Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy
-
Minim Invasive Ther Allied Technol · Jan 2008
Comparative StudyBipolar radiofrequency ablation: is the shape of the coagulation volume different in comparison to monopolar RF-ablation using variable active tip lengths?
We investigated the differences between bipolar and monopolar radiofrequency (RF)-ablation devices regarding the shape and volume of the induced coagulation zone. RF-ablations were performed in freshly excised porcine liver. For bipolar RF-ablation needle electrodes with 9, 20 and 30 mm active tip lengths were used. ⋯ At 20 and 30 mm tip length bipolar RF-ablation created significantly larger areas of necrosis (20 mm: 3.498+/-0.605 cm(3) vs. 2.569+/-0,620 cm(3), 30 mm: 7.441+/-906 cm(3) vs. 3.317+/-0.737 cm(3)). Using the probes with 9 mm, active length areas of necrosis induced by the monopolar system are more spherical, whereas with 20 and 30 mm active tip length the bipolar system creates more spherical lesions. The proper combination of RF-system and electrode length allows to individually adapt the shape and volume of the generated coagulation necrosis to the target lesion.
-
Minim Invasive Ther Allied Technol · Jan 2007
Laparoscopic Nissen solo surgery using PMAT (first experience).
This article describes the use of a Postural Mechatronic Assistant Trainer (PMAT) in pediatric Nissen surgery. This mechatronic system enables users to establish the logistical considerations for solo surgery and determine the advantages this new tool offers for the autonomous handling of optics.
-
Minim Invasive Ther Allied Technol · Jan 2007
A new system for continuous recurrent laryngeal nerve monitoring.
Existing nerve monitoring devices in thyroid surgery are - except for one - mainly intermittently working nerve identification tools. We present a new vagal electrode which allows true continuous monitoring of the recurrent laryngeal nerve (RLN). The electrode was designed as a tripolar hybrid cuff electrode consisting of polyimide, gold and platinum layers embedded in a flexible silicon cuff which can be opened at the long side for introducing the nerve. ⋯ The stimulation current could be kept extremely low due to the special geometry of the electrode. It offers the possibility for uninterrupted, continuous laryngeal nerve monitoring in thyroid surgery. In an ongoing clinical trial its compatibility as an add-on for existing nerve monitoring devices is being tested.
-
Minim Invasive Ther Allied Technol · Jan 2006
ReviewLumbar microdiscectomy and microendoscopic discectomy.
Lumbar microdiscectomy, which relies on the operating microscope for visualization, was first described in the late 1970s. This operation is considered the gold standard procedure for patients who require surgery for symptomatic lumbar disc herniation causing radiculopathy that has not improved with conservative measures. A new approach to the management of symptomatic lumbar disc herniation, microendoscopic discectomy, was introduced in 1997. ⋯ As it is a new procedure, long-term outcomes have not yet been established for this operation. However, recent literature suggests that microendoscopic discectomy may be as effective as the traditional lumbar microdiscectomy in relieving radiculopathy. This article describes the operative techniques and outcomes reported in the literature for both lumbar microdiscectomy and microendoscopic discectomy.
-
Minim Invasive Ther Allied Technol · Apr 2004
Epidural spinal cord stimulation in chronic non-reconstructible limb ischemia.
For patients with chronic non-reconstructible limb ischemia (chronic CLI), spinal-cord stimulation (SCS) has been advocated for the treatment of ischemic pain and prevention of amputation. The present clinical report was performed to evaluate the long-term effects of SCS on limb survival. A retrospective review was performed of 21 patients who had undergone SCS between December 1997 and July 2002 due to chronic CLI. ⋯ Major amputation could be avoided in 15 (71%) of 21 patients. Two electrode dislocation, one pulse-generator dislocation, and one wire disconnection occurred; no other complications were observed. SCS represents a safe and effective therapy for patients with chronic non-reconstructible critical limb ischemia.