scholarly journals Relevance of a simulation model to microsurgery for military surgical residents

2021 ◽  
Author(s):  
Ammar GHABI ◽  
Alexandre SABATE FERRIS ◽  
Georges PFISTER ◽  
Marie Pauline CHAPON ◽  
Josette Legagneux ◽  
...  
Keyword(s):  
Simulation Model ◽  
Operating Time ◽  
Surgery Simulation ◽  
Self Assessment ◽  
Surgical Residents ◽  
Orthopedic Surgeons ◽  
Average Operating ◽  
Average Operating Time ◽  
Assessment Questionnaire

Abstract IntroductionMicrosurgical training is an asset for military orthopedic surgeons who frequently treat hand or nerve injuries in external operations. The objective of this study was to evaluate a microvascular surgery simulation model intended to prepare residents prior to their enrolment in conventional degree training.Materials and MethodsAn experimental study was conducted to evaluate technical progress and satisfaction of military surgical residents using a model based on Japanese noodles with four tests of increasing difficulty. Objective endpoints included: instrument handling, distribution and quality of stitches, duration of anastomoses and responses to the Structured Assesment of MicrosurgerySkill (SAMS) self-assessment questionnaire were also analyzed.ResultsNine residents from different specialties participated in the study. The quality of their anastomoses and their average satisfaction were significantly increased between the first and the last session: respectively 7.2 / 15 versus 10.7 / 15 (p < 0.05) and 37.5 / 70 versus 47.5 / 70 (p < 0.05). Conversely, the average operating time decreased significantly over the sessions (92 min versus 52 min, p < 0.001).ConclusionsThis simulation model seems to constitute a satisfactory initiation to microsurgery which could limit the use of the animal model. It could also be included in the continuing education of military surgeons who perform microsurgery only occasionally in external operations.

Minilaparotomy Cholecystectomy as a Day Surgery Procedure: A Prospective Clinical Pilot Study

2007 ◽  
Vol 96 (3) ◽  
pp. 206-208 ◽  
Author(s):  
J. Harju ◽  
M. Pääkkönen ◽  
M. Eskelinen
Keyword(s):  
Randomised Trial ◽  
Operating Time ◽  
Day Surgery ◽  
Prospective Randomised Trial ◽  
Wound Pain ◽  
Average Operating ◽  
Average Operating Time ◽  
Study Support ◽  
The Mean

Background and Aims: In some studies minilaparotomy cholecystectomy (MC) has been shown to be as good as laparoscopic cholecystectomy (LC) in the surgical treatment of cholecystolithiasis. To our knowledge, the MC operation is rarely considered as a day surgery procedure. Patients and Methods: Thirty elective symptomatic non-complicated patients were included in the study during the end of the year 2004 to June 2005. The mean age of patients was 52 years (range 27–68), the mean body mass index 29 kg/m2 (range 19–41). Gallstones were confirmed with ultrasound and the pre-operative liver laboratory tests were normal in all patients. A five (+/-2) centimetre-long incision was used avoiding to split the rectus abdominis muscle. All patients were re-evaluated four weeks postoperatively with the follow-up letter. Results: The average operating time was 51 minutes (range 30–105 minutes). Day surgery was possible in 25 cases (83%). Five patients (17%) stayed over night at the hospital. There were four (13%) conversions to conventional cholecystectomy. The average postoperative sick leave was 16 days (range 14–30). Two patients returned to hospital. One patient had wound pain, but no complication was found, and the patient was not admitted. One patient had a wound infection and spent 6 days in the hospital. Twenty-nine (97%) patients were satisfied with the operation and were ready to recommend it for other patients. Conclusions: The results of this study support the suitability of MC as a day surgery procedure, but a prospective randomised trial is needed to evaluate the relative advantages of MC and LC.

scholarly journals Video assisted resections. Increasing access to minimally invasive liver surgery?

