scholarly journals Transperitoneal Subcostal Access for Urologic Laparoscopy: Experience of a Large Chinese Center

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Lei Zhang ◽  
Dong Fang ◽  
Xuesong Li ◽  
Lin Yao ◽  
Gengyan Xiong ◽  
...  
Keyword(s):  
Success Rate ◽  
Complication Rate ◽  
Costal Margin ◽  
Left Costal Margin ◽  
Midclavicular Line ◽  
The Right

Objective. To present our experience of using transperitoneal subcostal access, Palmer’s point (3 cm below the left costal margin in the midclavicular line), and its right corresponding site, in urologic laparoscopy. Methods. We used Palmer’s point and the right corresponding site for initial access in 302 urologic surgeries (62 cases with prior surgeries). The record of these cases was reviewed. Results. Success rate of initial access is 99.4%, and complication rate of puncturing is only 3.4% with no serious complication. In the cases with prior surgeries, there were only two cases with access complication on the right side (minor laceration of liver). For people with BMI more than 30 kg/m2 (12, 3.9%), the success rate was also 100 percent. Conclusions. Palmer’s point and the corresponding right location are feasible, effective, and safe for initial access in urologic laparoscopic surgeries. This entry technique should be used routinely in urologic laparoscopic surgeries.

CLINICAL CONFERENCE

PEDIATRICS ◽  
1958 ◽  
Vol 21 (4) ◽  
pp. 682-684
Author(s):  
William A. Silverman
Keyword(s):  
Cerebrospinal Fluid ◽  
Male Infant ◽  
Costal Margin ◽  
Routine Manner ◽  
Cytomegalic Inclusion Disease ◽  
Left Costal Margin ◽  
History Of ◽  
Funduscopic Examination ◽  
The Right ◽  
Uneventful Pregnancy

Dr. Silverman: I shall present the history of an infant who was admitted to our premature nursery on May 9, 1956. This Puerto Rican male infant was born during the thirty-sixth week of an uneventful pregnancy. An antenatal serologic test for syphilis was negative. Delivery was spontaneous. Birth weight was 1070 gm. Physical examination on admission to the nursery revealed the liver to be 1 cm below the right costal margin and the spleen was firm, 1 cm below the left costal margin. Nothing else worthy of comment was noted and the infant was managed in a routine manner. The immediate newborn period was entirely uneventful, specifically neither petechiae nor unusual degree of icterus were noted. The ocular fundi were examined, as a matter of routine, during the third and fifth weeks of life and they were described as normal. During the sixth week of life, when the infant weighed 2080 gm, it was suddenly noted that the abdomen was quite distended. Examination at this time disclosed marked hepatosplenomegaly, both organs were firm. Again neither icterus nor petechiae were noted. There appeared to be some difficulty in swallowing. Roentgenograms of the chest at this time were normal and of the skull revealed intracranial calcification which was displayed in a pattern that seemed to outline dilated lateral ventricles. Lumbar puncture yielded cerebrospinal fluid which was negative except for protein of 198 mg/100 ml. The urine and cerebrospinal fluid were examined for the cells characteristic of cytomegalic inclusion disease and none were found. Funduscopic examination at this time disclosed an area of chorioretinitis in the right eye. It was presumed at this time that the infant had toxoplasmosis.

scholarly journals Immuno-Electronmicroscopic Studies of Surface Antigens of Blood Elements

Blood ◽  
1969 ◽  
Vol 33 (4) ◽  
pp. 648-648
Author(s):  
Giorgio Tonietti ◽  
Giuseppe A. Andres ◽  
Lidia Accinni ◽  
Maria Purpura ◽  
Konrad C. Hsu
Keyword(s):  
Osmotic Fragility ◽  
Surface Antigens ◽  
Costal Margin ◽  
Red Cell ◽  
Left Costal Margin ◽  
History Of ◽  
Red Cell Count ◽  
The Right ◽  
Blood Elements ◽  
Antibody Coating

