Minimally Invasive Surgery

A combination atlas and procedural guide for minimally invasive surgery Atlas of Minimally Invasive Surgical Operations delivers easy-to-follow, step-by-step procedural guidance accompanied by more than 800 high-quality illustrations designed to teach readers minimally invasive surgery techniques. Following the proven effective model of the acclaimed Zollinger’s Atlas of Surgical Operations, each procedure is fully explained with text and accompanying illustrations. The beautifully rendered line drawings depict every important action a surgeon must consider while performing the operation. The text includes consistently formatted coverage of indications, preoperative preparation, anesthesia, position, operative preparation, incision and exposure, procedure, closure, and postoperative care. · Illustrations were created by professors of medical illustration at Johns Hopkins University · Companion DVD shows the actual procedures in real time

Minimally invasive surgery has become a common term in visceral as well as gynecologic surgery. It has almost evolved into its own surgical speciality over the past 20 years. Today, being firmly established in every subspeciality of visceral surgery, it is now no longer a distinct skillset, but a fixed part of the armamentarium of surgical options available. In every indication, the advantages of a minimally invasive approach include reduced intraoperative blood loss, less postoperative pain, and shorter rehabilitation times, as well as a marked reduction of overall and surgical postoperative morbidity. In the advent of modern oncologic treatment algorithms, these effects not only lower the immediate impact that an operation has on the patient, but also become important key steps in reducing the side-effects of surgery. Thus, they enable surgery to become a module in modern multi-disciplinary cancer treatment, which blends into multimodular treatment options at different times and prolongs and widens the possibilities available to cancer patients. In this quickly changing environment, the requirement to learn and refine not only open surgical but also different minimally invasive techniques on high levels deeply impact modern surgical training pathways. The use of modern elearning tools and new and praxis-based surgical training possibilities have been readily integrated into modern surgical education, which persists throughout the whole surgical career of modern gynecologic and visceral surgery specialists.

Minimally invasive surgery has evolved as an alternative to the traditional approaches in orthopedic surgery and has gathered a great deal of attention. Many surgeons are now p- forming all types of procedures through smaller surgical felds. Along with changes in the surgical technique, there have been rapid advances in computer navigation and robotics as tools to enhance the surgeon’s vision in the limited operative felds. With these new techniques and technologies, we must ensure that these procedures are performed safely and effectively with predictable clinical outcomes. This book has been expanded from our previous publi- tions to include spine and foot and ankle surgery, along with updated sections on knee arth- plasty, hip arthroplasty, and upper extremity surgery. The clinical information and surgical techniques, along with tips and pearls, provided by experts in the feld allows the reader to grasp a comprehensive understanding of the nuances of MIS. It is our intention that this text will be a valuable reference for all orthopedic surgeons. New York, NY Giles R. Scuderi, MD Piscataway, NJ Alfred J. Tria, MD v BookID 127440_ChapID FM_Proof# 1 - 14/09/2009 Contents Section I The Upper Extremities 1 What Is Minimally Invasive Surgery and How Do You Learn It? . . . . . . . . . . . . . . . . . . . . . 3 Aaron G. Rosenberg 2 Overview of Shoulder Approaches: Choosing Between Mini-incision and Arthroscopic Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Raymond A. Klug, Bradford O. Parsons, and Evan L. Flatow 3 Mini-incision Bankart Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Edward W. Lee, Kenneth Accousti, and Evan L. Flatow 4 Mini-open Rotator Cuff Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

This text is designed to present a comprehensive, up to date and safe approach to managing emergency general surgery patients with a minimally invasive approach. This book bridges the gap between the minimally invasive surgery (MIS) expert who may not routinely be involved in the care of the acute care surgery patient and the ACS expert surgeon who may not have a routine MIS elective practice. The first section reviews the physiology of the acute care surgery patient and the physiologic impact of MIS techniques including pnemoperitoneum in critically ill patients. This review is crucial to assure that the surgeon has a clear understanding of when a MIS approach is safe and when it can be potentially dangerous to the patient. The illustrations are presented in an atlas-style format to describe the surgical procedures. The authors of the various sections are minimally invasive and acute care surgeons from prominent academic centers. The format represents a narrative review with appropriate illustrations and links to online videos.

