저자들은 중국의 국가 핵심 연구 개발 프로그램(보조금 2017YFC840102)의 지원에 감사를 표하고자 합니다.

여기에 설명된 모든 방법은 베이징 병원 윤리 위원회의 승인을 받았습니다. 수술 적응증은 비신경원성 남성 LUTS에 대한 유럽 비뇨기과 협회 지침에 따릅니다. 금기 사항에는 의심되는 전립선암 또는 배뇨근 기능 장애가 포함됩니다.
1. 가동을 위한 계기
<ol><li>연속 모드(980-80W)를 포함한 전력을 가진 다이오드 레이저(100nm) 장비의 가용성을 보장합니다.</li>
	<li>수술 중 방광 세척을 위해 레이저 섬유와 0.9% 식염수를 사용합니다.</li>
	<li>26F 레이저 절제내시경을 사용하여 우수한 시각화를 얻고 효율성을 향상시킵니다.</li>
</ol>2. 수술 준비
<ol><li>수술 당일에 피부 준비를 실시하십시오.</li>
	<li>모든 환자에게 수술 전 항생제 정맥 투여10. 참고: 세푸록시메 나트륨(0.9% 염화나트륨 100mL에 1.5g)은 작업 30분 전에 제공됩니다.</li>
	<li>마취 전에 환자를 수술대에 눕히십시오. 참고: 전신 마취는 이 수술에 효과적이고 적합합니다. 마취과 의사는 환자의 일반적인 상태에 따라 마취 모드를 결정해야 합니다.</li>
	<li>등쪽 쇄석술 위치에서 멸균 방식으로 환자를 드레이프합니다.</li>
</ol>3. 절차 단계
<ol><li>관찰<ol><li>절제경(15-30°)으로 요도, 방광경, 방광경, 요관 구멍, 방광 점막, 섬유주 증식증을 직접 관찰합니다.</li>
	</ol></li>
	<li>적출 범위(큐피드의 화살표)를 설계합니다.<ol><li>레이저로 방광경부 점막을 원형으로 절개(땀샘까지의 깊이, 너비 약 3-4mm)합니다(그림 1).</li>
		<li>레이저로 정맥의 근위부 끝에 있는 전립선 요도 점막(분비샘까지의 깊이, 너비 약 3-4mm)을 절개합니다(그림 2). 참고: 방광경부 점막과 괄약근 요도의 부상을 방지하기 위해 절개 전에 해부학적 표시를 확인하십시오. 지혈을 제외하고 작업 중 80-100W의 레이저 출력을 사용하십시오.</li>
		<li>방광 목의 동심원과 전립선의 정점을 후방 요도의 12시 위치에 연결합니다.</li>
		<li>레이저로 좌엽과 우엽을 절개합니다(그림 3). 알림: 후방 요도의 12시 위치가 미리 절개되면 원위 점막을 유지합니다. 방광의 목과 전립선의 정점에 형성된 동심원을 큐피드 화살이라고 합니다.</li>
	</ol></li>
	<li>채널 만들기<ol><li>전립선 정점의 5시와 7시 위치에서 수술 캡슐을 찾습니다.</li>
		<li>5시 및 7시 방향의 수술 캡슐 위치에서 수술 캡슐을 찾습니다.</li>
		<li>5시 및 7시 방향의 수술 캡슐 위치를 레이저로 연결합니다(그림 4).</li>
		<li>전립선 정점의 6시 위치에서 레이저로 전립선 정점에서 방광 경부까지 수술 캡슐의 정중엽을 분리합니다(그림 5). 참고: 전립선의 부피가 >80mL인 경우 전립선 정점의 5시와 7시 위치에서 정중엽과 외엽이 완전히 분리됩니다.</li>
	</ol></li>
	<li>좌엽과 우엽의 적출<ol><li>시계 반대 방향으로 절제내시경으로 전립선 정점에서 방광 경부까지 6시와 12시 방향에 있는 우엽을 적출합니다(그림 6).</li>
		<li>시계 방향으로 전립선 정점에서 방광 경부까지 6시와 12시 방향에 있는 좌엽을 적출합니다(그림 7).</li>
		<li>적출 후 모든 분비샘을 방광으로 밀어 넣습니다. 참고: 전립선의 부피가 >80mL인 경우 정중엽과 외엽을 적절한 순서로 적출합니다. 그런 다음 방광에 밀어 넣습니다.</li>
	</ol></li>
	<li>지혈<ol><li>더 낮은 레이저 출력(50W)을 사용하여 수술 부위 주변의 출혈을 멈춥니다. 적절한 거리(즉, 1-3mm)를 유지하십시오.</li>
	</ol></li>
	<li>전립선 조직을 모르셀레이트합니다.<ol><li>모셀레이터를 사용하여 적출된 전립선 조직을 작은 조각(가능한 한 작게)으로 모셀레이트한 다음 방광에서 조직을 제거합니다(그림 8).</li>
	</ol></li>
	<li>카테터 삽입<ol><li>요도에서 모셀레이터를 제거합니다.</li>
		<li>요도에 리도카인 젤을 충분히 윤활한 후 풍선에 30mL의 물과 함께 요도 구멍을 통해 22F 폴리 카테터를 방광강에 부드럽게 삽입합니다.</li>
	</ol></li>
	<li>수술 후 관리10<ol><li>수술 후 환자가 마취에서 완전히 깨어날 때까지 치료실에서 약 3시간 동안 침대에 누워 있도록 합니다. 이 시간 동안 환자 모니터와 의료용 산소를 사용할 수 있는지 확인하십시오.</li>
		<li>환자가 완전히 깨어나면 환자를 병동으로 돌려보냅니다. 환자에게 물을 마시고 음식을 먹기 시작하게 한다. 모든 소변 배출량을 기록하고 소변 색에 주의를 기울이십시오.</li>
	</ol></li>
</ol>

