopic surgery (SLS) has been successfully introduced for treating colorectal cancer. Here we describe our experience of APR with SLS plus one port (SLS + 1) for treating advanced rectal cancer. A 65-year-old man underwent the procedure, which involved a 35-mm incision in the left side of the umbilicus for the insertion of a single multichannel port as well as the insertion of a 5-mm port into the right lower quadrant. The sigmoid colon and rectum were mobilized from the pelvic floor using a medial and lateral approach. After the rectum with the mesorectum was completely mobilized according to the total mesorectal excision, the sigmoid colon was intracorporeally transected. The specimen was removed through the perineal wound. Terminal colostomy was fashioned at the left lower trocar site. Lateral pelvic lymph node dissection was bilaterally performed. There were no perioperative complications. The total operating time was 592 minutes, and the estimated blood loss was 180 mL. To our knowledge, this is the first reported case of SLS + 1 APR with lateral pelvic lymph node dissection for treating rectal cancer. We conclude that SLS + 1 APR is a technically promising alternative method for treating selected patients with advanced rectal cancer. PMID:25594635

Tokuoka, Masayoshi; Ide, Yoshihito; Takeda, Mitsunobu; Hashimoto, Yasuji; Matsuyama, Jin; Yokoyama, Shigekazu; Morimoto, Takashi; Fukushima, Yukio; Nomura, Takashi; Kodama, Ken; Sasaki, Yo

2015-01-01

24

Laparoscopic Removal of Pelvic Hydatid Cysts in Young Female: A Case Report  

PubMed Central

Hydatid disease is a zoonotic infection caused by larval stages of dog tapeworms belonging to the genus Echinococcus (family taeniidae) and is also referred to as echinococcosis. Human cystic echinococcosis caused by E. granulosus is the most common presentation and probably accounts for more than 95% of the estimated 2-3 million annual worldwide cases. The liver (70–80%) and lungs (15–25%) are the most frequent locations for echinococcal cysts. The diagnosis is made through the combined assessment of clinical, radiological, and laboratory findings. The treatment is mainly surgical, and, with appropriate diagnosis and treatment, prognosis is good. With advances and increasing experience in laparoscopic surgery, many more attempts have been made to offer the advantage of such a procedure to these patients (Chowbey et al. (2003)). PMID:22096619

Gorad, Kedar; Rayate, Neeraj; Oswal, Kunal; Krishna, Ashish; Deshmukh, Avanish; Rajmanickam, Sarvana; Puntambekar, Shailesh

2011-01-01

25

Ontogenetic scaling patterns and functional anatomy of the pelvic limb musculature in emus (Dromaius novaehollandiae)  

PubMed Central

Emus (Dromaius novaehollandiae) are exclusively terrestrial, bipedal and cursorial ratites with some similar biomechanical characteristics to humans. Their growth rates are impressive, as their body mass increases eighty-fold from hatching to adulthood whilst maintaining the same mode of locomotion throughout life. These ontogenetic characteristics stimulate biomechanical questions about the strategies that allow emus to cope with their rapid growth and locomotion, which can be partly addressed via scaling (allometric) analysis of morphology. In this study we have collected pelvic limb anatomical data (muscle architecture, tendon length, tendon mass and bone lengths) and calculated muscle physiological cross sectional area (PCSA) and average tendon cross sectional area from emus across three ontogenetic stages (n = 17, body masses from 3.6 to 42 kg). The data were analysed by reduced major axis regression to determine how these biomechanically relevant aspects of morphology scaled with body mass. Muscle mass and PCSA showed a marked trend towards positive allometry (26 and 27 out of 34 muscles respectively) and fascicle length showed a more mixed scaling pattern. The long tendons of the main digital flexors scaled with positive allometry for all characteristics whilst other tendons demonstrated a less clear scaling pattern. Finally, the two longer bones of the limb (tibiotarsus and tarsometatarsus) also exhibited positive allometry for length, and two others (femur and first phalanx of digit III) had trends towards isometry. These results indicate that emus experience a relative increase in their muscle force-generating capacities, as well as potentially increasing the force-sustaining capacities of their tendons, as they grow. Furthermore, we have clarified anatomical descriptions and provided illustrations of the pelvic limb muscle–tendon units in emus. PMID:25551028

Main, Russell P.; Hutchinson, John R.

2014-01-01

26

Ontogenetic scaling patterns and functional anatomy of the pelvic limb musculature in emus (Dromaius novaehollandiae).  

PubMed

Emus (Dromaius novaehollandiae) are exclusively terrestrial, bipedal and cursorial ratites with some similar biomechanical characteristics to humans. Their growth rates are impressive, as their body mass increases eighty-fold from hatching to adulthood whilst maintaining the same mode of locomotion throughout life. These ontogenetic characteristics stimulate biomechanical questions about the strategies that allow emus to cope with their rapid growth and locomotion, which can be partly addressed via scaling (allometric) analysis of morphology. In this study we have collected pelvic limb anatomical data (muscle architecture, tendon length, tendon mass and bone lengths) and calculated muscle physiological cross sectional area (PCSA) and average tendon cross sectional area from emus across three ontogenetic stages (n = 17, body masses from 3.6 to 42 kg). The data were analysed by reduced major axis regression to determine how these biomechanically relevant aspects of morphology scaled with body mass. Muscle mass and PCSA showed a marked trend towards positive allometry (26 and 27 out of 34 muscles respectively) and fascicle length showed a more mixed scaling pattern. The long tendons of the main digital flexors scaled with positive allometry for all characteristics whilst other tendons demonstrated a less clear scaling pattern. Finally, the two longer bones of the limb (tibiotarsus and tarsometatarsus) also exhibited positive allometry for length, and two others (femur and first phalanx of digit III) had trends towards isometry. These results indicate that emus experience a relative increase in their muscle force-generating capacities, as well as potentially increasing the force-sustaining capacities of their tendons, as they grow. Furthermore, we have clarified anatomical descriptions and provided illustrations of the pelvic limb muscle-tendon units in emus. PMID:25551028

Lamas, Luis P; Main, Russell P; Hutchinson, John R

2014-01-01

27

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

28

NOTES ON THE ANATOMY, POSITIONING AND HOMOLOGY OF THE PELVIC BONES IN SMALL CETACEANS (CETACEA, DELPHINIDAE, PONTOPORIIDAE)  

Microsoft Academic Search

1 Abstract - This report analyzes the variations in positioning and orientation of the pelvic bones in small cetaceans, and to contribute to establishing a possible homology based on the attachment of the abdominal musculature. Seven carcasses of three cetacean species (Tursiops truncatus, Sotalia guianensis, Pontoporia blainvillei) were analyzed. There is some variation in positioning and orientation of the pelvic

Paulo C. Simões-Lopes; Carolina S. Gutstein

29

Laparoscopic Hysterectomy  

PubMed

Retrospective analysis of 200 laparoscopic hysterectomies performed from June 1991 to July 31, 1995, showed the main indications to be symptomatic uterine fibroids, advanced endometriosis, chronic pelvic inflammatory disease, and endometrial hyperplasia with atypia. Some women had more than one indication, and pathology reports contained more than one diagnosis. Three cases were converted to abdominal procedures. Operating room time was under 2 hours in general, and blood loss was around 120 ml. Most of the initial cases were performed with endostapling. This technique was changed in favor of bipolar and unipolar coagulation and suturing. Laparoscopic hysterectomy is a safe, superior technique that should be an integral part of gynecologic practice. PMID:9074095

Charles

1996-08-01

30

Pelvic congestion syndrome and pelvic varicosities.  

PubMed

Pelvic venous insufficiency (PVI), defined as retrograde flow in the gonadal and internal iliac veins, is the underlying cause of pelvic congestion syndrome (PCS), a common cause of disabling chronic pelvic pain in women of child-bearing age. PCS is a chronic pain syndrome characterized by positional pelvic pain that is worse in the upright position and is associated with pelvic and vulvar varicosities as well as symptoms of dyspareunia and postcoital pain. Through collaterals to the lower extremity venous system, PVI may also contribute to varicose vein formation and recurrence in the lower extremities. Endovascular embolization of the ovarian and internal iliac veins has become the treatment of choice for PVI and PCS. This article reviews the pelvic retroperitoneal venous anatomy, pathophysiology of PCS, treatment options and techniques, and clinical outcomes of embolotherapy for PCS. PMID:24840963

Koo, Sonya; Fan, Chieh-Min

2014-06-01

31

Abdominal Cavity and Laparoscopic Surgery  

NSDL National Science Digital Library

For students interested in studying biomechanical engineering, especially in the field of surgery, this lesson serves as an anatomy and physiology primer of the abdominopelvic cavity. Students are introduced to the abdominopelvic cavityâa region of the body that is the focus of laparoscopic surgeryâas well as the benefits and drawbacks of laparoscopic surgery. Understanding the abdominopelvic environment and laparoscopic surgery is critical for biomechanical engineers who design laparoscopic surgical tools.

Integrated Teaching And Learning Program

32

Functional anatomy and muscle moment arms of the pelvic limb of an elite sprinting athlete: the racing greyhound (Canis familiaris)  

PubMed Central

We provide quantitative anatomical data on the muscle–tendon architecture and geometry of the pelvic limb of an elite sprint athlete, the racing greyhound. Specifically, muscle masses, muscle lengths, fascicle lengths, pennation angles and muscle moment arms were measured. Maximum isometric force and power of muscles, the maximum muscle torque at joints and tendon stress and strain were estimated. We compare data with that published for a generalized breed of canid, and other cursorial mammals such as the horse and hare. The pelvic limb of the racing greyhound had a relatively large volume of hip extensor muscle, which is likely to be required for power production. Per unit body mass, some pelvic limb muscles were relatively larger than those in less specialized canines, and many hip extensor muscles had longer fascicle lengths. It was estimated that substantial extensor moments could be created about the tarsus and hip of the greyhound allowing high power output and potential for rapid acceleration. The racing greyhound hence possesses substantial specializations for enhanced sprint performance. PMID:18657259

Williams, S B; Wilson, A M; Rhodes, L; Andrews, J; Payne, R C

2008-01-01

33

Laparoscopic resection of presacral schwannomas.  

PubMed

Presacral tumors are particularly rare in the adult. Schwannomas are neurogenic neoplasms, rarely occurring in the retroperitoneum and the pelvis. Presented herein are the cases of 2 female patients with chronic pelvic pain who were discovered to have presacral schwannomas and were managed laparoscopically. Laparoscopy is a safe and efficient option in approaching benign pelvic tumors and might offer the advantage of better visualization of structures due to the magnification of laparoscopic view, especially in narrow anatomic spaces. PMID:16215494

Konstantinidis, Konstantinos; Theodoropoulos, George E; Sambalis, George; Georgiou, Michael; Vorias, Michael; Anastassakou, Kornelia; Mpontozoglou, Nikolaos

2005-09-01

34

Pelvic and acetabular fractures  

SciTech Connect

This treatise focuses primarily on the clinical aspects of diagnosis and treatments of pelvic and acetabular fractures. However, considerable attention is also paid to the radiographic diagnosis of trauma and postoperative effects. The book begins with a succinct review of pelvic and acetabular anatomy and pelvic biomechanics. It continues with a radiographic classification of pelvic injury, which will represent the major source of the book's interest for radiologists. The remainder of the book is concerned with clinical management of pelvic and acetabular trauma, including preoperative planning, surgical approaches, techniques of reduction, internal fixation, eternal fixation, post-operative care, and late problems. Even throughout this later portion of the book there are extensive illustrations, including plain radiographs, computed tomographic (CT) scans, reconstructed three-dimensional CT scans, and schematic diagrams of diverse pelvic and acetabular fractures and the elementary surgical techniques for their repair.

Mears, D.C.; Rubash, H.E.

1986-01-01

35

Laparoscopic oophorectomy.  

PubMed

Laparoscopic oophorectomy is one of the most controversial and challenging areas of endoscopic surgery. Judicious preoperative evaluation along with careful patient selection can reduce the risk of operating on an unsuspected ovarian malignancy. Appropriate patient consent and planning should be obtained before the procedure, in case an ovarian neoplasia should be encountered. Although endoscopic pelvic biopsy, treatment and staging has been reported recently, the standard of care still appears to be by a laparoscopy. The removal of benign cystic teratomas of all sizes can be handled laparoscopically with the assistance of a retrieval bag or pouch. Reports of endoscopic treatment of ovarian remnant syndrome, androgen insensitivity syndrome, and even prophylactic oophorectomy are appearing in the literature. They have major benefits to patients including reduced cost, decreased hospitalization and time away from work, and with similar or lower complication rates compared with other modes of treatment. Pelviscopy or operative laparoscopy is gaining in popularity and acceptance as our experience and training improves. PMID:7578970

Russell, J B

1995-08-01

36

Early Introduction to the Pelvic Examination: An Anatomical Approach.  

ERIC Educational Resources Information Center

The use of a special cadaver is discussed that could be used during the first-year gross anatomy course to supplement the usual dissection of pelvic viscera. Pelvic anatomy is emphasized from the perineal approach as used in a typical pelvic exam. (MLW)

And Others; Munger, Bryce L.

1981-01-01

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

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

39

Automatic segmentation of male pelvic anatomy on computed tomography images: a comparison with multiple observers in the context of a multicentre clinical trial  

PubMed Central

Background This study investigates the variation in segmentation of several pelvic anatomical structures on computed tomography (CT) between multiple observers and a commercial automatic segmentation method, in the context of quality assurance and evaluation during a multicentre clinical trial. Methods CT scans of two prostate cancer patients (‘benchmarking cases’), one high risk (HR) and one intermediate risk (IR), were sent to multiple radiotherapy centres for segmentation of prostate, rectum and bladder structures according to the TROG 03.04 “RADAR” trial protocol definitions. The same structures were automatically segmented using iPlan software for the same two patients, allowing structures defined by automatic segmentation to be quantitatively compared with those defined by multiple observers. A sample of twenty trial patient datasets were also used to automatically generate anatomical structures for quantitative comparison with structures defined by individual observers for the same datasets. Results There was considerable agreement amongst all observers and automatic segmentation of the benchmarking cases for bladder (mean spatial variations < 0.4 cm across the majority of image slices). Although there was some variation in interpretation of the superior-inferior (cranio-caudal) extent of rectum, human-observer contours were typically within a mean 0.6 cm of automatically-defined contours. Prostate structures were more consistent for the HR case than the IR case with all human observers segmenting a prostate with considerably more volume (mean +113.3%) than that automatically segmented. Similar results were seen across the twenty sample datasets, with disagreement between iPlan and observers dominant at the prostatic apex and superior part of the rectum, which is consistent with observations made during quality assurance reviews during the trial. Conclusions This study has demonstrated quantitative analysis for comparison of multi-observer segmentation studies. For automatic segmentation algorithms based on image-registration as in iPlan, it is apparent that agreement between observer and automatic segmentation will be a function of patient-specific image characteristics, particularly for anatomy with poor contrast definition. For this reason, it is suggested that automatic registration based on transformation of a single reference dataset adds a significant systematic bias to the resulting volumes and their use in the context of a multicentre trial should be carefully considered. PMID:23631832

2013-01-01

40

Pelvic Exam  

MedlinePLUS

... My Pictures Browse Search Quick Search Image Details Pelvic Exam View/Download: Small: 719x590 View Download Add to My Pictures Title: Pelvic Exam Description: Pelvic exam; drawing shows a side ...

41

Laparoscopic Radical Trachelectomy  

PubMed Central

Introduction: The standard treatment for patients with early-stage cervical cancer has been radical hysterectomy. However, for women interested in future fertility, radical trachelectomy is now considered a safe and feasible option. The use of minimally invasive surgical techniques to perform this procedure has recently been reported. Case Description: We report the first case of a laparoscopic radical trachelectomy performed in a developing country. The patient is a nulligravid, 30-y-old female with stage IB1 adenocarcinoma of the cervix who desired future fertility. She underwent a laparoscopic radical trachelectomy and bilateral pelvic lymph node dissection. The operative time was 340 min, and the estimated blood loss was 100mL. There were no intraoperative or postoperative complications. The final pathology showed no evidence of residual disease, and all pelvic lymph nodes were negative. At 20 mo of follow-up, the patient is having regular menses but has not yet attempted to become pregnant. There is no evidence of recurrence. Conclusion: Laparoscopic radical trachelectomy with pelvic lymphadenectomy in a young woman who desires future fertility may also be an alternative technique in the treatment of early cervical cancer in developing countries. PMID:23318085

Rendón, Gabriel J.; Ramirez, Pedro T.; Frumovitz, Michael; Schmeler, Kathleen M.

2012-01-01

42

Evaluation of the Gynecology Teaching Associate versus Pelvic Model Approach to Teaching Pelvic Examination.  

ERIC Educational Resources Information Center

Students were taught pelvic examination methods either by use of an inanimate model or use of the model and examination of volunteer gynecological teaching associates (GTAs). Students in the latter group were superior in communication and manual skills, and scored better on recognizing deviant pelvic anatomy. (MSE)

Shain, Rochelle N.; And Others

1982-01-01

43

[Laparoscopic surgical treatment of anorectal malformations].  

PubMed

Anorectal Malformations (ARM) include a wide spectrum of anomalies, ranging from anal and rectal agenesis (usually associated with a recto-urethral, rectovaginal or recto-vestibular fistula) to ano-cutaneous fistula. On the basis of studies on the anatomy of the muscular structures contained in the pelvic cavity and on the physiology of the mechanisms which regulate the continence, many different techniques have been performed to allow a surgical treatment for the ARMs and to obtain post-operative results as nearer as possible to normality, that is to an adequate colic motility and a defecation control. In 2000, a new surgical technique for high and intermediate ARMs has been introduced, the laparoscopically assisted ano-rectal pull-through (LAARP) according to Georgeson. At the Department of Pediatric Surgery, Bologna University, from 2000 to nowadays, we have treated with LAARP 7 cases of high ARMs, all male patients and with colostomy. The average age at operation was between 2 and 10 months. PMID:17533901

Lima, M; Antonellini, C; Ruggeri, G; Libri, M; Gargano, T; Mondardini, M C

2006-01-01

44

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

45

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

46

Pelvic Neurofibroma  

PubMed Central

A 58-year old male presented with a hard lump in lower abdomen extending into pelvis. Clinical examination and computed tomography scan revealed pelvic retroperitoneal mass. Patient underwent exploratory laparotomy - revealing a well encapsulated retroperitoneal mass extending up to coccyx, posterior to the urinary bladder. It had displaced the recto-sigmoid colon and urinary bladder to the right. Histopathological findings revealed a neurofibroma. Pelvic neurofibromas are known to arise from certain pelvic organ. However, present case ruled out any organ involvement both on imaging and intraoperatively. This shows that these tumors can arise de novo also. A brief case report and review of literature is presented.

Bakhshi, Girish D.; Tayade, Mukund B.; Yadav, Rajesh B.; Jadhav, Kavita V.; Shenoy, Sachin S.; Amin, Margi V.

2014-01-01

47

Interfractional Variations in the Setup of Pelvic Bony Anatomy and Soft Tissue, and Their Implications on the Delivery of Proton Therapy for Localized Prostate Cancer  

SciTech Connect

Purpose: To quantify daily variations in the anatomy of patients undergoing radiation therapy for prostate carcinoma, to estimate their effect on dose distribution, and to evaluate the effectiveness of current standard planning and setup approaches employed in proton therapy. Methods: We used series of computed tomography data, which included the pretreatment scan, and between 21 and 43 in-room scans acquired on different treatment days, from 10 patients treated with intensity-modulated radiation therapy at Morristown Memorial Hospital. Variations in femur rotation angles, thickness of subcutaneous adipose tissue, and physical depth to the distal surface of the prostate for lateral beam arrangement were recorded. Proton dose distributions were planned with the standard approach. Daily variations in the location of the prescription isodose were evaluated. Results: In all 10 datasets, substantial variation was observed in the lateral tissue thickness (standard deviation of 1.7-3.6 mm for individual patients, variations of >5 mm from the planning computed tomography observed in all series), and femur rotation angle (standard deviation between 1.3{sup o} and 4.8{sup o}, with the maximum excursion exceeding 10{sup o} in 6 of 10 datasets). Shifts in the position of treated volume (98% isodose) were correlated with the variations in the lateral tissue thickness. Conclusions: Analysis suggests that, combined with image-guided setup verification, the range compensator expansion technique prevents loss of dose to target from femur rotation and soft-tissue deformation, in the majority of cases. Anatomic changes coupled with the uncertainties of particle penetration in tissue restrict possibilities for margin reduction in proton therapy of prostate cancer.

Trofimov, Alexei, E-mail: atrofimov@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Nguyen, Paul L. [Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA (United States); Efstathiou, Jason A.; Wang, Yi; Lu, Hsiao-Ming; Engelsman, Martijn [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States); Merrick, Scott [Department of Radiation Oncology, Morristown Memorial Hospital, Morristown, NJ (United States); Cheng, Chee-Wai [Midwest Proton Radiotherapy Institute, Department of Radiation Oncology, Indiana University, Bloomington, IN (United States); Wong, James R. [Department of Radiation Oncology, Morristown Memorial Hospital, Morristown, NJ (United States); Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)

2011-07-01

48

MR imaging staging of pelvic lymph nodes.  

PubMed

Accurate pelvic nodal staging is important in the workup of many pelvic tumors for assessing prognosis and directing therapy. Advances in diagnostic imaging have played an integral role in the staging of these tumors. Cross-sectional imaging, including MR imaging,however, uses size criteria and morphology to infer malignancy within a node,which is neither sensitive nor specific. This article reviews the normal pelvic nodal anatomy and techniques of conventional MR imaging for optimal nodal evaluation as well as introducing the recent technique of ultra small supraparamagnetic iron oxide(USPIO)-enhanced MR lymphangiography, which uses nodal function rather than structural criteria in assessing for metastatic nodes. PMID:15271372

Kim, John Y; Harisinghani, Mukesh G

2004-08-01

49

Effect of Letrozole on endometriosis-related pelvic pain  

PubMed Central

Background: To determine the role of Letrozole, an aromatase inhibitor, in the treatment of endometriotic pain. Methods: In this prospective, randomized, controlled clinical trial in minimally invasive surgery research center, 51 women with pelvic endometriosis and endometriotic pain (dyspareunia, dysmenorrhea, pelvic pain) score of 5 or more (for at least one of these endometriotic pain), after laparoscopic diagnosis and conservative laparoscopic surgery were treated with either Letrozole plus OCP (n=25) or only OCP (n=26) for 4 months continuously. Results: Using VAS test, the score of dyspareunia, dysmenorrhea and pelvic pain 4 months after the laparoscopic surgery declined significantly in both groups but the difference between results of the two groups was not significant. Conclusion: Both treatment modalities showed comparable effectiveness in the treatment of pains related to endometriosis and in comparison with OCP, Letrozole did not affect the outcome. PMID:25664308

Almassinokiani, Fariba; Almasi, Alireza; Akbari, Peyman; Saberifard, Mahboubeh

2014-01-01

50

Adequacy of laparoscopic oophorectomy.  

PubMed

Ovarian remnant syndrome occurs infrequently after oophorectomy, yet when present it can contribute greatly to pelvic discomfort. The syndrome may be difficult to diagnose, identify surgically, and treat without intraoperative or postoperative complications developing. Recently, laparoscopic oophorectomy has been performed with increasing frequency. We assessed the outcome after laparoscopic removal of both ovaries or the sole remaining ovary in 27 premenopausal women. No intraoperative or postoperative complications were identified, and no patients have experienced symptoms consistent with ovarian remnant syndrome. All women had a marked rise in serum follicle-stimulating hormone (FSH) levels (81 to 72+/-5 mIU/ml), and luteinizing hormone (LH) levels (8+/-1 to 37+/-3 mIU/ml) after oophorectomy, and all but one had FSH levels 40 mIU/ml or above. Thirteen women had gonadotropin levels measured after 4 weeks of hormone replacement therapy; all had reductions in FSH levels, but 10 had elevations of their LH levels. These findings indicate that ovarian remnant syndrome occurs infrequently after laparoscopic oophorectomy. In addition, the data suggest a different, nonovarian regulation of gonadotropin secretion. PMID:9050455

Johns, D A; Diamond, M P

1993-11-01

51

Laparoscopic inguinal hernia repair.  

PubMed

Between March 1991 and May 1994, 444 laparoscopic inguinal hernia repairs were undertaken in 375 patients: 386 transperitoneal and 58 extraperitoneal. During a follow-up period of 20.5 months (range 1-38) there have been three recurrences at 6, 7 and 12 months, all direct and all after transperitoneal repair. A total of 52 patients were treated as a day case (< 6 h), 317 patients spent less than 24 h in hospital and four patients were discharged on the second postoperative day. Operating time for transperitoneal hernia repair was 27 min (range 10-68) and extraperitoneal repair, 29 min (range 11-48). Short-term complications occurred in 18 patients: six haematomas, four seromas, one urinary retention and seven suffered persistent groin pain. Six patients have had neuralgia, three have had mesh removed and three further patients had individual clips removed from within the inguinal canal. There have been two adhesive small bowel obstructions. The first occurred 2 months after laparoscopic surgery and required laparotomy; the second occurred 2 years after surgery and had laparoscopic division of an adhesive band to a pelvic staple. There was one infected lymphocoele treated percutaneously. PMID:7741670

Fielding, G A

1995-05-01

52

Hysterectomy - laparoscopic - discharge  

MedlinePLUS

Supracervical hysterectomy - discharge; Removal of the uterus - discharge; Laparoscopic hysterectomy - discharge; Total laparoscopic hysterectomy - discharge; TLH - discharge; Laparoscopic supracervical hysterectomy - discharge

53

Pharynx Anatomy  

MedlinePLUS

... Pictures Browse Search Quick Search Image Details Pharynx Anatomy View/Download: Small: 720x576 View Download Add to My Pictures Title: Pharynx Anatomy Description: Anatomy of the pharynx; drawing shows the ...

54

Larynx Anatomy  

MedlinePLUS

... Pictures Browse Search Quick Search Image Details Larynx Anatomy View/Download: Small: 648x576 View Download Add to My Pictures Title: Larynx Anatomy Description: Anatomy of the larynx; drawing shows the ...

55

Vulva Anatomy  

MedlinePLUS

... Pictures Browse Search Quick Search Image Details Vulva Anatomy View/Download: Small: 720x634 View Download Add to My Pictures Title: Vulva Anatomy Description: Anatomy of the vulva; drawing shows the ...

56

Laparoscopic enterocystoplasty  

Microsoft Academic Search

Objectives. To report the initial clinical experience with laparoscopic augmentation enterocystoplasty using the ileum, sigmoid, or right colon.Methods. Three patients with functionally reduced bladder capacities due to neurogenic causes underwent laparoscopic enterocystoplasty: ileocystoplasty (n = 1), sigmoidocystoplasty (n = 1), and cystoplasty with cecum and proximal ascending colon (n = 1). In the last patient, a continent, catheterizable, ileal conduit

Inderbir S Gill; Raymond R Rackley; Anoop M Meraney; Peter W Marcello; Gyung Tak Sung

2000-01-01

57

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 ...

58

Laparoscopic colectomy.  

PubMed Central

Fifty-one laparoscopic colectomies were attempted at two institutions. The clinical results and methods are presented. Seven cases (14%) were converted to facilitated procedures, and four cases (8%) were converted to "open." Cases of cancer, diverticulitis, endometriosis, regional enteritis, villous adenomas, and sessile polyps were operated. Right, transverse, left, low anterior, and abdominoperineal colectomies were performed. Colotomies and wedge resections were also performed. Laparoscopic suturing was required in five cases of incomplete anastomosis by circular stapler (18%). Suturing was required in all right, transverse colectomies and colotomies. Operative time averaged 2.3 hours. Hospitalization averaged 4.6 days. Four patients had complications (8%), and one 95-year-old died of pneumonia (2%). Laparoscopic colectomies can be performed safely, but require two-handed laparoscopic coordination, as well as suturing and knot-tying skills. Images FIG. 2. FIG. 3. PMID:1466626

Phillips, E H; Franklin, M; Carroll, B J; Fallas, M J; Ramos, R; Rosenthal, D

1992-01-01

59

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

60

Venous Anatomy of the Right Colon  

Microsoft Academic Search

PURPOSE: This study was designed to describe the precise venous anatomy of the right colon, which is especially important for laparoscopic right hemicolectomy. METHODS: Fifty-eight adult cadavers were dissected to define the three major venous tributaries of the right colon: the ileocolic vein, right colic vein, and middle colic vein. Two or three middle colic veins were often present, and

Shigeki Yamaguchi; Hiroya Kuroyanagi; Jeffrey W. Milsom; Richard Sim; Hiroshi Shimada

2002-01-01

61

Pelvic Inflammatory Disease (PID)  

MedlinePLUS

MENU Return to Web version Pelvic Inflammatory Disease Overview What is pelvic inflammatory disease (PID)? Pelvic inflammatory disease (PID) is an infection of the female reproductive organs (the uterus, ...

62

Eye Anatomy  

MedlinePLUS

Eye Anatomy en Español email Send this article to a friend by filling out the fields below: Your name: ... You at Risk For Glaucoma? Childhood Glaucoma Eye Anatomy Five Common Glaucoma Tests Glaucoma Facts and Stats ...

63

Paraganglioma Anatomy  

MedlinePLUS

... Pictures Browse Search Quick Search Image Details Paraganglioma Anatomy View/Download: Small: 648x576 View Download Add to My Pictures Title: Paraganglioma Anatomy Description: Paraganglioma of the head and neck; drawing ...

64

Nasal Anatomy  

MedlinePLUS

... Devyani Lal, MD Jayakar V. Nayak, MD, PhD anatomy The nose is the organ of smell, and ... sinuses drain into the nose, and their detailed anatomy is discussed in another Patient Education section. Smell ...

65

[Laparoscopic splenectomy].  

PubMed

From 1995 to 1998, 14 patients have been treated with laparoscopic splenectomy. Seven patients had immune thrombocytopenic purpura (ITP), six hereditary spherocytosis and one chronic myelomonocytic leukaemia with trombocytopenia. 12 of the patients had normal or nearly normal sized spleen. Median duration of surgery was 156 minutes and the median postoperative hospital stay four days. All operations were completed laparoscopically. Three patients had postoperative fever without any sign of infection, one developed urinary retention and one was readmitted with pneumonia. The patient with chronic myelomonocytic leukaemia died 15 days postoperatively from an intracerebral bleeding. Two patients suffer from relapse of trombocytopenia, one is treated with steroids. Laparoscopic splenectomy can be performed safely in patients with normal sized spleen with all the advantages of minimal access surgery. However, problems related to identification of accessory spleens and splenectomy in patients with splenomegali, should be further evaluated. PMID:10327847

Glomsaker, T; Faerden, A E; Reiertsen, O; Edwin, B; Rosseland, A R

1999-04-10

66

[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

67

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

68

Pelvic Inflammatory Disease  

MedlinePLUS

... inflammatory disease What is pelvic inflammatory disease (PID)? Female reproductive system Pelvic inflammatory disease (PID) is an infection of a ... treatment for you. You must take all your medicine, even if your symptoms go away. This ... and chronic pelvic pain. Any damage done to your pelvic organs ...

69

Laparoscopic cholecystectomy in situs inversus totalis.  

PubMed

Situs inversus totalis is a rare condition where the organs in the body is placed in the opposite side. When such patient presents with the diseases of the intra abdominal organs the diagnosis is challenging and the operative procedure to be performed will be difficult. This may require the anticipation of variations in anatomy, ergonomic changes required during surgery and mastery over the operative skills in reversed anatomy. Cholelithiasis in situs inversus totalis is one such situation. Herein we report a case of situs inversus totalis who underwent successful laparoscopic cholecystectomy for symptomatic gallbladder calculi. PMID:25177601

Mn, Raghuveer; S, Mahesh Shetty; Bb, Sunil Kumar

2014-07-01

70

Laparoscopic Cholecystectomy in Situs Inversus Totalis  

PubMed Central

Situs inversus totalis is a rare condition where the organs in the body is placed in the opposite side. When such patient presents with the diseases of the intra abdominal organs the diagnosis is challenging and the operative procedure to be performed will be difficult. This may require the anticipation of variations in anatomy, ergonomic changes required during surgery and mastery over the operative skills in reversed anatomy. Cholelithiasis in situs inversus totalis is one such situation. Herein we report a case of situs inversus totalis who underwent successful laparoscopic cholecystectomy for symptomatic gallbladder calculi. PMID:25177601

S, Mahesh Shetty; BB, Sunil Kumar

2014-01-01

71

The Pelvic Kidney of Male Ambystoma maculatum (Amphibia, Urodela, Ambystomatidae) with Special  

E-print Network

The Pelvic Kidney of Male Ambystoma maculatum (Amphibia, Urodela, Ambystomatidae) with Special- scopic anatomy of the pelvic kidney in male Ambystoma maculatum. The nephron of male Ambystoma macula of structure and chemistry to sex- ual segments of the kidneys in other vertebrates, lead us to believe

Sever, David M.

72

Follow-up report on a randomized controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal to moderate endometriosis  

Microsoft Academic Search

Objective: To assess the longer term efficacy of laparoscopic laser surgery in the treatment of painful pelvic endometriosis and to observe the natural history of the disease at second-look laparoscopy in a control group.Design: One-year follow-up of a prospective, randomized, double-blind controlled trial.Setting: A referral center for the laparoscopic laser treatment of endometriosis.Patient(s): Sixty-three patients with pelvic pain and minimal

Christopher J. G Sutton; Andrew S Pooley; Simon P Ewen; Patricia Haines

1997-01-01

73

Hematocele After Laparoscopic Appendectomy  

PubMed Central

Background: Laparoscopic appendectomy is one of the most common laparoscopic surgeries performed. We report an unusual complication of hematocele after laparoscopic appendectomy. Case Description: A 48-y-old male presented with swelling and discomfort in his right scrotum 11 d after he underwent laparoscopic appendectomy for acute appendicitis. Before the surgery, he had no scrotal swelling or inguinal hernia. PMID:23484582

Bhullar, Jasneet Singh; Subhas, Gokulakrishna; Mittal, Vijay K.

2012-01-01

74

Pelvic ring fractures: what the orthopedic surgeon wants to know.  

PubMed

Treating trauma patients with displaced pelvic fractures requires a multidisciplinary approach at a designated trauma center to reduce morbidity and mortality. Immediate recognition of pelvic ring disruption and determination of pelvic stability are critical components in the evaluation of such patients. Stability is achieved by the ability of the osseoligamentous structures of the pelvis to withstand physiologic stresses without abnormal deformation. The supporting pelvic ligaments, including the posterior and anterior sacroiliac, iliolumbar, sacrospinous, and sacrotuberous ligaments, play a crucial role in pelvic stabilization. Radiologists should be familiar with the ligamentous anatomy and biomechanics relevant to understanding pelvic ring disruptions, as well as the Young and Burgess classification system, a systematic approach for interpreting pelvic ring disruptions and assessing stability on the basis of fundamental force vectors that create predictable patterns. This system provides an algorithmic approach to interpreting images and categorizes injuries as anterioposterior (AP) compression, lateral compression, vertical shear, or combined. Opening and closing of the pelvis from rotational forces result in AP compression and lateral compression injuries, respectively, whereas vertical shear injuries result from cephalad displacement of the hemipelvis. AP and lateral compression fractures are divided into types 1, 2, and 3, with increasing degrees of severity. Knowledge of these injury patterns leads to prompt identification and diagnosis of other subtle injuries and associated complications at pelvic radiography and cross-sectional imaging, allowing the orthopedic surgeon to apply corrective forces for prompt pelvic stabilization. PMID:25208283

Khurana, Bharti; Sheehan, Scott E; Sodickson, Aaron D; Weaver, Michael J

2014-01-01

75

Pelvic schwannoma in the right parametrium  

PubMed Central

Neurilemomas are benign usually encapsulated nerve sheath tumors derived from the Schwann cells. These tumors commonly arise from the cranial nerves as acoustic neurinomas but they are extremely rare in the pelvis and the retroperitoneal area (less than 0.5% of reported cases), unless they are combined with von Recklinghausen disease (type 1 neurofibromatosis). We report the case of a 58-year-old female with pelvic schwannoma, 6.5 × 5.5 cm in size, in the right parametrium. This is the first case reported in the literature. Based on the rarity of this tumor and in order to ensure optimum treatment and survival for our patient, we performed laparotomy with total abdominal hysterectomy and en-block tumor excision. A frozen section was taken during the surgery before complete resection of the mass, which was ambiguous. Because of the possibility of malignancy, complete excision of the mass was performed, with pelvic blunt dissection. Histological examination showed a benign neoplasm, originating from the cells of peripheral nerve sheaths; diagnosis was a schwannoma. There were degenerative areas, including cystic degeneration, hemorrhagic infiltrations, ischemic foci with pycnotic cells, and collagen replacement. Pelvic schwannomas are rare neoplasms that can be misdiagnosed. Laparoscopy is a safe and efficient option for approaching benign pelvic tumors and might offer the advantage of better visualization of structures due to the magnification in laparoscopic view, especially in narrow anatomic spaces. PMID:23515244

Machairiotis, Nikolaos; Zarogoulidis, Paul; Stylianaki, Aikaterini; Karatrasoglou, Eleni; Sotiropoulou, Georgia; Floreskou, Alvin; Chatzi, Eleana; Karamani, Athanasia; Liapi, Georgia; Papakonstantinou, Eleni; Katsikogiannis, Nikolaos; Courcoutsakis, Nikolaos; Machairiotis, Christodoulos

2013-01-01

76

Pelvic Support Problems  

MedlinePLUS

The pelvic floor is a group of muscles and other tissues that form a sling or hammock across the pelvis. In women, it holds the uterus, bladder, bowel, and other pelvic organs in place so that they can work ...

77

Pelvic Floor Disorders Network  

MedlinePLUS

... and perform research studies related to women with pelvic floor disorders. In this way, studies can be ... learn more about how to help women with pelvic floor problems. Treatments are available, but there are ...

78

Pelvic laparoscopy - series (image)  

MedlinePLUS

The female reproductive organs are in the pelvis. The fallopian tubes connect the ovaries to the uterus ... Pelvic laparoscopy is used both for diagnosis and for treatment and may be recommended for: pelvic pain ...

