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At least 721 records · Page 40Linked to original sources
PubMed1993

The efficacy of acetone in the sterilisation of ophthalmic instruments.

Acetone has been considered a quick, effective and less expensive chemical sterilising agent and continues to be used by ophthalmic surgeons, at least in developing countries. Its utility however has been questioned recently. This study was designed to assess the efficacy of acetone against Pseudomonas aeruginosa, Bacillus subtilis and Aspergillus flavus present on ophthalmic surgical instruments (forceps, sutures). The instruments were contaminated by immersion in standard suspensions of the organisms and thereafter were either unwashed (group-I), washed and dried (group-II) or only washed (group-III) before immersion in acetone. The exposure to acetone was kept at 3, 10 and 20 minutes in each group. The results showed that acetone could eliminate Pseudomonas (vegetative bacteria) after 10 minutes exposure in unwashed group and 3 minutes exposure in washed groups. It was ineffective against spore bearing bacteria (B. subtilis) and fungus (Aspergillus flavus) even after 20 minutes of exposure.

Acetone↗
PubMed2002

Infection control: preventing iatrogenic transmission of spongiform encephalopathy in Danish hospitals.

The Danish infection control guidelines dealing with transmissible spongiform encephalopathy (TSE) recognise that preventive measures to avoid iatrogenic transmission must be taken, though the risk for patients in Danish hospitals can be characterised as minimal. A minimal risk situation cannot meanwhile be maintained unless hospitals and other healthcare institutions are prepared and have effective and well-functioning decontamination procedures in place suited for the purpose. The guidelines recommend that staff both in the operating theatre and in the Central Sterile Supply Department (CSSD) must be able to apply the procedures needed for safe handling and decontamination of used instruments. These include cleaning and effective sterilisation, as well as quarantine procedures and ways to discard and incinerate certain used instruments. The guidelines also address occupational safety, and single-use instruments are recommended where these are available and can be safely used. Effective procedures for decontamination of instruments and other medical devices are identified as the key to prevention of iatrogenic spread of TSE. Hospitals are advised to have their sterilisers and other equipment professionally checked in order to make sure that specific procedures for safe handling and decontamination of used surgical instruments and other medical equipment are available in case of suspected or confirmed TSE.

Decontamination↗
PubMed1994

Electromagnetic field focusing instrument augments resection of meningiomas.

The electromagnetic field focusing (EFF) surgical instrument creates an oscillating electromagnetic field that induces eddy currents in the tissue, which converge at the point of contact. This energy creates a focal spark capable of vaporizing tissue. The EFF instrument was used to resect 17 meningiomas in 14 patients. The effectiveness of the EFF probe in resecting tumor tissue was compared with that of the Cavetron ultrasonic surgical aspirator (Model 100) in 11 patients. The EFF system was superior to the Cavetron ultrasonic surgical aspirator in tumor excision in all but two cases, in which the EFF grounding tip was poorly tuned. Surgical time and blood loss were reduced by subjective analysis in all but these two cases, especially in the rubbery or calcified meningiomas resistant to aspiration. No complications were directly attributable to use of the EFF. Drawbacks encountered with the EFF system include buildup of "char" on the tip, requiring scraping, and intense heat at the tip, which occasionally melted the insulating sheath, requiring replacement.

Adult↗
PubMed2004

Effect of fixation of shoulder and elbow joint movement on the precision of laparoscopic instrument manipulations.

BACKGROUND: Motion analysis of the upper limb and the surgical instruments is used for objective assessment of endoscopic manipulations. The aim of this study was to investigate the effect of fixation of shoulder and elbow joint movement on the precision of laparoscopic instrument manipulations. METHODS: Two experiments were conducted to correlate hand movement with instrument tip during free and restricted movement of the shoulder and elbow joints. A three-dimensional infrared optical tracking system has been used. Five subjects participated in the study, and each completed the range of movements twice. End points were velocity (m/s), angular velocity (r/s) and acceleration (m/s2). RESULTS: There was a weak correlation for all end points between the instrument tip and individual joint movement during free upper limb movement (r < 0.4). With restricted movement of the shoulder and elbow joints, the correlation between hand movement and instrument tip was found to be good for the velocity (r = 0.66 for flexion; r = 0.72 for abduction; r = 0.56 for supination) and angular velocity (r = -0.83 for flexion; r = -0.48 for abduction; r = -0.70 for supination), but weak for the acceleration (r < 0.4). CONCLUSIONS: The characteristics of hand movements do not correlate with movement of the laparoscopic instrument tip when the upper limb is unsupported. The precision of laparoscopic surgical manipulations is increased if both joints (shoulder and elbow) are supported.

Elbow Joint↗
PubMed2002

[Surgical procedures improvements thanks to navigators and robots].

Navigator is a three-dimensional C-T scan image localization device, which supplies the surgeon with a real time relationship of surgical instruments with pathological lesion and vital organs. Robot controls surgical devices movements according to a various sophisticated programming, in order to palliate the imperfection of their manual use. Navigators and robots, frequently connected, allow a precise control of the instruments course, improving accuracy and efficiency of most surgical procedures. It is necessary to contribute to their improvement and development, taking in count the economic, ethic and legal problems which may be encountered.