Abstract PART I Immuno-Electronmicroscopic Studies of Surface Antigens of Blood Elements. I. Autoantibody on Erythrocytes in Acute Hemolytic Anemia, by Tonietti et al. Page 179—Methods and Material: The top 6 lines on page 180 should be transposed to page 179 starting as the 3rd line under Source of Erythrocytes, and the section properly reading as follows: Source of Erythrocytes The patient (L.S.), a seven year old male, was studied at the Centro Nazionale Transfusione Sangue, C.R.I., in March 1967. His history of anemia dated back to May 1964. Physical examination showed a deeply jaundiced boy. On palpation of the abdomen, the liver was felt 2 cm. below the right costal margin and the spleen 3 cm. below the left costal margin. The superficial lymph nodes were minimally but definitely enlarged. Examination of the blood revealed a red cell count of 1.8 million, a total white count of 3,600 and a platelet count of 180,000 per cu. mm. Bilirubin was 4.9 mg./100 ml. and the osmotic fragility of the red blood cells was normal. The blood group was O CCDee. Etc. Antiglobulin Tests Direct agglutination tests performed with the patient’s erythrocytes and antiserum to human globulin and antiserum to human IgG were positive. Absorption of the antihuman globulin with pure IgG rendered the serum incapable of agglutinating the erythrocytes of the patient,6 thus showing that the antibody coating the erythrocytes was of the IgG class.

scholarly journals Laparoscopic adrenalectomy for large adrenal pheochromocytoma: a case report and discussion

2017 ◽  
Vol 4 (3) ◽  
pp. 1123
Author(s):  
Shwetank Prakash ◽  
Vaibhav Thakare ◽  
Anubhav Goel ◽  
Atiharsh Mohan
Keyword(s):  
Laparoscopic Adrenalectomy ◽  
Activity Level ◽  
Oral Feeding ◽  
Costal Margin ◽  
Anterior Axillary Line ◽  
Tumor Specimen ◽  
Adrenal Pheochromocytoma ◽  
Midclavicular Line ◽  
Lateral Decubitus ◽  
The Right

A 40-year-old patient who presented hypertension and hyperglyemia, on CECT showing 7x6.2x5 cm sized retroperitoneal mass lesion in left para-aortic region extending to suprarenal region, diagnosed as pheochromocytoma. Patients BP monitored hourly, started antihypertensive and insulin. After adequate control of blood pressure and blood sugar patient planned for laparoscopic adrenalectomy by lateral transperitoneal approach. GA and combined epidural spinal anesthesia given. The patient was placed in the right-lateral decubitus position with the left side up. The surgeon and assistant stand on the right side of the table. and 4 trocars were inserted. The first port is situated 2 cm below the costal margin at the midclavicular line. The lateral port is placed under direct visualization at the anterior axillary line. The remaining port was placed between the two port. Adrenal Vein bluntly dissected, the vein is carefully doubly ligated with hemlock clips and transacted between clips. The adrenal gland was retracted in a superolateral direction and the harmonic scalpel was used to continue dissection laterally. The specimen was retrieved via a small, 4 cm incision on lateral costal margin. Histopathology of tumor specimen confirmed diagnosis as pheochromocytoma. Laparoscopy offers a better anatomical exposure, shorter length of stay, a decrease in postoperative pain, faster return to preoperative activity level, improved cosmesis, and reduced blood loss, early to resumption of oral feeding.

scholarly journals Comparative outcome analysis of bleb needling of fibrotic blebs in the clinic versus the operating room: a retrospective case series

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vikram Ponnusamy ◽  
Van Nguyen ◽  
Jella A. An
Keyword(s):  
Success Rate ◽  
Operating Room ◽  
Complication Rate ◽  
Primary Outcome ◽  
Case Series ◽  
Outcome Analysis ◽  
Retrospective Case ◽  
Xen Gel Stent ◽  
Retrospective Case Series ◽  
Ab Interno

