The Experts below are selected from a list of 26274 Experts worldwide ranked by ideXlab platform
Abraham Mathew - One of the best experts on this subject based on the ideXlab platform.
-
self approximating transluminal access technique for natural orifice transluminal endoscopic surgery a porcine survival study with video
Gastrointestinal Endoscopy, 2008Co-Authors: Eric M Pauli, Matthew T Moyer, Randy S Haluck, Abraham MathewAbstract:Background The ability to access the Abdominal Cavity though a direct (modified-PEG type) gastric incision to perform natural orifice transluminal endoscopic surgery (NOTES) has been demonstrated in the literature. However, the optimal technique to access the abdomen remains unknown. Objective The aim of this study was to evaluate the safety and feasibility of a transgastric approach to the Abdominal Cavity through an extended submucosal tunnel. Design Animal feasibility study. Interventions Transgastric endoscopic peritoneoscopy was performed in 7 anesthetized swine, including 2 acute and 5 survival animals. After the creation of a 10-cm to 12-cm tunnel in the gastric submucosal plane, the peritoneal Cavity was accessed by needle-knife puncture through the gastric wall near the greater curvature. The peritoneal Cavity was examined before the gastric mucosal incision was closed with endoclips. Survival animals were euthanized two weeks after the procedure, and a necropsy was performed. Results The Abdominal Cavity was successfully entered without complication in all 7 animals. The mucosal incisions were able to be closed by endoscopy. In the survival experiments, all animals recovered and gained weight. Two animals experienced clinically unapparent infectious complications. Limitations Small sample size. Conclusions A peroral transgastric approach to the Abdominal Cavity through an extended submucosal tunnel is technically feasible and allows safe Abdominal access and reliable closure with currently available technology. It has potential benefits as an alternative to direct transgastric access for NOTES procedures.
Nabeel Ibrahim - One of the best experts on this subject based on the ideXlab platform.
-
preoperative progressive pneumoperitoneum complementing chemical component relaxation in complex ventral hernia repair
Surgical Endoscopy and Other Interventional Techniques, 2017Co-Authors: Kristen E Elstner, John W Read, Omar Rodriguezacevedo, Kevin Hoshon, John Magnussen, Nabeel IbrahimAbstract:Background A rarely used technique for enabling closure of large ventral hernias with loss of domain is preoperative progressive pneumoperitoneum (PPP), which uses intermittent insufflation to gradually stretch the contracted Abdominal wall muscles, increasing the capacity of the Abdominal Cavity. This allows the re-introduction of herniated viscera into the Abdominal Cavity and assists in closure of giant hernias which may otherwise be considered inoperable.
Eric M Pauli - One of the best experts on this subject based on the ideXlab platform.
-
self approximating transluminal access technique for natural orifice transluminal endoscopic surgery a porcine survival study with video
Gastrointestinal Endoscopy, 2008Co-Authors: Eric M Pauli, Matthew T Moyer, Randy S Haluck, Abraham MathewAbstract:Background The ability to access the Abdominal Cavity though a direct (modified-PEG type) gastric incision to perform natural orifice transluminal endoscopic surgery (NOTES) has been demonstrated in the literature. However, the optimal technique to access the abdomen remains unknown. Objective The aim of this study was to evaluate the safety and feasibility of a transgastric approach to the Abdominal Cavity through an extended submucosal tunnel. Design Animal feasibility study. Interventions Transgastric endoscopic peritoneoscopy was performed in 7 anesthetized swine, including 2 acute and 5 survival animals. After the creation of a 10-cm to 12-cm tunnel in the gastric submucosal plane, the peritoneal Cavity was accessed by needle-knife puncture through the gastric wall near the greater curvature. The peritoneal Cavity was examined before the gastric mucosal incision was closed with endoclips. Survival animals were euthanized two weeks after the procedure, and a necropsy was performed. Results The Abdominal Cavity was successfully entered without complication in all 7 animals. The mucosal incisions were able to be closed by endoscopy. In the survival experiments, all animals recovered and gained weight. Two animals experienced clinically unapparent infectious complications. Limitations Small sample size. Conclusions A peroral transgastric approach to the Abdominal Cavity through an extended submucosal tunnel is technically feasible and allows safe Abdominal access and reliable closure with currently available technology. It has potential benefits as an alternative to direct transgastric access for NOTES procedures.
Samir Rasslan - One of the best experts on this subject based on the ideXlab platform.
