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Surgical device

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58 papers 25 to 100 followers
By Giovanni Gambino M.D. Ph.D.
Hang Cheng, Chia-Wen Hsiao, Jeffrey W Clymer, Michael L Schwiers, Bryanna N Tibensky, Leena Patel, Nicole C Ferko, Edward Chekan
The ultrasonic Harmonic scalpel has demonstrated clinical and surgical benefits in dissection and coagulation. To evaluate its use in gastrectomy, we conducted a systematic review and meta-analysis of randomized controlled trials comparing the Harmonic scalpel to conventional techniques in gastrectomy for patients with gastric cancer. International databases were searched without language restrictions for comparisons in open or laparoscopic gastrectomy and lymphadenectomy. The meta-analysis used a random-effects model for all outcomes; continuous variables were analyzed for mean differences and dichotomous variables were analyzed for risk ratios...
2015: International Journal of Surgical Oncology
Emad Abdallah, Mohamed Abd Ellatif, Saleh El Awady, Alaa Magdy, Mohamed Youssef, Waleed Thabet, Ahmed Lotfy, Ayman Elshobaky, Mosaad Morshed
BACKGROUND: To compare the efficacy and safety of both mechanical methods (clips) and electrosurgical instruments, harmonic scalpel (HS) and LigaSure (LS), for securing the cystic duct during laparoscopic cholecystectomy (LC). METHODS: During the study period from October 2010 to October 2012, 458 patients with gallbladder stones underwent LC. A total of 38 patients were excluded from the study for different reasons. The gallbladder was excised laparoscopically through the traditional method...
October 2015: Asian Journal of Surgery
David N Naumann, Aneel Bhangu, Michael Kelly, Douglas M Bowley
BACKGROUND: The optimal technique for gastrointestinal anastomosis remains controversial in emergency laparotomy. The aim of this meta-analysis was to compare outcomes of stapled versus handsewn anastomosis after emergency bowel resection. METHODS: A systematic review was performed for studies comparing outcomes after emergency laparotomy using stapled versus handsewn anastomosis until July 2014 (PROSPERO registry number: CRD42013006183). The primary endpoint was anastomotic failure, a composite measure of leak, abscess and fistula...
April 2015: Surgery
Curtis Bower, Jeffrey W Hazey, Edward L Jones, Kyle A Perry, Daniel L Davenport, J Scott Roth
BACKGROUND: Numerous mesh materials are available for laparoscopic inguinal hernia repair. The role of fixation of mesh in laparoscopic inguinal hernia repair remains controversial. Mesh materials have been engineered to anatomically conform to the pelvis to potentially reduce or eliminate the need for fixation. This study evaluates the outcomes of laparoscopic inguinal hernia utilizing a device consisting of a lightweight polypropylene mesh with a nitinol frame (Rebound HRD) compared with repair with lightweight polypropylene mesh with permanent tack fixation...
October 2015: Surgical Innovation
Sathyan Balaji, Pritam Singh, Mikael H Sodergren, Harry P Corker, Richard M Kwasnicki, Ara Darzi, Paraskevas Paraskeva
INTRODUCTION: The proximity of instrumentation in single-incision laparoscopic surgery (SILS) creates ergonomic challenges. An innovative method to reduce external collisions between instruments and handles is to use instruments of different lengths. This study evaluated the impact of instrument and laparoscope length on simulated SILS performance. METHODS: Performance was assessed using peg transfer (PEG) and pattern cutting (CUT) tasks from the Fundamentals of Laparoscopic Surgery (FLS) curriculum...
December 2015: Surgical Innovation
David Webb, Nathaniel Stoikes, Guy Voeller
Hernia repair remains one of the most common surgical procedures performed around the world. Over the past several decades, in response to various mesh-related complications and coinciding with the influx of laparoscopy into the field of general surgery, numerous advancements have been made in regards to the technology of mesh products being used in hernia repair today. Along these same lines, devices used for mesh fixation have evolved at a similar pace. The goal of this chapter is to review the various materials and methods of mesh fixation being utilized in both ventral and inguinal hernia repair today...
November 2014: Surgical Technology International
James Dana Kondrup, Fran Anderson, Brenda Sylvester, Michelle Branning
The latest version of HARMONIC®, the HARMONIC ACE®+7 Shears by Ethicon US, LLC, is now commercially available. While earlier models also had easy-to-use handles and a fine, non-stick tip, the HARMONIC ACE®+7 Shears adds a new hemostasis feature. The "7" in HARMONIC ACE®+7 stands for the device's ability to coagulate and divide 7-mm vessels. This is accomplished via an Advanced Hemostasis Mode and button located on both sides of the handle. The HARMONIC ACE®+7 will prove itself the leader in the ultrasonic energy field...