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저자는 밝힐 것이 없습니다.

현재 980mm 다이오드 레이저가 BPH5의 치료에 사용되기 시작했습니다. 관련 임상 연구를 설명한 보고서는 거의 없습니다. 전립선 비대증 치료에 대한 TURP의 효과와 비교하여, 많은 연구에서 DiLEP가 출혈을 덜 일으키고, 배뇨 기능이 더 우수하며, 카테터 유지 시간이 더 짧다는 것을 보여주었다 9,13,14,15.<su...

전통적인 전립선 경요도 절제술(TURP)과 비교했을 때, 레이저 수술은 환자의 내성이 우수하고, 수술 중 출혈량이 적으며, 효능이 우수하고, 수술 후 회복이 짧기 때문에 점차 대중화되고 있습니다 4,5.
최근 몇 년 동안 가장 빠르게 성장하는 기술에는 다양한 파장의 레이저가 사용되었습니다. 현재 다양한 특성을 가진 많은 종류의 레이저를 사용하여 전립선 적출을 완료할 수 있습니다. 다이오드 레이저는 2007년 미국 FDA로부터 전립선 비대증에 대한 승인을 받은 이래로 뛰어난 절단 능력과 지혈 효과로 인해 전립선 비대증 치료에 대한 사용이 점차 증가하고 있다6. 레이저 파장은 물과 헤모글로빈에 의한 흡수 정도를 결정합니다. 980nm 파장의 다이오드 레이저는 물과 헤모글로빈의 결합 흡수율이 가장 높습니다. 조직 침투 능력은 0.5mm이며 더 깊은 조직에서 응고 효과를 낼 수 있어 매우 우수한 조직 절제 및 지혈 능력 7,8을 제공합니다.
많은 연구 센터에서 양성 전립선 비대증 치료를 위해 DiLEP를 사용하기 시작했습니다. 실제로, 전통적인 DiLEP는 학습 곡선이 더 길고 요로 괄약근 보호와 관련된 뚜렷한 이점이 없다9. 위와 같은 이유로, 전립선 비대증 환자에서 다이오드 레이저 치료의 가치를 높이기 위해 기존 DiLEP를 수정했습니다.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>HU Diode Laser</td>
			<td>Beijing L.H.H.Medical Science Development Co., Ltd</td>
			<td>HU-150</td>
			<td>Wavelength: 980nm 
			Maximum Power: 150W 
			Operation Mode: Continuous and pulsed</td>
		</tr>
		<tr>
			<td>Optical Fiber</td>
			<td>Beijing L.H.H.Medical Science Development Co., Ltd</td>
			<td>YYGX600</td>
			<td>Fiber core diameter: 
			600 &#956;m 
			Fiber length: 2m</td>
		</tr>
		<tr>
			<td>Morcellator System</td>
			<td>Beijing L.H.H.Medical Science Development Co., Ltd</td>
			<td>PXQ-01</td>
			<td>Rotate Speed: 100-3000rpm 
			MAX. Vacuum Pressure: -80KPa 
			Rated Output Torque: 12mNm 
			Blade Size: &#934;5.0*390mm; &#934;3.5*390mm 
			Blade Work Mode: Corotation alternates reversal</td>
		</tr>
	</tbody>
</table>

enucleation of the prostate for the treatment of benign prostatic hyperplasia using a 980 nm diode laser

