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Vessel sealing

Carsten Deppermann, Paul Kubes
The primary function of platelets is to patrol the vasculature and seal vessel breaches to limit blood loss. However, it is becoming increasingly clear that they also contribute to pathophysiological conditions like thrombosis, atherosclerosis, stroke and infection. Severe sepsis is a devastating disease that claims hundreds of thousands of lives every year in North America and is a major burden to the public health system. Platelet surface receptors like GPIb, αIIbβ3, TLR2 and TLR4 are involved in direct platelet-bacteria interactions...
October 18, 2016: Seminars in Immunology
Giovanni Milito, Giorgio Lisi, Elena Aronadio, Michela Campanelli, Dario Venditti, Simona Grande, Michele Grande
BACKGROUNDS: Hemorrhoidectomy is considered the gold standard and the most effective and definitive treatment for grades 3 or 4 haemorrhoids, and Milligan-Morgan's and Ferguson's procedures are the most widely used techniques throughout the world. The aim of the study is to present our surgical technique using LigasureTM vessel sealing, focus on technical aspects and surgical tricks showing our results with a huge number of patients and a long-term follow-up. METHODS: Between June 2001 and June 2014 at the University Hospital of Tor Vergata, Rome, Italy, 1000 patients were selected to underwent LigaSureTM hemorrhoidectomy for III and IV degree haemorrhoids...
October 21, 2016: Minerva Gastroenterologica e Dietologica
Daniel Croom, Heather Tracy
Thrombotic microangiopathy (TMA) syndromes represent a spectrum of illnesses that share common clinical and pathologic features of microangiopathic hemolytic anemia, thrombocytopenia, and organ injury from pathologic small-vessel thrombosis. At least nine primary TMA syndromes have been described and classified based on common probable etiologies, diagnostic criteria, and treatments. The most recognized of the TMA syndromes include thrombotic thrombocytopenic purpura (TTP) and hemolytic-uremic syndrome (HUS)...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Sarah Townsend, Michelle L Oblak, Ameet Singh, Michele A Steffey, Jeffrey J Runge
OBJECTIVE: To report the diagnosis, treatment, and short-term outcome in dogs with suspected persistent right aortic arch (PRAA) undergoing thoracoscopy with concurrent esophagoscopy. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Dogs with suspected PRAA (n=9). METHODS: Medical records were reviewed from 2012 to 2016. Dogs undergoing thoracoscopy for PRAA at 3 referral hospitals were included...
October 12, 2016: Veterinary Surgery: VS
Eric Goudie, Mehdi Tahiri, Moishe Liberman
VATS lobectomy is a safe and effective treatment strategy for operable stage I and II lung cancer. It has a similar five-year survival compared to open lobectomy (thoracotomy). VATS lobectomy is associated with less postoperative complications and shorter hospital length of stay when compared to lobectomy by thoracotomy. VATS lobectomy has not been widely adopted by the thoracic surgical community, in part, due to technical reasons. Pulmonary artery branch manipulation in VATS lobectomy is one of the most critical parts of the procedure, especially when endostaplers are used for ligation and division of the vessel...
October 6, 2016: Surgical Technology International
Tao Guo, Liang Ren, Quanxiong Wang, Kun Li
OBJECTIVE: To determine the best haemostatic strategy for hysterectomy through a network meta-analysis. METHODS: We conducted a systematic literature search of the PubMed, Embase, and Cochrane Library databases and extracted data from randomized controlled trials comparing haemostatic strategies for hysterectomy. Direct comparisons and network meta-analyses were conducted in RevMan and ADDIS. Consistency models were established to identify the differences among different haemostatic strategies, and cumulative probability was used to rank the included strategies...
October 8, 2016: International Journal of Surgery
Steven Rothenberg
PURPOSE: Thoracoscopic lobectomy for congenital cystic lung disease has become an accepted and in many institutions the preferred technique. However, the technical challenges are many. Previous endoscopic staplers (12 mm) used commonly in adults are too large for use in infants This study evaluates the safety and efficacy of using a 5 mm stapling device to seal and divide major pulmonary structures. METHODS: From July 2014 to March 2016, 26 patients of age 6 weeks to 13 months underwent thoracoscopic lobectomy for CPAM or sequestration...
