ABSTRACT
BACKGROUND: Atrial fibrillation is the most common form of serious arrhythmia in humans. The therapeutic options offered are medical, surgical, and interventional. The surgical approach is justified in cases of atrial fibrillation already subjected to cardiac surgery for an associated organic heart disease such as a valvular or ischemic disease. A minimally invasive surgical approach is needed to extend the possibility of surgical treatment to patients with lone atrial fibrillation and those who cannot be treated by interventional procedures. This study aimed to use sheep as an experimental model in developing a minimally invasive surgical procedure for chronic atrial fibrillation therapy in humans. METHODS: The investigation was conducted with 20 animals using a video-assisted thoracoscopic approach, in which a flexible microwave energy ablating probe was positioned on the epicardial surface encircling the pulmonary veins. RESULTS: In 10 of the 20 animals, it was possible to encircle the pulmonary veins using the thoracoscopic approach in less than 3 h without major complications. CONCLUSION: The epicardial ablation procedure using the thoracoscopic approach is feasible, safe, and reproducible.
Subject(s)
Atrial Fibrillation/surgery , Catheter Ablation/methods , Thoracic Surgery, Video-Assisted , Thoracoscopy , Animals , Microwaves , SheepABSTRACT
Laparoscopic nephrectomy is a new procedure in which the entire kidney is removed introducing it in an Endopouch and, after morcellation pulled out through a 12 mm port. After an initial experimental experience, in our Institute we have performed one laparoscopic nephrectomy for left pyelonephritic kidney and ureteral reflux. The operation required the positioning of 5 trocars and 4 hours for its execution. The discharge of the patient was possible four days after.
Subject(s)
Laparoscopy , Nephrectomy/methods , Adult , Female , HumansABSTRACT
During our experimental trial we achieved laparoscopic cistectomies with urinary diversion to prove our manual capability with the reconstructive surgery. We executed, on male pigs, 10 cistectomies with urinary diversion using laparoscopic technique. We performed 5 ureterocutaneostomies on 5 pigs and, in the other ones, 5 ureterosigmoidostomies. During UCS the pigs laid in lateral position, and during USS in supine position. The average time of the operation is going to reduce in consideration of the overcoming of the initial techno-instrumental difficulties and is 60 minutes for cistectomy, 30 minutes for ureterocutaneostomy and 120 minutes for ureterosigmoidostomy.
