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At least 739 records · Page 41Linked to original sources
PubMed2001

A soft dual-port trocar for endoscopic subcutaneous surgery.

BACKGROUND: We developed a new trocar for endoscopic subcutaneous surgery and tested it in subfascial endoscopic perforator surgery (SEPS) for varicose veins of the lower leg. METHODS: The soft trocar is a y-shaped polyvinyl chloride bag equipped with two ports at one end and a flexible ring at the other end. We performed SEPS on 12 patients through a 2-cm incision below the knee. After dissection of the subfascial plane, the ring of the trocar was inserted beneath the fascia, and the subfascial cavity was inflated with CO2 gas. The perforating veins were divided with UltraShears (Autosuture, USSC, Norwalk, CT, USA) inserted through the second port of the trocar with an endoscope. RESULTS: There were no major device-related difficulties or wound complications. CONCLUSION: The soft trocar allowed both an endoscope and a surgical instrument to be inserted simultaneously in the tissue space through a single incision. This useful instrument may have applications in other endoscopic surgical procedures.

Carbon Dioxide↗
PubMed2001

Development of micro-active forceps for future microsurgery.

A new eye microsurgical system is proposed. The final goal of our research project has been not only to improve surgical instruments, but also to establish a total surgical system applicable to today's most difficult microsurgery, within the eye. The new prototype micro-forceps, which have a joint that enlarges the surgical area and a built-in thin optical fibrescope to increase the dexterity of retinal microsurgery, was designed as the first step in a long-term research plan. The micro-active forceps is equipped with a thin optical fibre inside the stem, giving a lateral view of the retina and a drastic improvement in fine operations. Moreover, this new tool, with an active joint and an end-effector, could find application in other microsurgical fields, such as in the brain, ear, nose and throat.

Journal Article↗
PubMed1994

Open tube thoracoscopy for removal of intrapleural foreign bodies.

Failure to remove all sponges and surgical instruments from the operative field after thoracic surgical procedures can lead to serious complications. Fortunately this occurrence is rare and preventable. Two patients are described in whom intrapleural foreign bodies were successfully removed by open tube thoracoscopy, a technique that the authors recommend as the procedure of choice in such cases.

Child, Preschool↗
PubMed1996

[History of the ear speculum. Images from the history of otorhinolaryngology, highlighted by instruments from the collection of the German Medical History Museum in Ingolstadt].

BACKGROUND. Inspection of or interventions in the external ear canal and the nostrils pose similar technical problems. This is the reason why early instruments devised for otoscopy and rhinoscopy were based on an identical principle. They were shaped like a pair of tongs, comparable to nasal specula of today. A similar type of instrument had been developed earlier by barber surgeons for inspecting narrow wound cavities. TONG-SHAPED SPECULA. The first description and illustration of an aural and nasal speculum was provided by Guy de Chauliac in Montpellier, France in 1363. Sophisticated models were presented by Fabricius Hildanus in Germany in 1646 and J.J. Perret in Paris in 1772, who offered them in his illustrated catalogue of surgical instruments at fixed prices. W. Kramer (1836) in Berlin improved this tong-shaped instrument and devised the ear speculum named after him that was generally favored during the first half of the 19th century. Further variations of this type were presented by Lincke and Schmalz (1846) in Germany. FUNNEL-SHAPED SPECULA. Ignaz Gruber in Vienna in 1838 devised the first tunnel-shaped ear specula made of metal. They had a simple conical shape, were not divided into separate jaws, and could not be spread. Gruber himself did not publish his invention, but he demonstrated his ear specula to W. R. Wilde from Dublin, who had paid a visit to his office in Vienna. Wilde reported on this in 1844, and subsequently systematically refined Gruber's specula. A. v. Tröltsch from Würzburg (Germany) had seen these instruments at Wilde's office and it was Wilde himself and v. Tröltsch who helped this type of ear speculum to gain acceptance on an international scale. A different type of bottle-shaped ear speculum was first used by Schmalz (1846) and Erhard (1859) in Germany, but it was only developed into a commercially available instrument by Josef Gruber in Vienna in 1870. The ear specula most in use today were first presented by A. Hartmann in Berlin in 1881. SUPPLEMENTARY INVENTIONS. An important supplementary invention was the pneumatic ear speculum by E. Siegle in Stuttgart (Germany) in 1864. It permitted not only inspecting the tympanic membrane but also examining its compliance and response to variations in air pressure in the ear canal. The importance of this instrument was recognized at once and has remained undisputed to this day. J. Bruton, an English military surgeon, presented his otoscope in 1862. It was the first device to incorporate interchangeable ear specula, illumination by a perforated mirror, and a magnifying lens into one handy instrument. It is the precursor of the modern diagnostic sets comprised of a battery-handle, various specula, and accessories for otoscopy, rhinoscopy, and ophthalmoscopy which started to come into use in the late twenties of this century. This historical development of the ear specula is described and illustrated in detail.

