833 Hyper Acute Dialysis Access Pathway (HADAP) – Undertaking Creation of Arteriovenous Fistulae in The Renal Ward

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Shetty ◽  
P Chowdary ◽  
D Dabare ◽  
C Seet ◽  
R Ahmed ◽  
...  
Keyword(s):  
Operating Time ◽  
Surgical Site Infections ◽  
Primary Patency ◽  
Successful Implementation ◽  
Dialysis Access ◽  
Arteriovenous Fistulae ◽  
Surgical Assistance ◽  
Average Operating ◽  
Average Operating Time ◽  
Duration Of Operation

Abstract Introduction The impetus to apply the “lean method” to creation of arteriovenous fistulae came with the pandemic restricting access to theatres. Here we present HADAP implemented in a dedicated procedure room in the Renal ward. Method Between April and September 2020, 44 patients underwent ward-based arteriovenous fistula operations with no more than 3 people in the room – surgeon, runner and patient. The parameters assessed were duration of operation, complications, patency, patient and surgeon feedback and financial implications. Results The service was predominantly registrar-led who created 91% of the fistulae. 95% operations were completed successfully with a 2-week primary patency of 73% and no surgical site infections. 40% of the procedures were radiocephalic fistulae. 14% procedures required surgical assistance by the runner. The average operating time reduced from 90 minutes for the first 10 cases to 50 minutes for the last 9. A structured questionnaire showed positive feedback from both patients and surgeons (4-5 out of 5). This service has cleared potentially 9 main theatre lists for more complex procedures. Conclusions Our study demonstrates the successful implementation of a novel operating environment allowing expedited care for renal failure patients. It has enhanced our ability to deliver a dialysis access program despite the challenges of COVID.

Minilaparotomy Cholecystectomy as a Day Surgery Procedure: A Prospective Clinical Pilot Study

2007 ◽  
Vol 96 (3) ◽  
pp. 206-208 ◽  
Author(s):  
J. Harju ◽  
M. Pääkkönen ◽  
M. Eskelinen
Keyword(s):  
Randomised Trial ◽  
Operating Time ◽  
Day Surgery ◽  
Prospective Randomised Trial ◽  
Wound Pain ◽  
Average Operating ◽  
Average Operating Time ◽  
Study Support ◽  
The Mean

Background and Aims: In some studies minilaparotomy cholecystectomy (MC) has been shown to be as good as laparoscopic cholecystectomy (LC) in the surgical treatment of cholecystolithiasis. To our knowledge, the MC operation is rarely considered as a day surgery procedure. Patients and Methods: Thirty elective symptomatic non-complicated patients were included in the study during the end of the year 2004 to June 2005. The mean age of patients was 52 years (range 27–68), the mean body mass index 29 kg/m2 (range 19–41). Gallstones were confirmed with ultrasound and the pre-operative liver laboratory tests were normal in all patients. A five (+/-2) centimetre-long incision was used avoiding to split the rectus abdominis muscle. All patients were re-evaluated four weeks postoperatively with the follow-up letter. Results: The average operating time was 51 minutes (range 30–105 minutes). Day surgery was possible in 25 cases (83%). Five patients (17%) stayed over night at the hospital. There were four (13%) conversions to conventional cholecystectomy. The average postoperative sick leave was 16 days (range 14–30). Two patients returned to hospital. One patient had wound pain, but no complication was found, and the patient was not admitted. One patient had a wound infection and spent 6 days in the hospital. Twenty-nine (97%) patients were satisfied with the operation and were ready to recommend it for other patients. Conclusions: The results of this study support the suitability of MC as a day surgery procedure, but a prospective randomised trial is needed to evaluate the relative advantages of MC and LC.

scholarly journals Video assisted resections. Increasing access to minimally invasive liver surgery?

