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https://www.readbyqxmd.com/read/28332921/leaving-the-skin-incision-open-may-not-be-as-beneficial-as-we-have-been-taught
#1
Jack C He, Brenda M Zosa, David Schechtman, Brian Brajcich, Jonathan C Savakus, Amanda L Wojahn, Derek Z Wang, Jeffrey A Claridge
BACKGROUND: Currently, various methods of skin closures are used in contaminated and dirty abdominal wounds without solid, evidence-based guidance. This study investigates whether closure methods affect surgical site infection (SSI) and other incisional complications. We hypothesize that open management of the skin would have the lowest complications, including SSI. PATIENTS AND METHODS: Patients age ≥18 who underwent trauma laparotomy (TL) or damage control laparotomy (DCL) from 2008-2013 and had class III/IV wounds were included...
March 23, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28325504/buttressing-of-the-eea-stapler-during-gastrojejunal-anastomosis-decreases-rate-of-bleeding-related-complications-for-laparoscopic-gastric-bypass
#2
Zachary A Ichter, Lindsay Voeller, Homero Rivas, Habib Khoury, Dan Azagury, John M Morton
BACKGROUND: Bariatric surgery is a well-tolerated and effective treatment for severe obesity. Newer surgical techniques and equipment have improved safety standards surrounding bariatric surgery. In particular, buttressing of the staple line in sleeve gastrectomy has decreased rates of clinically significant postoperative bleeding. The present study investigates the effectiveness of buttressing the circular stapled anastomosis during laparoscopic Roux-en-Y gastric bypass (LRYGB). SETTING: Academic, accredited hospital...
January 11, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28322488/surgical-glue-in-laparoscopic-sleeve-gastrectomy-an-initial-experience-and-cost-effectiveness-analysis
#3
Gregoire Mercier, Marcelo Loureiro, Vera Georgescu, El Mehdi Skalli, Marius Nedelcu, Mohamed Ramadan, Jean Michel Fabre, Patrick Lefebvre, David Nocca
RATIONALE, AIMS, AND OBJECTIVES: Laparoscopic sleeve gastrectomy (LSG) is one of the most common bariatric procedures. Gastric leaks and bleeding are the most frequent complications, associated with a high clinical and economic burden. The best method of staple line reinforcement in LSG is debated. Surgical glue is one of the options available. The aim of this study was to assess the safety, efficiency, and relative cost-effectiveness of surgical glue used to perform LSG in morbid obese adults as compared with standard stapling...
March 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28291453/a-sutureless-vascular-closure-device-for-emergent-bovine-xenograft-implantation
#4
Joseph F Knapp, Matt Maxwell, Cassidy Briggs, Erin T Shaw, Milton V Marshall, David Cheung
A novel vascular staple (C-staple) was developed that does not enter the vasculature lumen during anastomoses. The objective of this study was to demonstrate C-staple safety when used with a bovine xenograft and compare efficacy of the C-staple procedure with Anastoclip surgical clips or suturing when used with a bovine xenograft. Eight sheep had an acute comparison between suturing and C-staples using both common carotid arteries. Sixteen sheep had xenograft placement in the left carotid artery, eight with C-staples and eight with Anastoclips in a chronic study...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28280982/risk-factors-for-anastomotic-leakage-after-laparoscopic-surgery-with-the-double-stapling-technique-for-stage-0-i-rectal-carcinoma-a-subgroup-analysis-of-a-multicenter-single-arm-phase-ii-trial
#5
Keitaro Tanaka, Junji Okuda, Seiichiro Yamamoto, Masaaki Ito, Kazuhiro Sakamoto, Yukihito Kokuba, Kenichi Yoshimura, Masahiko Watanabe
PURPOSE: The aim of this study was to determine the risk factors for anastomotic leakage after laparoscopic rectal surgery. METHODS: We conducted a prospective trial involving 395 patients with stage 0/I rectal carcinoma who underwent laparoscopic low anterior resection using a double stapling technique. Data concerning variables related to patient background, tumors and surgical factors were evaluated. The outcomes with respect to anastomotic leakage were recorded, and univariate and multivariate analyses were performed to identify relevant risk factors...
