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https://www.readbyqxmd.com/read/28634630/development-and-validation-of-a-tool-for-non-technical-skills-evaluation-in-robotic-surgery-the-icars-system
#1
Nicholas Raison, Thomas Wood, Oliver Brunckhorst, Takashige Abe, Talisa Ross, Ben Challacombe, Mohammed Shamim Khan, Giacomo Novara, Nicolo Buffi, Henk Van Der Poel, Craig McIlhenny, Prokar Dasgupta, Kamran Ahmed
BACKGROUND: Non-technical skills (NTS) are being increasingly recognised as vital for safe surgical practice. Numerous NTS rating systems have been developed to support effective training and assessment. Yet despite the additional challenges posed by robotic surgery, no NTS rating systems have been developed for this unique surgical environment. This study reports the development and validation of the first NTS behavioural rating system for robotic surgery. METHODS: A comprehensive index of all relevant NTS behaviours in robotic surgery was developed through observation of robotic theatre and interviews with robotic surgeons...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28623244/it-s-a-cod-finding-nemo-impacted-fishbone-in-the-emergency-department
#2
Aileen McCabe, Andrew Patton, Nigel Salter
A 23-year-old woman presented to the emergency department (ED) with a sensation of a 'fish bone' stuck in her throat after eating cod. On physical examination, while she reported an uncomfortable sensation in her throat, no airway compromise was evident. Clinical examination, including ear, nose and throat (ENT) and oropharyngeal assessment, was unremarkable. A linear opacity consistent with a fishbone was visualised on a soft tissue lateral neck X-ray anterior to the vertebral body of C4-6. One attempt to visualise the fishbone on direct laryngoscopy failed in the ED...
June 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28609136/can-the-urolift-prostatic-implant-device-treat-the-symptoms-of-benign-prostatic-hypertrophy-avoid-sexual-dysfunction-and-reduce-hospital-turp-waiting-times-a-single-centre-single-surgeon-experience-and-review-of-the-literature
#3
Antonio D Bardoli, Will St J Taylor, Wasim Mahmalji
BPH associated with LUTS and sexual dysfunction is common. We performed UroLift on 11 patients, average age 71 years (range 56-90). IPSS improved by an average of 9 points post-procedure. Pre-operatively their post-void residuals were 306.3 ml (range 120-499 ml SD [120.6]) and their QMAX was 7 ml/s (range 4-14 SD [2.8] ml/s). Post-procedure the post-void residual decreased by 35.4% at 4 months (mean difference - 106.3 ml). QMAX improved by an average of 1.7 ml/s, which was not statistically significant...
June 13, 2017: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
https://www.readbyqxmd.com/read/28605949/venous-flaps-for-coverage-of-traumatic-soft-tissue-defects-of-the-hand-a-systematic-review
#4
R Wharton, H Creasy, C Bain, M James, A Fox
A PRISMA-guided systematic review was performed of all published cases that detail the use of venous flaps for soft tissue reconstruction of the hand following trauma. Outcome measures examined included flap survival rates, venous congestion, and return to theatre. Database searches were performed on Medline, Embase, AHMED, CINAHL. A total of 381 articles were identified. Data were extracted from 45 articles that met inclusion criteria. A total of 756 flaps were described and their data analysed. A total of 75% of flaps were arterialized and 25% were pure venous flaps...
June 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28604991/ureteroscopy-in-the-diagnosis-of-upper-tract-transitional-cell-cancer-a-10-year-experience-providing-outcome-data-for-informed-consent
#5
Luke Hanna, Vera Chung, Ahmed Ali, Robert Ritchie, Ann Rogers, Mark Sullivan, Stephen Keoghane
PURPOSE: The aim of the study was to assess the effectiveness of ureteroscopy and biopsy in the diagnosis and management of upper tract urothelial carcinoma. METHODS: We retrospectively collated data from pathology, radiology and operating theatre data sets from two large UK hospitals. During the 10-year period examined, 160 patients underwent ureteroscopy prior to nephro-ureterectomy (NU)/distal ureterectomy (DU). RESULTS: Of the 160 patients identified, 140 were ureteroscopically evaluated and biopsied, 104 (74...
June 7, 2017: Urologia
https://www.readbyqxmd.com/read/28602930/illumination-in-spinal-surgery-depending-on-different-approaches-and-light-sources
#6
Eike Wilbers, Christian Ewelt, Stephanie Schipmann, Walter Stummer, Mark Klingenhöfer
Sufficient visualisation of the operating field is crucial for success in surgery and is important especially concerning minimal invasive and deep approaches in spine surgery METHODS: The spinal microsurgical approach was imitated using an isolated box that was accessed with different devices. Different light sources and auxiliary devices were analysed aiming to compare them to each other. As light source we used one microscope, one standard operating theatre lamp and one headlamp. The auxiliary devices included different tubes with and without optic light fibre, different retractors and one endoscope RESULTS/CONCLUSION: Hence, we demonstrated that different combinations of light sources and auxiliary devices provide significantly different illumination in the artificial operating field...