79

Pelvic Inflammatory Disease  

MedlinePLUS

... JavaScript on. Read more information on enabling JavaScript. Pelvic Inflammatory Disease Top Banner Content Area Skip Content Marketing Share this: Main Content Area Understanding PID Cause Symptoms Diagnosis Treatment Prevention Complications Pelvic inflammatory ...

80

Pelvic Inflammatory Disease (PID)  

MedlinePLUS

... STD, and TB Prevention Division of STD Prevention Pelvic Inflammatory Disease (PID) - CDC Fact Sheet Untreated sexually transmitted diseases (STDs) can cause pelvic inflammatory disease (PID), a serious condition, in women. 1 in ...

81

Pelvic Support Problems  

MedlinePLUS

... problems? The pelvic organs include the vagina , cervix , uterus , bladder , urethra , small intestines, and rectum . The pelvic ... Prolapse: Sagging of the uterus into the vagina. Uterus: A muscular organ located in the female pelvis ...

82

Laparoscopic Resection of Retroperitoneal Neural Tumors  

PubMed Central

Purpose Retroperitoneal neural tumor (RNT) is rarely excised laparoscopically, and the laparoscopic management of RNT remains controversial. We herein report 4 cases of laparoscopic excision of RNT that resulted in diverse clinical outcomes. Patients and Methods Between August 2005 and January 2011, we performed laparoscopic excision of RNT in 4 patients. The mean tumor size was 4.5 cm. The mean operative time was 297 minutes and the mean amount of blood loss was 55 ml. The surgeries were uneventful, with no operative complications or evidence of intra-abdominal bleeding. However, 2 patients required reoperation for delayed hemorrhage and urinoma formation, respectively. Results The postoperative pathological diagnoses were schwannoma in 3 patients and ganglioneuroblastoma in 1 patient. All patients were well with no signs of peripheral neuropathy or radiculopathy, and CT and/or 18F-FDG PET/CT performed during follow-up indicated no evidence of disease. Conclusions Obtaining extensive preoperative knowledge of the source neural and vascular anatomy of the tumor is important for the surgical planning of laparoscopic resection of RNT. When a great deal of care is taken to divide the tumor and the source nerves and vital vessels, safe execution of RNT can be achieved for minimal postoperative mortality and morbidity. PMID:24917756

Nozaki, Tetsuo; Kato, Tomonori; Morii, Akihiro; Fuse, Hideki

2013-01-01

83

Chronic pelvic pain.  

PubMed

Chronic pelvic pain is pain lasting longer than 6 months and is estimated to occur in 15% of women. Causes of pelvic pain include disorders of gynecologic, urologic, gastroenterologic, and musculoskeletal systems. The multidisciplinary nature of chronic pelvic pain may complicate diagnosis and treatment. Treatments vary by cause but may include medicinal, neuroablative, and surgical treatments. PMID:24280400

Stein, Sharon L

2013-12-01

84

[Laparoscopic appendectomy].  

PubMed

The authors report their experience of 6 cases of appendicectomy using a laparoscopic route of which 5 were performed under local anesthesia and 1 under general anesthesia. The results indicate that this new technique is easy to perform and as rapid and safe as the traditional operation. The possibility of using local anesthesia, the lack of complications when operating on obese patients, the lower incidence of wound infections and rapid postoperative mobilisation all argue in favour of this alternative approach to conventional open surgery. PMID:7603611

Vadalà, G; Mangiameli, A; Altamore, S; Roveccio, S; Scalia, A; L'Anfusa, G

1995-03-01

85

Laparoscopic pancreaticoduodenectomy  

PubMed Central

Laparoscopic pancreaticoduodenectomy (LPD) is one of the most complex operations in general surgery. With the development and maturation of surgical technology, more and more of such surgeries have been reported each year. Five LPDs have been performed in our department in the past year. We have achieved very satisfying clinical results with very few complications. The average operation takes 6.5 hours, which is significantly shorter compared to prior operations. In addition, the average hospitalization time was significantly shortened. Here we present a case report on one of the LPDs. PMID:25568867

Zhou, Xinhua; Ying, Dongjian; Zheng, Siming

2014-01-01

86

Instant Anatomy  

NSDL National Science Digital Library

There might not be such a thing as "instant" anatomy, but this nice site does offer up some podcasts on the matter that can provide a pathway to anatomical enlightenment. The site was created by Robert Whitaker, a professor of clinically applied topographical anatomy in the United Kingdom. Visitors can wander through a range of useful instructional materials here, and the nine free podcasts are some of the best items available. The titles include "Surface Anatomy," "Classification of the Joints," "Venous Drainage of the Limbs," and "Principles of Movements at Joints in the Upper Limb." Also, users have access to several free podcast apps, including a series of flashcards and embryology diagrams.

Whitaker, Robert

87

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

88

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. PMID:25210690

Lee, Taek-Gu

2014-01-01

89

Clinical observation of laparoscopic radical hysterectomy for cervical cancer  

PubMed Central

To evaluate safety, feasibility and the improvement of surgical method of laparoscopic extensive hysterectomy and pelvic lymph node dissection in patients with early-stage cervical cancer. Clinical data were prospectively collected from patients with IA2-IIA cervical cancer who underwent laparoscopic extensive hysterectomy (n1=22) and laparotomy (n2=23) in Department of Obstetrics and Gynecology in the Subei People’s Hospital from June 2010 to August 2013. The successful rates in two groups of operation were 100%. Blood loss, postoperative hospital stay, complication rate, postoperative recovery of gastrointestinal tract and bladder function of the laparoscopy group of the laparoscopic group were all better than those of the laparotomy group, and there were significant differences (all P < 0.05). But in the laparoscopy group, the operative time was longer than the laparotomy group with statistical significance (P < 0.05). There was no statistically significant difference in the number of excised lymph nodes and the duration time of postoperative urinary catheterization between the two groups (P > 0.05). Laparoscopic extensive hysterectomy and pelvic lymph node dissection can fully meet the requirement of laparotomy. It has the properties of minor trauma and rapid recovery. The clinical efficacy is superior to laparotomy surgery. The results indicated laparoscopic is an ideal method for the treatment of early cervical cancer. PMID:24995098

Yin, Xiang-Hua; Wang, Zhong-Qin; Yang, Shi-Zhang; Jia, Hong-Yan; Shi, Min

2014-01-01

90

KTP-532 laser utilization in endoscopic pelvic lymphadenectomy  

NASA Astrophysics Data System (ADS)

Laparoscopic pelvic lymphadenectomy has become increasingly of interest to Urologists in staging patients not only with prostatic carcinoma but for those patients suffering with carcinoma of the bladder. It also allows access for therapeutic treatment such as treatment of varicoceles and laser phototherapy for transmural coagulation of bladder cancers. Lasers have proven extremely better in allowing surgical incisions through the laparoscope and coagulation of bleeders. Both the KTP and Neodymium Yag Laser have been used for this purpose. The KTP Laser has distinct advantages in that it allows 1) flexible fiber easily used through laparoscopes, 2) the ability to coagulate and cut retroperitoneal tissue, and 3) seal lymphatics when lymph nodes are removed. The KTP fiber can be used to incise the retroperitoneum to expose the lymph node tissue. Grasping the lymph nodes with forceps, the laser can excise and coagulate the proximal and lymphatic channels. The laser fiber will not experience carbonization as can occur with the Yag Laser fiber unless a contact tip sapphire end is utilized. The KTP's laser fiber ability to give coagulation and ablation of tissue through a liquid medium allow it to be an excellent choice for laparoscopic pelvic lymphadenectomy.

Malloy, Terrence R.

1991-07-01

91

Parasitic peritoneal leiomyomatosis diagnosed 6 years after laparoscopic myomectomy with electric tissue morcellation: Report of a case and review of the literature  

Microsoft Academic Search

A 33-year-old woman, gravid 2 para 2, underwent laparoscopic myomectomy with electric tissue morcellation for intraligamental myoma. Six years later, asymptomatic pelvic tumor was found during a routine checkup. Under laparoscopic observation, multiple soft tumors were detected in the peritoneal cavity and these tumors were successfully excised by a laparoscopic-assisted procedure. Pathological examination demonstrated that these tumors were progesterone receptor-positive

Akihiro Takeda; Masahiko Mori; Kotaro Sakai; Takashi Mitsui; Hiromi Nakamura

2007-01-01

92

Robotic-assisted laparoscopic mesh sacrocolpopexy  

PubMed Central

The current ‘gold standard’ surgical repair for apical prolapse is the abdominal mesh sacrocolpopexy. Use of a robotic-assisted laparoscopic surgical approach has been demonstrated to be feasible as a minimally invasive approach and is gaining popularity amongst pelvic floor reconstructive surgeons. Although outcome data for robotic-assisted sacrocolpopexy (RASC) is only just emerging, several small series have demonstrated anatomic and functional outcomes, as well as complication rates, comparable to those reported for open surgery. The primary advantages thus far for RASC over open surgery include decreased blood loss and shorter hospital stay. PMID:21789075

Gilleran, Jason P.; Johnson, Matthew; Hundley, Andrew

2010-01-01

93

Orthopedic trauma: pelvic fracture.  

PubMed

1. The incidence of pelvic fractures has greatly increased; automobile and motorcycle crashes, pedestrian accidents, and falls from great height are the most common causes. Pelvic fractures caused by high-energy trauma often result in significant morbidity and mortality with mortality rates variously reported at 10% to 50%, dependent upon fracture classification and associated injuries. Mortality occurs from associated trauma to viscera, abdominal organs, and abdominal vessels, and from early complications of hemorrhage. 2. The difficulty in management of patients with pelvic fractures is determining whether fractures are stable or unstable. Single breaks with no displacement in the pelvic ring, which includes injuries to the ischium, ilium, pubis, and sacrum, are stable fractures and account for one third of all pelvic fractures. 3. Increasingly widespread use of surgical stabilization internally via rigid fixation of pelvic fractures has helped reduce the morbidity and mortality related to these fractures. Other benefits that have resulted include shortened hospitalization, decreased complications, and earlier mobility. PMID:8342218

Edwards, K P

1993-01-01

94

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

95

The role of laparoscopy as a diagnostic tool in chronic pelvic pain.  

PubMed

More than 40% of laparoscopies are performed for the diagnosis of chronic pelvic pain (CPP). Although laparoscopic evaluation is sometimes considered a routine part of the evaluation, ideally the decision to perform a laparoscopy should be based on the patient's history, physical examination and findings of non-invasive tests. About 65% of women with CPP have at least one diagnosis detectable by laparoscopy and it is common to attribute causality to this diagnosis. Endometriosis is diagnosed in one-third of laparoscopies for CPP. Endometriosis requires histological confirmation to assure an accurate diagnosis. Adhesions are diagnosed in about one-quarter of laparoscopies. Ovarian cysts, hernias, pelvic congestion syndrome, ovarian remnant syndrome, ovarian retention syndrome, post-operative peritoneal cysts and endosalpingiosis are other diagnoses that can be made laparoscopically in some cases. Laparoscopic conscious pain mapping has the potential to improve the accuracy of laparoscopy as a diagnostic tool in CPP. PMID:10962637

Howard, F M

2000-06-01

96

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.

97

[Laparoscopic-assisted colectomy].  

PubMed

After gaining experience in laparoscopic cholecystectomy, laparoscopic appendectomy and other laparoscopic procedures, we decided to perform laparoscopic-assisted colectomy. During July 1992 to February 1993 we performed 14 such procedures. Ages ranged from 46-83 years (mean, 68). In all cases the indication for surgery was neoplasm of the colon. 8 of the tumors were located in the right colon and 6 in the sigmoid. Procedures performed were laparoscopic-assisted right hemicolectomy with a biofragmentable anastomotic ring or laparoscopic-assisted sigmoidectomy with end-to-end anastomosis. In 1 operation we combined laparoscopic cholecystectomy with laparoscopic right hemicolectomy. Operation time varied from 90-130 min (mean, 100 min). In our opinion the procedure is as radical as standard laparotomy with the number of lymph nodes per specimen ranging from 4-10 (mean, 7); the surgical margins were free of tumor in all cases. There was less pain in the postoperative period than with the standard procedure and the average time from operation to discharge was 7 days (range, 5-9). Complications included 1 fatality due to postoperative myocardial infarction, and 1 case of duodenal perforation which was sutured during the operation. We conclude that laparoscopic-assisted right hemicolectomy and laparoscopic sigmoidectomy are feasible for carcinoma, and that recovery is quicker and with less pain. However, we need a larger series and long-term follow-up to conclude whether the laparoscopic assisted technic is an adequate operation in cases of cancer. PMID:8144081

Walfisch, S; Twena, M; Avinoah, E; Charuzi, I

1994-01-16

98

Pelvic floor muscle training exercises  

MedlinePLUS

Kegel exercises ... Pelvic floor muscle training exercises are recommended for: Women with urinary stress incontinence People who have fecal incontinence Pelvic floor muscle training exercises can help ...

99

Application of epoxy resin to a solid-foam pelvic model: creating a dry-erase pelvis.  

PubMed

The value of preoperative planning and templating has been well-established in fracture surgery. We have found that using 3-dimensional (3-D) models in preoperative planning aids in the understanding of anatomy, fracture-reduction techniques, and fixation methods, particularly in pelvic and acetabular fractures. To facilitate the correction of errors and reuse for future cases, we coat pelvic models with dry-erase epoxy resin. Fracture lines and planned implants are drawn onto the models with dry-erase markers. The creation of 3-D planning tools is useful in understanding the anatomy of pelvic and acetabular fractures. PMID:25379750

Weaver, Michael J; Brubacher, Jacob W; Vrahas, Mark S

2014-11-01

100

A ‘critical view’ on a classical pitfall in laparoscopic cholecystectomy!  

PubMed Central

INTRODUCTION Laparoscopic cholecystectomy is the most common laparoscopic surgery performed by general surgeons. Although being a routine procedure, classical pitfalls shall be regarded, as misperception of intraoperative anatomy is one of the leading causes of bile duct injuries. The “critical view of safety” in laparoscopic cholecystectomy serves the unequivocal identification of the cystic duct before transection. The aim of this manuscript is to discuss classical pitfalls and bile duct injury avoiding strategies in laparoscopic cholecystectomy, by presenting an interesting case report. PRESENTATION OF CASE A 71-year-old patient, who previously suffered from a biliary pancreatitis underwent laparoscopic cholecystectomy after ERCP with stone extraction. The intraoperative situs showed a shrunken gallbladder. After placement of four trocars, the gall bladder was grasped in the usual way at the fundus and pulled in the right upper abdomen. Following the dissection of the triangle of Calot, a “critical view of safety” was established. As dissection continued, it however soon became clear that instead of the cystic duct, the common bile duct had been dissected. In order to create an overview, the gallbladder was thereafter mobilized fundus first and further preparation resumed carefully to expose the cystic duct and the common bile duct. Consecutively the operation could be completed in the usual way. DISCUSSION Despite permanent increase in learning curves and new approaches in laparoscopic techniques, bile duct injuries still remain twice as frequent as in the conventional open approach. In the case presented, transection of the common bile duct was prevented through critical examination of the present anatomy. The “critical view of safety” certainly offers not a full protection to avoid biliary lesions, but may lead to a significant risk minimization when consistently implemented. CONCLUSION A sufficient mobilization of the gallbladder from its bed is essential in performing a critical view in laparoscopic cholecystectomy. PMID:25437680

Dziodzio, Tomasz; Weiss, Sascha; Sucher, Robert; Pratschke, Johann; Biebl, Matthias

2014-01-01

101

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

102

Pelvic Congestion Syndrome  

PubMed Central

Patients with pelvic congestion syndrome present with otherwise unexplained chronic pelvic pain that has been present for greater than 6 months, and anatomic findings that include pelvic venous insufficiency and pelvic varicosities. It remains an underdiagnosed explanation for pelvic pain in young, premenopausal, usually multiparous females. Symptoms include noncyclical, positional lower back, pelvic and upper thigh pain, dyspareunia, and prolonged postcoital discomfort. Symptoms worsen throughout the day and are exacerbated by activity or prolonged standing. Examination may reveal ovarian tenderness and unusual varicosities—vulvoperineal, posterior thigh, and gluteal. Diagnosis is suspected by clinical history and imaging that demonstrates pelvic varicosities. Venography is usually necessary to confirm ovarian vein reflux, although transvaginal ultrasound may be useful in documenting this finding. Endovascular therapy has been validated by several large patient series with long-term follow-up using standardized pain assessment surveys. Embolization has been shown to be significantly more effective than surgical therapy in improving symptoms in patients who fail hormonal therapy. Although there has been variation in approaches between investigators, the goal is elimination of ovarian vein reflux with or without direct sclerosis of enlarged pelvic varicosities. Symptom reduction is seen in 70 to 90% of the treated females despite technical variation. PMID:24436564

Durham, Janette D.; Machan, Lindsay

2013-01-01

103

Laparoscopic Presacral Neurectomy Versus Neurotomy with the Argon Beam Coagulator  

PubMed

Presacral neurectomy is effective treatment for dysmenorrhea and midline pelvic pain. The purpose of this paper is to report the benefits of the argon beam coagulator (ABC) used laparoscopically to perform a presacral neurotomy compared with conventional techniques for presacral neurectomy. In 51 patients undergoing laparoscopic presacral neurectomy, 34 were performed using the ABC only without dissection or excision, and 17 underwent presacral neurectomy by conventional methods. Postoperative pain reduction was the same in both groups, 77% versus 73%, with average anesthesia time 64 minutes for the ABC neurotomy versus 92 minutes with conventional techniques. One major vascular complication requiring immediate laparotomy occurred in the ABC group. When properly applied laparoscopically, the ABC is an effective tool to rapidly coagulate and separate the presacral nerves with minimal smoke, excellent visualization and no retroperitoneal dissection. PMID:9073717

McTavish; Daniell; Lalonde

1994-08-01

104

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

105

The Anatomy of Learning Anatomy  

ERIC Educational Resources Information Center

The experience of clinical teachers as well as research results about senior medical students' understanding of basic science concepts has much been debated. To gain a better understanding about how this knowledge-transformation is managed by medical students, this work aims at investigating their ways of setting about learning anatomy.…

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

2010-01-01

106

Robotic Compared With Laparoscopic Sacrocolpopexy: A Randomized Controlled Trial  

PubMed Central

Objective: Laparoscopic and robotic sacrocolpopexy are widely used for pelvic organ prolapse (POP) treatment. Evidence comparing outcomes and costs is lacking. We compared costs and clinically relevant outcomes in women randomized to laparoscopic sacrocolpopexy compared with robotic sacrocolpopexy. Methods: Participants with symptomatic stage POP II or greater, including significant apical support loss, were randomized to either laparoscopic or robotic sacrocolpopexy. We compared surgical costs (including costs for robot, initial hospitalization) and re-hospitalization within 6 weeks. Secondary outcomes included postoperative pain, POP quantification, symptom severity and quality of life, and adverse events. Results: We randomized 78 women [mean age 59 years]: laparoscopic (n=38), robotic (n=40). The robotic sacrocolpopexy group had higher initial hospital costs ($19,616 vs. $11,573, p < 0.001) and over 6 weeks, hospital costs remained higher for robotic sacrocolpopexy ($20,898 vs. $12,170, p < 0.001). When we excluded costs of robot purchase and maintenance, we did not detect a statistical difference in initial day of surgery costs of robotic vs. laparoscopic ($12,586 vs. $11,573; p = 0.160) or hospital costs over 6 weeks ($13,867 vs. $12,170; p = 0.060). The robotic group had longer operating room times (202.8 min vs. 178.4 min, p = 0.030) and higher pain scores 1-week after surgery (3.5 ± 2.1 vs. 2.6 ± 2.2; p = 0.044). There were no group differences in symptom bother by Pelvic Floor Distress Inventory, POP stage, or rate of adverse events. Conclusion: Costs of robotic sacrocolpopexy are higher than laparoscopic, while short-term outcomes and complications are similar. Primary cost differences resulted from robot maintenance and purchase costs. PMID:24463657

Anger, Jennifer T.; Mueller, Elizabeth R.; Tarnay, Christopher; Smith, Bridget; Stroupe, Kevin; Rosenman, Amy; Brubaker, Linda; Bresee, Catherine; Kenton, Kimberly

2014-01-01

107

Laparoscopic-assisted transanal pull-through for Hirschsprung's disease: Comparison between partial and near total laparoscopic mobilization of rectum  

PubMed Central

Background: Transanal pull-through with laparoscopic assistance is gaining popularity. How much rectal dissection to do laparoscopically and how much transanally is not clear. Laparoscopic rectal mobilization is akin to open pelvic dissection of Swenson's operation — the most physiological procedure. Through this comparative study, we aim to evolve a technique that maximizes the benefits of Swenson's technique and minimizes the problems of a transanal procedure. Materials and Methods: Twenty patients (19 boys and one girl, newborn to 6 years) with Hirschsprung's disease (HD) were randomized for laparoscopic-assisted transanal pull-through (LATAPT) either by near complete (Group A) or partial (Group B) laparoscopic mobilization of rectum. Patients were followed up for at least 3 months. Demographic profile; operative details (time taken, blood loss, operative difficulty, and complications); postoperative course (duration of urinary catheter, oral feeding, and hospital stay); and follow-up stooling pattern, consistency, and continence were compared in the two groups. Results: The time taken for laparoscopic mobilization was marginally higher in group A, but the time taken for transanal dissection in this group was significantly less than in group B. All other comparisons showed no significant difference in the two groups. Stool frequency and continence improved with time in both groups. Conclusion: Extent of laparoscopic mobilization of rectum does not appear to be a factor deciding the outcomes. No recommendations could be made in view of the small number of cases. However, it shows that laparoscopic assistance can be used to maximize the benefits of Swenson type of operation and a transanal pull-through. PMID:24741208

Mathur, Mohit Kumar; Aggarwal, Satish Kumar; Ratan, Simmi K.; Sinha, Shandip Kumar

2014-01-01

108

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

109

Early pregnancy loss following laparoscopic management of ovarian abscess secondary to oocyte retrieval.  

PubMed

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

2014-10-01

110

Case report: loss of hernia mesh after simultaneous laparoscopic extraperitoneal lymphadenectomy, radical prostatectomy, and hernioplasty.  

PubMed

We present a case of prosthetic mesh hernia repair of a unilateral inguinal hernia following laparoscopic extraperitoneal pelvic lymph node dissection and radical prostatectomy. After an uneventful intraoperative and early postoperative period, the patient developed a lymphocele. This resulted in the detachment of the mesh from the abdominal wall, which necessitated its removal. PMID:19187012

Häcker, Axel; Janetschek, Gunter

2009-02-01

111

Recurrence of unclassifiable uterine cancer after modified laparoscopic hysterectomy with morcellation  

Microsoft Academic Search

In a premenopausal patient with a 1-year history of abnormal bleeding laparoscopic supracervical hysterectomy in combination with vaginal intrafascial cylindriform enucleation of the cervix was performed. Histologic evaluation of the morcellated uterus was unremarkable. Five months later the patient was diagnosed with a pelvic mass consistent with an undifferentiated adenocarcinoma. Retrospective evaluation of the cored and morcellated hysterectomy specimen showed

Achim Schneider

1997-01-01

112

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".

113

Laparoscopic supracervical hysterectomy with transcervical morcellation and sacrocervicopexy: initial experience with a novel surgical approach to uterovaginal prolapse.  

PubMed

The objective of this retrospective study was to evaluate the feasibility, safety, and efficacy of a new laparoscopic technique for the treatment of uterovaginal prolapse using a transcervical access port to minimize the laparoscopic incision. From February 2008 through August 2010, symptomatic pelvic organ prolapse in 43 patients was evaluated and surgically treated using this novel procedure. Preoperative assessment included pelvic examination, the pelvic organ prolapse quantification scoring system (POP-Q), and complex urodynamic testing with prolapse reduction to evaluate for symptomatic or occult stress urinary incontinence. The surgical procedure consisted of laparoscopic supracervical hysterectomy with transcervical morcellation and laparoscopic sacrocervicopexy with anterior and posterior mesh extension. Concomitant procedures were performed as indicated. All procedures were completed laparoscopically using only 5-mm abdominal port sites, with no intraoperative complications. Patients were followed up postoperatively for pelvic examination and POP-Q at 6 weeks, 6 months, and 12 months. The median (interquartile range) preoperative POP-Q values for point Aa was 0 (-1.0 to 1.0), and for point C was -1.0 (-3.0 to 2.0). Postoperatively, median points Aa and C were significantly improved at 6 weeks, 6 months, and 12 months (all p < .001). One patient was found to have a mesh/suture exposure from the sacrocervicopexy, which was managed conservatively without surgery. We conclude that laparoscopic supracervical hysterectomy with transcervical morcellation and laparoscopic sacrocervicopexy is a safe and feasible surgical approach to treatment of uterovaginal prolapse, with excellent anatomic results at 6 weeks, 6 months, and 12 months. Potential advantages of the procedure include minimizing laparoscopic port site size, decreasing the rate of mesh exposure compared with other published data, and reducing the rate of postoperative cyclic bleeding in premenopausal women by removing the cervical core. Longer follow-up is needed to determine the durability and potential long-term sequelae of the procedure. PMID:23084680

Rosenblatt, Peter L; Apostolis, Costas A; Hacker, Michele R; DiSciullo, Anthony

2012-01-01

114

Laparoscopic Supracervical Hysterectomy With Transcervical Morcellation and Sacrocervicopexy: Initial Experience With a Novel Surgical Approach to Uterovaginal Prolapse  

PubMed Central

The objective of this retrospective study was to evaluate the feasibility, safety, and efficacy of a new laparoscopic technique for the treatment of uterovaginal prolapse using a transcervical access port to minimize the laparoscopic incision. From February 2008 through August 2010, symptomatic pelvic organ prolapse in 43 patients was evaluated and surgically treated using this novel procedure. Preoperative assessment included pelvic examination, the pelvic organ prolapse quantification scoring system (POP-Q), and complex urodynamic testing with prolapse reduction to evaluate for symptomatic or occult stress urinary incontinence. The surgical procedure consisted of laparoscopic supracervical hysterectomy with transcervical morcellation and laparoscopic sacrocervicopexy with anterior and posterior mesh extension. Concomitant procedures were performed as indicated. All procedures were completed laparoscopically using only 5-mm abdominal port sites, with no intraoperative complications. Patients were followed up postoperatively for pelvic examination and POP-Q at 6 weeks, 6 months, and 12 months. The median (interquartile range) preoperative POP-Q values for point Aa was 0 (?1.0 to 1.0), and for point C was ?1.0 (?3.0 to 2.0). Postoperatively, median points Aa and C were significantly improved at 6 weeks, 6 months, and 12 months (all p < .001). One patient was found to have a mesh/suture exposure from the sacrocervicopexy, which was managed conservatively without surgery. We conclude that laparoscopic supracervical hysterectomy with transcervical morcellation and laparoscopic sacrocervicopexy is a safe and feasible surgical approach to treatment of uterovaginal prolapse, with excellent anatomic results at 6 weeks, 6 months, and 12 months. Potential advantages of the procedure include minimizing laparoscopic port site size, decreasing the rate of mesh exposure compared with other published data, and reducing the rate of postoperative cyclic bleeding in premenopausal women by removing the cervical core. Longer follow-up is needed to determine the durability and potential long-term sequelae of the procedure. PMID:23084680

Rosenblatt, Peter L.; Apostolis, Costas A.; Hacker, Michele R.; DiSciullo, Anthony

2013-01-01

115

Laparoscopic creation of stomas  

Microsoft Academic Search

Background: Some indications for laparoscopic bowel surgery are still controversial. However, the use of laparoscopic techniques for\\u000a the treatment of benign disorders is less often challenged. Moreover, the morbidity of nonresectional procedures is less than\\u000a that encountered with resectional cases. Therefore, stoma creation seems ideally suited to laparoscopy. The aim of our study\\u000a was to assess the outcome of laparoscopic

L. Oliveira; P. Reissman; J. Nogueras; S. D. Wexner

1997-01-01

116

Normal Pancreas Anatomy  

MedlinePLUS

... 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 the ...

117

Thymus Gland Anatomy  

MedlinePLUS

... Browse Search Quick Search Image Details Thymus Gland Anatomy Adult View/Download: Small: 720x576 View Download Add to My Pictures Title: Thymus Gland Anatomy Adult Description: Anatomy of the thymus gland; illustration ...

118

Normal Female Reproductive Anatomy  

MedlinePLUS

... Search Quick Search Image Details Reproductive System, Female, Anatomy View/Download: Small: 720x756 View Download Add to My Pictures Title: Reproductive System, Female, Anatomy Description: Anatomy of the female reproductive system; drawing ...

119

Pelvic Inflammatory Disease  

MedlinePLUS

... disease can lead to serious, long-term problems: • Infertility —One in ten women with PID becomes infertile. ... lead to pelvic inflammatory disease, infertility, and arthritis. Infertility: A condition in which a couple has been ...

120

Pelvic Floor Dysfunction  

MedlinePLUS

... Cancer Hemorrhoids Hemorrhoids: Expanded Version Irritable Bowel Syndrome Ostomy Pelvic Floor Dysfunction Pilonidal Disease Polyps of the ... on the surface of the skin around the opening to the rectum (anus) and on the abdominal ...

121

Chronic Pelvic Pain  

MedlinePLUS

... regular cycle. For example, it may occur during menstruation . It also can occur only at certain times, ... to view the pelvic organs or perform surgery. Menstruation: The monthly discharge of blood and tissue from ...

122

Pelvic Organ Prolapse  

MedlinePLUS

... UPDATE ON THE SAFETY AND EFFECTIVENESS OF Transvaginal PLACEMENT for Pelvic Organ Prolapse . Back to top Page ... View FDA photos on Flickr FDA Archive Combination Products Advisory Committees Regulatory Information Safety Emergency Preparedness International ...

123

Pelvic Inflammatory Disease: Complications  

MedlinePLUS

... JavaScript on. Read more information on enabling JavaScript. Pelvic Inflammatory Disease Skip Content Marketing Share this: Main Content Area ... and appropriate treatment can help prevent complications of PID. Without treatment, PID can cause permanent damage to ...

124

Pelvic Inflammatory Disease: Diagnosis  

MedlinePLUS

... JavaScript on. Read more information on enabling JavaScript. Pelvic Inflammatory Disease Skip Content Marketing Share this: Main Content Area Diagnosis PID can be difficult for your healthcare provider to ...

125

Pelvic Inflammatory Disease: Treatment  

MedlinePLUS

... JavaScript on. Read more information on enabling JavaScript. Pelvic Inflammatory Disease Skip Content Marketing Share this: Main Content Area ... 40 percent of women with gonorrhea may develop PID. Many different bacteria may cause an episode of ...

126

Laparoscopic intestinal stomas  

Microsoft Academic Search

PURPOSE: We report our early experiences with laparoscopic intestinal stomas, describing the indications, the surgical techniques, and the complications of this new procedure. METHODS: The medical records of the 17 patients who had successfully undergone laparoscopic intestinal diversion at The University of Texas M. D. Anderson Cancer Center were reviewed. RESULTS: The mean follow-up of this group has been 24.3

George M. Fuhrman; David M. Ota

1994-01-01

127

Single Incision Laparoscopic Myomectomy  

PubMed Central

Single port laparoscopic surgery (SPLS), also called SILS is the natural extension of multi-incisional laparoscopic surgery, in the quest for reduction of traumatic insult and residual scarring to the patient. Today with the evolution of newer instruments, bidirectional self-retaining sutures, and surgical experience we are able to perform many surgeries in gynecology. PMID:22442539

Ramesh, B; Vidyashankar, Madhuri; Bharathi, BV

2011-01-01

128

The role of synthetic and biologic materials in the treatment of pelvic organ prolapse.  

PubMed

Pelvic organ prolapse is a significant medical problem that poses a diagnostic and management dilemma. These diseases cause serious morbidity in those affected and treatment is sought for relief of pelvic pain, rectal bleeding, chronic constipation, obstructed defecation, and fecal incontinence. Numerous procedures have been proposed to treat these conditions; however, the search continues as colorectal surgeons attempt to find the procedure that would optimally treat these conditions. The use of prosthetics in the repair of pelvic organ prolapse has become prevalent as the benefits of their use are realized. While advances in biologic mesh and new surgical techniques promise improved functional outcomes with decreased complication rates without de novo symptoms, the debate concerning the best prosthetic material, synthetic or biologic, remains controversial. Furthermore, laparoscopic ventral mesh rectopexy has emerged as a procedure that could potentially fill this role and is rapidly becoming the procedure of choice for the surgical treatment of pelvic organ prolapse. PMID:25435827

Brown, Ramon A; Ellis, C Neal

2014-12-01

129

Female Urinary Disorders and Pelvic Organ Prolapse  

E-print Network

Female Urinary Disorders and Pelvic Organ Prolapse Female Urinary Disorders and Pelvic Organ Prolapse Richard S. Bercik, M.D. Director, Division of Urogynecology & Reconstruction Pelvic Surgery of Urogynecology & Reconstruction Pelvic Surgery Department of Obstetrics, Gynecology & Reproductive Sciences #12

Lee, Daeyeol

130

Development of pelvic abscess following water-skiing injury.  

PubMed

Several descriptions of hydrostatic injuries while water-skilng have been described, including lacerations of the perineum, vagina, and cervix. Salpingitis or pelvic abscess resulting from water-skiing injuries are rare but important complications. A case of a pelvic abscess following a fall while water-skiing is described. The abscess was drained laparoscopically, resulting in a good clinical outcome. The mechanism of injury and recommendations for prevention are also presented. Upper genital tract infection may result from water-skiing injuries due to hydrostatic pressure forcing bacteria and water through the vagina and cervix into the endometrium, fallopian tube, and peritoneal cavity. While an uncommon complication, physicians and other practitioners caring for women should be aware of this potential complication from water-skiing. PMID:18476207

Pearlman, M D; Zoschnick, L

1993-01-01

131

Anatomy of the Brain  

MedlinePLUS

... org Donate Now Menu Brain Tumor Information Brain Anatomy Brain Structure Neuron Anatomy Brain Tumor Symptoms Diagnosis Types of Tumors ... Email: ABTAcares@abta.org Brain Tumor Information Brain Anatomy Brain Structure Neuron Anatomy Brain Tumor Symptoms Diagnosis Types of Tumors ...

132

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

133

An atlas of radiological anatomy  

SciTech Connect

This book contains a wealth of radiologic images of normal human anatomy; plain radiographs, contrast-enhanced radiographs, and computed tomography (CT) scans. There are 18 pages of magnetic resonance (MR) images, most on the brain and spinal cord, so that there are only two pages on MR imaging of the heart and two pages on abdominal and pelvic MR imaging. Twelve pages of ultrasound (US) images are included. This book has the radiologic image paired with an explanatory drawing; the image is on the left with a paragraph or two of text, and the drawing is on the right with legends. This book includes images of the brain and spinal cord obtained with arteriography, venography, myelography, encephalography, CT, and MR imaging.

Weir, J.; Abrahams, P.

1986-01-01

134

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.

135

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.

136

Pelvic Inflammatory Disease (PID) Statistics  

MedlinePLUS

... Disease (PID) Sexually Transmitted Diseases (STDs) Share Compartir Pelvic Inflammatory Disease (PID) Statistics Most Recent Data STD ... National Family Growth Survey, 1995, 2002, 2006–2010 Pelvic Inflammatory Disease—Initial Visits to Physicians’ Offices by ...

137

Lymphatic metastases from pelvic tumors: anatomic classification, characterization, and staging.  

PubMed

The spread of pelvic tumors to lymph nodes is an important means of tumor dissemination. Nodal metastases have important management and prognostic impact. Pelvic tumors usually metastasize first to regional lymph nodes, which are specific groups of nodes for each tumor, and are classified according to the TNM system as N-stage disease. If a pelvic tumor spreads to a lymph node outside of the defined regional nodes, this is considered M-stage disease, which usually results in upstaging of the disease to overall stage IV cancer and may potentially affect the patient's treatment options. Knowledge of the regional nodal spread of each tumor is essential in formulating effective search strategies for cross-sectional imaging studies performed for staging. Also important is correct description of the nomenclature of nodal metastases to facilitate proper staging. In this review, the patterns of regional nodal spread and N-stage classification are presented for carcinomas of the anus, bladder, cervix, endometrium, ovary, penis, prostate, rectum, testis, vagina, and vulva. Pelvic lymph node anatomy and nomenclature are reviewed with schematic illustrations and clinical examples from patients with pelvic tumors. PMID:20032141

McMahon, Colm J; Rofsky, Neil M; Pedrosa, Ivan

2010-01-01

138

[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

139

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

140

The effects and effectiveness of laparoscopic excision of endometriosis: a prospective study with 2-5 year follow-up  

Microsoft Academic Search

BACKGROUND: This study investigates the outcomes for women up to 5 years after laparoscopic excision of endo- metriosis. METHODS: In this prospective observational cohort study, 254 women with chronic pelvic pain were referred to two units specializing in minimal access surgical management of endometriosis. Of these, 216 women underwent surgical assessment and 176 were confirmed to have endometriosis. Questionnaires and

J. A. Abbott; J. Hawe; R. D. Clayton; R. Garry

2003-01-01

141

Antimullerian Hormone Changes after Laparoscopic Ovarian Cystectomy for Endometrioma Compared with the Nonovarian Conditions  

PubMed Central

Laparoscopic ovarian cystectomy is recommended for surgical procedure of endometrioma. The negative impact on ovarian reserve following removal had been documented. Little evidence had been reported for nonovarian originated effects. Objective. To evaluate the impact of laparoscopic ovarian cystectomy for endometrioma on ovarian reserve, measured by serum antimullerian hormone (AMH), compared to nonovarian pelvic surgery. Materials and Methods. A prospective study was conducted. Women who underwent laparoscopic ovarian cystectomy (LOC) and laparoscopic nonovarian pelvic surgery (NOS) were recruited and followed up through 6 months. Clinical baseline data and AMH were evaluated. Results. 39 and 38 participants were enrolled in LOC and NOS groups, respectively. Baseline characteristics (age, weight, BMI, and height) and preoperative AMH level between 2 groups were not statistically different. After surgery, AMH of both groups decreased since the first week, at 1 month and at 3 months. However, as compared to the LOC group at 6 months after operation, the mean AMH of the NOS group had regained its value with a highly significant difference. Conclusion. This study demonstrated the negative impact of nonovarian or indirect effects of laparoscopic surgery to ovarian reserve. The possible mechanisms are necessary for more investigations. PMID:25580291

Manusook, Sakol; Somprasit, Charintip; Ekarattanawong, Sophapun; Sreshthaputra, Opas; Vutyavanich, Teraporn

2014-01-01

142

Antimullerian hormone changes after laparoscopic ovarian cystectomy for endometrioma compared with the nonovarian conditions.  

