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Sample records for sutureless telescoping anastomosis

  1. Side-to-side sutureless vascular anastomosis with magnets.

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    Erdmann, Detlev; Sweis, Ranya; Heitmann, Christoph; Yasui, Koji; Olbrich, Kevin C; Levin, L Scott; Sharkawy, A Adam; Klitzman, Bruce

    2004-09-01

    Abbe and Payr introduced vascular techniques and devices to facilitate vessel anastomosis over a century ago. Obora published the idea of a sutureless vascular anastomosis with use of magnetic rings in 1978. The purpose of this study was to assess the performance of a new magnetic device to perform a side-to-side arteriovenous anastomosis in a dog model. Male fox hounds (25 kg) were treated preoperatively and daily postoperatively with clopidogrel bisulfate (Plavix) and aspirin. The femoral artery and vein were exposed unilaterally in 3 dogs and bilaterally in 4 dogs (n = 11 anastomoses). A 4-mm arteriotomy was performed, and 1 oval magnet 0.5 mm thick was inserted into the lumen of the artery and a second magnet was applied external to the artery, compressing and stabilizing the arterial wall to create a magnetic port. An identical venous magnetic port was created with another pair of oval magnets. When the 2 ports were allowed to approach each other, they self-aligned and magnetically coupled to complete the arteriovenous anastomosis. Patency was assessed for the first hour with direct observation, again after 9 weeks with duplex ultrasound scanning, and at 10 weeks under direct open observation. The anastomoses were explanted after 10 weeks. Hydrodynamic resistance was measured ex vivo on the final 8 anastomoses by measuring the pressure drop across an anastomosis with a known flow rate. After implantation, very high flow created visible turbulence and palpable vibration. All 11 anastomoses were patent under direct observation and palpation. Ten of 11 anastomoses were clearly patent on duplex scans, and patency of 1 anastomosis was questionable. Hydrodynamic resistance averaged 0.73 +/- 0.33 mm Hg min/mL (mean +/- SEM). Vascular anastomoses performed with magnets demonstrated feasibility; exhibited 100% patency after 10 weeks in a dog arteriovenous shunt model; lacked apparent aneurysm or other potentially catastrophic failure; demonstrated remodeling of the

  2. Evaluation of a poly(L-lactic acid) stent for sutureless vascular anastomosis.

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    Nakano, Yoshiyuki; Hori, Yoshio; Sato, Akira; Watanabe, Tetsuo; Takada, Shuji; Goto, Hitoshi; Inagaki, Akiko; Ikada, Yoshito; Satomi, Susumu

    2009-03-01

    We have developed a sutureless anastomosis device consisting of a biodegradable stent and stainless steel band for end-to-end anastomosis. The aim of this acute phase study was to evaluate the feasibility of a sutureless anastomotic procedure with a bioabsorbable stent during a 4-week period in a swine model. The porcine infrarenal aorta was replaced with an expanded polytetrafluoroethylene graft. A proximal anastomosis was completed using a sutureless anastomotic procedure employing a bioabsorbable stent made of poly(L-lactic acid) (PLLA) and a stainless steel plate. A distal anastomosis completed by manual suturing served as a control. At 4 weeks after surgery, angiography was performed. The animals were then killed, and the specimens were evaluated histologically. The sutureless anastomotic procedure required significantly less time than the suturing technique. Angiograms showed patency of the grafts, and no signs of either stenosis or leakage. Both pressure-proof and tensile tests confirmed the adequate mechanical strength of the anastomoses. Sutureless anastomosis with a PLLA stent appears to be feasible, at least within an observation period of 4 weeks. This simple procedure shortened the time of surgery and would contribute to reducing the risks of operation-related complications.

  3. Development of trans-1, 4-polyisoprene for sutureless vascular anastomosis

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    Yang, Hou-Ching; Silverman, Joseph

    Radiation crosslinked trans-1,4-polyisoprene (t-PIP) is shown to be effective as a heat shrinkable connector for severed blood vessels. The sutureless vascular anastomosis system (SVAS) requires a plastic sleeve with the following requirements: biocompatibility, heat shrinkability, melting point 50 to 60°C, and proper mechanical properties. The effects of irradiation by cobalt-60 gammas on pertinent physical properties were determined. The measurements of gel fraction, thermal and mechanical properties demonstrate that at appropriate dose levels t-PIP meets initial SVAS requirements. The ability of processed t-PIP to retain its structural integrity after aging was measured in various oxidizing environments for twenty weeks. The results show no change in the gel fraction and mechanical strength. An in-vitro test of the processed t-PIP with intravenous saline solution demonstrates that the material undergoes no physical property changes after five months. Also, biocompatibility of the crosslinked t-PIP sleeve was established by tests performed at the University of Tennessee. Both in-vitro in in-vivo tests were performed at The Johns Hopkins University. In the in-vivo test, an SVAS operation was performed on the carotid artery of a live dog. The results of all the tests demonstrated that the procedure and the t-PIP sleeve were effective and safe.

  4. Surgical repair of a celiac artery aneurysm using a sutureless proximal anastomosis device

    OpenAIRE

    Tetsuro Uchida, MD, PhD; Azumi Hamasaki, MD, PhD; Yoshinori Kuroda, MD; Atsushi Yamashita, MD; Jun Hayashi, MD; Mitsuaki Sadahiro, MD, PhD

    2017-01-01

    Some celiac artery aneurysms are not suitable for endovascular therapy. We describe the case of a 63-year-old man with a celiac trunk aneurysm extending to the hepatosplenic bifurcation. The aneurysm was resected and oversewn at the origin from the abdominal aorta. A saphenous vein bypass from the supraceliac aorta to the celiac artery bifurcation was performed using a sutureless anastomotic device (PAS-Port system; Cardica, Redwood City, Calif) to create the proximal anastomosis, eliminating...

  5. Surgical repair of a celiac artery aneurysm using a sutureless proximal anastomosis device.

    Science.gov (United States)

    Uchida, Tetsuro; Hamasaki, Azumi; Kuroda, Yoshinori; Yamashita, Atsushi; Hayashi, Jun; Sadahiro, Mitsuaki

    2017-12-01

    Some celiac artery aneurysms are not suitable for endovascular therapy. We describe the case of a 63-year-old man with a celiac trunk aneurysm extending to the hepatosplenic bifurcation. The aneurysm was resected and oversewn at the origin from the abdominal aorta. A saphenous vein bypass from the supraceliac aorta to the celiac artery bifurcation was performed using a sutureless anastomotic device (PAS-Port system; Cardica, Redwood City, Calif) to create the proximal anastomosis, eliminating the need for aortic clamping. This system is thought to make direct proximal aortic anastomosis safe and easy in patients requiring surgical reconstruction of celiac artery aneurysms.

  6. Surgical repair of a celiac artery aneurysm using a sutureless proximal anastomosis device

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    Tetsuro Uchida, MD, PhD

    2017-12-01

    Full Text Available Some celiac artery aneurysms are not suitable for endovascular therapy. We describe the case of a 63-year-old man with a celiac trunk aneurysm extending to the hepatosplenic bifurcation. The aneurysm was resected and oversewn at the origin from the abdominal aorta. A saphenous vein bypass from the supraceliac aorta to the celiac artery bifurcation was performed using a sutureless anastomotic device (PAS-Port system; Cardica, Redwood City, Calif to create the proximal anastomosis, eliminating the need for aortic clamping. This system is thought to make direct proximal aortic anastomosis safe and easy in patients requiring surgical reconstruction of celiac artery aneurysms.

  7. Sutureless functional end-to-end anastomosis using a linear stapler with polyglycolic acid felt for intestinal anastomoses

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    Masanori Naito, MD, PhD

    2017-05-01

    Conclusion: Sutureless functional end-to-end anastomosis using the Endo GIA™ Reinforced appears to be safe, efficacious, and straightforward. Reinforcement of the crotch site with a bioabsorbable polyglycolic acid sheet appears to mitigate conventional problems with crotch-site vulnerability.

  8. Telescoping Colonic Anastomosis in Dogs: Gross and Microscopic Configurations

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    Aly Saber

    2012-06-01

    Full Text Available Introduction: Colorectal anastomotic leakage remains one of the most feared post-operative complications. The telescoping technique has been used but never widely acclaimed. The aim was to study both the external and internal features as well as the microscopic configuration of the invaginating colocolic anastomosis. Materials and Methods: After the scheduled three-week post-operative period, animals were reopened for a second-look laparotomy to detect: an external appearance of the anastomosis, internal appearance of the anastomosis and histopathological study. Results: Good and fair ratings were seen for external and internal appearance of the anastomosis, while no poor ratings were detected in our experiments. Microscopic study revealed a good healing process of the anastomotic lines. Conclusion: Our data showed that the telescopic anastomosis is a secure, easy to be constructed, fast and cheap procedure for colonic anastomoses. [Arch Clin Exp Surg 2012; 1(3.000: 151-157

  9. Experimental examination of the healing process of telescopic esophageal anastomosis.

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    Szücs, G; Tóth, I; Barna, T; Bráth, E; Gyáni, K; Mikó, I

    2003-01-01

    The basis of telescopic anastomosis is old, only the practical details of it have changed and improved. The telescopic anastomosis technique is successfully applied in our practice for reconstruction of gastrectomy and esophageal resection. The reason for this study was that data about the healing process of telescopic anastomosis had not been found in the literature. We used four groups of mongrel dogs for our experiments: Group A (n = 3) received 20 mm-long invaginations with a survival time of 7 days; Group B (n = 3) received 10 mm-long invaginations with a survival time of 21 days; Group C (n = 3) received 20 mm-long invaginations with a survival time of 21 days; Group D (n = 3) received 30 mm-long invaginations with a survival time of 21 days. At the end of the above survival times we removed the anastomosing area, measured the bursting pressures and performed morphological and histological examinations. In each case we also performed an anastomosis exactly the same as a completely healed anastomosis and its pressure tolerance was measured (0 day). The pressure tolerance within the anastomosis rises gradually and independently of the length of the invaginated esophageal part. Anastomosis leakage did not occur. The invaginated esophageal part did not suffer any damage. The muscular wall of the intragastric part of the esophagus became covered by the mucosa of the stomach during the healing process and it joined with the esophageal mucosa at the edge of the free end of the esophagus.

  10. Pregnancy outcomes and prognostic factors from tubal sterilization reversal by sutureless laparoscopical re-anastomosis: a retrospective cohort study

    NARCIS (Netherlands)

    Schepens, Janneke J. B. F. G.; Mol, Ben W. J.; Wiegerinck, Maarten A. H. M.; Houterman, Saskia; Koks, Carolien A. M.

    2011-01-01

    BACKGROUND: Female sterilization is a widely used contraceptive method but in a small group of women, post-sterilization regret occurs. A dilemma for these women is the choice between surgical re-anastomosis and IVF. We evaluated the factors that affected pregnancy rate after laparoscopic tubal

  11. [Transanal laparoscopic radical resection with telescopic anastomosis for low rectal cancer].

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    Li, Shiyong; Chen, Gang; Du, Junfeng; Chen, Guang; Wei, Xiaojun; Cui, Wei; Yuan, Qiang; Sun, Liang; Bai, Xue; Zuo, Fuyi; Yu, Bo; Dong, Xing; Ji, Xiqing

    2015-06-01

    To assess the safety, feasibility and clinical outcome of laparoscopic radical resection for low rectal cancer with telescopic anastomosis or with colostomy by stapler through transanal resection without abdominal incisions. From January 2010 to September 2014, 37 patients underwent laparoscopic radical resection for low rectal cancer through transanal resection without abdominal incisions. The tumors were 4-7 cm above the anal verge. On preoperative assessment, 26 cases were T1N0M0 and 11 were T2N0M0. For all cases, successful surgery was performed. In telescopic anastomosis group, the mean operative time was (178±21) min, with average blood loss of (76±11) ml and (13±7) lymph nodes harvested. Return of bowel function was (3.0±1.2) d and the hospital stay was (12.0±4.2) d without postoperative complications. Patients were followed up for 3-45 months. Twelve months after surgery, 94.6%(35/37) patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal. Laparoscopic radical resection for low rectal cancer with telescopic anastomosis or colostomy by stapler through transanal resection without abdominal incisions is safe and feasible. Satisfactory clinical outcome can be achieved mini-invasively.

  12. Laparoscopic resection of lower rectal cancer with telescopic anastomosis without abdominal incisions.

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    Li, Shi-Yong; Chen, Gang; Du, Jun-Feng; Chen, Guang; Wei, Xiao-Jun; Cui, Wei; Zuo, Fu-Yi; Yu, Bo; Dong, Xing; Ji, Xi-Qing; Yuan, Qiang

    2015-04-28

    To assess laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through transanal resection without abdominal incisions. From March 2010 to June 2014, 30 patients (14 men and 16 women, aged 36-78 years, mean age 59.8 years) underwent laparoscopic radical resection of lower rectal cancer with telescopic anastomosis through anus-preserving transanal resection. The tumors were 5-7 cm away from the anal margin in 24 cases, and 4 cm in six cases. In preoperative assessment, there were 21 cases of T1N0M0 and nine of T2N0M0. Through the middle approach, the sigmoid mesentery was freed at the root with an ultrasonic scalpel and the roots of the inferior mesenteric artery and vein were dissected, clamped and cut. Following the total mesorectal excision principle, the rectum was separated until the anorectal ring reached 3-5 cm from the distal end of the tumor. For perineal surgery, a ring incision was made 2 cm above the dentate line, and sharp dissection was performed submucosally towards the superior direction, until the plane of the levator ani muscle, to transect the rectum. The rectum and distal sigmoid colon were removed together from the anus, followed by a telescopic anastomosis between the full thickness of the proximal colon and the mucosa and submucosal tissue of the rectum. For the present cohort of 30 cases, the mean operative time was 178 min, with an average of 13 positive lymph nodes detected. One case of postoperative anastomotic leak was observed, requiring temporary colostomy, which was closed and recovered 3 mo later. The postoperative pathology showed T1-T2N0M0 in 19 cases and T2N1M0 in 11 cases. Twelve months after surgery, 94.4% patients achieved anal function Kirwan grade 1, indicating that their anal function returned to normal. The patients were followed up for 1-36 mo, with an average of 23 mo. There was no local recurrence, and 17 patients survived for > 3 years (with a survival rate of 100%). Laparoscopic radical

  13. [Telescopic adhesive anastomosis of small blood vessel applied in formation of arteriovenous fistula for hemodialysis].

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    Shen, G; Leng, Y; Rong, G

    1997-03-01

    The formation of an arteriovenous fistual for dialysis by routine interrupted sutures anastomosing the vein and artery is difficult to perform and time-consuming. A new method, telescopic adhesive anastomosis was studied and applied in 10 hemodialysis patients, who were in need of an arteriovenous fistula. The external diameter of the vessels anastomosed was 2.40 +/- 0.20 mm (radial artery) or 2.40 +/- 0.35 mm (cephalic vein). After thorough debridement of the vascular ends, the arterial end was put in the venous lumen. In order to fix the telescopic vessels, two stitches were applied 180 degrees apart from each other and tied. Each stitch was inserted from vein (penetrating the whole wall) to artery (just through the adventitia and partial thickness of the media vasorum). The distance from the stitch to the edge of the vein was 0.5 mm, and that of the artery was approximated to the external diameter of the vessle. The medical adhesive was then applied for sealing the anastomotic adventitia. Ten seconds were given for the solidification of the adhesive. The patients were followed up for 8 months. The patency rate was 100%, and the rate of blood flow was more than 300 ml/min (measured by ultrasonography). It was shown that this method could be managed easily and quickly, and the so-formed fistula would fulfill the need of hemodialysis.

  14. Sutureless vascular anastomoses by N-butyl-2 cyanoacrylate adhesive: an experimental animal study.

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    Saba, D; Yilmaz, M; Yavuz, H; Noyan, S; Avci, B; Ercan, A; Ozkan, H; Cengiz, M

    2007-01-01

    The purpose of this animal study was to find out whether sutureless anastomoses using N-butyl-2-cyanoacrylate were effective in the suppression of neointimal hyperplasia or not. Ten male adult mongrel dogs were used in this animal study. The animals were randomly divided into a control group (n = 5) and a study group (n = 5). The study group underwent sutureless anastomoses using N-buthyl-2-cyanoacrylate adhesive. Infrarenal aortoaortic graft was interposed using polytetrafluoroethylene. In the study group, the mean intimal thickness at the proximal anastomosis was 27.4 +/- 1.94 microm and 27.4 +/- 1.51 microm at the distal anastomosis. In the control group, the mean intimal thickness was 138.4 +/- 5.02 mum at the proximal anastomosis and 67.6 +/- 6.42 microm at the distal anastomosis. Intimal thickness at the proximal and distal anastomoses in the control group was significantly (p anastomoses using with N-butyl-2-cyanoacrylate adhesive might be a good alternative to conventional suture technique. Copyright 2007 S. Karger AG, Basel.

  15. Sutureless repair of inguinal hernia.

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    Gilbert, A I

    1992-03-01

    Sutureless repair is successful for all but the largest of indirect inguinal hernias. After reduction of the peritoneal sac, the presenting indirect component of the hernia is immediately resolved by placement of a polypropylene mesh through the internal ring. The posterior wall is reinforced with a second swatch of Prolene mesh to prevent herniation, which often results from future degenerative changes. Both swatches of mesh are held in place in separate tissue planes by the body's internal hydrostatic forces. Being sutureless, no tension is placed on any layer; there is no damage to tissues from an errant suturing technique. This procedure has been used in 412 of the 1,091 inguinal hernia repairs over the past 36 months.

  16. Primary correction of total anomalous pulmonary venous return with a modified sutureless technique.

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    Mueller, Christoph; Dave, Hitendu; Prêtre, René

    2013-03-01

    The objective was to evaluate primary sutureless repair of total anomalous pulmonary venous return (TAPVR) in neonates using a modified technique that minimizes hypothermia and circulatory arrest times. From 2009 to 2011, seven consecutive patients underwent primary sutureless repair for the treatment of TAPVR, by which the prepared posterior pericardium was sutured to an opening in the left atrium. Three patients had the obstructed infracardiac type, and four patients had the unobstructed supracardiac type of TAPVR. Moderate hypothermia was used in all patients with a median temperature of 28°C (26-32). Circulatory arrest was not used except for the opening of the collector, which lasted between 3 and 5 min. The connecting vein was ligated in all seven patients (five during repair and two early postoperatively). The follow-up was 100% complete, with a median duration of 652 (range 370-1023) days. There was no operative mortality and no late death. No patient required reoperation. Postoperative echocardiography showed unobstructed pulmonary venous flow in all patients. Recurrent pulmonary venous stenosis was not seen during the follow-up in any patient. The sutureless technique is an effective technique with potential advantages even for the primary correction of TAPVR. With the described technique, the need for circulatory arrest is substantially reduced. Not handling the pulmonary venous collector by avoiding a direct anastomosis may contribute to better compliance, better growth and the absence of subsequent stenosis.

  17. Sutureless Intrascleral Fixated Intraocular Lens Implantation.

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    Karadag, Remzi; Celik, Haci Ugur; Bayramlar, Huseyin; Rapuano, Christopher J

    2016-08-01

    To review sutureless intrascleral intraocular lens (IOL) fixation methods. Review of published literature. Sutureless intrascleral IOL fixation methods are newer and have been developed to eliminate the suture-related complications of sutured scleral fixation methods such as suture-induced inflammation or infection and IOL dislocation or subluxation due to suture degradation or suture breakage. Sutureless intrascleral fixation methods aim for intrascleral haptic fixation to achieve stability of the IOL. Various methods of sutureless scleral fixation have been described. Using a needle, a blade, or a trochar, sclerostomies are created in all techniques for intraocular access. Some surgeons prefer to create scleral tunnels, whereas others use scleral flaps for scleral fixation of haptics. The stability of IOLs is attained by the scar tissue formed around the haptics. Short-term results of these new methods are acceptable; studies including more cases with longer follow-up are needed to determine their long-term success. [J Cataract Refract Surg. 2016;32(9):586-597.]. Copyright 2016, SLACK Incorporated.

  18. Aortic Root Enlargement or Sutureless Valve Implantation?

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    Nikolaos G. Baikoussis

    2016-11-01

    Full Text Available Aortic valve replacement (AVR in patients with a small aortic annulus is a challenging issue. The importance of prosthesis–patient mismatch (PPM post aortic valve replacement (AVR is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution. The Perceval sutureless bioprosthesis provides reasonable hemodynamic performance avoiding the PPM and providing the maximum of aortic orifice area. We would like to see in the near future the role of the aortic root enlargement techniques in the era of surgical implantation of the sutureless valve (SAVR and the transcatheter valve implantation (TAVI.

  19. Early Outcomes of Sutureless Aortic Valves

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    Muhammet Onur Hanedan

    2016-06-01

    Full Text Available Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA valves were used. Results: The mean age of the patients was 71.15±8.60 years. Forty-four patients (67.7% were female. The average preoperative left ventricular ejection fraction was 56.9±9.93. The CPB time was 96.51±41.27 minutes and the cross-clamping time was 60.85±27.08 minutes. The intubation time was 8.95±4.19 hours, and the intensive care unit and hospital stays were 2.89±1.42 days and 7.86±1.42 days, respectively. The mean quantity of drainage from chest tubes was 407.69±149.28 mL. The hospital mortality rate was 3.1%. A total of five patients (7.69% died during follow-up. The mean follow-up time was 687.24±24.76 days. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

  20. Sutureless Deep Sclerectomy: A Preliminary Report.

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    Abdelrahman, Ahmed M; ElTanamly, Rasha; Sabry, Mohamed

    2017-11-01

    This study describes a modification of deep sclerectomy, making it completely sutureless, with a 6-month follow-up period. This was a prospective pilot phase that included 24 eyes of 16 patients, 13 male individuals and 3 female individuals, with medically uncontrolled open-angle glaucomas despite maximally tolerated medical therapy. After excising the deep flap, no sutures are added to the superficial scleral flap or to the conjunctiva. A statistically significant reduction of the intraocular pressure was reported during all the follow-up visits without serious complications.

  1. Magnetic compression anastomosis for enteroenterostomy under peritonitis conditions in dogs.

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    Zhang, Hongke; Tan, Kai; Fan, Chao; Du, Jingwei; Li, Jiangbin; Yang, Tao; Lv, Yi; Du, Xilin

    2017-02-01

    The risk of complications and mortality are high after enteroenterostomy in severe peritonitic conditions. Magnetic compression anastomosis (MCA) is a sutureless technique of high efficacy and safety. The purpose of this study was to compare the efficacy of MCA for enteroenterostomy with stapled and hand-sewn techniques under peritonitic conditions. The peritonitic conditions were created by puncturing the colon with a circular blade in 27 mongrel dogs. Eight hours later, the peritoneal cavity was washed with warm, sterilized normal saline solution. The animals were then randomly divided into three groups and underwent colonic anastomosis with MCA, stapled, or hand-sewn techniques, respectively. Animals were euthanized at 1, 2, and 4 w after the operation; anastomoses were compared on the basis of gross appearance and histology. All magnetic devices formed patent anastomoses without a leak. However, one stapled anastomosis and three hand-sewn anastomoses resulted in leaks. The anastomosis time was significantly less in the MCA group than that of the other two groups (P anastomoses for MCA was smoother than that of the other two groups. MCA is a feasible, safe, and effective alternative for enteroenterostomy under peritonitic conditions in the canine model. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. A new approach for sutureless 20-G vitrectomy

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    Dikran G Hovaghimian

    2015-01-01

    The new approach of 20-G sutureless vitrectomy utilizing N-butyl-2-cyanoacrylate is a safe and effective technique for the surgical treatment of a variety of vitreoretinal pathologies. Conversion to this technique is very simple. A very short learning curve is required, with no need for new expensive instrumentation. It combines all the advantages of 20-G vitrectomy, adding to it the sutureless advantage of the technique.

  3. A sutureless method for digestive tract reconstruction during pancreaticoduodenectomy in a dog model.

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    Cui, Xiaohai; Lei, Peng; Liu, Shiqi; Liu, Xuemin; Wu, Zheng; Lv, Yi

    2015-01-01

    Development of pancreatic fistulas as a result of anastomotic gaps is still a major complication after pancreaticoduodenectomy, and can cause post-operative death. Therefore, safer and more effective methods of anastomosis are needed to avoid leakage and decrease mortality. Twenty domestic dogs with body weights ranging from 15 to 25 kg were used, regardless of gender. A model of common bile duct and pancreatic duct dilatation was surgically prepared in these dogs. Pancreaticobiliary stents combined with magnetic anastomoses (PB-MA), and controls were treated with fibrin glue were studied in terms of and efficacy by measurement of serum amylase, incidence of complications, and survival times. The mean time required to create the fibrin glue pancreaticoenterostomy was 9 ± 2.05 min, while the mean time required to create the magnet cholangioenterostomy was 5 ± 0.9 min. The total operative time was 2.7 ± 0.6 h. Eighty percent of the dogs that underwent the operations were still alive for 15 days after the operations and none developed pancreatic fistulas. Examination by macroscopic observation, and hematoxylin and eosin staining of the pathological specimens showed that the anastomoses were completed healed. The use of a PB-MA in sutureless digestive tract reconstruction for pancreatoduodenectomy resulted in an elimination of pancreatic fistulas, and shortening of the stent removed time. In addition, the procedure is simple to perform, fast, and appears to be safe in this dog model.

  4. Paediatric sutureless circumcision-an alternative to the standard technique.

    LENUS (Irish Health Repository)

    2012-01-31

    INTRODUCTION: Circumcision is one of the most commonly performed surgical procedures in male children. A range of surgical techniques exist for this commonly performed procedure. The aim of this study is to assess the safety, functional outcome and cosmetic appearance of a sutureless circumcision technique. METHODS: Over a 9-year period, 502 consecutive primary sutureless circumcisions were performed by a single surgeon. All 502 cases were entered prospectively into a database including all relevant clinical details and a review was performed. The technique used to perform the sutureless circumcision is a modification of the standard sleeve technique with the use of a bipolar diathermy and the application of 2-octyl cyanoacrylate (2-OCA) to approximate the tissue edges. RESULTS: All boys in this study were pre-pubescent and the ages ranged from 6 months to 12 years (mean age 3.5 years). All patients had this procedure performed as a day case and under general anaesthetic. Complications included: haemorrhage (2.2%), haematoma (1.4%), wound infection (4%), allergic reaction (0.2%) and wound dehiscence (0.8%). Only 9 (1.8%) parents or patients were dissatisfied with the cosmetic appearance. CONCLUSION: The use of 2-OCA as a tissue adhesive for sutureless circumcisions is an alternative to the standard suture technique. The use of this tissue adhesive, 2-OCA, results in comparable complication rates to the standard circumcision technique and results in excellent post-operative cosmetic satisfaction.

  5. An Experimental Study to Replace the Thoracic Descending Aorta for Pigs with a Self-Made Sutureless Blood Vessel

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    Fenglin Song

    2014-01-01

    Full Text Available To simplify the procedure of blood vessel replacement operation and shorten the vascular anastomosis time, we developed a special artificial blood vessel which can be connected to native blood vessels without suture. The self-made sutureless blood vessel (SMSBV was made from two titanium connectors and a Gore-Tex graft. To investigate blood compatibility and histocompatibility of the SMSBV, we carried thoracic descending aorta replacement using either SMSBV or Gore-Tex, respectively, in pigs. The aortic clamp time and the operative blood loss in the experimental group (using SMSBV were less than those in the control group (using Gore-Tex. The whole blood hematocrit, platelet count, plasma soluble P-selectin, plasma free hemoglobin, and interleukins 2, 6 at each time point were not different significantly between the two groups. Light microscopy and transmission electron microscopy examination showed there were layers of vascular smooth muscle cells and endothelial cells adhered in the inner wall of artificial blood vessel without any signs of thrombosis. Based on the result, we have drawn the conclusion that the application of SMSBV can significantly shorten the vascular anastomosis time, reduce operative blood loss, and show good blood and tissue compatibility.

  6. An Experimental Study to Replace the Thoracic Descending Aorta for Pigs with a Self-Made Sutureless Blood Vessel

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    Song, Fenglin; Zhou, Wenwu; Tang, Tao; Li, Xiaobing; Wu, Xiaoming; Yang, Jinfu

    2014-01-01

    To simplify the procedure of blood vessel replacement operation and shorten the vascular anastomosis time, we developed a special artificial blood vessel which can be connected to native blood vessels without suture. The self-made sutureless blood vessel (SMSBV) was made from two titanium connectors and a Gore-Tex graft. To investigate blood compatibility and histocompatibility of the SMSBV, we carried thoracic descending aorta replacement using either SMSBV or Gore-Tex, respectively, in pigs. The aortic clamp time and the operative blood loss in the experimental group (using SMSBV) were less than those in the control group (using Gore-Tex). The whole blood hematocrit, platelet count, plasma soluble P-selectin, plasma free hemoglobin, and interleukins 2, 6 at each time point were not different significantly between the two groups. Light microscopy and transmission electron microscopy examination showed there were layers of vascular smooth muscle cells and endothelial cells adhered in the inner wall of artificial blood vessel without any signs of thrombosis. Based on the result, we have drawn the conclusion that the application of SMSBV can significantly shorten the vascular anastomosis time, reduce operative blood loss, and show good blood and tissue compatibility. PMID:24696856

  7. An experimental study to replace the thoracic descending aorta for pigs with a self-made sutureless blood vessel.

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    Song, Fenglin; Zhou, Wenwu; Tang, Tao; Li, Xiaobing; Wu, Xiaoming; Yang, Jinfu

    2014-01-01

    To simplify the procedure of blood vessel replacement operation and shorten the vascular anastomosis time, we developed a special artificial blood vessel which can be connected to native blood vessels without suture. The self-made sutureless blood vessel (SMSBV) was made from two titanium connectors and a Gore-Tex graft. To investigate blood compatibility and histocompatibility of the SMSBV, we carried thoracic descending aorta replacement using either SMSBV or Gore-Tex, respectively, in pigs. The aortic clamp time and the operative blood loss in the experimental group (using SMSBV) were less than those in the control group (using Gore-Tex). The whole blood hematocrit, platelet count, plasma soluble P-selectin, plasma free hemoglobin, and interleukins 2, 6 at each time point were not different significantly between the two groups. Light microscopy and transmission electron microscopy examination showed there were layers of vascular smooth muscle cells and endothelial cells adhered in the inner wall of artificial blood vessel without any signs of thrombosis. Based on the result, we have drawn the conclusion that the application of SMSBV can significantly shorten the vascular anastomosis time, reduce operative blood loss, and show good blood and tissue compatibility.

  8. ViPS (Viabahn Padova Sutureless) technique: preliminary results in the treatment of peripheral arterial disease.

    Science.gov (United States)

    Ferretto, Luca; Piazza, Michele; Bonvini, Stefano; Battocchio, Piero; Grego, Franco; Ricotta, Joseph J

    2012-01-01

    To describe early results of a novel technique (ViPS, Viabahn Padova Sutureless) that connects a vascular prosthetic graft to a target artery in a sutureless fashion. A consecutive series of five patients with peripheral arterial occlusive disease (Rutherford class IV and V) underwent six ViPS procedures (one bilateral) for limb revascularization. Angiography in all cases demonstrated complete superficial femoral artery (SFA) occlusion with reconstitution of a circumferentially calcified above-knee popliteal artery. Ultrasonography revealed no adequate vein for autogenous bypass creation. In all cases, a previous attempt of SFA endovascular recanalization was unsuccessful. A Viabahn (W.L. Gore, Flagstaff, AZ) endoprosthesis was partially deployed, and its proximal end was sutured to a polytetrafluoroethylene graft. After surgical exposure, the circumferentially calcified popliteal artery, which could not be safely sutured, was transected and the undeployed distal portion of the Viabahn was inserted into the popliteal artery supported by a stiff guidewire. The distal portion of the Viabahn graft was then deployed 2.5 cm into the popliteal artery with optimal apposition. The proximal end of the polytetrafluoroethylene graft was then sutured to the common femoral artery. The distal portion of the Viabahn was ballooned to ensure apposition with the popliteal artery. The mean time for surgical modification of the device was 6.6 minutes with a mean time for ViPS anastomosis deployment of 7 seconds. Mean operative time for ViPS procedure was 61 minutes (range: 48-74). Completion angiogram in all cases demonstrated a patent graft with no sign of dissection. The patients' symptoms resolved in all cases, with complete ulcer healing occurring in five patients within 3 weeks. Follow-up imaging (mean = 2.6 months, range: 1-5) with eco-color-Doppler and computed tomography angiogram demonstrated a patent graft with no loss of device integrity in all cases. The ViPS technique is

  9. Central pancreatectomy without anastomosis

    Directory of Open Access Journals (Sweden)

    Pahuja Anil

    2009-08-01

    Full Text Available Abstract Background Central pancreatectomy has a unique application for lesions in the neck of the pancreas. It preserves the distal pancreas and its endocrine functions. It also preserves the spleen. Methods This is a retrospective review of 10 patients who underwent central pancreatectomy without pancreatico-enteric anastomosis between October 2005 and May 2009. The surgical indications, operative outcomes, and pathologic findings were analyzed. Results All 10 lesions were in the neck of the pancreas and included: 2 branch intraductal papillary mucinous neoplasms (IPMNs, a mucinous cyst, a lymphoid cyst, 5 neuroendocrine tumors, and a clear cell adenoma. Conclusion Central pancreatectomy without pancreatico-enteric anastomosis for lesions in the neck and proximal pancreas is a safe and effective procedure. Morbidity is low because there is no anastomosis. Long term endocrine and exocrine function has been maintained.

  10. Radiopaque anastomosis marker

    International Nuclear Information System (INIS)

    Elliott, D.P.; Halseth, W.L.

    1977-01-01

    This invention relates to split ring markers fabricated in whole or in part from a radiopaque material, usually metal, having the terminal ends thereof and a medial portion formed to define eyelets by means of which said marker can be sutured to the tissue at the site of an anastomosis to provide a visual indication of its location when examined fluoroscopically

  11. Externalized ileocolic anastomosis: case report.

    Science.gov (United States)

    Simcock, James; Kuntz, Charles A; Newman, Raquel

    2010-01-01

    A 6-year-old, spayed female Labrador retriever was presented 48 hours after an intestinal resection and anastomosis for management of a small intestinal foreign body. Abdominal ultrasound confirmed the presence of peritoneal effusion. Cytology of fluid collected by abdominocentesis revealed a large number of degenerate neutrophils with intracellular cocci. A diagnosis of septic peritonitis was made, presumably because of dehiscence of the anastomosis. Upon repeat exploratory celiotomy, the intestinal anastomosis (located 4 cm orad to the cecum) was found to be leaking intestinal contents into the abdomen. The distal ileum, cecum, and proximal colon were resected. An end-to-end, ileocolic anastomosis was performed and subsequently exteriorized into the subcutaneous space via a paramedian incision through the abdominal wall. The anastomosis was inspected daily for 4 days before it was returned to the abdomen and the subcutaneous defect was closed. Serial cytology of the peritoneal fluid, which was performed during this 4-day postoperative period, confirmed progressive resolution of peritonitis. The dog was discharged from the hospital 2 days following return of the anastomosis into the abdomen. Externalized intestinal anastomosis is used with good success in human medicine for repair of colonic injuries. In this case, externalization of the anastomosis permitted healing of the intestinal anastomosis in an environment isolated from the detrimental effects created by septic peritonitis. In addition, direct visualization of the anastomosis allowed assessment of healing. To our knowledge, this procedure has not been previously reported in companion animals.

  12. Establishment of an immunocompetent nipple valve anastomosis to prevent faecal reflux after ileocolic resection in dogs.

    Science.gov (United States)

    Ecker, K W; Pistorius, G; Menger, M D; Feifel, G

    2000-05-01

    To construct an immunocompetent nipple valve anastomosis (NVA) to exclude faecal reflux and compare it with an end-to-end anastomosis to see if it would prevent recurrent inflammation caused by intraluminal bacterial antigens in Crohn's disease. Laboratory study. Teaching hospital, Germany. Two groups of six beagle dogs each of which had NVA or end-to-end anastomosis. Construction of a NVA by stapling the telescoped nipple, and replacing the ileal mucosa on the valve by colonic mucosa; end-to-end anastomosis. Radiological, bacteriological, angiographic, and morphometric results. Absolute retrograde pressure-competence and free orthograde permeability of the NVA resulted in significantly lower intestinal bacterial counts compared with the end-to-end anastomosis (p < 0.05). Transposition of colonic mucosa was successful as demonstrated by revascularisation from the ileal nipple and looked normal on morphometry. If NVA were constructed in patients with Crohn's disease, recurrences should be prevented, which would verify the immunopathogenetic hypothesis of new inflammation.

  13. Upper Eyelid Silicone Oil Migration After Sutureless 23-Gauge Vitrectomy

    Directory of Open Access Journals (Sweden)

    Alireza Dehghani

    2017-01-01

    Full Text Available To report a case of upper eyelid swelling and ptosis caused by silicone oil migration in a patient after sutureless 23-gauge pars plana vitrectomy and silicone oil injection. A 36-year-old female was referred to eye clinic with total retinal detachment (RD and superotemporal giant dialysis secondary to trauma in the left eye. Transconjunctival sutureless 23-gauge pars plana vitrectomy and intraocular silicone oil (1300 centistokes injection were performed. After about 5 months, she came back with the left upper eyelid and periorbital swelling. Palpation of the eyelid revealed soft and mobile subcutaneous small lumps that were not attached to the skin. Computed tomography scan of the orbit showed an 11 mm × 8 mm soft tissue density mass in lateral aspect of the left orbit. Transcutaneously surgical exploration was performed. The patient was seen after 1 week postoperatively and there was a significant improvement of the ptosis. Eyelid swelling and ptosis caused by silicone oil migration after RD surgery are very rare and this is one of the few reports in literature.

  14. Bioptics in sutureless intrascleral multifocal posterior chamber intraocular lens fixation.

    Science.gov (United States)

    Pavlidis, Mitrofanis; de Ortueta, Diego; Scharioth, Gabor B

    2011-05-01

    To present a technique for sutureless fixation of a three-piece, multifocal, posterior chamber intraocular lens (IOL) in the ciliary sulcus. A 24-year-old woman presented with bilateral subluxation of the crystalline lens. Two straight sclerotomies were prepared with a 24-gauge cannula 2.0 mm from the limbus 180° apart from each other. The cannula was used to create a 2.0- to 3.0-mm tunnel parallel to the limbus starting from the sclerotomies. The leading haptic of the multifocal IOL was grasped at its tip with end-gripping, 25-gauge forceps and pulled through the sclerotomy. The forceps was used to introduce the IOL haptic into the scleral tunnel parallel to the limbus. Multifocal posterior chamber IOLs were stable and well centered. No postoperative complications occurred in the 16-month follow-up period. Preoperative astigmatism was corrected after IOL implantation with corneal wavefront-guided laser epithelial keratomileusis. Sutureless fixation of multifocal posterior chamber IOL haptics in a scleral tunnel parallel to the limbus can be successful, resulting in long-term centration and three-dimensional axial stability for optimal refractive results. If necessary, postoperative wavefront-guided refractive correction can be performed to optimize final refraction. Copyright 2011, SLACK Incorporated.

  15. Intermediate results of sutureless intrascleral posterior chamber intraocular lens fixation.

    Science.gov (United States)

    Scharioth, Gabor B; Prasad, Som; Georgalas, Ilias; Tataru, Calin; Pavlidis, Mitrofanis

    2010-02-01

    To report the intermediate multicenter results of a technique of sutureless intrascleral fixation of a standard 3-piece posterior chamber intraocular lens (PC IOL) in the ciliary sulcus. Four European ophthalmology centers. A technique for sutureless intrascleral fixation of the haptics of a standard 3-piece PC IOL was retrospectively evaluated. The technique uses standardized maneuvers to fixate the PC IOL without need for special haptic architecture or preparation or haptic suturing. All patients having IOL implantation by the technique were evaluated for preoperative status (visual acuity, refractive error, preexisting ocular conditions, optical biometry), postoperative status, complications, and need for further surgery. The study evaluated 63 consecutive patients from 4 institutions (4 surgeons). The median follow-up was 7 months. Two dislocated PC IOLs (3.6%) were decentered; the other 61 IOLs (96.8%) were stable and well centered. There were no cases of recurrent dislocation, endophthalmitis, retinal detachment, or glaucoma. Fixation of PC IOL haptics in a limbus-parallel scleral tunnel provided exact centration and axial stability of the IOL and prevented distortion and subluxation in most cases. Copyright 2010 ASCRS and ESCRS. All rights reserved.

  16. Outcomes of Sutureless Iris-Claw Lens Implantation.

    Science.gov (United States)

    Choragiewicz, Tomasz; Rejdak, Robert; Grzybowski, Andrzej; Nowomiejska, Katarzyna; Moneta-Wielgoś, Joanna; Ozimek, Małgorzata; Jünemann, Anselm G M

    2016-01-01

    Purpose. To evaluate the indications, refraction, and visual and safety outcomes of iris-claw intraocular lens implanted retropupillary with sutureless technique during primary or secondary operation. Methods. Retrospective study of case series. The Haigis formula was used to calculate intraocular lens power. In all cases the wound was closed without suturing. Results. The study comprised 47 eyes. The mean follow-up time was 15.9 months (SD 12.2). The mean preoperative CDVA was 0.25 (SD 0.21). The final mean CDVA was 0.46 (SD 0.27). No hypotony or need for wound suturing was observed postoperatively. Mean postoperative refractive error was -0.27 Dsph (-3.87 Dsph to +2.85 Dsph; median 0.0, SD 1.28). The mean postoperative astigmatism was -1.82 Dcyl (min -0.25, max -5.5; median -1.25, SD 1.07). Postoperative complications were observed in 10 eyes. The most common complication was ovalization of the iris, which was observed in 8 eyes. The mean operation time was 35.9 min (min 11 min, max 79 min; median 34, SD 15.4). Conclusion. Retropupilary iris-claw intraocular lens (IOL) implantation with sutureless wound closing is an easy and fast method, ensuring good refractive outcome and a low risk of complication. The Haigis formula proved to be predictable in postoperative refraction.

  17. Outcomes of Sutureless Iris-Claw Lens Implantation

    Directory of Open Access Journals (Sweden)

    Tomasz Choragiewicz

    2016-01-01

    Full Text Available Purpose. To evaluate the indications, refraction, and visual and safety outcomes of iris-claw intraocular lens implanted retropupillary with sutureless technique during primary or secondary operation. Methods. Retrospective study of case series. The Haigis formula was used to calculate intraocular lens power. In all cases the wound was closed without suturing. Results. The study comprised 47 eyes. The mean follow-up time was 15.9 months (SD 12.2. The mean preoperative CDVA was 0.25 (SD 0.21. The final mean CDVA was 0.46 (SD 0.27. No hypotony or need for wound suturing was observed postoperatively. Mean postoperative refractive error was −0.27 Dsph (−3.87 Dsph to +2.85 Dsph; median 0.0, SD 1.28. The mean postoperative astigmatism was −1.82 Dcyl (min −0.25, max −5.5; median −1.25, SD 1.07. Postoperative complications were observed in 10 eyes. The most common complication was ovalization of the iris, which was observed in 8 eyes. The mean operation time was 35.9 min (min 11 min, max 79 min; median 34, SD 15.4. Conclusion. Retropupilary iris-claw intraocular lens (IOL implantation with sutureless wound closing is an easy and fast method, ensuring good refractive outcome and a low risk of complication. The Haigis formula proved to be predictable in postoperative refraction.

  18. Aortic valve replacement with sutureless prosthesis: better than root enlargement to avoid patient-prosthesis mismatch?

    Science.gov (United States)

    Beckmann, Erik; Martens, Andreas; Alhadi, Firas; Hoeffler, Klaus; Umminger, Julia; Kaufeld, Tim; Sarikouch, Samir; Koigeldiev, Nurbol; Cebotari, Serghei; Schmitto, Jan Dieter; Haverich, Axel; Shrestha, Malakh

    2016-06-01

    Aortic valve replacement in patients with a small aortic annulus may result in patient-prosthesis mismatch (PPM). Aortic root enlargement (ARE) can reduce PPM, but leads to extended cardiac ischaemia times. Sutureless valves have the potential to prevent PPM while reducing cardiac ischaemia times. Between January 2007 and December 2011, a total of 128 patients with a small aortic annulus underwent surgery for aortic valve stenosis at our centre. Thirty-six (17% male, n = 6) patients received conventional valve replacement with ARE and 92 (16% male, n = 18) subjects received sutureless valve implantation (Sorin Perceval). We conducted a comparative, retrospective study with follow-up. The sutureless group showed a significantly higher age (79 years) than the ARE patients (62 years, P body surface area was 0.91 ± 0.2 cm(2)/m(2) in ARE patients and 0.83 ± 0.14 cm(2)/m(2) in sutureless patients (P = 0.040). The rate of patients with severe PPM was 6% (n = 2) in ARE patients and 11% (n = 8%) in sutureless patients (not significant, n.s.). The 30-day mortality rates were 2% (n = 2) in sutureless patients and 6% (n = 2) in ARE patients (n.s.). The 1- and 5-year survival rates of the sutureless group were 92 and 54% years, respectively, whereas the 1- and 5-year survival rates of the ARE group were 76% (n.s.). Although the sutureless valve patients received significantly more concomitant procedures, all operation-associated times were significantly shorter. Despite sutureless valve patients being older, the 30-day mortality and survival rates were comparable in the two groups. Since the indexed EOA was only slightly lower and the incidence of severe PPM was not significantly higher in the sutureless valve patients, we conclude that sutureless valve implantation is an alternative to conventional ARE to treat a small aortic annulus and avoid PPM, especially in geriatric patients who benefit from the quick implantation process. © The Author 2016. Published by Oxford

  19. Vascular anastomosis by Argon Laser

    International Nuclear Information System (INIS)

    Gomes, O.M.; Macruz, R.; Armelin, E.; Brum, J.M.G.; Ribeiro, M.P.; Mnitentog, J.; Verginelli, G.; Pileggi, F.; Zerbini, E.J.

    1982-01-01

    Twenty four mongrel dogs, wheighing 13 to 24 kilograms were studied. After anesthesia, intubation and controlled ventilation, they were submitted to three types of vascular anastomosis: Group I - eight dogs with saphenous vein inter-carotid arteries by-pass: Group II - eight dogs with left mammary artery - left anterior descending coronary artery by-pass; Group III - eight dogs with venovenous anastomosis. In all groups 0.8 to 15 watts of Argon Laser power was applied to a total time of 90 to 300 seconds. The lower power for venovenous anastomosis and the greater for the arterial ones. The mean valves of resistence of the Laser anastomosis to pressure induced rupture was 730 mmHg in the immediate post operative study, and superior to 2.500 mmHg 30 days after. No signs of occlusion was demonstrated at the anastomosis sites by the angiographic and anathomo-patological study performed. (Author) [pt

  20. Sutureless versus Transfemoral Transcatheter Aortic Valve Implant: A Propensity Score Matching Study.

    Science.gov (United States)

    Santarpino, Giuseppe; Vogt, Ferdinand; Pfeiffer, Steffen; Dell'Aquila, Angelo M; Jessl, Jürgen; Cuomo, Federica; von Wardenburg, Che; Fischlein, Theodor; Pauschinger, Matthias; Schwab, Johannes

    2017-05-01

    Transcatheter aortic valve implantation (TAVI), especially via the transfemoral (TF) route, is increasingly performed in patients considered in the 'gray zone' between TAVI and surgery. However, the best treatment option in this patient population remains to be established. Since 2010, a total of 923 patients underwent either TAVI (n = 538) or sutureless aortic valve replacement (AVR) (n = 385) at the authors' institutions. Among these patients, 79 treated with TF-TAVI were compared with 79 propensity score-matched patients who had undergone elective isolated AVR with the sutureless Perceval bioprosthesis. In-hospital mortality did not differ significantly between patients who underwent sutureless AVR or TF-TAVI (none versus three; 3.8%; p = 0.123). Similarly, postoperative complications were comparable between groups. Atrioventricular block requiring postoperative pacemaker implantation occurred in seven patients (9.2%) of the sutureless group and in eight patients (11.1%) of the TF-TAVI group (p = 0.455). The use of blood products varied between groups in terms of red blood cell transfusions (1.7 ± 2 versus 0.3 ± 0.9 units for the sutureless group versus TF-TAVI group; p <0.001). Paravalvular leakage at discharge was present in three patients (3.8%) in the sutureless group and in 26 patients (32.9%) in the TF-TAVI group (p <0.001). The mean follow up was longer for sutureless AVR (36 ± 21 versus 27 ± 20 months; p = 0.003). Survival rates were 97.5% and 84.8% in the sutureless and TF-TAVI groups, respectively (p = 0.001). Both, TF-TAVI and sutureless AVR are well-standardized, safe and effective procedures. TF-TAVI seems to be a valuable alternative to surgical AVR for frail patients, reducing the need for perioperative blood transfusion. In contrast, in patients with a favorable long-term survival outcome, minimally invasive AVR remains the procedure of choice as it is associated with better long-term results.

  1. Can Perceval sutureless valve reduce the rate of patient-prosthesis mismatch?†.

    Science.gov (United States)

    Belluschi, Igor; Moriggia, Stefano; Giacomini, Andrea; Del Forno, Benedetto; Di Sanzo, Stefania; Blasio, Andrea; Scafuri, Antonio; Alfieri, Ottavio

    2017-06-01

    The aim of this study is to compare the theoretical incidence of patient-prosthesis mismatch (PPM) in patients undergoing a sutureless or a sutured aortic valve replacement using an exact statistical matching. Between May 2012 and March 2016, 65 patients with severe symptomatic aortic stenosis underwent a sutureless aortic valve replacement with the Perceval bioprosthesis in 2 centres. Moreover, 177 aortic valve replacements with conventional sutured bioprosthesis were performed between August 2003 and September 2015. Perceval and sutured patients were 1:1 exactly matched for sex and body surface area (BSA), resulting in 62 couples (sutureless: BSA 1.77 ± 0.16 m 2 , female 62.9% vs sutured: BSA 1.77 ± 0.15 m 2 , female 62.9%). After matching, the indexed effective orifice area was 1.50 ± 0.18 cm 2 /m 2 and 0.81 ± 0.19 cm 2 /m 2 in the sutureless and the sutured group, respectively ( P  < 0.001). No PPM occurred in patients who received a Perceval bioprosthesis ( n  = 62). In the sutured group ( n  = 62), 38 patients (61.3%) developed a PPM, which was moderate in 41.9% ( n  = 26) and severe in 19.4% ( n  = 12) ( P  < 0.001). The indexed effective orifice area of the sutureless group was significantly larger than in the sutured one. The incidence of PPM with the conventional sutured biprosthesis was 61.3%, while it decreases to 0% in the sutureless group. No PPM was reported in the sutureless valve group. Therefore, the Perceval sutureless valve provides larger effective orifice areas compared to the sutured conventional bioprosthesis and could be considered as a good option to reduce the risk of a PPM. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. Sutureless onlay omental patch for the laparoscopic repair of perforated peptic ulcers.

    Science.gov (United States)

    Wang, Yu-Chun; Hsieh, Chi-Hsun; Lo, Hung-Chieh; Su, Li-Ting

    2014-08-01

    Because the feasibility and safety of laparoscopic approaches for the treatment of perforated peptic ulcer (PPU) have been fully recognized, laparoscopic repair of PPU (LPPU) has become a widely accepted procedure. Following closure of a PPU, the rationale to add an omental patch is based on the assumptions that a patch may decrease the possibility of leakage and make the closure more secure. However, one of the often mentioned disadvantages of LPPU is that it requires a significantly longer operating time. The purpose of the present study was to evaluate the efficacy of LPPU with a sutureless onlay omental patch. Over 60 months, 43 patients underwent LPPU with sutureless onlay omental patch, and another 64 patients underwent LPPU with sutured omental patch. Patient demographics, operation parameters, and surgical outcomes were analyzed retrospectively. All patients in both groups survived to the end of the study. There were no leaks in either group. The operating time and length of stay in the sutureless onlay omental patch group were significantly shorter than in the sutured omental patch group. A sutureless onlay omental patch is as safe and effective as a sutured omental patch for the laparoscopic repair of PPU.

  3. Prompt 27-gauge sutureless transconjunctival vitrectomy for bleb-associated endophthalmitis.

    Science.gov (United States)

    Xiao, Bo; Yang, Jin; Chu, Yanhua; Han, Quanhong

    2017-10-23

    To summarize the characters of 6 bleb-associated endophthalmitis (BAE) cases and to report the outcomes of prompt 27-gauge sutureless transconjunctival vitrectomy to treat these cases. Retrospective, non-randomized, consecutive case series of patients diagnosed with bleb-associated endophthalmitis who underwent prompt 27-gauge vitrectomy. The interval to get bleb-associated endophthalmitis from previous surgery was variant from 2 weeks to 36 months. Most of the patients experienced eye pain. The visual acuity was affected quickly. All the patients presented with hypopyon, fibrinous reaction, and vitreous wick. The size of the hypopyon was from 2 to 4 mm. Two patients came with intraocular lenses. Prompt 27-gauge sutureless transconjunctival vitrectomy was performed on all patients with bleb-associated endophthalmitis. None of the patients experienced complications of sutureless vitrectomy such as hypotony or wound leak. The improvement of best corrected visual acuity (BCVA) was significant in four of six patients. The improvement of BCVA was statistically calculated by using logMAR VA (p  21 mmHg) and received pressure-lowering agents. BAE is associated with substantial visual morbidity. Prompt 27-gauge sutureless transconjunctival vitrectomy is an effective and safe way for treating bleb-associated endophthalmitis.

  4. Clinical effect of 23G transconjunctival sutureless vitrectomy for idiopathic macular hole

    Directory of Open Access Journals (Sweden)

    Wei Cao

    2014-06-01

    Full Text Available AIM: To observe the clinical effects of 23-gauge(23Gtransconjunctival sutureless vitrectomy for idiopathic macular hole.METHODS: In this retrospective study, 28 eyes of 28 consecutive patients who underwent 23-gauge transconjunctival sutureless vitrectomy for idiopathic macular hole between January 2013 and October 2013 in our hospital were evaluated. The follow-up time was 3-12mo. The operation effects were analyzed.RESULTS: The macular hole was closed in 27 eyes of 28 eyes which underwent 23G transconjunctival sutureless vitrectomy and not closed in 1 eye after surgery. Best-corrected visual acuity at postoperative 1, 3mo was significantly improved compared to pre-operation(χ2=8.65, P=0.003; χ2=10.33, P=0.001. The macular hole was closed as shown by OCT. Intraoperative incision was sutured in 5 cases(18%. There was no statistically significant difference in intraocular pressure between pre-operation and post-operation. No post-operative complications such as endophthalmitis, retinal detachment, vitreous hemorrhage came up. CONCLUSION: 23G transconjunctival sutureless vitrectomy is observed to be safe and effective technique in the treatment of macular hole. It is therefore our preferred system for straightforward macular surgery.

  5. The way of prophylaxis of unfoundedness of pancreatojejunal anastomosis and hepaticojejunal anastomosis with pancreatoduodenal resection

    OpenAIRE

    Bakhtin, V.; Chikishev, S.

    2008-01-01

    The results of using of original method of transhepatic decompression drainage of pancreatojejunal anastomosis and hepaticojejunal anastomosis with pancreatoduodenal resection have been presented. The decreasing of postoperative complications' number and reduction of lethality while using the method have been discovered.

  6. Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

    OpenAIRE

    Kensuke Tashiro, MD; Shuji Yamashita, MD; Mitsunaga Narushima, MD; Isao Koshima, MD; Shimpei Miyamoto, MD

    2017-01-01

    Background:. Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one side of the vessel. We conducted lymphaticovenular anastomosis, free perforator flap transfer, and fingertip replantation with supermicrosurgical anastomosis using hemi-IVaS technique and examined...

  7. Autologous fibrin adhesive in experimental tubal anastomosis.

    Science.gov (United States)

    Rajaram, S; Rusia, U; Agarwal, S; Agarwal, N

    1996-01-01

    To evaluate autologous fibrin in rabbit oviduct anastomosis versus 7-0 vikryl, a conventional suture material used in tubal anastomosis. Thrombin was added to the autologous fibrinogen at the site of anastomosis to obtain a tissue adhesive. The anastomotic time, pregnancy rate, and litter size were evaluated. Three months later, a relaparotomy was done to evaluate patency and degree of adhesions, and a tubal biopsy was taken from the site of anastomosis. Analysis of results showed a statistically significant (P < .001) shortened anastomotic time and superior histopathological union in the tissue adhesive group. Patency rate, pregnancy rate, and degree of adhesions were comparable in both groups.

  8. Sutureless anastomoses using magnetic rings in canine liver transplantation model.

    Science.gov (United States)

    Liu, Shi-Qi; Lei, Peng; Cui, Xiao-Hai; Lv, Yi; Li, Jian-Hui; Song, Yu-Long; Zhao, Ge

    2013-12-01

    In the first posttransplant month, the most frequent complications are due to technical problems related to complex vascular and bile duct reconstructions during the operation. Moreover, despite great improvements in suturing technique and materials, severe organ ischemia-reperfusion caused by time-consuming hand suturing is still an important factor in graft survival. During the operation, severe hypotension, hypoxic acidosis, hyperkalemia, and renal dysfunction may occur during the anhepatic phase due to the prolonged venous clamping time required for hand suturing. Therefore, hand suturing is a handicap in the development of further advancements in liver transplantation. In this study, we aimed to test a new "mechanical installation method" for rapid vascular reconstruction. The magnetic pinning-ring device was developed consisting of paired magnetic rings coated with titanium oxide and embedded in a polypropylene shell. The rings were equipped with alternately spaced holes and titanium pins. Forty adult mongrel dogs were randomly divided into groups: A (n = 16), all vascular and bile duct reconstruction by magnetic ring without venous bypass; B (n = 16), all vascular and bile duct reconstruction by hand suturing with venous bypass; C (n = 8), sham transplantation group, transection of all vessels and common bile duct followed by anastomosis with the magnetic rings without liver transplantation. From groups A and B, dogs were randomly selected as donors (n = 8) or recipients (n = 8) of liver transplantations. We recorded operation time, vascular and bile duct anastomosis time, anhepatic time, administration of supplemental fluids during operation, and survival; blood samples were collected for the detection of liver damage (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) and tumor necrosis factor α level. Patency was confirmed using ultrasound scans at various time points as late as 24 wk after surgery. Angiography was used to evaluate the

  9. Fingertip replantation without venous anastomosis.

    Science.gov (United States)

    Chen, Yi-Chieh; Chan, Fuan Chiang; Hsu, Chung-Chen; Lin, Yu-Te; Chen, Chien-Tzung; Lin, Chih-Hung

    2013-03-01

    Replantation of amputated fingertips is a technical challenge, as many salvage procedures fail because no suitable vein in the fingertip is available for anastomosis. In this study, we examined our experience in fingertip replantation in cases without venous anastomosis with our established fingertip replantation treatment protocol. Between August 2002 and August 2010, a retrospective study examined all patients who had undergone fingertip replantation at Chang-Gung Memorial Hospital. All the patients (n = 24) suffered from complete digital amputations at or distal to the interphalangeal joint of the thumb, or distal to distal interphalangeal joint of the fingers. A total of 30 fingertips that were salvaged by microsurgical anastomosis of the digital arteries but not of digital veins were included in this study. On satisfactory arterial anastomosis, a 2-mm incision was made over the fingertip with a number 11 Scalpel blade, and 0.1 to 0.2 mL heparin (5000 IU/mL) was injected subcutaneously around the incision immediately and once per day thereafter to ensure continuous blood drainage from the replanted fingertip. None of the replanted nail plate was removed, and no medical leeches were used. The perfusion of the replanted digits and patient's hemoglobin level were closely monitored. The wound bleeding was maintained until physiologic venous outflow was restored. Of 30 fingertips, 27 (90%) replanted fingertips survived. The average length needed for maintaining external bleeding by chemical leech was 6.8 days (range, 5-10 days). Twelve patients (including a 2-year-old child) received blood transfusions. The average amount of blood transfusion in the 23 adults was 4.0 units (range, 0-16 units) for each patient or 3.29 units (range, 0-14 units) for each digit. A 2-year-old child received 100 mL blood transfusion or 50 mL for each digit. This study showed that a protocol that promotes controlled bleeding from the fingertip is essential to achieve consistent high

  10. Sutureless implantation of the perceval s aortic valve prosthesis through right anterior minithoracotomy.

    Science.gov (United States)

    Gilmanov, Daniyar; Miceli, Antonio; Bevilacqua, Stefano; Farneti, Pierandrea; Solinas, Marco; Ferrarini, Matteo; Glauber, Mattia

    2013-12-01

    Many new, less invasive strategies are proposed for aortic valve operation in elderly patients. Rapid deployment sutureless aortic valve prosthesis has been recently introduced. We analyzed our experience with a sutureless valve implanted through a minimally invasive approach. A retrospective observational study with prospectively registered data was conducted on 137 patients undergoing aortic valve replacement through a right anterior minithoracotomy. Between April 2011 and January 2013, 137 consecutive patients underwent aortic valve replacement with a recently introduced, rapid deployment, sutureless pericardial valve in minithoracotomy access (47 men; mean age, 76.6 ± 7.1 years). There were 35 obese patients with a body mass index of more than 30 kg/m(2). Mean logistic EuroSCORE I was 10.0; 74 (54%) patients were in New York Heart Association functional class III and IV. In all, 19 (13.9%), 45 (32.8%), and 73 (53.3%) patients received 21-, 23-, and 25-mm valve prostheses, respectively. The mean aortic cross-clamp and cardiopulmonary bypass times were 59.3 ± 19 min and 92.3 ± 27 min, respectively. No operative mortality occurred. Median stay in the intensive care unit was 1 day, with assisted ventilation necessary for a median of 6 hours. Three cases of postoperative ischemic stroke were observed (1 patient with a previous history of an ischemic cerebral event). Median hospital length of stay was 6 days. A sutureless valve for minimally invasive aortic valve replacement is a feasible, effective, and safe tool. Ultimately amplifying indications for less invasive aortic valve replacement in a high surgical risk subset of patients, it can become a valid alternative for transcatheter aortic valve implantation. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. 23-Gauge Sutureless Vitreo-Retinal Surgery for Superior Rhegmatogenous Retinal Detachment

    International Nuclear Information System (INIS)

    Zafar, S.; Mal, W.; Shakir, M.; Kamil, Z.; Bokhari, S. A.; Rizvi, S. F.

    2014-01-01

    Objective: To determine the results of 23-gauge sutureless vitreo-retinal surgery for superior/supero-temporal rhegmatogenous retinal detachment (RRD). Study Design: Quasi experimental study. Place and Duration of Study: LRBT, Free Base Eye Hospital, Karachi, from January 2010 to December 2011. Methodology: Adult patients who underwent 23-gauge sutureless vitreo-retinal surgery along with use of Perfluoropropane (C3F8) gas as internal tamponading agent for fresh (upto 3 weeks) superior/supero-temporal RRD was reviewed. Major outcome measures were anatomical success, best corrected visual acuity (BCVA) with Log Mar and complications during and after surgery. Postoperative follow-up was done on 1st day and at 1st, 4th, 8th and finally at 12th week. Results: Sixty eyes of 60 patients, age between 30 - 60 years including 37 (61.67%) males and 23 (38.33%) females having superior or superatemporal RRD underwent 23-guage sutureless vitreo-retinal surgery with the use of perfluoropropane (C3 F8) gas as internal temponade at the end of procedure. Anatomical success rate was 81.66% (49 out of 60 eyes) with first surgery and raised to 90% (54 cases) with second surgery. Log Mar BCVA significantly improved from mean baseline 0.93 to 0.49 with mean difference of 0.43 (p < 0.001), 95% confidence interval. Postoperative complications were sub-conjunctival haemorrhage in 11 eyes (18.33%), wound leak in 7 eyes (11.66%), anterior chamber became shallow in 6 eyes (10%), cataract developed in 5 eyes (8.33%), re-retinal detachment in 4 eyes (6.66%), ocular hypotony and sterile inflammatory reaction in 3 eyes (5%) each, while iatrogenic breaks developed in 2 eyes (3.33%). Conclusion: The 23-gauge sutureless vitreo-retinal surgery for superior rhegmatogenous retinal detachment achieved high anatomical success and significant visual improvement. Sub-conjunctival haemorrhage was the most frequent procedural complication. (author)

  12. The future of surgical aortic valve replacement and the role of sutureless technology.

    Science.gov (United States)

    Isbir, Selim

    2018-04-01

    Aortic valve stenosis has become the most frequent type of valve disease in worldwide. Surgical aortic valve replacement is still the gold standard therapy. More recently transcatheter aortic valve implantation has been demonstrated to be not inferior in patients with high and intermediate risk patients. Sutureless aortic valves were designed to simplify the surgical aortic valve replacement. With the aid of this new technology, the invasiveness of surgery can be reduced with potential improvements in outcome.

  13. Experience with single-layer rectal anastomosis.

    OpenAIRE

    Khubchandani, M; Upson, J

    1981-01-01

    Anastomotic dehiscence following resection of the large intestine is a serious complication. Satisfactory results of single-layer anastomosis depend upon meticulous technique and a scrupulously clean colon. Out of 65 single-layer anastomoses involving the rectum, significant leakage occurred in 4 patients. The results are reported in order to draw attention to the safety and efficacy of one-layer anastomosis.

  14. Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification for rhegmatogenous retinal detachment repair

    Directory of Open Access Journals (Sweden)

    Hoseok Moon

    2015-02-01

    Full Text Available AIM: To assess the outcomes of combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for rhegmatogenous retinal detachment (RRD repair. METHODS: This was a retrospective, consecutive, non-comparative, interventional case series of 30 eyes of 30 patients who underwent combined sutureless vitrectomy and clear corneal cataract surgery for the repair of RRD. The principal outcome measures were primary anatomical success rate, reasons for redetachment, final visual acuity, and surgical complications. RESULTS: Primary reattachment was achieved in 27 eyes (90.0%. The reasons for redetachment (3 eyes, 10% were incomplete laser retinopexy, persistent chronic subretinal fluid, and proliferative vitreoretinopathy, respectively. The logarithm of the minimum angle of resolution visual acuity (mean±SD improved from 0.76±0.74 preoperatively to 0.21±0.37 6 months’ postoperatively (PCONCLUSION: Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for RRD repair was proven safe and effective. It may provide not only the known advantages of conventional combined surgery, but also additional advantages such as less conjunctival fibrosis and the maintenance of stable intraocular pressure with low risks of postoperative hypotony and intraocular pressure elevation.

  15. Neutrino telescopes

    CERN Document Server

    Carr, J

    2002-01-01

    This review presents the scientific objectives and status of Neutrino Telescope Projects. The science program of these projects covers: neutrino astronomy, dark matter searches and measurements of neutrino oscillations. The two neutrino telescopes in operation: AMANDA and BAIKAL will be described together with the ANTARES neutrino telescope being built in the Mediterranean. (18 refs).

  16. Early postoperative intraocular pressure stability after combined 23-gauge sutureless vitrectomy and cataract surgery in patients with proliferative diabetic retinopathy.

    Science.gov (United States)

    Lee, Jong Yeon; Jeong, Hoon Seok; Lee, Dae Yeong; Sohn, Hee Jin; Nam, Dong Heun

    2012-10-01

    To compare rates of early postoperative hypotony and intraocular pressure (IOP) elevation between 23-gauge sutureless vitrectomies with and without phacoemulsification and intraocular lens implantation in patients with proliferative diabetic retinopathy. This study reviewed the medical records of 302 eyes of patients who underwent primary 23-gauge sutureless vitrectomy for the complications of proliferative diabetic retinopathy. A case series of 207 eyes that underwent combined vitrectomy and cataract surgery (combined group) was compared with that of 95 eyes that underwent vitrectomy only (vitrectomy group): The eyes that remained phakic after the vitrectomy were excluded from this study. The main outcome measures were postoperative hypotony (IOP 30 mmHg). Postoperative hypotony was identified in 4 (1.9%) of 207 eyes in combined group, but in 7 (7.4%) of 95 eyes in vitrectomy group (P = 0.048). Rate of IOP elevation was very low and not different between the two groups. The multivariate analysis showed that vitrectomy without cataract surgery was associated with the postoperative hypotony (odds ratio = 4.6, P = 0.045). The incidence of early postoperative hypotony was lower in combined sutureless vitrectomy and cataract surgery than in sutureless vitrectomy alone and that of IOP elevation was very low in both groups. The maintenance of a stable IOP with a low risk of IOP fluctuation may be an additional advantage of sutureless diabetic vitrectomy combined with cataract surgery.

  17. Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

    Science.gov (United States)

    Yamashita, Shuji; Narushima, Mitsunaga; Koshima, Isao; Miyamoto, Shimpei

    2017-01-01

    Background: Although supermicrosurgical anastomosis is a widely known reconstructive microsurgical technique, it is difficult to perform. To expand the clinical use of supermicrosurgery, we used hemi-intravascular stenting (hemi-IVaS), which is performed by inserting an intravascular stent into one side of the vessel. We conducted lymphaticovenular anastomosis, free perforator flap transfer, and fingertip replantation with supermicrosurgical anastomosis using hemi-IVaS technique and examined its usefulness. Methods: Between January 2013 and February 2015, 11 anastomoses in 11 cases of lymphaticovenular anastomosis for lymphedema patients, 14 anastomoses in 7 cases of free perforator flap transfer with supermicrosurgical perforator-to-perforator anastomosis, and 9 anastomoses in 5 cases of fingertip replantation were performed using hemi-IVaS. Time required for anastomosis and complications were examined. Flap survival rate was also examined in free perforator flap transfer cases and fingertip replantation cases. Results: In all cases, anastomoses were performed without complications such as inadvertent catching of the back wall of the vessel during the procedure or the need for reanastomoses. The average time required to complete the anastomosis was 16.4 ± 3.20 minutes using the hemi IVaS technique. All flaps survived in the supermicrosurgical perforator-to-perforator anastomosis as well as fingertip replantation cases. Conclusions: Hemi-IVaS could be a useful alternative to conventional intravascular stenting techniques and is also effective for supermicrosurgical perforator-to-perforator anastomosis. Further studies are needed to improve the success rate and to explore its other possible utilizations in supermicrosurgery. PMID:29263952

  18. Laser-assisted vascular anastomosis

    Science.gov (United States)

    Kao, Race L.; Tsao-Wu, George; Magovern, George J.

    1990-06-01

    The milliwatt CO2 laser and a thermal activated binding compound (20% serum albumin) were used for microvascular anastomoses. Under general anesthesia, the femoral arteries (0.7 to 1.0 mm diameter) of 6 rats were isolated. After the left femoral artery in each rat was clamped and transected, the vessel was held together with 3 equidistant 10-0 Xomed sutures. The cut edges were coated 3 to 4 times with the albumin solution and sealed with the CO2 laser (power density = 120 W/cm2). The binding compound solidified to a translucent tensile substance which supported the anastomosis until self healing and repair were achieved. The right femoral artery was used as sham operated control. Complete hemostasis and patency were observed in every case immediately and at 1, 3, and 6 months following surgery. The binding compound absorbed most of the laser energy thus minimizing thermal injury to the underlying tissue. Mongrel dogs weighing 28 to 33 kg were anesthetized and prepared for sterile surgical procedures. In 5 dogs, the femoral and jugular veins were exposed, transected, and anastomosed using a CO2 laser (Sharplan 1040) with the binding compound. In another 12 dogs, cephalic veins were isolated and used for aortocoronary artery bypass procedures. The Sharplan 1040 CO2 laser and 20% albumin solution were utilized to complete the coronary anastomoses in 6 dogs, and 6 dogs were used as controls by suturing the vessels. Again, hemostasis, patency, and minimal tissue damage were observed immediately and 6 weeks after the procedures. Improved surgical results, reduced operating time, minimized tissue damage, and enhanced anastomotic integrity are the advantages of laser assisted vascular anastomosis with a thermal activated binding compound.

  19. Primary small bowel anastomosis in generalised peritonitis

    NARCIS (Netherlands)

    deGraaf, JS; van Goor, Harry; Bleichrodt, RP

    Objective: To find out if primary small bowel anastomosis of the bowel is safe in patients with generalised peritonitis who are treated by planned relaparotomies. Design: Retrospective study. Setting: University hospital, The Netherlands. Subjects. 10 Patients with generalised purulent peritonitis

  20. Multispectral tissue characterization for intestinal anastomosis optimization

    Science.gov (United States)

    Cha, Jaepyeong; Shademan, Azad; Le, Hanh N. D.; Decker, Ryan; Kim, Peter C. W.; Kang, Jin U.; Krieger, Axel

    2015-10-01

    Intestinal anastomosis is a surgical procedure that restores bowel continuity after surgical resection to treat intestinal malignancy, inflammation, or obstruction. Despite the routine nature of intestinal anastomosis procedures, the rate of complications is high. Standard visual inspection cannot distinguish the tissue subsurface and small changes in spectral characteristics of the tissue, so existing tissue anastomosis techniques that rely on human vision to guide suturing could lead to problems such as bleeding and leakage from suturing sites. We present a proof-of-concept study using a portable multispectral imaging (MSI) platform for tissue characterization and preoperative surgical planning in intestinal anastomosis. The platform is composed of a fiber ring light-guided MSI system coupled with polarizers and image analysis software. The system is tested on ex vivo porcine intestine tissue, and we demonstrate the feasibility of identifying optimal regions for suture placement.

  1. Sutureless Aortic Prosthesis Implantation: the First Brazilian Experience with Perceval Device.

    Science.gov (United States)

    Tagliari, Ana Paula; de Moura, Leandro; Dussin, Luiz Henrique; Saadi, Eduardo Keller

    2016-01-01

    This is a report of the first Brazilian experience with the Perceval sutureless aortic prosthesis in two patients with severe aortic stenosis. Transesophageal echocardiography was used during the procedure. The aortotomy was performed 1 cm above the sinotubular junction, followed by leaflets removal and decalcification. Correct valve size was selected, device released and an accommodation balloon used. The cardiopulmonary bypass times were 47 and 38 min and the cross-clamp times were 38 and 30 min. There was a significant decrease in mean gradients (41 and 75 mmHg preoperatively; 7 and 8 mmHg postoperatively). There was no major complication or paravalvular leak.

  2. Changes in day 1 post-operative intraocular pressure following sutureless 23-gauge and conventional 20-gauge pars plana vitrectomy.

    Science.gov (United States)

    Gosse, Emily; Newsom, Richard; Hall, Peter; Lochhead, Jonathan

    2013-01-01

    The benefits associated with transconjunctival sutureless vitrectomy techniques are continuing to be defined. The purpose of this study was to compare the incidence of extreme changes in day 1 intraocular pressure (IOP) following 23-gauge sutureless vitrectomy compared with conventional 20-gauge vitrectomy. Fifty consecutive 23-gauge and 50 consecutive 20-gauge cases were included; eyes with a history of previous vitreoretinal surgery were excluded. 23-gauge surgery was completed with passive fluid air exchange where no long acting tamponade was indicated. The surgery remained sutureless unless a leak was visible at the end of the procedure. Data were collected by retrospective case note review. Statistical analysis was carried out using Fisher's exact and chi-square tests. Twenty-two percent (11/50) of 23-gauge vitrectomies required suturing of one or more ports. On the first post-operative day hypotony (IOPgauge groups. Raised pressure (IOP>21mmHg) occurred in 30% (15/50) of eyes in the 20-gauge group and 8% (4/50) of eyes in the 23-gauge group; IOP>30mmHg only occurred in the 20-gauge group (3/50). Fluid air exchange following 23-gauge vitrectomy is associated with very low risk of day 1 hypotony. This predominantly sutureless technique appears to reduce the incidence and magnitude of early post-operative IOP elevation compared with conventional 20-gauge vitrectomy.

  3. Sutureless aortic valve replacement using a novel autologous tissue heart valve with stent (stent biovalve): proof of concept.

    Science.gov (United States)

    Kishimoto, Satoru; Takewa, Yoshiaki; Nakayama, Yasuhide; Date, Kazuma; Sumikura, Hirohito; Moriwaki, Takeshi; Nishimura, Motonobu; Tatsumi, Eisuke

    2015-06-01

    We developed an autologous, trileaflet tissue valve ("biovalve") using in-body tissue architecture technology to overcome the disadvantages of current bioprosthetic valves. We designed a novel biovalve with a balloon-expandable stent: the stent biovalve (SBV). This study evaluated the technical feasibility of sutureless aortic valve replacement using the SBV in an orthotopic position, as well as the functionality of the SBV under systemic circulation, in an acute experimental goat model. Three adult goats (54.5-56.1 kg) underwent sutureless AVR under cardiopulmonary bypass (CPB). The technical feasibility and functionality of the SBVs were assessed using angiography, pressure catheterization, and two-dimensional echocardiography. The sutureless AVR was successful in all goats, and all animals could be weaned off CPB. The mean aortic cross-clamp time was 45 min. Angiogram, after weaning the animals off CPB, showed less than mild paravalvular leakage and central leakage was not detected in any of the goats. The mean peak-to-peak pressure gradient was 6.3 ± 5.0 mmHg. Epicardial two-dimensional echocardiograms showed smooth leaflet movement, including adequate closed positions with good coaptation; the open position demonstrated a large orifice area (average aortic valve area 2.4 ± 0.1 cm2). Sutureless AVR, using SBVs, was feasible in a goat model. The early valvular functionalities of the SBV were sufficient; future long-term experiments are needed to evaluate its durability and histological regeneration potential.

  4. Keratometric alterations following the 25-gauge transconjunctival sutureless pars plana vitrectomy versus the conventional pars plana vitrectomy.

    Science.gov (United States)

    Citirik, Mehmet; Batman, Cosar; Bicer, Tolga; Zilelioglu, Orhan

    2009-09-01

    To assess the alterations in keratometric astigmatism following the 25-gauge transconjunctival sutureless pars plana vitrectomy versus the conventional pars plana vitrectomy. Sixteen consecutive patients were enrolled into the study. Conventional vitrectomy was applied to eight of the cases and 25-gauge transconjunctival sutureless vitrectomy was performed in eight patients. Keratometry was performed before and after the surgery. In the 25-gauge transconjunctival sutureless pars plana vitrectomy group, statistically significant changes were not observed in the corneal curvature in any post-operative follow-up measurement (p > 0.05); whereas in the conventional pars plana vitrectomy group, statistically significant changes were observed in the first postoperative day (p = 0.01) and first postoperative month (p = 0.03). We noted that these changes returned to baseline in three months (p = 0.26). Both 25-gauge transconjunctival sutureless and conventional pars plana vitrectomy are effective surgical modalities for selected diseases of the posterior segment. Surgical procedures are critical for the visual rehabilitation of the patients. The post-operative corneal astigmatism of the vitrectomised eyes can be accurately determined at least two months post-operatively.