June 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28602594/operating-efficiency-of-an-emergency-burns-theatre-an-eight-month-analysis
#7
Arvind Mohan, Christopher Lutterodt, Jorge Leon-Villapalos
BACKGROUND: The efficient use of operating theatres is important to insure optimum cost-benefit for the hospital. We used the emergency Burns theatre as a model to assess theatre efficiency at our institution. METHODS: Data was collected retrospectively on every operation performed in the Burns theatre between 01/04/15 and 30/11/15. Each component of the operating theatre process was considered and integrated to calculate values for surgical/anaesthetic time, changeover time and ultimately theatre efficiency...
June 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28600853/mixed-methods-study-on-the-use-of-and-attitudes-towards-safety-checklists-in-interventional-radiology
#8
Zachary Munn, Kristy Giles, Edoardo Aromataris, Anita Deakin, Timothy Schultz, Catherine Mandel, Micah Dj Peters, Guy Maddern, Alan Pearson, William Runciman
INTRODUCTION: The use of safety checklists in interventional radiology is an intervention aimed at reducing mortality and morbidity. Currently there is little known about their practical use in Australian radiology departments. The primary aim of this mixed methods study was to evaluate how safety checklists (SC) are used and completed in radiology departments within Australian hospitals, and attitudes towards their use as described by Australian radiologists. METHODS: A mixed methods approach employing both quantitative and qualitative techniques was used for this study...
June 10, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28591673/the-windmill-technique-avoids-manual-removal-of-the-retained-placenta-a-new-solution-for-an-old-problem
#9
Larry Hinkson, Mia Amelie Suermann, Susan Hinkson, Wolfgang Henrich
OBJECTIVE: The primary objective is to assess the reduction in manual removal of placenta with the Windmill technique of placenta delivery in patients with retained placenta. DESIGN: The Windmill technique involves the application of continuous 360° umbilical cord traction and rotation in such a manner as to be perpendicular to the direction of the birth canal at the level of the introitus. This rotation through 360° is repeated slowly with movement akin to the motion of the blades of a windmill...
June 1, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28583417/extremity-injuries-sustained-by-the-uk-military-in-the-iraq-and-afghanistan-conflicts-2003-2014
#10
Henry Chandler, Kirsty MacLeod, Jowan G Penn-Barwell
INTRODUCTION: Extremity injuries predominate in warfare, however their nature, and overall burden to the individual and the health service is yet to be characterised for the UK military in the recent conflicts of Iraq and Afghanistan. METHODS: We reviewed the all extremity injuries in survivors from the Joint Theatre Trauma Registry (JTTR) between 2003 and 2014. All cases recorded in the JTTR between the invasion of Iraq on the 19th March 2003 and cessation of combat operations in Afghanistan on the 27th October 2014, were examined...
May 17, 2017: Injury
https://www.readbyqxmd.com/read/28580205/solid-variant-of-an-aneurysmal-bone-cyst-of-the-thoracic-spine
#11
Varshil Mehta, Pravin Padalkar, Maya Kale, Ambadas Kathare
The solid variant of an aneurysmal bone cyst (ABC) has been observed very rarely, especially those involving the spine. In this case report, we present a very unusual tumour of the thoracic spine which was managed by 360˚ decompression via posterior-only approach and stabilization. A 16-year-old boy presented to us with a sudden onset of weakness in both lower limbs leading to paraplegia. He also had a history of back and chest pain over the past one year. A collapse of the T5 vertebrae on plain radiograph was observed...
May 1, 2017: Curēus
https://www.readbyqxmd.com/read/28569457/advances-in-radioguided-surgery-in-oncology
#12
Renato A Valdés Olmos, Sergi Vidal-Sicart, Gianpiero Manca, Giuliano Mariani, Luisa F León-Ramírez, Domenico Rubello, Francesco Giammarile
The sentinel lymph node (SLN) biopsy is probably the most well known radioguided technique in surgical oncology. Today SLN biopsy reduces the morbidity associated with lymphadenectomy and increases the identification rate of occult lymphatic metastases by offering the pathologist the lymph nodes with the highest probability of containing metastatic cells. These advantages may result in a change in clinical clinical management both in melanoma and breast cancer patients. The SLN evaluation by pathology currently implies tumour burden stratification for further prognostic information...
June 1, 2017: Quarterly Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28567195/abdominal-myomectomy-a-retrospective-review-of-determinants-and-outcomes-of-complications-at-the-university-of-ilorin-teaching-hospital-ilorin-nigeria
#13
Kikelomo T Adesina, Beatrice O Owolabi, Hadijat O Raji, Adebunmi O Olarinoye
BACKGROUND: The aim of this study was to describe the pattern, outcomes, and determinants of perioperative complications of abdominal myomectomy at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. METHODS: This was a retrospective review of cases of abdominal myomectomy between January 2010 and December 2013. Data were obtained from ward and operating theatre case records and analysed using SPSS version 20. The continuous variables were analysed with Student's t-test...