PubMed

Laparoscopic ovarian cystectomy is recommended for surgical procedure of endometrioma. The negative impact on ovarian reserve following removal had been documented. Little evidence had been reported for nonovarian originated effects. Objective. To evaluate the impact of laparoscopic ovarian cystectomy for endometrioma on ovarian reserve, measured by serum antimullerian hormone (AMH), compared to nonovarian pelvic surgery. Materials and Methods. A prospective study was conducted. Women who underwent laparoscopic ovarian cystectomy (LOC) and laparoscopic nonovarian pelvic surgery (NOS) were recruited and followed up through 6 months. Clinical baseline data and AMH were evaluated. Results. 39 and 38 participants were enrolled in LOC and NOS groups, respectively. Baseline characteristics (age, weight, BMI, and height) and preoperative AMH level between 2 groups were not statistically different. After surgery, AMH of both groups decreased since the first week, at 1 month and at 3 months. However, as compared to the LOC group at 6 months after operation, the mean AMH of the NOS group had regained its value with a highly significant difference. Conclusion. This study demonstrated the negative impact of nonovarian or indirect effects of laparoscopic surgery to ovarian reserve. The possible mechanisms are necessary for more investigations. PMID:25580291

Tanprasertkul, Chamnan; Manusook, Sakol; Somprasit, Charintip; Ekarattanawong, Sophapun; Sreshthaputra, Opas; Vutyavanich, Teraporn

2014-01-01

143

Towards laparoscopic tissue aspiration.  

PubMed

The soft tissue aspiration experiment has been further developed for application during laparoscopic surgery. The new setup has been tested and validated under lab-conditions and came then to in vivo operation. It is to our knowledge the first time ever a mechanical experiment has been performed under laparoscopic conditions on the human, which enables determining corresponding constitutive model equations. As most important results, the feasibility of laparoscopic tissue aspiration has been demonstrated and, based on an ad hoc parameter for the tissue stiffness, the liver and the stomach gave significantly different responses. Furthermore, the determined constitutive behavior for one healthy human liver was in line with results obtained from tissue aspiration during open surgery. Eventually, laparoscopic tissue aspiration might qualify as minimally invasive testing method for tactile feedback systems. The presented results are preliminary and more research is required. PMID:23876854

Hollenstein, Marc; Bugnard, Guillaume; Joos, Renzo; Kropf, Saskia; Villiger, Peter; Mazza, Edoardo

2013-12-01

144

Laparoscopic exploration of the common bile duct: experience in 16 selected patients.  

PubMed

The authors' initial experience with transcystic duct and direct laparoscopic approaches to the exploration of the common bile duct is reported. The technique requires standard laparoscopic equipment, specialized endoscopes, and instruments developed for urologic stone manipulations. After cholangiography confirmed the presence of common bile duct stones, common duct stone extraction was performed in 16 selected patients age 20-88 years. Stones ranged in size from 1 mm to 30 mm and they were unsuspected in 60% of the patients. Five patients had normal liver function tests and only 3 had clinical evidence of jaundice. Ductal exploration and stone extraction was successful in all 16 patients. One patient required a direct laparoscopic ductal exploration due to the presence of a common hepatic duct stone and the anatomy of the cystic duct. No major complications or deaths were observed in this series. Appropriately trained surgeons can safely and effectively perform laparoscopic common bile duct exploration and stone extraction in selected patients. PMID:1838940

Shapiro, S J; Gordon, L A; Daykhovsky, L; Grundfest, W

1991-12-01

145

Left hepatic vein injury during laparoscopic antireflux surgery for large para-oesophageal hiatus hernia  

PubMed Central

Although the advent of laparoscopic fundoplication has increased both patient and physician acceptance of antireflux surgery, it has become apparent that the laparoscopic approach is associated with an increased risk of some complications and as well as the occurrence of new complications specific to this approach. One such complication occurred in our patient who had intra-operative left hepatic vein injury during laparoscopic floppy Nissen fundoplication for large para-oesophageal rolling hernia. With timely conversion to open procedure, the bleeding was controlled and the antireflux and the procedure were completed uneventfully. However, this suggests that even with an experience in advanced laparoscopy surgery, complications can occur. Clear understanding of the normal and pathologic anatomy and its variations facilitates laparoscopic surgery and should help the surgeon avoid complications. The incidence of some of these complications decreases as surgeons gain experience; however, new complications can arise due to the increase in such procedures. PMID:20040801

Nagpal, Anish P; Soni, Harshad; Haribhakti, Sanjiv P

2009-01-01

146

Large Abdominal Wall Endometrioma Following Laparoscopic Hysterectomy  

PubMed Central

Background: Endometriosis is a common condition in women that affects up to 45% of patients in the reproductive age group by causing pelvic pain. It is characterized by the presence of endometrial tissue outside the uterine cavity and is rarely found subcutaneously or in abdominal incisions, causing it to be overlooked in patients with abdominal pain. Methods: A 45-year-old woman presented with lower abdominal pain 2 years following a laparoscopic supracervical hysterectomy. She was found to have incidental cholelithiasis and a large abdominal mass suggestive of a significant ventral hernia on CT scan. Results: Due to the peculiar presentation, surgical intervention took place that revealed a large 9cm×7.6cm×6.2cm abdominal wall endometrioma. Conclusion: Although extrapelvic endometriosis is rare, it should be entertained in the differential diagnosis for the female patient who presents with an abdominal mass and pain and has a previous surgical history. PMID:21902990

Borncamp, Erik; Mehaffey, Philip; Rotman, Carlos

2011-01-01

147

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?, ?brahim

2014-01-01

148

Laparoscopic Partial Nephrectomy  

Microsoft Academic Search

\\u000a Laparoscopic partial nephrectomy is an excellent management option for small, superficial renal masses. With experience, larger\\u000a and deeper tumors can be addressed as well. Intermediate-term follow-up (3- and 5-year) suggests cancer control similar to\\u000a that of open surgery. The benefit of laparoscopy over open surgery is a briefer and less intense convalescence. The disadvantage\\u000a of laparoscopic partial nephrectomy, at least

149

Pelvic Inflammatory Disease (PID)  

MedlinePLUS

KidsHealth > Teens > Sexual Health > STDs & Other Infections > Pelvic Inflammatory Disease (PID) Print A A A Text Size What's in this article? ... possible. So when you're making choices about sex, be smart and be safe. Reviewed by: Larissa Hirsch, MD Date reviewed: January ... For Teens For Kids For Parents MORE ON THIS TOPIC ...

150

[History of pelvic prolapse].  

PubMed

The history of pelvic prolapse back to the era of the pharaohs, about 1500 years before Christ. Hippocrates practiced succussion. Grenades, pieces of soaked linen were used as pessaries.Over the centuries, the eolution in understanding of this female pathology led to different treatment modalities, some of which we can currently seem strange. PMID:23673698

Ziouziou, I; Zizi, M; Bennani, H; Karmouni, T; El Khader, K; Koutani, A; Iben Attya Andaloussi, A

2013-04-01

151

Neural control of the female urethral and anal rhabdosphincters and pelvic floor muscles  

PubMed Central

The urethral rhabdosphincter and pelvic floor muscles are important in maintenance of urinary continence and in preventing descent of pelvic organs [i.e., pelvic organ prolapse (POP)]. Despite its clinical importance and complexity, a comprehensive review of neural control of the rhabdosphincter and pelvic floor muscles is lacking. The present review places historical and recent basic science findings on neural control into the context of functional anatomy of the pelvic muscles and their coordination with visceral function and correlates basic science findings with clinical findings when possible. This review briefly describes the striated muscles of the pelvis and then provides details on the peripheral innervation and, in particular, the contributions of the pudendal and levator ani nerves to the function of the various pelvic muscles. The locations and unique phenotypic characteristics of rhabdosphincter motor neurons located in Onuf's nucleus, and levator ani motor neurons located diffusely in the sacral ventral horn, are provided along with the locations and phenotypes of primary afferent neurons that convey sensory information from these muscles. Spinal and supraspinal pathways mediating excitatory and inhibitory inputs to the motor neurons are described; the relative contributions of the nerves to urethral function and their involvement in POP and incontinence are discussed. Finally, a detailed summary of the neurochemical anatomy of Onuf's nucleus and the pharmacological control of the rhabdosphincter are provided. PMID:20484700

de Groat, William C.

2010-01-01

152

Laparoscopic infrared imaging.  

PubMed

A system was developed to determine the potential role of infrared imaging as a tool for localizing anatomic structures and assessing tissue viability during laparoscopic surgical procedures. A camera system sensitive to emitted energy in the midinfrared range (3-5 micron) was incorporated into a two-channel visible laparoscope. Laparoscopic cholecystectomy, dissection of the ureter, and assessment of bowel perfusion were performed in a porcine model with the aid of this infrared imaging system. Inexperienced laparoscopists were asked to localize and differentiate structures before dissection using the visible system and then using the infrared system. Assessment of bowel perfusion was also conducted using each system. Infrared imaging proved to be useful in differentiating between blood vessels and other anatomic structures. Differentiation of the cystic duct and arteries and transperitoneal localization of the ureter were successful in all instances using the infrared system when use of the visible system had failed. This system also permitted assessment of bowel perfusion during laparoscopic occlusion of mesenteric vessels. These initial studies demonstrate that infrared imaging may improve the differentiation and localization of anatomic structures and allow assessment of physiologic parameters such as perfusion not previously attainable with visible laparoscopic techniques. It may thus potentially be a powerful adjunct to laparoscopic surgery. PMID:9373300

Roberts, W W; Dinkel, T A; Schulam, P G; Bonnell, L; Kavoussi, L R

1997-12-01

153

[Nephrectomy - pro laparoscopic].  

PubMed

Laparoscopic radical nephrectomy (LRN) is considered as a standard of care for T2 renal masses and T1 tumors not treatable by nephron-sparing surgery. It can be performed transperitoneally, retroperitoneoscopic or hand-assisted. However, the morbidity after laparoscopic nephrectomy has been shown to be lower than the open procedure and patients seem to benefit from early mobilization, less pain medication, shorter hospital stays and an earlier return to normal daily activities. Furthermore, the extent of perioperative activation of the systemic stress response appears to be less during laparoscopic procedures. This has been shown to have evidently beneficial clinical impact on patient's recovery; however, its importance for the oncologic prognosis is somewhat unclear. In addition, the progression-free and overall tumor-specific survival rates for laparoscopic nephrectomy are equivalent to those for open surgery. The experiences with robot-assistance for laparoscopic nephrectomy reported so far show no significant advantages over traditional laparoscopic nephrectomy. However, the problem of high costs of acquisition and operation of robots still remains unsolved. For the future, prospective studies are needed in order to compare the functional and oncological outcomes and cost-effectiveness of different methods of radical nephrectomy. PMID:22526177

Hoda, M R; Fornara, P

2012-05-01

154

SKELETAL ANATOMY The Anatomy of Sea Turtles 53  

E-print Network

SKELETAL ANATOMY The Anatomy of Sea Turtles 53 intermedium centrale humerus lateral process distal ANATOMY The Anatomy of Sea Turtles54 intermedium humerus medial process centrale radius ulna pisiform) and become sepa- rate elements when skeletons are prepared. #12;SKELETAL ANATOMY The Anatomy of Sea Turtles

155

Pregnancy After a Laparoscopic Sacrohysteropexy: a Case Report.  

PubMed

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. PMID:25364035

Albowitz, M; Schyrba, V; Bolla, D; Schöning, A; Hornung, R

2014-10-01

156

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. PMID:25364035

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

2014-01-01

157

Laparoscopic repair of recurrent lateral enterocele and rectocele.  

PubMed

It is difficult to determine what types of procedures should be attempted in patients who have recurrent prolapse. We present a case of recurrent lateral enterocele and rectocele after the patient had undergone multiple surgeries for pelvic organ prolapse (POP), including a vaginal hysterectomy, bladder-neck suspension, anterior colporrhaphy, site-specific rectocele repair, apical mesh implant, iliococcygeus vault suspension, and transobturator suburethral sling procedure. With recurrence, the patient underwent robot-assisted laparoscopic sacral colpopexy, tension-free vaginal tape transobturator sling insertion, rectocele repair, and perineorrhaphy with cystoscopy. She then presented with defecatory outlet obstruction and constipation and subsequently was treated with a stapled transanal rectal resection. The patient returned with continued defecatory dysfunction and a recurrent lateral enterocele and rectocele. The recurrence was treated laparoscopically using a lightweight polypropylene mesh. The postoperative period was uneventful. Two years later, the patient reported decreased defecatory symptoms and no further symptomatic prolapse. PMID:25224146

Solomon, Ellen R; Muffly, Tyler M; Hull, Tracy; Paraiso, Marie Fidela R

2015-01-01

158

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 ( ...

159

Anatomy of the heart  

Microsoft Academic Search

This article is intended as a concise description of the external and internal topographical anatomy of the heart, and those aspects of cardiac functional anatomy that are essential to clinical cardiac examination.

Vishy Mahadevan

160

Anatomy of the heart  

Microsoft Academic Search

This contribution is intended as a concise description of the external and internal topographical anatomy of the heart, and those aspects of cardiac functional anatomy that are essential to clinical cardiac examination.

Vishy Mahadevan

2008-01-01

161

The barbel-like specialization of the pelvic fins in Ophidion rochei (Ophidiidae).  

PubMed

Pelvic fins in Ophidion rochei are reduced to four rod-like structures situated at the ventral jaws. While the fish is swimming, they make continuous sweeping movements on the bottom. This paper examines and describes the anatomy of the pelvic fins to determine the possible functions of these appendages in relation to the mode of life of this fish species. The pelvic fins of O. rochei show strong similarities with barbels because they have identical sensory cell types, (taste buds, solitary chemosensory cells, and goblet cells), innervations and sensory function. Having nocturnal habits, specialization of pelvic fins in O. rochei corresponds to a supporting role to the life in dark environment. PMID:22911939

Codina, Elisabet; Loïc, Kéver; Compère, Philippe; Dragi?evi?, Branko; Dul?i?, Jakov; Parmentier, Eric

2012-12-01

162

Laparoscopic surgery in weightlessness  

NASA Technical Reports Server (NTRS)

BACKGROUND: Performing a surgical procedure in weightlessness has been shown not to be any more difficult than in a 1g environment if the requirements for the restraint of the patient, operator, and surgical hardware are observed. The feasibility of performing a laparoscopic surgical procedure in weightlessness, however, has been questionable. Concerns have included the impaired visualization from the lack of gravitational retraction of the bowel and from floating debris such as blood. METHODS: In this project, laparoscopic surgery was performed on a porcine animal model in the weightlessness of parabolic flight. RESULTS: Visualization was unaffected due to the tethering of the bowel by the elastic mesentery and the strong tendency for debris and blood to adhere to the abdominal wall due to surface tension forces. CONCLUSIONS: There are advantages to performing a laparoscopic instead of an open surgical procedure in a weightless environment. These will become important as the laparoscopic support hardware is miniaturized from its present form, as laparoscopic technology becomes more advanced, and as more surgically capable crew medical officers are present in future long-duration space-exploration missions.

Campbell, M. R.; Billica, R. D.; Jennings, R.; Johnston, S. 3rd

1996-01-01

163

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

164

The Virtual Pelvic Floor, a tele-immersive educational environment.  

PubMed

This paper describes the development of the Virtual Pelvic Floor, a new method of teaching the complex anatomy of the pelvic region utilizing virtual reality and advanced networking technology. Virtual reality technology allows improved visualization of three-dimensional structures over conventional media because it supports stereo vision, viewer-centered perspective, large angles of view, and interactivity. Two or more ImmersaDesk systems, drafting table format virtual reality displays, are networked together providing an environment where teacher and students share a high quality three-dimensional anatomical model, and are able to converse, see each other, and to point in three dimensions to indicate areas of interest. This project was realized by the teamwork of surgeons, medical artists and sculptors, computer scientists, and computer visualization experts. It demonstrates the future of virtual reality for surgical education and applications for the Next Generation Internet. PMID:10566378

Pearl, R K; Evenhouse, R; Rasmussen, M; Dech, F; Silverstein, J C; Prokasy, S; Panko, W B

1999-01-01

165

The Virtual Pelvic Floor, a tele-immersive educational environment.  

PubMed Central

This paper describes the development of the Virtual Pelvic Floor, a new method of teaching the complex anatomy of the pelvic region utilizing virtual reality and advanced networking technology. Virtual reality technology allows improved visualization of three-dimensional structures over conventional media because it supports stereo vision, viewer-centered perspective, large angles of view, and interactivity. Two or more ImmersaDesk systems, drafting table format virtual reality displays, are networked together providing an environment where teacher and students share a high quality three-dimensional anatomical model, and are able to converse, see each other, and to point in three dimensions to indicate areas of interest. This project was realized by the teamwork of surgeons, medical artists and sculptors, computer scientists, and computer visualization experts. It demonstrates the future of virtual reality for surgical education and applications for the Next Generation Internet. Images Figure 1 Figure 2 Figure 3 PMID:10566378

Pearl, R. K.; Evenhouse, R.; Rasmussen, M.; Dech, F.; Silverstein, J. C.; Prokasy, S.; Panko, W. B.

1999-01-01

166

Laparoscopic donor nephrectomy.  

PubMed

Living donor nephrectomy has been developed and promoted as a method to address the shortfall in kidneys available for transplantation. The classical method to procure a kidney from a living donor is the open donor nephrectomy performed through a flank lumbotomy incision. However, this classical method has negative short- and long-term side effects for the donor. These disincentives are a drawback for possible donors to donate a kidney. Therefore, transplant surgeons were stimulated to develop new and less invasive techniques. In this review several new open and laparoscopic techniques are described. Compared with open donor nephrectomy, laparoscopic donor nephrectomy has shown superior results in terms of postoperative pain, cosmetics, convalescence, and return to normal daily activities. No significant differences exist between the two approaches in terms of complication rates, cost-effectiveness and graft function. Nowadays, laparoscopic donor nephrectomy has become the preferred method for procuring kidney grafts of living donors in many centres. PMID:20508268

Minnee, R C; Idu, M M

2010-05-01

167

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

168

Ultrasonography evaluation of pelvic masses.  

PubMed

Ultrasonography is the primary imaging modality for evaluation of pelvic masses. Ultrasonography has the advantage of being inexpensive, widely available, and offering superior tissue characterization compared with computed tomography. The real-time imaging ability of ultrasonography and three-dimensional ultrasonography also has the advantage of being able to identify the organ of origin of the pelvic mass. Many pelvic masses have characteristic sonographic appearances that allow confident diagnosis and management. This article reviews the sonographic appearances and management of common pelvic masses encountered in nonpregnant women, and is organized based on anatomic location: uterus, cervix, ovaries, and fallopian tubes. PMID:25444103

Chu, Linda C; Coquia, Stephanie F; Hamper, Ulrike M

2014-11-01

169

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

170

A Case of Disseminated Peritoneal Leiomyomatosis Developing after Laparoscope-Assisted Myomectomy  

Microsoft Academic Search

A 36-year-old nulliparous woman developed multiple extra-uterine fibroids in the pelvic cavity years after laparoscopic myomectomy. Molecular genetic analysis by methylation-specific polymerase chain reaction (MSPCR) of the human X-linked androgen receptor gene and loss of heterozygosity (LOH) analysis at 5 microsatellite loci was performed on the tumors. All tumors showed an identical non-random X-chromosome inactivation pattern by MSPCR and an

Takahito Miyake; Takayuki Enomoto; Yutaka Ueda; Kenichiro Ikuma; Eiichi Morii; Shinya Matsuzaki; Yuji Murata

2009-01-01

171

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

172

Feasibility of diffusion tensor imaging (DTI) with fibre tractography of the normal female pelvic floor  

Microsoft Academic Search

Objectives  To prospectively determine the feasibility of diffusion tensor imaging (DTI) with fibre tractography as a tool for the three-dimensional\\u000a (3D) visualisation of normal pelvic floor anatomy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Five young female nulliparous subjects (mean age 28?±?3 years) underwent DTI at 3.0T. Two-dimensional diffusion-weighted axial\\u000a spin-echo echo-planar (SP-EPI) pulse sequence of the pelvic floor was performed, with additional T2-TSE multiplanar sequences\\u000a for anatomical

F. M. Zijta; M. Froeling; M. P. van der Paardt; M. M. E. Lakeman; S. Bipat; A. D. Montauban van Swijndregt; G. J. Strijkers; A. J. Nederveen; J. Stoker

2011-01-01

173

Laparoscopic Reoperation for Early Complications of Laparoscopic Gastric Bypass  

Microsoft Academic Search

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is a popular operation for morbid obesity.Early complications can\\u000a be treated successfully with a laparoscopic approach.We reviewed our experience with laparoscopic re-exploration in the early\\u000a postoperative period. Methods: The initial 85 patients who underwent LRYGBP by two surgeons at a training hospital were reviewed.\\u000a All patients who required re-exploration within the first 60 days

Pavlos K. Papasavas; Michael S. O'Mara; Robert F. Quinlin; Julie Maurer; Philip F. Caushaj; Daniel J. Gagné

2002-01-01

174

Explorable Three-Dimensional Digital Model of the Female Pelvis, Pelvic Contents, and Perineum for Anatomical Education  

ERIC Educational Resources Information Center

The anatomy of the pelvis is complex, multilayered, and its three-dimensional organization is conceptually difficult for students to grasp. The aim of this project was to create an explorable and projectable stereoscopic, three-dimensional (3D) model of the female pelvis and pelvic contents for anatomical education. The model was created using…

Sergovich, Aimee; Johnson, Marjorie; Wilson, Timothy D.

2010-01-01

175

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.

176

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

PubMed

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

2012-12-01

177

Pelvic Muscle Rehabilitation: A Standardized Protocol for Pelvic Floor Dysfunction  

PubMed Central

Introduction. Pelvic floor dysfunction syndromes present with voiding, sexual, and anorectal disturbances, which may be associated with one another, resulting in complex presentation. Thus, an integrated diagnosis and management approach may be required. Pelvic muscle rehabilitation (PMR) is a noninvasive modality involving cognitive reeducation, modification, and retraining of the pelvic floor and associated musculature. We describe our standardized PMR protocol for the management of pelvic floor dysfunction syndromes. Pelvic Muscle Rehabilitation Program. The diagnostic assessment includes electromyography and manometry analyzed in 4 phases: (1) initial baseline phase; (2) rapid contraction phase; (3) tonic contraction and endurance phase; and (4) late baseline phase. This evaluation is performed at the onset of every session. PMR management consists of 6 possible therapeutic modalities, employed depending on the diagnostic evaluation: (1) down-training; (2) accessory muscle isolation; (3) discrimination training; (4) muscle strengthening; (5) endurance training; and (6) electrical stimulation. Eight to ten sessions are performed at one-week intervals with integration of home exercises and lifestyle modifications. Conclusions. The PMR protocol offers a standardized approach to diagnose and manage pelvic floor dysfunction syndromes with potential advantages over traditional biofeedback, involving additional interventions and a continuous pelvic floor assessment with management modifications over the clinical course. PMID:25006337

Pedraza, Rodrigo; Nieto, Javier; Ibarra, Sergio; Haas, Eric M.

2014-01-01

178

Laparoscopic Splenectomy for Malignant Diseases  

Microsoft Academic Search

\\u000a Since Delaitre and Maignien [1] reported the first laparoscopic splenectomy in 1991, the utility of laparoscopic splenectomy\\u000a in the treatment of hematologic diseases such as hereditary spherocytosis, immune thrombocytopenic purpura, and autoimmune\\u000a hemolytic anemia has been well established. Thousands of cases in the surgical literature have documented laparoscopic splenectomy\\u000a as safe and effective in the management of these benign hematologic

R. Matthew Walsh; B. Todd Heniford

179

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

180

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.

181

Clinical Use of a Cordless Laparoscopic Ultrasonic Device  

PubMed Central

Objective: On April 25, 2012, the first laparoscopic cordless ultrasonic device (Sonicision, Covidien, Mansfield, Massachusetts) was used in a clinical setting. We describe our initial experience. Methods: The cordless device is assembled with a reusable battery and generator on a base hand-piece. It has a minimum and maximum power setting controlled by a single trigger for both coagulation and cutting. A laparoscopic radical nephrectomy was performed on a 56-year-old man with a 7-cm right renal mass. A laparoscopic pelvic lymphadenectomy was performed in a 51-year-old man with high-risk prostate cancer. Data on surgical team satisfaction, operative time, number of activations, and times the laparoscope was removed as a result of plume were collected. Results: The surgical technician successfully assembled the device at the beginning of the cases with verbal instructions from the surgeon. Operative time for nephrectomy was 77 minutes, with 143 total activations (minimum = 86, maximum = 57). The operative time for the pelvic lymphadenectomy was 27 minutes, with 38 total activations (minimum = 27, maximum = 11). One battery was used in each case. The laparoscope was removed twice during the nephrectomy and once during the lymphadenectomy. Surgical staff satisfaction survey results revealed easier and faster assembly, more space in the operating room, ergonomic handle, and comparable cutting/coagulation, weight, and plume generation with other devices (Table 1). Table 1. Survey of Operating Room Staffa Easy/Yes Difficult/No Ability to assemble the device 7 (100%) 0 Ability to hand the device over to other members of the surgical team 7 (100%) 0 Efficiency in saving space in the operating room 7 (100%) 0 Overall satisfaction Unsatisfactory Indifferent Satisfactory 0 0 7 (100%) a Operating staff consisted of 4 surgeons and 3 scrub technicians and/or registered nurses. Conclusion: The first clinical application of the pioneering cordless dissector was successfully performed, resulting in surgeons' perceptions of comparable results with other devices of easier and safer use and faster assembly. PMID:25392676

Sehrt, David; Molina, Wilson R.; Pompeo, Alexandre

2014-01-01

182

Virtual reality in laparoscopic surgery.  

PubMed

Although the many advantages of laparoscopic surgery have made it an established technique, training in laparoscopic surgery posed problems not encountered in conventional surgical training. Virtual reality simulators open up new perspectives for training in laparoscopic surgery. Under realistic conditions in real time, trainees can tailor their sessions with the VR simulator to suit their needs and goals, and can repeat exercises as often as they wish. VR simulators reduce the number of experimental animals needed for training purposes and are suited to the pursuit of research in laparoscopic surgery. PMID:15747974

Uranüs, Selman; Yanik, Mustafa; Bretthauer, Georg

2004-01-01

183

An Unusual Extremely Distant Noncommunicating Uterine Horn with Myoma and Adenomyosis Treated with Laparoscopic Hemihysterectomy  

PubMed Central

A 41-year-old woman referred to us with dysmenorrhea and severe pelvic pain although she was previously submitted to right laparotomic adnexectomy for ovarian endometrioma and to a subsequent operative laparoscopy for pelvic adhesions. After ultrasound examination, the patient underwent diagnostic hysteroscopy and operative laparoscopy which confirmed the clinic suspect of an unicornuate uterus. However, it was very unusual to see an extremely distanced right horn, without communication with uterus, without adnexa, and with a small myoma belonging to it. Moreover, omentum and bowel were attached to fundus of right horn and thick adhesions fixed it to rectum and right pelvic wall. Therefore, identification of anatomical structures was difficult, as it was extremely arduous to isolate the ureter, which was involved inside the adhesions surrounding the right uterine horn. Nevertheless, laparoscopic right hemihysterectomy was successfully performed and right horn was sent to our pathologist who recognized hypotrophic endometrium and adenomyosis. PMID:24109532

Morelli, Michele; Mocciaro, Rita; Lico, Daniela; Zullo, Fulvio

2013-01-01

184

Imaging in laparoscopic cholecystectomy--what a radiologist needs to know.  

PubMed

Laparoscopic cholecystectomy is the gold standard treatment option for cholelithiasis. In order to properly assess for the complications related to the procedure, an understanding of the normal biliary anatomy, its variants and the normal postoperative imaging is essential. Radiologist must be aware of benefits and limitations of multiple imaging modalities in characterizing the complications of this procedure as each of these modalities have a critical role in evaluating a symptomatic post-cholecystectomy patient. The purpose of this article is describe the multi-modality imaging of normal biliary anatomy and its variants, as well as to illustrate the imaging features of biliary, vascular, cystic duct, infectious as well as miscellaneous complications of laparoscopic cholecystectomy. We focus on the information that the radiologist needs to know about the radiographic manifestations of potential complications of this procedure. PMID:24657107

Desai, Naman S; Khandelwal, Ashish; Virmani, Vivek; Kwatra, Neha S; Ricci, Joseph A; Saboo, Sachin S

2014-06-01

185

Communication Barriers among Spanish-speaking Women with Pelvic Floor Disorders: Lost in Translation?  

PubMed Central

Objectives: The purpose of our study was to evaluate barriers in communication and disease understanding among office staff and interpreters when communicating with Spanish-speaking women with pelvic floor disorders. Methods: We conducted a qualitative study to evaluate barriers to communication with Spanish-speaking women with pelvic floor disorders among office staff and interpreters. Sixteen office staff and interpreters were interviewed; interview questions focused on experiences with Spanish-speaking patients with pelvic floor disorders in the clinic setting. Interview transcripts were analyzed qualitatively using grounded theory methodology. Results: Analysis of the interview transcripts revealed several barriers in communication as identified by office staff and interpreters. Three major classes were predominant: patient, interpreter, and system-related. Patient-related barriers included 1) a lack of understanding of anatomy and medical terminology and inhibited discussions due to embarrassment. Provider-related barriers included poor interpreter knowledge of pelvic floor vocabulary and the use of office staff without interpreting credentials. System-related barriers included poor access to information. From these preliminary themes, an emergent concept was revealed: it is highly likely that Spanish-speaking women with pelvic floor disorders have poor understanding of their condition due to multiple obstacles in communication. Conclusions: There are many levels of barriers to communications with Latinas treated for pelvic floor disorders, arising from the patient, interpreter, and the system itself. These barriers contribute to a low level of understanding of their diagnosis, treatment options, and administered therapies. PMID:23611934

Khan, Aqsa A.; Sevilla, Claudia; Wieslander, Cecilia K.; Moran, Meghan B.; Rashid, Rezoana; Mittal, Brita; Maliski, Sally L.; Rogers, Rebecca G.; Anger, Jennifer T.

2013-01-01

186

Anatomy Comic Strips  

ERIC Educational Resources Information Center

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…

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

2011-01-01

187

Laparoscopic robotic total gastrectomy  

PubMed Central

Minimally invasive gastrectomy has become the standard of care in many centers in Asia but remains unpopular in Europe. The aim of this article is to present the technique of laparoscopic robot-assisted total gastrectomy. The presented case involved a 66-year-old female patient with an advanced gastric cancer on the lesser curvature of the stomach. The laparoscopic part of the procedure involved opening the lesser sac, mobilization of the greater curvature and transection of the duodenum. A robot was used for the D2 lymphadenectomy and creation of the anastomosis. In summary, we have found that during a total gastrectomy for advanced gastric cancer a successful oncological resection can be achieved using a minimally invasive approach. We have also found that by combining conventional laparoscopy with robotic assistance we could overcome the technical difficulties with regards to lymph node dissection and anastomosis.

Witkiewicz, Wojciech

2014-01-01

188

Appraisal of laparoscopic cholecystectomy.  

PubMed Central

This paper reports the experience of three general surgeons performing 304 laparoscopic cholecystectomies in three private hospitals between October 1989 and November 1990. Laparoscopic cholecystectomy boasts two major advantages over the conventional procedure: the remarkable reduction in postoperative pain and economic benefit, largely due to the patient's early return to work. Revealing a complication rate of 2% and no deaths, this study has shown that this procedure can offer patients these advantages with a medical risk no greater than that accompanying conventional cholecystectomy. Patient safety must be paramount, and it is the responsibility of the surgical community to ensure that all surgeons receive the highest quality training and that the technique is applied appropriately. Images Fig. 3. Fig. 4. Fig. 5. Fig. 6. Fig. 7. PMID:1828140

Graves, H A; Ballinger, J F; Anderson, W J

1991-01-01

189

Laparoscopic Adjustable Gastric Banding  

Microsoft Academic Search

. We introduced open adjustable silicone gastric banding (ASGB) for treatment of morbid obesity in our institution\\u000a in 1991. It was done in a prospective study comparing ASGB with vertical banded gastroplasty (VBG) with regard to weight loss.\\u000a After 200 cases of open ASGB and 210 VBG procedures and the encouraging weight loss results, we started laparoscopic placement\\u000a of the

Mitiku Belachew; Marc Legrand; Vernon Vincent; Michel Lismonde; Nicole Le Docte; Veronique Deschamps

1998-01-01

190

Laparoscopic specimen retrieval bags.  

PubMed

Specimen retrieval bags have long been used in laparoscopic gynecologic surgery for contained removal of adnexal cysts and masses. More recently, the concerns regarding spread of malignant cells during mechanical morcellation of myoma have led to an additional use of specimen retrieval bags for contained "in-bag" morcellation. This review will discuss the indications for use retrieval bags in gynecologic endoscopy, and describe the different specimen bags available to date. PMID:25368466

Smorgick, Noam

2014-10-01

191

Primary ovarian adenocarcinoma developing in ovarian remnant tissue ten years after laparoscopic hysterectomy and bilateral salpingo-oophorectomy for endometriosis.  

PubMed

Ovarian remnant syndrome is a rare but known complication of bilateral salpingo-oophorectomy associated or not with hysterectomy. This complication is frequently related to a history of multiple surgery, pelvic inflammatory disease, or endometriosis. Here we report the eighth documented case of a primary ovarian adenocarcinoma developing in an ovarian remnant but, to our knowledge, the first case to occur after laparoscopic hysterectomy and bilateral salpingo-oophorectomy. We discuss the management of pelvic masses suspected of malignancy after bilateral salpingo-oophorectomy and the possible role of endometriosis in the development of malignancy in ovarian remnant syndrome. PMID:17980339

Donnez, Olivier; Squifflet, Jean; Marbaix, Etienne; Jadoul, Pascale; Donnez, Jacques

2007-01-01

192

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

193

Surface-based determination of the pelvic coordinate system  

NASA Astrophysics Data System (ADS)

In total hip replacement (THR) one technical factor influencing the risk of dislocation is cup orientation. Computer-assisted surgery systems allow for cup navigation in anatomy-based reference frames. The pelvic coordinate system most used for cup navigation in THR is based on the mid-sagittal plane (MSP) and the anterior pelvic plane (APP). From a geometrical point of view, the MSP can be considered as a mirror plane, whereas the APP can be considered as a tangent plane comprising the anterior superior iliac spines (ASIS) and the pubic tubercles. In most systems relying on the pelvic coordinate system, the most anterior points of the ASIS and the pubic tubercles are selected manually. As manual selection of landmark points is a tedious, time-consuming and error-prone task, a surface-based approach for combined MSP and APP computation is presented in this paper: Homologous points defining the MSP and the landmark points defining the APP are selected automatically from surface patches. It is investigated how MSP computation can benefit from APP computation and vice versa, and clinical perspectives of combined MSP and APP computation are discussed. Experimental results on computed tomography data show that the surface-based approach can improve accuracy.

Fieten, Lorenz; Eschweiler, Jörg; Heger, Stefan; Kabir, Koroush; Gravius, Sascha; de la Fuente, Matías; Radermacher, Klaus

2009-02-01

194

Management of chronic pelvic pain.  

PubMed

Chronic pelvic pain (CPP) is a common complaint of women presenting for gynecologic and primary care. Evaluation of CPP requires obtaining a careful history including not only obstetrical and gynecologic information but also screening for gastrointestinal, urologic, musculoskeletal, and neurological disorders. A detailed physical examination is also necessary. Management of CPP depends largely on the cause. Gynecologic causes include endometriosis, pelvic inflammatory disease, adhesive disease, pelvic congestion syndrome, ovarian retention syndrome, ovarian remnant syndrome, adenomyosis, and leiomyomas. Some non-gynecologic causes are interstitial cystitis/painful bladder syndrome, irritable bowel syndrome, pelvic floor tension myalgia, and abdominal myofascial pain syndrome. Treatments may be directed toward specific causes or may be targeted to general pain management. The most effective therapy may involve using both approaches. The diagnosis and treatment of each of the above disorders, and the management of CPP itself, is discussed. PMID:20938429

Benjamin-Pratt, A R; Howard, F M

2010-10-01

195

Chronic and Recurrent Pelvic Pain  

Microsoft Academic Search

\\u000a Chronic and recurrent pelvic pain (CPP) in ­children and adolescents has been recognized for decades. However, data on the\\u000a etiology, natural history, treatment, and long-term consequences of painful pelvic conditions in these patients are lacking.\\u000a The problem’s prevalence remains uncertain, and the majority of therapies are extrapolated from research on adults. The normal\\u000a developmental changes and coping strategies of children

Lynda Wells

196

Prevention of pelvic radiation disease  

PubMed Central

Pelvic cancers are among the most frequently diagnosed cancers worldwide. Treatment of patients requires a multidisciplinary approach that frequently includes radiotherapy. Gastrointestinal (GI) radiation-induced toxicity is a major complication and the transient or long-term problems, ranging from mild to very severe, arising in non-cancerous tissues resulting from radiation treatment to a tumor of pelvic origin, are actually called as pelvic radiation disease. The incidence of pelvic radiation disease changes according to the radiation technique, the length of follow up, the assessment method, the type and stage of cancer and several other variables. Notably, even with the most recent radiation techniques, i.e., intensity-modulated radiotherapy, the incidence of radiation-induced GI side effects is overall reduced but still not negligible. In addition, radiation-induced GI side effects can develop even after several decades; therefore, the improvement of patient life expectancy will unavoidably increase the risk of developing radiation-induced complications. Once developed, the management of pelvic radiation disease may be challenging. Therefore, the prevention of radiation-induced toxicity represents a reasonable way to avoid a dramatic drop of the quality of life of these patients. In the current manuscript we provide an updated and practical review on the best available evidences in the field of the prevention of pelvic radiation disease. PMID:25664197

Fuccio, Lorenzo; Frazzoni, Leonardo; Guido, Alessandra

2015-01-01

197

Prevention of pelvic radiation disease.  

