scholarly journals Safety and Efficacy of Pressure-assisted Tissue-welding Tonsillectomy: A Preliminary Evaluation

2008 ◽  
Vol 87 (2) ◽  
pp. 100-112 ◽  
Author(s):  
Randall G. Michel ◽  
Bernard I. Weinstock ◽  
Kang Tsau
Keyword(s):  
Blood Loss ◽  
Postoperative Bleeding ◽  
Normal Diet ◽  
Intraoperative Blood Loss ◽  
Total Recovery ◽  
Safety And Efficacy ◽  
Tissue Welding ◽  
Welding Technology ◽  
The Mean ◽  
Clinic Visits

We conducted a retrospective study of the safety and efficacy of a new pressure-assisted tissue-welding technology (ENTceps; Starion Instruments Corp.; Sunnyvale, Calif.) for total tonsillectomy, either alone or with adenoidectomy. The use of this instrument was compared in two groups of patients categorized by age. The younger group was made up of 50 patients aged 2 to 12 years who had undergone total tonsillectomy and adenoidectomy (T&A), and the older group was made up of 50 patients aged 13 to 47 years who had undergone either T&A or isolated total tonsillectomy. The primary safety endpoint was the presence or absence of intra- or postoperative complications—particularly the amount of intraoperative blood loss and the incidence of delayed postoperative bleeding. In each group, the mean amount of intraoperative blood loss was no more than 30 ml, and only 2 of the 100 patients experienced postoperative hemorrhage. Among the efficacy parameters were the amount of operating and recovery time and the postoperative appearance of the tonsillar fossae. The mean operating time was 13.0 minutes in the younger group and 19.5 minutes in the older group, and the mean total recovery times were 120.0 and 130.4 minutes, respectively; all tonsillar fossae were well epithelialized by 2 weeks after surgery. Finally, surgical morbidity was determined on the basis of the amount of perioperative pain medication administered, the number of unscheduled patient telephone contacts and clinic visits, and the amount of time needed to return to a normal diet and activities. Nine patients in the younger group and 6 in the older group required no pain medications during recovery; overall, pain was not a significant issue for most patients. Sixteen patients made a total of 20 telephone calls and 8 clinic visits prior to their scheduled postoperative appointment; almost all of these encounters dealt with postoperative pain. Only 1 patient, who had previously undiagnosed von Willebrand disease, had not returned to a normal diet and activities by the end of 1 week. Based on our preliminary findings—and a comparison of our results with those of other studies published in the literature relative to the amount of intraoperative bleeding, the incidence of postoperative bleeding, and operating times—we conclude that pressure-assisted tissue-welding technology is safe and compares favorably with other tonsillectomy techniques. This method of electrocautery is straightforward and relatively easy to learn.

Phẫu thuật nội soi 3D cắt bán phần xa dạ dày trong điều trị ung thư dạ dày

2021 ◽  
Author(s):  
Hai Thanh Phan
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Operative Time ◽  
Distal Gastrectomy ◽  
Three Dimensional ◽  
Oncologic Outcome ◽  
Intraoperative Blood Loss ◽  
3D Laparoscopy ◽  
Distal Gastric Cancer ◽  
The Mean

