Microdebrider-Assisted Supraglottoplasty for Laryngomalacia

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P66-P66
Author(s):  
Jan Casimir Groblewski ◽  
Rahul K Shah ◽  
George H Zalzal
Keyword(s):  
Surgical Treatment ◽  
Revision Surgery ◽  
Retrospective Review ◽  
Operative Time ◽  
Demographic Characteristics ◽  
Alternative Methods ◽  
Esophageal Reflux ◽  
Operative Outcome ◽  
Operative Complications ◽  
Average Operative Time

Objective To describe our series in the surgical treatment of laryngomalacia using a microdebrider. Methods A retrospective review of patients undergoing supraglottoplasty for laryngomalacia at a tertiary children's hospital between October 2004 and February 2008 was performed. Patients with complex co-morbidities and those undergoing alternative methods for supraglottoplasty were excluded. Patient charts and operative reports were reviewed to assess demographic characteristics, co-morbidities, procedural times, hospitalizations, intra-operative and post-operative complications, and post-operative outcome. Main outcome measures included complications, pain, resolution of stridor, presence of aspiration, and need for revision surgery. Results 27 patients underwent microdebrider-assisted supraglottoplasty. Mean age at diagnosis was 109 days; mean age at time of the procedure was 187 days. 18 Eighteen patients (67%) had gastro-esophageal reflux at the time the laryngomalacia was diagnosed. Average operative time was 35.7 minutes (std. dev. 12.9, range 11–65 minutes). No intra-operative complications or device problems were noted. Only 2 patients remained intubated at the conclusion of the procedure; no patient required tracheotomy or revision supraglottoplasty. One patient had post-operative aspiration, which later resolved. One patient was readmitted for stridor one month following her procedure. There was no pain from the procedure, as all patients immediately resumed a diet. All patients had eventual resolution of stridor. Conclusions This is the largest series of patients that underwent microdebrider-assisted supraglottoplasty for laryngomalacia. This procedure is safe, without pain, and effective in patients with laryngomalacia. Microdebrider- assisted supraglottoplasty is the method of choice for supraglottoplasty in our institution.

Microdebrider-Assisted Supraglottoplasty for Laryngomalacia

2009 ◽  
Vol 118 (8) ◽  
pp. 592-597 ◽  
Author(s):  
Jan C. Groblewski ◽  
Rahul K. Shah ◽  
George H. Zalzal
Keyword(s):  
Surgical Treatment ◽  
Gastroesophageal Reflux ◽  
Outcome Measures ◽  
Revision Surgery ◽  
Retrospective Review ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Age At Diagnosis ◽  
Average Operative Time ◽  
The Mean

Objectives We describe our series in the surgical treatment of laryngomalacia using a microdebrider. Methods We performed a retrospective review of patients who underwent microdebrider-assisted supraglottoplasty for laryngomalacia between October 2004 and February 2008. Patients with neurologic conditions and secondary airway lesions were excluded. The main outcome measures included complications, pain, resolution of stridor, presence of aspiration, and need for revision surgery. Results Twenty-eight patients underwent microdebrider-assisted supraglottoplasty. The mean age at diagnosis was 109 days, and the mean age at the time of the procedure was 182 days. Nineteen patients (68%) had gastroesophageal reflux at diagnosis. The average operative time was 35.7 minutes (range, 11 to 65 minutes). No intraoperative complications or device problems occurred. Two patients remained intubated after the procedure. One patient required a tracheotomy, and 1 patient underwent revision supraglottoplasty. Three patients had aspiration that resolved. There was negligible pain from the procedure, as all patients immediately resumed a diet. All patients had immediate or eventual resolution of stridor. Conclusions This is the largest series of patients who underwent microdebrider-assisted supraglottoplasty for laryngomalacia. This procedure is relatively safe, with minimal pain, and effective in patients with laryngomalacia. Microdebrider-assisted supraglottoplasty is the method of choice for supraglottoplasty in our institution.

scholarly journals Laparoscopic management of appendicular lump

2020 ◽  
Vol 7 (9) ◽  
pp. 3065
Author(s):  
Manoj Kumar Chaudhary ◽  
Mrinal Shankar ◽  
Tridip Dutta Baruah ◽  
Rubik Ray ◽  
Shubham Samal
Keyword(s):  
Retrospective Study ◽  
Learning Curve ◽  
Treatment Cost ◽  
Operative Time ◽  
Site Infection ◽  
Early Recovery ◽  
Operative Complications ◽  
Average Operative Time ◽  
Laparoscopic Intervention ◽  
Time Of Admission

