Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Operating Tables”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources
PubMed2003

Application of controlled arterial hypotension in endoscopic rhinosurgery.

Intraoperative bleeding is one of the major problems in endoscopic surgery of sinuses. In the case of the expanded process, still more numerous interventions are performed with general anesthesia. The objective of research is to compare intraoperative hemorrhage and the visibility of the operative field during normotension and hypotension anesthesia caused by nitroglycerin and captopril when performing endoscopic operations of accessory nasal sinuses. Fifty-two patients of physical health state 1-2 according to ASA were examined: for 32 the controlled hypotension (Group H) was applied, 20 patients underwent operations in normotension (Group N). All patients on the eve of the operation were premedicated with diazepam; Group H patients on the day of operation received 6.25 mg of captopril. Anesthesia was carried out with fentanyl and halothane steam in the 50:50% mixture of oxygen and laughing gas. In Group H arterial blood pressure was lowered by nitroglycerin infusion. The average arterial blood pressure was maintained in GroupH within the limits of 50-60 mmHg. Hypotension was coordinated with the rising of the head-bed of the operating table at 5 degrees. Hemorrhage was measured by collecting blood with the pump graded with the precision of 25 ml. The visibility of the operative field was evaluated subjectively every 15 minutes according to the scale of 5 points proposed by Fromm. In both groups the average arterial blood pressure values as well as the values of the frequency of heart contractions differed statistically significantly. In the hypotensive group, hemorrhage during operation was less, on the average, (208 ml) than in Group N (349.2 ml). The visibility of the operative field was by one point, on the average, better than in Group H. No anesthetic complications were observed during investigation. In summary, it is possible to state that the controlled arterial hypotension caused by captopril and nitroglycerin reduced significantly intraoperative hemorrhage and improved the visibility of the operative field in endoscopic rhinosurgery.

Adjuvants, Anesthesia↗
PubMed1997

Thoracoscopic surgery of the oesophagus in rats: a training concept for the treatment of tracheo-oesophageal malformations in preterm infants

In extremely preterm babies with type Vogt III b oesophageal atresia, the primary operative management can be restricted to a gastrostomy and ligation of the fistula. Some of these patients, however, may not even tolerate a thoracotomy or placement on the operating table. We developed a minimally invasive procedure to prepare and ligate the oesophagus thoracoscopically and perform laparoscopic gastrostomy in a rat model. In 15 operations we observed only one complication. This study implies that after adequate practice, thoracoscopic dissection of the oesophagus with ligation of a tracheo-oesophageal fistula could be performed even in every small infants.

Journal Article↗
PubMed1997

Thoracoscopic surgery of the oesophagus in rats: a training concept for the treatment of tracheo-oesophageal malformations in preterm infants.

In extremely preterm babies with type Vogt III b oesophageal atresia, the primary operative management can be restricted to a gastrostomy and ligation of the fistula. Some of these patients, however, may not even tolerate a thoracotomy or placement on the operating table. We developed a minimally invasive procedure to prepare and ligate the oesophagus thoracoscopically and perform laparoscopic gastrostomy in a rat model. In 15 operations we observed only one complication. This study implies that after adequate practice, thoracoscopic dissection of the oesophagus with ligation of a tracheo-oesophageal fistula could be performed even in every small infants.

Animals↗
PubMed1998

Unreamed intramedullary nailing of femoral shaft fractures using a traction device.

The authors present a simple distraction apparatus that is used in the sterile field and makes it possible to perform unreamed intramedullary nailing of the femur on a normal operation table. Intramedullary (IM) nails were placed, without reaming, in 24 femoral shaft fractures with the use of this device. Although it appears as though the use of the distractor did not lengthen the operative procedure, the set-up time was 60 per cent less compared with a stratified group of 28 femoral nailing using the fracture table. We feel that this device provides a safe and effective means for achieving fracture reduction without the need for a fracture table. It is especially useful in the multiply injured patient where the additional lesions can be treated without the need for patient transfer to the fracture table.

