Coronary Artery Bypass Grafting surgery is the most commonly performed and thoroughly examined adult cardiac surgery procedure in the world. Minimally invasive techniques which include Robotic-Assisted Minimally Invasive Direct Coronary Artery Bypass Grafting and Totally Endoscopic Coronary Artery Bypass Grafting have been helping to lessen the postoperative complications, pain, and length of stay, while enhancing postoperative quality of life of patients. However, practical application of these advanced procedures has yet to be broadly mastered for expanding the usage of minimally invasive robotic assisted techniques. This chapter describes the development and application of Minimally Invasive CABG procedures as well as the current knowledge and future perspectives on Robotic-Assisted CABG procedures.

Background and Objectives: Regional and systemic analgesic techniques, such as erector spinae plane (ESP) block and opioid administration, implemented during cancer surgery, have been shown to influence immune responses and potentially affect cancer outcomes. Surgical stress and analgesic techniques used in cancer surgery—such as regional nerve blocks or systemic opioids—not only affect pain control but also influence immune and inflammatory pathways that may impact cancer progression. To understand the biological consequences of these interventions, metabolomic profiling has emerged as a powerful approach for capturing systemic metabolic and immunological changes, which are particularly relevant in the oncologic perioperative setting. In this study, we examined the impact of the ESP on the metabolomic profile, as well as levels of VEGF, cortisol, and CRP, in addition to its analgesic effects in breast cancer surgery. Materials and Methods: Ninety patients were placed into three different analgesia groups (morphine, ESP, and control groups). Demographic data, ASA classification, comorbidities, surgery types, and pain scores were documented. Blood samples were taken at preoperative hour 0, postoperative hour 1, and postoperative hour 24 (T0, T1, and T24). VEGF, cortisol, and CRP levels were measured, and metabolomic analysis was performed. Results: Study groups were comparable regarding demographic findings, comorbidities, and surgery types (p > 0.05). NRS scores of group ESP were lowest in the first 12 h period (p < 0.01) and ESP block reduced opioid consumption (p < 0.01). VEGF and cortisol levels of group morphine were similar to ESP at T24 (p > 0.05). Group ESP had lower VEGF and cortisol levels than the control at T24 (p = 0.025, p = 0.041, respectively.). The CRP level of group morphine was higher than both ESP and control at T24 (p = 0.022). Metabolites involved in primary bile acid, steroid hormone biosynthesis, amino acid, and glutathione metabolism were changed in group ESP. Conclusions: Metabolites in bile acid biosynthesis and steroid hormone pathways, which play a key role in immune responses, were notably lower in the ESP group. Accordingly, VEGF and cortisol peaks were more moderate in group ESP. In conclusion, we think that ESP block, which provides adequate analgesia, is an acceptable approach in terms of modulating immune responses in breast cancer surgery.

Background/Objectives: Postoperative nausea and vomiting (PONV) is a common complication that may negatively affect patient comfort and recovery following procedures performed under sedation. Although gastrointestinal endoscopic procedures are widely performed, data on the incidence and risk factors of PONV after esophagogastroduodenoscopy (EGD) remain limited. This study aimed to determine the incidence of PONV following EGD under sedation and to identify factors associated with its development. Methods: This single-center retrospective study included adult patients who underwent elective EGD under sedation between June and November 2023. Demographic and clinical data, Apfel risk scores, sedative agents, procedure duration, and macroscopic endoscopic findings were obtained from electronic medical records. PONV was assessed based on documentation during the post-anesthesia care unit stay. Patients were categorized into PONV-positive and PONV-negative groups and compared using appropriate statistical tests. Results: A total of 152 patients were included, and PONV occurred in 13 patients (8.6%). Female sex (p = 0.020), higher body mass index (BMI) (p = 0.009), preoperative nausea or vomiting (p = 0.002), thyroid disease (p = 0.004), oral antidiabetic drug use (p = 0.003), and higher Apfel risk scores (p = 0.008) were significantly associated with PONV. Age, American Society of Anesthesiologists (ASA) score, procedure duration, sedative agents, and macroscopic endoscopic findings showed no significant association. Conclusions: PONV following EGD under sedation was relatively uncommon. Patient-related factors, particularly female sex, higher BMI, preoperative nausea, thyroid disease, oral antidiabetic drug use, and higher Apfel scores, were associated with increased risk.

Kritik travma hastalarının yönetimi elbette ki ülkemizde modern tıbbın uygulanmaya başladığından beri ve hatta geleneksel tıbbın uygulandığı dönemlerde de en iyi şekilde yapılmaktaydı. Ancak gelişen teknoloji sayesinde kritik travma hastalarına yapılan müdahaleler artmakta ve kritik travma hastalarının yaşam süreleri uzamakta ve ölüm oranları azalmaktadır. Kritik travma hastalarının bakımı için gerekli olan tıbbi bilgi, klinik beceriler ve teknolojinin anlaşılması kritik travma hastalarının bakımı için gerekli olan alt uzmanlık dallarını aşmaya devam etmekte ve bu nedenle kitabın yazımında görev alan yazarlar fizyologların yanında hemen hemen tüm cerrahi branşların ve ilgili dahili branşların bakış açısını yansıtacak şekilde dizayn edilmiştir. Her branş kendi bakış açısıyla kritik travma hastalarının takip ve tedavisindeki kilit noktaların açılımı için görüş ve önerilerini bu kitapta sunmuştur.

Shoulder arthroscopy causes substantial postoperative pain and operating room resource use. Randomized trials integrating postoperative pain trajectory wit