This work is a topic highlight on the surgical treatment of the right colon pathologies,focusing on the literature state of art and comparing the open surgery to the different laparoscopic and robotic procedures.Diffe...This work is a topic highlight on the surgical treatment of the right colon pathologies,focusing on the literature state of art and comparing the open surgery to the different laparoscopic and robotic procedures.Different laparoscopic procedures have been described for the treatment of right colon tumors: Totally laparoscopic right colectomy,laparoscopic assisted right colectomy,laparoscopic facilitated right colectomy,hand-assisted right colectomy,single incision laparoscopic surgery colectomy,robotic right colectomy.Two main characteristics of these techniques are the different type of anastomosis: Intracorporeal(for totally laparoscopic right colectomy,single incision laparoscopic surgery colectomy,laparoscopic assisted right colectomy and robotic technique) or extracorporeal(for laparoscopic assisted right colectomy,laparoscopic facilitated right colectomy,hand-assisted right colectomy and open right colectomy) and the different incision(suprapubic,median or transverse on the right side of abdomen).The different laparoscopic techniques meet the same oncological criteria of radicalism as the open surgery for the right colon.The totally laparoscopic right colectomy with intracorporeal anastomosis and even more the single incision laparoscopic surgery colectomy,remain a technical challenge due to the complexity of procedures(especially for the single incision laparoscopic surgery colectomy) and the particular right colon vascular anatomy but they seem to have some theoretical advantages compared to the other laparoscopic and open procedures.Data reported in literature while confirming the advantages of laparoscopic approach,do not allow to solve controversies about which is the best laparoscopic technique(Intracorporeal vs Extracorporeal Anastomosis) to treat the right colon cancer.However,the laparoscopic techniques with intracorporeal anastomosis for the right colon seem to show some theoretical advantages(functional,technical,oncological and cosmetic advantages) even if all studies conclude that further prosp展开更多
This study explored the feasibility of employing computer-aided design(CAD)and 3 dimensional(3D)-printed personalized guide plate for the mini-invasive percutaneous internal screw fixation of fractured scaphoid.The st...This study explored the feasibility of employing computer-aided design(CAD)and 3 dimensional(3D)-printed personalized guide plate for the mini-invasive percutaneous internal screw fixation of fractured scaphoid.The study consisted of two parts:(1)experimentation on upper limbs from corpses and(2)preliminary clinical application.Corpse experiments involved upper limbs of 6 adult corpses.The specimens of upper limbs were subjected to plain CT scan.Then the CT data were input into computer to conduct 3D reconstruction of wrist region.The direction and depth of the guide wire and screw were designed on the basis of the principle that screw should lie at the center of scaphoid and the long axis of the screw should be aligned with that of the scaphoid.The carpal bone model and the guide plate were designed and 3D-printed.By using the guide plates,the guide wire was placed and the cannulated compression screw was inserted.The wrist region was examined by X-ray and CT to observe the location of the screw in the scaphoid.The scaphoid was longitudinally excised to grossly observe the location and evaluate the result of screw insertion.For clinical application,the guide plate was employed in 4 patients with fresh scaphoid fracture using the aforementioned operative technique.Our results showed that,in the 6 corpse limbs,the guide plate well fitted the skin surface and the guide wire and screw were accurately put in place in one session.X-ray examination and gross observation confirmed that the screw was satisfactorily positioned and the result met the requirements of the preoperative design.For 4 patients,the guide wire and screw were all precisely inserted into place in one session.The operation time and X-ray exposure times were apparently reduced.The imaging examination exhibited satisfactory results and the hand functioned well.It was concluded that the operative guide plate used for the miniinvasive percutaneous internal screw fixation of fractured scaphoid not only can assist in accurate placement of screw but also 展开更多
文摘This work is a topic highlight on the surgical treatment of the right colon pathologies,focusing on the literature state of art and comparing the open surgery to the different laparoscopic and robotic procedures.Different laparoscopic procedures have been described for the treatment of right colon tumors: Totally laparoscopic right colectomy,laparoscopic assisted right colectomy,laparoscopic facilitated right colectomy,hand-assisted right colectomy,single incision laparoscopic surgery colectomy,robotic right colectomy.Two main characteristics of these techniques are the different type of anastomosis: Intracorporeal(for totally laparoscopic right colectomy,single incision laparoscopic surgery colectomy,laparoscopic assisted right colectomy and robotic technique) or extracorporeal(for laparoscopic assisted right colectomy,laparoscopic facilitated right colectomy,hand-assisted right colectomy and open right colectomy) and the different incision(suprapubic,median or transverse on the right side of abdomen).The different laparoscopic techniques meet the same oncological criteria of radicalism as the open surgery for the right colon.The totally laparoscopic right colectomy with intracorporeal anastomosis and even more the single incision laparoscopic surgery colectomy,remain a technical challenge due to the complexity of procedures(especially for the single incision laparoscopic surgery colectomy) and the particular right colon vascular anatomy but they seem to have some theoretical advantages compared to the other laparoscopic and open procedures.Data reported in literature while confirming the advantages of laparoscopic approach,do not allow to solve controversies about which is the best laparoscopic technique(Intracorporeal vs Extracorporeal Anastomosis) to treat the right colon cancer.However,the laparoscopic techniques with intracorporeal anastomosis for the right colon seem to show some theoretical advantages(functional,technical,oncological and cosmetic advantages) even if all studies conclude that further prosp
文摘This study explored the feasibility of employing computer-aided design(CAD)and 3 dimensional(3D)-printed personalized guide plate for the mini-invasive percutaneous internal screw fixation of fractured scaphoid.The study consisted of two parts:(1)experimentation on upper limbs from corpses and(2)preliminary clinical application.Corpse experiments involved upper limbs of 6 adult corpses.The specimens of upper limbs were subjected to plain CT scan.Then the CT data were input into computer to conduct 3D reconstruction of wrist region.The direction and depth of the guide wire and screw were designed on the basis of the principle that screw should lie at the center of scaphoid and the long axis of the screw should be aligned with that of the scaphoid.The carpal bone model and the guide plate were designed and 3D-printed.By using the guide plates,the guide wire was placed and the cannulated compression screw was inserted.The wrist region was examined by X-ray and CT to observe the location of the screw in the scaphoid.The scaphoid was longitudinally excised to grossly observe the location and evaluate the result of screw insertion.For clinical application,the guide plate was employed in 4 patients with fresh scaphoid fracture using the aforementioned operative technique.Our results showed that,in the 6 corpse limbs,the guide plate well fitted the skin surface and the guide wire and screw were accurately put in place in one session.X-ray examination and gross observation confirmed that the screw was satisfactorily positioned and the result met the requirements of the preoperative design.For 4 patients,the guide wire and screw were all precisely inserted into place in one session.The operation time and X-ray exposure times were apparently reduced.The imaging examination exhibited satisfactory results and the hand functioned well.It was concluded that the operative guide plate used for the miniinvasive percutaneous internal screw fixation of fractured scaphoid not only can assist in accurate placement of screw but also
