Abstract:

Traumatic and end-stage organ loss or tissue damage remains a devastating issue for everyone, and a major problem for millions of patients. It has been estimated that each year in the United States more than 8 million surgical operations are performed to solve these health problems.

Authors:

Boris A. Nasseri, M.D., Joseph P. Vacanti, M.D., F.A.C.S.

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Abstract:

President Clinton's Advisory Commission report on Consumer Protection & Quality in the Health-Care Industry, identified medical error prevention as an important issue in health-management. Patient safety is finally being institutionalized due to growing concern over the increasing cost of human error. Medicine's punitive perfectibility model in dealing with unintended injury is slowly evolving to accept error during operations as an inevitable, yet manageable, reality of surgery.

Authors:

Boris A. Nasseri, M.D., Joseph P. Vacanti, M.D., F.A.C.S.

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Abstract:

A telerobotic device, the daVinci Surgical System (Intuitive Surgical, Inc., Mountain View, CA) is one of the recently developed, remotely operated systems for laparoscopic surgical procedures. This telemanipulation system consists of two components: a control console operated by the surgeon, and the surgical arm cart that holds a three-dimensional (3-D) 30° laparoscope and two detachable laparoscopic surgical tools. The instruments are equipped with a wrist - a unique feature that provides additional dexterity, Since its clinical introduction in Europe in early 1999, this system has opened up a new era in minimally invasive surgery enhancing endoscopic vision and anastomosis suturing. For the first time, cardiac surgeons were able to perform a totally endoscopic coronary bypass procedure on a beating heart.

Authors:

Jochen Binder, M.D., Wolfgang Kramer, M.D.

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Abstract:

Worldwide, hepatocellular carcinoma (HCC) is one of the most common and deadly solid cancers. At least one million new patients are diagnosed annually with this cancer. Incidence in non-Western countries is related to infections of hepatitis B virus and dietary ingestion of aflatoxins, whereas in Western countries alcohol-related cirrhosis and chronic hepatitis C virus infection are leading causes of HCC. In the United States, approximately 155,000 new cases of cancer of the liver and bile duct occur annually, with the majority being colorectal metastases.

Authors:

Steven A. Curley, M.D., F.A.C.S., Francesco Izzo, M.D.

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Abstract:

Pancreaticoduodenectomy, mostly performed for pancreatic cancer, has been associated with considerable morbidity rates (40%-60%) and mortality rates (20%-30%). Even after resection, the prognosis is poor, and as a result some physicians have kept a nihilistic approach; Gudjonsson concluded in his review that pancreatic resections are a waste of resources. During the last decade, mortality rates have decreased dramatically to less than 5% in centers with experrence, and have led to a more optimistic view in favor of resection.

Authors:

Rutger C.I. Van Geenen, M.D., Dirk J. Gouma, M.D.

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Abstract:

Primary hyperparathyroidism (HPT) is a common disease that occurs in one of 500 women and one of 2000 men over the age of 40. In 85% to 90% of patients, primary HPT is caused by a solitary parathyroid adenoma. Recent advances in evaluation and surgical management of HPT, including improved localization techniques and intraoperative parathyroid hormone (PTH) monitoring, have permitted a more targeted approach to parathyroid surgery.

Authors:

Francesco Rubino, M.D., William B. Inabnet, M.D.

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Abstract:

The surgeon's working environment has changed continuously in recent years regarding the technical complexity of the components in use in the operating room (OR). Parallel to this development, demands for process-optimized procedures have also grown constantly. The impetus for these changes was the beginning of use of minimally invasive techniques in surgery. In contrast, overall development of the OR itself has been slight or nonexistent. What we are typically confronted with currently is an OR outfitted with high-tech medical equipment, whereas only to a limited extent can the design of the OR itself be regarded as ergonomic or holistic. This situation has spread to related specialties as well, and represents a general tendency. Whereas dentists, for example, already enjoy the benefits of a centralized management and operation workplace, this development has not yet reached a satisfactory level for surgeons.

Authors:

Prof. Anton Schafmayer, M.D., Dirk Lehmann-Beckow, M.D., Martin Holzner

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Abstract:

Leiomyosarcoma of the vulva is a rare gynaecological malignancy. To date, only few cases have been reported in the literature, the majority of which are from Western countries. Although leiomyosarcoma is classically regarded as a malignant tumor, the generally favorable prognosis following surgical treatment, as well as its reduced propensity for widespread metastasis, makes it one of the most enigmatic malignancies in the medical literature. In addition, the tumor may attain enormous morphological proportions, a situation unusual in many malignant tumors.

Authors:

Valentine Otoide, M.D., Michael Okobia, M.D., Jonathan Aligbe, M.D., F.M.C. Path, Friday Okonofua, M.D., F.W.A.C.S., F.M.C.O.G.

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