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Surgical technique

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https://www.readbyqxmd.com/read/28918534/do-surgical-helmet-systems-affect-intraoperative-wound-contamination-a-randomised-controlled-trial
#1
Otis C Shirley, Ali Bayan, Mark Zhu, James P Dalton, Siouxsie Wiles, Simon W Young
BACKGROUND: Deep infection following arthroplasty remains a devastating complication. Some registry data suggests that modern positive-pressure surgical helmet systems (SHS) are associated with a paradoxical increase in infection rates, and as such their role in arthroplasty remains unclear. The aim of this study was to investigate whether SHS increase wound contamination in total knee arthroplasty (TKA) and if this contamination can be reduced by placing tape around the gown/glove interface...
September 16, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28918365/review-of-breast-augmentation-and-reconstruction-for-the-radiologist-with-emphasis-on-mri
#2
REVIEW
Lauren A Green, Jillian A Karow, Jordan E Toman, Antonella Lostumbo, Karen Xie
It is imperative to continue screening for breast cancer and/or detect tumor recurrence in patients after they have undergone breast augmentation or reconstruction. As there is an increasing role for both screening and diagnostic imaging of the post-operative breast, it is important for the radiologist to be familiar with the commonly performed surgical techniques in breast augmentation and reconstruction. Imaging of the augmented and reconstructed breast, as well as complications, will be reviewed with a focus on Magnetic Resonance Imaging (MRI)...
August 25, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28917992/securing-extraocular-muscles-in-strabismus-surgery-biomechanical-analysis-of-knot-tying-technique
#3
Steven E Brooks
BACKGROUND: The safe and precise reattachment of extraocular muscles requires a technical approach that minimizes any opportunity for the muscle to slip intraoperatively or postoperatively while minimizing surgical risk. Biomechanical testing can provide important quantitative information about the tensile properties of different knot configurations that may inform surgical technique. METHODS: A precision digital force gauge was used to assess the tensile strength created by different knot tying techniques and configurations in human sclera using 6-0 polyglactin 910 suture...
September 13, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28917969/hysterectomy-for-the-transgendered-male-a-review-of-perioperative-considerations-and-surgical-techniques-with-description-of-a-novel-2-port-laparoscopic-approach
#4
REVIEW
Cherie Q Marfori, Catherine Z Wu, Quinton Katler, Mollie Kotzen, Parisa Samimi, Matthew T Siedhoff
Transgendered individuals can suffer a significant amount of psychological distress which can be alleviated through hormonal treatments and/or gender-affirming surgery. The World Professional Association for Transgender Health (WPATH) considers a hysterectomy and BSO medically necessary gender-affirming procedures for the interested transgendered male. Several surgical approaches have been described in the literature, the majority of which endorse a laparoscopic approach. This review will summarize the available literature on surgical techniques in addition to reporting our institutional outcomes using a novel 2-port laparoscopic approach...
September 13, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28917585/total-urogenital-sinus-mobilization-for-ambiguous-genitalia
#5
Vinicius Menezes Jesus, Francisco Buriti, Rodrigo Lessa, Maria Betânia Toralles, Luciana Barros Oliveira, Ubirajara Barroso
INTRODUCTION: Genital ambiguity is a very common phenomenon in disorders of sex development (DSD). According to the Chicago Consensus 2006, feminizing genitoplasty, when indicated, should be performed in the most virilized cases (Prader III to V). Advances in the knowledge of genital anatomy in DSD have enabled the development and improvement of various surgical techniques. Mobilization of the urogenital sinus (MUS), first described by Peña, has become incorporated by most surgeons. However, the proximity of the urethral sphincter prompts concern over urinary incontinence, especially for full mobilization of the urogenital sinus...
August 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28917520/short-term-complications-in-intra-and-extra-articular-anterior-cruciate-ligament-reconstruction-comparison-with-the-literature-on-isolated-intra-articular-reconstruction-a-multicenter-study-by-the-french-society-of-arthroscopy
#6
J C Panisset, R Pailhé, B Schlaterrer, L Sigwalt, B Sonnery-Cottet, C Lutz, S Lustig, C Batailler, S Bertiaux, F P Ehkirch, P Colombet, C Steltzlen, M L Louis, P D'ingrado, F Dalmay, P Imbert, D Saragaglia
INTRODUCTION: Lateral tenodesis (LT) is performed to limit the risk of iterative tear following anterior cruciate ligament (ACL) reconstruction in at-risk patients. By adding an extra procedure to isolated ACL graft, LT reconstruction increases operating time and may complicate postoperative course. The objective of the present study was to evaluate the rate of early complications. The study hypothesis was that associating ALL reconstruction to ACL reconstruction does not increase the complications rate found with isolated ACL reconstruction...
September 13, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28917396/modified-bean-shaped-ring-segments-for-suture-fixation-of-the-bag-in-the-lens-intraocular-implant
#7
Sorcha Ní Dhubhghaill, Anca Cristina Dogaroiu, Nadia Zakaria, Marie-José Tassignon
We describe a surgical technique for secondary stabilization of a bag-in-the-lens intraocular lens (BIL IOL) using 2 modified bean-shaped ring segments in cases of zonular dehiscence associated with pseudophakodonesis. The first modified bean segment is anchored in the sulcus with a suture to the sclera in the area of maximum zonular dehiscence, and the second segment is implanted in the opposite sulcus area. Both segments are placed in the BIL IOL interhaptic groove. The segments stabilize and center the BIL IOL by creating an artificial zonule that provides the necessary extra support for the IOL...
