Hand-Assisted Laparoscopic Surgery (HALS) With the HandPort System

Litwin, Demetrius E. M.; Darzi, Ara; Jakimowicz, Jack J.; Kelly, John J.; Arvidsson, Dag; Hansen, Paul; Callery, Mark P.; Denis, Ronald; Fowler, Dennis L.; Medich, David S.; O’Reilly, Michael; Atlas, Henry; Himpens, Jacques; Swanström, Lee L.; Arous, Elias J.; Pattyn, Piet; Yood, Steven M.; Ricciardi, Rocco; Sándor, András; Meyers, William C.

doi:10.1097/00000658-200005000-00012

Cited by 176 publications

(113 citation statements)

References 22 publications

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“…Lesions located on the posterior wall of the upper stomach, which are difficult to resect endoscopically, are candidates for this approach. Recently, a technique of hand-assisted laparoscopic surgery (HALS) [90]was applied to gastric cancer surgery, and gastrectomy with D2 lymph node dissection was done under HALS without any complications [91]. …”

Section: Surgical Proceduresmentioning

confidence: 99%

Modern Treatment of Early Gastric Cancer: Review of the Japanese Experience

Adachi

Shiraishi²,

Kitano³

2002

Dig Surg

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Background: Recently, detections of early gastric cancer (EGC) have been increasing, and the treatment strategies for gastric cancer have been changing. To demonstrate recent clinical experience of EGC in Japan and to assess modern strategies for the treatment of EGC, we investigated the English-language literature of the past 10 years through computer searches. Methods: This article intends to provide gastric surgeons with recent Japanese experience of the treatment for EGC. In a search for modern treatments of EGC, we selected 100 papers published in well-known medical journals, and focused on the following items of EGC: (1) prognostic factors, (2) endoscopic treatment, (3) surgical procedures, and (4) Japanese guidelines. Results: The most important factor influencing the survival of patients with EGC is the status of lymph node metastasis. The incidence of lymph node metastasis is 1–3% for mucosal cancers and 11–20% for submucosal cancers. Endoscopic mucosal resection (EMR) is a technique for the treatment of EGC, and the recent indication includes the tumors confined to the mucosa up to 3 cm in size or those invading the superficial submucosa. Surgical procedures include conventional Billroth I gastrectomy, limited resections, and laparoscopic surgery. Laparoscopic wedge resection using the lesion-lifting method and laparoscopy-assisted distal gastrectomy provide less pain, faster recovery and shorter hospital stay. Guidelines for the treatment of gastric cancer proposed by the Japanese Gastric Cancer Association show that patients with mucosal cancer can be managed by EMR or distal gastrectomy, whereas patients with submucosal cancer are candidates for distal gastrectomy with lymph node dissection. Conclusion: Although the prognosis of patients with EGC depends on the presence or absence of lymph node metastasis, most are successfully treated by modern endoscopic or surgical techniques. Laparoscopic surgery and limited resections will contribute to the better quality of life of patients with EGC.

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Section: Surgical Proceduresmentioning

confidence: 99%

Modern Treatment of Early Gastric Cancer: Review of the Japanese Experience

Adachi

Shiraishi²,

Kitano³

2002

Dig Surg

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“…Finally, it is worthy to remember that, in this kind of donor, a more detailed study for HLA typing is conducted, decreasing the possibility of immunological problems in the posttransplantation period and therefore less immunosuppression is employed. Moreover, a shorter cold ischemia time is achieved, which represents improved survival and early function of the graft (6,8,9,11).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic nephrectomy in live donor

et al. 2004

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Objective: To present the initial experience of videolaparoscopic nephrectomy in live renal donor.Materials and Methods: In the period from April 2000 to August 2003, 50 left nephrectomies in live donor were performed by videolaparoscopy for transplantation. Twenty-eight patients were male (56%) and 22 female (44%). Mean age was 37.2 years, and the mean body mass index (BMI) was 27.1 kg/m 2 . Results: Mean surgical time was 179.5 minutes, and warm ischemia time of the graft was 3.79 minutes. The mean estimated bleeding was 141 mL. There was no need of blood transfusion or conversion to open surgery. In 42 cases (84%), the vascular portion of the graft was considered good by the recipient's surgical team and in all cases, the ureter was considered of proper size, though in one of them (2%) its vascularization was considered improper. The transplanted kidneys produced urine still in the surgical room in 46 of the 50 transplantations considered. In only 2 cases opioid was required for analgesia. In average, 3.1 doses of dipyrone were used for each patient during hospital stay, and hospital discharge occurred, in average, after 3.2 days post-operatively. Two patients required re-operations and one of them evolved to death.Conclusions: The laparoscopic nephrectomy in live donor for renal transplantation is an alternative to conventional open surgery. In relation to the graft, no alteration, either anatomic or functional, was detected. Though there is already a large documentation in the international literature regarding this procedure, in our setting a prospective randomized study with the usual surgical study is still necessary in order to prove the advantages and disadvantages of the method.