Adult↗
PubMed1994

[Minimum required number of anesthetists for general hospitals (41-1300 beds) in Japan--analysis of questionnaire, 1992].

BACKGROUND: We have elucidated the deficit of anesthetists in general hospitals excluding university hospitals by assessing the results of questionnaires from 204 institutions in Japan. METHODS: Answers to the questionnaire were computed in average, maximum, and minimum values, using MS-Excel soft ware for statistical analysis. RESULTS: The 204 hospitals were classified into 4 groups; G-1(46)-more than 640 beds, G-2(53)-more than 500 beds, G-3(53)-more than 360 beds, and G-4(52)-less than 359 beds, respectively (parenthesis indicate hospital numbers). The number of cases of anesthesia performed by anesthesiologists were 2055(G-1), 1516(G-2), 1177(G-3) and 959(G-4), respectively. The number of anesthetists per operating table were as follows; 0.62(G-1), 0.62(G-2), 0.58(G-3) and 0.74(G-4), but remarkably low compared to the number of operating theater nurses: 5.49(G-1), 2.96(G-2), 2.82(G-3) and 3.07(G-4). Moreover, the number of emergency cases were as follows; 235(G-1), 187(G-2), 134(G-3) and 125(G-4), respectively. In prolonged surgery over 6 hours, patients were anesthetized with an exchange system or two anesthetists system in 74% of the institutions in G-1. Also, 28-50% of anesthetists in the 4 groups were concerned with intensive care medicine and 0.94-1.54 anesthetists worked in pain clinics with combined operation-theater tasks 1.37-2.49 days per week. In G-1-G-4 institutions, we found that anesthesia cases per year were equivalent to 5 times their bed numbers. CONCLUSION: We concluded that the number of anesthetists should be at least 50% of that of operation-theater nurses. Without increasing anesthesiologists, we cannot expect sophisticated medical care in the 21st century.

Anesthesiology↗
PubMed1998

[Spinal microsurgery at the thoracic to sacral level in the "prone-oblique" position].

Until the present time, almost all posterior approaches to the thoracic to sacral region have been made in either the knee-elbow or the prone position. Those positions, however, have potential disadvantages such as respiratory suppression and/or disturbance of venous return due to compression of the anterior chest and belly. In order to avoid the above mentioned disadvantages, the patient was laid on the operating table in a "Prone-Oblique" position, with the body rotating about 40 degrees around the long axis. The authors performed, with successful results, spinal operations via the posterior route in the "Prone-Oblique" position in 30 cases. An illustrative case was presented of a metastatic intramedullary tumor at the T11/12 level from an unresectable mammary cancer. The cancer had infiltrated and bulged out of the left anterior chest wall so severely and extensively that an operation in the conventional position was impossible. The metastatic tumor was totally and successfully removed via the posterior approach in the "Prone-Oblique" position without any complications related to the position. This "Prone-Oblique" position seems to be physiologically suitable, giving rise to no harmful compression of any part of the patient's body and it provides the surgeon a comfortable posture and a good operative view during microsurgery.

Adult↗
PubMed1992

Age-standardized incidence of ruptured aortic aneurysm in a defined Swedish population between 1952 and 1988: mortality rate and operative results.

The incidence and mortality rate of ruptured aortic aneurysm in a defined and stable Swedish population was determined for the period 1952-1988. The annual rupture rate of abdominal aneurysm rose significantly from 0.9 per 100,000 inhabitants in the 1950s to 6.9 in the 1980s. After standardization for age, the mortality rate increased between 1960 and 1988 by 2.4 per cent annually (95 per cent confidence interval 1.2-3.6 per cent, P = 0.0004). Comparable figures from the UK during the 1980s have been reported to be two to three times higher. The mortality rate of ruptured thoracic aneurysm in the Swedish population did not increase when adjusted for age. In the 1980s the overall mortality rate of ruptured abdominal aneurysm was 85 per cent. Death occurred outside surgical clinics in 52 per cent of cases; 37 per cent of the total number of patients with ruptured aneurysm reached the operating table but only 30 per cent underwent aortic reconstruction. Patients treated by vascular surgeons had lower blood loss and transfusion needs, shorter aortic clamp time and operation time, and lower mortality rate than patients treated by non-specialized general surgeons. Specialized vascular surgeons also completed the reconstruction, and used straight grafts, in a higher proportion of cases than general surgeons.

