Innovations : technology and techniques in cardiothoracic and vascular surgery
-
Innovations (Phila) · Feb 2019
Interactive 3D Reconstruction of Pulmonary Anatomy for Preoperative Planning, Virtual Simulation, and Intraoperative Guiding in Video-Assisted Thoracoscopic Lung Surgery.
Routine imaging modalities combined with state-of-the-art reconstruction software can substantially improve preoperative planning and simplify complex procedure by enhancing the surgeon's knowledge of the patient's specific anatomy. The aim of the current study was to demonstrate the feasibility of interactive three-dimensional (3D) computed tomography (CT) reconstructions for preoperative planning and intraoperative guiding in video-assisted thoracoscopic lung surgery (VATS) with 3D vision. ⋯ Preoperative planning with interactive 3D CT reconstruction is a useful method to enhance the surgeon's knowledge of the patient's specific anatomy and to reveal anatomic variations. Intraoperative 3D guiding in VATS with 3D vision is feasible and could contribute to the safety and accuracy of anatomic resection.
-
Innovations (Phila) · Feb 2019
Comparative StudyAortic Valve Replacement in Elderly Patients With Small Aortic Annulus: Results With Three Different Bioprostheses.
Aortic valve replacement (AVR) in patients with small aortic annulus (diameter ≤21 mm) is considered a challenging scenario because of technical aspects and the high risk of patient-prosthesis mismatch (PPM). The choice of the appropriate prosthesis is crucial, and at the moment, an ideal device has yet to be identified. We compare clinical and hemodynamic results after AVR with three bioprostheses with different design and characteristics. ⋯ Despite higher postoperative pressure gradients observed with the Trifecta valve, all three prostheses (Trifecta, Edwards INTUITY Elite, and Perceval) have proven to be reliable when implanted in small aortic annuli, with good clinical outcome and favorable left ventricular mass regression.
-
Innovations (Phila) · Sep 2018
Learning Curve of Robotic Lobectomy for Early-Stage Non-Small Cell Lung Cancer by a Thoracic Surgeon Adept in Open Lobectomy.
The aim of the study was to characterize the clinical outcomes and learning curve during the adoption of a robotic platform for lobectomy for early-stage non-small cell lung cancer by a thoracic surgeon experienced in open thoracotomy. ⋯ Adoption of a robotic platform for lobectomy for early-stage non-small cell lung cancer by an experienced open thoracic surgeon is safe and feasible, with fewer complications, less blood loss, and equivalent nodal sampling rate even during the learning curve. The conversion to open rate significantly dropped after the first 40 robotic lobectomies, and operative time for robotic lobectomy approached open thoracotomy after 60 cases, after a bimodal curve.
-
Innovations (Phila) · Sep 2018
Nonrobotic Total Endoscopic Coronary Artery Bypass Grafting: A Proof-of-Concept Study in 20 Patients.
At present, minimal invasive direct coronary artery grafting is the least invasive nonrobotic surgical approach to revascularize the left anterior descending artery with the left internal mammary artery. Total endoscopic coronary bypass grafting is performed with the help of a telemanipulator ("robot"). A prospective proof-of-concept study was initiated to investigate a nonrobotic total endoscopic coronary bypass grafting approach. ⋯ With a thoroughly surveyed learning curve, nonrobotic total endoscopic coronary bypass grafting procedure could become an alternative to other available treatment options; however, the value of the procedure has to be further investigated.
-
Innovations (Phila) · Jul 2018
Comparative StudyMini Right Anterior Thoracotomy Approach Versus Sternotomy for Resection of Intracardiac Myxoma.
The standard approach in treating cardiac myxoma is the median full sternotomy. After recent advances in surgical techniques, the mini right anterior thoracotomy has emerged as an alternative method. ⋯ A minimally invasive surgery through mini right anterior thoracotomy is a good alternative technique for treating cardiac myxoma. Despite the small size of the experience, there is a clear diminution in preoperative blood loss and an interesting trend toward a shorter intensive care unit and hospital stay.