TÓM TẮT Đặt vấn đề: Những nghiên cứu gần đây cho thấy phẫu thuật nội soi với kỹ thuật 3D (three - dimensional) đã mang lại nhiều thuận lợi trong điều trị ung thư dạ dày khi so sánh với màn hình 2D truyền thống. Vì vậy chúng tôi thực hiện nghiên cứu này với mục đích đánh giá tính an toàn, kết quả ngắn hạn và kết quả ung thư học của phẫu thuật nội soi 3D trong điều trị ung thư phần xa dạ dày. Phương pháp nghiên cứu: Thực hiện nghiên cứu tiến cứu trên 37 bệnh nhân cắt phần xa dạ dày kèm nạo vét hạch điều trị ung thư dạ dày bằng phẫu thuật nội soi kỹ thuật 3D tại Khoa Ngoại nhi - cấp cứu bụng, Bệnh viện Trung Ương Huế từ 03/2018 đến 09/2021. Kết quả: Phẫu thuật nội soi 3D được thực hiện ở tất cả 37 bệnh nhân, không có trường hợp nào chuyển mổ mở. Thời gian phẫu thuật trung bình là 69,86 ± 20,46 phút, lượng máu mất trong mổ trung bình là 171,22 ± 15,47 ml, số hạch vét được trung bình là 20,49 ± 4,11 hạch và thời gian nằm viện sau phẫu thuật trung bình là 10 ngày (6 - 26 ngày). Tỷ lệ biến chứng là 8,1 % với 1 trường hợp (2,7%) dò mỏm tá tràng, không có trường hợp nào tử vong sớm sau mổ. Tỉ lệ sống còn sau 1 năm là 87,27% và sau 3 năm là 83,31%. Kết luận: Áp dụng phẫu thuật nội soi 3D trong cắt phần xa dạ dày có thể thực hiện an toàn và khả thi. Giúp giảm đáng kể thời gian mổ, lượng máu mất trong mổ và đảm bảo được nguyên tắc an toàn về ung thư học. ABSTRACT EFFICACY USING THREE - DIMENSIONAL LAPAROSCOPY IN THE TREATMENT OF DISTAL GASTRIC CANCER Background: Recent studies have supported that three - dimensional (3D) laparoscopy has advantages in treating gastric cancer compared with conventional two - dimensional (2D) screens. This study investigated the safety, short - term efficacy, and oncological outcome of three - dimensional (3D) laparoscopic distal gastric cancer surgery. Materials and Methods: We prospectively analyzed the clinical data from 37 patients treated with 3D laparoscopic systemic lymphadenectomy for distal gastric cancer at the Hue Central Hospital from March 2018 to September 2021. The effects on operative time, intraoperative blood loss, the number of lymph nodes removed, postoperative recovery time, complications, and oncologic outcome were analyzed. Results: Three - dimensional (3D) laparoscopic distal gastrectomy was successfully carried out in 37 patients. The mean operative time was 69,86 ± 20,46 minutes, mean intraoperative blood loss was 171,22 ± 15,47 ml, the number of harvested lymph nodes was 20,49 ± 4,11, and the mean postoperative hospital stay was 10 (6 - 26 days). The incidence of postoperative complications was 8,1%, with 1 case of duodenal stump fistula. The one - year overall survival rate was 87,27%, and the three - year overall survival rate was 83,31%. Conclusions: 3D laparoscopy distal gastrectomy could be performed safely and feasibly. They reducethe operative time and intraoperative blood loss in distal gastrectomy with a good oncologic outcome. Keywords: Laparoscopic gastrectomy, D2 lymphadenectomy, 3D laparoscopy

scholarly journals A clinico-surgical outcome of vaginal hysterectomy with or without hydro dissection: a Quasi experimental study

2018 ◽  
Vol 7 (9) ◽  
pp. 3668
Author(s):  
Kirti M. Hurakadli ◽  
L. L. Pujari ◽  
Prashant G.
Keyword(s):  
Blood Loss ◽  
Vaginal Hysterectomy ◽  
Minimal Invasive Surgery ◽  
Minimal Invasive ◽  
Intraoperative Blood Loss ◽  
Duration Of Surgery ◽  
Quasi Experimental ◽  
Abdominal Route ◽  
The Mean ◽  
Lower Morbidity

Background: Vaginal hysterectomy -the signature operation of gynecologic profession, is a hallmark of gynecological extirpative hysterectomy surgery and surgical excellance1. In the era of minimal invasive surgery, Nondescent vaginal hysterectomy has evolved over the years and is opted over abdominal route. It is because of lower morbidity, less postoperative pain, more rapid   return to normal activities and lesser hospital stay associated with this route of surgery. Practice of hydrodissection with diluted adrenalin has been noticed by few surgeons.Methods: We did a retrospective analysis of 267 cases of vaginal hysterectomies in our hospital over a period of three years, regarding the benefit of hydro dissection in reducing the blood loss and time of surgery, so as to incorporate this technique on routine basis.Results: Of 267 cases, NDVH was done in 107 (40.1%) cases, and 160 (59.9%) patients underwent vaginal hysterectomy with PFR. Of 267 cases, 121 (45.3%) cases had hydro dissection. In 146 (54.7%) cases hydro dissection was not done. The mean blood loss was significantly reduced in cases with hydro dissection to a mean of 1.07 mops when compared to cases with no hydro dissection-mean of 1.71 mops. Duration of surgery was also significantly reduced to a mean of 39.9 minutes in cases with hydro dissection when compared to cases with no hydro dissection with a mean of 46.3 minutes. There was no significant change in duration of hospital stay.Conclusions: Hydro dissection with diluted adrenaline should be routinely practice by all vaginal surgeons to reduce the duration of surgery and intraoperative blood loss.

