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1

Anatomy of pelvic floor dysfunction.  

PubMed

Normal physiologic function of the pelvic organs depends on the anatomic integrity and proper interaction among the pelvic structures, the pelvic floor support components, and the nervous system. Pelvic floor dysfunction includes urinary and anal incontinence; pelvic organ prolapse; and sexual, voiding, and defecatory dysfunction. Understanding the anatomy and proper interaction among the support components is essential to diagnose and treat pelvic floor dysfunction. The primary aim of this article is to provide an updated review of pelvic support anatomy with clinical correlations. In addition, surgical spaces of interest to the gynecologic surgeon and the course of the pelvic ureter are described. Several concepts reviewed in this article are derived and modified from a previous review of pelvic support anatomy. PMID:19932407

Corton, Marlene M

2009-09-01

2

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

ERIC Educational Resources Information Center

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

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

2010-01-01

3

Surgical anatomy for pelvic external fixation.  

PubMed

Pelvic external fixators have a high rate of reported complications, most of which relate to pin placement. In this descriptive study, we analyzed the morphology of the ilium in cadaveric specimens and compared these with the measures obtained from normal human pelvic computer tomograph scans, and how these related to each of the three basic configurations of pin positioning for the external fixation of a pelvis: anterosuperior (Slätis type), anteroinferior (supra-acetabular), and subcristal. The irregular shape and size of the iliac wing and the abdominal wall overlying the pin's insertion site could hinder accurate placement of anterosuperior pins. Potential disadvantages of the use of anteroinferior pins was found related to the deep location of the anterior inferior iliac spine, interference with the hip flexion area, risk of hip joint penetration, and the variable obliquity of the ilium. As subcristal pins are positioned between two superficial bony landmarks of the iliac crest, our findings suggest that they are more likely to have a correct placement and avoid complications. PMID:18773474

Solomon, L B; Pohl, A P; Chehade, M J; Malcolm, A M; Howie, D W; Henneberg, M

2008-10-01

4

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

5

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

PubMed

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

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

2009-01-01

6

[Identification of gallbladder pedicle anatomy during laparoscopic cholecystectomy].  

PubMed

Laparoscopic cholecystectomy is widely accepted nowadays as the gold standard in the treatment of cholelithiasis. This new technique was initially associated with a significant increase in morbidity, and in particular in iatrogenic biliary injuries and arterial haemorrhages, perhaps due to a lack of knowledge of the "laparoscopic anatomy" of the gallbladder pedicle. In this technique the anatomical structures are viewed on a two-dimensional video monitor, and the dissection is performed with long instruments without manual sensitivity. Therefore, the laparoscopic surgeon has to deal with new anatomical views and must be aware of the possible arterial and biliary variants. In this review we describe our technique of laparoscopic cholecystectomy, with particular reference to manoeuvres useful for identifying the various anatomical structures at the gallbladder hilum. In our opinion, it is mandatory to avoid cutting any duct if its identity has yet to be established. For this reason, we pay great attention to the anatomical dissection of Calot's triangle, in order to accurately identify the cystic duct and the cystic artery and any other vascular or biliary structures. Routine intraoperative cholangiography may be useful for identifying the biliary anatomy. When in doubt, the surgeon should not hesitate to convert the procedure to open surgery. PMID:15287636

Tebala, Giovanni D; Innocenti, Paolo; Ciani, Renzo; Zumbo, Antonella; Fonsi, Giovanni B; Bellini, Pierpaolo; De Chiara, Fabio; Fittipaldi, Domenico; Hadjiamiri, Hossein; Lamaro, Stefano; Marinoni, Riccardo

2004-01-01

7

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

8

Standardization of laparoscopic pelvic examination: a proposal of a novel system.  

PubMed

Objective. Laparoscopic pelvic assessment is often performed in a nonstandardized fashion depending on the surgeon's discretion. Reporting anatomic findings is inconsistent and lesions in atypical locations may be missed. We propose a method for systematic pelvic assessment based on anatomical landmarks. Design. Retrospective analysis. Setting. Tertiary care academic medical center. Intervention. We applied this system to operative reports of 540 patients who underwent diagnostic or operative laparoscopy for unexplained infertility between 2006 and 2012. The pelvis was divided into 2 midline zones (zone I and II) and right and left lateral zones (zone III and IV). All reports were evaluated for the comprehensiveness of description with respect to normal findings or pathology for each zone. Results. Of 540 surgeries, all reports commented on the uterus, tubes, and ovaries (100%), but only 17% (n = 93, 95% CI: 13.8-20.2) commented on the dome of the bladder and the anterior cul-de-sac. 24% (n = 130, 95% CI: 20.4-27.6) commented on the posterior cul-de-sac, and 5% (n = 29, 95% CI: 3.2-6.8) commented on the pelvic sidewall. Overall, 6% (n = 34, 95% CI: 4-8) reported near complete documentation of the pelvic zones. Conclusion. Implementation of a systematic approach for laparoscopic pelvic examination will enhance the diagnostic accuracy and provide better communication between care providers. In the absence of pelvic pathology, we recommend a minimum of 6 photographs of the 6 pelvic zones. PMID:24490066

Bedaiwy, Mohamed A; Pope, Rachel; Henry, Drisana; Zanotti, Kristin; Mahajan, Sangeeta; Hurd, William; Falcone, Tommaso; Liu, James

2013-01-01

9

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

10

Transection of the obturator nerve by an electrosurgical instrument and its immediate repair during laparoscopic pelvic lymphadenectomy: a case report.  

PubMed

Obturator nerve injury seldom occurs in gynecologic surgery. However, gynecologic oncologic surgery, including pelvic lymph node dissection, increases the risk of this type of injury. Microsurgical techniques are usually performed for the repair of the nerve injury. Herein the authors report a case of obturator nerve injury caused by an electrosurgical instrument during laparoscopic pelvic lymphadenectomy, and its prompt repair by laparoscopic procedure in a 44-year-old patient with cervical cancer. PMID:24772921

Song, M J; Lee, C W; Yoon, J H; Hur, S Y

2014-01-01

11

Role of laparoscopic pelvic lymph node dissection in the management of patients with penile cancer and inguinal adenopathy.  

PubMed

Patients with invasive squamous cell carcinoma of the penis and tumor involvement of the inguinal nodes are at risk for pelvic lymph node metastases. When this spread occurs, the chance for patient survival is limited. Because the sensitivity of CT in detecting pelvic lymph node metastases is low, open surgical pelvic lymphadenectomy is frequently performed. We have utilized laparoscopic pelvic lymphadenectomy as a minimally invasive alternative to this open approach in three patients with Stage T3 (UICC staging system) squamous cell carcinoma of the penis who had persistent inguinal adenopathy after a standard course of postpenectomy antiobiotic therapy. There were no intraoperative or postoperative complications, and all patients were discharged within 24 hours after surgery. The mean number of nodes removed was eight, and all specimens were free of tumor. Laparoscopic pelvic lymphadenectomy should be considered in patients with persistent inguinal adenopathy after antibiotic therapy before proceeding with inguinal lymph node dissection. PMID:7858625

Assimos, D G; Jarow, J P

1994-10-01

12

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

13

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

PubMed Central

Background: Our purpose was to provide the clinical advantages of the laparoscopic approach compare to the vaginal approach in correcting uterine and vaginal vault prolapse. Methods: Between June 2007 and June 2011, 174 women were admitted to HUMC (Hallym University Medical Center) and underwent pelvic reconstructive surgery for prolapsed vaginal vault and uterus. Upon retrospective review of the medical records, 174 of the patients who had symptoms of pelvic organ prolapsed and Baden-Walker prolapse grade ? 2 were selected and divided into two groups as follows: vaginal approach group (n=120) and laparoscopic approach group (n=54). We compared the results of clinical outcome by analyzing Student's t-test and ?2-test or the Fisher exact test as appropriate. Results: There were significant difference in success rates without reoperation for recurrence as 91.7% (vaginal approach group, n=110) vs 100% (laparoscopic approach group, n=54), p=0.032. Mean follow-up duration was 31.3 ± 7.6 months for vaginal approach group and 29.7 ± 9.7 months for laparoscopic approach group. The Foley catheter indwelling duration (4.7± 1.9 vs 3.4±2.1 days, p< 0.001) and the length of postoperative hospitalization (6.4 ± 2.1 vs 5.0 ± 1.9 days, p <0.001) were significantly longer in vaginal approach group, whereas the operative time was significantly longer (108.2 ± 38.6 vs 168.3 ± 69.7 minutes, p <0.001) in laparoscopic approach group. Conclusions: Our result suggest there is significantly lower recurrence rate requiring reoperation and less catheterization time but increased operative time for laparascopic sacrocolpopexy. PMID:25170290

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

2014-01-01

14

Inter-observer variability at laparoscopic assessment of pelvic adhesions.  

PubMed

A total of 25 women undergoing videolaparoscopy and a dye test to investigate pelvic adhesions and infertility were evaluated to determine whether applying a score system to pelvic adhesions was reproducible, and its place in determining prognosis or management. The surgeon performing the laparoscopies scored each case using the American Fertility Society (AFS) system, gave an estimate of the likely prognosis from microsurgery and recorded a recommended management [surgery or in-vitro fertilization (IVF)]. The video images and histories were independently reviewed by two other surgeons experienced in tubal surgery, who also scored each case and recorded prognosis from surgery and recommended management. Several differences in adhesion scores for each case were noted. Agreement was present between surgeons regarding estimated prognosis for microsurgery and also in recommending management, particularly when prognosis was considered poor and IVF was recommended. Despite some reproducibility, the AFS score system did not predict outcome or management decisions. However, the surgeons' fundamental impression of the state of the pelvis and recommendation for either surgery or IVF were more consistent and reproducible. Any future proposed system for adhesion classification will need to account for, and be predictive of, the decreasing number of patients for whom surgery (rather than IVF) is the preferred management. PMID:7745047

Bowman, M C; Li, T C; Cooke, I D

1995-01-01

15

Novel hybrid laparoscopic sacrocolpopexy for pelvic organ prolapse with a severe paravaginal defect.  

PubMed

Abdominal sacrocolpopexy is the gold standard for treating pelvic organ prolapse (POP) because of safety and durable good results. More recently laparoscopic sacrocolpopexy (LSC), a less invasive approach, has become popular. Although these surgeries are versatile and can treat almost all patients with POP, these techniques have shortcomings. Specifically, reinforcement of lateral vaginal defects are not very strong, thus patients with POP and a severe paravaginal defect are not good candidates for abdominal or laparoscopic sacrocolpopexy. To overcome this problem, we developed a novel type of LSC, which can reinforce severe paravaginal defects by using a reversed T-shaped anterior mesh combining the advantage of transvaginal mesh surgery. We refer to this novel surgery as 'hybrid LSC'. Thus far, eight patients have successfully undergone this surgery. Hybrid LSC is a simple and secure method, and is an alternative treatment for POP with a severe paravaginal defect. PMID:23002783

Ichikawa, Masao; Akira, Shigeo; Mine, Katsuya; Ohuchi, Nozomi; Kurose, Keisuke; Takeshita, Toshiyuki

2013-02-01

16

Laparoscopic Pelvic Autonomic Nerve-Preserving Surgery for Sigmoid Colon Cancer  

Microsoft Academic Search

Background  To test the feasibility of laparoscopic approach in performing the simultaneous pelvic autonomic nerve preservation during\\u000a standard anterior resection of sigmoid colon cancer.\\u000a \\u000a \\u000a \\u000a Methods  Patients meeting appropriate eligibility criteria were recruited for the present study. The surgical procedures are shown\\u000a in the video. The genitourinary function was evaluated on the basis of validated questionnaires including International Prostate\\u000a Symptom Score (IPSS), International

Jin-Tung Liang; Hong-Shiee Lai; Po-Huang Lee; King-Jen Chang

2008-01-01

17

Technique and outcomes about a new laparoscopic procedure: the Pelvic Organ Prolapse Suspension (POPS)  

PubMed Central

Summary: Pelvic organ prolapse suspension (POPS) is a recent surgical procedure for one-stage treatment of multiorgan female pelvic prolapse. This study evaluates the preliminary results of laparoscopic POPS in 54 women with a mean age of 55.2 and a BMI of 28.3. Patients underwent at the same time stapled transanal rectal resection (STARR) to correct the residual rectal prolapse. We had no relapses and the preliminary results were excellent. We evaluated the patients after 1 year follow-up and we confirmed the validity of our treatment. The technique is simplier than traditional treatments with an important reduction or completely disappearance of the pre-operative symptomatology. PMID:23837949

CECI, F.; SPAZIANI, E.; CORELLI, S.; CASCIARO, G.; MARTELLUCCI, A.; COSTANTINO, A.; NAPOLEONI, A.; CIPRIANI, B.; NICODEMI, S.; DI GRAZIA, C.; AVALLONE, M.; ORSINI, S.; TUDISCO, A.; AIUTI, F.; STAGNITTI, F.

2013-01-01

18

A modified method in laparoscopic peritoneal catheter implantation: the combination of preperitoneal tunneling and pelvic fixation.  

PubMed

Introduction. Continuous ambulatory peritoneal dialysis (CAPD) is widely accepted for the management of end-stage renal disease (ESRD). Although not as widely used as hemodialysis, CAPD has clear advantages, especially those related to patient satisfaction and simplicity. Peritoneal dialysis (PD) catheter insertion can be accomplished by several different techniques. In this study, we aimed to evaluate our results obtained with peritoneal dialysis catheter placement by combination of pelvic fixation plus preperitoneal tunneling. Material and Methods. Laparoscopic peritoneal catheter implantation by combining preperitoneal tunneling and pelvic fixation methods was performed in 82 consecutive patients with end-stage renal disease. Sex, age, primary disease etiology, complications, mean duration of surgery, mean duration of hospital stay, morbidity, mortality, and catheter survival rates and surgical technique used were assessed. Analysis of catheter survival was performed using the Kaplan-Meier method. Results. Mean follow-up period was 28.35 ± 14.5 months (range of 13-44 months). Mean operative time was 28 ± 6 minutes, and mean duration of hospital stay was 3 ± 1 days. There were no conversions from laparoscopy to other insertion methods. None of the patients developed serious complications during surgery or the postoperative period. No infections of the exit site or subcutaneous tunnel, hemorrhagic complications, abdominal wall hernias, or extrusion of the superficial catheter cuff was detected. No mortality occurred in this series of patients. Catheter survival was found to be 92% at 3 years followup. Conclusions. During one-year followup, we had seven patients of migrated catheters due to separation of pelvic fixation suture from peritoneal surface, but they were reimplanted and fixated again laparoscopically with success. Over a three-year followup period, catheter survival was found to be 92%. In the literature, similar catheter survival rates without combination of the two techniques are reported. As a conclusion, although laparoscopic placement of PD catheters avoids many perioperative and early complications, as well as increasing catheter free survival period and quality of life, our results comparing to other studies in the literature indicate that different laparoscopic placement methods are still in debate, and further studies are necessary to make a more accurate decision. PMID:23762625

Gunes, Mehmet Emin; Uzum, Gungor; Koc, Oguz; Duzkoylu, Yi?it; Kucukyilmaz, Meltem; Sari, Yavuz Selim; Tunal?, Vahit; Kose, Sennur

2013-01-01

19

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

PubMed

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

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

2007-05-01

20

Robotic and laparoscopic pelvic lymph node dissection for rectal cancer: short-term outcomes of 21 consecutive series  

PubMed Central

Purpose The aim of this study is to describe our initial experience and assess the feasibility and safety of robotic and laparoscopic lateral pelvic node dissection (LPND) in advanced rectal cancer. Methods Between November 2007 and November 2012, extended minimally invasive surgery for LPND was performed in 21 selected patients with advanced rectal cancer, including 11 patients who underwent robotic LPND and 10 who underwent laparoscopic LPND. Extended lymphadenectomy was performed when LPN metastasis was suspected on preoperative magnetic resonance imaging even after chemoradiation. Results All 21 procedures were technically successful without the need for conversion to open surgery. The median operation time was 396 minutes (range, 170-581 minutes) and estimated blood loss was 200 mL (range, 50-700 mL). The median length of stay was 10 days (range, 5-24 days) and time to removal of the urinary catheter was 3 days (range, 1-21 days). The median total number of lymph nodes harvested was 24 (range, 8-43), and total number of lateral pelvic lymph nodes was 7 (range, 2-23). Six patients (28.6%) developed postoperative complications; three with an anastomotic leakages, two with ileus and one patient with chyle leakage. Two patients (9.5%) developed urinary incontinence. There was no mortality within 30 days. During a median follow-up of 14 months, two patients developed lung metastasis and there was no local recurrence. Conclusion Robotic and laparoscopic LPND is technically feasible and safe. Minimally invasive techniques for LPND in selected patients can be an acceptable alternative to an open LPND. PMID:24761412

Bae, Sung Uk; Saklani, Avanish P.; Hur, Hyuk; Min, Byung Soh; Baik, Seung Hyuk; Lee, Kang Young

2014-01-01

21

Surface curvature of pelvic joints from three laser scanners: separating anatomy from measurement error.  

PubMed

Recent studies have reported that quantifying symphyseal and auricular surface curvature changes on 3D models acquired by laser scanners has a potential for age estimation. However, no tests have been carried out to evaluate the repeatability of the results between different laser scanners. 3D models of the two pelvic joints were generated using three laser scanners (Custom, Faro, and Minolta). The surface curvature, the surface area, and the distance between co-registered meshes were investigated. Close results were found for surface areas (differences between 0.3% and 2.4%) and for distance deviations (average <20 ?m, SD <200 ?m). The curvature values were found to be systematically biased between different laser scanners, but still showing similar trends with increasing phases/scores. Applying a smoothing factor to the 3D models, it was possible to separate anatomy from the measurement error of each instrument, so that similar curvature values could be obtained (p < 0.05) independent of the specific laser scanner. PMID:25684259

Villa, Chiara; Gaudio, Daniel; Cattaneo, Cristina; Buckberry, Jo; Wilson, Andrew S; Lynnerup, Niels

2015-03-01

22

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

23

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

24

Controlling difficult pelvic bleeding with argon beam coagulator during laparoscopic ultra low anterior resection.  

PubMed

In recent years, the standard of care for lower rectal tumors has developed to include a total mesorectal excision, which provides optimal long-term results. There has been debate with regard to the best approach for lower rectal tumors, conventional open versus less invasive procedures. As the trend toward less invasive surgical procedures progresses, similar complications, which are seen in open cases, are being encountered, such as the notorious presacral fascia bleed. These are small vessels, which are difficult to locate and control. Surgical literature suggests different methods during laparoscopic procedures. These include: placing lap pads and holding pressure, placing saline bag, placing tacks, using bone wax, and electrocautry at different settings. We present a case of a 57-year-old male, positive for lymph node disease, who underwent laparoscopic ultra low anterior resection with total mesorectal excision and protective loop ileostomy. PMID:21304367

Kandeel, Ahmed; Meguid, Ahmed; Hawasli, Abdelkader

2011-02-01

25

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

26

SIU/ICUD Consultation On Urethral Strictures: Epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, strictures, and pelvic fracture urethral disruption injuries.  

PubMed

This committee reviewed and evaluated published data, and recommended standardized terminology relating to the epidemiology, etiology, anatomy, and nomenclature of urethral stenoses, urethral strictures, and pelvic fracture urethral disruption injuries, as well as their surgical management. A literature search using Medline, PubMed (U.S. National Library of Medicine and the National Institutes of Health), Embase, online acronym databases, and abstracts from scientific meetings was performed from 1980-2010. Articles were evaluated using the Levels of Evidence adapted by the International Consultation on Urological Diseases (ICUD) from the Oxford Centre for Evidence-Based Medicine. Recommendations were based on the level of evidence and discussed among the committee to reach a consensus. There is expert opinion to support standards regarding the epidemiology, anatomy, and nomenclature of urethral stenoses, urethral strictures, and pelvic fracture urethral disruption injuries. There is level 3 evidence regarding the epidemiology and etiology of urethral stenoses, urethral strictures, and pelvic fracture urethral injuries. The literature regarding the epidemiology, anatomy, and nomenclature of urethral stenoses, urethral strictures, and pelvic fracture urethral disruption injuries are sparse and generally of a low level of evidence. The proposed ICUD system does not readily apply to these areas. Further research is needed so that stronger levels of evidence can be developed leading to recommendations regarding the accuracy of the data. To improve future research and promote effective scientific progress and communication, a standardized nomenclature and anatomy regarding the urethra and urethral surgery is detailed herein. PMID:24210733

Latini, Jerilyn M; McAninch, Jack W; Brandes, Steven B; Chung, Jae Yong; Rosenstein, Daniel

2014-03-01

27

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

28

Preoperative assessment of vascular anatomy by multidetector computed tomography before laparoscopic colectomy for transverse colon cancer: report of a case.  

PubMed

Although the safety of laparoscopic surgery for colon cancer has been reported in many randomized controlled trials, concerns about the difficulty of surgery for transverse colon cancer has not been fully resolved, mainly because of the variation in the vascular anatomy of mesenteric vessels, which leads to difficulty in determining the optimal operative procedure and the extent of lymph node dissection. We present the case of a patient with transverse colon cancer who underwent laparoscopic surgery after preoperative assessment using a combination of endoscopic clipping and three-dimensional computed tomography angiography (3DCTA). A 68-year-old man was diagnosed with transverse colon cancer, and laparoscopic surgery has been planned. 3DCTA showed right-middle and left-middle colic arteries arising independently from the superior mesenteric artery. The relationship between the clip and vessels showed that the right-middle colic artery was the feeding artery of the tumor. Operative findings were consistent with 3DCTA findings, and transverse colectomy with lymph node dissection was successfully performed. PMID:25692419

Kawamoto, Aya; Inoue, Yasuhiro; Okigami, Masato; Yasuda, Hiromi; Okugawa, Yoshinaga; Hiro, Junichiro; Toiyama, Yuji; Tanaka, Koji; Uchida, Keiichi; Mohri, Yasuhiko; Kusunoki, Masato

2015-02-01

29

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

30

Single-incision Plus One Port Laparoscopic Total Mesorectal Excision and Bilateral Pelvic Node Dissection for Advanced Rectal Cancer-A Medial Umbilical Ligament Approach.  

PubMed

We prove the safety and feasibility of single-incision plus 1 port (SILS+1) laparoscopic total mesorectal excision (TME) + lateral pelvic lymph node dissection (LPLD) via a medial umbilical approach for rectal cancer. Only a few reports have been published about single-incision multiport laparoscopic low anterior resection with LPLD. Recently, minimally invasive surgery such as single-incision plus 1 port (SILS + 1) for advanced rectal cancer has been reported as safe and feasible. To our knowledge, this is the first reported case of SILS + 1 used for LPLD. A wound protector was inserted through a 30-mm transumbilical incision. Next, a single-port access device was mounted to the wound protector and 3 ports (5 mm each) were placed. A 12-mm port was inserted in the right lower quadrant. Super-low anterior resection of the rectum and bilateral LPLD and temporary ileostomy were performed with SILS + 1, with a blood loss of 50 mL and a total surgical time of 525 minutes. The time for right lateral dissection was 74 minutes; the time for left lateral dissection was 118 minutes. The total number of dissected lymph nodes was 57 and the number of lateral lymph nodes dissected was 21 (8 left pelvic lymph nodes, 13 right pelvic lymph nodes). No postoperative anastomotic insufficiency or voiding dysfunction was observed. We have documented the safety and feasibility of SILS + 1-TME + LPLD via a medial umbilical approach for rectal cancer. PMID:25785320

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

2015-03-01

31

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

32

Controlled balloon dilatation of the extraperitoneal space for laparoscopic urologic surgery.  

PubMed

Laparoscopic urologic surgery has become increasingly more popular, with the majority of procedures and techniques that have been described based on intraperitoneal experience and anatomic considerations. Urologic surgery, traditionally confined mostly to the extraperitoneal space, has followed these intraperitoneal descriptions when undertaken laparoscopically. Our experience of controlled, laparoscopically monitored dilatation of the extraperitoneal space using a new trocar-mounted balloon dissector can create a working space in a surgical environment familiar to traditional open urologic surgery. We report our initial experience with the preperitoneal distention balloon in 15 patients, emphasizing the technique of extraperitoneal access and the laparoscopic visualization of anatomy relevant to pelvic lymph node dissection, varicocele ligation, nephropexy, and renal biopsy. In this early experience, laparoscopic pelvic lymph node dissection was performed successfully in 7 of 11 patients and in all other patients undergoing the retroperitoneal procedures. Patients with a prior history of hernia repair or appendectomy do not appear to be suitable to this approach when used for pelvic lymphadenectomy. The trocar-mounted balloon device allows direct visualization and control of the dissection process. Avoiding the transperitoneal approach may eliminate many of the complications associated with the transperitoneal access and procedure completion. We conclude that the extraperitoneal technique using this device merits further investigation and more widespread application in the laparoscopic approach to conventional extraperitoneal urologic procedures. PMID:7949382

Hirsch, I H; Moreno, J G; Lotfi, M A; Gomella, L G

1994-08-01

33

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

PubMed

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

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

2010-12-01

34

Diagnostic accuracy of a volume-rendered computed tomography movie and other computed tomography-based imaging methods in assessment of renal vascular anatomy for laparoscopic donor nephrectomy  

Microsoft Academic Search

To evaluate the diagnostic accuracy of computed tomography (CT)-based imaging methods for assessing renal vascular anatomy,\\u000a imaging studies, including standard axial CT, three-dimensional volume-rendered CT (3DVR-CT), and a 3DVR-CT movie, were performed\\u000a on 30 patients who underwent laparoscopic donor nephrectomy (10 right side, 20 left side) for predicting the location of the\\u000a renal arteries and renal, adrenal, gonadal, and lumbar

Shingo Yamamoto; Masao Tanooka; Kumiko Ando; Toshiko Yamano; Reiichi Ishikura; Michio Nojima; Shozo Hirota; Hiroki Shima

2009-01-01

35

Laparoscopic Sacrocolpopexy  

PubMed Central

Laparoscopy offers great exposure and surgical detail, reduces blood loss and the need for excessive abdominal packing and bowel manipulation making it an excellent modality to perform pelvic floor surgery. Laparoscopic repair of level I or apical vaginal prolapse may be challenging, due to the need for extensive dissection and advanced suturing skills. However, it offers the efficacy of open abdominal sacrocolpopexy, such as lower recurrence rates and less dyspareunia than sacrospinous fixation, as well as the reduced morbidity of a laparoscopic approach. PMID:24753860

Manodoro, S.; Werbrouck, E.; Veldman, J.; Haest, K.; Corona, R.; Claerhout, F.; Coremans, G.; De Ridder, D.; Spelzini, F.; Deprest, J.

2011-01-01

36

Laparoscopic-assisted low anterior resection of the rectum—a review of the fascial composition in the pelvic space  

Microsoft Academic Search

Introduction  Outcomes of rectal cancer treatment depend on the operative technique, and complication rates vary. Complications can occur\\u000a during mobilization of the rectum, with damage to the ureter, autonomic nerves, and the rectum itself. Frequencies of these\\u000a complications can be reduced by careful dissection of the correct tissue plane in the pelvic space.\\u000a \\u000a \\u000a \\u000a \\u000a Methodology  This paper reviews the fascial composition of the

Makio Mike; Nobuyasu Kano

2011-01-01

37

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 cavity—a region of the body that is the focus of laparoscopic surgery—as 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,

38

Diagnostic accuracy of a volume-rendered computed tomography movie and other computed tomography-based imaging methods in assessment of renal vascular anatomy for laparoscopic donor nephrectomy.  

PubMed

To evaluate the diagnostic accuracy of computed tomography (CT)-based imaging methods for assessing renal vascular anatomy, imaging studies, including standard axial CT, three-dimensional volume-rendered CT (3DVR-CT), and a 3DVR-CT movie, were performed on 30 patients who underwent laparoscopic donor nephrectomy (10 right side, 20 left side) for predicting the location of the renal arteries and renal, adrenal, gonadal, and lumbar veins. These findings were compared with videos obtained during the operation. Two of 37 renal arteries observed intraoperatively were missed by standard axial CT and 3DVR-CT, whereas all arteries were identified by the 3DVR-CT movie. Two of 36 renal veins were missed by standard axial CT and 3DVR-CT, whereas 1 was missed by the 3DVR-CT movie. In 20 left renal hilar anatomical structures, 20 adrenal, 20 gonadal, and 22 lumbar veins were observed during the operation. Preoperatively, the standard axial CT, 3DVR-CT, and 3DVR-CT movie detected 11, 19, and 20 adrenal veins; 13, 14, and 19 gonadal veins; and 6, 11, and 15 lumbar veins, respectively. Overall, of 135 renal vascular structures, the standard axial CT, 3DVR-CT, and 3DVR-CT movie accurately detected 99 (73.3%), 113 (83.7%), and 126 (93.3%) vessels, respectively, which indicated that the 3DVR-CT movie demonstrated a significantly higher detection rate than other CT-based imaging methods (P < 0.05). The 3DVR-CT movie accurately provides essential information about the renal vascular anatomy before laparoscopic donor nephrectomy. PMID:19266308

Yamamoto, Shingo; Tanooka, Masao; Ando, Kumiko; Yamano, Toshiko; Ishikura, Reiichi; Nojima, Michio; Hirota, Shozo; Shima, Hiroki

2009-12-01

39

Laparoscopic Repair of Perineal Hernia  

PubMed Central

Perineal hernia is a rare but known complication following major pelvic surgery. It may occur spontaneously or following abdominoperineal resection, sacrectomy, or pelvic exenteration. Very little is known about spontaneous perineal hernia. Surgical repair via open transabdominal and transperineal approaches has been previously described. We report laparoscopic repair of spontaneous and postoperative perineal hernia in 2 patients. PMID:19660225

Rayhanabad, Jessica; Sassani, Pejvak

2009-01-01

40

Preoperative Surgical Planning Using Virtual Laparoscopic Camera  

E-print Network

Preoperative Surgical Planning Using Virtual Laparoscopic Camera Dmitry Oleynikov, M.D Leonid require the surgeon to operate based on a 2-dimensional (2D) image visible through the laparoscopic camera. The objective of this study is to generate a 3D laparoscopic simulation of peri- toneal surface anatomy based

Zhukov, Leonid

41

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

42

Robotic-assisted laparoscopy for the excision of a pelvic leiomyosarcoma.  

PubMed

The indications for robot-assisted laparoscopic surgery in Urology are expanding as surgical experience with robotic surgery mounts. We describe our experience of performing a laparoscopic robot-assisted excision of a pelvic leiomyosarcoma in an adult. PMID:25484985

Chavin, Grant; Gettman, Matthew

2008-01-01

43

Chronic pelvic floor dysfunction.  

