Pub Date : 2024-02-22eCollection Date: 2023-12-01DOI: 10.1515/iss-2023-0040
Beate Blank, Aijia Cai
In microsurgery, many different imaging techniques are available in both flap and lymphatic surgery that all come with their own advantages and disadvantages. In flap surgery, CT angiography is considered as the gold standard. Among others, Doppler ultrasound, color Doppler ultrasound, ICG, and smartphone-based thermal cameras are valuable imaging techniques. In lymphatic surgery, photoacoustic imaging, laser tomography, contrast-enhanced magnetic resonance imaging, and high frequency ultrasound stand available to surgeons next to the current standard of lymphoscintigraphy. It is crucial to know the advantages and disadvantages to various techniques and highly adviced to microsurgeons be capable of using a variety of them.
{"title":"Imaging in reconstructive microsurgery - current standards and latest trends.","authors":"Beate Blank, Aijia Cai","doi":"10.1515/iss-2023-0040","DOIUrl":"10.1515/iss-2023-0040","url":null,"abstract":"<p><p>In microsurgery, many different imaging techniques are available in both flap and lymphatic surgery that all come with their own advantages and disadvantages. In flap surgery, CT angiography is considered as the gold standard. Among others, Doppler ultrasound, color Doppler ultrasound, ICG, and smartphone-based thermal cameras are valuable imaging techniques. In lymphatic surgery, photoacoustic imaging, laser tomography, contrast-enhanced magnetic resonance imaging, and high frequency ultrasound stand available to surgeons next to the current standard of lymphoscintigraphy. It is crucial to know the advantages and disadvantages to various techniques and highly adviced to microsurgeons be capable of using a variety of them.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andreas Stalder, Federico Mazzola, Michel Adamina, René Fahrner
Since its introduction as a clinical technique, robotic surgery has been extended to different fields of surgery. However, the indications as well as the number of robotic procedures varied in different institutions. The aim of this investigation was to evaluate the current use of robotic surgery in general and digestive surgery in Switzerland. All Swiss surgical departments that are recognized training institutes for postgraduate training in surgery by the Swiss Institute of Medical Education (SIWF) were queried with a detailed questionnaire regarding the use of robotic surgery techniques and were analyzed regarding hospital size and type of hospital. Ninety-three departments were queried, and 67 % (n=63) answered the survey. Fifty-eight were public, and five were private institutions. Seventeen (26 %) of the queried departments used robotic surgery in digestive surgery. Four out of 17 (23 %) of the departments that performed robotic surgery were private hospitals, while 13 (77 %) were public institutions. In the majority of departments, robotic surgery of the rectum (n=12; 70.6 %) and colon (n=11; 64.7 %) was performed, followed by hernia procedures (n=8; 47.1 %) and fundoplication (n=7; 41.2 %). Less frequently, pancreatic resections (n=5; 29.4 %), cholecystectomy (n=4; 23.5 %), adrenalectomy (n=4; 23.5 %), gastric bypass (n=3; 17.7 %), gastric sleeve (n=3; 17.7 %), hepatic procedures (n=2; 11.7 %), or small bowel resections (n=1; 5.9 %) were performed as robotic procedures. More than 25 procedures per year per department were performed for hernia surgery (n=5 departments), gastric bypass (n=2 departments), cholecystectomy, fundoplication, and colon surgery (each n=1 department). The number and range of robotic procedures performed in Switzerland varied widely. Higher accreditation for general surgery or subspecialization of visceral surgery of the department was positively associated with the use of robotic techniques, reflecting an unequal availability of robotic surgery.