scholarly journals Microendoscope-Assisted Decompression Surgery With Resection of Bony Fragment for Treating a Separation of Lumbar Posterior Ring Apophysis in Young Athletes

2020 ◽  
pp. 219256822092929 ◽  
Author(s):  
Motohiro Okada ◽  
Munehito Yoshida ◽  
Akihito Minamide ◽  
Kazunori Nomura ◽  
Kazuhiro Maio ◽  
...  
Keyword(s):  
Blood Loss ◽  
Japanese Orthopaedic Association ◽  
Operating Time ◽  
Case Series ◽  
Decompression Surgery ◽  
Return To Sports ◽  
Intraoperative Blood Loss ◽  
Young Athletes ◽  
The Mean ◽  
Posterior Ring

Study Design: Case series. Objectives: To report the clinical outcomes of the decompression procedure using the microendoscopic discectomy system for the treatment of a separation of lumbar posterior ring apophysis in young active athletes. Methods: We retrospectively reviewed 17 cases that underwent the microendoscopic surgery to treat a symptomatic separated lumbar ring apophysis between 2001 and 2014 at our institute or our associated hospital. The cases consisted of 15 males and 2 females, with their ages ranging from 12 to 19 years. The surgeries were performed at total of 18 lumbar levels, including 15 L4/5 and 3 L5/S1 levels. All patients were young athletes. We evaluated the following: (1) the Japanese Orthopaedic Association (JOA) score for low back pain, (2) recovery rates using Hirabayashi’s method, (3) operating time, (4) intraoperative blood loss, (5) perioperative complications, (6) the status of comeback to sports, and (7) the period taken to return to sports. Results: The JOA score was improved after the surgery in all cases. Recovery rate was 92.0% ± 8.1%. The mean operating time per level was 89.2 ± 33.3 minutes. The mean intraoperative blood loss per level was 95.3 ± 93.1 mL. A pinhole size dural tear occurred in one case as a perioperative complication. All cases returned to sports. The mean period taken to return to sports was 10.9 ± 3.5 weeks. Conclusion: Microendoscopic decompression surgery is useful for treating a separation of lumbar posterior ring apophysis.

scholarly journals A novel electrosurgical divider: performance in a self-controlled tonsillectomy study

2021 ◽  
Author(s):  
Gerold Besser ◽  
Stefan Grasl ◽  
Elias L. Meyer ◽  
Julia Schnoell ◽  
Tina J. Bartosik ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Postoperative Bleeding ◽  
Neck Surgery ◽  
Controlled Clinical Trial ◽  
Intraoperative Blood Loss ◽  
Bleeding Events ◽  
Surgical Time ◽  
Secondary Bleeding ◽  
Temperature Controlled

