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Surgical innovation

Rosario Maugeri, Luigi Basile, Carlo Gulì, Aurelia Banco, Giovanna Giordano, Antonella Giugno, Francesca Graziano, Roberto Giuseppe Giammalva, Domenico Gerardo Iacopino
BACKGROUND:  Lumbar spinal stenosis (LSS) is a narrowing of the spinal canal due to spinal degeneration, and its main clinical symptom is neurogenic claudication. Surgical treatment is pursued for patients who do not improve with conservative care. Patients with symptomatic LSS who also have significant medical comorbidities, although clearly in need of intervention, are unattractive candidates for traditional open lumbar decompressive procedures. Thus it is important to explore minimally invasive surgical techniques to treat select patients with LSS...
June 14, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Aileen W K Chan, Fiona W K Tang, Kai Chow Choi, Ting Liu, Ruth E Taylor-Piliae
BACKGROUND: Clinical practicum is a major learning component for pre-registration nursing students. Various clinical practicum models have been used to facilitate students' clinical learning experiences, employing both university-based and hospital-based clinical teachers. Considering the strengths and limitations of these clinical practicum models, along with nursing workforce shortages, we developed and tested an innovative clinical partnership model (CPM) in Hong Kong. OBJECTIVE: To evaluate an innovative CPM among nursing students actual and preferred clinical learning environment, compared with a conventional facilitation model (CFM)...
June 5, 2018: Nurse Education Today
Benjamin Wilke, Anna Cooper, C Parker Gibbs, Andre Spiguel
Allograft reconstruction of large segmental intercalary bone defects after tumor resection is a well-accepted surgical technique. Although results generally have been satisfactory, nonunion at the allograft-host bone junction site remains a notable concern. Various reports have described attempts to enhance junctional healing with a variety of complex osteotomies, often complicating an already complex procedure. The use of an innovative reverse reaming technique can decrease the level of intraoperative difficulty mating the allograft-host junction and theoretically may improve junctional healing by enhancing stability and increasing the contact surface area...
June 11, 2018: Journal of the American Academy of Orthopaedic Surgeons
Naveen Madapana, Glebys Gonzalez, Richard Rodgers, Lingsong Zhang, Juan P Wachs
OBJECTIVE: Gestural interfaces allow accessing and manipulating Electronic Medical Records (EMR) in hospitals while keeping a complete sterile environment. Particularly, in the Operating Room (OR), these interfaces enable surgeons to browse Picture Archiving and Communication System (PACS) without the need of delegating functions to the surgical staff. Existing gesture based medical interfaces rely on a suboptimal and an arbitrary small set of gestures that are mapped to a few commands available in PACS software...
2018: PloS One
Chad G Ball, Sean C Grondin, Janice L Pasieka, Andrew W Kirkpatrick, Anthony R MacLean, Paul Cantle, Elijah Dixon, Prism Schneider, Mark Hamilton
Innovation can be variably defined, but when applied to healthcare is often considered to be the introduction of something new, whether an idea, method or device, into an unfilled void or needy environment. Despite the introduction of many positive surgical subspecialty altering concepts/devices however, epic failures are not uncommon. These failures can be dramatic in regards to both their human and economic costs. They can also be very public or more quiet in nature. As surgical leaders in our communities and advocates for patient safety and outcomes, it remains crucial that we meet new introductions in technology and patient care with a measured level of curiosity, skepticism and science-based conclusions...
June 11, 2018: Journal of Comparative Effectiveness Research
Yeh Chen Lee, Nazlin Jivraj, Catherine O'Brien, Tanya Chawla, Eran Shlomovitz, Sarah Buchanan, Jenny Lau, Jennifer Croke, Johane P Allard, Preeti Dhar, Stephane Laframboise, Sarah E Ferguson, Neesha Dhani, Marcus Butler, Pamela Ng, Terri Stuart-McEwan, Pamela Savage, Lisa Tinker, Amit M Oza, Stephanie Lheureux
Malignant bowel obstruction (MBO) is a major complication in women with advanced gynecologic cancers which imposes a significant burden on patients, caregivers, and healthcare systems. Symptoms of MBO are challenging to palliate and result in progressive decompensation of already vulnerable patients with limited therapeutic options and a short prognosis. However, there is a paucity of guidelines or innovative approaches to improve the care of women who develop MBO. MBO is a complex clinical situation that requires a multidisciplinary approach to ensure the appropriate treatment modality and interprofessional care to optimally manage these patients...
