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Surgical clipping

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https://www.readbyqxmd.com/read/28444497/evaluation-of-crowd-sourced-assessment-of-the-critical-view-of-safety-in-laparoscopic-cholecystectomy
#1
Shanley B Deal, Dimitrios Stefanidis, Dana Telem, Robert D Fanelli, Marian McDonald, Michael Ujiki, L Michael Brunt, Adnan A Alseidi
BACKGROUND: Faculty experts (FE) and crowd workers (CW) can assess technical skill, but assessment of operative technique has not been explored. We sought to evaluate if CW could be taught to assess completion of the critical view of safety (CVS) in laparoscopic cholecystectomy. METHODS: We prepared 160 blinded, surgical videos of laparoscopic cholecystectomy from public domain websites. Videos were edited to ≤60 s, ending when a structure was cut/clipped. CW analyzed videos using Global Objective Assessment of Laparoscopic Skills (GOALS) and CVS criteria assessment tools after watching an instructional tutorial...
April 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28437673/successful-primary-repair-of-late-diagnosed-spontaneous-esophageal-rupture-a-case-report
#2
Diana Y Kircheva, Wickii T Vigneswaran
INTRODUCTION: Spontaneous esophageal rupture is rare, roughly 300 cases reported annually. Diagnosis is often delayed or missed. Overall mortality is about 20%. This feared high mortality rate has led to the misconception that primary esophageal repair should be avoided in late diagnosed patients. We report a successful primary repair of spontaneous esophageal rupture which was delayed for more than two weeks. METHODS: A 53 year-old male presented to our medical service after falsely having been treated for pneumonia at an outside hospital...
April 1, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28427127/-surgical-management-of-ophthalmic-artery-aneurysms-via-minimally-invasive-frontolateral-approach
#3
J T Wang, Z S Kan, S Wang
Objective: To explore the minimally invasive techniques and outcome of carotid ophthalmic artery aneurysms clipping via a frontolateral approach. Methods: The clinical data of 95 patients with carotid ophthalmic artery aneurysms treated via frontolateral approach in the last 1.5 years in Beijing Tiantan Hospital and Beijing Anzhen Hospital were analyzed retrospectively.Before the operation, digital subtraction angiogram (DSA) was performed among all patients.The patients were divided into two groups by the lateral approach...
April 18, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28422878/microsurgical-treatment-of-carotid-ophthalmic-aneurysm-associated-with-multiple-anterior-and-posterior-circulation-aneurysms-a-case-report
#4
Jiantao Wang, Zhisheng Kan, Shuo Wang
BACKGROUND: The clipping of multiple intracranial aneurysms in 1 stage is uncommon. In this case, we report clipping of an ophthalmic aneurysm associated with multiple anterior and posterior circulation aneurysms via the Dolenc approach. METHODS: The main symptoms of the patient are headache, along with nausea and vomiting. The patient's arteriogram revealed a wide-necked aneurysm of the right ophthalmic artery, an irregular aneurysm of the anterior communicating artery, and a basilar artery aneurysm...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28417489/management-of-septic-emboli-in-patients-with-infectious-endocarditis
#5
Seyed Hossein Aalaei-Andabili, Tomas Martin, Phillip Hess, Brian Hoh, Meshka Anderson, Charles T Klodell, Thomas M Beaver
BACKGROUND AND AIM: Septic emboli (SE) associated with infectious endocarditis (IE) can result in splenic abscesses and infectious intracranial aneurysms (IIA). We investigated the impact of SE on patient outcomes following surgery for IE. METHOD: From January-2000 to October-2015, all patients with surgical IE (n = 437) were evaluated for incidence and management of SE. RESULTS: Overall SE was found in 46/437 (10.52%) patients (n = 17 spleen, 13 brain, and 16 both)...