-
a computerized tomography scan method for calculating the hernia sac and Abdominal Cavity volume in complex large incisional hernia with loss of domain
Hernia, 2010Co-Authors: E Y Tanaka, J H Yoo, Aldo Junqueira Rodrigues, Edivaldo Massazo Utiyama, D Birolini, Samir RasslanAbstract:Preoperative progressive pneumoperitoneum (PPP) is a safe and effective procedure in the treatment of large incisional hernia (size > 10 cm in width or length) with loss of domain (LIHLD). There is no consensus in the literature on the amount of gas that must be insufflated in a PPP program or even how long it should be maintained. We describe a technique for calculating the hernia sac volume (HSV) and Abdominal Cavity volume (ACV) based on Abdominal computerized tomography (ACT) scanning that eliminates the need for subjective criteria for inclusion in a PPP program and shows the amount of gas that must be insufflated into the Abdominal Cavity in the PPP program. Our technique is indicated for all patients with large or recurrent incisional hernias evaluated by a senior surgeon with suspected LIHLD. We reviewed our experience from 2001 to 2008 of 23 consecutive hernia surgical procedures of LIHLD undergoing preoperative evaluation with CT scanning and PPP. An ACT was required in all patients with suspected LIHLD in order to determine HSV and ACV. The PPP was performed only if the volume ratio HSV/ACV (VR = HSV/ACV) was ≥25% (VR ≥ 25%). We have performed this procedure on 23 patients, with a mean age of 55.6 years (range 31–83). There were 16 women and 7 men with an average age of 55.6 years (range 31–83), and a mean BMI of 38.5 kg/m2 (range 23–55.2). Almost all patients (21 of 23 patients—91.30%) were overweight; 43.5% (10 patients) were severely obese (obese class III). The mean calculated volumes for ACV and HSV were 9,410 ml (range 6,060–19,230 ml) and 4,500 ml (range 1,850–6,600 ml), respectively. The PPP is performed by permanent catheter placed in a minor surgical procedure. The total amount of CO2 insufflated ranged from 2,000 to 7,000 ml (mean 4,000 ml). Patients required a mean of 10 PPP sessions (range 4–18) to achieve the desired volume of gas (that is the same volume that was calculated for the hernia sac). Since PPP sessions were performed once a day, 4–18 days were needed for preoperative preparation with PPP. The mean VR was 36% (ranged from 26 to 73%). We conclude that ACT provides objective data for volume calculation of both hernia sac and Abdominal Cavity and also for estimation of the volume of gas that should be insufflated into the Abdominal Cavity in PPP.
Wei Bo Zhang - One of the best experts on this subject based on the ideXlab platform.
-
characterization of the primo vascular system in the Abdominal Cavity of lung cancer mouse model and its differences from the lymphatic system
PLOS ONE, 2010Co-Authors: Jung Sun Yoo, Hossein M Ayati, Hong Bae Kim, Wei Bo Zhang, Kwangsup SohAbstract:Cancer growth and dissemination have been extensively studied for a long time. Nevertheless, many new observations on anatomy and histopathology of cancer events are still reported such as formation of a vasculogenic-like network inside aggressive tumors. In this research, new kinds of micro-conduits, named primo-vessels, were found inside the Abdominal Cavity of NCI-H460 lung cancer murine xenograft models. These vascular threads were largely distributed on the surfaces of various organs and were often connected to peritoneal tumor nodules. Histological and immunofluorescent investigations showed that the primo-vessels had characteristic features that were distinctively different from those of similar-looking lymphatic vessels. They had multiple channels surrounded with loose collageneous matrices, which is in contrast to the single-channel structure of other vascular systems. The rod-shaped nuclei aligned longitudinally along the channels were assumed to be the endothelial cells of the primo-vessels, but LYVE-1, a specific marker of lymphatics, was not expressed, which indicates a clear difference from lymphatic endothelial cells. Taken together these findings on and characterization of the novel threadlike vascular structures in cancer models may have important implications for cancer prognosis and for therapy.
-
characterization of the primo vascular system in the Abdominal Cavity of lung cancer mouse model and its differences from the lymphatic system
PLOS ONE, 2010Co-Authors: Hossein M Ayati, Wei Bo ZhangAbstract:Cancer growth and dissemination have been extensively studied for a long time. Nevertheless, many new observations on anatomy and histopathology of cancer events are still reported such as formation of a vasculogenic-like network inside aggressive tumors. In this research, new kinds of micro-conduits, named primo-vessels, were found inside the Abdominal Cavity of NCI-H460 lung cancer murine xenograft models. These vascular threads were largely distributed on the surfaces of various organs and were often connected to peritoneal tumor nodules. Histological and immunofluorescent investigations showed that the primo-vessels had characteristic features that were distinctively different from those of similar-looking lymphatic vessels. They had multiple channels surrounded with loose collageneous matrices, which is in contrast to the single-channel structure of other vascular systems. The rod-shaped nuclei aligned longitudinally along the channels were assumed to be the endothelial cells of the primo-vessels, but LYVE-1, a specific marker of lymphatics, was not expressed, which indicates a clear difference from lymphatic endothelial cells. Taken together these findings on and characterization of the novel threadlike vascular structures in cancer models may have important implications for cancer prognosis and for therapy.
