- Daniel A. Tsin, M.D. Member of the New European Surgical Academy. Former Director of Minimally Invasive Surgery. The... moreDaniel A. Tsin, M.D.
Member of the New European Surgical Academy.
Former Director of Minimally Invasive Surgery.
The Mount Sinai Hospital of Queens, Long Island City, New York. USA.
Dr. Tsin graduated from the University of Buenos Aires, Argentina, School of Medicine in 1965. He trained as an Endocrinologist at the Instituto de Endocrinologia of the Instituto Nacional de la Salud, Haedo, Province of Buenos Aires. He is Board Certified in Endocrinology in Argentina. In 1968, he attended a conference in coelioscopy given by Dr. Raoul Palmer. This conference was the beginning of his interest in diagnostic laparoscopy in polycystic ovaries and infertility, as he participated as an observer during numerous laparoscopies in 1969.
Dr. Tsin moved to the USA in 1971 and trained in Obstetrics and Gynecology at Roosevelt Hospital, College of Physicians and Surgeons, Columbia University, New York City, under the supervision of Dr. Thomas F. Dillon, a pioneer in laparoscopy. He is certified by the Board of Obstetrics and Gynecology and Laser Surgery in the USA.
Dr. Tsin was in charge of the Reproductive Endocrinology Clinics at Roosevelt Hospital and the Knickerbocker Hospital in New York City. In 1987, he transferred to The Mount Sinai Hospital of Queens, where he was the Director of Gynecology, a position held for 15 years. Since 2002 until 2014 he was the Director of Minimally Invasive Surgery at The Mount Sinai Hospital of Queens.
During Dr. Tsin's career he has developed techniques for minimally invasive surgery, including: The Laparoscopy Leash, Culdolaparoscopy, Minilaparoscopy Assisted Natural Orifice Surgery (MANOS), The Laparoscopy Rein, Transvaginal Cholecystectomy without abdominal ports, Secured Independent Tools (SIT): a deployment system for instruments, lights, cameras and micro robotics.
In addition, Dr. Tsin has described safe practice modifications for laparoscopy and natural orifice surgery. He is a member of the New European Surgical Academy, natural orifice surgery, working group. Furthermore, Dr. Tsin has participated in the safe implementation of Natural Orifice Transvaginal Endoscopic Surgery (NOTES) in many countries.edit
Exploration of the abdominal cavity is routinely performed during abdominal and laparoscopic hysterectomies. The visualization of the abdomen during vaginal hysterectomy, however, is not usually done. During a vaginal hysterectomy, after... more
Exploration of the abdominal cavity is routinely performed during abdominal and laparoscopic hysterectomies. The visualization of the abdomen during vaginal hysterectomy, however, is not usually done. During a vaginal hysterectomy, after the uterus is removed, an opening is present in the cul-de-sac, which offers a unique opportunity for the performance of not only exploratory but also concomitant surgeries, such as a cholecystectomy. Culdolaparascopy is a culdoscopy assisted laparoscopic technique that utilizes a 12-mm trocar in the vagina as a multifunctional port in conjunction with laparoscopy and minilaparoscopy. A cholecystectomy was performed utilizing the vaginal trocar as an insufflation, visual, and extracting port during a vaginal hysterectomy. Culdolaparoscopy, when performed during vaginal hysterectomy, can be used for exploration and operation in the abdominal cavity. This case report illustrates the feasibility of a cholecystectomy performed using this surgical concept.
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Desde que el abordaje laparoscopico logra una aceptacion universal en el ambito quirurgico, la inquietud del cirujano por optimizar las ventajas ya conocidas de la cirugia laparoscopica no ha parado. En su busqueda ha recurrido a... more
Desde que el abordaje laparoscopico logra una aceptacion universal en el ambito quirurgico, la inquietud del cirujano por optimizar las ventajas ya conocidas de la cirugia laparoscopica no ha parado. En su busqueda ha recurrido a diferentes caminos, como son la disminucion del calibre de puertos e instrumentos laparoscopicos (minilaparoscopia). Disminucion del numero de puertos utilizados, y mas recientemente, a traves de un cambio en el abordaje tradicional en el abdomen, por el uso de orificios naturales, utilizando las vias de acceso transgastrica, transcolonica y transvaginal (culdoscopica). Esta nueva cirugia endoscopica transluminal, realizada a traves de los orificios naturales (NOTES), tambien sustituye el uso del laparoscopio por un moderno endoscopio flexible con 2 o 3 canales de trabajo. Ha logrado tal efervescencia en diferentes grupos quirurgicos a nivel mundial que la literatura medica y los congresos y foros de cirugia endoscopica muestran un porcentaje importante de ...