March 9, 2017: Surgery Today
https://www.readbyqxmd.com/read/28273604/mucocele-complicating-stapled-hemorrhoidopexy
#6
Asia Grapsi, Alessandro Sturiale, Bernardina Fabiani, Gabriele Naldini
INTRODUCTION: Stapled hemorrhoidopexy is a safe and effective treatment for circumferential hemorrhoidal prolapse. The overall rate of complications ranges from 12,7% to 36,4% and the surgeon should be aware about their early identification and adequate treatment. PRESENTATION OF CASE: Female patient, 57 years was treated with stapled hemorrhoidopexy. Two years after surgery she reported to our center the occurrence of perineal discomfort, anal spasm and tenesmus...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28265770/a-novel-preoperative-predictor-of-pancreatic-fistula-using-computed-tomography-after-distal-pancreatectomy-with-staple-closure
#7
Yasunari Fukuda, Daisaku Yamada, Hidetoshi Eguchi, Yoshifumi Iwagami, Takehiro Noda, Tadafumi Asaoka, Hiroshi Wada, Koichi Kawamoto, Kunihito Gotoh, Masaki Mori, Yuichiro Doki
PURPOSE: A thick pancreas has proven to be a conspicuous predictor of pancreatic fistula (PF) following distal pancreatectomy (DP) using staples. Other predictors for this serious surgical complication currently remain obscure. This study sought to identify novel predictors of PF following DP. METHODS: One hundred and twenty-two patients were retrospectively assessed to determine the correlation between PF occurrence and the clinicopathological findings and radiologic data from preoperative computed tomography (CT)...
March 6, 2017: Surgery Today
https://www.readbyqxmd.com/read/28236013/needlescopic-sleeve-gastrectomy-pushing-the-boundaries-of-the-standard-technique
#8
Marcelo Loureiro, Abdulah Sultan, Mohannad Alhaddad, Hatem Mostafa, David Nocca, Marius Nedelcu, Walled Buhaimed
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most common bariatric surgery performed worldwide. Improvements in LSG have been suggested to achieve better weight loss or to lessen the complications rates. We propose a change in the standard technique to privilege the use of thinner instruments, the needlescopic sleeve gastrectomy (NSG). METHODS: A 40-year-old female, BMI 40, with no previous abdominal surgery was selected for a NSG. She was placed in a semi-sitting position with the surgeon standing between the legs...
February 24, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28218394/cross-sectional-observational-study-of-the-availability-of-evidence-supporting-novel-implantable-devices-used-in-gastrointestinal-surgery
#9
S J Chapman, B Shelton, M Maruthappu, P Singh, P McCulloch, A Bhangu
BACKGROUND: Evidence supporting the implementation of novel surgical devices is unstandardized, despite recommendations for assessing novel innovations. This study aimed to determine the proportion of novel implantable devices used in gastrointestinal surgery that are supported by evidence from RCTs. METHODS: A list of novel implantable devices placed intra-abdominally during gastrointestinal surgery was produced. Systematic searches were performed for all devices via PubMed and clinical trial registries...
