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Surgical Technology International

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https://www.readbyqxmd.com/read/28182829/transoral-endoscopic-thyroidectomy-vestibular-approach-toetva-from-a-to-z
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28182826/the-learning-curve-associated-with-the-administration-of-intra-articular-liposomal-bupivacaine-for-total-knee-arthroplasty-a-pilot-study
#4
Anton Khlopas, Randa K Elmallah, Morad Chughtai, George A Yakubek, Mhamad Faour, Alison K Klika, Carlos A Higuera, Robert M Molloy, Michael A Mont
INTRODUCTION: Liposomal bupivacaine is a long-acting, local, injectable anesthetic that is used to potentially mitigate post-operative pain after total knee arthroplasty (TKA). In addition, it may reduce opioid use in the post-operative period and shorten lengths-of-stay (LOS). There have been mixed results in the literature with regards to its efficacy, which raises questions regarding the injection technique used. Therefore, we evaluated the learning curve associated with injection techniques prior to, and after, formal teaching...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28182825/biosurgical-hemostatic-agents-in-neurosurgical-intracranial-procedures
#5
Roberto Gazzeri, Marcelo Galarza, Giorgio Callovini, Alex Alfieri
Intraoperative hemostasis during neurosurgical procedures is one of the most important aspects of intracranial surgery. Hemostasis is mandatory to keep a clean operative field and to prevent blood loss and postoperative hemorrhage. In neurosurgical practice, biosurgical hemostatic agents have proved to be extremely useful to complete the more classic use of electrocoagulation. During recent years, many biosurgical topical hemostatic agents were created. Although routinely used during neurosurgical procedures, there is still a great deal of confusion concerning optimal use of these products, because of the wide range of products, as absorbable topical agents, antifibrinolytics agents, fibrin sealants and hemostatic matrix, which perform their hemostatic action in different ways...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28182824/a-portable-shoulder-mounted-camera-system-for-surgical-education-in-spine-surgery
#6
Martin H Pham, Ifije E Ohiorhenuan, Neil N Patel, Andre M Jakoi, Patrick C Hsieh, Frank L Acosta, Jeffrey C Wang, John C Liu
The past several years have demonstrated an increased recognition of operative videos as an important adjunct for resident education. Currently lacking, however, are effective methods to record video for the purposes of illustrating the techniques of minimally invasive (MIS) and complex spine surgery. We describe here our experiences developing and using a shoulder-mounted camera system for recording surgical video. Our requirements for an effective camera system included wireless portability to allow for movement around the operating room, camera mount location for comfort and loupes/headlight usage, battery life for long operative days, and sterile control of on/off recording...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28182823/how-to-direct-the-neuronal-growth-process-in-peripheral-nerve-regeneration-future-strategies-for-nanosurfaces-scaffold-and-magnetic-nanoparticles
#7
Andrea Poggetti, Pietro Battistini, Paolo Domenico Parchi, Michela Novelli, Simona Raffa, Marco Cecchini, Anna Maria Nucci, Michele Lisanti
Currently, the gold standard to repair large nerve defects is the autologous nerve graft. These solutions offer a mechanical support, adhesion substrates, and, with Schwann cells (SC), a source of neurotropic factors for axonal growth. The technical limits are the donor side damage, multiple surgical accesses, and the unavailability of large amounts of grafts. In recent years, several researchers focused their attention on the interaction between cells (nervous and glial) and physic-chemical cues that arise from the extracellular milieu...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28182822/early-termination-of-randomized-clinical-trials-in-orthopaedics
#8
Nicolas Piuzzi, Morad Chughtai, Anton Khlopas, Chukwuweike U Gwam, George Muschler, Kurt P Spindler, Michael A Mont
Randomized controlled clinical trials (RCTs) in orthopaedics, similar to all medical fields, provide the highest level of clinical data and constitute the cornerstone for evidence-based therapeutic advances. Orthopaedic clinical trials face the same challenges as in other medical fields, such as insufficient recruitment, unforeseen adverse events, and futility. In this article, we highlight the reasons for early termination of clinical trials and provide examples of each type.
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28182821/intrawound-vancomycin-powder-reduces-early-prosthetic-joint-infections-in-revision-hip-and-knee-arthroplasty
#9
Jeffrey E Otte, Joel R Politi, Bryan Chambers, Craig A Smith
Intrawound vancomycin powder has shown efficacy and safety in decreasing postoperative spine infections, but its use in arthroplasty has not been well established. The purpose of this study was to compare the rate of early prosthetic joint infections (PJI) with and without the use of intrawound vancomycin powder during joint arthroplasty. A retrospective cohort of all patients who underwent primary or revision hip or knee arthroplasty by two surgeons over a two-year period at a single hospital system was evaluated...
