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Healthcare
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Minimally Invasive Techniques and Advanced Surgical Procedures
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Minimally Invasive Techniques and Advanced Surgical Procedures

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Healthcare Quality and Patient Safety".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 14820

Special Issue Editor

Dr. Panagiotis Fikatas

E-Mail Website
Guest Editor
Charité–Universitätsmedizin Berlin, 13353 Berlin, Germany
Interests: minimally invasive surgery; robotic surgery; hernia repair; colorectal surgery; visceral surgery; innovative surgery; medical devices

Special Issue Information

Dear Colleagues,

Technical progress and continuous improvement of surgical techniques have massively shifted the limits of surgical procedures in recent years. More and more surgeries can be performed minimally invasively in cases that used to require major surgery. In addition, surgical interventions are currently possible for indications that could not be treated surgically in the past.

I would like to invite you to submit your work to the Special Issue ‘’Minimally Invasive Techniques and Advanced Surgical Procedures’’ to explore the extending limits of surgery.  The topic of this Special Issue includes minimally invasive surgeries performed laparoscopically or robotically assisted; microsurgical procedures; less invasive techniques; radiologically guided interventions; the use of innovative surgical methods or medical devices; and extended indications with demanding surgeries of a higher degree of difficulty, beyond regular care surgery.

Dr. Panagiotis Fikatas
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Minimally invasive surgery
  • Laparoscopy
  • Robotic surgery
  • Microsurgical procedures
  • Less invasive techniques
  • The use of radiologically guided interventions
  • Innovative surgical methods
  • Medical devices
  • Extended indications
  • Advanced surgeries

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (6 papers)

