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Surgical Technology International

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https://www.readbyqxmd.com/read/28395393/opportunities-in-total-knee-arthroplasty-worldwide-surgeons-perspective
#1
Michael Dunbar, Jared M Newman, Anton Khlopas, Morad Chughtai, Nick Martinez, Manoshi Bhowmik-Stoker, Michael A Mont
INTRODUCTION: This study surveyed a group of US and international orthopaedic surgeons to prioritize areas of improvement in primary total knee arthroplasty (TKA). Specifically, we assessed surgeon responses regarding the top five areas of TKA needing improvement; which were stratified by: a) US surgeons, b) international surgeons, c) US surgeons' implant-brand-loyalty, and d) surgeons' years of experience and case volume. MATERIALS AND METHODS: Four hundred and eighteen surgeons who were board-certified, in practice for at least two years, spent 60% of their time in clinical practice, and performed a minimum of 25 lower extremity joint arthroplasties per year were surveyed...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28395392/case-history-review-of-2-467-anal-fistulae-surgically-treated-with-the-method-of-arnous-s-french-school
#2
Massimo Giordano, Graziella Estienne, Francesca Mandolfino
INTRODUCTION: Considering the extensive experience developed in 28 years of medical practice in a specialist facility dedicated to proctological surgery and the treatment of 2.467 patients presenting with an anal fistula, the authors review problems associated with this disease from an aetiopathogenic, classifying, diagnostic, and therapeutic viewpoint. MATERIALS AND METHODS: The surgical treatment of Arnous's French School was adopted. The method envisions slow sectioning of the sphincter by means of elastic constriction, even dividing surgical sessions...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28395391/dual-mobility-acetabular-cups-in-primary-total-hip-arthroplasty-in-patients-at-high-risk-for-dislocation
#3
Steven F Harwin, Jaydev B Mistry, Morad Chughtai, Anton Khlopas, Chukwuweike Gwam, Jared M Newman, Carlos A Higuera, Peter M Bonutti, Arthur L Malkani, Frank R Kolisek, Ronald E Delanois, Michael A Mont
INTRODUCTION: Postoperative dislocation occurs in approximately 2% of primary total hip arthroplasties (THAs). Risk factors associated with dislocation include: age of 70 years or older, body mass index (BMI) of 30 kg/m2 or greater, alcohol abuse, and neuro-degenerative diseases such as multiple sclerosis or Parkinson's disease. As a result, dual-mobility articulations, which have been typically used for revision procedures, have become an increasingly popular option for these "at risk" primary THAs...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28395390/surgical-treatment-of-rectovaginal-fistula-in-crohn-s-disease-a-tertiary-center-experience
#4
Giovanni Milito, Giorgio Lisi, Dario Venditti, Michela Campanelli, Elena Aronadio, Michele Grande
BACKGROUND: Rectovaginal fistula (RVF) is a disastrous complication of Crohn's disease (CD) that is exceedingly difficult to treat. It is a disabling condition that negatively impacts a woman's quality of life. Current treatment algorithms range from observation to medical management to the need for surgical intervention. A wide variety of success rates have been reported for all management options. The choice of surgical repair methods depends on various fistula and patient characteristics, and its published success rates vary with initial success being around 50% rising to 80% with repeated surgery...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28395389/tranexamic-acid-and-computer-assisted-surgery-in-cemented-and-cementless-total-knee-arthroplasty-are-the-effects-additive-for-blood-conservation
#5
Michael Fleischman, Mark Hood, Mary Ziemba-Davis, R Michael Meneghini
INTRODUCTION: Efforts continue to minimize blood loss associated with total knee arthroplasty (TKA). The primary objective of this study was to determine whether computer-assisted surgery (CAS) and tranexamic acid (TXA) were additive in minimizing blood loss in cemented TKA. The secondary objective was to assess the combined effectiveness of CAS and TXA in cementless TKA. MATERIALS AND METHODS: A retrospective study of 393 consecutive primary TKAs with cemented and cementless fixation was performed...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28395388/results-of-a-modular-femoral-revision-system-before-and-after-taper-roller-hardening-in-total-hip-arthroplasty
