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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Minimally-invasive surgery, or video-assisted surgery, includes laparoscopy, retroperitoneoscopy and thoracoscopy, can be used for diagnosis (biopsies) and treatment (resections) in various malignant solid tumours in children. Potential advantages of MIS techniques include a decreased parietal trauma (cosmetic benefit, bowel adhesions) and less postoperative discomfort (postoperative pain, analgesics requirement, postoperative ileus, length of hospital stay). Main indications of MIS techniques are represented by diagnostic biopsies (mediastinal or lung tumors, retroperitoneal extrarenal masses), resection of the primary tumor in thoracic and abdominal neuroblastic tumors and in post-treatment residual mass in lymphoma.
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PMID:[Minimally-invasive surgery in cancer children]. 1815 18

Hip Osteoarthritis has always been a challenge for the orthopaedic community and, in the present age of increasing life expectancy and quality, it has become one of the most common causes for orthopaedic surgery. Nowadays, the development of THR focuses on refining the surgical technique, especially on minimising operative tissue injury. Convencional approaches in THR surgery preserve main vessels and nerves and provide excellent visualisation of the operative field but at the expense of muscle attachments and ligaments which are inevitably injured. The authors of MIS concept underline the idea of minimising injury inflicted on the muscle-tendon unit. There are a lot of evidence that the MIS procedures allow for early rehabilitation, shorter in-hospital stay and hasten full functional recovery. They are also associated with decreased perioperative blood loss, reduced postoperative pain and decreased risk of infections.
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PMID:Minimally invasive approaches in total hip replacement. 1884 28

The purpose of this study is to describe our early experience in the development and use of a minimally invasive, anterolateral approach to the hip joint for total hip arthroplasty (THA). This approach uses a specific intraoperative protocol involving leg positioning to maximise exposure and hip joint visualisation. Between October, 2004 and December, 2004, we operated on 18 male and 29 female patients without selection and in consecutive order. The average patient age at surgery was 66 years (range 28 to 86 yrs) with an average body mass index (BMI) of 26 (range 18 36) and with a majority of patients presenting with osteoarthritis as the primary indication for surgery. The average length of the skin incision was 8 cm and the average incision-to-suture time was 45 minutes. The preoperative average Harris Hip Score was 38 and improved to 70 at 10 days postoperatively, and 92 at three and six months. Similarly, the HHS average pain component score increased from 12.6 preoperatively to 39 at 10 days postoperatively, and 40 at three and six months. An exact neutral implantation of the stem was found in 48% of the patients, between one to three degrees out of neutral in 40% and greater than four degrees of varus in 12%. The average inclination angle of the cup was measured at 44 degrees. No intraoperative or perioperative complications of any kind occurred in this series of 47 consecutive patients. From our experience, the MIS AL approach for THA with patients in the lateral position can be applied without restrictions for patient indication. Improved results can be observed when using the MIS AL approach, especially in the ear-ly postoperative phase. Since the abductors can be completely spared during the surgery, improved long-term results may be expected. Moreover and when necessary, an operative expansion is always possible without difficulties. Overall, the approach yields promising results.
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PMID:Minimally invasive anterolateral surgical approach for total hip arthroplasty: early clinical results. 1921 28

The purpose of the review is to report the modified Smith-Peterson technique for use with minimal invasive total hip arthroplasty (MIS THA) with supine patient positioning. The modified Smith-Peterson technique allows for direct visualisation of the acetabulum and is an internerval approach. The MIS anterior approach with supine patient positioning offers a complete intermuscular and internervous access to the hip joint. The use of this technique yields a reduction of muscular trauma, intraoperative bloodloss, and postoperative rehabilitation. The reduction of soft tissue trauma may lead to minimal postoperative pain. While cosmesis is never a reason for using MIS, it does yield great patient satisfaction. The MIS anterior approach with supine patient positioning is a safe and reproducible method, offering an alternative option in MIS THA.
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PMID:The minimal invasive surgery anterior approach with supine patient positioning: a step-wise introduction of technique. 1921 29

Two innovative approaches in minimally invasive surgery that have been introduced recently are the da Vinci robotic platform and single port laparoscopic surgery (SPLS). Robotic surgery has many advantages such as 3-dimensional view, the wrist like motion of the robotic arm and ergonomically comfortable position for the surgeon. Numerous literatures have demonstrated the feasibility of robotic surgery in gynecologic oncology. However, further research should be performed to demonstrate the superiority of robotic surgery compared to conventional laparoscopy. Additionally, cost reduction of robotic surgery is needed to adopt robotic surgery into gynecologic oncology worldwide. SPLS has several possible benefits including reduced operative complications, reduced postoperative pain, and better cosmetic results compared to conventional laparoscopy. Although several authors have indicated that SPLS is a feasible approach for gynecologic surgery, there have been few reports demonstrating the potential advantages over conventional laparoscopy. Moreover, technical difficulties of SPLS still exist. Therefore, the advantages of a single port approach compared to conventional laparoscope should be evaluated with comparative study, and further technologic development for SPLS is also needed. These two progressive technologies take the lead in the development of MIS and further studies should be performed to evaluate the benefits of robot surgery and SPLS.
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PMID:Recent advances of robotic surgery and single port laparoscopy in gynecologic oncology. 1980 46