Age Factors↗
PubMed1988

Epidural anesthesia during lower extremity free tissue transfer.

A continuous epidural bupivacaine infusion was used for anesthesia in 20 patients who underwent lower extremity free tissue transfer. In 60 percent of the patients, general anesthesia supplementation with nitrous oxide was used for comfort during prolonged lying on the operating table. In all cases, this technique provided adequate surgical anesthesia with no obvious untoward effects. The same infusion was used in seven patients who underwent further operative procedures a few days later. This technique is simple, requires minimal or no general anesthesia supplementation, provides a perioperative and postoperative sympathectomy effect, and provides postoperative analgesia or anesthesia for as long as it is continued.

Adult↗
PubMed2003

Changes in nerve root motion and intraradicular blood flow during intraoperative femoral nerve stretch test. Report of four cases.

OBJECT: It is not known whether changes in intraradicular blood flow (IRBF) occur during the femoral nerve stretch test (FNST) in patients with lumbar disc herniation. An FNST was conducted in patients with lumbar disc herniation to observe the changes in IRBF, and results were then compared with clinical features. METHODS: The study was composed of four patients with L3-4 disc herniation who underwent microdiscectomy. Patients were placed prone immediately before surgery, so that their knee flexed on the operating table with the hip joint kept in hyperextension, and the FNST was performed to confirm at which region pain developed in the anterolateral thigh. During the operation, the hernia-affected nerve roots were visualized under a microscope. The needle sensor of a laser Doppler flowmeter was then inserted into each nerve root immediately above the hernia, and the change in IRBF was measured during the intraoperative FNST. After removal of the herniated disc, a similar procedure was repeated and IRBF was measured again. The intraoperative FNST showed that the hernia compressed the nerve roots and there was marked disturbance of gliding, which was reduced to only a few millimeters. During the test, IRBF decreased by 92.8 to 100% (mean 96.9 +/- 3.7% [+/- standard error of the mean]) relative to the blood flow before the test. This study demonstrated that the blood flow in the nerve root is reduced when the nerve root is compressed in vivo. CONCLUSIONS: The intraoperative FNST showed that the hernia compressd the nerve roots and there was marked disturbance of gliding, which was reduced to only a few millimeters. During the test, IRBF decreased by 92.8 to 100% (96.9 +/- 3.7% [mean +/- standard error of the mean]).

Adult↗
PubMed1996

Positioning the patient for surgery.

The aim of this paper is to identify some of the potential hazards involved with the positioning of the patient on the operating table prior to surgery. The development of good practice within this area is essential to both the patient and staff so helping to avoid unnecessary post operative complications for the patient and avoiding unnecessary potential problems for the staff. The UKCC guidelines are quite clear regarding the nurse's role in patient care: The nurse must always promote and safeguard the interests and well-being of the patient and ensure that no action or omission in her area of responsibility is detrimental to the patient. The nurse must have regard to the environment and its physical, psychological and social effects on the patient and to the adequacy of resources and inform appropriate authorities of any circumstances which could place the patient at risk or which militate against safe standards of practice. The nurse must endeavour to achieve, maintain and develop knowledge, skills and competence to meet the needs of the patient at all times.

Beds↗
PubMed2004

Totally endoscopic coronary artery bypass graft: initial experience with an additional instrument arm and an advanced camera system.

