Sample records for kareem surgery university

  1. Universal definition of perioperative bleeding in adult cardiac surgery. (United States)

    Dyke, Cornelius; Aronson, Solomon; Dietrich, Wulf; Hofmann, Axel; Karkouti, Keyvan; Levi, Marcel; Murphy, Gavin J; Sellke, Frank W; Shore-Lesserson, Linda; von Heymann, Christian; Ranucci, Marco


    Perioperative bleeding is common among patients undergoing cardiac surgery; however, the definition of perioperative bleeding is variable and lacks standardization. We propose a universal definition for perioperative bleeding (UDPB) in adult cardiac surgery in an attempt to precisely describe and quantify bleeding and to facilitate future investigation into this difficult clinical problem. The multidisciplinary International Initiative on Haemostasis Management in Cardiac Surgery identified a common definition of perioperative bleeding as an unmet need. The functionality and usefulness of the UDPB for clinical research was then tested using a large single-center, nonselected, cardiac surgical database. A multistaged definition for perioperative bleeding was created based on easily measured clinical end points, including total blood loss from chest tubes within 12 hours, allogeneic blood products transfused, surgical reexploration including cardiac tamponade, delayed sternal closure, and the need for salvage treatment. Depending on these components, bleeding is graded as insignificant, mild, moderate, severe, or massive. When applied to an established cardiac surgery dataset, the UDPB provided insight into the incidence and outcome of bleeding after cardiac surgery. The proposed UDPB in adult cardiac surgery provides a precise classification of bleeding that is useful in everyday practice as well as in clinical research. Once fully validated, the UDPB may be useful as an institutional quality measure and serve as an important end point in future cardiac surgical research. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  2. Air quality in Ain Shams University Surgery Hospital. (United States)

    El Awady, M Y; El Rahman, A T Abd; Al Bagoury, L S; Mossad, I M


    Through air sampling, it was possible to evaluate microbial contamination in environments at high risk of infection, and to check the efficiency of ventilation system and the medical team's hygiene procedures. This study measured the concentration of particulate matter (PM) 2.5 or less microns and microbiological organisms in operating rooms (OR), intensive care units (ICU) and emergency rooms (ER) in Ain Shams University Surgery Hospital, and to assess ventilation characteristics in operating rooms in the hospital. The passive air sampling was done from ICUs, ORs, and ERs in Ain Shams University Surgery Hospital. Also for each operating room, an observational checklist was done to record other factors that may affect air quality in the room. The evaluated air quality indices were: suspended (PM) 2.5 micrometer or less, culture media and microbial identification of bacteria and fungi, and temperature and relative humidity. The results showed that the highest mean found for bacterial (105.70±30.49) and fungi concentration (7.50±5.30) was in ER. The three settings did not differ statistically as regard levels of PM 2.5, temperature, and relative humidity. A positive correlation exits between bacteria and fungi concentration on one hand and relative humidity on the other. Diphteroid, CONS, MRSA, S. aureus, and Anthracoid were the most frequent isolated bacterial types, while Penicillium and Asperigillus fumigatus were the most frequent isolated fungi. In operating rooms, the percent of unmasked persons present and the temperature positively influence the bacterial count, while ventilation condition is negatively influencing fungi count, and the number of persons present in the operating room positively affects the PM level.

  3. Pattern of Nerve Blocks for Upper Limb Surgery at the University of ...

    African Journals Online (AJOL)

    Pattern of Nerve Blocks for Upper Limb Surgery at the University of Benin Teaching Hospital - A Ten Year Survey. ... Log in or Register to get access to full text downloads. ... Lower limb surgery is amenable to central neural blockade techniques, ... Information about patient demographic characteristics, surgical indication, ...

  4. BKR.2014.003 (Kareem)

    African Journals Online (AJOL)

    Femi Olorunniji

    optimally active at pH 5.0 and temperature of 80 °C. It exhibited a half-life of 60 minutes ... KEYWORDS: Enzyme purification, thermostability, Rhizopus oligosporus, glucoamylase, ... origin especially Rhizopus spp are usually employed in the.

  5. The University Münster model surgery system for Orthognathic surgery. Part I – The idea behind

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike


    Full Text Available Abstract Background We describe a procedure for diagnosis and planning for orthognatic surgery based on international standards. A special 2D planning based on lateral cephalograms (Axis Orbital Marker Lines System realize a transmission to the SAM 2P articulator (3D by means of the Axis Orbital Plane. Methods Former intraoperative measurement of the average height of the LeFort I osteotomy plane relative to the molar occlusal plane allow to construct a virtual osteotomy plane in the lateral cephalogram. This is the basis for the development of the Axis Orbital Marker Lines System (AO-MLS. Results The AO-MLS is presented graphically, and in detail, with construction guidelines. The system could be integrated into various lateral cephalometric analysis- and surgical prediction schemes. It forms the basis for a standardized transfer of the 2D planning to the 3D planning in the articulator, and vice versa. This procedure makes it possible to generate surgical planning protocols based on the model surgery, which represent the dislocations in the proximity of the real osteotomy planes. Conclusions The Axis Orbital Marker Lines System (software component in conjunction with the University Münster Model Surgery System (hardware system increases the predictability of model operations in orthognathic surgery.

  6. [The experimental surgery and your relation with the university: an experience report]. (United States)

    Yamaki, Vitor Nagai; Teixeira, Renan Kleber Costa; Feijo, Daniel Haber; Silva, José Antonio Cordero da; Botelho, Nara Macedo; Henriques, Marcus Vinicius


    The laboratory of experimental surgery represents one of the key points for the university, especially in the biomedical area. This focuses on the university's tripod of primary structure that are teaching, research and extension, which are essential for formation of humanistic and practice of a good doctor that is based, first of all, on scientific evidence and critical knowledge. The importance of a laboratory of experimental surgery centers for medical education was regulated from the new curriculum guidelines of the Ministério da Educação e Cultura, establishing a mandatory laboratory within college centers. Therefore, it is of great importance to the contribution of the laboratories of experimental surgery in the curriculum, both in the discipline of surgical technics and experimental surgery, and an incentive for basic research. Thus, the study presents the experience of 15 years of the Laboratory of Experimental Surgery from Universidade do Estado do Pará, with the goal show the importance of this to medical graduation and the university.

  7. Surgical Education: Attitudes toward Animal Use in Teaching Surgery at Louisiana State University. (United States)

    Hedlund, Cheryl S.; Hosgood, Giselle; Naugler, Sasha


    Surveyed students and faculty at Louisiana State University about the use of animals for teaching surgery. Found that they favored the practice, finding it helpful for learning aseptic technique and suturing skills but less so for learning tissue handling, dissection, hemostasis, or anesthesia. (EV)

  8. Virginia Commonwealth University: committed to the professional growth of women in surgery. (United States)

    Ferrada, Paula A; Anand, Rahul J; Grover, Amelia


    Academic surgery programs need to offer avenues not only to increase recruitment of women, but also to provide support so women can stay in the surgical field successfully. Virginia Commonwealth University has served to enable the growth of women surgeons in their careers. This article reviews the aspects in which this institution has provided with the necessary support for career and personal growth.

  9. [Abdominal unplanned reoperations in the Service of General Surgery, University Hospital of Puebla]. (United States)

    León-Asdrúbal, Samuel Báez; Juárez-de la Torre, Juan Carlos; Navarro-Tovar, Fernando; Heredia-Montaño, Mónica; Quintero-Cabrera, José Eduardo


    The reoperation is considered as the access to the abdominal cavity before complete healing of the surgical wound from a previous operation within the first 60 days after the first procedure. It occurs in 0.5 to 15% of patients undergoing abdominal surgery and generates significant increase in morbidity and mortality in patients undergoing abdominal surgery. Identify the number of unplanned abdominal surgical reoperations and identify the causes of these unplanned reoperations were performed in our department. This is a retrospective study conducted at the University Hospital of Puebla in the period between April 2009 to February 2012, a total of 1,709 abdominal surgeries performed by the Service of General Surgery were included. Ninety-seven cases of reoperation of which 50 cases were not planned surgery cases were identified; 72% (36 cases) from emergency operations, and 28% of elective surgery. The incidence found in our study is low compared to similar studies. Prospective studies and focus on risk factors and causes of unplanned reoperations are required, in order to know them in detail and, consequently, reduce its incidence and morbidity and mortality they add.

  10. Medical student mentorship in a university setting as a strategy for a career in surgery. (United States)

    Barry, Parul N; Fallat, Mary E


    Gender balance in surgery is a respectable and necessary goal. At the University of Louisville (UL) School of Medicine, we have compared percentages of UL medical student applicants to general surgery or surgical subspecialty residency programs, surgical residents, and surgical faculty with the rest of the nation. Although UL has at times paralleled or exceeded the nation in many of these categories, there is room for improvement and the comparison data allow for strategic planning initiatives. To promote gender balance among future generations of surgeons at UL, we recently implemented a mentoring program that pairs medical students with residents and faculty in surgery. We plan to track the success over time and correct any shortcomings of this program. Virginia Commonwealth University's commitment to gender balance in surgery is exemplary. As part of a more comprehensive vision to create a mentorship program for female medical students at the UL School of Medicine, we have recently recruited female surgical residents and faculty, whom we hope will provide the type of inspiration and guidance that will increase the number of women from UL who decide to train in general surgery and the surgical specialties. To understand why women across the nation are not generally at numerical parity in these fields, it is important to consider the length and intensity of the surgical residency programs in the context of the other goals and objectives that a woman might have for her future. This article does not address this broad topic but provides a perspective of how a medical school can evaluate and perhaps intervene to mentor medical students more effectively about the satisfaction derived from a career in surgery. As part of this project, we have evaluated each step of the path through medical school and a surgical residency by comparing data for our students, residency programs, and faculty with national data.

  11. [Consequences of the Foundation of a University Centre for Orthopaedics and Accident Surgery]. (United States)

    Schneiders, W; Dittmann, U; Hannemann, F; Jäger, M; Eberlein-Gonska, M; Schaser, K D; Zwipp, H; Günther, K-P


    Background: Since the combination of orthopaedic and traumatology surgery as a single speciality, an extremely wide variety of orthopaedic and trauma surgery centres have been founded in Germany. The present investigation analysed the degree to which additional value has been generated by merging two previously independent university departments - one for orthopaedics, the other for trauma surgery - into a single orthopaedics and trauma surgery centre. Material and Methods: The centre, merged in 1 June 2013, is led by two equal co-chairs (a full professor for orthopaedics and a full professor for trauma surgery). It consists of an acute division and five other divisions for specific parts of the body. The pre-existing certifications (level 1 trauma- and joint arthroplasty centre) were maintained in the new merged entity. Data from patient and employee questionnaires, as well as key economic indicators, were compared before and after the merger. Results: 11 % of the patients rated the medical treatment as mediocre or bad before the merger. After the merger, 5.7 % of the patients were moderately satisfied or unsatisfied; 92 % would recommend the merged centre to others and would return for further treatment. The evaluation of patient complaints before and after the merger showed no change. The evaluation of the employee questionnaires showed heterogeneous results. Overall, positive evaluations predominated, but in areas where there had been major changes, negative aspects were occasionally reported. The merger did not bring about any essential change in the number of in-patients (2012: 6693; 2014: 6649) or in the severity of the medical cases (CMI in 2012: 1.41; in 2014: 1.45). But in 2015, there was an increase in the number of in-patients (6837) and in the CMI (1.54). In the out-patient clinic, the merger led to a reduction in the material costs per patient (2012: 3.53 €/patient; 2014: 3.07 €/patient) and in the staff costs. The material costs for the

  12. The University of Florida Department of Surgery: building a stronger tomorrow on yesterday's foundation. (United States)

    Behrns, Kevin E; Copeland, Edward M; Howard, Richard J


    Established in 1957, the University of Florida Department of Surgery has a solid foundation on which current faculty are driven to build a stronger tomorrow. The department is focused on promoting patient-centered care, expanding its research portfolio to improve techniques and outcomes, and training the surgical leaders of tomorrow. It fosters an environment where faculty, residents, students, and staff challenge long-held traditions with the goal of improving the health of our patients, the quality of our care, and the vitality of our work environment.

  13. Direct hip joint distraction during acetabular fracture surgery using the AO universal manipulator. (United States)

    Calafi, L Afshin; Routt, M L Chip


    Certain acetabular fractures may necessitate distraction of the hip joint for removal of intra-articular debris and assessment of reduction. Distraction can be accomplished by manual traction, using a traction table or an AO universal manipulator (UM). The UM is a relatively simple and an inexpensive device that can provide focal distraction in a controlled manner without the risks associated with the use of a traction table. We describe a technique using the UM for hip joint distraction during acetabular fracture surgery through a Kocher-Langenbeck surgical exposure.

  14. Epidemiology of nosocomial infections and mortality following congenital cardiac surgery in Cairo University, Egypt. (United States)

    El Tantawy, Amira Esmat; Seliem, Zeinab Salah; Agha, Hala Monir; El-Kholy, Amany Ali; Abdelaziz, Doaa Mohamed


    Nosocomial infections (NI) have been associated with significant morbidity and attributed mortality, as well as increased healthcare costs. Relatively few data on congenital cardiac surgical ICU NI have been reported from developing countries. Little is known about the epidemiology of NI following congenital cardiac surgery in Egypt. The aims of the present study were: (a) to estimate the incidence rate and types of NI among children admitted to Pediatric Surgical Cardiac ICU in Cairo University Children's Hospital (Egypt) and (b) to estimate the mortality rate related to congenital cardiac surgery and identify its contributing risk factors. A follow-up study in the period between 1 January 2009 and 1 January 2010 included all patients admitted to the Pediatric Surgical Cardiac ICU in Cairo University, Abo El Reesh Children's Specialized Hospital (Egypt). Data were collected for each patient during the preoperative, intraoperative, and postoperative periods. Certain infection control procedures were carried out in certain months. Of 175 patients, NI were identified in 119 (68%). Poor hand hygiene was associated with increased NI in certain months of the study duration. NI were significantly higher at a younger age [median 9 (5-30) months, Plesions, prolonged cardiopulmonary bypass and ischemic times, NI, prolonged mechanical ventilation, prolonged central line insertion, and the use of total parenteral nutrition. Mortality among the NI patients was found in 44 of 119 (37%). On carrying out a multivariate analysis, Acute Physiology and Chronic Health Evaluation II score [PUniversity Children's Hospital (Cairo, Egypt). Early surgical interference, enforcement of proper infection control practices, especially hand hygiene, can reduce NI and trials for early extubation from mechanical ventilation might improve outcome following congenital cardiac surgery in pediatrics.

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

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike


    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.

  16. [What were the obstacles to the development of outpatient cataract surgery in Toulouse University Hospital in 2013?]. (United States)

    Suarez, C; Tolou, C; Cassagne, M; Lajoie, J; Mahieu, L; Hamid, S; Malecaze, F; Soler, V


    Cataract surgery is an ideal candidate for outpatient care. In 2013, in the Toulouse University Hospital, outpatient care rate for phacoemulsification was 75.8%. We conducted this study to identify the barriers that limit the development of outpatient cataract surgery in our establishment. A retrospective observational study was conducted. We included all patients who underwent phacoemulsification (Medical Act Code BFGA004) as a traditional inpatient in 2013. We excluded admissions for which the medical, anesthesia or nursing records, as well as scheduling sheets, were incomplete. Patients were classified according to the reason for inpatient hospitalization and the type of surgery: cataract as primary surgery or cataract as combined procedure. Two hundred and ninety-eight stays were included with a mean age of 66.8 ± 16.8 years, and a male/female ratio of 0.76. The indication for inpatient hospitalization was a social, surgical or anesthetic reason in the following respective proportions: 41, 34 and 8% of cases. Failure of ambulatory care represented 7% of cases. Social isolation represented 89% of social reasons. In a combined gesture, the reason was surgical in 89% of cases. Development of outpatient surgery requires the participation of all involved. Taking into account the social factors is an essential element for developing ambulatory surgery. Social isolation is a frequent situation requiring a societal response. With regard to surgical considerations, practice patterns must target outpatient combined procedures in particular. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  17. Incidence of deep venous thrombosis and stratification of risk groups in a university hospital vascular surgery unit

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    Alberto Okuhara


    Full Text Available BACKGROUND: There is a knowledge gap with relation to the true incidence of deep vein thrombosis among patients undergoing vascular surgery procedures in Brazil. This study is designed to support the implementation of a surveillance system to control the quality of venous thromboembolism prophylaxis in our country. Investigations in specific institutions have determined the true incidence of deep vein thrombosis and identified risk groups, to enable measures to be taken to ensure adequate prophylaxis and treatment to prevent the condition.OBJECTIVE: To study the incidence of deep venous thrombosis in patients admitted to hospital for non-venous vascular surgery procedures and stratify them into risk groups.METHOD: This was a cross-sectional observational study that evaluated 202 patients from a university hospital vascular surgery clinic between March 2011 and July 2012. The incidence of deep venous thrombosis was determined using vascular ultrasound examinations and the Caprini scale.RESULTS: The mean incidence of deep venous thrombosis in vascular surgery patients was 8.5%. The frequency distribution of patients by venous thromboembolism risk groups was as follows: 8.4% were considered low risk, 17.3% moderate risk, 29.7% high risk and 44.6% were classified as very high risk.CONCLUSION: The incidence of deep venous thrombosis in vascular surgery patients was 8.5%, which is similar to figures reported in the international literature. Most vascular surgery patients were stratified into the high and very high risk for deep venous thrombosis groups.

  18. Surgery Videos: MedlinePlus (United States)

    ... Winston-Salem, NC, 1/15/2009) Weight Loss Surgery Laparoscopic Gastric Bypass Surgery (University of Miami Hospital ... Boston, Boston, MA, 6/08/2010) Weight Loss Surgery Laparoscopic Gastric Bypass Surgery (University of Miami Hospital ...

  19. Heart Surgery Experience in Hitit University Faculty of Medicine Corum Research and Training Hospital: First Year Results

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    Adem Diken


    Full Text Available Aim: We aimed to assess the clinical outcomes of our department of cardiac surgery which was newly introduced in Hitit University Corum Education and Research Hospital. Material and Method: Between November 2012 and November 2013, a total of 110 open-heart surgeries were performed. Ten out of these (9.1% were emergency operations for acute ST elevation myocardial infarction Off-pump technique was used in 31 (29.2% patients and cardiopulmonary bypass was used in 75 (70.8%. A total of 106 patients received coronary artery bypass grafting, 1 received mitral reconstruction, 1 received Bentall procedure, 1 received tricuspid valve repair, 1 received mitral valve replacement, 1 received aortic valve replacement with aortic root enlargement and 1 received aortic supracoronary graft replacement. Results: Hospital mortality occurred in 1 (0.9% patient. Four patients (3.6% who were on dual antiaggregants underwent a revision for bleeding on the day of the operation. Morbidities occurred in 3 (2.7% patients. Atrial fibrillation occurred in 11 (10% patients and the normal sinus rhythm was achieved by amiodarone. Intraaortic balloon counterpulsation was used in 5 (4.5% patients. Discussion: The newly introduced cardiac surgery department of the Hitit University Corum Education and Research Hospital, which provides tertiary care to a wide rural community, serves with low morbidity and mortality.


    Directory of Open Access Journals (Sweden)

    Izilda Esmenia Muglia Araújo


    Full Text Available This study to do an analysis of the PONV`s importance, by nurses from the Daily’s SurgeryRoom of an University Hospital, through forms distributed to them and to apply the written communicationinstrument on the PONV,proposed by NORONHA & ARAÚJO (1995. The results this research were: 92,9% ofthe nurses from the Daily’s Surgery Room think that it is important the performance of the PONV to the patientand Nursing aid, and 85,7% think the PONV is important for the nurse who works in a Surgery Room. Thewritten communication instrument on the PONV was applied with success, being really easy to fill it in with clearquestions , showing so to be a lot of viable but some items of the instrument like blood group and FATOR RHcouldn’t be filled even after the records check. In this way, I think it is worth the suggestion o9f sitting the writtencommunication instrument proposed by ARAÚJO AND NORONHA (1995 at this State University, proposinghowever, inclusion on the patients’ records data about blood group and FATOR RH.

  1. Surveillance of antibiotic and analgesic use in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo

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    Haliti NR


    Full Text Available Naim R Haliti,1 Fehim R Haliti,2 Ferit K Koçani,3 Ali A Gashi,4 Shefqet I Mrasori,3 Valon I Hyseni,5 Samir I Bytyqi,5 Lumnije L Krasniqi,2 Ardiana F Murtezani,5 Shaip L Krasniqi5 1Department of Forensic Medicine, Faculty of Medicine, University of Prishtina “Hasan Prishtina”, 2Department of Children Dentistry, University Dentistry Clinical Center of Kosovo, 3Department of Oral Disease, University Dentistry Clinical Center of Kosovo, 4Department of Oral Surgery, University Dentistry Clinical Center of Kosovo, 5Institute of Pharmacology and Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Prishtina “Hasan Prishtina”, Prishtina, Kosovo Background: Because Kosovo has no reliable information on antimicrobial and analgesic use in dental practice, the survey reported here evaluated the antibiotic and analgesic prescriptions in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo (UDCCK.Methods: The data of 2,442 registered patients for a 1-year period were screened and analyzed concerning antibiotic and analgesic use as per standards of rational prescription.Results: Dentistry doctors prescribed antibiotics significantly more often than analgesics. Antibiotics were prescribed in 8.11% of all cases, while only 1.35% of total prescriptions were for analgesics. The total consumption of antibiotic drugs in the UDCCK was 4.53 Defined Daily Doses [DDD]/1,000 inhabitants/day, compared with only 0.216 DDD/1,000 inhabitants/day for analgesics. From a total number of 117 patients, 32 patients received combinations of two antibiotics.Conclusion: Pharmacotherapy analysis showed that the prescription rates of antibiotics and analgesics in the UDCCK are not rational in terms of the qualitative aspects of treatment. For the qualitative improvement of prescription of these drug groups, we recommend the implementation of treatment guidelines following rational standards. Keywords: antibiotic, analgesics

  2. Preliminary results of robotic colorectal surgery at the National Cancer Institute, Cairo University

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    Ashraf Saad Zaghloul


    Conclusion: To the best of our knowledge, this is the first study reporting the outcomes of robotic colorectal cancer intervention in Egyptian patients. Our preliminary results suggest that robotic-assisted surgery for colorectal cancer can be carried out safely and according to oncological principles.

  3. A Systematic Review to Uncover a Universal Protocol for Accuracy Assessment of 3-Dimensional Virtually Planned Orthognathic Surgery. (United States)

    Gaber, Ramy M; Shaheen, Eman; Falter, Bart; Araya, Sebastian; Politis, Constantinus; Swennen, Gwen R J; Jacobs, Reinhilde


    The aim of this study was to systematically review methods used for assessing the accuracy of 3-dimensional virtually planned orthognathic surgery in an attempt to reach an objective assessment protocol that could be universally used. A systematic review of the currently available literature, published until September 12, 2016, was conducted using PubMed as the primary search engine. We performed secondary searches using the Cochrane Database, clinical trial registries, Google Scholar, and Embase, as well as a bibliography search. Included articles were required to have stated clearly that 3-dimensional virtual planning was used and accuracy assessment performed, along with validation of the planning and/or assessment method. Descriptive statistics and quality assessment of included articles were performed. The initial search yielded 1,461 studies. Only 7 studies were included in our review. An important variability was found regarding methods used for 1) accuracy assessment of virtually planned orthognathic surgery or 2) validation of the tools used. Included studies were of moderate quality; reviewers' agreement regarding quality was calculated to be 0.5 using the Cohen κ test. On the basis of the findings of this review, it is evident that the literature lacks consensus regarding accuracy assessment. Hence, a protocol is suggested for accuracy assessment of virtually planned orthognathic surgery with the lowest margin of error. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Early experience with the da Vinci® surgical system robot in gynecological surgery at King Abdulaziz University Hospital

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    Sait KH


    Full Text Available Khalid H SaitObstetrics and Gynecology Department, Faculty of Medicine, Gynecology Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi ArabiaBackground: The purpose of this study was to review our experience and the challenges of using the da Vinci® surgical system robot during gynecological surgery at King Abdulaziz University Hospital.Methods: A retrospective study was conducted to review all cases of robot-assisted gynecologic surgery performed at our institution between January 2008 and December 2010. The patients were reviewed for indications, complications, length of hospital stay, and conversion rate, as well as console and docking times.Results: Over the three-year period, we operated on 35 patients with benign or malignant conditions using the robot for a total of 62 surgical procedures. The docking times averaged seven minutes. The mean console times for simple hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic lymphadenectomy were 125, 47, and 62 minutes, respectively. In four patients, laparoscopic procedures were converted to open procedures, giving a conversion rate of 6.5%. All of the conversions were among the first 15 procedures performed. The average hospital stay was 3 days. Complications occurred in five patients (14%, and none were directly related to the robotic system.Conclusion: Our early experience with the robot show that with proper training of the robotic team, technical difficulty with the robotic system is limited. There is definitely a learning curve that requires performance of gynecological surgical procedures using the robot.Keywords: da Vinci robot, gynecological surgery, laparoscopy

  5. Classical and Quantum Surgery of Geometries in an Open Inflationary Universe

    CERN Document Server

    Kim, S P


    We study classically and quantum mechanically the Euclidean geometries compatible with an open inflationary universe of a Lorentzian geometry. The Lorentzian geometry of the open universe with an ordinary matter state matches either an open or a closed Euclidean geometry at the cosmological singularity. With an exotic matter state it matches only the open Euclidean geometry and describes a genuine instanton regular at the boundary of a finite radius. The wave functions are found that describe the quantum creation of the open inflationary universe.

  6. Dietary intake in the postoperative bariatric surgery at a university hospital in Rio de Janeiro

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    Louise Crovesy-de-Oliveira


    Full Text Available Introduction: bariatric surgery is a treatment for morbid obesity that besides result in high weight loss promotes improvements in laboratory tests and in the pressure reduction. However the surgery can cause bad effects as deficiency some nutrients. This fact become more important evaluates the adequacy of dietary intake of these patients. The objective this study was evaluates the adequacy dietetic of patients after bariatric surgery.Material and methods: we select forty women who underwent Roux-en-Y gastric and carried evaluation anthropometric and dietetic. The dietary evaluate was compared with the daily consumption requirement and food pyramid for these patients.Results: forty women with 43.1 ± 9.96 years, obesity and very high risk for metabolic complications associate with obesity, and with acceptation of supplementation (95% participated this study. The majority of women consumed group’s foods “high-calorie foods, fats and sweets are energy-dense foods” and showed high intake of foods groups “grains and cereals” and “high-fiber, low-calorie foods”. Dietary intake was low-calorie (1342.50 ± 474.06 Kcal, adequate in protein (22.10 ± 6.94%, carbohydrate (50.74 ± 10.96%, lipid (26.14 ± 7.17%, saturated fatty acids (8.69 ± 2.74% and polyunsaturated fatty acids (8.93 ± 3.51% and low-monounsaturated fatty acids (4.13 ± 1.78% and fibers (17.02 ± 10.64 g.Conclusions: nutritional habits of women showed inadequacy, these results reinforce the importance of nutritional accompanying in the late postoperative bariatric surgery.

  7. Department of Surgery, University of the Witwatersrand – a brief history

    African Journals Online (AJOL)

    described (as recorded in the British Medical Journal) as 'cal- culated to be detrimental .... Non-European Hospital (NEH) which was built in 1923. The University of the .... Ophthalmology followed suit under Maurice Luntz. The clinical facilities ...

  8. Sex reassignment surgery for male to female transsexuals: initial experience in Okayama university hospital.

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    Full Text Available

    The first case of sex reassignment surgery (SRS in our hospital was performed in January 2001; as of February, 2005, 4 cases of MTF-SRS had been performed. In the 2 most recent cases, we used penile and scrotal skin flaps to avoid complications. The depth and width of the new vagina was made to be adequate for sexual intercourse. Future attention should be focused on devising a surgical technique that will help prevent the complications of partial necrosis of the epidermal skin and wound dehiscence. Although ours is only an initial experience, we describe our surgical technique herein.

  9. History of Cardiothoracic Surgery at Columbia University: A Century at the Vanguard of Clinical Care, Education, and Innovation. (United States)

    Argenziano, Michael; Smith, Craig R; Spotnitz, Henry M; Steinglass, Kenneth M; Bacha, Emile


    The Columbia University Cardiothoracic Surgery Program dates back to the earliest days of the specialty itself, when the first pioneers ventured into the chest, and eventually the heart, to treat diseases previously believed to be beyond the reach of medicine. This spirit of innovation, creativity, and vision has grown over the ensuing century and has driven the development of advances that have defined the specialty and saved countless lives. From novel techniques for the repair of complex congenital cardiac defects and acquired cardiovascular diseases, to comprehensive management of lung and esophageal maladies, and to the marvel of minimally invasive and percutaneous interventions, the march of progress has never been stronger, more dramatic, or more consequential that it is at Columbia today. Fueled by people who -- as descendants of those early pioneers -- have been raised in the "Columbia culture," the commitment to innovation and education has never been greater. Copyright © 2016. Published by Elsevier Inc.

  10. Urological laparoscopic surgery: Our experience of first 100 cases in Dicle University

    Directory of Open Access Journals (Sweden)

    Ahmet Ali Sancaktutar


    Full Text Available Objectives: In this study the experience and results of first100 laparoscopic surgery is presented.Materials and methods: The laparoscopic surgical operationswere reviewed between July 2010 and October 2011,retrospectively.Results: During a year period we performed of 100 laparoscopicinterventions. The ratio of male to female and themean age was 57/43 and 48,65±8,94 years respectively.The kind of operation and total numbers were like this: simplenephrectomy 34, radical nephrektomy 22, renal cyst excision21, orchiectomy 7, ureterolitotomy 4, adrenalectomy 4,orchiopexy 3, pyeloplasti 2, nefroureterectomy+cystectomy1, nefroureterectomy+partial cystectomy 1 nefroureterectomy1 patient.Transperitoneal approach was used for 91 patients whileretroperitoneal approach was used to 9 patients. The operationwas completed by open surgical interventions foronly 6 of 100 patients. The reason for open proceduresduring laparoscopy was not reaching to renal pedicles forthree patients, adhesions to pararenal tissue and colonfor 2 patients and splenic artery injury for 1 patient. Threepatients needed blood transfusions. Except these patientsthere wasn’t any complications and mortalities. When performingright nephrectomy and adrenalectomy the fourthport was used to ecartate liver. Except these cases in alloperations 3 ports was used. The mean hospitalizationstay was 1,7(1-8 days. The operation times of mostlyperformed operations were like these minute (interval:simple nephrectomy 95 (70-135, radical nephrectomy 148(125-190, renal cyst excision 45 (20-80, orchiectomy 41(30-45, ureterolithotomy 104 (95-135, orchiopexy 85 (80-100, adrenalectomy 148 (110-180, pyeloplasty 170 (160-180 nefroureterectomy 150 minutes.Conclusions: The results, success and complication ratesof laparoscopic operations which are performed in our clinicswere found as similar to literature. The laparoscopicsurgery is alternative to open surgery that it can be usedsafely and effectively. J Clin

  11. The effects of work on the health of nurses who work in clinical surgery departments at university hospitals 1 (United States)

    da Silva, Rosângela Marion; Zeitoune, Regina Célia Gollner; Beck, Carmem Lúcia Colomé; de Martino, Milva Maria Figueiredo; Prestes, Francine Cassol


    ABSTRACT Objective: to analyze the effects of work on the health of nurses who work in clinical surgery departments at university hospitals in relation to physical, social and psychological suffering and pain. Methods: a quantitative transversal study was carried out between 2012 and 2013 in four institutions in a state located in the south of Brazil. We studied 65 nurses who responded to questions on their habits. We also obtained sociodemographical information on them as well as conducting an evaluation on work relational damage using an evaluation scale. Associations were checked through the use of the Chi-Sqaure and Fisher's exact test. Correlations were checked using the Spearmann test. Results: we found that physical ailments persisted and that there were connections between social and psychological pain/suffering and variable physical activities as well as connections with accidents in the work place and the option to work shifts. We noted correlations between social and psychological pain/suffering. Conclusion: nurses had their health compromised due to their work in clinical surgery departments. PMID:27508914

  12. Translational research in thoracic surgery-the National Taiwan University Hospital experience. (United States)

    Lin, Mong-Wei; Yang, Pei-Wen; Lee, Jang-Ming


    Thoracic surgeons should be more aware of the latest information about histopathological, genetic and epigenetic alterations that may influence treatment policy and patient outcome in the biomolecular era. Translational research studies often produce a promising diagnostic tool or new treatment that can be used clinically. The results of these translational studies may even change the practical guidelines and current staging system in thoracic malignancies. The following article summarizes the experiences of translational research in esophageal cancer and non-small cell lung cancer (NSCLC) at National Taiwan University Hospital in Taiwan.


    African Journals Online (AJOL)

    lbadan, Nigeria. Reprint requests to: Dr. V. O. Adegboye, Department Of Surgery, University College Hospital, Iberian,. Nigeria. ... been shown to be related to the rate of bleeding. .... patients after an interval of conservative/medical treatment.

  14. [Systematic Readability Analysis of Medical Texts on Websites of German University Clinics for General and Abdominal Surgery]. (United States)

    Esfahani, B Janghorban; Faron, A; Roth, K S; Grimminger, P P; Luers, J C


    Background: Besides the function as one of the main contact points, websites of hospitals serve as medical information portals. As medical information texts should be understood by any patients independent of the literacy skills and educational level, online texts should have an appropriate structure to ease understandability. Materials and Methods: Patient information texts on websites of clinics for general surgery at German university hospitals (n = 36) were systematically analysed. For 9 different surgical topics representative medical information texts were extracted from each website. Using common readability tools and 5 different readability indices the texts were analysed concerning their readability and structure. The analysis was furthermore stratified in relation to geographical regions in Germany. Results: For the definite analysis the texts of 196 internet websites could be used. On average the texts consisted of 25 sentences and 368 words. The reading analysis tools congruously showed that all texts showed a rather low readability demanding a high literacy level from the readers. Conclusion: Patient information texts on German university hospital websites are difficult to understand for most patients. To fulfill the ambition of informing the general population in an adequate way about medical issues, a revision of most medical texts on websites of German surgical hospitals is recommended.

  15. Training in Laparoscopic Gastric Cancer Surgery in the Western World: Current Educational Practices, Challenges, and Potential Opportunities at a Large University Centre. (United States)

    Fecso, Andras B; Bonrath, Esther M; Grantcharov, Teodor P


    The purpose of this study was to explore and understand how surgeons distribute tasks during a laparoscopic gastrectomy for gastric cancer in an academic teaching environment. An anonymous, cross-sectional, census survey was used to poll trainees' and staff members' opinions pertaining to laparoscopic gastrectomy. Academic and community tertiary teaching hospitals, affiliated with the University of Toronto. All surgeons, within the Department of General Surgery at the University of Toronto, who practice laparoscopic gastrectomy for gastric cancer, were invited to participate. All general surgery residents, postgraduate year 1-5, minimally invasive surgery and surgical oncology fellows at the University of Toronto were invited to participate. Overall response rate was 74.35% (n = 87/117). The results suggested that trainees do not routinely perform the major operative steps. Trainees agreed with faculty in this regard; however, there was a statistically significant difference in opinions, related to the degree of the perceived active operating of the trainees. There was also a difference in opinion, between trainees and faculty, regarding the common reasons for takeover. The present survey highlights that current level of active exposure of surgical trainees to laparoscopic gastric surgery might be insufficient. A lack of role clarity may further hinder an optimal educational experience during these cases. Adopting a stepwise approach, with task deconstruction, could optimize training. Additional training modalities may be required to ensure technical proficiency is acquired before independent practice. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  16. Induced astigmatism after cataract surgery - a retrospective analysis of cases from the University of Port Harcourt Teaching Hospital, Nigeria

    Directory of Open Access Journals (Sweden)

    A. O. Adio


    Full Text Available Visual rehabilitation after cataract surgery may often be disappointing due to induction of corneal astigmatism following issues in realigning, point to point, the corneal wound margin in the process of surgery despite biometry and use of the appropriateintraocular lens. The purpose of this study is to determine the amount of surgically induced astigmatism after sutured cataract extraction-extracapsular cataract extraction (ECCE and intracapsular cataract extraction (ICCE and intraocular lens (IOLimplantation in the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. Folders of all cataract patients operated on in the eye theatre of the aforenamed tertiary facility between2002 and 2006 were considered.  Relevant patient details and intraoperative and postoperative management were examined and reported upon. One hundred and fourteen eyes (114 of one hundred patients who had cataract surgeries done within the five-year period of this study were examined. ECCE + IOL implantation were examined in the period under review. The post-operative refraction objectively and subjectively was retrieved from the records of each patient. The post-operative cylinderpower (total astigmatism was recorded.Of 114 eyes, only 83 eyes (72.8% had refraction results postoperatively due to loss of fol-low-up. The total number with astigmatism was 57(68.7%. Forty-two had against-the-rule (73.7%, twelve (21.1% with-the-rule, while five (0.09% were oblique. The mean post-operative astigmatism was 1.85 D. The surgically induced corneal astigmatism was highest with ECCE with PCIOL. Astigmatism less than 2 D was highest in this group (ECCE with IOL while ICCE with ACIOL had the highest number with astigmatism in the range between 2 D and 4 D. The total astigmatism which was mainly with-the-rule (vertical plus cylinder did not seem to impair severely the post-operative visual acuity of the patients.In conclusion, surgically induced astigmatism affected almost

  17. Surveillance of antibiotic and analgesic use in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo. (United States)

    Haliti, Naim R; Haliti, Fehim R; Koçani, Ferit K; Gashi, Ali A; Mrasori, Shefqet I; Hyseni, Valon I; Bytyqi, Samir I; Krasniqi, Lumnije L; Murtezani, Ardiana F; Krasniqi, Shaip L


    Because Kosovo has no reliable information on antimicrobial and analgesic use in dental practice, the survey reported here evaluated the antibiotic and analgesic prescriptions in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo (UDCCK). The data of 2,442 registered patients for a 1-year period were screened and analyzed concerning antibiotic and analgesic use as per standards of rational prescription. Dentistry doctors prescribed antibiotics significantly more often than analgesics. Antibiotics were prescribed in 8.11% of all cases, while only 1.35% of total prescriptions were for analgesics. The total consumption of antibiotic drugs in the UDCCK was 4.53 Defined Daily Doses [DDD]/1,000 inhabitants/day, compared with only 0.216 DDD/1,000 inhabitants/day for analgesics. From a total number of 117 patients, 32 patients received combinations of two antibiotics. Pharmacotherapy analysis showed that the prescription rates of antibiotics and analgesics in the UDCCK are not rational in terms of the qualitative aspects of treatment. For the qualitative improvement of prescription of these drug groups, we recommend the implementation of treatment guidelines following rational standards.

  18. Prevalence of Diabetes Mellitus in the Surgical Population of the University of Puerto Rico Affiliated Hospitals: A Study using the Surgery Database. (United States)

    Cruz, Norma I; Santiago, Elvis; Abdul-Hadi, Anwar


    To evaluate the prevalence of diabetes mellitus in the surgical population of the University of Puerto Rico (UPR)-affiliated hospitals. We examined all the surgical cases that were entered into the Surgical Database from April 1, 2014 through September 30, 2014. This database collects patient and procedural information from different surgical services of various UPR-affiliated hospitals (the University District Hospital, the University Pediatric Hospital, the UPR Carolina Hospital, the Dr. Isaac Gonzalez Oncologic Hospital, the PR Cardiovascular Center [thoracic service], the Pavia Hospital [colorectal service], and the Auxilio Mutuo Hospital [colorectal and oncological services]). The prevalence of diabetes mellitus (types 1 and 2 combined) was estimated, and the nondiabetic and diabetic groups were compared. The difference between groups was evaluated using a Chi2 test, Student's t-test, or ANOVA, whichever was appropriate, with a p-value of less than 0.05 being considered significant. Information from 2,603 surgical patients was available. The mean age of the group was 49 (±23) years. The gender distribution indicated that 56% were women and 44% were men. Diabetes was present in 21% of the surgical population, increasing to 40% in patients aged 65 and over. The surgical procedures most frequently required by diabetic patients were in the categories of general surgery (36%), colorectal surgery (22%), vascular surgery (16%) and oncologic surgery (14%). Complications (5%, diabetic group vs. 2%, nondiabetic group; p surgery than did the non-diabetic patients. Surgeons must consider the specific needs of these diabetic patients in order to provide optimal care.

