Abstract：
:Objective This video is a step-by-step illustration of the laparoscopic-assisted mobilisation and resection of a sacrococcygeal teratoma Altman type III. Indication Laparoscopic supralevatory tumour mobilisation is an established method in selected centres and can be the initial step in approaching sacrococcygeal teratomas with an intrapelvic portion, facilitating a complete (R0) resection. Method Laparoscopic surgery is performed in supine position with a 5 mm umbilical trocar, a 5 mm trocar in the right upper abdomen, and two 3 mm trocars in the left middle and lower abdomen. We use a 5 mm 45° optic and 3 mm laparoscopic grasping forceps as well as Overholt clamps. For coagulation, a laparoscopic 5 mm diathermy Sealer (LigaSure™, Covidien, Neustadt) is used. Conclusion In selected tumours, laparoscopic assisted tumour mobilisation enables surgeons to clearly identify and ligate the primary tumour-supplying vascular structures at the beginning of the operation, thereby avoiding the risk of major bleeding throughout the subsequent tumour mobilisation. The laparoscopic approach also allows an accurate dissection and mobilisation of the supralevatory tumour parts under direct vision. After repositioning the patient into the prone position, infralevatory preparation can be carried out safely and fast in the conventional sacral approach without any major risk of bleeding. :Zielsetzung Der vorliegende Beitrag zeigt Schritt für Schritt die laparoskopisch assistierte Mobilisation und Resektion eines Steißbeinteratoms Altman Typ III. Indikation Die laparoskopische supralevatorische Tumormobilisation ist eine in ausgewählten Zentren etablierte Methode und kann als initialer Schritt einer Steißbeinteratomresektion mit intrapelvinem Anteil die komplette (R0-) Resektion vereinfachen. Methode Es erfolgt eine laparoskopische Operation in Rückenlage mit einem 5-mm-Trokar umbilikal, einem 5-mm-Trokar im rechten Oberbauch und 2 3-mm-Trokaren im linken Mittel- und Unterbauch. Wir verwenden dazu eine 5-mm-45°-Optik und laparoskopische 3-mm-Fasszangen sowie Overholt-Klemmen. Zur Koagulation wird ein laparoskopischer 5-mm-Diathermieversiegler (LigaSure™, Covidien, Neustadt) eingesetzt. Schlussfolgerung Das Verfahren der laparoskopisch assistierten Tumormobilisation bietet unserer Meinung nach für geeignete Tumoren den Vorteil, dass sich die primär tumorversorgenden Gefäßstrukturen gleich bei Beginn der Operation sicher identifizieren und durchtrennen lassen. Der laparoskopische Ansatz erlaubt ferner exakte Präparation und Mobilisierung des supralevatorischen Tumoranteils unter direkter Sicht. Nach Umlagerung des Patienten in die Bauchlage kann dann von sakral die infralevatorische Präparation ohne größere Blutungsgefahr zeitsparend und sicher erfolgen.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Gödeke J,Engel V,Münsterer Odoi
10.1055/s-0043-100015subject
Has Abstractpub_date
2017-06-01 00:00:00pages
255-256issue
3eissn
0044-409Xissn
1438-9592journal_volume
142pub_type
杂志文章abstract：:Neuroendocrine tumors are rare and can be observed in different gastrointestinal organs. The diagnosis often is made by incidence like in carcinoids of the appendix vermiformis, or special clinical symptoms may develop due to tumor growth. 29 consecutive patients were evaluated prospectively during 30 months. In 21 of...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-2001-11721
更新日期：2001-01-01 00:00:00
abstract：:The role of total mesorectal excision for rectal cancer treatment is one of the most exciting findings in surgical oncology of the recent years. The patient's prognosis largely depends on the surgical quality of rectal resection. The excision of the cancer bearing rectum has to follow very precisely along the mesorect...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1999-01-01 00:00:00
abstract：INTRODUCTION:We analysed our long-term results with postoperative radiotherapy of the chest wall in male breast cancer patients with respect to local control and survival. METHODS:Twenty-five patients with 26 histological proven carcinomas of the male breast underwent postoperative radiotherapy of the chest wall with ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2007-981268
更新日期：2007-10-01 00:00:00
abstract：:The treatment and outcome of the respiratory failure decisively depend on its pathophysiological background. Besides simple blood gas analysis the investigation of the respiratory mechanics, interstitial lung water and the monitoring of the pulmonary pressure are necessary for an exact diagnosis. As a scoring method o...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1994-01-01 00:00:00
abstract：:The importance of carcinoembryonic antigen as a tumor marker to the follow-up of patients with liver metastases from colorectal cancer was investigated. It was reported about 29 patients receiving chemotherapy. We estimated the effect of therapy according to sonographic and computer tomographic criteria and related to...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