August 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28917291/intraoperative-raman-spectroscopy
#8
REVIEW
Michelle Brusatori, Gregory Auner, Thomas Noh, Lisa Scarpace, Brandy Broadbent, Steven N Kalkanis
Surgical excision of brain tumors provides a means of cytoreduction and diagnosis while minimizing neurologic deficit and improving overall survival. Despite advances in functional and three-dimensional stereotactic navigation and intraoperative MRI, delineating tissue in real time with physiologic confirmation is challenging. Raman spectroscopy has potential to be an important modality in the intraoperative evaluation of tissue during surgical resection. In vitro experimental studies have shown that this technique can be used to differentiate normal brain tissue from tissue with infiltrating cancer cells and dense cancerous masses with high specificity, indicating the feasibility of this method for in vivo application...
October 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28917255/stereotactic-body-radiotherapy-for-primary-renal-cell-carcinoma-and-adrenal-metastases
#9
Gargi Kothari, Alexander V Louie, David Pryor, Ian Vela, Simon S Lo, Bin S Teh, Shankar Siva
The incidence of renal cell carcinoma (RCC) and metastatic adrenal lesions continues to rise and present evolving complexities in terms of management. Technical challenges in treatment delivery are compounded by the setting of an ageing patient population with multiple medical co-morbidities. While the standard of care treatment for both primary RCC and oligometastatic adrenal lesions has typically been surgery, a number of patients may be medically or surgically inoperable, and for whom alternative options require consideration...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28917254/stereotactic-radiotherapy-in-oligometastatic-cancer
#10
Thomas A C Kennedy, Mark T Corkum, Alexander V Louie
Oligometastatic cancer describes a disease state somewhere between localized and metastatic cancer. Proposed definitions of oligometastatic disease have typically used a cut-off of five or fewer sites of disease. Treatment of oligometastatic disease should have the goal of long-term local control, and in selected cases, disease remission. While several retrospective cohorts argue for surgical excision of limited metastases (metastasectomy) as the preferred treatment option for several clinical indications, limited randomized data exists for treating oligometastases...
September 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28917092/progressive-halo-vest-traction-preceding-posterior-occipitocervical-instrumented-fusion-for-irreducible-atlantoaxial-dislocation-and-basilar-invagination
#11
Peng Li, Deming Bao, Huijuan Cheng, Fanshuai Meng, Junwei Li
OBJECTIVES: Surgical treatment of irreducible atlantoaxial dislocation (IAAD) with basilar invagination (BI) is associated with high rates of severe complications, including mortality. This retrospective study investigated the safety and efficacy of progressive halo-vest traction for IAAD with BI prior to posterior occipitocervical instrumented fusion. PATIENTS AND METHODS: Between 2009 and 2013, 39 patients with IAAD with BI underwent preoperative reduction by progressive halo-vest traction for 20...
September 5, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28917012/operative-and-short-term-oncologic-outcomes-of-laparoscopic-versus-open-liver-resection-for-colorectal-liver-metastases-located-in-the-posterosuperior-liver-a-propensity-score-matching-analysis
#12
Masayuki Okuno, Claire Goumard, Takashi Mizuno, Kiyohiko Omichi, Ching-Wei D Tzeng, Yun Shin Chun, Thomas A Aloia, Jason B Fleming, Jeffrey E Lee, Jean-Nicolas Vauthey, Claudius Conrad
BACKGROUND: Laparoscopic resection (LLR) of colorectal liver metastases (CRLM) located in the posterosuperior liver (segments 4a, 7, and 8) is challenging but has become more practical recently due to progress in operative techniques. We aimed to compare tumor-specific, perioperative, and short-term oncological outcomes after LLR and open liver resection (OLR) for CRLM. METHODS: Patients who underwent curative resection of CRLM with at least 1 tumor in the posterosuperior liver during 2012-2015 were analyzed...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916948/viewer-discretion-advised-is-youtube-a-friend-or-foe-in-surgical-education
#13
H Alejandro Rodriguez, Monica T Young, Hope T Jackson, Brant K Oelschlager, Andrew S Wright
BACKGROUND: In the current era, trainees frequently use unvetted online resources for their own education, including viewing surgical videos on YouTube. While operative videos are an important resource in surgical education, YouTube content is not selected or organized by quality but instead is ranked by popularity and other factors. This creates a potential for videos that feature poor technique or critical safety violations to become the most viewed for a given procedure. METHODS: A YouTube search for "Laparoscopic cholecystectomy" was performed...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916892/precision-in-robotic-rectal-surgery-using-the-da-vinci-xi-system-and-integrated-table-motion-a-technical-note
#14
Sofoklis Panteleimonitis, Mick Harper, Stuart Hall, Nuno Figueiredo, Tahseen Qureshi, Amjad Parvaiz
Robotic rectal surgery is becoming increasingly more popular among colorectal surgeons. However, time spent on robotic platform docking, arm clashing and undocking of the platform during the procedure are factors that surgeons often find cumbersome and time consuming. The newest surgical platform, the da Vinci Xi, coupled with integrated table motion can help to overcome these problems. This technical note aims to describe a standardised operative technique of single docking robotic rectal surgery using the da Vinci Xi system and integrated table motion...