PubMed

Pelvic cancers are among the most frequently diagnosed cancers worldwide. Treatment of patients requires a multidisciplinary approach that frequently includes radiotherapy. Gastrointestinal (GI) radiation-induced toxicity is a major complication and the transient or long-term problems, ranging from mild to very severe, arising in non-cancerous tissues resulting from radiation treatment to a tumor of pelvic origin, are actually called as pelvic radiation disease. The incidence of pelvic radiation disease changes according to the radiation technique, the length of follow up, the assessment method, the type and stage of cancer and several other variables. Notably, even with the most recent radiation techniques, i.e., intensity-modulated radiotherapy, the incidence of radiation-induced GI side effects is overall reduced but still not negligible. In addition, radiation-induced GI side effects can develop even after several decades; therefore, the improvement of patient life expectancy will unavoidably increase the risk of developing radiation-induced complications. Once developed, the management of pelvic radiation disease may be challenging. Therefore, the prevention of radiation-induced toxicity represents a reasonable way to avoid a dramatic drop of the quality of life of these patients. In the current manuscript we provide an updated and practical review on the best available evidences in the field of the prevention of pelvic radiation disease. PMID:25664197

Fuccio, Lorenzo; Frazzoni, Leonardo; Guido, Alessandra

2015-02-01

198

Anatomy Atlases: A Digital Library of Anatomy Information  

NSDL National Science Digital Library

This collection of atlases and textbooks is intended to educate patients, healthcare providers, and students in anatomy. Topics include human anatomy, human anatomy in cross-section, microscopic anatomy, anatomy of first aid, human anatomic variation, and osteology. The collection includes both historic and modern atlases, is searchable by keyword or term, and includes a frequently-asked-questions feature. Other materials include user reviews and links to related digital libraries.

199

The role of laparoscopy in chronic pelvic pain: promise and pitfalls.  

PubMed

Published studies relating to the usefulness of diagnostic and operative laparoscopy in women with chronic pelvic pain (CPP) were reviewed. This revealed that approximately 40 per cent of all laparoscopies were done for CPP. However, the definition of CPP was found to be nebulous and inconsistent, and that muddled definitive conclusions about patient diagnoses and treatments. The following definition of CPP was proposed: nonmenstrual pain of 3 or more months duration that localizes to the anatomic pelvis and is severe enough to cause functional disability and require medical or surgical treatment. A survey of published reports showed laparoscopically diagnosable abnormalities in 61 per cent of patients, compared with abnormalities in 28 per cent of women without CPP. Studies in adolescents were also reviewed and showed that adolescents with CPP also had significant laparoscopically diagnosed abnormalities, with 78 per cent showing some pathology, especially endometriosis (40 per cent). Endometriosis, pelvic adhesions, chronic pelvic inflammatory disease, and ovarian cysts were the diagnoses most commonly made via laparoscopy in CPP patients. The potential roles of each of these abnormalities in CPP were discussed, as well as the results of laparoscopic treatment of each disease. Laparoscopy was also found to have a limited role in women with CPP after hysterectomy or bilateral salpingo-oophorectomy, with usefulness in diagnosing and treating adhesions and residual ovary syndrome, although its role in ovarian remnant syndrome was uncertain. Overall, the data showed that less than 50 per cent of women with CPP were helped by diagnostic and operative laparoscopy, stressing the need for both physicians and patients to recognize that laparoscopy is neither the ultimate evaluation nor the panacea for CPP. PMID:8327235

Howard, F M

1993-06-01

200

Medical & Surgical Management of Pelvic Floor Disorders Affecting Defecation  

PubMed Central

Pelvic floor disorders that affect stool evacuation include structural (example: rectocele) and functional disorders (example: dyssynergic defecation). Meticulous history, digital rectal examination, and physiological tests such as anorectal manometry, colonic transit study, balloon expulsion and imaging studies such as anal ultrasound, defecography, and static and dynamic MRI can facilitate an objective diagnosis and optimal treatment. Management consists of education and counseling regarding bowel function, diet, laxatives, most importantly behavioral and biofeedback therapies, and lastly surgery. Randomized clinical trials have established that biofeedback therapy is effective in treating dyssynergic defecation. Because dyssynergic defecation may co-exist with conditions such as solitary rectal ulcer syndrome (SRUS), and rectocele, before considering surgery, biofeedback therapy should be tried and an accurate assessment of the entire pelvis and its function should be performed. Several surgical approaches have been advocated for the treatment of pelvic floor disorders including open, laparoscopic and trans-abdominal approach, stapled transanal rectal resection (STARR), and robotic colon and rectal resections. However, there is lack of well controlled randomized studies and efficacy of these surgical procedures remains to be established. PMID:22907620

Schey, Ron; Cromwell, John; Rao, Satish S.C.

2014-01-01

201

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

202

Ruptured Spleen Following Laparoscopic Cholecystectomy  

PubMed Central

Background: Laparoscopic cholecystectomy is generally a safe and well-accepted procedure. However, in a small percentage of patients, it is associated with complications, such as bleeding and injury to the bile duct and other viscera. Splenic injury as a result of laparoscopic surgery has been reported only in the context of direct trauma, for example due to retraction in hand-assisted urologic surgery. To date, there have been no reported cases of patients requiring splenectomy following laparoscopic cholecystectomy. We report an unusual case of ruptured spleen presenting less than 28 days following “uncomplicated” laparoscopic cholecystectomy. Results: A 52-year-old female presented to our Accident and Emergency department 3 weeks following “uncomplicated” laparoscopic cholecystectomy, complaining of severe left upper quadrant pain radiating to the left shoulder tip. Clinical examination revealed a patient in hypovolemic shock, with localized left upper quadrant peritonism. Abdominal computed tomography supported a diagnosis of splenic rupture, and the patient required an emergency splenectomy. Discussion: Splenic injury rarely complicates laparoscopic cholecystectomy. We postulate that either congenital or posttraumatic adhesions of the parietal peritoneum to the spleen may have caused the capsule to tear away from the spleen when the pneumoperitoneum was established, resulting in subcapsular hematoma and subsequent rupture in this patient. Videoscopic assessment of the spleen at the end of laparoscopic cholecystectomy might be a worthwhile exercise to aid early recognition and management in such cases. PMID:17651581

Leff, Daniel; Nortley, Mei; Melly, Lucy

2007-01-01

203

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.

204

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

205

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

206

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

207

Laparoscopic partial splenectomy  

Microsoft Academic Search

Background  The immunologic function of the spleen and its important role in immune defense has led to splenic-preserving surgery. This\\u000a study aimed to evaluate whether laparoscopic partial splenectomy is safe.\\u000a \\u000a \\u000a \\u000a Methods  Data on consecutive patients presenting with localized benign or malignant disease of the spleen were included in a prospective\\u000a database. The surgical technique consisted of six steps: patient positioning and trocar

S. Uranues; D. Grossman; L. Ludwig; R. Bergamaschi

2007-01-01

208

Evidence-Based Anatomy  

PubMed Central

Anatomy is a descriptive basic medical science that is no longer considered a research-led discipline. Many publications in clinical anatomy are prevalence studies treating clinically relevant anatomical variations and reporting their frequencies and/or associations with variables such as age, sex, side, laterality, and ancestry. This article discusses the need to make sense of the available literature. A new concept, evidence-based anatomy (EBA), is proposed to find, appraise, and synthetize the results reported in such publications. It consists in applying evidence-based principles to the field of epidemiological anatomy research through evidence synthesis using systematic reviews and meta-analyses to generate weighted pooled results. Pooled frequencies and associations based on large pooled sample size are likely to be more accurate and to reflect true population statistics and associations more closely. A checklist of a typical systematic review in anatomy is suggested and the implications of EBA for practice and future research, along with its scope, are discussed. The EBA approach would have positive implications for the future preservation of anatomy as a keystone basic science, for sound knowledge of anatomical variants, and for the safety of medical practice. Clin. Anat. 27:847–852, 2014. PMID:24797314

Yammine, Kaissar

2014-01-01

209

How Are Pelvic Floor Disorders Commonly Treated?  

MedlinePLUS

... Trials Resources and Publications En Español How are pelvic floor disorders commonly treated? Skip sharing on social ... Treatment Nonsurgical treatments commonly used for PFDs include: Pelvic floor muscle training (PFMT). Also called Kegel (pronounced ...

210

How Are Pelvic Floor Disorders Diagnosed?  

MedlinePLUS

... Trials Resources and Publications En Español How are pelvic floor disorders diagnosed? Skip sharing on social media ... bulge that suggests a prolapse during a routine pelvic exam. In other cases, a woman may see ...

211

Screening Pelvic Examination in Nonpregnant Adult Women  

MedlinePLUS

... the cervix to look for cervical cancer (Papanicolaou [Pap] smear) during the pelvic examination. However, the value of ... have no symptoms and do not need a Pap smear is unclear. The potential bene?ts of pelvic examination ...

212

Management of pelvic organ prolapse.  

PubMed

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. PMID:25405010

Choi, Kyung Hwa; Hong, Jae Yup

2014-11-01

213

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. PMID:25405010

Choi, Kyung Hwa

2014-01-01

214

Anatomy of autonomic nerve component in the male pelvis: the new concept from a perspective for robotic nerve sparing radical prostatectomy  

Microsoft Academic Search

The DaVinci Robot (Intuitive Surgical, Sunnyvale California) with its magnified 3-D vision and multi-jointed wristed instruments enabled us to perform radical prostatectomy with consideration for the pelvic anatomy. In the present paper, we review the pelvic autonomic neuroanatomy with respect to robotic prostatectomy and demonstrate the procedures and critical points of nerve-sparing robotic radical prostatectomy based on novel anatomic concepts.

Atsushi Takenaka; Robert A. Leung; Masato Fujisawa; Ashutosh K. Tewari

2006-01-01

215

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

216

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

217

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)

2008-05-01

218

Laparoscopic Surgery for Ulcerative Colitis  

PubMed Central

Laparoscopic techniques have become increasingly used in the treatment of ulcerative colitis: in experienced hands, they are safe and feasible. Recovery advantages have not been consistently demonstrated and functional results have been comparable to open surgery. Other possible benefits and costs issues have also been inconsistent. Further investigation on the role of laparoscopic surgery for ulcerative colitis with larger populations and longer follow-up with a focus on recovery parameters, quality of life, and costs are needed. PMID:22131895

Stocchi, Luca

2010-01-01

219

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

220

Comparison of robotic surgery and laparoscopy to perform total hysterectomy with pelvic adhesions or large uterus  

PubMed Central

BACKGROUND: Currently, benefits of robotic surgery in patients with benign gynecological conditions remain unclear. In this study, we compared the surgical outcome of robotic and laparoscopic total hysterectomies and evaluated the feasibility of robotic surgery in cases with pelvic adhesions or large uterus. MATERIALS AND METHODS: A total of 216 patients receiving total hysterectomy via robotic or laparoscopic approach were included in this study. Of all 216 patients, 88 underwent robotic total hysterectomy and 128 underwent laparoscopic total hysterectomy. All cases were grouped by surgical type, adhesion score, and uterine weight to evaluate the interaction or individual effect to the surgical outcomes. The perioperative parameters, including operation time, blood loss, postoperative pain score, time to full diet resumption, length of hospital stay, conversion rate, and surgery-related complications were compared between the groups. RESULTS: Operation time and blood loss were affected by both surgical type and adhesion score. For cases with severe adhesions (adhesion score greater than 4), robotic surgery was associated with a shortened operation time (113.9 ± 38.4 min versus 164.3 ± 81.4 min, P = 0.007) and reduced blood loss (187.5 ± 148.7 mL versus 385.7 ± 482.6, P=0.044) compared with laparoscopy. Moreover, robotic group showed a lower postoperative pain score than laparoscopic group, as the effect was found to be independent of adhesion score or uterine weight. The grade-II complication rate was also found to be lower in the robotic group. CONCLUSIONS: Comparing to laparoscopic approach, robotic surgery is a feasible and potential alternative for performing total hysterectomy with severe adhesions. PMID:25598606

Chiu, Li-Hsuan; Chen, Ching-Hui; Tu, Pei-Chia; Chang, Ching-Wen; Yen, Yuan-Kuei; Liu, Wei-Min

2015-01-01

221

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

222

Techniques in laparoscopic donor nephrectomy.  

PubMed

What's known on the subject? and What does the study add? Innovations in laparoscopic surgery have provided transplant surgeons with a range of techniques as well as a vast array of minimally invasive instruments. Whilst randomized control trials have compared open and laparoscopic donor nephrectomy, there is a paucity of high quality data comparing different laparoscopic approaches. This article summarizes the main techniques of laparoscopic donor nephrectomy currently in use and reviews the evidence available for each. In addition, controversial aspects of donor nephrectomy are examined, including the technological advances applicable to this operation. Increasing numbers of living donor kidney transplants are being performed worldwide, and the majority of donor operations are now laparoscopic. Transperitoneal 'pure' and hand-assisted laparoscopic donor nephrectomy are the two most commonly performed procedures, although retroperitoneal approaches are advocated by some centres. Controversy persists with respect to the technical aspects of donor nephrectomy, including both the approach and the method of ligation of the hilar vessels. More recently, robot-assisted, laparo-endoscopic single site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES) -assisted donor nephrectomy have also been performed, further increasing the number of options available, but creating uncertainty as to the ideal approach. PMID:22489654

Banga, Neal; Nicol, David

2012-11-01

223

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)

2010-03-04

224

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

225

Laparoscopic Renal Cryosurgery: The Northwestern Experience  

Microsoft Academic Search

PurposeLaparoscopic renal cryosurgery provides a minimally invasive alternative for the treatment of small renal lesions of undefined malignant potential. We report on our series of patients treated with laparoscopic renal cryosurgery.

ROBERT B. NADLER; SAMUEL C. KIM; JONATHAN N. RUBENSTEIN; RONALD L. YAP; STEVEN C. CAMPBELL

2003-01-01

226

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

227

Efficacy of the modified anvil grasper for laparoscopic intra-corporeal circular stapled anastomosis  

PubMed Central

The traditional anvil grasper may be difficult to use for connecting the stem of an anvil with the centre rod of a circular stapler because the grasper holds the anvil completely still. In addition, the head angle is fixed and cannot handle the anvil head delicately in a tight pelvic space. Many surgeons use a grasper designed for holding the bowel or a dissector for holding the anvil during intra-corporeal circular stapled anastomosis during low anterior resection, sigmoidectomy, left hemi colectomy and know that it is difficult to connect segments with these instruments due to slipping. A new modified anvil grasper was developed with curved blades that can easily grasp the stem of an anvil and smoothly connect it with the centre rod of the circular stapler. This grasper should be useful for surgeons performing laparoscopic intra-corporeal circular stapled anastomoses, which are the most challenging part of laparoscopic colorectal surgery. PMID:23248448

Nakase, Yuen; Takagi, Tsuyoshi; Fukumoto, Kanehisa; Miyagaki, Takuya

2012-01-01

228

Anatomy Videos: MedlinePlus  

MedlinePLUS

... Health Topics Drugs & Supplements Videos & Cool Tools ESPAÑOL Anatomy Videos To use the sharing features on this ... please enable JavaScript. These animated videos show the anatomy of body parts and organ systems and how ...

229

How Is Pelvic Pain Treated?  

MedlinePLUS

... respond well to physical therapy. This type of therapy might involve massage, stretching, strengthening, or learning to relax or control pelvic muscles. 5 Surgery. Some women may need surgery to remove adhesions, 6 fibroids , and/or endometriosis. In some cases, the surgery ...

230

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

231

Unstable pelvic fractures in children.  

PubMed

A total of 3561 freshly injured children received treatment at the paediatric trauma department of the National Institute of Traumatology between 1984 and 1994. Out of these 38 (approx. 1%) had pelvic fractures. Based on the classification of Tile and Laer, 15 pelvic fractures were diagnosed to be unstable, from which 8 were polytraumatised, 4 shocked and 1 was a casualty. Run downs could be considered as the main cause of these fractures. Conservative treatment was provided for 13 unstable cases (bed rest: 5, band suspension: 1, femur skeletal traction: 4, femur traction and band suspension: 3). Surgery was performed in 2 cases (symphysis cerclage: 1, acetabulum plate o.s.: 1). Eleven patients were called in for late controls (after 3 years). Subsequent complications were: pain: 3, limb shortening: 4, lumbal scoliosis: 1, minor pelvic deformations: 4, partial necrosis of caput femoris: 2. The subjective complaints of 3 adolescent cases seem to be small in number, however, it is a fair assumption that the control period of 3-6 years later is not enough to form a comprehensive conception on the nature of early degenerative deformations occurring later, e.g. during adulthood. Because of further surgeries and examinations, correct traction and suspensional treatment can only be carried out with great difficulties regarding children. Therefore, posterior stabilisation of the pelvic ring must be planned with percutaneous sacroiliac pinning or screwing in unstable cases. PMID:10196615

Hargitai, E; Szita, J; Dóczi, J; Renner, A

1998-01-01

232

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.

233

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

234

Laparoscopic port closure.  

PubMed

Formation of a post-operative trocar site hernia (TSH) is a serious complication of laparoscopic surgery with an incidence of 1.5%-1.8%, and may necessitate emergent surgical correction in the case of bowel strangulation. Many contributing factors increase the risk of this complication, and various surgical devices have been developed to help prevent post-operative TSH formation. Bladeless trocars with radially expanding technology have been shown to decrease the incidence of post-operative TSH. Various port site closure devices are also available on the market, which assist in closing the fascia, thus decreasing the risk of this complication. In this article, we will review the use of these devices and their potential to reduce post-operative TSH formation. PMID:24700212

Mikhail, Emad; Hart, Stuart

2014-03-01

235

Laparoscopic partial splenic resection.  

PubMed

Twenty domestic pigs with an average weight of 30 kg were subjected to laparoscopic partial splenic resection with the aim of determining the feasibility, reliability, and safety of this procedure. Unlike the human spleen, the pig spleen is perpendicular to the body's long axis, and it is long and slender. The parenchyma was severed through the middle third, where the organ is thickest. An 18-mm trocar with a 60-mm Endopath linear cutter was used for the resection. The tissue was removed with a 33-mm trocar. The operation was successfully concluded in all animals. No capsule tears occurred as a result of applying the stapler. Optimal hemostasis was achieved on the resected edges in all animals. Although these findings cannot be extended to human surgery without reservations, we suggest that diagnostic partial resection and minor cyst resections are ideal initial indications for this minimally invasive approach. PMID:7773460

Uranüs, S; Pfeifer, J; Schauer, C; Kronberger, L; Rabl, H; Ranftl, G; Hauser, H; Bahadori, K

1995-04-01

236

Laparoscopic ventral hernia repair.  

PubMed

Ventral hernias, whether naturally occurring or the result of previous surgery, comprise one of the most common problems confronting general surgeons. As many as 25% of laparotomy incisions develop a hernia over long-term follow-up, which is a difficult problem with many treatment algorithms. Laparoscopic ventral hernia repair has improved over the last decade and has proven to be an effective treatment option. With fewer wound complications and low recurrence rates, it is a useful tool in the surgeon's armamentarium. Care should be taken regarding patient selection, operative technique, and mesh size to ensure adequate repair of the hernia, thereby preventing recurrence at a later date. The first attempt at a hernia repair has the highest chance of long-term success, so it is important that the surgeon take all the factors into mind before proceeding with operative repair. PMID:21424876

Melvin, W Scott; Renton, David

2011-07-01

237

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.

238

[Anatomy lessons on animals].  

PubMed

The first anatomical studies were realized on the animal by Galen and Vesalius. Bourgelat created the first veterinarian school in Lyons, then in Paris where the famous dissection of a man on his horse can be seen (Fragonard). The Lafosse dynasty was interested in the study of the horse care and the painter Sollier showed the most beautiful coloured engravings about the horses. A chair of anatomy was created to compare the human and animal anatomy by the school of Jardin des Plantes en 1855. PMID:17526401

Bouchet, Alain

2006-01-01

239

Laparoscopic surgery for colon cancer: a review of the fascial composition of the abdominal cavity.  

PubMed

Laparoscopic surgery has generally been performed for digestive diseases. Many patients with colon cancer undergo laparoscopic procedures. The outcomes of laparoscopic colectomy and open colectomy are the same in terms of the long-time survival. It is important to dissect the embryological plane to harvest the lymph nodes and to avoid bleeding during colon cancer surgery. To date, descriptions of the anatomy of the fascial composition have mainly involved observations unrelated to fundamental embryological concepts, causing confusion regarding the explanations of the surgical procedures, with various vocabularies used without definitions. We therefore examined the fascia of the abdominal space using a fascia concept based on clinical anatomy and embryology. Mobilization of the bilateral sides of the colon involves dissection between the fusion fascia of Toldt and the deep subperitoneal fascia. It is important to understand that the right fusion fascia of Toldt is divided into the posterior pancreatic fascia of Treitz dorsally and the anterior pancreatic fascia ventrally at the second portion of the duodenum. A comprehensive understanding of fascia composition between the stomach and transverse colon is necessary for dissecting the splenic flexure of the colon. As a result of these considerations of the fascia, more accurate surgical procedures can be performed for the excision of colon cancer. PMID:24515451

Mike, Makio; Kano, Nobuyasu

2015-02-01

240

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.

241

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

242

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

243

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

244

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

245

Surgical management of pelvic Ewing’s sarcoma  

PubMed Central

Background: Despite advances in adjuvant therapy, Ewing’s sarcoma of the pelvis remains an anatomic site with a poor prognosis due to its relative inaccessibility, complex anatomy, and limited reconstructive options available. This study evaluates the role of surgery in the management of patients with pelvic Ewing’s sarcoma who also have received conventional radiation therapy and chemotherapy. Materials and Methods: From July 1990 to July 2006, we received 10 patients with Ewing’s sarcoma of pelvis at our center. Nine patients were in stage II B and one in Stage III at the time of presentation to us. All patients underwent surgical resection after preoperative chemotherapy with or without radiotherapy, which was given at the discretion of the referral center. Reconstruction was attempted using plate osteosynthesis in four patients, SS wires and screws in three patients, free fibular strut graft in one patient, and none was done in two patients. Results: Functional outcome assessed by Enneking’s criteria revealed excellent outcome in two patients, good outcome in five patients, and poor outcome in two patients. At a mean followup of 10.3 years, seven patients remained free from the disease, and three patients died. The 5- and 10-year cumulative survival (Kaplan Meier method) was 63% and 34%, respectively. Conclusion: This study demonstrates that surgery plus chemotherapy and radiation therapy is helpful for treating patients with pelvic Ewing’s sarcoma, particularly in achieving local control. PMID:20924480

Natarajan, Mayil Vahanan; Sameer, M Mohamed; Bose, Jagdish Chandra; Dheep, Kunal

2010-01-01

246

[Laparoscopic surgery in day surgery].  

PubMed

Since ten years laparoscopic techniques have been employed as alternatives of many established open procedures in gynecologic, abdominal and finally urologic surgery. Laparoscopic techniques show significant advantages compared to open surgery, such as less hospitalization, reduced need of analgesic drugs, quick return to daily activities and far a better cosmetic results. Laparoscopic surgery has been advocated for urologic, uro-gynecologic and andrologic diseases. Since 1983 one-day surgery was proposed for only a few gynecologic and abdominal procedures and only recently for laparoscopic renal biopsy and abdominal testis evaluation. In these preliminary experiences the conditions for a correct management of laparoscopic one-day surgery have been clearly pointed out: 1. correct surgical indication; 2. through knowledge of surgical technique; 3. duration of the procedure less than 90 minutes; 4. correct anesthesia. Technique of anesthesia must be adapted to the surgical procedure required, its duration and the physical features of the patient. General anesthesia is usually preferred for either longer and more complex procedures or when a higher abdominal insufflation pressure is needed. Spinal or local anesthesia are preferred for simpler procedures or when only one trocar is required. At date only few urologic procedures seem to be suitable to one-day laparoscopic surgery. 1) Varicocele: although laparoscopic varicocelectomy in one-day surgery has never been reported previously, it can be performed in a short time, only 3 trocars are needed and insufflation pressure can be maintained within 15 mm Hg. 2) Renal biopsy and marsupialization of renal cysts. These are usually managed percutaneously but in some particular indications procedures under direct vision should be preferable. Both are short-lasting and only superficial general anesthesia is required; as surgical access is retroperitoneal only two trocars are sufficient; at date only renal biopsies have previously been reported. 3) Diagnostic procedures on abdominal testis. The procedure is brief only superficial general anesthesia is needed and only one trocar is required. Conclusions. One-day laparoscopic surgery will require in the future a more and more strict cooperation between urologists and anesthetists in order to tailor the correct anesthesiological and laparoscopic technique to the procedure required and the features of the patient. PMID:9707775

Micali, S; Bitelli, M; Torelli, F; Valitutti, M; Micali, F

1998-06-01

247

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.

0000-00-00

248

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

249

Anatomy of the heart  

Microsoft Academic Search

Despite centuries of writings and research into cardiac anatomy and function, the topic is still advancing, particularly in reference to clinical applications and embryological significance. This article presents the heart with reference to the classical anatomical position and attempts to clarify the nomenclature that is most commonly used by anatomists. We encourage clinicians to use the same terminology. The references

Robert H. Whitaker

2010-01-01

250

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

251

Illustrated Speech Anatomy.  

ERIC Educational Resources Information Center

Written for students in the fields of speech correction and audiology, the text deals with the following: structures involved in respiration; the skeleton and the processes of inhalation and exhalation; phonation and pitch, the larynx, and esophageal speech; muscles involved in articulation; muscles involved in resonance; and the anatomy of the…

Shearer, William M.

252

Anatomy for Biomedical Engineers  

ERIC Educational Resources Information Center

There is a perceived need for anatomy instruction for graduate students enrolled in a biomedical engineering program. This appeared especially important for students interested in and using medical images. These students typically did not have a strong background in biology. The authors arranged for students to dissect regions of the body that…

Carmichael, Stephen W.; Robb, Richard A.

2008-01-01

253

Anatomy and physiology of the lower-extremity deep and superficial veins.  

PubMed

A thorough understanding of venous anatomy and physiology is foundational to the diagnosis and management of venous disease. Compared with the arterial system, there is significantly greater developmental variation in the venous system. The veins of the lower extremity include the superficial and deep veins, which are defined by their respective relationships to the muscular fascia. Perforating veins traverse the muscular fascia to connect superficial and deep veins. Communicating veins connect veins within the same venous compartment, either deep to deep or superficial to superficial. The deep veins of the lower extremities primarily drain muscles and are encompassed by muscular fascia. The veins located between the skin and the muscular fascia are considered superficial veins. Superficial veins drain the cutaneous microcirculation. The pelvic venous system is a complex transitional outflow pathway between the lower extremities, the pelvic structures, and the inferior vena cava. The terminology used to describe lower-extremity, pelvic, and abdominal vasculature conforms to published international standards. PMID:24840960

Black, Carl M

2014-06-01

254

Single incision laparoscopic hepatectomy: Advances in laparoscopic liver surgery  

PubMed Central

BACKGROUND: Laparoscopic liver surgery is now an established practice in many institutions. It is a safe and feasible approach in experienced hands. Single incision laparoscopic surgery (SILS) has been performed for cholecystectomies, nephrectomies, splenectomies and obesity surgery. However, the use of SILS in liver surgery has been rarely reported. We report our initial experience in seven patients on single incision laparoscopic hepatectomy (SILH). PATIENTS AND METHODS: From October 2010 to September 2012, seven patients underwent single-incision laparoscopic liver surgery. The abdomen was approached through a 25 mm periumbilical incision. No supplemental ports were required. The liver was transected using a combination of LigaSure™ (Covidien-Valleylab. Boulder. USA), Harmonic Scalpel and Ligaclips (Ethicon Endo-Surgery, Inc.). RESULTS: Liver resection was successfully completed for the seven patients. The procedures consisted of two partial resections of segment three, two partial resections of segment five and three partial resections of segment six. The mean operative time was 98.3 min (range: 60-150 min) and the mean estimated blood loss was 57 ml (range: 25-150 ml). The postoperative courses were uneventful and the mean hospital stay was 5.1 days (range: 1-13 days). Pathology identified three benign and four malignant liver tumours with clear margins. CONCLUSION: SILH is a technically feasible and safe approach for wedge resections of the liver without oncological compromise and with favourable cosmetic results. This surgical technique requires relatively advanced laparoscopic skills. Further studies are needed to determine the potential advantages of this technique, apart from the better cosmetic result, compared to the conventional laparoscopic approach. PMID:24501503

Claude, Tayar; Daren, Subar; Chady, Salloum; Alexandre, Malek; Alexis, Laurent; Daniel, Azoulay

2014-01-01

255

Stereoscopic augmented reality using ultrasound volume rendering for laparoscopic surgery in children  

NASA Astrophysics Data System (ADS)

In laparoscopic surgery, live video provides visualization of the exposed organ surfaces in the surgical field, but is unable to show internal structures beneath those surfaces. The laparoscopic ultrasound is often used to visualize the internal structures, but its use is limited to intermittent confirmation because of the need for an extra hand to maneuver the ultrasound probe. Other limitations of using ultrasound are the difficulty of interpretation and the need for an extra port. The size of the ultrasound transducer may also be too large for its usage in small children. In this paper, we report on an augmented reality (AR) visualization system that features continuous hands-free volumetric ultrasound scanning of the surgical anatomy and video imaging from a stereoscopic laparoscope. The acquisition of volumetric ultrasound image is realized by precisely controlling a back-and-forth movement of an ultrasound transducer mounted on a linear slider. Furthermore, the ultrasound volume is refreshed several times per minute. This scanner will sit outside of the body in the envisioned use scenario and could be even integrated into the operating table. An overlay of the maximum intensity projection (MIP) of ultrasound volume on the laparoscopic stereo video through geometric transformations features an AR visualization system particularly suitable for children, because ultrasound is radiation-free and provides higher-quality images in small patients. The proposed AR representation promises to be better than the AR representation using ultrasound slice data.

Oh, Jihun; Kang, Xin; Wilson, Emmanuel; Peters, Craig A.; Kane, Timothy D.; Shekhar, Raj

2014-03-01

256

Minimal invasive treatment of ureteropelvic junction obstruction in low volume pelvis: A comparative study of endopyelotomy and laparoscopic nondismembered pyeloplasty  

PubMed Central

Objective: To evaluate the role of nondismembered laparoscopic pyeloplasty and percutaneous endopyelotomy for ureteropelvic junction obstruction (UPJO) with low volume renal pelvis. Material and Methods: Retrospective acquired data of 34 patients of laparoscopic nondismembered pyeloplasty was compared with 26 patients of UPJO with pelvic volume less than 50 ml undergoing antegrade endopyelotomy and analyzed for clinical parameters, operative outcomes and success of procedures. All patients were followed up clinically and with diuretic renogram at regular intervals. Results: Mean age, renal pelvic volume and preoperative glomerular filtration rate (GFR) was 25 years, 43.6 ml and 42.5 ml/min, respectively in endopyelotomy group and 21 years, 34.4 ml and 39.9 ml/min, respectively in laparoscopic pyeloplasty group. Mean operative time, postoperative analgesic requirement and mean hospital stay was 100min, 250 mg and 4 days, respectively in endopyelotomy group and 210 min, 300 mg and 4 days, respectively in laparoscopic pyeloplasty group. Only operative time was significantly different between two groups (P < 0.05). Mean follow-up was 36 and 39 months and success rates were 91.2% and 88.8% in laparoscopy and endopyelotomy group, respectively (P < 0.05). No significant complication was seen in endopyelotomy group while two patients had hematuria (one requiring blood transfusion) and three had increased drain output for more than 3 days in laparoscopy group. Conclusion: Percutaneous endopyelotomy is associated with significantly less operative time and postoperative complication rate and provides equivalent success in comparison to nondismembered laparoscopic pyeloplasty in patients with UPJO and low volume pelvis. It can be a preferred minimally invasive treatment modality for such patients. PMID:19468432

Singh, Pratipal; Jain, Paresh; Dharaskar, Anand; Mandhani, Anil; Dubey, Deepak; Kapoor, Rakesh; Kumar, Anant; Srivastava, Aneesh

2009-01-01

257

Transcystic Approach to Laparoscopic Common Bile Duct Exploration  

PubMed Central

Background and Objectives: One-stage laparoscopic management for common bile duct stones in patients with gallbladder stones has gained wide acceptance. We developed a novel technique using a transcystic approach for common bile duct exploration as an alternative to the existing procedures. Methods: From April 2010 to June 2012, 9 consecutive patients diagnosed with cholelithiasis and common bile duct stones were enrolled in this study. The main inclusion criteria included no upper abdominal surgical history and the presence of a stone measuring <5 mm. After the gallbladder was dissected free from the liver connections in a retrograde fashion, the fundus of the gallbladder was extracted via the port incision in the right epigastrium. The choledochoscope was inserted into the gallbladder through the small opening in the fundus of the gallbladder extracorporeally and was advanced toward the common bile duct via the cystic duct under the guidance of both laparoscopic imaging and endoscopic imaging. After stones were retrieved under direct choledochoscopic vision, a drainage tube was placed in the subhepatic space. Results: Of 9 patients, 7 had successful transcystic common bile duct stone clearance. A narrow cystic duct and the unfavorable anatomy of the junction of the cystic duct and common bile duct resulted in losing access to the common bile duct. No bile leakage, hemobilia, or pancreatitis occurred. Wound infection occurred in 2 patients. Transient epigastric colic pain occurred in 2 patients and was relieved by use of anisodamine. A transient increase in the amylase level was observed in 3 patients. Short-term follow-up did not show any recurrence of common bile duct stones. Conclusion: Our novel transcystic approach to laparoscopic common bile duct exploration is feasible and efficient. PMID:25516702

Fei, Zhewei; Huang, Xia; Wang, Xiaojun

2014-01-01

258

Intraoperative ultrasound as an educational guide for laparoscopic biliary surgery  

PubMed Central

AIM: To analyze the efficacy of routine intraoperative ultrasound (IOUS) as a guide for understanding biliary tract anatomy, to avoid bile duct injury (BDI) after laparoscopic cholecystectomy (LC), as well as any burden during the learning period. METHODS: A retrospective analysis was performed using 644 consecutive patients who underwent LC from 1991 to 2006. An educational program with the use of IOUS as an operative guide has been used in 276 cases since 1998. RESULTS: IOUS was highly feasible even in patients with high-grade cholecystitis. No BDI was observed after the introduction of the educational program, despite 72% of operations being performed by inexperienced surgeons. Incidences of other morbidity, mortality, and late complications were comparable before and after the introduction of routine IOUS. However, the operation time was significantly extended after the educational program began (P < 0.001), and the grade of laparoscopic cholecystitis (P = 0.002), use of IOUS (P = 0.01), and the experience of the surgeons (P = 0.05) were significant factors for extending the length of operation. CONCLUSION: IOUS during LC was found to be a highly feasible modality, which provided accurate, real-time information about the biliary structures. The educational program using IOUS is expected to minimize the incidence of BDI following LC, especially when performed by less-skilled surgeons. PMID:18416464

Hakamada, Kenichi; Narumi, Shunji; Toyoki, Yoshikazu; Nara, Masaki; Oohashi, Motonari; Miura, Takuya; Jin, Hiroyuki; Yoshihara, Syuichi; Sugai, Michihiro; Sasaki, Mutsuo

2008-01-01

259

Fibroids, Infertility and Laparoscopic Myomectomy  

PubMed Central

Objective: To review the literature and summarize the available evidence about the relationship of fibroids with infertility and to review the role of laparoscopic myomectomy in infertility. Materials and Methods: Medline, PubMed, and Cochrane Databases were searched for articles published between 1980 and 2010. Results: Fertility outcomes are decreased in women with submucosal fibroids, and myomectomy is of value. Subserosal fibroids do not affect fertility outcomes, and removal may not confer benefit. Intramural fibroids appear to decrease fertility, but the results of therapy are unclear. Although pregnancy rates for women with leiomyomata, managed endoscopically, are similar to those after laparotomy, there is a risk of uterine rupture. The risk is essentially unknown. Finally, the risk of recurrence seems higher after laparoscopic myomectomy compared to laparotomy. Conclusions: Laparoscopic myomectomy, when performed by an experienced surgeon, can be considered a safe technique, with an extremely low failure rate and good results in terms of the outcome of pregnancy. PMID:22442534

Desai, Pankaj; Patel, Purvi

2011-01-01

260

The spastic pelvic floor syndrome  

Microsoft Academic Search

In 12 patients with constipation, it was detected by defecography that, during straining, the anorectal angle did not increase,\\u000a but remained at 90 degrees. These patients were unable to excrete barium. since the anorectal angle is a measure of activity\\u000a of the pelvic floor musculature, a dysfunction of this muscle was suspected. In order to determine whether this abnormality\\u000a represented

Han C. Kuijpers; Gijs Bleijenberg

1985-01-01

261

[Pelvic exenteration, morbidity and survival].  

PubMed

Between 1985 and 1990, 17 patients have undergone pelvic exenteration at the Obstetric and Gynecology Hospital 4, Mexican Social Security Institute, Mexico City. Sixteen patients had undergone radiation therapy previously. Most operative procedures were performed for cancer of the cervix, recurrent or persistent. The major type of pelvic neoplasm was epidermoid carcinoma, occurring in 15 patients. No exenterations were performed in presence of pelvic lymph nodes. Operative mortality was 5.8%. One or more major surgical complications occurred in nine patients, three patients required one or more surgical procedures to correct these complications. There was no mortality in patients undergoing reoperation. Nonsurgical complications were encountered in five patients. All patients were followed for at least 2 years or until time of death. The cumulative 5-year survival was significantly related to type of tumor. All patients with recurrent tumor were alive and disease free in the last follow-up compared to only 33% of patients with persistent tumor. Four patients underwent anterior surgical procedure, all with persistent tumour. Three had documented recurrence and none survived beyond 14 months. PMID:8056362

Méndez, L; Bernal, A; Escudero, P; González, G; Fajardo, A

1994-06-01

262

Laparoscopic live-donor nephrectomy.  

