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Espen Fevang, Karin Haaland, Jo Røislien, Conrad Arnfinn Bjørshol
BACKGROUND: Endotracheal intubation of patients with massive regurgitation represents a challenge in emergency airway management. Gastric contents tend to block suction catheters, and few treatment alternatives exist. Based on a technique that was successfully applied in our district, we wanted to examine if endotracheal intubation would be easier and quicker to perform when the patient is turned over to a semiprone position, as compared to the supine position. METHODS: In a randomized crossover simulation trial, a child manikin with on-going regurgitation was intubated both in the supine and semiprone positions...
January 18, 2018: BMC Anesthesiology
Maarten F J Seesing, Lucas Goense, Jelle P Ruurda, Misha D P Luyer, Grard A P Nieuwenhuijzen, Richard van Hillegersberg
BACKGROUND: The preferred surgical approach for esophageal cancer is a minimally invasive transthoracic esophagectomy with a two-field lymph node dissection. The thoracoscopic phase may be performed either in prone- or in left lateral decubitus (LLD) position. Prone positioning has been associated with better pulmonary outcomes compared to LLD positioning; however, conversion to a classic thoracotomy is more difficult. The semiprone position has been proposed as an alternative approach...
December 5, 2017: Surgical Endoscopy
Erez Nossek, David J Chalif, Razvan Buciuc, Eric J Gandras, Erich G Anderer, Sal Insigna, Amir R Dehdashti, Avi Setton
BACKGROUND: Intraoperative angiography is routinely utilized for aneurysms and arteriovenous malformations (AVMs) to verify complete occlusion and resection. Surgery for spinal and posterior fossa neurovascular lesions is usually performed in prone position. Intraoperative angiography in the prone position is challenging and there is no standardized protocol for this procedure. OBJECTIVE: To describe our experience with intraoperative angiography in the prone and lateral positions, using upper extremity arterial access...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
Zongwu Lin, Junjie Xi, Songtao Xu, Qun Wang
A 63-year-old male was referred to our hospital with two existing lesions in bilateral lungs. Computed tomography (CT) showed a 15-mm ground-glass opacity (GGO) in the superior segment of left lower lung (S6) and a 5-mm GGO in the center of the right upper lobe. The preoperative clinical diagnosis was stage I primary lung cancer for the left lesion while the right lesion needed follow-up. Uniportal video-assisted thoracic surgery (VATS) left superior segmentectomy in the semiprone position was performed in this case and the right upper lobe was kept untouched...
August 2016: Journal of Thoracic Disease
Mathieu D'Hondt, Emi Yoshihara, Franky Vansteenkiste, Pieter Jan Steelant, Barbara Van Ooteghem, Hans Pottel, Dirk Devriendt, Frank Van Rooy
INTRODUCTION: All patients who underwent laparoscopic liver resections in the posterosuperior segments (LPSS) at our center were positioned in semiprone since August 2011. The aims of this study were to assess differences in perioperative outcomes between laparoscopic left lateral sectionectomies (LLLS) performed in supine position and LPSS in semiprone position. METHODS: We reviewed our prospectively collected database of all liver resections performed between January 2012 and January 2015...
March 2016: Langenbeck's Archives of Surgery
Zongwu Lin, Junjie Xi, Songtao Xu, Wei Jiang, Lin Wang, Qun Wang
BACKGROUND: Uniportal video-assisted thoracic surgery (VATS) is becoming popular, and uniportal lobectomy in semiprone position was reported in 2014. This study aimed to investigate the feasibility and safety of uniportal VATS in semiprone position. METHODS: From May 28, 2014 to October 19, 2015, we attempted uniportal VATS lobectomy in semiprone position in 105 cases. Forty-five patients were male, and 60 patients were female. Average age was 57.1±10.6 years (24-76 years)...
December 2015: Journal of Thoracic Disease
Naoyuki Nakao
This video demonstrates surgical techniques of the occipital transtentorial approach to a pineal region tumor without using a fixed brain retractor, which may cause functional impairment or even tissue injury to the occipital visual cortex. There are several ways to facilitate retractorless surgery through this approach. A lateral-semiprone positioning of the patient can induce gravity retraction. The brain is relaxed by draining CSF fluid through lumbar drainage or lateral ventricular tap in the case of obstructive hydrocephalus...