{"title":"The distribution of robotic surgery in general and visceral surgery departments in Switzerland – a nationwide inquiry","authors":"Andreas Stalder, Federico Mazzola, Michel Adamina, René Fahrner","doi":"10.1515/iss-2023-0052","DOIUrl":"https://doi.org/10.1515/iss-2023-0052","url":null,"abstract":"\u0000 \u0000 \u0000 Since its introduction as a clinical technique, robotic surgery has been extended to different fields of surgery. However, the indications as well as the number of robotic procedures varied in different institutions. The aim of this investigation was to evaluate the current use of robotic surgery in general and digestive surgery in Switzerland.\u0000 \u0000 \u0000 \u0000 All Swiss surgical departments that are recognized training institutes for postgraduate training in surgery by the Swiss Institute of Medical Education (SIWF) were queried with a detailed questionnaire regarding the use of robotic surgery techniques and were analyzed regarding hospital size and type of hospital.\u0000 \u0000 \u0000 \u0000 Ninety-three departments were queried, and 67 % (n=63) answered the survey. Fifty-eight were public, and five were private institutions. Seventeen (26 %) of the queried departments used robotic surgery in digestive surgery. Four out of 17 (23 %) of the departments that performed robotic surgery were private hospitals, while 13 (77 %) were public institutions. In the majority of departments, robotic surgery of the rectum (n=12; 70.6 %) and colon (n=11; 64.7 %) was performed, followed by hernia procedures (n=8; 47.1 %) and fundoplication (n=7; 41.2 %). Less frequently, pancreatic resections (n=5; 29.4 %), cholecystectomy (n=4; 23.5 %), adrenalectomy (n=4; 23.5 %), gastric bypass (n=3; 17.7 %), gastric sleeve (n=3; 17.7 %), hepatic procedures (n=2; 11.7 %), or small bowel resections (n=1; 5.9 %) were performed as robotic procedures. More than 25 procedures per year per department were performed for hernia surgery (n=5 departments), gastric bypass (n=2 departments), cholecystectomy, fundoplication, and colon surgery (each n=1 department).\u0000 \u0000 \u0000 \u0000 The number and range of robotic procedures performed in Switzerland varied widely. Higher accreditation for general surgery or subspecialization of visceral surgery of the department was positively associated with the use of robotic techniques, reflecting an unequal availability of robotic surgery.\u0000","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139958882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This review aims to provide an overview of diagnosing and managing traumatic haemothorax for young surgeons. Of 27,333 polytrauma patients in Germany in 2021, 35 % were admitted with thoracic trauma. In polytrauma patients, chest injuries are an independent negative predictor of 30-day mortality. These patients should be treated in an evidence-based and standardized manner to reduce mortality and morbidity. There are several methods of immediate diagnosis that should be used depending on hemodynamic stability. In addition to physical examination and chest X-ray, more specific techniques such as the eFAST protocol and Computed tomography (CT) of the chest are available. Once the source of bleeding has been identified, acute treatment is given depending on hemodynamic stability. Thoracic drainage remains the gold standard in the initial management of hemothorax. If surgery is required because of an active source of bleeding, a hemothorax that has not been completely relieved, or associated injuries, either a minimally invasive or open approach can be used. The main focus is to stabilize the patient and avoid early and late complications. Rapid and prompt diagnosis and management of traumatic hemothorax is essential for patient outcome and should be taught to all young surgeons who are in direct contact with these patients.
{"title":"From diagnosis to therapy: the acute traumatic hemothorax – an orientation for young surgeons","authors":"Romina M. Rösch","doi":"10.1515/iss-2023-0062","DOIUrl":"https://doi.org/10.1515/iss-2023-0062","url":null,"abstract":"\u0000 \u0000 \u0000 This review aims to provide an overview of diagnosing and managing traumatic haemothorax for young surgeons.\u0000 \u0000 \u0000 \u0000 Of 27,333 polytrauma patients in Germany in 2021, 35 % were admitted with thoracic trauma. In polytrauma patients, chest injuries are an independent negative predictor of 30-day mortality. These patients should be treated in an evidence-based and standardized manner to reduce mortality and morbidity. There are several methods of immediate diagnosis that should be used depending on hemodynamic stability. In addition to physical examination and chest X-ray, more specific techniques such as the eFAST protocol and Computed tomography (CT) of the chest are available. Once the source of bleeding has been identified, acute treatment is given depending on hemodynamic stability. Thoracic drainage remains the gold standard in the initial management of hemothorax. If surgery is required because of an active source of bleeding, a hemothorax that has not been completely relieved, or associated injuries, either a minimally invasive or open approach can be used. The main focus is to stabilize the patient and avoid early and late complications.\u0000 \u0000 \u0000 \u0000 Rapid and prompt diagnosis and management of traumatic hemothorax is essential for patient outcome and should be taught to all young surgeons who are in direct contact with these patients.\u0000","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139833368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This review aims to provide an overview of diagnosing and managing traumatic haemothorax for young surgeons. Of 27,333 polytrauma patients in Germany in 2021, 35 % were admitted with thoracic trauma. In polytrauma patients, chest injuries are an independent negative predictor of 30-day mortality. These patients should be treated in an evidence-based and standardized manner to reduce mortality and morbidity. There are several methods of immediate diagnosis that should be used depending on hemodynamic stability. In addition to physical examination and chest X-ray, more specific techniques such as the eFAST protocol and Computed tomography (CT) of the chest are available. Once the source of bleeding has been identified, acute treatment is given depending on hemodynamic stability. Thoracic drainage remains the gold standard in the initial management of hemothorax. If surgery is required because of an active source of bleeding, a hemothorax that has not been completely relieved, or associated injuries, either a minimally invasive or open approach can be used. The main focus is to stabilize the patient and avoid early and late complications. Rapid and prompt diagnosis and management of traumatic hemothorax is essential for patient outcome and should be taught to all young surgeons who are in direct contact with these patients.
