New Concept for a Thoracic Drainage System Using Magnetic Actuation

2019 ◽  
Vol 26 (6) ◽  
pp. 705-711
Author(s):  
Daisuke Taniguchi ◽  
Keitaro Matsumoto ◽  
Yoshihiro Kondo ◽  
Tomoshi Tsuchiya ◽  
Ikuo Yamamoto ◽  
...  

Objectives. Thoracic drainage is a common procedure to drain fluid, blood, or air from the pleural cavity. Some attempts to develop approaches to new thoracic drainage systems have been made; however, a simple tube is often currently used. The existing drain presupposes that it is placed correctly and that the tip does not require moving after insertion into the thoracic cavity. However, in some cases, the drain is not correctly placed and reinsertion of an additional drain is required, resulting in significant invasiveness to the patient. Therefore, a more effective drainage system is needed. This study aimed to develop and assess a new thoracic drain via a collaboration between medical and engineering personnel. Methods. We developed the concept of a controllable drain system using magnetic actuation. A dry laboratory trial and accompanying questionnaire assessment were performed by a group of thoracic and general surgeons. Objective mechanical measurements were obtained. Porcine experiments were also carried out. Results. In a dry laboratory trial, use of the controllable drain required significantly less time than that required by replacing the drain. The average satisfaction score of the new drainage system was 4.07 out of 5, indicating that most of the research participants were satisfied with the quality of the drain with a magnetic actuation. During the porcine experiment, the transfer of the tip of the drain was possible inside the thoracic cavity and abdominal cavity. Conclusion. This controllable thoracic drain could reduce the invasiveness for patients requiring thoracic or abdominal cavity drainage.

2019 ◽  
Vol 5 (2) ◽  
pp. 103-108
Author(s):  
S. Abdykerimov ◽  
D. Kochkunov

The paper analyzes the results of ventriculoperitoneal shunting operations in the treatment of congenital hydrocephalus in 55 patients aged 3 months up to 3 years. There were 37 boys and 18 girls who underwent various types of shunting operations after the failure of conservative treatment. Retrospectively, by the nature of the performed surgical interventions, the patients were divided into two groups: the first group included 25 children with congenital forms of cerebral dropsy, where ventriculoperitoneal shunting is performed with fixation of the distal shunt by separate sutures into the abdominal cavity; the second group included 30 children of similar ages, who underwent ventriculoperitoneal shunting without fixation by creating a tunnel and two, three holes fixing it. By studying the nature and causes of occlusive syndromes, the authors modified the method of shunting operations, which proved its rationality and effectiveness. In the scientific–grounded causes of occlusion of shunt catheters and methods for their correction. Dynamics with the use of neurosonography and MRI are recommended for detection and early treatment of disturbed shunt conditions. The most dangerous complication hyperdrainage detected during the operation was the formation of hydromas. To prevent the development of this pathology, it is enough to put the patient on the bed with the lowered head end. For the detection and subsequent treatment of conditions associated with dysfunction of the shunt required regular re not, with the spuriousness of this method is the computerized tomography scan or MRI. It is very important to have a conversation with the parents of the child who underwent shunting operations about the properties of the drainage system, the nature of possible complications and tactics of behaviour that allows you to timely provide the necessary assistance to patients.


2012 ◽  
Vol 452-453 ◽  
pp. 538-542 ◽  
Author(s):  
Abdelkader Djehiche ◽  
Rekia Amieur ◽  
Mustafa Gafsi

This paper presents an experimental study of a homogenous earth dam. The work is focused to the search of solutions of problems encountered in the earth dams after their construction. One of the major problems is the choice and design of systems of drainage. The effective drainage system to prevent harmful accumulations of excess water is one of the most important roles of dams. Efficient drainage systems can improve the safety of earth dams. The paper presented herein reports the results obtained from the experimental study. Empiric relations have been obtained which can be help in the control of the flow rate in the chimney drain of the earth dams on pervious foundation, which can increase safety earth dams


2016 ◽  
Vol 27 (03) ◽  
pp. 274-279
Author(s):  
Koji Fukumoto ◽  
Masaya Yamoto ◽  
Hiroshi Nouso ◽  
Masakatsu Kaneshiro ◽  
Mariko Koyama ◽  
...  

Purpose Patients with asplenia syndrome (AS) are likely to have upper gastrointestinal tract malformations such as hiatal hernia. This report discusses the treatment of such conditions. Methods Seventy-five patients with AS underwent initial palliation in our institution between 1997 and 2013. Of these, 10 patients had hiatal hernia. Of the patients with hiatal hernia, 6 had brachyesophagus and 7 had microgastria. Results Of the 10 patients with hiatal hernia, 9 underwent surgery in infancy (7 before Glenn operation, 2 after Glenn operation). Two underwent typical Toupet fundoplication, and the other 7 underwent atypical repair including reduction of the stomach. Two patients with atypical repair showed recurrence of hernia and required reoperation. Three patients required reoperation due to duodenal obstruction. Duodenal obstruction occurred due to preduodenal portal vein or abnormal vessels compressing the duodenum. Obstructive symptoms were not seen in any cases preoperatively. Conclusions In patients with hiatal hernia, typical fundoplication is often difficult because most have concomitant brachyesophagus, microgastria, and hypoplasia of the esophageal hiatus. However, we should at least reduce the stomach to the abdominal cavity as early as possible to increase thoracic cavity volume and allow good feeding. Increasing the volume of the thoracic cavity thus makes Glenn and Fontan circulations more stable. Duodenal obstruction secondary to vascular anomalies is also common, so the anatomy in the area near the duodenum should be evaluated pre- and intraoperatively.