Abstract Purpose Tonsillectomies are among the most common surgeries in otorhinolaryngology. A novel electrosurgical temperature-controlled instrument (device) promises rapid tonsillectomies and might reduce postoperative pain, but comparative studies to assess performance are warranted. Methods This randomized self-controlled clinical trial was conducted from October 2019 to October 2020 at the Department of Otorhinolaryngology, Head and Neck Surgery of the Medical University of Vienna. Forty-eight patients underwent a tonsillectomy with the device on one side and using cold-steel with localized bipolar cauterization on the other side (control). Main outcomes were the time for tonsil removal (per side) and the time to stop bleeding (per side). Secondary measurements were postoperative pain, assessed once on day 0 and five times on days 1, 3, 5, 7, and 10. Postoperative bleeding episodes and consequences were recorded. Results Device tonsillectomies were performed significantly faster than controls; the mean surgical time difference was 209 s (p < 0.001, 95% CI 129; 288). Intraoperative blood loss was significantly lower on the device side (all p < 0.05). Postoperative measurements of pain and bleeding were similar for both sides. Two return-to-theatre secondary bleeding events were recorded for the control side. Conclusion The novel electrosurgical temperature-controlled divider reduced the tonsillectomy surgical time and intraoperative blood loss, with no apparent negative effects on postoperative pain or bleeding, compared to a cold-steel tonsillectomy with localized bipolar cauterization. In time-restricted settings, the device could be beneficial, particularly after familiarization with device handling. Trial registration ClinicalTrials.gov Identifier: < Blinded for review > 

scholarly journals Conventional Dissection and Bipolar Electrocauterization Methods of Tonsillectomy: A Comparative Study

2022 ◽  
Vol 19 (1) ◽  
pp. 77-80
Author(s):  
Anshu Sharma ◽  
Shama Bhandari ◽  
Dhundi Raj Paudel
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Pain Intensity ◽  
Postoperative Blood Loss ◽  
Intraoperative Blood Loss ◽  
Advantages And Disadvantages ◽  
Post Operative Pain ◽  
Significant Difference ◽  
The Mean ◽  
Dissection Method

Introduction: Tonsillectomy is frequently performed surgical procedure. There are several different methods with varied advantages and disadvantages. In spite of the different techniques available there is no consensus and definite evidence for best method. The most commonly performed are conventional dissection and bipolar electrocauterization methods. Aims: The aim of the study was to compare time required for the completion of surgery, intraoperative and postoperative blood loss along with post operative pain between conventional dissection and bipolar electrocauterization methods. Methods: This comparative study was conducted from August 2019 to March 2021 in total of 30 patients planned for tonsillectomy in department of Otorhinolaryngology, Nepalgunj Medical College Teaching Hospital.In every patient right side tonsillectomy was done with conventional dissection method and left side tonsillectomy was done with bipolar electrocauterization method. Results: The mean age was 27.2±13.08 years. The mean duration of surgery was 16.53 ± 2.43 min and 11.10 ± 1.93 min in conventional dissection method and bipolar electrocauterization method respectively. The difference was statistically significant. Intraoperative blood loss was significantly lower in bipolar electrocauterization method with mean intraoperative blood loss of 19 ±4.62 ml in bipolar electrocauterization group and 81.83 ±36.54 ml in conventional dissection method. The pain intensity was statistically similar in both methods at all-time intervals post operatively. Conclusion: In tonsillectomy, bipolar electrocauterization method has advantage over conventional dissection method in regards to reduced surgical time and intra operative blood loss, without any significant difference in post-operative pain intensity and post-operative hemorrhage.

scholarly journals Laparoendoscopic Two-Site Myomectomy (LETS-M) Using Conventional Laparoscopic Instruments and The Glove-Port Technique

2021 ◽  
Author(s):  
Pei-Chi Wu ◽  
Bor-Ching Sheu ◽  
Kuan-Ju Huang ◽  
Su-Cheng Huang ◽  
Wen-Chun Chang
Keyword(s):  
Blood Loss ◽  
Operation Time ◽  
Intraoperative Blood Loss ◽  
Tertiary Referral Center ◽  
Experienced Surgeon ◽  
Minimally Invasive Surgical ◽  
Postoperative Hematoma ◽  
Significant Difference ◽  
The Mean ◽  
Glove Port

