Search results for "Esophageal"

Real-time fluorescence image-guided gastrointestinal oncologic surgery: Towards a new era

2021

Technological improvements are crucial in the evolution of surgery. Real-time fluorescence-guided surgery (FGS) has spread worldwide, mainly because of its usefulness during the intraoperative decision-making processes. The success of any gastrointestinal oncologic resection is based on the anatomical identification of the primary tumor and its regional lymph nodes. FGS allows also to evaluate the blood perfusion at the gastrointestinal stumps after colorectal or esophageal resections. Therefore, a reduction on the anastomotic leak rates has been postulated as one of the foreseeable benefits provided by the use of FGS in these procedures. Although the use of fluorescence in lymph node detec…

Technical details of the hand-sewn and circular-stapled anastomosis in robot-assisted minimally invasive esophagectomy.

2020

SUMMARY The circular mechanical and hand-sewn intrathoracic anastomosis are most often used in robot-assisted minimally invasive esophagectomy (RAMIE). The aim of this study was to describe the technical details of both techniques that were pioneered in two high volume centers for RAMIE. A prospectively maintained database was used to identify patients with esophageal cancer who underwent RAMIE with intrathoracic anastomosis. The primary outcome was anastomotic leakage, which was analyzed using a moving average curve. For the hand-sewn anastomosis, video recordings were reviewed to evaluate number of sutures and distances between the anastomosis and the longitudinal staple line or gastric c…

On implementation of the Gibbs sampler for estimating the accuracy of multiple diagnostic tests

2010

Implementation of the Gibbs sampler for estimating the accuracy of multiple binary diagnostic tests in one population has been investigated. This method, proposed by Joseph, Gyorkos and Coupal, makes use of a Bayesian approach and is used in the absence of a gold standard to estimate the prevalence, the sensitivity and specificity of medical diagnostic tests. The expressions that allow this method to be implemented for an arbitrary number of tests are given. By using the convergence diagnostics procedure of Raftery and Lewis, the relation between the number of iterations of Gibbs sampling and the precision of the estimated quantiles of the posterior distributions is derived. An example conc…

Echocardiographic Assessment of Ventricular Septal Rupture and Left Ventricular Aneurysm after Inferior and Posterior Myocardial Infarction

2018

We present a case of posterior ventricular septal rupture associated to left ventricular aneurysm manged, during peri-operative period, by transthoracic and transesophageal echocardiography. Three-dimensional transesophageal echocardiography findings add adjunctive and more accurate information regarding morphological details of the ventricular septal rupture rather than two-dimensional echocardiography, allowing, meanwhile, the detection of the outcome of the surgical repair.

Innovative fully robotic 4-arm Ivor Lewis esophagectomy for esophageal cancer (RAMIE4).

2019

Nowadays robotic surgery is established for abdominal and thoracic surgery. It has been shown that complex procedures are feasible using robotic systems, e.g., da Vinci Xi, with a huge benefit in precision. Different techniques for esophageal cancer surgery are reported; however, only a few robotic and partial robotic procedures are described. Therefore, a fully robotic (abdominal and thoracic) Ivor Lewis esophageal resection using four robotic arms-RAMIE4-the standard technique used for lower esophageal cancer, is presented in this paper. The technique shown in the video was performed successfully in 100 cases in 24 months. The reconstruction is performed with a gastric conduit pull-up and…

Diagnosis of papillary muscle rupture after acute myocardial infarction by transthoracic and transesophageal echocardiography.

1993

The sensitivity of transthoracic echocardiography to visualize the structural abnormality of papillary muscle rupture (PMR) after acute myocardial infarction can be anticipated to average about 50%; therefore, we evaluated five patients exhibiting the condition with both transthoracic and transesophageal echocardiography. The use of the two imaging techniques resulted in the fact that no instance of PMR was missed. Using transthoracic echocardiography in two patients and transesophageal echocardiography in four, the ruptured papillary muscle was visualized directly. Mitral insufficiency as an indirect sign was observed in all patients. In one patient the papillary muscle rupture developed i…

Robotic-assisted minimally invasive esophagectomy (RAMIE) for esophageal cancer training curriculum—a worldwide Delphi consensus study

2021

Summary Background Structured training protocols can safely improve skills prior initiating complex surgical procedures such as robotic-assisted minimally invasive esophagectomy (RAMIE). As no consensus on a training curriculum for RAMIE has been established so far it is our aim to define a protocol for RAMIE with the Delphi consensus methodology. Methods Fourteen worldwide RAMIE experts were defined and were enrolled in this Delphi consensus project. An expert panel was created and three Delphi rounds were performed starting December 2019. Items required for RAMIE included, but were not limited to, virtual reality simulation, wet-lab training, proctoring, and continued monitoring and educa…

Bayesian Analysis of Diagnostic Accuracy for Gastroesophageal Reflux Disease in the absence of gold standard

2007

Locust neuropeptides stimulating sex pheromone production in female European corn borer moth, Ostrinia nubilalis

1990

Abstract The presence of a pheromonotropically active hormone (PBAN-like substance) from locust organs, ( Locusta migratoria ) has been demonstrated. Extracts of brain, corpora cardiaca, corpora allata, suboesophageal ganglia and thoracic ganglia of L. migratoria caused highly pheromonotropic responses in decapitated females of the European corn borer moth ( Ostrinia nubilalis ). The highest activity per unit weight of tissue was found in the corpora cardiaca and corpora allata of the locust followed by the brain plus suboesophageal ganglion of O. nubilalis . Following 8 days of disconnection, separating the corpora allata from the corpora cardiaca and suboesophageal ganglion, the pheromono…

Myotomy of cricopharungeal muscle in the therapy of dyskinesia of upper esophageal sphincter: personal experience

2012

Dyskinesia of the esophagus includes the entire esophagus from the upper esophageal sphincter to the lower esophageal sphinc - ter together with a wide spectrum of physi - opathological and clinical variations. Related to functional diseases such as Dyskinesia of UES (Upper Esophageal Sphincter), myo- tomy is an excellent procedure for patients with cervical dysphagia. In our experience, the surgical treatment is the only procedure to treat UES dyskinesia. For a successful in - tervention is mandatory: a pharyngeal pump efficiency, hypertension of UES and conservation of esophageal peristalsis in the absence of GERD (Gatroesophageal Reflux Disease). From January 2006 to December 2011, the A…