The surgical management of an appendicular lump remains controversial. With the revolution and advancement of laparoscopic instrumentation and technical learning curve, it is possible to remove an inflamed appendix in presence of lump. This retrospective study was performed between August 2018 and August 2019 in AIIMS Raipur, 86 patients were treated for appendicitis laparoscopically, in these 14 patients had appendicular lump at the time of admission. 12 patients (total 14; 2 patients were excluded) underwent laparoscopic intervention for appendicular lump. Average operative time were 90 minutes. Average post-operative hospital stay were 5 days. Post-operative complications were seen in 2 patients (surgical site infection). In histopathology report, appendicular inflammation suggestive of appendicitis were present in all operated cases. We conclude, early laparoscopic appendectomy confirms the diagnosis. It is safe and feasible in patients with appendicular lump. It reduces the treatment cost, early recovery and satisfactory overall outcome.

scholarly journals Three port versus four port laparoscopic cholecystectomy: a prospective comparative clinical study

2019 ◽  
Vol 7 (8) ◽  
pp. 3054
Author(s):  
Shams Ul Bari ◽  
Faheem Ul Islam ◽  
Ajaz A. Rather ◽  
Ajaz A. Malik
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
P Value ◽  
Analgesic Requirement ◽  
Medical College ◽  
Number Of Patients ◽  
Operative Complications ◽  
Comparative Clinical Study ◽  
Average Operative Time ◽  
Prospective Comparative Study

Background: Although, traditional laparoscopic cholecystectomy is performed using four-port technique, various modifications were made to further enhance the advantages of laparoscopic cholecystectomy. Aim of the study is to compare the results of three-port and four-port laparoscopic cholecystectomy at single center in terms of technical feasibility, safety of the procedure, operative time, intra-operative complications, postoperative pain and post-operative analgesia requirementMethods: It was a  prospective comparative study conducted  in the department of surgery Skims Medical college Srinagar, India from July 2015 to March 2017. The study was performed on all adult patients with ultrasound documented cholelithiasis and gall bladder Polyposis. The total number of patients studied was 100 which were divided into two groups of 50 each.Results: The average operative time in three port group was 29.2 minutes (range, 15-37) compared to 30.66 minutes (range, 15-42) in four port group, which was statistically insignificant. The final visual analog scores for pain in the postoperative period was 2.30 vs 2.86 in three port and four port group respectively, with a P value=0.008, which was statistically significant.Conclusions: The three-port technique is as safe as the standard four-port technique and can be a viable alternative to four port cholecystectomy with an advantage of less pain and less analgesic requirement and better cosmetic results.

Efficacy of Routine Intraoperative Cranio-Femoral Traction in Surgical Treatment of Adolescent Idiopathic Scoliosis Curves Measuring Between 50° and 90°

2021 ◽  
pp. 219256822110529
Author(s):  
Jacob R. Carl ◽  
Gurpal Pannu ◽  
Evan Cherng-Yeh Chua ◽  
Adam Bacon ◽  
Blythe Durbin-Johnson ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Adolescent Idiopathic Scoliosis ◽  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Revision Surgery ◽  
Operative Time ◽  
Curve Correction ◽  
Major Curve ◽  
Estimated Blood Loss ◽  
Retrospective Comparative Study

Study Design Retrospective Comparative Study, Level III. Objective In patients with scoliosis >90°, cranio-femoral traction (CFT) has been shown to obtain comparable curve correction with decreased operative time and blood loss. Routine intraoperative CFT use in the treatment of AIS <90° has not been established definitively. This study investigates the effectiveness of intraoperative CFT in the treatment of AIS between 50° and 90°, comparing the magnitude of curve correction, blood loss, operative time, and traction-related complications with and without CFT. Methods 73 patients with curves less than 90° were identified, 36 without and 37 with cranio-femoral traction. Neuromuscular scoliosis and revision surgery were excluded. Age, preoperative Cobb angles, bending angles, and curve types were recorded. Surgical characteristics were analyzed including number of levels fused, estimated blood loss, operative time, major curve correction (%), and degree of postoperative kyphosis. Results Patients with traction had significantly higher preoperative major curves but no difference in age or flexibility. Lenke 1 curves had significantly shorter operative time and improvement in curve correction with traction. Among subjects with 5 to 8 levels fused, subjects with traction had significantly less EBL. Operative time was significantly shorter for subjects with 5-8 levels and 9-11 levels fused. Curves measuring 50°-75° showed improved correction with traction. Conclusion Intraoperative traction resulted in shorter intraoperative time and greater correction of major curves during surgical treatment of adolescent idiopathic scoliosis less than 90°. Strong considerations should be given to use of intraoperative CFT for moderate AIS.