Abstract We aim to evaluate the surgical outcome of laparoendoscopic two-site myomectomy (LETS-M). The medical records of 204 women receiving LETS-M in a tertiary referral center, including 183 surgeries performed by the experienced surgeon and 21 surgeries performed by 3 well-supervised trainees were retrospectively reviewed. The age of the participants was 39.3±6.4 years. The mean diameter of the largest myoma was 8.5±2.2 cm. The mean weight of the myomas was 281.1±183.1 g. The operation time was 97.6±40.2 min, and the intraoperative blood loss was 99.3±115.2 mL. There were 3 (1%) cases of excessive blood loss (more than 500 mL) and 2 (1%) of postoperative hematoma. The only significant difference between the experienced surgeon and trainees was the operation time (92.3±32.2 min vs. 141.2±54 min, p<.001), while the myoma number, myoma diameter, myoma weight, and intraoperative blood loss were not significantly different. The operation time did not differ among different myoma locations. In multivariate analysis, virginity, myoma number, more than 2 large myomas, and myoma size were independent variables for longer operation times. No patient experienced any major complications. The result revealed that LETS-M is a minimally invasive surgical method that is safe, effective, and easy to learn for managing uterine myoma.

scholarly journals 3D-printed Prostheses Assisted by Osteotomy Guide Plates for Reconstruction Following Periacetabular Tumor Resection via Two Approaches

2021 ◽  
Author(s):  
Yong-jie Zhao ◽  
Jing-yu Zhang ◽  
Xiao-qiang Deng ◽  
Xin-chong Du ◽  
Hao Zhang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tumor Resection ◽  
Intraoperative Blood Loss ◽  
Musculoskeletal Tumor Society ◽  
Prosthetic Reconstruction ◽  
Operative Duration ◽  
Vas Score ◽  
Surgical Data ◽  
3D Printed ◽  
The Mean

Abstract Background: Prosthetic reconstruction after periacetabular tumor resection likely yield good function. However, complications with this technique are common. Therefore, alternative prosthetic design and surgical technique warrant study. Methods: Six patients were retrospectively reviewed with malignant periacetabular tumors who received reconstruction using 3D-printed prostheses assisted by osteotomy guide plates via two approaches between July 2017 and June 2020. The surgical data, including operative duration and intraoperative blood loss were recorded. Preoperative and postoperative pain at rest was examined using the visual analog scale (VAS). The postoperative functional outcomes were evaluated using the Musculoskeletal Tumor Society (MSTS) scoring system, and the postoperative complications were analyzed.Results: The mean follow-up was 19 months (range, 3-36 months). The mean intraoperative blood loss was 1416 ml (range, 600-2000 ml), and the mean operative duration was 333 min (range, 300-370 min). Satisfactory surgical margins were achieved in all patients. Six patients complained of severe pain preoperatively (VAS score, mean, 6; range, 4-8) and described significant alleviation of pain at 4 weeks postoperatively (VAS score, mean, 2; range, 0-5). At the 12 weeks after surgery, the mean MSTS score was 15.6 (range, 5-27). Local recurrence occurred in one patient at 3 months after surgery.Conclusions: The 3D-printed prosthesis represents a potential alternative for reconstruction after malignant periacetabular tumor resection. The design of the two approaches and the use of osteotomy guide plates can yield good functional results, as well as low rate of complications.Trial registration: This study has been granted an exemption from requiring ethics approval by the ethics committee of Tianjin Hospital.

scholarly journals Sutureless, bloodless, safe new circumcision technique

2017 ◽  
Vol 4 (8) ◽  
pp. 2530
Author(s):  
Wael Barakaat Ahmed Mohamed ◽  
Ahmed Eisa Ahmed
Keyword(s):  
Blood Loss ◽  
Prospective Observational Study ◽  
Harmonic Scalpel ◽  
Postoperative Bleeding ◽  
Suture Technique ◽  
University Hospital ◽  
Intraoperative Blood Loss ◽  
Minimal Complication ◽  
Male Patients ◽  
Surgery Department

Background: Several techniques of circumcision are available such as conventional surgical technique, the device (Gomco, Plastibell), mono and bipolar diathermy and sutureless methods such as fibrin glue. Our knowledge, the first report of using harmonic scalpel in circumcision was published by Peng et al, in the Asian journal of andrology but the study was done on dogs, this one of the little studies describe the use of the harmonic scalpel in male circumcision in humans. Aim was to describe the technique of the harmonic scalpel circumcision and report its outcomes in the term of safety and efficacy.Methods: This was a prospective observational study performed in the general surgery department at Sohag university hospital, Sohag, Egypt from 1st January 2015 to 31 December 2016.Results: 90 male patients were included in this study. Their age ranged between 3 and 18 years. The most common indication was religious circumcision 50%. No intraoperative blood loss or a postoperative bleeding. One case of wound infection and three cases of a postoperative edema respond to conservative treatment. No injury to the surrounding structure.Conclusions: The result of this study determines that the harmonic scalpel circumcision not associated with intraoperative blood loss or postoperative bleeding and a good postoperative cosmetic result, with a minimal complication. So, it is an appropriate alternative to the traditional scalp and suture technique.

