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Khan S, Khan MZ, Saeed R, Ahmed J, Naveed AK, Shah HH. Age of Robotic Surgery and Telemedicine: Is Pakistan Lagging Behind? Ann Biomed Eng 2024; 52:1537-1541. [PMID: 37530908 DOI: 10.1007/s10439-023-03337-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 08/03/2023]
Abstract
Robotic surgery and telemedicine have revolutionized the healthcare industry, offering improved patient outcomes and access to medical knowledge. However, Pakistan lags behind in adopting these cutting-edge technologies due to several challenges, including limited infrastructure, budget constraints, and low awareness among patients and healthcare professionals. This article provides an in-depth analysis of the current state of the healthcare system in Pakistan, highlighting the need for investment and policy reforms to integrate robotic surgery and telemedicine effectively. The potential benefits, including medical tourism, enhanced facilities, and skilled workforce retention, are discussed as incentives for the government to embrace digital medicine and bridge the healthcare gap. Through increased awareness, training programs, and collaborations with other nations, Pakistan can pave the way for a digitally empowered healthcare future.
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Affiliation(s)
- Shanza Khan
- Dow University of Health Sciences, Karachi, Pakistan
| | | | - Risham Saeed
- Karachi Medical and Dental College, Karachi, Pakistan
| | - Jalib Ahmed
- Dow University of Health Sciences, Karachi, Pakistan
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Ludwig B, Ludwig M, Dziekiewicz A, Mikuła A, Cisek J, Biernat S, Kaliszewski K. Modern Surgical Techniques of Thyroidectomy and Advances in the Prevention and Treatment of Perioperative Complications. Cancers (Basel) 2023; 15:cancers15112931. [PMID: 37296896 DOI: 10.3390/cancers15112931] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Thyroid cancer is the most common cancer of the endocrine system, and, in recent years, there has been a phenomenon of overdiagnosis followed by subsequent overtreatment. This results in an increasing number of thyroidectomy complications being faced in clinical practice. In this paper, we present the current state of knowledge and the latest findings in the fields of modern surgical techniques, thermal ablation, the identification and assessment of parathyroid function, recurrent laryngeal nerve monitoring and treatment and perioperative bleeding. We reviewed 485 papers, from which we selected 125 papers that are the most relevant. The main merit of this article is its comprehensive view of the subject under discussion-both general, concerning the selection of the appropriate method of surgery, and particular, concerning the selection of the appropriate method of prevention or treatment of selected perioperative complications.
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Affiliation(s)
- Bartłomiej Ludwig
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Maksymilian Ludwig
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Anna Dziekiewicz
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Agnieszka Mikuła
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Jakub Cisek
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Szymon Biernat
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Krzysztof Kaliszewski
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Saavedra-Pérez D, Manyalich M, Domínguez P, Farguell J, Rull R, López-Boado MÁ, Vilaça J, Vidal Ó. Unilateral axilo-breast approach (UABA) with gas insufflation versus open conventional hemithyroidectomy: A prospective comparative study. Cir Esp 2023; 101:107-115. [PMID: 36100055 DOI: 10.1016/j.cireng.2022.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/17/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The objective of this study was to compare with the conventional open approach, the surgical and aesthetic results of endoscopic thyroidectomy via unilateral axillo-breast approach (UABA) with gas insufflation in patients with a unilateral thyroid nodule. METHODS Between August 2017 and August 2020, a prospective comparative cohort study was carried out in patients proposed for hemithyroidectomy. The patients were assigned to one type of approach (Open or Endoscopic) in a successive manner. Surgical results and aesthetic satisfaction at hospital discharge and during the 12-month follow-up were evaluated and compared between both groups. RESULTS A total of 200 patients were included in the study: 100 for the Open approach and 100 for the Endoscopic. The baseline patient characteristics were similar between both groups. Total operative time was longer in the Endoscopic approach, due to the time required for subcutaneous dissection (the hemithyroidectomy time was similar in both groups). There was no significant difference in the frequency of major complications. The length of hospital stay was longer (for 1 day) in the Endoscopic group. The aesthetic satisfaction of the patients was significantly higher in the Endoscopic than in the Open group (p < 0.001), at hospital discharge and at 12-month follow-up. CONCLUSION UABA with gas insufflation for hemithyroidectomy represents a safe and effective therapeutic option for the treatment of unilateral benign thyroid pathologies.