2018: Obstetrics and Gynecology International
Michael Benson, Moneer K Hanna
INTRODUCTION: Congenital scrotal agenesis (CSA) is an extremely rare condition with fewer than 10 cases reported in the literature. These patients are often further complicated by undescended testicles as well as systemic developmental disorders. Herein, we report our experience and an innovative surgical technique for creation of a neo-scrotum in three children. MATERIALS AND METHODS: We evaluated the records of three children in our database who were labeled as having an absent (1 patient) or severely underdeveloped scrotum (2 patients)...
May 5, 2018: Journal of Pediatric Urology
Q Y Wu
Due to the tireless efforts of medical staff, we have made great progress in the surgical treatment of congenital heart disease in recent years. A lot of new experiences has been accumulated and many new methods have been created in the diagnosis and treatment of congenital heart disease in neonates, minimal invasive surgical technique, hybrid procedure and the surgical treatment of complicated congenital heart disease. It is proved that innovation and practice are the basis of the surgical treatment of congenital heart disease...
June 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Jennifer Phan, V Raman Muthusamy
PURPOSE OF REVIEW: The goal of this review is to critically analyze the current literature regarding the management of incidental pancreatic cysts. Given their increased rates of detection due to the frequent use of cross-sectional imaging, correctly identifying the subset of high risk lesions that are appropriate for surgical resection is critical. However, the existing consensus and societal guidelines discussed in this review lack high quality data to create evidence-based recommendations, making achieving this important aim challenging...
June 9, 2018: Current Gastroenterology Reports
William A Lackington, Rosanne M Raftery, Fergal J O'Brien
Despite the success of tissue engineered nerve guidance conduits (NGCs) for the treatment of small peripheral nerve injuries, autografts remain the clinical gold standard for larger injuries. The delivery of neurotrophic factors from conduits might enhance repair for more effective treatment of larger injuries but the efficacy of such systems is dependent on a safe, effective platform for controlled and localised therapeutic delivery. Gene therapy might offer an innovative approach to control the timing, release and level of neurotrophic factor production by directing cells to transiently sustain therapeutic protein production in situ...
June 7, 2018: Acta Biomaterialia
Anne Lambert-Kerzner, Kelsey Lynett Ford, Karl E Hammermeister, William G Henderson, Michael R Bronsert, Robert A Meguid
Background: Risk assessment in surgery is essential to guide treatment decisions but is highly variable in practice. Providing formal preoperative risk assessment to surgical teams and patients may optimize understanding of risk. Implementation of the Surgical Risk Preoperative Assessment System (SURPAS), an innovative real time, universal, preoperative tool providing individualized risk assessment, may enhance informed consent and reduce adverse outcomes. To ensure optimal development and implementation of SURPAS we performed an in-depth pre-implementation evaluation of SURPAS at an academic tertiary referral center in Colorado...
2018: Patient Safety in Surgery
Hsuan Su, Lulu Huang, Chien-Min Han, Yu-Jen Lin, Chih-Feng Yen, Chyi-Long Lee, Chin-Jung Wang
OBJECTIVE: Hysterectomy via transvaginal natural orifice transluminal endoscopic surgery (NOTES) has been carried out for benign uterine diseases and nonprolapsed uteri in recent years. Subtotal hysterectomy was performed to remove the uterus with preservation of the cervix by abdominal, laparoscopic, or vaginal routes. The aim of this retrospective study is to gain insight into the feasibility and safety of subtotal hysterectomy through transvaginal NOTES. MATERIALS AND METHODS: This is the first case series study to describe the technique and to evaluate the feasibility of this innovative surgical procedure...
June 2018: Taiwanese Journal of Obstetrics & Gynecology
Wen-Bin Guo, Cheng Yang, Jun Bian, Hui Xia, Jian-Kun Yang, Qi-Zhao Zhou, Ming-Kun Chen, Kang-Yi Xue, Wan-Song Zhang, Peng Wang, Xin Li, Cun-Dong Liu
BACKGROUND: We introduced and recreated a more consistent and effective experimental varicocele rat model by a new clip technique. METHODS: A total of 40 rats were numbered and randomly assigned to 5 groups of 8 each, including sham surgery (Group I), conventional (Group II) and clip groups with 0.7, 0.8, 0.9 mm gap widths, respectively (Group III, IV, V). All of the rats in each group were sacrificed at 8 weeks after initial surgery, and the rats forming out with less than 1 mm diameter of left spermatic vein or no presence of the pampiniform plexus dilation were excluded from the experimental groups...