고령 남성 인구에서 양성 전립선 비대증(BPH)으로 인한 하부 요로 증상(LUTS)의 발생은 흔한 문제입니다. 여기에서는 BPH1을 치료하기 위해 980nm 다이오드 레이저 적출(DiLEP)이라는 새로운 기술을 소개합니다. 다이오드 레이저는 물과 헤모글로빈을 동시에 흡수 할 수 있기 때문에 절단 및 지혈에 좋습니다2. 다이오드 레이저는 2007 년 FDA의 승인을 받았으며 효과적인 절단 및 지혈 효과로 인해 전립 비대증 치료에 사용되었습니다3. DiLEP는 TURP, HoLEP 및 PVP와 같은 다른 기술에 비해 몇 가지 이점을 제공합니다. 시술 중에는 부피가 큰 전립선의 경계를 정의하고 다이오드 레이저로 두 개의 고리와 하나의 홈(큐피드의 화살처럼)을 태워 3개의 엽으로 분리합니다. 다른 시술에 비해 mDiLEP는 수술 중 합병증이 적고 학습 곡선이 짧으며 더 많은 조직 절제를 달성합니다.

DiLEP를 받은 총 40명의 전립선 비대증 환자가 본 연구 중 하나에 포함되었습니다. 통계적 방법으로 독립적인 표본 t-검정을 사용하였다. 모든 환자가 수술을 성공적으로 마쳤습니다. 거의 모든 환자가 수술 후 5일 이내에 카테터를 제거했다(표 1). 모든 환자는 수술 후 1개월, 3개월, 12개월에 후속 검사를 위해 병원으로 돌아왔습니다. 국?...

Watch this Scientific Journal Video about Enucleation of the Prostate for the Treatment of Benign Prostatic Hyperplasia Using a 980 nm Diode Laser at JoVE.com

Enucleation of the Prostate for the Treatment of Benign Prostatic Hyperplasia Using a 980 nm Diode Laser

여기에서는 대용량 양성 전립선 비대증을 치료하기 위한 수정된 980nm 다이오드 레이저 적출을 위한 프로토콜을 제시합니다.

980nm 다이오드 레이저를 사용한 양성 전립선 비대증 치료를 위한 전립선 적출

In the aging male population, the occurrence of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) is a common problem. ...

enucleation-prostate-for-treatment-benign-prostatic-hyperplasia-using

Research

JoVE Journal

Medicine

2.0K 조회수.  Beijing Hospital. 여기에서는 대용량 양성 전립선 비대증을 치료하기 위한 수정된 980nm 다이오드 레이저 적출을 위한 프로토콜을 제시합니다.

비디오: Enucleation of the Prostate for the Treatment of Benign Prostatic Hyperplasia Using a 980 nm Diode Laser

Renal Capsule Xenografting and Subcutaneous Pellet Implantation for the Evaluation of Prostate Carcinogenesis and Benign Prostatic Hyperplasia

New therapies for two common prostate diseases, prostate cancer (PrCa) and benign prostatic hyperplasia (BPH), depend critically on experiments evaluating their hormonal regulation. Sex steroid hormones (notably androgens and estrogens) are important in PrCa and BPH; we probe their respective roles in inducing prostate growth and carcinogenesis in mice with experiments using compressed hormone pellets. Hormone and/or drug pellets are easily manufactured with a pellet press, and surgically implanted into the subcutaneous tissue of the male mouse host. We also describe a protocol for the evaluation of hormonal carcinogenesis by combining subcutaneous hormone pellet implantation with xenografting of prostate cell recombinants under the renal capsule of immunocompromised mice. Moreover, subcutaneous hormone pellet implantation, in combination with renal capsule xenografting of BPH tissue, is useful to better understand hormonal regulation of benign prostate growth, and to test new therapies targeting sex steroid hormone pathways.

We describe the manufacture of compressed hormone pellets, as well as subcutaneous surgical implantation into mice. This strategy can be combined with the growth of cell and tissue xenografts under the renal capsule of athymic nude mice to evaluate hormonal carcinogenesis and regulation of benign prostate growth.

