BACKGROUND Intraoperative determination of resection margin and adequate residual liver parenchyma are the key points of hepatectomy for the treatment of liver tumors.Intraoperative ultrasound and indocyanine green fl...BACKGROUND Intraoperative determination of resection margin and adequate residual liver parenchyma are the key points of hepatectomy for the treatment of liver tumors.Intraoperative ultrasound and indocyanine green fluorescence navigation are the most commonly used methods at present,but the technical barriers limit their promotion.AIM To evaluate the value of the three-dimensional location approach with silk thread(3D-LAST)in precise resection of liver tumors.METHODS From September 2020 to January 2022,8 patients with liver tumors including hepatocellular carcinoma,intrahepatic cholangiocarcinoma,hilar cholangiocar-cinoma,and gastric cancer liver metastasis were included in this study.All patients underwent 3D-LAST in precise resection of liver tumors.RESULTS All patients(8/8,100%)underwent the operation successfully without any complications.During the mean follow-up of 8.7 months,all patients survived without tumor recurrence.CONCLUSION In conclusion,the 3D-LAST is a safe and effective new method for liver intraop-erative navigation,which is practical and easy to promote.Core Tip:The aim of this study is to evaluate the value of the three-dimensional location approach with silk thread(3D-LAST)in precise resection of liver tumors.Eight patients with liver tumors including hepatocellular carcinoma,intrahepatic cholangiocarcinoma,hilar cholangiocarcinoma,and gastric cancer liver metastasis underwent the operation successfully without any complications.During the mean follow-up of 8.7 months,all patients survived without tumor recurrence.In conclusion,the 3D-LAST is a safe and effective new method for liver intraoperative navigation,which is practical and easy to promote.INTRODUCTION Hepatectomy is widely used for the treatment of liver tumors.In recent decades,the concept and practice of hepatectomy have developed from irregular,regular and anatomical to the current precise resection.Necessary assistive technologies have enabled these advances.Intraoperative ultrasound(IOUS)localization and indocyanine green(ICG)fluorescence imaging guidance are two frequently-used approaches for laparoscopic hepatectomy[1,2].IOUS is an invaluable auxiliary means widely accepted in surgery for real-time diagnostic information to determine resection range and navigate the surgical path[3].However,the major limitation of IOUS is the time cost during the procedure for paging the sono-graphers and the difficulty of deciphering two dimensional images[4].ICG is a non-toxic water-soluble fluorophore that reveals fluorescence under the near-infrared spectrum[5].Since liver tissue penetration is limited to 5 to 10 mm,that restricted the visualization of deeper tumors by ICG excitation,thereby interfering with its application in laparoscopic hepatectomy[6].IOUS and ICG navigation require specific technical equipment,making implementation difficult in many centers.And these techniques will significantly increase the operation time.Three-dimensional(3D)visualization involves extracting features and producing volumetric images based on computed tomography(CT)through a computer postprocessing technique.This tool offers a reasonable approach to the clinical decision for the potential to display the complex internal anatomy in an intuitive and stereoscopic manner[7].In the past few decades,applying 3D simulation software for liver volume calculation,virtual simulation surgery,portal hypertension monitor,and surgical navigation has proven to be safe and effective[8].Therefore,we propose a new method to find obvious anatomical markers and calculate the resection range according to 3D positioning before operation.During the operation,the scope of resection was delineated with silk thread,and resection was performed.This is a new practical approach,which we named as 3D location approach with silk thread(3D-LAST).RESULTS During the study period from September 2020 to January 2022,5 patients with hepatocellular carcinoma,1 patient with intrahepatic cholangiocarcinoma,1 patient with hilar cholangiocarcinoma,and 1 patient with gastric cancer liver metastasis were assessed for liver resection.There were 5 males and 3 females.The mean age of these patients was 54.3±10.2 years(34-66 years).Preoperative 3D positioning was conducted and the scope of resection was delineated with a surgical suture successfully performed in all 8 patients without complications.The treatment results of these 8 patients are shown in Table 1.The 90-day operative mortality was zero.Complications worse than Dindo-Clavien IIIa was not observed at a mean follow-up time of 8.7 months(4-16 months),there was no evidence of tumor recurrence or extrahepatic metastasis.At the time of reporting,the patients are all alive and lead normal lives.We take one patient as an example,58-year-old male,who found a liver lesion 10 months after gastric cancer surgery.Enhanced CT showed that the lesion was located in the liver S5,about 1.5 cm in diameter,and considered metastatic lesions.We performed 3D-LAST guided hepatectomy on this patient(Figure 1).Other representative 3D-LAST surgical procedures are shown in Figure 2.展开更多
