scholarly journals Effects of laparoscopy, laparotomy, and respiratory phase on liver volume in a live porcine model for liver resection

2021 ◽  
Author(s):  
Hannes G. Kenngott ◽  
Felix Nickel ◽  
Anas A. Preukschas ◽  
Martin Wagner ◽  
Shivalik Bihani ◽  
...  
Keyword(s):  
Porcine Model ◽  
Liver Volume ◽  
Lung Ventilation ◽  
Preoperative Imaging ◽  
Deep Inspiration ◽  
Precise Calculation ◽  
Mesh Model ◽  
Respiratory Phase ◽  
Liver Transplantations ◽  
Preoperative Simulation

Abstract Background Hepatectomy, living donor liver transplantations and other major hepatic interventions rely on precise calculation of the total, remnant and graft liver volume. However, liver volume might differ between the pre- and intraoperative situation. To model liver volume changes and develop and validate such pre- and intraoperative assistance systems, exact information about the influence of lung ventilation and intraoperative surgical state on liver volume is essential. Methods This study assessed the effects of respiratory phase, pneumoperitoneum for laparoscopy, and laparotomy on liver volume in a live porcine model. Nine CT scans were conducted per pig (N = 10), each for all possible combinations of the three operative (native, pneumoperitoneum and laparotomy) and respiratory states (expiration, middle inspiration and deep inspiration). Manual segmentations of the liver were generated and converted to a mesh model, and the corresponding liver volumes were calculated. Results With pneumoperitoneum the liver volume decreased on average by 13.2% (112.7 ml ± 63.8 ml, p < 0.0001) and after laparotomy by 7.3% (62.0 ml ± 65.7 ml, p = 0.0001) compared to native state. From expiration to middle inspiration the liver volume increased on average by 4.1% (31.1 ml ± 55.8 ml, p = 0.166) and from expiration to deep inspiration by 7.2% (54.7 ml ± 51.8 ml, p = 0.007). Conclusions Considerable changes in liver volume change were caused by pneumoperitoneum, laparotomy and respiration. These findings provide knowledge for the refinement of available preoperative simulation and operation planning and help to adjust preoperative imaging parameters to best suit the intraoperative situation.

scholarly journals Establishing a Porcine Model of Small for Size Syndrome following Liver Resection

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Mohammad Golriz ◽  
Maryam Ashrafi ◽  
Elias Khajeh ◽  
Ali Majlesara ◽  
Christa Flechtenmacher ◽  
...  
Keyword(s):  
Liver Resection ◽  
Porcine Model ◽  
Clinical Laboratory ◽  
Liver Volume ◽  
International Normalized Ratio ◽  
Remnant Liver ◽  
Extended Liver Resection ◽  
Group A ◽  
Group B ◽  
Small For Size

Background. Small for size syndrome (SFSS) is responsible for a high proportion of mortalities and morbidities following extended liver resection. Aim. The aim of this study was to establish a porcine model of SFSS. Methods. Twenty-four Landrace pigs underwent liver resection with a remnant liver volume of 50% (group A, n=8), 25% (group B, n=8), and 15% (group C, n=8). After resection, the animals were followed up for 8 days and clinical, laboratory, and histopathological outcomes were evaluated. Results. The survival rate was significantly lower in group C compared with the other groups (p<0.001). The international normalized ratio, bilirubin, aspartate transaminase, alanine transaminase, and alkaline phosphatase levels increased shortly after surgery in groups B and C, but no change was observed in group A (p<0.05 for all analyses). The histopathological findings in group A were mainly mild mitoses, in group B severe mitoses and hepatocyte ballooning, moderate congestion, and hemorrhage, along with mild necrosis, and in group C extended tissue damage with severe necrosis, hemorrhage, and congestion. Conclusions. Combination of clinical, laboratory, and histopathological evaluations is needed to confirm the diagnosis of SFSS. 75% liver resection in porcine model results in SFSS. 85% liver resection causes irreversible liver failure.

Right Anterior Minithoracotomy for Aortic Valve Replacement: A Widely Applicable, Simple, and Stepwise Approach

2019 ◽  
Vol 14 (4) ◽  
pp. 321-329 ◽  
Author(s):  
Igo B. Ribeiro ◽  
Marc Ruel
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Lung Ventilation ◽  
Preoperative Imaging ◽  
Stepwise Approach ◽  
Simplified Approach ◽  
Digital Palpation ◽  
Wide Range ◽  
Knot Pusher

