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Surgical Technology International

Olivia J Bono, Chris Damsgaard, Claire Robbins, Mehran Aghazadeh, Carl T Talmo, James V Bono
BACKGROUND: Surgical technique in total hip arthroplasty (THA) has been a topic of debate over the last 50 years. Evidence-based studies are needed to compare one technique to another. This study investigated the outcome of the direct superior approach in primary THA as measured by patient perception of pain and recovery over a 16-year period. MATERIALS AND METHODS: We retrospectively reviewed a series of 3,357 consecutive patients who underwent primary THA by a single surgeon using the direct superior approach between 2001 and 2017...
July 5, 2018: Surgical Technology International
Jordi Castellví Valls, Javier Pérez Calvo, Ana Centeno Álvarez, Verónica Gonzâlez Santín, Lorenzo Viso Pons, Sergio Mompart García, Luis Ortiz de Zárate, Nuria Farreras Catasus, Jordi Mas Jove, Vicente Fernández Trigo, Domenico Sabia
INTRODUCTION: Bowel reconstruction techniques after right hemicolectomy has currently been objective of review, due to the high rate of anastomotic leak. The aim of this study is to analyse our results of the mechanical reinforced terminolateral ileo-transverse anastomosis. MATERIALS AND METHODS: A prospective and descriptive study of a consecutive series of right colonic cancer cases that underwent right hemicolectomy. Mechanical reinforced terminolateral ileo-transverse anastomosis technique was carried out in all patients...
July 5, 2018: Surgical Technology International
Giuseppe Currò, Iman Komaei, Claudio Lazzara, Federica Sarra, Andrea Cogliandolo, Saverio Latteri, Giuseppe Navarra
PURPOSES: Management of staple-line leaks following laparoscopic sleeve gastrectomy (LSG) is challenging and controversial. Guidelines for leak treatment are not standardized and often involve multidisciplinary management by surgical, medical and radiological methods. Herein we present our experience and proposed strategy for handling leaks after LSG. PATIENTS AND METHODS: Retrospective data regarding LSG performed from April 2012 to October 2017 at the Surgical Oncology Division, Department of Human Pathology in Adulthood and Childhood ''G...
July 5, 2018: Surgical Technology International
Thomas Neri, David Anthony Parker, Aaron Beach, Bertrand Boyer, Frederic Farizon, Remi Philippot
To better control anterolateral rotational instability (ALRI) after anterior cruciate ligament reconstruction (ACLR), many recent studies have examined the anterolateral ligament (ALL). Although some inconsistencies have been reported, anatomic studies demonstrated that the ALL runs on the lateral side of the knee from the femoral lateral epicondyle area to the proximal tibia, between Gerdy's tubercle and the fibula head. Histologic research has characterized the ALL structure, which is more than a simple capsular thickening; it shows a dense collagen core, typical bony insertions and mechanoreceptor function...
July 5, 2018: Surgical Technology International
Julio J Jauregui, Shivam J Desai, Vaughn Hodges, Arun Hariharan, Jared M Newman, Farshad Adib, Aditya V Maheshwari
Lower extremity total joint arthroplasty (TJA) is one of the most successful orthopaedic procedures. However, it is estimated that as many as 10% to 20% of TJAs could fail due to various well-known causes. Furthermore, metal allergy-related complications have recently gained attention as one of the potential causes of failure when the common reasons have been excluded. Reported symptoms from metal allergy can include chronic eczema, joint effusions, joint pain, and limited range of motion. Few studies have explored the outcomes of patients undergoing revisions due to allergic complications...
July 5, 2018: Surgical Technology International
Emad Mikhail, Papri Sarkar, Marilyn Moucharite, Stuart Hart
BACKGROUND: There are large variations in the use of minimally invasive surgery (MIS), and outpatient hysterectomy (OP) among Medicare patients according to hospital surgical volume and geographical distribution. OBJECTIVE: To explore the changing trend in OP and MIS hysterectomy in the United States. STUDY DESIGN: We used all Medicare fee-for-service claims data for 2012 and 2014 to determine the incidence of OP and MIS hysterectomy according to hospital surgical volume and geographical distribution...
July 5, 2018: Surgical Technology International
James Dana Kondrup, Conor Grey
Since 1993 (and prior, WISAP® [WISAP Medical Technology GmbH, Brunnthal, Germany] hand morcellators), laparoscopic power morcellation has been an indispensably employed technique for minimally invasive gynecologic surgery, contributing both to laparoscopic myomectomies and hysterectomies. However, the technique was highlighted with concern by the FDA for the given potential to disseminate neoplastic and non-neoplastic cells by morcellating an unexpected uterine sarcoma (Fig. 1). Given this concern, many gynecologists are either resorting to performing traditional laparotomies or risking dissemination with uncontained power morcellation techniques...
