scholarly journals Economics and safety of continuous and interrupted suture hepaticojejunostomy: An audit of 556 surgeries

2021 ◽  
Vol 25 (4) ◽  
pp. 472-476
Author(s):  
Rajan Saxena ◽  
Nalini Kanta Ghosh ◽  
Saurabh Galodha
Keyword(s):  
Interrupted Suture

scholarly journals A Novel Suture Training System for Open Surgery Replicating Procedures Performed by Experts Using Augmented Reality

2021 ◽  
Vol 45 (5) ◽  
Author(s):  
Yuri Nagayo ◽  
Toki Saito ◽  
Hiroshi Oyama
Keyword(s):  
Augmented Reality ◽  
Motion Capture ◽  
Open Surgery ◽  
Three Dimensional ◽  
Training System ◽  
Surgical Skills ◽  
Surgical Instruments ◽  
Interrupted Suture ◽  
Education Environment ◽  
Surgical Field

AbstractThe surgical education environment has been changing significantly due to restricted work hours, limited resources, and increasing public concern for safety and quality, leading to the evolution of simulation-based training in surgery. Of the various simulators, low-fidelity simulators are widely used to practice surgical skills such as sutures because they are portable, inexpensive, and easy to use without requiring complicated settings. However, since low-fidelity simulators do not offer any teaching information, trainees do self-practice with them, referring to textbooks or videos, which are insufficient to learn open surgical procedures. This study aimed to develop a new suture training system for open surgery that provides trainees with the three-dimensional information of exemplary procedures performed by experts and allows them to observe and imitate the procedures during self-practice. The proposed system consists of a motion capture system of surgical instruments and a three-dimensional replication system of captured procedures on the surgical field. Motion capture of surgical instruments was achieved inexpensively by using cylindrical augmented reality (AR) markers, and replication of captured procedures was realized by visualizing them three-dimensionally at the same position and orientation as captured, using an AR device. For subcuticular interrupted suture, it was confirmed that the proposed system enabled users to observe experts’ procedures from any angle and imitate them by manipulating the actual surgical instruments during self-practice. We expect that this training system will contribute to developing a novel surgical training method that enables trainees to learn surgical skills by themselves in the absence of experts.

Short- and long-term outcomes of choledochojejunostomy during pancreaticoduodenectomy and total pancreatectomy: interrupted suture versus continuous suture

2018 ◽  
Vol 403 (8) ◽  
pp. 959-966
Author(s):  
Takaaki Tatsuguchi ◽  
Hidenori Takahashi ◽  
Hirofumi Akita ◽  
Shogo Kobayashi ◽  
Akira Tomokuni ◽  
...  
Keyword(s):  
Total Pancreatectomy ◽  
Continuous Suture ◽  
Long Term Outcomes ◽  
Interrupted Suture ◽  
Short And Long Term

scholarly journals Spontaneous Pregnancy in Postoperative Microperforated Hymen: A Case Report

2021 ◽  
Vol 17 (1) ◽  
pp. 79
Author(s):  
Pribakti Budinurdjaja ◽  
Ihya Ridlo Nizomy ◽  
Inas Tsurayya Fauziah Lahdimawan
Keyword(s):  
Case Report ◽  
Female Genital Tract ◽  
Reproductive Function ◽  
Vaginal Tissue ◽  
Small Opening ◽  
Interrupted Suture ◽  
Spontaneous Pregnancy ◽  
Patient Will ◽  
Term Baby ◽  
Vaginal Introitus

