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Sample records for billroth ii surgery

  1. Development of type 2 diabetes mellitus thirty-one years after Billroth II in a patient asking for diabetes surgery

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    M. Garciacaballero

    2014-07-01

    Full Text Available Introduction: Diabetes surgery in obese and slim patients seems to be a superior alternative to the current medical treatment. Gastric bypass is an alternative treatment for diabetes. Nevertheless, there are still doubts whether diabetes can recur if you gain weight or if the effects are maintained over time. Other questions refer to the type of surgery to make the bypass limb length or reservoir size for the resolution of the Diabetes Mellitus. Presentation of case: Male patient 69-year-old came to us in order to perform tailored One Anastomosis Gastric Bypass (BAGUA to treat his type 2 diabetes mellitus and metabolic syndrome. He has a history of peptic ulcer treated with subtotal gastrectomy and Billroth II reconstruction 49 years ago. He currently is not obese and developed diabetes 31 years after surgery. Discussion: Globally there are no reports of patients with normal BMI that after performing gastric bypass developed diabetes mellitus. There are cases where obese diabetic patients after gastric bypass improve or remits the T2DM, but it relapses due to insufficient weight loss or gain it. The patient with gastric bypass Billroth II type, should not developed diabetes. He is normal weight and not had weight gain that could be linked to the development of diabetes. Conclusions: The results generated by bariatric surgery are encouraging, but still do not clarify the precise way how surgery produces rapid improvement of systemic metabolism as in diabetes, but in our patient, the effect was quite different because the gastric bypass had no protective effect against diabetes.

  2. Development of type 2 diabetes mellitus thirty-one years after Billroth II in a patient asking for diabetes surgery.

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    Garciacaballero, M; Reyes-Ortiz, A; Toval, J A; Martínez-Moreno, J M; Miralles, F

    2014-07-01

    INTRODUCCIÓN: La cirugía de la diabetes en pacientes obesos y delgados parece ser una alternativa superior al tratamiento médico actual. El bypass gástrico es un tratamiento alternativo al tratamiento médico actual. Sin embargo, todavía hay dudas sobre si la diabetes puede reaparecer si hay aumento de peso o si se mantienen los efectos en el tiempo. Otras preguntas se refieren al tipo de cirugía para hacer la longitud del remanente gástrico o el tamaño del reservorio para la resolución de la Diabetes Mellitus. Presentación del caso: Paciente masculino de 69 años de edad, vino a nosotros con el fin de realizar el bypass gástrico de una anastomosis a medida (BAGUA) para tratar su diabetes mellitus tipo 2 y el síndrome metabólico. Tiene antecedentes de úlcera péptica tratado con gastrectomía subtotal y reconstrucción tipo Billroth II hace 49 años. Actualmente él no es obeso y desarrolló diabetes 31 años después de la cirugía. DISCUSIÓN: A nivel mundial no hay reportes de pacientes con IMC normal que después de realizar un bypass gástrico desarrollaron diabetes mellitus. Hay casos en que los pacientes diabéticos obesos después del bypass gástrico mejoran o remite la DMT2, pero reaparece debido a la pérdida de peso insuficiente o reganancia de él. El paciente con un bypass gástrico tipo Billroth II, no debió desarrollar diabetes. Él tiene peso normal y no ha aumentado de peso que podría estar relacionado con el desarrollo de diabetes. CONCLUSIÓN: Los resultados generados por la cirugía bariátrica son alentadores, pero aún no aclaran la forma precisa cómo la cirugía produce una rápida mejoría del metabolismo sistémico como la diabetes, pero en nuestro paciente, el efecto fue muy diferente debido a que el bypass gástrico no tuvo un efecto protector contra la diabetes.

  3. [Medicine, music, friendship and prejudices: Billroth I and Billroth II, the string quartets Opus 51, N° 1 and N° 2 by Johannes Brahms].

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    Cabello, Felipe C

    2012-06-01

    The great German surgeon Theodor Billroth and the imaginative and creative composer Johannes Brahms had a very close friendship centered on musical activities, that lasted for more than thirty years while they lived and worked in Zurich and Vienna, during the second half of the Nineteenth Century. Billroth, besides his all-consuming medical activities, had time to be a musical enthusiast who directed orchestras, played the violin in chamber music groups, and wrote musical criticism for newspapers. The common affection between these two creative giants is documented by their abundant and effusive correspondence, by the constant requests by Brahms of Billroth's opinions regarding his compositions, and by the positive and stimulating answers that Billroth gave to these requests. Billroth opened his house for musical evenings to play Brahms chamber compositions for the first time, and Brahms dedicated his two Opus 51 string quartets Nos. 1 and 2, known in the musical milieu as Billroth I and II, to his physician friend. Unfortunately, the close bonds between these two geniuses weakened towards the end of their lives as a result of Billroth's becoming intolerant to the lack of social refinements and gruff behavior of the composer. This baffling intolerance of Billroth to his friend Brahms can be better understood after reading Billroth's writings in his book The Medical Sciences in the German Universities. A Study in the History of Civilization. There Billroth expresses strong prejudices against potential medical students of humble social origins, such as those of Brahms, coupled to a primitive anti-Semitism.

  4. [Medicine, music, friendship and prejudices: Billroth I and Billroth II, the string quartets Opus 51, N° 1 and N° 2 by Johannes Brahms].

    Science.gov (United States)

    Cabello, Felipe C

    2012-06-01

    The great German surgeon Theodor Billroth and the imaginative and creative composer Johannes Brahms had a very close friendship centered on musical activities, that lasted for more than thirty years while they lived and worked in Zurich and Vienna, during the second half of the Nineteenth Century. Billroth, besides his all-consuming medical activities, had time to be a musical enthusiast who directed orchestras, played the violin in chamber music groups, and wrote musical criticism for newspapers. The common affection between these two creative giants is documented by their abundant and effusive correspondence, by the constant requests by Brahms of Billroth's opinions regarding his compositions, and by the positive and stimulating answers that Billroth gave to these requests. Billroth opened his house for musical evenings to play Brahms chamber compositions for the first time, and Brahms dedicated his two Opus 51 string quartets Nos. 1 and 2, known in the musical milieu as Billroth I and II, to his physician friend. Unfortunately, the close bonds between these two geniuses weakened towards the end of their lives as a result of Billroth's becoming intolerant to the lack of social refinements and gruff behavior of the composer. This baffling intolerance of Billroth to his friend Brahms can be better understood after reading Billroth's writings in his book The Medical Sciences in the German Universities. A Study in the History of Civilization. There Billroth expresses strong prejudices against potential medical students of humble social origins, such as those of Brahms, coupled to a primitive anti-Semitism. PMID:23282623

  5. Endoscopic Retrograde Cholangiopancreatography Using a Dual-Lumen Endogastroscope for Patients with Billroth II Gastrectomy

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    Wei Yao

    2013-01-01

    Full Text Available Objective. To evaluate the safety and efficacy of a dual-lumen forward-viewing endoscope for ERCP in patients with prior Billroth II gastrectomy. Methods. The records of 46 patients treated with ERCP by a dual-lumen forward-viewing endoscope after Billroth II gastrectomy from 2007 to 2012 were reviewed. Results. The success rate of selective cannulation was 82.6% (38/46. Of the 38 cases with successful selective cannulation, endoscopic sphincterotomy was achieved in 23 cases by placing the needle knife through the 2nd lumen, while endoscopic papillary balloon dilatation was conducted in the other 15 cases. Of the 8 failed cases of selective cannulation, 6 had failed afferent loop intubation, and 3 of these 6 patients had Braun’s anastomosis. The safety and efficacy of catheter-assisted endoscopic sphincterotomy were increased by placing the needle knife through the 2nd lumen without altering the conventional endoscopic sphincterotomy procedure. Conclusions. A dual-lumen forward-viewing endoscope can be safely and effectively used to perform ERCP in patients with a Billroth II gastrectomy, except for patients with additional Braun’s anastomosis.

  6. [Billroth and Brahms: personal encounter of medicine and music].

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    Hadaschik, B A; Hadaschik, E N; Hohenfellner, M

    2012-02-01

    Theodor Billroth and Johannes Brahms shared a decades long personal friendship. The music-loving Billroth influenced the work of the famous composer and in turn Brahms also left traces within Billroth's lifetime achievements. To shed light on the close relationship of medicine and music, this manuscript describes both Billroth's life and surgical career as they were influenced and stimulated by his close friendship to Brahms.Theodor Billroth and Johannes Brahms first met in 1865 in Zurich, Switzerland. After Billroth accepted the chair of surgery at the University of Vienna in 1867, Brahms moved to Vienna in 1869. During the following years, Billroth analyzed most of Brahms' compositions prior to publication. Similar to his effective way of teaching medical students and assistants, Billroth stimulated Brahms to publish many of his later compositions. Brahms on the other hand supported Billroth in writing his essay"Who is musical?". Furthermore, music helped Billroth to cope with the demanding working life of a surgeon.Music and surgery share both structural and emotional analogies. While both professions require meticulous techniques, personal interaction is a prerequisite for success. "Science and art scoop from the same well."

  7. Single port Billroth I gastrectomy

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    Jeremy R Huddy

    2013-01-01

    Full Text Available Introduction: Experience has allowed increasingly complex procedures to be undertaken by single port surgery. We describe a technique for single port Billroth I gastrectomy with a hand-sewn intracorporeal anastomosis in the resection of a benign tumour diagnosed incidentally on a background of cholelithiasis. Materials and Methods: Single port Billroth I gastrectomy and cholecystectomy was performed using a transumbilical quadport. Flexible tipped camera and straight conventional instruments were used throughout the procedure. The stomach was mobilised including a limited lymph node dissection and resection margins in the proximal antrum and duodenum were divided with a flexible tipped laparoscopic stapler. The lesser curve was reconstructed and an intracorporal hand sewn two layer end-to-end anastomosis was performed using unidirectional barbed sutures. Intraoperative endoscopy confirmed the anastomosis to be patent without leak. Results: Enteral feed was started on the day of surgery, increasing to a full diet by day 6. Analgesic requirements were a patient-controlled analgesia morphine pump for 4 postoperative days and paracetamol for 6 days. There were no postoperative complications and the patient was discharged on the eighth day. Histology confirmed gastric submucosal lipoma. Discussion: As technology improves more complex procedures are possible by single port laparoscopic surgery. In this case, flexible tipped cameras and unidirectional barbed sutures have facilitated an intracorporal hand-sewn two layer end-to-end anastomosis. Experience will allow such techniques to become mainstream.

  8. [Theodor Billroth and Johannes Brahms--friendship between two giants].

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    Teplý, I

    1989-09-01

    The study portrays the exceptional personality of Theodor Billroth and his friendship with Johannes Brahms. Billroth who laid the foundation of modern abdominal surgery by performing his pioneer operations was also an excellent musician and connoisseur of the arts. His enthusiasm for the music of Brahms and Brahms' respect for Billroth, his knowledge and musical instinct, were the basis of a mutual intensive relationship. The paper describes the productive period of a 30-year friendship of the two great men, presenting basic bibliographic data and an outline of their work.

  9. [Theodor Billroth: more than a century of artistic greatness].

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    López-Valdés, Julio César

    2014-01-01

    Christian Albert Theodor Billroth, a German surgeon of great artistry and immense culture and promoter of abdominal surgery, who drove the length of the physiology of the surgical field through the use of experimental surgery, is considered the leading German medical figure of the second half of the 19th century in Europe. His works and techniques transcended through time and continue to be implemented (albeit with modifications). He founded a new school of surgery based in criticism, the influence of which affected the development of numerous European and American surgeons. He was also a born artist who excelled in the music field, with many interests in music criticism and public events. PMID:24604002

  10. The feasibility and advantages of billroth-I reconstruction in distal gastric cancers following resection

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    M S Ganesh

    2012-01-01

    Full Text Available Background: Gastric carcinomas are common malignancies in southern India and distal stomach remains the commonest site in low socio economic groups. Surgery still remains an important modality of treatment to achieve local control and also relieve obstructive symptoms. In this study we investigated the feasibility of performing a gastrectomy and billroth-1 type of anastomosis in a rural cancer center setting, with parameters like adequacy of margins, ease of anastomosis and its functional results were analysed Materials and Methods: Eight patients presenting to a rurally based cancer center underwent a distal gastrectomy and billroth-1 type of anastomosis for continuity restoration Results: All the patients had adequate proximal and distal marg. The surgical time varied between-hrs. The anastomosis was constructed without any tension on bowel ends in all patients. The average time to start oral feeds varied between- None of the patients showed symptoms of bile reflux nor dumping. The average hospital stay varied between- Conclusions: Billroth-1 anastomosis is a physiologically more natural way of restoring continuity following a gastrectomy and it is a procedure which would be technically more simpler and decrease per and post operative complications and allow speedier post operative recovery following surgery on distal gastric cancers.

  11. OSAS Surgery and Postoperative Discomfort: Phase I Surgery versus Phase II Surgery

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    Giulio Gasparini

    2015-01-01

    Full Text Available Introduction. This study aims to investigate the reasons that discourage the patients affected by OSAS to undergo orthognathic surgery and compares the postoperative discomfort of phase I (soft tissue surgery and phase II (orthognathic surgery procedures for treatment of OSAS. Material and Methods. A pool of 46 patients affected by OSAS was divided into two groups: “surgery patients” who accepted surgical treatments of their condition and “no surgery patients” who refused surgical procedures. The “surgery patients” group was further subdivided into two arms: patients who accepted phase I procedures (IP and those who accepted phase II (IIP. To better understand the motivations behind the refusal of II phase procedures, we asked the patients belonging to both the IP group and “no surgery” group to indicate the main reason that influenced their decision to avoid II phase procedures. We also monitored and compared five parameters of postoperative discomfort: pain, painkiller assumption, length of hospitalization, foreign body sensation, and diet assumption following IP and IIP procedures. Results. The main reason to avoid IIP procedures was the concern of a more severe postoperative discomfort. Comparison of the postoperative discomfort following IP versus IIP procedures showed that the former scored worse in 4 out of 5 parameters analyzed. Conclusion. IIP procedures produce less postoperative discomfort. IIP procedures, namely, orthognathic surgery, should be the first choice intervention in patients affected by OSAS and dentoskeletal malformation.

  12. Megaesophagus was complicated with billroth I gastroduodenostomy in a cat

    International Nuclear Information System (INIS)

    A seven-year-old, female, domestic short hair cat was presented with a history of chronic anorexia. Radiographic examination revealed a large space-occupying calcified mass in the abdominal cavity. The mass was located in pylorus and did not extend into the duodenum and surrounding tissues. Billroth I gastroduodenostomy was conducted to remove the mass. Histopathological examination of the mass showed a lymphoma. Although Recovery following the operation was excellent, the patient showed intermittent vomiting unrelated to feeding. Radiographical examination revealed a megaesophagus, which was assumed to be a complication of the Billroth I procedure, since the condition was not observed before the procedure

  13. Exeretic surgery in complicated peptic ulcer: An inopportune procedure?

    International Nuclear Information System (INIS)

    INTRODUCTION: The aim of present study was to analyze the surgical treatment results in the complicated duodenal or gastric chronic peptic ulcer over 15 years. METHODS: A retrospective and descriptive study was conducted in patients presenting with complicated peptic ulcer by exeresis. Patients (n=45) were seen by some of us in the ''Amalia Simoni'' Clinical Surgical of Camaguey province from January, 1989 to December, 2004. RESULTS: Disease was more frequent in male sex (82,22%) and in ages from 36 to 50 years (46,67%). The 95,56% of patients treated suffered from duodenal ulcer and the main criterion for surgery was its unmanageable condition (62,22%). Endoscopy was very useful for diagnosis of this entity. All operated on underwent vagotomy with antrectomy; in the 68,89% we performed a Billroth's II anastomosis and in remainder (31,11% it was of Billroth I type. There was a similar figure of early complications related to techniques used and among them prevails the anastomosis bleeding and delay evacuation. There were more late complications in type Billroth II anastomosis than in the Billroth I. Surgical results were excellent and very good in the 89% of cases. The enterocolitis variant has the great percentage of non-satisfactory results (9,09%). Only two patients had poor results, although there wasn't operative mortality. CONCLUSIONS: This kind of surgery is indicated only in cases of complicated peptic ulcer. It is not the choice method in ulcer patients, but in its use it is necessary to know about different techniques and its use. Thus, we must to know a lot about this procedure. (author)

  14. Laparoscopic versus open surgery for rectal cancer (COLOR II)

    DEFF Research Database (Denmark)

    van der Pas, Martijn Hgm; Haglind, Eva; Cuesta, Miguel A;

    2013-01-01

    Laparoscopic surgery as an alternative to open surgery in patients with rectal cancer has not yet been shown to be oncologically safe. The aim in the COlorectal cancer Laparoscopic or Open Resection (COLOR II) trial was to compare laparoscopic and open surgery in patients with rectal cancer....

  15. Laparoscopy-Assisted Billroth I Gastrectomy for Ectopic Pancreas in the Prepyloric Region

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    Yueh-Tsung Lee

    2012-11-01

    Full Text Available Ectopic pancreatic tissue is an uncommon developmental anomaly. The condition mostly occurs in the gastrointestinal tract and is usually asymptomatic. It rarely causes symptoms of inflammation, bleeding and perforation, and has potential for malignant change. Though it is an uncommon condition, cases of ectopic pancreas have been reported worldwide. Preoperative diagnosis of ectopic pancreas is challenging because of its nonspecific symptoms and signs. Owing to the revolution of minimally invasive surgery, submucosal tumors of the stomach can be resected by laparoscopic techniques. We have earlier reported on a case of ectopic pancreas in the stomach treated by robotics-assisted laparoscopic wedge resection. Herein, we report a case of ectopic pancreas in the prepyloric region of the stomach. A 44-year-old female presented with a two-week history of epigastralgia with radiation to the back. She received endoscopy check-up which disclosed a mass in the stomach. By endoscopic findings, a submucosal lesion in the prepyloric region with umbilical folding on the mucosa was identified. The umbilical folding on the mucosa hint the orifice of the duct of ectopic pancreas into the gastric mucosa suggestive of ectopic pancreas. Contrast-enhanced abdominal computed tomography showed a 5 cm cystic mass with heterogeneous content. To sum it up, the patient was diagnosed as ectopic pancreas in the stomach. She underwent laparoscopy-assisted antrectomy with Billroth I anastomosis (excision of the antrum and prepyloric region with reconstruction of gastrointestinal continuity by gastroduodenostomy and had an uneventful hospitalization course. The histopathology of the resected tumor demonstrated ectopic pancreatic tissue in the gastric wall. To the best of our knowledge, excision of gastric ectopic pancreas using laparoscopy-assisted antrectomy with Billroth I anastomosis has never been reported in the literature.

  16. HISTORY OF THE ENDOCRINE SURGERY (II)

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    E. Tarcoveanu; A. Vasilescu; Oana Epure

    2005-01-01

    The history of the endocrine surgery is recent, with the discovery of glands and hormones at the beginning of the twentieth century. Most of the major endocrine glands were described anatomically around 1900. The hormones were identified during the first decades of the twentieth century. In 1922 a Romanian doctor, Paulescu, discovered a hypoglycemiant hormone, the insulin. Other hormones like aldosterone and cortisol were discovered after a few years. The diffuse gastrointestinal glandular sy...

  17. Confirmatory Factor Analysis of the Beck Depression Inventory-II in Bariatric Surgery Candidates

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    Hall, Brian J.; Hood, Megan M.; Nackers, Lisa M.; Azarbad, Leila; Ivan, Iulia; Corsica, Joyce

    2013-01-01

    Screening for depression is an integral part of psychological evaluations conducted prior to bariatric surgery. The Beck Depression Inventory-II (BDI-II) is the most commonly used measure of depression in these treatment evaluations. The reliability and validity of the BDI-II has not yet been evaluated within bariatric surgery-seeking samples,…

  18. Gastroenterostoma after Billroth antrectomy as a premalignant condition

    NARCIS (Netherlands)

    Sitarz, Robert; Maciejewski, Ryszard; Polkowski, Wojciech P.; Offerhaus, G. Johan A.

    2012-01-01

    Gastric stump carcinoma (GSC) following remote gastric surgery is widely recognized as a separate entity within the group of various types of gastric cancer. Gastrectomy is a well established risk factor for the development of GSC at a long time after the initial surgery. Both exo- as well as endoge

  19. Perioperatory antibiotic prophylaxis in Pediatric Surgery (Part II: non-abdominal surgery.

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    Sergio Luis González López

    2005-12-01

    Full Text Available The surgical wound infection is the biggest cause of infectious morbility in surgical patients. It is an important cause of morbility that causes lincreased hospital demurrages, increased cost of medical attention and serious inconveniences to the patients and their familiies. 25% of all nosocomial infections are surgical wound infection. One of the big advances of the surgery in the last three decades is an introduction of antibiotic prophylaxis in the surgical practice. Is considered that it has saved more lives than any other novel procedure in surgery in the last 20 years. We presented the Good Clinical Practices Guideline for Antibiotic prophylaxis in no-abdominal surgery, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.

  20. Theodor Billroth's vision and Karl Ziegler's action: commemoration of the 40th day of death and the 50th anniversary of conferment of Nobel Prize for Chemistry of Karl Ziegler.

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    Kapischke, Matthias; Pries, Alexandra

    2014-02-01

    Alloplastic materials are broadly used in modern surgery. Until the middle of the 20th century, metal materials and especially silver were used because of their antimicrobial properties. With the development of a new catalytic process for the production of high-density polyethylene and polypropylene materials, a new era of prosthesis was introduced. These polymers are integral part of our everyday operations surgery, especially in hernia repair. The famous surgeon Billroth mentioned to his pupil Czerny in 1878: "If we could artificially produce tissues of the density and toughness of fascia and tendon, the secret of the radical cure of hernia would be discovered". The polypropylene developed by Karl Ziegler gave the surgeon a material for daily practice, which in its properties (nearly) achieved Billroth's initial vision. In 1963 the Nobel Prize for Chemistry was awarded to Karl Ziegler and Giulio Natta in Stockholm. Furthermore, August 11, 2013 will be the 40th anniversary of Karl Ziegler's death. This manuscript honors both days.

  1. Vascular Surgery in World War II: The Shift to Repairing Arteries.

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    Barr, Justin; Cherry, Kenneth J; Rich, Norman M

    2016-03-01

    Vascular surgery in World War II has long been defined by DeBakey and Simeone's classic 1946 article describing arterial repair as exceedingly rare. They argued ligation was and should be the standard surgical response to arterial trauma in war. We returned to and analyzed the original records of World War II military medical units housed in the National Archives and other repositories in addition to consulting published accounts to determine the American practice of vascular surgery in World War II. This research demonstrates a clear shift from ligation to arterial repair occurring among American military surgeons in the last 6 months of the war in the European Theater of Operations. These conclusions not only highlight the role of war as a catalyst for surgical change but also point to the dangers of inaccurate history in stymieing such advances. PMID:25719811

  2. Vascular Surgery in World War II: The Shift to Repairing Arteries.

    Science.gov (United States)

    Barr, Justin; Cherry, Kenneth J; Rich, Norman M

    2016-03-01

    Vascular surgery in World War II has long been defined by DeBakey and Simeone's classic 1946 article describing arterial repair as exceedingly rare. They argued ligation was and should be the standard surgical response to arterial trauma in war. We returned to and analyzed the original records of World War II military medical units housed in the National Archives and other repositories in addition to consulting published accounts to determine the American practice of vascular surgery in World War II. This research demonstrates a clear shift from ligation to arterial repair occurring among American military surgeons in the last 6 months of the war in the European Theater of Operations. These conclusions not only highlight the role of war as a catalyst for surgical change but also point to the dangers of inaccurate history in stymieing such advances.

  3. BEST-PRACTICE GUIDELINES FOR FIELD-BASED SURGERY AND ANESTHESIA ON FREE-RANGING WILDLIFE. II. SURGERY.

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    Fiorello, Christine V; Harms, Craig A; Chinnadurai, Sathya K; Strahl-Heldreth, Danielle

    2016-04-01

    The principles of surgical asepsis apply to field surgeries with few exceptions. The minimum level for performance of surgeries in the field on free-ranging animals should be the same as for domestic animals undergoing surgery in animal hospitals. Surgeries in the field are typically done as part of research and management projects and usually involve a combination of biologists and veterinarians with the possibility of conflicts in scientific cultures. This article outlines a minimum standard of care for field surgeries and will serve as a resource for Institutional Animal Care and Use Committees and biologists and veterinarians planning projects that involve surgeries on free-ranging wildlife in field conditions.

  4. Survival analysis of children with stage II testicular malignant germ cell tumors treated with surgery or surgery combined with adjuvant chemotherapy

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    Su-Ying Lu; Xiao-Fei Sun; Zi-Jun Zhen; Zi-Ke Qin; Zhuo-Wei Liu; Jia Zhu; Juan Wang; Fei-Fei Sun

    2015-01-01

    For children with stage II testicular malignant germ cell tumors (MGCT), the survival is good with surgery and adjuvant chemotherapy. However, there is limited data on surgical results for cases in which there was no imaging or pathologic evidence of residual tumor, but in which serum tumor markers either increased or failed to normalize after an appropriate period of half-life time post-surgery. To determine the use of chemotherapy for children with stage II germ cel tumors, we analyzed the outcomes (relapse rate and overall survival) of patients who were treated at the Sun Yat-sen University Cancer Center between January 1990 and May 2013. Twenty-four pediatric patients with a median age of 20 months (range, 4 months to 17 years) were enrol ed in this study. In 20 cases (83.3%), the tumors had yolk sac histology. For definitive treatment, 21 patients underwent surgery alone, and 3 patients received surgery and adjuvant chemotherapy. No relapse was observed in the 3 patients who received adjuvant chemotherapy, whereas relapse occurred in 16 of the 21 patients (76.2%) treated with surgery alone. There were a total of 2 deaths. Treatment was stopped for 1 patient, who died 3 months later due to the tumor. The other patient achieved complete response after salvage treatment, but developed lung and pelvic metastases 7 months later and died of the tumor after stopping treatment. For children treated with surgery alone and surgery combined with adjuvant chemotherapy, the 3-year event-free survival rates were 23.8% and 100%, respectively (P=0.042), and the 3-year overal survival rates were 90.5%and 100%, respectively (P=0.588). These results suggest that adjuvant chemotherapy can help to reduce the recurrence rate and increase the survival rate for patients with stage II germ cel tumors.

  5. The effect of laparoscopic surgery in stage II and III right-sided colon cancer: a retrospective study

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    Kye Bong-Hyeon

    2012-05-01

    Full Text Available Abstract Background This retrospective study compared the clinicopathological results among three groups divided by time sequence to evaluate the impact of introducing laparoscopic surgery on long-term oncological outcomes for right-sided colon cancer. Methods From April 1986 to December 2006, 200 patients who underwent elective surgery with stage II and III right-sided colon cancer were analyzed. The period for group I referred back to the time when laparoscopic approach had not yet been introduced. The period for group II was designated as the time when first laparoscopic approach for right colectomy was carried out until we overcame its learning curve. The period for group III was the period after overcoming this learning curve. Results When groups I and II, and groups II and III were compared, overall survival (OS did not differ significantly whereas disease-free survival (DFS in groups I and III were statistically higher than in group II (P = 0.042 and P = 0.050. In group III, laparoscopic surgery had a tendency to provide better long-term OS ( P = 0.2036 and DFS ( P = 0.2356 than open surgery. Also, the incidence of local recurrence in group III (2.6% was significantly lower than that in groups II (7.4% and I (12.1% ( P = 0.013. Conclusions Institutions should standardize their techniques and then provide fellowship training for newcomers of laparoscopic colon cancer surgery. This technique once mastered will become the gold standard approach to colon surgery as it is both safe and feasible considering the oncological and technical aspects.

  6. Surgery-induced hippocampal angiotensin II elevation causes blood-brain barrier disruption via MMP/TIMP in aged rats

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    Zhengqian eLi

    2016-04-01

    Full Text Available Reversible BBB disruption has been uniformly reported in several animal models of postoperative cognitive dysfunction (POCD. Nevertheless, the precise mechanism underlying this occurrence remains unclear. Using an aged rat model of POCD, we investigated the dynamic changes in expression of molecules involved in BBB disintegration, matrix metalloproteinase-2 (MMP-2 and -9 (MMP-9, as well as three of their endogenous tissue inhibitors (TIMP-1, -2, -3, and tried to establish the correlation between MMP/TIMP balance and surgery-induced hippocampal BBB disruption. We validated the increased hippocampal expression of angiotensin II (Ang II and Ang II receptor type 1 (AT1 after surgery. We also found MMP/TIMP imbalance as early as 6 h after surgery, together with increased BBB permeability and decreased expression of Occludin and zonula occludens-1 (ZO-1, as well as increased basal lamina protein laminin at 24 h postsurgery. The AT1 antagonist candesartan restored MMP/TIMP equilibrium and modulated expression of Occludin and laminin, but not ZO-1, thereby improving BBB permeability. These events were accompanied by suppression of the surgery-induced canonical nuclear factor-κB (NF-κB activation cascade. Nevertheless, AT1 antagonism did not affect nuclear receptor peroxisome proliferator-activated receptor-γ expression. Collectively, these findings suggest that surgery-induced Ang II release impairs BBB integrity by activating NF-κB signaling and disrupting downstream MMP/TIMP balance via AT1 receptor.

  7. Radiation therapy after breast-conserving surgery for Stage I and II mammary carcinoma

    International Nuclear Information System (INIS)

    This report describes the results of a program of limited surgery, usually tumor excision, followed by curative radiation therapy in a series of 794 evaluable Stage I and II breast cancer patients treated prior to December, 1976. Clinical cure rates at 5, 10 and 15 years were 85%, 74% and 58% respectively. At 10 years, 86% of the apparently cured patients had the affected breast preserved, 79% of them with a good cosmetic result. In 10-year local/regional recurrence rate was 14%, but 84% of local failures were operable. Salvage surgery provided ultimate local control for 94% of the operable local failures, 61.5% of whom lived for at least 5 years after their secondary operations. It is concluded that a combination of primary tumor excision, limited axillary dissection and curative radiation therapy provides end results which are equivalent to those of primary radical mastectomy and affords the considerable advantage of successful breast preservation in a large majority of cases. (orig.)

  8. The university münster model surgery system for orthognathic surgery. Part II – KD-MMS

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    Ehmer Ulrike

    2013-01-01

    Full Text Available Abstract Background Model surgery is an integral part of the planning procedure in orthognathic surgery. Most concepts comprise cutting the dental cast off its socket. The standardized spacer plates of the KD-MMS provide for a non-destructive, reversible and reproducible means of maxillary and/or mandibular plaster cast separation. Methods In the course of development of the system various articulator types were evaluated with regard to their capability to provide a means of realizing the concepts comprised of the KD-MMS. Special attention was dedicated to the ability to perform three-dimensional displacements without cutting of plaster casts. Various utilities were developed to facilitate maxillary displacement in accordance to the planning. Objectives of this development comprised the ability to implement the values established in the course of two-dimensional ceph planning. Results The system - KD-MMS comprises a set of hardware components as well as a defined procedure. Essential hardware components are red spacer and blue mounting plates. The blue mounting plates replace the standard yellow SAM mounting elements. The red spacers provide for a defined leeway of 8 mm for three-dimensional movements. The non-destructive approach of the KD-MMS makes it possible to conduct different model surgeries with the same plaster casts as well as to restore the initial, pre-surgical situation at any time. Thereby, surgical protocol generation and gnathologic splint construction are facilitated. Conclusions The KD-MMS hardware components in conjunction with the defined procedures are capable of increasing efficiency and accuracy of model surgery and splint construction. In cases where different surgical approaches need to be evaluated in the course of model surgery, a significant reduction of chair time may be achieved.

  9. [Maxillo-facial surgery in skeletal Class II: repercussions on the temporo-mandibular joints].

    Science.gov (United States)

    Manière-Ezvan, Armelle; Savoldelli, Charles; Busson, Floriant; Oueiss, Arlette; Orthlieb, Jean-Daniel

    2016-03-01

    These interventions usually aimed at the correction of the skeletal discrepancy by mandibular retrognatism with an advancement of the distal portion of the mandible after mandibular osteotomy. The position of the condyle is determined during the osteosynthesis with miniplates. Condyles are set back in relation with the supine position of the patient and the weakness of his (her) curarized muscle. All studies show that surgery of mandibular advancement causes a lateral, torque and backward movement of the condyles, all harmful to the condyles. Factors that predispose to condylar resorption are "the patient": a woman, young (between 15 and 40), high mandibular angle, with a history of temporo-mandibular disorders and surgical overload applied to the condyles. What are the possible solutions to avoid failures? Patient preparation before surgery and surgery simulation with an articulator, condylar position control during surgery, working with surgeons to achieve a condylar portion stabilization system (with the CAD), quickly set up a mobilization of the mandible by physiotherapy.

  10. Neoadjuvant chemoradiation therapy with gemcitabine/cisplatin and surgery versus immediate surgery in resectable pancreatic cancer. Results of the first prospective randomized phase II trial

    Energy Technology Data Exchange (ETDEWEB)

    Golcher, Henriette; Merkel, Susanne; Hohenberger, Werner [University Hospital Erlangen, Department of Surgery, Erlangen (Germany); Brunner, Thomas B. [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany); University Hospital Freiburg, Department of Radiation Oncology, Freiburg (Germany); Witzigmann, Helmut [University Hospital Leipzig, Department of Surgery, Leipzig (Germany); Hospital Dresden-Friedrichstadt, General Surgery, Dresden (Germany); Marti, Lukas [Hospital of Kanton St. Gallen, General Surgery, St. Gallen (Switzerland); Bechstein, Wolf-Otto [University Hospital Frankfurt, Department of Surgery, Frankfurt/Main (Germany); Bruns, Christiane [University Hospital Munich, Department of Surgery - Hospital Campus Grosshadern, Munich (Germany); University Hospital Magdeburg, Department of Surgery, Magdeburg (Germany); Jungnickel, Henry [Hospital Dresden-Friedrichstadt, General Surgery, Dresden (Germany); Schreiber, Stefan [University Hospital Leipzig, Department of Surgery, Leipzig (Germany); Grabenbauer, Gerhard G. [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany); Hospital Coburg, Department of Radiation Oncology, Coburg (Germany); Meyer, Thomas [University Hospital Erlangen, Department of Surgery, Erlangen (Germany); Hospital Ansbach, General Surgery, Ansbach (Germany); Fietkau, Rainer [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany)

    2014-09-25

    In nonrandomized trials, neoadjuvant treatment was reported to prolong survival in patients with pancreatic cancer. As neoadjuvant chemoradiation is established for the treatment of rectal cancer we examined the value of neoadjuvant chemoradiotherapy in pancreatic cancer in a randomized phase II trial. Radiological staging defining resectability was basic information prior to randomization in contrast to adjuvant therapy trials resting on pathological staging. Patients with resectable adenocarcinoma of the pancreatic head were randomized to primary surgery (Arm A) or neoadjuvant chemoradiotherapy followed by surgery (Arm B), which was followed by adjuvant chemotherapy in both arms. A total of 254 patients were required to detect a 4.33-month improvement in median overall survival (mOS). The trial was stopped after 73 patients; 66 patients were eligible for analysis. Twenty nine of 33 allocated patients received chemoradiotherapy. Radiotherapy was completed in all patients. Chemotherapy was changed in 3 patients due to toxicity. Tumor resection was performed in 23 vs. 19 patients (A vs. B). The R0 resection rate was 48 % (A) and 52 % (B, P = 0.81) and (y)pN0 was 30 % (A) vs. 39 % (B, P = 0.44), respectively. Postoperative complications were comparable in both groups. mOS was 14.4 vs. 17.4 months (A vs. B; intention-to-treat analysis; P = 0.96). After tumor resection, mOS was 18.9 vs. 25.0 months (A vs. B; P = 0.79). This worldwide first randomized trial for neoadjuvant chemoradiotherapy in pancreatic cancer showed that neoadjuvant chemoradiation is safe with respect to toxicity, perioperative morbidity, and mortality. Nevertheless, the trial was terminated early due to slow recruiting and the results were not significant. ISRCTN78805636; NCT00335543. (orig.) [German] Mehrere nichtrandomisierte Studien zeigten, dass eine neoadjuvante Therapie das Ueberleben bei Patienten mit Pankreaskarzinom verlaengert. Beim lokal fortgeschrittenen Rektumkarzinom gehoert die

  11. Complex Regional Pain Syndrome (CRPS Type II After Carpal Tunnel Release Surgery: Case Report

    Directory of Open Access Journals (Sweden)

    Hakan Tunç

    2010-08-01

    Full Text Available Summary Complex regional pain syndrome is a chronic syndrome characterised with dystrophic changes and neurovascular disordes of bone and skin of extremities. The most common etiological factors are trauma, ischemic heart disease, cerebral lesions, servical region disorders, infections, and surgical treatments. Carpal tunnel syndrome is the most common compressive neuropaty of the upper extremity. There are various surgical and conservative alternatives in the treatment of carpal tunnel syndrome. Complex regional pain syndrome has been reported as a complication of surgical carpal tunnel release in 2-5% of patients. In this case report clinical characteristics and rehabilitation outcomes of a patient with complex regional pain syndrome after carpal tunnel release surgery is presented. (Osteoporoz Dünyasından 2010;16:41-3

  12. COLOR II. A randomized clinical trial comparing laparoscopic and open surgery for rectal cancer

    DEFF Research Database (Denmark)

    2009-01-01

    INTRODUCTION: Laparoscopic resection of rectal cancer has been proven efficacious but morbidity and oncological outcome need to be investigated in a randomized clinical trial. Trial design: Non-inferiority randomized clinical trial. METHODS: The COLOR II trial is an ongoing international randomized...... clinical trial. Currently 27 hospitals from Europe, South Korea and Canada are including patients. The primary endpoint is loco-regional recurrence rate three years post-operatively. Secondary endpoints cover quality of life, overall and disease free survival, post-operative morbidity and health economy...

  13. Surgery and national identity in late nineteenth-century Vienna.

    Science.gov (United States)

    Buklijas, Tatjana

    2007-12-01

    For historians of medicine, the professor Theodor Billroth of the University of Vienna was the leading European surgeon of the late nineteenth century and the personification of intervention by organ or body part removal. For social and political historians, he was a German nationalist whose book on medical education heralded the rise of anti-Semitism in the Austrian public sphere. This article brings together and critically reassesses these two hitherto separate accounts to show how, in a period of dramatic social and political change, Viennese surgery split into two camps. One, headed by Billroth, was characterized by an alliance with the German educational model, German nationalism leading to racial anti-Semitism and an experimental approach to the construction of surgical procedure, which heavily relied on the methods of pathological physiology. The other, which followed a long Austrian tradition, stood for a clinically oriented and strictly organized medical education that catered to an ethnically and socially diverse population and, simultaneously, for an anatomically oriented surgery, largely of the locomotor apparatus. This study shows how, in a major centre of medical education and capital of a multiethnic empire, surgical and national identities were forged together. PMID:18053931

  14. Robotic surgery

    Science.gov (United States)

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... Robotic surgery is similar to laparoscopic surgery. It can be performed through smaller cuts than open surgery. ...

  15. Patient-reported genitourinary dysfunction after laparoscopic and open rectal cancer surgery in a randomized trial (COLOR II)

    DEFF Research Database (Denmark)

    Andersson, J; Abis, G; Gellerstedt, M;

    2014-01-01

    the European Organization for Research and Treatment of Cancer (EORTC) QLQ-CR38 questionnaire before surgery, and after 4 weeks, 6, 12 and 24 months. Adjusted mean differences on a 100-point scale were calculated using changes from baseline value at the various time points in the domains of sexual functioning...

  16. Cosmetic Surgery

    Science.gov (United States)

    ... Body Looking and feeling your best Cosmetic surgery Cosmetic surgery Teens might have cosmetic surgery for a number ... about my body? What are the risks of cosmetic surgery? top People who have cosmetic surgery face many ...

  17. Nose Surgery

    Science.gov (United States)

    ... is as high a priority as appearance. Can Cosmetic Nasal Surgery Create A "Perfect" Nose? Aesthetic nasal surgery (rhinoplasty) ... Cover Nasal Surgery? Insurance usually does not cover cosmetic surgery. However, surgery to correct or improve breathing function, ...

  18. Cosmetic Surgery

    Science.gov (United States)

    ... Submit Home > Body Image > Cosmetic surgery Body Image Cosmetic surgery ASPS list of inappropriate candidates for surgery ... their appearance. Return to top Additional resources on cosmetic surgery Breast surgery Explore other publications and websites ...

  19. Perioperatory antibiotic prophylaxis in Pediatric Surgery (Part II: non-abdominal surgery. Profilaxis antibiótica perioperatoria en Cirugía Pediátrica (Parte II: cirugía no abdominal.

    Directory of Open Access Journals (Sweden)

    Guillermo Cortiza Orbe

    Full Text Available The surgical wound infection is the biggest cause of infectious morbility in surgical patients. It is an important cause of morbility that causes lincreased hospital demurrages, increased cost of medical attention and serious inconveniences to the patients and their familiies. 25% of all nosocomial infections are surgical wound infection. One of the big advances of the surgery in the last three decades is an introduction of antibiotic prophylaxis in the surgical practice. Is considered that it has saved more lives than any other novel procedure in surgery in the last 20 years. We presented the Good Clinical Practices Guideline for Antibiotic prophylaxis in no-abdominal surgery, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.

    La infección posoperatoria de la herida quirúrgica es la mayor causa de morbilidad infecciosa en el paciente quirúrgico. Ocasiona prolongadas estadías hospitalarias, incremento de los costos de la atención médica y serios inconvenientes a los pacientes y sus familiares. El 25 % de todas las infecciones nosocomiales son infecciones de la herida quirúrgica. Uno de los grandes avances que ha experimentado la cirugía en las tres últimas décadas, es la introducción de la profilaxis antibiótica perioperatoria en la práctica quirúrgica. Se considera que en los últimos 20 años ha salvado más vidas que cualquier otro procedimiento novedoso en cirugía. Se presenta la Guía de Buenas Prácticas Clínicas para profilaxis antibiótica perioperatoria en cirugía abdominal, aprobada por consenso en el 1er Taller Nacional de Buenas Prácticas Clínicas en Cirugía Pediátrica (Cienfuegos, 7 al 9 de marzo del 2002.

  20. The application of European system for cardiac operative risk evaluation II (EuroSCORE II and Society of Thoracic Surgeons (STS risk-score for risk stratification in Indian patients undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    Deepak Borde

    2013-01-01

    Full Text Available Aims and Objectives: To validate European system for cardiac operative risk evaluation II (EuroSCORE II and Society of Thoracic Surgeons (STS risk-score for predicting mortality and STS risk-score for predicting morbidity in Indian patients after cardiac surgery. Materials and Methods: EuroSCORE II and STS risk-scores were obtained pre-operatively for 498 consecutive patients. The patients were followed for mortality and various morbidities. The calibration of the scoring systems was assessed using Hosmer-Lemeshow test. The discriminative capacity was estimated by area under receiver operating characteristic (ROC curves. Results: The mortality was 1.6%. For EuroSCORE II and STS risk-score C-statics of 5.43 and 6.11 were obtained indicating satisfactory model fit for both the scores. Area under ROC was 0.69 and 0.65 for EuroSCORE II and STS risk-score with P values of 0.068 and 0.15, respectively, indicating poor discriminatory power. Good fit and discrimination was obtained for renal failure, long-stay in hospital, prolonged ventilator support and deep sternal wound infection but the scores failed in predicting risk of reoperation and stroke. Mortality risk was correctly estimated in low ( 5% patients by both scoring systems. Conclusions: EuroSCORE II and STS risk-scores have satisfactory calibration power in Indian patients but their discriminatory power is poor. Mortality risk was over-estimated by both the scoring systems in high-risk patients. The present study highlights the need for forming a national database and formulating risk stratification tools to provide better quality care to cardiac surgical patients in India.

  1. Papel da cirurgia bariátrica no controle do diabete melito tipo II The role of bariatric surgery on diabetes mellitus type 2 control

    Directory of Open Access Journals (Sweden)

    Daniella Vodola Forcina

    2008-09-01

    Full Text Available RACIONAL: Sabe-se que hoje um dos grandes problemas de saúde pública refere-se a diabete melito com projeção de atingir 366 milhões de pacientes até 2030, entre indivíduos insulino (DM tipo I e não-insulino (DM tipo II dependentes. OBJETIVOS: Avaliar por meio de revisão ampla da literatura os resultados encontrados no controle do DM tipo II com diferentes modalidades de tratamento cirúrgico disponíveis em nosso meio. MÉTODO: A partir de 2004 foram levantados 73 trabalhos, sendo que destes 22 versavam especificamente sobre o tema nas bases de dados LiIacs, Medline, Pubmed cruzando os descritores diabete melito e cirurgia. RESULTADOS: Dentre as operações avaliadas obtiveram resultados satisfatórios em 98,9% a derivação biliopancreática ou duodenal, em 83,7% bypass gástrico, em 71,6% gastroplastia e em 47,9% bandas gástricas. Quanto às complicações, encontram-se descritas as mais diversas, desde as da ferida operatória até casos de insuficiência hepática aguda após cirurgia bariátrica que evoluíram com necessidade de transplante ou mesmo óbito, demonstrando que a decisão pelo tratamento operatório deve ser feita de maneira criteriosa ponderando-se o custo benefício. CONCLUSÃO: As técnicas cirúrgicas bariátricas, exercem melhora do diabete tipo II e as derivações biliopancreática, duodenal switch, Scopinaro e bypass gástrico com Y de Roux são as mais indicadas.INTRODUCTION: One of the today's biggest health problems is diabetes mellitus and is projected to have 366 million patients in 2030, between insulin (DM I and non-insulin dependent (DM II. AIM: To evaluate through a literature review the surgical results in the type II using surgical methods available in bariatric surgery. METHOD: The scientific databases Lilacs, Medline and Pubmed were used to collect papers with the surgical treatment of diabetes and 73 articles were found, being 22 specifically related to the subject. RESULTS: Surgery shows inicial

  2. Cataract Surgery

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  3. Near-Infrared Sentinel Lymph Node Mapping With Indocyanine Green Using the VITOM II ICG Exoscope for Open Surgery for Gynecologic Malignancies.

    Science.gov (United States)

    Buda, Alessandro; Dell'Anna, Tiziana; Vecchione, Francesca; Verri, Debora; Di Martino, Giampaolo; Milani, Rodolfo

    2016-01-01

    Sentinel lymph node (SLN) mapping is emerging as an effective method for surgical staging of different gynecologic malignancies. Near-infrared (NIR) technology using a fluorescent dye such as indocyanine green (ICG) represents an interesting and feasible method for SLN mapping even in traditional open surgeries by applying video telescope operating microscope (VITOM) system technology. We report our preliminary experience in 12 women who underwent surgical nodal staging for early-stage vulvar and uterine or cervical cancer. Surgical and pathological outcomes are described, and the VITOM II ICG system's intraoperative image quality, handling and docking, and teaching value are assessed. The general impression of the surgical staff was that the VITOM II system is easy to use, and that the image quality of the anatomic structures is impressive. Traditional open SLN mapping with ICG appears to be easy to perform and reproducible, providing a new tool in the management of patients with gynecologic malignancies. Moreover, we believe that this technology has great potential as an operative teaching and learning modality for trainers for open surgical cases. Additional studies involving the VITOM system with a large sample size of patients are needed to confirm these promising results. PMID:26921484

  4. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy improves survival for patients with peritoneal carcinomatosis from colorectal cancer: a phase II study from a Chinese center.

    Directory of Open Access Journals (Sweden)

    Chao-Qun Huang

    Full Text Available Peritoneal carcinomatosis (PC is a difficult clinical challenge in colorectal cancer (CRC because conventional treatment modalities could not produce significant survival benefit, which highlights the acute need for new treatment strategies. Our previous case-control study demonstrated the potential survival advantage of cytoreductive surgery (CRS plus hyperthermic intraperitoneal chemotherapy (HIPEC over CRS alone. This phase II study was to further investigate the efficacy and adverse events of CRS+HIPEC for Chinese patients with CRC PC.A total of 60 consecutive CRC PC patients underwent 63 procedures consisting of CRS+HIPEC and postoperative chemotherapy, all by a designated team focusing on this combined treatment modality. All the clinico-pathological information was systematically integrated into a prospective database. The primary end point was disease-specific overall survival (OS, and the secondary end points were perioperative safety profiles.By the most recent database update, the median follow-up was 29.9 (range 3.5-108.9 months. The peritoneal cancer index (PCI ≤20 was in 47.0% of patients, complete cytoreductive surgery (CC0-1 was performed in 53.0% of patients. The median OS was 16.0 (95% confidence interval [CI] 12.2-19.8 months, and the 1-, 2-, 3-, and 5-year survival rates were 70.5%, 34.2%, 22.0% and 22.0%, respectively. Mortality and grades 3 to 5 morbidity rates in postoperative 30 days were 0.0% and 30.2%, respectively. Univariate analysis identified 3 parameters with significant effects on OS: PCI ≤20, CC0-1 and adjuvant chemotherapy over 6 cycles. On multivariate analysis, however, only CC0-1 and adjuvant chemotherapy ≥6 cycles were found to be independent factors for OS benefit.CRS+HIPEC at a specialized treatment center could improve OS for selected CRC PC patients from China, with acceptable perioperative safety.