#6
Dean J Marshall, Keith R Berend, Michael J Morris, Joanne B Adams, Adolph V Lombardi
INTRODUCTION: Modular component options can aid in addressing complex femoral reconstructions in total hip arthroplasty (THA) by allowing for customization of version control and proximal to distal sizing. However, component breakage at the modular junction has occurred, particularly in the presence of poor bone stock. A taper roller hardening (RH) process was developed to strengthen the modular junction to reduce breakage. The purpose of this study is to review THA patients before and after taper roller hardening to compare stem survival and frequency of breakage...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28395387/novel-techniques-and-approaches-to-minimally-invasive-thoracic-surgery
#7
Osita Onugha, Rasheed Ivey, Robert McKenna
Approximately two decades ago, thoracic surgery witnessed the leap from thoracotomy to the first video-assisted thoracic surgery (VATS) lobectomy. Minimally invasive lobectomy and hilar lymphadenectomy is now widely established as a safe and oncological sound technique that is the standard of care for early-stage lung cancer. The move toward less invasive surgery has no doubt driven the innovation of sophisticated instruments and technology to cope with the demanding need of working through a restricted incision...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277599/pregnancy-complications-after-hysteroscopic-metroplasty-a-ten-year-case-control-study
#8
Alessandro Loddo, Maurizio Nicola D'Alterio, Manuela Neri, Francesca Masala, Fiorenza Lo Cane, Gian Benedetto Melis
INTRODUCTION: Septate uterus is one of the most common congenital uterine anomalies and it may effect female reproductive health causing different obstetric complications, in particular miscarriages and reduction of fertility. MATERIALS AND METHODS: We conducted a retrospective case-control (1:4) comparative study (Canadian Task Force Classification II-2) with the purpose to evaluate pregnancy complications (abnormal fetal presentations, preterm deliveries, and caesarean sections) and reproductive outcome after hysteroscopic metroplasty...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277598/pisat-s-visual-vasopressor-injection-needle-an-innovative-tool-for-increasing-patient-safety-in-laparoscopic-myomectomy
#9
Sanket Pisat, Bruno van Herendael
INTRODUCTION: The use of vasopressin and other vasoconstrictive agents to reduce blood loss during laparoscopic myomectomy significantly reduces blood loss and operative time. However, serious cardiovascular complications following the use of intramyometrial injection of vasopressin solution have also been reported. Most of these side effects are believed to be due to inadvertent intravascular injection of vasopressin solution. AIMS AND OBJECTIVES: To describe a new design of an injection needle...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277597/radiofrequency-procedure-secca%C3%A2-for-fecal-incontinence-one-year-experience
#10
Marco Frascio, Cesare Stabilini, Marco Casaccia, Tommaso Testa, Rosario Fornaro, Maria Caterina Parodi, Ciro Marrone, Ezio Gianetta, Francesca Mandolfino
INTRODUCTION: Radiofrequency is a treatment option for patients suffering from fecal incontinence. OBJECTIVE: To assess the one-year follow-up results following the radiofrequency procedure for fecal incontinence. DESIGN: Prospective, single-center, observational study. MATERIALS AND METHODS: Twenty-one patients underwent the SECCA® radiofrequency procedure, 19 of who completed the one-year of follow-up (Cleveland Clinic Florida Fecal Incontinence score, Fecal Incontinence Quality of Life Scale (FIQoL), anorectal manometry, and endoanal ultrasound)...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277596/the-mccarus-volker-fornisee%C3%A2-a-novel-trans-illuminating-colpotomy-device-and-uterine-manipulator-for-use-in-conventional-and-robotic-assisted-laparoscopic-hysterectomy
#11