June 7, 2018: BMC Urology
Jon R Davids
Optimal clinical decision making and surgical management of hip dysplasia in children with cerebral palsy (CP) requires an understanding of the underlying pathophysiology (pathomechanics and pathoanatomy), incidence, and natural history. The incidence of hip dysplasia in children with CP is directly related to the degree of motor impairment. A subluxated or dislocated hip in a child with CP can compromise the quality of life for both the child and their caregivers. The goal of this article is to highlight the events over the last 25 years that have had the greatest impact on the management of hip dysplasia in children with CP...
July 2018: Journal of Pediatric Orthopedics
Dhelal Al-Rudainy, Xiangyang Ju, Felicity V Mehendale, Ashraf Ayoub
OBJECTIVE: Longitudinal evaluation of asymmetry of the surgically managed unilateral cleft lip and palate (UCLP) to assess the impact of facial growth on facial appearance. DESIGN: Prospective study. SETTING: Glasgow Dental Hospital and School, University of Glasgow, United Kingdom Patients: Fifteen UCLP infants. METHOD: The 3-D facial images were captured before surgery, 4 months after surgery, and at 4-year follow-up using stereophotogrammetry...
January 1, 2018: Cleft Palate-craniofacial Journal
Kuo-Hsin Chen, Tiing Foong Siow, U-Chon Chio, Jiann-Ming Wu, Kuo-Shyang Jeng
Laparoscopic liver resection has been applied to treat most indications for liver resection during the past two decades. According to the literature, patient numbers have increased exponentially as a result, and surgical difficulty has increased as well. In expert centers, laparoscopic anatomical hemihepatectomy and major liver resection more than 3 segments have become the acceptable treatment. Moreover, with surgical innovations and accumulated experience, living donor liver transplantation has become an established treatment choice for patients on the transplant waiting list...
May 2018: Asian Journal of Endoscopic Surgery
G Köhler, I Fischer, R Kaltenböck, M Mitteregger, G Seitinger, A Szyszkowitz
PURPOSE: Transabdominal preperitoneal hernia mesh plasty (TAPP) offers significant benefits to patients undergoing bilateral inguinal hernia repair. We evaluated a novel pre-shaped, large-pored, titanium-coated, lightweight polypropylene mesh for bilateral placement as an alternative to two separate meshes. METHODS: Thirty-six patients underwent elective surgical repair of bilateral inguinal hernias with the new mesh at three departments of surgery in Linz and Graz, Austria, between May 1, 2015 and June 30, 2017...
June 5, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Michael A Bohl, David S Xu, Claudio Cavallo, Gabriella M Paisan, Kris A Smith, Peter Nakaji
OBJECTIVE: The Barrow Innovation Center consists of an educational program that promotes interdisciplinary collaboration among neurosurgery, legal, and engineering professionals to foster the development of new medical devices. This report describes a common issue faced during the placement of ventricular shunts for the treatment of hydrocephalus, and the solution to this problem that was developed through the Barrow Innovation Center. METHODS: Neurosurgery residents involved in the Barrow Innovation Center presented the problem of ferromagnetic retractors interfering with pinless image-guidance systems at a monthly meeting...
June 1, 2018: World Neurosurgery
J Metovic, L Bertero, C Musuraca, F Veneziano, L Annaratone, S Mariani, P Cassoni, G Bussolati, Mauro Papotti
Diagnostic pathology activities are largely based on fixation of tissues in 4% formaldehyde, which has recently been re-classified as a carcinogenic compound and banned in several countries. Hospitals that do not have in-house pathology services need to send surgical and biopsy specimens to referral centers. These are generally transferred in liquid containers, under suboptimal safety conditions, as accidental spillage of potentially dangerous substances may occur. A safe, innovative, two-step procedure for pathology sample transportation is presented...
June 2, 2018: Virchows Archiv: An International Journal of Pathology
Kaji Tamanna Keya, Pooja Sripad, Emmanuel Nwala, Charlotte E Warren
BACKGROUND: Women living with obstetric fistula often live in poverty and in remote areas far from hospitals offering surgical repair. These women and their families face a range of costs while accessing fistula repair, some of which include: management of their condition, lost productivity and time, and transport to facilities. This study explores, through women's, communities', and providers' perspectives, the financial, transport, and opportunity cost barriers and enabling factors for seeking repair services...
June 1, 2018: International Journal for Equity in Health
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