Effective intracorporeal space in robot-assisted multiquadrant surgery in a pediatric inanimate model

AbstractPediatric robot-assisted surgery is technically challenging, but it is becoming the most desirable approach for most of the pediatric urological abdominal surgical procedures. Distance between ports has been adopted based on adult surgery experience. Currently, there is scarce information and literature about effective trocar position and distance between ports for highly complex pediatric multiquadrant surgery. The aim of this study is to evaluate the most effective way of port placement for pediatric multiquadrant robot-assisted surgery using an inanimate model. Two inanimate models simulating the abdominal area of an older infant were created: model (1) 33.3  × 29.6 × 11.5 cm and model (2) 15 × 13 × 8 cm. A simulation of a robot-assisted laparoscopic Mitrofanoff procedure was performed in both models simulating appendix procurement and subsequent anastomosis to the bladder dome. In the first model, the simulation was performed in tw o ways: (a) adult trocars were placed with a distance of 4 cm between them and placed longitudinally and (b) ports were placed by triangulating the camera 2 cm in a cephalic fashion. In the second model, (a) scenario was used as described above (c) single port crossing the arms. Volume of the firs t model was 11,335.32 cm3. Simulation (b) reached higher percentage of volumes without arm clash (30.19 vs. 41.92%,p = 0.021). In...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research

Related Links:

AbstractAcute appendicitis is one of the main indications for urgent surgery representing a high-volume procedure worldwide. The current spending review in Italy (and not only in this country) affects the health service and warrants care regarding the use of different surgical devices. The aim of our study is to perform a cost evaluation, comparing the use of endoloops and staplers in complicated acute appendicitis (phlegmonous and gangrenous), taking into consideration the cost of the device in relation to the management of any associated postoperative complications. We retrospectively evaluated 996 laparoscopic appendect...
Source: Updates in Surgery - Category: Surgery Source Type: research
OBJECTIVE The American Association for the Surgery of Trauma (AAST) developed an anatomic grading system to assess disease severity through increasing grades of inflammation. Severity grading can then be utilized in risk-adjustment and stratification of patient outcomes for clinical benchmarking. We sought to validate the AAST appendicitis grading system by examining the ability of AAST grade to predict clinical outcomes used for clinical benchmarking. METHODS Surgical quality program data were prospectively collected on all adult patients undergoing appendectomy for acute appendicitis at our institution between Decem...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research
Conclusions: At 5 years of follow-up 46% of children treated with antibiotics for acute nonperforated appendicitis had undergone an appendectomy, although acute appendicitis was only histologically confirmed in 4/24 (17%). Treatment with antibiotics seems to be safe in the intermediate-term; none of the children previously treated nonoperatively re-presented with complicated appendicitis.
Source: Annals of Surgery - Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research
AbstractIt is estimated that 0.5 –2% of women will require nonobstetric surgery during pregnancy,1,2 yet operative laparoscopy after 20 weeks of gestation remains uncommon. The most common indications for nonobstetric surgery during pregnancy are acute appendicitis, acute cholecystitis1 and torsion of adnexal masses. Before any intervention in pregnancy, clinicians must consider the safety of the woman and be mindful of risks to the fetus.
Source: The Obstetrician and Gynaecologist - Category: OBGYN Authors: Tags: TIPS AND TECHNIQUES Source Type: research
Publication date: Available online 6 May 2020Source: International Journal of Surgery Case ReportsAuthor(s): Yang Chen, Jie-Qing Yuan, Shi-Gang Guo, Zhen-Jiang Yang
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
This report emphasizes the need for maintaining a high index of suspicion towards a possibility of a complicated MD in patients presenting with an acute abdomen, once other causes of acute abdomen are ruled out.
Source: Pediatric Emergency Care - Category: Emergency Medicine Tags: Illustrative Cases Source Type: research
CONCLUSION: This study showed that both intracorporeal knotting and Hem-o-loc clips were effective, reliable and similar cost-effective in laparoscopic appendectomy. The decision should be based on the surgeon's experience. PMID: 32436964 [PubMed - in process]
Source: Turkish Journal of Trauma and Emergency Surgery : TJTES - Category: Emergency Medicine Authors: Tags: Ulus Travma Acil Cerrahi Derg Source Type: research
Authors: Wagner PJ, Haroon M, Morarasu S, Eguare E, Al-Sahaf O Abstract In surgical practice, surgeons request CT scans to rule out acute appendicitis, even in young patients. We aimed to assess the feasibility of using a CT scan to reduce the rate of negative laparoscopies in patients younger than 40 with equivocal signs of acute appendicitis. Therefore, we conducted a retrospective observational study on the patients admitted with a provisional diagnosis of acute appendicitis. Patients younger than 40 and with the Alvarado score between 3 and 6 were included. These were divided into two groups: those who had or d...
Source: Journal of Medicine and Life - Category: General Medicine Tags: J Med Life Source Type: research
Abstract Currently, transvaginal natural orifice transluminal endoscopic surgery (NOTES), the most minimally invasive option for laparoscopic surgery, suffers various technological restraints limiting its implementation. We discuss a simple modification for vaginal access to improve the existing hybrid NOTES technique. We retrospectively studied 18 women at our rural hospital in central India, who, under defined criteria, underwent transvaginal appendicectomy using innovative strategically designed submucosal tunnels. The procedure was successfully completed in all but the first three cases. None required addition...
Source: Tropical Doctor - Category: Tropical Medicine Authors: Tags: Trop Doct Source Type: research
AbstractBackgroundIntra-abdominal abscesses (IAA) may develop after laparoscopic appendectomies (LA) for acute appendicitis. The identification of risk factors for postoperative IAA could lead to a decrease in the readmission rate and surgery redoes after LA for acute appendicitis.Materials and methodsThe present study retrospectively analyzed patients undergone LA for acute appendicitis during the period 2001 –2017. Clinical, intraoperative, and postoperative outcomes were described. Comparison between groups was made via univariate and multivariate analyses.ResultsThe charts of 2076 patients undergone LA were revie...
Source: Updates in Surgery - Category: Surgery Source Type: research
More News: Appendicitis | Laparoscopy | Pediatrics | Study | Surgery | Urology & Nephrology