{"title":"From diagnosis to therapy: the acute traumatic hemothorax – an orientation for young surgeons","authors":"Romina M. Rösch","doi":"10.1515/iss-2023-0062","DOIUrl":"https://doi.org/10.1515/iss-2023-0062","url":null,"abstract":"\u0000 \u0000 \u0000 This review aims to provide an overview of diagnosing and managing traumatic haemothorax for young surgeons.\u0000 \u0000 \u0000 \u0000 Of 27,333 polytrauma patients in Germany in 2021, 35 % were admitted with thoracic trauma. In polytrauma patients, chest injuries are an independent negative predictor of 30-day mortality. These patients should be treated in an evidence-based and standardized manner to reduce mortality and morbidity. There are several methods of immediate diagnosis that should be used depending on hemodynamic stability. In addition to physical examination and chest X-ray, more specific techniques such as the eFAST protocol and Computed tomography (CT) of the chest are available. Once the source of bleeding has been identified, acute treatment is given depending on hemodynamic stability. Thoracic drainage remains the gold standard in the initial management of hemothorax. If surgery is required because of an active source of bleeding, a hemothorax that has not been completely relieved, or associated injuries, either a minimally invasive or open approach can be used. The main focus is to stabilize the patient and avoid early and late complications.\u0000 \u0000 \u0000 \u0000 Rapid and prompt diagnosis and management of traumatic hemothorax is essential for patient outcome and should be taught to all young surgeons who are in direct contact with these patients.\u0000","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139773757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral cancer is among the most common tumour worldwide. Due to the anatomical peculiarities of the head and neck region, the treatment of oral cancer is a major challenge with regard to the preservation of aesthetics and function. The aim of the present study is to analyze currently practiced therapeutic strategies as well as current and future challenges in the therapy of oral cancer. A Pubmed-based selective literature search was performed considering literature predominantly from 2021 to 2022. Search terms were “oral cancer,” “oral cavity cancer,” and “head and neck cancer.” Head and neck tumours are the seventh most common cancer worldwide. The suspected diagnosis of oral cancer is often made by outpatient dentists during routine examinations. With the outbreak of the 2020 COVID 19 pandemic, risk behaviour has changed with regard to the development and diagnosis of oral cancer. The gold standard of therapy is surgical resection. The need for adjuvant therapy measures depends on the histopathological TNM stage and other defined risk factors. Recurrences occur frequently and should be evaluated with regard to renewed surgical therapy. Future treatment strategies are aimed at early diagnosis, precision in resection, the use of digital technologies, and aspects of quality assurance. The economic importance in the treatment of oral cancer is currently given little consideration. The study presents a selective portfolio of treatment strategies currently practiced in Germany and in many parts of the world. In addition, future challenges in the therapy of oral cancer, in particular squamosa cell carcinoma, are presented.