PubMed

Laparoscopic nephrectomy with ablative intent has been performed clinically. The current study aimed to determine whether a physiologically and anatomically intact kidney suitable for transplantation could be harvested laparoscopically. Three weeks after an ablative laparoscopic right nephrectomy, 15 pigs were divided into two groups: the study group (n = 10) underwent a laparoscopic live-donor left nephrectomy of the solitary kidney and conventional autotransplantation; the control group (n = 5) underwent an open live-donor left nephrectomy of the solitary kidney and conventional autotransplantation. All study kidneys underwent laparoscopic in situ hypothermic perfusion. The mean length of the left renal artery and vein were similar in the study and control groups: 3.1 cm and 3.4 cm, respectively, in the study group compared with 2.5 cm and 3.8 cm, respectively, in the control group (P = 0.5). No intraoperative renal vascular injuries or postoperative ureteral complications were noted in either group. Renal histopathologic examination immediately after live-donor nephrectomy and at 1 month post-transplant showed similar findings in the two groups. The mean serum creatinine at 7 and 30 days postoperatively was not significantly different: 2.1 mg/dL and 1.6 mg/dL, respectively, in the study group and 1.7 mg/dL, and 1.4 mg/dL, respectively, in the control group (P = 0.4). We conclude that laparoscopic live-donor nephrectomy can be performed safely and reproducibly in the porcine model. PMID:8061673

Gill, I S; Carbone, J M; Clayman, R V; Fadden, P A; Stone, M A; Lucas, B A; McRoberts, J W

1994-04-01

263

Laparoscopic reversal of Hartmann's procedure.  

PubMed

Reestablishing continuity after a Hartmann's procedure is considered a major surgical procedure with high morbidity/mortality. The aim of this study was to assess the short-/long-term outcome of laparoscopic restoration of bowel continuity after HP. A prospectively collected database of colorectal laparoscopic procedures (>800) performed between June 2005 and June 2013 was used to identify 20 consecutive patients who had undergone laparoscopic reversal of Hartmann's procedure (LHR). Median age was 65.4. Ten patients (50 %) had undergone surgery for perforated diverticulitis, 3 (15 %) for cancer, and 7 (35 %) for other reasons (volvulus, posttraumatic perforation, and sigmoid perforation from foreign body). Previous HP had been performed laparoscopically in only 3 patients. Median operative time was 162.5 min. All the procedures were completed laparoscopically. Intraoperative complication rate was nil. Post-operative mortality and morbidity were respectively 0 and 10 % (1 pneumonia, 1 bowel obstruction from post-anastomotic stenosis which required resection and redo of the anastomosis). Median time to first flatus was 3 days, to normal diet 5 days. Median hospital stay was 9 days without readmissions. We followed up the patients for a median of 44 months: when asked, all 20 (100 %) said they would undergo the operation (LHR) again; 3 (15 %) had been re-operated of laparoscopic mesh repair for incisional hernia. When performed by experienced surgeons, LHR is a feasible, safe, reproducible operation, which allows early return of bowel function, early discharge and fast return to work for the patient. It has a low morbidity rate. PMID:25262377

Fiscon, Valentino; Portale, Giuseppe; Mazzeo, Antonio; Migliorini, Giovanni; Frigo, Flavio

2014-12-01

264

Fracture Detection in Traumatic Pelvic CT Images  

PubMed Central

Fracture detection in pelvic bones is vital for patient diagnostic decisions and treatment planning in traumatic pelvic injuries. Manual detection of bone fracture from computed tomography (CT) images is very challenging due to low resolution of the images and the complex pelvic structures. Automated fracture detection from segmented bones can significantly help physicians analyze pelvic CT images and detect the severity of injuries in a very short period. This paper presents an automated hierarchical algorithm for bone fracture detection in pelvic CT scans using adaptive windowing, boundary tracing, and wavelet transform while incorporating anatomical information. Fracture detection is performed on the basis of the results of prior pelvic bone segmentation via our registered active shape model (RASM). The results are promising and show that the method is capable of detecting fractures accurately. PMID:22287952

Wu, Jie; Davuluri, Pavani; Ward, Kevin R.; Cockrell, Charles; Hobson, Rosalyn; Najarian, Kayvan

2012-01-01

265

Laparoscopic management of colorectal endometriosis  

Microsoft Academic Search

Background: In the past, intestinal endometriosis diagnosed at laparoscopy has generally required conversion to conventional surgery.\\u000a The purpose of this study was to describe the laparoscopic management of colorectal endometriosis at a tertiary referral center.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: From November 1994 to March 1998, 509 consecutive patients with endometriosis requiring laparoscopic intervention were prospectively\\u000a evaluated. Those with colorectal involvement were analyzed for

B. L. Jerby; H. Kessler; T. Falcone; J. W. Milsom

1999-01-01

266

Laparoscopic Surgery for Rectal Cancer  

PubMed Central

Laparoscopic surgery for rectal cancer is much more challenging than that for colon cancer because of the confined space within the pelvis. Further, because of the tumor's location in the pelvis, maintenance of resection margins is of greater concern. Nonrandomized studies by groups experienced in laparoscopic surgery have shown both that it produces short-term outcomes equivalent to those for open surgery and that it can be performed safely from an oncologic perspective. Nonsurgical complications appear to be fewer, but conversion to open surgery may become a real issue. This review summarizes these findings by addressing technical considerations, early outcomes, late outcomes, costs, and complications. PMID:21373245

Indar, Adrian; Efron, Jonathan

2009-01-01

267

Laparoscopic ultrasound and gastric cancer  

NASA Astrophysics Data System (ADS)

The management of gastrointestinal malignancies continues to evolve with the latest available therapeutic and diagnostic modalities. There are currently two driving forces in the management of these cancers: the benefits of minimally invasive surgery so thoroughly demonstrated by laparoscopic surgery, and the shift toward neoadjuvant chemotherapy for upper gastrointestinal cancers. In order to match the appropriate treatment to the disease, accurate staging is imperative. No technological advances have combined these two needs as much as laparascopic ultrasound to evaluate the liver and peritoneal cavity. We present a concise review of the latest application of laparoscopic ultrasound in management of gastrointestinal malignancy.

Dixon, T. Michael; Vu, Huan

2001-05-01

268

The laparoscopic learning curve.  

PubMed

To characterize the learning curve for laparoscopic cholecystectomy, we compared the first 47 cases (group A), which were performed by two senior attending surgeons who assisted each other when the procedure was introduced into clinical practice (1990-1991), with the first 46 cases (group R) performed by two surgical chief residents who were assisted by members of the teaching faculty in 1992-1993. The patient groups were comparable in terms of age, sex, and anesthetic class, but pathologically proven acute cholecystitis was more common in group R (33% vs. 9%; p < 0.005). To analyze operative procedures and outcomes, we compared operative time, frequency of successful operative cholangiography (attempted in all cases), frequency of conversion to open cholecystectomy, major complication rate, and days of postoperative stay for all patients and for those without complications. Of these parameters, only operative time for nonacute cases differed significantly between the groups (144 min for group A vs. 114 min for group R; p < 0.05). Complications in group A included one ductal injury and one case of postoperative pancreatitis; group R had one ductal injury and two cases of postoperative bleeding. We conclude that (a) the learning curve has similar structure for senior surgeons and resident trainees; and (b) the resident learning curve is not hazardous when teaching assistants are trained in the procedure, which has implications for safe instruction and proctoring of residents and staff. PMID:8611992

Lekawa, M; Shapiro, S J; Gordon, L A; Rothbart, J; Hiatt, J R

1995-12-01

269

Laparoscopic surgical technique to facilitate management of high anorectal malformations – report of seven cases  

PubMed Central

Anorectal malformations (ARMs) occur in approximately 1 per 5000 live births. The most commonly used procedure for repair of high ARMs is posterior sagittal anorectoplasty (PSARP). This operation is performed entirely through a perineal approach. The first report of laparoscopically assisted anorectal pull-through (LAARP) for repair of ARMs was presented by Georgeson in 2000. The aim is presenting early experience with laparoscopically assisted anorectal pull-through technique in boys with high anorectal malformations. In the last 5 years 7 boys (9 months to 2 years old) with high ARMs were operated on using the LAARP technique. Laparoscopically the rectal pouch was exposed down to the urethral fistula, which was clipped and divided. Externally, the centre of the muscle complex was identified using an electrical stimulator. In the first 4 patients after a midline incision of 2 cm at the planned anoplasty site, a tunnel to the pelvis was created bluntly and dilated with Hegar probes under laparoscopic control. In the last 3 boys a minimal PSARP was done creating a channel into the pelvis. The separated rectum was pulled down and sutured to the perineum. Laparoscopic mobilization of the rectal pouch and fistula division was possible in all cases. There were no intraoperative complications except one ureteral injury. Patients were discharged home on post-operative day 5 to 7. The early results prove that LAARP, an alternative option to PSARP for treatment of imperforate anus, offers many advantages, including excellent visualization of the pelvic anatomical structures, accurate placement of the bowel into the muscle complex and a minimally invasive abdominal and perineal incision. It allows for shorter hospital stay and faster recovery. However, to compare the functional results against the standard procedure (PSARP), longer follow-up of all patients is necessary. PMID:23255974

Murawski, Maciej; ?osin, Marcin; Królak, Marek; Czauderna, Piotr

2011-01-01

270

Laparoscopic surgical technique to facilitate management of high anorectal malformations - report of seven cases.  

PubMed

Anorectal malformations (ARMs) occur in approximately 1 per 5000 live births. The most commonly used procedure for repair of high ARMs is posterior sagittal anorectoplasty (PSARP). This operation is performed entirely through a perineal approach. The first report of laparoscopically assisted anorectal pull-through (LAARP) for repair of ARMs was presented by Georgeson in 2000. The aim is presenting early experience with laparoscopically assisted anorectal pull-through technique in boys with high anorectal malformations. In the last 5 years 7 boys (9 months to 2 years old) with high ARMs were operated on using the LAARP technique. Laparoscopically the rectal pouch was exposed down to the urethral fistula, which was clipped and divided. Externally, the centre of the muscle complex was identified using an electrical stimulator. In the first 4 patients after a midline incision of 2 cm at the planned anoplasty site, a tunnel to the pelvis was created bluntly and dilated with Hegar probes under laparoscopic control. In the last 3 boys a minimal PSARP was done creating a channel into the pelvis. The separated rectum was pulled down and sutured to the perineum. Laparoscopic mobilization of the rectal pouch and fistula division was possible in all cases. There were no intraoperative complications except one ureteral injury. Patients were discharged home on post-operative day 5 to 7. The early results prove that LAARP, an alternative option to PSARP for treatment of imperforate anus, offers many advantages, including excellent visualization of the pelvic anatomical structures, accurate placement of the bowel into the muscle complex and a minimally invasive abdominal and perineal incision. It allows for shorter hospital stay and faster recovery. However, to compare the functional results against the standard procedure (PSARP), longer follow-up of all patients is necessary. PMID:23255974

Go??biewski, Andrzej; Murawski, Maciej; Losin, Marcin; Królak, Marek; Czauderna, Piotr

2011-09-01

271

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

272

We introduce a ur from pelvic  

E-print Network

from pelvic mentation du gular shape a r shell. We ov ur into two ro d and another n to reduce gle pelvic scan goal is to eme which gre mur from a p accurate resul ber of factors from a CT pel seg ive manual la t accurate me-consuming; n, even with c o create a eatly reduces pelvic CT scan lts

Lee, WonSook

273

21 CFR 884.1720 - Gynecologic laparoscope and accessories.  

Code of Federal Regulations, 2010 CFR

...Devices § 884.1720 Gynecologic laparoscope and accessories...Identification. A gynecologic laparoscope is...perform diagnostic and surgical procedures on the female genital... (2) Class I for gynecologic laparoscope...

2010-04-01

274

Immediate Repair of an Incompletely Transected Obturator Nerve During Robotic-assisted Pelvic Lymphadenectomy.  

PubMed

Intraoperative injury of the obturator nerve may occur in gynecologic oncologic procedures when extensive pelvic side wall dissection is performed. In this case, we report an immediate repair of an incompletely transected obturator nerve during robotic-assisted pelvic lymphadenectomy. A 62-year-old gravida 3, para 3 woman was admitted to our clinic for postmenopausal bleeding. The result of an endometrial biopsy was complex endometrial hyperplasia with atypia, and a robotic-assisted laparoscopic hysterectomy was performed. A frozen section of the specimen revealed grade 1 endometrioid adenocarcinoma with >1/2 myometrial invasion. During the pelvic lymphadenectomy, the left obturator nerve was incompletely transected. The obturator nerve edges were oriented and reapproximated end-to-end with two 6/0 polypropylene sutures. The operation and console times were 244 and 223 minutes, respectively. The final pathologic finding was a stage IB endometrial adenocarcinoma. The number of the obtained lymph nodes was 38. Postoperatively, the patient did not exhibit any clinically apparent loss of adductor function or any other neurologic deficiency. Over 6 months of follow-up, the patient experienced no residual neuropathy or deficit in the left thigh. Robotic-assisted repair of a transected obturator nerve during surgery is feasible, and immediate repair of the damaged nerve may result in no neurologic deficit postoperatively. PMID:25218992

Göçmen, Ahmet; Sanl?kan, Fatih

2014-09-16

275

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

276

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

277

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

278

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

279

[Laparoscopic colo-rectal surgery].  

PubMed

Laparoscopic colorectal surgery was less invasive for patients although it was difficult to perform complete resection of colon combined with regional lymph node. The skillful manner of the laparoscopic surgery was required for the surgical team. The laparoscopic equipments, in order to perform curative dissection of mesenterium and intermediate lymph node, such as Ultrasonic-aspiration surgical unit (USU) or Harmonic scalpel laparoscopic coagulation shears (LCS), were useful for safer dissection of D2 regional lymph node. Meticulous manner of grasping forceps and special dissectors was made sufficient lymph node dissection. The reconstruction of extracorporeal anastomotic technique by hand or valtrac (biofragmentable anastomosis ring) were safer manner for anastomosis after resection of the right side colon. Reconstruction by double stapling technique of linear stapler and circular stapler was admired for anastomosis for left side colonic and rectal surgery. We had safely performed locar resection in 3, partial resection with Do dissection in 2, with D1 dissection in 14, with D2 dissection in 21 and right and left hemicolectomy in 1 each. PMID:8965357

Hayashi, K; Munakata, Y

1996-05-01

280

Surgical anatomy of the liver.  

PubMed

Vital intrahepatic structures, especially the large veins, are of special concern to the surgeon. These intrahepatic structures are seldom taught or displayed in anatomy courses, and illustrations are often presented with the posterior surface of the liver facing the viewer, an aspect seldom seen by the surgeon. In this article, the topographical anatomy of the liver is described in a manner most useful to the practicing surgeon. For this purpose, specimens were specifically prepared to demonstrate the vascular anatomy. PMID:2928899

Ger, R

1989-04-01

281

[Anatomy of the levator ani muscle and implications for obstetrics and gynaecology].  

PubMed

Pelvic floor disorders include urogenital and anorectal prolapse, urinary and faecal incontinence. These diseases affect 25% of patients. Most of time, treatment is primarily surgical with a high post-operative risk of recurrence, especially for pelvic organ prolapse. Vaginal delivery is the major risk factor for pelvic floor disorders through levator ani muscle injury or nerve damage. After vaginal delivery, 20% of patients experiment elevator ani trauma. These injuries are more common in case of instrumental delivery by forceps, prolonged second phase labor, increased neonatal head circumference and associated anal sphincter injuries. Moreover, 25% of patients have temporary perineal neuropathy. Recently, pelvic three-dimensional reconstructions from RMI data allowed a better understanding of detailed levator ani muscle morphology and gave birth to a clear new nomenclature describing this muscle complex to be developed. Radiologic and anatomic studies have allowed exploring levator ani innervation leading to speculate on the muscle and nerve damage mechanisms during delivery. We then reviewed the levator ani muscle anatomy and innervation to better understand pelvic floor dysfunction observed after vaginal delivery. PMID:25544728

Nyangoh Timoh, K; Bessede, T; Zaitouna, M; Peschaud, F; Chevallier, J-M; Fauconnier, A; Benoit, G; Moszkowicz, D

2015-01-01

282

Pelvic congestion syndrome: etiology of pain, diagnosis, and clinical management.  

PubMed

Pelvic congestion syndrome is associated with pelvic varicosities that result in chronic pelvic pain, especially in the setting of prolonged standing, coitus, menstruation, and pregnancy. Although the underlying pathophysiology of pelvic congestion syndrome is unclear, it probably results from a combination of dysfunctional venous valves, retrograde blood flow, venous hypertension, and dilatation. Asymptomatic women may also have pelvic varicosities, making pelvic congestion syndrome difficult to diagnose. This article explores the etiologies of pain, use of imaging techniques, and clinical management of pelvic congestion syndrome. Possible explanations for the spectrum of pain among women with pelvic varicosities are also discussed. PMID:24745902

Phillips, Darci; Deipolyi, Amy R; Hesketh, Richard L; Midia, Mehran; Oklu, Rahmi

2014-05-01

283

Efficacy and safety of reuse of disposable laparoscopic instruments in laparoscopic cholecystectomy: a prospective randomized study  

Microsoft Academic Search

Background The aim of this prospective randomized study was to investigate the efficacy and safety of the reuse of disposable laparoscopic instruments (DLI) in laparoscopic cholecystectomy. Methods A total of 125 consecutive patients with symptomatic cholelithiasis were randomly assigned to undergo laparoscopic cholecystectomy with single-use DLI (group 1, n = 62) or DLI that were reused (group 2, n =

T. Colak; G. Ersoz; T. Akca; A. Kanik; S. Aydin

2004-01-01

284

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

285

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.

286

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

287

Two-port laparoscopic adnexal surgery with a multichannel port using a wound retractor: is it safe and minimally scarring?  

PubMed

This study aimed to explore and evaluate the feasibility and safety of laparoscopic adnexal surgery using a two-port technique with a multichannel port, using a wound retractor, as previously reported. A series of patients undergoing two-port laparoscopy for a benign pelvic mass were enrolled in this study. To perform two-port laparoscopic surgery, the ancillary 5-mm trocar was inserted at the left iliac fossa under laparoscopic view after umbilical trocar insertion. The inserted umbilical trocar was removed and the skin incision was extended about 1.5 cm with index-finger-passable width. An Alexis wound retractor XS (Applied Medical, Santa Rancha Margarita, CA) was inserted through the umbilical wound. Two trocars were inserted into two fingers of a no. 6 surgical rubber glove and ligated with rubber bands. The wrist portion of the rubber glove covered the wound retractor, and the edge of the wound retractor was clamped with three Babcock clamps to prevent carbon-dioxide gas leakage. Both a 10-mm laparoscope and atraumatic forceps were inserted through the umbilical multichannel port. Laparoscopic adnexal surgery was performed in the usual manner. A total of 19 patients were enrolled. The operative procedures were adnexectomy (n = 8), myomectomy (n = 1), and ovarian cystectomy and/or salpingectomy (n = 10). There were no operative complications, conversion to laparotomy, or additional trocar insertions. The mean operation time was 81.3 +/- 28.7 min. The pathologic diagnosis were mature cystic teratoma (n = 6), benign cyst (n = 4), endometrial cyst (n = 3), serous cystadenoma (n = 3), mucinous cystadenoma (n = 1), leiomyoma (n = 1), and tubo-ovarian abscess (n = 1). The mean postoperative hospital stay was 4.0 +/- 1.3 days. This two-port method seems to be safe and needs no additional cost from the use of the conventional laparoscopic instruments. It is also cosmetically effective and highly appreciated by patients, leaving minimal abdominal scarring. PMID:19694570

Yi, Sang-Wook

2009-12-01

288

Pseudomonas pelvic osteomyelitis in a healthy child  

PubMed Central

Pediatric pelvic osteomyelitis is a rare entity. The diagnosis is frequently delayed due to difficulty in confirming the diagnosis. To our knowledge, this is the first case report of Pseudomonas pelvic osteomyelitis in a previously healthy adolescent boy. The diagnosis was made radiographically and confirmed by culture. The patient was treated with Levofloxacin and Gentamicin resulting in a complete recovery. PMID:24470915

Akhras, Nour; Blackwood, Alexander

2011-01-01

289

Laparoscopic pericystectomy for liver hydatid cysts  

Microsoft Academic Search

  Background: The laparoscopic approach for managing of liver echinococcosis is a controversial issue because of scarce experience\\u000a worldwide. The aim of this report is to describe the technical details of our laparoscopic method and present our results.\\u000a Methods: Consecutive cases of liver echinococcosis managed by laparoscopic surgery are reported. Thoracic x-ray and abdominal\\u000a ultrasound had been performed previously. The following

C. Manterola; O. Fernández; S. Muñoz; M. Vial; H. Losada; R. Carrasco; N. Bello; M. Barroso

2002-01-01

290

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

291

The anatomy of anatomy: a review for its modernization.  

PubMed

Anatomy has historically been a cornerstone in medical education regardless of nation or specialty. Until recently, dissection and didactic lectures were its sole pedagogy. Teaching methodology has been revolutionized with more reliance on models, imaging, simulation, and the Internet to further consolidate and enhance the learning experience. Moreover, modern medical curricula are giving less importance to anatomy education and to the acknowledged value of dissection. Universities have even abandoned dissection completely in favor of user-friendly multimedia, alternative teaching approaches, and newly defined priorities in clinical practice. Anatomy curriculum is undergoing international reformation but the current framework lacks uniformity among institutions. Optimal learning content can be categorized into the following modalities: (1) dissection/prosection, (2) interactive multimedia, (3) procedural anatomy, (4) surface and clinical anatomy, and (5) imaging. The importance of multimodal teaching, with examples suggested in this article, has been widely recognized and assessed. Nevertheless, there are still ongoing limitations in anatomy teaching. Substantial problems consist of diminished allotted dissection time and the number of qualified anatomy instructors, which will eventually deteriorate the quality of education. Alternative resources and strategies are discussed in an attempt to tackle these genuine concerns. The challenges are to reinstate more effective teaching and learning tools while maintaining the beneficial values of orthodox dissection. The UK has a reputable medical education but its quality could be improved by observing international frameworks. The heavy penalty of not concentrating on sufficient anatomy education will inevitably lead to incompetent anatomists and healthcare professionals, leaving patients to face dire repercussions. PMID:20205265

Sugand, Kapil; Abrahams, Peter; Khurana, Ashish

2010-01-01

292

Contraindications and complications of laparoscopic cholecystectomy.  

PubMed

Laparoscopic cholecystectomy is a commonly performed procedure for the removal of symptomatic gallstones. Compared with open cholecystectomy, laparoscopic cholecystectomy is associated with less postoperative pain, earlier discharge from the hospital and a more rapid recovery. However, there are specific contraindications to the procedure, including empyema of the gallbladder, gangrenous cholecystitis, coagulopathy, portal hypertension and peritonitis. Complications from laparoscopic cholecystectomy include common duct injury, bleeding, bile leakage and wound infection. An understanding of these issues allows the family physician to more appropriately select patients for laparoscopic removal of the gallbladder. PMID:7977000

Rappaport, W D; Gordon, P; Warneke, J A; Neal, D; Hunter, G C

1994-12-01

293

Laparoscopic pouch surgery in ulcerative colitis  

PubMed Central

Laparoscopic restorative proctocolectomy is a complex procedure with a steep learning curve. It has been proven to be safe and feasible with outcomes comparable to those of open surgery if performed in experienced centers. Published evidence in favor of laparoscopic approach is mainly from small case series and data from randomized controlled trials are currently awaited. This article reviews and analyzes the existing literature on laparoscopic ileoanal pouch surgery in light of the available evidence, demonstrating safety and efficacy of the laparoscopic approach and potential short-term benefits. Technical aspects and future directions in the minimally invasive approach to restorative proctocolectomy are also discussed. PMID:24714253

Hemandas, Anil K.; Jenkins, John T.

2012-01-01

294

Laparoscopic fundoplication in infants and children  

Microsoft Academic Search

Background: Laparoscopic fundoplication is a new method for treating gastroesophageal reflux in children. We present 160 children with\\u000a gastroesophageal reflux treated by laparoscopic fundoplication.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: Patients underwent either a laparoscopic Nissen or Toupet fundoplication. Many patients also required gastrostomies and gastric\\u000a outlet procedures.\\u000a \\u000a \\u000a \\u000a \\u000a Results: Twelve patients (7.5%) were converted to open fundoplication. Laparoscopic gastrostomies were placed in 112 patients (75.7%)

J. J. Meehan; K. E. Georgeson

1996-01-01

295

Single-incision laparoscopic pyloromyotomy: initial experience  

Microsoft Academic Search

Background  Laparoscopic pyloromyotomy has become the standard treatment for hypertrophic pyloric stenosis. Single-incision laparoscopic\\u000a surgery is an emerging operative approach that utilizes the umbilical scar to hide the surgical incision.\\u000a \\u000a \\u000a \\u000a \\u000a Objective  To describe our initial experience with single-incision laparoscopic pyloromyotomy in 15 infants.\\u000a \\u000a \\u000a \\u000a Materials and methods  Laparoscopic pyloromyotomy was performed through a single skin incision in the umbilicus, using a 4-mm 30° endoscope

Oliver J. Muensterer; Obinna O. Adibe; Carrol M. Harmon; Albert Chong; Erik N. Hansen; Donna Bartle; Keith E. Georgeson

2010-01-01

296

Mapping pelvic lymph nodes: Guidelines for delineation in intensity-modulated radiotherapy  

SciTech Connect

Purpose: To establish guidelines for delineating the clinical target volume for pelvic nodal irradiation by mapping the location of lymph nodes in relation to the pelvic anatomy. Methods and Materials: Twenty patients with gynecologic malignancies underwent magnetic resonance imaging with administration of iron oxide particles. All visible lymph nodes were outlined. Five clinical target volumes were generated for each patient using modified margins of 3, 5, 7, 10, and 15 mm around the iliac vessels. The nodal contours were then overlaid and individual nodes analyzed for coverage. The volume of normal tissue within each clinical target volume and planning target volume was also measured to aid selection of the margin that could provide maximal nodal, but minimal normal tissue, coverage. Results: In total, 1216 nodal contours were evaluated. The nodal coverage was 56%, 76%, 88%, 94%, and 99% using vessel margins of 3, 5, 7, 10, and 15 mm, respectively. The mean volume of bowel within the planning target volume was 146.9 cm{sup 3} with a 7-mm margin, 190 cm{sup 3} with a 10-mm margin, and 266 cm{sup 3} with a 15-mm margin. Minor modification to the 7-mm margin ensured 99% coverage of the pelvic nodes. Conclusion: Blood vessels with a modified 7-mm margin offer a good surrogate target for pelvic lymph nodes. By making appropriate adjustments, coverage of specific nodal groups may be increased and the volume of normal tissue irradiated decreased. On the basis of these findings, recommended guidelines for outlining pelvic nodes have been produced.

Taylor, Alexandra [Department of Radiotherapy, St. Bartholomew's Hospital, London (United Kingdom)]. E-mail: alexandra.taylor@blueyonder.co.uk; Rockall, Andrea G. [Department of Radiology, St. Bartholomew's Hospital, London (United Kingdom); Reznek, Rodney H. [Department of Radiology, St. Bartholomew's Hospital, London (United Kingdom); Powell, Melanie [Department of Radiotherapy, St. Bartholomew's Hospital, London (United Kingdom)

2005-12-01

297

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

298

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.

299

Virtual anatomy: an anatomist's playground.  

PubMed

Virtual anatomy presents significant advantages over the reality of a cadaver as it can provide different views and perspectives, portability, longevity, standardization, diversity and most importantly the opportunity to learn the anatomy of the living human body instead of the corpse. Virtual anatomy is the life-like appearance of visible anatomy, a good example of which is the evolution of the Visible Human. Racial and statistical diversity is already developing as the population of photographic "Visible Humans" is now at least 10. Virtual anatomy should include additional diversity and therefore, consideration should be given to the preparation of more visible anatomy that will better support the virtual integration of all areas of physiology, kinematics, pathology and pathophysiology, development and evolution. Integration of anatomists with mathematicians, computer scientists, information scientists, physiologists, pathologists and clinicians (and LIST other basic scientist) is needed in order to facilitate this development. As this unfolds it is proposed, or challenged, that anatomists should maintain their position of responsibility for building anatomy as the foundation for all medical and healthcare education. In order to maintain that position they must understand and participate in this development and enjoy the rewards of teaching more visually empowering, functional, and clinical anatomy. The trip is a long one and is only about to begin but the train is leaving. Are you on board? PMID:16565945

Spitzer, Victor M; Scherzinger, Ann L

2006-04-01

300

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

301

The quail anatomy portal  

PubMed Central

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

302

Laparoscopic management of ovarian remnant.  

PubMed

Ovarian remnant syndrome has become increasingly recognized as a cause of pelvic pain after extirpative surgery. Surgical removal of the ovarian remnant is the optimal treatment. Laparoscopy is safe and effective in managing ovarian remnant syndrome when performed by an experienced laparoscopist. PMID:15450320

Mahdavi, Ali; Berker, Bulent; Nezhat, Ceana; Nezhat, Farr; Nezhat, Camran

2004-09-01

303

Laparoscopic approach to retrorectal cyst.  

PubMed

Retrorectal cysts are rare benign lesions in the presacral space which are frequently diagnosed in middle-aged females. We report here our experience with two symptomatic female patients who were diagnosed as having a retrorectal cyst and managed using a laparoscopic approach. The two patients were misdiagnosed as having an ovarian cystic lesion after abdominal ultrasonography. Computer tomograghy (CT) scan was mandatory to establish the diagnosis. The trocar port site was the same in both patients. An additional left oophorectomy was done for a coexisting ovarian cystic lesion in one patient in the same setting. There was no postoperative morbidity or mortality and the two patients were discharged on the 5th and 6th post operative days, respectively. Our cases show that laparoscopic management of retrorectal cysts is a safe approach. It reduces surgical trauma and offers an excellent tool for perfect visualization of the deep structures in the presacral space. PMID:19030218

Gunkova, Petra; Martinek, Lubomir; Dostalik, Jan; Gunka, Igor; Vavra, Petr; Mazur, Miloslav

2008-11-14

304

Genetic and developmental basis of evolutionary pelvic reduction  

E-print Network

Genetic and developmental basis of evolutionary pelvic reduction in threespine sticklebacks Michael that are still unknown. To determine the number and type of genetic changes underlying pelvic reduction or missing pelvic structures. Genome-wide linkage mapping shows that pelvic reduction is controlled by one

Shapiro, Mike

305

Transvaginal ultrasound findings in women with chronic pelvic pain  

Microsoft Academic Search

Objective: To determine the prevalence of anatomic abnormalities as diagnosed by transvaginal ultrasonography in women with chronic pelvic pain whose pelvic examination did not demonstrate an anatomic abnormality.Methods: Transvaginal ultrasonography was performed in premenopausal women who were diagnosed with chronic pelvic pain, had a speculum and bimanual pelvic examination that revealed no evidence of gynecologic pathology, and were subsequently referred

Dale W. Stovall

2000-01-01

306

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

307

Spontaneous Healing of a Rectovaginal Fistula Developing after Laparoscopic Segmental Bowel Resection for Intestinal Deep Infiltrating Endometriosis  

PubMed Central

The surgical treatment of intestinal deep infiltrating endometriosis has an associated risk of major complications such as dehiscence of the intestinal anastomosis, pelvic abscess, and rectovaginal fistula. The management of postoperative rectovaginal fistula frequently requires a reoperation and the construction of a stoma for temporary fecal diversion. In this paper we describe a 27-year-old woman undergoing laparoscopic treatment of deep infiltrating endometriosis (extramucosal cystectomy, resection of the uterosacral ligaments, resection of the posterior vaginal fornix, and segmental bowel resection) complicated by a rectovaginal fistula, which healed spontaneously with nonsurgical conservative treatment. PMID:23710392

Trippia, Carlos Henrique; Zomer, Monica Tessmann

2013-01-01

308

Complications of Laparoscopic Donor Nephrectomy  

Microsoft Academic Search

\\u000a “Laparoscopic donor nephrectomy is a unique surgical procedure due to the fact that the surgeon is operating on a healthy\\u000a individual in order to benefit another patient he or she is unlikely managing, with a potential for complications ensuing\\u000a in both the donor and the recipient patients. Overall surgical technique, anatomic considerations, and perioperative management\\u000a remain important for minimizing the

Alexei Wedmid; Michael A. Palese

309

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

310

Understanding and optimizing laparoscopic videosystems.  

PubMed

As tactile feedback and degree of freedom for instrument movement are restricted in laparoscopic surgery, the video image plays the most crucial role in giving the surgeon information about the performance of the operation. The development of small, reliable, high-resolution imaging systems is essential for the surgeon's acquisition detailed information about the tissues being manipulated. Image quality depends on each component of the laparoscopic imaging unit. In this context, it is crucial for the surgeon to have an understanding of how the video signal is formed, transmitted, and displayed. Moreover, the surgeon also needs to have an idea about the basic principles and specifications of the surgical video systems (i.e. charge-coupled device (CCD) camera, monitors, and digitizers). This knowledge is essential for choosing pieces of equipment and knowing how to assemble them into a functional operating suite. The aim of this review is to provide the surgeon with the basics of video signaling, and to familiarize him or her with the technical principles of the surgical video systems. An insight into the future of laparoscopic video systems also is made, and practical tips for improving image quality and troubleshooting are given throughout the article. PMID:11443427

Berber, E; Siperstein, A E

2001-08-01

311

Review. Laparoscopic appendicectomy: current status.  

PubMed Central

Laparoscopic appendicectomy (LA), has failed to gain unequivocal acceptance by the general surgical community as an alternative to open appendicectomy (OA). This is because the early postoperative recovery leading to quicker hospital discharge, which led to the worldwide acceptance of laparoscopic cholecystectomy, has not been universally seen with LA. Moreover, in the majority of the published series of LAs, there seems to be a trend towards an increased incidence of intra-abdominal abscesses. However, laparoscopy is superior to the 'watch and wait' policy where the diagnosis of appendicitis is questionable. Furthermore, since a large incision can be avoided by using the LA technique in obese patients, the incidence of postoperative morbidity can be reduced considerably. Nevertheless, before endorsing routine and widespread use of LA, it is essential that this technique is critically evaluated in well-designed, controlled, randomised trials, showing clearly the major benefits to the patient in terms of quicker hospital discharge, reduced postoperative pain, decreased wound infection and early return to full activities. Laparoscopic appendicectomy will never replace all open appendicectomies, but should become an alternative in certain groups of patients. PMID:9422862

Memon, M. A.

1997-01-01

312

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. PMID:25408763

Stoica, RA; Enache, T; Iordache, N

2014-01-01

313

Laparoscopic colorectal cancer surgery for palliation  

Microsoft Academic Search

PURPOSE: The aim of this study was to review our experience with laparoscopic colorectal cancer surgery for palliative purposes and to assess its safety and efficacy. METHODS: This was a prospective analysis of 30 patients with incurable colorectal cancer considered for laparoscopic surgery for palliative purposes. RESULTS: Resection of a single segment of the bowel was performed in 15 patients

Jeffrey W. Milsom; Seon Hahn Kim; Katherine A. Hammerhofer; Victor W. Fazio

2000-01-01

314

Laparoscopic vs. open abdominoperineal resection for cancer  

Microsoft Academic Search

PURPOSE: The aim of this study was to compare the safety and efficacy of laparoscopic abdominoperineal resection and open abdominoperineal resection for cancer. METHODS: Records of 194 patients who underwent laparoscopic abdominoperineal resection (42 patients) or open abdominoperineal resection (152 patients) at three institutions between 1991 and 1997 were reviewed. Follow-up was through office charts, American College of Surgeons cancer

James W. Fleshman; Steven D. Wexner; Mehran Anvari; Jean-Francois LaTulippe; Elisa H. Birnbaum; Ira J. Kodner; Thomas E. Read; Juan J. Nogueras; Eric G. Weiss

1999-01-01

315

Laparoscopic Adrenal Surgery for Neuroblastomas in Children  

Microsoft Academic Search

PurposeThe role of laparoscopy in children with neuroblastomas has not been fully defined. The laparoscopic approach to the adrenal gland is already largely used in adults and a few cases have been reported in children. We report the experience of a single surgical team center with laparoscopic adrenal surgery for neuroblastomas in children.

P. De LAGAUSIE; D. BERREBI; J. MICHON; P. PHILIPPE-CHOMETTE; A. EL GHONEIMI; C. GAREL; H. BRISSE; M. PEUCHMAUR; Y. AIGRAIN

2003-01-01

316

Laparoscopically assisted vaginal resection of rectovaginal endometriosis  

Microsoft Academic Search

Background: We wanted to establish a technique of laparoscopically assisted radical vaginal surgery for deep endometriosis of the rectovaginal septum with extensive rectal involvement.Technique: The procedure is started by vaginally excising the involved area which is left on the rectum, followed by bilateral dissection of the pararectal and retrorectal spaces. Para- and retrosigmoido-rectal spaces are developed laparoscopically along the coccygeosacral

Marc Possover; Herbert Diebolder; Karin Plaul; Achim Schneider

2000-01-01

317

Is laparoscopic hysterectomy a waste of time?  

Microsoft Academic Search

SummaryLaparoscopic hysterectomy (LH) is a way to avoid laparotomy. However, there is evidence that most women treated by abdominal hysterectomy are suitable for vaginal surgery. To test this hypothesis, and to determine the relative merits of laparoscopic and vaginal hysterectomy (VH) and the best technique for LH, we prospectively studied 98 women who had relative contraindications for vaginal surgery by

R. E Richardson; N Bournas; A. L Magos

1995-01-01

318

Laparoscopic correction of right transverse colostomy prolapse.  

