Lobectomy in octogenarians: real world outcomes for robotic-assisted, video-assisted thoracoscopic, and open approaches.

Background: The proportion of the elderly (≥80 years old) patient population in the United States is increasing. Consequently, surgeons are more involved in the care of these patients than they had been in the past. Therefore, surgeons must re-evaluate their prior assumptions about their surgical management of octogenarian patients.

Propensity-Matched Analysis of Sigmoidectomies for Diverticular Disease.

Background And Objectives: The role for the robotic-assisted approach as a minimally invasive alternative to open colorectal surgery is in the evaluation phase. While the benefits of minimally invasive colorectal surgery when compared to the open approach have been clearly demonstrated, the adoption of laparoscopy has been limited. The purpose of this study was to evaluate clinical outcomes, hospital and payer characteristics of patients undergoing robotic-assisted, laparoscopic, and open elective sigmoidectomy for diverticular disease in the United States.

Robotic-assisted ileocolic resection for Crohn's disease: outcomes from an early national experience.

Crohn's disease is an incurable inflammatory disorder that can affect the entire gastrointestinal tract. While medical management is considered first-line treatment, approximately 70-90% of patients with Crohn's disease will require at least one surgical intervention during the course of their lifetimes. Traditionally, abdominal surgery for Crohn's disease has been performed via an open approach with an increasing adoption of minimally invasive techniques.

Robotic-Assisted Versus Thoracoscopic Lobectomy Outcomes From High-Volume Thoracic Surgeons.

Background: Reports of surgical outcomes comparing proficient surgeons who perform either robotic-assisted or video-assisted thoracoscopic lobectomy are lacking. We evaluate the comparative effectiveness of robotic-assisted and video-assisted thoracoscopic lobectomies by surgeons who performed 20 or more annual surgical procedures in a national database.

Methods: Patients 18 years or older, who underwent elective lobectomy by surgeons who performed 20 or more annual lobectomies by robotic-assisted or thoracoscopic approach from January 2011 through September 2015, were identified in the Premier Healthcare database with the use of codes from the ninth revision of the International Statistical Classification of Diseases and Related Health Problems.

Robotic-Assisted, Video-Assisted Thoracoscopic and Open Lobectomy: Propensity-Matched Analysis of Recent Premier Data.

Background: Robotic-assisted lobectomy (RL) is becoming a popular alternative technique to video-assisted thoracoscopic lobectomy (VL), although open lobectomy (OL) remains the most common approach. The objective of this study is to provide a comparative analysis of perioperative clinical outcomes from elective RL, VL, and OL.

Methods: The Premier Healthcare Database was analyzed for lobectomies performed from January 1, 2011, to September 30, 2015.

Sideways displacement of the endograft within the aneurysm sac is associated with late adverse events after endovascular aneurysm repair.

Objective: Previous studies have shown the importance of proximal and distal endograft fixation. There is little information on the middle, unsupported section of endograft within the aneurysm sac. We quantified sideways movement of the endograft within the aneurysm sac and correlated it to late adverse events.

Computational analysis of stresses acting on intermodular junctions in thoracic aortic endografts.

Purpose: To evaluate the biomechanical and hemodynamic forces acting on the intermodular junctions of a multi-component thoracic endograft and elucidate their influence on the development of type III endoleak due to disconnection of stent-graft segments.

Methods: Three-dimensional computer models of the thoracic aorta and a 4-component thoracic endograft were constructed using postoperative (baseline) and follow-up computed tomography (CT) data from a 69-year-old patient who developed type III endoleak 4 years after stent-graft placement. Computational fluid dynamics (CFD) techniques were used to quantitate the displacement forces acting on the device.

Long-term results of Talent endografts for endovascular abdominal aortic aneurysm repair.

Background: Since the introduction of endovascular aneurysm repair (EVAR), long-term follow-up studies reporting single-device results are scarce. In this study, we focus on EVAR repair with the Talent stent graft (Medtronic, Santa Rosa, Calif).

Methods: Between July 2000 and December 2007, 365 patients underwent elective EVAR with a Talent device.

Preliminary 3D computational analysis of the relationship between aortic displacement force and direction of endograft movement.

Objective: Endograft migration is usually described as a downward displacement of the endograft with respect to the renal arteries. However, change in endograft position is actually a complex process in three-dimensional (3D) space. Currently, there are no established techniques to define such positional changes over time.