Transluminal Replacement of Displaced Peritoneal Catheter Using a Special “Alpha-Replacer” Guidewire: Effectiveness and Limitations

2007 ◽  
Vol 27 (6) ◽  
pp. 702-706 ◽  
Author(s):  
Hiroyuki Terawaki ◽  
Masaaki Nakayama ◽  
Hirofumi Nakano ◽  
Toshio Hasegawa ◽  
Makoto Ogura ◽  
...  
Keyword(s):  
Success Rate ◽  
Surgical Intervention ◽  
Peritoneal Catheter ◽  
Noninvasive Treatment ◽  
Safe Treatment ◽  
Abdominal Organs ◽  
Primary Success

Background Transluminal replacement of a displaced peritoneal catheter (TRC) using a metal guidewire is a noninvasive treatment of catheter displacement with acute malfunction. The “alpha-replacer” is a special guidewire developed specifically for TRC. This wire is usually flexible but becomes harder if coiled in the hand. Application of this unique guidewire might improve the effectiveness of TRC. Methods TRC using an alpha-replacer was performed in 10 cases for urgent correction of peritoneal catheter displacement. All patients had received a double cuffed, straight-end swan-neck catheter. Results The primary success rate of TRC using the alpha-replacer was 90% (9 of 10 cases). No patients developed complications such as injury of the peritoneum or abdominal organs. Relapse of catheter displacement was observed in 2 cases (20%) within 1 week, requiring surgical intervention to prevent relapse. Conclusion TRC using the alpha-replacer as described herein offers effective and safe treatment of peritoneal catheter displacement.

scholarly journals Management of Gallbladder Empyema in a patient with Situs Inversus, Levocardia and Morbid Obesity: a Case Report.

2021 ◽  
Vol 1 (3) ◽  
pp. 155-161
Author(s):  
Dulcyane Ferreira de Oliveira ◽  
Denis Alves Pinho ◽  
Fernando Fernandes Rodrigues ◽  
Luiz Fabrício Moura Marques ◽  
Pedro Henrique Rosa Araújo ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Case Report ◽  
Situs Inversus ◽  
Surgical Intervention ◽  
Rare Event ◽  
Transposition Of Great Vessels ◽  
Unusual Condition ◽  
Abdominal Organs ◽  
Left Hypochondrium ◽  
Great Vessels

Situs Inversus with levocardia is an unusual condition, in which the main organs of the thorax and abdomen are located in a reverse or enantiomorphic position in relation to the usual topography. It is estimated a prevalence of 1:10000 people with some Situs Inversus condition, but Situs Inversus with Levocardia is reported in only 1:22000 cases. The presence of acute cholecystitis in patients is an extremely rare event,however, one of its possible complications, Gallbladder Empyema can develop, causing an increase in severity and the need for surgical intervention. Since the inversion of abdominal organs proper to Situs Inversus with levocardia is commonly associated with the transposition of great vessels, fatally, as described in the literature of Vesicle empyema and Situs Inversus, it only occurred in patients with dextrocardia, not yet being reported in patients with Levocardia. We report a case of a female patient with pain in the left hypochondrium with Situs Inversus Viscerum, Levocardia, Empyema of Biliary Vesicles and Morbid Obesity.

Death after liposuction: case report and review of the literature

2010 ◽  
Vol 50 (3) ◽  
pp. 161-163 ◽  
Author(s):  
Claudio Terranova ◽  
Daniela Sartore ◽  
Rossella Snenghi
Keyword(s):  
Cause Of Death ◽  
Medical Errors ◽  
Surgical Intervention ◽  
Methodological Approach ◽  
Review Of The Literature ◽  
Spontaneous Thrombosis ◽  
Abdominal Organs ◽  
Lethal Complications ◽  
Massive Necrosis ◽  
Clinical Records

We report the case of a 41-year-old woman who died after surgical intervention for liposuction. The case was studied by a methodological approach including examination of clinical records and documentation, analysis of anatomo-histopathological findings and evaluation of physicians' behaviour. Autopsy excluded the lethal complications most frequently associated with liposuction (pulmonary embolism, sepsis, necrotizing fasciitis, perforation of abdominal organs) and identified the cause of death as ‘massive necrosis of brain-stem and cerebellum, due to spontaneous thrombosis of the basilar and cerebellar district’. Analysis of the physicians' behaviour, together with a review of the literature, excluded medical errors or malpractice. The Court of Law ruled the death as a fatal unforeseeable complication of the operation. The medico-legal interest of the case lies in the singular anatomo-pathological cause of death, discussed in relation to the hypothesis of professional responsibility after surgical intervention for liposuction.

