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S Coe

Publications and source records attributed to S Coe.

7 recordsLinked to original sources
PubMed2000

Cardiac lead extraction with a novel locking stylet.

Extraction of chronically implanted pacing and defibrillator leads is facilitated by using specialized locking stylets placed in the lead to allow application of traction and to stabilize the lead during sheath dissection of fibrotic tissue. We report the initial multicenter series of cases using a novel lead locking device (LLD). In 57 consecutive patients presenting at 6 institutions for lead extraction, 99 leads were treated using the LLD. After removing the pulse generator, leads were severed, the inner coil dilated and an LLD was successfully inserted and locked in the inner lumen of 95/99 (96 %) leads. With traction applied to the LLD, a variety of sheaths were advanced over the lead body to separate it from adhesions. In 97/99 (98 %) leads, all or most of the lead was removed via the implant vein; 2 leads were removed via the femoral vein. No major complications were observed. The LLD deploys safely and reliably, and provides stable support for advancement of dissecting sheaths.

Adult↗
PubMed1995

Vaginal hysterectomy by uterine morcellation: an efficient, non-morbid procedure.

OBJECTIVE: To evaluate the relationship between uterine size and a possible increase in operative morbidity and procedure failure rates in women undergoing total vaginal hysterectomy. METHODS: A retrospective chart analysis of all hysterectomies performed for histologically confirmed leiomyomata was completed. A total of 128 cases qualified. Patients were stratified into three groups: group I, patients undergoing vaginal hysterectomy with a uterine weight of 300 g or greater but less than 1000 g; group II, patients undergoing vaginal hysterectomy with a uterine weight of 100-299 g; and group III, patients undergoing abdominal hysterectomy with a uterine weight of 100-1000 g. The variables evaluated included the following: length of hospital stay, operative time, estimated blood loss, and operative complications. Data regarding failed vaginal hysterectomy requiring an abdominal approach were also obtained. RESULTS: Both vaginal hysterectomy groups had a significantly reduced length of stay compared with the total abdominal hysterectomy group. There was no significant difference in mean estimated blood loss between groups I and III. Similarly, there were no significant differences in complication rates among the three groups. Group I had an 84% (31 of 37) success rate versus 95% (40 of 42) for group II (not statistically significant). There were no significant differences in the mean uterine weight, estimated blood loss, and complication rate in unsuccessful versus successful vaginal hysterectomies. The estimated blood loss was significantly higher for unsuccessful vaginal hysterectomy. CONCLUSION: Uterine size alone is not an absolute contra-indication to vaginal hysterectomy. Large uterine size (greater than 300 g) was not related to a significant increase in failed vaginal hysterectomy. Conversely, failed vaginal hysterectomy was not size-dependent. Furthermore, there is no additional operative morbidity when vaginal hysterectomy is converted to a total abdominal hysterectomy because of a technical inability to complete the surgery vaginally.

Adult↗
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