BACKGROUND: Robotically enhanced telemanipulation for totally endoscopic coronary artery bypass does not provide adequate tactile feedback, traction, or countertraction. The exposition of coronary target sites is difficult, the visual field is limited, and the epicardial stabilization may be troublesome. A fourth robotic arm for endothoracic instrumentation has been added to the da Vinci surgical system to facilitate totally endoscopic operations. The stereoendoscope was upgraded with a wide-angle feature. METHODS: The procedure was performed in five patients. Four of these patients had left internal thoracic artery (LITA) to left anterior descending artery (LAD) grafting on the beating heart and the fifth had sequential bypass grafting (LITA to diagonal branch and LAD) on an arrested heart. The additional effector arm of the da Vinci surgical system was brought into the operative field beneath the operating table and used as a second right arm. The wide-angle view was activated by either the console or the patient side surgeon. RESULTS: The mean operative, port placement, and anastomotic times for a beating-heart totally endoscopic coronary artery bypass were 195 +/- 58, 25 +/- 10, and 18 +/- 5 min, respectively. All procedures were free of morbidity and mortality, with satisfactory angiographic control. The sequential arterial bypass grafting procedure was fully completed in totally endoscopic technique. CONCLUSIONS: The additional instrumentation arm and wide-angle visualization are useful technical improvements of the da Vinci surgical system, solving the problem of traction, countertraction, and facilitated exposition of target sites as well as visualization of the surgical field. They provide potential for wider acceptance of totally endoscopic coronary artery bypass grafting in a larger surgical community.

Aged↗
PubMed2006

Eight years' clinical experience with the Orthofix tibial nailing system in the treatment of tibial shaft fractures.

Intramedullary nailing has become a popular and effective procedure for the treatment of most tibial fractures. However, concerns regarding difficulties with reduction, the use and extent of intramedullary reaming, and hardware failure are probably the only constraints to its widespread use. In this prospective study, we present the clinical and radiographic results of the Orthofix tibial nailing system used in the treatment of tibial shaft fractures. One hundred and fifteen fresh tibial fractures in the same number of patients with a mean age of 37.5 years (17-85 years) were treated with operative stabilisation using the Orthofix tibial nailing system. All of the operations took place in a conventional operating theatre, on a simple tranlucent operating table and with manual reduction of the fracture. In the majority of the cases closed reduction and conventional reaming were performed and the mean duration of the operation was 38 min. Fracture healing occurred at 16 weeks (11-30 weeks) and was confirmed both clinically and radiographically. In six cases (two severely comminuted and four segmental fractures) delayed union occurred, however there were no tibial non-unions necessitating re-operation. There were no substantial differences in time to fracture union or in the rate of complications related to minimal open reduction. In addition, there seem to be more benefits than risks in the use of power intramedullary reaming during intramedullary fixation of tibial shaft fractures. In conclusion, most tibial shaft fractures can effectively and safely be treated using this type of locking intramedullary nailing device, with relatively few complications, and with satisfactory long-term clinical results.

Adolescent↗
PubMed1995

[The prognostic effect of scintigraphy-guided lymphadenectomy in therapy of stage Ib cervix carcinoma].

In a retrospective study the survival rates of 161 patients with stage Ib cervical cancer after radical operation (Latzko, Wertheim-Meigs) including complete or incomplete pelvine lymphadenectomy were compared. To increase radicality of lymphadenectomy, preoperative targeting of pelvic lymph nodes was done in all the patients using 99mTc-Sb2S3 radiocolloid. Intraoperatively, a gamma-camera being integral part of an operating table allowed delineation and scintigraphy-guided resection of pelvic lymph nodes. Dependent on the evidence of remaining pelvine foci of radioactivity at the end of the operation, lymphadenectomy was assessed as complete or incomplete. Mean observation time of completely lymphadenectomised patients (n = 117,72.67%) were 80 months (5-169 months) and 42 months (1-149 months) of the incompletely lymphadenectomised patients (n = 44,27.33%). In 28 (23.93%) completely lymphadenectomised patients against only 5 (11.36%) patients with incomplete lymphadenectomy, lymph node metastases were proved histologically. Five year-survival rate of completely lymphadenectomised patients was 85.47% and 88.64% of incompletely lymphadenectomised patients (not significant, Mantel-Test). Also, selective comparison of lymph node-positive patients did not suggest a divergent trend indicated by 13 (46.43%) deaths of completely and 3 (60.0%) deaths of the incompletely lymphadenectomised patients after an observation of five years. The technique of scintigraphy-guided pelvic lymphadenectomy using 99mTc-Sb2S3 radiocolloid cannot be expected to improve prognosis of patients with cervical cancer stage Ib.