Percutaneous Transluminal Angioplasty of Crural Arteries

1992 ◽  
Vol 33 (2) ◽  
pp. 152-155 ◽  
Author(s):  
F. Flueckiger ◽  
J. Lammer ◽  
G. E. Klein ◽  
K. Hausegger ◽  
E. Pilger ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Stage ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Long Term Results ◽  
Safe Procedure ◽  
Peripheral Embolization ◽  
Primary Success ◽  
Percutaneous Transluminal ◽  
Crural Arteries

In 91 patients suffering from peripheral arterial occlusive disease (Fontaine stage IIb—IV) 125 percutaneous transluminal angioplasties (PTA) of crural arteries were performed. Eighty-six of the dilatations were done in combination with a recanalization procedure (PTA, laser angioplasty, fibrinolysis) of a femoropopliteal obstruction in order to improve outflow. PTA was performed with 5 F balloon catheters 2.5 to 4 mm in diameter in combination with steerable guide wires. A primary technical success was achieved in 41 of 42 (97.6%) vessels with a single stenosis, in 64 of 68 (94.1%) vessels with 2 or more stenoses, and 9 of 15 (60%) vessels with total occlusions (overall primary success rate 91.2%). Complications included spasm (n = 3), thrombosis (n = 2), peripheral embolization (n = 2), and dissection (n = 1). None of the complications required surgical intervention. After PTA, accumulative patency rate of 71% at 2 years and 64.2% at 3 years was achieved. These results demonstrated that PTA of crural arteries is a safe procedure with an excellent primary success rate and satisfying long-term results. Thus we believe that even arterial occlusive disease in the clinical stage Fontaine IIb should be accepted as an indication for crural PTA. Furthermore, crural PTA should be used to improve reduced peripheral outflow after femoropopliteal PTA.

scholarly journals The runaway kidney: a rare case of a parastomal hernia with partial kidney herniation

2020 ◽  
Vol 2020 (5) ◽  
Author(s):  
Jonathan B Livezey ◽  
Alexa M Bolock ◽  
Timothy J Farrell
Keyword(s):  
Parastomal Hernia ◽  
Surgical Intervention ◽  
Ureteral Stone ◽  
Kidney Injury ◽  
Computed Tomography Scan ◽  
Abdominal Organs ◽  
Surgical History ◽  
The Right ◽  
Proximal Ureteral Stone ◽  
Tomography Scan

Abstract Although parastomal hernias are a common complication of ostomy formation, herniation of intra-abdominal organs, aside from intestine, is infrequent. Furthermore, herniation of retroperitoneal organs, such as the kidney, is an extremely rare finding. We report the case of a 59-year-old male with a right ileostomy who presented with an acute kidney injury with suggestive urinary tract infection. A computed tomography scan revealed a left proximal ureteral stone with left hydronephrosis and a prominent right parastomal hernia with herniation of the mesenteric/retroperitoneal fat, portion of the right kidney, right proximal ureter and some bowel. The patient was taken to the operating room for a left cystourethroscopy with stent placement and made a full recovery. Due to the patient’s extensive surgical history, high risk of postoperative infection and lack of evidence demonstrating functional impairment of the right kidney, surgical intervention was not recommended at the present time.