September 15, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28916868/laparoscopic-liver-resection-using-a-monopolar-soft-coagulation-device-to-provide-maximum-intraoperative-bleeding-control-for-the-treatment-of-hepatocellular-carcinoma
#15
Mitsuo Miyazawa, Masayasu Aikawa, Katsuya Okada, Yukihiro Watanabe, Kojun Okamoto, Isamu Koyama
BACKGROUND: The popularity of laparoscopic liver resection (LLR) is spreading, worldwide, because the intraoperative blood loss is less than for open hepatectomy and it is associated with a shorter hospitalization period [1-6]. During LLR, intraoperative hemostasis is difficult to achieve, unlike during laparotomy where bleeding can be stopped instantly [7-10]. Our LLR method for the treatment of hepatocellular carcinoma (HCC) includes maximal control of intraoperative bleeding using a monopolar soft-coagulation device...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916847/endoscopic-resection-of-gastric-gastrointestinal-stromal-tumors-originating-from-the-muscularis-propria-layer-in-north-america-methods-and-feasibility-data
#16
Iman Andalib, Daniel Yeoun, Ramesh Reddy, Steve Xie, Shahzad Iqbal
INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. In recent years, endoscopic procedures such as endoscopic enucleation (EN) and endoscopic full-thickness resection (EFTR) have been used to resect GISTs. This study aimed to investigate the clinical efficacy, safety, and feasibility of endoscopic resection of GISTs in a North American population. METHODS: A total of 25 patients with gastric submucosal lesions (SML) underwent endoscopic resection from December 2014 to April 2016...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916463/penile-prosthesis-implantation-in-priapism
#17
REVIEW
Ömer Barış Yücel, Yaşar Pazır, Ateş Kadıoğlu
INTRODUCTION: Priapism is defined as a full or partial erection lasting longer than 4 hours after sexual stimulation and orgasm or unrelated to sexual stimulation. The main goal of priapism management is to resolve the episode immediately to preserve erectile function and penile length. Corporal smooth muscle necrosis is likely to have already occurred, and medically refractory erectile dysfunction is expected in patients with a protracted episode. Penile prosthesis implantation (PPI) in the early or late phase of priapism can restore erectile function...
September 12, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28916408/robot-assisted-kidney-transplantation-the-european-experience
#18
Alberto Breda, Angelo Territo, Luis Gausa, Volkan Tuğcu, Antonio Alcaraz, Mireia Musquera, Karel Decaestecker, Liesbeth Desender, Michael Stockle, Martin Janssen, Paolo Fornara, Nasreldin Mohammed, Giampaolo Siena, Sergio Serni, Luis Guirado, Carma Facundo, Nicolas Doumerc
BACKGROUND: Robot-assisted kidney transplantation (RAKT) has recently been introduced to reduce the morbidity of open kidney transplantation (KT). OBJECTIVE: To evaluate perioperative and early postoperative RAKT outcomes. DESIGN, SETTING AND PARTICIPANTS: This was a multicenter prospective observational study of 120 patients who underwent RAKT, predominantly with a living donor kidney, in eight European institutions between July 2015 and May 2017, with minimum follow-up of 1 mo...
September 12, 2017: European Urology
https://www.readbyqxmd.com/read/28916304/rationale-and-design-of-the-arrest-trial-investigating-mesenchymal-stem-cells-in-the-treatment-of-small-aaa
#19
S Keisin Wang, Linden A Green, Ashley R Gutwein, Natalie A Drucker, Raghu L Motaganahalli, Andres Fajardo, Clifford C Babbey, Michael P Murphy
BACKGROUND: Abdominal aortic aneurysms (AAA) are a major source of morbidity and mortality despite continuing advances in surgical technique and care. Although the inciting factors for AAA development continue to be elusive, accumulating evidence suggests a significant peri-aortic inflammatory response leading to degradation and dilation of the aortic wall. Previous human trials have demonstrated safety and efficacy of mesenchymal stem cells (MSCs) in the treatment of inflammation-related pathologies such as rheumatoid arthritis, graft vs host disease, and transplant rejection...
September 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28916260/primary-facial-reanimation-in-head-and-neck-cancer
#20
REVIEW
Axel Sahovaler, David Yeh, John Yoo
Facial Paralysis (FP) profoundly impairs the life of individuals, both functionally and psychosocially. Surgical approaches to treat this condition are myriad, but the ultimate goal is to restore symmetry and movement. Ablative surgery for tumors of the head and neck region are amongst the most common etiologies causing FP and this group of patients represents unique challenges. Surgical defects may have multiple competing reconstructive requirements and addressing the FP must be considered in this context...
September 12, 2017: Oral Oncology
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