As surgeons formidably continue to forge into the twentytwenties,after a considerably coronavirus-induced rocky start,one can predict that the era of minimally invasive surgery(mIS),an era of robotics,telehealth,and e...As surgeons formidably continue to forge into the twentytwenties,after a considerably coronavirus-induced rocky start,one can predict that the era of minimally invasive surgery(mIS),an era of robotics,telehealth,and enhanced recovery after surgery(ERAS■),is not only here to stay but will continue to thrive,develop,and transform our practices.Critics of robotics platforms would be hard pressed not to indulge in this prediction.Will the satisfyingly large midline“stem to stern”,the impressing exposuregenerating Makuuchi or transverse abdominal,the Kocher,paramedian,McBurney,Chevron,and Pfannenstiel incisions begin to disappear and fade away into a scar minimizing future precluding trauma laparotomies?Most likely not.Understanding and developing the skill and technique for a minimally invasive“mIS”approach does not negate or abrogate the maximally invasive“MIS”ones.It is not one or the other;not a“to be or not to be”Shakespearean scenario.Hepatobiliary surgery is a qualified landscape upon which to illuminate and exemplify this declaration:the necessity and companionship of“mIS”and“MIS”–minimally and maximally invasive surgery.展开更多
To the Editor,Tumor invasion of the inferior vena cava(IVC)through direct erosion is a rare and poor prognostic feature of aggressive hepatic or perihepatic malignancies[1,2].Literature shows poor response to chemothe...To the Editor,Tumor invasion of the inferior vena cava(IVC)through direct erosion is a rare and poor prognostic feature of aggressive hepatic or perihepatic malignancies[1,2].Literature shows poor response to chemotherapy,such that resection often is the only option for improved survival[3].Multidisciplinary collaborations can expand technical options;incorporation of transplant techniques has led to successful R0 resection involving difficult vascular reconstruction and extended resection[4,5].This study describes and analyzes the ten-year collaborative experience of hepatobiliary(HPB)surgeons in management of malignancies involving the perihepatic IVC.展开更多
文摘As surgeons formidably continue to forge into the twentytwenties,after a considerably coronavirus-induced rocky start,one can predict that the era of minimally invasive surgery(mIS),an era of robotics,telehealth,and enhanced recovery after surgery(ERAS■),is not only here to stay but will continue to thrive,develop,and transform our practices.Critics of robotics platforms would be hard pressed not to indulge in this prediction.Will the satisfyingly large midline“stem to stern”,the impressing exposuregenerating Makuuchi or transverse abdominal,the Kocher,paramedian,McBurney,Chevron,and Pfannenstiel incisions begin to disappear and fade away into a scar minimizing future precluding trauma laparotomies?Most likely not.Understanding and developing the skill and technique for a minimally invasive“mIS”approach does not negate or abrogate the maximally invasive“MIS”ones.It is not one or the other;not a“to be or not to be”Shakespearean scenario.Hepatobiliary surgery is a qualified landscape upon which to illuminate and exemplify this declaration:the necessity and companionship of“mIS”and“MIS”–minimally and maximally invasive surgery.
文摘To the Editor,Tumor invasion of the inferior vena cava(IVC)through direct erosion is a rare and poor prognostic feature of aggressive hepatic or perihepatic malignancies[1,2].Literature shows poor response to chemotherapy,such that resection often is the only option for improved survival[3].Multidisciplinary collaborations can expand technical options;incorporation of transplant techniques has led to successful R0 resection involving difficult vascular reconstruction and extended resection[4,5].This study describes and analyzes the ten-year collaborative experience of hepatobiliary(HPB)surgeons in management of malignancies involving the perihepatic IVC.