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Research Interests: Surgery, Microsurgery, Medicine, Humans, Female, and 8 moreMale, Clinical Sciences, Myoma, Uterus, Leiomyoma, Myometrium, Prostatic neoplasms, and Prostatectomy
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New technology has allowed us to perform major abdominal and pelvic surgeries with increasingly smaller instruments. The ultimate goal is surgery with no visible scars. Until current technical limitations are overcome,... more
New technology has allowed us to perform major abdominal and pelvic surgeries with increasingly smaller instruments. The ultimate goal is surgery with no visible scars. Until current technical limitations are overcome, minilaparoscopy-assisted natural orifice surgery (MANOS) provides a solution. The aim of this study was to examine our clinical and experimental experience with MANOS. Minilaparoscopic abdominal instruments were used together with a large vaginal port, which was used for insufflation, visual purposes, introduction of operative instruments, and specimen extraction. Minilaparoscopy-assisted intraperitoneal transgastric appendectomy was done in simulators (Lap trainer with SimuVision, Simulab Corp., Seattle, WA). Since 1998, we have used this technique in 100 cases including ovarian cystectomies, oophorectomies, salpingo-oophorectomies, myomectomies, appendectomies, and cholecystectomies. Some oophorectomies were performed after vaginal hysterectomy in cases where vagina...
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Research Interests: Surgery, Medicine, Humans, Female, Hysteroscopy, and 6 moreAdult, Laparoscopy, Anastomosis, Laparotomy, Fallopian tubes, and Cannula
The knowledge of the topographic anatomy of the rectouterine pouch is a pivotal point for the understanding of the inclusion and exclusion criteria in this surgical approach [1].
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Transvaginal Cholecystectomy Using Magnetic Graspers Tsin DA, Dominguez GM, Jesus R, Aguilar S, Davila F. Minimally Invasive Surgery, The Mount Sinai Hospital of Queens, Long Island City, New York; General Surgery, Sanatorio Mitre, Buenos... more
Transvaginal Cholecystectomy Using Magnetic Graspers Tsin DA, Dominguez GM, Jesus R, Aguilar S, Davila F. Minimally Invasive Surgery, The Mount Sinai Hospital of Queens, Long Island City, New York; General Surgery, Sanatorio Mitre, Buenos Aires, CF, Argentina; Dean, Universidad Nacional Autonoma de Mexico, Poza Rica, Veracruz, Mexico; Surgery, Hospital Regional de Poza Rica, Poza Rica, Veracruz, Mexico; Surgery, Hospital Regional de Poza Rica, Poza Rica, Veracruz, Mexico
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A 36-year-old woman had primary amenorrhea, pelvic pain, Mayer-Rokitansky-Kuster-Hauser syndrome, and an 8.5-cm, solid pelvic mass. The leiomyoma uteri was removed laparoscopically from the vestigial mullerian duct with secondary... more
A 36-year-old woman had primary amenorrhea, pelvic pain, Mayer-Rokitansky-Kuster-Hauser syndrome, and an 8.5-cm, solid pelvic mass. The leiomyoma uteri was removed laparoscopically from the vestigial mullerian duct with secondary vaginopoiesis. The patient had a satisfactory clinical outcome. Finding of a leiomyoma in a patient with Rokitansky syndrome is rare. To our knowledge this is the first such case in which the myoma was removed by laparoscopy.