  19. Impact of a medical university on laparoscopic surgery in a service-oriented public hospital in the Caribbean

    Directory of Open Access Journals (Sweden)

    Cawich SO


    Full Text Available Shamir O Cawich,1 Suresh Pooran,2 Barbara Amow,2 Ernest Ali,2 Fawwaz Mohammed,1 Marlon Mencia,1 Samuel Ramsewak,1 Seetharaman Hariharan,1 Vijay Naraynsingh1 1Department of Clinical Surgical Sciences, University of the West Indies, St Augustine, 2North West Regional Health Authority, Port of Spain General Hospital, Port of Spain, Trinidad and Tobago Introduction: The Caribbean lags behind global trends for volume and complexity of laparoscopic operations. In an attempt to promote laparoscopy at a single facility, a partnership was formed between the University of the West Indies (UWI and the Port of Spain General Hospital in Trinidad and Tobago. This study seeks to document the effect of this partnership on laparoscopic practice.Materials and methods: In this partnership, the UWI took the bold step of volunteering to staff a surgical team if the Ministry of Health provided the necessary legislative changes. On August 1, 2013, a UWI team was introduced with a mandate to optimize teaching and promote laparoscopic surgery. The UWI team had a similar staff complement to the existing service-oriented teams. There was no immediate investment in equipment, hospital beds, ICU beds, or operating room space. Therefore, the new team was introduced with limited change in existing conditions, resources, and equipment.Results: There were 252 laparoscopic operations performed over the study period. After introduction of the UWI team, there was an increase in the mean number of unselected laparoscopic operations (3.17 vs 10.83 cases per month; P<0.001; 95% confidence interval [95% CI] −8.5 to −6.84; standard error of the difference [SED] 0.408, the mean number of basic laparoscopic operations (3.17 vs 6.94 cases per month; P<0.0001; 95% CI −4.096 to −3.444; SED 0.165, the mean number of advanced laparoscopic operations (0 vs 3.89; P<0.0001, the number of teams undertaking unselected laparoscopic operations (2 vs 5, and the number of teams independently

  20. Factors driving James Cook University Bachelor of Medicine, Bachelor of Surgery graduates' choice of internship location and beyond. (United States)

    Schauer, Anna; Woolley, Torres; Sen Gupta, Tarun


    To identify the main reason James Cook University (JCU) Bachelor of Medicine, Bachelor of Surgery graduates chose their internship location and first four practice relocations. This cross-sectional study invited 261 JCU medical graduates to participate in an email or telephone survey. Graduates' main reason for choosing internship location and up to four subsequent relocations, post-graduate specialty training undertaken and practice location (either metropolitan or non-metropolitan) for graduates' internship year and current practice year (2012). Respondents (n=175; response rate=67%) reported personal factors as the primary driver for choosing their internship location, with 33% returning to 'near their family/home town', and 21% staying in the town they were based in Years 5 and 6. Professional reasons dominated for subsequent relocations, particularly 'long-term career ambitions'. Fifty-nine of the 175 (34%) JCU graduates had undertaken their internship in a metropolitan location (Australian Standard Geographical Classification Remoteness Area 1), while 80 (46%) currently (in 2012) practised in a metropolitan location. Internship location was not associated with later specialty training, but current metropolitan practice was associated with Surgical or Paediatrics training (P=0.007 and P=0.063, respectively), while current non-metropolitan practice was associated with General Practice and Rural Generalist training (P=0.010 and P=0.001, respectively). Personal decisions take precedence over professional career decisions for why JCU medical graduates chose their internship location, but subsequent relocations are driven by career ambitions, usually around specialty training requirements. These findings support establishing more post-graduate training opportunities in non-metropolitan settings for Surgical and Paediatric specialties as a retention strategy for a rural medical career. © 2014 National Rural Health Alliance Inc.

  1. Topical negative pressure therapy Recent experience of the department of plastic surgery at Ibn Sina University Hospital, Rabat, Morocco

    Directory of Open Access Journals (Sweden)

    Abdelmoughit Echchaoui


    Full Text Available IntroductionThe topical negative pressure therapy (TNP is a non-invasive method to treat chronic and acute wounds locally, using a continuous or intermittent negative pressure.The objective of this study is to present the first experience of this type of treatment used in clinical cases in our department. By presenting these cases, we highlight indication and efficiency of this new technique applied in relatively complicated situations, at the same time it also allows a significant improvement in treating injuries and chronic wounds.Materials and methodsIn this study, we present the recent experience of the Department of Reconstructive and Plastic Surgery of the University Hospital Center of Avicenne in Rabat. This therapy was used for the first time this year (in 2014, in three young patients who presented with chronic wounds associated with local and general factors that are unfavorable for the healing process.ResultsIn all three of our cases we obtained highly satisfactory clinical results.TNP allows wounds to bud in a shorter time, as well as a fast healing by second intention due to controlled wound healing or split-skin graft without using flaps. This enables to decrease the margin of error, the time and the number of dressing replacements, and to reduce the length of hospital stay.ConclusionThis is an expensive and specific equipment. However, the cost-benefit ratio analysis shows that it is an essential method that should be part of our therapeutic strategies.Keywords: loss of substance, negative pressure, budding, healing.  

  2. Aids and Surgery

    African Journals Online (AJOL)


    HIV/AIDS patients require surgery sometimes during their illness. ... risks to surgical equipes and analysing preventive strategies to HIV ... problems in patients presenting HIV, AIDS and ... Dentistry, Surgery of Awolowo University in Nigeria3.

  3. The effects of work on the health of nurses who work in clinical surgery departments at university hospitals. (United States)

    Silva, Rosângela Marion da; Zeitoune, Regina Célia Gollner; Beck, Carmem Lúcia Colomé; Martino, Milva Maria Figueiredo de; Prestes, Francine Cassol


    to analyze the effects of work on the health of nurses who work in clinical surgery departments at university hospitals in relation to physical, social and psychological suffering and pain. a quantitative transversal study was carried out between 2012 and 2013 in four institutions in a state located in the south of Brazil. We studied 65 nurses who responded to questions on their habits. We also obtained sociodemographical information on them as well as conducting an evaluation on work relational damage using an evaluation scale. Associations were checked through the use of the Chi-Sqaure and Fisher's exact test. Correlations were checked using the Spearmann test. we found that physical ailments persisted and that there were connections between social and psychological pain/suffering and variable physical activities as well as connections with accidents in the work place and the option to work shifts. We noted correlations between social and psychological pain/suffering. nurses had their health compromised due to their work in clinical surgery departments. analisar os efeitos do trabalho na saúde de enfermeiros que atuam em clínicas cirúrgicas de hospitais universitários, relacionando-os aos danos físicos, sociais e psicológicos. estudo quantitativo, transversal, realizado entre 2012 e 2013 em quatro instituições de um Estado da região sul do Brasil. A amostra foi composta por 65 enfermeiros que responderam questões sobre os hábitos de vida e dados sociodemográficos e a Escala de Avaliação de Danos Relacionados ao Trabalho. Associações foram verificadas pelo teste Qui-Quadrado e Exato de Fisher e as correlações pelo teste de Spearmann. prevaleceu o adoecimento físico, encontrando associação entre os fatores Danos Sociais e Psicológicos e as variáveis prática de atividade física, acidente de trabalho e opção pelo turno de trabalho. Evidenciou-se correlação entre Danos Sociais e Psicológicos. o trabalho realizado por enfermeiros que atuam

  4. Increasing Incidence of Degenerative Spinal Diseases in Japan during 25 Years: The Registration System of Spinal Surgery in Tohoku University Spine Society. (United States)

    Aizawa, Toshimi; Kokubun, Shoichi; Ozawa, Hiroshi; Kusakabe, Takashi; Tanaka, Yasuhisa; Hoshikawa, Takeshi; Hashimoto, Ko; Kanno, Haruo; Morozumi, Naoki; Koizumi, Yutaka; Sato, Tetsuro; Hyodo, Hironori; Kasama, Fumio; Ogawa, Shinji; Murakami, Eiichi; Kawahara, Chikashi; Yahata, Jun-Ichiro; Ishii, Yushin; Itoi, Eiji


    Spinal disorders affect mainly older people and cause pain, paralysis and/or deformities of the trunk and/or extremities, which could eventually disturb locomotive functions. For ensuring safe and high-quality treatment of spinal disorders, in 1987, the Tohoku University Spine Society (TUSS) was established by orthopedic departments in Tohoku University School of Medicine and its affiliated hospitals in and around Miyagi Prefecture. All spine surgeries have been enrolled in the TUSS Spine Registry since 1988. Using the data from this registration system between 1988 and 2012, we demonstrate here the longitudinal changes in surgical trends for spinal disorders in Japan that has rushed into the most advanced "aging society" in the world. In total, data on 56,744 surgeries were retrieved. The number of spinal surgeries has annually increased approximately 4-fold. There was a particular increase among patients aged ≥ 70 years and those aged ≥ 80 years, with a 20- to 90-fold increase. Nearly 90% of the spinal operations were performed for degenerative disorders, with their number increasing approximately 5-fold from 705 to 3,448. The most common disease for surgery was lumbar spinal stenosis (LSS) (35.9%), followed by lumbar disc herniation (27.7%) and cervical myelopathy (19.8%). In 2012, approximately half of the patients with LSS and cervical myelopathy were ≥ 70 years of age. In conclusion, the number of spinal operations markedly increased during the 25-year period, particularly among older patients. As Japan has a notably aged population, the present study could provide a near-future model for countries with aging population.

  5. Accuracy of quick and easy undernutrition screening tools--Short Nutritional Assessment Questionnaire, Malnutrition Universal Screening Tool, and modified Malnutrition Universal Screening Tool--in patients undergoing cardiac surgery. (United States)

    van Venrooij, Lenny M W; van Leeuwen, Paul A M; Hopmans, Wendy; Borgmeijer-Hoelen, Mieke M M J; de Vos, Rien; De Mol, Bas A J M


    The objective of this study was to compare the quick-and-easy undernutrition screening tools, ie, Short Nutritional Assessment Questionnaire and Malnutrition Universal Screening Tool, in patients undergoing cardiac surgery with respect to their accuracy in detecting undernutrition measured by a low-fat free mass index (FFMI; calculated as kg/m(2)), and secondly, to assess their association with postoperative adverse outcomes. Between February 2008 and December 2009, a single-center observational cohort study was performed (n=325). A low FFMI was set at ≤14.6 in women and ≤16.7 in men measured using bioelectrical impedance spectroscopy. To compare the accuracy of the Malnutrition Universal Screening Tool and Short Nutritional Assessment Questionnaire in detecting low FFMI sensitivity, specificity, and other accuracy test characteristics were calculated. The associations between the Malnutrition Universal Screening Tool and Short Nutritional Assessment Questionnaire and adverse outcomes were analyzed using logistic regression analyses with odds ratios and 95% confidence intervals (CI) presented. Sensitivity and receiver operator characteristic-based area under the curve to detect low FFMI were 59% and 19%, and 0.71 (95% CI: 0.60 to 0.82) and 0.56 (95% CI: 0.44 to 0.68) for the Malnutrition Universal Screening Tool and Short Nutritional Assessment Questionnaire, respectively. Accuracy of the Malnutrition Universal Screening Tool improved when age and sex were added to the nutritional screening process (sensitivity 74%, area under the curve: 0.72 [95% CI: 0.62 to 0.82]). This modified version of the Malnutrition Universal Screening Tool, but not the original Malnutrition Universal Screening Tool or Short Nutritional Assessment Questionnaire, was associated with prolonged intensive care unit and hospital stay (odds ratio: 2.1, 95% CI: 1.3 to 3.4; odds ratio: 1.6, 95% CI: 1.0 to 2.7). The accuracy to detect a low FFMI was considerably higher for the Malnutrition

  6. [The Role of a Modular Universal Tumour and Revision System (MUTARS®) in Lower Limb Endoprosthetic Revision Surgery - Outcome Analysis of 25 Patients]. (United States)

    Schmolders, J; Koob, S; Schepers, P; Gravius, S; Wirtz, D C; Burger, C; Pennekamp, P H; Strauss, A C


    Introduction/Background: With extended life expectancy, the number of primary joint arthroplasties has also increased. Revision surgery is also more often necessary, due to aseptic or septic loosening of the prosthesis or periprosthetic fracture. Large bone defects often occur in these patients and several non-modular, conventional implants are available to handle this difficult situation. Custom made implants offer an individually designed and defect-adapted shape with perfect covering of the lesion, but may delay the operation. The Modular Universal Tumor And Revision System (MUTARS®) offers the possibility to vary the length and angle of the femoral neck and the antetorsion angle. Thus, it permits intraoperative adaption to the individual patient's defect. The aim of our study is to present clinical, functional results and the rate of complications in a cohort of patients undergoing revision surgery for failed endoprosthetic replacement or failed trauma surgery, using the Modular Universal Tumor And Revision System with short-to midterm follow-up. Patients and Methods: Between August 2005 and September 2014, 25 patients (17 female, 8 male) with an average age of 72 years (min. 56, max. 92 years) were included in a retrospective study using the MUTARS® system. The patients underwent surgical revision of osseous defects that were not susceptible to conventional care. The mean follow-up was 16 months (min. 12, max. 72 months). The indications which led to revision surgery were as follows: loosened metal-on-metal prosthesis with an acetabular defect caused by a metal-induced granuloma (n = 1), pseudoarthrosis after implantation of femur nail (n = 2), cut-out of a femur nail (n = 1), aseptic loosening of an implanted endoprosthesis (n = 4), septic loosening of an implanted endoprosthesis (n = 1), periprosthetic fracture (n = 6) and periprosthetic infection after two stage revision surgery (infection consolidated Girdlestone situation) (n = 10). All patients were

  7. Universe

    CERN Document Server


    Updated for 2011, the Universe, is one book in the Britannica Illustrated Science Library Series that covers today's most popular science topics, from digital TV to microchips to touchscreens and beyond. Perennial subjects in earth science, life science, and physical science are all explored in detail. Amazing graphics-more than 1,000 per title-combined with concise summaries help students understand complex subjects. Correlated to the science curriculum in grades 5-9, each title also contains a glossary with full definitions for vocabulary.

  8. Universe

    CERN Document Server


    The Universe, is one book in the Britannica Illustrated Science Library Series that is correlated to the science curriculum in grades 5-8. The Britannica Illustrated Science Library is a visually compelling set that covers earth science, life science, and physical science in 16 volumes.  Created for ages 10 and up, each volume provides an overview on a subject and thoroughly explains it through detailed and powerful graphics-more than 1,000 per volume-that turn complex subjects into information that students can grasp.  Each volume contains a glossary with full definitions for vocabulary help and an index.

  9. The Emory University Perioperative Algorithm for the Management of Hyperglycemia and Diabetes in Non-cardiac Surgery Patients. (United States)

    Duggan, Elizabeth W; Klopman, Matthew A; Berry, Arnold J; Umpierrez, Guillermo


    Hyperglycemia is a frequent manifestation of critical and surgical illness, resulting from the acute metabolic and hormonal changes associated with the response to injury and stress (Umpierrez and Kitabchi, Curr Opin Endocrinol. 11:75-81, 2004; McCowen et al., Crit Care Clin. 17(1):107-24, 2001). The exact prevalence of hospital hyperglycemia is not known, but observational studies have reported a prevalence of hyperglycemia ranging from 32 to 60 % in community hospitals (Umpierrez et al., J Clin Endocrinol Metab. 87(3):978-82, 2002; Cook et al., J Hosp Med. 4(9):E7-14, 2009; Farrokhi et al., Best Pract Res Clin Endocrinol Metab. 25(5):813-24, 2011), and 80 % of patients after cardiac surgery (Schmeltz et al., Diabetes Care 30(4):823-8, 2007; van den Berghe et al., N Engl J Med. 345(19):1359-67, 2001). Retrospective and randomized controlled trials in surgical populations have reported that hyperglycemia and diabetes are associated with increased length of stay, hospital complications, resource utilization, and mortality (Frisch et al., Diabetes Care 33(8):1783-8, 2010; Kwon et al., Ann Surg. 257(1):8-14, 2013; Bower et al., Surgery 147(5):670-5, 2010; Noordzij et al., Eur J Endocrinol. 156(1):137-42, 2007; Mraovic et al., J Arthroplasty 25(1):64-70, 2010). Substantial evidence indicates that correction of hyperglycemia reduces complications in critically ill, as well as in general surgery patients (Umpierrez et al., J Clin Endocrinol Metab. 87(3):978-82, 2002; Clement et al., Diabetes Care 27(2):553-97, 2004; Pomposelli et al., JPEN J Parented Enteral Nutr. 22(2):77-81, 1998). This manuscript reviews the pathophysiology of stress hyperglycemia during anesthesia and the perioperative period. We provide a practical outline for the diagnosis and management of preoperative, intraoperative, and postoperative care of patients with diabetes and hyperglycemia.

  10. The Nottingham Expectation and Complication score following Surgery (NECS): an universal scale for surgical outcome audit and peer comparison. (United States)

    Ingale, Harshal; Muquit, Samiul; Al-Helli, Othman; White, Barrie; Basu, Surajit


    Consultant Outcomes Publication (COP) is an NHS England initiative for promoting improvements in quality of care. However, at present outcomes are commonly expressed as mortality rates which do not necessarily reflect the performance of surgeons. We developed the Nottingham Expectation and Complication score following Surgery (NECS) to determine the success of surgical treatment from both the clinical perspective and the practical expectations agreed between surgeons and patients during the consent process. This was a pilot study to trial the use of the NECS score. It is a simple expression of overall outcome comprising three clinical domains: S - surgical outcome, T - surgical/technical complications and M - medical complications recorded by the treating clinician, and practical outcome determined by a joint clinical/patient assessment. 107 elective neurosurgical patients were included in this prospective study. 95 completed questionnaires were included. 75% patients achieved the best possible treatment score (S3T3M4). Of the 25% of patients who did not achieve this ideal outcome, the most common cause was either medical deterioration 18%, or technical complications of surgery discussed during the consent process 17%, or both. Surgeons rated their outcomes as expectations exceeded in 2% of cases, met in 92%, partially met in 5% and failed in 1%. Patients rated their outcomes as expectations exceeded in 37%, met in 37%, partially met in 18%, and 5% reported that their expectations were not met or they were worse than before the operation. Bivariate correlation analysis (Pearson's r coefficient) between overall 'expectation score' of patients and surgeons showed moderate correlation with r = .25 (p = .014). NECS score can be used as an indicator to assess technical performance and patient satisfaction. It provides a more balanced quality indicator of the surgical service delivery than COP. It also offers additional advantages for auditing/planning improving

  11. Bariatric Surgery (United States)

    ... Metabolic and Bariatric Surgery MedlinePlus What is bariatric surgery? Bariatric surgery helps people who are very obese to ... What are the endocrine-related benefits of bariatric surgery? Bariatric surgery and the weight loss that results can: ...

  12. Global surgical oncology disease burden: addressing disparities via global surgery initiatives: the University of Michigan International Breast Cancer Registry. (United States)

    Jiagge, Evelyn; Bensenhaver, Jessica M; Oppong, Joseph K; Awuah, Baffour; Newman, Lisa A


    Disparities in breast cancer incidence and outcome between African American and white American women are multifactorial in etiology. The increased frequency of triple-negative breast cancers (TNBC) in African American patients suggests the possible contribution of hereditary factors related to African ancestry. The University of Michigan (UM)-Komfo Anoyke Teaching Hospital (KATH) Breast Cancer Research Collaborative and International Breast Registry was established in 2004. It features epidemiologic information, tumor tissue, and germline DNA specimens from African American, white American, and Ghanaian women. This research collaborative has generated valuable findings regarding the pathogenesis and patterns of TNBC while concomitantly improving the standard of breast oncology care in Ghana. This partnership has also yielded important opportunities for academic and educational exchange. It has expanded to involve other sites in Africa and Haiti. The UM-KATH collaborative is a model for demonstrating the research and academic exchange value of international partnerships.

  13. Thyroid Surgery (United States)

    ... Fax/Phone Home » Thyroid Surgery Leer en Español Thyroid Surgery GENERAL INFORMATION Your doctor may recommend that ... made in conjunction with your endocrinologist and surgeon. Thyroid Surgery FAQs QUESTIONS AND CONSIDERATIONS When thyroid surgery ...

  14. Plastic Surgery (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A A ... forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word "plastic" ...

  15. Integrated bariatric surgery residency

    Directory of Open Access Journals (Sweden)

    Eltorai AE


    Full Text Available Adam EM Eltorai Warren Alpert Medical School of Brown University, RI, USA Abstract: Obesity is a major public health concern. Given its lasting efficacy for improving obesity and obesity-related diseases, bariatric surgery is an increasingly common treatment option. As the implementation of the Affordable Care Act progresses, the impending physician shortage will become more severe. Thus there will be an even greater need for doctors specialized in the management and treatment of obese patients. The development of integrated bariatric surgery residency programs could be considered and is discussed herein. Keywords: obesity, bariatric surgery, integrated residency, surgery education

  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. [The development of bariatric surgery and the role of the First Surgical Clinic of the General Medical School Hospital and the First Medical School of Charles University in Prague in this specialty]. (United States)

    Fried, M; Kasalický, M; Gürlich, R


    The authors discuss the development of bariatric surgery in Europe and the USA from its beginnings at the onset of the fifties. More detailed attention is paid in particular to the development of the method of gastric bandings and the role at the First Surgical Department in this field in "classical" as well as miniinvasive surgery. Results of gastric banding are summarized in 683 patients operated since 1983, in particular the numbers of early and late complications after laparotomies and laparoscopic operations, similarly as complications which are directly associated with gastric banding itself. In the conclusion it is stated that the First Surgical Department of the General Faculty Hospital and First Medical Faculty Charles University in Prague belong as regards their results in surgical treatment of obese subjects and the position in the field of bariatric surgery on an international scale to the foremost departments in this field worldwide.

  18. [Bariatric surgery. Would you undergo surgery again?]. (United States)

    Albaina Landaluce, E; Díez Andrés, A; Navaridas Berganzo, A; Ruiz de Arcaute, I I


    The authors analyze the negative repercussions of morbid obesity; then they explain what baryatric surgery, a surgical technique employed with a high degree of success, consists of. They study the results, in terms of satisfaction, obtained from patients operated on in the Txagorritxu Hospital in Vitoria. The project on which this article is based was presented as a Main Project in a Course on Health Research Methodology, extension class section, "IDER", at the University of Alcalá and the University of Antioquia.

  19. Lung surgery (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- ...

  20. Turbinate surgery (United States)

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - turbinate surgery ... There are several types of turbinate surgery: Turbinectomy: All or ... This can be done in several different ways, but sometimes a ...

  1. Cataract Surgery (United States)

    ... and Videos: What Do Cataracts Look Like? Cataract Surgery Written By: Kierstan Boyd Reviewed By: Elena M ... how they work. What to expect with cataract surgery Before surgery: Your ophthalmologist will measure your eye ...

  2. Weight Loss Surgery (Bariatric Surgery) (For Parents) (United States)

    ... to Be Smart About Social Media Weight Loss Surgery (Bariatric Surgery) KidsHealth > For Parents > Weight Loss Surgery (Bariatric Surgery) ... bariatric surgery might be an option. About Bariatric Surgery Bariatric surgery had its beginnings in the 1960s, ...

  3. Physical Therapy and Surgery


    Valle-Onate, Rafael; Ward, Michael M.; Kerr, Gail S.


    Physical therapy and orthopedic surgery are important components in the treatment of ankylosing spondylitis (AS). Supervised physical therapy is more effective that individual or unsupervised exercise in improving symptoms, but controlled trials suggest than combined inpatient and outpatient therapy provides the greatest improvement. Recommendations for exercise are universal, but the best types and sequence of therapies are not known. Total hip replacement is the surgery most commonly perfor...

  4. Physical Therapy and Surgery (United States)

    Valle-Onate, Rafael; Ward, Michael M.; Kerr, Gail S.


    Physical therapy and orthopedic surgery are important components in the treatment of ankylosing spondylitis (AS). Supervised physical therapy is more effective that individual or unsupervised exercise in improving symptoms, but controlled trials suggest than combined inpatient and outpatient therapy provides the greatest improvement. Recommendations for exercise are universal, but the best types and sequence of therapies are not known. Total hip replacement is the surgery most commonly performed for AS, with good long-term implant survival. Heterotopic ossification may occur no more frequently after hip replacement in patients with AS than in patients with other diseases. Corrective spinal surgery is rarely performed and requires specialized centers and experienced surgeons. PMID:22543536

  5. [Dr. Michiharu Matsuoka, founder of the Department of Orthopaedic Surgery, Kyoto University, and his achievements (Part 6: Studying abroad of Dr. Matsuoka and opening to public, reputation and achievement of the department)]. (United States)

    Hirotani, Hayato


    Dr. Michiharu Matsuoka studied orthopaedic surgery in Germany, Austria and other countries during the period from August, 1902 to May, 1906. He visited many university pathological institutes and surgical and orthopaedic clinics to study pathology and to learn the practice of orthopaedic surgery. After that, he started his practice at the newly established Department of Orthopaedic Surgery in the Medical School of Kyoto Imperial University in June, 1906. The department was opened in 1907 and in 1911 it was opened to all citizens and practical doctors in Kyoto City and exhibited many orthopaedic specimens and instruments. In particular, the x-ray apparatus of the Department was so well equipped that a German radiologist who visited the Department admired it in his article that was published in the journal of radiology in 1911. The Department was not surpassed by others for the number of patients with the dislocation of the hip and tuberculous spondylitis as well as the advanced quality and variety of roentgenological and pathological researches on these diseases.

  6. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  7. Dental Implant Surgery (United States)

    ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  8. Nose Surgery (United States)

    ... Patient Health Home Copyright © 2017 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2017. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  9. After Surgery (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 ...

  10. Patient-reported health outcomes after total hip and knee surgery in a Dutch University Hospital Setting: results of twenty years clinical registry

    NARCIS (Netherlands)

    Wees, P.J. van der; Wammes, J.J.G.; Akkermans, R.P.; Koetsenruijter, J.; Westert, G.P.; Kampen, A. van; Hannink, G.J.; Waal Malefijt, M.C. de; Schreurs, B.W.


    BACKGROUND: Patient-Reported Outcome (PRO) measurement is a method for measuring perceptions of patients on their health and quality of life. The aim of this paper is to present the results of PRO measurements in total hip and knee replacement as routinely collected during 20 years of surgery in a

  11. Decreasing delays in urgent and expedited surgery in a university teaching hospital through audit and communication between peri-operative and surgical directorates. (United States)

    Cosgrove, J F; Gaughan, M; Snowden, C P; Lees, T


    National Confidential Enquiry into Patient Outcome and Death guidelines for urgent surgery recommend a fully staffed emergency operating theatre and restriction of 'after-midnight' operating to immediate life-, limb- or organ-threatening conditions. Audit performed in our institution demonstrated significant decreases in waiting times for urgent surgery and an increased seniority of medical care associated with overnight pre-operative assessment of patients by anaesthetic trainees. Nevertheless, urgent cases continued to be delayed unnecessarily. A classification of delays was developed from existing guidelines and their incidence was audited. The results were disseminated to involved directorates. A repeat of the audit demonstrated a significant decrease in delays (p = 0.001), a significant increase in the availability of surgeons (p = 0.001) and a significant decrease in the median waiting time for urgent surgery compared to the first audit cycle and a previous standard (p auditing delays and disseminating the results of the audit significantly decreases delays and median waiting times for urgent surgery because of improved surgical availability.

  12. Orthopaedics in day surgery

    African Journals Online (AJOL)

    Orthopaedics surgery, University of Nairobi, P.O. Box 52507-00200, Nairobi, Kenya and M.A. Odhiambo, KRN,. KRM, BSc ... processing of day cases is separate, more efficient and cases of ... centre is by rule of the medicare and accreditation.

  13. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws and ... Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by ...

  14. Endodontic surgery. (United States)

    Chong, B S; Rhodes, J S


    A better understanding of endodontic disease and the causes of treatment failure has refined the role of surgery in endodontics. The advent of newer materials, advances in surgical armamentarium and techniques have also led to an improved endodontic surgical outcome. The aim of this article is to provide a contemporary and up-to-date overview of endodontic surgery. It will focus primarily on the procedures most commonly performed in endodontic surgery.

  15. [Dr. Michiharu Matsuoka, founder of the Department of Orthopaedic Surgery, Kyoto University, and his achievements. Part 4: Prof. M. Matsuoka's lecture to medical and civic communities]. (United States)

    Hirotani, Hayato


    Dr. M. Matsuoka gave many lectures to physicians at the Postdoctoral Course Lectures sponsored by the Kyoto Eisei Kensasho (Kyoto Bacterial and Biochemical Laboratory) run by the Kyoto Medical Association, and the Postdoctoral Course Lectures of the Kyoto Medical School, Kyoto Imperial University. He was also invited to give lectures at several regional medical associations. He also was a speaker at the Kyoto Imperial University Extension course and he lectured at the Enryakuji Temple on Mt. Hiei, sponsored by a newspaper company. It is remarkable that these activities were carried out in addition to his other notable academic work previously reported.

  16. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by a trained ... Dental Implant Surgery Dental implant surgery is, of course, surgery, and is best performed by a trained ...

  17. Thyroid Surgery (United States)

    ... etc.). Surgery is also an option for the treatment of hyperthyroidism (Grave’s disease or a “toxic nodule” (see Hyperthyroidism brochure ), for large and multinodular goiters and for any goiter that may be causing ... MEANS OF TREATMENT? Surgery is definitely indicated to remove nodules suspicious ...

  18. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard


    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......-depth qualitative interviews were conducted with young (aged 18-35), physically active individuals with ACL rupture who were participating in a RCT comparing training and surgical reconstruction with training only. 22/34 were randomised to training only but crossed over to surgery. Of these, 11 were interviewed...... before surgery, and 11 were interviewed at least 6 months after surgery. To provide additional information, 12 patients were interviewed before randomisation. Interviews were audio-recorded, transcribed and analysed using the Framework approach. RESULTS: Strong preference for surgery was commonplace...

  19. Port Access Cardiac Surgery. (United States)

    Viganó, Mario; Minzioni, Gaetano; Spreafico, Patrizio; Rinaldi, Mauro; Pasquino, Stefano; Ceriana, Piero; Locatelli, Alessandro


    The port-access technique for cardiac surgery was recently developed at Stanford University in California as a less invasive method to perform some cardiac operations. The port-access system has been described in detail elsewhere. It is based on femoral arterial and venous access for cardiopulmonary bypass (CPB) and on the adoption of a specially designed triple-lumen catheter described originally by Peters, and subsequently modified and developed in the definitive configuration called the endoaortic clamp.

  20. [Neurological complications associated with ultrasound-guided interscalene and supraclavicular block in elective surgery of the shoulder and arm. Prospective observational study in a university hospital]. (United States)

    Bilbao Ares, A; Sabaté, A; Porteiro, L; Ibáñez, B; Koo, M; Pi, A


    The incidence of postoperative neurological symptoms after performing interscalene block varies between 4 and 16%. The majority of cases are resolved spontaneously within a year, but some patients have their symptoms permanently. Our objective was to assess the incidence of postoperative neurological symptoms after performing the ultrasound-assisted interscalene and supraclavicular anaesthetic blocks. A prospective and observational study was conducted on consecutive patients who had undergone upper extremity surgery with an interscalene or supraclavicular block as an isolated technique, or as a complement to general anaesthesia. Seven days after the intervention, a telephone interview was conducted that focused on the detection of neurological symptoms in the operated limb. Further serial interviews were conducted on patients with symptoms (after the first, the third and the sixth month, and one year after surgery) until resolution of symptoms. Neurological evaluation was offered to those patients with persistent symptoms after one year. A total of 121 patients were included, on whom 96 interscalene blocks and 22 supraclavicular blocks were performed. Postoperative neurological symptoms were detected in 9.9% (95% CI, 5-15%) of patients during the first week. No significant differences were observed between interscalene (9%) and supraclavicular block (14%). After 3 months the symptoms persisted in 9 patients (7.4%), with symptoms remaining in 4 patients (3.3%) after 1.5 years. Electromyogram was performed on 3 patients who tested positive for nerve damage. A high incidence of postoperative neurological symptoms was observed, and a worrying percentage of permanence of them. There were no significant differences in incidence according to the type of block, or any features of the patient or the anaesthesia technique that were associated with the incidence of these symptoms, except a marginal relationship with age. These complications must be clearly explained to the


    Silva, Cátia Ferreira da; Cohen, Larissa; Sarmento, Luciana d'Abreu; Rosa, Felipe Monnerat Marino; Rosado, Eliane Lopes; Carneiro, João Régis Ivar; Souza, Antônio Augusto Peixoto de; Magno, Fernanda Cristina Carvalho Mattos

    Due to the high failure rate observed in the clinical treatment of morbid obesity an increase in bariatric surgery indications, as an alternative for the control of obesity and comorbidities, is noticeable. To evaluate the performance of type 2 diabetes mellitus, high blood pressure and dyslipidemia in patients submitted to Roux-en-Y gastric bypass in late follow-up. Retrospective analysis of 59 patients included in the bariatric surgery program. Anthropometric (height and body weight) and laboratory (LDLc, HDLc, VLDLc, triglyceride -TG - and glucose) data were collected on pre- and postoperative stages, through medical records. Among the patients, 86% were female aged 43±11, of whom 52% had attended high school. The average postoperative time was 7±3 years. During the postoperative period, there were decreases of weight and body mass index, respectively (133±06 kg vs 91±04 kg pdislipidemia em pacientes submetidos à gastroplastia redutora em Y-de-Roux no período de pós-operatório tardio. Análise retrospectiva de 59 pacientes inseridos em programa de cirurgia bariátrica. Foram coletados dados antropométricos (altura e peso corporal) e laboratoriais (LDLc, HDLc, VLDLc, triglicerídeo -TG - e glicose) nos períodos pré e pós-operatório por meio de prontuários médicos. Entre os pacientes, 86% eram mulheres com idade de 43±11 anos e 52% tinham cursado o ensino médio. O tempo médio de pós-operatório foi de 7±3 anos. Houve redução no peso e no índice de massa corporal no pós-operatório, respectivamente (133±06 kg vs 91±04 kg pdislipidemia em 81% e 94% dos casos, respectivamente. A gastroplastia redutora em Y-de-Roux mostrou ser procedimento eficaz em longo prazo, com resultados persistentes na perda de peso, remissão do DM2 e da dislipidemia.


    da SILVA, Cátia Ferreira; COHEN, Larissa; SARMENTO, Luciana d'Abreu; ROSA, Felipe Monnerat Marino; ROSADO, Eliane Lopes; CARNEIRO, João Régis Ivar; de SOUZA, Antônio Augusto Peixoto; MAGNO, Fernanda Cristina Carvalho Mattos


    ABSTRACT Background: Due to the high failure rate observed in the clinical treatment of morbid obesity an increase in bariatric surgery indications, as an alternative for the control of obesity and comorbidities, is noticeable. Aim: To evaluate the performance of type 2 diabetes mellitus, high blood pressure and dyslipidemia in patients submitted to Roux-en-Y gastric bypass in late follow-up. Methods: Retrospective analysis of 59 patients included in the bariatric surgery program. Anthropometric (height and body weight) and laboratory (LDLc, HDLc, VLDLc, triglyceride -TG - and glucose) data were collected on pre- and postoperative stages, through medical records. Results: Among the patients, 86% were female aged 43±11, of whom 52% had attended high school. The average postoperative time was 7±3 years. During the postoperative period, there were decreases of weight and body mass index, respectively (133±06 kg vs 91±04 kg p<0.05 e 49±74 kg/m2 vs 33±79 kg/m2, p<0.05). In comparison to the preoperative stage, lower concentrations of glucose (101.00±26.99 vs 89,11±15.19, p=0.014), total cholesterol rates (179.00±37,95 vs 167.48±28,50, p=0.016), LDLc (104.30±33.12 vs 91.46±24.58, p=0.016), VLDLc (25.40±11,12 vs 15.68±7.40, p<0.01), and TG (143.35±86.35 vs 82.45±37.39, p<0.01) and higher concentrations of HDLc (43.53±8.23 vs 57.90±15.60, p<0.01) were identified in the postoperative stage. 40% of hypertensive patients were still undergoing high blood pressure treatment during the postoperative stage. There was remission of type 2 diabetes mellitus and dyslipidemia on 81% and 94% of the cases, respectively. Conclusion: Roux-en-Y gastric bypass has proven itself to be an effective long term procedure, promoting weight loss, remission of DM2 and dyslipidemia. PMID:27683769

  3. General Surgery

    African Journals Online (AJOL)


    underwent major colonic restorative resection between July 1997 and September 199 in order to ... factors, the level of anastomosis and the experience of the surgeon are perhaps the ... indications for surgery and cancer stage were similar.

  4. Brain surgery (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 ...

  5. Hemorrhoid surgery (United States)

    ... and hemorrhoidectomy. In: Delaney CP, ed. Netter's Surgical Anatomy and Approaches . Philadelphia, PA: Elsevier Saunders; 2014:chap 26. Review Date 4/5/2015 Updated by: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason ...


    African Journals Online (AJOL)

    The traditional operative approach is an open surgical one to drain the cysts and ... early outcomes of laparoscopic treatment of liver hydatid cysts at our institution. .... O. Radical vs. conservative surgery for hydatid liver cysts: Experience from ...

  7. Outpatient Surgery (United States)

    ... thirds of all operations are performed in outpatient facilities, according to the Centers for Disease Control and Prevention. Outpatient surgery provides patients with the convenience of recovering at home, and can cost less. ...

  8. Laparoscopic Surgery (United States)

    ... surgeon’s perspective, laparoscopic surgery may allow for easier dissection of abdominal scar tissue (adhesions), less surgical trauma, ... on Facebook About ACG ACG Store ACG Patient Education & Resource Center Home GI Health and Disease Recursos ...

  9. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N


    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... 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...

  10. [Robotic surgery]. (United States)

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


    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.

  11. [Aesthetic surgery]. (United States)

    Bruck, Johannes C


    The WHO describes health as physical, mental and social well being. Ever since the establishment of plastic surgery aesthetic surgery has been an integral part of this medical specialty. It aims at reconstructing subjective well-being by employing plastic surgical procedures as described in the educational code and regulations for specialists of plastic surgery. This code confirms that plastic surgery comprises cosmetic procedures for the entire body that have to be applied in respect of psychological exploration and selection criteria. A wide variety of opinions resulting from very different motivations shows how difficult it is to differentiate aesthetic surgery as a therapeutic procedure from beauty surgery as a primarily economic service. Jurisdiction, guidelines for professional conduct and ethical codes have tried to solve this question. Regardless of the intention and ability of the health insurances, it has currently been established that the moral and legal evaluation of advertisements for medical procedures depends on their purpose: advertising with the intent of luring patients into cosmetic procedures that do not aim to reconstruct a subjective physical disorder does not comply with a medical indication. If, however, the initiative originates with the patient requesting the amelioration of a subjective disorder of his body, a medical indication can be assumed.

  12. [Psychomotor skills assessment in basic procedures of laparoscopic surgery in undergraduate medical students at the School of Medicine of the University of Colima]. (United States)

    Prieto-Díaz-Chávez, Emilio; Medina-Chávez, José Luís; Martínez-Lira, Rafael; Millán-Guerrero, Rebeca; Vázquez-Jiménez, Clemente; Trujillo-Hernández, Benjamín


    The changes in recent decades in the training of medical student seem to agree that the educational model for professional skills is most appropriate. The virtual simulator translates skills acquired the operating room, in the Faculty of Medicine of the University of Colima noticed the need to prepare the students of pregrade transferring surgical trainees' skills in basic laparoscopic activities that require a simple cognitive effort. The hypothesis in this study was to evaluate the acquisition of skills in laparoscopic simulator in students of pregrade. Educational research, analytical comparison, which was conducted within the activities of the program of Problem Based Learning in the program of Education and Surgical Technique, Faculty of Medicine of the University of Colima. All participants in the simulator achieved a significantly better during the task one after three repetitions (p= 0.001). The evaluation of final students calcification, we observed significant differences in means being lower during the initial assessment (8.60 ± 0.76) compared to the end (8.96 ± 0.58) p= 0.001. The acquisition of skills in the simulator is longer but at the end is better than the acquisition of skills from the traditional method, showing that leads to the acquisition of skills that promote the transfer of skills to the surgical environment.

  13. HCUP State Ambulatory Surgery Databases (SASD) - Restricted Access Files (United States)

    U.S. Department of Health & Human Services — The State Ambulatory Surgery Databases (SASD) contain the universe of hospital-based ambulatory surgery encounters in participating States. Some States include...

  14. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... find out more. Dental and Soft Tissue Surgery Dental and Soft Tissue Surgery Oral and facial surgeons ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ...

  15. Tennis elbow surgery (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 given ...

  16. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  17. Mohs micrographic surgery (United States)

    Skin cancer - Mohs surgery; Basal cell skin cancer - Mohs surgery; Squamous cell skin cancer - Mohs surgery ... Mohs surgery usually takes place in the doctor's office. The surgery is started early in the morning and is ...