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Research

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14 pages, 2510 KiB  
Article
Laparogastroscopy—A Transgastric Laparoscopic Approach for Malignant Esophageal Stenosis
by Alexandra Delia Lupu-Petria, Alexandru Dan Sabau, Dragos Serban, Tiberiu Trotea, Ionela Maniu and Dan Sabau
Healthcare 2023, 11(6), 815; https://doi.org/10.3390/healthcare11060815 - 9 Mar 2023
Cited by 1 | Viewed by 1939
Abstract
This paper presents the laparogastroscopy procedure, a mini-invasive, palliative method as an alternative to gastrostomy to be recommended by gastroenterologists. Laparogastroscopic stenting with endoluminal transtumoral drilling solves the problem of oral nutrition in patients with unresectable esophageal cancer, avoiding percutaneous feeding. The results [...] Read more.
This paper presents the laparogastroscopy procedure, a mini-invasive, palliative method as an alternative to gastrostomy to be recommended by gastroenterologists. Laparogastroscopic stenting with endoluminal transtumoral drilling solves the problem of oral nutrition in patients with unresectable esophageal cancer, avoiding percutaneous feeding. The results of this technique are presented in a retrospective analysis of a study group of 63 patients with advanced esophageal carcinoma admitted between January 2015 and December 2020 at Department of General Surgery of Emergency County Hospital Sibiu, Romania, in terms of post-operative morbidity and mortality. The type of stents used were Pezzer prostheses (48.6%), silicone prostheses (31.9%), and self-expanding metal stents (6.9%). Eight patients (12.7%) had fistulas (at admission to the clinic), which were successfully sealed. Post-operative dysphagia was absent in most patients and minimal in 16.6% of patients, so all patients could initiate oral feeding, improving their nutritional status. The average length of hospitalization for all patients was 9.22 ± 5.05 days. The most frequent local complications were restenosis (9.5%), stent displacement (7.9%), and bleeding (4.8%). The mean survival time was 10.75 ± 15.72 months. Laparogastroscopic stenting could be a valuable alternative in palliative esophageal cancer surgery, improving the quality of life and nutritional status in patients unsuitable for endoscopic stenting. Full article
(This article belongs to the Special Issue Minimally Invasive Techniques and Advanced Surgical Procedures)
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9 pages, 852 KiB  
Article
Microsurgical Reconstruction of Foot Defects: A Case Series with Long-Term Follow-Up
by David Breidung, Panagiotis Fikatas, Patrick Mandal, Maresa D. Berns, Andrè A. Barth, Moritz Billner, Ioannis-Fivos Megas and Bert Reichert
Healthcare 2022, 10(5), 829; https://doi.org/10.3390/healthcare10050829 - 30 Apr 2022
Viewed by 2852
Abstract
(1) Background: Microsurgical reconstruction of foot defects with free flaps is rare as it is a challenging task for a surgeon. For extensive defects, advanced surgical procedures, such as free flap transfer with microsurgical anastomosis, may be the last chance to avoid major [...] Read more.
(1) Background: Microsurgical reconstruction of foot defects with free flaps is rare as it is a challenging task for a surgeon. For extensive defects, advanced surgical procedures, such as free flap transfer with microsurgical anastomosis, may be the last chance to avoid major amputation. The aim of the study was to examine the opportunities and risks posed by free flap reconstruction of foot defects and to illustrate in which situations reconstruction is useful on the basis of case characteristics. (2) Methods: In this study, we retrospectively analyzed data of cases with free flap reconstruction of the foot from 2007 to 2022. Therefore, demographic data, comorbidities, information about the defect situation, data on the operational procedure, and complications were evaluated. (3) Results: A total of 27 cases with free flap coverage of foot defects could be included. In 24 of these cases (89%), defect coverage was successful. In 18 patients, some form of complication occurred in the postoperative stage. The most frequently used flap was the latissimus dorsi flap, with 13 procedures. (4) Conclusions: Foot reconstruction using free flaps is a proven procedure for the treatment of larger foot defects and can offer a predominantly good functional outcome. The lengthy process and possible complications should be thoroughly discussed in advance so as to provide criteria, suitably adjusted to the individual prerequisites of the patients, for deciding whether limb salvage using advanced surgical procedures should be attempted. Full article
(This article belongs to the Special Issue Minimally Invasive Techniques and Advanced Surgical Procedures)
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26 pages, 3799 KiB  
Article
Risk Assessment-Oriented Design of a Needle Insertion Robotic System for Non-Resectable Liver Tumors
by Bogdan Gherman, Nadim Al Hajjar, Paul Tucan, Corina Radu, Calin Vaida, Emil Mois, Alin Burz and Doina Pisla
Healthcare 2022, 10(2), 389; https://doi.org/10.3390/healthcare10020389 - 18 Feb 2022
Cited by 5 | Viewed by 2423
Abstract
Medical robotics is a highly challenging and rewarding field of research, especially in the development of minimally invasive solutions for the treatment of the worldwide leading cause of death, cancer. The aim of the paper is to provide a design methodology for the [...] Read more.
Medical robotics is a highly challenging and rewarding field of research, especially in the development of minimally invasive solutions for the treatment of the worldwide leading cause of death, cancer. The aim of the paper is to provide a design methodology for the development of a safe and efficient medical robotic system for the minimally invasive, percutaneous, targeted treatment of hepatocellular carcinoma, which can be extended with minimal modification for other types of abdominal cancers. Using as input a set of general medical requirements to comply with currently applicable standards, and a set of identified hazards and failure modes, specific methods, such as the Analytical Hierarchy Prioritization, Risk Analysis and fuzzy logic Failure Modes and Effect Analysis have been used within a stepwise approach to help in the development of a medical device targeting the insertion of multiple needles in brachytherapy procedures. The developed medical device, which is visually guided using CT scanning, has been tested for validation in a medical environment using a human-size ballistic gel liver, with promising results. These prove that the robotic system can be used for the proposed medical task, while the modular approach increases the chances of acceptance. Full article