scholarly journals Fractures of the upper part of the femur treated with Mitkovic selfdynamisable internal fixator (SIF)

2010 ◽  
Vol 57 (4) ◽  
pp. 103-107 ◽  
Author(s):  
Milorad Mitkovic ◽  
Marko Bumbasirevic ◽  
Sasa Milenkovic ◽  
Ivan Micic ◽  
Milan Mitkovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Neck ◽  
Blood Loss ◽  
Operative Time ◽  
Femoral Fractures ◽  
Internal Fixator ◽  
Average Period ◽  
Femoral Neck Axis ◽  
Invasive Method ◽  
Average Operative Time

Complex transtrochanteric and subtrochanteric fractures need dynamisation in two axis: in neck axis and in the long axis of the femur. In this study is present one new concept of the surgical treatment of the fractures of proximal femur using new double dynamic selfdynamisable internal fixator (SIF). Dynamisation along the femoral neck axis is available immediately after the fixation, while dynamisation in the long axis of the femur is activated spontaneously 4-6 weeks after the fixation. It is shown series of 30 consecutive fractures of the upper femur. The average operative time was 42 minutes and average blood loss was 70 (seventy) milliliters. All fractures healed within an average period of sixteen weeks (ranging from 12 to 24 weeks). There were no serious complications. Conclusion: SIF is one effective minimally invasive method for the treatment of complex trochanteric and subtrochanteric femoral fractures.

NONINVAGINATION VS. INVAGINATION OF APPENDICULAR STUMP: A RETROSPECTIVE STUDY

2021 ◽  
pp. 64-65
Author(s):  
Nirmal Kumar Agarwal ◽  
Bibhu Priyo Das
Keyword(s):  
Operative Time ◽  
Standard Treatment ◽  
Laparoscopic Approach ◽  
Purse String Suture ◽  
Purse String ◽  
Group I ◽  
Operative Complications ◽  
Average Operative Time ◽  
Good Technique ◽  
Appendicular Stump

Appendicitis is the most common abdominal surgical emergency. The standard treatment of acute appendicitis is appendicectomy which can be performed by either open or laparoscopic approach. While during laparoscopic approach the stump is mostly not invaginated, in open method management of stump remains debatable- simple ligation or ligation and invagination of the stump. Aim of the study was to compare results of simple ligation alone or ligation and invagination of the appendicular stump during appendicectomy. Materials And Methods: Altogether 74 patients were included in this study and divided into two groups. Group I ligation and invagination of the stump with purse string suture and Group II simple ligation of the stump. The two methods were compared with respect to operative time, intraoperative and post-operative complications. Results: There was no signicant difference in either the rate of post-operative complication and post-operative hospital stay between the two groups. The average operative time was shorter in group without invagination. Conclusion: simple ligation of appendicular stump is a safe, simpler good technique associated with shorter operative time.

Assessment of progress and competence in tonsillectomy surgery using cumulative sum analysis

2018 ◽  
Vol 132 (8) ◽  
pp. 734-738
Author(s):  
A K Abou-Foul ◽  
A Taghi ◽  
N S Tolley ◽  
Z Awad
Keyword(s):  
Standard Deviation ◽  
Operative Time ◽  
Outcome Measure ◽  
Poor Performance ◽  
Cumulative Sum ◽  
Cumulative Sum Analysis ◽  
Performance Curves ◽  
Operative Complications ◽  
Average Operative Time ◽  
Low Incidence

AbstractObjectiveTo assess the feasibility of using cumulative sum analysis to show trainees’ performance curves and highlight concerns in tonsillectomy surgery.MethodsIn this prospective study, the performance of eight otolaryngology trainees (in their first 6–12 months in the specialty) was compared to that of experts (over 150 tonsillectomies performed) in terms of operative time and post-operative complications. Cumulative sum analysis curves were generated to highlight trainees’ performance, and were updated after each performance.ResultsThe average operative time was 23 minutes (standard deviation = 11) for experts and 38 minutes (standard deviation = 16) for trainees (p < 0.0001). Cumulative sum analysis charts for trainees’ operative time initially rose and then started to plateau after a number of cases (range, 25–30), while that of experts remained low. Cumulative sum analysis charts for complications can be used to monitor performance. In this study, complications were combined (because of low incidence) to allow use of this outcome measure.ConclusionThe flexibility of the cumulative sum analysis makes it adaptable to any outcome. It is a strong adjunct in surgical training to monitor progress and competence. Its sensitivity also allows early detection of poor performance, to instigate intervention.