  18. Corrective Jaw Surgery (United States)

    ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  19. The University of Toronto's lasting contribution to war surgery: how Maj. L. Bruce Robertson fundamentally transformed thinking toward blood transfusion during the First World War. (United States)

    Tien, Abigail; Beckett, Andrew; Pannell, Dylan


    During the Great War, Canadian military surgeons produced some of the greatest innovations to improve survival on the battlefield. Arguably, the most important was bringing blood transfusion practice close to the edge of the battlefield to resuscitate the many casualties dying of hemorrhagic shock. Dr. L. Bruce Robertson of the Canadian Army Medical Corps was the pioneering surgeon from the University of Toronto who was able to demonstrate the benefit of blood transfusions near the front line and counter the belief that saline was the resuscitation fluid of choice in military medicine. Robertson would go on to survive the Great War, but would be taken early in life by influenza. Despite his life and career being cut short, Robertson's work is still carried on today by many military medical organizations who strive to bring blood to the wounded in austere and dangerous settings. This article has an Appendix, available at

  20. Robotic surgery. (United States)

    Diana, M; Marescaux, J


    Proficiency in minimally invasive surgery requires intensive and continuous training, as it is technically challenging for unnatural visual and haptic perceptions. Robotic and computer sciences are producing innovations to augment the surgeon's skills to achieve accuracy and high precision during complex surgery. This article reviews the current use of robotically assisted surgery, focusing on technology as well as main applications in digestive surgery, and future perspectives. The PubMed database was interrogated to retrieve evidence-based data on surgical applications. Internal and external consulting with key opinion leaders, renowned robotics laboratories and robotic platform manufacturers was used to produce state-of-the art business intelligence around robotically assisted surgery. Selected digestive procedures (oesophagectomy, gastric bypass, pancreatic and liver resections, rectal resection for cancer) might benefit from robotic assistance, although the current level of evidence is insufficient to support widespread adoption. The surgical robotic market is growing, and a variety of projects have recently been launched at both academic and corporate levels to develop lightweight, miniaturized surgical robotic prototypes. The magnified view, and improved ergonomics and dexterity offered by robotic platforms, might facilitate the uptake of minimally invasive procedures. Image guidance to complement robotically assisted procedures, through the concepts of augmented reality, could well represent a major revolution to increase safety and deal with difficulties associated with the new minimally invasive approaches. © 2015 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  1. [Short- and long-term results in operable pancreatic ductal adenocarcinomas from a cooperation between two departments gastroenterology-visceral surgery at non-university hospitals benchmarked to results of expert-centers]. (United States)

    Dippold, Wolfgang; Sivanathan, Visvakanth; Statt, Katharina; Roitman, Marc; Link, Karl Heinrich


    The only curative approach in pancreatic ductal adenocarcinoma (PDAC) is resection, which is possible only in 15 - 30 % of patients. Local tumor spread or distant metastases are contraindications for resection in the majority of patients. Surgical-oncological quality with short- and long-term results are varying tremendously, so that "expertise/quality" are associated to hospital- or surgeon's volume and/or center formation. The treatment results also depend, to a great extent, on the medical diagnostic quality. With our retrospective study, we aim to compare the results-quality of cooperative pancreatic cancer treatment based on an extensive preoperative diagnostic procedure for staging and risk estimation in a specialized GI-medical department and visceral surgical-oncological expertise in pancreatic cancer surgery at a general hospital with the results-quality of expert centers. Fifty-three patients with PDAC had diagnosis and resection of their cancer between 1/2002 and 12/2009. The 30 day hospital-mortality was 3.8 % and the median survival time after demission from the hospital was 23.1 months. The 5-year-survival rate of R0-resected patients, all of whom had received adjuvant chemotherapy, was high with 31 %. The survival data and the extraordinarily high resection rate of 98.1 % in the patient group, whose primary tumor stage was pT3 in 81 %, reflects the excellent cooperation of high standards in medical diagnostic processes, visceral pancreatic surgery, and adjuvant medical chemotherapy. The results are well comparable to those of "high volume centers". The responsible heads of the two departments have been trained at university expert centers. Expertise in the treatment of pancreatic cancer patients may be successfully transferred from an expert center to a general hospital, if the team has high expertise. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Orthognathic Surgery

    DEFF Research Database (Denmark)

    Kjærgaard Larsen, Marie; Thygesen, Torben Henrik


    The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence...... on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were...... in beauty than women (P = 0.030). Sixty-four percent replied that their attractiveness had been increased after OS. Eighty-six percent were happy with the results and 89% would recommend the surgery to others in need. No significant differences in esthetic results and satisfaction were seen with regard...

  3. Robotic assisted minimally invasive surgery

    Directory of Open Access Journals (Sweden)

    Palep Jaydeep


    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.

  4.  Evaluation of the reasons for the extraction among patients referred to the Oral Surgery Department,Faculty of Dentistry, Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Ramezanian M.


    Full Text Available Statement of Problem: Tooth extraction is always considered as the final treatment option in dentistry."nConsidering the numerous advances in dentistry, nowadays the preservation of the permanent teeth until old"nage is common. However, in most economically poor countries or those without security service insurance,"nthe high rate of extraction, particularly among restorable teeth, is regrettable."nPurpose: The aim of the present study was to determine the reasons for tooth extraction among patients"nreferred to the faculty of Dentistry, Tehran University of Medical Sciences in 2002."nMaterials and Methods: This descriptive and cross-sectional study was conducted on 320 patients. The"ninformation about patient's general knowledge, oral health status, tooth location and causes of extraction were"ncollected and recorded in a questionnaire. The data were submitted to statistical Chi-Square test."nResults: No statistically significant difference was found between two genders in their mentioned causes for"nextraction. The most prevalent reasons were as follows: Caries (50%, Periodontal diseases (16.6%. Absence"nof an acceptable occlusion, prosthetic problems, patient's request, etc... make up the remaining 33.4% of the"nreasons."nConclusion: According to this study, it is suggested to investigate extraction etiology at the society level and"nif similar results are obtained, necessary steps should be taken to prevent caries and periodontal problems as"nthe major mentioned causes for tooth extraction.

  5. [Geriatric surgery]. (United States)

    Paulino-Netto, Augusto


    Modern medicine, which is evidence-based and overly scientific, has forgotten its artistic component, which is very important for surgery in general and for geriatric surgery in particular. The surgeon treating an old patient must be a politician more than a technician, more an artist than a scientist. Like Leonardo da Vinci, he or she must use scientific knowledge with intelligence and sensitivity, transforming the elderly patient's last days of life into a beautiful and harmonious painting and not into something like an atomic power station which, while no doubt useful, is deprived of beauty and sometimes very dangerous.

  6. [DRG and gastrointestinal surgery]. (United States)

    Leardi, S; Altilia, F; Pietroletti, R; Risetti, A; Schietroma, M; Simi, M


    The diagnosis-related-groups (DRG) is the cost-based system for hospital reimbursement. However, the proceeds does not coincide with the costs. Aim of the study was to identify the profit, which we could gained with 147, 155, 158, 162, 165, 198 gastrointestinal surgery DRG. 30 consecutive patients, undergone to surgery in Clinica Chirurgica of L'Aquila University, had been studied. We had calculated the daily costs of medical and nursing practice, diagnostic tests, drugs, hospitalization, surgical instruments for every patient's therapy. The DRG-proceeds had been correlated with the DRG-costs. The "major gastrointestinal surgery" had not profit (147 DRG: anterior resection of rectum = -354428 Pounds, Miles = -94020 Pounds; 155 DRG: total gastrectomy = -1920641 Pounds). On the contrary, "minimal surgery" had good profits (158 DRG: hemorroidectomy with local anestesia = 1469605 Pounds;162 DRG: sutureless groin hernioplasty = 1561200 Pounds; 198 DRG: videolaparochole-cystectomy: 1208807 Pounds). The study seems to demonstrate the disparity of the reimbursement system related to DRG. However, the surgeons, as managers, must employ warily the resources for producing DRG.


    African Journals Online (AJOL)

    Globally, the entry of female students into medical schools has ... how female registrars perceived the impact of gender on their training and practice of surgery. ... male-dominated specialty, their choice of mentors and the challenges that they encountered ..... Social Determinants of Health2007 (Accessed on 23 Sep 2016).

  8. Determinants of adoption and euthanasia of shelter dogs spayed or neutered in the university of california veterinary student surgery program compared to other shelter dogs. (United States)

    Clevenger, Jaime; Kass, Philip H


    Limited economic resources and pet overpopulation force animals shelters to consider euthanasia of adoptable animals every day. Veterinary medical schools can play a positive role in increasing pet adoption and combating overpopulation by providing free neutering for shelter animals. This retrospective cohort study illustrated that the cooperative efforts of a veterinary medicine surgical teaching program and local animal shelters decreases euthanasia of adoptable pets. At the University of California, Davis (UCD), shelter dogs are neutered by veterinary students and then returned to the shelter for adoption. The rates of adoption and euthanasia of the dogs neutered at UCD were contrasted with a comparison shelter group to determine the effect of pre-adoption neutering. The UCD-neutered dogs had a lower rate of euthanasia than the comparison shelter group at the shelters investigated. At Sacramento County Animal Care and Regulation, 73% of the UCD group but only 36% of the comparison group were adopted. At Yolo County Animal Services, 71% of the UCD group and 45% of the comparison group were adopted. The sex of an animal did not significantly affect the rate of euthanasia. Dogs that were predominantly pit bull, rottweiler, or chow chow breeds had higher rates of euthanasia than other breeds, independent of neuter status. Also, juveniles (less than one year old) had lower rates of euthanasia than adults, independent of neuter status. UCD adult dogs had lower rates of euthanasia than comparison adults. Post-surgical UCD dogs spent a longer average time in the shelter before adoption (15 days at Sacramento; 16 days at Yolo) than the comparison dogs (11 and 12 days, respectively). UCD dogs also spent a longer average time in the shelter before euthanasia (18 and 25 days, respectively) than the comparison dogs (13 days at both shelters). Lower probabilities of euthanasia for behavioral or medical reasons were found for UCD dogs than for the comparison dogs. The

  9. Carotid artery surgery (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 ...

  10. Petrophysical investigations to both Rudeis and Kareem formations, Ras Ghara oil field, Gulf of Suez, Egypt

    Directory of Open Access Journals (Sweden)

    A.A. El-Khadragy


    In this research, Tech-log software is used to evaluate the petrophysical characteristics of the studied formations in the form of litho-saturation plots which are considered as an important vertical representation because they are used for more accurate evaluation in the individual wells in the comparison between different wells.

  11. Impact of Epilepsy Surgery on Motor Performance

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available The impact of epilepsy surgery on motor performance of 37 children (ages 1 month to 15 years with refractory seizures was evaluated at the Wilhelmina University Children's Hospital, Utrecht, The Netherlands.


    Nagayoshi, Kinuko; Mori, Hitomi; Kameda, Chizu; Nakamura, Katsuya; Ueki, Takashi; Tanaka, Masao


    A shortage of surgeons has been a serious problem in recent years. There is an urgent need to utilize female surgeons who tend to resign because of bearing and raising of children. To examine possible measures to deal with the issue, we performed questionnaire survey about work-life balance and career planning on 20 female surgeons in the Department of Surgery and Oncology, Kyushu University. The response rate was 80.0%. In the 16 respondents, seven were unmarried and nine were married. A large fraction of the respondents recognized the importance of work-life-balance. Female surgeons have many difficulties to continue working with good work-life balance; therefore, understanding and cooperation of both their spouses and coworkers is considered to be necessary. Married female surgeons considered that improvement of the working environment and sufficient family support were more important for good work-life balance compared to those who were unmarried. Female surgeons should recognize the importance of improvement of their environment, including the workplace and the family to continue working with good work-life balance in youth and should have the prospects about their career plan of their own.

  13. What Is Refractive Surgery? (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 ...

  14. LASIK - Laser Eye Surgery (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 ...

  15. Pediatric heart surgery (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... the type of defect, and the type of surgery that was done. Many children recover completely and lead normal, active lives.

  16. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ... implant surgery is, of course, surgery, and is best performed by a trained surgeon with specialized education ...

  17. Surgery for Breast Cancer (United States)

    ... Pregnancy Breast Cancer Breast Cancer Treatment Surgery for Breast Cancer Surgery is a common treatment for breast cancer, ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  18. 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 ...

  19. Preparing for Surgery (United States)

    ... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

  20. Refractive corneal surgery - discharge (United States)

    Nearsightedness surgery - discharge; Refractive surgery - discharge; LASIK - discharge; PRK - discharge ... You had refractive corneal surgery to help improve your vision. This surgery uses a laser to reshape your cornea. It corrects mild-to-moderate nearsightedness, ...

  1. Preparing for Surgery (United States)

    ... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

  2. Corrective Jaw Surgery (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  3. Dental Implant Surgery (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  4. Facial Cosmetic Surgery (United States)

    ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  5. Facial Cosmetic Surgery (United States)

    ... 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 ...


    African Journals Online (AJOL)

    Department of Forensic Medicine, University of Pretoria, Pretoria ..... Addiction. 2007;102(3):369–376. 16. Skibin L, Bilban M, Balazic J. Harmful alcohol use of those ... Student. Health Services [homepage on the Internet]. c2015. Available.

  7. [Hand surgery training]. (United States)

    Moutet, F; Haloua, J P


    Training of the hand surgeon HAND SURGEON A CONCEPT: The hand surgeon is supposed to be in charge of all the hand lesions regarding, skeleton, muscles, tendons, nerves and vessels. He has to be able to insure reparation and coverage of all of them. So he is involved in all the structures, which insure integrity and function of the hand. PURPOSE AND WAYS OF TRAINING: To obtain the asked ability, the hand surgeon training has to be global and sustained by two underlying surgical specialities: orthopedic surgery and plastic and reconstructive surgery. From 2000 after many years of dealings, a Right to the Title in Hand Surgery was born. This Right to the Title wants to be the formal recognition of the specific training of the hand surgeon. For the well-recognized ancient hand surgeons they need to be confirmed by one's peers. Now a day the hand surgeon has to satisfy to this specific training: Passed the complete training and exam of the Orthopedic or Plastic surgery board. Spent at least 6 months as resident in the other underlying specialty. Passed a microsurgery examination. Passed one of the four national Hand Surgery diplomas (DIU/Inter-Universitary Diploma). The examinations have been harmonized. A common formation is delivered regarding hand surgery, the way of examination is the same and the formation is 2 years long. The final exam is presented in front of board of examiners where a teacher of one of the other three national diplomas is present. Spent at least 2 years in a formative hand surgery unit, listed by the French College of Hand Surgeons, as senior surgeon. Those requirements are heavy to assume and need a heavy personal involvement. That seems to be necessary to have an ability level as high as possible. Emergency surgery practice is absolutely necessary in this training. All the 17 university formative hand surgery units listed by the French College of Hand Surgeons are members of the FESUM (European Federation of the Emergency Hand Units

  8. Surgery, sterilization and sterility. (United States)

    Green, V W


    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.

  9. [Pressure sore revision surgery]. (United States)

    Dorsche, Karin Marion


    Pressure sores are a major problem for patients as well as society in general. Immobilised patients are especially at risk. This group of patients with pressure sores should be hospitalised to perform surgical revision of the wound and reconstruction using a flap. Such surgery demands extensive postoperative relief of the flap. The University Centre for Wound Healing at Odense University Hospital has tested the effects of a reduction of the formerly recommended relief period from three to two weeks. In this article we report results covering all patients who have undergone surgery and reconstruction of pressure sores during the period from 1st October 2001 to 1st November 2008. The results are divided into two periods: the period before and the period after the introduction of the reduced relief period. A total of 80 patients were included; 34 in the first period and 46 in the second period. We achieved a considerable reduction in median length of stay from 38 to 27 days with no increase in surgical or complication frequency. Furthermore, the share of fully healed remained unchanged. We believe that there is no risk in shortening the immobile postoperative relief phase following reconstruction of pressure wounds in immobilised patients.

  10. The developments and achievements of endoscopic surgery, robotic surgery and function-preserving surgery. (United States)

    Yoshida, Masashi; Furukawa, Toshiharu; Morikawa, Yasuhide; Kitagawa, Yuko; Kitajima, Masaki


    The breakthrough in laparoscopic surgery has been the development of a charge-coupled device camera system and Mouret performing cholecystectomy in 1987. The short-term benefits of laparoscopic surgery are widely accepted and the long-term benefit of less incidence of bowel obstruction can be expected. The important developments have been the articulating instrumentation via new laparoscopic access ports. Since 2007, single-incision laparoscopic surgery has spread all over the world. Not only single-scar but also no-scar operation is a current topic. In 2004, Kalloo reported the flexible transgastric peritoneoscopy as a novel approach to therapeutic interventions. In 2007, Marescaux reported transvaginal cholecystectomy in a patient. The breakthrough in robotic surgery was the development of the da Vinci Surgical System. It was introduced to Keio University Hospital in March 2000. Precision in the surgery will reach a higher level with the use of robotics. In collaboration with the faculty of technology and science, Keio University, the combined master-slave manipulator has been developed. The haptic forceps, which measure the elasticity of organs, have also been developed. The first possible sites of lymphatic metastasis are known as sentinel nodes. Otani reported vagus-sparing segmental gastrectomy under sentinel node navigation. This kind of function-preserving surgery will be performed frequently if the results of the multicenter prospective trial of the dual tracer method are favorable. Indocyanine green fluorescence-guided method using the HyperEye charge-coupled device camera system can be a highly sensitive method without using the radioactive colloid. 'Minimally invasive, function-preserving and precise surgery under sentinel node navigation in community hospital' may be a goal for us.

  11. Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery


    Metin Keskin; Turgut Akgül; Adem Bayraktar; Fatih Dikici; Emre Balık


    Case Report Superior Mesenteric Artery Syndrome: An Infrequent Complication of Scoliosis Surgery Metin Keskin,1 Turgut Akgül,2 Adem Bayraktar,1 Fatih Dikici,2 and Emre BalJk3 1 General Surgery Department, Istanbul Faculty of Medicine, Istanbul University, Capa, Millet Caddesi, 34093 Istanbul, Turkey 2Orthopedic Department, Istanbul Faculty of Medicine, Istanbul University, Capa, Millet Caddesi, 34093 Istanbul, Turkey 3 General Surgery Department, School of Medicine, Koc¸ Uni...

  12. Shoulder Pain After Thoracic Surgery

    DEFF Research Database (Denmark)

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


    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...... 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...... shoulder pain. On postoperative day 4, 19 patients (32%) still suffered shoulder pain, but only 4 patients (7%) had clinically relevant pain. Four patients (8%) still suffered shoulder pain 12 months after surgery. In 26 patients (55%), the shoulder pain was classified as referred versus 21 patients (45...

  13. Impact of implementation of a pediatric surgery fellowship on general surgery resident operative volume. (United States)

    Snyder, Rebecca A; Phillips, Sharon E; Terhune, Kyla P


    The purpose of this study was to determine the impact of the initiation of a pediatric surgery fellowship on general surgery resident operative volume at 1 major academic institution. Retrospective review of operative records obtained from the Accreditation Council for Graduate Medical Education (ACGME) general surgery resident and pediatric surgery fellow case logs. Data collected included number and type of pediatric index cases per year, number of total pediatric surgery cases per year, and number of total cases logged as primary surgeon to date. Vanderbilt University School of Medicine Department of Surgery, which has an accredited general surgery program, finishes 7 chief residents per year during the study period, and instituted a new pediatric surgery fellowship in 2007. Case logs submitted by third and fourth year general surgery residents and first and second year pediatric surgery fellows were studied. The number of pediatric attending surgeons, relative value units (RVUs), and hospital admissions increased from 2003 to 2011. The median number of pediatric index cases performed by a resident decreased after the onset of fellowship from 34 cases to 23.5 cases per year (p pediatric surgery rotation also decreased from 74 to 53 cases per year after onset of the fellowship (p surgery resident index and overall case volume in pediatric surgery. Although operative volume is only 1 measure of surgical educational value, these findings suggest that the addition of surgical fellowships affects the educational experience of general surgery residents. We recommend that residency programs establish goals and calculate any potential impact on general surgery resident case volume before initiating a new surgical fellowship. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  14. [Minimally invasive surgery and robotic surgery: surgery 4.0?]. (United States)

    Feußner, H; Wilhelm, D


    Surgery can only maintain its role in a highly competitive environment if results are continuously improved, accompanied by further reduction of the interventional trauma for patients and with justifiable costs. Significant impulse to achieve this goal was expected from minimally invasive surgery and, in particular, robotic surgery; however, a real breakthrough has not yet been achieved. Accordingly, the new strategic approach of cognitive surgery is required to optimize the provision of surgical treatment. A full scale integration of all modules utilized in the operating room (OR) into a comprehensive network and the development of systems with technical cognition are needed to upgrade the current technical environment passively controlled by the surgeon into an active collaborative support system (surgery 4.0). Only then can the true potential of minimally invasive surgery and robotic surgery be exploited.

  15. Open heart surgery (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.

  16. Bariatric Surgery Procedures (United States)

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by restricting the ... Online Education Directory Search Patient Learning Center Bariatric Surgery ... Surgery Procedures BMI Calculator Childhood and Adolescent Obesity ...

  17. Tennis elbow surgery - discharge (United States)

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed a ...

  18. Plastic Surgery Statistics (United States)

    ... PSN PSEN GRAFT Contact Us News Plastic Surgery Statistics Plastic surgery procedural statistics from the American Society of Plastic Surgeons. Statistics by Year Print 2016 Plastic Surgery Statistics 2015 ...

  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. Who Needs Heart Surgery? (United States)

    ... this page from the NHLBI on Twitter. Who Needs Heart Surgery? Heart surgery is used to treat ... will work with you to decide whether you need heart surgery. A cardiologist specializes in diagnosing and ...

  1. Gastric Sleeve Surgery (United States)

    ... A Week of Healthy Breakfasts Shyness Gastric Sleeve Surgery KidsHealth > For Teens > Gastric Sleeve Surgery Print A ... buying healthy food ) continue Preparing for Gastric Sleeve Surgery Preparing for this major operation takes months of ...

  2. Cavus Foot Surgery (United States)

    ... All Site Content AOFAS / FootCareMD / Treatments Cavus Foot Surgery Page Content What is a cavus foot? A ... problems. What are the goals of cavus foot surgery? The main goal of surgery is to reduce ...

  3. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Do Who We Are News Videos Contact Find a Surgeon What We Do Administration of Anesthesia Administration ... Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more surgeries ...

  4. Laser surgery - skin (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 ...

  5. Smoking and surgery (United States)

    Surgery - quitting smoking; Surgery - quitting tobacco; Wound healing - smoking ... Smokers who have surgery have a higher chance than nonsmokers of blood clots forming in their legs. These clots may travel to and ...

  6. Lung surgery - discharge (United States)

    ... Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - discharge ... milk) for 2 weeks after video-assisted thoracoscopic surgery and 6 to 8 weeks after open surgery. ...

  7. Weight Loss Surgery (Bariatric Surgery) (For Parents) (United States)

    ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... Surgery Types of Surgery Gastric Bypass ... or intestines removed due to ulcers or cancer tended to lose a lot of weight after ...

  8. Diplopia after strabismus surgery. (United States)

    Holgado, Sandra


    The presence of diplopia is an undesirable result following strabismus surgery. There are a variety of scenarios where diplopia exists prior to strabismus surgery, and, after surgery, has either been alleviated or decreased to a magnitude amenable to prism correction. In other cases, the patient does not experience diplopia prior to the strabismus surgery, but there exists a definite risk of diplopia after the surgery. In the current review, I examine the literature to help determine the incidence of diplopia after strabismus surgery.

  9. Single incision laparoscopic surgery

    Institute of Scientific and Technical Information of China (English)

    Arun; Prasad


    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...

  10. Evaluation of the indication for surgical extraction of third molars according to the oral surgeon and the primary care dentist. Experience in the Master of Oral Surgery and Implantology at Barcelona University Dental School


    Fuster Torres, M. Angeles; Gargallo Albiol, Jordi; Berini Aytés, Leonardo; Gay Escoda, Cosme


    Introduction: Third molar extraction is the most frequent procedure in oral surgery. The present study evaluates the indication of third molar extraction as established by the primary care dentist (PCD) and the oral surgeon, and compares the justification for extraction with the principal reason for patient consultation. Patients and method: A descriptive study was made of 319 patients subjected to surgical removal of a third molar in the context of the Master of Oral Surgery and Implantology...

  11. Nutritional deficiencies after bariatric surgery. (United States)

    Bal, Bikram S; Finelli, Frederick C; Shope, Timothy R; Koch, Timothy R


    Lifestyle intervention programmes often produce insufficient weight loss and poor weight loss maintenance. As a result, an increasing number of patients with obesity and related comorbidities undergo bariatric surgery, which includes approaches such as the adjustable gastric band or the 'divided' Roux-en-Y gastric bypass (RYGB). This Review summarizes the current knowledge on nutrient deficiencies that can develop after bariatric surgery and highlights follow-up and treatment options for bariatric surgery patients who develop a micronutrient deficiency. The major macronutrient deficiency after bariatric surgery is protein malnutrition. Deficiencies in micronutrients, which include trace elements, essential minerals, and water-soluble and fat-soluble vitamins, are common before bariatric surgery and often persist postoperatively, despite universal recommendations on multivitamin and mineral supplements. Other disorders, including small intestinal bacterial overgrowth, can promote micronutrient deficiencies, especially in patients with diabetes mellitus. Recognition of the clinical presentations of micronutrient deficiencies is important, both to enable early intervention and to minimize long-term adverse effects. A major clinical concern is the relationship between vitamin D deficiency and the development of metabolic bone diseases, such as osteoporosis or osteomalacia; metabolic bone diseases may explain the increased risk of hip fracture in patients after RYGB. Further studies are required to determine the optimal levels of nutrient supplementation and whether postoperative laboratory monitoring effectively detects nutrient deficiencies. In the absence of such data, clinicians should inquire about and treat symptoms that suggest nutrient deficiencies.

  12. International Conference on Natural Orifice Transluminal Endoscopic Surgery (NOTES) (United States)


    scopic versus open appendectomy: prospective randomized trial. Surg Laparosc Endosc Percutan Tech 9: 187-189 35. Paik PS. Towson JA. Anthone GJ. Ortega...Maxwell4 R. Seifeldin5 1 North Oakland Medical Centers. Surgery Wayne State University United States 2 Caritas Carney Hospital. Internal Medicine...Tufts University School of Medicine United States North Oakland Medical. General Surgery Wayne State University United States 4 North Oakland

  13. Morbidity and mortality of diabetes with surgery

    Directory of Open Access Journals (Sweden)

    L. L. Chuah


    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.

  14. The history of women in surgery. (United States)

    Wirtzfeld, Debrah A


    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.

  15. Notes on surgery and C*-algebras


    Roe, John


    Surgery and Geometric Topology : Proceedings of the conference held at Josai University 17-20 September, 1996 / edited by Andrew Ranicki and Masayuki Yamasaki. 本文データは許諾を得てeditorのHPサイト から複製再利用したものである。

  16. Robot-assisted surgery: applications in urology

    Directory of Open Access Journals (Sweden)

    Mathew C Raynor


    Full Text Available Mathew C Raynor, Raj S PruthiDivision of Urologic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USAAbstract: The past decade has seen a dramatic shift in the surgical management of certain urologic conditions with the advent of a robotic surgical platform. In fact, the surgical management of prostate cancer has seen the most dramatic shift, with the majority of cases now being performed robotically. Technical refinements over the years have led to improved outcomes regarding oncologic and functional results. Recently, robotic surgery has also been utilized for the surgical management of bladder cancer, renal cancer, and other benign conditions. As further experience is gained and longer-term outcomes are realized, robotic surgery will likely play an increasing role in the surgical management of many urologic conditions.Keywords: robot-assisted surgery, robotic surgery, cystectomy, prostatectomy, partial nephrectomy

  17. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... of jaws and teeth. Surgery can improve chewing, speaking and breathing. While the patient's appearance may be dramatically enhanced as a result of their surgery, orthognathic surgery is performed to correct functional problems. Jaw Surgery can have a dramatic effect on ...

  18. Gastric bypass surgery (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 ...

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ...

  20. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  1. University Community

    African Journals Online (AJOL)

    vahQO,com. ABSTRACT. Background: Oral and maxillofacial surgery is a specialty that is expanding its ... KEYWORDS: Perception, Oral, Maxillofacial Surgery. Introduction. Oral and ..... public and professional colleagues need to be properly ...

  2. Oral surgery: part 2. Endodontic surgery. (United States)

    Pop, I


    In the past, the interaction between dentoalveolar surgery and restorative dentistry has been limited to the removal of teeth with pulp and/or periradicular disease or those that were unrestorable. However, with the increasing dental awareness of the population and the retention of teeth into later life, the interaction between dentoalveolar surgery and restorative dentistry is becoming a fundamental aspect of clinical practice. Indeed, endodontic and implant surgery are core activities that facilitate the retention of a functional dentition.

  3. Gynecological endoscopic surgery in Cienfuegos.

    Directory of Open Access Journals (Sweden)

    Alberto Jorge Fernández


    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.

  4. Second eye cataract surgery: perceptions of a population assisted at a university hospital Cirurgia de catarata no segundo olho: percepção de população atendida em Hospital Universitário

    Directory of Open Access Journals (Sweden)

    Amaryllis Avakian


    Full Text Available OBJECTIVE: To identify daily life difficulties perceived by patients suffering from senile cataract before and after second eye cataract surgery. METHODS: Longitudinal prospective study with 84 patients consecutively seen within the framework of the Cataract Project, with visual acuity equal to or higher than 20/30 in the pseudophakic eye, and equal to or lower than 20/40 with the best possible optical correction in the cataractous eye. A questionnaire was applied during an interview. RESULTS: Before surgery, 60.7% complained about visual impairment (moderate or marked; after surgery, 92.8% had no difficulty. Routine activities, mobility, and leisure activities were significantly altered after surgery (P =.001. CONCLUSION: According to the patients' perceptions, there was a significant reduction in visual difficulties after second eye cataract surgery.OBJETIVO: Identificar dificuldades na vida diária percebidas por pacientes com catarata senil, antes e após a cirurgia de catarata no segundo olho. MÉTODOS: Estudo longitudinal prospectivo de 84 pacientes consecutivos atendidos por "Projeto Catarata", com acuidade visual maior ou igual a 20/30 no olho pseudofácico e menor ou igual a 20/40 with the best possible optical correction no olho com catarata. Aplicou-se questionário por entrevista. RESULTADOS: Antes da cirurgia 60,7% declararam dificuldade visual (média ou muita; após, 92,8% nenhuma dificuldade. Atividades rotineiras, de mobilidade e lazer alteraram-se significativamente após a cirurgia (p= 0,001. CONCLUSÃO: Na percepção dos pacientes, após a cirurgia de catarata do segundo olho houve redução importante das dificuldades visuais.

  5. Perioperative visual loss in ocular and nonocular surgery

    Directory of Open Access Journals (Sweden)

    Kathleen T Berg


    Full Text Available Kathleen T Berg, Andrew R Harrison, Michael S LeeDepartment of Ophthalmology, University of Minnesota, Minneapolis, MN, USAAbstract: Incidence estimates for perioperative vision loss (POVL after nonocular surgery range from 0.013% for all surgeries up to 0.2% following spine surgery. The most common neuro-ophthalmologic causes of POVL are the ischemic optic neuropathies (ION, either anterior (AION or posterior (PION. We identified 111 case reports of AION following nonocular surgery in the literature, with most occurring after cardiac surgery, and 165 case reports of PION following nonocular surgery, with most occurring after spine surgery or radical neck dissection. There were an additional 526 cases of ION that did not specify if the diagnosis was AION or PION. We also identified 933 case reports of central retinal artery occlusion (CRAO, 33 cases of pituitary apoplexy, and 245 cases of cortical blindness following nonocular surgery. The incidence of POVL following ocular surgery appears to be much lower than that seen following nonocular surgery. We identified five cases in the literature of direct optic nerve trauma, 47 cases of AION, and five cases of PION following ocular surgery. The specific pathogenesis and risk factors underlying these neuro-ophthalmic complications remain unknown, and physicians should be alert to the potential for loss of vision in the postoperative period.Keywords: perioperative, postoperative, vision loss, ocular surgery, nonocular surgery

  6. Infections in outpatient surgery. (United States)

    Nazarian Mobin, Sheila S; Keyes, Geoffrey R; Singer, Robert; Yates, James; Thompson, Dennis


    In the plastic surgery patient population, outpatient surgery is cost effective and will continue to grow as the preferred arena for performing surgery in healthy patients. Although there is a widespread myth that outpatient surgery centers may suffer from increased infection rates due to lax infection control, the data presented from American Association for Accreditation of Ambulatory Surgery Facilities-accredited facilities prove the contrary. There is a lack of data investigating infection prevention in the perioperative period in plastic surgery patients. As data collection becomes more refined, tracking the postoperative care environment should offer additional opportunities to lower the incidence of postoperative infections.

  7. [Thymus surgery in a general surgery department]. (United States)

    Mega, Raquel; Coelho, Fátima; Pimentel, Teresa; Ribero, Rui; Matos, Novo de; Araújo, António


    Evaluation of thymectomy cases between 1990-2003, in a General Surgery Department. Evaluation of the therapeutic efficacy in Miastenia Gravis patients. Retrospective study based on evaluation of data from Serviço de Cirurgia, Neurologia and Consult de Neurology processes, between 1990-2003, of 15 patients submitted to total thymectomy. 15 patients, aged 17 to 72, 11 female and 4 male. Miastenia Gravis was the main indication for surgery, for uncontrollable symptoms or suspicion of thymoma. In patients with myasthenia, surgery was accomplish after compensation of symptoms. There weren't post-surgery complications. Pathology were divided in thymic hyperplasia and thymoma. Miastenia patients have there symptoms diminished or stable with reduction or cessation of medical therapy. Miastenia was the most frequent indication for thymectomy. Surgery was good results, with low morbimortality, as long as the protocols are respected.

  8. Short- and long-term outcomes of laparoscopic surgery vs open surgery for transverse colon cancer: a retrospective multicenter study

    Directory of Open Access Journals (Sweden)

    Kim JW


    Full Text Available Jong Wan Kim,1 Jeong Yeon Kim,1 Byung Mo Kang,2 Bong Hwa Lee,3 Byung Chun Kim,4 Jun Ho Park5 1Department of Surgery, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong Si, 2Department of Surgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon Si, 3Department of Surgery, Hallym Sacred Heart Hospital, College of Medicine, Hallym University, Anyang Si, 4Department of Surgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, 5Department of Surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Republic of Korea Purpose: The purpose of the present study was to compare the perioperative and oncologic outcomes between laparoscopic surgery and open surgery for transverse colon cancer.Patients and methods: We conducted a retrospective review of patients who underwent surgery for transverse colon cancer at six Hallym University-affiliated hospitals between January 2005 and June 2015. The perioperative outcomes and oncologic outcomes were compared between laparoscopic and open surgery.Results: Of 226 patients with transverse colon cancer, 103 underwent laparoscopic surgery and 123 underwent open surgery. There were no differences in the patient characteristics between the two groups. Regarding perioperative outcomes, the operation time was significantly longer in the laparoscopic group than in the open group (267.3 vs 172.7 minutes, P<0.001, but the time to soft food intake (6.0 vs 6.6 days, P=0.036 and the postoperative hospital stay (13.7 vs 15.7 days, P=0.018 were shorter in the laparoscopic group. The number of harvested lymph nodes was lower in the laparoscopic group than in the open group (20.3 vs 24.3, P<0.001. The 5-year overall survival (90.8% vs 88.6%, P=0.540 and disease-free survival (86.1% vs 78.9%, P=0.201 rates were similar in both groups.Conclusion: The present study showed that laparoscopic surgery is associated

  9. Bariatric Surgery Procedures (United States)

    ... Center Access to Care Toolkit EHB Access Toolkit Bariatric Surgery Procedures Bariatric surgical procedures cause weight loss by ... Bariatric procedures also often cause hormonal changes. Most weight loss surgeries today are performed using minimally invasive techniques (laparoscopic ...

  10. Complications of Sinus Surgery (United States)

    ... further intracranial surgeries. Impaired sense of taste or smell : The sense of smell usually improves after the procedure because airflow is ... in their voice after sinus surgery. Impairment of smell or taste: (see above) Infection: The most common ...

  11. Bariatric Surgery Misconceptions (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 ...

  12. Pediatric heart surgery - discharge (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  13. Breast Reduction Surgery (United States)

    ... breastfeeding: A systematic review. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2010;63:1688. Kerrigan CL, et al. Evidence-based medicine: Reduction mammoplasty. Plastic and Reconstructive Surgery. 2013;132: ...

  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. Weight Loss Surgery (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 ...

  16. Ear Plastic Surgery (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information ... they may improve appearance and self-confidence. Can Ear Deformities Be Corrected? Formation of the ear during ...

  17. Scoliosis surgery - child (United States)

    ... this page: // Scoliosis surgery - child To use the sharing features on this page, please enable JavaScript. Scoliosis surgery repairs abnormal curving of the spine ( scoliosis ). ...

  18. Cosmetic breast surgery - discharge (United States)

    ... this page: // Cosmetic breast surgery - discharge To use the sharing features on this page, please enable JavaScript. You had cosmetic breast surgery to change the size or shape ...

  19. LASIK Eye Surgery (United States)

    ... are nearsighted. You may need another refractive surgery (enhancement surgery) within a year to remove more tissue. ... may happen due to certain conditions, such as abnormal wound healing, hormonal imbalances or pregnancy. Visual loss ...

  20. Laparoscopic Spine Surgery (United States)

    ... Exhibit Opportunities Sponsorship Opportunities Log In Laparoscopic Spine Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Laparoscopic Spine Surgery Your spine surgeon has determined that you need ...

  1. Types of Heart Surgery (United States)

    ... from the NHLBI on Twitter. Types of Heart Surgery Coronary Artery Bypass Grafting Coronary artery bypass grafting ( ... TAHs) might be used to treat these patients. Surgery To Place Ventricular Assist Devices or Total Artificial ...

  2. Cosmetic ear surgery (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 ...

  3. Hip fracture surgery (United States)

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

  4. Surgery for Testicular Cancer (United States)

    ... Stage Testicular Cancer Treating Testicular Cancer Surgery for Testicular Cancer Surgery is typically the first treatment for all ... Testicular Cancer, by Type and Stage More In Testicular Cancer About Testicular Cancer Causes, Risk Factors, and Prevention ...

  5. Heart valve surgery (United States)

    ... Tricuspid valve stenosis Risks The risks of having cardiac surgery include: Death Heart attack Heart failure Bleeding requiring ... and the A.D.A.M. Editorial team. Heart Surgery Read more Heart Valve Diseases Read more Latest ...

  6. Otoplasty (Cosmetic Ear Surgery) (United States)

    ... By Mayo Clinic Staff Otoplasty — also known as cosmetic ear surgery — is a procedure to change the ... Society of Plastic Surgeons. Accessed June 16, 2015. ...

  7. 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, ...

  8. Risk factors for treatment failure in surgery for primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Madsen, Anders Rørbæk; Rasmussen, Lars; Godballe, Christian


    Surgery for primary hyperparathyroidism (pHPT) has a high cure-rate and few complications. Preoperative localization procedures have permitted a dramatic shift from routine bilateral exploration to focused, minimally invasive procedures. At Odense University Hospital, Denmark, the introduction...

  9. Laparoscopic surgery of ovarian cyst in comparison with laparotomy ...

    African Journals Online (AJOL)

    Laparoscopic surgery of ovarian cyst in comparison with laparotomy at university hospital of Brazzaville. ... Open Access DOWNLOAD FULL TEXT ... The average age of patients was 32.2 years versus 33 years in laparoscopy to laparotomy.

  10. Fertility after conservative and radical surgery for tubal pregnancy

    NARCIS (Netherlands)

    Mol, BWJ; Matthijsse, HC; Tinga, DJ; Huynh, T; Hajenius, PJ; Ankum, WM; Bossuyt, PMM; van der Veen, F


    A retrospective cohort study was set up to evaluate the effectiveness of conservative and radical surgery for tubal pregnancy towards subsequent fertility. Consecutive patients undergoing conservative or radical surgery for tubal pregnancy between January 1990 and August 1993 in two university hospi

  11. Two years of experience with robot-assisted anti-reflux surgery

    DEFF Research Database (Denmark)

    Sanberg Jensen, Jonas; Kold Antonsen, Henning; Durup, Jesper


    Background and aims Robot-assisted anti-reflux surgery (RAAS) is an alternative to conventional laparoscopic anti-reflux surgery (CLAS). The purpose of this study was to evaluate initial Danish experiences with robot-assisted anti-reflux surgery compared to conventional laparoscopic anti...... no particular advantages to performing antireflux surgery as robot-assisted procedures neither intra-operatively nor at follow-up.......-reflux surgery incorporating follow-up and evaluation of possible learning curve. Material and methods Patients undergoing primary RAAS or CLAS at The Department of Surgery A, Odense University Hospital and The Department of General Surgery, Kolding Hospital from April 2013 to April 2015 was included...

  12. Cardiac surgery using a single thoracic port—current status and future directions (United States)

    Guerra, Nuno Carvalho; Gonzalez-Rivas, Diego; Carvalheiro, Catarina; Ferreira, Hugo; Sena, André; Junqueira, Nádia; Velho, Tiago Rodrigues; Nobre, Ângelo


    Cardiac surgery is almost universally performed through a median sternotomy, an approach which is painful, unestethical, and prone to life-threatening infections. Minimally invasive cardiac surgery has tried to avoid problems associated with full sternotomy for many years. Recently, uniportal thoracic surgery was shown to be very advantageous when compared to standard thoracotomy and classical video assisted thoracic surgery (VATS). Despite very good results in lung surgery, cardiac surgery through a single thoracic port has rarely been attempted and successfully conducted. The authors present the rational, the technique, and their experience in cardiac single thoracic port surgery (CSTPS). PMID:28523134

  13. Validation of open-surgery VR trainer

    NARCIS (Netherlands)

    Sanders, A.J.B.; Luursema, J.M.; Warntjes, P.; Mastboom, W.J.B.; Geelkerken, R.H.; Klaase, J.M.; Rödel, S.G.J.; ten Cate Hoedemaker, H.O.; Kommers, P.A.M.; Verwey, W.B.; Kunst, E.E.; Westwood, James D.


