0000000000482120
AUTHOR
M. Naruhn
Endoscopic microsurgical dissection of the esophagus. Results in an animal model.
Blunt dissection of the esophagus is considered the least invasive technique in the treatment of either benign or malignant diseases of the esophagus. Its disadvantage is that it has to be carried out blindly. The results may be uncontrollable hemorrhage, unrecognized injuries to the trachea, and damage to the recurrent laryngeal nerve. In order to reduce the degree of invasiveness a new endoscopic microsurgical technique for the dissection of the esophagus has been developed and tried out in animals. This paper presents the operative technique. Our new endoscopic microsurgical technique obviates a thoracotomy, while direct endoscopic vision results in improved dissection. The magnified end…
Endoscopic Microsurgery of Rectal Tumors
Seventy-five patients with sessile adenomas or early carcinomas of the rectum or rectosigmoid were operated on with the new technique "transanal endoscopic microsurgery" Employing a newly developed complex endoscopic operating system, complete removal of sessile adenomas can be accomplished up to a distance of 25 cm from the anal verge, accurately and non-invasively. Complications occurred in three cases, with no resulting mortality. In the follow-up period we discovered only one adenomatous recurrence that required operative treatment. The superior accuracy of preparation, a short average stay in hospital, and low recurrence and complication rates are the advantages of this transanal endos…
Neue Techniken in der endoskopischen Mikrochirurgie
In dem Videofilm werden die tierexperimentellen Ergebnisse zweier neuer endosko-pisch-mikrochirurgischer Techniken gezeigt: Die Transanale Endoskopische Rektopexie beim Rektumprolaps: Quere Incision in der Rektumhinterwand; Abpraparieren des Rektums vom Kreuzbein; transmurale Einzelnahte vom Darmlumen aus durch die pasacralen Ligamente zum Darmlumen zuruck; Verschlus der Incision mit querer Naht. Die Endoskopische Dissektion der Speiserohre: Spezielles Operationsendoskop; freipraparieren des Oesophagus vom cervicalen Zugang; Hochziehen eines Katheters neben der Speiserohre; Einnahen in den aboralen Stumpf der durchtrennten Speiserohre; Herausziehen nach abdominal.
Die endoskopisch-mikrochirurgische Dissektion der Speiseröhre — Tierexperimentelle Ergebnisse
Ist in der Behandlung von gutartigen oder malignen Speiserohrenerkrankungen die Entfernung des Oesophagus erforderlich, so gilt die stumpfe Dissektion im Gegensatz zum Zweihohleneingriff als das weniger invasive Verfahren. Der Nachteil liegt in der fehlenden Sicht wahrend der Praparation mit daraus resultierendem unkontrollierten Blutverlust, unerkannten Trachealverletzungen und Lasionen des linken Nervus recurrens, die in der Literatur mit bis zu 40% angegeben werden (2, 4, 5).
Training program for transanal endoscopic microsurgery.
Televised endoscopy and the concept of the “assisted” endoscopic operation is of great help in teaching surgical endoscopic techniques. The use of training dummies provides a new method of training manual dexterity and surgical skills in special courses or in surgical skill laboratories. We have developed a training system for transanal endoscopic microsurgery. Operations with our technique were performed on 116 patients. Like other microsurgical techniques, our method requires a special introduction and intensive training. This paper presents our multistage, video-supported training course for teaching transanal endoscopic microsurgery. The one-day training session is divided into four ste…