Clinical outcomes of tracheoesophageal diversion for intractable aspiration

2015 ◽  
Vol 129 (S2) ◽  
pp. S69-S73 ◽  
Author(s):  
K Adachi ◽  
T Umezaki ◽  
H Kiyohara ◽  
H Miyaji ◽  
S Komune
Keyword(s):  
High Risk ◽  
Clinical Outcomes ◽  
Operative Time ◽  
Oral Feeding ◽  
Speech Communication ◽  
Swallowing Function ◽  
Operative Complications ◽  
Average Operative Time ◽  
Intractable Aspiration ◽  
Risk Of Aspiration

AbstractObjectives:The purpose of the present study was to examine the clinical outcomes of using tracheoesophageal diversion for preventing intractable aspiration.Method:We retrospectively reviewed 25 patients who underwent tracheoesophageal diversion from 2003 to 2009 at our hospital (median age, 25 years; range, 0–78 years). End-to-side anastomosis was used in 16 cases and side-to-side anastomosis was used in 9.Results:The average operative time was 141 minutes for end-to-side anastomosis and 191 minutes for side-to-side anastomosis. Peri-operative complications were observed in only two (8 per cent) cases: one with infection and one with haematoma. No fistulas were observed. Aspiration was prevented in all cases, but the nutritional route depended on the swallowing function of the patient. Oral feeding was the main nutritional route after surgery in only four patients (16 per cent).Conclusion:This procedure is well suited to patients who lack speech communication and are at high risk of aspiration.

scholarly journals Analysis of 300 Total Laparoscopic Hysterectomy Cases Performed by The Same Surgeon

2021 ◽  
Vol 3 (2) ◽  
pp. 20-24
Author(s):  
Esra Tamburacı ◽  
Barış Mulayim
Keyword(s):  
Hospital Stay ◽  
Open Surgery ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Technical Difficulty ◽  
Demographic Characteristics ◽  
Total Laparoscopic Hysterectomy ◽  
Conversion To Open Surgery ◽  
Operative Complications

Aim: This study aimed to evaluate the results of 300 cases of total laparoscopic hysterectomy (TLH) performed by the same surgeon. Material and methods: During the study period, a total of 300 TLH operations were performed between January 2017 and December 2018. Demographic characteristics, indications of hysterectomy, uterine weights, intra-operative and post-operative complications, duration of the operation, length of hospital stay, blood loss of patients, visual analogue scores and amount of analgesics needed were retrospectively evaluated. Complications were analysed and compared with literature. Results: Parameters analysed for 300 patients included in the study were as follows: mean age 47.82 ± 6.18 years, mean parity 3.4 ± 2.0 (0–11), BMI 27.41 ± 4.36 (kg/m²), mean uterine weight 367.67 ± 266.21 g (50–1600 g), mean operative time 89.07 ± 37.94 min (30–240 min), mean hospital stay 54.37 ± 21.95 h (24–168 h) and total complication rate 28 (9.3%). Conversion to open surgery was required in 29 (9.7%) patients. The level of technical difficulty and existence of prior abdominal surgery were associated with a higher risk of complications and conversions to laparotomy. Conclusion: Total laparoscopic hysterectomy is a well-designed surgical procedure for the management of benign gynaecological conditions, and after adequate training, it seems to be a safe and effective procedure for patients.

LAPAROSCOPIC TRANS-ABDOMINAL PRE-PERITONEAL (TAPP) REPAIR FOR TREATMENT INGUINAL HERNIA DISEASE

2018 ◽  
Vol 8 (4) ◽  
pp. 76-80
Author(s):  
Thao Nguyen Minh ◽  
Vu Pham Anh ◽  
Tri Nguyen Huu ◽  
Phu Nguyen Doan Van ◽  
Phuc Nguyen Thanh ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Bilateral Hernia ◽  
Repair Method ◽  
Tapp Repair ◽  
Post Operation ◽  
Average Operative Time ◽  
The Mean

Background: Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans-abdominal pre-peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. Patient and method: The study included 60 cases with inguinal hernia that have been treated by laparoscopic transabdominal pre-peritoneal (TAPP) repair. Method: Description, prospective follow-up. Result: The mean age was 58±18.2. 96.7% were males. The average operative time was 45.6±15.1 minutes for one side hernia, 73±25.2 minutes for bilateral hernia. 02 cases have been post-operation inguinal seroma complication (3.3%), 02 cases with hydrocele (3.3%), 01 case with abdominal seroma (1.7%). 04 cases (6.7%) opposite inguinal hernia were detected and 05 cases (8.3%) with combined diseases were resolved. Duration of post-operative stay was 3.9±1.1 days. Conclusion: TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

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