We hypothesized that patella eversion during total knee arthroplasty (TKA) reduces early return of active knee extension and flexion, quadriceps muscle strength, and postoperative pain. In 100 conventional TKA knees and 100 minimally invasive TKA (MIS TKA) knees, we compared knee range of motion (ROM), postoperative pain, and quadriceps muscle strength at 1 day, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 12 weeks, 1 year, and 5 years after surgery. The differences of surgical approach between MIS TKA and conventional TKA of this study are length of skin incision with subcutaneal flap and patella eversion. In MIS TKA, skin incision is shorter than conventional TKA. Furthermore, patella is not everted in MIS TKA procedure. There were no significant differences in preoperative factors. Postoperative improvement of ROM, postoperative muscle strength recovery, and postoperative improvement of visual analog scale were faster in patients with MIS TKA when compared to that in patients with conventional TKA. On the other hand, no significant difference was observed in complication, 5-year clinical results of subjective knee function score, and the postoperative component angle and lower leg alignment. These results indicate that patella eversion may affect muscle strength recovery and postoperative pain.
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PMID:Patella Eversion Reduces Early Knee Range of Motion and Muscle Torque Recovery after Total Knee Arthroplasty: Comparison between Minimally Invasive Total Knee Arthroplasty and Conventional Total Knee Arthroplasty. 2204 26

This clinical study prospectively compares the results of open surgery to minimally invasive fusion for degenerative lumbar spine pathologies. Eighty-two patients were studied (41 minimally invasive surgery [MIS] spinal fusion, 41 open surgical equivalent) under a single surgeon (R. J. Mobbs). The two groups were compared using the Oswestry Disability Index, the Short Form-12 version 1, the Visual Analogue Scale score, the Patient Satisfaction Index, length of hospital stay, time to mobilise, postoperative medication and complications. The MIS cohort was found to have significantly less postoperative pain, and to have met the expectations of a significantly greater proportion of patients than conventional open surgery. The patients who underwent the MIS approach also had significantly shorter length of stay, time to mobilisation, lower opioid use and total complication rates. In our study MIS provided similar efficacy to the conventional open technique, and proved to be superior with regard to patient satisfaction, length of hospital stay, time to mobilise and complication rates.
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PMID:Minimally invasive surgery compared to open spinal fusion for the treatment of degenerative lumbar spine pathologies. 2245 84

Upon implantation of a hip prosthesis by total hip arthroplasty (THA), clinical criteria are not always sufficient for an objective assessment of the functional outcome. Thus, functional improvement of gait behavior was comparatively validated by instrumented 3D gait analysis for a current, minimally invasive surgical approach (MIS; anterolateral approach) and a conventional, transgluteal approach (KONV). In selected cases, disturbed motion sequences were registered by measuring the muscle activity via high-resolution, monopolar surface electromyography (S-EMG) above the operation area. Despite continuous and significant improvement of practically all analyzed kinematic and kinetic gait parameters for both surgical approaches already after 5 weeks but in particular after 6 and 12 months, no significant differences were detected between the 2 procedures for any parameter or time point. The S-EMG demonstrated non-physiological muscle activation on the operated, but also on the non-operated side, even at 6 months after surgery. Advantages of the MIS approach thus seem primarily restricted to early, post-operative results, such as more rapid pain reduction and rehabilitation.
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PMID:[Gait analysis after minimally invasive total hip arthroplasty]. 2255 42

This retrospective study of 50 consecutive patients treated by a single orthopedic spine surgeon in private practice was conducted to evaluate the safety and efficacy of minimally invasive sacroiliac joint fusion using a series of triangular, porous plasma spray coated titanium implants.Medical charts were reviewed for perioperative metrics, complications, pain, quality of life and satisfaction with surgery. All patients were contacted at a 24 months post-op to assess SI joint pain, satisfaction with surgery and work status.An early and sustained statistically significant improvement in pain function was identified at all post-operative time points (ANOVA, p<0.000). A clinically significant improvement (>2 point change from baseline) was observed in 7 out of 9 domains of daily living. The complication rate was low and more than 80% of patients would have the same surgery again.MIS SI joint fusion appears to be a safe and effective procedure for the treatment of sacroiliac joint disruption or degenerative sacroiliitis.
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PMID:Sacroiliac Joint Arthrodesis-MIS Technique with Titanium Implants: Report of the First 50 Patients and Outcomes. 2328 93

Symptomatic disc herniation is a common indication for spinal operations. The open microscopic discectomy has been the traditional method of addressing this pathology, but minimally invasive techniques are increasingly popular. Potential advantages of the MIS microdiscectomy approach include decreased muscle and soft tissue disruption, shorter length of stay and decreased postoperative pain. Here we demonstrate an MIS microdiscectomy on a 24-year-old female with a left L-4 and L-5 radiculopathy secondary to a large L4-5 disc herniation. The video can be found here: http://youtu.be/aXyZ2FJMh2s.
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PMID:Minimally invasive surgery for lumbar microdiscectomy. 2382 45


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