7 results on '"Tolboom RC"'
Search Results
2. Laparoscopic Hiatal Hernia Repair in Patients with an Intrathoracic Pancreas: Case Series and a Review of Literature.
- Author
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Tolboom RC, Wijsman PJ, Broeders I, and Draaisma WA
- Abstract
Transhiatal herniation of the pancreas is rare with only 17 cases reported in 25 years. Presentation of pancreatic herniation is diverse. In the majority of cases, the pancreatic herniation is found incidentally on CT-scans made for evaluating complaints related to a large or giant hiatal hernia. We present a literature review and case series of three patients with symptomatic type IV hiatal hernia with incidental, asymptomatic pancreatic herniation. All cases were managed laparoscopically with robotic assistance., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Tolboom et al.) more...
- Published
- 2020
- Full Text
- View/download PDF
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3. Morbidity and mortality in complex robot-assisted hiatal hernia surgery: 7-year experience in a high-volume center.
- Author
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Mertens AC, Tolboom RC, Zavrtanik H, Draaisma WA, and Broeders IAMJ
- Subjects
- Female, Fundoplication methods, Hernia, Hiatal physiopathology, Hernia, Hiatal psychology, Humans, Male, Middle Aged, Netherlands epidemiology, Outcome and Process Assessment, Health Care, Recurrence, Reoperation methods, Reoperation statistics & numerical data, Gastroesophageal Reflux etiology, Gastroesophageal Reflux surgery, Hernia, Hiatal surgery, Herniorrhaphy adverse effects, Herniorrhaphy methods, Herniorrhaphy mortality, Laparoscopy adverse effects, Laparoscopy methods, Laparoscopy mortality, Postoperative Complications epidemiology, Postoperative Complications surgery, Quality of Life, Robotic Surgical Procedures adverse effects, Robotic Surgical Procedures methods, Robotic Surgical Procedures mortality
- Abstract
Introduction: Published data regarding robot-assisted hiatal hernia repair are mainly limited to small cohorts. This study aimed to provide information on the morbidity and mortality of robot-assisted complex hiatal hernia repair and redo anti-reflux surgery in a high-volume center., Materials and Methods: All patients that underwent robot-assisted hiatal hernia repair, redo hiatal hernia repair, and anti-reflux surgery between 2011 and 2017 at the Meander Medical Centre, Amersfoort, the Netherlands were evaluated. Primary endpoints were 30-day morbidity and mortality. Major complications were defined as Clavien-Dindo ≥ IIIb., Results: Primary surgery 211 primary surgeries were performed by two surgeons. The median age was 67 (IQR 58-73) years. 84.4% of patients had a type III or IV hernia (10.9% Type I; 1.4% Type II; 45.5% Type III; 38.9% Type IV, 1.4% no herniation). In 3.3% of procedures, conversion was required. 17.1% of patients experienced complications. The incidence of major complications was 5.2%. Ten patients (4.7%) were readmitted within 30 days. Symptomatic early recurrence occurred in two patients (0.9%). The 30-day mortality was 0.9%. Redo surgery 151 redo procedures were performed by two surgeons. The median age was 60 (IQR 51-68) years. In 2.0%, the procedure was converted. The overall incidence of complications was 10.6%, while the incidence of major complications was 2.6%. Three patients (2.0%) were readmitted within 30 days. One patient (0.7%) experienced symptomatic early recurrence. No patients died in the 30-day postoperative period., Conclusions: This study provides valuable information on robot-assisted laparoscopic repair of primary or recurrent hiatal hernia and anti-reflux surgery for both patient and surgeon. Serious morbidity of 5.2% in primary surgery and 2.6% in redo surgery, in this large series with a high surgeon caseload, has to be outweighed by the gain in quality of life or relief of serious medical implications of hiatal hernia when counseling for surgical intervention. more...