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“…Não se demonstraram grandes vantagens daquela sobre esta, mas há elevação de custos (11 e 12) . O desenvolvimento de dispositivos que permitem o acesso da mão do cirurgião à cavidade abdominal em procedimentos laparoscópicos tem merecido destaque na literatura nos últimos anos (13)(14)(15)(16) . Tais materiais proporcionam a sensação tátil ao cirurgião e a manipulação direta das vísceras, mas atualmente encarecem em cerca de US$ 700 o procedimento, embora aqueles que defendam sua utilização argumentem que o tempo operatório é menor e maior o conforto do cirurgião.…”

Section: Via De Acesso E Recidivaunclassified

Acesso vídeo-laparoscópico no tratamento cirúrgico da diverticulite aguda

Sousa¹,

Neto²,

Habr‐Gama³

2006

Rev bras. colo-proctol.

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RESUMO: A revisão de conceitos baseada na literatura recente relacionada ao tratamento da doença diverticular dos cólons pelo acesso vídeolaparoscópico é apresentada ao lado das indicações de formas de tratamento clássicas. A dupla abordagem videolaparoscópica, imediata para tratamento da peritonite seguida da ressecção tornada eletiva é a modalidade nova na literatura, mas ainda não padronizada. Discutem os autores dados relativos a esta tática e de outros estudos que podem ampliar o emprego desta abordagem.Descritores: Colectomia; colectomia laparoscópica; cirurgia minimamente invasiva; doença diverticular; diverticulite. Disciplina de Coloproctologia do Departamento de Gastroenterologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de INTRODUÇÃOA alta e crescente prevalência da doença diverticular dos cólons, que atinge cerca de 60% na população acima da sétima década de vida (1) , assim como os riscos inerentes aos episódios agudos de diverticulite aguda (DA), perpetuam a discussão quanto ao seu melhor manejo.Por outro lado, a relativa baixa proporção de casos de diverticulite, torna interessante a revisão de literatura dirigida, por amplificar a análise de dados e rediscutir condutas clássicas.O tratamento de quadro agudo da doença diverticular dos cólons, manifestado com infecção, está entre os tópicos que merecem revisão, em que pese constituir somente 1% ou menos de casuísticas de portadores de doença diverticular.Da mesma forma, a discussão quanto ao diagnóstico, às medidas clínicas (jejum até recuperação do íleo paralítico, emprego de antibióticos, tipo de hidratação parenteral, repouso, prazos de observação cliínica até eventual mudança para a atitude cirúrgi-ca) e até os meandros do raciocínio relativos à fisiopatologia são atuais, mas escapam ao escopo deste trabalho, estando disponíveis em revisões minuciosas e ilustrativas (2,3) . Indicação do tratamento cirúrgicoConstitui o quadro agudo infeccioso da diverticulite aguda urgência médica que enseja variadas opções terapêuticas, uma vez que sua apresentação é também variada, em espectro contínuo desde a diverticulite propriamente dita -um divertículo e a região onde se encontra tornam-se substrato de infecção -até a peritonite fecal disseminada originada de comunicação da luz intestinal com a cavidade abdominal através de divertículo perfurado devido ao agravamento da infecção diverticular inicial. Assim, o quadro mais lo-

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Hand-Assisted Laparoscopic Surgery (HALS) With the HandPort System

Cited by 176 publications

References 22 publications

Modern Treatment of Early Gastric Cancer: Review of the Japanese Experience

Modern Treatment of Early Gastric Cancer: Review of the Japanese Experience

Laparoscopic nephrectomy in live donor

Acesso vídeo-laparoscópico no tratamento cirúrgico da diverticulite aguda

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