(This article belongs to the Special Issue Minimally Invasive Techniques and Advanced Surgical Procedures)
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11 pages, 1017 KiB  
Article
Health-Related Quality of Life and Mental Health after Surgical Treatment of Hepatocellular Carcinoma in the Era of Minimal-Invasive Surgery: Resection versus Transplantation
by Linda Feldbrügge, Alexander Langenscheidt, Felix Krenzien, Mareike Schulz, Nicco Krezdorn, Kaan Kamali, Andreas Hinz, Michael Bartels, Panagiotis Fikatas, Moritz Schmelzle, Johann Pratschke and Christian Benzing
Healthcare 2021, 9(6), 694; https://doi.org/10.3390/healthcare9060694 - 9 Jun 2021
Cited by 5 | Viewed by 2317
Abstract
Laparoscopic liver resection (LLR) is an increasingly relevant treatment option for patients with resectable hepatocellular carcinoma (HCC). Orthotopic liver transplantation (OLT) has been considered optimal treatment for HCC in cirrhosis, but is challenged by rising organ scarcity. While health-related quality of life (HRQoL) [...] Read more.
Laparoscopic liver resection (LLR) is an increasingly relevant treatment option for patients with resectable hepatocellular carcinoma (HCC). Orthotopic liver transplantation (OLT) has been considered optimal treatment for HCC in cirrhosis, but is challenged by rising organ scarcity. While health-related quality of life (HRQoL) and mental health are well-documented after OLT, little is known about HRQoL in HCC patients after LLR. We identified all HCC patients who underwent LLR at our hospital between 2014 and 2018. HRQoL and mental health were assessed using the Short Form 36 and the Hospital Anxiety and Depression Scale, respectively. Outcomes were compared to a historic cohort of HCC patients after OLT. Ninety-eight patients received LLR for HCC. Postoperative morbidity was 25% with 17% minor complications. LLR patients showed similar overall HRQoL and mental health to OLT recipients, except for lower General Health (p = 0.029) and higher anxiety scores (p = 0.010). We conclude that LLR can be safely performed in patients with HCC, with or without liver cirrhosis. The postoperative HRQoL and mental health are comparable to that of OLT recipients in most aspects. LLR should thus always be considered an alternative to OLT, especially in times of organ shortage. Full article
(This article belongs to the Special Issue Minimally Invasive Techniques and Advanced Surgical Procedures)
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9 pages, 1458 KiB  
Article
Macrophage Migration Inhibitory Factor—An Innovative Indicator for Free Flap Ischemia after Microsurgical Reconstruction
by Ioannis-Fivos Megas, David Simons, Bong-Sung Kim, Christian Stoppe, Andrzej Piatkowski, Panagiotis Fikatas, Paul Christian Fuchs, Jacqueline Bastiaanse, Norbert Pallua, Jürgen Bernhagen and Gerrit Grieb
Healthcare 2021, 9(6), 616; https://doi.org/10.3390/healthcare9060616 - 21 May 2021
Cited by 5 | Viewed by 1853
Abstract
(1) Background: Nowadays, the use of microsurgical free flaps is a standard operative procedure in reconstructive surgery. Still, thrombosis of the microanastomosis is one of the most fatal postoperative complications. Clinical evaluation, different technical devices and laboratory markers are used to monitor critical [...] Read more.
(1) Background: Nowadays, the use of microsurgical free flaps is a standard operative procedure in reconstructive surgery. Still, thrombosis of the microanastomosis is one of the most fatal postoperative complications. Clinical evaluation, different technical devices and laboratory markers are used to monitor critical flap perfusion. Macrophage migration inhibitory factor (MIF), a structurally unique cytokine with chemokine-like characteristics, could play a role in predicting vascular problems and the failure of flap perfusion. (2) Methods: In this prospective observational study, 26 subjects that underwent microsurgical reconstruction were observed. Besides clinical data, the number of blood leukocytes, CRP and MIF were monitored. (3) Results: Blood levels of MIF, C-reactive protein (CRP) and leukocytes increased directly after surgery. Subjects that needed surgical revision due to thrombosis of the microanastomosis showed significantly higher blood levels of MIF than subjects without revision. (4) Conclusion: We conclude that MIF is a potential and innovative indicator for thrombosis of the microanastomosis after free flap surgery. Since it is easy to obtain diagnostically, MIF could be an additional tool to monitor flap perfusion besides clinical and technical assessments. Full article
(This article belongs to the Special Issue Minimally Invasive Techniques and Advanced Surgical Procedures)
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8 pages, 2989 KiB  
Case Report
Hemoperitoneum as a Life-Threatening Complication of an Acute Cholecystitis in a Patient with Hemophilia A with Inhibitors: A Case Report
by Oana Viola Badulescu, Adelina Papancea, Nina Filip, Bogdan Mihnea Ciuntu, Ciprian Cirdeiu, Gabriela Bordeianu, Dan Vintila, Minerva Codruta Badescu, Manuela Ciocoiu and Stefan Octavian Georgescu
Healthcare 2022, 10(9), 1652; https://doi.org/10.3390/healthcare10091652 - 30 Aug 2022
Viewed by 1604
Abstract
We present the case of a 52-year-old male with severe hemophilia A with inhibitors, who was diagnosticated with acute lithiasic cholecystitis that required surgical intervention due to lack of favorable response to conservatory treatment. During surgery, hemostatic support was performed with activated recombinant [...] Read more.
We present the case of a 52-year-old male with severe hemophilia A with inhibitors, who was diagnosticated with acute lithiasic cholecystitis that required surgical intervention due to lack of favorable response to conservatory treatment. During surgery, hemostatic support was performed with activated recombinant factor VII (rFVIIa, NovoSeven®). The surgery was performed first laparoscopically with adhesiolysis, followed by subcostal laparotomy and cholecystectomy because of the findings of a pericholecystic plastron with abscess and massive inflammatory anatomical modifications. The patient presented postoperative complications, requiring a second surgical intervention, due to the installation of a hemoperitoneum. Hemostatic treatment with rFVIIa was given for a further 3 weeks postoperatively, and the patient was discharged in safe condition. A surgical intervention increases the risk of bleeding in hemophilic patients, which may have vital complications in the absence of adequate hemostatic support and the support of a multidisciplinary team with experience in hemophilic surgery. Full article
(This article belongs to the Special Issue Minimally Invasive Techniques and Advanced Surgical Procedures)
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