  5. Influence of Dietary Interventions on Gastric Cancer Patients' Quality of Life and Complications after Billroth Ⅱ Gastrectomy%饮食干预对胃癌毕Ⅱ式根治术后患者生活质量及并发症的影响

    Institute of Scientific and Technical Information of China (English)

    周桂兰; 洪菁; 方登

    2012-01-01

    Objective To investigate the influence of dietary interventions on the gastric cancer patients' quality of life after Billroth II gastrectomy. Methods From June 2009 to December 2010,60 patients undergoing Billroth TJ gastrectomy in the hospital were randomly divided into interventional group(n = 30) and control group(n = 30). The patients of the control group received conventional dietary guidance,and the interventional group used the project of individual dietary guidance in accordance with the principle of gradual and orderly progress at the suggestion of nutritionists. The patients'quality of life and the incidences of complications were evaluated at six months and one year after gastrectomy separately using quality of life questionnaire of stomach 22(QLQ-STO22). Results The patients' overall QLQ-STO22 level in the interventional group was significantly higher than that of the control group (P<0. 01). The patients in both groups suffered from bloating after meals,gastro-esophageal reflux,dumping syndrome and other complications. The incidence of complications in 6 months after operation was significantly lower in the observational group than that in the control group (P<0. 05). Conclusion Individual dietary interventions can change patients' unhealthy lifestyle,reduce the complication rate and improve their quality of life after gastrectomy.%目的 探讨饮食干预对毕Ⅱ式胃癌根治术后患者生活质量的影响.方法 便利抽样法选取2009年6月至2010年12月在桂林医学院附属医院行胃癌毕Ⅱ式根治术的患者60例为研究对象,按随机数字表法将其分为观察组和对照组,每组30例.对照组患者根据胃癌毕Ⅱ式根治术后饮食原则给予常规饮食指导,观察组在此基础上根据患者的个体情况,与营养师合作按照循序渐进原则进行个体化指导及跟踪督查、指导.分别于术后6个月、1年采用胃癌患者生活质量问卷(quality of life questionnaire of stomach 22,QLQ

  6. Phase I-II trial of concomitant continuous carboplatin (CBDCA) infusion and radiotherapy in advanced nonsmall cell lung cancer with evaluation for surgery: final report

    International Nuclear Information System (INIS)

    Purpose: The goal of this trial was to determine the maximum tolerable dose when carboplatin (CBDCA) was administered in continuous infusion concurrently with radiotherapy in patients with nonsmall cell lung cancer. Methods and Materials: From October 1989 to July 1993, 54 patients were studied (male/female ratio: 44 to 10), median age was 62 years. Two patients had Stage II cancer, 22 had Stage IIIA, 24 had Stage IIIB, and 6 had Stage IV. Carboplatin was given for 96 h, starting at a dose of 30 mg/m2/day: 13 patients received 30 mg/m2/day (group A), 12 patients received 50 mg/m2/day (group B), 12 patients received 70 mg/m2/day (group C), 10 patients received 90 mg/m2/day (group D), and 7 patients 110 mg/m2/day (group E). The radiation dose was 50.40 Gy delivered to the target volume in 5.3 weeks. Results: Fifty-three of 54 patients were evaluable for toxicity and 52 out of 54 for response. Toxicity (Miller score): Myelotoxicity: in groups A and B it was almost absent; in groups C and D it was moderate (leukopenia G1-2: 45.4% patients; trombocytopenia G1-2: 22.7%, G3: 9%; anemia G1-2: 9%); only in group E was it severe (leukopenia G1 and G3 16.6% respectively; trombocytopenia G3: 33.3%, G4: 16.6%; anemia G1-2: 50%). Nephrotoxicity was present only in one patient of group E and was Grade 3. Nausea and vomiting were related to CBDCA dose. One patient in Group E died of intractable toxicity 3 days after the end of infusion; then the study was closed. The limiting toxicity dose was shown to be 110 mg/m2/day given for 96 h. Clinical response rate: Twenty-six of 52 patients had major response, 24 had minor response, and only 2 patients had progression of disease. Surgery: Twenty-one of 52 tumors were judged resectable: 18 patients had complete tumor resection, 1 had exploratory thoracotomy, and 2 patients refused surgery. Pathological response rate: Five patients had pathologic state T0 or Tis. Conclusions: These results indicate that the maximum tolerable dose of CBDCA

  7. 毕Ⅱ式胃切除术后胆总管十二指肠残端吻合术%Choledocho duodenal stump anastomisis after Billroth Ⅱ subtotal gastrectomy

    Institute of Scientific and Technical Information of China (English)

    楼立新; 施维锦

    2001-01-01

    Objective:To discuss the clinical effect and value of modified choledochoduodenostomy.Methods:We retrospectively analyzed fifteen cases after subtotal gastrectomy Billroth Ⅱ. These patients received choledocho-duodenal stump anastomosis and were followed up for an average of eight years.Results:None of the 15 cases suffered from stricture of the anastomosis stoma or retrograde biliary infection. Three cases accepted reoperation but none was because of stricture or retrograde infection.Conclusion:Choledochoduodenostomy after subtotal Billroth Ⅱ gastrectomy is reliable operation, which can prevent entero-biliary reflux and retrograde biliary infection. It also prevents anastomosis stricture induced by chironic drawing. So this operation is safet with, rare complications, so it is suitable for elder and serious patients, or for postoperation of upper abdomon. But the complication of blind loop syndrom still exits, which should be explored in future studies.%目的:探讨经改良后的胆总管十二指肠吻合术,在胆肠吻合中的疗效及应用价值。 方法:对15例行Billroth Ⅱ式胃大部切除术后,十二指肠残端与胆总管进行吻合的病例资料进行回顾分析,并进行术后疗效的随访观察。结果:本组15例经8个月至14年(平均随访8年)的远期随访,无1例发生吻合口狭窄及胆道逆行感染。随访中3例因症状复发而再次手术,但术后证实无1例症状是由吻合口狭窄或逆行感染引起。结论:行Billroth Ⅱ式胃大部切除术后,将排外的十二指肠与胆总管吻合,可克服胆肠返流、胆道逆行感染、吻合口慢性牵拉造成狭窄等缺点,具有手术安全性大、术后并发症少、可大大缩短手术时间等优点,尤其适用于年老体弱、病情危重、且有多次上腹部手术史的病人。但产生盲端综合征的问题可能依旧存在,值得以后在吻合术式的选择中进一步探讨。

  8. Plastic Surgery

    Science.gov (United States)

    ... How Can I Help a Friend Who Cuts? Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word " ...

  9. Foot Surgery

    Science.gov (United States)

    ... in the toe to maintain realignment. Neuroma Surgery: Neuroma surgery involves removing a benign enlargement of a nerve, usually between the metatarsal heads in the ball of the foot. This soft tissue surgery tends to have a ...

  10. Lung surgery

    Science.gov (United States)

    ... Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS ... You will have general anesthesia before surgery. You will be asleep and unable to feel pain. Two common ways to do surgery on your lungs are thoracotomy and video- ...

  11. [100 years of surgery in the Kosevo Hospital in Sarajevo].

    Science.gov (United States)

    Durić, O

    1994-01-01

    The surgery Department of the Regional Hospital was opened on 1st July, 1894 in Sarajevo, what meant the beginnings of European surgery school influence here. The School was in the second half of its activity, better known as "century of surgery". The building, fittings, equipment and staff continued their work here coping the Viennese school achievements. It was headed by the prominent European surgeon, primarius Dr Josef Preindisberger, first assistant to the great personality Dr. Billroth. In the way this institution became a referral centre for two other hospitals in Sarajevo: the Vakuf's and the Military Hospital, but for some 17 more in BH, which were built in the course of ten years. Because of the therapeutic success in the domain of the general surgery and diseases of the eye and according the annual reports, the first 50 beds became insufficient for all those who wanted the treatment. So, the Department was enlarged, in 1905 a new regional Hospital was planned, to act as clinics. The World War 1 stopped the plans. During the period of Kingdom of Yugoslavia, destroyed by war, the Surgery Department continued its work with the doctors educated to continue the work on the pre war level. As a broad pathology basis, but the need of space that time chief surgeon. Primarius Milivoje Kostić worked out in details the former plan of the new hospital building up with a base for clinics. It was accepted as a ten years project, which, to the regrets, did not come to existence to the World War 2.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Acute Cholangitis following Biliary Obstruction after Duodenal OTSC Placement in a Case of Large Chronic Duodenocutaneous Fistula

    Directory of Open Access Journals (Sweden)

    Yaseen Alastal

    2015-01-01

    Full Text Available Over-the-Scope Clip system, also called “Bear Claw,” is a novel endoscopic modality used for closure of gastrointestinal defect with high efficacy and safety. We present a patient with history of eosinophilic gastroenteritis and multiple abdominal surgeries including Billroth II gastrectomy complicated by a large chronic duodenocutaneous fistula from a Billroth II afferent limb to the abdominal wall. Bear Claw clip was used for closure of this fistula. The patient developed acute cholangitis one day after placement of the Bear Claw clip. Acute cholangitis due to papillary obstruction is a potential complication of Bear Claw placement at the dome of the duodenal stump (afferent limb in patient with Billroth II surgery due to its close proximity to the major papilla.

  13. After Surgery

    Science.gov (United States)

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  14. Turbinate surgery

    Science.gov (United States)

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery ... There are several types of turbinate surgery: Turbinectomy: All or part of the lower turbinate is taken out. This can be done in several different ways, but sometimes a ...

  15. Heart Surgery Terms

    Science.gov (United States)

    ... Patients Choosing Wisely® Adult Cardiac Surgery What is Pediatric Heart Disease? What is Risk Adjustment? Valve Repair/Replacement Surgery Esophageal Surgery Lung/Thoracic Surgery Aneurysm Surgery Arrhythmia Surgery Other Types of Surgery Clinical ...

  16. Strabismus Surgery

    Science.gov (United States)

    ... used. Some surgeons prescribe an antibiotic or combination antibiotic/steroid drop or ointment after surgery. More technical ... Screening Recommendations Loading... Most Common Searches Adult ...

  17. Corrective Jaw Surgery

    Science.gov (United States)

    ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of ...

  18. Down-Regulation of Renal Gluconeogenesis in Type II Diabetic Rats Following Roux-en-Y Gastric Bypass Surgery: A Potential Mechanism in Hypoglycemic Effect

    Directory of Open Access Journals (Sweden)

    Yi Wen

    2015-03-01

    Full Text Available Objective: This study was initiated to evaluate the effects of Roux-en-Y gastric bypass surgery on renal gluconeogenesis in type 2 diabetic rats and its relationship with hormonal parameters. Methods: Diabetic rats were induced by intraperitoneal injection of streptozotocin (STZ; 35 mg/kg combined with a high-fat diet. They were then randomly divided into three groups: diabetes model group (DM group, n = 8, sham Roux-en-Y gastric bypass group (SRYGB group, n = 8, and Roux-en-Y gastric bypass group (RYGB group, n = 14. Another 8 normal rats comprised the normal control group (NC group, n = 8. Body weight, glucose, serum lipid, insulin, glucagon-like peptide-1 (GLP-1, leptin, and adiponectin were measured pre- and postoperatively. Glucose-6-phosphatase (G6Pase, phosphoenolpyruvate carboxykinase (PEPCK, insulin receptor-α (IR-α, insulin receptor-β (IR-β, and glycogen synthase kinase 3 beta (Gsk3b were measured in renal cortex by using RT-PCR and Western immune-blot analyses on the 4th week after operation. Results: Following RYGB surgery, surgery-treated rats showed significantly improved oral glucose tolerance, dyslipidemia and insulin resistance as well as increased post-gavage insulin levels and serum circulating levels of GLP-1 and adiponectin. RT-PCR and Western immune-blot analyses showed PEPCK and G6Pase protein and mRNA to be significantly decreased in the renal cortex in the RYGB group (p Conclusion: Down-regulation of renal gluconeogenic enzymes might be a potential mechanism in hypoglycemia. An improved insulin signal pathway in the renal cortex and increased circulating adiponectin concentrations may contribute to the decline of renal gluconeogenesis following RYGB surgery.

  19. Bioimpedance Spectroscopy in Detecting Lower-Extremity Lymphedema in Patients With Stage I, Stage II, Stage III, or Stage IV Vulvar Cancer Undergoing Surgery and Lymphadenectomy

    Science.gov (United States)

    2016-02-09

    Lymphedema; Perioperative/Postoperative Complications; Stage IA Vulvar Cancer; Stage IB Vulvar Cancer; Stage II Vulvar Cancer; Stage IIIA Vulvar Cancer; Stage IIIB Vulvar Cancer; Stage IIIC Vulvar Cancer; Stage IVA Vulvar Cancer; Stage IVB Vulvar Cancer

  20. Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: How regular follow-up is important for good outcome. The Miraj Pediatric Cataract Study II

    Directory of Open Access Journals (Sweden)

    Parikshit Gogate

    2014-01-01

    Full Text Available Background: Regular follow up and amblyopia treatment are essential for good outcomes after pediatric cataract surgery. Aim: To study the regularity of follow-up after cataract surgery in children and to gauge the causes of poor compliance to follow up. Subjects: 262 children (393 cataracts who underwent cataract surgery in 2004-8. Materials and Methods: The children were identified and examined in their homes and a "barriers to follow-up" questionnaire completed. Demographic data collected, visual acuity estimated, and ocular examination performed. Statistical Analysis: SPSS version 19. Results: Of the 262 children, only 53 (20.6% had been regularly following up with any hospital, 209 (79.4% had not. A total of 150 (57.3% were boys and the average age was 13.23 years (Std Dev 5 yrs. Poor follow up was associated with the older age group ( P 1 line with regular follow-up. Conclusion: Regular follow-up is important and improves vision; eye care practitioners need to take special efforts to ensure better follow-up.

  1. Late anastomotic perforation following surgery for gastric neuroendocrine tumor complicated by perforated duodenal ulcer: a case report.

    Science.gov (United States)

    Han, Jun; He, Zhenyu

    2013-03-01

    Neuroendocrine tumors (NETs) are a group of neoplasms that are characterized by the secretion of a variety of hormones and diverse clinical syndromes. NETs are considered to be rare, but the incidence of NETs has increased rapidly in recent years. NETs provide a clinical challenge for physicians because they comprise a heterogeneous group of malignancies with a wide range of morphological, functional, and behavioral characteristics. Subtotal gastrectomy with Billroth II reconstruction is the mainstay of therapy in the management of gastric NETs complicated by perforated duodenal ulcer. Late perforation of anastomotic stoma as a long-term complication has been rarely reported. Here, we report a case of anastomotic perforation 5 years after subtotal gastrectomy due to perforated duodenal ulcer and gastric NETs.

  2. Rhabdomyosarcoma: Surgery

    Science.gov (United States)

    ... plastic surgeons, maxillofacial surgeons, and neurosurgeons. If a tumor is large or is in a spot where removing it completely would severely affect the child’s appearance or cause other problems, then surgery may be ...

  3. Brain surgery

    Science.gov (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  4. Oesophageal surgery

    Institute of Scientific and Technical Information of China (English)

    Erik J. Simchuk; Derek Alderson

    2001-01-01

    @@INTRODUCTION The origins of oesophageal surgery ,like most surgical treatments ,are based in the treatment of traumatic injury .The Smith Surgical Papyrus describes the examination, diagnosis and treatment of "a gaping wound of throat, penetrating the gullet" [1].

  5. Acne Surgery

    OpenAIRE

    Dilworth, G. R.

    1983-01-01

    Acne surgery consists of comedone extraction of non-inflamed lesions, triamcinolone acetate injections of some inflamed lesions, and extraction of milia. Prevention is a very important part of comedone treatment, especially avoidance of picking, moisturizers and harsh soaps. Instruments are also very important: even the finest may be too thick and may have to be filed down. Acne surgery is only an adjunct of good medical therapy.

  6. [Robotic surgery].

    Science.gov (United States)

    Moreno-Portillo, Mucio; Valenzuela-Salazar, Carlos; Quiroz-Guadarrama, César David; Pachecho-Gahbler, Carlos; Rojano-Rodríguez, Martín

    2014-12-01

    Medicine has experienced greater scientific and technological advances in the last 50 years than in the rest of human history. The article describes relevant events, revises concepts and advantages and clinical applications, summarizes published clinical results, and presents some personal reflections without giving dogmatic conclusions about robotic surgery. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) defines robotic surgery as a surgical procedure using technology to aid the interaction between surgeon and patient. The objective of the surgical robot is to correct human deficiencies and improve surgical skills. The capacity of repeating tasks with precision and reproducibility has been the base of the robot´s success. Robotic technology offers objective and measurable advantages: - Improving maneuverability and physical capacity during surgery. - Correcting bad postural habits and tremor. - Allowing depth perception (3D images). - Magnifying strength and movement limits. - Offering a platform for sensors, cameras, and instruments. Endoscopic surgery transformed conceptually the way of practicing surgery. Nevertheless in the last decade, robotic assisted surgery has become the next paradigm of our era. PMID:25643879

  7. Tennis elbow surgery

    Science.gov (United States)

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is usually an outpatient surgery. This means you will not stay in the hospital overnight. You will be ...

  8. Five-year Irish trial of CLI patients with TASC II type C/D lesions undergoing subintimal angioplasty or bypass surgery based on plaque echolucency.

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2009-06-01

    To report a 5-year observational parallel group study comparing the effectiveness of subintimal angioplasty (SIA) to bypass grafting (BG) for treatment of TASC II type C\\/D lesions in the lower limb arteries of patients with critical limb ischemia (CLI).

  9. Epilepsy surgery: Recommendations for India

    Directory of Open Access Journals (Sweden)

    Chandra P

    2010-01-01

    Full Text Available The following article recommends guidelines for epilepsy surgery for India. This article reviews the indications, the various surgical options available and the outcome of surgery for drug resistant epilepsy based on current evidence. Epilepsy surgery is a well-established option for patients who have been diagnosed to have drug resistant epilepsy (DRE (on at least two appropriate, adequate anti-epileptic drugs (AEDs (either in monotherapy or in combination with continuing seizures, where the presurgical work-up has shown concordance of structural imaging (magnetic resonance imaging and electrical mapping data (electroencephalography (EEG, video EEG. There may be a requirement of functional imaging techniques in a certain number of DRE like positron emission tomography (PET, single photon emission tomography, (SPECT. Invasive monitoring should be restricted to a few when all noninvasive investigations are inconclusive, there is a dual pathology or there is a discordance of noninvasive data. The types of surgery could be curative (resective surgeries: amygdalo hippocampectomy, lesionectomy and multilobar resections; functional surgeries: hemispherotomy and palliative (multiple subpial transaction, corpus callosotomy, vagal nerve stimulation. Epilepsy surgery in indicated cases has a success range from 50 to 86% in achieving seizure freedom as compared with < 5% success rate with AEDs only in persons with DRE. Centers performing surgery should be categorized into Level I and Level II.

  10. A phase II trial of Xeloda and oxaliplatin (XELOX) neo-adjuvant chemotherapy followed by surgery for advanced gastric cancer patients with para-aortic lymph node metastasis

    OpenAIRE

    Wang, Yan; Yu, Yi-yi; Li, Wei; Feng, Yi; Hou, Jun; Ji, Yuan; Sun, Yi-Hong; Shen, Kun-Tang; Shen, Zhen-Bin; Qin, Xin-Yu; Liu, Tian-shu

    2014-01-01

    Purpose Gastric cancer with para-aortic lymph node (PAN) involvement is regarded as advanced disease, and only chemotherapy is recommended from the guidelines. In unresectable cases, neoadjuvant chemotherapy could prolong survival if conversion to resectability could be achieved. Methods The study was a single-arm phase II trial. Patients who were diagnosed with gastric cancer and PAN involvement (Stations No. 16a2/16b1) were treated with capecitabine and oxaliplatin combination chemotherapy ...

  11. A scoring system based on artificial neural network for predicting 10-year survival in stage II A colon cancer patients after radical surgery

    Science.gov (United States)

    Jiang, Wu; Lu, Shi-Xun; Lu, Zhen-Hai; Li, Pei-Xing; Yun, Jing-Ping; Zhang, Rong-Xin; Pan, Zhi-Zhong; Wan, De-Sen

    2016-01-01

    Nearly 20% patients with stage II A colon cancer will develop recurrent disease post-operatively. The present study aims to develop a scoring system based on Artificial Neural Network (ANN) model for predicting 10-year survival outcome. The clinical and molecular data of 117 stage II A colon cancer patients from Sun Yat-sen University Cancer Center were used for training set and test set; poor pathological grading (score 49), reduced expression of TGFBR2 (score 33), over-expression of TGF-β (score 45), MAPK (score 32), pin1 (score 100), β-catenin in tumor tissue (score 50) and reduced expression of TGF-β in normal mucosa (score 22) were selected as the prognostic risk predictors. According to the developed scoring system, the patients were divided into 3 subgroups, which were supposed with higher, moderate and lower risk levels. As a result, for the 3 subgroups, the 10-year overall survival (OS) rates were 16.7%, 62.9% and 100% (P < 0.001); and the 10-year disease free survival (DFS) rates were 16.7%, 61.8% and 98.8% (P < 0.001) respectively. It showed that this scoring system for stage II A colon cancer could help to predict long-term survival and screen out high-risk individuals for more vigorous treatment. PMID:27008710

  12. A scoring system based on artificial neural network for predicting 10-year survival in stage II A colon cancer patients after radical surgery.

    Science.gov (United States)

    Peng, Jian-Hong; Fang, Yu-Jing; Li, Cai-Xia; Ou, Qing-Jian; Jiang, Wu; Lu, Shi-Xun; Lu, Zhen-Hai; Li, Pei-Xing; Yun, Jing-Ping; Zhang, Rong-Xin; Pan, Zhi-Zhong; Wan, De Sen

    2016-04-19

    Nearly 20% patients with stage II A colon cancer will develop recurrent disease post-operatively. The present study aims to develop a scoring system based on Artificial Neural Network (ANN) model for predicting 10-year survival outcome. The clinical and molecular data of 117 stage II A colon cancer patients from Sun Yat-sen University Cancer Center were used for training set and test set; poor pathological grading (score 49), reduced expression of TGFBR2 (score 33), over-expression of TGF-β (score 45), MAPK (score 32), pin1 (score 100), β-catenin in tumor tissue (score 50) and reduced expression of TGF-β in normal mucosa (score 22) were selected as the prognostic risk predictors. According to the developed scoring system, the patients were divided into 3 subgroups, which were supposed with higher, moderate and lower risk levels. As a result, for the 3 subgroups, the 10-year overall survival (OS) rates were 16.7%, 62.9% and 100% (P < 0.001); and the 10-year disease free survival (DFS) rates were 16.7%, 61.8% and 98.8% (P < 0.001) respectively. It showed that this scoring system for stage II A colon cancer could help to predict long-term survival and screen out high-risk individuals for more vigorous treatment.

  13. Management of cataract with macular oedema due to diabetes mellitus Type-II and hypertension with grid laser prior to surgery and intra-vitreal bevacizumab (avastin) peroperatively

    International Nuclear Information System (INIS)

    To study the visual outcome in patients subjected to cataract extraction with prior grid laser and intraoperative intravitreal bevacizumab injection. Methods: This prospective case series comprised of 38 patients subjected to phacoemulsification and in the bag intraocular lens implantation at Al-Noor Eye Hospital and Sindh Govt Lyari General Hospital Karachi from January 2007 to December 2008. All the patients had prior macular grid treatment and intra-operative injection of intra-vitreal Avastin. Diabetes mellitus duration, preoperative glycosylated haemoglobin (HbA1c) level and other systemic and local complications of diabetes were recorded. The patients were clinically assessed with bio microscopic examination preoperatively, and postoperatively on day 1, week 1, and in months 1, 2, 3 and 6 respectively. Visual acuity and state of macular oedema was clinically assessed and documented. Results: Out of thirty-eight patients, eighteen were males and 20 were females. Mean duration of diabetes was 9.92 +- 5.5 years (Range 4-16) while that of hypertension was 7.87 +- 3.66 years (Range = 2-15). HbA1c level was 8.36% +- 1.93% (range 6.3 - 12.3). Thirty-one (81.5%) patients had HbA1c level 8.0% or above indicating a poor control. At 6 months of follow up best corrected distant visual acuity of 6/6 to 6/9 was achieved in 23(60.5 %), 6/12 in 11(28.9%) and 6/24 in 4(10.5%) cases while best corrected near acuity of N/6 was achieved in 22(57.8%) N/8 in 12(31.4%) and N/12 in 4(10.5%) cases. At 6 months follow up visual acuity declined in two cases because of uncontrolled diabetes and hypertension. Conclusion: Cataract surgery in diabetic patients with macular oedema and hypertension has a good visual outcome if prior macular grid laser is performed and intra-vitreal anti VEGF is injected during surgery. (author)

  14. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  15. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

  16. Cosmetic surgery.

    OpenAIRE

    1989-01-01

    The psychotherapeutic nature of cosmetic surgery is emphasised by outlining the range of symptoms from which patients suffer and by explaining the sequence of psychological reactions which cause them. The principles which govern the selection of patients are defined. A brief account of each of the main cosmetic operations is given together with notes on their limitations and risks.

  17. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard;

    2009-01-01

    ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in...

  18. The effect of early physiotherapy on the recovery of mandibular function after orthognathic surgery for class III correction. Part II: electromyographic activity of masticatory muscles.

    Science.gov (United States)

    Ko, Ellen Wen-Ching; Teng, Terry Te-Yi; Huang, Chiung Shing; Chen, Yu-Ray

    2015-01-01

    The study was conducted to evaluate the effect of early physical rehabilitation by comparing the differences of surface electromyographic (sEMG) activity in the masseter and anterior temporalis muscles after surgical correction of skeletal class III malocclusion. The prospective study included 63 patients; the experimental groups contained 31 patients who received early systematic physical rehabilitation; the control group (32 patients) did not receive physiotherapy. The amplitude of sEMG in the masticatory muscles reached 72.6-121.3% and 37.5-64.6% of pre-surgical values in the experimental and control groups respectively at 6 weeks after orthognathic surgery (OGS). At 6 months after OGS, the sEMG reached 135.1-233.4% and 89.6-122.5% of pre-surgical values in the experimental and control groups respectively. Most variables in the sEMG examination indicated that recovery of the masticatory muscles in the experimental group was better than the control group as estimated in the early phase (T1 to T2) and the total phase (T1 to T3); there were no significant differences between the mean recovery percentages in the later phase (T2 to T3). Early physical rehabilitative therapy is helpful for early recovery of muscle activity in masticatory muscles after OGS. After termination of physical therapy, no significant difference in recovery was indicated in patients with or without early physiotherapy.

  19. [Tumor surgery].

    Science.gov (United States)

    Hausamen, J E

    2000-05-01

    Surgery is still the primary therapeutic approach in treatment of tumors in the head and neck area, dating back to the early nineteenth century. More than 150 years ago, hemimaxillectomies and mandibular resections as well as hemiglossectomies were already performed by leading surgeons. The block principle we are now following dates back to Crile, who also established the principle of cervical lymph node dissection. Ablative oncologic surgery has always been closely linked with plastic and reconstructive surgery, rendering radical surgical interventions possible without disfiguring patients. The development of facial reconstructive surgery proceeded in stages, in the first instance as secondary reconstruction using tube pedicled flaps. The change to the concept of primary reconstruction occurred via arterialized skin flaps and myocutaneous flaps to the widely accepted and performed free tissue transfer. Free bone grafting, inaugurated earlier and still representing the majority of bone grafting, has been supplemented for certain reconstructive purposes by free vascularized bone transfer from various donor sites. Although the five-year-survival rate of carcinoma of the oral cavity has remained unchanged in the past 30 years, distinctive improvements in tumor surgery can be recorded. This is primarily based on improved diagnostics such as modern imaging techniques and the refinement of surgical techniques. The DOSAK has worked out distinctive guidelines for effective ablative oncologic surgery. Surgical approaches offering wide exposure and carrying low morbidity play a decisive role in radical resections. For this reason, midfacial degloving offers an essential improvement for the resection of midface tumors, especially from an aesthetic point of view. Tumors situated deep behind the viscerocranium at the skull base can be clearly exposed either through a lateral approach following a temporary osteotomy of the mandibular ramus or a transmandibular, transmaxillar, or

  20. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... more. Dental and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the ... more. Dental and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the ...

  1. LASIK - Laser Eye Surgery

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  2. Alternative Refractive Surgery Procedures

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  3. What Is Refractive Surgery?

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  4. American Board of Surgery

    Science.gov (United States)

    ... Exam Results Results of our fall exams in vascular surgery, pediatric surgery, surgical critical care and surgical oncology ... Feedback Joint Pathway - General & Thoracic Surgery Specialty Definition Vascular Surgery Training Pathways Related Policies Credit for Foreign Medical ...

  5. Facial Cosmetic Surgery

    Science.gov (United States)

    ... and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the soft tissues ... and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the soft tissues ...

  6. Dental Implant Surgery

    Science.gov (United States)

    ... and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the soft tissues ... and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons surgically treat the soft tissues ...

  7. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving ...

  8. Surgery for Breast Cancer

    Science.gov (United States)

    ... Next Topic Breast-conserving surgery (lumpectomy) Surgery for breast cancer Most women with breast cancer have some type ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  9. Scoliosis surgery - child

    Science.gov (United States)

    Spinal curvature surgery - child; Kyphoscoliosis surgery - child; Video-assisted thoracoscopic surgery - child; VATS - child ... Before surgery, your child will receive general anesthesia. This will make your child unconscious and unable to feel pain ...

  10. Heart bypass surgery

    Science.gov (United States)

    Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

  11. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

  12. The role of duodenogastric reflux in formation of precarcinogenic gastric lesions: An experimental study

    Directory of Open Access Journals (Sweden)

    Zlatić Aleksandar

    2013-01-01

    Full Text Available Introduction. Duodenogastric reflux, commonly encountered as an aftermath of gastroenteroanastomosis, with or without gastric resection (Billroth I, Billroth II, vagotomy and pyloroplastic surgery, is known to cause inflammatory-dystrophic-metaplastic lesions of gastric mucosa. Our objective was to determine the effects of surgery-induced duodenogastric reflux on the development of precarcinogenic lesions or carcinoma in correlation with the reflux duration. Material and Methods. The experiment was performed on three groups of Wistar rats with 1 Billroth II-induced reflux surgery, 2 resection of the Roux-en-Y type reconstruction, and 3 control group with no resection. The aim of the experiment was to study the effects of duodenogastric reflux on the rat gastric mucosa in correlation with two different types of gastroenteroanastomosis 8, 16 and 24 weeks after the surgery. Results. In Billroth II group, hyperplastic changes were observed as early as in week 16. Statistically significant results were recorded in week 24, with 6.7% of metaplastic alterations, including dysplasia of all three degrees, dominantly severe dysplasia in 66.67%, early carcinoma in 20% and gastric carcinoma in 6.67%. In the Roux-en-Y group, gastric mucosa remained predominantly normal (60%, with somewhat increased frequency of gastritis and dysplasia in week 24. In the control group, the finding of normal gastric mucosa was constant. Conclusion. The experiment confirms that direct contact of duodenal juice with gastric mucosa associated with Billroth II resection causes precarcinogenic lesions. Development of adenocarcinoma caused solely by duodenogastric reflux, excluding a carcinogenic agent is possible 20 weeks after the experiment - earlier than suggested by previous researchers.

  13. Orthognathic surgery with or without induced hypotension.

    Science.gov (United States)

    Carlos, E; Monnazzi, M S; Castiglia, Y M M; Gabrielli, M F R; Passeri, L A; Guimarães, N C

    2014-05-01

    This study involved a retrospective evaluation of patients subjected to surgery for dentofacial deformities treated without induced controlled hypotension (group I, n=50) and a prospective evaluation of patients who were subjected to surgery under hypotensive general anaesthesia (group II, n=50). No statistical differences were found between the study groups with regard to the duration of surgery. However, there were statistically significant differences in the need for blood transfusion and the occurrence of bradycardia during the maxillary down-fracture. Hypotensive anaesthesia decreased the need for a blood transfusion and the occurrence of bradycardia, and is therefore considered highly beneficial for patients undergoing orthognathic surgery.

  14. Accelerated Partial Breast Irradiation: 5-Year Results of the German-Austrian Multicenter Phase II Trial Using Interstitial Multicatheter Brachytherapy Alone After Breast-Conserving Surgery

    International Nuclear Information System (INIS)

    Purpose: To evaluate the impact of accelerated partial breast irradiation on local control, side effects, and cosmesis using multicatheter interstitial brachytherapy as the sole method for the adjuvant local treatment of patients with low-risk breast cancer. Methods and Materials: 274 patients with low-risk breast cancer were treated on protocol. Patients were eligible for the study if the tumor size was 35 years, hormone receptors were positive, and histologic grades were 1 or 2. Of the 274 patients, 175 (64%) received pulse-dose-rate brachytherapy (Dref = 50 Gy). and 99 (36%) received high-dose-rate brachytherapy (Dref = 32.0 Gy). Results: Median follow-up was 63 months (range, 9-103). Only 8 of 274 (2.9%) patients developed an ipsilateral in-breast tumor recurrence at the time of analysis. The 5-year actuarial local recurrence-free survival probability was 98%. The 5- year overall and disease-free survival probabilities of all patients were 97% and 96%, respectively. Contralateral in-breast malignancies were detected in 2 of 274 (0.7%) patients, and distant metastases occurred in 6 of 274 (2.2%). Late side effects ≥Grade 3 (i.e., breast tissue fibrosis and telangiectasia) occurred in 1 patient (0.4%, 95%CI:0.0-2.0%) and 6 patients (2.2%, 95%CI:0.8-4.7%), respectively. Cosmetic results were good to excellent in 245 of 274 patients (90%). Conclusions: The long-term results of this prospective Phase II trial confirm that the efficacy of accelerated partial breast irradiation using multicatheter brachytherapy is comparable with that of whole breast irradiation and that late side effects are negligible.

  15. The effects of sequence and type of chemotherapy and radiation therapy on cosmesis and complications after breast conserving surgery and radiation therapy in stage I and II breast cancer

    International Nuclear Information System (INIS)

    Purpose: Chemotherapy plays an increasingly important role in the treatment of both node negative and node positive breast cancer patients, but the optimal sequencing of chemotherapy and radiation therapy is not well established. Our goal is to evaluate the interaction of sequence and type of chemotherapy and hormonal therapy given with radiation therapy on the cosmetic outcome and the incidence of complications of stage I and II breast cancer patients treated with breast conserving therapy. Methods and Materials: The records of 1053 stage I and II breast cancer patients treated with curative intent with breast conserving surgery, axillary dissection and radiation therapy between 1977-91 were reviewed. Median follow-up after treatment was 80 months. 206 patients received chemotherapy alone, 141 patients received hormonal therapy alone, 94 patients received both and 612 patients received no adjuvant therapy. Patients who received chemotherapy +/- hormonal therapy were grouped according to sequence of chemotherapy: (a)concurrent = concurrent chemotherapy with radiation therapy followed by chemotherapy; (b)sequential = radiation followed by chemotherapy or chemotherapy followed by radiation; and (c)sandwich = chemotherapy followed by concurrent chemotherapy and radiation followed by chemotherapy. Compared to node negative patients, node positive patients more commonly received chemotherapy (77% vs. 9%, p2 cm difference in arm circumference) was 2% without chemotherapy vs. 9% with chemotherapy (p-.00001). However, the incidence of arm edema was not affected by sequencing or type of chemotherapy (all p>.40). Patients treated sequentially had a 10% incidence of grade 4 or 5 arm edema vs. 7% in the patients treated concurrently (p=.53). The incidence was 8% vs. 18% in patients treated with CMF vs. CAF (p=.19). The incidence of clinical pneumonitis and rib fracture was not influenced by use of chemotherapy, sequence of chemotherapy or use of hormonal therapy (all p>.13

  16. A novel blood-sparing agent in cardiac surgery? First in-patient experience with the synthetic serine protease inhibitor MDCO-2010: a phase II, randomized, double-blind, placebo-controlled study in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass

    OpenAIRE

    Englberger, Lars; Dietrich, Wulf; Eberle, Balthasar; Erdös, Gabor; Keller, Dorothee; Carrel, Thierry

    2014-01-01

    BACKGROUND Antifibrinolytics have been used for 2 decades to reduce bleeding in cardiac surgery. MDCO-2010 is a novel, synthetic, serine protease inhibitor. We describe the first experience with this drug in patients. METHODS In this phase II, double-blind, placebo-controlled study, 32 patients undergoing isolated primary coronary artery bypass grafting with cardiopulmonary bypass were randomly assigned to 1 of 5 increasing dosage groups of MDCO-2010. The primary aim was to evalua...

  17. Open heart surgery

    Science.gov (United States)

    Heart surgery - open ... lung machine is used in most cases during open heart surgery. While the surgeon works on the ... with these procedures, the surgeon may have to open the chest to do the surgery.

  18. Carotid artery surgery - discharge

    Science.gov (United States)

    ... Surgery, Society for Vascular Medicine, and Society for Vascular Surgery. J Am Coll Cardiol . 2011 Feb 22;57( ... 21288680 . Kinlay S, Bhatt DL. Treatment of noncoronary obstructive ... Textbook of Surgery . 19th ed. Elsevier Saunders; 2012:chap 63.

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Soft Tissue Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures Administration of Anesthesia Administration of Anesthesia Oral ...

  20. Ear Plastic Surgery

    Science.gov (United States)

    ... receive light-weight earrings. Does Insurance Pay for Cosmetic Ear Surgery? Insurance usually does not cover surgery solely for ... republication strictly prohibited without prior written permission. Ears Cosmetic Surgery, Facelift, Rhinoplasty, Blepharoplasty ... Get Involved Professional Development Practice ...

  1. Laser surgery - skin

    Science.gov (United States)

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  2. Surgery for pancreatic cancer

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007649.htm Surgery for pancreatic cancer To use the sharing features on this page, ... surgery are used in the surgical treatment of pancreatic cancer. Whipple procedure: This is the most common surgery ...

  3. A multistep approach to manage Fournier’s gangrene in a patient with unknown type II diabetes: surgery, hyperbaric oxygen, and vacuum-assisted closure therapy: a case report

    Directory of Open Access Journals (Sweden)

    Pastore Antonio Luigi

    2013-01-01

    Full Text Available Abstract Introduction Fournier’s gangrene is an infectious necrotizing fasciitis of the perineum and genital regions and has a high mortality rate. It is a synergistic infection caused by a mixture of aerobic and anaerobic organisms and predisposing factors, including diabetes mellitus, alcoholism, malnutrition, and low socioeconomic status. We report a case of Fournier’s gangrene in a patient with unknown type II diabetes submitted to 24-hour catheterization 15 days before gangrene onset. Case presentation The patient, a 60-year-old Caucasian man, presented with a swollen, edematous, emphysematous scrotum with a crepitant skin and a small circle of necrosis. A lack of resistance along the dartos fascia of the scrotum and Scarpa’s lower abdominal wall fascia combined with the presence of gas and pus during the first surgical debridement also supported the diagnosis of Fournier’s gangrene. On the basis of the microbiological culture, the patient was given multiple antibiotic therapy, combined hypoglycemic treatment, hyperbaric oxygen therapy, and several surgical debridements. After five days the infection was not completely controlled and a vacuum-assisted closure device therapy was started. Conclusions This report describes the successful multistep approach of an immediate surgical debridement combined with hyperbaric oxygen and negative pressure wound therapy. The vacuum-assisted closure is a well-known method used to treat complex wounds. In this case study, vacuum-assisted closure treatment was effective and the patient did not require reconstructive surgery. Our report shows that bladder catheterization, a minimally invasive maneuver, may also cause severe infective consequences in high-risk patients, such as patients with diabetes.

  4. Single incision laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    Arun; Prasad

    2010-01-01

    As a complement to standard laparoscopic surgery and a safe alternative to natural orifice transluminal endoscopic surgery,single incision laparoscopic surgery is gaining popularity.There are expensive ports,disposable hand instruments and flexible endoscopes that have been suggested to do this surgery and would increase the cost of operation.For a simple surgery like laparoscopic cholecystectomy,these extras are not needed and the surgery can be performed using standard ports,instruments and telescopes.Tri...

  5. Cosmetic Plastic Surgery Statistics

    Science.gov (United States)

    2014 Cosmetic Plastic Surgery Statistics Cosmetic Procedure Trends 2014 Plastic Surgery Statistics Report Please credit the AMERICAN SOCIETY OF PLASTIC SURGEONS when citing statistical data or using ...

  6. Gastric bypass surgery

    Science.gov (United States)

    ... Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass ... bypass surgery is not a quick fix for obesity. It will greatly change your lifestyle. After this surgery, you must eat healthy foods, control portion sizes of ...

  7. 1998-1999 Patterns of Care Study process survey of national practice patterns using breast-conserving surgery and radiotherapy in the management of Stage I-II breast cancer

    International Nuclear Information System (INIS)

    Purpose: The Patterns of Care Study survey process evaluation has been an effective means of assessing the evaluation and treatment practices used by radiation oncologists in the United States for Stage I-II breast cancer. The current 1998-1999 report updates the previous 1989 and 1993-1994 analyses and reflects the recent changes in surgery and systemic therapy observed nationally in the management of early-stage disease. Methods and Materials: A weighted sample size of 71,877 patient records of women treated with breast-conserving surgery and radiotherapy (RT) was obtained from a stratified two-stage sampling of 353 patient records. These cases were centrally reviewed from academic and private radiation oncology practices across the United States. The data collected included patient characteristics, clinical and pathologic factors, and surgical and RT details. The results were compared with those of previous Patterns of Care Study survey reports. Results: Of the patients in the current survey, 97% had undergone mammography before biopsy. A review of the primary tumor pathologic findings indicated improved quantification of an intraductal component from 7.0% in 1993-1994 to 20.4% in 1998-1999 (p = 0.01). The tumor characteristics were better defined, with estrogen and progesterone receptor measurement performed in 91.4% and 91.3% in the 1998-1999 survey vs. 83.7% and 80.3% in the 1989 survey, respectively (p = 0.03 and p = 0.002, respectively). Axillary dissection was performed in 82.2% in the present survey compared with 93.6% in the 1993-1994 survey (p = 0.0004); sentinel node biopsy was performed in 20.1% of the present cases. The use of CT for planning was increased in the current survey, with 22.9% cases CT planned vs. 9% in 1993-1994 (p = 0.10). In the present survey, 100% had received whole breast RT. When a supraclavicular field was added, the dose was prescribed to a specified depth in 67.5% of cases, most commonly 3 cm. When an axillary field was added

  8. [What do general, abdominal and vascular surgeons need to know on plastic surgery - aspects of plastic surgery in the field of general, abdominal and vascular surgery].

    Science.gov (United States)

    Damert, H G; Altmann, S; Stübs, P; Infanger, M; Meyer, F

    2015-02-01

    There is overlap between general, abdominal and vascular surgery on one hand and plastic surgery on the other hand, e.g., in hernia surgery, in particular, recurrent hernia, reconstruction of the abdominal wall or defect closure after abdominal or vascular surgery. Bariatric operations involve both special fields too. Plastic surgeons sometimes use skin and muscle compartments of the abdominal wall for reconstruction at other regions of the body. This article aims to i) give an overview about functional, anatomic and clinical aspects as well as the potential of surgical interventions in plastic surgery. General/abdominal/vascular surgeons can benefit from this in their surgical planning and competent execution of their own surgical interventions with limited morbidity/lethality and an optimal, in particular, functional as well as aesthetic outcome, ii) support the interdisciplinary work of general/abdominal/vascular and plastic surgery, and iii) provide a better understanding of plastic surgery and its profile of surgical interventions and options.

  9. ERCP with double-channel endoscope for patients with Billroth-Ⅱ gastroenterostomy%双腔前视胃镜治疗毕Ⅱ式胃空肠吻合术后胆胰疾病的临床观察

    Institute of Scientific and Technical Information of China (English)

    姚炜; 黄永辉; 常虹; 黄雪彪; 李柯

    2014-01-01

    Objective To evaluate the therapeutic effect and safety of forward-viewing,doublechannel endoscope in the process of ERCP in patients with bile duct diseases after Billroth-Ⅱ gastroenterostomy.Methods ERCP was applied to 46 patients with bile duct diseases using forward-viewing,doublechannel endoscope.All patients had the history of Billroth-Ⅱ gastroenterostomy.The success rate of selective cannulation,complication rate and the outcome of all the patients were recorded.Results The procedure succeeded in 38 patients with a success rate of 82.6%,and failed in 8.Of all the failing cases,the afferent loop couldn't be accessed in 6,failure in biliary cannulation in 2.Of 38 successful cases,bile duct stones were successfully removed in 31,metal stents placed for malignant bile duct obstruction in 4,and endoscopic balloon dilation for benign common bile duct stricture in 3.All patients recovered without complications of perforation,delayed bleeding or pancreatitis.Conclusion For patients with history of Billroth-Ⅱgastroenterostomy,ERCP with forward-viewing,double-channel endoscope yields to a higher success rate and lower complication rate.%目的 评价使用双腔前视胃镜对毕Ⅱ式胃空肠吻合术后胆胰疾病患者进行经内镜逆行胰胆管造影术(ERCP)治疗的疗效及安全性.方法 回顾性总结46例使用双腔前视胃镜进行ERCP治疗的毕Ⅱ式胃空肠吻合术后胆胰疾病患者的临床资料,统计十二指肠乳头插管成功率、并发症发生情况和治疗情况.结果 十二指肠乳头插管成功率为82.6% (38/46),8例失败,其中6例因双腔前视胃镜无法进入输入袢找到十二指肠乳头而失败,2例因乳头插管困难而失败.38例插管成功者中,31例胆管结石者均成功取出结石,4例胆总管下端恶性梗阻者均成功置入胆管金属支架,3例十二指肠乳头良性狭窄者经气囊扩张后均成功置入鼻胆引流管;所有患者术后恢复良好,无一例发生出血

  10. [Andreas Vesalius and surgery].

    Science.gov (United States)

    Van Hee, R

    1993-01-01

    By publishing De Humani Corporis Fabrica Libri Septem in 1543, Andries van Wesel (1514-1564) gave surgical science an immense impulse. The revolutionary renovation in the knowledge of man's anatomical structure changed slowly and progressively into topographical and physiological understanding of surgical diseases. At the same time, this made better aimed and more secure operations possible. Apart from the importance of this anatomical publication, Andreas Vesalius also won his spurs as a surgeon. He taught surgery in Padua for many years. He was appointed court physician and surgeon at the Habsburg Court of Charles V and Philip II. He personally performed lots of operations known at the time as major ones. He not only quickly adopted the surgical innovations of his fellow-surgeon Ambroise Paré, but he even performed operations that had been forgotten during several centuries, among which thoracocentesis for pleural empyema. His clinical perspicacity in discovering the indication for some operations was staggering and was appreciated by all great monarchs of Europe in the 16th century. In his several consilia, numerous pieces of advice were given for the treatment of surgical patients. The surgical practice which Vesalius had in Brussels for many years, consequently became most successful. Many publications by Vesalius about surgery and blood-letting are well-known. His Chirurgia magna in septem Libros digesta still remains controversial; these books were published by Prospero Borgarruccio (1560) in 1568 by the Venetian editor Valgrisi. This book gives an excellent survey of surgical pathology as it was taught and treated in the 16th century. The scientific method that Vesalius used, not only in his anatomical studies but also in his surgical practice, deserves not only our full appraisal but should still be studied in our own time.

  11. Oncoplastia surgery breast conservation. First results

    International Nuclear Information System (INIS)

    Oncoplastic surgery is an important tool in the treatment patients with breast cancer stages I and II. A prospective study descriptive period between October 2005 and October 2006, which included 10 patients younger than 60 years in stages I and II, selected from the universe that came to the National Cancer Institute and Havana Radiobiology (INOR), following the inclusion criteria and exclusion. Were assessed before and after surgery from surveys that collected data questioning the patients and data clinical examination performed by the plastic surgeon. The predominant lesion was invasive ductal cancer and most patients were in stage I. There were no loco-regional recurrence in 2 year period. The most common complication was dehiscence surgical wound. Good aesthetic results were obtained in sixty percent of cases. It is confirmed that the surgery is Breast Oncoplastic very effective for the oncological safety and promising in terms of aesthetic results. (Author)

  12. Weight Loss Surgery

    Science.gov (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you ... caused by obesity. There are different types of weight loss surgery. They often limit the amount of food ...

  13. Spine surgery - discharge

    Science.gov (United States)

    ... Vertebral interbody fusion - discharge; Posterior spinal fusion - discharge; Arthrodesis - discharge; Anterior spinal fusion - discharge; Spine surgery - spinal fusion - discharge Images Spinal surgery -- cervical - series References Agrawal BM, Zeidman SM, Rhines L, ...

  14. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  15. Refractive corneal surgery - discharge

    Science.gov (United States)

    ... after surgery, it should be okay to use artificial tears. Check with your doctor. Do NOT wear contact lenses on the eye that had surgery, even if you have blurry vision. Do NOT use any makeup, creams, or lotions ...

  16. Bariatric Surgery Misconceptions

    Science.gov (United States)

    ... from depression or anxiety and to have lower self-esteem and overall quality of life than someone who ... is a Candidate for Bariatric Surgery? Childhood and Adolescent Obesity Find a Provider Benefits of Bariatric Surgery ...

  17. Cosmetic ear surgery

    Science.gov (United States)

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  18. Hip fracture surgery

    Science.gov (United States)

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis-hip ... You may receive general anesthesia before this surgery. This means ... spinal anesthesia. With this kind of anesthesia, medicine is ...

  19. Coronary Artery Bypass Surgery

    Science.gov (United States)

    ... don't help, you may need coronary artery bypass surgery. The surgery creates a new path for ... narrowed area or blockage. This allows blood to bypass (get around) the blockage. Sometimes people need more ...

  20. Robotic liver surgery.

    Science.gov (United States)

    Leung, Universe; Fong, Yuman

    2014-10-01

    Robotic surgery is an evolving technology that has been successfully applied to a number of surgical specialties, but its use in liver surgery has so far been limited. In this review article we discuss the challenges of minimally invasive liver surgery, the pros and cons of robotics, the evolution of medical robots, and the potentials in applying this technology to liver surgery. The current data in the literature are also presented. PMID:25392840

  1. Development of plastic surgery

    OpenAIRE

    Pećanac Marija Đ.

    2015-01-01

    Introduction. Plastic surgery is a medical specialty dealing with corrections of defects, improvements in appearance and restoration of lost function. Ancient Times. The first recorded account of reconstructive plastic surgery was found in ancient Indian Sanskrit texts, which described reconstructive surgeries of the nose and ears. In ancient Greece and Rome, many medicine men performed simple plastic cosmetic surgeries to repair damaged parts of the body c...

  2. MOCK SURGERIES IN AYURVEDA

    OpenAIRE

    Bali Yogitha

    2012-01-01

    The present trend is very well aware of mock tests, exams and even the mock surgeries that are very common in healthcare and play an important role in providing the surgeons, the necessary practical knowledge and expertise in their specialized field. In addition, patients also get benefited by the mock surgeries by having the complete knowledge before they undergo any surgery. The same concept of mock or the experimental surgeries can be found explained centuries ago by Susrutha, father of bo...

  3. Pediatric heart surgery

    Science.gov (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

  4. The effects of stimulation of the autonomic nervous system via perioperative nutrition on postoperative ileus and anastomotic leakage following colorectal surgery (SANICS II trial): a study protocol for a double-blind randomized controlled trial

    OpenAIRE

    Peters, Emmeline G; Smeets, Boudewijn JJ; Dekkers, Marloes; Buise, Marc D; de Jonge, Wouter J.; Slooter, Gerrit D; Reilingh, Tammo S de Vries; Wegdam, Johannes A; Nieuwenhuijzen, Grard AP; Rutten, Harm JT; de Hingh, Ignace HJT; Hiligsmann, Mickael; Buurman, Wim A.; Luyer, Misha DP

    2015-01-01

    Background Postoperative ileus and anastomotic leakage are important complications following colorectal surgery associated with short-term morbidity and mortality. Previous experimental and preclinical studies have shown that a short intervention with enriched enteral nutrition dampens inflammation via stimulation of the autonomic nervous system and thereby reduces postoperative ileus. Furthermore, early administration of enteral nutrition reduced anastomotic leakage. This study will investig...

  5. RECURRENCE PATTERN FOLLOWING BREAST - CONSERVING SURGERY FOR EARLY BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Govindaraj

    2015-08-01

    Full Text Available OBJECTIVE: To study the Local Recurrence and metastasis pattern after Breast - Conserving Surgery for early breast cancer. MATERIALS AND METHODS: From 2010 to 2014 in department of surgery in VIMS Bellary, 70 patients with stage I or II invasive breast carcinoma were treated with breast - conserving surgery, radiation and chemotherapy. In this study we investigated the prognostic value of clinical and pathological factors in early breast cancer patients treated with BCS. All of the surgeries were performed by a single surgical team. Recurrence and its risk factors were evaluated.

  6. Phytobezoar: a recurring abdominal problem.

    Science.gov (United States)

    Hines, J R; Guerkink, R E; Gordon, R T; Weinermann, P

    1977-06-01

    Phytobezoars often follow gastric surgery for peptic ulcer disease. Billroth I resections have a high incidence of gastric bezoars, especially if accompanied by vagotomy. The larger opening of a Billroth II resection may result in intestinal bezoars with obstruction in the narrow terminal ileum. Gastric bezoars can be treated with enzymes or can be broken up by endoscopy; only rarely is operative removal required. Intestinal bezoars can be treated by long-tube and enzyme instillation but usually require laparotomy. If possible, the bolus should be milked into the cecum, but enterotomy or even resection may be required. Prevention is the best treatment and can be carried out by instructing patients who have had gastric surgery to avoid the fibrous portion of oranges and grapefruit and to avoid persimmons.