2015 ◽  
Vol 42 (5) ◽  
pp. 318-324 ◽  
Author(s):  
Fabricio Ferreira Coelho ◽  
Marcos Vinícius Perini ◽  
Jaime Arthur Pirola Kruger ◽  
Renato Micelli Lupinacci ◽  
Fábio Ferrari Makdissi ◽  
...  
Keyword(s):  
Operating Time ◽  
Perioperative Outcomes ◽  
Liver Lesions ◽  
Minimally Invasive Liver Surgery ◽  
Video Assisted ◽  
Average Operating ◽  
Average Operating Time ◽  
Average Size ◽  
Anesthesia Time ◽  
Prospective Database

Objective: To evaluate perioperative outcomes, safety and feasibility of video-assisted resection for primary and secondary liver lesions. Methods : From a prospective database, we analyzed the perioperative results (up to 90 days) of 25 consecutive patients undergoing video-assisted resections in the period between June 2007 and June 2013. Results : The mean age was 53.4 years (23-73) and 16 (64%) patients were female. Of the total, 84% were suffering from malignant diseases. We performed 33 resections (1 to 4 nodules per patient). The procedures performed were non-anatomical resections (n = 26), segmentectomy (n = 1), 2/3 bisegmentectomy (n = 1), 6/7 bisegmentectomy (n = 1), left hepatectomy (n = 2) and right hepatectomy (n = 2). The procedures contemplated postero-superior segments in 66.7%, requiring multiple or larger resections. The average operating time was 226 minutes (80-420), and anesthesia time, 360 minutes (200-630). The average size of resected nodes was 3.2 cm (0.8 to 10) and the surgical margins were free in all the analyzed specimens. Eight percent of patients needed blood transfusion and no case was converted to open surgery. The length of stay was 6.5 days (3-16). Postoperative complications occurred in 20% of patients, with no perioperative mortality. Conclusion : The video-assisted liver resection is feasible and safe and should be part of the liver surgeon armamentarium for resection of primary and secondary liver lesions.

Laparoscopic “en-bloc” ligation of spermatic veins

1996 ◽  
Vol 63 (3) ◽  
pp. 384-388
Author(s):  
C. Trombetta ◽  
G. Savoca ◽  
G. Liguori ◽  
A. Tamai ◽  
S. Siracusano ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Operating Time ◽  
Case Histories ◽  
En Bloc ◽  
Optical Magnification ◽  
Average Operating ◽  
Average Operating Time ◽  
The Right

Laparoscopic varicocelectomy is suggested only for II-III grade bilateral varicocele. The optical magnification granted by videosurgical techniques, prevents damaging testicular arteries; this possibility, however, requires a considerable amount of time. We performed a laparoscopic “en-bloc” ligation without sparing the artery on 13 patients with bilateral varicocele in order to assess eventual changes in gonadal volume. 10 patients underwent bilateral “en-bloc” ligation of spermatic vessels with an average operating time of 21 minutes. In 3 other patients, “en-bloc” ligation was performed on the right side while on the left side the artery was identified and saved; in these cases the average operating time was 33 minutes. After an average follow-up period of 19 months no cases of testicle atrophy nor of hydrocele were reported. ColorDoppler sonography, performed 3 months later on the 10 patients treated by bilateral “en-bloc” ligation, showed no persistent reflux. No case of homolateral persistent reflux was encountered in the 3 patients who underwent only right-side “en-bloc” ligation, but on the left side, where selective ligation had been performed, persistence of reflux was registered in one patient. Our experience has confirmed that laparoscopic “en-bloc” ligation of the internal spermatic pedicle, sparing vasa deferentia, prevents the persistence of reflux in all cases and allows a reduction in operating time. The opportunity of treating a pathology like bilateral varicocele by means of laparoscopy, which requires general anaesthesia, needs further confirmation and a larger number of case histories.