PubMed

The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management. PMID:25108498

Hartmann, Dee; Sarton, Julie

2014-10-01

44

Surgical Treatment for Chronic Pelvic Pain  

PubMed Central

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

1998-01-01

45

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

46

Ureteral injury after laparoscopic surgery  

Microsoft Academic Search

Ureteral injuries are uncommon but serious complications of laparoscopic pelvic surgery. When unrecognized, patients experience fever, abdominal pain, signs of peritonitis, and leukocytosis usually 48 to 72 hours after the surgical procedure. A 48-year-old woman underwent laparoscopic-assisted vaginal hysterectomy, bilateral salpingo-oophorectomy, and anterior and posterior colporrhapy due to a large, symptomatic uterine myoma. Postoperatively, she suffered from progressive left lower

Cheng-Hsien Liu; Peng-Hui Wang; Wei-Ming Liu; Chio-Chung Yuan

1997-01-01

47

SYSTEM FOR LAPAROSCOPIC TISSUE TRACKING Darin Knaus1  

E-print Network

SYSTEM FOR LAPAROSCOPIC TISSUE TRACKING Darin Knaus1 , Eric Friets1 , Jerry Bieszczad1 , Richard.miga@vanderbilt.edu, bob.galloway@vanderbilt.edu ABSTRACT This paper describes the development of a laparoscopic tissue with the actual anatomy encountered during surgery. The laparoscopic tissue tracking system relies on projection

Miga, Michael I.

48

Ethical issues in laparoscopic hysterectomy.  

PubMed

Hysterectomy is performed for a wide range of benign and malignant conditions, such as fibroids, menorrhagia and pelvic pain, and gynaecological malignancies. One in four women has a chance of undergoing hysterectomy in her lifetime. Conventionally abdominal hysterectomy is done through the open approach. However, many patients assume that the modern laparoscopic hysterectomy is superior to the standard approach. Laparoscopic surgical centres are mushrooming in major cities. This article presents ethical considerations involved in the decision-making process of choosing from the surgical options available. PMID:16832925

Hebbar, Shripad; Nayak, Sathisha

2006-01-01

49

[Laparoscopic appendectomy. Our experience].  

PubMed

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

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

2012-01-01

50

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

51

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

52

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

53

MDCT angiography of living laparoscopic renal donors  

Microsoft Academic Search

Laparoscopic donor nephrectomy has become the accepted method of harvesting the kidney at many institutions because of multiple\\u000a advantages over open donor nephrectomy. Spiral computed tomographic (CT) angiography provides accurate information of renal\\u000a vascular anatomy and has become an accepted method of preoperative evaluation of potential laparoscopic renal donors. More\\u000a recently, multidetector CT (MDCT) provides more detailed datasets compared with

S. Kawamoto; E. K. Fishman

2006-01-01

54

Laparoscopic urology: Past, present, and future  

Microsoft Academic Search

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

Ralph V. Clayman; Louis R. Kavoussi

1993-01-01

55

Urogynecologic conditions: pelvic organ prolapse.  

PubMed

Chronic pelvic pain is a commonly encountered condition that often is multifactorial. Etiologies include gynecologic, urologic, gastrointestinal, and neurologic conditions. Laboratory tests, imaging, and surgical intervention are not always helpful in identifying the etiology of pelvic pain. For appropriate management of this complex disease process, a detailed history and physical examination, and a multidisciplinary approach are needed. Pelvic pain may be caused by endometriosis, pelvic inflammatory disease, adenomyosis, interstitial cystitis/painful bladder syndrome, or other factors. Evaluation may include keeping a pain diary; laboratory tests, such as a pregnancy test, urinalysis, or tests for sexually transmitted infections; ultrasonography of abnormalities detected on physical examination; and laparoscopy. Specific first-line treatments include nonsteroidal anti-inflammatory drugs and oral contraceptives for endometriosis; progestins, gonadotropin-releasing hormone analogs, aromatase inhibitors, or hysterectomy for adenomyosis; and education, food avoidance, and behavioral modifications for interstitial cystitis/painful bladder syndrome. Surgical options include nerve transection procedures, laparoscopic uterosacral nerve ablation, and presacral neurectomy, although data on effectiveness are limited. PMID:25756374

Noor, Nabila; Garely, Alan D

2015-03-01

56

Female Anatomy Lecture outline Human Reproduc.ve  

E-print Network

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

Dever, Jennifer A.

57

Laparoscopic Hysterectomy and Prolapse: A Multiprocedural Concept  

PubMed Central

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

Mettler, Liselotte; Peters, Goentje; Noé, Günter; Holthaus, Bernd; Jonat, Walter; Schollmeyer, Thoralf

2014-01-01

58

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 ...

59

Pelvic fracture  

Microsoft Academic Search

Pelvic fractures are common and often devastating injuries. Along with a high mortality, the long-term morbidity is consequential for both the individual patient and society. A thorough knowledge of the clinical approach will assist the emergency physician in providing optimal care and offer a rapid and effective treatment plan for life threatening hemorrhage. Using a case-based scenario, the initial management

Jean Hammel; Eric Legome

2006-01-01

60

Pelvic Exenteration: Surgical Approaches  

PubMed Central

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

2012-01-01

61

Laparoscopic surgery - series (image)  

MedlinePLUS

... of different procedures can be performed laparoscopically, including gallbladder removal (laparoscopic cholecystectomy), esophageal surgery (laparoscopic fundoplication), colon surgery (lapraoscopic colectomy), and surgery ...

62

Incarcerated tubal herniation, an unusual complication of operative laparoscopy and an odd cause of pelvic pain  

Microsoft Academic Search

Tubal herniation after laparoscopic surgery to relieve pelvic pain and adhesions was associated with long-term, chronic pelvic pain in the left lower quadrant. Laparoscopy was performed to diagnose and reduce the herniation. Review of the literature revealed no previous report of this complication.

Donald L. Chatman

2000-01-01

63

Laparoscopic splenectomy  

Microsoft Academic Search

Summary Splenectomy has traditionally been done through a generous laparotomy incision, requiring complete mobilization of the spleen for removal. In selected cases, however, splenectomy may either be facilitated or performed entirely by laparoscopic means. Two patients with Hodgkin's disease in whom splenectomy was facilitated laparoscopically are described; in another patient with idiopathic thrombocytopenic purpura (ITP), the splenectomy was successfully performed

Brendan J. Carroll; Edward H. Phillips; Chester J. Semel; Moses Fallas; Leon Morgenstern

1992-01-01

64

Pelvic Organ Prolapse  

MedlinePLUS

Pelvic Organ Prolapse Pelvic organ prolapse, or POP, is the dropping of the pelvic organs caused by the loss of normal support of the vagina. POP occurs ... Victoria Handa and Gunhilde Buchsbaum about pelvic organ prolapse. Am I at Risk? Pelvic organ prolapse is ...

65

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

Microsoft Academic Search

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

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

2000-01-01

66

Laparoscopic Hysteropexy in a Patient with Spina Bifida and Ventriculoperitoneal Shunt  

PubMed Central

Laparoscopic repair of pelvic organ prolapse in patients with ventriculoperitoneal shunts has not been previously described. The optimum management of patients with ventriculoperitoneal shunts undergoing laparoscopy is uncertain. We describe the case of a 21-year-old female patient with spina bifida and ventriculoperitoneal shunt who underwent laparoscopic hysteropexy for severe pelvic organ prolapse. The implications of performing laparoscopy on patients with ventriculoperitoneal shunts are reviewed along with strategies to reduce potential intraoperative complications. PMID:21902988

Askari, Reza; Kasturi, Seshadri; Ravangard, Samadh F.

2011-01-01

67

Laparoscopic pyeloplasty for ureteropelvic junction obstruction of the lower moiety in a completely duplicated collecting system: a case report  

Microsoft Academic Search

INTRODUCTION: There are only a few reports on laparoscopic pyeloplasty in kidney abnormalities and only one case for laparoscopic pyeloplasty in a duplicated system. Increasing experience in laparoscopic techniques allows proper treatment of such anomalies. However, its feasibility in difficult cases with altered kidney anatomy such as that of duplicated renal pelvis still needs to be addressed. CASE PRESENTATION: We

Konstantinos G Stravodimos; Ioannis Anastasiou; Theodoros Kapetanakis; Georgios Koritsiadis; Constantinos Constantinides

2008-01-01

68

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

69

[Laparoscopic gastrectomy].  

PubMed

Laparoscopy-assisted gastrectomy has become a popular surgical option, particularly for the treatment of early gastric cancer. A multi-institutional clinical trial has recently demonstrated that satisfactory results have been obtained with the clinical outcomes of laparoscopic gastrectomy for early gastric cacer, which was not inferior to those obtained by a conventional open procedure. However, the indication of laparoscopic gastrectomy for the treatment of patients with advanced gastric cancer has remained controversial. In this paper, we describe the current status of gastric cancer treatment, including lymph node dissection and reconstruction procedures. We also provide future perspectives concerning the robot-assisted laparoscopic gastrectomy for gastric cancer. PMID:23198560

Yoshimura, Fumihiro; Uyama, Ichiro

2012-10-01

70

Primate pelvic anatomy and implications for birth.  

PubMed

The pelvis performs two major functions for terrestrial mammals. It provides somewhat rigid support for muscles engaged in locomotion and, for females, it serves as the birth canal. The result for many species, and especially for encephalized primates, is an 'obstetric dilemma' whereby the neonate often has to negotiate a tight squeeze in order to be born. On top of what was probably a baseline of challenging birth, locomotor changes in the evolution of bipedalism in the human lineage resulted in an even more complex birth process. Negotiation of the bipedal pelvis requires a series of rotations, the end of which has the infant emerging from the birth canal facing the opposite direction from the mother. This pattern, strikingly different from what is typically seen in monkeys and apes, places a premium on having assistance at delivery. Recently reported observations of births in monkeys and apes are used to compare the process in human and non-human primates, highlighting similarities and differences. These include presentation (face, occiput anterior or posterior), internal and external rotation, use of the hands by mothers and infants, reliance on assistance, and the developmental state of the neonate. PMID:25602069

Trevathan, Wenda

2015-03-01

71

The outcome of treatment for pelvic congestion syndrome.  

PubMed

Pelvic congestion syndrome is one of many causes of chronic pelvic pain. It is generally accepted that this is attributable to ovarian and pelvic vein incompetence which may result in varices in the lower limb leading to presentation in varicose vein clinics. However, far more patients have pelvic varices associated with varicose veins in the lower limb than have pelvic congestion syndrome. Magnetic resonance imaging and computed tomographic venography are usually used in the diagnosis of this condition and criteria have been established to identify pelvic varices. Many different treatments have been used to manage the symptoms of pelvic congestion. Hysterectomy combined with oophrectomy, open surgical ligation of ovarian veins and laparoscopic vein ligation have been used in the past. The most common treatments used currently involve embolization of pelvic and ovarian veins. The results of this treatment have been published in a limited number of clinical series, usually with fairly short follow-up periods. These treatments may be complicated by migration of embolization of coils used to occlude veins. The longest duration of follow-up currently reported is five years. Limited clinical evidence supports the use of embolotherapy in the management of pelvic congestion syndrome. PMID:22312071

Smith, P Coleridge

2012-03-01

72

MDCT angiography of living laparoscopic renal donors.  

PubMed

Laparoscopic donor nephrectomy has become the accepted method of harvesting the kidney at many institutions because of multiple advantages over open donor nephrectomy. Spiral computed tomographic (CT) angiography provides accurate information of renal vascular anatomy and has become an accepted method of preoperative evaluation of potential laparoscopic renal donors. More recently, multidetector CT (MDCT) provides more detailed datasets compared with single-detector spiral CT and has been used for preoperative evaluation of laparoscopic donor nephrectomy to provide accurate anatomic information. MDCT (especially 16- and 64-slice MDCT) angiography has advantages over single-detector helical CT due to rapid scan time that allows coverage of a large volume of interest with higher spatial and temporal resolutions. In this article, we review the current status of MDCT angiography in the evaluation of laparoscopic renal donors and potential advantages of using this technology. PMID:16447094

Kawamoto, S; Fishman, E K

2006-01-01

73

Laparoscopic removal of an intrauterine device from the sigmoid colon  

PubMed Central

Uterine wall perforation which is commonly seen through the posterior wall of the uterus is the most serious complication of an intrauterine device (IUD). We present a case of laparoscopic removal of an IUD from the sigmoid colon in a 31-years-old female who was admitted to hospital with a history of pelvic pain and abnormal vaginal bleeding for one month. The dislocated IUD was removed from the sigmoid colon of laparoscopic intervention without any complications. In conclusion, the treatment modality for the removal of a dislocated IUD is possible by laparoscopic surgery in selected patients where the dislocated IUD is accessible.

?anl?kan, Fatih; Arslan, O?uz; Avc?, Muhittin Eftal; Göçmen, Ahmet

2015-01-01

74

Symptomatic cystic seminal vesicle: a laparoscopic approach for effective treatment  

PubMed Central

This case report highlights a symptomatic cystic seminal vesicle lesion, treated laparoscopically. A young adult male known to have congenital right renal agenesis presented with a history of recurrent right iliac fossa pain, as well as deep pelvic discomfort. The preoperative evaluation revealed a 7 × 4.5 × 4 cm cystic seminal vesicle mass. After discovery of the mass, the patient underwent a transperitoneal laparoscopic excision of the lesion. The patient was discharged on the third postoperative day and had an uneventful recovery. There were no complications noted during a routine follow-up. The laparoscopic approach was shown to be effective in the management of this rare condition. PMID:20019960

Nassir, Anmar

2009-01-01

75

Laparoscopic Image Guidance via Conoscopic Holography R. A. Lathrop, T. T. Cheng, and R. J. Webster III, Vanderbilt Univ., Nashville, TN, USA  

E-print Network

Laparoscopic Image Guidance via Conoscopic Holography R. A. Lathrop, T. T. Cheng, and R. J. Webster a laparoscopic port. The system consists of a commercial conoscope (Optimet, Inc., Probe Head Mk3), designed (surface) with intraoperative anatomy. Laser at point of measurementConoprobe Optical Tracking Laparoscopic

Webster III, Robert James

76

Solo surgeon single-port laparoscopic surgery with a homemade laparoscope-anchored instrument system in benign gynecologic diseases.  

PubMed

The objective of this study was to present the initial operative experience of solo surgeon single-port laparoscopic surgery (SPLS) in the laparoscopic treatment of benign gynecologic diseases and to investigate its feasibility and surgical outcomes. Using a novel homemade laparoscope-anchored instrument system that consisted of a laparoscopic instrument attached to a laparoscope and a glove-wound retractor umbilical port, we performed solo surgeon SPLS in 13 patients between March 2011 and June 2012. Intraoperative complications and postoperative surgical outcomes were determined. The primary operative procedures performed were unilateral salpingo-oophorectomy (n = 5), unilateral salpingectomy (n = 2), adhesiolysis (n = 1), and laparoscopically assisted vaginal hysterectomy (n = 5). Additional surgical procedures included additional adhesiolysis (n = 4) and ovarian drilling (n = 1).The primary indications for surgery were benign ovarian tumors (n = 5), ectopic pregnancy (n = 2), pelvic adhesion (infertility) (n = 1), and benign uterine tumors (n = 5). Solo surgeon SPLS was successfully accomplished in all procedures without a laparoscopic assistant. There were no intraoperative or postoperative complications. Our laparoscope-anchored instrument system obviates the need for an additional laparoscopic assistant and enables SPLS to be performed by a solo surgeon. The findings show that with our system, solo surgeon SPLS is a feasible and safe alternative technique for the treatment of benign gynecologic diseases in properly selected patients. PMID:24509292

Yang, Yun Seok; Kim, Seung Hyun; Jin, Chan Hee; Oh, Kwoan Young; Hur, Myung Haeng; Kim, Soo Young; Yim, Hyun Soon

2014-01-01

77

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.

78

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

Microsoft Academic Search

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

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

2000-01-01

79

A prospective endoscopic study of retropubic vascular anatomy in 121 patients undergoing endoscopic extraperitoneal inguinal hernioplasty  

Microsoft Academic Search

Background: A sound knowledge of retropubic pelvic vascular anatomy is pivotal to the successful performance of endoscopic total extraperitoneal (TEP) inguinal hernioplasty. The objective of the current study was to evaluate the incidence and anatomy of iliopubic and aberrant obturator vessels. Methods: Between July 2001 and March 2002, a prospective endoscopic evaluation of retropubic vascular anatomy was performed on patients

H. Lau; F. Lee

2003-01-01

80

Pelvic Floor Disorders  

MedlinePLUS

... types of PFDs are the following: Pelvic organ prolapse. A "prolapse" occurs in women when the pelvic muscles and ... press into the vagina. For instance, in uterine prolapse, the cervix and uterus can descend into the ...

81

Pelvic Floor Dysfunction  

MedlinePLUS

... which is a special form of pelvic floor physical therapy aimed at improving a patient’s rectal sensation and ... patients perform this specialized form of pelvic floor physical therapy, they are often able to view EMG or ...

82

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

83

Laparoscopic Radical Prostatectomy  

Microsoft Academic Search

Purpose: The laparoscopic access for radical prostatectomy offeres an alternative to the open surgical procedure with less morbidity. We report on our experience with 125 laparoscopic prostatectomies, especially with respect to making the laparoscopic approach a routine procedure and with a view to the oncological and functional results.Material and Methods: From June 1999 to September 2000, we performed 125 laparoscopic

Ingolf Türk; Serdar Deger; Björn Winkelmann; Bernd Schönberger; Stefan A. Loening

2001-01-01

84

MR imaging-based assessment of the female pelvic floor.  

PubMed

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

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

2014-01-01

85

Radiological anatomy of prostatic arteries.  

PubMed

One of the most challenging aspects of prostatic arterial embolization for patients with lower urinary tract symptoms and prostate enlargement or benign prostatic hyperplasia is identifying the prostatic arteries (PAs). With preprocedural computed tomography angiography it is possible to plan treatment and exclude patients when arterial anatomy is not suited, or when extensive atherosclerotic changes may affect technical success. There is an excellent correlation between the computed tomography angiography and digital subtraction angiography findings, enabling correct depiction of the male pelvic arterial anatomy (internal iliac branching patterns, relevant variants as accessory pudendal arteries, and PA anatomy). The prostate has a dual vascular arterial supply: a cranial or vesico-PA (named anterior-lateral prostatic pedicle) and a caudal PA (named posterior-lateral prostatic pedicle). These 2 prostatic pedicles may arise from the same artery in patients with only 1 PA (found in 60% of pelvic sides), or may arise independently in patients with 2 independent PAs (found in 40% of pelvic sides). The anterior-lateral prostatic pedicle vascularizes most of the central gland and benign prostatic hyperplasia nodules, frequently arises from the superior vesical artery in patients with 2 independent PAs, and is the preferred artery to embolize. The posterior-lateral prostatic pedicle has an inferior or distal origin, vascularizes most of the peripheral and caudal gland, and may have a close relationship with rectal or anal branches. In up to 60% of cases considerable anastomoses may be seen between the prostatic branches and surrounding arteries that should be taken into account when planning embolization. PAs lack pathognomonic digital subtraction angiography features; thus correct anatomical identification of the male pelvic and PAs is necessary to avoid untargeted ischemia to the bladder, rectum, anus, or corpus cavernosum. PMID:23244724

Bilhim, Tiago; Tinto, Hugo Rio; Fernandes, Lúcia; Martins Pisco, João

2012-12-01

86

Pathways of extrapelvic spread of pelvic disease: imaging findings.  

PubMed

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

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

2011-01-01

87

Integer anatomy  

SciTech Connect

The title integer anatomy is intended to convey the idea of a systematic method for displaying the prime decomposition of the integers. Just as the biological study of anatomy does not teach us all things about behavior of species neither would we expect to learn everything about the number theory from a study of its anatomy. But, some number-theoretic theorems are illustrated by inspection of integer anatomy, which tend to validate the underlying structure and the form as developed and displayed in this treatise. The first statement to be made in this development is: the way structure of the natural numbers is displayed depends upon the allowed operations.

Doolittle, R. [ONR, Arlington, VA (United States)

1994-11-15

88

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

89

Physical examination of the female internal and external genitalia with and without pelvic organ prolapse: A review.  

PubMed

Pelvic organ prolapse, a herniation of pelvic organs through the vagina, is a common condition in older women. Pelvic organ prolapse distorts vaginal anatomy making pelvic examination difficult. A clinician must accurately identify anatomic landmarks both in women presenting with symptoms of prolapse and in women noted to have coincidental prolapse during routine gynecologic examination. We present a systematic approach to the female pelvic examination including anatomic landmarks of the external genitalia, vagina, and uterus in women with normal support as well as changes that occur with pelvic organ prolapse. Knowledge and awareness of normal anatomic landmarks will improve a clinician's ability to identify defects in pelvic support and allow for better diagnosis and treatment of pelvic organ prolapse. Clin. Anat. 28:305-313, 2015. © 2014 Wiley Periodicals, Inc. PMID:25256076

Pahwa, Avita K; Siegelman, Evan S; Arya, Lily A

2015-04-01

90

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

91

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

92

Pelvic Inflammatory Disease  

MedlinePLUS

... PID treated? • How can PID be prevented? • Glossary Pelvic Inflammatory Disease Upper reproductive tract Fallopian tubes The Female Reproductive System Ovaries Uterus Cervix Vagina Lower reproductive tract Who ...

93

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

94

Pelvic Inflammatory Disease (For Parents)  

MedlinePLUS

... pelvic pain and serious damage to the reproductive system . PID is the most common, preventable cause of infertility, ... First Gynecology Visit Pelvic Exams Pelvic Inflammatory Disease (PID) About Birth Control Gyn Checkups Contact Us Print Additional resources Send ...

95

Laparoscopic cecopexy for cecal volvulus after laparoscopy. Case report and a review of the literature.  

PubMed

Cecal volvulus is a rare cause of large bowel obstruction. Surgical therapy depends on visceral circulatory conditions at diagnosis. Possible options include endoscopic decompression, detorsion, cecopexy with or without cecostomy, right colectomy with immediate or delayed anastomosis. The present paper describes a case of cecal volvulus in a 40-year-old woman after laparoscopic removal of a pelvic mass successfully treated by laparoscopic cecopexy. PMID:17519847

Baldarelli, M; De Sanctis, A; Sarnari, J; Nisi, M; Rimini, M; Guerrieri, M

2007-06-01

96

Laparoscopic sacrocolpopexy for uterine and post-hysterectomy prolapse: anatomical results, quality of life and perioperative outcome—a prospective study with 101 cases  

Microsoft Academic Search

Our prospective study evaluates laparoscopic sacrocolpopexy for vaginal vault prolapse focusing on perioperative data, objective\\u000a anatomical results using the pelvic organ prolapse quantification (POP-Q) system and postoperative quality of life using the\\u000a Kings Health questionnaire. One hundred one patients completed the study. Fifty five had laparoscopic supracervical hysterectomy\\u000a and sacrocolpopexy for uterine prolapse and 46 had laparoscopic sacrocolpopexy for post-hysterectomy

Dimitri Sarlos; Sonja Brandner; LaVonne Kots; Nicolle Gygax; Gabriel Schaer

2008-01-01

97

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 ...

Ms. Schultz

2007-11-09

98

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

99

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

100

Gallbladder removal - laparoscopic  

MedlinePLUS

Laparoscopic gallbladder removal is surgery to remove the gallbladder using a medical device called a laparoscope. ... lets the doctor see inside your belly. Gallbladder removal surgery is done while you are under general ...

101

Laparoscopic Radical Trachelectomy: Technique, Feasibility, and Outcomes  

PubMed Central

Background and Objectives: Our objectives are to describe our surgical technique for laparoscopic radical trachelectomy, to evaluate its feasibility, and to present the perioperative results at Hospital Italiano de Buenos Aires, Argentina. Methods: We analyzed 4 patients who underwent laparoscopic radical trachelectomy for early-stage cervical cancer between December 2011 and May 2013. Results: Four patients were included in this study. Total laparoscopic radical trachelectomy was performed in all cases. The mean age was 26 years (range, 19–32 years), the mean body mass index was 21 (range, 18–23), and the mean length of hospital stay was 33 hours (range, 24–36 hours). The mean operative time was 225 minutes (range, 210–240 minutes), and no complications were reported. During the postoperative period, only 1 patient presented with left vulvar edema, which resolved spontaneously. The pelvic and parametrial lymph nodes, as well as the vaginal cuff and cervical resection margins, were negative for malignancy in all cases. On average, 18 pelvic lymph nodes (range, 15–20) were removed. The tumor stage was IB in all 4 patients, and the mean tumor size was 17 mm (range, 12–31 mm). No patient required conversion to laparotomy. Conclusion: We consider laparoscopic radical trachelectomy, performed by trained surgeons, a feasible and safe therapeutic option as a fertility-sparing surgical technique, with good perioperative outcomes for women with early-stage cervical cancer with a desire to preserve their fertility. Minimally invasive surgery provides the widely known benefits of this type of approach.

Saadi, José Martín; Perrotta, Myriam; Orti, Roberto; Salvo, Gloria; Gogorza, Sebastían; Testa, Roberto

2015-01-01

102

Vulva Anatomy  

MedlinePLUS

... Pictures Browse Search Quick Search Image Details Vulva Anatomy View/Download: Small: 720x634 View Download Add to ... Search | Accessibility | Staff U.S. Department of Health and Human Services | National Institutes of Health | National Cancer Institute | ...

103

Larynx Anatomy  

MedlinePLUS

... Pictures Browse Search Quick Search Image Details Larynx Anatomy View/Download: Small: 648x576 View Download Add to ... Search | Accessibility | Staff U.S. Department of Health and Human Services | National Institutes of Health | National Cancer Institute | ...

104

Pharynx Anatomy  

MedlinePLUS

... Pictures Browse Search Quick Search Image Details Pharynx Anatomy View/Download: Small: 720x576 View Download Add to ... Search | Accessibility | Staff U.S. Department of Health and Human Services | National Institutes of Health | National Cancer Institute | ...

105

Paraganglioma Anatomy  

MedlinePLUS

... Pictures Browse Search Quick Search Image Details Paraganglioma Anatomy View/Download: Small: 648x576 View Download Add to ... Search | Accessibility | Staff U.S. Department of Health and Human Services | National Institutes of Health | National Cancer Institute | ...

106

Rectal mesh exposure after laparoscopic sacrocolpopexy.  

PubMed

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

Ferry, Philippe; Sedille, Lucie; Roncheau, Valérie

2014-01-01

107

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

108

Complications of Liver Resection: Laparoscopic Versus Open Procedures  

PubMed Central

Background and Objective: Minimally invasive surgery for liver resection remains controversial. This study was designed to compare open versus laparoscopic surgical approaches to liver resection. Methods: We performed a single-center retrospective chart review. Results: We compared 45 laparoscopic liver resections with 17 open cases having equivalent resections based on anatomy and diagnosis. The overall complication rate was 25.8%. More open resection patients had complications (52.9% vs 15.5%, P < .008). The conversion rate was 11.1%. The mean blood loss was 667.1 ± 1450 mL in open cases versus 47.8 ± 89 mL in laparoscopic cases (P < .0001). Measures of intravenous narcotic use, intensive care unit length of stay, and hospital length of stay all favored the laparoscopic group. Patients were more likely to have complications or morbidity in the open resection group than in the laparoscopic group for both the anterolateral (P < .085) and posterosuperior (P < .002) resection subgroups. Conclusion: In this series comparing laparoscopic and open liver resections, there were fewer complications, more rapid recovery, and lower morbidity in the laparoscopic group, even for those resections involving the posterosuperior segments of the liver. PMID:23743371

Simms, Eric; Drew, Barbara; Yazdi, Farshid; Roberts, Brett

2013-01-01

109

Challenges of Laparoscopic Surgery  

NSDL National Science Digital Library

Students teams use a laparoscopic surgical trainer to perform simple laparoscopic surgery tasks (dissections, sutures) using laparoscopic tools. Just like in the operating room, where the purpose is to perform surgery carefully and quickly to minimize patient trauma, students' surgery time and mistakes are observed and recorded to quantify their performances. They learn about the engineering component of surgery.

Integrated Teaching and Learning Program,

110

Use of the Endoractor(®) in Laparoscopic Colorectal Surgery: video vignette.  

PubMed

The laparoscopic approach to colorectal resections is well established, however to enable deep pelvic dissections, patients are often placed in a steep Trendelenburg position, to ensure that bowel does not fall into the operative field. This position impacts negatively on respiratory and cardiac function due to higher intra-thoracic pressure. This position also increases intra-cranial pressure and intra-ocular pressure. This article is protected by copyright. All rights reserved. PMID:25469721

Peiris, S P M; Hanratty, Daniel Robert; Naguib, Nader Nayeem; Aziz, Moayed; Haray, P N

2014-12-01

111

Laparoscopic gonadectomy in two patients with gonadal dysgenesis  

Microsoft Academic Search

Individuals with androgen insensitivity syndrome have a high risk (20–30%) of developing malignancy in their gonads. Accordingly, bilateral gonadectomy is recommended. In a 17-year-old woman with Swyer syndrome gonads were located as streaks above the pelvic brim. In a 13-year-old with Morris syndrome they were located within the inguinal canals. Bilateral laparoscopic gonadectomy was performed under general anesthesia in both

Sebastiano Campo; Nicola Garcea

1998-01-01

112

[Pelvic lymph node dissection. Complication management].  