  7. One-year results of coronary revascularization in diabetic patients with multivessel coronary artery disease.Sirolimus stent vs. coronary artery bypass surgery and bare metal stent: insights from ARTS-II and ARTS-I.

    OpenAIRE

    Macaya, Carlos; Garcia-Garcia, Hector M; Colombo, Antonio; Morice, Marie-Claude; LEGRAND, Victor; Kuck, Karl-Heinz; Sheiban, Imad; Suttorp, Maarten Jan; Carrie, Didier; Vrolix, Mathias; Wittebols, Kristel; Stoll, Hans-Peter; Donohoe, Dennis; Bressers, Marco; Serruys, Patrick W.

    2006-01-01

    Background: ARTS-II was designed to evaluate the sirolimus-eluting stent (SES) versus ARTS-I. The objective of this analysis is to assess the safety and efficacy of the SES in diabetic patients with multivessel disease (MVD) versus both arms of ARTS-I.Methods and results: The ARTS studies included 367 diabetic patients (ARTS-II: 159; ARTS-I-CABG: 96; ARTS-I-PCI: 112). Baseline characteristics showed a more diseased patient population in the ARTS-II study: 50.3% with 3VD vs. 35.4% (ARTS-I-CABG...

  8. Avaliação da alteração do plano oclusal em cirurgias ortognáticas combinadas com utilização de fixação interna rígida em pacientes com padrão facial de Classe II Evaluation of occlusal plane alteration in Orthognathic Surgeries combined with rigid internal fixation in Class II skeletal facial standard patients

    Directory of Open Access Journals (Sweden)

    Karina Eiras Dela Coleta Pizzol

    2006-08-01

    Full Text Available OBJETIVO: avaliar a estabilidade de cirurgias bimaxilares com fixação interna rígida, na qual promoveu-se uma rotação anti-horária da mandíbula e conseqüente redução do ângulo do plano oclusal. METODOLOGIA: foram estudados 15 pacientes com padrão facial de Classe II e deficiência mandibular. Os movimentos cirúrgicos foram avaliados por meio de medidas lineares e angulares realizadas no programa CefX, obtidas de telerradiografias cefalométricas em norma lateral em três diferentes tempos: (T0 pré-operatório, (T1 pós-operatório imediato e (T2 pós-operatório de no mínimo 6 meses. RESULTADOS E CONCLUSÕES: os resultados demonstraram que a cirurgia bimaxilar promove mudanças faciais significativas e, principalmente, que a rotação anti-horária da mandíbula com redução do ângulo do plano oclusal mostrou-se estatisticamente estável, sendo uma opção confiável em cirurgias de pacientes com padrão facial de Classe II com deficiência mandibular.AIM: to access the surgical stability combined with rigid internal fixation, where the counter-clockwise jaw rotation was carried out, and consequently the occlusal plane reduction. METHODS: fifteen Class II skeletal facial standard patients were studied. The surgical movements were assessed by linear measures and angles accomplished at the CefX program, collected from cephalometric teleradiography lateral norms in three different moments: (T0 presurgical, (T1 instantaneous postsurgical and (T2 postsurgical at least six months. RESULTS AND CONCLUSION: the results showed that the bimaxillary surgery causes meaningful facial changes and mainly, the counter-clockwise mandible rotation and consequently the occlusal plane angle reduction showed statistically stable, suggesting a reliable opinion in Class II standard facial surgeries with defective mandibular.

  9. [Single Port Thoracic Surgery and Reduced Port Thoracic Surgery].

    Science.gov (United States)

    Onodera, Ken; Noda, Masafumi

    2016-07-01

    Single port thoracic surgery, reduced port surgery and needlescopic surgery attract attention as one of the minimally invasive surgery in thoracic surgery recently. Single port thoracic surgery was advocated by Rocco in 2004, it was reported usefulness of single port thoracic surgery for primary spontaneous pneumothorax. The surgical procedure as single (or reduced) port thoracic surgery is roughly divided into the following. One is operated with instruments inserted from the single extended incision, and the other is operated with instruments punctured without extending incision. It is not generally complicated procedures in single port thoracic surgery. Primary spontaneous pneumothorax and biopsy for lung and pleura are considered the surgical indication for single (or reduced) port surgery. It is revealed that single port surgery for primary spontaneous pneumothorax is less invasive than conventional surgery. Single port and reduced port thoracic surgery will spread furthermore in the future. PMID:27440029

  10. Energy systems in surgery

    OpenAIRE

    Pantelić Miloš; Ljikar Jelena; Devečerski Gordana; Karadžić Jelena

    2015-01-01

    Introduction. The systems of energy in surgery are applied in order to achieve better and more effective performing of procedures. Whereas various energy sources, including electricity, ultrasound, laser and argon gas, may be used, the fundamental principle involves tissue necrosis and hemostasis by heating. Electro Surgery. Electro Surgery is a surgical technique by which surgical procedures are performed by focused heating of the tissue using devices base...

  11. Complications of strabismus surgery

    Directory of Open Access Journals (Sweden)

    Scott E Olitsky

    2015-01-01

    Full Text Available All surgeries carry risks of complications, and there is no way to avoid ever having a complication. Strabismus surgery is no different in this regard. There are methods to reduce the risk of a complication during or after surgery, and these steps should always be taken. When a complication occurs, it is important to first recognize it and then manage it appropriately to allow for the best outcome possible. This article will discuss some of the more common and/or most devastating complications that can occur during or after strabismus surgery as well as thoughts on how to avoid them and manage them should they happen.

  12. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B;

    1994-01-01

    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553......, 78% stated that their quality of life had improved or was unchanged after surgery and had resumed working. These data justify a therapeutically aggressive approach, including ICU therapy following AAA surgery, despite failure of one or more organ systems....

  13. Surgery center joint ventures.

    Science.gov (United States)

    Zasa, R J

    1999-01-01

    Surgery centers have been accepted as a cost effective, patient friendly vehicle for delivery of quality ambulatory care. Hospitals and physician groups also have made them the vehicles for coming together. Surgery centers allow hospitals and physicians to align incentives and share benefits. It is one of the few types of health care businesses physicians can own without anti-fraud and abuse violation. As a result, many surgery center ventures are now jointly owned by hospitals and physician groups. This article outlines common structures that have been used successfully to allow both to own and govern surgery centers.

  14. Hyperoxaluria and Bariatric Surgery

    Science.gov (United States)

    Asplin, John R.

    2007-04-01

    Bariatric surgery as a means to treat obesity is becoming increasingly common in the United States. An early form of bariatric surgery, the jejunoileal bypass, had to be abandoned in 1980 due to numerous complications, including hyperoxaluria and kidney stones. Current bariatric procedures have not been systematically evaluated to determine if they cause hyperoxaluria. Presented here are data showing that hyperoxaluria is the major metabolic abnormality in patients with bariatric surgery who form kidney stones. Further studies are needed to assess the prevalence of hyperoxaluria in all patients with bariatric surgery.

  15. Lung surgery - discharge

    Science.gov (United States)

    Thoracotomy - discharge; Lung tissue removal - discharge; Pneumonectomy - discharge; Lobectomy - discharge; Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - ...

  16. Indications and contraindications for surgery in esophageal cancer

    International Nuclear Information System (INIS)

    In this story we will present the main problems that we have as a surgeons at the moment to decide the indication for surgery in patients with esophageal cancer. Undoubtedly, the patient that will be submitted to surgery must have strict criteria in order to obtain good results. The patient must be compensated from respiratory, cardiovascular, hepatic and renal point of view with a (IMC) above 20, with Karnofsky index above 80% (wanders well), that declares the acceptance of surgery as well as the conserved appetite. After deciding the surgery according to the general conditions, should be discuss the type of procedure, based primarily on tumor topography, because there are different results both morbidity and long-term survival. The indications for resection or palliative surgery depend on the tumor stage. The indications for resection surgery with conventional or eventual extended lymphadenectomy require a patient in good condition, good experience the surgical team and a good hospital support. In tumor stage I the indication is a supposedly curative surgery. The tumor stages II b, III and IV are the heritage of palliative surgery, with or without tumor resection. The age is not an absolute contraindication for surgery, but the hypertension, liver cirrhosis, respiratory diseases with severe functional impact, ischemic heart disease, dilated heart with lowered LVEF, severe psychological disorders and the loss of appetite are contraindication. The morbidity and mortality has declined markedly due to technological advances and specialization of surgical groups, so that surgery is still the best treatment for selected patients

  17. Efficacy observation of acetabular cups of hip replacement surgery on adult hip crowe II and III dysplasia%大臼杯全髋关节置换术治疗 CroweⅡ~Ⅲ型成人髋关节发育不良疗效观察

    Institute of Scientific and Technical Information of China (English)

    谢贵杰; 何森荣; 甘伟伟

    2014-01-01

    目的:总结大型臼杯生物型人工全髋关节置换术治疗CroweⅡ~Ⅲ型成人髋关节发育的早期疗效。方法12例12髋, CroweⅡ型为7例,CroweⅢ型为5例,全髋关节置换术臼杯外径58~64 mm,假体选用国产爱康宜诚公司生产的假体。结果随访2~3年。髋关节功能Harris标准评分平均92分,其中功能优9例,良3例,目前尚无1例需行翻修。结论对部分CroweⅡ、Ⅲ型成人髋关节发育不良,采用大型臼杯全髋关节置换术治疗早期能够获得满意的临床疗效。%Objective To summize the early efficacy of large-scare acetabular cups of hip replacement surgery on adult hip Crowe II and III dysplasia .Methods There were 12 patients in which 7 cases were Crowe II and 5 cases were Crowe III .The outside diameter of acetabular cup for total hip replacement surgery was 58~64 mm.Ai-Kang prostheses which were made in China were used .Results The patients were followed up for 2 to 3 years.The average Harris hip standard score was 92.The hip functions of 9 cases were excel-lent and those of 3 cases were good .No case needed to restore .Conclusions For some cases of adult hip Crowe II and III dysplasia , early hip replacement surgery with large-scare acetabular cups can obtain satisfactory clinical effect .

  18. Revision Knee Surgery

    Medline Plus

    Full Text Available Revision Knee Surgery Featuring the Zimmer® NexGen® LCCK System. Zimmer, Inc. Indio, California March 31, 2010 Welcome to this ... surgery, demonstrating the role of the NexGen LCCK Knee Revision System. If we could go to the ...

  19. [Cognitive deterioration after surgery

    DEFF Research Database (Denmark)

    Steinmetz, J.; Rasmussen, L.S.

    2008-01-01

    Delirium and postoperative cognitive dysfunction are important and common complications after surgery. Risk factors are first of all increasing age and type of surgery, whereas the type of anaesthesia does not seem to play an important role. Mortality is higher among patients with cognitive...

  20. Less extensive surgery compared to extensive surgery

    DEFF Research Database (Denmark)

    Lauszus, Finn F; Petersen, Astrid C; Neumann, Gudrun;

    2014-01-01

    -up by hospital data files, general practitioner, death certificate, and autopsy report. Revision of histopathology by a single pathologist. Main outcome measures: Survival and relapse by clinical data, stage, and type of surgery. RESULTS: The incidence of AGCT was 1.37 per year per 100,000 women (95% CI: 1.08, 1...

  1. Paclitaxel, Bevacizumab And Adjuvant Intraperitoneal Carboplatin in Treating Patients Who Had Initial Debulking Surgery for Stage II, Stage III, or Stage IV Ovarian Epithelial, Primary Peritoneal, or Fallopian Tube Cancer

    Science.gov (United States)

    2014-06-18

    Brenner Tumor; Fallopian Tube Cancer; Ovarian Clear Cell Cystadenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mixed Epithelial Carcinoma; Ovarian Mucinous Cystadenocarcinoma; Ovarian Serous Cystadenocarcinoma; Ovarian Undifferentiated Adenocarcinoma; Primary Peritoneal Cavity Cancer; Stage II Ovarian Epithelial Cancer; Stage III Ovarian Epithelial Cancer; Stage IV Ovarian Epithelial Cancer

  2. Tests and visits before surgery

    Science.gov (United States)

    Before surgery - tests; Before surgery - doctor visits ... Pre-op is the time before your surgery. It means "before operation." During this time, you will meet with one of your doctors. This may be your surgeon or primary care ...

  3. Surveys on surgery theory

    CERN Document Server

    Cappell, Sylvain; Rosenberg, Jonathan

    2014-01-01

    Surgery theory, the basis for the classification theory of manifolds, is now about forty years old. There have been some extraordinary accomplishments in that time, which have led to enormously varied interactions with algebra, analysis, and geometry. Workers in many of these areas have often lamented the lack of a single source that surveys surgery theory and its applications. Indeed, no one person could write such a survey. The sixtieth birthday of C. T. C. Wall, one of the leaders of the founding generation of surgery theory, provided an opportunity to rectify the situation and produce a

  4. Surveys on surgery theory

    CERN Document Server

    Cappell, Sylvain; Rosenberg, Jonathan

    2014-01-01

    Surgery theory, the basis for the classification theory of manifolds, is now about forty years old. The sixtieth birthday (on December 14, 1996) of C.T.C. Wall, a leading member of the subject''s founding generation, led the editors of this volume to reflect on the extraordinary accomplishments of surgery theory as well as its current enormously varied interactions with algebra, analysis, and geometry. Workers in many of these areas have often lamented the lack of a single source surveying surgery theory and its applications. Because no one person could write such a survey, the editors ask

  5. Single port laparoscopic surgery

    DEFF Research Database (Denmark)

    Springborg, Henrik; Istre, Olav

    2012-01-01

    LESS, or laparo-endoscopic single site surgery, is a promising new method in minimally invasive surgery. An increasing number of surgical procedures are being performed using this technique, however, its large-scale adoption awaits results of prospective randomized controlled studies confirming...... potential benefits. Theoretically, cosmetic outcomes, postoperative pain and complication rates could be improved with use of single site surgery. This study describes introduction of the method in a private hospital in Denmark, in which 40 patients have been treated for benign gynecologic conditions...

  6. Non Invasive Transcutaneous Carbondioxide Monitoring in Adult Open Heart Surgery

    OpenAIRE

    UÇAR, P.; GAZİOĞLU, G.; ERDEMLİ, Ö.; ÇİÇEK, Ö. F.; DEMİR, A.

    2013-01-01

    Non Invasive Transcutaneous Carbondioxide Monitoring in Adult Open Heart SurgeryObjective: Follow-up of CO level during open heart surgery is crucial in terms of monitoring and management of the metabolic status. In this prospective observational study,measurement of end tidal CO and arterial CO levels in adult open heart surgery was compared with transcutaneous CO monitoring which is a non-invasive method.Material and Method: The study included 22 ASA II-III patients with an age range of 30-...

  7. Nose surgery - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100070.htm Nose surgery - series To use the sharing features on ... 4 out of 4 Normal anatomy Overview The nose is made up of bone and cartilage. The ...

  8. Blood donation before surgery

    Science.gov (United States)

    ... type of donor blood. Many communities have a blood bank where healthy people can donate blood. This blood ... need to arrange with your hospital or local blood bank before your surgery to have directed donor blood. ...

  9. Retrosternal thyroid surgery

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007558.htm Retrosternal thyroid surgery To use the sharing features on this page, please enable JavaScript. The thyroid gland is normally located at the front of ...

  10. Corrective Jaw Surgery

    Medline Plus

    Full Text Available AAOMS - Oral and maxillofacial surgeons. The experts in face, mouth and jaw surgery.™ What We Do Who ... surgeons surgically treat the soft tissues of the face, mouth and gums to improve function, appearance and ...

  11. Knee microfracture surgery

    Science.gov (United States)

    Cartilage regeneration - knee ... Three types of anesthesia may be used for knee arthroscopy surgery: Medicine to relax you, and shots of painkillers to numb the knee Spinal (regional) anesthesia General anesthesia (you will be ...

  12. Surgery for Testicular Cancer

    Science.gov (United States)

    ... have sex. But if both testicles are removed, sperm cells cannot be produced and a man becomes ... sparing surgery with their doctors, as well as sperm banking (freezing and storing sperm cells obtained before ...

  13. Smoking and surgery

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000437.htm Smoking and surgery To use the sharing features on ... you succeed. There Are Many Reasons to Quit Smoking Tar, nicotine, and other chemicals from smoking can ...

  14. Types of Heart Surgery

    Science.gov (United States)

    ... or heart wall with a patch or graft. Heart Transplant A heart transplant is surgery to remove a person's diseased heart ... a healthy heart from a deceased donor. Most heart transplants are done on patients who have end-stage ...

  15. INDIRECT MICROLARYNGOSTROBOSCOPIC SURGERY

    NARCIS (Netherlands)

    MAHIEU, HF; DIKKERS, FG

    1992-01-01

    Detailed preoperative laryngostroboscopic examination is a prerequisite for phonosurgical correction of organic dysphonia. Although suspension microlaryngoscopic surgery has proved its value in the past, it excludes functional control during the removal of vocal fold swellings. Using an indirect mic

  16. Robotics in Colorectal Surgery

    Science.gov (United States)

    Weaver, Allison; Steele, Scott

    2016-01-01

    Over the past few decades, robotic surgery has developed from a futuristic dream to a real, widely used technology. Today, robotic platforms are used for a range of procedures and have added a new facet to the development and implementation of minimally invasive surgeries. The potential advantages are enormous, but the current progress is impeded by high costs and limited technology. However, recent advances in haptic feedback systems and single-port surgical techniques demonstrate a clear role for robotics and are likely to improve surgical outcomes. Although robotic surgeries have become the gold standard for a number of procedures, the research in colorectal surgery is not definitive and more work needs to be done to prove its safety and efficacy to both surgeons and patients. PMID:27746895

  17. Tennis elbow surgery - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000657.htm Tennis elbow surgery - discharge To use the sharing features ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed ...

  18. Breast augmentation surgery

    Science.gov (United States)

    ... a sac filled with either sterile salt water (saline) or a material called silicone. The surgery is ... sensation around the nipple with this method. A saline implant may be placed through a cut near ...

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... experts in face, mouth and jaw surgery.™ What We Do Who We Are News Videos Contact Find a Surgeon What We Do Administration of Anesthesia Administration of Anesthesia Oral ...

  20. Lung Carcinoid Tumor: Surgery

    Science.gov (United States)

    ... Research Get Involved Find Local ACS Learn About Cancer » Lung Carcinoid Tumor » Detailed Guide » Surgery to treat lung carcinoid tumors Share this Page Close Push escape to close share window. Print ...

  1. Pediatric heart surgery - discharge

    Science.gov (United States)

    ... second day and can sometimes be managed with acetaminophen (Tylenol). Many children behave differently after heart surgery. ... Tiredness all the time Bluish or grayish skin Dizziness, fainting, or heart palpitations Feeding problems or reduced ...

  2. Expectations of Sinus Surgery

    Science.gov (United States)

    ... Q&A Complications of Sinusitis Epistaxis (Nosebleeds) Allergic Rhinitis (Hay Fever) Headaches and Sinus Disease Disorders of ... a prescription for pain medication to help you control pain during your recovery from surgery. Patients who ...

  3. Endoscopic Sinus Surgery

    Science.gov (United States)

    ... eye, face or brain, nasal polyps (See Figure, black arrows) , impaired sense of smell, tumors of the ... second opinion from another surgeon. What is endoscopic skull base surgery? Over the course of the last ...

  4. Is day surgery safe?

    DEFF Research Database (Denmark)

    Majholm, Birgitte; Engbæk, J; Bartholdy, Jens;

    2012-01-01

    Day surgery is expanding in several countries, and it is important to collect information about quality. The aim of this study was to assess morbidity and unanticipated hospital visits 0-30 days post-operatively in a large cohort.......Day surgery is expanding in several countries, and it is important to collect information about quality. The aim of this study was to assess morbidity and unanticipated hospital visits 0-30 days post-operatively in a large cohort....

  5. Future of cosmetic surgery.

    Science.gov (United States)

    Goldberg, Robert Alan

    2014-04-01

    Changes in cosmetic surgery will be driven by several key forces. The patient's self-image, and perceived place in society, will continue to drive patients to the cosmetic surgeon as well as to demand newer and better treatments. Technological advances, especially those based on an enhanced understanding of cellular and tissue physiology, promise enhanced tools other than the scalpel for the surgeon. Conceptual advances in our understanding of beauty and patient psychology will lead to a more integrative approach to cosmetic surgery.

  6. Minimally Invasive Thoracic Surgery

    OpenAIRE

    McFadden, P. Michael

    2000-01-01

    To reduce the risk, trauma, and expense of intrathoracic surgical treatments, minimally invasive procedures performed with the assistance of fiberoptic video technology have been developed for thoracic and bronchial surgeries. The surgical treatment of nearly every intrathoracic condition can benefit from a video-assisted approach performed through a few small incisions. Video-assisted thoracoscopic and rigid-bronchoscopic surgery have improved the results of thoracic procedures by decreasing...

  7. Cosmetic Facial Surgery

    OpenAIRE

    Adamson, Peter A.

    1987-01-01

    Canadians have committed themselves to a healthier lifestyle, and many are seeking to look as well as they feel. For patients with realistic expectations, modern techniques of cosmetic facial surgery can enhance appearance and be of psychological benefit. Today most procedures can be done under local anesthesia on an out-patient basis. Facial contour defects can be improved by means of procedures such as rhinoplasty, mentoplasty, otoplasty and malarplasty. Facial rejuvenation surgery to decre...

  8. Complications of pancreatic surgery

    OpenAIRE

    Åke Andrén-Sandberg

    2011-01-01

    Many diseases, including pancreatitis benign tumors and cancer, may require pancreas surgery. Pancreatic resection can lead to a prolonged survival in pancreatic cancer and even a potential chance for cure. However, the pancreatic surgery can result in complications, and high postoperative morbidity rates are still presence. This article reviews the pancreatic abstracts of American Pancreas Club 2011, which involves the more common complications, their prevention and treatment.

  9. Robotic surgery in gynecology.

    Science.gov (United States)

    Sinha, Rooma; Sanjay, Madhumati; Rupa, B; Kumari, Samita

    2015-01-01

    FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon's console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D) vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over. PMID:25598600

  10. Robotic surgery in gynecology

    Directory of Open Access Journals (Sweden)

    Rooma Sinha

    2015-01-01

    Full Text Available FDA approved Da Vinci Surgical System in 2005 for gynecological surgery. It has been rapidly adopted and it has already assumed an important position at various centers where this is available. It comprises of three components: A surgeon′s console, a patient-side cart with four robotic arms and a high-definition three-dimensional (3D vision system. In this review we have discussed various robotic-assisted laparoscopic benign gynecological procedures like myomectomy, hysterectomy, endometriosis, tubal anastomosis and sacrocolpopexy. A PubMed search was done and relevant published studies were reviewed. Surgeries that can have future applications are also mentioned. At present most studies do not give significant advantage over conventional laparoscopic surgery in benign gynecological disease. However robotics do give an edge in more complex surgeries. The conversion rate to open surgery is lesser with robotic assistance when compared to laparoscopy. For myomectomy surgery, Endo wrist movement of robotic instrument allows better and precise suturing than conventional straight stick laparoscopy. The robotic platform is a logical step forward to laparoscopy and if cost considerations are addressed may become popular among gynecological surgeons world over.

  11. Society of Surgical Oncology–American Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer

    International Nuclear Information System (INIS)

    Purpose: To convene a multidisciplinary panel of breast experts to examine the relationship between margin width and ipsilateral breast tumor recurrence (IBTR) and develop a guideline for defining adequate margins in the setting of breast conserving surgery and adjuvant radiation therapy. Methods and Materials: A multidisciplinary consensus panel used a meta-analysis of margin width and IBTR from a systematic review of 33 studies including 28,162 patients as the primary evidence base for consensus. Results: Positive margins (ink on invasive carcinoma or ductal carcinoma in situ) are associated with a 2-fold increase in the risk of IBTR compared with negative margins. This increased risk is not mitigated by favorable biology, endocrine therapy, or a radiation boost. More widely clear margins than no ink on tumor do not significantly decrease the rate of IBTR compared with no ink on tumor. There is no evidence that more widely clear margins reduce IBTR for young patients or for those with unfavorable biology, lobular cancers, or cancers with an extensive intraductal component. Conclusions: The use of no ink on tumor as the standard for an adequate margin in invasive cancer in the era of multidisciplinary therapy is associated with low rates of IBTR and has the potential to decrease re-excision rates, improve cosmetic outcomes, and decrease health care costs

  12. Society of Surgical Oncology–American Society for Radiation Oncology Consensus Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stages I and II Invasive Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Moran, Meena S. [Department of Therapeutic Radiology, Yale School of Medicine, Yale University, New Haven, Connecticut (United States); Schnitt, Stuart J. [Department of Pathology, Harvard Medical School, Boston, Massachusetts (United States); Giuliano, Armando E. [Department of Surgery, Cedars Sinai Medical Center, Los Angeles, California (United States); Harris, Jay R. [Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts (United States); Khan, Seema A. [Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois (United States); Horton, Janet [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Klimberg, Suzanne [Department of Surgery, University of Arkansas for Medical Sciences, Fayetteville, Arkansas (United States); Chavez-MacGregor, Mariana [Department of Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Freedman, Gary [Department of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania (United States); Houssami, Nehmat [School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales (Australia); Johnson, Peggy L. [Advocate in Science, Susan G. Komen, Wichita, Kansas (United States); Morrow, Monica, E-mail: morrowm@mskcc.org [Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2014-03-01

    Purpose: To convene a multidisciplinary panel of breast experts to examine the relationship between margin width and ipsilateral breast tumor recurrence (IBTR) and develop a guideline for defining adequate margins in the setting of breast conserving surgery and adjuvant radiation therapy. Methods and Materials: A multidisciplinary consensus panel used a meta-analysis of margin width and IBTR from a systematic review of 33 studies including 28,162 patients as the primary evidence base for consensus. Results: Positive margins (ink on invasive carcinoma or ductal carcinoma in situ) are associated with a 2-fold increase in the risk of IBTR compared with negative margins. This increased risk is not mitigated by favorable biology, endocrine therapy, or a radiation boost. More widely clear margins than no ink on tumor do not significantly decrease the rate of IBTR compared with no ink on tumor. There is no evidence that more widely clear margins reduce IBTR for young patients or for those with unfavorable biology, lobular cancers, or cancers with an extensive intraductal component. Conclusions: The use of no ink on tumor as the standard for an adequate margin in invasive cancer in the era of multidisciplinary therapy is associated with low rates of IBTR and has the potential to decrease re-excision rates, improve cosmetic outcomes, and decrease health care costs.

  13. Multicenter Phase II Study Evaluating Two Cycles of Docetaxel, Cisplatin and Cetuximab as Induction Regimen Prior to Surgery in Chemotherapy-Naive Patients with NSCLC Stage IB-IIIA (INN06-Study.

    Directory of Open Access Journals (Sweden)

    Wolfgang Hilbe

    Full Text Available Different strategies for neoadjuvant chemotherapy in patients with early stage NSCLC have already been evaluated. The aim of this study was to evaluate the tolerability and efficacy of a chemoimmunotherapy when limited to two cycles.Between 01/2007 and 03/2010 41 patients with primarily resectable NSCLC stage IB to IIIA were included. Treatment consisted of two cycles cisplatin (40 mg/m2 d1+2 and docetaxel (75 mg/m2 d1 q3 weeks, accompanied by the administration of cetuximab (400 mg/m2 d1, then 250 mg weekly. The primary endpoint was radiological response according to RECIST.40 patients were evaluable for toxicity, 39 for response. The main grade 3/4 toxicities were: neutropenia 25%, leucopenia 11%, febrile neutropenia 6%, nausea 8% and rash 8%. 20 patients achieved a partial response, 17 a stable disease, 2 were not evaluable. 37 patients (95% underwent surgery and in three of them a complete pathological response was achieved. At a median follow-up of 44.2 months, 41% of the patients had died, median progression-free survival was 22.5 months.Two cycles of cisplatin/ docetaxel/ cetuximab showed promising efficacy in the neoadjuvant treatment of early-stage NSCLC and rapid operation was possible in 95% of patients. Toxicities were manageable and as expected.EU Clinical Trials Register; Eudract-Nr: 2006-004639-31.

  14. Role of fetal surgery in spinal dysraphism

    Directory of Open Access Journals (Sweden)

    A Martina Messing-Jünger

    2013-01-01

    Full Text Available Open spinal dysraphism is a common and clinically challenging organo-genetic malformation. Due to the well-known multi-organ affection with significant implication on the lives of patients and their families, abortion after prenatal diagnosis became reality in most parts of the world. After publication of the Management of Myelomeningocele Study (MOMS results fetal surgery seems to be a new option and a broad discussion arose regarding advantages and risks of in utero treatment of spina bifida. This paper tries to evaluate objectively the actual state of knowledge and experience. This review article gives a historical overview as well as the experimental and pathophysiological background of fetal surgery in open spinal dysraphism. Additionally clinical follow-up experience of foetoscopically treated patients are presented and discussed. After carefully outweighing all available information on fetal surgery for spina bifida, one has to conclude, in accordance with the MOMS investigators, that in utero surgery cannot be considered a standard option at present time. But there is clear evidence of the hypothesis that early closure of the spinal canal has a positive influence on spinal cord function and severity of Chiari malformation type II, has been proven. A persisting problem is the fetal risk of prematurity and the maternal risk of uterus damage. There is also evidence that due to technical restrictions, fetal closure of the spinal canal bears unsolved problems leading to a higher postnatal incidence of complication surgery. Finally, missing long-term results make a definite evaluation impossible so far. At the moment, fetal surgery in open spinal dysraphism is not a standard of care despite promising results regarding central nervous system protection due to early spinal canal closure. Many technical problems need to be solved in the future in order to make this option a safe and standard one.

  15. Robotic Surgery for Thyroid Disease

    OpenAIRE

    Lee, Jandee; Chung, Woong Youn

    2013-01-01

    Robotic surgery is an innovation in thyroid surgery that may compensate for the drawbacks of conventional endoscopic surgery. A surgical robot provides strong advantages, including three-dimensional imaging, motion scaling, tremor elimination, and additional degrees of freedom. We review here recent adaptations, experience and applications of robotics in thyroid surgery. Robotic thyroid surgeries include thyroid lobectomy, total thyroidectomy, central compartment neck dissection, and radical ...

  16. Computer Assisted Surgery

    Science.gov (United States)

    Arámbula Cosío, F.; Padilla Castañeda, M. A.

    2003-09-01

    Computer assisted surgery (CAS) systems can provide different levels of assistance to a surgeon during training and execution of a surgical procedure. This is done through the integration of : measurements taken on medical images; computer graphics techniques; and positioning or tracking mechanisms which accurately locate the surgical instruments inside the operating site. According to the type of assistance that is provided to the surgeon, CAS systems can be classified as: Image guided surgery systems; Assistant robots for surgery; and Training simulators for surgery. In this work are presented the main characteristics of CAS systems. It is also described the development of a computer simulator for training on Transurethral Resection of the Prostate (TURP) based on a computer model of the prostate gland which is able to simulate, in real time, deformations and resections of tissue. The model is constructed as a 3D mesh with physical properties such as elasticity. We describe the main characteristics of the prostate model and its performance. The prostate model will also be used in the development of a CAS system designed to assist the surgeon during a real TURP procedure. The system will provide 3D views of the shape of the prostate of the patient, and the position of the surgical instrument during the operation. The development of new computer graphics models which are able to simulate, in real time, the mechanical behavior of an organ during a surgical procedure, can improve significantly the training and execution of other minimally invasive surgical procedures such as laparoscopic gall bladder surgery.

  17. Innovations in Bariatric Surgery.

    Science.gov (United States)

    Zhu, Catherine; Pryor, Aurora D

    2015-11-01

    Surgery has consistently been demonstrated to be the most effective long-term therapy for the treatment of obesity. However, despite excellent outcomes with current procedures, most patients with obesity- and weight-related comorbidities who meet criteria for surgical treatment choose not to pursue surgery out of fear of operative risks and complications or concerns about high costs. Novel minimally invasive procedures and devices may offer alternative solutions for patients who are hesitant to pursue standard surgical approaches. These procedures may be used for primary treatment of obesity, early intervention for patients approaching morbid obesity, temporary management prior to bariatric surgery, or revision of bypass surgery associated with weight regain. Novel bariatric procedures can in general be divided into four categories: endoluminal space-occupying devices, gastric suturing and restrictive devices, absorption-limiting devices, and neural-hormonal modulating devices. Many of these are only approved as short-term interventions, but these devices may be effective for patients desiring low-risk procedures or a transient effect. We will see the expansion of indications and alternatives for metabolic surgery as these techniques gain approval.

  18. Clinical innovations in Philippine thoracic surgery.

    Science.gov (United States)

    Danguilan, Jose Luis J

    2016-08-01

    Thoracic surgery in the Philippines followed the development of thoracic surgery in the United States and Europe. With better understanding of the physiology of the open chest and refinements in thoracic anesthetic and surgical approaches, Filipino surgeons began performing thoracoplasties, then lung resections for pulmonary tuberculosis and later for lung cancer in specialty hospitals dealing with pulmonary diseases-first at the Quezon Institute (QI) and presently at the Lung Center of the Philippines although some university and private hospitals made occasional forays into the chest. Esophageal surgery began its early attempts during the post-World War II era at the Philippine General Hospital (PGH), a university hospital affiliated with the University of the Philippines. With the introduction of minimally invasive thoracic surgical approaches, Filipino thoracic surgeons have managed to keep up with their Asian counterparts although the problems of financial reimbursement typical of a developing country remain. The need for creative innovative approaches of a focused multidisciplinary team will advance the boundaries of thoracic surgery in the Philippines.

  19. Robotic Surgery for Thoracic Disease

    Science.gov (United States)

    Yoshida, Yasuhiro; Iwasaki, Akinori

    2016-01-01

    Robotic surgeries have developed in the general thoracic field over the past decade, and publications on robotic surgery outcomes have accumulated. However, controversy remains about the application of robotic surgery, with a lack of well-established evidence. Robotic surgery has several advantages such as natural movement of the surgeon’s hands when manipulating the robotic arms and instruments controlled by computer-assisted systems. Most studies have reported the feasibility and safety of robotic surgery based on acceptable morbidity and mortality compared to open or video-assisted thoracic surgery (VATS). Furthermore, there are accumulated data to indicate longer operation times and shorter hospital stay in robotic surgery. However, randomized controlled trials between robotic and open or VATS procedures are needed to clarify the advantage of robotic surgery. In this review, we focused the literature about robotic surgery used to treat lung cancer and mediastinal tumor. PMID:26822625

  20. Viscoless microincision cataract surgery

    Directory of Open Access Journals (Sweden)

    Guy Sallet

    2008-06-01

    Full Text Available Guy SalletDepartment of Opthamology, Aalsters Stedelijk Ziekenhuis, BelgiumAbstract: A cataract surgery technique is described in which incisions, continuous circular capsulorhexis and hydrodissection are made without the use of any viscoelastics. Two small incisions are created through which the different parts of the procedure can take place, maintaining a stable anterior chamber under continuous irrigation. Subsequent bimanual phacoemulsification can be done through these microincisions. At the end of the procedure, an intraocular lens can be inserted through the self-sealing incision under continuous irrigation. 50 consecutive cataract patients were operated on without the use of viscoelastics and then compared with a group of 50 patients who had been helped with viscoelastics. No difference in outcome, endothelial cell count or pachymetry was noted between the two groups. No intraoperative complication was encountered. Viscoless cataract surgery was a safe procedure with potential advantages.Keywords: ophthalmic visco-surgical device, viscoless cataract surgery, microincision

  1. Stereolithography for craniofacial surgery.

    Science.gov (United States)

    Sinn, Douglas P; Cillo, Joseph E; Miles, Brett A

    2006-09-01

    Advances in computer technology have aided in the diagnostic and clinical management of complex congenital craniofacial deformities. The use of stereolithographic models has begun to replace traditional milled models in the treatment of craniofacial deformities. Research has shown that stereolithography models are highly accurate and provide added information in treatment planning for the correction of craniofacial deformities. These include the added visualization of the complex craniofacial anatomy and preoperative surgical planning with a highly accurate three-dimensional model. While the stereolithographic process has had a beneficial impact on the field of craniofacial surgery, the added cost of the procedure continues to be a hindrance to its widespread acceptance in clinical practice. With improved technology and accessibility the utilization of stereolithography in craniofacial surgery is expected to increase. This review will highlight the development and current usage of stereolithography in craniofacial surgery and provide illustration of it use.

  2. MOCK SURGERIES IN AYURVEDA

    Directory of Open Access Journals (Sweden)

    Bali Yogitha

    2012-10-01

    Full Text Available The present trend is very well aware of mock tests, exams and even the mock surgeries that are very common in healthcare and play an important role in providing the surgeons, the necessary practical knowledge and expertise in their specialized field. In addition, patients also get benefited by the mock surgeries by having the complete knowledge before they undergo any surgery. The same concept of mock or the experimental surgeries can be found explained centuries ago by Susrutha, father of both the Ancient and Modern surgery in the Susrutha samhitha under the chapter yogya-sutriya. Hence here, an effort was made to explore the same. Further research studies should be focused on the concept explained by Sushrutha to make it valid and applicable to the present day. The ancient surgical science is known as Salya-tantra. Salya-tantra (surgical science embraces all processes aiming at the removal of factors responsible for producing pain or misery to the body or mind. Salya(salya-surgical instrument denotes broken parts of an arrow /other sharp weapons while tantra denotes maneuver. 1 To obtain the complete success in the aimed operating work, practice of similar operations before hand is called yoga and the experiment of such practice is called yogya. An intelligent surgeon, who does experimental surgery methodically, does not lose his presence of mind while doing the actual operations.Therefore, he who wants to be an expert in the use of surgical operations, caustics or thermal cauterizations should practice the same experimentally on similar subjects.

  3. [Czech paediatric cardiac surgery - history and presence].

    Science.gov (United States)

    Hučín, Bohumil

    2012-01-01

    The beginnings of the Paediatric Cardiac Surgery in the Czech Republic date back to the period immediately after the end of World War II. Its protagonists were Prof. Emerich Polák from the Surgical Clinic in Prague, Vinohrady, Prof. Jan Bedrna from Surgical Clinic in Hradec Kralove, Prof. Vladislav Rapant from Surgical Clinic in Olomouc and Prof. Václav Kafka from the Second Surgical Clinic in Prague. They started with operations of the patent ductus arteriosus, the Blalock-Taussig shunt in cyanotic heart defects and resection of coarctation of the aorta. Operations of congenital heart defects, on the open heart were elaborated namely by cardiosurgeons in Brno, under the leadership of Professor Jan Navrátil. On the extension of those methods participated Professor Jaroslav Procházka in Hradec Kralove and Prof. Václav Kafka at the newly opened department of Paediatric surgery in Prague. In the next period, attention of paediatric cardiac surgery was directed at operations of critical congenital heart defects in the smallest children. Palliative operations of the critical heart defects in newborns and infants were first introduced at the clinic of paediatric surgery of the Paediatric University Hospital in Prague. Radical operations of infants and newborns with extra-corporal circulation were elaborated in the Children's heart centre in Prague, Motol. Initiative in the further development of paediatric cardiac surgery was taken over by the Children's heart centre in Prague since its founding in 1977. There was concentrated all medical care of children born with a congenital heart defect in the Czech Republic. This concentration of specialized care at one institution allowed to accumulate extremely large experience with the diagnostics and surgical treatment of congenital heart defects in all age groups with the decrease of patients mortality after operations to 1% even for the smallest children and enabled continuously monitor the quality of life of patients

  4. Surgery in Amphibians.

    Science.gov (United States)

    Chai, Norin

    2016-01-01

    Amphibian surgery has been especially described in research. Since the last decade, interest for captive amphibians has increased, so have the indications for surgical intervention. Clinicians should not hesitate to advocate such manipulations. Amphibian surgeries have no overwhelming obstacles. These patients heal well and tolerate blood loss more than higher vertebrates. Most procedures described in reptiles (mostly lizards) can be undertaken in most amphibians if equipment can be matched to the patients' size. In general, the most difficult aspect would be the provision of adequate anesthesia.

  5. Update on obesity surgery

    Institute of Scientific and Technical Information of China (English)

    Dan Eisenberg; Andrew J Duffy; Robert L Bell

    2006-01-01

    The prevalence of obesity in the United States has reached epidemic proportions. With more than 30 million Americans clinically obese, the younger population has also been affected. Surgical therapy should be offered to the severely obese patient who is refractory to nonsurgical therapy, as established by the 1991 NIH Consensus Conference on Gastrointestinal Surgery for Severe Obesity. Surgery is currently the most effective therapy for weight loss. It is far more effective than any other treatment modality, both in terms of the amount of weight loss and in terms of durability in maintaining weight loss.

  6. [Robotic surgery in gynecology].

    Science.gov (United States)

    Hibner, Michał; Marianowski, Piotr; Szymusik, Iwona; Wielgós, Mirosław

    2012-12-01

    Introduction of robotic surgery in the first decade of the 21 century was one of the biggest breakthroughs in surgery since the introduction of anesthesia. For the first time in history the surgeon was placed remotely from the patient and was able to operate with the device that has more degrees of freedom than human hand. Initially developed for the US Military in order to allow surgeons to be removed from the battlefield, surgical robots quickly made a leap to the mainstream medicine. One of the first surgical uses for the robot was cardiac surgery but it is urology and prostate surgery that gave it a widespread popularity Gynecologic surgeons caught on very quickly and it is estimated that 31% of hysterectomies done in the United States in 2012 will be done robotically. With over half a million hysterectomies done each year in the US alone, gynecologic surgery is one of the main driving forces behind the growth of robotic surgery Other applications in gynecology include myomectomy oophorectomy and ovarian cystectomy resection of endometriosis and lymphadenectomy Advantages of the surgical robot are clearly seen in myomectomy The wrist motion allows for better more precise suturing than conventional "straight stick" laparoscopy The strength of the arms allow for better pulling of the suture and the third arm for holding the suture on tension. Other advantage of the robot is scaling of the movements when big movement on the outside translates to very fine movement on the inside. This enables much more precise surgery and may be important in the procedures like tubal anastomosis and implantation of the ureter Three-dimensional vision provides excellent depth of field perception. It is important for surgeons who are switching from open surgeries and preliminary evidence shows that it may allow for better identification of lesions like endometriosis. Another big advantage of robotics is that the surgeon sits comfortably with his/her arms and head supported. This

  7. Current status of surgery for benign disorders of the esophagus

    NARCIS (Netherlands)

    Draaisma, Werner Adriaan

    2006-01-01

    This thesis aimed at exploring new techniques for the surgical treatment of benign disorders of the esophagus. Specifically, studies were performed on surgery for gastroesophageal reflux disease and large (type II-IV) hiatal hernia. The chapters presented in this thesis involve studies that have bee

  8. Surgery for Complex Disorders of the Upper Digestive Tract

    NARCIS (Netherlands)

    Furnée, E.J.B.

    2010-01-01

    In this thesis, the complexity of surgical treatment for failed antireflux procedures and large hiatal hernias (type II-IV) is described. The studies in the first part have addressed the results of antireflux surgery after previous endoscopic or surgical procedures performed for refractory gastro-oe

  9. Psychological effects of day case surgery compared with inpatient surgery.

    OpenAIRE

    Campbell, I R; Scaife, J M; Johnstone, J M

    1988-01-01

    Short term psychological disturbance in 70 children undergoing minor surgery was compared in two randomly allocated groups by means of questionnaires answered by their parents. Significantly less psychological disturbance was reported in children undergoing day case surgery compared with children admitted on the day before and discharged on the day after surgery. Children who had day case surgery were less often reported to require extra attention in the first week after discharge home, and a...

  10. Oncoplastic breast conserving surgery

    OpenAIRE

    Mansfield, Lucy; Agrawal, Avi; Cutress, Ramsey I.

    2013-01-01

    Oncoplastic breast conserving surgery is a fundamental component of the repertoire for the management of breast cancer. It facilitates removal of large volumes of breast tissue, and can improve cosmetic outcomes and patient satisfaction whilst maintaining good oncological principles, reducing re-excision and mastectomy rates and assisting in adjuvant radiotherapy planning.

  11. Hair transplantation surgery

    OpenAIRE

    Khanna Manoj

    2008-01-01

    Techniques in hair transplantation have evolved recently which make results look more natural. Hair restoration is one of the most exciting and innovative surgical fields in aesthetic surgery today. A precise appreciation of anatomy has allowed the use of follicular unit grafts. With better methods of harvesting and implantation, hair transplantation results represent a blend of art and science.

  12. Cataract surgery and anticoagulants

    NARCIS (Netherlands)

    Koopmans, SA; VanRij, G

    1996-01-01

    A questionnaire was sent to 240 members of the Netherlands Intraocular implant Club (NIOIC) to register their policy followed in 1993 with regard to anticoagulant therapy (ACT) and the use of aspirin in patients having cataract surgery. Ninety-one (32%) forms were suitable for analysis. Most eye sur

  13. Plastic Surgery for Teenagers

    Science.gov (United States)

    ... Ambulatory Surgery Facilities (AAAASF), the Accreditation Association for Ambulatory Health Care (AAAHC), or the Joint Commission on Accreditation of ... requirements. Informed Consent At the highest level of care, ... physician-patient relationship is one of shared decision-making. This decision- ...

  14. Thromboprophylaxis in orthopaedic surgery

    NARCIS (Netherlands)

    M.C. Struijk-Mulder

    2014-01-01

    This thesis describes the use of thromboprophylatic modalities after total hip and total knee arthroplasty by Dutch orthopedic departments over a period of ten years and several uncertainties regarding thromboprophylaxis in other areas of orthopedic surgery. In this thesis some of these uncertaintie

  15. Nutrition & Pancreatic Surgery

    NARCIS (Netherlands)

    Gerritsen, A.

    2015-01-01

    The aim of the first part of this thesis was to determine the optimal feeding strategy after pancreatoduodenectomy. The available nutritional guidelines give conflicting recommendations and are all based on studies after major gastrointestinal surgery for cancer in general. We systematically reviewe

  16. Urogenital Reconstructive Surgery

    DEFF Research Database (Denmark)

    Jakobsen, Lotte Kaasgaard

    Urogenital reconstructive surgery Lotte Kaasgaard Jakobsen1 Professor Henning Olsen1 Overlæge Gitte Hvistendahl1 Professor Karl-Erik Andersson2 1 – Dept. of Urology, Aarhus University Hospital 2 – Dept. of Gynecology and Obstetrics, Aarhus University hospital Background: Congenital obstruction...

  17. Cataract Surgery in Uveitis

    Directory of Open Access Journals (Sweden)

    Rupesh Agrawal

    2012-01-01

    Full Text Available Cataract surgery in uveitic eyes is often challenging and can result in intraoperative and postoperative complications. Most uveitic patients enjoy good vision despite potentially sight-threatening complications, including cataract development. In those patients who develop cataracts, successful surgery stems from educated patient selection, careful surgical technique, and aggressive preoperative and postoperative control of inflammation. With improved understanding of the disease processes, pre- and perioperative control of inflammation, modern surgical techniques, availability of biocompatible intraocular lens material and design, surgical experience in performing complicated cataract surgeries, and efficient management of postoperative complications have led to much better outcome. Preoperative factors include proper patient selection and counseling and preoperative control of inflammation. Meticulous and careful cataract surgery in uveitic cataract is essential in optimizing the postoperative outcome. Management of postoperative complications, especially inflammation and glaucoma, earlier rather than later, has also contributed to improved outcomes. This manuscript is review of the existing literature and highlights the management pearls in tackling complicated cataract based on medline search of literature and experience of the authors.

  18. Revision Knee Surgery

    Medline Plus

    Full Text Available Revision Knee Surgery Featuring the Zimmer® NexGen® LCCK System. Zimmer, Inc. Indio, California March 31, 2010 Welcome ... the role of the NexGen LCCK Knee Revision System. If we could go to the slides, please. ...

  19. Cosmetic breast surgery - discharge

    Science.gov (United States)

    ... have a loss of sensation in your breast skin and nipples after surgery. Sensation may return over time. You may need help with your everyday activities for a few days until your pain and swelling decrease. Incision scars may take several months to over a year ...

  20. Robotics in gynecologic surgery.

    Science.gov (United States)

    Frick, A C; Falcone, T

    2009-06-01

    Robotic surgery has evolved from an investigational surgical approach to a clinically useful adjunct in multiple surgical specialties over the past decade. Advocates of robotic-assisted gynecologic surgery revere the system's wristed instrumentation, ergonomic positioning, and three-dimensional high-definition vision system as significant improvements over laparoscopic equipment's four degrees of freedom and two-dimensional laparoscope that demand the surgeon stand throughout a procedure. The cost, lack of haptic feedback, and the bulky size of the equipment make robotics less attractive to others. Studies evaluating outcomes in robotic-assisted gynecologic surgery are limited. Multiple small retrospective studies demonstrate the safety and feasibility of robotic hysterectomy. With increased surgeon experience, operative times are similar to, or shorter than, laparoscopic cases. Robotic assistance can facilitate suturing in laparoscopic myomectomies, and is associated with decreased blood loss and a shorter hospital stay, although may require longer operative times. Robotic assistance has also been applied to multiple procedures in the subspecialties of infertility, urogynecology and gynecologic oncology with good success and relatively low morbidity. However, further research is warranted to better evaluate the relative benefits and costs of robotic assisted gynecologic surgery.

  1. [Minilaparoscopic surgery : alternative or supplement to single-port surgery?].

    Science.gov (United States)

    Brinkmann, L; Lorenz, D

    2011-05-01

    In recent years scarless surgery (axillo-bilateral-breast aproach [ABBA], natural orifice transluminal endoscopic surgery [NOTES], single-port surgery) has gained importance in order to improve postoperative outcome in laparoscopic surgery. As part of this effort minilaparoscopic surgery might be a suitable alternative concerning cosmetic outcome without implementing a completely new technique. Due to the definition minilaparoscopic surgery is based on instruments which reduce the total length of trocar incisions to less than 2.5 cm. Nevertheless the total number of incisions is similar to conventional laparoscopic techniques. Most recent indications for minilaparoscopic surgery are cholecystectomy, appendectomy, hernia and colorectal surgery. This article describes the technical aspects and feasibility of minilaparoscopic cholecystectomy and transabdominal preperitoneal hernia repair (TAPP).While the trocar positions remain in the original setting the laparoscopic surgeon benefits from experience gained in conventional laparoscopic surgery. Although the cosmetic outcome is not comparable to single-port surgery, in the author's opinion minilaparoscopic surgery is a useful alternative in scarless surgery due to the fact that it is easy to adapt without establishing a completely new technique. PMID:21424297

  2. Early extubation after congenital heart surgery

    Directory of Open Access Journals (Sweden)

    Mirza Halimić

    2014-12-01

    Full Text Available Introduction: Despite recent advances in anesthesia, cardiopulmonary bypass and surgical techniques, children undergoing congenital heart surgery require postoperativemechanical ventilation. Early extubation was definedas ventilation shorter than 12 hours. Aim of this study is to identify factors associated with successful early extubation after pediatric cardiac surgery.Methods: The study was performed during period from January 2006 to January 2011 at Pediatric Clinic and Heart Center University Clinical center Sarajevo. One hundred children up to 5 years of age, who have had congenital heart disease, with left–right shunt and obstructive heart disease were included in the study. Patients were divided into two groups: Group I - patients extubated within 12 hours after surgery and Group II - patients extubated 12 or more hours after surgery. Results: The most frequently encountered preoperative variables were age with odds ratio 4% 95%CI (1-7%, Down's syndrome 8.5 95%CI (1.6-43.15, failure to thrive 4.3 95%CI( 1-18. Statistically significant postoperative data included lung disease (reactive airways, pneumonia, atelectasis, pneumothorax and with odds ratio 35.1 95 %CI (4-286 and blood transfusion with odds ratio 4.6 95%CI (2-12. Blood transfusion (p=0.002 (Wald=9.2 95%CI (2-12, during as well as after operation procedure has statistically significant influence on prediction time of extubation. Proven markers were age with cut of 21.5 months (sensitivity 74% and specificity 70% and extracorporeal circulation (ECC with cut-of 45.5 minutes (sensitivity 71% and specificity 65%.Conclusion: Early extubation is possible in many children undergoing congenital heart surgery. Younger age and prolonged ECC time are markers associated with prolonged mechanical ventilation.