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Affiliation(s)
- David Saavedra-Pérez
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain.
| | - Marti Manyalich
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
| | - Paula Domínguez
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
| | - Jordi Farguell
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
| | - Ramón Rull
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
| | - Miguel Ángel López-Boado
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
| | - Jaime Vilaça
- Departamento de Cirugía General y del Aparato Digestivo, Hospital da Luz Arrábida, Escola de Medicina, Universidade do Minho, Braga, Porto, Portugal
| | - Óscar Vidal
- Unidad de Endocrinología Médico-Quirúrgica, Cirugía Endocrina, Servicio de Cirugía General y del Aparato Digestivo, Instituto Clínic de Enfermedades Digestivas y Metabólicas (ICMDiM), Hospital Clínic de Barcelona, Universidad de Barcelona, IDIBAPS, Barcelona, Spain
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Saavedra-Pérez D, Manyalich M, Domínguez P, Farguell J, Rull R, López-Boado MÁ, Vilaça J, Vidal Ó. Hemitiroidectomía vía abordaje axilo-mamario unilateral (UABA) con insuflación de gas vs. convencional abierta: estudio prospectivo comparativo. Cir Esp 2022. [DOI: 10.1016/j.ciresp.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Choi JB, Lee BC, Park YM, Jung HJ, Kim DI. Application of minimal invasive technique for thyroidectomy without remote access in locally advanced thyroid carcinoma with gross extra-thyroidal extension. Int J Surg Case Rep 2020; 75:143-146. [PMID: 32949912 PMCID: PMC7502781 DOI: 10.1016/j.ijscr.2020.09.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/05/2020] [Accepted: 09/05/2020] [Indexed: 11/25/2022] Open
Abstract
Minimally invasive thyroidectomy (MIT) is useful and famous technique that is being applied to thyroid carcinoma. MIT without remote access is useful and applicable in thyroid disease and carcinoma in terms of cost effect and cosmetic outcome. MIT without remote access can be feasible method for thyroid carcinoma with gross extra-thyroidal extension, especially, upper pole carcinoma.
Introduction Minimally invasive thyroidectomy (MIT) is technically less damaging tissue and is better cosmetic results with small neck scar, decreasing postoperative pain and neck discomfort. We present the experience of MIT without remote access with case of grossly extra-thyroidal extension positive papillary thyroid carcinoma. Presentation of case A 44-year-old, female presented 1.6 cm irregular hypoechoic nodule at upper pole in Right thyroid gland and diagnosed to papillary thyroid carcinoma. The tumor was suspicious to have extra-thyroidal extension. We performed MIT without remote access for this patient with 2 cm cervical incision. Postoperative course was uneventful and patient was discharged on the 3th postoperative day. At present, she is taking 100mcg levothyroxine and is free of disease 3 years post-surgery. Conclusion If experienced surgeons can get sufficient resection margin and control bleeding of superior thyroid artery, MIT without remote access can be feasible method for thyroid carcinoma with gross extra-thyroidal extension, especially, upper pole carcinoma.
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Affiliation(s)
- Jung Bum Choi
- Department of Surgery, Pusan National University Hospital, Republic of Korea
| | - Byoung Chul Lee
- Department of Surgery, Pusan National University Hospital, Republic of Korea
| | - Young Mok Park
- Department of Surgery, Pusan National University Hospital, Republic of Korea
| | - Hyuk Jae Jung
- Department of Surgery, Pusan National University Hospital, Republic of Korea
| | - Dong-Il Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Republic of Korea.
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Guo F, Wang W, Zhu X, Xiang C, Wang P, Wang Y. Comparative Study Between Endoscopic Thyroid Surgery via the Oral Vestibular Approach and the Areola Approach. J Laparoendosc Adv Surg Tech A 2020; 30:170-174. [PMID: 31621490 DOI: 10.1089/lap.2019.0562] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Fangdong Guo
- Department of Breast and Thyroid Surgery, The Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Wenrui Wang
- Department of Breast and Thyroid Surgery, Dezhou People's Hospital of Shandong Province, Dezhou, China
| | - Xiaoyu Zhu
- Department of Breast and Thyroid Surgery, The Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Cheng Xiang
- Department of Thyroid Surgery, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Ping Wang
- Department of Thyroid Surgery, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
| | - Yong Wang
- Department of Thyroid Surgery, The Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, China
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