  5. Active Silicone Oil Removal with a Transconjunctival Sutureless System: Is the 23-Gauge System Safe and Effective?

    Directory of Open Access Journals (Sweden)

    Mahmut Kaya

    2016-01-01

    Full Text Available Objectives: To evaluate the safety and efficacy of active silicone oil removal with a 23-gauge (G transconjunctival sutureless system. Materials and Methods: One hundred sixteen eyes of 113 patients who had previous retinal detachment surgery with pars plana vitrectomy and silicone oil injection surgery, and underwent silicone oil removal surgery with 23-G transconjonctival sutureless technique in our clinic between January 2009 and April 2014 were reviewed retrospectively. The patients were evaluated with regard to postoperative changes in best corrected visual acuity and intraocular pressure (IOP, and complications that occurred during and after surgery. Results: Of the 113 patients with mean age of 61.1±9.7 years (29-88 years, 62 (54.8% were males and 51 (45.2% were females. Silicone oil removal was performed 8.43±5.24 months after the initial surgery. Mean follow-up was 13.38±4.35 months. Visual acuity improved in 69 eyes (59.48%. Anatomic success was achieved in 113 eyes (97.41%. Mean IOP was 16.2±7.2 mmHg at baseline and 14.4±2.6 mmHg at postoperative day 1 (p=0.643. Eight eyes needed suturation of at least one sclerotomy. Retinal redetachment occurred in 3 eyes (2.5% resulting in a decrease in vision. There were no cases of choroidal detachment, endophthalmitis, clinically significant corneal endothelial decompensation, or macular edema. Conclusion: Active removal of 1,300-centistoke silicone oil with a 23-G transconjunctival sutureless system is a simple, sutureless technique causing minor surgical trauma. Active removal of silicone oil with the 23-G transconjunctival sutureless technique was found to be effective and safe in both phakic and pseudophakic eyes

  6. Safe Resection and Primary Anastomosis of Gangrenous Sigmoid ...

    African Journals Online (AJOL)

    %) of the sigmoid volvulus was gangrenous and 85.2% of all the sigmoid volvulus was managed by resection and primary anastomosis. Complications seen after resection and primary anastomosis were anastomotic leak at 4.5%, resection.

  7. Significance of venous anastomosis in fingertip replantation.

    Science.gov (United States)

    Hattori, Yasunori; Doi, Kazuteru; Ikeda, Keisuke; Abe, Yukio; Dhawan, Vikas

    2003-03-01

    Adequate venous outflow is the most important factor for successful fingertip replantation. The authors have attempted venous anastomosis in all cases of fingertip replantation to overcome postoperative congestion. In this article, the significance of venous repair for fingertip replantation is described from the authors' results of 64 complete fingertip amputations in 55 consecutive patients, which were replanted from January of 1996 to June of 2001. The overall survival rate was 86 percent. Of the 44 replantations in zone I, 37 survived, and the success rate was 84 percent. Of the 20 replantations in zone II, 18 survived, and the success rate was 90 percent. Venous anastomosis was attempted in all cases, but it was possible in 39 zone I and in all zone II replantations. For arterial repair, vein grafts were necessary in 17 of the 44 zone I and in one of the 20 zone II replantations; for venous repair, they were necessary in six zone I replantations and one zone II replantation. Postoperative vascular complications occurred in 15 replantations. There were five cases of arterial thrombosis and 10 cases of venous congestion. Venous congestion occurred in nine zone I and one zone II replantations. In five of these 10 replantations, venous anastomosis was not possible. In another five replantations, venous outflow was established at the time of surgery, but occlusion occurred subsequently. Except for the five failures resulting from arterial thrombosis, successful venous repair was possible in 49 of 59 replantations (83 percent). Despite the demand for skillful microsurgical technique and longer operation time, the authors' results using venous anastomosis in successful fingertip replantations are encouraging. By performing venous anastomosis, external bleeding can be avoided and a higher survival rate can be achieved. Venous anastomosis for fingertip replantation is a reliable and worthwhile procedure.

  8. Morbidity Following Coloanal Anastomosis: A Comparison of Colonic J-Pouch vs Straight Anastomosis.

    Science.gov (United States)

    Brown, Shaun; Margolin, David A; Altom, Laura K; Green, Heather; Beck, David E; Kann, Brian R; Whitlow, Charles B; Vargas, Herschel David

    2018-02-01

    Low rectal tumors are often treated with sphincter-preserving resection followed by coloanal anastomosis. The purpose of this study was to compare the short-term complications following straight coloanal anastomosis vs colonic J-pouch anal anastomosis. Patients were identified who underwent proctectomy for rectal neoplasia followed by coloanal anastomosis in the 2008 to 2013 American College of Surgeons National Surgical Quality Improvement Program database. Demographic characteristics and 30-day postoperative complications were compared between groups. A national sample was extracted from the American College of Surgeons National Surgical Quality Improvement Project database. Inpatients following proctectomy and coloanal anastomosis for rectal cancer were selected. Demographic characteristics and 30-day postoperative complications were compared between the 2 groups. One thousand three hundred seventy patients were included, 624 in the straight anastomosis group and 746 in the colonic J-pouch group. Preoperative characteristics were similar between groups, with the exception of preoperative radiation therapy (straight anastomosis 35% vs colonic J-pouch 48%, p = 0.0004). Univariate analysis demonstrated that deep surgical site infection (3.7% vs 1.4%, p = 0.01), septic shock (2.25% vs 0.8%, p = 0.04), and return to the operating room (8.8% vs 5.0%, p = 0.0006) were more frequent in the straight anastomosis group vs the colonic J-pouch group. Major complications were also higher (23% vs 14%, p = 0.0001) and length of stay was longer in the straight anastomosis group vs the colonic J-pouch group (8.9 days vs 8.1 days, p = 0.02). After adjusting for covariates, major complications were less following colonic J-pouch vs straight anastomosis (OR, 0.57; CI, 0.38-0.84; p = 0.005). Subgroup analysis of patients who received preoperative radiation therapy demonstrated no difference in major complications between groups. This study had those limitations inherent to a

  9. [Application value of magnetic compression anastomosis in digestive tract reconstruction].

    Science.gov (United States)

    Du, Xilin; Fan, Chao; Zhang, Hongke; Lu, Jianguo

    2014-05-01

    Magnetic compression anastomosis can compress tissues together and restore the continuity. Magnetic compression anastomosis mainly experienced three stages: magnetic ring, magnetic ring and column, and smart self-assembling magnets for endoscopy (SAMSEN). Nowadays, the magnetic compression anastomosis has been applied in vascular and different digestive tract surgeries, especially for complex surgery, such as anastomotic stenosis of biliary ducts after liver transplantation or congenital esophageal stenosis. Although only case reports are available at present, the advantages of the magnetic compression anastomosis includes lower cost, simplicity, individualization, good efficacy, safety, and minimally invasiveness. We are building a better technical platform to make magnetic compression anastomosis more advanced and popularized.

  10. Hemi-Intravascular Stenting for Supermicrosurgical Anastomosis

    Directory of Open Access Journals (Sweden)

    Kensuke Tashiro, MD

    2017-11-01

    Conclusions:. Hemi-IVaS could be a useful alternative to conventional intravascular stenting techniques and is also effective for supermicrosurgical perforator-to-perforator anastomosis. Further studies are needed to improve the success rate and to explore its other possible utilizations in supermicrosurgery.

  11. Epidural block and neostigmine cause anastomosis leak

    Directory of Open Access Journals (Sweden)

    Ataro G

    2016-05-01

    Full Text Available Getu Ataro Department of Anesthesia, Jimma University, Jimma, EthiopiaI read the article by Phillips entitled, “Reducing gastrointestinal anastomotic leak rates: review of challenges and solutions”, published in the journal of Open Access Surgery with enthusiasm and found it crucial for perioperative management of patients with gastrointestinal (GI surgery, particularly anastomosis. I appreciate the author’s exhaustive search of literature and discussion with some limitation on review basics like methodology, which may affect the reliability of the review findings. The effects of risk factors for anastomosis leak, such as malnutrition, smoking, steroid use, bowel preparation, chemotherapy, duration of surgery, use of pressors, intravenous fluid administration, blood transfusion, and surgical anastomotic technique, were well discussed.1 However, from anesthesia perspective, there are some other well-studied risk factors that can affect healing of anastomosis wound and cause anastomosis leak. Among others, the effect of neostigmine and epidural block has been reported in many studies since half a century ago. View the original paper by Phillips

  12. Robot-sewn ileoileal anastomosis during robot-assisted cystectomy.

    Science.gov (United States)

    Loertzer, P; Siemer, S; Stöckle, M; Ohlmann, C H

    2018-03-02

    To analyze the feasibility and perioperative results of patients undergoing robot-assisted cystectomy with intracorporeal urinary diversion and robot-sewn ileoileal anastomosis. This is a mono-centric analysis of perioperative data from 48 consecutive patients undergoing robot-assisted cystectomy with intracorporeal urinary diversion and robot-sewn ileoileal anastomosis. Data include the preoperative variables, operative and postoperative course and complication rates related to bowel anastomosis. End points were time spent for anastomosis and intra- and postoperative complication rates. Median operating time was 23.0 (13-60) min for the ileoileal anastomosis. Median overall operating time was 295 (200-780) min, with a median of 282 (200-418) min and 414.0 (225-780) min for the ileum conduit (N = 35) and ileal neobladder (N = 13). Two patients developed paralytic ileus; in another patient acute peritonitis occurred, but was caused by urinary leakage and therefore unrelated to the bowel anastomosis. No anastomotic leakage was noticed. Costs for the robot-sewn anastomosis was 8€ compared to 1250€ for a stapled anastomosis which was performed in previous cases. Limitations are the non-comparative nature of the analysis and the limited number of patients. Robot-sewn ileoileal anastomosis is feasible with low complication rates. Compared to the stapled anastomosis, a robot-sewn ileoileal anastomosis may serve as an alternative and cost-saving approach.

  13. Laparoscopic right colon resection with intracorporeal anastomosis.

    Science.gov (United States)

    Chang, Karen; Fakhoury, Mathew; Barnajian, Moshe; Tarta, Cristi; Bergamaschi, Roberto

    2013-05-01

    This study was performed to evaluate short-term clinical outcomes of laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon. This was a retrospective study of selected patients who underwent laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon for tumors or Crohn's disease by a single surgeon from July 2002 through June 2012. Data were retrieved from an Institutional Review Board-approved database. Study end point was postoperative adverse events, including mortality, complications, reoperations, and readmissions at 30 days. Antiperistaltic side-to-side anastomoses were fashioned laparoscopically with a 60-mm-long stapler cartridge and enterocolotomy was hand-sewn intracorporeally in two layers. Values were expressed as medians (ranges) for continuous variables. There were 243 patients (143 females) aged 61 (range = 19-96) years, with body mass index of 29 (18-43) kg/m(2) and ASA 1:2:3:4 of 52:110:77:4; 30 % had previous abdominal surgery and 38 % had a preexisting comorbidity. There were 84 ileocolic resections with ileo ascending anastomosis and 159 right colectomies with ileotransverse anastomosis. Operating time was 135 (60-220) min. Estimated blood loss was 50 (10-600) ml. Specimen extraction site incision length was 4.1 (3-4.4) cm. Conversion rate was 3 % and there was no mortality at 30 days, 15 complications (6.2 %), and 8 reoperations (3.3 %). Readmission rate was 8.7 %. Length of stay was 4 (2-32) days. Pathology confirmed Crohn's disease in 84 patients, adenocarcinoma in 152, and other tumors in 7 patients. Laparoscopic intracorporeal ileocolic anastomosis following resection of the right colon resulted in a favorable outcome in selected patients with Crohn's disease or tumors of the right colon.

  14. Intraoperative iatrogenic peripheral retinal break in 23-gauge transconjunctival sutureless vitrectomy versus 20-gauge conventional vitrectomy.

    Science.gov (United States)

    Cha, Dong Min; Woo, Se Joon; Park, Kyu Hyung; Chung, Hum

    2013-06-01

    To compare the incidence of intraoperative iatrogenic peripheral retinal breaks (IPRBs) during 23-gauge transconjunctival sutureless vitrectomy (TSV) and conventional 20-gauge vitrectomy for various indications. This was a single-center, comparative, retrospective, interventional case series of 973 23-gauge TSVs and 402 conventional 20-gauge vitrectomies done by two surgeons between January 2004 and December 2009. The incidence rate of intraoperative IPRBs and risk factors were analyzed in association with various clinical and surgical factors. IPRBs occurred significantly less often during 23-gauge TSV (16 of 973 cases, 1.6 %) than during conventional vitrectomy (25 of 402 cases, 6.2 %, Pgauge TSV procedure with the trocar system has a lower incidence of intraoperative IPRBs than conventional 20-gauge vitrectomy. Longer operation time and induction of PVD are also independent risk factors of the complication.

  15. Outcomes of 23- and 25-gauge transconjunctival sutureless vitrectomies for dislocated intraocular lenses.

    Science.gov (United States)

    Bajgai, Priya; Tigari, Basavraj; Singh, Ramandeep

    2017-10-04

    To compare the outcome of 23-gauge as compared with 25-gauge transconjunctival sutureless vitrectomy (TSV) in the management of dislocated intraocular lenses (IOLs). Retrospective, non-consecutive, comparative, interventional case series. Patients with dislocated intraocular lens who underwent sutureless PPV using either 23-gauge or 25-gauge instruments. The patients who presented with a dislocated IOL, underwent TSV with repositioning of the intraocular lens, either in the sulcus or scleral-fixated sutured/glued. Of the total 61 eyes, 33 (54.09%) underwent 23-gauge TSV and 28 (45.90%) underwent 25-gauge TSV. The mean logMAR BCVA at baseline and 6 months after surgery was 0.8 and 0.46 in the 23-gauge group, and 0.82 and 0.47 in the 25-gauge group. There was no significant difference in logMAR BCVA values between the two groups at any time point of time during the follow-up. The mean postoperative IOP on postoperative day 1 was 14.76 ± 5.4 in 23-gauge group and 17.57 ± 7.9 in the 25-gauge group (p = 0.10). Retinal break was noticed intraoperatively in two cases in 23-gauge group and in three cases in 25-gauge group (p = 0.509). Postoperative complications included IOL decentration in one case of 23-gauge vitrectomy and two cases in 25-gauge group (p = 0.5), cystoid macular edema in four patients in 23-gauge group and six cases of 25-gauge group (p = 0.3) and retinal detachment in one case in each group (p = 0.9). 25-gauge appears to be as safe and as effective as 23-gauge TSV in the management of dislocated intraocular lenses.

  16. A new infusion sustainer that stabilizes perfusion during sutureless 25-gauge vitrectomy.

    Science.gov (United States)

    Hattori, Takayuki; Shimada, Hiroyuki; Nakashizuka, Hiroyuki; Mori, Ryusaburo; Mizutani, Yoshihiro; Yuzawa, Mitsuko

    2010-12-01

    To stabilize perfusion during sutureless 25-gauge (25G) vitrectomy, we designed an infusion sustainer and examined its usefulness. A reusable infusion sustainer was constructed by soldering a piece of metal wire to a metal paper clip and curling the two ends of the wire. For use, the sustainer was clipped onto the lip retractor, and the infusion line and chandelier fiber were passed through the wire loops. 25G vitrectomy was conducted in three porcine eyes, with insertion of a tonometer to monitor intraocular pressure (IOP). The relation between infusion port direction and IOP was examined. In a clinical study, 30 eyes that underwent 25G vitrectomy using the infusion sustainer and 30 eyes without using the infusion sustainer were compared for IOP maintenance and complications. In the porcine eye, after angled incision, the infusion tip was pointing toward the basal vitreous on the anterior side of the eyeball. Under these conditions, vitreous resection was accompanied by IOP lowering. When the infusion tip was moved so as to be directed toward the central vitreous, IOP was maintained. In the clinical study, among the eyes undergoing vitrectomy without the infusion sustainer, IOP decreased during operation in 30 eyes, and infusion fluid or air flowed into the anterior chamber in four eyes. In the 30 eyes in which the sustainer was used, no IOP lowering and no infusion fluid or air flow into the anterior chamber were detected, due to stabilization of the infusion port. Use of the infusion sustainer orients the infusion port toward the central vitreous, stabilizes IOP and prevents flow of infusion fluid or air into the anterior chamber. This infusion sustainer is useful to perform sutureless 25G vitrectomy safely.

  17. Neutrino Telescope

    International Nuclear Information System (INIS)

    Mezzetto, M.

    2011-01-01

    The Conference Series 'Un Altro Modo di guardare il Cielo', held in Venice, started in 1988. It included 13.editions of 'Neutrino Telescopes' and four editions of 'Neutrino Oscillations in Venice'. The conference Series ideated , created and conducted by Prof. Milla Baldo Ceolin, after her guidance 'Un Altro Modo di guardare il Cielo' became one of the most important fixed appointments of thr neutrino physics and astrophysics community.

  18. Schmidt Telescope

    Science.gov (United States)

    Murdin, P.

    2000-11-01

    A type of telescope, invented by the Estonian optician Bernhard Schmidt (1879-1935), that is used to photograph large areas of the sky. Because, in its original design, it was useable only for photography, the instrument is also known as the Schmidt camera. The Schmidt uses a concave spherical mirror as its light collector and corrects for the optical defect, known as spherical aberration, that i...

  19. Clinical repercussions of Martin-Gruber anastomosis: anatomical study

    Directory of Open Access Journals (Sweden)

    Cristina Schmitt Cavalheiro

    2016-04-01

    Full Text Available OBJECTIVE: The main objective of this study was to describe Martin-Gruber anastomosis anatomically and to recognize its clinical repercussions. METHOD: 100 forearms of 50 adult cadavers were dissected in an anatomy laboratory. The dissection was performed by means of a midline incision along the entire forearm and the lower third of the upper arm. Two flaps including skin and subcutaneous tissue were folded back on the radial and ulnar sides, respectively. RESULTS: Nerve communication between the median and ulnar nerves in the forearm (Martin-Gruber anastomosis was found in 27 forearms. The anastomosis was classified into six types: type I: anastomosis between the anterior interosseous nerve and the ulnar nerve (n = 9; type II: anastomosis between the anterior interosseous nerve and the ulnar nerve at two points (double anastomosis (n = 2; type III: anastomosis between the median nerve and the ulnar nerve (n = 4; type IV: anastomosis between branches of the median nerve and ulnar nerve heading toward the flexor digitorum profundus muscle of the fingers; these fascicles form a loop with distal convexity (n = 5; type V: intramuscular anastomosis (n = 5; and type VI: anastomosis between a branch of the median nerve to the flexor digitorum superficialis muscle and the ulnar nerve (n = 2. CONCLUSION: Knowledge of the anatomical variations relating to the innervation of the hand has great importance, especially with regard to physical examination, diagnosis, prognosis and surgical treatment. If these variations are not given due regard, errors and other consequences will be inevitable.

  20. Randomized trial on the application of biofragmentable anastomosis ring in intestinal anastomosis.

    Science.gov (United States)

    Chen, Shuang; Yang, Bin; He, Jia-hui; Zhang, Yu-chao; Lai, Dong-ming

    2009-08-05

    The biofragmentable anastomosis ring (BAR) is a simple alternative device to create intestinal anastomosis. Our study was designed to evaluate the clinical value of BAR in intestinal anastomosis. A total of 167 patients performed intestinal anastomosis from January 2002 to February 2006 were randomized to BAR group (n = 82) and manual suture group (n = 85) as control. They were equally allocated to the two groups regarding sex, age, site of anastomosis, emergent or elective surgery and contaminant diseases. The results of postoperative complications and recovery were recorded in each group. Eighty-seven intraperitoneal BAR anastomoses were completed in 82 patients. Two and one postoperative deaths were recorded in BAR and suture group, respectively, no deaths were directly related to anastomotic technique. In suture group, anastomotic leakage and early bleeding both occurred in two patients respectively, no anastomotic bleeding occurred in BAR group, one patient in BAR group developed enterocutaneous fistulae. Perioperative bleeding, operation time and length of hospitalization were similar in two groups (P > 0.05). Time for return of bowel function was significantly shortened in BAR group than that in suture group (P emergent intraperitoneal intestinal anastomotic surgery.

  1. Clinical and hemodynamic outcomes of Perceval S sutureless bioprostheses implanted through a mini-approach in the aortic position

    Directory of Open Access Journals (Sweden)

    A. N. Molchanov

    2017-11-01

    Full Text Available Aim. Aortic valve disease is one of three most common cardiovascular problems. Aortic stenosis is responsible for 70% of valve disease. Aortic valve replacement is the most effective treatment for aortic stenosis nowadays. A traditional suture technique of aortic valve replacement is associated with a high risk of complications. Most of these complications occur due to ischemic aortic cross-clamp time and comorbidities. Perceval S sutureless aortic valves to be implanted in selected patients are supposed to meet the challenge. The study was aimed at assessing Perceval S sutureless aortic valve hemodynamic and clinical parameters, its intraoperative advantages and postoperative complication rates.Methods. A prospective cohort study of Perceval S sutureless aortic valve implanted via J-sternotomy (n = 22 and median sternotomy (n = 10 was conducted. Early and medium postoperative clinical and functional outcomes were obtained and evaluated.Results. A decrease in the transaortic gradient was observed in early (peak gradient 21.6±4.2 (p = 0.1, mean gradient 11.3±2.8 (p = 0.58 and medium (peak gradient 15.8±5.5 (p = 0.342, mean gradient 8.8±1.9 (p = 0.54 follow-up. The myocardial mass index tended to be reduced throughout the entire follow-up (p = 0.01. There were no prosthesis dysfunctions or biodegradation. No patient died in the postoperative period. Survival at 36 months of follow-up was 93.75%.Conclusion. Perceval S xenopericardial sutureless aortic bioprostheses adequately resolve hemodynamic problems and improve left ventricle functional parameters in early and median follow-up. They may be recommended for elderly patients. Sutureless aortic valve implantation is technically feasible through J-sternotomy and contributes to an eventless follow-up.Received 17 February 2017. Revised 16 August 2017. Accepted 28 August 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.

  2. Neutrino Telescope

    International Nuclear Information System (INIS)

    Coelin Baldo, Milla

    2009-01-01

    The present volume contains the proceedings of the 13. International Workshop on 'Neutrino Telescope', 17. of the series 'Un altro modo di guardare il cielo', held in Venice at the 'Istituto Veneto di Scienze, Lettere ed Arti' from March 10 to March 13, 2009. This series started in Venice 21 years ago, in 1988, motivated by the growing interest in the exciting field of the neutrino physics and astrophysics, with the aim to bring together experimentalists and theorists and encourage discussion on the most recent results and to chart the direction of future researchers.

  3. [Billroth I anastomosis with biodegradable anastomosis ring in the animal model].

    Science.gov (United States)

    Dietz, U A; Debus, E S; Hirt, A L; Czeczko, N G; Nassif, P A; Repka, J C; Malafaia, S; Geiger, D; Thiede, A

    1999-01-01

    In the present study, the Billroth-I anastomosis with the biofragmentable anastomosis ring was examined in dogs. 24 dogs were randomized into a group of manual suturing (n = 12) and a BAR-group (n = 12). In the group of manual suturing, a distal gastric resection and gastroduodenostomy with sero-submucous suture was performed. In the BAR-group, the distal gastric resection was done with the linear stapler PLC-75, whereby the BAR gastroduodenostomy crossed the stapling line. The dogs were evaluated on p.o. days 4, 14, and 30 and tested for bursting strength and bursting location, appearance of mucosa, hydroxyprolin concentration, and histologic features. There was no functional disorder in the gastrointestinal transit in any animal; in summary with regard to the various parameters, the crossing of BAR and stapling line does not represent any additional risk factor in the Billroth-I anastomosis in dogs.

  4. Concavo-convex oblique anastomosis technique for jejuno ileal atresia

    Directory of Open Access Journals (Sweden)

    Hasan Zaheer

    2009-01-01

    Full Text Available Aim: To evaluate the role of end-to-end oblique bowel anastomosis in bowel atresia. Methods: End-to-end oblique anastomosis was done in 25 neonates of bowel atresia and the results were compared with traditional method of end to back anastomosis in 25 cases. Results: We found less mortality and morbidity (5% in our technique as compared to end to back technique (20%. Conclusions: We recommend this technique, as anastomosis is wide with less angulations, flow of effluent is linear, and there is less force exerted over post-anastomotic side wall.

  5. Sutureless femtosecond anterior lamellar keratoplasty: A 1-year follow-up study

    Directory of Open Access Journals (Sweden)

    Rohit Shetty

    2014-01-01

    Full Text Available Aim: To study the safety and efficacy of sutureless femtosecond anterior lamellar keratoplasty (FALK in patients with corneal stromal opacities. Materials and Methods: Eleven eyes of 11 consecutive patients with corneal stromal opacities involving < 250 μ due to various pathologies were included in the study. Preoperatively, all underwent anterior segment imaging with spectral domain optical coherence tomography (SD-OCT (Bioptigen Inc., Durham, North Carolina, USA to measure the depth of the stromal opacity. All patients underwent FALK, and bandage contact lens was placed for a period of 2 weeks. Postoperatively, uncorrected visual acuity, best corrected visual acuity (BCVA, and SD-OCT evaluation were performed. Results: All patients showed significant improvement in BCVA. The mean postoperative BCVA (in decimals improved from 0.11 ± 0.06 preoperatively to 0.59 ± 0.08. There were no intraoperative or significant postoperative complications that were noticed. Conclusion: FALK is a safe and effective alternative to deep anterior lamellar keratoplasty or penetrating keratoplasty in the treatment of anterior stromal opacities.

  6. Tracheal resection and anastomosis in dogs.

    Science.gov (United States)

    Lau, R E; Schwartz, A; Buergelt, C D

    1980-01-15

    Resection and end-to-end anastomosis of the trachea is a practical procedure for the correction of various forms of tracheal stenosis. Preplacing retention sutures facilitates manipulation of the trachea and rapid apposition of the tracheal ends. These same sutures then relieve tension on the primary suture line, assuring early epithelialization. Two dogs with tracheal stenosis were treated by use of this technique. Slight narrowing of the trachea was evident postoperatively in both dogs, but neither dyspnea nor coughing occurred during the follow-up period.

  7. The use of cyanoacrylate in surgical anastomosis: An alternative to ...

    African Journals Online (AJOL)

    To present anastomosis with cyanoacrylate as a cheap, simple, fast, and available technique for anastomosis in urological, vascular, gynecological, and general surgical procedures. This method may in the future be a good alternative to microsurgery, particularly in centers where facilities are unavailable and the financial ...

  8. Effectiveness of bilateral tubotubal anastomosis in a large outpatient population

    OpenAIRE

    Berger, Gary S.; Thorp, John M.; Weaver, Mark A.

    2016-01-01

    STUDY QUESTION Is bilateral tubotubal anastomosis a successful treatment in an outpatient patient population? SUMMARY ANSWER For women wanting children after tubal sterilization, bilateral tubotubal anastomosis is an effective outpatient treatment. WHAT IS KNOWN ALREADY With the current emphasis in reproductive medicine on high technology procedures, the effectiveness of female surgical sterilization reversal is often overlooked. Previous clinical studies of tubal sterilization reversal have ...

  9. Hypoplasia of the internal carotid artery with intercavernous anastomosis

    International Nuclear Information System (INIS)

    Chen, C.J.; Wang, L.J.; Wong, Y.C.; Chen, S.T.; Hsieh, F.Y.

    1998-01-01

    We report a symptomatic case of unilateral hypoplasia of the internal carotid artery with an intercavernous anastomosis, a very rare developmental anomaly. The symptoms were caused by occlusion of the proximal middle cerebral artery which possibly related to the haemodynamic stress caused by the anomalous intercavernous anastomosis. (orig.)

  10. Billroth I anastomosis using a circular stapler for corrosive gastric ...

    African Journals Online (AJOL)

    Introduction: Resection and hand-sewn Billroth I reconstruction is the commonly carried out procedure for type I gastric strictures. The use of staplers for Billroth I anastomosis is limited. Here we describe a unique technique of Billroth I anastomosis using a circular stapler without a gastrotomy in a case of corrosive gastric ...

  11. A sutureless method for digestive tract reconstruction during pancreaticoduodenectomy in a dog model

    OpenAIRE

    Cui, Xiaohai; Lei, Peng; Liu, Shiqi; Liu, Xuemin; Wu, Zheng; Lv, Yi

    2015-01-01

    Development of pancreatic fistulas as a result of anastomotic gaps is still a major complication after pancreaticoduodenectomy, and can cause post-operative death. Therefore, safer and more effective methods of anastomosis are needed to avoid leakage and decrease mortality. Materials and methods: Twenty domestic dogs with body weights ranging from 15 to 25 kg were used, regardless of gender. A model of common bile duct and pancreatic duct dilatation was surgically prepared in these dogs. Panc...

  12. Management of small aortic annulus in the era of sutureless valves: A comparative study among different biological options.

    Science.gov (United States)

    Ghoneim, Aly; Bouhout, Ismail; Demers, Philippe; Mazine, Amine; Francispillai, Mary; El-Hamamsy, Ismail; Carrier, Michel; Lamarche, Yoan; Bouchard, Denis

    2016-10-01

    Aortic valve replacement (AVR) in patients with a small aortic annulus is a challenging problem. The objective of this study was to compare 4 surgical approaches in terms of hemodynamics and perioperative outcomes. A retrospective single-center study included 351 consecutive patients with a small aortic annulus (≤21 mm) who underwent aortic valve surgery between January 2007 and December 2014. Surgical techniques included standard AVR in 259 (74%) patients, aortic root enlargement in 20 (6%), implantation of a stentless bioprosthesis in 23 (6%), and sutureless AVR in 49 (13%). Three hundred and eleven (89%) patients were female. The mean Logistic EuroSCORE II varied significantly among the groups and ranged from 6.5% ± 5.4% in the standard AVR group to 9.2% ± 4.7% in the stentless group. Early mortality occurred in 26 (7%) patients. Patients in the stentless group had the lowest aortic valve mean gradients on predischarge transthoracic echocardiography (10.9 ± 6.2 mm Hg; P < .001). In the stented group, the Trifecta prosthesis displayed the lowest postoperative mean transaortic gradient (10.3 ± 3.6; P < .001) with no severe prosthesis-patient mismatch. Postoperative gradients of the sutureless group were comparable with stented prostheses. In our study, stentless AVR and Trifecta bioprostheses had the best hemodynamic outcomes. The Perceval sutureless prosthesis provides reasonable hemodynamic performance and is a safe alternative. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  13. Clinical observation of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis

    Directory of Open Access Journals (Sweden)

    Huang Zhang

    2014-09-01

    Full Text Available AIM:To evaluate the clinical efficacy of corneal lamellar debridement combined with sutureless amniotic membrane transplantation for the treatment of superficial fungal keratitis.METHODS:Totally 22 cases(22 eyeswith superficial fungal keratitis were referred to our hospital from April 2012 to October 2013. The patients with persistent cornea ulcer after treatment of local and systemic antifungal drugs underwent corneal lamellar debridement combined with sutureless amniotic membrane transplantation, and the recipient bed was covered with an amniotic membrane using fibrin sealant during the operation. All patients were still given topical antifungal therapy for 1-2mo after operation. The followed-up time was 3mo or above. We observed the corneal healing and amniotic membrane adhesion by split lamp microscope, and investigated the transformation of amniotic membrane and fungal infection recurrence with confocal microscope. RESULTS: Corneal edema and anterior chamber reaction of 21 patients disappeared gradually, and no amniotic membrane graft dissolved and shed off within 1-2wk postoperatively. Two weeks after operation, the graft integrated into the corneal and the corneal wounds' thickness increased gradually, the corneal epithelium reconstructed and corneas became clear. Four weeks after operation, the corneal scarring developed gradually and fluorescence staining was negative. Nineteen cases' amniotic membranes that adhered with the cornea dissolved 4wk after operation. There were different degrees of corneal nebula or macula remained 3mo postoperatively. All patients' vision improved in varying degrees, except in 1 case with fungal keratitis who had been cured by lamellar keratoplasty.CONCLUSION:Corneal lamellar debridement combined with sutureless amniotic membrane transplantation can effectively remove the foci of inflammation, improve the local efficacy, shorten the operation time, relieve the postoperative reaction, and promote cornea

  14. Comparison of 25-gauge sutureless vitrectomy and 20-gauge vitrectomy in the treatment of posterior capsule opacification in pseudophakic children.

    Science.gov (United States)

    Wu, Xiao-Ming; Xie, Li-Xin

    2015-01-01

    To compare the effectiveness and safety of pars plana capsulotomy and vitrectomy using 25-gauge tansconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system for posterior capsule opacification (PCO) in pseudophakic children. Retrospectively study. Pars plana capsulotomy and vitrectomy using 25-gauge sutureless vitrectomy system was performed for PCO in the study group (32 eyes). Patients in the control group (34 eyes) underwent capsulotomy and vitrectomy using standard 20-gauge vitrectomy system, providing a comparison between 2 groups with regard to preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), and intraoperative and postoperative complications. The two groups were performed consequentially. The patients ages ranged from 2 to 13y (means: 6.61±2.73y). Surgical technique, intraoperative and postoperative complications, visual acuity, IOP, and recurrent PCO were recorded. The surgical procedure was performed uneventfully in all patients. Visual acuity improved significantly in both groups. BCVA improved in 22 eyes (81.5%) in the study group and in 28 eyes (87.5%) in the control group. There was no statistical difference of visual acuity that were attainable in two groups (H=0.115, P=0.909). Mean postoperative IOP showed no significant difference between the groups at 1wk. All sort of PCO were accomplished by 20-gauge system, while 25-gauge system was effective for pearls style and 2 grade of fibrous PCO, and was insufficient to grade 3 of PCO. In the study group two cases were not accomplished by 25-gauge system while 20-gauge system conquered them. Compared with the control group, mean operative time for opening and closing the sclerotomy in the study group was considerably reduced. The mean follow-up was 38.2mo (range: 8-79mo). During the follow-up period, no incision leakage, corneal edema, vitreous loss, IOL damage, retinal detachment, recurrent PCO, or other complications were noted. Pars plana

  15. Comparison of 25-gauge sutureless vitrectomy and 20-gauge vitrectomy in the treatment of posterior capsule opacification in pseudophakic children

    Directory of Open Access Journals (Sweden)

    Xiao-Ming Wu

    2015-12-01

    Full Text Available AIM: To compare the effectiveness and safety of pars plana capsulotomy and vitrectomy using 25-gauge tansconjunctival sutureless vitrectomy system and 20-gauge vitrectomy system for posterior capsule opacification (PCO in pseudophakic children. METHODS: Retrospectively study. Pars plana capsulotomy and vitrectomy using 25-gauge sutureless vitrectomy system was performed for PCO in the study group (32 eyes. Patients in the control group (34 eyes underwent capsulotomy and vitrectomy using standard 20-gauge vitrectomy system, providing a comparison between 2 groups with regard to preoperative and postoperative best corrected visual acuity (BCVA, intraocular pressure (IOP, and intraoperative and postoperative complications. The two groups were performed consequentially. The patients ages ranged from 2 to 13y (means: 6.61±2.73y. Surgical technique, intraoperative and postoperative complications, visual acuity, IOP, and recurrent PCO were recorded. RESULTS: The surgical procedure was performed uneventfully in all patients. Visual acuity improved significantly in both groups. BCVA improved in 22 eyes (81.5% in the study group and in 28 eyes (87.5% in the control group. There was no statistical difference of visual acuity that were attainable in two groups (H=0.115, P=0.909. Mean postoperative IOP showed no significant difference between the groups at 1wk. All sort of PCO were accomplished by 20-gauge system, while 25-gauge system was effective for pearls style and 2 grade of fibrous PCO, and was insufficient to grade 3 of PCO. In the study group two cases were not accomplished by 25-gauge system while 20-gauge system conquered them. Compared with the control group, mean operative time for opening and closing the sclerotomy in the study group was considerably reduced. The mean follow-up was 38.2mo (range: 8-79mo. During the follow-up period, no incision leakage, corneal edema, vitreous loss, IOL damage, retinal detachment, recurrent PCO, or other

  16. Bronchus anastomosis after sleeve resection for lung cancer: does the suture technique have an impact on postoperative complication rate?

    Science.gov (United States)

    Palade, Emanuel; Holdt, Holger; Passlick, Bernward

    2015-06-01

    Bronchoplastic resections emerged as an alternative to pneumonectomy for patients with impaired pulmonary function and have gained popularity due to a marked decrease in morbidity and at least similar oncological outcome. Actual guidelines recommend sleeve resections whenever technically feasible, even in cases with adequate pulmonary reserve for pneumonectomy, in order to maximally preserve functional lung parenchyma. Various suture techniques were described; the existing evidence, however, is insufficient to recommend one of them as standard. The aim of this study was to compare two suture techniques for bronchus repair after sleeve resection. Two groups of patients from two separate institutions were retrospectively analysed. In Group A (n = 20), the anastomosis was performed with a running suture at the membranous part and an interrupted suture for the rest of the circumference. In Group B (n = 40), a telescoping continuous suture was used. Intra- and postoperative findings directly related to the anastomosis were compared. The parameters were assessed as absolute numbers and percentages; the statistical significance was determined using Pearson's χ(2) test for categorical variables and Student's t-test for continuous data (P resection type (predominance of the right upper lobe for Group B), the groups were comparable regarding patient characteristics. The intraoperative anastomotic assessment revealed: patency 100% in both groups, initial air tightness (100 vs 82.5%; P = 0.047) and buttressing 85 vs 5%. No suture revision was necessary in both groups. The analysis of anastomosis-related morbidity revealed no significant difference: atelectasis (1 in Group A and 2 in Group B; P = 1), reversible anastomotic changes (0 vs 2; P = 0.309), early stenosis (0 vs 0), bronchopleural fistula (1 vs 0; P = 0.154), bronchovascular fistula (0 vs 0), late stenosis (1 vs 0; P = 0.119) and reoperations (15 vs 5%; P = 0.186). The operative mortality rate was similar (2 vs 3; P

  17. Is "functional end-to-end anastomosis" really functional? A review of the literature on stapled anastomosis using linear staplers.

    Science.gov (United States)

    Kano, Masayuki; Hanari, Naoyuki; Gunji, Hisashi; Hayano, Koichi; Hayashi, Hideki; Matsubara, Hisahiro

    2017-01-01

    Anastomosis is one of the basic skills of a gastrointestinal surgeon. Stapling devices are widely used because stapled anastomosis (SA) can shorten operation times. Antiperistaltic stapled side-to-side anastomosis (SSSA) using linear staplers is a popular SA technique that is often referred to as "functional end-to-end anastomosis (FEEA)." The term "FEEA" has spread without any definite validation of its "function." The aim of this review is to show the heterogeneity of SA and conventional hand-sewn end-to-end anastomosis (HEEA) and to advocate the renaming of "FEEA." We conducted a narrative review of the literature on SSSA. We reviewed the literature on ileocolic and small intestinal anastomosis in colonic cancer, Crohn's disease and ileostomy closure due to the simplicity of the technique. The superiority of SSSA in comparison to HEEA has been demonstrated in previous clinical studies concerning gastrointestinal anastomosis. Additionally, experimental studies have shown the differences between the two anastomotic techniques on peristalsis and the intestinal bacteria at the anastomotic site. SSSA and HEEA affect the postoperative clinical outcome, electrophysiological peristalsis, and bacteriology in different manners; no current studies have shown the functional equality of SSSA and HEEA. However, the use of the terms "functional end-to-end anastomosis" and/or "FEEA" could cause confusion for surgeons and researchers and should therefore be avoided.

  18. The Perceval Sutureless Aortic Valve: Review of Outcomes, Complications, and Future Direction.

    Science.gov (United States)

    Powell, Ramsey; Pelletier, Marc P; Chu, Michael W A; Bouchard, Denis; Melvin, Kevin N; Adams, Corey

    Surgical aortic valve replacement with a stented prosthesis has been the standard of care procedure for aortic stenosis. The Perceval (LivaNova, London, United Kingdom) is a sutureless aortic valve bioprosthesis currently implanted in more than 20,000 patients. The purpose of this article was to review the literature available after 9 years of clinical experience of the Perceval aortic valve. PubMED, Embase, and the Cochrane Library databases were searched. A meta-analysis of summary statistics from individual studies was conducted. A total of 333 studies were identified and 84 studies were included. Thirty-day mortality and 5-year survival ranged from 0% to 4.9% and 71.3% to 85.5%, respectively. Compared with stented prosthesis, pooled analysis demonstrated a statistically significant reduction in aortic cross-clamp and cardiopulmonary bypass times (minutes) with Perceval (38.6 vs 63.3 and 61.4 vs 84.9, P < 0.00001, respectively). Compared with transcatheter aortic valve implantation, pooled analysis demonstrated a statistically significant reduction with Perceval in paravalvular leakage (1.26% vs 14.31%) and early mortality (2.3% vs 6.9%). Favorable hemodynamics, acceptable valve durability, and ease of implantation in minimally invasive cases were reported as benefits. A trend toward increased rates of permanent pacemaker implantation and low postoperative platelet count were identified. Special use and off-label procedures described included bicuspid aortic valves, valve-in-valve for homograft and stentless prosthesis failure, concomitant valvular procedures, porcelain aorta, and endocarditis. The Perceval valve has shown safe clinical and hemodynamic outcomes. Outcomes support its continued usage and potential expansion.

  19. Outcomes of 23-gauge transconjunctival sutureless vitrectomy for acute postoperative endophthalmitis.

    Science.gov (United States)

    Hsu, Chia-Ming; Chen, Shih-Chou; Wu, Tsung-Tien; Sheu, Shwu-Jiuan

    2017-08-01

    To report our 3-year experience of 23-gauge transconjunctival sutureless vitrectomy (TSV) for acute postoperative endophthalmitis at a tertiary referral center in southern Taiwan. This retrospective chart review study included 19 patients with acute postoperative endophthalmitis who underwent 23-gauge TSV from January 2011 to January 2015 at Kaohsiung Veterans General Hospital, Taiwan. Bacterial and fungal cultures from aqueous samples, vitreous samples, or both were performed. Nineteen patients (12 male; 7 female) were included. The mean age was 72.4 ± 8.29 years. Acute postoperative endophthalmitis was noted in 18 patients after cataract surgery and in 1 patient after 23-gauge vitrectomy for a rhegmatogenous retinal detachment. Upon presentation, visual acuity was less than hand movement for 80% of the patients. Chief complaints included blurred vision (19 patients, 100%), followed by pain (10 patients, 52.6%) and red eye (4 patients, 21%). All patients were administered an intravitreal injection (IVI) of antibiotics and 23-gauge TSV, and the average number of IVIs was 2.68 ± 1.73 (1-9 IVIs). The interval between their initial eye symptoms and vitrectomy was 4.11 ± 4.73 days (0-2 days), and the interval between diagnosis with endophthalmitis and a vitrectomy was 1.11 ± 1.52 days (0-6 days). The final visual acuity was no light perception for 1 patient (5.3%), between 6/60 and 6/12 for 8 patients (42.1%), and 6/12 or better for 9 patients (47.4%). No retinal detachment or hypotony was noted postoperatively in any case. 23-gauge vitrectomy is safe and effective for the management of acute postoperative endophthalmitis. Early diagnosis and treatment with 23-gauge vitrectomy may provide a good visual outcome. Copyright © 2017. Published by Elsevier Taiwan LLC.

  20. Surgical outcomes of transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection

    Directory of Open Access Journals (Sweden)

    Erakgun Tansu

    2009-01-01

    Full Text Available Aims: To evaluate the outcomes and complications of 23-gauge transconjunctival sutureless vitrectomy (TSV with Silicone oil (SO tamponade in complex vitreoretinal diseases. Settings and Design: Ege university hospital ophthalmology department. Retrospective case series. Materials and Methods: Forty eyes of 40 patients with diabetic tractional retinal detachment (DTRD and proliferative vitreoretinopathy (PVR were included in the study. Vitrectomy using 23-gauge system with SO endotamponade was performed. Peroperative and postoperative complications, anatomical and visual results were evaluated. Statistical analysis used: Paired Student′s t-test. Results: Simultaneous cataract surgery was performed in 17 eyes. Peroperative complications were posterior capsule rupture during phacoemulsification in one patient, vitreous and retinal incarceration in one patient. One eye required suture placement at the end of surgery due to SO leakage. Postoperatively, a small subconjunctival SO bubble in three patients, and hypotony in one patient (6 mmHg were observed. Recurrent retinal detachment under SO occurred in one patient. Mean follow-up was 6.5 months (±2.7. Pre- and postoperative mean visual acuity was 2.22±0.91 logMAR and 1.11±0.8 logMAR, respectively ( P< 0.001. Mean intraocular pressure (IOP on the first postoperative day was lower than preoperative IOP (11.3 ±3.2 versus 14.0 ±2.4 mmHg ( P< 0.001. Conclusions: Twenty-three gauge instrumentation seems to be feasible, effective and safe for vitrectomy with SO injection in DTRD and PVR, and can be considered in the surgical management of these complex vitreoretinal diseases.

  1. Surgical outcomes of transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection

    Science.gov (United States)

    Erakgun, Tansu; Egrilmez, Sait

    2009-01-01

    Aims To evaluate the outcomes and complications of 23-gauge transconjunctival sutureless vitrectomy (TSV) with Silicone oil (SO) tamponade in complex vitreoretinal diseases. Settings and Design Ege university hospital ophthalmology department. Retrospective case series. Materials and Methods Forty eyes of 40 patients with diabetic tractional retinal detachment (DTRD) and proliferative vitreoretinopathy (PVR) were included in the study. Vitrectomy using 23-gauge system with SO endotamponade was performed. Peroperative and postoperative complications, anatomical and visual results were evaluated. Statistical analysis used Paired Student's t-test. Results Simultaneous cataract surgery was performed in 17 eyes. Peroperative complications were posterior capsule rupture during phacoemulsification in one patient, vitreous and retinal incarceration in one patient. One eye required suture placement at the end of surgery due to SO leakage. Postoperatively, a small subconjunctival SO bubble in three patients, and hypotony in one patient (6 mmHg) were observed. Recurrent retinal detachment under SO occurred in one patient. Mean follow-up was 6.5 months (±2.7). Pre- and postoperative mean visual acuity was 2.22±0.91 logMAR and 1.11±0.8 logMAR, respectively (Ppressure (IOP) on the first postoperative day was lower than preoperative IOP (11.3 ±3.2 versus 14.0 ±2.4 mmHg) (Pgauge instrumentation seems to be feasible, effective and safe for vitrectomy with SO injection in DTRD and PVR, and can be considered in the surgical management of these complex vitreoretinal diseases. PMID:19237782

  2. Outcome after ileoanal anastomosis in pediatric patients with ulcerative colitis.

    Science.gov (United States)

    Durno, C; Sherman, P; Harris, K; Smith, C; Dupuis, A; Shandling, B; Wesson, D; Filler, R; Superina, R; Griffiths, A

    1998-11-01

    To review the outcome after restorative proctocolectomy among children and adolescents with ulcerative colitis at a pediatric inflammatory bowel disease center. The records of all patients with ulcerative colitis undergoing colectomy and ileoanal anastomosis at The Hospital for Sick Children, Toronto, Canada, were reviewed. Questionnaires concerning functional results were sent to patients with restored transanal defecation. Seventy three patients (mean age, 13.2 years; range, 2.6-18.8 years) underwent ileoanal anastomosis (19 straight ileoanal anastomosis, 41 J pouch, 13 S pouch) between January 1980 and June 1995 and were observed 5.8+/-3.3 years. The ileoanal anastomosis is nonfunctional in 19 (26%) patients. Excision rates according to type of restorative procedure were J pouch, 7% (3 of 41); S pouch, 32% (4 of 13); and straight ileoanal anastomosis, 32% (6 of 19). Failure was usually attributable to intractable diarrhea among patients with straight ileoanal anastomosis but was caused by anastomotic leak or pelvic-perianal sepsis among patients with pouch procedures. Failure rates did not vary with age at ileoanal anastomosis. Among patients retaining ileoanal continuity, continence problems reported in the questionnaire were frequent and tended to be more extreme among younger patients. Overall, 90% of respondents reported satisfaction with the functional outcome of the restorative operation. The success rate of the ileoanal anastomosis/J-pouch procedure is comparable to that in adult series. The ileoanal anastomosis/J-pouch procedure is the operation of choice for children and adolescents who want ileoanal continuity restored after colectomy for ulcerative colitis.

  3. Diagnosis of false proximal anastomosis aneurysms after aortofemoral reconstructive operations

    International Nuclear Information System (INIS)

    Pokrovskij, A.V.; Dan, V.N.; Karazeev, G.L.

    1993-01-01

    The paper deals with the diagnostic aspects of false aneurysms of proximal anastomosis of prostheses with the aorta on the basis of examination of 9 patients aged 3-65 years after aortofemoral reconstructive operations. The periods of the occurrence of false aneurysms were 2 weeks to 6 years. The causes of anastomosis aneurysms: infection, endartectomy fro the aorta at the site of applied anastomosis, progressive underlying disease. The authors provide strong evidence for a high informative value of various examinations, including ultrasound echoscanning, computer tomography, radioopaque aortography

  4. Ureterocolonic anastomosis in clinically normal dogs

    International Nuclear Information System (INIS)

    Stone, E.A.; Walter, M.C.; Goldschmidt, M.H.; Biery, D.N.; Bovee, K.C.

    1988-01-01

    Ureterocolonic anastomosis was evaluated in 13 clinically normal dogs. Urinary continence was maintained after surgery, and the procedure was completed without technique errors in all but 2 dogs. Three dogs died within 5 weeks (2 of undetermined causes and 1 of aspiration pneumonia and neurologic disease), and 1 dog was euthanatized 4 months after surgery because of neurologic signs. Two healthy dogs were euthanatized 3 months after surgery for light microscopic evaluation of their kidneys. Five dogs were euthanatized 6 months after surgery for light microscopic evaluation of their kidneys. Gastrointestinal and neurologic disturbances developed in 4 dogs at various postoperative intervals. Plasma ammonia concentration measured in 2 dogs with neurologic signs was increased. Plasma ammonia concentration measured in 5 dogs without neurologic signs was within normal limits. All 5 dogs, in which metabolic acidosis was diagnosed, had high normal or above normal serum chloride concentration. Serum urea nitrogen values were increased after surgery because of colonic absorption of urea. Serum creatinine concentration was increased in 1 dog 6 months after surgery. Individual kidney glomerular filtration rate was reduced in 38% (3/8) of the kidneys from 4 other dogs at 6 months after surgery. Of 5 dogs euthanatized at 3 to 4 months after surgery, 4 had bilateral pyelitis, and 1 had unilateral pyelonephritis. Six months after surgery, pyelonephritis was diagnosed in 40% (4/10) of the kidneys from 5 dogs. The ureterocolonic anastomosis procedure is a salvage procedure that should allow complete cystectomy. However, variable degress of metabolic acidosis, hyperammonemia, and neurologic disease may result

  5. Novel brain model for training of deep microvascular anastomosis.

    Science.gov (United States)

    Ishikawa, Tatsuya; Yasui, Nobuyuki; Ono, Hidenori

    2010-01-01

    Models of the brain and skull were developed using a selective laser sintering method for training in the procedures of deep microvascular anastomosis. Model A has an artificial skull with two craniotomies, providing fronto-temporal-subtemporal and suboccipital windows. The brain in Model A is soft and elastic, and consists of the brainstem and a hemispheric part with a detailed surface. Rehearsals or training for anastomosis to the insular part of the middle cerebral artery, superior cerebellar artery, posterior cerebral artery, and posterior inferior cerebellar artery can be performed through the craniotomies. Model B has an artificial skull with a bifrontal craniotomy and an artificial brain consisting of the bilateral frontal lobes with an interhemispheric fissure and corpus callosum. Rehearsals or training for anastomosis of the callosal segment of the anterior cerebral artery can be practiced through this craniotomy. These realistic models will help to develop skills for deep vascular anastomosis, which remains a challenging neurosurgical procedure, even for experienced neurosurgeons.

  6. Induced chorioretinal venous anastomosis in experimental retinal branch vein occlusion.

    OpenAIRE

    McAllister, I L; Yu, D Y; Vijayasekaran, S; Barry, C; Constable, I

    1992-01-01

    Iatrogenic retinal vein to choroidal vein anastomoses were created using laser photocoagulation in six of seven dog eyes in which a partial branch retinal vein occlusion had previously been created photochemically. A similar attempt to create an anastomosis was made in six control eyes in which no branch vein occlusion was present. In the eyes in which a branch retinal vein had been created, a venous chorioretinal anastomosis appeared to be present by 3 to 6 weeks. In three control eyes simil...

  7. Magnetic compression anastomosis as a nonsurgical treatment for esophageal atresia

    Energy Technology Data Exchange (ETDEWEB)

    Zaritzky, Mario [Hospital de Ninos de La Plata, Department of Radiology, Buenos Aires (Argentina); University of Chicago Medical Center, Department of Radiology, Chicago, IL (United States); Ben, Ricardo [Hospital de Ninos de La Plata, Department of Gastroenterology, Buenos Aires (Argentina); Zylberg, Gaston I.; Yampolsky, Brian [Hospital de Ninos de La Plata, Department of Radiology, Buenos Aires (Argentina)

    2009-09-15

    We describe a unique technique to promote a nonsurgical esophageal anastomosis with magnets in children with esophageal atresia. To evaluate the efficacy of magnetic lengthening of atretic esophageal ends to produce an anastomosis and to communicate our results after more than 2 years of follow-up. Between September 2001 and March 2004, five children were selected for treatment. Two of the children had esophageal atresia without fistula (type A) and three had atresia with fistula converted to type A surgically; however, surgeons failed to achieve an anastomosis because of the width of the gap. Neodymium-iron-boron magnets were used. Daily chest radiographs were taken until union of the magnets was observed. They were then replaced with an orogastric tube. Anastomosis was achieved in all patients in an average of 4.8 days. One patient, with signs of early sepsis, was successfully treated with antibiotics. In four of the five patients, esophageal stenosis developed. At the time of this report, two patients were free of treatment and on an oral diet (after 26 months), two patients required periodic balloon dilatation, and one patient had recently undergone surgery due to recurrent esophageal stenosis not amenable to balloon dilatation. Magnetic esophageal anastomosis is a feasible method in selected patients with esophageal atresia. Esophageal anastomosis was achieved in all patients. The only observed complication of significance was esophageal stenosis. One patient needed surgery because of stenosis. (orig.)

  8. Operation technique and healing process of telescopic ileocolostomy in dogs.

    Science.gov (United States)

    Szucs, G; Tóth, I; Barna, T; Bráth, E; Gyáni, K; Mikó, Irén

    2003-01-01

    The healing process of telescopic anastomoses was found in an animal experiment with 12 mongrel dogs. After the division of vessels an ileal segment of different length was invaginated into the lumen of the colon using single-layer interrupted sutures. The following four groups were used: Group A (n = 3): end-to-side ileocolostomy, single-layer interrupted suture (invagination length: 0 mm), survival time: 21 days. Group B (n = 3): invagination length: 20 mm, survival time: 7 days. Group C (n = 3): invagination length: 10 mm, survival time: 21 days. Group D (n = 3): invagination length: 20 mm, survival time: 21 days. At the end of the above survival times the anastomosis area was removed. The bursting pressure was measured and morphological as well as histological examinations were performed. In each case the 0-day look-alikes of anastomoses were performed using the remnant bowels, and bursting pressure measurements were done on these models as well. Anastomosis leakage did not occur. The serosal layer of the intracolonic part of the ileum disappeared during the healing process. The free surface of the intracolonic ileal segment became covered by the sliding mucosa of the colon and the prolapsing mucosa of the ileum. The following could be concluded after the experiments: The inner pressure tolerance of a telescopic ileocolostomy promptly after preparation is better than in case of another single-layer anastomosis. This fact results in increased safety against leakage on the first postoperative days. The inner pressure tolerance of the telescopic ileocolostomy increases during the healing process and it does not depend on the length of the invaginated part (0 day-20 mm: 56 mmHg +/- 6, Group A: 252 +/- 39, Group B: 154 +/- 19, Group C: 249 +/- 20, Group D: 298 +/- 2). There is no difference in pressure tolerance between the telescopic and the end-to-side single-layer interrupted anastomoses after the healing process. The invaginated section within the lumen of the

  9. Optical Space Telescope Assembly

    Data.gov (United States)

    National Aeronautics and Space Administration — The Optical Space Telescope Assembly (OSTA) task is to demonstrate the technology readiness of assembling large space telescopes on orbit in 2015. This task is an...

  10. Virtual Telescope Alignment System

    Data.gov (United States)

    National Aeronautics and Space Administration — Next-generation space telescopes require two spacecraft to fly in a coordinated fashion in space forming a virtual telescope. Achieving and maintaining this precise...

  11. Murine Ileocolic Bowel Resection with Primary Anastomosis

    Science.gov (United States)

    Perry, Troy; Borowiec, Anna; Dicken, Bryan; Fedorak, Richard; Madsen, Karen

    2014-01-01

    Intestinal resections are frequently required for treatment of diseases involving the gastrointestinal tract, with Crohn’s disease and colon cancer being two common examples. Despite the frequency of these procedures, a significant knowledge gap remains in describing the inherent effects of intestinal resection on host physiology and disease pathophysiology. This article provides detailed instructions for an ileocolic resection with primary end-to-end anastomosis in mice, as well as essential aspects of peri-operative care to maximize post-operative success. When followed closely, this procedure yields a 95% long-term survival rate, no failure to thrive, and minimizes post-operative complications of bowel obstruction and anastomotic leak. The technical challenges of performing the procedure in mice are a barrier to its wide spread use in research. The skills described in this article can be acquired without previous surgical experience. Once mastered, the murine ileocolic resection procedure will provide a reproducible tool for studying the effects of intestinal resection in models of human disease. PMID:25406841

  12. [Termino-terminal hypoglossofacial anastomosis, indications, results].

    Science.gov (United States)

    Lamas, G; Lannadère, E; Tankéré, F; Truong Tan, T; Bernat, I; Gatignol, P

    2010-01-01

    Retrospective study about the indications and the results of the end to-end hypoglossofacial anastomosis (AHF tt). Between 2004 and 2010, 38 patients were able to benefit from an AHF tt. It was about 13 men and 25 women. The mean age was of 40 years and the average deadline of coverage after facial paralysis was of 21.3 months. The etiology of the paralysis was in 47.7% of the cases a surgery for vestibular schwannoma and in 18% of the cases, of the facial nerve schwannoma. Besides the AHF tt, a golden weight was put to 6 of our patients. A specific and premature speech therapy remediation was realized at our all patient's. The beginning of recovery was spread out between 3 and 9 months. The final result was a grade III HB (37%) and IV HB (60%). Only a case of grade VHB was observed. The complications often reported by the AHF tt were very widely decreased by the specific reeducation. AHF tt is a particularly reliable technique, for rehabilitation of facial palsy, when the peripheral branches are intact and it, for the deadline 4-years-old subordinate except particular cases.

  13. ATST telescope mount: telescope of machine tool

    Science.gov (United States)

    Jeffers, Paul; Stolz, Günter; Bonomi, Giovanni; Dreyer, Oliver; Kärcher, Hans

    2012-09-01

    The Advanced Technology Solar Telescope (ATST) will be the largest solar telescope in the world, and will be able to provide the sharpest views ever taken of the solar surface. The telescope has a 4m aperture primary mirror, however due to the off axis nature of the optical layout, the telescope mount has proportions similar to an 8 meter class telescope. The technology normally used in this class of telescope is well understood in the telescope community and has been successfully implemented in numerous projects. The world of large machine tools has developed in a separate realm with similar levels of performance requirement but different boundary conditions. In addition the competitive nature of private industry has encouraged development and usage of more cost effective solutions both in initial capital cost and thru-life operating cost. Telescope mounts move relatively slowly with requirements for high stability under external environmental influences such as wind buffeting. Large machine tools operate under high speed requirements coupled with high application of force through the machine but with little or no external environmental influences. The benefits of these parallel development paths and the ATST system requirements are being combined in the ATST Telescope Mount Assembly (TMA). The process of balancing the system requirements with new technologies is based on the experience of the ATST project team, Ingersoll Machine Tools who are the main contractor for the TMA and MT Mechatronics who are their design subcontractors. This paper highlights a number of these proven technologies from the commercially driven machine tool world that are being introduced to the TMA design. Also the challenges of integrating and ensuring that the differences in application requirements are accounted for in the design are discussed.

  14. Investigation of postoperative intraocular pressure in cases of silicone oil removal using 25-gauge transconjunctival sutureless vitrectomy with oblique incisions.

    Science.gov (United States)

    Takashina, Hirotsugu; Watanabe, Akira; Tsuneoka, Hiroshi

    2015-01-01

    The purpose of this study was to investigate postoperative intraocular pressure (IOP) in cases of silicone oil (SO) removal when using 25-gauge transconjunctival sutureless vitrectomy (TSV) with oblique incisions. We enrolled ten consecutive eyes with SO removal (SO group) and eleven consecutive eyes with idiopathic epiretinal membrane (ERM) as the initial vitrectomy (ERM group) in cases using 25-gauge TSV with oblique incisions. Postoperative IOPs were compared between the two groups at each of the four examination periods. No significant differences were identified in any of the periods examined. The use of 25-gauge TSV with oblique incisions resulted in almost equivalent postoperative IOPs between cases with SO removal and idiopathic ERM as the initial operation. Self-sealing sclerotomy in 25-gauge TSV with oblique incisions may primarily involve the valve architecture, and be complemented by vitreous incarceration.

  15. Effect of omentum graft on esophageal anastomosis in dogs

    Directory of Open Access Journals (Sweden)

    A. K. Mahdi

    2011-01-01

    Full Text Available The aim of this study was to evaluate the complications and final function outcome of wrapping nonvascularized omentum graft around the suture line of esophageal anastomosis. Twelve adult local breed dogs were used in this study. The animals were divided into two equal groups (control and treated, all animal induced into general anesthesia by injection of atropen sulphate in a dose 0.04 mg/kg B.W, intramuscularly then after 15 minute given mixture of ketamine hydrochloride and xylazine hydrochloride in doses 15 mg/kg and 5 mg/kg B.W intramuscularly respectively. An oblique resection of about 1cm of the esophageal length and anastomosis by double layer of simple interrupted pattern by 2.0 cat gut suture (control group, same procedure was done in treated group except the wrapping the anastomosis site with patch of omentum tissue after lapratomy operation in the left flank region procedure. The clinical signs of treated animal revealed signs of dysphagia and regurgitation in treated group while this signs disappear in the control group. Radiological and histopathological examination of the anastomosis site performed at 15 and 30 days post operation. Radiological study recorded high degree of stenosis in the anastomosis site in treated group at 15 and 30 days post operation in compared with animals in control group that record mean degree of stenosis in treated group at 15 day (57.61±0.2 and at 30 day (55.78±0.2 while it recorded in control group at 15 day (39.34±1.04 and at 30 day (36.0.6 ±0.9, histopathological results recorded enhanced healing of anastomosis site in treated animals more than control animals. In conclusion we found that non vascularized omental graft prevent leak when used around the anastomosis line in esophageal and enhanced healing of anastomosis line but it increase the stenosis, fibrosis and adhesion of anastomosis site with surrounding muscle and this interferes with the swallowing as well as dysphagia and regurgitation

  16. [Postoperative enteral feeding in digestive anastomosis with proximal oesophageal partner].

    Science.gov (United States)

    Vasile, I; Mirea, C; Vîlcea, I D; Calotă, F; Paşalega, M; Meşină, C; Cheie, M; Mogoanţă, S; Dumitrescu, T; Grecu, C; Radu, V; Moraru, E

    2010-01-01

    This paper aim is to discuss the advantages of enteral postoperative feeding on patients submitted to surgery finalized through an eso-digestive anastomosis; in these cases enteral feeding is often delayed 5-8 days after the surgery, and in case of an anastomotic dehiscence may be even impossible. Also, the paper promotes duodenostomy as an important enteral feeding way, and discusses the indications and contraindications of different enteral nutrition pathways in such cases. There were studied 230 cases, 149 cases submitted to cancer surgery and 81 cases with benign condition surgery followed by an eso-digestive anastomosis, in which the following enteral nutrition pathways was practiced: nasogastric or naso-esojejunal feeding tube (55 cases); Witzel jejunostomy (28 cases); gastrostomy (79 cases); duodenostomy (68 cases). Postoperative morbidity induced exclusively by the enteral nutrition pathway was encountered in 36% of patients. On patients with an eso-gastric cervical anastomosis or esogastric thoracic anastomosis we used jejunostomy as enteral feeding path and a gastric tube passed by pyloric canal for gastric decompression. In cases of esophageal reconstruction for benign esophageal strictures gastrostomy remains the best feeding method. Duodenostomy was practiced as a feeding pathway in cases of total gastrectomy with esojejunal anastomosis, with closure of the duodenal stump.

  17. Resection and anastomosis of the descending colon in 43 horses.

    Science.gov (United States)

    Prange, Timo; Holcombe, Susan J; Brown, Jennifer A; Dechant, Julie E; Fubini, Susan L; Embertson, Rolf M; Peroni, John; Rakestraw, Peter C; Hauptman, Joe G

    2010-08-01

    To determine (1) the short- (to hospital discharge) and long- (>6 months) term survival, (2) factors associated with short-term survival, and (3) the perioperative course for horses with resection and anastomosis of the descending colon. Multicentered case series. Horses (n=43) that had descending colon resection and anastomosis. Medical records (January 1995-June 2009) of 7 equine referral hospitals were reviewed for horses that had descending colon resection and anastomosis and were recovered from anesthesia. Retrieved data included history, results of clinical and clinicopathologic examinations, surgical findings, postsurgical treatment and complications, and short-term survival (hospital discharge). Long-term survival was defined as survival > or =6 months after hospital discharge. Of 43 horses, 36 (84%) were discharged from the hospital. Twenty-eight of 30 horses with follow-up information survived > or =6 months. No significant associations between perioperative factors and short-term survival were identified. Lesions included strangulating lipoma (n=27), postfoaling trauma (4), infarction (4), intraluminal obstruction (2), and other (6). Common postoperative complications included fever and diarrhea. During hospitalization 7 horses were euthanatized or died because of septic peritonitis (3), endotoxemia (3), and colic and ileus (1). Descending colon resection and anastomosis has a favorable prognosis for hospital discharge and survival > or =6 months. The most common cause of small colon incarceration was strangulating lipoma. Complications include postoperative fever and diarrhea but the prognosis is good after small colon resection and anastomosis.

  18. Granulocyte migration in uncomplicated intestinal anastomosis in man

    Energy Technology Data Exchange (ETDEWEB)

    Keshavarzian, A.; Gibson, R.; Guest, J.; Spencer, J.; Lavender, J.P.; Hodgson, H.J.

    1986-03-01

    We have investigated the presence, duration, and clinical significance of granulocyte accumulation, using indium-111 granulocyte scanning, in patients following uncomplicated intestinal anastomosis. Eight patients underwent intestinal resection and anastomosis (right hemicolectomy, 5; sigmoid colectomy, 2; ileal resection, 1) for carcinoma, angiodysplasia, or perforation. All patients had an uneventful postoperative course, with no evidence of any leakage or infection. Indium-111 granulocyte scan and abdominal ultrasound were performed 7-20 days (12 +/- 4.7 means +/- SD) following surgery. Indium-111 granulocyte scan showed the presence of labeled granulocytes at the site of anastomosis in all patients. In three of eight, cells subsequently passed into the lumen of the bowel. In contrast, granulocytes were not visualized along the abdominal incision. Thus, in contrast to skin wounds, granulocytes continue migrating into the intestinal wall in areas of anastomosis for at least up to 20 days following surgical trauma. They may play a significant role both in healing the anastomosis and in preventing systemic bacterial infection. Moreover, indium-111 granulocyte scans following intestinal surgery should be interpreted with care, and the presence of labeled granulocytes around anastomoses does not necessarily indicate abscess formation.

  19. Granulocyte migration in uncomplicated intestinal anastomosis in man

    International Nuclear Information System (INIS)

    Keshavarzian, A.; Gibson, R.; Guest, J.; Spencer, J.; Lavender, J.P.; Hodgson, H.J.

    1986-01-01

    We have investigated the presence, duration, and clinical significance of granulocyte accumulation, using indium-111 granulocyte scanning, in patients following uncomplicated intestinal anastomosis. Eight patients underwent intestinal resection and anastomosis (right hemicolectomy, 5; sigmoid colectomy, 2; ileal resection, 1) for carcinoma, angiodysplasia, or perforation. All patients had an uneventful postoperative course, with no evidence of any leakage or infection. Indium-111 granulocyte scan and abdominal ultrasound were performed 7-20 days (12 +/- 4.7 means +/- SD) following surgery. Indium-111 granulocyte scan showed the presence of labeled granulocytes at the site of anastomosis in all patients. In three of eight, cells subsequently passed into the lumen of the bowel. In contrast, granulocytes were not visualized along the abdominal incision. Thus, in contrast to skin wounds, granulocytes continue migrating into the intestinal wall in areas of anastomosis for at least up to 20 days following surgical trauma. They may play a significant role both in healing the anastomosis and in preventing systemic bacterial infection. Moreover, indium-111 granulocyte scans following intestinal surgery should be interpreted with care, and the presence of labeled granulocytes around anastomoses does not necessarily indicate abscess formation

  20. Laparoscopic anterior resection: new anastomosis technique in a pig model.

    Science.gov (United States)

    Bedirli, Abdulkadir; Yucel, Deniz; Ekim, Burcu

    2014-01-01

    Bowel anastomosis after anterior resection is one of the most difficult tasks to perform during laparoscopic colorectal surgery. This study aims to evaluate a new feasible and safe intracorporeal anastomosis technique after laparoscopic left-sided colon or rectum resection in a pig model. The technique was evaluated in 5 pigs. The OrVil device (Covidien, Mansfield, Massachusetts) was inserted into the anus and advanced proximally to the rectum. A 0.5-cm incision was made in the sigmoid colon, and the 2 sutures attached to its delivery tube were cut. After the delivery tube was evacuated through the anus, the tip of the anvil was removed through the perforation. The sigmoid colon was transected just distal to the perforation with an endoscopic linear stapler. The rectosigmoid segment to be resected was removed through the anus with a grasper, and distal transection was performed. A 25-mm circular stapler was inserted and combined with the anvil, and end-to-side intracorporeal anastomosis was then performed. We performed the technique in 5 pigs. Anastomosis required an average of 12 minutes. We observed that the proximal and distal donuts were completely removed in all pigs. No anastomotic air leakage was observed in any of the animals. This study shows the efficacy and safety of intracorporeal anastomosis with the OrVil device after laparoscopic anterior resection.

  1. [Hypoglossofacial anastomosis for facial palsy treatment: Indications and results].

    Science.gov (United States)

    Lamas, G; Gatignol, P; Barbut, J; Bernat, I; Tankéré, F

    2015-10-01

    Hypoglossofacial anastomosis is a classical surgical procedure for the treatment of facial paralysis when the trunk of the facial nerve cannot be repaired and its peripheral branches are normal. Between 2004 and 2015, 77 patients were able to benefit from an hypoglossofacial anastomosis. The etiology of the paralysis was mainly the surgery of vestibular schwannoma, tumors of the facial nerve and diseases of the brainstem. A specific and premature speech therapy remediation was realized for all patients in order to preserve the tongue function and to upgrade the facial motricity. Sixty-nine patients could be studied. The House Brackmann grading scale was used to appreciate the result. Thirty-one patients are grade III, 34 grade IV and in only one case the result is a grade V despite the anastomosis works. The main predictive factor for a good result is a small delay between the onset of the paralysis and the surgery for the rehabilitation. The specific physiotherapy upgrades the result with less side effects of the anastomosis. Hypoglossofacial anastomosis is a simple and reliable surgical procedure for rehabilitation of paralysed face. The quality of the result is linked with an early surgery and a specific physiotherapy. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Microvascular Anastomosis Training in Neurosurgery: A Review

    Directory of Open Access Journals (Sweden)

    Vadim A. Byvaltsev

    2018-01-01

    Full Text Available Cerebrovascular diseases are among the most widespread diseases in the world, which largely determine the structure of morbidity and mortality rates. Microvascular anastomosis techniques are important for revascularization surgeries on brachiocephalic and carotid arteries and complex cerebral aneurysms and even during resection of brain tumors that obstruct major cerebral arteries. Training in microvascular surgery became even more difficult with less case exposure and growth of the use of endovascular techniques. In this text we will briefly discuss the history of microvascular surgery, review current literature on simulation models with the emphasis on their merits and shortcomings, and describe the views and opinions on the future of the microvascular training in neurosurgery. In “dry” microsurgical training, various models created from artificial materials that simulate biological tissues are used. The next stage in training more experienced surgeons is to work with nonliving tissue models. Microvascular training using live models is considered to be the most relevant due to presence of the blood flow. Training on laboratory animals has high indicators of face and constructive validity. One of the future directions in the development of microsurgical techniques is the use of robotic systems. Robotic systems may play a role in teaching future generations of microsurgeons. Modern technologies allow access to highly accurate learning environments that are extremely similar to real environment. Additionally, assessment of microsurgical skills should become a fundamental part of the current evaluation of competence within a microneurosurgical training program. Such an assessment tool could be utilized to ensure a constant level of surgical competence within the recertification process. It is important that this evaluation be based on validated models.

  3. Fingertip replantations: importance of venous anastomosis and the clinical results.

    Science.gov (United States)

    Hasuo, Takaaki; Nishi, Genzaburo; Tsuchiya, Daiji; Otsuka, Takanobu

    2009-01-01

    Overall survival rate for 143 digits with complete amputation of the distal phalanx was 78%. Replanted digits that underwent venous anastomosis showed a very high survival rate of 93%. Loss of the distal interphalangeal joint function in subzone IV was significantly inferior to that in subzones II and III. Protective sensation was achieved in 96% of replanted digits. Sensory recovery in the absence of nerve repair was significantly worse for avulsion injury than for crush injury. Nail deformity tended to be increased for replanted digits in subzone III or with crush-type injury. Successful venous anastomosis appears to offer the best way to promote survival of replanted digits. If venous anastomosis is infeasible, a replanted digit can survive with any methods for venous drainage in subzones II and III, but does not survive in subzone IV. To minimise nail deformity, repair of the germinal matrix is necessary.

  4. Tracheal growth after resection and anastomosis in puppies.

    Science.gov (United States)

    Blanchard, H; Brochu, P; Bensoussan, A L; Lagacé, G; Khan, A H

    1986-09-01

    Tracheal morphology, morphometric changes, and growth and histologic changes were studied in puppies submitted to tracheal resection and anastomosis. Fifteen mongrel puppies about 12 weeks old and weighing on an average 5.5 kg were operated under general anesthesia using fluothane. A median cervicotomy incision was made in ten puppies (experimental group, EG) and the proximal 14 tracheal rings were resected (average length 5.08 cm or about 35% to 38% of total tracheal length). One layer anastomosis was done using vicryl 4.0 maintaining the average tension of 1,450 g. Five puppies (control group, CG) were submitted to tracheal transection and anastomosis and the following parameters were studied. Tracheal morphology the trachea of the EG was a rounded triangle whereas in the CG it was oval in shape, there was increase in the intercartilageneous spaces in the EG, no granulation tissue was present, two mucous webs were seen in the EG and one in the CG. Morphometric changes average tracheal length EG 13 cm, CG 17.7 cm, intercartilagenous space EG 3.08 mm, CG 1.3 mm, intercricothyroid space EG 1.2 cm, CG 0.53 cm, sagittal and transverse tracheal thickness at the anastomosis EG 2.6 and 3.3 mm, CG 2 and 1.5 mm, sagittal and transverse diameter reduced on an average 2 mm in EG. Histology Moderate fibrosis was found at the level of anastomosis with no modification of chondrocytes at the cartilagenous rings in the EG. Even with high anastomotic tension, the dogs had normal tracheal growth without stenosis; the sagittal and transverse growth at the anastomosis in the EG was 90% and 85%, respectively, when compared with the CG.

  5. [Prevention of the anastomosis dehiscence following low anterior rectal resections].

    Science.gov (United States)

    Hut'an, M; Lukác, I; Poticný, V

    2005-10-01

    Authors analyse 106 patients that were operated in their department by Dixon's method, in retrospective study. They analyse indications for operations, lesions distance in rectum, endosonographic and CT findings. Basic principles of the operation technique are adequate blood flow, sufficient colon mobilization and tightness of the anastomosis being supplemented with transanal pertubation. Out of early complications anastomosis dehiscence appeared in 6 patients (e.g. 5.6%) out of which 4 were treated conservatively and 2 were being reoperated on (by axial ileostomia and drainage). In discussion different opinions on preoperative preparation, neoadjuvant therapy, presacral drainage, transanal pertubation and other decompressive techniques are anticipated.

  6. The great Melbourne telescope

    CERN Document Server

    Gillespie, Richard

    2011-01-01

    Erected at Melbourne Observatory in 1869, the telescope was the second largest in the world, designed to explore the nature of the nebulae in the southern skies. Richard Gillespie, head of the History and Technology department at the Melbourne museum has written an entertaining account of the telescope's extraordinary history and tells the story through an amazing cast of characters whose lives intersected with the telescope.

  7. Use of a circular stapler for Billroth I anastomosis after distal ...

    African Journals Online (AJOL)

    2013-11-04

    Nov 4, 2013 ... linear staplers. Takeuchi et al.[3] then reported the first gastroduodenal anastomosis using one circular and one linear stapler. This technique has also been effectively used for Billroth II anastomosis.[4] We established gastroduodenal anastomosis using the circular stapler before resection of the stomach ...

  8. Diabetes resolution after one anastomosis gastric bypass.

    Science.gov (United States)

    Abu-Abeid, Adam; Lessing, Yonatan; Pencovich, Niv; Dayan, Danit; Klausner, Joseph M; Abu-Abeid, Subhi

    2018-02-01

    Diabetes and other obesity-related diseases are a worldwide pandemic that transcends geographic borders as well as socioeconomic levels. Currently, it is well known that medical treatment alone is insufficient to ensure adequate and sustainable weight loss and co-morbidity resolution. It has been well proven that bariatric surgery can produce almost immediate resolution of diabetes and other co-morbidities as well as long-term weight loss. Here, we present our experience with the one anastomosis gastric bypass (OAGB) in terms of weight loss and diabetes resolution with 1 year of follow-up. Large, metropolitan, tertiary, university hospital. A retrospective analysis of all patients who underwent OAGB between March 2015 and March 2016 was performed. Patient demographic characteristics, co-morbidities, operative and postoperative data, as well as first year outcomes were collected and analyzed. There were 407 patients who underwent OAGB (254 females, average age 41.8 ± 12.05 yr, body mass index = 41.7 ± 5.77 kg/m 2 ). Of patients, 102 (25.1%) had diabetes with average glycosylated hemoglobin of 8.64 ± 1.94 g%, 93 (22.8%) had hypertension, 123 (28.8%) had hyperlipidemia, and 35 patients (8.6%) had obstructive sleep apnea. The average length of hospital stay was 2.2 ± .84 days (range, 2-10 d). The average excess weight loss 1 year after surgery was 88.9 ± 27.3. After 1 year, follow-up data were available for more than 85% of the study's general population. Of 102 diabetic patients, only 8 (7.8%) were still considered diabetic and taking antidiabetic medication, with an average glycosylated hemoglobin of 5.4 ± 0.6. OAGB may be performed safely and with promising efficacy as both a primary and a revisional bariatric surgery, and it offers excellent resolution of diabetes. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  9. Goddard Robotic Telescope

    International Nuclear Information System (INIS)

    Sakamoto, Takanori; Donato, Davide; Gehrels, Neil; Okajima, Takashi; Ukwatta, Tilan N.

