A approach of gastric conduit via the anterior of pulmonary hilum route during minimally invasive McKeown esophagectomy.

BACKGROUND: The gastric conduit is the most commonly used replacement organ for reconstruction after minimally invasive McKeown esophagectomy. Although the optimal route of gastric conduit remains controversial, the posterior mediastinal route is physiologically preferable but is not without disadvantages. Here, we report the safety and efficacy of a method of gastric conduit reconstruction via the anterior of the pulmonary hilum route. METHODS: We have used the anterior of the pulmonary hilum route since 2021. This procedure involves pulling the gastric conduit up through a substernal tunnel between the right thoracic cavity and the abdominal cavity and passing it into the neck via the anterior of the pulmonary hilum route. In this retrospective study, we compared the clinical outcomes between 20 patients who underwent this procedure and 20 patients who underwent the posterior mediastinal route from 2021 to 2022. RESULTS: No mortality was reported in either group. No significant differences were observed between the two groups in duration of surgery, blood loss, incidence of postoperative complications, and postoperative hospital stay. As a result of the anterior of the pulmonary hilum route, the primary tumor bed and lymph node drainage area were effectively bypassed, which facilitates postoperative adjuvant radiotherapy or chemoradiotherapy. The distance of the gastric conduit accompanying the airway was significantly shorter in the anterior of the pulmonary hilum route group. CONCLUSIONS: Our method is considered to be a safe and useful technique for the reconstruction of gastric conduit.

Distal-continual colon interposition for esophageal reconstruction after esophagectomy: Two case reports.

Background: Colon interposition is a complex and time-consuming procedure requiring at least three or four digestive anastomoses. However, the long-term functional outcomes are promising, with an acceptable operative risk. Case presentation: Herein, two cases of esophageal carcinoma that received esophagus reconstruction using the distal continual colon interposition technique have been described. The transverse colon was lifted to the thoracic cavity for the end-to-side anastomosis with the esophagus, and a closure device was used to close the colon instead of severing and isolating the distal end. The duration of the operation was 140 and 150 min, respectively. The blood supply of the colon was maintained during the intervention. The tension-free anastomosis was performed without severe complications, and oral food intake was resumed on postoperative day 6. Neither anastomotic stenosis, antiacid or heartburn, dysphagia, or emptying obstacles nor complaints of diarrhea, bloating, or malodor were reported during the follow-up period. Conclusions: The modified distal-continual colon interposition technique may have the advantages of a short operation time and potential prevention of serious complications caused by the torsion of mesocolon vessels.

Stability and interaction of few-cycle pulses in a Kerr medium.

The different aspects of few-cycle pulse dynamics governed by the regularized short pulse equation (RSPE) are reported. It is shown that the RSPE provides an accurate description of the dynamics of the few-cycle pulse whose duration is larger than a single optical period when the few-cycle pulse's spectrum is in the medium's anomalous dispersion regime. The approximate solutions of the RSPE are constructed from the soliton solutions of the nonlinear Schrödinger (NLS) equation. We demonstrate numerically that the stability of these few-cycle pulses strongly depends on their pulse duration. Furthermore, the interactions of the two and three few-cycle pulses are studied. When pulse parameters are suitably chosen, we show the elastic collision, inelastic collision and repulsive interaction between these multi few-cycle pulses. It is revealed that the interactions of the multi few-cycle pulses rely heavily on their pulse duration.

Preliminary study for motion scaling based control in minimally invasive vascular interventional robot.

Robot-assisted vascular interventions present promising trend for reducing the X-ray radiation to the surgeon during the operation. However, the control methods in the current vascular interventional robots only repeat the manipulation of the surgeon. While under certain circumstances, it is necessary to scale the manipulation of the surgeon to obtain a higher precision or a shorter manipulation time. A novel control method based on motion scaling for vascular interventional robot is proposed in this paper. The main idea of the method is to change the motion speed ratios between the master and the slave side. The motion scaling based control method is implemented in the vascular interventional robot we've developed before, so the operator can deliver the interventional devices under different motion scaling factors. Experiment studies verify the effectiveness of the motion scaling based control.