February 20, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28211291/a-biomechanical-analysis-of-tibial-acl-reconstruction-with-graft-length-mismatch
#10
Evan B Gaines, Diana Lau, Qais Naziri, Westley Hayes, Julio J Jauregui, Bhaveen H Kapadia, William P Urban, Bashir A Zikria
INTRODUCTION: The incidence of graft length mismatch (GLM) during anterior cruciate ligament (ACL) reconstruction is reported to be up to 13%, with a rate of 20% when using bone-patellar tendon-bone (BPTB) allografts. Multiple techniques have been described to accommodate for the longer BPTB graft. As no study has compared the biomechanical properties of these methods (with cyclic loading), we evaluated the strength of four different surgical techniques used to accommodate for GLM during ACL reconstruction...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28205037/the-mesenteric-defects-in-laparoscopic-roux-en-y-gastric-bypass-5-years-follow-up-of-non-closure-versus-closure-using-the-stapler-technique
#11
Ebrahim Aghajani, Bent J Nergaard, Bjorn G Leifson, Jan Hedenbro, Hjortur Gislason
BACKGROUND: Internal hernia (IH) is a common complication of laparoscopic Roux-en-Y gastric bypass (LRYGB). Little large-volume data exist on how to handle the mesenteric defects during LRYGB. This study evaluated long-term follow-up (5.5 years) of 2443 patients with primary closure of the mesenteric defects with a stapling device at LRYGB, in comparison with a non-closed group from the same centre. METHODS: All patients (N = 4013) undergoing LRYGB over a 10-year period (2005-2015) at a single institution were evaluated...
February 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28185993/intracarpal-shortening-osteotomy-for-kienb%C3%A3-ck-s-disease-a-retrospective-study-of-28%C3%A2-cases
#12
J Chevrollier, G Pomares, S Huguet, F Dap, G Dautel
INTRODUCTION: Kienböck's disease is rare in patients with a neutral or positive ulnar variance. In these situations, treatment is challenging and controversial. Various intracarpal shortening osteotomy (ICSO) procedures have been proposed. OBJECTIVE: Study the effect of the type of ICSO (isolated capitate osteotomy or combined with hamate osteotomy) on the clinical and radiological outcomes in a retrospective series. METHODS: Patients with Kienböck's disease were treated with ICSO...
February 7, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28177992/limited-endoscopic-assisted-wedge-resection-for-excision-of-colon-polyps
#13
Laura W Leicher, Wouter H de Vos Tot Nederveen Cappel, Henderik L van Westreenen
BACKGROUND: Combined endoscopic laparoscopic surgical removal is used for polyps in the colon that are not suitable for endoscopic removal because of size, location, or scarring. However, the placement of a linear stapler can be challenging. Currently a wedge resection is mostly documented in the cecum or ascending colon. OBJECTIVE: We report on our experience with limited endoscopy-assisted wedge resections in the entire colon. DESIGN: A retrospective study was performed...
March 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28170219/on-demand-dissolution-of-chemically-cross-linked-hydrogels
#14
Marlena D Konieczynska, Mark W Grinstaff
The formation and subsequent on-demand dissolution of chemically cross-linked hydrogels is of keen interest to chemists, engineers, and clinicians. In this Account, we summarize our recent advances in the area of dissolvable chemically cross-linked hydrogels and provide a comparative discussion of other recent hydrogel systems. Using biocompatible macromonomers, we developed a library of cross-linked dendritic hydrogels that possess favorable properties, including biocompatibility, tissue adhesion, and swelling...
February 7, 2017: Accounts of Chemical Research
https://www.readbyqxmd.com/read/28144206/functional-disorders-rectoanal-intussusception
#15
REVIEW
Kristen Blaker, Joselin L Anandam
Rectoanal intussusception is an invagination of the rectal wall into the lumen of the rectum. Patients may present with constipation, incomplete evacuation, incontinence, or may be asymptomatic. Defecography has been the gold standard for detection. Magnetic resonance imaging defecography and dynamic anal endosonography are alternatives to conventional defecography. However, both methods are not as sensitive as conventional defecography. Treatment options range from conservative/medical treatment such as biofeedback to surgical procedures such as Delorme, rectopexy, and stapled transanal rectal resection...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28138899/case-control-study-of-postoperative-blood-pressure-in-patients-with-hemorrhagic-complications-after-laparoscopic-sleeve-gastrectomy-and-matched-controls
#16
Michał Robert Janik, Tomasz Rogula, Piotr Kowalewski, Maciej Walędziak, Maciej Matłok, Jakub Brągoszewski, Andrzej Kwiatkowski, Krzysztof Paśnik
INTRODUCTION: Laparoscopic sleeve gastrectomy is associated with a moderate risk of hemorrhagic complications (HC). There is a debate regarding the relationship between HC and high blood pressure in postoperative period. AIM: The aim is to clarify whether the postoperative blood pressure is an independent risk factor for hemorrhagic complications after laparoscopic sleeve gastrectomy. METHODS: Medical records of 522 patients were reviewed...
