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1

Comparison of hybrid procedure and open surgical revascularization for multilevel infrainguinal arterial occlusive disease  

PubMed Central

Objective To compare outcomes of hybrid (combined surgical and endovascular) procedures (HYBRID) with open surgical reconstructions (OPEN) in patients with multilevel infrainguinal artery occlusive diseases. Design Case series study with retrospective analysis of prospectively collected nonrandomized data. Methods Between 2008 and 2012, 64 patients underwent OPEN and 43 underwent HYBRID. Patient characteristics, technique success, clinical improvement, and procedure-related morbidity were reviewed and compared. Patency rates and limb salvages were analyzed and compared using Kaplan–Meier life tables. Cox regression analyses were used to assess the influence of various risk factors on primary patency. Results HYBRID patients were older and presented with worse New York Heart Association function compared with OPEN patients. The increase in the ankle-brachial index and improvement of Ruthford category after procedures were equivalent between two groups, but HYBRID patients had shorter hospital length of stay (7.6±12.0 versus 15.5±17.3; P= 0.018) and less overall perioperative morbidity (12% versus 28%; P=0.042) compared with OPEN patients. No statistically significant difference in 36-month primary (47.1%±7.1% versus 50.1%±9.4%; P=0.418), assisted primary (57.0%±7.9% versus 62.4%±9.2%; P=0.517), or secondary (82.0%±6.8% versus 83.1%±7.3%; P=0.445) patency was seen between the two groups. Limb salvage rates of HYBRID vs OPEN at 3 years were similar (76.3%±9.3% versus 80.4%±8.2%; P=0.579). Critical limb ischemia was a negative predictor of long-term patency of patients in both the HYBRID and OPEN groups (P=0.012 and P<0.001, respectively), and the presence of diabetes and renal insufficiency were another two independent predictors of decreased primary patency for HYBRID (P=0.017 and P=0.019, respectively). Conclusion Multilevel infrainguinal artery occlusive diseases could be treated by hybrid procedure, with shorter hospitalization, less perioperative morbidity, and similar early- and long-term efficacy compared with open revascularization. A hybrid procedure should be considered for patients with high surgical risk, but critical limb ischemia, diabetes, and renal insufficiency could compromise its long-term patency. PMID:25284992

Zhou, Min; Huang, Dian; Liu, Chen; Liu, Zhao; Zhang, Min; Qiao, Tong; Liu, Chang-Jian

2014-01-01

2

Laser Hemorrhoidoplasty Procedure vs Open Surgical Hemorrhoidectomy: a Trial Comparing 2 Treatments for Hemorrhoids of Third and Fourth Degree  

PubMed Central

Objective: According to the ‘‘vascular’’ theory, arterial overflow in the superior hemorrhoidal arteries would lead to dilatation of the hemorrhoidal venous plexus. Hemorrhoid laser procedure (LHP) is a new laser procedure for outpatient treatment of hemorrhoids in which hemorrhoidal arterial flow feeding the hemorrhoidal plexus is stopped by laser coagulation. Aim: Our aim was to compare the hemorrhoid laser procedure with open surgical procedure for outpatient treatment of symptomatic hemorrhoids. Material and method: A comparison trial between hemorrhoid laser procedure or open surgical hemorrhoidectomy was made. This study was conducted at Aloka hospital in Kosovo. Patients with symptomatic grade III or grade IV hemorrhoids with minimal or complete mucosal prolapse were eligible for the study: 20 patients treated with the laser hemorrhoidoplasty, and 20 patients–with open surgery hemorrhoidectomy. Operative time and postoperative pain with visual analog scale, were evaluated. Results: A total number of 40 patients (23 men and 17 women, mean age, 46 years) entered the trial. Significant differences between laser hemorrhoidoplasty and open surgical procedure were observed in operative time and early postoperative pain. There was a statistically significant difference between the two groups regarding the early postoperative period: 1 week, 2 weeks, 3 weeks and 1 month after respective procedure (p<0.01). The procedure time for LHP was 15.94 min vs. 26.76 min for open surgery (p<0.01). Conclusion: The laser hemorrhoidoplasty procedure was more effective than open surgical hemorrhoidectomy. Postoperative pain and duration time are only two indicators for this difference between there procedures.

Maloku, Halit; Gashi, Zaim; Lazovic, Ranko; Islami, Hilmi; Juniku-Shkololli, Argjira

2014-01-01

3

Abstract--Replacing open-heart surgical procedures with beating-heart interventions substantially decreases the trauma  

E-print Network

Abstract-- Replacing open-heart surgical procedures with beating-heart interventions substantially on the beating heart is valve repair. To address this need, this paper proposes a tool for replacing mitral valve replacement and reduction of regurgitation was demonstrated in an ex-vivo heart simulator. I. INTRODUCTION UE

Dupont, Pierre

4

Abstract--A teleoperated surgical robotic system allows surgical procedures to be conducted across long distances while  

E-print Network

Abstract--A teleoperated surgical robotic system allows surgical procedures to be conducted across that may affect the outcome. An open architecture portable surgical robotic system (Raven) was developed. Diagnosis, consultation, and medical intervention in remote sites can save patient lives in, combat

5

Computer assisted planning of surgical procedures  

Microsoft Academic Search

A system for computer-assisted planning of surgical procedures has been developped. Its components are a workstation with hardware accelerated 3D rendering board, a software environment and a set of procedures. Data sets from over 41 patients have been analyzed so far. We found a potential for improving the surgeons understanding of the anatomical situation he was going to face and

Ron Kikinis; Harvey Cline; David Altobelli; Michael Halle; William Lorensen; Brahm Rhodes; Ferenc Jolesz

1992-01-01

6

Characterization of aerosols produced by surgical procedures  

SciTech Connect

In many surgeries, especially orthopedic procedures, power tools such as saws and drills are used. These tools may produce aerosolized blood and other biological material from bone and soft tissues. Surgical lasers and electrocautery tools can also produce aerosols when tissues are vaporized and condensed. Studies have been reported in the literature concerning production of aerosols during surgery, and some of these aerosols may contain infectious material. Garden et al. (1988) reported the presence of papilloma virus DNA in the fumes produced from laser surgery, but the infectivity of the aerosol was not assessed. Moon and Nininger (1989) measured the size distribution and production rate of emissions from laser surgery and found that particles were generally less than 0.5 {mu}m diameter. More recently there has been concern expressed over the production of aerosolized blood during surgical procedures that require power tools. In an in vitro study, the production of an aerosol containing the human immunodeficiency virus (HIV) was reported when power tools were used to cut tissues with blood infected with HIV. Another study measured the size distribution of blood aerosols produced by surgical power tools and found blood-containing particles in a number of size ranges. Health care workers are anxious and concerned about whether surgically produced aerosols are inspirable and can contain viable pathogens such as HIV. Other pathogens such as hepatitis B virus (HBV) are also of concern. The Occupational Safety and Health funded a project at the National Institute for Inhalation Toxicology Research Institute to assess the extent of aerosolization of blood and other tissues during surgical procedures. This document reports details of the experimental and sampling approach, methods, analyses, and results on potential production of blood-associated aerosols from surgical procedures in the laboratory and in the hospital surgical suite.

Yeh, H.C.; Muggenburg, B.A.; Lundgren, D.L.; Guilmette, R.A.; Snipes, M.B.; Jones, R.K. [Inhalation Toxicology Research Institute, Albuquerque, NM (United States); Turner, R.S. [Lovelace Health Systems, Albuquerque, NM (United States)

1994-07-01

7

Guidelines for surgical procedures after liver transplantation.  

PubMed Central

OBJECTIVE: The first purpose of this study is to identify the types and incidences of surgical procedures in patients who have previously undergone liver transplantation, with particular focus on the complication rates and the lengths of hospital stay. The second purpose is to present the management guidelines for patients with liver transplants at the preoperative, intraoperative, and postoperative stages of surgical procedure. SUMMARY BACKGROUND DATA: The surgical literature on this issue is scant, and with the growing liver transplant patient population it is not unlikey for any surgery specialist to have to operate on a patient who has undergone liver transplantation. METHODS: A sample of 409 patients with available hospital records, with a minimum of a 2-year follow-up, and with telephone access for interviews was chosen. Type of surgery, time from the liver transplant, hospital stay, immunosuppressive regimen, and complications were recorded. RESULTS: A large proportion of patients (24.2%) underwent some type of surgical procedure 2 to 10 years after liver transplantation. The authors demonstrate that most of the elective procedures can be safely carried out without an increased incidence of complication and without longer hospital stay than the general population. Conversely, emergent procedures are plagued by a greater incidence of complications that not only affect the function of the liver graft but may risk the life of the patient. PMID:9563551

Testa, G; Goldstein, R M; Toughanipour, A; Abbasoglu, O; Jeyarajah, R; Levy, M F; Husberg, B S; Gonwa, T A; Klintmalm, G B

1998-01-01

8

Surgical Procedures in Predoctoral Periodontics Programs.  

ERIC Educational Resources Information Center

A survey of 58 dental school periodontics departments revealed the frequency of predoctoral dental students performing surgery, the frequency of specific procedures, the degree of participation or performance of students, incidence of preclinical surgical laboratories in the curricula, and materials and anesthesia used. A wide range in…

Radentz, William H.; Caffesse, Raul G.

1991-01-01

9

Major surgical complications from minor urological procedures.  

PubMed Central

Some urological procedures are regarded as minor or simple. As a result, these may be delegated to trainee surgeons to do. Occasionally nonmedical persons embark on some of the procedures such as male circumcision. Published serious complications from urological procedures considered minor or simple were identified from a Medline search (1966 through 1999) and reference lists of relevant publications. The operations regarded as minor were carried out by medical personnel of all grades as well as by nonmedical persons. The complications can be classified as mutilatory, infective, hemorrhagic, or obstructive. Although the mutilatory complications affect mainly procedures on the penis, infective and hemorrhagic complications affect almost all the procedures. Tumor implantation has occurred along needle biopsy tracts. Although many of the complications are not related to technique or competence, a plea is made for the awareness of their occurrence to encourage preventive strategies. Adequate training of surgical personnel remains essential worldwide. PMID:10976176

Eke, N.

2000-01-01

10

Allocation of surgical procedures to operating rooms.  

PubMed

Reduction of health care costs is of paramount importance in our time. This paper is a part of the research which proposes an expert hospital decision support system for resource scheduling. The proposed system combines mathematical programming, knowledge base, and database technologies, and what is more, its friendly interface is suitable for any novice user. Operating rooms in hospitals represent big investments and must be utilized efficiently. In this paper, first a mathematical model similar to job shop scheduling models is developed. The model loads surgical cases to operating rooms by maximizing room utilization and minimizing overtime in a multiple operating room setting. Then a prototype expert system which replaces the expertise of the operations research analyst for the model, drives the modelbase, database, and manages the user dialog is developed. Finally, an overview of the sequencing procedures for operations within an operating room is also presented. PMID:8522909

Ozkarahan, I

1995-08-01

11

Analgesia for Surgical Husbandry Procedures in Sheep and Other Livestock  

Microsoft Academic Search

SUMMARY Surgical husbandry procedures in livestock are invariably associated with pain and stress, yet are traditionally performed without analgesia. Concern for the welfare of animals undergoing these procedures is contributing to major conflicts between farmers and animal advocacy organisations with important negative trade implications. Whilst the ultimate long term solution is to breed animals that do not require these procedures,

Meredith L Sheil

12

[Surgical procedures involved in claims for alleged defects in praxis].  

PubMed

Medical professional liability and adverse events in health care are major concerns worldwide and the analysis of claims for alleged defects in praxis is a potential source of knowledge. High rates of adverse events and complaints have been reported in surgical procedures. This article analyzes the claims registered by the Council of Medical Colleges in Catalonia between 1986 and 2012, and explores surgical procedures claimed (ICD- 9-CM coding), as well as the final outcome of the claim. Among the 5,419 records identified on surgical procedures, the interventions of the musculoskeletal system and skin and integument showed the highest frequencies. Interventions related to "non-curative" medicine should be emphasized because of their higher rates of economical agreement or condemnation outcomes, which were significantly higher for mastopexia. The results underscore the importance of the surgical area in medical professional liability and the high risk of payouts among those procedures belonging to the so-called "non-curative" medicine. PMID:24913754

Arimany-Manso, Josep; Benet-Travé, J; Bruguera-Cortada, M; Torné-Escasany, R; Klamburg-Pujol, J; Gómez-Durán, Esperanza L

2014-03-01

13

42 CFR 416.65 - Covered surgical procedures.  

Code of Federal Regulations, 2011 CFR

...recovery or convalescent time. (2) If the covered surgical procedures require anesthesia, the anesthesia must be— (i) Local or regional anesthesia; or (ii) General anesthesia of 90 minutes or less duration. (3) Covered...

2011-10-01

14

42 CFR 416.65 - Covered surgical procedures.  

Code of Federal Regulations, 2013 CFR

...recovery or convalescent time. (2) If the covered surgical procedures require anesthesia, the anesthesia must be— (i) Local or regional anesthesia; or (ii) General anesthesia of 90 minutes or less duration. (3) Covered...

2013-10-01

15

42 CFR 416.65 - Covered surgical procedures.  

Code of Federal Regulations, 2012 CFR

...recovery or convalescent time. (2) If the covered surgical procedures require anesthesia, the anesthesia must be— (i) Local or regional anesthesia; or (ii) General anesthesia of 90 minutes or less duration. (3) Covered...

2012-10-01

16

42 CFR 416.65 - Covered surgical procedures.  

Code of Federal Regulations, 2010 CFR

...recovery or convalescent time. (2) If the covered surgical procedures require anesthesia, the anesthesia must be— (i) Local or regional anesthesia; or (ii) General anesthesia of 90 minutes or less duration. (3) Covered...

2010-10-01

17

42 CFR 416.65 - Covered surgical procedures.  

Code of Federal Regulations, 2014 CFR

...recovery or convalescent time. (2) If the covered surgical procedures require anesthesia, the anesthesia must be— (i) Local or regional anesthesia; or (ii) General anesthesia of 90 minutes or less duration. (3) Covered...

2014-10-01

18

Early experiences of endoscopic procedures in general surgery assisted by a computer-enhanced surgical system  

Microsoft Academic Search

  We performed a variety of complete total endoscopic general surgical procedures, including colon resection, distal gastrectomy,\\u000a and splenectomy, successfully with the assistance of the da Vinci computer-enhanced surgical system. The robotic system allowed\\u000a us to manipulate the endoscopic instruments as effectively as during open surgery. It enhanced visualization of both the operative\\u000a field and precision of the necessary techniques, as

M. Hashizume; M. Shimada; M. Tomikawa; Y. Ikeda; I. Takahashi; R. Abe; F. Koga; N. Gotoh; K. Konishi; S. Maehara; K. Sugimachi

2002-01-01

19

The Gastric Bypass for Failed Bariatric Surgical Procedures  

Microsoft Academic Search

Background: Revision of failed bariatric surgical procedures is a significant challenge for every bariatric surgeon. Methods:\\u000a Evaluated are surgical difficulties, management problems and weight loss in patients with distal gastric bypass as a revisionary\\u000a procedure. Eighty patients were followed up to 3 years; four were lost to follow-up. Mean age was 43; mean prebariatric surgery\\u000a weight 134 kg; height 1.65

S. Ross Fox; Katherine M. Fox; Ki Hyun Oh

1996-01-01

20

Randomised Trial Support for Orthopaedic Surgical Procedures  

PubMed Central

We investigated the proportion of orthopaedic procedures supported by evidence from randomised controlled trials comparing operative procedures to a non-operative alternative. Orthopaedic procedures conducted in 2009, 2010 and 2011 across three metropolitan teaching hospitals were identified, grouped and ranked according to frequency. Searches of the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Database of Systematic Reviews (CDSR) and the Database of Abstracts of Reviews of Effects (DARE) were performed to identify RCTs evaluating the most commonly performed orthopaedic procedures. Included studies were categorised as “supportive” or “not supportive” of operative treatment. A risk of bias analysis was conducted for included studies using the Cochrane Collaboration's Risk of Bias tool. A total of 9,392 orthopaedic procedures were performed across the index period. 94.6% (8886 procedures) of the total volume, representing the 32 most common operative procedure categories, were used for this analysis. Of the 83 included RCTs, 22.9% (19/83) were classified as supportive of operative intervention. 36.9% (3279/8886) of the total volume of procedures performed were supported by at least one RCT showing surgery to be superior to a non-operative alternative. 19.6% (1743/8886) of the total volume of procedures performed were supported by at least one low risk of bias RCT showing surgery to be superior to a non-operative alternative. The level of RCT support for common orthopaedic procedures compares unfavourably with other fields of medicine. PMID:24927114

Lim, Hyeung C.; Adie, Sam; Naylor, Justine M.; Harris, Ian A.

2014-01-01

21

Patient perception of physician reimbursement for common hand surgical procedures.  

PubMed

Health care-related costs have been the focus of intense scrutiny in politics and in the media. However, public perception of physician reimbursement is poorly understood. The purpose of this study was to determine patient perception of physician reimbursement for 2 common hand surgery procedures: carpal tunnel release and open reduction and internal fixation of a distal radius fracture. Anonymous surveys were completed by 132 patients in an outpatient hand and upper-extremity practice. The surveys asked patients to estimate reasonable surgeon fees and actual Medicare reimbursement for 2 common hand surgery procedures (carpal tunnel release and internal fixation of a distal radius fracture) and 2 common surgical procedures (coronary artery bypass and appendectomy). On average, patients estimated that a reasonable surgeon fee for carpal tunnel release and 90 days of postoperative care was $2629 and that actual Medicare reimbursement was $1891. Patients estimated that a reasonable surgeon fee for internal fixation of an extra-articular distal radius fracture and 90 days of postoperative care was $3874 and that actual Medicare reimbursement was $2671. Higher level of education, annual household income, and insurance status had no statistically significant effect on patient estimates of reimbursement. Patients in an outpatient hand and upper extremity practice believe that surgeons are reimbursed at a rate 3.6 to 4.7 times greater than actual reimbursement. These misperceptions highlight the lack of understanding and transparency in health care costs and may interfere with the ability of patients to make well-informed decisions about health care. PMID:24025005

Fowler, John R; Buterbaugh, Glenn A

2013-09-01

22

Chronic pancreatitis: A surgical disease? Role of the Frey procedure  

PubMed Central

Although medical treatment and endoscopic interventions are primarily offered to patients with chronic pancreatitis, approximately 40% to 75% will ultimately require surgery during the course of their disease. Although pancreaticoduodenectomy has been considered the standard surgical procedure because of its favorable results on pain control, its high postoperative complication and pancreatic exocrine or/and endocrine dysfunction rates have led to a growing enthusiasm for duodenal preserving pancreatic head resection. The aim of this review is to better understand the rationale underlying of the Frey procedure in chronic pancreatitis and to analyze its outcome. Because of its hybrid nature, combining both resection and drainage, the Frey procedure has been conceptualized based on the pathophysiology of chronic pancreatitis. The short and long-term outcome, especially pain relief and quality of life, are better after the Frey procedure than after any other surgical procedure performed for chronic pancreatitis. PMID:25068010

Roch, Alexandra; Teyssedou, Jérome; Mutter, Didier; Marescaux, Jacques; Pessaux, Patrick

2014-01-01

23

The evolution of surgical procedures in the management of duodenal and gastric ulcers.  

PubMed

Surgical procedures for the surgical management of duodenal ulcer had evolved through many stages, over the years. It started with gastroenterostomy alone, then followed by subtotal gastrectomy, vagotomy alone, vagotomy and gastro-jejunostomy, vagotomy and pyloroplasty, and highly selective vagotomy - all which started as open surgical procedures. Now unless there are complications the treatment is essentially medical following the work of Marshall and Warren. Currently, even when surgery is indicated, minimal invasive procedures are preferred. Four main types of pyloroplasties are well known. They are Weinberg, Heinecke-Mikulicz, Finney and Jaboulay. Vagotomy can be truncal, selective, and highly selective. Accepted surgical treatment for gastric ulcer is the distal gastric resection to include the ulcerated area, but not resecting more than 50-60% of the stomach. In the uncommon cases of Zollinger-Ellison syndrome, aggressive gastric surgery, the use of drugs, and the resection of the tumour have all been recommended in appropriate cases. With the discovery of Helicobacter pylori and its effective medical treatment, surgery has little role in the initial management of peptic ulcer disease. The place of the history of the surgical procedures employed earlier in the treatment of this disease would remain relevant. PMID:24122679

Ajao, O G; Ugwu, B T

2013-01-01

24

Effect of short surgical procedures on salivary paracetamol elimination.  

PubMed Central

The effect of short surgical procedures on paracetamol elimination was studied in seven male patients undergoing surgery with epidural anaesthesia. Five healthy volunteers who did not undergo surgery served as a control group. Paracetamol concentration was measured in saliva at various intervals 1 day before and after surgery. Paracetamol half-life (t1/2,z) decreased and metabolic clearance rate (CL) increased after surgery as compared to preoperative values. The results suggest that surgical stress may enhance the hepatic metabolism of paracetamol. PMID:4041337

Ray, K; Adithan, C; Bapna, J S; Kangle, P R; Ray, K; Ramakrishnan, S

1985-01-01

25

Survey of antimicrobial prophylaxis for surgical procedures in Lebanese hospitals.  

PubMed

Antimicrobial prophylaxis (AMP) is an effective measure to prevent the surgical site infection (SSI). This prospective survey of three months describe the adequacy of AMP in 10 acute care hospitals (affiliated to the Lebanese University, Faculty of Medical Sciences) based on international guidelines for only three parameters, digestive, orthopaedic and vascular surgery. Out of 964 surgical procedures, 916 (95%) were eligible for AMP, of which 767 (84%) received one or several antibiotics. Cefazolin was frequently prescribed (49%), followed by beta-lactamase-inhibitor/penicillin (18%), cefuroxime (17%), ceftriaxone (7%) and vancomycin (0.1%). In compliance with current US guidelines on indication, choice of drug, duration and time of first dose administration, AMP was given for only 32% of the procedures. Duration of AMP was < or = 24 hours in 35% and exceeded 48 hours in 57%. A single dose of prophylaxis was given to 26%, 12% receive an additional dose and 62% receive more than 2 doses. The first dose was administered within 30 min before operation in 92% of procedures. We conclude that AMP in Lebanese hospitals was fairly adequate in terms of respecting indications for selected surgical procedures. Improvement could be made by reducing the duration of prophylaxis and avoiding the use of broad-spectrum antibiotics. PMID:15112851

Azzam, Raghida; Hamadé, Nohad; Bedrossian, Nora; Assaad, Chafica

2002-01-01

26

Posterior approach (Kraske procedure) for surgical treatment of presacral tumors  

PubMed Central

Presacral tumors are rare, but can comprise a great variety of histological types. Congenital tumors are the most common. Once the diagnosis is established, surgical resection is essential because of the potential for malignancy or infection. Previous biopsy is not necessary or may be even harmful. To decide the best surgical approach (abdominal, sacral or combined) an individual and multidisciplinary analysis must be carried out. We report three cases of cystic presacral masses in which a posterior approach (Kraske procedure) enabled complete resection, the only way to decrease local recurrence. All patients had a satisfactory recovery. A brief overview of retrorectal tumors is presented, focusing on classification, clinical presentation, diagnosis and surgical management. PMID:22655127

Aranda-Narváez, José Manuel; González-Sánchez, Antonio Jesús; Montiel-Casado, Custodia; Sánchez-Pérez, Belinda; Jiménez-Mazure, Carolina; Valle-Carbajo, Marta; Santoyo-Santoyo, Julio

2012-01-01

27

Posterior approach (Kraske procedure) for surgical treatment of presacral tumors.  

PubMed

Presacral tumors are rare, but can comprise a great variety of histological types. Congenital tumors are the most common. Once the diagnosis is established, surgical resection is essential because of the potential for malignancy or infection. Previous biopsy is not necessary or may be even harmful. To decide the best surgical approach (abdominal, sacral or combined) an individual and multidisciplinary analysis must be carried out. We report three cases of cystic presacral masses in which a posterior approach (Kraske procedure) enabled complete resection, the only way to decrease local recurrence. All patients had a satisfactory recovery. A brief overview of retrorectal tumors is presented, focusing on classification, clinical presentation, diagnosis and surgical management. PMID:22655127

Aranda-Narváez, José Manuel; González-Sánchez, Antonio Jesús; Montiel-Casado, Custodia; Sánchez-Pérez, Belinda; Jiménez-Mazure, Carolina; Valle-Carbajo, Marta; Santoyo-Santoyo, Julio

2012-05-27

28

Myelomeningocele (open spina bifida) - surgical management.  

PubMed

Myelomeningocele has been recognized since ancient times although written descriptions began not before the 17th century. Among all serious congenital malformations, myelomeningocele is unique that is has a steady and considerable prevalence while being compatible with life. It has a dismal prognosis when left untreated where virtually all die within the first year while aggressive treatment have a profound effect on survival and quality of life. Effective surgical treatment became possible parallel to the treatment of hydrocephalus in the late 1950s. Advent of the shunt systems undoubtedly changed the morbidity and mortality rates due to associated hydrocephalus. Aggressive and effective treatment improved survival rates but also those suffering physical and mental disabilities have increased as well. Ethical and socioeconomic concerns have led to proposal for selective treatment criteria which have raised arguments on medical and ethico-legal rounds. After the swing of the pendulum between early treatment in all affected children and selective treatment of those who fulfilled the criteria for good prognosis, early myelomeningocele repair is practiced widely unless the infant is critically ill.Incidence of myelomeningocele has been decreasing especially in the Western world, partly due to prenatal diagnosis and elective terminations, dietary folate supplementation. Still, it is the most common central nervous system malformation and one of the leading causes of paraplegia, worldwide. Unfortunately, gains in the management of myelomeningocele have been mainly on antenatal diagnosis and prevention while efforts on understanding its cause, mechanisms involved are still tentative. Concerning the surgical management, no revolutionary modification improving outcome has been introduced unlike other fields of neurosurgery.Medical management of a child with myelomeningocele requires a lifelong effort of several disciplines including urology, orthopedics physical and social therapy besides neurosurgery. The initial and probably the most crucial step begin with proper repair of the lesion. The aim of surgery, with its simplest definition should be towards maintaining the medical condition of the newborn. In other words, consequences of an open spinal cord segment with associated malformations have to be avoided with appropriate measures. Comparable to the surgical treatment of any congenital malformation, myelomeningocele repair consist of reversing the failed steps of normal neural tube closure. This requires a thorough understanding of the normal and abnormal embryological sequence of events in formation of the spinal cord. Although the purpose of this chapter is to describe the basic concepts and technique of myelomeningocele repair, contemporary information and progress on epidemiology, and etiology and embryology is presented with discussion of controversial issues regarding the selection process, optimal time for surgery and technical modifications. PMID:21997743

Akalan, N

2011-01-01

29

[The transrectus sheath preperitoneal procedure: a safe, effective and cheap surgical approach to inguinal hernia?].  

PubMed

The main complication of surgery for inguinal hernia is chronic postoperative pain. This is often reported following the Lichtenstein procedure. A new, open surgical technique for the repair of inguinal hernia has been developed. This procedure is called the transrectus sheath preperitoneal procedure (TREPP). At TREPP a lightweight mesh with a ring made of memory metal is introduced into the preperitoneal space through the transrectus sheath. The first results of this operative technique are very promising: short operation time, short learning curve and not many patients with chronic postoperative pain. In a randomised, multi-centre study which will start mid-2013 (ISRCTN18591339), the TREPP procedure is compared with the transinguinal preperitoneal procedure. The primary outcome measure of this study is chronic postoperative pain. PMID:23890168

Prins, M W Wiesje; Voropai, D A Dasha; van Laarhoven, C J H M Kees; Akkersdijk, Willem L

2013-01-01

30

Using double gloves in surgical procedures: a literature review.  

PubMed

This article will present a critical review of the literature relating to the use of double gloves during surgery in order to identify best practice by using available resources and to improve health care. During surgery there is an increased risk of exposure to blood and, as a result, pathogens can be transferred through contact between the patient and surgical team. Health professionals working in the operating room are prone to frequent exposure to patients' blood and body fluids ( Davanzo et al, 2008 ; Au et al, 2008 ; Myers et al, 2008 ). Several researchers have also demonstrated that the highest incidence of blood and body fluid exposure is in the operating room during surgical procedures ( Ganczak et al, 2006 ; Myers et al, 2008 ; Naghavi and Sanati, 2009 ). PMID:25426524

Al Maqbali, Mohammed Abdullah

2014-11-27

31

[Modified Fontan procedure on 106 cases: indication and surgical results].  

PubMed

Since 1974, we have performed modified Fontan procedure on 106 patients, ranging in ages from 1 to 32 years, consisting of 44 cases of tricuspid atresia (TA), 21 with univentricular heart (UVH) of right ventricular type, 18 with UVH of left ventricular type, for which ventricular partition was unfeasible, and 23 with various complex anomalies. Hospital mortality rates for TA and other complex anomalies were 11.4 and 11.3%, respectively. Surgical results have markedly improved recently. Since 1986, 50 cases underwent Fontan procedure with 3 hospital deaths (6.0%). Late death occurred in 4 cases in a mean follow-up period of 49 months. Regarding the indication for operation, majority of patients had 2 to 3 parameters which were out of 10 criteria for Fontan procedure. Regurgitation of atrioventricular valve was repaired by annuloplasty in 19 patients underwent Fontan procedure and 17 survived. Abnormal systemic venous connection was seen in 11 cases and all survived. Association of total anomalous pulmonary venous connection is still a difficult problem and 2 of 5 cases died. Fontan procedure was performed in 8 patients following palliative right ventricular outflow reconstruction for poor development of pulmonary artery and 7 survived. Cumulative mortality rate for the entire series was relatively well at 15.1%. PMID:9301908

Imai, Y; Kurosawa, H; Fukuchi, S; Ishihara, K; Sawatari, K; Kawada, M; Matsuo, K; Seo, K; Terada, M; Takeuchi, K

1989-04-01

32

Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures  

Microsoft Academic Search

Background. Diabetes mellitus is a risk factor for deep sternal wound infection after open heart surgical procedures. We previously showed that elevated postoperative blood glucose levels are a predictor of deep sternal wound infection in diabetic patients. Therefore, we hypothesized that aggressive intravenous pharmacologic control of postoperative blood glucose levels would reduce the incidence of deep sternal wound infection.Methods. In

Anthony P Furnary; Kathryn J Zerr; Gary L Grunkemeier; Albert Starr

1999-01-01

33

Effect of Surgical Training Course on Performance of Minor Surgical Procedures in Family Medicine Physicians’ Offices: an Observational Study  

PubMed Central

Aim To examine the influence of a practical surgical course on the number of minor surgical procedures performed by family physicians. Methods We compared the number of minor surgical procedures performed by family physicians in 59 offices in the city of Osijek and surrounding rural area, Croatia, during 12 months before and after the 40-hour practical surgical course held in September 2006 by surgeons and family medicine specialists. Minor surgical procedures taught in the course included management of ingrown toenails, abscesses/comedones, and minor wounds, anesthesia application, disinfection, use and sterilization of surgical instruments, and antibiotic treatment. Results The number of minor surgical procedures performed in family medicine offices almost doubled (503 vs 906 after the course, P<0.001, Wilcoxon test). The median number of abscesses/comedones treatments per physician increased from 1 to 6 (P<0.001, Wilcoxon test), the number of managed wounds increased from 111 to 217 (P<0.001, Wilcoxon test), while the number of ingrown toenail resections increased from 120 to 186 (P?=?0.004, Wilcoxon test). Fifty percent of physicians did not treat patients surgically, irrespective of the training. We found no association between the number of performed procedures and age, length of employment, or location of the physician’s office (urban vs rural). However, we found that male physicians performed more surgical treatments both before and after the course (abscesses/comedones: P<0.001 and P?=?0.108 respectively; ingrown toenail resections: P?=?0.008 and P?=?0.008 respectively; minor wounds: P?=?0.030 and P<0.001; respectively). Conclusion Practical courses can encourage practitioners to treat the patients surgically in their offices and, thus, increase the number of services offered in primary care. Female physicians should be more encouraged to perform minor surgical procedures in their offices. PMID:18581614

Gmajni?, Rudika; Pribi?, Sanda; Luki?, Anita; Ebling, Barbara; ?upi?, Nikola; Markovi?, Ivana

2008-01-01

34

Surgical procedure in immunoglobulin G4-related ascending aortitis?  

PubMed

Immunoglobulin G4 (IgG4)-related fibroinflammatory systemic disease accounts for 7% of all noninfectious aneurysms of the thoracic aorta. A patient was admitted with a symptomatic ascending aortic aneurysm and thickened aortic wall (outer/inner diameter 55/45 mm), which was replaced. Probes revealed IgG4-related aortitis associated with a primary tuberculosis infection. Corticosteroid and antituberculosis therapies were used, and the patient's clinical evolution was favorable. The optimal treatment strategy of IgG4-related aortitis, a new entity, remains vague. Inner aortic diameter alone does not justify aortic replacement, but wall thickening may mimic intramural hematoma. In this particular case of IgG4-related aortitis, immunosuppressive treatment alone, as an alternative to a surgical procedure, may be debatable. PMID:24694451

Colombier, Sébastien; Ruchat, Patrick; Gronchi, Fabrizio; Prêtre, René; Niclauss, Lars

2014-04-01

35

Evaluating new surgical techniques in Australia: the Australian Safety and Efficacy Register of New Interventional Procedures-Surgical experience.  

PubMed

The Australian Safety and Efficacy Register of New Interventiona lProcedures-Surgical (ASERNIP-S) exists primarily to assess new surgical technologies and techniques. It originally conducted systematic literature reviews, but now uses accelerated reviews, horizon scanning for emerging procedures, research and clinical audits,preparation of patient information, assistance with guideline development,and the production of research protocols of new surgical techniques. Future international cooperation and networking among health technology assessment groups will avoid duplication of effort and maximize outputs. Experience has shown that when surgeons lead in assessing new and emerging surgical techniques and technologies, the benefits of an evidence-based approach are realized, and the surgical community accepts the complementary role of evidence-based medicine in the provision of high-quality patient care. PMID:16442424

Maddern, Guy J; Middleton, Philippa F; Tooher, Rebecca; Babidge, Wendy J

2006-02-01

36

Femoroacetabular Impingement in Professional Ice Hockey PlayersA Case Series of 5 Athletes After Open Surgical Decompression of the Hip  

Microsoft Academic Search

Background: Femoroacetabular impingement of the hip joint has been identified as a major cause for hip pain in athletes. Surgical open decompression of the hip has historically been proposed as the first treatment of choice. Functional outcomes in athletes after this procedure are unknown.Purpose: To describe the functional and sport-related outcome 2 years after open surgical hip decompression in a

Mario Bizzini; Hubert P. Notzli; Nicola A. Maffiuletti

2007-01-01

37

Surgical site infection surveillance after open gastrectomy and risk factors for surgical site infection  

Microsoft Academic Search

Surgical site infection (SSI) surveillance was examined in gastric cancer patients who had undergone an open gastrectomy between\\u000a 1997 and 2003 at Keio University Hospital in Tokyo, Japan. National Nosocomial Infections Surveillance (NNIS) reports and\\u000a several studies have discussed SSI risk factors, but only open gastrectomy was analyzed by regression analysis. The purpose\\u000a of this study was to examine these

Eiko Imai; Masakazu Ueda; Kent Kanao; Koichi Miyaki; Tetsuro Kubota; Masaki Kitajima

2005-01-01

38

Acute necrotizing pancreatitis: Surgical indications and technical procedures  

PubMed Central

Necrosis of pancreatic parenchyma or extrapancreatic tissues is present in 10%-20% of patients with acute pancreatitis, defining the necrotizing presentation frequently associated with high morbidity and mortality rates. During the initial phase of acute necrotizing pancreatitis the most important pillars of medical treatment are fluid resuscitation, early enteral nutrition, endoscopic retrograde colangiopancreatography if associated cholangitis and intensive care unit support. When infection of pancreatic or extrapancreatic necrosis occurs, surgical approach constitutes the most accepted therapeutic option. In this context, we have recently assited to changes in time for surgery (delaying the indication if possible to around 4 wk to deal with “walled-off” necrosis) and type of access for necrosectomy: from a classical open approach (with closure over large-bore drains for continued postoperative lavage or semiopen techniques with scheduled relaparotomies), trends have changed to a “step-up” philosophy with initial percutaneous drainage and posterior minimally invasive or endoscopic access to the retroperitoneal cavity for necrosectomy if no improvement has been previously achieved. These approaches are progressively gaining popularity and morbidity and mortality rates have decreased significantly. Therefore, a staged, multidisciplinary, step-up approach with minimally invasive or endoscopic access for necrosectomy is widely accepted nowadays for management of pancreatic necrosis. PMID:25516858

Aranda-Narváez, José Manuel; González-Sánchez, Antonio Jesús; Montiel-Casado, María Custodia; Titos-García, Alberto; Santoyo-Santoyo, Julio

2014-01-01

39

Acute necrotizing pancreatitis: Surgical indications and technical procedures.  

PubMed

Necrosis of pancreatic parenchyma or extrapancreatic tissues is present in 10%-20% of patients with acute pancreatitis, defining the necrotizing presentation frequently associated with high morbidity and mortality rates. During the initial phase of acute necrotizing pancreatitis the most important pillars of medical treatment are fluid resuscitation, early enteral nutrition, endoscopic retrograde colangiopancreatography if associated cholangitis and intensive care unit support. When infection of pancreatic or extrapancreatic necrosis occurs, surgical approach constitutes the most accepted therapeutic option. In this context, we have recently assited to changes in time for surgery (delaying the indication if possible to around 4 wk to deal with "walled-off" necrosis) and type of access for necrosectomy: from a classical open approach (with closure over large-bore drains for continued postoperative lavage or semiopen techniques with scheduled relaparotomies), trends have changed to a "step-up" philosophy with initial percutaneous drainage and posterior minimally invasive or endoscopic access to the retroperitoneal cavity for necrosectomy if no improvement has been previously achieved. These approaches are progressively gaining popularity and morbidity and mortality rates have decreased significantly. Therefore, a staged, multidisciplinary, step-up approach with minimally invasive or endoscopic access for necrosectomy is widely accepted nowadays for management of pancreatic necrosis. PMID:25516858

Aranda-Narváez, José Manuel; González-Sánchez, Antonio Jesús; Montiel-Casado, María Custodia; Titos-García, Alberto; Santoyo-Santoyo, Julio

2014-12-16

40

Open surgical excision of subglottic hemangioma in children.  

PubMed

Subglottic hemangioma is an unusual entity which may involute spontaneously without aggressive surgical intervention; although tracheotomy is sometimes necessary. The actual time course for involution is not clear by reviewing the literature [1,14]. Numerous treatment modalities are described for the treatment of this condition, including tracheotomy, CO2 laser ablation and intralesional steroid injection with or without endotracheal intubation. Surgical resection of subglottic hemangioma is an option which is described in the literature and may be utilized in certain selected cases. We present seven cases of subglottic hemangioma treated at three institutions which were resected via a crico-tracheotomy approach. Postoperative follow-up for these patients range from 6 months to 4.5 years. Although conservative measures are still advocated as the treatment of choice for subglottic hemangioma, open surgical resection may be indicated in selected cases resulting in a satisfactory outcome. PMID:8770689

Wiatrak, B J; Reilly, J S; Seid, A B; Pransky, S M; Castillo, J V

1996-01-01

41

Automated Tissue Retraction for Robot-Assisted Surgical Procedures Sachin Patil Ron Alterovitz  

E-print Network

delicate and precise minimally invasive surgery (MIS). Studies have shown that these robots can improveAutomated Tissue Retraction for Robot-Assisted Surgical Procedures Sachin Patil Ron Alterovitz Abstract--Robotic surgical assistants (RSAs) are enhancing physician performance, enabling them to perform

North Carolina at Chapel Hill, University of

42

A Workcell for the Development of Robot-Assisted Surgical Procedures  

Microsoft Academic Search

This paper describes a robotic workstation for the development of new robot-assisted surgical procedures. This work is motivated by the difficulties and cost associated to the development of surgical robots, often requiring large investments and several re-designs which limit wider use of this technology. The approach presented here consists of using a general purpose robotic workcell to develop the hardware

Claudio Casadei; Sandra Martelli; Paolo Fiorini

2000-01-01

43

An Event-Driven Framework for the Simulation of Complex Surgical Procedures  

E-print Network

rarely encountered in actual patients. We present here a framework for a full- procedure surgical one, do one, teach one" model [1]. However, in recent years simulation-based training has become more and anim

Salisbury, Kenneth

44

Design and development of a tissue retractor for use in minimally invasive surgical procedures  

E-print Network

Laparoscopic surgery is a widespread and rapidly growing surgical technique. One of the challenges facing surgeons performing laparoscopic procedures is the retraction of anatomical structures that restrict vision and ...

Begg, Nikolai David Michael

2009-01-01

45

Further results of incorporating innovative procedures in a surgical residency.  

PubMed

The instruction in precipitously advancing surgical technologies remains a real challenge to every surgery program. Our institution's ongoing experience with an identified center for student and resident education and clinical investigation provides an option for addressing these needs in a general surgery residency. Over the past 8 years, we have developed and described previously the Center for Advanced Surgical Technologies (CAST) in a joint undertaking of the Department of Surgery and the Norton Hospital, an affiliated hospital on our medical school campus. The idea behind this program has been to focus and develop high-quality skills in the hospital in many areas of advanced technology. CAST has subsequently provided a vehicle for excellent clinical research as well as the development of specially focused advanced surgical technologies, fellowships, and a large number of publications that have often focused on new, advanced methods for imaging surgical disease and minimal access treatment. This program has had a very positive impact on the general surgery residency as a whole and has permitted a steadily advancing agenda of new technologies, while relegating recently emerged but perfected technologies into the central aspect of our accredited general surgery residency. PMID:16034508

Kehdy, Farid J; Allen, Jeffrey W; Vitale, Gary C; Polk, Hiram C

2005-06-01

46

Surgical Complications in Hair Transplantation: A Series of 533 Procedures  

Microsoft Academic Search

BACKGROUND: Surgical complications in hair transplantation can sometimes be a serious matter. Most of the published literature on this issue deals with individual case reports rather than larger series of patients.OBJECTIVE: The authors analyze complications in 425 consecutive patients undergoing 533 hair transplantations.METHODS: Patients with androgenetic alopecia (407 men and 17 women), cicatricial alopecia (9 men and 8 women), and

Sandro Salanitri; Antonio José Gonçalves; Américo Helene Jr.; Flavia Helena Junqueira Lopes

2009-01-01

47

A Modular Surgical Robotic System for Image Guided Percutaneous Procedures  

Microsoft Academic Search

This paper presents a robotic system for precise needle ins- ertion under radiological guidance for surgical interventions and for deli- very of therapy. It is extremely compact and is compatible with portable X-ray units and computer tomography scanners. The system presents a modular structure comprising a global positioning module, a miniature robotic module, and a radiolucent needle driver module. This

Dan Stoianovici; Louis L. Whitcomb; James H. Anderson; Russell H. Taylor; Louis R. Kavoussi

1998-01-01

48

The use of electromagnetic motion tracking analysis to objectively measure open surgical skill in the laboratory-based model 1 1 No competing interests declared  

Microsoft Academic Search

BACKGROUND:Technical performance has traditionally been assessed subjectively within the operating theater, with few successful attempts at objective analysis. The Imperial College Surgical Assessment Device (ICSAD) has already been shown to be a valid quantitative measure of dexterity in laparoscopic surgical simulation. We describe its application to the assessment of open surgical procedures.STUDY DESIGN:Fifty-one participants were recruited from four different levels

Vivek Datta; Sean Mackay; Mirren Mandalia; Ara Darzi

2001-01-01

49

[Urological complications following surgical procedures and their management].  

PubMed

The urological complications of surgical interventions are discussed on the basis of the authors' clinical material collected over six years. Mainly fistulas and inflammatory complications occurred due to gynaecological operations performed by abdominal penetration. The possibilities and incidence of complications, as well as the diagnostic methods used for their detection and the applied therapies are reviewed. The importance of the proper choice of restituting surgical interventions is stressed. Complete anatomical and functional restoration and preservation of the organ are attempted. Attention is called to the importance and possibilities of preventing complications due to injuries. In the reduction of the incidence of urological complications after gynaecological operations, beside prevention, a close co-operation with the urologist is necessary as well as post-operative check-ups even in symptomless cases. PMID:7347971

Magasi, P; Páczelt, F; Szemes, Z

1981-01-01

50

A surgical procedure for the Osgood-Schlatter lesion  

Microsoft Academic Search

Although the Osgood-Schlatter lesion (OSL) usually heals spontaneously, symptoms often continue for 2 or 3 years. Affected young people are often keen on sporting or strenuous activities, and enforced reduced physical activity may cause considerable frustration and emotional disruption. A simple procedure which had been advocated for severely affected children wanting to be active in sports was evaluated. The procedure

Andrew G. King; G. Blundell-Jones

1981-01-01

51

A critical investigation of some of the procedures employed in the surgical use of titanium  

Microsoft Academic Search

Rigorous and exhaustive procedures are employed when titanium (Ti) is surgically implanted, whether for orthopaedic or dental applications. Many of these are adopted because it is thought that surface cleanliness is paramount for clinical success. This paper critically examines the necessity for some of these procedures, concentrating on the surface chemistry of Ti plates. Radio frequency plasma treatments are used

A. P. Ameen; R. D. Short; C. W. I. Douglas; R. Johns; B. Ballet

1996-01-01

52

Biomechanical effects of different surgical procedures on the extensor mechanism of the patellofemoral joint.  

PubMed

Loadbearing stresses in the patellofemoral joint were studied at different degrees of flexion before and after various surgical techniques recommended to treat knee disorders. Surgical procedures intended to reduce the intensity of stress were analyzed experimentally. The study was done using different experimental methods on whole knee specimens from fresh human cadavers that were not treated with formaldehyde. The results indicate that the most predictable procedure for increasing surface area and decreasing patellar stress is a combined procedure of anterior displacement of the anterior tibial tubercle by 1 cm while displacing it 0.5 to 1 cm medially. PMID:7586823

Molina, A; Ballester, J; Martin, C; Muñoz, I; Vazquez, J; Torres, J

1995-11-01

53

Bedside Percutaneous Tracheostomy versus Open Surgical Tracheostomy in Non-ICU Patients.  

PubMed

Percutaneous bedside tracheostomy (PBT) is a one of the common and safe procedures in intensive care units through the world. In the present paper we published our clinical experience with a performance of PBTs in the regular ward by intensive care physicians' team. We found it safe and similar outcome in comparison to open surgical tracheostomy method in operation room by ENT team. The performance of PBT in the regular ward showed potential economic advantages in saving medical staff and operating room resources. PMID:24523960

Brotfain, Evgeni; Koyfman, Leonid; Frenkel, Amit; Semyonov, Michael; Peiser, Jochanan G; Hayun-Maman, Hagit; Boyko, Matthew; Gruenbaum, Shaun E; Zlotnik, Alexander; Klein, Moti

2014-01-01

54

A prospective analysis of 211 robotic-assisted surgical procedures  

Microsoft Academic Search

Background: The Academic Robotics Group prospectively studied 211 robotically assisted operations to assess the safety and utility of robotically assisted surgery. Methods: All operations took place at one of four member institutions between June 2000 and June 2001 using the recently FDA-approved daVinci robotic system. A variety of procedures were undertaken, including antireflux surgery (69), cholecystectomy (36), Heller myotomy (26),

M. A. Talamini; S. Chapman; S. Horgan; W. S. Melvin

2003-01-01

55

Local Anesthesia for Surgical Procedures of the Upper Eyelid Using Filling Cannula: Our Technique  

PubMed Central

Summary: Sometimes, after local anesthetic injection for surgical procedures of the upper eyelid, it is possible to observe superficial preseptal hematomas or excessive lid swelling that may distort the tissues and obscure surgical landmarks. We present a technique to perform local anesthesia of the upper eyelids, using a 27-gauge needle and a 26-gauge filling cannula, that may decrease the incidence of hematomas and bruising. PMID:25289336

Veneroso, Aniello

2014-01-01

56

Office-Based Surgical and Medical Procedures: Educational Gaps  

PubMed Central

Over the past decade, the number of procedures performed in office-based settings by a variety of practitioners—including surgeons, gastroenterologists, ophthalmologists, radiologists, dermatologists, and others—has grown significantly. At the same time, patient safety concerns have intensified and include issues such as proper patient selection, safe sedation practices, maintenance of facilities and resuscitation equipment, facility accreditation and practitioner licensing, and the office staff's ability to deal with emergencies and complications. An urgent need exists to educate practitioners about safety concerns in the office-based setting and to develop various educational strategies that can meet the continued growth of these procedures. This review outlines educational needs and possible solutions such as simulation exercises and education during residency training. PMID:23267269

Urman, Richard D.; Punwani, Nathan; Shapiro, Fred E.

2012-01-01

57

Refractive effect of two scleral-buckling surgical procedures  

NASA Astrophysics Data System (ADS)

To reattach the retina, in many instances, biological or synthetic belt-shaped exoplants are inserted in the orbit and tightened around the globe's equator to inwardly depress the sclera until its inner layers contact the retina. In deforming the globe these `buckling procedures' are thought to affect the eye's optical system and thus vision. A new non-contact optical technique was devised to quantify the refractive effect of the two most common techniques used in retinal detachment surgery.

Kuhne, Francois; Parel, Jean-Marie A.; Takesue, Yoshiko; Villain, Franck L.; Trivedi, Bavia; Ducournau, Didier; Le Rebeller, Marie-Jose

1993-06-01

58

The role of shortening procedures for the surgical therapy of Peyronie's disease.  

PubMed

In this article we briefly review the current surgical treatment options for Peyronie's disease (PD) in its stable phase. We emphasize the important role of tunical shortening procedures which account for the major share of operations for PD. Shortening procedures provide excellent curvature correction combined with a very low risk of new erectile dysfunction. Since erectile function is already heavily impaired by the disease and its comorbidities in many patients with PD, tunical shortening procedures often are the treatment of choice for the correction of penile curvature. While there is no hard evidence for the superiority of a specific shortening procedure, several authors prefer the classical Nesbit technique over simple plication techniques. We also present our experiences with the Tunica albuginea underlap technique (TAU-technique), a new modification of the Nesbit procedure, that might add further surgical advantages while preserving the strength of the classical Nesbit technique. PMID:23703100

Schwarzer, J U; Steinfatt, H

2013-06-01

59

Alternative Approach to the Management of Postoperative Pain after Pediatric Surgical Procedures  

PubMed Central

ABSTRACT Aim: This paper reports two clinical cases in which the application of low-level laser therapy (LLLT) enhanced the postoperative symptoms after pediatric surgical procedures. Background: The uses of novel technologies allow more comfort to the patients and ensure a rapid procedure, and LLLT application has shown a positive effect in the prevention of discomfort after invasive procedures. Case description: Low-level laser therapy protocol was applied after surgical removal of supernumerary tooth and frenectomy resulting in less swallow and pain with no need of medication intake. Conclusion: The laser application was well accepted by both children and parents and showed a clinical efficiency in the follow-up examinations beyond the satisfactory quality of wound healing. Clinical significance: The LLLT approach is an excellent adjuvant therapy resource for delivery an optimal postoperative after surgical procedures in children. How to cite this article: Paschoal M, Souza J, Santos-Pinto L, Pansani C. Alternative Approach to the Management of Postoperative Pain after Pediatric Surgical Procedures. Int J Clin Pediatr Dent 2014;7(2):125-129. PMID:25356012

Souza, Juliana; Santos-Pinto, Lourdes; Pansani, Cyneu

2014-01-01

60

The incidence, morbidity, and mortality of surgical procedures after orthotopic heart transplantation.  

PubMed Central

OBJECTIVE: The authors present their experience with patients having undergone orthotopic heart transplantation (OHT) in whom surgical conditions subsequently developed that required operative intervention. The incidence, morbidity, and mortality of these procedures are reported. SUMMARY BACKGROUND DATA: Several studies have evaluated the management options of biliary tract disease after OHT. Multiple reports of patients having undergone OHT who subsequently underwent peripheral vascular reconstructions, plastic reconstructive, and thoracic procedures also have been published. METHODS: A chart review of 349 patients who underwent OHT between 1985 and 1996 was conducted to identify surgical procedures that were required in the post-transplant period. Their outcomes are reported. RESULTS: Of 349 patients who underwent OHT, conditions requiring 94 surgical procedures developed in 54 patients (15%). Biliary tract disease developed in 17 patients (5%) who required cholecystectomy, 2 of the 5 patients with acute cholecystitis died. Eight patients (2%) underwent orthopedic procedures with no operative mortality. Flap advancements for sternal wound infections were performed in five patients and four deaths occurred. Seventeen thoracic procedures were performed in 11 patients with an overall mortality of 45%. Twenty-one vascular procedures were performed on 17 patients with 1 delayed death due to a malignancy. Seven patients underwent procedures of the colon and rectum with no mortality. Seven patients underwent repair of inguinal or incisional hernias with no mortality. Various infections occurred with one resultant death after operative intervention. Six procedures were performed for diseases of the small intestine with no resultant mortalities. CONCLUSIONS: Patients having undergone OHT and chronic immunosuppression are at increased risk of having complications develop from infection. Acute cholecystitis and sternal wound infection caused an inordinate risk of complications and death. Malignancies developed in four patients who required surgical intervention. A heightened awareness of coexisting peripheral vascular disease in patients transplanted for ischemic cardiomyopathy should exist. Close screening before surgery and surveillance after surgery to identify risk factors for infection and vascular disease and to screen for malignancies are essential. PMID:9230809

Bhatia, D S; Bowen, J C; Money, S R; Van Meter, C H; McFadden, P M; Kot, J B; Pridjian, A K; Ventura, H O; Mehra, M R; Smart, F W; Ochsner, J L

1997-01-01

61

[Principles of qualifying children for planned surgical procedures].  