April 17, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28409729/neuropsychological-function-after-endovascular-and-neurosurgical-treatment-of-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#6
Peter Egeto, R Loch Macdonald, Tisha J Ornstein, Tom A Schweizer
OBJECTIVE Subarachnoid hemorrhage (SAH) is treated with either surgical clipping or endovascular coiling, though the latter is the preferred treatment method given its more favorable functional outcomes. However, neuropsychological functioning after treatment is rarely taken into account. In this meta-analysis, the authors synthesized relevant data from the literature and compared neuropsychological functioning in patients after coiling and clipping of SAH. They hypothesized that the coiled patients would outperform the clipped patients; that group differences would be greater with higher posterior circulation rupture rates, in older patients, and in more recent publications; that group differences would be smaller with greater rates of middle cerebral artery (MCA) rupture; and that anterior communicating artery (ACoA) rupture rates would not influence effect sizes...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28408994/endoscopic-management-of-patients-with-post-surgical-leaks-involving-the-gastrointestinal-tract-a-large-case-series
#7
Raffaele Manta, Angelo Caruso, Carlo Cellini, Mariano Sica, Angelo Zullo, Vincenzo Giorgio Mirante, Helga Bertani, Marzio Frazzoni, Massimiliano Mutignani, Giuseppe Galloro, Rita Conigliaro
BACKGROUND: Post-surgical anastomotic leaks often require a re-intervention, are associated with a definite morbidity and mortality, and with relevant costs. We described a large series of patients with different post-surgical leaks involving the gastrointestinal tract managed with endoscopy as initial approach. METHODS: This was a retrospective analysis of prospectively collected cases with anastomotic leaks managed with different endoscopic approaches (with surgical or radiological drainage when needed) in two endoscopic centres during 5 years...
December 2016: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28408258/predictors-of-postoperative-cerebral-ischemia-in-patients-with-ruptured-anterior-communicating-artery-aneurysms
#8
Pei-Sen Yao, Guo-Rong Chen, Shu-Fa Zheng, De-Zhi Kang
OBJECTIVE: Cerebral ischeamia is a major contributor to poor outcome after ruptured anterior communicating artery aneurysms (AcoAs), and is not well classified. Here we develop a classification and identify risk factors of cerebral ischemia after ruptured ACoAs. MATHERIAL AND METHODS: A total of 360 patients with ruptured ACoAs undergoing microsurgical clipping were collected. Sex, age, smoking, Hunt-Hess grade, Fisher grade, hospital stay, surgical timing, hypertension, diabetes, postoperative cerebral ischemia, and postoperative mRS score were collected...
April 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28403602/nonabsorbable-polymer-clip-as-a-cause-of-chronic-perineal-pain-after-radical-prostatectomy-description-of-a-case-treated-by-transperineal-approach
#9
Massimiliano Creta, Sergio Di Meo, Roberto Buonopane, Bernardo Rocco, Vittorio Imperatore
The occurrence of persistent perineal pain caused by surgical clips has rarely been described after radical prostatectomy (RP). We describe the case of a patient complaining of chronic perineal pain occurred soon after robotic RP, refractory to conventional medical therapy and exacerbated by the sitting position. Pain was related to a nonabsorbable polymer clip used to secure lateral pedicles. A transpeerineal approach was used to perform an hydrodissection of the rectovesical space at the level of the surgical clip combined with local injection of mepivacaine and betametasone...
March 31, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28402528/macrovascular-decompression-of-the-brainstem-and-cranial-nerves-evolution-of-an-anteromedial-vertebrobasilar-artery-transposition-technique
#10
Omar Choudhri, Ian D Connolly, Michael T Lawton
BACKGROUND: Tortuous and dolichoectatic vertebrobasilar arteries can impinge on the brainstem and cranial nerves to cause compression syndromes. Transposition techniques are often required to decompress the brainstem with dolichoectatic pathology. We describe our evolution of an anteromedial transposition technique and its efficacy in decompressing the brainstem and relieving symptoms. OBJECTIVE: To present the anteromedial vertebrobasilar artery transposition technique for macrovascular decompression of the brainstem and cranial nerves...