{"title":"Best practices and future challenges in the treatment of oral cancer","authors":"Juliane Kröplin, Jil-Charlot Reppenhagen","doi":"10.1515/iss-2023-0031","DOIUrl":"https://doi.org/10.1515/iss-2023-0031","url":null,"abstract":"\u0000 \u0000 \u0000 Oral cancer is among the most common tumour worldwide. Due to the anatomical peculiarities of the head and neck region, the treatment of oral cancer is a major challenge with regard to the preservation of aesthetics and function. The aim of the present study is to analyze currently practiced therapeutic strategies as well as current and future challenges in the therapy of oral cancer.\u0000 \u0000 \u0000 \u0000 A Pubmed-based selective literature search was performed considering literature predominantly from 2021 to 2022. Search terms were “oral cancer,” “oral cavity cancer,” and “head and neck cancer.”\u0000 \u0000 \u0000 \u0000 Head and neck tumours are the seventh most common cancer worldwide. The suspected diagnosis of oral cancer is often made by outpatient dentists during routine examinations. With the outbreak of the 2020 COVID 19 pandemic, risk behaviour has changed with regard to the development and diagnosis of oral cancer. The gold standard of therapy is surgical resection. The need for adjuvant therapy measures depends on the histopathological TNM stage and other defined risk factors. Recurrences occur frequently and should be evaluated with regard to renewed surgical therapy. Future treatment strategies are aimed at early diagnosis, precision in resection, the use of digital technologies, and aspects of quality assurance. The economic importance in the treatment of oral cancer is currently given little consideration.\u0000 \u0000 \u0000 \u0000 The study presents a selective portfolio of treatment strategies currently practiced in Germany and in many parts of the world. In addition, future challenges in the therapy of oral cancer, in particular squamosa cell carcinoma, are presented.\u0000","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139803109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral cancer is among the most common tumour worldwide. Due to the anatomical peculiarities of the head and neck region, the treatment of oral cancer is a major challenge with regard to the preservation of aesthetics and function. The aim of the present study is to analyze currently practiced therapeutic strategies as well as current and future challenges in the therapy of oral cancer. A Pubmed-based selective literature search was performed considering literature predominantly from 2021 to 2022. Search terms were “oral cancer,” “oral cavity cancer,” and “head and neck cancer.” Head and neck tumours are the seventh most common cancer worldwide. The suspected diagnosis of oral cancer is often made by outpatient dentists during routine examinations. With the outbreak of the 2020 COVID 19 pandemic, risk behaviour has changed with regard to the development and diagnosis of oral cancer. The gold standard of therapy is surgical resection. The need for adjuvant therapy measures depends on the histopathological TNM stage and other defined risk factors. Recurrences occur frequently and should be evaluated with regard to renewed surgical therapy. Future treatment strategies are aimed at early diagnosis, precision in resection, the use of digital technologies, and aspects of quality assurance. The economic importance in the treatment of oral cancer is currently given little consideration. The study presents a selective portfolio of treatment strategies currently practiced in Germany and in many parts of the world. In addition, future challenges in the therapy of oral cancer, in particular squamosa cell carcinoma, are presented.
{"title":"Best practices and future challenges in the treatment of oral cancer","authors":"Juliane Kröplin, Jil-Charlot Reppenhagen","doi":"10.1515/iss-2023-0031","DOIUrl":"https://doi.org/10.1515/iss-2023-0031","url":null,"abstract":"\u0000 \u0000 \u0000 Oral cancer is among the most common tumour worldwide. Due to the anatomical peculiarities of the head and neck region, the treatment of oral cancer is a major challenge with regard to the preservation of aesthetics and function. The aim of the present study is to analyze currently practiced therapeutic strategies as well as current and future challenges in the therapy of oral cancer.\u0000 \u0000 \u0000 \u0000 A Pubmed-based selective literature search was performed considering literature predominantly from 2021 to 2022. Search terms were “oral cancer,” “oral cavity cancer,” and “head and neck cancer.”\u0000 \u0000 \u0000 \u0000 Head and neck tumours are the seventh most common cancer worldwide. The suspected diagnosis of oral cancer is often made by outpatient dentists during routine examinations. With the outbreak of the 2020 COVID 19 pandemic, risk behaviour has changed with regard to the development and diagnosis of oral cancer. The gold standard of therapy is surgical resection. The need for adjuvant therapy measures depends on the histopathological TNM stage and other defined risk factors. Recurrences occur frequently and should be evaluated with regard to renewed surgical therapy. Future treatment strategies are aimed at early diagnosis, precision in resection, the use of digital technologies, and aspects of quality assurance. The economic importance in the treatment of oral cancer is currently given little consideration.\u0000 \u0000 \u0000 \u0000 The study presents a selective portfolio of treatment strategies currently practiced in Germany and in many parts of the world. In addition, future challenges in the therapy of oral cancer, in particular squamosa cell carcinoma, are presented.\u0000","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139863317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Horner syndrome (HS) is a rare complication of thyroid surgery. However, the relationship between the occurrence of HS and thyroid upper pole injury is still not completely clear, and there are only few reports. A 24-year-old female underwent endoscopic thyroidectomy for thyroid papillary carcinoma. The intraoperative examination found that the upper pole of the thyroid was bleeding. During hemostasis, the ultrasonic knife consciously peeled too deep and stopped. The patient developed HS immediately after operation. We analyzed the association between deep dissection of the upper thyroid pole and an increase in the HS incidence rate through literature searches and anatomical relationships. Our case report discussed the potential relationship between the degree of thyroid upper pole dissection and the occurrence of HS in routine thyroid surgery, and provided a warning for the degree of thyroid upper pole dissection in the clinic to avoid HS.