abstract：:The physiological significance of the residual distal stomach after proximal gastrectomy (PG) was evaluated in dogs from the view-point of serum gastrin. The fasting gastrin levels in both (1/2 and 2/3) PG groups were high, especially in the 1/2 PG group. The serum gastrin levels did not decrease with time after test ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
abstract：:Only in 2/3 out of a total of 33 patients suffering from renal artery stenosis surgery was indicated. Thrombendarterectomy and saphenous patch are the method of choice for reconstructive procedures. In 87% of successful reconstructions the functional result was satisfactory. The follow-up gave evidence of change to th...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1979-01-01 00:00:00
abstract：:According to the postoperative prophylaxis of thromboembolia a review of actual publications is given. The therapeutical problems of Coumarin, Dextran, Acetylsalicylic acid and low dosis Heparin were discussed. A final answer to the various questions can not be given. Concerning the prophylaxis low dosis Heparin seems...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1977-01-01 00:00:00
abstract：UNLABELLED:This randomized controlled trial aims to evaluate the influence of preoperative relaxation techniques on postoperative outcomes. From January 1997 to June 1998 208 patients were operated on for primary inguinal hernia or goiter. The patients were randomized into two groups: Group A (n = 103) underwent the su...
journal_title：Zentralblatt fur Chirurgie
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：2000-01-01 00:00:00
abstract：BACKGROUND:The increasing number of endovascular procedures made aware of a kidney disease induced by contrast media (CM). Contrast-induced nephropathy (= CIN) can develop in 0.6-44 % of the treated patients by angiography and / or endovascular intervention. The incidence in high-risk patients ranges from 50 to 70 %. I...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-0031-1283759
更新日期：2011-10-01 00:00:00
abstract：:Psychooncology is an interdisciplinary field that focuses on the various somatic, social and psychological factors influencing the well-being of oncological patients. Although the importance of psychooncological support of cancer patients is well accepted, universal standards for psychooncological care have not been e...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2008-1004664
更新日期：2008-02-01 00:00:00
abstract：:By introduction of laparoscopic cholecystectomy, an increase of accidental common bile duct injuries up to 1.2% has been reported. In the present study of 325 cholecystectomies we evaluated whether mandatory intraoperative cholangiography (IOC) can reduce the rate of accidental bile duct injuries or, at least, identif...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1997-01-01 00:00:00
abstract：:The study described in this paper helped to establish the present position in locally delimited treatment of children for thermic injuries. 25 hospitals or other medical institutions were involved in the inquiry programme, including 16 departments of paediatric surgery and nine departments of general surgery. Studies ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
abstract：:Aetiopathogenesis, diagnosis as well as typical and atypical courses are described and discussed with regard to 50 patients with gallstone ileus. Overall lethality amounted to 36 per cent, including 15 per cent for patients with enterotomy alone and 53 per cent for patients who had undergone enterotomy with faecal asp...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1987-01-01 00:00:00
abstract：:This disease has not been fully clarified yet. In our opinion, surgery should only be performed in cases of stage IV because of ulcers, irreversible scar formation, metaplasia of the epithelium, endobrachyoesophagus, stenoses or malignant degeneration. 11 patients suffering from severe reflux oesophagitis (stage IV) u...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1983-01-01 00:00:00
abstract：:With the new method of gas exchange and dialysis carried out simultaneously with a standard dialysis module, for the first time normothermic ex-vivo whole blood perfusion of pig kidneys becomes practicable under nearly physiological conditions. To show the possibility of animal experiment replacements we use slaughter...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
abstract：:CT and MRI have become more frequently established in the diagnosis of the pelvis for the last few years. CT and even more MRI are technically essential for the diagnosis of problems of the pelvis like anal carcinoma, anal atresia, anal fistula of the anal canal and rectum. Modern technical equipment allow a scanning ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND:Due to uncontrolled activation of digestive enzymes produced within the pancreas, acute pancreatitis is a disease with a great potential for complications and variable course. Since the pathophysiological steps of human pancreatitis can only be inadequately investigated, various animal models were establishe...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-0032-1328099