    VREST (Virtual Reality Educational Surgical Tools) is developing a universal and autonomous simulation platform which can be used for training and assessment of medical students and for continuing education of physicians. With the VREST - Virtual Lichtenstein Trainer, simulating the open surgery

  14. Validation of open-surgery VR trainer

    NARCIS (Netherlands)

    Sanders, A.J.B.; Luursema, J.-M.; Warntjes, P.; Mastboom, W.J.B.; Geelkerken, R.H.; Klaase, J.M.; Rodel, S.G.J.; Cate Hoedemaker, ten H.O.; Kommers, P.A.M.; Verwey, W.B.; Kunst, E.E.; Westwood, J.D.


    VREST (Virtual Reality Educational Surgical Tools) is developing a universal and autonomous simulation platform which can be used for training and assessment of medical students and for continuing education of physicians. With the VREST - Virtual Lichtenstein Trainer, simulating the open surgery pro

  15. Breast Cancer Surgery (United States)

    FACTS FOR LIFE Breast Cancer Surgery The goal of breast cancer surgery is to remove the whole tumor from the breast. Some lymph nodes ... might still be in the body. Types of breast cancer surgery There are two types of breast cancer ...

  16. Perioperative management of facial bipartition surgery

    Directory of Open Access Journals (Sweden)

    Caruselli M


    Full Text Available Marco Caruselli,1 Michael Tsapis,1,2 Fabrice Ughetto,1 Gregoire Pech-Gourg,3 Dario Galante,4 Olivier Paut1 1Anesthesia and Intensive Care Unit, La Timone Children’s Hospital, 2Pediatric Transport Team, SAMU 13, La Timone Hospital, 3Pediatric Neurosurgery Unit, La Timone Children’s Hospital, Marseille, France; 4Anesthesia and Intensive Care Unit, University Hospital Ospedali Riuniti of Foggia, Foggia, Italy Abstract: Severe craniofacial malformations, such as Crouzon, Apert, Saethre-Chotzen, and Pfeiffer syndromes, are very rare conditions (one in 50,000/100,000 live births that often require corrective surgery. Facial bipartition is the more radical corrective surgery. It is a high-risk intervention and needs complex perioperative management and a multidisciplinary approach. Keywords: craniofacial surgery, facial bipartition surgery, craniofacial malformations, pediatric anesthesia

  17. Short convalescence after vaginal prolapse surgery

    DEFF Research Database (Denmark)

    Ottesen, Marianne; Sørensen, Mette; Kehlet, Henrik


    OBJECTIVE: Retrospectively to describe the recommended convalescence according to patients who had undergone vaginal prolapse surgery in 1996-98, and prospectively to describe the need for and limiting factors for convalescence after vaginal prolapse surgery in 1999-2000 at a Danish University...... Hospital. METHODS: The retrospective study included a validated, postal, questionnaire and review of patient files. In the prospective study, we followed consecutive women after vaginal surgery in a fast-track setting using a multimodal rehabilitation model with well-defined recommendations...... exceeding 10 kg. Limiting factors were fatigue and pain. The 1-year subjective recurrence rate was 17%. CONCLUSION: Traditionally, recommended convalescence has been median 6 weeks after vaginal prolapse surgery. Convalescence has been shortened to 1-3 weeks with a multimodal rehabilitation model...

  18. Cortisol levels and sleep patterns in infants with orofacial clefts undergoing surgery


    Mueller AA; Kalak N; Schwenzer-Zimmerer K; Holsboer-Trachsler E; Br; De, S.


    Andreas A Mueller,1,2 Nadeem Kalak,3 Katja Schwenzer-Zimmerer,1,2 Edith Holsboer-Trachsler,3 Serge Brand3,4 1Craniomaxillofacial Surgery, University of Basel and University Hospital of Basel, Basel, Switzerland; 2Hightech Research Center of Craniomaxillofacial Surgery, University of Basel, Basel, Switzerland; 3Psychiatric Clinics of the University of Basel, Center for Affective, Stress, and Sleep Disorders, Basel, Switzerland; 4Department of Sport and Health Science, Division of Sport Scienc...


    Directory of Open Access Journals (Sweden)

    Mojca Globočnik-Petrovič


    Full Text Available Background. Vitreoretinal surgery is the second most frequent surgery after cataract extraction. It is indicated in the treatment of various vitreous and retinal disorders such as diabetic retinopathy, proliferative vitreoretinopathy, endophthalmitis, penetrating and perforating injuries of the eye. 400 vitreoretinal operations were done in University Eye Clinic in Ljubljana last year which is three times more like years ago. Almost third of all vitreoretinal operations were done on patients with diabetic retinopathy, 22% on patients with proliferative vitreoretinopathy, 10% on traumatic eyes and 14% were reoperations. Remaining 28% of operations were done on eyes with different diagnoses such as macular diseases, retinal detachment, haematovitreus, endophthalmitis and dropped nucleus.During vitrectomy, vitreous opacities are excised and abnormal structural changes above and beneath the retina can be removed. Depending on the type of retinal disease different types of vitreous cavity tamponade such as silicone oil, gas or intraocular saline are used.Conclusions. Improved knowledge of the pathohistology of abnormal vitreoretinal structural changes and new surgical techniques have resulted in improved anatomical and visual results of vitreoretinal surgery. The list of indications has expanded and some macular diseases which were untreatable a few years ago can now be routinely operated with good results.

  20. Eye surgery in the elderly

    Directory of Open Access Journals (Sweden)

    Raczyńska D


    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

  1. Development of plastic surgery

    Directory of Open Access Journals (Sweden)

    Pećanac Marija Đ.


    Full Text Available 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 caused by war mutilation, punishment or humiliation. In the Middle Ages, the development of all medical braches, including plastic surgery was hindered. New age. The interest in surgical reconstruction of mutilated body parts was renewed in the XVIII century by a great number of enthusiastic and charismatic surgeons, who mastered surgical disciplines and became true artists that created new forms. Modern Era. In the XX century, plastic surgery developed as a modern branch in medicine including many types of reconstructive surgery, hand, head and neck surgery, microsurgery and replantation, treatment of burns and their sequelae, and esthetic surgery. Contemporary and future plastic surgery will continue to evolve and improve with regenerative medicine and tissue engineering resulting in a lot of benefits to be gained by patients in reconstruction after body trauma, oncology amputation, and for congenital disfigurement and dysfunction.

  2. Laparoscopic surgery for complicated diverticular disease: a single-centre experience.

    LENUS (Irish Health Repository)

    Royds, J


    The role of laparoscopic surgery in the management of patients with diverticular disease is still not universally accepted. The aim of our study was to evaluate the results of laparoscopic surgery for diverticular disease in a centre with a specialist interest in minimally invasive surgery.

  3. The first American textbook of surgery. (United States)

    Smythe, W Roy


    The first systematic textbook of surgery written in the United States, The Elements of Surgery, was completed in 1813 by John Syng Dorsey, a University of Pennsylvania surgeon. The work thoroughly covered all major clinical areas of surgery of that time in a two-volume, 797-page text. Subsequent editions were published in 1818, 1823, and 1831. It became the standard surgical textbook in this country during that era and was the first American medical text exported abroad for use at the more established European centers of medical education. The reasons for writing the text included a desire to put into print the teachings of Philip Syng Physick (first Chair of the Department of Surgery at the University of Pennsylvania, and Dorsey's uncle), the new American nationalism, and socioeconomic pressures forced on the American publishing industry by the War of 1812 and preceding trade embargoes. In addition to extensive exposure to Physick, Dorsey was also uniquely qualified to write and illustrate this text, as he exhibited an unusually succinct style and was a remarkable medical artist. The book was the forerunner to William Gibson's The Institutes and Practice of Surgery and all American surgical textbooks to follow.

  4. Universal Usability (United States)

    Horton, Sarah; Leventhal, Laura

    Universal usability of World Wide Web (Web) environments—that is, having 90% of households as successful users—requires universal access, usability, and universal design. Factors such as Web technology and user-centered design contribute to universal access and usability, but key to universal usability is a universal design methodology. Universal design principles for the Web follow from universal design principles for the built environment, and emphasize perceptibility, self-explanation, and tailorability for the user. Universally usable Web environments offer the benefit of expanded participation, as well as the unanticipated benefits that generally follow from innovative design initiatives. However, to achieve Web universal usability, Web designers need tools that facilitate the design of intuitive interfaces without sacrificing universal access.

  5. Clinical innovations in Philippine thoracic surgery. (United States)

    Danguilan, Jose Luis J


    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.

  6. Ergonomics in Laparoscopic Surgery


    Supe Avinash; Kulkarni Gaurav; Supe Pradnya


    Laparoscopic surgery provides patients with less painful surgery but is more demanding for the surgeon. The increased technological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparoscopic surgery. Ergonomic integration and suitable laparoscopic operating room environment are essential to improve efficiency, safety, and comfort for the operating team. Understanding ergonomics can not only make life of surgeon comf...

  7. Ergonomics in laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Supe Avinash


    Full Text Available Laparoscopic surgery provides patients with less painful surgery but is more demanding for the surgeon. The increased technological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparoscopic surgery. Ergonomic integration and suitable laparoscopic operating room environment are essential to improve efficiency, safety, and comfort for the operating team. Understanding ergonomics can not only make life of surgeon comfortable in the operating room but also reduce physical strains on surgeon.

  8. General surgery career resource. (United States)

    Parsee, Ana M; Ross, Sharona B; Gantt, Nancy L; Kichler, Kandace; Hollands, Celeste


    General surgery residency training can lead to a rewarding career in general surgery and serve as the foundation for careers in several surgical subspecialties. It offers broad-based training with exposure to the cognitive and technical aspects of several surgical specialties and prepares graduating residents for a wide range of career paths. This career development resource discusses the training aspects of general surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Bariatric surgery for obesity and diabetes. (United States)

    Azizi, Fereidoun


    With the imminent threat of a global health crisis of obesity and diabetes or "diabesity" as it is referred to today, healthcare professionals urgently need an effective range of treatment options for management of these two epidemics. After many decades in obscurity, bariatric surgery has emerged as an impressive treatment of obesity and type 2 diabetes. The field of bariatric surgery has seen a rapid evolution over the last 30 years and current procedures are safe, effective, less invasive, and relatively cost- effective. Bariatric procedures produce durable weight loss, long -term remission of type 2 diabetes, and beneficial effects on other comorbidities; they lead to a significant reduction in mortality in the long term. The adverse events after surgery are not uncommon but in majority of cases are not fatal. Bariatric surgery is costly, but cost-efficacy analysis consistently shows that the additional years of lives gained through bariatric surgery can be obtained at a reasonable and affordable cost. However, universal surgical treatment of obesity is not achievable with the world's current healthcare and surgical resources. The conclusion of this review is that although bariatric surgery is a good addition to management of obesity and diabetes, these epidemics must be addressed by more comprehensive and long-term health policy efforts and appropriate research to determine the most effective ways of prevention and nonsurgical alternatives to treat obesity and type 2 diabetes.

  10. [Crohn's disease surgery]. (United States)

    Kala, Zdeněk; Marek, Filip; Válek, Vlastimil A; Bartušek, Daniel


    Surgery of Crohns disease is an important part of the general treatment algorithm. The role of surgery is changing with the development of conservative procedures. The recent years have seen the return to early treatment of patients with Crohns disease. Given the character of the disease and its intestinal symptoms, a specific approach to these patients is necessary, especially regarding the correct choice of surgery. The paper focuses on the luminal damage of the small and large intestine including complications of the disease. We describe the individual indications for a surgical solution, including the choice of anastomosis or multiple / repeated surgeries.

  11. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

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


    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....

  12. Hyperoxaluria and Bariatric Surgery (United States)

    Asplin, John R.


    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.

  13. Complications of strabismus surgery

    Directory of Open Access Journals (Sweden)

    Scott E Olitsky


    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.

  14. Surgery center joint ventures. (United States)

    Zasa, R J


    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.

  15. Complicações respiratórias no pós-operatório de cirurgias eletivas e de urgência e emergência em um hospital universitário Postoperative respiratory complications from elective and urgent/emergency surgery performed at a university hospital

    Directory of Open Access Journals (Sweden)

    Luiz Joia Neto


    determine any correlations between respiratory complications and potential risk factors. METHOD: A retrospective cohort study of patients submitted to elective or urgent/emergency surgery at a university hospital during 2001. The sample was restricted to patients hospitalized for at least 24 hours following surgery. Data were collected from patient charts and according to protocol. RESULTS: Of the 5075 patients submitted to elective or urgent/emergency surgery during the year 2001, 1345 (25.5% were included in the study. There was no statistically significant difference between elective surgery and urgent/emergency surgery in terms of respiratory complications. The incidence of respiratory complications was 11.7%. The most frequent complication (at 52.5% was pneumonia. Overall mortality was 7.2% and 27.8% of deaths were related to respiratory complications. CONCLUSION: The incidence of postoperative respiratory complications was 11.7% (11.3% in elective surgery and 12.3% in urgent/emergency surgery. Pneumonia was the most frequent complication. The risk factors that correlated with respiratory complications were previous lung disease, use of a nasogastric tube, admission to the intensive care unit, endotracheal intubation and tracheostomy.

  16. Less extensive surgery compared to extensive surgery

    DEFF Research Database (Denmark)

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


    OBJECTIVE: To describe the outcome of adult granulosa cell tumor (AGCT) with respect to initial clinical findings, methods of surgery, and perioperative treatment. STUDY DESIGN: Retrospective follow-up study. Setting: All hospitals in Jutland. Sample: 163 women diagnosed with AGCT. Methods: Follow......-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...... in postmenopausal women was associated with surgery including hysterectomy and bilateral oophorectomy (psurgery. Endometrial carcinoma was found 138 times (95% CI: 48, 275) more prevalent than the expected rate. CONCLUSION...

  17. [Haemorrhage after thyroid surgery]. (United States)

    Swirta, Jarosław S; Barczyński, Marcin


    Haemorrhage after thyroid surgery is rare, but if it occurs it is a life-threatening condition necessitating emergency surgery. The aim of this study was to evaluate prevalence and risk factors of haemorrhage after thyroid surgery. A retrospective analysis was undertaken in a group of 8931 consecutive patients with various thyroid diseases treated in 2004-2013 at our institution. Potential risk factors for postoperative haemorrhage after thyroid surgery were analysed using logistic regression model. Haemorrhage after thyroid operation necessitating emergency surgery occurred in 40 (0.45%) of 8931 patients. None of the patients died within the perioperative period. Bleeding occurred within first 24 hours following surgery in 38 (95%) patients, and in the remaining 2 (5%) patients in more than 24 hours after initial surgery. The following risk factors for bleeding after thyroid operation were identified: male sex (OR 3.618; 1.762-7.430; p or = 70 years (OR 3.052; 1.275-7.304; p = 0.012), surgery for hyperthyroidism (OR 2.873; 1.511-5.462; p = 0.001), smoking (OR 2.855; 1.502-5.428; p = 0.001), subtotal thyroidectomy in contrast to total thyroidectomy or lobectomy (OR 2.853; 1.356-6.004; p=0.006), and thyroid operation undertaken by resident in training in general surgery (OR 2.596; 1.393-4.837; p = 0.003). Haemorrhage after thyroid operation necessitating emergency surgical intervention occurs most frequently within first 24 hour following surgery. Hence, for safety reasons a minimum of 24-hour hospital stay is recommended in all patients with risk factors for postoperative bleeding after thyroid operation. Quality monitoring of thyroid surgery should include also risk factors for postoperative bleeding.

  18. Socioeconomic status influences time to surgery and surgical outcome in pediatric epilepsy surgery. (United States)

    Rubinger, Luc; Chan, Carol; Andrade, Danielle; Go, Cristina; Smith, Mary Lou; Snead, O Carter; Rutka, James T; Widjaja, Elysa


    The aims of this study were to evaluate the influence of socioeconomic status (SES) on time-to-surgery (TTS) and surgical outcome in children with treatment-resistant epilepsy in a universal health care system. The cohort consisted of children who had undergone resective epilepsy surgery between 2001 and 2013 in Canada. The patients' postal codes were linked to Statistics Canada National Household Survey data to obtain dissemination area income, which was used to infer SES. Time-to-surgery was defined as the interval from date of epilepsy onset to date of surgery. Seizure outcome was classified using ILAE classification. The associations between SES and TTS, as well as SES and surgical outcome, were assessed. Two hundred eighty-four children who had epilepsy surgery were included. Patients in the lowest income quintile had a significantly higher TTS relative to the highest income quintile (β=0.121, p=0.044). There were no significant associations between income quintiles and seizure-free surgical outcome (odds ratio (OR)=0.746-1.494, all p>0.05). However, patients in the lowest income quintile had a significantly lower odds of an improvement in seizure frequency relative to the highest income quintile (OR=0.262, p=0.046). The TTS was not uniform across SES in spite of the existence of a universal health care system. This finding highlights the need to address social and economic barriers for epilepsy surgery to improve access to this potentially curative treatment. Those with lower SES had lower likelihood of improvement in seizure control following epilepsy surgery and may require additional support including social and financial support to mitigate the discrepancies in seizure control following surgery between SES levels.

  19. [Robotic surgery in gynecology]. (United States)

    Csorba, Roland


    Minimally invasive surgery has revolutionized gynecological interventions over the past 30 years. The introduction of the da Vinci robotic surgery in 2005 has resulted in large changes in surgical management. The robotic platform allows less experienced laparoscopic surgeons to perform more complex procedures. It can be utilized mainly in general gynecology and reproductive gynecology. The robot is being increasingly used for procedures such as hysterectomy, myomectomy, adnexal surgery, and tubal anastomosis. In urogynecology, the robot is being utilized for sacrocolopexy as well. In the field of gynecologic oncology, the robot is being increasingly used for hysterectomy and lymphadenectomy in oncologic diseases. Despite the rapid and widespread adaption of robotic surgery in gynecology, there are no randomized trials comparing its efficacy and safety to other traditional surgical approaches. This article presents the development, technical aspects and indications of robotic surgery in gynecology, based on the previously published reviews. Robotic surgery can be highly advantageous with the right amount of training, along with appropriate patient selection. Patients will have less blood loss, less post-operative pain, faster recovery, and fewer complications compared to open surgery and laparoscopy. However, until larger randomized control trials are completed which report long-term outcomes, robotic surgery cannot be stated to have priority over other surgical methods.

  20. Contemporary endodontic surgery. (United States)

    Rubinstein, Richard; Torabinejad, Mahmoud


    During the past decade, endodontics has seen a dramatic shift in the application of periradicular surgery and the role it plays in endodontic treatment. With the introduction of enhanced magnification, periradicular ultrasonics and other associative technologies, teeth that might otherwise be extracted now have a chance for retention. This article describes the role of these advances in contemporary endodontic surgery.

  1. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... functional problems. Jaw Surgery can have a dramatic effect on many aspects of life. Following are some of the conditions that may indicate the need for corrective jaw surgery: Difficulty chewing, or biting food Difficulty swallowing Chronic jaw or jaw joint (TMJ) ...

  2. Coronary Artery Bypass Surgery (United States)

    In coronary artery disease (CAD), the arteries that supply blood and oxygen to your heart muscle grow hardened and narrowed. You may try ... these treatments don't help, you may need coronary artery bypass surgery. The surgery creates a new ...

  3. [Cognitive deterioration after surgery

    DEFF Research Database (Denmark)

    Steinmetz, J.; Rasmussen, L.S.


    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...

  4. 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 We Are News Videos Contact Find a Surgeon What We ... may require one or more surgeries depending on the extent of the repair needed. Click here to ...

  5. Cancelamento de cirurgias programadas em um hospital-escola: um estudo exploratório La cancelación de cirugías programadas en un hospital-escuela: un estudio exploratorio Cancellation of scheduled surgeries in a university hospital: an exploratory study

    Directory of Open Access Journals (Sweden)

    Jacqueline Borges Cavalcante


    seleccionados y sometidos a la cirugía en el periodo de septiembre a diciembre de 1996. Se analizaron los datos cuantitativamente y se presentaron en tablas. Los resultados demuestran que de las 1.145 cirugías programadas en el periodo seleccionado, 379 (33% fueron suspendidas. Los servicios afectados fueron: Cirugía General, Oftalmología, Cirugía de Cabeza y Cuello, Traumatología y Ortopedia, Otorrinolaringología, Nefrología y Trasplante Renal, y Proctología. Se hacen necesarias investigaciones en esta área para saber las razones que determinaron la cancelación de esas cirugías, así como la participación de enfermería en el estudio de esta problemática.In spite of the extensive available literature on surgery patients' preparation and on the performance of surgeries, the focus given to the cancellation of the surgical act has been quite restricted. This study aims at identifying the number of scheduled and cancelled surgeries as well as the services that are mostly affected by such cancellations and was carried out in the surgery service of a big public university hospital located in the metropolitan area of Fortaleza, Ceará. The data were collected through surgery registration books, daily maps of surgery schedules and from the files of patients scheduled for surgery from September to December, 1996. The gathered data were analyzed quantitatively and introduced in charts. The results demonstrate that from the 1,145 surgeries programmed in the selected period, 379 (33% had been cancelled. The mostly prejudiced services were General Surgery, Ophthalmology, Head and Neck Surgery, Trauma and Orthopedics, Otorhinolaryngology, Nephrology and Renal Transplant, and Proctology. Further investigation in this area in order to know the determinant causes of surgery cancellation as well as the participation of nursing in the study of this problem are necessary.


    SIQUEIRA-BATISTA, Rodrigo; SOUZA, Camila Ribeiro; MAIA, Polyana Mendes; SIQUEIRA, Sávio Lana


    ABSTRACT Introduction: The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. Objective: To present review of the ethical aspects of robot use in surgery. Method: Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Results: Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains brief presentation on robotics, its inclusion in health and bioethical aspects, and the use of robots in surgery. Conclusion: Robotic surgery is a reality today in many hospitals, which makes essential bioethical reflection on the relationship between health professionals, automata and patients. PMID:28076489

  7. Best Practices for Robotic Surgery Programs. (United States)

    Estes, Stephanie J; Goldenberg, David; Winder, Joshua S; Juza, Ryan M; Lyn-Sue, Jerome R


    Robotic surgical programs are increasing in number. Efficient methods by which to monitor and evaluate robotic surgery teams are needed. Best practices for an academic university medical center were created and instituted in 2009 and continue to the present. These practices have led to programmatic development that has resulted in a process that effectively monitors leadership team members; attending, resident, fellow, and staff training; credentialing; safety metrics; efficiency; and case volume recommendations. Guidelines for hospitals and robotic directors that can be applied to one's own robotic surgical services are included with examples of management of all aspects of a multispecialty robotic surgery program. The use of these best practices will ensure a robotic surgery program that is successful and well positioned for a safe and productive environment for current clinical practice.


    Directory of Open Access Journals (Sweden)

    Alberto Schanaider


    Full Text Available Objective: To analyze critically the effectiveness and value of bibliometric indicators in journals of Surgery or Cardiovacular Surgery in the context of the postgraduate programs of CAPES Medicine III. Methods: A sampling with 16 academic programs and one professional master of Medicine III, encompassing the General and Digestive System Surgery, Cardiovascular Surgery and Multidisciplinary courses with such contents, was evaluated. Thomson Reuters/ISI (JCR, Elsevier/Scopus (SJR, and also Scielo databases were used. Results: Only in seven programs, the teachers had an average of Qualis A1 articles greater than the others strata. Eleven journals in the surgical area are in stratum A1 (5% and it reaches 25% in Cardiovascular Surgery. Among the six journals with the largest number of publications Qualis A1 in area Medicine III, five are from non-specific areas. The Acta Cirúrgica Brasileira represented 58% of the publications in the stratum A2. There are some obstacles in the Qualis classification with little uniformity among the Medicine areas I, II and III. Conclusions: A permanent committee should be set to update the Qualis, composed by the three medical areas. It should be considered using other index databases and the unification of the Qualis criteria for journals in medicine. Rating criteria of multi and transdisciplinary journals need to be reviewed. It is essential an institutional financial support for national journals chosen by peers aiming to provide a full computerization process and a professional reviewer of the English language, in order to increase the impact factor.

  9. Predictors of willingness to undergo elective musculoskeletal surgery

    Directory of Open Access Journals (Sweden)

    Gandhi R


    Full Text Available Rajiv Gandhi,1,2 Anthony V Perruccio,1,3 Y Raja Rampersaud1,21Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network, 2Department of Surgery, Faculty of Medicine, University of Toronto, 3Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, CanadaPurpose: Knowledge of what influences patients’ willingness to undergo elective orthopedic surgery is vital to the patient shared decision-making process. We sought to document the prevalence and identify the predictors of unwillingness to undergo surgery among a cohort of hip/knee, foot/ankle, neck/back, and hip/knee patients.Patients and methods: Patient demographics and information on patient health status, perceptions of risk and success of surgery, and willingness to undergo surgery were collected. Sequential logistic regression models were used to investigate the influence of the captured variables on willingness to undergo surgery.Results: Overall, 392 (20% of 1946 participants reported being unwilling to undergo or unsure about undergoing (“unwilling/unsure” surgery if it was offered to them. From adjusted analyses, low income and non-White ethnicity were associated with a greater likelihood of being unwilling/unsure. Compared with hip/knee patients, neck/back patients were more likely to report being unwilling/unsure (odds ratio: 1.90 [95% confidence interval: 1.36, 265]; no differences were found between the remaining anatomical groups. However, when perceptions of risk and success were additionally considered, the influence for the neck/back cohort was significantly attenuated. Foot/ankle and elbow/shoulder patients were found to be significantly less likely to report unwillingness when perceptions were considered.Conclusion: In addition to demographic/economic influences, perceptions of surgical risk and success play a critical role in patients’ willingness to undergo surgery.Keywords: risk perception, orthopedic surgery

  10. Cancer Surgery: Physically Removing Cancer (United States)

    ... in cancer diagnosis, staging, treatment and symptom relief. Robotic surgery. In robotic surgery, the surgeon sits away from the operating table ... to maneuver surgical tools to perform the operation. Robotic surgery helps the surgeon operate in hard-to-reach ...

  11. Gamma knife surgery for craniopharyngioma. (United States)

    Prasad, D; Steiner, M; Steiner, L


    We present our results of Gamma Knife surgery for craniopharyngioma in nine patients. The current status of surgery, radiation therapy, intracavitary instillation of radionucleides and Gamma Knife surgery in the management of craniopharyngiomas is discussed.

  12. Preparing for Breast Reconstruction Surgery (United States)

    ... Cancer Breast Reconstruction Surgery Preparing for Breast Reconstruction Surgery Your surgeon can help you know what to ... The plan for follow-up Costs Understanding your surgery costs Health insurance policies often cover most or ...

  13. Intracranial Hypertension: Medication and Surgery (United States)

    ... Intracraneal en Espanol. STORE Shop the IHRF Store Medication and Surgery Medication and Surgery Both drugs and surgery are used ... to treat the headache that accompanies chronic IH. Medications for chronic headache like tricyclic anti-depressants, beta- ...

  14. Tests and visits before surgery (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 ...

  15. Cleft Lip and Palate Surgery (United States)

    ... The experts in face, mouth and jaw surgery. Cleft Lip / Palate and Craniofacial Surgery This type of surgery is ... the carefully orchestrated, multiple-stage correctional program for cleft lip and palate patients. The goal is to help restore the ...

  16. Zhejiang University

    Institute of Scientific and Technical Information of China (English)



    In September 1998,a new Zhejiang University was established on the basis of the amalgamation of the four former individual universities,namely Zhejiang University,Hangzhou University,Zhejiang Agricultural University and Zhejiang Medical University,which were all located in the garden city of Hangzhou.Approved by the State Council,the founding of the new Zhejiang University has been a significant move in the reform and development of China’s higher education.The four universities have grown out of the same ancestry,the Qiushi(with the literal meaning of "seeking truth" in Chinese) Academy,which was founded a century ago as one of the earliest institutions of higher learning in China.As a result,they have all inherited from it the spirit of "Qiushi" and at the same time,built up their owndistinctive features in teaching and research.

  17. Fractal universe

    CERN Document Server

    Khokhlov, D L


    The model of the universe is considered in which background of the universe is not defined by the matter but is a priori specified as a homogenous and isotropic flat space. The scale factor of the universe follows the linear law. The scale of mass changes proportional to the scale factor. This leads to that the universe has the fractal structure with a power index of 2.

  18. Comparative efficacy of amoxicillin/clavulanic acid and levofloxacin in the reduction of postsurgical sequelae after third molar surgery: a randomized, double-blind, clinical trial in a Nigerian university teaching hospital

    Directory of Open Access Journals (Sweden)

    Kizito Chioma Ndukwe


    Full Text Available Background: The most common sequelae after surgical removal of mandibular third molar are pain, trismus, swelling, and dysphagia. However, these symptoms can also signal the onset of surgical site infection and alveoli osteitis. The aim of this study was to evaluate the efficacy of prophylactic amoxicillin/clavulanic acid and levofloxacin and preemptive therapy of amoxicillin/clavulanic acid in the reduction of postinflammatory complications, surgical site infection, and alveolar osteitis following the third molar surgery. Patients and Methods: A total of 135 patients were randomized into three equal groups: Group A (preemptive therapy of amoxicillin/clavulanic acid with preoperative dose of 875/125 mg amoxicillin/clavulanic acid followed by 500/125 mg amoxicillin/clavulanic acid 12 hourly for 5 days, Group B (amoxicillin/clavulanic acid prophylaxis with a single preoperative dose of amoxicillin/clavulanic acid 875/125 mg tablets, and Group C (levofloxacin prophylaxis with a single preoperative dose of levofloxacin 1000 mg tablets. All patients had ostectomy using surgical handpiece and burs and received same analgesics (tabs ibuprofen 400 mg 8 hourly for 3 days. Results: No case of surgical site infection or alveoli osteitis was recorded in the study groups. There were no statistically significant differences between the treatment groups with regard to pain, mouth opening, postoperative facial dimension, and body temperature. Conclusion: Amoxicillin/clavulanic acid as a single preoperative bolus should be adequate for the prevention of postoperative wound infection and alveoli osteitis following the third molar extraction as there is no need for an extension of the antibiotic. Moreover, levofloxacin can be utilized as prophylaxis in patients undergoing mandibular third molar extraction if such patients are allergic to penicillins.

  19. Complicações pulmonares em crianças submetidas à cirurgia cardíaca em um hospital universitário Pulmonary complications in pediatric cardiac surgery at a university hospital

    Directory of Open Access Journals (Sweden)

    Daniel Lago Borges


    Full Text Available OBJETIVO: Identificar a prevalência de complicações pulmonares em crianças submetidas à cirurgia cardíaca, assim como características demográficas e clínicas da população estudada. MÉTODOS: A amostra foi composta por 37 crianças, de ambos os sexos, submetidas à cirurgia cardíaca no Hospital Universitário Presidente Dutra, São Luís (MA, durante o ano de 2007. Não foram incluídos pacientes que apresentaram doença pulmonar pré-cirúrgica, portadores de distúrbios neurológicos, óbito intra-operatório, além de falta de dados no prontuário. Os dados foram obtidos pela coleta nas evoluções médicas e de enfermagem dos respectivos prontuários. RESULTADOS: Quanto às características populacionais, houve predomínio de crianças do sexo feminino, provenientes do interior do estado e na faixa etária escolar. Patologias consideradas de baixo risco foram a maioria, destacando-se a persistência do canal arterial, comunicação interventricular e comunicação interatrial. Observou-se que a maior parcela das crianças fez uso de circulação extracorpórea por mais de 30 minutos, sendo a mediana igual a 80 minutos, sofreu esternotomia mediana, utilizou apenas dreno mediastinal e fez uso de ventilação mecânica pós-operatória, sendo a mediana aproximadamente de 6,6 horas. Somente três (8,1% pacientes apresentaram complicações pulmonares, sendo que destes, dois foram a óbito. CONCLUSÃO: A maioria das crianças da amostra era do sexo feminino, na faixa etária escolar e proveniente do interior do estado. Os baixos tempos de circulação extracorpórea e ventilação mecânica, além de cardiopatias congênitas consideradas de baixo risco, podem ter sido fatores contribuintes para o pequeno índice de complicações pulmonares no pós-operatório.OBJECTIVE: To identify the prevalence of pulmonary complications in children undergone cardiac surgery, as well as demographic and clinical characteristics of this population

  20. Chair in Pediatric Surgery


    Graña, Francisco; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú


    Inaugural lecture of the course of 1922, Department of Paediatric Surgery, by Dr. Francisco Grana, Professor of Pediatric Surgery and Orthopedics at the Faculty of Medicine of Lima, the National Academy of Medicine, of the Peruvian Society of Surgery. Lección inaugural del curso de 1922, Cátedra de Cirugía Infantil, por el Dr. Francisco Graña, Catedrático de Cirugía Infantil y Ortopedia en la Facultad de Medicina de Lima, de la Academia Nacional de Medicina, de la Sociedad Peruana de Cirug...

  1. Single port laparoscopic surgery

    DEFF Research Database (Denmark)

    Springborg, Henrik; Istre, Olav


    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...

  2. Surveys on surgery theory

    CERN Document Server

    Cappell, Sylvain; Rosenberg, Jonathan


    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

  3. Surveys on surgery theory

    CERN Document Server

    Cappell, Sylvain; Rosenberg, Jonathan


    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

  4. Standing equine sinus surgery. (United States)

    Barakzai, Safia Z; Dixon, Padraic M


    Trephination of the equine sinuses is a common surgical procedure in sedated standing horses. Standing sinus flap surgery has become increasingly popular in equine referral hospitals and offers several advantages over sinusotomy performed under general anesthesia, including reduced patient-associated risks and costs; less intraoperative hemorrhage, allowing better visualization of the operative site; and allows surgeons to take their time. Other minimally invasive surgical procedures include sinoscopic surgery, balloon sinuplasty, and transnasal laser sinonasal fenestration. Despite the procedure used, appropriate indications for surgery, good patient selection, and familiarity with regional anatomy and surgical techniques are imperative for good results. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Safe Surgery Trainer (United States)


    CDRL A001 For: Safe Surgery Trainer Prime Contract: N00014-14-C-0066 For the Period July 1, 2015 to July 31, 2015 Submitted: 15 Aug 2015...DATE 15 AUG 2015 2. REPORT TYPE 3. DATES COVERED 01-07-2015 to 31-07-2015 4. TITLE AND SUBTITLE Safe Surgery Trainer 5a. CONTRACT NUMBER 5b... Surgery Trainer ONR N00014-14-C-0066 Unclassified Unclassified Use or disclosure of the data contained on this page is subject to the restriction

  6. Minimally invasive surgery for Achilles tendon pathologies

    Directory of Open Access Journals (Sweden)

    Nicola Maffulli


    Full Text Available Nicola Maffulli1, Umile Giuseppe Longo2, Filippo Spiezia2, Vincenzo Denaro21Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, London, England; 2Department of Orthopedic and Trauma Surgery, Campus Bio-Medico University, Rome, ItalyAbstract: Minimally invasive trauma and orthopedic surgery is increasingly common, though technically demanding. Its use for pathologies of the Achilles tendon (AT hold the promise to allow faster recovery times, shorter hospital stays, and improved functional outcomes when compared to traditional open procedures, which can lead to difficulty with wound healing because of the tenuous blood supply and increased chance of wound breakdown and infection. We present the recent advances in the field of minimally invasive AT surgery for tendinopathy, acute ruptures, chronic tears, and chronic avulsions of the AT. In our hands, minimally invasive surgery has provided similar results to those obtained with open surgery, with decreased perioperative morbidity, decreased duration of hospital stay, and reduced costs. So far, the studies on minimally invasive orthopedic techniques are of moderate scientific quality with short follow-up periods. Multicenter studies with longer follow-up are needed to justify the long-term advantages of these techniques over traditional ones.Keywords: tendinopathy, rupture, percutanous repair, less invasive

  7. Navigation in Orthognathic Surgery: 3D Accuracy. (United States)

    Badiali, Giovanni; Roncari, Andrea; Bianchi, Alberto; Taddei, Fulvia; Marchetti, Claudio; Schileo, Enrico


    This article aims to determine the absolute accuracy of maxillary repositioning during orthognathic surgery according to simulation-guided navigation, that is, the combination of navigation and three-dimensional (3D) virtual surgery. We retrospectively studied 15 patients treated for asymmetric dentofacial deformities at the Oral and Maxillofacial Surgery Unit of the S.Orsola-Malpighi University Hospital in Bologna, Italy, from January 2010 to January 2012. Patients were scanned with a cone-beam computed tomography before and after surgery. The virtual surgical simulation was realized with a dedicated software and loaded on a navigation system to improve intraoperative reproducibility of the preoperative planning. We analyzed the outcome following two protocols: (1) planning versus postoperative 3D surface analysis; (2) planning versus postoperative point-based analysis. For 3D surface comparison, the mean Hausdorff distance was measured, and median among cases was 0.99 mm. Median reproducibility orthognathic surgery, if compared with the surgical computer-designed project realized with a dedicated software, particularly for the vertical dimension, which is the most challenging to manage.

  8. Plate removal following orthognathic surgery. (United States)

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


    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.

  9. University Internationalization and University Autonomy

    DEFF Research Database (Denmark)


    Turcan and Gulieva deepen our theoretical understanding of the process of university internationalisation by exploring the relationship between university internationalisation and university autonomy. They conjecture that the process of university internationalisation and its sustainability are d......, dissimilar, and sometimes conflicting dimensions of the financial, legal, organisational, staffing, and academic autonomy of the host country, are compromising key aspects of their own autonomy and core mission?...

  10. Cataract surgery during active methicillin-resistant Staphylococcus aureus infection

    Directory of Open Access Journals (Sweden)

    Mansour AM


    Full Text Available Ahmad M Mansour,1,2 Haytham I Salti11Department of Ophthalmology, American University of Beirut, 2Rafic Hariri University Hospital, Beirut, LebanonAbstract: We present two patients with active, foul-smelling, methicillin-resistant ­Staphylococcus aureus (MRSA wounds of the forehead and sternum following craniotomy or open heart surgery. Both had debilitating cataracts and were told by the infectious diseases team that cataract surgery is very risky. Both underwent sequential bilateral phacoemulsification with no sign of infection. Patients with active MRSA wound infections may safely undergo cataract surgery with additional precautions observed intraoperatively (good wound construction and postoperatively (topical antibiotics and close observation. Banning such surgeries can unnecessarily jeopardize the lifestyles of such patients.Keywords: cataract, infection, methicillin-resistant Staphylococcus aureus, phacoe­mulsification

  11. Superior oblique surgery: when and how?

    Directory of Open Access Journals (Sweden)

    Taylan Şekeroğlu H


    Full Text Available Hande Taylan Şekeroğlu,1 Ali Sefik Sanac,1 Umut Arslan,2 Emin Cumhur Sener11Department of Ophthalmology, 2Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, TurkeyBackground: The purpose of this paper is to review different types of superior oblique muscle surgeries, to describe the main areas in clinical practice where superior oblique surgery is required or preferred, and to discuss the preferred types of superior oblique surgery with respect to their clinical outcomes.Methods: A consecutive nonrandomized retrospective series of patients who had undergone superior oblique muscle surgery as a single procedure were enrolled in the study. The diagnosis, clinical features, preoperative and postoperative vertical deviations in primary position, type of surgery, complications, and clinical outcomes were reviewed. The primary outcome measures were the type of strabismus and the type of superior oblique muscle surgery. The secondary outcome measure was the results of the surgeries.Results: The review identified 40 (20 male, 20 female patients with a median age of 6 (2–45 years. Nineteen patients (47.5% had Brown syndrome, eleven (27.5% had fourth nerve palsy, and ten (25.0% had horizontal deviations with A pattern. The most commonly performed surgery was superior oblique tenotomy in 29 (72.5% patients followed by superior oblique tuck in eleven (27.5% patients. The amount of vertical deviation in the fourth nerve palsy and Brown syndrome groups (P = 0.01 for both and the amount of A pattern in the A pattern group were significantly reduced postoperatively (P = 0.02.Conclusion: Surgery for the superior oblique muscle requires experience and appropriate preoperative evaluation in view of its challenging nature. The main indications are Brown syndrome, fourth nerve palsy, and A pattern deviations. Superior oblique surgery may be effective in terms of pattern collapse and correction of vertical deviations in primary

  12. Complications in neonatal surgery. (United States)

    Escobar, Mauricio A; Caty, Michael G


    Neonatal surgery is recognized as an independent discipline in general surgery, requiring the expertise of pediatric surgeons to optimize outcomes in infants with surgical conditions. Survival following neonatal surgery has improved dramatically in the past 60 years. Improvements in pediatric surgical outcomes are in part attributable to improved understanding of neonatal physiology, specialized pediatric anesthesia, neonatal critical care including sophisticated cardiopulmonary support, utilization of parenteral nutrition and adjustments in fluid management, refinement of surgical technique, and advances in surgical technology including minimally invasive options. Nevertheless, short and long-term complications following neonatal surgery continue to have profound and sometimes lasting effects on individual patients, families, and society. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. About Hand Surgery (United States)

    ... us eat, dress, write, earn a living, create art and do many other activities. To accomplish these ... 2009 American Society for Surgery of the Hand. Definition developed by ASSH Council. Other Links CME Mission ...


