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Laparoscopic Observations in Acquired Inguinal Hernia before and after Robotic-Assisted Laparoscopic Prostatectomy

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Surgical Science 2014年第4期5卷 170-175页

作者： Masahiko Kawaguchi Yoshifumi Kadono Masanari Shimada Hideki Moriyama norihiko ishikawa Go Watanabe Departments of General and Cardiothoracic Surgery Kanazawa University Kanazawa Japan Departments of Urology Kanazawa University Kanazawa Japan

Background: The mechanism of the development of acquired inguinal hernia, especially indirect inguinal hernia, is not well known. Although anatomical studies have been performed to explain development of inguinal hernia, they have mainly involved autopsy or temporal findings at the time of hernioplasty. To elucidate the pattern of development of acquired inguinal hernia, we studied the occurrence of inguinal hernia after robotic-assisted laparoscopic prostatectomy (RALP). Methods: From March 2009 to November 2011, RALP for prostatic cancer was performed on 60 patients in our institute. The RALP was performed by one urologist using the da Vinci Surgical System. The postsurgical development of inguinal hernia was diagnosed based on patients’ symptoms. Seven patients were treated with laparoscopic hernioplasty, and one underwent mesh-plug repair. Using video recordings, the laparoscopic findings during RALP and laparoscopic hernioplasty were compared among all patients. Results: Seven of 59 patients (11.9%) developed an inguinal hernia. One patient had a pre-existing pantaloon inguinal hernia at the time of RALP. Eleven inguinal lesions in the seven patients who underwent laparoscopic hernioplasty were reviewed, and all were indirect inguinal hernias. Conclusion: A main factor in the development of inguinal hernia after RALP could be a combination of outer-side intact layers and inner-side hard scar of the inguinal ring, which seems like “out swing door”.

关键词： Acquired Inguinal Hernia Laparoscopic Hernioplasty Robotic-Assisted Laparoscopic Prostatectomy

The da Vinci Surgical System versus the Radius Surgical System

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Surgical Science 2012年第7期3卷 358-361页

作者： norihiko ishikawa Go Watanabe Noriyuki Inaki Hideki Moriyama Masanari Shimada Masahiko Kawaguchi Department of General and Cardiothoracic Surgery Kanazawa University Kanazawa Japan

Objective: Kanazawa University introduced the da Vinci surgical system and the Radius surgical system. In this study, we compared the advantages and disadvantages of each system. Methods: The da Vinci system is a master-slave tele-manipulation system, which provides hi-resolution 3D images. The Radius system is pair of hand-guided surgical manipulators. In this study we focus on the operability of both instruments rather than their 3D optical systems. Results: The Radius was originally developed specifically focused on ligation and suturing with suture sizes bigger than 4-0, it is more effective, less expensive compared with the da Vinci. Although the da Vinci system is bulky, it allows surgeons to perform endoscopic surgeries only if ports are properly placed to prevent each arm from colliding with the other arms. A crucial difference between the Radius and the da Vinci is not limited to anastomose small vessels but is extended to multidirectional dissection. Currently, the cost including initial investment is the biggest issue;however, the da Vinci is absolutely necessary to implement delicate cardiac surgeries endoscopically and less-invasively. Early approval of robotic surgery by the government is urgently required in Japan. Conclusions: Although both the da Vinci and the Radius have endoscopic instruments with a multi-degree of freedom, applications need to be differentiated depending on the procedures and indications. Therefore, it can be clearly said that these unique innovative systems will never compete against each other.

关键词： Da Vinci Surgical System Radius Surgical System

Laparoscopic Hernioplasty Using Omega-3 Coating Mesh

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Surgical Science 2012年第8期3卷 389-392页

作者： Masahiko Kawaguchi norihiko ishikawa Youji Nishida Hideki Moriyama Masahiro Kaneki Go Watanabe Department of General and Cardiothoracic Surgery Kanazawa University Kanazawa Japan

Background: Laparoscopic hernioplasty has gained popularity with significant advances in prostheses. Omega-3 coating mesh (C-Qur) is a prosthesis that can be used in the abdominal cavity, and the coating prevents adhesion of the mesh to the viscera. We planned a prospective observational study of laparoscopic hernioplasty using C-Qur. Methods: C-Qur was used in laparoscopic hernioplasty over the course of 1 year. We considered laparoscopic approaches as our primary treatment method for abdominal wall hernias. Although only a single incision was made for the majority of the laparoscopic hernioplasties, additional incisions were made when severe adhesions were encountered. For incisional or ventral hernias, a lateral lower incision was made. For inguinal hernias, an umbilical incision was made. Sex, age, diagnosis, number of incisions, additional incisions, morbidity, and follow-up period were evaluated. Results: Twenty-four patients who underwent surgery between May 2010 and April 2011 were included in this study. The median follow-up period was 14 months. The most common early complications included wound pain and edema;however, there were no persistent complications.

关键词： Omega-3 Coating Mesh Single Incision Laparoscopic Surgery Laparoscopic Hernioplasty Inguinal Hernia Incisional Hernia

Efficient Production of δ-Guaiene, an Aroma Sesquiterpene Compound Accumulated in Agarwood, by Mevalonate Pathway-Engineered Escherichia coli Cells

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Advances in Bioscience and Biotechnology 2016年第11期7卷 435-445页

作者： Fumiya Kurosaki Takahiro Kato norihiko Misawa Futoshi Taura Laboratory of Medicinal Bioresources Graduate School of Medicine and Pharmaceutical Sciences for Research University of Toyama Toyama Japan Laboratory for Plant Genetic Function Science Research Institute for Bioresources and Biotechnology Ishikawa Prefectual University Nonoichi Japan

Mevalonate pathway for isoprenoid biosynthesis was constructed in Escherichia coli cells by the transformation with a gene cluster isolated from Streptomyces sp., and farnesyl diphosphate synthase and δ-guaiene synthase genes were coexpressed in this strain. This transformant was capable of liberating an appreciable amount of δ-guaiene, an aroma sesquiterpene compound accumulated in agarwood, and its concentration was elevated to more than 30 μg/ml culture by the incubation with mevalonolactone as an isoprene precursor in a nutrient-enriched Terrific broth. Coexpression of type 1 isopentenyl diphosphate isomerase plus acetoacetyl-CoA ligase genes also enhanced δ-guaiene production, and the concentration of the compound was approximately 38 - 42 μg/ml culture in the presence of mevalonolactone or lithium acetoacetate. These results clearly indicate that mevalonate pathway-engineered E. coli cells showed an appreciable δ-guaiene producing activity in the en- riched medium in the presence of appropriate isoprene precursors.

关键词： Engineered Escherichia coli δ-Guaiene Production Isoprenoids Mevalonate Pathway Secondary Metabolism Sesquiterpene