Uso del separador Lone Star(R) en cirugía de tiroides y paratiroides / Usefulness of the Lone Star(R) retractor in thyroid and parathyroid surgery

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[EFFICACY OF WELDING TECHNOLOGY AS A PRINCIPAL METHOD OF DISSECTION AND HEMOSTASIS IN ENDOCRINAL SURGERY].

Today in the clinic all surgical interventions on endocrinal organs are conducted, using welding technology. Comparative analysis of the operative interventions efficacy, performed applying a standard method (control group) and using welding technology (the main group), was conducted. Performance of operations, using electric welding technologies have permitted to reduce the operative intervention duration by 20 - 30%, the blood loss volume--by 30 - 50%, a postoperative pain syndrome severity and the analgetics expense--by 20%, a postoperative stationary treatment duration--by 1-2 days.

[Experience of high frequency electric welding in endocrine surgery].

The comparative analsis of the effectiveness of surgical interventions performed by the standard method and using electric welding technology in endocrine surgery was hold. Compared duration of surgery, amount of intraoperatve blood loss, frequency of intra- and early postoperative complications. Found that the use of weding technology ensures shorter duration of surgery, on average by 30%, amount of blood loss--by 20-50%, the frequency of intra- and early postoperative complications.

[Methods for the surgical treatment of chronic sphenoiditis and ethmoiditis].

The objective of the present study was to design tools for the enhancement of safety of the surgical instruments used in the treatment of chronic sphenoiditis and ethmoiditis. The proposed instruments for endonasal surgery on sphenoidal sinuses and posterior cells of the ethmoidal labyrinth make it possible to improve the quality of surgical interventions, decrease their duration , and reduce the risk of damage to the important anatomical structures. The instruments were used for the surgical treatment of 120 patients that produced no complications. 98 patients were followed up for 3 years; five of them (5.2%) developed relapses compared with 38 (24.2%) patients operated by the traditional techniques. It is concluded that the proposed surgical instruments for the treatment of sphenoidal sinuses and posterior cells of the ethmoidal labyrinth help to increase the effectiveness and safety of surgical interventions on these structures.

[Current operative techniques and strategies in endocrine surgery]. / Aktuelle operative Techniken und Strategien in der endokrinen Chirurgie.

Technical advances and focusing on subsets modified endocrine surgery in the last ten years tremendously. There is on one side a clear trend towards minimal invasive approaches, first of all in the surgery of the adrenal glands, where the transperitoneal or retroperitoneal laparoscopic adrenalectomy has become the gold standard for tumors up to a size of 10 cm in diameter. But also in pancreatic endocrine surgery for small tumors localized in the pancreas tail and up to a certain extend in thyroid and parathyroid surgery, laparoscopic or video assisted techniques are used. On the other side more precise techniques allow a more complete and radical removal of endocrine tissue, especially in thyroid surgery. This article presents a summary of current operative techniques and strategies in endocrine surgery.

Value of high-definition imaging in neuroendoscopy.

To compare the image quality of a standard definition (SD) three-chip camera with a new high-definition (HD) three-chip camera. In five neurosurgical interventions, an SD three-chip camera and an HD three-chip camera were used with the same endoscopic equipment. Both cameras were used while performing one endoscopic third ventriculostomy, one endoscope-assisted microvascular decompression, one endoscope-assisted removal of a vestibular schwannoma, and two endonasal pituitary surgeries. To provide comparable conditions, the outputs of both cameras were displayed on the same flat screen and were recorded on hard disk with an appropriate workstation using a visually lossless codec. Both cameras were used with full light intensity and maximal zoom. The cameras were connected to the same rod-lens endoscopes (2.7- and 1.7-mm lens) one after the other. The image quality of the HD camera was far superior in all applications. Especially in pituitary surgery, the difference was striking when the tumor had to be differentiated from the normal pituitary tissue. Improved resolution and color information explained the better images in HD imaging. Additionally, because of the 16:9 aspect ratio, the viewing field of the HD camera was larger than with the 4:3 aspect ratio of the SD camera. The progressive image processing of the HD camera provided a much clearer image than the interlaced image processing of the SD camera, especially with a modern flat panel screen. HD imaging provides a much better image quality compared to SD imaging. Therefore, we recommend use of HD cameras in neuroendoscopic procedures.

Robotic renal and adrenal surgery.

Technology today is evolving at a dramatic rate. Quantum development has occurred in the area of robotic enhancement technology (RET) in the last decade. Incorporation of RET with advanced telecommunication technologies is a recent integration in medicine, with growth potential and application in the delivery of modern health care. There remain, however, many areas which need to be further improved and evaluated before clinical applications of the robot become accepted in adrenal and renal minimally invasive surgery.