scholarly journals Combined Phacoendoscopic Cyclophotocoagulation versus Combined Phacotrabeculectomy in the Management of Coexisting Cataract and Glaucoma: A Comparative Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Charles Sing Lok Lau ◽  
Jeffrey Chi Wang Chan ◽  
Sophia Fei So ◽  
Orlando Chia Chieh Chan ◽  
Kenneth Kai Wang Li
Keyword(s):  
Success Rate ◽  
Surgical Procedures ◽  
Surgical Intervention ◽  
Operation Time ◽  
Macula Edema ◽  
One Year ◽  
The One ◽  
Significant Cataract ◽  
Cystoid Macula Edema

Purpose. To compare the surgical outcome of combined phacoemulsification and endoscopic cyclophotocoagulation (phacoECP) versus combined phacoemulsification and mitomycin C-augmented trabeculectomy (phacoTbx) in patients with coexisting glaucoma and visually significant cataract. Methods. A retrospective review of 89 eyes of 89 patients who received phacoECP (N=49) and phacoTbx (N=40) was carried out at a tertiary eye center in Hong Kong. The minimum follow-up period was 6 months. Criterion of success was reduction of IOP at least 30% or absolute IOP of 15 mmHg or below without (complete success) or with (qualified success) antiglaucomatous medication. Results. PhacoTbx had more reduction of antiglaucomatous medication (4 vs 1, P<0.001). At postoperative year one, there was more IOP reduction for phacoTbx than phacoECP (8 mmHg vs 3 mmHg, P=0.012). The one-year complete success rate was also higher for phacoTbx (46.2% vs 8.2%, P<0.001), while qualified success was comparable between the 2 groups (74.4% vs 73.5%, P=0.925). Operation time was shorter for phacoECP (37 vs 73 minutes, P<0.001). The number of postoperative follow-up visits was less (6 vs 11.5, P<0.001) for phacoECP. Additional surgical procedures were more common in phacoTbx (55% vs 0%, P<0.001). There was no postoperative cystoid macula edema, hypotony, or endophthalmitis reported in both groups. Conclusions. PhacoECP is significantly less effective than phacoTbx in reduction of both IOP and number of antiglaucomatous medications for patients with medically uncontrolled glaucoma and cataract. Its complete success rate is also significantly lower than that of phacoTbx. With its comparable qualified success, shorter operation time, less number of postoperative visits, and secondary surgical intervention, phacoECP may still have a role in very selected cases.

Glaucoma in children with facial port wine stain

2018 ◽  
Vol 30 (1) ◽  
pp. 168-174 ◽  
Author(s):  
Nader Hussein Lotfy Bayoumi ◽  
Eman Nabil Elsayed
Keyword(s):  
Success Rate ◽  
Chart Review ◽  
Clinical Presentation ◽  
Surgical Intervention ◽  
Retrospective Chart Review ◽  
Port Wine Stain ◽  
Port Wine ◽  
Intravitreal Gas ◽  
Paediatric Ophthalmology

Purpose: To report on the clinical presentation and surgical treatment (procedure and outcome(s)) of glaucoma in children with facial port wine stain. Materials and methods: This is a retrospective chart review of children with facial port wine stain referred to Alexandria University paediatric ophthalmology practice from 2005 to 2016. The charts of 22 children (44 eyes) with facial port wine stain were reviewed. The data extracted included demographics, results of ophthalmic examination findings and treatment(s). The main outcome measures were the number of eyes stratified as glaucoma, glaucoma suspects and no glaucoma at the initial and final presentations. Results: The average age of presentation was 18.2 (±33.9) months. After a follow-up of over 16.1 (±24.8) months, there were 34%, 30% and 36% of the study eyes diagnosed as glaucoma, glaucoma suspects and no glaucoma, respectively with mean ± standard deviation of intraocular pressure of 20.6 ± 5.1, 13.6 ± 5.4 and 7.5 ± 1.7 mmHg. The majority (91%) of eyes presenting with glaucoma had clear corneas. In total, 11 eyes were operated upon for glaucoma. The recorded success rate was 91%. Two eyes developed a postoperative exudative choroidal detachment, of which one resolved spontaneously and the other was successfully managed by intravitreal gas injection. Conclusion: Glaucoma is a significant ocular hazard in children with facial port wine stain that may not be evident on the initial presentation. The presentation is usually with a clear cornea and surgical intervention is associated with a high success rate and a low rate of complications.

