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Surgical Technology International

Jonathan F Arnold, Melissa Roscum
INTRODUCTION: Hyperbaric oxygen therapy (HBOT) is defined as breathing 100% oxygen at a pressure ≥1.4 atmospheres absolute (ATA). Adjunct HBOT is one modality used for treatment of certain complex wounds. The resulting increase in oxygen delivery to wounded tissue has been associated with reduced edema, reduced inflammation, improved infection control, increased collagen deposition, and increased angiogenesis. However, there remains a relative paucity of evidence supporting the use of HBOT in the treatment of certain acute and chronic, non-healing wounds...
October 10, 2016: Surgical Technology International
Antoine Dangin, Sandrine Boulat, Frédéric Farizon, Rémi Philippot
INTRODUCTION: Total hip arthroplasty (THA) is a common surgery presenting well-known failures that may require surgical revision. To reduce the risk of hip dislocation after revision THA, we hypothesize the interest of the use of a new generation dual mobility cup by evaluating its survival and complication rates. MATERIALS AND METHODS: We analyzed the survival and the failures rate of 91 patients who underwent revision THAs with a specific dual mobility cup Novae® E TH (SERF, Décines-Charpieu, France)...
October 6, 2016: Surgical Technology International
Alexandra M Moore, Lisa N Anderson, David C Chen
INTRODUCTION: Minimally invasive laparoscopic and robotic techniques for ventral hernia repair have evolved to achieve the benefits and minimize the limitations of both the open Rives-Stoppa sublay mesh repair and laparoscopic intraperitoneal onlay mesh (IPOM) repair. By combining the principles of a retromuscular repair with the benefits of a minimally invasive approach, these techniques attempt to decrease recurrence, increase functionality, exclude mesh from the viscera, limit infection and wound complications, and minimize pain...
October 6, 2016: Surgical Technology International
William T Wilson, Graeme P Hopper, Paul A Byrne, Gordon M MacKay
BACKGROUND: Anterior cruciate ligament (ACL) reconstruction using tendon or ligament autograft is the gold standard surgical treatment for acute ruptures; however, this is still associated with subsequent problems and variable outcomes. Renewed interest in healing of injured ACL tissue has led to new surgical repair techniques. CASE DESCRIPTION: We report the case of one of the first patients to undergo this novel procedure of ACL repair with internal bracing. An internal brace is a bridging concept using braided suture tape and knotless bone anchors to reinforce ligament strength...
October 6, 2016: Surgical Technology International
Brandon R Bukowski, Paul Anderson, Anton Khlopas, Morad Chughtai, Michael A Mont, Richard Ii L Illgen
INTRODUCTION: Functional outcome following total hip arthroplasty (THA) is affected by accurate component positioning and restoration of hip biomechanics. Robotic-assisted THA (rTHA) has been shown to improve accuracy of component positioning, but its impact on functional outcomes has not been demonstrated. The purpose of this study was to compare: 1) operative time; 2) estimated blood loss; 3) postoperative complications; and 4) patient-reported outcome measures (PROMs) between patients who either underwent rTHA or manual THA (mTHA)...
October 6, 2016: Surgical Technology International
Damien Billow, Anton Khlopas, Morad Chughtai, Anas Saleh, Marcelo B Siqueira, Patrick Marinello, Michael A Mont
The reamer-irrigator-aspirator (RIA) system has been recently developed to decrease the incidence of osseous thermal necrosis and fat embolism associated with intramedullary reaming of long bones in trauma cases. This is achieved by continuous irrigation and suction. Recently, the use of RIA has been expanded to harvest bone graft and debride the medullary canal of long bones in cases of osteomyelitis and intramedullary tumors. Additionally, the collection system of this device has been utilized for its ability to capture bone graft and marrow aspirate...
October 6, 2016: Surgical Technology International
Martin Roche, Tsun Yee Law, Morad Chughtai, Randa K Elmallah, Zachary Hubbard
INTRODUCTION: The purpose of this study was to: 1) determine the incidence of revision total knee arthroplasty (TKA); 2) correlate the percent of glycated hemoglobin with incidence of revision; and 3) determine the cause of revision in diabetic patients stratified by a glycated hemoglobin level. MATERIALS AND METHODS: We analyzed 424,107 patients from a national private payer database from 2007 to 2015 to determine who had diabetes and underwent TKA. We determined the incidence of revision TKA in the overall cohort and stratified it by glycated hemoglobin levels...