PubMed

Extended pelvic lymph node dissection allows exact lymph node staging and has the potential to improve prognosis. In addition to these advantages, there are some perioperative and postoperative complications. In case of transection of the obturator nerve, a microsurgical end-to-end anastomosis should be performed. The most frequent postoperative complication is (symptomatic) lymphocele which is predominantly diagnosed after extraperitoneal surgery. Meticulous lymph node dissection with clipping of lymphatic vessels, sparing the lateral wall of the external iliac artery from dissection, sufficient postoperative drainage, and application of low molecular weight heparin in the upper arm may reduce their incidence. Instillation of sclerosing agents and sufficient drainage are normally successful. If not, laparoscopic fenestration of lymphocele should be performed. Regular ultrasound examinations are necessary to diagnose and treat postoperative lymphocele in a timely manner. PMID:24705476

Weckermann, D

2014-07-01

113

Laparoscopic assisted adenomyomectomy using double flap method  

PubMed Central

Objective The purpose of this study was to evaluate postoperative prognosis and progression in patients who received laparoscopic-assisted adenomyomectomy using the double flap method. Methods The pelvic cavity was explored by the conventional laparoscopic method, and drainage was achieved through a 5-mm trocar. After a small incision in the abdomen, the uterus was incised from the fundus to the upper cervical margin until exposing the endometrial cavity. Adenomyotic tissue was removed using a scalpel, scissors, or monopolar electrical bovie. The endometrial cavity was repaired with interrupted sutures using 2-0 vicryl. One side of the serosal flap was used to cover the endometrial side of the uterus. The second serosal flap covered the first flap after removal of the serosal surface of the first flap. Results From January 2008 to March 2012, there were 11 cases of laparoscopic-assisted adenomyomectomy at Chungnam National University Hospital. Nine cases were analyzed, excluding two cases with less than one year of follow-up. The average patient age was 37.0 years and average follow-up duration was 32.8 months. All patients showed improvement in dysmenorrhea (P < 0.001) and hypermenorrhea (P = 0.001) after surgery and were evaluated by visual analogue scale score. However, symptoms of adenomyosis were aggravated in three patients. Adenomyosis was progressed in the side opposite the site of operation. One patient required a total laparoscopic hysterectomy 27 months after surgery. Conclusion Laparoscopic-assisted adenomyomectomy using the double flap method is effective for uterine reduction and relief of dysmenorrhea and hypermenorrhea. Conservative management and careful follow-up are needed because adenomyosis can recur or progress in some patients. PMID:24678486

Kim, Jang-Kew; Shin, Chang-Soo; Ko, Young-Bok; Nam, Sang-Yun; Yim, Hyun-Sun

2014-01-01

114

Anatomy and Physiology of Anorectal Prolapse  

Microsoft Academic Search

\\u000a The pathophysiology of hemorrhoids and obstructed defecation requires a sound knowledge of the structure and function of the\\u000a pelvic floor. The essential structure of this area is disussed with a specific emphasis on applied anatomy. Current theories\\u000a regarding the physiology of continence and defecation are described. These concepts are then applied to explain the underlying\\u000a pathophysiology of hemorrhoids and obstructed

S. R. Brown; A. J. Shorthouse

115

Pelvic Inflammatory Disease  

MedlinePLUS

Pelvic inflammatory disease (PID) is an infection and inflammation of the uterus, ovaries, and other female reproductive organs. It causes scarring ... United States. Gonorrhea and chlamydia, two sexually transmitted diseases, are the most common causes of PID. Other ...

116

Chronic Pelvic Pain  

MedlinePLUS

... Us Sign In AAPM&R - American Academy of Physical Medicine and Rehabilitation Physicians Adding Quality to Life ® AAPM& ... pelvic pain, too What you can do: A physical medicine and rehabilitation physician (physiatrist) can evaluate you for ...

117

Pelvic Inflammatory Disease (PID)  

MedlinePLUS

... result in chronic pelvic pain, infertility, or an ectopic pregnancy. What Are the Symptoms of PID? PID ... has more of a chance of being infertile. Ectopic pregnancy. If someone who has had PID does ...

118

Pelvic Inflammatory Disease: Complications  

MedlinePLUS

... were in the uterus, it is called an ectopic or tubal pregnancy. An ectopic pregnancy can rupture the fallopian tube, causing severe ... likely to suffer infertility (20 percent of women), ectopic pregnancy (9 percent), or chronic pelvic pain (18 ...

119

Pelvic Support Problems  

MedlinePLUS

... an urgent or frequent need to urinate Feeling pain while urinating Leaking stool or having a hard ... in time Your health care provider diagnoses the problem with a physical exam, a pelvic exam, or ...

120

Prine et grossesse Pelvic floor and pregnancy  

E-print Network

incontinence, anal incontinence, pelvic organ prolapse, dyspareunia). Vaginal delivery may cause injury-words Pelvic floor; delivery; pregnancy; urinary incontinence; anal incontinence; pelvic organ prolapse

Paris-Sud XI, Université de

121

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.

122

[Laparoscopic cholecystectomy in a patient with situs inversus].  

PubMed

Laparoscopic cholecystectomy is the standard approach to manage symptomatic gallbladder stones. However, only twelve patients with total situs invertus have been previously reported in the literature. We report a new case of a 58-year-old patient hospitalized for acute pain of the left hypochondrium with fever. The diagnosis of acute cholecystitis with situs inversus totalis was made following clinical examination and radiological investigations. Laparoscopic cholecystectomy was subsequently performed through a modification of the technique to adapt to the mirror image anatomy. PMID:16460662

Bedioui, H; Chebbi, F; Ayadi, S; Makni, A; Fteriche, F; Ksantini, R; Jouini, M; Kacem, M; Ben Safta, Z

2006-01-01

123

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

124

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

125

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

126

Successful Treatment of Deep Dyspareunia and Primary Dysmenorrhea with Laparoscopic Uterosacral Nerve Ablation (LUNA) Procedure  

Microsoft Academic Search

Deep dyspareunia, often described as pain resulting from pelvic thrusting during sexual intercourse, is relatively common and has many causes. To date, feasible surgical interventions for deep dyspareunia are very rare. The two procedures which have been mentioned in the literature for the treatment of deep dyspareunia were laparoscopic uterosacral ligament ablation (LUNA) and uterine ventrosuspension. We report the case

Chi-Mou Juang; Ming-Shien Yen; Huann-Cheng Horng; Hung-Chuan Yu; Chia-Ming Chang; Jiun-Yih Yeh

2006-01-01

127

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

128

Laparoscopic infrared imaging  

Microsoft Academic Search

.   A system was developed to determine the potential role of infrared imaging as a tool for localizing anatomic structures and\\u000a assessing tissue viability during laparoscopic surgical procedures. A camera system sensitive to emitted energy in the midinfrared\\u000a range (3–5 ?m) was incorporated into a two-channel visible laparoscope. Laparoscopic cholecystectomy, dissection of the ureter,\\u000a and assessment of bowel perfusion were

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

1997-01-01

129

Lateral transperitoneal laparoscopic adrenalectomy  

Microsoft Academic Search

Several laparoscopic approaches to the adrenal gland have been described. The lateral transperitoneal approach has several\\u000a distinct advantages when contrasted with other techniques for laparoscopic adrenalectomy (LA). We present our technique and\\u000a results obtained in 50 consecutive transperitoneal LAs. We review 50 consecutive laparoscopic adrenalectomies (28 female,\\u000a 19 male) performed from 1993 to 1998. S.J. Shichman or R.E. Sosa was

Steven J. Shichman; C. D. Anthony Herndon; R. Ernest Sosa; Giles F. Whalen; Dougald C. MacGillivray; Carl D. Malchoff; E. Darracott Vaughan

1999-01-01

130

Pelvic Floor Therapies in Chronic Pelvic Pain Syndrome  

Microsoft Academic Search

Chronic pelvic pain syndrome is a poorly understood clinical entity associated with urinary symptoms, pelvic floor dysfunction,\\u000a and multisystem disorders. Treatment of pelvic floor dysfunction is difficult and often frustrating for the patient as well\\u000a as for the involved physician. The purpose of this review is to update clinicians on the latest research for the treatment\\u000a of pelvic floor dysfunction

Ragi Doggweiler; Adam F. Stewart

2011-01-01

131

How Is Pelvic Pain Diagnosed?  

MedlinePLUS

... pain. These tests or procedures may include 1 , 2 : Lab tests, such as blood work or a urine test Pelvic ultrasound, a procedure that uses sound waves to look at organs and structures inside the pelvic region 3 ...

132

Web Anatomy  

NSDL National Science Digital Library

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

Jensen, Murray

133

Instant Anatomy  

NSDL National Science Digital Library

Created by Professor Robert Whitaker, this website was designed to teach medical students about anatomy. Visitors to the site will find a range of materials, including diagrams, illustrations, quizzes, tips, mnemonics, and so on. On the homepage, visitors will find a What's New area, which includes podcasts that deal with subjects such as the small muscles of the hand and the anatomy of the posterior forearm. Other sections on the homepage include Head & Neck, Thorax, Abdomen, Arm, and Leg. Each of these sections includes dozens of illustrations, along with some useful Brain Training Games. These games are designed to increase comprehension of the materials covered in each area. Moving on, the Lectures area includes talks such as "Parasympathetic Supply of the Head," "Cortical Control of Cranial Nerves," and several others. The site is rounded out by a collection of iPhone and iPad apps, along with a set of detailed flash cards.

Whitaker, Andrew

2012-06-01

134

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".

135

Successful laparoscopic management of an incarcerated obturator hernia  

PubMed Central

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

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

2013-01-01

136

One Thousand and Six Consecutive Laparoscopic Intraoperative Cholangiograms  

PubMed Central

Intraoperative cholangiography was successfully performed in 1,000 out of 1,006 attempts in 1019 consecutive cholecystectomies. There were 783 chronic, 95 acute, 61 fibrotic, 27 gangrenous and 40 cases of hydrops of the gallbladder in those laparoscopic cholecystectomies performed. Unsuspected common duct stones were identified in 5% of the patients. There were no injuries resulting from intra-operative cholangiography performed via the cystic duct. In this large series, routine cholangiography was thought to be helpful in the prevention of common bile duct injuries and the establishment of abnormal anatomy. In non-acute cholecystitis, intraoperative cholangiography is necessary due to the importance of abnormal anatomy verification. The technique of laparoscopic cholecystectomy differs greatly from that of open technique, and, therefore, routine intraoperative cholangiography is strongly advised. PMID:9876641

Leonetti, Lori A.

1997-01-01

137

Transient Occlusion of Uterine Arteries in Laparoscopic Uterine Surgery  

PubMed Central

Background and Objectives: This study was conducted to determine the feasibility and effectiveness of transient occlusion of the uterine arteries (TOUA) during laparoscopic surgery for benign uterine tumors, with preservation of fertility. Methods: Patients with uterine myoma or adenomyoma underwent laparoscopic uterine surgery, with or without TOUA, performed by a single surgeon (Y.-S.K.). Surgical outcomes included operative time; occurrence of intraoperative injury of blood vessels, nerves, and pelvic organs; and intraoperative blood loss. Results: Of the 168 surgical patients included in this study, 144 were enrolled consecutively during the study period, and 24 had undergone adenomectomy before the study period. A total of 104 women (70 with myoma; 34 with adenomyoma) seeking uterine preservation underwent laparoscopic surgery with TOUA for benign uterine tumors. Sixty-four women (40 with myoma; 24 with adenomyoma) underwent surgery without TOUA. The mean total surgical time of the TOUA groups was 74.85 minutes for uterine myoma and 84.09 minutes for uterine adenomyoma. The mean estimated blood loss during laparoscopic myomectomy and adenomyomectomy was less in the TOUA groups than in the non-TOUA groups (109 vs. 203.4 mL in myomectomy, P < .05; 148.1 vs. 158.9 mL in adenomyomectomy; P < .05). Time to perform TOUA was 13.9 minutes in laparoscopic myomectomy and 7.33 minutes in laparoscopic adenomyomectomy. The hospital stay of the TOUA groups was 3.32 days for uterine myoma and 3.82 days for uterine adenomyoma. No intraoperative conversion to laparotomy was necessary, and no major complications occurred during any of the procedures. Conclusion: Laparoscopic uterine surgery with TOUA could be a safe and effective surgical method for women with symptomatic benign uterine tumors who wish to preserve fertility.

Kwon, Yong-Soon; Roh, Hyun Jin; Ahn, Jun Woo; Lee, Sang-Hun

2015-01-01

138

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

139

Laparoscopic total abdominal colectomy  

Microsoft Academic Search

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

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

1992-01-01

140

Normal Pancreas Anatomy  

MedlinePLUS

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

141

Normal Female Reproductive Anatomy  

MedlinePLUS

... My Pictures Browse 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 ...

142

AAA: Anatomy Textbook Reviews  

NSDL National Science Digital Library

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

2011-12-23

143

Pelvic organ prolapse: an overview.  

PubMed

Pelvic organ prolapse is a common gynecologic complaint in which the vaginal walls are weakened, resulting in descent of pelvic organs through the vagina. Prolapse may be asymptomatic or associated with pelvic pressure and difficulties with urination and defecation, but usually is not responsible for pelvic or lower abdominal pain. Treatment options include conservative measures such as a pessary or pelvic floor physical therapy, or surgical correction. Patients should be reassured that prolapse typically is not an emergency or life-threatening condition. PMID:24500120

Smith, Taryn A; Poteat, Tamara A; Shobeiri, S Abbas

2014-03-01

144

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

145

A three-dimensional reconstructive study of pelvic cavity in the New Zealand rabbit (Oryctolagus cuniculus).  

PubMed

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

Özkadif, Sema; Eken, Emrullah; Kalayc?, Ibrahim

2014-01-01

146

Laparoscopic distal gastrectomy with D2 dissection for advanced gastric cancer.  

PubMed

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

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

2013-08-01

147

Pitfalls in the use of laparoscopic staplers to perform subtotal cholecystectomy  

PubMed Central

Laparoscopic subtotal cholecystectomy (LSC) is considered to be a safe option in severe cholecystitis with non-discernible anatomy within the Calot’s triangle where there is a potential risk of causing injury to the common bile duct. Here we present two cases of gallstone pancreatitis associated with use of an endoscopic stapler during LSC. PMID:23595185

Chaudery, Muzzafer; Hunjan, Tia; Beggs, Andrew; Nehra, Dhiren

2013-01-01

148

Laparoscopic partial adrenalectomy  

Microsoft Academic Search

Background: Most laparoscopic adrenalectomies involve total removal of the whole adrenal gland, and reports of laparoscopic partial adrenalectomies\\u000a have been very few. The criteria for performing a laparoscopic partial adrenalectomy have not been described.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: (a) Patients with functioning adrenal tumors smaller than 3 cm in diameter were selected. (b) The solitary adrenal tumors\\u000a were evaluated by preoperative thin-slice computed

T. Imai; Y. Tanaka; T. Kikumori; M. Ohiwa; N. Matsuura; T. Mase; H. Funahashi

1999-01-01

149

Exenterative pelvic surgery.  

PubMed

A review of the history, indications, basic technique, end results, and complications of exenterative surgery for pelvic neoplasms is provided. The authors discuss their broad personal experience with the operation. Much of this experience evolved from work at Barnes Hospital and the Ellis Fischel State Cancer Hospital. The techniques are applicable to advanced neoplasms of the cervix uteri, scrotum, urinary bladder, and other, less frequent neoplasms still confined to the pelvis. PMID:10518108

Lopez, M J; Spratt, J S

1999-10-01

150

Is laparoscopic colorectal cancer surgery equal to open surgery? An evidence based perspective  

PubMed Central

Laparoscopic colorectal surgery (LCS) is an evolving subject. Recent studies show that LCS can not only offer safe surgery but evidence is growing that this new technique can be superior to classical open procedures. Fewer perioperative complications and faster postoperative recovery are regularly mentioned when studies of LCS are presented. Even though the learning curve of LCS is frequently debated when limitations of laparoscopic surgeries are reviewed, studies show that in experienced hands LCS can be a safe procedure for colorectal cancer treatment. The learning curve however, is associated with high conversion rates and economical aspects such as higher costs and prolonged hospital stay. Nevertheless, laparoscopic colorectal cancer surgery (LCCR) offers several advantages such as less co-morbidity and less postoperative pain in comparison with open procedures. Furthermore, the good exposure of the pelvic cavity by laparoscopy and the magnification of anatomical structures seem to facilitate pelvic dissection laparoscopically. Moreover, recent studies describe no difference in safety and oncological radicalness in LCCR compared to the open total mesorectal excision (TME). The oncological adequacy of LCCR still remains unproven today, because long-term results do not yet exist. To date, only a few studies have described the results of laparoscopic TME combined with preoperative adjuvant treatment for colorectal cancer. The aim of this review is to examine the various areas of development and controversy of LCCR in comparison to the conventional open approach. PMID:21160858

Künzli, Beat M; Friess, Helmut; Shrikhande, Shailesh V

2010-01-01

151

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

152

Is pelvic organ prolapse a cause of pelvic or low back pain?  

Microsoft Academic Search

OBJECTIVE: To test the null hypothesis that there is no association between pelvic organ prolapse and pelvic or low back pain.METHODS: A total of 152 consecutive patients with pelvic organ prolapse completed a visual faces scale to quantify the amount of pelvic or low back pain present. Pelvic organ prolapse severity was graded by three techniques: 1) pelvic organ prolapse

Michael Heit; Patrick Culligan; Chris Rosenquist; Susan Shott

2002-01-01

153

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.

154

Laparoscopic pancreatic reconstruction technique following laparoscopic pancreaticoduodenectomy.  

PubMed

With the advance of laparoscopic experiences and techniques, it is carefully regarded that laparoscopic pancreaticoduodenectomy (lap-PD) is feasible and safe in managing perimapullary pancreatic pathology. Especially, laparoscopic management of remnant pancreas can be a critical step toward completeness of minimally invasive PD. According to available published reports, there is a wide range of technical differences in choosing surgical options in managing remnant pancreas after lap-PD. For the evidence-based surgical approach, it would be ideal to test potential techniques by randomized controlled trials, but, currently, it is thought to be very difficult to expect those clinical trials to be successful because there are still a lack of expert surgeons with sound surgical techniques and experience. In addition, lap-PD is so complicated and technically demanding that many surgeons are still questioning whether this surgical approach could be standardized and popular like laparoscopic cholecystectomy. In general, surgical options are usually chosen based on following question: (1) Is it simple? (2) Is it easy and feasible? (3) Is it secure and safe? (4) Is there any supporting scientific evidence? It would be interesting to estimate which surgical technique would be appropriate in managing remnant pancreas under these considerations. It is hoped that a well standardized multicenter-based randomized control study would be successful to test this fundamental issues based on sound surgical techniques and scientific background. PMID:25546026

Kang, Chang Moo; Lee, Sung Hwan; Chung, Myung Jae; Hwang, Ho Kyoung; Lee, Woo Jung

2015-03-01

155

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

156

Laparoscopic repair of urogenital fistulae: A single centre experience  

PubMed Central

CONTEXT: Sparse literature exists on laparoscopic repair of urogenital fistulae (UGF). AIMS: The purpose of the following study is to report our experience of laparoscopic UGF repair with emphasis on important steps for a successful laparoscopic repair. SETTINGS AND DESIGN: Data of patients who underwent laparoscopic repair of UGF from 2003 to 2012 was retrospectively reviewed. MATERIALS AND METHODS: Data was reviewed as to the aetiology, prior failed attempts, size, number and location of fistula, mean operative time, blood loss, post-operative storage/voiding symptoms and episodes of urinary tract infections (UTI). RESULTS: Laparoscopic repair of 22 supratrigonal vesicovaginal fistulae (VVF) (five recurrent) and 31 ureterovaginal fistulae (UVF) was performed. VVF followed transabdominal hysterectomy (14), lower segment caesarean section (LSCS) (7) and oophrectomy (1). UVF followed laparoscopy assisted vaginal hysterectomy (18), transvaginal hysterectomy (2) and transabdominal hysterectomy (10) and LSCS (1). Mean VVF size was 14 mm. Mean operative time and blood loss for VVF and UVF were 140 min, 75 ml and 130 min, 60 ml respectively. In 20 VVF repairs tissue was interposed between non-overlapping suture lines. Vesico-psoas hitch was done in 29 patients of urterovaginal fistulae. All patients were continent following surgery. There were no urinary complaints in VVF patients and no UTI in UVF patients over a median follow-up of 3.2 years and 2.8 years respectively. CONCLUSION: Laparoscopic repair of UGF gives easy, quick access to the pelvic cavity. Interposition of tissue during VVF repair and vesico-psoas hitch during UVF repair form important steps to ensure successful repair. PMID:25336817

Sharma, Sumit; Rizvi, Syed Jamal; Bethur, Santhosh Shivanandaiah; Bansal, Jyoti; Qadri, Syed Javid Farooq; Modi, Pranjal

2014-01-01

157

Multidetector CT angiography of renal vasculature: normal anatomy and variants  

Microsoft Academic Search

Knowledge of the variations in renal vascular anatomy is important before laparoscopic donor or partial nephrectomy and vascular\\u000a reconstruction for renal artery stenosis or abdominal aortic aneurysm. Recently, multidetector computed tomographic (MDCT)\\u000a angiography has become a principal imaging investigation for assessment of the renal vasculature and has challenged the role\\u000a of conventional angiography. It is an excellent imaging technique because

Aysel Türkvatan; Mustafa Özdemir; Turhan Cumhur; Tülay Ölçer

2009-01-01

158

Pelvic Muscle Strength After Childbirth  

PubMed Central

OBJECTIVE The objective was to estimate the effect of vaginal childbirth and other obstetric exposures on pelvic muscle strength 6–11 years after delivery and to investigate the relationship between pelvic muscle strength and pelvic floor disorders. METHODS Among 666 parous women, pelvic muscle strength was measured with a perineometer 6–11 years after delivery. Obstetric exposures were classified by review of hospital records. Pelvic floor outcomes, including stress incontinence, overactive bladder, anal incontinence, and prolapse symptoms, were assessed with a validated questionnaire. Pelvic organ support was assessed using the Pelvic Organ Prolapse Quantification system. Kruskal-Wallis tests were used to estimate the univariable associations of obstetric exposures and pelvic floor outcomes with peak muscle strength. Stepwise multivariable linear regression models were used to estimate the association between obstetric exposures and muscle strength. RESULTS In comparison with women who delivered all of their children by cesarean, peak muscle strength and duration of contraction were reduced among women with a history of vaginal delivery (39 compared with 29 cm H2O, P<.001). Pelvic muscle strength was further reduced after history of forceps delivery (17 cm H2O, P<.001). After vaginal delivery, reduced pelvic muscle strength was associated with symptoms of anal incontinence (P=.028) and pelvic organ prolapse on examination (P=.025); these associations were not observed among those who had delivered exclusively by cesarean. CONCLUSION Pelvic muscle strength almost a decade after childbirth is affected by vaginal delivery and by forceps delivery. Although statistically significant, some of the differences observed were small in magnitude. PMID:23090518

Friedman, Sarah; Blomquist, Joan L.; Nugent, Joann M.; McDermott, Kelly C.; Muñoz, Alvaro; Handa, Victoria L.

2013-01-01

159

Pelvic Muscle Strength After Childbirth.  

PubMed

OBJECTIVE:: The objective was to estimate the effect of vaginal childbirth and other obstetric exposures on pelvic muscle strength 6-11 years after delivery and to investigate the relationship between pelvic muscle strength and pelvic floor disorders. METHODS:: Among 666 parous women, pelvic muscle strength was measured with a perineometer 6-11 years after delivery. Obstetric exposures were classified by review of hospital records. Pelvic floor outcomes, including stress incontinence, overactive bladder, anal incontinence, and prolapse symptoms, were assessed with a validated questionnaire. Pelvic organ support was assessed using the Pelvic Organ Prolapse Quantification system. Kruskal-Wallis tests were used to estimate the univariable associations of obstetric exposures and pelvic floor outcomes with peak muscle strength. Stepwise multivariable linear regression models were used to estimate the association between obstetric exposures and muscle strength. RESULTS:: In comparison with women who delivered all of their children by cesarean, peak muscle strength and duration of contraction were reduced among women with a history of vaginal delivery (39 compared with 29 cm H2O, P<.001). Pelvic muscle strength was further reduced after history of forceps delivery (17 cm H2O, P<.001). After vaginal delivery, reduced pelvic muscle strength was associated with symptoms of anal incontinence (P=.028) and pelvic organ prolapse on examination (P=.025); these associations were not observed among those who had delivered exclusively by cesarean. CONCLUSION:: Pelvic muscle strength almost a decade after childbirth is affected by vaginal delivery and by forceps delivery. Although statistically significant, some of the differences observed were small in magnitude. LEVEL OF EVIDENCE:: II. PMID:23044533

Friedman, Sarah; Blomquist, Joan L; Nugent, Joann M; McDermott, Kelly C; Muñoz, Alvaro; Handa, Victoria L

2012-10-01

160

A Case of Laparoscopic Ureteric Reimplantation in a Solitary Urinary System  

PubMed Central

Ureteric strictures can be caused by traumatic pelvic surgery, urolithiasis and instrumentation. There are various treatment options for ureteric stricture, including laparoscopic ureteric reimplantation. A 56-year-old female with a history of chronic left pelviureteric junction obstruction presented with urosepsis secondary to right-sided urolithiasis. The patient had a left nephrectomy and developed right-sided ureteric stricture following repeated ureteroscopy to manage her stone disease. The treatment with ureteric stenting was unsuccessful. Here we present a case on the feasibility of laparoscopic reimplantation for ureteric stricture in a solitary kidney to preserve renal function and avoid further ureteroscopy or nephrostomies.

Pang, Karl H.; Miah, Saiful; Haynes, Mark D.; Oakley, Neil E.

2015-01-01

161

Laparoscopic approach for very large benign ovarian cyst in young woman  

PubMed Central

Ovarian cysts are the most common cause of pelvic masses in women, and in the majority of the cases, women are in their fertile age. Today, the surgical treatment has become more conservative and less invasive; hence, a laparoscopic approach in the presence of benign cysts has become a gold standard. Herein, we report a case of a 21-year-old woman referred to our Surgical Department for an abdominal mass, discovered with a computerised tomographic scan, of 20 ×10 × 25 cm arising from the left ovary, treated with the laparoscopic approach. PMID:20040802

Tagliabue, Fulvio; Acquaro, Paola; Confalonieri, Gianmaria; Spagnolo, Salvatore; Romelli, Antonio; Costa, Melchiorre

2009-01-01

162

Gallbladder Removal: Laparoscopic Method  

MedlinePLUS

... Method Gallbladder Removal: Laparoscopic Method How is the gallbladder removed? The surgery to remove the gallbladder is called a cholecystectomy ( ... it hard for your doctor to see your gallbladder, an open surgery may be better for you. Your doctor will ...

163

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

164

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

165

Laparoscopic pancreatectomy for malignancy.  

PubMed

Utilization of laparoscopic techniques for resection of the pancreas has slowly gained acceptance in specific situations and is now being applied to more challenging endeavors, such as pancreaticoduodenectomy for cancer. This review provides a summary of laparoscopic applications for pancreatic malignancy, with specific attention to the most common methods of pancreatic resection and their respective oncologic outcomes, including margin status, lymph node retrieval, and survival. PMID:22991263

Fisher, Sarah B; Kooby, David A

2013-01-01

166

Hemobilia post laparoscopic cholecystectomy  

PubMed Central

Hepatic artery pseudoaneurysm is a rare complication of laparoscopic cholecystectomy. A high index of suspicion and early identification and therapy are important points needed to prevent rupture. We report a case of complex biliary and vascular injuries 4 weeks after a laparoscopic cholecystectomy. The patient had recurrent bleeding from a hepatic artery pseudoaneurysm that has been treated successfully with angiographic stenting and embolization. PMID:25666365

Bin Traiki, Thamer A.; Madkhali, Ahmad A.; Hassanain, Mazen M.

2015-01-01

167

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

168

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

169

Open Versus Laparoscopic Radical Prostatectomy  

PubMed Central

Expert laparoscopic surgeons have demonstrated that laparoscopic radical prostatectomy with or without robotic assistance can be performed with excellent results. There is no evidence that laparoscopic radical prostatectomy with or without robotic assistance offers any clinically relevant advantage over open radical prostatectomy. Laparoscopic radical prostatectomy with or without robotic assistance requires a significant learning curve, is a longer surgical procedure, carries greater costs, and requires an expanded operating room team. The literature suggests that laparoscopic radical prostatectomy is associated with more intraoperative complications and higher positive surgical margins. The lesser amount of postoperative bleeding associated with laparoscopic radical prostatectomy is not clinically relevant. Laparoscopic radical prostatectomy is not associated with less pain and does not facilitate earlier urinary catheter removal. The best way to improve overall outcomes after radical prostatectomy is to direct patients to expert open or laparoscopic surgeons. PMID:16985822

Lepor, Herbert

2005-01-01

170

Acetabular and pelvic fractures in multiple trauma  

Microsoft Academic Search

Summary  \\u000a We see pelvic fractures in about 50 % of all multiple trauma patients. In many cases, these pelvic fractures are complicated\\u000a by complex pelvic traumata, i. e., a pelvic fracture with pelvic vessel damage, neurological, visceral or soft-tissue damage,\\u000a and therefore have the character of life-threatening lesions. The incidence of complex pelvic trauma is extremely high in\\u000a cases of

E. Euler; D. Nast-Kolb; L. Schweiberer

1997-01-01

171

Obturator nerve injury in laparoscopic inguinal hernia mesh repair.  

PubMed

Injury to pelvic nerves during laparoscopy mostly occurs in gynecological and urological procedures. In abdominal surgery, these complications are infrequent. We present a case report of a patient who suffered a rare obturator nerve injury during a laparoscopic hernioplasty caused by clipping the nerve to the edge of the mesh. After revision and release of nerve from the clip and scars tissue, the associated pain rapidly disappeared and thigh adduction strength improved. Now, 4 years later, MRI and EMG show no sign of nerve compression. PMID:22836919

Haninec, P; Horak, L; Kaiser, R

2013-12-01

172

Chronic pelvic pain in women  

Microsoft Academic Search

Chronic pelvic pain is a major public health problem for women throughout the developed world. The complex innervation of the pelvis and the anatomical proximity of pelvic viscera mean this symptom frequently overlaps traditional medical specialties, leading to diagnostic delay and frequently inadequate treatment. Careful history taking and examination can in itself be therapeutic and will likely identify a number

K Vincent

2009-01-01

173

Stress and chronic pelvic pain.  

PubMed

Chronic pelvic pain is the number one reason that patients suffering from irritable bowel syndrome, interstitial cystitis/painful bladder syndrome, vulvodynia, or chronic prostatitis/chronic pelvic pain syndrome seek medical attention. These syndromes generally have no associated pathology or identified underlying etiology, although dysfunction within the immune system, central nervous system, and peripheral nervous system has been identified. Due to the lack of pathology, chronic pelvic pain syndromes are often diagnosed by exclusion, and the high degree of comorbid symptomology among these and other functional pain disorders complicate identifying appropriate treatment strategies. Chronic stress exposure early in life has been shown to increase the likelihood of pelvic pain later in life, and acute stress exposure can induce or increase symptom severity. In this chapter, we describe the individual chronic pelvic pain syndromes and how stress influences the likelihood of diagnosis and the severity of symptoms experienced by patients. PMID:25744684

Pierce, Angela N; Christianson, Julie A

2015-01-01

174

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.

175

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

176

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

177

[Radical cystectomy - pro laparoscopic].  

