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217 papers 0 to 25 followers
Lukas van den Haak, Anne C van der Eijk, Evelien M Sandberg, Gerard Peter G M Frank, Karin Ansink, Rob C M Pelger, Cor D de Kroon, Frank Willem Jansen
BACKGROUND: To assess potential risks of new surgical procedures and devices before their introduction into daily practice, a prospective risk inventory (PRI) is a required step. This study assesses the applicability of the Health Failure Mode and Effects Analysis (HFMEA) as part of a PRI of new technology in minimally invasive gynecologic surgery. METHODS: A reference case was defined of a patient with presumed benign leiomyoma undergoing a laparoscopic hysterectomy or myomectomy including in-bag power morcellation; however, pathology defined a stage I uterine leiomyosarcoma...
July 9, 2018: Surgical Endoscopy
Seyed Amirhossein Razavi, Karan A Desai, Alexandra M Hart, Peter W Thompson, Albert Losken
The goal in abdominal wall reconstruction (AWR) is to minimize morbidity and prevent hernia recurrence. Components separation and mesh reconstruction are two options, however, with advantages and disadvantages. The purpose of this review was to investigate outcomes in patients with abdominal wall hernia undergoing primary closure with component separation (CS) versus CS with acellular dermal matrix (ADM) reinforcement (CS + mesh). Medical records of consecutive patients who underwent abdominal wall reconstruction using CS with or without ADM reinforcement were retrospectively reviewed...
June 1, 2018: American Surgeon
James Dana Kondrup, Conor Grey
Since 1993 (and prior, WISAP® [WISAP Medical Technology GmbH, Brunnthal, Germany] hand morcellators), laparoscopic power morcellation has been an indispensably employed technique for minimally invasive gynecologic surgery, contributing both to laparoscopic myomectomies and hysterectomies. However, the technique was highlighted with concern by the FDA for the given potential to disseminate neoplastic and non-neoplastic cells by morcellating an unexpected uterine sarcoma (Fig. 1). Given this concern, many gynecologists are either resorting to performing traditional laparotomies or risking dissemination with uncontained power morcellation techniques...
July 5, 2018: Surgical Technology International
Chloe Thompson, Thomas Faunce
On 28 March 2018 the Australian Senate Community Affairs References Committee issued its final report on transvaginal mesh devices. It found these devices have caused unnecessary physical and emotional pain and suffering to thousands of women who were not told by their doctors of the objective material risks associated with their use. The Senate Committee concurred with the description by the Public Health Association of Australia of the complications resulting from transvaginal mesh implants as constituting a serious public health issue requiring a response at both an individual and at a population level, including counselling, public education, clinical interventions and long-lasting protective mechanisms...
July 2018: Journal of Law and Medicine
Carsten Holzmann, Christian Saager, Gunhild Mechtersheimer, Dirk Koczan, Burkhard M Helmke, Jörn Bullerdiek
A 50 year old woman underwent laparoscopic supracervical hysterectomy because of symptomatic fibroids. Histologic examination of samples obtained after morcellation revealed typical uterine leiomyomas in all samples investigated. 28 and 47 months later, respectively, the patient presented with peritoneal spreading of nodules that were surgically removed and histologically classified as leiomyosarcoma. In 3/4 of samples obtained after morcellation copy number/SNP-array hybridization showed complex genomic alterations widely identical to the pattern characterizing the sarcoma...
June 12, 2018: Oncotarget
Femke van Zanten, Jan J van Iersel, Francis E Hartog, Karin C I M Aalders, E Lenters, Ivo A M J Broeders, Steven E Schraffordt Koops
STUDY OBJECTIVE: The safety of mesh usage in pelvic floor surgery is being debated due to the occurrence of mesh-related complications. Based on the current literature available, mesh-related complications seem to be lower in transabdominal mesh surgery than in transvaginal mesh surgery. Large prospective trials investigating mesh-related complications after transabdominal placed mesh are, however, lacking. The aim of this study was to prospectively evaluate the mesh exposure rate after robot-assisted laparoscopic pelvic floor surgery for the treatment of female pelvic organ prolapse (POP) in a large cohort...
