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Biomedical subjects

G Berci

Publications and source records attributed to G Berci.

At least 91 records · Page 5Linked to original sources
PubMed1987

Advantages of video endoscopy in pediatric aerodigestive tract disorders.

The naked eye examination of the larynx through the laryngoscope is inadequate for the examination of the minute anatomic structures and does not permit the visualization of the subglottic space or the trachea. A telescope coupled to a miniature television camera is advanced under precise visual control through the vocal cords and into the trachea. Oxygen is administered through the instrument to avoid fogging and provide diffusion oxygenation during the apneic phase. The procedure is safe, fast, and provides a simultaneous record. A vastly improved image allows the examination to be performed from the television screen. Electronic imaging has much to offer in the area of pediatric endoscopy. Video endoscopic examinations of the aerodigestive tract of 151 infants were successfully performed without any complications.

Child↗
PubMed1987

Pneumoperitoneum complicating coronary bypass surgery: management without laparotomy.

Drainage of the mediastinum or thoracic cavity following bypass surgery is a routine procedure. A case is reported where pneumoperitoneum developed after the surgical procedure with vague abdominal symptoms accompanied by fever and leukocytosis. Because of the possibility of a rupture of an intra-abdominal organ laparoscopy was performed in this very ill patient and laparotomy avoided. Attention is drawn to this particular group of patients with the sequela of pneumoperitoneum in which laparoscopy can solve the diagnostic dilemma.

Aged↗
PubMed1987

A biliary endoscopy model.

Intraoperative biliary endoscopy (choledochoscopy) is often not practiced by surgeons despite the availability of both rigid and flexible endoscopes in many operating rooms. The main reasons for this reluctance are lack of familiarity and experience with endoscopic techniques. A biliary model was designed that permits the procedure to be learned. Its important features are mobilization of the duodenum, the use of irrigation, and the possibility of practicing the removal of calculi under visual control. We stress that the use of the choledochoscope is important to reduce the incidence of retained stones after common bile duct explorations.

Biliary Tract↗
PubMed1986

Aspiration and nasogastric intubation.

Routine use of nasogastric tubes in major surgery is associated with unwarranted risks of aspiration through at least three mechanisms: hypersalivation--allowing pooling of secretions in the hypopharynx, a depressed cough reflex, which is often associated with nasogastric intubation, and various laryngeal and pharyngeal abnormalities that are frequently caused by nasogastric tubes, leading to an inability to handle secretions and protect the airway. Using indirect cinelaryngoscopy, we can accurately document these mechanisms; three representative cases are presented here. Aspiration associated with nasogastric intubation is a newly described but potentially serious complication. Routine use of nasogastric intubation should be abandoned, except when the clinical situation warrants it.

Aged↗
PubMed1986

TV laparoscopy. A new dimension in visualization and documentation of pelvic pathology.

A new miniature color TV camera is employed routinely during laparoscopy. It offers the following advantages: a binocular view from a convenient distance; a significantly enlarged image; easy observation of minute changes; observation of the procedure by the entire team, thereby permitting faster coordinated manipulations involving the assistant; provision of simultaneous, permanent records; and the method of choice in teaching.

Female↗
PubMed1985

Angioscopic visualization of blood vessel interior in animals and humans.

The purpose of this study is to describe the use of angioscopes in flowing bloodstreams of animals and humans, to demonstrate the ability to precisely deliver laser energy to an intravascular target using visual guidance and to determine the information content and spatial content of angioscopy. Angioscopy was performed in 5 living dogs, 16 cadaver vascular segments, and 14 patients at the time of peripheral or coronary bypass surgery. Five canine femoral artery segments received angioscopically directed intravascular Nd:YAG laser irradiation. We were able to precisely direct the laser irradiation to predetermined intimal targets. Gross tissue injury varied from none to carbonization and vascular perforation, depending on incident energy. Using a variety of flexible fiberoptic endoscopes ranging in diameter from 1.5 to 3.7 mm, we were able to visualize intravascular structures including plaque, suture lines, venous valves, and thrombi in living patients. No patient incurred complications of any sort. We conclude that angioscopy using flexible endoscopes can be performed safely, can provide clinically useful information, and may provide a means for delivering visually directed intravascular laser irradiation.