  3. Patch in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alireza Alizadeh Ghavidel

    2014-06-01

    Full Text Available Introduction: Excessive bleeding presents a risk for the patient in cardiovascular surgery. Local haemostatic agents are of great value to reduce bleeding and related complications. TachoSil (Nycomed, Linz, Austria is a sterile, haemostatic agent that consists of an equine collagen patchcoated with human fibrinogen and thrombin. This study evaluated the safety and efficacy of TachoSil compared to conventional technique.Methods: Forty-two patients scheduled for open heart surgeries, were entered to this study from August 2010 to May 2011. After primary haemostatic measures, patients divided in two groups based on surgeon’s judgment. Group A: 20 patients for whom TachoSil was applied and group B: 22 patients that conventional method using Surgicel (13 patients or wait and see method (9 cases, were performed in order to control the bleeding. In group A, 10 patients were male with mean age of 56.95±15.67 years and in group B, 9 cases were male with mean age of 49.95±14.41 years. In case group 70% (14/20 of the surgeries were redo surgeries versus 100% (22/22 in control group.Results: Baseline characteristics were similar in both groups. In TachoSil group 75% of patients required transfusion versus 90.90% in group B (P=0.03.Most transfusions consisted of packed red blood cell; 2±1.13 units in group A versus 3.11±1.44 in group B (P=0.01, however there were no significant differences between two groups regarding the mean total volume of intra and post-operative bleeding. Re-exploration was required in 10% in group A versus 13.63% in group B (P=0.67.Conclusion: TachoSil may act as a superior alternative in different types of cardiac surgery in order to control the bleeding and therefore reducing transfusion requirement.

  4. Intraperitoneal wound in abdominal surgery

    OpenAIRE

    Kahokehr, Arman Adam

    2013-01-01

    The intraperitoneal wound is often forgotten after transperitoneal surgery. This review is a on the peritoneum and the implications of peritoneal injury after surgery. This review will focus on the intraperitoneal wound response after surgical injury.

  5. Anti-reflux surgery - children

    Science.gov (United States)

    ... stomach). Problems with these muscles can lead to gastroesophageal reflux disease (GERD). This surgery can also be done during a ... Anti-reflux surgery is usually done to treat GERD in children only after medicines have not worked ...

  6. Bariatric Surgery for Severe Obesity

    Science.gov (United States)

    ... switch, less often. Each type of surgery has advantages and disadvantages. ​ ​​​​ Bariatric Surgery Benefits Bariatric surgery can ... basic and clinical research into many disorders. ​ Additional Reading Active at Any Size! Binge Eating Disorder Dieting ...

  7. Thurston norm and cosmetic surgeries

    CERN Document Server

    Ni, Yi

    2010-01-01

    Two Dehn surgeries on a knot are called cosmetic if they yield homeomorphic manifolds. For a null-homologous knot with certain conditions on the Thurston norm of the ambient manifold, if the knot admits cosmetic surgeries, then the surgery coefficients are equal up to sign.

  8. Thurston norm and cosmetic surgeries

    OpenAIRE

    NI, YI

    2011-01-01

    Two Dehn surgeries on a knot are called cosmetic if they yield homeomorphic manifolds. For a null-homologous knot with certain conditions on the Thurston norm of the ambient manifold, if the knot admits cosmetic surgeries, then the surgery coefficients are equal up to sign.

  9. Timing of surgery for sciatica

    NARCIS (Netherlands)

    Peul, Wilco C.

    2008-01-01

    The frequently diagnosed lumbar disc herniation can disappear by natural course, but still leads to high low back surgery rates. The optimal period of conservative care, before surgery is executed, was unknown. It is surprising that scientific evidence was lacking which justified “early” surgery. Su

  10. The day of surgery for your child

    Science.gov (United States)

    ... surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. ... surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. ...

  11. Exceptional cosmetic surgeries on homology spheres

    OpenAIRE

    Ravelomanana, Huygens C.

    2016-01-01

    We investigate the cosmetic surgery conjecture for hyperbolic knots in integer homology spheres, focusing on exceptional surgeries. We give some restrictions on the slopes of exceptional truly cosmetic surgeries according to the type of surgery.

  12. Refractive surgery for keratoconus.

    Science.gov (United States)

    Ormonde, Sue

    2013-03-01

    Traditionally, keratoconus has been managed with glasses when mild, contact lenses when moderate and keratoplasty when severe. When cornea-based refractive surgery was first developed it appeared to be a useful option for keratoconus until reports of post-operative progressive ectasia emerged and thus keratoconus was considered a contraindication to refractive surgery. However, improvements in older techniques and the development of new techniques mean that there are now several viable options to avoid keratoplasty in contact lens-intolerant patients. This review discusses the risks and benefits of excimer laser refractive procedures, both with and without corneal collagen cross linking, as well as intra-corneal ring segments, phakic intraocular lenses and refractive lens exchange with toric intraocular lens implantation. PMID:23496655

  13. [Bariatric surgery in Denmark.

    DEFF Research Database (Denmark)

    Funch-Jensen, P.; Iversen, M.G.; Kehlet, H.

    2008-01-01

    INTRODUCTION: In 2005 the National Board of Health (NBH) published guidelines on bariatric surgery in Denmark. The aim of the present study was to shed light on the national bariatric effort in relation to these guidelines. MATERIAL AND METHODS: The analysis is based on extraction of the following......, a tendency which was attributable to the activities of one of the private clinics. CONCLUSION: The frequency with which bariatric surgery is performed follows a strongly increasing trend and the procedures are only performed at the public departments selected by the National Board of Health...... and at the private centres that have entered into an agreement with Danish Regions. Since the operative access and selection of procedures varies between departments we conclude that research should be a firm requirement for all centres, and that research efforts should comprise cooperation concerning the database...

  14. Robotic mitral valve surgery.

    Science.gov (United States)

    Kypson, Alan P; Nifong, L Wiley; Chitwood, W Randolph

    2003-12-01

    A renaissance in cardiac surgery has begun. The early clinical experience with computer-enhanced telemanipulation systems outlines the limitations of this approach despite some procedural success. Technologic advancements, such as the use of nitinol U-clips (Coalescent Surgical Inc., Sunnyvale, CA) instead of sutures requiring manual knot tying, have been shown to decrease operative times significantly. It is expected that with further refinements and development of adjunct technologies, the technique of computer-enhanced endoscopic cardiac surgery will evolve and may prove to be beneficial for many patients. Robotic technology has provided benefits to cardiac surgery. With improved optics and instrumentation, incisions are smaller. The ergometric movements and simulated three-dimensional optics project hand-eye coordination for the surgeon. The placement of the wristlike articulations at the end of the instruments moves the pivoting action to the plane of the mitral annulus. This improves dexterity in tight spaces and allows for ambidextrous suture placement. Sutures can be placed more accurately because of tremor filtration and high-resolution video magnification. Furthermore, the robotic system may have potential as an educational tool. In the near future, surgical vision and training systems might be able to model most surgical procedures through immersive technology. Thus, a "flight simulator" concept emerges where surgeons may be able to practice and perform the operation without a patient. Already, effective curricula for training teams in robotic surgery exist. Nevertheless, certain constraints continue to limit the advancement to a totally endoscopic computer-enhanced mitral valve operation. The current size of the instruments, intrathoracic instrument collisions, and extrathoracic "elbow" conflicts still can limit dexterity. When smaller instruments are developed, these restraints may be resolved. Furthermore, a working port incision is still required for

  15. Solo hand surgery

    OpenAIRE

    Bell, Michael SG; Reitsma, Bert J

    2005-01-01

    Unassisted hand surgery is being undertaken by necessity for both elective and emergency cases, due to hospital resource restrictions. The authors outline the principles of local anesthesia, surgeon-controlled tourniquet techniques, and a number of new instruments which allow a surgeon to work in comfort and safety, unassisted. The traditional surgical instruments designed for the days when trained surgical assistants were available to hold them are no longer suitable. We are entering a new e...

  16. Pediatric Sleep Surgery

    Directory of Open Access Journals (Sweden)

    Cecille Gail Sulman

    2014-06-01

    Full Text Available Adenotonsillectomy is the most common surgery performed for sleep disordered breathing with good outcomes. Children with obesity, craniofacial disorders, and neurologic impairment are at risk for persistent sleep apnea after adenotonsillectomy. Techniques exist to address obstructive lesions of the palate, tongue base, or craniofacial skeleton in children with persistent sleep apnea. Children with obstructive sleep apnea have a higher rate of peri-operative complications.

  17. Advances in Plastic Surgery

    OpenAIRE

    McDonald, Harold D.; Luis O. Vasconez

    1982-01-01

    Recent progress in plastic surgery has been rapid and many new techniques have been developed. Reconstructive procedures have been advanced by a better understanding of the anatomy of the blood supply to skin and muscle, with the subsequent development of the use of axial flaps, musculocutaneous flaps and neurosensory flaps. Burn treatment has advanced greatly, making it possible to successfully treat larger and more complicated burns. The development of microsurgery has made possible free-fl...

  18. Pediatric Sleep Surgery

    OpenAIRE

    Cecille Gail Sulman

    2014-01-01

    Adenotonsillectomy is the most common surgery performed for sleep disordered breathing with good outcomes. Children with obesity, craniofacial disorders, and neurologic impairment are at risk for persistent sleep apnea after adenotonsillectomy. Techniques exist to address obstructive lesions of the palate, tongue base, or craniofacial skeleton in children with persistent sleep apnea. Children with obstructive sleep apnea have a higher rate of peri-operative complications.

  19. Cell response to surgery.

    LENUS (Irish Health Repository)

    Ni Choileain, Niamh

    2012-02-03

    OBJECTIVES: To describe the profound alterations in host immunity that are produced by major surgery as demonstrated by experimental and clinical studies, and to evaluate the benefits of therapeutic strategies aimed at attenuating perioperative immune dysfunction. DATA SOURCES: A review of the English-language literature was conducted, incorporating searches of the MEDLINE, EMBASE, and Cochrane collaboration databases to identify laboratory and clinical studies investigating the cellular response to surgery. STUDY SELECTION: Original articles and case reports describing immune dysfunction secondary to surgical trauma were included. DATA EXTRACTION: The results were compiled to show outcomes of different studies and were compared. DATA SYNTHESIS: Current evidence indicates that the early systemic inflammatory response syndrome observed after major surgery that is characterized by proinflammatory cytokine release, microcirculatory disturbance, and cell-mediated immune dysfunction is followed by a compensatory anti-inflammatory response syndrome, which predisposes the patient to opportunistic infection, multiple organ dysfunction syndrome, and death. Because there are currently no effective treatment options for multiple organ dysfunction syndrome, measures to prevent its onset should be initiated at an early stage. Accumulating experimental evidence suggests that targeted therapeutic strategies involving immunomodulatory agents such as interferon gamma, granulocyte colony-stimulating factor, the prostaglandin E(2) antagonist, indomethacin, and pentoxifylline may be used for the treatment of systemic inflammatory response syndrome to prevent the onset of multiple organ dysfunction syndrome. CONCLUSIONS: Surgical trauma produces profound immunological dysfunction. Therapeutic strategies directed at restoring immune homeostasis should aim to redress the physiological proinflammatory-anti-inflammatory cell imbalance associated with major surgery.

  20. Femtosecond laser cataract surgery

    OpenAIRE

    Nagy, Zoltan Z.; McAlinden, Colm

    2015-01-01

    Femtosecond laser (FSL) cataract surgery is in its infancy but is rapidly gaining popularity due to the improved consistency and predictability for corneal incisions and anterior capsulorhexis. It enables subsequently less phacoemulsification energy and time to be employed, which has gains in terms of reduced corneal oedema. In addition, the FSL allows better circularity of the anterior capsulotomy, capsule overlap, intraocular lens (IOL) placement and centration of the IOL. These advantages ...

  1. [Glaucoma and retinal surgery].

    Science.gov (United States)

    Müller, M; Geerling, G; Zierhut, M; Klink, T

    2010-05-01

    In the therapeutic approach to complex glaucomas different initial situations were considered: pre-existing glaucoma, induction of glaucoma after vitreoretinal surgery and antiglaucomatous procedures. In pre-existing glaucoma and after filtering surgery maintenance of the filtering bleb requires a vitreoretinal approach for conjunctiva preservation with techniques such as pneumatic retinopexy or small gauge vitrectomy. After vitreoretinal surgery an increase in intraocular pressure (IOP) is common. Secondary glaucoma may occur after scleral buckling and after vitrectomy with or without gas or silicone oil tamponade as well as after application of steroids. Angle closure glaucoma after scleral buckling develops because of congestion and anterior rotation of the ciliary body. Vitreous tamponades with expansive or saturated gases may cause angle-closure glaucoma with or without pupillary blockage and may critically shorten ocular perfusion. Postoperative checks, immediate action and a ban on boarding aircraft over the period of intraocular gas tamponade prevent permanent damage to the eye. The majority of secondary glaucomas can effectively be controlled by topical medication and adequate postoperative posture of the patient. Besides the temporary use of systemic antiglaucomatous medication or laser therapy, very rarely in cases of massive swelling or overfill, a direct intervention, such as partial gas or silicone oil removal is required. A prophylactic inferior peripheral iridectomy prevents pupillary blockage in aphakic eyes with intraocular tamponade. In cases of heavy silicone oil use, the peripheral iridectomy is placed in the superior position. Nd:YAG laser application will regulate IOP in cases of occlusion. Secondary glaucoma due to silicone oil emulsification overload is treated by trabecular meshwork aspiration and lavage. In refractory glaucoma repetitive cyclophotocoagulation and drainage implants represent an approved method for long-term IOP regulation

  2. Antifibrinolytics in liver surgery

    OpenAIRE

    Jalpa Makwana; Saloni Paranjape; Jyotsna Goswami

    2010-01-01

    Hyperfibrinolysis, a known complication of liver surgery and orthotopic liver transplantation (OLT), plays a significant role in blood loss. This fact justifies the use of antifibrinolytic drugs during these procedures. Two groups of drug namely lysine analogues [epsilon aminocaproic acid (EACA) and tranexamic acid (TA)] and serine-protease-inhibitors (aprotinin) are frequently used for this purpose. But uniform data or guidelines on the type of antifibrinolytic drugs to be used, their indica...

  3. Theatre of paediatric surgery.

    Science.gov (United States)

    McBride, Craig A; Holland, Andrew J A

    2015-01-01

    In the 50 years since the first edition of this journal, operative paediatric surgery has undergone radical change. Many of the most common instruments are unchanged, both as a testament to their utility and in recognition of past surgeons remembered eponymously. Surrounding that basic core of instruments, theatre has changed radically as new tools and techniques have arisen. Surgeons have come down from their pedestals, recognising surgery as a team sport rather than a solo performance. More than half of the current paediatric surgical trainees are women, a higher proportion than in any other craft group of the Royal Australasian College of Surgeons. The appearance, and rapid development, of laparoscopy is to many observers the most notable change in surgery over the last 50 years. Placed in its context though, it is simply the most prominent example of a frameshift in surgical thinking. The patient as a whole is now the focus, rather than just the disease. Recent developments are as much about minimising harm to normal tissues as they are about extirpating pathology. As a surgical maxim, 'Primum non nocere' is even more in evidence in 2015 than it was in 1965. PMID:25586851

  4. Robotically assisted gynaecological surgery.

    Science.gov (United States)

    Falcone, Tommaso; Steiner, Charles P

    2002-05-01

    Industry has used robots successfully for fine, delicate, repetitive tasks for decades. Recently, robots have been introduced into clinical medicine and specifically into the surgical suite. Voice algorithms have been developed that allow voice activation of some types of equipment in the operating room, such as the laparoscope or the light source. Advances in computer software have allowed a computer controller to translate a surgeon's movements from the handles located in a console to the robotic arms that hold the surgical instruments. This console is placed away from the surgical table. Clinical experience is limited and there are few published clinical trials. The initial trials have focused on laparoscopic microsuturing such as that performed during coronary bypass surgery or tubal anastomosis. Preliminary results have demonstrated that laparoscopic coronary bypass surgery with the internal mammary artery can be achieved. In gynaecological surgery, laparoscopic tubal reanastomosis can be performed using the same technique that has been used traditionally at laparotomy. Future clinical trials will assess whether other gynaecological procedures can be performed with robotic assistance. PMID:12082211

  5. Robotic systems in surgery.

    Science.gov (United States)

    Bargar, W L; Carbone, E J

    1993-10-01

    Computer-driven robots and medical imaging technology may soon enable surgeons to plan and execute intricate procedures with unprecedented precision. Our experience in introducing a robotic system for use in an active role in cementless total hip replacement surgery has convinced us that the marriage of these two technologies-robotics and medical imaging-is likely to change the way many types of surgical procedures are performed. The ability to link an image-based preoperative plan with its surgical execution by a robot may be the key to improved outcomes. Research and development of robotic systems for a wide variety of medical applications is underway at a number of prestigious institutions. Grenoble University has developed the IGOR (Imaged Guided Operating Robot) system. This six-axis robot has performed more than 400 interventions, acting as a positioner for brain surgery in both biopsy and therapeutic procedures. AlephMed and Digital are currently assisting the developers in integrating image analysis into the system. Future development plans include an application for spinal surgery. PMID:25951597

  6. Robotic Surgery in Gynecology.

    Science.gov (United States)

    Bouquet de Joliniere, Jean; Librino, Armando; Dubuisson, Jean-Bernard; Khomsi, Fathi; Ben Ali, Nordine; Fadhlaoui, Anis; Ayoubi, J M; Feki, Anis

    2016-01-01

    Minimally invasive surgery (MIS) can be considered as the greatest surgical innovation over the past 30 years. It revolutionized surgical practice with well-proven advantages over traditional open surgery: reduced surgical trauma and incision-related complications, such as surgical-site infections, postoperative pain and hernia, reduced hospital stay, and improved cosmetic outcome. Nonetheless, proficiency in MIS can be technically challenging as conventional laparoscopy is associated with several limitations as the two-dimensional (2D) monitor reduction in-depth perception, camera instability, limited range of motion, and steep learning curves. The surgeon has a low force feedback, which allows simple gestures, respect for tissues, and more effective treatment of complications. Since the 1980s, several computer sciences and robotics projects have been set up to overcome the difficulties encountered with conventional laparoscopy, to augment the surgeon's skills, achieve accuracy and high precision during complex surgery, and facilitate widespread of MIS. Surgical instruments are guided by haptic interfaces that replicate and filter hand movements. Robotically assisted technology offers advantages that include improved three-dimensional stereoscopic vision, wristed instruments that improve dexterity, and tremor canceling software that improves surgical precision. PMID:27200358

  7. Robotic surgery in gynecology

    Directory of Open Access Journals (Sweden)

    Jean eBouquet De Jolinière

    2016-05-01

    Full Text Available Abstract Minimally invasive surgery (MIS can be considered as the greatest surgical innovation over the past thirty years. It revolutionized surgical practice with well-proven advantages over traditional open surgery: reduced surgical trauma and incision-related complications, such as surgical-site infections, postoperative pain and hernia, reduced hospital stay, and improved cosmetic outcome. Nonetheless, proficiency in MIS can be technically challenging as conventional laparoscopy is associated with several limitations as the two-dimensional (2D monitor reduction in-depth perception, camera instability, limited range of motion and steep learning curves. The surgeon has a low force feedback which allows simple gestures, respect for tissues and more effective treatment of complications.Since 1980s several computer sciences and robotics projects have been set up to overcome the difficulties encountered with conventional laparoscopy, to augment the surgeon's skills, achieve accuracy and high precision during complex surgery and facilitate widespread of MIS. Surgical instruments are guided by haptic interfaces that replicate and filter hand movements. Robotically assisted technology offers advantages that include improved three- dimensional stereoscopic vision, wristed instruments that improve dexterity, and tremor canceling software that improves surgical precision.

  8. Robotic assisted andrological surgery

    Institute of Scientific and Technical Information of China (English)

    Sijo J Parekattil; Ahmet Gudeloglu

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy,unparalleled to any previous visual loop or magnification techniques.This technology revolutionized techniques for microsurgery in andrology.Today,we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology.Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields,such as ophthalmology,hand surgery,plastics and reconstructive surgery.The potential advantages of robotic assisted platforms include elimination of tremor,improved stability,surgeon ergonomics,scalability of motion,multi-input visual interphases with up to three simultaneous visual views,enhanced magnification,and the ability to manipulate three surgical instruments and cameras simultaneously.This review paper begins with the historical development of robotic microsurgery.It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures,such as vasectomy reversal,subinguinal varicocelectomy,targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE).

  9. Robot-assisted cardiac surgery.

    Science.gov (United States)

    Ishikawa, Norihiko; Watanabe, Go

    2015-01-01

    Recognition of the significant advantages of minimizing surgical trauma has resulted in the development of minimally invasive surgical procedures. Endoscopic surgery offers patients the benefits of minimally invasive surgery, and surgical robots have enhanced the ability and precision of surgeons. Consequently, technological advances have facilitated totally endoscopic robotic cardiac surgery, which has allowed surgeons to operate endoscopically rather than through a median sternotomy during cardiac surgery. Thus, repairs for structural heart conditions, including mitral valve plasty, atrial septal defect closure, multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB), and totally endoscopic coronary artery bypass graft surgery (CABG), can be totally endoscopic. Robot-assisted cardiac surgery as minimally invasive cardiac surgery is reviewed. PMID:26134073

  10. Influence of Bariatric Surgery on Remission of Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Paweł Nalepa

    2011-12-01

    Full Text Available The plague of obesity afflicts an increasing group of people. Moreover type 2 diabetes, which is the most serious illness accompanying excessive weight, is becoming more and more common. Traditional methods of obesity treatment, such as diet and physical exercise, fail. This applies especially to people with class III obesity. The only successful way of treating obesity in their case is bariatric surgery. There are three types of bariatric surgery: restrictive procedures (reducing stomach volume, malabsorptive procedures, and mixed procedures, which combine both methods. In spite of the risk connected with the surgery and complications after it, bariatric procedures are advised to patients with class III obesity and class II with an accompanying illness which increases the probability of death. It has been proved that bariatric surgery not only eliminates obesity but also very frequently (in 90�0of cases leads to the remission of type 2 diabetes. Moreover, the remission occurs very fast – it takes place a long time before the patients reduce their weight, even within a few days after surgery. Detailed studies have shown that the remission of diabetes is caused mostly by the change of the gastro-intestinal hormones’ profile, resulting from the surgery. These hormones include GLP-1, GIP, peptide YY, ghrelin and oxyntomodulin. Additionally, the change of the amount of adipose tissue after the surgery influences the level of adipokines, i.e. the hormones of the adipose tissue, among which the most important are leptin, adiponectin and resistin. Thus, bariatric surgery not only changes the shape of the gastrointestinal tract but it also modulates the hormonal activity. Bariatric surgery is considered as therapy not only for the obese but also for diabetic patients.

  11. Increasing orthodontic and orthognathic surgery treatment efficiency with a modified surgery-first approach.

    Science.gov (United States)

    Uribe, Flavio; Agarwal, Sachin; Shafer, David; Nanda, Ravindra

    2015-11-01

    This case report describes the treatment of a 33-year-old white man who had a skeletal Class III and dental Class II subdivision malocclusion caused by a retrognathic maxilla, with severe maxillary crowding, a highly placed maxillary left canine, mild mandibular crowding, and a bilateral posterior crossbite. Treatment was performed with a modified surgery-first approach, which included a short presurgical alignment phase for the correction of the significant maxillary crowding while controlling the incisal angulation, followed by LeFort I maxillary advancement surgery. The short presurgical orthodontic phase aimed at eliminating the anterior dental interferences before the maxillary advancement, and the use of the inherent increased bone turnover in the postsurgical phase helped to reduce the total orthodontic treatment time to 12 months. Pleasing esthetic results and a good functional occlusion were achieved. PMID:26522045

  12. Dexamethasone as antiemetic during gynaecological laparoscopic surgery

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of intravenous dexamethasone for preventing postoperative nausea and vomiting in women undergoing gynecological laparoscopic surgery. Design: Double blind trial. Place and duration of Study: December 2001 to June 2002 at Hayatabad Medical Complex, Peshawar. Patients and Methods: A 100 admitted female patients of ASA-1-II scheduled for diagnostic gynecological laparoscopic surgery were included in this study. Patients with severe systemic or endocrine disease who had predisposing factors for delayed gastric emptying, such as diabetes, chronic choleystills neuromuscular disorders were excluded. In addition patients who suffered from postoperative nausea and vomiting (PONV) or had received and antiemetic agent or narcotic medications within last 24 hours were also excluded. Patients were divided into two equal groups, patients in one group were given dexamethasone while saline was injected to patients in the second group. Nausea and vomiting were assessed immediately after operation, at 1 hour interval for 4 hours in the recovery and from 410 hours in the Ward. Result was compared in two groups by chi-square test. Results: During patient's stay in the Post anesthesia Care Unit (4 hours postoperatively) 26% patients in the dexamethasone group in comparison with 54% of patients in the saline group reported PONV (P<0.01). Sixteen percent of patients in the dexamethasone group, in comparison with 28% of patients in the saline group needed rescue antiemtic (P 0.05), postoperative nausea vomiting (P<0.01). During the postoperative observation period of 10 hours, 42% of the patients in the dexamethasone group in comparison with 82% of patients in the saline group reported postoperative nausea and vomiting (P<0.01). Conclusion: Dexamethasone significantly reduced the incidence of postoperative nausea and vomiting in women undergoing laparoscopic surgery. Furthermore, it is freely available, is less costly and has few side-effects. So, it

  13. Wrong-level surgery: A unique problem in spine surgery

    OpenAIRE

    Hsiang, John

    2011-01-01

    Background: Even though a lot of effort has gone into preventing operating at the wrong site and wrong patient, wrong-level surgery is a unique problem in spine surgery. Methods: The current method to prevent wrong level spine surgery performed is mainly relied on intra-operative X-ray. Unfortunately, because of the unique features and anatomy of the spinal column, wrong level spine surgery still happens. There are situations that even with intraoperative X-ray, correct level still cannot be ...

  14. Energy systems in surgery

    Directory of Open Access Journals (Sweden)

    Pantelić Miloš

    2015-01-01

    Full Text Available Introduction. The systems of energy in surgery are applied in order to achieve better and more effective performing of procedures. Whereas various energy sources, including electricity, ultrasound, laser and argon gas, may be used, the fundamental principle involves tissue necrosis and hemostasis by heating. Electro Surgery. Electro Surgery is a surgical technique by which surgical procedures are performed by focused heating of the tissue using devices based on high-frequency currents. It represents one of the most frequently used energy systems in laparoscopy. Ultrasound Energy. The basic principle of operation of the ultrasound surgical instruments is the usage of low-frequency mechanic vibrations (ultrasound energy within the range of 20-60 kHz for cutting and coagulation of tissue. Laser. Laser is the abbreviation for Light Amplification by Stimulated Emission of Radiation, aimed at increasing light by stimulated emission of radiation and it is the name of the instrument which generates coherent beam of light. Argon Plasma Coagulation. It has been in use since 1991 for endoscopic hemostasis. It uses highfrequency electric current and ionized gas argon. The successful application of devices depends on the type of surgical procedure, training of the surgeon and his knowledge about the device. Surgeons do not agree on the choice of device which would be optimal for a certain procedure. Conclusion. The whole team in the operating room must have the basic knowledge of the way an energy system works so as to provide a safe and effective treatment of patients. The advantages and shortcomings of different systems of energy have to be taken into account while we use a special mode.

  15. SEBACEOUS CYSTS MINOR SURGERY

    Directory of Open Access Journals (Sweden)

    I Gusti Ayu Agung Laksemi

    2013-12-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Minor surgery is small surgery or localized example cut ulcers and boils, cyst excision, and suturing. Somethings that need to be considered in the preparation of the surgery is minor tools, operating rooms and operating tables, lighting, maintenance of tools and equipment, sterilization and desinfection equipment, preparation of patients and anesthesia. In general cysts is walled chamber that consist of fluid, cells and the remaining cells. Cysts are formed not due to inflammation although then be inflamed. Lining of the cysts wall is composed of fibrous tissue and usually coated epithelial cells or endothelial. Cysts formed by dilated glands and closed channels, glands, blood vessels, lymph channels or layers of the epidermis. Contents of the cysts wall consists of the results is serum, lymph, sweat sebum, epithelial cells, the stratum corneum, and hair. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  16. Antifibrinolytics in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Achal Dhir

    2013-01-01

    Full Text Available Cardiac surgery exerts a significant strain on the blood bank services and is a model example in which a multi-modal blood-conservation strategy is recommended. Significant bleeding during cardiac surgery, enough to cause re-exploration and/or blood transfusion, increases morbidity and mortality. Hyper-fibrinolysis is one of the important contributors to increased bleeding. This knowledge has led to the use of anti-fibrinolytic agents especially in procedures performed under cardiopulmonary bypass. Nothing has been more controversial in recent times than the aprotinin controversy. Since the withdrawal of aprotinin from the world market, the choice of antifibrinolytic agents has been limited to lysine analogues either tranexamic acid (TA or epsilon amino caproic acid (EACA. While proponents of aprotinin still argue against its non-availability. Health Canada has approved its use, albeit under very strict regulations. Antifibrinolytic agents are not without side effects and act like double-edged swords, the stronger the anti-fibrinolytic activity, the more serious the side effects. Aprotinin is the strongest in reducing blood loss, blood transfusion, and possibly, return to the operating room after cardiac surgery. EACA is the least effective, while TA is somewhere in between. Additionally, aprotinin has been implicated in increased mortality and maximum side effects. TA has been shown to increase seizure activity, whereas, EACA seems to have the least side effects. Apparently, these agents do not differentiate between pathological and physiological fibrinolysis and prevent all forms of fibrinolysis leading to possible thrombotic side effects. It would seem prudent to select the right agent knowing its risk-benefit profile for a given patient, under the given circumstances.

  17. Minimally invasive mediastinal surgery.

    Science.gov (United States)

    Melfi, Franca M A; Fanucchi, Olivia; Mussi, Alfredo

    2016-01-01

    In the past, mediastinal surgery was associated with the necessity of a maximum exposure, which was accomplished through various approaches. In the early 1990s, many surgical fields, including thoracic surgery, observed the development of minimally invasive techniques. These included video-assisted thoracic surgery (VATS), which confers clear advantages over an open approach, such as less trauma, short hospital stay, increased cosmetic results and preservation of lung function. However, VATS is associated with several disadvantages. For this reason, it is not routinely performed for resection of mediastinal mass lesions, especially those located in the anterior mediastinum, a tiny and remote space that contains vital structures at risk of injury. Robotic systems can overcome the limits of VATS, offering three-dimensional (3D) vision and wristed instrumentations, and are being increasingly used. With regards to thymectomy for myasthenia gravis (MG), unilateral and bilateral VATS approaches have demonstrated good long-term neurologic results with low complication rates. Nevertheless, some authors still advocate the necessity of maximum exposure, especially when considering the distribution of normal and ectopic thymic tissue. In recent studies, the robotic approach has shown to provide similar neurological outcomes when compared to transsternal and VATS approaches, and is associated with a low morbidity. Importantly, through a unilateral robotic technique, it is possible to dissect and remove at least the same amount of mediastinal fat tissue. Preliminary results on early-stage thymomatous disease indicated that minimally invasive approaches are safe and feasible, with a low rate of pleural recurrence, underlining the necessity of a "no-touch" technique. However, especially for thymomatous disease characterized by an indolent nature, further studies with long follow-up period are necessary in order to assess oncologic and neurologic results through minimally invasive

  18. Effects of tranexamic acid during endoscopic sinsus surgery in children

    Directory of Open Access Journals (Sweden)

    Ahmed A Eldaba

    2013-01-01

    Full Text Available Objectives: This study was conducted to evaluate the effect of tranexamic acid (TA on the intra-operative bleeding during the functional endoscopic sinus surgery (FESS in children. Methods: A total of 100 children recruited to undergo FESS were randomized into two groups. Group I: Was given just after induction, intra-venous 25 mg/kg TA diluted in 10 ml of normal saline. Group II: Was given 10 ml of normal saline. Non-invasive blood pressure, heart rate, and quality of the surgical field were estimated every 15 min. Volume of bleeding and duration of the surgical procedure were recorded. Results: Surgical field quality after 15 min revealed that seven patients in group I had minimal bleeding versus no one in group II, P=0.006. Meanwhile, 35 patients in group I had mild bleeding versus 26 patients in group II, P=0.064. Higher number of patients in group II than in group I had moderate bleeding, P=0006. Also, at 30 min, revealed that 10 patients in group I had minimal bleeding versus one patient in group II, P=0.004. Meanwhile, 37 patients in group I had mild bleeding versus 28 patients in group II, P=0.059. Higher number of patients in group II than in group I had moderate bleeding, P<0001. Duration of the surgeries and volume of bleeding were significantly less in tranexamic group than the placebo group, P<0.0001. Conclusion: Single intra-venous bolus dose of tranexamic in children during the FESS improves quality of surgical field, reduces intra-operative bleeding, and duration of surgery.

  19. Femoroacetabular impingement surgery

    DEFF Research Database (Denmark)

    Reiman, Michael P; Thorborg, Kristian

    2015-01-01

    Femoroacetabuler impingement (FAI) is becoming increasingly recognised as a potential pathological entity for individuals with hip pain. Surgery described to correct FAI has risen exponentially in the past 10 years with the use of hip arthroscopy. Unfortunately, the strength of evidence supporting...... both the examination and treatment of FAI does not appear to accommodate this exponential growth. In fact, the direction currently taken for FAI is similar to previously described paths of other orthopaedic and sports medicine pathologies (eg, shoulder impingement, knee meniscus tear) for which we have...

  20. Anesthesia for thoracoscopic surgery

    Directory of Open Access Journals (Sweden)

    Conacher I

    2007-01-01

    Full Text Available Anesthesia for thoracoscopy is based on one lung ventilation. Lung separators in the airway are essential tools. An anatomical shunt as a result of the continued perfusion of a non-ventilated lung is the principal intraoperative concern. The combination of equipment, technique and process increase risks of hypoxia and dynamic hyperinflation, in turn, potential factors in the development of an unusual form of pulmonary edema. Analgesia management is modelled on that shown effective and therapeutic for thoracotomy. Perioperative management needs to reflect the concern for these complex, and complicating, processes to the morbidity of thoracoscopic surgery.

  1. Surgery of vestibular schwannomas

    Directory of Open Access Journals (Sweden)

    Madjid Samii

    2012-01-01

    Full Text Available Vestibular schwannomas (VS are the most common tumors of the cerebellopontine angle (CPA. Their surgical management has reached high standards in the last decade. Treatment options for VS are microsurgical removal or Radiosurgery. The following three basic operative approaches are currently utilized: Retrosigmoid approach (RSA, translabyrinthine and middle fossa approach. The following article elaborates the operative technique by the senior author based on his vast experience of VS surgery formed over the last three decades; during which period he has operated more than 3500 of such patients.

  2. Robotics in colorectal surgery.

    Science.gov (United States)

    Hance, J; Rockall, T; Darzi, A

    2004-01-01

    Minimally invasive surgery has been shown to offer many advantages to general surgical patients but has not been widely adopted for colorectal disease. Initial fears surrounding the oncological safety of laparoscopic colectomies have largely subsided but the technical challenges still remain. Surgical robots or telemanipulators present the laparoscopic surgeon with unrivaled dexterity and vision, which may allow colonic resections to be completed with greater ease. Although initial studies suggest promising results using currently available systems, it will take further time for patient benefits to be proven, therefore justifying the greater expense of operating with this new technology.

  3. [Robotics in pediatric surgery].

    Science.gov (United States)

    Camps, J I

    2011-10-01

    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  4. Pregnancy management following bariatric surgery.

    Science.gov (United States)

    Uzoma, A; Keriakos, R

    2013-02-01

    Bariatric surgery is gaining in popularity, due to globally increasing rates of obesity. In the UK, this has manifested as a 14-fold increase in bariatric surgery between 2004 and 2010, making it necessary to develop strategies to manage women who become pregnant following bariatric surgery. This review paper has explored all the current evidence in the literature and provided a comprehensive management strategy for pregnant women following bariatric surgery. The emphasis is on a multidisciplinary team approach to all aspects of care. Adequate pre-conception and antenatal and postnatal care is essential to good pregnancy outcomes with emphasis on appropriate nutritional supplementation. This is especially important following malabsorptive procedures. There is no evidence to suggest that pregnancy outcome is worse after bariatric surgery, though women who remain obese are prone to obesity-related risks in pregnancy. Neonatal outcome post-bariatric surgery is no different from the general population. PMID:23445128

  5. Pediatric robotic urologic surgery-2014.

    Science.gov (United States)

    Kearns, James T; Gundeti, Mohan S

    2014-07-01

    We seek to provide a background of the current state of pediatric urologic surgery including a brief history, procedural outcomes, cost considerations, future directions, and the state of robotic surgery in India. Pediatric robotic urology has been shown to be safe and effective in cases ranging from pyeloplasty to bladder augmentation with continent urinary diversion. Complication rates are in line with other methods of performing the same procedures. The cost of robotic surgery continues to decrease, but setting up pediatric robotic urology programs can be costly in terms of both monetary investment and the training of robotic surgeons. The future directions of robot surgery include instrument and system refinements, augmented reality and haptics, and telesurgery. Given the large number of children in India, there is huge potential for growth of pediatric robotic urology in India. Pediatric robotic urologic surgery has been established as safe and effective, and it will be an important tool in the future of pediatric urologic surgery worldwide. PMID:25197187

  6. Robotic Surgery in Gynecologic Oncology

    Directory of Open Access Journals (Sweden)

    Robert DeBernardo

    2011-01-01

    Full Text Available Robotic surgery for the management of gynecologic cancers allows for minimally invasive surgical removal of cancer-bearing organs and tissues using sophisticated surgeon-manipulated, robotic surgical instrumentation. Early on, gynecologic oncologists recognized that minimally invasive surgery was associated with less surgical morbidity and that it shortened postoperative recovery. Now, robotic surgery represents an effective alternative to conventional laparotomy. Since its widespread adoption, minimally invasive surgery has become an option not only for the morbidly obese but for women with gynecologic malignancy where conventional laparotomy has been associated with significant morbidity. As such, this paper considers indications for robotic surgery, reflects on outcomes from initial robotic surgical outcomes data, reviews cost efficacy and implications in surgical training, and discusses new roles for robotic surgery in gynecologic cancer management.

  7. Oncoplastic breast surgery: current strategies

    OpenAIRE

    Piper, Merisa; Peled, Anne Warren; Sbitany, Hani

    2015-01-01

    The surgical management of breast cancer has dramatically evolved over the past 20 years, with oncoplastic surgery gaining increased popularity. This field of breast surgery allows for complete resection of tumor, preservation of normal parenchyma tissue, and the use of local or regional tissue for immediate breast reconstruction at the time of partial mastectomy. These techniques extend the options for breast conservation surgery, improve aesthetic outcomes, have high patient satisfaction an...

  8. Oncoplastic breast surgery in Denmark

    DEFF Research Database (Denmark)

    Klit, Anders; Henriksen, Trine Foged; Siersen, Hans Erik;

    2014-01-01

    With improved survival rates after breast cancer treatment, more attention is drawn to improve the cosmetic outcome after surgical treatment of breast cancer. In this process the oncoplastic breast surgery was conceived. It supplements the traditional surgical treatments (mastectomy and breast...... conserving surgery) with increased focus on individualized therapy. The ambition is to obtain the best possible cosmetic outcome without compromising recurrence rates and survival. This article provides an overview of the current oncoplastic breast surgery treatment offered in Denmark....

  9. Preoperative erythropoietin in spine surgery

    OpenAIRE

    Colomina, Maria J.; Bagó, Juan; Pellisé, Ferran; Godet, Carmen; Villanueva, Carlos

    2004-01-01

    Spine surgery may be associated with profuse intraoperative bleeding that often requires blood transfusions. In recent years several techniques have been developed to avoid allogenic transfusions and their potential complications to surgical patients. In this study we review and analyse the role of preoperative recombinant human erythropoietin (rHuEPO) administration in spine surgery as a blood conservation strategy. Between 1998 and 2002, a total of 250 patients scheduled for spine surgery w...

  10. Advances in percutaneous stone surgery

    Directory of Open Access Journals (Sweden)

    Christopher Hartman

    2015-01-01

    Full Text Available Treatment of large renal stones has changed considerably in recent years. The increasing prevalence of nephrolithiasis has mandated that urologists perform more surgeries for large renal calculi than before, and this has been met with improvements in percutaneous stone surgery. In this review paper, we examine recent developments in percutaneous stone surgery, including advances in diagnosis and preoperative planning, renal access, patient position, tract dilation, nephroscopes, lithotripsy, exit strategies, and post-operative antibiotic prophylaxis.

  11. National Epilepsy Surgery Support Activity

    Directory of Open Access Journals (Sweden)

    K Radhakrishnan

    2014-01-01

    Full Text Available While there are over one million people with drug-resistant epilepsy in India, today, there are only a handful of centers equipped to undertake presurgical evaluation and epilepsy surgery. The only solution to overcome this large surgical treatment gap is to establish comprehensive epilepsy care centers across the country that are capable of evaluating and selecting the patients for epilepsy surgery with the locally available technology and in a cost-effective manner. The National Epilepsy Surgery Support Activity (NESSA aims to provide proper guidance and support in establishing epilepsy surgery programs across India and in neighboring resource-poor countries, and in sustaining them.

  12. Aesthetic adjuncts with orthognathic surgery.

    Science.gov (United States)

    Mohamed, Waheed V; Perenack, Jon D

    2014-11-01

    Traditional orthognathic surgery aligns the patient's bony jaws into a desired, more appropriate position but may leave other cosmetic issues unaddressed. Soft tissue deformities may be treated concomitantly with orthognathic surgery, including soft tissue augmentation (fillers), reduction (liposuction), hard tissue augmentation, cosmetic lip procedures, and rhinoplasty. Some cosmetic adjunctive procedures may be performed at a later date after soft tissue edema from orthognathic surgery has resolved to achieve a more predictable outcome. Undesired cosmetic changes may occur months to years after orthognathic surgery and may be addressed by adjunctive cosmetic procedures.

  13. Surgery Risk Assessment (SRA) Database

    Data.gov (United States)

    Department of Veterans Affairs — The Surgery Risk Assessment (SRA) database is part of the VA Surgical Quality Improvement Program (VASQIP). This database contains assessments of selected surgical...

  14. [Computer-assisted surgery].

    Science.gov (United States)

    Micali, Salvatore

    2011-01-01

    The broad range of Computer Assisted Surgery (CAS) represents the integration of computer technology in surgical procedures for presurgical planning, guiding or manipulation. Surgical robots and surgical endoscopic navigation are the most challenging applications to urology. A surgical robot is defined as a computer-controlled manipulator with artificial sensing which can be programmed to move, and position tools to carry out surgical tasks. In urology, robots have been tested in two areas: endourology and laparoscopy. Surgical navigation allows the surgeon to process data from pre- and intraoperative sources, aiming at purification and presentation of the most relevant information. Image-guided systems (IGS), augmented reality (AR) and navigation in endoscopic soft tissue surgery represent the three main topics of surgical urological navigation. IGS involve matching the coordinates from medical imaging (preoperative registration) with coordinates from the patient in the operating room (registration and updating images). IGS have become the standard of care in providing navigational assistance during neurosurgery, offering subsurface and functional information to the surgeon. PMID:21452161

  15. Leadership in cardiac surgery.

    Science.gov (United States)

    Rao, Christopher; Patel, Vanash; Ibrahim, Michael; Ahmed, Kamran; Wong, Kathie A; Darzi, Ara; von Segesser, Ludwig K; Athanasiou, Thanos

    2011-06-01

    Despite the efficacy of cardiac surgery, less invasive interventions with more uncertain long-term outcomes are increasingly challenging surgery as first-line treatment for several congenital, degenerative and ischemic cardiac diseases. The specialty must evolve if it is to ensure its future relevance. More importantly, it must evolve to ensure that future patients have access to treatments with proven long-term effectiveness. This cannot be achieved without dynamic leadership; however, our contention is that this is not enough. The demands of a modern surgical career and the importance of the task at hand are such that the serendipitous emergence of traditional charismatic leadership cannot be relied upon to deliver necessary change. We advocate systematic analysis and strategic leadership at a local, national and international level in four key areas: Clinical Care, Research, Education and Training, and Stakeholder Engagement. While we anticipate that exceptional individuals will continue to shape the future of our specialty, the creation of robust structures to deliver collective leadership in these key areas is of paramount importance. PMID:20884217

  16. Surgery, sterilization and sterility.

    Science.gov (United States)

    Green, V W

    1993-03-01

    The history of sterilization was not linked from the first with surgery. Surgery came first, fully 600 years before the principles of asepsis and anesthesia were even introduced in the middle of the 1800s. Also in the 1800s, the beginnings of thermal sterilization were being developed in the food industry. The basic principles of antisepsis and prevention of wound suppuration, including the destruction of germs on instruments, dressings, the hands of the surgeon and his assistants, and everything else in contact with the wound were clearly elucidated by Lister in the 1870s and remain the inviolate principles of surgical asepsis today. In general, the marriage between the surgeons and the sterilizers was a successful one; the major handicap to eternal bliss and harmony, however, was an incompatibility between the partners. As in many marriages, the partners made unwarranted demands upon each other, and became frustrated when these demands were unfulfilled. The field of surgical sterilization and surgical safety is less confused by technical inconsistencies than it is by semantic nightmares, such that we will never reach a universal definition of sterility. However, we do not really need a universal definition of sterility. Rather we should learn how to translate sterility tests in terms of the real world infections hazards.

  17. [Ethics in aesthetic surgery].

    Science.gov (United States)

    de Fontaine, S

    2013-09-01

    The use of aesthetic medicine and surgery is increasingly popular, and becomes a true phenomenon of society. Many women and men are asking for such treatments. A large proportion of the population carry the idea that this branch of medicine is a true consumer product. The acts of aesthetic medicine and surgery are not without consequences. They produce important changes in the human body, and carry risks of complications that must be taken into account. The overrated media interest of this subject produce commercial drifts that act against the general health of the patients. The invasive acts of medical aesthetics must be placed in a precise legal and ethical framework to protect the patients. A project of a new Belgian law is on the way, awaiting for publication in "Le Moniteur": this law (proposed by Senator Dominique Tilmans) clarifies the competences required for performing non-surgical aesthetic treatments and specific aesthetic invasive treatments. Other projects of law are being studied, and will concern publicity, information of the public, and rules of private clinics where aesthetic invasive acts are performed. Recent international news have shown, with the PIP breast prosthesis scandal, that surveillance of the medical aesthetic field is mandatory. To provide a better protection of patients, the legislator has decided legislate over the subject.

  18. Patents and heart valve surgery - II: tissue valves.

    Science.gov (United States)

    Cheema, Faisal H; Kossar, Alexander P; Rehman, Atiq; Younas, Fahad; Polvani, Gianluca

    2013-08-01

    Valvular heart disease affects millions of Americans yearly and currently requires surgical intervention to repair or replace the defective valves. Through a close-knit collaboration between physicians, scientists and biomedical engineers, a vast degree of research and development has been aimed towards the optimization of prosthetic heart valves. Although various methods have made fantastic strides in producing durable prostheses, the therapeutic efficacy of prosthetic valves is inherently limited by a dependency upon lifelong anticoagulant regimens for recipients - a difficult challenge for many in clinical setting. Thus, biological tissue valves have been developed to circumvent vascular and immunemediated complications by incorporating biological materials to mimic native valves while still maintaining a necessary level of structural integrity. Over the past decade, a multitude of patents pertaining to the refinement of designs as well as the advancement in methodologies and technologies associated with biological tissue valves have been issued. This review seeks to chronicle and characterize such patents in an effort to track the past, present, and future progress as well as project the trajectory of tissue valves in the years to come. PMID:23919429

  19. Patents and heart valve surgery - II: tissue valves.

    Science.gov (United States)

    Cheema, Faisal H; Kossar, Alexander P; Rehman, Atiq; Younas, Fahad; Polvani, Gianluca

    2013-08-01

    Valvular heart disease affects millions of Americans yearly and currently requires surgical intervention to repair or replace the defective valves. Through a close-knit collaboration between physicians, scientists and biomedical engineers, a vast degree of research and development has been aimed towards the optimization of prosthetic heart valves. Although various methods have made fantastic strides in producing durable prostheses, the therapeutic efficacy of prosthetic valves is inherently limited by a dependency upon lifelong anticoagulant regimens for recipients - a difficult challenge for many in clinical setting. Thus, biological tissue valves have been developed to circumvent vascular and immunemediated complications by incorporating biological materials to mimic native valves while still maintaining a necessary level of structural integrity. Over the past decade, a multitude of patents pertaining to the refinement of designs as well as the advancement in methodologies and technologies associated with biological tissue valves have been issued. This review seeks to chronicle and characterize such patents in an effort to track the past, present, and future progress as well as project the trajectory of tissue valves in the years to come.

  20. The relationship between cerebral oxygen saturation changes and post operative neurologic complications in patients undergoing cardiac surgery

    International Nuclear Information System (INIS)

    To study the relationship between cerebral oxygen saturation changes and postoperative neurologic complications. Seventy two adult patients with ASA class II, III who were scheduled for elective cardiac surgery, were randomized into three groups: Group I: with CPB (on -pump) Group II: without CPB (off- pump) Group III: valve surgery. Neuropsychological outcome was assessed by the Mini-Mental State Examination (MMSE). Cerebral oxygen saturation was also measured. There was no statistical difference in desaturation of more than 20% among three groups (P=0.113) but it was significant between group I and II (P=0.042). Changes of rSo/sub 2/ in different hours of surgery was significant in group I and group II (P=0.0001 in both) but it was not significant in group III ( P=0.075) . Although cerebral oximetry is a noninvasive and useful method of monitoring during cardiac surgery, it has low accuracy to determine postoperative neurologic complications. (author)

  1. Additional Surgery after Breast-Conserving Surgery Varies Widely

    Science.gov (United States)

    A study published in the Feb. 1, 2012, issue of JAMA found that the number of women who have one or more additional surgeries to remove suspected residual tumor tissue (re-excisions) following breast-conserving surgery (BCS) for breast cancer varies widely across surgeons and hospitals.