PubMed

Colostomy prolapse is a frequently seen complication of transverse colostomy. In one child with recurrent stoma prolapse, we performed a loop-to-loop fixation and peritoneal tethering laparoscopically. No prolapse had recurred at follow-up. Laparoscopic repair of transverse colostomy prolapse seems to be a less invasive method than other techniques. PMID:23879415

Gundogdu, Gokhan; Topuz, Ufuk; Umutoglu, Tarik

2013-08-01

319

OBSTETRIC TRAUMA, PELVIC FLOOR INJURY AND FECAL INCONTINENCE: A POPULATION-BASED CASE-CONTROL STUDY  

PubMed Central

Background and Aims Current concepts based on referral center data suggest that pelvic floor injury from obstetric trauma is a major risk factor for fecal incontinence (FI) in women. In contrast, a majority of community women only develop FI decades after vaginal delivery, and obstetric events are not independent risk factors for FI. However, obstetric events are imperfect surrogates for anal and pelvic floor injury, which is often clinically occult. Hence, our objectives were to evaluate the relationship between prior obstetric events, pelvic floor injury, and FI among community women. Design In this nested case-control study of 68 women with FI (cases; mean age 57y) and 68 age-matched controls from a population-based cohort in Olmsted County, MN, pelvic floor anatomy and motion during voluntary contraction and defecation were assessed by MRI. Obstetric events and bowel habits were recorded. Results By multivariable analysis, internal sphincter injury (cases-28%, controls-6%; odds ratio [OR], 8.8; 95% CI, 2.3–34) and reduced perineal descent during defecation (cases-2.6 ± 0.2 cm, controls-3.1 ± 0.2 cm; OR, 1.7; 95% CI, 1.2–2.4) increased FI risk, but external sphincter injury (cases-25%, controls-4%;p < 0.005) was not independently predictive. Puborectalis injury was associated (p<0.05) with impaired anorectal motion during squeeze, but was not independently associated with FI. Grade 3–4 episiotomy (OR, 3.9; 95% CI, 1.4–11) but not other obstetric events increased the risk for pelvic floor injury. Heavy smoking (? 20 pack-years) was associated (p=0.052) with external sphincter atrophy. Conclusions State-of-the-art imaging techniques reveal pelvic floor injury or abnormal anorectal motion in a minority of community women with FI. Internal sphincter injury and reduced perineal descent during defecation are independent risk factors for FI. In addition to grade 3–4 episiotomy, smoking may be a potentially preventable, risk factor for pelvic floor injury. PMID:22415196

Bharucha, Adil E.; Fletcher, J.G.; Melton, L. Joseph; Zinsmeister, Alan R.

2012-01-01

320

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

321

Correlation of symptoms with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse?  

Microsoft Academic Search

OBJECTIVE: The purpose of this study was to evaluate the correlation between the symptoms of pelvic organ prolapse and the stage of support as determined by the pelvic organ prolapse quantification system.STUDY DESIGN: Four hundred ninety-seven women who were seen for annual gynecologic examinations were recruited. Subjects underwent a pelvic examination and their degree of pelvic support was described according

Steven E Swift; Susan B Tate; Joyce Nicholas

2003-01-01

322

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

323

CARO: The Common Anatomy Reference Ontology  

Microsoft Academic Search

The Canonical Anatomy Reference Ontology (CARO) is being developed to facilitate interoperability between existing anatomy ontologies for different species, and will provide a template for building new anatomy ontologies. CARO has a structural axis of classification based on the top-level nodes of the Foundational Model of Anatomy. CARO will complement the developmental process sub-ontology of the GO Biological Process ontology,

D. S. Neuhaus; Duncan Davidson; Richard Baldock

324

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

325

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

326

Pelvic incidence: a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves  

Microsoft Academic Search

This paper proposes an anatomical parameter, the pelvic incidence, as the key factor for managing the spinal balance. Pelvic\\u000a and spinal sagittal parameters were investigated for normal and scoliotic adult subjects. The relation between pelvic orientation,\\u000a and spinal sagittal balance was examined by statistical analysis. A close relationship was observed, for both normal and scoliotic\\u000a subjects, between the anatomical parameter

J. Legaye; G. Duval-Beaupère; J. Hecquet; C. Marty

1998-01-01

327

Pelvic Floor Muscle Training in Prevention and Treatment of Pelvic Organ Prolapse  

Microsoft Academic Search

\\u000a This chapter describes the four randomized controlled trials (RCTs) published on the effect of pelvic floor muscle training\\u000a (PFMT) to treat pelvic organ prolapse (POP) and symptoms of prolapse. The results of all four trials show a significant effect\\u000a of PFMT. However, to date there is only one full-scale RCT using the gold standard Pelvic Organ Prolapse Quantification (POP-Q)\\u000a system

Kari Bø; Ingeborg Hoff Brækken

328

D-light for laparoscopic fluorescence diagnosis  

NASA Astrophysics Data System (ADS)

To evaluate the role of ALA induced fluorescence diagnosis in laparoscopic surgery, we induced peritoneal carcinosis in rats by multilocular intraabdominal tumorcell implantation (CC531). The animals were photosensitized by intraabdominal ALA lavage. Laparoscopy was performed with both, conventional white and then blue light (D-Light, KARL STORZ Germany) excitation. Laparoscopy with conventional white light showed peritoneal carcinoma foci from 0.1 to 2 cm in diameter. All macroscopically visible tumors (n equals 142) were fluorescence positive after laparoscopic blue light excitation. In addition, 30 laparoscopic not visible (white light) tumors showed fluorescence and were histologically confirmed as colon carcinoma metastases. We conclude that only ALA induced laparoscopic fluorescence detection after blue light excitation is the adequate method to detect the entire extent of the intraabdominal tumor spread. Fluorescence laparoscopy is essential for laparoscopic staging of colorectal cancer because of a higher rate of cancer foci detection.

Gahlen, Johannes; Laubach, Hans-Heinrich; Stern, Josef; Pressmar, Jochen; Pietschmann, Mathias; Herfarth, Christian

1999-07-01

329

Online Resources: Anatomy  

NSDL National Science Digital Library

The University of Alberta has several dozen excellent annotated subject guides for use by its academic community. In an act of great benevolence, it has offered up this guide to the world of anatomy at no charge. On this site visitors can browse through over a dozen helpful sites that provide teaching materials, atlases, quizzes, and other materials that will help medical students and health care professionals. Two of the most useful items here are the "Cells Alive!" site and the "eSkeletons Project" from the University of Texas at Austin. Additionally, users are encouraged to leave their own suggestions for sites that they feel might be an excellent contribution to the site.

330

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

331

Changes in Sexual Function and Comparison of Questionnaires Following Surgery for Pelvic Organ Prolapse  

PubMed Central

Purpose The aim of this study was to evaluate the effect of surgical repair of pelvic organ prolapse on female sexual function and to assess correlations between the two using two current standardized questionnaires. Materials and Methods From October 2009 to September 2010, 143 patients with posterior compartment or combined vaginal prolapse were included. We assessed surgical outcomes according to anatomical change in the vagina and results of the Female Sexual Function Index (FSFI) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Function questionnaire (PISQ-12) both pre- and postoperatively. Results Among the 143 preoperative patients, 99 and 84 patients responded to the PISQ-12 and FSFI, respectively. The mean PISQ-12 score increased after surgery (p<0.001). Specifically, postoperative scores for questions 8 and 12 were higher than their respective preoperative scores (p<0.001). Postoperatively, mean FSFI score changed only slightly (p=0.76), and only the score for the satisfaction domain was improved (p=0.023). In regards to vaginal anatomy, vaginal length was significantly greater postoperatively (6.99±0.18 vs. 7.56±1.08, p<0.001), and postoperative vaginal caliber was narrowed to a two-finger width. Conclusion In this study, surgery for pelvic organ prolapse was shown to affect female sexual function. Moreover, menopause was associated with a change in postoperative sexual function. PMID:24339303

Kim, Soo Rim; Moon, Yeo Jung; Kim, Sei Kwang

2014-01-01

332

Dynamics of Female Pelvic Floor Function Using Urodynamics, Ultrasound and Magnetic Resonance Imaging (MRI)  

PubMed Central

In this review the diagnostic potential of evaluating female pelvic floor muscle (PFM)) function using magnetic and ultrasound imaging in the context of urodynamic observations is considered in terms of determining the mechanisms of urinary continence. A new approach is used to consider the dynamics of PFM activity by introducing new parameters derived from imaging. Novel image processing techniques are applied to illustrate the static anatomy and dynamics PFM function of stress incontinent women pre and post operatively as compared to asymptomatic subjects. Function was evaluated from the dynamics of organ displacement produced during voluntary and reflex activation. Technical innovations include the use of ultrasound analysis of movement of structures during maneuvers that are associated with external stimuli. Enabling this approach is the development of criteria and fresh and unique parameters that define the kinematics of PFM function. Principal among these parameters, are displacement, velocity, acceleration and the trajectory of pelvic floor landmarks. To accomplish this objective, movement detection, including motion tracking algorithms and segmentation algorithms were developed to derive new parameters of trajectory, displacement, velocity and acceleration, and strain of pelvic structures during different maneuvers. Results highlight the importance of timing the movement and deformation to fast and stressful maneuvers, which are important for understanding the neuromuscular control and function of PFM. Furthermore, observations suggest that timing of responses is a significant factor separating the continent from the incontinent subjects. PMID:19303690

Constantinou, Christos E.

2009-01-01

333

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

334

MDCT evaluation of potential living renal donor, prior to laparoscopic donor nephrectomy: What the transplant surgeon wants to know?  

PubMed

As Laparoscopic Donor Nephrectomy (LDN) offers several advantages for the donor such as lesser post-operative pain, fewer cosmetic concerns and faster recovery time, there is growing global trend towards LDN as compared to open nephrectomy. Comprehensive pre-LDN donor evaluation includes assessment of renal morphology including pelvi-calyceal and vascular system. Apart from donor selection, evaluation of the regional anatomy allows precise surgical planning. Due to limited visualization during laparoscopic renal harvesting, detailed pre-transplant evaluation of regional anatomy, including the renal venous anatomy is of utmost importance. MDCT is the modality of choice for pre-LDN evaluation of potential renal donors. Apart from appropriate scan protocol and post-processing methods, detailed understanding of surgical techniques is essential for the Radiologist for accurate image interpretation during pre-LDN MDCT evaluation of potential renal donors. This review article describes MDCT evaluation of potential living renal donor, prior to LDN with emphasis on scan protocol, post-processing methods and image interpretation. The article laid special emphasis on surgical perspectives of pre-LDN MDCT evaluation and addresses important points which transplant surgeons want to know. PMID:25489130

Ghonge, Nitin P; Gadanayak, Satyabrat; Rajakumari, Vijaya

2014-10-01

335

MDCT evaluation of potential living renal donor, prior to laparoscopic donor nephrectomy: What the transplant surgeon wants to know?  

PubMed Central

As Laparoscopic Donor Nephrectomy (LDN) offers several advantages for the donor such as lesser post-operative pain, fewer cosmetic concerns and faster recovery time, there is growing global trend towards LDN as compared to open nephrectomy. Comprehensive pre-LDN donor evaluation includes assessment of renal morphology including pelvi-calyceal and vascular system. Apart from donor selection, evaluation of the regional anatomy allows precise surgical planning. Due to limited visualization during laparoscopic renal harvesting, detailed pre-transplant evaluation of regional anatomy, including the renal venous anatomy is of utmost importance. MDCT is the modality of choice for pre-LDN evaluation of potential renal donors. Apart from appropriate scan protocol and post-processing methods, detailed understanding of surgical techniques is essential for the Radiologist for accurate image interpretation during pre-LDN MDCT evaluation of potential renal donors. This review article describes MDCT evaluation of potential living renal donor, prior to LDN with emphasis on scan protocol, post-processing methods and image interpretation. The article laid special emphasis on surgical perspectives of pre-LDN MDCT evaluation and addresses important points which transplant surgeons want to know. PMID:25489130

Ghonge, Nitin P; Gadanayak, Satyabrat; Rajakumari, Vijaya

2014-01-01

336

Characterization of a near-infrared laparoscopic hyperspectral imaging system for minimally invasive surgery.  

PubMed

We developed and characterized a new imaging platform for minimally invasive surgical venues, specifically a system to help guide laparoscopic surgeons to visualize biliary anatomy. This platform is a novel combination of a near-infrared hyperspectral imaging system coupled with a conventional surgical laparoscope. Intraoperative tissues are illuminated by optical fibers arranged in a ring around a center-mounted relay lens collecting back-reflected light from tissues to the hyperspectral imaging system. The system consists of a focal plane array (FPA) and a liquid crystal tunable filter, which is continuously tunable in the near-infrared spectral range of 650-1100 nm with the capability of passing light with a mean bandwidth of 6.95 nm, and the FPA is a high-sensitivity back-illuminated, deep depleted charge-coupled device. Placing a standard resolution target 5.1 cm from the distal end of the laparoscope, a typical intraoperative working distance, produced a 7.6-cm-diameter field of view with an optimal spatial resolution of 0.24 mm. In addition, the system's spatial and spectral resolution and its wavelength tuning accuracy are characterized. The spectroscopic images are formatted into a three-dimensional hyperspectral image cube and processed using principle component analysis. The processed images provide contrast based on measured spectra associated with chemically different anatomical structures helping identify the main molecular chromophores inherent to each tissue. The principal component images were found to image swine gallbladder and biliary structures from surrounding tissues, in real time, during cholecystectomy surgery. Furthermore, it is shown that surgeons can interrogate selected image subregions for their molecular composition identifying biliary anatomy during surgery and before any invasive action is undertaken. PMID:17492839

Zuzak, Karel J; Naik, Sabira C; Alexandrakis, George; Hawkins, Doyle; Behbehani, Khosrow; Livingston, Edward H

2007-06-15

337

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

338

Unstable pelvic fractures: a retrospective analysis  

Microsoft Academic Search

Thirty-nine patients with unstable pelvic fractures were analysed retrospectively. The mean age of the group was 41 years (range 15–77). Of these cases 35 had sustained high energy trauma. The mean Hospital Trauma Index-Injury Severity Score of the population was 32 (16–66). Nine cases were haemodynamically unstable on admission. The type of unstable pelvic fracture was classified according to Tile.

I. H. P. A. A. van Veen; A. A. M. van Leeuwen; T. van Popta; P. A. van Luyt; P. J. Bode; A. B. van Vugt

1995-01-01

339

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

340

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....

341

The anatomy of the mermaid.  

PubMed

Investigation of the anatomy of the mermaid and of mermaid lore has revealed a tangled web of stories, sightings and specimens of the most diverse nature, extending worldwide into the realms of folklore and legend, zoology and cryptozoology, anatomy, physiology, radiography and folk medicine, ethnography, social history and the history of science. The stereotype we know as the mermaid is surely a fit subject for further serious study PMID:11620025

Heppell, D

342

[Laparoscopic and general surgery guided by open interventional magnetic resonance].  

PubMed

Interventional magnetic resonance (IMR) machines have produced unique opportunity for image-guided surgery. The open configuration design and fast pulse sequence allow virtual real time intraoperative scanning to monitor the progress of a procedure, with new images produced every 1.5 sec. This may give greater appreciation of anatomy, especially deep to the 2-dimensional laparoscopic image, and hence increase safety, reduce procedure magnitude and increase confidence in tumour resection surgery. The aim of this paper was to investigate the feasibility of performing IMR-image-guided general surgery, especially in neoplastic and laparoscopic field, reporting a single center -- St. Mary's Hospital (London, UK) -- experience. Procedures were carried out in a Signa 0.5 T General Elettric SP10 Interventional MR (General Electric Medical Systems, Milwaukee, WI, USA) with magnet-compatible instruments (titanium alloy instruments, plastic retractors and ultrasonic driven scalpel) and under general anesthesia. There were performed 10 excision biopsies of palpable benign breast tumors (on female patients), 3 excisions of skin sarcoma (dermatofibrosarcoma protuberans), 1 right hemicolectomy and 2 laparoscopic cholecystectomies. The breast lesions were localized with pre- and postcontrast (intravenous gadolinium DPTA) sagittal and axial fast multiplanar spoiled gradient recalled conventional Signa sequences; preoperative real time fast gradient recalled sequences were also obtained using the flashpoint tracking device. During right hemicolectomy intraoperative single shot fast spin echo (SSFSE) and fast spoiled gradient recalled (FSPGR) imaging of right colon were performed after installation of 150 cc of water or 1% gadolinium solution, respectively, through a Foley catheter; imaging was also obtained in an attempt to identify mesenteric lymph nodes intraoperatively. Concerning laparoscopic procedures, magnetic devices (insufflator, light source) were positioned outside scan room, the tubing and light head being passed through penetration panels. Intraoperative MR-cholangiography was performed using fast spin echo (SSFSE) techniques with minimal intensity projection 3-dimensional reconstruction. About skin sarcomas, 2 of them were skin recurrences of previously surgically treated sarcomas (all of them received preoperative biopsy) and the extent of the lesion was then determined using short tau inversion recovery (STIR) sequence. The skin was closed in each case without need for any plastic reconstruction. The breast lesions were visualized with both Signa and real-time imaging and all enhanced with contrast: 2 (20%) were visualized only after contrast enhancement; intraoperative real time imaging clearly demonstrated a resection margin in all cases. Maximum dimensions of breast specimens (range 8-50 mm, median 24.5 mm) were not significantly different from those measured by Signa (p>0.17, Student's paired t-test) or real time images (p>0.4): also there was no significant difference in lesion size between Signa and real time images (p>0.25). All postprocedure scans clearly demonstrated complete excision. The extent of the tumor at MR imaging was greater in each case than suggested by clinical examination. Adequate resection margins were planned using STIR sequences. Histological examination confirmed clear surgical margins of at least 1 cm in each case. During right hemicolectomy, both intraoperative SSFSE and FSPGR contrast imaging revealed the lesion and details of the colonic surface; imaging of the lymph node draining right colon was only partially successful, due to movement artifact. Concerning laparoscopic procedures, both FSE and SSFSE techniques produced reasonable images of the gallbladder and intrahepatic ducts, but the FSE imaging was of poor quality due to respiration artifact; however, SSFSE allowed visualization of the gallbladder and part of the common bile duct. About skin sarcomas, the extent of the tumor at MR imaging was greater in each case than suggested by clinical examination and in each case the com

Lauro, A; Gould, S W T; Cirocchi, R; Giustozzi, G; Darzi, A

2004-10-01

343

Is cirrhosis a contraindication to laparoscopic cholecystectomy?  

PubMed

Laparoscopic cholecystectomy is the gold standard treatment for the vast majority of patients with symptomatic cholelithiasis. Although cirrhotic patients are twice as likely to develop gallstones as compared with noncirrhotic patients, cirrhosis has historically been considered a relative, if not absolute, contraindication to laparoscopic cholecystectomy. More recently a number of authors have reported on the safety of laparoscopic cholecystectomy in cirrhotic patients. We reviewed our patients retrospectively and assessed the safety of laparoscopic cholecystectomy in cirrhotic patients as compared with noncirrhotics at a large liver transplant center. A retrospective longitudinal cohort study was conducted of all laparoscopic cholecystectomies performed by our surgical group between August 2002 and April 2011. Of 63 patients undergoing laparoscopic cholecystectomy, 32 (51%) were cirrhotic. Of the 30 for whom a Child score could be calculated, 11 (34%) were Child A, 14 (44%) were Child B, and five (16%) were Child C. The morbidity rate was 33 per cent and mortality rate was 2 per cent. Length of stay, conversion rates, 30-day readmission rates, and morbidity and mortality rates were not significantly different between the cirrhotic and noncirrhotic groups. There was a trend toward higher complication rates in Child C cirrhotics. Our results indicate that laparoscopic cholecystectomy can be performed with acceptable morbidity and mortality in carefully selected cirrhotic patients. PMID:25569066

McGillicuddy, John W; Villar, Juan José E; Rohan, Vinayak S; Bazaz, Sapna; Taber, David J; Pilch, Nicole A; Baliga, Prabhakar K; Chavin, Kenneth D

2015-01-01

344

Laparoscopic Cholecystectomy in Cirrhotic Patients  

PubMed Central

Background and Objectives: Gallstones are twice as common in cirrhotic patients as in the general population. Although laparoscopic cholecystectomy (LC) has become the gold standard for symptomatic gallstones, cirrhosis has been considered an absolute or relative contraindication. Many authors have reported on the safety of LC in cirrhotic patients. We reviewed our patients retrospectively and assessed the safety of LC in cirrhotic patients at a tertiary care hospital in Pakistan. Methods: From January 2003 to December 2005, a retrospective study was conducted at SU IV, Liaquat University of Medical & Health Sciences Jamshoro. All the cirrhotic patients with Child-Pugh class A and B cirrhosis undergoing LC were included in the study. Cirrhosis was diagnosed based on clinical, biochemical, ultrasonography, and intraoperative findings of the nodular liver and histopathological study. Results: Of 250 patients undergoing laparoscopic cholecystectomy, 20 (12.5%) were cirrhotic. Of these 20, 12 (60%) were Childs group A and 8 (40%) were group B. Thirty percent were hepatitis B positive, and 70% were hepatitis C positive. Preoperative diagnosis of cirrhosis was possible in 80% of cases, and 20% were diagnosed during surgery. Morbidity rate was 15% and mortality rate was 0%. Two patients developed postoperative ascites, and mean hospital stay was 2.8±0.1 days. Of the 20 cases, 2 (10%) were converted to open cholecystectomy. The mean operation time was 70.2±32.54 minutes. Conclusion: Laparoscopic cholecystectomy is an effective and safe treatment for symptomatic gallstone disease in select patients with Child-Pugh A and B cirrhosis. The advantages over open cholecystectomy are the lower morbidity rate and reduced hospital stay. PMID:20202403

Muneer, Ambreen

2009-01-01

345

Chronic Pelvic Pain due to Pelvic Congestion Syndrome: The Role of Diagnostic and Interventional Radiology  

SciTech Connect

Chronic pelvic pain (CPP) is a common cause of gynecologic referral. Pelvic congestion syndrome, which is said to occurs due to ovarian vein incompetence, is a recognized cause of CPP. The aim of this paper is to briefly describe the clinical manifestations, and to review the role of diagnostic and interventional radiology in the management of this probably under-diagnosed condition.

Ganeshan, Arul; Upponi, Sara [John Radcliffe Hospital, Department of Radiology (United Kingdom); Hon, Lye-Quen [The Royal Hallamshire Hospital, Department of Radiology (United Kingdom); Uthappa, M. C.; Warakaulle, Dinuke R. [Stoke Mandeville Hospital, Department of Radiology (United Kingdom); Uberoi, Raman [John Radcliffe Hospital, Department of Radiology (United Kingdom)], E-mail: raman.uberoi@orh.nhs.uk

2007-11-15

346

Laparoscopic approach to Meckel's diverticulum  

PubMed Central

AIM: To retrospective review the laparoscopic management of Meckel Diverticulum (MD) in two Italian Pediatric Surgery Centers. METHODS: Between January 2002 and December 2012, 19 trans-umbilical laparoscopic-assisted (TULA) procedures were performed for suspected MD. The children were hospitalized for gastrointestinal bleeding and/or recurrent abdominal pain. Median age at diagnosis was 5.4 years (range 6 mo-15 years). The study included 15 boys and 4 girls. All patients underwent clinical examination, routine laboratory tests, abdominal ultrasound and technetium-99m pertechnetate scan, and patients with bleeding underwent gastrointestinal endoscopy. The abdominal exploration was performed with a 10 mm operative laparoscope. Pneumoperitoneum was established based on the body weight. Systematic overview of the peritoneal cavity allowed the ileum to be grasped with an atraumatic instrument. The complete exploration and surgical treatment of MD were performed extracorporeally, after intestinal exteriorization through the umbilicus. All patients’ demographics, main clinical features, diagnostic investigations, operative time, histopathology reports, conversion rate, hospital stay and complications were registered and analyzed. RESULTS: MD was identified in 17 patients, while 1 had an ileal duplication and 1 a jejunal hemangioma. Fifteen patients had painless intestinal bleeding, while 4 had recurrent abdominal pain and exhibited cyst like structures in an ultrasound study. Eleven patients had a positive technetium-99m pertechnetate scan. In the patients with bleeding, gastrointestinal endoscopy did not name the source of hemorrhage. All patients were subjected to a TULA surgical procedure. An intestinal resection/anastomosis was performed in 14 patients, while 4 had a wedge resection of the diverticulum and 1 underwent stapling diverticulectomy. All surgical procedures were performed without conversion to open laparotomy. Mean operative time was 75 min (range 40-115 min). No major surgical complications were recorded. The median hospital stay was 5-7 d (range 4-13 d). All patients are asymptomatic at a median follow up of 4, 5 years (range 10 mo-10 years). CONCLUSION: Trans-umbilical laparoscopic-assisted Meckel’s diverticulectomy is safe and effective in the treatment of MD, with excellent results. PMID:25009390

Papparella, Alfonso; Nino, Fabiano; Noviello, Carmine; Marte, Antonio; Parmeggiani, Pio; Martino, Ascanio; Cobellis, Giovanni

2014-01-01

347

[Value of intraoperative laparoscopic cholangiography].  

PubMed

Discussion about the necessity of intraoperative cholangiography restarted when laparoscopic cholecystectomy was established. The value of cholangiography was examined in a prospectively randomized study of one hundred patients. We could show that the routinely performed intraoperative cholangiography represents a careful, secure and sensitive method for the detection of common bile duct stones. As it is not very time consuming nor linked to high costs we believe it to be unrenouncible. It allows a detailed anatomic presentation and may be combined with ERCP for definitive treatment of bile duct stones. PMID:9206908

Tusek, D; Hufschmidt, M; Raguse, T

1997-01-01

348

[LAPAROSCOPIC SURGERY IN DIGESTIVE SYSTEM  

PubMed

The principal procedures of digestive surgery to be made by laparoscopy are mentioned. Some of them (Cholecystectomy, Fundoplication, highly selective Vagotomy, some diagnosis procedures, etc.) are perfectly consolidated, and they are the chosen procedures for they have passed the test of time and experience.However, some other procedures are still a controversial topic, and it is expected that in the near future they will be defined, according to results.Some indications are emerging as for example the Laparoscopic Staging of certain digestive cancers. lf its feasibility and efficacy is demonstrated, it will be a new tool with which the doctor in change will count with for his patients' benefit. PMID:12271342

De Vinatea, José

1998-01-01

349

Laparoscopic repair of complicated umbilical hernia with Strattice Laparoscopic™ reconstructive tissue matrix  

PubMed Central

INTRODUCTION Complex hernias continue to present a challenge. Surgical techniques for repair are carefully considered to reduce risk for complications. Laparoscopic repairs improve postoperative infection rates, and placement of biologic mesh decreases mesh infection rates. However, laparoscopic repairs using biologic mesh is generally challenging due to difficulty with maneuverability. PRESENTATION OF CASE We present a case of a complex ventral hernia that was laparoscopically repaired using a new FDA cleared laparoscopic biologic graft. The patient had multiple comorbidities, including obesity, hepatitis C, endocarditis secondary to IV drug use, tobacco smoking, bilateral inguinal hernia, and recurrent umbilical hernia. The recurrent hernia was larger, irreducible, and discolored compared to original defect. The patient underwent laparoscopic repair with primary closure and reinforcement with Strattice™ Tissue Matrix Laparoscopic (LifeCell Corporation, Branchburg, NJ). At nine months postoperative, the patient had no evidence of recurrence, infection, or chronic pain, demonstrating early success from the surgical management. DISCUSSION Presence of multiple comorbidities and incarcerated recurrent hernia increase risk for complications during and/or after hernia repair. Considering these factors, laparoscopic repair with Strattice Laparoscopic and defect closure was a reasonable technique for repair. CONCLUSION Laparoscopic suture repair reinforced with biologic dermal tissue matrix was successfully performed during a complex hernia repair. PMID:25437666

Tsuda, Shawn

2014-01-01

350

Acute effects of pelvic irradiation on the adult uterus revealed by dynamic contrast-enhanced MRI  

PubMed Central

Objective: Pelvic radiation therapy (RT) can influence fertility in female rectal cancer survivors. Data regarding its effects on the adult uterus are scant. This study aims to evaluate the uterus before and after RT, using dynamic contrast-enhanced MRI. Methods: Eligible patients (n=10) received RT for rectal cancer, had an intact uterus and underwent dynamic contrast-enhanced MRI before and after RT. Seven patients were pre-menopausal. Results: Patients received pelvic RT (median, 50.2?Gy) with concurrent 5-fluorouracil. Five patients were treated with intensity modulated RT (IMRT) and five with a three-field technique. The median D95 of the uterus was 30?Gy; D05 was 48?Gy; and V95 was 97%. The median cervical D95 was 45?Gy; D05, 50?Gy; and V95, 100%. Cervical dose was higher with IMRT than with three-field plans (p?0.038). On T2 MRI, the junctional zone was visible in nine patients before and in one after RT (p=0.001). Median cervical length (2.3 vs 3.0?cm) and endometrial thickness (2.6 vs 5.9?mm) were reduced after RT (p?0.008). In pre-menopausal patients, the volume transfer constant, Ktrans, (0.069 vs 0.195, p=0.006) and the extracellular extravascular volume fraction, Ve, (0.217 vs 0.520, p=0.053) decreased. Conclusion: Pelvic RT significantly affected uterine anatomy and perfusion. Cervical dose was higher with IMRT than three-field plans, but no attempt was made to constrain the dose. Advances in knowledge: Pelvic RT significantly affects the adult uterus. These findings are crucial to understand the potential consequences of RT on fertility, and they lay the groundwork for further prospective studies. PMID:24052311

Milgrom, S A; Alberto Vargas, H; Sala, E; Frankel Kelvin, J; Hricak, H

2013-01-01

351

Laparoscopic Heminephrectomy of a Horseshoe Kidney  

PubMed Central

Minimally invasive surgery has revolutionized surgery for urologic disorders, and laparoscopic procedures have become widely available for several different ablative and reconstructive operations. Laparoscopic heminephrectomy in patients with horseshoe kidney can be a technically challenging procedure due to aberrant vessels, functional parenchyma in the isthmus, and abnormal location. We report the management of a case of symptomatic nonfunctioning left moiety of a horseshoe kidney with emphasis on its surgical technique combined with a review of the literature. Laparoscopic heminephrectomy is a feasible option in the surgical management of benign and malignant conditions of the horseshoe kidney and can be performed safely using a transperitoneal or a retroperitoneal approach. PMID:21985738

Khan, Atif; Myatt, Andrew; Palit, Victor

2011-01-01

352

Laparoscopic excision of a retrorectal schwannoma.  

PubMed

Retrorectal tumors are uncommon and are usually managed by open surgical excision. Recent advances in laparoscopic techniques have led to the use of laparoscopy for a variety of problems in colorectal surgery, including the excision of retrorectal tumours. This case report, which describes the laparoscopic excision of a benign schwannoma arising from the second sacral nerve root, highlights the benefits of accurate preoperative diagnosis with MR imaging and the advantages of a laparoscopic approach while pointing out principles that should be adhered to when using this approach. The tumour was successfully resected without neural compromise and with a prompt and full postoperative recovery. PMID:20454822

Rao, M; Sagar, P; Duff, S; Hulme-Moir, M; Brayshaw, I

2010-12-01

353

Penile embryology and anatomy.  

PubMed

Knowledge of penile embryology and anatomy is essential to any pediatric urologist in order to fully understand and treat congenital anomalies. Sex differentiation of the external genitalia occurs between the 7th and 17th weeks of gestation. The Y chromosome initiates male differentiation through the SRY gene, which triggers testicular development. Under the influence of androgens produced by the testes, external genitalia then develop into the penis and scrotum. Dorsal nerves supply penile skin sensation and lie within Buck's fascia. These nerves are notably absent at the 12 o'clock position. Perineal nerves supply skin sensation to the ventral shaft skin and frenulum. Cavernosal nerves lie within the corpora cavernosa and are responsible for sexual function. Paired cavernosal, dorsal, and bulbourethral arteries have extensive anastomotic connections. During erection, the cavernosal artery causes engorgement of the cavernosa, while the deep dorsal artery leads to glans enlargement. The majority of venous drainage occurs through a single, deep dorsal vein into which multiple emissary veins from the corpora and circumflex veins from the spongiosum drain. The corpora cavernosa and spongiosum are all made of spongy erectile tissue. Buck's fascia circumferentially envelops all three structures, splitting into two leaves ventrally at the spongiosum. The male urethra is composed of six parts: bladder neck, prostatic, membranous, bulbous, penile, and fossa navicularis. The urethra receives its blood supply from both proximal and distal directions. PMID:20602076

Yiee, Jenny H; Baskin, Laurence S

2010-01-01

354

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

355

Laparoscopic Liver Mobilization: Tricks of the Trade to Avoid Complications  

PubMed Central

Laparoscopic liver resection is gaining popularity because of the availability of new laparoscopic instruments and advanced techniques. Laparoscopic liver mobilization is not only necessary for pure laparoscopic liver resection but also for laparoscopy-assisted hepatectomy. Laparoscopy-assisted hepatectomy significantly reduces the length of the laparotomy incision, and it is a good educational transition to the more advanced laparoscopic liver resection. Laparoscopic liver mobilization is a simple and easy procedure if surgeons know what challenges to expect. Here, the technique of liver mobilization is summarized, along with those challenges. PMID:25370795

Ikoma, Naruhiko; Oshima, Go; Kitagawa, Yuko

2015-01-01

356

Laparoscopic liver mobilization: tricks of the trade to avoid complications.  

PubMed

Laparoscopic liver resection is gaining popularity because of the availability of new laparoscopic instruments and advanced techniques. Laparoscopic liver mobilization is not only necessary for pure laparoscopic liver resection but also for laparoscopy-assisted hepatectomy. Laparoscopy-assisted hepatectomy significantly reduces the length of the laparotomy incision, and it is a good educational transition to the more advanced laparoscopic liver resection. Laparoscopic liver mobilization is a simple and easy procedure if surgeons know what challenges to expect. Here, the technique of liver mobilization is summarized, along with those challenges. PMID:25370795

Ikoma, Naruhiko; Itano, Osamu; Oshima, Go; Kitagawa, Yuko

2015-02-01

357

Laparoscopically implanted system for stimulation of the hypogastric plexus induces colonic motility, defecation, and micturition: experimental study.  

PubMed

Background. Modulation of the enteric nervous system seems to be promising in several functional colorectal disorders for which targeted, causal treatment methods do not exist. However, sacral nerve stimulation can induce undesirable muscle contraction or paresthesia. Therefore, we have developed a laparoscopic technique for implanting a neural electrode, placed directly over the pelvic autonomic nerve plexus. The aim of this experimental study was to evaluate the effect of stimulating the hypogastric plexus and pelvic nerves on inducing distal colon contraction, defecation, and micturition. Method. A total of 10 white, male healthy pigs (25-30 kg) were subjected to the laparoscopic implantation of the electrode and the stimulator. In the third and fourth weeks postimplantation, the efficacy of the acute and chronic stimulation to induce defecation was evaluated. Results. The average operative time was 105 minutes (85-150 minutes). In all pigs, acute stimulation activated induced defecation, every second day, every time on demand, with an average delay of 139.7 s. Micturition was induced incidentally. Acute or chronic stimulation did not cause any harm, pain, or suffering to the animals. No adverse effects of the stimulation were observed, and no septic complications or macroscopic fibrosis around the electrodes were found on autopsy. Conclusion. Hypogastric plexus stimulation can be a useful and safe option of distal colon contraction, defecation, and micturition. However, the efficacy of the stimulation was observed for a relatively short period of time, and it is not known if it will be sustained for a longer duration. PMID:24756977

Sobocki, Jacek; Nowakowski, Michal; Herman, Roman M; Wa??ga, Piotr; Fr?czek, Mariusz; Tuz, Ryszard; Schwartz, Tomasz; Murawski, Maciej

2015-02-01

358

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

359

Uropathogenic Escherichia coli Induces Chronic Pelvic Pain ?  

PubMed Central

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a debilitating syndrome of unknown etiology often postulated, but not proven, to be associated with microbial infection of the prostate gland. We hypothesized that infection of the prostate by clinically relevant uropathogenic Escherichia coli (UPEC) can initiate and establish chronic pain. We utilized an E. coli strain newly isolated from a patient with CP/CPPS (strain CP1) and examined its molecular pathogenesis in cell culture and in a murine model of bacterial prostatitis. We found that CP1 is an atypical isolate distinct from most UPEC in its phylotype and virulence factor profile. CP1 adhered to, invaded, and proliferated within prostate epithelia and colonized the prostate and bladder of NOD and C57BL/6J mice. Using behavioral measures of pelvic pain, we showed that CP1 induced and sustained chronic pelvic pain in NOD mice, an attribute not exhibited by a clinical cystitis strain. Furthermore, pain was observed to persist even after bacterial clearance from genitourinary tissues. CP1 induced pelvic pain behavior exclusively in NOD mice and not in C57BL/6J mice, despite comparable levels of colonization and inflammation. Microbial infections can thus serve as initiating agents for chronic pelvic pain through mechanisms that are dependent on both the virulence of the bacterial strain and the genetic background of the host. PMID:21078846

Rudick, Charles N.; Berry, Ruth E.; Johnson, James R.; Johnston, Brian; Klumpp, David J.; Schaeffer, Anthony J.; Thumbikat, Praveen

2011-01-01

360

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. PMID:25264537

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

2014-01-01

361

Laparoscopic repair of parastomal hernias: early results  

Microsoft Academic Search

Background: Open repair of parastomal hernias is associated with high rates of morbidity and recurrence. Laparoscopic repair with mesh has been described, and good results have been reported in small case series with short-term follow-up. The purpose of this study was to review our institution’s experience with the laparoscopic repair of parastomal hernias. Methods: Nine patients with symptomatic parastomal hernias

B. Safadi

2004-01-01

362

Laparoscopic excision of a retrorectal schwannoma  

Microsoft Academic Search

Retrorectal tumors are uncommon and are usually managed by open surgical excision. Recent advances in laparoscopic techniques\\u000a have led to the use of laparoscopy for a variety of problems in colorectal surgery, including the excision of retrorectal\\u000a tumours. This case report, which describes the laparoscopic excision of a benign schwannoma arising from the second sacral\\u000a nerve root, highlights the benefits

M. Rao; P. Sagar; S. Duff; M. Hulme-Moir; I. Brayshaw

2010-01-01

363

Laparoscopic renal cryoablation in 32 patients  

Microsoft Academic Search

Objectives. Laparoscopic renal cryoablation is a developmental minimally invasive nephron-sparing treatment alternative for highly select patients with small renal tumors. We present our evolving experience with this procedure.Methods. Thirty-two patients (34 tumors) with a mean tumor size of 2.3 cm on preoperative computed tomography underwent laparoscopic renal cryoablation. As dictated by the tumor location, cryoablation was performed by either the

Inderbir S Gill; Andrew C Novick; Anoop M Meraney; Roland N Chen; Michael G Hobart; Gyung Tak Sung; Jonathan Hale; Dana K Schweizer; Erick M Remer

2000-01-01

364

Laparoscopic Approaches to Pancreatic Endocrine Tumors  

Microsoft Academic Search

\\u000a Pancreatic endocrine tumors (PETs) are rare. Resection is the only curative treatment [1, 2]. A brief overview of the pathophysiology\\u000a and classification of PETs along with epidemiology and survival data is presented. The role of various diagnostic imaging\\u000a modalities is discussed and appropriate patient selection is presented as a guide. Laparoscopic and hand-assisted laparoscopic\\u000a (HALS) approaches to distal pancreatectomy, with

John B. Martinie; Stephen M. Smeaton

365

Massive left hemothorax following laparoscopic pyeloplasty.  