{"title":"Horner syndrome immediately after deep dissection of upper thyroid pole: a case report and review of the literature","authors":"Hongdan Chen, Yiceng Sun, Mi Tang, Fan Zhang","doi":"10.1515/iss-2023-0056","DOIUrl":"https://doi.org/10.1515/iss-2023-0056","url":null,"abstract":"\u0000 \u0000 \u0000 Horner syndrome (HS) is a rare complication of thyroid surgery. However, the relationship between the occurrence of HS and thyroid upper pole injury is still not completely clear, and there are only few reports.\u0000 \u0000 \u0000 \u0000 A 24-year-old female underwent endoscopic thyroidectomy for thyroid papillary carcinoma. The intraoperative examination found that the upper pole of the thyroid was bleeding. During hemostasis, the ultrasonic knife consciously peeled too deep and stopped. The patient developed HS immediately after operation. We analyzed the association between deep dissection of the upper thyroid pole and an increase in the HS incidence rate through literature searches and anatomical relationships.\u0000 \u0000 \u0000 \u0000 Our case report discussed the potential relationship between the degree of thyroid upper pole dissection and the occurrence of HS in routine thyroid surgery, and provided a warning for the degree of thyroid upper pole dissection in the clinic to avoid HS.\u0000","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139869645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Horner syndrome (HS) is a rare complication of thyroid surgery. However, the relationship between the occurrence of HS and thyroid upper pole injury is still not completely clear, and there are only few reports. A 24-year-old female underwent endoscopic thyroidectomy for thyroid papillary carcinoma. The intraoperative examination found that the upper pole of the thyroid was bleeding. During hemostasis, the ultrasonic knife consciously peeled too deep and stopped. The patient developed HS immediately after operation. We analyzed the association between deep dissection of the upper thyroid pole and an increase in the HS incidence rate through literature searches and anatomical relationships. Our case report discussed the potential relationship between the degree of thyroid upper pole dissection and the occurrence of HS in routine thyroid surgery, and provided a warning for the degree of thyroid upper pole dissection in the clinic to avoid HS.
{"title":"Horner syndrome immediately after deep dissection of upper thyroid pole: a case report and review of the literature","authors":"Hongdan Chen, Yiceng Sun, Mi Tang, Fan Zhang","doi":"10.1515/iss-2023-0056","DOIUrl":"https://doi.org/10.1515/iss-2023-0056","url":null,"abstract":"\u0000 \u0000 \u0000 Horner syndrome (HS) is a rare complication of thyroid surgery. However, the relationship between the occurrence of HS and thyroid upper pole injury is still not completely clear, and there are only few reports.\u0000 \u0000 \u0000 \u0000 A 24-year-old female underwent endoscopic thyroidectomy for thyroid papillary carcinoma. The intraoperative examination found that the upper pole of the thyroid was bleeding. During hemostasis, the ultrasonic knife consciously peeled too deep and stopped. The patient developed HS immediately after operation. We analyzed the association between deep dissection of the upper thyroid pole and an increase in the HS incidence rate through literature searches and anatomical relationships.\u0000 \u0000 \u0000 \u0000 Our case report discussed the potential relationship between the degree of thyroid upper pole dissection and the occurrence of HS in routine thyroid surgery, and provided a warning for the degree of thyroid upper pole dissection in the clinic to avoid HS.\u0000","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139809688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Liver surgery is the cornerstone of the curative treatment of malignant liver tumors. However, the liver anatomy is very complex, and liver surgery is still associated with relevant morbidity despite many technical advances. The Brisbane nomenclature is used worldwide to classify liver resection. However, this nomenclature has several limitations as multiple terms are used for the same type of resection. Non-anatomical resections, multiple resections, and combined bilio-vascular resections were not mentioned. Therefore, new terminologies have been proposed for the precise and simple classification of liver resection. Furthermore, in recent years, many technical innovations have been introduced in liver surgery, such as 3D imaging systems and indocyanine green fluorescence, for better preoperative and intraoperative identification of tumor localization and critical vascular structures. Minimally invasive techniques are used more frequently in liver surgery. Potential benefits include less intraoperative blood loss, less pain, and a shorter hospital stay. The implementation of robotic systems also has an impact on liver surgery, and the number of cases reported in the literature is constantly increasing. The potential benefits of robotic liver resection over laparoscopic liver resection will be the subject of future studies.
