Minimally invasive surgery started spreading worldwide in 1987,when the first laparoscopic cholecystectomy was performed.Meanwhile,improvement of endoscopic equipment and instruments allowed gastroenterologists to att...Minimally invasive surgery started spreading worldwide in 1987,when the first laparoscopic cholecystectomy was performed.Meanwhile,improvement of endoscopic equipment and instruments allowed gastroenterologists to attempt more aggressive endoluminal interventions,even beyond the wall barrier.The first transgastric peri-toneoscopy,in 2004,brought to light the concept of natural orifice transluminal endoscopic surgery(NOTES).The idea of incisionless surgery is attractive and has become a new goal for both surgeons and other people interested in this field of investigation.The authors present a review of all developments concerning NOTES,including animal studies and human experience.展开更多
Although in the past two decades,laparoscopic surgery,considered as a great revolution in the minimally inva-sive surgery field,has undergone major development worldwide,another dramatic surgical revolution has quietl...Although in the past two decades,laparoscopic surgery,considered as a great revolution in the minimally inva-sive surgery field,has undergone major development worldwide,another dramatic surgical revolution has quietly appeared in recent years.Ever since Kalloo's first report on transgastric peritoneoscopy in a porcine model in 2004,interest in a new surgical procedure named natural orifice transluminal endoscopic surgery(NOTES)has blossomed worldwide.Considering that a NOTES procedure could theoretically avoid any abdomi-nal incision,operation-related pain and scarring,many surgeons and endoscopists have been enthusiastic in their study of this new technique.In recent years,sev-eral NOTES studies have been carried out on porcine models and even on humans,including transvaginal cholecystectomy,transgastric appendectomy,transvagi-nal appendectomy,and transvesical peritoneoscopy.So what is the current situation of NOTES and how many challenges do we still face?This review discusses the current research progress in NOTES.展开更多
A cavernous hemangioma of the cecum is a rare vascular malformation but is clinically important because of the possibility of massive bleeding.We report a case of a large cavernous hemangioma with pericolic inf iltrat...A cavernous hemangioma of the cecum is a rare vascular malformation but is clinically important because of the possibility of massive bleeding.We report a case of a large cavernous hemangioma with pericolic inf iltration in the cecum which was removed successfully using minimally invasive surgery.展开更多
Thanks to the development of minimally invasive surgery, the last 20 years have witnessed a change in the treatment algorithm of benign esophageal disorders. Today a laparoscopic operation is the treatment of choice f...Thanks to the development of minimally invasive surgery, the last 20 years have witnessed a change in the treatment algorithm of benign esophageal disorders. Today a laparoscopic operation is the treatment of choice for esophageal achalasia and for most patients with gastroesophageal reflux disease. Because the pathogenesis of achalasia is unknown, treatment is palliative and aims to improve esophageal emptying by decreasing the functional obstruction at the level of the gastro-esophageal junction. The refinement of minimally invasive techniques accompanied by large, multiple randomized control trials with long-term outcome has allowed the laparoscopic Heller myotomy and partial fundoplication to become the treatment of choice for achalasia compared to endoscopic procedures, including endoscopic botulinum toxin injection and pneumatic dilatation. Patients with suspected gastroesophageal reflux need to undergo a thorough preoperative workup. After establishing diagnosis, treatment for gastroesophageal reflux should be individualized to patient characteristics and a decision about an operation made jointly between surgeon and patient. The indications for surgery have changed in the last twenty years. In the past, surgery was often considered for patients who did not respond well to acid reducing medications. Today, the best candidate for surgery is the patient who has excellent control of symptoms with proton pump inhibitors. The minimally invasive approach to antireflux surgery has allowed surgeons to control reflux in a safe manner, with excellent long term outcomes. Like achalasia and gastroesophageal reflux, the treatment of patients with paraesophageal hernias has also seen a major evolution. The laparoscopic approach has been shown to be safe, and durable, with good relief of symptoms over the long-term. The most significant controversy with laparoscopic paraesophageal hernia repair is the optimal crural repair. This manuscript reviews the evolution of these techniques.展开更多
Throughout history,surgeons have been on a quest to refine the surgical treatment options for their patients and to minimize operative trauma.During the last three decades,there have been tremendous advances in the fi...Throughout history,surgeons have been on a quest to refine the surgical treatment options for their patients and to minimize operative trauma.During the last three decades,there have been tremendous advances in the field of minimally invasive colorectal surgery,with an explosion of different technologies and approaches offered to treat well-known diseases.Laparoscopic surgery has been shown to be equal or superior to open surgery.The boundaries of laparoscopy have been pushed further,in the form of single-incision laparoscopy,natural-orifice transluminal endoscopic surgery and robotics.This paper critically reviews the pathway of development of minimally invasive surgery,and appraises the different minimally invasive colorectal surgical approaches available to date.展开更多
From January 2013 to January 2015, 19 patients of traumatic hemothorax with hemorrhagic shock were treated in our department by thoracoscopic surgery combined with autologous blood transfusion. This study retrospectiv...From January 2013 to January 2015, 19 patients of traumatic hemothorax with hemorrhagic shock were treated in our department by thoracoscopic surgery combined with autologous blood transfusion. This study retrospectively analyzed the therapeutic effect and shared our experience. The average amount of blood transfused back was 662.41 ml ± 269.15 ml. None of the patients developed transfusion reaction and were all discharged uneventfully. Thoracoscopic surgery combined with autologous blood transfusion is effective in the rescue of patients with progressive hemothorax and hemorrhagic shock. When corresponding indications are well managed, treatment for these patients is quicker, safer, and more effective.展开更多
文摘Minimally invasive surgery started spreading worldwide in 1987,when the first laparoscopic cholecystectomy was performed.Meanwhile,improvement of endoscopic equipment and instruments allowed gastroenterologists to attempt more aggressive endoluminal interventions,even beyond the wall barrier.The first transgastric peri-toneoscopy,in 2004,brought to light the concept of natural orifice transluminal endoscopic surgery(NOTES).The idea of incisionless surgery is attractive and has become a new goal for both surgeons and other people interested in this field of investigation.The authors present a review of all developments concerning NOTES,including animal studies and human experience.