scholarly journals Catheter ablation of difficult accessory pathways guided by three-dimensional electroanatomic mapping: first experience

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
N Vecchio ◽  
A Bochoeyer ◽  
JC Lopez Diez ◽  
N Schnetzer ◽  
J Dorado ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Success Rate ◽  
Three Dimensional ◽  
Electroanatomic Mapping ◽  
Av Block ◽  
Accessory Pathways ◽  
Primary Success ◽  
Acute Success ◽  
One Year

Abstract Funding Acknowledgements Type of funding sources: None. Background Catheter ablation of paraseptal accessory pathways (PAP)  is associated with longer fluoroscopy and procedure times, more radiofrequency lesions, as well as a higher rate of recurrence and complications. In anteroseptal or midseptal PAP, recurrence and risk of AV block is even higher. Guided ablations with a three-dimensional  electroanatomic mapping system  (3D) report greater efficacy and safety. Purpose To assess the acute success rate and complications of PAP 3D catheter ablation. Report the recurrence rate at one year of follow-up. Methods Descriptive analysis that included patients with difficult PAP 3D catheter ablation between 2017 and 2019. Acute success was defined as the disappearance of ventricular pre-excitation 15 seconds after starting the application and the absence of retrograde conduction (Figure). In all cases, a one-year follow-up was performed with ECG and 24-hour Holter. Results 25 patients were included during the mentioned period. The average age was 23 years, 60% (15 p) were men and 56% (14 p) were symptomatic due to palpitations. 1 patient had previous heart disease (ebstein"s anomaly). 36% (9 p) had a previous procedure: 5 patients with previous failed radiofrequency ablation, 1 patient with failed anteroseptal cryoablation and 3 patients with suspended ablation due to risk of AV block. The most frequent location was the posteroseptal. (Table) The primary success rate was 92% (23 of 25 p). Ablation was unsuccessful in two patients, one with Ebstein"s disease and the other with a left posteroseptal PAP. None of the patients presented complications associated with the procedure. During the one-year follow-up, one patient was registered with asymptomatic recurrence (1 of 23; 4.35%: right posteroseptal location), demonstrated by manifest preexcitation on the control ECG. Conclusion In our first experience, catheter ablation of difficult accessory pathways guided by three-dimensional electroanatomic mapping showed a high primary success rate without associated complications. Recurrence during follow-up was similar to that reported in the literature. Accessory Pathway locationPatientsRight Posteroseptal11 (44%)Left Posteroseptal5 (20%)Anteroseptal5 (20%)Midseptal4 (16%)Abstract Figure

scholarly journals Regarding the issue of abdominal drainage

2012 ◽  
Vol 93 (4) ◽  
pp. 671-674
Author(s):  
E K Salakhov
Keyword(s):  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Primary Method ◽  
Optimal Method ◽  
Abdominal Drainage ◽  
Abdominal Organs ◽  
Frequency Of Use ◽  
Effective Drainage ◽  
The Impact ◽  
Outcome Of Surgery

The article discusses with main questions regarding drainage of the abdominal cavity, the types of drains and drainage devices. The outcome of surgery on the abdominal organs is largely dependent on effective drainage. There is still debate regarding the drainage techniques, shape and drainage material, indications and frequency of use. In deciding whether abdominal drainage is needed it is necesary to determine the most optimal method, its effectiveness and possible complications. Abdominal drainage is a necessary and important final stage of many operations, and sometimes the primary method of surgical intervention. At the same time, at the time of draining the abdominal cavity it is essential to know about the negative sides of the drainage and complications. There are certain difficulties in assessing the impact of abdominal drainage.

scholarly journals Individualized transscleral cyclophotocoagulation as the initial surgical intervention for medically uncontrolled glaucoma after blunt trauma

2020 ◽  
Author(s):  
Xu Hou ◽  
Jing Wu ◽  
Jian Zhou ◽  
Yu-Sheng Wang ◽  
Dan Hu
Keyword(s):  
Anterior Chamber ◽  
Success Rate ◽  
Blunt Trauma ◽  
Surgical Intervention ◽  
Ultrasound Biomicroscopy ◽  
Anterior Chamber Angle ◽  
Significant Difference ◽  
Transscleral Cyclophotocoagulation ◽  
The Mean ◽  
Chamber Angle