    2009-01-01

    We are constructing the 14'' fully automated optical robotic telescope, Goddard Robotic Telescope (GRT), at the Goddard Geophysical and Astronomical Observatory. The aims of our robotic telescope are 1) to follow-up the Swift/Fermi Gamma-Ray Bursts (GRBs) and 2) to perform the coordinated optical observations of the Fermi/Large Area Telescope (LAT) Active Galactic Nuclei (AGN). Our telescope system consists of the 14'' Celestron Optical Telescope Assembly (OTA), the Astro-Physics 1200GTO mount, the Apogee U47 CCD camera, the JMI's electronic focuser, and the Finger Lake Instrumentation's color filter wheel with U, B, V, R and I filters. With the focal reducer, 20'x20' field of view has been achieved. The observatory dome is the Astro Haven's 7 ft clam-shell dome. We started the scientific observations on mid-November 2008. While not observing our primary targets (GRBs and AGNs), we are planning to open our telescope time to the public for having a wider use of our telescope in both a different research field and an educational purpose.

  10. Athermal laser launch telescopes

    NARCIS (Netherlands)

    Kamphues, F.G.; Henselmans, R.; Rijnveld, N.; Lemmen, M.H.J.; Doelman, N.J.; Nijkerk, M.D.

    2011-01-01

    ESO has developed a concept for a compact laser guide star unit for use in future Adaptive Optics (AO) systems. A small powerful laser is combined with a telescope that launches the beam, creating a single modular unit that can be mounted directly on a large telescope. This approach solves several

  11. Anastomosis Procedure through an Inguinal Hernia Incision in ...

    African Journals Online (AJOL)

    The bowel resection was performed extracorporeally, and an anvil was placed at the proximal end of the colon over a purse-string suture. After colorectal anastomosis was performed using a circular stapler inserted through the anus, the inguinal hernia was repaired with a mesh. The inguinal wound healed without surgical ...

  12. Hepaticoduodenostomy as a technique for biliary anastomosis in ...

    African Journals Online (AJOL)

    Hepaticoduodenostomy as a technique for biliary anastomosis in children with choledochal cyst: ... anastomotic technique in cases of choledochal cyst in children. Ann Pediatr Surg 13:78–80 c 2017 .... versus hepaticojejunostomy after resection of choledochal cyst: a systematic review and meta-analysis. J Pediatr Surg ...

  13. Surgery for necrotising enterocolitis : primary anastomosis or enterostomy?

    NARCIS (Netherlands)

    Hofman, FN; Bax, NMA; van der Zee, DC

    The ideal surgical management of neonates with necrotising enterocolitis (NEC) is still a matter of debate. The purpose of this study was to compare the results of bowel resection with primary anastomosis with the results of bowel resection with enterostomy. Sixty-three neonates with NEC had a bowel

  14. Comparison between strictureplasty and resection anastomosis in tuberculous intestinal strictures

    International Nuclear Information System (INIS)

    Zafar, A.; Qureshi, A.M.; Iqbal, M.

    2003-01-01

    Objective: To compare the effectiveness, safety and morbidity of strictureplasty with resection anastomosis in patients with tuberculous small gut strictures. Subjects and Methods: Thirty patients who presented with intestinal obstruction due to tuberculous strictures, and underwent either resection anastomosis or strictureplasty where included in the study. Data was collected on a proforma and analyzed using software SPSS (version 8.0). Chi-square and t-test were used to test the hypothesis. Main outcome measures included the presence or absence of postoperative leakage anastomosis, wound infection, recurrence of intestinal obstruction and postoperative study. Results: Chi-square test applied to see the effectiveness showed no significant difference (p>0.5) between the two procedures. t-Test on the score of morbidity also showed no significant difference (p>0.5) between the two procedures. Conclusion: Both procedures performed were equally effective and had equal morbidity in cases of intestinal tuberculous strictures. Strictureplasty is superior to resection anastomosis in cases of multiple strictures as it conserves gut length and can even be performed safely in cases with coexistent gut perforation. (author)

  15. Effect of Erythropoietin on Microvascular Anastomosis in Rat ...

    African Journals Online (AJOL)

    Purpose: To investigate the re-endothelialization potential of erythropoietin (EPO) following microvascular anastomosis in rat femoral artery. Methods: Ninety-six male Sprague-Dawley rats weighing between 300 g and 320 g were allocated randomly into two groups (control and EPO, n = 48). Left femoral artery ...

  16. OCT-aided anastomosis platform study in the rodent model

    Science.gov (United States)

    Huang, Yong; Tong, Dedi; Zhu, Shan; Wu, Lehao; Ibrahim, Zuhaib; Lee, WP Andrew; Brandacher, Gerald; Kang, Jin U.

    2014-02-01

    Anastomosis is one of the most commonly performed procedure in the clinical environment that involves tubular structures, such as blood vessel, lymphatic vessel, seminal duct and ureter. Suture based anastomosis is still the foundation for most basic surgical training and clinical operation, although alternate techniques have been developed and under development. For those tubular-structure-anastomosis, immediate real-time post-operative evaluation of the surgical outcome is critical to the success of surgery. Previously evaluation is mostly based on surgeons' experience. Fourier-domain optical coherence tomography is high-speed, high-resolution noninvasive 3D imaging modality that has been widely used in the biomedical research and clinical study. In this study we used Fourier-domain optical coherence tomography as an evaluation tool for anastomosis of lymphatic vessels, ureter and seminal duct in rodent model. Immediate post-operative and long term surgical site data were collected and analyzed. Critical clinical parameters such as lumen patency, anastomosed site narrowing and suture error detection are provided to surgeons.

  17. Radiological Recanalization of an Occluded Anterior Resection Anastomosis

    International Nuclear Information System (INIS)

    Rahman, A.; Cowley, J.B.; Hartley, J.E.; Cast, J.E.I.

    2006-01-01

    We present a case of occluded colorectal anastomosis following surgery for rectal tumor. Contrast enema and antegrade ileography confirmed occlusion by a thin membrane. This was thought amenable to needle puncture and placement of a temporary stent under fluoroscopy guidance, avoiding surgery and its associated morbidity. This provides a minimally invasive alternative to surgery and has only been reported once before

  18. Effect of Erythropoietin on Microvascular Anastomosis in Rat

    African Journals Online (AJOL)

    Purpose: To investigate the re-endothelialization potential of erythropoietin (EPO) following microvascular anastomosis in rat femoral artery. Methods: Ninety-six male Sprague-Dawley rats weighing between 300 g and 320 g were allocated randomly into two groups (control and EPO, n = 48). Left femoral artery ...

  19. Observing the Sun with Coronado telescopes telescopes

    CERN Document Server

    Pugh, Philip

    2007-01-01

    The Sun provides amateur astronomers with one of the few opportunities for daytime astronomy. In order to see the major features of our nearest star, special telescopes that have a very narrow visible bandwidth are essential. The bandwidth has to be as narrow as 1 A- 10-10 m (1 Angstrom) and centred on the absorption line of neutral hydrogen. This makes many major features of the Suna (TM)s chromosphere visible to the observer. Such narrow-band "Fabry-Perot etalon filters" are high technology, and until the introduction of the Coronado range of solar telescopes, were too expensive for amateur use. The entry-level Coronado telescope, the PST (Personal Solar Telescope) costs under 500. Solar prominences (vast columns of plasma, best seen at the edge of the solar disk), filaments, flares, sunspots, plage and active regions are all visible and can be imaged to produce spectacular solar photographs. Philip Pugh has assembled a team of contributors who show just how much solar work can be done with Coronado telesco...

  20. Large Binocular Telescope Project

    Science.gov (United States)

    Hill, John M.; Salinari, Piero

    1998-08-01

    The Large Binocular Telescope (LBT) Project is a collaboration between institutions in Arizona, Germany, Italy, and Ohio. With the addition of the partners from Ohio State and Germany in February 1997, the Large Binocular Telescope Corporation has the funding required to build the full telescope populated with both 8.4 meter optical trans. The first of two 8.4 meter borosilicate honeycomb primary mirrors for LBT was cast at the Steward Observatory Mirror Lab in 1997. The baseline optical configuration of LBT includes adaptive infrared secondaries of a Gregorian design. The F/15 secondaries are undersized to provide a low thermal background focal plane. The interferometric focus combining the light from the two 8.4 meter primaries will reimage the two folded Gregorian focal planes to three central locations. The telescope elevation structure accommodates swing arms which allow rapid interchange of the various secondary and tertiary mirrors. Maximum stiffness and minimal thermal disturbance were important drivers for the design of the telescope in order to provide the best possible images for interferometric observations. The telescope structure accommodates installation of a vacuum bell jar for aluminizing the primary mirrors in-situ on the telescope. The detailed design of the telescope structure was completed in 1997 by ADS Italia (Lecco) and European Industrial Engineering (Mestre). A series of contracts for the fabrication and machining of the telescope structure had been placed at the end of 1997. The final enclosure design was completed at M3 Engineering & Technology (Tucson), EIE and ADS Italia. During 1997, the telescope pier and the concrete ring wall for the rotating enclosure were completed along with the steel structure of the fixed portion of the enclosure. The erection of the steel structure for the rotating portion of the enclosure will begin in the Spring of 1998.

  1. MARTIN–GRUBER ANASTOMOSIS AND ITS CLINICAL IMPORTANCE

    Directory of Open Access Journals (Sweden)

    I. G. Mikhaylyuk

    2015-01-01

    Full Text Available The communication between the median and ulnar nerves on the forearm, known as the Martin–Gruber anastomosis, is widespread in the general population. Despite the fact that this connection is described by anatomists in XVIII century, its importance has only recently been appreciated because of the widespread of the electrophysiological techniques in clinical practies. However, in the Russian literature aspects of its practical value described so far is not enough. This article deals with the prevalence of the anastomosis, its anatomical and electrophysiological classification, options innervation of muscles of the hand, is carried out through him, described electrophysiological methods and criteria for its diagnosis, including the collision technique, in healthy subjects and patients with lesions of the median and ulnar nerves, given its practical value. Such a course of nerve fibers through this anastomosis can have a significant impact on the clinical manifestations in patients with lesions of the median and ulnar nerves, as well as the results of an electrophysiological study. Martin–Gruber anastomosis provides variability innervation muscles of the hand, which can make it difficult topic diagnostic damage to the median and ulnar nerves, in addition, because of the connection between the nerves of the clinical presentation may not reflect the extent of their defeat: the hand muscles function can be preserved with full nerve damage or, conversely, significantly disrupted with minimal nerve lesions. Moreover, different electrophysiological findings on patients with pathology of the median or ulnar nerves in the conditions of functioning anastomosis may also complicate the interpretation of the clinical data. Thus, knowledge of the anatomy and physiology of the Martin–Gruber communication as necessary for the electrophysiologist for correct interpretation of the finding and the clinician to accurately diagnose the pathology of the median

  2. Rehabilitation of central facial paralysis with hypoglossal-facial anastomosis.

    Science.gov (United States)

    Corrales, C Eduardo; Gurgel, Richard K; Jackler, Robert K

    2012-10-01

    To evaluate the ability of hypoglossal-facial nerve anastomosis to reanimate the face in patients with complete nuclear (central) facial nerve palsy. Retrospective case series. Tertiary academic medical center. Four patients with complete facial nerve paralysis due to lesions of the facial nucleus in the pons caused by hemorrhage due to arteriovenous or cavernous venous malformations, stroke, or injury after tumor resection. All patients underwent end-to-end hypoglossal-facial nerve anastomosis. Facial nerve function using the House-Brackmann (HB) scale and physical and social/well-being function using the facial disability index. The mean age of the patients was 53.3 years (range, 32-73). There were 3 female and 1 male patients. All patients had preoperative facial function HB VI/VI. With a minimum of 12 months' follow-up after end-to-end hypoglossal-facial anastomosis, 75% of patients regained function to HB grade III/VI, and 25% had HB grade IV/VI. Average facial disability index scores were 61.25 for physical function and 78 for social/well-being, comparable to results from complete hypoglossal-facial anastomosis after peripheral facial nerve palsy after acoustic neuroma resection. Patients with nuclear facial paralysis who undergo end-to-end hypoglossal-facial nerve anastomosis achieve similar degrees of reanimation compared with those with peripheral facial nerve palsies. This raises the intriguing possibility that reinnervation may also be of benefit in patients with the vastly more common facial dysfunction because of cortical stroke or injury.

  3. The AMANDA neutrino telescope

    Energy Technology Data Exchange (ETDEWEB)

    Andres, E.C.; Askebjer, P.; Barwick, S.W.; Bay, R.C.; Bergstroem, L.; Biron, A.; Booth, J.; Botner, O.; Bouchta, A.; Carius, S.; Carlson, M.; Chinowsky, W.; Chirkin, D.; Conrad, J.; Costa, C.G.S.; Cowen, D.; Dalberg, E.; DeYoung, T.; Edsjoe, J.; Ekstroem, P.; Goobar, A.; Gray, L.; Hallgren, A.; Halzen, F.; Hardtke, R.; Hart, S.; He, Y.; Heros, C.P. de los; Hill, G.; Hulth, P.O.; Hundertmark, S.; Jacobsen, J.; Jones, A.; Kandhadai, V.; Karle, A.; Kim, J.; Leich, H.; Leuthold, M.; Lindahl, P.; Liubarsky, I.; Loaiza, P.; Lowder, D.; Marciniewski, P.; Miller, T.C.; Miocinovic, P.; Mock, P.C.; Morse, R.; Newcomer, M.; Niessen, P.; Nygren, D.; Porrata, R.; Potter, D.; Price, P.B.; Przybylski, G.; Rhode, W.; Richter, S.; Rodriquez, J.; Romenesko, P.; Ross, D.; Rubinstein, H.; Schmidt, T.; Schneider, E.; Schwartz, R.; Schwendicke, U.; Smoot, G.; Solarz, M.; Sorin, V.; Spiering, C.; Steffen, P.; Stokstad, R.; Streicher, O.; Taboada, I.; Thon, T.; Tilav, S.; Walck, C.; Wiebusch, C.H.; Wischnewski, R.; Woschnagg, K.; Wu, W.; Yodh, G.; Young, S

    1999-05-01

    With an effective telescope area of order 10{sup 4} m{sup 2} for TeV neutrinos, a threshold near {approx}50 GeV and a pointing accuracy of 2.5 degrees per muon track, the AMANDA detector represents the first of a new generation of high energy neutrino telescopes, reaching a scale envisaged over 25 years ago. We describe early results on the calibration of natural deep ice as a particle detector as well as on AMANDA's performance as a neutrino telescope.

  4. The AMANDA neutrino telescope

    Energy Technology Data Exchange (ETDEWEB)

    Andres, E.C.; Askebjer, P.; Barwick, S.W.; Bay, R.C.; Bergstrom,L.; Biron, A.; Booth, J.; Botner, O.; Bouchta, A.; Carius, S.; Carlson,M.; Chinowsky, W.; Chirkin, D.; Conrad,J.; Costa, C.G.S.; Cowen, D.; Dalberg, E.; DeYoung, T.; Edsjo, J.; Ekstrom, P.; Goobar, A.; Gray, L.; Hallgren, A.; Halzen, F.; Hardtke, R.; Hart, S.; He, Y.; de, los, Heros,C.P.; Hill, G.; Hulth, PO.; Hundertmark, S.; Jacobsen, J.; Jones, A.; Kandhadai, V.; Karle, A.; Kim, J.; Leich, H.; Leuthold, M.; Lindahl, P.; Liubarsky, I.; Loaiza, P.; Lowder, D.; Marciniewski, P.; Miller, T.C.; Miocinovic, P.; Mock, P.C.; Morse, R.; Newcomer, M.; Niessen, P.; Nygren,D.; Porrata, R.; Potter, D.; Price, P.B.; Przybylski, G.; Rhode, W.; Richter, S.; Rodriguez, J.; Romenesko, P.; Ross, D.; Rubinstein, H.; Schmidt, T.; Schneider, E.; Schwarz, R.; Schwendicke, U.; Smoot, G.; Solarz, M.; Sorin, V.; Spiering, C.; Steffen, P.; Stokstad, R.; Streicher, O.; Taboada, I.; Thon, T.; Tilav, S.; Walck, C.; Wiebusch,C.H.; Wischnewski, R.; Woschnagg, K.; Wu, W.; Yodh, G.; Young, S.; AMANDACollaboration

    1999-04-01

    With an effective telescope area of order 10(4) m(2) for TeVneutrinos, a threshold near similar to 50 GeV and a pointing accuracy of2.5 degrees per muon track, the AMANDA detector represents the first of anew generation of high energy neutrino telescopes, reaching a scaleenvisaged over 25 years ago. We describe early results on the calibrationof natural deep ice as a particle detector as well as on AMANDA'sperformance as a neutrino telescope.

  5. James Clerk Maxwell Telescope

    Science.gov (United States)

    The James Clerk Maxwell Telescope (JCMT) is a 15 m diameter telescope of high surface accuracy, operating in the millimeter and submillimeter bands, and is situated on Mauna Kea in Hawaii. The JCMT facility is described and a scientific report which includes a variety of scientific results over the years 1989 and 1990 showing the range of astronomical problems tackled with the telescope is presented. Operations, which note the decrease in both the time lost to faults and the time required for engineering and commissioning work, are described. Objectives and progress of the instrumentation program are described. A financial statement is presented.

  6. Comparison of postoperative intraocular pressure changes between 23-gauge transconjunctival sutureless vitrectomy and conventional 20-gauge vitrectomy

    Science.gov (United States)

    Ahn, S J; Woo, S J; Ahn, J; Park, K H

    2012-01-01

    Purpose To compare the intraocular pressure (IOP) after 23-gauge transconjunctival sutureless vitrectomy (TSV) and conventional 20-gauge vitrectomy for various vitreoretinal diseases. Methods This was a retrospective interventional case series including 338 cases of 23-gauge TSV and 476 cases of 20-gauge vitrectomy with minimum follow-up period of 1 month. Postoperative 1 day, 1 week and 1 month IOPs were compared. Multiple regression analysis to assess the actual effect of gauge of vitrectomy on postoperative IOP was performed including intraoperative and postoperative factors influencing postoperative IOP as covariates. Results The mean IOP of 20-gauge vitrectomy was significantly higher than that of 23-gauge TSV (20.6±8.02 mm Hg vs12.8±4.48 mm Hg, Pgauge TSV demonstrated more stable course than that of 20-gauge vitrectomy. At 1 day post vitrectomy, the incidence of hypertony was higher in 20-gauge, whereas that of hypotony was higher in 23-gauge. Among risk factors, the 20-gauge vitrectomy showed the strongest association with postoperative 1 day IOP rise. Conclusion Twenty-three-gauge TSV has stable and lower IOP in the early postoperative period than the 20-gauge vitrectomy. In patients whose retina and optic nerves are vulnerable to higher or fluctuating IOP, 23-gauge TSV may be more beneficial. PMID:22388595

  7. Influence of sutureless 23-gauge sclerotomy architecture on postoperative intraocular pressure decrease: results of a multivariate analysis.

    Science.gov (United States)

    Tahiri Joutei Hassani, Rachid; El Sanharawi, Mohamed; Adam, Raphael; Monin, Claire; Dupont-Monod, Sylvère; Baudouin, Christophe

    2013-05-01

    To evaluate the factors affecting the postoperative intraocular pressure (IOP) decrease in 23-gauge (23-G) sutureless vitrectomy, including incision architecture evaluated by anterior segment spectral-domain optical coherence tomography (SD-OCT). A prospective cohort study of 43 patients who underwent primary transconjunctival 23-G pars plana vitrectomy. All sclerotomy wounds were imaged 1 day after surgery using the anterior segment module of SD-OCT (OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany). 23-G sclerotomy architecture, preoperative and postoperative medical data were also prospectively collected. Multivariate logistic regression analysis, with backward elimination, found that surgery duration (adjusted OR = 9.17, p = 0.020) and loss of wound apposition (adjusted OR = 15.12, p = 0.022) were risk factors for significant postoperative IOP decrease (≥3 mmHg) 1 day after surgery; while age, gender, myopia, and gas tamponade were not risk or protective factors for postoperative IOP decrease. In 23-G pars plana vitrectomy, the early postoperative decrease in IOP is mainly influenced by surgery duration and the self-sealing nature of the sclerotomy. The IOP decrease was not influenced by the presence or the absence of gas tamponade.

  8. Comparison of postoperative intraocular pressure changes between 23-gauge transconjunctival sutureless vitrectomy and conventional 20-gauge vitrectomy.

    Science.gov (United States)

    Ahn, S J; Woo, S J; Ahn, J; Park, K H

    2012-06-01

    To compare the intraocular pressure (IOP) after 23-gauge transconjunctival sutureless vitrectomy (TSV) and conventional 20-gauge vitrectomy for various vitreoretinal diseases. This was a retrospective interventional case series including 338 cases of 23-gauge TSV and 476 cases of 20-gauge vitrectomy with minimum follow-up period of 1 month. Postoperative 1 day, 1 week and 1 month IOPs were compared. Multiple regression analysis to assess the actual effect of gauge of vitrectomy on postoperative IOP was performed including intraoperative and postoperative factors influencing postoperative IOP as covariates. The mean IOP of 20-gauge vitrectomy was significantly higher than that of 23-gauge TSV (20.6 ± 8.02 mm Hg vs 12.8 ± 4.48 mm Hg, Pgauge TSV demonstrated more stable course than that of 20-gauge vitrectomy. At 1 day post vitrectomy, the incidence of hypertony was higher in 20-gauge, whereas that of hypotony was higher in 23-gauge. Among risk factors, the 20-gauge vitrectomy showed the strongest association with postoperative 1 day IOP rise. Twenty-three-gauge TSV has stable and lower IOP in the early postoperative period than the 20-gauge vitrectomy. In patients whose retina and optic nerves are vulnerable to higher or fluctuating IOP, 23-gauge TSV may be more beneficial.

  9. New catadioptric telescope

    Science.gov (United States)

    Richter, J. L.

    1981-01-01

    The Acme telescope is a compound telescope that resembles the familiar Cassegrain type except that the main mirror is spherical and the secondary is an achromatic doublet mangin mirror. Three 6-in. aperture f/15 telescope designs are described. With a cemented, all spherical surface achromangin mirror, there is a small amount of coma which can be eliminated by redesigning with an air space between the crown and flint elements of the achromangin mirror, or by cementing them with one of the concave external surfaces of achromangin figured to an hyperboloid. In the examples, the spherical aberration is nil and the chromatic residual is roughly half that of an achromatic objective of the same speed, aperture, and glass types. Readily available crown and flint glasses such as Schott BK-7 and F-2 are entirely satisfactory for the achromangin mirror. Also considered are two examples of Acme-like telescopes with paraboloidal instead of spherical main mirrors.

  10. Goddard Robotic Telescope (GRT)

    Data.gov (United States)

    National Aeronautics and Space Administration — Since it is not possible to predict when a Gamma-Ray Burst (GRB) occurs, the follow-up ground telescopes must be distributed as uniform as possible all over the...

  11. Telescopes in History

    Science.gov (United States)

    Bond, P.; Murdin, P.

    2000-11-01

    The precise origins of the optical telescope are hidden in the depths of time. In the thirteenth century Roger Bacon claimed to have devised a combination of lenses which enabled him to see distant objects as if they were near. Others who have an unsubstantiated claim to have invented the telescope in the sixteenth century include an Englishman, Leonard DIGGES, and an Italian, Giovanni Batista Po...

  12. Eclipse telescope design factors

    Science.gov (United States)

    Hull, Tony; Trauger, John T.; Macenka, Steven A.; Moody, Dwight; Olarte, Guillermo; Sepulveda, Cesar; Tsuha, Walter; Cohen, David

    2003-02-01

    Very high contrast imagery, required for exoplanet image acquisition, imposes significantly different criteria upon telescope architecture than do the requirements imposed upon most spaceborne telescopes. For the Eclipse Mission, the fundamental figure-of-merit is a stellar contrast, or brightness reduction ratio, reaching a factor of 10-9 or better at star-planet distances as close as the 4th Airy ring. Factors necessary to achieve such contrast ratios are both irrelevant and largely ignored in contemporary telescope design. Although contemporary telescoeps now meet Hubble Space Telescope performance at substantially lower mass and cost than HST, control of mid-spatial-frequency (MSF) errors, crucial to coronagraphy, has not been emphasized. Accordingly, roughness at MSF has advanced little since HST. Fortunately, HST primary mirror smoothness would nearly satisfy Eclipse requirements, although other aspects of HST are undesirable for stellar coronagraphy. Conversely, the narrow field required for Eclipse eases other drivers of traditional telescope design. A systematic approach to telescope definition, with primary and sub-tier figures-of-merit, will be discussed in the context of the Eclipse Mission.

  13. Effects of preoperative irradiation on primary tracheal anastomosis

    International Nuclear Information System (INIS)

    Tsubota, N.; Simpson, W.J.; Van Nostrand, A.W.P.; Pearson, F.G.

    1975-01-01

    Preoperative radiotherapy was used in the management of selected patients with cancer of the lung or trachea who might subsequently require segmental resection of bronchus or trachea and reconstruction by primary anastomosis. This study was designed to determine the effects of varying dosages of preoperative irradiation on anastomotic healing. Two rings were resected from the cervical trachea of 20 dogs following irradiation with varying doses of cesium. There were no important adverse effects on healing of the trachea or adjacent organs in dogs receiving up to 3,500 rads. All dogs receiving a higher dose than this developed some anastomotic stenosis, which was severe in 6 of 8 animals. Similar adverse effects were observed in 2 patients managed by preoperative radiotherapy (4,000 rads in three weeks) and tracheal resection with primary anastomosis

  14. Effects of preoperative irradiation on primary tracheal anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Tsubota, N.; Simpson, W.J.; Van Nostrand, A.W.P.; Pearson, F.G.

    1975-08-01

    Preoperative radiotherapy was used in the management of selected patients with cancer of the lung or trachea who might subsequently require segmental resection of bronchus or trachea and reconstruction by primary anastomosis. This study was designed to determine the effects of varying dosages of preoperative irradiation on anastomotic healing. Two rings were resected from the cervical trachea of 20 dogs following irradiation with varying doses of cesium. There were no important adverse effects on healing of the trachea or adjacent organs in dogs receiving up to 3,500 rads. All dogs receiving a higher dose than this developed some anastomotic stenosis, which was severe in 6 of 8 animals. Similar adverse effects were observed in 2 patients managed by preoperative radiotherapy (4,000 rads in three weeks) and tracheal resection with primary anastomosis.

  15. Infliximab treatment reduces tensile strength in intestinal anastomosis

    DEFF Research Database (Denmark)

    Jensen, Jonas Sanberg; Petersen, Nacie Bello; Biagini, Matteo

    2015-01-01

    :1) to receive either repeated IFX treatment or placebo. On day 15, three separate end-to-end anastomoses were performed on the jejunum. On postoperative day 5, tensile strength and bursting pressure for the anastomoses were tested and histologic changes examined. RESULTS: We found a significantly reduced...... as number of sutures in the tested anastomosis (coefficient = 0.51; P = 0.024). The general histologic score was significantly higher in the placebo group (5.00 +/- 1.26 versus 3.31 +/- 1.65, P = 0.03). CONCLUSIONS: Repeated high-dose IFX treatment reduces tensile strength significantly in rabbits...... effect on the healing process in intestinal anastomosis. The objective of this study was to examine the effect of repeated IFX treatment on anastomotic strength and degree of inflammation in the anastomotic line in the small intestine of rabbits. METHODS: Thirty-two rabbits were randomized (2...

  16. Sphincter preservation with preoperative radiation therapy and coloanal anastomosis

    International Nuclear Information System (INIS)

    Minsky, Bruce D.; Cohen, Alfred M.; Enker, Warren E.; Paty, Philip

    1995-01-01

    Purpose: To determine if preoperative radiation therapy allows sphincter preservation in the treatment of rectal cancer. Methods and Materials: Thirty patients with the diagnosis of invasive, resectable, primary adenocarcinoma of the rectum limited to the pelvis were enrolled on a Phase I/II trial of preoperative radiation therapy plus low anterior resection/coloanal anastomosis. By preoperative assessment, all patients had invasive tumors (2: T2, 28: T3) involving the distal half of the rectum and required an abdominoperineal resection. The median tumor size was 4 cm (range: 1.5-6 cm) and the median distance from the anal verge was 4 cm (range: 3-7 cm). The whole pelvis received 46.8 Gy followed by a 3.60 Gy boost to the primary tumor bed. The median follow-up was 43 months (range: 6-82 months). Results: Of the 29 patients who underwent resection, 3 (10%) had a complete pathologic response and 24 (83%) were able to successfully undergo a low anterior resection/coloanal anastomosis. The incidence of local failure was crude: 17% and 4-year actuarial: 23%. The 4-year actuarial survival was 75%. One patient developed a partial disruption of the anastomosis and two developed rectal stenosis. Analysis of sphincter function using a previously published scale was performed at the time of last follow-up in 22 of the 24 patients who underwent a low anterior resection/coloanal anastomosis. Function was good or excellent in 77%. The median number of bowel movements/day was two (range: 1-6). Conclusions: This technique may be an alternative to an abdominoperineal resection in selected patients. Continued follow-up is needed to determine if this approach ultimately has similar local control and survival rates as an abdominoperineal resection

  17. Effect of omentum graft on esophageal anastomosis in dogs

    OpenAIRE

    A. K. Mahdi

    2011-01-01

    The aim of this study was to evaluate the complications and final function outcome of wrapping nonvascularized omentum graft around the suture line of esophageal anastomosis. Twelve adult local breed dogs were used in this study. The animals were divided into two equal groups (control and treated), all animal induced into general anesthesia by injection of atropen sulphate in a dose 0.04 mg/kg B.W, intramuscularly then after 15 minute given mixture of ketamine hydrochloride and xylazine hydro...

  18. The Efficacy of Polydioxanone Monofilament Absorbable Suture for Tracheal Anastomosis

    OpenAIRE

    Kawahara, Katsunobu; Yamasaki, Naoya; Yamamoto, Satoshi; Nagayasu, Takeshi; Kusano, Hiroyuki; Akamine, Shinji; Takahashi, Takao; Tomita, Masao

    1994-01-01

    To evaluate the efficacy of polydioxanon absorbable suture for tracheal anastomoses, we performed an experimental study using dose. Eight adult mongrel dogs underwent sleeve resection of the mediastinal trachea. A length of ten to twelve cartilage rings was resected. An end-to-end anastomosis was performed using either interrupted or continuous running 4-0 polydioxanone (PDS) suture. There was no detectable difference bronchoscopically, microangiografically, or histologically, in tracheal ana...

  19. DISTAL SPLENORENAL VENOUS ANASTOMOSIS IN TREATMENT OF DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    T. I. Shraer

    2010-01-01

    Full Text Available We studied the outcomes of the operations for distal splenorenal venous anastomosis of 134 patients with type 1 diabetes mellitus. We have noticed the significant improvement of patient’s general condition due to spasmolytic effect of glucagon, bypassed to blood circulation without coming through liver and also a stabilization of glyce- mia because of a restoration of insulin-glucagon ratio in systemic circulation. The effect of a surgery depends on a stage of microangiopathy and nephrosclerosis. 

  20. Evaluation healing of jejunal anastomosis in preoperative dexamethasone treated dogs

    Directory of Open Access Journals (Sweden)

    A.S. Al-Qadhi

    2015-06-01

    Full Text Available The objective of this study is to evaluate the healing process of jejunal anastomosis by the aid of histopathology and measurement of bursting pressure of anastomosis site in thirty two adult preoperatively with dexamethasone. The animals were randomly divided into 2 equal groups: Group 1: consists of 16 dogs underwent apposition end-to-end jejunal anastomosis using simple interrupted suture technique which in turn divided into 2 subgroups: subgroup A: consists of 8 dogs treated preoperatively for 15 days with dexamethasone at a dose of (0.2mg/kg given I/M. Subgroup B: control group consists of 8 dogs not treated with dexamethasone. Group 2: consists of 16 dogs underwent inverted end-to-end jejunal anastomosis using continuous Lembert suture pattern that also divided into 2 subgroups: subgroup A: consists of 8 dogs treated preoperatively for 15 days with dexamethasone at a dose of (0.2mg/kg given I/M. subgroup B: control group consists of 8 dogs not treated with dexamethasone. The result of bursting pressure measurement showed higher tensile strength in the control groups (445±9.6 in comparison with the steroidal groups (255±25.3 for both techniques. The histopathological study showed that the healing was good in all groups but the rupture that occur due to shedding the pressure lead to non discrimination between which is better in terms of healing. Massonʼs trichrome showed that collagen content of subgroups taking dexamethasone was lower than that of subgroups not treated with dexamethasone.

  1. Ethyl pyruvate protects colonic anastomosis from ischemia-reperfusion injury.

    Science.gov (United States)

    Unal, B; Karabeyoglu, M; Huner, T; Canbay, E; Eroglu, A; Yildirim, O; Dolapci, M; Bilgihan, A; Cengiz, O

    2009-03-01

    Ethyl pyruvate is a simple derivative in Ca(+2)- and K(+)-containing balanced salt solution of pyruvate to avoid the problems associated with the instability of pyruvate in solution. It has been shown to ameliorate the effects of ischemia-reperfusion (I/R) injury in many organs. It has also been shown that I/R injury delays the healing of colonic anastomosis. In this study, the effect of ethyl pyruvate on the healing of colon anastomosis and anastomotic strength after I/R injury was investigated. Anastomosis of the colon was performed in 32 adult male Wistar albino rats divided into 4 groups of 8 individuals: (1) sham-operated control group (group 1); (2) 30 minutes of intestinal I/R by superior mesenteric artery occlusion (group 2); (3) I/R+ ethyl pyruvate (group 3), ethyl pyruvate was administered as a 50-mg/kg/d single dose; and (4) I/R+ ethyl pyruvate (group 4), ethyl pyruvate administration was repeatedly (every 6 hours) at the same dose (50 mg/kg). On the fifth postoperative day, animals were killed. Perianastomotic tissue hydroxyproline contents and anastomotic bursting pressures were measured in all groups. When the anastomotic bursting pressures and tissue hydroxyproline contents were compared, it was found that they were decreased in group 2 when compared with groups 1, 3, and 4 (P .05). Ethyl pyruvate significantly prevents the delaying effect of I/R injury on anastomotic strength and healing independent from doses of administration.

  2. Trichobezoar obstruction after stapled jejunal anastomosis in a dog.

    Science.gov (United States)

    Carobbi, Barbara; Foale, Robert D; White, Richard A S

    2009-04-01

    To describe an unusual long-term complication of circular end-to-end anastomosis (CEEA) stapling in a dog. Clinical case report. An 11-year-old, female neutered, Labrador Retriever. The dog was referred for clinical signs of bowel obstruction. An enterectomy was performed 2 years before presentation using a CEEA stapling device. Palpation, plain radiographs, and ultrasound of the abdomen confirmed the presence of a mass in the bowel, causing obstruction, and requiring surgical approach. An exploratory celiotomy revealed a 5 cm mass in the jejunum, involving the site of the previous surgery. The mass was removed by enterectomy. Dissection of the mass revealed the presence of many staples at the previous enterectomy site, and a trichobezoar entangled in the exposed parts of the staples. An enterectomy was required to treat an intestinal obstruction caused by a trichobezoar entangled in a CEEA-stapled anastomosis. Development of trichobezoar and subsequent bowel obstruction should be considered an unusual but potential long-term complication of CEEA-stapled anastomosis.

  3. Rectovaginal fistula following colectomy with an end-to-end anastomosis stapler for a colorectal adenocarcinoma.

    Science.gov (United States)

    Klein, A; Scotti, S; Hidalgo, A; Viateau, V; Fayolle, P; Moissonnier, P

    2006-12-01

    An 11-year-old, female neutered Labrador retriever was presented with a micro-invasive differentiated papillar adenocarcinoma at the colorectal junction. A colorectal end-to-end anastomosis stapler device was used to perform resection and anastomosis using a transanal technique. A rectovaginal fistula was diagnosed two days later. An exploratory laparotomy was conducted and the fistula was identified and closed. Early dehiscence of the colon was also suspected and another colorectal anastomosis was performed using a manual technique. Comparison to a conventional manual technique of intestinal surgery showed that the use of an automatic staple device was quicker and easier. To the authors' knowledge, this is the first report of a rectovaginal fistula occurring after end-to-end anastomosis stapler colorectal resection-anastomosis in the dog. To minimise the risk of this potential complication associated with the limited surgical visibility, adequate tissue retraction and inspection of the anastomosis site are essential.

  4. The South Pole Telescope

    Energy Technology Data Exchange (ETDEWEB)

    Ruhl, J.E.; Ade, P.A.R.; Carlstrom, J.E.; Cho, H.M.; Crawford,T.; Dobbs, M.; Greer, C.H.; Halverson, N.W.; Holzapfel, W.L.; Lanting,T.M.; Lee, A.T.; Leitch, E.M.; Leong, J.; Lu, W.; Lueker, M.; Mehl, J.; Meyer, S.S.; Mohr, J.J.; Padin, S.; Plagge, T.; Pryke, C.; Runyan, M.C.; Schwan, D.; Sharp, M.K.; Spieler, H.; Staniszewski, Z.; Stark, A.A.

    2004-11-04

    A new 10 meter diameter telescope is being constructed for deployment at the NSF South Pole research station. The telescope is designed for conducting large-area millimeter and sub-millimeter wave surveys of faint, low contrast emission, as required to map primary and secondary anisotropies in the cosmic microwave background. To achieve the required sensitivity and resolution, the telescope design employs an off-axis primary with a 10 m diameter clear aperture. The full aperture and the associated optics will have a combined surface accuracy of better than 20 microns rms to allow precision operation in the submillimeter atmospheric windows. The telescope will be surrounded with a large reflecting ground screen to reduce sensitivity to thermal emission from the ground and local interference. The optics of the telescope will support a square degree field of view at 2mm wavelength and will feed a new 1000-element micro-lithographed planar bolometric array with superconducting transition-edge sensors and frequency-multiplexed readouts. The first key project will be to conduct a survey over 4000 degrees for galaxy clusters using the Sunyaev-Zeldovich Effect. This survey should find many thousands of clusters with a mass selection criteria that is remarkably uniform with redshift. Armed with redshifts obtained from optical and infrared follow-up observations, it is expected that the survey will enable significant constraints to be placed on the equation of state of the dark energy.

  5. Assessment of corneal astigmatism following frown and straight incision forms in sutureless manual small incision cataract surgery

    Directory of Open Access Journals (Sweden)

    Amedo AO

    2016-04-01

    Full Text Available Angela Ofeibea Amedo, Kwadwo Amoah, Nana Yaa Koomson, David Ben Kumah, Eugene Appenteng Osae Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Abstract: To investigate which of two tunnel incision forms (frown versus straight in sutureless manual small incision cataract surgery creates more corneal astigmatism. Sixty eyes of 60 patients who had consented to undergo cataract surgery and to partake in this study were followed from baseline through >12-week postoperative period. Values of preoperative and postoperative corneal astigmatism for the 60 eyes, measured with a Bausch and Lomb keratometer, were extracted from the patients’ cataract surgery records. Residual astigmatism was computed as the difference between preoperative and postoperative keratometry readings. Visual acuity was assessed during the preoperative period and at each postoperative visit with a Snellen chart at 6 m. Fifty eyes of 50 patients were successfully followed-up on. Overall, the mean residual astigmatism was 0.75±0.12 diopters. The differences in mean residual astigmatism between the two different incision groups were statistically significant (t [48]=6.33, P<0.05; frown incision group recorded 1.00±0.12 diopters, whereas the straight incision group recorded 0.50±0.12 diopters. No significant difference was observed between male and female groups (t [48]=0.24, P>0.05. Residual corneal astigmatism in the frown incision group was significantly higher than in the straight incision group. Fisher’s exact test did not reveal a significant association between incision forms and visual acuity during the entire postoperative period (P>0.05. Keywords: cataract, residual corneal astigmatism, frown incision, straight incision

  6. In vivo comparison of 23- and 25-gauge sutureless vitrectomy incision architecture using spectral domain optical coherence tomography.

    Science.gov (United States)

    Teixeira, Anderson; Rezende, Flavio A; Salaroli, Camila; Souza, Nonato; Sousa, Benedito Antonio; Allemann, Norma

    2013-01-01

    Purpose. To investigate the in vivo incision architecture using spectral domain optical coherence tomography (SD-OCT) in 23-gauge and 25-gauge transconjunctival sutureless pars plana vitrectomy (TSPPV). Methods. A prospective observational study of 22 eyes of 22 patients that underwent three-port 25-gauge (10 eyes) or 23-gauge (12 eyes) TSPPV was performed. The three sclerotomies sites in each eye were analyzed by Corneal Adapter Model (CAM) RTVue SD-OCT (Optovue Inc., Fremont, CA, USA) with wound cross-section images (longitudinal and transversal) on days 1, 7, and 30 postoperatively. Transversal and longitudinal length, location, angle between the conjunctival surface tangent and the incision plane, and architecture deformations were evaluated. Results. All patients (22 eyes) completed the study and surgeries lasted less than 60 minutes. All wounds were obliquely performed, 23-gauge mean angle was 23 ± 5°, and 25-gauge angule was 21 ± 4°. Twenty-three-gauge sclerotomy transversal mean length was 1122 ± 242  μ m and 25-gauge transversal sclerotomy mean length was 977 ± 174  μ m; 23-gauge longitudinal mean length was 363 ± 42  μ m and 25-gauge longitudinal sclerotomy mean length was 234 ±19  μ m; 23-gauge open wound thickness mean was 61 ± 28  μ m and 25-gauge open wound thickness mean was 22 ± 6  μ m. All results were statistically significant (P gauges. Conclusions. The 23-gauge and 25-gauge architectural wound constructions were well visualized using CAM SD-OCT. Statistical differences between the two gauges were observed throughout the study period.

  7. The preparation of anastomosis site at the insular segment of middle cerebral artery

    OpenAIRE

    Katsuno, Makoto; Tanikawa, Rokuya; Izumi, Naoto; Hashimoto, Masaaki

    2014-01-01

    Background: An anastomosis at the insular segment of the middle cerebral artery (M2) is often required in cerebral reconstruction with high- or low-flow bypass. It is necessary to create a shallow, wide, fixed, and bloodless anastomosis field to achieve a safe and quick anastomosis for low surgical morbidity. We describe a method to perform a safe and quick anastomosis. Methods: From 2009 to 2013, the technique was used in 20 procedures to create an extracranial M2 high-flow bypass. The S...

  8. Corot telescope (COROTEL)

    Science.gov (United States)

    Viard, Thierry; Mathieu, Jean-Claude; Fer, Yann; Bouzou, Nathalie; Spalinger, Etienne; Chataigner, Bruno; Bodin, Pierre; Magnan, Alain; Baglin, Annie

    2017-11-01

    COROTEL is the telescope of the COROT Satellite which aims at measuring stellar flux variations very accurately. To perform this mission, COROTEL has to be very well protected against straylight (from Sun and Earth) and must be very stable with time. Thanks to its high experience in this field, Alcatel Alenia Space has proposed, manufactured and tested an original telescope concept associated with a high baffling performance. Since its delivery to LAM (Laboratoire d'Astrophysique de Marseille, CNRS) the telescope has passed successfully the qualification tests at instrument level performed by CNES. Now, the instrument is mounted on a Proteus platform and should be launched end of 2006. The satellite should bring to scientific community for the first time precious data coming from stars and their possible companions.

  9. Telescopes and Techniques

    CERN Document Server

    Kitchin, C R

    2013-01-01

    Telescopes and Techniques has proved itself in its first two editions, having become probably one of the most widely used astronomy texts, both for amateur astronomers and astronomy and astrophysics undergraduates. Both earlier editions of the book were widely used for introductory practical astronomy courses in many universities. In this Third Edition the author guides the reader through the mathematics, physics and practical techniques needed to use today's telescopes (from the smaller models to the larger instruments installed in many colleges) and how to find objects in the sky. Most of the physics and engineering involved is described fully and requires little prior knowledge or experience. Both visual and electronic imaging techniques are covered, together with an introduction to how data (measurements) should be processed and analyzed. A simple introduction to radio telescopes is also included. Brief coverage of the more advanced topics of photometry and spectroscopy are included, but mainly to enable ...

  10. Inguinal Hernia Repair Using Self-adhering Sutureless Mesh: Adhesix™: A 3-Year Follow-up with Low Chronic Pain and Recurrence Rate.

    Science.gov (United States)

    Tabbara, Malek; Genser, Laurent; Bossi, Manuela; Barat, Maxime; Polliand, Claude; Carandina, Sergio; Barrat, Christophe

    2016-02-01

    To review our experience and outcomes after inguinal hernia repair using the lightweight self-adhering sutureless mesh "Adhesix™" and demonstrate the safety and efficacy of this mesh. This is a 3-year retrospective study that included 143 consecutive patients who underwent 149 inguinal hernia repairs at our department of surgery. All hernias were repaired using a modified Lichtenstein technique. Preoperative, perioperative, and postoperative data were prospectively collected. Incidence of chronic pain, postoperative complications, recurrence, and patient satisfaction were assessed three years postoperatively by conducting a telephone survey. We had 143 patients with a mean age of 58 years (17-84), who underwent 149 hernia repairs using the Adhesix™ mesh. Ninety-two per cent (131 patients) were males. Only 10 patients (7%) had a postoperative pain for more than three years. In our series, neither age nor gender was predictive of postoperative pain. Only one patient had a hematoma lasting for more than one month and only four patients (2.8%) had a recurrence of their hernia within three years of their initial surgery. Ninety per cent of the patient expressed their satisfaction when surveyed three years after their surgery. In conclusion, the use of the self-adhering sutureless mesh for inguinal hernia repair has been proving itself as effective as the traditional mesh. Adhesix™ is associated with low chronic pain rate, recurrence rate, and postoperative complications rate, and can be safely adopted as the sole technique for inguinal hernia repair.

  11. Reflecting telescope optics

    CERN Document Server

    Wilson, Raymond N

    2004-01-01

    R.N. Wilson's two-volume treatise on reflecting telescope optics has become a classic in its own right. It is intended to give a complete treatment of the subject, addressing professionals in research and industry as well as students of astronomy and amateur astronomers. This first volume, Basic Design Theory and its Historical Development, is devoted to the theory of reflecting telescope optics and systematically recounts the historical progress. The author's approach is morphological, with strong emphasis on the historical development. The book is richly illustrated including spot-diagrams a

  12. Single Layered Versus Double Layered Intestinal Anastomosis: A Randomized Controlled Trial

    Science.gov (United States)

    Mohapatra, Vandana; Singh, Surendra; Rath, Pratap Kumar; Behera, Tapas Ranjan

    2017-01-01

    Introduction Gastrointestinal anastomosis is one of the most common procedures being performed in oesophagogastric, hepatobiliary, bariatric, small bowel and colorectal surgery; however, the safety and efficacy of single layer or double layer anastomotic technique is still unclear. Aim To assess and compare the efficacy, safety and cost effectiveness of single layered versus double layered intestinal anastomosis. Materials and Methods This prospective, double-blind, randomized controlled comparative study comprised of patients who underwent intestinal resection and anastomosis. They were randomly assigned to undergo either single layered extra-mucosal anastomosis (Group-A) or double layered intestinal anastomosis (Group-B). Primary outcome measures included average time taken for anastomosis, postoperative complications, mean duration of hospital stay and cost of suture material used; secondary outcome measures assessed the postoperative return of bowel function. Statistical analysis was done by Chi-square test and student t-test. Results A total of 97 participants were randomized. Fifty patients were allocated to single layered extramucosal continuous anastomosis (Group-A) and 47 patients to double layered anastomosis (Group-B). The patients in each group were well matched for age, sex and diagnosis. The mean time taken for anastomosis (15.12±2.27 minutes in Group-A versus 24.38±2.26 minutes in Group-B) and the length of hospital stay (5.90±1.43 days in Group-A versus 7.29±1.89 days in Group-B) was significantly shorter in Group-A {p-value anastomosis. However, there was no significant difference in the complication rates between the two groups. Conclusion It can be concluded that single layered extramucosal continuous intestinal anastomosis is equally safe and perhaps more cost effective than the conventional double layered method and may represent the optimal choice for routine surgical practice. PMID:28764239

  13. A Simple "Tubeless" Telescope

    Science.gov (United States)

    Straulino, S.; Bonechi, L.

    2010-01-01

    Two lenses make it possible to create a simple telescope with quite large magnification. The set-up is very simple and can be reproduced in schools, provided the laboratory has a range of lenses with different focal lengths. In this article, the authors adopt the Keplerian configuration, which is composed of two converging lenses. This instrument,…

  14. Taiwan Automated Telescope Network

    Directory of Open Access Journals (Sweden)

    Dean-Yi Chou

    2010-01-01

    can be operated either interactively or fully automatically. In the interactive mode, it can be controlled through the Internet. In the fully automatic mode, the telescope operates with preset parameters without any human care, including taking dark frames and flat frames. The network can also be used for studies that require continuous observations for selected objects.

  15. The Falcon Telescope Network

    Science.gov (United States)

    Chun, F.; Tippets, R.; Dearborn, M.; Gresham, K.; Freckleton, R.; Douglas, M.

    2014-09-01

    The Falcon Telescope Network (FTN) is a global network of small aperture telescopes developed by the Center for Space Situational Awareness Research in the Department of Physics at the United States Air Force Academy (USAFA). Consisting of commercially available equipment, the FTN is a collaborative effort between USAFA and other educational institutions ranging from two- and four-year colleges to major research universities. USAFA provides the equipment (e.g. telescope, mount, camera, filter wheel, dome, weather station, computers and storage devices) while the educational partners provide the building and infrastructure to support an observatory. The user base includes USAFA along with K-12 and higher education faculty and students. Since the FTN has a general use purpose, objects of interest include satellites, astronomical research, and STEM support images. The raw imagery, all in the public domain, will be accessible to FTN partners and will be archived at USAFA in the Cadet Space Operations Center. FTN users will be able to submit observational requests via a web interface. The requests will then be prioritized based on the type of user, the object of interest, and a user-defined priority. A network wide schedule will be developed every 24 hours and each FTN site will autonomously execute its portion of the schedule. After an observational request is completed, the FTN user will receive notification of collection and a link to the data. The Falcon Telescope Network is an ambitious endeavor, but demonstrates the cooperation that can be achieved by multiple educational institutions.

  16. The Dutch Open Telescope

    NARCIS (Netherlands)

    Rutten, R.J.; Hammerschlag, R.H.; Bettonvil, F.C.M.

    1997-01-01

    The Dutch Open Telescope is now being installed at La Palma. It is intended for optical solar observations with high spatial resolution. Its open design aims to minimize disturbances of the local air ow and so re- duce the locally-generated component of the atmospheric seeing. This paper brie y

  17. The Large Millimeter Telescope

    Science.gov (United States)

    Hughes, David H.; Jáuregui Correa, Juan-Carlos; Schloerb, F. Peter; Erickson, Neal; Romero, Jose Guichard; Heyer, Mark; Reynoso, David Huerta; Narayanan, Gopal; Perez-Grovas, Alfonso Serrano; Souccar, Kamal; Wilson, Grant; Yun, Min

    2010-07-01

    This paper describes the current status of the Large Millimeter Telescope (LMT), the near-term plans for the telescope and the initial suite of instrumentation. The LMT is a bi-national collaboration between Mexico and the USA, led by the Instituto Nacional de Astrofísica, Óptica y Electrónica (INAOE) and the University of Massachusetts at Amherst, to construct, commission and operate a 50m-diameter millimeter-wave radio telescope. Construction activities are nearly complete at the 4600m LMT site on the summit of Volcán Sierra Negra, an extinct volcano in the Mexican state of Puebla. Full movement of the telescope, under computer control in both azimuth and elevation, has been achieved. The commissioning and scientific operation of the LMT is divided into two major phases. As part of phase 1, the installation of precision surface segments for millimeter-wave operation within the inner 32m-diameter of the LMT surface is now complete. The alignment of these surface segments is underway. The telescope (in its 32-m diameter format) will be commissioned later this year with first-light scientific observations at 1mm and 3mm expected in early 2011. In phase 2, we will continue the installation and alignment of the remainder of the reflector surface, following which the final commissioning of the full 50-m LMT will take place. The LMT antenna, outfitted with its initial complement of scientific instruments, will be a world-leading scientific research facility for millimeter-wave astronomy.

  18. Comparative study of three methods of esophageal anastomosis in dogs

    Directory of Open Access Journals (Sweden)

    Z. T. Abd Al-Maseeh

    2009-01-01

    Full Text Available This study was performed to compare three methods of esophageal anastomosis. Twenty four healthy adult dogs were used in this study. The animals were divided into three groups; each one consisted of 8 animals. In group 1; two layers were used to perform the esophageal anastomosis. The first layer represented simple interrupted suture to close the mucosa with knot inside the lumen, and the second layer represented horizontal mattress interrupted suture to close the other layers of esophagus. While in group 2; one layer of cross interrupted mattress suture was used to close all layers of esophageal wall, and in group 3; one layer of Schmieden's suture was used to close all layers of esophageal wall. The results of clinical, radiological and histopathological studies after 15 and 30 days of surgical operation revealed that most of the animals showed different degrees of difficulty concerning the moderate dysphagia and regurgitation. The radiological study showed significant difference of stenosis. The best results were recorded in the second group where the mean degree of stenosis was 7.69%, however the mean degree of stenosis was 42.80% in the first group, while the mean degree of stenosis in the third groups was 37.81%, through 30 days. The histopathological study of group 2 showed rapid healing of the site of anastomosis, lack of granulation tissue and consequently the less degree of stricture and other complications as compared with groups 1 and 3. The Schmieden's suture was characterized by its standard short time as compared with group 1 and 2, although accompanied by some complications. In conclusion this study revealed that the cross mattress suture used in the second group characterized by faster healing and minimal amount of fibrous tissue formation manifested by decrease in moderate degree of stenosis as compared with the two other suture patterns used in the first and third groups.

  19. The relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection

    DEFF Research Database (Denmark)

    Laurberg, Søren

    2017-01-01

    BACKGROUND: Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit...

  20. [Influence of the type of arterial anastomosis on the development of endothelial hyperplasia].

    Science.gov (United States)

    Becquemin, J P; Deleuze, P; Léandri, J; Lautier, A; Mellière, D

    1984-01-01

    This study was designed to evaluate intimal hyperplasia distal to the suture line in two types of vascular anastomosis: end to end and end to side. 49 aorto-iliac homografts have been performed on rabbits New-Zealand. The aortic anastomosis was side to end, iliac anastomosis were end to end on one side, end to side on the other one. Scanning electronic microscopical study and histological evaluation were carried out at various time of survival from 2 hours to 180 days. The scanning microscopy has evidenced the surface changes: early platelets adhesion and the healing process. Histological evaluation demonstrated that the intimal proliferation was prevailing at the level of the suture line in both anastomosis, and at the opposite to the mouth of the anastomosis in the end to side one. Intimal thickness was measured on arterial section immediately distal to the suture line. In the end to end anastomosis, hyperplasia was absent on the 5th post-operative days, it reached 120 mu +/- 33 on the 40th days, and decreased to 40 mu +/- 35 on the 150th post-operative day. In the end to side anastomosis evolution was the same: 0 mu on the 5th, 106 mu +/- 49 on the 40th day and 53 mu +/- 45 on the 150th post-operative day. In conclusion, this experimental study gives some support to the fact that the type of anastomosis, per se, end to side or end to end does not influence the development of intimal hyperplasia.

  1. Mediastinoscopic Bilateral Bronchial Release for Long Segmental Resection and Anastomosis of the Trachea

    OpenAIRE

    Kang, Jeong-Han; Park, In Kyu; Bae, Mi-Kyung; Hwang, Yoohwa

    2011-01-01

    The extent of resection and release of the trachea is important for successful anastomosis. Bilateral bronchial dissection is one of the release techniques for resection of the lower trachea. We present the experience of cervical video-assisted mediastinoscopic bilateral bronchial release for long segmental resection and anastomosis of the lower trachea.

  2. Pancreatico-Gastric Anastomosis with and without Sutures – Experimental Swine Model

    Directory of Open Access Journals (Sweden)

    Tudor A

    2015-06-01

    Full Text Available Objectives. The aim of our study is to identify a surgical technical that has the lowest rate of pancreatic fistulas in pancreatico-gastric anastomosis following duodenopancreatectomies. We studied pancreatico-gastric anastomosis performed with stitches compared to the ones performed without stitches.

  3. Peri-operative care for patients undergoing lymphaticovenular anastomosis: A systematic review

    NARCIS (Netherlands)

    Winters, H.; Tielemans, H.J.P.; Sprangers, P.N.; Ulrich, D.J.O.

    2017-01-01

    BACKGROUND: Lymphaticovenular anastomosis (LVA) is a supermicrosurgical procedure that involves the anastomosis of a functional lymphatic channel to a venule. Although peri-operative care might be an important contributor to the success of this technique, evidence about optimal peri-operative care

  4. An alternative to conventional hand-sewing colocolic anastomosis: anastomosis with absorbable surgical barrier film without sutures.

    Science.gov (United States)

    Nejdet, Bildik; Ayhan, Cevik; Doğan, Fakıoğlu; Mehmet, Altıntaş; Hüseyin, Ekinci; Gülay, Dalkılıç; Mustafa, Gülmen; Nagehan, Barışık

    2010-12-01

    As a result of its high morbidity and mortality rates, anastomotic leakage is one of the most feared complications in colorectal surgery. Therefore, this issue is one of the most relevant in colorectal surgery and a lot of work has been conducted to research it. The aim of this experimental study was to compare colocolic anastomosis performed by using absorbable surgical barrier film without suture and conventional anastomosis performed by hand-sewing technique in terms of anastomosis safety. In this study, 40 Norway Wistar Albino 3-month-old female rats were used. Each weighed between 250 and 300g. The rates were divided into two groups, a control group and an experimental group. Full-thickness incisions were made on the ascending colon of both groups of rats. The control group's anastomoses were conducted using a hand-sewn technique consisting of one layer of nonabsorbable sutures (Gambee suture). The experimental group's anastomoses were performed using absorbable surgical barrier film without sutures. Afterwards, sample pieces of the anastomosis area were taken from all rats on either the 3rd or the 7th day following the operation, resulting in subgroups that led to a total of four test groups. The samples taken were subjected first to an anastomosis bursting pressure test followed by histopathological examinations and a test to detect the levels of hydroxyproline in the tissue. The control groups (groups 1 and 3) had average anastomotic bursting pressures of 33.0±9.49mmHg and 146.0±15.06mmHg respectively, whereas experimental groups (groups 2 and 4) had average anastomotic bursting pressures of 58.0±10.33mmHg and 190.0±25.82mmHg respectively. Mann-Whitney U-test analysis of the bursting pressure values indicates the differences between groups 1 and 2 (3rd day postoperatively) and groups 3 and 4 (7th day postoperatively) to be statistically significant (P=0.0001 and P=0.0003 respectively). Values obtained from histopathological staging conducted according

  5. Difference in Recurrence Patterns Between Anastomosis and Strictureplasty After Surgical Treatment for Crohn Disease

    Science.gov (United States)

    Hayakawa, Shoichiro; Hotokezaka, Masayuki; Ikeda, Takuto; Uchiyama, Shuichiro; Chijiiwa, Kazuo

    2012-01-01

    This study aimed to investigate whether the initial indication for surgery or type of surgery (strictureplasty or resection) performed determines recurrence patterns in patients with Crohn disease. Recurrence patterns of 41 patients (31 patients: only resection and anastomosis of the intestine, and 10 patients: strictureplasty with/without resection and anastomosis) who underwent operation for recurrent Crohn disease (June 2002–December 2010) were evaluated. Strictureplasty for nonperforating disease was performed at 17 sites, and reoperation was required at 11 sites (10 sites for nonperforating disease and 1 site for perforating disease). There was a significant difference in the recurrence pattern in patients who underwent resection and anastomosis (P resection and anastomosis (P resection and anastomosis was performed for nonperforating and for perforating disease. Initial indication for surgery, but not the type of surgery, appeared to determine recurrence patterns. PMID:23102077

  6. Experimental research on end-to-side anastomosis of peripheral nerves and effect of FK506 on end-to-side anastomosis.

    Science.gov (United States)

    Yang, L M; Wu, Y X; Zhang, X P; Li, X H

    2014-01-01

    To study the effects of end-to-side anastomosis of initially-denatured nerves at different times. 60 male Wistar albino rats were used to fabricate animal models for the experiment on end-to-side anastomosis of peripheral nerves and 50 female Wistar albino rats were used to fabricate animal models for the experiment on the effect of FK506 on end-to-side anastomosis. Bilateral common peroneal nerve, tibialis anterior muscle electrophysiological and histological examinations, tibialis anterior muscle wet muscle weight determination, and motor end plate examination were performed 3 months after operation. All recovery rates of action potential, single muscle contraction force and tetanic contraction force of the FK506 experimental group are significantly higher than those of the control group and the sectional area of muscle fiber is also higher than that of the control group of normal saline. The best time for end-to-side anastomosis of nerves should be controlled within 2 weeks and the effect of end-to-side anastomosis of nerves will gradually become unsatisfactory. FK506 plays a role in promoting functional rehabilitation following nerve end-to-side anastomosis (Tab. 7, Fig. 4, Ref. 31).

  7. Calibrating the Athena telescope

    Science.gov (United States)

    de Bruijne, J.; Guainazzi, M.; den Herder, J.; Bavdaz, M.; Burwitz, V.; Ferrando, P.; Lumb, D.; Natalucci, L.; Pajot, F.; Pareschi, G.

    2017-10-01

    Athena is ESA's upcoming X-ray mission, currently set for launch in 2028. With two nationally-funded, state-of-the-art instruments (a high-resolution spectrograph named X-IFU and a wide-field imager named WFI), and a telescope collecting area of 1.4-2 m^2 at 1 keV, the calibration of the spacecraft is a challenge in itself. This poster presents the current (spring 2017) plan of how to calibrate the Athena telescope. It is based on a hybrid approach, using bulk manufacturing and integration data as well as dedicated calibration measurements combined with a refined software model to simulate the full response of the optics.

  8. Cervicovaginal anastomosis by Gore-Tex in Mullerian agenesis.

    Science.gov (United States)

    Rezaei, Zahra; Omidvar, Azizeh; Niroumanesh, Shirin; Omidvar, Azadeh

    2015-02-01

    To determine usage of polytetrafluoroethylene, Gore-Tex, as a stent in patients with congenital cervicovaginal agenesis. Follow-up study. Tertiary center referral hospital. Eight patients with Mullerian agenesis who had congenital cervical agenesis, associated with partial or complete vaginal aplasia. Laparoscopic uterovaginal anastomosis with placement of a polytetrafluoroethylene stent for reconstruction of cervical agenesis. In cases associated with vaginal agenesis, modified McIndoe vaginoplasty was done concomitantly. Eight patients with cervical agenesis who had partial and complete vaginal aplasia underwent vaginoplasty. Mean (SD) follow-up after surgery (3 years old). All patients except three of them, (62.5 %) experienced relief of abdominal pain and regular menstruation. Due to ascending infection three of them (37.5 %) needed reoperation. So, they underwent laparotomy. Two of these three patients had total abdominal hysterectomy and one case tolerated resection of right obstructed side of didelphys uterus, then she became pregnant spontaneously. Four out of these eight cases were married and the others were single. One out of our married patients conceived three times. Her first pregnancy was aborted. She delivered two alive babies after inserting transabdominal Shirodkar suture in her other pregnancies. Uterovaginal anastomosis assisted laparoscopy with polytetrafluoroethylene (Gore-Tex) is effective and hopeful to relieve patients' symptoms, menstruation regularity, and saving fertility. If ascending infection threatening health happens, hysterectomy will be recommended.

  9. Compatibility and incompatibility in hyphal anastomosis of arbuscular mycorrhizal fungi

    Directory of Open Access Journals (Sweden)

    Candido Barreto de Novais

    Full Text Available ABSTRACT: Arbuscular mycorrhizal fungi (AMF, which live in symbiosis with 80 % of plants, are not able to grow when separated from their hosts. Spore germination is not host-regulated and germling growth is shortly arrested in the absence of host roots. Germling survival chances may be increased by hyphal fusions (anastomoses, which allow access to nutrients flowing in the extraradical mycelium (ERM. Perfect anastomoses, occurring with high frequency among germlings and the ERM of the same isolate, show protoplasm continuity and disappearance of hyphal walls. A low frequency of perfect fusions has been detected among co-specific genetically different isolates, although fungal nuclei have been consistently detected in all perfect fusions, suggesting active nuclear migration. When plants of different taxa establish symbioses with the same AMF species, anastomoses between ERM spreading from single root systems establish a common mycelium, which is an essential element to plant nutrition and communication. The interaction among mycelia produced by different isolates may also lead to pre-fusion incompatibility which hinders anastomosis formation, or to incompatibility after fusion, which separates the hyphal compartments. Results reported here, obtained by analyses of hyphal compatibility/incompatibility in AMF, suggest that anastomosis formation and establishment of protoplasm flow, fundamental to the maintenance of mycelial physiological and genetic continuity, may affect the fitness of these ecologically important biotrophic fungi.

  10. The COROT telescope

    Science.gov (United States)

    Viard, Thierry

    2017-11-01

    The COROT telescope, of which the customer is the French "INSU" / "CNES" (Institut National des Sciences de l'Univers / Centre National des Etudes Spatiales) is in fact a very precise and stable imaging instrument, which will be pointed towards fixed areas in the sky (each containing more than 3000 target stars) for periods of at least 5 months, in order to carry out its two missions.

  11. Workshop: Neutrino telescopes

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    Despite being the most elusive of the known particles, neutrinos provide vital new physics insights. Most neutrino knowledge so far has come from studies using beams from reactors and accelerators, but in recent years important new contributions have resulted from investigation of natural neutrinos from cosmic rays, nearby stars (the sun), or distant sources, such as the 1987 supernova. The supernova observations marked the start of a new era in neutrino astronomy, but neutrino telescopes were anyway assured of an important ongoing role

  12. [Galileo and his telescope].

    Science.gov (United States)

    Strebel, Christoph

    2006-01-01

    Galileo's publication of observations made with his newly reinvented telescope provoked a fierce debate. In April 1610 Martinus Horky, a young Bohemian astronomer, had an opportunity to make his own observations with Galileo's telescope in the presence of Antonio Magini and other astronomers. Horky and the other witnesses denied the adequacy of Galileo's telescope and therefore the bona fides of his discoveries. Kepler conjectured Horky as well as all his witnesses to be myopic. But Kepler's objection could not stop the publication of Horky's Peregrinatio contra nuncium sidereum (Modena, 1610), the first printed refutation of Galileo's Sidereus nuncius. In his treatise, Horky adresses four questions: 1) Do the four newly observed heavenly bodies actually exist? Horky denies their existence on various grounds: a) God, as every astronomer teaches, has created only seven moveable heavenly bodies and astronomical knowledge originates in God, too. b) Heavenly bodies are either stars or planets. Galileo's moveable heavenly bodies fit into neither category. c) If they do exist, why have they not already been observed by other scholars? Horky concludes that there are no such heavenly bodies. 2) What are these phenomena? They are purely artefactual, and produced by Galileo's telescope. 3) How are they like? Galileo's "stars" are so small as to be almost invisible. Galileo claims that he has measured their distances from each other. This however is impossible due to their diminutive size and other observational problems. Hence, Galileo's claim is a further proof that he is a fraud. 4) Why are they? For Galileo they are a chance to earn money but for astronomers like Horky they are a reason to offer thanks and honour to God. Horky's treatise was favourably received by the enemies of Galileo. But Kepler's critique was devastating. After calling on Kepler in Prague, Horky had to revoke the contents of his book.

  13. Systematic review and meta-analysis of published, randomized, controlled trials comparing suture anastomosis to stapled anastomosis for ileostomy closure.

    Science.gov (United States)

    Sajid, M S; Craciunas, L; Baig, M K; Sains, P

    2013-12-01

    The objective of this article is to systematically analyze the randomized, controlled trials comparing the effectiveness of suture anastomosis (SUA) versus stapled anastomosis (STA) in patients undergoing ileostomy closure. Randomized, controlled trials comparing the effectiveness of SUA versus STA in patients undergoing ileostomy closure were analyzed using RevMan(®), and combined outcomes were expressed as odds risk ratio (OR) and standardized mean difference (SMD). Four randomized, controlled trials that recruited 645 patients were retrieved from electronic databases. There were 327 patients in the STA group and 318 patients in the SUA group. There was significant heterogeneity among included trials. Operative time (SMD -1.02; 95 % CI -1.89, -0.15; z = 2.29; p infection, reoperation and readmission were similar following STA and SUA in patients undergoing ileostomy closure. Length of hospital stay was also similar between STA and SUA groups. In ileostomy closure, STA was associated with shorter operative time and lower risk of postoperative small bowel obstruction. However, STA and SUA were similar in terms of anastomotic leak, surgical site infection, readmission, reoperations and length of hospital stay.

  14. Tackling the Issue of High Postoperative Pacemaker Implantation Rates in Sutureless Aortic Valve Replacement: Should Balloon Inflation be Removed from the Implantation Method of the Perceval Prosthesis?

    Science.gov (United States)

    Charles Blouin, Mathieu; Bouhout, Ismail; Demers, Philippe; Carrier, Michel; Perrault, Louis; Lamarche, Yoan; El-Hamamsy, Ismail; Bouchard, Denis

    2017-05-01

    Sutureless aortic valve replacement (AVR) is an emerging alternative to standard AVR in elderly and high-risk patients. This procedure is associated with a high rate of postoperative permanent pacemaker implantation (PPI). The study aim was to assess the impact on the rate of PPI of implanting the Perceval prosthesis without using balloon inflation. A total of 159 patients who underwent sutureless AVR using the Perceval prosthesis was included. Balloon inflation was used in 132 patients (Balloon group) and not used in the remaining 27 (No-Balloon group). Clinical, echocardiographic and electrocardiographic outcomes were assessed. There was no significant difference in PPI rate between the two groups (26% for Balloon group versus 22% in No-Balloon group; p = 0.700). Balloon inflation had no significant impact on the incidence of paravalvular leaks (p = 0.839), or on the need to return to cardiopulmonary bypass (CPB) intraoperatively due to paravalvular leak or unsatisfactory deployment (p >0.999). Mean and peak transaortic pressure gradients were similar between the two groups (p = 0.417 and p = 0.522, respectively). Cross-clamp and CPB times were shorter in the No-Balloon group (49.6 ± 15.9 min versus 61.1 ± 25.6 min and 64.1 ± 26.3 min versus 79.6 ± 35.4 min, respectively; p = 0.027 and p = 0.012, respectively). The two groups had similar postoperative PPI rates. Implanting the Perceval prosthesis without balloon inflation is safe and had no impact on paravalvular leaks, intraoperative complications or hemodynamic results. Reductions in aortic cross-clamp time and CPB time were observed when the balloon was not used.

  15. Sutureless replacement of aortic valves with St Jude Medical mechanical valve prostheses and Nitinol attachment rings: feasibility in long-term (90-day) pig experiments.

    Science.gov (United States)

    Berreklouw, Eric; Koene, Bart; De Somer, Filip; Bouchez, Stefaan; Chiers, Koen; Taeymans, Yves; Van Nooten, Guido J

    2011-05-01

    Nitinol attachment rings (devices) used to attach mechanical aortic valve prostheses suturelessly were studied in long-term (90 days) pig experiments. The aortic valve was removed and replaced by a device around a St Jude Medical mechanical valve prosthesis in 10 surviving pigs. Supravalvular angiography was done at the end of the operation. No coumarin derivates were given. No or minimal aortic regurgitation was confirmed in all surviving pigs at the end of the operation. Total follow-up was 846 days. In 4 pigs, follow-up was shorter than 90 days (28-75 days); the other 6 pigs did reach 90 days' survival or more. Repeat angiography in 4 pigs at the end of follow-up confirmed the unchanged position of the device at the aortic annulus, without aortic regurgitation. At autopsy, in all pigs the devices proved to be well grown in at the annulus, covered with endothelium, and sometimes tissue overgrowth related to not using coumarin derivates. There was no case of para-device leakage, migration, or embolization. No damage to surrounding anatomic structures or prosthetic valves was found. Nitinol attachment rings can be used to replace the aortic valve suturelessly with St Jude Medical mechanical aortic valve prostheses, without para-device leakage, migration, or damage to the surrounding tissues, in long-term pig experiments during a follow-up of 90 days or more. Refraining from anticoagulation in pigs with mechanical valve prostheses can lead to tissue overgrowth of the valve prosthesis. Further studies are needed to determine long-term feasibility of this method in human beings. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  16. The Complete Genome of a New Betabaculovirus from Clostera anastomosis.

    Directory of Open Access Journals (Sweden)

    Feifei Yin

    Full Text Available Clostera anastomosis (Lepidoptera: Notodontidae is a defoliating forest insect pest. Clostera anastomosis granulovirus-B (ClasGV-B belonging to the genus Betabaculovirus of family Baculoviridae has been used for biological control of the pest. Here we reported the full genome sequence of ClasGV-B and compared it to other previously sequenced baculoviruses. The circular double-stranded DNA genome is 107,439 bp in length, with a G+C content of 37.8% and contains 123 open reading frames (ORFs representing 93% of the genome. ClasGV-B contains 37 baculovirus core genes, 25 lepidopteran baculovirus specific genes, 19 betabaculovirus specific genes, 39 other genes with homologues to baculoviruses and 3 ORFs unique to ClasGV-B. Hrs appear to be absent from the ClasGV-B genome, however, two non-hr repeats were found. Phylogenetic tree based on 37 core genes from 73 baculovirus genomes placed ClasGV-B in the clade b of betabaculoviruses and was most closely related to Erinnyis ello GV (ErelGV. The gene arrangement of ClasGV-B also shared the strongest collinearity with ErelGV but differed from Clostera anachoreta GV (ClanGV, Clostera anastomosis GV-A (ClasGV-A, previously also called CaLGV and Epinotia aporema GV (EpapGV with a 20 kb inversion. ClasGV-B genome contains three copies of polyhedron envelope protein gene (pep and phylogenetic tree divides the PEPs of betabaculoviruses into three major clades: PEP-1, PEP-2 and PEP/P10. ClasGV-B also contains three homologues of P10 which all harbor an N-terminal coiled-coil domain and a C-terminal basic sequence. ClasGV-B encodes three fibroblast growth factor (FGF homologues which are conserved in all sequenced betabaculoviruses. Phylogenetic analysis placed these three FGFs into different groups and suggested that the FGFs were evolved at the early stage of the betabaculovirus expansion. ClasGV-B is different from previously reported ClasGV-A and ClanGV isolated from Notodontidae in sequence and gene

  17. [Animal experimental study of compression anastomosis ring for low anterior resection].

    Science.gov (United States)

    Liang, Jian-Wei; Wang, Zheng; Zhang, Xing-Mao; Zhan, Da-Wei; Zhou, Zhi-Xiang

    2011-05-01

    To evaluate the feasibility and safety of nickel-titanium compression anastomosis ring (CAR27) in colorectal anastomosis after low anterior rectal resection in animal models. End-to-end colorectal anastomosis was performed using CAR27 in 6 experimental pigs after resection of the middle and lower third of the rectum. The animals were observed postoperatively for up to 56 days. Five pigs were sacrificed at day 14 and the other at day 56. Distance from anal verge to anastomosis and anastomotic circumference were measured. Histopathologic examination was performed. The median distance from anal verge was 5.3(4-6) cm. No anastomotic leak or other complications were observed. All the pigs recovered and gained weight. In 5 animals sacrificed at day 14, the mean circumference of the anastomosis was 6.8(6.5-7.0) cm, and histopathological examination showed mild inflammatory reaction and fibrosis. In the one sacrificed at day 56, the circumference expanded to 9.3 cm, and no inflammation and fibrosis were observed. Minor adhesion was noticed in only one pig, while smooth and intact serosa in the anastomosis was seen in the rest of the animals. CAR27 is a promising device for mid and low colorectal anastomosis.

  18. The Effects of Hyperbaric Oxygen Therapy on Experimental Colon Anastomosis After Preoperative Chemoradiotherapy

    Science.gov (United States)

    Yildiz, Ramazan; Can, Mehmet Fatih; Yagci, Gokhan; Ozgurtas, Taner; Guden, Metin; Gamsizkan, Mehmet; Ozturk, Erkan; Cetiner, Sadettin

    2013-01-01

    The aim of the present study was to investigate the effect of hyperbaric oxygen therapy (HBOT) on colon anastomosis after chemoradiotherapy (CRT). Sixty female Wistar-Albino rats were divided into 5 groups and underwent left colon resection and end-to-end anastomosis. CRT simulation was performed on 2 sham groups before the anastomosis, and 1 of these groups was administered additional postoperative HBOT. Two groups were administered CRT before the anastomosis, and 1 of them received additional postoperative HBOT. On postoperative day 5, all groups underwent relaparotomy; burst pressure was measured and samples were obtained for histopathologic and biochemical analysis. There was a significant weight loss in the CRT groups and postoperative HBOT had an improving effect. Significantly decreased burst pressure values increased up to the levels of the controls after HBOT. Hydroxyproline levels were elevated in all groups compared to the control group. Hydroxyproline levels decreased with HBOT after CRT. No significant difference was observed between the groups regarding fibrosis formation at the anastomosis site. However, regression was observed in fibrosis in the group receiving HBOT after CRT. Preoperative CRT affected anastomosis and wound healing unfavorably. These unfavorable effects were alleviated by postoperative HBOT. HBOT improved the mechanical and biochemical parameters of colon anastomosis in rats. PMID:23438274

  19. Laparoscopic intersphincteric resection for low rectal cancer: comparison of stapled and manual coloanal anastomosis.

    Science.gov (United States)

    Cong, J C; Chen, C S; Ma, M X; Xia, Z X; Liu, D S; Zhang, F Y

    2014-05-01

    The study aim was to analyse the safety and feasibility of laparoscopic intersphincteric resection with stapled coloanal anastomosis for low rectal cancer. Between March 2009 and August 2010, 22 patients underwent laparoscopic intersphincteric resection with a stapled coloanal anastomosis without a diverting ileostomy. The results were compared retrospectively with hand-sewn coloanal anastomoses performed between January 2001 and May 2009, which included 55 open and 38 laparoscopic intersphincteric resections. The morbidity comparison only included data relevant to the anastomosis. Function was compared using the Saito function questionnaire and the Wexner score and only involved data relevant to the laparoscopy. The anastomotic complication rates were similar for fistula, bleeding and neorectal mucosal prolapse (P = 0.526, P = 0.653 and P = 0.411, respectively). Anastomotic leakage and stricture formation of the stapled coloanal anastomosis were significantly lower than those of the hand-sewn coloanal anastomosis (P = 0.037 and P = 0.028, respectively). There were no significant differences in the Saito function questionnaire and the Wexner score between the stapled and hand-sewn coloanal anastomotic groups (all P > 0.05). Laparoscopic intersphincteric resection with a stapled coloanal anastomosis is technically feasible and is less likely to result in anastomotic leakage and stricture formation than a hand-sewn anastomosis. Colorectal Disease © 2014 The Association of Coloproctology of Great Britain and Ireland.

