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

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.

Download Full-text

Coblation versus bipolar electrocautery tonsillectomy: a comparative study in children

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213284 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1482

Author(s):

G. Abhinav Kiran ◽

Y. Prabhakara Rao ◽

B. Shanthi Priyanka ◽

Supreety .

Keyword(s):

Blood Loss ◽

Surgical Techniques ◽

Operation Time ◽

Postoperative Recovery ◽

Intraoperative Blood Loss ◽

Medical Sciences ◽

Secondary Hemorrhage ◽

Pain Scores ◽

Significant Difference ◽

The Mean

Background: Tonsillectomy is a commonly done surgery by ENT surgeons all over the world. There are many surgical techniques to do this surgery. This study is aimed to compare intraoperative efficiency and postoperative recovery between coblation and bipolar electrocautery tonsillectomy.Methods: This prospective study was carried out on 60 patients that underwent tonsillectomy over 2 years from February 2019 to January 2021 in Mallareddy Institute of Medical Sciences, Suraram, Hyderabad. The patients were equally divided into two groups; coblation tonsillectomy (30 patients) and bipolar electrocautery tonsillectomy (30 patients). Their age ranged between 4-15 years. The operative time and intraoperative blood loss were recorded for each patient and compared. The parents were given a pain diary to record the level of pain each morning for ten days. Also, they were asked to report any complication like bleeding.Results: There was no statistically significant difference in the mean operation time and intra operative blood loss between the coblation group and bipolar electrocautery group There was a statistically significant difference in the daily pain scores between the two groups in which the coblation group was associated with lower mean pain score. 1 episode of secondary hemorrhage was recorded in bipolar electrocautery tonsillectomy.Conclusions: Bipolar electrocautery tonsillectomy offers the same operative speed, similar intraoperative blood loss, more postoperative pain scores when compared with coblation tonsillectomy.

Download Full-text

Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1403-7 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 3

Author(s):

Yuan-Wei Zhang ◽

Xin Xiao ◽

Wen-Cheng Gao ◽

Yan Xiao ◽

Su-Li Zhang ◽

...

Keyword(s):

3D Printing ◽

Blood Loss ◽

Three Dimensional ◽

Operation Time ◽

Varus Deformity ◽

Conventional Group ◽

Intraoperative Blood Loss ◽

Cubitus Varus ◽

Guide Plate ◽

Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

Download Full-text

Intraoperative Nice knots assistance for reduction in displaced comminuted clavicle fractures

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04348-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Fangning Hu ◽

Xi Liu ◽

Fanxiao Liu ◽

Honglei Jia ◽

Xiaolong Lv ◽

...

Keyword(s):

Blood Loss ◽

Rating Scale ◽

Clavicle Fracture ◽

Operation Time ◽

Clinical Results ◽

Intraoperative Blood Loss ◽

Traditional Group ◽

Significant Difference ◽

Clavicle Fractures ◽

Displaced Clavicle Fracture

Abstract Purpose The Nice knots have been widely used in orthopedic surgeries to fix torn soft tissue and fracture in recent years. The study aims to investigate the clinical efficacy and prognosis of intraoperative and postoperative Nice Knots-assisted reduction in the treatment of displaced comminuted clavicle fracture. Methods From Jan 2014 to Dec 2019, 75 patients diagnosed with unilateral closed displaced comminuted clavicle fracture were treated with open reduction and internal fixation (ORIF) in this study. Nice knot group (the NK group) included 38 patients and the other 37 patients were in the traditional group (the TK group). The time of operation and the amount of bleeding during operation were recorded. Post-operative clinical outcomes and radiographic results were recorded and compared between these two groups. The Visual Analogue Scale (VAS), Neer score, Rating Scale of the American Shoulder and Elbow Surgeons, Constant-Murley score and complications such as infection, nonunion, implant loosening, fragment displacement and hardware pain were observed in the two groups. Results In the comparison between the two groups, there was no significant difference in age, sex, the cause of displaced clavicle fracture, and other basic information between the two groups. The operation time, intraoperative fluoroscopy time, and intraoperative blood loss were significantly reduced in the NK group (P < 0.01). There were 2 cases of plate fracture in the TK group. The follow-up results showed that there was no significant difference in VAS, Neer score, ASES, and Constant-Murley scores between the two groups. Conclusion The use of Nice knot, in comminuted and displaced clavicle fractures can reduce intraoperative blood loss, shorten operation time, facilitate intraoperative reduction, and achieve satisfactory postoperative clinical results. This study demonstrates that Nice knot is a simple, safe, practical and effective auxiliary reduction method.

