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At least 757 records · Page 42Linked to original sources
PubMed1999

Video-assisted thoracoscopic closure of the delayed bronchial rupture after thoracoscopic resection of mediastinal bronchogenic cyst.

Video-assisted thoracoscopic surgery (VATS) is an effective and less invasive modality for management of mediastinal disorders, but various complications can result from the procedure. This report describes a case of delayed rupture of the bronchus intermedius which occurred on postoperative day 1 after the patient underwent complete thoracoscopic removal of a mediastinal bronchogenic cyst (BC) with pericystic adhesions to the bronchus. The bronchial rupture was successfully treated by conventional surgical instruments through limited thoracotomy with video-assisted thoracoscopic guidance. In recognition of this possibility, VATS for a BC with adhesions should be carefully performed. Additionally, the role of VATS in bronchial repair is beneficial.

Adult↗
PubMed1983

[Transanal endoscopic surgery of the rectum - testing a new method in animal experiments].

Surgery of the lower third of the rectum can be done without difficulty through the anus using an endoscopical approach. Polyps or tumors located in the upper two thirds of the rectum can be removed using the Mason or Kraske procedure, or by the transabdominal approach. A new endoscopic technique has been developed with the aim, to allow surgery in the whole rectum through the anus. The rectum is being dilated by mechanical means and air insufflation. An oblique angle stereoscopic endoscope as well as modified surgical instruments are used. In animals 47 excisions of mucosa were done, and the incisions were closed by continuous suture. Application of this technique in a clinical setting is planned.

Anal Canal↗
PubMed2001

From sterile debate to burning issue: the economics and safety dichotomy.

Surgical instruments are thought to be capable of transmitting spongiform encephalopathies from patient to patient, even after sterilisation. At the same time, there is an increasing trend to reuse devices intended for single use. This article discusses certain aspects of that apparent contradiction.

Bacterial Infections↗
PubMed1981

Hepatic resection. Pillars of success built on the foundation of 15 years of experience.

Two hundred eight-eight hepatic resections performed over the past 15 years are discussed. The safety and success achieved are attributed to the original work in Malaysia on the anatomy of the liver and its anomalies, the use of surgical instruments specially designed for hepatic resection, various types of resections devised and studies on aids to liver regeneration after resection. The diversity of the principles and practice of surgery in the Western countries compared with those in Malaysia is illustrated.

Calculi↗
PubMed1995

Estimating the true costs of disposable and reusable instruments.

The real issue in the debate about reusable versus disposable surgical instruments is the true cost and efficacy of specific instruments. Each device needs to be scrutinized on its own merits and analytically compared to other instruments. The goal of this case study was not to promote one type of instrument over the other but to focus on some of the data elements and complex issues involved in determining true costs, cost-effectiveness, and efficacy of the reusable and disposable instruments.

Costs and Cost Analysis↗
PubMed1994

Artifacts in magnetic resonance imaging of the spine after surgery with or without implant.

Magnetic resonance (MR) imaging is often disturbed after spine surgical procedures with or without an implant. Artifacts are induced by ferromagnetic or nonferromagnetic implants and devices and by small metallic particles left by surgical instruments. All metallic artifacts can affect the quality and usefulness of postoperative spine MR examinations. The physical effects caused by the introduction of metal or other conductive materials into a magnetic field and their consequences are presented. The application to postoperative spine MR examinations and solutions to reduce artifacts are discussed.

Artifacts↗
PubMed1994

A modified right angle clamp for radical retropubic prostatectomy and cystectomy.

A modified version of a classic right angle clamp is described. The use of the new surgical instrument is advocated during radical retropubic prostatectomy and cystectomy for a safer and easier division of the puboprostatic ligaments and the dorsal vein complex as a single unit. The special shape of the clamp allows the surgeon to move freely and angle it beneath the pubis without hindrance from the bladder.

Cystectomy↗
PubMed1990

Failure of the STER-O-LIZER MD 200 to pass the EPA sporicidal test.

The U.S. Environmental Protection Agency (EPA) officially licenses and authorizes use of commercial gas and liquid sterilants. Products registered by the EPA include ethylene oxide gas, formalin-alcohol vapor, glutaraldehyde liquid, and chlorine dioxide liquid. One product that is exempted from EPA registration is the STER-O-LIZER MD 200, in which the active component is electropotentiated saline solution. The manufacturer of the STER-O-LIZER claims that the device sterilizes surgical instruments in 2 minutes. Sterilization claims for the product are based on a test selected by the manufacturer. The EPA, however, is not concerned about the use of the STER-O-LIZER because it is non-toxic to humans. This study tested the validity of the manufacturer's claim by using EPA standards.

