Since the days of Albukasim in medieval Spain, natural orifices have been regarded not only as a rather repugnant source of bodily odors, fluids and excreta, but also as a convenient invitation to explore and treat the inner passages of the organism. However, surgical ingenuity needed to be matched by appropriate tools and devices. Lack of technologically advanced instrumentation was a strong deterrent during almost a millennium until recent decades when a quantum jump materialized. Endoscopic surgery is currently a vibrant and growing subspecialty, which successfully handles millions of patients every year. Additional opportunities lie ahead which might benefit millions more, however, requiring even more sophisticated apparatuses, particularly in the field of robotics, artificial intelligence, and tissue repair (surgical suturing). This is a particularly exciting and worthwhile challenge, namely of larger and safer endoscopic interventions, followed by seamless and scarless recovery. In synthesis, the future is widely open for those who use together intelligence and creativity to develop new prototypes, new accessories and new techniques. Yet there are many challenges in the path of endoscopic surgery. In this new era of robotic endoscopy, one will likely need a virtual simulator to train and assess the performance of younger doctors. More evidence will be essential in multiple evolving fields, particularly to elucidate whether more ambitious and complex pathways, such as intrathoracic and intraperitoneal surgery via natural orifice transluminal endoscopic surgery (NOTES), are superior or not to conventional techniques.
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http://dx.doi.org/10.1111/jgh.12577 | DOI Listing |
Tech Coloproctol
December 2024
Department of Faculty Surgery No. 2, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Background: Reduced-port laparoscopic surgery (RPLS) uses the minimum possible number of ports or small-sized ports in laparoscopic surgery. The combination of RPLS and natural orifice specimen extraction (NOSE) minimizes the procedural damage.
Methods: A total of 17 patients diagnosed with right colon cancer were included: 5 patients in the RPLS + NOSE group and 12 patients in the conventional laparoscopic surgery (CL) + mini-laparotomy (ML) group.
Arch Orthop Trauma Surg
December 2024
Department of Trauma and Orthopaedic, AO Hospital, Karachi, Pakistan.
Aims: This study presents clinical outcomes, functional results, and return to sports after anterior cruciate ligament (ACL) reconstruction using quadruple hamstring tendon autograft or peroneus longus tendon autograft in a randomized controlled trial.
Patients And Methods: Between February 2018 and July 2019, patients who underwent ACL reconstruction were randomly assigned to two groups: hamstring and peroneus longus. Patient related outcome measurements and pain intensity were evaluated using IKDC, Lysholm, and visual analog scores at 3 and 6 months, 1, 2, and 5 years after the surgery.
ACS Nano
December 2024
School of Chemical Engineering, Sungkyunkwan University, Suwon 16419, Republic of Korea.
Rapid diagnosis of cerebrospinal fluid (CSF) leaks is critical as endoscopic endonasal skull base surgery gains global prominence. Current clinical methods such as endoscopic examination with and without intrathecal injection of fluorescent dye are invasive and rely on subjective judgment by physicians, highlighting the clinical need for label-free point-of-care (POC). However, a viable solution remains undeveloped due to the molecular complexity of CSF rhinorrhea mixed with nasal discharge and the scarcity of specific biomarkers, delaying sensor development.
View Article and Find Full Text PDFGastroenterol Nurs
December 2024
About the authors: Frances R. Roe, MSN, RN, CNOR, Clinical Practice Support, Legacy Health, Portland, Oregon.
Anesthesia shortages impact patient accessibility to endoscopy procedures. The administration of midazolam and fentanyl by a nurse is an accepted practice of delivering procedural sedation, though there is still controversy around the safety of a nurse administered propofol sedation (NAPS) program. Applicable professional organizations have provided statements supporting NAPS by a trained and competent nurse under the direction of an appropriately credentialed proceduralist.
View Article and Find Full Text PDFWorld J Gastroenterol
December 2024
Department of Gastroenterology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou 450000, Henan Province, China.
Background: Submucosal invasion in early-stage gastric cancer (GC) is a critical determinant of prognosis and treatment strategy, significantly influencing the risk of lymph node metastasis and recurrence. Identifying risk factors associated with submucosal invasion is essential for optimizing patient management and improving outcomes.
Aim: To comprehensively analyze clinical, imaging, and endoscopic characteristics to identify predictors of submucosal invasion in patients with early-stage differentiated GC.
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