scholarly journals Laparoscopic Adrenalectomy for Adrenal Tumors

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Sun Chuan-yu ◽  
Ho Yat-faat ◽  
Ding Wei-hong ◽  
Gou Yuan-cheng ◽  
Hu Qing-feng ◽  
...  
Keyword(s):  
Blood Loss ◽  
Laparoscopic Adrenalectomy ◽  
Benign Tumor ◽  
Operating Time ◽  
Adrenal Tumors ◽  
Benign Tumors ◽  
Intraoperative Blood Loss ◽  
First Choice ◽  
Average Operating ◽  
Average Operating Time

Objective. To evaluate the indication and the clinical value of laparoscopic adrenalectomy of different types of adrenal tumor.Methods. From 2009 to 2014, a total of 110 patients were diagnosed with adrenal benign tumor by CT scan and we performed laparoscopic adrenalectomy. The laparoscopic approach has been the procedure of choice for surgery of benign adrenal tumors, and the upper limit of tumor size was thought to be 6 cm.Results. 109 of 110 cases were successful; only one was converted to open surgery due to bleeding. The average operating time and intraoperative blood loss of pheochromocytoma were significantly more than the benign tumors (P<0.05). After 3 months of follow-up, the preoperative symptoms were relieved and there was no recurrence.Conclusions. Laparoscopic adrenalectomy has the advantages of minimal invasion, less blood loss, fewer complications, quicker recovery, and shorter hospital stay. The full preparation before operation can decrease the average operating time and intraoperative blood loss of pheochromocytomas. Laparoscopic adrenalectomy should be considered as the first choice treatment for the resection of adrenal benign tumor.

scholarly journals URBAN PUBLIC TRANSPORT: MARGINAL VALUE OF THE CAPACITY FACTOR

2019 ◽  
Vol 16 (3) ◽  
pp. 290-301
Author(s):  
A. I. Fadeev ◽  
Ye. V. Fomin ◽  
S. Alhusseini
Keyword(s):  
Public Transport ◽  
Operating Time ◽  
Capacity Utilization ◽  
Utilization Factor ◽  
Marginal Value ◽  
Passenger Traffic ◽  
Urban Public Transport ◽  
Speed Fluctuation ◽  
Average Operating ◽  
Average Operating Time

Introduction. One of the most important indicators determining the public transport service quality is the capacity utilization factor of transport fleet. This parameter directly effects on the economic efficiency of the transport organization. For the carrier it is desirable from an economic point of view that the value of the capacity utilization factor takes on the greatest value. Passengers, on the contrary, prefer to transfer without overfull capacity of transport vehicles. Moreover, this factor is used in determining travel fares, analyzing the executed movement regarding the availability of reserves in carrying capacity and planning transportation process. The paper discusses the method of marginal value calculation of the transport fleet’s capacity utilization factor of urban public transport based on ensuring standard vehicle's cabin filling limits.Materials and methods. The authors solved the task of determining the filling marginal value for transport fleet while working on regular urban routes by analyzing the dependence of the capacity utilization factor on the passenger traffic parameters, the average operating time of the transport fleet on the route and the speed fluctuation during public transport operation. The authors also proposed the indicator of the transportation speed fluctuation during the operation of urban public transport.Results. The authors found out that the capacity utilization factor of transport fleet substantially depended on the passenger traffic parameters, on the average operating time of the transport fleet and on the speed fluctuation during public transport operation.Discussion and conclusion. The obtained dependences allow us calculating the marginal values of capacity utilization factor with taking into account the parameters of the planned transport process. The standard capacity utilization factor varies within considerable limits from 0.2 to 0.4, depending on the operating conditions.

