Surgical Techniques Development

645 KiB

Open AccessArticle

Retroperitoneal Hand-Assisted Laparoscopic Nephrectomy and Partial Nephrectomy

by Nosratollah Nezakatzgoo, Janet L. Colli, Matthew Mutter, Sheg Aranmolate and Robert Wake

Surg. Tech. Dev. 2013, 3(1), e3; https://doi.org/10.4081/std.2013.e3 - 7 Nov 2013

The purpose of the present paper is to describe our technique and experience with retroperitoneal hand-assisted laparoscopic (HAL) nephrectomies as an alternative to the transperitoneal approach. Eight retroperitoneal HAL nephrectomies and one partial nephrectomy were performed. Several excisional techniques were employed incorporating the [...] Read more.

The purpose of the present paper is to describe our technique and experience with retroperitoneal hand-assisted laparoscopic (HAL) nephrectomies as an alternative to the transperitoneal approach. Eight retroperitoneal HAL nephrectomies and one partial nephrectomy were performed. Several excisional techniques were employed incorporating the Harmonic scalpel or Ligasure device. Hemostatic agents were used to cover the renal defect. Surgical bolsters were sutured to the renal capsule with pleget reinforcements to aid in hemostasis. The average operative time was 210 min and estimated blood loss 110 mL. Mean change in hematocrit was 3 units and creatinine was 1 point. No patient required a transfusion. There were no major complications, with a mean follow-up of fourteen months. On average, patients resumed oral intake in 2 days, and were discharged in 3 days. Pathological examination revealed that two lesions were benign and seven malignant. Tumor diameter averaged 3 cm. There were no positive surgical margins. In conclusion, we have demonstrated the feasibility of retroperitoneal laparoscopic hand-assisted nephrectomy and partial nephrectomy surgery for solid renal masses. Full article

759 KiB

Open AccessArticle

The Use of Interstitial Echo-Guided Diode Laser 980-nm for Deep Vascular Anomalies in Pediatric Patients: A Preliminary Study

by Luigino Santecchia, Maria Francesca Bianciardi Valassina, Guido Ciprandi, Rodolfo Fruhwirth and Mario Zama

Surg. Tech. Dev. 2013, 3(1), e2; https://doi.org/10.4081/std.2013.e2 - 23 Sep 2013

Abstract

A wide range of therapeutic options is available to treat vascular anomalies, arising from the systemic therapies to surgery or using lasers. The purpose of this preliminary study is to assess the effectiveness of treatment of vascular anomalies anywhere in the body, along [...] Read more.

A wide range of therapeutic options is available to treat vascular anomalies, arising from the systemic therapies to surgery or using lasers. The purpose of this preliminary study is to assess the effectiveness of treatment of vascular anomalies anywhere in the body, along with the use of interstitial echo-guided 980 nm diode laser. The analysis occurs through accurate angio magnetic resonance imaging (MRI) pre- and post-treatment measurements. We enrolled all the patients (16) affected on vascular malformations everywhere in the body, treated from January to August 2012. We obtained excellent results in 6 patients (37.5%) with mean mass reduction of 85%, good in 9 patients (56%) with mean mass reduction of 65% and unsatisfactory in 1 patient (6%). In pediatric patients, low-flow vascular malformations resistant to progressive sclerotherapy or in critical anatomical sites, benefit of echo guided interstitial 980-nm diode laser.
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Open AccessCase Report

One Stage Implant-Based Reconstruction of the Breast in a Single Patient: Comparison between Mesh and Modified Dual Plane Technique

by Egidio Riggio, Joseph Ottolenghi, Veronica Grassi and Maurizio Nava

Surg. Tech. Dev. 2013, 3(1), e1; https://doi.org/10.4081/std.2013.e1 - 9 Aug 2013

Cited by 1

Abstract

Acellular dermal matrix and similar meshes are used in breast reconstruction to cover the inferior implant pocket. We considered whether using a modified dual-plane technique in immediate breast reconstruction could improve the outcome when compared with mesh reconstruction. The paper presents a case [...] Read more.

Acellular dermal matrix and similar meshes are used in breast reconstruction to cover the inferior implant pocket. We considered whether using a modified dual-plane technique in immediate breast reconstruction could improve the outcome when compared with mesh reconstruction. The paper presents a case of a patient who underwent one-stage bilateral immediate breast reconstruction (IBR) with 470 g implants, using alloplastic mesh in one side and the composed dual-plane pocket in the other. In the case described, the composed dual plane technique gave a better result in terms of absence of rippling and smoother surface at the palpation; the mesh coverage gave a better inframammary contour. Our case suggests that the modified dual-plane technique gives a satisfactory cosmetic outcome. It also reduces costs and avoids mesh-related complications. This technique should therefore be considered as an option to the mesh in implant-based breast reconstruction. Full article

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Surg. Tech. Dev., Volume 3, Issue 1 (August 2013) – 3 articles

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