PubMed

Although the technical feasibility of laparoscopic radical cystectomy (LRC) has been proven and the procedure has been accepted in the EAU guidelines 2011 as a valid alternative, its actual position has to be determined. On the one hand the advantages of LRC (less blood loss, lower transfusion rates, shorter analgesia time) have been proven in retrospective studies; however, the technical difficulties of purely laparoscopic urinary diversion result in very long operating times and in cases of a laparoscopic-assisted creation of a neobladder, the question of the advantage of this approach remains doubtful. Despite case reports of port metastases and peritoneal carcinosis following laparoscopic and robot-assisted radical cystectomy, there is no difference in terms of oncological long-term data (up to 10 years) between laparoscopy and open surgery performed at centres of excellence. Evidently, the curative options for the patients do not depend on the type of surgery (open versus minimally invasive) but on the efficacy of adjuvant treatment strategies (polychemotherapy). Currently it is believed that LRC should be considered for patients with low risk of progression (pT1-2). The final position of laparoscopic radical cystectomy can only be evaluated in a multicentric randomized controlled trial. PMID:22532364

Rassweiler, J; Godin, K; Goezen, A S; Kusche, D; Chlosta, P; Gaboardi, F; Abbou, C C; van Velthoven, R

2012-05-01

178

Laparoscopic treatment of intussusception  

PubMed Central

Introduction The success of laparoscopic approach in children has encouraged the application of this technique in young (<2 years) children with non-complicated intussusception. Material and method A retrospective analysis of our database provided a total of 4 patients who underwent laparoscopic reduction of intestinal intussusception between 8/2008 and 4/2013. A comprehensive review of each case was done including the video description of the laparoscopic technique of one of them. Results Four patients (2 boys) were treated by laparoscopy for intestinal intussusception. Mean age was 9 months (5–20 months). Delay time between initial symptoms and diagnosis and between diagnosis and surgery were 3.5 days and 6 h respectively. Mean operative time was 35 min. There were no conversions. There were no complications. Patients were discharged after 2.5 days (2–4 days). We herein report (video) the laparoscopic approach in a 5 month male child who suffered from a ileocecal intussusception. A 10 mm trocar was placed in the left lower quadrant and two 5 mm trocars were placed in the upper left quadrant and suprapubic just to the right midline. The cause of the intussusception was identified and the bowel was reduced. A concomitant appendectomy was performed. Conclusion Laparoscopic reduction of intussusception appears to be a safe procedure, in young children with uncomplicated intussusception. PMID:25574769

Vilallonga, Ramon; Himpens, Jacques; Vandercruysse, Femke

2014-01-01

179

Survival, Local Recurrence, and Function After Pelvic Limb Salvage at 23 to 38 Years of Followup  

Microsoft Academic Search

Background  Malignant pelvic tumors frequently pose challenges to surgeons owing to complex pelvic anatomy and local extension. External\\u000a hemipelvectomy frequently allows adequate margins but is associated with substantial morbidity and reduced function. Limb\\u000a salvage is an alternative approach when adequate margins can be achieved, but long-term function and survival are unclear.\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  We therefore determined the long-term survival; development of late local

Courtney E. Sherman; Mary I. O’Connor; Franklin H. Sim

180

Anatomy: Spotlight on Africa  

NSDL National Science Digital Library

This article describes a survey of African Anatomy Departments in the Medical School setting. The purpose of the survey was to understand how African Anatomy Departments and curriculum compare in various factors to western medical schools.

Dr. Amadi O Ihunwo (University of the Witwatersrand Anatomical Sciences)

2008-05-01

181

Pelvic Fistulas Complicating Pelvic Surgery or Diseases: Spectrum of Imaging Findings  

PubMed Central

Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas. PMID:11752977

Moon, Sung Gyu; Lee, Hak Jong; Moon, Min Hoan; Myung, Jae Sung

2001-01-01

182

Simulation in laparoscopic surgery.  

PubMed

Nowadays surgical trainees are faced with a more reduced surgical practice, due to legal limitations and work hourly constraints. Also, currently surgeons are expected to dominate more complex techniques such as laparoscopy. Simulation emerges as a complementary learning tool in laparoscopic surgery, by training in a safe, controlled and standardized environment, without jeopardizing patient' safety. Simulation' objective is that the skills acquired should be transferred to the operating room, allowing reduction of learning curves. The use of simulation has increased worldwide, becoming an important tool in different surgical residency programs and laparoscopic training courses. For several countries, the approval of these training courses are a prerequisite for the acquisition of surgeon title certifications. This article reviews the most important aspects of simulation in laparoscopic surgery, including the most used simulators and training programs, as well as the learning methodologies and the different key ways to assess learning in simulation. PMID:25039039

León Ferrufino, Felipe; Varas Cohen, Julián; Buckel Schaffner, Erwin; Crovari Eulufi, Fernando; Pimentel Müller, Fernando; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Boza Wilson, Camilo

2015-01-01

183

Laparoscopic pancreatic surgery.  

PubMed

Laparoscopic pancreatectomy may be associated with lower operative morbidity, less postoperative pain, lower wound infection rates, decreased physiological stress, and fewer postoperative hernias and bowel obstructions. In this review, we summarize the current data on laparoscopic and robotic assisted pancreaticoduodenectomy/distal pancreatectomy/central pancreatectomy. We reviewed the indications, the perioperative and oncologic outcomes, and the cost analysis following minimally invasive pancreatic resections. In conclusion, we found minimally invasive approaches to pancreatic resections are feasible, safe, and appear to have comparable oncologic outcomes to the standard open approaches when performed by experienced surgeons at high-volume centers. The potential advantages of a minimally invasive approach to pancreatic surgery, such as reduced blood loss and shorter length of hospital stay, have now been well established. The overall cost of laparoscopic pancreatectomy appears to be similar to that of the open approach. PMID:25077736

He, J; Pawlik, T M; Makary, M A; Wolfgang, C L; Weiss, M J

2014-12-01

184

Multidetector CT angiography of renal vasculature: normal anatomy and variants.  

PubMed

Knowledge of the variations in renal vascular anatomy is important before laparoscopic donor or partial nephrectomy and vascular reconstruction for renal artery stenosis or abdominal aortic aneurysm. Recently, multidetector computed tomographic (MDCT) angiography has become a principal imaging investigation for assessment of the renal vasculature and has challenged the role of conventional angiography. It is an excellent imaging technique because it is a fast and non-invasive tool that provides highly accurate and detailed evaluation of normal renal vascular anatomy and variants. The number, size and course of the renal arteries and veins are easily identified by MDCT angiography. The purpose of this pictorial essay is to illustrate MDCT angiographic appearance of normal anatomy and common variants of the renal vasculature. PMID:18665365

Türkvatan, Aysel; Ozdemir, Mustafa; Cumhur, Turhan; Olçer, Tülay

2009-01-01

185

Female Urinary Disorders and Pelvic Organ Prolapse  

E-print Network

of the bladder ("dropping of bladder") Treated with pelvic floor exercises, medication and/or surgery #12;NormalFemale 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

Lee, Daeyeol

186

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

187

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

188

21 CFR 884.1730 - Laparoscopic insufflator.  

Code of Federal Regulations, 2013 CFR

...Laparoscopic insufflator. (a) Identification. A laparoscopic insufflator is a device used to facilitate the use of the laparoscope by filling the peritoneal cavity with gas to distend it. (b) Classification. (1) Class II (performance...

2013-04-01

189

21 CFR 884.1730 - Laparoscopic insufflator.  

Code of Federal Regulations, 2014 CFR

...Laparoscopic insufflator. (a) Identification. A laparoscopic insufflator is a device used to facilitate the use of the laparoscope by filling the peritoneal cavity with gas to distend it. (b) Classification. (1) Class II (performance...

2014-04-01

190

21 CFR 884.1730 - Laparoscopic insufflator.  

Code of Federal Regulations, 2012 CFR

...Laparoscopic insufflator. (a) Identification. A laparoscopic insufflator is a device used to facilitate the use of the laparoscope by filling the peritoneal cavity with gas to distend it. (b) Classification. (1) Class II (performance...

2012-04-01

191

21 CFR 884.1730 - Laparoscopic insufflator.  

Code of Federal Regulations, 2011 CFR

...Laparoscopic insufflator. (a) Identification. A laparoscopic insufflator is a device used to facilitate the use of the laparoscope by filling the peritoneal cavity with gas to distend it. (b) Classification. (1) Class II (performance...

2011-04-01

192

21 CFR 884.1730 - Laparoscopic insufflator.  

Code of Federal Regulations, 2010 CFR

...Laparoscopic insufflator. (a) Identification. A laparoscopic insufflator is a device used to facilitate the use of the laparoscope by filling the peritoneal cavity with gas to distend it. (b) Classification. (1) Class II (performance...

2010-04-01

193

Laparoscopic Pectopexy: A Prospective, Randomized, Comparative Clinical Trial of Standard Laparoscopic Sacral Colpocervicopexy with the New Laparoscopic Pectopexy—Postoperative Results and Intermediate-Term Follow-Up in a Pilot Study  

PubMed Central

Abstract Purpose: The purpose of the study was to compare the outcome of laparoscopic sacral colpocervicopexy with laparoscopic pectopexy. Our aim was to show that the safety and effectiveness of the new technique is similar to the traditional technique. We expected differences regarding defecation disorders. Patients and Methods: We randomly assigned patients to two treatment groups: 44 in the pectopexy and 41 in the sacropexy group. If necessary, the operative procedures were planned in a so-called multicompartment setting regarding the different pelvic floor disorders. All defects were managed at the same time. Eighty-one patients were examined 12 to 37 months after treatment (mean follow-up 20.67 months). Results: The long-term follow-up (21.8 months for pectopexy and 19.5 months for sacropexy) showed a clear difference regarding de novo defecation disorders (0% in the pectopexy vs 19.5% in the sacropexy group). The incidence of de novo stress urinary incontinence was 4.8% (pectopexy) vs 4.9% (sacropexy). The incidence of rectoceles (9.5% vs 9.8%) was similar in both groups. No de novo lateral defect cystoceles were found after pectopexy, whereas 12.5% were found after sacropexy. The apical descensus relapse rates, 2.3% for pectopexy vs 9.8% for sacropexy, were not statistically significant. The occurrence of de novo anterior defect cystoceles and rectoceles revealed no significant differences. Conclusion: Laparoscopic pectopexy is a novel method of vaginal prolapse therapy that offers clear practical advantages compared with laparoscopic sacropexy. Because laparoscopic pectopexy does not reduce the pelvic space, it results in a zero percentage of defecation disorders. PMID:25350228

Schiermeier, Sven; Alkatout, Ibrahim; Anapolski, Michael

2015-01-01

194

Percutaneous transhepatic cholangiography for choledocholithiasis after laparoscopic gastric bypass surgery  

PubMed Central

INTRODUCTION Gallstones are a common condition in bariatric patients after a laparoscopic Roux-en-Y gastric bypass (LRYGB). The management of ductal stones is challenging due to the altered gastrointestinal anatomy. Various techniques have been reported to manage bile duct stones. PRESENTATION OF CASE We present the successful percutaneous trans hepatic management of common bile duct stones after LRYGB. One year after a LRYGB for morbid obesity, a 59-year-old female presented with acute cholecystitis. One month after laparoscopic cholecystectomy a 1 cm calculus was found within the distal CBD and patient underwent a percutaneous trans hepatic cholangiography under local anesthetic. This involved a right sided anterior segmental duct puncture. With the sphincter dilated to 10 mm, a balloon catheter was used to push the stone into the duodenum leaving an internal- external drain. Patient recovered completely at follow up. DISCUSSION Patients with morbid obesity have a higher incidence of gallstones. After LRYGB, the altered anatomy does not allow the conventional endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis. Various techniques have been reported as means of managing bile duct stones in LRYGB patients. These include a double balloon enteroscope-assisted ERCP, laparoscopic transgastric ERCP, laparoscopic or open biliary surgery and interventional radiology. We report a non-surgical approach using percutaneous transhepatic technique under local anesthetic that resulted effective and could be applied more extensively. CONCLUSION Due to the increase of global obesity, bariatric centers need to strategically plan resources such as interventional radiology in order to manage post LRYGB choledocholithiasis safely, efficiently and in a cost effective manner. PMID:24705194

Milella, Marialessia; Alfa-Wali, Maryam; Leuratti, Luca; McCall, James; Bonanomi, Gianluca

2014-01-01

195

Pelvic floor muscle training exercises  

MedlinePLUS

... pelvic floor muscle training correctly, you can use biofeedback and electrical stimulation to help find the correct muscle group to work. Biofeedback is a method of positive reinforcement. Electrodes are ...

196

How Is Pelvic Pain Treated?  

MedlinePLUS

... Hormones can help pain related to endometriosis and menstruation . 4 These include hormones that are swallowed, injected, ... 04/12/2013 Related A-Z Topics Endometriosis Menstruation and Menstrual Problems Pelvic Floor Disorders All related ...

197

Pelvic Inflammatory Disease (PID) Statistics  

MedlinePLUS

... Diseases (STDs) Share Compartir Pelvic Inflammatory Disease (PID) Statistics Most Recent Data STD Surveillance 2012 - STDs in ... PID) Facts & Brochures Fact Sheet Detailed Fact Sheet Statistics Treatment Archive STDs Home Page Bacterial Vaginosis (BV) ...

198

Brachytherapy Anatomy-based inverse planning dose optimization in HDR prostate  

E-print Network

Brachytherapy Anatomy-based inverse planning dose optimization in HDR prostate implant: A toxicity received HDR implant boost using inverse planning, and to determine dose volume correlations. Patients pelvic field followed by 2­3 fraction of inverse-planned HDR implant boost (6­9.5 Gy /fraction). Median

Pouliot, Jean

199

Complications of laparoscopic herniorrhaphy  

Microsoft Academic Search

Anterior inguinal hernia repair is the second-most-commonly performed abdominal operation and has been associated with low morbidity and mortality rates. The principle of laparoscopy has been applied to this surgical problem in a series of 762 patients with 841 inguinal hernias. Four types of laparoscopic repairs were conducted: (1) high ligation of the indirect inguinal hernia sac and closure of

Bruce V. MacFadyen; Maurice E. Arregui; John D. Corbitt; Charles J. Filipi; Robert J. Fitzgibbons; Morris E. Franklin; J. Barry McKernan; Douglas O. Olsen; Edward H. Phillips; Daniel Rosenthal; Leonard S. Schultz; Robert W. Sewell; Roy T. Smoot; Albert T. Spaw; Frederick K. Toy; Robert L. Waddell; Karl A. Zucker

1993-01-01

200

Laparoscopic esophagomyotomy for achalasia  

Microsoft Academic Search

Results of an ongoing clinical study treating achalasia patients with a transabdominal laparoscopic Heller myotomy and Toupet partial fundoplication are presented. Twelve patients underwent surgery between January 1992 and October 1993. All patients had barium esophagograms, preoperative endoscopy, esophageal manometry, 24-h pH studies, and extensive GI history preoperatively. Surgical complications included two perforations of the mucosa at the gastroesophageal junction

L. L. Swanstrom; J. Pennings

1995-01-01

201

Telesurgical Laparoscopic Radical Prostatectomy  

Microsoft Academic Search

Introduction: Telepresence surgery offers theoretically to overcome two main problems of laparoscopic surgery, i.e. the limitation to only four degrees of freedom and the lack of stereovision. Since 1998, telesurgical minimally invasive procedures have been performed with the da Vinci system mainly for cardiac bypass surgery. Clinical experience in urology is still very limited. We want to present our initial

Jens Rassweiler; Thomas Frede; Othmar Seemann; Christian Stock; Ludger Sentker

2001-01-01

202

Laparoscopic Reconstructive Urology  

Microsoft Academic Search

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

JIHAD H. KAOUK; INDERBIR S. GILL

2003-01-01

203

Laparoscopic cholecystectomy during pregnancy  

Microsoft Academic Search

Summary  There is a strong association between pregnancy and gallstones. When acute cholecystitis or recurring bouts of biliary colic occur during pregnancy, medical therapy is usually initiated but occasionally fails. Laparoscopic cholecystectomy has recently been described for the treatment of symptomatic cholelithiasis, but many authors consider pregnancy to be an absolute contraindication to this operation. We herein describe the management of

Nathaniel J. Soper; John G. Hunter; Roy H. Petrie

1992-01-01

204

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

205

Effectiveness of ovarian suspension in preventing post-operative ovarian adhesions in women with pelvic endometriosis: A randomised controlled trial  

PubMed Central

Background Endometriosis is a common benign condition, which is characterized by the growth of endometrial-like tissue in ectopic sites outside the uterus. Laparoscopic excision of the disease is frequently carried out for the treatment of severe endometriosis. Pelvic adhesions often develop following surgery and they can compromise the success of treatment. Ovarian suspension (elevating both ovaries to the anterior abdominal wall using a Prolene suture) is a simple procedure which has been used to facilitate ovarian retraction during surgery for severe pelvic endometriosis. The study aims to assess the effect of temporary ovarian suspension following laparoscopic surgery for severe pelvic endometriosis on the prevalence of post-operative ovarian adhesions. Methods A prospective double blind randomised controlled trial for patients with severe pelvic endometriosis requiring extensive laparoscopic dissection with preservation of the uterus and ovaries. Severity of the disease and eligibility for inclusion will be confirmed at surgery. Patients unable to provide written consent, inability to tolerate a transvaginal ultrasound scan, unsuccessful surgeries or suffer complications leading to oophorectomies, bowel injuries or open surgery will be excluded. Both ovaries are routinely suspended to the anterior abdominal wall during surgery. At the end of the operation, each participant will be randomised to having only one ovary suspended post-operatively. A new transabdominal suture will be reinserted to act as a placebo. Both sutures will be cut 36 to 48 hours after surgery before the woman is discharged home. Three months after surgery, all randomised patients will have a transvaginal ultrasound scan to assess for ovarian mobility. Both the patients and the person performing the scan will be blinded to the randomisation process. The primary outcome is the prevalence of ovarian adhesions on ultrasound examination. Secondary outcomes are the presence, intensity and site of post-operative pain. Discussion This controlled trial will provide evidence as to whether temporary ovarian suspension should be included into the routine surgical treatment of women with severe pelvic endometriosis. Trial registration ISRCTN: ISRCTN24242218 PMID:21569374

2011-01-01

206

Laparoscopic vs . Hand-Assisted Laparoscopic Sigmoidectomy for Diverticulitis  

Microsoft Academic Search

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

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

2006-01-01

207

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

208

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

209

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

210

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

PubMed Central

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

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

2012-01-01

211

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

212

Aberrant left main bile duct draining directly into the cystic duct or gallbladder: an unreported anatomical variation and cause of bile duct injury during laparoscopic cholecystectomy.  

PubMed

Despite recent advances, iatrogenic bile duct injury remains one of the most common complications of laparoscopic cholecystectomy. Aberrant biliary tract anatomy is one of the major risk factors for iatrogenic bile duct injury. In this case report, for the first time, we report a case of aberrant left main bile duct draining directly into the cystic duct or gallbladder that presented with bile duct injury after laparoscopic cholecystectomy. We hope that the diagnostic and management approach used in this case will help physicians to identify and manage their patients should they face such a rare anatomy. PMID:25369222

Shokouh-Amiri, Hosein; Fallahzadeh, Mohammad Kazem; Abdehou, Sophia T; Sugar, Miles; Zibari, Gazi B

2014-01-01

213

Laparoscopic myomectomy using ultrasonic dissection.  

PubMed

Laparoscopic myomectomy is gaining in popularity as a means of treating leiomyoma uteri, avoiding hysterectomy, and thereby preserving or restoring fertility, when compared with traditional laparotomic surgery. While technically demanding, a laparoscopic procedure has advantages beneficial to the patient; these include decreased postoperative pain and discomfort, decreased length of stay and cost, and more rapid return to full activity. The disadvantages of laparoscopic myomectomy include increased operative time, inability to palpate the uterus at myomectomy, and the requirement of advanced technical skills. We report on our experience with laparoscopic myomectomy for treatment of infertility, habitual abortion, or to treat symptomatic myomata while preserving fertility. PMID:21400440

Miller, C E; Johnston, M

1995-01-01

214

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

215

Laparoscopic cholecystectomy for a left-sided gallbladder  

PubMed Central

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

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

2013-01-01

216

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

PubMed

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

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

2014-03-01

217

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

218

Comparative Cardiac Anatomy  

Microsoft Academic Search

Anatomy is one of the oldest branches of medicine, with historical records dating back at least as far as the 3rd century\\u000a bc; animal research dates back equally as far. Aristotle (384–322 bc) studied comparative animal anatomy and physiology, and Erasistratus of Ceos (304–258 bc) studied live animal anatomy and physiology (1). Galen of Pergamum (129–199 ad) is probably the

Alexander J. Hill; Paul A. Iaizzo

219

Successful laparoscopic reversal of gastric bypass in a patient with malnutrition  

PubMed Central

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

Park, Ji Yeon

2014-01-01

220

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.

221

Supernumerary kidney laparoscopically treated  

PubMed Central

Congenital anomalies of the kidney and urinary tract are part of a family of diseases with different anatomical origins. Duplicated collecting systems can be defined as a renal unit containing 2 pyelocalyceal systems associated with a single ureter or with double ureters. The supernumerary kidney is a definitive accessory organ with its own collecting system, blood supply, and distinct encapsulated parenchima. The true incidence of supernumerary kidney remains unknown, but most cases are in males, are unilateral and on the left side. We present a case of an adult woman with a hypoplastic supernumerary kidney with a complete ureteral duplication and an ectopic junction. The case has been laparoscopically treated. We demonstrate that a laparoscopic nephro-ureterectomy is feasible and that the management of the complication (urinoma and fistula) can be managed conservatively. PMID:24282475

Innocenzi, Michele; Casale, Paolo; Alfarone, Andrea; Ravaziol, Michele; Cattarino, Susanna; Grande, Pietro; Minisola, Francesco; Gentilucci, Alessandro; Gentile, Vincenzo; Sciarra, Alessandro

2013-01-01

222

Supernumerary kidney laparoscopically treated.  

PubMed

Congenital anomalies of the kidney and urinary tract are part of a family of diseases with different anatomical origins. Duplicated collecting systems can be defined as a renal unit containing 2 pyelocalyceal systems associated with a single ureter or with double ureters. The supernumerary kidney is a definitive accessory organ with its own collecting system, blood supply, and distinct encapsulated parenchima. The true incidence of supernumerary kidney remains unknown, but most cases are in males, are unilateral and on the left side. We present a case of an adult woman with a hypoplastic supernumerary kidney with a complete ureteral duplication and an ectopic junction. The case has been laparoscopically treated. We demonstrate that a laparoscopic nephro-ureterectomy is feasible and that the management of the complication (urinoma and fistula) can be managed conservatively. PMID:24282475

Innocenzi, Michele; Casale, Paolo; Alfarone, Andrea; Ravaziol, Michele; Cattarino, Susanna; Grande, Pietro; Minisola, Francesco; Gentilucci, Alessandro; Gentile, Vincenzo; Sciarra, Alessandro

2013-01-01

223

Total Laparoscopic Pancreaticoduodenectomy  

PubMed Central

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

Kamyab, Armin

2013-01-01

224

Totally laparoscopic feeding jejunostomy  

Microsoft Academic Search

  Background: A feeding jejunostomy should be used for nutritional support in a small subset of patients. Minimal-access approaches\\u000a for the placement of jejunal tubes have been described, but they often require special equipment not common to all operating\\u000a theaters. We describe a technique of totally laparoscopic jejunostomy tube (LJT) placement using equipment found in most operating\\u000a theaters. Methods: Thirty-five patients

J. W. Allen; A. Ali; J. Wo; J. M. Bumpous; R. N. Cacchione

2002-01-01

225

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

226

Is Pelvic Organ Prolapse a Cause of Pelvic or Low Back Pain?  

Microsoft Academic Search

METHODS: A total of 152 consecutive patients with pelvic organ prolapse completed a visual faces scale to quantify the amount of pelvic or low back pain present. Pelvic organ prolapse severity was graded by three techniques: 1) pelvic organ prolapse quantification staging; 2) descent of the leading edge of prolapse; and 3) dynamic cystoproctogra- phy. Linear and nonlinear associations of

Michael Heit; Patrick Culligan; Chris Rosenquist; Susan Shott

2002-01-01

227

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

228

[Laparoscopic hysterectomy -- indications, technic, complications].  

PubMed

In recent decades, interest in laparoscopic gynecological practice increase. This technic applied first as a diagnostic tool in women with infertility. Subsequently starts to be used to perform surgery in small region of the fallopian tubes and ovaries, being increasingly developed and today, it is considered that any gynecological operation can be performed laparoscopically. PMID:24505638

Bechev, Bl; Kornovski, J; Kostov, I; Lazarov, I

2013-01-01

229

Laparoscopic radical prostatectomy: preliminary results  

Microsoft Academic Search

Objectives. To evaluate our preliminary experience with laparoscopic radical prostatectomy. The indications for laparoscopy are currently being extended to complex oncologic procedures.Methods. Forty-three men underwent laparoscopic radical prostatectomy. We used five trocars. The surgical technique replicates the steps of traditional retropubic prostatectomy, except that the rectoprostatic cleavage plane is developed transperitoneally at the beginning of the procedure. In the first

C. C Abbou; L Salomon; A Hoznek; P Antiphon; A Cicco; F Saint; W Alame; J Bellot; D. K Chopin

2000-01-01

230

Multi-detector row CT evaluation of living renal donors prior to laparoscopic nephrectomy.  

PubMed

Since its introduction in 1995, laparoscopic nephrectomy has become the preferred technique at many medical centers for the harvesting of kidneys from living donors for transplantation. Because the field of view at laparoscopic surgery is limited, preoperative radiologic evaluation of the donor's anatomy---the renal veins and arteries, collecting system, and parenchyma--is critical. Spiral computed tomographic (CT) angiography is a fast, safe, minimally invasive, and generally accepted method for preoperative evaluation of the renal vessels. Multi-detector row CT scanners offer shorter image acquisition time, narrower collimation, better spatial resolution, and less tube heating than do single-detector row CT scanners. Multi-row scanners also provide more complete anatomic coverage, increased contrast enhancement of the arteries, and greater longitudinal spatial resolution--all of which are important both for accurate imaging of the renal vasculature and for three-dimensional postprocessing of image data. Dual-phase multi-detector row CT angiography combined with three-dimensional postprocessing enables minimally invasive and highly accurate depiction of the preoperative donor anatomy. To make the most effective use of this method, radiologists must be familiar with its technical aspects, advantages, and potential pitfalls. They also must be able to identify variations in vasculature and in renal and extrarenal anatomy that are important for laparoscopic donor nephrectomy. PMID:15026593

Kawamoto, Satomi; Montgomery, Robert A; Lawler, Leo P; Horton, Karen M; Fishman, Elliot K

2004-01-01

231

Anatomy Quiz Pro app.  

PubMed

There are many apps for learning anatomy, but this one is developed by an established developer in California called Real Bodywork, and uses the novel approach of multiple-choice quizzes. It is proving popular with students and is an excellent study tool for basic anatomy. PMID:25783267

Ryan, Bridget

2015-03-18

232

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

233

Laparoscopic retroperitoneoscopic nephrectomy and partial nephrectomy in children  

PubMed Central

Objectives: The aim was to evaluate our experience in the retroperitoneal laparoscopic approach in total and partial nephrectomies in children. Materials and Methods: We retrospectively reviewed the medical records of 41 patients who underwent retroperitoneal laparoscopic total or partial nephrectomies performed in our center from 2004 to 2012. We looked at the demographic data, age at surgery, indication, operative time, surgical complications, conversion to open surgery and operative complications. Results: Thirty-five total and six partial nephrectomies (upper pole) were performed. The mean age was 84 months (7-175). Vesicoureteric reflux, pelviureteric junction obstruction, and multicystic dysplastic kidney disease were the main underlying pathologies. The mean operative time was 158 min (60-280). There were no intraoperative complications (surgical and anesthetic), and no significant blood loss was observed. Conversion to open surgery was necessary in two cases caused by failure to progress due to difficult anatomy during the partial nephrectomies. No major postoperative complications were noted. The mean hospital stay was 2.5 days (1-5). A drain was used in 12 cases and was removed after a mean of 2 days. Conclusions: Laparoscopic retroperitoneoscopic renal surgery can be carried out safely and effectively in children. Still, this procedure is more challenging and requires an excellent image of the retroperitoneal space, especially when partial nephrectomies are concerned.

Al-hazmi, Hamdan H.; Farraj, Hamzeh M.

2015-01-01

234

Implementation of a Robotic Surgical Program in Gynaecological Oncology and Comparison with Prior Laparoscopic Series  

PubMed Central

Background. Robotic surgery in gynaecological oncology is a rapidly developing field as it offers several technical advantages over conventional laparoscopy. An audit was performed on the outcome of robotic surgery during our learning curve and compared with recent well-established laparoscopic procedure data. Method. Following acquisition of the da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, California, USA), we prospectively analysed all cases performed over the first six months by one experienced gynaecologist who had been appropriately trained and mentored. Data on age, BMI, pathology, surgery type, blood loss, morbidity, return to theatre, hospital stay, and readmission rate were collected and compared with a consecutive series over the preceding 6 months performed laparoscopically by the same team. Results. A comparison of two consecutive series was made. The mean age was somewhat different, 55 years in the robotic versus 69 years in the laparoscopic group, but obesity was a feature of both groups with a mean of BMI 29.3 versus 28.06, respectively. This difference was not statistically significant (P = 0.54). Three subgroups of minimal access surgical procedures were performed: total hysterectomy and bilateral salpingooophorectomy (TH + BSO), total hysterectomy and bilateral salpingooophorectomy plus bilateral pelvic lymphadenectomy (TH + BSO + BPLND), and radical hysterectomy plus bilateral pelvic lymphadenectomy (RH + BPLND). The mean time taken to perform surgery for TH + BSO was longer in the robotic group, 151.2?min compared to 126.3?min in the laparoscopic group. TH + BSO + BPLND surgical time was similar to 178.3?min in robotic group and 176.5?min in laparoscopic group. RH + BPLND surgical time was similar, 263.6?min (robotic arm) and 264.0?min (laparoscopic arm). However, the numbers in this initial analysis were small especially in the last two subgroups and do not allow for statistical analysis. The rate of complications necessitating intervention (Clavien-Dindo classification grade 2/3) was higher in the robotic arm (22.7%) compared to the laparoscopic approach (4.5%). The readmission rate was higher in the robotic group (18.2%) compared to the laparoscopic group (4.5%). The return to theatre in the robotic group was 18.2% and 4.5% in laparoscopic group. Uncomplicated robotic surgery hospital stay appeared to be shorter, 1.3 days compared to the uncomplicated laparoscopic group, 2.5 days. There was no conversion to the open procedure in either arm. Estimated blood loss in all cases was less than 100?mL in both groups. Conclusion. Robotic surgery is comparable to laparoscopic surgery in blood loss; however, the hospital stay in uncomplicated cases appears to be longer in the laparoscopic arm. Surgical robotic time is equivalent to laparoscopic in complex cases but may be longer in cases not requiring lymph node dissection. The robotic surgery team learning curve may be associated with higher rate of morbidity. Further research on the benefits to the surgeon is needed to clarify the whole picture of this versatile novel surgical approach. PMID:25785195

Povolotskaya, Natalia; Woolas, Robert; Brinkmann, Dirk

2015-01-01

235

STUDY PROTOCOL Open Access Open versus laparoscopically-assisted  

E-print Network

STUDY PROTOCOL Open Access Open versus laparoscopically-assisted oesophagectomy for cancer%, respectively, for both the abdominal and thoracic approaches. The worldwide popularity of laparoscopic to the reduced postoperative trauma. We hypothesise that the laparoscopic abdominal approach (laparoscopic

Paris-Sud XI, Université de

236

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

PubMed Central

Pelvic lipomatosis is a rare benign disease, associated with overgrowth of fat in the perivesical and perirectal area. It is of unknown etiology. We describe a 45–year–old male with pelvic lipomatosis causing bladder storage dysfunction symptoms and pelvic pain that affected his quality of life. Surgical excision of the pelvic mass with bladder preservation was performed. After surgery, the patient had a marked improvement in his quality of life, with resolution of bladder storage dysfunction symptoms and pelvic pain. PMID:25247089

Ali, Ahmed; Swain, Sanjaya

2014-01-01

237

Anatomy comic strips.  

