Association of occupational direct radiation exposure to the hands with longitudinal melanonychia and hand eczema in spine surgeons: a survey by the society for minimally invasive spinal treatment (MIST)

2021 ◽  
Author(s):  
Yasukazu Hijikata ◽  
Tsukasa Kamitani ◽  
Yosuke Yamamoto ◽  
Takahiro Itaya ◽  
Toshiaki Kogame ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Radiation Exposure ◽  
Hand Eczema ◽  
Direct Radiation ◽  
Longitudinal Melanonychia

Radiation exposure of patient and surgeon in minimally invasive kidney stone surgery

2016 ◽  
Vol 26 (6) ◽  
pp. 353-359 ◽  
Author(s):  
A. Demirci ◽  
O. Raif Karabacak ◽  
F. Yalçınkaya ◽  
O. Yiğitbaşı ◽  
C. Aktaş
Keyword(s):  
Minimally Invasive ◽  
Radiation Exposure ◽  
Kidney Stone

A Review of Techniques, Time Demand, Radiation Exposure, and Outcomes of Skin-anchored Intraoperative 3D Navigation in Minimally Invasive Lumbar Spinal Surgery

Spine ◽  
2020 ◽  
Vol 45 (8) ◽  
pp. E465-E476 ◽  
Author(s):  
Avani S. Vaishnav ◽  
Robert K. Merrill ◽  
Harvinder Sandhu ◽  
Steven J. McAnany ◽  
Sravisht Iyer ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Radiation Exposure ◽  
Spinal Surgery ◽  
3D Navigation ◽  
Lumbar Spinal Surgery ◽  
Lumbar Spinal

Improving accuracy and reducing radiation exposure in minimally invasive lumbar interbody fusion

2010 ◽  
Vol 12 (5) ◽  
pp. 533-539 ◽  
Author(s):  
Martin James Wood ◽  
Richard John Mannion
Keyword(s):  
Minimally Invasive ◽  
Radiation Exposure ◽  
Interbody Fusion ◽  
Case Series ◽  
Guidance System ◽  
Screw Placement ◽  
Invasive Technique ◽  
Computer Assisted ◽  
Lumbar Interbody Fusion ◽  
Screw Misplacement

Object The authors assessed the accuracy of placement of lumbar transpedicular screws by using a computer-assisted, imaged-guided, minimally invasive technique with continuous electromyography (EMG) monitoring. Methods This was a consecutive case series with prospective assessment of procedural accuracy. Forty-seven consecutive patients underwent minimally invasive lumbar interbody fusion and placement of pedicle screws (PSs). A computer-assisted image guidance system involving CT-based images was used to guide screw placement, while EMG continuously monitored the lumbar nerve roots at the operated levels with a 5-mA stimulus applied through the pedicle access needle. All patients underwent CT scanning to determine accuracy of PS placement. All episodes of adjusted screw trajectory based on positive EMG responses were recorded. Pedicle screw misplacement was defined as breach of the pedicle cortex by the screw of more than 2 mm. Results Two hundred twelve PSs were inserted in 47 patients. The screw misplacement rate was 4.7%. One patient experienced new postoperative radiculopathy resulting from a sacral screw that was too long, with lumbosacral trunk impingement. The trajectory of the pedicle access needle was altered intraoperatively on 20 occasions (9.4% of the PSs) based on positive EMG responses, suggesting that nerve root impingement may have resulted from these screws had the EMG monitoring not been used. Conclusions The combination of computer-assisted navigation combined with continuous EMG monitoring during pedicle cannulation results in a low rate of PS misplacement, with avoidance of screw positions that might cause neural injury. Furthermore, this technique allows reduction of the radiation exposure for the surgical team without compromising the accuracy of screw placement.

Relationship of drain amylase and anastomotic leak after esophagectomy.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 118-118 ◽  
Author(s):  
Joshua S. Hill ◽  
Erin Marie Hanna ◽  
Susie C. Hurley ◽  
Mark Reames ◽  
Jonathan C. Salo
Keyword(s):  
Minimally Invasive ◽  
Radiation Exposure ◽  
Anastomotic Leak ◽  
Minimally Invasive Esophagectomy ◽  
Locally Advanced ◽  
Chi Square ◽  
Ivor Lewis ◽  
Invasive Esophagectomy ◽  
Drain Amylase ◽  
Relationship Of