전립선 발암 및 양성 전립선 비대증의 평가를위한 신장 캡슐 Xenografting 및 피하 펠렛 주입

New therapies for two common prostate diseases,  prostate cancer (PrCa) and benign prostatic hyperplasia (BPH), depend  critically on experiments ...

연구

의학

Laser-capture Microdissection of Human Prostatic Epithelium for RNA Analysis

The prostate gland contains a heterogeneous milieu of stromal, epithelial, neuroendocrine and immune cell types. Healthy prostate is comprised of fibromuscular stroma surrounding discrete epithelial-lined secretory lumens and a very small population of immune and neuroendocrine cells. In contrast, areas of prostate cancer have increased dysplastic luminal epithelium with greatly reduced or absent stromal population. Given the profound difference between stromal and epithelial cell types, it is imperative to separate the cell types for any type of downstream molecular analysis. Despite this knowledge, the bulk of gene expression studies compare benign prostate to cancer without micro-dissection, leading to stromal bias in the benign samples. Laser-capture micro-dissection (LCM) is an effective method to physically separate different cell types from a specimen section. The goal of this protocol is to show that RNA can be successfully isolated from LCM-collected human prostatic epithelium and used for downstream gene expression studies such as RT-qPCR and RNAseq.

The goal of this protocol is to use laser-capture micro-dissection as an effective method to isolate pure populations of cell types from heterogeneous prostate tissues for downstream RNA analysis.

RNA 분석을위한 인간의 전립선 상피 세포의 레이저 캡처 이외에 Microdissection

The prostate gland contains a heterogeneous milieu of stromal, epithelial, neuroendocrine and immune cell types.  Healthy prostate is comprised of ...

Network Analysis of Foramen Ovale Electrode Recordings in Drug-resistant Temporal Lobe Epilepsy Patients

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control seizures. However, a significant minority of patients continues to exhibit post-operative seizures, even in those cases in which the suspected source of seizures has been correctly localized and resected. The protocol presented here combines a clinical procedure routinely employed during the pre-operative evaluation of temporal lobe epilepsy (TLE) patients with a novel technique for network analysis. The method allows for the evaluation of the temporal evolution of mesial network parameters. The bilateral insertion of foramen ovale electrodes (FOE) into the ambient cistern simultaneously records electrocortical activity at several mesial areas in the temporal lobe. Furthermore, network methodology applied to the recorded time series tracks the temporal evolution of the mesial networks both interictally and during the seizures. In this way, the presented protocol offers a unique way to visualize and quantify measures that considers the relationships between several mesial areas instead of a single area.

This protocol describes a procedure to track the evolution of mesial network measures in temporal lobe epilepsy (TLE) patients. It is based on the combination of intracranial recordings with a novel numerical technique for data analysis. Specifically, we present a protocol for network analyses of foramen ovale recordings.

Approximately 30% of epilepsy patients are refractory to antiepileptic drugs. In these cases, surgery is the only alternative to eliminate/control ...

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

Today&#39;s gold standard in the treatment of infrasaccal primary acquired nasolacrimal duct obstruction (PANDO) is external dacryocystorhinostomy (DCR), a relatively invasive procedure that can be performed after failure of recanalizing treatments. However, with progress in the field of diode laser technology, new approaches have emerged. Laser-assisted transcanalicular DCR with subsequent bicanalicular silicon intubation is a new option showing great promise as a viable minimally invasive procedure. Under permanent endoscopic visual control from the nasal cavity, a diode laser fiber is inserted into the lacrimal sac and laser energy is applied to create a bony ostium between the lacrimal sac and the nasal cavity. Since no skin incision needs to be made, advantages of this method comprise the sparing of the skin as well as the medial palpebral structures and the physiological palpebral-canalicular pump mechanism. The duration of surgery as well as reconvalescence is generally shorter than with external DCR. Complications include silicon tube prolapse, mild swelling and, rarely, canalicular infection and thermal injury. One-year functional success rates, defined as complete resolution of symptoms and ostium patency, are high, yet still range behind those of external DCR. However, secondary external DCR after failure of laser-assisted DCR can be performed without difficulty. Thus, laser-assisted transcanalicular DCR is a valid option that should be considered as a second-step procedure after failure of recanalization procedures and before external DCR.

The goal of this protocol is to present transcanalicular laser-assisted dacryocystorhinostomy as a minimally invasive approach in the treatment of primary acquired nasolacrimal duct obstruction.

