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Stuttgart, Germany

Duppers P.,Universitatsklinikum Dusseldorf | Sunder-Plassmann L.,Klinik fur Allgemein Viszeral | Schelzig H.,Universitatsklinikum Dusseldorf
Gefasschirurgie | Year: 2014

The mediastinal bronchial artery aneurysm is a rare but life-threatening vascular lesion and should be treated independently of the type of lesion and clinical symptoms. Diagnostic procedures should always include registration of cardiopulmonary risk factors, contrast-enhanced computed tomography scan and if applicable arterial angiography. Advantages and disadvantages of surgical and endovascular therapy have to be carefully recalculated for every patient individually. Due to described relapses, especially for patients treated exclusively by interventions, frequent follow-up examinations are strongly advised. © 2014 Springer-Verlag Berlin Heidelberg. Source

Fuchs K.-H.,Klinik fur Allgemein Viszeral | Breithaupt W.,Klinik fur Allgemein Viszeral
Surgical Endoscopy and Other Interventional Techniques | Year: 2012

Background: Recently, natural orifice transluminal endoscopic surgery has been introduced using flexible endoscopic technology. Traditional endoscopes lack several capabilities that are needed to perform complex surgical procedures safely. The purpose of this study was to evaluate the new multitasking platform for transgastric small bowel resection including dissection of the mesentery and suturing an anastomosis. Methods: A new prototype of endoscopic multifunctional platform, EndoSAMURAI ™ (ES), was tested. A standardized in vitro setting was established with segments of small bowel and an anastomosis was sutured with the device and compared with that by stapler (ST) and handsewn (HS). Leak pressure was measured. In addition, the system was tested in an experimental in vivo situation by performing a transgastric small bowel segmental resection under general anesthesia. Results Median time to perform an anastomosis in the bench test was 41 min; median leak pressure for the anastomosis by ES was 14 mmHg, by ST 25 mmHg, and HS 15 mmHg. For the in vivo study, the median total procedure time was 110 min and leak pressure 53 mmHg. These results show that the end-to-end small bowel anastomosis can be sutured sufficiently. Conclusions: This study has shown that with a multifunctional platform such as the EndoSAMURAITM, the majority of complex surgical tasks can be performed if technically independently moving instruments can be used via an ergonomic workstation interface that allows for laparoscopy-like maneuvers by the operator. Even with the shortcomings of the prototype, it was possible to perform an anastomosis of the small bowel of acceptable quality within a reasonable time. © Springer Science+Business Media, LLC 2012. Source

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