July 5, 2018: Surgical Technology International
Francesco Frattin, Vincenzo Pappalardo, Davide Inversini, Matteo Lavazza, Tefano Rausei, Giulio Carcano
Sleeve gastrectomy is the most frequently performed operation for the treatment of morbid obesity. Even though sleeve gastrectomy is now widely standardized, it may still benefit from the use of certain devices and procedures such as intraoperative endoscopy. The use of an endoscope offers numerous advantages that can considerably reduce the morbidity and mortality of patients who undergo laparoscopic sleeve gastrectomy. This paper describes our experience with a case in which the information obtained by endoscopy allowed us to perform a real-time assessment of the location of two large gastric polyps to control the staple-line...
July 5, 2018: Surgical Technology International
Michael Korenkov
The most commonly performed Roux-en-Y gastric bypass (RYGB) procedure is difficult and has many technical variations. The individual patient's anatomic characteristics, like an exceptionally large left liver lobe, fatty mesentery with limited mobile Roux limb, difficulty in positioning a stapler, etc., can greatly increase the technical difficulty of this procedure. Challenging situations in laparoscopic gastric bypass surgery can be classified according to the intraoperative complexity. According to this classification scheme, all patients in laparoscopic linear-stapled gastric bypass can be classified into one of four types: Type I - ideal...
July 5, 2018: Surgical Technology International
Yishen Zhao, Changlin Li, Tie Wang, Le Zhou, Xiaoli Liu, Jingwei Xin, Shijie Li, Hui Sun, Gianlorenzo Dionigi
PURPOSE: We investigated the function of the recurrent laryngeal nerve (RLN) in a live porcine model during adjacent activation with bipolar forceps (BF), LigaSure™ small jaw (LSJ), Sonicision™ and PlasmaBlade™ (PB) devices. METHODS: Each of the energy-based devices (EBD) was activated for 3 seconds at different power settings at 5, 3, 2, and 1 mm from the RLN. Nerve root function and thermal spread were measured by continuous intraoperative neuromonitoring and infrared thermal imaging...
April 23, 2018: Surgical Technology International
Nathaniel Stoikes, Esra Roan, David Webb, Guy R Voeller
Seroma is a common postoperative finding after ventral hernia repair with an incidence of 20%. Often, it can be managed conservatively, but in the case of persistent or chronic seroma, reinterventions may be required. Closed drain suction has been the mainstay of seroma management for the last 40 years. Other alternative technologies have been evaluated to improve outcomes with mixed results. Because seroma is common, it is often an accepted outcome. Patient morbidity and costs to the healthcare system are underestimated, which begs for a re-evaluation of the current state of seroma management that is nearly a half-century old...
June 1, 2018: Surgical Technology International
Rami O Tadros, Vivek S Prakash, Melissa J Baldwin, Adam Korayem, Michael L Marin, Peter L Faries
Simultaneous technological advancements in both imaging as well as devices have resulted in an expansion of endovascular options for vascular access. In particular, radial access has traditionally been more favored for coronary interventions; its use in the aortoiliac and lower extremity vasculature has been constrained by the length of devices and the size of sheaths required. However, with increasing catheter shaft lengths, in addition to new thin-walled sheaths allowing for downsizing, the ability to perform transradial interventions on infrainguinal and infrageniculate vessels has been more readily facilitated...
June 1, 2018: Surgical Technology International
E Scott Sills, Natalie S Rickers, Xiang Li
OBJECTIVE: To describe a non-hysterectomy surgical technique for symptomatic patients with >2 Essure® (Bayer Healthcare, Whippany, New Jersey) devices. DESIGN: Patients (n=4) presented with sharp pelvic pain, irregular vaginal bleeding, dyspareunia, weight gain, hair loss, fatigue, and/or diffuse skin rash, all of which were absent before undergoing hysteroscopic sterilization (HS). Hysterosalpingogram obtained before surgical excision of contraceptive tubal implants confirmed more than two Essure® devices in all patients...
June 1, 2018: Surgical Technology International
Martino Pepe, Emanuela De Cillis, Tommaso Acquaviva, Annagrazia Cecere, Pasquale D'Alessandro, Arturo Giordano, Marco Matteo Ciccone, Alessandro Santo Bortone
Mitral regurgitation (MR) is the most prevalent valvular heart disease (VHD) and represents an important cause of heart failure. Medical therapy has a limited role in improving symptoms and does not hinder the progression of valvular disease. Surgery is the treatment of choice for severe symptomatic MR; valve repair is currently the preferred surgical approach because it reduces peri-operative mortality and ensures a good medium- to long-term survival outcome. Nevertheless, a non-negligible proportion of patients with indications for surgical correction are considered to be at prohibitive perioperative risk, mainly because of old age and multiple comorbidities...