Bacillus subtilis↗
PubMed2000

[VRATS--Virtual Reality Arthroscopy Training Simulator].

The subject of this paper is a highly interactive medical training system for arthroscopic surgery; this is based on computer graphics and virtual reality (VR) techniques and offers an alternative to conventional training methods. To provide the virtual environment, a realistic 3D representation of the knee joint is derived from 2D medical image data. The use of tracking techniques guarantees an intuitive handling of the surgical instruments. The system allows navigation via a virtual camera and interaction with the virtual anatomical structures. First approaches for the simulation of tissue deformation caused by collisions with the instruments are implemented. One important advantage over conventional training systems is the possibility of verifying the training progress. Work is in progress on the realization of tactile feedback with the aim of providing a higher degree of interactive realism.

Arthroscopy↗
PubMed1995

Principles of development and design of microsystems.

The state of the art in microsystem design and fabrication is reviewed. The focus is on silicon micromachining, which uses the equipment and processes of IC-technology to produce highly miniaturized, three-dimensional structures, sensors and actuators for various biomedical applications. The micro components can be integrated into surgical instruments, catheters and implants. Thus new functions and a higher level of intelligence are created. Portable microsystems are being developed for chemical analysis and biomedical monitoring. The cultivation and investigation of live cells on chip substrates offers encouraging perspectives for the future.

Artificial Intelligence↗
PubMed1997

[Laparoscopy-assisted aortoiliac reconstructions].

Five patients underwent an aortobifemoral bypass using a laparoscope-assisted procedure. With the help of a wall-lifting device, balloon dissection of the retroperitoneum was performed. A total number of five ports were inserted and the aorta was dissected out from the bifurcation to the renal arteries under the guidance of a laparoscopic video camera. A 5-cm incision was required for suturing the proximal anastomosis of the bifurcated graft. Tunneling from the groin to the aorta was performed either video-assisted or with the help of the balloon dissector with a camera inside. All patients could be fully mobilized on the first postoperative day and were discharged after a mean hospital stay of 7.6 days. Mean length of the operation was 250 min. Originally, seven patients were scheduled for the video-assisted procedure. In two cases, we had to change to a conventional technique: in one case because we could not achieve adequate exposure of the aorta in an obese patient using a transperitoneal access, and in the second case owing to extensive adhesions after a bowel resection. Both patients had a regular, uneventful postoperative course. Gasless laparoscopy allowed us to use standard surgical instruments and most importantly a regular aortic clamp, which proved to be beneficial in a heavily calcified aorta. In conclusion, retroperitoneal gasless laparoscopic procedures can be safely performed in infrarenal aortoiliac reconstructions. Further clinical studies are required to prove the usefulness of this new technique.

Aged↗
PubMed2005

Evaluation of surgical skills in microgravity using force sensing.

INTRODUCTION: Force measurements can be used to characterize surgical maneuvers in microgravity. METHODS: : A series of surgical tasks was performed by a group of 20 participants (n=20) both in 1g on the ground and in 0 g aboard NASA's KC-135 aircraft in parabolic flight. The group included astronauts, a flight surgeon, surgeons, physicians, Ph.D.-scientists, and technical personnel. The interaction forces between the surgical instruments and the mock tissue were measured for a clip-applying, suturing, grasping, and cutting. Seven evaluations in 1g and a single evaluation in 0 g were performed by each of the participants. RESULTS: The data from a single participant are examined in detail. Statistical results for the group of 20 participants do not show significant differences in the average or peak forces during clip-applying or in the average forces applied during suturing in 0 g versus in 1g. However, the results do show statistically greater (43% higher) peak forces during suturing in microgravity. DISCUSSION: These data show the usefulness of analyzing force information to assess surgical task performance in microgravity. Although peak suturing forces were statistically higher in microgravity, their clinical relevance is unknown, but likely would not result in a change in clinical outcome. Overall, the data suggest that forces exerted during surgical tasks will not pose a significant barrier to effective surgery in microgravity.

Aerospace Medicine↗
PubMed1975

Bacterial aerosolization from an ultrasonic cleaner.