PubMed

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

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

2011-01-01

238

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

239

First ever case of spontaneous triplet cornual pregnancy: management of laparoscopic cornual resection with modified endoloop method.  

PubMed

A 23-year-old woman, gravida 2 para 0, presented at 8?weeks gestation with a spontaneously conceived triplet cornual ectopic pregnancy. She was at high risk of ectopic pregnancy as she had been previously treated for pelvic inflammatory disease and had also undergone laparoscopic salpingostomy for right-sided ectopic pregnancy. She was clinically stable and her abdomen was soft and non-tender. The diagnosis was made on transvaginal ultrasound scan and this was confirmed on the three-dimensional scan. She was counselled about her treatment options and subsequently underwent laparoscopic cornual resection using the modified endoloop method. The estimated blood loss was 20?ml intraoperatively and the patient recovered well. She subsequently conceived spontaneously with an intrauterine pregnancy and underwent lower segment caesarean section at 37?weeks in view of previous laparoscopic cornual resection. Intraoperatively, the right cornua appeared normal and there was no sign of thinning. PMID:25716043

Gosavi, Arundhati; Lim, Li Min; Agarwal, Anupriya; Fong, Yoke Fai

2015-01-01

240

Growing teratoma syndrome in a post laparoscopic excision of ovarian immature teratoma  

PubMed Central

A 26-year-old girl was referred to us in December 2008 with progressive pelvic mass while on chemotherapy. In May 2008, she presented with large adnexal mass and high alpha-fetoprotein (AFP, 265.7 ng/mL; normal range, 0 to 10). She underwent laparoscopic right salpingo-oophorectomy with staging. Since histology was immature teratoma grade I, FIGO stage 1 she was kept on surveillance. In September 2008, she developed recurrent pelvic mass with AFP levels of 2,400 ng/mL. Three courses of chemotherapy (bleomycin-etoposide-cisplatin) were given. Post-chemotherapy AFP normalized but tumor size increased. CT-scan (abdomen-pelvis) showed a large pelvic mass with calcification specks; infiltrating the sigmoid colon and abdominal wall. With provisional diagnosis of growing teratoma syndrome she had exploratory laparotomy with excision of pelvic mass along with sigmoid colon, excision of right pelvic and subcutaneous deposits, omentectomy and sigmoid anastomosis. Left ovary, left tube and uterus appeared normal and were preserved. Histology of all masses showed mature teratoma, no immature elements. At six months follow up she is disease free and has resumed menstruation. Growing teratoma syndrome is a clinico-pathological presentation during/post-chemotherapy in malignant ovarian germ cell tumor where mature teratoma grows and requires complete surgical excision. Our case highlights the safety and adequacy concerns of laparoscopic management of malignant ovarian tumor. Literature review suggests good prospects of resumption of menses, child bearing and five year survival in case of growing teratoma syndrome. PMID:20613905

Sengar, Anju Rani

2010-01-01

241

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

242

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.

243

Vaginal childbirth and pelvic floor disorders  

PubMed Central

Childbirth is an important event in a woman’s life. Vaginal childbirth is the most common mode of delivery and it has been associated with increased incidence of pelvic floor disorders later in life. In this article, the authors review and summarize current literature associating pelvic floor disorders with vaginal childbirth. Stress urinary incontinence and pelvic organ prolapse are strongly associated with vaginal childbirth and parity. The exact mechanism of injury associating vaginal delivery with pelvic floor disorders is not known, but is likely multifactorial, potentially including mechanical and neurovascular injury to the pelvic floor. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist in clusters; hence, the isolated effect of these variables on the pelvic floor is difficult to study. PMID:23638782

Memon, Hafsa U; Handa, Victoria L

2013-01-01

244

Adult Stentless Laparoscopic Pyeloplasty  

PubMed Central

Background and Objectives: Pyeloplasty, whether open or laparoscopic, has been the mainstay of treatment for ureteropelvic junction obstruction (UPJO). A nonstented pyeloplasty has only been reported in the pediatric literature. Herein, to the best of our knowledge, we report the first published experience with laparoscopic stentless pyeloplasty (LSP) in the adult population. Methods: Patients with a normal contralateral kidney who underwent a laparoscopic pyeloplasty were included in this study. A dismembered pyeloplasty was performed without the placement of a ureteral stent. Functional Tc-99m MAG3 renal-scan data were compared with results at 4 weeks and 6 months postoperatively. Perioperative complications and long-term follow-up were prospectively gathered. Results: To date, 5 patients have undergone LSP with a mean follow-up of 15.7 months. Mean age and body mass index of this group were 42.8 years and 29.3 kg/m2, respectively. Mean operative time, estimated blood loss, and hospital stay were 196 minutes, 58 mL, 1.6 days, respectively. Three patients had right-sided UPJO, and 2 patients had left UPJO. No patient had undergone previous surgery for UPJO. All patients had a ureteral stent in place at the time of surgery. No intraoperative complications occurred. Only one patient complained of flank pain on POD1. No obstruction or urinary extravasation was seen on retrograde pyelography, but a ureteral stent was placed. During our follow-up, all patients had complete resolution of their symptoms. Postoperative renal scans demonstrated improved urinary drainage in all patients. Conclusion: Our initial experience suggests that in experienced hands, LSP may be an effective method for treating UPJO. PMID:17651549

Shalhav, Arieh L.; Mikhail, Albert A.; Orvieto, Marcelo A.; Gofrit, Ofer N.; Gerber, Glenn S.

2007-01-01

245

Laparoscopic sterilization kit.  

PubMed

A suitcase size laparoscopic sterilization kit produced by Medical Technology Internationale, Inc. was tested on 50 patients at the Johns Hopkins Hospital and field tested in San Jose, Costa Rica. The pneumoperitoneum device has reduced overall size with 2 "pop-off" valves, one to prevent more than one l carbon dioxide from entering the abdomen and one to protect against sudden expansion of any carbon dioxide within the peritoneal cavity. Electrocoagulation capacity has been adequate for fulguration of the uterine tube. The miniaturization of the equipment should provide greater mobility in delivering family planning services. PMID:4269087

Wheeless, C R

1973-08-01

246

Complications of laparoscopic pyeloplasty  

Microsoft Academic Search

Objectives  With the development of new video-endoscopic techniques like endopyelotomy, laparoscopy and retroperitoneoscopy the treatment\\u000a of UPJO has become less invasive. The complications and learning curve of laparoscopic pyeloplasty are presented together\\u000a with recommendations for adequate management.\\u000a \\u000a \\u000a \\u000a Materials and methods  Based on the personal experience with 189 cases of retroperitoneoscopic pyeloplasty, a literature review (PubMed) was performed\\u000a focussing on complication and success

Jens J. Rassweiler; Dogu Teber; Thomas Frede

2008-01-01

247

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

248

Laparoscopically assisted colon surgery  

PubMed Central

Laparoscopy has been used in surgical procedures more frequently in the past decade because it reduces postoperative pain, decreases the length of hospitalization, decreases the duration of disability, and provides a better cosmetic result. We retrospectively reviewed our experience with laparoscopic colon surgery at Baylor University Medical Center. Since 1995, we have done 17 procedures, including 10 colon resections and 7 colostomies. The results in these patients have been quite good: only 1 patient was converted to an open procedure, and the remaining 16 patients experienced no mortality, major morbidity, or wound infection. PMID:16389383

2000-01-01

249

Entomology 201 Lab 3 Anatomy and  

E-print Network

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 Anatomy abdomen ovipositor cerci This is actually an immature (nymph) cricket! #12;Feeding Apparatus

Eubanks, Micky

250

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

251

Mesh fistulation into the rectum after laparoscopic ventral mesh rectopexy?  

PubMed Central

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

Adeyemo, Dayo

2013-01-01

252

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

253

Thymus Gland Anatomy  

MedlinePLUS

... Browse Search Quick Search Image Details Thymus Gland Anatomy Adult View/Download: Small: 720x576 View Download Add ... Search | Accessibility | Staff U.S. Department of Health and Human Services | National Institutes of Health | National Cancer Institute | ...

254

Anatomy of the Eye  

MedlinePLUS

... Children Scientists in the Laboratory Visual Acuity Testing Anatomy of the Eye Nearsightedness Illustration of a Normal ... the NEI Website Manager . Department of Health and Human Services | The National Institutes of Health | USA.gov ...

255

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.

256

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 Joseph

257

Laparoscopic treatment of perforated appendicitis  

PubMed Central

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

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

2014-01-01

258

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

259

Robotic-Assisted Laparoscopic Heminephrectomy  

Microsoft Academic Search

\\u000a Ehrlich et al.1 first reported the use of laparoscopic nephrectomy in children, and Jordon and Winslow 2 reported the first\\u000a laparoscopic partial nephrectomy (LPN) in a 14-year-old girl with bilateral duplicated systems. Since these reports, there\\u000a has been a boom in the utilization of laparoscopy in pediatric urology, where it has been aggressively pursued as an alternative\\u000a to traditional open

Drew A. Freilich; Hiep T. Nguyen

260

Laparoscopic Repair of Inguinal Hernias  

Microsoft Academic Search

For patients with recurrent inguinal hernia, or bilateral inguinal hernia, or for women, laparoscopic repair offers significant\\u000a advantages over open techniques with regard to recurrence risk, pain, and recovery. For unilateral first-time hernias, either\\u000a laparoscopic or open repair with mesh can offer excellent results. The major drawback of laparoscopy is that the technique\\u000a requires a significant number of cases to

Jonathan Carter; Quan-Yang Duh

261

Laparoscopic-assisted colon resection  

Microsoft Academic Search

The popularity and success of laparoscopic biliary tract surgery have persuaded surgeons to explore other applications for\\u000a rigid endoscopic surgery. From July 1990 to February 1993 a total of 65 patients (mean age 57 years; range 41–82) underwent\\u000a attempted laparoscopic colon resection. Indications for surgical intervention included cancer (39), adenomatous polyps (14),\\u000a diverticulosis (10), stricture (1), and foreign-body perforation (1).

K. A. Zucker; D. E. Pitcher; D. T. Martin; R. S. Ford

1994-01-01

262

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

263

[Hepatic and pancreatic laparoscopic surgery].  

PubMed

The development of laparoscopic surgery also includes the more complex procedures of abdominal surgery such as those that affect the liver and the pancreas. From diagnostic laparoscopy, accompanied by laparoscopic echography, to major hepatic or pancreatic resections, the laparoscopic approach has spread and today encompasses practically all of the surgical procedures in hepatopancreatic pathology. Without forgetting that the aim of minimally invasive surgery is not a better aesthetic result but the reduction of postoperative complications, it is undeniable that the laparoscopic approach has brought great benefits for the patient in every type of surgery except, for the time being, in the case of big resections such as left or right hepatectomy or resections of segments VII and VIII. Pancreatic surgery has undergone a great development with laparoscopy, especially in the field of distal pancreatectomy due to cystic and neuroendocrine tumours where the approach of choice is laparoscopic. Laparoscopy similarly plays an important role, together with echolaparoscopy, in staging pancreatic tumours, prior to open surgery or for indicating suitable treatment. In coming years, it is to be hoped that it will continue to undergo an exponential development and, together with the advances in robotics, it will be possible to witness a greater impact of the laparoscopic approach on the field of hepatic and pancreatic surgery. PMID:16511579

Pardo, F; Rotellar, F; Valentí, V; Pastor, C; Poveda, I; Martí-Cruchaga, P; Zozaya, G

2005-01-01

264

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

265

Laparoscopic Anti-Reflux (GERD) Surgery  

MedlinePLUS

... Exhibit Opportunities Sponsorship Opportunities Login Patient Information for Laparoscopic Anti-Reflux (GERD) Surgery from SAGES Download PDF ... suffer from “heartburn” your surgeon may have recommended Laparoscopic Anti-Reflux Surgery to treat this condition, technically ...

266

RETROPERITONEAL LAPAROSCOPIC VERSUS OPEN RADICAL NEPHRECTOMY  

Microsoft Academic Search

PurposeWe analyze the retroperitoneal approach to laparoscopic radical nephrectomy in regard to feasibility, safety, morbidity and cancer control, and compare results and outcomes in patients who underwent retroperitoneal laparoscopic or open radical nephrectomy from 1995 to 1998.

C. C. ABBOU; A. CICCO; D. GASMAN; A. HOZNEK; P. ANTIPHON; D. K. CHOPIN; L. SALOMON

1999-01-01

267

Design of a pressure sensing laparoscopic grasper  

E-print Network

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

Reyda, Caitlin J. (Caitlin Jilaine)

2011-01-01

268

Biofeedback, pelvic floor re-education, and bladder training for male chronic pelvic pain syndrome  

Microsoft Academic Search

Objectives. Pelvic floor tension myalgia may contribute to the symptoms of male patients with chronic pelvic pain syndrome (CPPS). Therefore, measures that diminish pelvic floor muscle spasm may improve these symptoms. Based on this hypothesis, we enrolled 19 patients with CPPS in a 12-week program of biofeedback-directed pelvic floor re-education and bladder training.Methods. Pre-treatment and post-treatment symptom assessments included daily

J. Quentin Clemens; ROBERT B. NADLER; ANTHONY J. SCHAEFFER; Jay Belani; Jeff Albaugh; Wade Bushman

2000-01-01

269

Risk factors for pelvic pouch failure  

Microsoft Academic Search

PURPOSE: This study was designed to identify factors associated with pelvic pouch failure. METHOD: A retrospective review of patients undergoing the pelvic pouch procedure with a minimum of 30 months follow-up was conducted. RESULTS: A total of 551 patients had pelvic pouch procedures from 1981 to 1992. Forty-nine patients (8.8 percent) have undergone pouch excision, and 9 (1.6 percent) have

Helen M. MacRae; Robin S. McLeod; Zane Cohen; Brenda I. O'Connor; Eddie Ng Cheong Ton

1997-01-01

270

Complete laparoscopic removal of a gastric trichobezoar  

PubMed Central

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

Vepakomma, Deepti; Alladi, Anand

2014-01-01

271

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

272

Rectouterine fistula after laparoscopic ultrasound-guided radiofrequency ablation of a uterine fibroid  

PubMed Central

In the conservative management of uterine fibroids is radiofrequency ablation (RFA) considered to be one of the safe, effective and minimal invasive approaches in selected women who desire to retain their uterus. Few studies were conducted on its adverse outcomes and most of the reported complications were minor events such as pain, discharge, adhesion which didn't require any intervention. However, although safe and effective, the RFA of a uterine myoma can be the cause for severe complications such as penetration and burn injuries of pelvic organs. In general, a rectouterine fistula is one of the rarest complications but can lead to serious adverse outcomes. Herein, to our knowledge, we report the first case involving a rectouterine fistula after laparoscopic ultrasound-guided RFA of a uterine myoma with pelvic endometriosis. In addition, we provide a brief review of the relevant literature. PMID:25469349

Jeong, Hyo Joo; Kwon, Byung-Su; Choi, Young Joon

2014-01-01

273

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

274

Grading pelvic prolapse and pelvic floor relaxation using dynamic magnetic resonance imaging  

Microsoft Academic Search

Objectives. With significant vaginal prolapse, it is often difficult to differentiate among cystocele, enterocele, and high rectocele by physical examination alone. Our group has previously demonstrated the utility of magnetic resonance imaging (MRI) for evaluating pelvic prolapse. We describe a simple objective grading system for quantifying pelvic floor relaxation and prolapse.Methods. One hundred sixty-four consecutive women presenting with pelvic pain

Craig V Comiter; Sandip P Vasavada; Zoran L Barbaric; Angelo E Gousse; Shlomo Raz

1999-01-01

275

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

276

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

277

Laparoscopic Management of Kidney Cancer: Updated Review  

Microsoft Academic Search

Background: Laparoscopy has emerged as the preferred option for the surgical management of kidney cancer. Although many reports have been published regarding the operative outcome of renal cell carcinoma (RCC) and upper-tract transitional cell carcinoma (TCCA) treated laparoscopically, few review the oncologic outcome of these pathologies treated with laparoscopic techniques. Methods: We review the literature regarding the laparoscopic approaches, the

Hosam S. Al-Qudah; Alejandro R. Rodriguez; Wade J. Sexton

2007-01-01

278

Laparoscopic tubal anastomosis: reversal of sterilization.  

PubMed

A case of laparoscopic reversal of tubal sterilization is reported. The patient was a 38 year old woman sterilized by bipolar diathermia two years earlier. Refertilization was performed by laparoscopic end to end anastomosis of one tube. Postoperatively, the patient had one menstruation and then achieved an intrauterine pregnancy. The laparoscopic method of refertilization saves expensive hospitalization costs. PMID:8259759

Istre, O; Olsboe, F; Trolle, B

1993-11-01

279

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

280

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; ?anl?kan, Fatih

2015-02-01

281

The critical view of safety in laparoscopic cholecystectomy is optimized by exposing the inner layer of the subserosal layer  

Microsoft Academic Search

During laparoscopic cholecystectomy (LC), misidentification of the cystic duct, which causes major bile duct injuries, can\\u000a result from wrong or incomplete dissection of Calot’s triangle. Therefore, the critical view of safety has been accepted as\\u000a a safe method for gaining a sufficient view of Calot’s triangle before transecting the cystic duct. However, even in cases\\u000a without aberrant anatomy of the

Goro Honda; Tomohiro Iwanaga; Masanao Kurata; Fumiaki Watanabe; Hiroki Satoh; Ken-ichi Iwasaki

2009-01-01

282

Laparoscopic inguinal herniorrhaphy. Results of a multicenter trial.  

PubMed Central

OBJECTIVE: The purpose of this study was to determine if laparoscopic inguinal herniorrhaphy represents a viable alternative to the conventional repair and to assess whether a prospective randomized controlled trial comparing both procedures is warranted. METHODS: Three types of laparoscopic inguinal herniorrhaphies (transabdominal preperitoneal [TAPP], intraperitoneal onlay mesh [IPOM], and totally extraperitoneal [EXTRA]) were studied in a phase II design. Twenty-one investigators from 19 institutions participated. Approval from the local human research committee was required at each institution before patients could be enrolled. RESULTS: There were 686 patients with 869 hernias; 366 (42.1%) were direct, 414 (47.6%) were indirect, 22 (2.5%) were femoral, and 67 (7.7%) were combination hernias. The TAPP procedure was used for 562 hernias, the IPOM was used for 217 hernias, and the EXTRA was used for 87 hernias. Sixty-one patients had additional abdominal procedures performed at the time of laparoscopy without any adverse affects on their herniorrhaphies. The overall recurrence rate was 4.5%, with a minimum follow-up of 15 months. Complications were divided into the following three groups: 1) those related to laparoscopy, 2) those related to the patient, and 3) those related to the herniorrhaphy. Complications related to the laparoscopy occurred in 5.4% of patients; bleeding or abdominal wall hematomas occurred 31 times, (two patients required transfusion); one patient had bowel perforation, which was sutured laparoscopically; a bladder injury required laparotomy for management. Patient complications occurred in 6.7%. The majority involved the urinary tract (5.8%). Two patients required secondary abdominal procedures for adhesions, one for pain in the right lower quadrant and the other for adhesive small bowel obstruction. Postoperative myocardial infarction on day 5 resulted in the only operative mortality, for a rate of 0.1%. Complications related to the herniorrhaphy itself occurred in 17.1%. Most of these were minor, consisting of transient groin pain (3.5%), seroma (3.5%), transient leg pain (3.3%), hematoma (1.5%), or transient cord or testicular problems (0.9%). The incidence of leg pain decreased dramatically as surgeons became more familiar with the anatomy of the nerve supply to the groin when viewed laparoscopically. Ninety-three percent of patients were discharged within 24 hours of their operations. CONCLUSIONS: Laparoscopic inguinal herniorrhaphy is an effective method to correct an inguinal hernia. It can be offered safely to patients undergoing other abdominal procedures. The TAPP, IPOM, and EXTRA procedures appear to be equally effective. A controlled randomized trial is needed to compare this procedure with conventional inguinal herniorrhaphy. PMID:7826159

Fitzgibbons, R J; Camps, J; Cornet, D A; Nguyen, N X; Litke, B S; Annibali, R; Salerno, G M

1995-01-01

283

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

PubMed

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

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

2013-04-01

284

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.

285

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. 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.

286

[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

287

The Drosophila anatomy ontology  

PubMed Central

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

2013-01-01

288

Comparison of a flexible-tip laparoscope with a rigid straight laparoscope for single-incision laparoscopic cholecystectomy.  

PubMed

This study assessed whether a flexible-tip laparoscope improves operative outcomes including operative length while performing single-incision laparoscopic cholecystectomy (SILC) compared with the use of a conventional straight laparoscope. The flexible-tip laparoscope decreased the operative time compared with the straight laparoscope. Although SILC has potential benefits, surgeons experience problems for in-line viewing through a laparoscope and from contact of instruments with the laparoscope, resulting in longer operative times and the need for additional ports. The aim of this study was to determine whether a flexible-tip laparoscope improves operative outcomes, including operative length and the rate of insertion of additional ports, while performing SILC compared with the use of a conventional rigid straight laparoscope. We reviewed data on patients for whom we performed SILC at the Department of Surgery, Kansai Medical University, for the period from November 1, 2009, to February 28, 2013. The information was assessed with respect to patient characteristics, types of laparoscope used, operative data as well as postoperative outcomes. Operating time for SILC using the flexible-tip laparoscope was significantly shorter than with the straight laparoscope (81.5 ± 23.2 vs 94.4 ± 21.1 minutes) as a result of a better view of the operating field without contact with working instruments. Although a trend was shown toward a reduced rate of the need for extra ports in the flexible-tip laparoscope group, the difference did not reach statistical significance. Using the flexible-tip laparoscope solved the problem of in-line viewing and decreased the operative time for SILC. PMID:25513924

Matsui, Yoichi; Ryota, Hironori; Sakaguchi, Tatsuma; Nakatani, Kazuyoshi; Matsushima, Hideyuki; Yamaki, So; Hirooka, Satoshi; Yamamoto, Tomohisa; Kwon, A-Hon

2014-12-01

289

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.

290

Gene expression profile in pelvic organ prolapse  

Microsoft Academic Search

It was hypothesized that the processes contributing to pelvic organ prolapse (POP) may be identified by transcriptional pro- filing of pelvic connective tissue in conjunction with light microscopy. In order to test this, we performed a frequency-matched case -control study of women undergoing hysterectomy for POP and controls. Total RNA, extracted from uterosacral and round ligament samples used to generate

S. S. Brizzolara; J. Killeen; J. Urschitz

2009-01-01

291

[Gestrinone in pelvic endometriosis. A one-year evaluation].  

PubMed

The therapeutical effectiveness of gestrinone in endometriosis treatment, as well as its long term side effects, were evaluated. Prospective, clinical trial. At "Dr. Alejandro Castanedo Kimball" Hospital (PEMEX). Salamanca, Guanajuato. México. Thirty women with laparoscopically confirmed endometriosis, were studied. Subjects received 2.5 mg. of gestrinone two times per week for 6 months. Laparoscopy was performed before treatment, and clinical response was determined by second laparoscopy after 6 months. The pregnancy rate, frequency of side effects and recurrence of symptoms were determined. Median total endometriosis scores and symptoms decreased significantly after treatment. Four pregnancies were observed after treatment. The principal side effects were: ponderal increase, changes in the voice and hirsutism. However, the side effects disappeared after one year of clinical survey. The results indicate that gestrinone is effective in the treatment of pelvic endometriosis. In despite of a clear benefic effect on stage of the disease and symptoms; the use of gestrinone should weigh the risk-benefit (cost versus metabolic side effects) of treatment. PMID:7672647

Cervantes Villarreal, E; García Zamarripa, H R; Herrera Prado, E; Barrón Vallejo, J

1995-08-01

292

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

PubMed Central

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

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

2014-01-01

293

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

294

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

NASA Astrophysics Data System (ADS)

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

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

1998-06-01

295

Intracorporeal Anastomosis in Laparoscopic Gastric Cancer Surgery  

PubMed Central

Laparoscopic gastrectomy has become widely used as a minimally invasive technique for the treatment of gastric cancer. When it was first introduced, most surgeons preferred a laparoscopic-assisted approach with a minilaparotomy rather than a totally laparoscopic procedure because of the technical challenges of achieving an intracorporeal anastomosis. Recently, with improved skills and instruments, several surgeons have reported the safety and feasibility of a totally laparoscopic gastrectomy with intracorporeal anastomosis. This review describes the recent technical advances in intracorporeal anastomoses using circular and linear staplers that allow for totally laparoscopic distal, total, and proximal gastrectomies. Data that demonstrate advantages in early surgical outcomes of a total laparoscopic method compared to laparoscopic-assisted operations are also discussed. PMID:23094224

Hosogi, Hisahiro

2012-01-01

296

Pelvic floor muscle rehabilitation using biofeedback.  

PubMed

Pelvic floor muscle exercises have been recommended for urinary incontinence since first described by obstetrician gynecologist Dr. Arnold Kegel more than six decades ago. These exercises are performed to strengthen pelvic floor muscles, provide urethral support to prevent urine leakage, and suppress urgency. In clinical urology practice, expert clinicians also teach patients how to relax the muscle to improve bladder emptying and relieve pelvic pain caused by muscle spasm. When treating lower urinary tract symptoms, an exercise training program combined with biofeedback therapy has been recommended as first-line treatment. This article provides clinical application of pelvic floor muscle rehabilitation using biofeedback as a technique to enhance pelvic floor muscle training. PMID:25233622

Newman, Diane K

2014-01-01

297

Male pelvic floor: history and update.  

PubMed

Our understanding of the male pelvic floor has evolved over more than 2,000 years. Gradually medical science has sought to dispel ancient myths and untruths. The male pelvic floor has many diverse functions. Importantly, it helps to support the abdominal contents, maintains urinary and fecal continence, and plays a major role in gaining and maintaining penile erection. Weakness of the male pelvic floor muscles may cause urinary and fecal incontinence and erectile dysfunction. Function may be restored in each of these areas by a comprehensive pelvic floor muscle training program. Spasm of the pelvic floor muscles may produce pain and require relaxation techniques. Additional research is needed to add further evidence to our knowledge base. PMID:16225345

Dorey, Grace

2005-08-01

298

Laparoscopic ventral and incisional hernioplasty  

Microsoft Academic Search

.  \\u000a \\u000a Background: While the first laparoscopic ventral hernia repair was reported in 1992, there have been no studies comparing laparoscopic\\u000a to conventional ventral herniorrhaphy.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Methods: Twenty-one ventral hernias repaired laparoscopically are compared to a similar group of 16 patients undergoing traditional\\u000a open repair during a 2-year period. Operative and hospital courses along with outcomes and cost analysis are analyzed.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a Results:

M. D. Holzman; C. M. Purut; K. Reintgen; S. Eubanks; T. N. Pappas

1997-01-01

299

Three-dimensional imaging laparoscope  

NASA Astrophysics Data System (ADS)

A laparoscope that generates three-dimensional images in real time by the VISIDEPtm technique of alternating frames has been tested. Images from two separate viewpoints are combined through special folded optics and brought out along a single light path where they are viewed with a single eye or with a single video camera. Liquid-crystal shutters are used to alternately switch between the two stereoscopically related views at a rate of 10 Hz in accordance with the VISIDEPtm teachings. The resulting three-dimensional image is autostereoscopic and may be viewed on any standard television monitor. Although the instrument provides for two separate viewpoints, it is built to the same external dimensions as conventional monocular laparoscopes with an outside diameter of 11 mm. This laparoscope can be adapted to field-sequential stereo for presentation of separate images to separate eyes with the aid of electro-optic glasses.

Jones, Edwin R., Jr.; McLaurin, A. P.; Mason, J. L., Jr.

1991-08-01

300

Anatomic Fundoplication Failure After Laparoscopic Antireflux Surgery  

PubMed Central

Objective Anatomic fundoplication failure occurs after antireflux surgery and may be more common in the learning curve of laparoscopic antireflux surgery (LARS). The authors’ aims were to assess the incidence, presentation, precipitating factors, and management of anatomic fundoplication failures after LARS. Summary Background Data The advent of LARS has increased the frequency with which antireflux surgery is performed for the treatment of gastroesophageal reflux disease. Postoperative symptoms frequently occur and may result from physiologic abnormalities or anatomic failure of the fundoplication (e.g., displacement or disruption). Few data exist on the potential causes or best treatment of anatomic fundoplication failures. Method LARS was performed in 290 patients by one of the authors over a 6-year period. In the first 53 patients (group 1), the short gastric vessels were divided on a selective basis and the diaphragmatic crura were closed only when large hiatal hernias were present. In the subsequent 237 patients (group 2), the crura were always approximated posterior to the short gastric vessels and full fundic mobilization was performed. Clinical postoperative evaluation was performed on a regular basis, with detailed tests of anatomy and physiology when untoward symptoms developed. Postoperative foregut symptoms were reported by 26% of the patients, of whom 73% were found to have an intact fundoplication. In 7% of the entire group, anatomic failure of the fundoplication was demonstrated, with the majority exhibiting intrathoracic migration of the wrap with or without disruption of the fundoplication. New-onset postoperative epigastric or substernal chest pain frequently heralded fundoplication failure. Factors correlated with the development of anatomic fundoplication failure included presence in group 1, early postoperative vomiting, other diaphragm “stressors,” and large hiatal hernias. Repeat operation has been performed in 8 of the 20 patients (40%), with 5 patients successfully treated using laparoscopic techniques. Conclusions Anatomic fundoplication failure occurred in 7% of patients undergoing LARS, with the majority occurring in patients who underwent surgery during the learning curve. Anatomic failure is associated with technical shortcomings, large hiatal hernias, and early postoperative vomiting. Full esophageal mobilization and meticulous closure of the diaphragmatic crura posterior to the esophagus should minimize anatomic functional failure after LARS. PMID:10235525

Soper, Nathaniel J.; Dunnegan, Deanna

1999-01-01

301

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

302

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

303

Anatomy of the Honeybee  

ERIC Educational Resources Information Center

In this insect morphology exercise, students study the external anatomy of the worker honeybee. The structures listed and illustrated are discussed in relation to their functions. A goal of the exercise is to establish the bee as a well-adapted, social insect. (MA)

Postiglione, Ralph

1977-01-01

304

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

305

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.