  20. Comparing NEO Search Telescopes

    Science.gov (United States)

    Myhrvold, Nathan

    2016-04-01

    Multiple terrestrial and space-based telescopes have been proposed for detecting and tracking near-Earth objects (NEOs). Detailed simulations of the search performance of these systems have used complex computer codes that are not widely available, which hinders accurate cross-comparison of the proposals and obscures whether they have consistent assumptions. Moreover, some proposed instruments would survey infrared (IR) bands, whereas others would operate in the visible band, and differences among asteroid thermal and visible-light models used in the simulations further complicate like-to-like comparisons. I use simple physical principles to estimate basic performance metrics for the ground-based Large Synoptic Survey Telescope and three space-based instruments—Sentinel, NEOCam, and a Cubesat constellation. The performance is measured against two different NEO distributions, the Bottke et al. distribution of general NEOs, and the Veres et al. distribution of Earth-impacting NEO. The results of the comparison show simplified relative performance metrics, including the expected number of NEOs visible in the search volumes and the initial detection rates expected for each system. Although these simplified comparisons do not capture all of the details, they give considerable insight into the physical factors limiting performance. Multiple asteroid thermal models are considered, including FRM, NEATM, and a new generalized form of FRM. I describe issues with how IR albedo and emissivity have been estimated in previous studies, which may render them inaccurate. A thermal model for tumbling asteroids is also developed and suggests that tumbling asteroids may be surprisingly difficult for IR telescopes to observe.

  1. Delayed Coloanal Anastomosis for rectovaginal fistula after colorectal resection for deep endometriosis.

    Science.gov (United States)

    Gallo, Gaetano; Luc, Alberto Realis; Tutino, Roberta; Clerico, Giuseppe; Trompetto, Mario

    2016-11-28

    The deep infiltrating endometriosis, defined as a subperitoneal infiltration of endometrial implants of ≥ 5 mm involving not only the colorectal tract but also rectovaginal septum, vagina and bladder often requires a challenging surgery. Endometriosis nodes of the rectovaginal septum, if symptomatic, need a resection of the involved colorectal tract with colorectal or coloanal anastomosis. Unfortunately in these cases is not uncommon the possibility of a postoperative rectovaginal fistula (RVF), caused by the weakness of the septum that must be skeletonized to completely remove the endometriosis nodes. Here we present a case of anastomotic leakage with high RVF after colorectal resection and low colorectal anastomosis for deep endometriosis in which, for a chronic pelvic sepsis and a high risk of failure of a new immediate coloanal anastomosis, a Turnbull-Cutait pull-through with delayed coloanal anastomosis (DCAA) has been performed. A now 34 years old woman was admitted to our Clinic because of a RVF due to recto-sigmoid resection with colorectal anastomosis for endometriosis. An evaluation in anesthesia confirmed the RVF. In this case we avoided an immediate new colorectal anastomosis for the high risk of a recurrent anastomotic leakage and performed a DCAA. The outcome of the two-steps operation has been satisfactory both for the healing of the RVF and for the functional results bringing the young patient to a completely restored social, sexual and working life. In our opinion Turnbull-Cutait pull-through with delayed coloanal anastomosis is a good choice in patients with RVF in which a new colorectal or coloanal anastomosis can bring to a recurrent leakage. Delayed coloanal anastomosis, Deep endometriosis, Rectovaginal fistula.

  2. Lateral Nail Fold Incision Technique for Venous Anastomosis in Fingertip Replantation.

    Science.gov (United States)

    Jeon, Byung-Joon; Yang, Jae-Won; Roh, Si Young; Ki, Sae Hwi; Lee, Dong Chul; Kim, Jin Soo

    2016-01-01

    Successful venous anastomosis is one of the most important factors in fingertip replantation. Volar veins in the fingertip course proximally in a random pattern, which makes it difficult to find out the exact locations. Although dorsal veins in the lateral nail fold have constant location and adequate diameter for anastomosis, they have been known as hard to dissect from the immobile subcutaneous tissue. The authors present a new lateral nail fold incision technique for venous anastomosis in the fingertip amputations. From February 2010 to October 2010, 9 replantations using the new incision and venous anastomosis technique were performed in 9 patients. The levels of amputations were from the nail base to half of the nail bed. After repairing the proper digital arteries, a skin incision was made along the junction between the lateral nail fold and nail bed. Careful dissection was performed to isolate the veins in the lateral nail fold. After evaluation of the suitability of the vessel, venous anastomosis was performed. Seven male and 2 female patients were enrolled in this study. Appropriate dorsal veins for anastomosis could be found in 8 of 9 patients. All the replanted stumps survived without venous congestion and following additional procedures. A sizable volar or dorsal vein could not be found in 1 patient. The salvage technique was required in this patient. Dorsal veins in the lateral nail fold can be found easily because of the constant anatomical location. The new incision on the lateral nail fold provides not only sufficient operative field for anastomosis but also additional opportunity of successful venous anastomosis in the selected cases. The authors, therefore, propose this technique as an effective method for an alternative venous anastomosis in the zone I replantation.

  3. Description and evaluation of a bench porcine model for teaching surgical residents vascular anastomosis skills

    Directory of Open Access Journals (Sweden)

    Jauch Karl-Walter

    2010-07-01

    Full Text Available Abstract Background Numerous models, of variable quality, exist to impart the complex skills required to perform vascular anastomosis. These models differ with regard to the kinds of materials used, as well as their sizes, the time needed for their preparation, their availability, and the associated costs. The present study describes a bench model that uses formalin-fixed porcine aorta, and its evaluation by young surgical residents during a recent skills course. Findings The aortic segments used were a by-product of slaughtering. They were fixed and stored after harvesting for eventual use. Ten young surgical residents participated, and each performed one end-to-side vascular anastomosis. The evaluation was a questionnaire maintaining anonymity of the participant containing questions addressing particular aspects of the model and the experiences of the trainee, along with their ratings concerning the need for a training course to learn vascular anastomosis techniques. The scoring on the survey was done using a global 6-point rating scale (Likert Scale. In addition, we ranked the present model by reviewing the current literature for models that address vascular anastomosis skills. The trainees who participated were within their first two years of training (1.25 ± 0.46. A strong agreement in terms of the necessity of training for vascular anastomosis techniques was evident among the participating trainees (5.90 ± 0.32, who had only few prior manual experiences (total number 1.50 ± 0.53. The query revealed a strong agreement that porcine aorta is a suitable model that fits the needs for training vascular anastomosis skills (5.70 ± 0.48. Only a few bench models designed to teach surgical residents vascular anastomosis techniques were available in the literature. Conclusions The preparatory and financial resources needed to perform anastomosis skills training using porcine aorta are few. The presented bench model appears to be appropriate for

  4. Anastomosis behavior differs between asymbiotic and symbiotic hyphae of Rhizophagus clarus.

    Science.gov (United States)

    Purin, Sonia; Morton, Joseph B

    2013-01-01

    The life history of arbuscular mycorrhizal fungi (AMF, Glomeromycota) consists of a short asymbiotic phase when spores germinate and a longer symbiotic phase where hyphae form a network within roots and subsequently in the rhizosphere. Hyphal anastomosis contributes to colony formation, yet this process has been studied mostly in the asymbiotic phase rather than in mycorrhizal plants because of methodological limitations. We sought to compare patterns of anastomosis during each phase of fungal growth by measuring hyphal fusions in genetically identical and different single spore isolates of Rhizophagus clarus from different environments and geographic locations. These isolates were genotyped with two anonymous markers of microsatellite-flanking regions. Anastomosis of hyphae from germinating spores was examined in axenic Petri dishes. A rhizohyphatron consisting of agar-coated glass slides bridging single or paired mycorrhizal sorghum plants allowed evaluation of anastomosis of symbiotic hyphae. Anastomosis of hyphae within a colony, defined here as a mycelium from an individual germinating spore or from mycorrhizal roots of one plant, occurred with similar frequencies (8-38%). However, anastomosis between paired colonies was observed in germinating spores from either genetically identical or different isolates, but it was never detected in symbiotic hyphae. The frequency of anastomosis in asymbiotic hyphae from paired interactions was low, occurring in fewer than 6% of hyphal contacts. These data suggest that anastomosis is relatively unconstrained when interactions occur within a colony but is confined to asymbiotic hyphae when interactions occur between paired colonies. This pattern of behavior suggests that asymbiotic and symbiotic phases of mycelium development by R. clarus may differ in function. Anastomosis in the asymbiotic phase may provide brief opportunities for gene flow between populations of this and possibly other AMF species.

  5. Robot-assisted Ivor-Lewis esophagectomy with intrathoracic robot-sewn anastomosis.

    Science.gov (United States)

    Jin, Runsen; Xiang, Jie; Han, Dingpei; Zhang, Yajie; Li, Hecheng

    2017-11-01

    This video clip demonstrated a performance of robot-assisted Ivor-Lewis esophagectomy with intrathoracic robot-sewn anastomosis. The patient had an esophageal mass located approximately 33 cm away from incisor, and robot-assisted Ivor-Lewis esophagectomy was applied for him. Importantly, a double-layer esophago-gastric anastomosis was made by robotic hand-sewn suture. Our early experience demonstrated that the robot-sewn intrathoracic anastomosis is feasible and safe with a lower complication rate and the absence of anastomotic leakage.

  6. Fingertip replantation using a single volar arteriovenous anastomosis and drainage with a transverse tip incision.

    Science.gov (United States)

    Yabe, T; Muraoka, M; Motomura, H; Ozawa, T

    2001-11-01

    Four cases of fingertip replantation using a single volar arteriovenous anastomosis and drainage with a transverse tip incision are reported. Because of lack of suitable arteries for anastomosis in the amputated finger, in each case a volar radial vein was anastomosed to the proximal digital artery and external drainage was performed through a transverse tip incision. In 3 cases the replanted fingertip survived completely; partial necrosis occurred in 1 case. Because veins are more superficial and larger than arteries, they are more available for anastomosis. The results indicate that this method is a useful alternative in fingertip replantation.

  7. Comprehensive Analysis of Chicken Vessels as Microvascular Anastomosis Training Model

    Directory of Open Access Journals (Sweden)

    Bo Young Kang

    2017-01-01

    Full Text Available BackgroundNonliving chickens are commonly used as a microvascular anastomosis training model. However, previous studies have investigated only a few types of vessel, and no study has compared the characteristics of the various vessels. The present study evaluated the anatomic characteristics of various chicken vessels as a training model.MethodsEight vessels—the brachial artery, basilic vein, radial artery, ulnar artery, ischiatic artery and vein, cranial tibial artery, and common dorsal metatarsal artery—were evaluated in 26 fresh chickens and 30 chicken feet for external diameter (ED and thicknesses of the tunica adventitia and media. The dissection time from skin incision to application of vessel clamps was also measured.ResultsThe EDs of the vessels varied. The ischiatic vein had the largest ED of 2.69±0.33 mm, followed by the basilic vein (1.88±0.36 mm, ischiatic artery (1.68±0.24 mm, common dorsal metatarsal artery (1.23±0.23 mm, cranial tibial artery (1.18±0.19 mm, brachial artery (1.08±0.15 mm, ulnar artery (0.82±0.13 mm, and radial artery (0.56±0.12 mm, and the order of size was consistent across all subjects. Thicknesses of the tunica adventitia and media were also diverse, ranging from 74.09±19.91 µm to 158.66±40.25 µm (adventitia and from 31.2±7.13 µm to 154.15±46.48 µm (media, respectively. Mean dissection time was <3 minutes for all vessels.ConclusionsOur results suggest that nonliving chickens can provide various vessels with different anatomic characteristics, which can allow trainees the choice of an appropriate microvascular anastomosis training model depending on their purpose and skillfulness.

  8. [VEGF expression in dog retina after chorioretinal venous anastomosis].

    Science.gov (United States)

    Lu, Ning; Li, Zhihui; Sun, Xianli; Wang, Guanglu; Zhang, Feng; Peng, Xiaoyan

    2002-09-01

    To identify changes in vascular endothelial growth factor (VEGF) expression in the dog retina after laser-induced chorioretinal venous anastomosis (CRVA), in order to find out the relationship between CRVA treatment and the related neovascular complications. Immediately after branch retinal vein occlusion (BRVO) model was made in 5 eyes of 5 normal dogs, CRVA treatment was done over a small tributary vein in the drainage distribution of the occluded vein. In each eye, there were 2 - 3 treatment sites. Four to six weeks later, a repeated treatment was given if the first treatment failed to show the anastomosis. The treatment sites with successful CRVA were divided into two groups: the small laser spot group, which received one treatment and the big laser spot group, which received more than one treatment. The expression of VEGF was investigated immunohistochemically in the treatment sites with successful anastomoses and in the 5 normal fellow eyes (control). There were totally 10 successful anastomoses in the 5 experimental eyes, among which, five received one treatment and the other 5 received more than one treatment. On fundus examination, the small laser spots were round and small, and the big laser spots were large with local proliferation. VEGF immunoreactivity was absent/weak in the normal dog retina, and remained unchanged in the small laser spot group, but somewhat increased in the big laser spot group. No neovascular complications occurred. All immunostaining experiments were accompanied by proper controls and none of the negative controls showed any immunoreactivity. Proper laser treatment can induce CRVA quite safely in nonischemic dog retina, which does not cause changes in the expression of VEGF, but severe laser damage in the treatment site can cause increased VEGF expression which may be related to neovascular complications.

  9. Hemodynamic evaluation before and after the STA-MCA anastomosis

    International Nuclear Information System (INIS)

    Touho, Hajime; Karasawa, Jun; Shishido, Hisashi; Yamada, Keisuke; Shibamoto, Keiji

    1990-01-01

    Twenty-seven patients with minor completed and major stroke in the chronic stage underwent superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis. The regional cerebral blood flow (rCBF), using inhalation of stable xenon and computed tomographic scanning (Xe s CT-CBF study), and the mode of transit time (MTT) in the MCA territory using intra-arterial digital aortography were measured. Activated rCBF and MTT was measured 20 minutes after the administration of acetazolamide (10 mg/kg) in 14 patients. Nineteen of the 23 patients with minor stroke (Group 1) showed immediate improvement in their neurological state within a few days of the operation, while four patients with minor stroke (Group 2) and four patients with major stroke (Group 3) showed no improvement. Based on the rCBF obtained with the Xe s CT-CBF study, affected side rCBF/unaffected side rCBF and %f [(peak DSA number/affected side MTT)/(peak DSA number/unaffected side MTT)] were compared. There was a significant positive correlation. Affected side MTT in Group 1 was 6.41±1.16 sec, preoperatively, and significantly decreased to 5.13±0.91 sec after the operation. On the other hand, preoperative MTT in Group 2 was 4.40±0.81 sec and 4.76±0.89 sec, postoperatively. Preoperative %f in Group 1 was 0.514±0.143 and significantly increased to 0.739±0.154, postoperatively. Group 2 showed no change. Vasodilatory capacity with acetazolamide showed a marked improvement in Group 1, postoperativery. Our study indicated that if MTT is moderately lengthened, %f is moderately decreased, and vasodilatory capacity is impaired, in patients with minor ischemic stroke will benefit from STA-MCA anastomosis. (author)

  10. Myofibroblasts and colonic anastomosis healing in Wistar rats

    Directory of Open Access Journals (Sweden)

    Vasiliadou Kalliopi

    2011-03-01

    Full Text Available Abstract Background The myofibroblasts play a central role in wound healing throughout the body. The process of wound healing in the colon was evaluated with emphasis on the role of myofibroblasts. Methods One hundred male Wistar rats weighing 274 ± 9.1 g (mean age: 3.5 months were used. A left colonic segment was transected and the colon was re-anastomosed. Animals were randomly divided into two groups. The first group experimental animals (n = 50 were sacrificed on postoperative day 3, while the second group rats (n = 50 were sacrificed on postoperative day 7. Healing of colonic anastomosis was studied in terms of anastomotic bursting pressure, as well as myofibroblastic reaction and expression of α-smooth muscle actin (α-SMA, adhesion formation, inflammatory reaction and neovascularization. Results The mean anastomotic bursting pressure increased from 20.6 ± 3.5 mmHg on the 3rd postoperative day to 148.8 ± 9.6 Hg on the 7th postoperative day. Adhesion formation was increased on the 7th day, as compared to the 3rd day. In addition, the myofibroblastic reaction was more profound on the 7th postoperative day in comparison with the 3rd postoperative day. The staining intensity for α-SMA was progressive from the 3rd to the 7th postoperative day. On the 7th day the α-SMA staining in the myofibroblats reached the level of muscular layer cells. Conclusions Our study emphasizes the pivotal role of myofibroblasts in the process of colonic anastomosis healing. The findings provide an explanation for the reduction in the incidence of wound dehiscence after the 7th postoperative day.

  11. Fingertip Reconstruction Using Free Toe Tissue Transfer Without Venous Anastomosis

    Directory of Open Access Journals (Sweden)

    Won Young Yoon

    2012-09-01

    Full Text Available BackgroundThis study was designed to introduce the feasibility of toe tissue transfer without venous outflow for fingertip reconstruction.MethodsFive cases of fingertip defects were treated successfully with this method. Four cases were traumatic fingertip defects, and one case was a hook-nail deformity. The lateral pulp of a great toe or medioinferior portion of a second toe was used as the donor site. An arterial pedicle was dissected only within the digit and anastomosis was performed within 2 cm around the defect margin. The digital nerve was repaired simultaneously. No additional dissection of the dorsal or volar pulp vein was performed in either the donor or recipient sites. Other surgical procedures were performed following conventional techniques. Postoperative venous congestion was monitored with pulp temperature, color, and degree of tissue oxygen saturation. Venous congestion was decompressed with a needle-puncture method intermittently, but did not require continuous external bleeding for salvage.ResultsVenous congestion was observed in all the flaps, but improved within 3 or 4 days postoperatively. The flap size was from 1.5×1.5 cm2 to 2.0×3.0 cm2. The mean surgical time was 2 hours and 20 minutes. A needle puncture was carried out every 2 hours during the first postoperative day, and then every 4 hours thereafter. The amount of blood loss during each puncture procedure was less than 0.2 mL. In the long-term follow-up, no flap atrophy was observed.ConclusionsWhen used properly, the free toe tissue transfer without venous anastomosis method can be a treatment option for small defects on the fingertip area.

  12. Origins Space Telescope

    Science.gov (United States)

    Cooray, Asantha; Origins Space Telescope Study Team

    2018-01-01

    The Origins Space Telescope (OST) is the mission concept for the Far-Infrared Surveyor, a study in development by NASA in preparation for the 2020 Astronomy and Astrophysics Decadal Survey. Origins is planned to be a large aperture, actively-cooled telescope covering a wide span of the mid- to far-infrared spectrum. Its spectrographs will enable 3D surveys of the sky that will discover and characterize the most distant galaxies, Milky-Way, exoplanets, and the outer reaches of our Solar system. Origins will enable flagship-quality general observing programs led by the astronomical community in the 2030s. The Science and Technology Definition Team (STDT) would like to hear your science needs and ideas for this mission. The team can be contacted at firsurveyor_info@lists.ipac.caltech.edu. This presentation will provide a summary of the OST STDT, our completed first mission concept and an introduction to the second concept that will be studied at the study center in 2018. This presentation will also summarize key science drivers and the key study milestones between 2018 and 2020.

  13. The GRASP telescope

    Science.gov (United States)

    Bignami, G. F.; Dean, A. J.; Durouchoux, Ph.; Hurley, K.; Lund, N.; McBreen, B.; Schönfelder, V.; Swanenburg, B. N.; Tomaschek, G.; Winkler, C.

    1989-01-01

    The GRASP mission Gamma-Ray Astronomy with Spectroscopy and Positioning addresses the scientific goals of fine spectroscopy with imaging and accurate positioning of gamma-ray sources, an unexplored area within gamma-ray astronomy. The assessment of GRASP as a future space astronomy mission in the mid-1990s has led to the design of the instrument outlined in this article. Thus GRASP is a third generation gamma-ray telescope and is designed to operate as a high quality spectral imager in the mid-1990s, when, following the GRO, SIGMA, and GAMMA-1 missions, there will be requirement for a more sophisticated instrument to maintain the momentum of advance in gamma-ray astronomy. The telescope will be capable of locating point sources with a precision of typically 1 arc min, whilst making a fine spectral analysis (E/ΔE ˜ 1000) of any gamma-ray line features. The high sensitivity of this instrument and the long (> 2 year) lifetime of the mission will enable a large number (˜ 1000) of astronomical objects to be studied. The GRASP mission has the potential to move gamma-ray astronomy from an era of basic exploration to one in which detailed and novel measurements can be used to gain a better understanding of many astrophysical problems.

  14. Antares Reference Telescope System

    International Nuclear Information System (INIS)

    Viswanathan, V.K.; Kaprelian, E.; Swann, T.; Parker, J.; Wolfe, P.; Woodfin, G.; Knight, D.

    1983-01-01

    Antares is a 24-beam, 40-TW carbon-dioxide laser-fusion system currently nearing completion at the Los Alamos National Laboratory. The 24 beams will be focused onto a tiny target (typically 300 to 1000 μm in diameter) located approximately at the center of a 7.3-m-diameter by 9.3-m-long vacuum (10 - 6 torr) chamber. The design goal is to position the targets to within 10 μm of a selected nominal position, which may be anywhere within a fixed spherical region 1 cm in diameter. The Antares Reference Telescope System is intended to help achieve this goal for alignment and viewing of the various targets used in the laser system. The Antares Reference Telescope System consists of two similar electro-optical systems positioned in a near orthogonal manner in the target chamber area of the laser. Each of these consists of four subsystems: (1) a fixed 9X optical imaging subsystem which produces an image of the target at the vidicon; (2) a reticle projection subsystem which superimposes an image of the reticle pattern at the vidicon; (3) an adjustable front-lighting subsystem which illuminates the target; and (4) an adjustable back-lighting subsystem which also can be used to illuminate the target. The various optical, mechanical, and vidicon design considerations and trade-offs are discussed. The final system chosen (which is being built) and its current status are described in detail

  15. Deep space telescopes

    CERN Multimedia

    CERN. Geneva

    2006-01-01

    The short series of seminars will address results and aims of current and future space astrophysics as the cultural framework for the development of deep space telescopes. It will then present such new tools, as they are currently available to, or imagined by, the scientific community, in the context of the science plans of ESA and of all major world space agencies. Ground-based astronomy, in the 400 years since Galileo’s telescope, has given us a profound phenomenological comprehension of our Universe, but has traditionally been limited to the narrow band(s) to which our terrestrial atmosphere is transparent. Celestial objects, however, do not care about our limitations, and distribute most of the information about their physics throughout the complete electromagnetic spectrum. Such information is there for the taking, from millimiter wavelengths to gamma rays. Forty years astronomy from space, covering now most of the e.m. spectrum, have thus given us a better understanding of our physical Universe then t...

  16. Cost Modeling for Space Telescope

    Science.gov (United States)

    Stahl, H. Philip

    2011-01-01

    Parametric cost models are an important tool for planning missions, compare concepts and justify technology investments. This paper presents on-going efforts to develop single variable and multi-variable cost models for space telescope optical telescope assembly (OTA). These models are based on data collected from historical space telescope missions. Standard statistical methods are used to derive CERs for OTA cost versus aperture diameter and mass. The results are compared with previously published models.

  17. [Robotic-assisted minimally invasive abdominothoracal oesophageal resection with intrathoracic anastomosis].

    Science.gov (United States)

    Egberts, J-H; Aselmann, H; Schafmayer, C; Jünemann, K-P; Becker, T

    2014-02-01

    Ivor Lewis oesophagectomy is one of the approaches used worldwide for treating oesophageal cancer. The adoption of minimally invasive oesophagectomy has increased worldwide since its first description more than 15 years ago. However, minimally invasive oesophagectomy with a chest anastomosis has advantages. By using a four-arm robotic platform, not only the preparation of the gastric tube and mobilisation of the oesophagus but also the intrathoracic anastomosis of the oesophagogastrostomy can be performed in a comfortable and safe way. The indication for oesophageal resection is oesophageal cancer. The operative procedure comprises robotic-assisted abdominothoracal oesophageal resection with reconstruction by a gastric tube and intrathoracic anastomosis (Ivor Lewis procedure). Robotic abdominal and thoracic minimally invasive esophagectomy is feasible, and safe with a complete lymph node dissection. Especially the intrathoracic anastomosis of the oesophagogastrostomy can be performed in a comfortable and safe way. Georg Thieme Verlag KG Stuttgart · New York.

  18. Tracheal resection and anastomosis after traumatic tracheal stenosis in a horse.

    Science.gov (United States)

    Barnett, Timothy P; Hawkes, Claire S; Dixon, Padraic M

    2015-02-01

    To report a resection and anastomosis technique to treat trauma-induced tracheal stenosis. Case report. A 9-year-old Warmblood gelding. Endoscopy, radiography, and ultrasonography were used to diagnose a single ring tracheal stenosis; the stenotic region was resected and adjacent tracheal rings anastomosed with an end-to-end technique. The anastomosis healed completely despite formation of a unilateral partial mucosal stenosis "web," which was subsequently removed by transendoscopic laser surgery. During tracheal anastomosis, the left recurrent laryngeal nerve was damaged, causing laryngeal hemiplegia, later treated successfully by laryngoplasty. The horse returned to its previous level of work. This tracheal resection and anastomosis technique successfully provided the horse with a large tracheal lumen, and despite major complications, allowed a return to full athletic work. © Copyright 2014 by The American College of Veterinary Surgeons.

  19. J-pouch ileoanal anastomosis in children and adolescents with ulcerative colitis

    DEFF Research Database (Denmark)

    Wewer, Vibeke; Hesselfeldt, Peter; Qvist, Niels

    2005-01-01

    OBJECTIVES: The aim of this study was to evaluate, over a 10-year period, severe surgical complications, functional outcome, patient satisfaction and impact on social life after colectomy and J-pouch ileoanal anastomosis for children and adolescents

  20. The use of pigs both intact and with ileo-rectal anastomosis to ...

    African Journals Online (AJOL)

    The use of pigs both intact and with ileo-rectal anastomosis to estimate the apparent and true digestibility of amino acids in untreated, heat-treated and thermal-ammoniated high-tannin grain sorghum.

  1. The metagenomic telescope.

    Directory of Open Access Journals (Sweden)

    Balázs Szalkai

    Full Text Available Next generation sequencing technologies led to the discovery of numerous new microbe species in diverse environmental samples. Some of the new species contain genes never encountered before. Some of these genes encode proteins with novel functions, and some of these genes encode proteins that perform some well-known function in a novel way. A tool, named the Metagenomic Telescope, is described here that applies artificial intelligence methods, and seems to be capable of identifying new protein functions even in the well-studied model organisms. As a proof-of-principle demonstration of the Metagenomic Telescope, we considered DNA repair enzymes in the present work. First we identified proteins in DNA repair in well-known organisms (i.e., proteins in base excision repair, nucleotide excision repair, mismatch repair and DNA break repair; next we applied multiple alignments and then built hidden Markov profiles for each protein separately, across well-researched organisms; next, using public depositories of metagenomes, originating from extreme environments, we identified DNA repair genes in the samples. While the phylogenetic classification of the metagenomic samples are not typically available, we hypothesized that some very special DNA repair strategies need to be applied in bacteria and Archaea living in those extreme circumstances. It is a difficult task to evaluate the results obtained from mostly unknown species; therefore we applied again the hidden Markov profiling: for the identified DNA repair genes in the extreme metagenomes, we prepared new hidden Markov profiles (for each genes separately, subsequent to a cluster analysis; and we searched for similarities to those profiles in model organisms. We have found well known DNA repair proteins, numerous proteins with unknown functions, and also proteins with known, but different functions in the model organisms.

  2. Early experience of the compression anastomosis ring (CARTM 27) in left-sided colon resection

    Science.gov (United States)

    Lee, Jung-Yeon; Woo, Jin-Hee; Choi, Hong-Jo; Park, Ki-Jae; Roh, Young-Hoon; Kim, Ki-Han; Lee, Hak-Yoon

    2011-01-01

    AIM: To evaluate clinical validity of the compression anastomosis ring (CAR™ 27) anastomosis in left-sided colonic resection. METHODS: A non-randomized prospective data collection was performed for patients undergoing an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27 between November 2009 and January 2011. Eligibility criteria of the use of the CAR™ 27 were anastomoses between the colon and at or above the intraperitoneal rectum. The primary short-term clinical endpoint, rate of anastomotic leakage, and other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the ring elimination time were evaluated. RESULTS: A total of 79 patients (male, 43; median age, 64 years) underwent an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27. Colectomy was performed laparoscopically in 70 patients, in whom two patients converted to open procedure (2.9%). There was no surgical mortality. As an intraoperative complication, total disruption of the anastomosis occurred by premature enforced tension on the proximal segment of the anastomosis in one patient. The ring was removed and another new CAR™ 27 anastomosis was constructed. One patient with sigmoid colon cancer showed postoperative anastomotic leakage after 6 d postoperatively and temporary diverting ileostomy was performed. Exact date of expulsion of the ring could not be recorded because most patients were not aware that the ring had been expelled. No patients manifested clinical symptoms of anastomotic stricture. CONCLUSION: Short-term evaluation of the CAR™ 27 anastomosis in elective left colectomy suggested it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique. PMID:22147979

  3. Early experience of the compression anastomosis ring (CAR™ 27) in left-sided colon resection.

    Science.gov (United States)

    Lee, Jung-Yeon; Woo, Jin-Hee; Choi, Hong-Jo; Park, Ki-Jae; Roh, Young-Hoon; Kim, Ki-Han; Lee, Hak-Yoon

    2011-11-21

    To evaluate clinical validity of the compression anastomosis ring (CAR™ 27) anastomosis in left-sided colonic resection. A non-randomized prospective data collection was performed for patients undergoing an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27 between November 2009 and January 2011. Eligibility criteria of the use of the CAR™ 27 were anastomoses between the colon and at or above the intraperitoneal rectum. The primary short-term clinical endpoint, rate of anastomotic leakage, and other clinical outcomes, including intra- and postoperative complications, length of operation time and hospital stay, and the ring elimination time were evaluated. A total of 79 patients (male, 43; median age, 64 years) underwent an elective left-sided colon resection, followed by an anastomosis using the CAR™ 27. Colectomy was performed laparoscopically in 70 patients, in whom two patients converted to open procedure (2.9%). There was no surgical mortality. As an intraoperative complication, total disruption of the anastomosis occurred by premature enforced tension on the proximal segment of the anastomosis in one patient. The ring was removed and another new CAR™ 27 anastomosis was constructed. One patient with sigmoid colon cancer showed postoperative anastomotic leakage after 6 d postoperatively and temporary diverting ileostomy was performed. Exact date of expulsion of the ring could not be recorded because most patients were not aware that the ring had been expelled. No patients manifested clinical symptoms of anastomotic stricture. Short-term evaluation of the CAR™ 27 anastomosis in elective left colectomy suggested it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique.

  4. Comparison of laparoscopic and conventional surgery of intestinal anastomosis in dogs

    OpenAIRE

    O. J. Ali; B. T. Abass

    2008-01-01

    The aim of this study was to evaluate operative laparoscopy in comparison with conventional laparotomy for intestinal resection and anastomosis in dogs. Eighteen adult dogs were equally and randomly divided into 3 groups: Group I: Intestinal anastomosis was performed extracorporeally, by laparoscopic-assisted surgery, in which a 5cm loop of small bowel was exteriorized through a mini-laparotomy opening (an enlarged trocar incision 1.5-2 cm in length), then surgically resected and anastomosed ...

  5. Fingertip replantation (zone I) without venous anastomosis: clinical experience and outcome analysis

    OpenAIRE

    Huan, An-shi; Regmi, Subhash; Gu, Jia-xiang; Liu, Hong-jun; Zhang, Wen-zhong

    2016-01-01

    Purpose The purpose of this study was to report our experience of fingertip replantation without venous anastomosis using alternate method to counter post-operative venous congestion. Methods 30 Patients (18 men and 12 women) with 30 fingertip amputations (Tamai zone I) were treated with artery-only anastomosis fingertip replantation between March 2010 and July 2014. Postoperative venous outflow was maintained by allowing bleeding through wound gaps combined with topical (12500u:250mlNS) and ...

  6. Esophageal-gastric anastomosis in radical resection of esophageal cancer under thoracoscopy combined with laparoscopy.

    Science.gov (United States)

    Hao, Zhang; Zhenya, Shen; Lei, Wang

    2014-10-01

    To determine the feasibility of esophagogastric anastomosis in esophageal cancer radical resection under thoracoscopy combined with laparoscopy in terms of complications and operation time. Experimental study. Department of Thoracic Surgery, Affiliated with The First Hospital, Suzhou University, from June 2008 to June 2012. Clinical data of 136 patients operated for esophageal cancer by radical resection under thoracoscopy combined with laparoscopy was analyzed. Eighty one superior and middle segment esophageal carcinoma patients were operated through right thoracoscope, abdominoscope, and neck incision. The esophagogastric anastomosis was completed in the left side of neck by handiwork. Fifty five inferior segment esophageal carcinoma were operated through right thoracoscope, abdominoscope and the esophagogastric anastomosis was completed with stapler in right thoracic cavity through superior belly incision and diaphragmatic hiatus. The operation time and the intra-operative blood loss in patients with intrathoracic mechanical anastomosis was significantly lower than that of cervical anastomosis. Other variables were not significantly different. The practicability of this method of anastomosis that completed with stapler in right thoracic cavity through superior belly incision and diaphragmatic hiatus had been well confirmed.

  7. Esophageal - Gastric Anastomosis in Radical Resection of Esophageal Cancer under Thoracoscopy Combined with Laparoscopy

    International Nuclear Information System (INIS)

    Hao, Z.; Lei, W.; Zhenya, S.

    2014-01-01

    Objective: To determine the feasibility of esophagogastric anastomosis in esophageal cancer radical resection under thoracoscopy combined with laparoscopy in terms of complications and operation time. Study Design: Experimental study. Place and Duration of Study: Department of Thoracic Surgery, Affiliated with The First Hospital, Suzhou University, from June 2008 to June 2012. Methodology: Clinical data of 136 patients operated for esophageal cancer by radical resection under thoracoscopy combined with laparoscopy was analyzed. Eighty one superior and middle segment esophageal carcinoma patients were operated through right thoracoscope, abdominoscope, and neck incision. The esophagogastric anastomosis was completed in the left side of neck by handiwork. Fifty five inferior segment esophageal carcinoma were operated through right thoracoscope, abdominoscope and the esophagogastric anastomosis was completed with stapler in right thoracic cavity through superior belly incision and diaphragmatic hiatus. Results: The operation time and the intra-operative blood loss in patients with intrathoracic mechanical anastomosis was significantly lower than that of cervical anastomosis. Other variables were not significantly different. Conclusion: The practicability of this method of anastomosis that completed with stapler in right thoracic cavity through superior belly incision and diaphragmatic hiatus had been well confirmed. (author)

  8. Deep organ space infection after emergency bowel resection and anastomosis: The anatomic site does not matter.

    Science.gov (United States)

    Benjamin, Elizabeth; Siboni, Stefano; Haltmeier, Tobias; Inaba, Kenji; Lam, Lydia; Demetriades, Demetrios

    2015-11-01

    Deep organ space infection (DOSI) is a serious complication after emergency bowel resection and anastomosis. The aim of this study was to identify the incidence and risk factors for the development of DOSI. National Surgical Quality Improvement Program database study including patients who underwent large bowel or small bowel resection and primary anastomosis. The incidence, outcomes, and risk factors for DOSI were evaluated using univariate and multivariate analyses. A total of 87,562 patients underwent small bowel, large bowel, or rectal resection and anastomosis. Of these, 14,942 (17.1%) underwent emergency operations and formed the study population. The overall mortality rate in emergency operations was 12.5%, and the rate of DOSI was 5.6%. A total of 18.0% required ventilatory support in more than 48 hours, and 16.0% required reoperation. Predictors of DOSI included age, steroid use, sepsis or septic shock on admission, severe wound contamination, and advanced American Society of Anesthesiologists classification. The anatomic location of resection and anastomosis was not significantly associated with DOSI. Patients undergoing emergency bowel resection and anastomosis have a high mortality, risk of DOSI, and systemic complications. Independent predictors of DOSI include wound and American Society of Anesthesiologists classification, sepsis or septic shock on admission, and steroid use. The anatomic location of resection and anastomosis was not significantly associated with DOSI. Epidemiologic/prognostic study, level III.

  9. Basic interrupted versus continuous suturing techniques in bronchial anastomosis following sleeve lobectomy in dogs.

    Science.gov (United States)

    Bayram, Ahmet Sami; Erol, Mehmet Muharrem; Salci, Hakan; Ozyiğit, Ozgür; Görgül, Sacit; Gebitekin, Cengiz

    2007-12-01

    Sleeve resection with or without lung resection is a valid conservative operation for patients with benign or malignant tumors; it enables the preservation of lung parenchyma. The aim of this prospective randomized study was to compare complications, operating time, and bronchial healing between the techniques of interrupted and continuous suturing for bronchial anastomosis in dogs. Twenty adult mongrel dogs each weighing 18-22 kg (average: 20 kg) were divided into two groups according to the anastomosis technique performed: group A, interrupted suturing and group B, continuous suturing. Each group comprised of 10 dogs. Following right thoracotomy, sleeve resection of the right cranial lobe was performed in all dogs. Basic interrupted sutures using 4/0 Vicryl (Ethicon, USA) were used in group A, and continuous sutures were used in group B. The median anastomosis time was 15.2 min (range: 13-21 min) in group A and 9.6 min (range: 8-13 min) in group B. In all dogs, the anastomosis line was resected via right pneumonectomy for histopathological investigation 1 month after sleeve resection. Histopathological examination revealed that the healing of the anastomosis was not affected by the suturing technique applied. One dog from each group died on the fourth postoperative day; Fisher's exact test, p=0.763. Our research revealed that the healing of the anastomosis was not affected by the suturing technique performed.

  10. Fingertip Replantation Without and With Palmar Venous Anastomosis: Analysis of the Survival Rates and Vein Distribution.

    Science.gov (United States)

    Aksoy, Alper; Gungor, Melike; Sir, Emin

    2017-01-01

    The purpose of this study was to compare the results of fingertip replantations without (artery anastomosis only replantations) and with venous anastomosis (replantations in which both arterial and palmar venous anastomoses were performed). Also, distribution of the veins used for anastomosis was analyzed retrospectively. First 53 digits (47 patients) received only arterial anastomosis (group 1). For relieving venous congestion, external bleeding method was used. Last 41 digits (38 patients) received both arterial and palmar venous anastomoses without external bleeding (group 2). There was statistical significance of the survival rate between group 1 [77.3% (41/53)] and group 2 [92.6% (38/41)] (P = 0.039). Venous congestion was encountered at 10 digits in group 1 (all underwent necrosis totally) and at 3 digits in group 2 (both were moderate and could be salvaged partially) (P = 0.094, no statistical significance). There was statistical significance of the mean operation time for single-fingertip replantation between group 1 (80 ± 7.8 minutes) and group 2 (105 ± 14.5 minutes) (P replantations with palmar venous anastomosis have simpler postoperative care and lower drawbacks as compared with artery anastomosis-only replantations.

  11. The preparation of anastomosis site at the insular segment of middle cerebral artery.

    Science.gov (United States)

    Katsuno, Makoto; Tanikawa, Rokuya; Izumi, Naoto; Hashimoto, Masaaki

    2014-01-01

    An anastomosis at the insular segment of the middle cerebral artery (M2) is often required in cerebral reconstruction with high- or low-flow bypass. It is necessary to create a shallow, wide, fixed, and bloodless anastomosis field to achieve a safe and quick anastomosis for low surgical morbidity. We describe a method to perform a safe and quick anastomosis. From 2009 to 2013, the technique was used in 20 procedures to create an extracranial M2 high-flow bypass. The Sylvian fissure was dissected wide open to expose the M2. A silicon sheet was laid under M2 and the absorbable gelatin-compressed sponges were inserted between M2 and the insula cortex to lift up the M2 and fix it. The rolling surgical sheets were placed at each edge of the dissected Sylvian fissure, instead of brain spatulas. Finally, a small suction tube was placed at the Sylvian fissure and cerebrospinal fluid was continuously sucked. The postoperative patency of the bypass was evaluated by three-dimensional computed tomographic angiography (3D-CTA) in the acute and chronic stages. In all cases, the operation field acquired for the anastomosis was adequate. The average time required for the procedure was 19 min 27 s. Good patency of all high-flow grafts was confirmed by postoperative three-dimensional computed tomography angiography (3D-CTA). In our series, there were no technical complications related to the anastomosis at M2 performed according to our method.

  12. Dutch Open Telescope: Status and Prospects

    NARCIS (Netherlands)

    Rutten, R.J.; Hammerschlag, R.H.; Bettonvil, F.C.M.

    1997-01-01

    The Dutch Open Telescope represents a new solar telescope concept. Being open rather than evacuated, it leads the way to large- aperture high resolution telescopes. It is now being installed on La Palma.

  13. Seismic Imager Space Telescope

    Science.gov (United States)

    Sidick, Erkin; Coste, Keith; Cunningham, J.; Sievers,Michael W.; Agnes, Gregory S.; Polanco, Otto R.; Green, Joseph J.; Cameron, Bruce A.; Redding, David C.; Avouac, Jean Philippe; hide

    2012-01-01

    A concept has been developed for a geostationary seismic imager (GSI), a space telescope in geostationary orbit above the Pacific coast of the Americas that would provide movies of many large earthquakes occurring in the area from Southern Chile to Southern Alaska. The GSI movies would cover a field of view as long as 300 km, at a spatial resolution of 3 to 15 m and a temporal resolution of 1 to 2 Hz, which is sufficient for accurate measurement of surface displacements and photometric changes induced by seismic waves. Computer processing of the movie images would exploit these dynamic changes to accurately measure the rapidly evolving surface waves and surface ruptures as they happen. These measurements would provide key information to advance the understanding of the mechanisms governing earthquake ruptures, and the propagation and arrest of damaging seismic waves. GSI operational strategy is to react to earthquakes detected by ground seismometers, slewing the satellite to point at the epicenters of earthquakes above a certain magnitude. Some of these earthquakes will be foreshocks of larger earthquakes; these will be observed, as the spacecraft would have been pointed in the right direction. This strategy was tested against the historical record for the Pacific coast of the Americas, from 1973 until the present. Based on the seismicity recorded during this time period, a GSI mission with a lifetime of 10 years could have been in position to observe at least 13 (22 on average) earthquakes of magnitude larger than 6, and at least one (2 on average) earthquake of magnitude larger than 7. A GSI would provide data unprecedented in its extent and temporal and spatial resolution. It would provide this data for some of the world's most seismically active regions, and do so better and at a lower cost than could be done with ground-based instrumentation. A GSI would revolutionize the understanding of earthquake dynamics, perhaps leading ultimately to effective warning

  14. Operating a heterogeneous telescope network

    Science.gov (United States)

    Allan, Alasdair; Bischoff, Karsten; Burgdorf, Martin; Cavanagh, Brad; Christian, Damien; Clay, Neil; Dickens, Rob; Economou, Frossie; Fadavi, Mehri; Frazer, Stephen; Granzer, Thomas; Grosvenor, Sandy; Hessman, Frederic V.; Jenness, Tim; Koratkar, Anuradha; Lehner, Matthew; Mottram, Chris; Naylor, Tim; Saunders, Eric S.; Solomos, Nikolaos; Steele, Iain A.; Tuparev, Georg; Vestrand, W. Thomas; White, Robert R.; Yost, Sarah

    2006-06-01

    In the last few years the ubiquitous availability of high bandwidth networks has changed the way both robotic and non-robotic telescopes operate, with single isolated telescopes being integrated into expanding "smart" telescope networks that can span continents and respond to transient events in seconds. The Heterogeneous Telescope Networks (HTN)* Consortium represents a number of major research groups in the field of robotic telescopes, and together we are proposing a standards based approach to providing interoperability between the existing proprietary telescope networks. We further propose standards for interoperability, and integration with, the emerging Virtual Observatory. We present the results of the first interoperability meeting held last year and discuss the protocol and transport standards agreed at the meeting, which deals with the complex issue of how to optimally schedule observations on geographically distributed resources. We discuss a free market approach to this scheduling problem, which must initially be based on ad-hoc agreements between the participants in the network, but which may eventually expand into a electronic market for the exchange of telescope time.

  15. Acute Cholangitis After Bilioenteric Anastomosis for Bile Duct Injuries.

    Science.gov (United States)

    Ortiz-Brizuela, Edgar; Sifuentes-Osornio, José; Manzur-Sandoval, Daniel; Terán-Ellis, Santiago Mier Y; Ponce-de-León, Sergio; Torres-González, Pedro; Mercado, Miguel Ángel

    2017-10-01

    The study aims to describe the clinical features, microbiology, and associated factors of acute cholangitis (AC) after bilioenteric anastomosis (BEA) for biliary duct injury (BDI). Additionally, we assessed the performance of the Tokyo Guidelines 2013 (TG13) recommendations in these patients. We conducted a case-control study of 524 adults with a history of BEA for BDI from January 2000 to January 2014. A propensity score adjustment was performed for the analysis of the independent role of the main factors identified during the univariate logistic regression procedure. We identified 117 episodes of AC in 70 patients; 51.3% were definitive AC according to the TG13 diagnostic criteria, and 39.3% did not fulfill the imaging criteria of AC. A history of post-operative biliary complications (OR 2.55, 95% CI 1.38-4.70) and the bile duct confluence preservation (OR 0.46, 95% CI 0.24-0.87) were associated with AC. Eighty-nine percent of the microorganisms were Enterobacteriaceae; of them, 28% were extended spectrum β-lactamase (ESBL) producers. AC is a common complication after BEA and must be suspected even in the absence of imaging findings, particulary in patients with a history of post-operative biliary complications, and/or without bile duct confluence preserved. An empirical treatment for ESBL-producing Enterobacteriaceae may be appropriate in patients living in countries with a high rate of bacterial drug resistance.

  16. Case Report: Laparoscopic Uterovaginal Anastomosis for Congenital Isolated Cervical Agenesis.

    Science.gov (United States)

    Scibilia, Giuseppe; Pecorino, Basilio; Pagano, Isabella; Scollo, Paolo

    Management of cervical agenesis is a challenge owing to the complexity of the malformation and the difficulty in restoring and preserving fertility. We propose a minimally invasive fertility-sparing surgery for a 17-year-old woman with congenital cervical agenesis and a normal vagina and uterus confirmed by vaginoscopy. The patient was admitted for primary amenorrhea, hematometra, and cyclic pelvic pain. She had undergone previous laparoscopies for ovarian endometriosis. Our surgical approach involved the creation of an isthmus-vaginal anastomosis with a uterovaginal reconnection. After surgery, the patient experienced regular menstrual cycles without dysmenorrhea. At 12 months postsurgery, she continued to experience normal menstruation, and the uterovaginal connection had not stenosed. Management of congenital cervical agenesis requires accurate diagnosis that includes appropriate classification of the malformation (European Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy classification). Surgical treatment is controversial and depends on the patient's age and desire for resolution. Copyright © 2017 AAGL. Published by Elsevier Inc. All rights reserved.

  17. The effects of ghrelin on colonic anastomosis healing in rats

    Directory of Open Access Journals (Sweden)

    Canan Ceran

    2013-01-01

    Full Text Available OBJECTIVES: In addition to its roles in the stimulation of growth hormone secretion and the regulation of appetite and metabolism, ghrelin exerts immunomodulatory, anti-inflammatory and antioxidant actions in several organ systems. In this study, we investigated the effects of ghrelin on the healing of experimental colonic anastomoses. METHODS: Wistar rats were randomly divided into two groups (n = 10 in each. A segment of colon was excised, and an end-to-end anastomosis was performed in the distal colon. The Ghrelin Group received 10 ng/kg/day IP ghrelin for seven days postoperatively, whereas the Control Group received an identical volume of saline. On the seventh postoperative day, the anastomotic bursting pressures and hydroxyproline levels were measured, and adhesion formation around the anastomoses was examined. Histopathological analyses were performed to evaluate inflammatory cell infiltration, fibroblast infiltration, collagen density and neovascularization. RESULTS: In the Ghrelin Group, the bursting pressure and hydroxyproline levels were significantly higher than in the Control Group. The adhesion formation scores were lower in the Ghrelin Group than in the Control Group. Although the inflammatory cell infiltration was diminished in the Ghrelin Group, the degrees of fibroblast infiltration, collagen density and neovascularization were not significantly different between the groups. CONCLUSION: Our results indicate that ghrelin improves the healing of colonic anastomoses in rats.

  18. Global Astrophysical Telescope System - GATS

    Science.gov (United States)

    Polińska, M.; Kamiński, K.; Dimitrov, W.; Fagas, M.; Borczyk, W.; Kwiatkowski, T.; Baranowski, R.; Bartczak, P.; Schwarzenberg-Czerny, A.

    2014-02-01

    The Global Astronomical Telescope System is a project managed by the Astronomical Observatory Institute of Adam Mickiewicz University in Poznań (Poland) and it is primarily intended for stellar medium/high resolution spectroscopy. The system will be operating as a global network of robotic telescopes. The GATS consists of two telescopes: PST 1 in Poland (near Poznań) and PST 2 in the USA (Arizona). The GATS project is also intended to cooperate with the BRITE satellites and supplement their photometry with spectroscopic observations.

  19. Large Millimeter Telescope (LMT) status

    Science.gov (United States)

    Schloerb, F. Peter; Carrasco, Luis; Wilson, Grant W.

    2003-02-01

    We present a summary of the Large Millimeter Telescope Project and its present status. The Large Millimeter Telescope (LMT) is a joint project of the University of Massachusetts (UMass) in the USA and the Instituto Nacional de Astrofisica, Optica y Electronica (INAOE) in Mexico to build a 50m-diameter millimeter-wave telescope. The LMT is being built at an altitude of 4600 m atop Volcan Sierra Negra, an extinct volcanic peak in the state of Puebla, Mexico, approximately 100 km east of the city of Puebla. Construction of the antenna is now well underway, and it is expected to be completed in 2004.

  20. Infrared up-conversion telescope

    DEFF Research Database (Denmark)

    2014-01-01

    There is presented to an up-conversion infrared telescope (110) arranged for imaging an associated scene (130), wherein the up-conversion infrared telescope (110) comprises a non-linear crystal (120) arranged for up-conversion of infrared electromagnetic radiation, and wherein a first optical...... at the plane of the external image) which is denominated D2 and wherein D1 is larger than a second diameter D2 and wherein the telescope further comprises a third optical component (103) and a fourth optical component (104); arranged for re-imaging the first image into a second image of the back-focal plane...

  1. Antireflux Status Post Roux-en-Y anastomosis: An Experimental Study for Optimal Antireflux Technique.

    Science.gov (United States)

    Verma, Ajay Kumar; Purbey, Om Prakash; Kureel, Shiv Narain; Gupta, Archika; Pandey, Anand; Sunil, Kanoujia; Chaubey, Digamber

    2018-01-01

    Roux-en-Y hepaticojejunostomy has been a gold standard to establish biliary-enteric anastomosis for various surgical indications, but associated with variable incidences of cholangitis. This experimental study was conducted to report a modification in Roux-en-Y anastomosis for possible better alternative to provide antireflux procedure after Roux-en-Y biliary-enteric anastomosis with the aim to minimize the possibility of reflux and its consequences. For experimental study, the required fresh segment of Lamb's small intestine was procured. Three sets of Roux-en-Y anastomosis were created for each experiment. In set 1, there was simple Roux-en-Y anastomosis. In set 2, Roux-en-Y anastomosis along with 4-5 cm long spur between the hepatic and duodenal limbs was created. In set 3, in addition to Roux-en-Y with creation of spur, additional antireflux mechanism was created at the junction of upper two-third and lower one-third of the hepatic limb. Saline mixed contrast was infused by infusion pump to raise the intraluminal pressure to more than 10 cm of H 2 O. X-ray was taken at that time. In set 1, all preparations demonstrated reflux of contrast in the hepatic limb. The set 2 also demonstrated the same findings of 100% reflux in the hepatic limb. In set 3, No reflux was observed in 8 (80%) preparations while remaining 2 (20%) preparations reveal partial reflux. This experimental study suggests that the provision of spur and additional valve may be able to decrease the possibility of reflux in Roux-en-Y biliary-enteric anastomosis.

  2. Blunt penetration technique for treatment of a completely obstructed anastomosis after rectal resection: a case report.

    Science.gov (United States)

    Yazawa, Keiichi; Morioka, Daisuke; Matsumoto, Chizuru; Miura, Yasuhiko; Togo, Shinji

    2014-06-27

    We present a case of completely obstructed anastomosis after rectal resection which was nonsurgically and successfully treated with a blunt penetration technique using a commonly used device for transanal ileus drainage. The technique we used in this case has not been previously reported. A 79-year-old Japanese man underwent redo rectal resection for completely separated anastomosis which was caused by anastomotic leakage after a sigmoidectomy performed 3 years previously that was remedied by diverging ileostomy. Immediately after the redo surgery, fluoroscopy showed good passage through the colorectal anastomosis but no anastomotic leakage. However, fluoroscopy and colonoscopy prior to the ileostomy takedown showed complete obstruction of the anastomosis. Unlike usual anastomotic strictures, the lumen between colon oral and rectum anal to the anastomosis was completely discontinued by a membranous structure. Therefore, a conventional balloon dilatation technique was unsuitable for this condition. We applied a blunt penetration technique using a commercially available device designed as a transanal drainage system for obstructing colorectal cancer to restore the continuity between the colon oral and rectum anal to the anastomosis. After restoring the continuity, we performed conventional balloon dilatation for the anastomosis and successfully treated the anastomotic obstruction. Subsequently, the patient underwent ileostomy takedown and is currently doing well 12 months after the ileostomy takedown. The penetration technique we applied is easy and less stressful to adopt because it does not require usage of materials specialized for other particular purposes. Furthermore, we believe that this technique is superior in safety to other reported methods for this condition even if applied in the wrong direction because this technique does not utilize electrocision or sharp needle puncture.

  3. Stapled versus hand-sewn cervical esophagogastric anastomosis in patients undergoing esophagectomy: A Retrospective Cohort Study

    Science.gov (United States)

    Mishra, Pramod Kumar; Shah, Harsh; Gupta, Nikhil; Varshney, Vaibhav; Patil, Nilesh Sadashiv; Jain, Amit; Saluja, Sundeep Singh

    2016-01-01

    Introduction Anastomotic leak is one of the main causes of morbidity following esophageal resection for carcinoma of the esophagus and gastroesophageal junction. We compared hand sewn and stapled cervical esophagogastric anastomotic techniques in terms of postoperative complications. Methods All patients who underwent esophagectomy with cervical esophagogastric anastomosis at a single academic center from 2004 to 2014 were included in the study. Both early and late complications were analyzed. Results 153 patients underwent resection for carcinoma of the esophagus and gastroesophageal junction. Of these 140 patients had esophagectomy with cervical esophagogastric anastomosis. 66 patients underwent a hand sewn anastomosis and 74 patients had a side-to-side stapled anastomosis fashioned. Both groups were comparable with respect to preoperative characteristics. There was no difference in the operative blood loss and T and N stage of the disease. The overall morbidity and mortality was 32.8% and 6.4%, respectively. Overall leak rate was 17%. There was no difference in the leak rates among two groups (12 in the hand-sewn group & 12 in the Stapled stapled group; p = 0.82). The rate of anastomotic stricture was significantly higher for the hand sewn group (16.1% vs 4.3%; p = 0.03) at median follow up of 30 months. Conclusion Both hand sewn and stapled anastomotic techniques are equally effective way of performing a cervical esophagogastric anastomosis. However, patients having anastomotic leak develop anastomotic stricture more often in those having hand-sewn anastomosis compared to stapled anastomosis. PMID:27222711

  4. Intimal Surface Suture Line (End-Product Assessment of End-to-Side Microvascular Anastomosis

    Directory of Open Access Journals (Sweden)

    Georgios Pafitanis, MD

    2017-07-01

    Full Text Available Summary:. Microsurgery simulation courses increasingly use assessment methodologies to evaluate the quality of microvascular anastomosis and to provide constructive feedback in competency-based training. Assessment tools evaluating the “journey” of skill acquisition in anastomosis have evolved, including global rating scores, hand motion analysis, and evaluation of the final outcome, that is, “end-product” assessment. Anastomotic patency is the gold standard end-product in clinical microvascular surgery, and in vivo end-to-side anastomosis, which can be confirmed using the Acland-test. Microsurgery simulation training is moving to include nonliving models, where possible, according to the principles of the replacement, reduction, and refinement of the use of animals in research. While a standardized end-product assessment tool for nonliving end-to-end anastomosis exists, there is no similar tool for end-to-side anastomosis. Intimal surface suture line assessment is an error list-based tool, which involves exposing the intimal surface of a vessel and analysis of the quality of suture placement. Errors in end-to side anastomosis were classified according to the potential clinical significance (high, medium, or low perceived by the senior authors. Intimal surface suture line assessment provides constructive feedback during microsurgery training, helping to minimize technical errors, which are likely to impact on the final outcome in a clinical environment. Intimal surface suture line assessment lends itself to nonliving simulation training courses as an end-product self-assessment tool, especially during the early learning curve, to demonstrate progression. It has intraoperative relevance by assessment of the intimal surface suture line as the final sutures are placed in an end-to-side anastomosis to provide objective feedback to trainees in relation to likely physiological anastomotic outcome.

  5. A retrospective study of end-to-side venous anastomosis for free flap in extremity reconstruction.

    Science.gov (United States)

    Mao, Haijun; Xu, Guangyue

    2015-05-01

    The success of end-to-side (ETS) venous anastomosis primarily depends on several mandatory factors including recipient vessel selection and reconstruction site. This retrospective study was designed to analyze the success rate of ETS venous anastomosis for free flap extremity reconstruction. Between 2009 and 2011, ETS venous anastomosis was performed in 117 patients to reconstruct soft tissue defects of extremity at Nanjing Drum Tower Hospital. The patients were divided into three groups: (1) only one large recipient vein left, (2) two deep venas, (3) one deep vein and one superficial vein. Medical records and the follow-up data were retrospectively reviewed. The success rates of the three groups were compared with Chi-squared test. Totally, 5, 52, and 60 patients were included in Group 1, Group 2, and Group 3, respectively. The overall surgery success rate was 96.6% (113/117) with four failures: zero in Group 1, two in Group 2 (2/52, 3.8%) and two in Group 3 (2/60, 3.3%), due to venous thrombosis. The re-anastomosis rate in re-exploration in Group 1, 2 and 3 was 0%, 1.9% (1/52), and 1.7% (1/60), respectively. No complication was observed during the operation. No statistical difference was observed in flap failure rate among the three different types of ETS anastomosis. This suggests that differences of the ETS anastomosis surgical site might not affect the surgery success rate. These results confirmed that the success rate of ETS anastomosis was not affected by the local conditions of surgery site. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  6. Small bowel fibrosis and systemic inflammatory response after ileocolonic anastomosis in IL-10 null mice.

    Science.gov (United States)

    Borowiec, Anna M; Sydora, Beate C; Doyle, Jason; Guan, Le Luo; Churchill, Thomas A; Madsen, Karen; Fedorak, Richard N

    2012-11-01

    Crohn's disease recurrence after an ileocecal resection is common; yet, its pathophysiology is poorly understood and available treatment is suboptimal. The purpose of this study was to examine the bacterial, local, and systemic immune changes that follow ileocolonic anastomosis in a rodent model of Crohn's disease, the interleukin-10 gene-deficient (IL-10 null) mice. We divided wild-type and IL-10 null mice into three treatment groups: ileocolonic anastomosis, sham operation (ileo-ileal anastomosis), and control group without an operation. We sacrificed mice at 6 and 15 wks after the operation. At 6 wks, we assessed bacterial changes using the denaturing gel electrophoresis and similarity coefficient calculation. At both time points, we examined the small bowel for inflammation and fibrosis with histology. We measured the interferon gamma secretion by splenocytes stimulated with gastrointestinal bacterial antigens and splenocyte composition as a marker of systemic response. At 6 wks, ileocolonic anastomosis resulted in increased similarity in bacterial species between the ileum and colon. The ileocolonic anastomosis did not lead to significant inflammation in the small intestine, but it resulted in an increased collagen deposition in all animals undergoing surgery, the most pronounced fibrosis of which was present in IL-10 null mice 15 wks after ileocolonic anastomosis. Furthermore, this was associated with significantly increased interferon gamma secretion by bacterial antigen-stimulated splenocytes and a decreased number of CD11+ cells in the same experimental group. Ileocolonic anastomosis leads to bacterial changes in the terminal ileum. In the genetically susceptible host, it is associated with small bowel fibrosis and systemic immune alterations. The composition of immune cells in the spleen is altered and splenocytes hypersecrete proinflammatory cytokine (interferon gamma) when challenged with gastrointestinal bacterial antigens. Copyright © 2012 Elsevier

  7. Impact of top end anastomosis design on patency and flow stability in coronary artery bypass grafting.

    Science.gov (United States)

    Koyama, Sachi; Kitamura, Tadashi; Itatani, Keiichi; Yamamoto, Tadashi; Miyazaki, Shohei; Oka, Norihiko; Nakashima, Kouki; Horai, Tetsuya; Ono, Minoru; Miyaji, Kagami

    2016-05-01

    For coronary artery bypass grafting (CABG), free grafts such as a saphenous vein or radial artery are often used for grafts to the lateral and posterior walls. However, the relationship between top-end anastomosis design and long-term patency remains unknown. Because coronary artery blood flow is dominant during diastole, top-end anastomosis may work better if the graft is directed towards the apex, whereas the shortest graft pathway appears to be most efficient. Using computational fluid dynamic models, we evaluated the hemodynamic variables that were affected by the angle of the top-end anastomosis. We created three-dimensional geometries of the aortic root with coronary arteries that involved 75 % stenosis in the obtuse marginal and postero-lateral branches. Two bypass models under vasodilator administration were created: in a"Model A", the top-end anastomosis is parallel to the long axis of the ascending aorta and the graft passed over the conus directed towards the apex; in a "Model B", the top-end anastomosis is directed toward the shortest pathway, and form near the right angles to the long axis of the ascending aorta. Wall shear stress (WSS) and its fluctuation, an oscillatory shear index (OSI) were evaluated to predict fibrosis progression at the anastomosis site and graft flow. Graft flow was 197.3 ml/min and 207.3 ml/min in the "Model A" and "Model B", respectively. The minimal WSS value inside the graft with the "Model A" and "Model B" was 0.53 Pa and 4.09 Pa, respectively, and the OSI value was 0.46 and 0.04, respectively. The top-end anastomosis of a free graft should be directed vertically towards the aorta to achieve the shortest graft pathway to maintain a high graft flow rate and to avoid the risks of endothelial fibrosis and plaque progression over the long-term after CABG.

  8. The effect of disc-shaped gastric resection of anastomosis site on reducing postoperative dysphagia and stricture after esophagogastric anastomosis in patients with esophageal cancer.

    Science.gov (United States)

    Mahmodlou, Rahim; Shateri, Kamran; Homayooni, Faramarz; Hatami, Sanaz

    2017-02-01

    Esophagectomy remains the most reliable technique for managing esophageal cancer, but anastomotic complications including postoperative leak, ischemia and stricture negatively affect outcomes of this specific surgery. The aim of this study was to evaluate the effects of a novel method of esophagogastric anastomosis for reducing postoperative dysphagia and stricture formation. Eighty patients who were scheduled for esophagectomy due to esophageal cancer were randomly assigned into two groups: intervention and control (40 each). In the control group, the esophagogastric anastomosis was performed with a linear gastric incision, whilst in the intervention group a new method of disc-shaped gastric resection for anastomosis was applied. Postoperative outcomes were compared between the two groups. The incidence of postoperative dysphagia and anastomotic stricture was significantly lower in the disc-shaped resection group (dysphagia 45% vs 75%, P = 0.02; stricture 12.5% vs 32.5%, P = 0.03), whilst the length of stay in an intensive care unit (ICU), anastomotic leakage and other complications were not significantly different between the two groups (all P > 0.05). Anastomotic complications can be reduced by improving surgical techniques. The decreased incidence of postoperative dysphagia and anastomotic stricture in our study may be partly due to providing the proper diameter for the site of anastomosis when using the disc-shaped gastric resection method. Hence, this new method can improve the clinical outcomes of patients who undergo esophagectomy with esophagogastric anastomosis. © The Author(s) 2016. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-Sen University.

  9. Lightweighted ZERODUR for telescopes

    Science.gov (United States)

    Westerhoff, T.; Davis, M.; Hartmann, P.; Hull, T.; Jedamzik, R.

    2014-07-01

    The glass ceramic ZERODUR® from SCHOTT has an excellent reputation as mirror blank material for earthbound and space telescope applications. It is known for its extremely low coefficient of thermal expansion (CTE) at room temperature and its excellent CTE homogeneity. Recent improvements in CNC machining at SCHOTT allow achieving extremely light weighted substrates up to 90% incorporating very thin ribs and face sheets. In 2012 new ZERODUR® grades EXPANSION CLASS 0 SPECIAL and EXTREME have been released that offer the tightest CTE grades ever. With ZERODUR® TAILORED it is even possible to offer ZERODUR® optimized for customer application temperature profiles. In 2013 SCHOTT started the development of a new dilatometer setup with the target to drive the industrial standard of high accuracy thermal expansion metrology to its limit. In recent years SCHOTT published several paper on improved bending strength of ZERODUR® and lifetime evaluation based on threshold values derived from 3 parameter Weibull distribution fitted to a multitude of stress data. ZERODUR® has been and is still being successfully used as mirror substrates for a large number of space missions. ZERODUR® was used for the secondary mirror in HST and for the Wolter mirrors in CHANDRA without any reported degradation of the optical image quality during the lifetime of the missions. Some years ago early studies on the compaction effects of electron radiation on ZERODUR® were re analyzed. Using a more relevant physical model based on a simplified bimetallic equation the expected deformation of samples exposed in laboratory and space could be predicted in a much more accurate way. The relevant ingredients for light weighted mirror substrates are discussed in this paper: substrate material with excellent homogeneity in its properties, sufficient bending strengths, space radiation hardness and CNC machining capabilities.

  10. HUBBLE SPACE TELESCOPE

    Science.gov (United States)

    Godon, Patrick; Sion, Edward M; Starrfield, Sumner; Livio, Mario; Williams, Robert E; Woodward, Charles E; Kuin, Paul; Page, Kim L

    2014-04-01

    With six recorded nova outbursts, the prototypical recurrent nova T Pyxidis (T Pyx) is the ideal cataclysmic variable system to assess the net change of the white dwarf mass within a nova cycle. Recent estimates of the mass ejected in the 2011 outburst ranged from a few ~10 -5 M ⊙ to 3.3 × 10 -4 M ⊙ , and assuming a mass accretion rate of 10 -8 -10 -7 M ⊙ yr -1 for 44 yr, it has been concluded that the white dwarf in T Pyx is actually losing mass. Using NLTE disk modeling spectra to fit our recently obtained Hubble Space Telescope COS and STIS spectra, we find a mass accretion rate of up to two orders of magnitude larger than previously estimated. Our larger mass accretion rate is due mainly to the newly derived distance of T Pyx (4.8 kpc, larger than the previous 3.5 kpc estimate), our derived reddening of E ( B - V ) = 0.35 (based on combined IUE and GALEX spectra), and NLTE disk modeling (compared to blackbody and raw flux estimates in earlier works). We find that for most values of the reddening (0.25 ≤ E ( B - V ) ≤ 0.50) and white dwarf mass (0.70 M ⊙ ≤ M wd ≤ 1.35 M ⊙ ) the accreted mass is larger than the ejected mass. Only for a low reddening (~0.25 and smaller) combined with a large white dwarf mass (0.9 M ⊙ and larger) is the ejected mass larger than the accreted one. However, the best results are obtained for a larger value of reddening.

  11. Spherical Primary Optical Telescope Testbed

    Data.gov (United States)

    National Aeronautics and Space Administration — This IRAD proposes to continue operation of the Spherical Primary Optical Telescope (SPOT) testbed as an image-based wavefront sensing demonstrator. In addition to...

  12. Advanced Athermal Telescopes, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — This proposed innovative athermal telescope design uses advanced lightweight and high-stiffness material of Beryllium-Aluminum (Be-38Al). Peregrine's expertise with...

  13. Automated telescope for variability studies

    Science.gov (United States)

    Ganesh, S.; Baliyan, K. S.; Chandra, S.; Joshi, U. C.; Kalyaan, A.; Mathur, S. N.

    PRL has installed a 50 cm telescope at Mt Abu, Gurushikhar. The backend instrument consists of a 1K × 1K EMCCD camera with standard UBVRI filters and also has polarization measurement capability using a second filter wheel with polaroid sheets oriented at different position angles. This 50 cm telescope observatory is operated in a robotic mode with different methods of scheduling of the objects being observed. This includes batch mode, fully manual as well as fully autonomous mode of operation. Linux based command line as well as GUI software are used entirely in this observatory. This talk will present the details of the telescope and associated instruments and auxiliary facilities for weather monitoring that were developed in house to ensure the safe and reliable operation of the telescope. The facility has been in use for a couple of years now and various objects have been observed. Some of the interesting results will also be presented.

  14. The JCMT Telescope Management System

    Science.gov (United States)

    Tilanus, Remo P. J.; Jenness, Tim; Economou, Frossie; Cockayne, Steve

    Established telescopes often face a challenge when trying to incorporate new software standards and utilities into their existing real-time control system. At the JCMT we have successfully added important new features such as a Relational Database (the Telescope Management System---TMS), an online data Archive, and WWW based utilities to an, in part, 10-year old system. The new functionality was added with remarkably few alterations to the existing system. We are still actively expanding and exploring these new capabilities.

  15. Hubble Space Telescope-Illustration

    Science.gov (United States)

    1989-01-01

    This illustration depicts a side view of the Hubble Space Telescope (HST). The HST is the product of a partnership between NASA, European Space Agency Contractors, and the international community of astronomers. It is named after Edwin P. Hubble, an American Astronomer who discovered the expanding nature of the universe and was the first to realize the true nature of galaxies. The purpose of the HST, the most complex and sensitive optical telescope ever made, is to study the cosmos from a low-Earth orbit. By placing the telescope in space, astronomers are able to collect data that is free of the Earth's atmosphere. The HST detects objects 25 times fainter than the dimmest objects seen from Earth and provides astronomers with an observable universe 250 times larger than visible from ground-based telescopes, perhaps as far away as 14 billion light-years. The HST views galaxies, stars, planets, comets, possibly other solar systems, and even unusual phenomena such as quasars, with 10 times the clarity of ground-based telescopes. The major elements of the HST are the Optical Telescope Assembly (OTA), the Support System Module (SSM), and the Scientific Instruments (SI). The HST is approximately the size of a railroad car, with two cylinders joined together and wrapped in a silvery reflective heat shield blanket. Wing-like solar arrays extend horizontally from each side of these cylinders, and dish-shaped anternas extend above and below the body of the telescope. The HST was deployed from the Space Shuttle Discovery (STS-31 mission) into Earth orbit in April 1990. The Marshall Space Flight Center had responsibility for design, development, and construction of the HST. The Perkin-Elmer Corporation, in Danbury, Connecticut, developed the optical system and guidance sensors. The Lockheed Missile and Space Company of Sunnyvale, California produced the protective outer shroud and spacecraft systems, and assembled and tested the finished telescope.

  16. Ultra-lightweight Telescope Technology

    Science.gov (United States)

    Chen, P. C.; Romeo, R. C.

    2003-12-01

    We report progress in the development of a new and rapidly maturing technology for astronomical telescopes and structures. By using carbon fiber composite materials, mirrors can be made that are far lighter and stiffer than are possible with traditional optical materials. Composite technology also permits the fabrication of mirrors with non-circular shapes, on-axis and off-axis figures, supersmooth surfaces, very thin to very thick substrates, and having very low sensitivity to temperature changes and thermal disturbances. Of special note is the ability to produce multiple identical units rapidly and at low cost. Significant achievements to date include the fabrication of extremely lightweight mirrors with areal density as low as 1 kg/sq.m., diffraction limited optical performance at visible wavelengths, a portable telescope with 0.5m mirror, large thin deformable mirrors for adaptive optics, 1m x 2m mirrors, reflectors and support structures for radio telescopes, and a six meter telescope platform. An observatory with a 1 meter composite mirror telescope is under construction. With further development, composite mirrors can become the enabling technology for new generations of extremely large telescopes (ELTs) on the ground and in space. This work is supported by the National Science Foundation under grant AST-0320784, B. Twarog (U. Kansas) PI.

  17. The Submillimeter Telescope (SMT) project

    International Nuclear Information System (INIS)

    Martin, R.N.; Baars, J.W.M.

    1990-01-01

    To exploit the potential of submillimeter astronomy, the Submillimeter Telescope (SMT) will be located at an altitude of 3178 meters on Emerald Peak 75 miles northeast of Tucson in Southern Arizona. The instrument is an altazimuth mounted f/13.8 Cassegrain homology telescope with two Nasmyth and bent Cassegrain foci. It will have diffraction limited performance at a wavelength of 300 microns and an operating overall figure accuracy of 15 microns rms. An important feature of the SMT is the construction of the primary and secondary reflectors out of aluminum-core CFRP face sheet sandwich panels, and the reflector backup structure and secondary support out of CFRP structural elements. This modern technology provides both a means for reaching the required precision of the SMT for both night and day operation (basically because of the low coefficient of thermal expansion and high strength-to-weight ratio of CFRP) and a potential route for the realization of lightweight telescopes of even greater accuracy in the future. The SMT will be the highest accuracy radio telescope ever built (at least a factor of 2 more accurate than existing telescopes). In addition, the SMT will be the first 10 m-class submillimeter telescope with a surface designed for efficient measurements at the important 350 microns wavelength atmospheric window. 9 refs

  18. Alt-Az Spacewatch Telescope

    Science.gov (United States)

    Gehrels, Tom

    1997-01-01

    This grant funded about one third of the cost of the construction of a telescope with an aperture 1.8 meters in diameter to discover asteroids and comets and investigate the statistics of their populations and orbital distributions. This telescope has been built to the PI's specifications and installed in a dome on Kitt Peak mountain in Arizona. Funds for the dome and building were provided entirely by private sources. The dome building and telescope were dedicated in a ceremony at the site on June 7, 1997. The attached abstract describes the parameters of the telescope. The telescope is a new item of capital property. It is permanently located in University of Arizona building number 910 in the Steward Observatory compound on Kitt Peak mountain in the Tohono O'odham Nation, Arizona. fts property tag number is A252107. This grant did not include funds for the coma corrector lens, instrument derotator, CCD detector, detector electronics, or computers to acquire or process the data. It also did not include funds to operate the telescope or conduct research with it. Funds for these items and efforts are pending from NASA and other sources.

  19. Internal Carotid Artery Agenesis with an Intercavernous Anastomosis: A Rare Case.

    Science.gov (United States)

    Erdogan, Mucahid; Senadim, Songul; Ince Yasinoglu, K Nur; Selcuk, H Hakan; Atakli, H Dilek

    2017-10-01

    Agenesis of the internal carotid artery (ICA) is a rare vascular anomaly that was first observed postmortem. Various anastomoses supply the distal vessels at the site of agenesis. Of these anastomoses, an intercavernous anastomosis is very rare. This paper presents a patient with ischemic stroke in whom we discovered left ICA agenesis and an ipsilateral intercavernous anastomosis. A 58-year-old man with a history of myocardial infarction and diabetes mellitus presented with sudden-onset difficulty in speaking, numbness on the left side of the face, and weakness of the left arm and leg. Neurological examination revealed dysarthria, left facial paralysis, left hemiparesis, and bilateral absence of the plantar reflexes. Diffusion-weighted magnetic resonance imaging showed a right middle cerebral artery (MCA) infarction. On cranial and cervical magnetic resonance angiography, the left ICA could not be seen distal to the bifurcation; the left MCA was supplied through an intercavernous anastomosis between the right ICA and the left ICA. Cranial computed tomography (CT) revealed the absence of the left carotid canal. Digital subtraction angiography led to a diagnosis of left ICA agenesis with an intercavernous anastomosis. The patient was discharged on acetylsalicylic acid and warfarin. ICA agenesis with an intercavernous anastomosis is a rare vascular anomaly that should be differentiated from secondary causes of ICA stenosis and occlusions by showing agenesis of the carotid canal on cranial CT. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  20. The fate of suboptimal anastomosis after colon resection: An experimental study.

    Science.gov (United States)

    Yıldız, Mehmet Kamil; Okan, İsmail; Nazik, Hasan; Bas, Gurhan; Alimoglu, Orhan; İlktac, Mehmet; Daldal, Emin; Sahin, Mustafa; Kuvat, Nuray; Ongen, Betugul

    2014-11-01

    The fate of suboptimal anastomosis is unknown and early detection of anastomotic leakage after colon resection is crucial for the proper management of patients. Twenty-six rats were assigned to "Control", "Leakage" and "Suboptimal anastomosis" groups where they underwent either sham laparotomy, cecal ligation, and puncture or anastomosis with four sutures following colon resection, respectively. At the fifth hour and on the third and ninth days; peripheral blood and peritoneal washing samples through relaparotomy were obtained. The abdomen was inspected macroscopically for anastomotic healing. Polymerase chain reaction (PCR) with 16s rRNA and E.coli-specific primers were run on all samples along with aerobic and anaerobic cultures. The sensitivity and specificity of PCR on different bodily fluids with 16s rRNA and E.coli-specific primers were 100% and 78%, respectively. All samples of peritoneal washing fluids on the third and ninth days showed presence of bacteria in both PCR and culture. The inspection of the abdomen revealed signs of anastomotic leakage in eight rats (80%), whereas mortality related with anastomosis was detected in two (20%). Anastomotic leakage with suboptimal anastomosis after colon resection is high and the early detection is possible by running PCR on peritoneal samples as early as 72 hours.

  1. [Surgical management of postoperative stricture of anastomosis after operation of intersphincteric resection for lower rectal cancer].

    Science.gov (United States)

    Yi, Bing-qiang; Wang, Zhen-jun; Zhao, Bo; Wei, Guang-hui; Han, Jia-gang; Ma, Hua-chong; Zhao, Bao-cheng

    2013-07-01

    To study surgical treatment of postoperative stricture of anastomosis for lower rectal cancer. The data of 9 cases who were diagnosed as postoperative stricture of anastomosis after operation of intersphincteric resection for lower rectal cancer during January 2008 to June 2011 were analyzed retrospectively. Transanal excision of stricture were used in 3 cases diagnosed as membranous stricture. Transanal radial incision of stricture were used in 5 cases diagnosed as tubulous stricture. Biologic patch was used to repair the defect of the posterior wall of rectum after excision of severe stricture in 1 case. All 9 cases of postoperative stricture of anastomosis were cured by surgery. Anal dilation were performed every day by patients themselves after discharge. Digital examination showed that 1 to 2 fingers could pass through the anastomosis after operation. The patient whose rectal defect was repaired by biological patch underwent colonoscopy examination two weeks after operation. Colonoscopy showed that the biological patch had been filled with granulation and integrated into the surrounding intestinal tissue. All patients defecated without difficulty and the anal function of all patients was good after restoration of intestinal continuity. Aggressive surgery, combining with the use of biological patch if necessary is an effective therapy of postoperative stricture of anastomosis for lower rectal cancer.