An ultrasonic device used for cleaning surgical instruments was found to produce a significant microbial aerosol. No correlation was found between the concentration of aerosol generated and the bacterial contamination in the cleaning solution. Table top contamination around the cleaner was due essentially to splash and dripping, and not from the settling of the aerosol. Recommendations are made for cleaning and disinfection protocols.

Aerosols↗
PubMed2003

Preventing accidental transmission of human transmissible spongifom encephalopathies.

The mechanism by which humans became infected with the BSE agent is discussed, and the matter of potential person-to person transmission of TSEs through contagion or medical procedures is considered. There is some discussion regarding the current evidence relating to whether or not the blood of humans infected with TSEs is infectious. Considerable emphasis is placed on the fact that TSE agents are known to be relatively resistant to decontamination by procedures that are effective with conventional micro-organisms, including (under worst-case conditions) the autoclaving procedures used to sterilise surgical instruments. Methods for providing additional re-assurance with regard to the safety of instruments are described. Safety in the pathology laboratory is discussed extensively because TSE agents are not inactivated by the usual processes used to fix tissues, and such laboratories will receive fixed tissues that are still highly infectious as far as TSE agents are concerned.

Animals↗
PubMed1986

X-ray-translucent retractors in spine surgery. Technical note.

With surgery of the vertebral column under image intensification, surgical instruments and conventional metal retractors often obscure important x-ray landmarks. Surgery is more difficult, operating time is longer, and exposure to x-rays is increased. The author has developed x-ray-translucent retractors for ventral and dorsal operations. Although for reasons of strength these retractors have somewhat more bulk than equivalent metal retractors, they are sufficiently stable and are compatible with spacial requirements. They can be sterilized and reused.

Humans↗
PubMed2005

Ultrasonic glossectomy--simple and bloodless.

BACKGROUND: The aim of the study was the evaluation of the feasibility of glossectomy using an ultrasonic-activated surgical instrument. METHODS: This was a prospective study of 13 consecutive patients who underwent glossectomy (12 partial and one total) for carcinoma of tongue with the use of ultrasonic scissors. RESULTS: All 13 patients had glossectomy, with median blood loss of 0 mL. The glossectomies were done with an ultrasonic dissector alone. None of the glossectomies required diathermy, ligature, plication, or other methods for hemostasis. The lingual artery and veins of all 13 patients were controlled by use of the ultrasonic scissors alone. No operative complications occurred, including bleeding or wound healing problems. CONCLUSIONS: The excellent combination of coagulation and the cutting effect of ultrasonic scissors has made glossectomy a simple and bloodless procedure. It is a recommended surgical technique in our surgical armamentarium.

Adult↗
PubMed1999

[History of surgery in Preci better known as surgeons of Norcia].

This paper makes a small contribution to a more detailed knowledge of the history of Italian surgery. Few know that Italy can boast a category of surgeons who should be regarded as the world forebears of modern surgery. These skilled individuals are better known as "Norcini", a term which is often regarded as negative and contemptible. However, in practice, they came from Preci and were only called "Norcini" because their village formed part of the "contado" of Norcia. Preci still possesses a large collection of surgical instruments and other items which testify how the art of surgery developed from this small centre. Extensive research has led to the reconstruction of a general picture of this phenomenon and its influence in Italy and throughout the world. These surgeons were the only ones capable of operating gallstones, cataracts and inguinal hernia. They developed specific instruments and were the first to introduce cauterization and narcosis. The latter enabled them to overcome almost all the factors which limited surgery at the time, namely infection, pain and hemorrhage. This study attempts to explain how and why such skillful surgeons were to be found in such a small and isolated area of Umbria.

Cataract Extraction↗
PubMed1989

Visual acuity after retrobulbar anesthesia.

Patients often say that they can see the surgical instruments with the operated eye during intraocular surgery. We examined 26 consecutive patients for visual acuity, ocular motility, and pupillary response before, during, and after retrobulbar anesthesia for cataract extraction. Twenty minutes after the anesthetic was injected, 19% of these patients had visual acuities better than 6/200, and 73% of patients described the movements of the instruments during surgery. Two patients (8%) recognized details on the ceiling after insertion of the intraocular lens. An afferent pupillary defect was found in 31% of patients. Although retrobulbar anesthesia results in a marked decrease in ocular motility and visual acuity, total akinesia and blindness do not occur. An incidental result of retrobulbar anesthesia may be a transient afferent pupillary defect.

Anesthetics, Local↗