February 7, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28085989/real-world-clinical-quality-improvement-for-complex-abdominal-wall-reconstruction
#10
Bruce Ramshaw, Brandie Remi Forman, Karla Moore, Eric Heidel, Michael Fabian, Greg Mancini, Girish P Joshi
INTRODUCTION: Traditional methods of clinical research may not be adequate to improve the value of care for patients undergoing abdominal wall reconstruction (AWR). These patients are prone to high complication rates and high costs. Here, we describe a clinical quality improvement (CQI) effort to enhance outcomes for patients undergoing AWR. MATERIALS AND METHODS: CQI was applied for the entire care cycle for consecutive patients who underwent AWR from August 2011-September 2015...
January 13, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072903/laparoscopic-treatment-of-giant-ventral-hernia-experience-of-35-patients
#11
Michele Grande, Giorgio Lisi, Michela Campanelli, Simona Grande, Dario Venditti, Casimiro Nigro, Francesca Cabry, Massimo Villa
BACKGROUND: Minimal access surgery for incisional hernia repair is still debated, especially for giant wall defects. Laparoscopic repair may reduce pain and hospital stay. This study was designed to evaluate the feasibility of the laparoscopic technique in giant hernia. MATERIALS AND METHODS: From 2007 to 2013, 35 consecutive patients with giant ventral hernia, according to the Chevrel classification, underwent laparoscopic repair. Fourteen patients were obese, with a body mass index (BMI) > 30 and in 21 patients the mean BMI was 24 (range 22-28)...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072902/development-of-an-encompassing-questionnaire-for-evaluating-the-outcomes-following-total-knee-arthroplasty
#12
Morad Chughtai, Anton Khlopas, Melbin Thomas, Chukwuweike U Gwam, Julio J Jauregui, Randa K Elmallah, Martin Roche, Michael A Mont
INTRODUCTION: There are many standardized scales and questionnaires used to evaluate TKA patients; however, individually they do not always assess patients adequately. Consequently, many are used in combinations to provide a thorough evaluation. However, this leads to redundancy, confusion, and an excessive patient time-burden. Therefore, the purpose of this study was to develop a usable combined knee questionnaire that combines questions in a non-redundant manner. Specifically, we aimed to: 1) create a combined knee questionnaire that encompasses questions from multiple systems, while eliminating redundancy; 2) correlate the new system with the existing validated questionnaires; and 3) determine the length of time it takes to administer this new questionnaire...
10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072901/achilles-tendon-repair-using-the-internalbrace%C3%A2-principle
#13
Graeme P Hopper, Gordon M Mackay
Despite extensive research, the management of acute ruptures of the Achilles tendon remains an area of controversy, and there is no consensus regarding the optimal treatment. An InternalBrace™ (Arthrex, Inc., Naples, Florida) is a ligament augmentation repair using high strength sutures/tape and knotless bone anchors which encourages healing and allows early mobilization. This article describes, with video illustration, a knotless Achilles tendon repair technique using the InternalBrace™ principle.