Objective A stepwise approach for right anterior minithoracotomy aortic valve replacement (RAT-AVR), without sutureless valves, special instruments, or preoperative imaging, was developed. We report our experience with this widely applicable, simplified approach. Methods Patients with a history of previous chest surgery, documented PVD, severe COPD, LVOT size <2.0 cm, and root size <2.8 cm were excluded. Chest CT was not mandatory. The stepwise surgical approach consists of 1) tolerability of single-lung ventilation; 2) 5-cm long incision on third right anterior ICS; 3) small pericardial opening to localize the aortic valve annular plane by digital palpation; 4) shingling of the correct rib to create a box field; 5) optimizing exposure with stay sutures; 6) femoral or central cannulation with right superior pulmonary vein venting and usual antegrade cardioplegia; 7) performing a standard AVR without adjunct instruments; and 8) reconstructing 1 costochondral cartilage. Results Fifty-five patients were operated. The mean age was 68.5 years (SD 10.4); 29.1% were female. Median STS PROM was 1.18 (0.4 to 6.6). Pump and cross-clamp times were 104.8 minutes (SD 27.9) and 73.2 minutes (SD 22.8), respectively. There was no need for a knot pusher. There was 1 conversion, 1 reopening for bleeding, and 1 pacemaker insertion. No patient had a stroke, MI, or death at 30 days. The median LOS was 6 days (3 to 19). Conclusion RAT-AVR can be applicable and performed safely in a wide range of patients by adopting a simple, stepwise approach with intraoperative assessment, without the need for special imaging, instrumentation, or advanced training.

scholarly journals Lung computed tomography density distribution in a porcine model of one-lung ventilation

2009 ◽  
Vol 102 (4) ◽  
pp. 551-560 ◽  
Author(s):  
A. Kozian ◽  
T. Schilling ◽  
H. Schütze ◽  
F. Heres ◽  
T. Hachenberg ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Density Distribution ◽  
Porcine Model ◽  
Lung Ventilation ◽  
One Lung Ventilation

scholarly journals Exogenous surfactant in the late respiratory phase of COVID-19

2021 ◽  
Vol 99 (5) ◽  
pp. 7-13
Author(s):  
K. G. Shapovalov ◽  
S. А. Lukyanov ◽  
V. А. Konnov ◽  
O. А. Rozenberg
Keyword(s):  
Chloride Solution ◽  
Sodium Chloride Solution ◽  
Disease Onset ◽  
Lung Ventilation ◽  
Exogenous Surfactant ◽  
Non Invasive ◽  
Respiratory Phase ◽  
Artificial Lung Ventilation ◽  
Isotonic Sodium Chloride ◽  
Coronavirus Infection

The article presents data on the course of inhalations with a native surfactant administered in two patients (66 and 53 years old) at the late respiratory phase of the new coronavirus infection of COVID-19 (the 22nd and the 19th days from the disease onset) who received non-invasive artificial lung ventilation.Subjects and methods. For inhalations, an AeroNeb™ micropump nebulizer was used; for one inhalation, 75 mg of surfactant-BL was dissolved in 5 ml of isotonic sodium chloride solution. The treatment course included 5 days with 2 inhalations a day.Results. In both patients, upon the end of this therapy with the native surfactant, regression of respiratory failure was noted, the level of respiratory support was reduced to insufflation with humidified oxygen, and rehabilitation measures were started with subsequent discharge from the hospital.

scholarly journals Ultrasonography for measuring rectus abdominis muscles diastasis

2007 ◽  
Vol 22 (3) ◽  
pp. 182-186 ◽  
Author(s):  
Denise de Almeida Mendes ◽  
Fábio Xerfan Nahas ◽  
Daniela Francescato Veiga ◽  
Fernando Vilela Mendes ◽  
Ricardo Góes Figueiras ◽  
...  
Keyword(s):  
Rectus Sheath ◽  
Accurate Method ◽  
Rectus Abdominis ◽  
Preoperative Imaging ◽  
Deep Inspiration ◽  
Rectus Abdominis Muscle ◽  
Imaging Evaluation ◽  
Anterior Rectus Sheath ◽  
Rectus Diastasis ◽  
Significant Difference

PURPOSE: Preoperative imaging evaluation may be useful for determining the position of recti abdominis muscles before their correction. The purpose of this study is to evaluate the accuracy of ultrasonography to measure the width of rectus abdominis muscle diastasis. METHODS: Rectus diastasis was measured by ultrasonography preoperatively in 20 females. Rectus diastasis was measured in seven levels along the anterior rectus sheath by ultrasound after sustained deep inspiration and after expiration. Rectus diastasis, at the same levels, was also measured after its exposition during abdominoplasty by two independent observers, using a surgical compass. These values were compared using Wilcoxon's statistical text, for non independent values. RESULTS: There was no significant difference between the values obtained by ultrasound and those measured during surgery in the supra-umbilical levels and at the level of the umbilicus. However, below the umbilicus these values differed significantly, showing smaller values in the imaging evaluation. CONCLUSION: Ultrasonography is an accurate method to measure rectus diastasis above the umbilicus and at the umbilical level.

695: Impact of Arterial and Arteriovenous Renal Clamping with and without Intrarenal Cooling on Renal Oxygenation and Temperature in a Porcine Model

2007 ◽  
Vol 177 (4S) ◽  
pp. 233-233
Author(s):  
Alexandra E. Perks ◽  
Trevor D. Schuler ◽  
Luke Fazio ◽  
Brian Blew ◽  
Greg Hare ◽  
...  
Keyword(s):  
Porcine Model
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