November 2014: Surgical Technology International
James Dana Kondrup, Fran Anderson, Brenda Sylvester, Michelle Branning
There are many times during laparoscopic surgery that a surgeon, whether gynecologist or general surgeon, must work in an environment where spillage of tissue or organ contents should be avoided. In gynecologic surgery, this involves management of ovarian cysts as well as containment of tissue fragments during morcellation of uteri or fibroids. Unfortunately, many laparoscopic containment bags on the market today are not large enough to remain open on their own during the entire procedure. The LI Endofield™ and LI Endofield™ TV bag offer a solution and provide an adjustable and suturable "field bag...
November 2014: Surgical Technology International
Abe Fingerhut, Selman Uranues, Giuseppe Maria Ettorre, Emanuele Felli, Marco Colasanti, Gregorio Scerrino, Giusepina Irene Melfa, Cristina Raspanti, Gaspare Gulotta, Alexander Meyer, Martin Oberhoffer, Michael Schmoeckel, Luca Paolo Weltert, Graziano Vignolini, Matteo Salvi, Lorenzo Masieri, Guido Vittori, Giampaolo Siena, Andrea Minervini, Sergio Serni, Marco Carini
Topical hemostatic agents that can seal tissues and assist in the coagulation cascade of patients undergoing surgery have been readily available for several decades. Using either synthetic or animal/plant-derived materials, these agents represent a powerful tool to reduce postoperative bleeding complications in cases where mechanical or energy-driven hemostasis is not possible or insufficient. Recently, a novel sealing hemostatic patch, HEMOPATCH (Baxter International, Deerfield, IL), was developed. The device is a thin and flexible patch consisting of a specifically-formulated porous collagen matrix, coated on one side with a thin protein-binding layer...
November 2014: Surgical Technology International
A Currie, A Brigic, N S Blencowe, S Potter, O D Faiz, R H Kennedy, J M Blazeby
BACKGROUND: The IDEAL framework (Idea, Development, Exploration, Assessment, Long-term study) proposes a staged assessment of surgical innovation, but whether it can be used in practice is uncertain. This study aimed to review the reporting of a surgical innovation according to the IDEAL framework. METHODS: Systematic literature searches identified articles reporting laparoendoscopic excision for benign colonic polyps. Using the IDEAL stage recommendations, data were collected on: patient selection, surgeon and unit expertise, description of the intervention and modifications, outcome reporting, and research governance...
January 2015: British Journal of Surgery
M Diana, V Agnus, P Halvax, Y-Y Liu, B Dallemagne, A-I Schlagowski, B Geny, P Diemunsch, V Lindner, J Marescaux
BACKGROUND: Fluorescence videography is a promising technique for assessing bowel perfusion. Fluorescence-based enhanced reality (FLER) is a novel concept, in which a dynamic perfusion cartogram, generated by computer analysis, is superimposed on to real-time laparoscopic images. The aim of this experimental study was to assess the accuracy of FLER in detecting differences in perfusion in a small bowel resection-anastomosis model. METHODS: A small bowel ischaemic segment was created laparoscopically in 13 pigs...
January 2015: British Journal of Surgery
S Atallah, B Martin-Perez, D Keller, J Burke, L Hunter
BACKGROUND: Natural-orifice transluminal endoscopic surgery (NOTES) represents one of the most significant innovations in surgery to emerge since the advent of laparoscopy. A decade of progress with this approach has now been catalogued, and yet its clinical application remains controversial. METHODS: A PubMed search was carried out for articles describing NOTES in both the preclinical and the clinical setting. Public perceptions and expert opinion regarding NOTES in the published literature were analysed carefully...
January 2015: British Journal of Surgery
María Echave, Itziar Oyagüez, Miguel Angel Casado
BACKGROUND: Surgical bleeding can be associated with an increased risk of morbidity and mortality across all surgical areas. Thus, numerous products have been developed to achieve haemostasis. A flowable haemostatic matrix such as Floseal® can quickly and reliably stop bleeding across the full spectrum of bleeding scenarios. The aim of this study was to systematically review clinical and economic evidence regarding the use of Floseal® in surgical procedures. METHODS: An extensive literature search was conducted in PubMed, EMBASE, and the Cochrane Library over the period spanning 2003-2013 to identify publications related to Floseal® use in all types of surgical procedures...
December 20, 2014: BMC Surgery
Minia Hellan, James Ouellette, Jorge A Lagares-Garcia, Stephen M Rauh, Harold L Kennedy, John D Nicholson, David Nesbitt, Craig S Johnson, Alessio Pigazzi
BACKGROUND: Conventional laparoscopy has been applied to colorectal resections for more than 2 decades. However, laparoscopic rectal resection is technically demanding, especially when performing a tumor-specific mesorectal excision in a difficult pelvis. Robotic surgery is uniquely designed to overcome most of these technical limitations. The aim of this study was to confirm the feasibility of robotic rectal cancer surgery in a large multicenter study. METHODS: Retrospective data of 425 patients who underwent robotic tumor-specific mesorectal excision for rectal lesions at seven institutions were collected...