Abstract Background: To investigate the safety and feasibility of individualized transscleral cyclophotocoagulation (TSCPC) as the initial non-incisional surgical intervention for medically uncontrolled glaucoma after blunt trauma. Methods: The therapy records were reviewed of medically uncontrolled traumatic glaucoma after blunt trauma treated with TSCPC in a single hospital between January 2014 and December 2018. 31 patients (31 eyes) received individualized TSCPC after ultrasound biomicroscopy and gonioscopy examination to localize and quantify the injured quadrants of the anterior chamber angle. In addition to the number of IOP lowing drugs, visual acuity (VA), IOP, inflammation and hemorrhage in the anterior chamber were analyzed at 1 day, 3 weeks and 3 months after operation, respectively. Success was defined as the IOP was not more than 21 mmHg.Results: Compared with the data of pre-operation, constituent ratio of VA had no significant difference at 3 weeks (c2 = 0.56, P > 0.75). At 3 months the mean IOP was 22.2±5.0 mmHg, which was significantly lower than that of pre-operation (46.6±5.6 mmHg) (t=19.818, P<0.001). No IOP lowing drug was needed in 12 eyes, and more than 3 kinds of drugs were still needed in 5 eyes. The average number of medications decreased significantly (c2=93.496，P＜0.001). The complete success rate was 38.7% and the relative success rate (combined with no more than two kinds of drugs) was 83.9% at 3 months.Conclusions: Individualized TSCPC could be applied as an initial non-incisional surgical intervention to treat traumatic glaucoma refractory to the medicine therapy.

scholarly journals An Effective Way to Prevent Depressurization of Carboxyperitoneum and Extraperitoneal Insufflation During Simultaneous Laparoscopic Interventions

2020 ◽  
Vol 9 (1) ◽  
pp. 21-26
Author(s):  
M. K. Abdulzhalilov ◽  
A. M. Abdulzhalilov ◽  
M. R. Imanaliyev
Keyword(s):  
Carbon Dioxide ◽  
Postoperative Complications ◽  
Surgical Intervention ◽  
Subcutaneous Tissue ◽  
Abdominal Cavity ◽  
Abdominal Organs ◽  
Number Of Patients ◽  
Simultaneous Surgery ◽  
Reduce Carbon Dioxide ◽  
The Cost

ABSTRACT. Laparoscopic simultaneous surgery (LSS) in patients with multisystem abdominal organs lesion is accompanied by ports’ re-installation for subsequent surgical intervention. Preserved trocar wounds (PTWs) pass carbon dioxide from the abdominal cavity, increasing its consumption and causing depressurization of the carboxyperitoneum. The incidence of extraperitoneal insufflation during laparoscopy varies from 0.43 to 2% (I.V. Vartanova et al., 2016). The presence of many methods of sealing PTWs indicates their inefficiency.AIM OF STUDY. To develop an easy-to-use, more reliable and effective way of sealing PTWs.RESULTS. As a result, a comparative evaluation of known methods of sealing PTWs, we have developed an easy-to-use, more reliable and effective way of sealing PTWs «Method for sealing punctures of the abdominal wall after removing the trocar during a laparoscopic surgery» (patent RF for the invention № 2621121).DISCUSSION. This method was performed in 55 patients, in all cases it provided reliable PTWs tightness, allowed maintaining stable carboxyperitoneum during laparoscopic interventions, without increasing carbon dioxide consumption, which reduced the cost of LSS and prevented the development of both intraand postoperative complications. The uniqueness of this method is that PTW is sealed from the side of the abdominal cavity, preventing carbon dioxide from penetrating into either the preperitoneal or subcutaneous tissue.CONCLUSION. An increase in the number of patients with combined surgical pathology necessitates the use of the developed method for sealing punctures when moving trocars and neutralizing sub- and postoperative complications. In addition, this method allows to reduce carbon dioxide consumption.

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