October 6, 2016: Surgical Technology International
Nathaniel Stoikes, David Webb, Guy Voeller
The use of the da Vinci robot for inguinal and ventral hernia repair has exponentially increased over the last five years. This increase is occurring in spite of historical cost analyses showing robotic surgery to be cost prohibitive for other general surgery procedures. Specific data regarding outcomes and cost analysis for hernia is lacking. The increase in robotic hernia repairs is likely related to intangible factors such as enhanced visualization, articulating instruments, and hospital resources. Further study of robotic hernia repair is needed prospectively as its use increases to delineate the true benefits...
October 6, 2016: Surgical Technology International
Arne de Niet, Michel Mpj Reijnen, Ignace Fj Tielliu, Jan Willem Hp Lardenoije, Clark J Zeebregts
Since the introduction of fenestrated endovascular aneurysm repair (FEVAR) in 1996, great advances have been made in endograft development. Custom-made and off-the-shelf fenestrated and branched endografts have been used to treat patients with complex abdominal aortic and thoraco-abdominal aneurysms. Most experience has been gained with the Cook Zenith® fenestrated endograft (Cook Medical Inc., Limerick, Ireland). The Cook Zenith® endograft is customized with fenestrations, (fixed) inner or outer branches, or a combination of them, to cover a wide range of complex aneurysms...
October 6, 2016: Surgical Technology International
Ohannes F Plate, Andrew D Wohler, Matthew L Brown, Daniel Sun, Nora F Fino, Jason E Lang
INTRODUCTION: Stiffness and loss of motion following total knee arthroplasty (TKA) is a complex and multifactorial complication that may require manipulation under anesthesia (MUA). However, patient and surgical factors that potentially influence the development of knee stiffness following TKA are not fully understood. The purpose of this study was to identify patient and surgical factors that may influence range of motion loss following TKA by assessing a cohort of patients that underwent MUA and comparing them to a matched cohort of patients without complications...
October 6, 2016: Surgical Technology International
Ran Schwarzkopf, Erik Schnaser, Taiki Nozaki, Yasuhito Kaneko, Michael J Gillman
INTRODUCTION: Patient-specific implants and instruments (PSI) have been used in both knee and shoulder replacements due to the perceived benefits of improved surgical accuracy and efficiency. The proposed benefits of using a PSI in total hip arthroplasty (THA) are numerous and include reduction of operative time and improved mechanical and anatomical alignment leading to increased implant longevity, increased stability, and clinical outcomes. We describe a novel patient-specific instrumentation and a surgical method that may improve directed resection of acetabular bone and accurate cup placement during THA...
October 6, 2016: Surgical Technology International
Marc Possover
We report on unexpected findings in 18 spinal cord injured peoples who underwent a laparoscopic bilateral implantation of neuroprosthesis (LION procedure) to the sciatic/femoral nerves pelvic somatic nerves for functional electrical stimulation (FES)-assisted locomotor training and continuous low-frequency electrical stimulation. Fifteen patients were paraplegics, three low tetraplegics, all of them fully dependent on a wheelchair. After a training period of at least one year, all patients not only started with electrical-assisted standing/stepping using a walker or crutches, but also developed some progressive caudalward recovery of lumbosacral sensoric functions and of supraspinal control of voluntary movements below the lesions...
October 6, 2016: Surgical Technology International
Bruce Ramshaw, Brandie Forman, Eric Heidel, Jonathan Dean, Andrew Gamenthaler, Michael Fabian
Patients who undergo laparoscopic ventral hernia repair can have significant post-operative pain and discomfort from both somatic pain due to mesh fixation and visceral pain due to CO2 insufflation pressure. In an attempt to improve outcomes, a Clinical Quality Improvement (CQI) project was implemented by a multi-disciplinary hernia team. CQI tools were applied for consecutive patients who underwent laparoscopic ventral hernia repair from June 2012 through September 2015 (39 months). Initiatives for improved patient outcomes during this period included the administration of a transversus abdominis plane (TAP) block and/or an intra-operative block with long-acting local anesthetic first, and then a low pressure pneumoperitoneum (LPP) system was implemented later in the project...
October 6, 2016: Surgical Technology International
Ayman Grada, Vincent Falanga
The number of individuals with chronic cutaneous wounds has been increasing worldwide due to an aging population, diabetes, obesity, and cardiovascular disease. In the United States, almost seven million Americans have chronic skin ulcers. Many therapeutic approaches have been used. However, the treatment outcomes are not always ideal because of failure to achieve complete wound closure in around 60% of cases, scarring, and high rate of recurrence. Therefore, there is a need for more effective therapies. Stem cells offer promising possibilities...