更新日期：2013-08-01 00:00:00
abstract：:VARY operations were performed at the authors' hospital on 25 patients for duodenal ulcer and on two patients for gastric ulcer, between May 1984 and January 1987. A postoperative complication was recorded from one patient only, that is bleeding of the anastomosis on the first postoperative day. All patients underwent...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1988-01-01 00:00:00
abstract：:The author reports about 183 patients with frontobasal injuries. 50 per cent of them were operated immediately because open injuries or intracranial complications. The other half was operated in an interval of 5 to 10 days after injury. The localisation of the frontobasal lesion, clinical results according to the Glas...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
abstract：:After edovascular repair of infrarenal aortic aneurysms (EVAR) endoleaks may occur necessitating further therapy. Therefore a reliable method for follow-up imaging after EVAR for detection and control of endoleaks is of high importance. Contrast-enhanced sonography (CEUS) does not require the application of nephrotoxi...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-0035-1546147
更新日期：2015-10-01 00:00:00
abstract：:A villous giant adenoma of the duodenum was diagnosed in a 56-year-old female patient with uncharacteristic upper abdominal discomfort after multiple previous laparotomies for various indications. A partial pancreaticoduodenectomy was performed as radical oncological procedure since the dignity of the neoplasm was unc...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2001-11720
更新日期：2001-01-01 00:00:00
abstract：:The laparoscopic resection of the colon and rectum is established for surgery of benign diseases. The main advantages compared to the open-conventional operation technique are reduced postoperative pain, reduced negative influences on pulmonary and gastrointestinal functions as well as a shorter reconvalescence. Minim...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2003-44844
更新日期：2003-12-01 00:00:00
abstract：:Ascending thrombophlebitis of the superficial leg veins is known to propagate into the deep leg veins and to embolize. In a prospective study we followed up 44 patients with sonographically diagnosed ascending thrombophlebitis into the deep veins (V. saphena magna n = 40, V. saphena parva n = 4). In 15 of 44 cases (34...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1997-01-01 00:00:00
abstract：PURPOSE OF THE STUDY:The current study presents a new technique and results of minimal invasive screw osteosynthesis in the treatment of Bennett's fractures and discusses its advantages and disadvantages. OPERATIVE TECHNIQUE:The Bennett's fragment has to be of sufficient size (at least one quarter of the articular sur...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2003-40628
更新日期：2003-06-01 00:00:00
abstract：:54 patients suffering from esophageal cancer have been treated in a period from 1990 to 1994. In 29 cases curative resection was possible, corresponding to a resection rate of 54%. Average age of resected patients was 62 years. According to pTNM-classification the stages T1 and T2 amounted to 45%, T3 and T4 to 55%. Ly...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1997-01-01 00:00:00
abstract：:Pneumothorax is defined as the accumulation of air in the pleural space. A distinction is made between a primary (idiopathic) spontaneous pneumothorax (PSP), secondary spontaneous pneumothorax (SSP) as well as between iatrogenic pneumothorax and traumatic pneumothorax. Primary spontaneous pneumothorax (PSP) occurs mai...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-0031-1284013
更新日期：2012-06-01 00:00:00
abstract：:Nailing has become the major method of treating lower leg fractures: though there are still different opinions how to treat lower leg fractures localized between the proximal-middle and middle-distal third as well as in the second and fifth/sixth. Following our own experiences with 192 lower leg nailings in that spher...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
abstract：:After explaining the tertiary patterns of prehension the possibilities of restoring prehensile function in patients after high cervical spinal injury (C4-C6) by means of orthotics or operation are discussed. Absolute indication for the application of electrical orthotics in patients with complete spinal cord injuries ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1976-01-01 00:00:00
abstract：:Decisions in surgery will have to consider economic obligations more than ever before. Consequences are evident: the assessment of surgical efficiency will be insufficient when only considering the accuracy and results of a clinical study. We actually will have to document, moreover, the economic impact of therapeutic...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1997-01-01 00:00:00