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072900/efficacy-of-adductor-canal-blockade-compared-to-multimodal-peri-articular-analgesia-following-total-knee-arthroplasty
#14
Chukwuweike U Gwam, Jaydev B Mistry, Priya Jha, Anton Khlopas, Melbin Thomas, Morad Chughtai, Michael A Mont, Ronald E Delanois
INTRODUCTION: Postoperative pain after total knee arthroplasty (TKA) can be an impediment to patient recovery. Many commonly used pain control modalities are effective, but are also associated with adverse effects. Other modalities, such as adductor canal blocks (ACB) and multimodal periarticular analgesia (MPA), have gained popularity due to their efficacy and high safety profile. However, to the best of our knowledge, there are no published studies indicating if a therapeutic advantage exists between the two pain control modalities...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072899/endoluminal-vacuum-therapy-as-treatment-for-anastomotic-colorectal-leakage
#15
Giovanni Milito, Giorgio Lisi, Dario Venditti, Michela Campanelli, Elena Aronadio, Simona Grande, Francesca Cabry, Michele Grande
BACKGROUND: The clinical leakage rate after anterior resection varies from 2.8-20%, with a 6-22% mortality rate and a 10-80% risk of permanent stoma. Endo-SPONGE® (B. Braun Melsungen AG, Melsungen, Germany) may treat extraperitoneal anastomotic leakage in the lesser pelvis. It consists of an open-pored sponge inserted into the cavity. A drainage tube fixed to a low vacuum drainage system is then connected to the sponge through the anus. MATERIAL AND METHODS: Between January 2007 and December 2014, 14 patients with anastomotic leakage following low anterior resection were treated with Endo-SPONGE® and were prospectively evaluated...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28072898/three-year-results-with-a-ringless-third-generation-porous-plasma-sprayed-acetabular-component-in-primary-total-hip-arthroplasty
#16
Keith R Berend, Joanne B Adams, Michael J Morris, Adolph V Lombardi
INTRODUCTION: We previously reported promising early results in patients undergoing primary total hip arthroplasty (THA) with a third-generation cementless acetabular system that has a porous plasma-sprayed coating on a titanium alloy substrate shell, a ringless barb and groove locking mechanism, and a vitamin E-infused highly crosslinked polyethylene insert. The purpose of this study was to examine the outcomes and need for revision in a subset of patients previously reviewed who now have potential for three-year follow-up...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/27984848/long-term-outcome-after-laparoscopic-repair-of-primary-unilateral-inguinal-hernia-using-a-self-adhering-mesh
#17
Tim Tollens, Halit Topal, Alexander Lucardie, Koen Vermeiren, Chris Aelvoet, Kurt Devroe
Following our previous study about a lightweight self-adhering mesh (Adhesix®, Cousin Biotech, Wervicq-Sud, France; distributed by Davol Inc., subsidiary of C.R. Bard, Inc.), we report the long-term results with the use of this mesh in patients treated for a primary, unilateral inguinal hernia without any other hernias. Prospectively collected data of 100 patients between February 2011 and February 2014 were analyzed. The mean follow-up time was 2.7 years (range 1-4), and mean length of hospital stay was 0...
December 16, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27984847/intraarticular-administration-of-tranexamic-acid-is-safe-and-effective-in-total-knee-arthroplasty-patients-at-high-risk-for-thromboembolism
#18
Ronald E Delanois, Chukwuweike Gwam, Jaydev B Mistry, Morad Chughtai, Melbin Thomas, Prathik P Mudaliar, Anton Khlopas, Vidur Tangri, Michael A Mont
INTRODUCTION: Tranexamic acid (TXA) is an antifibrinolytic agent that can be used to reduce blood loss in total knee arthroplasty (TKA) patients. Due to its thrombogenic properties, intravenous (IV) TXA is contraindicated in patients who have an increased risk of arterial or venous thrombosis. For such patients, intraarticular (IA) TXA may be a safe alternative. In this study, we compare: 1) complication rates; 2) intraoperative blood loss; and 3) need for transfusion in TKA patients who received IA TXA versus patients who used IV TXA...
December 16, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27984597/neurofibroma-of-the-gallbladder-not-associated-with-neurofibromatosis
#19
Tsutomu Namikawa, Yasuhiro Kawanishi, Yuki Fujieda, Kazune Fujisawa, Eri Munekage, Masaya Munekage, Hiromichi Maeda, Hiroyuki Kitagawa, Michiya Kobayashi, Kazuhiro Hanazak
An 82-year-old woman had visited her local clinic with a history of abdominal discomfort and dyspepsia related to meals over a period of several months. Esophagogastroduodenoscopy revealed a superficial spreading tumor that, on biopsy, was proven to be an adenocarcinoma, and colonoscopy revealed an ascending mass that was found to be an adenocarcinoma on biopsy, so the patient was referred to our hospital. Abdominal computed tomography revealed a mass in the ascending colon with regional lymph node swelling and a gallbladder stone measuring 1...
December 16, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27960222/factors-predisposing-to-dislocation-after-primary-total-hip-arthroplasty-a-multivariate-analysis-of-risk-factors-at-7-to-10-years-follow-up
#20
Michele Francesco Surace, Luca Monestier, Fabio D'Angelo, Andrea Bertagnon
BACKGROUND: Dislocation of primary THA (total hip arthroplasty) is one of the most undesirable complications with an incidence ranging from 2% to 5%. Several risk factors are described, related to the patient, surgery, or prosthetic design. The aim of the study was to assess risk factors and their potential influence on dislocation. MATERIALS AND METHODS: 387 primary THA were performed between September 2005 to December 2008 at our institute (Varese, Italy) through a modified posterior-lateral approach...
December 13, 2016: Surgical Technology International
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