PubMed Health⌕ Search

Biomedical subjects

Catherine S Wiegand

Publications and source records attributed to Catherine S Wiegand.

2 recordsLinked to original sources

Robotics in vascular surgery.

The procedure for surgical correction of aortic disease has gone relatively unchanged over the last 50 years, requiring a xiphoid pubic incision as well as shifting of the abdominal viscera. These maneuvers produce significant pathophysiologic changes that consequently affect intraoperative and postoperative care and recovery. In approaching minimally invasive aortic surgery, advances in computer-enhanced technology have the potential to revolutionize aortic surgery and improve patient safety. A MEDLINE search specific to robotic aortic vascular procedures was performed and produced 7 articles (3 animal model and 4 clinical application). Robotically assisted technology became available for use in 2000. Since that time, computer-enhanced technology for aortic anastomoses has been applied successfully in the animal model. Early application in the clinical setting for aortoiliac disease also has been successfully initiated. Robotic technology provides the vascular surgeon with the ability to perform the delicate tissue handling necessary for aortic procedures. Based on their knowledge of current procedures, surgeons must redesign their surgical strategies to adapt to this computer-enhanced methodology.

Anastomosis, Surgical↗

Computer-assisted instrumentation during endoscopic transaxillary first rib resection for thoracic outlet syndrome: a safe alternate approach.

UNLABELLED: The purpose of this article is to discuss the feasibility of using computer-enhanced instrumentation to improve visualization and therefore patient safety during transaxillary first rib resection. From November 1998 to July 2005, 105 patients who had failed conservative treatment underwent 131 procedures for thoracic outlet decompression. Eighty-nine endoscopic transaxillary first rib resections were completed using Aesop/Hermes integrated voice control instrumentation (Computer Motion, Goleta, CA). Since February 2003, dissection in 42 procedures was performed using the daVinci Surgical System (Intuitive Surgical, Inc, Sunnyvale, CA). The surgical findings with cervical bands correlated with the preoperative symptoms. One hundred percent of patients with a combination of neurogenic and arterial thoracic outlet syndrome (TOS) requiring cervical rib resection had Roos type I and/or II bands. Additional surgical findings included the following: combination of neurogenic and arterial TOS without cervical ribs or neurogenic TOS alone had type III, IV, or V bands, and patients with venous compression (100%) had type VII bands. No mortalities or permanent neurovascular injuries occurred. There was a 6.1% postoperative complication rate. Persistent myofibrositis was found in 34% of patients with ongoing symptoms. CONCLUSION: The daVinci three-dimensional optical imaging system enhances visualization, thereby promoting telemanipulation of soft tissue structures in a relatively inaccessible working space. Endoscopic computerized instrumentation in transaxillary first rib resection decreases the risk of neurovascular injury, promotes complete decompression, and therefore provides a safe alternative to standard first rib resections.

Adult↗