Abstract: Female genital tract anomalies have important effects on reproductive function, and usually recognized after puberty. The membrane canalization process end to various hymenal forms. Microperforate hymen appears as a partial obstruction depending on its  size. Most often, patient will present with menstrual disorders, dyspareunia, and infertility. The aim of this research was to report a case of spontaneous pregnancy in postoperative microperforated hymen in form of case report. A 27-year-old woman, P0A0, complained of pain during intercouse. Patient had been married for 1,5 years, had reguler menstrual cycles without any contraceptive method, but not conceived yet. Inspection showed an obstructed vaginal introitus with a small opening laterally at 3 o’clock, consistent witn microperforate hymen. During surgery, short vaginal introitus was observed and no vaginal canal was seen. A sound was inserted through a small opening of 1 mm in diameter laterally at 3 o'clock, followed by sufficient incision and excision of the distal vaginal tissue. Interrupted suture of the proximal and distal mucosa was performed. The vaginal portion as well as uterus appeared normal. Postoperative tissue healing was good. A spontaneous pregnancy occurred 56 days after the surgery and a healthy term baby was born by caesarean section. In the case of microperforated hymen, menstrual flow can be normal. The patient complained of dyspareunia or impaired sexual penetration leading to infertility, although the presence of a small opening may allow passage of sperm and spontaneous pregnancy may occur before the surgery. Surgery can reduce psychological stress and improve reproductive function, allowing pregnancy to occur. Keywords:Abstract: Female genital tract anomalies have important effects on reproductive function, and usually recognized after puberty. The membrane canalization process end to various hymenal forms. Microperforate hymen appears as a partial obstruction depending on its  size. Most often, patient will present with menstrual disorders, dyspareunia, and infertility. The aim of this research was to report a case of spontaneous pregnancy in postoperative microperforated hymen in form of case report. A 27-year-old woman, P0A0, complained of pain during intercouse. Patient had been married for 1,5 years, had reguler menstrual cycles without any contraceptive method, but not conceived yet. Inspection showed an obstructed vaginal introitus with a small opening laterally at 3 o’clock, consistent witn microperforate hymen. During surgery, short vaginal introitus was observed and no vaginal canal was seen. A sound was inserted through a small opening of 1 mm in diameter laterally at 3 o'clock, followed by sufficient incision and excision of the distal vaginal tissue. Interrupted suture of the proximal and distal mucosa was performed. The vaginal portion as well as uterus appeared normal. Postoperative tissue healing was good. A spontaneous pregnancy occurred 56 days after the surgery and a healthy term baby was born by caesarean section. In the case of microperforated hymen, menstrual flow can be normal. The patient complained of dyspareunia or impaired sexual penetration leading to infertility, although the presence of a small opening may allow passage of sperm and spontaneous pregnancy may occur before the surgery. Surgery can reduce psychological stress and improve reproductive function, allowing pregnancy to occur. Keywords: hymen, microperforate, infertility, spontaneous pregnancy

scholarly journals RISK FACTORS ASSOCIATED WITH HEPATIC ARTERY THROMBOSIS: ANALYSIS OF 1050 LIVER TRANSPLANTS

2020 ◽  
Vol 33 (4) ◽  
Author(s):  
Luis Eduardo Veras PINTO ◽  
Gustavo Rego COELHO ◽  
Madalena Maria Silva COUTINHO ◽  
Orlando Jorge Martins TORRES ◽  
Plinio Cunha LEAL ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatic Artery ◽  
Warm Ischemia ◽  
Warm Ischemia Time ◽  
Hepatic Artery Thrombosis ◽  
Continuous Suture ◽  
Ischemia Time ◽  
Interrupted Suture ◽  
Artery Thrombosis ◽  
Independent Risk Factors

ABSTRACT Background: Hepatic artery thrombosis is an important cause of graft loss and ischemic biliary complications. The risk factors have been related to technical aspects of arterial anastomosis and non-surgical ones. Aim: To evaluate the risk factors for the development of hepatic artery thrombosis. Methods: The sample consisted of 1050 cases of liver transplant. A retrospective and cross-sectional study was carried out, and the variables studied in both donor and recipient. Results: Univariate analysis indicated that the variables related to hepatic artery thrombosis are: MELD (p=0.04) and warm time ischemia (p=0.005). In the multivariate analysis MELD=14.5 and warm ischemia time =35 min were independent risk factors for hepatic artery thrombosis. In the prevalence ratio test for analysis of the anastomosis as a variable, it was observed that patients with continuous suture had an increase in thrombosis when compared to interrupted suture. Conclusions: Prolonged warm ischemia time, calculated MELD and recipient age were independent risk factors for hepatic artery thrombosis after liver transplantation in adults. Transplanted patients with continuous suture had an increase in thrombosis when compared to interrupted suture. Re-transplantation due to hepatic artery thrombosis was associated with higher recipient mortality.

scholarly journals Laparoscopic Davydov Procedure for Creation of Neovagina in MRKH Syndrome