PubMed

Children are prone to greater preoperative stress and more frequent accidents during anaesthesia. To reduce stress--a preoperative visit, information for child and parents, premedication and parental presence during induction of anaesthesia have all been successfully used. Surgery can often be performed as a "day case", there is no need for longer than 6 hour fasting (2-3 hours in infants and after fluids only) before induction of anaesthesia, and needle sticks are often avoided before the child loses consciousness. Laboratory tests are also not needed in children with good general health status planned for minor procedures. There is less emphasis on minimal hemoglobin level of 10 g/dl, the physician assessment of circulatory status is preferred rather than stiff laboratory values. Less stress for children means also less problems during induction and recovery as well as less need for prolonged postoperative care. PMID:12815779

Piotrowski, A

2001-01-01

62

Microporous polysaccharide hemosphere absorbable hemostat use in cardiothoracic surgical procedures  

PubMed Central

Background Topical hemostatic agents are used to reduce bleeding and transfusion need during cardiothoracic surgery. We report our experience with Arista® AH Absorbable Hemostatic Particles (Arista® AH), a novel plant-based microporous polysaccharide hemostatic powder. Methods Data were retrospectively collected for patients (n?=?240) that received cardiothoracic surgery at our institution from January 2009 to January 2013 with (n?=?103) or without (n?=?137) the use of Arista® AH. Endpoints included protamine to skin closure time (hemostasis time), cardiopulmonary bypass time, quantity of Arista® AH applied, intraoperative blood product usage, intraoperative blood loss, chest tube output 48 hours postoperatively, blood products required 48 hours postoperatively, length of stay in the intensive care unit, 30-day morbidity, and 30-day mortality. Results 240 patients (176 M: 64 F) underwent 240 cardiothoracic procedures including heart transplantation (n?=?53), cardiac assist devices (n?=?113), coronary artery bypass grafts (n?=?20), valve procedures (n?=?19), lung transplantation (n?=?17), aortic dissection (n?=?8), and other (n?=?10). Application of Arista® AH led to significant reduction in hemostasis time versus the untreated control group (Arista® AH: 93.4?±?41 min. vs. Control: 107.6?±?56 min., p?=?0.02). Postoperative chest tube output in the first 48 hours was also significantly reduced (Arista® AH: 1594?±?949 mL vs. Control: 2112?±?1437 mL, p?

2014-01-01

63

Raven-II: an open platform for surgical robotics research.  

PubMed

The Raven-II is a platform for collaborative research on advances in surgical robotics. Seven universities have begun research using this platform. The Raven-II system has two 3-DOF spherical positioning mechanisms capable of attaching interchangeable four DOF instruments. The Raven-II software is based on open standards such as Linux and ROS to maximally facilitate software development. The mechanism is robust enough for repeated experiments and animal surgery experiments, but is not engineered to sufficient safety standards for human use. Mechanisms in place for interaction among the user community and dissemination of results include an electronic forum, an online software SVN repository, and meetings and workshops at major robotics conferences. PMID:23204264

Hannaford, Blake; Rosen, Jacob; Friedman, Diana W; King, Hawkeye; Roan, Phillip; Cheng, Lei; Glozman, Daniel; Ma, Ji; Kosari, Sina Nia; White, Lee

2013-04-01

64

Pathologic comparison of video-assisted thoracic surgical lung biopsy with traditional open lung biopsy  

Microsoft Academic Search

Video-assisted thoracic surgical lung biopsy is an alternative to traditional open lung biopsy for diagnosis in patients with pleuropulmonary diseases. Between January 7, 1991, and August 3, 1993, 71 consecutive patients had video-assisted thoracic surgical lung biopsy and 42 patients had traditional open lung biopsy. A specific histologic diagnosis that correlated with the clinical findings was sought in each case

Mitsutaka Kadokura; Thomas V. Colby; Jeffrey L. Myers; Mark S. Allen; Claude Deschamps; Victor F. Trastek; Peter C. Pairolero

1995-01-01

65

Synergistic benefits of combined technologies in complex, minimally invasive surgical procedures  

Microsoft Academic Search

The new burden surgical technology must assume demands not only improved efficiency and reduced risk, but also diminished\\u000a cost and resource utilization. To this end, we have instituted the use of multiple, sequential technologies in complex, minimally\\u000a invasive procedures: laparoscopic gastric surgery (44 cases), spine procedures (38 cases), and colectomies (96 cases). The\\u000a technologies include head-mounted display, 3-D optics, robotic

W. P. Geis; H. C. Kim; P. C. McAfee; J. G. Kang

1996-01-01

66

Surgical treatment for paediatric patients with moyamoya disease by indirect revascularization procedures (EDAS, EMS, EMAS)  

Microsoft Academic Search

Summary Surgical results of paediatric patients with Moyamoya disease who were treated by indirect revascularization procedures are reported. Encephalo-duro-arterio-synangiosis (EDAS), encephalomyo-arterio-synangiosis (EMAS), and\\/or encephalo-myo-synangiosis (EMS) were performed on 47 sides of 29 children with Moyamoya disease. The results of those non-anastomotic EC-IC bypass procedures were evaluated clinically, angiographically, and by computed tomography (CT). Postoperative external carotid angiograms showed a good

T. Matsushima; S. Fujiwara; S. Nagata; K. Fujii; M. Fukui; K. Kitamura; K. Hasuo

1989-01-01

67

Duty Hour Restrictions, Ambulatory Experience, and Surgical Procedural Volume in Obstetrics and Gynecology  

PubMed Central

Background Prior studies of resident experience in gynecology looked only at the year before and after adoption of ACGME duty hour standards. This study sought to determine whether procedure volume differed after completion of a 4-year residency training program, before and after work hour reform. Method Inpatient and outpatient procedures performed by MetroHealth Medical Center/Cleveland Clinic program residents from 1998 to 2006 were obtained from Annual Reports of Institutional and Resident Experience. Four-year experience before and after duty hour restrictions were compared: hours worked were collected from resident schedules, ambulatory hours and procedures were compared directly, surgical procedures and deliveries were compared using a 2-tailed t test. Data were also obtained for institutional volume changes, and a corrected value, based on the rates of resident cases per available cases, was analyzed. Results Ambulatory hours worked per resident decreased after implementing work hour reform from 674 to 366 hours. The types of ambulatory and surgical procedures performed varied over time. Overall, basic surgical and obstetrical volume per resident did not change before and after work hour reform (mean before reform, 723?±?117, mean after reform, 781?±?200, P??=??.58 for gynecologic procedures; mean before reform, 611?±?107, mean after reform, 535?±?73, P??=??.18 for basic obstetrics and vaginal and cesarean deliveries). Institutional volume did not change significantly, although the percentage of the institutions' cases performed by residents did decrease for some procedures. Conclusion The ACGME duty hour restrictions do not limit the overall ambulatory or surgical procedural volume in an obstetrics and gynecology residency-training period. PMID:22132273

Kane, Sarah M.; Siddiqui, Nazema Y.; Bailit, Jennifer; Blanchard, May Hsieh

2010-01-01

68

Changes in surgical procedures for acromioclavicular joint dislocation over the past 30 years.  

PubMed

Generally, surgical treatment is recommended for Rockwood type 5 traumatic acromioclavicular joint dislocations. Since 1980, the authors have performed the modified Dewar procedure, the modified Cadenat procedure, and anatomical reconstruction of the coracoclavicular ligaments for this injury. The goal of this study was to determine the ideal surgical procedure for acromioclavicular joint dislocations by comparing these 3 procedures. The modified Dewar procedure was performed on 55 patients (Dewar group), the modified Cadenat procedure was performed on 73 patients (Cadenat group), and anatomical reconstruction of the coracoclavicular ligaments was performed on 11 patients (reconstruction group). According to the UCLA scoring system, therapeutic results averaged 27.3 points in the Dewar group, 28.2 in the Cadenat group, and 28.4 in the reconstruction group. The incidence of residual subluxation or dislocation in the acromioclavicular joint was evaluated at final radiographic follow-up. Subluxation occurred in 21 patients in the Dewar group, 18 in the Cadenat group, and 3 in the reconstruction group. Dislocation occurred in 3 patients in the Dewar group. Osteoarthritic changes in the acromioclavicular joint occurred in 20 patients in the Dewar group, 9 in the Cadenat group, and 1 in the reconstruction group. The modified Cadenat procedure can provide satisfactory therapeutic results and avoid postoperative failure or loss of reduction compared with the modified Dewar procedure. However, the modified Cadenat procedure does not anatomically restore the coracoclavicular ligaments. Anatomic restoration of both coracoclavicular ligaments can best restore acromioclavicular joint function. PMID:24093704

Takase, Katsumi; Yamamoto, Kengo

2013-10-01

69

Mandibular midline distraction using a tooth-borne device and a minimally invasive surgical procedure.  

PubMed

In this technical note we share our experience of mandibular midline distraction, a powerful tool in orthognathic surgery. The use of a tooth-borne distractor and a minimally invasive surgical procedure to perform the midline osteotomy is discussed. PMID:25487564

Nadjmi, N; Stevens, S; Van Erum, R

2014-12-01

70

Deep Femoral Artery Branch Pseudoaneurysm After Orthopedic Procedure Requiring Surgical Treatment: A Case Report  

PubMed Central

Pseudoaneurysms (PSA) of deep femoral artery (DFA) have been reported following penetrating and blunt trauma to the thigh and orthopedic procedures of the proximal femur. We describe a case of pseudoaneurysm of DFA as a late complication of limb trauma which was confirmed by exploration in an urgent surgery. After two operations successful surgical repair was performed. PMID:24350112

Khoshnevis, Jalalludin; Sobhiyeh, Mohammad Reza; Fallah Zavareh, Mahtab

2012-01-01

71

An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence  

Microsoft Academic Search

The object was to study prospectively the results of a modified intravaginal slingplasty for the surgical treatment of female stress incontinence, carried out under local anesthesia as a day procedure. Seventy five patients with genuine stress incontinence were operated upon and followed for a 2-year period. All patients were diagnosed urodynamically to have genuine stress incontinence. Pad tests and quality

U. Ulmsten; L. Henriksson; P. Johnson; G. Varhos

1996-01-01

72

Partial fingertip necrosis following a digital surgical procedure in a patient with primary Raynaud's phenomenon.  

PubMed

Raynaud's phenomenon is a common clinical disorder consisting of recurrent, long-lasting and episodic vasospasm of the fingers and toes often associated with exposure to cold. In this article, we present a case of partial fingertip necrosis following digital surgical procedure in a patient with primary Raynaud's phenomenon. PMID:25200107

Uygur, Safak; Tuncer, Serhan

2014-12-01

73

[Thin perforator flaps elevated in the plane of the superficial fascia: Principle and surgical procedure.  

PubMed

Perforator flaps have an ever growing place in reconstructive surgery and classical surgical procedures describe sub or supra-fascial plane elevation. In some indications, defatting of perforator flaps may be necessary and different methods have been described, primary or secondary, but may expose to partial loss of the flap or to another operation. Recently, a new method of perforator flap elevation in the plane of the superficial fascia has been described. This method permits to obtain a thin and reliable flap in the same procedure without the need of debulking and while decreasing donor site morbidity. We present the principle and the surgical procedure of this new method. Advantages and drawbacks are discussed with the help of clinical cases. PMID:25201098

Qassemyar, Q; Delobaux, A

2014-09-01

74

Recovery profile of patients undergoing nasal surgical procedures: a comparison between sevoflurane and propofol  

Microsoft Academic Search

Objectives  To compare the recovery profile of sevoflurane and propofol in nasal surgical procedures.\\u000a \\u000a \\u000a \\u000a Design  A prospective, double blind, randomized study\\u000a \\u000a \\u000a \\u000a Setting  King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, a tertiary care teaching hospital, attached with King Saud University,\\u000a Riyadh Saudi Arabia.\\u000a \\u000a \\u000a \\u000a Patients  60 ASA I–II patients age between 18–35 years, and weighing 50-80 kg, scheduled for nasal surgical procedures.\\u000a \\u000a \\u000a \\u000a Methods  Patients were assigned

Aziz Ul Haq; Mansoor Aqil; Amjad Rasheed; Rana Altaf Ahmed

2008-01-01

75

Adult Women and Coronary Heart Disease: Studies on Surgical Procedures and Perception  

Microsoft Academic Search

?????Schlorke, Patricia J., Adult Women and Coronary Heart Disease: Studies on Surgical Procedures and Perception. Doctor of Public Health (Biostatistics), December 2010, 124 pp., 12 tables, 3 figures, bibliography, 95 titles.\\u000aCoronary heart disease (CHD) was the number one cause of death in the United States. The main CHD symptom was a heart attack. The most common form of a

Patricia Schlorke

2010-01-01

76

Phaeochromocytoma Crisis: Two Cases of Undiagnosed Phaeochromocytoma Presenting after Elective Nonrelated Surgical Procedures  

PubMed Central

Phaeochromocytoma is a catecholamine producing tumour and an uncommon cause of hypertension. We present two cases of relatively asymptomatic individuals, in which previously undiagnosed phaeochromocytoma was unmasked by elective nonadrenal surgical procedures, manifesting as postoperative hypertensive crisis and subsequent cardiogenic shock. The initial management in intensive care is discussed, in addition to the clinical and biochemical diagnostic challenges present. Successful adrenalectomy was performed in each case. PMID:24288628

Johnston, P. C.; Silversides, J. A.; Wallace, H.; Farling, P. A.; Hutchinson, A.; Hunter, S. J.; Eatock, F.; Mullan, K. R.

2013-01-01

77

A simple method to decrease surgical trauma in wire localization procedures.  

PubMed

Minimally invasive breast biopsies of nonpalpable lesions are used for early diagnosis and treatment of breast cancer. This report describes a simple method to decrease surgical trauma in wire localization procedures. After wire localization with mammography or ultrasound, the course of the wire in the breast was marked on the skin to guide the surgeon. As a result, fewer tissue samples were taken and smaller hematomas occurred. This method is particularly useful in deep lesions and in large breasts, leading to shortened surgery time and improved cosmetic results. This technique can be used in any wire-guided procedure. PMID:18814133

Alicio?lu, Banu; Yücesoy, Cüneyt

2008-09-01

78

Pediatric fasting times before surgical and radiologic procedures: benchmarking institutional practices against national standards.  

PubMed

Prolonged preoperative fasting can be associated with adverse outcomes, particularly in children. Our aims were to assess the time pediatric patients fasted prior to surgical or radiologic procedures and evaluate whether fasting (NPO) orders complied with national guidelines. We measured NPO start time, time of last intake, and time test or surgery was scheduled, took place, or was cancelled in 219 pediatric patients. Findings demonstrate that pediatric patients experienced prolonged fasting before procedures and that the majority of NPO orders were non-compliant with national guidelines. We have developed strategies to reduce fasting times and ensure compliance with recommended national fasting standards. PMID:24365219

Williams, Catherine; Johnson, Pat A; Guzzetta, Cathie E; Guzzetta, Philip C; Cohen, Ira Todd; Sill, Anne M; Vezina, Gilbert; Cain, Sherry; Harris, Christine; Murray, Jodi

2014-01-01

79

Surgical Technique for Spinal Cord Delivery of Therapies: Demonstration of Procedure in Gottingen Minipigs  

PubMed Central

This is a compact visual description of a combination of surgical technique and device for the delivery of (gene and cell) therapies into the spinal cord. While the technique is demonstrated in the animal, the procedure is FDA-approved and currently being used for stem cell transplantation into the spinal cords of patients with ALS. While the FDA has recognized proof-of-principle data on therapeutic efficacy in highly characterized rodent models, the use of large animals is considered critical for validating the combination of a surgical procedure, a device, and the safety of a final therapy for human use. The size, anatomy, and general vulnerability of the spine and spinal cord of the swine are recognized to better model the human. Moreover, the surgical process of exposing and manipulating the spinal cord as well as closing the wound in the pig is virtually indistinguishable from the human. We believe that the healthy pig model represents a critical first step in the study of procedural safety. PMID:23242422

Federici, Thais; Hurtig, Carl V.; Burks, Kentrell L.; Riley, Jonathan P.; Krishna, Vibhor; Miller, Brandon A.; Sribnick, Eric A.; Miller, Joseph H.; Grin, Natalia; Lamanna, Jason J.; Boulis, Nicholas M.

2012-01-01

80

[Characteristics of anesthesia in patients with osteogenesis imperfecta undergoing orthopedic surgical procedures].  

PubMed

The aim is to show our experience in anesthesia of patients with osteogenesis imperfecta (OI) who have undergone orthopedic surgical procedures. This is a retrospective analysis of OI patients treated at our Department from 1980 to 2012. We analyzed demographics, comorbidities, preoperative characteristics, anesthesia types, anesthetics and intraoperative and postoperative complications. In the given period, 26 OI patients were treated, using 103 surgeries, and 103 anesthesia procedures. Most procedures, a total of 68, were used in children aged 0-10 years. According to the diagnosis, OI type III was mostly encountered. The rating of the American Society of Anesthesiologist (ASA) physical status was II in most cases, a total of 99. General anesthesia was used in 89 cases, and regional anesthesia in 14. Fourteen intraoperative complications were seen, mostly difficult intubation, and six postoperative cardiovascular instability cases. With careful preparation, and knowledge of pitfalls, anesthesia in these patients should be a safe procedure. PMID:25632774

Tripkovi?, Branko; Anti?evi?, Darko; Buljan, Melita; Jakovina-Blažekovi?, Sanja; Oreškovi?, Zrinka; Kubat, Ozren

2014-01-01

81

Development of a surgical procedure for implantation of a prototype suprachoroidal retinal prosthesis  

PubMed Central

Background Current surgical techniques for retinal prosthetic implantation require long and complicated surgery, which can increase the risk of complications and adverse outcomes. Method The suprachoroidal position is known to be an easier location to access surgically, and so this study aimed to develop a surgical procedure for implanting a prototype suprachoroidal retinal prosthesis. The array implantation procedure was developed in 14 enucleated eyes. A full-thickness scleral incision was made parallel to the intermuscular septum and superotemporal to the lateral rectus muscle. A pocket was created in the suprachoroidal space, and the moulded electrode array was inserted. The scleral incision was closed and scleral anchor point sutured. In 9 of the 14 eyes examined, the device insertion was obstructed by the posterior ciliary neurovascular bundle. Subsequently, the position of this neurovascular bundle in 10 eyes was characterized. Implantation and lead routing procedure was then developed in six human cadavers. The array was tunnelled forward from behind the pinna to the orbit. Next, a lateral canthotomy was made. Lead fixation was established by creating an orbitotomy drilled in the frontal process of the zygomatic bone. The lateral rectus muscle was detached, and implantation was carried out. Finally, pinna to lateral canthus measurements were taken on 61 patients in order to determine optimal lead length. Results These results identified potential anatomical obstructions and informed the anatomical fitting of the suprachoroidal retinal prosthesis. Conclusion As a result of this work, a straightforward surgical approach for accurate anatomical suprachoroidal array and lead placement was developed for clinical application. PMID:24330322

Saunders, Alexia L; Williams, Chris E; Heriot, Wilson; Briggs, Robert; Yeoh, Jonthan; Nayagam, David AX; McCombe, Mark; Villalobos, Joel; Burns, Owen; Luu, Chi D; Ayton, Lauren N; McPhedran, Michelle; Opie, Nicholas L; McGowan, Ceara; Shepherd, Robert K; Guymer, Robyn; Allen, Penelope J

2014-01-01

82

Isokinetic muscle assessment after treatment of pectoralis major muscle rupture using surgical or non-surgical procedures  

PubMed Central

INTRODUCTION: Rupture of the pectoralis major muscle appears to be increasing in athletes. However, the optimal treatment strategy has not yet been established. OBJECTIVES: To compare the isokinetic shoulder performance after surgical treatment to that after non-surgical treatment for pectoralis major muscle rupture. METHODS: We assessed 33 pectoralis major muscle ruptures (18 treated non-surgically and 15 treated surgically). Horizontal abduction and adduction as well as external and internal rotation at 60 and 120 degrees/s were tested in both upper limbs. Peak torque, total work, contralateral deficiency, and the peak torque agonist-to-antagonist ratio were measured. RESULTS: Contralateral muscular deficiency did not differ between the surgical and non-surgical treatment modalities. However, the surgical group presented twice the number of athletes with clinically acceptable contralateral deficiency (<20%) for internal rotators compared to the non-surgical group. The peak torque ratio between the external and internal rotator muscles revealed a similar deficit of the external rotation in both groups and on both sides (surgical, 61.60% and 57.80% and non-surgical, 62.06% and 54.06%, for the dominant and non-dominant sides, respectively). The peak torque ratio revealed that the horizontal adduction muscles on the injured side showed similar weakness in both groups (surgical, 86.27%; non-surgical, 98.61%). CONCLUSIONS: This study included the largest single series of athletes reported to date for this type of injury. A comparative analysis of muscular strength and balance showed no differences between the treatment modalities for pectoralis major muscle rupture. However, the number of significant clinical deficiencies was lower in the surgical group than in the non-surgical group, and both treatment modalities require greater attention to the rehabilitation process, especially for the recovery of muscle strength and balance. PMID:21484052

Fleury, Anna Maria; da Silva, Antonio Carlos; de Castro Pochini, Alberto; Ejnisman, Benno; de Lira, Claudio Andre Barbosa; dos Santos Andrade, Marilia

2011-01-01

83

The increasing number of surgical procedures for female genital fistula in England: Analysis of Hospital Episode Statistics (HES) data.  

PubMed

Abstract The aim of this study was to describe the number and trend of surgical procedures for female genital fistula in England. An online search of Hospital Episode Statistics (HES) data was carried out. Data were available for the 4-year period from 2002-03 until 2005-06. The total number of surgical procedures carried out for female genital fistula steadily increased by 28.7% from 616 in 2002-03 to 793 in 2005-06. The number of surgical procedures performed for rectovaginal fistula exceeded the total number of surgical procedures carried out for vesicovaginal and urethrovaginal fistula in each year of the study period. This pattern needs to be monitored and investigated further. PMID:25020114

Ismail, S I M F

2015-01-01

84

Surgical site infections following coronary artery bypass graft procedures: 10 years of surveillance data  

PubMed Central

Background Surgical site infections following coronary artery bypass graft (CABG) procedures pose substantial burden on patients and healthcare systems. This study aims to describe the incidence of surgical site infections and causative pathogens following CABG surgery over the period 2003–2012, and to identify risk factors for complex sternal site infections. Methods Routine computerised surveillance data were collected from three public hospitals in Queensland, Australia in which CABG surgery was performed between 2003 and 2012. Surgical site infection rates were calculated by types of infection (superficial/complex) and incision sites (sternal/harvest sites). Patient and procedural characteristics were evaluated as risk factors for complex sternal site infections using a logistic regression model. Results There were 1,702 surgical site infections (518 at sternal sites and 1,184 at harvest sites) following 14,546 CABG procedures performed. Among 732 pathogens isolated, Methicillin-sensitive Staphylococcus aureus accounted for 28.3% of the isolates, Pseudomonas aeruginosa 18.3%, methicillin-resistant Staphylococcus aureus 14.6%, and Enterobacter species 6.7%. Proportions of Gram-negative bacteria elevated from 37.8% in 2003 to 61.8% in 2009, followed by a reduction to 42.4% in 2012. Crude rates of complex sternal site infections increased over the reporting period, ranging from 0.7% in 2004 to 2.6% in 2011. Two factors associated with increased risk of complex sternal site infections were identified: patients with an ASA (American Society of Anaesthesiologists) score of 4 or 5 (reference score of 3, OR 1.83, 95% CI 1.36-2.47) and absence of documentation of antibiotic prophylaxis (OR 2.03, 95% CI 1.12-3.69). Conclusions Compared with previous studies, our data indicate the importance of Gram-negative organisms as causative agents for surgical site infections following CABG surgery. An increase in complex sternal site infection rates can be partially explained by the increasing proportion of patients with more severe underlying disease. PMID:24916690

2014-01-01

85

Extended Open Transgastric Necrosectomy (EOTN) as a Safer Procedure for Necrotizing Pancreatitis  

PubMed Central

The treatment of infected necrotizing pancreatitis has evolved from time to time and the success of surgical intervention depends on the timing of necrosectomy. Bacterial infection occurs in 40–70% of patients with necrotizing pancreatitis. Infection is the main risk factor for mortality among patients with pancreatic necrosis. Timely intervention is generally required for pancreatic necrosis but is now deferred until four weeks after disease onset in order to permit encapsulation and demarcation of the necrotic material. Demarcation facilitates necrosectomy and reduces complications related to the drainage and debridement procedures. The approach to pancreatic necrosectomy has evolved from primary open necrosectomy to minimally-invasive radiologic, surgical and endoscopic procedures. Direct endoscopic necrosectomy is a minimally-invasive technique that was introduced in recent years for the treatment of walled-off necrosis. The pancreas is approached through the posterior wall of stomach and debridement is done. PMID:25177603

Nidoni, Ravindra; Baloorkar, Ramakanth; Sindgikar, Vikram; Shankar, Bharat

2014-01-01

86

[From plastic surgery to space conquest. First microsurgical procedure and first surgical procedure in man during weightlessness].  

PubMed

The authors present their experience of surgery in weightlessness conditions. Russians and Americans already focused on that subject but two questions were still unsolved: what was the limit of human skill in these extreme conditions and was it possible to operate a human under total safety? Between 2003 and 2007, using a 0G plane for our experiment, we focused on two goals: firstly, the conception of a microsurgical module to test complex microsurgical procedures in rats and secondly, the construction of a surgical workstation with specific air filtration device and define surgical and anaesthetic protocols to carry on a surgery in man. In September 2003, we succeeded to perform the microscopic report of a 0,5mm artery (which is the smallest we can suture in terrestrial conditions) by using seven stitches of 10 x 0 monofilament suture. The 27th of September 2007, we removed a lipoma from the forearm of a 47-year-old man. These experiments take place in a wide program of development of telesurgery controlled through satellite transmission with all forthcoming civil, military and humanitarian applications. PMID:18930573

Martin, D; de Coninck, L; Pinsolle, V; Delia, G

2008-12-01

87

Surgical procedures and experimental outcomes of closed fractures in rodent models.  

PubMed

The closed fracture rat model, first described by Bonnarens and Einhorn, has been widely implemented in recent years to characterize various fracture phenotypes and evaluate treatment modalities. Slight modifications in the fixation depth, to reduce surgical error associated with movement/dislocation of the k-wire fixation, were previously described. Here, we describe this method which involves the creation of a medial parapatellar incision, dislocation of the patella, boring an 18 gauge hole through the center of the femur, delivery of an adjunct (if applicable), fixation of the k-wire in the greater trochanter of the femur, suturing of muscle and skin, and finally creation of the mid-diaphyseal fracture with a three-point bending fracture device. Many laboratories routinely perform surgical procedures in which a closed fracture is induced using rat or mouse models. The benefits of such surgical models range from general orthopaedic trauma applications to the assessment of the healing process in genetically modified animals. Other important applications include the assessment of the safety and efficacy of various treatment modalities as well as the characterization of bone repair in metabolic bone diseases or skeletal dysplasia. PMID:25331052

Drissi, Hicham; Paglia, David N

2015-01-01

88

Two surgical procedures for esophagogastric variceal bleeding in patients with portal hypertension  

PubMed Central

AIM: To determine the clinical value of a splenorenal shunt plus pericardial devascularization (PCVD) in portal hypertension (PHT) patients with variceal bleeding. METHODS: From January 2008 to November 2012, 290 patients with cirrhotic portal hypertension were treated surgically in our department for the prevention of gastroesophageal variceal bleeding: 207 patients received a routine PCVD procedure (PCVD group), and 83 patients received a PCVD plus a splenorenal shunt procedure (combined group). Changes in hemodynamic parameters, rebleeding, encephalopathy, portal vein thrombosis, and mortality were analyzed. RESULTS: The free portal pressure decreased to 21.43 ± 4.35 mmHg in the combined group compared with 24.61 ± 5.42 mmHg in the PCVD group (P < 0.05). The changes in hemodynamic parameters were more significant in the combined group (P < 0.05). The long-term rebleeding rate was 7.22% in the combined group, which was lower than that in the PCVD group (14.93%), (P < 0.05). CONCLUSION: Devascularization plus splenorenal shunt is an effective and safe strategy to control esophagogastric variceal bleeding in PHT. It should be recommended as a first-line treatment for preventing bleeding in PHT patients when surgical interventions are considered. PMID:24409071

Yang, Lin; Yuan, Li-Juan; Dong, Rui; Yin, Ji-Kai; Wang, Qing; Li, Tao; Li, Jiang-Bin; Du, Xi-Lin; Lu, Jian-Guo

2013-01-01

89

Multi-procedure management in an eyeglasses-related open globe injury  

PubMed Central

We present a case of successful multi-procedure management of a patient with an open globe injury. A 47-year-old man sustained an injury to his left eye caused by glass fragments of his own spectacles shattered while he was protecting an unknown woman from physical assault at a bus stop. Over a span of 65 months the patient underwent multiple procedures including primary wound repair, penetrating keratoplasty combined with extracapsular cataract extraction, neodymium: YAG laser capsulotomy, and laser-assisted subepithelial keratectomy (LASEK), and had a successfully treated episode of corneal graft rejection. This sequence of treatment substantially improved his left eye vision from hand movements at the time of admission to 0.9–0.5 × 90 at the last follow-up nearly 10 years after the trauma. Proper initial surgical management of an open globe injury can create the possibility for virtually complete vision restoration. PMID:24729818

Skopi?ski, Piotr; Langwi?ska-Wo?ko, Ewa; Korwin, Magdalena; Ko?odziejczyk, Wojciech; Ambroziak, Anna Maria

2014-01-01

90

Environmental impacts of surgical procedures: life cycle assessment of hysterectomy in the United States.  

PubMed

The healthcare sector is a driver of economic growth in the U.S., with spending on healthcare in 2012 reaching $2.8 trillion, or 17% of the U.S. gross domestic product, but it is also a significant source of emissions that adversely impact environmental and public health. The current state of the healthcare industry offers significant opportunities for environmental efficiency improvements, potentially leading to reductions in costs, resource use, and waste without compromising patient care. However, limited research exists that can provide quantitative, sustainable solutions. The operating room is the most resource-intensive area of a hospital, and surgery is therefore an important focal point to understand healthcare-related emissions. Hybrid life cycle assessment (LCA) was used to quantify environmental emissions from four different surgical approaches (abdominal, vaginal, laparoscopic, and robotic) used in the second most common major procedure for women in the U.S., the hysterectomy. Data were collected from 62 cases of hysterectomy. Life cycle assessment results show that major sources of environmental emissions include the production of disposable materials and single-use surgical devices, energy used for heating, ventilation, and air conditioning, and anesthetic gases. By scientifically evaluating emissions, the healthcare industry can strategically optimize its transition to a more sustainable system. PMID:25517602

Thiel, Cassandra L; Eckelman, Matthew; Guido, Richard; Huddleston, Matthew; Landis, Amy E; Sherman, Jodi; Shrake, Scott O; Copley-Woods, Noe; Bilec, Melissa M

2015-02-01

91

[Specialized surgical care for children (victims of the earthquake) with open injuries].  

PubMed

The article presents the authors' experience of providing specialized surgical care for 197 children who had been affected by the earthquake in Pakistan (2005), Indonesia (2006 and 2009) and Haiti (2010). All victims had open injuries of soft tissues and bones. The article recites the strategy and principles of work organization of the mobile team of specialists from the Research Institute of Clinical and Research Institute of Urgent Pediatric Surgery and Traumatology in disaster areas. It includes the creation of a center for specialized surgical care for children, consultative work in all regional hospitals to where victims are initially evacuated, transportation and concentration of children with the most severe injuries in a specialized center. The basic principles of interaction with the central and local public health authorities and medical staff of hospitals were developed. The main characteristics of such injuries and their complications were defined as well. Mistakes made by the local and international surgical teams at the stages of primary and specialized surgical care were described. The effectiveness of the applied strategy of active surgical treatment of open injuries of soft tissue and bones complicated by surgical infection has been analyzed. PMID:24429717

Roshal', L M; Mitish, V A; Medinski?, P V

2014-01-01

92

Balanced anesthesia with sevoflurane does not alter redox status in patients undergoing surgical procedures.  

PubMed

Despite the effectiveness and safety of anesthetics, some unanswered questions remain concerning their toxicity and effects on cellular redox balance. To test for possible toxic effects of balanced anesthesia maintained with the volatile anesthetic sevoflurane, we evaluated oxidative stress during and after general anesthesia in 15 adult patients without comorbidities who underwent elective minor surgical procedures. Venous blood samples were collected at baseline, before anesthesia (t0); after anesthesia induction and immediately before surgery (t1); 2h after the beginning of anesthesia (t2); and on the day following surgery (t3). Antioxidant defense was determined by fluorometry. Oxidative stress markers included oxidative DNA damage, evaluated by the alkaline comet assay, and plasma malondialdehyde (MDA), assessed by high performance liquid chromatography (HPLC). No increase in oxidized DNA damage or antioxidant defense was observed. Plasma MDA increased only at t3 compared with t2. Balanced sevoflurane-maintained anesthesia appears neither to damage DNA nor to alter redox status. PMID:25308703

Orosz, José Eduardo B; Braz, Leandro G; Ferreira, Ana Lucia A; Amorim, Rosa Beatriz; Salvadori, Daisy Maria F; Yeum, Kyung-Jin; Braz, José Reinaldo C; Braz, Mariana G

2014-10-01

93

The combined Collis gastroplasty-Nissen fundoplication: surgical procedure and radiographic evaluation.  

PubMed

The combined Collis gastroplasty-Nissen fundoplication consists of a combination of an esophagus-lengthening Collis gastroplasty with 360 degrees complete Nissen fundoplication operation. This report reviews the clinical and radiographic features of 60 consecutive patients who underwent this operation for the control of symptomatic gastroesophageal reflux. The surgical procedure, the technique of postoperative radiographic examination, normal radiographic anatomy, and abnormalities detectable radiographically are briefly described. All patients were examined on the seventh postoperative day initially with iodinated water-soluble contrast medium followed by barium to establish integrity of the gastroplasty tube, fundoplication wrap, and dilated esophageal stricture. Later in the postoperative period, elective barium esophagrams were prompted by complaints of dysphagia (three patients) and symptoms of gastroesophageal reflux (five patients). PMID:3875991

Agha, F P; Trenkner, S W; Orringer, M B; Vinh, P N

1985-10-01

94

AneuRx stent graft versus open surgical repair of abdominal aortic aneurysms: Multicenter prospective clinical trial  

Microsoft Academic Search

The results of a prospective, nonrandomized, multicenter clinical trial that compared endovascular stent graft exclusion of abdominal aortic aneurysms with open surgical repair are presented. During an 18-month period, 250 patients with infrarenal aneurysms underwent treatment at 12 study sites—190 patients underwent endovascular repair using the Medtronic AneuRx stent graft (Sunnyvale, Calif), and 60 underwent open surgical repair. There was

Christopher K. Zarins; Rodney A. White; Donald Schwarten; Edward Kinney; Edward B. Diethrich; Kim J. Hodgson; Thomas J. Fogarty

1999-01-01

95

Non-photorealistic rendering of virtual implant models for computer-assisted fluoroscopy-based surgical procedures  

NASA Astrophysics Data System (ADS)

Surgical navigation systems visualize the positions and orientations of surgical instruments and implants as graphical overlays onto a medical image of the operated anatomy on a computer monitor. The orthopaedic surgical navigation systems could be categorized according to the image modalities that are used for the visualization of surgical action. In the so-called CT-based systems or 'surgeon-defined anatomy' based systems, where a 3D volume or surface representation of the operated anatomy could be constructed from the preoperatively acquired tomographic data or through intraoperatively digitized anatomy landmarks, a photorealistic rendering of the surgical action has been identified to greatly improve usability of these navigation systems. However, this may not hold true when the virtual representation of surgical instruments and implants is superimposed onto 2D projection images in a fluoroscopy-based navigation system due to the so-called image occlusion problem. Image occlusion occurs when the field of view of the fluoroscopic image is occupied by the virtual representation of surgical implants or instruments. In these situations, the surgeon may miss part of the image details, even if transparency and/or wire-frame rendering is used. In this paper, we propose to use non-photorealistic rendering to overcome this difficulty. Laboratory testing results on foamed plastic bones during various computer-assisted fluoroscopybased surgical procedures including total hip arthroplasty and long bone fracture reduction and osteosynthesis are shown.

Zheng, Guoyan

2007-03-01

96

Multifactor Screener in OPEN: Scoring Procedures  

Cancer.gov

Scoring procedures were developed to convert a respondent's screener responses to estimates of individual dietary intake for percentage energy from fat, grams of fiber, and servings of fruits and vegetables, using USDA's 1994-96 Continuing Survey of Food Intakes of Individuals (CSFII 94-96) dietary recall data.

97

Percutaneous and open surgical repairs of Achilles tendon rupturesA comparative study  

Microsoft Academic Search

A comparative study between percutaneous repair and open surgical repair of acute spontaneous Achilles ten don ruptures in young athletic patients is presented. Twenty-seven patients with acute Achilles ruptures were evaluated objectively and with subjective ques tionnaires. Fifteen of the patients were treated by re construction with a gastrocsoleus fascial graft (fol lowup, 4.6 years) and 12 treated by percutaneous

James P. Bradley; James E. Tibone

1990-01-01

98

A Critical Analysis of Penile Enhancement Procedures for Patients with Normal Penile Size: Surgical Techniques, Success, and Complications  

Microsoft Academic Search

Context: Most men who request surgical penile enhancement have a normal-sized and fully functional penis but visualize their penises as small (psychological dysmor- phism). Objectives: The aim of this review is to describe the various reported techniques and to provide the available scientific data on the success and complication rates of penile enhancement procedures. Evidence acquisition: We performed an extensive

Yoram Vardi; Yaron Harshai; Tamir Gil; Ilan Gruenwald

2008-01-01

99

Abstract--Image-guided and robot-assisted minimally invasive surgical procedures are rapidly evolving due to their  

E-print Network

MRI-guided and robot-assisted surgeries on the free-beating heart. To implement this CPS weAbstract--Image-guided and robot-assisted minimally invasive surgical procedures are rapidly evolving due to their improved patient management and potential cost effectiveness. Currently, robot

Deng, Zhigang

100

Surgical Procedures of the Elbow: A Nationwide Cross-Sectional Observational Study in the United States  

PubMed Central

Background: Elbow surgery is shared by several subspecialties. We were curious about the most common elbow surgeries and their corresponding diagnoses in the United States. Methods: We used the National Hospital Discharge Survey (NHDS) and the National Survey of Ambulatory Surgery (NSAS) data gathered in 2006-databases that together provide an estimate of all inpatient and ambulatory surgical care in the US. Results: An estimated 150,000 elbow surgeries were performed in the US in 2006, 75% in an outpatient setting. The most frequent diagnosis treated operative was enthesopathy (e.g. lateral epicondylitis) and it was treated with several different procedures. More than three quarters of all elbow surgeries treated enthesopathy, cubital tunnel syndrome, or fracture (radial head in particular). Arthroscopy and arthroplasty accounted for less than 10% of all elbow surgeries. Conclusions: Elbow surgery in the United States primarily addresses enthesopathies such as tennis elbow, cubital tunnel syndrome, and trauma. It is notable that some of the most common elbow surgeries (those that address enthesopathy and radial head fracture) are some of the most variably utilized and debated.

Kinaci, Ahmet; Neuhaus, Valentin; Ring, David

2015-01-01

101

Development of a Mass Spectrometry Sampling Probe for Chemical Analysis in Surgical and Endoscopic Procedures  

PubMed Central

A sampling probe based on ambient desorption ionization was designed for in-vivo chemical analysis by mass spectrometry in surgical and endoscopic procedures. Sampling ionization of analytes directly from tissue was achieved by sealing the sampling tip against the tissue surface without allowing leakage of the auxiliary gas used for desorption ionization. The desorbed charged species were transferred over a long distance (up to 4 m) through a flexible tube of internal diameter as small as 1/16 inch to the inlet of the mass spectrometer used for analysis. The conditions used for desorption electrospray ionization (DESI) were optimized to achieve biocompatibility for clinical applications while obtaining adequate efficiency for the analysis. This optimization involved removal of high voltage and use of pure water as spray solvent instead of the organic solvents or aqueous mixtures normally used. Improved sensitivity was achieved under these conditions by increasing the gas flow rate in the transfer tube. The destructive effect on tissue surfaces associated with typical desorption ionization was avoided by altering the local gas dynamics in the sample area without compromising the overall analysis efficiency. PMID:24251679

Chen, Chien-Hsun; Lin, Ziqing; Garimella, Sandilya; Zheng, Lingxing; Shi, Riyi; Cooks, R. Graham; Ouyang, Zheng

2014-01-01

102

Galen: a third generation terminology tool to support a multipurpose national coding system for surgical procedures.  

PubMed

GALEN has developed a new generation of terminology tools based on a language independent concept reference model using a compositional formalism allowing computer processing and multiple reuses. During the 4th framework program project Galen-In-Use we applied the modelling and the tools to the development of a new multipurpose coding system for surgical procedures (CCAM) in France. On one hand we contributed to a language independent knowledge repository for multicultural Europe. On the other hand we support the traditional process for creating a new coding system in medicine which is very much labour consuming by artificial intelligence tools using a medically oriented recursive ontology and natural language processing. We used an integrated software named CLAW to process French professional medical language rubrics produced by the national colleges of surgeons into intermediate dissections and to the Grail reference ontology model representation. From this language independent concept model representation on one hand we generate controlled French natural language to support the finalization of the linguistic labels in relation with the meanings of the conceptual system structure. On the other hand the classification manager of third generation proves to be very powerful to retrieve the initial professional rubrics with different categories of concepts within a semantic network. PMID:10725030

Trombert-Paviot, B; Rodrigues, J M; Rogers, J E; Baud, R; van der Haring, E; Rassinoux, A M; Abrial, V; Clavel, L; Idir, H

1999-01-01

103

The orthodontic-surgical correction of a Class II malocclusion with anterior open bite  

Microsoft Academic Search

This is the case report of a 39-year-old woman who presented with a skeletal Class II malocclusion, anterior open bite, and chronic temporomandibular disorder. Small maxillary lateral incisors and moderate mandibular anterior crowding led to the treatment plan, which involved extraction of a mandibular incisor. A combined orthodontic-surgical treatment plan resulted in greatly improved occlusal function and in a reduction

Gayle Glenn

1996-01-01

104

Ultrasound-guided radiofrequency thermal ablation of liver tumors: Percutaneous, laparoscopic, and open surgical approaches  

Microsoft Academic Search

Only 10% to 20% of patients with primary and colorectal metastatic liver tumors are candidates for curative surgical resection.\\u000a Even after curative treatment, tumors recur commonly in the liver. As a less invasive therapy, radiofrequency thermal ablation\\u000a (RFA) of primary, metastatic, and recurrent liver tumors was performed under percutaneous, laparoscopic, or open intraoperative\\u000a ultrasound guidance. The safety and local control

Junji Machi; Shinji Uchida; Kenneth Sumida; Whitney M. L. Limm; Scott A. Hundahl; Andrew J. Oishi; Nancy L. Furumoto; Robert H. Oishi

2001-01-01

105

The prophylactic use of C1 inhibitor in hereditary angioedema patients undergoing invasive surgical procedures: a retrospective study  

PubMed Central

Background Hereditary Angioedema (HAE) is a rare autosomal dominant condition characterized by episodic angioedema, which may be triggered by invasive procedures and surgery. C1 inhibitor (C1 INH) was approved in the United States and Canada in 2009 and 2010, respectively, for the treatment of acute attacks. Most recently in April 2013, it was approved in Europe for short-term prophylaxis (STP), prior to medical, dental, or surgical procedures, to prevent HAE attacks in both children and adults. Currently, C1 INH is not approved in Canada or the United States for STP of HAE attacks. Our objective was to demonstrate the effectiveness of C1 INH as a short-term prophylactic treatment for patients with Type I HAE undergoing invasive surgical procedures. Methods A retrospective chart review between 1997-2013 was performed at one Canadian Tertiary Care Allergy and Asthma Clinic affiliated with The Ottawa Hospital, in Ottawa, Canada. The standard dose of C1 INH for STP was 10 or 20 U/kg. Results In all 24 procedures, there were no post-procedure HAE attacks after short-term prophylactic administration of C1 INH. Conclusions In this retrospective chart review at one tertiary care Allergy and Clinical Immunology Clinic, short-term prophylactic use of C1 INH was found to be effective at preventing post-procedure HAE attacks, in patients diagnosed with Type I HAE. PMID:24772176

2014-01-01

106

GALEN: a third generation terminology tool to support a multipurpose national coding system for surgical procedures.  

PubMed

Generalised architecture for languages, encyclopedia and nomenclatures in medicine (GALEN) has developed a new generation of terminology tools based on a language independent model describing the semantics and allowing computer processing and multiple reuses as well as natural language understanding systems applications to facilitate the sharing and maintaining of consistent medical knowledge. During the European Union 4 Th. framework program project GALEN-IN-USE and later on within two contracts with the national health authorities we applied the modelling and the tools to the development of a new multipurpose coding system for surgical procedures named CCAM in a minority language country, France. On one hand, we contributed to a language independent knowledge repository and multilingual semantic dictionaries for multicultural Europe. On the other hand, we support the traditional process for creating a new coding system in medicine which is very much labour consuming by artificial intelligence tools using a medically oriented recursive ontology and natural language processing. We used an integrated software named CLAW (for classification workbench) to process French professional medical language rubrics produced by the national colleges of surgeons domain experts into intermediate dissections and to the Grail reference ontology model representation. From this language independent concept model representation, on one hand, we generate with the LNAT natural language generator controlled French natural language to support the finalization of the linguistic labels (first generation) in relation with the meanings of the conceptual system structure. On the other hand, the Claw classification manager proves to be very powerful to retrieve the initial domain experts rubrics list with different categories of concepts (second generation) within a semantic structured representation (third generation) bridge to the electronic patient record detailed terminology. PMID:10978911

Trombert-Paviot, B; Rodrigues, J M; Rogers, J E; Baud, R; van der Haring, E; Rassinoux, A M; Abrial, V; Clavel, L; Idir, H

2000-09-01

107

Long-term total parenteral nutrition and cholecystostomy tube in a rabbit model surgical procedure: management and preliminary results  

Microsoft Academic Search

A rabbit model for long-term total parenteral nutrition (TPN), specially provided with cholecystostomy tube, was designed\\u000a to investigate further aspects of TPN-associated cholestasis (TPN-AC). Modified surgical procedures concerning vascular access,\\u000a cholecystostomy tube implantation and authors' original modalities for prolonged infusion management in the rabbit were used.\\u000a Continuous TPN was performed in 30 young rabbits. Five animals died during the experiment

D. Zovko; S. Loff; A. Dzakovic; B. Kränzlin; H.-P. Hohl; S. Grün; K.-L. Waag

1996-01-01

108

MD Anderson study finds African American women with breast cancer less likely to have newer, recommended surgical procedure  

Cancer.gov

African American women with early stage, invasive breast cancer were 12 percent less likely than Caucasian women with the same diagnosis to receive a minimally invasive technique, axillary sentinel lymph node (SLN) biopsy, years after the procedure had become the standard of surgical practice, according to research from The University of Texas MD Anderson Cancer Center. The study, presented at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium, also found that those African American women who underwent the older, more invasive procedure, axillary lymph node (ALN) dissection, had higher rates of lymphedema.

109

The surgical treatment of children with congenital convex foot (vertical talus): evaluation of midtarsal surgical release and open reduction.  

PubMed

In this study we evaluated the results of midtarsal release and open reduction for the treatment of children with convex congenital foot (CCF) (vertical talus) and compared them with the published results of peritalar release. Between 1977 and 2009, a total of 22 children (31 feet) underwent this procedure. In 15 children (48%) the CCF was isolated and in the remainder it was not (seven with arthrogryposis, two with spinal dysraphism, one with a polymalformative syndrome and six with an undefined neurological disorder). Pre-operatively, the mean tibiotalar angle was 150.2° (106° to 175°) and the mean calcaneal pitch angle was -19.3° (-72° to 4°). The procedure included talonavicular and calcaneocuboid joint capsulotomies, lengthening of tendons of tibialis anterior and the extensors of the toes, allowing reduction of the midtarsal joints. Lengthening of the Achilles tendon was necessary in 23 feet (74%). The mean follow-up was 11 years (2 to 21). The results, as assessed by the Adelaar score, were good in 24 feet (77.4%), fair in six (19.3%) and poor in one foot (3.3%), with no difference between those with isolated CCF and those without. The mean American Orthopaedic Foot and Ankle Society midfoot score was 89.9 (54 to 100) and 77.8 (36 to 93) for those with isolated CCF and those without, respectively. At the final follow-up, the mean tibiotalar (120°; 90 to 152) and calcaneal pitch angles (4°; -13 to 22) had improved significantly (p < 0.0001). Dislocation of the talonavicular and calcaneocuboid joints was completely reduced in 22 (70.9%) and 29 (93.6%) of feet, respectively. Three children (five feet) underwent further surgery at a mean of 8.5 years post-operatively, three with pes planovalgus and two in whom the deformity had been undercorrected. No child developed avascular necrosis of the talus. Midtarsal joint release and open reduction is a satisfactory procedure, which may provide better results than peritalar release. Complications include the development of pes planovalgus and persistent dorsal subluxation of the talonavicular joint. PMID:24891587

Ramanoudjame, M; Loriaut, P; Seringe, R; Glorion, C; Wicart, P

2014-06-01

110

A Human Factors Analysis of Technical and Team Skills Among Surgical Trainees During Procedural Simulations in a Simulated Operating Theatre  

PubMed Central

Background: High-risk organizations such as aviation rely on simulations for the training and assessment of technical and team performance. The aim of this study was to develop a simulated environment for surgical trainees using similar principles. Methods: A total of 27 surgical trainees carried out a simulated procedure in a Simulated Operating Theatre with a standardized OR team. Observation of OR events was carried out by an unobtrusive data collection system: clinical data recorder. Assessment of performance consisted of blinded rating of technical skills, a checklist of technical events, an assessment of communication, and a global rating of team skills by a human factors expert and trained surgical research fellows. The participants underwent a debriefing session, and the face validity of the simulated environment was evaluated. Results: While technical skills rating discriminated between surgeons according to experience (P = 0.002), there were no differences in terms of the checklist and team skills (P = 0.70). While all trainees were observed to gown/glove and handle sharps correctly, low scores were observed for some key features of communication with other team members. Low scores were obtained by the entire cohort for vigilance. Interobserver reliability was 0.90 and 0.89 for technical and team skills ratings. Conclusions: The simulated operating theatre could serve as an environment for the development of surgical competence among surgical trainees. Objective, structured, and multimodal assessment of performance during simulated procedures could serve as a basis for focused feedback during training of technical and team skills. PMID:16244534

Moorthy, Krishna; Munz, Yaron; Adams, Sally; Pandey, Vikas; Darzi, Ara

2005-01-01

111

Surgical Outcomes of 2041 Consecutive Laparoscopic Gastrectomy Procedures for Gastric Cancer: A Large-Scale Case Control Study  

PubMed Central

Background Laparoscopic gastrectomy (LG) for gastric cancer has increased in popularity due to advances in surgical techniques. The aim of this study is to validate the efficacy and safety of laparoscopic gastrectomy for gastric cancer compared with open gastrectomy (OG). Methods The study comprised 3,580 patients who were treated with curative intent either by laparoscopic gastrectomy (2,041 patients) or open gastrectomy (1,539 patents) between January 2005 and October 2013. The surgical outcomes were compared between the two groups. Results Laparoscopic gastrectomy was associated with significantly less blood loss, transfused patient number, time to ground activities, and post-operative hospital stay, but with similar operation time, time to first flatus, and time to resumption of diet, compared with the open gastrectomy. No significant difference in the number of lymph nodes dissected was observed between these two groups. The morbidity and mortality rates of the LG group were comparable to those of the OG group (13.6% vs. 14.4%, P = 0.526, and 0.3% vs. 0.2%, P = 0.740). The 3-year disease-free and overall survival rates between the two groups were statistically significant (P<0.05). According to the UICC TNM classification of gastric cancer, the 3-year disease-free and overall survival rates were not statistically different at each stage. Conclusions Our single-center study of a large patient series revealed that LG for gastric cancer yields comparable surgical outcomes. This result was also true of local advanced gastric cancer (AGC). A well-designed randomized controlled trial comparing surgical outcomes between LG and OG in a larger number of patients for AGC can be carried out. PMID:25642698

Lin, Jian-Xian; Huang, Chang-Ming; Zheng, Chao-Hui; Li, Ping; Xie, Jian-Wei; Wang, Jia-Bin; Lu, Jun; Chen, Qi-Yue; Cao, Long-Long; Lin, Mi

2015-01-01

112

AneuRx stent graft versus open surgical repair of abdominal aortic aneurysms: Multicenter prospective clinical trial  

Microsoft Academic Search

The results of a prospective, nonrandomized, multicenter clinical trial that compared endovascular stent graft exclusion of abdominal aortic aneurysms with open surgical repair are presented. During an 18-month period, 250 patients with infrarenal aneurysms underwent treatment at 12 study sites—190 patients underwent endovascular repair using the Medtronic AneuRx stent graft (Sunnyvale, Calif), and 60 underwent open sur- gical repair. There

Christopher K. Zarins; Rodney A. White; Donald Schwarten; Edward Kinney; Edward B. Diethrich; Kim J. Hodgson; Thomas J. Fogarty

113

A comparison of open and percutaneous techniques in the surgical treatment of tennis elbow.  