基金Supported by Fund for scientific research of Shanghai Shenkang Hospital Development Center,No.SHDC12006102
文摘Although in the past two decades,laparoscopic surgery,considered as a great revolution in the minimally inva-sive surgery field,has undergone major development worldwide,another dramatic surgical revolution has quietly appeared in recent years.Ever since Kalloo's first report on transgastric peritoneoscopy in a porcine model in 2004,interest in a new surgical procedure named natural orifice transluminal endoscopic surgery(NOTES)has blossomed worldwide.Considering that a NOTES procedure could theoretically avoid any abdomi-nal incision,operation-related pain and scarring,many surgeons and endoscopists have been enthusiastic in their study of this new technique.In recent years,sev-eral NOTES studies have been carried out on porcine models and even on humans,including transvaginal cholecystectomy,transgastric appendectomy,transvagi-nal appendectomy,and transvesical peritoneoscopy.So what is the current situation of NOTES and how many challenges do we still face?This review discusses the current research progress in NOTES.
文摘A cavernous hemangioma of the cecum is a rare vascular malformation but is clinically important because of the possibility of massive bleeding.We report a case of a large cavernous hemangioma with pericolic inf iltration in the cecum which was removed successfully using minimally invasive surgery.
文摘Thanks to the development of minimally invasive surgery, the last 20 years have witnessed a change in the treatment algorithm of benign esophageal disorders. Today a laparoscopic operation is the treatment of choice for esophageal achalasia and for most patients with gastroesophageal reflux disease. Because the pathogenesis of achalasia is unknown, treatment is palliative and aims to improve esophageal emptying by decreasing the functional obstruction at the level of the gastro-esophageal junction. The refinement of minimally invasive techniques accompanied by large, multiple randomized control trials with long-term outcome has allowed the laparoscopic Heller myotomy and partial fundoplication to become the treatment of choice for achalasia compared to endoscopic procedures, including endoscopic botulinum toxin injection and pneumatic dilatation. Patients with suspected gastroesophageal reflux need to undergo a thorough preoperative workup. After establishing diagnosis, treatment for gastroesophageal reflux should be individualized to patient characteristics and a decision about an operation made jointly between surgeon and patient. The indications for surgery have changed in the last twenty years. In the past, surgery was often considered for patients who did not respond well to acid reducing medications. Today, the best candidate for surgery is the patient who has excellent control of symptoms with proton pump inhibitors. The minimally invasive approach to antireflux surgery has allowed surgeons to control reflux in a safe manner, with excellent long term outcomes. Like achalasia and gastroesophageal reflux, the treatment of patients with paraesophageal hernias has also seen a major evolution. The laparoscopic approach has been shown to be safe, and durable, with good relief of symptoms over the long-term. The most significant controversy with laparoscopic paraesophageal hernia repair is the optimal crural repair. This manuscript reviews the evolution of these techniques.
文摘Throughout history,surgeons have been on a quest to refine the surgical treatment options for their patients and to minimize operative trauma.During the last three decades,there have been tremendous advances in the field of minimally invasive colorectal surgery,with an explosion of different technologies and approaches offered to treat well-known diseases.Laparoscopic surgery has been shown to be equal or superior to open surgery.The boundaries of laparoscopy have been pushed further,in the form of single-incision laparoscopy,natural-orifice transluminal endoscopic surgery and robotics.This paper critically reviews the pathway of development of minimally invasive surgery,and appraises the different minimally invasive colorectal surgical approaches available to date.
文摘From January 2013 to January 2015, 19 patients of traumatic hemothorax with hemorrhagic shock were treated in our department by thoracoscopic surgery combined with autologous blood transfusion. This study retrospectively analyzed the therapeutic effect and shared our experience. The average amount of blood transfused back was 662.41 ml ± 269.15 ml. None of the patients developed transfusion reaction and were all discharged uneventfully. Thoracoscopic surgery combined with autologous blood transfusion is effective in the rescue of patients with progressive hemothorax and hemorrhagic shock. When corresponding indications are well managed, treatment for these patients is quicker, safer, and more effective.