306

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

307

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

308

Student learning of anatomy  

Microsoft Academic Search

Relationships between student approaches to learning and learning outcomes were explored in a population of fi rst year students studying anatomy in a medical program off ered by a research intensive Australian university. An online survey version of the Study Process Questionnaire (Biggs et al, 2001), examination scripts and student results were the source data for this study. Th ese

Priti Pandey; Craig Zimitat

2005-01-01

309

Anatomy of the Heart  

MedlinePLUS

... Share this page from the NHLBI on Twitter. Anatomy of the Heart Your heart is located under your ribcage in the center of your chest between your right and left lungs. Its muscular walls beat, or contract, pumping blood to all parts ...

310

Hemostasis in laparoscopic renal surgery  

PubMed Central

Hemorrhage is a potential risk at any step of laparoscopic nephrectomies (LNs). The advances in surgical equipment and tissue sealants have increased the safety and efficiency of performing LN and laparoscopic partial nephrectomy (LPN). However, hemostasis remains a major issue and there is still scope for further development to improve haemostatic techniques and devices. In this article a literature review of the current methods and techniques of hemostasis was carried out using the MEDLINE ®/PubMed® resources. The results of the review were categorized according to the three main operative steps: Dissection, control of renal pedicle and excision of the renal lesion. PMID:22557709

Hassouna, Hussam A.; Manikandan, Ramaswamy

2012-01-01

311

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

312

Laparoscopic management of gallbladder duplication.  

PubMed

Gallbladder duplication is a rare condition. Because laparoscopic cholecystectomy is the primary treatment modality for the diseased single gallbladders, it should be the choice of treatment for double gallbladders. However, preoperative imaging methods may be unsatisfactory for the correct diagnosis. As a result, incomplete resections may be performed. Intraoperative cholangiography should be performed in suspected cases to prevent inadvertent injury to the biliary system. In this report, we present a symptomatic patient with double gallbladders with separate cystic ducts in whom the gallbladders were successfully resected as a single specimen by laparoscopic means. The pitfalls of diagnostic modalities and surgical strategy are discussed in the context of the available literature. PMID:18050826

Nursal, Tarik Zafer; Ulusan, Serife; Tercan, Fahri; Yildirim, Sedat; Tarim, Akin; Noyan, Turgut; Bilgin, Nevzat

2007-01-01

313

Laparoscopic colectomy in an adult with single ventricle physiology: Anesthetic implications and management.  

PubMed

Increasing numbers of adult patients with complex congenital heart conditions are presenting for noncardiac surgery later in life. These disorders can present challenges for surgical and anesthesia providers. Specifically, single ventricle lesions offer anatomic and physiologic concerns during the perioperative period. Single ventricle physiology represents a delicate balance between systemic and pulmonary blood flow. Any alterations in blood flow through these systems can produce undesirable hemodynamic changes, especially during the perioperative period. We present a case of an adult patient with a single left ventricle who presented for laparoscopic total colectomy due to inflammatory bowel disease. His abnormal anatomy coupled with the hemodynamic disruptions caused by laparoscopy presented significant anesthetic challenges. We highlight the anesthetic concerns of single ventricle physiology, specifically pertaining to laparoscopic surgery. We provide recommendations for safely managing these patients perioperatively. With detailed preoperative evaluation and close hemodynamic monitoring during the perioperative period, these patients can experience successful surgical and anesthetic outcomes. PMID:25849703

Zach, Kelly J; Ramakrishna, Harish; Chandrasekaran, Krishnashwamy; Weis, Ricardo A

2015-01-01

314

21 CFR 884.1720 - Gynecologic laparoscope and accessories.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 false Gynecologic laparoscope and accessories. 884.1720 ...Devices § 884.1720 Gynecologic laparoscope and accessories. (a) Identification. A gynecologic laparoscope is a device used to...

2012-04-01

315

TRAININGANATOMY RECOGNITION THROUGH REPETITIVE VIEWING OF LAPAROSCOPIC SURGERYVIDEO CLIPS  

E-print Network

TRAININGANATOMY RECOGNITION THROUGH REPETITIVE VIEWING OF LAPAROSCOPIC SURGERYVIDEO CLIPS Stephanie of procedural steps using edited laparoscopic surgeryvideos to enforce absorption,expose the learnerto varied recognitionduring minimallyinvasive (laparoscopic)surgery. Currently,novice surgeonslearn these skills primarily

Virginia, University of

316

21 CFR 884.1720 - Gynecologic laparoscope and accessories.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 false Gynecologic laparoscope and accessories. 884.1720 ...Devices § 884.1720 Gynecologic laparoscope and accessories. (a) Identification. A gynecologic laparoscope is a device used to...

2014-04-01

317

Methods of training using pelvic trainers.  

PubMed

During the past decade, the clinical applications of laparoscopic surgery in urology have been growing steadily. The laparoscopic version of various procedures, such as nephrectomy, is becoming the standard of care. This has led to an increased need for laparoscopic training in urology and focused the attention on the various modalities for laparoscopic skill acquisition. The common training modalities for laparoscopy are box trainers, animal and cadaveric laparoscopy, and virtual reality simulators. Each modality carries its own benefits to the practicing surgeon. The box trainers are the first practiced and are basic training simulators. They were first designed to help with training in basic laparoscopic skills and to assist surgeons in getting acquainted with instruments. However, these simple boxes are being upgraded constantly by tissue- and organ-specific models, allowing the surgeon to train in a convenient and cost-effective environment. This article describes the ways to work with box trainers, from basic skills to advanced laparoscopic tasks, and discusses the contribution of these trainers to real surgery as well as their role in defining criterion levels of surgical performance. PMID:16526993

Katz, Ran

2006-03-01

318

Laparoscopic treatment of endometriosis.  

PubMed

Endometriosis can be considered as a chronic disease which is characterized by the presence of ectopic endometrium outside the endometrial cavity and which is associated with symptoms as pelvic pain and infertility. Medical treatment is often not sufficient in patients with moderate to severe endometriosis and deep infiltrative endometriosis (DIE), therefore requiring surgical intervention. Over the past 15 years, we have built a multidisciplinary surgical team to perform a radical but fertility preserving resection of extensive endometriosis with involvement of surrounding organ systems, realizing a good clinical outcome with low complication and recurrence rate, a very good improvement of QOL and a high pregnancy rate. However, for future research evaluating surgical treatment of extensive endometriosis, it is important to reach agreement on study design and on reporting clinical outcome data. A multicenter study with clear patient identification and well defined outcome parameters needs to be set up. Moreover, prevention of DIE with colorectal extension is important, ideally by early identification and management of girls and women at risk. Years of pain and disability as well as a lot of money could be saved when patients, at risk of developing extensive forms of endometriosis could be diagnosed during adolescence. PMID:23598780

Meuleman, C; Tomassetti, C; Gaspar Da Vitoria Magro, M; Van Cleynenbreugel, B; D'Hoore, A; D'Hooghe, T

2013-04-01

319

Influence of Bladder Volume on Pelvic Organ Prolapse Quantification Results  

Microsoft Academic Search

Aims: To compare the degree of pelvic organ prolapse between examinations performed with full and empty bladder in patients without any prolapse and with pelvic organ prolapse stage I or II using the pelvic organ prolapse quantification (POPQ) system. Methods: A prospective observational study with 120 consecutive patients with and without symptoms of pelvic organ prolapse was evaluated. All women

Andreas Reich; Frauke Kohorst; Rolf Kreienberg; Felix Flock

2010-01-01

320

Endometriosis and Chronic Pelvic Pain  

PubMed Central

Nurses often encounter patients with chronic pelvic pain associated with endometriosis, which is a puzzling and problematic gynecologic condition that has continued to plague women and baffle doctors and researchers worldwide since it was first identified by Dr. J. Sampson in the 1920s (Sampson, 1940). Endometriosis is defined as the growth, adhesion and progression of endometrial glands and stroma outside of the uterine cavity, with cellular activity evident in lesions, nodules, cysts or endometriomas (Audebert et al., 1992). Although it typically appears benign on histopathology, endometriosis has been likened to a malignant tumor since the lesions grow, infiltrate and adhere to adjacent tissues and interfere with physiologic processes (Kitawaki et al., 2002; Noble, Simpson, Johns, & Bulun, 1996). Ectopic endometriotic growths respond to cyclic changes of estrogen and proliferate and shed in a manner similar to eutopic endometrium. This cyclic ectopic activity results in internal bleeding, formation of scar tissue, inflammation and sometimes debilitating chronic pain (Kitawaki et al.). PMID:18837717

Bloski, Terri; Pierson, Roger

2010-01-01

321

Laparoscopic arcuate line hernia repair.  

PubMed

Arcuate line hernia is considered a surgical rarity. This type of hernia is characterized by protrusion of intraperitoneal structures in a concave parietal fold in the abdominal wall. In this report, we aim to describe the diagnostic images of 2 cases of arcuate line hernia. Laparoscopic repair using a polypropylene mesh with a preattached inflatable balloon has been illustrated as well. PMID:24710227

Messaoudi, Nouredin; Amajoud, Zainab; Mahieu, Geert; Bestman, Raymond; Pauli, Steven; Van Cleemput, Marc

2014-06-01

322

Day-case laparoscopic cholecystectomy  

PubMed Central

Objectives: To assess the safety and feasibility of laparoscopic cholecystectomy as a day-case procedure. Methods: All consecutive patients who were admitted to the day-surgery unit for laparoscopic cholecystectomy at the Department of Surgery, King Saud Medical City, Riyadh, Saudi Arabia from July 2009 to June 2013 were considered for this retrospective study. The medical records were reviewed for age, gender, presenting symptoms, laboratory findings, imaging studies, American Society of Anesthesiology (ASA) grade, anesthesia, conversion to open cholecystectomy, complications, the operating surgeons, pain management, nausea, and vomiting, overnight stay, readmission, morbidity, mortality, and outpatient follow up were collected and analyzed. Results: A total of 487 patients underwent laparoscopic cholecystectomy as a day case (ASA I=316, ASA II=171). Surgery was performed by high surgical trainees (HSTs) (n=417) and consultants (n=70) with conversion to open cholecystectomy in 4 patients. Twenty-two (5%) patients were admitted for overnight stay for different reasons, while 465 (95%) patients were discharged before 8 pm. Two patients (0.4 %) were re-admitted to the hospital due to abdominal pain. Five patients developed umbilical port site infection (1%). A total of 443 patients were satisfied (97%), while 14 (3%) were unsatisfied. There was no mortality or intra-abdominal septic collection. Conclusion: Day-case laparoscopic cholecystectomy is safe and feasible with optimal patient selection, education, and planned postoperative antiemetic and analgesia management. PMID:25630004

Al-Qahtani, Hamad H.; Alam, Mohammed K.; Asalamah, Saleh; Akeely, Mohammed; Ibrar, Mouhammed

2015-01-01

323

Spleen removal - laparoscopic - adults - discharge  

MedlinePLUS

Your spleen was removed after you were given general anesthesia (asleep and pain-free). The surgeon made 3 to ... Recovering from laparoscopic spleen removal usually takes about 1 to 3 weeks. You may have some of these symptoms as you recover: Pain ...

324

Laparoscopic colectomy: A critical appraisal  

Microsoft Academic Search

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

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

1993-01-01

325

Laparoscopic management of appendicular mass  

PubMed Central

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

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

2011-01-01

326

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

327

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

328

Human ocular anatomy.  

PubMed

We review the normal anatomy of the human globe, eyelids, and lacrimal system. This contribution explores both the form and function of numerous anatomic features of the human ocular system, which are vital to a comprehensive understanding of the pathophysiology of many oculocutaneous diseases. The review concludes with a reference glossary of selective ophthalmologic terms that are relevant to a thorough understanding of many oculocutaneous disease processes. PMID:25704934

Kels, Barry D; Grzybowski, Andrzej; Grant-Kels, Jane M

2015-01-01

329

A case of an omphalomesenteric duct remnant in an adult treated with laparoscopic surgery  

PubMed Central

Introduction The presence of an omphalomesenteric duct (OMD) remnant is a rare condition that typically affects the pediatric population. This report describes an extremely rare case of an OMD remnant that was diagnosed and resected by laparoscopic surgery in an adult. Presentation of case A 52-year-old man underwent a medical examination at our hospital for right lower quadrant pain. Laboratory findings showed slight leukocytosis and an elevated C-reactive protein level. A luminal structure connected to the umbilicus was detected in the right pelvic wall by abdominal computed tomography, and an OMD remnant was suspected. Laparoscopic surgery was performed by inserting three trocars into the left side of the abdomen; no trocars were inserted near the umbilicus. This procedure provided both a good field of view around the umbilicus and adequate working space. We definitively diagnosed the structure as an OMD remnant and resected it with minimal invasion. The patient was discharged on postoperative day 7 without complications. Pathologic analysis found the lumen is covered by ileum-like mucosa, and a microabscess is formed in the surrounding fat tissue. Discussion OMD remnants are uncommon, and their diagnosis is difficult. Most reports advocate for prompt surgical resection in symptomatic patients. Conclusion In the present case, definitive diagnosis and treatment were accomplished with minimally invasive laparoscopic surgery. PMID:25680534

Morita, Keisuke; Haga, Yoshio; Miyanari, Nobutomo; Sawayama, Hiroshi; Matsumoto, Katsutaka; Mizumoto, Takao; Kubota, Tatsuo; Baba, Hideo

2015-01-01

330

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

331

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

332

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

333

Expanding Laparoscopic Cholecystectomy to Rural Mongolia  

Microsoft Academic Search

Background  Although laparoscopic cholecystectomy was first introduced in Mongolia in 1994, the benefits of the laparoscopic approach\\u000a have been largely unavailable to the majority of the population. The burden of gallbladder disease in Mongolia is significant.\\u000a Despite the barriers to expanding laparoscopic surgery in Mongolia (lack of physical resources and adequate training opportunities,\\u000a a difficult political situation, and an austere environment),

Catherine M. Straub; Raymond R. Price; Douglas Matthews; Diana L. Handrahan; Davaatseren Sergelen

2011-01-01

334

How Are Pelvic Floor Disorders Diagnosed?  

MedlinePLUS

... control problems who would most likely benefit from surgery. 1 Kuncharapu, I., Majeroni, B. A., & Johnson, D. W. (2010). Pelvic organ prolapse. American Family Physician, 81 , 1111-1117. [top] American ...

335

Pelvic Surgical Site Infections in Gynecologic Surgery  

PubMed Central

The development of surgical site infection (SSI) remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery. PMID:25788822

Lachiewicz, Mark P.; Moulton, Laura J.; Jaiyeoba, Oluwatosin

2015-01-01

336

Pelvic surgical site infections in gynecologic surgery.  

PubMed

The development of surgical site infection (SSI) remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery. PMID:25788822

Lachiewicz, Mark P; Moulton, Laura J; Jaiyeoba, Oluwatosin

2015-01-01

337

How Are Pelvic Floor Disorders Commonly Treated?  

MedlinePLUS

... Mechanisms Active Funding Opportunity Announcements, notices & mechanisms Small Business Programs Grant Programs for Small Businesses Peer Review ... pelvic floor problems is a topic of intense research. Researchers are also comparing ... to see what works best. Combination Treatment "Combination" ...

338

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

PubMed Central

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

Dumont, Karl-Andreas; Wexels, Jan Cyril

2013-01-01

339

Laparoscopic management of gastric gastrointestinal stromal tumors  

PubMed Central

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

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

2014-01-01

340

Robotic-assisted pelvic organ prolapse surgery  

Microsoft Academic Search

Background: This study describes technical aspect and short-term results of pelvic organ prolapse surgery using the da Vinci robotic system. Methods: During a 1-year period, 18 consecutive patients with pelvic organ prolapse were operated on using the da-Vinci system. Clinical data were prospectively collected and analyzed. Results: All but one procedure was successfully completed robotically (95%). Performed procedures were colpohysteropexy

A. Ayav; L. Bresler; J. Hubert; L. Brunaud; P. Boissel

2005-01-01

341

Primary Pelvic Hydatid Cyst: A Case Report  

PubMed Central

This is a case report of a young man who presented to us as a case of hypogastric pain and frequency of micturation. General physical examination and radiological evaluation confirmed a multiloculated pelvic swelling. Patient was subjected to laparotomy which confirmed the diagnosis of a primary pelvic hydatid disease. Patient was put on chemotherapy after surgery and is doing well on follow up. PMID:22606594

Parray, Fazl Q.; Wani, Shadab Nabi; Bazaz, Sajid; Khan, Shakeel-ur Rehman; Malik, Nighat Shaffi

2011-01-01

342

Pelvic Pain Associated with a Coloproctologic Etiology  

Microsoft Academic Search

\\u000a Pelvic pain is the most common form of pain experienced by people and one of the most frequent reasons inducing patients to\\u000a seek medical attention. Many conditions are related to anorectal pain: inflammatory disease; functional disease; pelvic tumors;\\u000a post operative complications. In inflammatory bowel disease (IBD) patients experience visceral pain secondary to hyperalgesia\\u000a and allodynia. Hyperalgesia is a peculiarity of

Aldo Infantino; Andrea Lauretta

343

Human Anatomy On-line  

NSDL National Science Digital Library

The Informative Graphics Corporation offers an excellent educational aid/tutorial. Human Anatomy On-line presents an interactive environment for the end user through the use of Java applets, over one hundred images, and animations. What makes this site so interesting is its use of descriptive links which provide names, information, and in some cases a link to an image providing a closer view. Human Anatomy On-line offers both the Interactive Anatomy version for exploration on your own and the Anatomy Lesson for a guided tour. IGC specializes in the development of commercial viewing software, however this site is free to all.

Davis, Marty.

344

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

345

Laparoscopic Management of Adnexal Masses  

PubMed Central

Background and Objective: Although laparoscopic surgery for removal of adnexal masses is common, controversy exists about the safety and efficacy of this procedure for patients with malignancies. The aim of this study was to evaluate the effectiveness and safety of laparoscopic surgical treatment for patients with adnexal masses. Methods: This was a retrospective chart review of one surgeon's experience in managing patients diagnosed with adnexal masses at 2 urban referral teaching hospitals in New York City. We reviewed the charts for 100 consecutive patients who underwent operative laparoscopy for management of adnexal masses between March 4, 1996 and November 9, 1998. Conversion to laparotomy, malignancy rate, complications, length of stay, and blood loss were recorded for each patient. Results: Laparoscopic management was successfully completed for 81 of the 100 patients in this study; however, 19 required conversion to laparotomy. All 81 patients managed laparoscopically had a benign diagnosis, whereas 7 of the 19 patients who underwent laparotomy were diagnosed with malignancy. The median length of stay, estimated blood loss, and operating room time were significantly lower for those treated by laparoscopy alone compared with those converted to laparotomy (2 vs. 7 days; 100 vs. 500 ccs; 130 vs. 235 minutes, respectively; P < 0.05). Though few patients were in the laparotomy group, that data are presented for completeness. A total of 10 complications occurred, 4 in the group of patients managed laparoscopically (2 enterotomies, 1 pneumothorax, and 1 vaginal cuff cellulitis). Six complications occurred in those managed with laparotomy (2 enterotomies, 2 wound infections, 1 pneumonia, and 1 postoperative fever). The indications for conversion to laparotomy were: 7 malignancies (5 ovarian cancers and 2 uterine cancers), 7 dense adhesions, 2 small bowel enterotomies, 1 intraoperative bleeding, 1 secondary to a large uterus (880 grams), and 1 secondary to a large myoma (13 cm x 14.5 cm x 6 cm). Conclusions: The laparoscopic approach is effective and safe for managing patients with adnexal masses of unknown pathology. Malignancies can be diagnosed accurately, converted to laparotomy, and staged appropriately. Adequate surgical skills along with timely use of frozen sections are required for successful operative management. PMID:11394427

Emeney, Pamela L.; Byrne, Daniel W.

2001-01-01

346

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

347

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.

348

Laparoscopic Vertical Banded Gastroplasty and Laparoscopic Gastric Bypass: a Comparison  

Microsoft Academic Search

Background: Vertical banded gastroplasty (VBG) and gastric bypass (GBP) are the two bariatric procedures recommended by NIH\\u000a consensus conference. Recent advancement in laparoscopic (L) techniques has made LVBG and LGBP alternatives for the conventional\\u000a open approach. Methods: From December 2000 to February 2002, 80 patients (24 men and 56 women; mean age 32 years, range 18-57)\\u000a with morbid obesity (mean

Wei-Jei Lee; Ming-Te Huang; Po-Jui Yu; Weu Wang; Tai-Chi Chen

2004-01-01

349

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

350

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

PubMed Central

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

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

2013-01-01

351

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

352

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

353

Pelvic Floor Spasms in Children: An Unknown Condition Responding Well to Pelvic Floor Therapy  

Microsoft Academic Search

Objective:During a study period of 4 years, 21 children are seen for night time pelvic pain. These children typical wake up in the middle of the night with severe lower abdominal or perineal pain. During day some of them suffer urge syndrome. During urodynamic investigation extremely high pelvic floor activity as recorded by high urethral pressure was observed in these

Piet Hoebeke; Erik Van Laecke; Catherine Renson; Ann Raes; Joke Dehoorne; Pieter Vermeiren; Johan Vande Walle

2004-01-01

354

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

355

Laparoscopic Liver Resection in the Netherlands: How Far Are We?  

Microsoft Academic Search

Background: The objective of this study was to provide a systematic review on the introduction of laparoscopic liver surgery in the Netherlands, to investigate the initial experience with laparoscopic liver resections and to report on the current status of laparoscopic liver surgery in the Netherlands. Methods: A systematic literature search of laparoscopic liver resections in the Netherlands was conducted using

Jan H. M. B. Stoot; Edgar M. Wong-Lun-Hing; Ione Limantoro; Ruben Visschers; Olivier R. Busch; Richard Van Hillegersberg; Koert M. De Jong; Arjen M. Rijken; Geert Kazemier; Steven W. M. Olde Damink; Toine M. Lodewick; Marc H. A. Bemelmans; Ronald M. van Dam; Cornelis H. C. Dejong

2012-01-01

356

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.

357

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

358

A rapid prototyping model for biomechanical evaluation of pelvic osteotomies.  

PubMed

The biomechanical consequences of Salter pelvic osteotomy are difficult to assess due to the complex three-dimensional anatomy of the pelvis. Therefore, models of the dysplastic pelvis are required to allow realistic biomechanical simulation of possible outcomes. A polyamide reversed-engineering model of the left hemipelvis and proximal femur was produced from a computed tomography dataset of an 8-year-old child with severe dysplasia of both hips using selective laser sintering. Hip joint forces before and after Salter osteotomy of the hip were measured using an experimental setup in which an industrial robot was exerting hip joint forces and moments representing one-legged stance. Hip extensor and abductor actuator forces were measured which counterbalanced the joint moments. The preoperative hip joint resultant force was 583 N (270% body weight), while after the operation a mean force of 266 N (120% body weight) was measured. The resulting bony model was geometrically accurate, while apparent joint incongruencies were due to the neglected cartilaginous structures in the model. The preoperative joint resultant force was within the limits reported in the literature. The results suggest that Salter innominate osteotomy not only increases joint contact area but also reduces the hip joint force. PMID:18979622

Pressel, Thomas; Max, Stefan; Pfeifer, Roman; Ostermeier, Sven; Windhagen, Henning; Hurschler, Christof

2008-04-01

359

Lymph node dissection during laparoscopic (LRC) and open (ORC) radical cystectomy due to muscle invasive bladder urothelial cancer (pT2-3, TCC)  

PubMed Central

Aim The aim of the study was to compare the number of nodes dissected during laparoscopic and open radical cystoprostatectomy in men or anterior exenteration in women due to muscle invasive bladder urothelial cancer (IBC). Material and methods Fifty-one patients treated with laparoscopic radical cystectomy (LRC) and 63 with open radical cystectomy (ORC) were compared. The LRC group consisted of 47 pT2 tumours and 4 pT3, while the ORC group was composed of 27 pT2 tumours and 36 pT3. During ORC external, internal, common iliac and obturator lymph nodes were removed separately, but were added and analysed together for each side. Nodes dissected from one side during ORC were compared to en bloc dissected nodes in the LRC group. Results There were no complications associated with extended pelvic lymph node dissection during LRC or ORC. There were significant differences in the mean number of resected lymph nodes between LRC and ORC for pT2 tumours. The laparoscopic approach allowed about 8-9 more lymph nodes to be removed than open surgery in the pT2 group. In 15% of patients with pT2 disease treated with open radical cystectomy node metastases were observed. Active disease was detected in 18% of nodes resected laparoscopically due to pT2 disease. Fourty-seven percentage of patients with pT3 disease treated with open surgery were diagnosed as harbouring metastatic lymph nodes. The laparoscopic group with pT3 disease was too small to analyse. Conclusions We have found that laparoscopic radical cystectomy can be performed without any compromise in lymph node dissection. The technique of lymph node dissection (LND) during laparoscopic cystectomy (LRC) resulted in sufficient resected lymphatic tissue, especially in patients with bladder-confined tumours with a low volume of lymph nodes. PMID:23255970

Chlosta, Piotr; Siekiera, Jerzy; Jaskulski, Jaros?aw; Petrus, Andrzej; Kamecki, Krzysztof; Miko?ajczak, Witold; Obarzanowski, Mateusz; Wronczewski, Andrzej; Krasnicki, Krzysztof; Jasinski, Milosz

2011-01-01

360

Chronic prostatitis/chronic pelvic pain syndrome and pelvic floor spasm: can we diagnose and treat?  

PubMed

National Institutes of Health category III prostatitis, also known as chronic prostatitis/chronic pelvic pain syndrome, is a common condition with significant impact on quality of life. This clinically defined syndrome has a multifactorial etiology and seems to respond best to multimodal therapy. At least half of these patients have pelvic floor spasm. There are several approaches to therapy including biofeedback, acupuncture, and myofascial release physical therapy. However, the only multicenter study of pelvic floor physical therapy for pelvic floor spasm in men failed to show an advantage over conventional Western massage. We have proposed a clinical phenotyping system called UPOINT to classify patients with urologic chronic pelvic pain and subsequently direct appropriate therapy. Here, we review the current approach to category III prostatitis and describe how clinical phenotyping with UPOINT may improve therapy outcomes. PMID:20490725

Westesson, Karin E; Shoskes, Daniel A

2010-07-01

361

[Possibilities of laparoscopic ultrasound diagnosis].  

PubMed

Both pre-operative transvaginal sonography and laparoscopical diagnosis leave gaps in the diagnosis of adnexal tumors. The combination of both methods seems to fill these gaps. For diagnosis with Laparoscopical Sonography a special scan head is needed: After removing the optical components there was a little linear-array installed into the original gastroscope with a diameter of only 9 mm which enables maximum flexibility during examinations. The linear-array consists of 128 crystals with a frequency of 7.5 MHz (penetration depth: 6 cm), enabling B-Image Sonography, Pulsed and Color Doppler as well as Angio-Color-Technique. Laparoscopical Sonography in addition to transvaginal and transabdominal sonography leads to progress in diagnosis and therapy. As the scan head can be placed directly in front of the area which is normally hardly detectable diagnosis is possible and plannings for the further operations as well as color-doppler controls during operations can be improved. In several cases this method allowed detection of metastases of the liver which were not visible by transabdominal ultrasound. PMID:8851098

Sohn, C; Wallwiener, D

1996-01-01

362

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

363

Laparoscopic pancreatectomy: indications and outcomes.  

PubMed

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

2014-10-21

364

Health Instruction Packages: Cardiac Anatomy.  

ERIC Educational Resources Information Center

Text, illustrations, and exercises are utilized in these five learning modules to instruct nurses, students, and other health care professionals in cardiac anatomy and functions and in fundamental electrocardiographic techniques. The first module, "Cardiac Anatomy and Physiology: A Review" by Gwen Phillips, teaches the learner to draw and label…

Phillips, Gwen; And Others

365

Student perceptions about learning anatomy  

Microsoft Academic Search

This research study was conducted to examine student perceptions about learning anatomy and to explore how these perceptions shape the learning experience. This study utilized a mixed-methods design in order to better understand how students approach learning anatomy. Two sets of data were collected at two time periods; one at the beginning and one at the end of the academic

Andrew John Notebaert

2009-01-01

366

Laparoscopic vs open hemicolectomy for colon cancer  

Microsoft Academic Search

Background: The role of laparoscopic resection in the management of colon cancer is still a subject of debate. In this clinical study, we compared the perioperative results and long-term outcome for two unselected groups of patients undergoing either laparoscopic or open hemicolectomy for colon cancer. Methods: This prospective nonrandomized study was based on a series of 248 consecutive patients operated

E. Lezoche; F. Feliciotti; A. M. Paganini; M. Guerrieri; A. De Sanctis; S. Minervini; R. Campagnacci

2002-01-01

367

Preoperative Evaluation of Complex Laparoscopic Patients  

Microsoft Academic Search

Complex laparoscopic patients require careful preoperative planning for optimal outcome. These patients present unique problems that necessitate special consideration and a surgeon experienced in basic laparoscopic cases. This chapter discusses a number of such patient groups, including patients with previous abdominal surgery, significant cardiopulmonary comorbidity, obesity, and pregnancy. When evaluating any of these patients, six questions should be asked: 1.

Dmitry Oleynikov; Karen D. Horvath IV

368

Cicatrical cecal volvulus following laparoscopic cholecystectomy.  