Adenocarcinoma↗
PubMed1984

Traumatic disruption of the thoracic aorta.

Fourteen cases of injury to the thoracic aorta treated in 1959-1981 are reviewed. Acute rupture was present in nine patients and chronic post-traumatic aneurysm in five. Most of the patients had other, associated injuries, and physical signs of the aortic injury were often scanty. Widening of the mediastinum was the most common roentgenographic finding. All the aortic ruptures were localized to the isthmus. One patient declined surgery. Another died on the operating table just before surgery was started. A third patient died peroperatively from severe bleeding when the aneurysm was dissected free. All of the other 11 patients survived operation without major complications. At follow-up (mean 10 years), ten patients were alive and well and one had died of unrelated cause. The most recent operations were performed with the aid of a TDMAC (Gott) shunt, which makes aortic repair safe and simple. Because aortic trauma often is accompanied by other, severe injuries which make transportation of the patient risky, and so as not to delay operation, the aortic lesions should be repaired at general surgical units. If necessary, a thoracic surgeon should be brought to the hospital.

Accidents, Traffic↗
PubMedDate not supplied

[Catheter therapy of congenital cardiovascular defects].

The authors analyze the experience gained in catheter operations performed at their Department over the recent 28 years. A total of 500 balloon (Rashkind) and 35 knife (Park) atrioseptostomies were performed in critical patients with different "blue" congenital diseases over this period. An immediate hemodynamic effect at the operation table was attained in 95% of patients. Transluminal balloon valvuloplasty (TLBVP) was performed in 372 patients with valvular stenosis of the pulmonary artery. The results of this operation depend on the patient's age, anatomy of the defect, and correct choice of the diameter of balloon catheter. This intervention is particularly effective in patients aged under 1. In patients with combined valvular and infundibular stenosis the results of TLBVP depend on the severity of stenosis and age of patient. An attempt at TLBVP of congenital aortal stenosis was undertaken in 67 patients. Valvuloplasty was carried out in 57 patients. The operation was effective in 13 (62%) out of 21 patients aged under 1. The mortality in this group was 5.5%. Balloon valvuloplasty of the pulmonary artery was carried out in 71 patients with cyanotic congenital heart diseases. The intervention helped eliminate the critical state, rise the systolic pressure in the pulmonary artery, improve blood saturation with oxygen, and evade the operation for creation of a systemic-pulmonary anastomosis. Isolated and postoperative stenoses of pulmonary arteries were removed in 65 patients. Six Johnson and Johnson stents were effectively implanted to 3 patients with rigid postoperative stenoses; in 32 patients transluminal balloon angioplasty (TLBAP) for coarctation and recoarctation of the aorta brought about a satisfactory immediate hemodynamic effect. TLBAP of Blalock-Taussig's stenosed anastomosis were performed in 60 patients with various cyanotic congenital heart diseases. Its results were good in 39 (65%) patients, satisfactory in 19 (31.7%), and unsatisfactory in only 2 (3%) cases. Of the novel endocardial interventions, dilatation of the conduit following Rastrelli's operation, creation of a defect of the atrial septum after Fontain's operation, and embolization of the coronary-cardiac fistulas and of patent ductus arteriosus were carried out. This review demonstrates wide use of endocardial surgery methods in the treatment of some congenital heart diseases; in many cases such treatment may be an alternative to surgical interventions.

Adolescent↗
PubMed1976

Bacteriological evaluation of a mobile laminar cross-flow unit for surgery, under laboratory circumstances.