PubMed

Laparoscopic pyeloplasty is viable standard minimally invasive alternative to open pyeloplasty for the treatment of ureteropelvic junction obstruction. Intrathoracic bleeding is an extremely rare complication after laparoscopic urological surgery, but it should be suspected and promptly diagnosed in case of worsening hemodynamic status and respiratory parameters during the intra or post-operative course. We report a case of hemothorax complicating an otherwise uneventful LP in an 18-year-old girl. PMID:25378831

Rao, Manjula; D'Souza, Nischith; Khan, Altaf; Rahiman, Mujeebu

2014-10-01

366

[Large simple liver cyst treated laparoscopically].  

PubMed

Simple liver cysts of various sizes are present in 1% of the population. Most are found incidentally and require no treatment. However, in a few the cyst is symptomatic and requires surgery: celiotomy and unroofing of the cyst. A 64-year-old woman with a symptomatic, simple cyst of the liver underwent laparoscopic surgery. After an uneventful course she was discharged on the 3rd postoperative day. Simple liver cysts can be safely treated by laparoscopic surgery. PMID:8138207

Lazauskas, T; Greif, F; Michowitz, M; Lelcuk, S

1994-01-01

367

Laparoscopic Colorectal Surgery in Obese Patients  

Microsoft Academic Search

Background: The aim of the study was to the evaluate results of laparoscopic colorectal surgery in obese patients. Methods:\\u000a All patients who underwent elective laparoscopic colorectal surgery from January 1993 to December 2003 were included in the\\u000a study. BMI >30 was used as an objective obesity criterion. The evaluated parameters included BMI, age, sex, diagnosis and\\u000a associated diseases, American Society

Jan Dostalík; Lubomír Martínek; Petr Vávra; Petr Andel; Igor Gunka; Petra Gunková

2005-01-01

368

Laparoscopic liver resection of benign liver tumors  

Microsoft Academic Search

  Objective: The objective of this study was to assess the feasibility, safety, and outcome of laparoscopic liver resection\\u000a for benign liver tumors in a multicenter setting. Background: Despite restrictive, tailored indications for resection in benign\\u000a liver tumors, an increasing number of articles have been published concerning laparoscopic liver resection of these tumors.\\u000a Methods: A retrospective study was performed in 18

B. Descottes; D. Glineur; F. Lachachi; D. Valleix; J. Paineau; A. Hamy; M. Morino; H. Bismuth; D. Castaing; E. Savier; P. Honore; O. Detry; M. Legrand; J. S. Azagra; M. Goergen; M. Ceuterick; J. Marescaux; D. Mutter; B. Hemptinne; R. Troisi; J. Weerts; B. Dallemagne; C. Jehaes; M. Gelin; V. Donckier; R. Aerts; B. Topal; C. Bertrand; B. Mansvelt; L. Krunckelsven; D. Herman; M. Kint; E. Totte; R. Schockmel; J. F. Gigot

2003-01-01

369

Vesicourethral dysfunction following pelvic visceral ablative surgery.  

PubMed

Management of vesicourethral dysfunction after a major extirpative pelvic visceral operation could be complex and difficult owing to the variety of partial and complete functional and anatomical derangements produced by the primary operation. We report our experience with 22 patients who suffered various types of vesicourethral dysfunctions after extirpative pelvic visceral surgery, 5 of whom had preoperative studies. The surgical procedures were abdominoperineal resection in 9 patients, proctocolectomy in 3, anterior resection of the rectum in 2 and radical hysterectomy in 8. All 22 patients underwent urodynamic evaluations. The abnormalities noted on the preoperative urodynamic evaluations in patients about to undergo extirpative pelvic visceral surgery suggest the need for routine preoperative assessment of the lower urinary tract for an accurate understanding of the postoperative changes. PMID:6471186

Yalla, S V; Andriole, G L

1984-09-01

370

CARO – The Common Anatomy Reference Ontology  

Microsoft Academic Search

The Common Anatomy Reference Ontology (CARO) is being developed to facilitate interoperability between existing anatomy ontologies\\u000a for different species, and will provide a template for building new anatomy ontologies. CARO has a structural axis of classification\\u000a based on the top-level nodes of the Foundational Model of Anatomy. CARO will complement the developmental process sub-ontology\\u000a of the GO Biological Process ontology,

Melissa A. Haendel; Fabian Neuhaus; David Osumi-Sutherland; Paula M. Mabee; L. V. Mejino Jr; Chris J. Mungall; Barry Smith

371

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

372

Breast anatomy for the interventionalist.  

PubMed

Normal breast anatomy can be seen on a variety of imaging modalities. Knowledge of normal breast anatomy on imaging examinations is important for an interventionalist, primarily to avoid mistaking normal anatomy for a pathologic disorder, so as not to harm a patient with an unnecessary intervention. Knowledge of breast anatomy is also critical in planning safe breast interventions and unwanted procedural complications. The key anatomical structures in the breast include skin, fat, fascial layers, Cooper ligaments, fibroglandular tissue, lymphatics, and neurovascular structures, all positioned over the chest wall. In men, the breast parenchyma is usually only composed of fat, with absence of fibroglandular tissue. In women, fibroglandular tissue volumes vary with age, with many women having a predominance of fat within the breasts after menopause. Embryologically, the breast develops under genetic and hormonal influence from skin precursor cells during the fourth through twelfth weeks of gestation, and the resulting breast bud continues to lengthen and branch throughout the remainder of gestation, forming a complex network of radially arranged breast ducts that connect the nipple with the mammary lobules. The key arterial blood supply to the breast arises from the internal thoracic artery, but additional arterial blood supply is seen from intercostal and lateral thoracic arteries. The venous anatomy and lymphatic drainage of the breast generally parallels the arterial anatomy, with presence of variation in communicating channels between deep and superficial venous and lymphatic channels. Tools that assess breast vascular structures (eg, contrast-enhanced breast magnetic resonance imaging) and lymphatic structures (nuclear medicine lymphoscintigraphy) are routinely used to assess extent of breast disease and help guide breast interventions. PMID:24636325

Jesinger, Robert A

2014-03-01

373

Management of pelvic injuries in pregnancy.  

PubMed

Pelvic fractures in pregnant women are usually high-energy injuries associated with risk of mortality to both mother and fetus. The mother's life always takes priority in the acute setting as it offers the best chance of survival to both the mother and the fetus. Indications for operative intervention of acute pubic symphysis rupture depend on presence of an open disruption, amount of displacement, and degree of disability. Chronic symphyseal instability related to pregnancy is a challenging problem and the first line of treatment is nonoperative care. A previous pelvic fracture is not a contraindication by itself to vaginal delivery. PMID:23827834

Amorosa, Louis F; Amorosa, Jennifer Harms; Wellman, David S; Lorich, Dean G; Helfet, David L

2013-07-01

374

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

375

Impact of pelvic radiotherapy on female sexuality  

Microsoft Academic Search

Purpose  To assess physical and psychological morbidity, sexual functioning and social and relationship satisfaction among women treated\\u000a with pelvic radiotherapy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Observational (case–control) study of 199 women: 98 submitted to pelvic radiotherapy for the treatment of uterine, rectal\\u000a or anal cancers and 101 without a personal history of cancer and similar socio-demographic variables. These completed a socio-demographic\\u000a and clinical questionnaire, and validated

Ana Cláudia Rodrigues; Rubina Teixeira; Tânia Teixeira; Sofia Conde; Paula Soares; Isabel Torgal

376

Comparative Punting Kinematics and Pelvic Fin Musculature of Benthic Batoids  

E-print Network

Comparative Punting Kinematics and Pelvic Fin Musculature of Benthic Batoids Laura J. Macesic motionless, the skate's pelvic fins are planted into the substrate and then retracted caudally, which thrusts punting,'' in which only the pelvic fins were engaged. The yellow stingray, Urobatis jamaicensis

Kajiura, Stephen

377

Adaptive Evolution of Pelvic Reduction in Sticklebacks by Recurrent Deletion  

E-print Network

Adaptive Evolution of Pelvic Reduction in Sticklebacks by Recurrent Deletion of a Pitx1 Enhancer are generally unknown. Pelvic loss in different natural populations of threespine stickleback fish has occurred regulatory mutations show molecular signatures of positive selection in pelvic-reduced populations

Chan, Yingguang

378

Parallel genetic origins of pelvic reduction in vertebrates  

E-print Network

Parallel genetic origins of pelvic reduction in vertebrates Michael D. Shapiro* , Michael A. Bell. Pelvic reduction in stickleback fish (family Gasterostei- dae) provides a striking example of parallel at the Pitx1 locus control pelvic reduction in a population of threespine sticklebacks (Gasterosteus aculeatus

Shapiro, Mike

379

INTRODUCTION Chronic prostatitis/chronic pelvic pain syndrome  

E-print Network

INTRODUCTION · Chronic prostatitis/chronic pelvic pain syndrome affects 5-10% of men pathophysiological correlates of CP/CPPS pain (prostate inflammation, endocrine abnormalities, pelvic floor muscle in Chronic Prostatitis / Chronic Pelvic Pain Syndrome M. A. Farmer1, M. L. Chanda1, E. L. Parks1, M. N

Apkarian, A. Vania

380

Does a pelvic belt influence sacroiliac joint laxity?  

Microsoft Academic Search

Objective. To evaluate the influence of different positions and tensions of a pelvic belt on sacroiliac joint laxity in healthy young women.Background. Clinical experience has shown that positive effects can be obtained with different positions and tensions of a pelvic belt. A functional approach to the treatment of the unstable pelvic girdle requires an understanding of the effect of a

Léonie Damen; Cornelis W Spoor; Chris J Snijders; Henk J Stam

2002-01-01

381

Pelvic Pain: Over looked and Underdiag- nosed Gynecologic  

Microsoft Academic Search

Chronic pelvic pain is a common, disabling problem among women. Although chronic pelvic pain can be produced by many conditions, some gynecologic causes are frequently overlooked and underdiag- nosed, resulting in inappropriate referral and inadequate treatment. The gynecologic conditions most often unrecognized are endometrio- sis, adenomyosis, pelvic congestion, and less common congenital and acquired abnormalities. Transvaginal ultrasonography (US) is helpful

382

Outpatient protocol for biofeedback therapy of pelvic floor outlet obstruction  

Microsoft Academic Search

Pelvic floor outlet obstruction is a rare cause of severe constipation. Anal myectomy, subtotal colectomy, and medical therapy have limited success. The purpose of this study was to develop a short outpatient treatment using biofeedback techniques. Nine patients with severe constipation and straining resulting from pelvic floor outlet obstruction underwent complete investigation of the pelvic floor musculature and anal sphincter

James W. Fleshman; Zeev Dreznik; Kathleen Meyer; Robert D. Fry; Robert Carney; Ira J. Kodner

1992-01-01

383

Pelvic Girdle Shape Predicts Locomotion and Phylogeny in Batoids  

E-print Network

pelvic fins of sharks (Elasmobranchii) are not involved in the primary force production during locomotion of the shark (Harris, 1938). The pelvic fins of more derived teleost fishes stabilize the body and assist, the pelvic gir- dle can reliably predict locomotor mode. Because of the diminished gravitational effects

Kajiura, Stephen

384

Image characteristics of computer tomography urography in pelvic lipomatosis  

PubMed Central

Pelvic lipomatosis is a rare disease where fat tissue deposition is observed in spaces of the pelvic area. The disease has a wide range of presenting obstruction symptoms varying from lower urinary tract symptoms to bowel symptoms. In this report, we described the clinical findings, classical radiological features and treatment in an elderly male patient with pelvic lipomatosis. PMID:24482720

Xia, Shengqiang; Yan, Yang; Peng, Bo; Yang, Bin; Zheng, Junhua

2014-01-01

385

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

386

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

387

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

388

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.

389

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

390

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

391

Singular solutions, momentum maps and computational anatomy  

E-print Network

Singular solutions, momentum maps and computational anatomy Colin J. Cotter1 and Darryl D. Holm1. This paper describes the variational formulation of tem- plate matching problems of computational anatomy (CA to instruct, or at least entertain, without wearying." ­ Lorenzo da Ponte 1 Introduction Computational Anatomy

Boyer, Edmond

392

Human Anatomy III: Respiratory, Urinary & Digestive  

E-print Network

1 Human Anatomy III: Respiratory, Urinary & Digestive Systems The Respiratory System Major, along with the lower part of the digestive system #12;6 Basic Anatomy of the Urinary System Kidneys lie in an aquatic insect larva Basic Anatomy of the Respiratory System I Air enters through the nose Inside nose

Brown, Christopher A.

393

Pure Laparoscopic and Robot-Assisted Laparoscopic Reconstructive Surgery in Congenital Megaureter: A Single Institution Experience  

PubMed Central

To report our experience of pure laparoscopic and robot-assisted laparoscopic reconstructive surgery in congenital megaureter, seven patients (one bilateral) with symptomatic congenital megaureter underwent pure laparoscopic or robot-assisted laparoscopic surgery. The megaureter was exposed at the level of the blood vessel and was isolated to the bladder narrow area. Extreme ureter trim and submucosal tunnel encapsulation or papillary implantations and anti-reflux ureter bladder anastomosis were performed intraperitoneally by pure laparoscopic or robot-assisted laparoscopic surgery. The clinical data of seven patients after operation were analyzed, including the operation time, intraoperative complications, intraoperative bleeding volumes, postoperative complications, postoperative hospitalization time and pathological results. All of the patients were followed. The operation was successfully performed in seven patients. The mean operation times for pure laparoscopic surgery and robotic-assistant laparoscopic surgery were 175 (range: 150–220) and 187 (range: 170–205) min, respectively, and the mean operative blood loss volumes were 20 (range: 10–30) and 28.75 (range: 15–20) ml, respectively. There were no intraoperative complications. The postoperative drainage time was 5 (range: 4–6) and 5.75 (range: 5–6) d, respectively, and the indwelling catheter time was 6.33 (range: 4–8) d and 7 (range: 7–7) d, respectively. The postoperative hospitalization time was 7.67 (range: 7–8) d and 8 (range: 7–10) d, respectively. There was no obvious pain, no secondary bleeding and no urine leakage after the operation. Postoperative pathology reports revealed chronic urothelial mucosa inflammation. The follow-up results confirmed that all patients were relieved of their symptoms. Both pure laparoscopic and robot-assisted laparoscopic surgery using different anti-reflux ureter bladder anastomoses are safe and effective approaches in the minimally invasive treatment of congenital megaureter. PMID:24924420

Zhang, Peng; Gao, Jiangping; Dong, Jun; Chen, Guangfu; Xu, Axiang; Ma, Xin; Li, Hongzhao; Shi, Lixin

2014-01-01

394

Laparoscopic intracorporeal distal rectal transection with the CONTOUR(®) device.  

PubMed

Laparoscopic rectal resection is considered technically more demanding than laparoscopic colectomy. Rectal transection is a challenging part of laparoscopic low anterior rectal resection and restorative proctocolectomy. We describe our technique for laparoscopic rectal transection with a curved cutter, a device initially designed for open surgery, combined with the use of a ring-mounted sterile drape that allows maintenance of sufficient intra-abdominal gas pressure in a series of 34 patients. PMID:22426929

Alevizos, L; Lirici, M M

2012-10-01

395

The Anatomy of Anatomy: A Review for Its Modernization  

ERIC Educational Resources Information Center

Anatomy has historically been a cornerstone in medical education regardless of nation or specialty. Until recently, dissection and didactic lectures were its sole pedagogy. Teaching methodology has been revolutionized with more reliance on models, imaging, simulation, and the Internet to further consolidate and enhance the learning experience.…

Sugand, Kapil; Abrahams, Peter; Khurana, Ashish

2010-01-01

396

Anatomy 1. Introduction to Human Anatomy: A Functional Approach.  

ERIC Educational Resources Information Center

An introductory human anatomy course designed to provide the basic understanding of human structure necessary for further study in allied health and related fields is described. First, a general course description provides an overview; discusses the courses' place within the science curriculum, noting that it does not meet the general education…

Silverman, Robert M.

397

Accessory wandering spleen: Report of a case of laparoscopic approach in an asymptomatic patient  

PubMed Central

INTRODUCTION Accessory wandering spleen is a rare but dangerous condition. Abnormalities of the ligamentous apparatus of an accessory spleen may evolve into torsion of its vascular axis, which can lead to a splenic infarct making surgery necessary. Patients are often asymptomatic and the diagnosis can be accidental. An early diagnosis and a correct treatment are fundamental. PRESENTATION OF CASE In this case report a young woman underwent laparoscopic surgery after an incidental finding at a Pelvic Ultrasound of an accessory wandering spleen. DISCUSSION In literature are reported cases of asymptomatic patients with an accessory wandering spleen treated with a conservative approach. However, a torsion or infarct of the accessory wandering spleen leads to emergency surgery. The presence of an independent vascular axis of the accessory spleen reduces the risk of postoperative complications (e.g. thrombocytosis) and the administration of low molecular weight heparin should prevent the risk of portal thrombosis. CONCLUSION We suggest performing surgery with a laparoscopic approach in patients with accessory wandering spleen, though asymptomatic, because of the risk of serious complications in case of accessory spleen torsion. PMID:25460427

Perin, Alessandro; Cola, Roberto; Favretti, Franco

2014-01-01

398

Modified approach for extraperitoneal laparoscopic staging for locally advanced cervical cancer.  

PubMed

Describe a modified approach to the technique for staging laparoscopic extraperitoneal aortic and common iliac lymph node dissection for locally advanced cervical cancer.Retrospective, nonrandomized clinical study. (Canadian Task Force classification II-2), setting in an acute-care, teaching hospital. Thirty-six patients with locally advanced cervical cancer underwent laparoscopic surgical staging via extraperitoneal approach with the conventional or the modified technique from August 2001 through September 2004. Clinical outcomes in 23 patients who were operated on with the conventional technique using index finger for first trocar entrance; 12 patients with the modified technique using direct trocar entrance, were compared. One patient was excluded due to peritoneal carcinomatosis. Technique, baseline characteristics, histopathologic variables and surgical outcome were measured. There were no significant differences in patients basal characteristics on comparative analysis between conventional and modified technique. With our proposed modified technique, we obtained a reduced surgical procedure duration and blood loss. The proposed modified surgical technique offers some advantages, is an easier approach because the parietal pelvic peritoneum is elastic and this helps to avoid its disruption at time of trocar insertion, size of incision is shorter, we achieved no CO2 leak through the trocar orifice, and wound suture is fast and simple. PMID:18365538

Gil-Moreno, A; Maffuz, A; Díaz-Feijoo, B; Puig, O; Martínez-Palones, J M; Pérez, A; García, A; Xercavins, J

2007-12-01

399

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

400

Pilot study of salvage laparoscopic prostatectomy for the treatment of recurrent prostate cancer  

PubMed Central

OBJECTIVE To evaluate feasibility, safety and oncological efficacy of salvage laparoscopic radical prostatectomy for pathology-proven biochemical recurrence after primary radiation therapy or cryotherapy for prostate cancer. MATERIALS AND METHODS This retrospective pilot study examined 15 patients from 2004 to 2010 with biochemical recurrence after external beam radiation therapy (n = 8), brachytherapy (n = 6) or cryotherapy (n = 1). Patients were treated with salvage laparoscopic radical prostatectomy (11 conventional, four robotic-assisted) with bilateral pelvic dissection. RESULTS Median duration of surgery was 235 min. None of the following occurred: conversion to open surgery, transfusion, urethrovesical stenosis or perioperative or postoperative mortality. One patient presented with a rectal injury, repaired using uninterrupted sutures and a colostomy. One patient had anastomotic leak treated with prolonged Foley catheterization. Pathological stage was pT2a in three, pT2b in three, pT3a in four, pT3b in three and pT4 in two patients; two patients had nodal metastasis. Within an 8-month median follow-up, 11 patients were disease-free and three had persistent postoperative prostate-specific antigen (PSA) elevation; the remaining patient experienced PSA recurrence after 21 months. Seven patients achieved continence (no pads) by 8.4 months (median), one patient manifested severe incontinence corrected by implanting an artificial sphincter, and seven patients with a 12.6-month mean follow-up continued to need one or two pads per day. Erectile dysfunction was present in five patients before surgery and in 14 patients after surgery. CONCLUSIONS Salvage laparoscopic radical prostatectomy seems to offer a safe therapeutic alternative for patients failing primary radiation or cryotherapy. However, larger studies with longer-term data are required. PMID:21166755

Ahallal, Youness; Shariat, Shahrokh F.; Chade, Daher C.; Mazzola, Clarisse; Reuter, Victor E.; Sandhu, Jaspreet S.; Laudone, Vincent P.; Touijer, Karim A.; Guillonneau, Bertrand D.

2014-01-01

401

SMA Syndrome Treated by Single Incision Laparoscopic Duodenojejunostomy.  

PubMed

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

402

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

403

Retained myoma after laparoscopic supracervical hysterectomy with morcellation  

Microsoft Academic Search

Laparoscopic myomectomy and, more recently, laparoscopic supracervical hysterectomy are practical alternatives to traditional surgical management of uterine fibroids. With the advent of mechanical morcellation these procedures are now much more feasible. A 6-cm fibroid was lost at the time of laparoscopic-assisted supracervical hysterectomy and caused persistent, severe abdominal pain over the next 3 weeks. The fibroid was lodged in the

Francis L. Hutchins; Elizabeth M. Reinoehl

1998-01-01

404

Minireview on laparoscopic hepatobiliary and pancreatic surgery  

PubMed Central

The first laparoscopic cholecystectomy was performed in the mid-1980s. Since then, laparoscopic surgery has continued to gain prominence in numerous fields, and has, in some fields, replaced open surgery as the preferred operative technique. The role of laparoscopy in staging cancer is controversial, with regards to gallbladder carcinoma, pancreatic carcinoma, hepatocellular carcinoma and liver metastasis from colorectal carcinoma, laparoscopy in conjunction with intraoperative ultrasound has prevented nontherapeutic operations, and facilitated therapeutic operations. Laparoscopic cholecystectomy is the preferred option in the management of gallbladder disease. Meta-analyses comparing laparoscopic to open distal pancreatectomy show that laparoscopic pancreatectomy is safe and efficacious in the management of benign and malignant disease, and have better patient outcomes. A pancreaticoduodenectomy is a more complex operation and the laparoscopic technique is not feasible for this operation at this time. Robotic assisted pancreaticoduodenectomy has been tried with limited success at this time, but with continuing advancement in this field, this operation would eventually be feasible. Liver resection remains to be the best management for hepatocellular carcinoma, cholangiocarcinoma and colorectal liver metastases. Systematic reviews and meta-analyses have shown that laparoscopic liver resections result in patients with equal or less blood loss and shorter hospital stays, as compared to open surgery. With improving equipment and technique, and the incorporation of robotic surgery, minimally invasive liver resection operative times will improve and be more efficacious. With the incorporation of robotic surgery into hepatobiliary surgery, donor hepatectomies have also been completed with success. The management of benign and malignant disease with minimally invasive hepatobiliary and pancreatic surgery is safe and efficacious. PMID:24634709

Tan-Tam, Clara; Chung, Stephen W

2014-01-01

405

How Much Anatomy is Enough?  

NSDL National Science Digital Library

This article describes a study conducted at 8 Dutch Medical Schools investigating the effect of various didactic approaches to teaching anatomy on performance. Outcomes discussed include that good test performance is not related to teaching style, but rather course hours, clinical relevance, and revisiting anatomical concepts.

2008-08-01

406

Curriculum Guidelines for Microscopic Anatomy.  

ERIC Educational Resources Information Center

The American Association of Dental Schools' guidelines for curricula in microscopic anatomy offer an overview of the histology curriculum, note primary educational goals, outline specific content for general and oral histology, suggest prerequisites, and make recommendations for sequencing. Appropriate faculty and facilities are also suggested.…

Journal of Dental Education, 1993

1993-01-01

407

Anatomy of the rabbit cecum  

Microsoft Academic Search

The anatomy of the rabbit cecum was investigated using macroscopic dissections, vascular injections, dried total specimens, light microscopy, and scanning and electron microscopy. The morphology of the three portions of the cecum (ampulla coli, corpus ceci and appendix vermiformis) is described. For comparison, the proximal colon, ileum and sacculus rotundus were also investigated. The thickness of the different layers of

Robert L. Snipes; Justus Liebig-Universitfit Giessen

1979-01-01

408

Orbital anatomy for the surgeon.  

PubMed

An anatomic description of the orbit and its contents and the eyelids directed toward surgeons is the focus of this article. The bone and soft tissue anatomic nuances for surgery are highlighted, including a section on osteology, muscles, and the orbital suspensory system. Innervation and vascular anatomy are also addressed. PMID:23107426

Turvey, Timothy A; Golden, Brent A

2012-11-01

409

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.

410

On the Anatomy of Understanding  

ERIC Educational Resources Information Center

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…

Wilhelmsson, Niklas; Dahlgren, Lars Owe; Hult, Hakan; Josephson, Anna

2011-01-01

411

Composite resection of posterior pelvic malignancy.  

PubMed

Advanced pelvic cancer is a formidable challenge to surgical resection. These tumors commonly invade the bony pelvis, may involve other viscera, and usually have been irradiated previously. The authors are presenting experience with 76 patients who had composite resection of posterior or lateral pelvic malignancy. Fifty-eight patients had secondary cancers involving the musculoskeletal pelvis. This included 47 patients with advanced carcinoma of the rectum (41 curative, 6 palliative), 10 epidermoid cancers of the anorectum (8) or cervix (2), and 1 bladder cancer. Among the 18 patients with primary pelvic tumors were three patients with chordomas, six with bone tumors (osteosarcoma chondrosarcoma, grade III giant cell tumor), and nine with soft tissue tumors. All required major resection of the sacrum or pelvic side walls, and one half had an additional exenterative procedure. The overall mortality rate was 7.9%. Long-term estimated survival was 24% in patients having curative resection of recurrent rectal cancer, and 22.5% in 10 patients with advanced epidermoid cancer. Fifty per cent of patients with primary bone or soft tissue tumors survived from 13 to 88 months. Most patients had reasonable return of function, and were able to return to work or resume their normal previous lifestyle. PMID:1632689

Wanebo, H J; Koness, R J; Turk, P S; Cohen, S I

1992-06-01

412

Neuromodulation of voiding dysfunction and pelvic pain  

Microsoft Academic Search

Neuromodulation of sacral roots provides an alternative mode of therapy for patients presenting with voiding dysfunctions and chronic pelvic pain. Physiologically, this is accomplished by intervention in the neuronal pathways of micturition via sacral nerve-root electrical stimulation. Preoperative evaluation using temporary percutaneous sacral root stimulation selects the patients who are most likely to benefit from permanent electrode implantation. To date,

W. F. Thon; L. S. Baskin; U. Jonas; E. A. Tanagho; R. A. Schmidt

1991-01-01

413

Comparison of Surgical Skills in Laparoscopic and Robotic Tasks Between Experienced Surgeons and Novices in Laparoscopic Surgery: An Experimental Study  

PubMed Central

Purpose Robotic surgery is known to provide an improved technical ability as compared to laparoscopic surgery. We aimed to compare the efficiency of surgical skills by performing the same experimental tasks using both laparoscopic and robotic systems in an attempt to determine if a robotic system has an advantage over laparoscopic system. Methods Twenty participants without any robotic experience, 10 laparoscopic novices (LN: medical students) and 10 laparoscopically-experienced surgeons (LE: surgical trainees and fellows), performed 3 laparoscopic and robotic training-box-based tasks. This entire set of tasks was performed twice. Results Compared with LN, LEs showed significantly better performances in all laparoscopic tasks and in robotic task 3 during the 2 trials. Within the LN group, better performances were shown in all robotic tasks compared with the same laparoscopic tasks. However, in the LE group, compared with the same laparoscopic tasks, significantly better performance was seen only in robotic task 1. When we compared the 2 sets of trials, in the second trial, LN showed better performances in laparoscopic task 2 and robotic task 3; LE showed significantly better performance only in robotic task 3. Conclusion Robotic surgery had better performance than laparoscopic surgery in all tasks during the two trials. However, these results were more noticeable for LN. These results suggest that robotic surgery can be easily learned without laparoscopic experience because of its technical advantages. However, further experimental trials are needed to investigate the advantages of robotic surgery in more detail. PMID:24851216

Kim, Hye Jin; Park, Jun Seok; Park, Soo Yeun

2014-01-01

414

Laparoscopic trocar port site endometriosis: a case report and brief literature review.  

PubMed

Endometriosis is defined as the presence of ectopic endometrial tissue outside the lining of the uterine cavity. It occurs most commonly in pelvic sites such as ovaries, cul-de-sac, and fallopian tubes but also can be found associated with the lungs, bowel, ureter, brain, and abdominal wall. Abdominal wall endometriosis, also known as scar endometriosis, is extremely rare and mainly occurs at surgical scar sites. Although many cases of scar endometriosis have been reported after a cesarean section, some cases of scar endometriosis have been reported after an episiotomy, hysterectomy, appendectomy, and laparoscopic trocar port tracts. To our knowledge, 14 case reports related to trocar site endometriosis have been published in the English language literature to date. Herein, we present the case of a 20-year-old woman (who had been previously operated on for left ovarian endometrioma 1.5 years ago by laparoscopy) with the complaint of a painful mass at the periumbilical trocar site with cyclic pattern. Consequently, although rare, if a painful mass in the surgical scar, such as the trocar site, is found in women of reproductive age with a history of pelvic or obstetric surgery, the physician should consider endometriosis. PMID:23102079

Emre, Arif; Akbulut, Sami; Yilmaz, Mehmet; Bozdag, Zehra

2012-01-01

415

Laparoscopic Management of Complex Crohn's Disease  

PubMed Central

Background: Although the technical feasibility of laparoscopic management of Crohn's disease has been described, it remains of limited perceived usefulness in the management of surgically complex Crohn's. Successful management of such disease by using minimal access techniques is described. Patients and Methods: Seventeen patients underwent laparoscopically assisted procedures to address clinically complex disease. Goals of the laparoscopic phase included mobilization of pertinent structures, localization of disease, and precise selection of incision location. Clinical situations encountered included fistulas, multiple-or long-segment disease, abscesses, and reoperative management. Results: Conversion to completely open procedures was not necessary in any case. Operative time was longer in complex Crohn's disease than in concurrently managed patients who underwent laparoscopic ileal/cecal resection for limited disease (244±18 vs 127±5 minutes, P<0.05). Management of long-segment or multi-segment disease was associated with the longest operative times (292±36 minutes). Length of hospitalization was also longer than after management of limited ileal disease (7.1±1.4 vs 4.5±0.4 days). Major complications occurred in 18%. Conclusions: Laparoscopic techniques can be applied to complex Crohn's disease with effective disease management. In patients who may require multiple procedures, maintenance of abdominal wall integrity should be of significant value. PMID:12856841

Kavic, Stephen M.

2003-01-01

416

Laparoscopic use of laser and monopolar electrocautery  

NASA Astrophysics Data System (ADS)

Most general surgeons are familiar with monopolar electrocautery, but few are equally comfortable with laser dissection and coagulation. At courses across the country, surgeons are being introduced to laparoscopy and laser use in one and two day courses, and are certified from that day forward as laser laparoscopists. Some surgeons are told that laser and electrosurgery may be equally acceptable techniques for performance of laparoscopic surgery, but that a surgeon may double his patient volume by advertising 'laser laparoscopic cholecystectomy.' The sale of certain lasers has skyrocketed on the basis of such hype. The only surprise is that laparoscopic cholecystectomy complications occurring in this country seem to be more closely related to the laparoscopic access and visualization than to the choice of laser of electrocautery as the preferred instrument for thermal dissection. The purpose of this article is to: 1) Discuss the physics and tissue effects of electrosurgery and laser; 2) compare the design and safety of electrosurgical and laser delivery systems; and 3) present available data comparing laser and electrocautery application in laparoscopic cholecystectomy.

Hunter, John G.

1991-07-01

417

Total Laparoscopic Hysterectomy for Large Uterus  

PubMed Central

Aim: In this review, we assessed the feasibility of total laparoscopic hysterectomy (TLH) in cases of very large uteri weighing more than 500 grams. We have analyzed whether it is possible for an experienced laparoscopic surgeon to perform efficient total laparoscopic hysterectomy for large myomatous uteri regardless of the size, number and location of the myomas. Design: Retrospective review (Canadian Task Force Classification II-1) Setting: Dedicated high volume Gynecological laparoscopy centre. Patients: 173 women with symptomatic myomas who underwent total laparoscopic hysterectomy at our center. There were no exclusion criteria based on the size number or location of myomas. Intervention: TLH and modifications of performing the surgery by ligating the uterine arteries prior, myomectomy followed by hysterectomy, direct morcellation after uterine artery ligation. Results: 72% of patients had previous normal vaginal delivery and 28% had previous cesarean section. Average clinical size of the uterus was 18 weeks (10, 32). The average weight of the specimen was 700 grams (500, 2240). The average duration of surgery was 107 min (40, 300) and the average blood loss was 228 ml (10, 3200). Conclusion: Total laparoscopic hysterectomy is a technically feasible procedure. It can be performed by experienced surgeons for large uteri regardless of the size, number or location of the myomas. PMID:22442509

Sinha, Rakesh; Sundaram, Meenakshi; Lakhotia, Smita; Mahajan, Chaitali; Manaktala, Gayatri; Shah, Parul

2009-01-01

418

Bimanual haptic workstation for laparoscopic surgery simulation.  

PubMed

Realistic laparoscopic surgical simulators will require real-time graphic imaging and tactile feedback. Our research objective is to develop a cost-effective haptic workstation for the simulation of laparoscopic procedures for training and treatment planning. The physical station consists of a custom-built frame into which laparoscopic trocars and surgical tools may be attached/inserted and which are continuously adjustable to various positions and orientations to simulate multiple laparoscopic surgical approaches. Instruments inserted through the trocars are attached to end effectors of two haptic devices and interfaced to a high speed PC with fast graphics capability. The haptic device transduces 3D motion of the two manually operated surgical instruments into slave maneuvers in virtual space. The slave instrument tips probe the simulated organ. Simulations currently in progress include: 1) Surface-only renderings, deformation, and haptic interactions with elements in the gall gladder surgical field; 2) Voxel-based simulations of the bulk manipulation of tissue; 3) laparoscopic herniorrhaphy. This system provides force feed-forward from the grasped tools to the contact tissue in virtual space, with deformation of the tissue by the virtual probe, and force feedback from the deformed tissue to the operator's hands. PMID:11317725

Devarajan, V; Scott, D; Jones, D; Rege, R; Eberhart, R; Lindahl, C; Tanguy, P; Fernandez, R

2001-01-01

419

Visual search behaviour during laparoscopic cadaveric procedures  

NASA Astrophysics Data System (ADS)

Laparoscopic surgery provides a very complex example of medical image interpretation. The task entails: visually examining a display that portrays the laparoscopic procedure from a varying viewpoint; eye-hand coordination; complex 3D interpretation of the 2D display imagery; efficient and safe usage of appropriate surgical tools, as well as other factors. Training in laparoscopic surgery typically entails practice using surgical simulators. Another approach is to use cadavers. Viewing previously recorded laparoscopic operations is also a viable additional approach and to examine this a study was undertaken to determine what differences exist between where surgeons look during actual operations and where they look when simply viewing the same pre-recorded operations. It was hypothesised that there would be differences related to the different experimental conditions; however the relative nature of such differences was unknown. The visual search behaviour of two experienced surgeons was recorded as they performed three types of laparoscopic operations on a cadaver. The operations were also digitally recorded. Subsequently they viewed the recording of their operations, again whilst their eye movements were monitored. Differences were found in various eye movement parameters when the two surgeons performed the operations and where they looked when they simply watched the recordings of the operations. It is argued that this reflects the different perceptual motor skills pertinent to the different situations. The relevance of this for surgical training is explored.

Dong, Leng; Chen, Yan; Gale, Alastair G.; Rees, Benjamin; Maxwell-Armstrong, Charles

2014-03-01

420

Complications of diverticular disease: surgical laparoscopic treatment  

PubMed Central

Surgical treatment of complicated colonic diverticular disease is still debatable. The aim of our study was to evaluate the outcome of laparoscopic colon resection in patients with diverticulitis and with complications like colon-vescical fistula, peridiverticular abscess, perforation or stricture. All patients underwent laparoscopic colectomy within 8 years period. Main data recorded were age, sex, return of bowel function, operation time, duration of hospital stay, ASA score, body mass index (BMI), early and late complications. During the study period, 33 colon resections were performed for diverticulitis and complications of diverticulitis. We performed 5 associated procedures. We had 2 postoperative complications; 1 of these required a redo operation with laparotomy for anastomotic leak and 3 patients required conversion from laparoscopic to open colectomy. The most common reasons for conversion were related to the inflammatory process with a severe adhesion syndrome. Mean operative time was 229 minutes, and average postoperative hospital stay was 9,8 days. Laparoscopic surgery for complications of diverticular disease is safe, effective and feasible. Laparoscopic colectomy has replaced open resection as standard surgery for recurrent and complicated diverticulitis in our institution. PMID:24979103

ANANIA, G.; VEDANA, L.; SANTINI, M.; SCAGLIARINI, L.; GIACCARI, S.; RESTA, G.; CAVALLESCO, G.

2014-01-01

421

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

422

Tendinous arch of the pelvic fascia: application to the technique of paravaginal colposuspension.  