PubMed

We conducted a prospective, randomised, controlled trial of 45 patients (47 elbows), with tennis elbow, who underwent either a formal open release or a percutaneous tenotomy. All patients had pre- and post-operative assessment using the Disability of Arm, Shoulder and Hand (DASH) scoring system. Both groups were followed up for a minimum of 12 months. Statistical analyses using the Mann-Whitney U test and repeated measured ANOVA showed significant improvements for patient satisfaction (p = 0.012), time to return to work (p = 0.0001), improvements in DASH score (p = 0.001) and improvement in sporting activities (p = 0.046) in the percutaneous group. Those patients undergoing a percutaneous release returned to work on average three weeks earlier and improved significantly more quickly than those undergoing an open procedure. The percutaneous procedure is a quicker and simpler procedure to undertake and produces significantly better results. PMID:15274267

Dunkow, P D; Jatti, M; Muddu, B N

2004-07-01

114

Management of asymptomatic carotid stenosis in patients undergoing general and vascular surgical procedures  

PubMed Central

Current available data do not seem to support the strategy for carotid endarterectomy prior to surgical intervention in patients with asymptomatic carotid stenosis. However, in patients with coronary artery disease, synchronous carotid endarterectomy and coronary artery bypass grafting should be considered where there is a proven surgical risk of <3% with unilateral asymptomatic stenosis >60% or bilateral carotid stenosis >75% on the same side as the most severe stenosis. Clarification of the optimal strategy requires an adequately powered, multicentre, randomised clinical trial. PMID:16170071

Paciaroni, M; Caso, V; Acciarresi, M; Baumgartner, R; Agnelli, G

2005-01-01

115

[Peculiarities of surgical care in case of open injuries of limbs in emergency situations in peacetime].  

PubMed

It was done the comparative analysis of treatment results of casualties with open injuries of limbs in emergency situations in peacetime. It was determined that traditional approach of field surgery is unacceptable for this group of casualties. It is connected with limitations of evacuation and high frequency of complications. The developed modified surgical protocol permits not only to provide specialized care to casualties with soft tissue trauma and open fracture of limbs but also to reduce frequency of deep suppuration in 1.9 times. Also it allows to decrease number of dressings for one patient and period of the wound defect preparation to reconstructive plastic surgeries in 2.6 and 1.5 times respectively. PMID:24874226

Dubrov, V É; Mitish, V A; Kobritsov, G P; Shabanov, V É; Ba?ramov, Sh A; Khanin, M Iu

2014-01-01

116

Sufficiency of Clinical Literature on the Appropriate Uses of Six Medical and Surgical Procedures  

PubMed Central

We reviewed the English-language clinical literature on carotid endarterectomy, cholecystectomy, upper gastrointestinal endoscopy, colonoscopy, coronary angiography and coronary artery bypass graft procedure to identify the appropriateness of using these procedures in 1981. Most of the 803 relevant articles and textbooks were published after 1975; about 10% of the 571 research studies were randomized, controlled trials, while two thirds were retrospective studies. Incomplete or contradictory information was available on the indications for and efficacy of using the procedures; almost no data were available on costs and use; data on complications failed to specify patients' symptoms or the relationship between complications and reasons for doing the procedure. PMID:3501201

Fink, Arlene; Brook, Robert H.; Kosecoff, Jacqueline; Chassin, Mark R.; Solomon, David H.

1987-01-01

117

Evidence based medicine and surgical approaches for colon cancer: Evidences, benefits and limitations of the laparoscopic vs open resection  

PubMed Central

AIM: To report a meta-analysis of the studies that compared the laparoscopic with the open approach for colon cancer resection. METHODS: Forty-seven manuscripts were reviewed, 33 of which employed for meta-analysis according to the PRISMA guidelines. The results were differentiated according to the study design (prospective randomized trials vs case-control series) and according to the tumor’s location. Outcome measures included: (1) short-term results (operating times, blood losses, bowel function recovery, post-operative pain, return to the oral intake, complications and hospital stay); (2) oncological adequateness (number of nodes harvested in the surgical specimens); and (3) long-term results (including the survivals’ rates and incidence of incisional hernias) and (4) costs. RESULTS: Meta-analysis of trials provided evidences in support of the laparoscopic procedures for a several short-term outcomes including: a lower blood loss, an earlier recovery of the bowel function, an earlier return to the oral intake, a shorter hospital stay and a lower morbidity rate. Opposite the operating time has been confirmed shorter in open surgery. The same trend has been reported investigating case-control series and cancer by sites, even though there are some concerns regarding the power of the studies in this latter field due to the small number of trials and the small sample of patients enrolled. The two approaches were comparable regarding the mean number of nodes harvested and long-term results, even though these variables were documented reviewing the literature but were not computable for meta-analysis. The analysis of the costs documented lower costs for the open surgery, however just few studies investigated the incidence of post-operative hernias. CONCLUSION: Laparoscopy is superior for the majority of short-term results. Future studies should better differentiate these approaches on the basis of tumors’ location and the post-operative hernias. PMID:24707154

Lorenzon, Laura; La Torre, Marco; Ziparo, Vincenzo; Montebelli, Francesco; Mercantini, Paolo; Balducci, Genoveffa; Ferri, Mario

2014-01-01

118

The meniscus tear: state of the art of rehabilitation protocols related to surgical procedures  

PubMed Central

Summary Meniscal injuries represent one of the most frequent lesions in sport practicing and in particular in soccer players and skiers. Pain, functional limitation and swelling are typical symptoms associated with meniscal tears. Epidemiological studies showed that all meniscal lesions, in different sports athletes, involves 24% of medial meniscus, while 8% of lateral meniscus and about 20–30% of meniscal lesions are associated with other ligament injuries. Meniscal tears can be treated conservatively or surgically. Surgery leads in many cases to complete resolution of symptoms and allows the return to sport activity. However many studies show that this treatment can induce more frequently the development of degenerative conditions if not correctly associated to a specific rehabilitation protocol. The aim of this article is to compare different timing in specific rehabilitation programs related to the most actual surgical options. PMID:23738313

Frizziero, Antonio; Ferrari, Raffaello; Giannotti, Erika; Ferroni, Costanza; Poli, Patrizia; Masiero, Stefano

2012-01-01

119

Surgical treatment of infective endocarditis in active intravenous drug users: a justified procedure?  

PubMed Central

Background Infective endocarditis is a life threatening complication of intravenous drug abuse, which continues to be a major burden with inadequately characterised long-term outcomes. We reviewed our institutional experience of surgical treatment of infective endocarditis in active intravenous drug abusers with the aim of identifying the determinants long-term outcome of this distinct subgroup of infective endocarditis patients. Methods A total of 451 patients underwent surgery for infective endocarditis between January 1993 and July 2013 at the University Hospital of Heidelberg. Of these patients, 20 (7 female, mean age 35?±?7.7 years) underwent surgery for infective endocarditis with a history of active intravenous drug abuse. Mean follow-up was 2504?±?1842 days. Results Staphylococcus aureus was the most common pathogen detected in preoperative blood cultures. Two patients (10%) died before postoperative day 30. Survival at 1, 5 and 10 years was 90%, 85% and 85%, respectively. Freedom from reoperation was 100%. Higher NYHA functional class, higher EuroSCORE II, HIV infection, longer operating time, postoperative fever and higher requirement for red blood cell transfusion were associated with 90-day mortality. Conclusions In active intravenous drug abusers, surgical treatment for infective endocarditis should be performed as extensively as possible and be followed by an aggressive postoperative antibiotic therapy to avoid high mortality. Early surgical intervention is advisable in patients with precipitous cardiac deterioration and under conditions of staphylococcal endocarditis. However, larger studies are necessary to confirm our preliminary results. PMID:24661344

2014-01-01

120

A review article on the benefits of early mobilization following spinal surgery and other medical/surgical procedures  

PubMed Central

Background: The impact of early mobilization on perioperative comorbidities and length of stay (LOS) has shown benefits in other medical/surgical subspecialties. However, few spinal series have specifically focused on the “pros” of early mobilization for spinal surgery, other than in acute spinal cord injury. Here we reviewed how early mobilization and other adjunctive measures reduced morbidity and LOS in both medical and/or surgical series, and focused on how their treatment strategies could be applied to spinal patients. Methods: We reviewed studies citing protocols for early mobilization of hospitalized patients (day of surgery, first postoperative day/other) in various subspecialties, and correlated these with patients’ perioperative morbidity and LOS. As anticipated, multiple comorbid factors (e.g. hypertension, high cholesterol, diabetes, hypothyroidism, obesity/elevated body mass index hypothyroidism, osteoporosis, chronic obstructive pulmonary disease, coronary artery disease and other factors) contribute to the risks and complications of immobilization for any medical/surgical patient, including those undergoing spinal procedures. Some studies additionally offered useful suggestions specific for spinal patients, including prehabilitation (e.g. rehabilitation that starts prior to surgery), preoperative and postoperative high protein supplements/drinks, better preoperative pain control, and early tracheostomy, while others cited more generalized recommendations. Results: In many studies, early mobilization protocols reduced the rate of complications/morbidity (e.g. respiratory decompensation/pneumonias, deep venous thrombosis/pulmonary embolism, urinary tract infections, sepsis or infection), along with the average LOS. Conclusions: A review of multiple medical/surgical protocols promoting early mobilization of hospitalized patients including those undergoing spinal surgery reduced morbidity and LOS. PMID:24843814

Epstein, Nancy E.

2014-01-01

121

Early open radical commissurotomy: surgical treatment of choice for mitral stenosis.  

PubMed

Between 1967 and 1979, 411 patients underwent surgical treatment of isolated mitral stenosis at our institution. Open radical mitral commissurotomy was performed in 150 patients (1967-1978; mean follow-up, 46 months; range, 4 to 116 months). Mitral valve replacement using a porcine prosthesis was performed in 74 patients (1976-1979; mean follow-up, 23 months; range, 2 to 48 months). Mitral valve replacement with a cloth-covered Starr-Edwards prosthesis was performed in 187 patients (1967-1975; mean follow-up, 45 months; range, 2 to 106 months). Preoperative characteristics were similar in the three groups. The open commissurotomy and Starr-Edwards groups were followed up to 9 years and the porcine valve group up to 4 years, with 97% follow-up in each group. Life-table analysis (6-month intervals) of all postoperative complications revealed significantly greater complication-free survival for patients who had open radical commissurotomy compared with Starr-Edwards (p less than 0.05) valve replacement. Similar analysis of thromboembolic and warfarin-related complications revealed significantly fewer complications in commissurotomy patients. No significant differences were found (p greater than 0.05) when comparing the need for subsequent reoperation in each group. Operative mortality following open radical mitral commissurotomy (0%; 0 out of 150) was significantly less (p less than 0.05) than after mitral valve replacement in both porcine (8.1%; 6 out of 74) and Starr-Edwards (11.2%; 21 out out 187) groups. Life-table analysis of late cardiac-related mortality revealed a significantly greater cumulative survival rate for the commissurotomy versus the Starr-Edwards groups at all intervals from 12 to 108 months (100 versus 84 +/- 5%, p less than 0.05). No significant differences were noted between commissurotomy and porcine valve groups during the 4-year follow-up period (100 +/- 0% versus 96 +/- 3%, p greater than 0.05). Based on these findings, we conclude that when the anatomy is favorable, the surgical treatment of choice for isolated mitral stenosis is open radical mitral commissurotomy. PMID:7114947

Laschinger, J C; Cunningham, J N; Baumann, F G; Isom, O W; Catinella, F P; Mendelsohn, A; Adams, P X; Spencer, F C

1982-09-01

122

A SURGICAL PROCEDURE USING SHEEP AS AN ANIMAL MODEL TO EVALUATE OSSEOINTEGRATION Um procedimento cirúrgico utilizando a ovelha como modelo animal para avaliar ossointegração  

Microsoft Academic Search

The aim of this paper is to describe a technical sequence of procedures, including anesthesia and surgery steps to adopt as standard surgical procedures using an animal model to evaluate the osseointegration phenomenon and perform the histological analysis after animal deaths at different healing times. In a macroscopic analysis the novel coin-shaped design of titanium implants intended to improve the

Alexandre Cunha; Renata Pedrolli Renz; Gleisse Wantowski; Rogério Belle de Oliveira; Eduardo Blando; Roberto Hübler

123

Metabolic and Behavioral Deficits Following a Routine Surgical Procedure in Rats  

PubMed Central

To test the hypothesis that functional metabolic deficits observed following surgical brain injury are associated with changes in cognitive performance in rodents, we performed serial imaging studies in parallel with behavioral measures in control animals and in animals with surgical implants. Memory function was assessed using the novel object recognition (NOR) test, administered 3 days prior to and 3, 7, 14, and 56 days after surgery. At each time point, general locomotion was also measured. Metabolic imaging with 18F-fluorodeoxyglucose ([18F]FDG) occurred 28 and 58 days after surgery. Animals with surgical implants performed significantly worse on tests of object recognition, while general locomotion was unaffected by the implant. There was a significant decrease in glucose uptake after surgery in most of the hemisphere ipsilateral to the implant relative to the contralateral hemisphere. At both time points, the most significant metabolic deficits occurred in the primary motor cortex (-25%; p<0.001), sensory cortex (-15%, p<0.001) and frontal cortex (-12%; p<0.001). Ipsilateral areas further from the site of insertion became progressively worse, including the sensory cortex, dorsal striatum and thalamus. This data was supported by a voxel-based analysis of the PET data, which revealed again a unilateral decrease in [18F]FDG uptake that extended throughout the ipsilateral cortex and persisted for the duration of the 58-day study. Probe implantation in the striatum results in a widespread and long lasting decline in cortical glucose metabolism together with a persistent, injury-related deficit in the performance of a cognitive (object recognition) task in rats. PMID:17346680

Frumberg, David B.; Fernando, Marion S.; Lee, Dianne E.; Biegon, Anat; Schiffer, Wynne K.

2009-01-01

124

High-speed 3-dimensional imaging in robot-assisted thoracic surgical procedures.  

PubMed

We used a high-speed 3-dimensional (3D) image analysis system (SYNAPSE VINCENT, Fujifilm Corp, Tokyo, Japan) to determine the best positioning of robotic arms and instruments preoperatively. The da Vinci S (Intuitive Surgical Inc, Sunnyvale, CA) was easily set up accurately and rapidly for this operation. Preoperative simulation and intraoperative navigation using the SYNAPSE VINCENT for robot-assisted thoracic operations enabled efficient planning of the operation settings. The SYNAPSE VINCENT can detect the tumor location and depict surrounding tissues quickly, accurately, and safely. This system is also excellent for navigational and educational use. PMID:24882302

Kajiwara, Naohiro; Akata, Soichi; Hagiwara, Masaru; Yoshida, Koichi; Kato, Yasufumi; Kakihana, Masatoshi; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

2014-06-01

125

Surgical treatment of odontogenic myxoma and facial deformity in the same procedure.  

PubMed

Odontogenic myxoma (OM) is an uncommon benign tumor with aggressive and invasive behavior. Predominant symptoms are usually slow and painless swelling, sometimes resulting in perforation of the cortical borders of the affected bone. In this paper, a case report of a patient with an OM on the right maxillary sinus and a vertical excess of maxilla will be presented. The treatment chosen was tumor resection in association with orthognathic surgery with biomodels assessment for surgical planning. A 3-year follow-up showed disease free and stability of the new position of maxilla. The international literature is evaluated to discuss this case report. PMID:24124313

Mayrink, Gabriela; Luna, Anibal Henrique Barbosa; Olate, Sergio; Asprino, Luciana; De Moraes, Marcio

2013-07-01

126

Surgical sterilization: an underutilized procedure for evaluating the merits of induced sterility  

USGS Publications Warehouse

Despite more than 4 decades of effort, development of effective wildlife damage control programs based on sterilization of target species has met with limited success. This is partly due to the fact that investigators have assumed, rather than empirically tested, whether the reproductive strategies of the target populations were vulnerable to the planned treatment. Equally important, methods selected to include sterility usually involve a chemical agent that can affect sociosexual behaviors of the nuisance population. In this report, we illustrate how surgically induced sterility circumvents both problems--how the concept without the potentially confounding secondary effects of a chemical. We assessed the merits of initiating research to develop a male chemosterilant for Norway rats, red-winged blackbirds, beaver, and Canada geese by inducing sterility surgically. The infidelity of many red-winged females to their polygynous territorial male was surprising and argued against searching for a male sterilant. On the other hand, beaver and Canada goose studies confirmed previous reports that both form par-bonds and are monogamous. Both should be vulnerable to a male chemosterilant approach, and research toward this goal is justified.

Kennelly, James J.; Converse, Kathryn A.

1993-01-01

127

Management of Infections with Rapidly Growing Mycobacteria after Unexpected Complications of Skin and Subcutaneous Surgical Procedures  

PubMed Central

Background Infection caused by rapidly growing mycobacteria (RGM) is not uncommon, and the prevalence of RGM infection has been increasing. Clinical diagnosis is difficult because there are no characteristic clinical features. There is also no standard antibiotic regimen for treating RGM infection. A small series of patients with RGM infections was studied to examine their treatments and outcomes. Methods A total of 5 patients who had developed postoperative infections from January 2009 to December 2010 were retrospectively reviewed. Patients were initially screened using a mycobacteria rapid screening test (polymerase chain reaction [PCR]-reverse blot hybridization assay). To confirm mycobacterial infection, specimens were cultured for nontuberculous mycobacteria and analyzed by 16 S ribosomal RNA and rpoB gene PCR. Results The patients were treated with intravenous antibiotics during hospitalization, and oral antibiotics were administered after discharge. The mean duration of follow-up was 9 months, and all patients were completely cured of infection with a regimen of a combination of antibiotics plus surgical treatment. Although none of the patients developed recurrence, there were complications at the site of infection, including hypertrophic scarring, pigmentation, and disfigurement. Conclusions Combination antibiotic therapy plus drainage of surgical abscesses appeared to be effective for the RGM infections seen in our patients. Although neither the exact dosage nor a standardized regimen has been firmly established, we propose that our treatment can provide an option for the management of rapidly growing mycobacterial infection. PMID:22783486

Lim, Jong Min; Kim, Jong Hwan

2012-01-01

128

Ten to 14Year Follow-up of the Nirschl Surgical Technique for Lateral Epicondylitis  

Microsoft Academic Search

Background: Good to excellent short-term results have been reported for the surgical treatment of lateral epicondylitis using various surgical techniques.Hypothesis: Surgical treatment for lateral epicondylitis using the mini-open Nirschl surgical technique will lead to durable results at long-term follow-up.Study Design: Case series; Level of evidence, 4.Methods: Records from 139 consecutive surgical procedures (130 patients) for lateral epicondylitis performed by 1

Jonathan H. Dunn; John J. Kim; Lonnie Davis; Robert P. Nirschl

2008-01-01

129

Influence of procedural differences on mitral valve configuration after surgical repair for functional mitral regurgitation: in which direction should the papillary muscle be relocated?  

PubMed

BackgroundAfter restrictive mitral annuloplasty (RMAP) for functional mitral regurgitation (MR), the MR frequently recurs. Papillary muscle relocation (PMR) should reduce the recurrence rate. We assessed the influence of procedural differences in PMR on the postoperative mitral valve configuration.MethodsThirty-nine patients who underwent mitral valve repair for functional MR were enrolled. In limited tethering cases, RMAP alone was performed (RMAP group; n¿=¿23). In severe tethering cases, in addition to RMAP, bilateral papillary muscles were relocated in the direction of the posterior annulus (posterior PMR group; n¿=¿10) or anterior annulus (anterior PMR group; n¿=¿6). We performed pre- and postoperative transthoracic echocardiographic studies, introducing a new index, mitral inflow angle (MIA), to assess the diastolic mitral leaflet excursion. MIA was measured as the angle between the mitral annular plane and the bisector of the anterior and posterior leaflets.ResultsPostoperative MR grade was significantly reduced in each group (P¿<¿0.001). Follow-up echocardiography showed recurrent MR in 13% of the patients in RMAP group. In contrast, no recurrent MR was observed in either the anterior PMR or the posterior PMR group. After surgery, MIA was significantly reduced in both the RMAP group (P¿<¿0.01) and the posterior PMR group (P¿<¿0.001), but was preserved in the anterior PMR group (NS). None of the postoperative variables showed any significant difference between the early and late postoperative phases.ConclusionsIn the surgical treatment of functional MR, a PMR procedure in addition to RMAP was effective in reducing systolic MR. However, mitral valve opening assessed by MIA was restricted even after RMAP alone. The restriction was severely augmented after additional posterior PMR, but was attenuated after additional anterior PMR. The papillary muscle should be relocated in the direction of the anterior annulus to preserve the diastolic opening of the mitral valve. PMID:25491075

Watanabe, Taiju; Arai, Hirokuni; Nagaoka, Eiki; Oi, Keiji; Hachimaru, Tsuyoshi; Kuroki, Hidehito; Fujiwara, Tatsuki; Mizuno, Tomohiro

2014-12-10

130

A review on surgical techniques and organ sparing procedures in bladder/prostate rhabdomyosarcoma.  

PubMed

The treatment outcomes in children with bladder/prostate rhabdomyosarcoma (B/P RMS) have considerably improved in the past few decades. Current protocols incorporate chemotherapy, radiotherapy, and surgery (radical or organ sparing). Using this multimodal and multidisciplinary approach, the cure rates for nonmetastatic RMS have gradually increased from 25% in the 1970s, and 70% in the 1990s, to over 80% in the 2000s. Surgery plays a role not only in the diagnosis and management of all stages of B/P RMS, but also in the urinary reconstruction and long-term follow-up. Furthermore, the tendency to avoid mutilating surgery and to preserve functional genitourinary tract has been noticeable. Authors describe the current status and future surgical treatment approaches and possibilities for patients with B/P RMS and how reconstructive urologic surgery in B/P RMS continues to evolve. PMID:25486411

Komasara, Leszek; Go??biewski, Andrzej; Anzelewicz, Stefan; Czauderna, Piotr

2014-12-01

131

Sterile versus clean technique in postoperative wound care of patients with open surgical wounds: A pilot study  

Microsoft Academic Search

Purpose: This study was completed to determine whether there were differences between sterile versus clean dressing change technique for open surgical wounds in the postoperative period with respect to (1) rate of wound healing and (2) cost of supplies.Methods: A two-group design was used for this pilot study. Of a sample of 30 patients undergoing elective gastrointestinal operations with wounds

Nancy A. Stotts; Susan Barbour; Kathleen Griggs; Brenda Bouvier; Leslie Buhlman; Deidre Wipke-Tevis; Donna F. Williams

1997-01-01

132

Preliminary experience with dexmedetomidine for monitored anesthesia care during ENT surgical procedures.  

PubMed

Dexmedetomidine is an alpha2-adrenergic agonist that produces anxiolysis, amnesia, sedation, potentiation of opioid analgesia, and sympatholysis. It is currently approved by the U.S. Food & Drug Administration for the sedation of adults in the intensive care setting for up to 24 hours during mechanical ventilation. Given its beneficial sedative and anxiolytic properties and limited adverse effect profile, it has been used in several other clinical scenarios. The authors present their experience using dexmedetomidine for monitored anesthesia care (MAC) during "awake" ENT procedures such as thyroplasty, a procedure requiring a patient to verbalize when requested but to otherwise remain immobile to allow for completion of the procedure, and in a patient with post-polio syndrome with poor pulmonary reserve requiring esophagoscopy with dilation and botulinum toxin injection for cricopharyngeal dysfunction. Our preliminary experience suggests that dexmedetomidine provides effective sedation as the primary agent for MAC during such procedures in adult patients. The end-organ effects of dexmedetomidine and previous reports of its use during MAC are reviewed. PMID:19127135

Busick, Tamra; Kussman, Mary; Scheidt, Troy; Tobias, Joseph D

2008-01-01

133

Malignant melanoma of glans penis and prepuce treated with organ-preserving surgical procedure.  

PubMed

The authors present a case of malignant melanoma of glans penis and prepuce. An organ-preserving operative procedure using buccal mucosa was performed with subsequent inguino-femoral modified lymphadenectomy. There was no disease progression during the follow-up period of twelve months. PMID:19595271

Slavov, Chavdar; Venkov, Georgi; Velikova, Kalina; Christova, Svetla; Popov, Elenko; Tsankov, Nikolay

2009-01-01

134

Short-term survival and effects of transmitter implantation into western grebes using a modified surgical procedure  

USGS Publications Warehouse

Two pilot trials and one study in a closely related grebe species suggest that Western grebes (Aechmophorus occidentalis) will not tolerate intracoelomic transmitter implantation with percutaneous antennae and often die within days of surgery. Wild Western grebes (n = 21) were captured to evaluate a modified surgical technique. Seven birds were surgically implanted with intracoelomic transmitters with percutaneous antennae by using the modified technique (transmitter group), 7 received the same surgery without transmitter implantation (celiotomy group), and 7 served as controls (only undergoing anesthesia). Modifications included laterally offsetting the body wall incision from the skin incision, application of absorbable cyanoacrylate tissue glue to the subcutaneous space between the body wall and skin incisions, application of a waterproof sealant to the skin incision after suture closure, and application of a piece of porcine small intestine submucosa to the antenna egress. Survival did not differ among the 3 groups with 7 of 7 control, 6 of 7 celiotomy, and 6 of 7 transmitter birds surviving the 9-day study. Experimental birds were euthanized at the end of the study, and postmortem findings indicated normal healing. Significant differences in plasma chemistry or immune function were not detected among the 3 groups, and only minor differences were detected in red blood cell indices and plasma proteins. After surgery, the birds in the transmitter group spent more time preening tail feathers than those in the control and celiotomy groups. These results demonstrate that, in a captive situation, celiotomy and intracoelomic transmitter implantation caused minimal detectable homeostatic disturbance in this species and that Western grebes can survive implantation of intracoelomic transmitters with percutaneous antennae. It remains to be determined what potential this modified surgical procedure has to improve postoperative survival of Western grebes that are intracelomically implanted with transmitters with percutaneous antennae and released into the wild.

Gaydos, Joseph K.; Massey, J. Gregory; Mulcahy, Daniel M.; Gaskins, Lori A.; Nysewander, David; Evenson, Joseph; Siegel, Paul B.; Ziccardi, Michael H.

2011-01-01

135

Postoperative wound dealing and superficial surgical site infection in open radical prostatectomy.  

PubMed

The number of open radical prostatectomy (RP) surgeries has been decreasing owing to the spread of laparoscopic and robotic surgery, which has implications for postoperative wound healing. The purpose of this study was to investigate and document the current status of postoperative wound healing and superficial surgical site infection (SSI) in open RPs. One hundred and seventy-five antegrade RPs with the same or similar kinds of prophylactic antibiotic administration were divided into two groups: (i) 'no intervention' (wound covering group) and (ii) 'washing', using a washing solution from the second postoperative day to the day of skin staple removal (wound washing group). We compared these groups for the occurrence of superficial SSI. The wound covering group had three (3·03%) cases of superficial SSI, with one case caused by methicillin sensitive Staphylococcus aureus (MSSA). The wound washing group had nine (11·8%) cases of superficial SSI, with three cases caused by MSSA, two cases caused by methicillin resistant Staphylococcus aureus (MRSA) and one by Pseudomonas aeruginosa. The wound covering group showed a significantly lower ratio of superficial SSI (P?=?0·0472). In conclusion, the postoperative wound status data in this study suggests that no wound intervention after RP resulted in a comparatively lower ratio of superficial SSI than in the wound washing group. PMID:25186077

Yamamichi, Fukashi; Shigemura, Katsumi; Yamashita, Mauso; Tanaka, Kazushi; Arakawa, Soishi; Fujisawa, Masato

2014-09-01

136

Surgical Airway  

PubMed Central

Close to 3% of all intubation attempts are considered difficult airways, for which a plan for a surgical airway should be considered. Our article provides an overview of the different types of surgical airways. This article provides a comprehensive review of the main types of surgical airways, relevant anatomy, necessary equipment, indications and contraindications, preparation and positioning, technique, complications, and tips for management. It is important to remember that the placement of a surgical airway is a lifesaving procedure and should be considered in any setting when one “cannot intubate, cannot ventilate”. PMID:24741501

Patel, Sapna A; Meyer, Tanya K

2014-01-01

137

Stryphnodendron adstringens extract associated with the hooves trimming surgical procedure for the treatment of bovine digital dermatitis.  

PubMed

Hoof care, lesion curettage, and application of 5 % Stryphnodendron adstringens bark extract (S. adstringens (Mart.) Coville) or 3 % copper sulfate on surgical wounds of cattle were carried out in this research. A total of 180 cattle with digital dermatitis were used. They were distributed into six groups of 30 animals each (GI, GII, GIII, GIV, GV, and GVI). In GI and GII, only the sick digit was trimmed; in GIII and GIV, both sick and healthy digits of the lesioned limb were trimmed; and in GV and GVI, all digits were trimmed. During the postoperative period, 5 % S. adstringens extract was applied in GI, GIII, and GV, and 3 % copper sulfate solution was applied in GII, GIV, and GVI. After 60 days of evaluation, the data were analyzed using the Chi-squared test (p? ? ?0.05). Both therapeutic protocols utilizing surgical curettage of the lesions were efficient for treating digital dermatitis. However, when the procedure is followed by the trimming of sick and healthy digits, the healing is optimized and a greater number of animals are rehabilitated. PMID:23443825

Silva, Luiz A F; de Moura, Maria I; Dambros, Carlos E; Freitas, Sabrina L R; Souza, Luiz A; Abreu, Morgana P

2013-06-01

138

A New Laparoscopic Surgical Procedure to Achieve Sufficient Mesorectal Excision in Upper Rectal Cancer  

PubMed Central

Objective. Mesorectal excision corresponding to the location of a tumor, termed tumor-specific mesorectal excision (TSME), is commonly performed for resection of upper rectal cancer. We devised a new laparoscopic procedure for sufficient TSME with rectal transection followed by mesorectal excision. Operative Technique. After mobilization of the sigmoid colon and ligation of inferior mesenteric vessels, we dissected the mesorectum along the layer of the planned total mesorectal excision. The rectal wall was carefully separated from the mesorectum at the appropriate anal side from the tumor. After the rectum was isolated and transected using an endoscopic linear stapler, the rectal stump drew immediately toward the anal side, enabling the mesorectum to be identified clearly. In this way, sufficient TSME can be performed easily and accurately. This technique has been successfully conducted on 19 patients. Conclusion. This laparoscopic technique is a feasible and reliable procedure for achieving sufficient TSME. PMID:22312519

Ohigashi, Seiji; Taketa, Takashi; Sudo, Kazuki; Shiozaki, Hironori; Onodera, Hisashi

2011-01-01

139

A rapid and non-surgical procedure for jugular catheterization of pigs.  

PubMed

A rapid and non-surgical method for jugular catheterization in pigs was set up in 30 piglets of 6.2 kg, 23 pigs of 46 kg and 84 kg and two lactating multiparous sows. The animal was restrained on a V-shaped table (piglets) or with a rope around the mandible (slaughter pigs and sows). The vein was located with the Vacutainer system and a wire guide was inserted into the Vacutainer needle up to the vein lumen. When the needle was removed, the catheter was inserted over the wire guide and advanced until it penetrated the skin and thereafter, the vein wall. The catheter was fixed outside by a large tape and coiled inside a patch just behind the ears. The technique utilizes readily available material and is no more risky for the animal than a single blood sampling. Moreover, it can be performed within 15 to 20 min (including animal restraint) within pens. This new approach might have important implications not only for research purposes by facilitating repeated blood samplings but also for projects which require a rapid and easy method for testing of any kind of pharmaceutical or other type of products under husbandry conditions. PMID:10780845

Matte, J J

1999-07-01

140

Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure  

PubMed Central

Background Simultaneous osteoarthritis (OA) of the ankle joint complicates primary total knee arthroplasty (TKA). In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components. Case presentation We present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA) during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week) and hospital stay (12 days) of this special patient was markedly reduced compared to the usual course of separate TJA. Conclusions Simultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient. PMID:21995682

2011-01-01

141

Intraocular Lens-Shell Technique: Adjustment of the Surgical Procedure Leads to Greater Safety When Treating Dense Nuclear Cataracts  

PubMed Central

Objective To compare the efficacy and safety of the intraocular lens (IOL)-shell procedure versus conventional phacoemulsification for the surgical treatment of dense cataracts. Methods Eighty eyes with dense nuclear cataracts were enrolled in a prospective, randomized controlled study. Patients were assigned to two groups. In Group I, the IOL was traditionally implanted after all nuclear fragments were completely removed, and in Group II, the IOL was innovatively implanted in the bag before the last residual nuclear fragment was removed. This novel adjusted surgical procedure, named the “IOL-shell technique”, features use of the IOL as a protective barrier rather than simply as a refractive alternative, and it is conceptually different from the traditional step-by-step procedure. Clinical examinations, including uncorrected visual acuity, central corneal thickness (CCT), temporal clear corneal incision thickness and corneal endothelial cell density, were carried out. Results The inter-group difference in temporal corneal thickness was found to be of no statistical significance at any of the visits. Compared to eyes in Group I, those in Group II were shown to have significantly less corneal endothelial cell loss on both the 7th and 30th day following surgery. At 7 days after surgery, the mean corneal endothelial cell loss in Group II was 10.29%, compared to 14.37% in Group I (P<0.05). The mean endothelial cell loss measured on postoperative day 30 was 16.88% in Group II compared to 23.32% in Group I (P<0.05). On the 1st day after surgery, the mean CCT of eyes in Group II was significantly smaller compared to Group I (Group I vs. Group II: 19.42% vs. 13.50%, P<0.05). Conclusions Compared to conventional phacoemulsification, the IOL-shell technique was shown to be a relatively safer procedure without compromised efficiency for dense cataracts, and it caused less corneal endothelial cell loss and milder postoperative corneal edema (Clinical Trials Identifier: NCT02138123). Trial Registration ClinicalTrials.gov NCT02138123 PMID:25401512

Chen, Weirong; Qu, Bo; Zhang, Xinyu; Lin, Zhuoling; Chen, Jingjing; Liu, Yizhi

2014-01-01

142

Comparison of surgical, functional, and oncological outcomes of open and robot-assisted partial nephrectomy  

PubMed Central

BACKGROUND: We aimed to compare the surgical, oncological, and functional outcomes of robot-assisted partial nephrectomy (RAPN) with open partial nephrectomy (OPN) in the management of small renal masses. MATERIALS AND METHODS: Between 2009 and 2013, a total of 46 RAPN patients and 20 OPN patients was included in this study. Patients’ demographics, mean operative time, estimated blood loss (EBL), warm ischemia time (WIT), length of hospital stay, pre- and post-operative renal functions, complications and oncological outcomes were recorded, prospectively. RESULTS: Mean tumor size was 4.04 cm in OPN group and 3.56 cm in RAPN group (P = 0.27). Mean R.E.N.A.L nephrometry score was 6.35 in OPN group and 5.35 in RAPN group (P = 0.02). The mean operative time was 152 min in OPN group and 225 min in RAPN group (P = 0.006). The mean EBL in OPN and RAPN groups were 417 ml and 268 ml, respectively (P = 0.001). WIT in OPN group was significantly shorter than RAPN group (18.02 min vs. 23.33 min, P = 0.003). The mean drain removal time and the length of hospital stay were longer in OPN group. There were no significant differences in terms of renal functional outcomes and postoperative complications between groups. CONCLUSION: Minimally invasive surgical management of renal masses with RAPN offers better outcomes in terms of EBL and length of stay. However, the mean operative time and WIT were significantly shorter in OPN group. RAPN is a safe and effective minimally invasive alternative to OPN in terms of oncological and functional outcomes. PMID:25598603

Boylu, Ugur; Basatac, Cem; Yildirim, Umit; Onol, Fikret F.; Gumus, Eyup

2015-01-01

143

Laparoscopic cholecystectomy for melanoma metastatic to the gallbladder: is it an adequate surgical procedure? Report of a case and review of the literature  

PubMed Central

Background Only 2% to 4% of patients with melanoma will be diagnosed with gastrointestinal metastasis during the course of their disease. The most common sites of gastrointestinal metastases from melanoma include the small bowel (35%–67%), colon (9%–15%) and stomach (5%–7%), with a median survival of 6–10 months after surgery, and 18% survival at five years. Metastatic melanoma to the gallbladder is extremely rare and it is associated with a very poor prognosis. Case presentation We report a case of a 54-year old man presented to observation with diagnosis of 6.1 mm thick, Clark's level IV, ulcerated melanoma of the trunk, developing in the course of the disease metastatic involvement of the gallbladder as first site of recurrence, treated by laparoscopic cholecystectomy. To date only few cases of patients with metastatic melanoma of the gallbladder treated by this surgical procedure have been reported in literature. Conclusion Gallbladder metastasis represents a rare event as a first site of recurrence. It must be considered a possible expression of systemic disease also despite radiological absence of other metastatic lesions. Laparoscopic approach has a possible therapeutic role, but open surgery has also a concomitant diagnostic purpose because gives the possibility of manual exploration of abdominal cavity, useful particularly to reveal bowel metastatic lesions, not easily identifiable by preoperative imaging examinations. PMID:18072972

Marone, Ugo; Caracò, Corrado; Losito, Simona; Daponte, Antonio; Chiofalo, Maria Grazia; Mori, Stefano; Cerra, Rocco; Pezzullo, Luciano; Mozzillo, Nicola

2007-01-01

144

A technique for administering xenon gas anesthesia during surgical procedures in mice.  

PubMed

Carrying out invasive procedures in animals requires the administration of anesthesia. Xenon gas offers advantages as an anesthetic agent compared with other agents, such as its protection of the brain and heart from hypoxia-induced damage. The high cost of xenon gas has limited its use as an anesthetic in animal experiments, however. The authors designed and constructed simple boxes for the induction and maintenance of xenon gas and isoflurane anesthesia in small rodents in order to minimize the amount of xenon gas that is wasted. While using their anesthesia delivery system to anesthetize pregnant mice undergoing caesarean sections, they measured the respiratory rates of the anesthetized mice, the survival of the pups and the percentages of oxygen and carbon dioxide within the system to confirm the system's safety. PMID:25333593

Ruder, Arne Mathias; Schmidt, Michaela; Ludiro, Alessia; Riva, Marco A; Gass, Peter

2014-11-01

145

A Fluidic Cell Embedded Electromagnetic Wave Sensor for Online Indication of Neurological Impairment during Surgical Procedures  

NASA Astrophysics Data System (ADS)

Lactate is known to be an indicator of neurological impairment during aortic aneurysm surgery. It is suggested that cerebrospinal fluid removed during such surgery could provide useful information in this regard. Medical professionals find the prospect of online detection of such analytes exciting, as current practice is time consuming and leads to multiple invasive procedures. Advancing from the current laboratory based analysis techniques to online methods could provide the basis for improved treatment regimes, better quality of care, and enhanced resource efficiency within hospitals. Accordingly, this article considers the use of a low power fluidic system with embedded electromagnetic wave sensor to detect varying lactate concentrations. Results are promising over the physiological range of 0 - 20 mmol/L with a calibration curve demonstrating an R2 value > 0.98.

Blakey, R. T.; Mason, A.; Al-Shamma'a, A. I.

2013-06-01

146

Oxford Phase 3 unicompartmental knee arthroplasty: medium-term results of a minimally invasive surgical procedure  

PubMed Central

Purpose In the last decade, a major increase in the use of and interest in unicompartmental knee arthroplasty (UKA) has developed. The Oxford Phase 3 UKA is implanted with a minimally invasive technique using newly developed instruments. The objective of this prospective study was to evaluate the outcome of UKA in patients with medial osteoarthritis of the knee in a high-volume unit. Methods Two-hundred and forty-four UKAs were performed with a minimally invasive approach. The median age was 72 (43–91) years. The median follow-up was 4.2 years (range 1–10.4 years). Fourteen patients died, and nine were considered to be lost to follow-up, but all had a well-functioning prosthesis in situ until their last follow-up. Pain, function and health-related quality of life were evaluated pre- and postoperatively using patient- and assessor-based outcome scores, as well as radiographic evidence. Results The mean Knee Society knee and function scores, WOMAC-scores, Oxford-score and VAS pain and satisfaction all improved. Nine knees required revision. Eleven patients required an additional arthroscopic procedure due to persisting pain secondary to intra-articular pathology, and four patients required manipulation under anaesthesia because of limited range of motion. The 7-year cumulative survival rate of the arthroplasty was 94.4%. A low incidence (21%) of a radiolucent line beneath the tibial component was observed at 5 years of follow-up. Conclusion This study showed a high survival rate of the Oxford Phase 3 UKA. Patient satisfaction and functional performance were also very high. Major complication rate was low; in addition, the incidence of radiolucency under the tibial component, when compared to present literature, was low. When strict indication criteria are followed, excellent, durable, and in our opinion reliable, results can be expected for this procedure. PMID:20640402

van den Bekerom, Michel P. J.; Pilot, Peter; van Dijk, C. Niek; Lisowski, Andrzej E.

2010-01-01

147

Image-guided cranial osteoma resection and bioceramic porous hydroxyapatite custom-made reconstruction in a one-step surgical procedure. Technical notes and illustrative case  

Microsoft Academic Search

Background  Removal of a large cranial tumour and reconstruction of the consequent bone defect in the same surgical setting is an ordinary\\u000a procedure. A custom-made hydroxyapatite ceramic reconstruction of a cranial bone defect is a modern option that currently\\u000a needs a preoperative stage of studying the bone defect and designing the implant. Consequently, if a reconstructive hydroxyapatite-based\\u000a procedure after a cranial

Alessandro Della Puppa; Ruggero Mottaran; Renato Scienza

2010-01-01

148

Clinical, functional, and radiographic assessments of the conventional and modified Boyd-Anderson surgical procedures for repair of distal biceps tendon ruptures.  

PubMed

The purpose of this study was to evaluate the clinical, functional, and radiographic outcomes of the conventional and modified Boyd-Anderson procedures for repair of distal biceps tendon ruptures. Thirteen of 18 men who underwent surgical repair for unilateral distal biceps tendon ruptures at one university center participated in the study. In general, follow-up outcomes were favorable with respect to return to premorbid activity levels, patient satisfaction with surgical outcome, and overall clinical results. Elbow flexion, forearm supination, and upper extremity functional concentric peak torque and range of motion results were not significantly different between the surgical and nonsurgical arms when dominance was controlled as a confounding factor. Radiographic findings revealed no clinically remarkable signs of heterotopic ossification or proximal radioulnar synostosis. Results of the study reveal that the conventional and modified Boyd-Anderson procedures are clinically, functionally, and radiographically efficacious for repair of distal biceps tendon ruptures. PMID:9548120

D'Arco, P; Sitler, M; Kelly, J; Moyer, R; Marchetto, P; Kimura, I; Ryan, J

1998-01-01

149

Non-photorealistic rendering of virtual implant models for computer-assisted fluoroscopy-based surgical procedures  

Microsoft Academic Search

Surgical navigation systems visualize the positions and orientations of surgical instruments and implants as graphical overlays onto a medical image of the operated anatomy on a computer monitor. The orthopaedic surgical navigation systems could be categorized according to the image modalities that are used for the visualization of surgical action. In the so-called CT-based systems or 'surgeon-defined anatomy' based systems,

Guoyan Zheng

2007-01-01

150

Clinical, Functional, and Radiographic Assessments of the Conventional and Modified Boyd-Anderson Surgical Procedures for Repair of Distal Biceps Tendon Ruptures  

Microsoft Academic Search

The purpose of this study was to evaluate the clinical, functional, and radiographic outcomes of the conventional and modified Boyd-Anderson procedures for repair of distal biceps tendon ruptures. Thirteen of 18 men who underwent surgical repair for unilateral distal biceps tendon ruptures at one university center participated in the study. In general, follow-up outcomes were favorable with respect to return

Patrick DArco; Michael Sitler; John Kelly; Raymond Moyer; Paul Marchetto; Iris Kimura; Jeff Ryan

1998-01-01

151

Thoracoscopy: a new era for surgical anatomy.  

PubMed

In this new era of minimal access surgery, advances in optics and illumination have established thoracoscopic sympathectomy as a pre-eminent procedure, including a safe and efficient technique for upper limb sympathectomy. The success of thoracoscopy will doubtless ensure that a greater number of these procedures will be carried out and will put some of the daunting technical challenges posed by traditional open surgical procedures to rest. The thoracoscopic era affords the surgical anatomist a new challenge: to move the teaching of living anatomy to a higher level. PMID:14566905

Satyapal, K S; Singh, B; Partab, P; Ramsaroop, L; Pather, N

2003-11-01

152

Comparison of results of laparoscopic and open antegrade continence enema procedures  

Microsoft Academic Search

Several modifications of the Malone antegrade continence enema (ACE) procedure have now been reported. In this study we have\\u000a compared the results of our experience with the laparoscopic appendicostomy (LACE procedure) with the published results of\\u000a previously described open ACE procedures. Children who had the LACE procedure at our institutions were reviewed. Intra- and\\u000a postoperative problems were identified by review

A. C. Lynch; S. W. Beasley; R. W. Robertson; P. N. Morreau

1999-01-01

153

Clinician-led surgical site infection surveillance of orthopaedic procedures: a UK multi-centre pilot study.  

PubMed

The UK Department of Health established the Healthcare-associated Infection (HAI) Surveillance Steering Group in 2000 to develop a strategy for implementing a national programme for HAI surveillance in National Health Service trusts. A subgroup of this committee examined the surveillance of surgical site infections following orthopaedic surgery. This group oversaw a pilot scheme that was set up in 12 hospitals around the UK to explore the feasibility of implementing a system of surveillance that engaged clinical staff in its operation, provided a process for continuous data collection and could be maintained as part of routine hospital operation over time. A minimum data set was established by the subgroup, and Centers for Disease Control and Prevention (CDC) definitions of infection were used. By March 2003, the surveillance had been undertaken continuously in 11 sites for one to two years, depending on the date of implementation. Only one hospital had ceased data collection. The information was collected mainly by clinical staff, with support and co-ordination usually provided by infection control teams. Data on more than 5400 procedures were available for analysis for four core procedures: arthroplasty of the hip and knee; hemi-arthroplasty of the hip; and internal fixation of trochanteric fractures of the femur. The data set permitted the calculation of risk-adjusted rates, allowing comparisons between hospitals and within a hospital over time. The methodology enhanced clinical ownership of the surveillance process, re-inforced infection control as the responsibility of all staff, and provided timely feedback and local data analysis. The use of CDC definitions permitted international comparisons of the data. PMID:15949611

Morgan, M; Black, J; Bone, F; Fry, C; Harris, S; Hogg, S; Holmes, A; Hughes, S; Looker, N; McIlvenny, G; Nixon, J; Nolan, J; Noone, A; Reilly, J; Richards, J; Smyth, E; Howard, A

2005-07-01

154

Positional changes of the masseter and medial pterygoid muscles after surgical mandibular advancement procedures: an MRI study.  

PubMed

This study evaluated whether surgical mandibular advancement procedures induced a change in the direction and the moment arms of the masseter (MAS) and medial pterygoid (MPM) muscles. Sixteen adults participated in this study. The sample was divided in two groups: Group I (n=8) with a mandibular plane angle (mpa) <39° and Group II (n=8) with an mpa >39°. Group I patients were treated with a bilateral sagittal split osteotomy (BSSO). Those in Group II were treated with a BSSO combined with a Le Fort I osteotomy. Pre- and postoperative direction and moment arms of MAS and MPM were compared in these groups. Postsurgically, MAS and MPM in Group II showed a significantly more vertical direction in the sagittal plane. Changes of direction in the frontal plane and changes of moment arms were insignificant in both groups. This study demonstrated that bimaxillary surgery in patients with an mpa >39° leads to a significant change of direction of MAS and MPM in the sagittal plane. PMID:22418077

Dicker, G J; Koolstra, J H; Castelijns, J A; Van Schijndel, R A; Tuinzing, D B

2012-08-01

155

Applicability of the Clavien-Dindo classification to emergency surgical procedures: a retrospective cohort study on 444 consecutive patients  

PubMed Central

Background Patients undergoing emergency surgery have a high risk for surgical complications and death. The Clavien-Dindo classification has been developed and validated in elective general surgical patients, but has not been validated in emergency surgical patients. The aim of the current study was to evaluate the Clavien-Dindo classification of surgical complications in emergency surgical patients and to study preoperative factors for risk stratification that should be included into a database of surgical complications. Methods A cohort of 444 consecutive patients having emergency general surgery during a three-month period was retrospectively analyzed. Surgical complications were classified according to the Clavien-Dindo classification. Preoperative risk factors for complications were studied using logistic regression analysis. Results Preoperatively 37 (8.3%) patients had organ dysfunctions. Emergency surgical patients required a new definition for Grade IV complications (organ dysfunctions). Only new onset organ dysfunctions or complications that significantly contributed to worsening of pre-operative organ dysfunctions were classified as grade IV complications. Postoperative complications developed in 115 (25.9%) patients, and 14 (3.2%) patients developed grade IV complication. Charlson comorbidity index, preoperative organ dysfunction and the type of surgery predicted postoperative complications. Conclusions The Clavien-Dindo classification of surgical complications can be used in emergency surgical patients but preoperative organ dysfunctions should be taken into account when defining postoperative grade IV complications. For risk stratification patients’ comorbidities, preoperative organ dysfunctions and the type of surgery should be taken into consideration. PMID:25075222

2014-01-01

156

Outcomes of Critical Pathway in Laparoscopic and Open Surgical Treatments for Gastric Cancer Patients: Patients Selection for Fast-Track Program through Retrospective Analysis  

PubMed Central

Purpose The aim of this study is to investigate the clinical factors affecting on the cure rate by invasive and open surgery for gastric cancer and to establish a subgroup of patients who can be applied by the early recovery after surgery program through this retrospective analysis. Materials and Methods In this retrospective study, we analyzed 425 patients who underwent gastric cancer surgery between January 2011 and December 2011 and were managed with conventional clinical therapies. This clinical algorithm was made when the patient was in minimally invasive surgery group and discharged from hospital one day faster than them in open surgery group. Results The completion rate of the clinical pathway was 62.4%. Despite the different applications of clinical pathway, completion rate in minimally invasive surgery group was significantly higher than that of open group (P<0.001). In multivariate analysis, the surgical procedure of minimally invasive surgery (odds ratio=4.281) was the most predictable factor to complete clinical pathway. Additionally, younger patients (odds ratio=1.933) who underwent distal gastrectomy (odds ratio=1.999) without combined resection (odds ratio=3.069) were predicted to accomplish the clinical pathway without any modifications. Conclusions We concluded that high efficacy of the clinical pathway for gastric cancer surgery was expected to selected patients through retrospective analysis (expected completion rate=85.4%). In addition, these patients would become enrolled criteria for early recovery program in gastric cancer surgery. PMID:23844324

Choi, Ji Woo; Xuan, Yi; Byun, Cheul Su; Han, Sang-Uk; Cho, Yong Kwan

2013-01-01

157

A surgical procedure for resecting the mouse rib: a model for large-scale long bone repair.  

PubMed

This protocol introduces researchers to a new model for large-scale bone repair utilizing the mouse rib. The procedure details the following: preparation of the animal for surgery, opening the thoracic body wall, exposing the desired rib from the surrounding intercostal muscles, excising the desired section of rib without inducing a pneumothorax, and closing the incisions. Compared to the bones of the appendicular skeleton, the ribs are highly accessible. In addition, no internal or external fixator is necessary since the adjacent ribs provide a natural fixation. The surgery uses commercially available supplies, is straightforward to learn, and well-tolerated by the animal. The procedure can be carried out with or without removing the surrounding periosteum, and therefore the contribution of the periosteum to repair can be assessed. Results indicate that if the periosteum is retained, robust repair occurs in 1 - 2 months. We expect that use of this protocol will stimulate research into rib repair and that the findings will facilitate the development of new ways to stimulate bone repair in other locations around the body. PMID:25651082

Tripuraneni, Nikita; Srour, Marissa K; Funnell, John W; Thein, Thu Zan Tun; Mariani, Francesca V

2015-01-01

158

IC Treatment: Surgical Procedures  

MedlinePLUS

... questions to take with you to the doctor. Laser Surgery Laser surgery has been used successfully to treat Hunner’s ... of IC patients. A type of transurethral fulguration, laser surgery works by destroying a layer of tissue ...