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We performed two techniques for laparoscopic extraction of benign ovarian teratomas. For cysts up to 5 cm, we used the pouch technique, with partial extraction followed by enlargement of the hypogastric port. A skin incision was enlarged... more
We performed two techniques for laparoscopic extraction of benign ovarian teratomas. For cysts up to 5 cm, we used the pouch technique, with partial extraction followed by enlargement of the hypogastric port. A skin incision was enlarged to allow the use of a scalpel in the pouch. This enabled us to perform several stab incisions in the cyst to spill its contents while still holding it in the pouch. This was followed by suction irrigation and forceps removal of the contents until the collapsed cyst could be removed in the pouch. For a cyst over 5 cm, we performed endoscopic aspiration irrigation with hot water inside the cyst, followed by partial extraction of the cyst; an opening was made in the exposed cyst wall and the contents extracted as described. When the cyst wall collapsed, we proceeded with the final extraction. When spillage occurred, it was managed with extensive warm lavage of the peritoneum, skimming the floating debris with suction tubing until clear, and underwater inspection and removal of teeth and other solid material. With these techniques, we experienced no complications.
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The following is a description of a combined vaginal and laparoscopic repair of vaginal eversion with uterine prolapse (procidentia). There are few procedures that seek to correct the condition while preserving vaginal function. Among... more
The following is a description of a combined vaginal and laparoscopic repair of vaginal eversion with uterine prolapse (procidentia). There are few procedures that seek to correct the condition while preserving vaginal function. Among them are (1) vaginal approach for sacrospinous fixation, (2) abdominal sling procedures, and (3) abdominal and laparoscopic approaches for promontorial fixation. We are presenting a technical report of a modified sling procedure done via laparoscopy. This technique achieves the functional vaginal reconstruction and avoids the potentially dangerous bleeding associated with the sacral fixation. It has also been our experience that the sacrospinous fixation technique affords limited visual exposure, and henceforth the laparoscopic vaginal sling procedure may be a better alternative.
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A survey was conducted in order to dispel misconceptions about natural orifice transvaginal cholecystectomy. Forty-two patients were surveyed after having undergone that procedure. Those patients were asked questions related to 1) patient... more
A survey was conducted in order to dispel misconceptions about natural orifice transvaginal cholecystectomy. Forty-two patients were surveyed after having undergone that procedure. Those patients were asked questions related to 1) patient satisfaction, 2) whether they would recommend the procedure to others, and 3) dyspaurenia. The survey was done after a sexual abstinence period that varied from 30 to 40 days. We encountered no complications, and all patients liked the procedure and would recommend it to family and friends. No patient developed dyspaurenia. The postoperative responses were unanimous and positive for all questions. The result of this postoperative transvaginal cholecystectomy survey will help patients and surgeons ease their fears and social taboos and better communicate, and this will help patients to become aware of the option of transvaginal peritoneoscopy.
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Research Interests: Surgery, Medicine, Humans, Clinical Sciences, Catheters, and 4 moreEquipment Design, Laparoscopy, Needles, and Cannula
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ObjectiveLymphoceles are among the most common postoperative complications of pelvic lymphadenectomy (PL), with a reported incidence of 1% to 50%. Symptoms are pelvic pain, leg edema, gastrointestinal obstruction, obstructive uropathy,... more
ObjectiveLymphoceles are among the most common postoperative complications of pelvic lymphadenectomy (PL), with a reported incidence of 1% to 50%. Symptoms are pelvic pain, leg edema, gastrointestinal obstruction, obstructive uropathy, and deep vein thrombosis, and severe complications such as sepsis and lymphatic fistula formation. After laparoscopic PL, we tested the prevention of lymphoceles using collagen patch coated with the human coagulation factors (TachoSil, Nycomed International Management GmbH, Zurich, Switzerland) on 55 patients with endometrial cancer stages IB to II who had undergone laparoscopy.Materials and MethodsThe authors divided the patients into 2 laparoscopy groups: PL plus TachoSil (group 1: 26 patients) and PL without TachoSil in a control group (group 2: 29 patients), as historical cohort of patients who underwent PL between 2010 and 2012. We collected surgical parameters, and the patients underwent ultrasound examination on postoperative days 7, 14, and 28...
