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At least 397 records · Page 22Linked to original sources
PubMed2002

Surgical instrument migration from the abdominal cavity through the bladder into the vagina: a rare long-term complication.

A foreign body in the bladder is a well-recognized, although rare, cause of urinary tract infections. We describe a 15-year-old girl who presented with abdominal pain and recurrent urinary tract infections. On analysis, a forceps was found, with the two legs of the instrument separately perforating both the back wall of the bladder and the trigone, with the top of the forceps lying in the vagina, covered with a large calculus. The forceps must have been left behind during laparotomy for bowel invagination in her first year of life.

Abdomen↗
PubMed2004

Developing a central sterile surgical instrument technician program.

Many hospitals report high vacancy rates in their central sterile processing departments related to the lack of a workforce that is knowledgeable about instrument processing and medical terminology. Creating an education course that focused on the knowledge and skills necessary for success in this vocation provided a solution to this problem for one facility. Outcomes included a dramatic decrease in the number of vacancies in the central sterile processing department and an increase in community awareness of employment options available in perioperative services.

Alabama↗
PubMed1996

Establishment of an in-use testing method for evaluating disinfection of surgical instruments using the duck hepatitis B model.

Nosocomial transmission of hepatitis B virus (HBV), associated with interventional procedures, has been attributed to its survival on improperly decontaminated instruments. To date, guidelines for chemical disinfection of potentially contaminated heat-sensitive instruments have been based largely on extrapolation of data from in-vitro disinfectant testing. Direct infectivity testing has not been possible for HBV because of the lack of a practical culture assay or susceptible experimental animal model. In this study the related duck hepadnavirus was used to simulate in-vivo transmission of a HBV during surgery, and to evaluate the effectiveness of 2% glutaraldehyde disinfection of surgical laparoscopes. Multiple laparoscopic liver biopsies were performed on 'biohazardous' duck hepatitis B (DHBV) positive ducks. Laparoscopes were then subjected to different disinfection regimes using 2% glutaraldehyde, and residual infectivity tested by placing their tips into the peritoneal cavities of uninfected four-day-old ducklings. Direct transmission of DHBV occurred in all ducks when laparoscopes were not washed. Rinsing with water lowered the transmission rate to 64% and no infection transmission occurred after 5 min of contact time with the disinfectant. In contrast, previous in-vitro studies had shown complete viral inactivation after a shorter period of disinfection. It is postulated that the longer inactivation time observed in our study may be a result of surface interactions of virus and instrument, interfering with disinfectant access or activity. Tests of instrument surface samples for viral DNA by the polymerase chain reaction (PCR) did not correlate with transmission of virus infection in vivo. PCR is an inappropriate test for evaluating the efficacy of disinfectant action despite its sensitivity. This in use method will allow testing of other decontamination procedures and their effectiveness on more complex surgical instruments.

Animals↗
PubMed1999

[A new cardiovascular surgical instrument: aorta sizer].

A new device comprising a set of graded aorta sizers is presented. Each sizer consists of a disc mounted on the top a straight holder. The length of each holder equals the circumference of its disc (the length of the holder equals the diameter of the disc times 3.14). The size of the discs are graded by 2 mm from 24 mm to 36 mm in diameter. In aneurysm operations, the proper-size vascular graft is selected by sizing the diameter of the transected aorta with the disc portion of a sizer. The proper length of the reinforcing felt strip is then determined by the length of the holder portion of the appropriate sizer.

Blood Vessel Prosthesis↗
PubMed1994

Multifunctional laparoscopic surgical instruments.

A miniature hook scissors was developed which facilitates the incision of the cystic duct and other important structures because of the characteristics. The organ in question can be hooked first before cutting, and with slight movements, the cut can be determined. Unnecessary transsection can be avoided. Simultaneous irrigation helps in case of oozing. A miniature alligator forceps can serve as a peanut holder for blunt dissection and can be of great help in case of gallbladder wall perforations in grasping the edges of the hole with great precision. After the open endo loop is placed, part of the organ in question is tented, to help to place the loop underneath with ease. Because of the teeth appropriate grasping of oedematous or thin walls is secured.

Equipment Design↗
PubMed1999

[A new cardiovascular surgical instrument: reversed-direction scissors].

A new reversed-direction scissors design was developed to facilitate the coronary artery incising procedure during bypass surgery. These scissors consist of a blade which is curved 180 degrees sideways in relation to the longitudinal axis of the handle. Also the blade portion is directed downward by about 20 degrees against the horizontal axis of the handle portion. It is important to note that when these scissors are used to make an incision in the coronary artery, the handles do not obstruct the surgeon's view of the blades and the coronary artery. It is also to be noted that the surgeon's arm holding these scissors can stay as low as when using regular straight scissors. Therefore, reversed-direction incisions of the coronary artery can be performed accurately and comfortably with these new scissors.