October 6, 2016: Surgical Technology International
Eric Goudie, Mehdi Tahiri, Moishe Liberman
VATS lobectomy is a safe and effective treatment strategy for operable stage I and II lung cancer. It has a similar five-year survival compared to open lobectomy (thoracotomy). VATS lobectomy is associated with less postoperative complications and shorter hospital length of stay when compared to lobectomy by thoracotomy. VATS lobectomy has not been widely adopted by the thoracic surgical community, in part, due to technical reasons. Pulmonary artery branch manipulation in VATS lobectomy is one of the most critical parts of the procedure, especially when endostaplers are used for ligation and division of the vessel...
October 6, 2016: Surgical Technology International
James Dana Kondrup, Frances R Anderson, Melanie Rose Katz
Biosurgical materials (biosurgicals) have a wide array of uses for providing hemostasis, including decreasing the risk of postoperative bleeding and, intraoperatively, controling bleeding. These materials are especially useful in situations where electrocautery, sutures, or clips are not feasible. Biosurgicals have long been used in general surgery and surgical subspecialties to provide hemostasis; however, they still are not commonly used during obstetric and gynecologic procedures. Three commonly used classes of biosurgicals will be discussed in this article: oxidized regenerated cellulose, flowables, fibrin sealants, and fibrin sealant patches...
October 6, 2016: Surgical Technology International
Ronald E Delanois, Jaydev B Mistry, Morad Chughtai, Alison K Klika, Anton Khlopas, Wael K Barsoum, Carlos A Higuera, Anil Bhave, Michael A Mont
Traditional techniques to balance total knee arthroplasties are often subject to variability, as they are usually based on the surgeon's subjective assessment. Improperly balanced total knee arthroplasties can cause complications such as stiffness, pain, or instability, which may ultimately result in a revision procedure. In an effort to mitigate this, a tibial insert sensor technology has recently been developed to allow for quantifiable, objective measurements of soft-tissue balancing. A systematic review of the current literature was performed, highlighting the utility of this sensor tibial insert with focus on: (1) compartment loading pressures; (2) component orientations; and (3) clinical outcomes...
September 10, 2016: Surgical Technology International
Morris Wortman, Josette C Dawkins
Endometrial ablation (EA) has become one of the most commonly performed gynecologic procedures in the United States and other developed countries. Global endometrial ablation (GEA) devices have supplanted resectoscopic ablation primarily because they have brought with them technical simplicity and unprecedented safety. These devices, all of which received FDA approval between 1997 and 2001, are typically used to treat abnormal uterine bleeding (AUB) in premenopausal women. Several million women in the US who have undergone a previous EA procedure are about to enter the risk pool for the development of endometrial cancer (EC)...
September 10, 2016: Surgical Technology International
Gustavo Leibaschoff, Pablo Gonzalez Izasa, Jose Luis Cardona, John R Miklos, Robert D Moore
OBJECTIVE: The aim of this study was to evaluate the effects of non-ablative, monopolar transcutaneous temperature controlled radiofrequency (TTCRF) technology in the treatment of postmenopausal women suffering from genuine stress urinary incontinence (SUI) related to menopause and to evaluate histological changes vaginally associated with the treatment. MATERIALS AND METHODS: Subjective and objective symptoms of SUI were assessed in study subjects before and after TTCRF, (1 treatment every 30 days, for 3 months; n=10) and compared with the effects of a placebo treatment on a control group of demographically similar women (n =10)...
September 10, 2016: Surgical Technology International
Sina Pourtaheri, Kimona Issa, Tyler Stewart, Yashika Patel, Kumar Sinha, Ki Hwang, Arash Emami
BACKGROUND: How the relative volume of an epidural abscess on MRI affects outcomes with antibiotics alone has limited literature. The purpose of this study was to identify which infected epidural collections will reabsorb with antibiotics alone. Specifically, what is the critical size and enhancement on contrast MRIs to require a drainage procedure? MATERIALS AND METHODS: A retrospective review of all spinal osteomyelitis patients from 2001-2012 was performed. Inclusion criteria included appropriate initial imaging, lab results, no drainage procedures of collections, and no treatment prior to admission at an outside institution...
September 10, 2016: Surgical Technology International
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