June 1, 2018: Surgical Technology International
Randa K Elmallah, Prem N Ramkumar, Anton Khlopas, Rathika R Ramkumar, Morad Chughtai, Nipun Sodhi, Assem A Sultan, Michael A Mont
BACKGROUND: Multiple factors have been implicated in determining why certain patients have increased postoperative pain, with the potential to develop chronic pain. The purpose of this study was to: 1) identify and describe genes that affect postoperative pain perception and control; 2) address modifiable risk factors that result in epigenetic altered responses to pain; and 3) characterize differences in pain sensitivity and thresholds between opioid-naïve and opioid-dependent patients...
June 1, 2018: Surgical Technology International
Ryan J Berger, Assem A Sultan, Connor Cole, Nipun Sodhi, Anton Khlopas, Michael A Mont
We present a unique case of a 62-year-old patient with bilateral osteonecrosis of the femoral heads secondary to corticosteroid use. She presented with an occult right femoral neck fracture and was treated with percutaneous pinning of the right femoral neck and a left-sided percutaneous drilling. Despite apparent appropriate technique, the patient sustained a left sub-trochanteric hip fracture while shifting in bed in the postoperative care unit and was taken back for cephalo-medullary nail fixation. Femoral head osteonecrosis may be an under-reported risk factor for development of pathological neck fractures...
June 1, 2018: Surgical Technology International
Karen You, Mahir Gachabayov, Jens Marius Nesgaard, Jela Bandovic, Dejan Ignjatovic, Arne Bakka, Roberto Bergamaschi
BACKGROUND: D3 extended mesenterectomy (D3EM) for right colon cancer has received increased attention owing to suggested improvement of oncological outcomes. The aim of this study was to evaluate the proficiency-based progression of content-valid metrics in a cadaveric model for right colectomy with D3EM. MATERIALS AND METHODS: Three expert surgeons were enrolled. Surgeon one performed the procedure robotically and surgeons two and three performed open D3EM. Proficiency-based progression was recorded for eight content-valid outcomes...
June 1, 2018: Surgical Technology International
Jeffrey C Caruth
INTRODUCTION: Vaginal laxity and atrophy are caused mainly by aging and vaginal childbirth, which lead to a loss of strength and flexibility within the vaginal wall. As a result, women may experience vaginal, pelvic, sexual and urinary symptoms that significantly affect their quality of life. OBJECTIVE: The aim of this study was to evaluate the safety and efficacy of a novel radiofrequency (RF) device for internal and external vaginal treatment. METHODS: Thirty women who had been diagnosed with symptoms of vaginal laxity and pelvic relaxation received a single treatment that consisted of continuous RF in the internal genitalia and continuous RF followed by fractional RF in the external vulva...
June 1, 2018: Surgical Technology International
Emanuela de Cillis, Tommaso Acquaviva, Pasquale D'Alessandro, Alessandro Santo Bortone
Cryptogenic stroke is the final diagnosis in almost 40% of ischemic acute cerebrovascular events. There is currently no definitive clinical evidence that percutaneous closure of patent foramen ovale (PFO) can prevent the recurrence of stroke or transient ischemic attack (TIA). Identification of the causes of neurologic ischemic syndromes is essential for any strategy intended to prevent the catastrophic consequences of cerebral infarction. Since the initial reports of an unexpectedly high prevalence of PFO in younger patients with cryptogenic stroke in 1988, there has been growing interest and experience in diagnosing and treating these patients, both medically and/or with percutaneous closure, in particular for the potential to eliminate paradoxical embolism via PFO, which is a likely mechanism for stroke in these patients...
June 1, 2018: Surgical Technology International
Natalie N Merchant, Robert McKenna, Osita Onugha
Lung cancer is the second most commonly diagnosed cancer and continues to be the leading cause of death for both men and women, with non-small cell lung cancer (NSCLC) accounting for 85% of all lung cancer cases. Once a lung mass is visualized on imaging, accurate staging is required for determination of treatment options and, when possible, surgical resection is recommended as it has been proven to have the best survival rates versus non-surgical treatment. If a patient has advanced or metastatic disease, therapeutic options include chemotherapy and radiation, while immunotherapy and specific agents that target tumor mutations are only recommended for appropriate candidates...
June 1, 2018: Surgical Technology International
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