Coronary Artery Bypass↗
PubMed1994

[The history of surgical instruments: 1. The Mikulicz peritoneal clamp].

The peritoneal clamp, which has been developed by the Breslau surgeon Johann von Mikulicz-Radecki (1850-1905), is presented on the basis of original publications from 1900. At this time, Mikulicz had been a full professor of surgery at the Medical Faculty of the University of Breslau. After laparotomy, Mikulicz recommended to seize the peritoneum with 4 to 8 clamps, developed by him to protect the wound of the abdominal wall from manipulations and to prevent a retraction of the peritoneum: "The fastened clamps are changed in their position in a way, that the grips lie out of the area of the wound on the abdominal wall." Moreover, a brief description of the Breslau surgeon's life and work is given. Further, we refer on his importance on the development of modern surgery in Germany.

History, 19th Century↗
PubMed1996

The history and evolution of surgical instruments. VII. Spring forceps (tweezers), hooks and simple retractors.

Instruments manufactured by bending a basic metal strip or rod, either about its middle to create spring forceps (tweezers), or towards one extremity to create hooks and retractors are related structures. Spring forceps depend on tension mediated at the bend (hoop) or fixed end which is transmitted as dynamic 'spring' to the jaws, whereas the bend of hooks and retractors remains fixed and static. If such instruments refine the digital postures of pinch, pincer and retraction during surgery, they have not supplanted these manual actions entirely. After a brief historical introduction, the structure, modifications, functions and controls of spring forceps are analysed. Importantly, this instrument enjoys both right and left-handed functions, some of which are ancient, some transient as haemostats and needle-holders, and some, including left-handed dissection, surprisingly recent. Hooks are sharp or blunt and, among other functions, pre-date the left-handed spring forceps for dissection; in general hooks function as retractors. Hand-held retractors are enlarged blunt hooks, the wide retracting contact surface reducing trauma to wound margins and viscera. The physical effort of employing these retractors deep in body cavities is abated by applying them autostatically around a square or circular frame.

Dissection↗
PubMed1991

Surgical instrumentation as a palliative treatment for spinal cord compression.

This paper describes a surgical procedure occasionally used to ameliorate symptoms caused by spinal cord compression in patients with metastatic cancer. After decompression of the spinal cord, Luque instrumentation has been effectively used to stabilize the spine and provide pain relief. Two malleable rods are fixed to the spine by sublaminal wires to several healthy laminae above and below the site of the metastatic lesions. Pre- and postoperative nursing care involves constant assessment to detect early neuromuscular and autonomic functional changes. Effective pain management is crucial to the patient's well-being. This surgery does not alter a patient's prognosis but can dramatically affect quality of life.

Adult↗
PubMed1987

[Surgery of metastatic brain tumors with new surgical instruments].

The risk of damages of neurological function by the operation of metastatic brain tumors was reduced considerably after introduction of neurosurgical apparatuses, such as ultrasonograph, ultrasonic surgical aspirator and laser scalpel. Of these, ultrasonograph is useful to indicate the exact location of brain tumor at real time during the operation. Ultrasonic surgical aspirator reduced the risk of damage on important brain structures due to the selectivity of fragmentation and the safety of the dissection in the vicinity of important vessels and nerve tissues. Laser scalpel is also useful to extirpate the hemorrhagic tumor with hard consistency. Cases introduced in this paper were: case 1, brain metastasis from lung cancer located just under the left motor area in brain; case 2, metastasis with abundant neovascularization from renal cancer to orbital cavity which showed invasion to orbital roof and frontal bone; case 3, radiation induced sarcoma after the treatment of retinoblastoma; case 4, a large cerebellar metastatic tumor; case 5, neurogenic sarcoma which were successfully removed by using one of or combination of ultrasonograph, ultrasonic aspirator and laser scalpel. Advantage of these new instruments for the surgery on metastatic brain tumor was mentioned here. However, it is necessarily to get a custom before we use these apparatuses at operation efficiently.

Adult↗
PubMed1986

[Dangers in the use of high-frequency surgical instruments in anesthesiologic monitoring].

Although the use of high-frequency units is routine in all surgical disciplines, there is still a justification for reminding users of the attendant risks. The most common injuries sustained by patients are burns caused by fault currents. Such risks increase when a combination of several electric devices is used, and in particular when the operation is performed with simultaneous anesthesiologic monitoring. All electrically conductive, direct or indirect contacts between the patient and the ground lead potential, and all connections resulting in a low resistance or a shorter distance between the active and "neutral" high-frequency electrode than the correct current pathway, may become competing "neutral" electrodes with high current densities. It is therefore imperative that all those involved should strictly observe the safety rules. The systematization of problem points is intended to introduce greater clarity into the relatively long list of admonitions, and to indicate possible organizational solutions.

Anesthesia, General↗