April 11, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28400817/nonhuman-primate-models-of-focal-cerebral-ischemia
#11
REVIEW
Jingjing Fan, Yi Li, Xinyu Fu, Lijuan Li, Xiaoting Hao, Shasha Li
Rodents have been widely used in the production of cerebral ischemia models. However, successful therapies have been proven on experimental rodent stroke model, and they have often failed to be effective when tested clinically. Therefore, nonhuman primates were recommended as the ideal alternatives, owing to their similarities with the human cerebrovascular system, brain metabolism, grey to white matter ratio and even their rich behavioral repertoire. The present review is a thorough summary of ten methods that establish nonhuman primate models of focal cerebral ischemia; electrocoagulation, endothelin-1-induced occlusion, microvascular clip occlusion, autologous blood clot embolization, balloon inflation, microcatheter embolization, coil embolization, surgical suture embolization, suture, and photochemical induction methods...
February 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28400348/to-clip-or-not-to-clip-the-breast-tumour-bed-a-retrospective-look-at-the-geographical-miss-index-and-normal-tissue-index-of-110-breast-cancer-patients
#12
Florian Ebner, Nikolaus deGregorio, Andreas Rempen, Peter Mohr, Amelie de Gregorio, Achim Wöckel, Wolfgang Janni, Gerlo Witucki
OBJECTIVE: Planning of breast radiation for patients with breast conserving surgery often relies on clinical markers like scars. Lately surgical clips have been used to identify the tumour location. The purpose of this study is to evaluate the geographical miss index (GMI) and the normal tissue index (NTI) for the electron boost in breast cancer treatment plans with and without surgical clips. MATERIAL AND METHODS: A retrospective descriptive study of 110 consecutive post surgical patients with breast-conserving treatment in early breast cancer comparing the clinical treatment field with the radiological (clipped) field and respectively calculating the GMI/NTI for the electron boost...
February 7, 2017: Journal of the Turkish German Gynecological Association
https://www.readbyqxmd.com/read/28387620/reoperation-and-readmission-after-clipping-of-an-unruptured-intracranial-aneurysm-a-national-surgical-quality-improvement-program-analysis
#13
Hormuzdiyar H Dasenbrock, Timothy R Smith, Robert F Rudy, William B Gormley, M Ali Aziz-Sultan, Rose Du
OBJECTIVE Although reoperation and readmission have been used as quality metrics, there are limited data evaluating the rate of, reasons for, and predictors of reoperation and readmission after microsurgical clipping of unruptured aneurysms. METHODS Adult patients who underwent craniotomy for clipping of an unruptured aneurysm electively were extracted from the prospective National Surgical Quality Improvement Program registry (2011-2014). Multivariable logistic regression and recursive partitioning analysis evaluated the independent predictors of nonroutine hospital discharge, unplanned 30-day reoperation, and readmission...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28386838/minimally-invasive-medial-supraorbital-combined-subfrontal-interhemispheric-approach-to-the-anterior-communicating-artery-complex-a-cadaveric-study
#14
Alexander Spiessberger, F Baumann, E Nevzati, K F Kothbauer, J Fandino, C Muroi
INTRODUCTION: In selected cases, microsurgical clipping remains a valuable treatment alternative to endovascular occlusion of anterior communicating artery (AComA) aneurysms. Their clipping is challenging and carries a risk of postsurgical cognitive impairment. We evaluate the microsurgical anatomy of a new, minimally invasive combined interhemispheric-subfrontal approach to the AComA complex via a medial supraorbital craniotomy. METHODS: In this descriptive anatomic study, four alcohol-embedded, silicon-injected human cadaver heads were used...
April 7, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28386697/postoperative-changes-after-surgical-mesh-hernia-repair-a-pitfall-in-interpretation-of-18f-fdg-pet-ct
#15
T Davidson, E Klang, E Goshen, J Goldstein, M Khaikin, B Chikman, S Ben-Haim
OBJECTIVE: A number of case reports have demonstrated FDG uptake around mesh prostheses after hernia repair surgery. This study characterizes FDG PET-CT findings after hernia repair with synthetic mesh in a series of cancer patients. MATERIALS AND METHODS: FDG PET-CT studies were reviewed for increased FDG uptake consistent with CT appearances of post-surgical hernia repair in cancer patients. The findings were correlated with clinical data and follow-up studies...