기본의 치료에 대 한 Transcanalicular 다이오드 레이저를 이용한 Dacryocystorhinostomy 인수 비누 덕트 방해

Today&#39;s gold standard in the treatment of infrasaccal primary acquired nasolacrimal duct obstruction (PANDO) is external dacryocystorhinostomy (DCR), ...

Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate (HoLEP).

Benign prostatic hyperplasia (BPH) commonly occurs among elderly males. The condition causes symptoms in the lower urinary tract, thereby reducing the quality of life. BPH includes 2 major treatments: medication and surgery. Surgical treatment is often the most effective and final intervention. Holmium laser enucleation of the prostate (HoLEP), one of the most efficient surgical procedures for BPH, is conducted transurethrally. During surgery, the most important and most difficult part is to locate the surgical capsule of the prostate, which is consistent to the idea of anatomic surgery. Different skills may be needed in treating different parts of the prostate. HoLEP tends to be efficient and safe with good hemostatic properties, and able to treat bladder calculus, which may be the complications of BPH. The technique is particularly suitable for prostate of varying volumes and sizes. Indeed, HoLEP also presents certain disadvantages, such as a long learning curve and costly equipment. Regardless, this method may be the "new standard" and the excellent method for the surgical treatment of BPH.

Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate HoLEP.

Here we present a safe and efficient protocol, holmium laser enucleation of the prostate, to treat benign prostatic hyperplasia.

양성 전립선 비 대 증에 대 한 수술 치료: Holmium 레이저 Enucleation (HoLEP) 전립선의.

Benign prostatic hyperplasia (BPH) commonly occurs among elderly males. The condition causes symptoms in the lower urinary tract, thereby reducing the ...

Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser

The occurrence of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) is a common problem with a high incidence in the aging male population. Although it is not a life-threatening disease, BPH causes problems that seriously impact the quality of life. Here, we introduce a new technique called photoselective vaporesection of the prostate (PVRP) in treating BPH, which can be seen as a variation of photoselective vaporization of the prostate (PVP). This procedure presents several advantages compared to the PVP technique including less laser energy loss, less intraoperative complications as well as more tissue resection rate.

Here we present a protocol to perform Photoselective Vaporesection of the Prostate (PVRP) for benign prostatic hyperplasia (BPH) treatment.

최종 발사 리튬 Triborate 크리스탈 레이저를 통해 전립선의 Photoselective Vaporesection

The occurrence of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) is a common problem with a high incidence in the aging ...

Endoscopy Guided Photoablation of Endometrial Cysts using a 980 nm Laser with a Contact Fiber in Mares

In mares, endometrial cysts are associated with endometriosis and can cause maternal recognition failure or compromise and delay pregnancy diagnoses. Historical treatments were invasive and had adverse effects on the endometrium. Hysteroscopically guided laser therapy is easy and effective for endometrial cysts resection, with no deleterious effects for the endometrium.
A 110 cm long and 1.0 cm wide endoscope is sterilely introduced in the uterus through the open cervix of an estrous mare after vulvar cleaning. The uterus is slowly infused with less than 1 L of physiologic solution and the laser fiber is inserted in the biopsy canal of the endoscope. Cysts are then cauterized with the 980 nm diode laser with a contact fiber set at 20&#8210;2 5W in continuous mode. Each cyst is punctured&#160;until complete voiding of the cyst and shrinking of the cyst wall around the fiber. Uterine lavages with sterile saline solution are performed directly after the surgery and for one or two days as non-inflammatory fluid can be observed.
This procedure is easy and quickly performed, with no obvious deleterious effects. Cysts resection makes ultrasound pregnancy diagnosis easier and, in some cases, could restore proper embryo migration in the uterine horns between day 6.5 and 17. However, this treatment does not improve the underlying histological lesions related to endometriosis. These considerations should be clearly expressed to the breeder before this procedure.

The aim of this report is to describe the photoablation of endometrial cysts in the mare using an endoscopic laser device, and to discuss the interest and limitations of this new approach to deal with low fertility issues.

내시경 검사 유도 자궁 내막 낭종의 980 nm 레이저를 사용 하 여 Mares에 접촉 섬유와

In mares, endometrial cysts are associated with endometriosis and can cause maternal recognition failure or compromise and delay pregnancy diagnoses. ...