Abstract Background To compare 6 month outcomes of bleb needling performed in the clinic vs. the operating room (OR) in adult glaucoma patients with failed bleb. Methods A retrospective case series of 47 eyes from 41 glaucoma patients who received needling with mitomycin C (MMC) of scarred bleb from prior bleb-forming procedures in clinic (32 eyes) vs. the OR (15 eyes), including trabeculectomy (14 eyes), ExPress shunt (16 eyes), and ab-interno XEN gel stent (17 eyes). The primary outcome was needling success, defined as IOP ≤ 18 mmHg on 0 glaucoma medications without requiring an additional IOP lowering procedure within 6 months after needling. Results At 6 months, bleb needling success rate was similar when performed in the clinic vs. in the OR (28% vs. 20%, P = 0.54). Success rate was not statistically different in patients with prior trabeculectomy, ExPress shunt, and XEN gel stent (29% vs. 38% vs. 12%, P = 0.26). When comparing clinic vs. the OR needling procedures at 6 months, there was no difference in mean IOP (14.2 vs. 14.9 mmHg, P = 0.73), mean glaucoma medications (1.4 vs. 1.7, P = 0.69), additional IOP-lowering procedure rate (16% vs. 27%, P = 0.37), or complication rate (0% vs. 7%, P = 0.32). Conclusion Bleb needling with MMC in clinic may be a safe and effective way to revise failed bleb after trabeculectomy, ExPress shunt, and XEN gel stent procedures when compared to needling in the OR.

Radiology guided antegrade GASTROSTOMY deployment of mushroom (pull type) catheters with classical and modified methods in patients with oropharyngeal, laryngeal carcinoma, and anesthesia risk

2021 ◽  
pp. 20201130
Author(s):  
Süleyman Bakdık ◽  
Muharrem Keskin ◽  
Fatih Öncü ◽  
Osman Koç
Keyword(s):  
Success Rate ◽  
Complication Rate ◽  
Demographic Data ◽  
Major Complication ◽  
Good Alternative ◽  
Transoral Approach ◽  
Colon Perforation ◽  
Minor Bleeding ◽  
Technical Success Rate ◽  
Wide Diameter

Objective: The aim of study is to evaluate the results of deployment of Percutaneous Radiological Gastrostomy (PRG), which is a good alternative to Surgical Gastrostomy (SG), with transoral approach in cases where Percutaneous Endoscopic Gastrostomy (PEG) is contraindicated, difficult or unsuccessful, in patients with high risk of American Society of Anesthesiologists with four scores. In addition, we aimed to demonstrate the advantages of mushroom pull type catheters over push type gastrostomy catheters. Methods: This retrospective study included a total of 40 patients (18 females and 22 males) aged 21–92 years who underwent PRG with the antegrade transoral approach. PRG was performed by retrograde passing through the esophagus or snaring the guidewire from the stomach and taking out of the anterior abdominal wall. Patients’ demographic data, indications for PRG, procedural outcomes and complications were screened and recorded. Results: PRG was performed in 39 of 40 patients included in the study. Technical success rate was 97.5%. Procedure-dependent major complications such as death, aspiration, colon perforation, and deep abscess were not observed. Aspiration occurred in the first patient during the first feeding on the day after the procedure. Major complication rate was 2.5%. The total minor complication rate was 17.5% in 7 patients; parastomal leakage in 2 patients (5%), skin rash and infection in 3 (7.5%) patients, minor bleeding in 2 (5%) patients with oropharynx cancer, minimal bleeding from the gastrostomy catheter 1 week after the procedure in 1 (2.5%) patient. None of the cases had buried buffer. Tube functionality was preserved in all patients without any damage. Conclusion: Mushroom tip (pull type) gastrostomy catheter is a safe treatment method for patients requiring prolonged feeding because of wide diameter, endurance, long staying opening duration, less excessive dilatation and parastomal leakage, and no need for gastropexy. Lower cost and easier access are advantageous for mushroom tip pull type catheters compared to push type gastrostomy catheters in our country. The less invasive PRG is an alternative option in patients who are difficult to administer PEG, are at high anesthesia risk and cannot be sedated. Advances in knowledge: This article is valuable in terms of its contribution to develop an alternative radiological method for the deployment of gastrostomy tubes in medical difficult patients. This method has shortened the duration of the procedure and increased the success rate in patients with difficulty in transition from the stomach to the esophagus or with difficulty in the upper gastrointestinal tract. Mushroom tip catheters can be placed successfully by radiological methods.

scholarly journals A rare gigantic primary epithelial cyst of spleen in an adolescent boy

2017 ◽  
Vol 4 (6) ◽  
pp. 2084
Author(s):  
Kiran George N. ◽  
Gayatri Balachandran ◽  
L. N. Mohan
Keyword(s):  
Histopathological Examination ◽  
Abdominal Distension ◽  
Splenic Cyst ◽  
Epithelial Cyst ◽  
Present Specimen ◽  
Left Flank ◽  
Left Hypochondrium ◽  
Midaxillary Line ◽  
Midclavicular Line ◽  
The Right