- Published
- 2019
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- View/download PDF
4. Long-term Results of Robotic Modified Belsey (Gastroesophageal Valvuloplasty) Fundoplication.
- Author
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Gharagozloo F, Atiquzzaman B, Tempesta B, Tolboom RC, Meyer M, and Gruessner S
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- Adult, Aged, Female, Follow-Up Studies, Fundoplication adverse effects, Humans, Laparoscopy, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Esophagus surgery, Fundoplication methods, Gastroesophageal Reflux surgery, Robotic Surgical Procedures, Stomach surgery
- Abstract
Purpose: Nissen fundoplication is associated with poor long-term durability, as well as dysphasia and gas bloat. We report here the long-term results of modified Belsey fundoplication (Gastroesophageal Valvuloplasty; GEV) performed laparoscopically using a surgical robot., Methods: Patients who underwent robotic GEV were reviewed retrospectively. Operations were performed by laparoscopy and included robotic dissection of the esophageal hiatus, primary closure of the hiatus, followed by intussusception of a 4 cm segment of the esophagus into the stomach for 270°, and suspension of the fundoplication on the hiatal closure. The results were assessed by postoperative endoscopy, contrast esophagography, a Subjective Symptom Questionnaire (SSQ), and objective Visick grading., Results: There were 291 patients (156 male, 135 female, mean age 51±14 years). Indications were intractability (73%) and pulmonary symptoms (27%). Mean operative time was 130 minutes ± 52 minutes. Minor complications were seen in 21%. There was no mortality. Mean hospitalization was 2.8 days ± 1.7 days. Mean follow-up was 85 months ± 7 months. During this period, the mean SSQ score decreased from 8.3 ± 0.6 to 0.7± 0.2 (P < 0.05). There was no long-term dysphasia or gas bloat. Ninety-five percent of patients were Visick I and 5% were Visick II. Hiatal hernia recurred in 7 patients (2%)., Conclusions: Robotic laparoscopic modified Belsey fundoplication (GEV) is associated with excellent long-term durability, reflux control, and low rates of dysphasia and gas bloat. This procedure may represent an alternative to medical antireflux therapy and other surgical antireflux procedures such as Nissen fundoplication. more...
- Published
- 2019
5. Evaluation of conventional laparoscopic versus robot-assisted laparoscopic redo hiatal hernia and antireflux surgery: a cohort study.
- Author
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Tolboom RC, Draaisma WA, and Broeders IA
- Subjects
- Female, Follow-Up Studies, Fundoplication, Humans, Length of Stay, Male, Middle Aged, Postoperative Complications, Reoperation adverse effects, Reoperation methods, Reoperation mortality, Treatment Failure, Gastroesophageal Reflux surgery, Hernia, Hiatal surgery, Laparoscopy adverse effects, Laparoscopy methods, Laparoscopy mortality, Laparoscopy statistics & numerical data, Reoperation statistics & numerical data, Robotic Surgical Procedures adverse effects, Robotic Surgical Procedures methods, Robotic Surgical Procedures mortality, Robotic Surgical Procedures statistics & numerical data
- Abstract
Surgery for refractory gastroesophageal reflux disease (GERD) and hiatal hernia leads to recurrence or persisting dysphagia in a minority of patients. Redo antireflux surgery in GERD and hiatal hernia is known for higher morbidity and mortality. This study aims to evaluate conventional versus robot-assisted laparoscopic redo antireflux surgery, with the objective to detect possible advantages for the robot-assisted approach. A single institute cohort of 75 patients who underwent either conventional laparoscopic or robot-assisted laparoscopic redo surgery for recurrent GERD or severe dysphagia between 2008 and 2013 were included in the study. Baseline characteristics, symptoms, medical history, procedural data, hospital stay, complications and outcome were prospectively gathered. The main indications for redo surgery were dysphagia, pyrosis or a combination of both in combination with a proven anatomic abnormality. The mean time to redo surgery was 1.9 and 2.0 years after primary surgery for the conventional and robot-assisted groups, respectively. The number of conversions was lower in the robot-assisted group compared to conventional laparoscopy (1/45 vs. 5/30, p = 0.035) despite a higher proportion of patients with previous surgery by laparotomy (9/45 vs. 1/30, p = 0.038). Median hospital stay was reduced by 1 day (3 vs. 4, p = 0.042). There were no differences in mortality, complications or outcome. Robotic support, when available, can be regarded beneficial in redo surgery for GERD and hiatal hernia. Results of this observational study suggest technical feasibility for minimal-invasive robot-assisted redo surgery after open primary antireflux surgery, a reduced number of conversions and shorter hospital stay. more...