    NARCIS (Netherlands)


    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

  15. American Board of Surgery (United States)

    ... separate application is no longer required. The American Board of Surgery is an independent, nonprofit organization founded in 1937 to provide board certification to individuals who have met a defined ...

  16. Cosmetic surgery: medicolegal considerations

    Directory of Open Access Journals (Sweden)

    Piras Mauro


    Full Text Available Cosmetic surgery is one of the two branches of plastic surgery. The characteristic of non-necessity of this surgical speciality implies an increased severity in the evaluation of the risk-benefit balance. Therefore, great care must be taken in providing all the information necessary in order to obtain valid consent to the intervention. We analyzed judgments concerning cosmetic surgery found in national legal databases. A document of National Bioethics Committee (CNB was also analyzed. Conclusion: The receipt of valid, informed consent is of absolute importance not only to legitimise the medical-surgical act, but it also represents the key element in the question concerning the existence of an obligation to achieve certain results/use of certain methods in the cosmetic surgery.

  17. Abdominal wall surgery (United States)

    ... pregnancy. Skin and muscle cannot regain its normal tone. This can be a problem for very overweight people who lost a lot of weight. Tummy tuck is major surgery. It is important to read about the procedure before having it. ...

  18. Surgery for pancreatic cancer (United States)

    ... using a tiny video camera) or using a robot depends on: The extent of the surgery The ... Procedure Meet with your doctor to make sure medical problems, such as diabetes, high blood pressure, and ...

  19. Surgery for Cervical Cancer (United States)

    ... Stage Cervical Cancer Treating Cervical Cancer Surgery for Cervical Cancer Many women with cervical cancer will have some ... Options for Cervical Cancer, by Stage More In Cervical Cancer About Cervical Cancer Causes, Risk Factors, and Prevention ...

  20. Robotics in Colorectal Surgery (United States)

    Weaver, Allison; Steele, Scott


    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


    NARCIS (Netherlands)



    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

  2. Septoplasty and Turbinate Surgery (United States)

    ... nose. Surgery on the septum can lead to stretching or injury to these nerves. This can lead ... a painless procedure that is performed in our office. A small endoscope is used to visualize the ...

  3. Ear surgery - slideshow (United States)

    ... this page: // Ear surgery - series—Normal anatomy To use the sharing ... Overview This image demonstrates normal appearance of the ears in relation to the face. Review Date 10/ ...

  4. Retrosternal thyroid surgery (United States)

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

  5. Pain Medications After Surgery (United States)

    ... aspx?id=23897. Accessed Dec. 16, 2013. Winn HR. Youmans Neurological Surgery. 6th ed. Philadelphia, Pa.: Saunders ... Terms and Conditions Privacy Policy Notice of Privacy Practices Notice of Nondiscrimination Advertising Mayo Clinic is a ...

  6. Ambulatory paediatric surgery

    African Journals Online (AJOL)

    operating time. Scarce nursing resources were also ... elective admission, treatment and discharge of a patient during the ... professional nurses and 5 auxiliary nurses, It has 2 fully ..... drawn, with the basic premise the provision of safe surgery.

  7. Lung Carcinoid Tumor: Surgery (United States)

    ... the sleeve above and below the stain and sewing the cuff back onto the shortened sleeve. A ... because it requires a great deal of technical skill. Possible risks and side effects of lung surgery ...

  8. Carotid artery surgery - discharge (United States)

    ... AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS guideline on the management of ... Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, Society for Vascular Medicine, and Society for Vascular ...

  9. Knee microfracture surgery (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 ...

  10. Is day surgery safe?

    DEFF Research Database (Denmark)

    Majholm, Birgitte; Engbæk, J; Bartholdy, Jens


    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....

  11. Complications of pancreatic surgery

    Directory of Open Access Journals (Sweden)

    Åke Andrén-Sandberg


    Full Text Available 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.

  12. Future of cosmetic surgery. (United States)

    Goldberg, Robert Alan


    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.

  13. Metabolic surgery: quo vadis? (United States)

    Ramos-Leví, Ana M; Rubio Herrera, Miguel A


    The impact of bariatric surgery beyond its effect on weight loss has entailed a change in the way of regarding it. The term metabolic surgery has become more popular to designate those interventions that aim at resolving diseases that have been traditionally considered as of exclusive medical management, such as type 2 diabetes mellitus (T2D). Recommendations for metabolic surgery have been largely addressed and discussed in worldwide meetings, but no definitive consensus has been reached yet. Rates of diabetes remission after metabolic surgery have been one of the most debated hot topics, with heterogeneity being a current concern. This review aims to identify and clarify controversies regarding metabolic surgery, by focusing on a critical analysis of T2D remission rates achieved with different bariatric procedures, and using different criteria for its definition. Indications for metabolic surgery for patients with T2D who are not morbidly obese are also discussed. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  14. Surgery for childhood epilepsy

    Directory of Open Access Journals (Sweden)

    Sita Jayalakshmi


    Full Text Available Approximately 60% of all patients with epilepsy suffer from focal epilepsy syndromes. In about 15% of these patients, the seizures are not adequately controlled with antiepileptic drugs; such patients are potential candidates for surgical treatment and the major proportion is in the pediatric group (18 years old or less. Epilepsy surgery in children who have been carefully chosen can result in either seizure freedom or a marked (>90% reduction in seizures in approximately two-thirds of children with intractable seizures. Advances in structural and functional neuroimaging, neurosurgery, and neuroanaesthesia have improved the outcomes of surgery for children with intractable epilepsy. Early surgery improves the quality of life and cognitive and developmental outcome and allows the child to lead a normal life. Surgically remediable epilepsies should be identified early and include temporal lobe epilepsy with hippocampal sclerosis, lesional temporal and extratemporal epilepsy, hemispherical epilepsy, and gelastic epilepsy with hypothalamic hamartoma. These syndromes have both acquired and congenital etiologies and can be treated by resective or disconnective surgery. Palliative procedures are performed in children with diffuse and multifocal epilepsies who are not candidates for resective surgery. The palliative procedures include corpus callosotomy and vagal nerve stimulation while deep brain stimulation in epilepsy is still under evaluation. For children with "surgically remediable epilepsy," surgery should be offered as a procedure of choice rather than as a treatment of last resort.

  15. Robotic surgery in gynecology

    Directory of Open Access Journals (Sweden)

    Rooma Sinha


    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.

  16. Photobiomodulation in laser surgery (United States)

    Liu, Timon Cheng-Yi; Rong, Dong-Liang; Huang, Jin; Deng, Xiao-Yuan; Liu, Song-Hao


    Laser surgery provides good exposure with clear operating fields and satisfactory preliminary functional results. In contrast to conventional excision, it was found that matrix metalloproteinases and the tissue inhibitors of metalloproteinases -1 mRNA expression is higher, myofibroblasts appeared and disappeared slower in laser excision wounds. It has been suggested that the better anatomical and functional results achieved following laser cordectomy may be explained by the fact that such procedures result in better, more rapid healing processes to recover vocal cord for early glottic tumors and better. In this paper, the role of photobiomodulation in laser surgery will be discussed by the cultured monolayer normal human skin fibroblast model of the photobiomodulation of marginal irradiation of high intensity laser beam, the photobiomodulation related to the irradiated tissue, the biological information model of photobiomodulation and the animal models of laser surgery. Although high intensity laser beam is so intense that it destroys the irradiated cells or tissue, its marginal irradiation intensity is so low that there is photobiomodulation on non-damage cells to modulate the regeneration of partly damaged tissue so that the surgery of laser of different parameters results in different post-surgical recovery. It was concluded that photobiomodulation might play an important role in the long-term effects of laser surgery, which might be used to design laser surgery.

  17. The scope of plastic surgery

    African Journals Online (AJOL)


    Aug 3, 2013 ... areas of surgery (especially general surgery), plastic surgeons are arguably the .... Who do you feel are experts in laparoscopic surgery? e (general surgeons) a. Maxillofacial .... of pressure sore. ORIF = open reduction internal fixation. ... Plastic versus cosmetic surgery: What's the difference? Plast Reconstr.

  18. Laparoscopic Surgery - What Is It? (United States)

    ... Surgery - What is it? Laparoscopic Surgery - What is it? Laparoscopic Surgery - What is it? | ASCRS WHAT IS LAPAROSCOPIC SURGERY? Laparoscopic or “minimally ... information about the management of the conditions addressed. It should be recognized that these brochures should not ...

  19. Bariatric surgery and the changing current scope of general surgery practice: implications for general surgery residency training. (United States)

    Mostaedi, Rouzbeh; Ali, Mohamed R; Pierce, Jonathan L; Scherer, Lynette A; Galante, Joseph M


    The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. To evaluate the current scope of academic general surgery and its implications on surgical residency. The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90,000 physicians who practice at 95 institutions across the United States. The FPSC database was queried to evaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of these procedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise

  20. Understanding Antegrade Colonic Enema (ACE) Surgery (United States)

    ... Enema (ACE) Surgery Understanding Antegrade Colonic Enema (ACE) Surgery Antegrade colonic enema surgery (ACE) or Malone antegrade ... Email Print What is antegrade colonic enema (ACE) surgery? Antegrade colonic enema surgery (ACE) or Malone antegrade ...

  1. Understanding Antegrade Colonic Enema (ACE) Surgery (United States)

    ... Enema (ACE) Surgery Understanding Antegrade Colonic Enema (ACE) Surgery Antegrade colonic enema surgery (ACE) or Malone antegrade ... Full Article What is antegrade colonic enema (ACE) surgery? Antegrade colonic enema surgery (ACE) or Malone antegrade ...

  2. Stanford University

    Institute of Scientific and Technical Information of China (English)



    The Leland Stanford Junior University,commonly known as Stanford University (or simply Stanford),is a private university located approximately 37 miles (60 kilometers) southeast of San Francisco and approximately 20 miles northwest of San Joséin an unincorporated area of Santa Clara County.Situated adjacent to the city of Palo Alto,California,Stanford lies at the heart of the Silicon Valley,both geographically and historically.

  3. Robotic surgery in gynecology. (United States)

    Alkatout, Ibrahim; Mettler, Liselotte; Maass, Nicolai; Ackermann, Johannes


    Robotic surgery is the most dynamic development in the sector of minimally invasive operations currently. It should not be viewed as an alternative to laparoscopy, but as the next step in a process of technological evolution. The advancement of robotic surgery, in terms of the introduction of the Da Vinci Xi, permits the variable use of optical devices in all four trocars. Due to the new geometry of the "patient cart," an operation can be performed in all spatial directions without re-docking. Longer instruments and the markedly narrower mechanical elements of the "patient cart" provide greater flexibility as well as access similar to those of traditional laparoscopy. Currently, robotic surgery is used for a variety of indications in the treatment of benign gynecological diseases as well as malignant ones. Interdisciplinary cooperation and cooperation over large geographical distances have been rendered possible by telemedicine, and will ensure comprehensive patient care in the future by highly specialized surgery teams. In addition, the second operation console and the operation simulator constitute a new dimension in advanced surgical training. The disadvantages of robotic surgery remain the high costs of acquisition and maintenance as well as the laborious training of medical personnel before they are confident with using the technology.

  4. Innovations in Bariatric Surgery. (United States)

    Zhu, Catherine; Pryor, Aurora D


    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.

  5. Percutaneous forefoot surgery. (United States)

    Bauer, T


    Percutaneous methods can be used to perform many surgical procedures on the soft tissues and bones of the forefoot, thereby providing treatment options for all the disorders and deformities seen at this site. Theoretical advantages of percutaneous surgery include lower morbidity rates and faster recovery with immediate weight bearing. Disadvantages are the requirement for specific equipment, specific requirements for post-operative management, and lengthy learning curve. At present, percutaneous hallux valgus correction is mainly achieved with chevron osteotomy of the first metatarsal, for which internal fixation and a minimally invasive approach (2 cm incision) seem reliable and reproducible. This procedure is currently the focus of research and evaluation. Percutaneous surgery for hallux rigidus is simple and provides similar outcomes to those of open surgery. Lateral metatarsal malalignment and toe deformities are good indications for percutaneous treatment, which produces results similar to those of conventional surgery with lower morbidity rates. Finally, fifth ray abnormalities are currently the ideal indication for percutaneous surgery, given the simplicity of the procedure and post-operative course, high reliability, and very low rate of iatrogenic complications. The most commonly performed percutaneous techniques are described herein, with their current indications, main outcomes, and recent developments.

  6. Cardiac surgery 2015 reviewed. (United States)

    Doenst, Torsten; Strüning, Constanze; Moschovas, Alexandros; Gonzalez-Lopez, David; Essa, Yasin; Kirov, Hristo; Diab, Mahmoud; Faerber, Gloria


    For the year 2015, almost 19,000 published references can be found in PubMed when entering the search term "cardiac surgery". The last year has been again characterized by lively discussions in the fields where classic cardiac surgery and modern interventional techniques overlap. Lacking evidence in the field of coronary revascularization with either percutaneous coronary intervention or bypass surgery has been added. As in the years before, CABG remains the gold standard for the revascularization of complex stable triple-vessel disease. Plenty of new information has been presented comparing the conventional to transcatheter aortic valve implantation (TAVI) demonstrating similar short- and mid-term outcomes at high and low risk, but even a survival advantage with transfemoral TAVI at intermediate risk. In addition, there were many relevant and interesting other contributions from the purely operative arena. This review article will summarize the most pertinent publications in the fields of coronary revascularization, surgical treatment of valve disease, heart failure (i.e., transplantation and ventricular assist devices), and aortic surgery. While the article does not have the expectation of being complete and cannot be free of individual interpretation, it provides a condensed summary that is intended to give the reader "solid ground" for up-to-date decision-making in cardiac surgery.

  7. Outcome of Endoscopic Transsphenoidal Surgery for Acromegaly. (United States)

    Kim, Jung Hee; Hur, Kyu Yeon; Lee, Jung Hyun; Lee, Ji Hyun; Se, Young-Bem; Kim, Hey In; Lee, Seung Hoon; Nam, Do-Hyun; Kim, Seong Yeon; Kim, Kwang-Won; Kong, Doo-Sik; Kim, Yong Hwy


    Endoscopic transsphenoidal surgery has recently been introduced in pituitary surgery. We investigated outcomes and complications of endoscopic surgery in 2 referral centers in Korea. We enrolled 134 patients with acromegaly (microadenomas, n = 15; macroadenomas, n = 119) who underwent endoscopic transsphenoidal surgery at Seoul National University Hospital (n = 74) and Samsung Medical Center (n = 60) between January 2009 and March 2016. Remission was defined as having a normal insulin-like growth factor-1 and a suppressed growth hormone (GH) <1 ng/mL during an oral glucose tolerance test. Remission was achieved in 73.1% of patients, including 13 of 15 microadenoma patients (86.7%) and 86 of 119 macroadenoma patients (72.3%). A multivariate analysis to determine a predictor of biochemical remission demonstrated that absence of cavernous sinus invasion and immediate postoperative GH levels <2.5 ng/dL were significant predictors of remission (adjusted odds ratio [OR], 5.14; 95% confidence interval [CI], 1.52-17.3 and OR, 9.60; 95% CI, 3.41-26.9, respectively). After surgery, normal pituitary function was maintained in 34 patients (25.4%). Sixty-four patients (47.7%) presented complete (n = 59, 44.0%) or incomplete (n = 5, 3.7%) recovery of pituitary function. Hypopituitarism persisted in 20 patients (14.9%) and worsened in 16 patients (11.9%). Postoperatively, transient diabetes insipidus was reported in 52 patients (38.8%) but only persisted in 2 patients (1.5%). Other postoperative complications were epistaxis (n = 2), cerebral fluid leakage (n = 4), infection (n = 1), and intracerebral hemorrhage (n = 1). Endoscopic transsphenoidal surgery for acromegaly presented high remission rates and a low incidence of endocrine deficits and complications. Regardless of surgical techniques, invasive pituitary tumors were associated with poor outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Nepalese patients' anxiety and concerns before surgery. (United States)

    Pokharel, Krishna; Bhattarai, Balkrishna; Tripathi, Mukesh; Khatiwada, Sindhu; Subedi, Asish


    To determine the changes in anxiety level and need for information at three different time points before surgery. Prospective observational study. Ward (T(1)), preoperative holding area (T(2)), and operating room (T(3)) of a university hospital. 201 adult, ASA physical status 1 and 2 patients scheduled for elective operations. Level of anxiety and need for information about surgery and/or anesthesia were assessed with the Amsterdam Preoperative Anxiety and Information Scale (APAIS) three times before the start of surgery: in the ward, the preoperative holding area, and the operating room. The psychometric characteristics of the APAIS were similar to its original Dutch version. The frequency of patients with high preoperative anxiety peaked at the preoperative holding area. The median score on need for information decreased from T(1) [4; interquartile range (IR) 2-5] to T(2) (3; IR 2-4) (P anxiety scores for anesthesia were significantly (P information about their surgical procedure was significantly (P information also were more anxious (P anxiety were female gender [odds ratio (OR) 4; 95% confidence interval (CI) 1.09-14.94] and need for general anesthesia (OR 7.1; 95% CI 0.93-54.98). The characteristics, general anesthesia (OR 3.3; 95% CI 1.1-10.0), younger age (≤ 30 yrs; OR 2.9; 95% CI 1.3-6.4), education (>12 yrs; OR 2.6; 95% CI 1.2-5.4), and no previous surgery (OR 2.6; 95% CI 1.2-5.5), correlated with greater need for information. The frequency of anxious patients is variable at different time points before surgery. The factors correlating with anxiety before surgery are nonmodifiable. Providing information to those individuals is the only modifiable option. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Harvard University

    Institute of Scientific and Technical Information of China (English)



    Harvard University, which celebrated its 370th anniversary in 2006, is the oldest institution of higher learning in the United States. Founded 16 years after the arrival of the Pilgrims at Plymouth, the University has grown from nine students with a

  10. Overseas Universities. (United States)

    Inter-University Council for Higher Education Overseas, London (England).

    The following articles and reports are presented in this publication of "Overseas Universities:""Appropriate Technology and University Education," by John Twidell; "The Training of Engineering Staff for Higher Education Institutions in Developing Countries," by D. W. Daniel, C. A. Leal, J. H. Maynes and T. Wilmore;…

  11. Innovative Universities. (United States)

    Barsi, Louis M.; Kaebnick, Gweneth W.


    The phenomenon of innovation within the university is examined, noting the possibility of innovation as a key to college vitality. A study was conducted using a group of institutions that demonstrated recent innovative spirit. Members of the American Association of State Colleges and Universities (AASCU), each has been recognized in an annual…


    Schanaider, Alberto


    To analyze critically the effectiveness and value of bibliometric indicators in journals of Surgery or Cardiovacular Surgery in the context of the postgraduate programs of CAPES Medicine III. A sampling with 16 academic programs and one professional master of Medicine III, encompassing the General and Digestive System Surgery, Cardiovascular Surgery and Multidisciplinary courses with such contents, was evaluated. Thomson Reuters/ISI (JCR), Elsevier/Scopus (SJR), and also Scielo databases were used. Only in seven programs, the teachers had an average of Qualis A1 articles greater than the others strata. Eleven journals in the surgical area are in stratum A1 (5%) and it reaches 25% in Cardiovascular Surgery. Among the six journals with the largest number of publications Qualis A1 in area Medicine III, five are from non-specific areas. The Acta Cirúrgica Brasileira represented 58% of the publications in the stratum A2. There are some obstacles in the Qualis classification with little uniformity among the Medicine areas I, II and III. A permanent committee should be set to update the Qualis, composed by the three medical areas. It should be considered using other index databases and the unification of the Qualis criteria for journals in medicine. Rating criteria of multi and transdisciplinary journals need to be reviewed. It is essential an institutional financial support for national journals chosen by peers aiming to provide a full computerization process and a professional reviewer of the English language, in order to increase the impact factor. Analisar criticamente a eficácia e valor de indicadores bibliométricos dos periódicos da Cirurgia e Cirurgia Cardiovascular no contexto dos Programas de Pós-Graduação da área Medicina III da CAPES. Foi avaliada uma amostragem com 16 programas acadêmicos e um mestrado profissional da área de Medicina III, compreendendo a Cirurgia Geral e do Aparelho Digestivo, a Cirurgia Cardiovascular e Cursos Multidisciplinares

  13. [Indication for bariatric surgery]. (United States)

    Hanusch-Enserer, Ursula; Enserer, Christian; Rosen, Harald R; Prager, Rudolf


    Morbid obesity is defined as obesity with body mass index (BMI) > or = 40 kg/m2 with secondary serious diseases. Conservative treatment generally fails to produce long-term weight loss in these patients, since several bariatric surgical techniques have been developed which are based on gastric restriction and/or gastric malabsorption resulting in permanent weight loss over years. Preoperative evaluation might detect suitable patients and reduce both non-surgical and surgical complications. Postoperative follow-up in a multidisciplinary program, including specialists in various fields of medicine, e.g. surgery, internal medicine, radiology, paediatrics and nutritional surveillance are mandatory in the treatment of patients after obesity surgery. Bariatric surgery results in a major weight loss, with amelioration of most obesity-associated conditions. The most serious side effect of some surgical procedere is malnutrition.

  14. Robotic aortic surgery. (United States)

    Duran, Cassidy; Kashef, Elika; El-Sayed, Hosam F; Bismuth, Jean


    Surgical robotics was first utilized to facilitate neurosurgical biopsies in 1985, and it has since found application in orthopedics, urology, gynecology, and cardiothoracic, general, and vascular surgery. Surgical assistance systems provide intelligent, versatile tools that augment the physician's ability to treat patients by eliminating hand tremor and enabling dexterous operation inside the patient's body. Surgical robotics systems have enabled surgeons to treat otherwise untreatable conditions while also reducing morbidity and error rates, shortening operative times, reducing radiation exposure, and improving overall workflow. These capabilities have begun to be realized in two important realms of aortic vascular surgery, namely, flexible robotics for exclusion of complex aortic aneurysms using branched endografts, and robot-assisted laparoscopic aortic surgery for occlusive and aneurysmal disease.

  15. [Antimicrobial prophylaxis in surgery]. (United States)

    Cisneros, José Miguel; Rodríguez-Baño, Jesús; Mensa, José; Trilla, Antoni; Cainzos, Miguel


    Antimicrobial prophylaxis in surgery refers to a very brief course of an antimicrobial agent initiated just before the start of the procedure. The efficacy of antimicrobials to prevent postoperative infection at the site of surgery (incisional superficial, incisional deep, or organ/space infection) has been demonstrated for many surgical procedures. Nevertheless, the majority of studies centering on the quality of preoperative prophylaxis have found that a high percentage of the antimicrobials used are inappropriate for this purpose. This work discusses the scientific basis for antimicrobial prophylaxis, provides general recommendations for its correct use and specific recommendations for various types of surgery. The guidelines for surgical antimicrobial prophylaxis are based on results from well-designed studies, whenever possible. These guidelines are focussed on reducing the incidence of infection at the surgical site while minimizing the contribution of preoperative administration of antimicrobials to the development of bacterial resistance.

  16. Viscoless microincision cataract surgery

    Directory of Open Access Journals (Sweden)

    Guy Sallet


    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

  17. Stereolithography for craniofacial surgery. (United States)

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


    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.

  18. [IMSS in numbers. Surgeries]. (United States)


    Surgery occupies a priority place within the organization of health services. In the IMSS around 1.4 million surgeries are performed annually and 3934 take place each day. A great part of the resources goes to obstetric interventions, since 222,928 caesarean sections were performed in 2004, and along with curettages, tubal occlusions and hysterectomies, they sum 37.6% of the surgeries performed in 2004. Abdominal deliveries (caesarean sections) were done in 39% of the pregnancies delivered in the IMSS and 8.3% were done in adolescents. Simple surgical interventions were also important. Cholecystectomies were 6 times more frequent in women aged 20 to 59 years old than in men the same age. Among the main interventions we also describe hernioplasty, appendicectomies, amygdalectomies, rhinoplasties, biopsies and circumcisions. Scarce data on complications are registered and no data is available for infections of surgical wounds. Surgical procedures are more frequent in women and in certain specialities.

  19. Robotic Surgery for Thoracic Disease. (United States)

    Yamashita, Shin-Ichi; Yoshida, Yasuhiro; Iwasaki, Akinori


    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.

  20. Robotic Surgery for Thoracic Disease (United States)

    Yoshida, Yasuhiro; Iwasaki, Akinori


    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

  1. [Bariatric surgery in Denmark.

    DEFF Research Database (Denmark)

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


    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...

  2. Ovarian cancer surgery

    DEFF Research Database (Denmark)

    Seibaek, Lene; Blaakaer, Jan; Petersen, Lone Kjeld


    PURPOSE: The study objective was to survey general health and coping in women undergoing ovarian cancer surgery, and subsequently to develop and test a supportive care intervention. METHODS/MATERIALS: Women who underwent surgery on the suspicion of ovarian cancer participated in a follow...... standard levels. Concerning mental health, levels were below standard during the entire period, but did improve with time, also in women in whom the potential cancer diagnosis was refuted. The preoperative differences between these groups leveled out postoperatively in terms of physical health. At the end...

  3. Surgery for Congenital Cataract

    Directory of Open Access Journals (Sweden)

    David Yorston FRCS FRCOphth


    Full Text Available The management of congenital cataract is very different to the treatment of a routine age-related cataract. In adults, surgery may be delayed for years without affecting the visual outcome. In infants, if the cataract is not removed during the first year of life, the vision will never be fully regained after surgery. In adults, if the aphakia is not corrected immediately, it can be corrected later. In young children, if the aphakia is not corrected, the vision will never develop normally.

  4. [Trends in surgery]. (United States)

    Cerantola, Y; Christoforidis, D; Halkic, N; Matter, M; Romy, S; Suter, M; Tempia-Caliera, A; Demartines, N; Givel, J-C


    More than the number of real novelties, trends and preliminary results characterise the annual development in surgery. The wealth and diversity of topics to be covered require arbitrary choices, therefore not necessarily complete. The constant development of choledocolithiasis management, dominated by minimal invasive technology, treatments of unusual nature of two frequent proctological conditions, fistulae and haemorrhoids, the increasing importance of metabolic bariatric surgery, as well as the strict rules of effective melanoma treatment, represent as many directions in which the operating procedure, although unseen, continue to gain quality and security.

  5. Surgery in Amphibians. (United States)

    Chai, Norin


    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.

  6. Robotic retroauricular thyroid surgery (United States)

    Alabbas, Haytham; Bu Ali, Daniah


    Surgery is the gold standard treatment for patients with thyroid cancer or nodules suspicious for cancer. Open conventional approach is the standard surgical approach. However, a visible neck incision could be a concern for most young female patients, especially for patients with a history of healing with keloid or hypertrophic scars. Robotic remote access approaches have evolved into a safe and feasible approach in selected patients, providing a hidden scar with good patient satisfaction. This review will focus on the performance and safety of robotic retroauricular thyroid surgery. PMID:28149806

  7. Update on obesity surgery

    Institute of Scientific and Technical Information of China (English)

    Dan Eisenberg; Andrew J Duffy; Robert L Bell


    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.

  8. [The beginnings of orthopedic surgery in Israel]. (United States)

    Tauber, Chanan


    In early mandatory Israel, orthopedics was mainly conservative, The first modern orthopedic surgeon was Ernst Spira from Czechoslovakia who established an orthopedic service at the Beilinson Hospital in Petah Tikva and left in 1948 to establish the Orthopedic Department and the Rehabilitation Center in Tel Hashomer, which treated the War of Independence casualties including amputees and victims of spinal cord injuries. A second orthopedic department was opened in Tel Hashomer by Shmuel Weissman who left in 1961 to open the Orthopedic Department at the Ichilov hospital in Tel Aviv. Shmuel Weissman became the first Chairman of Orthopedic Surgery at the Tel Aviv University medical school. In 1955, Myer Makin opened a modern orthopedic department in the Hadassah Hospital in Jerusalem and the Alyn Hospital for crippled children. In 1951, Assaf Harofeh Hospital opened the Department of Orthopedic Surgery headed by Anatol Axer who specialized in the treatment and rehabilitation of polio patients. The majority of the second generation of orthopedic department directors was trained by these four surgeons. Major developments in the 1960s and 1970s were the introduction of the AO system revolutionizing fracture treatment from conservative to operative treatment, the advent of total hip and knee replacements, Harrington instrumentation in spinal surgery and arthroscopy were major advances in orthopedic patient care brought to Israel by the aforementioned second generation of orthopedic surgeons. Hand surgery became an independent subspecialty of orthopedics and was lead by the internationally renowned hand surgeon, Isidore Kessler.

  9. Universe Awareness (United States)

    Sankatsing Nava, Tibisay; Russo, Pedro


    Universe Awareness (UNAWE) is an educational programme coordinated by Leiden University that uses the beauty and grandeur of the Universe to encourage young children, particularly those from an underprivileged background, to have an interest in science and technology and foster their sense of global citizenship from the earliest age.UNAWE's twofold vision uses our Universe to inspire and motivate very young children: the excitement of the Universe provides an exciting introduction to science and technology, while the vastness and beauty of the Universe helps broaden the mind and stimulate a sense of global citizenship and tolerance. UNAWE's goals are accomplished through four main activities: the coordination of a global network of more than 1000 astronomers, teachers and educators from more than 60 countries, development of educational resources, teacher training activities and evaluation of educational activities.Between 2011 and 2013, EU-UNAWE, the European branch of UNAWE, was funded by the European Commission to implement a project in 5 EU countries and South Africa. This project has been concluded successfully. Since then, the global project Universe Awareness has continued to grow with an expanding international network, new educational resources and teacher trainings and a planned International Workshop in collaboration with ESA in October 2015, among other activities.

  10. [Robotic surgery in gynecology]. (United States)

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


    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

  11. The universe

    CERN Document Server

    Osborne, Richard


    Where did the Universe come from? The single biggest and most difficult question that there is. From early religions through Greek Philosophy and Western Science man has attempted to discover the meaning of our place in the Universe. In the last twenty years these debates have been cast in a new light by amazing discoveries, big bang theory and ideas about new sub-atomic layers. The nature of Time and Space are truly up for grabs. With a witty and accessible style Osborne leads us on a historical and informative journey through the philosophies of the universe including the importance

  12. 4. Primary Malignant Bone Tumours at the University Teaching ...

    African Journals Online (AJOL)


    1Orthopaedic Unit Department of Surgery, University Teaching Hospital, ... osteosarcoma, followed, in descending order, by multiple myeloma 42 (27.6%), chondrosarcoma 11 (7.2%),. Ewing's sarcoma 8 (5.3%), fibrosarcoma 3 (2.0%) and.

  13. Comparing techniques for pterygium surgery

    Directory of Open Access Journals (Sweden)

    Atilla Alpay


    Full Text Available Atilla Alpay, Suat Hayri Ugurbas, Berktug ErdoganDepartment of Ophthalmology, Faculty of Medicine, Zonguldak, Karaelmas University, Zonguldak, TurkeyPurpose: To compare various techniques of pterygium surgery including bare sclera, intraoperative mitomycin C application, conjunctival flap reconstruction, and conjunctival autografting technique.Methods: This study is designed to compare 4 currently used techniques in order to determine the complication and recurrence rates after pterygium exision. Included in the study were 77 eyes from 60 patients. Bare sclera technique was used to treat 21 primary pterygia; mitomycin C was used to treat 20 (16 primary, 4 recurrent pterygia; 18 (17 primary, 1 recurrent pterygia were treated by conjuntival flap reconstruction; and 18 (9 primary, 9 recurrent pterygia were treated by conjunctival autografting technique. All patients who underwent surgery were followed up for between 6 months and 2 years.Results: Eight recurrences (38.09% were observed in the bare sclera group whereas there were 5 (25% recurrences in the mitomycin C group. In the conjunctival flap reconstruction group, 6 (33.33% recurrences were detected. In the conjunctival autografting group, 3 recurrences were  observed. There were no major complications threatening visual ability in the surgical patients.Conclusion: A comparison of the groups demonstrated that the recurrence rate was highest in the bare sclera group, and lowest in conjunctival autografting and mitomycin C treatment groups respectively. Although the conjunctival autografting technique is a more difficult and time consuming technique than the others, cosmetic and surgical results were found to be superior. We advise conjunctival autografting for the treatment of pterygium in view of the high recurrence rates of other techniques, and the possible complications of mitomycin C treatment for benign disease.Keywords: pterygium, comparing, techniques, mitomycin C

  14. Simultaneous bilateral cataract surgery: economic analysis; Helsinki Simultaneous Bilateral Cataract Surgery Study Report 2. (United States)

    Leivo, Tiina; Sarikkola, Anna-Ulrika; Uusitalo, Risto J; Hellstedt, Timo; Ess, Sirje-Linda; Kivelä, Tero


    To present an economic-analysis comparison of simultaneous and sequential bilateral cataract surgery. Helsinki University Eye Hospital, Helsinki, Finland. Economic analysis. Effects were estimated from data in a study in which patients were randomized to have bilateral cataract surgery on the same day (study group) or sequentially (control group). The main clinical outcomes were corrected distance visual acuity, refraction, complications, Visual Function Index-7 (VF-7) scores, and patient-rated satisfaction with vision. Health-care costs of surgeries and preoperative and postoperative visits were estimated, including the cost of staff, equipment, material, floor space, overhead, and complications. The data were obtained from staff measurements, questionnaires, internal hospital records, and accountancy. Non-health-care costs of travel, home care, and time were estimated based on questionnaires from a random subset of patients. The main economic outcome measures were cost per VF-7 score unit change and cost per patient in simultaneous versus sequential surgery. The study comprised 520 patients (241 patients included non-health-care and time cost analyses). Surgical outcomes and patient satisfaction were similar in both groups. Simultaneous cataract surgery saved 449 Euros (€) per patient in health-care costs and €739 when travel and paid home-care costs were included. The savings added up to €849 per patient when the cost of lost working time was included. Compared with sequential bilateral cataract surgery, simultaneous bilateral cataract surgery provided comparable clinical outcomes with substantial savings in health-care and non-health-care-related costs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  15. Femoroacetabular impingement surgery

    DEFF Research Database (Denmark)

    Reiman, Michael P; Thorborg, Kristian


    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...

  16. Tendon Transfer Surgery (United States)

    ... Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is ... include: Repair or transfer of nerves Repair of muscle or tendon Splinting or fusion of joints Find a hand surgeon in your area to discuss the best ...

  17. Decreasing strabismus surgery (United States)

    Arora, A; Williams, B; Arora, A K; McNamara, R; Yates, J; Fielder, A


    Aim: To determine whether there has been a consistent change across countries and healthcare systems in the frequency of strabismus surgery in children over the past decade. Methods: Retrospective analysis of data on all strabismus surgery performed in NHS hospitals in England and Wales, on children aged 0–16 years between 1989 and 2000, and between 1994 and 2000 in Ontario (Canada) hospitals. These were compared with published data for Scotland, 1989–2000. Results: Between 1989 and 1999–2000 the number of strabismus procedures performed on children, 0–16 years, in England decreased by 41.2% from 15 083 to 8869. Combined medial rectus recession with lateral rectus resection decreased from 5538 to 3013 (45.6%) in the same period. Bimedial recessions increased from 489 to 762, oblique tenotomies from 43 to 121, and the use of adjustable sutures from 29 to 44, in 2000. In Ontario, operations for squint decreased from 2280 to 1685 (26.1%) among 0–16 year olds between 1994 and 2000. Conclusion: The clinical impression of decrease in the frequency of paediatric strabismus surgery is confirmed. In the authors’ opinion this cannot be fully explained by a decrease in births or by the method of healthcare funding. Two factors that might have contributed are better conservative strabismus management and increased subspecialisation that has improved the quality of surgery and the need for re-operation. This finding has a significant impact upon surgical services and also on the training of ophthalmologists. PMID:15774914

  18. Robotics in gynecologic surgery. (United States)

    Frick, A C; Falcone, T


    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.

  19. Ghrelin and Metabolic Surgery

    Directory of Open Access Journals (Sweden)

    Dimitrios J. Pournaras


    Full Text Available Metabolic surgery is the most effective treatment for morbid obesity. Ghrelin has been implicated to play a role in the success of these procedures. Furthermore, these operations have been used to study the gut-brain axis. This article explores this interaction, reviewing the available data on changes in ghrelin levels after different surgical procedures.

  20. Mitral valve surgery - open (United States)

    ... Saunders; 2012:chap 61. Otto CM, Bonow RO. Valvular heart disease. In: Mann DL, Zipes DP, Libby P, Bonow ... Editorial team. Related MedlinePlus Health Topics Heart Surgery Heart Valve Diseases Mitral Valve Prolapse Browse the Encyclopedia A.D. ...

  1. Heart valve surgery - discharge (United States)

    ... ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College ... Editorial team. Related MedlinePlus Health Topics Heart Surgery Heart Valve Diseases Browse the Encyclopedia A.D.A.M., Inc. ...

  2. Aortic valve surgery - open (United States)

    ... Saunders; 2012:chap 61. Otton CM, Bowow RO. Valvular heart disease. In: Mann DL, Zipes DP, Libby P, Bonow ... Editorial team. Related MedlinePlus Health Topics Heart Surgery Heart Valve Diseases Browse the Encyclopedia A.D.A.M., Inc. ...

  3. Cataract surgery and anticoagulants

    NARCIS (Netherlands)

    Koopmans, SA; VanRij, G


    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

  4. Cataract Surgery in Uveitis

    Directory of Open Access Journals (Sweden)

    Rupesh Agrawal


    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.

  5. Improvements in Cataract Surgery

    NARCIS (Netherlands)

    Nibourg, Lisanne Maria


    Cataract is the leading cause of blindness and visual impairment in the elderly. It involves lens opacification due to biochemical changes in the lens. Cataract surgery provides restoration of good vision by removal of the opaque lens, followed by implantation of an intraocular lens (IOL) in the rem

  6. Heart bypass surgery (United States)

    ... help. Contact your provider if you have a cold, flu, fever, herpes breakout, or any other illness. Prepare your home so you can move around easily when you return from the hospital. The day before your surgery: Shower and shampoo well. You may be asked to ...

  7. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... which will probably include orthodontics before and after surgery, may take several years to complete. Your OMS and orthodontist understand that this is a long-term commitment for you and your family, and will try to realistically estimate the time ...

  8. Nutrition & Pancreatic Surgery

    NARCIS (Netherlands)

    Gerritsen, A.


    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

  9. Thromboprophylaxis in orthopaedic surgery

    NARCIS (Netherlands)

    M.C. Struijk-Mulder


    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


    African Journals Online (AJOL)


    technology in the field of surgery and the hopes it hold out to surgeons in developing countries. Key words: ... space-crafts and for specific interest research groups. 8. Broadly ... been left out of this new dispensation and sundry bounties of ...

  11. Cataract surgery - slideshow (United States)

    ... this page: // Cataract surgery - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 5 Go to slide ... 5 Overview The lens of an eye is normally clear. A cataract is when the lens becomes cloudy as you ...

  12. Surgery for Bone Cancer (United States)

    ... be amputated mid-thigh, the lower leg and foot can be rotated and attached to the thigh bone. The old ankle joint becomes the new knee joint. This surgery is called rotationplasty (roh-TAY-shun-PLAS-tee). A prosthesis is used to make the new leg the ...

  13. Sustainable Universities

    DEFF Research Database (Denmark)

    Grindsted, Thomas Skou


    , has put a counter pressure on the university, forcing it to review its role as a driver for sustainable development. Today, universities and intergovernmental institutions have developed more than 31 SHE declarations, and more than 1400 universities have signed a SHE declaration globally. However....... Declarations tend to have impact on three trends. Firstly, there is emerging international consensus on the university’s role and function in relation to sustainable development; secondly, the emergence of national legislation, and thirdly, an emerging international competition to be leader in sustainable......Declarations on Sustainability in Higher Education (SHE) can be viewed as a piece of international regulation. Over the past 30 years research at universities has produced convincing data to warn about deterioration of the environment, resource scarcity and the need for sustainability. This in turn...

  14. USAID University (United States)

    US Agency for International Development — USAID University is USAID's learning management system. Features include 1) Access online courses 2) Register for instructor-led courses 3)Access your student...

  15. Reoperation for bleeding in cardiac surgery

    DEFF Research Database (Denmark)

    Kristensen, Katrine Lawaetz; Rauer, Line Juul; Mortensen, Poul Erik


    bleeding, we aim to identify risk factors that predict reoperation. A total of 1452 consecutive patients undergoing cardiac surgery using extracorporeal circulation (ECC) between November 2005 and December 2008 at OUH were analysed. Statistical tests were used to identify risk factors for reoperation. We...... after cardiac surgery was low ejection fraction, high EuroSCORE, procedures other than isolated CABG, elongated time on ECC, low body mass index, diabetes mellitus and preoperatively elevated s-creatinine. Reoperated patients significantly had a greater increase in postoperative s-creatinine and higher......At Odense University Hospital (OUH), 5-9% of all unselected cardiac surgical patients undergo reoperation due to excessive bleeding. The reoperated patients have an approximately three times greater mortality than non-reoperated. To reduce the rate of reoperations and mortality due to postoperative...