July 2015: Annals of Surgical Oncology
N Merali, A Verma, T Davies
A patient presented with a recurrent incarcerated inguinoscrotal hernia requiring urgent surgery. The defect was through the gap in the mesh left originally for the cord structures. As a result, a modified funnel repair was performed. An innovative approach was adopted that was best suited to tackling and reducing the risk of recurrence.
November 2014: Annals of the Royal College of Surgeons of England
Haiyang Zhou, Canping Ruan, Yanping Sun, Jian Zhang, Zhiguo Wang, Zhiqian Hu
BACKGROUND: Urogenital dysfunctions are well-recognized problems after rectal cancer surgery and are often due to autonomic nerve damage. Although following holy planes during total mesorectal excision (TME) reduces the possibility of damage to the autonomic nerve fibers, these could still be affected in some critical areas.1 (,) 2 To improve the quality of surgery and prevent nerve damage, accurate intraoperative anatomical orientation of autonomic nerve is essential.3 Thanks to advancement of the high-definition laparoscopic technology, even the finest nerve fibers deep in the pelvic cavity can be identified through illumination and magnification...
February 2015: Annals of Surgical Oncology
André L Mihaljevic, Rebekka Schirren, Mine Özer, Stephanie Ottl, Sybille Grün, Christoph W Michalski, Mert Erkan, Carsten Jäger, Carolin Reiser-Erkan, Victoria Kehl, Tibor Schuster, Jürgen Roder, Ulf Clauer, Carolin Orlitsch, Tomas F Hoffmann, Reinhard Lange, Thomas Harzenetter, Phillip Steiner, Milena Michalski, Karl Henkel, Josef Stadler, Georg A Pistorius, Anja Jahn, Robert Obermaier, Robert Unger, Roland Strunk, Frank Willeke, Holger Vogelsang, Bert Halve, Karl-Heinz Dietl, Hendrik Hilgenstock, Alexander Meyer, Hans-Jörg Krämling, Markus Wagner, Michael H Schoenberg, Florian Zeller, Johannes Schmidt, Helmut Friess, Jörg Kleeff
OBJECTIVE: To determine whether circular plastic wound edge protectors (CWEPs) significantly reduce the rate of surgical site infections (SSIs) in comparison to standard surgical towels in patients undergoing laparotomy. BACKGROUND: SSIs cause substantial morbidity, prolonged hospitalization, and costs and remain one of the most frequent surgical complications. CWEPs have been proposed as a measure to reduce the incidence of SSIs. METHODS: In this randomized controlled, multicenter, 2-arm, parallel-group design, patient- and observer-blinded trial patients undergoing open elective abdominal surgery were assigned to either intraoperative wound coverage with a CWEP or standard coverage with surgical towels...
November 2014: Annals of Surgery
Mario Santini, Alfonso Fiorelli, Gaetana Messina, Antonio Mazzella, Marina Accardo
OBJECTIVE: To evaluate the feasibility and the effectiveness of LigaSure Forced Triad to create intestinal anastomosis in an ex vivo porcino model. METHODS: Colon samples (n = 100) were prospectively randomized into 2 groups: LigaSure group (n = 90) and Stapler group (n = 10). The LigaSure group was divided into 9 subgroups, each of 10 samples, according to the different power levels of the LigaSure system (Bar 1, Bars 2, and Bars 3) and radiofrequency application (1 application, 2 applications, and 3 applications) used...
June 2015: Surgical Innovation
Dimitrios K Manatakis, Nikolaos Georgopoulos
Cost-effectiveness in health care management is critical. The situation in debt-stricken Greece is further aggravated by the financial crisis and constant National Health System expense cut-downs. In an effort to minimize the cost of laparoscopy, our department introduced reusable laparoscopic instruments in December 2011. The aim of this study was to assess potential cost reduction of laparoscopic operations in the field of general surgery. Hospital records, invoice lists, and operative notes between January 2012 and December 2013, were retrospectively reviewed and data were collected on laparoscopic procedures, instrument failures, and replacement needs...
2014: Minimally Invasive Surgery
Jeroen Heemskerk, H Reinier Zandbergen, Sander W M Keet, Ingrid Martijnse, Gust van Montfort, Rob J A Peters, Vesna Svircevic, R Arthur Bouwman, Cor G M I Baeten, Nicole D Bouvy
BACKGROUND: Laparoscopic surgery might be beneficial for the patient, but it imposes increased physical and mental strain on the surgeon. Robot-assisted laparoscopic surgery addresses some of the laparoscopic drawbacks and may potentially reduce mental strain. This could reduce the risk of surgeon's fatigue, mishaps and strain-induced illnesses, which may eventually improve the safety of laparoscopic surgical procedures. METHODS: To test this hypothesis, a randomized study was performed, comparing both heart rate and heart rate variability (HRV) of the surgeon as a measure of total and mental strain, respectively, during conventional and robot-assisted laparoscopic cholecystectomy...
2014: Digestive Surgery
2014-10-19 11:07:09
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