Research Interests: Medicine, Endometrial Cancer, Fibrinogen, Humans, Complications, and 15 moreBlood Coagulation Factors, Female, Middle Aged, Neoplasm Invasiveness, Drainage, Gynecological cancer, Laparoscopy, Gynecologic Cancer, Case Control Studies, Lymph nodes, Myometrium, Neoplasm grading, Drug combinations, Endometrial neoplasms, and Lymphocele
Research Interests: Wound Healing, Medicine, Prospective studies, Humans, Calibration, and 14 moreFemale, Body Mass Index, Human reproduction, Adult, Time Factors, Internal medicine Doppler ultrasonography, Uterus, Laparoscopy, Scars, Leiomyoma, Cohort Studies, Laser Doppler Velocimetry, Myometrium, and Medical and Health Sciences
To allow a morphological evaluation of pseudocapsule vasculature of uterine leiomyomas (ULs). Preliminary prospective study. University-affiliated hospitals. Ten women with symptomatic myomas warranting laparotomic hysterectomies.... more
To allow a morphological evaluation of pseudocapsule vasculature of uterine leiomyomas (ULs). Preliminary prospective study. University-affiliated hospitals. Ten women with symptomatic myomas warranting laparotomic hysterectomies. Pseudocapsules of ULs were isolated from the surrounding myometrium, for a digital reconstruction of pseudocapsule vessels and analysis by three-dimensional structure applying the Allen-Cahn mathematical model. The images were converted in a matrix and an appropriate created software elaborated the images. The "nonlocal" Allen-Cahn mathematical model was applied to reduce the image noise and to regulate vessel outlines obtaining a "clean" image. The geometrical characteristics and morphology of vessel pseudocapsule network of ULs. The disarray in vascular architecture was evident from the absence of vessel parallelism and variable intervascular distances. An abnormal vascular branching of pseudocapsule was indicated by the different density of vessels per space and some vascular walls without interruption indicated vessel tortuosity. There were vascular spaces, which did not communicate with other vessels ("cul-de-sac" vessels). Pseudocapsule vasculature showed increase of tortuosity, disarray, abnormal branching and the presence of "cul-de-sac" vessels. Three-dimensional reconstruction of leiomyoma pseudocapsule vasculature network, despite the benign nature of ULs, showed geometrical characteristics of malignant neoplasm vessels.
Research Interests: Mathematics, Biomedicine, Fertility, Medicine, Prospective studies, and 15 moreHumans, Female, Hysterectomy, Mathematical Model, Middle Aged, Adult, Three Dimensional, Myoma, Tortuosity, Three dimensional Reconstruction, Leiomyoma, Uterine Leiomyoma, Myometrium, Laparotomy, and Pharmacology and pharmaceutical sciences
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Pioneers in natural orifice transvaginal cholecystectomy are in search of an approach that uses less percutaneous assistance. The approach must be safe and affordable. The authors present a successful cholecystectomy using a technique of... more
Pioneers in natural orifice transvaginal cholecystectomy are in search of an approach that uses less percutaneous assistance. The approach must be safe and affordable. The authors present a successful cholecystectomy using a technique of transvaginal operative laparoscopy with no abdominal ports. A 24-year-old female patient with gallbladder lithiasis underwent a natural orifice cholecystectomy with only one transvaginal 12-mm port, using a laparoscope with a working channel. We used laparoscopic instruments 5 mm in diameter by 43cm in length (including a needle holder, Maryland dissector clamp, spatula, hook, suction cannula, and clip applier) and assistance with percutaneous marionette leashes. The patient stayed in the hospital for 24 hours and was discharged without pain and without scars. Transvaginal cholecystectomy performed using an operative laparoscope with a working channel is possible in select cases. This technique requires no abdominal ports and is an alternative to cu...
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Tienda online donde Comprar Cirugia Sin Huella. Cirugia Laparoscopica Con 1 Puerto (Cl1p) Y Culdolaparoscopia + 9 DVD'S 2a Ed. al precio 147,00 € de Fausto Davila Avila | Daniel Tsin, tienda de Libros de Medicina, Libros de Cirugia -... more
Tienda online donde Comprar Cirugia Sin Huella. Cirugia Laparoscopica Con 1 Puerto (Cl1p) Y Culdolaparoscopia + 9 DVD'S 2a Ed. al precio 147,00 € de Fausto Davila Avila | Daniel Tsin, tienda de Libros de Medicina, Libros de Cirugia - Cirugia General