  16. Telesurgery: remote knowledge translation in clinical surgery. (United States)

    Anvari, Mehran


    Dissemination of new surgical knowledge, skills, and techniques across the wide spectrum of practicing surgeons in the community is often difficult and slow. This is even more problematic in countries such as Canada, where geographic distances separate a large portion of community surgeons from the large teaching centers. As an example, the penetration of advanced minimally invasive techniques in Canada has been severely hampered by the inability to provide adequate training opportunities and support for community surgeons, many of whom live in remote regions of the country. In an attempt to overcome the barriers that exist, the Centre for Minimal Access Surgery (CMAS) at McMaster University has been using broadband Internet and telecommunication systems to provide distance training and mentoring to community surgeons living in remote northern communities of Canada. This article describes our experience with telementoring and robot-assisted remote telepresence surgery and assisting, between a teaching hospital in Hamilton and two community hospitals in northern Ontario and Quebec.

  17. Endodontic surgery prognostic factors. (United States)

    Azarpazhooh, Amir; Shah, Prakesh S


    Medline, (PubMed) and the Cochrane databases together with hand searching of the following journals: Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology (name changed to Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics in 1995), Endodontics and Dental Traumatology (name changed to Dental Traumatology in 2001), Journal of Oral and Maxillofacial Surgery, and International Journal of Oral and Maxillofacial Surgery. Clinical studies evaluating apical surgery with placement of a root-end filling were included. Studies on apical surgery with orthograde root canal filling or about apicectomy alone without root-end filling were excluded, as were experimental and animal studies. Only studies with ≥ ten patients with a minimum six month follow-up period and clearly defined radiographic and clinical healing criteria, with healing reported for at least two categories of a specific prognostic factor were accepted. Studies reporting in English, German, French, Spanish, Italian, Portuguese and Scandinavian languages were included. All studies were assessed separately by two of the three authors, with disagreements resolved by discussion. Prognostic factors were divided into patient related, tooth-related or treatment-related factors. The reported percentages of healed teeth were pooled per category. The statistical method of Mantel-Haenszel was applied to estimate the odds ratios and their 95% confidence intervals. Homogeneity was assessed using Woolf's test. With regard to tooth-related factors, the following were identified as predictors of healing: absence of preoperative pain or signs, good density of the root canal filling and a periapical lesion size of ≤ 5 mm. With regard to treatment-related factors, teeth treated with the use of an endoscope tended to have higher healed rates than teeth treated without the use of an endoscope. Although the clinician may be able to control treatment


    Institute of Scientific and Technical Information of China (English)


    Type of Company: Government institution. New Preparartions and Late-Model Drug Delivery System Technical Plaform of Peking University School of Pharmaceutical Sciences is a national technical plaform for developing new and important drugs. The person in charge for the platform is a pharmaceutical science professor of Peking University School of Pharmaceutical Sciences. The plaform selects the following as the main research areas: late-model carrier drug delivery system, biotechnological drug delivery system,

  19. Undulant Universe

    Energy Technology Data Exchange (ETDEWEB)

    Barenboim, Gabriela; /Valencia U.; Mena, Olga; Quigg, Chris; /Fermilab


    If the equation of state for ''dark energy'' varies periodically, the expansion of the Universe may have undergone alternating eras of acceleration and deceleration. We examine a specific form that survives existing observational tests, does not single out the present state of the Universe as exceptional, and suggests a future much like the matter-dominated past: a smooth expansion without a final inflationary epoch.

  20. The prevalence of body contouring surgery after gastric bypass surgery. (United States)

    Kitzinger, Hugo B; Abayev, Sara; Pittermann, Anna; Karle, Birgit; Kubiena, Harald; Bohdjalian, Arthur; Langer, Felix B; Prager, Gerhard; Frey, Manfred


    As bariatric surgery has become more popular, more patients are undergoing body contouring surgery after massive weight loss. Many of the surgical procedures performed on the massive weight loss patient are complex and labor-intensive. Therefore, the plastic surgery unit needs to be prepared for a patient's demand. Little literature is available on how frequently patients who have undergone gastric bypass surgery receive body contouring surgery. Two hundred fifty-two subjects (out of 425 who were mailed the questionnaire) who had undergone gastric bypass surgery between 2003 and 2009 completed the questionnaire, which obtained information on body image satisfaction and frequency of body contouring surgery after massive weight loss. Of all patients, 74% desire a body contouring surgery after gastric bypass surgery. Fifty-three patients (21%) have undergone a total of 61 body contouring procedures. The most common were abdominoplasties (59%), followed by lower body lifts (20%). In contrast to a positive judgment of the general aspect of the body image satisfaction after massive weight loss, both genders are unsatisfied with body areas like abdomen/waist, breast, and thighs. Paralleling the increasing use of bariatric surgery, there is a high demand for body contouring surgery. A huge disparity exists between the number of subjects who desire a body contouring surgery and those who actually received it.

  1. Patch in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alireza Alizadeh Ghavidel


    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.

  2. Accidental burns during surgery. (United States)

    Demir, Erhan; O'Dey, Dan Mon; Pallua, Norbert


    The purpose of this report is to increase awareness of intraoperative burns during standard procedures, to discuss their possible causes and warning signs and to provide recommendations for prevention and procedures to follow after their occurrence. A total of 19 patients associated with intraoperative burn accidents were treated surgically and analyzed after a mean follow-up of 5 +/- 3.5 months. Review included retrospective patient chart analysis, clinical examination, and technical device and equipment testing. A total of 15 patients recently underwent cardiac surgery, and 4 pediatric patients recovered after standard surgical procedures. A total of 15 patients had superficial and 4 presented with deep dermal or full-thickness burns. The average injured TBSA was 2.1 +/- 1% (range, 0.5-4%). Delay between primary surgery and consultation of plastic surgeons was 4.5 +/- 3.4 days. A total of 44% required surgery, including débridment, skin grafting or musculocutaneous gluteus maximus flaps, and the remaining patients were treated conservatively. Successful durable soft-tissue coverage of the burn region was achieved in 18 patients, and 1 patient died after a course of pneumonia. Technical analysis demonstrated one malfunctioning electrosurgical device, one incorrect positioned neutral electrode, three incidents occurred after moisture under the negative electrode, eight burns occurred during surgery while fluid or blood created alternate current pathways, five accidents were chemical burns after skin preparation with Betadine solution, and in one case, the cause was not clear. The surgical team should pay more attention to the probability of burns during surgery. Early patient examination and immediate involvement of plastic and burn surgeons may prevent further complications or ease handling after the occurrence.


    Siqueira-Batista, Rodrigo; Souza, Camila Ribeiro; Maia, Polyana Mendes; Siqueira, Sávio Lana


    The use of robots in surgery has been increasingly common today, allowing the emergence of numerous bioethical issues in this area. To present review of the ethical aspects of robot use in surgery. Search in Pubmed, SciELO and Lilacs crossing the headings "bioethics", "surgery", "ethics", "laparoscopy" and "robotic". Of the citations obtained, were selected 17 articles, which were used for the preparation of the article. It contains brief presentation on robotics, its inclusion in health and bioethical aspects, and the use of robots in surgery. Robotic surgery is a reality today in many hospitals, which makes essential bioethical reflection on the relationship between health professionals, automata and patients. A utilização de robôs em procedimentos cirúrgicos tem sido cada vez mais frequente na atualidade, o que permite a emergência de inúmeras questões bioéticas nesse âmbito. Apresentar revisão sobre os aspectos éticos dos usos de robôs em cirurgia. Realizou-se revisão nas bases de dados Pubmed, SciELO e Lilacs cruzando-se os descritores "bioética", "cirurgia", "ética", "laparoscopia" e "robótica". Do total de citações obtidas, selecionou-se 17 artigos, os quais foram utilizados para a elaboração do artigo. Ele contém breve apresentação sobre a robótica, sua inserção na saúde e os aspectos bioéticos da utilização dos robôs em procedimentos cirúrgicos. A cirurgia robótica é uma realidade, hoje, em muitas unidades hospitalares, o que torna essencial a reflexão bioética sobre as relações entre profissionais da saúde, autômatos e pacientes.

  4. Advances in mucogingival surgery. (United States)

    Prato, G P


    The term Mucogingival Surgery was proposed by Friedman in 1957 to indicate any surgery "designed to preserve attached gingiva, to remove frena or muscle attachment, and to increase the depth of the vestibule". The aim of this type of surgery was to maintain an adequate amount of attached gingiva and to prevent continuous loss of attachment. This philosophy was supported by many horizontal observations in humans that confirmed the need for a certain band of attached gingiva to maintain periodontal tissue in a healthy state. Subsequently, clinical and experimental studies by Wennström and Lindhe (1983) demonstrated that as long as plaque buildup is kept under careful control there is no minimum width of keratinised gingiva necessary to prevent the development of periodontal disease. These observations reduce the importance of Mucogingival Surgery. Surgical techniques are used mostly to solve aesthetic problems, since the term "Periodontal Plastic Surgery" has been suggested to indicate surgical procedures performed to correct or eliminate anatomical, developmental or traumatic deformities of the gingiva or alveolar mucosa. More recently the Consensus Report of the American Academy of Periodontology (1996) defines Mucogingival Therapy as "non surgical and surgical correction of the defects in morphology, position and/or amount of soft tissue and underlying bone". This assigns importance to non-surgical therapy and to the bone condition because of its influence on the morphology of the defects. In this respect the Mucogingival Therapy includes: Root coverage procedures, Gingival augmentation, Augmentation of the edentulous ridge, Removing of the aberrant frenulum, Prevention of ridge collapse associated with tooth extraction, Crown lengthening, Teeth that are not likely to erupt, Loss of interdental papilla which presents an aesthetic and/or phonetic problem.

  5. Surgery for Stress Urinary Incontinence (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Surgery for Stress Urinary Incontinence Home For Patients Search ... Stress Urinary Incontinence FAQ166, July 2014 PDF Format Surgery for Stress Urinary Incontinence Special Procedures What is ...

  6. Anaesthesia for robotic gynaecological surgery. (United States)

    Gupta, K; Mehta, Y; Sarin Jolly, A; Khanna, S


    Robotic surgery is gaining widespread popularity due to advantages such as reduced blood loss, reduced postoperative pain, shorter hospital stay and better visualisation of fine structures. Robots are being used in urological, cardiac, thoracic, orthopaedic, gynaecological and general surgery. Robotic surgery received US Food and Drug Administration approval for use in gynaecological surgery in 2005. The various gynaecological robotic operations being performed are myomectomy, total and supracervical hysterectomy, ovarian cystectomy, sacral colpopexy, tubal reanastomosis, lymph node dissection, surgery of retroperitoneal ectopic pregnancy, Moskowitz procedure and endometriosis surgery. The anaesthetic considerations include difficult access to the patient intraoperatively, steep Trendelenburg position, long surgical duration and the impact of pneumoperitoneum. We highlight the complications encountered in these surgeries and methods to prevent these complications. Robotic gynaecological surgery can be safely performed after considering the physiological effects of the steep Trendelenburg position and of pneumoperitoneum. The benefits of the surgical procedure should be weighed against the risks in patients with underlying cardiorespiratory problems.

  7. Breast Reconstruction with Flap Surgery (United States)

    Breast reconstruction with flap surgery Overview By Mayo Clinic Staff Breast reconstruction is a surgical procedure that restores shape to ... breast tissue to treat or prevent breast cancer. Breast reconstruction with flap surgery is a type of breast ...

  8. SvO2 Trigger in Transfusion Strategy After Cardiac Surgery (United States)


    Undergoing Nonemergent Cardiac Surgery; Central Venous Catheter on the Superior Vena Cava (to Perform ScVO2 Measure); Anemia (Transfusion; Hemodynamic and Respiratory Stability; Bleeding Graded as Insignificant, Mild, Moderate of Universal Definition of Perioperative Bleeding

  9. Contemporary oral and maxillofacial surgery. (United States)

    Pavel, F; Machado, L


    This article provides a panoramic view of the nine major areas of subspecialty in the field of oral and maxillofacial surgery: facial trauma, surgical pathology, dentoalveolar surgery, rehabilitation of the cleft lip/palate patient, temporomandibular joint surgery, preprosthetic and implant rehabilitation, surgical management of obstructive sleep apnea, correction of jaw deformities and cosmetic+ surgery. Clinical cases are used to illustrate the most recent advances in each of these nine areas.

  10. Early extubation after congenital heart surgery

    Directory of Open Access Journals (Sweden)

    Mirza Halimić


    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.

  11. [Centralization of robotic surgery: better results and cost savings

    NARCIS (Netherlands)

    Sluis, P.C. van der; Schreuder, H.W.B.; Merks, B.T.; Kruger, A.E. Boeken; Verheijen, R.; Hillegersberg, R. van


    In the University Medical Center Utrecht, the Netherlands, robot-assisted surgical procedures are performed weekly within the departments of Surgery, Gynaecology and Urology. Training for robot-assisted minimally invasive surgical procedures can be divided into two parts: system training and procedu

  12. [Centralization of robotic surgery: better results and cost savings

    NARCIS (Netherlands)

    Sluis, P.C. van der; Schreuder, H.W.B.; Merks, B.T.; Kruger, A.E. Boeken; Verheijen, R.; Hillegersberg, R. van


    In the University Medical Center Utrecht, the Netherlands, robot-assisted surgical procedures are performed weekly within the departments of Surgery, Gynaecology and Urology. Training for robot-assisted minimally invasive surgical procedures can be divided into two parts: system training and

  13. Thurston norm and cosmetic surgeries

    CERN Document Server

    Ni, Yi


    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.

  14. Timing of surgery for sciatica

    NARCIS (Netherlands)

    Peul, Wilco C.


    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

  15. Robot-assisted endoscopic surgery

    NARCIS (Netherlands)

    Ruurda, J.P.


    During the last three years, robot-assisted surgery systems are increasingly being applied in endoscopic surgery. They were introduced with the objective to overcome the challenges of standard endoscopic surgery. With the improvements in manipulation and visualisation that robotic-assistance offers,

  16. [Approach to the patient in the ambulatory surgery unit]. (United States)

    Cordero-Ponce, Montserrat; Romero-Sánchez, Isabel María; López-Barea, José; Martínez-Ramos, Pablo


    Ambulatory surgery aims to improve the quality of care, provide services in an environment closer to users' normal surroundings, reduce the risk of nosocomial infection and release hospital beds for other uses demanded by the population, thus reducing health costs. Nursing activity in these units should aim to restore health and aid the rapid recovery of patients in their homes. To achieve this, an effective health education program is required. Such programs should be simple and, at the same time, cover the care that these patients will require during the recovery period at home. The unit covers patients in the Virgen de Rocío University Hospital, The Fleming Peripheral Center for Specialties and the Virgen de los Reyes Peripheral Center for Specialties in Seville, Spain and the the specialties included are plastic surgery, otorhinolaryngology, orthopedic surgery, urology, and general surgery. The duration of the education program will be at most 14-17 h.

  17. Waldemar Wilhelm: father of oral and maxillofacial surgery in Colombia. (United States)

    Castro-Núñez, Jaime


    Waldemar Wilhelm (1913-1994) was honored by the Asociación Colombiana de Cirugía Oral y Maxilofacial (Colombian Association of Oral and Maxillofacial Surgery) as the Father of Oral and Maxillofacial Surgery in Colombia. Born in Karlsruhe, Germany, Wilhelm graduated as a dentist from Johann Wolfgang Goethe University in 1936. He emigrated shortly thereafter to Colombia, receiving his dental license there in 1943. He completed his oral and maxillofacial surgery training at Nordwestdeutsche Kieferklinic, under the tutelage of Prof. Dr. Dr. Karl Schuchardt in Hamburg. In 1950, he settled in Bogotá, where he joined the Universidad Nacional School of Dentistry, opened Colombia's first oral and maxillofacial surgery department at Hospital San José, and trained the first maxillofacial surgeons in Colombia in 1958.

  18. Personality traits within a pediatric surgery fellowship applicant pool. (United States)

    Hazboun, Rajaie; Rodriguez, Samuel; Thirumoorthi, Arul; Baerg, Joanne; Moores, Donald; Tagge, Edward P


    The Big Five framework examines five factors that represent a description of human personality. These factors correlate with success measures and job satisfaction. The Big Five Inventory is a 44-item instrument designed to measure the Big Five framework. Our aim was to document the distribution of Big Five personality traits among Pediatric Surgery fellowship applicants, compare with community norms, surgical residents, between genders, and correlate to the fellowship match results. Forty Pediatric Surgery fellowship applicants at a university hospital completed the Big Five Inventory during the interview process. It was analyzed and compared with general surgery residents' results and community norms. The data were compared regarding gender and match results. Continuous variables were compared by unpaired t-tests and Mann-Whitney tests. A P value surgery residents and community norms, applicants of both genders scored higher on agreeableness (P Pediatric Surgery fellowship applicants expressed higher levels of desirable professional traits compared with general surgery residents and community norms. Male applicants demonstrated higher emotional stability than females. Conscientiousness was higher in matching applicants. This first reported experience with personality testing in Pediatric Surgery fellow selection demonstrated potential utility in applicant matching. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The History of Cardiothoracic Surgery at Emory University. (United States)

    Guyton, Robert A; Thourani, Vinod H


    Over the past 50 years, the Emory Cardiothoracic Surgical Program has become one of the premier training programs in the United States. During this time, the Emory program has been sequentially led by Drs Osler Abbott, Charles Hatcher, and Robert Guyton. The program has grown from single faculty member to 25, and the culture of team collaboration, clinical excellence, research, and teaching established by Dr Hatcher has continued under the leadership of Dr Guyton for the past 26 years. Copyright © 2016. Published by Elsevier Inc.

  20. Pattern and Outcome of Conjunctival Surgeries in Jos University ...

    African Journals Online (AJOL)

    Objective: To assess the output, pattern, and outcome of conjunctival ... others to remix, tweak, and build upon the work non‑commercially, as long as the ..... Thomas JO. ... Farah S, Baum TD, Conlon MR, Alfonso EC, Starck T, Albert D.

  1. M. Misauno, FWACS, Department of Surgery, Jos University ...

    African Journals Online (AJOL)


    Sep 1, 2007 ... solid organ injury was detected in two patients with ultrasound. Diagnostic peritoneal .... prolapse through the hole and partly seal it making early signs ... faecal fistula, pelvic abscess and superficial wound infection. Thorough ...

  2. Department of Surgery, Kenyatta National Hospital, University of ...

    African Journals Online (AJOL)


    May 5, 2001 ... Eighty five per cent of the patients with systolic BP of less than 90. mmHg on admission died ..... more frequently detected and promptly corrected arterial hypotension is more ... intracranial pressure monitoring. In this study ...

  3. Transoral Robotic Surgery. (United States)

    Yee, Shokjean


    Transoral robotic surgery (TORS) is a technique used to treat oral, throat, and skull base cancers using a minimally invasive robotic approach through the mouth and throat. The TORS procedure allows deeper access and dissection of suspicious lesions and neoplastic growths in the oral cavity and those that extend from the throat to the base of the skull. Robotic surgery allows the surgeon to operate in tight spaces without a large open incision. This article discusses symptoms and risk factors of oral, throat, and skull base cancers; types of procedures that can be performed using the TORS approach; specialized instrumentation; patient selection; surgical advantages and disadvantages; patient benefits; and the role of the surgical team in preparing to intraoperatively care for the TORS patient.

  4. [Cosmetic eyelid surgery]. (United States)

    Ruban, J-M; Barbier, J; Malet, T; Baggio, E


    Cosmetic eyelid surgery is becoming increasingly popular. It can rejuvenate the patient's appearance with relatively minor side effects. Its risk/benefit ratio is one of the best in facial cosmetic surgery. However, the patient does not always accurately assess the aesthetic appearance of his or her eyelids. This underscores the importance of clinical examination in order to determine the patient's wishes, and then make an accurate diagnosis and potential surgical plan. We currently oppose, in general, surgical techniques involving tissue removal (skin-muscle and/or fat) in favor of those involving tissue repositioning and grafting (autologous fat pearl transposition, obtained by liposuction, and lipostructure). Furthermore, the place of adjuvant therapies to blepharoplasty is steadily increasing. They mainly include surface treatments (peels and lasers), dermal fillers and anti-wrinkle botulinum toxin injections. They are also increasingly used in isolation in novel ways. In all cases, a perfect knowledge of anatomy and relevant skills and experience remain necessary.

  5. Cataract Surgery Tool (United States)


    The NASA-McGannon cataract surgery tool is a tiny cutter-pump which liquefies and pumps the cataract lens material from the eye. Inserted through a small incision in the cornea, the tool can be used on the hardest cataract lens. The cutter is driven by a turbine which operates at about 200,000 revolutions per minute. Incorporated in the mechanism are two passages for saline solutions, one to maintain constant pressure within the eye, the other for removal of the fragmented lens material and fluids. Three years of effort have produced a design, now being clinically evaluated, with excellent potential for improved cataract surgery. The use of this tool is expected to reduce the patient's hospital stay and recovery period significantly.

  6. [Stress in surgeries]. (United States)

    Daian, Márcia Rodrigues; Petroianu, Andy; Alberti, Luiz Ronaldo; Jeunon, Ester Eliane


    The purpose of this article was to provide the literature regarding the psychological stress in the peri-operative period of adult patients undergoing operations under general anesthesia. The articles were obtained by surveying the papers published and catalogued in the Medline Pubmed interface database, Lilacs and the Biblioteca Virtual de Saúde (BVS) since 1984, crossing the headings stress, surgery, general anesthesia, psychology. Over 800 articles related to stress and surgery were analyzed with regards to their relevance to the considered subject. Eighteen articles were related to psychological stress. Their results confirmed the presence of psychological and physical stress, during the peri-operative period as well as relation between stress and de clinical post-operative recovery. There is a gap regarding in the peri-operative period. More studies on psychological influence on stress may benefit patients and help professionals during the surgical treatment.

  7. Robotic mitral valve surgery. (United States)

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


    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

  8. Heart Surgery: MedlinePlus Health Topic (United States)

    ... Is a Pediatric Heart Surgeon? (American Academy of Pediatrics) Also in Spanish Patient Handouts Aortic valve surgery - open (Medical Encyclopedia) ... Spanish Open heart surgery (Medical Encyclopedia) Also in Spanish ... heart surgery Pediatric heart surgery - discharge Sternal exploration or closure Related ...

  9. What to Expect After Breast Reconstruction Surgery (United States)

    ... En Español Category Cancer A-Z Breast Cancer Breast Reconstruction Surgery Women who have surgery as part of ... and after your surgery. Deciding Whether To Have Breast Reconstruction Many women choose to have reconstruction surgery, but ...

  10. Bariatric Surgery and the Endocrine System (United States)

    ... Surgery and the Endocrine System Fact Sheet Bariatric Surgery and the Endocrine System February, 2012 Download PDFs ... Morton, MD Marzieh Salehi, MD What is bariatric surgery? Bariatric surgery helps people who are very obese ...

  11. The day of surgery for your child (United States)

    Same-day surgery - child; Ambulatory surgery - child; Surgical procedure - child ... The anesthesia and surgery team will talk with you and your child before surgery. You may meet with them at an appointment before ...

  12. [Apical endodontic surgery]. (United States)

    Lindeboom, J A


    If (a revision of) a conventional endodontic treatment is not possible or not successful, apical endodontic surgery can be indicated. The contemporary indications, the better retrograde preparation techniques with ultrasonic retro-tips, and the better visualisation of the operation area with an operation microscope can lead to higher success percentages. Moreover, the current developments in the field of compatible filling materials are promising. Also the application of lasers is promising, but has still to prove its clinical usefulness.

  13. Paraendodontic surgery: case report


    Letícia Marchetti LODI; Sheila POLETO; Renata Grazziotin SOARES; Luis Eduardo Duarte IRALA; Salles, Alexandre Azevedo; Limongi,Orlando


    Introduction: Paraendodontic surgery is a procedure that aims problemsresolution that couldn’t be solved by the conventional endodontictreatment, or when the accomplishment conventional treatment is notpossible. Case report and conclusion: The aim of this study was to report a clinical case where was made apicectomy on the teeth 11, 21 and 22.The tooth 22 was sealing of root-end cavity MTA retrofilling.

  14. [Glaucoma and retinal surgery]. (United States)

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


    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

  15. Cell response to surgery.

    LENUS (Irish Health Repository)

    Ni Choileain, Niamh


    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.

  16. [Aesthetic surgery, psychic preparation]. (United States)

    Feiss, R


    The aesthetic surgery impacts the psychological picture of the body. The candidate must be prepared to this change in appearance. If not, the surgeon must suggest the psychological preparation, evaluating the risk of dissatisfaction, in order to allow the surgical and narcissistic success of his operation. The author, a psychiatric, beneficiary in a strong experience of a surgical assistance, develops the interest of such a preparation upon a period of about 15 years (1988-2002).

  17. Robotic Assisted Colorectal Surgery


    Baik, Seung Hyuk; M.D&#


    Improvements of the robotic surgical system are continuously being made to overcome the technical limitations and disadvantages found during the surgeries. So detailed operation methods are newly designed to adapt to the upgraded model of the robotic surgical system. The major core technologies of the robotic surgical system are a three dimensional image of the surgical field and a function of articulation of the instruments tips compared to conventional laparoscopic instruments. With the hel...


    Institute of Scientific and Technical Information of China (English)


    Type of Company: Government institution. New Preparartions and Late-Model Drug Delivery System Technical Plaform of Peking University School of Pharmaceutical Sciences is a national technical plaform for developing new and important drugs. The person in charge for the platform is a pharmaceutical science professor of Peking University School of Pharmaceutical Sciences. The plaform selects the following as the main research areas: late-model carrier drug delivery system, biotechnological drug delivery system, mucous and transdermal drug delivery system, oral controlled-release drug delivery system, and four corresponding research teams are set up to study in depth the main problems and key issues.

  19. [Bariatric surgery: an update]. (United States)

    Moreno Esteban, B; Zugasti Murillo, A


    The indication of bariatric surgery as therapeutic procedure for morbid obese patients requires the application of selection criteria which deal with the degree of obesity, associated complications and previous failure of conventional therapy. Alcohol or drug addiction and concomitant serious disease are contraindications for bariatric surgery. Before operation, a full assessment is needed to identify possible eating behaviour disturbances and associated comorbidity such as cardiovascular disease, sleep apnoea, metabolic and psychiatric alterations which might induce intra and postoperative complications. Surgical techniques can be classified as restrictive, malabsortive and mixed procedures. Gastroplasty and adjustable gastric banding are restrictive techniques, which are indicated in obese patients with body mass index less than 45 kg/m2. Mixed techniques are the most used procedures. They include gastric by-pass which causes a reduction of 60-70% of weight excess, biliopancreatic diversion and duodenal switch which can eliminate a 75% of body weight excess. Following bariatric surgery a dramatic improvement in associated comorbidity can be demonstrated, specially in what refers to diabetes, hypertension, dislipidaemia and apnoea. Postoperative mortality is around 1-2%. Peritonitis and venous thromboembolism are the most serious complications. Postoperative follow-up should be lifelong and requires a progressive nutrition planning and vitamin supplementation.

  20. Robotic surgery in gynecology

    Directory of Open Access Journals (Sweden)

    Jean eBouquet De Jolinière


    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.

  1. Robotic assisted andrological surgery

    Institute of Scientific and Technical Information of China (English)

    Sijo J Parekattil; Ahmet Gudeloglu


    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).

  2. Quantifying innovation in surgery. (United States)

    Hughes-Hallett, Archie; Mayer, Erik K; Marcus, Hani J; Cundy, Thomas P; Pratt, Philip J; Parston, Greg; Vale, Justin A; Darzi, Ara W


    The objectives of this study were to assess the applicability of patents and publications as metrics of surgical technology and innovation; evaluate the historical relationship between patents and publications; develop a methodology that can be used to determine the rate of innovation growth in any given health care technology. The study of health care innovation represents an emerging academic field, yet it is limited by a lack of valid scientific methods for quantitative analysis. This article explores and cross-validates 2 innovation metrics using surgical technology as an exemplar. Electronic patenting databases and the MEDLINE database were searched between 1980 and 2010 for "surgeon" OR "surgical" OR "surgery." Resulting patent codes were grouped into technology clusters. Growth curves were plotted for these technology clusters to establish the rate and characteristics of growth. The initial search retrieved 52,046 patents and 1,801,075 publications. The top performing technology cluster of the last 30 years was minimally invasive surgery. Robotic surgery, surgical staplers, and image guidance were the most emergent technology clusters. When examining the growth curves for these clusters they were found to follow an S-shaped pattern of growth, with the emergent technologies lying on the exponential phases of their respective growth curves. In addition, publication and patent counts were closely correlated in areas of technology expansion. This article demonstrates the utility of publically available patent and publication data to quantify innovations within surgical technology and proposes a novel methodology for assessing and forecasting areas of technological innovation.

  3. Art and epilepsy surgery. (United States)

    Ladino, Lady Diana; Hunter, Gary; Téllez-Zenteno, José Francisco


    The impact of health and disease has led many artists to depict these themes for thousands of years. Specifically, epilepsy has been the subject of many famous works, likely because of the dramatic and misunderstood nature of the clinical presentation. It often evokes religious and even mythical processes. Epilepsy surgical treatment has revolutionized the care of selected patients and is a relatively recent advance. Epilepsy surgery has been depicted in very few artistic works. The first portrait showing a potential surgical treatment for patients with epilepsy was painted in the 12th century. During the Renaissance, Bosch famously provided artistic commentary on traditional beliefs in "The stone of madness". Several of these works demonstrate a surgeon extracting a stone from a patient's head, at one time believed to be the source of all "folly", including epileptic seizures, psychosis, intellectual disability, depression, and a variety of other illnesses. There are some contemporary art pieces including themes around epilepsy surgery, all of them depicting ancient Inca Empire procedures such as trepanning. This article reviews the most relevant artistic works related with epilepsy surgery and also its historical context at the time the work was produced. We also present a painting from the Mexican artist Eduardo Urbano Merino that represents the patient's journey through refractory epilepsy, investigations, and ultimately recovery. Through this work, the artist intends to communicate hope and reassurance to patients going through this difficult process.

  4. Cortisol levels and sleep patterns in infants with orofacial clefts undergoing surgery

    Directory of Open Access Journals (Sweden)

    Mueller AA


    Full Text Available Andreas A Mueller,1,2 Nadeem Kalak,3 Katja Schwenzer-Zimmerer,1,2 Edith Holsboer-Trachsler,3 Serge Brand3,4 1Craniomaxillofacial Surgery, University of Basel and University Hospital of Basel, Basel, Switzerland; 2Hightech Research Center of Craniomaxillofacial Surgery, University of Basel, Basel, Switzerland; 3Psychiatric Clinics of the University of Basel, Center for Affective, Stress, and Sleep Disorders, Basel, Switzerland; 4Department of Sport and Health Science, Division of Sport Science, University of Basel, Basel, Switzerland Background: Traumatic events during early infancy might damage infants’ psychobiological functioning, such as sleep and cortisol secretion. Infants born with orofacial clefts (OFCs undergo functional, anatomical, and aesthetic surgery. The aim of the present study was to determine whether infants with OFC and undergoing OFC surgery show deteriorated sleep and cortisol secretion compared with healthy controls and with their presurgery status.Methods: A total of 27 infants with OFC (mean age: 22 weeks and 30 healthy controls (mean age: 23 weeks took part in the study. For infants with OFC, sleep actigraphy was performed and saliva cortisol was analyzed 5 days before, during, and 5 days after surgery. For controls, sleep and saliva cortisol were assessed similarly, except for the period taken up with surgery.Results: Compared with healthy controls, infants with OFC undergoing OFC surgery did not differ in sleep and cortisol secretion. Their sleep and cortisol secretion did deteriorate during the perisurgical period but recovered 5 days postsurgery. Conclusion: In infants with OFC undergoing corrective surgery, the pattern of results for sleep and cortisol suggests that OFC surgery does not seem to constitute a traumatic event with long-term consequences. Keywords: cortisol, sleep, orofacial cleft, surgery, infants

  5. Pregnancy Management After Bariatric Surgery. (United States)

    Badreldin, Nevert; Kuller, Jeffrey; Rhee, Eleanor; Brown, Laura; Laifer, Steven


    Obesity is a source of major morbidity and mortality and is a growing concern worldwide. Maternal obesity is associated with increased maternal and fetal risks during pregnancy. Bariatric surgery has emerged as one of the most sustainable treatments for severe obesity and its comorbidities. Patients who have undergone bariatric surgery often experience drastic improvements in hypertension and diabetes. It is not surprising, therefore, that the incidence of bariatric surgery is increasing, particularly in women of childbearing age. In fact, many women undergoing bariatric surgery plan to become pregnant in the future. Bariatric surgery may have a beneficial effect on rates of fetal macrosomia, gestational diabetes, hypertension, and preeclampsia. Conversely, studies have showed that bariatric surgery may increase the risk of small for gestational age infants and preterm birth. Given its rising incidence, it is important that physicians be able to thoroughly and accurately counsel and treat patients who plan to, or do, become pregnant after bariatric surgery.

  6. New Universities (United States)

    Burgett, Bruce


    The public-private alliance signals a future in which self-serving agreements could become the coin of the realm. Such a future would be a betrayal of the historical promise of public universities to innovate in ways that expand access to higher education. Given the rise of market-based models in educational policy circles, the threat of the…


    African Journals Online (AJOL)

    HIV/AIDS PERCEPTION AND SEXUAL BEHAVIOUR AMONG NIGERIAN. UNIVERSITY .... DO not like 118111511 _ 49 55 '1 Giving them money for treatment 21 3.7. Not available ... fact of the presence of the disease in the country. Whereas ...

  8. Princeton University

    Institute of Scientific and Technical Information of China (English)



    Recognized globally for academic excellence, Princeton University is a vibrant community of scholarship and learning. Princeton provides an academic and social setting where students quickly can become active members of the campus community. From the first day of class to Commencement, the opportunities for personal growth are countless.

  9. Risk factors associated with postoperative pain after ophthalmic surgery: a prospective study

    Directory of Open Access Journals (Sweden)

    Lesin M


    Full Text Available Mladen Lesin,1,* Mirna Dzaja Lozo,1,* Zeljka Duplancic-Sundov,1 Ivana Dzaja,1 Nikolina Davidovic,2 Adriana Banozic,3 Livia Puljak3 1Department of Ophthalmology, 2Department of Psychiatry, University Hospital Split, 3Laboratory for Pain Research, University of Split School of Medicine, Split, Croatia *These authors contributed equally to this work Background: Risk factors associated with postoperative pain intensity and duration, as well as consumption of analgesics after ophthalmic surgery are poorly understood. Methods: A prospective study was conducted among adults (N=226 who underwent eye surgery at the University Hospital Split, Croatia. A day before the surgery, the patients filled out questionnaires assessing personality, anxiety, pain catastrophizing, sociodemographics were given and details about the procedure, anesthesia, and analgesia for each postoperative day. All scales were previously used for the Croatian population. The intensity of pain was measured using a numerical rating scale from 0 to 10, where 0 was no pain and 10 was the worst imaginable pain. The intensity of pain was measured before the surgery and then 1 hour, 3 hours, 6 hours, and 24 hours after surgery, and then once a day until discharge from the hospital. Univariate and multivariate analyses were performed. Results: A multivariate analysis indicated that independent predictors of average pain intensity after the surgery were: absence of premedication before surgery, surgery in general anesthesia, higher pain intensity before surgery and pain catastrophizing level. Independent predictors of postoperative pain duration were intensity of pain before surgery, type of anesthesia, and self-assessment of health. Independent predictors of pain intensity ≥5 during the first 6 hours after the procedure were the type of procedure, self-assessment of health, premedication, and the level of pain catastrophizing. Conclusion: Awareness about independent predictors associated

  10. Efficiency of Medial Rectus Advancement Surgery in Consecutive Exotropia

    Directory of Open Access Journals (Sweden)

    Kemal Yar


    Full Text Available Purpose: To evaluate the efficiency of medial rectus advancement surgery in consecutive exotropia. Material and Methods: The study group consisted of 20 cases, 10 male, 10 female, who were diagnosed as consecutive exotropia and underwent surgery between 2008-2013 at Cukurova University Medical Faculty Ophthalmology Department. Records of the patients were investigated retrospectively. We evaluated best corrected visual acuity, existence of ambliopia, postoperative duration following the first surgery and applied surgical procedures. Postoperative deviation lower than 10 PD were assesed as successful. Mean follow up period was 29,8 +/- 21,36 (8-80 months, patients with inadequate follow up period were dismissed from the study group. Results: We only applied bilateral medial rectus advancement surgery to 6 and unilateral medial rectus advancement surgery to 5 patients and obtained intended surgical result in these 11 cases. The other patients underwent lateral rectus recession or/and medial rectus resection operations inorder to reach projected deviation degrees. Deviation was found to be 46,4+/-9,24 (40-70 PD in cases who only underwent advancement surgery and was 65,56 +/- 18,78 (40-90 PD in cases who underwent additional surgical procedure. 16 (%80 of the cases had hypermetropi various dioptries and 7 (%35 had ambliopia. Discussion: Consecutive exotropia can appear years after surgery and is an important late period complication. In this study achievement of %55 success with medial rectus advancement surgery indicates that this is a preferable procedure. But in wide angle deviations additional lateral rectus recession or/and medial rectus resection operations can be applied inorder to reach intended adjustment. Accurrate prediction of the propotion of advancement surgery and adjustment is not always possible because of intensive fybrosis in operated muscles and enviroment tissue. [Cukurova Med J 2015; 40(4.000: 707-713

  11. Delayed elective surgery in a major teaching hospital in Uganda

    Directory of Open Access Journals (Sweden)

    Kajja I


    Full Text Available Isaac Kajja,1 Cees Th Smit Sibinga21Department of Orthopedics, Makerere University, Kampala, Uganda; 2ID Consulting for International Development of Transfusion Medicine (IDTM, Groningen, The NetherlandsBackground: A number of factors come into play in determining the timing of an elective surgical intervention, particularly in the developing world. The present study explores the factors that contribute to the timing of elective surgery and patients' opinions on their quality of life as they wait for surgery.Methods: We followed adult patients with delayed elective surgical interventions (n=204. The causes for the delay and, particularly, the influence of blood shortage on the timing of the procedure were noted. Patients' perceptions on their quality of life as they waited for surgery were also noted.Results: We were able to establish a cause for delayed elective surgery in 133 patients. Shortage of operating space was the leading cause of surgery delay in 44 patients, while blood shortage followed closely in 40 patients. The higher the amount of blood ordered for use in the perioperative time, the longer the delay to surgery (P=0.001. Patients waiting for surgery had a low opinion of their in-hospital quality of life. Here, the key indicators included the threat of losing a job, limited family time, and an increase in day-to-day living costs.Conclusion: Blood shortage is the second most common cause of the delayed performance of elective surgical interventions in our institution. The patients have a low opinion on their quality of life as they wait for surgery.Keywords: blood shortage, delayed elective surgery, quality of life

  12. Cataract surgery following KAMRA presbyopic implant

    Directory of Open Access Journals (Sweden)

    Tan TE


    Full Text Available Tien-En Tan,1,2 Jodhbir S Mehta2–4 1Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 2Singapore National Eye Centre, Singapore; 3Singapore Eye Research Institute, Singapore; 4Department of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore Abstract: Intrastromal corneal inlays are an emerging treatment for presbyopic patients. The KAMRA™ small aperture inlay was the first such inlay to receive Conformité Européenne (CE marking in 2005. It has been shown to improve uncorrected near and intermediate visual acuity without adversely affecting uncorrected distance visual acuity. Due to the age of presbyopic patients, they may eventually develop cataracts. In two such cases, we found that cataract surgery with the KAMRA implant left in place was not technically more difficult, and that the surgical procedure could be improved by additional ocular rotations to improve visualization. Biometry readings were reliable, and it appeared that the SRK/T formula was accurate for calculation of intraocular lens power. Cataract surgery with the KAMRA implant left in situ is a viable option for patients. Keywords: cataract surgery, KAMRA, corneal inlay, AcuTarget, presbyopia

  13. History of power sources in endoscopic surgery. (United States)

    Sutton, Christopher; Abbott, Jason


    The history of energy sources used in surgery is inextricably linked to the history of electricity. Milestones include identification of safe electrical waveforms that can be used in the human body, patient isolation to prevent alternate-site burns, bipolar energy sources to negate capacitance injuries, laser energy, and the combination vessel sealing devices commonly used today. Engineering efforts to eliminate many of the hazards of electrosurgery are critical to how we practice modern gynecologic surgery. The introduction of bipolar instruments, increasing the safety of monopolar electrosurgery by not using hybrid trocars, and introduction of active shielding of the instruments from stray radiofrequency energy using intelligent secondary conductors have led to the re-emergence of electrosurgery as the universal surgical energy source. The low ongoing costs and the presence of electrosurgical generators in all hospitals readily enables electrosurgery to be the mainstay. Expensive lasers are confined to specialized centers, where they continue to be used, but for a long while filled a gap created by complications of electrosurgery. Sophisticated power sources continue to be introduced and include the ultrasonic scalpel, plasma surgery, and various devices for sealing vessels, all of which have advantages and disadvantages that are recognized as they begin to be subjected to scientific validation in randomized trials. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

  14. Waiting for surgery from the patient perspective

    Directory of Open Access Journals (Sweden)

    Tracey Carr


    Full Text Available Tracey Carr1, Ulrich Teucher2, Jackie Mann4, Alan G Casson31Health Sciences, 2Department of Psychology, 3Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; 4Acute Care, Saskatoon Health Region, Saskatoon, Saskatchewan, CanadaAbstract: The aim of this study was to perform a systematic review of the impact of waiting for elective surgery from the patient perspective, with a focus on maximum tolerance, quality of life, and the nature of the waiting experience. Searches were conducted using Medline, PubMed, CINAHL, EMBASE, and HealthSTAR. Twenty-seven original research articles were identified which included each of these three themes. The current literature suggested that first, patients tend to state longer wait times as unacceptable when they experienced severe symptoms or functional impairment. Second, the relationship between length of wait and health-related quality of life depended on the nature and severity of proposed surgical intervention at the time of booking. Third, the waiting experience was consistently described as stressful and anxiety provoking. While many patients expressed anger and frustration at communication within the system, the experience of waiting was not uniformly negative. Some patients experienced waiting as an opportunity to live full lives despite pain and disability. The relatively unexamined relationship between waiting, illness and patient experience of time represents an area for future research.Keywords: wait time, scheduled surgery, patient perspective, literature review

  15. Components of Patient Satisfaction After Orthognathic Surgery. (United States)

    Kufta, Kenneth; Peacock, Zachary S; Chuang, Sung-Kiang; Inverso, Gino; Levin, Lawrence M


    The purpose of this study was to compare overall patient satisfaction after orthognathic surgery with the following specific categories: appearance, functional ability, general health, sociability, and patient-clinician communication. A 16-question survey was developed and administered to include patients at either 6 or 12 months after orthognathic surgery between June 2013 and June 2014 at the University of Pennsylvania and Massachusetts General Hospital. The predictor variables included age, sex, type of procedure, medical comorbidities, intra- or postoperative complications, and presence of paresthesia. The outcome variable was patient satisfaction overall and in each category based on a Likert scale (0: not satisfied at all to 5: very satisfied).A total of 37 patients completed the survey and had a high overall rate of satisfaction (100% of responses were 4 or 5 on Likert scale). Overall satisfaction had the highest correlation with appearance (ρ=0.52, P=0.0009) followed by sociability (ρ=0.47, P=0.004), patient-clinician communication (ρ=0.38, P=0.02) functionality (ρ=0.19, P=0.26), and general health (ρ = -0.11, P = 0.51). Patients had high satisfaction scores for orthognathic surgery. Satisfaction with postoperative appearance had the strongest correlation with overall satisfaction.