  2. Mucociliary clearance following tracheal resection and end-to-end anastomosis.

    Science.gov (United States)

    Toomes, H; Linder, A

    1989-10-01

    Mucociliary clearance is an important cleaning system of the bronchial tree. The complex transport system reacts sensitively to medicinal stimuli and inhaled substances. A disturbance causes secretion retention which encourages the development of acute and chronic pulmonary diseases. It is not yet known in which way sectional resection of the central airway effects mucociliary clearance. A large number of the surgical failures are attributable to septic complications in the area of the anastomosis. In order to study the transportation process over the anastomosis, ten dogs underwent a tracheal resection with end-to-end anastomosis, and the mucociliary activity was recorded using a bronchoscopic video-technical method. Recommencement of mucous transport was observed on the third, and transport over the anastomosis from the sixth to tenth, postoperative days. The mucociliary clearance had completely recovered on the twenty-first day in the majority of dogs. Histological examination of the anastomoses nine months postoperatively showed a flat substitute epithelium without cilia-bearing cells in all dogs. This contrasts with the quick restitution of the transport function. In case of undamaged respiratory mucosa, a good adaptation of the resection margins suffices for the mucous film to slide over the anastomosis.

  3. Comparison of laparoscopic and conventional surgery of intestinal anastomosis in dogs

    Directory of Open Access Journals (Sweden)

    O. J. Ali

    2008-01-01

    Full Text Available The aim of this study was to evaluate operative laparoscopy in comparison with conventional laparotomy for intestinal resection and anastomosis in dogs. Eighteen adult dogs were equally and randomly divided into 3 groups: Group I: Intestinal anastomosis was performed extracorporeally, by laparoscopic-assisted surgery, in which a 5cm loop of small bowel was exteriorized through a mini-laparotomy opening (an enlarged trocar incision 1.5-2 cm in length, then surgically resected and anastomosed by simple interrupted suture 3-0 polygalactine. Group II: Underwent laparoscopic intracorporeal intestinal resection and anastomosis, in which the loop of the small bowel was suspended into the ventral abdominal wall, then it was resected and anastomsed with simple continuous suture by polygalactine 3-0. Group III: Small bowel resection and anastomosis was conducted by conventional laparotomy technique with simple interrupted pattern by polygalactine 3-0 suture. The result showed that laparoscopic intestinal resection and anastomosis by either intra- or extracorporeal techniques can be applied in dogs safely and have less morbidity rate. Intra abdominal adhesion of the omentum and even the bowel to the abdominal wall occurred in group III but not in groups I and II. The post operative hospitalization time was earlier in group I and II, as indicated by the earlier return of intestinal motility and appetite, in comparison to group III where it was delayed.

  4. The side-to-side fashion for individual distal coronary anastomosis using venous conduit.

    Science.gov (United States)

    Kato, Takayoshi; Tsunekawa, Tomohiro; Motoji, Yusuke; Hirakawa, Akihiro; Okawa, Yasuhide; Tomita, Shinji

    2017-04-01

    Regarding to coronary artery bypass grafting (CABG), the end-to-side anastomosis (ESA) has been performed as a gold standard. Recently, the effectiveness of the distal side-to-side anastomosis (SSA) in CABG using internal mammary artery has been reported. The benefit of SSA comparing to ESA also has been disclosed by computing simulation. However, use of SSA by venous conduit for individual CABG has not been reported. In this study, we investigated feasibility of SSA. From January 2013 to October 2014, we conducted 114 CABGs. There were 92 venous distal anastomoses without sequential anastomotic site (61 SSA and 31 ESA). The anastomosis was evaluated before discharge and at 1 year after the procedure by angiography or multi-detector row computed tomographic coronary angiography. The median values for time to anastomosis were 13 min in the two group (p = 0.89). There was no revision of anastomosis in both groups. Additional stitches for hemostasis were required significantly less in SSA than ESA (18.0 vs 45.2 %, respectively, p fashion is easy to perform and maybe beneficial in blood flow pattern.

  5. The effects of duration of CO2 pneumoperitoneum on colonic anastomosis.

    Science.gov (United States)

    Ozer, Ilter; Ulas, Murat; Ercan, Metin; Ozogul, Yusuf B; Zengin, Neslihan; Bostanci, E Birol; Ozel, Ummuhani; Bilgihan, Ayse; Akoglu, Musa

    2008-01-01

    The aim of this study is to evaluate the effects of duration of carbon dioxide (CO(2)) pneumoperitoneum on experimental colonic anastomosis. Forty-eight male Sprague-Dawley rats were used. The rats were divided into three groups. The rats in group 1 (n = 16) underwent laparotomy and colonic anastomosis without pneumoperitoneum. The rats in group 2 (n = 16) and group 3 (n = 16) were subjected to 2 and 4 hours of 12 mm Hg pneumoperitoneum, respectively, before laparotomy and colonic anastomosis. Half of the rats were sacrified on the third postoperative day; and the other half, on the seventh postoperative day. A colonic segment including anastomosis site was resected for histopathologic and biochemical evaluation. On day 3, hydroxyproline levels of the three groups were similar. The edema score of group 2 was significantly higher than that of group 1, and the necrosis score was higher in group 2 than in group 3. The scores of the other histopathologic parameters were similar. On day 7, group 3 showed significantly higher hydroxyproline levels than group 1, and group 1 showed a higher necrosis score than group 3. In conclusion, CO(2) pneumoperitoneum of 12 mm Hg for 2 and 4 hours did not result in impaired healing of experimental colonic anastomosis.

  6. [Pancreatico-jejunal vs pancreatico-gastric anastomosis after cephalic duodenopancreatectomy].

    Science.gov (United States)

    Miron, A; Ardelean, M; Sîrbu-Boeţi, V; Calu, V; Giulea, C; Pop, A I

    2006-01-01

    Pancreatoduodenectomy has been for a long time a procedure with high postoperative morbidity and mortality. Several complications after pancreatic resections are known, but one of the most severe is the fistula of the pancreatic anastomosis. Avoiding the pancreatic fistula caused many surgical innovations regarding the procedure of reestablishing the continuity after pancreatoduodenectomy. The aim of this retrospective study was to compare pancreatico-jejunostomy vs pancreatico-gastrostomy with regard to safety of pancreatic anastomosis after pancreatoduodenectomy. No technique was proved to be superior so far, the benefits of these 2 types of pancreatic anastomosis being the subject for intense debates. From 2000 to 2004, 17 patients underwent pancreatoduodenectomy, for pancreas, ampulla, distal bile duct or duodenum cancers. Pancreatic anastomosis was accomplished by pancreatico-gastrostomy in 11 cases and by pancreatico-jejunostomy in 6 cases. There was no significant difference between the two groups (age, gender and primary disease). Comparison between the two groups was made mainly analysing postoperative mortality and morbidity. Postoperative morbidity was 9,1% after pancreatico-gastrostomy and 33,3% after pancreatico-jejunostomy. Postoperative mortality was none after pancreatico-gastrostomy and 16,7% after pancreatico-jejunostomy. This study seems to demonstrate the superiority of the pancreatico-gastric anastomosis, but in most cases the surgeon will choose based on his experience. These results have to be confirmed or invalidated by a prospective multicentric randomised study.

  7. Carotid-anterior cerebral artery anastomosis on MR angiography: a university hospital-based study

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Saito, Naoko; Okada, Yoshitaka; Inoue, Kaiji [Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka, Saitama (Japan)

    2012-01-15

    Rarely in the anterior circulation, an anastomosis of the carotid and anterior cerebral arteries occurs when an anomalous branch arises from the ophthalmic segment of the internal carotid artery and anastomoses with the A1-A2 junction of the anterior communicating artery. Right-side predominance is known. To our knowledge, the incidence of carotid-anterior cerebral artery anastomosis has not been reported, so we researched cases in our institution records to determine incidence and investigated characteristic features of the condition on magnetic resonance (MR) angiography. To isolate such cases, we retrospectively reviewed cranial MR angiographic images of 3,491 consecutive patients in our institution. We found three cases with carotid-anterior cerebral artery anastomosis (two men, one woman), representing an incidence of 0.086%. The anastomosis was on the right in all three cases. A normal A1 segment of the anterior cerebral artery (ACA) was present in two cases but could not be identified in the remaining case on MR angiographic images that included source images. Two of the three patients demonstrated associated arterial variations in their carotid systems. On MR angiography, we observed a 0.086% incidence of carotid-anterior cerebral artery anastomosis in our institution and reaffirmed the right-side predominance of this anomaly. We found a high frequency of other associated arterial variations in the carotid system. (orig.)

  8. SOFIA: Flying the Telescope

    Science.gov (United States)

    Asher, Troy A.; Cumming, Stephen B.

    2012-01-01

    and a proof of concept mission for which SOFIA was opportunely positioned is showcased. Success on this time-critical mission to observe a rare astronomical event proved the usefulness of an airborne observatory and the value in waiting for the capability provided by SOFIA. Finally, lessons learned in the test program are presented with emphasis on how lessons from previous aircraft and successful test programs were applied to SOFIA. Effective application of these lessons was crucial to the success of the SOFIA flight test program. SOFIA is an international cooperative program between NASA and the German Space Agency, DLR. It is a 2.5 meter (100-inch) telescope mounted in a Boeing 747SP aircraft used for astronomical observations at altitudes above 35,000 feet. SOFIA will accommodate a host of scientific instruments from the international science community and has a planned operational lifespan of more than 20 years.

  9. Circular myotomy as an aid to resection and end-to-end anastomosis of the esophagus.

    Science.gov (United States)

    Attum, A A; Hankins, J R; Ngangana, J; McLaughlin, J S

    1979-08-01

    Segments ranging from 40 to 70% of the thoracic esophagus were resected in 80 mongrel dogs. End-to-end anastomosis was effected after circular myotomy either proximal or distal, or both proximal and distal, to the anastomosis. Among dogs undergoing resection of 60% of the esophagus, distal myotomy enabled 6 of 8 animals to survive, and combined proximal and distal myotomy permitted 8 of 10 to survive. Cineesophagography was performed in a majority of the 50 surviving animals and showed no appreciable delay of peristalsis at the myotomy sites. When these sites were examined at postmortem examination up to 13 months after operation, 1 dog showed a small diverticulum but none showed dilatation or stricture. It is concluded that circular myotomy holds real promise as a means of extending the clinical application of esophageal resection with end-to-end anastomosis.

  10. An automated interrupted suturing device for coronary artery bypass grafting: automated coronary anastomosis.

    Science.gov (United States)

    Shennib, H; Korkola, S J; Bousette, N; Giaid, A

    2000-09-01

    The purpose of this study was to have a preliminary assessment of the safety and efficacy of an automated vascular suturing device. The device (Heartflo, Perclose/Abbott Labs, Redwood City, CA), which delivers 10 interrupted 7-0 polypropylene sutures between side-to-side arteriotomies, was evaluated in animals (8 Yorkshire pigs). Tissue edge capture and quality of anastomosis were highly rated. Time of anastomoses averaged 22 minutes. This time was prolonged primarily due to suture management, tying of interrupted sutures, and learning curve effects. Six of the anastomoses were hemostatic and two required an additional stitch each. Angiography and histology of the anastomosis confirmed patency and quality of the anastomosis. Our preliminary results indicate that the Heartflo automated anastomotic device is safe and effective. Preclinical and clinical studies to validate its acute and long-term effectiveness will commence shortly.

  11. Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit

    NARCIS (Netherlands)

    Pinkney, T.; Battersby, N.; Bhangu, A.; Chaudhri, S.; El-Hussuna, A.; Frasson, M.; Nepogodiev, D.; Singh, B.; Vennix, S.; Zmora, O.; Altomare, D.; Bemelman, W.; Christensen, P.; D'Hoore, A.; Laurberg, S.; Morton, D.; Rubbini, M.; Vaizey, C.; Magill, L.; Perry, R.; Sheward, N.; Ives, N.; Mehta, S.; Cillo, M.; Estefania, D.; Patron Uriburu, J.; Ruiz, H.; Salomon, M.; Makhmudov, A.; Selnyahina, L.; Varabei, A.; Vizhynis, Y.; Claeys, D.; Defoort, B.; Muysoms, F.; Pletinckx, P.; Vergucht, V.; Debergh, I.; Feryn, T.; Reusens, H.; Nachtergaele, M.; Francart, D.; Jehaes, C.; Markiewicz, S.; Monami, B.; Weerts, J.; Bouckaert, W.; Houben, B.; Knol, J.; Sergeant, G.; Vangertruyden, G.; Haeck, L.; Lange, C.; Sommeling, C.; Vindevoghel, K.; Castro, S.; de Bruyn, H.; Huyghe, M.; de Wolf, E.; Reynders, D.; van Overstraeten, A. de Buck; Wolthuis, A.; Delibegovic, S.; Christiani, A.; Marchiori, M.; Rocha de Moraes, C.; Tercioti, V.; Arabadjieva, E.; Bulanov, D.; Dardanov, D.; Stoyanov, V.; Yonkov, A.; Angelov, K.; Maslyankov, S.; Sokolov, M.; Todorov, G.; Toshev, S.; Georgiev, Y.; Karashmalakov, A.; Zafirov, G.; Wang, X.; Condic, D.; Kraljik, D.; Mrkovic, H.; Pavkovic, V.; Raguz, K.; Bencurik, V.; Holaskova, E.; Skrovina, M.; Farkasova, M.; Grolich, T.; Kala, Z.; Antos, F.; Pruchova, V.; Sotona, O.; Chobola, M.; Dusek, T.; Ferko, A.; Orhalmi, J.; Hoch, J.; Kocian, P.; Martinek, L.; Bernstein, I.; Sunesen, K. Gotschalck; Leunbach, J.; Thorlacius-Ussing, O.; Oveson, A. Uth; Chirstensen, S. Dahl; Gamez, V.; Oeting, M.; Loeve, U. Schou; Ugianskis, A.; Jessen, M.; Krarup, P.; Linde, K.; Mirza, Q.; Stovring, J. Overgaard; Erritzoe, L.; Jakobsen, H. Loft; Lykke, J.; Colov, E. Palmgren; Madsen, A. Husted; Friis, T. Linde; Funder, J. Amstrup; Dich, R.; Kjaer, S.; Rasmussen, S.; Schlesinger, N.; Kjaer, M. Dilling; Qvist, N.; Khalid, A.; Ali, G.; Hadi, S.; Walker, L. Rosell; Kivela, A.; Lehtonen, T.; Lepisto, A.; Scheinin, T.; Siironen, P.; Kossi, J.; Kuusanmaki, P.; Tomminen, T.; Turunen, A.; Rautio, T.; Vierimaa, M.; Huhtinen, H.; Karvonen, J.; Lavonius, M.; Rantala, A.; Varpe, P.; Cotte, E.; Francois, Y.; Glehen, O.; Kepenekian, V.; Passot, G.; Maggiori, L.; Manceau, G.; Panis, Y.; Gout, M.; Rullier, E.; van Geluwe, B.; Chafai, N.; Lefevre, J. H.; Parc, Y.; Tiret, E.; Couette, C.; Duchalais, E.; Agha, A.; Hornberger, M.; Hungbauer, A.; Iesalnieks, I.; Weindl, I.; Crescenti, F.; Keller, M.; Kolodziejski, N.; Scherer, R.; Sterzing, D.; Bock, B.; Boehm, G.; El-Magd, M.; Krones, C.; Niewiera, M.; Buhr, J.; Cordesmeyer, S.; Hoffmann, M.; Krueckemeier, K.; Vogel, T.; Schoen, M.; Baral, J.; Lukoschek, T.; Muench, S.; Pullig, F.; Horisberger, K.; Kienle, P.; Magdeburg, J.; Post, S.; Batzalexis, K.; Germanos, S.; Agalianos, C.; Dervenis, C.; Gouvas, N.; Kanavidis, P.; Kottikias, A.; Katsoulis, I. E.; Korkolis, D.; Plataniotis, G.; Sakorafas, G.; Akrida, I.; Argentou, M.; Kollatos, C.; Lampropoulos, C.; Tsochatzis, S.; Besznyak, I.; Bursics, A.; Egyed, T.; Papp, G.; Svastics, I.; Atladottir, J.; Moller, P.; Sigurdsson, H.; Stefansson, T.; Valsdottir, E.; Andrews, E.; Foley, N.; Hechtl, D.; Majeed, M.; McCourt, M.; Hanly, A.; Hyland, J.; Martin, S.; O'Connell, P. R.; Winter, D.; Connelly, T.; Joyce, W.; Wrafter, P.; Berkovitz, R.; Avital, S.; Yahia, I. Haj; Hermann, N.; Shpitz, B.; White, I.; Lishtzinsky, Y.; Tsherniak, A.; Wasserberg, N.; Horesh, N.; Keler, U.; Pery, R.; Shapiro, R.; Tulchinsky, H.; Badran, B.; Dayan, K.; Iskhakov, A.; Lecaros, J.; Nabih, N.; Angrima, I.; Bardini, R.; Pizzolato, E.; Tonello, M.; Arces, F.; Balestri, R.; Ceccarelli, C.; Prosperi, V.; Rossi, E.; Giannini, I.; Vincenti, L.; Altomare, D. F.; Di Candido, F.; Di Iena, M.; Guglielmi, A.; Caputi-Iam-Brenghi, O.; Marsanic, P.; Mellano, A.; Muratore, A.; Annecchiarico, M.; Bencini, L.; Bona-Pasta, S. Amore; Coratti, A.; Guerra, F.; Asteria, C. R.; Boccia, L.; Gerard, L.; Pascariello, A.; Manca, G.; Marino, F.; Casaril, A.; Inama, M.; Moretto, G.; Bacchelli, C.; Carvello, M.; Mariani, N.; Montorsi, M.; Spinelli, A.; Romairone, E.; Scabini, S.; Belli, A.; Bianco, F.; de Franciscis, S.; Romano, G. Maria; Delrio, P.; Pace, U.; Rega, D.; Sassaroli, C.; Scala, D.; de Luca, R.; Ruggieri, E.; Elbetti, C.; Garzi, A.; Romoli, L.; Scatizzi, M.; Vannucchi, A.; Curletti, G.; Durante, V.; Galleano, R.; Mariani, F.; Reggiani, L.; Bellomo, R.; Infantino, A.; Franceschilli, L.; Sileri, P.; Clementi, I.; Coletta, D.; La Torre, F.; Mingoli, A.; Velluti, F.; Di Giacomo, A.; Fiorot, A.; Massani, M.; Padoan, L.; Ruffolo, C.; Caruso, S.; Franceschini, F.; Laessig, R.; Monaci, I.; Rontini, M.; de Nardi, P.; Elmore, U.; Lemma, M.; Rosati, R.; Tamburini, A.; de Luca, M.; Sartori, A.; Benevento, A.; Bottini, C.; Ferrari, C. C.; Pata, F.; Tessera, G.; Pellino, G.; Selvaggi, F.; Lanzani, A.; Romano, F.; Sgroi, G.; Steccanella, F.; Turati, L.; Yamamoto, T.; Ancans, G.; Gerkis, S.; Leja, M.; Pcolkins, A.; Sivins, A.; Latkauskas, T.; Lizdenis, P.; Saladzin-Skas, Z.; Svagzdys, S.; Tamelis, A.; Razbadauskas, A.; Sokolovas, M.; Dulskas, A.; Samalavicius, N.; Jotautas, V.; Mikalauskas, S.; Poskus, E.; Poskus, T.; Strupas, K.; Camenzuli, C.; Cini, C.; Predrag, A.; Psaila, J.; Spiteri, N.; Buskens, C.; de Groof, E. J.; Gooszen, J.; Tanis, P.; Belgers, E.; Davids, P.; Furnee, E.; Postma, E.; Pronk, A.; Smakman, N.; Clermonts, S.; Zimmerman, D.; Omloo, J.; van der Zaag, E.; van Duijvendijk, P.; Wassenaar, E.; Bruijninckx, M.; de Graff, E.; Doornebosch, P.; Tetteroo, G.; Vermaas, M.; Iordens, G.; Knops, S.; Toorenvliet, B.; van Westereenen, H. L.; Boerma, E.; Coene, P.; van der Harst, E.; van der Pool, A.; Raber, M.; Melenhorst, J.; de Castro, S.; Gerhards, M.; Arron, M.; Bremers, A.; de Wilt, H.; Ferenschild, F.; Yauw, S.; Cense, H.; Demirkiran, A.; Hunfeld, M.; Mulder, I.; Nonner, J.; Swank, H.; van Wagensveld, B.; Bolmers, M.; Briel, J.; van Geloven, A.; van Rossem, C.; Klemann, V.; Konsten, J.; Leenders, B.; Schok, T.; Bleeker, W.; Brun, M.; Helgeland, M.; Ignjatovic, D.; Oresland, T.; Yousefi, P.; Backe, I. Faten; Sjo, O. Helmer; Nesbakken, A.; Tandberg-Eriksen, M.; Cais, A.; Traeland, J. Hallvard; Herikstad, R.; Korner, H.; Lauvland, N.; Jajtner, D.; Kabiesz, W.; Rak, M.; Gmerek, L.; Horbacka, K.; Horst, N.; Krokowicz, P.; Kwiatkowski, A.; Pasnik, K.; Karcz, P.; Romaniszyn, M.; Rusek, T.; Walega, P.; Czarencki, R.; Obuszko, Z.; Sitarska, M.; Wojciech, W.; Zawadzki, M.; Amado, S.; Clara, P.; Couceiro, A.; Malaquias, R.; Rama, N.; Almeida, A.; Barbosa, E.; Cernadas, E.; Duarte, A.; Silva, P.; Costa, S.; Martinez Insua, C.; Pereira, J.; Pereira, C.; Sacchetti, M.; Carvalho Pinto, B.; Vieira Sousa, P. Jorge; Marques, R.; Oliveira, A.; Cardoso, R.; Carlos, S.; Corte-Real, J.; Moniz Pereira, P.; Souto, R.; Carneiro, C.; Marinho, R.; Nunes, V.; Rocha, R.; Sousa, M.; Leite, J.; Melo, F.; Pimentel, J.; Ventura, L.; Vila Nova, C.; Copacscu, C.; Bintintan, V.; Ciuce, C.; Dindelegan, G.; Scurtu, R.; Seicean, R.; Domansky, N.; Karachun, A.; Moiseenko, A.; Pelipas, Y.; Petrov, A.; Pravosudov, I.; Aiupov, R.; Akmalov, Y.; Parfenov, A.; Suleymanov, N.; Tarasov, N.; Jumabaev, H.; Mamedli, Z.; Rasulov, A.; Aliev, I.; Chernikovskiy, I.; Kochnev, V.; Komyak, K.; Smirnov, A.; Achkasov, S.; Bolikhov, K.; Shelygin, Y.; Sushkov, O.; Zapolskiy, A.; Gvozdenovic, M.; Jovanovic, D.; Lausevic, Z.; Cvetkovic, D.; Maravic, M.; Milovanovic, B.; Stojakovic, N.; Tripkovic, I.; Mihajlovic, D.; Nestorovic, M.; Pecic, V.; Petrovic, D.; Stanojevic, G.; Barisic, G.; Dimitrijevic, I.; Krivokapic, Z.; Markovic, V.; Popovic, M.; Aleksic, A.; Dabic, D.; Kostic, I.; Milojkovic, A.; Perunicic, V.; Lukic, D.; Petrovic, T.; Radovanovic, D.; Radovanovic, Z.; Cuk, V. M.; Cuk, V. V.; Kenic, M.; Kovacevic, B.; Krdzic, I.; Korcek, J.; Rems, M.; Toplak, J.; Escarra, J.; Gil Barrionuevo, M.; Golda, T.; Kreisler Moreno, E.; Zerpa Martin, C.; Alvarez Laso, C.; Cumplido, P.; Padin, H.; Baixauli Fons, J.; Hernandez-Lizoain, J.; Martinez-Ortega, P.; Molina-Fernandez, M.; Sanchez-Justicia, C.; Gracia Solanas, J. Antonio; Diaz de laspra, E. Cordoba; Echazarreta-Gallego, E.; Elia-Guedea, M.; Ramirez, J.; Arredondo Chaves, J.; Gonzalez, P. Diez; Elosua, T.; Sahagun, J.; Turienzo Frade, A.; Alvarez Conde, J.; Castrillo, E.; Diaz Maag, R.; Maderuelo, V.; Saldarriaga, L.; Aldrey Cao, I.; Fernandez Varela, X.; Nunez Fernandez, S.; Parajo Calvo, A.; Villar Alvarez, S.; Blesa Sierra, I.; Lozano, R.; Marquez, M.; Porcel, O.; Menendez, P.; Fernandez Hevia, M.; Flores Siguenza, L.; Jimenez Toscano, M.; Lacy Fortuny, A.; Ordonez Trujillo, J.; Espi, A.; Garcia-Botello, S.; Martin-Arevalo, J.; Moro-Valdezate, D.; Pla-Marti, V.; Blanco-Antona, F.; Abrisqueta, J.; Ibanez Canovas, N.; Lujan Mompean, J.; Escola Ripoll, D.; Martinez Gonzalez, S.; Parodi, J.; Fernandez Lopez, A.; Ramos Fernandez, M.; Castellvi Valls, J.; Ortiz de Zarate, L.; Ribas, R.; Sabia, D.; Viso, L.; Alonso Goncalves, S.; Gil Egea, M. Jose; Pascual Damieta, M.; Pera, M.; Salvans Ruiz, S.; Bernal, J.; Landete, F.; Ais, G.; Etreros, J.; Aguilo Lucia, J.; Bosca, A.; Deusa, S.; Garcia del Cano, J.; Viciano, V.; Garcia-Armengol, J.; Roig, J.; Blas, J.; Escartin, J.; Fatas, J.; Fernando, J.; Ferrer, R.; Arias Pacheco, R.; Garcia Florez, L.; Moreno Gijon, M.; Otero Diez, J.; Solar Garcia, L.; Aguilar Teixido, F.; Balaguer Ojo, C.; Bargallo Berzosa, J.; Lamas Moure, S.; Sierra, J. Enrique; Ferminan, A.; Herrerias, F.; Rufas, M.; Vinas, J.; Codina-Cazador, A.; Farres, R.; Gomez, N.; Julia, D.; Planellas, P.; Lopez, J.; Luna, A.; Maristany, C.; Munoz Duyos, A.; Puertolas, N.; Alcantara Moral, M.; Serra-Aracil, X.; Concheiro Coello, P.; Gomez, D.; Carton, C.; Miguel, A.; Reoyo Pascual, F.; Valero Cerrato, X.; Zambrano Munoz, R.; Cervera-Aldama, J.; Gonzalez, J. Garcia; Ramos-Prada, J.; Santamaria-Olabarrieta, M.; Uriguen-Echeverria, A.; Coves Alcover, R.; Espinosa Soria, J.; Fernandez Rodriguez, E.; Hernandis Villalba, J.; Maturana Ibanenz, V.; de la Torre Gonzalez, F.; Huerga, D.; Perez Viejo, E.; Rivera, A.; Ruiz Ucar, E.; Garcia-Septiem, J.; Jimenez, V.; Jimenez Miramon, J.; Ramons Rodriquez, J.; Rodriguez Alvarez, V.; Garcea, A.; Ponchietti, L.; Borda, N.; Enriquez-Navascues, J.; Saralegui, Y.; Febles Molina, G.; Nogues, E.; Rodriguez Mendez, A.; Roque Castellano, C.; Sosa Quesada, Y.; Alvarez-Gallego, M.; Pascual, I.; Rubio-Perez, I.; Diaz-San Andres, B.; Tone-Villanueva, F.; Alonso, J.; Cagigas, C.; Castillo, J.; gomez, M.; Martin-Parra, J.; Mengual Ballester, M.; Pellicer Franco, E.; Soria Aledo, V.; Valero Navarro, G.; Caballero Rodriguez, E.; Gonzalez de Chaves, P.; Hernandez, G.; Perez Alvarez, A.; Soto Sanchez, A.; Becerra Garcia, F. Cesar; Alonso Roque, J. Guillermo; Rodriguez Arias, F. Lopez; del Valle Ruiz, S. R.; Sanchez de la Villa, G.; Compan, A.; Garcia Marin, A.; Nofuentes, C.; Orts Mico, F.; Perez Auladell, V.; Carrasco, M.; Duque Perez, C.; Galvez-Pastor, S.; Navarro Garcia, I.; Sanchez Perez, A.; Enjuto, D.; Manuel Bujalance, F.; Marcelin, N.; Perez, M.; Serrano Garcia, R.; Cabrera, A.; de la Portilla, F.; Diaz-Pavon, J.; Jimenez-Rodriguez, R.; Vazquez-Monchul, J.; Daza Gonzalez, J.; Gomez Perez, R.; Rivera Castellano, J.; Roldan de la Rua, J.; Errasti Alustiza, J.; Fernandez, L.; Romeo Ramirez, J.; Sardon Ramos, J.; Cermeno Toral, B.; Alias, D.; Garcia-Olmo, D.; Guadalajara, H.; Herreros, M.; Pacheco, P.; del Castillo Diez, F.; Lima Pinto, F.; Martinez Alegre, J.; Ortega, I.; Nieto Antonio, A. Picardo; Caro, A.; Escuder, J.; Feliu, F.; Millan, M.; Alos Company, R.; Frangi Caregnato, A.; Lozoya Trujillo, R.; Rodriguez Carrillo, R.; Ruiz Carmona, M.; Alonso, N.; Ambrona Zafra, D.; Ayala Candia, B. Amilka; Bonnin Pascual, J.; Pineno Flores, C.; Alcazar Montero, J.; Angoso Clavijo, M.; Garcia, J.; Sanchez Tocino, J.; Gomez-Alcazar, C.; Costa-Navarro, D.; Ferri-Romero, J.; Rey-Riveiro, M.; Romero-Simo, M.; Arencibia, B.; Esclapez, P.; Garcia-Granero, E.; Granero, P.; Medina Fernandez, F. J.; Gallardo Herrera, A. B.; Diaz Lopez, C.; Navarro Rodriguez, E.; Torres Tordera, E.; Arenal, J.; Citores, M.; Marcos, J.; Sanchez, J.; Tinoco, C.; Espin, E.; Garcia Granero, A.; Jimenez Gomez, L.; Sanchez Garcia, J.; Vallribera, F.; Folkesson, J.; Skoldberg, F.; Bergman, K.; Borgstrom, E.; Frey, J.; Silfverberg, A.; Soderholm, M.; Nygren, J.; Segelman, J.; Gustafsson, D.; Lagerqvist, A.; Papp, A.; Pelczar, M.; Abraham-Nordling, M.; Ahlberg, M.; Sjovall, A.; Tengstrom, J.; Hagman, K.; Chabok, A.; Ezra, E.; Nikberg, M.; Smedh, K.; Tiselius, C.; Al-Naimi, N.; Duc, M. Dao; Meyer, J.; Mormont, M.; Ris, F.; Prevost, G.; Villiger, P.; Hoffmann, H.; Kettelhack, C.; Kirchhoff, P.; Oertli, D.; Weixler, B.; Aytac, B.; Leventoglu, S.; Mentes, B.; Yuksel, O.; Demirbas, S.; Ozkan, B. Busra; Ozbalci, G. Selcuk; Sungurtekin, U.; Gulcu, B.; Ozturk, E.; Yilmazlar, T.; Challand, C.; Fearnhead, N.; Hubbard, R.; Kumar, S.; Arthur, J.; Barben, C.; Skaife, P.; Slawik, S.; Williams, M.; Zammit, M.; Barker, J.; French, J.; Sarantitis, I.; Slawinski, C.; Clifford, R.; Eardley, N.; Johnson, M.; McFaul, C.; Vimalachandran, D.; Allan, S.; Bell, A.; Oates, E.; Shanmugam, V.; Brigic, A.; Halls, M.; Pucher, P.; Stubbs, B.; Agarwal, T.; Chopada, A.; Mallappa, S.; Pathmarajah, M.; Sugden, C.; Brown, C.; Macdonald, E.; Mckay, A.; Richards, J.; Robertson, A.; Kaushal, M.; Patel, P.; Tezas, S.; Touqan, N.; Ayaani, S.; Marimuthu, K.; Piramanayagam, B.; Vourvachis, M.; Iqbal, N.; Korsgen, S.; Seretis, C.; Shariff, U.; Arnold, S.; Chan, H.; Clark, E.; Fernandes, R.; Moran, B.; Bajwa, A.; McArthur, D.; Cao, K.; Cunha, P.; Pardoe, H.; Quddus, A.; Theodoropoulou, K.; Bolln, C.; Denys, G.; Gillespie, M.; Manimaran, N.; Reidy, J.; Malik, A. I.; Malik, A.; Pitt, J.; Aryal, K.; El-Hadi, A.; Lal, R.; Pal, A.; Velchuru, V.; Cunha, M. Oliveira; Thomas, M.; Bains, S.; Boyle, K.; Miller, A.; Norwood, M.; Yeung, J.; Goian, L.; Gurjar, S.; Saghir, W.; Sengupta, N.; Stewart-Parker, E.; Bailey, S.; Khalil, T.; Lawes, D.; Nikolaou, S.; Omar, G.; Church, R.; Muthiah, B.; Garrett, W.; Marsh, P.; Obeid, N.; Chandler, S.; Coyne, P.; Evans, M.; Hunt, L.; Lim, J.; Oliphant, Z.; Papworth, E.; Weaver, H.; Leon, K. Cuinas; Williams, G.; Hernon, J.; Kapur, S.; Moosvi, R.; Shaikh, I.; Swafe, L.; Aslam, M.; Evans, J.; Ihedioha, U.; Kang, P.; Merchant, J.; Hompes, R.; Middleton, R.; Broomfield, A.; Crutten-Wood, D.; Foster, J.; Nash, G.; Akhtar, M.; Boshnaq, M.; Eldesouky, S.; Mangam, S.; Rabie, M.; Ahmed, J.; Khan, J.; Goh, N. Ming; Shamali, A.; Stefan, S.; Thompson, C.; Amin, A.; Docherty, J.; Lim, M.; Walker, K.; Watson, A.; Hossack, M.; Mackenzie, N.; Paraoan, M.; Alam, N.; Daniels, I.; Narang, S.; Pathak, S.; Smart, N.; Al-Qaddo, A.; Codd, R.; Rutka, O.; Bronder, C.; Crighton, I.; Davies, E.; Raymond, T.; Bookless, L.; Griffiths, B.; Plusa, S.; Carlson, G.; Harrison, R.; Lees, N.; Mason, C.; Quayle, J.; Branagan, G.; Broadhurst, J.; Chave, H.; Sleight, S.; Awad, F.; Cruickshank, N.; Joy, H.; Boereboom, C.; Daliya, P.; Dhillon, A.; Watson, N.; Watson, R.; Artioukh, D.; Gokul, K.; Javed, M.; Kong, R.; Sutton, J.; Faiz, O.; Jenkins, I.; Leo, C. A.; Samaranayake, S. F.; Warusavitarne, J.; Arya, S.; Bhan, C.; Mukhtar, H.; Oshowo, A.; Wilson, J.; Duff, S.; Fatayer, T.; Mbuvi, J.; Sharma, A.; Cornish, J.; Davies, L.; Harries, R.; Morris, C.; Torkington, J.; Knight, J.; Lai, C.; Shihab, O.; Tzivanakis, A.; Hussain, A.; Luke, D.; Padwick, R.; Torrance, A.; Tsiamis, A.; Dawson, P.; Balfour, A.; Brady, R.; Mander, J.; Paterson, H.; Chandratreya, N.; Chu, H.; Cutting, J.; Vernon, S.; Ho, C. Wai; Andreani, S.; Patel, H.; Warner, M.; Tan, J. Yan Qi; Gidwani, A.; Lawther, R.; Loughlin, P.; Skelly, B.; Spence, R.; Iqbal, A.; Khan, A.; Perrin, K.; Raza, A.; Tan, S.

    2017-01-01

    Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit

  12. Comparative study of hand sewn single layer anastomosis of dog's bowel Estudo comparativo das anastomoses manuais em plano único do intestino delgado de cães

    OpenAIRE

    João Luiz Moreira Coutinho Azevedo; Octávio Hypólito; Otávio Cansanção Azevedo; Otávio Monteiro Becker Jr.; Dalmer Faria Freire

    2008-01-01

    BACKGROUND: Two-layer intestinal anastomosis increases the inflammatory response while single-layer anastomosis results in a better wound healing. However the four main kinds of stitches which may be chosen in performing single layer intestinal sutures never before had been comparatively studied. AIM: To compare the four more commonly used types of single layer surgical anastomosis sutures of the digestive tract. METHODS: Six mongrel dogs were operated, each one receiving two anastomosis: one...

  13. Fluorescent Angiography Used to Evaluate the Perfusion Status of Anastomosis in Laparoscopic Anterior Resection.

    Science.gov (United States)

    Koh, Frederick H; Tan, Ker-Kan

    2016-12-01

    Anastomotic leakage after gastrointestinal surgery is associated with significant morbidity and mortality.1 Insufficient vascular supply is one cause.2 Recent reports of using intraoperative indocyanine green (ICG) fluorescent angiography to evaluate whether perfusion of the anastomosis is adequate has yielded positive outcomes.3 - 6 The authors describe their use of ICG-enhanced fluorescence angiography in a laparoscopic anterior resection. The patient was an 80-year-old with an upper rectal adenocarcinoma and significant cardiovascular risk factors. Fluorescence angiography with 0.4 mg/kg of ICG was administered intravenously just before the colorectal anastomosis was fashioned. A near-infrared (NIR) laparoscopic camera (KARLSTORZ, GmbH & Co. KG, Tuttlingen, Germany) was used to inspect the anastomosis. For this video, 0.4 mg/kg of ICG also was injected after ligation of the inferior mesenteric artery to demonstrate the appearance of a poorly perfused sigmoid bowel. Just before the staple was fired to fashion the colorectal anastomosis, an intravenous bolus of ICG was administered. Within seconds, vessels on both ends of the anastomosis turned fluorescent blue, indicating adequacy of perfusion. The use of ICG did not significantly lengthen the operative time (285 min) because its effect appeared within seconds after its administration. The patient recovered well and was discharged on postoperative day 5. Another four patients who also underwent intraoperative fluorescent angiography for left-sided colorectal lesions did not experience anastomotic leakage. The study showed that ICG fluorescent angiography is a simple and quick intraoperative tool for evaluating the perfusion of the anastomosis. The authors' experience with ICG fluorescent angiography has shown promising results, with a 0 % anastomotic leak rate.

  14. The use of arteriovenous anastomosis for venous drainage during Tamai zone I fingertip replantation.

    Science.gov (United States)

    Wu, Fei; Shen, Xiaofang; Eberlin, Kyle R; Sun, Zhibo; Zhou, Xiao; Xue, Mingyu

    2018-03-27

    The purpose of this study was to evaluate outcomes for patients sustaining a distal fingertip amputation who underwent replantation witharteriovenous anastomosis for venous drainage over a one year period at our institution. This technique has been utilized when insufficient veins are identified in the amputated part for standard veno-venous anastomosis. A retrospective study was performed on patients presenting from 2013 to 2014. Guillotine, crush, and avulsion/degloving injuries were included if they underwent fingertip (Tamai Zone I) replantation with arterial anastomosis for vascular inflow and arteriovenous anastomosis for venous drainage. The cases were further classified as Ishikawa subzone I and subzone II. Arteriovenous anastomosis for venous drainage during replantation was used in 45 digits in 35 patients. 41 of the 45 digits underwent successful replantation using this technique (91%). The mean active ROM in the DIP joint of the fingers and in the IP joint of thumbs was 65° and 57°, respectively. Sensory evaluation demonstrated a mean of 6.9 mm s2PD in digits where the digital nerves could be repaired. 11 replanted digits without nerve repair regained some sensory recovery with a mean of 9.6 mm s2PD. 91% of patients were highly satisfied with the appearance of the replanted digits based on Tamai criteria. Arteriovenous anastomosis for venous outflow should be considered during zone I fingertip replantation if sufficient veins are not identified in the amputated part. This technique may allow for more routine and successful distal replantation. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Fingertip amputation salvage on arterial anastomosis alone: an investigation of its limitations.

    Science.gov (United States)

    Ito, Hiroshi; Sasaki, Kenji; Morioka, Kousuke; Nozaki, Motohiro

    2010-09-01

    We have previously reported the importance of adequate and precise arterial anastomosis and the hypothesis that, up to subzone III, fingertip amputation salvage can be achieved on arterial anastomosis alone. These findings were reported during the meeting of the Japanese Society of Reconstructive Microsurgery. This is our follow-up report with insight and opinion on the limitations of complete fingertip amputation salvage on arterial anastomosis alone. We examined 67 fingers (59 patients) with fingertip amputations presenting to our hospital between January 2005 and December 2008. Amputation levels and whether these injuries received only arterial or both arterial and venous anastomoses were noted. Fisher exact test was used to examine statistical differences between the groups. Amputation levels were 11 in subzone I, 20 in subzone II, 17 in subzone III, and 19 in subzone IV. Successful replantation was achieved in 87% (58 of 67) of fingers. There was no statistically significant difference between fingers receiving arterial alone versus both anastomoses in amputations of subzones I, II, and III. We found that with proper postoperative congestion care, no statistically significant difference in replantation success of fingers receiving arterial anastomosis alone versus both arterial and venous were noted up to subzone III. However, in subzone IV, regardless of the postoperative congestion, compete necrosis rates are high; thus, it is speculated that a venous anastomosis is necessary for successful replantation. It is preferable to perform as many anastomoses as possible, but we believe that it is also desirable for the procedure to be fast and less invasive. In cases that have no adequate vein, fingertip replantation can be achieved on arterial anastomosis alone up to subzone III.

  16. Successful pregnancy after uterovaginal anastomosis in patients with congenital atresia of cervix uteri.

    Science.gov (United States)

    Prorocic, M; Vasiljevic, M; Tasic, L; Brankovic, S

    2012-01-01

    We present a case of successful pregnancy after effective uterovaginal anastomosis in a 26-years-old patient with congenital atresia of the cervix uteri. She spontaneously achieved pregnancy after four years of uterovaginal anastomosis. Gestation was at the eighth lunar month and the delivery was done by cesarean section due to rapidly progressing fetal asphyxia. The patient gave birth to a live healthy male, weighing 1,950 g, with an Apgar score of 5 and 8 at 1 and 5 min, respectively. The postoperative course was uneventful, and leakage of lochia was normal.

  17. The use of shape memory compression anastomosis clips in cholecystojejunostomy in pigs – a preliminary study

    Directory of Open Access Journals (Sweden)

    Piotr Holak

    2015-01-01

    Full Text Available This paper reports on the use of compression anastomosis clips (CAC in cholecystoenterostomy in an animal model. Cholecystojejunostomy was performed in 6 pigs using implants made of nickel-titanium alloy in the form of elliptical springs with two-way shape memory. The applied procedure led to the achievement of tight anastomosis with a minimal number of complications and positive results of histopathological evaluations of the anastomotic site. The results of the study indicate that shape memory NiTi clips are a promising surgical tool for cholecystoenterostomy in cats and dogs.

  18. [Successful endoscopic dilatation of a stenosis in relation to an ileorectal anastomosis by acute ileus].

    Science.gov (United States)

    Kjærgaard, Jane Christensen; Hendel, Jakob; Gügenur, Ismail

    2014-02-17

    Endoscopic dilatation is a treatment option for patients with Crohns disease suffering from stenosis in relation to an ileorectal anastomosis. We present a case of a patient with Crohns disease who was admitted with acute obstructive symptoms due to a stensosis of the ileorectal anastomosis. The patient was septic. We performed a successful endoscopic dilatation in the acute phase and the patient was discharged few days after an uneventful recovery. Endoscopic dilatation of an ileorectal anastomsis in patients with Crohns disease is a treatment option in the acute setting when performed by experienced endoscopists.

  19. Adenocarcinoma in the anal canal after ileal pouch-anal anastomosis for familial adenomatous polyposis using a double-stapled technique: report of two cases

    NARCIS (Netherlands)

    Vrouenraets, Bart C.; van Duijvendijk, Peter; Bemelman, Willem A.; Offerhaus, G. Johan A.; Slors, J. Frederik M.

    2004-01-01

    Restorative proctocolectomy with an ileal pouch-anal anastomosis is thought to abolish the risk of colorectal adenoma development in patients suffering from familial adenomatous polyposis. Both after mucosectomy with a handsewn anastomosis and after a double-stapled anastomosis, rectal mucosa is

  20. Outcomes of One Anastomosis Gastric Bypass in 472 Diabetic Patients.

    Science.gov (United States)

    Taha, Osama; Abdelaal, Mahmoud; Abozeid, Mohamed; Askalany, Awny; Alaa, Mohamed

    2017-11-01

    The positive impact of Roux-en-Y gastric bypass (RYGB) on metabolic syndrome and glycemic control has been proven in obese patients. One anastomosis gastric bypass (OAGB) is a simple, effective and easy to learn procedure. OAGB provides encouraging results for the treatment of diabetes obese patients, but does it have the ability to be an alternative procedure to RYGB in the treatment of these patients? The aim of this study is to evaluate the outcomes of OAGB on diabetic obese patients at the bariatric centre of our university hospital. By extension, we evaluated the possibility of BMI and the preoperative antidiabetic medication usage to be predictive factors for postoperative diabetes resolution. This is a retrospective single-centre study of 472 diabetic patients who underwent OAGB from November 2009 to December 2015. All patients were followed-up for at least 1 year, and up to 3 years, where available. Weight, HbA1c, and anti-diabetic medications were recorded at baseline, 3, 6, 12, 24 and 36 months. A total of 472 patients have been followed-up for 1 year and 361 for 3 years. The mean BMI decreased from 46.8 ± 7.2 to 29.5 ± 2.8 kg/m 2 and HbA1c from 9.6 ± 1.3 to 5.7 ± 1.5% at the 12-month follow-up. At the 3-year follow-up, the mean BMI was 32.1 ± 3.3 and HbA1c mean was 5.8 ± 0.9%. Diabetes remission was achieved by 84.1% of patients. OAGB can be an excellent alternative to RYGB for the treatment of diabetes and obesity. Pre-operative medications may be used to predict postoperative diabetes remission, but not BMI.

  1. Tubal anastomosis after previous sterilization: a systematic review.

    Science.gov (United States)

    van Seeters, Jacoba A H; Chua, Su Jen; Mol, Ben W J; Koks, Carolien A M

    2017-05-01

    chance of conception was female age. The surgical approach (i.e. laparotomy [microscopic], laparoscopy or robotic) had no impact on the outcome, with the exception of the macroscopic laparotomic technique, which had inferior results and is not currently utilized. For older women, IVF could be a more cost-effective alternative for the reversal of sterilization. However, direct comparative data are lacking and a cut-off age cannot be stated. In sterilized women who suffer regret, surgical tubal re-anastomosis is an effective treatment, especially in younger women. However, there is a need for randomized controlled trials comparing the success rates and costs of surgical reversal with IVF.

  2. Trick or Treat and Telescopes

    Science.gov (United States)

    Buratti, Bonnie J.; Meinke, Bonnie K.; Schmude, Richard W.

    2017-10-01

    Based on an activity that DPS member Richard Schmude Jr. has been doing for years, with over 5000 children reached, DPS initiated in 2016 a pilot program entitled “Trick-or-Treat and Telescopes.” DPS encouraged its members to put out their telescopes during trick-or-treat time on Halloween, in their own lawns or in a neighbor’s lawn with better viewing (or more traffic). The program will be continued in 2017. This year should offer good viewing with a waxing gibbous moon and Saturn visible. The program was also advertised though the Night Sky Network, a consortium of astronomy clubs. The following website gives advice and connections to resources.https://dps.aas.org/education/trick-or-treat-and-telescopes acknowledged.

  3. Scientific management of Space Telescope

    Science.gov (United States)

    Odell, C. R.

    1981-01-01

    A historical summay is given on the science management of the Space Telescope, the inception of which began in 1962, when scientists and engineers first recommended the development of a nearly diffraction limited substantial-size optical telescope. Phase A, the feasibility requirements generation phase, began in 1971 and consisted largely of NASA scientists and a NASA design. Phase B, the preliminary design phase, established a tiered structure of scientists, led by the Large Space Telescope operations and Management Work Group. A Mission Operations Working Group headed six instrument definition teams to develop the essential instrument definitions. Many changes took place during Phase B, before design and development, which began in 1978 and still continues today.

  4. LSST Telescope and Optics Status

    Science.gov (United States)

    Gressler, William; Krabbendam, V. L.; Andrew, J. R.; Barr, J. D.; DeVries, J.; Hileman, E.; Liang, M.; Neill, D. R.; Sebag, J.; Stubbs, C.; Wiecha, O.; LSST Collaboration

    2010-01-01

    Progress continues on the final design of key elements of the LSST Telescope system thanks to private support. Rear surface polishing of the unique 8.4m M1/M3 monolithic mirror has been completed with the subsequent attachment of support loadspreaders and hardpoints. The mirror will now undergo the final two year planned effort of front surface grinding and polishing. The LSST telescope cell design has matured to accommodate on-telescope mirror support, pointing, and thermal conditioning requirements in addition to off-telescope optical coating requirements. Performance and environmental testing of hardware components has commenced to assist with prototyping and final design selection of the M1/M3 mirror support system. LSST plans to design, fabricate, assemble, and deliver qualified subassemblies for integration of the M1/M3 and telescope cell in early 2012. Corning has completed and delivered the M2 ULE™ substrate. This 3.5m diameter, 100mm thick meniscus substrate has been acid etched to passivate any stress features and the convex surface has been finished via precision contour grinding to near net final shape. The substrate awaits construction funding to enable final optical polishing. The LSST Calibration System design utilizes a fiber-fed reflective projector system. An array of these projectors provides uniform illumination across the telescope field of view in tunable wavelength bands to calibrate the LSST camera detector elements. Finally, advancement continues forward on LSST support facility development via the award of an A&E contract to provide specific site design and development activities.

  5. Superconductor lunar telescopes --Abstract only

    Science.gov (United States)

    Chen, P. C.; Pitts, R.; Shore, S.; Oliversen, R.; Stolarik, J.; Segal, K.; Hojaji, H.

    1994-01-01

    We propose a new type of telescope designed specifically for the lunar environment of high vacuum and low temperature. Large area UV-Visible-IR telescope arrays can be built with ultra-light-weight replica optics. High T(sub c) superconductors provide support, steering, and positioning. Advantages of this approach are light-weight payload compatible with existing launch vehicles, configurable large area optical arrays, no excavation or heavy construction, and frictionless electronically controlled mechanisms. We have built a prototype and will be demonstarting some of its working characteristics.

  6. Infrared up-conversion telescope

    DEFF Research Database (Denmark)

    2014-01-01

    There is presented to an up-conversion infrared telescope (110) arranged for imaging an associated scene (130), wherein the up-conversion infrared telescope (110) comprises a non-linear crystal (120) arranged for up-conversion of infrared electromagnetic radiation, and wherein a first optical...... component (101) has an entrance pupil with a first diameter D1, and an optical component system which is arranged for forming an first image (136) of the back-focal plane (132) of the objective optical component (100), which has a diameter (given by the diameter of a circle enclosing all optical paths...

  7. The network of INTA telescopes

    Science.gov (United States)

    Cuesta, L.

    2008-06-01

    The Spanish Instituto Nacional de Técnica Aeroespacial has a network of three telescopes located at some of the best places for astronomy in mainland Spain. The first is at the Observatorio de Calar Alto in Almeria, at an altitude of more than 2100 m. The second is near Calatayud in Zaragoza, at the summit of a 1400-m high mountain. The last is on the campus of the Instituto Nacional de Técnica Aerospatial (INTA), in Madrid. The three telescopes are either 40 or 50 cm in diameter and will be available for communications and educational projects.

  8. A monolithic silicon detector telescope

    International Nuclear Information System (INIS)

    Cardella, G.; Amorini, F.; Cabibbo, M.; Di Pietro, A.; Fallica, G.; Franzo, G.; Figuera, P.; Papa, M.; Pappalardo, G.; Percolla, G.; Priolo, F.; Privitera, V.; Rizzo, F.; Tudisco, S.

    1996-01-01

    An ultrathin silicon detector (1 μm) thick implanted on a standard 400 μm Si-detector has been built to realize a monolithic telescope detector for simultaneous charge and energy determination of charged particles. The performances of the telescope have been tested using standard alpha sources and fragments emitted in nuclear reactions with different projectile-target colliding systems. An excellent charge resolution has been obtained for low energy (less than 5 MeV) light nuclei. A multi-array lay-out of such detectors is under construction to charge identify the particles emitted in reactions induced by low energy radioactive beams. (orig.)

  9. Stapled side-to-side anastomosis might be better than handsewn end-to-end anastomosis in ileocolic resection for Crohn's disease: a meta-analysis.

    Science.gov (United States)

    He, Xiaosheng; Chen, Zexian; Huang, Juanni; Lian, Lei; Rouniyar, Santosh; Wu, Xiaojian; Lan, Ping

    2014-07-01

    Ileocolic anastomosis is an essential step in the treatment to restore continuity of the gastrointestinal tract following ileocolic resection in patients with Crohn's disease (CD). However, the association between anastomotic type and surgical outcome is controversial. The aim of this meta-analysis is to compare surgical outcomes between stapled side-to-side anastomosis (SSSA) and handsewn end-to-end anastomosis (HEEA) after ileocolic resection in patients with CD. Studies comparing SSSA with HEEA after ileocolic resection in patients with CD were identified in PubMed and EMBASE. Outcomes such as complication, recurrence, and re-operation were evaluated. Eight studies (three randomized controlled trials, one prospective non-randomized trial, and four non-randomized retrospective trials) comparing SSSA (396 cases) and HEEA (425 cases) were included. As compared with HEEA, SSSA was superior in terms of overall postoperative complications [odds ratio (OR), 0.54; 95 % confidence interval (CI) 0.32-0.93], anastomotic leak (OR 0.45; 95 % CI 0.20-1.00), recurrence (OR 0.20; 95 % CI 0.07-0.55), and re-operation for recurrence (OR 0.18; 95 % CI 0.07-0.45). Postoperative hospital stay, mortality, and complications other than anastomotic leak were comparable. Based on the results of our meta-analysis, SSSA would appear to be the preferred procedure after ileocolic resection for CD, with reduced overall postoperative complications, especially anastomotic leak, and a decreased recurrence and re-operation rate.

  10. Perioperative changes of the intraocular pressure during the treatment of epiretinal membrane by using 25- or 27-gauge sutureless vitrectomy without gas tamponade.

    Science.gov (United States)

    Takashina, Hirotsugu; Watanabe, Akira; Tsuneoka, Hiroshi

    2017-01-01

    The purpose of this study was to compare perioperative intraocular pressures (IOPs) in 25- or 27-gauge microincision vitrectomy surgery (MIVS) and to evaluate the stability of postoperative sclerotomy closure. This is a retrospective review of 147 eyes treated for epiretinal membrane by using 25- or 27-gauge MIVS as the initial vitrectomy (25-gauge phacovitrectomy [25-P group]: 73 eyes, 25-gauge vitrectomy alone [25-A group]: 15 eyes, 27-gauge phacovitrectomy [27-P group]: 47 eyes, and 27-gauge vitrectomy alone [27-A group]: 12 eyes). Statistical analyses of perioperative IOPs on preoperative day (PreOp), postoperative day (POD)1, POD2, postoperative week 1, and postoperative month 1 were performed. All self-sealing sclerotomies were obtained without gas tamponade at the end of surgery. Also, no significant differences were noted in the age and axial length among the 4 groups and in the surgical time between 25-P and 27-P groups and between 25-A and 27-A groups. Significant decreases in IOP were found at POD1 and POD2 in the 25-P, 25-A, and 27-P groups compared with PreOP, but not in the 27-A group. Even though surgeons confirm that there is no leakage from sutureless sclerotomy and that a normal IOP is preserved at the end of 25- or 27-gauge MIVS, there is a possibility of postoperative sclerotomy leakage on the day of the surgery. Furthermore, postoperative sclerotomy self-sealing of the MIVS in previous intraocular lens implantation cases is considered to be acquired easily than that in phacovitrectomy.

  11. Phacoaspiration with a Cionni ring versus pars plana lensectomy, vitrectomy and sutureless transscleral IOL fixation in pediatric patients with a subluxated lens.

    Science.gov (United States)

    Thapa, Bikram Bahadur; Agarwal, Aniruddha; Singh, Ramandeep; Gupta, Parul Chawla; Ram, Jagat

    2016-05-01

    To compare outcomes of phacoaspiration (PA) with Cionni ring-assisted posterior-chamber intraocular lens implantation (PCIOL) versus pars plana lensectomy (PPL) with anterior vitrectomy (AV) and sutureless transscleral fixation of the IOL (TSFIOL) assisted with fibrin glue in the management of a subluxated lens. In this prospective and comparative interventional study, one eye of children with a bilateral subluxated lens was randomized to undergo PA with PCIOL using a Cionni ring (group A: n = 14 eyes), and the other eye underwent PPL + AV with glue-assisted TSFIOL (group B: n = 14 eyes). The outcome measures included best-corrected visual acuity (BCVA) in logMAR units and rates of complications at 12-month follow-up visits. 28 eyes of 14 children (age: 8.06 ± 4.49 years) were included in the study. BCVA improved from preoperative value of 1.21 to 0.4 (p = 0.001) in group A and from 1.53 to 0.31 (p = 0.001) in group B at month 12. There was no significant difference in the BCVA on comparing the two groups at month 12 (p > 0.411). Postoperative complications in group A included corneal edema (two eyes), Cionni hook capture (one eye), elevated IOP (one eye), and posterior capsular opacification (five eyes). In group B, corneal edema was seen in two eyes, hypotony in one eye, vitreous hemorrhage in one eye and pupillary optic capture in four eyes. Head-to-head comparison of the two techniques demonstrates no significant difference in the rates of complications at month 12. The decision to choose either technique may be based on the operating surgeon's skill, experience and preference.

  12. Comparison of Colonic J-pouch and Straight Coloanal anastomosis after Low Anterior Resection.

    Science.gov (United States)

    Mehrvarz, Shaban; Towliat, Seyed Mohsen; Mohebbi, Hassan Ali; Derakhshani, Saieed; Abavisani, Mahdi

    2013-01-01

    The tendency towards sphincter preserving for low rectal cancers with low anterior resection, has led to the technique of straight coloanal anastomosis (SCAA) or colonic J-pouch anal anastomosis (CPAA). The aim of our study was to compare functional outcomes, complication rates and quality of life (QoL) after LAR with either a straight or colonic J pouch anastomosis. In 88 patients with rectal tumors located in lower third, who were candidate for LAR with coloanal anastomosis. They were divided for reconstruction using either SCAA (n= 47) or CPAA (n= 41) from January 2007 to May 2009. Functional results were assessed after closure of temporary loop ileostomy, 6 months postoperatively. Quality of life (QoL) was measured using European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30. The two groups were matched for gender, age, and preoperative chemotherapy and radiotherapy. There were no significant differences between the SCAA and CPAA groups relative to anastomotic leakage. Among patients with CPAA, the mean of 24 hours bowel movements, daytime bowel movements, incontinence scores, and incidence of urgency were significantly lower than those in the SCAA group. Also, patients with a CPAA had a significantly better quality of life. CPAA provided not only better functional results than SCAA, but also improved quality of life, thus may be the better choice.

  13. Risk factors for anastomotic leakage after laparoscopic low anterior resection with DST anastomosis.

    Science.gov (United States)

    Kawada, Kenji; Hasegawa, Suguru; Hida, Koya; Hirai, Kenjiro; Okoshi, Kae; Nomura, Akinari; Kawamura, Junichiro; Nagayama, Satoshi; Sakai, Yoshiharu

    2014-10-01

    Laparoscopic rectal surgery involving rectal transection and anastomosis with stapling devices is technically difficult. The aim of this study was to evaluate the risk factors for anastomotic leakage (AL) after laparoscopic low anterior resection (LAR) with double-stapling technique (DST) anastomosis. This was a retrospective single-institution study of 154 rectal cancer patients who underwent laparoscopic LAR with DST anastomosis between June 2005 and August 2013. Patient-, tumor-, and surgery-related variables were examined by univariate and multivariate analyses. The outcome of interest was clinical AL. The overall AL rate was 12.3% (19/154). In univariate analysis, tumor size (P = 0.001), operative time (P = 0.049), intraoperative bleeding (P = 0.037), lateral lymph node dissection (P = 0.009), multiple firings of the linear stapler (P = 0.041), and precompression before stapler firings (P = 0.008) were significantly associated with AL. Multivariate analysis identified tumor size (odds ratio [OR] 4.01; 95% confidence interval [CI] 1.25-12.89; P = 0.02) and precompression before stapler firings (OR 4.58; CI 1.22-17.20; P = 0.024) as independent risk factors for AL. In particular, precompression before stapler firing tended to reduce the AL occurring in early postoperative period. Using appropriate techniques, laparoscopic LAR with DST anastomosis can be performed safely without increasing the risk of AL. Important risk factors for AL were tumor size and precompression before stapler firings.

  14. Circumferential tracheal resection with primary anastomosis for post-intubation tracheal stenosis: study of 24 cases.

    Science.gov (United States)

    Negm, Hesham; Mosleh, Mohamed; Fathy, Hesham

    2013-09-01

    The objective of this study is to evaluate the results of circumferential tracheal and cricotracheal resection with primary anastomosis for the treatment of post-intubation tracheal and cricotracheal stenosis. This is a retrospective analytical study. A total number of 24 patients were included in this study. The relevant preoperative, operative and postoperative records were collected and analyzed. Twenty patients were finally symptom-free reflecting an anastomosis success rate of 83.3 %. Variable grades of anastomotic restenosis occurred in 11 (45.8 %) patients, three patients were symptom-free and eight had airway obstructive symptoms. Four out of the eight patients with symptomatic restenosis were symptom-free with endoscopic dilatation while the remaining four patients required a permanent airway appliance (T-tube, tracheostomy) for the relief of airway obstruction and this group was considered as anastomotic failure. Cricoid involvement, associated cricoid resection and the type of anastomosis were the variables that had statistical impact on the occurrence of restenosis (P = 0.017, 0.017, 0.05; respectively). Tracheal resection with primary anastomosis is a safe effective treatment method for post-intubation tracheal stenosis in carefully selected patients. Restenosis does not always mean failure of the procedure since it may be successfully managed with endoscopic dilatation.

  15. [Descending hypoglossal branch-facial nerve anastomosis in treating unilateral facial palsy after acoustic neuroma resection].

    Science.gov (United States)

    Liang, Jiantao; Li, Mingchu; Chen, Ge; Guo, Hongchuan; Zhang, Qiuhang; Bao, Yuhai

    2015-12-15

    To evaluate the efficiency of the descending hypoglossal branch-facial nerve anastomosis for the severe facial palsy after acoustic neuroma resection. The clinical data of 14 patients (6 males, 8 females, average age 45. 6 years old) underwent descending hypoglossal branch-facial nerve anastomosis for treatment of unilateral facial palsy was analyzed retrospectively. All patients previously had undergone resection of a large acoustic neuroma. House-Brackmann (H-B) grading system was used to evaluate the pre-, post-operative and follow up facial nerve function status. 12 cases (85.7%) had long follow up, with an average follow-up period of 24. 6 months. 6 patients had good outcome (H-B 2 - 3 grade); 5 patients had fair outcome (H-B 3 - 4 grade) and 1 patient had poor outcome (H-B 5 grade) Only 1 patient suffered hemitongue myoparalysis owing to the operation. Descending hypoglossal branch-facial nerve anastomosis is effective for facial reanimation, and it has little impact on the function of chewing, swallowing and pronunciation of the patients compared with the traditional hypoglossal-facial nerve anastomosis.

  16. [Terminolateral esophagojejunostomy after gastrectomy with the biofragmentable anastomosis ring in the dog model].

    Science.gov (United States)

    Dietz, U A; Araújo, A C F; Czeczko, N G; Lemos, R; Araújo, U; Inácio, C M; Salles, G; Corrêa Neto, M; Repka, J C D; Zanellato, C M F; Malafaia, O; Debus, E S; Thiede, A

    2005-06-01

    Esophagojejunostomy after total gastrectomy still remains a high risk anastomosis with a considerable morbidity and mortality. The majority of these anastomoses are performed by the intraluminal stapler technique, yet stenoses are a known late complication even after an uneventful postoperative course. In the present study, the osophagojejunostomy with the biofragmentable anastomosis ring (BAR) was examined in dogs. 28 dogs were randomized into a group of manual suture (n = 14) and a BAR-group (n = 14). After gastrectomy, the esophagojejunostomy was performed by hand-suture with polypropylene 4-0 in the manual suture group, and with the 25/1.5 mm BAR in the BAR-group. In both groups the Roux-en-Y jejunojejunostomy was performed by hand-suture. The dogs were evaluated on postoperative days 4, 7 and 14 with regard to macroscopy, bursting strength, tissue hydroxyproline and histology. There was one leakage without clinical effect in the hand-sewn group on postoperative day 4; there was no leak in the BAR-group. In observing fibre-free enteral feeding, neither functional disorders nor obstruction of the BAR were observed. The general anastomosis parameters were matchable between the groups. The infracarinal BAR-esophagojejunostomy is comparable to the hand-sewn anastomosis in the dog-model.

  17. Hand-assisted laparoscopic versus open restorative proctocolectomy with ileal pouch anal anastomosis - a randomized trial

    NARCIS (Netherlands)

    Maartense, Stefan; Dunker, Michalda S.; Slors, J. Frederick; Cuesta, Miguel A.; Gouma, Dirk J.; van Deventer, Sander J.; van Bodegraven, Ad A.; Bemelman, Willem A.

    2004-01-01

    Objective: The aim of the study was to evaluate postoperative recovery after hand-assisted laparoscopic or open restorative proctocolectomy with ileal pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis in a randomized controlled trial. Methods: Sixty patients were

  18. Heterogeneity in electrophoretic karyotype within and between anastomosis groups of Rhizoctonia solani

    NARCIS (Netherlands)

    Keijer, J.; Houterman, P.M.; Dullemans, A.M.; Korsman, M.G.

    1996-01-01

    Isolates of the soil borne basidiomycete Rhizoctonia solani vary in cultural appearance, in growth characteristics and in pathogenicity towards plants. Isolates of R. solani can be divided into anastomosis groups (AGs) and this division accommodates part of the observed diversity. However, a clear

  19. When is primary anastomosis safe in the colon? | Ostrow | Annals of ...

    African Journals Online (AJOL)

    When is primary anastomosis safe in the colon? B Ostrow. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/aas.v1i1.45796 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  20. Evaluation and further development of the Excimer Laser Assisted Non-occlusive Anastomosis (ELANA) technique

    NARCIS (Netherlands)

    van Doormaal, T.P.C.

    2010-01-01

    The research described in this thesis had 2 main goals. The first goal was to evaluate the clinical results of the Excimer Laser Assisted Non-occlusive Anastomosis (ELANA) technique. The most important subgroups of patients were separately evaluated in the first part of this thesis (chapters 2 to

  1. Effect of Previous Irradiation on Vascular Thrombosis of Microsurgical Anastomosis: A Preclinical Study in Rats

    Science.gov (United States)

    Gallardo-Calero, Irene; López-Fernández, Alba; Romagosa, Cleofe; Vergés, Ramona; Aguirre-Canyadell, Marius; Soldado, Francisco; Velez, Roberto

    2016-01-01

    Background: The objective of the present investigation was to compare the effect of neoadjuvant irradiation on the microvascular anastomosis in cervical bundle using an experimental model in rats. Methods: One hundred forty male Sprague–Dawley rats were allocated into 4 groups: group I, control, arterial microanastomosis; group II, control, venous microanastomosis; group III, arterial microanastomosis with previous irradiation (20 Gy); and group IV, venous microanastomosis with previous irradiation (20 Gy). Clinical parameters, technical values of anastomosis, patency, and histopathological parameters were evaluated. Results: Irradiated groups (III and IV) and vein anastomosis groups (II and IV) showed significantly increased technical difficulties. Group IV showed significantly reduced patency rates (7/35) when compared with the control group (0/35). Radiotherapy significantly decreased the patency rates of the vein (7/35) when compared with the artery (1/35). Groups III and IV showed significantly reduced number of endothelial cells and also showed the presence of intimal thickening and adventitial fibrosis as compared with the control group. Conclusion: Neoadjuvant radiotherapy reduces the viability of the venous anastomosis in a preclinical rat model with a significant increase in the incidence of vein thrombosis. PMID:27975009

  2. Kinetics of primary bile acids in patients after proctocolectomy and ileal pouch-anal anastomosis

    NARCIS (Netherlands)

    Gotthardt, Daniel Nils; Sauer, Peter; Schaible, Anja; Stern, Josef; Stiehl, Adolf; Beuers, Ulrich

    2014-01-01

    The high incidence of cholesterol gallstones in patients after proctocolectomy with ileal pouch-anal anastomosis (IPAA) may be due to an increased loss of bile acids. We aimed to evaluate the kinetics of the primary bile acids cholic acid (CA) and chenodeoxycholic acid (CDCA) in these patients. Pool

  3. Early Versus Delayed (Traditional) Postoperative Oral Feeding in Patients Undergoing Colorectal Anastomosis.

    Science.gov (United States)

    Nematihonar, Behzad; Salimi, Sohrab; Noorian, Vahid; Samsami, Majid

    2018-01-01

    A period of starvation after colorectal anastomosis to permit for resolution of the clinical evidence of ileus has been an unchallenged surgical dogma until recent years. We intended to determine the safety and feasibility of an unconventional postoperative oral intake protocol in patients experiencing colorectal anastomosis. Between 2013 and 2015, sixty consecutive patients underwent colorectal anastomosis and they were randomized into two groups. The early feeding group began fluids on the first postoperative day while the regular feeding group was managed in the traditional way - nothing by mouth until the complete resolution of ileus. The majority of patients (93%) tolerated the early feeding. The times to first passage of flatus (2.66 ± 0.71 days vs. 3.9 ± 0.071 days) and stool (3.9 ± 0.92 days vs. 5.4 ± 0.77 days) were significantly quicker in early feeding group. Hospital stay was also significantly shorter in the early feeding group (4 ± 0.64 days vs. 6.1 ± 0.84 days). Anastomosis leakage and abscess formation were not seen in early feeding group. The patient's satisfaction (visual analog scale) in the early feeding group was higher than delayed feeding group (8.56 ± 1.16 vs. 7.06 ± 1.59, P feeding after colorectal surgeries is safe and tolerated by the majority of patients.

  4. [Organisation and early outcome of restorative proctocolectomy and ileal pouch-anal anastomosis

    DEFF Research Database (Denmark)

    Ljungmann, K.; Bendixen, A.; Laurberg, S.

    2008-01-01

    INTRODUCTION: Restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) has become the operation of choice for patients with ulcerative colitis and familial polyposis. However, the procedure is complex with a long learning curve, and carries a risk of both early and late complications...

  5. Sources and severity of self-reported food intolerance after ileal pouch-anal anastomosis

    NARCIS (Netherlands)

    Steenhagen, E.; Roos, de N.M.; Bouwman, C.A.; Laarhoven, van C.J.H.M.; Staveren, van W.A.

    2006-01-01

    Data on food intolerance after ileal pouch-anal anastomosis are scarce. The aim of this study was to identify foods causing intolerance and to determine the nature and severity of reported symptoms. Patients from the Dutch Crohn's and Ulcerative Colitis Association were mailed a survey on food

  6. Cardiovascular Surgery Residency Program: Training Coronary Anastomosis Using the Arroyo Simulator and UNIFESP Models

    Directory of Open Access Journals (Sweden)

    Miguel Angel Maluf

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: Engage the UNIFESP Cardiovascular Surgery residents in coronary anastomosis, assess their skills and certify results, using the Arroyo Anastomosis Simulator and UNIFESP surgical models. METHODS: First to 6th year residents attended a weekly program of technical training in coronary anastomosis, using 4 simulation models: 1. Arroyo simulator; 2. Dummy with a plastic heart; 3. Dummy with a bovine heart; and 4. Dummy with a beating pig heart. The assessment test was comprised of 10 items, using a scale from 1 to 5 points in each of them, creating a global score of 50 points maximum. RESULTS: The technical performance of the candidate showed improvement in all items, especially manual skill and technical progress, critical sense of the work performed, confidence in the procedure and reduction of the time needed to perform the anastomosis after 12 weeks practice. In response to the multiplicity of factors that currently influence the cardiovascular surgeon training, there have been combined efforts to reform the practices of surgical medical training. CONCLUSION: 1 - The four models of simulators offer a considerable contribution to the field of cardiovascular surgery, improving the skill and dexterity of the surgeon in training. 2 - Residents have shown interest in training and cooperate in the development of innovative procedures for surgical medical training in the art.

  7. Colectomy and ileorectal anastomosis is still an option for selected patients with familial adenomatous polyposis

    DEFF Research Database (Denmark)

    Bülow, Steffen; Bulow, C.; Vasen, H.

    2008-01-01

    PURPOSE: The risk of rectal cancer after colectomy and ileorectal anastomosis may be reduced in the last decades, as patients with severe polyposis now have an ileoanal pouch. We have reevaluated the risk of rectal cancer and proctectomy for all causes according to the year of operation. METHODS:...

  8. X-ray determination of the reoccurrence of Crohn's disease in patients with anastomosis

    International Nuclear Information System (INIS)

    Kulke, H.; Hoerl, M.; Wilhelm, T.; Wuerzburg Univ.

    1987-01-01

    Of 322 patients receiving operations for Crohn's disease, 52 were determined by the use of GI series with small bowel follow through, barium enema, and fistulography to have reoccurence. The patients had received different operation procedures, including atypical ones. Reoccurences were primarily found in the previous anastomosis region. (orig.) [de

  9. Das James Webb Space Telescope

    Science.gov (United States)

    Lemke, Dietrich

    2005-07-01

    Nicht nach einem berühmten Astronomen, sondern nach einem ihrer erfolgreichen Behördenleiter hat die NASA ihr neues astronomisches Flaggschiff benannt: Im Jahre 2011 soll das James Webb Space Telescope (JWST) das Weltraumteleskop Hubble ablösen.

  10. Results from the AMANDA telescope

    Energy Technology Data Exchange (ETDEWEB)

    Ahrens, J.; Bai, X.; Barwick, S.W.; Becka, T.; Becker, K.-H.; Bernardini, E.; Bertrand, D.; Binon, F.; Biron, A.; Boeser, S.; Botner, O.; Bouhali, O.; Burgess, T.; Carius, S.; Castermans, T.; Chirkin, D.; Conrad, J.; Cooley, J.; Cowen, D.F.; Davour, A.; De Clercq, C.; DeYoung, T.; Desiati, P.; Dewulf, J.-P.; Ekstroem, P.; Feser, T.; Gaisser, T.K.; Ganupati, R.; Gaug, M.; Geenen, H.; Gerhardt, L.; Goldschmidt, A.; Hallgren, A.; Halzen, F.; Hanson, K.; Hardtke, R.; Hauschildt, T.; Hellwig, M.; Herquet, Ph.; Hill, G.C.; Hulth, P.O.; Hultqvist, K.; Hundertmark, S.; Jacobsen, J.; Karle, A.; Koepke, L.; Kuehn, K.; Kowalski, M.; Lamoureux, J.I.; Leich, H.; Leuthold, M.; Lindahl, P.; Liubarsky, I.; Madsen, J.; Mandli, K.; Marciniewski, P.; Matis, H.S.; McParland, C.P.; Messarius, T.; Minaeva, Y.; Miocinovic, P.; Morse, R.; Nahnhauer, R.; Neunhoeffer, T.; Niessen, P.; Nygren, D.R.; Ogelman, H.; Olbrechts, Ph.; Perez de los Heros, C.; Pohl, A.C.; Price, P.B.; Przybylski, G.T.; Rawlins, K.; Resconi, E.; Rhode, W.; Ribordy, M.; Richter, S.; Rodriguez Martino, J.; Sander, H.-G.; Schmidt, T.; Schneider, D.; Schinarakis, K.; Schwarz, R.; Silvestri, A.; Solarz, M.; Spiczak, G.M.; Spiering, C.; Steele, D.; Steffen, P.; Stokstad, R.G.; Sudoff, P.; Sudoff, K.-H.; Sulanke, K.-H.; Taboada, I.; Thollander, L.; Tilav, S.; Wagner, W.; Walck, C.; Weinheimer, C.; Wiebusch, C.H.; Wiedemann, C.; Wischnewski, R.; Wissing, H.; Woschnagg, K.; Yodh, G.; Young, S

    2003-06-30

    We present results from the AMANDA high energy neutrino telescope located at the South Pole. They include measurements of the atmospheric neutrino flux, search for UHE point sources, and diffuse sources producing electromagnetic/hadronic showers at the detector or close to it.

  11. Monster telescope hunts blue planets

    CERN Multimedia

    Leake, J

    2003-01-01

    BRITAIN is to back a project to build the world's biggest telescope - so powerful that it could see life-bearing planets in other solar systems. It will need the largest mirror ever built at about 100 metres in diameter (1/2 page).

  12. Overdenture dengan Pegangan Telescopic Crown

    Directory of Open Access Journals (Sweden)

    Pambudi Santoso

    2014-06-01

    Full Text Available Kaitan presisi merupakan alat retensi mekanis yang menghubungkan antara satu atau lebih pegangan gigi tiruan, yang bertujuan untuk menambah retensi dan/atau stabilisasi. Kaitan presisi dapat digunakan secara luas pada gigi tiruan cekat, gigi tiruan sebagian lepasan, overdenture, implant untuk retensi overdenture, dan protesa maksilo fasial. Overdenture dengan kaitan presisi dapat membantu dalam pembagian beban kunyah, meminimalkan trauma pada gigi pegangan dan jaringan lunak, meminimalkan resorbsi tulang, dan meningkatkan estetik dan pengucapan suara. Salah satu jenis dari kaitan presisi adalah telescopic crown, terdiri dari 2 macam mahkota, yaitu mahkota primer yang melekat secara permanen pada gigi penyangga, dan mahkota sekunder yang melekat pada gigi tiruan. Tujuan pemaparan kasus ini adalah untuk memberikan informasi tentang rehabilitasi pasien edentulous sebagian rahang atas dengan telescopic crown..  Pasien wanita berusia 45 tahun datang ke klinik prostodonsia RSGM Prof.Soedomo dengan keluhan ingin dibuatkan gigi tiruan. Pasien kehilangan gigi 11 12 15 16 17 21 22 24 25 26 dan 27 yang diindikasikan untuk pembuatan overdenture gigi tiruan sebagian lepasan (GTS kerangka logam dengan pegangan telescopic crown pada gigi 13 dan 14 dengan sistem parallel-sided crown. Tahap-tahap pembuatan telescopic crown yaitu mencetak model study dengan catatan gigit pendahuluan. Perawatan saluran dilakukan pada akar gigi 13, dilanjutkan pemasangan pasak fiber serta rewalling dinding bukal. Gigi 13 dan 14 dilakukan preparasi mahkota penuh, dilanjutkan dengan pencetakan model kerja untuk coping primer dan kerangka logam dengan metode double impression. Coping primer disementasi pada gigi penyangga, dilanjutkan pasang coba coping sekunder beserta kerangka logam. Selanjutnya dilakukan pencatatan gigit, pencetakan model kerja, penyusunan gigi dan pasang coba penyusunan gigi pada pasien. Prosedur dilanjutkan dengan proses di laboratorium, serta insersi pada

  13. NEAT: A Microarcsec Astrometric Telescope

    Science.gov (United States)

    Shao, M.; Nemati, B.; Zhai, C.; Goullioud, R.