Focal Laser Ablation of Prostate Cancer: An Office Procedure

In this article, we describe and illustrate an outpatient procedure for focal laser ablation (FLA) of prostate cancer (PCa). The procedure is conceptually similar to a fusion biopsy and is performed under local anesthesia in a clinic setting; treatment time is usually less than one hour. Laser insertion is guided by ultrasound; lesion targeting is via magnetic resonance imaging-ultrasound (MRI/US) fusion, as in targeted prostate biopsy. Real-time ablation monitoring is achieved utilizing a thermal probe adjacent to the laser fiber. The video demonstrates procedure planning, patient preparation, various steps during the procedure, and treatment monitoring. Safety, feasibility, and efficacy of this approach have been established during a previous trial. Outpatient FLA under local anesthesia is an option for management of intermediate risk prostate cancer.

This article presents and describes an outpatient treatment for prostate cancer using focal laser ablation. Laser catheter placement is guided by MRI-ultrasound fusion imaging in a fashion similar to prostate needle biopsy. Treatment is monitored in real-time with a thermal probe, placed adjacent to the laser fiber.

전립선암의 초점 레이저 절제: 사무실 절차

In this article, we describe and illustrate an outpatient procedure for focal laser ablation (FLA) of prostate cancer (PCa). The procedure is conceptually ...

Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease

Periodontal and peri-implant diseases are plaque-induced infections with a high prevalence, seriously impairing people&#39;s quality of life. The diode laser has long been recommended as adjunctive therapy in treating periodontitis. However, the optimal combination of usage mode (inside or outside periodontal pocket) and application regimen (single or multiple sessions of appointment) has not been described in detail. Meanwhile, probiotic Lactobacillus is regarded as a potential adjuvant in the management of the peri-implant disease. Nonetheless, a detailed protocol for an effective probiotic application is lacking. This article aims to summarize two clinical protocols. For periodontitis, the optimal collaboration of laser usage mode and application regimen was identified. Regarding peri-implant mucositis, a combined therapy containing professional topical use and home administration of probiotic Lactobacillus was established. This updated laser protocol clarifies the relationship between the treatment mode (inside or outside the periodontal pocket) and the number of laser appointments, further refining the existing diode laser therapy. For inside pocket irradiation, a single session of laser treatment is suggested whereas, for outside pocket irradiation, multiple sessions of laser treatment provide better effects. The improved probiotic Lactobacillus therapy resulted in the disappearance of swelling of the peri-implant mucosa, a reduced bleeding on probing (BOP), and an obvious reduction and good control of plaque and pigmentation; however, probing pocket depth (PPD) had limited improvement. The current protocol should be regarded as preliminary and could be further enhanced.

Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease

This article describes two protocols: 1) adjunctive diode laser therapy for treating periodontitis and 2) probiotic Lactobacillus therapy for treating peri-implant disease, with emphasis on the laser usage mode (inside or outside pocket), laser application regimen (single or multiple sessions), and a probiotic protocol of professional and home administration.

보조 다이오드 레이저 요법 및 프로바이오틱 유산균 요법은 치주염 및 임플란트 주위 질환 치료에 사용됩니다.

Periodontal and peri-implant diseases are plaque-induced infections with a high prevalence, seriously impairing people&#39;s quality of life. The diode ...

Laparoscopic Duodenum-Preserving Pancreatic Head Resection via Inferior Infracolic Approach: A Surgical Approach for Benign Lesions

Minimally invasive pancreatic resections are gaining popularity despite being technically demanding. However, in contrast to laparoscopic pancreatoduodenectomy (LPD), laparoscopic duodenum-preserving pancreatic head resection (LDPPHR) has not yet obtained wide acceptance. This could be attributed to the technical challenges involved in preserving the blood supply of the duodenum and bile duct.
This study describes and demonstrates all the steps of LDPPHR. A 48-year-old woman was diagnosed with a 3.0 cm x 2.5 cm pancreatic head cystic mass, which was detected unexpectedly. The surgery was performed using the 3D laparoscopy via an inferior infracolic approach. The operation lasted approximately 310 min with 100 mL of blood loss. Postoperatively, the patient experienced no complications and was discharged 5 days later. Pathology revealed intraductal papillary mucinous neoplasms.
LDPPHR via an inferior infracolic approach is feasible and safe when performed by experienced surgeons in selected patients with thin mesenteric fat layers. The described technique for LDPPHR via inferior infracolic approach should be well standardized and performed at high-volume centers with experienced surgeons in both open and laparoscopic pancreatology.

This article provides a whole technical process of laparoscopic duodenum-preserving pancreatic head resection via an inferior infracolic approach. This is a surgical approach for benign tumors without intraoperative fluorescence image guidance.