159

A Systematic Review of Systematic Reviews and Panoramic Meta-Analysis: Staples versus Sutures for Surgical Procedures  

PubMed Central

Objective To systematically evaluate the evidence across surgical specialties as to whether staples or sutures better improve patient and provider level outcomes. Design A systematic review of systematic reviews and panoramic meta-analysis of pooled estimates. Results Eleven systematic reviews, including 13,661 observations, met the inclusion criteria. In orthopaedic surgery sutures were found to be preferable, and for appendicial stump sutures were protective against both surgical site infection and post surgical complications. However, staples were protective against leak in ilecolic anastomosis. For all other surgery types the evidence was inconclusive with wider confidence intervals including the possibly of preferential outcomes for surgical site infection or post surgical complication for either staples or sutures. Whilst reviews showed substantial variation in mean differences in operating time (I2 94%) there was clear evidence of a reduction in average operating time across all surgery types. Few reviews reported on length of stay, but the three reviews that did (I2 0%, including 950 observations) showed a non significant reduction in length of stay, but showed evidence of publication bias (P-value for Egger test 0.05). Conclusions Evidence across surgical specialties indicates that wound closure with staples reduces the mean operating time. Despite including several thousand observations, no clear evidence of superiority emerged for either staples or sutures with respect to surgical site infection, post surgical complications, or length of stay. PMID:24116028

Hemming, Karla; Pinkney, Thomas; Futaba, Kay; Pennant, Mary; Morton, Dion G.; Lilford, Richard J.

2013-01-01

160

Preliminary Development of a Workstation for Craniomaxillofacial Surgical Procedures: Introducing a Computer-Assisted Planning and Execution System  

PubMed Central

Introduction Facial transplantation represents one of the most complicated scenarios in craniofacial surgery because of skeletal, aesthetic, and dental discrepancies between donor and recipient. However, standard off-the-shelf vendor computer-assisted surgery systems may not provide custom features to mitigate the increased complexity of this particular procedure. We propose to develop a computer-assisted surgery solution customized for preoperative planning, intraoperative navigation including cutting guides, and dynamic, instantaneous feedback of cephalometric measurements/angles as needed for facial transplantation. Methods We developed the Computer-Assisted Planning and Execution (CAPE) workstation to assist with planning and execution of facial transplantation. Preoperative maxillofacial computed tomography (CT) scans were obtained on 4 size-mismatched miniature swine encompassing 2 live face-jaw-teeth transplants. The system was tested in a laboratory setting using plastic models of mismatched swine, after which the system was used in 2 live swine transplants. Postoperative CT imaging was obtained and compared with the preoperative plan and intraoperative measures from the CAPE workstation for both transplants. Results Plastic model tests familiarized the team with the CAPE workstation and identified several defects in the workflow. Live swine surgeries demonstrated utility of the CAPE system in the operating room, showing submillimeter registration error of 0.6 ± 0.24 mm and promising qualitative comparisons between intraoperative data and postoperative CT imaging. Conclusions The initial development of the CAPE workstation demonstrated integration of computer planning and intraoperative navigation for facial transplantation are possible with submillimeter accuracy. This approach can potentially improve preoperative planning, allowing ideal donor-recipient matching despite significant size mismatch, and accurate surgical execution. PMID:24406592

Gordon, Chad R.; Murphy, Ryan J.; Coon, Devin; Basafa, Ehsan; Otake, Yoshito; Al Rakan, Mohammed; Rada, Erin; Susarla, Sriniras; Swanson, Edward; Fishman, Elliot; Santiago, Gabriel; Brandacher, Gerald; Liacouras, Peter; Grant, Gerald; Armand, Mehran

2014-01-01

161

Current Spectrum of Surgical Procedures Performed for Ebstein’s Malformation: An Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database  

PubMed Central

Background Ebstein’s malformation is a rare congenital cardiac anomaly. Available data are limited to individual reports demonstrating highly variable approaches. We sought to understand the spectrum of surgical treatment of Ebstein’s anomaly across institutions. Methods A retrospective review of surgical procedures performed on patients with primary diagnosis of Ebstein’s malformation (2002 through 2009) in The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) was conducted. Results A total of 595 operations on 498 patients with Ebstein’s anomaly were included: 116 on neonates (19%), 122 on infants (21%), 264 on children (44%), and 93 on adults (16%). Average annual institutional case volumes were low (median, 1 per year; range, 0 to 8 per year). Neonates had a high rate of palliative procedures: systemic-to-pulmonary artery shunts with or without tricuspid valve closure (43; 37.1%) and tricuspid valve closure (10; 8.6%); Ebstein’s repair or tricuspid valvuloplasty was performed in 32%. The most common procedures among infants were superior cavopulmonary connections (62; 50.8%) and systemic-to-pulmonary shunt (10; 8.2%). Among older patients, procedures were primarily in three categories: tricuspid valve surgery (children, 54.5%; adults, 68.8%), arrhythmia procedures (children, 8.7%; adults, 17.3%), and Fontan (children, 14.8%). In-hospital mortality was high in neonatal patients (23.4%) in comparison with infants (4.1%), children (0.7%), and adults (1.1%). Conclusions Surgery for Ebstein’s anomaly consists of a wide range of procedures, with low individual institutional volumes. Mortality is highest among neonates. A prospective multicenter inception cohort study would be valuable to better define indications for specific strategies of surgical management. PMID:24067335

Davies, Ryan R.; Pasquali, Sara K.; Jacobs, Marshall L.; Jacobs, Jeffrey J.; Wallace, Amelia S.; Pizarro, Christian

2014-01-01

162

Endoscopically assisted procedure for removal of a foreign body from the maxillary sinus and contemporary endodontic surgical treatment of the tooth  

PubMed Central

There have been reports on the migration of teeth or implants into the maxillary sinus. We know of only one report on the migration of a gutta-percha point that had been used to fill a root canal into the ethmoid sinus. We report such a case treated with an endoscopically assisted procedure for removal of the foreign body and contemporary endodontic surgical treatment of the tooth. PMID:17090337

Costa, Fabio; Robiony, Massimo; Toro, Corrado; Sembronio, Salvatore; Politi, Massimo

2006-01-01

163

Endoscopically assisted procedure for removal of a foreign body from the maxillary sinus and contemporary endodontic surgical treatment of the tooth.  

PubMed

There have been reports on the migration of teeth or implants into the maxillary sinus. We know of only one report on the migration of a gutta-percha point that had been used to fill a root canal into the ethmoid sinus. We report such a case treated with an endoscopically assisted procedure for removal of the foreign body and contemporary endodontic surgical treatment of the tooth. PMID:17090337

Costa, Fabio; Robiony, Massimo; Toro, Corrado; Sembronio, Salvatore; Politi, Massimo

2006-01-01

164

A 1-minute hand wash does not impair the efficacy of a propanol-based hand rub in two consecutive surgical hand disinfection procedures  

Microsoft Academic Search

We studied the effect of a 1-min hand wash on the bacterial hand flora in two consecutive surgical hand disinfection procedures.\\u000a A propanol-based hand rub (PBHR; Sterillium®) and n-propanol (60%, v\\/v) were tested in a Latin-square design according to\\u000a EN 12791 in four variations. The reference alcohol was always applied for 3 min after a 1-min hand wash (variation 1). The

G. Kampf; C. Ostermeyer

2009-01-01

165

[Early and late postoperative results of mitral and tricuspid valve insufficiency surgical treatment using edge-to-edge central coaptation procedure].  

PubMed

Edge-to-edge approximation of the mitral leaflets and creation of a double-orifice mitral valve (Jatene-Alfieri procedure), for mitral regurgitation surgical treatment was effective in most cases, especially for patients who had rheumatic and degenerative valve disease, traumatic or ischemic mitral valve insufficiency. Positive results of double-orifice technique encourages to use this method to correct some forms of tricuspid insufficiency. Triple-orifice repair procedure is a lot more effective to correct central prolapses in all of the three leaflets (extraordinary elongated chordaes) and/or degenerative tricuspid annular dilation than the ordinary routine procedures. This study aims to evaluate early and long-term postoperative outcomes for 29 patients after mitral double-orifice and/or triple orifice repair procedures. It also determines clinical and echocardiographic results at follow-up period for more than two years. PMID:12560653

Gateliene, Egle; Voluckiene, Elvyra; Ivaskeviciene, Loreta; Uzdavinys, Giedrius; Semetiene, Giedre

2002-01-01

166

CLINICAL RESULTS WITH THE TRABECTOME, A NOVEL SURGICAL DEVICE FOR TREATMENT OF OPEN-ANGLE GLAUCOMA  

PubMed Central

Purpose To describe treatment outcomes after Trabectome surgery in an initial series of 101 patients with open-angle glaucoma. Methods A 19-gauge microelectrosurgical device enabled ab interno removal of a strip of trabecular meshwork and inner wall of Schlemm’s canal under gonioscopic control with continual infusion and foot-pedal control of aspiration and electrosurgery. A smooth, pointed ceramic-coated insulating footplate was inserted into Schlemm’s canal to act as a guide within the canal and to protect adjacent structures from mechanical or heat injury during ablation of a 30- to 90-degree arc of angle tissue. Results Mean preoperative intraocular pressure (IOP) in the initial 101 patients was 27.6 ± 7.2 mm Hg. Thirty months postoperatively, mean IOP was 16.3 ± 3.3 mm Hg (n = 11). The mean percentage drop over the whole course of follow-up was 40%. At all times postoperatively, the absolute and percent decrease in IOP from preoperative levels were statistically significant (paired t test, P < .0001). Overall success (IOP ? 21 mm Hg with or without medications and no subsequent surgery) was 84%. Nine eyes subsequently underwent trabeculectomy, two others had IOP greater than 21 mm Hg in spite of resuming topical medications, and the rest of the patients either refused to resume medications or were still in the 1-month postoperative period without medications (total failure rate including trabeculectomies, 16/101 = 16%). Intraoperative reflux bleeding occurred in 100% of cases. Complications have been minimal and not vision-threatening. Conclusions The Trabectome facilitates minimally invasive and effective glaucoma surgery, which spares the conjunctiva and does not preclude subsequent standard filtering procedures. PMID:17471324

Minckler, Don; Baerveldt, George; Ramirez, Marina Alfaro; Mosaed, Sameh; Wilson, Richard; Shaarawy, Tarek; Zack, Barend; Dustin, Laurie; Francis, Brian

2006-01-01

167

Comparison of surgical procedures and percutaneous drainage in the treatment of liver hydatide cysts: a retrospective study in an endemic area  

PubMed Central

Introduction: Surgical procedures are still the golden standard option in the treatment of liver cystic echinococcosis. However, minimal invasive technics like percutaneous drainage are rising trends. We aimed to compare the efficacy of surgical and percutaneous options in the treatment of liver hydatidosis in an endemic area. Methods: Patients who underwent surgical or percutaneous procedures for hydatid disease between January 2007 and December 2012 were retrospectively evaluated. Recurrence rates, hospital stay time, and related factors were analyzed. Results: There were 44 (35.5%) male and 80 (64.5%) female patients in this study. Eighty two patients (Group I) had undergone surgery (66.1%) and 42 patients (Group II) had undergone percutaneous drainage (33.9%). The mean cyst size was 7.28 ± 2.51 cm in Group I and 8.76 ± 3.30 cm in Group II. Nine recurrences (7.3%) were detected during study. Five of the recurrences were in Group II (11.9%) and four (4.9%) of them were in Group I. The mean length of hospital stay of all patients was 5.42 ± 3.16 days. Discussion: Percutaneous drainage techniques can be a good alternative to surgery in selected patients. In complicated cases like cystobiliary fistula, surgery is superior to percutaneous approaches. The hospital stay time, recurrence rate and postoperative complications were not enhanced when compared to percutaneous treatment in our study. Despite all controversy about the low morbidity after percutaneous treatment, surgical approach is still a preferable option in patients with liver hydatidosis when it is performed by experienced surgeons. PMID:25232421

Akkucuk, Seckin; Aydogan, Akin; Ugur, Mustafa; Yetim, Ibrahim; Davran, Ramazan; Oruc, Cem; Kilic, Erol; Temiz, Muhyittin

2014-01-01

168

Severe Surgical Site Infection in Community Hospitals: Epidemiology, Key Procedures, and the Changing Prevalence of Methicillin?Resistant Staphylococcus aureus  

Microsoft Academic Search

objective. To characterize the epidemiology of severe (ie, nonsuperficial) surgical site infection (SSI) in community hospitals. methods. SSI data were collected prospectively at 26 community hospitals in the southeastern United States. Two analyses were performed: (1) a study of the overall prevalence rates of SSI and the prevalence rates of SSI due to specific pathogens in 2005 at all participating

Deverick J. Anderson; Daniel J. Sexton; Zeina A. Kanafani; Grace Auten; Keith S. Kaye

2007-01-01

169

Geographic variation in rates of common surgical procedures in France in 2008-2010, and comparison to the US and Britain.  

PubMed

Geographic variation in use of elective surgeries has been widely studied in the US, where over-utilization is incentivized. We wanted to explore recent trends in the geographic variation of common surgical procedures in France - where a global budget, centralized planning process, and compulsory insurance scheme are in place - and to compare measures of variation there to those in the US and Britain. For 2008-2010, we calculated French age- and sex-adjusted per capita utilization rates and four measures of geographic variation for hip fracture admission (which is standard treatment and shows minimal geographic variation across countries) and 14 elective surgical procedures. We found substantial geographic variation in age-sex adjusted per capita admission rates for elective procedures: radical prostatectomy, spine surgery, and CABG showed the greatest variation, while hip fracture, colectomy, and cholecystectomy showed the least. Among older patients, most French admission rates were lower than those seen in the US. In general, measures of geographic variation were lower in France than those reported in the US or Britain. French policymakers could use analyses of geographic variation in service utilization to inform policy, to identify areas for intervention, or to measure the effectiveness of efforts designed to reduce variation in care. PMID:25260910

Weeks, William B; Paraponaris, Alain; Ventelou, Bruno

2014-11-01

170

Influence of Japan's New Diagnosis Procedure Combination-Based Payment System on the Surgical Sector: Does it Really Shorten the Hospital Stay?  

Microsoft Academic Search

Purpose  In 2003, the Diagnosis Procedure Combination (DPC)-based payment system was introduced on a trial basis in 82 major Japanese\\u000a hospitals. We analyzed the influence of this system on hospital revenue and expenditure, focusing on whether it reduces the\\u000a length of stay in hospital (LOS), particularly in the surgical sector.\\u000a \\u000a \\u000a \\u000a Methods  We studied 120 patients hospitalized at the University of Tokyo hospital

Hideo Yasunaga; Hiroo Ide; Tomoaki Imamura; Kazukiko Ohe

2006-01-01

171

Does human immunodeficiency virus status affect early wound healing in open surgically stabilised tibial fractures?: A prospective study.  

PubMed

We compared early post-operative rates of wound infection in HIV-positive and -negative patients presenting with open tibial fractures managed with surgical fixation. The wounds of 84 patients (85 fractures), 28 of whom were HIV positive and 56 were HIV negative, were assessed for signs of infection using the ASEPIS wound score. There were 19 women and 65 men with a mean age of 34.8 years. A total of 57 fractures (17 HIV-positive, 40 HIV-negative) treated with external fixation were also assessed using the Checkett score for pin-site infection. The remaining 28 fractures were treated with internal fixation. No significant difference in early post-operative wound infection between the two groups of patients was found (10.7% (n = 3) vs 19.6% (n = 11); relative risk (RR) 0.55 (95% confidence interval (CI) 0.17 to 1.8); p = 0.32). There was also no significant difference in pin-site infection rates (17.6% (n = 3) vs 12.5% (n = 5); RR 1.62 (95% CI 0.44 to 6.07); p = 0.47). The study does not support the hypothesis that HIV significantly increases the rate of early wound or pin-site infection in open tibial fractures. We would therefore suggest that a patient's HIV status should not alter the management of open tibial fractures in patients who have a CD4 count > 350 cells/?l. PMID:24293603

Howard, N E; Phaff, M; Aird, J; Wicks, L; Rollinson, P

2013-12-01

172

Unusual causes of reduced mouth opening and it's suitable surgical management: Our experience  

PubMed Central

Reduced mouth opening is a common clinical problem and many individuals experience it at least once in his or her life and most dental practitioners see patients with restricted mouth opening quite often. It can occur due to a variety of underlying conditions which may involve complex factors. Hence, it is essential for the clinician to thoroughly investigate and examine these cases for proper diagnosis and its appropriate management. PMID:22442560

Gupta, Sunil Kumar; Rana, Amar S.; Gupta, Deepak; Jain, Gaurav; Kalra, Puneet

2010-01-01

173

Unusual causes of reduced mouth opening and it's suitable surgical management: Our experience.  

PubMed

Reduced mouth opening is a common clinical problem and many individuals experience it at least once in his or her life and most dental practitioners see patients with restricted mouth opening quite often. It can occur due to a variety of underlying conditions which may involve complex factors. Hence, it is essential for the clinician to thoroughly investigate and examine these cases for proper diagnosis and its appropriate management. PMID:22442560

Gupta, Sunil Kumar; Rana, Amar S; Gupta, Deepak; Jain, Gaurav; Kalra, Puneet

2010-01-01

174

The open-ended guidewire as superselective catheter for intraarterial chemotherapy: experience in 190 procedures.  

PubMed

With intraarterial infusion, high levels of chemotherapeutic agents can be achieved in the tumoral area. We present our experience with open-ended guidewire (OEGW) associated with steerable guidewires (SGW) as superselective catheters for intraarterial chemotherapeutic infusion and embolization. This technique was used successfully in 62 patients (190 procedures) over 15 months. PMID:2126996

Bilbao, J I; Aquerreta, J D; Longo, J M; Rodríguez-Cabello, J; Fernández-Virgós, A; Ruza, M

1990-12-01

175

Relation of Surgical Volume to Outcome in Eight Common Operations  

PubMed Central

Objective To examine, in the Veterans Health Administration (VHA), the relation between surgical volume and outcome in eight commonly performed operations of intermediate complexity. Summary Background Data In multihospital health care systems such as VHA, consideration is often given to closing low-volume surgical services, with the assumption that better surgical outcomes are achieved in hospitals with larger surgical volumes. Literature data to support this assumption in intermediate-complexity operations are either limited or controversial. Methods The VHA National Surgical Quality Improvement Program data on nonruptured abdominal aortic aneurysmectomy, vascular infrainguinal reconstruction, carotid endarterectomy (CEA), lung lobectomy/pneumonectomy, open and laparoscopic cholecystectomy, partial colectomy, and total hip arthroplasty were used. Pearson correlation, analysis of variance, mixed effects hierarchical logistic regression, and automatic interaction detection analysis were used to assess the association of annual procedure/specialty volume with risk-adjusted 30-day death (and stroke in CEA). Results Eight major surgical procedures (68,631 operations) were analyzed. No statistically significant associations between procedure or specialty volume and 30-day mortality rate (or 30-day stroke rate in CEA) were found. Conclusions In VHA hospitals, the procedure and surgical specialty volume in eight prevalent operations of intermediate complexity are not associated with risk-adjusted 30-day mortality rate from these operations, or with the risk-adjusted 30-day stroke rate from CEA. Volume of surgery in these operations should not be used as a surrogate for quality of surgical care. PMID:10493488

Khuri, Shukri F.; Daley, Jennifer; Henderson, William; Hur, Kwan; Hossain, Monir; Soybel, David; Kizer, Kenneth W.; Aust, J. Bradley; Bell, Richard H.; Chong, Vernon; Demakis, John; Fabri, Peter J.; Gibbs, James O.; Grover, Frederick; Hammermeister, Karl; McDonald, Gerald; Passaro, Edward; Phillips, Lloyd; Scamman, Frank; Spencer, Jeannette; Stremple, John F.

1999-01-01

176

Using Surgical Microscope for Sclera Buckling and Transscleral Cryopexy: An Alternative Procedure of Treatment for Rhegmatogenous Retinal Detachment  

PubMed Central

Purpose. To observe the long-term effectiveness of scleral buckling and transscleral cryopexy conducted under a surgical microscope in the treatment of uncomplicated rhegmatogenous retinal detachment. Methods. This was a retrospective analysis in a total of 227 consecutive patients (244 eyes) with uncomplicated rhegmatogenous retinal detachment (proliferative vitreoretinopathy ? C2). All patients underwent scleral buckling and transscleral cryopexy under a surgical microscope without using a binocular indirect ophthalmoscope or a contact lens. Results. After initial surgery, complete retinal reattachment was achieved in 226 eyes (92.6%), and retinal redetachment developed in 18 eyes (7.4%). The causes of retinal redetachment included presence of new breaks in eight eyes (44%), failure to completely seal the breaks in five eyes (28%), missed retinal breaks in four eyes (22%), and iatrogenic retinal breaks in one eye (6%). Scleral buckling surgery was performed again in 12 eyes (66%). Four eyes (22%) developed proliferative vitreoretinopathy and then were treated by vitrectomy. The sealing of retinal breaks and complete retinal reattachment were achieved in 241 eyes (98.8%). Conclusion. Probably because of clear visualization of retinal breaks and being controllable under a surgical microscope, the microsurgery of scleral buckling and transscleral cryopexy for uncomplicated retinal detachment exhibits advisable effectiveness. PMID:24790997

Zhong, Liu-xue-ying; Liu, Wen; Huang, Su-Ying; Zhang, Shao-chong

2014-01-01

177

A comparison of open and percutaneous techniques in the surgical treatment of tennis elbow  

Microsoft Academic Search

We conducted a prospective, randomised, controlled trial of 45 patients (47 elbows), with tennis elbow, who underwent either a formal open release or a percutaneous tenotomy. All patients had pre- and post-operative assessment using the Disability of Arm, Shoulder and Hand (DASH) scoring system. Both groups were followed up for a minimum of 12 months. Statistical analyses using the Mann-Whitney

P. D. Dunkow; M. Jatti; B. N. Muddu

2004-01-01

178

Segmental myocardial wall motion during minimally invasive coronary artery bypass grafting using open and endoscopic surgical techniques.  

PubMed

Current options for minimally invasive surgical treatment of single-vessel coronary artery disease include beating heart procedures without cardiopulmonary bypass (CPB) via mini-thoracotomy (MIDCAB) and totally endoscopic robot-assisted techniques (TECAB) with CPB. Both procedures are associated with potential myocardial stress before revascularization, such as single-lung ventilation (SLV), temporary coronary artery occlusion, cardiac luxation, intrathoracic carbon dioxide insufflation, and extended CPB and operating time. In this echocardiographic study we sought to evaluate the extent of intraoperative segmental wall motion abnormalities (SWMA) during MIDCAB and TECAB surgery and to identify factors affecting SWMA. Forty-six patients with single-vessel coronary artery disease were studied. Sixteen patients were operated using the MIDCAB technique and 30 patients with TECAB. In both groups sequential transesophageal echocardiograms were recorded during the entire procedure. Hemodynamic data and oxygenation variables were acquired simultaneously. In both groups, mild but obvious perioperative SWMA were identified and noted to increase during the course of the operation. These SWMA were more pronounced in the TECAB group. Independent of operating time, these changes disappeared completely after revascularization. No significant hemodynamic compromise was observed. We conclude that MIDCAB and TECAB techniques are associated with significant perioperative SWMA. The appearance of more profound SWMA in the TECAB group compared with the MIDCAB patients might have been the result of intrathoracic CO(2) insufflation, as SLV was used in both groups. No persistent SWMA or post-CPB SWMA were apparent in either group. More extensive intraoperative ventricular SWMA was detected in the TECAB group, suggesting that a more frequent risk for right ventricular dysfunction may exist during TECAB procedures. PMID:15673848

Mierdl, S; Byhahn, C; Lischke, V; Aybek, T; Wimmer-Greinecker, G; Dogan, S; Viehmeyer, S; Kessler, P; Westphal, Klaus

2005-02-01

179

[Voluntary surgical sterilization in Greater Metropolitan Campinas, São Paulo State, Brazil, before and after legal regulation of the procedure].  

PubMed

This cross-sectional study compared the provision of surgical sterilization in public health services in Greater Metropolitan Campinas, São Paulo State, Brazil, and the characteristics of women and men who underwent sterilization before and after its legal regulation. Structured and pre-tested questionnaires were applied to 398 women, 15 directors of municipal family planning programs, and 15 coordinators of basic health units. Eight municipalities in Greater Metropolitan Campinas provided tubal ligation and nine performed vasectomy. Approximately half reported following the guidelines of the prevailing family planning legislation. There were no significant differences before or after legal regulation in terms of the characteristics of women and men sterilized or the waiting time for surgery. Most tubal ligations were still performed in combination with cesarean sections (the additional payment for sterilization had decreased, but the difference was not significant). There is strong evidence that in Greater Metropolitan Campinas the changes expected from legal regulation of surgical sterilization did not materialize. Although progress has been made, several distortions still need to be corrected. PMID:18157333

Carvalho, Luiz Eduardo Campos de; Osis, Maria José Duarte; Cecatti, José Guilherme; Bento, Silvana Ferreira; Manfrinati, Márcia B

2007-12-01

180

The Australian experiment: the use of evidence based medicine for the reimbursement of surgical and diagnostic procedures (1998–2004)  

PubMed Central

Background In 1998 a formal process using the criteria of safety, effectiveness and cost-effectiveness (evidence based medicine) on the introduction and use of new medical procedures was implemented in Australia. As part of this process an expert panel, the Medical Services Advisory Committee (MSAC) was set up. This paper examines the effectiveness of this process based on the original criteria, that is, evidence based medicine. Method The data for this analysis was sourced primarily from that made available in the public domain. The MSAC web site provided Minutes from MSAC meetings; Annual Reports; Assessment and Review reports; Progress status; and Archived material. Results The total number of applications submitted to the MSAC has been relatively low averaging approximately only fourteen per year. Additionally, the source of applications has quickly shifted to the medical devices, equipment and diagnostic industry as being the major source of applications. An overall average time for the processing of an application is eighteen months. Negative recommendations were in most cases based on insufficient clinical evidence rather than clinical evidence that clearly demonstrated a lack of clinical effectiveness. It was rare for a recommendation, either positive or negative, to be based on cost-effectiveness. Conclusion New medical procedures are often the result of a process of experimentation rather than formally conducted research. Affordability and the question of who should pay for the generation, collection and analysis of the clinical evidence is perhaps the most difficult to answer. This is especially the case where the new procedure is the result of a process of experimentation with an old procedure. A cost-effective way needs to be found to collect acceptable levels of evidence proving the clinical effectiveness of these new procedures, otherwise the formal processes of evaluation such as that used by the Australian MSAC since 1998 will continue to run the risk of committing Type II errors, that is, denying access to medical procedures that are beneficial and efficient. PMID:16684362

O'Malley, Sue P

2006-01-01

181

Surgical procedures and postsurgical tissue processing significantly affect expression of genes and EGFR-pathway proteins in colorectal cancer tissue  

PubMed Central

An understanding of tissue data variability in relation to processing techniques during and postsurgery would be desirable when testing surgical specimens for clinical diagnostics, drug development, or identification of predictive biomarkers. Specimens of normal and colorectal cancer (CRC) tissues removed during colon and liver resection surgery were obtained at the beginning of surgery and postsurgically, tissue was fixed at 10, 20, and 45 minutes. Specimens were analyzed from 50 patients with primary CRC and 43 with intrahepatic metastasis of CRC using a whole genome gene expression array. Additionally, we focused on the epidermal growth factor receptor pathway and quantified proteins and their phosphorylation status in relation to tissue processing timepoints. Gene and protein expression data obtained from colorectal and liver specimens were influenced by tissue handling during surgery and by postsurgical processing time. To obtain reliable expression data, tissue processing for research and diagnostic purposes needs to be highly standardized. PMID:25526028

David, Kerstin A.; Unger, Florian T.; Uhlig, Philipp; Juhl, Hartmut; Moore, Helen M.; Compton, Carolyn; Nashan, Björn; Dörner, Arnulf; de Weerth, Andreas; Zornig, Carsten

2014-01-01

182

Central-part laryngectomy is a useful and less invasive surgical procedure for resolution of intractable aspiration.  

PubMed

A novel narrow-field laryngectomy procedure known as central-part laryngectomy (CPL) for less invasive laryngeal diversion in patients with intractable aspiration is introduced. We conducted retrospective case reviews of 15 patients who underwent CPL. In this procedure, an area of the glottis including the mid-part of the thyroid cartilage and cricoid cartilage is removed to separate the digestive tract from the air way. The lateral part of the thyroid cartilage, the entire hypopharyngeal mucosa and epiglottis are preserved. The superior laryngeal vessels and nerve are not invaded. All fifteen patients were relieved of aspiration without major complications. In good accordance with cutting of the cricopharyngeal muscles and removal of the cricoid cartilage, postoperative videofluoroscopy demonstrated smooth passages of barium. Ten of 12 patients who had hoped to resume oral food intake became able to do so after CPL and two others also achieved partial oral deglutition. CPL is a useful procedure for treatment of intractable aspiration and offers considerable advantages over other laryngotracheal diversion procedures from the view point of oral food intake. PMID:24136476

Kawamoto, Ai; Katori, Yukio; Honkura, Yohei; Kakuta, Risako; Higashi, Kenjiro; Ogura, Masaki; Miyazaki, Makiko; Arakawa, Kazuya; Kashima, Kazutaka; Asada, Yukinori; Matsuura, Kazuto

2014-05-01

183

Secondary bicoronal synostosis after metopic craniosynostosis surgical reconstruction  

PubMed Central

Re-synostosis after standard surgical procedures for nonsyndromic craniosynostosis is a rare event, which can occur at the same suture or rarely in adjacent sutures. Here, we report 2 patients with primary metopic craniosynostosis who developed bicoronal synostosis in previously opened sutures several months after surgery.

Esmaeli, Arash; Nejat, Farideh; Habibi, Zohreh; El Khashab, Mostafa

2014-01-01

184

Successful Outcome of Modified Quad Surgical Procedure in Preteen and Teen Patients with Brachial Plexus Birth Palsy  

PubMed Central

Objective: To evaluate the outcome of modified Quad procedure in preteen and teen patients with brachial plexus birth palsy. Background: We have previously demonstrated a significant improvement in shoulder abduction, resulting from the modified Quad procedure in children (mean age 2.5 years; range, 0.5–9 years) with obstetric brachial plexus injury. Methods: We describe in this report the outcome of 16 patients (6 girls and 10 boys; 7 preteen and 9 teen) who have undergone the modified Quad procedure for the correction of the shoulder function, specifically abduction. The patients underwent transfer of the latissimus dorsi and teres major muscles, release of contractures of subscapularis pectoralis major and minor, and axillary nerve decompression and neurolysis (the modified Quad procedure). Mean age of these patients at surgery was 13.5 years (range, 10.1–17.9 years). Results: The mean preoperative total Mallet score was 14.8 (range, 10–20), and active abduction was 84° (range, 20°–140°). At a mean follow-up of 1.5 years, the mean postoperative total Mallet score increased to 19.7 (range, 13–25, P < .0001), and the mean active abduction improved to 132° (range, 40°–180°, P < .0003). Conclusion: The modified Quad procedure greatly improves not only the active abduction but also other shoulder functions in preteen and teen patients, as this outcome is the combined result of decompression and neurolysis of the axillary nerve and the release of the contracted internal rotators of the shoulder. PMID:23308301

Nath, Rahul K.; Somasundaram, Chandra

2012-01-01

185

Surgical Instrument Restraint in Weightlessness  

NASA Technical Reports Server (NTRS)

Performing a surgical procedure during spaceflight will become more likely with longer duration missions in the near future. Minimal surgical capability has been present on previous missions as the definitive medical care time was short and the likelihood of surgical events too low to justify surgical hardware availability. Early demonstrations of surgical procedures in the weightlessness of parabolic flight indicated the need for careful logistical planning and restraint of surgical hardware. The consideration of human ergonomics also has more impact in weightlessness than in the conventionall-g environment. Three methods of surgical instrument restraint - a Minor Surgical Kit (MSK), a Surgical Restraint Scrub Suit (SRSS), and a Surgical Tray (ST) were evaluated in parabolic flight surgical procedures. The Minor Surgical Kit was easily stored, easily deployed, and demonstrated the best ability to facilitate a surgical procedure in weightlessness. Important factors in this surgical restraint system include excellent organization of supplies, ability to maintain sterility, accessibility while providing secure restraint, ability to dispose of sharp items and biological trash, and ergonomical efficiency.

Campbell, Mark R.; Dawson, David L.; Melton, Shannon; Hooker, Dona; Cantu, Hilda

2000-01-01

186

Flexible delivery of Er:YAG radiation at 2.94 µm with negative curvature silica glass fibers: a new solution for minimally invasive surgical procedures  

PubMed Central

We present the delivery of high energy microsecond pulses through a hollow-core negative-curvature fiber at 2.94 µm. The energy densities delivered far exceed those required for biological tissue manipulation and are of the order of 2300 J/cm2. Tissue ablation was demonstrated on hard and soft tissue in dry and aqueous conditions with no detrimental effects to the fiber or catastrophic damage to the end facets. The energy is guided in a well confined single mode allowing for a small and controllable focused spot delivered flexibly to the point of operation. Hence, a mechanically and chemically robust alternative to the existing Er:YAG delivery systems is proposed which paves the way for new routes for minimally invasive surgical laser procedures. PMID:23413120

Urich, A.; Maier, R. R. J.; Yu, Fei; Knight, J. C.; Hand, D. P.; Shephard, J. D.

2012-01-01

187

DeloRes trial: study protocol for a randomized trial comparing two standardized surgical approaches in rectal prolapse - Delorme’s procedure versus resection rectopexy  

PubMed Central

Background More than 100 surgical approaches to treat rectal prolapse have been described. These can be done through the perineum or transabdominally. Delorme’s procedure is the most frequently used perineal, resection rectopexy the most commonly used abdominal procedure. Recurrences seem more common after perineal compared to abdominal techniques, but the latter may carry a higher risk of peri- and postoperative morbidity and mortality. Methods/Design DeloRes is a randomized, controlled, observer-blinded multicenter trial with two parallel groups. Patients with a full-thickness rectal prolapse (third degree prolapse), considered eligible for both operative methods are included. The primary outcome is time to recurrence of full-thickness rectal prolapse during the 24?months following primary surgery. Secondary endpoints are time to and incidence of recurrence of full-thickness rectal prolapse during the 5-year follow-up, duration of surgery, morbidity, hospital stay, quality of life, constipation, and fecal incontinence. A meta-analysis was done on the basis of the available data on recurrence rates from 17 publications comprising 1,140 patients. Based on the results of a meta-analysis it is assumed that the recurrence rate after 2?years is 20% for Delorme’s procedure and 5% for resection rectopexy. Considering a rate of lost to follow-up without recurrence of 30% a total of 130 patients (2 x 65 patients) was calculated as an adequate sample size to assure a power of 80% for the confirmatory analysis. Discussion The DeloRes Trial will clarify which procedure results in a smaller recurrence rate but also give information on how morbidity and functional results compare. Trial registration German Clinical Trial Number DRKS00000482 PMID:22931552

2012-01-01

188

Comparative clinical study of the effect of LLLT in the immediate and late treatments of hypoesthesia due to surgical procedures  

NASA Astrophysics Data System (ADS)

We evaluated the effect of LLLT in 68 patients who presented hypoesthesia due to odontological surgery procedures: dental implant surgeries (N=51); extraction of impacted lower third molars (N=10); endodontics in lower first molars (N=7). Lesions treated within 30 days after the nerve injury had occurred were part of the immediate group, and lesions with more than 30 days from the occurrence of the injury were part of the late group. Treatments were carried out with an infrared diode laser of 40 mW-830nm, continuous wave emission, spot size 3 mm2, and a total dosage of 18 joules per session in a contact mode of application, 20 sessions altogether. The efficacy of laser therapy in peripheral nerve regeneration is also related to the degree of the peripheral nerve lesion, and not only to the lesion duration. LLLT resulted in neurosensory functional improvement in both immediate and late treatments of hypoesthesia.

Ladalardo, Thereza C.; Brugnera, Aldo, Jr.; Pinheiro, Antonio L. B.; Castanho Garrini, Ana E.; Bologna, Elisangela D.; Takamoto, Marcia; Siqueira, Jose T.; Dias, Pedro; Campos, Roberto A. d. C.

2002-06-01

189

Prevention of Surgical Site Infection After Open Prosthetic Inguinal Hernia Repair: Efficacy of Parenteral Versus Oral Prophylaxis with Amoxicillin-Clavulanic Acid in a Randomized Clinical Trial  

Microsoft Academic Search

The aim of this prospective study was to compare the efficacy of oral versus parenteral prophylactic amoxicillin–clavulanic acid for preventing surgical site infection after open prosthetic mesh repair of inguinal hernia. A total of 480 inguinal-hernia patients were randomly assigned to two groups. Group I (n = 240) received 1.313 g oral amoxicillin–clavulanic acid 2 hours before operation, and group

Mehmet A. Kuzu; Selçuk Hazinedaro?lu; ?ükrü Dolalan; Nam?k Özkan; Samet Yalç?n; A. Bülent Erkek; Hatem Mahmoudi; Acar Tüzüner; Atilla H. Elhan; Ercümet Kuterdem

2005-01-01

190

Free software, Open source software, licenses. A short presentation including a procedure for research software and data dissemination  

E-print Network

Free software, Open source software, licenses. A short presentation including a procedure for research software and data dissemination T. Gomez-Diaz CNRS, Universit´e Paris-Est, Laboratoire d to revisit the basic concepts in software distribution such as free software, open source software, licenses

191

Our student appeals procedure The Open University often has to take decisions that affect you personally, perhaps to do  

E-print Network

Our student appeals procedure The Open University often has to take decisions that affect you properly considered or that a decision is unfair, you have the right to query and then to appeal against it. This document explains the general procedure for querying and appealing against University decisions. Some kinds

Bandara, Arosha

192

Preference of surgical procedure for the forefoot deformity in the rheumatoid arthritis patients-A prospective, randomized, internal controlled study.  

PubMed

Objectives. The deformed rheumatoid forefoot may be treated with resection of lesser metatarsal heads combined with arthrodesis or resection of the first metatarsophalangeal joint. Recurrent hallux valgus deformity has been reported by resection. We performed a prospective, randomized, internal-controlled study to compare results between arthrodesis and resection. Methods. We resected the lesser metatarsal heads bilaterally and performed arthrodesis of the first metatarsophalangeal joint on one side and resection on the opposite side. We investigated 26 patients (52 feet) who were followed at least one year. Patients were assessed for clinical score, hallux valgus angle (HVA), angle between first and second metatarsals, and angle between first and fifth metatarsals preoperatively, postoperatively and at final follow-up. We evaluated callosities, claw toes, recurrences, and procedure preferences. Results. The mean follow-up period was 4.1 years. No significant differences between arthrodesis and resection were seen, with the exception of HVA. That was significantly less on arthrodesis side (11.5°) than on resection side (17.0°, p < 0.05). Seven callosities on resection side and four on arthrodesis side were observed. On resection side, hallux valgus deformity often recurred (15.3%). Patients expressed a significant preference for arthrodesis over resection (p = 0.008). Conclusions. Arthrodesis provides better results for maintaining HVA. PMID:25295921

Tada, Masahiro; Koike, Tatsuya; Okano, Tadashi; Sugioka, Yuko; Wakitani, Shigeyuki; Mamoto, Kenji; Inui, Kentaro; Nakamura, Hiroaki

2014-10-01

193

Electrocautery-Ignited Surgical Field Fire Caused by a High Oxygen Level during Tracheostomy  

PubMed Central

Tracheostomy is a relatively common surgical procedure that is performed easily in an operating room or intensive care unit. Open tracheostomy is needed in patients requiring prolonged ventilation when percutaneous tracheostomy is inappropriate. Sometimes, it is difficult to achieve bleeding control in the peritracheal soft tissue, and in such cases, we usually use diathermy. However, the possibility of an electrocautery-ignited surgical field fire can be overlooked during the procedure. This case report serves as a reminder that the risk of a surgical field fire during tracheostomy is real, particularly in patients requiring high-oxygen therapy. PMID:25346908

Kim, Myung-Su; Lee, Jang-Hoon; Lee, Dong-Hyup; Lee, Young Uk; Jung, Tae-Eun

2014-01-01

194

Open Source Procedure for Assessment of Loss using Global Earthquake Modelling software (OPAL)  

NASA Astrophysics Data System (ADS)

This paper provides a comparison between Earthquake Loss Estimation (ELE) software packages and their application using an "Open Source Procedure for Assessment of Loss using Global Earthquake Modelling software" (OPAL). The OPAL procedure was created to provide a framework for optimisation of a Global Earthquake Modelling process through: 1. overview of current and new components of earthquake loss assessment (vulnerability, hazard, exposure, specific cost, and technology); 2. preliminary research, acquisition, and familiarisation for available ELE software packages; 3. assessment of these software packages in order to identify the advantages and disadvantages of the ELE methods used; and 4. loss analysis for a deterministic earthquake (Mw = 7.2) for the Zeytinburnu district, Istanbul, Turkey, by applying 3 software packages (2 new and 1 existing): a modified displacement-based method based on DBELA (Displacement Based Earthquake Loss Assessment, Crowley et al., 2006), a capacity spectrum based method HAZUS (HAZards United States, FEMA, USA, 2003) and the Norwegian HAZUS-based SELENA (SEismic Loss EstimatioN using a logic tree Approach, Lindholm et al., 2007) software which was adapted for use in order to compare the different processes needed for the production of damage, economic, and social loss estimates. The modified DBELA procedure was found to be more computationally expensive, yet had less variability, indicating the need for multi-tier approaches to global earthquake loss estimation. Similar systems planning and ELE software produced through the OPAL procedure can be applied to worldwide applications, given exposure data.

Daniell, J. E.

2011-07-01

195

Protocol for the surgical and large bore procedures in malignant pleural mesothelioma and radiotherapy trial (SMART Trial): an RCT evaluating whether prophylactic radiotherapy reduces the incidence of procedure tract metastases  

PubMed Central

Introduction Patients with malignant pleural mesothelioma (MPM) may develop painful ‘procedure tract metastasis’ (PTM) at the site of previous pleural interventions. Prophylactic radiotherapy has been used to minimise this complication; however, three small randomised trials have shown conflicting results regarding its effectiveness. The surgical and large bore procedures in malignant pleural mesothelioma and radiotherapy trial (SMART Trial) is a suitably powered, multicentre, randomised controlled trial, designed to evaluate the efficacy of prophylactic radiotherapy within 42?days of pleural instrumentation in preventing the development of PTM in MPM. Methods and analysis 203 patients with a histocytologically proven diagnosis of MPM, who have undergone a large bore pleural intervention (thoracic surgery, large bore chest drain, indwelling pleural catheter or local anaesthetic thoracoscopy) in the previous 35?days, will be recruited from UK hospitals. Patients will be randomised (1:1) to receive immediate radiotherapy (21?Gy in 3 fractions over 3 working days within 42?days of the pleural intervention) or deferred radiotherapy (21?Gy in 3 fractions over 3 working days given if a PTM develops). Patients will be followed up for 12?months. The primary outcome measure is the rate of PTM until death or 12?months (whichever is sooner), as defined by the presence of a clinically palpable nodule of at least 1?cm diameter felt within 7?cm of the margins of the procedure site as confirmed by two assessors. Secondary outcome measures include chest pain, quality of life, analgaesic requirements, healthcare utilisation and safety (including radiotherapy toxicity). Ethics and dissemination The trial has received ethical approval from the Southampton B Research Ethics Committee (11/SC/0408). There is a Trial Steering Committee, including independent members and a patient and public representative. The trial results will be published in a peer-reviewed journal and presented at international conferences. Trial registration number ISRCTN72767336. PMID:25575875

Clive, Amelia O; Wilson, Paula; Taylor, Hazel; Morley, Anna J; de Winton, Emma; Panakis, Niki; Rahman, Najib; Pepperell, Justin; Howell, Timothy; Batchelor, Timothy J P; Jordan, Nikki; Lee, Y C Gary; Dobson, Lee; Maskell, Nick A

2015-01-01

196

Automatic Detection and Segmentation of Robot-Assisted Surgical Motions  

Microsoft Academic Search

Robotic surgical systems such as Intuitive Surgical's da Vinci system provide a rich source of motion and video data from surgical procedures. In principle, this data can be used to evaluate surgical skill, provide surgical training feedback, or document essential aspects of a procedure. If processed online, the data can be used to provide context- specific information or motion enhancements

Henry C. Lin; Izhak Shafran; Todd E. Murphy; Allison M. Okamura; David D. Yuh; Gregory D. Hager

2005-01-01

197

Comparative evaluation of human placental extract for its healing potential in surgical wounds after orthopaedic surgery: an open, randomised, comparative study.  

PubMed

The study was conducted to compare the efficacy and safety of topical application of purified extract of human placenta (placentrex gel) versus povidone iodine for its wound healing potential after orthopaedic surgeries. In this open, comparative, randomised study, 79 patients above 18 years of age undergoing elective clean and uncontaminated orthopaedic surgery (open fracture reduction, spine surgery and debridement of wound) were enrolled in the study after obtaining written informed consent. Enrolled patients were randomised as per the PC generated randomisation chart (Rando 1.2, 2004) to receive either topical application of human placenta purified extract (PE) on the surgical wound or topical application of povidone iodine (PI) ointment on the surgical wound. Both preparations were applied topically on the surgical wound after the surgery, on days 3, 7 and on day 10, if required. Assessment of surgical wound was done after recovery from anaesthesia and on days 3, 7 and 10 based upon wound healing, physicians' global assessment of response to therapy (PGART) scale, pain and adverse effects. All 79 patients (40 PE and 39 PI) completed the study on day 10 as per the study protocol. Healing of the wound was observed in all patients. The number of patients reporting pain on days 3, 7 and 10 were similar in both PE and PI treatment (p, 0.527) groups. Wound induration was observed in 6 patients (15.00%) of PE and 15 (38.46%) of PI on day 7 (p, 0.041). None of the patients reported any side/adverse events during the study period. Purified placental extract and povidone iodine have comparative wound healing effects. PMID:18839655

Chandanwale, Ajay; Langade, Deepak; Mohod, Vaishali; Sinha, Shyamal; Ramteke, Alankar; Bakhshi, G D; Motwani, Madhur

2008-06-01

198

Surgical Procedures for Vestibular Dysfunction  

MedlinePLUS

... using only the opposite ear to maintain balance. Chemical labyrinthectomy A chemical labyrinthectomy is also known as transtympanic or intratympanic ... ear by filling the scala tympani with a chemical solution. Click here to download the "Surgery for ...

199

Insertion slanting strabismus surgical procedures.  

PubMed

Insertion slanting recessions or biased resections have been reported to be useful for treating A- and V-pattern strabismus, convergence insufficiency, and convergence excess esotropia. Paradoxically, good results have been reported with methods that are opposite in nature. For example, some researchers would recess the medial rectus muscles and slant the superior pole of each muscle back farther than the inferior pole (Simonsz/von Graefe method) for a V-pattern esotropia, and others would slant the inferior poles back farther (Bietti method). The Simonsz/von Graefe method seems to be based on sound concepts of oculomotor mechanics. The Bietti method has been justified based on a misquoting and misinterpretation of previous work by Alan Scott, MD. Probably neither method contributes substantially to the outcome of strabismus surgery because sarcomere remodeling should rapidly negate the effect of the slanting. Most likely it is the recession or resection itself that affects the outcome. PMID:22159685

Kushner, Burton J

2011-12-01

200

Conscious sedation for surgical procedures  

MedlinePLUS

Anesthesia - conscious ... have, what medicines you are taking, and what anesthesia or sedation you have had before. You may ... Eriksson LI, Fleisher LA, et al., eds. Miller's Anesthesia. 7th ed. Philadelphia, PA: Elsevier Churchill-Livingstone; 2009: ...

201

Surgical sperm retrieval: Techniques and their indications  

PubMed Central

Men with azoospermia can father a child through intra-cytoplasmic sperm injection if sperm can be retrieved from their epididymis or testis. Several percutaneous and open surgical procedures have been described to retrieve sperm. The various techniques and their merits are discussed in this review. In men with obstructive azoospermia, epididymal sperm can usually be retrieved by percutaneous epididymal sperm aspiration (PESA). If PESA fails then testicular sperm are obtained by needle aspiration biopsy (NAB). In men with non-obstructive azoospermia, there will be no sperm in the epididymis and testicular sperm retrieval is required. Percutaneous retrieval by NAB can be tried first. If that fails then testicular sperm extraction (TESE) from open microsurgical biopsies is performed using the single seminiferous tubule (SST) or the microdissection TESE techniques. The simplest, least invasive procedure should be tried first. PMID:21716933

Shah, Rupin

2011-01-01

202

Giant Choledochal Calculosis: Surgical Treatment  

PubMed Central

Context: Gallstone disease is one of the most common surgical pathologies. Choledocholithiasis may occur in some of these cases and require surgical intervention. Although there are relatively non-invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP), this technique is usually unsuccessful in patients with stones larger than 10 mm. In our case, we aimed to report a giant choledochal stone (15 cm × 4.5 cm), which is rare in surgical practice and our treatment with open surgery. Case Report: The patient was a 59-year-old woman. Magnetic resonance cholangiopancreatography (MRCP) had showed a hydropic gallbladder with an excessively dilated CBD and a 110 mm × 41 mm stone. In the operation, an excessively dilated CBD was seen and after choledochotomy and a very large calculus that filled CBD completely. Choledochotomy incision was carried forward and a T-tube choledochostomy with choledochoduodenostomy (CD) was performed. The patient was discharged without any complications on postoperative 8th day. Conclusion: Benign gallstone disease is a multifactorial process, with risk factors such as obesity, hemolytic diseases, diabetes mellitus, and pregnancy. Risk factors for choledocholithiasis are similar to those for gallstone disease. MRCP is a non-invasive technique in detecting choledocholithiasis. The gold standard intervention for CBD stones is ERCP. Stones in CBD may reach very considerable dimensions without causing serious symptoms. The most common symptom is jaundice. During preoperative radiological examination, giant stones may be interfered with malignancies. Surgeons should obey conventional algorithms in diagnosis and open surgery must be kept in mind in earlier stages without being too insistent on endoscopic interventions. PMID:25489567

Bektas, Hasan; Duzkoylu, Yigit; Cakar, Ekrem; Buyukas?k, Kenan; Colak, Sukru

2014-01-01

203

Surgical treatment of developmental dysplasia of the hip.  

PubMed

Ideally, developmental dysplasia of the hip is treated early in childhood by nonsurgical methods. If these methods are ineffective, surgical reduction in a nonambulating child is required. A young child (age 6 to 18 months) who requires surgical reduction can be treated by formal anterior open reduction or by the medial Ludloff approach to the hip. Additional bony procedures are usually not required in these young patients. Delayed diagnosis is still common, requiring surgical reduction for children of walking age. These older children usually require formal open reduction (anterior approach) plus an associated bony osteotomy (acetabular, proximal femoral, or, in some cases, both types of osteotomies) to better stabilize the hip. The addition of a proximal femoral derotational shortening osteotomy for open reduction in older children was first used in children older than 3 years, but now it is commonly used in children as young as 2 years. This osteotomy decreases the forces on the reduced hip and minimizes the chances for redislocation and osteonecrosis. In all surgical procedures for developmental dysplasia of the hip, the surgeon must avoid too great a focus on bony osteotomies because the management of soft-tissue abnormalities is critical in achieving a stable reduction. PMID:24720317

Wenger, Dennis R

2014-01-01

204

Non-transectional Open Gastric Bypass as the Definitive Bariatric Procedure for 61 Patients with BMI of 70 and Higher  

Microsoft Academic Search

Background  Technical difficulties in laparoscopic gastric bypass for severely obese patients have led to sleeve gastrectomy first and\\u000a then laparoscopic gastric bypass as a second stage after significant weight loss. Rather than commit these fragile patients\\u000a to two operations, we have done open gastric bypass as a definitive surgical treatment for extreme obesity.\\u000a \\u000a \\u000a \\u000a Methods  Office records of 61 patients with body mass

Gus J. Slotman

2010-01-01

205

Predicting the need for muscle flap salvage after open groin vascular procedures: A clinical assessment tool.  

PubMed

Abstract Groin wound complications after open vascular surgery procedures are common, morbid, and costly. The purpose of this study was to generate a simple, validated, clinically usable risk assessment tool for predicting groin wound morbidity after infra-inguinal vascular surgery. A retrospective review of consecutive patients undergoing groin cutdowns for femoral access between 2005-2011 was performed. Patients necessitating salvage flaps were compared to those who did not, and a stepwise logistic regression was performed and validated using a bootstrap technique. Utilising this analysis, a simplified risk score was developed to predict the risk of developing a wound which would necessitate salvage. A total of 925 patients were included in the study. The salvage flap rate was 11.2% (n = 104). Predictors determined by logistic regression included prior groin surgery (OR = 4.0, p < 0.001), prosthetic graft (OR = 2.7, p < 0.001), coronary artery disease (OR = 1.8, p = 0.019), peripheral arterial disease (OR = 5.0, p < 0.001), and obesity (OR = 1.7, p = 0.039). Based upon the respective logistic coefficients, a simplified scoring system was developed to enable the preoperative risk stratification regarding the likelihood of a significant complication which would require a salvage muscle flap. The c-statistic for the regression demonstrated excellent discrimination at 0.89. This study presents a simple, internally validated risk assessment tool that accurately predicts wound morbidity requiring flap salvage in open groin vascular surgery patients. The preoperatively high-risk patient can be identified and selectively targeted as a candidate for a prophylactic muscle flap. PMID:24666001

Fischer, John P; Nelson, Jonas A; Shang, Eric K; Wink, Jason D; Wingate, Nicholas A; Woo, Edward Y; Jackson, Benjamin M; Kovach, Stephen J; Kanchwala, Suhail

2014-12-01

206

Surgical virtual reality - highlights in developing a high performance surgical haptic device.  