118 Background: Esophagectomy is considered the only curative approach in patients with esophageal cancers without locally advanced or metastasis. Anastomotic leak can lead to significant morbidity and mortality. CT esophagram (CTE) is a sensitive method of evaluating for leak; however this test carries with it financial cost and radiation exposure. This study evaluates the utility of drain amylase in the prediction of anastomotic leak. Methods: Fifty-nine patients underwent esophagectomy between 3/10 and 8/12; serial drain amylases and CTE were obtained in 50. Leak was defined by extravasation of contrast or the presence of empyema on CTE. Elevated drain amylase was defined as any level > 400 IU/L. Chi-square and descriptive statistics were performed and the sensitivity of drain amylase >400 IU/L in predicting leak was calculated. Results: A minimally invasive esophagectomy was performed in 47, and an open Ivor-Lewis in 2 and a minimally invasive Ivor-Lewis in 1. Stapled intra-thoracic anastomoses were performed in 47, 3 had a cervical anastomoses. Average age was 61 years and 84% were males. Leak occurred in 6 patients (12.5%). One patient with a late leak was excluded from analysis as they did not have concurrent drain amylase values. This patient had low amylase levels and a normal CTE, though later presented with leak. The overall peri-operative mortality rate was 4.2% (2/48). Mortality in the non-leak and leak cohorts were 0% & 33%. Drain amylase was an accurate marker of anastomotic leak. Of 6 patients with an elevated drain amylase, 5 had an anastomotic leak (sensitivity 83.3%). 40/41 patients with low drain amylase had no leak. Using a cut-off value of 400 IU/L, the negative predictive value of drain amylase in predicting leak after esophagectomy was 97.6% (95%CI; 85.6, 99.9). Conclusions: Drain amylase is a simple and inexpensive test that has excellent sensitivity and negative prediction for the detection of anastomotic leak after esophagectomy. To our knowledge, this is the first study to demonstrate this finding. Routine evaluation of drain amylase may safely replace CTE in the management of patients after esophagectomy, thus reducing radiation exposure and overall cost.

Minimizing Radiation Exposure in Minimally Invasive Spine Surgery

2014 ◽  
Vol 25 (2) ◽  
pp. 247-260 ◽  
Author(s):  
Najib E. El Tecle ◽  
Tarek Y. El Ahmadieh ◽  
Biraj M. Patel ◽  
Rohan R. Lall ◽  
Bernard R. Bendok ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Radiation Exposure ◽  
Spine Surgery ◽  
Minimally Invasive Spine Surgery ◽  
Minimally Invasive Spine

scholarly journals Surgical Outcomes for Minimally Invasive vs Open Transforaminal Lumbar Interbody Fusion

Neurosurgery ◽  
2015 ◽  
Vol 77 (6) ◽  
pp. 847-874 ◽  
Author(s):  
Nickalus R. Khan ◽  
Aaron J. Clark ◽  
Siang Liao Lee ◽  
Garrett T. Venable ◽  
Nicholas B. Rossi ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Radiation Exposure ◽  
Interbody Fusion ◽  
Operative Time ◽  
Meta Analysis ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Complication Rates ◽  
Lumbar Interbody Fusion

BACKGROUND: Minimally invasive transforaminal lumbar interbody fusion (TLIF)—or MI-TLIF—has been increasing in prevalence compared with open TLIF (O-TLIF) procedures. The use of MI-TLIF is an evolving technique with conflicting reports in the literature about outcomes. OBJECTIVE: To investigate the impact of MI-TLIF in comparison with O-TLIF for early and late outcomes by using the Visual Analog Scale for back pain (VAS-back) and the Oswestry Disability Index (ODI). Secondary end points include blood loss, operative time, radiation exposure, length of stay, fusion rates, and complications between the 2 procedures. METHODS: During August 2014, a systematic literature search was performed identifying 987 articles. Of these, 30 met inclusion criteria. A random-effects meta-analysis was performed by using both pooled and subset analyses based on study type. RESULTS: Our meta-analysis demonstrated that MI-TLIF reduced blood loss (P < .001), length of stay (P < .001), and complications (P = .001) but increased radiation exposure (P < .001). No differences were found in fusion rate (P = .61) and operative time (P = .34). A decrease in late VAS-back scores was demonstrated for MI TLIF (P < .001), but no differences were found in early VAS-back, early ODI, and late ODI. CONCLUSION: MI-TLIF is associated with reduced blood loss, decreased length of stay, decreased complication rates, and increased radiation exposure. The rates of fusion and operative time are similar between MI-TLIF and O-TLIF. Differences in long-term outcomes in MI-TLIF vs O-TLIF are inconclusive and require more research, particularly in the form of large, multi-institutional prospective randomized controlled trials.