PubMed

The authors give a description of the anatomy and topography of the tendinous arch of the pelvic fascia (TAPF), in order to facilitate its location during surgery. 35 TAPF in 25 female cadavers were dissected. The reproducibility of the landmarks was then verified at laparotomy. The TAPF can be easily identified and its resistance remains constant, even when the pelvic floor is hypotrophic. Its anterior extremity (d2) is at about 46 mm on a line perpendicular to the anterior edge of the pectineal ligament (35-55 mm), next to the pubovesical ligament. Its median part (dl) is perpendicular to the obturator foramen at a site located at an average of 30 mm below the obturator foramen (25-50 mm). Its posterior end is located at the ischial spine. These anterior landmarks, the only ones useful during surgery, allow its very easy location with the palmar surface of the finger. Testard and Delancey demonstrated the major role of the TAPF in stabilising the urethra submitted to strain. Richardson described a technique of paravaginal suspension for curing paravaginal fascial defect. The TAPF has never been well described, but his work allows its easy location during surgery. The suture of the vagina to the TAPF allows a more physiologic and stronger suspension of the bladder neck than other classical techniques. PMID:10959671

Mauroy, B; Goullet, E; Stefaniak, X; Bonnal, J L; Amara, N

2000-01-01

423

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

424

Recurrence of uterine tissue residues after laparoscopic hysterectomy or myomectomy.  

PubMed Central

Objective: To report a new complication after laparoscopic surgery i.e recurrence of endometrium and leiomyoma fragments from uterine tissue residues after laparoscopic hysterectomy or laparoscopic myomectomy. Methods: This study was carried out on three patients with the recurrence of endometrium or leiomyoma fragments from tissue residues after laparoscopic hysterectomy or laparoscopic myomectomy in the First Affiliated Hospital, Yangtze University, China. We also explored the possible reasons and corresponding preventative strategies. Results: Small residues of endometrium and leiomyoma fragments could implant into normal tissue anywhere in the peritoneal cavity after laparoscopic myomectomy or laparoscopic hysterectomy. Conclusion: These cases emphasize the importance of removing every single fragment to prevent the recurrence of endometrium and leiomyoma from tissue residues. PMID:25225541

Yi, Cunjian; Li, Li; Wang, Xiaowen; Liu, Xiangqiong

2014-01-01

425

Anatomy of a Bird  

NASA Astrophysics Data System (ADS)

Using ESO's Very Large Telescope, an international team of astronomers [1] has discovered a stunning rare case of a triple merger of galaxies. This system, which astronomers have dubbed 'The Bird' - albeit it also bears resemblance with a cosmic Tinker Bell - is composed of two massive spiral galaxies and a third irregular galaxy. ESO PR Photo 55a/07 ESO PR Photo 55a/07 The Tinker Bell Triplet The galaxy ESO 593-IG 008, or IRAS 19115-2124, was previously merely known as an interacting pair of galaxies at a distance of 650 million light-years. But surprises were revealed by observations made with the NACO instrument attached to ESO's VLT, which peered through the all-pervasive dust clouds, using adaptive optics to resolve the finest details [2]. Underneath the chaotic appearance of the optical Hubble images - retrieved from the Hubble Space Telescope archive - the NACO images show two unmistakable galaxies, one a barred spiral while the other is more irregular. The surprise lay in the clear identification of a third, clearly separate component, an irregular, yet fairly massive galaxy that seems to be forming stars at a frantic rate. "Examples of mergers of three galaxies of roughly similar sizes are rare," says Petri Väisänen, lead author of the paper reporting the results. "Only the near-infrared VLT observations made it possible to identify the triple merger nature of the system in this case." Because of the resemblance of the system to a bird, the object was dubbed as such, with the 'head' being the third component, and the 'heart' and 'body' making the two major galaxy nuclei in-between of tidal tails, the 'wings'. The latter extend more than 100,000 light-years, or the size of our own Milky Way. ESO PR Photo 55b/07 ESO PR Photo 55b/07 Anatomy of a Bird Subsequent optical spectroscopy with the new Southern African Large Telescope, and archive mid-infrared data from the NASA Spitzer space observatory, confirmed the separate nature of the 'head', but also added further surprises. The 'head' and major parts of the 'Bird' are moving apart at more than 400 km/s (1.4 million km/h!). Observing such high velocities is very rare in merging galaxies. Also, the 'head' appears to be the major source of infrared luminosity in the system, though it is the smallest of the three galaxies. "It seems that NACO has caught the action right at the time of the first high-speed fly-by of the 'head' galaxy through the system consisting of the other two galaxies," says Seppo Mattila, member of the discovery team. "These two galaxies must have met earlier, probably a couple of hundred million years ago." The 'head' is forming stars violently, at a rate of nearly 200 solar masses per year, while the other two galaxies appear to be at a more quiescent epoch of their interaction-induced star formation history. The 'Bird' belongs to the prestigious family of luminous infrared galaxies, with an infrared luminosity nearly one thousand billion times that of the Sun. This family of galaxies has long been thought to signpost important events in galaxy evolution, such as mergers of galaxies, which in turn trigger bursts of star formation, and may eventually lead to the formation of a single elliptical galaxy. The findings presented here are reported in a paper to appear in a future issue of the journal Monthly Notices of the Royal Astronomical Society ("Adaptive optics imaging and optical spectroscopy of a multiple merger in a luminous infrared galaxy", by P. Väisänen" et al.). Note [1]: The team is composed of P. Väisänen, A. Kniazev, D. A. H. Buckley, L. Crause, Y. Hashimoto, N. Loaring, E. Romero-Colmenero, and M. Still (SAAO, South Africa), S. Mattila (Tuorla Observatory, Finland), A. Adamo and G. Östlin (Stockholm University, Sweden), A. Efstathiou (Cyprus College, Nicosia, Cyprus), D. Farrah (Cornell University, USA), P. H. Johansson (Universitäts-Sternwarte München, Germany), E. B. Burgh and K. Nordsieck (University of Wisconsin, USA), P. Lira (Universidad de Chile, Santiago, Chile),

2007-12-01

426

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

427

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

428

[Bilateral gonadectomy and laparoscopic hysterosalpingectomy in an adolescent with ovotesticular disorder of sexual development].  

PubMed

Disorders of sexual development in adolescents refer to children whose genitals at birth present characteristics of both genders, or to those children with normal phenotype that present a development alteration during puberty or adolescence. These disorders represent diagnostic and therapeutic challenges, because they can be triggered by different nosological entities; and on the other hand, patients carrying the same pathologies can present different anatomical alterations. Laparoscopy plays an important role in the diagnostic approach of these patients because, besides the fact that it allows an excellent visualization of the internal genitals anatomy, it also allows tissue sample taking for histological studies. On the other hand, from a therapeutic point of view, laparoscopic surgery allows removal of internal structures opposed to the patient's definite gender. We report the case of an adolescent with ovotesticular disorder of sexual development (True Hermaphrodite) from whom, once his male gender was socially defined, the embrionary remnants derived from Müller were removed through laparoscopic approach. Mamoplastic reduction and testicular prosthesis implantation were also practiced through conventional surgery. PMID:20306724

Fernández-Fernández, Jesús; Pachano-Arenas, Freddy; Chacín-Fuenmayor, Josymar; Villalobos-Robles, Joalice; Zara-Chirinos, Carmen

2009-12-01

429

Laparoscopic cholecystostomy for acute acalculous cholecystitis.  

PubMed

Acute acalculous cholecystitis (AAC) can occur in up to 18% of severely injured patients. Diagnosis is made by positive ultrasound findings of gallbladder sludge, hydrox, and wall thickening. There may also be recent-onset jaundice, positive ultrasound induced Murphy's sign, and unexplained sepsis. Mortality can be as high as 50%. Laparoscopic confirmation was obtained in six ICU trauma patients when omentum was drawn up over a distended gallbladder. Laparoscopic cholecystectomy (LC) was done by first directly decompressing the gallbladder through the fundus. This trocar was replaced by a 16 French Foley catheter passed through an Endoloop into the gallbladder and secured by tightening the loop around a cuff of gallbladder. Sepsis resolved in all cases. Only one required subsequent laparoscopic cholecystectomy. LC has a low morbidity and may be life saving during the early stages of AAC. It is not indicated in gangrene or perforation of the gallbladder. PMID:8662413

Yang, H K; Hodgson, W J

1996-06-01

430

The first total laparoscopic pancreatoduodenectomy in Poland.  

PubMed

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 3(rd) 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

Budzy?ski, Andrzej; Zub-Pokrowiecka, Anna; Zychowicz, Anna; P?dziwiatr, Micha?; Wierdak, Mateusz; Mat?ok, Maciej; Zaj?c, Ma?gorzata

2014-09-01

431

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

Budzy?ski, Andrzej; Zub-Pokrowiecka, Anna; Zychowicz, Anna; Wierdak, Mateusz; Mat?ok, Maciej; Zaj?c, Ma?gorzata

2014-01-01

432

Diagnostic laparoscopic biopsy for intraabdominal tumors.  

PubMed

Improvements in imaging technology have resulted in an increase in the incidental detection of intraabdominal tumors. Diagnostic computed tomography (CT)- and ultrasound (US)-guided biopsy, while minimally invasive, often provides specimens that are insufficient for histological evaluation. Moreover, it can be difficult to perform because the location and size of the tumor. In such cases, laparoscopic biopsy is useful because it is less invasive than laparotomy, but more reliable than imaging-guided biopsy, to obtain a sufficient specimen, regardless of the location and size of the tumor. We report a series of seven patients who underwent laparoscopic biopsy of intraabdominal tumors of unknown origin. There were no cases of conversion to laparotomy and all patients were able to resume oral intake on postoperative day 1. There were no intraoperative or postoperative complications. Thus, laparoscopic biopsy for a tumor of unknown origin is useful and minimally invasive. PMID:25212568

Sakamoto, Yasuo; Karashima, Ryuichi; Ida, Satoshi; Imamura, Yu; Iwagami, Shiro; Baba, Yoshifumi; Miyamoto, Yuji; Yoshida, Naoya; Baba, Hideo

2015-03-01

433

Comments to young surgeons concerning laparoscopic spleen-preserving D2 lymph node dissection for advanced gastric cancer on the upper body  

PubMed Central

Qualified radical gastrectomy with lymph node dissection is very important to the prognosis of patients with gastric cancer. Now D2 lymph node dissection is standard procedure for gastric cancer surgery, and spleen hilar lymph node dissection is mandatory for gastric cancer in upper body. Because the anatomy of vessels in this area is very complicated, D2 lymph node dissection is technical challenging not only for open gastrectomy but also for laparoscopic one. Adapting a new technique is important to all surgeons, but we surgeons should always consider a patient’s safety as the most important factor during surgery and that efforts should be based on scientific rationale with oncologic principles. I hope that the recent report by Huang et al. about laparoscopic spleen preserving hilar lymph node dissection would be helpful to young surgeons who will perform laparoscpic total gastrectomy for gastric cancer. PMID:25035646

Choi, Yoon Young; An, Ji Yeong; Hyung, Woo Jin

2014-01-01

434

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

435

Ergonomic problems associated with laparoscopic surgery  

Microsoft Academic Search

Background: The Society of American Gastrointestinal Endoscopic Surgeons (SAGES) Task Force on Ergonomics conducted a subjective and\\u000a objective assessment of ergonomic problems associated with laparoscopic instrument use. The goal was to assess the prevalence,\\u000a causes, and consequences of operational difficulties associated with the use of laparoscopic instruments.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: A questionnaire was distributed asking respondents to rate the frequency with which

R. Berguer; D. L. Forkey; W. D. Smith

1999-01-01

436

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

437

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

438

Laparoscopic Treatment of Ovarian Retention Pathology  

PubMed

We define ovarian retention pathology as the complications (cystic, degenerative, adhesions, endometriosis, pain, etc.) attributed to ovaries deliberately retained at the time of hysterectomy. We established a protocol for laparoscopy in these women. During 14 laparoscopic procedures for ovarian retention pathology, only one intraoperative complication occurred, a small bowel injury requiring minilaparotomy. One woman required repeat surgery for ovarian remnant syndrome. Published experience with laparotomy suggests that significant injuries to or resections of bowel, bladder, or ureters can occur, but the limited experience with laparoscopic surgery has not shown significant complications. PMID:9074105

Dionisi; Dionisi; Dionisi

1996-08-01

439

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

440

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

441

Laparoscopic management of acute small bowel obstruction  

Microsoft Academic Search

Background: The use of laparoscopy has expanded to include the management of acute abdomen. This study describes the author's experience\\u000a with laparoscopic management of acute small bowel obstruction.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: From February 1994 through March 1998, 19 patients underwent laparoscopic intervention for acute small bowel obstruction.\\u000a Their clinical data were analyzed to evaluate the outcome.\\u000a \\u000a \\u000a \\u000a \\u000a Results: A total of 19 patients

A. A. Al-Mulhim

2000-01-01

442

Oncologic implications of laparoscopic and open surgery.  

PubMed

Although instrumental manipulation and mechanical tumor cell spillage seem to play the major role in port-site metastases from laparoscopic cancer surgery, minimally invasive procedures are used more and more in the resection of malignancies. However, port-site metastases also have been reported after resection of colon cancer in International Union Against Cancer (UICC) stage I [2, 14]. Therefore, changes in the peritoneal environment during laparoscopy also might influence intra- and extraperitoneal tumor growth during laparoscopy and pneumoperitoneum. Different results of experimental studies presented at the Third International Conference for Laparoscopic Surgery are analyzed and discussed. PMID:11928024

Jacobi, C A; Bonjer, H J; Puttick, M I; O'Sullivan, R; Lee, S W; Schwalbach, P; Tomita, H; Kim, Z G; Hewett, P; Wittich, P; Fleshman, J W; Paraskeva, P; Gessman, T; Neuhaus, S J; Wildbrett, P; Reymond, M A; Gutt, C; Whelan, R I

2002-03-01

443

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

444

Anatomy of the Human Heart  

Microsoft Academic Search

\\u000a This chapter covers the internal and external anatomy and function of the heart, as well as its positioning within the thorax.\\u000a Briefly, the heart is a muscular pump, located in the protective thorax, which serves two functions: (1) collect blood from\\u000a the tissues of the body and pump it to the lungs; and (2) collect blood from the lungs and

Anthony J. Weinhaus; Kenneth P. Roberts

445

Kissing of ovaries: laparoscopic view of uterine inversion after vaginal delivery with postpartum hemorrhage.  

PubMed

A 30 y/o female, G1P1 , with postpartum hemorrhage and shock was sent to our emergent department after vaginal delivery one hour before admission. Her blood pressure was 70/40 mmHG , PR 100 , RR 30.A resuscitation was done with 2 large bore IV line setting and the endotracheal intubation. The Pelvic examination revealed no obvious vaginal wall laceration, but the cervix could not be examined well and the uterine fundus is 2-3 finger breadth below the umbilicus. A GYN ultrasound revealed irregular contour of uterus. Manual reduction of uterus through vagina was tried but failed. Owing to the un-confirmed etiology of PPH and failed manual reduction , a diagnostic laparoscope was decided to exclude the rare situation like cervix laceration extending to retroperitoneal space of posterior cervix or spontaneous uterine rupture, and guide the procedure of uterine reduction if correct diagnosis. She was then taken to the operation room . Under general anesthesia, an emergent laparoscopy was done to confirm the diagnosis. The laparoscopic view revealed the typical picture of uterine inversion diagnosis, and the manual reduction of inversion was performed under laparoscopy guide. The cause of postpartum hemorrhage was confirmed. An obstetricians hand was inserted into the patient's vagina to push back the fundus of uterus under laparoscopic guide. After reduction of uterus, there is some dimpling of anterior surface of uterus.3 units of Oxytocin was injection into the myometrium of uterus after reduction to increased uterine contraction. A rolling gauze was inserted into the uterine cavity for compression of uterine cavity and preventing recurrence of inversion. The laparoscope was withdraw, IV fluid with oxytocin was prescribed for 24 hours. The patient was sent to ICU for observation for one night. She was then discharged days 3 post-operatively smoothly CONCLUSION: The laparoscopy is a great tool to make the differentiate diagnosis in this life-threatened situation and help to guide the reduction of inversion uterus in a short time. Although the laparoscopy instrument did not have enough strength to pull the fundus back, the laparoscopy still played a role in saving the patient's life. PMID:25433278

Lu, Hsin-Fen; Fu-Shiang, Peng; Sun, Hsu-Dong; Stella Ting, Wha Hua; Chuang, Yi-Chen

2014-11-26

446

Laparoscopic Appendectomy and Minilaparoscopic Approach: A Retrospective Review After 8-Years' Experience  

PubMed Central

Background: This is a presentation of our 8-year experience in laparoscopic appendectomy, showing complications and results to determine the advantages and efficacy of laparoscopy. Methods: We used this technique from December 1990 to December 1998 on 282 consecutive and non-selected patients (169 females and 113 males) with an average age of 24 years (range 5-86 years). All patients were suffering from sub-acute appendicitis or chronic appendicopathies, except for 84 (29.7%) cases of acute appendicitis and 25 (8.9%) cases of gangrenous appendicitis with peritonitis. All patients with suspected appendicitis were evaluated with a laparoscopic exploration. Results: In 39 patients (13.9%), appendectomy was performed along with 19 enucleated or endocoagulated ovarian cysts, 8 adhesiolyses, 6 transperitoneal hernioplasties (4 right and 2 left), 2 cholecystectomies, 2 excisions of a Meckel diverticulum, 1 aspiration and suture of a right tubal pregnancy and 1 electrodesiccation of pelvic endometriosis. Thirty-five patients (12.5%) revealed the presence of a gynecological-type pathology. We performed 2 (0.7%) conversions to open exploration and experienced 6 (2.1%) complications, of which only 1 (0.35%) was a major complication: a delayed hemoperitoneum (1 liter), re-operated elsewhere, the cause of which was not identified. We performed 4 (1.4%) relaparoscopies for retrocecal abscess (three patients with primary gangrenous appendicitis and peritonitis presenting with an abscess in the right iliac fossa and in one patient with widespread intestinal adhesions with primary acute appendicitis). No patient with a diagnosis of a normal appendix developed an intraperitoneal abscess. Mortality was non-existent. The postoperative course, which was subjectively better than in cases operated in the traditional way, was, on an average, 2 days (range 1-18 days) for appendectomies carried out with the traditional laparoscopic technique and 1 day for appendectomies carried out with the minilaparoscopic technique (6 patients). Conclusion: We believe that the laparoscopic technique can handle any type of clinical situation, as it can cure several pathologies during the same session with minimal trauma and maximum benefit for the patient. The advantages of a minilaparoscopy approach are based on its low invasiveness and small surgical wounds. PMID:10694075

Croce, E.; Azzola, M.; Russo, R.

1999-01-01

447

Sociopsychological factors in women with chronic pelvic pain with and without pelvic venous congestion.  

PubMed

Social and psychological factors have long been proposed as being of importance in a sizeable subgroup of women complaining of unexplained chronic pelvic pain (CPP). The aim of this study was to examine this in two subgroups of CPP patients, thereby eliminating pain alone as the determining variable. Consecutive attenders at a clinic for CPP were assessed on a range of somatic, historical, social, and psychological variables using detailed interviews and questionnaires. They were subsequently allocated to one of two groups, based on the presence or absence of pelvic venous congestion (PVC). Significant associations emerged between some social arrangements, paternal parenting, and patterns of hostility in the group with pelvic venous congestion. The groups also differed in patterns of family illness, and the congested group tended to report more childhood sexual abuse (CSA). Clear case definition in CPP is important. In the subgroup with pelvic venous congestion early social experience may play an important role. Father-daughter relationships may be particularly relevant. Hostility patterns may influence the development of the condition. CSA does not appear to play a specific role in all unexplained CPP cases, but may have relevance for the subgroup with pelvic venous congestion. PMID:9055215

Fry, R P; Beard, R W; Crisp, A H; McGuigan, S

1997-01-01

448

Laser photoablation of renal pelvic tumours  

PubMed Central

We evaluated the clinical effects of the Zeiss OPMILAS (Oberkochen, Germany) multi–yttrium–aluminum–garnet (YAG) laser in the treatment of renal pelvic tumours as an alternative to nephroureterectomy. Four patients with evidence of transitional cell carcinoma (TCC) in the renal pelvis and a previous history of TCC of the bladder or opposite renal pelvis were treated with the Zeiss OPMILAS multi-YAG laser. Three patients underwent a retrograde ureteroscopic approach and 1 patient required percutaneous resection. Two wavelengths were used: 1060 nm continuous coagulative mode and 1440 nm pulsed ablative mode. The patients were followed for 12, 24, 76 and 84 months, respectively. Two patients showed no evidence of recurrence as determined by cystoscopy, retrograde pyelography and selective pelvic urine cytology. One patient experienced a recurrence of TCC requiring subsequent treatment. The ureteroscopic approach was associated with fewer complications and a more rapid recovery, compared with the percutaneous approach. All patients with solitary kidneys avoided dialysis. PMID:18781220

Weber, Bryce; McCallum, Theresa J.; Tulip, John; Moore, Ronald B.

2008-01-01

449

Laparoscopic gastrostomy as an adjunctive procedure to laparoscopic fundoplication in children  

Microsoft Academic Search

.   Infants and children requiring fundoplication for gastroesophageal reflux frequently have significant associated medical\\u000a problems necessitating placement of a gastrostomy at the time of fundoplication. This article reviews the techniques, complications,\\u000a and results of 141 laparoscopic Stamm gastrostomies performed in conjunction with laparoscopic fundoplication in infants and\\u000a children. The three techniques employed were the T-fastener technique (63\\/141) which is best

L. K. Sampson; K. E. Georgeson; D. C. Winters

1996-01-01

450

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

451

Pelvic Floor Disorders and Multiple Sclerosis  

PubMed Central

Background: Despite recent efforts to educate multiple sclerosis (MS) health-care providers about the importance of pelvic floor disorders (urinary, bowel, and sexual dysfunction), no data are currently available to assess outcomes of these efforts in terms of patient satisfaction. Methods: As part of the fall 2010 North American Research Committee on Multiple Sclerosis survey, we conducted a prospective, survey-based cohort study (N = 14,268) to evaluate patient satisfaction with the current evaluation and treatment of pelvic floor disorders. Patients were queried about 1) bother from bladder, bowel, or sexual symptoms; 2) whether they had been evaluated by a health-care provider for pelvic floor issues in the last 12 months; and 3) satisfaction with the evaluation and treatment they received, on a 5-point Likert scale. Patients were also asked whether these treatments had affected their quality of life (7-point Likert scale). Results: A total of 9397 responses were received (response rate of 65.9%); respondents were primarily white (89%) and female (77.4%). Moderate-to-severe pelvic floor symptoms were reported by one-third of patients (bladder, 41%; bowel, 30%; sexual, 42%). Most respondents had been asked about bladder (61%) or bowel (50%) issues by their health-care providers, but only 20% had been queried about sexual dysfunction. Most respondents were moderately to very satisfied with the management of their bladder and bowel disorders but significantly less satisfied with that of sexual dysfunction. Conclusions: While MS patients are generally satisfied with current management of bladder and bowel dysfunction, improvement is needed in that of sexual dysfunction. PMID:24688351

James, Rebecca; Frasure, Heidi

2014-01-01

452

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

453

Pelvic reconstruction for massive acetabular insufficiency.  

PubMed

Joint reconstruction for pelvic discontinuity because of massive acetabular insufficiency presents a significant surgical challenge. Using retrograde-inserted Steinmann pins to rebuild the dome may be associated with early implant failure because of insufficient mechanical stability and neurovascular injury resulting from pin misplacement. Retrograde pins cannot be placed completely across the pelvic defect. We hypothesized that large Steinmann pins placed anterograde under direct vision from the iliac crest completely across the acetabular column and floor defects would minimize the risk of early failure, and could be placed safely without the use of fluoroscopy in combination with a posterior hip approach. The purpose of our study was to review the mechanical failure and complication rates of nine patients (10 hips) treated between 1996 and 2002 for pelvic discontinuity using this pin placement technique to reinforce a cemented roof ring hip reconstruction done via a posterior approach. None of the patients had implant loosening or failure, there were no neurovascular complications, and no perioperative deaths. One patient required cup revision for recurrent dislocation. All patients were bedridden or wheelchair-bound before surgery, but regained independent household walking by 6 weeks postoperatively. Reinforcing the acetabulum with a lattice girder of anterograde pins provides safe and effective hip reconstruction. PMID:15864056

Parikh, Shital N; Kreder, Hans J

2005-05-01

454

Anatomy of the spermatic venous plexus (pampiniform plexus) in men with and without varicocele: intraoperative venographic study.  

PubMed

Venous anatomy of the testis was reexamined by retrograde spermatic venography during surgery in 17 men with and in 11 without a varicocele. The route of venous drainage of the testis was the internal spermatic vein and the external pudendal vein. The cremasteric and vasal veins were smaller collaterals. There was no cross communication between the right and left spermatic venous systems in the scrotal, retropubic or pelvic areas. In men with a varicocele the spermatic venous plexus was formed of numerous venous sinuses and large dilated veins. PMID:1569670

Wishahi, M M

1992-05-01

455

[Vaginal reconstruction after pelvic exenteration: when and which techniques?].  

PubMed

Pelvic exenterations are commonly performed to treat locally advanced or recurrent tumours of the pelvic organs to achieve long-term survival. Those procedures may present complications. Reconstructive procedures have become an important part of radical pelvic surgery to improve quality of life. Various surgical procedure of vaginal reconstruction have been describe. Myocutaneous flaps are effective in the prevention of major morbidity with pelvic filling and physiological neovagina. Vertical rectus abdominis myocutaneous flap is the technique of choice with simple harvesting and large pelvic filling. Gracilis and gluteal thight flaps are particularly adapted in pelvectomy with perineal resection. Enteroclpoplasty and omental flap must be used in radical colpectomie or difficulty pelvic access. PMID:12868455

Ferron, Gwénaël; Martel, Pierre; Querleu, Denis

2003-05-01

456

LEAF ANATOMY OF ORCUTTIEAE (POACEAE: CHLORIDOIDEAE): MORE EVIDENCE OF C4 PHOTOSYNTHESIS WITHOUT KRANZ ANATOMY  

E-print Network

LEAF ANATOMY OF ORCUTTIEAE (POACEAE: CHLORIDOIDEAE): MORE EVIDENCE OF C4 PHOTOSYNTHESIS WITHOUT KRANZ ANATOMY LAURA M. BOYKIN1,2,3 , WILLIAM T. POCKMAN1 AND TIMOTHY K. LOWREY1 1 Department of Biology, University of New Mexico, Albuquerque, NM 87131 ABSTRACT C4 photosynthesis without Kranz anatomy (single

Pockman, William T.

457

Treatment of the spastic pelvic floor syndrome with biofeedback  

Microsoft Academic Search

The spastic pelvic floor syndrome is a functional disorder based on contraction instead of relaxation of the pelvic floor\\u000a muscle during straining, which inhibits defecation and gives rise to constipation. Until now no adequate treatment has been\\u000a found for this condition. The treatment described here is aimed at teaching patients to relax their pelvic floor muscle during\\u000a straining. Treatment consists

Gijs Bleijenberg; Han C. Kuijpers

1987-01-01

458

Tools for Predicting Biomechanical Consequences of Alterations to Orofacial Anatomy  

E-print Network

Tools for Predicting Biomechanical Consequences of Alterations to Orofacial Anatomy 2008-facial anatomy and predicting functional deficits associated with jaw surgery, such as mandible reconstruction that detailed examination of the biomechanics of surgically reconstructed anatomy through computer simulation

British Columbia, University of

459

Laparoscopic intrauterine insemination in the bitch  

Microsoft Academic Search

A technique for laparoscopic intrauterine insemination in bitches is described. During natural estrus, 5 beagle bitches were inseminated and S others were naturally mated (control group) twice at a 48-h interval on Days 3 and S (n = 4) or Days 4 and 6 (n = 6) after the increase in plasma progesterone considered to be indicative of the day

L. D. M. Silva; K. Onclin; F. Snaps; J. Verstegen

1995-01-01

460

Laparoscopic repair of strangulated Morgagni hernia  

Microsoft Academic Search

A 73 year old man presented with vomiting and pain due to a strangulated Morgagni hernia containing a gastric volvulus. Laparoscopic operation allowed reduction of the contents, excision of necrotic omentum and the sac, with mesh closure of the large defect. A brief review of the condition is presented along with discussion of the technique used.

Michael D Kelly

2007-01-01

461

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

462

Laparoscopic Hysterectomy with Automatic Stapling Devices  

PubMed Central

Purpose: To evaluate outcomes including operating time, blood loss, length of stay (LOS), return to work and complications of laparoscopic hysterectomy performed with automatic stapling devices. Methods: Between 6/11/91 and 11/23/95, 127 laparoscopic hysterectomies were performed with automatic stapling devices. On an average, 6 firings with the stapler were done per case. Postoperative telephone survey and retrospective review of records were done. Results: Data averages for operating time, blood loss, LOS and return to work, respectively, were 90 minutes, 190 cc's, 1.1 day and 2 weeks. Significant complications included delayed postoperative bleeding in 4 patients, all of which occurred within the first 35 cases. One was controlled laparoscopically and 3 others required exploratory laparotomies. Since certain precautionary measures as described were taken, hemorrhagic complications were eliminated. Conclusions: Laparoscopic hysterectomy can be performed safely and effectively with automatic stapling devices in properly selected patients. A potential hazard inherent with this technique includes intraoperative and postoperative bleeding from the staple lines, the incidence of which can be minimized by taking certain precautionary measures such as the use of white cartridges only and bipolar desiccation of staple lines when indicated. PMID:9876650

Tabb, Reese

1997-01-01

463

Laparoscopic treatment of post renal transplant lymphoceles  

Microsoft Academic Search

Background: Traditionally, a post transplant lymphocele (PTL) is drained by widely opening the wall connecting the lymphocele cavity to the intraperitoneal space via laparotomy. We hypothesize that laparoscopic techniques can be effectively used for the treatment of PTL. Methods: Patients requiring intervention for PTL between 1993 and 2002 were identified via a retrospective review. Results of drainage via laparotomy and

S. H. Bailey; M. C. Mone; J. M. Holman; E. W. Nelson

2003-01-01

464

Laparoscopic repair of strangulated Morgagni hernia  

PubMed Central

A 73 year old man presented with vomiting and pain due to a strangulated Morgagni hernia containing a gastric volvulus. Laparoscopic operation allowed reduction of the contents, excision of necrotic omentum and the sac, with mesh closure of the large defect. A brief review of the condition is presented along with discussion of the technique used. PMID:17935621

Kelly, Michael D

2007-01-01

465

Laparoscopic surgery: A pioneer's point of view.  

PubMed

For a surgeon who performed some of the first laparoscopic cholecystectomies, laparoscopic surgery is undoubtedly the main revolution in the last decade of this century. It is impossible not to be fascinated by the extraordinary changes introduced in our profession in less than 10 years. However, looking back in history, one realizes that laparoscopy is but one of those leaps forward that have always punctuated the evolution of our profession. Since the last century we have witnessed the advent of painless surgery, infectionless surgery, reconstructive surgery, microsurgery, surgery under extracorporeal circulation, organ replacement, and so on. We are in the time of scarless surgery, with no lengthy postoperative handicap. Maybe tomorrow will see surgery performed by remote-controlled robots and surgery at the molecule level. The laparoscopic revolution is particularly important because for the first time surgery no longer involves any physical contact between the surgeon's hand and the patient. Let us hope that this will not lead to total absence of a human relationship in the surgical operation. To avoid this possibility we must remain resolutely involved in the development of laparoscopic surgery; we must keep our minds open to the future advances of science and technology and integrate them in our operative procedures. PMID:10415213

Périssat, J

1999-08-01

466

Pediatric laparoscopic appendectomy for acute appendicitis  

Microsoft Academic Search

Background: The benefit of laparoscopy in the treatment of pediatric acute appendicitis continues to be controversial, particularly as it relates to operative time and costs. Methods: We reviewed the charts of 200 children who underwent appendectomy for acute appendicitis concurrently over 35 months at a large teaching children’s hospital. Results: Laparoscopic ( n = 106) and open ( n =

A. H. Vernon; K. E. Georgeson; C. M. Harmon

2004-01-01

467

Helical Tomotherapy With Simultaneous Integrated Boost After Laparoscopic Staging in Patients With Cervical Cancer: Analysis of Feasibility and Early Toxicity  

SciTech Connect

Purpose: To demonstrate the feasibility and safety of the simultaneous integrated boost technique for dose escalation in combination with helical tomotherapy in patients with cervical cancer. Methods and Materials: Forty patients (International Federation of Gynecology and Obstetrics Stage IB1 pN1-IVA) underwent primary chemoradiation with helical tomotherapy. Before therapy, 29/40 patients underwent laparoscopic pelvic and para-aortic lymphadenectomy. In 21%, 31%, and 3% of the patients, pelvic, pelvic and para-aortic, and skip metastases in the para-aortic region could be confirmed. All patients underwent radiation with 1.8-50.4 Gy to the tumor region and the pelvic (para-aortic) lymph node region (planning target volume-A), and a simultaneous boost with 2.12-59.36 Gy to the boost region (planning target volume-B). The boost region was defined using titan clips during laparoscopic staging. In all other patients, standardized borders for the planning target volume-B were defined. High-dose-rate brachytherapy was performed in 39/40 patients. The mean biologic effective dose to the macroscopic tumor ranged from 87.5 to 97.5 Gy. Chemotherapy consisted of weekly cisplatin 40 mg/m{sup 2}. Dose-volume histograms and acute gastrointestinal, genitourinary, and hematologic toxicity were evaluated. Results: The mean treatment time was 45 days. The mean doses to the small bowel, rectum, and bladder were 28.5 {+-} 6.1 Gy, 47.9 {+-} 3.8 Gy, and 48 {+-} 3 Gy, respectively. Hematologic toxicity Grade 3 occurred in 20% of patients, diarrhea Grade 2 in 5%, and diarrhea Grade 3 in 2.5%. There was no Grade 3 genitourinary toxicity. All patients underwent curettage 3 months after chemoradiation, which confirmed complete pathologic response in 38/40 patients. Conclusions: The concept of simultaneous integrated boost for dose escalation in patients with cervical cancer is feasible, with a low rate of acute gastrointestinal and genitourinary toxicity. Whether dose escalation can be translated into improved outcome will be assessed after a longer follow-up time.

Marnitz, Simone, E-mail: simone.marnitz@charite.de [Department of Radiooncology, Charite University Medicine, Berlin (Germany); Koehler, Christhardt [Department of Gynecology, Charite University Medicine, Berlin (Germany); Burova, Elena; Wlodarczyk, Waldemar; Jahn, Ulrich; Gruen, Arne; Budach, Volker; Stromberger, Carmen [Department of Radiooncology, Charite University Medicine, Berlin (Germany)

2012-02-01

468

MRI and venographic aspects of pelvic venous insufficiency.  

PubMed

Pelvic venous insufficiency is a frequent pathology in multiparous women. Diagnosis can be made by chance or suspected in the case of symptoms suggesting pelvic congestion syndrome or atypical lower limb varicosity fed by pelvic leaks. After ultrasound confirmation, dynamic venography is the reference pretherapeutic imaging technique, searching for pelvic varicosity and possible leaks to the lower limbs. MRI is less invasive and allows a three-dimensional study of the varicosity and, with dynamic angiography, it can assess ovarian reflux. It also helps to plan or even sometimes avoid diagnostic venography. PMID:24630150

Leiber, L M; Thouveny, F; Bouvier, A; Labriffe, M; Berthier, E; Aubé, C; Willoteaux, S

2014-11-01

469

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

470

Vaginal mesh repair: is it appropriate for pelvic organ prolapse in a nulliparous female following pelvic ring fracture?  

PubMed

Pelvic organ prolapse (POP) in a nulliparous woman is a rare sequela of high-energy pelvic trauma. We report a case of a 26-year-old nulliparous woman who developed stage III pelvic organ prolapse two decades after pelvic ring disruption. Abdominal wall cervicopexy was performed as a primary procedure by her attending local gynecologist. Recurrence occurred in early postoperative period following which she was referred to our institute. Examination revealed 5-cm pubic symphysis widening and stage III pelvic organ prolapse with deficient perineal body. Widened levator hiatus with atrophic pelvic floor muscles were confirmed on MRI. The patient was successfully managed by sacrospinous hysteropexy using predesigned vaginal mesh kit along with anterior colporrhaphy and colpoperineorrhaphy. Mesh exposure detected at the 6th year of follow-up required partial excision of the exposed mesh. PMID:22890281

Rajamaheswari, N; Chhikara, Archana Bharti; Agarwal, Sugandha

2013-07-01

471

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

MedlinePLUS

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

472

Laparoscopic surgery for colorectal cancer in China: an overview  

PubMed Central

Since its introduction into China in 2001, laparoscopic techniques have been extensively used for the surgical management of colorectal cancer during the last two decades in China. Like all the pioneers of the technique, Chinese gastrointestinal surgeons claim that laparoscopic surgery for colorectal cancer led to faster recovery, shorter hospital stay and more rapid return to daily activities respect to open surgery while offering the same functional and oncological results. There has been booming interest in laparoscopic surgery for colorectal cancer since 2006 in China. The last decade has witnessed national growth in the application of laparoscopic surgery for colorectal cancer and yielded a significant amount of scientific data to support its clinical merits and advantages. However, few prospective randomized controlled trials have investigated the benefits of laparoscopic surgery for colorectal cancer in China. In this article, we make an overview of the current data and state of the art of laparoscopic surgery for colorectal cancer in China. PMID:25663960

Jin, Ketao; Wang, Jun; Lan, Huanrong; Zhang, Ruili

2014-01-01

473

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

474

Comments on the Extraperitoneal Approach for Standard Laparoscopic Radical Prostatectomy: What Is Gained and What Is Lost  

PubMed Central

Laparoscopic extraperitoneal radical prostatectomy (LERP) is considered the standard care treatment option for the management of localized and locally advanced prostatic cancer (PCa) in many institutes worldwide. In this work, the main advantages and disadvantages of LERP approach are reviewed with regard to its outcomes, the complication management, the learning curve, and the extend of pelvic lymph node dissection (PLND). It is concluded that LERP demonstrates comparable cancer control, urinary continence, and potency outcomes with the open and the robot-assisted radical prostatectomy, while offering advantages in complication management in comparison to the transperitoneal approach. Learning curve of LERP is considered long and stiff and significantly affects perioperative outcomes and morbidity, cancer control, and functional results. Thus, close mentoring especially in the beginning of the learning curve is advised. Fi