April 6, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28385100/predictive-factors-for-the-migration-of-endoscopic-self-expanding-metal-stents-placed-in-the-foregut
#16
Jordan L Singer, Amir H Aryaie, Mojtaba Fayezizadeh, Jon Lash, Jeffrey M Marks
BACKGROUND: With recent advancements in endoscopy, self-expandable metal stents (SEMS) have been used to treat gastrointestinal leaks, perforations, and strictures. Stent migration frequently complicates management and often requires additional treatments to reach resolution. Our study aimed to determine predictive factors for stent migration. METHODS: Consecutive procedures involving SEMS placed with and without fixation after upper gastrointestinal surgery between 2009 and 2014 were retrospectively reviewed...
April 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28381783/endoscopic-ultrasonography-guided-biliary-drainage-for-repetitive-acute-cholangitis-of-the-accessory-hepatic-duct-obstructed-by-clipping-during-laparoscopic-cholecystectomy
#17
Fumisato Kozakai, Yoshihide Kanno, Kei Ito, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Kaori Masu, Toshitaka Sakai, Yoshiharu Masaki, Toji Murabayashi, Sho Hasegawa, Yutaka Noda
An 88-year-old man who had been suffering from repetitive fever and abdominal pain every few months for several years was diagnosed with localized acute cholangitis and referred to our center. Various examinations, including computed tomography (CT) and endoscopic ultrasonography (EUS), revealed that the accessary hepatic duct was obstructed by clips used during laparoscopic cholecystectomy performed 7 years previously. It was not possible to approach the completely isolated duct via the transpapillary route...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28379515/far-lateral-approach-without-drilling-the-occipital-condyle-for-vertebral-artery-posterior-inferior-cerebellar-artery-aneurysms
#18
Pablo Seoane, Samuel Kalb, Justin C Clark, Juan C Rivas, David S Xu, George A C Mendes, Mark C Preul, Joseph M Zabramski, Robert F Spetzler, Peter Nakaji
BACKGROUND: The far-lateral transcondylar surgical approach is often used to clip vertebral artery (VA) and posterior inferior cerebellar artery (PICA) aneurysms. The role of condyle resection during this approach is controversial. OBJECTIVE: To evaluate patient outcomes in patients with VA-PICA aneurysms in whom drilling the occipital condyle was not necessary. METHODS: Between May 2005 and December 2012, a total of 56 consecutive patients with incidental or ruptured VA-PICA aneurysms underwent surgery with a far-lateral approach without condylar resection...
April 4, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28378087/the-tunnel%C3%A2-%C3%A2-clip-strategy-standardised-and-facilitates-oesophageal-esd-procedures-a-prospective-consecutive-bi-centric-study
#19
Jérémie Jacques, Romain Legros, Jérome Rivory, Aurélie Charissoux, Denis Sautereau, Thierry Ponchon, Mathieu Pioche
INTRODUCTION: ESD is the treatment of choice for superficial neoplasms of the oesophagus; ESD is oncologically efficient and associated with less morbidity than the surgical alternative. ESD requires a high level of skill, being both technically challenging and time consuming. Therefore, ESD is often reserved for experts. A combination of a tunnel technique with clip-line traction may enable optimisation of oesophageal ESD. PATIENTS AND METHODS: From January 2015 to December 2016, we performed a prospective two-centre case study of consecutive "tunnel + clip" oesophageal ESD...
April 4, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28377249/trends-in-resident-operative-teaching-opportunities-for-treatment-of-intracranial-aneurysms
#20
Matthew Piazza, Nikhil Nayak, Zarina Ali, Gregory Heuer, Matthew Sanborn, Sherman Stein, James Schuster, M Sean Grady, Neil R Malhotra
OBJECTIVE: The International Subarachnoid Aneurysm Trial heralded a paradigm shift in the treatment of intracranial aneurysms. During this same time frame neurosurgical training programs increased in size and scope. The present study examines the impact of trends in surgical clipping and the endovascular treatment of intracranial aneurysms, over one decade, and the neurosurgical resident complement on the resident teaching environment using the Nationwide Inpatient Sample (NIS). METHODS: The NIS was used to estimate the number of aneurysms treated with either surgical clipping and endovascular methods from 2002 through 2011 at teaching institutions...
April 1, 2017: World Neurosurgery
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