June 28, 2018: Journal of Minimally Invasive Gynecology
Andrea Lazzati, Georges Bou Nassif, Luca Paolino
This study is a review on the management of ventral hernia during bariatric surgery. The main outcomes are the recurrence rate after ventral hernia repair and the incidence of prosthetic infection. Eleven studies were included. Ventral hernias were treated by simple suture (n = 191), synthetic mesh (n = 186), and biological mesh (n = 72). Mean defect size was 18 cm2 . Recurrence rate was 25.7% in the suture group, 14.3% in the biomesh group, and 1.1% in the synthetic mesh group (p < 0.05)...
June 27, 2018: Obesity Surgery
D Weyhe, J Conze, A Kuthe, F Köckerling, B J Lammers, R Lorenz, H Niebuhr, W Reinpold, K Zarras, R Bittner
SURGICAL TECHNIQUES: The HerniaSurge guidelines have the highest evidence with respect to a strong recommendation for mesh-based surgical techniques. This evidence is equally valid for the Lichtenstein procedure as for the minimally invasive procedures TEP/TAPP. In the case of discrete symptomatic or asymptomatic inguinal hernias, watchful waiting can be an option, taking into account health status and social circumstances. Femoral hernias, on the other hand, should be treated promptly with mesh insertion...
June 21, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Mooyad A Ahmed, Qutaiba A Tawfic, Christopher M Schlachta, Nawar A Alkhamesi
OBJECTIVES: The aim of this meta-analysis was to examine postoperative pain and surgical outcomes (operative time, hospital stay, the incidence of seroma and recurrence) with different mesh fixation methods following laparoscopic ventral hernia repair (LVHR). METHODS: Randomized clinical trials compared different methods of mesh fixation in LVHR and reported on pain outcome measures analyzed. The results were expressed as odds ratio (OR) for combined dichotomous and mean difference (MD) for continuous data...
June 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Philippe Ferry, Pauline Bertherat, Anne Gauthier, Richard Villet, Francesco Del Piano, David Hamid, Hervé Fernandez, Pierre-Louis Broux, Delphine Salet-Lizée, Etienne Vincens, Pierre Ntshaykolo, Philippe Debodinance, Philippe Pocholle, Yannick Thirouard, Renaud de Tayrac
Vaginal mesh safety information is limited, especially concerning single incision techniques using ultra lightweight meshes for the treatment of anterior pelvic organ prolapse (POP). Objective To determine the intraoperative and postoperative complication rates after anterior POP repair involving an ultralight mesh (19kg/m2 ): Restorelle® Direct Fix™. Methods A case series of 218 consecutive patients, operated on between January 2013 and December 2016 in ten tertiary and secondary care centres, was retrospectively analysed...
June 16, 2018: Journal of gynecology obstetrics and human reproduction
Nasim Zargar, Andrew Carr
BACKGROUND: All surgical meshes entering the U.S. market have been cleared for clinical use by the 510(k) process of the Food and Drug Administration (FDA), in which devices simply require proof of "substantial equivalence" to predicate devices, without the need for clinical trials. However, recalled meshes associated with adverse effects may, indirectly, continue to serve as predicates for new devices raising concerns over the safety of the 510(k) route. METHODOLOGY: Here we assess the potential magnitude of this problem by determining the ancestral network of equivalence claims linking recently cleared surgical meshes...
2018: PloS One
Nisse V Clark, Sarah L Cohen
Morcellation allows minimally invasive approaches to surgery even in the presence of large uteri or myomas. Recent restrictions in the use of power morcellation, as well as concerns regarding the potential for morcellation to disseminate malignant tissue, have initiated investigation and innovation to find safer methods. This review examines current techniques for tissue extraction during uterine surgery, with a focus on contained power morcellation and contained manual morcellation via mini-laparotomy or colpotomy...
February 2018: Journal of Minimally Invasive Gynecology
Foozhan Tahmasebinia, Arash Pourgholaminejad
The role of T helper 17 (Th17) cells in auto-inflammatory neurological disorders such as Multiple Sclerosis (MS), Alzheimer's disease (AD), Parkinson's disease (PD) and schizophrenia has not been clarified completely. Th17-derived pro-inflammatory cytokines including IL-17, IL-21, IL-22, IL-23, GM-CSF, and IFN-γ have a critical role in the pathogenesis of these disorders. In this review, we demonstrate the role of Th17 cells and their related cytokines in the immunopathology of above-mentioned disorders to get a better understanding of neuroinflammatory mechanisms mediated by Th17 cells associated with events leading to neurodegeneration...