Endoscopy↗
PubMed1990

Toxic endothelial cell destruction of the cornea after routine extracapsular cataract surgery.

Eighteen patients developed an acute corneal decompensation following normal intraocular surgery (cataract extraction in 17 patients), characterized by star-shaped endothelial folds, a twofold increase in corneal thickness, and a visual acuity of counting fingers during several postoperative days. In some cases, there was an additional iritis and transient hypotony. There was no effect of topical and/or subconjunctival corticosteroids on the course of the decompensation. Endothelial morphometric analysis showed a mean endothelial cell loss of 72%. Endothelial wound healing, as determined by coefficient of variation and percentage hexagonals, stabilized 6 months postoperatively. We coined the term toxic endothelial cell destruction for this syndrome. Epidemiological evaluation revealed the toxic endothelial cell destruction syndrome to be linked with the 10-fold increase of a detergent solution in the ultrasonic bath for cleaning the surgical instruments.

Aged↗
PubMed1997

Establishment of normal values of nasal choanal size in children: comparison of nasal choanal size in children with and without symptoms of nasal obstruction.

Twenty-eight pediatric patients between the ages of 2 and 13 years underwent intraoperative measurement of the nasal choanae using an instrument custom designed for this purpose by the Pilling Surgical Instrument Company. Additional data points recorded included age, surgical procedure, and the presence or absence of nasal obstructive symptoms which was determined by carefully questioning parents or guardians. Results were analyzed using linear regression, analysis of variance, and logistic regression. Data supported the following conclusions: (1) a linear relationship exists between age and average choanal size with the choanae enlarging at a rate of 0.208 +/- 0.09 mm per year (P < 0.03, r2 = 0.16); (2) there is no significant difference between the average choanal size in children with and without nasal obstructive symptoms; (3) the size of the posterior choanal air space cannot be used to accurately predict the presence or absence of nasal obstructive symptoms in children between the ages of 2 and 13 years.

Adolescent↗
PubMed1984

Shaving of the lumbar disk space--a new technique in lumbar nucleotomy.

A complete curettage of the intervertebral space using the common surgical instruments (forceps, sharp spoons) is not possible during nucleotomy because of the anatomic site and the shape of the instruments. An alternative technique--called "shaving"--is described, which enables a faster, more effective, and less traumatizing removal of free-floating, pulpy residue in the intervertebral space.

Humans↗
PubMedDate not supplied

Castroviejo's square corneal grafts.

The evolutionary history of the modern day keratoplasty technique is filled with numerous attempts to implant all manner of material using very creative surgical techniques. Many different shapes of incisions were tried. Castroviejo introduced a square shaped keratoplasty technique which had considerable success. He also introduced new surgical instruments which made the procedure easier to perform. This technique remained popular until the 1950s when improved instrumentation along with the demand for the most cosmetically pleasing result displaced the square keratoplasty technique as the keratoplasty procedure of choice.

Animals↗
PubMed2003

The use of lasers for treatment of upper respiratory tract disorders.

Lasers have become important tools for the equine surgeon in the treatment of upper respiratory tract disease in the horse. Multiple wavelengths and delivery systems are available. Indications for the use of lasers in the upper respiratory tract primarily include minimally invasive procedures not possible with conventional surgical instrumentation. New applications for the use of lasers to treat upper respiratory disease are likely to evolve with the development and introduction of new wavelengths and delivery systems.

Animals↗
PubMedDate not supplied

[The diagnosis and method of surgical treatment in dislocation of the brain under the falx cerebri in craniocerebral trauma].

In 6.6% of cases a severe craniocerebral trauma is accompanied with dislocation of the brain under the falx cerebri with incarceration of the cingulate gyrus. The diagnosis of dislocation under the falx in intracranial traumatic hematoma and brain contusion-crushing is discussed. Falxotomy may be among the methods for the prevention or correction of incarceration of the cingulate gyrus. The authors suggest an operative approach for performing falxotomy with little injury as well as a surgical instrument for one-stage clipping of the inferior sagittal sinus and its division.

Acute Disease↗
PubMed1978

Costly materials retrieved from laundry chutes.

About +47,000 in replacement costs have been saved since the hospital instituted a plan to retrieve materials that are inadvertantly deposited in laundry chutes with soiled linens. Scissors, hot-water bottles, and rubber pillows, as well as a variety of expensive surgical instruments and clamps, are now placed in boxes at sorting sites at the hospital's laundry.

Costs and Cost Analysis↗
PubMed1976

Lacrimal trephine.

This article introduces a surgical instrument that facilitates treatment of obstructions of the common canaliculus or the internal canalicular punctum and which can be used with failure of dacryocystorhinostomy secondary to a membrane formation in the area of nasolacrimal anastomosis.