Minimally invasive surgery has impacted the outcomes of surgery more than any technology since the development of sterile technique. The hard science has demonstrated that decrease in wound complications and recovery time has created the biggest gap with open approaches to surgery. The total economic benefit may be unfathomable when looked at comprehensively. Integral to the rise of minimal access and therapeutic techniques in surgery has been the growth of technological improvements over time. Beginning with insufflators, videoscopy, and energy devices, that evolution has continued into the development of tele-surgical devices that feature full articulation of instruments, high-resolution 3-D optics, and computer assisted movement. This has come with controversy – as the dominant manufacturer of robotic assisted devices, Intuitive Surgical, and their generations of da Vinci surgical platforms, holds enough market share to spur cries of monopoly and financial excess. However, with over 3000 world-wide systems in use, and over 6000 peer-reviewed research articles, the impact of robotic surgery cannot be ignored. The current state of data suggests equivalency in most procedures with regard to traditional outcome measures, equal or somewhat elevated costs, with specific areas of superiority. The first section of this textbook, Surgical Robots, covers the history, economics, training, and medico-legal aspects of robotic surgery that will be of interest to students, residents, fellows, surgical staff, and administrators or public health specialists who seek to gain a comprehensive background on robotic surgery, or justification for purchasing a robotic system for their institution. Surgeons will also find this background valuable to their practice, to give context to their procedures so they can better counsel their patients, help with advocating for robotic platform purchases, and proactively prepare themselves for medico-legal issues. The chapter on legal issues will have specific instances of robotic surgery-related lawsuits and their outcomes, a first for robotic surgery texts. The second section of this textbook, Robotic Procedures, will contain a comprehensive catalogue of procedures that have been performed robotically in general surgery, gynecology, urology, plastic surgery, cardiothoracic, and otolaryngology. Each author will cover the existing literature, preoperative planning, room and patient setup, steps of the procedure, and postoperative care. Standardized room maps and port placement will help the student, resident, fellow, surgeon or OR Staff to quickly reference these before cases. Each chapter will also cover the specific equipment needs and expected complexity of the procedures, allowing administrators to better gauge how to prepare for, or ration, use or their robotic resources. The final section, Future of Robotics, will give the entire scope of audience a look into what exciting advancements in the field are on the horizon. This textbook is a complete resource for robotic-assisted minimally invasive surgery, covering the history, current state, technical and clinical aspects, and future considerations that may be of interest to any who has a role, stake, or curiosity regarding robotic surgery.

The second edition of Minimally Invasive Bariatric Surgery provides a comprehensive, state-of-the art review of this field, and it serves as a valuable resource for clinicians, surgeons and researchers with an interest in minimally invasive bariatric surgery. Additionally, the second edition includes new features that will benefit the resident, fellow, or bariatric surgeon new to the field. Specifically, each evidence-based chapter (i.e. outcomes, complications, epidemiology, etc) concludes with three or four exam questions that emphasize the salient points of the chapter and provide fellowship programs a valuable training tool and resource for their academic curriculum. These questions are either single-answer multiple choice or true/false format and the correct response with a brief explanation follows. As more emphasis is placed on completing a comprehensive curriculum and obtaining certification for bariatric training, this aspect of the book is unique and provides added value to the text. The new edition also incorporates many new or updated medical illustrations to enhance the technique chapters and provide more uniformity for the artwork throughout the book. Each of the major procedures include surgical technique, outcomes, and management of complications in separate chapters to provide an easy reference for the busy clinician preparing for a case or presentation. Another unique feature of the text is a link to video files hosted online for the relevant chapters. This video library will be of great value to the user. As the number of fellowships in laparoscopic bariatric surgery continues to increase, this updated text will provide a valuable resource for general and bariatric surgeons, laparoscopic surgeons, fellows, residents, medical students, obesity researchers, and industry representatives involved in this field.

The EAES Manual of Endoscopic Surgery provides surgeons and surgical residents with the best practical knowledge currently available on commonly performed minimally invasive abdominal and thoracic procedures. Expert European surgeons share their career-long experience by dissecting operative procedures step by step and highlighting potential technical and anatomical hazards. Authors instruct the reader in a fashion similar to the conversations that take place between master surgeons and their apprentices while scrubbing for surgery. Uniform full color illustrations complete the detailed descriptions of minimally invasive surgeries. In addition to the operative instructions, a key component of the manual is the provision of information on patient selection, choice of operative approach, special needs for minimally invasive procedures, and the early diagnosis and treatment of complications after surgery. ​

Laparoscopic colectomy has been introduced in the early 90ies as a new technique with proven improvement in short and long term outcome. Despite significant patient benefits the overall adoption rate remains low. On the other hand significant more advanced techniques such as single incision laparoscopy, robotics and transanal access surgery have been introduced in the last several years and are rapidly evolving. Therefore a significant gap between the practicing community surgeon and innovator seems to exist. Advanced Techniques in Minimally Invasive and Robotic Colorectal Surgery bridges that gap and provides a foundation summarizing and organizing all classic and new techniques in minimally invasive colorectal surgery available in literature and from masters within the field.It provides tips and tricks that allow the user to move up the learning curve, manage difficult scenarios, overcome challenges, increase the utilization of minimal invasive techniques and decrease the conversion to open surgery. By enhancing the surgical tool box the surgeon will be able to progress from the novice to the master. Rather than describing operative procedures which may be very biased by an individual author, the guide provides alternative building blocks of various difficulty for different procedures which can be then tailored to the patient and surgeon`s own comfort level and experience. Advanced Techniques in Minimally Invasive and Robotic Colorectal Surgery will serve as a inspirational guide for the innovator of the future. It will allow surgeons of all levels to better adapt to inevitable changes in future techniques and will be of great value to general surgeons, colon and rectal surgeons, minimally invasive surgeons as well as residents and fellows.