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Fertility outcome analysis after modified laparoscopic microsurgical tubal anastomosis

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《医学前沿（英文）》 2011年 第5卷 第3期   页码 310-314 doi: 10.1007/s11684-011-0152-8

摘要：

Modified laparoscopic microsurgical tubal anastomosis is an alternative for microsurgical anastomosis via laparotomy to reverse sterilization in women with renewed child wish. The current study aims to evaluate the fertility outcome after modified laparoscopic microsurgical tubal anastomosis. A retrospective study was performed. Fifty-eight women who underwent modified laparoscopic microsurgical tubal anastomosis were monitored to investigate the fertility outcome and characteristics of this new technology. Of the 58 patients, the cumulative pregnancy rate (PR) in the 42 patients with follow-up data was 23.8% (10/42), 57.1% (24/42), 66.7% (28/42), and 73.8% (31/42) within 6, 12, 24, and 36 months after surgery, respectively. The intrauterine PR was 69.0% (29/42). Two patients (4.8%) had ectopic pregnancies that occurred within 24 months of surgery; three cases ended in spontaneous abortion. The delivery rate was 83.9% (26/31). The length of operating time was 1.2±0.3 h, with a range of 1.0–2.5 h (60–145 min), and the mean time was approximately 75 min. The blood loss was relatively small, between 10 and 50 ml with an average amount of 22 ml. Thus, the modified laparoscopic tubal anastomosis is a highly successful procedure and a viable alternative to open abdominal microsurgical approaches. Compared with the traditional laparoscopic tubal sterilization reversal, this modified approach has three advantages: (1) less invasive approach via a trocar reduction; (2) remodeling of tube is better performing tied together after 3–4 sutures; and (3) faster operating time.

关键词： modified laparoscopy     tubal anastomosis     microsurgery    

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The second short-term warm ischemia after vascular anastomosis did not affect early renal function recovery

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《医学前沿（英文）》 2012年 第6卷 第3期   页码 329-331 doi: 10.1007/s11684-012-0211-9

摘要：

Ischemic postconditioning was defined as rapid intermittent interruptions of blood ?ow in the early phase of reperfusion, which has been found to be protective against renal ischemia-reperfusion injury (IRI) in animal models but not in clinical trials. We describe a case that the allograft renal vein was twisted because of the surgeon’s mistake, which caused the warm ischemia of allograft after reperfusion. The allograft restored blood flow without second reperfusion and cold preservation after 9 min of warm ischemia. The patient was followed up for 3 months and the allograft worked well without complications.

关键词： renal transplantation     vein twist     ischemia-reperfusion injury    

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Splenic autotransplantation and oesophageal transection anastomosis in patients with portal hypertension

CHEN Jisheng, HUO Jinshan, ZHANG Hongwei, SHANG Changzhen, CHEN Rufu, ZHANG Jie, Obetien Mapudengo, CHEN Yajin, ZHANG Lei

《医学前沿（英文）》 2007年 第1卷 第1期   页码 30-35 doi: 10.1007/s11684-007-0006-6

摘要： The surgical treatment methods for cirrhosis patients complicated with portal hypertension are complicated. In this study, we evaluated the effectiveness of a new treatment strategy: splenic auto-transplantation and oesophageal transection anastomosis on 274 patients from three aspects: clinical observation, splenic immunology and portal dynamics. From 1979 to 2005, 274 cirrhosis patients with portal hypertension who underwent the new treatment strategy were followed up to observe different clinical indexes, which were then compared with those of the traditional surgery treatment. From 1999 to 2002, a randomized control trial (RCT) was performed on 40 patients to compare their immune function after operation. From 1994 to 2004, another RCT was carried out on 28 patients to compare the portal dynamics through three-dimensional dynamic contrast enhanced MR angiography (3D DEC MRA) investigation after operation. Among 274 patients (mean age 41.8 years), the emergency operative mortality (4.4%), selective operative mortality (2.2%), complication rate (17.9%), morbidity of hepatic encephalopathy (<1%), bleeding rate of portal hypertension gastritis (PHG) (9.1%), and morbidity of hepatic carcinoma (8%) were similar to those under traditional operation; the spleen immunology function (Tuftsin, IgM) decreased among the groups 2 months after operation. Through 3D DCE MRA, the cross section area, the velocity and volume of blood flow of main portal vein decrease significantly after operation in both groups, the auto transplantation group was significantly lower in velocity and volume of blood flow than in the control group. Splenic auto transplantation and esophageal transection anastomosis are a safe, effective, and reasonable treatment strategy for portal hypertension with varicial bleeding. It can not only correct hypersplenism but also completely stanch blood, and auto transplanted spleen in the retroperitoneal space can preserve immune function and establish abroad collateral circulation.