October 5, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Debashree Goswami, Dietmar Vestweber
The entry of leukocytes into tissues requires well-coordinated interactions between the immune cells and endothelial cells which form the inner lining of blood vessels. The molecular basis for recognition, capture, and adhesion of leukocytes to the endothelial apical surface is well studied. This review will focus on recent advances in our understanding of events following the firm interaction of leukocytes with the inner surface of the blood vessel wall. We will discuss how leukocytes initiate the transmigration (diapedesis) process, trigger the opening of gaps in the endothelial barrier, and eventually move through this boundary...
2016: F1000Research
Mahamud-Ur Rashid, Christine Marie George, Shirajum Monira, Toslim Mahmud, Zillur Rahman, Munshi Mustafiz, K M Saif-Ur-Rahman, Tahmina Parvin, Sazzadul Islam Bhuyian, Fatema Zohura, Farzana Begum, Shwapon Kumar Biswas, Xiaotong Zhang, David Sack, R Bradley Sack, Munirul Alam
Household members of cholera patients are at a 100 times higher risk of cholera infections than the general population because of shared contaminated drinking water sources and secondary transmission through poor household hygiene practices. In this study, we investigated the bactericidal concentration of free chlorine required to inactivate Vibrio cholerae in household drinking water in Dhaka city. In laboratory experiments, we found that the concentrations of free chlorine required to inactivate 10(5) colony-forming units (CFU)/mL of V...
October 3, 2016: American Journal of Tropical Medicine and Hygiene
Mario Testini, Alessandro Pasculli, Giovanna Di Meo, Valentina Ferraro, Francesco Logoluso, Francesco Minerva, Angela Pezzolla, Angela Gurrado
INTRODUCTION: When total thyroidectomy is performed for substernal goitre, a high risk of morbidity is reported. Advanced vessel sealing devices provide an alternative to the conventional clamp and tie technique. The aim of this study is to compare the outcome of patients who underwent total thyroidectomy for substernal goitre using Ligasure Small Jaw, Harmonic Focus, or conventional technique. METHODS: Between 2011 and 2014, from a population of 393 patients undergoing surgery for thyroid disease, 75 (49 females, 26 males, mean age: 57...
September 28, 2016: International Journal of Surgery
Benjamin W Starnes, Rachel E Heneghan, Billi Tatum
OBJECTIVE: The objective of this study was to report midterm results of an ongoing physician-sponsored investigational device exemption pivotal clinical trial using physician-modified endovascular grafts (PMEGs) for treatment of patients with juxtarenal aortic aneurysms who are deemed unfit for open repair. METHODS: Data from a nonrandomized, prospective, consecutively enrolling investigational device exemption clinical trial were used. Data collection began on April 1, 2011, and data lock occurred on May 31, 2015, with outcomes analysis through December 31, 2015...
September 26, 2016: Journal of Vascular Surgery
A Ichida, K Hasegawa, T Takayama, H Kudo, Y Sakamoto, S Yamazaki, Y Midorikawa, T Higaki, Y Matsuyama, N Kokudo
BACKGROUND: Previous RCTs have failed to demonstrate the usefulness of combining energy devices with the conventional clamp crushing method to reduce blood loss during liver transection. Here, the combination of an ultrasonically activated device (UAD) and a bipolar vessel-sealing device (BVSD) with crush clamping was investigated. METHODS: Patients scheduled to undergo hepatectomy at the University of Tokyo Hospital or Nihon University Itabashi Hospital were eligible for this parallel-group, single-blinded randomized study...
September 29, 2016: British Journal of Surgery
Lisa Kabelitz, Andrea Nonn, Kay W Nolte, Omid Nikoubashman, Ahmed Othman, Sarah Heringer, Martin Kramer, Martin Wiesmann, Marc A Brockmann
Minipigs are frequently used in (neuro-)interventional research. Longitudinal experiments may require repeated vessel access via the femoral artery. Anticoagulation and incompliance of the animals necessitates the use of a vascular closure device (VCD). The effects of the Angio-Seal VCD in minipigs were longitudinally assessed. Minipig (42±8.4 kg body weight) femoral arteries were sealed using the 8F (n = 6) or 6F (n = 7) Angio-Seal VCD. The pre-interventional femoral artery diameter was 5.1±0.4 mm (4.3-5...