PubMed

Just like simulators are a standard in aviation and aerospace sciences, we expect for surgical simulators to soon become a standard in medical applications. These will correctly instruct future doctors in surgical techniques without there being a need for hands on patient instruction. Using virtual reality by digitally transposing surgical procedures changes surgery in are volutionary manner by offering possibilities for implementing new, much more efficient, learning methods, by allowing the practice of new surgical techniques and by improving surgeon abilities and skills. Perfecting haptic devices has opened the door to a series of opportunities in the fields of research,industry, nuclear science and medicine. Concepts purely theoretical at first, such as telerobotics, telepresence or telerepresentation,have become a practical reality as calculus techniques, telecommunications and haptic devices evolved,virtual reality taking a new leap. In the field of surgery barrier sand controversies still remain, regarding implementation and generalization of surgical virtual simulators. These obstacles remain connected to the high costs of this yet fully sufficiently developed technology, especially in the domain of haptic devices. PMID:24331310

Custur?-Cr?ciun, D; Cochior, D; Constantinoiu, S; Neagu, C

2013-01-01

207

A Hyperelastic Finite-Element Model of Human Skin for Interactive Real-Time Surgical Simulation  

Microsoft Academic Search

A finite-element (FE) model of human skin is pro- posed for future use in an interactive real-time surgical simulation to teach surgeons procedures, such as facial reconstruction using skin-flap repair. For this procedure, skin is cut into flaps that are stretched to cover openings in the face. Thus, the model must recre- ate the visual, haptic, and force feedback expected

Rudy J. Lapeer; Paul D. Gasson; Vasudev Karri

2011-01-01

208

Enhanced Recovery after Elective Open Surgical Repair of Abdominal Aortic Aneurysm: A Complementary Overview through a Pooled Analysis of Proportions from Case Series Studies  

PubMed Central

Objectives To evaluate the efficacy and safety of enhanced recovery after surgery (ERAS) programs in elective open surgical repair (OSR) of abdominal aortic aneurysm (AAA). Background Open surgical repair of AAA is associated with high morbidity and mortality, prolonged hospital stay and high costs. ERAS programs contribute to the optimization of treatment by reducing hospital stay and improving clinical outcomes. Methods A review of PubMed, EMBASE and LILACS databases was conducted. As only one randomized controlled trial was found, a pooled analysis of proportions from case series was conducted, considering it a complementary overview of the topic. Inclusion criteria were case series with more than five cases reported, adult patients who underwent an elective OSR of AAA and use of an ERAS program. ERAS was compared to conventional perioperative care. The pooled proportion and the confidence interval (CI) are shown for each outcome. The overlap of the CI suggests similar effect of the interventions studied. Results Thirteen case series studies with ERAS involving 1,250 patients were compared to six case series with conventional care with a total of 1,429 patients. The pooled, respective proportions for ERAS and conventional care were: mortality, 1.51% [95% CI: 0.0091, 0.0226] and 3.0% [95% CI 0.0183, 0.0445]; and incidence of complications, 3.82% [95% CI 0.0259, 0.0528] and 4.0% [95% CI 0.03, 0.05]. Conclusion This review shows that ERAS and conventional care therapies have similar mortality and complication rates in OSR of AAA. PMID:24887022

Gurgel, Sanderland J. T.; El Dib, Regina; do Nascimento, Paulo

2014-01-01

209

The effect of the timing of antibiotics and surgical treatment on infection rates in open long-bone fractures: a 6-year prospective study after a change in policy.  

PubMed

Our current protocol in treating open long-bone fractures includes early administration of intravenous antibiotics and surgery on a scheduled trauma list. This represents a change from a previous protocol where treatment as soon as possible after injury was carried out. This review reports the infection rates in the period 6 years after the start of this protocol. Two hundred and twenty open long-bone fractures were reviewed. Data collected included time of administration of antibiotics, time to theatre and seniority of surgeon involved. The patients were followed up until clinical or radiological union occurred or until a secondary procedure for non-union or infection was performed. Clinical, radiological and haematological signs of infection were documented. If present, infection was classified as deep or superficial. Surgical debridement was performed within 6 h of injury in 45 % of cases and after 6 h in 55 % of cases. Overall infection rates were 11 and 15.7 %, respectively (p = 0.49). The overall deep infection rate was 4.3 %. There was also no statistically significant difference in the subgroups of deep (p = 0.46) and superficial (p = 0.78) infection. Intravenous antibiotics were administered within 3 h of injury in 80 % of cases and after 3 h in 20 % of cases. The infection rates were 14 and 12.5 %, respectively (p = 1.0). There was no statistically significant difference in the subgroups of deep (p = 0.62) and superficial (p = 0.73) infection. Further statistical analysis did not reveal a significant difference in infection rates for any combination of timing of antibiotics and surgical debridement. Infection rates where the most senior surgeon present was a consultant were 9.5 % as opposed to 16 % with the consultant not present, but this trend was not statistically significant. These results suggest that the change in policy may have contributed to an improvement of the deep infection rate to 4.3 % from the previous figure of 8.5 % although this decrease is not statistically significant. Surgeons may have had concerns that delaying theatre may lead to an increased infection rate, but these results do not substantiate this concern. PMID:25526857

Leonidou, Andreas; Kiraly, Zoltan; Gality, Hristifor; Apperley, Shane; Vanstone, Sean; Woods, David A

2014-11-01

210

A qualitative analysis of health professionals’ job descriptions for surgical service delivery in Uganda  

PubMed Central

Background The ever increasing demand for surgical services in sub-Saharan Africa is creating a need to increase the number of health workers able to provide surgical care. This calls for the optimisation of all available human resources to provide universal access to essential and emergency surgical services. One way of optimising already scarce human resources for health is by clarifying job descriptions to guide the scope of practice, measuring rewards/benefits for the health workers providing surgical care, and informing education and training for health professionals. This study set out to determine the scope of the mandate to perform surgical procedures in current job descriptions of surgical care health professionals in Uganda. Methods A document review was conducted of job descriptions for the health professionals responsible for surgical service delivery in the Ugandan Health care system. The job descriptions were extracted and subjected to a qualitative content data analysis approach using a text based RQDA package of the open source R statistical computing software. Results It was observed that there was no explicit mention of assignment of delivery of surgical services to a particular cadre. Instead the bulk of direct patient related care, including surgical attention, was assigned to the lower cadres, in particular the medical officer. Senior cadres were assigned to perform predominantly advisory and managerial roles in the health care system. In addition, a no cost opportunity to task shift surgical service delivery to the senior clinical officers was identified. Conclusions There is a need to specifically assign the mandate to provide surgical care tasks, according to degree of complexity, to adequately trained cadres of health workers. Health professionals’ current job descriptions are not explicit, and therefore do not adequately support proper training, deployment, defined scope of practice, and remuneration for equitable surgical service delivery in Uganda. Such deliberate assignment of mandates will provide a means of increasing surgical service delivery through further optimisation of the available human resources for health.

2014-01-01

211

A procedure for tissue freezing and processing applicable to both intra-operative frozen section diagnosis and tissue banking in surgical pathology  

Microsoft Academic Search

Different methods for snap freezing surgical human tissue specimens exist. At pathology institutes with higher work loads,\\u000a solid carbon dioxide, freezing sprays, and cryostat freezing are commonly used as coolants for diagnosing frozen tissue sections,\\u000a whereas for tissue banking, liquid nitrogen or isopentane cooled with liquid nitrogen is preferred. Freezing tissues for diagnostic\\u000a and research purposes are therefore often time

Susanne Steu; Maya Baucamp; Gabriela von Dach; Marion Bawohl; Susanne Dettwiler; Martina Storz; Holger Moch; Peter Schraml

2008-01-01

212

Open Reduction and Plate Fixation of Dorsally Displaced Fractures of the Distal Radius: Surgical Technique, Clinical and Radiological Outcome  

Microsoft Academic Search

Thirty-five unstable dorsally displaced fractures of the distal radius in 34 patients (mean age 39) were studied; 28 fractures were intra-articular. All fractures had open reduction and fixation, through a dorsal approach, with mini-fragment plates placed between the first and second dorsal tendon compartments and deep to the fourth compartment. A congruous reduction of the articular surface was obtained in

T. E. J. Hems; B. Rooney

2010-01-01

213

Two Different Surgical Approaches for Prostatic Stromal Sarcoma: Robot-Assisted Laparoscopic Radical Prostatectomy and Open Radical Cysto-Prostatectomy With Ileal Conduit  

PubMed Central

Stromal sarcoma of the prostate is very rare and shows rapid growth, which consequently is related to poor prognosis. Recently, we treated two cases of prostatic stromal sarcoma: one with robot-assisted laparoscopic radical prostatectomy and the other with open radical cysto-prostatectomy with an ileal conduit. To the best of our knowledge, this is the first case report of a prostatic stromal sarcoma managed by use of a robotic procedure. Here, we report of our experiences in the treatment of prostatic stromal sarcoma by use of two different methods. PMID:25237465

Choi, Seock Hwan; Kim, Tae-Hwan; Yoon, Ghil Suk; Chung, Sung Kwang; Kim, Bup Wan

2014-01-01

214

Two different surgical approaches for prostatic stromal sarcoma: robot-assisted laparoscopic radical prostatectomy and open radical cysto-prostatectomy with ileal conduit.  

PubMed

Stromal sarcoma of the prostate is very rare and shows rapid growth, which consequently is related to poor prognosis. Recently, we treated two cases of prostatic stromal sarcoma: one with robot-assisted laparoscopic radical prostatectomy and the other with open radical cysto-prostatectomy with an ileal conduit. To the best of our knowledge, this is the first case report of a prostatic stromal sarcoma managed by use of a robotic procedure. Here, we report of our experiences in the treatment of prostatic stromal sarcoma by use of two different methods. PMID:25237465

Choi, Seock Hwan; Kim, Tae-Hwan; Yoon, Ghil Suk; Chung, Sung Kwang; Kim, Bup Wan; Kwon, Tae Gyun

2014-09-01

215

Surgical Technologists  

MedlinePLUS

... the average for all occupations. Advances in medical technology have made surgery safer, and more operations are ... universities and hospitals, have accredited programs in surgical technology. Programs range in length from several months to ...

216

Minimally invasive procedures on the lumbar spine.  

PubMed

Degenerative disease of the lumbar spine is a common and increasingly prevalent condition that is often implicated as the primary reason for chronic low back pain and the leading cause of disability in the western world. Surgical management of lumbar degenerative disease has historically been approached by way of open surgical procedures aimed at decompressing and/or stabilizing the lumbar spine. Advances in technology and surgical instrumentation have led to minimally invasive surgical techniques being developed and increasingly used in the treatment of lumbar degenerative disease. Compared to the traditional open spine surgery, minimally invasive techniques require smaller incisions and decrease approach-related morbidity by avoiding muscle crush injury by self-retaining retractors, preventing the disruption of tendon attachment sites of important muscles at the spinous processes, using known anatomic neurovascular and muscle planes, and minimizing collateral soft-tissue injury by limiting the width of the surgical corridor. The theoretical benefits of minimally invasive surgery over traditional open surgery include reduced blood loss, decreased postoperative pain and narcotics use, shorter hospital length of stay, faster recover and quicker return to work and normal activity. This paper describes the different minimally invasive techniques that are currently available for the treatment of degenerative disease of the lumbar spine. PMID:25610845

Skovrlj, Branko; Gilligan, Jeffrey; Cutler, Holt S; Qureshi, Sheeraz A

2015-01-16

217

Minimally invasive procedures on the lumbar spine  

PubMed Central

Degenerative disease of the lumbar spine is a common and increasingly prevalent condition that is often implicated as the primary reason for chronic low back pain and the leading cause of disability in the western world. Surgical management of lumbar degenerative disease has historically been approached by way of open surgical procedures aimed at decompressing and/or stabilizing the lumbar spine. Advances in technology and surgical instrumentation have led to minimally invasive surgical techniques being developed and increasingly used in the treatment of lumbar degenerative disease. Compared to the traditional open spine surgery, minimally invasive techniques require smaller incisions and decrease approach-related morbidity by avoiding muscle crush injury by self-retaining retractors, preventing the disruption of tendon attachment sites of important muscles at the spinous processes, using known anatomic neurovascular and muscle planes, and minimizing collateral soft-tissue injury by limiting the width of the surgical corridor. The theoretical benefits of minimally invasive surgery over traditional open surgery include reduced blood loss, decreased postoperative pain and narcotics use, shorter hospital length of stay, faster recover and quicker return to work and normal activity. This paper describes the different minimally invasive techniques that are currently available for the treatment of degenerative disease of the lumbar spine. PMID:25610845

Skovrlj, Branko; Gilligan, Jeffrey; Cutler, Holt S; Qureshi, Sheeraz A

2015-01-01

218

Surgical bleeding in microgravity  

NASA Technical Reports Server (NTRS)

A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd

1993-01-01

219

Changes in hospitalisation and surgical procedures among the oldest-old: a follow-up study of the entire Danish 1895 and 1905 cohorts from ages 85 to 99 years  

PubMed Central

Objective: to examine whether the Danish 1905 cohort members had more active hospital treatment than the 1895 cohort members from ages 85 to 99 years and whether it results in higher in-hospital and post-operative mortality. Methods: in the present register-based follow-up study the complete Danish birth cohorts born in 1895 (n = 12,326) and 1905 (n = 15,477) alive and residing in Denmark at the age of 85 were followed from ages 85 to 99 years with regard to hospitalisations and all-cause and cause-specific surgical procedures, as well as in-hospital and post-operative mortality. Results: the 1905 cohort members had more frequent hospital admissions and operations, but they had a shorter length of hospital stay than the 1895 cohort at all ages from 85 to 99 years. The increase in primary prosthetic replacements of hip joint was observed even within the 1895 cohort: no patients were operated at ages 85–89 years versus 2.2–3.6% at ages 95–99 years. Despite increased hospitalisation and operation rates, there was no increase in post-operative and in-hospital mortality rates in the 1905 cohort. These patterns were similar among men and women. Conclusions: the observed patterns are compatible with more active treatment of the recent cohorts of old-aged persons and reduced age inequalities in the Danish healthcare system. No increase in post-operative mortality suggests that the selection of older patients eligible for a surgical treatment is likely to be based on the health status of old-aged persons and the safety of surgical procedures rather than chronological age. PMID:23531440

Oksuzyan, Anna; Jeune, Bernard; Juel, Knud; Vaupel, James W.; Christensen, Kaare

2013-01-01

220

Open reduction and plate fixation of dorsally displaced fractures of the distal radius: surgical technique, clinical and radiological outcome.  

PubMed

Thirty-five unstable dorsally displaced fractures of the distal radius in 34 patients (mean age 39) were studied; 28 fractures were intra-articular. All fractures had open reduction and fixation, through a dorsal approach, with mini-fragment plates placed between the first and second dorsal tendon compartments and deep to the fourth compartment. A congruous reduction of the articular surface was obtained in all cases. Twenty-four patients were available for follow-up (median 38 months). The Modified Mayo wrist score was excellent in 12 cases, good in four, and fair in eight. The median Patient Evaluation Measure score was 23.5. There were no cases of extensor tendon rupture. Radiographic assessment at follow-up showed a mean palmar angle of 6 degrees. There was evidence of osteoarthritis in six patients who had had intra-articular fractures. Open reduction and plating gives satisfactory medium term results for treatment of displaced intra-articular fractures of the distal radius in young patients. PMID:19687079

Hems, T E J; Rooney, B

2010-01-01

221

Effectiveness and safety of elective surgical procedures to improve wound healing and reduce re-ulceration in diabetic patients with foot ulcers.  

PubMed

The objective is to evaluate the effectiveness and safety of surgical off-loading to heal diabetic foot ulcers and prevent ulcer recurrence. Usually, structural foot deformities such as hallux rigidus, hammertoe deformities and equinus of the ankle contribute to abnormal pressure and shear forces and non-healing foot ulcers. Elective surgery to remove the deformity and restore joint mobility has been shown to be safe and effective to improve wound healing of recalcitrant ulcer and to reduce the risk of re-ulceration. Unfortunately, there is very little high-level evidence to help guide patient selection or to compare clinical outcomes. PMID:22271725

Lavery, Lawrence A

2012-02-01

222

The Surgical Treatment for Atrial Fibrillation: Ablation Technology and Surgical Approaches  

PubMed Central

The Cox maze procedure developed originally in 1987 by Dr James Cox has evolved from a “cut and sew” surgical procedure, where the maze was applied using multiple surgical cuts, to an extensive use of surgical ablation technology where ablation lesions are placed with alternative energy sources (radiofrequency, cryothermy, microwave, and high-frequency ultrasound). Furthermore, the procedure has changed from a median sternotomy approach only to one that can be performed minimally invasively and robotically. The purpose of this paper is to review the current available technology for the ablation of atrial fibrillation as well as the different procedural approaches for the surgical ablation of atrial fibrillation. PMID:23908871

Henry, Linda; Ad, Niv

2013-01-01

223

Comparative Efficacy of Pulse-Spray Thrombolysis and Angioplasty Versus Surgical Salvage Procedures for Treatment of Recurrent Occlusion of PTFE Dialysis Access Grafts  

SciTech Connect

Purpose: To compare the efficacy of surgery versus pulse-spray thrombolysis and angioplasty in patients with recurrent thrombosis of polytetrafluoroethylene (PTFE) dialysis access grafts. Methods: We analyzed 96 consecutive interventions for thrombosed PTFE dialysis access grafts in 18 patients. Primary patency after thrombolysis and angioplasty (n= 25) was compared with primary patency following thrombectomy alone (n= 50) or thrombectomy followed by graft revision (n= 21) using life-table analysis. A Cox proportional hazards model that accounted for graft age and number of previous interventions was used to generate the relative risk for recurrent occlusion following therapy. Results: Life-table analysis showed that patency after thrombolysis and angioplasty was greater than that following thrombectomy alone (p= 0.02). After accounting for the age of the graft and the number of previous interventions (average six per patient), the relative risk for recurrent occlusion [3.0; 95% confidence intervals (CI): 1.5, 6.4] was greater for thrombectomy alone than for thrombolysis/angioplasty [0.6; CI = 0.3, 1.3]. The relative risks of repeat occlusion following thrombolysis/angioplasty [0.6; CI = 0.3, 1.3] and thrombectomy/surgical revision [1.0; CI = 0.5, 1.7] were similar. Conclusion: Outcome data from our retrospective study on recurrent thrombosis of PTFE dialysis access grafts suggest that thrombolysis/angioplasty is superior to thrombectomy alone, and equivalent to thrombectomy/surgical revision.

Polak, Joseph F. [Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 (United States); Berger, Markus F. [Roentgeninstitut Klinik Hirslanden, Witellikerstrasse 40, CH-8029 Zurich (Switzerland); Pagan-Marin, Heriberto [Department of Radiology, Boston University Medical Center, University Hospital, 88 East Newton Street, Roxbury, MA 02118 (United States); Aruny, John E. [Department of Radiology, DePaul Medical Center, 150 Kingsley Lane, Norfolk, VA 23505 (United States); Meyerovitz, Michael F. [Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 (United States)

1998-07-15

224

Surgical sentinel lymph node biopsy in early breast cancer. Could it be avoided by performing a preoperative staging procedure? A pilot study  

PubMed Central

Summary Background The aim of this pilot trial was to study the feasibility of sentinel node percutaneous preoperative gamma probe-guided biopsy as a valid preoperative method of assessment of nodal status compared to surgical sentinel lymph node biopsy. Material/Methods This prospective study enrolled 10 consecutive patients without evidence of axillary lymph node metastases at preoperative imaging. All patients underwent sentinel node occult lesion localization (SNOLL) using radiotracer intradermic injection that detected a “hot spot” corresponding to the sentinel node in all cases. Gamma probe over the skin detection with subsequent ultrasonographically guided needle biopsy of the sentinel node were performed. The percutaneous needle core histopathological diagnosis was compared to the results of the surgical biopsy. Results Preoperative sentinel node identification was successful in all patients. Conclusions The combination of preoperative gamma probe sentinel node detection and ultrasound-guided biopsy could represent a valid alternative to intraoperative sentinel node biopsy in clinically and ultrasonographically negative axillary nodes, resulting in shorter duration of surgery and lower intraoperative risks. PMID:22936189

Testori, Alberto; Meroni, Stefano; Moscovici, Oana Codrina; Magnoni, Paola; Malerba, Paolo; Chiti, Arturo; Rahal, Daoud; Travaglini, Roberto; Cariboni, Umberto; Alloisio, Marco; Orefice, Sergio

2012-01-01

225

Opening Packages Containing RAM in Clinical Areas Procedure: 7.511 Created: 07/24/2013 Version: 1.0 Revised  

E-print Network

Opening Packages Containing RAM in Clinical Areas Procedure: 7.511 Created: 07/24/2013 Version: 1.0 Revised: Page 1 of 4 A. Purpose Incoming packages containing radioactive materials must be surveyed) personnel who open packages containing RAM in clinical areas. C. Definitions DPM ­ disintegrations per

Jia, Songtao

226

DeterminingthemassofSaturn: Open a Matlab session, and then try this procedure. You will use a file with positions of Saturn's moons  

E-print Network

DeterminingthemassofSaturn: Open a Matlab session, and then try this procedure. You will use a file with positions of Saturn's moons (rather than Jupiter's) but the procedure will be the same. First, download the file Saturn_moons.xls from the course web site. Read the file Saturn

Gary, Dale E.

227

A procedure for tissue freezing and processing applicable to both intra-operative frozen section diagnosis and tissue banking in surgical pathology.  

PubMed

Different methods for snap freezing surgical human tissue specimens exist. At pathology institutes with higher work loads, solid carbon dioxide, freezing sprays, and cryostat freezing are commonly used as coolants for diagnosing frozen tissue sections, whereas for tissue banking, liquid nitrogen or isopentane cooled with liquid nitrogen is preferred. Freezing tissues for diagnostic and research purposes are therefore often time consuming, laborious, even hazardous, and not user friendly. In tissue banks, frozen tissue samples are stored in cryovials, capsules, cryomolds, or cryocassettes. Tissues are additionally embedded using freezing media or wrapped in plastic bags or aluminum foils to prevent desiccation. The latter method aggravates enormously further tissue handling and processing. Here, we describe an isopentane-based workflow which concurrently facilitates tissue freezing and processing for both routine intra-operative frozen section and tissue banking and satisfies the qualitative demands of pathologists, cancer researchers, laboratory technicians, and tissue bankers. PMID:18253747

Steu, Susanne; Baucamp, Maya; von Dach, Gabriela; Bawohl, Marion; Dettwiler, Susanne; Storz, Martina; Moch, Holger; Schraml, Peter

2008-03-01

228

Surgical therapy for benign prostatic hypertrophy/bladder outflow obstruction  

PubMed Central

Monopolar transurethral resection of the prostate (TURP) with endoscopic electrocautery remains the gold standard surgical technique for benign prostatic hypertrophy (BPH) by which all new procedures are compared. We reviewed the current literature, and international urological guidelines and consensus opinion on various surgical options for BPH and present a brief overview of alternative techniques including bipolar TURP, transurethral incision of the prostate, transurethral vaporization of the prostate, laser prostatectomy (with holmium, thulium and potassium titanyl phosphate greenlight lasers) and open prostatectomy (with mention of new techniques including laparoscopic and robotic prostatectomy). Emerging, experimental and less established techniques are also described including endoscopic heat generation (transurethral microwave thermotherapy, radiofrequency transurethral needle ablation of the prostate, high intensity focused ultrasound, hot water induced thermotherapy, pulsed electromagnetic radiofrequency), injection therapy (transurethral ethanol ablation and botulinum toxin) and mechanical devices (intraprostatic stents and urethral lift devices). Despite a plethora of surgical options, none have realistically improved outcomes in the long-term compared with TURP. Improvements have been made on improving surgical morbidity and time in hospital. Questions remain in this area, including what specific elements of bladder outflow obstruction (BOO) result in damage to the urinary tract, how does BPH contribute to BOO and how much prostate volume reduction is necessary to relieve BOO or lower urinary tract symptoms. Given these unanswered questions and the multitude of procedures available, it is clear that appropriate counselling is necessary in all men who undergo BPH surgery. PMID:24744521

Thiruchelvam, Nikesh

2014-01-01

229

Impact of the introduction of fee for service payments on types of minor surgical procedures undertaken by general practitioners: observational study.  

PubMed

The 1990 general practitioners (GPs) contract introduced item of service payment for minor surgery, payable for six categories of procedure. Early review showed no substitution of cheaper procedures for more expensive treatments. Detailed payment data from six Health Authorities for the period 1993-2000 show an 11 per cent increase in claims, largely accounted for by the rise in cautery, incorporating cryotherapy. Cryotherapy is no more effective at treating warts than cheap commercially available products, but is quite profitable for GPs. This is yet another example of item of service payment distorting treatment priorities. The new GP contract, and the initiative to develop GPs with special interests in dermatology and minor surgery, will allow primary care trusts to develop minor surgery undertaken by appropriately skilled and experienced GPs, and which reflects the needs of the population. PMID:15454594

Pockney, Pete; George, Steve; Primrose, John; Smith, Helen; Kinley, Helen; Little, Paul; Lattimer, Val; Lowy, Adam; Kneebone, Roger

2004-09-01

230

Sensorineural hearing loss after select procedures  

Microsoft Academic Search

Hearing is one of the most significant senses; therefore, any loss can be frightening. Previous studies have found that certain surgical and medical procedures can result in hearing loss. Cardiac surgical procedures are most commonly associated with hearing loss owing to the use of the cardiopulmonary bypass pump. Other noncardiac, nonotologic surgical procedures also may result in hearing loss. Additionally,

Susan M. Irvin

2002-01-01

231

Hallux valgus correction using combined reverdin-laird and opening base wedge procedures: a radiographic analysis.  

PubMed

A retrospective review of 7 patients (8 total feet) was conducted by the authors to determine the effects of combined 1st metatarsal Reverdin-Laird and opening base wedge osteotomy in the management of hallux valgus deformity. Postoperative radiographs were compared with preoperative radiographs for improvement in the 1st intermetatarsal angle, proximal articular set angle, hallux abductus angle, and tibial sesamoid position. PMID:23827496

Dennis, Lester; Snyder, Jason; Khan, Tahir

2013-07-01

232

Surgical access to separate branches of the cat vestibular nerve  

NASA Technical Reports Server (NTRS)

A posteroventral approach for access to separate branches of the cat vestibular nerve is presented which permits simultaneous surgical access to the ampullary and otolithic nerves. Surgical procedures are discussed.

Radkevich, L. A.; Ayzikov, G. S.

1981-01-01

233

Postintubation injuries and open surgical tracheostomy: should we always perform isthmectomy?* Sequelas pós-intubação e traqueostomia cirúrgica aberta: devemos sempre fazer a istmectomia?  

Microsoft Academic Search

Objective: To evaluate the influence of the surgical team (general surgery or thoracic surgery) and the surgical technique (with or without isthmectomy) on the incidence of postintubation injuries in the airways of tracheostomized patients. Methods: Between January 1st and August 31st, 2007, 164 patients admitted to the adult intensive care unit and tracheally intubated for more than 24 h were

Alexandre Garcia de Lima; Ariovaldo Marques; Ivan Felizardo; Contrera Toro

2009-01-01

234

Surgical Management of Early Endometrial Cancer: An Update and Proposal of a Therapeutic Algorithm  

PubMed Central

In the last few years technical improvements have produced a dramatic shift from traditional open surgery towards a minimally invasive approach for the management of early endometrial cancer. Advancement in minimally invasive surgical approaches has allowed extensive staging procedures to be performed with significantly reduced patient morbidity. Debate is ongoing regarding the choice of a minimally invasive approach that has the most effective benefit for the patients, the surgeon, and the healthcare system as a whole. Surgical treatment of women with presumed early endometrial cancer should take into account the features of endometrial disease and the general surgical risk of the patient. Women with endometrial cancer are often aged, obese, and with cardiovascular and metabolic comorbidities that increase the risk of peri-operative complications, so it is important to tailor the extent and the radicalness of surgery in order to decrease morbidity and mortality potentially derivable from unnecessary procedures. In this regard women with negative nodes derive no benefit from unnecessary lymphadenectomy, but may develop short- and long-term morbidity related to this procedure. Preoperative and intraoperative techniques could be critical tools for tailoring the extent and the radicalness of surgery in the management of women with presumed early endometrial cancer. In this review we will discuss updates in surgical management of early endometrial cancer and also the role of preoperative and intraoperative evaluation of lymph node status in influencing surgical options, with the aim of proposing a management algorithm based on the literature and our experience. PMID:25063051

Falcone, Francesca; Balbi, Giancarlo; Di Martino, Luca; Grauso, Flavio; Salzillo, Maria Elena; Messalli, Enrico Michelino

2014-01-01

235

Endoscopy-MR Image Fusion for Image Guided Procedures  

PubMed Central

Minimally invasive endoscope based abdominal procedures provide potential advantages over conventional open surgery such as reduced trauma, shorter hospital stay, and quick recovery. One major limitation of using this technique is the narrow view of the endoscope and the lack of proper 3D context of the surgical site. In this paper, we propose a rapid and accurate method to align intraoperative stereo endoscopic images of the surgical site with preoperative Magnetic Resonance (MR) images. Gridline light pattern is projected on the surgical site to facilitate the registration. The purpose of this surface-based registration is to provide 3D context of the surgical site to the endoscopic view. We have validated the proposed method on a liver phantom and achieved the surface registration error of 0.76 ± 0.11?mm. PMID:24298281

Huang, Xishi; Ren, Jing

2013-01-01

236

International survey on esophageal cancer: part I surgical techniques.  

PubMed

In patients with esophageal cancer, radical surgical resection of the esophagus and surrounding lymph nodes is the only curative treatment option. Nevertheless, no standard surgical procedure exists. The aims of the present study were to gain insight into the frequencies of the various surgical techniques in esophageal cancer surgery as applied by surgeons throughout the world and to identify intercontinental differences regarding surgical techniques. Surgeons with particular interest in esophageal surgery, including members of the International Society for Diseases of the Esophagus, the European Society of Esophagology Group d'Etude Européen des Maladies de l'Oesophage and the OESO, were invited to participate in an online questionnaire. Questions were asked regarding approach to esophagectomy, extent of lymphadenectomy (LND), type of reconstruction, and anastomotic techniques. Subanalyses were performed for the surgeons' case volume per year, years of experience in esophageal cancer surgery, and continent. Of 567 invited surgeons, 269 participated, resulting in an overall response rate of 47%. The responders currently performing esophagectomies (n= 250; 44%), represented 41 countries across the six continents. Fifty-two percent of responders favor open transthoracic esophagectomy (TTE) over transhiatal esophagectomy (THE) or minimally invasive esophagectomy (MIE). THE is preferred by 26%, whereas MIE is favored by 14%. Eight percent have no preference for one approach to esophagectomy over the other. The extent of LND is most frequently the 2-field, routinely performed by 73% of surgeons. The continuity of the digestive tract is most frequently restored with a gastric conduit (85%). In open TTE, the anastomosis is routinely created in the neck by 56% of responders and in the chest by 40%. Cervical anastomoses are routinely fashioned by means of a handsewn technique by 65% of responders, while 35% favor the stapled technique. The cervical incision is predominantly performed vertically on the left side of the neck (routinely by 66%). A horizontal neck incision is routinely carried out by 19% of responders and a vertical right-sided incision by 11%. Significant differences in surgical techniques could be detected between low- and high-volume surgeons, between surgeons with or=21 years of experience, and between surgeons from different continents. In conclusion, currently the most commonly applied surgical procedure is the open right-sided transthoracic approach with a two-field lymphadenectomy, using a gastric tube anastomosed at the left side of the neck by means of a handsewn, end-to-side technique. The results of this survey provide baseline data for future research and for the development of international guidelines. PMID:19191856

Boone, Judith; Livestro, Daan P; Elias, Sjoerd G; Borel Rinkes, Inne H M; van Hillegersberg, Richard

2009-01-01

237

Canine glaucoma: medical and surgical treatment options.  

PubMed

Canine glaucoma can be treated medically or surgically, depending on the underlying cause, disease stage, desired outcome, available equipment, and owner's financial limitations. Common medications for glaucoma include hyperosmotics, I(2)-blockers, carbonic anhydrase inhibitors, cholinergics, and prostaglandin analogues. Surgical options include aqueous humor shunts, cyclodestructive procedures, enucleation, intrascleral prostheses, and chemical ablation. Each patient requires a customized treatment plan that generally includes a combination of medications and, potentially, surgical intervention. PMID:20180214

Reinstein, Shelby; Rankin, Amy; Allbaugh, Rachel

2009-10-01

238

The chimney procedure is an emergently available endovascular solution for visceral aortic aneurysm rupture.  

PubMed

A 79-year-old woman presented with a ruptured saccular thoracoabdominal aortic aneurysm involving the celiac and mesenteric artery. The patient was unfit for open surgical repair. A "chimney" procedure was performed, which involved placement of stents in the aortic side branches alongside the endograft. The patient underwent another chimney procedure 2 weeks later for a type I endoleak. Computed tomography angiography (CTA) at 1 and 6 months showed a good result with no endoleaks or graft migration. The chimney procedure provides an alternative for emergency patients unfit for open repair and has the advantage that stents can be used that are already available in most institutions. PMID:21276684

Schlösser, Felix J V; Aruny, John E; Freiburg, Carter B; Mojibian, Hamid R; Sumpio, Bauer E; Muhs, Bart E

2011-05-01

239

Liquid Repellency and Surgical Fabric Barrier Properties  

Microsoft Academic Search

Those who are responsible for controlling the surgical environment require a technically sound, practical, valid, and consistent means of evaluating the barrier properties of surgical drapes and apparel. While many laboratories have, by necessity, agreed upon a limited number of test procedures to evaluate the liquid penetration resistance or repellency of a barrier material, there is no uniform code or

G M Olderman

1984-01-01

240

Surgical options for short bowel syndrome  

Microsoft Academic Search

Most children with short bowel syndrome experience spontaneous small bowel adaptation over time. This allows the majority to be weaned from parenteral nutrition. There are, however, some children who cannot be weaned and are potential candidates for techniques to promote intestinal adaptation and intestinal lengthening. Here, surgical therapeutic options are described, literature reviewed, and reported results evaluated. Surgical procedures for

Ashley H. Vernon; Keith E. Georgeson

2001-01-01

241

Guideline implementation: surgical attire.  

PubMed

Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures. PMID:25645036

Cowperthwaite, Liz; Holm, Rebecca L

2015-02-01

242

Surgical decisions in Peyronie’s disease  

Microsoft Academic Search

In this review, we examine recent advances assisting surgical decision in Peyronie’s disease. Surgical treatment is indicated\\u000a in penile deformities that have persisted for at least 6 months and functionally impair or preclude intercourse. Procedures\\u000a shortening the longer side of the penis are invariably associated with length reduction, which may displease patients, despite\\u000a penile straightening. Procedures lengthening the shorter side

Paulo H. Egydio; Miguel Srougi

2006-01-01

243

Retained surgical sponges, needles and instruments  

PubMed Central

Introduction Retained sponges and instruments (RSI) due to surgery are a recognised medical ‘never event’ and have catastrophic implications for patients, healthcare professionals and medical care providers. The aim of this review was to elucidate the extent of the problem of RSI and to identify preventative strategies. Methods A comprehensive literature search was performed on MEDLINE®, Embase™, the Science Citation Index and Google™ Scholar for articles published in English between January 2000 and June 2012. Studies outlining the incidence, risk, management and attempts to prevent RSI following surgical intervention were retrieved. Results The overall incidence of RSI is low although its incidence is substantially higher in operations performed on open cavities. Sponges are the most commonly retained item when compared with needles and instruments. Clinical presentation is varied, leading to avoidable morbidity, and the error is indefensible medicolegally. Risk factors include emergency operations, operations involving unexpected change in procedure, raised body mass index, and a failure to perform accurate sponge and instrument counts. The existing strategy for prevention is manual counting of sponges and instruments undertaken by surgical personnel. This, however, is fallible. Computer assisted counting of sponges using barcodes and gauze sponges tagged with a radiofrequency identification device aiding manual counting have been trialled recently, with success. Conclusions Vigilance among operating theatre personnel is paramount if RSI is to be prevented. Prospective multicentre trials to assess efficacy of new technologies aiding manual counting should be undertaken if this medical error is to be eliminated completely. PMID:23484986

Hariharan, D

2013-01-01

244

Teleoperation in surgical robotics--network latency effects on surgical performance.  

PubMed

A teleoperated surgical robotic system allows surgical procedures to be conducted across long distances while utilizing wired and wireless communication with a wide spectrum of performance that may affect the outcome. An open architecture portable surgical robotic system (Raven) was developed for both open and minimally invasive surgery. The system has been the subject of an intensive telesurgical experimental protocol aimed at exploring the boundaries of the system and surgeon performance during a series of field experiments in extreme environments (desert and underwater) teleportation between US, Europe, and Japan as well as lab experiments under synthetic fixed time delay. One standard task (block transfer emulating tissue manipulation) of the Fundamentals of Laparoscopic Surgery (FLS) training kit was used for the experimental protocol. Network characterization indicated a typical time delay in the range of 16-172 ms in field experiments. The results of the lab experiments showed that the completion time of the task as well as the length of the tool tip trajectory significantly increased (alpha< 0.02) as time delay increased in the range of 0-0.5 sec increased. For teleoperation with a time delay of 0.25s and 0.5s the task completion time was lengthened by a factor of 1.45 and 2.04 with respect to no time delay, whereas the length of the tools' trajectory was increased by a factor of 1.28 and 1.53 with respect to no time delay. There were no statistical differences between experienced surgeons and non-surgeons in the number of errors (block drooping) as well as the completion time and the tool tip path length at different time delays. PMID:19964184

Lum, Mitchell J H; Rosen, Jacob; King, Hawkeye; Friedman, Diana C W; Lendvay, Thomas S; Wright, Andrew S; Sinanan, Mika N; Hannaford, Blake

2009-01-01

245

Best surgical option for arch extension of type B dissection: the endovascular approach  

PubMed Central

Despite advances in surgical techniques and postoperative management, the in-hospital mortality rate for patients undergoing conventional open surgical repair for type B dissections is still significant. In light of this, the less invasive surgical procedure for acute type B aortic dissections, defined as thoracic endovascular aortic repair (TEVAR), was developed. Despite some controversy, the use of TEVAR for the management of type B aortic dissections has become commonplace. Generally, the main entry tear in type B aortic dissection is located in the vicinity of the orifice of the left subclavian artery (LSA). The proximal landing zone in the aortic arch must be secured as long as the aim of TEVAR for type B dissection is primary entry closure. This requires hybrid surgery that includes the use of open surgical procedures, such as debranching for revascularization of cervical branches. Despite the presence of challenging anatomic conditions in the aortic arch, hybrid repair has evolved as an increasingly viable alternative, and promising early and long-term results have been reported. As the next step, fenestrated and branched TEVAR techniques have recently been reported with satisfactory early results. In the coming years, there will be intense competition to develop the devices themselves, improve delivery systems, and supplement devices with auxiliary functions. Thus there is high expectations for the next generation and how they will improve and advance treatment methods of TEVAR for type B aortic dissections. PMID:24967169

2014-01-01

246

Surgical Treatment  

Microsoft Academic Search

\\u000a Tumor resection principally remains the mainstay of treatment and a prerequisite of cure in most cases of pediatric liver\\u000a tumors. While in the past tumor biopsies were taken by open surgery before treatment, this can now be done percutaneously\\u000a with a tru-cut needle. Treatment of hepatoblastoma without a biopsy is reserved to selected cases. The international SIOPEL\\u000a group recommends, as

Piotr Czauderna; Dietrich von Schweinitz

247

Surgical wound infections after peripheral vascular surgery.  

PubMed

Surgical wound infection is one of the most common complications after peripheral vascular surgery. It increases the affected patient's risk for major amputation as well as mortality. Furthermore, surgical wound infection is an additional cost. Wound infections after vascular surgery are of multifactorial nature and generally result from the interplay of patient- and procedure-related factors. The use of systemic antibiotic prophylaxis may be the most important method in preventing surgical wound infections. In this review article, we report the current literature of surgical wound infections after peripheral vascular surgery. PMID:24737857

Turtiainen, J; Hakala, T

2014-12-01

248

Surgical therapy for diabesity.  

PubMed

Type 2 diabetes mellitus affects more than 170 million people worldwide. Because this disease is strongly linked to obesity, the term "diabesity" has been coined to describe the confluence of the 2 disease processes. Bariatric surgery has been performed for many years to achieve sustained weight loss in the morbidly obese population. As a secondary effect, a remarkable improvement in glycemic control is commonly achieved postoperatively. This has led to substantial interest in the use of bariatric procedures to treat type 2 diabetes mellitus. Surgical procedures in common use include the adjustable gastric band, the Roux-en-Y gastric bypass, the biliopancreatic diversion with duodenal switch, and the sleeve gastrectomy. Additionally, several investigational procedures including the ileal interposition and duodenal-jejunal bypass have been proposed as primary interventions for type 2 diabetes mellitus. These operations achieve their metabolic effects through a combination of volume restriction, intestinal bypass, and hormonal changes. As more data become available on the positive effect of bariatric procedures on type 2 diabetes mellitus, the use of such operations may grow. Bariatric surgery may ultimately become a major tool in the long-term treatment of type 2 diabetes mellitus. This manuscript presents an extensive review of the literature supporting these concepts. PMID:20960546

Arroyo, Kervin; Kini, Subhash U; Harvey, John E; Herron, Daniel M

2010-01-01

249

Clinical-surgical treatment of temporomandibular joint disorder in a psoriatic arthritis patient  

PubMed Central

Introduction Condylotomy is a surgical procedure that has been used as an option to treat temporomandibular disorder (TMD) patients. This technique has the advantage of avoiding intra-capsular alterations that might be found involving other surgical procedures. Its use, even when unilateral, has positive effect on treatment of both joints. Methods In order to better evaluate the benefits of a clinical-surgical treatment for TMD, the present report describes the case of a psoriatic arthritis patient. The case was clinically characterized by dental malloclusion, and imaging exams showed joint degeneration of the right mandibular condyle. The patient was treated by condylotomy technique after a prosthetic oral rehabilitation. Results No clinical-radiological signs or symptoms of progression of articular disease were observed within a period of 16 months after surgery. Furthermore, there was functional stability of the temporomandibular joint, total absence of local pain and improvement of mouth opening. Conclusion The present study suggests that condylotomy can be considered as a valid option for the management of TMD, since it has low surgical morbidity and favorable clinical outcomes. In this case, the patient had a medical diagnosis of systemic disease presenting general pain and pain at the temporomandibular joint (TMJ), in addition of causal agent of TMD (dental malloclusion). The difficulty of finding a single etiology (malocclusion vs. systemic disease) did not exclude the indication of a clinical-surgical treatment to re-establish the balance of TMJ. PMID:23556553

2013-01-01

250

Stereolithographic surgical template: a review.  

PubMed

Implant placement has become a routine modality of dental care.Improvements in surgical reconstructive methods as well as increased prosthetic demands,require a highly accurate diagnosis, planning and placement. Recently,computer-aided design and manufacturing have made it possible to use data from computerised tomography to not only plan implant rehabilitation,but also transfer this information to the surgery.A review on one of this technique called Stereolithography is presented in this article.It permits graphic and complex 3D implant placement and fabrication of stereolithographic surgical templates. Also offers many significant benefits over traditional procedures. PMID:24179955

Dandekeri, Shilpa Sudesh; Sowmya, M K; Bhandary, Shruthi

2013-09-01

251

Outcomes of surgical treatment of Peyronie's disease.  

PubMed

The aims of the present review were to assess the literature on published outcomes and complications associated with surgical treatments for Peyronie's disease (PD) and to assist clinicians in the effective management of PD by increasing understanding and awareness of the outcomes associated with current surgical treatment options. A PubMed literature search was conducted to identify relevant, peer-reviewed clinical and review articles published between January 1980 and October 2013 related to outcomes of surgical correction of PD. Search terms for this non-systematic review included 'Peyronie's disease', 'outcomes', 'complications', 'erectile dysfunction or ED', 'patient expectation', and 'patient satisfaction'; search terms were searched separately and in combination. Case studies and editorials were excluded, primary manuscripts and reviews were included, and bibliographies of articles of interest were reviewed and key references were obtained. Assessment of the study design, methodology, clinical relevance and impact on the surgical outcomes of PD was performed on the sixty-one articles that were selected and analysed. Currently, there are several investigational minimally invasive and non-surgical treatment options for PD; however, surgical treatment remains the standard of care for patients with stable disease and disabling deformity or drug-resistant erectile dysfunction. Each of the different surgical procedures that are used for treatment of PD, including tunical shortening, tunical lengthening (plaque incisions or partial excision and grafting), and use of inflatable penile prostheses, carries its own advantages and disadvantages in terms of potential complications and postoperative satisfaction. Because of the variety of ways that PD may present in affected patients, no single, standard, surgical treatment for this disorder has prevailed and multiple variations of each type of procedure may exist. Surgical outcomes of the most commonly used procedures are not substantially different; therefore, the appropriateness of each treatment option may often depend on disease and patient characteristics (e.g. deformity and erectile function). Surgical algorithms have been published to guide surgeons and patients through the selection of surgical procedures in the absence of conclusive, long-term outcome data. Accumulating data on outcomes associated with established procedures, modifications to these procedures, and new surgical techniques and materials may serve to further guide practice and refine evidence-based selection of the surgical approach. PMID:24219080

Carson, Culley C; Levine, Laurence A

2014-05-01

252

Surgical technique affects outcomes in acromioclavicular reconstruction.  

PubMed

Optimal treatment for acromioclavicular (AC) dislocation is unknown. Numerous surgical procedures for AC injuries have been described with little comparison. This study sought to compare the clinical and radiographic results of various surgical techniques in order to identify the optimal surgical technique. Ninety patients met inclusion criteria of AC reconstruction at this institution. A retrospective review of outcomes was performed using the electronic records system. Radiographs were measured for pre- and postoperative grade and percent elevation versus the contralateral side. Overall revision rate was 9%. Suture button fixation had a revision rate of 0% compared to 14% (p = .01). Reconstruction procedures performed with distal clavicle excision showed a higher revision rate, 17% compared to 0% (p = .003). There were no statistically significant clinical differences. AC reconstructions performed with suture button construct were superior to other surgical techniques. Procedures performed with distal clavicle excision were inferior to those without. PMID:23449059

Grassbaugh, Jason A; Cole, Chad; Wohlrab, Kurt; Eichinger, Josef

2013-01-01

253

Open globe injuries: factors predictive of poor outcome  

Microsoft Academic Search

ObjectiveDespite advances in ocular and orbital imaging, instrumentation, materials, and surgical procedures, the management of open globe injuries continues to pose difficult management dilemmas. In this retrospective study, we identify clinical characteristics and outcome of a series of open globe injuries presenting to a major UK centre.MethodOperating department records were reviewed to identify all patients who had undergone repair of

I Rahman; A Maino; D Devadason; B Leatherbarrow

2006-01-01

254

[Endoscopic and surgical procedures for enteral nutrition].  

PubMed

Standardized management of oncology patients necessarily includes screening for nutritional risk. Weight loss of >?5 kg within 3 months and diminished food intake are warning signals even in overweight patients. In case oral nutrition is neither adequate nor feasible even by fortification or oral nutritional supplements, the implantation of a percutaneous endoscopic gastrostomy (PEG) or fine needle catheter jejunostomy (FNCJ) offers enteral access for long-term nutritional support. Although the indications derive from fulfilling caloric needs, endoscopic or operative measures are not considered to be an urgent or even emergency measure. The endoscopist or surgeon should be fully aware and informed of the indications and make a personal assessment of the situation. The implantation of a feeding tube requires informed consent of the patient or legal surrogates. The review summarizes recent indications, technical problems and complications. PMID:23719727

Wallstabe, I; Tiedemann, A; Schiefke, I; Weimann, A

2013-07-01

255

Risk of surgical site infection in patients undergoing orthopedic surgery.  

PubMed

This study aimed to identify risk factors associated with surgical site infections in orthopedic surgical patients at a public hospital in Minas Gerais, Brazil, between 2005 and 2007. A historical cohort of 3,543 patients submitted to orthopedic surgical procedures. A descriptive analysis was conducted and surgical site infection incidence rates were estimated. To verify the association between infection and risk factors, the Chi-square Test was used. The strength of association of the event with the independent variables was estimated using Relative Risk, with a 95% confidence interval and p<0.05. The incidence of surgical site infection was 1.8%. Potential surgical wound contamination, clinical conditions, time and type of surgical procedure were statistically associated with infection. Identifying the association between surgical site infection and these risk factors is important and contributes to nurses' clinical practice. PMID:22249670

Ercole, Flávia Falci; Franco, Lúcia Maciel Castro; Macieira, Tamara Gonçalves Rezende; Wenceslau, Luísa Cristina Crespo; de Resende, Helena Isabel Nascimento; Chianca, Tânia Couto Machado

2011-01-01

256

Surgical management of Peyronie's disease.  

PubMed

Peyronie's disease (PD) has a significant impact on the quality of life of both patients and their partners due to the compromised sexual function and physical deformation resulting from the condition. PD is a connective tissue disorder marked by fibrotic healing of the tunica albuginea, leading to penile deformities including curvature, shortening, loss of girth, hourglass appearance, and hinging. Despite the multiple medical therapies available, surgery is the gold standard of treatment once the plaque has stabilized. We present a review of the disease process, preoperative evaluation, operative planning, surgical treatments with outcomes and complications, and nascent developments in surgical management and graft development. Options include tunical lengthening procedures, tunical shortening procedures, and penile prosthesis. Decision-making is governed by degree of curvature, erectile function, and associated penile deformities. In cases with curvature of less than 60-70 degrees, adequate penile length, and no hourglass deformity, patients are candidates for tunical shortening procedures. Patients with curvature greater than 60-70 degrees, penile hourglass or hinge-destabilizing deformities, and adequate erectile function should be counseled with regard to tunical lengthening procedures. Patients with poor preoperative erectile function should undergo inflatable penile prosthesis placement, with possible secondary straightening procedures. Technique selection should be based upon surgeon preference, expertise, and experience, as evidence does not necessarily support one procedure over another. PMID:25118854

Zaid, Uwais B; Alwaal, Amjad; Zhang, Xiaoyu; Lue, Tom F

2014-10-01

257

Complications of diverticular disease: surgical laparoscopic treatment  

PubMed Central

Surgical treatment of complicated colonic diverticular disease is still debatable. The aim of our study was to evaluate the outcome of laparoscopic colon resection in patients with diverticulitis and with complications like colon-vescical fistula, peridiverticular abscess, perforation or stricture. All patients underwent laparoscopic colectomy within 8 years period. Main data recorded were age, sex, return of bowel function, operation time, duration of hospital stay, ASA score, body mass index (BMI), early and late complications. During the study period, 33 colon resections were performed for diverticulitis and complications of diverticulitis. We performed 5 associated procedures. We had 2 postoperative complications; 1 of these required a redo operation with laparotomy for anastomotic leak and 3 patients required conversion from laparoscopic to open colectomy. The most common reasons for conversion were related to the inflammatory process with a severe adhesion syndrome. Mean operative time was 229 minutes, and average postoperative hospital stay was 9,8 days. Laparoscopic surgery for complications of diverticular disease is safe, effective and feasible. Laparoscopic colectomy has replaced open resection as standard surgery for recurrent and complicated diverticulitis in our institution. PMID:24979103

ANANIA, G.; VEDANA, L.; SANTINI, M.; SCAGLIARINI, L.; GIACCARI, S.; RESTA, G.; CAVALLESCO, G.