Cysts arising from spleen are a rare clinical entity, with their discovery usually being incidental. We present a case of the largest reported primary epithelial cyst of spleen. In present study a 16-year-old child presented with abdominal distension for 1 month associated with abdominal pain for 2 weeks. On examination, a mass was felt in the epigastrium, left hypochondrium and left flank, extending across from the right midclavicular line to the left midaxillary line, and extended inferiorly till 6cm caudal to umbilicus. CT abdomen revealed a unilocular cyst of 17x20x24cm arising from the spleen with a volume of 3700ml. Splenectomy was performed; intra-operatively there was a huge splenic cyst measuring 30x30x30cm. Histopathological examination was diagnostic of Primary congenital epithelial cyst of the spleen. Till date the largest congenital splenic cyst documented in literature is 20 cm × 13 cm × 21 cm, as reported by Valentina et al, in 2014. Present specimen bests this previous case considerably.

scholarly journals Deteksi Zona pada KRSTI dengan Sensor Warna TCS3200

2019 ◽  
Vol 1 (2) ◽  
pp. 56
Author(s):  
Ahmad Imam Bardani ◽  
Nuryono Satya Widodo
Keyword(s):  
Success Rate ◽  
Blue Light ◽  
Direct Contact ◽  
Dance Movement ◽  
Light Blue ◽  
Color Sensor ◽  
Automation Control ◽  
Different Color ◽  
The Right

Robot seni tari Lanange Jagad untuk lomba Kontes Robot Seni Tari Indonesia (KRSTI) belum mampu membedakan zona warna pada arena yang menyebabkan robot melakukan gerakan tarian yang tidak sesuai dengan tempatnya. Oleh karena itu dibutuhkan kontrol otomatisasi menggunakan sensor warna TCS3200. TCS3200 akan memperoleh komposisi RGB yang tepat menggunakan perhitungan frekuensi. Hasil yang dicapai dalam penelitian ini adalah robot seni tari Lanange Jagad dapat membedakan zona dengan memanfaatkan warna merah, biru, biru muda, hijau, dan putih dengan tingkat keberhasilan 84%. Ketika robot mendeteksi warna yang sudah ditentukan pada setiap zona, robot akan secara otomatis melakukan gerakan tari yang sudah disesuaikan dengan zona tersebut. Saat robot masuk ke zona warna berbeda maka robot akan menghentikan gerakan tari pada zona sebelumnya dan memanggil gerakan tari selanjutnya. Namun masih terdapat banyak noise saat melakukan pengujian sehingga nilai RGB yang digunakan untuk memanggil gerakan tari berubah sehingga robot tidak merespons perintah yang dimasukkan pada program. Nilai RGB yang stabil di dapatkan pada kondisi kaki robot menapak atau bersentuhan langsung dengan zona warna, nilai tersebut yang digunakan untuk pemanggilan gerakan tari.The Lanange Jagad dance robot for the Indonesian Robot Dance Contest (KRSTI) has not been able to distinguish the color zone in the arena that causes the robot to perform dance moves that are not in accordance with its place. Therefore we need automation control using the TCS3200 color sensor. TCS3200 will obtain the right RGB composition using frequency calculations. The results achieved in this study are the Lanange Jagad dance robot can distinguish zones by utilizing red, blue, light blue, green, and white with a success rate of 84%. When the robot detects the colors that have been determined in each zone, the robot will automatically perform dance moves that have been adapted to the zone. When the robot enters a different color zone, the robot will stop the dance movement in the previous zone and call the next dance movement. However, there is still a lot of noise when testing so that the RGB value used to call dance moves changes so that the robot does not respond to commands entered in the program. A stable RGB value is obtained when the robot's foot steps or comes into direct contact with the color zone, the value that is used for calling dance moves.