PubMed

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

Morris, Michael W; Barker, Andrea K; Harrison, James M; Anderson, Andrew J; Vanderlan, Wesley B

2013-01-01

369

Comparative Study of Laparoscopic and Open Adrenalectomy  

Microsoft Academic Search

Background: Laparoscopic adrenalectomy (LA) had become the preferred operation for management of adrenal neoplasm. We conducted this cohort study to evalu- ate the outcome of laparoscopic and open adrenalectomy (OA). Methods: A total of 67 patients with complete medical records were included in this study. Thirty patients underwent OA and the other 37 patients received LA. The intraoperative and perioperative

Chun-Te Wu; Yang-Jen Chiang; Chien-Chung Chou; Kuan-Lin Liu; Sheng-Hui Lee; Ying-Hsu Chang; Cheng-Keng Chuang

370

[Laparoscopic sterilization using the tubal ring].  

PubMed

Interval ring laparoscopic sterilization, in line with law, was in the last four years performed in 103 women on the principles applied to other laparoscopic operations. There were ten immediate complications (7 technical and 3 surgical). One patient was subfebrile following surgery and one became pregnant a few months after sterilization. PMID:1836246

Rizner, T; Gregorac, D; Lavric, M

1991-01-01

371

[Laparoscopic partial nephrectomy: technique and outcomes].  

PubMed

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

Colombo, J R; Gill, I S

2006-05-01

372

Cicatrical Cecal Volvulus Following Laparoscopic Cholecystectomy  

PubMed Central

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

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

2013-01-01

373

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

374

Successful Transfer of Open Surgical Skills to a Laparoscopic Environment Using a Robotic Interface: Initial Experience With Laparoscopic Radical Prostatectomy  

Microsoft Academic Search

PurposeFor a skilled laparoscopic surgeon the learning curve for achieving proficiency with laparoscopic radical prostatectomy (LRP) is estimated at 40 to 60 cases. For the laparoscopically naïve surgeon the curve is estimated at 80 to 100 cases. The development of a robotic interface might significantly shorten the LRP learning curve for an experienced open yet naïve laparoscopic surgeon. To our

THOMAS E. AHLERING; DOUGLAS SKARECKY; DAVID LEE; RALPH V. CLAYMAN

2003-01-01

375

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

376

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

377

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

378

Pelvic floor muscle evaluation in incontinent patients.  

PubMed

The aim of this study was to assess pelvic floor muscle (PFM) strength and perception and its correlation with stress urinary incontinence (SUI). One hundred and one women were divided into two groups according to the presence (G1=51 patients) or absence (G2=50 patients) of SUI. Subjective [urine stream interruption test (UST), visual survey of perineal contraction and transvaginal digital palpation to assess pelvic muscle contraction] and objective evaluations of pelvic floor muscles in all patients were performed (vaginal manometry). During the UST, 25.5% of G1 patients and 80% of G2 patients were able to interrupt the urine stream (p<0.05). Digital evaluation of pelvic muscular contraction showed higher strength in G2 than in G1 patients (p<0.0001). Perineometer evaluation of PFM strength was significantly higher in the continent group (p<0.001). Pelvic floor muscle weakness in incontinent patients demonstrates the importance of functional and objective evaluation of this group of muscles. PMID:15645148

Amaro, João Luiz; Moreira, Eliane Cristina Hilberath; De Oliveira Orsi Gameiro, Mônica; Padovani, Carlos Roberto

2005-01-01

379

The Surgical Treatment of Pelvic Bone Metastases  

PubMed Central

Pelvic bone metastases are a growing concern in the field of orthopedic surgery. Patients with pelvic metastasis are individually different with different needs of treatment in order to attain the best possible quality of life despite the advanced stage of disease. A holistic collaboration among the oncologist, radiation therapist, and orthopedic surgeon is mandatory. Special attention has to be directed to osteolytic lesions in the periacetabular region as they can provoke pathological fractures and subsequent functional impairment. Different reconstruction techniques for the pelvis are available; the choice depends on the patient's prognosis, size of the bone defect, and response of the tumor to adjuvant treatment. If all the conservative treatments are exhausted and the patient is not eligible for surgery, one of the various percutaneous ablation procedures can be considered. We propose a pelvic analogue to the treatment algorithm in long bone metastasis and a scoring system in pelvic metastasis. This algorithm aims to simplify the teamwork and to avoid under- or overtreatment of pelvic bone metastases.

Müller, Daniel A.; Capanna, Rodolfo

2015-01-01

380

Pelvic girdle and fin of Tiktaalik roseae  

PubMed Central

A major challenge in understanding the origin of terrestrial vertebrates has been knowledge of the pelvis and hind appendage of their closest fish relatives. The pelvic girdle and appendage of tetrapods is dramatically larger and more robust than that of fish and contains a number of structures that provide greater musculoskeletal support for posture and locomotion. The discovery of pelvic material of the finned elpistostegalian, Tiktaalik roseae, bridges some of these differences. Multiple isolated pelves have been recovered, each of which has been prepared in three dimensions. Likewise, a complete pelvis and partial pelvic fin have been recovered in association with the type specimen. The pelves of Tiktaalik are paired and have broad iliac processes, flat and elongate pubes, and acetabulae that form a deep socket rimmed by a robust lip of bone. The pelvis is greatly enlarged relative to other finned tetrapodomorphs. Despite the enlargement and robusticity of the pelvis of Tiktaalik, it retains primitive features such as the lack of both an attachment for the sacral rib and an ischium. The pelvic fin of Tiktaalik (NUFV 108) is represented by fin rays and three endochondral elements: other elements are not preserved. The mosaic of primitive and derived features in Tiktaalik reveals that the enhancement of the pelvic appendage of tetrapods and, indeed, a trend toward hind limb-based propulsion have antecedents in the fins of their closest relatives. PMID:24449831

Shubin, Neil H.; Daeschler, Edward B.; Jenkins, Farish A.

2014-01-01

381

Laparoscopic vs. laparoscopically assisted management of Meckel’s diverticulum in children  

PubMed Central

To investigate the management of Meckel’s diverticulum in children and the feasibility of using laparoscopic and laparoscopically assisted Meckel’s diverticulum resection and intestinal anastomosis according to the different subtypes classified laparoscopically. 55 symptomatic Meckel’s diverticulum cases were classified into two categories, the simple and the complex types depending on Meckel’s diverticulum appearance upon laparoscopic exploration. Forty-one cases of simple Meckel’s diverticulum were treated with simple diverticulectomy during laparoscopy, and 14 cases of complicated Meckel’s diverticulum were treated with laparoscopically assisted Meckel’s diverticulum resection and intestinal anastomosis. The operation time for the laparoscopically assisted was significant longer than laparoscopic-only surgeries [45~123 min (54.57 ± 20.17min) vs 29~78min (38.85 ± 9.75 min)], P = 0.013. Among the 55 cases, Just one child with simple type MD during laparoscopic exploration, and presented a diverticulum with a base that was considered to be in the mesangial margin. The remaining 54 patients were cured, and follow-up for 4~36 months revealed that they did not present abdominal pain, and no hematochezia occurred as a complication. Surgery selection either laparoscopy only or transumbilical laparoscopically assisted intestinal resection and intestinal anastomosis by laparoscopic exploration for Meckel’s diverticulum treatment, based on the type of Meckel’s diverticulum in children, is safe, feasible, and effective. PMID:25784978

Duan, Xufei; Ye, Guogang; Bian, Hongqiang; Yang, Jun; Zheng, Kai; Liang, Chong; Sun, Xuan; Yan, Xueqiang; Yang, Hu; Wang, Xin; Ma, Jingwei

2015-01-01

382

An ectopic ureter of a duplicated system presenting as a pelvic collection following laparoscopic radical prostatectomy.  

PubMed

Radical prostatectomy remains the gold-standard surgical treatment for clinically localized prostate cancer. Contrast imaging of the upper urinary tract is not part of the routine work-up of the patient before radical prostatectomy. This may lead to rare, albeit serious complications when anatomical anomalies are present. This article reports a case of delayed anastomotic leakage following radical prostatectomy due to an unrecognized duplex system on the left side and inclusion of the ureteric orifice draining the upper moiety in the anastomosis, which caused failure of healing and persistent leakage. PMID:23035770

Minh, Hoangdo; Qazi, Hasan Abdur Rahman; Dietel, Anja; Stolzenburg, Jens-Uwe

2013-08-01

383

Misinterpretation of radioisotope imaging in pelvic kidneys.  

PubMed

We report the case of a gentleman referred with apparent worsening function in a hydronephrotic left-sided pelvic kidney. Imaging with Tc-99m-Mercaptoacetyltriglycine (MAG 3) in 1999, showed that the left kidney contributed 46% of renal function with no evidence of obstruction. Three years later, repeat scanning showed ectopic kidney function had decreased to 20% and with worsening pain, nephrectomy had been suggested. Review of the second MAG 3 scan revealed that only posterior images had been obtained. With pelvic kidneys, the pelvis forms a barrier between the radioactively labelled tracer and the gamma camera, thus, reducing the amount of radiation detected and underestimating function. A subsequent Dimercaptosuccinic acid scan (DMSA) was carried out with posterior and anterior images, the latter showing split renal function was identical to that seen on the initial scan. In patients with pelvic kidneys, anterior views must be obtained during radionuclide scanning if unnecessary nephrectomy is to be avoided. PMID:15875644

Allen, D; Bultitude, M F; Nunan, T; Glass, J M

2005-04-01

384

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

385

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

386

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

387

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

388

Sexual function in women after surgery for pelvic organ prolapse  

Microsoft Academic Search

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

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

2008-01-01

389

Myofascial dysfunction associated with chronic pelvic floor pain: Management strategies  

Microsoft Academic Search

Myofascial pain as a cause of chronic pelvic pain with or without pelvic organ pathology is well-documented in the literature.\\u000a Causes of this pain are multifactorial, including specific pelvic organ pathologies, neuromuscular disorders, and psychologic\\u000a causes. Management of this myofascial component of chronic pelvic pain involves a multidisciplinary approach including physicians,\\u000a physical therapists, neurologists, and psychiatrists. Treatment strategies, including behavioral

Arun K. Srinivasan; Jonathan D. Kaye; Robert Moldwin

2007-01-01

390

Pelvic venous insufficiency: imaging diagnosis, treatment approaches, and therapeutic issues.  

PubMed

OBJECTIVE. The purposes of this article are to review the causes of pelvic congestion syndrome and the imaging used to make the diagnosis and to summarize the treatment options. CONCLUSION. Pelvic congestion syndrome is one of many causes of chronic pelvic pain. It is thought to arise from ovarian and pelvic venous incompetence. Findings from various noninvasive imaging studies, such as Doppler ultrasound and MRI, in association with the clinical symptoms are critical in establishing the diagnosis. PMID:25615769

Knuttinen, M-Gracia; Xie, Karen; Jani, Aarti; Palumbo, Alison; Carrillo, Tami; Mar, Winnie

2015-02-01

391

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.

392

Pleura space anatomy  

PubMed Central

The pleural cavity is the potential space between the two pleurae (visceral and parietal) of the lungs. The pleurae are serous membranes which fold back onto themselves to form a two-layered membranous structure. The thin space between the two pleural layers is known as the pleural cavity and normally contains a small amount of pleural fluid. There are two layers; the outer pleura (parietal pleura) is attached to the chest wall and the inner pleura (visceral pleura) covers the lungs and adjoining structures, via blood vessels, bronchi and nerves. The parietal pleurae are highly sensitive to pain, while the visceral pleura are not, due to its lack of sensory innervation. In the current review we will present the anatomy of the pleural space. PMID:25774304

Charalampidis, Charalampos; Youroukou, Andrianna; Lazaridis, George; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Papaiwannou, Antonis; Karavergou, Anastasia; Tsakiridis, Kosmas; Katsikogiannis, Nikolaos; Sarika, Eirini; Kapanidis, Konstantinos; Sakkas, Leonidas; Korantzis, Ipokratis; Lampaki, Sofia; Zarogoulidis, Konstantinos

2015-01-01

393

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

394

Pleura space anatomy.  

PubMed

The pleural cavity is the potential space between the two pleurae (visceral and parietal) of the lungs. The pleurae are serous membranes which fold back onto themselves to form a two-layered membranous structure. The thin space between the two pleural layers is known as the pleural cavity and normally contains a small amount of pleural fluid. There are two layers; the outer pleura (parietal pleura) is attached to the chest wall and the inner pleura (visceral pleura) covers the lungs and adjoining structures, via blood vessels, bronchi and nerves. The parietal pleurae are highly sensitive to pain, while the visceral pleura are not, due to its lack of sensory innervation. In the current review we will present the anatomy of the pleural space. PMID:25774304

Charalampidis, Charalampos; Youroukou, Andrianna; Lazaridis, George; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Papaiwannou, Antonis; Karavergou, Anastasia; Tsakiridis, Kosmas; Katsikogiannis, Nikolaos; Sarika, Eirini; Kapanidis, Konstantinos; Sakkas, Leonidas; Korantzis, Ipokratis; Lampaki, Sofia; Zarogoulidis, Konstantinos; Zarogoulidis, Paul

2015-02-01

395

Splenic artery embolization using contour emboli before laparoscopic or laparoscopically assisted splenectomy.  

PubMed

The present study assessed preoperative splenic artery embolization using spherical embolic material, super absorbent polymer microspheres (SAP-MS), before laparoscopic or laparoscopically assisted splenectomy. Distal splenic artery embolization using 250 to 400 microm SAP-MS was performed in nine cases with ITP and in seven cases with the other diseases with splenomegaly. Laparoscopic or laparoscopically assisted splenectomies, including a hand-assisted procedure and the procedure involving left upper minilaparotomy, were done 2 to 4 hours after embolization. Conversion to traditional laparotomy was not required in any of the 16 cases, while conversion to 12-cm laparotomy was required in one case with massive splenomegaly. Mean operating time was 161 minutes, and mean intraoperative blood loss was 290 mL. No major postoperative complications were identified, and only one patient reported postembolic pain before surgery. Preoperative splenic artery embolization using painless embolic material, SAP-MS, would be effective for easy and safe laparoscopic or laparoscopically assisted splenectomy. PMID:12409699

Iwase, Kazuhiro; Higaki, Jun; Yoon, Hyung-Eun; Mikata, Shoki; Miyazaki, Minoru; Nishitani, Akiko; Hori, Shinichi; Kamiike, Wataru

2002-10-01

396

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

397

Successful management of chronic pelvic pain.  

PubMed

Chronic pelvic pain is a common, multifactorial complaint that affects both women and men, causing disability and frustration for patients. The exact aetiology remains unknown, although several theories have been proposed. Assessment should be undertaken with care and compassion, while considering the sensitive nature of the area. Management involves ruling out treatable pathology concomitant with strategies to control pain. Novel treatment approaches have been investigated for specific clinical scenarios. The more severe CPP cases are best managed using a multidisciplinary approach. Management requires good integration and knowledge of all pelvic organ systems and including musculoskeletal, neurologic and psychological mechanisms. PMID:23909900

Rhodin, Annica

2013-08-01

398

Pelvic resection of recurrent rectal cancer.  

PubMed Central

OBJECTIVE: The authors describe their experience with pelvic resection of recurrent rectal cancer with emphasis on patient selection for curative intent based on known tumor risk factors. SUMMARY BACKGROUND DATA: Pelvic recurrence is a formidable problem in 30% of patients who have undergone a curative resection of primary rectal cancer. Although radiation can reduce the development of local recurrence and can provide palliation to many patients with localized disease, it is not curative. The authors and others have used the technique of abdominal sacral resection (ABSR) with or without pelvic exenteration to resect pelvic recurrence and its musculoskeletal extensions in selected patients with satisfactory long-term survival. METHODS: The technique of ABSR with or without pelvic exenteration or resection of pelvic viscera, which the authors have described previously, was used in 53 patients with recurrent rectal cancer--47 patients for curative intent and 6 for palliation. Previous surgeries were abdominal perineal resections (APRs) in 26 patients, anterior resections in 19 patients, and other procedures in 2 patients; original primary Dukes' stage was B in 52% and C in 48%. Almost all patients had been irradiated previously, generally in the 4000 to 5900 cGy range. Preoperative carcinoembryonic antigen (CEA) levels (before ABSR) were elevated (> 5 ng/mL) in 54%. RESULTS: Postoperative morbidity was encountered in most patients. Mortality was 8.5% in the curative group. Long-term survival for 4 years was achieved in 14 of 43 patients (33%), and 10 patients were alive with an acceptable quality of life after 5 years. Patients who had previous anterior resections or whose preoperative CEA levels were less than 10 ng/mL had a survival rate of approximately 45%, whereas patients with previous APRs and preoperative CEA levels greater than 10 ng/mL had a survival rate of only 15% to 18%. Patients with bone marrow invasion, positive margins, or pelvic node metastases had a median survival of only 10 months. CONCLUSIONS: Pelvic recurrence of rectal cancer can be resected safely with expectation of long-term survival of 33%. Patient selection based on known risk factors can identify patients most likely to benefit from resection and eliminate those who should be treated for palliation only. Images Figure 1. Figure 2. Figure 3. Figure 4. PMID:7524455

Wanebo, H J; Koness, R J; Vezeridis, M P; Cohen, S I; Wrobleski, D E

1994-01-01

399

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

400

Concomitant pelvic organ prolapse surgery with TVT procedure  

Microsoft Academic Search

The aim of this study is to evaluate the efficacy and feasibility of concomitant pelvic reconstructive surgery with tension-free vaginal tape (TVT) procedure to treat pelvic organ prolapse women with urodynamic stress incontinence (USI) or occult USI. Seventy-five women with pelvic organ prolapse and diagnosed as USI or occult USI were enrolled in this study. All patients with USI or

Kuan-Hui Huang; Fu-Tsai Kung; Hsi-Mi Liang; Chih-Wei Chen; Shiuh-Young Chang; Lih-Lian Hwang

2006-01-01

401

Urinary incontinence and pelvic organ prolapse in nulliparous women  

Microsoft Academic Search

Objective: To determine differences between vaginally parous and nulliparous women presenting with urinary incontinence and pelvic organ prolapse.Methods: Seven hundred forty eight consecutive referrals with urinary incontinence or pelvic organ prolapse, 62 of whom were nulliparous, were included in the analysis. Five hundred thirty-seven (72%) had urinary incontinence and 235 (31%) had at least stage III pelvic organ prolapse. Each

Robert L Harris; Geoffrey W Cundiff; Kimberly W Coates; Richard C Bump

1998-01-01

402

Pelvic floor muscle training in males: practical applications.  

PubMed

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

Siegel, Andrew L

2014-07-01

403

Contraction of the pelvic floor muscles during abdominal maneuvers  

Microsoft Academic Search

Sapsford RR, Hodges PW. Contraction of the pelvic floor muscles during abdominal maneuvers. Arch Phys Med Rehabil 2001;82:1081-8. Objective: To determine whether voluntary abdominal muscle contraction is associated with pelvic floor muscle activity. Design: Pelvic floor muscle activity was recorded during contractions of the abdominal muscles at 3 different intensities in supine and standing positions. Setting: Research laboratory. Participants: Six

Ruth R. Sapsford; Paul W. Hodges

2001-01-01

404

Unilateral ectopic right kidney, an incidental finding during pelvic sonogram.  

PubMed Central

An ectopic renal kidney was found incidentally during pelvic sonogram of a woman with incomplete abortion. The importance of pelvic ectopic kidney in obstetrics and gynecology and the significance of looking for a contralateral kidney before any pelvic surgery is embarked upon are discussed. A short review of significant differential diagnosis was also made. Images Figure 1 Figure 2 PMID:17052069

Dabiri, Luqman; Cheung, Wellman

2006-01-01

405

Laparoscopic splenectomy: lessons from the learning curve  

PubMed Central

Objective Initial reports suggest that laparoscopic splenectomy is a difficult procedure with a steep learning curve and limited scope. The objective of this study was to review various approaches to simplify the operation. Design A descriptive study of a prospective database. Setting A tertiary care teaching hospital. Patients Fifty-one consecutive patients, seen over a 4-year period, who underwent laparoscopic splenectomy (partial laparoscopic splenectomy in 1 patient) for a wide variety of disorders. Interventions Anterior and lateral surgical approaches to laparoscopic splenectomy and the selective use of preoperative splenic artery embolization. Main outcome measures Blood loss, morbidity, mortality and rate of conversion to open splenectomy, operating time and postoperative hospital stay. Results The morbidity (11%), death rate (2%), and rate of conversion were low. The recovery rate of accessory spleens was high (24%). Average operating time (3 hours), postoperative stay (3 days) and volume of blood loss improved with time. Conclusions Laparoscopic splenectomy is a reliable procedure for patients with spleens less than 20 cm long. For spleens 20 to 30 cm long, preoperative embolization is advisable, and the surgeon should be experienced. Laparoscopic splenectomy should not be performed for spleens more than 30 cm long. The lateral approach has eliminated most of the difficulty with this procedure for spleens less than 20 cm long (no embolization). The anterior approach is reserved for large spleens and partial laparoscopic splenectomy (with embolization). PMID:9492745

Poulin, Eric C.; Mamazza, Joseph

1998-01-01

406

Robotic Versus Laparoscopic Colorectal Surgery  

PubMed Central

Background: Robotic approaches have become increasingly used for colorectal surgery. The aim of this study is to examine the safety and efficacy of robotic colorectal procedures in an adult population. Study Design: A systematic review of articles in both PubMed and Embase comparing laparoscopic and robotic colorectal procedures was performed. Clinical trials and observational studies in an adult population were included. Approaches were evaluated in terms of operative time, length of stay, estimated blood loss, number of lymph nodes harvested, and perioperative complications. Mean net differences and odds ratios were calculated to examine treatment effect of each group. Results: Two hundred eighteen articles were identified, and 17 met the inclusion criteria, representing 4,342 patients: 920 robotic and 3,422 in the laparoscopic group. Operative time for the robotic approach was 38.849 minutes longer (95% confidence interval: 17.944 to 59.755). The robotic group had lower estimated blood loss (14.17 mL; 95% confidence interval: –27.63 to –1.60), and patients were 1.78 times more likely to be converted to an open procedure (95% confidence interval: 1.24 to 2.55). There was no difference between groups with respect to number of lymph nodes harvested, length of stay, readmission rate, or perioperative complication rate. Conclusions: The robotic approach to colorectal surgery is as safe and efficacious as conventional laparoscopic surgery. However, it is associated with longer operative time and an increased rate of conversion to laparotomy. Further prospective randomized controlled trials are warranted to examine the cost-effectiveness of robotic colorectal surgery before it can be adopted as the new standard of care. PMID:25489216

Jackson, Nicole R.; Hauch, Adam T.; Hu, Tian; Kandil, Emad

2014-01-01

407

Laparoscopic Repair of Paraesophageal Hernias  

PubMed Central

Background and Objectives: Laparoscopy has quickly become the standard surgical approach to repair paraesophageal hernias. Although many centers routinely perform this procedure, relatively high recurrence rates have led many surgeons to question this approach. We sought to evaluate outcomes in our cohort of patients with an emphasis on recurrence rates and symptom improvement and their correlation with true radiologic recurrence seen on contrast imaging. Methods: We retrospectively identified 126 consecutive patients who underwent laparoscopic repair of a large paraesophageal hernia between 2000 and 2010. Clinical outcomes were reviewed, and data were collected regarding operative details, perioperative and postoperative complications, symptoms, and follow-up imaging. Radiologic evidence of any size hiatal hernia was considered to indicate a recurrence. Results: There were 95 female and 31 male patients with a mean age (± standard deviation) of 71 ± 14 years. Laparoscopic repair was completed successfully in 120 of 126 patients, with 6 operations converted to open procedures. Crural reinforcement with mesh was performed in 79% of patients, and 11% underwent a Collis gastroplasty. Fundoplications were performed in 90% of patients: Nissen (112), Dor (1), and Toupet (1). Radiographic surveillance, obtained at a mean time interval of 23 months postoperatively, was available in 89 of 126 patients (71%). Radiographic evidence of a recurrence was present in 19 patients (21%). Reoperation was necessary in 6 patients (5%): 5 for symptomatic recurrence (4%) and 1 for dysphagia (1%). The median length of stay was 4 days. Conclusion: Laparoscopic paraesophageal hernia repair results in an excellent outcome with a short length of stay when performed at an experienced center. Radiologic recurrence is observed relatively frequently with routine surveillance; however, many of these recurrences are small, and few patients require correction of the recurrence. Furthermore, these small recurrent hernias are often asymptomatic and do not seem to be associated with the same risk of severe complications developing as the initial paraesophageal hernia. PMID:25392650

Borao, Frank; Squillaro, Anthony; Mansson, Jonas; Barker, William; Baker, Thomas

2014-01-01

408

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

409

Alterations in hepatic function during laparoscopic surgery  

Microsoft Academic Search

Background: Very few studies have been done on the consequences of pneumoperitoneum on hepatic function. At present, there is no consensus\\u000a on the physiopathological hepatic implications of pneumoperitoneum. The purpose of this clinical study was to evaluate the\\u000a effects of pneumoperitoneum on hepatic function in 52 patients treated with laparoscopic procedures.\\u000a \\u000a \\u000a \\u000a \\u000a Methods: Thirty-two laparoscopic cholecystectomies and 20 nonhepatobiliary laparoscopic procedures

M. Morino; G. Giraudo; V. Festa

1998-01-01

410

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

411

Total Laparoscopic Hysterectomy Using the Harmonic Scalpel  

PubMed Central

Total laparoscopic hysterectomy (TLH) is the complete hysterectomy including transection of the uterine vessels and opening/closure of the vaginal vault performed laparoscopically. This procedure can be performed as an alternative to total abdominal hysterectomy in many cases. We previously found use of the harmonic scalpel to be extremely helpful in performing laparoscopically assisted vaginal hysterectomies. In this series, the harmonic scalpel was used to facilitate performing TLH. Our experience has shown this can be performed without major complications in a cost-effective manner. PMID:10527328

Mendelsohn, Susan A.

1999-01-01

412

Fever and Diarrhea after Laparoscopic Bilioenteric Anastomosis  

PubMed Central

Bile duct injuries are well-known complications of laparoscopic and open cholecystectomies. Here, we report anastomosis of the common bile duct to the transverse colon that occurred as a complication of laparoscopic cholecystectomy. To the best of our knowledge, a similar case has not been reported in the literature so far. As in our patient, persistent diarrhea (in addition to fever and icterus) can be a warning sign of complication after these procedures. Surgeons who do advanced laparoscopic techniques must be familiar with this complication. PMID:21912066

Fazeli, Mohammad S.; Kazemeini, Alireza; Safari, Saeed; Larti, Farnoosh

2011-01-01

413

Please complete and give to Karen Evans in 401 MREB Neurobiology & AnatomyNeurobiology & Anatomy  

E-print Network

Please complete and give to Karen Evans in 401 MREB Neurobiology & AnatomyNeurobiology & Anatomy: Microbiology Neuroscience Anatomy Lab Name: Lab Location: Lab Ph #: Bldg. Rm # EMERGENCY CONTACT INFORMATION

Alvarado, Alejandro Sánchez

414

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....

415

Clinical anatomy of the hand.  

PubMed

This article reviews the underlying anatomy of trigger finger and thumb (fibrous digital pulleys, sesamoid bones), flexor tenosynovitis, de Quervain's syndrome, Dupuytren's contracture, some hand deformities in rheumatoid arthritis, the carpal tunnel syndrome and the ulnar nerve compression at Guyon's canal. Some important syndromes and structures have not been included but such are the nature of these seminars. Rather than being complete, we aim at creating a system in which clinical cases are used to highlight the pertinent anatomy and, in the most important part of the seminar, these pertinent items are demonstrated by cross examination of participants and teachers. Self learning is critical for generating interest and expanding knowledge of clinical anatomy. Just look at your own hand in various positions, move it, feel it, feel also your forearms while you move the fingers, do this repeatedly and inquisitively and after a few tries you will have developed not only a taste, but also a lifelong interest in clinical anatomy. PMID:23219083

Vargas, Angélica; Chiapas-Gasca, Karla; Hernández-Díaz, Cristina; Canoso, Juan J; Saavedra, Miguel Ángel; Navarro-Zarza, José Eduardo; Villaseñor-Ovies, Pablo; Kalish, Robert A

416

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

417

Chronic Prostatitis\\/Chronic Pelvic Pain Syndrome and Pelvic Floor Spasm: Can We Diagnose and Treat?  

Microsoft Academic Search

National Institutes of Health category III prostatitis, also known as chronic prostatitis\\/chronic pelvic pain syndrome, is\\u000a a common condition with significant impact on quality of life. This clinically defined syndrome has a multifactorial etiology\\u000a and seems to respond best to multimodal therapy. At least half of these patients have pelvic floor spasm. There are several\\u000a approaches to therapy including biofeedback,

Karin E. Westesson; Daniel A. Shoskes

2010-01-01

418

The Neurobiology of Chronic Pelvic Pain  

Microsoft Academic Search

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

Jennifer Gunter

419

[Gluteal muscular metastasis from renal pelvic tumor].  

PubMed

We present a case of gluteal muscular metastasis from a renal pelvic tumor. A 57-year-old man had undergone right nephroureterectomy and received 2 courses of adjuvant chemotherapy (MEC: methotrexate, epirubicin, cisplatin) for invasive renal pelvic tumor. Five months after the operation, computed tomography (CT) revealed pulmonary metastasis and right adrenal gland recurrence. He underwent 2 courses of chemotherapy (gemcitabine, paclitaxel). Postchemotherapy-CT scan showed a 2.2 cm mass in the right gluteal muscle. Since the size of the pulmonary metastasis and right adrenal gland recurrence showed no change, the gluteal mass was excised. Pathological diagnosis was metastatic urothelial carcinoma. Adjuvant chemotherapy (TIN: paclitaxel, ifosfamide, nedaplatin) 3 courses were performed, but postchemotherapy-CT scan showed a new 2.4 cm mass in the right gluteal muscle. He received radiation therapy (total 30 Gy) for the new gluteal mass. The common metastatic sites of renal pelvic tumor are lungs, liver, bone, and lymph nodes. Gluteal muscle is an uncommon site of metastasis of urothelial carcinoma. This is the 1st case of gluteal muscle metastasis from renal pelvic tumor in the literature. PMID:18546862

Sawazaki, Harutake; Okasyo, Kosuke; Takahashi, Takeshi; Taki, Yoji; Takeuchi, Hideo

2008-05-01

420

Single-Incision Laparoscopic Splenectomy and Splenic Autotransplantation for an Enlarged Wandering Spleen with Torsion  

PubMed Central

A wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant, but instead is found in the lower abdomen or in the pelvic region because of the laxity of the peritoneal attachments. The unusually long pedicle is susceptible to twisting, which can lead to ischemia, and eventually to necrosis. We herein report a case of an enlarged wandering spleen with torsion, successfully treated by single-incision laparoscopic splenectomy and autotransplantation. The transplanted splenic tissues could be identified on a spleen scintigram obtained 3 months after the surgery. Howell-Jolly bodies were not observed in blood specimens. This procedure is able to prevent an overwhelming postsplenectomy infection, and leads to satisfactory cosmetic results. PMID:25755963

Katsura, Shunsaku; Kawamura, Daichi; Harada, Eijiro; Enoki, Tadahiko; Hamano, Kimikazu

2013-01-01

421

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

PubMed

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

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

2014-09-01

422

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

423

Single-incision laparoscopic splenectomy and splenic autotransplantation for an enlarged wandering spleen with torsion.  