2016: PloS One
Kathryn A Pitt, Philipp D Mayhew, Michele A Steffey, William T N Culp, Mark C Fuller, Ann Della Maggiore, Richard W Nelson
OBJECTIVE: To report the surgical technique and outcome of dogs undergoing laparoscopic adrenalectomy for removal of unilateral noninvasive pheochromocytoma. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs with unilateral noninvasive adrenal tumors (n=10). METHODS: Medical records of dogs that underwent laparoscopic adrenalectomy for histologically confirmed pheochromocytoma were reviewed. Dogs were positioned in lateral recumbency with the table tilted up to create a semi-sternal position...
September 23, 2016: Veterinary Surgery: VS
Rita Quesada, Ignasi Poves, Enrique Berjano, Carles Vilaplana, Anna Andaluz, Xavier Moll, Dimitri Dorcaratto, Luis Grande, Fernando Burdio
PURPOSE: To evaluate the impact of using monopolar thermal coagulation based on radiofrequency (RF) currents on intraoperative blood loss during liver resection. MATERIALS AND METHODS: A prospective randomised controlled trial was planned. Patients undergoing hepatectomy were randomised into two groups. In the control group (n = 10), hemostasis was obtained with a combination of stitches, vessel-sealing bipolar RF systems, sutures or clips. In the monopolar radiofrequency coagulation (MRFC) group (n = 18), hemostasis was mainly obtained using an internally cooled monopolar RF electrode...
October 5, 2016: International Journal of Hyperthermia
K Verónica Chavez, E Manuel Barajas, Jaqueline Ramírez, Juan Pablo Pantoja, Mauricio Sierra, David Velázquez-Fernandez, Miguel F Herrera
BACKGROUND: Advanced bipolar and ultrasonic devices have shown significant reduction in the surgical time of thyroid operations. This randomized, controlled trial assessed if operative time and other relevant outcomes are different for thyroidectomies performed either with a second-generation advanced bipolar device or traditional tie and suture technique. METHODS: Forty-one patients were randomized into 2 groups (advanced bipolar device and traditional tie and suture)...
September 7, 2016: Surgery
Flore Vărcuş, Ciprian Duţă, Amadeus Dobrescu, Fuger Lazăr, Marius Papurica, Cristi Tarta
AIM: The purpose of the study was to compare the results of laparoscopic inguinal hernia repair using two different methods: transabdominal preperitoneal (TAPP) repair and the technique of totally extraperitoneal repair (TEP). METHODS: In this retrospective study were included 90 cases of inguinal hernia that underwent for laparoscopic approach of inguinal hernia repair at the Emergency County Hospital Timisoara at the 2nd Surgical Clinic between 2012 and 2013. The primary outcome was recurrence of the hernia at two years follow-up...
July 2016: Chirurgia
Saeed Moradi, Ali Talati, Maryam Forghani, Amir Hossein Jafarian, Mandana Naseri, Shiva Shojaeian
OBJECTIVE: Pulp regeneration within the root canal of necrotic teeth is considered an ideal treatment to allow for continued root development and recover teeth vitality. This study aims to evaluate the inductive effect of platelet-rich plasma (PRP) on expression of angiogenesis factors and pulpal revascularization of immature necrotic teeth. MATERIALS AND METHODS: In this experimental animal study, we randomly divided 28 immature premolars from two mixed breed dogs into four groups, two experimental, negative and a positive control...
2016: Cell Journal
Yoshikuni Kawaguchi, Vimalraj Velayutham, David Fuks, Frederic Mal, Norihiro Kokudo, Brice Gayet
BACKGROUND: The lack of a complete hepatic overview and tactile feedback during laparoscopic hepatectomy may result in near misses or fatal intraoperative complications despite the advantage of a magnified laparoscopic view. The aim of the study is to describe operative techniques and guiding principles with which to address near misses unique to laparoscopic hepatectomy and evaluate the intraoperative complication rate overtime. METHODS: Data of 408 consecutive patients who underwent laparoscopic hepatectomy were reviewed...
August 23, 2016: Surgery
Wenshan Wang, Patrick Seale
Brown and beige adipocytes expend chemical energy to produce heat and are therefore important in regulating body temperature and body weight. Brown adipocytes develop in discrete and relatively homogenous depots of brown adipose tissue, whereas beige adipocytes are induced to develop in white adipose tissue in response to certain stimuli - notably, exposure to cold. Fate-mapping analyses have identified progenitor populations that give rise to brown and beige fat cells, and have revealed unanticipated cell-lineage relationships between vascular smooth muscle cells and beige adipocytes, and between skeletal muscle cells and brown fat...
August 24, 2016: Nature Reviews. Molecular Cell Biology
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