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Robotic pancreatic surgery: a slowly developing field

Hepatobiliary Surgery and Nutrition 2020年第5期9卷 673-675页

作者： Patrick N.Salibi john B.martinie Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryAtrium Health Carolinas Medical CenterCharlotteNCUSA

Robotic surgery has undergone rapid development over the last several decades and minimally invasive surgery has become the standard of care for many surgical *** adoption within the world of hepatobiliary and pancreas surgery has been tempered by the complexity of the *** reports showcased the feasibility of distal pancreatectomy and pancreaticoduodenectomy in a minimally invasive fashion and where followed by case series demonstrating its safety and efficacy(1,2).This has since been confirmed with large matched cohorts confirming at a minimum oncologic equivalence between minimally invasive pancreatic resections as compared to open procedures(3).Given the complexity of pancreatic surgery and the inherent limitations of laparoscopic surgery the robotic surgical platform has seen an exponential rise in attention with its role in minimally invasive pancreatic *** this interest there have been two consensus guidelines published on minimally invasive pancreatic surgery demonstrating its growth within the field(4,5).

关键词： surgery slowly matched

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The Janus of mIS in hepatobiliary surgery:Importance of maximally invasive surgery in an era of minimally invasive surgery

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Hepatobiliary & Pancreatic Diseases International 2020年第5期19卷 409-410页

作者： Maria R.Baimas-George Christoph Tschuor john B.martinie David A.Iannitti Erin H.Baker Dionisios Vrochides Division of HPB Surgery Department of SurgeryAtrium Health-Carolinas Medical Center1025 Morehead Medical DriveSuite 600CharlotteNC 28204USA

As surgeons formidably continue to forge into the twentytwenties,after a considerably coronavirus-induced rocky start,one can predict that the era of minimally invasive surgery(mIS),an era of robotics,telehealth,and enhanced recovery after surgery(ERAS■),is not only here to stay but will continue to thrive,develop,and transform our *** of robotics platforms would be hard pressed not to indulge in this *** the satisfyingly large midline“stem to stern”,the impressing exposuregenerating Makuuchi or transverse abdominal,the Kocher,paramedian,McBurney,Chevron,and Pfannenstiel incisions begin to disappear and fade away into a scar minimizing future precluding trauma laparotomies?Most likely *** and developing the skill and technique for a minimally invasive“mIS”approach does not negate or abrogate the maximally invasive“MIS”*** is not one or the other;not a“to be or not to be”Shakespearean *** surgery is a qualified landscape upon which to illuminate and exemplify this declaration:the necessity and companionship of“mIS”and“MIS”–minimally and maximally invasive surgery.

关键词： surgery maximal continue

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Prognostic impact of the Bismuth-Corlette classification:Higher rates of local unresectability in stageⅢb hilar cholangiocarcinoma

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Hepatobiliary & Pancreatic Diseases International 2020年第2期19卷 157-162页

作者： Michael J Passeri Maria R Baimas-George Jesse K Sulzer David A Iannitti john B martinie Erin H Baker Lee M Ocuin Dionisios Vrochides Division of HPB Surgery Department of SurgeryCarolinas Medical Center1025 Morehead Medical Dr.Suite 600CharlotteNC 28204USA

Background:The Bismuth-Corlette(BC)classification is used to categorize hilar cholangiocarcinoma by proximal extension along the biliary *** the right hepatic artery crosses just behind the left bile duct,we hypothesized that BCⅢb tumors would have a higher likelihood of local unresectability due to involvement of the contralateral ***:A retrospective review of a prospectively maintained database identified patients with hilar cholangiocarcinoma taken to the operating room for intended curative resection between April 2008 and September *** were assigned BC stages based on preoperative ***:Sixty-eight patients were included in the *** underwent staging laparoscopy after which 16 cases were aborted for metastatic *** the remaining 52 cases,14 cases were explored and aborted for locally advanced ***-eight underwent attempt at curative *** exclud-ing cases aborted for metastatic disease,the chance of proceeding with resection was 55.6%for BCⅢb staged lesions compared to 80.0%of BCⅢa lesions and to 82.4%for BCⅠ-Ⅲa staged lesions(P<0.05).About 44.4%of BCⅢb lesions were aborted for locally advanced disease versus 17.6%of remaining BC ***:When hilar cholangiocarcinoma is preoperatively staged as BCⅢb,surgeons should antici-pate higher rates of locally unresectable disease,likely involving the right hepatic artery.