Download Full-text

A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/645 ◽

2021 ◽

Vol 8 (41) ◽

pp. 3559-3566

Author(s):

Abdul Salam R. T. ◽

Shahul Hameed A. ◽

Meera Rajan

Keyword(s):

Blood Loss ◽

Comparative Study ◽

Tertiary Care ◽

Operation Time ◽

Care Hospital ◽

Adenoid Tissue ◽

Significant Difference ◽

Tube Function ◽

Prospective Comparative Study ◽

The Mean

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

Download Full-text

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

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v19i1.40429 ◽

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.

Download Full-text

Intraoperative Nice knots assistance for reduction in displaced comminuted clavicle fractures

10.21203/rs.3.rs-198656/v1 ◽

2021 ◽

Author(s):

Fangning Hu ◽

Xi Liu ◽

Fanxiao Liu ◽

Honglei Jia ◽

Fengrui Wang ◽

...

Keyword(s):

Blood Loss ◽

Clavicle Fracture ◽

Operation Time ◽

Clinical Results ◽

Intraoperative Blood Loss ◽

Traditional Group ◽

Shoulder Range Of Motion ◽

Significant Difference ◽

Clavicle Fractures ◽

Displaced Clavicle Fracture

Abstract Purpose: The Nice knots have been widely used in orthopedic surgeries to fix torn soft tissue and fracture in recent years. The study aims to investigate the clinical efficacy and prognosis of intraoperative and postoperative Nice Knots-assisted reduction in the treatment of displaced comminuted clavicle fracture.Methods: From Jan 2014 to Dec 2019, 75 patients diagnosed with unilateral closed displaced comminuted clavicle fracture were treated with open reduction and internal fixation (ORIF) in this study. Nice knot group (the NK group) included 38 patients and the other 37 patients were in the traditional group (the TK group). The time of operation and the amount of bleeding during operation were recorded. Post-operative clinical outcomes and radiographic results were recorded and compared between these two groups. The Visual Analogue Scale (VAS), shoulder range of motion (ROM), Constant-Murley score and complications such as infection, nonunion, implant loosening, fragment displacement and hardware pain were observed in the two groups. Results: In the comparison between the two groups, there was no significant difference in age, sex, the cause of displaced clavicle fracture, and other basic information between the two groups. The operation time, intraoperative fluoroscopy time, and intraoperative blood loss were significantly reduced in the NK group (P < 0.01). There were 2 cases of plate fracture in the TK group. The follow-up results showed that there was no significant difference in VAS, ROM, and Constant-Murley scores between the two groups.Conclusion: The use of Nice knot, in comminuted and displaced clavicle fractures can reduce intraoperative blood loss, shorten operation time, facilitate intraoperative reduction, and achieve satisfactory postoperative clinical results. This study demonstrates that Nice knot is a simple, safe, practical and effective auxiliary reduction method.

Download Full-text

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

Canadian Urological Association Journal ◽

10.5489/cuaj.2750 ◽

2015 ◽

Vol 9 (9-10) ◽

pp. 626 ◽

Cited By ~ 12

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.

Download Full-text

Minimally invasive subtalar arthrodesis for traumatic subtalar arthritis

Journal of International Medical Research ◽

10.1177/0300060519847814 ◽

2019 ◽

Vol 47 (12) ◽

pp. 6129-6138 ◽

Cited By ~ 1

Author(s):

Lei Sun ◽

Zhigang Kong ◽

Ming Xu

Keyword(s):