2014-01-01

258

Using a Simulated Surgical Skills Station to Assess Laceration Management by Surgical and Nonsurgical Residents  

PubMed Central

Objective To assess laceration management performance among surgical and nonsurgical postgraduate year-1 (PGY-1) residents objectively and to test for interval improvement. Methods From 2006 to 2008, 106 PGY-1 residents from 10 medical specialties were evaluated with a simulated surgical skills station using pigs' feet before and after internship. Subjects were given 11 minutes to choose the proper suture, prepare and close the wound, and answer laceration management questions. Trainees were classified as surgical (emergency medicine, general surgery, obstetrics and gynecology, orthopedics, and otolaryngology) and nonsurgical (family medicine, internal medicine, neurology, pediatrics, and transitional year). An objective checklist was used to assess performance. Results A total of 106 PGY-1 residents (age range, 25–44 years; mean, 28.7 years) participated, consisting of 41 surgical (39%) and 65 nonsurgical residents (61%). Surgical group scores improved from 78.4% to 87.7% (P?surgical, 9.4%; nonsurgical, 5.9%; P??=??.21). Surgical residents outscored nonsurgical residents before (P?Surgical residents outperformed nonsurgical residents before and after the PGY-1 year with similar score improvements. A simulated surgical skills station can be used to evaluate procedure performance objectively and to test for interval improvement. A simulated surgical skills station may serve as a useful adjunct to apprenticeship in assessing procedure competence. PMID:22942957

Fargo, Matthew V; Edwards, John A; Roth, Bernard J; Short, Matthew W

2011-01-01

259

Caesarean section surgical site infection surveillance  

Microsoft Academic Search

Summary Surveillance of surgical site infection (SSI) is an important infec-tion control activity. The Caesarean section procedure was selected, as part of the Scottish Surveillance of Healthcare Associated Infection Programme, to monitor and report upon the incidence of SSI. Data were collected prospec-tively for 715 patients undergoing a Caesarean section procedure for 35 weeks during the latter months of 2002

A. Johnson; D. Young; J. Reilly

2006-01-01

260

Steam Sterilization of Cordless Surgical Instruments  

Microsoft Academic Search

This project was undertaken to evaluate the effectiveness of different sterilization procedures on a new line of cordless surgical drills and driver\\/reamers which have recently come onto the commercial market. The procedures include both conventional and flash steam sterilization protocols. The study demonstrated that the new line of cordless instruments can be easily and quickly sterilized by normal hospital sterilization

Dezso K. Merenyi; Lucy Brown; Neil S. Rothman; Robert Austin Milch; Edward M. Soffen

1981-01-01

261

Surgical Robotics Research in Cardiovascular Disease  

SciTech Connect

This grant is to support a research in robotics at three major medical centers: the University of Southern California-USC- (Project 1); the University of Alabama at Birmingham-UAB-(Project 2); and the Cleveland Clinic Foundation-CCF-(Project 3). Project 1 is oriented toward cardiovascular applications, while projects 2 and 3 are oriented toward neurosurgical applications. The main objective of Project 1 is to develop an approach to assist patients in maintaining a constant level of stress while undergoing magnetic resonance imaging or spectroscopy. The specific project is to use handgrip to detect the changes in high energy phosphate metabolism between rest and stress. The high energy phosphates, ATP and phosphocreatine (PCr) are responsible for the energy of the heart muscle (myocardium) responsible for its contractile function. If the blood supply to the myocardium in insufficient to support metabolism and contractility during stress, the high energy phosphates, particularly PCr, will decrease in concentration. The high energy phosphates can be tracked using phosphorus-31 magnetic resonance spectroscopy ({sup 31}P MRS). In Project 2 the UAB Surgical Robotics project focuses on the use of virtual presence to assist with remote surgery and surgical training. The goal of this proposal was to assemble a pilot system for proof of concept. The pilot project was completed successfully and was judged to demonstrate that the concept of remote surgical assistance as applied to surgery and surgical training was feasible and warranted further development. The main objective of Project 3 is to develop a system to allow for the tele-robotic delivery of instrumentation during a functional neurosurgical procedure (Figure 3). Instrumentation such as micro-electrical recording probes or deep brain stimulation leads. Current methods for the delivery of these instruments involve the integration of linear actuators to stereotactic navigation systems. The control of these delivery devices utilizes an open-loop configuration involving a team consisting of neurosurgeon, neurologist and neurophysiologist all present and participating in the decision process of delivery. We propose the development of an integrated system which provides for distributed decision making and tele-manipulation of the instrument delivery system.

Pohost, Gerald M; Guthrie, Barton L; Steiner, Charles

2008-02-29

262

Surgical treatment for residual or recurrent strabismus  

PubMed Central

Although the surgical treatment is a relatively effective and predictable method for correcting residual or recurrent strabismus, such as posterior fixation sutures, medial rectus marginal myotomy, unilateral or bilateral rectus re-recession and resection, unilateral lateral rectus recession and adjustable suture, no standard protocol is established for the surgical style. Different surgical approaches have been recommended for correcting residual or recurrent strabismus. The choice of the surgical procedure depends on the former operation pattern and the surgical dosages applied on the patients, residual or recurrent angle of deviation and the operator's preference and experience. This review attempts to outline recent publications and current opinion in the management of residual or recurrent esotropia and exotropia. PMID:25540765

Wang, Tao; Wang, Li-Hua

2014-01-01

263

Increasing Patient Safety and Surgical Team Communication by Using a Count\\/Time Out Board  

Microsoft Academic Search

Communication and collaboration in patient care settings is vital for promoting the best possible patient outcomes. The counting of sponges, sharps, and instruments, and the surgical time out before the start of any surgical procedure are opportunities for the surgical team to address patient safety risks. Personnel in the surgical services department at St Luke's Episcopal Hospital, Houston, Texas, implemented

Elizabeth Morell Edel

2010-01-01

264

Computer Assisted Acquisition of Surgical Process Models with a Sensor-Driven Ontology  

Microsoft Academic Search

Surgical Process Models (SPMs) are models of surgical interven- tions. Those models might be used in various applications, such as evaluation of surgical instruments or optimization of surgical procedures. A crucial topic for SPM modeling is data acquisition. This work seeks to extend existing methods such as observer-based or sensor-based data acquisition by introducing a new concept: Computer Assisted Acquisition

Thomas Neumuth; Michael Czygan; Dayana Goldstein; Oliver Burgert

265

Echols’ Procedure for Treating Syringomyelia: Case Report and Historical Review  

PubMed Central

A 9 year-old girl with syringomyelia and scoliosis was treated with Echols’ procedure, a surgical technique that employs a metal stent to maintain drainage of fluid from the syrinx into the subarachnoid space. The patient presented to our institution 34 years later with a history of progressive myelopathy and surgically-treated deformities of the thoracic spine, lumbar spine, and right foot. Computer-assisted myelography indicated that the metal wire remained in place and that the syrinx had collapsed. Neurological examination and neurophysiological testing confirmed the presence of thoracic myelopathy, which may be due to the wire tethering the thoracic spinal cord to the dorsal dura. This is believed to be the sole long-term report of the effects of Echols’ procedure. The history of direct treatment of syringomyelia is reviewed and is contrasted with indirect treatment of syringomyelia, which relieves the condition by opening obstructed CSF pathways within the foramen magnum or spine. PMID:19119937

Peterson, Matthew M.; Cracium, Liviu; Heiss, John D.

2009-01-01

266

Current Surgical Options for the Management of Pediatric Glaucoma  

PubMed Central

Currently, there are numerous choices for the treatment of pediatric glaucoma depending on the type of glaucoma, the age of the patient, and other particularities of the condition discussed in this review. Traditionally, goniotomy and trabeculotomy ab externo have been the preferred choices of treatment for congenital glaucoma, and a variety of adult procedures adapted to children have been utilized for other types of pediatric glaucoma with variable results and complications. More recently, seton implantations of different types have become more popular to use in children, and newer techniques have become available including visualized cannulation and opening of Schlemm's canal, deep sclerectomy, trabectome, and milder more directed cyclodestructive procedures such as endolaser and transcleral diode laser cyclophotocoagulation. This paper reviews the different surgical techniques currently available, their indications, results, and most common complications to allow the surgeon treating these conditions to make a more informed choice in each particular case. Although the outcome of surgical treatment in pediatric glaucoma has improved significantly, its treatment remains challenging. PMID:23738051

Morales, Jose; Al Shahwan, Sami; Al Odhayb, Sami; Al Jadaan, Ibrahim; Edward, Deepak P.

2013-01-01

267

Closed hyperthermic intraperitoneal chemotherapy with open abdomen: A novel technique to reduce exposure of  

E-print Network

the expansion of this otherwise beneficial technique. The toxic and teratogenic effects of these drugs have been the open-abdomen method is potentially more effective, it has not become a standard procedure because surfaces. This technique allows optimal HIPEC while limiting the potential toxic effects for the surgical

Boyer, Edmond

268

Fewer complications after laparoscopic nephrectomy as compared to the open procedure with the modified Clavien classification system - a retrospective analysis from Southern China  

PubMed Central

Background The objective of the study is to compare complication rates of laparoscopic nephrectomy and open nephrectomy using a standardized classification method Methods We retrospectively included 843 patients from March 2006 to November 2012, of whom 88 had laparoscopic radical nephrectomy (LRN), 526 had open radical nephrectomy (ORN), 42 had laparoscopic partial nephrectomy (LPN), and 187 had open partial nephrectomy (OPN). A modified Clavien classification system was applied to quantify complications of nephrectomy. Fisher’s exact or chi-square test were used to compare complication rates between laparoscopic and open approaches. Results The overall complication rate was 19.31%, 30.04%, 35.71%, and 36.36% in LRN, ORN, LPN, and OPN, respectively. More Grade II complications (odds ratio?=?2.593, 95% CI 1.172 to 5.737, P?=?0.010) and longer postoperation hospital stay (9.2 days and 7.6 days, P?surgical approach (LRN/ORN) (P?=?0.036), age (P?=?0.044), height (P?=?0.020), systolic pressure (P?=?0.012), fasting blood glucose level (P?=?0.032), and blood loss during operation (P?=?0.011) were significant predictors for grade II complications in radical nephrectomy. LPN had similar complication rates compared with OPN. Conclusions In conclusion, LRN had the advantages of less grade II complications and shorter postoperation hospital stay than ORN. Older age and more blood loss during operation would also contribute to more grade II complications in radical nephrectomy. PMID:25081928

2014-01-01

269

Surgical rehearsal platform: potential uses in microsurgery.  

PubMed

Surgical training has remained remarkably similar in many respects since the early days of halstedian training. Neurosurgery is a demanding field that requires extensive cognitive, perceptive, and technical training. Surgical simulation is a promising approach to facilitate acquiring proficiency in neurosurgical procedures. Simulation can permit mentoring trainees in a "safe" environment. By incorporating images that depict specific abnormalities in actual patients, simulation can provide realistic rehearsal for any given case for both novice and experienced surgeons in much the same way that data acquired from drones can be used to allow pilots to rehearse mission-critical maneuvers in a simulator before taking flight. Most neurosurgical simulators to date have focused on endovascular procedures, spinal procedures, temporal bone dissection, and stereotactic procedures. The use of simulator technology for microsurgery is in its infancy. This article describes a novel simulator technology developed by Surgical Theater LLC (http://www.surgicaltheater.net/home.html) called the Selman Surgical Rehearsal Platform. The platform shows promise for use in intracranial microvascular procedures, which require experience that is becoming increasingly limited for trainees who have to become proficient in more procedures in much less time than ever before. PMID:24051875

Bambakidis, Nicholas C; Selman, Warren R; Sloan, Andrew E

2013-10-01

270

Patellofemoral instability: surgical treatment of soft tissues  

PubMed Central

Summary Instability of the patella is a relatively frequent occurrence in adolescents. Its pathogenesis, which is multi-factorial, is still much debated. Stability of the patella is guaranteed by a delicate balance of a series of factors (osteo-cartilaginous, ligamentous and muscular), and it is not surprising that alteration of one or more of these can lead to pathological conditions that can range from simple anterior pain associated with a hypermobile patella to recurrent dislocation. The aim of surgical treatment is to correct these anatomical abnormalities. Surgical procedures on the soft tissues comprise reefing, realignment and reconstruction of the medial stabilizing structures, and release of the lateral structures. These procedures, although having precise indications, provide the surgeon with the instruments necessary to deal with almost all these anatomo-pathological conditions. Furthermore, preserving the osteo-cartilaginous components results in less morbidity than is associated with traditional surgical procedures, such as trochleoplasty and transposition of the anterior tibial tuberosity.

Panni, Alfredo Schiavone; Cerciello, Simone; Vasso, Michele

2013-01-01

271

[Surgical Managment of Retinal Detachment.  

PubMed

The detachment of the neurosensory retina from the underlying retinal pigment epithelium can be related to breaks of the retina allowing vitreous fluid to gain access to the subretinal space, to exudative changes of the choroid such as tumours or inflammatory diseases or to excessive tractional forces exerted by interactions of the collagenous vitreous and the retina. Tractional retinal detachment is usually treated by vitrectomy and exudative detachment can be addressed by treatment of the underlying condition in many cases. In rhegmatogenous retinal detachment two different surgical procedures, vitrectomy and scleral buckling, can be applied for functional and anatomic rehabilitation of our patients. The choice of the surgical procedure is not really standardised and often depends on the experience of the surgeon and other more ocular factors including lens status, the number of retinal breaks, the extent of the detachment and the amount of preexisting PVR. Using both techniques, anatomic success rates of over 90?% can be achieved. Especially in young phakic patients scleral buckling offers the true advantage to prevent the progression of cataract formation requiring cataract extraction and intraocular lens implantation. Therefore, scleral buckling should be considered in selected cases as an alternative surgical option in spite of the very important technical refinements in modern vitrectomy techniques. PMID:25393439

Haritoglou, C; Wolf, A

2014-11-13

272

Procedures for restoring vestibular disorders  

PubMed Central

This paper will discuss therapeutic possibilities for disorders of the vestibular organs and the neurons involved, which confront ENT clinicians in everyday practice. Treatment of such disorders can be tackled either symptomatically or causally. The possible strategies for restoring the body's vestibular sense, visual function and co-ordination include medication, as well as physical and surgical procedures. Prophylactic or preventive measures are possible in some disorders which involve vertigo (bilateral vestibulopathy, kinetosis, height vertigo, vestibular disorders when diving (Tables 1 (Tab. 1) and 2 (Tab. 2)). Glucocorticoid and training therapy encourage the compensation of unilateral vestibular loss. In the case of a bilateral vestibular loss, it is important to treat the underlying disease (e.g. Cogan's disease). Although balance training does improve the patient's sense of balance, it will not restore it completely. In the case of Meniere's disease, there are a number of medications available to either treat bouts or to act as a prophylactic (e.g. dimenhydrinate or betahistine). In addition, there are non-ablative (sacculotomy) as well as ablative surgical procedures (e.g. labyrinthectomy, neurectomy of the vestibular nerve). In everyday practice, it has become common to proceed with low risk therapies initially. The physical treatment of mild postural vertigo can be carried out quickly and easily in outpatients (repositioning or liberatory maneuvers). In very rare cases it may be necessary to carry out a semicircular canal occlusion. Isolated disturbances of the otolith function or an involvement of the otolith can be found in roughly 50% of labyrinth disturbances. A specific surgical procedure to selectively block the otolith organs is currently being studied. When an external perilymph fistula involving loss of perilymph is suspected, an exploratory tympanotomy involving also the round and oval window niches must be carried out. A traumatic rupture of the round window membrane can, for example, also be caused by an implosive inner ear barotrauma during the decompression phase of diving. Dehiscence of the anterior semicircular canal, a relatively rare disorder, can be treated conservatively (avoiding stimuli which cause dizziness), by non-ablative „resurfacing" or by „plugging" the semicircular canal. A perilymph fistula can cause a Tullio-phenomenon resulting from a traumatic dislocation or hypermobility of the stapes, which can be surgically corrected. Vestibular disorders can also result from otosurgical therapy. When balance disorders persist following stapedectomy it is necessary to carry out a revision operation in order to either exclude a perilymph fistula or shorten the piston. Surgically reducing the size of open mastoid cavities (using for example porous hydroxylapatite or cartilage) can result in a reduction of vertiginous symptoms while nursing or during exposure to ambient air. Vestibular disturbances can occur both before and after vestibular nerve surgery (acoustic neuroma). Initially, good vestibular compensation can be expected after surgically removing the acoustic neuroma. An aberrant regeneration of nerve fibers of the vestibulocochlear nerve has been suggested as a cause for secondary worsening. Episodes of vertigo can be caused by an irritation of the vestibular nerve (vascular loop). Neurovascular decompression is generally regarded as the best surgical therapy. In the elderly, vestibular disturbances can severely limit quality of life and are often aggravated by multiple comorbidities. Antivertiginous drugs (e.g. dimenhydrinate) in combination with movement training can significantly reduce symptoms. Administering antivertiginous drugs over varying periods of time (e.g. transdermal scopolamine application via patches) as well as kinetosis training can be used as both prophylactically and as a therapy for kinetosis. Exposure training should be used as a prophylactic for height vertigo. PMID:22073053

Walther, Leif Erik

2005-01-01

273

Surgical Management for Peyronie's Disease.  

PubMed

Peyronie's disease is a common debilitating condition for both men and their partners that results in penile deformity and compromises sexual functioning. While there are a myriad of medical therapeutic options, these have not been demonstrated to correct the deformity and restore sexual function definitively. As such, surgery is the mainstay of treatment for this disease, and multiple surgical approaches may be considered depending on disease characteristics, patient co-morbidity, and findings on preoperative diagnostic testing. The purpose of this review is to highlight the different surgical approaches and different procedures within each approach, and to examine important issues for surgeons to consider for administering the best treatment that restores function while reconciling patient expectations. PMID:23658860

Segal, Robert L; Burnett, Arthur L

2013-04-01

274

Surgical Management for Peyronie's Disease  

PubMed Central

Peyronie's disease is a common debilitating condition for both men and their partners that results in penile deformity and compromises sexual functioning. While there are a myriad of medical therapeutic options, these have not been demonstrated to correct the deformity and restore sexual function definitively. As such, surgery is the mainstay of treatment for this disease, and multiple surgical approaches may be considered depending on disease characteristics, patient co-morbidity, and findings on preoperative diagnostic testing. The purpose of this review is to highlight the different surgical approaches and different procedures within each approach, and to examine important issues for surgeons to consider for administering the best treatment that restores function while reconciling patient expectations. PMID:23658860

Segal, Robert L.

2013-01-01

275

Loop Electrosurgical Excision Procedure (LEEP)  

MedlinePLUS

... that acts like a scalpel (surgical knife). An electric current is passed through the loop, which cuts away ... A procedure in which an instrument works with electric current to destroy tissue. Local Anesthesia: The use of ...

276

Loop Electrosurgical Excision Procedure (LEEP)  

MedlinePLUS

... that acts like a scalpel (surgical knife). An electric current is passed through the loop, which cuts ... A procedure in which an instrument works with electric current to destroy tissue. Local Anesthesia: The use ...

277

Unusual presentation of caustic ingestion and its surgical treatment: a case report.  

PubMed

Treatment and reconstruction of oral scar contracture, is always a challenging procedure to restore structure and functions of the oral cavity. We present a case of a patient with limited mouth opening who sustained extensive oral scar contracture with complete adhesion of tongue to floor of mouth following ingestion of caustic soda without his knowledge 4 years back. We performed a surgical release of the scar contractures from buccal mucosa on both sides, along with a release of the tongue from the floor of the mouth, followed by reconstruction of all sites using split skin grafts. Adequate mouth opening and tongue movement was achieved. There was a follow up period of 1 month with excellent mouth opening and tongue function. PMID:22379326

Gupta, Sunil Kumar; Rana, A S; Gupta, Deepak; Jain, Gaurav; Kalra, Puneet

2011-03-01

278

Inpatient procedures in elderly women: An analysis over time  

PubMed Central

Objectives To describe inpatient surgical and diagnostic/therapeutic procedures in women ?65 years old and assess procedure trends over time. Study Design Procedure data for all women ?65 years was collected using the National Hospital Discharge Survey, a federal dataset drawn from a representative sampling of U.S. inpatient hospitals which includes patient and hospital demographics and ICD-9-CM diagnosis and procedure codes for admissions from 1979-2006. Main Outcome Measures Age-adjusted rates (AAR) per 1000 women were created using 1990 U.S. Census data to compare trends over time. Results Over 96 million procedures were performed in women age ?65 years from 1979-2006. Women age ?65 years constituted 17% of women with ?1 inpatient procedure in 1979, rising to 32% in 2006. The most common surgical procedures were lower extremity joint replacement, open reduction internal fixation, and cholecystectomy. The most common concurrent diagnosis was femoral neck fracture. Women with femoral neck fracture were more likely to undergo open reduction internal fixation compared to joint replacement. AARs for ORIF fell from 4.3 to 3.2 (p=.02) from 1979-2006, while AARs for joint replacement increased from 0.2 to 3.4 (p=<.001, 1979-1988; p=.14, 1990-2006). Conclusions The rate of women age ?65 years undergoing inpatient procedures has increased dramatically in the last 30 years. Hip fracture was the most common diagnosis for elderly women, highlighting the impact of osteoporosis and falls and the importance of prevention strategies and optimization of peri-operative care in this population. Further comparative study of hip fracture treatment strategies in this population is needed. PMID:23707727

OLIPHANT, Sallie S.; GHETTI, Chiara; MCGOUGH, Richard L.; WANG, Li; BUNKER, Clareann H.; LOWDER, Jerry L.

2013-01-01

279

Jannin P, Raimbault M, Morandi X, Riffaud L and Gibaud B. Models of Surgical Procedures for Multimodal Image-Guided Neurosurgery, Journal of Computer Aided Surgery, 2003;8(2):98-106  

E-print Network

for Multimodal Image-Guided Neurosurgery, Journal of Computer Aided Surgery, 2003;8(2):98-106 Models of Surgical.M.,L.R.) Abstract Objective: Improvement of the planning stage in image-guided surgery requires a better manuscript, published in "Computer Aided Surgery 8, 2 (2003) 98-106" #12;Jannin P, Raimbault M, Morandi X

Boyer, Edmond

280

Surgical treatment of Dupuytren’s disease – outcome and health economy in relation to smoking and diabetes  

PubMed Central

Background The conventional treatment for Dupuytren’s disease is surgery. The introduction of alternative treatment strategies creates a need to track outcomes and costs relating to surgical treatment and risk factors, such as smoking and diabetes. This was the aim of the present study. Methods In a prospective study, the outcome of open surgical treatment for finger flexion contracture in Dupuytren’s disease (175 patients; 182 surgical procedures) was studied by evaluating valid QuickDASH forms answered by subjects before surgery and one year postoperatively. Data were also obtained from medical records, and preoperative declarations concerning health. Results In all subjects (median [25% - 75% percentiles] age 68 [62-73]), the QuickDASH score improved from 22 [9-36] to 5 [0-18]. Smokers (27/179 procedures) were younger and had a more severe degree of disease and dysfunction preoperatively than non-smokers, but the outcome of surgery did not differ between the groups. Subjects with diabetes (20/181 procedures) were younger than those without diabetes, but their disease severity or outcome did not differ. Hand specialists operated faster than residents, but the surgical outcome did not differ. Healthcare costs for surgery for Dupuytren’s contracture were $ 2392 (€ 1859), which were not higher among smokers or subjects with diabetes. Only 22 patients remained in hospital (2 [1-2.3] days) and 28 patients needed sick leave (28 [21-31] days). The occurrence of necrosis of skin flaps (12%) or infections (6%) was no more frequent among smokers or those with diabetes. Conclusions There is no difference in surgical outcome for finger flexion contracture in Dupuytren’s disease between smokers and non-smokers or between subjects with or without diabetes, although smokers had more severe preoperative contracture. The costs for surgical treatment for finger flexion contracture in Dupuytren’s disease should be viewed in relation to that for other treatment strategies. PMID:24694095

2014-01-01

281

Surgical Results of the Carotid Occlusion Surgery Study  

PubMed Central

Object The Carotid Occlusion Surgery Study (COSS) was conducted to determine if STA-MCA bypass, when added to best medical therapy, would reduce subsequent ipsilateral stroke in patients with complete ICA occlusion and an elevated OEF in the cerebral hemisphere distal to the carotid occlusion. A recent publication reported the methodology of COSS in detail and briefly outlined the major findings of the trial.29 The surgical results of COSS are described in detail in this report. Methods The Carotid Occlusion Surgery Study (COSS) was a parallel group, prospective, 1:1 randomized, open-label, blinded-adjudication treatment trial. Participants with angiographic confirmed complete occlusion of the ICA causing either a transient ischemic attack (TIA) or ischemic stroke within 120 days and hemodynamic cerebral ischemia demonstrated by an increased oxygen extraction fraction (OEF) measured by positron emission tomography (PET) were randomized to either surgical or medical treatment. The surgical patients underwent a STA-MCA cortical branch anastomosis. One hundred and ninety-five patients were randomized: 97 to the surgical group and 98 to the medical group. Results In the intention-to-treat analysis, the two-year rates of the primary endpoint were 0.210 for the surgical group and 0.227 for the medical group (p=0.78, log rank). Fourteen (15%) of the 93 patients who had an STA-MCA arterial bypass had an endpoint ipsilateral hemispheric stroke in the 30 day peri-operative period, 12 within two days. The STA-MCA arterial bypass patency rate was 98% at the 30 day post-operative visit and 96% at the last follow-up examination. STA-MCA arterial bypass markedly improved, although it did not normalize, the level of elevated OEF in the symptomatic cerebral hemisphere. Five operated patients and one non-operated patient in the surgical group had an endpoint ipsilateral hemispheric stroke after the 30 day peri-operative period. No baseline characteristics or intra-operative variables were identified that permitted the identification of those who would experience a procedure related stroke. Conclusions In spite of excellent bypass graft patency and improved cerebral hemodynamics, STA-MCA anastomosis did not provide an overall benefit on ipsilateral two-year stroke recurrence, mainly due to a much better than expected stroke recurrence rate (22.7%) in the medical group in the trial, but also because of a significant peri-operative stroke rate (15%). PMID:23101451

Grubb, Robert L.; Powers, William J.; Clarke, William R.; Videen, Tom O.; Adams, Harold P.; Derdeyn, Colin P.

2014-01-01

282

Efficacy of a dual-ring wound protector for prevention of incisional surgical site infection after Whipple's procedure (pancreaticoduodenectomy) with preoperatively-placed intrabiliary stents: protocol for a randomised controlled trial  

PubMed Central

Introduction Among surgical oncology patients, incisional surgical site infection is associated with substantially increased morbidity, mortality and healthcare costs. Moreover, while adults undergoing pancreaticoduodenectomy with preoperative placement of an intrabiliary stent have a high risk of this type of infection, and wound protectors may significantly reduce its risk, no relevant studies of wound protectors yet exist involving this patient population. This study will evaluate the efficacy of a dual-ring wound protector for prevention of incisional surgical site infection among adults undergoing pancreaticoduodenectomy with preoperatively-placed intrabiliary stents. Methods and analysis This study will be a parallel, dual-arm, randomised controlled trial that will utilise a more explanatory than pragmatic attitude. All adults (?18?years) undergoing a pancreaticoduodenectomy at the Foothills Medical Centre in Calgary, Alberta, Canada with preoperative placement of an intrabiliary stent will be considered eligible. Exclusion criteria will include patient age <18?years and those receiving long-term glucocorticoids. The trial will employ block randomisation to allocate patients to a commercial dual-ring wound protector (the Alexis Wound Protector) or no wound protector and the current standard of care. The main outcome measure will be the rate of surgical site infection as defined by the Centers for Disease Control and Prevention criteria within 30?days of the index operation date as determined by a research assistant blinded to treatment allocation. Outcomes will be analysed by a statistician blinded to allocation status by calculating risk ratios and 95% CIs and compared using Fisher's exact test. Ethics and dissemination This will be the first randomised trial to evaluate the efficacy of a dual-ring wound protector for prevention of incisional surgical site infection among patients undergoing pancreaticoduodenectomy. Results of this study are expected to be available in 2016/2017 and will be disseminated using an integrated and end-of-grant knowledge translation strategy. Trial registration number ClinicalTrials.gov identifier NCT01836237. PMID:25146716

Bressan, Alexsander K; Roberts, Derek J; Edwards, Janet P; Bhatti, Sana U; Dixon, Elijah; Sutherland, Francis R; Bathe, Oliver; Ball, Chad G

2014-01-01

283

Mini-Open Suture Bridge Repair with Porcine Dermal Patch Augmentation for Massive Rotator Cuff Tear: Surgical Technique and Preliminary Results  

PubMed Central

Background The aim of this study was to describe the mini-open suture bridge technique with porcine dermal patch augmentation for massive rotator cuff tear and to assess preliminary clinical and radiological results. Methods Five patients with massive rotator cuff tear for which it was not possible to restore the anatomical footprint underwent mini-open suture bridge repair using a porcine dermal patch. The patients' average age was 53.4 years (range, 45 to 57 years), and the average duration of follow-up was 20.6 months (range, 14 to 26 months). Patients were evaluated with preoperative and postoperative outcome measures, including a visual analog scale (VAS) for pain, the University of California Los Angeles (UCLA) score, and the American Shoulder and Elbow Surgeons (ASES) score. The structural integrity of repaired rotator cuffs was assessed by magnetic resonance imaging 6 months postoperatively. Results The average VAS pain score, UCLA score, and ASES score improved from 6.8, 15.4, and 39.4 preoperatively to 0.8, 31.2, and 86.4 postoperatively (p = 0.041, 0.042, and 0.043, respectively). Magnetic resonance images obtained at an average of 8 months after surgery showed that four patients had intact repair integrity with graft incorporation. One patient had a re-tear with partial healing but still had a satisfactory clinical outcome. There was no intraoperative or postoperative complication in any patient. Conclusions Mini-open suture bridge repair with porcine dermal patch augmentation can be an option in young patients with high physical demands and massive rotator cuff tears for which it is not possible to restore the anatomical footprint. PMID:25177460

Lee, Sung-Moon; Lee, Young-Kuk; Shin, Hong-Kwan

2014-01-01

284

Regional programs for surgical bone banking.  

PubMed

The findings of a survey of 12 regional programs engaged in collection, storage, and distribution of surgical bone grafts are described in this report. In approximately one year, 1944 grafts (mostly femoral heads) were collected. The overall discard rate for the grafts was 30%. An unacceptable medical history, and laboratory evidence of positive screening tests for hepatitis B surface antigen and human immunodeficiency virus (HIV) antibodies accounted for 34.0%, 3.4%, and 1.2% of the discard rate, respectively. Eighty-seven percent of the grafts were used for three surgical procedures, i.e., revision hip surgery, spinal fusions, and treatment of nonunited fractures. The practices and experiences of the regional program described in this report of surgical bone collection and transplantation appear to be similar to those previously described for the community-hospital-based institutional programs. Regional programs represent an alternative approach to institutional programs in surgical bone banking. PMID:2295187

Kakaiya, R M; Jackson, B

1990-02-01

285

Unique surgical tool as an iatromagic charm.  

PubMed

Papyri are writings made on special sheets made out of reeds grown on the banks of the river Nile. The Authors comment on the relationship between a ritual text and surgical therapy with an exploration of an ancient charm as recorded in a Greek written papyrus stored in the Medicea Laurenziana Library papyri collection. This charm was presumably intended to act apotropaically, rendering harmless the aggressive surgical tool by means of still keeping its therapeutic value and thereby affording healing protection. This ritual charm acts as a "therapeutic medium" to help the surgical procedure useful to cut or to excise the uvula. The surgical power of stafillotomos is linked to the protective power of the iatromagic charm, giving the chance to analyze ancient data and to suggest a possible shape of the original scalpel. PMID:21657101

Somma, Alfredo Musajo; Somma, Laura Musajo

2010-12-01

286

A review of microgravity surgical investigations  

NASA Technical Reports Server (NTRS)

The likelihood of performing a surgical procedure in space will increase as the Soviet Mir space station is expanded and the Space Station Freedom becomes operational. A review of previous research and hardware development, performed mostly in parabolic flight both in the Soviet Union and the U.S., reveals an interest in surgical chambers to prevent cabin atmosphere contamination. Surgical techniques appear to be no more difficult than in a 1-G environment if a restraint system is used. Minimizing the changes of wound infection from the high particle count spacecraft atmosphere is an additional concern. Additional research is necessary to delineate the clinical significance of these problems and to further develop surgical techniques in microgravity.

Campbell, Mark R.; Billica, Roger D.

1992-01-01

287

Surgical treatment of primary headaches.  

PubMed

Neuromodulation for the treatment of drug-refractory cranial neuralgias constitutes an exciting field of research for physicians; in the last decade, several methodologies have been described which could help many patients to exit such desperate conditions; although the exact mechanisms of action of these techniques are still matter of debate, several experimental and neuroradiological modalities can help us to get near the concept of understanding them. In this paper, the authors summarize the most recent surgical procedures used to treat severe and pharmaco-resistant cranial painful conditions, along with brief descriptions of the results obtained in the several published so far. PMID:22644188

Franzini, Angelo; Messina, Giuseppe; Cordella, Roberto; Proietti Cecchini, Alberto; Leone, Massimo; Bussone, Gennaro

2012-05-01

288

Surgical Complications After Implant Placement.  

PubMed

Placement of dental implants in the maxillofacial region is routine and considered safe. However, as with any surgical procedure, complications occur. Many issues that arise at surgery can be traced to the preoperative evaluation of the patient and assessment of the underlying anatomy. In this article, the authors review some common and uncommon complications that can occur during and shortly after implant placement. The emphasis of each section is on the management and prevention of complications that may occur during implant placement. PMID:25434559

Camargo, Igor Batista; Van Sickels, Joseph E

2015-01-01

289

Staphylococcus aureus nasal carriage and surgical-site infections  

Microsoft Academic Search

The current literature indicates that surgical-site infections significantly increase costs and length of stay. Nosocomial infections that are acquired after operative procedures increase mortality rates. Staphylococcus aureus is a major cause of surgical-site infections among patients, particularly patients who undergo cardiothoracic surgery. Patients who carry S aureus in their nares are at increased risk for surgical-site infections that are caused

Loreen A Herwaldt

2003-01-01

290

The use of an open-ended group in the intake procedure of a mental hygiene unit  

Microsoft Academic Search

Several clinics have found screening in small groups on intake to be beneficial in reducing waiting lists and evaluating patients for treatment. Others have used small short-term groups to orient and educate patients to treatment. We have run a continuous, open-ended intake group for these purposes and to provide nuclei for other closed therapy groups. The result has been elimination

Andrew S. Dibner; Robert D. Palmer; Benjamin Cohen; Arnold G. Gofstein

1963-01-01

291

Multimodal augmented reality system for surgical microscopy  

NASA Astrophysics Data System (ADS)

Image-guided, computer-assisted neurosurgery has emerged to improve localization and targeting, to provide a better anatomic definition of the surgical field, and to decrease invasiveness. Usually, in image-guided surgery, a computer displays the surgical field in a CT/MR environment, using axial, coronal or sagittal views, or even a 3D representation of the patient. Such a system forces the surgeon to look away from the surgical scene to the computer screen. Moreover, this kind of information, being pre-operative imaging, can not be modified during the operation, so it remains valid for guidance in the first stage of the surgical procedure, and mainly for rigid structures like bones. In order to solve the two constraints mentioned before, we are developing an ultrasoundguided surgical microscope. Such a system takes the advantage that surgical microscopy and ultrasound systems are already used in neurosurgery, so it does not add more complexity to the surgical procedure. We have integrated an optical tracking device in the microscope and an augmented reality overlay system with which we avoid the need to look away from the scene, providing correctly aligned surgical images with sub-millimeter accuracy. In addition to the standard CT and 3D views, we are able to track an ultrasound probe, and using a previous calibration and registration of the imaging, the image obtained is correctly projected to the overlay system, so the surgeon can always localize the target and verify the effects of the intervention. Several tests of the system have been already performed to evaluate the accuracy, and clinical experiments are currently in progress in order to validate the clinical usefulness of the system.

Garcia Giraldez, Jaime; Talib, Haydar; Caversaccio, Marco; Gonzalez Ballester, Miguel A.

2006-03-01

292

Surgical approaches for total hip arthroplasty  

Microsoft Academic Search

Total hip replacement is a commonly performed procedure. The National Joint Registry for England and Wales identifies the four most commonly used approaches. An understanding of the relevant anatomy, benefits and common complications for each approach is essential core knowledge for all orthopaedic surgeons. In this article we provide an overview of our preferred technique for the surgical approaches commonly

Andrew Graham Sloan; Henry Wynn Jones; Martyn Lonsdale Porter; Kevin Hardinge

2010-01-01

293

Personality Characteristics of the Cosmetic Surgical Insatiable Patient  

Microsoft Academic Search

It is argued that the personality of the cosmetic surgical patient is undisturbed. Furthermore it is argued that a vast majority of these patients are very pleased with the results of the cosmetic correction. A very small percentage however is dissatisfied (although no surgical-technical mistake was made) and is urging again and again for a repetition of the procedure. The

N. H. Groenman; H. C. Sauër

1983-01-01

294

Biomimetic Propulsion for a Swimming Surgical Micro-Robot  

E-print Network

Biomimetic Propulsion for a Swimming Surgical Micro-Robot Jon Edd1 , Sébastien Payen1 , Boris of the propulsion mechanism is determined through simultaneous modeling of the viscous drag on the filaments and the propulsion analysis are applicable to many other possible surgical procedures. I. INTRODUCTION This paper

Sitti, Metin

295

Computer Assisted Surgical Planner for Craniofacial Reconstruction - Imaging Techniques  

Microsoft Academic Search

Computer tomography (CT) and magnetic resonance imagery (MRI) have had an enormous impact in medicine. Using medical imagery, computer assisted surgery (CAS) systems decrease the invasiveness of surgical procedures, increase accuracy and facilitate surgical planning and analysis. Craniofacial anomalies and fine anatomic details of facial traumic injuries can be well studied with such imaging techniques. This research is focused on

Mohammad Azam Rana; Halim Setan; Zulkepli Majid; Albert K. Chong

2006-01-01

296

42 CFR 482.51 - Condition of participation: Surgical services.  

Code of Federal Regulations, 2012 CFR

...procedures, LPNs and surgical technologists may assist in circulatory duties under the surpervision of a qualified registered nurse...must be available to the operating room suites: call-in-system, cardiac monitor, resuscitator, defibrillator,...

2012-10-01

297

42 CFR 482.51 - Condition of participation: Surgical services.  

Code of Federal Regulations, 2011 CFR

...procedures, LPNs and surgical technologists may assist in circulatory duties under the surpervision of a qualified registered nurse...must be available to the operating room suites: call-in-system, cardiac monitor, resuscitator, defibrillator,...

2011-10-01

298

42 CFR 482.51 - Condition of participation: Surgical services.  

Code of Federal Regulations, 2013 CFR

...procedures, LPNs and surgical technologists may assist in circulatory duties under the surpervision of a qualified registered nurse...must be available to the operating room suites: call-in-system, cardiac monitor, resuscitator, defibrillator,...

2013-10-01

299

42 CFR 482.51 - Condition of participation: Surgical services.  

Code of Federal Regulations, 2010 CFR

...procedures, LPNs and surgical technologists may assist in circulatory duties under the surpervision of a qualified registered nurse...must be available to the operating room suites: call-in-system, cardiac monitor, resuscitator, defibrillator,...

2010-10-01

300

42 CFR 482.51 - Condition of participation: Surgical services.  

Code of Federal Regulations, 2014 CFR

...procedures, LPNs and surgical technologists may assist in circulatory duties under the surpervision of a qualified registered nurse...must be available to the operating room suites: call-in-system, cardiac monitor, resuscitator, defibrillator,...

2014-10-01

301

21 CFR 886.4350 - Manual ophthalmic surgical instrument.  

Code of Federal Regulations, 2010 CFR

...handheld device intended to aid or perform ophthalmic surgical procedures. This generic type of device includes the manual corneal burr, ophthalmic caliper, ophthalmic cannula, eyelid clamp, ophthalmic muscle clamp, iris retractor clip,...

2010-04-01

302

42 CFR 485.639 - Condition of participation: Surgical services.  

Code of Federal Regulations, 2013 CFR

... false Condition of participation: Surgical...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION: SPECIALIZED...procedures, and with State scope of practice laws. Surgery is...

2013-10-01

303

42 CFR 485.639 - Condition of participation: Surgical services.  

Code of Federal Regulations, 2012 CFR

... false Condition of participation: Surgical...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION: SPECIALIZED...procedures, and with State scope of practice laws. Surgery is...

2012-10-01

304

42 CFR 485.639 - Condition of participation: Surgical services.  

Code of Federal Regulations, 2014 CFR

... false Condition of participation: Surgical...SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION: SPECIALIZED...procedures, and with State scope of practice laws. Surgery is...

2014-10-01

305

[Surgical management of varicose ulcers].  

PubMed

One of the most often diseases of the European population is the venous chronic leg ulcer. It requires a long-term and expensive therapy. Basic elements of the therapy are elastic banding of the leg, diuretics, antibiotics and local treatment. In some cases a profit can be acquired from surgical procedure, which includes the stripping and/or crossectomy of the saphenous vein or the subfascial ligation of insufficient perforators and skin grafting (two phases operation). This procedure shorts the time of therapy and prevents the ulcer recurrence, because it resolves the reason and the results of the disease. We present 22 patients treated by this cure during the last 3 years at our surgery department of the 3rd faculty of medicine Charles University in Prague. 21 patients (95.5%) are healed. PMID:16447575

Ston, R; Havl?j, L; Ocadlík, M; Masri, A

2005-12-01

306

Concept of the aortic aneurysm repair-related surgical stress: a review of the literature  

PubMed Central

Objective: Abdominal aorta aneurysm (AAA) is a serious threat for human life. AAA repair is a high-risk procedure which results in a severe surgical stress response. We aim to give a conceptual description of the underlying pathophysiology of stress after surgical repair of AAA. Methods: The MEDLINE/PubMed database was searched for publications with the medical subject heading “surgical stress” and keywords “abdominal aortic aneurysms (AAA)”, or “cytokines” or “hormones” or “open repair (OR)” or “endovascular repair (EVAR)”. We restricted our search to English till 2012 and only in cases of abdominal and thoracoabdominal aneurysms (TAAA). Results: We identified 93 articles that were available in English as abstracts or/and full-text articles that were deemed appropriate for our review. Conclusions: Literature highlights no statistical significance for early acute TNF-? production in EVAR and no TNF-? production in OR. IL-6 and IL-8 levels are higher after OR especially when compared with those of EVAR. IL-10 peak was observed during ischemic phase in aneurysm surgical repair. Cortisol and epinephrine levels are higher in OR patients in comparison to EVAR patients. Finally, the incidence of systemic inflammatory response syndrome was significantly higher in OR than EVAR patients. PMID:25356092

Moris, Demetrios N; Kontos, Michalis I; Mantonakis, Eleftherios I; Athanasiou, Antonios K; Spartalis, Eleftherios D; Bakoyiannis, Chris N; Chrousos, George P; Georgopoulos, Sotirios E

2014-01-01

307

A virtual reality model of the clivus and surgical simulation via transoral or transnasal route  

PubMed Central

Background: Neurosurgery in areas with restricted space and complicated anatomy can be greatly aided by the virtual reality (VR) technique. The clivus represents one of such challenging surgical areas, but its VR has not been established. The present study aimed to document a VR model of clival anatomy that may be useful in clival surgery. Methods: High resolution CT angiography and MRI were used. The study included a total of 20 patients who did not have any obvious abnormalities detected in the oral, nasal, and clival areas. The images were fused with a Dextroscope. Results: In the VR model, the key structures such as the clival bone, basilar artery, brainstem, pituitary gland, and paranasal sinuses were clearly observed. The morphology of the clivus and its spatial relationships with the neighboring structures were also illustrated. Visualization of the clival model can be made flexible from various planes, angles, or orientations. In addition, surgical access to the clivus via the transoral route or transnasal route was simulated in detail. Conclusion: The simulation of the VR model offers a straightforward, three-dimensional, interactive understanding of the size and shape of the clivus, and its relationships with the surrounding blood vessels and bones. It also demonstrates simulated operational procedures such as opening the surgical window, measuring the exposure distance and angles, and determining the critical boundaries in relation to key structures such as the brainstem and arteries. Digitalized VR modeling appears to be helpful for understanding the anatomy of the clivus and its surgical approaches. PMID:25419358

Wang, Shou-Sen; Li, Jun-Feng; Zhang, Shang-Ming; Jing, Jun-Jie; Xue, Liang

2014-01-01

308

Robotic Surgical Training in an Academic Institution  

PubMed Central

Objective To detail robotic procedure development and clinical applications for mitral valve, biliary, and gastric reflux operations, and to implement a multispecialty robotic surgery training curriculum for both surgeons and surgical teams. Summary Background Data Remote, accurate telemanipulation of intracavitary instruments by general and cardiac surgeons is now possible. Complex technologic advancements in surgical robotics require well-designed training programs. Moreover, efficient robotic surgical procedures must be developed methodically and safely implemented clinically. Methods Advanced training on robotic systems provides surgeon confidence when operating in tiny intracavitary spaces. Three-dimensional vision and articulated instrument control are essential. The authors’ two da Vinci robotic systems have been dedicated to procedure development, clinical surgery, and training of surgical specialists. Their center has been the first United States site to train surgeons formally in clinical robotics. Results Established surgeons and residents have been trained using a defined robotic surgical educational curriculum. Also, 30 multispecialty teams have been trained in robotic mechanics and electronics. Initially, robotic procedures were developed experimentally and are described. In the past year the authors have performed 52 robotic-assisted clinical operations: 18 mitral valve repairs, 20 cholecystectomies, and 14 Nissen fundoplications. These respective operations required 108, 28, and 73 minutes of robotic telemanipulation to complete. Procedure times for the last half of the abdominal operations decreased significantly, as did the knot-tying time in mitral operations. There have been no deaths and few complications. One mitral patient had postoperative bleeding. Conclusion Robotic surgery can be performed safely with excellent results. The authors have developed an effective curriculum for training teams in robotic surgery. After training, surgeons have applied these methods effectively and safely. PMID:11573041

Chitwood, W. Randolph; Nifong, L. Wiley; Chapman, William H. H.; Felger, Jason E.; Bailey, B. Marcus; Ballint, Tara; Mendleson, Kim G.; Kim, Victor B.; Young, James A.; Albrecht, Robert A.

2001-01-01

309

Medical & Surgical Management of Pelvic Floor Disorders Affecting Defecation  

PubMed Central

Pelvic floor disorders that affect stool evacuation include structural (example: rectocele) and functional disorders (example: dyssynergic defecation). Meticulous history, digital rectal examination, and physiological tests such as anorectal manometry, colonic transit study, balloon expulsion and imaging studies such as anal ultrasound, defecography, and static and dynamic MRI can facilitate an objective diagnosis and optimal treatment. Management consists of education and counseling regarding bowel function, diet, laxatives, most importantly behavioral and biofeedback therapies, and lastly surgery. Randomized clinical trials have established that biofeedback therapy is effective in treating dyssynergic defecation. Because dyssynergic defecation may co-exist with conditions such as solitary rectal ulcer syndrome (SRUS), and rectocele, before considering surgery, biofeedback therapy should be tried and an accurate assessment of the entire pelvis and its function should be performed. Several surgical approaches have been advocated for the treatment of pelvic floor disorders including open, laparoscopic and trans-abdominal approach, stapled transanal rectal resection (STARR), and robotic colon and rectal resections. However, there is lack of well controlled randomized studies and efficacy of these surgical procedures remains to be established. PMID:22907620

Schey, Ron; Cromwell, John; Rao, Satish S.C.

2014-01-01

310

Surgical Management of Urolithiasis in Patients after Urinary Diversion  

PubMed Central

Objective To present our experience in surgical management of urolithiasis in patients after urinary diversion. Patients and Methods Twenty patients with urolithiasis after urinary diversion received intervention. Percutaneous nephrolithotomy, percutaneous based antegrade ureteroscopy with semi-rigid or flexible ureteroscope, transurethral reservoir lithotripsy, percutaneous pouch lithotripsy and open operation were performed in 8, 3, 2, 6, and 1 patients, respectively. The operative finding and complications were retrospectively collected and analyzed. Results The mean stone size was 4.5±3.1 (range 1.5–11.2) cm. The mean operation time was 82.0±11.5 (range 55–120) min. Eighteen patients were rendered stone free with a clearance of 90%. Complications occurred in 3 patients (15%). Two patients (10%) had postoperative fever greater than 38.5°C, and one patient (5%) suffered urine extravasations from percutaneous tract. Conclusions The percutaneous based procedures, including percutaneous nephrolithotomy, antegrade ureteroscopy with semi-rigid ureteroscope or flexible ureteroscope from percutaneous tract, and percutaneous pouch lithotripsy, provides a direct and safe access to the target stones in patients after urinary diversion, and with high stone free rate and minor complications. The surgical management of urolithiasis in patients after urinary diversion requires comprehensive evaluation and individualized consideration depending upon the urinary diversion type, stone location, stone burden, available resource and surgeon experience. PMID:25360621

Zhong, Wen; Yang, Bicheng; He, Fang; Wang, Liang; Swami, Sunil; Zeng, Guohua

2014-01-01

311

Surgical ablation for atrial fibrillation.  

PubMed

This paper reviews the history of surgical procedures developed for eradication of atrial fibrillation (AF) during cardiac surgery for structural heart disease, and in patients with AF without other indication for cardiac surgery. Current evidence indicates that, despite their proven efficacy, the Cox-Maze procedure and its modifications require cardiopulmonary bypass and cannot be easily justified in the case of AF without other indication for cardiac surgery. In patients undergoing cardiac surgery for mitral valve disease, concomitant ablation techniques using modifications of the Maze and alternative energy sources appear to be safe and effective in treating AF, especially in non-rheumatic disease. Minimally invasive epicardial ablation has been recently developed and can be performed on a beating heart through small access incision ports. Various techniques combining pulmonary vein isolation, ganglionated plexi ablation, and left atrial lines have been tried. Initial results are promising but further clinical experience is required to establish ideal lesion sets, appropriate energy sources, and the benefit-risk ratio of such an approach in patients without other indication for cardiac surgery. The role of surgical ablation in the current management of AF is under investigation. PMID:22490369

Fragakis, Nikolaos; Pantos, Ioannis; Younis, Jenan; Hadjipavlou, Marios; Katritsis, Demosthenes G

2012-11-01

312

CULTIVATING NETWORKS: IMPLEMENTING SURGICAL  

E-print Network

i CULTIVATING NETWORKS: IMPLEMENTING SURGICAL TELEMEDICINE Margunn Aanestad THE INTERVENTIONAL OF MATHEMATICS AND NATURAL SCIENCES, UNIVERSITY OF OSLO #12;ii CULTIVATING NETWORKS: IMPLEMENTING SURGICAL single site use: the challenges of growing networks 38 6.2.2 Micro- and macro-level design in use 39 6

Sahay, Sundeep

313

Surgical Technology Program Guide.  

ERIC Educational Resources Information Center

This surgical technology program guide presents the standard curriculum for technical institutes in Georgia. The curriculum addresses the minimum competencies for a surgical technology program. The program guide is designed to relate primarily to the development of those skills needed by individuals in the field to provide services in the…

Georgia Univ., Athens. Dept. of Vocational Education.

314

Elec 331 -Surgical Instruments Surgical Instruments  

E-print Network

Alloys - Substitutional Atoms · Same size as Fe · Positions normally occupied by Fe. #12;Elec 331 - Surgical Instruments 3 Alloys - Interstitial Atoms · Smaller than Fe · Occupy gaps · Greater solubility in Austenite (larger gaps) · Precipitate out during cooling Iron Alloy Atoms Substitutional Atoms · Chromium

Pulfrey, David L.

315

Update on Schlemm's Canal Based Procedures  

PubMed Central

Surgical options for glaucoma have expanded in recent years. This article provides an evidence-based update on the novel or emerging surgical techniques for the treatment of open-angle glaucoma that are based on the Schlemm's canal (SC). Canaloplasty is an ab externo approach and was developed as an alternative to traditional filtering surgeries. The Hydrus microstent (Ivantis Inc., Irvine, CA) is a so-called SC scaffold that directly bypasses the trabecular meshwork to drain aqueous humor into the SC, which it keeps dilated over approximately one quadrant. Canaloplasty has also been shown to lower intraocular pressure (IOP) by up to 40% and combined with cataract surgery. IOP was lowered 44% at 24 months while maintaining a favorable safety profile. The Hydrus device has been proposed as an adjunct to cataract extraction surgery. To date, no published evidence from clinical trials is available on its in vivo safety and efficacy. Schlemm's canal based glaucoma procedures show promise as alternative treatments to traditional glaucoma surgery. Surgeons must be comfortable with angle anatomy. A prerequisite for functionality of these techniques is the integrity of the distal outflow system. At present, however, it is not possible to conclude whether these novel procedures will be viable alternatives to standard filtering surgery over the long-term. PMID:25624672

Mansouri, Kaweh; Shaarawy, Tarek

2015-01-01

316

Update on Schlemm's Canal Based Procedures.  