关键词： Bismuth-Corlette stage Cholangiocarcinoma Biliary tract surgical procedures Biliary tree Liver surgery

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A ten-year experience of inferior vena cava reconstruction for malignancy:The importance of a multidisciplinary approach with hepatobiliary surgery

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Hepatobiliary & Pancreatic Diseases International 2020年第4期19卷 396-398页

作者： Maria R.Baimas-George Ryan C.Pickens Jesse K.Sulzer Dionisios Vrochides john B.martinie David M.Levi David A.Iannitti Division of Hepatopancreatobiliary Surgery Department of SurgeryCarolinas Medical Center1025 Morehead Medical DriveSuite 600CharlotteNC 28204USA Division of Transplant Surgery Department of SurgeryCarolinas Medical CenterCharlotteNCUSA

To the Editor,Tumor invasion of the inferior vena cava(IVC)through direct erosion is a rare and poor prognostic feature of aggressive hepatic or perihepatic malignancies[1,2].Literature shows poor response to chemotherapy,such that resection often is the only option for improved survival[3].Multidisciplinary collaborations can expand technical options;incorporation of transplant techniques has led to successful R0 resection involving difficult vascular reconstruction and extended resection[4,5].This study describes and analyzes the ten-year collaborative experience of hepatobiliary(HPB)surgeons in management of malignancies involving the perihepatic IVC.

关键词： hepato hepatic invasion

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Hyperspectral Imaging Based on Compressive Sensing: Determining Cancer Margins in Human Pancreatic Tissue <i>ex Vivo</i>, a Pilot Study

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Open Journal of Medical Imaging 2021年第4期11卷 115-131页

作者： Joseph Peller Cobey L. McGinnis Kyle J. Thompson Imran Siddiqui john martinie David A. Iannitti Susan R. Trammell Department of Physics and Optical Science University of North Carolina at Charlotte Charlotte USA Carolinas Medical Center Charlotte USA

Cancer is the second-leading cause of death in the United State and surgery remains the primary treatment for most solid mass tumors. However, accurately identifying tumor margins in real-time remains a challenge. In this study, the design and testing of hyperspectral imaging (HSI) system based on a single-pixel camera engine is discussed. The primary advantage of a single pixel architecture over traditional scanning HSI techniques is its high sensitivity and potential to function at low light levels. The objective for the imaging system described here is to detect changes in the reflectance spectra of tissue and to use these differences to delineate tumor margins. This paper presents the results of a 19-patient pilot study that assesses the ability of the HSI system to use reflectance imaging to delineate adenocarcinoma tumor margins in human pancreatic tissue imaged ex vivo. Pancreatic tissue excised during pancreatectomy was imaged immediately after being sent to the pathology lab. A pathologist sectioned the tissue and placed samples into standard tissue embedding cassettes. These tissue samples were then imaged using the HSI system. After imaging, the samples were returned to the pathologist for processing and analysis. The HSI was later compared to the histological analysis. The spectral angle mapping (SAM) and support vector machine (SVM) algorithms were used to classify pixels in the HSI images as healthy or unhealthy in order to delineate margins. Good agreement between margins determined via HSI (using both SAM and SVM) and histology/white light imaging was found.

关键词： Hyperspectral Imaging Cancer Detection Reflectance Spectroscopy Single Pixel Camera

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