{"title":"An update on liver surgery – a new terminology and modern techniques","authors":"V. Tripke, Nils Sommer","doi":"10.1515/iss-2023-0032","DOIUrl":"https://doi.org/10.1515/iss-2023-0032","url":null,"abstract":"Abstract Liver surgery is the cornerstone of the curative treatment of malignant liver tumors. However, the liver anatomy is very complex, and liver surgery is still associated with relevant morbidity despite many technical advances. The Brisbane nomenclature is used worldwide to classify liver resection. However, this nomenclature has several limitations as multiple terms are used for the same type of resection. Non-anatomical resections, multiple resections, and combined bilio-vascular resections were not mentioned. Therefore, new terminologies have been proposed for the precise and simple classification of liver resection. Furthermore, in recent years, many technical innovations have been introduced in liver surgery, such as 3D imaging systems and indocyanine green fluorescence, for better preoperative and intraoperative identification of tumor localization and critical vascular structures. Minimally invasive techniques are used more frequently in liver surgery. Potential benefits include less intraoperative blood loss, less pain, and a shorter hospital stay. The implementation of robotic systems also has an impact on liver surgery, and the number of cases reported in the literature is constantly increasing. The potential benefits of robotic liver resection over laparoscopic liver resection will be the subject of future studies.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objectives The gold standard for the treatment of pathologies of the aortic arch remains the open surgical reconstruction of the affected segments. However, endovas-cular treatment options have emerged that eliminate the need for invasive open surgery. Several endograft devices – with fenestrations or branches for the supraaortic vessels – are currently available to address different pathologies and anatomical variations. Parallel-graft techniques and in situ fenestrations expand the treatment options for emergent cases. In this selective review of the literature of 2020 and 2021, we summarize the current chances and challenges of endovascular aortic repair. Content Reported mortality rates range from 0 to 13.2 %. Although technical success rates for fenestrated and branched devices are promising (98 %), stroke rates remain a relevant issue (10 and 3 % for BTEVAR and FTEVAR respectively). The reported technical success rate for in situ fenestrations is also encouraging (94 %) and the stroke rates acceptable (5 %). Parallel-graft techniques are associated with high early and late endoleak rates (early 76 %; late 31 %), but still hold a valuable place in the treatment of emergent cases or in bail-out situations. Summary and Outlook The endovascular repair of the aortic arch expands the range of patients with pathologies of the arch eligible for treatment to those unfit for open surgery offering a minimally invasive, yet technically challenging procedure. More data and meta-analyses are needed to define the benefits and drawbacks of this promising treatment option in an aging population with increasing co-morbidities.
{"title":"Endovascular repair of the aortic arch","authors":"Florian Kursch, Panagiotis Doukas","doi":"10.1515/iss-2023-0029","DOIUrl":"https://doi.org/10.1515/iss-2023-0029","url":null,"abstract":"Abstract Objectives The gold standard for the treatment of pathologies of the aortic arch remains the open surgical reconstruction of the affected segments. However, endovas-cular treatment options have emerged that eliminate the need for invasive open surgery. Several endograft devices – with fenestrations or branches for the supraaortic vessels – are currently available to address different pathologies and anatomical variations. Parallel-graft techniques and in situ fenestrations expand the treatment options for emergent cases. In this selective review of the literature of 2020 and 2021, we summarize the current chances and challenges of endovascular aortic repair. Content Reported mortality rates range from 0 to 13.2 %. Although technical success rates for fenestrated and branched devices are promising (98 %), stroke rates remain a relevant issue (10 and 3 % for BTEVAR and FTEVAR respectively). The reported technical success rate for in situ fenestrations is also encouraging (94 %) and the stroke rates acceptable (5 %). Parallel-graft techniques are associated with high early and late endoleak rates (early 76 %; late 31 %), but still hold a valuable place in the treatment of emergent cases or in bail-out situations. Summary and Outlook The endovascular repair of the aortic arch expands the range of patients with pathologies of the arch eligible for treatment to those unfit for open surgery offering a minimally invasive, yet technically challenging procedure. More data and meta-analyses are needed to define the benefits and drawbacks of this promising treatment option in an aging population with increasing co-morbidities.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139172810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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