Equipment Design↗
PubMed1998

[A manual boring device for Kirschner wires].

A new surgical instrument is presented that is designed for manual placement of Kirschner wires. Its construction is based on that of a micro-screwdriver. The whole instrument is cannulated for wires of any length up to a gauge of 1.2 mm. This instrument facilitates smooth placement of Kirschner wires in difficult situations, especially in hand surgery.

Bone Wires↗
PubMed1975

Minimal internal fixation of tibial fractures.

Flexible wire and small pins cause minimal disturbance of osseous blood supply, and introduce minimal foreign material into the wound. Supplemental support by a plaster cast or by traction is required, but the external support can generally be discontinued early for joint mobilization. Several simple auxillary fixation devices extend the usefulness of wire fixation. Removal of metal is not required. Many common fractures of the tibia are amenable to this method of minimal internal fixation. In the diaphysis, long oblique fractures are the most suitable for this application; the firmness of their fixation by cerclage is augmented by muscle pull. Rotation is effectively controlled by a plate which is L-shaped in cross section, and is held in position by cerclage. In the metaphysis, articular fractures of the knee and ankle are securely fixed by a flattened loop of wire and two washers (wire-washer set), supplemented sometimes by pins or hand-made staples. Two pins alone provide excellent fixation of the medial malleolus. A single pin, or a single wire loop through drill holes, may be sufficient to impart stability to an unstable tibial fracture. A key-type graft of iliac bone, maintained by crossed wire loops through cortical drill holes, is effective in the tibial diaphysis. Autogenous iliac cancellous chips provide minimal and effective internal fixation for an infected ununited fracture of the tibia. The surgical instrument most important for making wire fixation highly successful is a tightener-twister which protects wire loops from excessive strain during application, and permits twisting at a predetermined and therefore reproducible tension. Other special and ordinary instruments are valuable assets.

Adult↗
PubMed1995

Gynecology in Pompeii.

By tracing the proveniences of the Greco-Roman surgical instruments in the Naples Museum, it is possible to identify sites in Pompeii where surgeons were active. Some of these sites attract special attention owing to the intricacy and quantity of the tools in their instrumentaria. In a few cases a surgical specialty is apparent. Into this category fall three houses that can be associated with the practice of gynecology.

Female↗
PubMed2002

The rate of instrument breakage during orthopaedic procedures.

The current study investigates instrument breakages during both emergency and elective orthopaedic surgery. Over a 2 year period a total of 7,775 procedures were performed. We found that 14 instruments were broken during 12 operative cases. Drill bits accounted for the largest proportion of breakages (11/14), and a specialist registrar was the lead surgeon in the majority (8/12) of cases. Only one case had a consultant as the lead surgeon. In seven cases the broken bit of the surgical instrument was left in the patient. Documentation of this peri-operative complication was deficient, and the patient was often not informed.

Adolescent↗
PubMed2002

Broken blade in the knee: A complication of arthroscopic meniscectomy.

Arthroscopic surgery has a very low incidence of intraoperative complications. However, while the authors were using a No. 11 blade to resect the anterior horn of a meniscus, the blade broke and the fragment flew into the posterior knee compartment. The only way to remove it was to make an incision over the popliteal area. We describe this complication to show that improvisation and use of inappropriate surgical instruments can lead to serious problems and the failure of arthroscopic procedures.

Adult↗
PubMed1993

Comparative gross and histological effects of the CO2 laser, Nd-YAG laser, scalpel, Shaw scalpel and cutting cautery on skin in rats.

Surgical instruments capable of sealing blood vessels while incising skin were compared to standard scalpel incisions in rats and the resultant scars examined in the early stages of wound healing for both gross and histological appearances. Those instruments which provide for hemostasis appear to do so with a delay in the early phases of wound healing.

Animals↗
PubMed2000

[Theodor Emil Kocher, modern surgery pioneer].

Theodore Kocher was awarded the Nobel Prize in 1909 for his work on the physiology, pathology and surgery of the thyroid gland. He was the first Swiss citizen and the first surgeon to ever receive such a distinction. He was a pioneer and a world leader in the surgical revolution of the end of the nineteenth century. After graduation in 1865, he traveled in Germany, England, France and Austria to observe the work of Langenbeck, Paget, Wells, Nelaton, Billroth.... In 1866, he returned to Bern and was appointed assistant in the surgical clinic of Lücke. In 1872 he applied for the succession of Lücke. After a lively debate, he was appointed by the Board of Regents against the recommendation of the faculty who wished to nominate a German surgeon, König. It proved to be a good choice, as, over a period of 45 years, Kocher developed a considerable activity in various fields of surgery leading to world-wide acclaim and renown. Kocher's most significant contribution to medicine concerned the thyroid gland. He considerably improved thyroid surgery. His anatomical knowledge, precise operating technic and respect of the aseptic principles defined by Lister, whom he had met in Glasgow, contributed to a reduction of mortality from 13% to 0.18%. He described postoperative hypothyroidism, which he called cachexia strumipriva and concluded that total thyroidectomy was not indicated in benign diseases. When he died, more than 7,000 thyroidectomies had been performed in his clinic. Kocher was also interested in orthopedics, abdominal and genitourinary surgery, surgical oncology, neurosurgery (Cushing conducted experimental research with him). He developed or modified many surgical instruments. He conducted a large number of experimental studies and published 249 articles and books.

