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Search Results: 1 - 10 of 3491 matches for " Masahiko Watanabe "
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Single-Incision Robotic Surgery  [PDF]
Norihiko Ishikawa, Masahiko Kawaguchi, Hideki Moriyama, Go Watanabe
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.32015
Abstract: Introduction: Single Incision Laparoscopic Surgery (SILSTM) has been developed as a less invasive laparoscopic surgery. On the other hand, robotically assisted surgical technology has offered new options for minimally invasive surgery. In this study, we report a new surgical technology to perform SILS using the da Vinci S surgical system (Intuitive Surgical Inc., Sunnyvale, CA). Materials and Surgical Technique: A porcine liver with gallbladder was placed on an endoscopic surgery trainer, and a 25 mm incision was made for one robotic camera and two instruments at the umbilicus position. Both instruments were crossed while preventing them from colliding with each other, and Robot-assisted single-incision cholecyctectomy was perfumed. Discussion: This technique is expected to contribute to the development of a number of procedures in the future.
Mobile Schwannoma of the Cauda Equina for Which Intraoperative Myelography Was Useful in Locating  [PDF]
Hiroki Kasama, Eiren Toh, Joji Mochida, Masahiko Watanabe
Surgical Science (SS) , 2017, DOI: 10.4236/ss.2017.84021
Abstract: We report on a case of a mobile schwannoma of the cauda equina. The patient was a 24-year-old woman who visited our hospital with the chief complaints of low back pain and numbness of the right leg. A tumor was noted from the L2 midbody level to the L3 upper endplate on preoperative MRI and myelogram. During the surgery, a right L2 hemilaminectomy was performed, and the dura was incised, but no tumor was founded in the surgical field, and this was noted as a missing tumor. Intraoperative myelography showed that the tumor had moved to the adjacent vertebra on the caudal side. Myelography applied again to the caudal side of the mobile tumor. Then, the tumor had moved upward, and could be excised without an additional laminectomy.
Laparoscopic Hernioplasty Using Omega-3 Coating Mesh  [PDF]
Masahiko Kawaguchi, Norihiko Ishikawa, Youji Nishida, Hideki Moriyama, Masahiro Kaneki, Go Watanabe
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.38077
Abstract: 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.
The da Vinci Surgical System versus the Radius Surgical System  [PDF]
Norihiko Ishikawa, Go Watanabe, Noriyuki Inaki, Hideki Moriyama, Masanari Shimada, Masahiko Kawaguchi
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.37070
Abstract: 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.
Efficacy of Modified Expansive Open-Door Laminoplasty for Cervical Myelopathy  [PDF]
Eiren Toh, Yukihiro Yamamoto, Daisuke Sakai, Masato Sato, Masahiko Watanabe, Joji Mochida
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.312112
Abstract: Objectives: Expansive open-door laminoplasty is used widely for the treatment of cervical spondylosis and Ossification of the Posterior Longitudinal Ligament (OPLL). We have developed a unique modification of the surgical procedure to keep the lamina expanded, with the aim of preventing reclosure of the vertebral arch. To examine the effectiveness of and problems associated with the modified expansive open-door laminoplasty technique developed at our institution by evaluating the surgical outcomes. Methods and Materials: Fifty-six patients (46 men and 10 women) underwent the modified expansive open-door laminoplasty and were followed up for at least 1 year. Thirty-eight had Cervical Spondylotic Myelopathy (CSM) and 18 had OPLL. The patients were 34 to 89 years of age (mean: 60.9 years). The severity of myelopathy was evaluated according to the Japanese Orthopaedic Association’s scoring system. Surgical outcomes were evaluated using Hirabayashi’s system for determining recovery rate. In the radiographic analysis, the following angles were measured before and after surgery: lordosis angle and Range of Motion (ROM) at C2 - C7 on lateral radiographs, and opening angle on computerized tomography (CT). The presence and absence of axial pain and postoperative C5 palsy were also evaluated. Results: The rate of JOA score improvement was about 60%, the lordosis angle observed on lateral radiographs was maintained. ROM decreased after surgery in both the CSM and OPLL groups, and the extent of the decrease was similar to that in previous reports. The opening angle of the lamina was 62°- 65° on post-operative CT. Axial pain was reported by 34% of patients. Conclusions: Our modified procedure produced satisfactory postoperative outcomes based on the clinical data and imaging findings for both CSM and OPLL. The advantage of this procedure is that it avoids potential complications associated with bone grafts or implants.
Newly emerging standard chemotherapies for gastric cancer and clinical potential in elderly patients
Shinichi Sakuramoto,Keishi Yamashita,Masahiko Watanabe
World Journal of Gastrointestinal Oncology , 2009,
Abstract: With the increase in average life expectancy, the rate of occurrence of gastric cancer in elderly patients is also rising. While many clinical trials have been conducted to examine the effect of chemotherapy treatment on gastric cancer, age limits for eligible subjects have prevented the establishment of standards for chemotherapy in elderly patients with gastric cancer. As of March 2009, evidence-based standard chemotherapy regimens were established. In the Western world, debates centered on the ECF (Epirubicin/cisplatin/5-FU) or DCF (Docetaxel/cisplatin/5-FU) regimens based on the phase III randomized controlled trial at the Royal Marsden Hospital (RMH) or the V325 study, respectively. The JCOG9912 and SPIRITS trials emerged from Japan indicating attractive regimens that include S-1 for advanced gastric cancer patients. Using these active anticancer drugs, the trials that studied the efficacy of adjuvant therapies or surgical approaches, such as the Int-116/MAGIC/ACTS-GC trials, have actually succeeded in demonstrating the benefits of adjuvant therapies in gastric cancer patients. For cases of gastric cancer in elderly patients, treatment policies should consider these studies while analyzing not only the therapeutic effects but also drug toxicity, individual general health conditions, and social factors to select treatments that emphasize quality of life.