Detecting Eyes and Lips Using Neural Networks and SURF Features

2012 ◽  
pp. 338-354 ◽  
Author(s):  
Artem A. Lenskiy ◽  
Jong-Soo Lee
Keyword(s):  
Neural Network ◽  
Neural Networks ◽  
Image Segmentation ◽  
Success Rate ◽  
Detection Rate ◽  
Facial Feature ◽  
Speed Up ◽  
Surf Features ◽  
Left And Right ◽  
The Right

In this chapter, the authors elaborate on the facial image segmentation and the detection of eyes and lips using two neural networks. The first neural network is applied to segment skin-colors and the second to detect facial features. As for input vectors, for the second network the authors apply speed-up robust features (SURF) that are not subject to scale and brightness variations. The authors carried out the detection of eyes and lips on two well-known facial feature databases, Caltech. and PICS. Caltech gave a success rate of 92.4% and 92.2% for left and right eyes and 85% for lips, whereas the PCIS database gave 96.9% and 95.3% for left and right eyes and 97.3% for lips. Using videos captured in real environment, among all videos, the authors achieved an average detection rate of 94.7% for the right eye and 95.5% for the left eye with a 86.9% rate for the lips

Transbrachial angiography: an effective and safe approach

VASA ◽  
2004 ◽  
Vol 33 (4) ◽  
pp. 231-234 ◽  
Author(s):  
Basche ◽  
Eger ◽  
Aschenbach
Keyword(s):  
Image Quality ◽  
Success Rate ◽  
Complication Rate ◽  
Low Risk ◽  
Retrospective Evaluation ◽  
Technical Success ◽  
Technical Success Rate ◽  
Transbrachial Approach ◽  
Safe Approach

Background: Description of the technique of the transbrachial catheter diagnostics, retrospective evaluation of the technical success rate and the complications. Patients and methods: In a period of 8 years the transbrachial approach was used in 2555 patients, 1734 men and 821 women with an average age of 62.9 years. The investigation was done with outpatients in approximately 90% of the cases. Usually, the preferred arm was not punctured. For the diagnostics F4 and F5-catheter sheaths and selective catheter and/or plain catheters were used. Results: 12 times (0.47%) the investigation did not succeed technically. The image quality of the vascular representations was diagnostically sufficient. The total complication rate amounted to 0.47%. The following complications appeared: four dissections in the site of puncture, one embolism into arteries at the forearm, three transitory ischemic attacks, four haematoma at the site of puncture. Conclusions: The transbrachial catheter diagnostics is a little invasive, efficient and low-risk method, which is practicable in out-patients.

Preoperative Computed Tomography-Guided Localization for Pulmonary Nodules with Glue and Dye

2020 ◽  
Vol 68 (06) ◽  
pp. 525-532
Author(s):  
Tian Jiang ◽  
Miao Lin ◽  
Mengnan Zhao ◽  
Cheng Zhan ◽  
Ming Li ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Methylene Blue ◽  
Success Rate ◽  
Complication Rate ◽  
Lung Resection ◽  
Surgical Margin ◽  
Pulmonary Nodules ◽  
Blue Dye ◽  
Methylene Blue Dye ◽  
Ct Guided

Abstract Background This study was aimed to describe a new localization technique developed using medical glue and methylene blue dye, and characterized the localization results and postoperative outcome to evaluate its safety and usefulness. Methods This retrospective study was conducted at our center from January 2016 to April 2018. Totally 346 consecutive patients with 383 nodules who underwent preoperative computed tomography (CT)-guided medical glue and methylene blue dye localization, followed by lung resection, were enrolled in this study. Results Mean nodule size was 7.7 ± 3.7 mm (range: 2–30 mm), with a mean depth from pleura or fissure of 9.4 ± 9.3 mm (range: 0–60 mm). The success rate of CT-guided localization for pulmonary nodules was 99.5% (381/383) of the nodules. Localization-related complications included mild pneumothorax in 16 (4.6%) patients, mild hemothorax in 7 (2.0%) patients, and hemoptysis in 1 (0.3%) patient. Pleural reaction occurred in 7 (2.0%) and pain in 25 (7.2%) patients. All 383 nodules were resected successfully, with conversion to thoracotomy only required in two patients for adhesion and calcification of lymph nodes. All patients recovered well postoperatively, with a short postoperative hospital stay (3.7 ± 2.0 days) and a low complication rate (2.6%, 9/346). Conclusion CT-guided medical glue and methylene blue dye localization prior to video-assisted thoracoscopic surgery (VATS) lung resection was a novel, safe, and technically feasible method, with a high-technical success rate and a low-complication rate. It allowed surgeons to easily locate and detect the nodules and estimate the surgical margin.

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