  2. Lithium toxicity after Roux-en-Y bariatric surgery.

    Science.gov (United States)

    Musfeldt, Deanna; Levinson, Andrew; Nykiel, Jennifer; Carino, Gerardo

    2016-01-01

    A 61-year-old woman with medical history significant for morbid obesity, type II diabetes mellitus, nephrogenic diabetes insipidus and bipolar disorder, had been stable on lithium carbonate therapy for several years. She had undergone a Roux-en-Y bypass surgery and, at the time of her surgery, her lithium level was found to be 0.61 mEq/L on a maintenance dose of 600 mg orally twice per day. She was discharged 8 days postoperatively on the same lithium dose, but presented to the emergency department 12 days postoperatively with signs of lithium toxicity. Her lithium level was elevated to 1.51 mEq/L and she was treated for lithium toxicity with supportive care and, ultimately, reduction of her lithium dose. Clinicians should be aware that dramatic and poorly understood changes in drug absorption may occur after bariatric surgery. PMID:26994048

  3. Circadian distribution of sleep phases after major abdominal surgery

    DEFF Research Database (Denmark)

    Gogenur, I.; Wildschiotz, G.; Rosenberg, J.

    2008-01-01

    Background. It is believed that the severely disturbed night-time sleep architecture after surgery is associated with increased cardiovascular morbidity with rebound of rapid eye movement (REM). The daytime sleep pattern of patients after major general surgery has not been investigated before. We...... nights after operation. Sleep was scored independently by two blinded observers and the recordings were reported as awake, light sleep (LS, stages I and II), slow wave sleep (SWS, stages III and IV), and REM sleep. Results. There was significantly increased REM sleep (P=0.046), LS (P=0.020), and reduced...... time awake (P=0.016) in the postoperative daytime period compared with the preoperative daytime period. Five patients had REM sleep during the daytime after surgery. Three of these patients did not have REM sleep during the preceding postoperative night. There was significantly reduced night-time REM...

  4. Spontaneous biliopneumothorax (thoracobilia) following gastropleural fistula due to stomach perforation by nasogastric tube.

    Science.gov (United States)

    Bini, Alessandro; Grazia, Manuele; Petrella, Francesco; Stella, Franco; Bazzocchi, Ruggero

    2004-07-01

    Gastropleural fistula may occur after pulmonary resection, perforated paraesophageal hernia, perforated malignant gastric ulcer at the fundus, or gastric bypass surgery for morbid obesity. We describe a case of gastropleural fistula after stomach perforation by a nasogastric tube in a patient who underwent Billroth II gastric resection for adenocarcinoma. Left biliopneumothorax occurred and was treated by thoracic drainage with -20 cm H2O aspiration. As gastropleural fistula persisted, laparotomy was repeated and gastric and diaphragmatic perforations were sutured. Gastropleural fistula is rare and, to our knowledge, this is the first reported case of gastropleural fistula and biliopneumothorax caused by gastric and diaphragmatic perforation by a nasogastric tube.

  5. Branding of vascular surgery.

    Science.gov (United States)

    Perler, Bruce A

    2008-03-01

    The Society for Vascular Surgery surveyed primary care physicians (PCPs) to understand how PCPs make referral decisions for their patients with peripheral vascular disease. Responses were received from 250 PCPs in 44 states. More than 80% of the respondents characterized their experiences with vascular surgeons as positive or very positive. PCPs perceive that vascular surgeons perform "invasive" procedures and refer patients with the most severe vascular disease to vascular surgeons but were more than twice as likely to refer patients to cardiologists, believing they are better able to perform minimally invasive procedures. Nevertheless, PCPs are receptive to the notion of increasing referrals to vascular surgeons. A successful branding campaign will require considerable education of referring physicians about the totality of traditional vascular and endovascular care increasingly provided by the contemporary vascular surgical practice and will be most effective at the local grassroots level.

  6. Smartphones in Surgery

    Directory of Open Access Journals (Sweden)

    Ara A. Salibian

    2011-01-01

    Full Text Available Smartphones have the capability of enhancing many aspects of the continuum of surgical care by providing an efficient means of multimedia communication among surgeons and healthcare personnel. The ability for mobile Internet and email access, along with features such as built-in cameras and video calling, allow surgeons to rapidly access, send and receive patient information without being restricted by issues of connectivity. Smartphones create an unrestricted network of data sharing, improving the flexibility of patient consultation, timeliness of preoperative preparation, efficiency of post-operative care and the effectiveness of a surgical team. Furthermore, smartphones provide mobile access to a multitude of surgical resources to bolster continued surgical education. This article presents a review of the current literature on the utilizations of smartphones in surgery, discusses their benefits and limitations, and addresses the possibility of incorporating smartphones into the protocol of surgical care.

  7. Cancer immunotherapy with surgery

    Directory of Open Access Journals (Sweden)

    Orita,Kunzo

    1977-08-01

    Full Text Available With the recent advances in the immunological surveillance system, an understanding of the role of host immunity has become essential to the management of carcinogenesis, tumor proliferation, recurrence and metastasis. Although it is important to continue chemical and surgical treatment of cancer, support of the anti-tumor immune system of the host should also be considered. Long term remission has been reported in leukemia by treating with BCG after chemotherapy whereas surgical treatment is usually more effective in preventing cancer recurrence in digestive organ cancer. The first step is extirpating the tumor as thoroughly as possible and the second step is chemo-immunotherapy. Cancer immunity, however weak, constitutes the basis for other treatments in selectively attacking cancer cells remaining after surgery, chemotherapy or irradiation. Immunotherapy should thus not replace chemotherapy or radiotherapy, but these methods should be employed in combination to attain more favorable results.

  8. Impact of Radioimmunoguided Surgery.

    Science.gov (United States)

    La Valle, G J; Chevinsky, A; Martin, E W

    1991-01-01

    Radioimmunoguided surgery (RIGS) is a technique employed to locate tumor deposits with the aid of intravenously injected, tumor-specific, radiolabeled monoclonal antibodies and a small gamma detecting device. The gamma detecting probe (GDP) is a small, portable unit which has the capacity to be used intraoperatively to survey the entire peritoneal surface for increased radioactivity indicative of targeted tumor tissue during abdominal exploration for colorectal cancer. Trials in humans have demonstrated the ability of this system to locate clinically nonpalpable tumor deposits in patients undergoing carcinoembryonic antigen second-look laparotomies. This feature may be of value in improving the definition of tumor location and extent as well as allowing a more thorough resection of tumor-bearing tissue to be performed and hopefully improving overall patient survival.

  9. Telemedicine, virtual reality, and surgery

    Science.gov (United States)

    Mccormack, Percival D.; Charles, Steve

    1994-01-01

    Two types of synthetic experience are covered: virtual reality (VR) and surgery, and telemedicine. The topics are presented in viewgraph form and include the following: geometric models; physiological sensors; surgical applications; virtual cadaver; VR surgical simulation; telesurgery; VR Surgical Trainer; abdominal surgery pilot study; advanced abdominal simulator; examples of telemedicine; and telemedicine spacebridge.

  10. The Ethics of Aesthetic Surgery

    OpenAIRE

    S R Mousavi

    2010-01-01

    Advances in plastic and reconstructive surgery have revolutionized the management of patients suffering from disfiguring congenital abnormalities, burns and skin cancers. The demand for aesthetic surgery has increased in recent years, as our culture has become more concerned with image and appearance. Several ethical considerations such as patient′s right for informed counseling, beneficience and maleficience need to be given careful consideration.

  11. Laparoscopic reintervention in colorectal surgery.

    NARCIS (Netherlands)

    Broek, RP Ten; Goor, H. van

    2008-01-01

    Laparoscopic colorectal surgery has developed in the 1990's and beginning of 2000. The favourable results and great progress in the development of laparoscopic techniques have expanded the indications of laparoscopic colorectal surgery. More and more complicated colorectal cases are treated laparosc

  12. Body dysmorphia and plastic surgery.

    Science.gov (United States)

    Kyle, Allison

    2012-01-01

    Body dysmorphic disorder is a mental disorder characterized by a preoccupation with some aspect of one's appearance. In cosmetic surgery, this preoccupation can be overlooked by practitioners resulting in a discrepancy between expected and realistic outcome. Identifying the characteristics of this disorder may be crucial to the practitioner-patient relationship in the plastic surgery setting. PMID:22929194

  13. Anaesthetic complications in plastic surgery

    OpenAIRE

    Soumya Sankar Nath; Debashis Roy; Farrukh Ansari; Pawar, Sundeep T.

    2013-01-01

    Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issue...

  14. HISTORY OF SURGERY TEMPOROMANDIBULAR JOIN

    Directory of Open Access Journals (Sweden)

    P. G. Sysolyatin

    2016-01-01

    Full Text Available The article presents the main stages of the historical development of the temporo-mandibular joint surgery. It was shown the evolution of treatments for diseases and injuries of joints. It summarizes the main work of domestic and foreign authors that influenced the development of surgery of the temporo-mandibular joint. 

  15. Mortality after surgery in Europe

    DEFF Research Database (Denmark)

    Pearse, Rupert M; Moreno, Rui P; Bauer, Peter;

    2012-01-01

    Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international...... study designed to assess outcomes after non-cardiac surgery in Europe....

  16. Early outcome of noma surgery

    NARCIS (Netherlands)

    Bouman, M A; Marck, K W; Griep, J E M; Marck, R E; Huijing, M A; Werker, P M N

    2010-01-01

    INTRODUCTION: Reconstructive noma surgery is performed on many short-term medical missions. The treatment outcome, however, has rarely been studied. MATERIALS AND METHODS: We studied complications and clinical outcome of reconstructive noma surgery performed during four short-term medical missions.

  17. Robotic assisted minimally invasive surgery

    Directory of Open Access Journals (Sweden)

    Palep Jaydeep

    2009-01-01

    Full Text Available The term "robot" was coined by the Czech playright Karel Capek in 1921 in his play Rossom′s Universal Robots. The word "robot" is from the check word robota which means forced labor.The era of robots in surgery commenced in 1994 when the first AESOP (voice controlled camera holder prototype robot was used clinically in 1993 and then marketed as the first surgical robot ever in 1994 by the US FDA. Since then many robot prototypes like the Endoassist (Armstrong Healthcare Ltd., High Wycombe, Buck, UK, FIPS endoarm (Karlsruhe Research Center, Karlsruhe, Germany have been developed to add to the functions of the robot and try and increase its utility. Integrated Surgical Systems (now Intuitive Surgery, Inc. redesigned the SRI Green Telepresence Surgery system and created the daVinci Surgical System ® classified as a master-slave surgical system. It uses true 3-D visualization and EndoWrist ® . It was approved by FDA in July 2000 for general laparoscopic surgery, in November 2002 for mitral valve repair surgery. The da Vinci robot is currently being used in various fields such as urology, general surgery, gynecology, cardio-thoracic, pediatric and ENT surgery. It provides several advantages to conventional laparoscopy such as 3D vision, motion scaling, intuitive movements, visual immersion and tremor filtration. The advent of robotics has increased the use of minimally invasive surgery among laparoscopically naοve surgeons and expanded the repertoire of experienced surgeons to include more advanced and complex reconstructions.

  18. [Modern mitral valve surgery].

    Science.gov (United States)

    Bothe, W; Beyersdorf, F

    2016-04-01

    At the beginning of the 20th century, Cutler and Levine performed the first successful surgical treatment of a stenotic mitral valve, which was the only treatable heart valve defect at that time. Mitral valve surgery has evolved significantly since then. The introduction of the heart-lung machine in 1954 not only reduced the surgical risk, but also allowed the treatment of different mitral valve pathologies. Nowadays, mitral valve insufficiency has become the most common underlying pathomechanism of mitral valve disease and can be classified into primary and secondary mitral insufficiency. Primary mitral valve insufficiency is mainly caused by alterations of the valve (leaflets and primary order chords) itself, whereas left ventricular dilatation leading to papillary muscle displacement and leaflet tethering via second order chords is the main underlying pathomechanism for secondary mitral valve regurgitation. Valve reconstruction using the "loop technique" plus annuloplasty is the surgical strategy of choice and normalizes life expectancy in patients with primary mitral regurgitation. In patients with secondary mitral regurgitation, implanting an annuloplasty is not superior to valve replacement and results in high rates of valve re-insufficiency (up to 30 % after 3 months) due to ongoing ventricular dilatation. In order to improve repair results in these patients, we add a novel subvalvular technique (ring-noose-string) to the annuloplasty that aims to prevent ongoing ventricular remodeling and re-insufficiency. In modern mitral surgery, a right lateral thoracotomy is the approach of choice with excellent repair and cosmetic results. PMID:26907868

  19. [Robotic surgery for cancer treatment].

    Science.gov (United States)

    Oouchida, Kenoki; Ieiri, Satoshi; Kenmotsu, Hajime; Tomikawa, Morimasa; Hashizume, Makoto

    2012-01-01

    Surgical operation is still one of the important options for treatment of many types of cancer. In the present-day treatment of cancer, patients' quality of life is focused on and surgeons need to provide minimally invasive surgery without decreasing the curability of disease. Endoscopic surgery contributed to the prevalence of minimally -invasive surgery. However it has also raised a problem regarding differences in surgical techniques among individual surgeons. Robot-assisted surgery provides some resolutions with 3D vision and increases the freedom of forceps manipulation. Furthermore, 3D visual magnification, scaling function, and the filtering function of surgical robots may make it possible for surgeons to perform microsurgery more delicate than open surgery. Here, we report the present status and the future of the representative surgical robot, and the da Vinci surgical system. PMID:22241345

  20. Ethnic Considerations for Metabolic Surgery.

    Science.gov (United States)

    Morton, John Magaña

    2016-06-01

    Obesity and diabetes represent twin health concerns in the developed world. Metabolic surgery has emerged as an established and enduring treatment for both obesity and diabetes. As the burden of obesity and diabetes varies upon the basis of ethnicity, it is also apparent that there may be differences for indications and outcomes for different ethnic groups after metabolic surgery. Whereas there appears to be evidence for variation in weight loss and complications for different ethnic groups, comorbidity remission particularly for diabetes appears to be free of ethnic disparity after metabolic surgery. The impacts of access, biology, culture, genetics, procedure, and socioeconomic status upon metabolic surgery outcomes are examined. Further refinement of the influence of ethnicity upon metabolic surgery outcomes is likely imminent. PMID:27222553

  1. Effects of Bariatric Surgery on Human Small Artery Function

    OpenAIRE

    Aghamohammadzadeh, Reza; Greenstein, Adam S.; Yadav, Rahul; Jeziorska, Maria; Hama, Salam; Soltani, Fardad; Pemberton, Phil W.; Ammori, Basil; Malik, Rayaz A; Soran, Handrean; Heagerty, Anthony M

    2013-01-01

    Objectives The aim of this study was to investigate the effects of bariatric surgery on small artery function and the mechanisms underlying this. Background In lean healthy humans, perivascular adipose tissue (PVAT) exerts an anticontractile effect on adjacent small arteries, but this is lost in obesity-associated conditions such as the metabolic syndrome and type II diabetes where there is evidence of adipocyte inflammation and increased oxidative stress. Methods Segments of small subcutaneo...

  2. The day of your surgery - adult

    Science.gov (United States)

    ... safety. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. ... surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. ...

  3. Limited Evidence for Robot-assisted Surgery

    DEFF Research Database (Denmark)

    Broholm, Malene; Onsberg Hansen, Iben; Rosenberg, Jacob

    2016-01-01

    PURPOSE: To evaluate available evidence on robot-assisted surgery compared with open and laparoscopic surgery. METHOD: The databases Medline, Embase, and Cochrane Library were systematically searched for randomized controlled trials comparing robot-assisted surgery with open and laparoscopic...

  4. American Society for Metabolic and Bariatric Surgery

    Science.gov (United States)

    ... Op Weight Loss, Intra-Gastric Balloon, and Revisional Surgery... Certified Bariatric Nurses Be a part of the ASMBS Certified ... Online Education Directory Search Patient Learning Center Bariatric Surgery FAQs Bariatric Surgery Procedures BMI Calculator Childhood and Adolescent Obesity ...

  5. Your diet after gastric bypass surgery

    Science.gov (United States)

    Gastric bypass surgery - your diet; Obesity - diet after bypass; Weight loss - diet after bypass ... You had gastric bypass surgery. This surgery made your stomach smaller by closing off most of your stomach with staples. It changed ...

  6. Asian perspective in surgery: thoracic surgery in Turkey.

    Science.gov (United States)

    Turna, Akif

    2016-08-01

    Turkey with a population of 78 million is located between Asia and Europe geographically and culturally. There are 577 active pure thoracic surgeon and 37 thoracic surgery teaching units. Thoracic surgeons usually deal with lung cancer patients due to relatively higher rate of tobacco usage as well as inflammatory diseases such as pulmonary hydatid disease, bronchiectasis and empyema. Minimally invasive thoracic surgery has been a new approach which is being adapted by increasingly more surgeons. There are a number of reasons to predict that the number of thoracic surgical cases will be increased and new generation of thoracic surgeons will be operating more minimally invasive resectional surgeries for most lung cancer in future.

  7. Effects of Bariatric Surgery on Human Small Artery Function

    Science.gov (United States)

    Aghamohammadzadeh, Reza; Greenstein, Adam S.; Yadav, Rahul; Jeziorska, Maria; Hama, Salam; Soltani, Fardad; Pemberton, Phil W.; Ammori, Basil; Malik, Rayaz A.; Soran, Handrean; Heagerty, Anthony M.

    2013-01-01

    Objectives The aim of this study was to investigate the effects of bariatric surgery on small artery function and the mechanisms underlying this. Background In lean healthy humans, perivascular adipose tissue (PVAT) exerts an anticontractile effect on adjacent small arteries, but this is lost in obesity-associated conditions such as the metabolic syndrome and type II diabetes where there is evidence of adipocyte inflammation and increased oxidative stress. Methods Segments of small subcutaneous artery and perivascular fat were harvested from severely obese individuals before (n = 20) and 6 months after bariatric surgery (n = 15). Small artery contractile function was examined in vitro with wire myography, and perivascular adipose tissue (PVAT) morphology was assessed with immunohistochemistry. Results The anticontractile activity of PVAT was lost in obese patients before surgery when compared with healthy volunteers and was restored 6 months after bariatric surgery. In vitro protocols with superoxide dismutase and catalase rescued PVAT anticontractile function in tissue from obese individuals before surgery. The improvement in anticontractile function after surgery was accompanied by improvements in insulin sensitivity, serum glycemic indexes, inflammatory cytokines, adipokine profile, and systolic blood pressure together with increased PVAT adiponectin and nitric oxide bioavailability and reduced macrophage infiltration and inflammation. These changes were observed despite the patients remaining severely obese. Conclusions Bariatric surgery and its attendant improvements in weight, blood pressure, inflammation, and metabolism collectively reverse the obesity-induced alteration to PVAT anticontractile function. This reversal is attributable to reductions in local adipose inflammation and oxidative stress with improved adiponectin and nitric oxide bioavailability. PMID:23665100

  8. Quality of life after surgery for neuromuscular scoliosis

    Directory of Open Access Journals (Sweden)

    Peter Obid

    2013-02-01

    Full Text Available Surgery in patients with neuromuscular scoliosis is associated with a higher rate of complications. It is still controversially discussed whether the patients truly benefit from deformity correction. The purpose of this study is to investigate if the quality of life has been improved and if the patients and their caregivers are satisfied with the results of surgery. This is a retrospective clinical outcome study of 46 patients with neuromuscular scoliosis which were treated with primary stable posterior pedicle screw instrumentation and correction. To achieve fusion only autologous bone was used. Follow up was minimum 2 years and maximum 5 years with an average of 36 months. The patients and/or their caregivers received a questionnaire based on the PEDI (pediatric disability inventory and the GMFS (gross motor function score. The patients (and their caregivers were also asked if the quality of life has improved after surgery. Only 32 of 46 patients answered the questionnaire. The answers showed a high approval-rate regarding the patients satisfaction with the surgery and the improvement of quality of life. The questionnaire could be answered from 1 (I do not agree to 4 (I completely agree. The average agreement to the following statements was: i the quality of life has improved: 3.35; ii I am satisfied with surgery: 3.95; iii the operation has fulfilled my expectations: 3.76. The average age at surgery was 12.7 years. The mean pre-operative cobb-angle of the main curve was 83.1° with a correction post-operatively to a mean of 36.9° and 42.6° at final follow-up. That is an average correction of 56.9%. Although spinal fusion in neuromuscular scoliosis is associated with a higher rate of complications our results show that the patients and their caregivers are satisfied with the operation and the quality of life has improved after surgery.

  9. Physiology of vitreous surgery.

    Science.gov (United States)

    Stefánsson, Einar

    2009-02-01

    Vitreous surgery has various physiological and clinical consequences, both beneficial and harmful. Vitrectomy reduces the risk of retinal neovascularization, while increasing the risk of iris neovascularization, reduces macular edema and stimulates cataract formation. These clinical consequences may be understood with the help of classical laws of physics and physiology. The laws of Fick, Stokes-Einstein and Hagen-Poiseuille state that molecular transport by diffusion or convection is inversely related to the viscosity of the medium. When the vitreous gel is replaced with less viscous saline, the transport of all molecules, including oxygen and cytokines, is facilitated. Oxygen transport to ischemic retinal areas is improved, as is clearance of VEGF and other cytokines from these areas, thus reducing edema and neovascularization. At the same time, oxygen is transported faster down a concentration gradient from the anterior to the posterior segment, while VEGF moves in the opposite direction, making the anterior segment less oxygenated and with more VEGF, stimulating iris neovascularization. Silicone oil is the exception that proves the rule: it is more viscous than vitreous humour, re-establishes the transport barrier to oxygen and VEGF, and reduces the risk for iris neovascularization in the vitrectomized-lentectomized eye. Modern vitreous surgery involves a variety of treatment options in addition to vitrectomy itself, such as photocoagulation, anti-VEGF drugs, intravitreal steroids and release of vitreoretinal traction. A full understanding of these treatment modalities allows sensible combination of treatment options. Retinal photocoagulation has repeatedly been shown to improve retinal oxygenation, as does vitrectomy. Oxygen naturally reduces VEGF production and improves retinal hemodynamics. The VEGF-lowering effect of photocoagulation and vitrectomy can be augmented with anti-VEGF drugs and the permeability effect of VEGF reduced with corticosteroids

  10. ROLE OF ESMOLOL AND SODIUM NITROPRUSSIDE AS HYPOTENSIVE AGENTS IN FUNCTIONAL ENDOSCOPIC SINUS SURGERIES

    OpenAIRE

    Fayaz Ahmad; Farhana; Saba,, Francesca; Mushtaq Ahmad

    2015-01-01

    BACKGROUND Present study was conducted to evaluate the efficacy of esmolol and sodium nitroprusside as hypotensive agents in functional endoscopic surgeries. METHODS Forty patients of age group 18-60 years and ASA I and II physical status scheduled for Functional Endoscopic Surgeries (FESS) were randomly assigned into two groups of twenty patients each. Patients in group A received Sodium Nitroprusside (SNP) 0.5- 10µg/kgwt/min. infusion after induction of anaesthes...

  11. Perioperatory antibiotic prophylaxis in Pediatric Surgery (Part I: abdominal surgery

    Directory of Open Access Journals (Sweden)

    Sergio Luis González López

    2005-12-01

    Full Text Available The surgical wound infection is the biggest cause of infectious morbility in surgical patients. It is an important cause of morbility that causes lincreased hospital demurrages, increased cost of medical attention and serious inconveniences to the patients and their familiies. 25% of all nosocomial infections are surgical wound infection. One of the big advances of the surgery in the last three decades is an introduction of antibiotic prophylaxis in the surgical practice. Is considered that it has saved more lives than any other novel procedure in surgery in the last 20 years. We presented the Good Clinical Practices Guideline for Antibiotic prophylaxis in abdominal surgery, approved by consensus in the 1st National Good Clinical Practices Workshop in Pediatric Surgery (Cienfuegos, Cuba, March 7 – 9, 2002.

  12. TBscore II

    DEFF Research Database (Denmark)

    Rudolf, Frauke; Lemvik, Grethe; Abate, Ebba;

    2013-01-01

    Abstract Background: The TBscore, based on simple signs and symptoms, was introduced to predict unsuccessful outcome in tuberculosis patients on treatment. A recent inter-observer variation study showed profound variation in some variables. Further, some variables depend on a physician assessing...... them, making the score less applicable. The aim of the present study was to simplify the TBscore. Methods: Inter-observer variation assessment and exploratory factor analysis were combined to develop a simplified score, the TBscore II. To validate TBscore II we assessed the association between start...

  13. Complications in hair restoration surgery.

    Science.gov (United States)

    Perez-Meza, David; Niedbalski, Robert

    2009-02-01

    Hair loss affects more than 1.2 billion people worldwide. As the technology and artistry of hair restoration surgery has improved including natural results, so too has the popularity of this procedure. As with any other surgical procedure, complications may occur and this presents a major challenge for the surgeon and the patient. This article provides an overview of the complications most likely to occur during the pre, intra, and postoperative periods with modern hair transplant surgery (single follicular unit or multifollicular unit) including scalp surgery, and discusses their treatment and most importantly their prevention. PMID:19185800

  14. Gastrointestinal Surgery of Neuroendocrine Neoplasms

    DEFF Research Database (Denmark)

    Hansen, Carsten Palnæs; Olsen, Ingrid Marie Holst; Knigge, Ulrich

    2015-01-01

    Surgery is the only treatment that may cure the patient with gastroenteropancreatic (GEP) neuroendocrine neoplasms (NENs) and should always be considered as the first-line treatment if radical resection can be achieved. Even in cases where radical surgery is not possible, palliative resection may...... be performed to reduce local or hormone-induced symptoms and to improve quality of life. The surgical procedures for GEP-NENs are accordingly described below. In most patients life-long follow-up is required, even following radical surgery, as recurrence may occur several years later....

  15. Update on Adolescent Bariatric Surgery.

    Science.gov (United States)

    Desai, Nirav K; Wulkan, Mark L; Inge, Thomas H

    2016-09-01

    Childhood obesity remains a significant public health issue. Approximately 8% of adolescent girls and 7% of adolescent boys have severe (≥class 2) obesity. Adolescent severe obesity is associated with numerous comorbidities, and persists into adulthood. Bariatric surgery is the most effective treatment available, resulting in major weight loss and resolution of important comorbid conditions. Clinical practice guidelines for pediatric obesity treatment recommend consideration of surgery after failure of behavioral approaches. Careful screening and postoperative management of patients by a multidisciplinary team is required. Long-term studies are needed to assess the impact of adolescent bariatric surgery. PMID:27519138

  16. Asian perspective in surgery: thoracic surgery in Turkey

    OpenAIRE

    Turna, Akif

    2016-01-01

    Turkey with a population of 78 million is located between Asia and Europe geographically and culturally. There are 577 active pure thoracic surgeon and 37 thoracic surgery teaching units. Thoracic surgeons usually deal with lung cancer patients due to relatively higher rate of tobacco usage as well as inflammatory diseases such as pulmonary hydatid disease, bronchiectasis and empyema. Minimally invasive thoracic surgery has been a new approach which is being adapted by increasingly more surge...

  17. Surgery for Peyronie's disease

    Institute of Scientific and Technical Information of China (English)

    Laurence A Levine; Stephen M Larsen

    2013-01-01

    Peyronie's disease (PD) is most simply referred to as a fibrotic wound-healing disorder of the tunica albuginea.It is both a physically and psychologically devastating disorder that causes penile deformity,curvature,hinging,narrowing and shortening,which may compromise sexual function.Although a variety of non-surgical treatments have been suggested,none to date offer a reliable and effective correction of the penile deformity.As a result,surgery remains the gold standard treatment option,offering the most rapid and reliable treatment which will be the focus of this article.We review the preoperative evaluation,surgical algorithm,graft materials and postoperative management of PD.Outcomes for tunical shortening,tunical lengthening and penile prosthesis placement for penile straightening are reviewed.Tunica albuginea plication is the preferred method of straightening for men with adequate rigidity and less severe disease defined as curvature less than 70° without narrowing/hinging.Men who have more severe,complex deformity,but maintain strong preoperative erectile function should be considered candidates for straightening with plaque incision or partial excision and grafting.Finally,for those men who have inadequate rigidity and PD,penile prosthesis placement with straightening is the best approach to address both problems.

  18. Surgery of Primary Melanomas

    International Nuclear Information System (INIS)

    Surgery remains the mainstay of melanoma therapy, regardless of the tumor site. Only the early diagnosis combined with proper surgical therapy currently gives patients affected by this malignancy the chance for a full cure. The main goal of surgical therapy is to provide the local control of the disease and to secure long-term survival of the patient without reasonable functional and esthetic impairment. The recommended method of biopsy—excisional biopsy, as an initial diagnostic and, to some extent, therapeutic procedure—is performed under local anesthesia as an elliptical incision with visual clear margins of 1–3 mm and with some mm of subcutaneous tissue. The extent of radical excision of the primary tumor (or scar after excisional biopsy) is based on the histopathologic characteristics of the primary tumor and usually consists of 1–2 cm margins with primary closure. The philosophy behind conducted randomized clinical trials has been to find the most conservative surgical approach that is able to guarantee the same results as more demolitive treatment. This has been the background of the trials designed to define the correct margins of excision around a primary cutaneous melanoma. Much less definition can be dedicated to the surgical management of patients with non-cutaneous melanomas

  19. [Prophylactic pancreas surgery].

    Science.gov (United States)

    Langer, P; Rothmund, M; Bartsch, D K

    2006-01-01

    The goal of prophylactic surgery is to prevent malignant growth in patients with hereditary tumor predisposition. The pancreas presents as particularly challenging, due to the difficulty of operation and comparatively high risk of morbidity and even mortality. In addition, partial operative procedures and, more significantly, total resection lead to exocrine pancreas insufficiency and secondary diabetes, with grave consequences for the patient. Hereditary tumor predisposition syndromes that can result in pancreaticoduodenal endocrine tumors (PET) include multiple endocrine neoplasia type 1 syndrome and von Hippel-Lindau syndrome. As penetrance is maximally 70-80% and the 10-year survival rate over 80%, prophylactic pancreatic resection without evidence of a tumor is not indicated. However, prophylactic extension of a resection would be advised, should a PET be diagnosed. Patients predisposed to developing ductal pancreatic carcinoma (PC) are at risk of familial pancreatic cancer syndrome (FPC), hereditary pancreatitis, and other hereditary tumor predisposition syndromes such as Peutz-Jeghers syndrome and familial atypical multiple mole-melanoma syndrome. As the gene defect responsible for FPC has yet to be identified and the penetrance of PC in the other tumor predisposition syndromes is low or unknown, a prophylactic pancreatectomy based on today's knowledge is not indicated. Prophylactic extension of the resection is advisable should PC or high-grade PanIN lesions be diagnosed, as these patients often present with multifocal dysplasia and even carcinoma.

  20. Sarcopenia in Orthopedic Surgery.

    Science.gov (United States)

    Bokshan, Steven L; DePasse, J Mason; Daniels, Alan H

    2016-01-01

    Sarcopenia is a loss of skeletal muscle mass in the elderly that is an independent risk factor for falls, disability, postoperative complications, and mortality. Although its cause is not completely understood, sarcopenia generally results from a complex bone-muscle interaction in the setting of chronic disease and aging. Sarcopenia cannot be diagnosed by muscle mass alone. Diagnosis requires 2 of the following 3 criteria: low skeletal muscle mass, inadequate muscle strength, and inadequate physical performance. Forty-four percent of elderly patients undergoing orthopedic surgery and 24% of all patients 65 to 70 years old are sarcopenic. Although dual-energy x-ray absorptiometry and bioelectrical impedance analysis may be used to measure sarcopenia and are relatively inexpensive and accessible, they are generally considered less specific for sarcopenia compared with computed tomography and magnetic resonance imaging. Sarcopenia has been shown to predict poor outcomes within the medical and surgical populations and has been directly correlated with increases in taxpayer costs. Strengthening therapy and nutritional supplementation have become the mainstays of sarcopenia treatment. Specifically, the American Medical Directors Association has released guidelines for nutritional supplementation. Although sarcopenia frequently occurs with osteoporosis, it is an independent predictor of fragility fractures. Initiatives to diagnose, treat, and prevent sarcopenia in orthopedic patients are needed. Further investigation must also explore sarcopenia as a predictor of surgical outcomes in orthopedic patients. PMID:26913764

  1. TECHNOLOGY AND THYROID SURGERY

    Directory of Open Access Journals (Sweden)

    A. Nicolosi

    2010-05-01

    Full Text Available The main complications after total thyroidectomy are less and include bleeding, injuries of recurrent laryngeal nerves (RLN and hypoparathyroidism. Modern technologies increase a quality of thyroid surgery. Accurate hemostasis is basic to prevent bleeding. Harmonic Focus is an ultrasonic scalpel that performs dissection, hemostasis and cut with small lateral thermal injuries. Harmonic Focus decrease operative time, hospital stay, postoperative drainage and postoperative hypoparathyroidism. Intraoperative RLN injury causes are section (mistake in surgical technique; ligature (without transection; mistake in haemostasis and dissection manoeuvres; stretch/traction; excessive traction during the medial traction of the thyroid lobe; excessive aspiration near to the nerve (suction; compression/contusion/pressure; thermal/electrical injury; diffusion by haemostatic devices; ischemia; ligation of the inferior pole vessels before identifying RLN; excessive dissection of the nerve with ischemia. Evolution of RLN monitoring was from intra-operative invasive techniques to non-invasive surface electrodes (endotracheal tube. Positive acoustic signal following stimulation of the vague nerve and the RLN always means: vocalis muscle is intact and positive acoustic signal only by RLN stimulation usually means: RLN paresis (nerve lesion distal to the stimulation site. The correlation between a positive acoustic signal and a postoperatively intact vocal function is very high (97%. The use of the nerve monitoring can be recommended as useful, but not generally demanded as obligatory.

  2. Antifibrinolytics in liver surgery

    Directory of Open Access Journals (Sweden)

    Jalpa Makwana

    2010-01-01

    Full Text Available Hyperfibrinolysis, a known complication of liver surgery and orthotopic liver transplantation (OLT, plays a significant role in blood loss. This fact justifies the use of antifibrinolytic drugs during these procedures. Two groups of drug namely lysine analogues [epsilon aminocaproic acid (EACA and tranexamic acid (TA] and serine-protease-inhibitors (aprotinin are frequently used for this purpose. But uniform data or guidelines on the type of antifibrinolytic drugs to be used, their indications and correct dose, is still insufficient. Antifibrinolytics behave like a double-edged sword. On one hand, there are benefits of less transfusion requirements but on the other hand there is potential complication like thromboembolism, which has been reported in several studies. We performed a systematic search in PubMed and Cochrane Library, and we included studies wherein antifibrinolytic drugs (EACA, TA, or aprotinin were compared with each other or with controls/placebo. We analysed factors like intraoperative red blood cell and fresh frozen plasma requirements, the perioperative incidence of hepatic artery thrombosis, venous thromboembolic events and mortality. Among the three drugs, EACA is least studied. Use of extensively studied drug like aprotinin has been restricted because of its side effects. Haemostatic effect of aprotinin and tranexamic acid has been comparable. However, proper patient selection and individualized treatment for each of them is required. Purpose of this review is to study various clinical trials on antifibrinolytic drugs and address the related issues like benefits claimed and associated potential complications.

  3. Image guidance in endoscopic sinus surgery and skull base surgery

    Institute of Scientific and Technical Information of China (English)

    Mitchell R.Gore; Brent A.Senior

    2012-01-01

    Objective The objective of this study was to review the current clinical applications and impact of intraoperative imaging on endoscopic sinonasal and skull base procedures in adult and pediatric patients.Methods The PubMed database was searched for articles related to the use of image guidance in otolaryngology using the search terms "image guidance otolaryngology".This was supplemented by the authors′ experience utilizing image guidance in nearly 3000 endoscopic sinus and skull base procedures.Results The literature demonstrates that intraoperative image guidance has utility in primary and revision endoscopic sinus surgery,as well as endoscopic surgery of the skull base.Image guidance also has applications in pediatric endoscopic surgery,such as pediatric sinus surgery and repair of choanal atresia.Conclusions Intraoperative image guidance,when combined with a thorough knowledge of paranasal sinus and skull base anatomy and technical proficiency,can provide improved safety when performing otolaryngologic procedures from endoscopic sinus surgery to endoscopic skull base surgery.While not a substitute for knowledge of anatomy,the increased availability and usability of image guidance systems make them a useful tool in the armamentarium of the otolaryngologist/head and neck surgeon and neurosurgeon.

  4. IMAGE-GUIDED SURGERY IN THE SPINE: NEURONAVIGATION VS. FLUOROSCOPY

    Directory of Open Access Journals (Sweden)

    Vinícius de Paula Guedes

    2015-09-01

    Full Text Available Objectives:To evaluate the accuracy and the operative complications of implanting pedicle screws in the thoracic and lumbar spine, using computer-assisted surgery compared to the implantation technique using fluoroscopy.Methods:A retrospective study was conducted at the Hospital Universitário Cajuru PUC-PR from January 2000 to January 2009. Two groups of patients undergoing implant pedicle screws were analyzed (n=80. Group I received implant pedicle screws through fluoroscopy technique and group II, through neuronavigation technique. The accuracy of positioning of pedicle screws was evaluated using rating scales.Results:The accuracy was higher in group II, where 77.5% of the screws were correctly positioned, whereas there were only 28.5% in group I (p=0.001. There was a reduction of 95% (CI: 80-97% in the risk of screws misplacement in group II. The average operation time was 312.2±78.1 minutes in group I and 270.3±41.4 in group II (p=0.004. Blood transfusion was needed in 28 patients in group I and 10 patients in group II (p=0.005, resulting in 64% risk reduction of blood transfusion in group II. Eight patients in group I underwent revision surgery whereas only one patient in the group II, that is, 75% of surgical revision risk reduction.Conclusion:The implantation technique of pedicle screws using neuronavigation is a more accurate method and has less operative complications compared with the technique that uses fluoroscopy.

  5. Effects of orthognathic surgery on psychological status of patients with jaw deformities.

    Science.gov (United States)

    Takatsuji, H; Kobayashi, T; Kojima, T; Hasebe, D; Izumi, N; Saito, I; Saito, C

    2015-09-01

    The purpose of this study was to determine the effect of orthognathic surgery on psychological status. The subjects were 119 patients (38 males and 81 females, mean age 25.5±9.4 years) who underwent orthognathic surgery. They were divided into class III (84 patients), class II (20 patients), and class I (15 patients) groups according to the anteroposterior skeletal pattern, and they were also divided into an asymmetry group (51 patients) and a symmetry group (68 patients). We assessed psychological status using the Minnesota Multiphasic Personality Inventory (MMPI) before surgery and at more than 6 months after surgery. The MMPI scores for the depression, hysteria, psychasthenia, and social introversion scales were significantly higher than standard values before surgery, and the hypomania scale significantly lower. The cannot say scale, depression scale, and hysteria scale decreased significantly after surgery. A comparison of MMPI scores among the groups showed the depression scale in the class III group to be higher than those in the class I and II groups; there was no significant difference between the asymmetry and symmetry groups. In conclusion, orthognathic surgery has a positive influence on the psychological status of patients with jaw deformities, especially patients with skeletal class III malocclusion.

  6. Evaluation of macular thickness change after inferior oblique muscle recession surgery

    Directory of Open Access Journals (Sweden)

    Ece Turan-Vural

    2014-01-01

    Full Text Available Purpose: This study aimed to evaluate the changes in macular thickness following inferior oblique muscle recession surgery. Materials and Methods: Thirty-eight eyes from 21 patients undergoing ocular muscle surgery were included. Patients were grouped into three groups based on the type of surgical intervention: Group I (n = 12, inferior oblique recession surgery alone; Group II (n = 12, inferior oblique plus horizontal muscle surgery; Group III (n = 14, horizontal muscle surgery alone. Each eye was scanned using the optical coherence tomography (OCT device preoperatively and on the first postoperative day to measure macular thickness. Results: Following surgery, a significant increase in foveal thickness occurred in Group I (P < 0.05 and Group II (P < 0.01. In addition, a statistically significant difference was observed between the groups with regard to the increase in foveal thickness (P = 0.016, with significantly lower changes in Group III. Conclusion: Our findings suggested that inferior oblique muscle recession surgery is associated with an increase in macular thickness.

  7. Robot-Assisted Gynecologic Surgery

    Science.gov (United States)

    ... guys tonight. We’re going to be talking robotic-assisted gynecologic surgery, and I can tell you, ... and it shows us how we start a robotic case really like standard laparoscopy, and there’s an ...

  8. Robot-Assisted Gynecologic Surgery

    Medline Plus

    Full Text Available ... upper level of normal of most labs these days is 21, so 64 is two, three times ... just saw, will go home on post-operative day number one. If their surgery is less involved, ...

  9. Robot-Assisted Gynecologic Surgery

    Medline Plus

    Full Text Available Halifax Health Presents: Roboti-Assisted Gynecologic Surgery Halifax Health Florida September 27, 2011 Hello, and welcome to another live ... you by the fine folks here at Halifax Health. Broadcasting live from sunny Daytona Beach, Florida, and ...

  10. Robot-Assisted Gynecologic Surgery

    Medline Plus

    Full Text Available ... direct our surgery. If it’s a situation where chemotherapy is indicated, then we also oversee and administer their chemotherapy and all of the follow up, thereafter. That’s ...

  11. Cognitive dysfunction after cardiovascular surgery

    DEFF Research Database (Denmark)

    Funder, K S; Steinmetz, J; Rasmussen, L S

    2009-01-01

    This review describes the incidence, risk factors, and long-term consequences of cognitive dysfunction after cardiovascular surgery. Postoperative cognitive dysfunction (POCD) is increasingly being recognized as an important complication, especially in the elderly. A highly sensitive neuropsychol...

  12. Animal Surgery and Resources Core

    Data.gov (United States)

    Federal Laboratory Consortium — The ASR services for NHLBI research animals include: animal model development, surgery, surgical support, post-operative care as well as technical services such as...

  13. Robot-Assisted Gynecologic Surgery

    Medline Plus

    Full Text Available ... Broadcasting live from sunny Daytona Beach, Florida, and I am your host, Dr. Scott Klioze. We’ve ... to be talking robotic-assisted gynecologic surgery, and I can tell you, we have got a lot ...

  14. The Ethics of Breast Surgery.

    Science.gov (United States)

    Throckmorton, Alyssa; VanderWalde, Lindi; Brackett, Craig; Dominici, Laura; Eisenhauer, Thomas; Johnson, Nathalie; Kong, Amanda; Ludwig, Kandice; O'Neill, Jennifer; Pugliese, Matthew; Teller, Paige; Sarantou, Terry

    2015-10-01

    Breast surgery has evolved as a subspecialty of general surgery and requires a working knowledge of benign and malignant diseases, surgical techniques, shared decision-making with patients, collaboration with a multi-disciplinary team, and a basic foundation in surgical ethics. Ethics is defined as the practice of analyzing, evaluating, and promoting best conduct based upon available standards. As new information is obtained or as cultural values change, best conduct may be re-defined. In 2014, the Ethics Committee of the ASBrS acknowledged numerous ethical issues, specific to the practice of breast surgery. This independent review of ethical concerns was created by the Ethics Committee to provide a resource for ASBrS members as well as other surgeons who perform breast surgery. In this review, the professional, clinical, research and technology considerations that breast surgeons face are reviewed with guidelines for ethical physician behavior. PMID:26219240

  15. Anti-reflux surgery - discharge

    Science.gov (United States)

    ... enable JavaScript. You had surgery to treat your gastroesophageal reflux disease (GERD). GERD is a condition that causes food or liquid ... is called a hiatal hernia. It may make GERD symptoms worse. Your surgeon also wrapped the upper ...

  16. Immediate Sequential Bilateral Cataract Surgery

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte;

    2015-01-01

    The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence......-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were...... performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery...

  17. Bariatric Surgery and Stone Disease

    Science.gov (United States)

    Lieske, John C.; Kumar, Rajiv

    2008-09-01

    Bariatric surgery is an effective treatment strategy for patients with morbid obesity that can result in effective weight loss, resolution of diabetes mellitus and other weight related complications, and even improved mortality. However, it also appears that hyperoxaluria is common after modern bariatric surgery, perhaps occurring in up to 50% of patients after Rouxen-Y gastric bypass. Although increasing numbers of patients are being seen with calcium oxalate kidney stones after bariatric surgery, and even a few with oxalosis and renal failure, the true risk of these outcomes remains unknown. The mechanisms that contribute to this enteric hyperoxaluria are also incompletely defined, although fat malabsorption may be an important component. Since increasing numbers of these procedures are likely to be performed in the coming years, further study regarding the prevalence and mechanisms of hyperoxaluria and kidney stones after bariatric surgery is needed to devise effective methods of treatment in order to prevent such complications.

  18. [Quality assurance in ambulatory surgery].

    Science.gov (United States)

    Hansis, M L

    2004-02-01

    Surgery in outpatients and surgery under hospital conditions should provide the patient with the same high level of quality and the same low risk level. The one-person surgery practice is able to offer the patient a classic "one client-one customer" relation. Thus, the continuity of treatment is optimal. On the other hand, intervening systemic complications are more easily managed by the multidisciplinary staff of a hospital with its equipment. The weaknesses of both principles can be counteracted by employing special precautions in organization. The future of surgery is to be seen in combined forms, for example, in-sourcing of a surgeon from private practice into a hospital. PMID:14991173

  19. Using your shoulder after surgery

    Science.gov (United States)

    ... Rotator cuff problems Rotator cuff repair Shoulder arthroscopy Shoulder pain Patient Instructions Rotator cuff exercises Rotator cuff - self-care Shoulder surgery - discharge Update Date 11/26/2014 Updated ...

  20. Heart bypass surgery - minimally invasive

    Science.gov (United States)

    Minimally invasive direct coronary artery bypass; MIDCAB; Robot assisted coronary artery bypass; RACAB; Keyhole heart surgery ... doctor may recommend a minimally invasive coronary artery bypass if you have a blockage in one or ...

  1. Basics of LASIK Eye Surgery

    Science.gov (United States)

    ... which can only be corrected with a corneal transplant.  What to Expect Before, During, and After Surgery Before You’ll need a complete eye examination by your refractive surgeon. Your referring eye ...

  2. Robotic Applications in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alan P. Kypson

    2008-11-01

    Full Text Available Traditionally, cardiac surgery has been performed through a median sternotomy, which allows the surgeon generous access to the heart and surrounding great vessels. As a paradigm shift in the size and location of incisions occurs in cardiac surgery, new methods have been developed to allow the surgeon the same amount of dexterity and accessibility to the heart in confined spaces and in a less invasive manner. Initially, long instruments without pivot points were used, however, more recent robotic telemanipulation systems have been applied that allow for improved dexterity, enabling the surgeon to perform cardiac surgery from a distance not previously possible. In this rapidly evolving field, we review the recent history and clinical results of using robotics in cardiac surgery.

  3. The commercialization of plastic surgery.

    Science.gov (United States)

    Swanson, Eric

    2013-09-01

    The last decade has brought a major challenge to the traditional practice of plastic surgery from corporations that treat plastic surgery as a commercial product and market directly to the public. This corporate medicine model may include promotion of a trademarked procedure or device, national advertising that promises stunning results, sales consultants, and claims of innovation, superiority, and improved safety. This article explores the ethics of this business practice and whether corporate medicine is a desirable model for patients and plastic surgeons.

  4. Orthodontist's Role in Orthognathic Surgery

    OpenAIRE

    Wirthlin, John O.; Shetye, Pradip R.

    2013-01-01

    Orthognathic surgery can eliminate severe esthetic and functional deformities and be a life-changing event for a patient. An orthodontist's role in orthognathic surgery can be divided into several phases: the initial evaluation, presurgical orthodontics, surgical planning, and postsurgical orthodontics. At each of these phases, collaboration between the orthodontist and the surgeon is critical. The ability of an orthodontist and a surgeon to coordinate their efforts during this time is what w...

  5. Complications in Ankle Fracture Surgery

    OpenAIRE

    Ovaska, Mikko

    2014-01-01

    Mikko Ovaska. Complications in Ankle Fracture Surgery. Helsinki Bone and Joint Research Group, Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, University of Helsinki, Finland. Helsinki 2014. Ankle fractures are among the most frequently encountered surgically treated fractures. The operative treatment of this fracture may be associated with several complications. The most frequently encountered complications are related wound healing, and deep infection may have d...

  6. Complications of vertebral metastasis surgery

    OpenAIRE

    Pascal-Moussellard, H.; Broc, G.; Pointillart, V.; Siméon, F.; Vital, J. M.; Sénégas, J.

    1998-01-01

    The authors report their experience concerning complications of spinal metastasis surgery. The purpose of this study was to assess the frequency of such complications and analyse the factors influencing their occurrence. The records of 145 patients treated between 1982 and 1991 for metastatic disease of the spine were retrospectively reviewed for intra- and postoperative complications. Other factors such as radiation therapy, emergent nature of surgery, and neurologic deficits were analysed f...

  7. Pulmonary complications after spine surgery

    OpenAIRE

    Stundner, Ottokar; Taher, Fadi; Pawar, Abhijit; Memtsoudis, Stavros G.

    2012-01-01

    Spine surgery is one of the fastest growing branches of orthopedic surgery. Patients often present with a relatively high acuity and, depending on surgical approach, morbidity and mortality can be comparatively high. Among the most prevalent and most frequently fatality-bound perioperative complications are those affecting the pulmonary system; evidence of clinical or subclinical lung injury triggered by spine surgical procedures is emerging. Increasing burden of comorbidity among the patient...

  8. Persistent Pain after Dental Surgery

    Science.gov (United States)

    Renton, Tara

    2011-01-01

    This article aims to cover post surgical trigeminal neuropathy and other conditions related to chronic trigeminal pain not specifically covered elsewhere in this series. Is estimated to occur in 4–5% of patients overall, considerably less compared with other site surgeries. Due to the high volume surgery undertaken in this region chronic post surgical pain remains common. Relatively few clinicians are aware of this condition and as a result it is frequently poorly managed. PMID:26526800

  9. Persistent Pain after Dental Surgery

    OpenAIRE

    Renton, Tara

    2011-01-01

    This article aims to cover post surgical trigeminal neuropathy and other conditions related to chronic trigeminal pain not specifically covered elsewhere in this series.Is estimated to occur in 4–5% of patients overall, considerably less compared with other site surgeries.Due to the high volume surgery undertaken in this region chronic post surgical pain remains common.Relatively few clinicians are aware of this condition and as a result it is frequently poorly managed.

  10. Surgery in a mission hospital.

    OpenAIRE

    Hankins, G. W.

    1980-01-01

    The western-trained surgeon working in a mission hospital in a developing country finds that in spite of the heavy demands placed upon him the work can be most absorbing, challenging, and satisfying. Some impressions gained during 31/2 years working in the department of surgery of a mission hospital in Kathmandu, Nepal, are recorded. Particular reference is made to the striking differences in disease incidence, as brought out in a review of operative surgery for 1977.

  11. New Approaches In Digestive Surgery

    OpenAIRE

    Martínez Ferré, Bernat

    2014-01-01

    Póster Oesophageal surgery has been associated with greater incisional dehiscence than surgery in other portions of the alimentary tract. Several factors may contribute to the high complication rate, including lack of serosa and omentum, the segmental nature of blood supply, the constant motion of swallowing and respiration and the tension at the surgical site. Regenerative medicine approaches facilitate the use of biological constructs to replace or regenerate normal tissue function. T...

  12. Key Questions in Thoracic Surgery

    OpenAIRE

    Subotic, Dragan R.

    2016-01-01

    This 1000-page textbook encompasses much more than the title suggests. In fact, the title “Key questions in thoracic surgery and pulmonology” would be more fitting. The specific format of the book, with precise questions and evidence-based, but equally clear answers covering all relevant fields of pulmonology and thoracic surgery, makes this 40-chapter book a “must read” not only for residents, but also for senior pulmonologists and thoracic surgeons.

