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At least 55 records · Page 3Linked to original sources

Digital angiography using hand-operated table movement for vascular disease of the pelvis and lower extremities.

We developed a new technique using hand-operated table movement during digital angiography (DA) for the study of vascular disease of the pelvis and lower extremities. Digital video memory (DVM) is used in this technique to digitize, record, and display fluorographic images without subtraction in real time. This allows free table movement and the imaging of a large area with a single injection of contrast medium. Forty-five examinations for vascular disease of the pelvis and lower extremities were performed by this DA technique. Good images of an extensive area from the lower abdomen to the lower leg were obtained in a single study.

Aged↗

[Symptoms of difficult interpretation or of unusual practical finding in pneumology. Error in the therapeutic indication in pulmonary diseases. Surprises at the operating table in thoracopulmonary surgery].

The most recent reports on the subject of "Hard to interpret or exceptional pneumopathies. Errors in pneumological symptomatology. Surprises at the operating table" are discussed. Attention is called to innovations in radiological and isotopic technique and to new possibilities for surgical, diagnostic or resolutive action. Personal cases of lung diseases classifiable within the subject are presented and discussed. Cases were part of isolated groups, some observed at the Saint-Feyre Centre in France, and are given as an appendix to the present publication. The intention is to lay stress on the justifiable embarrassment, or otherwise, and the responsibilities of the chest and lung surgeon. Emphasis is laid on the complexity of pulmonary surgical symptomatology.

Adult↗

An ergonomic study of the optimum operating table height for laparoscopic surgery.

BACKGROUND: Laparoscopic surgery requires the use of longer instruments than open surgery, thus changing the relation between the height of the surgeon's hands and the desirable height of the operating room table. The optimum height of the operating room table for laparoscopic surgery is investigated in this study. METHODS: Twenty-one surgeons performed a two-handed, one-fourth circle cutting task using a laparoscopic video system and laparoscopic instruments positioned at five instrument handle heights relative to subjects' elbow height (-20, -10, 0, +10, and +20 cm) by adjusting the height of the trainer box. Subjects rated the difficulty and discomfort experienced during each task on a visual analog scale. Skin conductance (SC) was measured in Micromhos via paired surface electrodes placed near the ulnar edge of the palm of the right (cutting) hand. The mean electromyographic (EMG) signal from the right deltoid and trapezius muscles was measured. Arm orientation was measured in three dimensions using a magnetometer/accelerometer. Signals were acquired using analog circuitry and digitally sampled using a National Instruments DAQCard 700 connected to a Macintosh PowerBook 5300c running LabVIEW software. Statistical analysis was carried out by analysis of variance and post hoc testing. RESULTS: Statistically significant changes were found in the subjective rating of discomfort (p <0.002), deltoid EMG (p <0.0006), trapezius EMG (p <0.0001), and arm elevation (p <0.0001) between instrument handle heights. SC values and task times did not change significantly. Discomfort and difficulty ratings were lowest when instrument handles were positioned at elbow height. EMG values and arm elevation all decreased with lower instrument height. CONCLUSION: This study suggests that the optimum table height for laparoscopic surgery should position the laparoscopic instrument handles close to surgeons' elbow level to minimize discomfort and upper arm and shoulder muscle work. This corresponds to an approximate table height of 64 to 77 cm above floor level. A redesign of current operating room tables may be required to meet these ergonomic guidelines.

Equipment Design↗

In situ pinning of hip for stable slipped capital femoral epiphysis on a radiolucent operating table.

Patients with stable slipped capital femoral epiphysis (SCFE) usually can ambulate at the time of diagnosis. Satisfactory results have been reported after percutaneous in situ pinning using a fracture table. The authors describe a technique to determine the skin-pin entry point for percutaneous pinning of the hip on a regular radiolucent operating table. The pin entry point determined by this modified method was reliable in 15 SCFEs in 13 patients. Pinning on a regular radiolucent table was much easier, without the need to transfer obese patients to a fracture table. It was also useful when a bilateral pinning procedure was performed using single draping. Obtaining modified frog-leg lateral radiographs in patients with a stable SCFE was not associated with avascular necrosis or chondrolysis.

Adolescent↗

[The operating table].

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Equipment and Supplies, Hospital↗

[Postoperative antero-external tibial compartment syndrome: co-responsibility of the operating table].

A 26-year-old, ASA1 patient underwent maxillofacial surgery under general anaesthesia, of 12-hour duration in the supine position. Postoperatively he developed rhabdomyolysis and acute renal failure. In the subsequent days, a bilateral leg compartment syndrome occurred with anterior tibial motor nerve injury requiring fasciotomies and excision of necrotic muscles. Several aetiological factors may have contributed to this accident: a long-lasting procedure, controlled hypotension and inappropriate position of the lower limbs. A laboratory study showed that the hardness of some new operating tables could be responsible for this complication. Some prophylactic measures are therefore required before the use of such devices.

Adult↗