2021 ◽  
Vol 5 (3) ◽  
pp. 809-813
Author(s):  
Ratih Krisna ◽  
Rizky Agustria
Keyword(s):  
Intraoperative Complications ◽  
Abdominal Cavity ◽  
Operating Time ◽  
Vaginal Wall ◽  
Primary Amenorrhea ◽  
Mrkh Syndrome ◽  
Gynecological Disorders ◽  
Interrupted Suture ◽  
Sexual Characteristics ◽  
Vaginal Canal

Introduction: The Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a condition in which there is an absence of the uterus and the upper part (2/3) of the vagina. Women with MRKH syndrome show normal development of secondary sexual characteristics and a normal 46, XX karyotype. MRKH syndrome is a common cause of primary amenorrhea. Ultrasonography examination confirms kidneys, presence of the ovaries, and absence of uterus. Treatment should include a multidisciplinary approach to create a functional vagina. One of the procedures is laparoscopic Davydov vaginoplasty. Aim: To report MRKH syndrome case treated with laparoscopic Davydov vaginoplasty. Method: Ms. A, 21 years old, P0A0, came to FER clinic Moh. Hoesin Hospital Palembang with complaint, never had menstruation, the patient admitted her breast, and her pubic had growth. She wants to get married in the next six months. From the US result, there was non visualized uterus, genital band (+), and both ovaries within normal limit ~ MRKH Syndrome. Karyotype Examination: 46, XX. Patient was diagnosed with primary amenorrhea caused by MRKH syndrome and was planned for neovagina (Davydov Procedure). Result: A woman 21-year-old, P0A0, was diagnosed with primary amenorrhea caused by MRKH syndrome. The Davydov procedure was done to create a neovagina. Intraoperative, after protrusion of the wood mold as a marker shown, an incision is made to the left and right side so that the mold penetrates the abdominal cavity, then the mold is pulled into the vaginal canal slowly. The anterior and posterior peritoneal layers are drawn into the vaginal canal. The anterior and posterior peritoneal layers were withdrawn with an ovum clamp and then interrupted suture. The anterior and posterior peritoneal layers were sutured in a circular method to form a vaginal cuff. The vaginal wall is sutured (interrupted) to hold mold fixed. Conclusion: MRKH syndrome is a disorder that occurs in females and mainly affects the reproductive system. This condition causes the vagina and the uterus to be underdeveloped or even absent at birth. Patients with diagnosed MRKH syndrome require interdisciplinary care. Davydov procedure is a laparoscopically-assisted technique, which has an advantage over traditional approaches. It has shorter operating time, lower intraoperative complications, shorter hospital stay, and no external scars. Postoperatively, sexual function is similar to women without gynecological disorders.

An Evaluation of Fascial Closure Techniques in Open Ventral Hernia Repair: Practice Patterns and Short-Term Outcomes

2019 ◽  
Vol 85 (11) ◽  
pp. 1213-1218
Author(s):  
Sarah S. Fox ◽  
Li-Ching Huang ◽  
W. Borden Hooks ◽  
John P. Fischer ◽  
William W. Hope
Keyword(s):  
Hernia Repair ◽  
Ventral Hernia ◽  
Recurrence Rate ◽  
Ventral Hernia Repair ◽  
Fascial Closure ◽  
Absorbable Suture ◽  
Short Term ◽  
Closure Technique ◽  
Interrupted Suture ◽  
Open Ventral Hernia Repair

The best method for fascial closure during hernia repair remains unknown. This study evaluates the impact of fascial closure techniques on short-term outcomes. All patients undergoing open ventral hernia repair were queried using the Americas Hernia Society Quality Collaborative database. Analysis was stratified by suture type (absorbable and permanent) and technique (figure-of-eight, running, and interrupted). Outcome measures included SSI, surgical site occurrence (SSO), SSO requiring intervention, recurrence rate, and quality of life. Descriptive statistics and logistic regression were used. The study included 6544 patients. Two-thirds of surgeons closed fascia during ventral hernia repair with absorbable suture and one-third with permanent suture. In the absorbable group, 17 per cent used figure-of-eight, 46 per cent running, and 4 per cent interrupted suture. In the permanent group, 13 per cent used figure-of-eight, 8 per cent running, and 11 per cent interrupted suture. There was no significant association between SSO and closure technique ( P = 0.2). However, SSO and suture type were significant ( P < 0.001) with the odds of SSO for closure with absorbable suture being 62 per cent higher than the odds of permanent. Fascial closure technique and suture type had no significant association ( P > 0.5) with SSI, SSO requiring intervention, hernia recurrence rate, or HerQLes or NIH PROMIS 3a scores at 30 days or 6 months. Fascial closure technique and suture material do not have a major impact on outcomes in ventral hernia repair. Despite a significantly higher rate of SSO for absorbable sutures than permanent, this did not increase the rate of interventions.