PubMed

Surgical options for glaucoma have expanded in recent years. This article provides an evidence-based update on the novel or emerging surgical techniques for the treatment of open-angle glaucoma that are based on the Schlemm's canal (SC). Canaloplasty is an ab externo approach and was developed as an alternative to traditional filtering surgeries. The Hydrus microstent (Ivantis Inc., Irvine, CA) is a so-called SC scaffold that directly bypasses the trabecular meshwork to drain aqueous humor into the SC, which it keeps dilated over approximately one quadrant. Canaloplasty has also been shown to lower intraocular pressure (IOP) by up to 40% and combined with cataract surgery. IOP was lowered 44% at 24 months while maintaining a favorable safety profile. The Hydrus device has been proposed as an adjunct to cataract extraction surgery. To date, no published evidence from clinical trials is available on its in vivo safety and efficacy. Schlemm's canal based glaucoma procedures show promise as alternative treatments to traditional glaucoma surgery. Surgeons must be comfortable with angle anatomy. A prerequisite for functionality of these techniques is the integrity of the distal outflow system. At present, however, it is not possible to conclude whether these novel procedures will be viable alternatives to standard filtering surgery over the long-term. PMID:25624672

Mansouri, Kaweh; Shaarawy, Tarek

2015-01-01

317

IEEE TRANSACTIONS ON ROBOTICS AND AUTOMATION, VOL. 19, NO. 5, OCTOBER 2003 893 Bone-Mounted Miniature Robot for Surgical  

E-print Network

a miniature robot is directly mounted on the patient's bony structure near the surgical site. The robot-Mounted Miniature Robot for Surgical Procedures: Concept and Clinical Applications Moshe Shoham, Member, IEEE surgical procedures. Since the robot forms a single rigid body with the anatomy, there is no need

Joskowicz, Leo

318

Surgical simulation in orthopaedic skills training.  

PubMed

Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated. PMID:22751160

Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

2012-07-01

319

Haptic feedback and control of a flexible surgical endoscopic robot.  

PubMed

A flexible endoscope could reach the potential surgical site via a single small incision on the patient or even through natural orifices, making it a very promising platform for surgical procedures. However, endoscopic surgery has strict spatial constraints on both tool-channel size and surgical site volume. It is therefore very challenging to deploy and control dexterous robotic instruments to conduct surgical procedures endoscopically. Pioneering endoscopic surgical robots have already been introduced, but the performance is limited by the flexible neck of the robot that passes through the endoscope tool channel. In this article we present a series of new developments to improve the performance of the robot: a force transmission model to address flexibility, elongation study for precise position control, and tissue property modeling for haptic feedback. Validation experiment results are presented for each sector. An integrated control architecture of the robot system is given in the end. PMID:23561289

Wang, Zheng; Sun, Zhenglong; Phee, Soo Jay

2013-11-01

320

UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE Pediatric Surgical Subspecialities Annual Report 2010-2011  

E-print Network

UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE Pediatric Surgical Subspecialities Annual Report 2010 the Department of Pediatric Surgical Subspecialties of Connecticut Children's Medical Center. Over the last year the surgical services have continued to experience tremendous growth, performing procedures on over 10

Kim, Duck O.

321

Intraoperative Redosing of Cefazolin and Risk for Surgical Site Infection in Cardiac Surgery  

Microsoft Academic Search

Intraoperative redosing of prophylactic antibiotics is recommended for pro- longed surgical procedures, although its efficacy has not been assessed. We retrospective ly compared the risk of surgical site infections in 1,548 patients who underwent cardiac surgery lasting >240 min after preoperative administration of cefazolin prophylaxis. The overall risk of surgical site infec- tion was similar among patients with (43 (9.4%)

Giorgio Zanetti; Richard Giardina; Richard Platt

2001-01-01

322

IEEE Robotics & Automation Magazine94 1070-9932/08/$25.002008 IEEE SEPTEMBER 2008 Surgical and  

E-print Network

the actual surgical procedure with the assistance of the computer, using appropriate technology (robotics and Interventional Robotics: Part II Surgical CAD-CAM Systems BY GABOR FICHTINGER, PETER KAZANZIDES, ALLISON M predictable manner. We, therefore, have classified them as surgical computer-aided design (CAD)­computer

Whitcomb, Louis L.

323

MR imaging guidance for minimally invasive procedures  

NASA Astrophysics Data System (ADS)

Image guidance is one of the major challenges common to all minimally invasive procedures including biopsy, thermal ablation, endoscopy, and laparoscopy. This is essential for (1) identifying the target lesion, (2) planning the minimally invasive approach, and (3) monitoring the therapy as it progresses. MRI is an ideal imaging modality for this purpose, providing high soft tissue contrast and multiplanar imaging, capability with no ionizing radiation. An interventional/surgical MRI suite has been developed at Brigham and Women's Hospital which provides multiplanar imaging guidance during surgery, biopsy, and thermal ablation procedures. The 0.5T MRI system (General Electric Signa SP) features open vertical access, allowing intraoperative imaging to be performed. An integrated navigational system permits near real-time control of imaging planes, and provides interactive guidance for positioning various diagnostic and therapeutic probes. MR imaging can also be used to monitor cryotherapy as well as high temperature thermal ablation procedures sing RF, laser, microwave, or focused ultrasound. Design features of the interventional MRI system will be discussed, and techniques will be described for interactive image acquisition and tracking of interventional instruments. Applications for interactive and near-real-time imaging will be presented as well as examples of specific procedures performed using MRI guidance.

Wong, Terence Z.; Kettenbach, Joachim; Silverman, Stuart G.; Schwartz, Richard B.; Morrison, Paul R.; Kacher, Daniel F.; Jolesz, Ferenc A.

1998-04-01

324

Surgical team mapping: implications for staff allocation and coordination.  

PubMed

Perioperative team membership consistency is not well researched despite being essential in reducing patient harm. We describe perioperative team membership and staffing across four surgical specialties in an Australian hospital. We analyzed staffing and case data using social network analysis, descriptive statistics, and bivariate correlations and mapped 100 surgical procedures with 171 staff members who were shared across four surgical teams, including 103 (60.2%) nurses. Eighteen of 171 (10.5%) staff members were regularly shared across teams, including 12 nurses, five anesthetists, and one registrar. We found weak but significant correlations between the number of staff (P < .001), procedure start time (P < .001), length of procedure (P < .05), and patient acuity (P < .001). Using mapping, personnel can be identified who may informally influence multiple team cultures, and nurses (ie, the majority of team members in surgery) can lead the development of highly functioning surgical teams. PMID:25645040

Sykes, Mark; Gillespie, Brigid M; Chaboyer, Wendy; Kang, Evelyn

2015-02-01

325

Surgical vs Nonoperative Treatment for Lumbar Disk Herniation  

PubMed Central

Context Lumbar diskectomy is the most common surgical procedure performed for back and leg symptoms in US patients, but the efficacy of the procedure relative to nonoperative care remains controversial. Objective To assess the efficacy of surgery for lumbar intervertebral disk herniation. Design, Setting, and Patients The Spine Patient Outcomes Research Trial, a randomized clinical trial enrolling patients between March 2000 and November 2004 from 13 multidisciplinary spine clinics in 11 US states. Patients were 501 surgical candidates (mean age, 42 years; 42% women) with imaging-confirmed lumbar intervertebral disk herniation and persistent signs and symptoms of radiculopathy for at least 6 weeks. Interventions Standard open diskectomy vs nonoperative treatment individualized to the patient. Main Outcome Measures Primary outcomes were changes from baseline for the Medical Outcomes Study 36-item Short-Form Health Survey bodily pain and physical function scales and the modified Oswestry Disability Index (American Academy of Orthopaedic Surgeons MODEMS version) at 6 weeks, 3 months, 6 months, and 1 and 2 years from enrollment. Secondary outcomes included sciatica severity as measured by the Sciatica Bothersomeness Index, satisfaction with symptoms, self-reported improvement, and employment status. Results Adherence to assigned treatment was limited: 50% of patients assigned to surgery received surgery within 3 months of enrollment, while 30% of those assigned to nonoperative treatment received surgery in the same period. Intent-to-treat analyses demonstrated substantial improvements for all primary and secondary outcomes in both treatment groups. Between-group differences in improvements were consistently in favor of surgery for all periods but were small and not statistically significant for the primary outcomes. Conclusions Patients in both the surgery and the nonoperative treatment groups improved substantially over a 2-year period. Because of the large numbers of patients who crossed over in both directions, conclusions about the superiority or equivalence of the treatments are not warranted based on the intent-to-treat analysis. Trial Registration clinicaltrials.gov Identifier: NCT00000410 PMID:17119140

Weinstein, James N.; Tosteson, Tor D.; Lurie, Jon D.; Tosteson, Anna N. A.; Hanscom, Brett; Skinner, Jonathan S.; Abdu, William A.; Hilibrand, Alan S.; Boden, Scott D.; Deyo, Richard A.

2008-01-01

326

Urogynecologic Surgical Mesh Implants  

MedlinePLUS

... Repair UPDATE on Serious Complications Associated with Transvaginal Placement of Surgical Mesh for Pelvic Organ Prolapse: FDA ... Update on the Safety and Effectiveness of Transvaginal Placement for Pelvic Organ Prolapse (July 2011) (PDF - 243KB) ...

327

Incontinence Treatment: Surgical Treatments  

MedlinePLUS

... Stories Who We Are Contact Us Donate Incontinence Treatment: Surgical Treatments Jump to Topic Lifestyle changes Dietary changes Medication ... July 8, 2014 at 09:36:27 AM Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback ...

328

Surgical Tools Recognition and Pupil Segmentation for Cataract Surgical Process  

E-print Network

generation of Computer-Assisted- Surgical (CAS) systems based on information from the Operating Room (OR) has of cataract surgery videos, to detect eight surgical phases. Keywords. Computer vision, video analysis, BagSurgical Tools Recognition and Pupil Segmentation for Cataract Surgical Process Modeling David

Boyer, Edmond

329

Osteotomy and osteosynthesis in complex segmental genioplasty with double surgical guide  

PubMed Central

Chin osteotomy is used in esthetic and functional procedure; genioplasty shows different surgical options as lineal osteotomy, curved osteotomy, segmental osteotomy and others for different conditions of the face. This communication shows the use of two surgical guides used in a patient with extremely facial asymmetry; the surgical plan was realized in a stereolithographic biomodel. The first surgical guide was used for osteotomy and the second surgical guide was used for putting the plate, previously bent, and for segmented osteotomy in the planned position on the biomodel; this technique showed adequate adaptation and security in this extremely asymmetric case. The potential use of this surgical guide was discussed. PMID:24995074

Assis, Adriano; Olate, Sergio; Asprino, Luciana; de Moraes, Márcio

2014-01-01

330

Upside-down stomach – results of mini-invasive surgical therapy  

PubMed Central

Aim The authors evaluate the results of mini-invasive therapy in patients diagnosed with upside-down stomach. Material and methods From 1998 to 2008, a total of 27 patients diagnosed with upside-down stomach were surgically treated at the 1st Department of Surgery, University Hospital Olomouc. Before the operation, patients were examined endoscopically and a barium swallow was performed. In all 27 patients (100%), the operation was performed electively laparoscopically. The principle of the operation in all cases was reposition of the stomach into the abdominal cavity, resection of the hernial sac and hiatoplasty. In addition, in 15 patients (56%) with reflux symptoms or endoscopic findings of reflux oesophagitis, fundoplication in Nissen's modification was also performed. Fundopexy was indicated in 12 patients (44%). Results In all patients (100%), the operation was performed mini-invasively; conversion to an open procedure was never necessary. In 3 cases (11%), the left pleural cavity was opened during the operation; this was treated by introducing a chest drain. The operation mortality in the patient set was zero; morbidity was 11%. A year after the operation, patients were re-examined, and follow-up endoscopy and barium swallow were performed. Conclusions In all patients diagnosed with upside-down stomach, surgical treatment is indicated due to the risk of developing severe complications. Mini-invasive surgical therapy in the hands of an experienced surgeon is a safe procedure which offers patients all the benefits of mini-invasive therapy with promising short- and long-term results. PMID:23255985

Vrba, Radek; Aujesky, Rene; Vomackova, Katherine; Zbrozkova, Lenka

2011-01-01

331

Determinants of surgical site infection after breast surgery  

Microsoft Academic Search

Background: Surgical site infection (SSI) after breast procedures may result in significant morbidity, psychologic trauma, and additional cost. SSI rates in patients at the Cleveland Clinic Foundation having biopsy, partial mastectomy, or modified radical mastectomy were higher during April and May 1995 than during the previous 12 months (8 infections for 74 procedures [10.8%] vs 10 for 378 [2.6%]; p

Mary L. Bertin; Joseph Crowe; Steven M. Gordon

1998-01-01

332

Interactive simulation of surgical needle insertion and steering  

Microsoft Academic Search

We present algorithms for simulating and visualizing the insertion and steering of needles through deformable tissues for surgical training and planning. Needle insertion is an essential component of many clinical procedures such as biopsies, injections, neurosurgery, and brachytherapy cancer treatment. The success of these procedures depends on accurate guidance of the needle tip to a clinical target while avoiding vital

Nuttapong Chentanez; Ron Alterovitz; Daniel Ritchie; Lita Cho; Kris K. Hauser; Ken Goldberg; Jonathan R. Shewchuk; James F. O'Brien

2009-01-01

333

Surgical Reconstruction of Radiation Injuries  

PubMed Central

Significance: Patients with cancer receive benefits from radiation therapy; however, it may have adverse effects on normal tissue such as causing radiation-induced ulcer and osteoradionecrosis. The most reliable method to treat a radiation ulcer is wide excision of the affected tissue, followed by coverage with well-vascularized tissue. As usual, radiation-induced skin ulcers are due to therapeutic irradiation for residual cancer or lymph nodes; the locations of radiation ulcers are relatively limited, including the head, neck, chest wall, lumbar, groin, and sacral areas. Thus, suitable reconstructive methods vary according to functional and aesthetic conditions. I reviewed the practices and surgical results for radiation ulcers over the past 30 years, and present the recommended surgical methods for these hard-to-heal ulcers. Recent Advances: At a minimum, flaps are required to treat radiation ulcers. Surgeons can recommend earlier debridement, followed by immediate coverage with axial-pattern musculocutaneous and fasciocutaneous flaps. Free flaps are also a useful soft tissue coverage option. The choice of flap varies with the location and size of the wounds. Critical Issues: The most crucial procedure is the complete resection of the radiation-affected area, followed by coverage with well-vascularized tissue. Future Directions: Recent developments in perforator flap techniques, which are defined as flaps with a blood supply from isolated perforating vessels of a stem artery, have allowed the surgeons to successfully resurface these difficult wounds with reduced morbidity. PMID:24761342

Fujioka, Masaki

2014-01-01

334

SELENA - An open-source tool for seismic risk and loss assessment using a logic tree computation procedure  

NASA Astrophysics Data System (ADS)

The era of earthquake risk and loss estimation basically began with the seminal paper on hazard by Allin Cornell in 1968. Following the 1971 San Fernando earthquake, the first studies placed strong emphasis on the prediction of human losses (number of casualties and injured used to estimate the needs in terms of health care and shelters in the immediate aftermath of a strong event). In contrast to these early risk modeling efforts, later studies have focused on the disruption of the serviceability of roads, telecommunications and other important lifeline systems. In the 1990s, the National Institute of Building Sciences (NIBS) developed a tool (HAZUS ®99) for the Federal Emergency Management Agency (FEMA), where the goal was to incorporate the best quantitative methodology in earthquake loss estimates. Herein, the current version of the open-source risk and loss estimation software SELENA v4.1 is presented. While using the spectral displacement-based approach (capacity spectrum method), this fully self-contained tool analytically computes the degree of damage on specific building typologies as well as the associated economic losses and number of casualties. The earthquake ground shaking estimates for SELENA v4.1 can be calculated or provided in three different ways: deterministic, probabilistic or based on near-real-time data. The main distinguishing feature of SELENA compared to other risk estimation software tools is that it is implemented in a 'logic tree' computation scheme which accounts for uncertainties of any input (e.g., scenario earthquake parameters, ground-motion prediction equations, soil models) or inventory data (e.g., building typology, capacity curves and fragility functions). The data used in the analysis is assigned with a decimal weighting factor defining the weight of the respective branch of the logic tree. The weighting of the input parameters accounts for the epistemic and aleatoric uncertainties that will always follow the necessary parameterization of the different types of input data. Like previous SELENA versions, SELENA v4.1 is coded in MATLAB which allows for easy dissemination among the scientific-technical community. Furthermore, any user has access to the source code in order to adapt, improve or refine the tool according to his or her particular needs. The handling of SELENA's current version and the provision of input data is customized for an academic environment but which can then support decision-makers of local, state and regional governmental agencies in estimating possible losses from future earthquakes.

Molina, S.; Lang, D. H.; Lindholm, C. D.

2010-03-01

335

Surgical Treatment of Pediatric Epileptic Encephalopathies  

PubMed Central

Pediatric epileptiform encephalopathies are a group of neurologically devastating disorders related to uncontrolled ictal and interictal epileptic activity, with a poor prognosis. Despite the number of pharmacological options for treatment of epilepsy, many of these patients are drug resistant. For these patients with uncontrolled epilepsy, motor and/or neuropsychological deterioration is common. To prevent these secondary consequences, surgery is often considered as either a curative or a palliative option. Magnetic resonance imaging to look for epileptic lesions that may be surgically treated is an essential part of the workup for these patients. Many surgical procedures for the treatment of epileptiform encephalopathies have been reported in the literature. In this paper the evidence for these procedures for the treatment of pediatric epileptiform encephalopathies is reviewed. PMID:24288601

Fridley, J.; Reddy, G.; Curry, D.; Agadi, S.

2013-01-01

336

Surgical management of necrotizing pancreatitis: An overview  

PubMed Central

Necrotizing pancreatitis is an uncommon yet serious complication of acute pancreatitis with mortality rates reported up to 15% that reach 30% in case of infection. Traditionally open surgical debridement was the only tool in our disposal to manage this serious clinical entity. This approach is however associated with poor outcomes. Management has now shifted away from open surgical debridement to a more conservative management and minimally invasive approaches. Contemporary approach to patients with necrotizing pancreatitis and/or infectious pancreatitis is summarized in the 3Ds: Delay, Drain and Debride. Patients can be managed in the intensive care unit and any intervention should be delayed. Percutaneous drainage can be utilized first and early in the course of the disease, followed by endoscopic drainage or video assisted retroperitoneoscopic drainage if necrosectomy is deemed necessary. Open surgery is now less frequently performed and should be reserved for cases refractory to any other approach. The management of necrotizing pancreatitis therefore requires a multidisciplinary dynamic model of approach rather than being a surgical disease. PMID:25473162

Kokosis, George; Perez, Alexander; Pappas, Theodore N

2014-01-01

337

Surgical Treatment of the Overweight Patient  

Microsoft Academic Search

Treatment of overweight patients with surgery is increasing at a rapid rate The Nationwide Inpatient Sample from 1998 to 2002 has provided one quantitative estimate of bariatric surgical procedures. Between 1998 and 2002 the number of operations increased from 13,365 to 72,177, a more than 5-fold increase. More than 80% of these were the so-called gastric bypass operation. Several other

George A. Bray

338

Laparoscopic surgical concepts of morbid obesity  

Microsoft Academic Search

Background According to the WHO, obesity and obesity with associated morbidity constitute a chronic, multi-factorial condition requiring treatment. Conservative treatment has been shown in long-term studies to be ineffective in morbid obesity. Surgical treatments break down into restrictive, malabsorptive, combined restrictive and malabsorptive or motility-reducing procedures. Method and results Laparoscopic implantation of an adjustable gastric band is an efficient restrictive

K. Miller; E. Hell

2003-01-01

339

Corrosion and fatigue of surgical implants  

NASA Technical Reports Server (NTRS)

Implants for the treatment of femoral fractures, mechanisms leading to the failure or degradation of such structures, and current perspectives on surgical implants are discussed. Under the first heading, general usage, materials and procedures, environmental conditions, and laboratory analyses of implants after service are considered. Corrosion, crevice corrosion, stress corrosion cracking, intergranular corrosion, pitting corrosion, fatigue, and corrosion fatigue are the principal degradation mechanisms described. The need for improvement in the reliability of implants is emphasized.

Lisagor, W. B.

1975-01-01

340

Surgical site infection surveillance following ambulatory surgery.  

PubMed

We assessed 4045 ambulatory surgery patients for surgical site infection (SSI) using claims-based triggers for medical chart review. Of 98 patients flagged by codes suggestive of SSI, 35 had confirmed SSIs. SSI rates ranged from 0 to 3.2% for common procedures. Claims may be useful for SSI surveillance following ambulatory surgery. Infect Control Hosp Epidemiol 2014;00(0):1-4. PMID:25633008

Rhee, Chanu; Huang, Susan S; Berríos-Torres, Sandra I; Kaganov, Rebecca; Bruce, Christina; Lankiewicz, Julie; Platt, Richard; Yokoe, Deborah S

2015-02-01

341

Surgical scar endometriosis.  

PubMed

Endometriosis is a common disorder in females of reproductive age. Surgical scar endometrioma after cesarean section develops in 1-2% of patients, and usually presents as a tender and painful abdominal wall mass. The diagnosis is suggested by pre or perimenstrual pelvic pain and is often established only by histology. In this retrospective observational cohort study, we reviewed the medical records of five patients with a histopathological diagnosis of scar endometriosis. A scar mass was found on a previous Pfannenstiel incision in four patients and in a median cesarean section in one patient. The mean age at diagnosis (38.6 years, median 38) was older than reported elsewhere. A histological examination of the surgical specimen confirmed the diagnosis of endometriosis in all cases. During the follow-up period (mean 34.6 months), local recurrence (n = 1) and pelvic recurrence (n = 1) were treated surgically. Surgery is the treatment of choice for surgical scar endometriosis. Excision with histologically proven free surgical margins of 1 cm is mandatory to prevent recurrence. As scar endometriosis may be associated with pelvic localization, explorative abdominal laparoscopy may be indicated to exclude the intraperitoneal spread of the disease in symptomatic patients. PMID:23307296

Mistrangelo, Massimiliano; Gilbo, Nicholas; Cassoni, Paola; Micalef, Salvatore; Faletti, Riccardo; Miglietta, Claudio; Brustia, Raffaele; Bonnet, Gisella; Gregori, Gianluca; Morino, Mario

2014-04-01

342

Pediatric appendectomy: optimal surgical timing and risk assessment.  

PubMed

Appendicitis is one of the most common pediatric surgical problems. In the older surgical paradigm, appendectomy was considered to be an emergent procedure; however, with changes to resident work hours and other economic factors, the operation has evolved into an urgent and deliberately planned intervention. This paradigm shift in care has not necessarily seen universal buy-in by all stakeholders. Skeptics worry about the higher incidence of complications, particularly intra-abdominal abscess (IAA), associated with the delay to appendectomy with this strategy. Development of IAA after pediatric appendectomy greatly burdens the healthcare system, incapacitates patients, and limits family functionality. The risk factors that influence the development of IAA after appendectomy were evaluated in 220 children admitted to a large urban teaching hospital over a recent 1.5-year period. Preoperative risk factors included in the study were age, sex, weight, ethnicity, duration and nature of symptoms, white cell count, and ultrasound or computed tomography scan findings (appendicolith, peritoneal fluid, abscess, phlegmon), failed nonoperative management, antibiotics administered, and timing. Intraoperative factors included were timing of appendectomy, surgical and pathological findings of perforation, open or laparoscopic procedure, and use of staple or Endoloop to ligate the appendix. Postoperative factors included were duration and type of antibiotic therapy. There were 94 (43%) perforated and 126 (57%) nonperforated appendicitis during the study period. The incidence of postoperative IAA was 4.5 per cent (nine of 220). Children operated on after overnight antibiotics and resuscitation had a significantly lower risk of IAA as compared with children managed by other strategies (P < 0.0003). Of the preoperative factors, only the presence of a fever in the emergency department (P < 0.001) and identification of complicated appendicitis on imaging (P < 0.0001) were significant risk factors for postoperative abscess development. Perforated appendicitis carries a higher risk of development of IAA that is not reduced by an emergent operative or delayed nonoperative management strategy. The timing of appendectomy appears to be an extremely important factor in reducing the incidence of IAA after all presentations of appendectomy. The role of resuscitation and antibiotics in limiting the effects of the inflammatory cascade and development of laboratory markers that accurately measure the latter need to be the focus of further research in this field. PMID:24887730

Burjonrappa, Sathyaprasad; Rachel, Dana

2014-05-01

343

Reducing depth uncertainty in large surgical workspaces, with applications to veterinary medicine  

NASA Astrophysics Data System (ADS)

This paper presents on-going research that addresses uncertainty along the Z-axis in image-guided surgery, for applications to large surgical workspaces, including those found in veterinary medicine. Veterinary medicine lags human medicine in using image guidance, despite MR and CT data scanning of animals. The positional uncertainty of a surgical tracking device can be modeled as an octahedron with one long axis coinciding with the depth axis of the sensor, where the short axes are determined by pixel resolution and workspace dimensions. The further a 3D point is from this device, the more elongated is this long axis, and the greater the uncertainty along Z of this point's position, in relation to its components along X and Y. Moreover, for a triangulation-based tracker, its position error degrades with the square of distance. Our approach is to use two or more Micron Trackers to communicate with each other, and combine this feature with flexible positioning. Prior knowledge of the type of surgical procedure, and if applicable, the species of animal that determines the scale of the workspace, would allow the surgeon to pre-operatively configure the trackers in the OR for optimal accuracy. Our research also leverages the open-source Image-guided Surgery Toolkit (IGSTK).

Audette, Michel A.; Kolahi, Ahmad; Enquobahrie, Andinet; Gatti, Claudio; Cleary, Kevin

2010-02-01

344

Surgical repair of rectocele. Comparison of transvaginal and transanal approach and personal technique  

PubMed Central

Summary Rectocele is defined as a herniation of the rectal wall inside the vagina due to a defect of the recto-vaginal septum. It is traditionally considered a posterior compartment damage with weakness of posterior vaginal wall support resulting in a bulging of the rectum into the vaginal cavity. One of the main causes of rectal prolapse is the operative vaginal birth, although the evidence of the defect may occur after many years The treatment of rectocele is surgical, and the approach can be transperineal, transvaginal, and transanal or, in selected cases, transperitoneal through open or laparoscopic techniques. In this study we compare two transvaginal surgical techniques - i.e. the perineal body anchorage to the posterior septum and the traditional Denonvilliers’ transversal suture after removing of the vaginal skin, with the mostly performed transanal procedure, the STARR - comparing the data from the literature on their results. Mean hospital stay, rectal symptoms, dyspareunia, quality of life, recurrence rate and postoperative complications have been considered. Both transvaginal and transrectal surgical techniques are effective to solve posterior compartment defect and to improve the quality of life. Vaginal approach may interfere with the sexual activity; furthermore it is associated with minimal postoperative pain than the transanal approach. Better anatomic results are assured after endovaginal surgery, while better rectal function prevail after the transanal approach. Vaginal techniques are more suitable to gynecologists, whereas the transrectal ones are usually performed by colo-proctologists or general surgeons. PMID:24342163

LEANZA, V.; INTAGLIATA, E.; LEANZA, G.; CANNIZZARO, M.A.; ZANGHÌ, G.; VECCHIO, R.

2013-01-01

345

Surgical repair of rectocele. Comparison of transvaginal and transanal approach and personal technique.  

PubMed

Rectocele is defined as a herniation of the rectal wall inside the vagina due to a defect of the recto-vaginal septum. It is traditionally considered a posterior compartment damage with weakness of posterior vaginal wall support resulting in a bulging of the rectum into the vaginal cavity. One of the main causes of rectal prolapse is the operative vaginal birth, although the evidence of the defect may occur after many years The treatment of rectocele is surgical, and the approach can be transperineal, transvaginal, and transanal or, in selected cases, transperitoneal through open or laparoscopic techniques. In this study we compare two transvaginal surgical techniques - i.e. the perineal body anchorage to the posterior septum and the traditional Denonvilliers' transversal suture after removing of the vaginal skin, with the mostly performed transanal procedure, the STARR - comparing the data from the literature on their results. Mean hospital stay, rectal symptoms, dyspareunia, quality of life, recurrence rate and postoperative complications have been considered. Both transvaginal and transrectal surgical techniques are effective to solve posterior compartment defect and to improve the quality of life. Vaginal approach may interfere with the sexual activity; furthermore it is associated with minimal postoperative pain than the transanal approach. Better anatomic results are assured after endovaginal surgery, while better rectal function prevail after the transanal approach. Vaginal techniques are more suitable to gynecologists, whereas the transrectal ones are usually performed by colo-proctologists or general surgeons. PMID:24342163

Leanza, V; Intagliata, E; Leanza, G; Cannizzaro, M A; Zanghì, G; Vecchio, R

2013-01-01

346

10 Questions to Ask Before a Cosmetic Procedure  

MedlinePLUS

... perform a cosmetic procedure at home. While products ranging from chemical peels to microdermabrasion kits can be ... a cosmetic surgical procedure: Botulinum rejuvenation Chemical peel Laser Light treatment Microdermabrasion Soft-tissue filler Patient Notepad: ...

347

Radical Hysterectomy: A comparison of surgical approaches after adoption of robotic surgery in gynecologic oncology  

PubMed Central

Objective To compare intra-operative, postoperative and pathologic outcomes of three surgical approaches to radical hysterectomy and bilateral pelvic lymph node dissection over a three year time period during which all three approaches were used. Methods We reviewed all patients who underwent radical hysterectomy with pelvic lymph node dissection between 1/2007 and 11/2010. Comparison was made between robotic, laparoscopic and open procedures in regard to surgical times, complication rates, and pathologic findings. Results A total of 95 radical hysterectomy procedures were performed during the study period: 30 open (RAH), 31 laparoscopic (LRH) and 34 robotic (RRH). There were no differences in age, body mass index or other demographic factors between the groups. Operative time was significantly shorter in the RAH compared to LRH and RRH (265 vs 338 vs 328 min, p=0.002). Estimated blood loss was significantly lower in LRH and RRH compared with RAH (100 vs 100 vs 350 mL, p<0.001). Thirteen (24%) of RAH required blood transfusion. Conversion rates were higher in the LRH (16%) compared to RRH (3%) although not significant (p=0.10). Median length of stay was significantly shorter in RRH (1 days) vs LRH or RAH (2 vs 4 days, p<0.01). Pathologic findings were similar among all groups. Conclusion Minimally invasive surgery has made a significant impact on patients undergoing radical hysterectomy including decrease in blood loss and transfusion rates however; operative times were significantly longer compared to open radical hysterectomy. Our findings suggest that the robotic approach may have the added benefit of even shorter length of stay compared to traditional laparoscopy. PMID:21872911

Soliman, Pamela T.; Frumovitz, Michael; Sun, Charlotte C.; dos Reis, Ricardo; Schmeler, Kathleen M.; Nick, Alpa M.; Westin, Shannon N.; Brown, Jubilee; Levenback, Charles F.; Ramirez, Pedro T.

2014-01-01

348

Open fenestration for complicated acute aortic B dissection.  

PubMed

Acute type B aortic dissection (ABAD) is a serious cardiovascular emergency in which morbidity and mortality are often related to the presence of complications at clinical presentation. Visceral, renal, and limb ischemia occur in up to 30% of patients with ABAD and are associated with higher in-hospital mortality. The aim of the open fenestration is to resolve the malperfusion by creating a single aortic lumen at the suprarenal or infrarenal level. This surgical procedure is less invasive than total aortic replacement, thus not requiring extracorporeal support and allowing preservation of the intercostal arteries, which results in decreased risk of paraplegia. Surgical aortic fenestration represents an effective and durable option for treating ischemic complications of ABAD, particularly for patients with no aortic dilatation. In the current endovascular era, this open technique serves as an alternative option in case of contraindications or failure of endovascular management of complicated ABAD. PMID:25133107

Trimarchi, Santi; Segreti, Sara; Grassi, Viviana; Lomazzi, Chiara; Cova, Marta; Piffaretti, Gabriele; Rampoldi, Vincenzo

2014-07-01

349

Open fenestration for complicated acute aortic B dissection  

PubMed Central

Acute type B aortic dissection (ABAD) is a serious cardiovascular emergency in which morbidity and mortality are often related to the presence of complications at clinical presentation. Visceral, renal, and limb ischemia occur in up to 30% of patients with ABAD and are associated with higher in-hospital mortality. The aim of the open fenestration is to resolve the malperfusion by creating a single aortic lumen at the suprarenal or infrarenal level. This surgical procedure is less invasive than total aortic replacement, thus not requiring extracorporeal support and allowing preservation of the intercostal arteries, which results in decreased risk of paraplegia. Surgical aortic fenestration represents an effective and durable option for treating ischemic complications of ABAD, particularly for patients with no aortic dilatation. In the current endovascular era, this open technique serves as an alternative option in case of contraindications or failure of endovascular management of complicated ABAD. PMID:25133107

Segreti, Sara; Grassi, Viviana; Lomazzi, Chiara; Cova, Marta; Piffaretti, Gabriele; Rampoldi, Vincenzo

2014-01-01

350

Evaluation of the motion of surgical instruments during intraocular surgery  

PubMed Central

Purpose Robot assistance in ocular microsurgery could improve precision, dexterity, save time or prevent complications by task automation, and provide access to ocular surgery in undeserved countries by teleoperation. However, to design robotic devices, the range of motion of surgical instruments needs to be precisely quantified. Methods An electromagnetic tracking system was developed for intraocular surgery in order to quantify the movements of ophthalmic surgeons. Kinematics of surgical steps during phacoemulsification and pars plana vitrectomy procedures were determined by measuring the maximum translation and angular range of motion of intraocular surgical tools in the three planes. Conclusion Important variations in amplitudes of rotation and translation were measured between both hands and between surgical tasks. These parameters may be used to develop a robotic intraocular surgical system or to improve training. PMID:21527954

Hubschman, J-P; Son, J; Allen, B; Schwartz, S D; Bourges, J-L

2011-01-01

351

Surgical Treatment of Adult Degenerative Scoliosis  

PubMed Central

The rapid increase of elderly population has resulted in increased prevalence of adult scoliosis. Adult scoliosis is divided into adult idiopathic scoliosis and adult degenerative scoliosis. These two types of scoliosis vary in patient age, curve pattern and clinical symptoms, which necessitate different surgical indications and options. Back pain and deformity are major indications for surgery in adult idiopathic scoliosis, whereas radiating pain to the legs due to foraminal stenosis is what often requires surgery in adult degenerative scoliosis. When selecting a surgical method, major symptoms and underlying medical diseases should be carefully evaluated, not only to relieve symptoms but also to minimize postoperative complications. Surgical options for adult degenerative scoliosis include: decompression alone; decompression and limited short fusion; and decompression coupled with long fusion and correction of deformity. Decompression and limited short fusion can be applied to patients with a small Cobb's angle and normal sagittal imbalance. For those with a large Cobb's angle and positive sagittal imbalance, long fusion with correction of deformity is required. When long fusion is applied, a careful decision regarding the extent of fusion level should be made when selecting L5 or S1 as the distal fusion level and T10 or the thoracolumbar junction as the proximal fusion level. For the fusion extending to the sacrum, restoration of sagittal balance and rigid fixation with additional iliac screws should be considered. Any surgical procedures for adult degenerative scoliosis are known to have relatively high occurrences of complications; therefore, risks and benefits should be meticulously considered before selecting a surgical procedure. PMID:24967054

Kim, Young-Tae; Shin, Sang-hyun; Suk, Se-Il

2014-01-01

352

Surgical treatment of adult degenerative scoliosis.  

PubMed

The rapid increase of elderly population has resulted in increased prevalence of adult scoliosis. Adult scoliosis is divided into adult idiopathic scoliosis and adult degenerative scoliosis. These two types of scoliosis vary in patient age, curve pattern and clinical symptoms, which necessitate different surgical indications and options. Back pain and deformity are major indications for surgery in adult idiopathic scoliosis, whereas radiating pain to the legs due to foraminal stenosis is what often requires surgery in adult degenerative scoliosis. When selecting a surgical method, major symptoms and underlying medical diseases should be carefully evaluated, not only to relieve symptoms but also to minimize postoperative complications. Surgical options for adult degenerative scoliosis include: decompression alone; decompression and limited short fusion; and decompression coupled with long fusion and correction of deformity. Decompression and limited short fusion can be applied to patients with a small Cobb's angle and normal sagittal imbalance. For those with a large Cobb's angle and positive sagittal imbalance, long fusion with correction of deformity is required. When long fusion is applied, a careful decision regarding the extent of fusion level should be made when selecting L5 or S1 as the distal fusion level and T10 or the thoracolumbar junction as the proximal fusion level. For the fusion extending to the sacrum, restoration of sagittal balance and rigid fixation with additional iliac screws should be considered. Any surgical procedures for adult degenerative scoliosis are known to have relatively high occurrences of complications; therefore, risks and benefits should be meticulously considered before selecting a surgical procedure. PMID:24967054

Cho, Kyu-Jung; Kim, Young-Tae; Shin, Sang-Hyun; Suk, Se-Il

2014-06-01

353

An introduction to the practical and ethical perspectives on the need to advance and standardize the intracoelomic surgical implantation of electronic tags in fish  

SciTech Connect

The intracoelomic surgical implantation of electronic tags (including radio and acoustic telemetry transmitters, passive integrated transponders and archival biologgers) is frequently used for conducting studies on fish. Electronic tagging studies provide information on the spatial ecology, behavior and survival of fish in marine and freshwater systems. However, any surgical procedure, particularly one where a laparotomy is performed and the coelomic cavity is opened, has the potential to alter the survival, behavior or condition of the animal which can impair welfare and introduce bias. Given that management, regulatory and conservation decisions are based on the assumption that fish implanted with electronic tags have similar fates and behavior relative to untagged conspecifics, it is critical to ensure that best surgical practices are being used. Also, the current lack of standardized surgical procedures and reporting of specific methodological details precludes cross-study and cross-year analyses which would further progress the field of fisheries science. This compilation of papers seeks to identify the best practices for the entire intracoelomic tagging procedure including pre- and post-operative care, anesthesia, wound closure, and use of antibiotics. Although there is a particular focus on salmonid smolts given the large body of literature available on that group, other life-stages and species of fish are discussed where there is sufficient knowledge. Additional papers explore the role of the veterinarian in fish surgeries, the need for minimal standards in the training of fish surgeons, providing a call for more complete and transparent procedures, and identifying trends in procedures and research needs. Collectively, this body of knowledge should help to improve data quality (including comparability and repeatability), enhance management and conservation strategies, and maintain the welfare status of tagged fish.

Brown, Richard S.; Eppard, M. B.; Murchie, Karen J.; Nielsen, Jennifer L.; Cooke, Steven J.

2011-01-01

354

An introduction to the practical and ethical perspectives on the need to advance and standardize the intracoelomic surgical implantation of electronic tags in fish  

USGS Publications Warehouse

The intracoelomic surgical implantation of electronic tags (including radio and acoustic telemetry transmitters, passive integrated transponders and archival biologgers) is frequently used for conducting studies on fish. Electronic tagging studies provide information on the spatial ecology, behavior and survival of fish in marine and freshwater systems. However, any surgical procedure, particularly one where a laparotomy is performed and the coelomic cavity is opened, has the potential to alter the survival, behavior or condition of the animal which can impair welfare and introduce bias. Given that management, regulatory and conservation decisions are based on the assumption that fish implanted with electronic tags have similar fates and behavior relative to untagged conspecifics, it is critical to ensure that best surgical practices are being used. Also, the current lack of standardized surgical procedures and reporting of specific methodological details precludes cross-study and cross-year analyses which would further progress the field of fisheries science. This compilation of papers seeks to identify the best practices for the entire intracoelomic tagging procedure including pre- and post-operative care, anesthesia, wound closure, and use of antibiotics. Although there is a particular focus on salmonid smolts given the large body of literature available on that group, other life-stages and species of fish are discussed where there is sufficient knowledge. Additional papers explore the role of the veterinarian in fish surgeries, the need for minimal standards in the training of fish surgeons, providing a call for more complete and transparent procedures, and identifying trends in procedures and research needs. Collectively, this body of knowledge should help to improve data quality (including comparability and repeatability), enhance management and conservation strategies, and maintain the welfare status of tagged fish. ?? 2010 Springer Science+Business Media B.V.

Brown, R.S.; Eppard, M.B.; Murchie, K.J.; Nielsen, J.L.; Cooke, S.J.

2011-01-01

355

Spontaneous Postmenopausal Urethral Prolapse Treated Surgically and Successfully  

PubMed Central

Urethral prolapse (UP) is a circular complete eversion of the distal urethral mucosa through the external meatus. It is a rare condition seen mostly in African-American premenarcheal girls. Both a medical and a surgical approach to this condition have been described. We present a case of a spontaneous urethral prolapse in a 60-year-old postmenopausal Caucasian woman, who failed medical management and underwent successful surgical management. The patient is asymptomatic 18 months following the procedure. PMID:25140273

Klein, I.; Dekel, Y.; Stein, A.

2014-01-01

356

Perioperative Strategies to Prevent Surgical-Site Infection  

PubMed Central

Colon and rectal resections are among the most common surgical procedures performed in the United States. Complication rates of up to 25% have been reported and result in a substantial impact on quality of life and cost of care. Recently, the Surgical Care Improvement Program (SCIP) has promoted guidelines to prevent postoperative and potentially preventable complications. A comprehensive evidenced-based review of these guidelines and other perioperative strategies for practicing colorectal surgeons is the basis of this review. PMID:24436669

Poggio, Juan Lucas

2013-01-01

357

Surgical site infection surveillance  

Microsoft Academic Search

Surgical site infection (SSI) is the third most commonly reported nosocomial infection and accounts for 14–16% of all nosocomial infections among hospital inpatients. A successful SSI surveillance programme includes standardized definitions of infection, effective surveillance methods and stratification of the SSI rates according to risk factors associated with the development of SSI. Surveillance with feedback of information to surgeons and

E. T. M. Smyth; A. M. Emmerson

2000-01-01

358

Surgical Technology Curriculum.  

ERIC Educational Resources Information Center

This curriculum guide contains materials for a 10-month postsecondary program to educate qualified adults to function as surgical technicians in association with surgeons and nurses in operating rooms and delivery rooms. The program provides for both a didactic and a clinical component. Contents include general information, a listing of major…

Connecticut State Dept. of Education, Hartford. Div. of Vocational-Technical Schools.

359

Surgical treatment of obesity  

Microsoft Academic Search

Obesity is very prevalent. Most treatments fail owing to hard-wired survival mechanisms, linking stress and appetite, which have become grossly maladaptive in the industrial era. Antiobesity (bariatric) surgery is a seemingly drastic, efficacious therapy for this serious disease of energy surfeit. Technical progress during the last two decades has greatly improved its safety. The surgical principles of gastric restriction and\\/or

Erik Näslund; John G Kral

2007-01-01

360

Ancient Egyptian surgical heritage.  

PubMed

Egyptian medicine influenced the medicine of neighboring cultures, including the culture of ancient Greece. From Greece, its influence spread onward, thereby affecting Western civilization significantly. The oldest extant Egyptian medical texts are six papyri: The Edwin Smith Surgical Papyrus and the Ebers Medical Papyrus are famous. PMID:21208098

Saber, Aly

2010-12-01

361

Surgical wound care - closed  

MedlinePLUS

... Skin glue Proper wound care can help prevent infection and reduce scarring as your surgical wound heals. ... When you come home after surgery, you may have a dressing on your ... don't catch on clothing Protect the area as it heals Soak ...

362

Minor surgical manipulations  

Microsoft Academic Search

ExtractMadam:– There is increasing community concern over minor surgical manipulations of animals. People are questioning our rights to dock tails. to castrate domestic species, to earmark and to brand for other than therapeutic reasons. The develvetting of deer remains remarkably unchallenged in this country, although there is widespread doubt in the western world about the claimed efficacy of the product

Gabrielle George

1985-01-01

363

Performance evaluation of a 64-pixel positron-sensitive surgical probe in simulated sentinel lymph node surgical environment  

Microsoft Academic Search

The prototype 64-pixel positron-sensitive surgical probe has been repackaged in preparation for moving the probe into clinical surgical environment The probe detector front opening is covered with a 25 ?m thick aluminum foil, which makes the probe a both light-tight and sterilizable system. As previously reported, the probe consists of a dual-layer detector and a multi-anode PMT (Hamamatsu H7546). The

F. Liu; R. Wiener; J. R. Saffer; G. M. Mayers; W. Kononenko; F. M. Newcomer; R. Van Berg; J. S. Karp

2004-01-01

364

Surgical Techniques Used for the Treatment of Atrial Fibrillation  

PubMed Central

The use of surgical lesion sets for the treatment of atrial fibrillation has been increasing, particularly in patients with complicated anatomical substrates and those undergoing concomitant surgery. Preferences in terms of lesion set, surgical approach and ablation technology vary by center. This review discusses both the surgical techniques and the outcomes for the most commonly performed procedures in the context of recent consensus guidelines. The Cox-Maze IV, pulmonary vein isolation, extended left atrial lesion sets, the hybrid approach and ganglionated plexus ablation are each reviewed in an attempt to provide insight into current clinical practice and patient selection PMID:23823731

Robertson, Jason O.; Lawrance, Christopher P.; Maniar, Hersh S.; Damiano, Ralph J.

2015-01-01

365

Toward fluorescence detection of protein residues on surgical instruments  

NASA Astrophysics Data System (ADS)

Prion proteins are the infectious agents that cause Creutzfeldt-Jakob Disease (CJD) in humans. These proteins are particularly resistant to normal sterilization procedures, and the theoretical risk of prion transmission via surgical instruments is of current public and professional concern. We are currently investigating fluorescence methods for the detection of proteins on surfaces, with a view to developing an optical-fiber-based system for routine, online monitoring of residual protein contamination on surgical instruments, in hospital sterilization departments. This paper presents preliminary results on the detection of femtomole amounts of fluorescently labelled protein on surgical steel and discusses some of the problems involved in the detection of fluorescence from metal samples.

Richardson, Patricia R.; Jones, Anita C.; Baxter, Robert L.; Baxter, Helen C.; Whittaker, A. Gavin; Campbell, Gaynor A.

2004-06-01

366

Exogenous Application of Platelet-Leukocyte Gel during Open Subacromial Decompression Contributes to Improved Patient Outcome  

Microsoft Academic Search

Background: Platelet-leukocyte gel (PLG) is being used during various surgical procedures in an attempt to enhance the healing process. We studied the effects of PLG on postoperative recovery of patients undergoing open subacromial decompression (OSD). Methods: PLG was produced from platelet-leukocyte-rich plasma (P-LRP), prepared from a unit of whole blood. Forty patients were included in the study. Self-assessed evaluations, using

P. A. Everts; R. J. J. Devilee; C. Brown Mahoney; A. van Erp; C. J. M. Oosterbos; M. Stellenboom; J. T. A. Knape; A. van Zundert

2008-01-01

367

Open Achilles tendon lacerations.  

PubMed

In contrast to closed Achilles tendon ruptures, open injuries are rarely reported in the literature. This paper provides information about open Achilles tendon wounds that are eventually seen in the Middle East. The reporting unit, Hamad Medical Corporation, is one of the biggest trauma centers in the Gulf area and the major health provider in Qatar. This is a retrospective study including patients admitted and operated for open Achilles tendon injuries between January 2011 and December 2013. Two hundred and five cases of open Achilles tendon lacerations were operated in Hamad General Hospital in this period. Forty-eight cases showed partial injuries, and the remaining are complete tendons cut. In the same period, fifty-one closed ruptured Achilles tendons were operated in the same trauma unit. In the majority of cases, the open injury resulted from a slip in the floor-leveled traditional toilette seats. Local damage to the toilette seats resulted in sharp edges causing the laceration of the heel if the patient was slipping over the wet floor. This occurrence is the cause in the vast majority of the cases. Wounds were located 1-5 cm proximal to tendon insertion. Standard treatment principles were applied. This included thorough irrigation in the emergency room, intravenous antibiotics, surgical debridement and primary repair within 24 h. Patients were kept in the hospital 1-7 days for intravenous antibiotics and possible dressing changes. Postoperatively below knee slabs were applied in the majority of patients and were kept for about 4 weeks followed by gradual weight bearing and range of motion exercises. Outpatients follow up in 1-2 weeks. Further follow-up visits at around 2-, 4-, 8- and 12-week intervals until complete wound healing and satisfactory rehabilitation outcome. Sixteen cases needed a second procedure. A high incidence of Achilles tendon open injuries is reported. This seems to be related to partially damaged floor-level toilettes in the typical Middle-East lavatory. The surgical treatment resulted in excellent outcome in the vast majority of the cases. Low incidence of complications resulted despite dramatic injury pattern. PMID:25337957

Said, M Nader; Al Ateeq Al Dosari, Mohamed; Al Subaii, Nasser; Kawas, Alaa; Al Mas, Ali; Al Ser, Yaser; Abuodeh, Yousef; Shakil, Malik; Habash, Ali; Mukhter, Khalid

2014-10-22

368

The Dor procedure for left ventricular reconstruction. Ten-year clinical experience  

Microsoft Academic Search

Objective: Surgical ventricular restoration by means of the Dor procedure is a surgical option in patients with coronary artery disease, postinfarction left ventricular aneurysm or ischemic dilated cardiomyopathy with or without ventricular tachycardia. The aim of this study was to evaluate the 10-year clinical experience of this procedure in our institution. Methods: From May 1994 to June 2004, surgical ventricular

Ulrik Sartipy; Anders Albage; Dan Lindblom

2010-01-01

369

Local surgical treatment with curative intent in rectal cancer.  

PubMed

The surgical treatment of rectal cancer includes radical resection techniques and local excision procedures. Radical resection techniques are still the golden standard in the management of rectal cancer, but the increased postoperative morbidity and mortality led to the idea that less traumatizing procedures of local excision may have the same oncologic results, in selected cases. Yet, the significantly higher local recurrence rate after local excision in comparison to radical resection has been certified by most studies; that points out the need of clearly defined guidelines for local excision. In the present review the following aspects were taken into consideration, when considering local surgical excision as a radical procedure for rectal cancer: the clinico-pathological features of the tumours, the various types of surgical techniques used in local excision, the need for an adjuvant or neoadjuvant oncological treatment, the variety of results obtained in a large number of studies, making this particular issue a topic that is currently subject to debate. PMID:23464763

Mirea, C S; Vilcea, I D; Vasile, I; Mita, A

2013-01-01

370

Surgical Treatment of Congenital Hallux Varus  

PubMed Central

Background The purpose of this study was to report outcomes of congenital hallux varus deformity after surgical treatment. Methods We evaluated ten feet of eight patients with a congenital hallux varus deformity, including four feet combined with a longitudinal epiphyseal bracket (LEB). There were seven male patients and one female patient with a mean age of 33 months (range, 7 to 103 months) at the time of surgery. Two patients were bilaterally involved. The mean duration of follow-up was 5.9 years (range, 2.3 to 13.8 years). Clinical outcomes were assessed according to the criteria of Phelps and Grogan. Surgical procedures included the Farmer procedure, the McElvenny procedure or an osteotomy at the first metatarsal or proximal phalanx. Results The clinical results were excellent in two feet, good in six and poor in two feet. The LEB was associated with hallux varus in four feet and were treated by osteotomy alone or in conjunction with soft tissue procedure. Conclusions Congenital hallux varus was successfully corrected by surgery with overall favorable outcome. Preoperatively, a LEB should be considered as a possible cause of the deformity in order to prevent recurrent or residual varus after surgery. PMID:24900905

Shim, Jong Sup; Koh, Kyoung Hwan; Lee, Do Kyung

2014-01-01

371

Comparison of Oxidative Stress Status in Dogs Undergoing Laparoscopic and Open Ovariectomy  

PubMed Central

ABSTRACT The present study evaluated and compared the oxidative stress status of dogs undergoing laparoscopic or open ovariectomy. Twelve healthy female dogs were divided into two groups according to the type of the surgical procedure, laparoscopic or open ovariectomy. Plasma total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) levels for the evaluation of oxidative stress were determined. Increases in plasma TOS and OSI levels and decreases in TAS levels were observed in both groups after surgery. The TOS level was significantly lower in the laparoscopic ovariectomy group compared with the open surgery group. Laparoscopic ovariectomy is a safe and beneficial surgical alternative to traditional ovariectomy with respect to oxidative stress status in dogs. PMID:24107463

LEE, Jae Yeon; KIM, Myung Cheol

2013-01-01

372

Comparison between two portal laparoscopy and open surgery for ovariectomy in dogs  

PubMed Central

Ovariectomy (OVE) is a routine surgical procedure for neutering in small animal practice. Laparoscopy is a new surgical technique which contains advantages such as less trauma, smaller incision and excellent visualization than traditional open surgery. The present study was conducted to examine the feasibility and safety of laparoscopic procedure through two portal comparing with the conventional open surgery for OVE in healthy female bitches (n=16). Dogs were divided in two equal groups. In laparoscopic group, two 5 and 10 mm portals were inserted; First in the umbilicus for introducing the camera and the second, caudal to the umbilicus for inserting the forceps. Laparoscopic procedure involved grasping and tacking the ovary to the abdominal wall, followed by electrocautery, resection and removal of the ovary. In open surgery, routine OVE was conducted through an incision from umbilicus to caudal midline. Mean operative time, total length of scar, blood loss, clinical and blood parameters and all intra and post-operative complications were recorded in both groups. Mean operative time, total length of scar, blood loss and post-operative adhesions were significantly less in laparoscopic group compared with open surgery. In conclusion, laparoscopic OVE is an acceptable procedure due to more advantages in comparison with traditional OVE.

