Pena Wilcox (kidneyflight0)

INTRODUCTION This report describes the techniques and outcomes of robot-assisted distal gastrectomy (RDG) for gastric carcinoma using an oval-shaped port device. MATERIALS AND METHODS A total of 15 patients underwent RDG with lymphadenectomy using the E‧Z Access/LAP-PROTECTOR oval-type device (Hakko Co., Ltd., Tokyo, Japan) performed by a single surgeon between 2018 and 2019. This device was introduced to the umbilicus under two settings, depending on the patient's figure. A horizontal setting (n=7) was used to reduce the number of trocar skin incisions in thin patients by placing a scope trocar and assist port within the E-Z Access. The vertical setting (n=8) was used for large and obese patients, enabling the endoscope position to move 50mm toward the cephalad side by rotating the device 180° to improve the surgical view of the suprapancreatic area ("dual port position" using the E‧Z Access oval-type device). The intracorporeal Billroth-I anastomosis or Roux-en-Y method was used for reconstruction. The short-term patient outcomes were determined to assess the safety and feasibility of our procedures. RESULTS The E-Z Access oval-type device was useful for maintaining an optimal surgical field and reducing the number of skin incisions and the level of surgeon stress. Furthermore, its removal cap and wound protector allowed for an airtight seal, umbilical wound protection, and smooth specimen removal and re-pneumoperitoneum. R0 resection was accomplished in all cases without the need for conversion to open or conventional laparoscopic surgery. The median operating time was 323 (range, 245-590) minutes, and the median blood loss was 5ml. The median number of retrieved lymph nodes was 30. Neither major postoperative complication, including umbilical skin damage, nor postoperative mortality, was observed. The mean length of the hospitalization was 12.5 days. CONCLUSIONS Our robotic approach using an oval-shaped port device for gastric cancer patients is feasible in terms of patient safety and curability.Myocardial recovery in left ventricular assist device patients is a rare opportunity to explant the assist device. Despite myocardial recovery, these patients remain high-risk candidates. Short, effective procedures are the key to successful left ventricular assist device explantation. Conventional methods such as ventriculoplasty are extensive and challenging procedures. Triparanol order Thus, an explantation tool was developed in order to simplify HeartMate 3 (Abbott Cooperation, Abbott Park, Ill, USA) explantation. A customized metal plug was designed to fit into the HeartMate 3-sewing ring. We now report the successful first-in-man use of this novel plug for HeartMate 3 explantation. © The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.SUMMARY The New E-Resource for Drug Discovery (NERDD) is a quickly expanding web portal focused on the provision of peer-reviewed in silico tools for drug discovery. NERDD currently hosts tools for predicting the sites of metabolism (FAME) and metabolites (GLORY) of small organic molecules, for flagging compounds that are likely to interfere with biological assays (Hit Dexter), and for identifying natural products and natural product derivatives in large compound collections (NP-Scout). Several additional models and components are currently in development. AVAILABILITY AND IMPLEMENTATION The NERDD web server is available at https//nerdd.zbh.uni-hamburg.de. Most tools are also available as software packages for local installation. © The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.Microvascular dysfunction (MVD) is a common pathophysiological change in various diseases, such as type 2 diabetes mellitus (T2DM), heart failure, dementia and depression. Recent technical advances enable the measurement and quantificati