Surrenectomia laparoscopica: Nostra esperienza

1997 ◽  
Vol 64 (1_suppl) ◽  
pp. 74-77
Author(s):  
F. Porpiglia ◽  
M. Morino ◽  
C. Garrone ◽  
M. Terzolo ◽  
I. Morra ◽  
...  
Keyword(s):  
Autologous Blood ◽  
Operating Time ◽  
Oral Intake ◽  
Average Hospital Stay ◽  
Average Hospital ◽  
Post Operative Period ◽  
Alternative Approach ◽  
Estimated Blood Loss ◽  
Average Operating ◽  
Average Operating Time

Laparoscopy has been described as an alternative approach for performing adrenalectomy. From January ‘96 to April ‘97, 14 laparoscopie adrenalectomies were performed in our Division. Patient age ranged from 33 to 64 years. The clinical diagnosis included 5 Conn's syndrome, 3 pheochromocytoma, 3 Cushing's syndrome, 1 Cushing's disease and 3 incidentalomas. Average operating time was 70’ and 90’ for right and left adrenalectomy respectively. The average estimated blood loss was 70 ml. All the patients resumed oral intake antalgic therapy with Ketorolac in the first 12 post-operative hours. The patients resumed oral intake within 1 day. Two patients received 500 ml of autologous blood in the post-operative period. The average hospital stay was 3.5 days. These results suggest that laparoscopie adrenalectomy is a minimally invasive alternative to traditional open adrenalectomy.

scholarly journals Antimicrobial photodynamic therapy in voice rehabilitation of patients after laryngectomy

2021 ◽  
Vol 10 (1) ◽  
pp. 11-16
Author(s):  
S. A. Shinkarev ◽  
S. V. Boldyrev ◽  
A. P. Zagadaev ◽  
V. N. Podolsky ◽  
V. A. Borisov ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Operating Time ◽  
Voice Rehabilitation ◽  
Control Group ◽  
Antimicrobial Photodynamic Therapy ◽  
Vocal Function ◽  
Prevention Of Infection ◽  
Average Operating ◽  
Average Operating Time ◽  
Monthly Dose

The article is devoted to the problem of voice rehabilitation of patients after laryngectomy. Modern possibilities of repairing laryngeal vocal function, methods for extending the lifetime of voice prostheses are considered. The author’s method of prevention of infection of vocal prostheses using the antimicrobial photodynamic therapy (PDT) with chlorin-type photosensitizer Radagel is presented. Performing antimicrobial PDT of vocal prostheses increased the average operating time to 11.9 months compared to the control group (6.8 months), where a monthly dose of 150 mg of fluconazole was used for prevention. The method developed by the authors makes it possible to significantly extend the lifetime of vocal prostheses, is devoid of adverse events, is well tolerated by patients.

scholarly journals GALLBLADDER CARCINOMA;

2011 ◽  
Vol 18 (01) ◽  
Author(s):  
AHMAD HASSAN KHAN ◽  
SAIFULLAH GORAYA ◽  
HAROON-UR- RASHID
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Gallbladder Carcinoma ◽  
Open Cholecystectomy ◽  
Operating Time ◽  
Chronic Cholecystitis ◽  
Surgical Department ◽  
Carcinoma Gallbladder ◽  
Average Operating ◽  
Average Operating Time

Objective: Chronic Cholecystitis is one of the commonest diseases presenting in surgical department and is subjected to cholecystectomy each time. A suspicious gall bladder on ultrasound initiates further investigations to rule out carcinoma of gall bladder yet some times a benign looking gall bladder on ultrasound turns out to be carcinoma of gall bladder on histopathology. Design: Descriptive study. Place & Duration of study: District Head Quarters Hospital, Sargodha, from September 2007 to March 2009. Patients & Methods: 200 patients who underwent both open and Laparoscopic cholecystectomy for cholelithiasis were subjected to this study. All relevant data was documented on a standardized data form. Patients were between the ages of 28-74. Patients already diagnosed as Gallbladder Carcinoma, empyema gall bladder, mucocele and gall bladder polyp were excluded from the study. Gall bladders removed after each surgery ware sent to laboratory for histopathological evaluation. Results: A total of 200 cases were studied (161 females, 39 males; M: F ratio 1:4). The mean age was 45 years (range 28-74 years). The most common presenting complaint was pain right hypochondrium with nausea and vomiting (85%).The average operating time was 50 minutes in case of open cholecystectomy and 1 hour in laparoscopic cholecystectomy. Complications included biliary leak in 2 patients (1%), Wound Infection in 3 patients (1.5%) and death in one case (0.5%). The overall rate of complications was 3%. There were a total of 5 patients of laparoscopic cholecystectomy who required extension of the incision, for Carcinoma Gallbladder. Conclusions: Carcinoma of gall bladder is a very aggressive malignancy and usually presents at a very advance stage as its symptoms mostly are marked by symptoms of cholecystitis. Detection of gall bladder carcinoma is very difficult in early stages on ultrasound. Any findings in ultrasound suggesting malignancy should be confirmed on further investigations like CT scan .Carcinoma of Gall bladder is not very common in cases of cholecystectomy for chronic Cholecystitis but once found should be dealt with extreme precision following established operating protocols. 