关键词： esophageal transection     oesophageal transection     RCT     dynamic contrast     DCE MRA    

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A novel method for reconstruction in laparoscopic pancreaticoduodenectomy: an experience of 13 cases

LU Bangyu, HUANG Yubin, CAI Xiaoyong, HUANG Fei, LU Wenqi, XU Jing, LIU Zujun, YAN Yihe, LI Jianjun, LI Jie

《医学前沿（英文）》 2007年 第1卷 第4期   页码 369-372 doi: 10.1007/s11684-007-0071-x

摘要： Laparoscopic pancreaticoduodenectomy (LPD) is a challenging operation to general surgeon. Up to date, only about 135 cases have been reported, 16 cases in China, 119 cases outside China. The reconstruction of alimentary system is a key procedure to ensure success of the whole surgery. It is worth investigating the methods of reconstruction in LPD. A retrospective study is made to investigate the methods of reconstruction in LPD. We analyze 13 cases of LPD performed in our center. Child s or modified Child s method was used to make the reconstruction in our practice. We tried three methods to make the anastomosis of pancreaticojejunostomy, including end-to-end dunking binding pancreaticojejunostomy in two cases, end-to-end dunking pancreaticojejunostomy using interrupted suture in two cases, and duct-to-jejunal end-to-side embedding pancreaticojejunostomy in nine cases. The clinical data was collected and analyzed. Three of four patients, who underwent end-to-end pancreaticojejunostomy, had a little pancreatic leakage, especially in the first case. None of other nine patients, who underwent duct-to-jejunal end-to-side embedding pancreaticojejunostomy, was detected to have pancreatic leakage, and the operating time of these nine cases was less than other four cases. Duct-to-jejunal end-to-side embedding pancreaticojejunostomy is a safe and efficient method of reconstruction in LPD.

关键词： alimentary     dunking pancreaticojejunostomy     challenging operation     anastomosis     success    

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Synthesis of spherical parallel manipulator for dexterous medical task

Abdelbadia CHAKER, Abdelfattah MLIKA, Med Amine LARIBI, Lotfi ROMDHANE, Sa?d ZEGHLOUL

《机械工程前沿（英文）》 2012年 第7卷 第2期   页码 150-162 doi: 10.1007/s11465-012-0325-4

摘要：

This paper deals with the design and the analysis of a spherical parallel manipulator (SPM) for a haptic minimally invasive surgery application. First the medical task was characterized with the help of a surgeon who performed a suture technique called anastomosis. A Vicon system was used to capture the motion of the surgeon, which yielded the volume swept by the tool during the anastomosis operation. The identified workspace can be represented by a cone with a half vertex angle of 26°. A multi objective optimization procedure based on genetic algorithms was then carried out to find the optimal SPM. Two criteria were considered, i.e., task workspace and mechanism dexterity. The optimized SPM was then analyzed to determine the error on the orientation of the end effector as a function of the manufacturing errors of the different links of the mechanism.

关键词： spherical parallel manipulator (SPM)     anastomosis     haptic     motion capture     optimization     workspace     dexterity     genetic algorithm     manufacturing errors    

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Successful infrainguinal revascularization with autologous vein for inadvertent stripping of superficial femoral artery: a case report

Yin XIA MD , Dan SHANG MD, PhD , Qin LI MD , Wenyi LI MD , Hanqing WU MD , Guofu HU MD , Chao YANG MD , Yiqing LI MD , Bi JIN MD ,

《医学前沿（英文）》 2009年 第3卷 第3期   页码 375-378 doi: 10.1007/s11684-009-0048-z

摘要： A referral patient who had previously undergone varicose vein surgery was admitted as an emergency case. On admission, the patient complained of intolerable pain, paralysis and paresthesia of the affected limb, which was characterized by acute arterial ischemia symptoms. Color Doppler of the artery of the affected limb indicated that no blood flow signal existed in the superficial femoral artery. During exploratory operation, we found that the right superficial femoral artery instead of the great saphenous vein of the affected limb had been stripped and ligated. Therefore, the intact right great saphenous vein was taken for auto-transplantation by inverse end-to-end anastomosis to the proximal and distal residual superficial femoral artery, which resulted in gradual recovery. Except for ischemic reperfusion injury, no other post-operative complications occurred after a 10 month follow-up; however, the long-term curative effect needs further observation. Here we report our treatment experience.

关键词： revascularization     saphenous vein     end-to-end anastomosis     stripping    

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标题 作者 时间 类型 操作

Fertility outcome analysis after modified laparoscopic microsurgical tubal anastomosis

null

期刊论文

The second short-term warm ischemia after vascular anastomosis did not affect early renal function recovery

null

期刊论文

Splenic autotransplantation and oesophageal transection anastomosis in patients with portal hypertension

CHEN Jisheng, HUO Jinshan, ZHANG Hongwei, SHANG Changzhen, CHEN Rufu, ZHANG Jie, Obetien Mapudengo, CHEN Yajin, ZHANG Lei

期刊论文

A novel method for reconstruction in laparoscopic pancreaticoduodenectomy: an experience of 13 cases

LU Bangyu, HUANG Yubin, CAI Xiaoyong, HUANG Fei, LU Wenqi, XU Jing, LIU Zujun, YAN Yihe, LI Jianjun, LI Jie

期刊论文

Synthesis of spherical parallel manipulator for dexterous medical task

Abdelbadia CHAKER, Abdelfattah MLIKA, Med Amine LARIBI, Lotfi ROMDHANE, Sa?d ZEGHLOUL

期刊论文

Successful infrainguinal revascularization with autologous vein for inadvertent stripping of superficial femoral artery: a case report

Yin XIA MD , Dan SHANG MD, PhD , Qin LI MD , Wenyi LI MD , Hanqing WU MD , Guofu HU MD , Chao YANG MD , Yiqing LI MD , Bi JIN MD ,

期刊论文