    2011-01-01

    NEAT, Nearby Exo-Earth Astrometric Telescope is a medium-small telescope (is) approximately 1m in diameter that is designed to make ultra precise (is) less than 1 uas (microarcsec) astrometric measurements of nearby stars in a (is) approximately 1hr observation. Four major error sources prevent normal space telescopes from obtaining accuracies close to 1 uas. Even with a small 1m telescope, photon noise is usually not a problem for the bright nearby target stars. But in general, the reference stars are much fainter. Typically a field of view of (is) approximately 0.5 deg dia is needed to obtain enough bright reference stars. The NEAT concept uses a very simple but unusual design to avoid optically induced astrometric errors. The third source of error is the accuracy and stability of the focal plane. A 1uas error over a (is) approximately 2000 arcsec field of view implies the focal plane is accurate or at least stable to 5 parts in 10(exp 10) over the lifetime of the mission ( (is) approximately 5yrs). The 4th class of error has to do with our knowledge of the PSF and how that PSF is sampled by an imperfect detector. A Nyquist sampled focal plane would have (is) greater than 2 pixels per lambda/D, and centroiding to 1uas means centroiding to 10-5 pixels. This paper describes the mission concept, and an overview of the technology needed to perform 1uas astrometry with a small telescope, and how we overcome problems 1 and 2. A companion paper will describe the technical progress we've made in solving problems 3 and 4.

  14. The use of disposable skin staples for intestinal resection and anastomosis in 63 dogs: 2000 to 2014.

    Science.gov (United States)

    Rosenbaum, J M; Coolman, B R; Davidson, B L; Daly, M L; Rexing, J F; Eatroff, A E

    2016-11-01

    To describe the use of disposable skin staples for intestinal resection and anastomosis in dogs and report associated dehiscence and mortality rates. Retrospective evaluation of medical records of dogs that underwent intestinal resection and anastomosis using disposable skin staples between 2000 and 2014. Data regarding patient signalment, indication for surgery, location of the resection and anastomosis, number of procedures performed, evidence of peritonitis at the time of surgery, surgeon qualifications, dehiscence, and mortality were obtained from the medical records. Mortality was defined as failure to survive beyond 10 days following resection and anastomosis. The overall mortality rate of patients undergoing intestinal resection and anastomosis was 12·7% (8/63). The most common indication for resection and anastomosis was neoplasia (20/63 [31·7%]), followed by foreign body removal (19/63 [30·2%]). The overall dehiscence rate was 4·8% (3/63). No difference in mortality associated with indication for surgery, whether multiple procedures were performed, surgeon qualifications, or evidence of peritonitis at the time of surgery was identified. In this retrospective study, the overall mortality and dehiscence rates using disposable skin staples were similar to previously reported outcomes following resection and anastomosis. © 2016 British Small Animal Veterinary Association.

  15. Suture-free technique for canine ureteral resection-anastomosis using a microvascular anastomotic system: a cadaveric study.

    Science.gov (United States)

    Wavreille, Vincent; Adin, Christopher A; Arango, Johnattan; Ham, Kathleen L; Byron, Julie K; McLoughlin, Mary A

    2015-01-01

    To describe a suture-free technique for canine ureteral resection-anastomosis using a microvascular anastomotic system (MAS) and to compare surgical time and burst pressure of hand-sewn (HS) ureteral end-to-end anastomosis with the MAS technique. Experimental ex vivo study. Canine cadavers (n = 8). For each cadaver, 1 ureter was randomly assigned to undergo HS anastomosis and the contralateral ureter had MAS anastomosis. The first 3 cadavers (6 ureters) were used to refine the MAS technique. In the other 5 dogs, surgical time and ureteral burst pressure were compared between groups (n = 5 ureters/group). Preliminary procedures showed that selective impaling of the mucosa and submucosa (without muscularis and adventitia) is necessary to allow complete mechanical interlock of the anastomotic rings for the MAS technique. Median anastomotic time was significantly shorter for MAS (7.6 min) than HS (16.6 min; p = .029) and burst pressure higher for MAS (393 cm H2 O) than HS (180 cm H2 O; p = .012). This study demonstrated the feasibility of a suture-free technique of canine ureteral resection-anastomosis using a commercially available MAS. The MAS anastomosis was faster and had higher burst strength compared with the HS anastomosis. © Copyright 2014 by The American College of Veterinary Surgeons.

  16. Tamai zone I fingertip replantation: is external bleeding obligatory for survival of artery anastomosis-only replanted digits?

    Science.gov (United States)

    Chen, Ko-Kang; Hsieh, Tung-Ying; Chang, Kao-Ping

    2014-10-01

    Distal fingertip replantation is associated with good functional and aesthetic results. Venous anastomosis is the most challenging procedure. For replantation with an artery anastomosis-only procedure (no venous anastomosis), some protocols have been designed to relieve venous congestion involve anticoagulation and the creation of wounds for persistent bleeding. This report presents the authors' experience of fingertip survival after artery anastomosis-only replantation with no persistent external bleeding. Twelve Tamai zone I fingertip total amputation patients who underwent artery anastomosis-only replantations were recruited from February 2009 to June 2012. Nerve repair was performed if identified. The patients were not subjected to conventional external bleeding methods. Both the blood color on pinprick and fingertip temperature difference between the replanted and uninjured digits were used as indicators of deteriorated venous congestion. The replanted digits of 11 patients survived. The only failed replant exhibited an average temperature difference of more than 6°C compared with the uninjured digits and consistently exhibited darker blood during the pinprick test. All other replants exhibited average temperature differences of less than 6°C. In these Tamai zone I artery anastomosis-only replantations, fingertips survived without the use of external bleeding method, indicating that external bleeding is probably not obligatory for survival of artery anastomosis-only replanted digits distal to Tamai zone I. An increasing temperature difference between the replanted and uninjured digits and darker blood on pinprick may be used as indicators of deteriorating congestion signs. © 2014 Wiley Periodicals, Inc.

  17. Effects of combined pulse electromagnetic field stimulation plus glutamine on the healing of colonic anastomosis in rats.

    Science.gov (United States)

    Girgin, Sadullah; Gedik, Ercan; Ozturk, Hayrettin; Akpolat, Veysi; Akbulut, Veysi; Kale, Ebru; Buyukbayram, Huseyin; Celik, Salih

    2009-04-01

    An experimental study was designed to investigate the effect of combined pulse electromagnetic field (PEMF) stimulation plus glutamine administration on colonic anastomosis. Anastomosis of the left colon was performed in 28 rats, which were divided into four groups; Group 1: normal resection anastomosis plus oral 50 mg/kg/day glutamine; Group 2: normal resection anastomosis plus PEMF stimulation plus oral 50 mg/kg/day glutamine; Group 3: normal resection anastomosis plus PEMF stimulation; Group 4: normal resection anastomosis. On the seventh postoperative day, the animals were killed and the bursting pressure and tissue hydroxyproline concentration of the anastomosis were analyzed and compared. The mean anastomotic bursting pressure in Group 2 was significantly higher than in Groups 1 and 4. On the other hand, the mean anastomotic bursting pressure in Group 1 was significantly higher than in Group 4. The collagen deposition and the fibroblast infiltration were significantly increased on the seventh day in Group 3 compared the other groups. On the other hand, Groups 1 and 2 had higher scores for collagen deposition and fibroblast infiltration than Group 4. In conclusion, burst pressures, hydroxyproline, and histologic features (fibroblast infiltration and collagen deposition) were improved in the PEMF group, and both PEMF and glutamine-enriched nutrition provide a significant gain in the strength of colonic anastomoses in rats.

  18. Does hyperbaric oxygen therapy reduce the effects of ischemia on colonic anastomosis in laparoscopic colon resection?

    Science.gov (United States)

    Emir, Seyfi; Gurdal, Sibel Ozkan; Sozen, Selim; Bali, Ilhan; Yesildag, Ebru; Celik, Atilla; Guzel, Savas; Sahin, Onder; Ay, Hakan; Topcu, Birol

    2016-01-01

    An increase in intra-abdominal pressure causes a decrease in the splanchnic blood flow and the intramucosal pH of the bowel, as well as increasing the risk of ischemia in the colon. The aim of the present study is to evaluate the effect of hyperbaric oxygen therapy (HBOT) on the ischemia caused by laparoscopy in colonic anastomosis in an experimental model of laparoscopic colonic surgery. We divided 30 male Wistar albino rats into three groups: Group A was the control (open colon anastomosis); Group B received LCA (laparoscopic colon anastomosis); while Group C received both LCA and HBOT. Each group contained ten animals. We placed Group C (LCA and HBOT) in an experimental hyperbaric chamber into which we administered pure oxygen at 2.1 atmospheres absolute 100% oxygen for 60 min for ten consecutive days. The anastomotic bursting pressure value was found to be higher in the open surgery group (226 ± 8.8) (Group A). The result for Group C (213 ± 27), which received HBOT, was better than that for Group B (197 ± 27). However, there was no statistically significant difference between Group B and Group C. Group A showed better healing than the other groups, while significant differences in the fibroblast proliferation scores were found between Groups A and B. In terms of tissue hydroxyproline levels, a significant difference was found between Groups A and B and between Groups A and C, but not between Groups B and C. HBOT increases the oxygen level in the injured tissue. Although HBOT might offer several advantages, it had only a limited effect on the healing of colonic anastomosis in rats with increased intra-abdominal pressure in our study. Anastomosis, Colon, Hyperbaric Oxygen Treatment, Oxidative Stress.

  19. Posterior muscolofascial reconstruction incorporated into urethrovescical anastomosis during robot-assisted radical prostatectomy.

    Science.gov (United States)

    Ficarra, Vincenzo; Gan, Melanie; Borghesi, Marco; Zattoni, Fabio; Mottrie, Alexandre

    2012-12-01

    The rationale of posterior musculofascial plate reconstruction during radical prostatectomy is to shorten the time to reach urinary continence recovery and to reduce the risk of bleeding and anastomosis leakage. We describe our original technique incorporating the posterior muscolofascial reconstruction into urethrovesical anastomosis using robot-assisted radical prostatectomy (RARP). For this reconstructive step, we use a 30-cm V-Loc 90 3-0 barbed suture (V-20 tapered needle). Specifically, the free edge of the posterior layer of the Denonvilliers fascia is approximated to the posterior part of the sphincteric apparatus in a running fashion from left to right. The musculature of the urethral wall is incorporated in this first layer of the running suture. This suture is then continued back to the left in a second layer incorporating the anterior layer of the Denonvilliers fascia (or prostatovesical muscle), the bladder neck, and again the urethra, this time also with urethral mucosa. The urethrovesical anastomosis is completed using a second running barbed suture (15-cm V-Loc 90 3-0 barbed suture, V-20 tapered needle). No intraoperative complications were observed during this step of the procedure. Anastomotic leakages were observed only in 2% of cases. Only 12.5% showed urinary incontinence after catheter removal (1-2 pads). At mean follow-up of 9 months, the urinary continence recovery was 95%, and an anastomosis stricture necessitating an endoscopic incision developed in only three (1.5%) patients. Recent systematic reviews of the literature showed only a minimal advantage in favor of posterior musculofascial reconstruction in terms of urinary continence recovery within 1 month after radical prostatectomy. We support the use of this step of RARP because it is simple, reproducible, with a very limited increase in operative time, and with only a slight risk of potential harm to the patient. Moreover, it could improve hemostasis and provide greater support for a

  20. Increased collagen maturity with sildenafil citrate: experimental high risk colonic anastomosis model.

    Science.gov (United States)

    Cakir, Tebessum; Ozer, Ilter; Bostanci, Erdal Birol; Keklik, Tulay Timucin; Ercin, Ugur; Bilgihan, Ayse; Akoglu, Musa

    2015-01-01

    Inadequate healing and high anastomosis leak rates at rectal anastomosis may be due to lack of supportive serosal layer and technical difficulty of low anterior resections. Positive effects of sildenafil on wound healing were observed. The aim of this study was to simulate rectal anastomosis as a technical insufficient anastomosis and investigate the effects of sildenafil on anastomosis healing. Colonic anastomoses were carried out in 64 rats and randomized into four groups, CA-S, complete anastomoses without sildenafil (10 mg/kg for 5 days); CA+S, complete anastomoses with sildenafil; IA-S, incomplete anastomoses without sildenafil; IA+S, incomplete anastomoses with sildenafil. Half of the rats in every group were sacrificed on post-operative day (POD) 3, half of them sacrificed on POD 7. Tissues from the anastomoses were used for functional, histochemical, biochemical investigations. Sildenafil treatment resulted in increased bursting pressures in IA+S on POD 7 (p=0.010). Collagen maturity was higher in IA+S on POD 3 and POD 7, CA+S on POD 7 (p=0.010; p=0.010; p<0.007). Collagen content was higher in IA+S on POD 7 (p<0.001). Glutathione, hydroxyproline levels were similar. Malondialdehyde levels were lower in IA+S on POD 3 (p<0.001). Epithelization score was higher in IA+S on POD 7 (p=0.007). Inflammation score was higher in CA-S group on POD 3 and POD 7 (p<0.001; p<0.001). Neutrophil score was lower in CA+S on POD 3 (p=0.005). An increase in collagen content, maturity, and epithelization, a decrease in neutrophil infiltration, oxidative stress and better mechanical strength were observed with the administration of sildenafil. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  1. Anastomotic leak rate and outcome for laparoscopic intra-corporeal stapled anastomosis

    Directory of Open Access Journals (Sweden)

    Goriainov Vitali

    2010-01-01

    Full Text Available Aims :A prospective clinical audit of all patients undergoing laparoscopic surgery with the intention of primary colonic left-sided intracorporeal stapled anastomosis to identify the rate of anastomotic leaks on an intention to treat basis with or without defunctioning stoma. Materials and Methods : All patients undergoing laparoscopic colorectal surgery resulting in left-sided stapled anastomosis were included with no selection criteria applied. All operations were conducted by the same surgical team and the same preparation and intraoperative methods were used. The factors analyzed for this audit were patient demographics (age and sex, indication for operation, procedure performed, height of anastomosis, leak rate and the outcome, inpatient stay, mortality, rate of defunctioning stomas, and rate of conversion to open procedure. Results for anastomotic leakage were compared with known results from the Wessex Colorectal Audit for open colorectal surgery. Results : A total of 69 patients (43 females, 26 males; median age 69 years, range 19 - 86 years underwent colonic procedures with left-sided intracorporeal stapled anastomoses. Of these, 14 patients underwent reversal of Hartmann′s, 42 - Anterior Resection, 11 - Sigmoid Colectomy, 2 - Left Hemicolectomy. Excluding reversals of Hartmann′s, 29 operations were performed for malignant and 26 for benign disease. Five patients were defunctioned, and 3 were subsequently reversed. The median height of anastomosis was 12 cm, range 4 - 18 cm from anal verge as measured either intra-operatively, or by rigid sigmoidoscopy post-operatively. Four cases were converted to open surgery. There was 1 post-operative death within 30 days. There was 1 anastomotic leak (the patient that died, and 1 patient developed a colo-vesical fistula. Median post-operative stay was 7 days, range 2-19. Conclusion : This clinical audit confirms that the anastomotic leak rate for left-sided colorectal stapled anastomosis is no

  2. Excimer Laser Assisted Non-occlusive Anastomosis (ELANA). Our experience with a training model in vivo.

    Science.gov (United States)

    Russo, G; Rotondo, M; Punzo, A; Di Napoli, D

    2007-03-01

    In this study the ELANA Technique has been reproduced in our experimental laboratory in order to verify its feasibility and reproducibility, the percentage of patent anastomosis in acute at different steps along the learning curve of the surgical team, specific problems related to the surgical technique. In 20 rabbits New Zealand 4kg body weight the training model in vivo proposed by Tulleken and coworkers has been reproduced, realizing 40 ELANA anastomosis. The model consists in the realization of two different end-to-side anastomosis on the abdominal aorta of each experimental animal, assisted by a special designed suction/excimer laser catheter, then connected by an end-to-end suture. After a few hours the animals are sacrificed and the by-pass site withdrawn and examined in order to verify the percentage of patency in acute. In the first 5 animals (group A), the anastomosis were realized using a jugular vein graft and the procedure results successful in only 3 cases out of ten (30%). For the following experiments - groups B, C and D where an aorta artery graft was used, the percentage of arterial flap retrieval was respectively 50%, 60% and 80%. ELANA is a feasible fascinating microsurgical technique for the realization of high flow, non-occlusive anastomosis. The rate of success results progressively higher along the learning curve of the surgical team. In our opinion, before the application of the ELANA technique on humans, a period of propaedeutic training in vivo on laboratory animals is essential for the dedicated team.

  3. Predictors of patency after two-stitch invagination vaso-epididymal anastomosis for idiopathic obstructive azoospermia

    Directory of Open Access Journals (Sweden)

    G Gautam

    2005-01-01

    Full Text Available Objectives: Anastomotic patency with return of sperm in the ejaculate following microsurgical vasoepididymostomy (VEA is not universal and may be delayed. The ability to predict the result of VEA based on preoperative or intra-operative parameters would enable the surgeon to offer the best treatment to the infertile couple. We used the two-stitch invagination technique of VEA in patients of idiopathic obstructive azoospermia and prospectively analyzed factors that could predict a patent anastomosis. While such studies have previously been done for patients undergoing VEA for secondary infertility following a vasectomy, to the best of our knowledge this is the first study analyzing these parameters for patients with primary infertility and idiopathic obstruction. Methods and materials: Over a 2-year period, 29 men underwent the 2-suture invagination VEA for idiopathic obstructive azoospermia. Twenty-four patients provided at least one postoperative semen sample. Preoperative and intra-operative parameters were compared between patients with a patent anastomosis with sperm in ejaculate (n = 12 and those with no sperm in the ejaculate (n = 12 using the t-test, Fisher′s exact test or chi-square test, as appropriate and a multivariate statistical analysis to determine any significant difference. Results: The mean follow up of the 24 patients was 7.6 months (2-30 months. A significantly greater number of patients with patent anastomosis had motile epididymal sperms (P = 0.034 and higher surgeon′s technical satisfaction with the procedure (P = 0.034. However, this difference was seen only on a univariate analysis and did not persist when a multivariate analysis was used. Conclusions: The presence of motile sperms in the epididymal fluid and a high level of technical satisfaction with the anastomosis may indicate a higher likelihood of success following a vaso-epididymal anastomosis for idiopathic obstruction. However, these parameters are not

  4. Identification of Spanish isolates of Rhizoctonia solani from potato by anastomosis grouping, ITS-RFLP and RAMS-fingerprinting

    Directory of Open Access Journals (Sweden)

    A.M. Elbakali

    2003-08-01

    Full Text Available Anastomosis grouping, restriction fragment length polymorphism (RFLP of the ITS regions including the 5.85 rDNA, and random amplified microsatellites (RAMS were used to characterize isolates of Rhizoctonia solani collected from Spain and Finland. There was a high similarity between the results obtained with the three techniques. RAMS markers revealed more genetic variation among isolates of R. solani than RFLP. The anastomosis group (AG–3 isolates were clearly separated from isolates belonging to other AGs by RAMS, RFLPs and anastomosis grouping. Almost all the isolates sampled from potato belonged to AG–3. No differences were observed between Spanish and Finnish AG–3 isolates.

  5. The Dutch Open Telescope: History, Status, Prospects

    NARCIS (Netherlands)

    Rutten, R.J.

    1999-01-01

    After many years of persistent telescope design and telescope construction, R.H. Hammerschlag has installed his Dutch Open Telescope (DOT) on La Palma. I brie y review its history and design. The future of optical solar physics at Utrecht hinges on a recently-funded three- year DOT science

  6. The Principles of Astronomical Telescope Design

    CERN Document Server

    Cheng, Jingquan

    2009-01-01

    Presents a summary of the author's twenty five years of experience in telescope design. This work provides a general introduction to various aspects of telescope design. It discusses the theory behind telescope design. It covers Radio, Infrared, Optical, X-Ray and Gamma-Ray wavelengths

  7. The Hubble Space Telescope: Problems and Solutions.

    Science.gov (United States)

    Villard, Ray

    1990-01-01

    Presented is the best understanding of the flaw discovered in the optics of the Hubble Space Telescope and the possible solutions to the problems. The spherical aberration in the telescope's mirror and its effect on the quality of the telescope's imaging ability is discussed. (CW)

  8. CFRP lightweight structures for extremely large telescopes

    DEFF Research Database (Denmark)

    Jessen, Niels Christian; Nørgaard-Nielsen, Hans Ulrik; Schroll, J.

    2008-01-01

    Telescope structures are traditionally built out of steel. To improve the possibility of realizing the ambitious extremely large telescopes, materials with a higher specific stiffness and a lower coefficient of thermal expansion are needed. An important possibility is Carbon Fibre Reinforced...... Plastic (CFRP). The advantages of using CFRP for the secondary mirror support structure of the European overwhelmingly large telescope are discussed....

  9. Focusing Telescopes in Nuclear Astrophysics

    CERN Document Server

    Ballmoos, Peter von

    2007-01-01

    This volume is the first of its kind on focusing gamma-ray telescopes. Forty-eight refereed papers provide a comprehensive overview of the scientific potential and technical challenges of this nascent tool for nuclear astrophysics. The book features articles dealing with pivotal technologies such as grazing incident mirrors, multilayer coatings, Laue- and Fresnel-lenses - and even an optic using the curvature of space-time. The volume also presents an overview of detectors matching the ambitious objectives of gamma ray optics, and facilities for operating such systems on the ground and in space. The extraordinary scientific potential of focusing gamma-ray telescopes for the study of the most powerful sources and the most violent events in the Universe is emphasized in a series of introductory articles. Practicing professionals, and students interested in experimental high-energy astrophysics, will find this book a useful reference

  10. Diffractive X-ray Telescopes

    OpenAIRE

    Skinner, Gerald K.

    2010-01-01

    Diffractive X-ray telescopes using zone plates, phase Fresnel lenses, or related optical elements have the potential to provide astronomers with true imaging capability with resolution several orders of magnitude better than available in any other waveband. Lenses that would be relatively easy to fabricate could have an angular resolution of the order of micro-arc-seconds or even better, that would allow, for example, imaging of the distorted space- time in the immediate vicinity of the super...

  11. The James Webb Space Telescope

    Science.gov (United States)

    Nowak, Maria; Eichorn, William; Hill, Michael; Hylan, Jason; Marsh, James; Ohl, Raymond; Sampler, Henry; Wright, Geraldine; Crane, Allen; Herrera, Acey; hide

    2007-01-01

    The James Webb Space Telescope (JWST) is a 6.6m diameter, segmented, deployable telescope for cryogenic IR space astronomy (approx.40K). The JWST Observatory architecture includes the Optical Telescope Element and the Integrated Science Instrument Module (ISIM) element that contains four science instruments (SI) including a Guider. The ISIM optical metering structure is a roughly 2.2x1.7x2.2mY, asymmetric frame that is composed of carbon fiber and resin tubes bonded to invar end fittings and composite gussets and clips. The structure supports the SIs, isolates the SIs from the OTE, and supports thermal and electrical subsystems. The structure is attached to the OTE structure via strut-like kinematic mounts. The ISM structure must meet its requirements at the approx.40K cryogenic operating temperature. The SIs are aligned to the structure s coordinate system under ambient, clean room conditions using laser tracker and theodolite metrology. The ISM structure is thermally cycled for stress relief and in order to measure temperature-induced mechanical, structural changes. These ambient-to-cryogenic changes in the alignment of SI and OTE-related interfaces are an important component in the JWST Observatory alignment plan and must be verified.

  12. Building the Green Bank Telescope

    Science.gov (United States)

    Kellermann, Kenneth I.

    2017-01-01

    In a previous presentation, I reported on how the freak collapse of the NRAO 300-ft transit radio telescope led to the inclusion of $75 million for a new radio telescope in the 1989 Congressional Emergency Supplemental Appropriations Act. But, this was only the beginning. NRAO was faced with challenging specifications and an unworkable schedule, but there was no design and no project team. Only one bid was even close to the Congressional appropriation. In an attempt to meet the unrealistic antenna delivery date, the contractor started construction of the foundation and fabrication of antenna members before the design was finished, leading to retrofits, redesign, and multiple delays. The antenna contractor was twice sold to other companies leading to further delays and cost escalation. In order to recoup their mounting losses, the new owners sued NRAO for $29 million for claimed design changes, and NRAO countersued demanding to be reimbursed for added project management costs and lost scientific data resulting from the seven-year delay in the completion of the telescope. Legal fees and a small net award in favor of the contractor left NRAO and the NSF with a nine million dollar bill which NSF handled by an innovative accounting adjustment.

  13. QUIJOTE telescope design and fabrication

    Science.gov (United States)

    Gomez, Alberto; Murga, Gaizka; Etxeita, Borja; Sanquirce, Rubén; Rebolo, Rafael; Rubiño-Martin, Jose Alberto; Herreros, José-Miguel; Hoyland, Roger; Gomez, Francisca; Génova-Santos, Ricardo T.; Piccirillo, Lucio; Maffei, Bruno; Watson, Robert

    2010-07-01

    The QUIJOTE CMB experiment aims to characterize the polarization of the CMB in the frequency range 10-30 GHz and large angular scales. It will be installed in the Teide Observatory, following the projects that the Anisotropy of the Cosmic Microwave Background group has developed in the past (Tenerife experiment, IAC-Bartol experiment...) and is running at the present time (VSA, Cosmosomas). The QUIJOTE CMB experiment will consist of two telescopes which will be installed inside a unique enclosure, which is already constructed. The layout of both telescopes is based on an altazimuth mount supporting a primary and a secondary mirror disposed in a offset Gregorian Dragon scheme. The use of industrial-like fabrication techniques, such as sand-mould casting, CNC machining, and laser tracker measuring for alignment, provided the required performances for microwave observation. A fast-track construction scheme, altogether with the use of these fabrication techniques allowed designing and manufacturing the opto-mechanics of the telescope in 14 months prior to delivery for final start-up in December 2008.

  14. Academic Training: Deep Space Telescopes

    CERN Multimedia

    Françoise Benz

    2006-01-01

    2005-2006 ACADEMIC TRAINING PROGRAMME LECTURE SERIES 20, 21, 22, 23, 24 February from 11:00 to 12:00 - Council Chamber on 20, 21, 23, 24 February, TH Auditorium, bldg 4 - 3-006, on 22 February Deep Space Telescopes G. BIGNAMI / CNRS, Toulouse, F & Univ. di Pavia, I The short series of seminars will address results and aims of current and future space astrophysics as the cultural framework for the development of deep space telescopes. It will then present such new tools, as they are currently available to, or imagined by, the scientific community, in the context of the science plans of ESA and of all major world space agencies. Ground-based astronomy, in the 400 years since Galileo's telescope, has given us a profound phenomenological comprehension of our Universe, but has traditionally been limited to the narrow band(s) to which our terrestrial atmosphere is transparent. Celestial objects, however, do not care about our limitations, and distribute most of the information about their physics thro...

  15. Recovery after intracorporeal anastomosis in laparoscopic right hemicolectomy: a systematic review and meta-analysis.

    Science.gov (United States)

    Milone, Marco; Elmore, Ugo; Vignali, Andrea; Gennarelli, Nicola; Manigrasso, Michele; Burati, Morena; Milone, Francesco; De Palma, Giovanni Domenico; Delrio, Paolo; Rosati, Riccardo

    2018-02-01

    Although intracorporeal anastomosis (IA) appears to guarantee a faster recovery compared to extracorporeal anastomosis (EA), the data are still unclear. Thus, we performed a systematic review of the literature with meta-analysis to evaluate the recovery benefits of intracorporeal anastomosis. A systematic search was performed in electronic databases (PubMed, Web of Science, Scopus, EMBASE) using the following search terms in all possible combinations: "laparoscopic," "right hemicolectomy," "right colectomy," "intracorporeal," "extracorporeal," and "anastomosis." According to the pre-specified protocol, all studies evaluating the impact of choice of intra- or extracorporeal anastomosis after right hemicolectomy on time to first flatus and stools, hospital stay, and postoperative complications according to Clavien-Dindo classification were included. Sixteen articles were included in the final analysis, including 1862 patients who had undergone right hemicolectomy: 950 cases (IA) and 912 controls (EA). Patients who underwent IA reported a significantly shorter time to first flatus (MD = - 0.445, p = 0.013, Z = - 2.494, 95% CI - 0.795, 0.095), to first stools (MD = - 0.684, p < 0.001, Z = - 4.597, 95% CI - 0.976, 0.392), and a shorter hospital stay (MD = - 0.782, p < 0.001, Z = -3.867, 95% CI - 1.178, - 0.385) than those who underwent EA. No statistically significant differences in complications between the IA and EA patients were observed in the Clavien-Dindo I-II group (RD = - 0.014, p = 0.797, Z = - 0.257, 95% CI - 0.117, 0.090, number needed to treat (NNT) 74) or in the Clavien-Dindo IV-V (RD = - 0.005, p = 0.361, Z = - 0.933, 95% CI - 0.017, 0.006, NNT 184). The IA procedure led to fewer complications in the Clavien-Dindo III group (RD = - 0.041, p = 0.006, Z = - 2.731, 95% CI - 0.070, 0.012, NNT 24). Although intracorporeal anastomosis appears to be safe in terms of

  16. Effect of Ozone Therapy (OT on Healing of Colonic Anastomosis in a Rat Model of Peritonitis

    Directory of Open Access Journals (Sweden)

    Başak Erginel

    2014-09-01

    Full Text Available Background: Ozone is a three-oxygen molecule (O3. Ozone therapy (OT is systematically effective when pathological inflammatory and immunologic processes are activated. Among of these conditions are wound healing, macular degeneration related to aging, and conditions that are ischemic or infectious. Aims: The aim of this study was to determine the effects of OT on wound healing of intestinal anastomosis in the presence of peritonitis in a rat model. Study Design: Animal experimentation. Methods: A total of 40 Wistar albino rats were randomized into four groups (n=10 including: sham (S, peritonitis (P, ozone 0 (O0, and ozone 24 (O24. In group S, only cecal dissection was carried out. The S group had only a cecal dissection and intestinal anastomosis performed, but no peritonitis. In all other groups, cecal ligation and puncture (CLP followed the cecal dissection to induce bacterial peritonitis. 24 h after puncture, a cecal resection and ileocolic anastomosis were performed. In group P, 24 h after CLP, a cecal resection and ileocolic anastomosis were performed and no ozone was administered. In group O0, immediately after the anastomosis, and in group O24, starting 24 hours after the anastomosis, an intraperitoneal 1 mg/kg/day ozone administration was applied for seven days. On the seventh day the animals were sacrificed, the anastomotic bursting pressures (BP and the hydroxyproline values of the anastomotic tissues were measured, and histopathologic examination of the anastomotic segment was carried out. Results: The highest BP was in group S, with 211±23.13 mmHg. The mean BP of group P was 141±56.25 mmHg, which was significantly lower than in the other two peritonitis groups that received ozone therapy, group O0 and O24, where it was 192±22 and 166±45 mmHg, respectively (p0.05. Histopathologic analyses of the anastomotic segments determined there was significantly more oedema and necrosis in the control group rats, and collagen deposition in

  17. J-pouch Ileoanal Anastomosis in Children and Adolescents with Ulcerative Colitis: Functional Outcome, Satisfaction and Impact on Social Life

    DEFF Research Database (Denmark)

    Wewer, V; Hesselfeldt, Peter; Qvist, N

    2005-01-01

    OBJECTIVES: The aim of this study was to evaluate, over a 10-year period, severe surgical complications, functional outcome, patient satisfaction and impact on social life after colectomy and J-pouch ileoanal anastomosis for children and adolescents

  18. Central arteriovenous anastomosis for the treatment of patients with uncontrolled hypertension (the ROX CONTROL HTN study): a randomised controlled trial.

    LENUS (Irish Health Repository)

    Lobo, Melvin D

    2015-01-22

    Hypertension contributes to cardiovascular morbidity and mortality. We assessed the safety and efficacy of a central iliac arteriovenous anastomosis to alter the mechanical arterial properties and reduce blood pressure in patients with uncontrolled hypertension.

  19. Genital and Subjective Sexual Response in Women After Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis-A Prospective Clinical Trial

    NARCIS (Netherlands)

    Vlug, Malaika S.; Laan, Ellen T.; van Lunsen, Rik H. W.; van Koperen, Paul J.; Polle, Sebastiaan W.; Bemelman, Willem A.

    2010-01-01

    Introduction. Sexual dysfunction after ileo pouch anal anastomosis (IPAA) is common. The most systematic physical reaction to sexual stimulation is an increase in vaginal vasocongestion. Genital response can be assessed by vaginal pulse amplitude (VPA) using vaginal photoplethysmography. Aim. To

  20. Comparison between double-balloon and single-balloon enteroscopy in therapeutic ERC after Roux-en-Y entero-enteric anastomosis.

    Science.gov (United States)

    Moreels, Tom G; Pelckmans, Paul A

    2010-09-16

    To compare the efficacy of double-balloon enteroscopy (DBE) and single-balloon enteroscopy (SBE) in therapeutic endoscopic retrograde cholangiography (ERC) in patients with Roux-en-Y entero-enteric anastomosis. Retrospective analysis of our patient cohort revealed 4 patients with enterobiliary anastomosis and Roux-en-Y entero-enteric anastomosis who underwent repeated ERC with DBE and SBE because of recurrent cholangitis. A total of 38 endoscopic retrograde cholangiopancreatography procedures were performed in 25 patients with Roux-en-Y entero-enteric anastomosis. DBE was used in 29 procedures and SBE in 9. The 4 patients who underwent repeated ERC with DBE and SBE suffered from recurrent cholangitis due to stenosis of the enterobiliary anastomosis. ERC was performed repeatedly to achieve balloon dilation with/without biliary stone extraction and multiple stent placement at the level of the enterobiliary anastomosis. In all 4 patients DBE and SBE were equally successful. Compared to DBE, SBE was equally effective in passing the Roux-en-Y entero-enteric anastomosis, reaching the enterobiliary anastomosis and performing therapeutic ERC. This retrospective comparison shows that DBE and SBE are equally successful in the performance of therapeutic ERC at the level of the enterobiliary anastomosis after Roux-en-Y entero-enteric anastomosis.

  1. Surgical induced astigmatism correlated with corneal pachymetry and intraocular pressure: transconjunctival sutureless 23-gauge versus 20-gauge sutured vitrectomy in diabetes mellitus.

    Science.gov (United States)

    Shao, Yan; Dong, Li-Jie; Zhang, Yan; Liu, Hui; Hu, Bo-Jie; Liu, Ju-Ping; Li, Xiao-Rong

    2015-01-01

    To determine the difference of surgical induced astigmatism between conventional 20-gauge sutured vitrectomy and 23-gauge transconjunctival sutureless vitrectomy, and the influence of corneal pachymetry and intraocular pressure (IOP) on surgical induced astigmatism in diabetic patients. This retrospective, consecutive case series consisted of 40 eyes of 38 diabetic subjects who underwent either 20-gauge or 23-gauge vitrectomy. The corneal curvature and thickness were measured with Scheimpflug imaging before surgery and 1wk; 1, 3mo after surgery. We compared the surgical induced astigmatism (SIA) on the true net power in 23-gauge group with that in 20-gauge group. We determined the correlation between corneal thickness change ratio, IOP and SIA measured by Pentacam. The mean SIAs were 1.082±0.085 D (mean±SEM), 0.689±0.070 D and 0.459±0.063 D at postoperative 1wk; 1, 3mo respectively in diabetic subjects. The vitrectomy induced astigmatisms were declined significantly with time (F 2,36=33.629, P=0.000) postoperatively. The 23-gauge surgery group induced significantly less astigmatism than 20-gauge surgery group (F -1,37=11.046, P=0.020). Corneal thickness in diabetes elevated after surgery (F 3,78=10.532, P=0.000). The linear regression analysis at postoperatively 1wk went as: SIA=-4.519+4.931 change ratio (Port3) +0.026 IOP (R(2)=0.46, P=0.000), whereas the rate of corneal thickness change and IOP showed no correlation with the change of astigmatism at postoperatively 1 and 3mo. There are significant serial changes in both 20-gauge and 23-gauge group in diabetic subjects. 23-gauge induce less astigmatism than 20-gauge and become stable more rapidly than 20-gauge. The elevation of corneal thickness and IOP was associated with increased astigmatim at the early postoperative stage both in 23-gauge and 20-gauge surgery group.

  2. "Birdlime" technique using TachoSil tissue sealing sheet soaked with fibrin glue for sutureless vessel transposition in microvascular decompression: operative technique and nuances.

    Science.gov (United States)

    Otani, Naoki; Toyooka, Terushige; Fujii, Kazuya; Kumagai, Kosuke; Takeuchi, Satoru; Tomiyama, Arata; Nakao, Yasuaki; Yamamoto, Takuji; Wada, Kojiro; Mori, Kentaro

    2017-08-11

    , or dysfunction of the cranial nerves was observed in any of the patients. Postoperative MRI showed that the offending vessels were displaced and fixed in the appropriate position. CONCLUSIONS The described transposition technique provides an easy and adjustable way to perform MVD safely and effectively. In addition, this transposition and fixation technique is simple and avoids the risk of needle injury close to the cranial nerves and vessels. This simple sutureless technique is recommended for MVD to reduce the risk of intraoperative neurovascular injury.

  3. Laparoscopic Low Anterior Resection and Eversion Technique Combined With a Nondog Ear Anastomosis for Mid- and Distal Rectal Neoplasms

    OpenAIRE

    Zhuo, Changhua; Liang, Lei; Ying, Mingang; Li, Qingguo; Li, Dawei; Li, Yiwei; Peng, Junjie; Huang, Liyong; Cai, Sanjun; Li, Xinxiang

    2015-01-01

    Abstract The transanal eversion and prolapsing technique is a well-established procedure, and can ensure an adequate distal margin for patients with low rectal neoplasms. Potential leakage risks, however, are associated with bilateral dog ear formation, which results from traditional double-stapling anastomosis. The authors determined the feasibility of combining these techniques with a commercial stapling set to achieve a nondog ear (end-to-end) anastomosis for patients with mid- and distal ...

  4. Hubble Space Telescope: The Telescope, the Observations & the Servicing Mission

    Science.gov (United States)

    1999-11-01

    Today the HST Archives contain more than 260 000 astronomical observations. More than 13 000 astronomical objects have been observed by hundreds of different groups of scientists. Direct proof of the scientific significance of this project is the record-breaking number of papers published : over 2400 to date. Some of HST's most memorable achievements are: * the discovery of myriads of very faint galaxies in the early Universe, * unprecedented, accurate measurements of distances to the farthest galaxies, * significant improvement in the determination of the Hubble constant and thus the age of the Universe, * confirmation of the existence of blacks holes, * a far better understanding of the birth, life and death of stars, * a very detailed look at the secrets of the process by which planets are created. Europe and HST ESA's contribution to HST represents a nominal investment of 15%. ESA provided one of the two imaging instruments - the Faint Object Camera (FOC) - and the solar panels. It also has 15 scientists and computer staff working at the Space Telescope Science Institute in Baltimore (Maryland). In Europe the astronomical community receives observational assistance from the Space Telescope European Coordinating Facility (ST-ECF) located in Garching, Munich. In return for ESA's investment, European astronomers have access to approximately 15% of the observing time. In reality the actual observing time competitively allocated to European astronomers is closer to 20%. Looking back at almost ten years of operation, the head of ST-ECF, European HST Project Scientist Piero Benvenuti states: "Hubble has been of paramount importance to European astronomy, much more than the mere 20% of observing time. It has given the opportunity for European scientists to use a top class instrument that Europe alone would not be able to build and operate. In specific areas of research they have now, mainly due to HST, achieved international leadership." One of the major reasons for

  5. Partial recovery of respiratory function and diaphragm reinnervation following unilateral vagus nerve to phrenic nerve anastomosis in rabbits.

    Directory of Open Access Journals (Sweden)

    Junxiang Wen

    Full Text Available Respiratory dysfunction is the leading cause of mortality following upper cervical spinal cord injury (SCI. Reinnervation of the paralyzed diaphragm via an anastomosis between phrenic nerve and a donor nerve is a potential strategy to mitigate ventilatory deficits. In this study, anastomosis of vagus nerve (VN to phrenic nerve (PN in rabbits was performed to assess the potential capacity of the VN to compensate for lost PN inputs. At first, we compared spontaneous discharge pattern, nerve thickness and number of motor fibers between these nerves. The PN exhibited a highly rhythmic discharge while the VN exhibited a variable frequency discharge pattern. The rabbit VN had fewer motor axons (105.3±12.1 vs. 268.1±15.4. Nerve conduction and respiratory function were measured 20 weeks after left PN transection with or without left VN-PN anastomosis. Compared to rabbits subjected to unilateral phrenicotomy without VN-PN anastomosis, diaphragm muscle action potential (AP amplitude was improved by 292%, distal latency by 695%, peak inspiratory flow (PIF by 22.6%, peak expiratory flow (PRF by 36.4%, and tidal volume by 21.8% in the anastomosis group. However, PIF recovery was only 28.0%, PEF 28.2%, and tidal volume 31.2% of Control. Our results suggested that VN-PN anastomosis is a promising therapeutic strategy for partial restoration of diaphragm reinnervation, but further modification and improvements are necessary to realize the full potential of this technique.

  6. A modified uncut Roux-en-Y anastomosis in totally laparoscopic distal gastrectomy: preliminary results and initial experience.

    Science.gov (United States)

    Ma, Jun-Jun; Zang, Lu; Yang, Annie; Hu, Wei-Guo; Feng, Bo; Dong, Feng; Wang, Ming-Liang; Lu, Ai-Guo; Li, Jian-Wen; Zheng, Min-Hua

    2017-11-01

    To investigate the safety and feasibility of totally laparoscopic uncut Roux-en-Y anastomosis in the distal gastrectomy with D2 dissection for gastric cancer. We also summarized the preliminary experience of totally laparoscopic uncut Roux-en-Y anastomosis. A retrospective analysis was done in 51 cases of total laparoscopic uncut Roux-en-Y anastomosis in the distant gastrectomy with D2 dissection for gastric cancer in our hospital from September 2014 to December 2015. All of 51 cases underwent total laparoscopic uncut Roux-en-Y anastomosis. All the procedures were performed successfully. There were neither conversions to open surgery nor intraoperative complications in all 51 cases. In this study, the median operative time was 170 (135-210) min and the median time of anastomosis was 27 (24-41) min. The blood loss was 60 (30-110) ml. The time to flatus and length of postoperative hospital stay were 2 (1-3) days, and 8 (7-12) days, respectively. The mean lymph node harvest was 34 (18-49). One anastomotic bleeding occurred postoperatively which was cured by conservative treatment. No major postoperative complication occurred, such as anastomotic leak, anastomotic stenosis, and Roux stasis syndrome. After a short-term follow-up, no recanalization or reflux gastritis was encountered by endoscopy. The totally laparoscopic uncut Roux-en-Y anastomosis in distal gastrectomy with lymph node dissection for gastric cancer is safe and feasible, with a very low rate of recanalization and reflux gastritis.

  7. Partial recovery of respiratory function and diaphragm reinnervation following unilateral vagus nerve to phrenic nerve anastomosis in rabbits.

    Science.gov (United States)

    Wen, Junxiang; Yang, Mingjie; Li, Lijun; Sun, Guixin; Tan, Jun

    2013-01-01

    Respiratory dysfunction is the leading cause of mortality following upper cervical spinal cord injury (SCI). Reinnervation of the paralyzed diaphragm via an anastomosis between phrenic nerve and a donor nerve is a potential strategy to mitigate ventilatory deficits. In this study, anastomosis of vagus nerve (VN) to phrenic nerve (PN) in rabbits was performed to assess the potential capacity of the VN to compensate for lost PN inputs. At first, we compared spontaneous discharge pattern, nerve thickness and number of motor fibers between these nerves. The PN exhibited a highly rhythmic discharge while the VN exhibited a variable frequency discharge pattern. The rabbit VN had fewer motor axons (105.3±12.1 vs. 268.1±15.4). Nerve conduction and respiratory function were measured 20 weeks after left PN transection with or without left VN-PN anastomosis. Compared to rabbits subjected to unilateral phrenicotomy without VN-PN anastomosis, diaphragm muscle action potential (AP) amplitude was improved by 292%, distal latency by 695%, peak inspiratory flow (PIF) by 22.6%, peak expiratory flow (PRF) by 36.4%, and tidal volume by 21.8% in the anastomosis group. However, PIF recovery was only 28.0%, PEF 28.2%, and tidal volume 31.2% of Control. Our results suggested that VN-PN anastomosis is a promising therapeutic strategy for partial restoration of diaphragm reinnervation, but further modification and improvements are necessary to realize the full potential of this technique.

  8. Abdominoendorectal resection with peranal anastomosis in the treatment of radiation injuries of the rectum

    Energy Technology Data Exchange (ETDEWEB)

    Athanasiadis, S.; Girona, J.

    1982-01-01

    During the period 1974-1980 39 patients underwent operations at the Prosper Hospital in Recklinghausen for radiation injuries to the rectum or rectosigmoid. They comprised 22 patients with rectovaginal fistulas, 6 with ulcers, 3 suffering from severe hemorrhagic proctitis, 5 with rectal strictures, 1 with necrosis, and 2 with radiation ulcers and carcinoma. A sphincter-saving operative method of treating postirradiation damage of the rectum is presented. The technique involves the peranal anastomosis of healthy colon to the midanal canal using a sleeve anastomosis. Technical and functional results of resectional surgery for the rectal complications of radiation therapy are reported. Subjectively, total continence was present in 78%, only 1 patient was incontinent because of flatus and watery stools.

  9. Measurement of blood flow through surgical anastomosis using the radioactive microsphere technique

    Energy Technology Data Exchange (ETDEWEB)

    Hummel, S.J.; Delgado, G.; Butterfield, A.; Dritschilo, A.; Harbert, J.

    1985-10-01

    Two different radioactive microspheres ( U Ce and UWSc) were used to measure blood flow to an area of the large intestine in dogs before and after a surgical resection was performed with surgical staples. The healing of an anastomosis is theoretically related to the blood flow to the anastomotic site. Blood flow studies were conducted in three dogs using this technique. The average blood flow preoperatively was 0.558 mL/minute per gram and 1.04 mL/minute per gram postoperatively. These results indicate a statistically significant increase in blood flow at the anastomotic site six days after anastomosis when compared with the blood flow to the same area before any surgical procedures.

  10. Measurement of blood flow through surgical anastomosis using the radioactive microsphere technique

    International Nuclear Information System (INIS)

    Hummel, S.J.; Delgado, G.; Butterfield, A.; Dritschilo, A.; Harbert, J.

    1985-01-01

    Two different radioactive microspheres ( 141 Ce and 46 Sc) were used to measure blood flow to an area of the large intestine in dogs before and after a surgical resection was performed with surgical staples. The healing of an anastomosis is theoretically related to the blood flow to the anastomotic site. Blood flow studies were conducted in three dogs using this technique. The average blood flow preoperatively was 0.558 mL/minute per gram and 1.04 mL/minute per gram postoperatively. These results indicate a statistically significant increase in blood flow at the anastomotic site six days after anastomosis when compared with the blood flow to the same area before any surgical procedures

  11. The abdominoendorectal resection with peranal anastomosis in the treatment of radiation injuries of the rectum

    International Nuclear Information System (INIS)

    Athanasiadis, S.; Girona, J.

    1982-01-01

    During the period 1974-1980 39 patients underwent operations at the Prosper Hospital in Recklinghausen for radiation injuries to the rectum or rectosigmoid. They comprised 22 patients with rectovaginal fistulas, 6 with ulcers, 3 suffering from severe hemorrhagic proctitis, 5 with rectal strictures, 1 with necrosis, and 2 with radiation ulcers and carcinoma. A sphincter-saving operative method of treating postirradiation damage of the rectum is presented. The technique involves the peranal anastomosis of healthy colon to the midanal canal using a sleeve anastomosis. Technical and functional results of resectional surgery for the rectal complications of radiation therapy are reported. Subjectively, total continence was present in 78%, only 1 patient was incontinent because of flatus and watery stools. (orig.) [de

  12. Transvaginal coloanal anastomosis after rectal resection for the treatment of a rectovaginal fistula induced by radiation.

    Science.gov (United States)

    Brezean, I

    2014-01-01

    Although decreasing in number, radiation induced rectovaginal fistulas are caused by some radiation injuries and chronic ischemic lesions. Most of the experienced authors recommend anterior rectal resection with coloanal anastomosis accessed through the abdominal-perineum area for high fistula. We present a patient with a fistula that developed 23 years after hysterectomy and radiotherapy. In this case we performed an abdominal-transvaginal rectal resection with transverse coloplastypouch, coloanal anastomosis and protection ileostomy three months after a terminal sigmoidostomy. The dissection of the distal rectum by posteriour colpotomy and coloanal transvaginalan astomosis is a technical variant that may prove advantage ous compared to the procedures featured in the literature as solutions by rectal resection for rectovaginal fistula. Celsius.

  13. Colovaginal anastomosis: an unusual complication of stapler use in restorative procedure after Hartmann operation

    Directory of Open Access Journals (Sweden)

    Liao Guoqing

    2005-11-01

    Full Text Available Abstract Background Rectovaginal fistula is uncommon after lower anterior resection for rectal cancer. The most leading cause of this complication is involvement of the posterior wall of the vagina into the staple line when firing the circular stapler. Case presentation A 50-year-old women underwent resection for obstructed carcinoma of the sigmoid colon with Hartmann procedure. Four months later she underwent restorative surgery with circular stapler. Following which she developed rectovaginal fistula. A transvaginal repair was performed but stool passing from vagina not per rectum. Laporotomy revealed colovaginal anastomosis, which was corrected accordingly. Patient had an uneventful recovery. Conclusion Inadvertent formation of colovaginal anastomosis associated with a rectovaginal fistula is a rare complication caused by the operator's error. The present case again highlights the importance of ensuring that the posterior wall of vagina is away from the staple line.

  14. Fingertip replantation at the eponychial level with venous anastomosis: an anatomic study and clinical application.

    Science.gov (United States)

    Cheng, L; Chen, K; Chai, Y-M; Wen, G; Wang, C-Y

    2013-11-01

    We present an anatomic study of the vein distribution at the eponychial level, in order to standardize outpatient fingertip replantation. The cross sectional anatomy of 100 fingers was studied by dissection following dye injection. The distribution of the veins >0.3 mm was recorded on a pie-chart. Thirty fingers in 27 patients with fingertip amputations at the eponychial level were replanted by anastomosis of the palmar subcutaneous veins, to reconstruct the venous reflux of the amputated digits. The operations were aided by the anatomical study and confirmed that the palmar area is the preferred site for venous anastomosis Following a distal finger amputation at the level of the eponychial fold we propose starting the search for veins between the 3 to 5 o'clock or 7 to 9 o'clock positions, as these are the areas where there are most likely to be suitable veins.

  15. Moist-condition Training for Cerebrovascular Anastomosis: A Practical Step after Mastering Basic Manipulations.

    Science.gov (United States)

    Shimizu, Satoru; Sekiguchi, Tomoko; Mochizuki, Takahiro; Sato, Kimitoshi; Koizumi, Hiroyuki; Nakayama, Kenji; Yamamoto, Isao; Kumabe, Toshihiro

    2015-01-01

    As cerebrovascular anastomosis is performed in moist conditions that may impede precise manipulations, surgeons must undergo extensive preoperative training. We developed a simple moist-condition training method. It involves placing a free-floating inner platform hosting an artery from a chicken wing in an outer container filled with tap water to just below the specimen. Trainees performed anastomosis under magnification. Training sessions mimicked difficulties encountered during operations such as poor visibility of the lumen and problems handling the sutures. A retrospective comparison of 100 wet- and 100 dry-condition training sessions for end-to-side anastomoses with 8 stitches showed that under moist condition the time required for the entire procedure was significantly longer (17.8 ± 2.1 vs. 15.3 ± 2.1 min, p bridge between training for basic manipulations under dry conditions and actual surgery.

  16. Poor Outcomes of Complicated Pouch-Related Fistulas after Ileal Pouch-Anal Anastomosis Surgery

    DEFF Research Database (Denmark)

    Kjaer, M D; Kjeldsen, J; Qvist, N

    2016-01-01

    . Overall pouch failure, defined as pouch excision or a diverting stoma, was seen in 34 (71%) patients, while pouch excision was seen in 23 (48%) of the patients. Patients who developed Crohn's disease had a significantly higher risk of pouch excision, as did patients with an early onset of the fistula...... after ileal pouch-anal anastomosis (P = 0.006 and P = 0.007, respectively). In conclusion, the present study demonstrated a high risk of pouch failure in patients with complicated pouch-related fistulas. Furthermore, it showed that Crohn's disease and the development of early onset fistulas......BACKGROUND AND AIMS: Development of a pouch-related fistula tract is an uncommon but highly morbid complication to restorative proctocolectomy with ileal pouch-anal anastomosis. Pouch failure with permanent ileostomy is reported in 21%-30% of patients, yet the factors contributing to pouch excision...

  17. Treatment of Budd-Chiari syndrome by dorsocranial liver resection and direct hepatoatrial anastomosis.

    Science.gov (United States)

    Bansky, G; Ernest, C; Jenni, R; Zollikofer, C; Burger, H R; Senning, A

    1986-01-01

    Since 1980 an operation which reestablishes the blood outflow from occluded hepatic veins was performed in 7 patients with Budd-Chiari syndrome by one of us (A. Senning). Using extracorporeal circulation a dorsocranial cylindrical resection of the liver including the confluence of the occluded hepatic veins was performed by transcaval approach. The incised right atrium was sutured around the resected liver area. There was one intraoperative death. In 6 patients with a mean postoperative follow-up of 19.2 months (4-42 months), the patency of hepatoatrial anastomosis was documented by angiography or Doppler-2d-echocardiography. Four patients are free of symptoms and signs of Budd-Chiari syndrome. In one of two patients with associated cirrhosis compression of inferior vena cava reoccurred and in another patient esophageal varices persist. We conclude, that the hepatoatrial anastomosis is an effective treatment of Budd-Chiari syndrome.

  18. A new anastomosis technique for intestinal diseases with proximal dilated segments

    Directory of Open Access Journals (Sweden)

    Metin Gündüz

    2016-01-01

    Full Text Available A number of techniques have been described for intestinal anastomosis. We describe a different, simple, and safe technique that can be used in patients with intestinal diseases, such as jejunoileal atresia and perforation that has proximal dilated segments. In this technique, an atraumatic bowel clamp was applied on the proximal dilated bowel at a 90° angle. In the narrow distal segment, we resected the bowel at a 0° angle and continued at a 30° angle from the antimesenteric side. Finally, a two-layer interrupted anastomosis was performed. We applied this technique to a 31-day-old patient who had a divided jejunostomy due to malrotation and perforation with a proximal dilated bowel. Neither anastomotic complications nor feeding and passage problems were seen postoperatively.

  19. A meta-analysis of aneurysm formation in laser assisted vascular anastomosis (LAVA)

    Science.gov (United States)

    Chen, Chen; Peng, Fei; Xu, Dahai; Cheng, Qinghua

    2009-08-01

    Laser assisted vascular anastomosis (LAVA) is looked as a particularly promising non-suture method in future. However, aneurysm formation is one of the main reasons delay the clinical application of LAVA. Some scientists investigated the incidence of aneurysms in animal model. To systematically analyze the literature on reported incidence of aneurysm formation in LAVA therapy, we performed a meta-analysis comparing LAVA with conventional suture anastomosis (CSA) in animal model. Data were systematically retrieved and selected from PUBMED. In total, 23 studies were retrieved. 18 studies were excluded, and 5 studies involving 647 animals were included. Analysis suggested no statistically significant difference between LAVA and CSA (OR 1.24, 95%CI 0.66-2.32, P=0.51). Result of meta analysis shows that the technology of LAVA is very close to clinical application.

  20. Laparoscopic restorative proctocolectomy ileal pouch anal anastomosis: How I do it?

    Science.gov (United States)

    Madnani, Manish A; Mistry, Jitendra H; Soni, Harshad N; Shah, Atul J; Patel, Kantilal S; Haribhakti, Sanjiv P

    2015-01-01

    Surgery for ulcerative colitis is a major and complex colorectal surgery. Laparoscopy benefits these patients with better outcomes in context of cosmesis, pain and early recovery, especially in young patients. For surgeons, it is a better tool for improving vision and magnification in deep cavities. This is not the simple extension of the laparoscopy training. Starting from preoperative preparation to post operative care there are wide variations as compared to open surgery. There are also many variations in steps of laparoscopic surgery. It involves left colon, right colon and rectal mobilisation, low division of rectum, pouch creation and anastomosis of pouch to rectum. Over many years after standardisation of this technique, it takes same operative time as open surgery at our centre. So we present our standardized technique of laparoscopic assisted restorative proctocolectomy and ileal pouch anal anastomosis (IPAA). PMID:26195886

  1. Image analysis in multisample biopsy after ileal pouch-anal anastomosis.

    Science.gov (United States)

    Giarnieri, E; Giovagnoli, M R; Montesani, C; Nagar, C; Pronio, A M; Alderisio, M; Ribotta, G; Vecchione, A

    1996-01-01

    Pouchitis in ileal anal anastomosis represents an important clinical complication after restorative proctocolectomy. Acute and chronic inflammation of the reservoir is a frequent event sometimes associated with villous atrophy and colonic metaplasia. After ileal pouch anastomosis, twenty-one patients affected by ulcerative colitis were studied. An image analyzer CAS 200 (Becton Dickinson) was utilized to evaluate the DNA intranuclear content in every biopsy. In two cases abnormal DNA distribution was observed, and in one case a poliploid pattern was seen. Abnormal DNA distribution was also present in colonic metaplasia. Therefore, image analysis for the detection of DNA aneuploidy may be of additional value together with histologic parameters in follow up, in order to exclude transformation of the ileal mucosa in neoplastic epithelia.

  2. Single-incision, laparoscopic-assisted jejunal resection and anastomosis following a gunshot wound.

    Science.gov (United States)

    Rubin, Jacob A; Shigemoto, Reynsen; Reese, David J; Case, J Brad

    2015-01-01

    A 2 yr old castrated male Pomeranian was evaluated for a 6 wk history of chronic vomiting, intermittent anorexia, and lethargy. Physical examination revealed a palpable, nonpainful, soft-tissue mass in the midabdominal area. Abdominal radiographs and ultrasound revealed a focal, eccentric thickening of the jejunal wall with associated jejunal mural foreign body and partial mechanical obstruction. Following diagnosis of a partial intestinal obstruction as the cause of chronic vomiting, the patient underwent general anesthesia for a laparoscopic-assisted, midjejunal resection and anastomosis using a single-incision laparoscopic surgery port. The patient was discharged the day after surgery, and clinical signs abated according to information obtained during a telephone interview conducted 2 and 8 wk postoperatively. The dog described in this report is a unique case of partial intestinal obstruction treated by laparoscopic-assisted resection and anastomosis using a single-incision laparoscopic surgery port.

  3. EFFECT OF OMEGA-3 FATTY ACID IN THE HEALING PROCESS OF COLONIC ANASTOMOSIS IN RATS

    OpenAIRE

    CASTILHO, Tiago Jacometo Coelho de; CAMPOS, Antônio Carlos Ligocki; MELLO, Eneri Vieira de Souza Leite

    2015-01-01

    Background: The use of long-chain polyunsaturated fatty acids has been studied in the context of healing and tissue regeneration mainly due to its anti-inflammatory, immunoregulatory and antioncogenic properties. Previous studies have demonstrated beneficial effects with the use of enteral immunonutrition containing various farmaconutrients such as L-arginine, omega-3, trace elements, but the individual action of each component in the healing of colonic anastomosis remains unclear. Aim: To e...

  4. Aberrant cervical vasculature anastomosis as cause of neck pain and successful treatment with embolization technique.

    Science.gov (United States)

    He, Lucy; Ladner, Travis R; Cobb, Mark; Mocco, J

    2016-01-27

    We report a patient with non-dermatomal radiating neck pain without focal neurologic deficit. Traditional workup could not identify an anatomic or biomechanical cause. Imaging showed a deep cervical vessel centered in the region of pain. Angiography later identified an aberrant anastomosis of this vessel with the occipital artery. Subsequent endovascular embolization of this arterial trunk resulted in complete pain relief. 2016 BMJ Publishing Group Ltd.

  5. Anastomotic leakage after low anterior resection for rectal cancer: comparison of stapled versus compression anastomosis.

    Science.gov (United States)

    Dauser, Bernhard; Braunschmid, Tamara; Ghaffari, Shahbaz; Riss, Stefan; Stift, Anton; Herbst, Friedrich

    2013-10-01

    Surgical technique and perioperative management in rectal cancer surgery have been substantially improved and standardized during the last decades. However, anastomotic leakage following low anterior resection still is a significant problem. Based on animal experimental data of improved healing of compression anastomosis, we hypothesized that a compression anastomotic device might improve healing rates of the highest-risk anastomoses. All low anterior resections for rectal cancer performed or directly supervised by the senior author between January 2004 and June 2012 were analyzed. Only patients with a stapled or compression anastomosis located within 6 cm from the anal verge were included. Until December 2008, circular staplers were employed, while since January 2009, a novel compression anastomotic device was used for rectal reconstruction exclusively. Out of 197 patients operated for rectal cancer, a total of 96 (34 females, 35.4 %) fulfilled inclusion criteria. Fifty-eight (60.4 %) were reconstructed with circular staplers and 38 (39.6 %) using a compression anastomotic device. Significantly, more laparoscopic procedures were recorded in the compression anastomosis group, but distribution of gender, age, body mass index, American Society of Anaesthesiologists score, rate of preoperative radiotherapy, tumor staging, or stoma diversion rate were similar. Anastomotic leakage was observed in seven cases (7/58, 12.1 %) in the stapled and twice (2/38, 5.3 %) in the compression anastomosis group (p = 0.26). In this series, rectal reconstruction following low anterior resection using a novel compression anastomotic device was safe and (at least) equally effective compared to traditional circular staplers concerning leak rate.

  6. [Abdominothoracic esophageal resection according to Ivor Lewis with intrathoracic anastomosis : standardized totally minimally invasive technique].

    Science.gov (United States)

    Runkel, N; Walz, M; Ketelhut, M

    2015-05-01

    The clinical and scientific interest in minimally invasive techniques for esophagectomy (MIE) are increasing; however, the intrathoracic esophagogastric anastomosis remains a surgical challenge and lacks standardization. Surgeons either transpose the anastomosis to the cervical region or perform hybrid thoracotomy for stapler access. This article reports technical details and early experiences with a completely laparoscopic-thoracoscopic approach for Ivor Lewis esophagectomy without additional thoracotomy. The extent of radical dissection follows clinical guidelines. Laparoscopy is performed with the patient in a beach chair position and thoracoscopy in a left lateral decubitus position using single lung ventilation. The anvil of the circular stapler is placed transorally into the esophageal stump. The specimen and gastric conduit are exteriorized through a subcostal rectus muscle split incision. The stapler body is placed into the gastric conduit and both are advanced through the abdominal mini-incision transhiatally into the right thoracic cavity, where the anastomosis is constructed. Data were collected prospectively and analyzed retrospectively. A total of 23 non-selected consecutive patients (mean age 69 years, range 46-80 years) with adenocarcinoma (n = 19) or squamous cell carcinoma (n = 4) were surgically treated between June 2010 and July 2013. Neoadjuvant therapy was performed in 15 patients resulting in 10 partial and 4 complete remissions. There were no technical complications and no conversions. Mean operative time was 305 min (range 220-441 min). The median lymph node count was 16 (range 4-42). An R0 resection was achieved in 91 % of patients and 3 anastomotic leaks occurred which were successfully managed endoscopically. There were no postoperative deaths. The intrathoracic esophagogastric anastomosis during minimally invasive Ivor Lewis esophagectomy can be constructed in a standardized fashion without an additional thoracotomy

  7. A Novel Technique for Duodenal Resection and Primary Anastomosis With Robotic Assistance and OrVil.

    Science.gov (United States)

    Bedirli, Abdulkadir; Salman, Bulent; Nasirov, Mahir; Dogan, Ibrahim

    2017-01-01

    Benign duodenal neoplasm is a rare occurrence. Minimally invasive tumor resection and anastomosis formation with an OrVil catheter is a novel approach to treating this disease. In this article, we present a new technique for duodenojejunal anastomosis. This technique was applied in 4 patients with benign distal duodenal tumors who were treated with minimally invasive surgery with robotic assistance. In 4 patients, after the removal of distal duodenal masses with a robotic technique, an orifice in the duodenum was opened to allow for the passage of a guidewire. The guidewire was removed from the orifice by holding it with forceps during an upper endoscopy. An OrVil catheter was sutured to the guidewire outside to allow 2 catheters to proceed consecutively. After the removal of the anvil, an end-lateral duodenojejunostomy was performed with a circular stapler. The patients included 3 men and 1 woman (average age, 56). The durations of the operations were 215, 175, 180, and 185 minutes. No complications were observed in any of the patients during the postoperative period. The patients began oral intake on the fifth day of the postoperative period, and they were discharged on the sixth postoperative day. Histopathologic analyses indicated that the removed tumors were adenomas in 2 patients and gastrointestinal stromal tumors (GISTs) in 2 patients. Clear surgical margins were observed in all of the patients. The placement of an OrVil catheter for anastomosis in benign neoplasms with distal duodenum localization and the subsequent achievement of duodenojejunal anastomosis with a circular stapler constitute a novel treatment approach.

  8. Effects of circular myotomy on the healing of esophageal suture anastomosis: an experimental study.

    Science.gov (United States)

    Tannuri, U; Tannuri, A C; Fukutaki, M F; de Oliveira, M S; Muoio, V M; Massaguer, A A

    1999-01-01

    For esophageal reconstruction in newborns with esophageal atresia, esophageal reunion with an end-to-end anastomosis is the ideal procedure, although it may result in leaks and strictures due to tension on the suture line, mainly in cases with a wide gap between the ends. Circular myotomy (Livaditis' procedure) is the best method to elongate the proximal esophageal pouch and reduce anastomotic tension. This experimental investigation in dogs was undertaken to attempt to verify that circular myotomy decreases the anastomotic leak rate in newborns with wide gap esophageal atresia, and to analyze whether the technique promotes morphologic changes in the anastomotic scar. A pilot study demonstrated that it is necessary to resect more than 8 cm (40% of the total esophageal length) in order to obtain high leak rates. In the experimental project, such resection was performed in dogs divided into two groups (control group, anastomosis only, and experimental group, anastomosis plus circular myotomy in the proximal esophageal segment). The animals were killed in the 14th postoperative day, submitted to autopsy, and were evaluated as to the presence of leaks and strictures, as well as to the features (macroscopic and microscopic aspects) of the anastomosis. Leak rates were the same in both groups. Morphometric analysis revealed that in animals in the experimental group, the anastomotic scar was thinner than the control animals, and the isolated muscular manchette distal to the site of myotomy was replaced by fibrous tissue. Correspondingly, a decreased number of newly formed small vessels were noted in the experimental animals, compared to control animals. We concluded that circular myotomy does not decrease the incidence of anastomotic leaks, and it also promotes deleterious changes in anastomotic healing.

  9. Effects of circular myotomy on the healing of esophageal suture anastomosis: an experimental study

    Directory of Open Access Journals (Sweden)

    Tannuri Uenis

    1999-01-01

    Full Text Available For esophageal reconstruction in newborns with esophageal atresia, esophageal reunion with an end-to-end anastomosis is the ideal procedure, although it may result in leaks and strictures due to tension on the suture line, mainly in cases with a wide gap between the ends. Circular myotomy (Livaditis' procedure is the best method to elongate the proximal esophageal pouch and reduce anastomotic tension. This experimental investigation in dogs was undertaken to attempt to verify that circular myotomy decreases the anastomotic leak rate in newborns with wide gap esophageal atresia, and to analyze whether the technique promotes morphologic changes in the anastomotic scar. A pilot study demonstrated that it is necessary to resect more than 8 cm (40% of the total esophageal length in order to obtain high leak rates. In the experimental project, such resection was performed in dogs divided into two groups (control group, anastomosis only, and experimental group, anastomosis plus circular myotomy in the proximal esophageal segment. The animals were killed in the 14th postoperative day, submitted to autopsy, and were evaluated as to the presence of leaks and strictures, as well as to the features (macroscopic and microscopic aspects of the anastomosis. Leak rates were the same in both groups. Morphometric analysis revealed that in animals in the experimental group, the anastomotic scar was thinner than the control animals, and the isolated muscular manchette distal to the site of myotomy was replaced by fibrous tissue. Correspondingly, a decreased number of newly formed small vessels were noted in the experimental animals, compared to control animals. We concluded that circular myotomy does not decrease the incidence of anastomotic leaks, and it also promotes deleterious changes in anastomotic healing.

  10. Use of atropine to reduce mucosal eversion during intestinal resection and anastomosis in the dog.

    Science.gov (United States)

    Agrodnia, Marta; Hauptman, Joe; Walshaw, Richard

    2003-01-01

    To determine whether atropine altered the degree of mucosal eversion during jejunal resection and anastomosis in the dog. Part I: Prospective, blinded, randomized, controlled study using a therapeutic dose (0.04 mg/kg systemic) of atropine. Part II: Prospective, unblinded, assigned, controlled study using a pharmacologic (0.04 mg/kg local arterial) dose of atropine. Part I: Twenty-two young adult female Beagle dogs used during a nonsurvival third-year veterinary student surgical laboratory (small intestinal resection and anastomosis). Part II: Ten young adult female Beagle dogs used immediately after completion of a nonsurvival third-year veterinary student orthopedic surgical laboratory. Part I: Dogs were randomly assigned to receive either atropine (0.04 mg/kg), or an equal volume of saline, given intramuscularly (premedication) and again intravenously prior to intestinal resection. Part II: In each dog, atropine (0.04 mg/kg)/saline was alternately given in the proximal/distal jejunum. Part I: There was no clinically or statistically significant difference between systemic atropine and saline solution on the degree of jejunal mucosal eversion after resection. Part II: There was a statistically significant decrease in jejunal mucosal eversion with atropine compared with saline solution when injected into a local jejunal artery. Systemic atropine (0.04 mg/kg) does not alter the degree of jejunal mucosal eversion during resection and anastomosis. Jejunal intraarterial atropine (0.04 mg/kg) reduced jejunal mucosal eversion during resection and anastomosis. The clinical usefulness and consequences of jejunal arterial atropine administration to reduce mucosal eversion remain to be determined. Copyright 2003 by The American College of Veterinary Surgeons

  11. New device for saphenous vein-to-aorta proximal anastomosis without side-clamping

    Directory of Open Access Journals (Sweden)

    Tappainer Ernesto

    2007-05-01

    Full Text Available Abstract Background Side clamping to perform saphenous vein-to-aorta proximal anastomosis is a well known cause of cerebral embolization during coronary bypass surgery. Automatic and manual devices have been introduced to avoid aortic clamping and facilitate proximal anastomosis but the manual ones only allow the traditional hand-sewing running suture. Nevertheless, they are not easy to use and very expensive to buy. Methods We developed a simple object that helps to perform a manual proximal anastomosis without the need to clamp the side of the aorta. This device is a steel bar which blocks the aortic hole and simultaneously it provides a slit to receive the needle. Through the slit comes out a thin, sharp, straight, but also well directed and predictable jet of blood which could be easily controlled during the suture. Results The function of the object is quite different from other devices. Nothing is deployed in the aorta. The object is only placed on the aorta with the small appendage slipped into the hole. The main advantage of the device is that while manipulation of the aorta is avoided no foreign bodies are incorporated in the suture and – most importantly – the aortic intima is not touched at all. The main drawback of the device is the blood jet coming from the slit so that the blood pressure has to be lowered by vasodilators during the anastomosis. Moreover, the suture has to change direction and the needle has to enter the aortic wall first to slip out through the slit. Conclusion The object was named "Slit Device" and is not a routine instrument. It would be only an alternative to other anastomotic devices with the same surgical indications. In the case of ascending aortic disease and saphenous vein grafting, the Slit Device avoids aortic clamping thereby preventing atheroembolism and also avoiding the need for hypothermic circulatory arrest in patients with unclampable aorta.

  12. Stapled versus handsewn intestinal anastomosis in emergency laparotomy: a systemic review and meta-analysis.

    Science.gov (United States)

    Naumann, David N; Bhangu, Aneel; Kelly, Michael; Bowley, Douglas M

    2015-04-01

    The optimal technique for gastrointestinal anastomosis remains controversial in emergency laparotomy. The aim of this meta-analysis was to compare outcomes of stapled versus handsewn anastomosis after emergency bowel resection. A systematic review was performed for studies comparing outcomes after emergency laparotomy using stapled versus handsewn anastomosis until July 2014 (PROSPERO registry number: CRD42013006183). The primary endpoint was anastomotic failure, a composite measure of leak, abscess and fistula. Odds ratio (OR; with 95% CI) and weighted mean differences were calculated using meta-analytical techniques. Subgroup analysis was conducted for trauma surgery (TS) and emergency general surgery (EGS) cohorts. Risk of bias for each study was calculated using the Newcastle-Ottawa scale for cohort studies, and Cochrane Collaboration's tool for randomized trials. The final analysis included 7 studies of 1,120 patients, with a total of 1,205 anastomoses. There were 5 TS studies and 2 EGS studies. There were no differences in anastomotic failure between handsewn and stapled techniques on an individual anastomosis level (OR, 1.53; 95% CI, 0.97-2.43; P = .070), or on an individual patient level (OR, 1.44; 95% CI, 0.92-2.25; P = .110). There were no differences in the individual rates of anastomotic leak, abscess, fistulae, or postoperative deaths between techniques. Subgroup analysis of EGS and TS studies demonstrated no superior operative technique. Available evidence is sparse and at high risk of bias, and neither stapling nor handsewing is justifiably favored in emergency laparotomy. Surgeons might therefore select the technique of their own choice with caution owing to unresolved uncertainty. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Apple-peel intestinal atresia: enteroplasty for intestinal lengthening and primary anastomosis.

    Science.gov (United States)

    Onofre, Luciano Silveira; Maranhão, Renato Frota de Albuquerque; Martins, Elaine Cristina Soares; Fachin, Camila Girardi; Martins, Jose Luiz

    2013-06-01

    Apple-peel atresia (or Type-IIIb intestinal atresia) is an unusual type of jejunoileal atresia. They present with jejunal atresia near the ligament of Treitz and a foreshortened small bowel. Many surgical options have been used, but the optimal method of repair remains unclear. We present a case of a newborn with apple-peel intestinal atresia managed by enteroplasty for intestinal lengthening and primary anastomosis. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Introduction of a potent single-donor fibrin glue for vascular anastomosis: An animal study

    Directory of Open Access Journals (Sweden)

    Mehdi Rasti Ardakani

    2012-01-01

    Full Text Available Background: Vascular anastomosis is considered as a difficult surgical procedure. Although different alternative methods have been tried to tackle these difficulties, none were found to be successful. Commercial fibrin glue has recently been used for vascular anastomosis. However, it did not gain popularity due to some limitations such as low tensile strength, rapid removal by the immune system, and risk of transmission of blood-borne viral infections. In this article, we presented a novel method for producing single-donor human fibrin glue and determined its success rate for vascular anastomosis in an animal model. Materials ans Methods : In this study, 3 mL of single-donor fibrin sealant was prepared from 150 mL of whole blood containing 50-70 mg/mL of fibrinogen. The study was performed on 10 dogs and 5 cats. After transection of the carotid artery, both ends were anastomosed by means of 3-4 sutures (Prolene 8-0. The suture line was then sealed with one layer of the new fibrin sealant. After 3-8 weeks, the site of anastomosis was evaluated angiographically and morphologically for healing and possible complications such as thrombosis or aneurysm. Results: In evaluations 3 weeks after the surgery, all arterial anastomoses were patent in dogs, but some degree of subintimal hyperplasia was noted. After 8 weeks, all anastomoses were patent and the degree of subintimal hyperplasia was decreased. In cats on the other hand, after 4 weeks, all anastomoses were patent and subintimal hyperplasia was absent. Conclusions: Single-donor fibrin glue was a quite reliable and practical alternative to minimize suturing and therefore operative time in our animal model. This sealant can easily be obtained from the patient′s whole blood. Its application in humans would require further studies.

  15. The Effects of Systemic IGF-I on the Arterial Anastomosis in Rats

    Directory of Open Access Journals (Sweden)

    Baris Keklik

    2014-04-01

    Full Text Available Objective: In this study, we aimed to document the effects of a well-known agent and mdash; and ldquo;insulin-like growth factor (IGF-I and rdquo; and mdash; on the microvascular anastomosis site. Methods: Sixteen Sprague-Dawley rats were used in this study. The rats were classified randomly into two equally numbered groups (eight rats each: the control (Group 1 and the experiment group (Group 2. The femoral artery was dissected completely in all rats. Following division of the artery, anastomoses were conducted with microvascular techniques. Forty-five minutes after the anastomoses, an Acland milking test was performed in order to check the patency and the first surgical session was terminated. In the second stage, LONG and reg; R3 IGF-I human (Sigma-Aldrich, St. Louis, Missouri, United States solution was introduced to Group 2 (experimental group intraperitoneally in doses of 2 mg/kg on the day of the surgery in addition to the third and seventh days postoperatively. On the 4th postoperative week, the patency of the anastomoses was evaluated with the Acland milking test. In addition, one centimeter of a vascular segment including the anastomosis site was excised and stained with hematoxylin-eosin. They were evaluated for edema, inflammation, vascular wall injury, intimal hyperplasia, medial atrophy, thrombus, calcification, foreign body reactions, and the endothelial proliferation. Results: The Acland milking test showed a 100% vascular patency in both groups. A statistically significant difference was found between the experimental and control groups in terms of edema and vascular wall injury (p0.05. Conclusion: Under the light of the obtained data, IGF-I was effective in preventing the edema and vascular wall injury at the anastomosis site. However, the net positive clinical effect on anastomosis patency necessitates further studies. [Arch Clin Exp Surg 2014; 3(2.000: 87-93

  16. Preoperative wireless capsule endoscopy does not predict outcome after ileal pouch-anal anastomosis.

    Science.gov (United States)

    Murrell, Zuri; Vasiliauskas, Eric; Melmed, Gil; Lo, Simon; Targan, Stephan; Fleshner, Phillip

    2010-03-01

    The extent of preoperative small-bowel mucosal inflammation may be an important predictor of pouchitis after ileal pouch-anal anastomosis. This study examined the value of preoperative wireless capsule endoscopy in predicting outcome of ileal pouch-anal anastomosis in patients with ulcerative colitis or indeterminate colitis. Patients undergoing complete wireless capsule endoscopy before ileal pouch-anal anastomosis were identified. Findings on wireless capsule endoscopy were classified as positive (erosions, ulcers or erythema) or negative. Outcome was assessed prospectively and included no pouchitis, acute pouchitis, chronic pouchitis, or de novo Crohn disease. Patients with acute pouchitis, chronic pouchitis, or de novo Crohn disease were considered to have pouch inflammation. The 68 study patients (48 ulcerative colitis; 20 indeterminate colitis) had a median age of 38 years and included 34 males. Median follow-up time after ileostomy closure was 12 months (range, 3-63 months). Wireless capsule endoscopy was positive in 15 patients (22%) and negative in 53 patients (78%). Pouch inflammation was observed in 23 patients (34%), and included 8 patients with acute pouchitis, 3 patients with chronic pouchitis, and 12 patients with de novo Crohn disease. The incidence of acute pouchitis, chronic pouchitis, de novo Crohn disease, and pouch inflammation in the wireless capsule endoscopy-positive patient group was 7%, 7%, 20%, and 33% compared with 13%, 4%, 17%, and 34% in the wireless capsule endoscopy-negative patient group (all P = NS). There was no statistical association between the results of preoperative wireless capsule endoscopy and outcome after ileal pouch-anal anastomosis in patients with ulcerative colitis or indeterminate colitis. There seems to be little value of wireless capsule endoscopy in the preoperative evaluation of these patients.