  13. Orthopedic surgery in ancient Egypt

    OpenAIRE

    Blomstedt, Patric

    2014-01-01

    Background — Ancient Egypt might be considered the cradle of medicine. The modern literature is, however, sometimes rather too enthusiastic regarding the procedures that are attributed an Egyptian origin. I briefly present and analyze the claims regarding orthopedic surgery in Egypt, what was actually done by the Egyptians, and what may have been incorrectly ascribed to them. Methods — I reviewed the original sources and also the modern literature regarding surgery in ancient Egypt, concentra...

  14. Robotic Surgery for Oropharyngeal Cancer

    Directory of Open Access Journals (Sweden)

    Shivani Shah

    2014-04-01

    Full Text Available Oropharyngeal cancer represents a growing proportion of head and neck malignancies. This has been associated with the increase in infection of the oropharynx by oncogenic strains of human papillomavirus (HPV. Transoral robotic surgery (TORS has opened the door for minimally invasive surgery for HPV-related and non-HPV-related oropharyngeal cancer. Compared to traditional open surgical approaches, TORS has been shown to improve functional outcomes in speech and swallowing, while maintaining good oncologic outcomes.

  15. The European educational platform on thoracic surgery.

    Science.gov (United States)

    Massard, Gilbert; Rocco, Gaetano; Venuta, Federico

    2014-05-01

    As the largest scientific organisation world-wide exclusively dedicated to general thoracic surgery (GTS), the European Society of Thoracic Surgeons (ESTS) recognized that one of its priorities is education. The educational platform designed ESTS addresses not only trainees, but also confirmed thoracic surgeons. The two main aims are (I) to prepare trainees to graduation and to the certification by the European Board of Thoracic Surgery and (II) to offer opportunities for continuous medical education in the perspective of life-long learning and continuous professional development to certified thoracic surgeons. It is likely that recertification will become an obligation during the coming decade. At its inception, the platform differentiated two different events. A 6-day course emphasizing on theoretic knowledge was created in Antalya in 2007. The same year, a 2-day school oriented to practical issues with hands-on in the animal lab was launched in Antalya. These two teaching tracks need further development. In the knowledge track, we intend to organize highly specialized 2-day courses to deepen insight into theoretical questions. The skill track will be implemented by specialized courses for high technology such as tracheal surgery, ECMO, robotics or chest wall reconstruction. In order to promote tomorrows' leadership, we created an academic competence track giving an insight into medical communication, methodology and management. We also had to respond to an increasing demand from the Russian speaking countries, where colleagues may face problems to attend western meetings, and where the language bareer may be a major impediment. We initiated a Russian school with three events yearly in 2012. Contemporary teaching must be completed with an e-learning platform, which is currently under development. The school activities are organized by the educational committee, which is headed by the ESTS Director of Education, assisted by coordinators of the teaching tracks and

  16. Limb salvage surgery.

    Science.gov (United States)

    Kadam, Dinesh

    2013-05-01

    The threat of lower limb loss is seen commonly in severe crush injury, cancer ablation, diabetes, peripheral vascular disease and neuropathy. The primary goal of limb salvage is to restore and maintain stability and ambulation. Reconstructive strategies differ in each condition such as: Meticulous debridement and early coverage in trauma, replacing lost functional units in cancer ablation, improving vascularity in ischaemic leg and providing stable walking surface for trophic ulcer. The decision to salvage the critically injured limb is multifactorial and should be individualised along with laid down definitive indications. Early cover remains the standard of care, delayed wound coverage not necessarily affect the final outcome. Limb salvage is more cost-effective than amputations in a long run. Limb salvage is the choice of procedure over amputation in 95% of limb sarcoma without affecting the survival. Compound flaps with different tissue components, skeletal reconstruction; tendon transfer/reconstruction helps to restore function. Adjuvant radiation alters tissue characters and calls for modification in reconstructive plan. Neuropathic ulcers are wide and deep often complicated by osteomyelitis. Free flap reconstruction aids in faster healing and provides superior surface for offloading. Diabetic wounds are primarily due to neuropathy and leads to six-fold increase in ulcerations. Control of infections, aggressive debridement and vascular cover are the mainstay of management. Endovascular procedures are gaining importance and have reduced extent of surgery and increased amputation free survival period. Though the standard approach remains utilising best option in the reconstruction ladder, the recent trend shows running down the ladder of reconstruction with newer reliable local flaps and negative wound pressure therapy.

  17. Limb salvage surgery

    Directory of Open Access Journals (Sweden)

    Dinesh Kadam

    2013-01-01

    Full Text Available The threat of lower limb loss is seen commonly in severe crush injury, cancer ablation, diabetes, peripheral vascular disease and neuropathy. The primary goal of limb salvage is to restore and maintain stability and ambulation. Reconstructive strategies differ in each condition such as: Meticulous debridement and early coverage in trauma, replacing lost functional units in cancer ablation, improving vascularity in ischaemic leg and providing stable walking surface for trophic ulcer. The decision to salvage the critically injured limb is multifactorial and should be individualised along with laid down definitive indications. Early cover remains the standard of care, delayed wound coverage not necessarily affect the final outcome. Limb salvage is more cost-effective than amputations in a long run. Limb salvage is the choice of procedure over amputation in 95% of limb sarcoma without affecting the survival. Compound flaps with different tissue components, skeletal reconstruction; tendon transfer/reconstruction helps to restore function. Adjuvant radiation alters tissue characters and calls for modification in reconstructive plan. Neuropathic ulcers are wide and deep often complicated by osteomyelitis. Free flap reconstruction aids in faster healing and provides superior surface for offloading. Diabetic wounds are primarily due to neuropathy and leads to six-fold increase in ulcerations. Control of infections, aggressive debridement and vascular cover are the mainstay of management. Endovascular procedures are gaining importance and have reduced extent of surgery and increased amputation free survival period. Though the standard approach remains utilising best option in the reconstruction ladder, the recent trend shows running down the ladder of reconstruction with newer reliable local flaps and negative wound pressure therapy.

  18. Pediatric robotic urologic surgery-2014

    Directory of Open Access Journals (Sweden)

    James T Kearns

    2014-01-01

    Full Text Available We seek to provide a background of the current state of pediatric urologic surgery including a brief history, procedural outcomes, cost considerations, future directions, and the state of robotic surgery in India. Pediatric robotic urology has been shown to be safe and effective in cases ranging from pyeloplasty to bladder augmentation with continent urinary diversion. Complication rates are in line with other methods of performing the same procedures. The cost of robotic surgery continues to decrease, but setting up pediatric robotic urology programs can be costly in terms of both monetary investment and the training of robotic surgeons. The future directions of robot surgery include instrument and system refinements, augmented reality and haptics, and telesurgery. Given the large number of children in India, there is huge potential for growth of pediatric robotic urology in India. Pediatric robotic urologic surgery has been established as safe and effective, and it will be an important tool in the future of pediatric urologic surgery worldwide.

  19. Gender reassignment surgery: an overview.

    Science.gov (United States)

    Selvaggi, Gennaro; Bellringer, James

    2011-05-01

    Gender reassignment (which includes psychotherapy, hormonal therapy and surgery) has been demonstrated as the most effective treatment for patients affected by gender dysphoria (or gender identity disorder), in which patients do not recognize their gender (sexual identity) as matching their genetic and sexual characteristics. Gender reassignment surgery is a series of complex surgical procedures (genital and nongenital) performed for the treatment of gender dysphoria. Genital procedures performed for gender dysphoria, such as vaginoplasty, clitorolabioplasty, penectomy and orchidectomy in male-to-female transsexuals, and penile and scrotal reconstruction in female-to-male transsexuals, are the core procedures in gender reassignment surgery. Nongenital procedures, such as breast enlargement, mastectomy, facial feminization surgery, voice surgery, and other masculinization and feminization procedures complete the surgical treatment available. The World Professional Association for Transgender Health currently publishes and reviews guidelines and standards of care for patients affected by gender dysphoria, such as eligibility criteria for surgery. This article presents an overview of the genital and nongenital procedures available for both male-to-female and female-to-male gender reassignment. PMID:21487386

  20. Cosmetic surgeries on knots in $S^3$

    OpenAIRE

    NI, YI; Wu, Zhongtao

    2010-01-01

    Two Dehn surgeries on a knot are called {\\it purely cosmetic}, if they yield manifolds that are homeomorphic as oriented manifolds. Suppose there exist purely cosmetic surgeries on a knot in $S^3$, we show that the two surgery slopes must be the opposite of each other. One ingredient of our proof is a Dehn surgery formula for correction terms in Heegaard Floer homology.

  1. PORT II

    Science.gov (United States)

    Muniz, Beau

    2009-01-01

    One unique project that the Prototype lab worked on was PORT I (Post-landing Orion Recovery Test). PORT is designed to test and develop the system and components needed to recover the Orion capsule once it splashes down in the ocean. PORT II is designated as a follow up to PORT I that will utilize a mock up pressure vessel that is spatially compar able to the final Orion capsule.

  2. Conservative surgery and radiation therapy for early breast cancer

    International Nuclear Information System (INIS)

    A retrospective review of 402 patients with stage I or II invasive breast carcinoma treated with conservative surgery and radiotherapy between 1979 and 1992 w as done. Disease free and actuarial survival rates, local, regional and distant recurrence rates and treatment related acute and chronic complications were evaluated according to stage. The technique and dose of radiotherapy were assessed in relation to stage of the disease, status of margin of lumpectomy and cosmetic results. Treatment related morbidity was minimal and overall cosmetic results were excellent. In stage 0 (in situ), I and II survival at 12 years has been 100%, 90% and 80% respectively. It is concluded that breast conservation treatment is an appropriate method of primary therapy, along with radiation therapy, for women with Stage I and II breast cancer

  3. 30 Years of Robotic Surgery.

    Science.gov (United States)

    Leal Ghezzi, Tiago; Campos Corleta, Oly

    2016-10-01

    The idea of reproducing himself with the use of a mechanical robot structure has been in man's imagination in the last 3000 years. However, the use of robots in medicine has only 30 years of history. The application of robots in surgery originates from the need of modern man to achieve two goals: the telepresence and the performance of repetitive and accurate tasks. The first "robot surgeon" used on a human patient was the PUMA 200 in 1985. In the 1990s, scientists developed the concept of "master-slave" robot, which consisted of a robot with remote manipulators controlled by a surgeon at a surgical workstation. Despite the lack of force and tactile feedback, technical advantages of robotic surgery, such as 3D vision, stable and magnified image, EndoWrist instruments, physiologic tremor filtering, and motion scaling, have been considered fundamental to overcome many of the limitations of the laparoscopic surgery. Since the approval of the da Vinci(®) robot by international agencies, American, European, and Asian surgeons have proved its factibility and safety for the performance of many different robot-assisted surgeries. Comparative studies of robotic and laparoscopic surgical procedures in general surgery have shown similar results with regard to perioperative, oncological, and functional outcomes. However, higher costs and lack of haptic feedback represent the major limitations of current robotic technology to become the standard technique of minimally invasive surgery worldwide. Therefore, the future of robotic surgery involves cost reduction, development of new platforms and technologies, creation and validation of curriculum and virtual simulators, and conduction of randomized clinical trials to determine the best applications of robotics.

  4. Bariatric surgery in hypothalamic obesity

    Directory of Open Access Journals (Sweden)

    Nathan eBingham

    2012-02-01

    Full Text Available Craniopharyngiomas (CP are epithelial neoplasms generally found in the area of the pituitary and hypothalamus. Despite benign histology, these tumors and/or their treatment often result in significant, debilitating disorders of endocrine, neurological, behavioral, and metabolic systems. Severe obesity is observed in a high percentage of patients with CP resulting in significant comorbidities and negatively impacting quality of life. Obesity occurs as a result of hypothalamic damage and disruption of normal homeostatic mechanisms regulating energy balance. Such pathological weight gain, termed hypothalamic obesity (HyOb, is often severe and refractory to therapy.Unfortunately, neither lifestyle intervention nor pharmacotherapy has proven truly effective in the treatment of CP-HyOb. Given the limited choices and poor results of these treatments, several groups have examined bariatric surgery as a treatment alternative for patients with CP-HyOb. While a large body of evidence exists supporting the use of bariatric surgery in the treatment of exogenous obesity and its comorbidities, its role in the treatment of HyOb has yet to be well defined. To date, the existing literature on bariatric surgery in CP-HyOb is largely limited to case reports and series with short term follow-up. Here we review the current reports on the use of bariatric surgery in the treatment of CP-HyOb. We also compare these results to those reported for other populations of HyOb, including Prader-Willi Syndrome and patients with melanocortin signaling defects. While initial reports of bariatric surgery in CP-HyOb are promising, their limited scope makes it difficult to draw any substantial conclusions as to the long term safety and efficacy of bariatric surgery in CP-HyOb. There continues to be a need for more robust, controlled, prospective trials with long term follow-up in order to better define the role of bariatric surgery in the treatment of all types of hypothalamic

  5. 30 Years of Robotic Surgery.

    Science.gov (United States)

    Leal Ghezzi, Tiago; Campos Corleta, Oly

    2016-10-01

    The idea of reproducing himself with the use of a mechanical robot structure has been in man's imagination in the last 3000 years. However, the use of robots in medicine has only 30 years of history. The application of robots in surgery originates from the need of modern man to achieve two goals: the telepresence and the performance of repetitive and accurate tasks. The first "robot surgeon" used on a human patient was the PUMA 200 in 1985. In the 1990s, scientists developed the concept of "master-slave" robot, which consisted of a robot with remote manipulators controlled by a surgeon at a surgical workstation. Despite the lack of force and tactile feedback, technical advantages of robotic surgery, such as 3D vision, stable and magnified image, EndoWrist instruments, physiologic tremor filtering, and motion scaling, have been considered fundamental to overcome many of the limitations of the laparoscopic surgery. Since the approval of the da Vinci(®) robot by international agencies, American, European, and Asian surgeons have proved its factibility and safety for the performance of many different robot-assisted surgeries. Comparative studies of robotic and laparoscopic surgical procedures in general surgery have shown similar results with regard to perioperative, oncological, and functional outcomes. However, higher costs and lack of haptic feedback represent the major limitations of current robotic technology to become the standard technique of minimally invasive surgery worldwide. Therefore, the future of robotic surgery involves cost reduction, development of new platforms and technologies, creation and validation of curriculum and virtual simulators, and conduction of randomized clinical trials to determine the best applications of robotics. PMID:27177648

  6. Prevention of visual field defects after macular hole surgery.

    LENUS (Irish Health Repository)

    Cullinane, A B

    2012-02-03

    BACKGROUND\\/AIM: The pathogenesis of visual field loss associated with macular hole surgery is uncertain but a number of explanations have been proposed, the most convincing of which is the effect of peeling of the posterior hyaloid, causing either direct damage to the nerve fibre layer or to its blood supply at the optic nerve head. The purpose of this preliminary prospective study was to determine the incidence of visual field defects following macular hole surgery in cases in which peeling of the posterior hyaloid was confined only to the area of the macula. METHODS: 102 consecutive eyes that had macular hole surgery had preoperative and postoperative visual field examination using a Humphrey\\'s perimeter. A comparison was made between two groups: I, those treated with vitrectomy with complete posterior cortical vitreous peeling; and II, those treated with a vitrectomy with peeling of the posterior hyaloid in the area of the macula but without attempting a complete posterior vitreous detachment. Specifically, no attempt was made to separate the posterior hyaloid from the optic nerve head. Eyes with stage II or III macular holes were operated. Autologous platelet concentrate and non-expansile gas tamponade was used. Patients were postured prone for 1 week. RESULTS: In group I, 22% of patients were found to have visual field defects. In group II, it was possible to separate the posterior hyaloid from the macula without stripping it from the optic nerve head and in these eyes no pattern of postoperative visual field loss emerged. There were no significant vision threatening complications in this group. The difference in the incidence of visual field loss between group I and group II was significant (p=0.02). The anatomical and visual success rates were comparable between both groups. CONCLUSION: The results from this preliminary study suggest that the complication of visual field loss after macular surgery may be reduced if peeling of the posterior hyaloid is

  7. Unfavourable outcomes in orthognathic surgery

    Directory of Open Access Journals (Sweden)

    Krishnamurthy Bonanthaya

    2013-01-01

    Full Text Available Unfavourable outcomes are part and parcel of performing surgeries of any kind. Unfavourable outcomes are results of such work, which the patient and or the clinician does not like. This is an attempt to review various causes for unfavorable outcomes in orthognathic surgery and discuss them in detail. All causes for unfavorable outcomes may be classified as belonging to one of the following periods A Pre- Treatment B During treatment Pre-Treatment: In orthognathic surgery- as in any other discipline of surgery- which involves changes in both aesthetics and function, the patient motivation for seeking treatment is a very important input which may decide, whether the outcome is going to be favorable or not. Also, inputs in diagnosis and plan for treatment and its sequencing, involving the team of the surgeon and the orthodontist, will play a very important role in determining whether the outcome will be favorable. In other words, an unfavorable outcome may be predetermined even before the actual treatment process starts. During Treatment: Good treatment planning itself does not guarantee favorable results. The execution of the correct plan could go wrong at various stages which include, Pre-Surgical orthodontics, Intra and Post-Operative periods. A large number of these unfavorable outcomes are preventable, if attention is paid to detail while carrying out the treatment plan itself. Unfavorable outcomes in orthognathic surgery may be minimized If pitfalls are avoided both, at the time of treatment planning and execution.

  8. Computational Planning in Facial Surgery.

    Science.gov (United States)

    Zachow, Stefan

    2015-10-01

    This article reflects the research of the last two decades in computational planning for cranio-maxillofacial surgery. Model-guided and computer-assisted surgery planning has tremendously developed due to ever increasing computational capabilities. Simulators for education, planning, and training of surgery are often compared with flight simulators, where maneuvers are also trained to reduce a possible risk of failure. Meanwhile, digital patient models can be derived from medical image data with astonishing accuracy and thus can serve for model surgery to derive a surgical template model that represents the envisaged result. Computerized surgical planning approaches, however, are often still explorative, meaning that a surgeon tries to find a therapeutic concept based on his or her expertise using computational tools that are mimicking real procedures. Future perspectives of an improved computerized planning may be that surgical objectives will be generated algorithmically by employing mathematical modeling, simulation, and optimization techniques. Planning systems thus act as intelligent decision support systems. However, surgeons can still use the existing tools to vary the proposed approach, but they mainly focus on how to transfer objectives into reality. Such a development may result in a paradigm shift for future surgery planning. PMID:26579861

  9. Hardware complications in scoliosis surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bagchi, Kaushik; Mohaideen, Ahamed [Department of Orthopaedic Surgery and Musculoskeletal Services, Maimonides Medical Center, Brooklyn, NY (United States); Thomson, Jeffrey D. [Connecticut Children' s Medical Center, Department of Orthopaedics, Hartford, CT (United States); Foley, Christopher L. [Department of Radiology, Connecticut Children' s Medical Center, Hartford, Connecticut (United States)

    2002-07-01

    Background: Scoliosis surgery has undergone a dramatic evolution over the past 20 years with the advent of new surgical techniques and sophisticated instrumentation. Surgeons have realized scoliosis is a complex multiplanar deformity that requires thorough knowledge of spinal anatomy and pathophysiology in order to manage patients afflicted by it. Nonoperative modalities such as bracing and casting still play roles in the treatment of scoliosis; however, it is the operative treatment that has revolutionized the treatment of this deformity that affects millions worldwide. As part of the evolution of scoliosis surgery, newer implants have resulted in improved outcomes with respect to deformity correction, reliability of fixation, and paucity of complications. Each technique and implant has its own set of unique complications, and the surgeon must appreciate these when planning surgery. Materials and methods: Various surgical techniques and types of instrumentation typically used in scoliosis surgery are briefly discussed. Though scoliosis surgery is associated with a wide variety of complications, only those that directly involve the hardware are discussed. The current literature is reviewed and several illustrative cases of patients treated for scoliosis at the Connecticut Children's Medical Center and the Newington Children's Hospital in Connecticut are briefly presented. Conclusion: Spine surgeons and radiologists should be familiar with the different types of instrumentation in the treatment of scoliosis. Furthermore, they should recognize the clinical and roentgenographic signs of hardware failure as part of prompt and effective treatment of such complications. (orig.)

  10. [Keratoplasty combined with cataract surgery].

    Science.gov (United States)

    Muraine, M; Gueudry, J; Retout, A; Genevois, O

    2012-09-01

    Corneal pathologies leading to keratoplasty are often associated with cataract and combined surgery is therefore mandatory. Triple procedure with penetrating keratoplasty and concurrent cataract extraction followed by intra ocular lens (IOL) implantation is usually the preferential choice because visual rehabilitation is theoretically more rapid. Surgeons have to be aware of surgical conditions during open-sky surgery because vitreous pressure is not counterbalanced by anterior chamber pressure. Today, many surgeons prefer non-simultaneous procedures with cataract surgery performed months after grafting because of the improvement in spherical refractive error. More recently, new triple procedures, Descemet's stripping automated keratoplasty and concurrent cataract surgery have gained popularity, especially in patients with Fuchs dystrophy associated with cataract. Surgery starts with phacoemulsification, followed by endothelium exchange through a 3 to 5 mm incision. Advantages against classic triple procedure are quick visual rehabilitation, fewer induced refractive errors, minimal postoperative discomfort and corneal integrity. Surgeons have to consider an eventual postoperative hyperopic shift secondary to corneal lenticule shape when choosing adequate intraocular lens. PMID:22921023

  11. COMPARATIVE RETROSPECTIVE STUDY ON ANAESTHESIA APPROACHES FOR LUMBAR SPINE SURGERY

    Directory of Open Access Journals (Sweden)

    Rangalakshmi S

    2016-07-01

    Full Text Available OBJECTIVE Lumbar spinal surgeries have been performed with either spinal or general anaesthesia. In this study, we aimed to evaluate the superiority of either spinal or general anaesthesia on lumbar spine surgery. METHODS After approval of institutional ethical committee, we retrospectively analysed 270 patients (ASA I and II undergoing surgery of lumbar spine from 2009 to 2015 by one surgeon. Of these 150 patients underwent general anaesthesia with controlled ventilation, 120 patients were offered spinal anaesthesia with conscious sedation. Patient records were reviewed to obtain demographic features, type of anaesthesia, baseline heart rate, mean arterial pressure, intraoperative maximum heart rate, mean arterial pressure, duration of surgery, amount of intravenous fluids, intraoperative blood loss, incidence of perioperative complications such as bleeding, nausea, vomiting, hypotension, bradycardia, and postoperative analgesic consumption. RESULTS Patient characteristics including baseline/intraoperative mean arterial pressure and heart rate values did not differ between groups. However, the spinal anaesthesia group experienced significantly shorter durations in the operating room and had a lower incidence of nausea, vomiting. Analgesic consumptions in general anaesthesia group was significantly higher than in spinal anaesthesia group. CONCLUSION The present study revealed that spinal anaesthesia is a safe and effective alternative to general anaesthesia for patients undergoing single level or two level lumbar laminectomy, discectomy, or even instrumentation below L2 level and has the advantage of decreased nausea, antiemetic, analgesic requirements, and fewer complications. It also ensures better postoperative recovery when compared to general anaesthesia

  12. Effect of desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery: a randomized, clinical trial

    OpenAIRE

    Shao, Hua; Kuang, Li-Ting; Hou, Wei-Jian; Zhang,Tao

    2015-01-01

    Background Bleeding during functional endoscopic sinus surgery is a challenge for the quality of the surgical field for surgeons. This study aimed to evaluate the effect of desmopressin premedication on blood loss and the quality of the surgical field in endoscopic sinus surgery. Methods A total of 90 American Society of Anesthesiologists physical status I–II patients underwent endoscopic sinus surgery for chronic sinusitis. They were randomly allocated to receive either desmopressin 0.3 μg/k...

  13. Surgery applications of virtual reality

    Science.gov (United States)

    Rosen, Joseph

    1994-01-01

    Virtual reality is a computer-generated technology which allows information to be displayed in a simulated, bus lifelike, environment. In this simulated 'world', users can move and interact as if they were actually a part of that world. This new technology will be useful in many different fields, including the field of surgery. Virtual reality systems can be used to teach surgical anatomy, diagnose surgical problems, plan operations, simulate and perform surgical procedures (telesurgery), and predict the outcomes of surgery. The authors of this paper describe the basic components of a virtual reality surgical system. These components include: the virtual world, the virtual tools, the anatomical model, the software platform, the host computer, the interface, and the head-coupled display. In the chapter they also review the progress towards using virtual reality for surgical training, planning, telesurgery, and predicting outcomes. Finally, the authors present a training system being developed for the practice of new procedures in abdominal surgery.

  14. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Juhl, C B; Roos, E M;

    2015-01-01

    OBJECTIVE: To determine benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease. DESIGN: Systematic review and meta-analysis. MAIN OUTCOME MEASURES: Pain and physical function...... and absent at one to two years after surgery. Knee arthroscopy is associated with harms. Taken together, these findings do not support the practise of arthroscopic surgery for middle aged or older patients with knee pain with or without signs of osteoarthritis. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD....... DATA SOURCES: Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. ELIGIBILITY CRITERIA FOR SELECTING...

  15. A STUDY OF CONVERSIONS OF LAPAROSOCOPIC SURGERIES INTO OPEN SURGERIES: A ANALYTICAL STUDY

    OpenAIRE

    Venkata Reddy; Sailaja Rani; Buddha; Mohsin; Jagadeesh; Sushma; Varun; Mounika

    2015-01-01

    INTRODUCTION: The aim of present study is to know the Conversions in Laparoscopic surgery to Open surgery in The patients of all the surgical units in the Department of General Surgery, Government General Hospital, Rangaraya Medical College, Kakinada over a period of 2 years from July 2013 to July 2015. The Objectives of present study is to compare the Conversion Rates of Laparoscopic Surgery to Open Surgery and the factors causing Conversion to Open Surgery in our institution...

  16. Potentials and applications of robotic surgery in Oral and Maxillofacial Surgery. A literature review.

    OpenAIRE

    Dimitrios VOLAKOS; Tzermpos, Fotios

    2014-01-01

    SUMMARY: Robotic surgery can be described as the latest advance in minimally invasive surgery, following the laparoscopic surgical approach. Since its first clinical trial in 1985, many steps have been taken. Nowadays, it is used successfully in many surgical disciplines, such as Urology, Orthopedic Surgery, Cardiothoracic Surgery, Oral and Maxillofacial Surgery (OMFS). The aim of this literature review is to present generally in surgery and more precisely in OMFS the applications of robotics...

  17. [Orthognathic surgery: corrective bone operations].

    Science.gov (United States)

    Reuther, J

    2000-05-01

    The article reviews the history of orthognathic surgery from the middle of the last century up to the present. Initially, mandibular osteotomies were only performed in cases of severe malformations. But during the last century a precise and standardized procedure for correction of the mandible was established. Multiple modifications allowed control of small fragments, functionally stable osteosynthesis, and finally a precise positioning of the condyle. In 1955 Obwegeser and Trauner introduced the sagittal split osteotomy by an intraoral approach. It was the final breakthrough for orthognathic surgery as a standard treatment for corrections of the mandible. Surgery of the maxilla dates back to the nineteenth century. B. von Langenbeck from Berlin is said to have performed the first Le Fort I osteotomy in 1859. After minor changes, Wassmund corrected a posttraumatic malocclusion by a Le Fort I osteotomy in 1927. But it was Axhausen who risked the total mobilization of the maxilla in 1934. By additional modifications and further refinements, Obwegeser paved the way for this approach to become a standard procedure in maxillofacial surgery. Tessier mobilized the whole midface by a Le Fort III osteotomy and showed new perspectives in the correction of severe malformations of the facial bones, creating the basis of modern craniofacial surgery. While the last 150 years were distinguished by the creation and standardization of surgical methods, the present focus lies on precise treatment planning and the consideration of functional aspects of the whole stomatognathic system. To date, 3D visualization by CT scans, stereolithographic models, and computer-aided treatment planning and simulation allow surgery of complex cases and accurate predictions of soft tissue changes.

  18. [Robotic surgery for colorectal cancer in elderly patients].

    Science.gov (United States)

    Xu, Pingping; Wei, Ye; Xu, Jianmin

    2016-05-25

    The outstanding advantages of robotic surgery include the stable and three-dimension image and the convenience of surgery manipulation. The disadvantages include the lack of factile feedback, high cost and prolonged surgery time. It was reported that robotic surgery was associated with less trauma stress and faster recovery in elderly patients(≥75 years old) when compared with open surgery. Elderly people have a higher incidence of carcinogenesis and also have more comorbidities and reduced functional reserve. Clinical data of patients over 75 years old treated by robotic surgery in Zhongshan Hospital affiliated to Fudan University from March 2011 to October 2014 were analyzed retrospectively. A total of 24 consecutive patients were included with a median age of 77.8 years old. There were 18 male and 6 female patients. Among them, 14 patients were diagnosed with descending and sigmoid colon cancers while 10 with rectal cancers; 19 had tumor size larger than 5 cm; 16 were diagnosed with ulcerative adenocarcinoma. Fourteen patients were complicated with hypertension, 6 with cardiopulmonary diseases, 4 with diabetes mellitus and 3 with cerebrovascular diseases. Twenty-two patients underwent low anterior resection and 2 abdominoperineal resection. The estimated blood loss was 85 ml; the median operation time was (123.1±45.2) min; the median number of retrieved lymph node was 12.4. Postoperative pathologic results showed that 3 patients were stageI(, 10 stageII(, and 11 stageIII(. Postoperative complication was observed in 3 patients: urinary infection in 1 case, intraperitoneal infection in 1 case and atria fibrillation in 1 case, respectively. Median time to first postoperative flatus was 2.8 days. Our results indicated that robotic surgery is safe and feasible in the elderly patients. The next generation of robotic system may make up for these deficiencies through new technologies. With the advantage of more advanced surgical simulator, robotic surgery will play a

  19. Intraoperative neuromonitoring in thyroid surgery

    Directory of Open Access Journals (Sweden)

    P O Rumyantsev

    2012-06-01

    Full Text Available Comparative analysis of post-surgical neurologic complications due to motor nerves damage (recurrent laryngeal and spine nerves during conventional and neuromonitoring-guide thyroid surgery is conducted in this clinical study. Implication of intraoperative neuromonitoring in thyroid as well as central neck (VI level surgery permitted to reduce recurrence laryngeal nerve palsy more than two times ( OR = 0,32; 95% CI0,11–0,86; P = 0,028. As ultimate indication towards intraoperative neuromonitoring author consider operations associated with a high risk of motor nerve causal injury as well as fault of its visual identification.

  20. Infections in open heart surgery.

    Science.gov (United States)

    Baddour, L M; Kluge, R M

    1989-01-01

    More than 250,000 open heart surgical procedures are performed annually in the United States. The majority of these procedures are coronary artery bypass grafts (CABG) and valve replacements. In this forum our authors discuss the kinds of infections that occur in patients following open heart surgery, as well as the documented risk factors and microbiology of these infections. We also asked each author to outline the criteria used to diagnose post open heart surgery infections, and to address associated consequences and complications. Finally, we were interested in each author's definition of the infection control practitioner's role in the prevention of this particular subset of nosocomial infections.

  1. Complications from international surgery tourism.

    Science.gov (United States)

    Melendez, Mark M; Alizadeh, Kaveh

    2011-08-01

    Medical tourism is an increasing trend, particularly in cosmetic surgery. Complications resulting from these procedures can be quite disruptive to the healthcare industry in the United States since patients often seek treatment and have no compensation recourse from insurance. Despite the increasing number of plastic surgery patients seeking procedures abroad, there have been little reported data concerning outcomes, follow-up, or complication rates. Through a survey of American Society of Plastic Surgeons (ASPS) members, the authors provide data on trends to help define the scope of the problem. PMID:21813883

  2. Outlined history of the development of the world and Polish cardiac surgery.

    Science.gov (United States)

    Dziatkowiak, A J

    2006-04-01

    new facilities for the Department of Cardiac Surgery of Cracow consecrated on June 9, 1997 by pope John Paul II, have been discussed. The contribution of the Club of Polish Cardiac Surgeons to the integration of surgical community and to development of the Polish cardiac surgery has been emphasized. In summary, it has been outlined that the contemporary standards of the Polish cardiac surgery do not differ from cardiac and vascular surgery and transplantology in developed countries.

  3. Exceptional Cosmetic surgeries on $S^3$

    OpenAIRE

    Ravelomanana, Huygens C.

    2015-01-01

    This paper concerns the truly or purely cosmetic surgery conjecture. We give a survey on exceptional surgeries and cosmetic surgeries. We prove that the slope of an exceptional truly cosmetic surgery on a hyperbolic knot in $S^3$ must be $\\pm 1$ and the surgery must be toroidal but not Seifert fibred. As consequence we show that there are no exceptional truly cosmetic surgeries on certain types of hyperbolic knot in $S^3$. We also give some properties of Heegaard Floer correction terms and to...

  4. Applications of navigation for orthognathic surgery.

    Science.gov (United States)

    Bobek, Samuel L

    2014-11-01

    Stereotactic surgical navigation has been used in oral and maxillofacial surgery for orbital reconstruction, reduction of facial fractures, localization of foreign bodies, placement of implants, skull base surgery, tumor removal, temporomandibular joint surgery, and orthognathic surgery. The primary goals in adopting intraoperative navigation into these different surgeries were to define and localize operative anatomy, to localize implant position, and to orient the surgical wound. Navigation can optimize the functional and esthetic outcomes in patients with dentofacial deformities by identifying pertinent anatomic structures, transferring the surgical plan to the patient, and verifying the surgical result. This article discusses the principles of navigation-guided orthognathic surgery.

  5. Postradiation sarcomas: importance of surgery

    International Nuclear Information System (INIS)

    Purpose: To evaluate the role of surgery in the treatment of Post-radiation sarcomas Materials. Post-radiation sarcomas is a rare entity and large series have rarely been reported. In order to improve knowledge about this entity the Radiotherapist group of the French Cancer Centres (FNCLCC) decided to collect retrospectively the cases treated in their institutions. In order to be sure of the histology, all the cases were reviewed by a panel of pathologists of the FNCLCC Pathologist group. A total of 129 cases of sarcomas, and 108 were reviewed; analysis of 8 is in progress, and no material was obtained in the other 11 cases. The diagnosis of sarcomas was confirmed in 80 cases. All patients (60 F, 20 M) have received radiation therapy (median dose 50 Gy; 9-110 Gy) for the treatment of the primary tumor. At this time the age was 44 years (6-83 y). Diagnoses included: breast C. 42%, Lymphomas 11.5%, gynaecological C. 10% benign lesions 5% miscellaneous. Sarcomas developed after a mean interval of 12 years (3-64 y), in bone in 30% of the cases and in soft tissue in 70%. The majority of lesions (90%) developed in the irradiated field (dose received was between 50 Gy and 60 Gy). Histologically there were 29% Malignant HistiocytofibroSarcomas, 19% OsteoSarcomas, 15% FibroSarcomas, 9% LipoSarcomas, 6% LeiomyoSarcomas, miscellaneous sarcomas 22%. Treatment included: Surgery 28 cases, Surgery+Chemotherapy 17 cases, Chemotherapy only 16 cases, Radiation therapy only 1 case, surgery + Radiation therapy 5 cases, Radiation therapy +chemotherapy 6 cases, Surgery + Radiation therapy + Chemotherapy 7 cases, no treatment 5 cases. Results. The outcome is known for all but 3 patients. 51 patients have died (44 of their sarcoma, 4 of the primary tumour, 2 of other cause and 1 iatrogenic). Median survival is 23 months (95% confidence interval 16-29 mo) but 9 patients survived 5 yr or more. Median survival was 43 mo for patients treated by surgery (28p), 6 mo for chemotherapy group (16 p

  6. 小儿十二指肠溃疡合并急性上消化道大出血的手术治疗%Emergency surgery for fatal upper gastrointestinal tract bleeding caused by duodenal ulcer in children

    Institute of Scientific and Technical Information of China (English)

    孙晓毅; 余东海

    2010-01-01

    Objective To retrospectively review the emergency surgeries for fatal bleeding caused by duodenal ulcer in children. Methods Four male patients aged 2. 5 to 4 years old were en-rolled in this study. Urgent operations were performed on the 4 patients due to an unexpected heavy bleeding during medical treatment of ulcer disease. Intraoperative inspection revealed the ulcer lesions located at the superior wall of duodenal bulb on one patient,at the anterior wall on another patient,and at the posterior wall on the other two patients. Blood spewed from the ulcer or seeped from the edge of the ulcer. Hemostatic suturing to the bleeding lesion was performed under direct vision. After complete hemostasis was achieved,the duodenal stump was closed,and subtotal gastric resection and Billroth Ⅱ gastrojejunostomy were performed. Results The four patients were recovered uneventful-ly. They were followed up for 1-5 years. No recurrence of preoperative gastrointestinal symptoms and ulcers or bleeding was noted on the 4 patients. Their hemoglobin,serum total protein and albumin were stayed at the normal levels. Their diet and growth were normal Conclusions The duodenal ul-cer complicated with uncontrollable bleeding in children is extremely rare. The bleeding is usually caused by arteries eroded by the ulcerations located at the posterior wall of duodenal bulb. Emergency operation is required to stop bleeding. After hemostasis was achieved,the ulcer lesion can be left out. Billroth Ⅱ gastrojejunostomy is performed to reconstruct the gastrointestinal continuity. Different from the gastrectomy scope on adults,subtotal gastric resection can get good results on pediatric patients.%目的 报道4例小儿十二指肠溃疡合并致命性上消化道大出血病例的手术抢救以及预后.方法 2002至2008年间收治的4例男性十二指肠溃疡合并急性上消化道大出血患儿,年龄2.5~4岁,均在内科治疗溃疡病期间发生不可控制的大出血而紧急手

  7. Comparing the Efficacy of Prophylactic P6 Acupressure, Ondansetron, Metoclopramide and Placebo in the Prevention of Vomiting and Nausea after Strabismus Surgery

    OpenAIRE

    Ali Reza Ebrahim Soltani; Hossein Mohammadinasab; Mehrdad Goudarzi; Shahriar Arbabi; Abbass Mohammadinasab; Fatemeh Mohammadinasab; Mahdi Samimi

    2011-01-01

    To compare the efficacy of acupressure wrist bands, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery. Two hundred patients, ASA physical status I or II, aged between 10 and 60 years, undergoing strabismus surgery in Farabi Hospital in 2007-2008 years, were included in this randomized, prospective, double-blind and placebo-controlled study. Group I was the Control, group II received metoclopramide 0.2 mg/kg, group III received ondansetro...

  8. Minimally Invasive Colorectal Cancer Surgery in Europe

    Science.gov (United States)

    Babaei, Masoud; Balavarca, Yesilda; Jansen, Lina; Gondos, Adam; Lemmens, Valery; Sjövall, Annika; B⊘rge Johannesen, Tom; Moreau, Michel; Gabriel, Liberale; Gonçalves, Ana Filipa; Bento, Maria José; van de Velde, Tony; Kempfer, Lana Raffaela; Becker, Nikolaus; Ulrich, Alexis; Ulrich, Cornelia M.; Schrotz-King, Petra; Brenner, Hermann

    2016-01-01

    Abstract Minimally invasive surgery (MIS) of colorectal cancer (CRC) was first introduced over 20 years ago and recently has gained increasing acceptance and usage beyond clinical trials. However, data on dissemination of the method across countries and on long-term outcomes are still sparse. In the context of a European collaborative study, a total of 112,023 CRC cases from 3 population-based (N = 109,695) and 4 institute-based clinical cancer registries (N = 2328) were studied and compared on the utilization of MIS versus open surgery. Cox regression models were applied to study associations between surgery type and survival of patients from the population-based registries. The study considered adjustment for potential confounders. The percentage of CRC patients undergoing MIS differed substantially between centers and generally increased over time. MIS was significantly less often used in stage II to IV colon cancer compared with stage I in most centers. MIS tended to be less often used in older (70+) than in younger colon cancer patients. MIS tended to be more often used in women than in men with rectal cancer. MIS was associated with significantly reduced mortality among colon cancer patients in the Netherlands (hazard ratio [HR] 0.66, 95% confidence interval [CI] (0.63–0.69), Sweden (HR 0.68, 95% CI 0.60–0.76), and Norway (HR 0.73, 95% CI 0.67–0.79). Likewise, MIS was associated with reduced mortality of rectal cancer patients in the Netherlands (HR 0.74, 95% CI 0.68–0.80) and Sweden (HR 0.77, 95% CI 0.66–0.90). Utilization of MIS in CRC resection is increasing, but large variation between European countries and clinical centers prevails. Our results support association of MIS with substantially enhanced survival among colon cancer patients. Further studies controlling for selection bias and residual confounding are needed to establish role of MIS in survival of patients. PMID:27258522

  9. Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery

    Directory of Open Access Journals (Sweden)

    Henning Bay Nielsen

    2014-03-01

    Full Text Available Near-infrared spectroscopy (NIRS is used to monitor regional cerebral oxygenation (rScO2 during cardiac surgery but is less established during non-cardiac surgery. This systematic review aimed i to determine the non-cardiac surgical procedures that provoke a reduction in rScO2 and ii to evaluate whether an intraoperative reduction in rScO2 influences postoperative outcome. The PubMed and Embase database were searched from inception until April 30, 2013 and inclusion criteria were intraoperative NIRS determined rScO2 in adult patients undergoing non-cardiac surgery. The type of surgery and number of patients included were recorded. There was included 113 articles and evidence suggests that rScO2 is reduced during thoracic surgery involving single lung ventilation, major abdominal surgery, hip surgery, and laparascopic surgery with the patient placed in anti-Tredelenburg’s position. Shoulder arthroscopy in the beach chair and carotid endarterectomy with clamped internal carotid artery also cause pronounced cerebral desaturation. A >20% reduction in rScO2 coincides with indices of regional and global cerebral ischemia during carotid endarterectomy. Following thoracic surgery, major orthopedic and abdominal surgery the occurrence of postoperative cognitive dysfunction might be related to intraoperative cerebral desaturation. In conclusion, certain non-cardiac surgical procedures is associated with an increased risk for the occurrence of regional cerebral oxygenation. Evidence for an association between cerebral desaturation and postoperative outcome parameters other than cognitive dysfunction needs to be established.

  10. Robot-Assisted Gynecologic Surgery

    Medline Plus

    Full Text Available ... guys tonight. We’re going to be talking robotic-assisted gynecologic surgery, and I can tell you, ... and it shows us how we start a robotic case really like standard laparoscopy, and there’s an ...

  11. Robotic systems in orthopaedic surgery.

    Science.gov (United States)

    Lang, J E; Mannava, S; Floyd, A J; Goddard, M S; Smith, B P; Mofidi, A; Seyler, T M; Jinnah, R H

    2011-10-01

    Robots have been used in surgery since the late 1980s. Orthopaedic surgery began to incorporate robotic technology in 1992, with the introduction of ROBODOC, for the planning and performance of total hip replacement. The use of robotic systems has subsequently increased, with promising short-term radiological outcomes when compared with traditional orthopaedic procedures. Robotic systems can be classified into two categories: autonomous and haptic (or surgeon-guided). Passive surgery systems, which represent a third type of technology, have also been adopted recently by orthopaedic surgeons. While autonomous systems have fallen out of favour, tactile systems with technological improvements have become widely used. Specifically, the use of tactile and passive robotic systems in unicompartmental knee replacement (UKR) has addressed some of the historical mechanisms of failure of non-robotic UKR. These systems assist with increasing the accuracy of the alignment of the components and produce more consistent ligament balance. Short-term improvements in clinical and radiological outcomes have increased the popularity of robot-assisted UKR. Robot-assisted orthopaedic surgery has the potential for improving surgical outcomes. We discuss the different types of robotic systems available for use in orthopaedics and consider the indication, contraindications and limitations of these technologies. PMID:21969424

  12. Virtual planning in orthognathic surgery

    DEFF Research Database (Denmark)

    Stokbro, K.; Aagaard, E.; Torkov, P.;

    2014-01-01

    and accuracy of three-dimensional (3D) virtual surgical planning of orthognathic procedures compared with the actual surgical outcome following orthognathic surgery reported in clinical trials. A systematic search of the current literature was conducted to identify clinical trials with a sample size of more...

  13. Recent Advances in IOL Surgery

    Institute of Scientific and Technical Information of China (English)

    P.Ranga; Reddy; Venkateshwara; Rao; Puligala

    1993-01-01

    Tremendous progress is made in recent time in the field of Ophthalmology especially after advent of IOL implantation surgery. Recent advance in anaesthesia/lOL, designs/IOL, quotings/cantering, techniques/advances in operating microscope and advances in suture materials/needles etc. will be discussed.

  14. The alcohol patient and surgery

    DEFF Research Database (Denmark)

    Tønnesen, H

    1999-01-01

    Alcohol abusers have a threefold increased risk of post-operative morbidity after surgery. The most frequent complications are infections, cardiopulmonary insufficiency, and bleeding episodes. Pathogenesis is suppressed immune capacity, subclinical cardiac dysfunction, and haemostatic imbalance....... The economic implications of alcohol abuse in surgical patients are tremendous. Interventional studies are required to reduce future increases in post-operative morbidity....

  15. Transtracheal ventilation in oral surgery.

    OpenAIRE

    Terry, R M

    1983-01-01

    The use of transtracheal ventilation as a routine method of ventilation during anaesthesia for 60 patients with gross pathology requiring oral surgery is reported. Theoretical hazards of the technique and protection of the airway are discussed. There were no serious complications in this series. The technique is recommended as a simple and safe alternative to blind nasal intubation.

  16. Gynecological endoscopic surgery in Cienfuegos.

    Directory of Open Access Journals (Sweden)

    Alberto Jorge Fernández

    2003-07-01

    Full Text Available Background: In the last few years less invasive techniques for patients have been developed and endoscopic surgery is important example. Objective: To determine the advantages of endoscopic surgery and to relate ultrasonographic findings with surgical diagnoses. Method: Case study of 73 surgeries performed by gynaecological endoscopic surgery at the University Hospital ¨Dr. Gustavo Aldereguía Lima¨ from Cienfuegos province in the period January 1998- May 2002. urgencies and and Salpingoclasias were excluded from this search. The statistical study included tests of percentage, accumulated frequency, Kappla´s index, mean and standard deviation. Results: The most recent gynaecological pathologies were: Pelvic Inflammatory Disease, infertility and ovarian cyst. The relationship between ultrasonographic and surgical diagnosis was good for P.I.D and the intrauterine device in the abdominal cavity but not for endometritis. The most frequent laparoscopic procedures were salpingovariolasis and fimbrioplasty , ovarian cystectomy and contrasted laparoscopy. The two complications were bleeding which was controlled and facial subcutaneous emphysema.

  17. [Laparoscopic surgery for esophageal achalasia].

    Science.gov (United States)

    Ozawa, S; Ando, N; Ohgami, M; Kitagawa, Y; Kitajima, M

    2000-04-01

    Laparoscopic surgery for esophageal achalasia was first reported by Shimi et al. in 1991. Subsequently the procedure has been performed all over the world and laparoscopic Heller myotomy and Dor fundoplication (Heller and Dor operation) is now thought to be the operation of first choice. It is indicated for patients who are resistant to medical therapy (calcium blocker etc.) or have pneumatic dilatation and those with frequent aspiration at night. As Csendes et al. reported that surgical treatment was better than pneumatic dilatation and as laparoscopic surgery is less invasive, the indications for the laparoscopic Heller and Dor operation can include all achalasia patients except those who respond to medical therapy, do not accept surgery, or cannot tolerate surgery. We successfully performed the laparoscopic Heller and Dor operation on 22 patients, all of whom had an uneventful postoperative course. Manometric evaluation, endoscopic examination, and 24-hour pH monitoring showed good results. There are six important technical points: 1) flexible laparoscopy; 2) pneumoperitoneum; 3) gauze in the abdominal cavity to absorb blood; 4) laparosonic coagulating shears; 5) extracorporeal knot-tying technique; and 6) intracorporeal knot-tying technique. If an experienced surgeon is in charge, the laparoscopic Heller and Dor operation is an ideal, minimally invasive treatment for esophageal achalasia.

  18. Surgery for GEP-NETs

    DEFF Research Database (Denmark)

    Knigge, Ulrich; Hansen, Carsten Palnæs

    2012-01-01

    Surgery is the only treatment that may cure the patient with gastroentero-pancreatic (GEP) neuroendocrine tumours (NET) and neuroendocrine carcinomas (NEC) and should always be considered as first line treatment if R0/R1 resection can be achieved. The surgical and interventional procedures for GEP...

  19. Surgery for pancreatic cancer -- discharge

    Science.gov (United States)

    ... enable JavaScript. Pancreatic surgery is done to treat cancer of the pancreas gland. When You Are in the Hospital All ... Claudius C, Lillemoe KD. Palliative Therapy for Pancreatic Cancer. In: Cameron ... Vickers SM. Exocrine Pancreas. In: Townsend CM Jr, Beauchamp RD, Evers BM, ...

  20. Gastropulmonary Fistula after Bariatric Surgery

    Directory of Open Access Journals (Sweden)

    Maya Doumit

    2009-01-01

    Full Text Available The Roux-en-Y gastric bypass is one of the most common operations for morbid obesity. Although rare, gastropulmonary fistulas are an important complication of this procedure. There is only one recently reported case of this complication. The present report describes the serious nature of this complication in a patient after an uneventful laparoscopic gastric bypass surgery.

  1. Epidural analgesia for cardiac surgery

    NARCIS (Netherlands)

    V. Svircevic; M.M. Passier; A.P. Nierich; D. van Dijk; C.J. Kalkman; G.J. van der Heijden

    2013-01-01

    Background A combination of general anaesthesia (GA) with thoracic epidural analgesia (TEA) may have a beneficial effect on clinical outcomes by reducing the risk of perioperative complications after cardiac surgery. Objectives The objective of this review was to determine the impact of perioperativ

  2. Future perspectives in robotic surgery.

    Science.gov (United States)

    Wedmid, Alexei; Llukani, Elton; Lee, David I

    2011-09-01

    • Robotics of the current day have advanced significantly from early computer-aided design/manufacturing systems to modern master-slave robotic systems that replicate the surgeon's exact movements onto robotic instruments in the patient. • Globally >300,000 robotic procedures were completed in 2010, including ≈98,000 robot-assisted radical prostatectomies. • Broadening applications of robotics for urological procedures are being investigated in both adult and paediatric urology. • The use of the current robotic system continues to be further refined. Increasing experience has optimized port placement reducing arm collisions to allow for more expedient surgery. Improved three-dimensional camera magnification provides improved intraoperative identification of structures. • Robotics has probably improved the learning curve of laparoscopic surgery while still maintaining its patient recovery advantages and outcomes. • The future of robotic surgery will take this current platform forward by improving haptic (touch) feedback, improving vision beyond even the magnified eye, improving robot accessibility with a reduction of entry ports and miniaturizing the slave robot. • Here, we focus on the possible advancements that may change the future landscape of robotic surgery.