Endocrinology↗
PubMedDate not supplied

Imaging of surgical paraphernalia: what belongs in the patient and what does not.

Many radiologists are not familiar with the names of various instruments, surgical sponges, and needles that may be seen on intraoperative and postoperative radiographs. These devices may be intentionally placed for localization or therapeutic intervention, discovered on radiographs obtained to evaluate incorrect sponge or needle counts, or incidentally encountered on postoperative radiographs. These paraphernalia are usually described in vague nonspecific terms in radiology reports. In this article, photographs and radiographs of several instruments commonly used for intraoperative localization or therapy are presented, as well as examples of sponges, needles, and other devices that should not be found on postoperative radiographs. Familiarity with their appearances will allow a more precise and knowledgeable description in radiology reports.

Foreign Bodies↗
PubMed1993

[Value of somatosensory evoked potentials in spinal surgery monitoring in children and adolescents: 110 cases].

This study shows the results obtained in 110 patients, children and adolescents by monitoring somatosensory evoked potentials during spinal surgery: Cotrel-Dubousset instrumention, surgical anterior correction by plating, spondylolisthesis and hemivertebra surgery. The recordings were made in preoperative, peroperative and postoperative period; the anaesthetic and electrophysiological conditions allowed us to obtain reliable recordings. In the peroperative period, the recordings were made: after induction of anesthesia and exposure of the spine, after instrumentation, after maximum traction and at the end of the operation. Analysis of the peroperative somatosensory evoked potentials (PESEP) showed significant differences in latencies, but also in amplitudes and morphology during distraction in scoliosis or spondylolisthesis. These impairments gradually improved and recovered their normal values at the end of the operation. The impairments were, with equal correction, 4 times more important in Cotrel-Dubousset instrumentation than in surgical anterior correction by plating. During instrumentation and in two cases, the impairments observed led the surgeon to change his operative behavior, certainly avoiding a postoperative neurological disorder, the "wake-up test" was made in one case. The correlation between the neurological problems, and the impairments of the potentials allowed us to define alarm criteria, and if they persist the "wake-up test" becomes necessary.

Adolescent↗
PubMed1995

Using shape-memory alloys.

Design considerations and material selection play important roles in the development of surgical instruments for minimally-invasive procedures. Substituting shape-memory or superelastic metals or alloys for conventional materials can lead to a significant improvement in the overall performance of those instruments. In addition, simplicity of design, a reduced number of parts, and ease of assembly and disassembly result in cost reductions.

Alloys↗
PubMed2005

Usefulness of a single trocar for intrathoracic anastomosis during open thoracic surgery for esophageal cancer.

When patients with esophageal cancer undergo intrathoracic anastomosis after esophagectomy in our institution, we resect the lesser curvature in the thorax using a surgical instrument after circular-stapled esophagogastric anastomosis. We then place the trocar in the seventh intercostal space on the midaxillary line, except in fifth intercostal anterolateral thoracotomy. A linear stapler applied through the thoracotomy sometimes blocks the operator's view, and so it is not so easy to operate with a rather big head in the thorax. We operate a linear cutter for laparoscopic surgery through the trocar. With this method, the instrument is used in good position in respect to the operator's view, and access to the gastric tube is easy. Moreover, we can adjust the resectional angle with this instrument by using the bending mechanism in its shaft. Furthermore, we can reuse the trocar site for the chest tube.

Anastomosis, Surgical↗
PubMed1982

Two per cent glutaraldehyde: a disinfectant in arthroscopy and arthroscopic surgery.

Arthroscopes and some instruments for arthroscopic surgery were prepared for use by soaking them for fifteen minutes in a cold solution of 2 per cent glutaraldehyde. This method was practical, economical, safe, and effective. Over a eight-year period we performed 12,505 arthroscopic procedures with an infection rate of 0.04 per cent. Although technically classified as a disinfectant, 2 per cent glutaraldehyde used under these conditions proved to be an effective method of preparing arthroscopic surgical instruments and was less damaging to these instruments than methods involving sterilization by steam.

Aldehydes↗
PubMed1982

Treatment of osteochondritis dissecans and cartilaginous fractures of the knee by osteo-cartilaginous autografts.

Osteochondritis dissecans and cartilaginous fractures of the knee joint are lesions in which, on removal of the necrotic areas of cartilage, extensive loss of substance may result, such as to limit joint function and be a predisposing cause of arthrosis. In such cases it is suggested that, in addition to curettage of the necrotic focus, an autograft of cartilage and spongy bone should be used, obtained from another part of the condyle of the same knee which is not weight bearing. The surgical technique used in fifteen such cases is described, and in particular the surgical instruments which when suitably prepared make this an easy and safe operation. The follow up was two years.

Adolescent↗