January 2016: Neurosurgical Focus
Ti Yin, Yeong-Seng Yuh, Jen-Jiuan Liaw, Yin-Yin Chen, Kai-Wei Katherine Wang
UNLABELLED: To determine the effect of positions (supine, lateral, semiprone) on the physiological parameters (HR, RR, SpO2) of premature infants receiving NCPAP who were non-oxygen-dependent and non-BPD, and to identify significant clinical changes associated with these variables. METHODS: A crossover study design with three different positions in the assigned sequence (supine-supine, supine-lateral and supine-semiprone) was used, and each position was maintained for 1h...
March 2016: Journal of Pediatric Nursing
Zong-wu Lin, Song-tao Xu, Qun Wang
Intralobar pulmonary sequestration (IPS) is a rare developmental abnormality of the lower respiratory system. Lobectomy by video-assisted thoracic surgery using a three-port or four-port technique is the generally accepted operative approach. However, lobectomy can also be accomplished with a single incision even if the IPS is large. This report describes the first case of a patient with a large IPS undergoing uniportal video-assisted thoracic lobectomy in a semiprone position.
October 2015: Interactive Cardiovascular and Thoracic Surgery
Aya Narita, Masaaki Sagae, Katsuhiko Suzuki, Takaaki Fujita, Tasuku Sotokawa, Haruki Nakano, Makoto Naganuma, Toshiaki Sato, Hiromi Fujii, Mitsuhiro Nito, Wataru Hashizume, Toshihiko Ogino, Akira Naito
In order to elucidate strict actions of the human wrist flexors, motion and force produced by electrical neuromuscular stimulation (ENS) to each of musculus (m.) flexsor carpi radialis (FCR) and m. flexsor carpi ulnaris (FCU) with the prone, semiprone, and supine forearm were studied in ten healthy human subjects. Abduction, extension, adduction, and flexion directions were represented by, respectively, 0°, 90°, 180°, and 270°. ENS to FCR and FCU produced motion in direction of, respectively, 273° (mean) and 265° with the prone, 249° and 232° with the semiprone, and 242° and 229° with the supine forearm to the maximal range...
August 2015: Journal of Electromyography and Kinesiology
Zongwu Lin, Songtao Xu, Qun Wang
A 53-year-old male smoker was referred to our hospital with an enlarged lesion in the right upper lung. Computed tomography (CT) showed a 1.5 cm solid lesion with pleural indentation in the right upper lobe adjacent to the oblique fissure. The preoperative clinical diagnosis was stage I primary lung cancer. Uniportal video-assisted thoracoscopic surgery (VATS) right upper lobectomy in a semiprone position was performed in this case. Frozen section examination confirmed the diagnosis of lung adenocarcinoma, and systematic lymphadenectomy was then performed...
December 2014: Journal of Thoracic Disease
Chirag M Thakkar, Alankar V Kumar, Harshad N Soni, Atul J Shah, Kantilal S Patel, Sanjiv P Haribhakti
INTRODUCTION: Surgical resection with curative intent is till the mainstay of treatment for resectable esophageal cancer. Minimal invasive oesophagectomy has the potential to lower morbidity and mortality. In all likelihood, thoracoscopic oesophagectomy in semiprone position gives all the benefits of prone position and can be converted to thoracotomy without change in patient position if needed. The aim of this study is to analyze the feasibility of thoracoscopic oesophagectomy in semiprone position...
August 2014: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Tetsuo Ikeda, Takao Toshima, Norifumi Harimoto, Youichi Yamashita, Toru Ikegami, Tomoharu Yoshizumi, Yuji Soejima, Ken Shirabe, Yoshihiko Maehara
BACKGROUND: Hepatic tumors in the lower edge and lateral segments are commonly treated by laparoscopic liver resection. Tumors in the anterosuperior and posterior segments are often large and locally invasive, and resection is associated with a higher risk of insufficient surgical margins, massive intraoperative bleeding, and breaching of the tumor. Laparoscopic surgery for such tumors often involves major hepatectomy, including resection of a large volume of normal liver tissue. We developed a novel method of laparoscopic resection of tumors in these segments with the patient in the semiprone position, using a dual-handling technique with an intercostal transthoracic port...
August 2014: Surgical Endoscopy
Jiangbo Lin, Mingqiang Kang, Chun Chen, Ruobai Lin
OBJECTIVES: The aim of this study is to compare thoracoscopic mobilization of the oesophagus in the lateral decubitus position and the semiprone position and to identify potential differences between the two techniques. METHODS: A retrospective review of a prospectively maintained oesophagectomy database identified 150 patients undergoing combined thoracoscopic and laparoscopic oesophagectomy (TLO). Of these, 90 cases underwent thoracoscopic oesophageal mobilization in the left lateral decubitus position...
