Minimally invasive surgery for pancreatic tumors: laparoscopy versus robotic surgery

Chirurgia tumorilor pancreatice reprezintă un domeniu în care dezvoltarea tehnologică încearcă să aducă progrese semnificative în ceea ce privește tehnica chirurgicală, mai ales atunci când se indică un abord minim invaziv. Lucrarea de față subliniază principalele indicații, avantaje, dezavantaje și rezultate ce însoțesc tehnicile minim invazive laparoscopice și robotice, prin prisma ultimelor date din literatura de specialitate și experiența autorilor, alături de conduita intraoperatorie, în funcție de localizarea tumorală: cefalopancreatică sau corporeo-caudală pancreatică.Surgery for pancreatic tumors represents an area in which technological development to day seeks to bring significant advances in surgical technique, especially when a minimally invasive approach is indicated. The present paper emphasizes the main indications, advantages, disadvantages and results accompanying the minimally invasive laparoscopic and robotic techniques, in the light of the latest data from the specialized literature and the authors' experience, along with the intraoperative tactical aspects, according to the tumoral topography: cephalopancreatic or corporeo-caudal pancreatic

Obtaining and Characterization of Vitroceram by Chemical Doped ZnO for Art Mosaic

This paper presents the obtaining and the characterization of ZnO doped vitroceramic, used as photo and termoresistive pigment for art mosaic. The coprecipitation involves two sequential steps, first of ions Zn2+(aq), Cr3+(aq), Co3+(aq) and Mn3+(aq), as oxihydroxides in predetermined molar reports: 98:0,6:0,7:06, followed by maturation, forced filtration and redispersion of the granules in distilled water, after which, by ion exchange is precipitated as intergranular film of Sb3+(aq) and Bi3+(aq) ions. After forced filtration and drying, the material is subjected gradually to a thermal process, according to a curve with three levels: 20-110 °C, 110-360 °C şi 360-950 °C, with a heating rate of 3 °C/min., each level keeping a constant temperature while varying between 4 and 8 h for nanostructures processes of crystalls reform. The vitroceramic was characterized by SEM-EDX, microFTIR and termic derivatography, after treatment at 110 °C and respectively 950 °C, underlining uniformity of grains and revealing their heterojonctional structure in cross-section

3D geological model of an overthrust napped structure. Hășmaș mountains, Eastern Carpathians, Romania

<p>This work represents an improvement of the methodology applied in the geological study of a napped structure by approaching the fault system and the formations in a 3D volumetric space. From a geological point of view, the studied area contains two thrust nappes: the Hășmaș Nappe, which is a gravitational nappe and the Bukovinian Nappe, which is an overthrust nappe. By combining data obtained from field measurements with the bibliographic support, we performed an overview of the study area. The 3D geological model has been achieved by the interpretation and drawing of 54 geological cross sections based on preexisting geological maps and accumulated field knowledge, using GSI3D and Move3D software. By using the model, one can extract information about any point in the space occupied by it, allowing real-time visualization. Also the 3D model provides a means to accurately estimate the exact limits of the strata, giving their volumes and surfaces in the context of a possible natural reserve calculation.</p

Rhinocerotidae and Chalicotheriidae (Perissodactyla, Tapiromorpha) from the Late Miocene of Pogana (Scythian Platform, Romania)

International audienc

The Learning Curve for Pancreaticoduodenectomy: The Experience of a Single Surgeon

Background and Aims: Pancreaticoduodenectomy (PD) is a complex and high-skill demanding procedure often associated with significant morbidity and mortality. However, the results have improved over the past two decades. However, there is a paucity of research concerning the learning curve for PD. Our aim was to report the outcomes of 100 consecutive PDs representing a single surgeon’s learning curve and to depict the factors that influenced the learning process. Methods: We reviewed the first 121 PDs performed at our academic center (2013–2019) by a single surgeon; 110 were PDs (5 laparoscopic and 105 open) and 11 were total PDs (1 laparoscopic and 10 open). Subsequent statistics was performed on the first 100 PDs, with attention paid to the learning curve and survival rate at 5 years. The data were analyzed comparing the first 50 cases (Group 1) to the last 50 cases (Group 2). Results: The most frequent histopathological tumor type was pancreatic ductal adenocarcinoma (50%). A total of 39% of patients had preoperative biliary drainage and 45% presented with positive biliary cultures. The preferred reconstruction technique included pancreaticogastrostomy (99%), in situ hepaticojejunostomy (70%), and precolic gastro-jejunal anastomosis (88%). Postoperative complications included biliary fistula (1%), pancreatic fistula (8%), pancreatic stump bleeding (4%), and delayed gastric emptying (13%). The mean operative time decreased after the first 50 cases (p p = 0.046). R1 resections lowered after 25 cases (p = 0.025). Vascular resections (17%) did not influence the rate of complications (p = 0.8). The survival rate at 5 years for pancreatic adenocarcinoma was 32.93%. Conclusions: Outcomes improve as surgeon experience increases, with proper training being the most important factor for minimizing the impact of the learning curve over the postoperative complications. Analyzing the learning curve from the perspective of a single surgeon is mandatory for accurate statistical results and interpretation