Predicting nipple-areolar involvement using preoperative breast MRI and primary tumor characteristics.

Background: Preoperative assessment of the nipple-areolar complex (NAC) is invaluable when considering nipple-sparing mastectomy. Our hypothesis is that breast magnetic resonance imaging (MRI) may predict involvement of the NAC with tumor.

Methods: Clinical, histopathologic, and imaging data were compiled for patients who underwent preoperative breast MRI followed by mastectomy or nipple-sparing mastectomy for malignancy between 2006 and 2009.

Local and regional control in breast cancer: role of sentinel node biopsy.

The development and acceptance of the SLND has profoundly affected the management of breast cancer. SLND has supplanted ALND as a highly accurate and less-morbid axillary staging procedure in patients with clinically node-negative early-stage breast cancer. SLND alone is associated with less than 1% isolated axillary recurrence in patients with node-negative disease and provides excellent regional nodal control.

Selective approach to use of upper gastroesophageal imaging study after laparoscopic Roux-en-Y gastric bypass.

Background: Many institutions routinely perform upper gastroesophageal imaging (UGI) studies on their laparoscopic Roux-en-Y gastric bypass (LRYGB) patients after surgery. We had routinely studied our patients with UGI on postoperative day 1 to rule out an anastomotic leak or obstruction, until recently when we abandoned this practice. As previously reported, we found that routine UGI did not contribute significantly to patient care.

Improved outcomes using a systematic and evidence-based approach to the laparoscopic Roux-en-Y gastric bypass in a single academic institution.

No standardized approach exists for laparoscopic Roux-en-Y gastric bypass (LRYGB). At a newly instituted bariatric surgery program, four experienced laparoscopic surgeons used the systematic and evidence-based approach consisting of multidisciplinary preoperative evaluation, screening, and education; standardized operative technique; inpatient clinical pathway; and close postoperative follow-up. The outcomes were subsequently analyzed to determine if this approach improved the morbidity and mortality.

A pneumatic haptic feedback actuator array for robotic surgery or simulation.

Robot-assisted minimally invasive surgery (MIS) offers improved range of motion over standard laparoscopic techniques, but is characterized by a total loss of haptic feedback, requiring surgeons to rely solely on visual cues. Pneumatic tactile displays have many advantages, including low mass, low cost, compact size, and adaptability. A pneumatic haptic feedback actuator array has been developed that is suitable for mounting unto surgical robotic tools.

Routine postoperative upper gastroesophageal imaging is unnecessary after laparoscopic Roux-en-Y gastric bypass.

Routine early postoperative upper gastroesophageal imaging (UGI) is often used in laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures to confirm anastomotic patency and to exclude leaks. The aim of our study was to assess the usefulness of this practice. From January 2003 to November 2004, 322 LRYGB cases were performed using linear staplers for the gastrojejunostomy and jejuno-jejunostomy anastomoses.