Melissa M Gutierrez, Jasmine D Pedroso, K Warren Volker, David L Howard, Steven D McCarus
PURPOSE: The purpose of this paper is to introduce a novel trans-illuminating culdotomy and uterine manipulator device. MATERIALS AND METHODS: The study was a prospective, non-randomized, non-blinded observational clinical study involving 50 female patients undergoing total laparoscopic hysterectomy (TLH) or laparoscopic supracervical hysterectomy (LSH) for benign indications. The surgeries were performed from March through May 2012 at two institutions. The primary study objectives were to demonstrate the safety and adequate clinical performance of the uterine manipulator device and to illustrate its potential widespread future use in minimally invasive gynecologic procedures...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277595/a-web-based-application-to-communicate-benefits-and-risks-of-surgical-treatments
#12
Fabienne E Stubenrouch, Marwin Baumann, Dink A Legemate, Dirk T Ubbink
BACKGROUND: In general, communication is an important aspect during surgeon-patient consultations. However, clear communication of the benefits and risks of the possible treatment options can be challenging. Visual presentation of information may increase patient comprehension. We developed and piloted a web-based application that provides graphical representations of the numerical benefits and risks of surgical treatment options. MATERIALS AND METHODS: The app was developed by assessing functional requirements, developing a prototype, pilot-testing and adjusting the prototype, and evaluating the final app...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277593/pain-management-with-adductor-canal-blockade-or-multimodal-periarticular-analgesia-in-elderly-total-knee-arthroplasty-patients
#13
Chukwuweike U Gwam, Nequesha Mohamed, Jaydev B Mistry, Melbin Thomas, Morad Chughtai, Sabahat Khan, Anton Khlopas, Michael A Mont, Ronald E Delanois
INTRODUCTION: Post-operative pain management in elderly total knee arthroplasty (TKA) patients has traditionally included opioids, epidurals, and femoral nerve blocks. Although these modalities are effective, they are often associated with adverse side effects, which may have a greater impact on this population. Alternative modalities, such as adductor canal blocks (ACB) and multimodal periarticular analgesia (MPA) have demonstrated great efficacy with a low side effect profile. However, it is unknown if one modality is advantageous over the other in the elderly...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277592/evaluation-of-the-effects-of-the-metha-short-stem-on-periprosthetic-bone-remodelling-in-total-hip-arthroplasties-results-at-48-months
#14
Paolo D Parchi, Gianluca Ciapini, Iacopo Castellini, Claudia Mannucci, Anna Maria Nucci, Nicola Piolanti, Silvia Maffei, Michele Lisanti
INTRODUCTION: Total hip arthroplasty is one of the most performed procedures in orthopaedic surgery. Implantation of a prosthesis determines changes in the distribution of loads on the host bone, and this phenomenon, known as stress shielding, is related to the biomechanical characteristics of the implant. Usually stress shielding involves the proximal portion of the femur by reducing the mechanical strength and ability to withstand the transmitted loads. The aim of our study is to demonstrate how the use of a short hip stem reduces the stress shielding phenomenon to the proximal femur...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277591/the-role-of-fluorescent-angiography-in-anastomotic-leaks
#15
Sarath Sujatha-Bhaskar, Mehraneh D Jafari, Michael J Stamos
Anastomotic leaks following colorectal anastomosis has substantial implications including increased morbidity, longer hospitalization, and reduced overall survival. The etiology of leaks includes patient factors, technical factors, and anastomotic perfusion. An intact anastomotic blood supply is especially crucial in the physiology of anastomotic healing. To date, no established intraoperative methods have been developed that reliably and reproducibly identify and prevent leak occurrence. Recently, fluorescent angiography (FA) with indocyanine green (ICG) has emerged as an innovative modality for intraoperative perfusion assessment...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277590/does-an-anterior-lipped-tibial-insert-adequately-substitute-for-a-post-cam-articulation-in-total-knee-arthroplasty