  17. [A case of dural AVM detected after STA-MCA anastomosis].

    Science.gov (United States)

    Igase, K; Oka, Y; Kumon, Y; Zenke, K; Iwata, S; Sakaki, S

    1996-01-01

    A case of dural arteriovenous malformation (AVM) in the posterior cranial fossa detected after STA-MCA anastomosis surgery. A 52-year-old male consulted a neighbourhood hospital for sudden headache and vomiting. He was diagnosed as having intraventricular hemorrhage on CT scan. Though the obstruction of the right internal carotid artery was revealed angiographically, his symptoms improved after conservative therapy. Two weeks after onset, his consciousness deteriorated and he developed left hemiparesis. Thereafter, he was transferred to our hospital. After thorough examination, right STA-MCA anastomosis surgery was performed. Approximately 2 months after surgery, right tinnitus developed and gradually exacerbated. Since it was thought to be due to increased blood flow in the right superficial temporal artery, it was kept under observation. On angiogram, 8 months after surgery, good blood flow supplied from the right superficial temporal artery to the territory of the right middle cerebral artery was shown, and a dural AVM fed by the right occipital artery was found. Fourteen months after the surgery, an enlarged dural AVM with backflow to the superficial cerebral veins fed by the enlarged right occipital artery and right ascending pharyngeal artery was revealed. Embolization therapy to the right occipital and ascending pharyngeal artery was performed using coils and ivalon, and irradiation of 30 Gy was added. After this treatment, right tinnitus improved. On angiography 2 years later, transverse sinus was slightly visible via the right occipital artery and ascending pharyngeal artery, but the dural AVM was significantly reduced. The origin of dural AVMs remains controversial. In our case, dural AVM was not found before the STA-MCA anastomosis surgery, and sinus thrombosis was not found throughout the course of observation. It is thought that the occult dural AVM was disclosed and enlarged by the increased blood flow through the external carotid artery via the STA

  18. Effects of Cholerella sp. microalgae extract on colonic anastomosis in rats with protein-energy malnutrition.

    Science.gov (United States)

    Salman, B; Kerem, M; Bedirli, A; Katircioglu, H; Ofluoglu, E; Akin, O; Onbasilar, I; Ozsoy, S; Haziroglu, R

    2008-06-01

    Algae, which are used as supplementary nutrients in various countries, are products rich in protein, vitamins and minerals. The aim of this study was to investigate the effects of algae extracts on the healing of colonic anastomosis in malnourished rats. Seventy-two rats were randomized to three groups. Group 1 was fed with standard diet for 15 days, before and after the colonic anastomosis. Groups 2 and 3 were fed with a malnutrition diet for 15 days prior to colonic anastomosis and then with the basic diet for 15 days there after. Group 3 also received an extract of algae derived from Cholerella sp. via oral gavage postoperatively, in addition to the basic diet. Rats were killed on the 3rd, 7th and 15th postoperative day. Blood samples were collected to evaluate prealbumin, transferring and albumin levels. Anastomotic bursting pressures (BPs), histopathology and tissue hydroxyproline levels were evaluated after killing. In group 3, the prealbumin level on the 3rd postoperative day and transferrin and albumin levels on the 7th and 15th postoperative days were significantly increased compared with the other groups (P < 0.05). Tissue hydroxyproline levels and anastomotic BPs of group 3 were significantly higher than in group 2 on the 3rd, 7th and 15th postoperative days (P < 0.05). Histopathological examination of the anastomosis revealed significantly better healing patterns for group 3 than for groups 1 and 2 (P < 0.05). Extract derived from Cholerella sp. microalgae has favourable effects on healing of experimental colon anastomoses.

  19. How to perform a coronary artery anastomosis in complete endoscopic fashion with robotic assistance

    Science.gov (United States)

    Canale, Leonardo Secchin; Bonatti, Johannes

    2014-01-01

    Current technology in robotic surgery allows us to perform myocardial revascularization procedures in a totally endoscopic fashion. We will describe the technique of choice for left internal mammary artery to left anterior descendent artery anastomosis with the use of cardiopulmonary bypass machine. The method is efficient and there is long term follow-up showing similar patency of the graft when compared to conventional methods (when performed through sternotomy). PMID:25714222

  20. How to perform a coronary artery anastomosis in complete endoscopic fashion with robotic assistance

    Directory of Open Access Journals (Sweden)

    Leonardo Secchin Canale

    2014-12-01

    Full Text Available Current technology in robotic surgery allows us to perform myocardial revascularization procedures in a totally endoscopic fashion. We will describe the technique of choice for left internal mammary artery to left anterior descendent artery anastomosis with the use of cardiopulmonary bypass machine. The method is efficient and there is long term follow-up showing similar patency of the graft when compared to conventional methods (when performed through sternotomy.

  1. Canadian very large optical telescope technical studies

    Science.gov (United States)

    Roberts, Scott C.; Morbey, Christopher L.; Crabtree, Dennis R.; Carlberg, Ray; Crampton, David; Davidge, Timothy J.; Fitzsimmons, Joeleff T.; Gedig, Michael H.; Halliday, David J.; Hesser, James E.; Herriot, Glen; Oke, J. Beverly; Pazder, John S.; Szeto, Kei; Veran, Jean-Pierre

    2003-01-01

    A design is proposed for a 20 m Canadian Very Large Optical Telescope (VLOT). This design meets the science, schedule, and availability requirements of the Canadian astronomical community. The telescope could be operational by early in the next decade to complement the science discoveries of the Next Generation Space Telescope (NGST) and Atacama Large Millimeter Array (ALMA). This design is suitable for location on the Mauna Kea summit ridge, and could replace the current 3.6 m CFHT telescope. The telescope structure provides room for two vertically oriented Nasmyth instruments, implements a very stiff monocoque mirror cell, and offers a short and direct load path to the telescope mount. A Calotte style dome structure offers many advantages over current designs including lower and more even power requirements, and a circular aperture that will better protect the telescope structure from wind buffeting. The science requirements are presented, and the telescope optical design, primary mirror pupil segmentation options, including hexagonal segments and a radial segment design with a central 8 m mirror, are considered. Point spread function plots and encircled energy calculations show that there is no significant diffraction performance difference between the options except that hexagonal segments in the 1 m point-to-point range appear to deliver poorer PSF's as compared to 2 m and larger segments. Plans for implementation of a Matlab based integrated telescope model are discussed. A summary of adaptive optics system issues for large telescopes is presented along with plans for future research in AO.

  2. Comparison of 10-0 polypropylene and 10-0 nylon sutures in rat arterial anastomosis.

    Science.gov (United States)

    Chen, L E; Seaber, A V; Urbaniak, J R

    1993-01-01

    The selection of suture materials is an important factor in further improving the results of microsurgical operations. In this study, two kinds of nonabsorbable suture materials, 10-0 polypropylene and 10-0 nylon monofilament, were compared in end-to-end anastomosis of 66 femoral arteries of adult rats. Both suture types were of identical size (70 microns needle/28 microns suture) and each artery received eight sutures. The vessels were harvested at various intervals from 2 hr to 180 days postoperatively and were evaluated by pathology, radiology, and tensile strength test. The results show that both sutures are capable of achieving excellent long-term patency (100%) of anastomosed sites. Polypropylene suture was equivalent to nylon in mechanical integrity of the anastomosis sites but was superior in handling, knotting, and biocompatibility. These physical and biological properties of polypropylene sutures may offer the benefits of diminished early and late complications at anastomosis sites and reduced operation time. Enhancement of contrast against surrounding tissue may make polypropylene a superior alternative to nylon sutures for microsurgical use.

  3. A new technique of laparoscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction.

    Science.gov (United States)

    Faller, Emilie; Albornoz, Jaime; Messori, Pietro; Leroy, Joël; Wattiez, Arnaud

    2013-01-01

    To show a new technique of laparoscopic intracorporeal anastomosis for transrectal bowel resection with transvaginal specimen extraction, a technique particularly suited for treatment of bowel endometriosis. Step-by-step explanation of the technique using videos and pictures (educative video). Endometriosis may affect the bowel in 3% to 37% of all endometriosis cases. Bowel endometriosis affects young women, without any co-morbidities and in particular without any vascular disorders. In addition, affected patients often express a desire for childbearing. Radical excision is sometimes required because of the impossibility of conservative treatment such as shaving, mucosal skinning, or discoid resection. Bowel endometriosis should not be considered a cancer, and consequently maximal resection is not the objective. Rather, the goal would be to achieve functional benefit. As a result, resection must be as economic and cosmetic as possible. The laparoscopic approach has proved its superiority over the open technique, although mini-laparotomy is generally performed to prepare for the anastomosis. Total laparoscopic approach in patients with partial bowel stenosis, using the vagina for specimen extraction. This technique of intracorporeal anastomosis with transvaginal specimen extraction enables a smaller resection and avoidance of abdominal incision enlargement that may cause hernia, infection, or pain. When stenosis is partial, this technique seems particularly suited for treatment of bowel endometriosis requiring resection. If stenosis is complete, the anvil can be inserted above the lesion transvaginally. Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.

  4. Parks coloanal pull-through anastomosis for severe, complicated radiation proctitis

    International Nuclear Information System (INIS)

    Gazet, J.C.

    1985-01-01

    A variety of operations have been proposed for the treatment of radiation injuries of the rectum. In this study, the procedure advocated by the late Sir Alan Parks--resection of the diseased segment down to its points of fixation to the vagina, bladder or prostate; with perianal mucosal stripping of the anorectal segment and primary coloanal (pull-through) anastomosis--was performed in 11 patients. In two others, an attempt at colorectal anastomosis was abandoned because of extreme scarring in the pelvis. The procedures were done following definitive treatment of carcinoma of the rectum (seven patients), carcinoma of the cervix (two patients), carcinoma of the uterus (one patient), carcinoma of the ovary (one patient), seminoma (one patient), and carcinoma of the bladder (one patient). One patient died from a pulmonary embolus on the seventh postoperative day. Of the survivors with a coloanal anastomosis, all had successful closure of their temporary colostomies with follow-up from one to six years. In eight, continence was assessed as being good or excellent. Four patients required anastomotic dilation and another required a surgical procedure for anastomotic stricture. There was one instance each of reoperation for small bowel obstruction and ileocolic fistula. There were no instances of recurrence of hemorrhage, fistulas, perineal pain or tenesmus. The Parks procedure obviates the need for a difficult dissection of the lower rectum and separation of tissues damaged by radiation and avoids the need for eversion techniques. Its selective use is advocated for patients suffering from severe radiation injuries of the rectum

  5. Coloanal anastomosis in the management of benign and malignant rectal disease

    Energy Technology Data Exchange (ETDEWEB)

    Drake, D.B.; Pemberton, J.H.; Beart, R.W. Jr.; Dozois, R.R.; Wolff, B.G.

    1987-11-01

    The aim was to determine the efficacy, safety, and long-term clinical and functional results of coloanal anastomosis in patients with complicated benign and malignant rectal disease. Twenty-nine patients underwent coloanal or colopouch-anal anastomosis for either carcinoma of the rectum not technically amenable to conventional low anterior resection, severe radiation injury, large benign lower third tumors, or complications of previous operations. The mean age of the patients was 61 years and 82% were men. A diverting colostomy was constructed in 55% of the patients. The mean (+/- SEM) length of follow-up was 20 +/- 3 months. There was no operative mortality. Transient urinary retention, however, occurred in 40%, anastomotic stricture in 28%, and anastomotic leakage in 3.4%. Four patients (14%) could not have intestinal continuity restored and therefore were considered failures. The stool frequency for all remaining patients (N = 25) was 3 +/- 1 per day (mean +/- SEM) and did not vary with age, sex, or indication for operation. Complete continence was achieved by 84% of patients, but no patient was incapacitated by poor bowel function. In patients in whom a conventional colorectostomy is impractical or unwise, coloanal anastomosis is a safe and efficacious alternative operation that preserves anal continence.

  6. The effect of erythropoietin on healing of obstructive vs nonobstructive left colonic anastomosis: an experimental study

    Directory of Open Access Journals (Sweden)

    Renda Nurten

    2007-05-01

    Full Text Available Abstract Background Anastomotic leakage is an important problem following primary resection in the left colon and is even more prominent when obstruction is present. We aimed to evaluate the possible effects of erythropoietin on the healing of anastomosis under both obstructive and non-obstructive states. Methods Forty male Wistar albino rats were divided into four groups. In group I, two cm left colonic resection and primary anastomosis were done. In group II, left colon were completely ligated and 24 hours later animals were re-operated for segmental resection. The same procedures were performed for rats in group III and IV in respect to group I and II and, 500 IU/kg a day erythropoietin were given in the latter two groups for seven days. For the quantative description of anastomotic healing mechanical, biochemical and histopathological parameters were employed on the seventh day and the animals were sacrificied. Results Although erythropoietin had positive effects on bursting pressure in group IV when compared to group II, it has no effect in group III. Despite the increased tissue hydroxyproline levels in group IV, erythropoietin failed to show any effects in group III. Erythropoietin had positive effects on neovascularization, fibroblast proliferiation and storage of collagen in group IV. Conclusion We failed to find any direct and evident effects of erythropoietin on healing of left colonic anastomosis. On the other hand, erythropoietin might prevent negative effects of obstruction on healing.

  7. Ileo-ceco-rectal Intussusception Requiring Intestinal Resection and Anastomosis in a Tawny Eagle (Aquila rapax).

    Science.gov (United States)

    Sabater, Mikel; Huynh, Minh; Forbes, Neil

    2015-03-01

    A 23-year-old male tawny eagle (Aquila rapax) was examined because of sudden onset of lethargy, regurgitation, and hematochezia. An intestinal obstruction was suspected based on radiographic findings, and an ileo-ceco-rectal intussusception was confirmed by coelioscopy. A 14.3-cm section of intestine was resected before an intestinal anastomosis was done. Coelomic endoscopic examination confirmed a postsurgical complication of adhesions between the intestinal anastomosis and the dorsal coelomic wall, resulting in a partial luminal stricture and requiring surgical removal of the adhesions. Rectoscopy was useful in diagnosing a mild luminal stricture related to the second surgery. Complete recovery was observed 2 months after surgery. Lack of further complications in the 2 years after surgery demonstrates good tolerance of intestinal resection and anastomosis of a large segment of bowel in an eagle. This report is the first reported case of intussusception in an eagle and emphasizes the potential use of endoscopic examination in the diagnosis as well as in the management of complications.

  8. Parks coloanal pull-through anastomosis for severe, complicated radiation proctitis

    Energy Technology Data Exchange (ETDEWEB)

    Gazet, J.C.

    1985-02-01

    A variety of operations have been proposed for the treatment of radiation injuries of the rectum. In this study, the procedure advocated by the late Sir Alan Parks--resection of the diseased segment down to its points of fixation to the vagina, bladder or prostate; with perianal mucosal stripping of the anorectal segment and primary coloanal (pull-through) anastomosis--was performed in 11 patients. In two others, an attempt at colorectal anastomosis was abandoned because of extreme scarring in the pelvis. The procedures were done following definitive treatment of carcinoma of the rectum (seven patients), carcinoma of the cervix (two patients), carcinoma of the uterus (one patient), carcinoma of the ovary (one patient), seminoma (one patient), and carcinoma of the bladder (one patient). One patient died from a pulmonary embolus on the seventh postoperative day. Of the survivors with a coloanal anastomosis, all had successful closure of their temporary colostomies with follow-up from one to six years. In eight, continence was assessed as being good or excellent. Four patients required anastomotic dilation and another required a surgical procedure for anastomotic stricture. There was one instance each of reoperation for small bowel obstruction and ileocolic fistula. There were no instances of recurrence of hemorrhage, fistulas, perineal pain or tenesmus. The Parks procedure obviates the need for a difficult dissection of the lower rectum and separation of tissues damaged by radiation and avoids the need for eversion techniques. Its selective use is advocated for patients suffering from severe radiation injuries of the rectum.

  9. [Segmental tracheal resection and anastomosis for the treatment of cicatricial stenosis in cervical tracheal].

    Science.gov (United States)

    Cui, P C; Luo, J S; Liu, Z; Bian, K; Guo, Z H; Ma, R N

    2016-02-01

    To evaluate the efficacy of segmental tracheal resection with end-to-end anastomosis for cicatricial cervical tracheal stenosis. The clinical outcomes of 40 patients treated with tracheal resection were retrospectively reviewed. There were 28 male patients and 12 female patients with the age ranged from 6 to 64 years (mean 33.7 years). The degree of stenosis was classified according to Myer-Cotton classification as follows: grade Ⅱ (n=7), grade Ⅲ (n=22) and grade Ⅳ (n=11). The stenosis extension ranged from 1.0 to 4.3 cm (mean 2.5 cm). The causes of the stenosis were postintubation (n=33), cervical trauma (n=6) and resection of tracheal neoplasm (n=1). Thirty-four(85.0%) patients were decannulated and 6 failed. Of the 6 patients failed, 4 were decannulated after reoperation with the sternohyoid myocutaneous flap or thyroid alar cartilage graft. Complications occurred in 10 patients. In 8 patients granulation tissues formed at the site of the tracheal anastomosis, which needed endoscopic resction, and in 2 patients anastomosic dehiscence occurred. No injury to recurrent laryngeal nerve or trachoesophageal fistula occurred. Segmental tracheal resection with end-to-end anastomosis is an effective surgical method for tracheal stenosis, which has a higher successful rate for primary operation and shorter therapeutic period.

  10. Segmental resection with primary anastomosis is not always safe in splenic flexure perforation.

    Science.gov (United States)

    Weledji, Elroy P; Mokake, Martin D; Sinju, Motaze

    2016-01-16

    Familial adenomatous polyposis (FAP) is caused by a rare mutation of the adenomatous polyposis coli gene on Chromosome 5q. The risk of colorectal cancer in patients with FAP is nearly 100% and intensive endoscopic surveillance or prophylactic colectomy are mandatory. If extensive endoscopic surveillance is chosen, there is a cumulative risk of perforation and bleeding especially after polypectomy. We discussed the problems and options in the management of the late diagnosis of an iatrogenic perforation of the splenic flexure complicating endoscopic surveillance in FAP. We present a 35-year-old black African man with FAP who sustained a splenic flexure perforation following a colonoscopic polypectomy of a suspicious lesion. He underwent a splenic flexure resection and primary anastomosis that dehisced and the patient benefited from an emergency definitive colectomy and ileorectal anastomosis. Resection with primary anastomosis following iatrogenic perforation of the splenic flexure is not safe because of a high chance of anastomotic dehiscence. Following a late diagnosis in an unstable patient exteriorization of the perforation as a stoma is a better option prior to a definitive prophylactic colectomy.

  11. Coloanal anastomosis in the management of benign and malignant rectal disease

    International Nuclear Information System (INIS)

    Drake, D.B.; Pemberton, J.H.; Beart, R.W. Jr.; Dozois, R.R.; Wolff, B.G.

    1987-01-01

    The aim was to determine the efficacy, safety, and long-term clinical and functional results of coloanal anastomosis in patients with complicated benign and malignant rectal disease. Twenty-nine patients underwent coloanal or colopouch-anal anastomosis for either carcinoma of the rectum not technically amenable to conventional low anterior resection, severe radiation injury, large benign lower third tumors, or complications of previous operations. The mean age of the patients was 61 years and 82% were men. A diverting colostomy was constructed in 55% of the patients. The mean (+/- SEM) length of follow-up was 20 +/- 3 months. There was no operative mortality. Transient urinary retention, however, occurred in 40%, anastomotic stricture in 28%, and anastomotic leakage in 3.4%. Four patients (14%) could not have intestinal continuity restored and therefore were considered failures. The stool frequency for all remaining patients (N = 25) was 3 +/- 1 per day (mean +/- SEM) and did not vary with age, sex, or indication for operation. Complete continence was achieved by 84% of patients, but no patient was incapacitated by poor bowel function. In patients in whom a conventional colorectostomy is impractical or unwise, coloanal anastomosis is a safe and efficacious alternative operation that preserves anal continence

  12. The Usefulness of Intraoperative Colonic Irrigation and Primary Anastomosis in Patients Requiring a Left Colon Resection.

    Science.gov (United States)

    Hong, Youngki; Nam, Soomin; Kang, Jung Gu

    2017-06-01

    The aim of this study is to assess the short-term outcome of intraoperative colonic irrigation and primary anastomosis and to suggest the usefulness of the procedure when a preoperative mechanical bowel preparation is inappropriate. This retrospective study included 38 consecutive patients (19 male patients) who underwent intraoperative colonic irrigation and primary anastomosis for left colon disease between January 2010 and December 2016. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, and postoperative short-term outcomes. Twenty-nine patients had colorectal cancer, 7 patients had perforated diverticulitis, and the remaining 2 patients included 1 with sigmoid volvulus and 1 with a perforated colon due to focal colonic ischemia. A diverting loop ileostomy was created in 4 patients who underwent a low anterior resection. Complications occurred in 15 patients (39.5%), and the majority was superficial surgical site infections (18.4%). Anastomotic leakage occurred in one patient (2.6%) who underwent an anterior resection due sigmoid colon cancer with obstruction. No significant difference in overall postoperative complications and superficial surgical site infections between patients with obstruction and those with peritonitis were noted. No mortality occurred during the first 30 postoperative days. The median hospital stay after surgery was 15 days (range, 8-39 days). Intraoperative colonic irrigation and primary anastomosis seem safe and feasible in selected patients. This procedure may reduce the burden of colostomy in patients requiring a left colon resection with an inappropriate preoperative mechanical bowel preparation.

  13. [Replantation of fingertip amputation in lack of availability of intravenous anastomosis].

    Science.gov (United States)

    Wei, Jian-Min; Sun, Jun-Suo; Jiao, Xiao-Hu; Jing, Dou-Xing; He, Wei; Jin, Wen-Kuo; Chen, Shi-Gao

    2012-08-01

    To discuss the replantation of fingertip amputation in lack of availability of intravenous anastomosis. From November 2009 to November 2010, 86 patients (104 fingers) with fingertip amputation were treated with replantatioin, including 64 males and 22 females, with an average age of 26 years ranging from 2 to 64 years. The time from injury to therapy was from 30 min to 12 h, time of broken finger ischemia was from 2.5 to 12 h. Preoperative examination showed no obvious abnormalities. Four different replantation methods were selectively applied to these 104 amputated fingertips of 86 cases: (1) replantation with anastomosis of single or bilateral proper digital artery in 37 fingers; (2) replantation with arteriovenous bypass in 27 fingers; (3) replantation with exclusive anastomosis of digital artery in 24 fingers; (4) replantation with removing the palmar pocket method in 16 fingers. One hundred and two of 104 amputated fingertips were survived. Among these survived fingers,75 cases (92 fingers) were followed-up for 6 to 24 months. According to the assessment standard of Chinese Medical Association of Hand Surgery, the results were excellent in 52 cases, good in 19, poor in 4. It benefits to expand the indications and improve the survival rate of replantation of fingertip amputation with the correct choice of different replantation methods according to the injury situation of the broken fingertip artery after debridement under the microscope.

  14. Laparoscopic Conversion of One Anastomosis Gastric Bypass to a Standard Roux-en-Y Gastric Bypass.

    Science.gov (United States)

    Amor, Imed Ben; Petrucciani, Niccolo; Kassir, Radwan; Al Munifi, Abdullah; Piche, Thierry; Debs, Tarek; Gugenheim, Jean

    2017-05-01

    One anastomosis gastric bypass (OAGB) demonstrated results similar to traditional Roux-en-Y procedures [1-3], in terms of weight loss and resolution of obesity-related comorbidities. The main controversy regarding OAGB is the concern for an association between biliary alkaline gastritis and esophageal or gastric cancer raised by some studies [4]. We present the case of a 51-year-old woman with a BMI of 41 kg/m2 who underwent a laparoscopic OAGB in 2014. One year later, she consulted for recurrent heartburns. An upper GI endoscopy showed pouchitis and bile reflux in the esophagus. Medical treatment of gastroesophageal reflux disease was ineffective. We decided to convert the OAGB to a Roux-en-Y gastric bypass (RYGB). In this video, we show how to revise an OAGB to treat chronic bile reflux, by converting the procedure to a standard RYGB. The intervention starts by restoring the normal anatomy of the small bowel, with the resection of the gastrojejunal anastomosis, which was located at 250-cm du Treitz's ligament. Then, the gastric pouch is created. A standard Roux-en-Y gastric bypass is performed. The resection of the gastrojejunal anastomosis allows fashioning the Roux-en-Y limb with the classical measures. This technique allows a conversion to a standard RYGB and is effective in treating the biliary reflux.

  15. Microvascular anastomosis in rodent model evaluated by Fourier domain Doppler optical coherence tomography

    Science.gov (United States)

    Huang, Yong; Tong, Dedi; Zhu, Shan; Wu, Lehao; Ibrahim, Zuhaib; Lee, WP Andrew; Brandacher, Gerald; Kang, Jin U.

    2014-03-01

    Vascular and microvascular anastomosis are critical components of reconstructive microsurgery, vascular surgery and transplant surgery. Imaging modality that provides immediate, real-time in-depth view and 3D structure and flow information of the surgical site can be a great valuable tool for the surgeon to evaluate surgical outcome following both conventional and innovative anastomosis techniques, thus potentially increase the surgical success rate. Microvascular anastomosis for vessels with outer diameter smaller than 1.0 mm is extremely challenging and effective evaluation of the outcome is very difficult if not impossible using computed tomography (CT) angiograms, magnetic resonance (MR) angiograms and ultrasound Doppler. Optical coherence tomography (OCT) is a non-invasive high-resolution (micron level), high-speed, 3D imaging modality that has been adopted widely in biomedical and clinical applications. Phaseresolved Doppler OCT that explores the phase information of OCT signals has been shown to be capable of characterizing dynamic blood flow clinically. In this work, we explore the capability of Fourier domain Doppler OCT as an evaluation tool to detect commonly encountered post-operative complications that will cause surgical failure and to confirm positive result with surgeon's observation. Both suture and cuff based techniques were evaluated on the femoral artery and vein in the rodent model.

  16. In vivo perfusion assessment of an anastomosis surgery on porcine intestinal model (Conference Presentation)

    Science.gov (United States)

    Le, Hanh N. D.; Opferman, Justin; Decker, Ryan; Cheon, Gyeong W.; Kim, Peter C. W.; Kang, Jin U.; Krieger, Axel

    2016-04-01

    Anastomosis, the connection of two structures, is a critical procedure for reconstructive surgery with over 1 million cases/year for visceral indication alone. However, complication rates such as strictures and leakage affect up to 19% of cases for colorectal anastomoses and up to 30% for visceral transplantation anastomoses. Local ischemia plays a critical role in anastomotic complications, making blood perfusion an important indicator for tissue health and predictor for healing following anastomosis. In this work, we apply a real time multispectral imaging technique to monitor impact on tissue perfusion due to varying interrupted suture spacing and suture tensions. Multispectral tissue images at 470, 540, 560, 580, 670 and 760 nm are analyzed in conjunction with an empirical model based on diffuse reflectance process to quantify the hemoglobin oxygen saturation within the suture site. The investigated tissues for anastomoses include porcine small (jejunum and ileum) and large (transverse colon) intestines. Two experiments using interrupted suturing with suture spacing of 1, 2, and 3 mm and tension levels from 0 N to 2.5 N are conducted. Tissue perfusion at 5, 10, 20 and 30 min after suturing are recorded and compared with the initial normal state. The result indicates the contrast between healthy and ischemic tissue areas and assists the determination of suturing spacing and tension. Therefore, the assessment of tissue perfusion will permit the development and intra-surgical monitoring of an optimal suture protocol during anastomosis with less complications and improved functional outcome.

  17. Immediate primary anastomosis for isolated oesophageal atresia: A single-centre experience

    Directory of Open Access Journals (Sweden)

    Ibrahim Uygun

    2015-01-01

    Full Text Available Background: Isolated oesophageal atresia without tracheo-oesophageal fistula represents a major challenge for most paediatric surgeons. Here, we present our experience with six neonates with isolated oesophageal atresia who successfully underwent immediate primary anastomosis using multiple Livaditis circular myotomy. Materials and Methods: All six neonates were gross type A isolated oesophageal atresia (6%, from among 102 neonates with oesophageal atresia, treated between January 2009 and December 2013. Five neonates were female; one was male. The mean birth weight was 2300 (range 1700-3100 g. Results: All six neonates successfully underwent immediate primary anastomosis using multiple myotomies (mean 3; range 2-4 within 10 (median 3 days after birth. The gap under traction ranged from 6 to 7 cm. One neonate died of a major cardiac anomaly. Another neonate was lost to follow-up after being well for 3 months. Three anastomotic strictures were treated with balloon dilatation, and four anastomotic leaks were treated conservatively. The mean duration of follow-up was 33 months. Conclusions: To treat isolated oesophageal atresia, an immediate primary anastomosis can be achieved using multiple myotomies. Although, this approach is associated with high complication rates, as are other similar approaches, these complications can be overcome.

  18. Technique of totally robotic delta-shaped anastomosis in distal gastrectomy

    Directory of Open Access Journals (Sweden)

    Hidehiko Kitagami

    2017-01-01

    Full Text Available Background: We aimed to clarify the utility of delta-shaped anastomosis (Delta, an intracorporeal Billroth-I anastomosis-based reconstruction technique used after laparoscopy-assisted distal gastrectomy (LADG, in robot-assisted distal gastrectomy (RADG. Methods: RADG was performed in patients with clinical Stage I gastric cancer, and reconstruction was performed using Delta. The Delta procedure was the same as that performed after LADG, and the operator practiced the procedure in simulated settings with surgical assistants before the operation. After gastrectomy, the scope and robotic first arm were reinserted from separate ports on the right side of the patient. Then, a port on the left side of the abdomen was used as the assistant port from which a stapler was inserted, with the robotic arm in a coaxial mode. The surgical assistant performed functional end-to-end anastomosis of the remnant stomach and duodenal stump using a powered stapler. Results: The mean anastomotic time in four patients who underwent Delta after RADG was 16.5 min. All patients were discharged on the post-operative day 7 without any post-operative complications or need for readmission. Conclusions: Pre-operative simulation, changes in ports for insertion of the scope and robotic first arm, continuation of the coaxial operation, and use of a powered stapler made Delta applicable for RADG. Delta can be considered as a useful reconstruction method.

  19. Interdigitation of the distal anastomosis between tubed fasciocutaneous flap and cervical esophagus for stricture prevention.

    Science.gov (United States)

    Fujiwara, Takashi; Shih, Hsiang-Shun; Chen, Chien-Chang; Tay, Sherilyn Keng Lin; Jeng, Seng-Feng; Kuo, Yur-Ren

    2011-02-01

    Distal end circular stricture is a major complication following circumferential pharyngoesophageal reconstruction with tubed fasciocutaneous free flaps. To reduce the stricture rates, we have incorporated spatulation with interdigitation at the distal anastomosis site. This study investigated whether this procedure could decrease the stricture rate. Retrospective review. There were 51 patients who underwent tubed fasciocutaneous free flap reconstruction following total laryngo-pharyngo-esophagectomy between July 2002 and August 2008. The interdigitation technique was applied in 10 patients; the 41 remaining patients underwent simple circumferential anastomosis. This modification technique consists of incising both distal skin tube and cervical esophagus into three triangular parts, respectively, and interdigitation by interposition of these flaps. Of the 10 patients with this procedure, five patients were reconstructed with an anterolateral thigh flap and five with a radial forearm flap. All 10 patients received postoperative radiotherapy. The mean follow-up period was 30.2 months. Of the 41 patients without any modification, 12 patients (29.3%) developed a stricture; however, in our series of 10 patients undergoing this modification, there was no stricture formation except one (10.0%) who had been reconstructed with a radial forearm flap. The nine remaining patients all achieved a modified or unrestricted full oral diet without complications. Esophagography revealed a wide and patent anastomosis without stricture. This interdigitation technique could prevent circular contracture at the neopharyngoesophageal segment in reconstruction with tubed fasciocutaneous free flaps. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  20. Coronary artery bypass grafting hemodynamics and anastomosis design: a biomedical engineering review.

    Science.gov (United States)

    Ghista, Dhanjoo N; Kabinejadian, Foad

    2013-12-13

    In this paper, coronary arterial bypass grafting hemodynamics and anastomosis designs are reviewed. The paper specifically addresses the biomechanical factors for enhancement of the patency of coronary artery bypass grafts (CABGs). Stenosis of distal anastomosis, caused by thrombosis and intimal hyperplasia (IH), is the major cause of failure of CABGs. Strong correlations have been established between the hemodynamics and vessel wall biomechanical factors and the initiation and development of IH and thrombus formation. Accordingly, several investigations have been conducted and numerous anastomotic geometries and devices have been designed to better regulate the blood flow fields and distribution of hemodynamic parameters and biomechanical factors at the distal anastomosis, in order to enhance the patency of CABGs. Enhancement of longevity and patency rate of CABGs can eliminate the need for re-operation and can significantly lower morbidity, and thereby reduces medical costs for patients suffering from coronary stenosis. This invited review focuses on various endeavors made thus far to design a patency-enhancing optimized anastomotic configuration for the distal junction of CABGs.

  1. Long-term assessments after pancreaticoduodenectomy with pancreatic duct invagination anastomosis

    International Nuclear Information System (INIS)

    Fujino, Yasuhiro; Matsumoto, Ippei; Sakai, Tetsuya; Ajiki, Tetsuo; Ueda, Takashi; Kuroda, Yoshikazu; Suzuki, Yasuyuki

    2007-01-01

    The purpose of this cohort was to evaluate the long-term patency of the anastomosis and the remnant pancreatic functions. Fifty-six consecutive patients undergoing a pancreaticoduodenectomy with pancreatic duct invagination anastomosis were enrolled in this study. During the follow-up, changes in the remnant pancreatic duct size, pancreatic exocrine and endocrine functions, and nutritional status were monitored. No seriously activated pancreatic fistula, no hemorrhagic complications, no reoperations, and no in-hospital deaths were observed after surgery. A dilatation of remnant pancreatic duct was detected a total of 37 times (51%) during annual computed tomography (CT) evaluations. Pancreatic dysfunctions were observed in a considerable number of patients (exocrine 4/12, 9/14, and 8/16, endocrine 9/35, 8/27, and 4/16 at 1, 2, and 3 postoperative years, respectively). Functional declines in the remnant pancreas, duct dilatation, and a decrease in the body mass index were observed from the first year. However, these data did not progressively deteriorate thereafter, at least during the first 3 postoperative years. This study demonstrated a significant correlation between the duct dilatation and endocrine dysfunction. Our pancreatic duct invagination anastomosis resulted in somewhat limited long-term outcomes, although it did prevent serious complications in the short-term. (author)

  2. Imaging monolithic silicon detector telescopes

    International Nuclear Information System (INIS)

    Amorini, F.; Sipala, V.; Cardella, G.; Boiano, C.; Carbone, B.; Cosentino, L.; Costa, E.; Di Pietro, A.; Emanuele, U.; Fallica, G.; Figuera, P.; Finocchiaro, P.; La Guidara, E.; Marchetta, C.; Pappalardo, A.; Piazza, A.; Randazzo, N.; Rizzo, F.; Russo, G.V.; Russotto, P.

    2008-01-01

    We show the results of some test beams performed on a new monolithic strip silicon detector telescope developed in collaboration with the INFN and ST-microelectronics. Using an appropriate design, the induction on the ΔE stages, generated by the charge released in the E stage, was used to obtain the position of the detected particle. The position measurement, together with the low threshold for particle charge identification, allows the new detector to be used for a large variety of applications due to its sensitivity of only a few microns measured in both directions

  3. Retinal detachment surgery with silicone oil injection in transconjunctival sutureless 23-gauge vitrectomy Cirurgia de descolamento de retina com injeção de óleo de silicone no sistema de vitrectomia transconjuntival sem sutura de 23-gauge

    Directory of Open Access Journals (Sweden)

    Rubens Camargo Siqueira

    2007-12-01

    Full Text Available PURPOSE: To report a surgical technique for retinal detachment surgery using transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection. METHODS: Thirty-one patients with retinal detachment underwent vitreoretinal surgery using a transconjunctival sutureless 23-gauge vitrectomy system. At the end of the procedure silicone oil was injected into all eyes through a microcannula. After removing the microcannula, a bipolar cautery was used in the conjunctiva over the wound to prevent silicone oil reflux. RESULTS: In all patients retinal reattachment and injection of silicone oil through transconjunctival sutureless 23-gauge vitrectomy system was possible. Retinal re-detachment occurred in 8 patients (25.80% who were submitted to a new vitreoretinal surgery by the technique described above, however, more extensive retinotomy was necessary in all cases, specially inferiorly. Three patients (9.67% presented silicone oil leakage in subconjuntival compartment. Another surgical procedure was necessary to remove the subconjuntival silicone oil. CONCLUSIONS: The retinal detachment surgery with silicone oil injection in transconjunctival sutureless 23-gauge vitrectomy is a safe and efficient technique to repair retinal detachment and it has the advantage of being minimally invasive.OBJETIVOS: Relatar técnica cirúrgica para descolamento de retina utilizando sistema de 23-gauge com injeção de óleo de silicone. MÉTODOS: Trinta e um pacientes com descolamento da retina foram submetidos a cirurgia vitreorretiniana usando o sistema 23-gauge de vitrectomia transconjuntival sem sutura. Ao final do procedimento o óleo de silicone foi injetado em todos os olhos através de uma microcânula. Após a retirada da microcânula, foi utilizado cautério bipolar na incisão conjuntival para prevenir o vazamento do óleo de silicone. RESULTADOS: Em todos os pacientes foi possível reaplicar a retina e injetar o óleo de silicone através do sistema 23

  4. Effects of intraperitoneal nitroglycerin on the strength and healing attitude of anastomosis of rat intestines with ischemia-reperfusion injury

    Directory of Open Access Journals (Sweden)

    Ahmet Oktay Cihan

    2011-01-01

    Full Text Available Background: Ischemic conditions in the intestine result in deterioration of anastomosis healing process. In this study, our aim was to evaluate the possible effects of intraperitoneal nitroglycerin on the intestinal anastomosis healing and anastomosis burst pressures in rats with ischemia and reperfusion injury (I/R. Materials and Methods: Fifty four Wistar albino rats were divided into six groups. In the first two groups, the rats underwent I/R. In the Group 1, the rats had normal saline (S and in Group 2, the rats had nitroglycerin (N injection. In the 3 rd and 4 th groups, an intestinal anastomosis was made at the 10 cm proximally to the ileocecal valve. In Group 3, S and in Group 4, N were injected. In Group 5, the rats received I/R, intestinal anastomosis and intraperitoneal S injection. I/R, intestinal anastomosis and intraperitoneal N injection were made in Group 6 rats. All nitroglycerin (50 ΅g/kg injections were made at postoperative days of 0, 1, 2, 3, 4, 5 consecutively. On the sixth day, all rats were killed. In all rats with anastomosis, anastomotic burst pressure (ABP was measured. Histopathological specimens were collected from all rats and evaluated under light microscopy. Results: Serious tissue damage was only detected in the Group 1 histopathologically (8 rats had grade 4 damage. In Group 2, there was a decrease in tissue damage according to histopathologic examination (5 rats had grade 1 damage. The effect onto the healing was similar in S and N groups. Nitroglycerin was noted to have a positive effect on collagen production. Nitroglycerin increased the ABP levels in rats both with and without I/R (the means are 17.93, 21.10, 14.67, and 17.63 in Groups 3, 4, 5, and 6, respectively. Conclusion: I/R may weaken the strength of intestinal anastomosis. Intraperitoneal application of nitroglycerin may prevent the histopathologic changes within a limited degree. Intraperitoneal nitroglycerin has also positive effects on the healing

  5. Merz telescopes a global heritage worth preserving

    CERN Document Server

    2017-01-01

    This book comprises a fascinating collection of contributions on the Merz telescopes in Italy that collectively offer the first survey on historical large refracting telescopes in the country, drawing on original documents and photographs. It opens with a general introduction on the importance of Merz telescopes in the history of astronomy and analyses of the local and international contexts in which the telescopes were made. After examination of an example of the interaction between the maker and the astronomer in the construction and maintenance of these refractors, the history of the Merz telescopes at the main Italian observatories in the nineteenth century is described in detail. Expert testimony is also provided on how these telescopes were successfully used until the second half of the twentieth century for research purposes, thus proving their excellent optical qualities.

  6. T-Stenting-and-Small-Protrusion Technique for Bifurcation Stenoses After End-to-Side Anastomosis of Transplant Renal Artery and External Iliac Artery: Report of Two Cases

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yong, E-mail: cheny102@163.com; Ye, Peng, E-mail: thomas19871223@163.com [Southern Medical University, Department of Interventional Radiology, Nanfang Hospital (China); Jiang, Wen-jin, E-mail: 18653501187@163.com [Yantai Yuhuangding Hospital (China); Ma, Shuo-yi, E-mail: mazelong123456789@126.com; Zhao, Jian-bo, E-mail: zhaojianbohgl@163.com; Zeng, Qing-le, E-mail: doctorzengqingle@126.com [Southern Medical University, Department of Interventional Radiology, Nanfang Hospital (China)

    2015-10-15

    Bifurcation stenoses after end-to-side anastomosis of transplant renal artery (TRA) and external iliac artery (EIA), including stenoses at the anastomosis and the iliac artery proximal to the TRA, are rare. In the present article, we report two successfully managed cases of bifurcation stenoses after end-to-side anastomosis of the TRA and EIA using the technique of T-stenting and small protrusion (TAP stenting)

  7. MEMS-based handheld fourier domain Doppler optical coherence tomography for intraoperative microvascular anastomosis imaging.

    Directory of Open Access Journals (Sweden)

    Yong Huang

    Full Text Available To demonstrate the feasibility of a miniature handheld optical coherence tomography (OCT imager for real time intraoperative vascular patency evaluation in the setting of super-microsurgical vessel anastomosis.A novel handheld imager Fourier domain Doppler optical coherence tomography based on a 1.3-µm central wavelength swept source for extravascular imaging was developed. The imager was minimized through the adoption of a 2.4-mm diameter microelectromechanical systems (MEMS scanning mirror, additionally a 12.7-mm diameter lens system was designed and combined with the MEMS mirror to achieve a small form factor that optimize functionality as a handheld extravascular OCT imager. To evaluate in-vivo applicability, super-microsurgical vessel anastomosis was performed in a mouse femoral vessel cut and repair model employing conventional interrupted suture technique as well as a novel non-suture cuff technique. Vascular anastomosis patency after clinically successful repair was evaluated using the novel handheld OCT imager.With an adjustable lateral image field of view up to 1.5 mm by 1.5 mm, high-resolution simultaneous structural and flow imaging of the blood vessels were successfully acquired for BALB/C mouse after orthotopic hind limb transplantation using a non-suture cuff technique and BALB/C mouse after femoral artery anastomosis using a suture technique. We experimentally quantify the axial and lateral resolution of the OCT to be 12.6 µm in air and 17.5 µm respectively. The OCT has a sensitivity of 84 dB and sensitivity roll-off of 5.7 dB/mm over an imaging range of 5 mm. Imaging with a frame rate of 36 Hz for an image size of 1000(lateral×512(axial pixels using a 50,000 A-lines per second swept source was achieved. Quantitative vessel lumen patency, lumen narrowing and thrombosis analysis were performed based on acquired structure and Doppler images.A miniature handheld OCT imager that can be used for intraoperative evaluation of

  8. Origins Space Telescope: Study Plan

    Science.gov (United States)

    Nayyeri, Hooshang; Cooray, Asantha; Origins Space Telescope Study Team

    2018-01-01

    The Origins Space Telescope (OST) is the mission concept for the Far-Infrared Surveyor, a study in development by NASA in preparation for the 2020 Astronomy and Astrophysics Decadal Survey. Origins is planned to be a large aperture, actively-cooled telescope covering a wide span of the mid- to far-infrared spectrum. Its spectrographs will enable 3D surveys of the sky that will discover and characterize the most distant galaxies, Milky-Way, exoplanets, and the outer reaches of our Solar system. Origins will enable flagship-quality general observing programs led by the astronomical community in the 2030s. The Science and Technology Definition Team (STDT) would like to hear your science needs and ideas for this mission. The team can be contacted at firsurveyor_info@lists.ipac.caltech.edu. This presentation will provide a summary of the OST STDT, the OST Study Team based at NASA Goddard Space Flight Center, study partners, and the advisory panel to the study. This presentation will also summarize recent activities, including the process used to reach a decision on the mission architecture, the identification of key science drivers, and the key study milestones between 2017 and 2020.

  9. ANTARES: An Undersea Neutrino telescope

    CERN Multimedia

    2002-01-01

    The ANTARES (Astronomy with a Neutrino Telescope and ${Abyss}$ environmental RESearch) deep-sea neutrino telescope is designed to search for neutrinos of astrophysical origin. Neutrinos are unique probes of the high energy universe; being neutral they are not deflected by magnetic fields and interacting weakly they can readily escape from the densest regions of the universe. Potential sources of neutrino are galactic (e.g supernova remnants, micro-quasars) and extra-galactic (e.g active galactic nuclei, gamma-ray bursters). Annihilation of dark matter particles in the Sun or Galactic Centre is another well motivated potential source of extra terrestrial neutrinos. The ANTARES detector is located 40 km off the coast of Toulon (France) at a depth of 2475m in the Mediterranean Sea. Being located in the Northern hemisphere it studies the Southern sky and in particular has the Galactic Centre in its field of view. Since 2006, the detector has operated continuously in a partial configuration. The detector was compl...

  10. Telescoping phenomenon in pathological gambling

    DEFF Research Database (Denmark)

    Grant, Jon E; Odlaug, Brian Lawrence; Mooney, Marc E

    2012-01-01

    The course of pathological gambling (PG) in women has been described as having a later age of initiation but a shorter time to problematic gambling ("telescoped"). This study examined evidence for telescoping and its relationship with comorbidities. Seventy-one treatment-seeking individuals with PG...... underwent a diagnostic interview to examine gambling behaviors, age at initiation of gambling, and time from initiation to meeting criteria for PG. The women had a higher mean age at gambling initiation compared with that of the men (mean [SD] age, 31.3 [13.0] years, compared with 22.4 [7.9] years; p = 0.......0003) and a significantly shorter time from initiation of gambling to meeting the criteria for PG (8.33 [8.7] years compared with 11.97 [9.1] years; p = 0.0476) after controlling for demographic and clinical variables. This study presents evidence for a gender-specific course of PG unrelated to psychiatric comorbidities...

  11. Advances in telescope mirror cleaning

    Science.gov (United States)

    Blanken, Maarten F.; Chopping, Alan K.; Dee, Kevin M.

    2004-09-01

    Metrology and cleaning techniques for telescope mirrors are generally well established. CO2 cleaning and water washing are mainly used. Water washing has proven to be the best method of removing oil and water stains and restoring the aluminium to nearly fresh values. The risk of water getting to unwanted places such as electronics or other optics prevents this method from being employed more often. Recently the Isaac Newton Group introduced a new cleaning technique for their telescope mirrors, which reduces the risks discussed above. This technique uses water vapour instead of water to wash the mirror. The advantage of this method is that the amount of water needed is drastically reduced. In addition the pressure of the vapour will blow away any large dust particles on the mirror and the temperature shock between the vapour and the mirror will help to de-bond the dust particles. Adding a soapy solution will help to clean oil and watermarks of the mirror. This paper describes the vapour cleaning method, tests that have been done and the overall findings.

  12. Far Ultraviolot Space Telescope (FAUST)

    Science.gov (United States)

    Bowyer, S.

    1988-01-01

    The Far Ultraviolet Space Telescope is a compact, wide field-of-view, far ultraviolet instrument designed for observations of extended and point sources of astronomical interest. It was originally used in sounding rocket work by both French and American investigators. The instrument was modified for flight on the space shuttle and flew on the Spacelab 1 mission as a joint effort between the Laboratoire d'Astronomie Spatiale and the University of California, Berkeley. The prime experiment objective of this telescope on the Atmospheric Laboratory Applications and Science (ATLAS 1) NASA mission is to observe faint astronomical sources in the far ultraviolet with sensitivities far higher than previously available. The experiment will cover the 1300 to 1800 A band, which is inaccessible to observers on earth. The observing program during the mission consists of obtaining deep sky images during spacecraft nighttime. The targets will include hot stars and nebulae in our own galaxy, faint diffuse galactic features similar to the cirrus clouds seen by the Infrared Astronomical Satellite (IRAS), large nearby galaxies, nearby clusters of galaxies, and objects of cosmological interest such as quasars and the diffuse far ultraviolet background.

  13. ANTARES: The first undersea neutrino telescope

    Science.gov (United States)

    Ageron, M.; Aguilar, J. A.; Al Samarai, I.; Albert, A.; Ameli, F.; André, M.; Anghinolfi, M.; Anton, G.; Anvar, S.; Ardid, M.; Arnaud, K.; Aslanides, E.; Assis Jesus, A. C.; Astraatmadja, T.; Aubert, J.-J.; Auer, R.; Barbarito, E.; Baret, B.; Basa, S.; Bazzotti, M.; Becherini, Y.; Beltramelli, J.; Bersani, A.; Bertin, V.; Beurthey, S.; Biagi, S.; Bigongiari, C.; Billault, M.; Blaes, R.; Bogazzi, C.; de Botton, N.; Bou-Cabo, M.; Boudahef, B.; Bouwhuis, M. C.; Brown, A. M.; Brunner, J.; Busto, J.; Caillat, L.; Calzas, A.; Camarena, F.; Capone, A.; Caponetto, L.; Cârloganu, C.; Carminati, G.; Carmona, E.; Carr, J.; Carton, P. H.; Cassano, B.; Castorina, E.; Cecchini, S.; Ceres, A.; Chaleil, Th.; Charvis, Ph.; Chauchot, P.; Chiarusi, T.; Circella, M.; Compère, C.; Coniglione, R.; Coppolani, X.; Cosquer, A.; Costantini, H.; Cottini, N.; Coyle, P.; Cuneo, S.; Curtil, C.; D'Amato, C.; Damy, G.; van Dantzig, R.; de Bonis, G.; Decock, G.; Decowski, M. P.; Dekeyser, I.; Delagnes, E.; Desages-Ardellier, F.; Deschamps, A.; Destelle, J.-J.; di Maria, F.; Dinkespiler, B.; Distefano, C.; Dominique, J.-L.; Donzaud, C.; Dornic, D.; Dorosti, Q.; Drogou, J.-F.; Drouhin, D.; Druillole, F.; Durand, D.; Durand, R.; Eberl, T.; Emanuele, U.; Engelen, J. J.; Ernenwein, J.-P.; Escoffier, S.; Falchini, E.; Favard, S.; Fehr, F.; Feinstein, F.; Ferri, M.; Ferry, S.; Fiorello, C.; Flaminio, V.; Folger, F.; Fritsch, U.; Fuda, J.-L.; Galatá, S.; Galeotti, S.; Gay, P.; Gensolen, F.; Giacomelli, G.; Gojak, C.; Gómez-González, J. P.; Goret, Ph.; Graf, K.; Guillard, G.; Halladjian, G.; Hallewell, G.; van Haren, H.; Hartmann, B.; Heijboer, A. J.; Heine, E.; Hello, Y.; Henry, S.; Hernández-Rey, J. J.; Herold, B.; Hößl, J.; Hogenbirk, J.; Hsu, C. C.; Hubbard, J. R.; Jaquet, M.; Jaspers, M.; de Jong, M.; Jourde, D.; Kadler, M.; Kalantar-Nayestanaki, N.; Kalekin, O.; Kappes, A.; Karg, T.; Karkar, S.; Karolak, M.; Katz, U.; Keller, P.; Kestener, P.; Kok, E.; Kok, H.; Kooijman, P.; Kopper, C.; Kouchner, A.; Kretschmer, W.; Kruijer, A.; Kuch, S.; Kulikovskiy, V.; Lachartre, D.; Lafoux, H.; Lagier, P.; Lahmann, R.; Lahonde-Hamdoun, C.; Lamare, P.; Lambard, G.; Languillat, J.-C.; Larosa, G.; Lavalle, J.; Le Guen, Y.; Le Provost, H.; Levansuu, A.; Lefèvre, D.; Legou, T.; Lelaizant, G.; Lévéque, C.; Lim, G.; Lo Presti, D.; Loehner, H.; Loucatos, S.; Louis, F.; Lucarelli, F.; Lyashuk, V.; Magnier, P.; Mangano, S.; Marcel, A.; Marcelin, M.; Margiotta, A.; Martinez-Mora, J. A.; Masullo, R.; Mazéas, F.; Mazure, A.; Meli, A.; Melissas, M.; Migneco, E.; Mongelli, M.; Montaruli, T.; Morganti, M.; Moscoso, L.; Motz, H.; Musumeci, M.; Naumann, C.; Naumann-Godo, M.; Neff, M.; Niess, V.; Nooren, G. J. L.; Oberski, J. E. J.; Olivetto, C.; Palanque-Delabrouille, N.; Palioselitis, D.; Papaleo, R.; Păvălaş, G. E.; Payet, K.; Payre, P.; Peek, H.; Petrovic, J.; Piattelli, P.; Picot-Clemente, N.; Picq, C.; Piret, Y.; Poinsignon, J.; Popa, V.; Pradier, T.; Presani, E.; Prono, G.; Racca, C.; Raia, G.; van Randwijk, J.; Real, D.; Reed, C.; Réthoré, F.; Rewiersma, P.; Riccobene, G.; Richardt, C.; Richter, R.; Ricol, J. S.; Rigaud, V.; Roca, V.; Roensch, K.; Rolin, J.-F.; Rostovtsev, A.; Rottura, A.; Roux, J.; Rujoiu, M.; Ruppi, M.; Russo, G. V.; Salesa, F.; Salomon, K.; Sapienza, P.; Schmitt, F.; Schöck, F.; Schuller, J.-P.; Schüssler, F.; Sciliberto, D.; Shanidze, R.; Shirokov, E.; Simeone, F.; Sottoriva, A.; Spies, A.; Spona, T.; Spurio, M.; Steijger, J. J. M.; Stolarczyk, Th.; Streeb, K.; Sulak, L.; Taiuti, M.; Tamburini, C.; Tao, C.; Tasca, L.; Terreni, G.; Tezier, D.; Toscano, S.; Urbano, F.; Valdy, P.; Vallage, B.; van Elewyck, V.; Vannoni, G.; Vecchi, M.; Venekamp, G.; Verlaat, B.; Vernin, P.; Virique, E.; de Vries, G.; van Wijk, R.; Wijnker, G.; Wobbe, G.; de Wolf, E.; Yakovenko, Y.; Yepes, H.; Zaborov, D.; Zaccone, H.; Zornoza, J. D.; Zúñiga, J.

    2011-11-01

    The ANTARES Neutrino Telescope was completed in May 2008 and is the first operational Neutrino Telescope in the Mediterranean Sea. The main purpose of the detector is to perform neutrino astronomy and the apparatus also offers facilities for marine and Earth sciences. This paper describes the design, the construction and the installation of the telescope in the deep sea, offshore from Toulon in France. An illustration of the detector performance is given.

  14. eSTAR: a distributed telescope network

    Science.gov (United States)

    Steele, Iain A.; Naylor, Tim; Allan, Alisdair; Etherton, Jason; Mottram, C. J.

    2002-11-01

    The e-STAR (e-Science Telescopes for Astronomical Research) project uses GRID techniques to develop the software infrastructure for a global network of robotic telescopes. The basic architecture is based around Intelligent Agents which request data from Discovery Nodes that may be telescopes or databases. Communication is based on a development of the XML RTML language secured using the Globus I/O library, with status serving provided via LDAP. We describe the system architecture and protocols devised to give a distributed approach to telescope scheduling, as well as giving details of the implementation of prototype Intelligent Agent and Discovery Node systems.

  15. European Extremely Large Telescope: progress report

    Science.gov (United States)

    Tamai, R.; Spyromilio, J.

    2014-07-01

    The European Extremely Large Telescope is a project of the European Southern Observatory to build and operate a 40-m class optical near-infrared telescope. The telescope design effort is largely concluded and construction contracts are being placed with industry and academic/research institutes for the various components. The siting of the telescope in Northern Chile close to the Paranal site allows for an integrated operation of the facility providing significant economies. The progress of the project in various areas is presented in this paper and references to other papers at this SPIE meeting are made.

  16. Preliminary Cost Model for Space Telescopes

    Science.gov (United States)

    Stahl, H. Philip; Prince, F. Andrew; Smart, Christian; Stephens, Kyle; Henrichs, Todd

    2009-01-01

    Parametric cost models are routinely used to plan missions, compare concepts and justify technology investments. However, great care is required. Some space telescope cost models, such as those based only on mass, lack sufficient detail to support such analysis and may lead to inaccurate conclusions. Similarly, using ground based telescope models which include the dome cost will also lead to inaccurate conclusions. This paper reviews current and historical models. Then, based on data from 22 different NASA space telescopes, this paper tests those models and presents preliminary analysis of single and multi-variable space telescope cost models.

  17. Effect of Human Amniotic Membrane on Prevention of Colorectal Anastomosis Leakage in Cases with Neoadjuvant Radiotherapy: An Experimental Animal Study

    Directory of Open Access Journals (Sweden)

    Sam Moslemi

    2016-11-01

    Full Text Available Background: Radiotherapy is one of the most important factors which results in negative effects on wound healing and increases anastomosis leakage. Diverting loop ileostomy has been usually performed after colorectal anastomosis in cases of colorectal cancer with a history of neoadjuvant radiotherapy to decrease the chance of leakage. Considering the side effects of diverting loop ileostomy, the objective of the present study is to investigate the effect of human amniotic membrane (HAM on colorectal anastomosis leakage after neo-adjuvant radiotherapy. Methods: In this experimental animal study, 20 crossbreed rabbits were randomly divided into two groups (case group: 13 rabbits, control group: 7 rabbits after receiving an equal dose of external beam radiation. Four weeks after irradiation, resection of 4 cm of colorectal segment and end-to-end single layer anastomosis were conducted. In the case group, a 2×2 cm wrap of HAM applied around the site of anastomosis. Eight weeks later, all the survived rabbits were sacrificed. A segment of anastomotic sites was resected in all expired and survived rabbits and sent for pathological evaluation. Mann-Whitney U Test (SPSS for Windows, Ver. 16, Chicago, IL was applied to analyze healing scores between the two groups. Results: Due to anastomosis dehiscence, 5 rabbits expired in the control group, but all the 13 rabbits (case group survived after 8 weeks and showed no leakage. In addition, pathological evaluation revealed significant epithelialization and neovascularization in the case group. Statistically, healing score was higher in the case group rather than the control group (P<0.001. Conclusion: To prevent post irradiation colorectal anastomosis leakage, the use of HAM might play a significant role and a feasible technical approach.

  18. Anastomosis Martin-Gruber: Aspectos anatómicos y electrofisiológicos Martin-Gruber Anastomosis: Anatomical and electrophysiological issues

    Directory of Open Access Journals (Sweden)

    Esperanza Herrera

    2009-08-01

    Full Text Available La anastomosis de Martin Gruber (AMG es una de las variaciones anatómicas más frecuentes que consiste en la contribución de axones motores desde el nervio mediano hacia el ulnar en el antebrazo. Factores filogenéticos y genéticos se asocian con la aparición de la AMG. Entre tanto, otros factores como género, raza o lateralidad no parecen tener importancia en la aparición de la rama comunicante. Las clasificaciones de la AMG han sido establecidas según los hallazgos anatómicos, electrofisiológicos e histológicos y también según el lugar de origen y destino de la anastomosis. El objetivo de este artículo es revisar los factores asociados a la presencia de la AMG, así como las descripciones y clasificaciones anatómicas y electrofisiológicas. Esta revisión aporta información relevante para el reconocimiento de los patrones clásico y variante de inervación de la musculatura intrínseca de la mano. Dicho reconocimiento permite diagnosticar e intervenir apropiadamente las alteraciones de los nervios periféricos de la extremidad superior. Salud UIS 2009; 41: 157-168The Martin Gruber Anastomosis (MGA is one of the most common anatomical variants of the upper limb, which consists of motor axons crossing through the forearm from the median nerve to the ulnar nerve. Phylogenetic and hereditary factors have been associated whit the MGA. However, gender, race, or laterality, do not seem to have importance in the appearance of the communicating branch. The MGA has been categorized according to findings in anatomy, electrophysiology and histology, in relation to the source and destination of the communicating branch. The aim of this article is to review the factors related to the presence of MGA, as well as the descriptions and classifications according to anatomy and electrophysiology. This revision contributes with important information relevant to the recognition of differences between the classic pattern and the variant pattern of the

  19. Can Radio Telescopes Find Axions?

    Science.gov (United States)

    Kohler, Susanna

    2017-08-01

    axions. Now scientists Katharine Kelley and Peter Quinn at ICRAR, University of Western Australia, have explored how we might use next-generation radio telescopes to search for photons that were created by axions interacting with the magnetic fields of our galaxy.Hope for Next-Gen TelescopesPotential axion coupling strengths vs. mass (click for a closer look). The axion mass is thought to lie between a eV and a meV; two theoretical models are shown with dashed lines. The plot shows the sensitivity of the upcoming SKA and its precursors, ASKAP and MEERKAT. [KelleyQuinn 2017]By using a simple galactic halo model and reasonable assumptions for the central galactic magnetic field even taking into account the time dependence of the field Kelley and Quinn estimate the radio-frequency power density that we would observe at Earth from axions being converted to photons within the Milky Ways magnetic field.The authors then compare this signature to the detection capabilities of upcoming radio telescope arrays. They show that the upcoming Square Kilometer Array and its precursors should have the capability to detect signs of axions across large parts of parameter space.Kelley and Quinn conclude that theres good cause for optimism about future radio telescopes ability to detect axions. And if we did succeed in making a detection, it would be a triumph for both particle physics and astrophysics, finally providing an explanation for the universes dark matter.CitationKatharine Kelley and P. J. Quinn 2017 ApJL 845 L4. doi:10.3847/2041-8213/aa808d

  20. Diffractive X-Ray Telescopes

    International Nuclear Information System (INIS)

    Skinner, G.K.; Skinner, G.K

    2010-01-01

    Diffractive X-ray telescopes using zone plates, phase Fresnel lenses, or related optical elements have the potential to provide astronomers with true imaging capability with resolution several orders of magnitude better than available in any other waveband. Lenses that would be relatively easy to fabricate could have an angular resolution of the order of micro arc seconds or even better, that would allow, for example, imaging of the distorted spacetime in the immediate vicinity of the supermassive black holes in the center of active galaxies What then is precluding their immediate adoption Extremely long focal lengths, very limited bandwidth, and difficulty stabilizing the image are the main problems. The history and status of the development of such lenses is reviewed here and the prospects for managing the challenges that they present are discussed atmospheric absorption

  1. The Large Synoptic Survey Telescope

    Science.gov (United States)

    Ivezic, Zeljko

    2007-05-01

    The Large Synoptic Survey Telescope (LSST) is currently by far the most ambitious proposed ground-based optical survey. With initial funding from the US National Science Foundation (NSF), Department of Energy (DOE) laboratories and private sponsors, the design and development efforts are well underway at many institutions, including top universities and leading national laboratories. The main science themes that drive the LSST system design are Dark Energy and Matter, the Solar System Inventory, Transient Optical Sky and the Milky Way Mapping. The LSST system, with its 8.4m telescope and 3,200 Megapixel camera, will be sited at Cerro Pachon in northern Chile, with the first light scheduled for 2014. In a continuous observing campaign, LSST will cover the entire available sky every three nights in two photometric bands to a depth of V=25 per visit (two 15 second exposures), with exquisitely accurate astrometry and photometry. Over the proposed survey lifetime of 10 years, each sky location would be observed about 1000 times, with the total exposure time of 8 hours distributed over six broad photometric bandpasses (ugrizY). This campaign will open a movie-like window on objects that change brightness, or move, on timescales ranging from 10 seconds to 10 years, and will produce a catalog containing over 10 billion galaxies and a similar number of stars. The survey will have a data rate of about 30 TB/night, and will collect over 60 PB of raw data over its lifetime, resulting in an incredibly rich and extensive public archive that will be a treasure trove for breakthroughs in many areas of astronomy and astrophysics.

  2. Healing of esophageal anastomoses performed with the biofragmentable anastomosis ring versus the end-to-end anastomosis stapler: comparative experimental study in dogs.

    Science.gov (United States)

    Kovács, Tibor; Köves, István; Orosz, Zsolt; Németh, Tibor; Pandi, Erzsébet; Kralovanszky, Judit

    2003-04-01

    The biofragmentable anastomosis ring (BAR) has been used successfully for anastomoses from the stomach to the upper rectum. The healing of intrathoracic esophageal anastomoses performed with the BAR or an end-to-end anastomosis (EEA) stapler on an experimental model was compared. Parameters of tissue repair were evaluated: macroscopic examination, bursting strength (BS), collagen (hydroxyproline, or HP), histology (H&E and Picrosirius red staining for collagen). A series of 48 mongrel dogs were randomly separated into two groups (30 BAR, 18 stapler) and subgroups according to the time of autopsy (days 4, 7, 14, 28). Mortality was 13.3% (4 BAR cases) with two deaths not related to surgery (excluded). There were four leaks in the BAR group (14.3%) and no leaks or deaths but two strictures in the stapler group. BS was significantly higher in the BAR group during the first week, and values were almost equal from the second week with both methods. The HP rate was significantly reduced on days 4 and 7 in both groups compared to the reference values; the values were close to reference values from the second week (lower in the BAR group). Stapled anastomoses caused less pronounced inflammation and were associated with an earlier start of regeneration, but the difference was not significant compared to that in the BAR group. Accumulation of new collagen (green polarization) started on day 7 in both groups, but maturation (orange-red polarization) was significantly more advanced in the BAR group after the second week. A strong linear correlation between the BS and HP rate was found with both methods. There was no significant difference in the complication rate or healing of intrathoracic BAR and stapled anastomoses. The BAR method is simple, quick, and safe; and it seems to be a feasible procedure for creating intrathoracic esophageal anastomoses in dogs.

  3. Proxy magnetometry with the Dutch Open Telescope

    NARCIS (Netherlands)

    Rutten, R.J.; Hammerschlag, R.H.; Sütterlin, P.; Bettonvil, F.C.M.

    1999-01-01

    Superb movies from the Dutch Open Telescope (DOT) on La Palma have proven the validity of the open concept of this innovative telescope for high-resolution imaging of the solar atmosphere. A five- camera speckle-burst registration system is being installed that should permit consistent and

  4. ANTARES : The first undersea neutrino telescope

    NARCIS (Netherlands)

    Ageron, M.; Aguilar, J. A.; Al Samarai, I.; Albert, A.; Ameli, F.; Andre, M.; Anghinolfi, M.; Anton, G.; Anvar, S.; Ardid, M.; Arnaud, K.; Aslanides, E.; Jesus, A. C. Assis; Astraatmadja, T.; Aubert, J. -J.; Auer, R.; Barbarito, E.; Baret, B.; Basa, S.; Bazzotti, M.; Becherini, Y.; Beltramelli, J.; Bersani, A.; Bertin, V.; Beurthey, S.; Biagi, S.; Bigongiari, C.; Billault, M.; Blaes, R.; Bogazzi, C.; de Botton, N.; Bou-Cabo, M.; Boudahef, B.; Bouwhuis, M. C.; Brown, A. M.; Brunner, J.; Busto, J.; Caillat, L.; Calzas, A.; Camarena, F.; Capone, A.; Caponetto, L.; Carloganu, C.; Carminati, G.; Carmona, E.; Carr, J.; Carton, P. H.; Cassano, B.; Castorina, E.; Cecchini, S.; Ceres, A.; Chaleil, Th; Charvis, Ph; Chauchot, P.; Chiarusi, T.; Circella, M.; Compere, C.; Coniglione, R.; Coppolani, X.; Cosquer, A.; Costantini, H.; Cottini, N.; Coyle, P.; Cuneo, S.; Curtil, C.; D'Amato, C.; Damy, G.; van Dantzig, R.; De Bonis, G.; Decock, G.; Decowski, M. P.; Dekeyser, I.; Delagnes, E.; Desages-Ardellier, F.; Deschamps, A.; Destelle, J. -J.; Di Maria, F.; Dinkespiler, B.; Distefano, C.; Dominique, J. -L.; Donzaud, C.; Dornic, D.; Dorosti, Q.; Drogou, J. -F.; Drouhin, D.; Druillole, F.; Durand, D.; Durand, R.; Eberl, T.; Emanuele, U.; Engelen, J. J.; Ernenwein, J. -P.; Escoffier, S.; Falchini, E.; Favard, S.; Fehr, F.; Feinstein, F.; Ferri, M.; Ferry, S.; Fiorello, C.; Flaminio, V.; Folger, F.; Fritsch, U.; Fuda, J. -L.; Galata, S.; Galeotti, S.; Gay, P.; Gensolen, F.; Giacomelli, G.; Gojak, C.; Gomez-Gonzalez, J. P.; Goret, Ph.; Graf, K.; Guillard, G.; Halladjian, G.; Hallewell, G.; van Haren, H.; Hartmann, B.; Heijboer, A. J.; Heine, E.; Hello, Y.; Henry, S.; Hernandez-Rey, J. J.; Herold, B.; Hoessl, J.; Hogenbirk, J.; Hsu, C. C.; Hubbard, J. R.; Jaquet, M.; Jaspers, M.; de Jong, M.; Jourde, D.; Kadler, M.; Kalantar-Nayestanaki, N.; Kalekin, O.; Kappes, A.; Karg, T.; Karkar, S.; Karolak, M.; Katz, U.; Keller, P.; Kestener, P.; Kok, E.; Kok, H.; Kooijman, P.; Kopper, C.; Kouchner, A.; Kretschmer, W.; Kruijer, A.; Kuch, S.; Kulikovskiy, V.; Lachartre, D.; Lafoux, H.; Lagier, P.; Lahmann, R.; Lahonde-Hamdoun, C.; Lamare, P.; Lambard, G.; Languillat, J-C; Larosa, G.; Lavalle, J.; Le Guen, Y.; Le Provost, H.; LeVanSuu, A.; Lefevre, D.; Legou, T.; Lelaizant, G.; Leveque, C.; Lim, G.; Lo Presti, D.; Loehner, H.; Loucatos, S.; Louis, F.; Lucarelli, F.; Lyashuk, V.; Magnier, P.; Mangano, S.; Marcel, A.; Marcelin, M.; Margiotta, A.; Martinez-Mora, J. A.; Masullo, R.; Mazeas, F.; Mazure, A.; Meli, A.; Melissas, M.; Migneco, E.; Mongelli, M.; Montaruli, T.; Morganti, M.; Moscoso, L.; Motz, H.; Musumeci, M.; Naumann, C.; Naumann-Godo, M.; Neff, M.; Niess, V.; Nooren, G. J. L.; Oberski, J. E. J.; Olivetto, C.; Palanque-Delabrouille, N.; Patioselitis, D.; Papaleo, R.; Pavalas, G. E.; Payet, K.; Payre, P.; Peek, H.; Petrovic, J.; Piattelli, P.; Picot-Clemente, N.; Picq, C.; Piret, Y.; Poinsignon, J.; Popa, V.; Pradier, T.; Presani, E.; Prono, G.; Racca, C.; Raia, G.; van Randwijk, J.; Real, D.; Reed, C.; Rethore, F.; Rewiersma, P.; Riccobene, G.; Richardt, C.; Richter, R.; Ricol, J. S.; Rigaud, V.; Roca, V.; Roensch, K.; Rolin, J. -F.; Rostovtsev, A.; Rottura, A.; Roux, J.; Rujoiu, M.; Ruppi, M.; Russo, G. V.; Salesa, F.; Salomon, K.; Sapienza, P.; Schmitt, F.; Schoeck, F.; Schuller, J. -P.; Schuessler, F.; Sciliberto, D.; Shanidze, R.; Shirokov, E.; Simeone, F.; Sottoriva, A.; Spies, A.; Spona, T.; Spurio, M.; Steijger, J. J. M.; Stolarczyk, Th; Streeb, K.; Sulak, L.; Taiuti, M.; Tamburini, C.; Tao, C.; Tasca, L.; Terreni, G.; Tezier, D.; Toscano, S.; Urbano, F.; Valdy, P.; Vallage, B.; Van Elewyck, V.; Vannoni, G.; Vecchi, M.; Venekamp, G.; Verlaat, B.; Vernin, P.; Virique, E.; de Vries, G.; Wijnker, G.; Wobbe, G.; de Wolf, E.; Yakovenko, Y.; Yepes, H.; Zaborov, D.; Zaccone, H.; Zornoza, J. D.; Zuniga, J.; van Wijk, R.

    2011-01-01

    The ANTARES Neutrino Telescope was completed in May 2008 and is the first operational Neutrino Telescope in the Mediterranean Sea. The main purpose of the detector is to perform neutrino astronomy and the apparatus also offers facilities for marine and Earth sciences. This paper describes the

  5. The lofar phased array telescope system

    NARCIS (Netherlands)

    Gunst, André W.; Bentum, Marinus Jan

    2010-01-01

    The Low Frequency Array (LOFAR) is the largest telescope in the world operating at a frequency range from 30 to 240 MHz. LOFAR is the first radio telescope of its size which uses phased array principles to detect radio signals. More than 10,000 antennas are installed in the field. The antennas are

  6. Introduction to the Solar Space Telescope

    Indian Academy of Sciences (India)

    tribpo

    The design of the space solar telescope (SST) (phase B) has ... Key words. Space telescopes. 1. Introduction. The world wide development of solar space based observations went through two steps in the spatial resolution: low resolution .... the National Science Foundation of China, the Ministry of Science and Technology.

  7. Telescopic Examination of the mastoid Cavity

    OpenAIRE

    Bhandari, Anita; Sharma, Man Prakash; Bapna, A. S.

    1998-01-01

    Otoendoscopy enables viewing of different angles of the tympanomastoid area and approach to them for better prognosis. A comparative study of post-operative mastoid cavities has been done using the Hopkin’s rod telescope, Otoscope and microscope. Various procedures have also been done successfully on the mastoid cavity using the telescope on an outdoor basis.

  8. Simulation and Track Reconstruction for Beam Telescopes

    CERN Document Server

    Maqbool, Salman

    2017-01-01

    Beam telescopes are an important tool to test new detectors under development in a particle beam. To test these novel detectors and determine their properties, the particle tracks need to be reconstructed from the known detectors in the telescope. Based on the reconstructed track, its predicted position on the Device under Test (DUT) are compared with the actual hits on the DUT. Several methods exist for track reconstruction, but most of them do not account for the effects of multiple scattering. General Broken Lines is one such algorithm which incorporates these effects during reconstruction. The aim of this project was to simulate the beam telescope and extend the track reconstruction framework for the FE-I4 telescope, which takes these effects into account. Section 1 introduces the problem, while section 2 focuses on beam telescopes. This is followed by the Allpix2 simulation framework in Section 3. And finally, Section 4 introduces the Proteus track reconstruction framework along with the General Broken ...

  9. Development of a total colectomy and ileorectal anastomosis rat model to evaluate colonic metaplasia.

    Science.gov (United States)

    Schieffer, Kathleen M; Poritz, Lisa S; Yochum, Gregory S; Koltun, Walter A

    2017-10-01

    Ulcerative colitis is an idiopathic inflammatory condition of the colon that may require surgical intervention including proctocolectomy and either ileal pouch-anal anastomosis or in the pediatric population, low ileorectal anastomosis (IRA). Often, subsequent physiologic alteration (or colonic metaplasia) occurs in the anastomosed small bowel that includes changes in mucin content, villous blunting, and increased expression of WNT5A, a marker of colonic crypt regeneration. We developed a rat low IRA model to assess and study the development of colonic metaplasia. We subjected male Sprague-Dawley rats (n = 17) to total colectomy and low IRA surgery and evaluated healing periodically by endoscopic evaluation. The ileum upstream of the anastomosis was assessed by hematoxylin and eosin staining, and the mucin content was measured by high iron diamine-Alcian blue staining. Wnt5a transcripts were quantified by reverse transcription and quantitative polymerase chain reaction at the 8-wk study end point. Although no gross endoscopic evidence of inflammation was seen throughout the course of the study, colonic metaplasia in the small bowel was detected in 7 out of 10 (70%) rats at the study end point. In rats with colonic metaplasia, enhanced expression of Wnt5a was evident at the study end point compared to levels in the terminal ileum at the time of surgery. Within 4-8 wk, the majority of rats subjected to IRA developed colonic metaplasia defined by villous blunting, changes in mucin content, and increased expression of Wnt5a. This model provides a method to study small bowel colonic metaplasia. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. First-line tracheal resection and primary anastomosis for postintubation tracheal stenosis.

    Science.gov (United States)

    Elsayed, H; Mostafa, A M; Soliman, S; Shoukry, T; El-Nori, A A; El-Bawab, H Y

    2016-07-01

    Introduction Tracheal stenosis following intubation is the most common indication for tracheal resection and reconstruction. Endoscopic dilation is almost always associated with recurrence. This study investigated first-line surgical resection and anastomosis performed in fit patients presenting with postintubation tracheal stenosis. Methods Between February 2011 and November 2014, a prospective study was performed involving patients who underwent first-line tracheal resection and primary anastomosis after presenting with postintubation tracheal stenosis. Results A total of 30 patients (20 male) were operated on. The median age was 23.5 years (range: 13-77 years). Seventeen patients (56.7%) had had previous endoscopic tracheal dilation, four (13.3%) had had tracheal stents inserted prior to surgery and one (3.3%) had undergone previous tracheal resection. Nineteen patients (63.3%) had had a tracheostomy. Eight patients (26.7%) had had no previous tracheal interventions. The median time of intubation in those developing tracheal stenosis was 20.5 days (range: 0-45 days). The median length of hospital stay was 10.5 days (range: 7-21 days). The success rate for anastomoses was 96.7% (29/30). One patient needed a permanent tracheostomy. The in-hospital mortality rate was 3.3%: 1 patient died from a chest infection 21 days after surgery. There was no mortality or morbidity in the group undergoing first-line surgery for de novo tracheal lesions. Conclusions First-line tracheal resection with primary anastomosis is a safe option for the treatment of tracheal stenosis following intubation and obviates the need for repeated dilations. Endoscopic dilation should be reserved for those patients with significant co-morbidities or as a temporary measure in non-equipped centres.