Blood Loss ◽

Minimally Invasive ◽

Bone Graft ◽

Iliac Crest ◽

Operation Time ◽

Iliac Crest Bone Graft ◽

Intraoperative Blood Loss ◽

Subtalar Arthrodesis ◽

Subtalar Arthritis ◽

The Mean

Objective This study was performed to introduce a new method of minimally invasive subtalar arthrodesis (MISA) and assess its clinical effects on traumatic subtalar arthritis (TSA). Methods Fifteen patients (8 male and 7 female; age range, 36–56 years; mean age, 48.67 years) with TSA who underwent MISA were included. All patients were treated using a series instrument. The intraoperative and postoperative indexes were recorded. Results Among all patients, the mean operation time was 59.67 ± 16.31 minutes and the mean intraoperative blood loss was 43.33 ± 52.87 mL. Four patients underwent iliac crest bone graft surgery, and one patient developed a complication involving fat liquefaction of the iliac crest wound. The mean bony fusion time among all patients was 3.5 months. According to the American Orthopaedic Foot and Ankle Society standard, an excellent outcome was obtained in eight patients and a good outcome was obtained in seven patients. The operation time and intraoperative blood loss were significantly different between patients who did and did not undergo iliac crest bone graft surgery. Conclusion MISA is a simple and effective method for the treatment of TSA.

Download Full-text

Reduced Postoperative Pain after Inguinal Hernia Repair with Absorbable String in Children

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.618.401 ◽

2014 ◽

Vol 618 ◽

pp. 401-404

Author(s):

Chuan Zhang ◽

Chun Yu Dong ◽

Xue Song Zhao ◽

Ji Xue Zhao ◽

Dan Dang ◽

...

Keyword(s):

Inguinal Hernia ◽

Postoperative Pain ◽

Blood Loss ◽

Operation Time ◽

Postoperative Hospital Stay ◽

High Ligation ◽

Absorbable Suture ◽

Intraoperative Blood Loss ◽

Hernia Sac ◽

The Mean

Object: To investigate effects of the high ligation of hernia sac with absorbable string for children with indirect inguinal hernia. Method: A retrospective analysis of 92 patients with inguinal hernia who underwent the high ligation of hernia sac was conducted in the present study, in which 20 cases underwent the high ligation of hernia sac with absorbable string while 72 cases treated with the high ligation of hernia sac with non-absorbable suture. The mean operation time, mean intraoperative blood loss and average postoperative hospital stay and postoperative pain rating were analyzed. Results: Though no statistical difference existed in the mean operation time, mean intraoperative blood loss, average postoperative hospital stay between the two groups (P>0.05). However, the postoperative pain in the high ligation of hernia sac with absorbable string group was significantly lower than that of the non-absorbable group. Conclusion: Compared with that of the high ligation of hernia sac with non-absorbable string, there is lower grade postoperative pain in the high ligation with absorbable suture.

Download Full-text

Kirschner Wire Temporary Intramedullary Fixation Combined with a Locking Anatomical Plate versus a Reconstruction Plate in the Treatment of Comminuted Clavicular Fractures: A Retrospective Study

BioMed Research International ◽

10.1155/2018/5017162 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6

Author(s):

Jianxin Xie ◽

Danfeng Xu ◽

Xiaofei Zheng ◽

Mingdi Zhou ◽

Wei Ouyang ◽

...

Keyword(s):

Blood Loss ◽

Fracture Healing ◽

Complication Rate ◽

Kirschner Wire ◽

Operation Time ◽

Intramedullary Fixation ◽

Plate Versus ◽

Intraoperative Blood Loss ◽

Reconstruction Plate ◽

Significant Difference

We investigate the clinical efficacy of Kirschner wire temporary intramedullary fixation combined with a locking anatomical plate for the treatment of comminuted clavicular fractures. We retrospectively studied 112 patients [80 (71%) men] treated between February 2007 and February 2014. The patients were allocated to treatment with Kirschner wire temporary intramedullary fixation combined with a locking anatomical plate [minimally invasive group (GM)] or a reconstruction plate [traditional group (GT)]. The 112 patients were followed up for 12–48 months (mean, 14 months). The operation time was significantly shorter in GM than in GT. Intraoperative blood loss was significantly less in GM than in GT. The total incision length was significantly shorter and the visual analog scale pain score 24 h after surgery was significantly lower in GM than in GT. Fracture healing time was significantly shorter and the complication rate was significantly lower in GM than in GT. No significant difference in shoulder function score was observed between groups. We recommend Kirschner wire temporary intramedullary fixation combined with a locking anatomical plate as the treatment of choice for comminuted clavicular fractures because of the shorter operation time, lesser intraoperative blood loss, easier reduction of the operation, quicker fracture healing, and lower postoperative complication rate.

Download Full-text