Efficacy of the transjugular approach in endovascular intervention for hemodialysis access comparing with conventional approach

2020 ◽  
Vol 21 (6) ◽  
pp. 1003-1010
Author(s):  
Chang Hun Lee ◽  
Jun Gyo Gwon ◽  
Cheol Woong Jung ◽  
Sung Bum Cho
Keyword(s):  
Survival Rate ◽  
Radiation Exposure ◽  
Conventional Approach ◽  
Endovascular Intervention ◽  
Hemodialysis Access ◽  
Direct Puncture ◽  
Direct Radiation ◽  
Lesion Location ◽  
Significant Difference ◽  
Approach Group

Purpose: Compared with the conventional approach, the benefits of the transjugular approach in endovascular intervention for hemodialysis access avoids complications due to direct puncture and reduces direct radiation exposure to the hands of operator. The aim of this non-inferiority study was to evaluate the efficacy of the transjugular approach in endovascular intervention for hemodialysis access comparing with conventional approach. Methods: We retrospectively assessed endovascular intervention for hemodialysis access performed in our hospital from 2012 to 2016, divided into the conventional approach group and the transjugular approach group. The hemodialysis access survival rate, re-intervention survival rate, and lesion characteristics were comparatively evaluated. Results: We included 223 cases in 118 patients (146 cases with conventional approaches and 77 cases with transjugular approaches). There was a higher incidence of thrombosis with the conventional approach (p < 0.001), however, no significant difference in the hemodialysis access type or main lesion location. The transjugular approach showed either a better hemodialysis access survival rate (p = 0.017) and a trend toward improved re-intervention survival rate (p = 0.098) than the conventional approach. Following classification according to the presence of thrombus, there was no significant difference in either the hemodialysis access survival rate or the re-intervention survival rate between the approaches with or without thrombus. Conclusion: The transjugular approach could be performed in most cases and was similar to the conventional approach in terms of outcomes. The transjugular approach should be considered as an alternative to either replace or use in combination with the conventional approach in endovascular intervention for hemodialysis access.

scholarly journals Comparison of Radiation Exposure of the Surgeon in Minimally Invasive Treatment of Osteoporotic Vertebral Fractures – Radiofrequency Kyphoplasty versus Balloon Kyphoplasty with Cement Delivery Systems (CDS)

2019 ◽  
Vol 192 (01) ◽  
pp. 59-64
Author(s):  
Steffen Reißberg ◽  
Lina Lüdeke ◽  
Michael Fritsch
Keyword(s):  
Minimally Invasive ◽  
Radiation Exposure ◽  
Radiation Protection ◽  
Balloon Kyphoplasty ◽  
Delivery Systems ◽  
Working Time ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Dose Area Product ◽  
Area Product

The aim of the present study was to compare the radiation exposure of the surgeon when using two different kyphoplasty systems for the minimally invasive treatment of osteoporotic vertebral body fractures. There was a preliminary investigation study by a Belgian working group from the ORAMED project (2010), which served as the basis and showed a dose reduction for the surgeon when using a balloon kyphoplasty system with cement delivery systems (CDS). Materials and Methods A bipedicular balloon kyphoplasty system (Medtronic GmbH) with CDS and a unipedicular radiofrequency kyphoplasty system (StabiliT, DFine Europe GmbH) were used in solitary fractures in the thoracolumbar junction in 20 patients each. The patient groups were relatively homogeneous with a mean age of 76.9 years for balloon kyphoplasty and 75 years for radiofrequency kyphoplasty. As expected, the proportion of woman was higher in both groups. The mean BMI value was higher in the radiofrequency kyphoplasty group, and the patient with the highest BMI was also in this group. The workflows were defined in three steps. The working time and the fluoroscopic time were measured in the individual work steps and the dose was measured over all work steps by TLD chips (thermoluminescence detector) on the forehead, on the X-ray apron, on both wrists and on the left ankle. The dose area product was registered for the entire procedure. Results In step 2, the main differences were found in working time and fluoroscopy time in transit. The difference was due to the bipedicular puncture for balloon kyphoplasty and the change of the working cannula, while only a unipedicular puncture was needed in radiofrequency kyphoplasty. The total fluoroscopy time over all procedures was three times longer than in balloon kyphoplasty and this was also reflected in the dose area product, which was more than twice that. The measured surface doses for the lenses were four times higher in balloon kyphoplasty. For the left wrist, the values for balloon kyphoplasty were about 8 times higher. Conclusion Overall, from a radiophysical perspective, the use of a unipedicular kyphoplasty system must be recommended. Should balloon kyphoplasty be used for medical reasons, all radiation protection products (lead gloves, lead glass, radiation protection goggles and CDS) should be used, the surface doses for both hands must be detected by a ring dosimeter and the lens dose must be recorded and documented by a TLD on the radiation protection goggles. Key Points: Citation Format

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