The Homeobox Only Protein Homeobox (HOPX) and Colorectal Cancer
Keishi Yamashita,Hiroshi Katoh,Masahiko Watanabe
International Journal of Molecular Sciences , 2013, DOI: 10.3390/ijms141223231
Abstract: The HOP (homeobox only protein) homeobox (HOPX) is most closely related to the homeobox protein that contains a homeobox-like domain but lacks certain conserved residues required for DNA binding. Here, we review the current understanding of HOPX in the progression of colorectal cancer (CRC). HOPX was initially reported as a differentiation marker and is expressed in various normal tissues. In the colon, HOPX is expressed uniquely in the quiescent stem cell, +4, and in differentiated mucosal cells of the colon. HOPX expression is markedly suppressed in a subset of cancers, mainly in an epigenetic manner. CRC may include separate entities which are differentially characterized by HOPX expression from a prognostic point of view. HOPX itself can regulate epigenetics, and defective expression of HOPX can result in loss of tumor suppressive function and differentiation phenotype. These findings indicate that HOPX may be both a central regulator of epigenetic dynamics and a critical determinant for differentiation in human cells. HOPX downstream targets were identified in CRC cell lines and hold promise as candidates for therapeutic targets of CRC, such as EphA2 or AP-1. Further analysis will elucidate and confirm the precise role of such proteins in CRC progression.
Laparoscopic Observations in Acquired Inguinal Hernia before and after Robotic-Assisted Laparoscopic Prostatectomy  [PDF]
Masahiko Kawaguchi, Yoshifumi Kadono, Masanari Shimada, Hideki Moriyama, Norihiko Ishikawa, Go Watanabe
Surgical Science (SS) , 2014, DOI: 10.4236/ss.2014.54030
Abstract: 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”.
Simplifying Laparoscopic Surgery for Left Side Colon and Rectal Cancer Using Linear Stapler for Vascular Ligation: A Prospective Cohort Study  [PDF]
Masanori Naito, Takeo Sato, Takatoshi Nakamura, Takahiro Yamanashi, Hirohisa Miura, Atsuko Tsutsui, Masahiko Watanabe
Journal of Cancer Therapy (JCT) , 2017, DOI: 10.4236/jct.2017.84030
Abstract: Introduction: Systematic lymphadenectomy and ligation of the feeding artery is extremely important when performing radical resection in colorectal cancer. However, vascular surgery via laparoscopy requires advanced skills and techniques; thus, this procedure needs to be simplified while maintaining quality of the surgery to make it a preferred technique for the surgeons. Methods: There were 49 patients who underwent laparoscopic sigmoidectomy or anterior resection till T2 level for sigmoid colon cancer and recto-sigmoid colon cancer. We analyzed short-term and long-term outcomes between stapling ligation and clipping ligation techniques used in these surgeries. Results: The mean volume of blood loss in the stapling ligation group was 12.8 ± 12.3 ml, which was significantly lower than 41.9 ± 71.2 ml of mean volume of blood loss in the clipping ligation group. There was no significant difference in the mean duration of surgery, the mean number of harvested lymph nodes, morbidity, recurrence, and 5-year relapse free survival rates between the 2 groups. Conclusions: This study demonstrates a surgical technique using staplers for vascular treatment of tumor-feeding arteries as a new technical improvement in laparoscopic colectomy for the treatment of early-stage colon cancer. We found that the described procedure was technically safe, simple, convenient, and oncologically valid.
Citrus jabara Extracts Suppress MUC5AC Mucin Production in Human Lung Epithelial Cells  [PDF]
Jun Iwashita, Naoki Iguchi, Akiko Takashima, Daisuke Watanabe, Kimihiko Sano, Masahiko Ishikuro, Keishi Hata, Jun Murata
Advances in Biological Chemistry (ABC) , 2017, DOI: 10.4236/abc.2017.73009
Abstract: In the human airway, the overproduction of MUC5AC mucin is a key feature of allergic asthma, and it induces airway narrowing and obstruction. The production of MUC5AC is regulated by several signals, but the mechanism is not completely understood. We investigated the effect of jabara, a citrus containing abundant flavonoids, on the regulation of MUC5AC production. When NCI-H292 human airway epithelial cells were cultured with jabara extracts, we found that the expression of Periodic acid-schiff stained mucin was suppressed with downregulated MUC5AC production. In human primary airway cells derived from asthmatic patients, MUC5AC production was also suppressed by jabara extracts. The treatment of cells with jabara extracts decreased ERK activation in NCI-H292 and in primary cells. These results show that jabara extracts contain some factors that suppress MUC5AC production and ERK activity and suggest that it will be useful for relieving asthma.
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