Biomedical subjects

P Vitásek

Publications and source records attributed to P Vitásek.

6 recordsLinked to original sources

PubMed2006

A modified technique of transperitoneal direct approach for totally laparoscopic aortoiliac surgery.

OBJECTIVE: To present our modification of the transperitoneal direct approach (TDA) for totally laparoscopic aortoiliac surgery. METHODS AND RESULTS: From September 2003 to August 2005 a total of 52 patients underwent laparoscopic operations for aortoiliac disease (50 aortoiliac occlusive disease; two abdominal aortic aneurysm). The modified TDA was used in 20 patients. CONCLUSION: The main advantage of TDA is reduced dissection of the aorta and pelvic arteries resulting in lowered blood loss and lymphatic injury.

Aorta↗

PubMed2006

[Initial experience with da Vinci robotic system in vascular surgery].

Robotic operational systems improve accuracy, control of and skilful management of surgical procedures up to levels unachievable by a human factor itself. A surgeon is also allowed to conduct the types of miniinvasive procedures, which cannot be conducted using contemporary technologies. High degree of the procedure's safety can be achieved. Currently, the robotic surgical systems are used in top clinics worldwide and the concept of the robotic operating theatre is considered to become standard for some procedures in future. In October 2005, a multispecialist robotic centre was opened in the Hospital Na Homolce, which then created a new qualitative standard in the miniinvasive surgical management. The authors present the initial group of patients, who were operated from November 2005 to January 2006 with employement of the da Vinci robotic system, listing its pros and cons.

Aged↗

PubMed2005

[Laparoscopic resection of the abdominal aortic aneurysm].

Some 500 aortoiliac aneurysms are mostly electively operated in the Czech Republic each year. Miniinvasive approaches already widely accepted in general surgery are gradually becoming more routine in vascular surgery as well. Better patient comfort hand in hand with reduced hospital stay represent the major advantages of these procedures. The authors present their initial experience with laparoscopic AAA resection with the use of their own modification of the transperitoneal-retroperitoneal approach. Ischemic preconditionning's techniques with regard to the expected prolonged aortic clamping time were used during surgery.

Aorta, Abdominal↗

PubMed2004

[Bacterial aortitis].

A cohort of 14 patients with bacterial destruction of various segments of the aortic wall is presented. The Salmonella enteritidis strain was predominantly responsible. Most patients had typical history of symptomatic trias of sepsis, abdominal and/or back pain and positive blood cultures. CT scan showed pseudoaneurysm within the thoracic, subphrenic or subrenal aorta as well as acute hemorrhage in three patients. One of these was excluded from invasive treatment due to hopeless prognosis. In one patient primary aortoduodenal phistula was responsible for GI bleeding. Five patients were operated and prosthetic replacement of subrenal or iuxtarenal aortic portion together with aortorenal bypass in a couple of cases was performed. In eight patients stentgrafts (SG) of various types were deployed completed with femorofemoral crossover bypass when necessary. All patients were subject to long-standing antibiotic therapy. Two patients expired following SG insertion, all operated patients survived. Average follow-up has been 1 year (1-22 months) so far. A groin abscess was later drained in one patient. Neither CT nor isotope scanning showed persistent or recurrent infectious or hemorrhagic foci in any survivors whatsoever. The authors review and consider the doubtful indication of aortic SG deployment into the septic terrain in selected cases. Midterm results might justify its use in overly debilitated patients otherwise not eligible for radical operation due to its prohibitive risk.

Aged↗

PubMed2004

[Comprehensive therapeutic approach to a symptomatic pseudoaneurysm in the distal aorto-aortic replacement anastomosis and carcinoma of the right kidney].

The authors present a case of a complex approach to treatment of a symptomatic pseudoaneurysm of the distal anastomosis of the aorta-aortic replacement in concurrence with a carcinoma of the right kidney. The patient was acutely hospitalized in August 2003 for a two-day-history of a stomach ache. In March 1996, the patient underwent a surgical resection and the aorta-aortic replacement of the abdominal aorta aneurysm. On admission, the CT-AG scan showed a large pseudoaneurysm (5 x 4 x 8 cm) localized in the area of the distal anastomosis with a suspected leak of the contrast matter to the surrounding tissues. Furthermore, an extrarnally bulging expansion in the superior part of the right kidney with a central necrosis measuring 31 mm and the sigmoid diverticulosis were reported as accidental findings.

Adenocarcinoma↗

PubMed2004

[Laparoscopic vascular reconstructions--initial experience].

Laparoscopic techniques, which have been found useful in the general surgical procedures, have influenced the vascular surgical procedures with a certain delay. The main reason for the delay were technical difficulties of the vascular anastomosis, which resulted in a reluctant acceptance of the laparoscopic procedures by vascular surgeons. However, with respect to clear benefits of the miniinvasive procedures, including reduction of the postoperative pain, faster recovery rates and reduction of the total treatment costs, the laparoscopic procedures are finally being applied in the vascular surgery as well. The authors introduce operative results and outcome of ten laparoscopic vascular procedures for aortoiliac occlusive disease, which were conducted from September 2003 to April 2004. In five cases, iliofemoral bypasses were conducted, fourtimes unilateral aortofemoral bypasses (AF) and once an aortobifemoral bypass (ABF). All the IF and AF reconstructions were conducted via laparoscopy and the ABF reconstruction was conducted as laparoscopy-assisted.

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