  16. Acute kidney injury is independently associated with higher mortality after cardiac surgery

    DEFF Research Database (Denmark)

    Kandler, Kristian; Jensen, Mathias E; Nilsson, Jens C


    OBJECTIVES: To investigate the incidence of acute kidney injury after cardiac surgery and its association with mortality in a patient population receiving ibuprofen and gentamicin perioperatively. DESIGN: Retrospective study with Cox regression analysis to control for possible preoperative.......21-4.51, p = 0.011) and 5.62 (95% CI: 2.42-13.06), pcardiac surgery developed AKI in this contemporary cohort. Furthermore, acute kidney injury was an independent......, intraoperative and postoperative confounders. SETTING: University hospital-based single-center study. PARTICIPANTS: All patients who underwent coronary artery bypass grafting ± valve surgery during 2012. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: Acute surgery within 24 hours of coronary angiography...

  17. Antimicrobial prophylaxis in colorectal surgery: focus on ertapenem

    Directory of Open Access Journals (Sweden)

    Fausto de Lalla


    Full Text Available Fausto de LallaLibero Docente of Infectious Diseases, University of Milano, Milano, ItalyAbstract: Despite improvement in infection control measures and surgical practice, surgical site infections (SSIs remain a major cause of morbidity and mortality. In colorectal surgery, perioperative administration of a suitable antimicrobial regimen that covers both anaerobic and aerobic bacteria is universally accepted. In a prospective, double-blind, randomized study ertapenem was recently found to be more effective than cefotetan, a parenteral cephalosporin so broadly used as to be considered as gold standard in the prevention of SSIs following colorectal surgery. In this adequate and well controlled study, the superiority of ertapenem over cefotetan was clearly demonstrated from the clinical and bacteriological points of view. However, data that directly compares ertapenem with other antimicrobial regimen effective in preventing SSIs following colorectal surgery are lacking; furthermore, the possible risk of promotion of carbapenem resistance associated with widespread use of ertapenem prophylaxis as well as the ertapenem effects on the intestinal gut flora are of concern. Further comparative studies of ertapenem versus other widely used prophylactic regimens for colorectal surgery in patients submitted to mechanical bowel preparation versus no preparation as well as further research on adverse events of antibiotic prophylaxis, including emergence of resistance and Clostridium difficile infection, seem warranted.Keywords: colorectal surgery, surgical prophylaxis, ertapenem

  18. Global cancer surgery: delivering safe, affordable, and timely cancer surgery. (United States)

    Sullivan, Richard; Alatise, Olusegun Isaac; Anderson, Benjamin O; Audisio, Riccardo; Autier, Philippe; Aggarwal, Ajay; Balch, Charles; Brennan, Murray F; Dare, Anna; D'Cruz, Anil; Eggermont, Alexander M M; Fleming, Kenneth; Gueye, Serigne Magueye; Hagander, Lars; Herrera, Cristian A; Holmer, Hampus; Ilbawi, André M; Jarnheimer, Anton; Ji, Jia-Fu; Kingham, T Peter; Liberman, Jonathan; Leather, Andrew J M; Meara, John G; Mukhopadhyay, Swagoto; Murthy, Shilpa S; Omar, Sherif; Parham, Groesbeck P; Pramesh, C S; Riviello, Robert; Rodin, Danielle; Santini, Luiz; Shrikhande, Shailesh V; Shrime, Mark; Thomas, Robert; Tsunoda, Audrey T; van de Velde, Cornelis; Veronesi, Umberto; Vijaykumar, Dehannathparambil Kottarathil; Watters, David; Wang, Shan; Wu, Yi-Long; Zeiton, Moez; Purushotham, Arnie


    Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

  19. Energy systems in surgery

    Directory of Open Access Journals (Sweden)

    Pantelić Miloš


    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.


    Directory of Open Access Journals (Sweden)

    I Gusti Ayu Agung Laksemi


    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;}

  1. University writing

    Directory of Open Access Journals (Sweden)

    Miguel Zabalza Beraza


    Full Text Available Writing in the University is a basic necessity and a long-range educational purpose. One of the basic characteristics of the university context is that it requires writing both as a tool of communication and as a source of intellectual stimulation. After establishing the basic features of academic writing, this article analyzes the role of writing for students (writing to learn and for teachers (write to plan, to reflect, to document what has been done. The article also discusses the contributions of writing for both students and teachers together: writing to investigate. Finally, going beyond what writing is as academic tool, we conclude with a more playful and creative position: writing for pleasure and enjoyment.

  2. [Performance indicators of maxillofacial surgery inpatient departments]. (United States)

    Marada, Gyula; Nagy, Ákos; Sebestyén, Andor; Zemplényi, Antal; Radnai, Márta; Boncz, Imre


    In Hungary, the number and structure of the maxillofacial surgery departments underwent significant changes in recent decades. The aim of our study was to present the actual performance indicators of maxillofacial inpatient departments and based on the available data to compare the departments. The study was based on the number of beds founded by the National Health Insurance Fund. Performance data were supplied by the National Health Insurance Fund Administration. The assessment included the following indicators: number of beds institutional breakdown by type, number of reimbursed cases, the weighted case number, hospital stay, bed occupancy rates and average length of stay. In the examined period 40% of active beds (65) were in university hospitals. The distribution of reimbursed cases was similar. The university hospitals showed higher weighted case number and case-mix index. The oral surgery departments' bed occupancy rate (45.75%) was below the national average. The indicators show significant differences among different departments in the examined period. Orv. Hetil., 2017, 158(12), 447-453.

  3. Complications in colorectal surgery. (United States)

    Frischer, Jason S; Rymeski, Beth


    Colorectal pediatric surgery is a diverse field that encompasses many different procedures. The pullthrough for Hirschsprung disease, the posterior sagittal anorectoplasty for anorectal malformations including complex cloaca reconstructions and the ileal pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis present some of the most technically challenging procedures pediatric surgeons undertake. Many children prevail successfully following these surgical interventions, however, a small number of patients suffer from complications following these procedures. Anticipated postoperative problems are discussed along with medical and surgical strategies for managing these complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Rabbit orthopedic surgery. (United States)

    Rich, Gregory A


    Orthopedic surgery in rabbits poses several unique parameters for the veterinary surgeon. It is imperative for the veterinarian to be knowledgeable about the anatomic features of the surgical repair site and to become familiar with a rabbit's pain and discomfort often associated with orthopedic injuries. Handling the perioperative and postoperative pain and potential GI disturbances are crucial for a successful outcome of the surgical case. This article is designed to help the veterinary surgeon prepare for the orthopedic surgical procedure and the peripheral physiologic needs of the rabbit from presentation through recovery.

  5. Robotics in colorectal surgery. (United States)

    Hance, J; Rockall, T; Darzi, A


    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.

  6. [Temporomandibular joint disc surgery]. (United States)

    Potier, J; Maes, J-M; Nicot, R; Dumousseau, T; Cotelle, M; Ferri, J


    Temporomandibular joint (TMJ) disorders are a common disease and may be responsible for major functional and painful repercussions. Treatment is not consensual. The literature highlights the role of conservative treatments (physiotherapy, analgesics, splints) in a first attempt. Minimally invasive surgical techniques (arthroscopy, arthrocentesis) have developed rapidly in recent decades. They have proven effective and reliable, especially in patients suffering from irreducible or reducible anterior disc dislocation or presenting with arthopathies. The goal of our work was to make an update about disk surgery. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. [Robotics in pediatric surgery]. (United States)

    Camps, J I


    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.

  8. Anesthesia for thoracoscopic surgery

    Directory of Open Access Journals (Sweden)

    Conacher I


    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.

  9. Recovery Following Orthognathic Surgery (United States)


    USAF Chief Administration 13. ABSTRACT (Mlaxomum 200 words ) Acaesslon For WTTS CPA&t DTIC TAB [1 Unlnlnounced 3)¶’rt QUTALIT 32CT! By~i~’bt f Ditiu~tif...cardiovascular physiology. Int J Adult Orthod Orthognath Surg 1986;1:133-159. 3. Zimmer B, Schwestka R, Kubein-Meesenburg D: Changes in mandibu- lar...mobility after different procedures of orthoganthic surgery. Eur J Orthod 1992;14:188-197. 4. Aragon SB, Van Sickels JE: Mandibular range of motion with

  10. Cutaneous mucormycosis postcosmetic surgery (United States)

    Al-Tarrah, Khaled; Abdelaty, Mahmoud; Behbahani, Ahmad; Mokaddas, Eman; Soliman, Helmy; Albader, Ahdi


    Abstract Background: Mucormycosis is a rare, aggressive, and life-threatening infection that is caused by organisms belonging to the order Mucorales. It is usually acquired through direct means and virtually always affects immunocompromised patients with the port of entry reflecting the site of infection, in this case, cutaneous. Unlike other mucormycoses, patients affected by Apophysomyces elegans (A elegans) are known to be immunocompetent. This locally aggressive disease penetrates through different tissue plains invading adjacent muscles, fascia, and even bone causing extensive morbidity and may prove fatal if treated inadequately. Cutaneous mucormycosis is associated with disruption of cutaneous barriers such as trauma. However, rarely, it may be iatrogenic. No cases have been previously reported postcosmetic surgery, especially one that is so commonly performed, lipofilling. Case Report: The patient is a, previously healthy, 41-year-old middle-eastern female who was admitted to the plastic surgery department 17 days after undergoing cosmetic surgery. She suffered from extensive tissue inflammation and necrosis in both gluteal regions. Following admission, she was initially started on empirical antimicrobial therapy which was changed to an antifungal agent, voriconazole, when preliminary microbiological results showed filamentous fungi. This was discontinued and liposomal amphotericin B was commenced when further mycological analysis identified A elegans. Furthermore, she underwent a total of 10 sessions of extensive debridement to the extent that portions of the sacrum and left femoral head became exposed. Her clinical status and wounds improved with the appropriate management and she remained an inpatient for 62 days. Subsequently, she had defects in both gluteal regions which required reconstructive surgery. Conclusion: A elegans is an uncommon cause of iatrogenic cutaneous mucormycosis. A high index of clinical suspicion is required, especially in the

  11. Monitoring in microvascular surgery. (United States)

    Furnas, H; Rosen, J M


    The importance of monitoring in microvascular surgery is underscored by the high reported salvage rates of failing free flaps and replants. In this overview, we begin by defining the physiology of ischemic tissue with emphasis given to the no-reflow phenomenon and the secondary critical ischemia times. Based on the physiological changes accompanying ischemia, several variables are defined that can be monitored to reflect the vascular state of a free flap or replant. Multifarious monitoring systems are then reviewed, including clinical observation, temperature, isotope clearance, ultrasonic Doppler, laser Doppler, transcutaneous oxygen tension, reflection plethysmography, dermofluorometry, pH, electromagnetic flowmetry, serial hematocrits, interstitial fluid pressure, and magnetic resonance imaging.

  12. University physics

    CERN Document Server

    Arfken, George


    University Physics provides an authoritative treatment of physics. This book discusses the linear motion with constant acceleration; addition and subtraction of vectors; uniform circular motion and simple harmonic motion; and electrostatic energy of a charged capacitor. The behavior of materials in a non-uniform magnetic field; application of Kirchhoff's junction rule; Lorentz transformations; and Bernoulli's equation are also deliberated. This text likewise covers the speed of electromagnetic waves; origins of quantum physics; neutron activation analysis; and interference of light. This publi

  13. Building shared situational awareness in surgery through distributed dialog

    Directory of Open Access Journals (Sweden)

    Gillespie BM


    Full Text Available Brigid M Gillespie,1 Karleen Gwinner,2 Nicole Fairweather,3 Wendy Chaboyer41NHMRC Research Centre for Clinical Excellence in Nursing Interventions for Hospitalised Patients (NCREN and Research Centre for Clinical and Community Practice Innovation (RCCCPI, Griffith Health Institute, Griffith University, Queensland, 2Griffith Centre for Cultural Research, Griffith University, Queensland, 3Department of Anaesthesiology, Princess Alexandra Hospital, Queensland, Australia, 4Excellence in Nursing Interventions for Hospitalized Patients (NCREN Research Centre for Clinical and Community Practice INHMRC Centre of Research Innovation (RCCCPI, Griffith Health Institute, Griffith University Queensland, AustraliaBackground: Failure to convey time-critical information to team members during surgery diminishes members' perception of the dynamic information relevant to their task, and compromises shared situational awareness. This research reports the dialog around clinical decisions made by team members in the time-pressured and high-risk context of surgery, and the impact of these communications on shared situational awareness.Methods: Fieldwork methods were used to capture the dynamic integration of individual and situational elements in surgery that provided the backdrop for clinical decisions. Nineteen semistructured interviews were performed with 24 participants from anesthesia, surgery, and nursing in the operating rooms of a large metropolitan hospital in Queensland, Australia. Thematic analysis was used.Results: The domain "coordinating decisions in surgery" was generated from textual data. Within this domain, three themes illustrated the dialog of clinical decisions, ie, synchronizing and strategizing actions, sharing local knowledge, and planning contingency decisions based on priority.Conclusion: Strategies used to convey decisions that enhanced shared situational awareness included the use of "self-talk", closed-loop communications, and

  14. University lobbying (United States)

    Richman, Barbara T.

    In the past year, an increasing number of individual academic institutions have lobbied in Congress for new science facilities funds thus circumventing the traditional peer review process of evaluating the merits of such facilities. As an attempt to stem this rising tide, the National Academy of Sciences (NAS) governing council and the Association of American Universities (AAU) recently and independently issued strong statements condemning lobbying by individual universities and enthusiastically supporting the peer review system.“Informed peer judgments on the scientific merits of specific proposals, in open competition, should be a central element in the awarding of all federal funds for science,” the NAS resolution stated. AAU, meanwhile, implored “scientists, leaders of America's universities, and members of Congress” to “refrain from actions that would make scientific decisions a test of political influence rather than a judgment on the quality of the work to be done.” Roughly 50 research institutions constitute AAU; the two AAU Canadian members did not vote on the consortium's statement.

  15. Human universe

    CERN Document Server

    Cox, Brian


    Human life is a staggeringly strange thing. On the surface of a ball of rock falling around a nuclear fireball in the blackness of a vacuum the laws of nature conspired to create a naked ape that can look up at the stars and wonder where it came from. What is a human being? Objectively, nothing of consequence. Particles of dust in an infinite arena, present for an instant in eternity. Clumps of atoms in a universe with more galaxies than people. And yet a human being is necessary for the question itself to exist, and the presence of a question in the universe - any question - is the most wonderful thing. Questions require minds, and minds bring meaning. What is meaning? I don't know, except that the universe and every pointless speck inside it means something to me. I am astonished by the existence of a single atom, and find my civilisation to be an outrageous imprint on reality. I don't understand it. Nobody does, but it makes me smile. This book asks questions about our origins, our destiny, and our place i...

  16. Malnutrition in cardiac surgery: food for thought. (United States)

    Chermesh, Irit; Hajos, Jonathan; Mashiach, Tatiana; Bozhko, Masha; Shani, Liran; Nir, Rony-Reuven; Bolotin, Gil


    Undernourished patients treated in general surgery departments suffer from prolonged and complicated hospitalizations, and higher mortality rates compared with well nourished patients. Pivotal information regarding patients' nutritional status and its effect on clinical outcome is lacking for cardiac surgery patients. We investigated the prevalence of malnutrition risk and its association with 30-day hospital mortality and postoperative complications. Four hundred and three patients who underwent cardiac surgery during 2008 and were screened with the Malnutrition Universal Screening Tool (MUST) on admission were enrolled. Univariate and multivariate logistic regression analyses compared the association of high and low risk for malnutrition with length of hospitalization (LOS), in-hospital and 30-day mortality, and postoperative complications. Almost 20% of the patients were found to be at high risk for malnutrition. Univariate analyses revealed higher in-hospital mortality rates (p = 0.03) and greater incidence of LOS and antibiotic treatment longer than 21 days (p = 0.002 and p = 0.04, respectively), vasopressor treatment longer than 11 days (p = 0.02), and positive blood cultures (p = 0.02) in patients belonging to the high-risk MUST group. Incorporation of the MUST in a multivariate model with the European System for Cardiac Operative Risk Evaluation (EuroSCORE) significantly improved postoperative complications prediction, as well as in-hospital and 30-day mortality, compared with the EuroSCORE alone. Malnutrition is prevalent in patients undergoing cardiac surgery, associated with higher postoperative mortality and morbidity. Preoperative MUST screening has emerged as highly relevant for enabling early diagnosis of patients at malnutrition risk, predicting postoperative mortality and morbidity, thus promoting well timed treatment. Prospective studies are needed to explore whether intervention can decrease malnutrition risk.

  17. Robotic surgery - advance or gimmick? (United States)

    De Wilde, Rudy L; Herrmann, Anja


    Robotic surgery is increasingly implemented as a minimally invasive approach to a variety of gynaecological procedures. The use of conventional laparoscopy by a broad range of surgeons, especially in complex procedures, is hampered by several drawbacks. Robotic surgery was created with the aim of overcoming some of the limitations. Although robotic surgery has many advantages, it is also associated with clear disadvantages. At present, the proof of superiority over access by laparotomy or laparoscopy through large randomised- controlled trials is still lacking. Until results of such trials are present, a firm conclusion about the usefulness of robotic surgery cannot be drawn. Robotic surgery is promising, making the advantages of minimally invasive surgery potentially available to a large number of surgeons and patients in the future.

  18. Pregnancy management following bariatric surgery. (United States)

    Uzoma, A; Keriakos, R


    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.

  19. Robotic Surgery in Gynecologic Oncology

    Directory of Open Access Journals (Sweden)

    Robert DeBernardo


    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.

  20. Robotic surgery of the pancreas (United States)

    Joyce, Daniel; Morris-Stiff, Gareth; Falk, Gavin A; El-Hayek, Kevin; Chalikonda, Sricharan; Walsh, R Matthew


    Pancreatic surgery is one of the most challenging and complex fields in general surgery. While minimally invasive surgery has become the standard of care for many intra-abdominal pathologies the overwhelming majority of pancreatic surgery is performed in an open fashion. This is attributed to the retroperitoneal location of the pancreas, its intimate relationship to major vasculature and the complexity of reconstruction in the case of pancreatoduodenectomy. Herein, we describe the application of robotic technology to minimally invasive pancreatic surgery. The unique capabilities of the robotic platform have made the minimally invasive approach feasible and safe with equivalent if not better outcomes (e.g., decreased length of stay, less surgical site infections) to conventional open surgery. However, it is unclear whether the robotic approach is truly superior to traditional laparoscopy; this is a key point given the substantial costs associated with procuring and maintaining robotic capabilities. PMID:25356035

  1. Programa de cirugía bariátrica laparoscópica en la Clínica Universidad de Navarra-Complejo Hospitalario de Navarra: resultados a un año Laparoscopic bariatric surgery program in the University Clinic of Navarre - Hospital Complex of Navarre: results after 1-year follow-up

    Directory of Open Access Journals (Sweden)

    V. Valentí Azcárate


    use bariatric surgery both to maintain long-term weight loss, and for the resolution of associated comorbidities. This article analyzes the initial results of the implementation of the laparoscopic bariatric surgery program in Navarre, obtained in a group of obese patients with surgical indication and operated on by means of the laparoscopic gastric bypass. Methods. From January 2010 until December 2011, 47 gastric bypasses were performed laparoscopically in the University Clinic of Navarre, all of them from the autonomous community of Navarre and previously and subsequently evaluated in the Hospital Complex of Navarre. The first 19 cases amongst them were selected for this work, as they presented at least one year of follow-up. Results. The percentage of excess weight lost was 65.47%, with a 31.68% reduction of total weight. The figures for glucose, uric acid, arterial tension and lipid metabolism one year after the intervention presented a very significant progressive fall. No significant medical or surgical complications were presented. Conclusions. The laparoscopic gastric bypass is an efficient technique for the long-term treatment of morbid obesity, with a scant number of complications, excellent weight loss and curing or improvement of the associated comorbidities in these patients.

  2. Logistics and outcome in urgent and emergency colorectal surgery

    DEFF Research Database (Denmark)

    Elshove-Bolk, J.; Ellensen, V. S.; Baatrup, G.


    Aim: Infrastructure-related factors are seldom described in detail in studies on outcome after surgical procedures. We studied patient, procedure, physician and infrastructure characteristics and their effect on outcome at a Norwegian University hospital. Method: All patients admitted between 1st...... January 2002 and 30th June 2003 who underwent urgent or emergency colorectal surgery were extracted from the hospital databases and retrospectively analysed. Results: There were 196 patients. The overall complication rate was 39%. Forty-six (24%) patients died during admission after surgery. Those who...

  3. Pre-prosthetic surgery: Mandible (United States)

    Devaki, Veeramalai Nadu; Balu, Kandasamy; Ramesh, Sadashiva Balakrishnapillai; Arvind, Ramraj Jayabalan; Venkatesan


    Pre-prosthetic surgery is that part of oral and maxillofacial surgery which restores oral function and facial form. This is concerned with surgical modification of the alveolar process and its surrounding structures to enable the fabrication of a well-fitting, comfortable, and esthetic dental prosthesis. The ultimate goal of pre-prosthetic surgery is to prepare a mouth to receive a dental prosthesis by redesigning and smoothening bony edges. PMID:23066301

  4. Pre-prosthetic surgery: Mandible

    Directory of Open Access Journals (Sweden)

    Veeramalai Naidu Devaki


    Full Text Available Pre-prosthetic surgery is that part of oral and maxillofacial surgery which restores oral function and facial form. This is concerned with surgical modification of the alveolar process and its surrounding structures to enable the fabrication of a well-fitting, comfortable, and esthetic dental prosthesis. The ultimate goal of pre-prosthetic surgery is to prepare a mouth to receive a dental prosthesis by redesigning and smoothening bony edges.

  5. Oncoplastic breast surgery in Denmark

    DEFF Research Database (Denmark)

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


    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....

  6. Advances in percutaneous stone surgery

    Directory of Open Access Journals (Sweden)

    Christopher Hartman


    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.

  7. New Trends in General Surgery


    Bautista Iturrizaga, Juan; Facultad de Medicina Universidad Nacional Mayor de San Marcos Lima, Perú


    Currently, with the advance of science, more and more basic disciplines are associated with surgery exerting some influence and giving rise to the concept of Medical-Surgical Science. Besides that, surgery has evolved in paralel with immunology (in the field of transplants), interventional radiology and diagnostic-therapeutic endoscopy. Indeed, many of changes in surgery, such as the use of new diagnostic tools, approaches with shorter incisions, and the colaboration -still in an evaluative p...

  8. Robotic surgery: colon and rectum. (United States)

    Baek, Seong Kyu; Carmichael, Joseph C; Pigazzi, Alessio


    Although robotic technology aims to obviate some of the limitations of conventional laparoscopic surgery, the role of robotics in colorectal surgery is still largely undefined and different with respect to its application in abdominal versus pelvic surgery. This review aims to elucidate current developments in colorectal robotic surgery.In colon surgery, robotic techniques are associated with longer operative times and higher costs compared with laparoscopic surgery. However, robotics provides a stable camera platform and articulated instruments that are not subject to human tremors. Because of these advantages, robotic systems can play a role in complex procedures such as the dissection of lymph nodes around major vessels. In addition robot-assisted hand-sewn intracorporeal anastomoses can be easily performed by the surgeon, without a substantial need for a competent assistant. At present, although the short-term outcomes and oncological adequacy of robotic colon resection have been observed to be acceptable, the long-term outcomes of robotic colon resection remain unknown.In rectal surgery, robotic-assisted surgery for rectal cancer can be carried out safely and in accordance with current oncological principles. However, to date, the impact of robotic rectal surgery on the long-term oncological outcomes of minimally invasive total mesorectal excision remains undetermined. Robotic total mesorectal excision may allow for better preservation of urinary and sexual functions, and robotic surgery may attenuate the learning curve for laparoscopic rectal resection. However, a major drawback to robotic rectal surgery is the high cost involved.Large-scale prospective randomized clinical trials such as the international randomized trial ROLARR are required to establish the benefits of robotic rectal surgery.

  9. Pediatric oral and maxillofacial surgery. (United States)

    Kutcipal, Elizabeth


    Pediatric oral and maxillofacial surgery is rarely seen as a separate entity from adult oral and maxillofacial surgery. Many procedures are similar on adults and children; however, children have unique behavioral, anatomic, and physiologic considerations. Children also have a propensity for certain injuries and pathologic lesions. Children born with congenital anomalies may also have a special subset of needs. This article is a brief review of oral and maxillofacial surgery on the pediatric population.

  10. Virtual Mentor Cataract Surgery Trainer (United States)


    TITLE: Virtual Mentor Cataract Surgery Trainer PRINCIPAL INVESTIGATOR: Principal Investigator: John I. Loewenstein MD Co-Investigator: Bonnie A...AND SUBTITLE Virtual Mentor Cataract Surgery Trainer 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-08-1-0531 5c. PROGRAM ELEMENT NUMBER...AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The Virtual Mentor Cataract Surgery

  11. Robotics for surgery. (United States)

    Howe, R D; Matsuoka, Y


    Robotic technology is enhancing surgery through improved precision, stability, and dexterity. In image-guided procedures, robots use magnetic resonance and computed tomography image data to guide instruments to the treatment site. This requires new algorithms and user interfaces for planning procedures; it also requires sensors for registering the patient's anatomy with the preoperative image data. Minimally invasive procedures use remotely controlled robots that allow the surgeon to work inside the patient's body without making large incisions. Specialized mechanical designs and sensing technologies are needed to maximize dexterity under these access constraints. Robots have applications in many surgical specialties. In neurosurgery, image-guided robots can biopsy brain lesions with minimal damage to adjacent tissue. In orthopedic surgery, robots are routinely used to shape the femur to precisely fit prosthetic hip joint replacements. Robotic systems are also under development for closed-chest heart bypass, for microsurgical procedures in ophthalmology, and for surgical training and simulation. Although results from initial clinical experience is positive, issues of clinician acceptance, high capital costs, performance validation, and safety remain to be addressed.

  12. [Erythropoietin in plastic surgery]. (United States)

    Günter, C I; Rezaeian, F; Harder, Y; Lohmeyer, J A; Egert, S; Bader, A; Schilling, A F; Machens, H-G


    EPO is an autologous hormone, which is known to regulate erythropoiesis. For 30 years it has been used for the therapy of diverse forms of anaemia, such as renal anaemia, tumour-related anaemias, etc. Meanwhile, a multitude of scientific publications were able to demonstrate its pro-regenerative effects after trauma. These include short-term effects such as the inhibition of the "primary injury response" or apoptosis, and mid- and long-term effects for example the stimulation of stem cell recruitment, growth factor production, angiogenesis and re-epithelialisation. Known adverse reactions are increases of thromboembolic events and blood pressure, as well as a higher mortality in patients with tumour anaemias treated with EPO. Scientific investigations of EPO in the field of plastic surgery included: free and local flaps, nerve regeneration, wound healing enhancement after dermal thermal injuries and in chronic wounds.Acute evidence for the clinical use of EPO in the field of plastic surgery is still not satisfactory, due to the insufficient number of Good Clinical Practice (GCP)-conform clinical trials. Thus, the initiation of more scientifically sound trials is indicated.

  13. Leadership in cardiac surgery. (United States)

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


    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.

  14. Future of robotic surgery. (United States)

    Lendvay, Thomas Sean; Hannaford, Blake; Satava, Richard M


    In just over a decade, robotic surgery has penetrated almost every surgical subspecialty and has even replaced some of the most commonly performed open oncologic procedures. The initial reports on patient outcomes yielded mixed results, but as more medical centers develop high-volume robotics programs, outcomes appear comparable if not improved for some applications. There are limitations to the current commercially available system, and new robotic platforms, some designed to compete in the current market and some to address niche surgical considerations, are being developed that will change the robotic landscape in the next decade. Adoption of these new systems will be dependent on overcoming barriers to true telesurgery that range from legal to logistical. As additional surgical disciplines embrace robotics and open surgery continues to be replaced by robotic approaches, it will be imperative that adequate education and training keep pace with technology. Methods to enhance surgical performance in robotics through the use of simulation and telementoring promise to accelerate learning curves and perhaps even improve surgical readiness through brief virtual-reality warm-ups and presurgical rehearsal. All these advances will need to be carefully and rigorously validated through not only patient outcomes, but also cost efficiency.

  15. Depo-Provera (depot medroxyprogesterone acetate use after bariatric surgery

    Directory of Open Access Journals (Sweden)

    Lam C


    Full Text Available Clarissa Lam,1 Amitasrigowri S Murthy2,3 1New York University School of Medicine, 2Department of Obstetrics and Gynecology, Bellevue Hospital Center, New York University School of Medicine, 3New York University Langone Medical Center, New York, NY, USA Abstract: In the US, obesity rates are increasing greatly. The Centers for Disease Control and Prevention estimates that 68.5% of Americans, including 63.9% of adult women older than 20 years, are overweight (body mass index between 25 kg/m2 and 29.9 kg/m2 or obese (body mass index >30 kg/m2. In light of this, it is not surprising that the rates of bariatric surgery have also been increasing. When considering the metabolic changes associated with both bariatric surgery and contraceptive use, in combination with the unique medical considerations of obese women, it is indisputable that clear guidelines are needed when counseling obese patients of reproductive age after bariatric surgery. In this literature review, we focus on depot medroxyprogesterone acetate (DMPA and the implications of its use in obese women, preweight and postweight loss following bariatric surgery. Both DMPA use and bariatric surgery are known to cause bone loss, but it is still unclear whether there is an additive effect of the two factors on bone loss and whether either of these factors directly leads to an increased risk of bone fracture. The current consensus guidelines do not impose a restriction on the use of DMPA after bariatric surgery. DMPA use is associated with weight gain, and it is unclear whether weight loss blunting occurs with the use of DMPA after bariatric surgery. Prior studies had demonstrated an association with weight gain in adolescents, and therefore, those prescribing DMPA use after bariatric surgery in adolescents should proceed with caution. Adult women do not have a similar response to the use of DMPA. DMPA use has rarely been associated with increased risk of venous thromboembolism (VTE. The

  16. Reconstructive valve surgery within 10 days of stroke in endocarditis. (United States)

    Raman, Jai; Ballal, Apoorva; Hota, Bala; Mirza, Sara; Lai, David; Bleck, Thomas; Lateef, Omar


    The optimal timing of surgical treatment for infective endocarditis complicated by cerebrovascular events is controversial, largely due to the perceived risk of perioperative intracranial bleeding. Current guidelines suggest waiting 2 weeks between the diagnosis of stroke and surgery. The aim of this study was to investigate the clinical and neurological outcomes of early surgery following a stroke. This was a single-center retrospective analysis of 12 consecutive patients requiring surgery for infective endocarditis between 2011 and 2014 at Rush University Medical Center, with either ischemic (n = 6) and/or hemorrhagic (n = 6) cerebrovascular complications. All underwent computed tomographic angiography prior to early valve reconstructive surgery to identify potentially actionable neurological findings. Early valve surgery was performed for ongoing sepsis or persistent emboli. Neurologic risk and outcome were assessed pre- and postoperatively using the National Institutes of Health Stroke Scale and the Glasgow Outcome Scale, respectively. All 12 patients underwent surgical treatment within 10 days of the diagnosis of stroke. Mortality in the immediate postoperative period was 8%. Eleven of the 12 patients exhibited good neurological recovery in the immediate postoperative period, with a Glasgow Outcome Scale score ≥ 3. There was no correlation between duration of cardiopulmonary bypass and neurological outcomes. Early cardiac surgery in patients with infective endocarditis and stroke maybe lifesaving with a low neurological risk. Comprehensive neurovascular imaging may help in identifying patient-related risk factors. © The Author(s) 2016.

  17. Acute kidney injury in septua- and octogenarians after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Schmid Christof


    Full Text Available Abstract Background An increasing number of septua- and octogenarians undergo cardiac surgery. Acute kidney injury (AKI still is a frequent complication after surgery. We examined the incidence of AKI and its impact on 30-day mortality. Methods A retrospective study between 01/2006 and 08/2009 with 299 octogenarians, who were matched for gender and surgical procedure to 299 septuagenarians at a university hospital. Primary endpoint was AKI after surgery as proposed by the RIFLE definition (Risk, Injury, Failure, Loss, End-stage kidney disease. Secondary endpoint was 30-day mortality. Perioperative mortality was predicted with the logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE. Results Octogenarians significantly had a mean higher logistic EuroSCORE compared to septuagenarians (13.2% versus 8.5%; p -1 × 1.73 m-2. In contrast, septuagenarians showed a slightly higher median body mass index (28 kg × m-2 versus 26 kg × m-2 and were more frequently active smoker at time of surgery (6.4% versus 1.6%, p The RIFLE classification provided accurate risk assessment for 30-day mortality and fair discriminatory power. Conclusions The RIFLE criteria allow identifying patients with AKI after cardiac surgery. The high incidence of AKI in septua- and octogenarians after cardiac surgery should prompt the use of RIFLE criteria to identify patients at risk and should stimulate institutional measures that target AKI as a quality improvement initiative for patients at advanced age.

  18. [Science and research in academic plastic surgery in Germany]. (United States)

    Giunta, R E; Machens, H-G


    Plastic surgery has passed through a very positive evolution in the last decades on the solid fundament of constantly developing academic plastic surgery. Aim of this paper is an objective evaluation of the current status of academic plastic surgery regarding research topics, currently available ressources and scientific outcome based on a questionnaire. The return rate of the questionnaire in academic departments was 92%. Main topics in research besides wound healing were topics from regenerative medicine such as tissue engineering, biomaterials, genetherapy and angiogenesis with the main focus on skin and fat tissues. In the past five years a total of 25 million Euros of third party research grants were raised. Research relied mainly on interdisciplinary research facilities. Regarding the scientific outcome more than 200 scientific papers were published in basic science research journals having an impactfactor higher than two. These results clearly demonstrate that plastic surgery is scientifically highly productive in academic surroundings where independent departments are established. Considering that independent units of plastic surgery exist in a relatively small number of all 36 university hospitals in germany, it has to be claimed for further independent departments so to provide adequate research facilities for further evolution of academic plastic surgery.

  19. [Early death in vascular surgery: an ongoing prognostic problem]. (United States)

    Kazimierczak, Arkadiusz; Sledź, Marcin; Guzicka-Kazimierczak, Renata; Gutowski, Piotr; Cnotliwy, Miłosław


    Prediction of complications in surgery is commonly done. There are conflicting reports concerning the usefulness of risk scales (P-POSSUM, APACHE, SAPS, ASA, Goldman, etc.) in vascular surgery. We decided to take a fresh look at preoperative risk factors of early death in the context of the usefulness of some parameters which have not been included in existing risk calculators. The study group consisted of 1270 patients treated at the Department of Vascular Surgery, General Surgery, and Angiology, Pomeranian Medical University in Szczecin, during one year. METHOD This was a prospective non-randomized study. All data recorded at admission and data from P-POSSUM, ASA, Goldman, and ECOG-Zubroda-WHO scales were analyzed. Statistics were done with discriminant, multivariate, and logistic tests. There were 42 early deaths in the group. The following independent risk factors were involved in early death: ASA > 2 (OR = 18.31), persistent atrial fibrillation (OR = 5.75), leukocytosis (OR = 13.31), glomerular filtration rate (GFR) SIRS) (OR = 11.36), emergency admission (OR = 38.62), critical limb ischemia (OR = 4.87), acute limb ischemia (OR = 8,98), abdominal aortic aneurysm (OR = 4.4), and ruptured aortic aneurysm (OR = 10.59). Logistic regression exposed the influence of five factors: ASA III, ASA IV, persistent atrial fibrillation, leukocytosis, GFR surgery need to be "refreshed". Creation of the Polish National Vascular Surgery Register seems to be unavoidable.

  20. Does thromboprophylaxis prevent venous thromboembolism after major orthopedic surgery?

    Directory of Open Access Journals (Sweden)

    Evrim Eylem Akpinar


    Full Text Available OBJECTIVE: Pulmonary embolism (PE is an important complication of major orthopedic surgery. The aim of this study was to evaluate the incidence of venous thromboembolism (VTE and factors influencing the development of VTE in patients undergoing major orthopedic surgery in a university hospital. METHODS: Patients who underwent major orthopedic surgery (hip arthroplasty, knee arthroplasty, or femur fracture repair between February of 2006 and June of 2012 were retrospectively included in the study. The incidences of PE and deep vein thrombosis (DVT were evaluated, as were the factors influencing their development, such as type of operation, age, and comorbidities. RESULTS: We reviewed the medical records of 1,306 patients. The proportions of knee arthroplasty, hip arthroplasty, and femur fracture repair were 63.4%, 29.9%, and 6.7%, respectively. The cumulative incidence of PE and DVT in patients undergoing major orthopedic surgery was 1.99% and 2.22%, respectively. Most of the patients presented with PE and DVT (61.5% and 72.4%, respectively within the first 72 h after surgery. Patients undergoing femur fracture repair, those aged ≥ 65 years, and bedridden patients were at a higher risk for developing VTE. CONCLUSIONS: Our results show that VTE was a significant complication of major orthopedic surgery, despite the use of thromboprophylaxis. Clinicians should be aware of VTE, especially during the perioperative period and in bedridden, elderly patients (≥ 65 years of age.

  1. Sex reassignment surgery

    Directory of Open Access Journals (Sweden)

    Bižić Marta


    Full Text Available Transsexualism, or gender incongruence, presents a state in which a person's assigned sex at birth conflicts with their psychological gender. It is classified in International Classification of Diseases as F64. Treating these persons require multidisciplinary approach, including psychiatrist, endocrinologist, gynecologist, urologist, plastic and reconstructive surgeon. Genital reconstruction is the final step in transition, and can be performed when all other conditions required by World Professional Association for Transgender Health (WPATH are accomplished. Female to male sex reassignment surgery Several surgical procedures can be done in female to male transsexuals, including mastectomy, removal of female genitalia, metoidioplasty, scrotoplasty with implantation of testicular implants, as well as total phalloplasty. The current operative technique of metoidioplasty comprise the following steps: vaginal removal, the release of the ventral chordee and clitoral ligaments, straightening and lengthening of the clitoris, urethroplasty by combining buccal mucosa graft and genital flaps and scrotoplasty with insertion of testicle prostheses. The goal is to perform all these procedures in one stage, and that makes our team famous worldwide. Metoidioplasty results in excellent cosmetic outcome with completely preserved sensitivity and sexual arousal, enables voiding while standing, but without ability to penetrate due to small size of the neophallus. Considering these advantages, including low complication rate, patients often choose this option. For those who require bigger phallus which enables implantation of penile prosthesis, several surgical techniques have been reported using either available local vascularized tissue or microvascular tissue transfer. However, none of them satisfy all the goals of modern penile construction, i.e. reproducibility, tactile and erogenous sensation, a competent neourethra with a meatus at the top of the neophallus

  2. Cosmetic surgery and conscientious objection. (United States)

    Minerva, Francesca


    In this paper, I analyse the issue of conscientious objection in relation to cosmetic surgery. I consider cases of doctors who might refuse to perform a cosmetic treatment because: (1) the treatment aims at achieving a goal which is not in the traditional scope of cosmetic surgery; (2) the motivation of the patient to undergo the surgery is considered trivial; (3) the patient wants to use the surgery to promote moral or political values that conflict with the doctor's ones; (4) the patient requires an intervention that would benefit himself/herself, but could damage society at large.