March 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28559124/effect-of-an-anaesthetic-screening-drape-on-vertical-laminar-airflow
#14
R Sehjal, N Bakti, R Goddard
BACKGROUND: Effective operating room ventilation is required to reduce the risk of surgical site infection. Vertical laminar airflow from above the surgical field provides a source of 'ultra-clean' air, carrying contaminants away from the operative site. An anaesthetic screening drape is often used to shield the operative site from the anaesthetic team, and this defies the principles of vertical laminar airflow. METHODS: A mock theatre set-up for a total knee replacement was constructed with and without the use of an anaesthetic screening drape...
April 19, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28553878/building-conditions-and-the-risk-of-nosocomial-infection-from-microbial-contamination-of-hospital-appliances-in-a-health%C3%A2-care-facility
#15
Abiola O Oluwagbemiga, Shade J Akinsete, Godson R Ana
Nosocomial infections (NIs) remain a global health burden with higher incidence in Africa. We assessed building conditions and risk of NIs from microbial contamination of appliances and surfaces in a Specialist hospital in Southwest Nigeria. The study sampled 120 surfaces in 12 wards during normal occupational activities. Moulds on ceilings and dusty surfaces were observed in the wards. Microbial burden (1038.0 × 10(5) cfu) peaked in the ICU but was lowest (446.9 × 10(5) cfu) in the male ward. Bacteria counts ( × 10(5) cfu) of 234...
May 29, 2017: International Journal of Environmental Health Research
https://www.readbyqxmd.com/read/28546703/histological-surprises-in-benign-cytologies-after-lymph-node-biopsy-surgeon-s-knife-improving-patient-care
#16
Mario Victor Newton, Rakesh S Ramesh, Suraj Manjunath, K ShivaKumar, Hemanth G Nanjappa, Ramu Damuluri, Elvis Peter Joseph, C Prasad
Lymphadenopathy can be due to multitude of causes. Owing to the high prevalence of infectious diseases in India, and malignancy being a life threatening cause for lymphadenopathy; accurate diagnosis is important in preventing delay or misdiagnosis and in improving patient care, thereby increasing longevity with quality. Fine needle aspiration cytology (FNAC) is the first line investigation commonly done. Should the doctor be contented with the benign FNAC or is a lymph node biopsy needed in this age? The aims of this study are the following: (1) to study the spectral pattern of lymph node biopsies done in a surgical oncology unit of tertiary care centre, (2) to assess the yield of malignant cases from lymph node biopsy and (3) to compare the reliability of benign FNAC with lymph node biopsy...
June 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28540513/utility-of-3d-printed-temporal-bones-in-pre-surgical-planning-for-complex-bonebridge-cases
#17
Payal Mukherjee, Kai Cheng, Sean Flanagan, Simon Greenberg
With the advent of single-sided hearing loss increasingly being treated with cochlear implantation, bone conduction implants are reserved for cases of conductive and mixed hearing loss with greater complexity. The BoneBridge (BB, MED-EL, Innsbruck, Austria) is an active fully implantable device with no attenuation of sound energy through soft tissue. However, the floating mass transducer (FMT) part of the device is very bulky, which limits insertion in complicated ears. In this study, 3D printed temporal bones of patients were used to study its utility in preoperative planning on complicated cases...
May 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28532976/microbiological-problems-and-biofilms-associated-with-mycobacterium-chimaera-in-heater-cooler-units-used-for-cardiopulmonary-bypass
#18
REVIEW
J Walker, G Moore, S Collins, S Parks, M I Garvey, T Lamagni, G Smith, L Dawkin, S Goldenberg, M Chand
The role of heater-cooler units (HCUs) in the transmission of Mycobacterium chimaera during open heart surgery has been recognized since 2013. Subsequent investigations uncovered a remarkable global outbreak reflecting the wide distribution of implicated devices. HCUs are an essential component of cardiopulmonary bypass operations and their withdrawal would severely affect capacity for life-saving cardiac surgery. However, studies have demonstrated that many HCUs are contaminated with a wide range of micro-organisms, including M...
July 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28528282/management-options-in-the-treatment-of-femoral-pseudoaneurysms-secondary-to-intravenous-drug-abuse-a-case-series
#19
James Rammell, Nisheeth Kansal, Vish Bhattacharya
INTRODUCTION: Infected femoral pseudoaneurysms are a common presentation in intravenous drug users with little consensus as to the optimum management of these patients. Whilst emergency revascularisation options are available, excision and ligation of the femoral artery remains the most common operative intervention but risks leaving the patient with critical ischaemia or intermittent claudication. This case series reviewed the outcomes of 4 patients who underwent excision-ligation without revascularisation of an infected femoral pseudoaneurysm at a district general hospital...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28524382/an-observational-study-of-patient-care-outcomes-sensitive-to-handover-quality-in-the-post-anaesthetic-care-unit
#20
Nichole Lillibridge, Mari Botti, Beverley Wood, Bernice Redley
AIMS AND OBJECTIVES: To identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post-Anaesthetic Care Unit nurse. BACKGROUND: The relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post-Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood. DESIGN: Naturalistic, exploratory descriptive design using observation...
May 19, 2017: Journal of Clinical Nursing
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