  3. "Oriental anthropometry" in plastic surgery

    Directory of Open Access Journals (Sweden)

    Senna-Fernandes Vasco

    2008-01-01

    Full Text Available Background : According to Chinese medicine, the acupuncture-points′ (acupoints locations are proportionally and symmetrically distributed in well-defined compartment zones on the human body surface Oriental Anthropometry" (OA. Acupoints, if considered as aesthetic-loci, might be useful as reference guides in plastic surgery (PS. Aim: This study aimed to use aesthetic-loci as anatomical reference in surgical marking of Aesthetic Plastic Surgery. Method: This was an observational study based on aesthetic surgeries performed in private clinic. This study was based on 106 cases, comprising of 102 women and 4 men, with ages varying from 07 to 73 years, and with heights of between 1.34 m and 1.80 m. Patients were submitted to aesthetic surgical planning by relating aesthetic-loci to conventional surgical marking, including breast surgeries, abdominoplasty, rhytidoplasty, blepharoplasty, and hair implant. The aesthetic-surgical-outcome (ASO of the patients was assessed by a team of plastic surgeons (who were not involved in the surgical procedures over a follow-up period of one year by using a numeric-rating-scale in percentage (% terms. A four-point-verbal-rating-scale was used to record the patients′ opinion of therapeutic-satisfaction (TS. Results: ASO was 75.3 ± 9.4% and TS indicated that most patients (58.5% obtained "good" results. Of the remainder, 38.7% found the results "excellent", and 2.8% found them "fair". Discussion and Conclusion : The data suggested that the use of aesthetic-loci may be a useful tool for PS as an anatomical reference for surgical marking. However, further investigation is required to assess the efficacy of the OA by providing the patients more reliable balance and harmony in facial and body contours surgeries.

  4. Anxiety disorders in plastic surgery.

    Science.gov (United States)

    Rankin, M; Borah, G L

    1997-08-01

    Surgery is a stressful event, with the potential for profound disturbance to the patient's psychological and physiologic homeostasis. Cosmetic surgery is a particularly intense psychological experience because, in addition to the usual concerns about surgical side effects, cosmetic patients bring their hopes and expectations for improved self-image, putting them at risk for the added anxiety of disappointment. High levels of anxiety coupled with the perception of vulnerability or threat to self can cause significant psychological reactions complicating care for the plastic surgical patient. This paper outlines the diagnostic features of the common types of anxiety disorders seen in plastic surgical patients, and it offers treatment strategies for the practitioner, delineating when referral to a mental health expert is advised. Specific clinical case studies of panic attack, posttraumatic stress disorder, and acute stress disorder are presented to illustrate the variety of abnormal anxiety responses that may be encountered in the perioperative setting. Interventions for the anxious patient are part science and part art. Careful questioning and psychosocial assessment can identify those patients who are at greater risk for psychological problems after surgery. However, some patients may mask or keep secret their concerns, which can be manifested with resulting anger and hostility. Plastic surgeons must use appropriate indicators of psychological anxiety and measure a specific patient's reactions to surgery to make the diagnosis of abnormal anxiety. Close follow-up by the plastic surgical team is an essential part of the anxiety disorder patient's psychological treatment, but it is imperative that these problematic patients be referred promptly to a qualified mental health professional to limit their adverse experience and promote their well-being. Patients who are less anxious during the perioperative period report less emotional distress and fewer defensive

  5. Innovative Incontinence Surgery: The Male Sling

    Medline Plus

    Full Text Available ... blood loss, so those that are faint of heart should be able to watch this whole procedure. ... one’s a hip replacement surgery, say they need heart surgery or something, how long should they wait ...

  6. Weighing the Options: Gastric Sleeve Surgery

    Medline Plus

    Full Text Available Weighing the Options: Gastric Sleeve Surgery Halifax Health Florida December 7, 2011 I chose to have bariatric surgery because I have struggled with yo-yo dieting for probably 25 years, and ...

  7. Life after weight-loss surgery

    Science.gov (United States)

    ... as your body gets used to the weight loss and your weight becomes stable. It is important that you follow ... taking vitamins. You may become sad after having weight-loss surgery. The reality of life after surgery may ...

  8. Patient Safety: Guide to Safe Plastic Surgery

    Science.gov (United States)

    ... and Consumer Information > Patient Safety Guide to Safe Plastic Surgery Patient Safety More Resources Choose a surgeon ... Important facts about the safety and risks of plastic surgery Questions to ask my plastic surgeon Choose ...

  9. Surgery for Crohn's Disease and Ulcerative Colitis

    Science.gov (United States)

    ... Crohn's Disease & Ulcerative Colitis Go Back Surgery for Crohn's Disease & Ulcerative Colitis Email Print + Share ( Disclaimer: Surgery information ... helps you to learn what to expect. About Crohn’s disease and ulcerative colitis Crohn’s disease and ulcerative colitis ...

  10. Prenatal Surgery: Helping Babies Before Birth

    Science.gov (United States)

    ... Tropical Delight: Melon Smoothie Pregnant? Your Baby's Growth Prenatal Surgery: Helping Babies Before Birth KidsHealth > For Parents > ... Before Birth Print A A A Text Size Prenatal Surgery: Helping Babies Before Birth Operating on a ...

  11. American Society for Surgery of the Hand

    Science.gov (United States)

    ... of Hand Surgery ASSH Annual Meeting Registration Program Hotel and Travel Industry and Exhibits Future Annual Meetings Shop our Store ... of Hand Surgery ASSH Annual Meeting Registration Program Hotel and Travel Industry and Exhibits Future Annual Meetings Shop our Store ...

  12. Robot-Assisted Gynecologic Oncology Surgery

    Medline Plus

    Full Text Available ... more. We had a question about are we planning to do any more live surgeries here at ... a few more live surgeries that we're planning in the upcoming months. We're having to ...

  13. Laparoscopic Anti-Reflux (GERD) Surgery

    Science.gov (United States)

    ... Exhibit Opportunities Sponsorship Opportunities Login Laparoscopic Anti-Reflux (GERD) Surgery Patient Information from SAGES Print PDF Find ... to have laparoscopic anti-reflux surgery What is Gastroesophageal Reflux Disease (GERD)? Although “heartburn” is often used to ...

  14. Epilepsy Surgery for Individuals with TSC

    Science.gov (United States)

    ... of epilepsy surgery in patients with tuberous sclerosis. Neurology 62(3):479-81 Kagawa K, Chugani DC, ... for epilepsy surgery in patients with tuberous sclerosis. Neurology 64(9):1651-4 Moshel YA, Elliott R, ...

  15. Heart Valve Surgery Recovery and Follow Up

    Science.gov (United States)

    ... Stroke More Heart Valve Surgery Recovery and Follow Up Updated:May 27,2016 Surgery Recovery Checklist English | ... self-care and are soon encouraged to get up, to breathe deeply, and to resume eating, drinking ...

  16. Robot-Assisted Gynecologic Oncology Surgery

    Medline Plus

    Full Text Available ... The procedure will utilize the da Vinci robotic system, which allows a more specific dissection. The robot ... re using robotic surgery, the da Vinci robotic system, so we're performing major surgery through minor ...

  17. Chemo Before Surgery May Help Stomach Cancer

    Science.gov (United States)

    Chemotherapy given before surgery for cancer of the lower esophagus and stomach increased the number of patients surviving for five years compared to surgery alone, according to findings presented at the 2007 ASCO meeting in Chicago.

  18. Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis.

    Science.gov (United States)

    Black, J A; White, B; Viner, R M; Simmons, R K

    2013-08-01

    The number of obese young people continues to rise, with a corresponding increase in extreme obesity and paediatric-adolescent bariatric surgery. We aimed to (i) systematically review the literature on bariatric surgery in children and adolescents; (ii) meta-analyse change in body mass index (BMI) 1-year post-surgery and (iii) report complications, co-morbidity resolution and health-related quality of life (HRQoL). A systematic literature search (1955-2013) was performed to examine adjustable gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass or biliopancreatic diversions operations among obese children and adolescents. Change in BMI a year after surgery was meta-analysed using a random effects model. In total, 637 patients from 23 studies were included in the meta-analysis. There were significant decreases in BMI at 1 year (average weighted mean BMI difference: -13.5 kg m(-2) ; 95% confidence interval [CI] -14.1 to -11.9). Complications were inconsistently reported. There was some evidence of co-morbidity resolution and improvements in HRQol post-surgery. Bariatric surgery leads to significant short-term weight loss in obese children and adolescents. However, the risks of complications are not well defined in the literature. Long-term, prospectively designed studies, with clear reporting of complications and co-morbidity resolution, alongside measures of HRQol, are needed to firmly establish the harms and benefits of bariatric surgery in children and adolescents.

  19. ndophthalmitis Following Glaucoma Drainage Implant Surgery

    OpenAIRE

    Tolga Kocatürk; Erol Erkan; Harun Çakmak

    2014-01-01

    Glaucoma surgery is performed widely in our country and all around the world to lower the intraocular pressure in refractory glaucoma. Glaucoma drainage implant surgery has a special and important place among glaucoma surgeries. Among various complications, endophthalmitis is a rare but the most devastating complication after glaucoma drainage implantation. In this review, the clinical characteristics and treatment options of endophthalmitis after glaucoma drainage implant surgery ar...

  20. ndophthalmitis Following Glaucoma Drainage Implant Surgery

    Directory of Open Access Journals (Sweden)

    Tolga Kocatürk

    2014-03-01

    Full Text Available Glaucoma surgery is performed widely in our country and all around the world to lower the intraocular pressure in refractory glaucoma. Glaucoma drainage implant surgery has a special and important place among glaucoma surgeries. Among various complications, endophthalmitis is a rare but the most devastating complication after glaucoma drainage implantation. In this review, the clinical characteristics and treatment options of endophthalmitis after glaucoma drainage implant surgery are discussed according to recent literature. (Turk J Ophthalmol 2014; 44: 138-43

  1. CT-guided stereotactic brain surgery

    International Nuclear Information System (INIS)

    An apparatus for stereotactic brain surgery combined with a whole-body CT scanner, by which surgery can be performed by CT scanning, was developed. This apparatus and an Archimedes screw were clinically applied to surgery for removal of deep-seated intracranial hematomas, and satisfactory results were obtained. An outline of this apparatus is given, and combined use of the apparatus and the Secta type of ultrasound apparatus for monitoring surgery is described. (Namekawa, K.)

  2. Treatment of bronchial ruptures by delayed surgery

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    Objective:To study the causes that resulted in delayed surgery for bronchial ruptures and the results.Methods:The cases with the bronchial ruptures by the delayed surgery last decade were retrospectively reviewed.The causes and unsatisfactory results were analysed.Results:The severe complications usually occurred after the delayed surgery and the results were not as satisfactory as those by early surgery.Conclusion:The bronchial ruptures ought to be operated in the early stage after being wounded.

  3. Small bowel bacterial overgrowth

    Science.gov (United States)

    ... Surgical procedures that create a loop of small intestine where excess bacteria can grow. An example is a Billroth II type of stomach removal ( gastrectomy ). Some cases of irritable bowel syndrome (IBS) Symptoms The most common symptoms are: Abdominal ...

  4. Robotic transaxillary and retroauricular parathyroid surgery

    OpenAIRE

    Mohamed, Hossam Eldin; Bhatia, Parisha; Aslam, Rizwan; Moulthrop, Thomas; Kandil, Emad

    2015-01-01

    Current advancement in robotic surgery has provided a safe, precise, 3-dimensional (3D) magnified dissection for parathyroid surgery without the need for CO2 insufflation, and with a better cosmetic outcome due to an invisible scar in the axillary or retroauricular region. Preoperative imaging studies that assist in the localization of lesions have been key elements in patients’ selection for targeted parathyroid surgery.

  5. Cosmetic surgeries on knots in $S^3$

    CERN Document Server

    Ni, Yi

    2010-01-01

    Two Dehn surgeries on a knot are called {\\it purely cosmetic}, if they yield manifolds that are homeomorphic as oriented manifolds. Using Heegaard Floer homology, we give necessary conditions for the existence of purely cosmetic surgeries on knots in $S^3$. Among other things, we show that the two surgery slopes must be the opposite of each other.

  6. Cosmetic surgeries on genus one knots

    OpenAIRE

    Wang, Jiajun

    2005-01-01

    In this paper, we prove that there are no truly cosmetic surgeries on genus one classical knots. If the two surgery slopes have the same sign, we give the only possibilities of reflectively cosmetic surgeries. The result is an application of Heegaard Floer theory and number theory.

  7. Anticipating urgent surgery in operating room departments

    NARCIS (Netherlands)

    Lans, van der M.; Hans, E.W.; Hurink, J.L.; Wullink, G.; Houdenhoven, van M.; Kazemier, G.

    2005-01-01

    Operating Room (OR) departments need to create robust surgical schedules that anticipate urgent surgery, while minimizing urgent surgery waiting time and overtime, and maximizing utilization. We consider two levels of planning and control to anticipate urgent surgery. At the tactical level, we study

  8. A randomized study of combining maze surgery for atrial fibrillation with mitral valve surgery

    NARCIS (Netherlands)

    Jessurun, ER; Van Hemel, NM; Defauw, JJ; De La Riviere, AB; Stofmeel, MAM; Kingma, JH; Ernst, JMPG

    2003-01-01

    Aim Mitral valve surgery seldom suppresses atrial fibrillation (AF), present prior to surgery. Maze III surgery eliminates AF in >80% of cases, the reason why combining this procedure with mitral valve surgery in patients with AF seems worthwhile. We prospectively studied the outcome of combining th

  9. [One stop surgery in pediatric surgery. Preliminary report].

    Science.gov (United States)

    Sanges, G; Astuto, M; Sentina, P; Morinello, E; Di Benedetto, A

    2002-01-01

    The One-Stop Surgery (OSS) is a new method of Day Surgery, which combines preoperative evaluation and subsequent operation into one visit. This report describes the initial experience of the authors. Referring physicians were informed by fax about method and selected surgical procedures. Included form helped them to gain anamnestic data and to inform parents about preoperative fast. Form was then sent back by fax to the pediatric surgeon and anesthesiologist who determined the patient suitability and scheduled the day of the surgery. At hospital admission, if the diagnosis was confirmed and no anesthesiologic contraindications were discovered, the patient underwent the prescheduled surgical procedure and was discharged as a day case. Another form containing informations about home postoperative care and telephone numbers for emergency call was gave to the parents. From November 2000 through February 2001 43 patients, aged from 2 to 7 years, underwent one-stop surgical procedure: central venous catheter removal (n = 16), umbilical (n = 2) and inguinal (n = 10) hernia repair, prepuce dorsal slit (n = 15). Recovery of all patient was uneventful. None of them called during the period considered necessary for postoperative follow-up. Decreased costs and increased satisfaction of the patients and parents are the most important advantages of the OSS. Potential disadvantages are a not appropriate indication for the planned procedure and/or an anesthesiologic contraindication at hospital admission. It could involve a waste of human and financial resources and an useless psychologic stress for the family. Authors conclude it is not advisable the OSS use on a large scale without a sound experience in pediatric Day Surgery.

  10. Glaucoma after Congenital Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Mahmoodreza Panahi Bazaz

    2014-05-01

    Full Text Available Purpose: To determine the incidence and risk factors associated with glaucoma following congenital cataract surgery (CCS in children under age of 15 Methods: This prospective cohort (since 2006 consisted of children less than 15 years of age who underwent cataract surgery with or without intraocular lens (IOL implantation. The role of the following factors on the development of glaucoma after CCS including age at surgery, gender, laterality of the cataract, IOL implantation, congenital ocular anomalies, intra- and postoperative complications, length of follow-up, central corneal thickness (CCT as well as the effect of the age of onset, time to development of glaucoma, and response to treatment were evaluated. Results: Overall, 161 eyes of 96 patients were included in this study of which 28 eyes developed glaucoma. Incidence of glaucoma was 17.4%. Mean±SD age at surgery was 9.3±6.9 (range, 1-24 months in glaucomatous and 40.4±41.1 (range, 1 m-13.6 year months in non-glaucomatous group (p<0.001. All glaucoma patients had the operation under two years of age. In group 1, 9 (60% and in group 2, 24 (30% patients were female (p=0.001. In group 1, 17 eyes (60.7% and in the group 2, 41 eyes (30.8% were aphakic (p=0.001. Mean time to diagnosis of glaucoma was 111.2 days (range 30-1200 days. Mean follow-up time was 3.1 years (range, 1-6 years. In 22 (78.6% eyes glaucoma was diagnosed within six months after surgery. Glaucoma was controlled with medications in 23 eyes (82% and with surgery in five eyes. Conclusion: In this study the incidence of glaucoma after CCS was 17.4% over a follow-up period of six years. Younger age at the time of lensectomy increases the risk of secondary glaucoma. IOL implantation may protect against glaucoma. Female gender was affected more than male.

  11. IOL Implants: Lens Replacement and Cataract Surgery (Intraocular Lenses)

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  12. Advances in Weight Loss Surgery: The Fully Robotic Gastric Bypass

    Medline Plus

    Full Text Available ... specialties including cardiac surgery, thoracic surgery, which is pulmonary surgery. The other procedure that we can use ... procedures. It’s also used in thoracic surgery for lung cancer, for lung tumors, gynecologic procedures -- the hysterectomy ...

  13. SEROMA FORMATION IN CANCER BREAST SURGERY

    Directory of Open Access Journals (Sweden)

    Sitaram

    2015-01-01

    Full Text Available Post - operative breast surgery for malignancy has a common side effect of seromas, whose formation and drainage requires a special attention to prevent as much as possible and as early as possible to avoid morbidity. How best we can prevent the dead space is the problem. In this study a review of various methods adopted all over the world is reviewed includ ing early discharge of the patient with drain. It is always preferable to remove the drain when the collection of serum is less than 25ml in 24 hours the chance of re accumulation of fluid is less likely . INTRODUCTION: Carcinoma breast has remained the sec ond leading cause of cancer death among women worldwide over the past three decades [ 1 ] and contributes significantly to cancer surgical load. Surgical treatment for breast cancer includes breast conservation therapy and mastectomy with or without axillary dissection depending on disease stage. Seroma formation is the most frequent postoperative Side effect seen after mastectomy and axillary surgery with an incidence of 3% to 85% . OBSERVATIONS: TYPE OF SURGERY : Surgical treatment for breast cancer has undergone a paradigm shift from Halstead's radical mastectomy to breast conservation. It has been demonstrated that radical mastectomy increases seroma formation compared with that of simple mastectomy , but the association is inconclusive when radical mastectomy is compared with modified radical mastectomy (MRM . SURGICAL DEVICES : Various electro - mechanical devices are used during surgery to reduce blood loss and operating time. These include electrocautery, laser scalpel, argon diathermy, ultrasonic scalpel, ultrasonic scissors, and vessel sealing systems. All of these devices have been investigated in an effort to reduce seroma formation. Randomized trials have shown that the use of electrocautery for dissecting flaps is significantly associated with increased seroma formation when compared to that of scalpel dissection . However

  14. [Temporo-mandibular joints and orthognathic surgery].

    Science.gov (United States)

    Bouletreau, P

    2016-09-01

    Temporo-Mandibular Joints (TMJ) and orthognathic surgery are closely linked. In the past, some authors have even described (with mixed results) the correction of some dysmorphosis through direct procedures on the TMJs. Nowadays, performing orthognathic surgery involves the TMJ in three different occasions: (1) TMJ disorders potentially responsible for dento-maxillary dysmorphosis, (2) effects of orthognathic surgery on TMJs, and (3) condylar positioning methods in orthognathic surgery. These three chapters are developed in order to focus on the close relationships between TMJ and orthognathic surgery. Some perspectives close this article.

  15. Shoulder Pain After Thoracic Surgery

    DEFF Research Database (Denmark)

    Blichfeldt-Eckhardt, Morten R; Andersen, Claus; Ørding, Helle;

    2016-01-01

    OBJECTIVES: To study the time course of ipsilateral shoulder pain after thoracic surgery with respect to incidence, pain intensity, type of pain (referred versus musculoskeletal), and surgical approach. DESIGN: Prospective, observational cohort study. SETTING: Odense University Hospital, Denmark....... PARTICIPANTS: Sixty patients for major lung resection. INTERVENTIONS: Postoperative observation of ipsilateral shoulder pain. MEASUREMENTS AND MAIN RESULTS: Postoperative numeric rating scale score of shoulder pain and thoracic pain and postoperative examination of the sites of shoulder pain...... for musculoskeletal involvement (muscle tenderness on palpation and movement) with follow-up 12 months after surgery. Clinically relevant pain was defined as a numeric rating scale score>3. Of the 60 patients included, 47 (78%) experienced ipsilateral shoulder pain, but only 25 (42%) reported clinically relevant...

  16. [Video-assisted thoracoscopic surgery].

    Science.gov (United States)

    Assaker, R; Fromont, G; Reyns, N; Louis, E; Chastanet, P; Lejeune, J P

    2001-05-01

    We describe our experience with video-assisted thoracoscopic surgery (VATS). Twenty-nine patients were operated on with this technique for various anterior thoracic spinal lesions. There were 6 cases of disc herniation with simple resection, 6 with acute thoracic fractures requiring anterior grafting and stabilization, 7 old fractures and malunions treated by corporectomy, grafting and anterior stabilization in 3, 4 with spinal metastases that were resected and stabilized, 3 with a paravertebral spinal tumor (2 schwannomas and 1 chondroblastoma), and 3 osteoid osteomas that were resected with anterior grafting in one case. Indications for these procedures are specified and the technical considerations discussed for each group of pathologies. We had three complications: one conversion to thoracotomy in a case of spinal metastasis, one pleural effusion, and one incomplete resection of a thoracic disc herniation. We emphasize the need for minimally invasive approaches in spinal surgery. PMID:11404678

  17. Psychosomatic disturbances and cosmetic surgery.

    Science.gov (United States)

    Harth, Wolfgang; Hermes, Barbara

    2007-09-01

    Medical activity in recent years has experienced a marked expansion of possibilities for aesthetic surgery, usually requested by patients. Especially in dermatology, an increasing demand for and use of doctor/medical services by healthy individuals has resulted in a drastic change to cosmetic dermatology. The request for cosmetic surgery is emotionally or psychosocially motivated. Patients with psychological disturbances sometimes push aside possible risks and complications or deny side effects and interactions of the procedures. Subjective impairments of appearance, feelings of inferiority and social pho-bias may be in the background of somatizing disorders. These emotional disorders, such as body dysmorphic disorder, personality disorder or polysurgical addiction, often remain undiscovered but should be excluded in any patient receiving cosmetic procedures. PMID:17760893

  18. [Surgery for diabetes type 2?].

    Science.gov (United States)

    Müller, Markus K; Nocito, A; Schiesser, M

    2010-02-17

    Diabetes mellitus type 2 is a chronic disease with increasing prevalence in western society. Obesity represents a well established risk factor for the development of diabetes mellitus type 2. Several studies on surgical procedures for the treatment of obesity have shown a postoperative reduction of obesity-related co-morbidities. Thus, diabetes mellitus type 2 was shown to resolve or improve in more than 75% of morbidly obese patients (BMI >35) after bariatric surgery. These insights paved the way for the advent of metabolic surgery - a novel field with the goal to improve glucose metabolism in patients with a BMI of less than 35. Encouraging results from mostly observational studies have sparked the interest in the surgical management of diabetes mellitus type 2.

  19. Intaoperative neuromonitoring in thyroid surgery

    Directory of Open Access Journals (Sweden)

    P O Rumyantsev

    2013-09-01

    Full Text Available Thyroid surgery is most frequent interventions on endocrine organs. Whereas laryngeal nerves which inner vate the muscles of larynx are passing nearby the thyroid and central compartment therefore the risk of their injury and functional integrity is extremely important. First of all it is recurrent laryngeal nerve which in 0.5–2.7% has not “recurrent” path and depart vagus at cricoid cartilage level. Secondary it is external branch of superior laryngeal nerve with innervates cricothyroid muscle. Routine use of intraoperative neuromonitoring significantly decrease laryngeal nerves temporary palsy (paresis rate however significant reduction of perma nent palsy frequency was not demonstrated in most published papers. At the same time all authors accept that intraoperative neuromonitoring undoubtedly facilitate detection of laryngeal nerves and allow to convince their functional capacity. Taking into account that safety is a paradigm of contemporary endocrine surgery the intra operative neuromonitoring going towards further investigation and improvement.

  20. Scar remodeling after strabismus surgery.

    OpenAIRE

    Ludwig, I H

    1999-01-01

    PURPOSE: Patients with overcorrected strabismus (and several patients with undercorrection after extraocular muscle resection) underwent exploration of previously operated muscles, with the intention of advancing their tendons to prevent the need for surgery on additional muscles. Unexpectedly, it was found that, in many cases, an elongated scar segment of variable length was interposed between the muscle and its insertion site on the sclera. Laboratory investigations were carried out to eluc...

  1. Ancient Technology in Contemporary Surgery

    OpenAIRE

    Buck, Bruce A.

    1982-01-01

    Archaeologists have shown that ancient man developed the ability to produce cutting blades of an extreme degree of sharpness from volcanic glass. The finest of these prismatic blades were produced in Mesoamerica about 2,500 years ago. The technique of production of these blades was rediscovered 12 years ago by Dr. Don Crabtree, who suggested possible uses for the blades in modern surgery. Blades produced by Dr. Crabtree have been used in experimental microsurgery with excellent results. Anima...

  2. Prophylactic antibiotics in orthopaedic surgery.

    Science.gov (United States)

    Prokuski, Laura; Clyburn, Terry A; Evans, Richard P; Moucha, Calin S

    2011-01-01

    The use of prophylactic antibiotics in orthopaedic surgery has been proven effective in reducing surgical site infections after hip and knee arthroplasty, spine procedures, and open reduction and internal fixation of fractures. To maximize the beneficial effect of prophylactic antibiotics, while minimizing any adverse effects, the correct antimicrobial agent must be selected, the drug must be administered just before incision, and the duration of administration should not exceed 24 hours.

  3. Cosmetic Surgery in Mid Life

    OpenAIRE

    Born, Gunter

    1984-01-01

    The aging of the skin and supportive tissues in mid-life causes a deterioration in appearance and/or accentuates preexisting deformities. This can adversely affect the patient's self image and self-respect. Cosmetic or esthetic surgery helps to rejuvenate the aging features to improve the patient's self-image and restore self-confidence. This article discusses the various corrective procedures, their indications, extent, morbidity, complications and cost.

  4. Physiotherapy after subacromial decompression surgery

    DEFF Research Database (Denmark)

    Christiansen, David Høyrup; Falla, Deborah; Frost, Poul;

    2015-01-01

    This paper describes the development and details of a standardised physiotherapy exercise intervention designed to address pain and disability in patients with difficulty returning to usual activities after arthroscopic decompression surgery for subacromial impingement syndrome. To develop...... the intervention, the literature was reviewed with respect to the effectiveness of postoperative exercises, components of previous exercise programmes were extracted, and input from clinical physiotherapists in the field was obtained through a series of workshops. The physiotherapy exercise intervention...

  5. Anaesthetic complications in plastic surgery

    Directory of Open Access Journals (Sweden)

    Soumya Sankar Nath

    2013-01-01

    Full Text Available Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist′s concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients′ experience and surgical outcome.

  6. Radioimmunoguided surgery using monoclonal antibody

    International Nuclear Information System (INIS)

    The potential proficiency of radioimmunoguided surgery in the intraoperative detection of tumors was assessed using labeled monoclonal antibody B72.3 in 66 patients with tissue-proved tumor. Monoclonal antibody B72.3 was injected 5 to 42 days preoperatively, and the hand-held gamma-detecting probe was used intraoperatively to detect the presence of tumor. Intraoperative probe counts of less than 20 every 2 seconds, or tumor-to-adjacent normal tissue ratios less than 2:1 were considered negative (system failure). Positive probe counts were detected in 5 of 6 patients with primary colon cancer (83 percent), in 31 of 39 patients with recurrent colon cancer (79 percent), in 4 of 5 patients with gastric cancer (80 percent), in 3 of 8 patients with breast cancer (37.5 percent), and in 4 of 8 patients with ovarian cancer (50 percent) undergoing second-look procedures. Additional patients in each group were scored as borderline positive. Overall, radioimmunoguided surgery using B72.3 identified tumors in 47 patients (71.2 percent), bordered on positive in 6 patients (9.1 percent), and failed to identify tumor in 13 patients (19.7 percent). Improved selection of patients for antigen-positive tumors, the use of higher affinity second-generation antibodies, alternate routes of antibody administration, alternate radionuclides, and more sophisticatedly bioengineered antibodies and antibody combinations should all lead to improvements in radioimmunoguided surgery

  7. Eye surgery in the elderly

    Directory of Open Access Journals (Sweden)

    Raczyńska D

    2016-04-01

    Full Text Available Dorota Raczyńska, Leopold Glasner, Ewelina Serkies-Minuth, Magdalena A Wujtewicz, Kamila Mitrosz Department of Ophthalmology, Medical University of Gdansk, Gdansk, Poland Abstract: Extending life expectancy is a human achievement. It does however entail problems. Ophthalmic treatments are widely recognized as having a low risk of general complications. A classic example is cataract surgery, considered to be one of the safest and most frequently performed surgical procedures in the world. However, advanced age brings with it risks that should be considered before surgery. Eye operations, as with procedures on other organs, are largely dependent on the quality of surgical tissues. Therefore, the elderly are at increased risk of complications. Improved general health and postoperative follow-up with the use of noninvasive technologies such as optical coherence tomography translate into lower intraoperative risk and better postoperative prognosis. In this review, we discuss the impact of general health on operational prognosis, therapeutic problems, and technical difficulties which a surgeon and anesthesiologist may encounter in the process. We also consider new technology and strategies specifically aimed at treating eye conditions in the elderly. Keywords: eye surgery, eye aging, anesthesiology in ophthalmology, cataract, glaucoma, vitrectomy, age-related macular degeneration

  8. Current advances in liver surgery

    Directory of Open Access Journals (Sweden)

    Shannon Melissa Chan

    2015-01-01

    Full Text Available Hepatobiliary surgery has taken a big step forward in recent decades especially in the minimally invasive approach for hepatectomy. From being sceptical at the beginning of the 1990s when laparoscopic surgery had become prevalent, to now, where laparoscopic hepatectomy has been well-established, especially in minor hepatectomies; this new technique has evolved rapidly over the past 20-years demonstrating better short-term outcomes and equivalent oncological outcomes in selected patients and in expert hands. Laparoscopic hepatectomy is indeed, more difficult to master than the open procedure with restrictions in working space, difficulty in haemostasis and the potential risk of gas embolism. However, with better visibility of the operative field around the liver, especially beneath the costal margin, the magnified view and theoretical advantage of pneumoperitoneum acting as haemostatic pressure have made laparoscopic hepatectomy increasingly popular. Another important advancement is the new surgical technique of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS. This procedure induces more rapid liver hypertrophy within a median period of 9-days, allowing resection to be performed in candidates with borderline functional liver remnant and at an earlier date. However, studies have shown that ALPPS is associated with a relatively higher rate of morbidity and mortality. Therefore, it remains a highly controversial treatment option and more studies have to be performed to establish its usefulness and define its role in liver surgery.

  9. [Assessment of bariatric surgery results].

    Science.gov (United States)

    Barros, Lívia Moreira; Frota, Natasha Marques; Moreira, Rosa Aparecida Nogueira; de Araújo, Thiago Moura; Caetano, Joselany Áfio

    2015-03-01

    The objective was to evaluate the results of bariatric surgery in patients in the late postoperative period using the Bariatric Analysis and Reporting Outcome System (BAROS). This cross-sectional study was conducted from November 2011 to June 2012 at a hospital in the state of Ceará, Brazil. Data were collected from 92 patients using the BAROS protocol, which analyzes weight loss, improved comorbidities, complications, reoperations and Quality of Life (QoL). Data were analysed using the chi-squared test, Fischer's exact test and the Mann-Whitney test. There was a reduction in the Body Mass Index (47.2±6.8 kg/m2 in the pre-operatory and 31.3±5.0 kg/m2 after surgery, p<0.001). The comorbidity with the highest resolution was arterial hypertension (p<0.001), and QV improved in 94.6% of patients. The main complications were hair loss, incisional hernia and cholelithiasis. The surgery provided satisfactory weight loss and improvements in the comorbidities associated to a better QL. Use of the BAROS protocol allows nurses to plan interventions and maintain the good results. PMID:26098798

  10. Robotic surgery: applications and cost effectiveness

    Directory of Open Access Journals (Sweden)

    Laura Sigismund Leddy

    2010-09-01

    Full Text Available Laura Sigismund Leddy, Thomas S Lendvay, Richard M SatavaDepartment of Urology, University of Washington, Seattle, WA, USAAbstract: Robotic surgery has been embraced by many surgical specialties and is being incorporated into an ever growing number of surgical procedures within those specialties. The outcomes and cost data that are available varies greatly between fields. This review examines the history of robotic surgery, the advantages and disadvantages of this technology followed by the applications of robotic surgery in the fields of: urology, gynecology, pediatric surgery and general surgery. Finally, the cost data from the fields of urology and pediatric surgery are reviewed and used to create a model to evaluate the financial impact of a surgical robot on a hospital.Keywords: robotic surgery, cost effectiveness

  11. A Bariatric Surgery Primer for Orthopedic Surgeons.

    Science.gov (United States)

    Kingsberg, Jessica G; Halpern, Alan A; Hill, Brian C

    2016-01-01

    Increasing numbers of patients who have undergone bariatric surgery are now presenting to orthopedic surgeons for elective arthroplasties. In addition, orthopedic surgeons themselves are referring more patients for consideration of bariatric surgery in anticipation of future elective procedures. Although the full effects of bariatric surgery on metabolism are not yet known, the altered digestion associated with these surgeries poses several issues for orthopedic surgeons. In this article, we address 3 aspects of care of this class of patient: review of the most commonly performed procedures and their metabolic consequences; suggested preoperative assessment of bariatric patients for any conditions that should be corrected before surgery; and evaluation of outcomes of elective procedures performed after bariatric surgery. Awareness of the unique characteristics of this group of patients helps minimize the potential for complications of planned orthopedic surgeries.

  12. Elizabeth II uus kunstigalerii

    Index Scriptorium Estoniae

    1999-01-01

    Tähistamaks oma troonile asumise 50. aastapäeva, avab Elizabeth II 6. II 2002 Buckinghami palees uue kunstigalerii, mis ehitatakse palee tiibhoonena. Arhitekt John Simpson. Elizabeth II kunstikogust

  13. Kinetics of Highly Sensitive Troponin T after Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Amr S. Omar

    2015-01-01

    Full Text Available Perioperative myocardial infarction (PMI confers a considerable risk in cardiac surgery settings; finding the ideal biomarker seems to be an ideal goal. Our aim was to assess the diagnostic accuracy of highly sensitive troponin T (hsTnT in cardiac surgery settings and to define a diagnostic level for PMI diagnosis. This was a single-center prospective observational study analyzing data from all patients who underwent cardiac surgeries. The primary outcome was the diagnosis of PMI through a specific level. The secondary outcome measures were the lengths of mechanical ventilation (LOV, stay in the intensive care unit (LOSICU, and hospitalization. Based on the third universal definition of PMI, patients were divided into two groups: no PMI (Group I and PMI (Group II. Data from 413 patients were analyzed. Nine patients fulfilled the diagnostic criteria of PMI, while 41 patients were identified with a 5-fold increase in their CK-MB (≥120 U/L. Using ROC analysis, a hsTnT level of 3,466 ng/L or above showed 90% sensitivity and 90% specificity for the diagnosis of PMI. Secondary outcome measures in patients with PMI were significantly prolonged. In conclusion, the hsTnT levels detected here paralleled those of CK-MB and a cut-off level of 3466 ng/L could be diagnostic of PMI.

  14. Autologous Transfusion in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Radmehr H

    2003-11-01

    Full Text Available Preoperative autologous blood donation is commonly used to reduce exposure to homologous blood transfusions among patients undergoing elective cardiac surgery. The aim of this study was to evaluate the effect of autologous transfusion on patients' hematocryte value, intra and postoperative blood loss, hospitalization time, the development of infective complications and other factors. Materials and Methods: Between June 2001 to April 2002, 208 patients were underwent cardiac surgery in cardiac surgery ward in Imam Khomeini Medical Center. One or more blood units donate from 104 Patients before cardiopulmonary bypass and heparin injection, and transfused to them after CPB and Protamin injection (autologous Group, group 1. 104 patients underwent cardiac surgery routinely (control group, group 2."nResults: Mean of age was 55.9±8.6 in group 1 and 56.6±9.3 in group 2 (P=NS. 73 male and 31 females were in group 1 and 79 males and 25 females were in group 2 (P=NS. Smoking, familial history, hyperlipidemia, diabetes mellitus, renal failure, hypertension, stroke, and history of myocardial infarction was similar in two groups."nSeverity of angina, urgency operation, number vessels disease, duration of cardiopulmonary bypass, duration of aortic cross clamp time, use of internal thoracic artery graft, and number of grafts was similar in both groups. Mean of bleeding post operation was 548 cc in group 1 and 803 cc in-group 2 (P=0.003. Bleeding that need to operation was 1.8% in group 1 and 8.6% in group 2 (P=0.002. Wound infection, mediastinitis, renal failure, ventilatory prolonged, stroke, need to Intra-aortic Balloon Pump (IABP, intraoperative bleeding, and hospital stay was similar in both groups. Mean of extubationt time was 10.2 hours in group 1 and 14.8 hours in group 2 (P=0.001."nConclusion: Preoperative and intra-operative donations are safe and continue to contribute uniquely to blood conservation, providing important options in comprehensive

  15. Hip dislocation in cerebral palsy: evolution of the contralateral side after reconstructive surgery

    Directory of Open Access Journals (Sweden)

    João Caetano Munhoz Abdo

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the progression of the contralateral hip after unilateral reconstruction of hip dislocation in patients classified as GMFCS IV-V; and to identify potential prognostic factors for their evolution. METHODS: This was a retrospective study on 17 patients with spastic cerebral palsy, who were classified on the GMFCS scale (Gross Motor Functional Classification System as degrees IV and V, and who underwent unilateral reconstruction surgery to treat hip dislocation (adductor release, femoral varus osteotomy and acetabuloplasty. The minimum postoperative follow-up was 30 months. The clinical parameters evaluated were sex, age at time of surgery, length of follow-up after surgery and range of abduction. The treatment parameters were use/nonuse of femoral shortening, application of botulinum toxin and any previous muscle releases. The radiographic parameters were Reimer's extrusion index (REI, acetabular angle (AA and the continuity of Shenton's line. RESULTS: Among the 17 patients evaluated, eight presented dislocation (group I and nine did not (group II. Group I comprised three males and five females; group II comprised one male and eight females. The mean age at the time of surgery among the group I patients was 62 months and the mean follow-up was 62 months. In group II, these were 98 and 83 months, respectively. There was a trend in which patients of greater age did not evolve with contralateral dislocation. Among the nine patients with the combination of REI < 30% and AA < 25°, only one presented dislocation during the follow-up. Contralateral subluxation occurred within the first two years after the surgery. CONCLUSION: Hips presenting REI < 30° and AA < 25° do not tend to evolve to subluxation and can be kept under observation. Preoperative clinical and radiographic measurements alone are not useful for indicating the natural evolution of non- operated hips. The critical period for subluxation is the first two

  16. An Update on the Level of Evidence for Plastic Surgery Research Published in Plastic and Reconstructive Surgery.

    Science.gov (United States)

    Nguyen, Anson; Mahabir, Raman C

    2016-07-01

    In 2011, Plastic and Reconstructive Surgery (PRS) implemented a level-of-evidence (LOE) pyramid to bring attention to evidence-based medicine and to promote quality of research. The objective of our study was to examine the current, overall quality of plastic surgery research when compared with that of the previous 30 years. Articles from PRS published in 2013 were culled for information, including LOE based on the assigned score from the LOE pyramid. (Animal, cadaver, and basic science studies; reviews; correspondence; and continuing medical education articles were excluded.) The LOE grades were compared with those from 1983, 1993, and 2003. In 2013, 536 articles were published in PRS; of these, 247 met the inclusion criteria and were included in the analysis. The mean LOE in PRS for 2013 was 3.42. For the year 2003, the mean LOE was 4.16; 1993, 4.25; and 1983, 4.42. Analysis of variance indicated significant improvement in research quality over time (P higher LOE. There was also a decrease in the percentage of level IV and V studies to 47.2% (from 51.4% in 2013), whereas higher quality level I and II studies had increased to 18.1% (from 17.4%). The quality of plastic surgery research has shown a continued upsurge as evidenced by overall improvement in LOE in published articles over the past 3 decades. PMID:27536477

  17. Central Corneal Thickness Measurement by Ultrasound versus Orbscan II

    Science.gov (United States)

    Faramarzi, Amir; Ziai, Hossein

    2008-01-01

    Purpose To compare Orbscan II and ultrasonic pachymetry for measurement of central corneal thickness (CCT) in eyes scheduled for keratorefractive surgery. Methods CCT was measured using Orbscan II (Bausch & Lomb, USA) and then by ultrasonic pachymetry (Tomey SP-3000, Tomey Ltd, Japan) in 100 eyes of 100 patients with no history of ocular surgery scheduled for excimer laser refractive surgery. Results Mean CCT was 544.7±35.5 (range 453–637) μm by ultrasonic pachymetry versus 546.9±41.6 (range 435–648) μm measured by Orbscan II applying an acoustic factor of 0.92 (P=0.14). The standard deviation of measurements was greater with Orbscan pachymetry but the difference was not statistically significant. Conclusion CCT measurements by Orbscan II (applying an acoustic factor) and by ultrasonic pachymetry are not significantly different; however, when CCT readings by Orbscan II are in the lower range, it is advisable to recheck the measurements using ultrasonic pachymetry. PMID:23479527

  18. Sedation in hypoalbuminemic geriatric patients under spinal anesthesia in hip surgery

    Science.gov (United States)

    Ersoy, Ayşın; Kara, Deniz; Ervatan, Zekeriya; Çakırgöz, Mensure; Kıran, Özlem

    2015-01-01

    Objectives: To compare midazolam and propofol sedation in hypoalbuminemic geriatric patients under spinal anesthesia in hip surgery with bispectral index monitoring. Methods: This prospective and randomized study was completed in the Department of Anesthesiology, Okmeydani Training and Research Hospital, Istanbul, Turkey between February 2013 and December 2014. Sixty patients undergoing elective hip surgery under spinal anesthesia in the geriatric age group with albumin levels below 3 g/dl were randomly divided into Group I and Group II. After administration of spinal block, Group I were given 0.05 mg/kg bolus midazolam, and then 0.02-0.1 mg/kg/hr dose infusion was begun. In Group II, 1 mg/kg bolus propofol was given within 10 minutes, and then 1-3 mg/kg/hr infusion was begun. The systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, peripheral oxygen saturation values, respiratory rate, and Wilson’s 5-stage sedation score were recorded at 15-minute intervals. At the end of the operation, the recovery time and surgeon satisfaction were recorded. Results: The recovery times for patients in Group I were found to be longer than in Group II (p<0.05). The respiration rate in patients in Group I at the start of surgery, 15th minute of surgery, and after surgery were lower than in Group II (p<0.05). Conclusion: We conclude that propofol is more reliable in terms of hemodynamic stability than midazolam, as it causes less respiratory depression and faster recovery in the propofol group. PMID:26446330

  19. [Hybrid surgery for the treatment of ovarial cysts in newborns].

    Science.gov (United States)

    Kozlov, Iu A; Novozhilov, V A; Rasputin, A A; Syrkin, N V; Podkamenev, A V; Iurkov, P S; Solov'ev, A A; Radikevich, O V

    2013-01-01

    The aim of this study was to evaluate the effect of hybrid technology (laparoscopy and open surgery) for treatment of ovarian cysts in small babies and infants. Between January 2002 and November 2012, we have performed 11 operation for neonatal ovarian cysts repaired through standard circumumbilical incision (Group I) and 16 operation with using combined hybrid laparoscopic-assisted technique (Group II). The circumumbilical incision utilized at our institution is a classic Bianchi procedure. The hybrid approach combined 2 technique - laparoscopic and open. The trocar for optic telescope was inserted through a circumumbilical incision. The one working instrument was introduced into the peritoneal cavity direct through umbilicus. Afterwords, ovarian cyst was deflated with using transabdominal needle aspiration, delivered by an extended umbilical incision and enucleated as in standard open surgery. The two groups were compared for patients demographics, operative report and early postoperative outcomes. All procedures were performed successfully with no complications rate. There were no differences in the preoperative parameters between the two groups. The differences between groups for operative and postoperative results were statistically significant (p<0.05). The mean operative time in Group I was 30.91 min. In contrast, the mean duration of the operation in the Group II was 21.56 min. The mean time to beginning and time of full enteral feeding for patients with hybrid approach were significantly shorter as for patients with umbilical incision (4.06 hours vs 10.91 hours; 13 hours vs 20.55 hours). Prolonged mean postoperative hospital stay were registered in patients of the Group I (6.36 days vs 3.19 days; p<0.05). The postoperative course and follow up was uneventful in the all patients. The experience described in this study confirms that hybrid operation can be applied for treatment of neonatal ovarian cysts with outcomes better than standard open surgery.

  20. Orthognathic surgery with or without autologous fat micrograft injection: preliminary report on aesthetic outcomes and patient satisfaction.

    Science.gov (United States)

    Raffaini, M; Pisani, C

    2015-03-01

    Orthognathic surgery leaves the intrinsic volume of the facial soft tissues untouched, sometimes resulting in unsatisfactory improvements in aesthetics. The aim of this study was to evaluate the aesthetic outcomes and patient satisfaction following bimaxillary orthognathic surgery with or without simultaneous facial lipofilling procedures. The preoperative and postoperative facial appearances of 210 patients were compared through analysis of photographs and postoperative clinical evaluation. A patient questionnaire was used to assess the perceived improvement in aesthetics. One hundred and twenty patients (mean age 20.3 years) underwent bimaxillary orthognathic surgery and simultaneous facial lipofilling procedures (group I). The remaining 90 patients (mean age 19.8 years) underwent skeletal procedures only (group II). The overall aesthetic improvement was similar in the two groups (group I 92.5%, group II 91.1%). Greater higher-level aesthetic improvement scores were recorded for group I (group I 80%, group II 55.6%). The overall patient satisfaction was 98.3% for group I and 97.8% for group II. Greater higher-level satisfaction scores were recorded for group I (group I 14.2%, group II 6.7%). The simultaneous use of the autologous fat micrograft is a promising technique that may improve the aesthetic outcomes of orthognathic surgery, leading to greater patient satisfaction.

  1. Potentials and applications of robotic surgery in Oral and Maxillofacial Surgery. A literature review.

    Directory of Open Access Journals (Sweden)

    Dimitrios VOLAKOS

    2014-12-01

    Full Text Available SUMMARY: Robotic surgery can be described as the latest advance in minimally invasive surgery, following the laparoscopic surgical approach. Since its first clinical trial in 1985, many steps have been taken. Nowadays, it is used successfully in many surgical disciplines, such as Urology, Orthopedic Surgery, Cardiothoracic Surgery, Oral and Maxillofacial Surgery (OMFS. The aim of this literature review is to present generally in surgery and more precisely in OMFS the applications of robotics and also present its potential for future use in the field.

  2. The relationship between the stress-related psychosocial factors and the psychosomatic adjustment after surgery(II):The effect of Qi-Gong relaxation training%心理社会因素与手术康复(二):气功的干预作用

    Institute of Scientific and Technical Information of China (English)

    沈晓红; 姜乾金; 叶圣雅

    2001-01-01

    Objective To study the effect of Qi-Gong relaxation training on the operation-related psychological stress and the post-operative psychosomatic adjustment in upper-abdominal surgery patients. Methods Forty-two patients undergoing upper-abdominal surgery in intervention group were instructed to do Qi-Gong relaxation training, and forty patients matched were controls without Qi-Gong relaxation training. On the day before surgery, a self-developed patients' pre-operative appraisal questionnaire, a self-developed patients' pre-operative behavior rating questionnaire for completion by medical workers, and State Anxiety Inventory (SAI) of State -Trait Anxiety Inventory (STAI) were used in two groups. In an hour before operation,the shift of the mean value of pulse and systolic pressure of every case compared with the base line measured at his (or her) admission was also recorded. After surgery, patients were assessed with a self-developed patients' post-operative appraisal questionnaire, a self-developed patients' post-operative behavior rating questionnaire for completion by medical workers and SAI of STAI. Besides, the indexes of physical rehabilitation, including intestinal aerofluxus, total dosage of analgesia and so on, were recorded. Data were analysed in t-test with SPSS. Results Compared with controls, the patients in intervention group had more positive anticipation about the following operation, lower pre- and post-operative anxiety, and lighter post-operative pain experience. There was no difference in the indexes of physical rehabilitation between two groups. Conclusions Qi-Gong relaxation training could lead patients to better psychological adjustment both before and after operation. This finding suggests that Qi-Gong relaxation training could be used as an effective psycho-behavior intervention in abdominal surgery patients.%目的探索气功放松训练在外科心理应激及术后心身康复中的干预作用。方法随机选

  3. [General surgery under discussion. From the viewpoint of vascular surgery].

    Science.gov (United States)

    Debus, E S; Eckstein, H H; Böckler, D; Imig, H; Florek, A

    2008-03-01

    Vascular diseases are common and their frequency is rising. Statistics show that 15% of the German population over 65 display some kind of peripheral arterial pathology. Even aneurysmatic degeneration and cardiac and visceral perfusion disorders are being observed more frequently, while peak age is dropping. Therapeutic surgical options are accordingly being continually advanced and refined. Additionally the range of interventional therapies and new conservative options has substantially increased vascular surgeons' armamentarium. Updates in surgical training have responded to this increase in such disorders, and the diversification of therapeutic modalities has resulted in the elevation of vascular surgery from specialized techniques to a fully accredited specialty equal in standing to the other seven surgical disciplines. Controversy exists however about the new accredition, beginning with the question of advancement from basic surgical training while excluding important elements of general surgery. Since those training for this specialty will branch off immediately after 2 years of basic surgical training, their final accreditation in the new classification would exclude essential skills that remain part of the training as general surgeons.

  4. Photoacoustic monitoring of clot formation during surgery and tumor surgery

    Science.gov (United States)

    Juratli, Mazen A.; Galanzha, Ekaterina I.; Sarimollaoglu, Mustafa; Nedosekin, Dmitry A.; Suen, James Y.; Zharov, Vladimir P.

    2013-03-01

    When a blood vessel is injured, the normal physiological response of the body is to form a clot (thrombus) to prevent blood loss. Alternatively, even without injury to the blood vessel, the pathological condition called thromboembolism may lead to the formation of circulating blood clots (CBCs), also called emboli, which can clog blood vessels throughout the body. Veins of the extremities (venous thromboembolism), lungs (pulmonary embolism ), brain (embolic stroke), heart (myocardial infarction), kidneys, and gastrointestinal tract are often affected. Emboli are also common complications of infection, inflammation, cancer, surgery, radiation and coronary artery bypass grafts. Despite the clear medical significance of CBCs, however, little progress has been made in the development of methods for real-time detection and identification of CBCs. To overcome these limitations, we developed a new modification of in vivo photoacoustic (PA) flow cytometry (PAFC) for real-time detection of white, red, and mixed clots through a transient decrease, increase or fluctuation of PA signal amplitude, respectively. In this work, using PAFC and mouse models, we present for the first time direct evidence that some medical procedures, such as conventional or cancer surgery may initiate the formation of CBCs. In conclusion, the PA diagnostic platform can be used in real-time to define risk factors for cardiovascular diseases, assist in the prognosis and potential prevention of stroke by using a well-timed therapy or as a clot count as a marker of therapy efficacy.