  3. Aesthetic adjuncts with orthognathic surgery. (United States)

    Mohamed, Waheed V; Perenack, Jon D


    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.

  4. Endocrine Surgery: A Hopkins Legacy. (United States)

    Udelsman, Robert


    : The field of Endocrine Surgery is linked to extraordinary contributions made by Hopkins leaders in surgery including William Stewart Halsted, Harvey Cushing, and John L Cameron. Halsted's contributions to the anatomic basis of thyroid and parathyroid surgery were based on his experimental and clinical work performed at Johns Hopkins Hospital. Halsted's disciple, Harvey Cushing, created the field of modern neurosurgery and recognized the disease and syndrome that are immortalized with his name. The Halstedian principles promulgated and transmitted by John L Cameron to subsequent generations of endocrine surgeons at Hopkins have transformed the field of Endocrine Surgery with the stamp of Johns Hopkins Hospital.

  5. Surgery Risk Assessment (SRA) Database (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...

  6. Results of cataract surgery in the very elderly population

    Directory of Open Access Journals (Sweden)

    Michalska-Małecka K


    Full Text Available Katarzyna Michalska-Małecka,1 Mariusz Nowak,2 Piotr Gościniewicz,1 Jacek Karpe,3 Ludmiła Słowińska-Łożyńska,4 Agnieszka Łypaczewska,1 Dorota Romaniuk11Department of Ophthalmology, University Hospital No 5, Medical University of Silesia, Katowice, 2Pathophysiology Division, Department of Pathophysiology and Endocrinology, Medical University of Silesia, Zabrze, 3Department of Anesthesiology and Intensive Therapy, Medical University of Silesia, Zabrze, 4Department of Biophysics, Faculty of Medicine in Zabrze, Medical University of Silesia, Katowice, Silesia, PolandAim: The aim of our study was to retrospectively evaluate the effectiveness and safety of cataract surgery and intraocular lens implantation (IOL for patients aged 90 years or older, whom we define as “very elderly.”Methods: The study involved a total number of 122 patients (122 eyes with senile cataracts. The mean age of patients was 91.2 ± 2.3 years (range 90–100 years old. Phacoemulsification (phaco was done on 113 of 122 eyes, and 9 of 122 eyes had extracapsular cataract extraction (ECCE. Postoperative visual acuity and intraocular pressure (IOP were analyzed on the first postoperative day, 3 months after surgery, and 6 months after surgery.Results: Best corrected visual acuity (BCVA improved in 100 of 122 eyes (82.0%. BCVA remained the same in 20 of 122 eyes (16.4% and decreased in 2 of 122 eyes (1.6%, mainly because of coexisting age-related macular degeneration (AMD. The BCVA 3 months after surgery was ≥0.8 in 23 of 122 eyes (18.9%, between 0.5 and 0.7 in 28 of 122 eyes (22.3%, and between 0.2 and 0.4 in 33 of 122 eyes (27.1%. We found significant implications of cataract surgery on decreasing IOP in the studied group of patients suffering from glaucoma compared to the patients without glaucoma.Conclusion: Advanced age is not a contraindication for cataract surgery. The results of the study showed that when systemic conditions are stable, both phaco and ECCE with

  7. Does intentional support of degree programs in general surgery residency affect research productivity or pursuit of academic surgery? (United States)

    Joshua Smith, Jesse; Patel, Ravi K; Chen, Xi; Tarpley, Margaret J; Terhune, Kyla P


    Many residents supplement general surgery training with years of dedicated research, and an increasing number at our institution pursue additional degrees. We sought to determine whether it was worth the financial cost for residency programs to support degrees. We reviewed graduating chief residents (n = 69) in general surgery at Vanderbilt University from 2001 to 2010 and collected the data including research time and additional degrees obtained. We then compared this information with the following parameters: (1) total papers, (2) first-author papers, (3) Journal Citation Reports impact factors of journals in which papers were published, and (4) first job after residency or fellowship training. The general surgery resident training program at Vanderbilt University is an academic program, approved to finish training 7 chief residents yearly during the time period studied. Chief residents in general surgery at Vanderbilt who finished their training 2001 through 2010. We found that completion of a degree during residency was significantly associated with more total and first-author publications as compared with those by residents with only dedicated research time (p = 0.001 and p = 0.017). Residents completing a degree also produced publications of a higher caliber and level of authorship as determined by an adjusted resident impact factor score as compared with those by residents with laboratory research time only (p = 0.005). Degree completion also was significantly correlated with a first job in academia if compared to those with dedicated research time only (p = 0.046). Our data support the utility of degree completion when economically feasible and use of dedicated research time as an effective way to significantly increase research productivity and retain graduates in academic surgery. Aggregating data from other academic surgery programs would allow us to further determine association of funding of additional degrees as a means to encourage academic

  8. Follow-Up After Cardiac Surgery Should be Extended to at Least 120 Days When Benchmarking Cardiac Surgery Centers. (United States)

    Hansen, Laura S; Sloth, Erik; Hjortdal, Vibeke E; Jakobsen, Carl-Johan


    Short-term (30 days) mortality frequently is used as an outcome measure after cardiac surgery, although it has been proposed that the follow-up period should be extended to 120 days to allow for more accurate benchmarking. The authors aimed to evaluate whether mortality rates 120 days after surgery were comparable to general mortality and to compare causes of death between the cohort and the general population. A multicenter descriptive cohort study using prospectively entered registry data. University hospital. The cohort was obtained from the Western Denmark Heart Registry and matched to the Danish National Hospital Register as well as the Danish Register of Causes of Death. A weighted, age-matched general population consisting of all Danish patients who died within the study period was identified through the central authority on Danish statistics. A total of 11,988 patients (>15 years) who underwent cardiac-surgery at Aarhus, Aalborg and Odense University Hospitals from April 1, 2006 to December 31, 2012 were included. Coronary artery bypass grafting, valve surgery and combinations. Mortality after cardiac surgery matches with mortality in the general population after 140 days. Mortality curves run almost parallel from this point onwards, regardless of The European system for cardiac operative risk evaluation (EuroSCORE) and intervention. The causes of death in the cohort differed statistically significantly from the background population (pcardiac (38%); 53% of which was categorized as heart failure. A total of 54% of these patients were assessed preoperatively as having normal or mildly impaired heart function (EuroSCORE). This study supported an extended follow-up period after cardiac surgery when benchmarking cardiac surgery centers. Regardless of preoperative heart function, heart failure was the consistent leading cause of death. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Results of low-dose human atrial natriuretic peptide infusion in nondialysis patients with chronic kidney disease undergoing coronary artery bypass grafting: the NU-HIT (Nihon University working group study of low-dose HANP Infusion Therapy during cardiac surgery) trial for CKD

    National Research Council Canada - National Science Library

    Sezai, Akira; Hata, Mitsumasa; Niino, Tetsuya; Yoshitake, Isamu; Unosawa, Satoshi; Wakui, Shinji; Kimura, Haruka; Shiono, Motomi; Takayama, Tadateru; Hirayama, Atsushi


    ...). CKD is an important risk factor for cardiac surgery. This was a randomized controlled study of 303 patients with CKD who underwent CABG, and were divided into a group who received carperitide infusion and another group without carperitide...

  10. Additional Surgery after Breast-Conserving Surgery Varies Widely (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.

  11. Universal overgroup (United States)

    Arnal, Didier; Selmi, Mohamed; Zergane, Amel


    A way to separate irreducible unitary representations π for a Lie group G by moment sets is to use an infinite-dimensional overgroup G˜ and extensions of each representation π to a representation π˜ of G˜, in such a manner that the moment set of π˜ characterizes π. In this paper we propose a universal overgroup G˜, which is an infinite-dimensional Fréchet-Lie group. We extend each π to a Hamiltonian action π˜ of G˜. The moment set of π˜ characterizes π.

  12. Open University

    CERN Document Server



    Michel Pentz est née en Afrique du Sud et venu au Cern en 1957 comme physicien et président de l'associaion du personnel. Il est également fondateur du mouvement Antiapartheid de Genève et a participé à la fondation de l'Open University en Grande-Bretagne. Il nous parle des contextes pédagogiques, culturels et nationaux dans lesquels la méthode peut s'appliquer.

  13. Yale University

    Institute of Scientific and Technical Information of China (English)



    Being one of the world's great universities, Yale enrolls no less than 11,000 students from more than one hundred countries. And the 3,200-member faculty is a richly diverse group of men and women who are leaders in their respective fields. The 260 buildings in Yale include contributions from distinguished architects of every period in its history. The central campus of Yale now covers 310 acres (125 hectares) stretching from the School of Nursing in downtown New Haven to tree-shaded residential neighbor...

  14. [Robotic surgery for colorectal cancer in elderly patients]. (United States)

    Xu, Pingping; Wei, Ye; Xu, Jianmin


    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 stage I, 10 stage II, and 11 stage III. 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

  15. Outpatient- and inpatient-based buckling surgery: a comparative study

    Directory of Open Access Journals (Sweden)

    Lee JC


    Full Text Available Jin Cheol Lee,* Yu Cheol Kim*Department of Ophthalmology, Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea *Both authors contributed equally to this workPurpose: To evaluate the clinical outcomes of ambulatory buckling surgery, comparing outpatient- with inpatient-based surgery.Methods: The authors performed a retrospective study of 80 consecutive cases of rhegmato genous retinal detachment from January 2009 to December 2011 treated by scleral buckling surgery. Two groups of patients were defined according to inpatient (group 1 or outpatient (group 2 surgery, and a comparison of several parameters between these two groups was performed.Results: Of the 80 subjects in this study, the average age of group 1 (50 patients was 49.7 years, and that of group 2 (30 patients was 47.5 years. There were no statistically significant differences in the average logarithm of the minimum angle of resolution-visual acuity, the condition of the lens, or the presence of retinal lattice degeneration prior to the surgery between the groups. There were no statistically significant differences in the patterns of tear or retinal detachment or in surgical procedure between the groups. Comparing the best-corrected visual acuity after 6 months with that prior to the surgery, the changes in group 1 and group 2 were 0.26 and 0.31, respectively. The functional success rates of group 1 and group 2 after 6 months were 90% and 93%, respectively, and the anatomical success rates of group 1 and group 2 after 6 months were 94% and 96%, respectively, but these were also statistically insignificant.Conclusion: Hospitalization is not essential for buckling surgery in uncomplicated rhegmatogenous retinal detachment surgery.Keywords: ambulatory, scleral buckling, rhegmatogenous retinal detachment

  16. Geneva University

    CERN Multimedia


    École de physique - Département de physique nucléaire et corpusculaire 24, quai Ernest-Ansermet 1211 GENÈVE 4 Tél: (022) 379 62 73 - Fax: (022) 379 69 92 Wednesday 13 May 2009 PARTICLE PHYSICS SEMINAR at 17:00 – Stückelberg Auditorium Observing the extreme universe with the Fermi Gamma-ray Space Telescope Prof. Olaf Reimer / Stanford University The Fermi Gamma-ray Space Telescope (FGST, formerly GLAST) is an international observatory-type satellite mission with a physics program spanning from gamma-ray astronomy to particle astrophysics and cosmology. FGST was launched on June 11, 2008 and is successfully conducting science observations of the high-energy gamma-ray sky since August 2008. A varienty of discoveries has been made already, including monitoring rapid blazar variability, the existence of GeV gamma-ray bursts, and numerous new gamma-ray sources of different types, including those belonging to previously unknown gamma-ray source classes like msPSRs, globula...

  17. Geneva University

    CERN Multimedia


    École de physique - Département de physique nucléaire et corspusculaire 24, quai Ernest-Ansermet 1211 GENÈVE 4 Tél: (022) 379 62 73 - Fax: (022) 379 69 92 Monday 9 March 2009 COLLOQUIUM at 17:00 – Stückelberg Auditorium Are We Descended From Heavy Neutrinos? Prof. Boris Kayser / Fermilab (Fermi National Accelerator Center, Geneva, Illinois, USA) Neutrinos are among the most abundant particles in the universe. The discovery that they have nonzero masses has raised a number of very interesting questions about them, and about their connections to other areas of physics and to cosmology. After briefly reviewing what has been learned about the neutrinos so far, we will identify the major open questions, explain why they are interesting, and discuss ideas and plans for answering them through future experiments. We will highlight a particularly intriguing question: Are neutrinos the key to understanding why the universe contains matter but almost no antimatter, making it s...

  18. Applications of piezoelectric surgery in endodontic surgery: a literature review. (United States)

    Abella, Francesc; de Ribot, Joan; Doria, Guillermo; Duran-Sindreu, Fernando; Roig, Miguel


    Piezosurgery (piezoelectric bone surgery) devices were developed to cut bone atraumatically using ultrasonic vibrations and to provide an alternative to the mechanical and electrical instruments used in conventional oral surgery. Indications for piezosurgery are increasing in oral and maxillofacial surgery, as in other disciplines, such as endodontic surgery. Key features of piezosurgery instruments include their ability to selectively cut bone without damaging adjacent soft tissue, to provide a clear operative field, and to cut without generating heat. Although piezosurgery instruments can be used at most stages of endodontic surgery (osteotomy, root-end resection, and root-end preparation), no published data are available on the effect of piezosurgery on the outcomes of endodontic surgery. To our knowledge, no study has evaluated the effect of piezosurgery on root-end resection, and only 1 has investigated root-end morphology after retrograde cavity preparation using piezosurgery. We conducted a search of the PubMed and Cochrane databases using appropriate terms and keywords related to the use and applications of piezoelectric surgery in endodontic surgery. A hand search also was conducted of issues published in the preceding 2 years of several journals. Two independent reviewers obtained and analyzed the full texts of the selected articles. A total of 121 articles published between January 2000 and December 2013 were identified. This review summarizes the operating principles of piezoelectric devices and outlines the applications of piezosurgery in endodontic surgery using clinical examples. Piezosurgery is a promising technical modality with applications in several aspects of endodontic surgery, but further studies are necessary to determine the influence of piezosurgery on root-end resection and root-end preparation. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  19. Branding of vascular surgery. (United States)

    Perler, Bruce A


    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.

  20. [Surgery for vertigo]. (United States)

    Lacombe, H


    Spontaneous recovery or central compensation makes surgical procedures rare in patients with vertigo. Surgery for vertigo proposed after pharmacological or physical therapy fails to eliminate Ménière's disease and some very rare cases of paroxystic positional vertigo. The main target in treating Ménière's disease is to promote vestibular compensation, which is possible only with a nonprogressive and stable deficit leading to readjustment of vestibular reflexes. Surgical procedures can be classified as nondestructive (endolymphatic sac decompression, vestibular nerve decompression, patching of perilymphatic fistulas), selectively destructive (middle fossa or retrosigmoid vestibular neurotomy, lateral semi-circular plugging) and destructive (labyrinthectomy). Surgical indications essentially concern incapacitating vertigo and depend mainly on hearing status. In Ménière's disease, vestibular neurotomy can be regarded as the gold standard considering its good results on vertiginous episodes; however, scoring with functional and quality-of-life scales bring out residual deficiency in some cases.

  1. Cancer immunotherapy with surgery

    Directory of Open Access Journals (Sweden)



    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.

  2. Smartphones in Surgery

    Directory of Open Access Journals (Sweden)

    Ara A. Salibian


    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.

  3. Impact of Radioimmunoguided Surgery. (United States)

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


    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.

  4. Robotics and general surgery. (United States)

    Jacob, Brian P; Gagner, Michel


    Robotics are now being used in all surgical fields, including general surgery. By increasing intra-abdominal articulations while operating through small incisions, robotics are increasingly being used for a large number of visceral and solid organ operations, including those for the gallbladder, esophagus, stomach, intestines, colon, and rectum, as well as for the endocrine organs. Robotics and general surgery are blending for the first time in history and as a specialty field should continue to grow for many years to come. We continuously demand solutions to questions and limitations that are experienced in our daily work. Laparoscopy is laden with limitations such as fixed axis points at the trocar insertion sites, two-dimensional video monitors, limited dexterity at the instrument tips, lack of haptic sensation, and in some cases poor ergonomics. The creation of a surgical robot system with 3D visual capacity seems to deal with most of these limitations. Although some in the surgical community continue to test the feasibility of these surgical robots and to question the necessity of such an expensive venture, others are already postulating how to improve the next generation of telemanipulators, and in so doing are looking beyond today's horizon to find simpler solutions. As the robotic era enters the world of the general surgeon, more and more complex procedures will be able to be approached through small incisions. As technology catches up with our imaginations, robotic instruments (as opposed to robots) and 3D monitoring will become routine and continue to improve patient care by providing surgeons with the most precise, least traumatic ways of treating surgical disease.

  5. [Andreas Vesalius and surgery]. (United States)

    Van Hee, R


    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.

  6. Liposuction with facelift surgery. (United States)

    Chrisman, B B


    During the past six years, the procedure now known as liposuction has revolutionized many aspects of cosmetic surgery, including the facelift, and is now finding applicability in other fields of medicine. The profound psychological benefits afforded to persons by facelifting have become increasingly available through the rapid public acceptance of outpatient surgery for this procedure. The latter has been assisted in no small way by the ancillary use of liposuction for facelifting, since liposuction has certainly made the facelift procedure easier and safer. Prior to the advent of liposuction, there were a number of reports in the medical literature about significant complication rates from facelifting, ranging in frequency from 1 to 8%. These included postoperative hematomas, infection, skin slough, significant hair loss, and nerve injury. The author has experienced none of these complications using adjunctive liposuction in over 100 facelifts. Liposuction has allowed treatment of facial areas previously almost unapproachable in facelifting, except perhaps by the most experienced hands. It has permitted the use of facial fat grafting, a further adjunct to the facelift procedure. Liposuction speeds the facelift procedure, lessening operator fatigue while shortening surgical and anesthesia time for the patient. These factors alone would provoke the rapid adoption of liposuction for facelifting, but its use is further solidified by the excellent results possible without resorting to the various complex and sometimes dangerous platysma-splitting and SMAS-undermining procedures often advocated in the past decade. Documentation of such results is provided by Figures 12 through 17. Thus, it seems reasonable to state that liposuction has had a tremendous and lasting impact on the surgical rejuvenation of the face and neck, whether used alone or in conjunction with facelift. It is in facelifting that the nuances and full potential of liposuction come to the fore.

  7. Laparoscopic surgery compared with open surgery decreases surgical site infection in obese patients

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel M; Sørensen, Lars T


    : To compare surgical site infections rate in obese patients after laparoscopic surgery with open general abdominal surgery.......: To compare surgical site infections rate in obese patients after laparoscopic surgery with open general abdominal surgery....

  8. Mortality after surgery in Europe

    DEFF Research Database (Denmark)

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


    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....

  9. Heart bypass surgery incision (image) (United States)

    ... the left part of the chest between the ribs. This incision is much less traumatic than the traditional heart bypass surgery incision which separates the breast bone. Minimally invasive heart bypass surgery allows the patient less pain and a faster recovery.

  10. Epilepsy surgery: Recommendations for India

    Directory of Open Access Journals (Sweden)

    Chandra P


    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.


    Directory of Open Access Journals (Sweden)

    P. G. Sysolyatin


    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. 

  12. Laparoscopic reintervention in colorectal surgery.

    NARCIS (Netherlands)

    Broek, RP Ten; Goor, H. van


    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

  13. [Intraoperative neuromonitoring in thyroid surgery]. (United States)

    Motos-Micó, José Jacob; Felices-Montes, Manuel; Abad-Aguilar, Teresa

    Intraoperative neuromonitoring of the recurrent laryngeal nerve in thyroid surgery facilitates the identification of anatomical structures in cervical endocrine surgery reducing the frequency of vocal cord paralysis. To study the normal electrophysiological values of the vague and recurrent laryngeal nerves before and after thyroid surgery. To compare rates of injury of recurrent nerve before and after the introduction of the intraoperative neuromonitoring in thyroid surgery. An observational, descriptive and prospective study in which a total of 490 patients were included. Between 2003-2010, surgery was performed on 411 patients (703 nerves at risk) with systematic identification of recurrent laryngeal nerves. Between 2010-2011 neuromonitorization was also systematically performed on 79 patients. Before the introduction of intraoperative neuromonitoring of 704 nerves at risk, there were 14 recurrent laryngeal nerve injuries. Since 2010, after the introduction of the intraoperative neuromonitoring in thyroid surgery, there has been no nerve injury in 135 nerves at risk. We consider the systematic identification of the recurrent laryngeal nerve is the 'gold standard' in thyroid surgery and the intraoperative neuromonitoring of nerves can never replace surgery but can complement it. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  14. Prohemostatic Interventions in Liver Surgery

    NARCIS (Netherlands)

    Stellingwerff, Menno; Brandsma, Amarins; Lisman, Ton; Porte, Robert J.

    Surgical procedures of the liver, such as partial liver resections and liver transplantation, are major types of abdominal surgery. Liver surgery can be associated with excessive intraoperative blood loss, not only because the liver is a highly vascularized organ, but also because it plays a central

  15. 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


    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.

  16. Periscopic Spine Surgery (United States)


    Supplement 1, November 2007, 21-33, DOI 10.1007/s10278-007-9054-3. [Lin 2008] Ralph Lin; Peng Cheng; David Lindisch; Filip Banovac; Justin Lee...produce high muscular endurance [1]. Until the 1970s, free weights (e.g. barbells and dumbells) and Universal Gyms utilizing weight stacks driven by cable...significant disadvantage of inertial training. Although our goal was to simply emulate an inertial trainer, the oscillations could be reduced or even

  17. Oculocardiac reflex during strabismus surgery

    Directory of Open Access Journals (Sweden)

    Mehryar Taghavi Gilani


    Full Text Available The activation of oculucardiac reflex (OCR is common during the strabismus surgeries. OCR is known as a trigemino-vagal reflex, which leads to the various side effects including bradycardia, tachycardia, arrhythmia, or in some cases cardiac arrest. This reflex could be activated during intraorbital injections, hematomas, and mechanical stimulation of eyeball and extraocular muscles surgeries. The incidence of OCR varies in a wide range, from 14% to 90%, that depends on anesthetic strategy and drug used for the surgery. The efficacy of various anticholinergic and anesthetic agents on declining the OCR reflex has been evaluated in different studies, especially in children. Although the detection of OCR goes back to 1908, its exact effect is not well recognized during strabismus surgery. In this review, we aimed to summarize the studies investigated the efficacy and potential of various anesthetic medications on inhibiting the OCR in children undergoing strabismus surgery.

  18. The future of glaucoma surgery

    Directory of Open Access Journals (Sweden)

    Arsham Sheybani


    Full Text Available Glaucoma surgery is ripe for innovation. In the last few years, there has been a substantial increase in the number of devices approaching commercialization. While not all that is new is necessarily good, the role of these devices in changing glaucoma surgery is equally important in terms of both success and failure. Trabeculectomy, the most commonly performed incisional filtration surgery for glaucoma, is subjective by nature and certainly has risks. As devices aim to standardize glaucoma surgery, specifically subconjunctival filtration surgery, predictability and in turn safety should theoretically improve. This may allow the glaucoma surgeon to intervene earlier in the disease process, prevent more advanced vision loss and potentially decrease the burden of medications.

  19. Condylar resorption in orthognathic surgery. The role of intermaxillary fixation. (United States)

    Bouwman, J P; Kerstens, H C; Tuinzing, D B


    Condylar resorption that occurs after orthognathic surgery was investigated in a large sample of patients treated in the Department of Oral and Maxillofacial Surgery of the Free University in Amsterdam, the Netherlands. The findings correspond with previous publications on this subject. In a 1-year follow-up study the role of intermaxillary fixation was investigated radiologically. In a group of 158 patients prone to show occurrence of condylar resorption, 24 (26.4%) of the 91 patients treated with intermaxillary fixation showed signs of condylar resorption. In the group of 67 patients treated without intermaxillary fixation only eight (11.9%) of the patients showed signs of reduced volume of the condyle. Avoidance of intermaxillary fixation seems to reduce the incidence of condylar resorption after orthognathic surgery in patients with a mandibular deficiency with high mandibular plane angle.

  20. Highlights on recurrence after surgery for cervical cancer

    DEFF Research Database (Denmark)

    Fuglsang, Katrine; Petersen, Lone Kjeld; Blaakær, Jan

    Objective After surgery due to cervical cancer women are offered to attend a follow-up program 10 times during five years with the purpose for early diagnosis of recurrence. The aim of this study is to evaluate the follow-up program, which has remained unchanged for 20 years even though reminding...... and concerning women, who we consider healthy after surgery. Methods A retrospective longitudinal study of women attending follow-up program after surgery due to cervical cancer at the Department of Gynecology and Obstetrics, Aarhus University Hospital. 524 patients were identified from 1996 to 2011...... with the diagnosis of cervical cancer combined with a surgical procedure. From the national pathological database and patient files information was extracted. Information was stored in Epidata. Associations were calculated using stratified analysis and logistic regression. Results 133(25%) women of 524 needed...

  1. Geneva University

    CERN Multimedia


    Ecole de physique - Département de physique nucléaire et corpusculaire 24, Quai Ernest-Ansermet 1211 GENEVE 4 Tél: (022) 379 62 73 Fax: (022) 379 69 92 Monday 28 April 2008 PHYSICS COLLOQUIUM at 17.00 – Stückelberg Auditorium Gravity : an Emergent Perspective by Prof. Thanu Padmanabhan, Pune University Dean, Ganeshkhind, Pune, India I will motivate and describe a novel perspective in which gravity arises as an emergent phenomenon, somewhat like elasticity. This perspective throws light on several issues which are somewhat of a mystery in the conventional approach. Moreover it provides new insights on the dark energy problem. In fact, I will show that it is necessary to have such an alternative perspective in order to solve the cosmological constant problem.Information:

  2. Geneva University

    CERN Multimedia

    École de physique - Département de physique nucléaire et corspusculaire 24, quai Ernest-Ansermet 1211 GENÈVE 4 Tél: (022) 379 62 73 - Fax: (022) 379 69 92 Monday 7 December 2009 PHYSICS COLLOQUIUM at 17:00 – Stückelberg Auditorium Topological insulators and topological superconductors Professor Shoucheng Zhang Department of Physics, Stanford University, CA   Recently, a new class of topological states has been theoretically predicted and experimentally realized. The topological insulators have an insulating gap in the bulk, but have topologically protected edge or surface states due to the time reversal symmetry. In two dimensions the edge states give rise to the quantum spin Hall (QSH) effect, in the absence of any external magnetic field. I shall review the theoretical prediction of the QSH state in HgTe/CdTe semiconductor quantum wells, and its recent experimental observation. The edge states of the QSH state supports fr...

  3. Geneva University

    CERN Multimedia

    École de physique - Département de physique nucléaire et corspusculaire 24, quai Ernest-Ansermet 1211 GENÈVE 4 Tél: (022) 379 62 73 - Fax: (022) 379 69 92 Wednesday 18 November  2009 PARTICLE PHYSICS SEMINAR at 17:00 – Stückelberg Auditorium Highlights of the European Strategy Workshop for Future Neutrino Physics Dr Ilias Efthymiopoulos, CERN   Seminar cancelled! Information Organizer : J.-S. Graulich Monday 7 December 2009 PHYSICS COLLOQUIUM at 17:00 – Stückelberg Auditorium Topological insulators and topological superconductors Professor Shoucheng Zhang Department of Physics, Stanford University, CA   Recently, a new class of topological states has been theoretically predicted and experimentally realized. The topological insulators have an insulating gap in the bulk, but have topologically protected edge or surface states due to the time reversal symmetry. In two dimensions the edge s...

  4. Decreased risk of surgery for small bowel obstruction after laparoscopic colon cancer surgery compared with open surgery

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Erichsen, Rune; Scheike, Thomas


    . The HR for mortality after colonic resection was 2.54 (CI 1.91 to 3.38, P surgery as compared to those who did not. CONCLUSIONS: Laparoscopic surgery for colonic cancer was associated with a decreased risk of subsequent SBO surgery compared with open...... surgery. Further, subsequent SBO surgery was associated with increased mortality after colonic cancer resection.......BACKGROUND: The impact of surgical approach on the incidence of small bowel obstruction (SBO) is unclear. The aim of the current study was to analyze the long-term risk of surgery for SBO after open and laparoscopic surgery and to assess how subsequent SBO surgery impacts on mortality after colonic...

  5. To ventilate or not after minimally invasive direct coronary artery bypass surgery : The role of epidural anesthesia

    NARCIS (Netherlands)

    de Vries, AJ; Mariani, MA; van der Maaten, JMAA; Loef, BG; Lip, H


    Objective: To evaluate the effect of immediate postoperative extubation and postoperative ventilation after minimally invasive direct coronary artery bypass (MIDCAB) surgery and to assess the role of epidural anesthesia. Design: Randomized prospective study. Setting: University hospital, single inst

  6. Using your shoulder after replacement surgery (United States)

    Joint replacement surgery - using your shoulder; Shoulder replacement surgery - after ... You have had shoulder replacement surgery to replace the bones of your shoulder joint with artificial parts. The parts include a stem made of metal and a ...

  7. Your diet after gastric bypass surgery (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 the way your ...

  8. The night before your surgery - children (United States)

    Surgery - child; Preoperative - night before ... food after 11 p.m. the night before surgery. Your child should not eat or drink any ... child the night before or the day of surgery, call the doctor. Stop giving your child any ...

  9. Asian perspective in surgery: thoracic surgery in Turkey. (United States)

    Turna, Akif


    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.

  10. Regenerative surgery of the complications with Morton's neuroma surgery: use of platelet rich plasma and hyaluronic acid. (United States)

    De Angelis, Barbara; Lucarini, Lucilla; Orlandi, Fabrizio; Agovino, Annarita; Migner, Alessia; Cervelli, Valerio; Izzo, Valentina; Curcio, Cristiano


    Morton's neuroma is an entrapment neuropathy of the plantar digital nerve. We treated five patients with wound dehiscence and tendon exposure, after Morton's neuroma surgery excision using a dorsal approach. In this article we describe our technique. From July 2010 to August 2011, at the Department of Plastic and Reconstructive Surgery, University of Rome 'Tor Vergata', five patients (four females and one male), with ages ranging between 35 and 52 years, were treated with a combination of PRP (platelet rich plasma) and HA (hyaluronic acid). Thirty days following surgery, all patients showed a complete healing of the wound. The use of this technique for the treatment of postoperative wound dehiscence and tendon exposure has proven as satisfactory.

  11. Reconstructive pelvic surgery and plastic surgery: safety and efficacy of combined surgery. (United States)

    Craig, Jocelyn B; Noblett, Karen L; Conner, Caroline A; Budd, Michael; Lane, Felicia L


    The purpose of this study was to address the safety of combining aesthetic and pelvic floor reconstructive procedures. Fifty-four subjects were included in a case-control study; 18 patients undergoing combined pelvic and plastic reconstructive surgery, age and procedure matched to 18 pelvic surgery and 18 plastic surgery only controls. Chi-square, t test, and Kruskal-Wallis analysis were used to compare the estimated blood loss (EBL), body mass index (BMI), hospital days, operative times, and complications between the groups. No differences were seen with regards to age, BMI, or EBL. There was, however, a significant increase in minor complications and hospital stay after combined procedures relative to the pelvic surgery control group but not the aesthetic control group. Operative times were only greater during combined procedures relative to isolated pelvic floor procedures. Combining pelvic and aesthetic procedures may increase complications, operative times, and length of hospital stay when compared to pelvic reconstructive surgery alone.

  12. Physiology of vitreous surgery. (United States)

    Stefánsson, Einar


    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

  13. First employment characteristics for the 2011 pediatric surgery fellowship graduates. (United States)

    Stolar, Charles J H; Aspelund, Gudrun


    Information regarding initial employment of graduating pediatric surgery fellows is limited. More complete data could yield benchmarks of initial career environment. An anonymous survey was distributed in 2011 to 41 pediatric surgery graduates from all ACGME training programs interrogating details of initial positions and demographics. Thirty-seven of 41 (90%) fellows responded. Male to female ratio was equal. Graduates carried a median debt of $220,000 (range: $0-$850,000). The majority of fellows were married with children. 70% were university/hospital employees, and 68% were unaware of a business plan. Median starting compensation was $354,500 (range: $140,000-$506,000). Starting salary was greatest for >90% clinical obligation appointments (median $427,500 vs. $310,000; p=0.002), independent of geographic location. Compensation had no relationship to private practice vs. hospital/university/military position, coastal vs. inland location, and practice sites number. Median clinical time was 75% and research time 10%. 49% identified a formal mentor. Graduates covered 1-5 different offices (median 1) and 1-5 surgery sites (median 2). 60% were satisfied with their compensation. Recent pediatric surgery graduates are engaged mainly in clinical care. Research is not incentivized. Compensation is driven by clinical obligations. Graduates have limited knowledge of the business plan supporting their compensation, nature of malpractice coverage, and commitments to resources including research. Graduates have important fiscal and parenting obligations. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Irrigation dynamic pressure-assisted hydrodissection during cataract surgery

    Directory of Open Access Journals (Sweden)

    Masuda Y


    Full Text Available Yoichiro Masuda,1 Hisaharu Iwaki,2 Noriko Kato,1 Genichiro Takahashi,1 Kotaro Oki,3 Hiroshi Tsuneoka4 1Department of Ophthalmology, The Jikei University, Katsushika Medical Center, 2Iwaki Eye Clinic, 3Oki Eye Surgery Center, 4Department of Ophthalmology, The Jikei University, School of Medicine, Tokyo, Japan Abstract: The irrigation dynamic pressure-assisted hydrodissection technique (irrigation-hydro [iH] does not require performing manual hydrodissection using a syringe and cannula to achieve cortical-capsular cleavage during cataract surgery. Since the iH technique uses the phaco tip to intentionally vacuum the intraocular fluid in order to induce the irrigation dynamic pressure for cortical-capsular cleavage, there is a reduction in the intraocular pressure (IOP from the bottle-height-dependent hydrostatic pressure. Thus, since the peak irrigation pressure derived from the phaco tip sleeve will be limited by the height of the irrigation fluid bottle, this is advantageous in helping to avoid excessively high IOP during cortical-capsular hydrodissection. Using this technique, we were able to effectively perform phacoemulsification without complications in 607 of 609 cataract eyes. Our findings show that utilization of the iH technique would be of benefit to patients, as it prevents high-pressure hydrodissection-related complications, such as capsular block syndrome and tears in the anterior hyaloid membrane during cataract surgery. Keywords: cataract surgery, hydrodissection, irrigation pressure, hydrodissection-related complication, capsular block syndrome, anterior hyaloid membrane tear, FLACS

  15. Video-assisted thoracoscopic surgery lobectomy – early experience

    Directory of Open Access Journals (Sweden)

    Robert Šimon


    Full Text Available Introduction: Video-assisted thoracoscopic surgery (VATS lobectomy is the anatomical resection of a whole lobe ofthe lung followed by removal of the lymph nodes from the mediastinum using a thoracoscope and an access incision(small thoracotomy ≤ 5 cm without using the rib spreader. Aim: To present the early experience with VATS lobectomy. Material and methods: Five patients were treated surgically using the VATS technique of anatomical lung resection atthe 2nd Department of Surgery, Pavol Jozef Šafárik University, University Hospital of L. Pasteur, Košice, (Slovak Republicwithin 12 months from 10.2008 to 10.2009. Lobectomy was performed in 4 patients and pneumonectomy in 1 patient. Results: The mean operating time was 120 min (range 80-170 min. Following lobectomy a drain was inserted into thepleural cavity in 4 cases, whereas there was no drainage after 1 pneumonectomy. Drains were removed 2-5 days afterthe surgery. Four patients suffered from lung carcinoma (1 squamous cell carcinoma, 3 adenocarcinomas; 1 patienthad chondroid hamartoma. Postoperative condition was good in all patients. There were no early complications andpatients were released home on the 6th postoperative day on average. Conclusions: The advantages of VATS lobectomy have been widely discussed. There is a consensus that in elderlypatients with non-small cell lung cancer VATS lobectomy accompanied by mediastinal lymphadenectomy reduces theincidence of complications after the surgery and patients recover faster.

  16. Future robotic platforms in urologic surgery: recent developments. (United States)

    Herrell, S Duke; Webster, Robert; Simaan, Nabil


    To review recent developments at Vanderbilt University of new robotic technologies and platforms designed for minimally invasive urologic surgery and their design rationale and potential roles in advancing current urologic surgical practice. Emerging robotic platforms are being developed to improve performance of a wider variety of urologic interventions beyond the standard minimally invasive robotic urologic surgeries conducted currently with the da Vinci platform. These newer platforms are designed to incorporate significant advantages of robotics to improve the safety and outcomes of transurethral bladder surgery and surveillance, further decrease the invasiveness of interventions by advancing LESS surgery, and to allow for previously impossible needle access and ablation delivery. Three new robotic surgical technologies that have been developed at Vanderbilt University are reviewed, including a robotic transurethral system to enhance bladder surveillance and transurethral bladder tumor, a purpose-specific robotic system for LESS, and a needle-sized robot that can be used as either a steerable needle or small surgeon-controlled micro-laparoscopic manipulator.

  17. Future robotic platforms in urologic surgery: Recent Developments (United States)

    Herrell, S. Duke; Webster, Robert; Simaan, Nabil


    Purpose of review To review recent developments at Vanderbilt University of new robotic technologies and platforms designed for minimally invasive urologic surgery and their design rationale and potential roles in advancing current urologic surgical practice. Recent findings Emerging robotic platforms are being developed to improve performance of a wider variety of urologic interventions beyond the standard minimally invasive robotic urologic surgeries conducted presently with the da Vinci platform. These newer platforms are designed to incorporate significant advantages of robotics to improve the safety and outcomes of transurethral bladder surgery and surveillance, further decrease the invasiveness of interventions by advancing LESS surgery, and allow for previously impossible needle access and ablation delivery. Summary Three new robotic surgical technologies that have been developed at Vanderbilt University are reviewed, including a robotic transurethral system to enhance bladder surveillance and TURBT, a purpose-specific robotic system for LESS, and a needle sized robot that can be used as either a steerable needle or small surgeon-controlled micro-laparoscopic manipulator. PMID:24253803

  18. [Establishment of university departments of urology in North Rhine-Westphalia: the Aachen model]. (United States)

    Moll, F H; Halling, T; Rathert, P; Krischel, M; Fangerau, H


    The foundation of university departments of urology in postwar East and West Germany faced some opposition by some university professors of surgery who wanted to preserve the unity of their discipline. In North Rhine-Westphalia, heads of municipal hospitals or senior members of university hospitals' staff often received the first chaired professorships of urology.

  19. Bariatric Surgery and Precision Nutrition

    Directory of Open Access Journals (Sweden)

    Carolina F. Nicoletti


    Full Text Available This review provides a literature overview of new findings relating nutritional genomics and bariatric surgery. It also describes the importance of nutritional genomics concepts in personalized bariatric management. It includes a discussion of the potential role bariatric surgery plays in altering the three pillars of nutritional genomics: nutrigenetics, nutrigenomics, and epigenetics. We present studies that show the effect of each patient’s genetic and epigenetic variables on the response to surgical weight loss treatment. We include investigations that demonstrate the association of single nucleotide polymorphisms with obesity phenotypes and their influence on weight loss after bariatric surgery. We also present reports on how significant weight loss induced by bariatric surgery impacts telomere length, and we discuss studies on the existence of an epigenetic signature associated with surgery outcomes and specific gene methylation profile, which may help to predict weight loss after a surgical procedure. Finally, we show articles which evidence that bariatric surgery may affect expression of numerous genes involved in different metabolic pathways and consequently induce functional and taxonomic changes in gut microbial communities. The role nutritional genomics plays in responses to weight loss after bariatric surgery is evident. Better understanding of the molecular pathways involved in this process is necessary for successful weight management and maintenance.

  20. Anterior and posterior tibial anesthetic block in diabetic foot surgery.


    José Julio Ojeda González; Evangelina Dávila Cabo; Remberto González Enoa; Obdulio Rodríguez García


    Fundament: Diabetes Mellitus is a disease of high and increasing prevalence and its complications follow a parallel course. Its morbidity is derived from its own complications which are produced at a long or short term and peripheral vascular disease hihglights among them.Objective: to check the usefulness of the anterior and posterior blockade of the tibia for the surgery of the diabetic foot. Method: Prospective study carried out from January to December 2003 at the University Hospital ¨Dr....