Animals↗
PubMed1985

Delineation of peripheral and coronary detail by intraoperative angioscopy.

In this study, the development of intraoperative angioscopy, the value of the information obtained, and the problems encountered with the procedure are reported. Eight angioscopes, 1.5 to 2.8 mm in diameter, with a line resolution of greater than 0.4 mm at 5 mm, were used. One-hundred ten angioscopic investigations were performed in 46 patients; 24 at peripheral bypass surgery and 22 at coronary artery bypass surgery. These included 68 arteries, 28 new anastomoses, six old grafts, five laser angioplasties, and three in situ vein grafts. The most important finding was that angioscopic data provide information not available from probes or angiography. Angioscopic findings were responsible for a change in surgical procedures in 12 patients (26%) including three anastomotic revisions, three alterations in graft site placement, and two repeat thrombectomies. The most significant technical problems were lack of steerability and insufficient irrigation, which resulted in poor angiographic images. Further technical development is necessary before routine intraoperative angioscopy is practical. Nevertheless, if these problems are resolved, angioscopy will provide unique, high-resolution information which can directly alter surgical therapy.

Angioplasty, Balloon↗
PubMed1985

Television choledochoscopy.

Present techniques of intraoperative cholangiography and choledochoscopy have not completely solved the problem of the common bile duct stone that is missed. Televised choledochoscopy provides an improved imaging technique which should facilitate stone retrieval. A similar television endoscopic technique has already become standard among orthopedic surgeons performing diagnostic and therapeutic arthroscopy. This equipment can be shared by surgeons specializing in orthopedic or general surgery.

Endoscopy↗
PubMed1983

Combined fluoroendoscopic removal of retained biliary stones.

Sixty-one patients were referred in the postoperative period for stone extraction through the T-tube tract. In four patients the calculi passed spontaneously. One patient had a papilloma and another a blood clot mimicking a stone. Of the remaining 55 cases, all but three were successfully treated by removal of all calculi from the ductal system, a success rate of 94.5%. No major complications occurred in this series. We believe the combined fluoroendoscopic approach to be the preferred method of extracting stones through the T-tube tract because of the greater precision possible when manipulating under direct vision and the reduction in radiation exposure of patients and personnel.

Cholelithiasis↗
PubMed1983

Emergency minilaparoscopy in abdominal trauma. An update.

In 106 cases of blunt abdominal trauma, the emergency minilaparoscope was used as a diagnostic tool. In 57 patients (53.5 percent), the findings proved to be negative. In 22 patients (20.8 percent), the laparoscopic findings were corroborated by exploration. But, in 27 instances (25.4 percent), minimal to moderate hemoperitoneum was found and the laparoscopic view indicated that these patients could be treated nonoperatively with close observation. None of these patients required subsequent exploration. There were no complications of laparoscopy which required surgical intervention. In our opinion, minilaparoscopy is more diagnostically accurate than lavage. It is a fast and safe examination which can be performed at the bedside with the patient under local anesthesia. The number of unnecessary abdominal explorations in severely injured patients can be reduced to a negligible figure, thus decreasing morbidity, hospitalization time, and costs.

Abdominal Injuries↗
PubMed1982

Observations on the pathogenesis of chronic non-specific pharyngitis and laryngitis.

Repeated analysis of cinephotographic and cinefluorographic studies, correlated with clinical observations, have provided insight into the physiopathology of many cases of chronic non-specific pharyngitis, laryngitis, contact ulcers, granulomas, and pachylaryngitis. Hiatal hernia and gastro-esophageal-pharyngeal reflux appear to be the cause of local irritation. Chronic coughing and habitual harsh throat clearing initiate the contact ulcers and granuloma formation. the successful treatment of this entire family of lesions is dependent upon elimination of vocal abuse and control of the factors that are responsible for the chronic irritations.

Chronic Disease↗