A mobile laminar cross-flow unit for surgery has been evaluated by the use of an experimental bacterial aerosol of Escherichia coli in different concentrations, generated at several different sites. A separate ventilation system, mounted underneath the table, produced an almost downward directed curtain of sterile air along both sides of the table. When the velocity of the air stream, discharged by the cross-flow unit, was adjusted at 0-50 m./sec. at 2 m. from the filter face (at the head end of the operation table), the surface of the table could be maintained free of bacterial settling even after aerosolization of heavily concentrated suspensions of 10(8) bacteria/ml. at different sites outside the enclosure and underneath the table as well.

Aerosols↗
PubMed2003

Occupational exposure from common fluoroscopic projections used in orthopaedic surgery.

BACKGROUND: Personnel assisting in or performing fluoroscopically guided procedures may be exposed to high doses of radiation. Accurate occupational dosimetric data for the orthopaedic theater staff are of paramount importance for practicing radiation safety. METHODS: Fluoroscopic screening was performed on an anthropomorphic phantom with use of four projections common in image-guided orthopaedic surgery. The simulated projections were categorized, according to the imaged anatomic area and the beam orientation, as (1) hip joint posterior-anterior, (2) hip joint lateral cross-table 45 degrees, (3) lumbar spine anterior-posterior, and (4) lumbar spine lateral 90 degrees. The scattered air kerma rate was measured on a grid surrounding the operating table. For each grid point, the effective dose, eye lens dose, and face skin dose values, normalized over the tube dose area product, were derived. For the effective dose calculations, three radiation protection conditions were considered: (1) with the exposed personnel using no protection measures, (2) with the exposed personnel wearing a 0.5-mm lead-equivalent protective apron, and (3) with the exposed personnel wearing both an apron and a thyroid collar. Maximum permissible workloads for typical hip, spine, and kyphoplasty procedures were derived on the basis of compliance with effective dose, eye lens dose, and skin dose limits. RESULTS: We found that the effective dose, eye lens dose, and face skin dose to an orthopaedic surgeon wearing a 0.5-mm lead-equivalent apron will not exceed the corresponding limits if the dose area product of the fluoroscopically guided procedure is <0.38 Gy m (2). When protective eye goggles are also worn, the maximum permissible dose area product increases to 0.70 Gy m (2), while the additional use of a thyroid shield allows a workload of 1.20 Gy m (2). The effective dose to the orthopaedic surgeon working tableside during a typical hip, spine, kyphoplasty procedure was 5.1, 21, and 250 micro Sv, respectively, when a 0.5-mm lead-equivalent apron alone was used. The additional use of a thyroid shield reduced the effective dose to 2.4, 8.4, and 96 micro Sv per typical hip, spine, and kyphoplasty procedure, respectively. CONCLUSIONS: The levels of occupational exposure vary considerably with the type of fluoroscopically assisted procedure, staff positioning, and the radiation protection measures used. The data presented in the current study will allow for accurate estimation of the occupational dose to orthopaedic theater personnel.

Fluoroscopy↗
PubMed1997

A new table-fixed soft tissue retractor for the anterior cervical spinal surgery.

Since surgeons sometimes encounter difficulty in keeping self- retaining soft tissue retractors in the proper position for anterior cervical spinal surgery, we have developed a new, simple soft tissue retractor system, which is fixed to the side rails of the operating table via retractor stands. All three joints of the retractor can be tightened simultaneously with a single handle. Each of two retractor blades can keep its position independent of the other thereby maintaining a well-exposed operative field for a long period of time. Fine adjustments of the blade position, after fixation of the retractors, is possible by sliding the head of the blade assembly along the axis of a ratchet mechanism. We have used these retractors in 43 surgical exposures, including 35 for anterior cervical fusion, 2 for posterior thoraco-lumbar decompression, and 6 for carotid endarterectomy. There have been no complications related to tissue damage.

Cervical Vertebrae↗