scholarly journals Diagnosis dan Tatalaksana Ruptur Diafragma pada Fase Akut dan Fase Laten

2020 ◽  
Vol 4 (1) ◽  
pp. 26
Author(s):  
Rizky Amaliah
Keyword(s):  
Ct Scan ◽  
Interrupted Suture

Latar belakang: Diafragma akan ruptur apabila terjadi trauma akselerasi-deselerasi dengan energi yang tinggi akibat dari peningkatan tekanan intraabdomen yang tiba-tiba meninggi. Diagnosis dan tatalaksana akan berbeda pada kasus ruptur diafragma yang terjadi pada fase akut dan fase laten. Kasus: Kami melaporkan dua kasus ruptur diafragma fase akut dan fase laten dengan dua pendekatan operasi yang berbeda. Kasus pertama adalah laki-laki, 59 tahun, dirujuk dengan riwayat kecelakaan lalu lintas 38 jam sebelum masuk rumah sakit. Pasien datang dengan gejala dispnoe dan foto polos toraks yang memperlihatkan adanya herniasi gaster ke rongga toraks kiri melalui defek pada diafragma. Pasien dilakukan CT scan torakoabdominal dan disimpulkan adanya ruptur diafragma kiri pada bagian posterior dengan herniasi gaster dan mesenterium. Pasien dilakukan laparotomi untuk memperbaiki diafragma dengan interrupted suture menggunakan benang nonabsorbable. Kasus kedua adalah wanita, 46 tahun, datang dengan keluhan dispepsia, mual dan muntah. Nyeri tidak hilang dengan tatalaksana dispepsia. Hasil foto polos toraks memperlihatkan elevasi hemidiafragma kiri. Dengan diagnosis eventratio, pasien direncanakan torakotomi posterolateral kiri. Intraoperatif, ditemukan ruptur diafragma kiri dengan herniasi dan perforasi gaster. Setelah ditelusuri pasien mempunyai riwayat kecelakaan lalu lintas 6 bulan sebelumnya. Pasien dilakukan pula laparotomi untuk melakukan adhesiolisis gaster dan paru yang telah melekat dan memperbaiki diafragma dengan interrupted suture menggunakan benang nonabsorbable serta melakukan jahit primer pada perforasi gaster. Simpulan: Tindakan operasi merupakan tindakan yang wajib dilakukan untuk memperbaiki diafragma. Pendekatan yang dipakai baik laparotomi atau torakotomi tergantung dari kelainan organ lainnya, akut atau laten suatu kasus, stabil atau tidak stabil kondisi pasien serta pengalaman operator.

scholarly journals Solitary fibrous tumor of the trachea: a case report

2019 ◽  
Vol 68 (12) ◽  
pp. 1523-1527
Author(s):  
Masahiro Kitada ◽  
Shunsuke Yasuda ◽  
Masahiro Abe ◽  
Nana Yoshida ◽  
Satoshi Okazaki ◽  
...  
Keyword(s):  
Solitary Fibrous Tumor ◽  
Suture Material ◽  
Median Sternotomy ◽  
Absorbable Suture ◽  
Sleeve Resection ◽  
Tracheal Tumor ◽  
Surgical Case ◽  
Interrupted Suture ◽  
Chief Complaints ◽  
Fibrous Tumor

AbstractWe experienced a surgical case of a rare primary tracheal tumor. A 77-year-old woman visited a local clinic with chief complaints of coughing, wheezing, and discomfort in the throat. Computed tomography revealed a mass measuring approximately 1.5 cm in the mediastinal trachea, extending from the membranous portion of the trachea to the esophagus. Bronchofibroscopy showed a flat, smooth-surfaced, round mass arising from the membranous portion. Surgery was performed because of the possibility of airway obstruction and suffocation. Sleeve resection of five tracheal rings was performed via median sternotomy and interrupted suture was performed using 3-0 absorbable suture material. The postoperative course was favorable and there has been no evidence of recurrence. The pathological diagnosis was solitary fibrous tumor. A primary solitary fibrous tumor of the trachea is extremely rare. Here, we report this disease with a literature review.

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