  5. Neuronavigator-guided glioma surgery

    Institute of Scientific and Technical Information of China (English)

    杜固宏; 周良辅; 毛颖

    2003-01-01

    Objective To evaluate the effectiveness of neuronavigator-guided surgery for the resection of gliomas. Methods A total of 80 patients with gliomas underwent surgical treatment under the StealthStation neuronavigator to estimate the extent of the tumors. In 27 cases, the measurements of brain shifts at the dura, cortical surface and lesion margin were recorded during the operations. A technique termed "micro-catheter fence post" was used in superficial gliomas to compensate for brain shift.Results Mean fiducial error and predicted accuracy in the 80 cases were 2.03 mm±0.89 mm and 2.43 mm±0.99 mm, respectively. The shifts at the dura, cortical surface and lesion margin were 3.44 mm±2.39 mm, 7.58 mm±3.75 mm, and 6.55 mm±3.19 mm, respectively. Although neuronavigation revealed residual tumors, operations were discontinued in 5 cases of deep-seated gliomas. In the other 75 cases, total tumor removals were achieved in 62 (82.7%), and subtotal removals were achieved in 13 (17.3%). Post-operation, neurological symptoms were improved or unchanged in 68 cases (85.0%), and worsened in 12 (15.0%). No deaths occurred during the operations and post-operations. Conclusions Intraoperative brain shifts mainly contribute to the fail of spatial accuracy during neuronavigator-guided glioma surgery. The "micro-catheter fence post" technique used for glioma surgery is shown to be useful for compensating for intraoperative brain shifts. This technique, thus, contributes to an increase in total tumor removal and a decrease in surgical complications.

  6. Surgery for Benign Salivary Neoplasms.

    Science.gov (United States)

    Gillespie, M Boyd; Iro, Heinrich

    2016-01-01

    Salivary neoplasms are relatively infrequent entities that account for only 4% of tumors of the head and neck. Although slow-growing lesions of the preauricular area and submandibular space are often confused with sebaceous cysts, lymph nodes, or lipomas by the non-otolaryngologist, otolaryngologists-head and neck surgeons recognize that all preauricular and submandibular masses should be considered a salivary neoplasm until proven otherwise. Surgery remains the treatment of choice for benign salivary gland neoplasms; however, techniques continue to evolve in order to preserve salivary function and reduce surgical morbidity. The goals of management of benign salivary neoplasms include accurate diagnosis of the lesion, complete surgical extirpation, and functional preservation of adjacent cranial nerves. Accurate diagnosis is aided by appropriate preoperative physical examination, imaging, and fine needle aspiration biopsy. Benign neoplasms typically present as slow-growing, painless, mobile masses without adverse features, such as tissue fixation, ulceration, a cranial nerve deficit, or regional lymphadenopathy. Preoperative imaging with ultrasonography, computed tomography, or magnetic resonance imaging reveals well-circumscribed lesions without an infiltrative growth pattern or associated adenopathy. Fine needle aspiration biopsy may favor a benign neoplasm, supporting the clinical presentation. Surgery for a benign or malignant salivary neoplasm is in essence a false dichotomy since the surgeon can never be completely confident of the diagnosis until the specimen is removed. The surgeon must recognize the significant overlap between benign and malignant salivary masses in terms of clinical presentation, imaging, and cytology, which requires the surgeon to remain vigilant and flexible at the time of surgery should tissue characteristics or frozen section analysis suggest a malignant process.

  7. [Dissection techniques in liver surgery].

    Science.gov (United States)

    Rau, H G; Schauer, R; Pickelmann, S; Beyer, B C; Angele, M K; Zimmermann, A; Meimarakis, G; Heizmann, O; Schildberg, F W

    2001-02-01

    The first liver resection was performed in 1888. Since then a wide variety of dissection techniques have been introduced. The blunt dissection was replaced by novel methods, i.e. the CUSA technique and the Jet Cutter for major liver resections. These methods represent selective dissection techniques; whereas non-selective methods include the scalpel, scissors, linear stapling cutter, high-frequency coagulation, and the laser technique. The aim of this review article is the comparison of the different resection techniques in liver surgery, focussing on blood loss and resection time. PMID:11253668

  8. Laser technologies in ophthalmic surgery

    Science.gov (United States)

    Atezhev, V. V.; Barchunov, B. V.; Vartapetov, S. K.; Zav’yalov, A. S.; Lapshin, K. E.; Movshev, V. G.; Shcherbakov, I. A.

    2016-08-01

    Excimer and femtosecond lasers are widely used in ophthalmology to correct refraction. Laser systems for vision correction are based on versatile technical solutions and include multiple hard- and software components. Laser characteristics, properties of laser beam delivery system, algorithms for cornea treatment, and methods of pre-surgical diagnostics determine the surgical outcome. Here we describe the scientific and technological basis for laser systems for refractive surgery developed at the Physics Instrumentation Center (PIC) at the Prokhorov General Physics Institute (GPI), Russian Academy of Sciences.

  9. Kerala Pioneering Pediatric Surgery in India

    Directory of Open Access Journals (Sweden)

    TP Joseph

    2014-04-01

    Full Text Available Pediatric surgeons of Kerala are very proud to have led the development of superspeciality in any branch of medicine in Kerala and also superspeciality of Pediatric surgery in whole of India. Late Prof. Raman Nair returned in 1954 after training under Dr. Everett Koop in US. Same year, in his far-sighted vision for future development of the speciality, he moved to SATH, Medical College, Trivandrum and started Pediatric surgery as a speciality attached to Paediatrics department; this was the beginning of Pediatric surgery in India. He opted for Pediatric surgery as a full time job and did not do any general surgery work in adults. He was the first full time Pediatric surgeon of India; during the next few years, 2 surgeons, one in Calcutta, Prof. UC Chakraboty and Prof. D Anjaneyulu in Hyderabad started working as full time Pediatric surgeons. In Mumbai, Delhi and Chennai, Pediatric surgery developed much later and then all over the country.

  10. Mini-invasive surgery for colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Wei-Gen Zeng; Zhi-Xiang Zhou

    2014-01-01

    Laparoscopic techniques have been extensively used for the surgical management of colorectal cancer during the last two decades. Accumulating data have demonstrated that laparoscopic colectomy is associated with better short-term outcomes and equivalent oncologic outcomes when compared with open surgery. However, some controversies regarding the oncologic quality of mini-invasive surgery for rectal cancer exist. Meanwhile, some progresses in colorectal surgery, such as robotic technology, single-incision laparoscopic surgery, natural orifice specimen extraction, and natural orifice transluminal endoscopic surgery, have been made in recent years. In this article, we review the published data and mainly focus on the current status and latest advances of mini-invasive surgery for colorectal cancer.

  11. Contact surgery and supporting open books

    CERN Document Server

    Avdek, Russell

    2011-01-01

    Let $(M,\\xi)$ be a contact 3-manifold. We present two new algorithms, the first of which converts an open book $(\\Sigma,\\Phi)$ supporting $(M,\\xi)$ with connected binding into a contact surgery diagram. The second turns a contact surgery diagram for $(M,\\xi)$ into a supporting open book decomposition. These constructions lead to a refinement of a result of Ding-Geiges, which states that every such $(M,\\xi)$ may be obtained by contact surgery from $(S^{3},\\xi_{std})$, as well as bounds on the support norm and genus of contact manifolds obtained by surgery in terms of classical link data. We then introduce Kirby moves called ribbon moves which use mapping class relations to modify contact surgery diagrams. Any two surgery diagrams of the same contact manifold are related by a sequence of Legendrian isotopies and ribbon moves. As most of our results are computational in nature, a number of examples are analyzed.

  12. Corneal Topographical Changes Flollowing Strabismus Surgery

    Institute of Scientific and Technical Information of China (English)

    MaiGH; WangZ

    1999-01-01

    Purpose:To study corneal topographical changes after strabismus surgery.Methods:Computer-aided corneal topography was used in 43 strabismus patients(45 eyes)one or two days prior to and six or seven ays after strabismus surgery.The spherical and cylindrical equivalents were calculated based on the simulated keratometry.Results:After the surgery,only the changes at 3mm in the inferior quadrant were statistically significant.The changes at 3mm in the rest quadrants and the changes at 7mm were no significant.Significant changes in spherical equivalent were found post-operatively.neither the horizontal nor the verical meridional equivalent showed significant changes after surgery.Conclusions:The results of corneal topographical changes following strabismus surgery in our preliminary study indicated the little effect of strabismus surgery on corneal curvature and corneal astigmatism.

  13. Plastic surgery after solid organ transplantations

    Institute of Scientific and Technical Information of China (English)

    QI Fa-zhi; ZHANG Yong; YANG Zhen; FENG Zi-hao; GU Jian-ying

    2009-01-01

    Background More patients receive organ transplantation surgeries due to the advancement in immunosuppressive agents and surgical techniques. Some of those patients may need to undergo plastic or reconstructive surgery.Long-term use of immunosuppressive agents raises some serious problems. Therefore, this study aimed to introduce our experience about the safety and effectiveness of plastic surgeries after solid organ allograft transplantation.Methods A retrospective review of 17 transplant recipients who underwent different reconstructive or cosmetic operations was carried out. The subjects included 1 heart transplant, 1 liver transplant and 15 kidney transplant recipients.Results "All patients tolerated the plastic surgery procedures well. Flaps and skin grafts were the main constructive methods. There were no postoperative infections and wound dehiscence. Transferred flaps survived completely. Skin grafts took well. Three of the cosmetic surgery patients were satisfied with the results.Conclusions Immunosuppressed organ transplant recipients can successfully undergo major reconstructive and cosmetic surgery when given special attention.

  14. A COMPARATIVE EVALUATION OF GABAPENTIN AND CLONIDINE PREMEDICATION ON POST OPERATIVE ANALGESIA REQUIREMENT FOLLOWING ABDOMINAL SURGERIES UNDER GENERAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Ashish

    2014-08-01

    Full Text Available AIM: Aim of our study was to compare the relative effectiveness of gabapentin and clonidine premedication on patients undergoing elective abdominal surgeries under G.A. OBJECTIVE: gabapentine and clonidine have anti-nociceptive properties .This study assess their efficacy in prolonging the analgesic effect intra-operative and postoperative analgesic requirement. MATERIAL AND METHOD: 225 patients of either sex of age between 20-60 years, ASA grade I & II, patient admitted to Hamidia hospital for elective abdominal surgeries under general anaesthesia were included in the study. The patients were randomly allocated into three groups 75 each group I : Control group (patients received placebo tablet at 90 min before the surgery,group II Gabapentin 300 mg tablet orally 90 min before surgery ,groupIII:clonidine150µg tablet orally given 90 min before surgery. Duration of postoperative analgesia, Degree of postoperative pain (VAS scoreand added rescue analgesia required in 24 hrs were recorded postoperatively. RESULT: Analysis reveled that there was no difference in the HR, SBP among the three group during the study. Duration of postoperative analgesia, observed from time of reversal to first demand of analgesia in the recovery room was more in group II compared to group I and group III (p-value <0.001, highly significant. Pain perception was highly blunted in groups II compared to group I & group III. Total rescue analgesic requirement during the postoperative 24hrs period was much lower in group II inj Diclofenac compared to group I and group III . ( p-value < 0.001, highly significant.CONCLUSION: Given 90 min before induction of GA oral gabapentin(300 mg or clonidine(150 µg preoperatively was effective in lowering postoperative VAS pain score and consumption of analgesics, it was also shows that gabapentin significantly decreases postoperative pain intensity and analgesic consumption after abdominal surgeries.

  15. New treatment concept in profile surgery.

    OpenAIRE

    Bernardo Canto Vidal; Domingo Francisco Fuentes Febles

    2009-01-01

    Background: Facial profile defects in nose prominence and retrognatia may cause psychological trauma. Aesthetic surgery allows patients with convex profile to recover psychologically and functionally. The possibility of performing both corrections in only one surgery enhances patient’s recovering y and reduces the cost. Objective: To prove the effectiveness of performing profile aesthetic treatment in only one surgery. Method: Descriptive study of 18 patients operated in a period of five year...

  16. Common surgical complications in degenerative spinal surgery

    OpenAIRE

    Papadakis, Michael; Aggeliki, Lianou; Papadopoulos, Elias C.; Girardi, Federico P.

    2013-01-01

    The rapid growth of spine degenerative surgery has led to unrelenting efforts to define and prevent possible complications, the incidence of which is probably higher than that reported and varies according to the region of the spine involved (cervical and thoracolumbar) and the severity of the surgery. Several issues are becoming progressively clearer, such as complication rates in primary versus revision spinal surgery, complications in the elderly, the contribution of minimally invasive sur...

  17. Vertebral artery injuries in cervical spine surgery

    OpenAIRE

    Schroeder, Gregory D.; Hsu, Wellington K.

    2013-01-01

    Background: Vertebral artery injuries during cervical spine surgery are rare, but potentially fatal. When performing cervical spine surgery, it is imperative that the surgeon has a systematic approach for avoiding, and if necessary, dealing with a vertebral artery injury. Methods: This is a review paper. Results: Upper posterior cervical spine surgeries put the vertebral artery at the highest risk, as opposed to anterior subaxial cervical spine procedures, which put the artery at the least ri...

  18. Imaging of lumbar spinal surgery complications

    OpenAIRE

    Malhotra, Ajay; Kalra, Vivek B; Wu, Xiao; Grant, Ryan; Bronen, Richard A; Abbed, Khalid M.

    2015-01-01

    Abstract Lumbar spine surgery for spinal stenosis is a frequently performed procedure and was the fastest growing type of surgery in the US from 1980 to 2000. With increasing surgical invasiveness, postoperative complications also tend to be higher. Cross-sectional imaging techniques (CT and MRI) are more sensitive than radiographs and play an increasingly important role in evaluation of patients with lumbar spine surgery. Their use in patients with metallic implants is somewhat limited by ar...

  19. Adverse events in spine surgery in Sweden

    OpenAIRE

    Öhrn, Annica; Olai, Anders; Rutberg, Hans; Nilsen, Per; Tropp, Hans

    2011-01-01

    Background and purpose Our knowledge of complications and adverse events in spinal surgery is limited, especially concerning incidence and consequences. We therefore investigated adverse events in spine surgery in Sweden by comparing patient claims data from the County Councils' Mutual Insurance Company register with data from the National Swedish Spine Register (Swespine). Methods We analyzed patient claims (n = 182) to the insurance company after spine surgery performed between 2003 and 200...

  20. Optimizing revenue at a cosmetic surgery centre

    OpenAIRE

    Funk, Joanna M; Verheyden, Charles N; Mahabir, Raman C.

    2011-01-01

    To run a successful medical practice and business, financial awareness is key. Cosmetic surgery is tied to the economy – as the economy improves, the demand for cosmetic surgery rises and vice versa. Surgeons must have a good understanding of financial decision making to optimize profitability. This article reviewed the financial records of a five-surgeon cosmetic surgery practice in Texas, USA, from 2003 to 2008, to investigate the methods of payment used for products, services and procedure...

  1. Analgesia and Sedation After Pediatric Cardiac Surgery

    OpenAIRE

    2010-01-01

    Abstract In recent years, the importance of appropriate intra-operative anesthesia and analgesia during cardiac surgery, has become recognised as a factor in postoperative recovery. This includes the early perioperative management of the neonate undergoing radical surgery and more recently the care surrounding fast track and ultra fast track surgery. However, outside these areas, relatively little attention has focused on postoperative sedation and analgesia within the pediatric in...

  2. Bariatric Surgery and Urinary Stone Disease

    Directory of Open Access Journals (Sweden)

    Cevahir Ozer

    2014-12-01

    Full Text Available Obesity is a major public health problem and has been suggested to play a role in the etiology of urinary tract stone disease. Furthermore, the increasingly widespread use of surgery in the treatment of obesity also is related with urinary stone disease. In daily practice, patients to whom obesity surgery has been planned or who have undergone obesity surgery are seen more frequently. This review aims to highlight the urological evaluation and management of this patient group.

  3. A multi-centric prospective study: Anxiety and associated factors among parents of children undergoing mild surgery in ENT

    Directory of Open Access Journals (Sweden)

    Mehmet Akdağ

    2014-06-01

    Full Text Available Objective: The aim of this study to evaluate the anxiety and expectancy among parents of children undergoing surgery in the multi-centric surgery units. Methods: Following approval from the ethics committee, a questionnaire was given to the parents of 123 children who were undergoing surgery in the multi-centric surgery units. The parents were informed that their answers would not affect the care given to their children. The questionnaire was evaluated using the State-Trait Anxiety Inventory (STAI-I and STAI-II. Results: The STAI results indicated that the parents’ anxiety level increased before their children underwent surgery. In addition, there was a negative correlation between STAI-II scores and high levels of wealth (p= 0.004. Also, those with steady employment and higher levels of education had lower anxiety levels and difference was significant (p=0.001. The state anxiety levels were unaffected by family income and education, but the trait anxiety levels decreased with increasing income and education. Mothers were less anxious if their child had undergone surgery in the past, while this result was not significant statistically (p>0.05. Parents were most commonly concerned with possible complications from the surgery and/or anesthesia. Conclusion: Results of our study indicate that parents of children undergoing surgery that have steady employment, to be informed, previously has been administered anesthesia or surgery, high level of wealth and education was observed less anxiety than others. J Clin Exp Invest 2014; 5 (2: 206-210

  4. A lumbar disc surgery predictive score card.

    Science.gov (United States)

    Finneson, B E

    1978-06-01

    A lumbar disc surgery predictive score card or questionnaire has been developed to assess potential candidates for excision of a herniated lumbar disc who have not previously undergone lumbar spine surgery. It is not designed to encompass patients who are being considered for other types of lumbar spine surgery, such as decompressive laminectomy or fusion. In an effort to make the "score card" usable by almost all physicians who are involved in lumbar disc surgery, only studies which have broad acceptance and are generally employed are included. Studies which have less widespread use such as electromyogram, discogram, venogram, special psychologic studies (MMPI, pain drawings) have been purposely excluded.

  5. Morbidity and mortality of diabetes with surgery

    Directory of Open Access Journals (Sweden)

    L. L. Chuah

    2013-01-01

    Full Text Available The prevalence of Type 2 diabetes mellitus (T2DM has increased; as a result the number of patients with T2DM undergoing surgical procedures has also increased. This population is at high risk of macrovascular (cardiovascular disease, peripheral vascular disease or microvascular (retinopathy, nephropathy or neuropathy complications, both increasing their perioperative morbidity and mortality. Diabetes patients are more at risk of poor wound healing, respiratory infection, myocardial infarction, admission to intensive care, and increased hospital length of stay. This leads to increased inpatient costs. The outcome of perioperative glycaemia management remains a significant clinical problem without a universally accepted solution. The majority of evidence on morbidity and mortality of T2DM patients undergoing surgery comes from the setting of cardiac surgery; there was less evidence on non-cardiac surgery and bariatric surgery. Bariatric surgery is increasingly performed in patients with severe obesity complicated by T2DM, but is distinguished from general surgery as it immediately improves the glucose homeostasis postoperatively. The improvements in glycaemia are thought to be independent of weight loss and this requires different postoperative management. Patients usually have to follow specific preoperative diets which lead to improvement in glycaemia immediately before surgery. Here we review the available data on the mortality and morbidity of patients with T2DM who underwent elective surgery (cardiac, non-cardiac and bariatric surgery and the current knowledge of the impact that preoperative, intraoperative and postoperative glycaemic management has on operative outcomes.

  6. Informed Consent for Reconstructive Pelvic Surgery.

    Science.gov (United States)

    Alam, Pakeeza; Iglesia, Cheryl B

    2016-03-01

    Informed consent is the process in which a patient makes a decision about a surgical procedure or medical intervention after adequate information is relayed by the physician and understood by the patient. This process is critical for reconstructive pelvic surgeries, particularly with the advent of vaginal mesh procedures. In this article, we review the principles of informed consent, the pros and cons of different approaches in reconstructive pelvic surgery, the current legal issues surrounding mesh use for vaginal surgery, and tips on how to incorporate this information when consenting patients for pelvic floor surgery.

  7. The history of women in surgery.

    Science.gov (United States)

    Wirtzfeld, Debrah A

    2009-08-01

    The history of women in surgery in Western civilization dates to 3500 before common era (BCE) and Queen Shubad of Ur. Ancient history reveals an active role of women in surgery in Egypt, Italy and Greece as detailed in surgical texts of the time. During the middle ages, regulations forbade women from practising surgery unless they assumed their husbands' practices upon their deaths or unless they were deemed fit by a "competent" jury. King Henry VIII proclaimed that "No carpenter, smith, weaver or women shall practise surgery." The modern period of surgery opens with women impersonating men to practise medicine and surgery (Dr. Miranda Stewart). The first female physicians (Dr. Elizabeth Blackwell and Dr. Emily Jennings Stowe) and surgeons (Dr. Mary Edwards Walker and Dr. Jennie Smillie Robertson) in North America found it difficult to obtain residency education after completing medical school. Dr. Jessie Gray was Canada's "First Lady of Surgery" and the first woman to graduate from the Gallie program at the University of Toronto in the 1940s. Currently, the ratio of women in surgical training is far less than that of women in medical school. The reasons that women choose surgery include appropriate role models and intellectual/technical challenge. Lack of mentorship and lifestyle issues are the strongest deterrents. Consideration of a "controllable lifestyle" by surgical administrators will help with the recruitment of women into surgery. PMID:19680519

  8. Ambulatory spine surgery: a survey study.

    Science.gov (United States)

    Baird, Evan O; Brietzke, Sasha C; Weinberg, Alan D; McAnany, Steven J; Qureshi, Sheeraz A; Cho, Samuel K; Hecht, Andrew C

    2014-08-01

    Study Design Cross-sectional study. Objective To assess the current practices of spine surgeons performing ambulatory surgery in the United States. Methods An electronic survey was distributed to members of the International Society for the Advancement of Spine Surgery. Data were initially examined in a univariate manner; variables with a p value ambulatory spine surgery, and 49.1% were investors in an ambulatory surgery center. Surgeon investors in ambulatory surgery centers were more likely to perform procedures of increased complexity than noninvestors, though limited data precluded a statistical correlation. Surgeons in private practice were more likely to perform ambulatory surgery (94.3%; p = 0.0176), and nonacademic surgeons were both more likely to invest in ambulatory surgery centers (p = 0.0024) and perform surgery at least part of the time in a surgery center (p = 0.0039). Conclusions Though the numbers were too few to calculate statistical significance, there was a trend toward the performance of high-risk procedures on an ambulatory basis being undertaken by those with investment status in an ambulatory center. It is possible that this plays a role in the decision to perform these procedures in this setting versus that of a hospital, where a patient may have better access to care should a complication arise requiring emergent assessment and treatment by a physician. This decision should divest itself of financial incentives and focus entirely on patient safety.

  9. Vestibular schwannoma surgery and headache.

    Science.gov (United States)

    Levo, H; Blomstedt, G; Pyykkö, I

    2000-01-01

    The aim of the study was to evaluate aetiological factors for postoperative headache after vestibular schwannoma (VS) surgery with respect to asymmetric activation of vestibular reflexes. After surgery, 27 VS patients with persistent postoperative headache, 16 VS patients without headache and 9 healthy controls were examined. The vestibular, cervicocollic and cervicospinal reflexes were evaluated to study whether asymmetric activation of vestibular reflexes could cause headache. The effect of neck muscle and occipital nerve anaesthesia and the effect of sumatriptan on headache were also evaluated. The vestibular function of VS patients with headache did not differ from that of VS patients without headache, but was abnormal when compared to that of normal controls. The cervicospinal and cervicocollic reflexes did not differ in the patient groups. Injection of lidocaine around the operation scar gave pain relief to two patients, and one of them had occipital nerve entrapment. Infiltration of lidocaine deep in the neck muscles in the vicinity of the C2 root did not alleviate headache, but caused vertigo. Nine patients with musculogenic headache got pain relief from supportive neck collars, and two patients with cervicobrachial syndrome got pain relief from manual neck traction. The study shows that asymmetric activation of cervicocollic reflexes does not seem to be the reason for headache. Headache seems to be linked to neuropathic pain, allegedly caused by trigeminal irritation of the inner ear and the posterior fossa, which has recently been linked to vascular pain. PMID:10908966

  10. Morphine use in cancer surgery

    Directory of Open Access Journals (Sweden)

    Banafsheh eAfsharimani

    2011-08-01

    Full Text Available Morphine is the core of perioperative pain management. However, when it comes to cancer surgery the possibility that this drug might affect tumor recurrence and metastasis has raised concerns. The results of two recent retrospective clinical trials indicated that regional anesthesia/analgesia might be beneficial in prostate and breast cancer surgery. It was proposed that morphine could be responsible for the higher recurrence and mortality rate observed in the general anesthesia/opioid analgesia groups. Nevertheless, the results of several other retrospective studies and one randomized prospective trial failed to confirm any advantage for regional anesthesia/analgesia over general anesthesia and opioid analgesia. Moreover laboratory data on the effect of morphine on cancer are contradictory, ranging from tumor-promoting to anti-tumor effects. Considering that surgical stress and pain promote the recurrence and spread of cancer, choosing a proper analgesic strategy is of high significance. Although the question of whether morphine causes any harm to cancer patients remains unanswered, alternative analgesic regimens could be used concomitant to or instead of morphine to limit its potential adverse effects.

  11. Research on Fast Track Surgery Application in Lung Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Kaiyun YANG

    2010-02-01

    Full Text Available Background and objective Fast track surgery (FTS is a systematical method to accelerate the recovery of surgical patients by reducing the physical and mental trauma stress of them. The research is to investigate the feasibility of FTS application in lung cancer surgery. Methods A total of 80 cases of lung cancer patients with single leaf lobotomy resection were randomized into two groups. While the experimental group was treated with the conception of FTS, and the control group was treated with the traditional methods. The incident rate of post-operation pain degrees, telecasts, pleural effusion, the post-operation time stay in hospital time and the total cost during hospitalization in two groups were compared respectively. Results In FTS group: the VAS score of post-operation pain at 1 h, 6 h, 12 h, 24 h and 48 h all significantly decreased compared to the traditional therapy group. The incidence rate of telecast was 10.53%. The incidence rate of pleural effusion was 26.31%. The length of stay after operation was (4±1 d and the total cost was RMB 15 600±7 600. In the control group, the above values were 77.78%, 33.33%, 22.22%, (9±1 d, RMB 23 600±5 400, respectively. The post operation pain (VAS method of FTS group was remarkablely below the control group. There has significant difference of the incident rate of telecasts, stay time in hospital and the total cast in two groups (P < 0.05. No significant difference was observed in the incident rate of pleural effusion. Conclusion The new methods of FTS can apparently accelerates recovery after lung cancer resection, reduces complications, shorten timestay in hospital and cut down the total cost.

  12. A STUDY OF CONVERSIONS OF LAPAROSOCOPIC SURGERIES INTO OPEN SURGERIES: A ANALYTICAL STUDY

    Directory of Open Access Journals (Sweden)

    Venkata Reddy

    2015-12-01

    Full Text Available INTRODUCTION: The aim of present study is to know the Conversions in Laparoscopic surgery to Open surgery in The patients of all the surgical units in the Department of General Surgery, Government General Hospital, Rangaraya Medical College, Kakinada over a period of 2 years from July 2013 to July 2015. The Objectives of present study is to compare the Conversion Rates of Laparoscopic Surgery to Open Surgery and the factors causing Conversion to Open Surgery in our institution. PATIENTS AND METHODS The protocol is approved by institution ethics committee and written informed consent was taken from each patient. Present clinical Study is an Analytical study conducted over period of 2 years from July 2013 to July 2015 in the Department of General Surgery, Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh. RESULTS Total number of 536 laparoscopic surgeries were attempted in elective operation theatres with 21 cases out of 536 cases were converted from laparoscopy to open surgery. Total conversion rate in present study is 4%. Most of conversions occurred in laparoscopic chelecystectomy 5.73% cases in comparison to laparoscopic appendectomy 2.26% and laparoscopic hernia repair with 0%. CONCLUSIONS Over all conversion rates of laparoscopic procedure into open surgery is low when compared to other international studies. Most common causes of conversion in present study is altered anatomy, adhesions and intra operative bleed. Conversion of laparoscopic surgery into open surgery resulted in decreased morbidity, complications and increase in duration of hospital stay

  13. Effect of intermediate care on mortality following emergency abdominal surgery. The InCare trial

    DEFF Research Database (Denmark)

    Vester-Andersen, Morten; Waldau, Tina; Wetterslev, Jørn;

    2013-01-01

    is all-cause 30-day mortality. We aim to enrol 400 patients in seven Danish hospitals. The sample size allows us to detect or refute a 34% relative risk reduction of mortality with 80% power. DISCUSSION: This trial evaluates the benefits and possible harm of intermediate care. The results may potentially....... The aim of the present trial is to evaluate the effect of postoperative intermediate care following emergency major abdominal surgery in high-risk patients.Methods and design: The InCare trial is a randomised, parallel-group, non-blinded clinical trial with 1:1 allocation. Patients undergoing emergency...... laparotomy or laparoscopic surgery with a perioperative Acute Physiology and Chronic Health Evaluation II score of 10 or above, who are ready to be transferred to the surgical ward within 24 h of surgery are allocated to either intermediate care for 48 h, or surgical ward care. The primary outcome measure...

  14. Socioeconomic position and surgery for early-stage non-small-cell lung cancer

    DEFF Research Database (Denmark)

    Kærgaard Starr, Laila; Osler, Merete; Steding-Jessen, Marianne;

    2013-01-01

    Register 2001-2008 (date of diagnosis, histology, stage, and treatment), the Central Population Register (vital status), the Integrated Database for Labour Market Research (socioeconomic position), and the Danish Hospital Discharge Register (comorbidity). Logistic regression analyses were performed overall...... and separately for stages I, II and IIIa. RESULTS: Of the 5538 eligible patients with stages I-IIIa NSCLC diagnosed 2001-2008, 53% underwent surgery. Higher stage, older age, being female and diagnosis early in the study period were associated with higher odds for not receiving surgery. Low disposable income...... the association with income or living alone for early-stage NSCLC patients. CONCLUSION: Early-stage NSCLC patients with low income or who live alone are less likely to undergo surgery than those with a high income or who live with a partner, even after control for possible explanatory factors. Thus, even...

  15. William Fulton Gillespie, 1891-1949: transitional figure in western Canadian academic surgery.

    Science.gov (United States)

    Macbeth, R A

    1998-01-01

    The professional life of William Fulton Gillespie, third professor of surgery at the University of Alberta (1939-49) and tenth president of the Royal College of Physicians and Surgeons of Canada (1947-49), exemplifies a critical transitional period in Canadian postgraduate surgical training and in western Canadian academic surgery. This article explores the background, the training, the professional career, and the personal character of a surgical scholar and student of the humanities and arts, a man who was thrust into the professorship of surgery in a maturing western Canadian medical school following the financial restraints of the Great Depression and during the challenges faced as a result of the World War II.

  16. Cobalt(II), nickel(II), copper(II), zinc(II), cadmium(II) and dioxouranium(II) complexes of thiophene-2-aldehyde-4-phenyl-thiosemicarbazone

    International Nuclear Information System (INIS)

    The present paper describes the synthesis and characterisation of thiophene-2-aldehyde-4-phenylthiosemicarbazone (TAPTSC) and its metal complexes with Co(II), Ni(II), Cu(II), Zn(II), Cd(II) and UO(II). (author). 30 refs., 1 table

  17. JEJUNOGASTRIC INTUSUSCEPTION: RARE COMPLICATION OF GASTROJEJUNOSTOMY

    Directory of Open Access Journals (Sweden)

    Bhupesh

    2014-08-01

    Full Text Available Jejunogastricintussusception through a gastrojejunostomy stoma is one of the rarest complications of the previous gastric surgery. The incidence is reported to be less than 0.1%. An elderly male presented to the hospital with h/o vomiting, pain in abdomen since 10 days. The patient was undergone upper G I Scopy and CT scan abdomen as a suspected c/o carcinoma stomach. A primarily healed midline scar from the previous surgery for large duodenal perforation. On exploration it was found that there was a mass in the stomach, which on gastrotomy revealed gangrenous jejunal loops herniated through previous stoma. Gangrenous jejunum was resected and Billroth II was done

  18. Spatial orientation in translumenal surgery.

    Science.gov (United States)

    Höller, Kurt; Schneider, Armin; Jahn, Jasper; Gutiérrez, Javier; Wittenberg, Thomas; Feussner, Hubertus; Hornegger, Joachim

    2010-10-01

    "Natural Orifice Translumenal Endoscopic Surgery" (NOTES) is assumed to offer significant benefits to patients, such as reduced trauma as well as reduced collateral damage. But the potential advantages of this new technology can only be achieved through safe and standardized operation methods. Several barriers, which have been identified during clinical practice in flexible intra-abdominal endoscopy, can only be solved with computer-assisted surgical (CAS) systems. In order to assist the surgeon during the intervention and enhance his visual possibilities, some of these CAS systems require 3-D information of the intervention site, for others 3-D information is even mandatory. Therefore it is evident that the definition and design of new technologies for CAS systems must be strongly considered. A 3-D endoscope, called "Multisensor-Time-of-Flight" (MUSTOF) endoscope, is actually being developed. Within these developments, an optical 3-D time-of-flight (TOF) sensor is attached to the proximal end of a common endoscope. The 3-D depth information obtained by this enhanced endoscope can furthermore be registered with preoperatively acquired 3-D volumetric datasets such as CT or MRI. These enhanced or augmented 3-D data volumes could then be used to find the transgastric or transcolonic entry point to the abdomen. Furthermore, such acquired endoscopic depth data can be used to provide better orientation within the abdomen. Moreover it can also prevent intra-operative collisions and provide an optimized field of view with the possibility for off-axis viewing. Furthermore, providing a stable horizon on video-endoscopic images, especially within non-rigid endoscopic surgery scenarios (particularly within NOTES), remains an open issue. Hence, our recently presented "endorientation" approach for automated image orientation rectification could turn out as an important contribution. It works with a tiny micro-electro-mechanical systems (MEMS) tri-axial inertial sensor that is

  19. Incidence and management of diaphragmatic palsy in patients after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Mehta Yatin

    2008-01-01

    Full Text Available Background: Diaphragm is the most important part of the respiratory system. Diaphragmatic palsy following cardiac surgery is not uncommon and can cause deterioration of pulmonary functions and attendant pulmonary complications. Objectives: Aim of this study was to observe the incidence of diaphragmatic palsy after off pump coronary artery bypass grafting (OPCAB as compared to conventional CABG and to assess the efficacy of chest physiotherapy on diaphragmatic palsy in post cardiac surgical patients. Design and Setting: An observational prospective interventional study done at a tertiary care cardiac centre. Patients: 2280 consecutive adult patients who underwent cardiac surgery from February 2005 to august 2005. Results: 30 patients out of 2280 (1.31% developed diaphragmatic palsy. Patients were divided based on the presence or absence of symptoms viz. breathlessness at rest or exertion or with the change of posture along with hypoxemia and / or hypercapnia. Group I included 14 patients who were symptomatic (CABG n=13, post valve surgery n=1, While Group II included 16 asymptomatic patients (CABG n=12, post valve surgery n=4, 9 patients (64% from Group I (n=14 and 4 patients (25% from group II showed complete recovery from diaphragmatic palsy as demonstrated ultrasonographically. Conclusion: The incidence of diaphragmatic palsy was remarkably less in our adult cardiac surgical patients because most of the cardiac surgeries were performed off pump and intensive chest physiotherapy beginning shortly after extubation helped in complete or near complete recovery of diaphragmatic palsy. Chest Physiotherapy led to marked improvement in functional outcome following post cardiac surgery diaphragmatic palsy. We also conclude that ultrasonography is a simple valuable bed-side tool for rapid diagnosis of diaphragmatic palsy

  20. Motion magnification for endoscopic surgery

    Science.gov (United States)

    McLeod, A. Jonathan; Baxter, John S. H.; de Ribaupierre, Sandrine; Peters, Terry M.

    2014-03-01

    Endoscopic and laparoscopic surgeries are used for many minimally invasive procedures but limit the visual and haptic feedback available to the surgeon. This can make vessel sparing procedures particularly challenging to perform. Previous approaches have focused on hardware intensive intraoperative imaging or augmented reality systems that are difficult to integrate into the operating room. This paper presents a simple approach in which motion is visually enhanced in the endoscopic video to reveal pulsating arteries. This is accomplished by amplifying subtle, periodic changes in intensity coinciding with the patient's pulse. This method is then applied to two procedures to illustrate its potential. The first, endoscopic third ventriculostomy, is a neurosurgical procedure where the floor of the third ventricle must be fenestrated without injury to the basilar artery. The second, nerve-sparing robotic prostatectomy, involves removing the prostate while limiting damage to the neurovascular bundles. In both procedures, motion magnification can enhance subtle pulsation in these structures to aid in identifying and avoiding them.

  1. Plate removal following orthognathic surgery.

    Science.gov (United States)

    Little, Mhairi; Langford, Richard Julian; Bhanji, Adam; Farr, David

    2015-11-01

    The objectives of this study are to determine the removal rates of orthognathic plates used during orthognathic surgery at James Cook University Hospital and describe the reasons for plate removal. 202 consecutive orthognathic cases were identified between July 2004 and July 2012. Demographics and procedure details were collected for these patients. Patients from this group who returned to theatre for plate removal between July 2004 and November 2012 were identified and their notes were analysed for data including reason for plate removal, age, smoking status, sex and time to plate removal. 3.2% of plates were removed with proportionally more plates removed from the mandible than the maxilla. 10.4% of patients required removal of one or more plate. Most plates were removed within the first post-operative year. The commonest reasons for plate removal were plate exposure and infection. The plate removal rates in our study are comparable to those seen in the literature.

  2. Pneumatic tourniquets in extremity surgery.

    LENUS (Irish Health Repository)

    Wakai, A

    2012-02-03

    Pneumatic tourniquets maintain a relatively bloodless field during extremity surgery, minimize blood loss, aid identification of vital structures, and expedite the procedure. However, they may induce an ischemia-reperfusion injury with potentially harmful local and systemic consequences. Modern pneumatic tourniquets are designed with mechanisms to regulate and maintain pressure. Routine maintenance helps ensure that these systems are working properly. The complications of tourniquet use include postoperative swelling, delay of recovery of muscle power, compression neurapraxia, wound hematoma with the potential for infection, vascular injury, tissue necrosis, and compartment syndrome. Systemic complications can also occur. The incidence of complications can be minimized by use of wider tourniquets, careful preoperative patient evaluation, and adherence to accepted principles of tourniquet use.

  3. Cancer surgery: risks and opportunities.

    LENUS (Irish Health Repository)

    Coffey, J C

    2012-02-03

    In the recent past, several papers have pointed to the possibility that tumour removal generates a permissive environment in which tumour growth is potentiated. This phenomenon has been coined "perioperative tumour growth" and whilst it represents a departure in terms of our attitude to the surgical process, this concept was first hinted at by Paget(1) himself. Despite this, the time interval immediately before and after cancer surgery (i.e. the perioperative period) remains an underutilised interval during which chemotherapeutic regimens are rarely implemented. Herein, we present a summarised review of the literature that supports the concept that tumour removal may potentiate the growth of residual neoplastic disease. We also outline current knowledge regarding underlying mechanisms and in this manner highlight potential therapeutic entry points. Finally, we emphasise the urgent need for trials of agents that could protect patients against the harmful host-tumour interactions that may occur during the perioperative period.

  4. Plastic surgery of radiation injuries

    International Nuclear Information System (INIS)

    The review of the book - Plastic surgery of radiation injuries, -written by the staff members of the RAMS surgical centre, the creators of a number of original methods for reconstructive and plastic microsurgery Milanov N.O. and Shilov B.L., is presented. The book consists of introduction, four chapters and conclusion. The introduction deals with the terms of operational intervention and indications for choice of the method of operation. Peculiarities of radiation injuries and basic principles for selection the method of plastic art are considered in the first and second chapters. The third and fourth chapters are related to treatment of late radiation defects. The possibilities for earlier intervention are contained in the fourth chapter

  5. Oray surgery and radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Carl, W.

    1975-07-01

    Clinical evidence seems to indicate that careful oral surgery after radiation therapy contributes little, if anything at all, to the onset of osteoradionecrosis. In many cases the process of bone dissolution has already well progressed before teeth have to be extracted. The bone changes can be demonstrated radiographically and clinically. The teeth in the immediate area become very mobile and cause severe pain during mastication. Whether this condition could have been prevented by extractions before radiation therapy is difficult to establish. Osteoradionecrosis may be encountered in edentulous jaws. It manifests itself clinically by bone segments which break loose and penetrate through the mucosa leaving a defect which does not heal over. More research and more comparative studies are needed in this area in order to make reasonably accurate predictions.

  6. Fertility-enhancing hysteroscopic surgery.

    Science.gov (United States)

    Cela, Vito; Litta, Pietro; Franchini, Mario; Sergiampietri, Claudia; Simi, Giovanna; Freschi, Letizia; Artini, Paolo G; Papini, Francesca

    2016-04-01

    Anatomical uterine element and functional components play a fundamental role in the enhancing of fertility are the major actors. Uterine pathologies, including congenital or acquired lesions, have been reported in 21 to 47% of patients undergoing in vitro fertilization cycles. Hysteroscopy is an important procedure in the study of one of the most important element of fertility: the uterus, even if its use in the world of infertility is discussed. There are many studies on safety and feasibility of the procedure and on patient compliance, but there is no consensus on its systemic use. This study, thanks to the wide literature about the use of hysteroscopic surgery to enhance fertility in most of the congenital and acquired problems affecting women in fertility age, allows defining that diagnostic and operative hysteroscopy is a rapid and safety technology to improve fertility. PMID:26928416

  7. Emergency Surgery for Spontaneous Hemopneumothorax

    International Nuclear Information System (INIS)

    Emergency management of spontaneous hemopneumothorax patients was retrospectively analysed in this study. From November 2009 to August 2012, 221 patients with spontaneous pneumothorax were treated in the thoracic surgery clinic. Among them, 9 (4.07%) were diagnosed with spontaneous hemopneumothorax. Chest X-ray and computed tomography were the diagnostic tools. Emergency thoracotomy was performed for 7 of 9 patients because of massive hemothorax and continuous bleeding from the chest tube. Massive hematoma was documented in 2 of 7 patients at tomography. Bridging veins and torn pleural adhesion between parietal and visceral pleura were the source of bleeding determined at thoracotomy. Hematoma evacuation, resection of bullae, ligation of pleural adhesions and apical pleurectomy were performed. Spontaneous hemopneumothorax is an emergency due to massive hemorrhage and hematoma formation. Early surgical treatment is recommended for patients with spontaneous hemopneumothorax. (author)

  8. Pneumatic tools for vitreoretinal surgery

    Directory of Open Access Journals (Sweden)

    Romano MR

    2012-03-01

    Full Text Available Mario R Romano, Jose Luis Vallejo-Garcia, Alessandro Randazzo, Paolo VinciguerraIstituto Clinico Humanitas, Via Manzoni 56, 20089 Rozzano, Milan, ItalyAbstract: One of the difficulties of microsurgery is learning how to control physiological tremors. The pneumatic tool eliminates the physiological tremor, but no tactile feedback is provided. The manual tremor when closing the forceps is completely eliminated and the exact target can be more easily grabbed. Forceps closure pressure can rise up to 50 psi, whereas the scissors can be used in two modes: multicut and proportional. When performing bimanual surgery the pedal range is divided into two steps: in the first step, the forceps are controlled, and in the second step, the forceps remain closed. At the same time the scissors start to work in the preselected mode. No adverse events occurred and no iatrogenic retinal breaks were produced. Precision and control sensation were a grateful surprise.Keywords: pneumatic forceps, pneumatic scissors, physiological tremor

  9. Surgery of malignant pancreatic tumors

    International Nuclear Information System (INIS)

    Ductal adenocarcinoma is the most common malignant tumor of the pancreas. Despite great efforts in basic and clinical pancreatic cancer research, the prognosis remains poor with an overall 5-year survival rate of less than 5%. Complete surgical resection represents the only curative treatment option and 5-year survival rates of 20-25% can be achieved following curative resection and adjuvant chemotherapy. Although pancreatic surgery is considered one of the most technically demanding and challenging procedures, there has been constant progress in surgical techniques and advances in perioperative care with a modern interdisciplinary approach including anesthesiology, oncology, radiology and nursing. This has reduced morbidity and especially mortality rates in high-volume centers. Among extended resection procedures multivisceral and venous resections are technically feasible and should be considered if a complete tumor resection can be achieved. Multimodal regimens have shown promising results, however, only adjuvant chemotherapy is supported by solid evidence from randomized controlled trials. (orig.)

  10. Esophageal reconstruction surgery in oncologic patients. Determination of gastric emptying time

    Energy Technology Data Exchange (ETDEWEB)

    Fonseca, L.; Maliska, C.M [Instituto Nacional de Cancer, Rio de Janeiro (Brazil); Rio de Janeiro, Univ. Federal, Hospital Universitario Clementino Fraga Filho, Sector de Medicina Nuclear, Dept. de Radiologia, Rio de Janeiro (Brazil); Cruz, M.G.A. [Rio de Janeiro, Univ. Federal, Hospital Universitario Clementino Fraga Filho, Sector de Medicina Nuclear, Dept. de Radiologia, Rio de Janeiro (Brazil); Castro, L. [Instituto Nacional de Cancer, Rio de Janeiro (Brazil); Gutfilen, B. [Rio de Janeiro, Univ. do Estado, Hospital Universitario Pedro Ernesto, Rio de Janeiro (Brazil)

    2000-06-01

    All parts of the gastrointestinal tract are accessible for study using nuclear medicine techniques. It has been studied the effect of esophageal reconstruction surgery, in different periods of time, after surgical procedure. Oncologic patients (19) were evaluated after esophageal reconstruction surgery with gastric (group II-14 patients) or colonic tube (group III - 5 patients) and they were compared with 15 healthy volunteers (group I). Gastric emptying was performed in the same subjects using solid food (egg sandwich) labeled with 99mTc-phytate. In emptying gastric studies, the mean (T1/2) of the patients was much faster than those of the control (p<0.05) when 1/3 distal tube was considered as stomach. However, there was no difference between the T1/2 of group II and group III. It could be concluded that this nuclear medicine method could be useful in the monitoring the surgical reconstruction of the esophagus.

  11. Analgesic Treatment in Laparoscopic Gastric Bypass Surgery

    DEFF Research Database (Denmark)

    Andersen, Lars P H; Werner, Mads U; Rosenberg, Jacob;

    2014-01-01

    This review aimed to present an overview of the randomized controlled trials investigating analgesic regimens used in laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. Literature search was performed in PubMed and EMBASE databases in August 2013 in accordance to PRISMA guidelines. The litera...... analgesic treatment in LRYGB surgery....

  12. Surgery for Breast Cancer in Men

    Science.gov (United States)

    ... to help prevent or reduce the effects of lymphedema are discussed in the section " What happens after treatment for breast cancer in men? " If your arm is swollen, tight, or painful after lymph node surgery, be sure to tell someone ... lymphedema after breast surgery, see our document Lymphedema: What ...

  13. Noncardiac Surgery in Patients With Aortic Stenosis

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Jørgensen, Mads Emil; Martinsson, Andreas;

    2014-01-01

    nationwide administrative registers. AS patients (n = 2823; mean age, 75.5 years, 53% female) were matched with patients without AS (n = 2823) on propensity score for AS and surgery type. RESULTS: In elective surgery, MACE (ie, nonfatal myocardial infarction, ischemic stroke, or cardiovascular death...

  14. Trends in day surgery in the Netherlands

    NARCIS (Netherlands)

    Wasowicz-Kemps, D.K.

    2008-01-01

    Hospital care has been subject to important changes during the last century. In stead of treating patients with various diseases with bed rest, medical care has shifted from in hospital to an ambulatory or outpatient setting as much as possible. Admission time after surgery shortened and day surgery

  15. Siegel-Surgery according to Gaofei Zhang

    DEFF Research Database (Denmark)

    Petersen, Carsten Lunde

    In a recent manuscript Gaofei Zhang has shown using quasi-conformal surgery, that the Siegel disk for the rotated sine function EXP(i2πθ)sin(z) is a quasi-disk passing whose boundary passes through the two neighbouring critical points ±π/2. His construction is similar in spirit to surgery...

  16. Computer assisted radiology and surgery. CARS 2010

    International Nuclear Information System (INIS)

    The conference proceedings include contributions to the following topics: (1) CARS Clinical Day: minimally invasive spiral surgery, interventional radiology; (2) CARS - computer assisted radiology and surgery: ophthalmology, stimulation methods, new approaches to diagnosis and therapy; (3) Computer assisted radiology 24th International congress and exhibition: computer tomography and magnetic resonance, digital angiographic imaging, digital radiography, ultrasound, computer assisted radiation therapy, medical workstations, image processing and display; (4) 14th Annual conference of the International Society for computer aided surgery; ENT-CMF head and neck surgery computer-assisted neurosurgery, cardiovascular surgery, image guided liver surgery, abdominal and laparoscopic surgery, computer-assisted orthopedic surgery, image processing and visualization, surgical robotics and instrumentation, surgical modeling, simulation and education; (5) 28th International EuroPACS meeting: image distribution and integration strategies, planning and evaluation, telemedicine and standards, workflow and data flow in radiology; (6) 11th CARS/SPIE/EuroPACS joint workshop on surgical PACS and the digital operating, management and assessment of OR systems and integration; (7) 12th International workshop on computer-aided diagnosis: special session on breast CAD, special session on thoracic CAD, special session on abdominal brain, lumbar spine CAD; (8) 16th computed Maxillofacial imaging congress: computed maxillofacial imaging in dental implantology, orthodontics and dentofacial orthopedics; approaches to 3D maxillofacial imaging; surgical navigation; (9) 2nd EuroNOTES/CARS workshop on NOTES: an interdisciplinary challenge; (10) 2nd EPMA/CARS workshop on personalized medicine and ICT.; (11)poster sessions.

  17. Application of Laser in Oral Surgery

    OpenAIRE

    Asnaashari, Mohammad; Zadsirjan, Saeede

    2014-01-01

    In this review collected from the literature on usage of laser in oral minor surgery based on a Medline search in the time period between the years: 2008 and 2013, the most current evidence on laser-assisted oral minor surgery is going to be surveyed.

  18. Role of Fibrin Sealants in Liver Surgery

    NARCIS (Netherlands)

    de Boer, Marieke T.; Boonstra, Elizabeth A.; Lisman, Ton; Porte, Robert J.

    2012-01-01

    Background: Fibrin sealants are widely used in liver surgery. The aim of this article is to review the literature on evidence of hemostatic and biliostatic capacities of different fibrin sealants in liver surgery. Methods: In PubMed, a literature search was done with the search terms 'fibrin sealant

  19. Preoperative respiratory physical therapy in cardiac surgery

    NARCIS (Netherlands)

    Hulzebos, H.J.

    2006-01-01

    Cardiac surgery is one of the most common surgical procedures and accounts for more resources expended in cardiovascular medicine than any other single procedure. Because cardiac surgery involves sternal incision and cardiopulmonary bypass, patients usually have a restricted respiratory function in

  20. Management of Cosmetic Eyelid Surgery Complications

    OpenAIRE

    Klapper, Stephen R.; Patrinely, James R.

    2007-01-01

    There is a broad spectrum of complications that can occur following cosmetic eyelid surgery. The experienced eyelid surgeon should be able to avoid most serious complications through proper patient selection, a comprehensive preoperative assessment and surgical plan, meticulous surgical technique, and appropriate postoperative care. The aesthetic eyelid surgeon must counsel a patient contemplating blepharoplasty surgery regarding typical expectations including edema, eyelid numbness, dry eyes...