November 2013: Interactive Cardiovascular and Thoracic Surgery
Tetsuo Ikeda, Yohei Mano, Kazutoyo Morita, Naotaka Hashimoto, Hirohito Kayashima, Atsuro Masuda, Toru Ikegami, Tomoharu Yoshizumi, Ken Shirabe, Yoshihiko Maehara
BACKGROUND: Pure laparoscopic liver resection is technically difficult for tumors located in the dorsal anterior and posterior sectors. We have developed a maneuver to perform pure laparoscopic hepatectomy in the semiprone position which was developed for resecting tumors located in these areas. METHODS: The medical records have been reviewed retrospectively in 30 patients who underwent laparoscopic liver resection in the semiprone position for carcinoma in the dorsal anterior or posterior sectors of the right liver between 2008 and 2011...
February 2013: Journal of Hepato-biliary-pancreatic Sciences
Hiroshi Makino, Tsutomu Nomura, Masao Miyashita, Keiichi Okawa, Nobutoshi Hagiwara, Eiji Uchida
We describe a 54-year-old man in whom esophageal carcinoma was diagnosed and who underwent video-assisted thoracoscopic surgery of the esophagus (VATS-E) in the prone position. Initially, the patient was fixed in a semiprone position, from which he could be rotated to a prone or left lateral position. Four ports were inserted, and then the patient was rotated to the prone position. Once the patient was prone, gravity caused the lung to move downwards. Next, the chest cavity was inflated with a CO(2) insufflation pressure of 6 mm Hg...
2011: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Thirugnanam Agasthian
The fully prone position, once used in surgery for chronic inflammatory lung diseases, has become obsolete. In the last 2 years, a modified semiprone position was used for video-assisted thoracoscopic surgery in 358 patients undergoing lobectomy with mediastinal complete lymphadenectomy The ports were placed with the patient in the lateral decubitus position. The patient was rotated 45-60 degrees towards the surgeon, giving enhanced exposure of the posterior mediastinum, esophagus, subcarinal and paratracheal spaces, due to displacement of the lung under gravity away from the operative field...
August 2010: Asian Cardiovascular & Thoracic Annals
Masaaki Sagae, Katsuhiko Suzuki, Takaaki Fujita, Tasuku Sotokawa, Haruki Nakano, Makoto Naganuma, Aya Narita, Toshiaki Sato, Hiromi Fujii, Toshihiko Ogino, Akira Naito
Motion and force produced by electrical neuromuscular stimulation (ENS) to each of the extensor carpi radialis longus (ECRL) and brevis (ECRB), and extensor carpi ulnaris (ECU) with the prone (P), semiprone (SP), and supine forearm (S) were studied in ten normal human subjects. Abduction (AB), extension (E), adduction (AD), and flexion (F) directions were represented by, respectively, 0°, 90°, 180°, and 270°. ENS to ECRL, ECRB, and ECU produced motion in direction of, respectively, 60° (mean), 87°, and 205° with P, 66°, 83°, and 166° with SP, and 47°, 66°, and 116° with S to maximal range...
December 2010: Journal of Electromyography and Kinesiology
Matthew L Tweet, Ryan P Calfee, Peter J Stern
PURPOSE: Intra-articular screw penetration is one complication of volar plate fixation of distal radius fractures. This study was designed to determine the most commonly used imaging techniques and views during volar plating of distal radius fractures and to evaluate surgeons' ability to detect intra-articular screw placement on static fluoroscopic images and rotational fluoroscopy. METHODS: Active members of the American Society for Surgery of the Hand were polled regarding preferred imaging techniques (fluoroscopic vs cassette radiographs) and views (rotational fluoroscopy or static orthogonal/anatomic tilt/semipronated imaging) during volar plating of distal radius fractures...
April 2010: Journal of Hand Surgery
Ofir Chechik, Yishai Rosenblatt
BACKGROUND: Fracture of the scaphoid is the most common fracture of a carpal bone. Nevertheless, the diagnosis of SF might be challenging. Plain X-rays that fail to demonstrate a fracture line while clinical findings suggest the existence of such a fracture is not uncommon. Currently there is no consensus in the literature as to how a clinically suspected SF should be diagnosed, immobilized and treated. OBJECTIVES: To assess the current status of diagnosis and treatment of clinically suspected scaphoid fractures in Israeli emergency departments...
April 2009: Israel Medical Association Journal: IMAJ
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