2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Charles Bull ◽  
Philip H Pucher ◽  
James Gossage

Abstract   The routine use of post-operative drains in surgery continues to evolve as part of modern practices. Modern enhanced recovery protocols eschew using abdominal drains due to their impact on patient comfort, mobility, and recovery. This change in practice has not applied to thoracic drainage after oesophagectomy, where one or multiple drains are routinely placed. The aim of this study was to determine the evidence for, and how best to use drains during oesophageal surgery. Methods A systematic literature search was performed in Medline, Embase and Cochrane collaboration databases until Jan 25th, 2021. All studies which compared outcomes for different types or uses of thoracic drainage, or reported outcomes directly related to chest drains in oesophageal surgery were included. Studies were collated into domains based on variations in number, position, type, removal criteria, diagnostic use and complications of drains. Methodological quality was assessed by the Newcastle-Ottawa and Jadad Scores. Results 28 studies met the inclusion criteria. Four studies compared drain numbers, three showed similar outcomes and pain reduction using one. A single study showed that another, ‘anastomotic drain’ aided diagnosis and reduced leak mortality. Transhiatal drains had less pain and similar outcomes compared to intercostal drains. Drain fluid amylase aids leak diagnosis, however, accuracy requires drains to remain for 6 days. Removal of drains with daily volumes of less than 300 mL did not impact effusion rate. Complications can arise from drains with a 7% chance of drains migrating into the lumen of a leak and a risk of drain-site metastasis. Conclusion Drain use is a small facet of oesophageal surgery that can have a significant impact on outcomes. There is no evidence for non-drain use. A single transhiatal drain reduces pain without impacting on outcomes. Drains can have a role in diagnosing and managing anastomotic leaks, however, to be accurate drains have to stay in situ for longer. This extends patients discomfort and moves away from ERP trends and other surgical specialities.


Trauma ◽  
2019 ◽  
Vol 22 (2) ◽  
pp. 142-147
Author(s):  
Sani Rabiou ◽  
Hicham Harmouchi ◽  
Marouane Lakranbi ◽  
Sani Rachid ◽  
Yassine Ouadnouni ◽  
...  

Background and aims The management of thoracic wounds induced by sharp objects outside an extreme emergency remains controversial. The means vary from exploratory thoracotomy to simple monitoring. Between these two extremes, videothoracoscopy as a means of exploration plays an important role and helps to avoid unnecessary thoracotomies, thus making it possible to make early diagnosis of diaphragmatic lesions. The aim of this study was to report our experience in videothoracoscopic management of thoracic wounds by penetrating objects. Material and methods From January 2010 to December 2015, 58 patients with an average age 22.5 years with a thoracic stab wound with a stable hemodynamic condition underwent videothoracoscopy. Results Thoracoscopy revealed a diaphragmatic injury in 17 patients, cardiac or pericardial wounds in four and a haemorrhagic pulmonary injury in 1; all were treated at video-assisted mini-thoracotomy. In the other 36 patients, videothoracoscopic exploration did not demonstrate any intra-thoracic lesion and the procedure consisted of aspiration of a residual hemothorax with the installation of a good view-controlled thoracic drainage. Hospital stay was between 48 and 72 h. Conclusion Videothoracoscopy is a safe and effective way to explore the thoracic cavity in patients with chest wounds with suspected diaphragmatic lesions. It avoids thoracotomy especially in hemodynamically stable patients.


2015 ◽  
Vol 24 (3) ◽  
pp. 283-285
Author(s):  
Gildardo Cortés Julián ◽  
José M Mier ◽  
Marco A Iñiguez ◽  
Enrique Guzmán de Alba

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Anwar Ul-Haq ◽  
Faisal Al-Otaibi ◽  
Saud Alshanafey ◽  
Mohamed Diya Sabbagh ◽  
Essam Al Shail

The ventriculoperitoneal (VP) shunt is a common procedure in pediatric neurosurgery that carries a risk of complications at cranial and abdominal sites. We report on the case of a child with shunt infection and malfunction. The peritoneal catheter was tethered within the abdominal cavity, precluding its removal. Subsequently, laparoscopic exploration identified a knot at the distal end of the peritoneal catheter around the omentum. A new VP shunt was inserted after the infection was healed. This type of complication occurs rarely, so there are a limited number of case reports in the literature. This report is complemented by a literature review.


2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Xue-Bo Zhang ◽  
Shuai-Shuai Shen ◽  
Xiao-Jun Feng ◽  
Yang Ming ◽  
Jia-jia Liu

To study the effects of the three deformation instability modes of gas drainage borehole on gas drainage, the deformation instability mechanism of soft coal seams is analyzed, three deformation instability modes are proposed for soft coal seams, namely, complete holes, collapse holes, and plug holes, and a solid-fluid coupling model incorporating dynamic change of borehole suction pressure is established. The results of the study show the following. (1) When there is no borehole deformation (i.e., complete borehole), the suction pressure loss of drainage system in the borehole is very small, whose effect on gas drainage can be neglected. (2) In case of borehole collapse, the suction pressure loss is big at the collapse segment, and the total suction pressure loss of the drainage system in the borehole is bigger than that in the complete hole. However, it is smaller than the suction pressure of the drainage system and exerts limited effect on gas drainage. As the borehole collapse deteriorates, the effective drainage section of the borehole becomes smaller, while the suction pressure loss in the borehole increases continuously; thus, the gas drainage effect continuously worsens. (3) In case of plug hole, a continuous medium forms between the plug segment coal body and the surrounding coal seam, the plug segment drainage pressure turns into coal-bed gas pressure, and effective drainage length of the borehole shortens, seriously affecting the gas drainage effect. The study carries important theoretical guiding significance for improving gas drainage effect and effectively preventing gas disasters.


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