scholarly journals Initial Canadian experience with robotic simple prostatectomy: Case series and literature review

2015 ◽  
Vol 9 (9-10) ◽  
pp. 626 ◽  
Author(s):  
Nathan Y. Hoy ◽  
Stephan Van Zyl ◽  
Blair A. St. Martin
Keyword(s):  
Blood Loss ◽  
Operating Time ◽  
Case Series ◽  
Transfusion Rate ◽  
Complication Rates ◽  
Intraoperative Blood Loss ◽  
Transfusion Requirements ◽  
Simple Prostatectomy ◽  
Significant Difference ◽  
The Mean

Introduction: Robotic-assisted simple prostatectomy (RASP) has been touted as an alternative to open simple prostatectomy (OSP) to treat large gland benign prostatic hyperplasia. Our study assesses our institution’s experience with RASP and reviews the literature.Methods: We performed a retrospective chart review from January 2011 to November 2013 of all patients undergoing RASP and OSP. Operative and 90-day outcomes, including operation time, intraoperative blood loss, length of hospital stay (LOS), transfusion requirements, and complication rates, were assessed.Results: Thirty-two patients were identified: 4 undergoing RASP and 28 undergoing OSP. There was no difference in mean age at surgery (69.3 vs. 75.2 years; p = 0.17), mean Charlson Comorbidity Index (2.5 vs. 3.5; p = 0.19), and mean prostate volume on TRUS (239 vs. 180 mL; p = 0.09) in the robotic and open groups, respectively. There was a significant difference in the mean length of operation, with RASP exceeding OSP (161 vs. 79 min; p = 0.008). The mean intraoperative blood loss was significantly higher in the open group (835.7 vs. 218.8 mL; p = 0.0001). Mean LOS was shorter in the RASP group (2.3 vs. 5.5 days; p = 0.0001). No significant differences were noted in the 90-day transfusion rate (p = 0.13), or overall complication rate at 0% with RASP vs. 57.1% with OSP (p = 0.10).Conclusions: Our data suggest RASP has a shorter LOS and lower intraoperative volume of blood loss, with the disadvantage of a longer operating time, compared to OSP. It is a feasible technique and deserves further investigation and consideration at Canadian centres performing robotic prostatectomies.

Tissue Welding Forceps Usage in Superficial Parotidectomy: A Clinical Assessment

2008 ◽  
Vol 74 (1) ◽  
pp. 51-55
Author(s):  
Randall G. Michel ◽  
Kang Tsau ◽  
Bernard I. Weinstock
Keyword(s):  
Blood Loss ◽  
Blood Vessel ◽  
Surgical Procedures ◽  
Clinical Assessment ◽  
Facial Weakness ◽  
Facial Paresis ◽  
Superficial Parotidectomy ◽  
Safety And Efficacy ◽  
Tissue Welding ◽  
Estimated Blood Loss

Tissue welding forceps (TWF) have been used effectively in a number of surgical procedures including blood vessel harvesting and tonsillectomy. Our objective was to assess the safety and efficacy of TWF usage in superficial parotidectomy. We performed a retrospective review of 25 patients between November 2002 and July 2006 who underwent superficial parotidectomy using TWF. The inpatient and outpatient records were reviewed for diagnosis, operative times, estimated blood loss, and postoperative facial paresis. Only one of the 25 patients (4%) who underwent superficial parotidectomy using TWF had transient postoperative facial weakness and no procedure had blood loss of greater than 150 cc. This initial evaluation suggests that use of TWF is safe in superficial parotidectomy and may help reduce the development of postoperative facial paresis.

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