The whole lacrimal passage intubation is widely used in lacrimal surgery.However,one of the most typical complications is the prolapse of the silicone tube from the medial canthus.In case,the bicanalicular silicone tu...The whole lacrimal passage intubation is widely used in lacrimal surgery.However,one of the most typical complications is the prolapse of the silicone tube from the medial canthus.In case,the bicanalicular silicone tube after whole lacrimal duct intubation has completely prolapsed from the medial canthus before extubation,then cannot be found in the opening of the nasolacrimal duct,and it would be a challenge to reposition or removal.A novel approach to employ a modified suture-probe and silk thread traction technique has been developed,and it is not only safe and effective,but also cost-effective.展开更多
Objective: to investigate the application effect of silk thread ligation in laparoscopic cholecystectomy for complicated and difficult cholecystitis. Methods: after being randomly divided into groups, they were treate...Objective: to investigate the application effect of silk thread ligation in laparoscopic cholecystectomy for complicated and difficult cholecystitis. Methods: after being randomly divided into groups, they were treated with different ligation methods according to the same standard. The control group was treated with conventional ligation, while the observation group was treated with silk thread ligation, with the same number of patients. After the experiment, the specific effect after ligation and the patients' satisfaction with the treatment by medical staff were observed. Results: it was found that the effect of ligation in the experimental group was better than that in the control group. The probability of complications after ligation was smaller, the satisfaction of patients was higher, and the overall data had statistical significance. The method of treatment had a good effect on improving the doctor-patient relationship in clinic. The scheme could be popularized and used in clinic.展开更多
Beyond the production of silk thread, there are several studies showing that the silk is a great biomaterial for surgical sutures and grafts. This paper shows a new technique to produce silk thread changing the natura...Beyond the production of silk thread, there are several studies showing that the silk is a great biomaterial for surgical sutures and grafts. This paper shows a new technique to produce silk thread changing the natural cycle of silk production, which is the production of cocoons. This new method has the purpose of producing a silk fabric free of impurities, through flat surfaces. Six different surfaces were tested: Glass, Formica Surface, Steel and Zinc Sheets, Cotton tissue and Burlap Bag. The first five surfaces had not presented enough larvae alive for statistical analysis, because there were several damages in silkworms larvae that resulted in mortality and low silk production. On the other hand, the burlap bag surface presented good results for web construction by biospinning and its use was indicated for silk industry focused on biomaterials. The present study suggested the potential of naturally biospun web, using Bombyx mori, to develop a new technique to produce silk thread matrices that will have several applications at the industry and production of biomedical materials.展开更多
目的:探讨在腹腔镜阑尾切除术(laparoscop ic appendectomy,LA)中运用普通丝线结扎阑尾动脉及阑尾根部的安全性及可靠性。方法:对2005年8月至2006年4月间施行无钛夹LA的150例患者的临床资料进行回顾性分析。结果:手术均获成功,无中转开...目的:探讨在腹腔镜阑尾切除术(laparoscop ic appendectomy,LA)中运用普通丝线结扎阑尾动脉及阑尾根部的安全性及可靠性。方法:对2005年8月至2006年4月间施行无钛夹LA的150例患者的临床资料进行回顾性分析。结果:手术均获成功,无中转开腹,平均手术时间为25m in,术后平均住院3d,无并发症发生。结论:LA术中使用普通丝线结扎阑尾动脉及根部,安全、可靠、经济。展开更多
文摘BACKGROUND Intraoperative determination of resection margin and adequate residual liver parenchyma are the key points of hepatectomy for the treatment of liver tumors.Intraoperative ultrasound and indocyanine green fluorescence navigation are the most commonly used methods at present,but the technical barriers limit their promotion.AIM To evaluate the value of the three-dimensional location approach with silk thread(3D-LAST)in precise resection of liver tumors.METHODS From September 2020 to January 2022,8 patients with liver tumors including hepatocellular carcinoma,intrahepatic cholangiocarcinoma,hilar cholangiocar-cinoma,and gastric cancer liver metastasis were included in this study.All patients underwent 3D-LAST in precise resection of liver tumors.RESULTS All patients(8/8,100%)underwent the operation successfully without any complications.During the mean follow-up of 8.7 months,all patients survived without tumor recurrence.CONCLUSION In conclusion,the 3D-LAST is a safe and effective new method for liver intraop-erative navigation,which is practical and easy to promote.Core Tip:The aim of this study is to evaluate the value of the three-dimensional location approach with silk thread(3D-LAST)in precise resection of liver tumors.Eight patients with liver tumors including hepatocellular carcinoma,intrahepatic cholangiocarcinoma,hilar cholangiocarcinoma,and gastric cancer liver metastasis underwent the operation successfully without any complications.During the mean follow-up of 8.7 months,all patients survived without tumor recurrence.In conclusion,the 3D-LAST is a safe and effective new method for liver intraoperative navigation,which is practical and easy to promote.INTRODUCTION Hepatectomy is widely used for the treatment of liver tumors.In recent decades,the concept and practice of hepatectomy have developed from irregular,regular and anatomical to the current precise resection.Necessary assistive technologies have enabled these advances.Intraoperative ultrasound(IOUS)localization and indocyanine green(ICG)fluorescence imaging guidance are two frequently-used approaches for laparoscopic hepatectomy[1,2].IOUS is an invaluable auxiliary means widely accepted in surgery for real-time diagnostic information to determine resection range and navigate the surgical path[3].However,the major limitation of IOUS is the time cost during the procedure for paging the