  11. Safety of Performing a Delayed Anastomosis During Damage Control Laparotomy in Patients with Destructive Colon Injuries

    Science.gov (United States)

    Ordoñez, Carlos A; Pino, Luis F; Badiel, Marisol; Sánchez, Alvaro I; Loaiza, Jhon; Ballestas, Leonardo; Puyana, Juan Carlos

    2011-01-01

    Background Recent studies report the safety and feasibility of performing delayed anastomosis (DA) in patients undergoing damage control laparotomy (DCL) for destructive colon injuries (DCI). Despite accumulating experience in both civilian and military trauma, questions regarding how to best identify high risk patients and minimize the number of anastomosis-associated complications remain. Our current practice is to perform a definitive closure of the colon during DCL, unless there is persistent acidosis, bowel wall edema, or evidence of intra-abdominal abscess. In this study, we evaluated the safety of this approach by comparing outcomes of patients with DCI who underwent definitive closure of the colon during DCL versus patients managed with colostomy with or without DCL. Methods We performed a retrospective chart review of patients with penetrating DCI during 2003–2009. Severity of injury, surgical management, and clinical outcome were assessed. Results Sixty patients with severe gunshot wounds (GSW) and 3 patients with stab wounds were included in the analysis. DCL was required in 30 patients, all with GSW. Three patients died within the first 48 hours, 3 underwent colostomy, and 24 were managed with DA. Thirty-three patients were managed with standard laparotomy: 26 patients with primary anastomosis, and 7 with colostomy. Overall mortality rate was 9.5%. Three late deaths occurred in the DCL group, and only one death was associated with an anastomotic leak. Conclusions Performing a DA in DCI during DCL is a reliable and feasible approach as long as severe acidosis, bowel wall edema, and/or persistent intra-abdominal infections are not present. PMID:22182861

  12. Uterovaginal Anastomosis for Cases of Cryptomenorrhea Due to Cervical Atresia with Vaginal Aplasia: Benefits and Risks.

    Science.gov (United States)

    Zayed, M; Fouad, R; Elsetohy, K A; Hashem, A T; AbdAllah, A A; Fathi, A I

    2017-12-01

    The objective of this study was to assess short-term benefits and risks of utero-vaginal anastomosis done for cases of cryptomenorrhea due to cervical atresia with vaginal aplasia. Prospective study. Surgical procedures were done between December 2013 and September 2015 at the department of Obstetrics and Gynecology, Cairo University Hospital. Five patients who had cryptomenorrhea due to cervical atresia associated with vaginal aplasia were included. Utero-vaginal anastomoses were performed in 2 stages; a stage of McIndoe vaginoplasty and a stage of excision of the atretic cervical tissue and anastomosing the uterus to the neovagina. Follow-up was done by gynecological and ultrasound examination in a duration ranged from 12 to 36 months. Occurrence of regular menstrual flow and relief of the severe cyclic pain. All patients had relief of the severe cyclic pain. Four patients had regular menstrual flow. One patient developed occlusion of the track after 1 year and needed dilatation once. Three patients developed low vaginal stenosis without occlusion of the track. One patient had rectal injury repaired without causing postoperative morbidity. Uterovaginal anastomosis is a promising conservative management option for cervical atresia with vaginal aplasia, which has benefits but is not free of risks. Long-term follow-up is still needed to judge its feasibility. We recommend performing McIndoe vaginoplasty as a starting stage before the anastomosis preferably in a separate setting. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  13. Single Anastomosis Sleeve Ileal Bypass: New Step in the Evolution of Bariatric Surgeries.

    Science.gov (United States)

    Salama, Tamer M S; Sabry, Karim; Ghamrini, Yaser El

    2017-10-01

    Single anastomosis sleeve ileal bypass (SASI) procedure appears as a new metabolic and bariatric surgery based on Santoro's operation, in which a sleeve gastrectomy is followed by a side-to-side gastroileal anastomosis. The study is aimed to evaluate the short-term outcomes of laparoscopic single anastomosis sleeve ileal bypass with respect to postoperative weight loss and metabolic and nutritional effects on patients. Forty-five morbidly obese patients with a mean age of 31.2 years and a mean body mass index (BMI) of 43.2 kg/m 2 underwent SASI bypass. Postoperatively, all patients were followed up at 1, 3, 6, and 12 months, and during each visit data about their BMI, obesity-related comorbidities, and nutritional status were collected. One year after the surgery, mean BMI decreased to 29.1 kg/m 2 and there was significant decrease in plasma level of fasting blood glucose, insulin, and low-density lipoprotein. On the other hand, there was significant increase in high-density lipoprotein plasma level, whereas hemoglobin and albumin plasma level remained normal. Six months after the surgery, calcium plasma level showed mild decrease in two cases, which was improved with multivitamin tablets. In 93% of our patients, multivitamin supplements were stopped after six months of surgery. Laparoscopic SASI bypass has been shown to be an effective, safe, and simple procedure for the treatment of morbid obesity and its associated metabolic consequences. Moreover, it results in minimal postoperative nutritional complications in comparison to other bariatric procedures.

  14. Preoperative chemoradiotherapy and colonic J-pouch anal anastomosis for lower rectal cancer

    International Nuclear Information System (INIS)

    Inoue, Yasuhiro; Okigami, Masato; Kawamoto, Aya; Hiro, Junichiro; Toiyama, Yuji; Kobayashi, Minako; Tanaka, Koji; Miki, Chikao; Kusunoki, Masato

    2011-01-01

    We performed colonic J-pouch anal anastomosis in 61 patients with rectal cancer located <4 cm from the anal verge. Surgical and oncological results were evaluated in multimodality therapy for advanced rectal cancer. According to Wexner's score, 7% of patients were fully continent, 71% had acceptable function with minor continence problems, and 22% were incontinent. No patients required intermittent self-catheterization during follow-up. After a median follow-up of 49 months, there was only 1 case of local recurrence after surgery. Our surgical approach irrespective of internal sphincter resection produces satisfactory functional and oncological results in multimodality therapy using preoperative chemoradiotherapy for lower rectal cancer. (author)

  15. Ovarian cancer mimicking recurrence at colorectal anastomosis: report of a case.

    LENUS (Irish Health Repository)

    Reardon, C M

    2012-02-03

    PURPOSE: The aim of this article is to emphasize the increased risk of developing metachronous ovarian tumors after resection of rectal cancer. METHOD AND RESULTS: We report the case of a postmenopausal female patient who, five years after anterior resection, developed a primary ovarian malignancy that invaded a rectal anastomosis and in so doing mimicked a recurrence of a Dukes A rectal cancer. To our knowledge, such an occurrence has not been described previously in the literature. CONCLUSION: This case illustrates the possible benefits of routine prophylactic oophorectomy at the time of colorectal cancer resection.

  16. [Stomach and intestinal function after Bilroth-II resection with modified transversal anastomosis].

    Science.gov (United States)

    Zaĭtsev, V T; Egorov, I V; Grigorian, G O

    1994-01-01

    The functional peculiarities of transversal gastrointestinal anastomosis performed according to the modified method was investigated with the help of radiological method in 16 mongrel dogs, whom the stomach resection according to Bilroth-II was conducted. The emptying of gastric stump contents occurred in time with small portions. Its reflux into the afferent loop of intestine was not noted. The small intestine filling in was regular all the way. Complete restoration of motor-evacuating function of gastric stump and transit of contents down the small intestine loops was caused by the conduction of the proposed operative procedure.

  17. An intraluminal prosthesis may improve healing of a one-layer colonic anastomosis

    DEFF Research Database (Denmark)

    Buch, N; Glad, H; Svendsen, P

    2002-01-01

    OBJECTIVE: To compare healing of one-layer colonic anastomoses with or without a soluble intraluminal prosthesis (* SBS-tube). DESIGN: Randomised, partly blinded controlled study. SETTING: University hospital, Denmark. SUBJECTS: 16 female Danish country strain pigs, of which 8 had the SBS tube...... inserted and 8 acted as controls. INTERVENTIONS: One-layer colonic anastomoses either hand-sewn (n = 8, controls) or hand-sewn onto an SBS tube (n = 8). MAIN OUTCOME MEASURES: Macroscopic evaluation, leakage test, breaking strength, histology, oxygen tension in and near the anastomosis peroperatively and 4...

  18. Factors affecting anastomotic leak after colorectal anastomosis in patients without protective stoma in tertiary care hospital

    International Nuclear Information System (INIS)

    Sultan, R.; Chawla, T.; Zaidi, M.

    2014-01-01

    Objective: To determine the factors associated with clinically significant anastomotic leak in patients having undergone large intestinal anastomosis. Method: The retrospective study at the Aga Khan University Hospital, Karachi, comprised data between January 2000 and March 2010, related to patients who underwent colorectal anastomosis. Demographic details of the patients, as well as preop, intraop and postop risk factors were recorded. Anastomotic leak was identified as per the defined criteria. Outcome of patients was recorded as postop hospital stay and mortality. Univariate and Multivariate analyses were applied to identify risk factors for anastomotic leakage. Results: Among the total 127 patients in the study, anastomotic leak occurred in 19 (15%) patients (Group 1), while there was no clinical leak in 108 (85%) patients (Group 2). Univariate analysis showed 8 factors to be affecting the anastomotic leak: operation time (p=0.003), intraoperative blood loss (p=0.006), intraoperative blood transfusion (p=0.013), indication of surgery malignancy vs. benign (p=0.049), type of surgery elective vs. emergency (p=0.037), intraop use of vasopressor (p=0.019), segment of bowel anastomosed left side vs. right side (p=0.012), and drain placement vs. no drain placed (p=0.035). Preop immunosuppressive therapy was borderline significant (p=0.089). Multivariate analysis showed that left vs. right sided anastomosis (p=0.068), blood transfusion >2 pack cells (p=0.028), smoker vs. non-smoker (p=0.049), elective vs. emergency surgery (p=0.012) were the independent risk factors which significantly affected the outcome of bowel anastomosis. Mortality rate was 15.79% (n=3/19) in Group 1, while it was 1.85% (n=2/108) in Group 2 (p=0.02). The postop hospital stay was 15+-5.44 days in Group 1, while it was 7.51+-4.04 days in Group 2 (p>0.001). Conclusion: In colorectal anastomotic surgeries temporary diversion stoma formation needs to be considered on the basis of risk factors to

  19. The relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection

    DEFF Research Database (Denmark)

    Laurberg, Søren

    2017-01-01

    BACKGROUND: Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit...... including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a two-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, using a pre-specified definition. Mixed effects logistic regression...... models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random effect variable. RESULTS: This study included 3208 patients, of whom 78.4% (n=2515) underwent surgery for malignancy and 11.7% (n=375...

  20. The Large Millimeter Telescope (LMT)

    Science.gov (United States)

    Young, J. S.; Carrasco, L.; Schloerb, F. P.

    2002-05-01

    The Large Millimeter Telescope (LMT) project is a collaboration between the University of Massachusetts (UMass) in the USA and the Instituto Nacional de Astrofisica, Optica y Electronica (INAOE) in Mexico to build a 50m-diameter millimeter-wave antenna which will operate with good efficiency at wavelengths as short as 1 mm. The LMT is being built at an altitude of 4600 m atop Volcan Sierra Negra, an extinct volcanic peak in the state of Puebla, Mexico, approximately 100 km east of the city of Puebla. At 18 degrees 59' N latitude, the site offers an excellent view of the Galactic Center and good sky coverage of both hemispheres. Construction of the telescope is now well underway, and it is expected to be completed in late 2004. The LMT specifications call for an overall effective surface accuracy of 75 microns rms and a pointing accuracy of 1" rms. The strategy for meeting these performance goals supplements conventional antenna designs with various "active" systems to bring the final performance within the requirements. For surface accuracy, the LMT will rely on an open loop active surface which includes 180 moveable surface segments. For pointing accuracy, we will use traditional approaches supplemented by measurements to characterize the behavior of the structure, including inclinometers and temperature sensors which may be used with finite element models to determine structural deformations and predict pointing behavior. The initial complement of instruments will include a 32 element, heterodyne focal plane array at 3mm; a large format, focal plane bolometer array; a unique wide band receiver and spectrometer to determine the redshifts of primordial galaxies; and a 4 element receiver for the 1mm band. With its excellent sensitivity and angular resolution, the LMT will enable unique studies of the early universe and galaxy evolution, the interstellar medium and star formation in galaxies, and planetary science. In particular, with nearly 2000 m2 of collecting

  1. Evaluation of a novel thermosensitive heparin-poloxamer hydrogel for improving vascular anastomosis quality and safety in a rabbit model.

    Directory of Open Access Journals (Sweden)

    Ying-Zheng Zhao

    Full Text Available Despite progress in the design of advanced surgical techniques, stenosis recurs in a large percentage of vascular anastomosis. In this study, a novel heparin-poloxamer (HP hydrogel was designed and its effects for improving the quality and safety of vascular anastomosis were studied. HP copolymer was synthesized and its structure was confirmed by Fourier transform infrared spectroscopy (FTIR and nuclear magnetic resonance spectroscopy ((1H-NMR. Hydrogels containing HP were prepared and their important characteristics related to the application in vascular anastomosis including gelation temperature, rheological behaviour and micromorphology were measured. Vascular anastomosis were performed on the right common carotid arteries of rabbits, and the in vivo efficiency and safety of HP hydrogel to achieve vascular anastomosis was verified and compared with Poloxamer 407 hydrogel and the conventional hand-sewn method using Doppler ultrasound, CT angiograms, scanning electron microscopy (SEM and histological technique. Our results showed that HP copolymer displayed special gel-sol-gel phase transition behavior with increasing temperature from 5 to 60 °C. HP hydrogel prepared from 18 wt% HP solution had a porous sponge-like structure, with gelation temperature at approximately 38 °C and maximum elastic modulus at 10,000 Pa. In animal studies, imaging and histological examination of rabbit common jugular artery confirmed that HP hydrogel group had similar equivalent patency, flow and burst strength as Poloxamer 407 group. Moreover, HP hydrogel was superior to poloxamer 407 hydrogel and hand-sewn method for restoring the functions and epithelial structure of the broken vessel junctions after operation. By combining the advantages of heparin and poloxamer 407, HP hydrogel holds high promise for improving vascular anastomosis quality and safety.

  2. Parametric Cost Models for Space Telescopes

    Science.gov (United States)

    Stahl, H. Philip; Henrichs, Todd; Dollinger, Courtney

    2010-01-01

    Multivariable parametric cost models for space telescopes provide several benefits to designers and space system project managers. They identify major architectural cost drivers and allow high-level design trades. They enable cost-benefit analysis for technology development investment. And, they provide a basis for estimating total project cost. A survey of historical models found that there is no definitive space telescope cost model. In fact, published models vary greatly [1]. Thus, there is a need for parametric space telescopes cost models. An effort is underway to develop single variable [2] and multi-variable [3] parametric space telescope cost models based on the latest available data and applying rigorous analytical techniques. Specific cost estimating relationships (CERs) have been developed which show that aperture diameter is the primary cost driver for large space telescopes; technology development as a function of time reduces cost at the rate of 50% per 17 years; it costs less per square meter of collecting aperture to build a large telescope than a small telescope; and increasing mass reduces cost.

  3. Parametric cost models for space telescopes

    Science.gov (United States)

    Stahl, H. Philip; Henrichs, Todd; Dollinger, Courtnay

    2017-11-01

    Multivariable parametric cost models for space telescopes provide several benefits to designers and space system project managers. They identify major architectural cost drivers and allow high-level design trades. They enable cost-benefit analysis for technology development investment. And, they provide a basis for estimating total project cost. A survey of historical models found that there is no definitive space telescope cost model. In fact, published models vary greatly [1]. Thus, there is a need for parametric space telescopes cost models. An effort is underway to develop single variable [2] and multi-variable [3] parametric space telescope cost models based on the latest available data and applying rigorous analytical techniques. Specific cost estimating relationships (CERs) have been developed which show that aperture diameter is the primary cost driver for large space telescopes; technology development as a function of time reduces cost at the rate of 50% per 17 years; it costs less per square meter of collecting aperture to build a large telescope than a small telescope; and increasing mass reduces cost.

  4. Large-segment tracheal resection and interannular anastomosis with a tension-release technique in the dog.

    Science.gov (United States)

    Dallman, M J; Bojrab, M J

    1982-02-01

    Tracheal resection and anastomosis were done on 7 dogs, and a modified procedure to provide optimum first-intention healing, minimum connective tissue proliferation, and optimum epithelialization was used. To test the integrity of the technique at high incision-line tensile forces, 15 to 17 tracheal rings were excised. Excessive tracheal manipulation resulted in an increased amount of lamina propria and submucosa collagenous tissue, increased size and number of blood vessels, and increased leukocytic invasion. Criteria for a successful anastomosis were minimum postoperative coughing, good mucosal apposition and epithelialization, and tracheal lumen diameters that were at least 80% of the preoperative measurement.

  5. Ligation of the caudal mesenteric artery during resection and anastomosis of the colorectal junction for annular adenocarcinoma in two dogs.

    Science.gov (United States)

    Sarathchandra, S K; Lunn, J A; Hunt, G B

    2009-09-01

    An 8-year-old terrier cross and a 10-year-old German Shorthaired Pointer presented to the University Veterinary Centre, Sydney, for investigation of long-standing tenesmus and dyschezia. Both patients had an annular adenocarcinoma at the colorectal junction. Exploratory laparotomy was performed and the affected large intestinal segment was removed by resection and anastomosis. In both dogs, the caudal mesenteric artery was intimately associated with the mass, necessitating its ligation and transection. Postoperatively, there was no evidence of anastomosis breakdown in either case and both animals recovered well from surgery. The dogs were euthanased 8 and 10 months, respectively, after surgery because of clinical signs relating to metastatic disease.

  6. The "Sun window" - a simple and effective alternative to the use of background contrast material during microvascular anastomosis.

    Science.gov (United States)

    Sun, Tzong-Bor; Hsu, Lee-Ping; Chen, Peir-Rong

    2003-11-01

    A new and simple alternative method, the "Sun window," is introduced for creating a comfortable environment while doing microvascular anastomoses. A prospective randomized study, analyzing the anastomosis time for 34 free radial forearm flaps, was conducted to validate the effectiveness of this method. The time required for doing anastomoses with and without a "Sun window" are 8.74 +/- 1.46 and 10.36 +/- 1.20, respectively, p Sun window" is an effective method for promoting the patency rate and accuracy of microvascular anastomosis.

  7. Buried plastic scintillator muon telescope

    Science.gov (United States)

    Sanchez, F.; Medina-Tanco, G.A.; D'Olivo, J.C.; Paic, G.; Patino Salazar, M.E.; Nahmad-Achar, E.; Valdes Galicia, J.F.; Sandoval, A.; Alfaro Molina, R.; Salazar Ibarguen, H.; Diozcora Vargas Trevino, M.A.; Vergara Limon, S.; Villasenor, L.M.

    Muon telescopes can have several applications, ranging from astrophysical to solar-terrestrial interaction studies, and fundamental particle physics. We show the design parameters, characterization and end-to-end simulations of a detector composed by a set of three parallel dual-layer scintillator planes, buried at fix depths ranging from 0.30 m to 3 m. Each layer is 4 m2 and is composed by 50 rectangular pixels of 4cm x 2 m, oriented at a 90 deg angle with respect to its companion layer. The scintillators are MINOS extruded polystyrene strips with two Bicron wavelength shifting fibers mounted on machined grooves. Scintillation light is collected by multi-anode PMTs of 64 pixels, accommodating two fibers per pixel. The front-end electronics has a time resolution of 7.5 nsec. Any strip signal above threshold opens a GPS-tagged 2 micro-seconds data collection window. All data, including signal and background, are saved to hard disk. Separation of extensive air shower signals from secondary cosmic-ray background muons and electrons is done offline using the GPS-tagged threefold coincidence signal from surface water cerenkov detectors located nearby in a triangular array. Cosmic-ray showers above 6 PeV are selected. The data acquisition system is designed to keep both, background and signals from extensive air showers for a detailed offline data.

  8. The Origins Space Telescope (OST)

    Science.gov (United States)

    Staguhn, Johannes

    2018-01-01

    The Origins Space Telescope is the mission concept for the Far-Infrared Surveyor, one of the four science and technology definition studies to be submitted by NASA Headquarters to the 2020 Astronomy and Astrophysics Decadal survey. The observatory will provide orders of magnitude improvements in sensitivity over prior missions, in particular for spectroscopy, enabling breakthrough science across astrophysics. The observatory will cover a wavelength range between 5 μm and 600 μm in order to enable the study of the formation of proto-planetary disks, detection of bio-signatures from extra-solar planet's atmospheres, characterization of the first galaxies in the universe, and many more. The five instruments that are currently studied are two imaging far-infrared spectrometers using incoherent detectors, providing up to R 10^5 spectral resolution, one far-infrared infrared heterodyne instrument for even higher spectral resolving powers, one far-infrared continuum imager and polarimeter, plus a mid-infrared coronagraph with imaging and spectroscopy mode. I will describe the scientific and technical capabilities of the observatory with focus on the expected synergies with AtLAST.

  9. Modified Blumgart anastomosis with the "complete packing method" reduces the incidence of pancreatic fistula and complications after resection of the head of the pancreas.

    Science.gov (United States)

    Kojima, Toru; Niguma, Takefumi; Watanabe, Nobuyuki; Sakata, Taizo; Mimura, Tetsushige

    2018-03-26

    Postoperative pancreatic fistula (POPF) and its complications remain problems. This study evaluated combination treatment with modified Blumgart anastomosis and an original infection control method (complete packing method) following pancreatic head resection. This study included 374 consecutive patients who underwent pancreatic head resection: 103 patients underwent Cattell-Warren anastomosis (CWA); 170 patients underwent modified Kakita anastomosis (KA); and 101 patients underwent modified Blumgart anastomosis with the complete packing method (BAC). The outcomes of the KA and BAC groups were compared statistically. The POPF rate was significantly lower in the BAC group than in the KA group (28.8% vs 2.97%; p anastomosis and the complete packing method is a simple and useful method for reducing the incidence of POPF and postoperative complications. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Calvin-Rehoboth Robotic Twin Telescopes

    Science.gov (United States)

    Haarsma, D. B.; Molnar, L. A.; VanBaak, D. A.

    2004-12-01

    The astronomy program at Calvin College, like many small colleges, is limited by poor weather and light pollution at its midwestern campus and by limited free time on the part of its astronomy faculty. Nonetheless we believe direct access to the physical universe is key to the science education both of science majors and nonmajors. Recent advances in hardware and software for modest robotic telescopes have made it possible for colleges like ours to incorporate the use of a remote bservatory into our curriculum within typical financial and time constraints. In this poster we make our first report on the installation of two robotic telescopes (one on campus and one at a remote site in New Mexico) using largely off-the-shelf components. Students learn first with the local telescope in order to understand the equipment and procedures, but obtain the majority of their data with the remote telescope. Equipment development is done first with the local telescope, and then implemented on the remote telescope (where time spent in development is difficult). We received an NSF CCLI grant and matching college funds in the summer of 2002. The local telescope was installed in the spring of 2003, and the New Mexico telescope was ready for remote operation in January 2004. Our poster will describe our equipment choices, including a few components (such as an equipment rack for the back end of the telescope) which we designed ourselves. It will also detail classroom use of the equipment in its first two semesters by students at a range of levels. A copy of the poster and many additional details of the project are available on the Calvin observatory website, http://www.calvin.edu/observatory/.

  11. Treatment of tailgut cysts by extended distal rectal segmental resection with rectoanal anastomosis.

    Science.gov (United States)

    Volk, Andreas; Plodeck, Verena; Toma, Marieta; Saeger, Hans-Detlev; Pistorius, Steffen

    2017-04-01

    Complete surgical resection is the treatment of choice for tailgut cysts, because of their malignant potential and tendency to regrow if incompletely resected. We report our experience of treating patients with tailgut cysts, and discuss diagnostics, surgical approaches, and follow-up. We performed extended distal rectal segmental resection of the tailgut cyst, with rectoanal anastomosis. We report the clinical, radiological, pathological, and surgical findings, describe the procedures performed, and summarize follow-up data. Two patients underwent en-bloc resection of a tailgut cyst, the adjacent part of the levator muscle, and the distal rectal segment, followed by an end-to-end rectoanal anastomosis. There was no evidence of anastomotic leakage postoperatively. At the time of writing, our patients were relapse-free with no, or non-limiting, symptoms of anal incontinence, respectively. This surgical approach appears to have a low complication rate and good recovery outcomes. Moreover, as the sphincter is preserved, so is the postoperative anorectal function. This approach could result in a low recurrence rate.

  12. Complications after tracheal and cricotracheal resection and anastomosis for inflammatory and neoplastic stenoses.

    Science.gov (United States)

    Piazza, Cesare; Del Bon, Francesca; Paderno, Alberto; Grazioli, Paola; Mangili, Stefano; Lombardi, Davide; Nicolai, Piero; Peretti, Giorgio

    2014-11-01

    This study aimed to evaluate complications and success rates of tracheal resection and anastomosis (TRA) and cricotracheal resection and anastomosis (CTRA) in patients treated in 2 academic institutions. Retrospective charts review of 137 patients submitted to TRA/CTRA. Fifty (36.5%) had neoplastic (group A) and 87 (63.5%) benign (group B) stenoses. Using univariate analysis, age, medical comorbidities, previous radiotherapy, type of TRA/CTRA, association with neck dissection and thyroidectomy, length of resected airway, and preoperative tracheotomy were evaluated to identify factors predictive of complications and outcomes. The mean length of resected airway was 2.7 and 3 cm in groups A and B, respectively. Overall decannulation and complication rates for group A were 96% and 36%, and 99% and 46% for group B, respectively. Length of airway resected and presence of preoperative tracheotomy had a statistically significant effect on major surgical complications. Age older than 70 and cardiovascular and pulmonary comorbidities were significantly associated with the incidence of major medical complications. No statistically significant difference was found considering the complication rates of group A versus group B. Even though the overall success rate of TRA/CTRA is high, it should always be regarded as a major surgical procedure with a non-negligible incidence of complications. © The Author(s) 2014.

  13. Effects of low-dose preoperative irradiation on low anterior anastomosis in dogs

    International Nuclear Information System (INIS)

    Schauer, R.M.; Bubrick, M.P.; Feeney, D.A.; Johnston, G.R.; Rolfsmeyer, E.S.; Strom, R.L.; Hitchcock, C.R.

    1982-01-01

    Twenty mongrel dogs underwent preoperative radiation therapy to the colon and rectum using the Nominal Standard Dose Equation to simulate treatment with 2000 rads. Each dog then underwent anterior resection of the rectosigmoid, and reconstruction was randomized into two groups consisting of either handsewn or EEA-stapled anastomoses. Anastomoses were examined digitally and radiographically on the day of surgery and on the seventh postoperative day. There were three radiographic leaks among the ten dogs having the handsewn anastomoses and one radiographic leak among the ten dogs having the EEA-stapled anastomoses. There was one clinically significant leak which occurred in a dog having an EEA-stapled anastomosis and was associated with peritonitis and death. The overall leak rate was 30 per cent among dogs having handsewn anastomoses and 20 per cent among dogs with stapled anastomoses. The data suggest that an anterior resection in low colorectal anastomosis can be done safely after low-dose radiation using either handsewn or stapling techniques

  14. Hepatobiliary scintigraphy in the assessment of biliary obstruction after hepatic resection with biliary-enteric anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J.S.; Moon, D.H.; Shin, J.W.; Ryu, J.S.; Lee, H.K. [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea); Lee, S.G.; Lee, Y.J.; Park, K.M. [Department of General Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea)

    2000-02-01

    We investigated the usefulness of hepatobiliary scintigraphy (HBS) for diagnosing biliary obstruction after curative hepatic resection with biliary-enteric anastomosis. The study population consisted of 54 patients who underwent surgery for benign (n=18) or malignant (n=36) biliary disease. We analysed 68 technetium-99m DISIDA scintigrams which were performed at least 1 month after the surgery (median: 9 months). Final diagnosis was made by operative exploration, other invasive radiological studies or clinical and radiological follow-up for at least 6 months after the surgery. Diagnostic accuracy was analysed according to the pretest likelihood of biliary obstruction. There were two total and 15 segmental biliary obstructions. In patients with symptoms of biliary obstruction and abnormal liver function, HBS always allowed correct diagnosis (two instances of total obstruction, seven of segmental obstruction and seven of non-obstruction). Among the patients with non-specific symptoms or isolated elevation of serum alkaline phosphatase, HBS diagnosed segmental biliary obstruction in seven of the eight instances, and non-obstruction in 22 of 23 instances. There were no cases of biliary obstruction and no false-positive results of HBS in 21 instances with no clinical signs or symptoms of biliary obstruction. The diagnostic sensitivity and specificity of HBS for biliary obstruction were 94% (16/17) and 97% (50/51), respectively. In conclusion, HBS is a highly accurate modality for the diagnosis of segmental biliary obstruction during long-term follow-up after hepatic resection with biliary-enteric anastomosis. (orig.)

  15. Intraoperative assessment of microperfusion with visible light spectroscopy in colorectal anastomosis

    Science.gov (United States)

    Karliczek, Anne; Benaron, David A.; Baas, Peter; van der Stoel, Anne; Wiggers, Theo; van Dam, Gooitzen M.

    2007-07-01

    In gastrointestinal surgery, leakage of anastomoses in general is a challenging problem because of the related mortality and morbidity1,2. The highest incidence of anastomotic leakage is found at the most proximal and most distal parts of the digestive tract, i.e. esophageal and colorectal anastomoses. Increased strain and limited vascular supply at the anastomoses are the two main reasons of leakage, especially in the absence of a serosal layer at these sites2,3,4. Apart from these local risk factors, several general risk factors attributed to the occurrence of anastomotic failure, of which smoking, cardiovascular disease, gender, age and malnutrition are the most important2,5-8. Most of these factors suggest local ischemia as an important cause of anastomotic dehiscence. In colorectal anastomosis the vascular supply is compromised due to resection of the diseased bowel segment. The vascular supply of the rectal stump is compromised by resection of the proximal feeding sigmoidal vessels. Apart from co-existing morbidities such as sepsis, cardiovascular and several systemic diseases, the altered vascular supply frequently compromises the microcirculation at both ends of the anastomosis, and is as such responsible for the higher rate of leakage compared to small and other large bowel anastomoses9,10.

  16. Effects of low-dose preoperative irradiation on low anterior anastomosis in dogs

    Energy Technology Data Exchange (ETDEWEB)

    Schauer, R.M.; Bubrick, M.P.; Feeney, D.A.; Johnston, G.R.; Rolfsmeyer, E.S.; Strom, R.L.; Hitchcock, C.R.

    Twenty mongrel dogs underwent preoperative radiation therapy to the colon and rectum using the Nominal Standard Dose Equation to simulate treatment with 2000 rads. Each dog then underwent anterior resection of the rectosigmoid, and reconstruction was randomized into two groups consisting of either handsewn or EEA-stapled anastomoses. Anastomoses were examined digitally and radiographically on the day of surgery and on the seventh postoperative day. There were three radiographic leaks among the ten dogs having the handsewn anastomoses and one radiographic leak among the ten dogs having the EEA-stapled anastomoses. There was one clinically significant leak which occurred in a dog having an EEA-stapled anastomosis and was associated with peritonitis and death. The overall leak rate was 30 per cent among dogs having handsewn anastomoses and 20 per cent among dogs with stapled anastomoses. The data suggest that an anterior resection in low colorectal anastomosis can be done safely after low-dose radiation using either handsewn or stapling techniques.

  17. Effects of albumin/glutaraldehyde glue on healing of colonic anastomosis in rats

    Science.gov (United States)

    Despoudi, Kalliopi; Mantzoros, Ioannis; Ioannidis, Orestis; Cheva, Aggeliki; Antoniou, Nikolaos; Konstantaras, Dimitrios; Symeonidis, Savvas; Pramateftakis, Manousos George; Kotidis, Efstathios; Angelopoulos, Stamatis; Tsalis, Konstantinos

    2017-01-01

    AIM To evaluate the effect of local surgical adhesive glue (albumin/glutaraldehyde-Bioglue) on the healing of colonic anastomoses in rats. METHODS Forty Albino-Wistar male rats were randomly divided into two groups, with two subgroups of ten animals each. In the control group, an end-to-end colonic anastomosis was performed after segmental resection. In the Bioglue group, the anastomosis was protected with extraluminar application of adhesive glue containing albumin and glutaraldehyde. Half of the rats were sacrificed on the fourth and the rest on the eighth postoperative day. Anastomoses were resected and macroscopically examined. Bursting pressures were calculated and histological features were graded. Other parameters of healing, such as hydroxyproline and collagenase concentrations, were evaluated. The experimental data were summarized and computed from the results of a one-way ANOVA. Fisher’s exact test was applied to compare percentages. RESULTS Bursting pressures, adhesion formation, inflammatory cell infiltration, and collagen deposition were significantly higher on the fourth postoperative day in the albumin/glutaraldehyde group than in the control group. Furthermore, albumin/glutaraldehyde significantly increased adhesion formation, inflammatory cell infiltration, neoangiogenesis, and collagen deposition on the eighth postoperative day. There was no difference in fibroblast activity or hydroxyproline and collagenase concentrations. CONCLUSION Albumin/glutaraldehyde, when applied on colonic anastomoses, promotes their healing in rats. Therefore, the application of protective local agents in colonic anastomoses leads to better outcomes. PMID:28883693

  18. Hybrid NOTES: TEO for transanal total mesorectal excision: intracorporeal resection and anastomosis.

    Science.gov (United States)

    Serra-Aracil, Xavier; Mora-López, Laura; Casalots, Alex; Pericay, Carles; Guerrero, Raul; Navarro-Soto, Salvador

    2016-01-01

    Laparoscopic surgery for rectal TME achieves better patient recovery, lower morbidity, and shorter hospital stay than open surgery. However, in laparoscopic rectal surgery, the overall conversion rate is nearly 20%. Transanal TME combined with laparoscopy, known as Hybrid NOTES, is a less invasive procedure that provides adequate solutions to some of the limitations of rectal laparoscopy. Transanal TME via TEO with technical variants (intracorporeal resection and anastomosis, TEO review of the anastomosis) attempts to standardize and simplify the procedure. Prospective observational study was used describe and assess the technique in terms of conversion to open surgery, overall morbidity, surgical site infection and hospital stay. The sample comprised consecutive patients diagnosed with rectal tumor less than 10 cm from the anal verge who were candidates for low anterior resection using TME (except T4). Demographic, surgical, postoperative, and pathological variables were analyzed, as well as morbidity rates. From September 2012 to August 2014, 32 patients were included. The conversion rate was 0%. Overall morbidity was 31.3%, SSI rate was 9.4%, and mean hospital stay was 8 days. Oncological radical criteria were achieved with pathological parameters of 94% of complete TME and a median circumferential margin of 13 mm. The introduction of technical variants of TEO for transanal resection can facilitate a procedure that requires extensive experience in transanal and laparoscopic surgery. Studies of sphincter function, quality of life, and long-term oncological outcome are now necessary.

  19. Circumferential resection and "Z"-shape plastic end-to-end anastomosis of canine trachea.

    Science.gov (United States)

    Zhao, H; Li, Z; Fang, J; Fang, C

    1999-03-01

    To prevent anastomotic stricture of the trachea. Forty young mongrel dogs, weighing 5-7 kg, were randomly divided into two groups: experimental group and control group, with 20 dogs in each group. Four tracheal rings were removed from each dog. In the experimental group, two "Z"-shape tracheoplastic anastomoses were performed on each dog, one on the anterior wall and the other on the membranous part of the trachea. In the control group, each dog received only simple end-to-end anastomosis. Vicryl 3-0 absorbable suture and OB fibrin glue were used for both groups. All dogs were killed when their body weight doubled. The average sagittal stenotic ratio were 1.20 +/- 0.12 for the experimental group and 0.83 +/- 0.05 for the control group. The average cross-sectional area stenotic ratio were 0.90 +/- 0.12 and 0.69 +/- 0.09 and T values were 8.71 and 4.57 for the two groups (P anastomosis in preventing anastomotic stricture of canine trachea.

  20. Effects of low-dose preoperative irradiation on low anterior anastomosis in dogs.

    Science.gov (United States)

    Schauer, R M; Bubrick, M P; Feeney, D A; Johnston, G R; Rolfsmeyer, E S; Strom, R L; Hitchcock, C R

    1982-01-01

    Twenty mongrel dogs underwent preoperative radiation therapy to the colon and rectum using the Nominal Standard Dose Equation to simulate treatment with 2000 rads. Each dog then underwent anterior resection of the rectosigmoid, and reconstruction was randomized into two groups consisting of either handsewn or EEA-stapled anastomoses. Anastomoses were examined digitally and radiographically on the day of surgery and on the seventh postoperative day. There were three radiographic leaks among the ten dogs having the handsewn anastomoses and one radiographic leak among the ten dogs having the EEA-stapled anastomoses. There was one clinically significant leak which occurred in a dog having an EEA-stapled anastomosis and was associated with peritonitis and death. The overall leak rate was 30 per cent among dogs having handsewn anastomoses and 20 per cent among dogs with stapled anastomoses. The data suggest that an anterior resection in low colorectal anastomosis can be done safely after low-dose radiation using either handsewn or stapling techniques.

  1. Evaluation of data from 35 dogs pertaining to dehiscence following intestinal resection and anastomosis.

    Science.gov (United States)

    Mouat, Emily E; Davis, Garrett J; Drobatz, Kenneth J; Wallace, Koranda A

    2014-01-01

    The objectives of this study were to evaluate blood and abdominal fluid lactate and glucose, fluid cytology, culture, and volume 24 and 48 hr following intestinal resection and anastomosis in dogs with and without closed-suction drains and to correlate findings with survival. Thirty-five client-owned dogs that underwent intestinal resection and anastomosis were prospectively enrolled in the study. Abdominal fluid was submitted for culture at surgery and again 24 hr postoperatively. Twenty-four and 48 hr postoperatively, blood and abdominal fluid glucose and lactate were measured and fluid was submitted for cytology. Abdominal fluid was collected either from a closed-suction drain or by abdominocentesis. Patients were followed either for 14 days or until death. Comparisons were made based on development of dehiscence and presence or absence of a drain. Patients with dehiscence were more likely to have positive cultures at 24 hr and to have had more bowel resected. Surviving patients without drains had significantly smaller differences in blood and fluid glucose and lactate both 24 and 48 hr postoperatively than surviving patients with drains. The significant differences identified between patients with and without drains suggests a need for further research into the effect of drains on abdominal fluid values.

  2. The role of mechanical bowel preparation for colonic resection and anastomosis: an experimental study.

    Science.gov (United States)

    Feres, O; Monteiro dos Santos, J C; Andrade, J I

    2001-11-01

    To evaluate the effect of mechanical bowel preparation (MBP) on colonic resection and anastomosis. Mongrel dogs were divided into two groups of 20 animals each. During the preoperative period (24 h) group A was not subjected to MBP, and group B was fasted and ingested 20 ml magnesium hydroxide plus 15 ml/kg 10% mannitol orally. All animals underwent segmental colectomy followed by end-to-end anastomosis. The survivors of both groups were reoperated upon on the 7th postoperative day. Mortality before reoperation was significantly higher in group A (45%) than in group B (10%; P0.05). Aerobic and anaerobic bacterial cultures showed similar growth in the two groups. We conclude that the omission of MBP increased the mortality due to early anastomotic leakage with peritonitis; MBP did not change the rate of localized anastomotic leakage, leakage with peritonitis, or intact anastomoses on the 7th day; no quantitative or qualitative differences were observed in the bacteria isolated from the two groups.

  3. Oesophageal flap valvuloplasty and wrapping suturing prevent gastrooesophageal reflux disease in dogs after oesophageal anastomosis

    Science.gov (United States)

    Dai, Ji-Gang; Liu, Quan-Xing; Den, Xu-Feng; Min, Jia-Xin

    2014-01-01

    AIM: To examine the efficiency of oesophageal flap valvuloplasty and wrapping suturing technique in decreasing the rate of postoperative gastrooesophageal reflux disease in a dog model. METHODS: We operated on 10 dogs in this study. First, we resected a 5-cm portion of the distal oesophagus and then restored the continuity of the oesophageal and gastric walls by end-to-end anastomosis. A group of five dogs was subjected to the oesophageal flap valvuloplasty and wrapping suturing technique, whereas another group (control) of five dogs was subjected to the stapling technique after oesophagectomy. The symptom of gastrooesophageal reflux was recorded by 24-h pH oesophageal monitoring. Endoscopy and barium swallow examination were performed on all dogs. Anastomotic leakage was observed by X-ray imaging, whereas benign anastomotic stricture and mucosal damage were observed by endoscopy. RESULTS: None of the 10 dogs experienced anastomotic leakage after oesophagectomy. Four dogs in the new technology group resumed regular feeding, whereas only two of the dogs in the control group tolerated solid food intake. pH monitoring demonstrated that 25% of the dogs in the experimental group exhibited reflux and that none had mucosal damage consistent with reflux. Conversely, both reflux and mucosal damage were observed in all dogs in the control group. CONCLUSION: The oesophageal flap valvuloplasty and wrapping suturing technique can improve the postoperative quality of life through the long-term elimination of reflux oesophagitis and decreased stricture formation after primary oesophageal anastomosis. PMID:25516655

  4. Risk factors for leakage following intestinal anastomosis in dogs and cats: 115 cases (1991-2000).

    Science.gov (United States)

    Ralphs, S Christopher; Jessen, Carl R; Lipowitz, Alan J

    2003-07-01

    To identify factors associated with leakage following intestinal anastomosis in dogs and cats. Retrospective study. 90 dogs and 25 cats. Medical records of all dogs and cats that underwent intestinal resection and anastomosis between 1991 and 2000 were reviewed, and information on 27 factors was recorded. Anastomotic leakage was identified in 13 of the 90 dogs but in none of the 25 cats. Preoperative factors significantly associated with development of anastomotic leakage in dogs included preoperative peritonitis, serum albumin concentration, a left shift, and indication for surgery (dogs with intestinal foreign bodies were more likely to have leakage than dogs that underwent surgery for any other cause). Postoperative and case management factors significantly associated with development of leakage included duration of hospitalization, supplemental alimentation, whether the dog ate the day after surgery, blood product administration, and outcome (died vs survived). Discriminant analysis was performed, and dogs with 2 or more of the following factors were predicted to develop anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration dogs. Results suggest that a variety of factors may be associated with development of intestinal anastomotic leakage in dogs. In particular, dogs with 2 or more of the following risk factors are predicted to be at high risk for developing anastomotic leakage: preoperative peritonitis, intestinal foreign body, and serum albumin concentration < or = 2.5 g/dL.

  5. [Fingertip replantation with anastomosis of palm vein and retaining the nail].

    Science.gov (United States)

    Wang, Xiang; Zhang, Wei-Kai; Yin, Shao-Meng; Wang, Hai-Bing; He, Tao; Gong, Yong-Qing; Zhu, Guo-Ming; Mao, Gen-Lian; Hu, Ming-Xing; Li, Jian

    2013-08-01

    To study the replantation methods and clinical results of amputated fingertip. From October 2007 to June 2011, 18 fingers of 13 cases were replanted with anastomosis of palm vein and retaining the nail, including 9 males and 4 females,with an average age of 26 years old ranging from 17 to 45 years old. The time from injury to therapy was from 30 min to 5 h, time of broken finger ischemia was from 1.5 to 7 h. All broken fingers were preservation under normal temperature. All fingers were survived, no vascular crisis happened. All cases were followed up from 3 to 24 months with an average of 14 months. The length and shape of replanted fingers were similar to that of the healthy side. The new nails were smooth, the function was perfect,the sense of pain and touched sensation had been recovered. Their two-piont discriminations ranged from 3 to 6 mm with an average of 5 mm. According to the assessment standard of Chinese Medical Association of Hand Surgery, the results were excellent in 14 cases, good in 3 cases, poor in 1 case. Fingertip replantation with anastomosis of palm vein and retaining the nail is regained satisfactory appearance and function of the digits with a high survival rate.

  6. Development and Feasibility of a Robotic Laparoscopic Clipping Tool for Wound Closure and Anastomosis.

    Science.gov (United States)

    Krieger, Axel; Opfermann, Justin; Kim, Peter C W

    2018-03-01

    This paper reports the design, development, and initial evaluation of a robotic laparoscopic clipping tool for single manipulator wound closure and anastomosis (tubular reconnection). The tool deploys biodegradable clips and clasps with the goal of (i) integrating grasping and suturing into a single device for single hand or manipulator use, (ii) applying the equivalent of interrupted sutures without the need of managing suture thread, and (iii) allowing for full six degrees-of-freedom (DOFs) laparoscopic control when mounted on a robot arm. The specifications, workflow, and detailed design of the robotic laparoscopic tool and injection molded bio-absorbable T shaped clip and locking clasp are reported. The clipping tool integrates forceps to grab and stabilize tissue and a clip and clasp applier to approximate and fixate the tissue. A curved needle is advanced on a circular needle path and picks up and drags clips through tissue. The clip is then tightened through the tissue and a clasp is clamped around the clip, before the clip is released from the needle. Results of several bench test runs of the tool show: (a) repeatable circular needle drive, (b) successful pick-up and deployment of clips, (c) successful shear of the clip to release the clip from the needle, and (d) closure of clasp on clip with an average of 2.0 N holding force. These data indicate that the robotic laparoscopic clipping tool could be used for laparoscopic wound closure and anastomosis.

  7. Hepatobiliary scintigraphy in the assessment of biliary obstruction after hepatic resection with biliary-enteric anastomosis

    International Nuclear Information System (INIS)

    Kim, J.S.; Moon, D.H.; Shin, J.W.; Ryu, J.S.; Lee, H.K.; Lee, S.G.; Lee, Y.J.; Park, K.M.

    2000-01-01

    We investigated the usefulness of hepatobiliary scintigraphy (HBS) for diagnosing biliary obstruction after curative hepatic resection with biliary-enteric anastomosis. The study population consisted of 54 patients who underwent surgery for benign (n=18) or malignant (n=36) biliary disease. We analysed 68 technetium-99m DISIDA scintigrams which were performed at least 1 month after the surgery (median: 9 months). Final diagnosis was made by operative exploration, other invasive radiological studies or clinical and radiological follow-up for at least 6 months after the surgery. Diagnostic accuracy was analysed according to the pretest likelihood of biliary obstruction. There were two total and 15 segmental biliary obstructions. In patients with symptoms of biliary obstruction and abnormal liver function, HBS always allowed correct diagnosis (two instances of total obstruction, seven of segmental obstruction and seven of non-obstruction). Among the patients with non-specific symptoms or isolated elevation of serum alkaline phosphatase, HBS diagnosed segmental biliary obstruction in seven of the eight instances, and non-obstruction in 22 of 23 instances. There were no cases of biliary obstruction and no false-positive results of HBS in 21 instances with no clinical signs or symptoms of biliary obstruction. The diagnostic sensitivity and specificity of HBS for biliary obstruction were 94% (16/17) and 97% (50/51), respectively. In conclusion, HBS is a highly accurate modality for the diagnosis of segmental biliary obstruction during long-term follow-up after hepatic resection with biliary-enteric anastomosis. (orig.)

  8. Oesophageal flap valvuloplasty and wrapping suturing prevent gastrooesophageal reflux disease in dogs after oesophageal anastomosis.

    Science.gov (United States)

    Dai, Ji-Gang; Liu, Quan-Xing; Den, Xu-Feng; Min, Jia-Xin

    2014-12-14

    To examine the efficiency of oesophageal flap valvuloplasty and wrapping suturing technique in decreasing the rate of postoperative gastrooesophageal reflux disease in a dog model. We operated on 10 dogs in this study. First, we resected a 5-cm portion of the distal oesophagus and then restored the continuity of the oesophageal and gastric walls by end-to-end anastomosis. A group of five dogs was subjected to the oesophageal flap valvuloplasty and wrapping suturing technique, whereas another group (control) of five dogs was subjected to the stapling technique after oesophagectomy. The symptom of gastrooesophageal reflux was recorded by 24-h pH oesophageal monitoring. Endoscopy and barium swallow examination were performed on all dogs. Anastomotic leakage was observed by X-ray imaging, whereas benign anastomotic stricture and mucosal damage were observed by endoscopy. None of the 10 dogs experienced anastomotic leakage after oesophagectomy. Four dogs in the new technology group resumed regular feeding, whereas only two of the dogs in the control group tolerated solid food intake. pH monitoring demonstrated that 25% of the dogs in the experimental group exhibited reflux and that none had mucosal damage consistent with reflux. Conversely, both reflux and mucosal damage were observed in all dogs in the control group. The oesophageal flap valvuloplasty and wrapping suturing technique can improve the postoperative quality of life through the long-term elimination of reflux oesophagitis and decreased stricture formation after primary oesophageal anastomosis.

  9. In situ analysis of anastomosis in representative genera of arbuscular mycorrhizal fungi.

    Science.gov (United States)

    Purin, Sonia; Morton, Joseph B

    2011-08-01

    Arbuscular mycorrhizal fungi (AMF) form obligate symbiotic associations with plants. As a result, the role of hyphal interactions in the establishment and maintenance of common mycorrhizal networks is poorly understood because of constraints on methods for in situ analysis. We designed a rhizohyphatron that allows the examination of intact mycelia growing from whole mycorrhizal plants. Plants preinoculated with spores were cultivated in a compartment with a connecting tube from which hyphae extend through a fine nylon mesh onto agar-coated slides. Species selected from each of the five AMF genera were used to assess and characterize the anastomosis behavior in the rhizohyphatron. Hyphal networks of Paraglomus occultum, Ambispora leptoticha, Scutellospora heterogama, and Gigaspora gigantea growing on the agar-coated slides showed no evidence of hyphal fusion. In contrast, anastomosis occurred in the hyphal networks of Glomus clarum and Glomus intraradices at an average frequency of less than 15% for both species. The rhizohyphatron developed in this study will provide knowledge of the biology and genetics of self/non-self recognition in AMF and help to better understand Glomeromycotan life history strategies.

  10. [Comparative study of intestinal anastomosis with manual suture and biofragmentable ring in dogs under corticosteroid administration].

    Science.gov (United States)

    Fernandes, L C; Matos, D; Novelli, M D; Kim, S B

    2000-01-01

    This study analyzed intestinal anastomoses by manual suture and by compression with biofragmentable ring under delay of cicatrization administering parenteral corticoids. Twenty dogs were divided into two groups: control and test, the latter submitted to intramuscular administration of hydrocortisone hemisuccinate, 25 to 33 mg/kg/day, on the 30th preoperative and 7th postoperative days. During surgery, each animal underwent two colon sections with anastomosis by manual suture in a single extramucous plane and compression with biofragmentable ring. The animals were sacrificed 7 days after the procedure to evaluate the anastomoses. In the postoperative period, one death occurred in the test group and two in the control group, caused by nonblocked fistula in the anastomoses by ring compression. Statistically, there was a similar incidence of adherences, fistulas, afferent dilatation and obstruction using comparison methods. On microscopy, deficiency in mucous regeneration of the anastomoses by compression was observed. Computerized histological analysis evidenced in the anastomoses by compression, a greater inflammatory reaction, greater edema of the submucous membrane and enlarged scars. It was concluded that, with the biofragmentable ring, in colonic anastomosis under delay of cicatrization induced by corticoids, similar results to manual suture regarding to postoperative complications incidence were obtained; ring, however, determined worse mucous regeneration and greater cicatricial inflammatory reaction.

  11. Incidence of neoplasias and effectiveness of postoperative surveillance endoscopy for patients with ulcerative colitis: comparison of ileorectal anastomosis and ileal pouch-anal anastomosis.

    Science.gov (United States)

    Ishii, Hiroaki; Hata, Keisuke; Kishikawa, Junko; Anzai, Hiroyuki; Otani, Kensuke; Yasuda, Koji; Nishikawa, Takeshi; Tanaka, Toshiaki; Tanaka, Junichiro; Kiyomatsu, Tomomichi; Kawai, Kazushige; Nozawa, Hiroaki; Kazama, Shinsuke; Yamaguchi, Hironori; Ishihara, Soichiro; Sunami, Eiji; Kitayama, Joji; Watanabe, Toshiaki

    2016-03-09

    The incidence of neoplasia after surgery has not been sufficiently evaluated in patients with ulcerative colitis (UC), particularly in the Japanese population, and it is not clear whether surveillance endoscopy is effective in detecting dysplasia/cancer in the remnant rectum or pouch. The aims of this study were to assess and compare postoperative development of dysplasia/cancer in patients with UC who underwent ileorectal anastomosis (IRA) or ileal pouch-anal anastomosis (IPAA) and to evaluate the effectiveness of postoperative surveillance endoscopy. One hundred twenty patients who received postoperative surveillance endoscopy were retrospectively reviewed for development of dysplasia/cancer in the remnant rectal mucosa or pouch. Three hundred seventy-nine endoscopy sessions were conducted for 30 patients after IRA, while 548 pouch endoscopy sessions were conducted for 90 patients after IPAA. In the IRA group, 5 patients developed dysplasia/cancer during postoperative surveillance and in all cases, neoplasia was detected at an early stage. In the IRA group, no patient developed neoplasia within 10 years of diagnosis; the cumulative incidence of neoplasia after disease onset was 7.2, 12.0, and 23.9% at 15, 20, and 25 years, respectively. In one case after stapled IPAA, dysplasia was found at the ileal pouch; a subsequent 9 endoscopy sessions in 8 years did not detect any dysplasia. Neoplasia was found more frequently during postoperative surveillance in the IRA group than in the IPAA group (p = .0028). The cumulative incidence of neoplasia after IRA was 3.8, 8.7, and 21.7% at 10, 15, and 20 years, respectively, and that after IPAA was 1.6% at 20 years. The cumulative incidence of neoplasia after IPAA was minimal. Those who underwent IRA had a greater risk of developing neoplasia than those who underwent IPAA, although postoperative surveillance endoscopy was able to detect dysplasia/cancer at an early stage. IRA can be the surgical procedure of choice only in

  12. The IRTS (Infrared Telescope in Space) Mission

    Science.gov (United States)

    Murakami, Hiroshi; Freund, Minoru M.; Ganga, Ken; Guo, Hongfeng; Hirao, Takanori; Hiromoto, Norihisa; Kawada, Mitsunobu; Lange, Andrew E.; Makiuti, Sin'itirou; Matsuhara, Hideo; Matsumoto, Toshio; Matsuura, Shuji; Murakami, Masahide; Nakagawa, Takao; Narita, Masanao; Noda, Manabu; Okuda, Haruyuki; Okumura, Ken'ichi; Onaka, Takashi; Roellig, Thomas L.; Sato, Shinji; Shibai, Hiroshi; Smith, Beverly J.; Tanabe, Toshihiko; Tanaka, Masahiro; Watabe, Toyoki; Yamamura, Issei; Yuen, Lunming

    1996-10-01

    The Japanese satellite-borne infrared telescope, the Infrared Telescope in Space (IRTS), has completed a successful survey of a portion of the infrared sky. The IRTS consists of a 15 cm telescope cooled with superfluid liquid helium, and is installed on board the Space Flyer Unit (SFU) spacecraft. The SFU was launched on 1995 March 18 UT. The sky survey by the IRTS started on March 29 UT, and was completed on April 25 UT after exhausting its liquid helium. The cryogenic system operated as designed, and maintained the telescope and the focal-plane instruments at a stable temperature of 1.9 K for 38 days. The four focal-plane instruments, which together covered almost the entire infrared wavelength range, observed a sky area of about 2700 deg(2) and returned a wealth of new data on a variety of objects, including the zodiacal light, interstellar gas and dust, near-infrared cosmic background light and point sources.

  13. a New Concept of Agile Telescope

    Directory of Open Access Journals (Sweden)

    Michael Valasek

    2010-01-01

    Full Text Available The paper deals with the description of a new concept for a spherical mechanism for agile telescopes. It is based on redundantly actuated parallel kinematical structure. Due to the three times overactuated structure and application of several further innovative concepts, the Hexasphere achieves the movability of ±100 degrees. This enables the use of a Hexasphere as the basis for mounts of telescopes. Such telescopes can be optimized for minimum weight or for maximum dynamics. The proposed mechanism is expected to play a role in novel robotic telescopes nowadays used in many fields of astronomy and astrophysics, with emphasis on automated systems for alert observations of celestial gamma-ray bursts.

  14. Beam Combination for Sparse Aperture Telescopes Project

    Data.gov (United States)

    National Aeronautics and Space Administration — This proposal is for funding to continue development of an alternative beam combiner for Stellar Imager (SI), a 30-aperture, interferometric telescope chosen as one...

  15. Possible GRB Observation with the MAGIC Telescope

    Science.gov (United States)

    Bastieri, D.; Bigongiari, C.; Mariotti, M.; Peruzzo, L.; Saggion, A.

    2001-08-01

    The MAGIC Telescope, with its reflecting parabolic dish of 17 m of diameter and its careful design of a robust, lightweight, alto-azimuthal mount, is an ideal detector for GRB phenomena. The telescope is an air Cherenkov telescope that, even in the first phase, equipped with standard PMTs, can reach an energy threshold below 30 GeV. The threshold is going to drop well below 10 GeV in the envisaged second phase, when chamber PMTs will be substituted by high quantum efficiency APDs. The telescope can promptly respond to GRB alerts coming, for instance, from GCN, and can reposition itself in less than 30 seconds, 20 seconds being the time to turn half a round for the azimuth bearing. In this report, the effective area of the detector as a function of energy and zenith angle is taken into account, in order to evaluate the expected yearly occurrence and the response to different kinds of GRBs.

  16. The ATHENA telescope and optics status

    Science.gov (United States)

    Bavdaz, Marcos; Wille, Eric; Ayre, Mark; Ferreira, Ivo; Shortt, Brian; Fransen, Sebastiaan; Collon, Maximilien; Vacanti, Giuseppe; Barriere, Nicolas; Landgraf, Boris; Haneveld, Jeroen; van Baren, Coen; Zuknik, Karl-Heintz; Della Monica Ferreira, Desiree; Massahi, Sonny; Christensen, Finn; Krumrey, Michael; Burwitz, Vadim; Pareschi, Giovanni; Spiga, Daniele; Valsecchi, Giuseppe; Vernani, Dervis; Oliver, Paul; Seidel, André

    2017-08-01

    The work on the definition and technological preparation of the ATHENA (Advanced Telescope for High ENergy Astrophysics) mission continues to progress. In parallel to the study of the accommodation of the telescope, many aspects of the X-ray optics are being evolved further. The optics technology chosen for ATHENA is the Silicon Pore Optics (SPO), which hinges on technology spin-in from the semiconductor industry, and uses a modular approach to produce large effective area lightweight telescope optics with a good angular resolution. Both system studies and the technology developments are guided by ESA and implemented in industry, with participation of institutional partners. In this paper an overview of the current status of the telescope optics accommodation and technology development activities is provided.

  17. The ATHENA telescope and optics status

    DEFF Research Database (Denmark)

    Bavdaz, Marcos; Wille, Eric; Ayre, Mark

    2017-01-01

    chosen for ATHENA is the Silicon Pore Optics (SPO), which hinges on technology spin-in from the semiconductor industry, and uses a modular approach to produce large effective area lightweight telescope optics with a good angular resolution. Both system studies and the technology developments are guided...... by ESA and implemented in industry, with participation of institutional partners. In this paper an overview of the current status of the telescope optics accommodation and technology development activities is provided....

  18. New infrared telescopic observation of Vesta

    Science.gov (United States)

    Palomba, E.; D'Aversa, E.; Sato, T.; Longobardo, A.; Aoki, S.; Sindoni, G.; Oliva, F.

    2017-09-01

    In this work we present new telescopic observations of the Vesta asteroid made at the Subaru Telescope by using the COMICS IR spectrometer. We were able to obtain 5 different observations in 5 day, at two different epochs. The obtained spectra do not exhibit Reststrahlen bands and show only weak features attributable to the Christiansen peak and to the transparency feature compatible with a fine grain size regolith.

  19. Thirty Meter Telescopes and Gravitational Lensing

    OpenAIRE

    Carlberg, R. G.

    2004-01-01

    Diffraction limited 30m class telescopes will play an important role in gravitational lensing studies, coming online in approximately 2015. As imaging telescopes they will complement the ~6m JWST, probing to smaller angular scales in greatly magnified objects near critical lines and for measuring shear of objects below the JWST angular scale, such as luminous super-star clusters at high redshift. The high source density will allow more detailed mass mapping in the weak lensing regime and will...

  20. Astronomy in Hawaii: Telescopes, Research, and Libraries

    Science.gov (United States)

    Robertson, A. K.

    2012-08-01

    Since early Polynesian way-finding combined observations of sky and ocean and allowed voyagers to locate and se ttle the far-flung islands of the Pacific, astronomy has impacted the islands of Hawaii. The Twentieth Century saw telescope development on both Haleakala on Maui and Mauna Kea on Hawaii Island. These complexes have developed libraries and information services to support and enhance their research. The University of Hawaii established the Institute for Astronomy (IfA). The IfA Library serves researchers and instrument developers at each of its three locations. Canada-France-Ha waii Telescope, the Joint Astronomy Center, the W. M. Keck Observatory, Gemini Northern Telescope and Subaru Telescope have each developed library services to respond to their unique needs. The librarians at these organizations have formed Astronomy Libraries of HAwaii (A LOHA) to share resources. As electronic research has developed, each library has responded to capitalize on these new capabilities. In coming years, projects such as the Advanced Technology Solar Telescope on Maui and the Thirty Meter Telescope on Hawaii Island have the promise of enlarging our understanding of the Universe. Astronomy libraries in Hawaii will con tinue to enhance their expertise to match the evolution of astronomy technologies and maximize research impact.

  1. Active optics for next generation space telescopes

    Science.gov (United States)

    Costes, V.; Perret, L.; Laubier, D.; Delvit, J. M.; Imbert, C.; Cadiergues, L.; Faure, C.

    2017-09-01

    High resolution observation systems need bigger and bigger telescopes. The design of such telescopes is a key issue for the whole satellite. In order to improve the imaging resolution with minimum impact on the satellite, a big effort must be made to improve the telescope compactness. Compactness is also important for the agility of the satellite and for the size and cost of the launcher. This paper shows how compact a high resolution telescope can be. A diffraction limited telescope can be less than ten times shorter than its focal length. But the compactness impacts drastically the opto-mechanical sensitivity and the optical performances. Typically, a gain of a factor of 2 leads to a mechanical tolerance budget 6 times more difficult. The need to implement active optics for positioning requirements raises very quickly. Moreover, the capability to compensate shape defaults of the primary mirror is the way to simplify the mirror manufacture, to mitigate the development risks and to minimize the cost. The larger the primary mirror is, the more interesting it is to implement active optics for shape compensations. CNES is preparing next generation of earth observation satellite in the frame of OTOS (Observation de la Terre Optique Super-Résolue; High resolution earth observing optical system). OTOS is a technology program. In particular, optical technological developments and breadboards dedicated to active optics are on-going. The aim is to achieve TRL 5 to TRL6 for these new technologies and to validate the global performances of such an active telescope.

  2. SCIENTIFIC EFFICIENCY OF GROUND-BASED TELESCOPES

    International Nuclear Information System (INIS)

    Abt, Helmut A.

    2012-01-01

    I scanned the six major astronomical journals of 2008 for all 1589 papers that are based on new data obtained from ground-based optical/IR telescopes worldwide. Then I collected data on numbers of papers, citations to them in 3+ years, the most-cited papers, and annual operating costs. These data are assigned to four groups by telescope aperture. For instance, while the papers from telescopes with an aperture >7 m average 1.29 more citations than those with an aperture of 2 to 7 m) telescopes. I wonder why the large telescopes do so relatively poorly and suggest possible reasons. I also found that papers based on archival data, such as the Sloan Digital Sky Survey, produce 10.6% as many papers and 20.6% as many citations as those based on new data. Also, the 577.2 papers based on radio data produced 36.3% as many papers and 33.6% as many citations as the 1589 papers based on optical/IR telescopes.

  3. Internal carotid artery agenesis associated with a rare collateral pathway: supraclinoid-supraclinoid anastomosis. A case report.

    Science.gov (United States)

    Hong, Jung Hee; Chang, Hyuk Won; Kim, Ji Min; Cho, Ho Chan; Kim, Sang Hyon; Hong, Ji Hee; Kim, Sung Jin; Jeong, Hea Woong

    2016-03-01

    Internal carotid artery (ICA) agenesis is an infrequent vascular anomaly, less than 0.01% of the population. Here we report a case of internal carotid agenesis with a rare collateral pathway, via supraclinoid ICA anastomosis to the contralateral supraclinoid ICA.

  4. Sexual function and continence after ileo pouch anal anastomosis : a comparison between a meta-analysis and a questionnaire survey

    NARCIS (Netherlands)

    Hueting, WE; Gooszen, HG; van Laarhoven, CJHM

    Background and aims. Ileo pouch anal anastomosis (IPAA) is the standard restorative procedure for patients with ulcerative colitis and familial adenomatous polyposis, but its pros and cons have not been explored in depth. This study analyzed the long-term complications such as incontinence and

  5. Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon

    Directory of Open Access Journals (Sweden)

    Mohamed I Kassem

    2017-09-01

    Conclusions: In favorable situations, omission of on-table lavage may be preferred for immediate anastomosis in obstructed left colonic emergencies. The technique is reliable and well-tolerated with no additional morbidity or mortality. [Arch Clin Exp Surg 2017; 6(3.000: 138-148

  6. Redo coloanal anastomosis for anastomotic leakage after low anterior resection for rectal cancer: an analysis of 59 cases

    NARCIS (Netherlands)

    Westerduin, E.; Borstlap, W. A. A.; Musters, G. D.; Westerterp, M.; van Geloven, A. A. W.; Tanis, P. J.; Wolthuis, A. M.; Bemelman, W. A.; D'Hoore, A.

    2018-01-01

    AimThe construction of a new coloanal anastomosis (CAA) following anastomotic leakage after low anterior resection (LAR) is challenging. The available literature on this topic is scarce. The aim of this two-centre study was to determine the clinical success and morbidity after redo CAA. MethodThis

  7. GROWTH OF THE HYPOPLASTIC AORTIC-ARCH AFTER SIMPLE COARCTATION RESECTION AND END-TO-END ANASTOMOSIS

    NARCIS (Netherlands)

    BROUWER, MHJ; CROMMEDIJKHUIS, AH; EBELS, T; EIJGELAAR, A

    Surgical treatment of a hypoplastic aortic arch associated with an aortic coarctation is controversial. The controversy concerns the claimed need to surgically enlarge the diameter of the hypoplastic arch, in addition to resection and end-to-end anastomosis. The purpose of this prospective study is

  8. Combined resection of aberrant right hepatic artery without anastomosis in panceaticoduodenectomy for pancreatic head cancer: A case report

    Directory of Open Access Journals (Sweden)

    Atsushi Nanashima

    2016-01-01

    Conclusion: By the preoperative and intraoperative imaging managements conducted, combined resection of the aberrant right hepatic artery without anastomosis was achieved by pancreaticoduodenectomy for pancreas head cancer. However, improvements in imaging diagnosis and careful management of R0 resection are important.

  9. New nonabsorbable stent versus a microsurgical procedure for vasectomy reversal: evaluating tissue reactions at the anastomosis in rabbits

    NARCIS (Netherlands)

    Vrijhof, Eric J.; de Bruine, Adriaan; Zwinderman, Aeilko; Lycklama à Nijeholt, August A. B.; Koole, Leo

    2005-01-01

    To investigate whether a newly designed nonabsorbable polymeric stent for the reconstruction of the vas deferens provided less stricturing at the site of the anastomosis in comparison with the conventional microsurgical reconstruction of the vas deferens. Prospective randomized study in 26 rabbits,

  10. Outcome of 132 consecutive reconstructive operations for intestinal fistula--staged operation without primary anastomosis improved outcome in retrospective analysis

    DEFF Research Database (Denmark)

    Runström, B; Hallböök, O; Nyström, P O

    2013-01-01

    (87%) of the 110 fistulae healed and 92 (91%) patients survived. A total of 9 patients with unhealed fistula died. Multivariate analysis revealed jaundice as an independent factor for both death and failed closure and operation without anastomosis as an independent positive factor for healing. Failure...

  11. The role of the defaecating pouchogram in the assessment of evacuation difficulty after restorative proctocolectomy and pouch-anal anastomosis

    NARCIS (Netherlands)

    Stellingwerf, M. E.; Maeda, Y.; Patel, U.; Vaizey, C. J.; Warusavitarne, J.; Bemelman, W. A.; Clark, S. K.

    2016-01-01

    Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) is the most frequently performed operation for intractable ulcerative colitis (UC) and for many patients with familial adenomatous polyposis (FAP). It can be complicated by a functional evacuation difficulty, which is not

  12. Early Mobilization after Free-flap Transfer to the Lower Extremities: Preferential Use of Flow-through Anastomosis

    Directory of Open Access Journals (Sweden)

    Shimpei Miyamoto, MD

    2014-03-01

    Conclusions: This study demonstrates that early mobilization after free-flap transfer to the lower extremity is made possible by flow-through anastomosis for both arteries and veins. Flow-through flaps have stable circulation from the acute phase and can tolerate early dangling and ambulation.

  13. Pouchitis-Associated Iritis (Uveitis Following Total Proctocolectomy and Ileal Pouch-to-Anal Anastomosis in Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Hugh James Freeman

    2001-01-01

    Full Text Available A 26-year-old woman with ulcerative colitis treated with a proctocolectomy and ileal pouch-to-anal anastomosis developed an erosive and ulcerative pouchitis. Although no ophthalmological manifestations were present before the staged surgical procedures, iritis developed after appearance of the pouchitis. Both conditions subsequently resolved with oral corticosteroids and metronidazole.

  14. Multiple adjustable vascular clamp prototype: feasibility study on an experimental model of end-to-side microsurgical vascular anastomosis.

    Science.gov (United States)

    Pereira, A; Ichihara, S; Collon, S; Bodin, F; Gay, A; Facca, S; Liverneaux, P

    2014-12-01

    The aim of this study was to establish the feasibility of microsurgical end-to-side vascular anastomosis with a multiclamp adjustable vascular clamp prototype in an inert experimental model. Our method consisted of performing an end-to-side microsurgical anastomosis with 10/0 suture on a 2-mm diameter segment. In group 1, the end-to-side segment was held in place by a double clamp and a single end clamp. In group 2, the segment was held in place with a single multiclamp adjustable clamp. The average time for performing the anastomosis was shorter in group 2. The average number of sutures was the same in both groups. No leak was found and permeability was always positive in both groups. Our results show that performing end-to-side anastomosis with a multiclamp adjustable vascular clamp is feasible in an inert experimental model. Feasibility in a live animal model has to be demonstrated before clinical use. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  15. Influence of irradiation and hyperthermia on the wound healing of the intestinal anastomosis and the skin suture in rat

    International Nuclear Information System (INIS)

    Kataoka, Takashi; Konishi, Fumio

    1994-01-01

    The influence of irradiation and/or hyperthermia on the wound healing in the rats was studied. In this study, an exteriorized segment of the small intestine or the skin of the right foot was exposed to single doses of irradiation(15 Gy), local hyperthermia (44deg C, 30 minutes), or irradiation plus hyperthermia. After the treatment, intestinal anastomosis or skin suture was performed. The wound healing was assessed by the bursting pressure of the anastomosis, by the tensile strength of suture of the skin, by the hydroxyproline concentration of the tissue around the anastomosis or the skin suture. The wound healing was significantly deteriorated in the group of irradiation. On the other hand, there was no difference in wound healing between the group of hyperthermia and the control group. In the group of combined irradiation and hyperthermia, depressed wound healing was observed. However in this group further deterioration of wound healing was not observed compared to the irradiation group. It was concluded that under the conditions of this experimental model, hyperthermia did not cause any significant deterioration of wound healing of the intestinal anastomosis and the skin suture. (author)

  16. Open principle for large high-resolution solar telescopes

    NARCIS (Netherlands)

    Hammerschlag, R.H.; Bettonvil, F.C.M.; Jägers, A.P.L.; Sliepen, G.

    2009-01-01

    Vacuum solar telescopes solve the problem of image deterioration inside the telescope due to refractive index fluctuations of the air heated by the solar light. However, such telescopes have a practical diameter limit somewhat over 1 m. The Dutch Open Telescope (DOT) was the pioneering demonstrator

  17. Novel double-stapling technique for distal oesophageal resection and oesophago-jejunal anastomosis.

    Science.gov (United States)

    Gentilli, Sergio; Portigliotti, Luca; Davoli, Fabio; Roncon, Alberto; Rena, Ottavio; Oldani, Alberto

    2016-01-01

    The restoration of the digestive tract by performing an esophago-jejunal anastomosis (EJA) is a crucial step of the total gastric and distal esophagus surgical resection for esophago-gastric junction (EGJ) cancer. We have already ideated and tested on a cadaver model an innovative technique which could be useful to minimize the risk of complications related to the phase of securing the anvil of the circular stapler prior to perform the EJA. This surgical technique was derived from the well-known "double-stapling Knight and Griffen" one that was described for the rectal resection. We used the following described technique in 20 patients with EGJ cancer and it is efficient, reliable, safe, easy to learn and easy to perform. From August 2014 to May 2015, 20 patients (14 male and 6 female) underwent surgery for esophagogastric junction cancer: In all patients a distal esophageal resection and total gastrectomy was performed. Through the trans-hiatal access, the free margins of the esophageal stump were suspended and the anvil of a circular stapler on a new dedicated and registered support bar was inserted into the lumen. Subsequently, the linear suturing stapler is closed over the bar and then fired to suture the distal stump of the esophagus; after the confirmation of a negative margin, the bar is retracted and the push-rod of the anvil is pulled out through the linear suture. Finally, the anastomosis is performed with the classic technique by using a circular stapler. No postoperative mortality occurred; postoperative course has been uneventful for 18 patients. One patient developed anastomotic fistula that has been treated conservatively with endoscopic prothesis, removed after 20 days. One patient developed in 3 POD myocardial infarction Mean Hospital stay has been 14 days (range 7-20 days). The aim of our new procedure is the insertion the anvil of a common circular stapler without handsewn securing; this is to reduce the technical difficulties related to the hand

  18. Full robot-assisted gastrectomy with intracorporeal robot-sewn anastomosis produces satisfying outcomes

    Science.gov (United States)

    Liu, Xin-Xin; Jiang, Zhi-Wei; Chen, Ping; Zhao, Yan; Pan, Hua-Feng; Li, Jie-Shou

    2013-01-01

    AIM: To evaluate the feasibility and safety of full robot-assisted gastrectomy with intracorporeal robot hand-sewn anastomosis in the treatment of gastric cancer. METHODS: From September 2011 to March 2013, 110 consecutive patients with gastric cancer at the authors’ institution were enrolled for robotic gastrectomies. According to tumor location, total gastrectomy, distal or proximal subtotal gastrectomy with D2 lymphadenectomy was fully performed by the da Vinci Robotic Surgical System. All construction, including Roux-en-Y jejunal limb, esophagojejunal, gastroduodenal and gastrojejunal anastomoses were fully carried out by the intracorporeal robot-sewn method. At the end of surgery, the specimen was removed through a 3-4 cm incision at the umbilicus trocar point. The details of the surgical technique are well illustrated. The benefits in terms of surgical and oncologic outcomes are well documented, as well as the failure rate and postoperative complications. RESULTS: From a total of 110 enrolled patients, radical gastrectomy could not be performed in 2 patients due to late stage disease; 1 patient was converted to laparotomy because of uncontrollable hemorrhage, and 1 obese patient was converted due to difficult exposure; 2 patients underwent extra-corporeal anastomosis by minilaparotomy to ensure adequate tumor margin. Robot-sewn anastomoses were successfully performed for 12 proximal, 38 distal and 54 total gastrectomies. The average surgical time was 272.52 ± 53.91 min and the average amount of bleeding was 80.78 ± 32.37 mL. The average number of harvested lymph nodes was 23.1 ± 5.3. All specimens showed adequate surgical margin. With regard to tumor staging, 26, 32 and 46 patients were staged as I, II and III, respectively. The average hospitalization time after surgery was 6.2 d. One patient experienced a duodenal stump anastomotic leak, which was mild and treated conservatively. One patient was readmitted for intra-abdominal infection and was

  19. A new anastomotic leakage model in circular double stapled colorectal anastomosis after low anterior rectum resection in pigs.

    Science.gov (United States)

    Wenger, F A; Szucsik, E; Hoinoiu, B F; Ionac, M; Walz, M K; Schmid, K W; Reis, H

    2013-12-01

    A high incidence of anastomotic leakage (37.5%) is reported after low anterior rectal resection (LAR) and circular double-stapled anastomosis without protective ileostoma. Since the pathomechanism of anastomosis leakage is still unclear, a suitable animal model would be most desirable. The objective was to assess the incidence of clinically apparent and inapparent leakage after LAR in pigs (n = 20). Endpoints were radiological, clinical, macroscopic, and histologic proof of anastomotic leakage on the 9th postoperative day. Integrity of anastomosis was assessed by double-contrast barium examination on 9th postoperative day. Animals were sacrificed and anastomoses were resected for histopathological investigation. In case of earlier clinical apparent anastomotic leakage, radiologic double-contrast barium was performed immediately. LAR with a circular double-stapled anastomosis without protective ileostoma was performed in 20 pigs (m:f = 8:12). Length of resection was 10-20 cm, anastomosis was performed 7 cm ab ano. Five animals (25%) developed clinical apparent anastomotic leakage (no appetite, fever, inactivity, tachypnea, discomfort, pain) between the 6th (n = 1) and 9th (n = 4) postoperative day, proven by double-contrast barium radiographs. Additionally in 1 animal clinical inapparent anastomotic insufficiency was observed radiologically. Total rate of leakage was 30% (n = 6). These results were confirmed by leucocytosis, low potassium levels, in two cases high ALT and AST and local peritonitis in all cases. Including one additional case of clinical inapparent leakage, total rate of anastomotic leakage was 30% (6/20). Thus we managed to establish a new experimental model of anastomotic leakage after low rectal resection comparable to the human situation.

  20. [Clinical value of "Kou mode of hepatic hilar anastomosis" in resection of type III or IV hepatic hilar cholangiocarcinoma].

    Science.gov (United States)

    He, Xiao-dong; Liu, Wei; Tao, Lian-yuan; Zhang, Zhen-huan; Cai, Lei; Zhang, Shuang-min

    2009-08-01

    To evaluate the surgical technique of "Kou mode of hepatic hilar anastomosis" in the treatment for type III or IV hilar cholangiocarcinoma. The clinical data of 89 patients with type III or IV hilar cholangiocarcinoma surgically treated in our department between Jan. 1990 and Jan. 2008 were retrospectively analyzed. Since January 2000, "Kou mode of hepatic hilar anastomosis" was performed for some patients with advanced hilar cholangiocarcinoma. The patients were divided into two groups: group A treated between 1990 and 1999, group B between 2000 and 2008. The rate of resection, therapeutic efficacy and complications in these two groups were compared, respectively. Of the 37 cases with hilar cholangiocarcinoma in group A, 4 were surgically treated (10.8%), with 1 (2.7%) radical resection and 3 (8.1%) palliative resection. Among the 52 cases with hilar cholangiocarcinoma in the group B, 35 (67.3%) received surgical resection, of them 15 (28.8%) underwent radical resection and 20 (38.5%) had palliative resection. Twenty-eight of these 35 cases underwent the "Kou mode of hepatic hilar anastomosis". The resection rate of advanced hilar cholangiocarcinoma in the group B was significantly higher than that in group A (P anastomosis" developed bile leakage to a varying degree and recovered after drainage and symptomatic treatment. The resection rate of type III or IV advanced hilar cholangiocarcinoma can be remarkably improved by using a novel alternative surgical technique called "Kou mode of hepatic hilar anastomosis". However, the long-term outcome still needs to be determined by close follow-up and further observation.