[Minimally invasive direct cardiac surgery with the jakoscope retractor]

The authors present a surgical retractor named jakoscope, useful in the field of abdominal, urological, vascular, thoracic and cardiac surgery procedures. This multifunctional device offers the possibility to utilize Minimally Invasive Direct Access Surgical Technology (MIDAST) in the above mentioned surgical specialties. In their department the authors use the jakoscope retractor for aortic valve replacement, off-pump coronary bypass operations and radiofrequency pulmonary vein ablation by mini-thoracotomy approach. In this report they published for the first time their experience with jakoscope device in the field of cardiac surgery. In these operations the device assured adequate minimally invasive direct access, without complications.

Jakoscope-an alternative method for minimal access surgery. Early experience in hysterectomies

Minimal access surgery is now a required technique in gynaecology. This paper reports on the first 15 hysterectomies performed through a new in gynaecology abdominal wall retractor-the Jakoscope. The abdominal incision was reduced to 4-6 cm in length. Operation time of 126 minutes (average) is longer than that observed in hysterectomies using a conventional incision. With more experience with the Jakoscope operation time is lessened associated with less abdominal pain, better postoperative recovery, shorter wound healing time and excellent cosmetic results. The hospital stay is lessened (from 10 to 3 days) and consequently the cost is decreasing.

Minimally invasive or conventional aorto-bifemoral by-pass. A randomised study

INTRODUCTION

open transperitoneal aorto-bifemoral by-pass is still associated with a relatively high morbidity and mortality. To decrease this surgical stress, minimally invasive direct aortic surgery (MIDAS) was developed, utilizing a minilaparotomy and a retroperitoneal approach to the aorta.

OBJECTIVES

to compare in a randomised controlled trial whether mortality and morbidity could be reduced with MIDAS.

METHODS

from October 1997 to September 2000, 300 patients were randomised to either MIDAS (n=150) or conventional aorto-bifemoral by-pass surgery (n=150).

RESULTS

the perioperative (30 days) mortality (2.6%), was equal in both groups. MIDAS were significantly reduced length of hospital stay (3.1 days), and pulmonary dysfunction.

CONCLUSIONS

MIDAS reduced trauma and pain, which resulted in a shorter hospital stay, and a reduction in costs.