sono-graphers and the difficulty of deciphering two dimensional images[4].ICG is a non-toxic water-soluble fluorophore that reveals fluorescence under the near-infrared spectrum[5].Since liver tissue penetration is limited to 5 to 10 mm,that restricted the visualization of deeper tumors by ICG excitation,thereby interfering with its application in laparoscopic hepatectomy[6].IOUS and ICG navigation require specific technical equipment,making implementation difficult in many centers.And these techniques will significantly increase the operation time.Three-dimensional(3D)visualization involves extracting features and producing volumetric images based on computed tomography(CT)through a computer postprocessing technique.This tool offers a reasonable approach to the clinical decision for the potential to display the complex internal anatomy in an intuitive and stereoscopic manner[7].In the past few decades,applying 3D simulation software for liver volume calculation,virtual simulation surgery,portal hypertension monitor,and surgical navigation has proven to be safe and effective[8].Therefore,we propose a new method to find obvious anatomical markers and calculate the resection range according to 3D positioning before operation.During the operation,the scope of resection was delineated with silk thread,and resection was performed.This is a new practical approach,which we named as 3D location approach with silk thread(3D-LAST).RESULTS During the study period from September 2020 to January 2022,5 patients with hepatocellular carcinoma,1 patient with intrahepatic cholangiocarcinoma,1 patient with hilar cholangiocarcinoma,and 1 patient with gastric cancer liver metastasis were assessed for liver resection.There were 5 males and 3 females.The mean age of these patients was 54.3±10.2 years(34-66 years).Preoperative 3D positioning was conducted and the scope of resection was delineated with a surgical suture successfully performed in all 8 patients without complications.The treatment results of these 8 patients are shown in Table 1.The 90-day operative mortality was zero.Complications worse than Dindo-Clavien IIIa was not observed at a mean follow-up time of 8.7 months(4-16 months),there was no evidence of tumor recurrence or extrahepatic metastasis.At the time of reporting,the patients are all alive and lead normal lives.We take one patient as an example,58-year-old male,who found a liver lesion 10 months after gastric cancer surgery.Enhanced CT showed that the lesion was located in the liver S5,about 1.5 cm in diameter,and considered metastatic lesions.We performed 3D-LAST guided hepatectomy on this patient(Figure 1).Other representative 3D-LAST surgical procedures are shown in Figure 2.
基金supported by the Natural Science Foundation of Guangdong Province of China(No.2021A1515012043).
文摘The whole lacrimal passage intubation is widely used in lacrimal surgery.However,one of the most typical complications is the prolapse of the silicone tube from the medial canthus.In case,the bicanalicular silicone tube after whole lacrimal duct intubation has completely prolapsed from the medial canthus before extubation,then cannot be found in the opening of the nasolacrimal duct,and it would be a challenge to reposition or removal.A novel approach to employ a modified suture-probe and silk thread traction technique has been developed,and it is not only safe and effective,but also cost-effective.
文摘Objective: to investigate the application effect of silk thread ligation in laparoscopic cholecystectomy for complicated and difficult cholecystitis. Methods: after being randomly divided into groups, they were treated with different ligation methods according to the same standard. The control group was treated with conventional ligation, while the observation group was treated with silk thread ligation, with the same number of patients. After the experiment, the specific effect after ligation and the patients' satisfaction with the treatment by medical staff were observed. Results: it was found that the effect of ligation in the experimental group was better than that in the control group. The probability of complications after ligation was smaller, the satisfaction of patients was higher, and the overall data had statistical significance. The method of treatment had a good effect on improving the doctor-patient relationship in clinic. The scheme could be popularized and used in clinic.
文摘Beyond the production of silk thread, there are several studies showing that the silk is a great biomaterial for surgical sutures and grafts. This paper shows a new technique to produce silk thread changing the natural cycle of silk production, which is the production of cocoons. This new method has the purpose of producing a silk fabric free of impurities, through flat surfaces. Six different surfaces were tested: Glass, Formica Surface, Steel and Zinc Sheets, Cotton tissue and Burlap Bag. The first five surfaces had not presented enough larvae alive for statistical analysis, because there were several damages in silkworms larvae that resulted in mortality and low silk production. On the other hand, the burlap bag surface presented good results for web construction by biospinning and its use was indicated for silk industry focused on biomaterials. The present study suggested the potential of naturally biospun web, using Bombyx mori, to develop a new technique to produce silk thread matrices that will have several applications at the industry and production of biomedical materials.
文摘目的:探讨在腹腔镜阑尾切除术(laparoscop ic appendectomy,LA)中运用普通丝线结扎阑尾动脉及阑尾根部的安全性及可靠性。方法:对2005年8月至2006年4月间施行无钛夹LA的150例患者的临床资料进行回顾性分析。结果:手术均获成功,无中转开腹,平均手术时间为25m in,术后平均住院3d,无并发症发生。结论:LA术中使用普通丝线结扎阑尾动脉及根部,安全、可靠、经济。