Shariati, Elnaz; Bakhtiari, Jalal; Khalaj, Alireza; Niasari-Naslaji, Amir

2014-01-01

373

Adjunctive use of monthly physician questionnaires for surveillance of surgical site infections after hospital discharge and in ambulatory surgical patients: Report of a seven-year experience  

Microsoft Academic Search

We report our experience with the use of monthly physician questionnaires, in conjunction with traditional in-house monitoring, for surveillance of surgical site infections (SSIs) in inpatients after hospital discharge and in ambulatory surgical patients (i.e., those not requiring perioperative hospitalization) over a 7-year period (July 1988 to June 1995) involving 156,977 surgical procedures. The mean annual response rate was 73%

Farrin A. Manian; Lynn Meyer

1997-01-01

374

Surgical management of spinal dural arteriovenous fistulas.  

PubMed

Spinal dural arteriovenous fistulas are the most common type of spinal arteriovenous malformations. Treatment options consist of microsurgical exclusion and/or endovascular embolization. We retrospectively identified all patients who benefited from surgical treatment at our tertiary center between January 2001 and December 2008. Clinical and imaging data were collected from patient files, including pre- and post-operative formal neurological examination, complete spine MRI and spinal digital subtraction angiography. Of our 30 patients, 25 were men and five were women with a median age of 62years (range 24-76). The average delay between symptom onset and clinical diagnosis was 27months (range 1-90). Complete cure of the fistula was obtained in all patients in a single surgical session with no procedural complications and no surgical morbidity. After a mean follow-up period of 32months (range 14-128), 25 patients (83%) had improved, four were stable and one worsened. Despite recent advances in endovascular techniques and materials, there is a subgroup of patients for which surgery remains the best treatment option. Careful patient selection, a multidisciplinary approach and standardized surgical techniques can lead to excellent results with virtually no complications. PMID:25304440

Chibbaro, Salvatore; Gory, Benjamin; Marsella, Marco; Tigan, Leonardo; Herbrecht, Anne; Orabi, Mikael; Bresson, Damien; Baumann, Fabian; Saint-Maurice, Jean Pierre; George, Bernard; Kehrli, Pierre; Houdart, Emmanuel; Manisor, Monica; Pop, Raoul

2015-01-01

375

Anatomical Basis for Surgical Approaches to the Hip  

PubMed Central

The hip joint is one of the most surgically exposed joints in the body. The indications for surgical exposure are numerous ranging from simple procedures such as arthrotomy for joint drainage in infection to complex procedures like revised total hip replacement. Tissue dissections based on sound knowledge of anatomic orientations is essential for best surgical outcomes. In this review, the anatomical basis for the various approaches to the hip is presented. Systematic review of the literature was done by using PubMed, Cochrane, Embase, OVID, and Google databases. Out of the initial 150 articles selected from the the review and selection criteria, only 37 that suited the study were eventually used. Selected articles included case reports, clinical trials, review and research reports. Each of these approaches has various modifications that seek to correct certain difficulties or problems encountered with previous descriptions. An ideal approach for a procedure should be safe and provide satisfactory exposure of the joint. It should avoid bone and soft tissue damage as well as avoid unnecessary devascularization. Among the factors that determine the choice of surgical approach to the hip are the indication for the procedure; the influence of previous surgical incisions as well as the personal preferences and training of the operating surgeon. PMID:25221692

Onyemaechi, NOC; Anyanwu, EG; Obikili, EN; Ekezie, J

2014-01-01

376

Oncological and Functional Outcome after Surgical Treatment of Early Glottic Carcinoma without Anterior Commissure Involvement  

PubMed Central

Introduction. Glottic carcinoma can be successfully diagnosed in its early stages and treated with high percentage of success. Organ preservation and optimal functional outcomes could be achieved with wide array of surgical techniques for early glottic cancer, including endoscopic approaches or open laryngeal preserving procedures, making surgery the preferred method of treatment of early glottic carcinoma in the last few years. Material and Methods. Prospective study was done on 59 patients treated for Tis and T1a glottic carcinoma over a one-year time period in a tertiary medical center. Patients were treated with endoscopic laser cordectomy (types II–IV cordectomies according to European Laryngological Society classification of endoscopic cordectomies) and open cordectomy through laryngofissure. Follow-up period was 60 months. Clinical and oncological results were followed postoperatively. Voice quality after the treatment was assessed using multidimensional voice analysis 12 months after the treatment. Results. There were no significant differences between oncological and functional results among two groups of patients, though complications were more frequent in patients treated with open cordectomy. Conclusion. Endoscopic laser surgery should be the first treatment of choice in treatment of early glottic carcinomas, though open approach through laryngofissure should be available for selected cases where anatomical factors present limiting adequate tumor removal. PMID:24991554

Milovanovic, Jovica; Jotic, Ana; Djukic, Vojko; Pavlovic, Bojan; Trivic, Aleksandar; Krejovic-Trivic, Sanja; Milovanovic, Andjela; Milovanovic, Aleksandar; Artiko, Vera; Banko, Bojan

2014-01-01

377

Carpal tunnel syndrome, the search for a cost-effective surgical intervention: a randomised controlled trial.  

PubMed Central

OBJECTIVE: There is insufficient evidence regarding the clinical and cost-effectiveness of surgical interventions for carpal tunnel syndrome. This study evaluates the cost, effectiveness and cost-effectiveness of minimally invasive surgery compared with conventional open surgery. PATIENTS AND METHODS: 194 sufferers (208 hands) of carpal tunnel syndrome were randomly assigned to each treatment option. A self-administered questionnaire assessed the severity of patients' symptoms and functional status pre- and postoperatively. Treatment costs were estimated from resource use and hospital financial data. RESULTS: Minimally invasive carpal tunnel decompression is marginally more effective than open surgery in terms of functional status, but not significantly so. Little improvement in symptom severity was recorded for either intervention. Minimally invasive surgery was found to be significantly more costly than open surgery. The incremental cost effectiveness ratio for functional status was estimated to be 197 UK pounds, such that a one percentage point improvement in functioning costs 197 UK pounds when using the minimally invasive technique. CONCLUSIONS: Minimally invasive carpal tunnel decompression appears to be more effective but more costly. Initial analysis suggests that the additional expense for such a small improvement in function and no improvement in symptoms would not be regarded as value-for-money, such that minimally invasive carpal tunnel release is unlikely to be considered a cost-effective alternative to the traditional open surgery procedure. PMID:15720906

Lorgelly, Paula K.; Dias, Joseph J.; Bradley, Mary J.; Burke, Frank D.

2005-01-01

378

Medicare program; hospital outpatient prospective payment system and CY 2007 payment rates; CY 2007 update to the ambulatory surgical center covered procedures list; Medicare administrative contractors; and reporting hospital quality data for FY 2008 inpatient prospective payment system annual payment update program--HCAHPS survey, SCIP, and mortality. Final rule with comment period and final rule.  

PubMed

This final rule with comment period revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system, and to implement certain related provisions of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 and the Deficit Reduction Act (DRA) of 2005. In this final rule with comment period, we describe changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2007. In addition, this final rule with comment period implements future CY 2009 required reporting on quality measures for hospital outpatient services paid under the prospective payment system. This final rule with comment period revises the current list of procedures that are covered when furnished in a Medicare-approved ambulatory surgical center (ASC), which are applicable to services furnished on or after January 1, 2007. This final rule with comment period revises the emergency medical screening requirements for critical access hospitals (CAHs). This final rule with comment period supports implementation of a restructuring of the contracting entities responsibilities and functions that support the adjudication of Medicare fee-for-service (FFS) claims. This restructuring is directed by section 1874A of the Act, as added by section 911 of the MMA. The prior separate Medicare intermediary and Medicare carrier contracting authorities under Title XVIII of the Act have been replaced with the Medicare Administrative Contractor (MAC) authority. This final rule continues to implement the requirements of the DRA that require that we expand the "starter set" of 10 quality measures that we used in FY 2005 and FY 2006 for the hospital inpatient prospective payment system (IPPS) Reporting Hospital Quality Data for the Annual Payment Update (RHQDAPU) program. We began to adopt expanded measures effective for payments beginning in FY 2007. In this rule, we are finalizing additional quality measures for the expanded set of measures for FY 2008 payment purposes. These measures include the HCAHPS survey, as well as Surgical Care Improvement Project (SCIP, formerly Surgical Infection Prevention (SIP)), and Mortality quality measures. PMID:17133695

2006-11-24

379

Role of coronoidectomy in increasing mouth opening  

PubMed Central

Aim: To evaluate the effectiveness of coronoidectomy in advanced (stage III-IV) oral submucous fibrosis (OSMF) and temporomandibular joint (TMJ) ankylosis. Materials and Methods: Five patients clinically diagnosed as grade III/IV OSMF (group 1) and seven patients clinically and radiographically confirmed as TMJ ankylosis (group 2) underwent surgery entailing coronoidectomy in addition to conventional surgical procedures required in both the conditions followed by vigorous mouth opening exercises. The results were evaluated using the interincisal distance at maximum mouth opening as the objective outcome over a follow-up period of 2 months. Results: OSMF patients (group I) showed a mean preoperative interincisal opening of 14.40 mm which increased to 24.60 mm after conventional procedures and showed further increment to 35 and 44.80 mm after unilateral and bilateral coronoidectomy, respectively; which was statistically significant (P = 0.043). Follow-up of 2 months showed a gradual increase in mean mouth opening compared to baseline which was also found to be statistically significant (P = 0.043). In TMJ ankylosis patients (group II), preoperative mean mouth opening of 6.71 mm increased to 24.29 mm after conventional procedures, and further to 37.29 mm after unilateral coronoidectomy which was statistically significant (P = 0.018). On subsequent follow-up of 2 months, a gradual increase in mean mouth opening compared to baseline was observed which was statistically significant (P = 0.018). Conclusion: Coronoidectomy is an effective adjunct in increasing intraoperative and stabilizing postoperative mouth opening. PMID:25298713

Gupta, Hemant; Tandon, Parul; Kumar, Deepak; Sinha, Vijay Prakash; Gupta, Sumit; Mehra, Hemant; Singh, Jasmeet

2014-01-01

380

Ontological Modelling of Surgical Knowledge  

Microsoft Academic Search

Computer Assisted Surgery seeks data from various sources related to surgical knowledge, which is mostly represented in the form of discrete databases. However, databases serve as data storage mechanism rather than knowledge representation system. As CAS is becoming more common for various types of surgical interventions, there is a need for representation, storage and processing of surgical knowledge in a

Raj Mudunuri; Oliver Burgert; Thomas Neumuth

2009-01-01

381

Surgical Device Engineering  

NSDL National Science Digital Library

This unit focuses on teaching students about the many aspects of biomedical engineering (BME). Students come to see that BME is a broad field that relies on concepts from many engineering disciplines. They also begin to understand some of the special considerations that must be made when dealing with the human body. Activities and class discussions encourage students to think as engineers to come up with their own solutions to some of medical challenges that have been solved throughout the history of BME. Class time iincludes brainstorming and presenting ideas to the class for discussion. Specific activities include examination of the material properties and functions of surgical instruments and prosthetics, a simulation of the training experience of a surgical resident, and an investigation of the properties of fluid flow in vascular tissue.

Techtronics Program

382

Spacecraft surgical scrub system  

NASA Technical Reports Server (NTRS)

Ease of handling and control in zero gravity and minimizing the quantity of water required were prime considerations. The program tasks include the selection of biocidal agent from among the variety used for surgical scrub, formulation of a dispensing system, test, and delivery of flight dispensers. The choice of an iodophore was based on effectiveness on single applications, general familiarity among surgeons, and previous qualification for space use. The delivery system was a choice between the squeeze foamer system and impregnated polyurethane foam pads. The impregnated foam pad was recommended because it is a simpler system since the squeeze foamer requires some applicator to effectively clean the skin surfaces, whereas the form pad is the applicator and agent combined. Testing demonstrated that both systems are effective for use as surgical scrubs.

Abbate, M.

1980-01-01

383

Stereo Display of 3D Ultrasound Images for Surgical Robot Guidance Paul M. Novotny, Daniel T. Kettler, Petr Jordan,  

E-print Network

the target site within the heart. A surgical robot is ideally suited for this situation. Recent studies haveStereo Display of 3D Ultrasound Images for Surgical Robot Guidance Paul M. Novotny, Daniel T a variety of surgical procedures to be performed within the beating heart. Implementation

384

Surgical adjuvant chemotherapy.  

PubMed

The evidence that the principles of surgical adjuvant chemotherapy developed in experimental animal systems also apply to a variety of neoplastic diseases in man has been clearly demonstrated. Micrometastatic disease can be eradicated with effective chemotherapy in several diseases. Prolongation of disease-free interval, if not cure, is now possible in diseases in which curative surgery alone or in combination with radiotherapy does not achieve these goals. The previously fatal childhood solid tumors--Wilms', Ewings' sarcoma, embryonal rhabdomyosarcoma--are curable in a high percentage of patients appropriately treated with combinations of surgery, radiotherapy, and chemotherapy. The prolongation of the disease-free interval in osteogenic sarcoma has permitted consideration of entirely new surgical approaches for this tumor in which radical amputation has traditionally been employed. The spectacular results achieved in the treatment of Stage II breast cancer may potentially save hundreds of thousands of lives in the coming decade. Clinically recognizable metastatic disease is rarely curable by any currently available treatment modality. The prolongation of disease-free intervals and production of cures when surgical adjuvant chemotherapy is employed may be partly explained by relatively more circulation, and thus drug delivery to each tumor cell, more favorable cellular kinetics, and a healthier and more immunocompetent host who is better able to withstand drug effects on normal tissues, and to participate in tumor destruction. Cures of certain patients with neoplastic diseases using surgical adjuvant chemotherapy has increased the incentive to learn more about new and old drugs and their effective use alone and in combination. Chemotherapy, in appropriate combinations with surgery, radiotherapy, and immunotherapy, may well be more efficacious in many clinical situations than the traditional use of single-modality treatment. The data presented in this paper relate solid evidence that the possibility of cure in a variety of neoplastic diseases is real. PMID:193434

Perloff, M; Holland, J F

1977-01-01

385

Surgical Approaches Based on Biological Objectives: GTR versus GBR Techniques  

PubMed Central

Guided tissue regenerative (GTR) therapies are performed to regenerate the previously lost tooth supporting structure, thus maintaining the aesthetics and masticatory function of the available dentition. Alveolar ridge augmentation procedures (GBR) intend to regain the alveolar bone lost following tooth extraction and/or periodontal disease. Several biomaterials and surgical approaches have been proposed. In this paper we report biomaterials and surgical techniques used for periodontal and bone regenerative procedures. Particular attention will be adopted to highlight the biological basis for the different therapeutic approaches. PMID:23843792

Pagni, Giorgio; Rasperini, Giulio

2013-01-01

386

Ablation Technology for the Surgical Treatment of Atrial Fibrillation  

PubMed Central

The Cox maze procedure for the surgical treatment of atrial fibrillation has been simplified from its original cut-and-sew technique. Various energy sources now exist which create linear lines of ablation that can be used to replace the original incisions, greatly facilitating the surgical approach. This review article describes the anatomy of the atria that must be considered in choosing a successful energy source. Furthermore the device characteristics, safety profile, mechanism of tissue injury, and ability to create transmural lesions of the various energy sources that have been used in the Cox maze procedure, along with the strengths and weaknesses of each device is discussed. PMID:23995989

Melby, Spencer J.; Schuessler, Richard B.; Damiano, Ralph J.

2014-01-01

387

Surgical treatment in proximal bile duct cancer. A single-center experience.  

PubMed Central

OBJECTIVES: The authors evaluated the experience and results of a single center in surgical treatment of proximal bile duct carcinoma. SUMMARY BACKGROUND DATA: Whenever feasible, surgery is the appropriate treatment in proximal bile duct carcinoma. To improve survival rates and with special regard to liver transplantation, the extent of surgical radicalness remains an open issue. PATIENTS AND METHODS: Retrospective analysis of 249 patients who underwent surgery for proximal bile duct carcinoma via the following procedures: resection (n = 125), liver transplantation (n = 25), and exploratory laparotomy (n = 99). Survival rates were calculated according to the Kaplan-Meier method, uni- and multivariate analysis of prognostic factors, and log rank test (p < 0.05). RESULTS: Survival rates after resection and liver transplantation are correlated with international Union Against Cancer (UICC) tumor stage (resection: overall 5-year, 27.1%; stage I and II, 41.9%; stage IV, 20.7%; liver transplantation: overall 5-year, 17.1%; stage I and II, 37.8%; stage IV, 5.8%). Significant univariate prognostic factors for survival after liver resection were lymph node involvement (N category), tumor stage, tumor-free margins, and vascular invasion; for transplantation, they were local tumor extent, N category, tumor stage, and infiltration of liver parenchyma. For resection and transplantation, a multivariate analysis showed prognostic significance of tumor stage and tumor-free margins. CONCLUSION: Resection remains the treatment of choice in proximal bile duct carcinoma. Whenever possible, decisions about resectability should be made during laparotomy. With regard to the observation of long-term survivors, liver transplantation still can be justified in selected patients with stage II carcinoma. It is unknown whether more radical procedures, such as liver transplantation combined with multivisceral resections, will lead to better outcome in advanced stages. With regard to palliation, surgical drainage of the biliary system performed as hepatojejunostomy can be recommended. PMID:8916878

Pichlmayr, R; Weimann, A; Klempnauer, J; Oldhafer, K J; Maschek, H; Tusch, G; Ringe, B

1996-01-01

388

Controlling infection potentials when passing surgical instruments.  

PubMed

1. Recent research suggests that percutaneous injury occurs in 6.9% of observed surgical procedures. This finding indicates that percutaneous injuries occur often during surgery, placing OR personnel at risk for infection potential with bloodborne pathogens. 2. One approach to reducing the risk of injury with contaminated sharps is to introduce a change in the normal method of passing sharps. A new method, the "hands-free" technique, focuses on the safety of the OR professional without disrupting the established routine of the operating room. This new technique is designed to reduce the number of "collisions" between sharps and OR professionals. 3. Caution and staff education are important during any attempt to use hands-free instrument passing techniques in an OR setting. The hands-free technique of passing sharps should be practiced until all members of the surgical team have a high degree of comfort using it. PMID:8291075

Kovach, T

1993-01-01

389

Intractable verrucous hyperplasia: a surgically corrected case.  

PubMed

Skin problems commonly occur after lower limb amputation. Wart-like lesions of verrucous hyperplasia is one such skin anomaly that develops on the residual-limb. The process is reversible if external compression in combination with adequate control of bacterial infection and edema is applied. Prosthetic adjustments usually help with this condition. However, we experienced an intractable verrucous hyperplasia case in a 65-year-old female. She complained of a painful, oozing, verrucous papule at the amputation site. Despite management with typical treatment procedures, the lesion worsened. Surgical treatment was therefore carried out. This case demonstrated that an intractable case is possible despite appropriate management and sometimes surgical correction is necessary. PMID:25479281

Chang, Ji Hea; Moon, Hee Bong; Kim, Chang Jae; Nam, Kiyeun; Lee, Ho Jun; Kwon, Bum Sun; Park, Jin-Woo

2014-12-01

390

Surgical Management of Diabetic Retinopathy  

PubMed Central

Surgery for late complications of proliferative diabetic retinopathy remains the cornerstone of management even in patients who have received optimal laser photocoagulation and medical therapy. With improvisation in the surgical techniques and development of micro-incision surgical techniques for vitrectomy, the indications for surgical intervention are expanding to include diabetic macular edema with a greater number of patients undergoing early intervention. This review describes the current indications, surgical techniques, adjunctive anti-vascular endothelial growth factor therapy, surgical outcomes, and postoperative complications of pars plana vitrectomy for proliferative diabetic retinopathy and macular edema. PMID:24339677

Gupta, Vishali; Arevalo, J. Fernando

2013-01-01

391

Prevention of retained surgical items.  

PubMed

Reduction in retained surgical items is an important part of any operating room patient-safety effort. Any item used in an operation can result in a retained surgical item, but sponges are the most frequent and the abdomen is the most common location. Retained sponges can cause significant morbidity, and the costs associated with both prevention and treatment of retained surgical items, including legal costs, can be considerable. This review will examine counting, teamwork, radiography, and new technology as methods used to prevent retained surgical items. Even though none of these techniques individually is likely to completely prevent retained surgical items, when used together the numbers can be reduced. PMID:22069210

Feldman, David L

2011-01-01

392

A review of current surgical treatment of patients with atrial fibrillation  

PubMed Central

Surgical therapy for patients with atrial fibrillation has undergone significant advances over the past 30 years. The Cox Maze III technique is currently the gold standard of care for these patients. However, Maze IV, a less complex procedure using alternative energy sources, is rapidly replacing the Cox Maze III in clinical practice. The use of alternative energy sources such as cryothermy and radiofrequency eliminates some of the “cut and sew” lesions of the Maze III, resulting in an easier and faster procedure with less morbidity. Video-assisted technology and hybrid procedures have further ushered in the future of surgical therapy. This article presents the latest surgical therapeutic options for patients with atrial fibrillation. The history of these procedures is presented, followed by a discussion of modern-era techniques, including concomitant ablation and standalone (also referred to as “lone”) procedures. Finally, the article explores breaking developments and future directions for the surgical treatment of patients with atrial fibrillation. PMID:22754118

Edgerton, Zachary J.

2012-01-01

393

A review of current surgical treatment of patients with atrial fibrillation.  

PubMed

Surgical therapy for patients with atrial fibrillation has undergone significant advances over the past 30 years. The Cox Maze III technique is currently the gold standard of care for these patients. However, Maze IV, a less complex procedure using alternative energy sources, is rapidly replacing the Cox Maze III in clinical practice. The use of alternative energy sources such as cryothermy and radiofrequency eliminates some of the "cut and sew" lesions of the Maze III, resulting in an easier and faster procedure with less morbidity. Video-assisted technology and hybrid procedures have further ushered in the future of surgical therapy. This article presents the latest surgical therapeutic options for patients with atrial fibrillation. The history of these procedures is presented, followed by a discussion of modern-era techniques, including concomitant ablation and standalone (also referred to as "lone") procedures. Finally, the article explores breaking developments and future directions for the surgical treatment of patients with atrial fibrillation. PMID:22754118

Edgerton, Zachary J; Edgerton, James R

2012-07-01

394

Orthopedic surgical analyzer for percutaneous vertebroplasty  

NASA Astrophysics Data System (ADS)

Since the spine is one of the most complex joint structures in the human body, its surgical treatment requires careful planning and high degree of precision to avoid any unwanted neurological compromises. In addition, comprehensive biomechanical analysis can be very helpful because the spine is subject to a variety of load. In case for the osteoporotic spine in which the structural integrity has been compromised, it brings out the double challenges for a surgeon both clinically and biomechanically. Thus, we have been developing an integrated medical image system that is capable of doing the both. This system is called orthopedic surgical analyzer and it combines the clinical results from image-guided examination and the biomechanical data from finite element analysis. In order to demonstrate its feasibility, this system was applied to percutaneous vertebroplasty. Percutaneous vertebroplasty is a surgical procedure that has been recently introduced for the treatment of compression fracture of the osteoporotic vertebrae. It involves puncturing vertebrae and filling with polymethylmethacrylate (PMMA). Recent studies have shown that the procedure could provide structural reinforcement for the osteoporotic vertebrae while being minimally invasive and safe with immediate pain relief. However, treatment failures due to excessive PMMA volume injection have been reported as one of complications. It is believed that control of PMMA volume is one of the most critical factors that can reduce the incidence of complications. Since the degree of the osteoporosis can influence the porosity of the cancellous bone in the vertebral body, the injection volume can be different from patient to patient. In this study, the optimal volume of PMMA injection for vertebroplasty was predicted based on the image analysis of a given patient. In addition, biomechanical effects due to the changes in PMMA volume and bone mineral density (BMD) level were investigated by constructing clinically relevant finite element models. In conclusion, we were able to demonstrate the feasibility of our orthopedic surgical analyzer in a case for percutaneous vertebroplasty.

Tack, Gye Rae; Choi, Hyung Guen; Lim, Do H.; Lee, Sung J.

2001-05-01

395

Surgical treatment of femoroacetabular impingement: what are the limits of hip arthroscopy?  

PubMed

The variety of hip pathology that can be addressed in a minimally invasive fashion in the young, pre-arthritic patient has rapidly grown in parallel with technical advances in hip arthroscopy. However, the indications and limits of arthroscopy must be carefully defined and indications must evolve correspondingly to avoid an increase in failure rates and unsatisfactory clinical outcomes. Some diagnoses may be better and more comprehensively addressed with open procedures or combined surgical approaches. The purpose of this article is to provide an unbiased and evidence-based review of conditions of the pre-arthritic hip to define our current understanding of the advantages, disadvantages, and limitations of an arthroscopic approach. PMID:24384276

Zaltz, Ira; Kelly, Bryan T; Larson, Christopher M; Leunig, Michael; Bedi, Asheesh

2014-01-01

396

Depressed Skull Fracture : Outcome of Surgical Treatment  

Microsoft Academic Search

Elevation and repair of an open depressed skull fracture is often thought of as an emergency procedure. Common indications for emergency elevation of a depressed skull fracture have been dural tear, seizure, gross contamination or mass effect from bone or a sizable underlying intracerebral hematoma. Over a 18 months period 93 patients with depressed skull fracture were admitted in the

M Zahed Hossain; M Monzurul Hoque

2008-01-01

397

Three different surgical techniques of crown lengthening: A comparative study  

PubMed Central

Introduction: A short clinical crown may lead to poor retention form thereby leading to improper tooth preparation. Surgical crown lengthening procedure is done to increase the clinical crown length without violating the biologic width. Several techniques have been proposed for clinical crown lengthening which includes gingivectomy, apically displaced flap with or without resective osseous surgery, and surgical extrusion using periotome. Objective: The aim of this paper is to compare clinically the three different surgical techniques of crown lengthening procedures. Materials and Methods: Fifteen patients who reported to the department of Periodontology, were included in the study. Patients were randomly divided into three groups, which include patients who underwent gingivectomy (Group A), apically repositioned flap (Group B) and surgical extrusion using periotome (Group C). Clinical measurements such as clinical crown length, gingival zenith, interdental papilla height were taken at baseline and at 3rd month post-operatively. Results: Clinical and radiographic evaluation at 3rd month suggest that surgical extrusion technique offers several advantages over the other conventional surgical techniques such as preservation of the interproximal papilla, gingival margin position and no marginal bone loss. Conclusions: This technique can be used to successfully treat a grossly damaged crown structure as a result of tooth fracture, dental caries and iatrogenic factors especially in the anterior region, where esthetics is of great concern. PMID:23946567

Nethravathy, Ramya; Vinoth, Santhana Krishnan; Thomas, Ashwin Varghese

2013-01-01

398

Surgical strategy for low rectal cancers.  

PubMed

The two goals of surgery for lower rectal cancer surgery are to obtain clear "curative" margins and to limit post-surgical functional disorders. The question of whether or not to preserve the anal sphincter lies at the center of the therapeutic choice. Histologically, tumor-free distal and circumferential margins of>1mm allow a favorable oncologic outcome. Whether such margins can be obtained depends of TNM staging, tumor location, response to chemoradiotherapy and type of surgical procedure. The technique of intersphincteric resection relies on these narrow margins to spare the sphincter. This procedure provides satisfactory oncologic outcome with a rate of circumferential margin involvement ranging from 5% to 11%, while good continence is maintained in half of the patients. The extralevator abdominoperineal resection provides good oncologic results, however this procedure requires a permanent colostomy. A permanent colostomy alters several domains of quality of life when located at the classical abdominal site but not when brought out at the perineal site as a perineal colostomy. PMID:25455959

Dumont, F; Mariani, A; Elias, D; Goéré, D

2014-11-20

399

Surgical treatment of endometriosis.  

PubMed

In this review, the pitfalls that still exist with the surgical treatment of endometriosisassociatedpelvic pain have been discussed and the best evidence regarding various aspects of surgical techniques have been reviewed. When laparoscopy is performed to evaluate a woman with pelvic pain symptoms, it is important she be counseled that the primary function of the surgery is to confirm the presence (and allow surgical treatment) of endometriosis, and that it is not the penultimate diagnostic modality for her pelvic pain. There are many etiologies of pelvic pain that present with symptoms resembling those of endometriosis-associated pelvic pain that are not diagnosable with laparoscopy, such as interstitial cystitis and irritable bowel syndrome. It is unfortunate that many women are left with the belief that if a laparoscopy fails to provide a diagnosis of a pain generator, then it means there are no diagnoses other than that the “pain is in her head,” often disparagingly termed “supratentorial” byclinicians. In fact, the pain-related diagnoses that are amenable to and possibly require a laparoscopy are quite limited, a group of diagnoses that this author terms the “dirty dozen” because there are just 12, and only the first 4 have good evidence to clearly associate them with chronic pelvic pain:1. Endometriosis 2. Ovarian remnant syndrome 3. Pelvic inflammatory disease 4. Tuberculous salpingitis 5. Adhesions 6. Benign cystic mesothelioma 7. Postoperative peritoneal cysts 8. Adnexal cysts (nonendometriotic)9. Chronic ectopic pregnancy 10. Endosalpingiosis 11. Residual accessory ovary 12. Hernias: ventral, inguinal, femoral, spigelian.I would argue that diagnostic laparoscopy in modern gynecology has a limited, if any role, and that when laparoscopy is planned for women with chronic pelvic pain, it should be with a very high suspicion of a diagnosis and with plans to treat the disease operatively. In this era, a negative diagnostic laparoscopy should be a rare event. PMID:22134016

Howard, Fred M

2011-12-01

400

[Radical prostatectomy in prostate cancer: indications and surgical approaches].  

PubMed

Prostate cancer is the most frequent in men: 71000 new cases were diagnosed in France in 2011. Early diagnosis allows treatments with curative intent. Risk groups by D'Amico classification system were validated to estimate progression risk after radical prostatectomy, external beam radiotherapy and brachytherapy. Radical prostatectomy is one of the reference treatments for localized prostate cancer. There are many surgical approaches: open retropubic approach, perineal, trans peritoneal or extra peritoneal laparoscopic approach, robotic assisted or not. Main surgical steps are the same between retropubic or laparoscopic approaches. Regarding oncologic (positive surgical margins rate, progression free survival) and functional results (continence and erections), no difference was reported between different surgical approaches. PMID:23682477

Toledano, Harry; Bastide, Cyrille; Rossi, Dominique

2013-04-01

401

Surgical management of spasticity.  

PubMed

Intractable and severe spasticity in childhood has the ability to impact on the quality of life, function and care of the child. Where medical and physical measures have proved insufficient, a surgical approach may be pursued. Irrespective of the underlying pathology, intrathecal baclofen will reduce spasticity in a controllable and reversible fashion, whereas selective dorsal rhizotomy is reserved for the management of bilateral cerebral palsy due to early birth. Owing to the potential for complications of intrathecal baclofen and the permanence of selective dorsal rhizotomy, careful selection and preparation are required to produce satisfactory results. PMID:24432100

Roberts, Andrew

2013-11-01

402

Surgical Treatments in Inferior Oblique Muscle Overaction  

PubMed Central

Purpose: To compare the outcomes of surgical procedures in the treatment of inferior oblique muscle overaction (IOOA) as a common disorder of ocular motility. Methods: This retrospective study was performed on patients with primary and secondary IOOA who underwent three surgical treatment procedures including disinsertion, myectomy and anterior transposition, between 2001 and 2011. Type of strabismus, ocular alignment, presence of pre-and post-operative dissociated vertical deviation (DVD), pre- and post-operative degree of IOOA were obtained using specified checklist. Results: A total of 122 eyes of 74 patients with mean age of 13 ± 11.7 (range, 1-51) years were included in this study. Disinsertion was performed on 12 eyes (9.8%), myectomy in 91 eyes (74.6%) and anterior transposition in 19 (15.6%). Preoperative V-pattern and DVD existed in 67 and 17 eyes; after surgery they remained in only 10 and 8 eyes, respectively. The success rate (IOOA <+1), in disinsertion, myectomy and anterior transposition groups were 91.7%, 97.8%, and 89.5%, respectively and these measures did not change after 6 months. Overall, 53.3% (n = 65) and 38.5% (n = 47) of eyes had preoperative esotropia and exotropia. Preoperative hypertropia and hypotropia were observed in 16.4% (n = 20) and 3.3% (n = 4) of eyes, respectively. After surgery there were no cases of additional strabismus. However, residual hypertropia was seen in 9 eyes, while preoperative hypotropia increased in one patient who underwent anterior transposition surgery. Esotropia and exotropia were not observed in any surgical treatment groups postoperatively. Conclusion: We conclude that all these three procedures are effective for treatment of primary or secondary IOOA with minimum side-effects.

Sanjari, Mostafa Soltan; Shahraki, Kourosh; Nekoozadeh, Shahbaz; Tabatabaee, Seyed-Morteza; Shahraki, Kianoush; Aghdam, Kaveh Abri

2014-01-01

403

Effect of surgical castration on the behavioural and acute phase responses of 5-day-old piglets  

Microsoft Academic Search

Pain and discomfort provoked by surgical castration of male pigs causes behavioural alterations that are particularly evident in the immediate days following this procedure. Less information is available in relation to whether the physiological consequences of surgical castration also persist with time. The objective of this study was to assess the behavioural response to this procedure; and evaluate its effects

Sara Llamas Moya; Laura A. Boyle; Patrick Brendan Lynch; Sean Arkins

2008-01-01

404

10 CFR 452.5 - Bidding procedures.  

Code of Federal Regulations, 2011 CFR

... PRODUCTION INCENTIVES FOR CELLULOSIC BIOFUELS § 452.5 Bidding procedures. ...only to pre-auction eligible cellulosic biofuels producers. The following procedures...from pre-auction eligible cellulosic biofuels producers during the open window...

2011-01-01

405

10 CFR 452.5 - Bidding procedures.  

Code of Federal Regulations, 2010 CFR

... PRODUCTION INCENTIVES FOR CELLULOSIC BIOFUELS § 452.5 Bidding procedures. ...only to pre-auction eligible cellulosic biofuels producers. The following procedures...from pre-auction eligible cellulosic biofuels producers during the open window...

2010-01-01

406

10 CFR 452.5 - Bidding procedures.  

Code of Federal Regulations, 2012 CFR

... PRODUCTION INCENTIVES FOR CELLULOSIC BIOFUELS § 452.5 Bidding procedures. ...only to pre-auction eligible cellulosic biofuels producers. The following procedures...from pre-auction eligible cellulosic biofuels producers during the open window...

2012-01-01

407

10 CFR 452.5 - Bidding procedures.  

Code of Federal Regulations, 2013 CFR

... PRODUCTION INCENTIVES FOR CELLULOSIC BIOFUELS § 452.5 Bidding procedures. ...only to pre-auction eligible cellulosic biofuels producers. The following procedures...from pre-auction eligible cellulosic biofuels producers during the open window...

2013-01-01

408

10 CFR 452.5 - Bidding procedures.  

Code of Federal Regulations, 2014 CFR

... PRODUCTION INCENTIVES FOR CELLULOSIC BIOFUELS § 452.5 Bidding procedures. ...only to pre-auction eligible cellulosic biofuels producers. The following procedures...from pre-auction eligible cellulosic biofuels producers during the open window...

2014-01-01

409

Migration of surgical clips through a right lobectomy stump mimicking an asthmatic syndrome.  

PubMed

The mechanical stapler is routinely used in thoracic surgery practice to attend resection of bronchus and vessels. Herein, we reported a very rare complication as the migration of a titanium surgical clip through a right lobectomy stump. One year after the procedure, the patient complained of persistent cough. A misdiagnosis of asthma was made and she treated for 6 months with bronchodilators, corticosteroid and antihistaminic without success. Thus, patient re-referred of our unit. No clinical signs of infection as fewer, productive cough, dyspnea were present. The laboratory exams were within normal value including white cells. CT scan revealed no abnormalities. Bronchoscopy demonstrated a healed upper bronchus stump without evidence of an actual, open bronchopleural fistula but with clips apparently working their way into the airway, with approximately half of the clip visible within the lumen. The side of the clips that would be open before closure by the surgeon formed the leading edge of the clips visible in the lumen. The clips were successfully removed during flexible bronchoscopy with a forceps usually used for biopsy. After the procedure, the cough disappeared. The endoscopy check after 3 months showed a normal bronchial stump without evidence of fistula. PMID:24267611

Di Crescenzo, Vincenzo; Laperuta, Paolo; Napolitano, Filomena; Carlomagno, Chiara; Danzi, Michele; Amato, Bruno; Garzi, Alfredo; Vitale, Mario

2013-01-01

410

Synchronous Laparoscopic Radical Nephrectomy Left and Contralateral Right Hemicolectomy during the Same Endoscopic Procedure  

PubMed Central

Synchronous renal cell carcinoma in patients with colorectal carcinoma is reported in various percentages ranging from 0.03 up to 4.85% (Halak et al. (2000), Capra et al. (2003)). When surgical treatment is indicated usually two separate operations are planned for resection. In open surgery, in such cases simultaneous resection is recommended if possible. Few reports have described the resection of colorectal and renal cell carcinoma in a single laparoscopic procedure. We have shown that combining left radical nephrectomy and right hemicolectomy is technically feasible, safe and that overall operative time can be limited. In our case operative time was 210 minutes, blood loss 100 milliliters, and duration of hospital stay was 8 days. Adequate port placement, preoperative scheduling, and surgical experience are essential to achieve this goal. PMID:22084746

Veenstra, G. M.; Fossion, L. M. C. L.; de Laet, K.; Luijten, A. A. P. M.

2011-01-01

411

Balancing surgical innovation with cost and efficiency  

PubMed Central

Summary The standard approach to neoplasia of the pancreatic head is pancreaticoduodenectomy, otherwise known as the Whipple procedure. Traditionally, this operation is performed through an open laparotomy incision. In high-volume centres, and when performed by appropriately qualified surgeons, the Whipple procedure is safe and effective management for diseases of the pancreatic head. Still, this operation remains one of the most complex abdominal procedures. With the proliferation of minimally invasive surgery, more complex operations are being performed using laparoscopy and other minimal access techniques. A group from McGill University and the Montreal Jewish General Hospital have prospectively evaluated their experience with minimally invasive pancreaticoduodenectomy and have compared this experience to the open approach. This is the first comparative series of its kind from Canada. PMID:25078925

Jayaraman, Shiva

2014-01-01

412

Balancing surgical innovation with cost and efficiency.  

PubMed

The standard approach to neoplasia of the pancreatic head is pancreaticoduodenectomy, otherwise known as the Whipple procedure. Traditionally, this operation is performed through an open laparotomy incision. In high-volume centres, and when performed by appropriately qualified surgeons, the Whipple procedure is safe and effective management for diseases of the pancreatic head. Still, this operation remains one of the most complex abdominal procedures. With the proliferation of minimally invasive surgery, more complex operations are being performed using laparoscopy and other minimal access techniques. A group from McGill University and the Montreal Jewish General Hospital have prospectively evaluated their experience with minimally invasive pancreaticoduodenectomy and have compared this experience to the open approach. This is the first comparative series of its kind from Canada. PMID:25078925

Jayaraman, Shiva

2014-08-01

413

Trials and tribulations: the professional development of surgical trialists  

PubMed Central

BACKGROUND Regulatory and professional bodies issue an ever-increasing number of guidance documents on the ethics and methods of clinical trials, but the quality of clinical trials of invasive therapeutic procedures continues to be a concern. We interviewed aspiring and accomplished surgical trialists to understand how they use guidance documents and other resources in their work. METHODS We performed a qualitative research study involving semistructured interviews of a diverse sample of 15 surgical trialists. RESULTS Professional development as a surgical trialist was haphazard, inefficient, and marked by avoidable mistakes. Four types of resources played constructive roles: formal education; written materials on clinical trials; experience with actual trials; and interpersonal interactions with peers, experts, collaborators, and mentors. Recommendations for improvement centered on education, mentoring, networking, participating in trials, and facilitation by department chairs. CONCLUSIONS The haphazard and unstructured nature of the current system is adding unnecessarily to the numerous challenges faced by surgical trialists. PMID:22920404

Jarman, Anna F.; Wray, Nelda P.; Wenner, Danielle M.; Ashton, Carol M.

2013-01-01

414

Surgical treatment of intrahepatic portosystemic shunts in 45 dogs.  

PubMed

The surgical attenuation of an intrahepatic portosystemic shunt in 45 dogs is described. Twenty-nine (64 per cent) had left divisional shunts consistent with a patent ductus venosus (PDV), 15 (33 per cent) had central divisional shunts and one had a right divisional shunt. In the dogs with a PDV, the shunt vessel could be most easily manipulated at a posthepatic site, whereas in those with central and right divisional shunts the manipulation could be more easily made intrahepatically but sometimes involved demanding intravascular surgical techniques. Eight dogs (18 per cent) died during the surgery or shortly afterwards. Of the 37 dogs surviving longer term, 28 (76 per cent) became clinically normal and required no medication or diet control. In a further three animals the shunt was ligated completely only during a second surgical procedure. The remaining six dogs were euthanased because of clinical signs of encephalopathy which were either surgically or medically uncontrollable. PMID:9587198

White, R N; Burton, C A; McEvoy, F J

1998-04-01

415

Perioperative Glucose Control and Infection Risk in Older Surgical Patients.  

PubMed

The aging of the U.S. population is leading to an increasing number of surgical procedures performed on older adults. At the same time, the quality of medical care is being more closely scrutinized. Surgical site infection is a widely-assessed outcome. Evidence suggests that strict perioperative serum glucose control among patients with or without diabetes can lower the risk of these infections, but it is unclear whether this control should be applied to older surgical patients. In this clinical review, we discuss current research on perioperative serum glucose management for cardiothoracic, orthopedic, and general/colorectal surgery. In addition, we summarize clinical recommendations and quality-of-care process indicators provided by surgical, diabetes, and geriatric medical organizations. PMID:25431751

Lee, Pearl; Min, Lillian; Mody, Lona

2014-03-01

416

Analysis of exfoliated gastric carcinoma cells attached on surgical supplies  

PubMed Central

Surgery is considered to have a leading role in the treatment of gastric carcinoma. Surgical supplies are used to cut, divide, and ligate during surgery, and are not only in close contact with normal tissues, but may also be contaminated by pathological tissues and cells. This study sought to determine the presence of exfoliated tumor cells on surgical supplies at different stages during the surgical procedure. We collected five types of surgical supplies from 90 patients who underwent D2 radical gastrectomy to find out if there was any cancer cells attached to them. Highest numbers of cancer cells were found on gauze used to clean the surgical instruments and on the gloves of scrub nurses. The likelihood of finding cancer cells increased with advancing clinical stage of disease, lower differentiation of cancer cells, increasing frequency of use of supplies and extent of contact, and was also associated with the characteristic of surgical supplies. Dissemination of tumor cells could be prevented by using a number of methods, depending on the type of surgical supply items. PMID:25336978

Yu, Xiao-Fen; Ma, Ying-Yu; Hu, Xian-Qin; Zhang, Qin-Fang; Ye, Zai-Yuan

2014-01-01

417

Surgical Repair of Lower Extremity Vascular Injuries in Children: Two Cases  

PubMed Central

The use of percutaneous devices is commonplace for the treatment of many congenital heart defects. However, there are some situations where procedure-related complications are encountered and surgical help is required to ameliorate this issue. Vascular injury due to transcatheter intervention is a significant and challenging complication and occasionally requires surgical approach. In this case report, we aimed to present successful surgical management of vascular injuries associated with percutaneous interventions in children. PMID:25221685

Tasar, Mehmet; Yaman, Nur Dikmen; Saricaoglu, Cahit; Eyileten, Zeynep; Kaya, Bulent; Uysalel, Adnan

2014-01-01

418

Transsternal surgical biopsy of a mediastinal mass under local anesthesia.  

PubMed

We describe a minimally invasive transsternal surgical approach to obtain biopsies from retrosternal masses under local anesthesia. This original procedure was carried out in a patient with superior vena cava syndrome because she was unfit to undergo a CT-guided biopsy and at high risk for narcosis. In patients with such features this procedure could be preferable to conventional techniques. The transsternal approach is reliable, produces minimal trauma and no risk of pleural or vessel injury, and is very fast. PMID:23748825

Bedini, Amedeo Vittorio; Libretti, Lidia; Pirondini, Emanuele

2013-01-01

419

Using improvement science methods to increase accuracy of surgical consents.  

PubMed

The surgical consent serves as a key link in preventing breakdowns in communication that could lead to wrong-patient, wrong-site, or wrong-procedure events. We conducted a quality improvement initiative at a large, urban pediatric academic medical center to reliably increase the percentage of informed consents for surgical and medical procedures with accurate safety data information at the first point of perioperative contact. Improvement activities focused on awareness, education, standardization, real-time feedback and failure identification, and transparency. A total of 54,082 consent forms from 13 surgical divisions were reviewed between May 18, 2011, and November 30, 2012. Between May 2011 and June 2012, the percentage of consents without safety errors increased from a median of 95.4% to 99.7%. Since July 2012, the median has decreased slightly but has remained stable at 99.4%. Our results suggest that effective safety checks allow discovery and prevention of errors. PMID:24973184

Mercurio, Patti; Shaffer Ellis, Andrea; Schoettker, Pamela J; Stone, Raymond; Lenk, Mary Anne; Ryckman, Frederick C

2014-07-01

420

Surgical removal of a seminoma from a black sea bass.  

PubMed

An adult black sea bass was examined because of abdominal distention and decreased appetite. A large abdominal swelling was evident and was firm on palpation. Differential diagnoses included neoplasia, abscess or granuloma, hematoma, or swim bladder abnormality. Diagnostic tests included survey radiography, positive-contrast radiography, and computed tomography. The sea bass was anesthetized with tricaine methanesulfonate. A ventral midline abdominal incision was made, and adhesions to the mass were gently dissected. The fish recovered without complications. Radiography was repeated 8 weeks after surgery, and there was no evidence of mass regrowth. To the authors' knowledge, this is the first report of a barium enema being performed in a fish. Although surgical procedures are performed more commonly on fish for research, a few reports of clinical surgical cases have been described. Our experience supports the conclusions of other reports that certain surgical procedures can be performed safely in fish. PMID:12118596

Weisse, Chick; Weber, E Scott; Matzkin, Zach; Klide, Alan

2002-07-15

421

Higher risk of incomplete mesorectal excision and positive circumferential margin in low rectal cancer regardless of surgical technique  

PubMed Central

Introduction Currently, the predominant question is whether a laparoscopic approach is comparatively radical in comparison with an open access approach, especially in the circumferential resection margin and quality of the completeness of total mesorectal excision. These factors are important in determining the quality of surgical care as well as long-term results of the treatment. Aim This article focuses on the evaluation of circumferential resection margins and on the quality of mesorectal excision of middle and lower rectum tumors. In addition, laparoscopic and open techniques are compared. Material and methods Data were collected prospectively and stored in a rectal cancer registry over a 3-year period. The parameters studied were age, sex, body mass index, localization and topography of the tumor, clinical stage, neoadjuvant chemotherapy and its response, the type of surgery, character of the circumferential and distal margins, quality of the mesorectal excision, pT and pN. Results One hundred and twenty-five patients were chosen for our study. Laparoscopy was performed in 53 operations and a conventional approach was performed in 72 operations. Complete mesorectal excision was achieved in 54.7% of laparoscopic operations versus 44.4% in the conventional technique; partially complete excision was performed in 20.8 and 12.5%, respectively. Incomplete excisions were described in 24.5 and 43.1% (p = 0.085). Positive circumferential margin occurred during laparoscopic surgery in 11 (20.8%) patients, and in the case of conventional resection in 27 (37.5%) patients (p = 0.044). Conclusions Our study showed comparable results between laparoscopic and open access procedures during rectal resection. The results achieved, in particular in the quality of the mesorectal excision and negative circumferential resection margin, show that the laparoscopic approach is comparable to conventional surgical techniques, with an adequate surgical outcome, in the treatment of rectal cancer.

Ferko, Alexander; Orhalmi, Julius; Chobola, Milan; Hovorkova, Eva; Nikolov, Dimitar Hadzi

2014-01-01

422

Surgical technique to correct complex ureterointestinal stricture with defunctionalized limb of Turnbull stoma  

Microsoft Academic Search

We describe a novel technique to repair a long ischemic ureterointestinal stricture using the defunctionalized limb of a Turnbull stoma in a patient who had previously undergone two attempts at open surgical revision.

Curtis Crane; William Bihrle

2005-01-01

423

Surgical Scar Revision: An Overview  

PubMed Central

Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods. PMID:24761092

Garg, Shilpa; Dahiya, Naveen; Gupta, Somesh

2014-01-01

424

Early Rehabilitation Following Surgical Fixation of a Femoral  

E-print Network

in young people and are the result of high-energy mechanisms, such as motor vehicle accidents, falls from. Fracture healing from this procedure is effective, with union rates of between 95% and 99%.11 ImpairmentsEarly Rehabilitation Following Surgical Fixation of a Femoral Shaft Fracture Background and Purpose

Weber, David J.

425

Raven II Research Surgical Robot Prof. Blake Hannaford  

E-print Network

-assisted surgery by creating a research surgical robot which builds collaboration. Researchers can program in the burgeoning field of robotic assisted surgery. The Raven systems do NOT have safety ratings sufficient for human surgery and must not be used for any human procedures. 2 Background Robotic Assisted Surgery began

426

Trauma Pod: a semi-automated telerobotic surgical system  

Microsoft Academic Search

Background The Trauma Pod (TP) vision is to develop a rapidly deployable robotic system to perform critical acute stabilization and\\/or surgical procedures, autonomously or in a teleoperative mode, on wounded soldiers in the battlefield who might otherwise die before treatment in a combat hospital could be provided.

Pablo Garcia; Jacob Rosen; Chetan Kapoor; Mark Noakes; Greg Elbert; Michael Treat; Tim Ganous; Matt Hanson; Joe Manak; Chris Hasser; David Rohler; Richard Satava

2009-01-01

427

Surgical Management of Submucosal Esophageal Cancer Extended or Regional Lymphadenectomy?  

Microsoft Academic Search

Introduction: Radical esophagectomy is considered the standard therapy for tumors that infiltrate the submucosa of the esophagus (T1b), as the prevalence of lymph node metastases has been reported in up to 40% of these patients. It remains unclear whether radical esophagectomy with extended lymphadenectomy is needed or whether a surgical procedure with only regional lymphadenectomy suffices. The aim of this

B. A. Grotenhuis; Heijl van M; J. Zehetner; J. Moons; B. P. L. Wijnhoven; Berge Henegouwen van M. I; H. W. Tilanus; T. R. DeMeester; T. Lerut; Lanschot van J. J. B

2010-01-01

428

Influences of Item Content and Format on the Dimensionality of Tests Combining Multiple-Choice and Open-Response Items: An Application of the Poly-DIMTEST Procedure.  

ERIC Educational Resources Information Center

The DIMTEST statistical procedure was used in a confirmatory manner to explore the dimensionality structures of three kinds of achievement tests: multiple-choice tests, constructed-response tests, and tests combining both formats. The DIMTEST procedure is based on estimating conditional covariances of the responses to the item pairs. The analysis…

Perkhounkova, Yelena; Dunbar, Stephen B.

429

The Effect of Traffic Patterns in the OR on Surgical Site Infections  

Microsoft Academic Search

Perioperative nurses are situated uniquely to promote good traffic control practices in the OR. This study was conducted to explore the effect of traffic patterns, specifically the number of people in the OR, on the incidence of surgical site infections (SSIs). Researchers analyzed 2,864 clean surgical procedures performed in 1995 in an academic medical center. Duration of surgery and American

Flavia Pryor; Patricia R. Messmer

1998-01-01

430

The effect of pre?wetting on liquid penetration performance of surgical gown fabrics  

Microsoft Academic Search

This paper presents the results of a study to explore the effects of pre?wetting of the inner and outer surface of surgical gown materials on their resistance to subsequent penetration. Two gown fabrics currently in common use, one disposable and one reusable, were tested for liquid penetration following standard procedures specified for categorizing surgical gown protection levels. Synthetic blood, simulated

Wei Cao; Rinn M. Cloud

2011-01-01

431

Surgical training in primary care: consensus recommendations by the Association of Surgeons in Training.  

PubMed

Health service reconfigurations may result in increasing numbers of minor surgical procedures migrating from secondary care in hospitals to primary care in the community. Procedures may be performed by General Practitioners with a specialist interest in Surgery, or secondary care Surgeons who are sub-contracted to perform procedures in the community. Surgical training in such procedures, which are currently hospital based, may therefore be adversely affected unless surgical training also takes advantage of these opportunities. There is potential for surgical trainees to benefit from training in the community setting. ASiT supports the development of formal surgical training in the community setting for junior surgical trainees, providing high standards of patient care and training provision are ensured. Anticipated problems relating to the migration of surgical services to the community relate to the availability and quality assurance of training opportunities in primary care, its funding, including exposure to issues of indemnity cover for trainees, and also the release of surgical trainees from hospital duties in order to attend these training opportunities. These consensus recommendations set out a framework through which both patient care and training remain at the forefront of these continued service reconfigurations. PMID:25200963

Gokani, V J; Ferguson, H J M; Fitzgerald, J E F; Beamish, A J

2014-11-01

432

An innovative method to evaluate the suture compliance in sealing the surgical wound lips  

Microsoft Academic Search

Background and aim: The increasing number of surgical procedures performed with local anesthesia, followed by immediate patient discharge fro