#16
Rahul K Biyani, Mary Ziemba-Davis, Philip H Ireland, R Michael Meneghini
INTRODUCTION: Newer tibial inserts with enhanced conformity (cruciate stabilizing anterior lip; CS) to obviate the need for a posteriorly stabilized (PS) post-cam articulation in posterior cruciate ligament-deficient knees have been recently introduced in modern total knee arthroplasty (TKA). The purpose of this study was to evaluate whether clinical and functional outcomes differ in TKA cohorts without a posterior cruciate ligament (PCL) utilizing either CS anterior-lipped or PS post-cam articulation...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277589/medical-missions-in-the-middle-east-an-orthopaedic-surgeon-s-experience-of-a-series-of-lower-extremity-cases
#17
Aiman Rifai, Todd P Pierce, Kimona Issa, Yasmine Rifai, Bartlomiej Szczech
Orthopaedic trauma accounts for a great deal of disability worldwide. There are many impoverished nations affected by war wherein victims suffer blast injuries associated with mines, missiles, high-powered gunshots, and bombings. One way to address this is through international medical missions sponsored by industrialized nations. It is imperative that practitioners have a basic understanding of the type of injuries that may be encountered in these nations impacted by war and conflict. Therefore, we described a small number of various lower extremity injuries seen by one orthopaedic surgeon during his volunteer medical mission to Jordan...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28182829/transoral-endoscopic-thyroidectomy-vestibular-approach-toetva-from-a-to-z
#18
Gianlorenzo Dionigi, Matteo Lavazza, Alessandro Bacuzzi, Davide Inversini, Vincenzo Pappalardo, Ralph P Tufano, Hoon Yub Kim, Angkoon Anuwong
We depict the transoral endoscopic thyroidectomy vestibular approach (TOETVA). Patient selection criteria are (1) ultrasonographically (US) estimated thyroid diameter no larger than 10cm, (2) US estimated gland volume ≥45mL, (3) nodule size ≥5mm, (4) a benign tumor, such as a thyroid cyst, single-nodular goiter, or multinodular goiter, (5) follicular neoplasm, and (6) papillary microcarcinoma without evidence of metastasis. TOETVA is carried out through a three-port technique placed at the oral vestibule, one 10mm port for 30° endoscope and two additional 5mm ports for dissecting and coagulating instruments...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28182828/scalp-metastasis-from-glioblastoma-multiforme-a-case-report-and-literature-review
#19
Marco Mammi, Roberto Altieri, Alessandro Agnoletti, Paolo Pacca, Federica Franchino, Diego Garbossa, Alessandro Ducati, Antonio Melcarne
Glioblastoma multiforme (GBM) is a common malignant brain tumor that rarely metastasizes extracranially, despite its aggressive clinical course. This report details the case of a young man presenting with a single subcutaneous localization of GBM that arose six months after initial surgery and recurred after excision. Only six other cases of scalp metastasis of GBM following surgery have been described in the literature, each with peculiar features. Whenever feasible, surgery is the most effective way to obtain local control of disease...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28182827/chronic-achilles-tendon-rupture-treated-with-allograft-a-case-report
#20
Giuseppe Restuccia, Alessandro Lippi, Francesco Casella, Carmine Citarelli, Federico Sacchetti, Maurizio Benifei
In clinical practice, chronic Achilles tendon ruptures are uncommon. Usually, these lesions are discovered four to six weeks after injuries. More frequently, Achilles tendon ruptures are acute and treated with tendon sutures.1 Many surgical techniques are available to treat chronic lesions such as sutures or V-Y elongation with or without augments.2-3 Our case is about a chronic Achilles tendon rupture discovered two years after injury. Our patient came to our attention with a 6 cm tendon gap. We performed tendon repair with cadaver allograft...
February 7, 2017: Surgical Technology International
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