PubMed

A wandering spleen is a rare condition in which the spleen is not located in the left upper quadrant, but instead is found in the lower abdomen or in the pelvic region because of the laxity of the peritoneal attachments. The unusually long pedicle is susceptible to twisting, which can lead to ischemia, and eventually to necrosis. We herein report a case of an enlarged wandering spleen with torsion, successfully treated by single-incision laparoscopic splenectomy and autotransplantation. The transplanted splenic tissues could be identified on a spleen scintigram obtained 3 months after the surgery. Howell-Jolly bodies were not observed in blood specimens. This procedure is able to prevent an overwhelming postsplenectomy infection, and leads to satisfactory cosmetic results. PMID:25755963

Katsura, Shunsaku; Kawamura, Daichi; Harada, Eijiro; Enoki, Tadahiko; Hamano, Kimikazu

2014-06-01

424

Prevention of childbirth injuries to the pelvic floor.  

PubMed

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

Heit, M; Mudd, K; Culligan, P

2001-08-01

425

Laparoscopic extirpation of giant adrenal ganglioneuroma  

PubMed Central

Laparoscopic adrenalectomy is the standard of care for management of adrenal neoplasms. However, large sized adrenal lesions are considered as relative contraindication for laparoscopic extirpation. We report laparoscopic excision of giant ganglioneuroma of adrenal gland in a 33-year-old female patient. Patient was presented with left loin pain of 2 months duration. Computed tomography (CT) scan was suggestive of non-enhancing left suprarenal mass measuring 17 × 10 cm. Preoperative endocrine evaluation ruled out functional adrenal tumor. Patient underwent transperitoneal excision of suprarenal mass. The lesion could be completely extirpated laparoscopically. Duration of surgery was 250 minutes. Estimated blood loss was 230 milliliters. Specimen was extracted through pfannenstiel incision. No significant intraoperative or postoperative happenings were recorded. Microscopic features were suggestive of ganglioneuroma of adrenal gland. PMID:24501511

Abraham, George P; Siddaiah, Avinash T; Das, Krishanu; Krishnamohan, Ramaswami; George, Datson P; Abraham, Jisha J; Chandramathy, Sreerenjini K

2014-01-01

426

Should all distal pancreatectomies be performed laparoscopically?  

PubMed

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

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

2009-01-01

427

Minimizing knot tying during reconstructive laparoscopic urology  

Microsoft Academic Search

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

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

2006-01-01

428

Laparoscopic extirpation of giant adrenal ganglioneuroma.  

PubMed

Laparoscopic adrenalectomy is the standard of care for management of adrenal neoplasms. However, large sized adrenal lesions are considered as relative contraindication for laparoscopic extirpation. We report laparoscopic excision of giant ganglioneuroma of adrenal gland in a 33-year-old female patient. Patient was presented with left loin pain of 2 months duration. Computed tomography (CT) scan was suggestive of non-enhancing left suprarenal mass measuring 17 × 10 cm. Preoperative endocrine evaluation ruled out functional adrenal tumor. Patient underwent transperitoneal excision of suprarenal mass. The lesion could be completely extirpated laparoscopically. Duration of surgery was 250 minutes. Estimated blood loss was 230 milliliters. Specimen was extracted through pfannenstiel incision. No significant intraoperative or postoperative happenings were recorded. Microscopic features were suggestive of ganglioneuroma of adrenal gland. PMID:24501511

Abraham, George P; Siddaiah, Avinash T; Das, Krishanu; Krishnamohan, Ramaswami; George, Datson P; Abraham, Jisha J; Chandramathy, Sreerenjini K

2014-01-01

429

Laparoscopic correction of intestinal malrotation in adult  

PubMed Central

Intestinal malrotation is rare in adults. Patients may present with acute obstruction or chronic abdominal pain. These symptoms are caused by Ladd's bands and narrow mesentery resulting from incomplete gut rotation. Barium, computed tomography (CT) and magnetic resonance imaging (MRI), angiography and sometimes explorative laparotomy are used for diagnosis. Ladd's procedure is the treatment of choice but data about laparoscopic approach in adult is scarce. We report three cases of laparoscopic correction of adult malrotation presenting with chronic abdominal pain. The diagnosis is made by CT/MRI. Laparoscopic Ladd's procedure (release of bands, broadening of mesentery and appendicectomy) was performed via three ports. Procedure time 25-45 min. All patients were discharged on postoperative day 2. At 6 month follow-up, all are symptom free. Laparoscopic Ladd's procedure is an acceptable alternative to the open technique in treating chronic symptoms of intestinal malrotation in adults. PMID:24761085

Panda, Nilanjan; Bansal, Nitin Kumar; Narasimhan, Mohan; Ardhanari, Ramesh

2014-01-01

430

Peritoneal changes due to laparoscopic surgery  

PubMed Central

Background Laparoscopic surgery has been incorporated into common surgical practice. The peritoneum is an organ with various biologic functions that may be affected in different ways by laparoscopic and open techniques. Clinically, these alterations may be important in issues such as peritoneal metastasis and adhesion formation. Methods A literature search using the Pubmed and Cochrane databases identified articles focusing on the key issues of laparoscopy, peritoneum, inflammation, morphology, immunology, and fibrinolysis. Results Laparoscopic surgery induces alterations in the peritoneal integrity and causes local acidosis, probably due to peritoneal hypoxia. The local immune system and inflammation are modulated by a pneumoperitoneum. Additionally, the peritoneal plasmin system is inhibited, leading to peritoneal hypofibrinolysis. Conclusion Similar to open surgery, laparoscopic surgery affects both the integrity and biology of the peritoneum. These observations may have implications for various clinical conditions. PMID:20552372

Lensvelt, M.; Rinkes, I. H. M. Borel; Klinkenbijl, J. H. G.; Reijnen, M. M. P. J.

2010-01-01

431

[Dental anatomy of dogs].  

PubMed

The aim of the research was to investigate dog teeth anatomy as animal model for study of etiopathogenesis of caries disease and physiological tooth wear in human. After examining the dog's dental system, following conclusions were drawn: the dog has 42 permanent teeth, which are distributed over the dental arches not equally, and so the upper dentition consists of 20, and the lower of 22 teeth. The largest are considered upper fourth premolar and lower first molars, which are called discordant teeth. Between discordant teeth and fangs a dog has an open bite, which is limited to the top and bottom conical crown premolar teeth. Thus, in the closed position of the jaws, behind this occlusion is limited by discordant teeth, just in contact are smaller in size two molars. Only large dog's molars in a valid comparison can be likened to human molars, which allows us to use them in an analog comparison between them with further study of the morphological features ensure durability short-crown teeth and their predisposition to caries. PMID:25617107

2014-12-01

432

Incidence of complications following laparoscopic hernioplasty  

Microsoft Academic Search

Smaller individual series on the outcome of laparoscopic hernioplasty techniques have been reported. This study reports on the complications of 3,229 laparoscopic hernia repairs performed by the authors in 2,559 patients. The TAPP (transabdominal preperitoneal) technique was the most frequently performed: 1,944 (60%). The totally preperitoneal technique was performed 578 (18%) times. The IPOM (intraperitoneal onlay mesh) repair was performed

E. H. Phillips; M. Arregui; B. J. Carroll; J. Corbitt; W. B. Crafton; M. J. Fallas; C. Filipi; R. J. Fitzgibbons; M. J. Franklin; B. McKernan; D. Olsen; A. Ortega; J. H. Payne; J. Peters; R. Rodriguez; P. Rosette; L. Schultz; A. Seid; R. Sewell; R. Smoot; F. Toy; R. Waddell; S. Watson

1995-01-01

433

Laparoscopic Gastric Banding after Heart Transplantation  

Microsoft Academic Search

Background: Obesity often complicates the postoperative course of heart transplant recipients. Laparoscopic adjustable gastric\\u000a banding (LAGB) represents a minimal invasive therapeutic possibility for weight reduction in non-transplanted patients. Case\\u000a Report: We report a 55-year-old diabetic, morbidly obese male (weight 138 kg, height 173 m, BMI 46 kg\\/m2) in whom 6 years after orthotopic heart transplantation, LAGB and laparoscopic cholecystectomy were

B. Ablassmaier; S. Klaua; C. A. Jacobi; J. M. Müller

2002-01-01

434

Complications of Laparoscopic and Robotic Pyeloplasty  

Microsoft Academic Search

\\u000a Treatment of ureteropelvic junction obstruction has increasingly shifted from open to minimally invasive surgery in the last\\u000a decade. Laparoscopic pyeloplasty in particular has become the standard of care for definitive treatment of this disease process\\u000a based on comparable mid- to long-term outcomes and improved morbidity compared to open surgery. Robotic- assisted laparoscopic\\u000a pyeloplasty has been increasingly performed in lieu of

Elias Hyams; Michael Stifelman

435

Complications of laparoscopic pyeloplasty in children  

Microsoft Academic Search

Introduction  Laparoscopic pyeloplasty in children has been proven to be safe and effective, with comparable results to open surgery. Due\\u000a to the extension of laparoscopic indications from ablative to reconstructive procedures requiring endoscopic suturing, most\\u000a centres have plateaued within their learning curve. Based on our own experience with a little more than 100 cases, we focus\\u000a on the complications and the

Rajendra B. Nerli; Mallikarjun Reddy; Vikram Prabha; Ashish Koura; Praveen Patne; M. K. Ganesh

2009-01-01

436

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

437

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

438

Laparoscopic radical nephrectomy for advanced kidney cancer  

Microsoft Academic Search

The management of advanced renal cell carcinoma (RCC) continues to evolve. With the advent of laparoscopic radical nephrectomy\\u000a (LRN), minimally invasive approaches to kidney cancer have developed. Laparoscopic resection of locally advanced RCC yields\\u000a a similar cancer-control rate with the advantage of decreased morbidity. Although cytoreductive LRN is a technically challenging\\u000a procedure, it may be completed safely in selected patients.

Stephen E. Paulter; McClellan M. Walther

2002-01-01

439

Laparoscopic retrieval of intraabdominal foreign bodies  

Microsoft Academic Search

The use of laparoscopy has been described as the means of removing intraabdominal foreign bodies, both intraperitoneal and\\u000a intraluminal, from the stomach or bowel. An early report detailed the laparoscopic removal of translocated intrauterine devices\\u000a from the peritoneal cavity [2]. Laparoscopic removal of a retained surgical sponge also has been reported [1]. For large ingested objects that cannot be retrieved

Edward H. Chin; David Hazzan; Daniel M. Herron; Barry Salky

2007-01-01

440

Laparoscopic renal cryoablation: initial clinical series  

Microsoft Academic Search

Objectives. To present the technique and short-term results of retroperitoneal laparoscopic renal cryoablation.Methods. Ten patients underwent laparoscopic renal cryoablation of 11 exophytic renal tumors ranging in size from 1.5 to 3 cm identified on computed tomography. Tumors were located at the upper (3), middle (5), or lower (3) pole of the kidney. Three patients had a solitary kidney. A 3-port

Inderbir S Gill; Andrew C Novick; Jon J Soble; Gyung Tak Sung; Erick M Remer; Jonathan Hale; Charles M O’Malley

1998-01-01

441

Complications of laparoscopic paraesophageal hernia repair  

Microsoft Academic Search

The complications of laparoscopic paraesophageal hernia repair at two institutions were reviewed to determine the rate and\\u000a type of complications. A total of 76 patients underwent laparoscopic paraesophageal hernia repair between December 1992 and\\u000a April 1996. Seventy-one of them had fundoplication (6 required a Collis-Nissen procedure). Five patients underwent hernia\\u000a reduction and gastropexy only. There was one conversion to laparotomy.

Thadeus L. Trus; Tim Bax; William S. Richardson; Gene D. Branum; Susan J. Mauren; Lee L. Swanstrom; John G. Hunter

1997-01-01

442

Laparoscopic splenectomy in patients with hematologic diseases.  

PubMed Central

OBJECTIVE. The authors review their initial experience with laparoscopic splenectomy in patients with hematologic diseases. Efficacy, morbidity, and mortality of the technique are presented, and other patient recovery parameters are discussed. SUMMARY BACKGROUND DATA. Laparoscopic splenectomy is performed infrequently and data regarding its safety and efficacy are scarce. Factors such as a high level of technical difficulty, the potential for sudden, severe hemorrhage, and slow accrual of operative experience due to a relatively limited number of procedures are responsible. The potential patient benefits from the development of a minimally invasive form of splenectomy are significant. METHODS. Clinical follow-up, a prospective longitudinal database, and review of medical records were analyzed for all patients referred for elective splenectomy for hematologic disease from March 1992 to March 1995. RESULTS. Laparoscopic splenectomy was attempted in 43 patients and successfully completed in 35 (81%). Therapeutic platelet response to splenectomy occurred in 82% of patients with immune thrombocytopenic purpura and hematocrit level increased in 60% of patients with autoimmune hemolytic anemia undergoing successful laparoscopic splenectomy. The morbidity rate was 11.6% (5 of 43 patients), and the mortality rate was 4.7% (2 of 43 patients). Return of gastrointestinal function occurred in patients 23.1 hours after laparoscopic splenectomy and 76 hours after conversion to open splenectomy (p < 0.05). Mean length of stay was 2.7 days after laparoscopic splenectomy and 6.8 days after conversion to open splenectomy (p < 0.05). CONCLUSION. Laparoscopic splenectomy may be performed with efficacy, morbidity, and mortality rates comparable to those of open splenectomy for hematologic diseases, and it appears to retain other patient benefits of laparoscopic surgery. Images Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. PMID:8678613

Flowers, J L; Lefor, A T; Steers, J; Heyman, M; Graham, S M; Imbembo, A L

1996-01-01

443

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

444

Update on laparoscopic pancreatectomy in 2010.  

PubMed

Minimally invasive surgery has been proven to be a safe and effective method of surgically managing several gastrointestinal conditions. In the last ten years, increased expertise in laparoscopic surgery and the availability of new surgical devices have contributed to the development of laparoscopic pancreatic surgery. Currently, distal pancreatectomies for benign/low-grade malignant tumors represent the majority of pancreatic resections performed laparoscopically. They are characterized by improved postoperative short-term outcomes compared to open surgery. Pancreaticoduodenectomy still represents a formidable technical challenge for laparoscopy. However, laparoscopic pancreaticoduodenectomy has been proven to be safe and feasible with outcomes comparable to those of open surgery if performed at experienced centers. Robotic surgery, recently introduced in the field of minimally invasive surgery, improves the view and the maneuverability of the instruments compared to standard laparoscopic surgery. The feasibility and safety of robotic pancreatectomy have been recently reported for complex pancreatic resection. This approach has the potential to bridge the gap between minimally invasive surgery and complex pancreatic surgery, allowing the indications for minimally invasive pancreatic surgery to be extended. Almost 15 years after its description, laparoscopic pancreatic surgery is seeing an exponential growth in its applications. The growing experience in laparoscopy and the introduction of robotics will further expand the field of minimally invasive pancreatic surgery in the next several years. PMID:21224799

Addeo, P; Giulianotti, P C

2010-12-01

445

Timing of laparoscopic cholecystectomy in acute cholecystitis.  

PubMed

Laparoscopic cholecystectomy was performed in 467 patients between November 1989 and April 1991. Fifty-four patients (12%) had acute inflammatory changes. These were divided into three different groups: group 1-13 patients who admitted having an attack of right upper quadrant pain within 24-48 h of their scheduled elective laparoscopic cholecystectomy; group 2-23 patients who had a history of acute cholecystitis treated 4-6 weeks before their elective laparoscopic cholecystectomy; group 3-18 patients who were admitted to the hospital and were diagnosed with acute cholecystitis; they had laparoscopic cholecystectomy performed in the same admission. All patients had a successful laparoscopic removal of their gallbladder except 2 in group 3 who had to be converted to an open procedure. Analysis of the operative time, complications, and hospital stay showed that after adequate experience is gained in performing laparoscopic cholecystectomy, acute cholecystitis is not a contraindication. The procedure is faster and safer if performed in the first 24-48 h of the onset of the symptoms. Different technical maneuvers are needed due to the nature of the disease. PMID:8173120

Hawasli, A

1994-02-01

446

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

447

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

448

Disseminated peritoneal leiomyomatosis after laparoscopic supracervical hysterectomy with characteristic molecular cytogenetic findings of uterine leiomyoma.  

PubMed

Disseminated peritoneal leiomyomatosis (DPL) is a rare condition characterized by scattered smooth muscle nodules over the peritoneal surfaces. The pathogenesis of DPL remains unclear. Herein, we report a case of DPL occurring 7 years after laparoscopic supracervical hysterectomy with morcellation for uterine leiomyomata (UL). We analyzed both the original UL and the subsequent DPL by molecular cytogenetics to assess the role of chromosomal abnormalities in DPL pathobiology. Interestingly, all of the chromosomal aberrations detected in this case of DPL, including r(1)(p34.3q41), del(3)(q23q26.33), and t(12;14)(q14.3;q24.1), are characteristic chromosomal abnormalities detected in UL. Fluorescence in situ hybridization analysis of the initial UL confirmed an interstitial deletion spanning at least 3q24 and 3q25.1, suggesting that functional alteration of a potential gene in this chromosomal region may play a role in DPL development from UL. With the increasing rate of hysterectomy through laparoscopic approach to UL, the unique complications of laparoscopy with morcellation, especially seeding and proliferation of tumor cells over abdominal organs and peritoneum, are becoming more significant and may necessitate review of current surgical protocols to prevent future seeding of the pelvic region with tumor particles. PMID:20842731

Ordulu, Zehra; Dal Cin, Paola; Chong, Wilson W S; Choy, Kwong Wai; Lee, Charles; Muto, Michael G; Quade, Bradley J; Morton, Cynthia C

2010-12-01

449

A comparison of different laparoscopic sterilization occlusion techniques in 24,439 procedures.  

PubMed

This investigation assessed the safety and efficacy of five laparoscopic tubal occlusion techniques for female sterilization: electrocoagulation, the tubal ring via conventional and open laparoscopy, the prototype spring-loaded clip, and the Rocket clip. The 24,439 cases make up a data set collected by collaborating staffs at 64 institutions in 27 countries. The five techniques were compared with respect to six commonly evaluated parameters. Rates of surgical difficulties ranged from 2.4% to 12.5% (5.1% overall); rates of surgical complications, from 0.7% to 2.7% (1.7% overall); and rates of technical failures, from 0.6% to 1.0% (0.8% overall). Twelve-month life-table pregnancy rates were less than one per 100 women years. Prospective data on six menstrual parameters revealed that the menstrual cycles of the majority of women were unchanged after sterilization; for those who reported a change, approximately half experienced a change in one direction and half in the other direction. For example, one half reported an increase in the amount of menstrual flow, and one half reported a decrease in the amount of flow. The reported incidence of subsequent pelvic operations was less than 1% at each long-term follow-up. These data indicate that laparoscopic sterilization is safe and effective and that none of the studied techniques has a distinct advantage. PMID:6214956

Bhiwandiwala, P P; Mumford, S D; Feldblum, P J

1982-10-01

450

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

451

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

452

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

453

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

454

Pure laparoscopic and robot-assisted laparoscopic reconstructive surgery in congenital megaureter: a single institution experience.  

PubMed

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

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

2014-01-01

455

Laparoscopic training in residency program.  

PubMed

The use of laparoscopy in general surgery has provided surgeons with a new approach to multiple procedures. New techniques are being developed daily. Laparoscopic training for surgical residents must be incorporated into their curriculum. To decrease the risks of training residents on patients and to decrease operative time, a program of videoscopic "bench" training exercises, to improve eye-hand coordination, was instituted for junior residents. Between July and September 1995, nine surgical residents participated in this proficiency videoscopic study. At the end of the study, there was a statistically significant improvement in the residents performance by an average of 37% (P = 0.0109). This program proved to be both effective and economical. It can be reproduced and easily incorporated into any surgical residency program. PMID:8807518

Hawasli, A; Featherstone, R; Lloyd, L; Vorhees, M

1996-06-01

456

Laparoscopic sterilization with the band.  

PubMed

Silastic bands were developed independently by I.B. Yoon at Johns Hopkins Hospital and C.L. Lay at the University of South Florida. The use of bands as a mechanical method of tubal occlusion in laparoscopic tubal sterilization is a response to rare but disastrous thermal complications which have followed the use of electrocautery. Laparoscopy is carried out in the usual fashion with the patient in the lithotomy position with catheterization of the bladder and application of an instrument for uterine manipulation, insufflation of 1-2 liters of carbon dioxide through a Virres needle followed by insertion of the operating laparoscope. Either a double or single puncture technique is used. After the pelvis has been inspected, the fimbriated end of each tube is identified. The applicator is then used to grasp just the tube, about 3 cm from the cornu. The tube is then carefully drawn up into the applicator and the band is applied. Both sides are inspected following application of the bands to be sure that the loop of tube appears avascular. Trocars are removed and the skin incisions are closed. This may be done on an outpatient or inpatient basis. Complications are rare and most are related to trying to bring an edematous or infected tube or one bound down by adhesions into the applicator. The largest series reported so far of 902 patients, with 3,839 woman months following sterilization, shows only 1 pregnancy as a result of method failure. The use of the ring is simple, easy to teach, and avoids the complications of electrocautery. PMID:152344

1978-10-01

457

Laparoscopic splenectomy using conventional instruments  

PubMed Central

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

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

2005-01-01

458

Long-Term Results of Reconstruction with Pelvic Allografts after Wide Resection of Pelvic Sarcomas  

PubMed Central

Reconstruction after the resection of a pelvic tumor is a challenging procedure in orthopedic oncology. The main advantage of allograft reconstruction is restoration of the bony architecture of the complex pelvic region. However, high complication rates such as infection and allograft resorption had been reported in the literature. In this study, we aimed to retrospectively review nine patients treated with pelvic resection and structural pelvic allograft reconstruction. Functional results, complications, and survival of the patients and the allografts were evaluated. At a mean follow-up of 79 months, three patients were dead. Major complications were detected in eight of the nine patients. Infection (four of the nine patients) and allograft resorption (three of the nine patients) were the most common causes of failure. The cumulative survival of the patients was 66.7 percent at 70 months. However, allograft survival was only 26.7 percent at 60 months. Mean MSTS score was 69. In conclusion, we suggest that other reconstruction options should be preferred after pelvic resections because of the high complication rates associated with massive allograft reconstruction. PMID:24616637

Ayvaz, Mehmet; Mermerkaya, M. Ugur; Caglar, Omur; Acaroglu, Emre; Tokgozoglu, A. Mazhar

2014-01-01

459

Anatomic and pathologic findings at external phased-array pelvic MR imaging after surgery for anorectal disease.  

PubMed

Pelvic magnetic resonance (MR) imaging is useful for identification of postoperative changes, complications, and disease recurrence in patients who have undergone surgery for primary or recurrent anorectal disease. Commonly used interventions include treatment for anorectal carcinoma: anterior rectal resection with or without creation of different colic anastomoses and abdominoperineal excision with or without pelvic reconstruction (omentoplasty, placement of myocutaneous flaps). Other common interventions include treatment for inflammatory bowel disease (coloproctectomy with or without creation of an ileoanal anastomosis and ileal pouch) and treatment for fistulas (placement of flaps or setons). Postoperative anatomic changes and formation of scar tissue can usually be identified with consecutive MR imaging examinations. Pelvic MR imaging is an accurate technique for assessment of complications including anastomotic leakage, septic complications such as fistulas and abscesses, neoplastic recurrence, and other less common complications (perineal hernia, peritoneal pseudocyst). The sophisticated surgical procedures used in rectal surgery can alter normal anatomy and make image interpretation difficult. Thus, familiarity with the appearances of postoperative anatomic changes, complications, and tumor recurrence is essential for accurate MR imaging evaluation after surgery for anorectal disease. PMID:16973771

Hoeffel, Christine; Arrivé, Lionel; Mourra, Najat; Azizi, Louisa; Lewin, Maité; Tubiana, Jean-Michel

2006-01-01

460

[Laparoscopic surgery performed for focal liver pathology of various etiology].  

PubMed

The own experience on surgical treatment of more than 400 patients, suffering parasytic and nonparasitic hepatic cysts, benign and malignant hepatic tumors, using laparoscopic technologies, was summarized. Indications for laparoscopic operations, the main technical aspects, immediate and late follow-up results were analyzed. Advantages of laparoscopic operations in comparison to open operative interventions in thoroughly selected patients were noted. PMID:25675778

Nychyta?lo, M Iu; Lytvynenko, O M; Zahri?chuk, M S; Lukecha, I I; Bulyk, I I; Homan, A V; Stokolos, A V; Prysiazhniuk, V V

2014-10-01

461

Trends in utilization and outcomes of laparoscopic versus open appendectomy  

Microsoft Academic Search

BackgroundAlthough a number of trials have analyzed the outcomes of laparoscopic versus open appendectomy, the clinical advantages, and cost-effectiveness of laparoscopic appendectomy in the management of acute and perforated appendicitis are still not clearly defined. The aim of this study was to examine utilization and outcomes of laparoscopic versus open appendectomy using a national administrative database of academic medical centers

Ninh T. Nguyen; Kambiz Zainabadi; Shahrazad Mavandadi; Mahbod Paya; C. Melinda Stevens; Jeffrey Root; Samuel E. Wilson

2004-01-01

462

Total laparoscopic live donor nephrectomy: a 6-year experience  

Microsoft Academic Search

BackgroundSince the introduction of the laparoscopic live donor nephrectomy in 1995, attempts have been made to depart from the total laparoscopic approach to the hand-assisted approach to decrease surgical time and complications. We present our 6-year experience with the total laparoscopic approach.

Abdelkader Hawasli; Richard Berri; Ahmed Meguid; Khoa Le; Henry Oh

2006-01-01

463

Real Time 3D Laparoscopic Ultrasonography Edward D. Light1  

E-print Network

1 Real Time 3D Laparoscopic Ultrasonography Edward D. Light1 , Salim F. Idriss2 , Kathryn F laparoscopic ultrasonography (3D LUS), and real time 3D transesophageal echocardiography (TEE fibrillation. Key Words: Laparoscopic Ultrasonography, Real Time 3D Imaging, 2D Array Transducer, Trocar

Smith, Stephen

464

Full Report The Use of Pneumoperitoneum During Laparoscopic  

E-print Network

Full Report The Use of Pneumoperitoneum During Laparoscopic Surgery as a Model to Study during laparoscopic surgery leads to diverse cardiovascular changes that can be used as a model to study (S1) obtained from the phonocardiogram, during laparoscopic surgery. Patients and Methods: Patients

Intrator, Nathan

465

VIRTUAL ENVIRONMENTS FOR TRAINING CRITICAL SKILLS IN LAPAROSCOPIC SURGERY  

E-print Network

VIRTUAL ENVIRONMENTS FOR TRAINING CRITICAL SKILLS IN LAPAROSCOPIC SURGERY MICHAEL DOWNES (1), M to a particular procedure. We have developed a prototype environment for training laparoscopic cholecystectomy.al., eds., IOS Press, Amsterdam, 1998. #12;Our group has focused on creating a simulation of laparoscopic

Cavusoglu, Cenk

466

Laparoscopic and open incisional hernia repair: A comparison study  

Microsoft Academic Search

Background: Techniques for performing laparoscopic incisional hernia repair have been described and some advantages over conventional open repair reported. However, most reported series of laparoscopic incisional hernia procedures are small, and only one has included a comparison with open repairs. Methods: From December 1993 to January 1998, we prospectively collected operative and outcome data on 56 consecutive laparoscopic prosthetic repairs

Adrian Park; Daniel W. Birch; Peter Lovrics

1998-01-01

467

Biomedical Paper Task Decomposition of Laparoscopic Surgery for  

E-print Network

Biomedical Paper Task Decomposition of Laparoscopic Surgery for Objective Evaluation of Surgical of the laparoscopic surgical skills of surgical residents is usually a subjective process carried out in the operating/tissue interactions (types and transitions) per- formed in laparoscopic surgery are skill-dependent, and (2

468

Laparoscopic Surgical Robot for Remote In Vivo Training Brian Allena  

E-print Network

Laparoscopic Surgical Robot for Remote In Vivo Training Brian Allena Brett Jordanb William Pannellb in advanced laparoscopic techniques. The Laparobot allows a student to practice surgery on a remotely located animal. The system uses standard laparoscopic tools for both the student's control interface

Faloutsos, Petros

469

Microline Surgical Articulating Laparoscopic Surgery Device Project Recap  

E-print Network

Microline Surgical Articulating Laparoscopic Surgery Device Project Recap · Due to IP restrictions an articulating laparoscopic surgery device to be manufactured by Microline Surgery. The device is capable. Laparoscopic surgery is a minimally invasive surgery, which is performed by making several small incisions

Demirel, Melik C.

470

Visual Tracking of Laparoscopic Instruments in Standard Training  

E-print Network

Visual Tracking of Laparoscopic Instruments in Standard Training Environments Brian F. ALLEN. We propose a method for accurately tracking the spatial mo- tion of standard laparoscopic instruments requires no modifications to the standard FLS training box, camera or instruments. Keywords. Laparoscopic

Faloutsos, Petros

471

Force Propagation Models in Laparoscopic Tools and Shahram Payandeh  

E-print Network

Force Propagation Models in Laparoscopic Tools and Trainers Shahram Payandeh Experimental Robotics in laparoscopic surgery are graspers and needle drivers. Although the operation of such basic tools are rather are beingfocused on developing a virtual laparoscopic trainers where the sense of touch in manipulating the virtual

472

Force Propagation Models in Laparoscopic Tools and Shahram Payandeh  

E-print Network

Force Propagation Models in Laparoscopic Tools and Trainers Shahram Payandeh Experimental Robotics in laparoscopic surgery are graspers and needle drivers. Although the operation of such basic tools are rather effort are being focused on developing a virtual laparoscopic trainers where the sense of touch

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