Dacryocystorhinostomy↗
PubMed1994

[Extraction of orbital foreign bodies using a new kind of image processing system].

We present a new localization system in orbital surgery. The procedure is based on the linkage of two methods. A preoperative thin-layer CT scan is taken and the image data are fed into a high-capacity computer which computes a three-dimensional model of the orbit. Intraoperatively, the volume model of the skull is linked to a mechanical arm for position measurement. Surgical instruments can be mounted to this arm. The computer then projects the position of the instrument into the volume model of the orbit, so that the surgeon can follow the movements of his instruments on the monitor. The surgeon has a means of checking position that comes close to constant intraoperative CT monitoring. Thereby the surgeon is able to localize even small foreign bodies without extensive explorations. We present six patients in whom orbital foreign bodies had to be extracted during the past 5 years. A 44-year-old man had an iron foreign body; the external wound was treated surgically elsewhere. Two patients (25 and 22 years old) had glass foreign bodies; in one of them the splinters were not seen using conventional X-ray. Choosing the exact level with the Hounsfield window, the foreign bodies could be demonstrated on the monitor. In three patients with orbital fractures and compression of the optic nerve, dislocated bone splinters were extracted. The localization of those splinters was easy using the imaging system, but would have been rather difficult by other means.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2000

History offhand: a golfer's needleholder.

Sir Harold D. Gillies was the father of modern plastic surgery. Apart from being an extraordinary surgeon, he was an innovator of surgical instruments and an outstanding golfer. He adopted Kocher's suture scissors and converted them for needleholding. The authors believe that the surgeon Gillies adapted this needleholder to fit his golfer's hand.

Equipment Design↗
PubMed2003

Creutzfeldt-Jakob disease--identifying prions and carriers.

Two major obstacles to be overcome in minimizing the possibility of transmitting Creutzfeldt-Jakob disease or variant Creutzfeldt-Jakob disease are associated with identifying the prion on disinfected surgical instruments and identifying carriers of the protease-resistant form of the prion. New developments indicate that the means for doing both soon may be available.

Adult↗
PubMed2003

A new, miniature ultrasonic surgical aspirator with a handpiece designed for transsphenoidal surgery. Technical note.

The authors describe an innovative surgical instrument designed to remove hard fibrous masses from the pituitary region, which cannot be completely removed using standard transsphenoidal surgical procedures. The innovative features of the instrument include a miniature ultrasonic surgical aspirator and an extra-long bayonet handpiece with a 1.9-mm-diameter translucent tip. Intraoperative use of this refined device may increase the effectiveness of the removal of fibrous lesions within a narrow operative field, while also preserving surgical safety.

Craniopharyngioma↗
PubMedDate not supplied

Novel methods for disinfection of prion-contaminated medical devices.

BACKGROUND: The unique resistance of prions to classic methods of decontamination, and evidence that prion diseases can be transmitted iatrogenically by medical devices pose a serious infection control challenge to health-care facilities. In view of the widespread tissue distribution of the variant Creutzfeldt-Jakob disease agent in human beings, new practicable decontamination procedures are urgently needed. METHODS: We adapted an in-vivo method using stainless steel wires contaminated with prions to the hamster-adapted scrapie strain 263K. A new in-vitro protocol of surface contamination compatible with subsequent biochemical detection of PrP(res) (protease-resistant form of the prion protein) from the treated surface was developed to explore the mechanisms of action of methods of decontamination under test. These models were used to investigate the effectiveness of innovative physical and chemical methods of prion inactivation. FINDINGS: Standard chemical decontamination methods (NaOH 1N, NaOCl 20000 ppm) and autoclaving in water at 134 degrees C reduced infectivity by >5.6 log10 lethal doses; autoclaving without immersion was somewhat less effective (4-4.5 log reduction). Three milder treatments, including a phenolic disinfectant, an alkaline cleaner, and the combination of an enzymatic cleaner and vaporised hydrogen peroxide (VHP) were also effective. VHP alone, which can be compatible with electronic components, achieved an approximately 4.5 log reduction in infectivity (equivalent to autoclaving without water immersion). INTERPRETATION: New decontamination procedures are proposed to ensure the safety of medical and surgical instruments as well as surfaces that cannot withstand the currently recommended prion inactivation procedures.

Animals↗
PubMed1989

[CAS (computer assisted surgery). A new procedure in head and neck surgery].

Computer assisted surgery (CAS) is a new imaging technique designed to assist the head and neck surgeon during surgery. This method is based upon a three-dimensional volume model of the patient's skull generated by computer tomographic imaging procedures such as CT and MR. Body points can be marked in the 3-D model by intra-operative correlation of model and patient using a volume digitizer. Real-time positioning of surgical instruments without visual control can be achieved. The use of the system in surgery of the skull base, orbit and the paranasal sinuses is demonstrated.

Computer Simulation↗