- Published
- 2016
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6. Robot-assisted laparoscopic hiatal hernia and antireflux surgery.
- Author
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Tolboom RC, Broeders IA, and Draaisma WA
- Subjects
- Fundoplication methods, Humans, Laparoscopy methods, Gastroesophageal Reflux surgery, Hernia, Hiatal surgery, Robotic Surgical Procedures methods
- Abstract
Gastroesophageal reflux disease is a common disorder of the GE-junction that allows gastric acid to enter the esophagus. Surgery is indicated when the presence of the disease is objectively documented. The laparoscopic Toupet fundoplication is the preferred treatment of GERD. There is no clear advantage in robotic assistance for primary antireflux surgery. In our center we find the robot to be of added value for redo surgery or large and giant hiatal repair., (© 2015 Wiley Periodicals, Inc.) more...
- Published
- 2015
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7. Multicentre randomized controlled trial comparing ferric(III)carboxymaltose infusion with oral iron supplementation in the treatment of preoperative anaemia in colorectal cancer patients.
- Author
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Borstlap WAA, Buskens CJ, Tytgat KMAJ, Tuynman JB, Consten ECJ, Tolboom RC, Heuff G, van Geloven N, van Wagensveld BA, C A Wientjes CA, Gerhards MF, de Castro SMM, Jansen J, van der Ven AWH, van der Zaag E, Omloo JM, van Westreenen HL, Winter DC, Kennelly RP, Dijkgraaf MGW, Tanis PJ, and Bemelman WA more...
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- Administration, Oral, Adolescent, Adult, Aged, Aged, 80 and over, Anemia, Iron-Deficiency etiology, Clinical Protocols, Colorectal Neoplasms complications, Dietary Supplements, Female, Ferric Compounds therapeutic use, Ferrous Compounds therapeutic use, Fumarates therapeutic use, Hematinics therapeutic use, Humans, Infusions, Intravenous, Male, Maltose administration & dosage, Maltose therapeutic use, Middle Aged, Treatment Outcome, Young Adult, Anemia, Iron-Deficiency drug therapy, Colorectal Neoplasms surgery, Ferric Compounds administration & dosage, Ferrous Compounds administration & dosage, Fumarates administration & dosage, Hematinics administration & dosage, Maltose analogs & derivatives, Preoperative Care methods
- Abstract
Background: At least a third of patients with a colorectal carcinoma who are candidate for surgery, are anaemic preoperatively. Preoperative anaemia is associated with increased morbidity and mortality. In general practice, little attention is paid to these anaemic patients. Some will have oral iron prescribed others not. The waiting period prior to elective colorectal surgery could be used to optimize a patients' physiological status. The aim of this study is to determine the efficacy of preoperative intravenous iron supplementation in comparison with the standard preoperative oral supplementation in anaemic patients with colorectal cancer., Methods/design: In this multicentre randomized controlled trial, patients with an M0-staged colorectal carcinoma who are scheduled for curative resection and with a proven iron deficiency anaemia are eligible for inclusion. Main exclusion criteria are palliative surgery, metastatic disease, neoadjuvant chemoradiotherapy (5 × 5 Gy = no exclusion) and the use of Recombinant Human Erythropoietin within three months before inclusion or a blood transfusion within a month before inclusion. Primary endpoint is the percentage of patients that achieve normalisation of the haemoglobin level between the start of the treatment and the day of admission for surgery. This study is a superiority trial, hypothesizing a greater proportion of patients achieving the primary endpoint in favour of iron infusion compared to oral supplementation. A total of 198 patients will be randomized to either ferric(III)carboxymaltose infusion in the intervention arm or ferrofumarate in the control arm. This study will be performed in ten centres nationwide and one centre in Ireland., Discussion: This is the first randomized controlled trial to determine the efficacy of preoperative iron supplementation in exclusively anaemic patients with a colorectal carcinoma. Our trial hypotheses a more profound haemoglobin increase with intravenous iron which may contribute to a superior optimisation of the patient's condition and possibly a decrease in postoperative morbidity., Trial Registration: ClincalTrials.gov: NCT02243735 . more...
- Published
- 2015
- Full Text
- View/download PDF
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