scholarly journals Laparoscopic appendectomy versus laparoscopic assisted appendectomy: a hospital based comparative study

2020 ◽  
Vol 7 (6) ◽  
pp. 1935
Author(s):  
Gopal Sharma ◽  
Barinder Kumar
Keyword(s):  
Comparative Study ◽  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Laparoscopic Technique ◽  
Average Operating ◽  
Group A ◽  
Prospective Comparative Study ◽  
Average Operating Time ◽  
Group B ◽  
Laparoscopic Assisted

Background: Laparoscopic appendectomy is more expensive and time consuming as compared to open technique. On the other hand, laparoscopic assisted appendectomy has the advantages of both the open and laparoscopic methods.Methods: This was a prospective comparative study of patients that underwent appendectomy by laparoscopic or laparoscopic assisted techniques.Results: A total of 40 patients were selected for the study. Standard laparoscopic technique was performed in 20 patients and laparoscopic assisted appendectomy was performed in 20 patients. The average operating time was 25.4±15 minutes in laparoscopic assisted appendectomy while it was 46.20±10.90 minutes in standard laparoscopic appendectomy which was statistically significant. Mean hospital stay in group A was 2.70±0.70 and in group B it was 2.10±0.70 which was not statistically significant.Conclusions: The laparoscopic-assisted method of appendix removal can be performed as efficiently as laparoscopically. It is fast and easy to perform, and it is expected to decrease the overall cost of laparoscopic appendectomy.

scholarly journals Assessment of the intensity of engine oil contamination during operation

2021 ◽  
Vol 2131 (3) ◽  
pp. 032061
Author(s):  
V Zhukov ◽  
O Melnik ◽  
E Khmelevskaya
Keyword(s):  
Internal Combustion Engines ◽  
Operating Time ◽  
Operating Conditions ◽  
Engine Oil ◽  
Oil Contamination ◽  
Engine Oils ◽  
Average Operating ◽  
Average Operating Time ◽  
Dispersing Ability ◽  
Physical And Chemical

Abstract The acceleration of internal combustion engines leads to an increase in thermal and mechanical loads on the most critical parts. To ensure the required resource indicators in conditions of increased loads, it is necessary to use high-quality lubricants, the requirements for the operational properties of which are also steadily increasing. In order to ensure the necessary physical and chemical characteristics of engine oils, additives are introduced into their composition, but during operation the quality of engine oil decreases, the reasons for this are both the destruction of additives, and the accumulation of dirt particles in the oil and the ingress of fuel and coolant into the oil. The conducted studies are devoted to determining the intensity of engine oil contamination under operating conditions in the Wärtsilä 6L20 engine lubrication system and the effectiveness of the dispersing additives contained in the oil. Samples of Petro Canada and TARO oils brands were used as prototypes at the beginning of the operational period, at the time of average operating time and at the time of oil change. The dispersing ability of the oil was determined by the method of assessing the oil stain. According to the results of the research, it is concluded that when the properties of the oil change as a result of contamination, their dispersing ability remains satisfactory. This result can serve as a justification for extending the service life of engine oil, provided that its properties are monitored during operation.

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