January 30, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28129320/totally-endoscopic-robotic-left-atrial-appendage-closure-demonstrates-high-success-rate
#17
Alison F Ward, Robert M Applebaum, Nana Toyoda, Ans Fakiha, Peter J Neuburger, Jennie Ngai, Robert G Nampiaparampil, David W Yaffee, Didier F Loulmet, Eugene A Grossi
OBJECTIVE: In patients with atrial fibrillation, 90% of embolic strokes originate from the left atrial appendage (LAA). Successful exclusion of the LAA is associated with a lower stroke rate in patients with atrial fibrillation. Surgical oversewing of the LAA is often incomplete when evaluated with transesophageal echocardiogram (TEE). External closure techniques of suturing and stapling have also demonstrated high failure rates with persistent flow and large stumps. We hypothesized that the precise visualization of a robotic LAA closure (RLAAC) would result in superior closure rates...
January 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28128912/robotic-assisted-radical-cystoprostatectomy-and-intracorporeal-ileal-conduit-urinary-diversion-for-a-kidney-transplant-recipient
#18
Peter A Caputo, Daniel Ramirez, Matthew Maurice, Ryan Nelson, Onder Kara, Ercan Malkoc, David Goldfarb, Jihad Kaouk
INTRODUCTION AND OBJECTIVES: Robotic assisted radical cystectomy (RARC) is an alternative to open radical cystectomy. As experience is gained with the RARC approach the technique is being applied to more complex surgical cases. We describe here our technique for RARC with intracorporeal ileal conduit urinary diversion for a renal transplant recipient. MATERIALS AND METHODS: The patient is a 60-year old man with high-grade muscle invasive bladder cancer. He has a history of renal failure due to polycystic kidney disease and received a deceased donor renal transplant in 2008...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28108931/systematic-review-and-meta-analysis-of-surgicaltreatment-of-non-zenker-s-oesophageal-diverticula
#19
David S Y Chan, Antonio Foliaki, Wyn G Lewis, Geoffrey W B Clark, Guy R J C Blackshaw
BACKGROUND: Oesophageal diverticula are rare outpouchings of the oesophagus which may be classified anatomically as pharyngeal (Zenker's), mid-oesophageal and epiphrenic. While surgery is indicated for symptomatic patients, no consensus exists regarding the optimum technique for non-Zenker's oesophageal diverticula. The aim of this study was to determine the outcome of surgery in patients with non-Zenker's oesophageal diverticula. METHODS: PubMed, MEDLINE and the Cochrane Library (January 1990 to January 2016) were searched for studies which reported outcomes of surgery in patients with non-Zenker's oesophageal diverticula...
January 20, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28103879/a-comparison-of-cervical-delta-shaped-anastomosis-and-circular-stapled-anastomosis-after-esophagectomy
#20
Chen Huang, Xunhai Xu, Binbin Zhuang, Wenshu Chen, Xunyu Xu, Chao Wang, Shengmei Lin
BACKGROUND: The delta-shaped anastomosis has been reported to reduce anastomotic complications for a decade. However, little has been written comparing this technique with the circular stapler technique. The objective of this retrospective study was to assess the safety and efficacy of cervical delta-shaped anastomosis after esophagectomy. METHODS: Medical records of patients with esophageal squamous cell carcinoma who underwent McKeown (three-incision) esophagectomy between September 2013 and June 2015 were reviewed...
January 19, 2017: World Journal of Surgical Oncology
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