October 3, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
Silvano Sozzani, Annalisa Del Prete, Daniela Bosisio
Dendritic cells (DCs) are professional antigen presenting cells displaying the unique capability to activate naïve T cells. DCs react to pathogen encounter also by the production of mediators of inflammation, including pro-inflammatory cytokines. Because of this complex role, any imbalance in DC function reflects into defective or exaggerated immune response and tissue damage. DCs comprise two main subsets, namely conventional or classical DCs (cDCs), that are dedicated antigen presenting cells, and plasmacytoid DCs (pDCs), that respond to nucleic acids by releasing high amounts of type I interferons (IFNs)...
December 2017: Journal of Autoimmunity
Kazuo Okamoto, Tomoki Nakashima, Masahiro Shinohara, Takako Negishi-Koga, Noriko Komatsu, Asuka Terashima, Shinichiro Sawa, Takeshi Nitta, Hiroshi Takayanagi
The immune and skeletal systems share a variety of molecules, including cytokines, chemokines, hormones, receptors, and transcription factors. Bone cells interact with immune cells under physiological and pathological conditions. Osteoimmunology was created as a new interdisciplinary field in large part to highlight the shared molecules and reciprocal interactions between the two systems in both heath and disease. Receptor activator of NF-κB ligand (RANKL) plays an essential role not only in the development of immune organs and bones, but also in autoimmune diseases affecting bone, thus effectively comprising the molecule that links the two systems...
October 1, 2017: Physiological Reviews
Pavlos Texakalidis, Kimon Bekelis, Elias Atallah, Stavropoula Tjoumakaris, Robert H Rosenwasser, Pascal Jabbour
Flow diversion with the Pipeline Embolization Device (PED) is reported as a safe and efficient treatment for patients with intracranial aneurysms; however, literature discussing the antiplatelet (APT) regimen used before and after the PED is limited. Our aim was to systematically review and summarize available data regarding the APT regimen and the platelet function test (PFT) that was used. We also sought to provide an overview of the aneurysm morphologies and adverse event rates associated with the PED use...
October 2017: Clinical Neurology and Neurosurgery
Mark J Pearson, Richard L Williams, Hayley Floyd, David Bodansky, Liam M Grover, Edward T Davis, Janet M Lord
Cobalt-chromium-molybdenum (CoCrMo) alloy-based metal-on-metal prostheses have been the implant of choice for total hip replacement in younger patients. However 6.2% of patients require revision of their CoCrMo total hip replacement (THR) implant within five years of surgery and their use was restricted in 2013. We aimed to determine if there were individual differences in the immune response to wear debris that might indicate a poor outcome with a CoCrMo prosthesis. Blood from 22 donors was incubated with CoCrMo particles (>99...
October 2015: Biomaterials
Rami Bechara, Diane Antonios, Hayat Azouri, Marc Pallardy
Allergic contact dermatitis, caused by nickel, is a delayed-type hypersensitivity reaction, and 14.5% of the general population may be affected in Europe. Among a wide range of cytokines, the IL-12 family has unique structural and immunological characteristics. Whereas IL-12p70 promotes T helper (Th) 1 cell polarization, IL-23 promotes Th17 cell development and both have been isolated from nickel-allergic patients. In this work, we were interested in understanding the mechanism behind nickel-induced Th17 cell development...
October 2017: Journal of Investigative Dermatology
Adrianne Wesol, Shauna Woolley
OBJECTIVE: This study was a quality improvement project investigating patterns of hysterectomy practice including changes in surgical techniques and patient outcomes after manufacturer withdrawal of a laparoscopic power morcellator from our hospitals in July 2014. STUDY DESIGN: This time-series pre and post retrospective review examined data from electronic health records, comparing one year when a laparoscopic power morcellator was available (Year 1, mid-2013 to mid-2014) to one year after withdrawal (Year 2, mid-2014 to mid-2015)...
August 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
2017-06-15 00:13:21
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