2015 ◽  
Vol 42 (5) ◽  
pp. 318-324 ◽  
Author(s):  
Fabricio Ferreira Coelho ◽  
Marcos Vinícius Perini ◽  
Jaime Arthur Pirola Kruger ◽  
Renato Micelli Lupinacci ◽  
Fábio Ferrari Makdissi ◽  
...  
Keyword(s):  
Operating Time ◽  
Perioperative Outcomes ◽  
Liver Lesions ◽  
Minimally Invasive Liver Surgery ◽  
Video Assisted ◽  
Average Operating ◽  
Average Operating Time ◽  
Average Size ◽  
Anesthesia Time ◽  
Prospective Database

Objective: To evaluate perioperative outcomes, safety and feasibility of video-assisted resection for primary and secondary liver lesions. Methods : From a prospective database, we analyzed the perioperative results (up to 90 days) of 25 consecutive patients undergoing video-assisted resections in the period between June 2007 and June 2013. Results : The mean age was 53.4 years (23-73) and 16 (64%) patients were female. Of the total, 84% were suffering from malignant diseases. We performed 33 resections (1 to 4 nodules per patient). The procedures performed were non-anatomical resections (n = 26), segmentectomy (n = 1), 2/3 bisegmentectomy (n = 1), 6/7 bisegmentectomy (n = 1), left hepatectomy (n = 2) and right hepatectomy (n = 2). The procedures contemplated postero-superior segments in 66.7%, requiring multiple or larger resections. The average operating time was 226 minutes (80-420), and anesthesia time, 360 minutes (200-630). The average size of resected nodes was 3.2 cm (0.8 to 10) and the surgical margins were free in all the analyzed specimens. Eight percent of patients needed blood transfusion and no case was converted to open surgery. The length of stay was 6.5 days (3-16). Postoperative complications occurred in 20% of patients, with no perioperative mortality. Conclusion : The video-assisted liver resection is feasible and safe and should be part of the liver surgeon armamentarium for resection of primary and secondary liver lesions.

Evaluation of the microbiological safety and quality of Vietnamese Pangasius hypophthalmus during processing by a microbial assessment scheme in combination with a self-assessment questionnaire

2014 ◽  
Vol 80 (5) ◽  
pp. 1117-1128 ◽  
Author(s):  
Anh Ngoc Tong Thi ◽  
Liesbeth Jacxsens ◽  
Bert Noseda ◽  
Simbarashe Samapundo ◽  
Binh Ly Nguyen ◽  
...  
Keyword(s):  
Self Assessment ◽  
Microbiological Safety ◽  
Assessment Questionnaire

scholarly journals Relationship Between Depression and Quality of Life Among Vitiligo Patients: A Self-assessment Questionnaire-based Study

2020 ◽  
Vol Volume 13 ◽  
pp. 511-520
Author(s):  
Narumol Silpa-archa ◽  
Chutipon Pruksaeakanan ◽  
Nattha Angkoolpakdeekul ◽  
Chayada Chaiyabutr ◽  
Kanokvalai Kulthanan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Self Assessment ◽  
Assessment Questionnaire

Laparoscopic “en-bloc” ligation of spermatic veins

1996 ◽  
Vol 63 (3) ◽  
pp. 384-388
Author(s):  
C. Trombetta ◽  
G. Savoca ◽  
G. Liguori ◽  
A. Tamai ◽  
S. Siracusano ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Operating Time ◽  
Case Histories ◽  
En Bloc ◽  
Optical Magnification ◽  
Average Operating ◽  
Average Operating Time ◽  
The Right

Laparoscopic varicocelectomy is suggested only for II-III grade bilateral varicocele. The optical magnification granted by videosurgical techniques, prevents damaging testicular arteries; this possibility, however, requires a considerable amount of time. We performed a laparoscopic “en-bloc” ligation without sparing the artery on 13 patients with bilateral varicocele in order to assess eventual changes in gonadal volume. 10 patients underwent bilateral “en-bloc” ligation of spermatic vessels with an average operating time of 21 minutes. In 3 other patients, “en-bloc” ligation was performed on the right side while on the left side the artery was identified and saved; in these cases the average operating time was 33 minutes. After an average follow-up period of 19 months no cases of testicle atrophy nor of hydrocele were reported. ColorDoppler sonography, performed 3 months later on the 10 patients treated by bilateral “en-bloc” ligation, showed no persistent reflux. No case of homolateral persistent reflux was encountered in the 3 patients who underwent only right-side “en-bloc” ligation, but on the left side, where selective ligation had been performed, persistence of reflux was registered in one patient. Our experience has confirmed that laparoscopic “en-bloc” ligation of the internal spermatic pedicle, sparing vasa deferentia, prevents the persistence of reflux in all cases and allows a reduction in operating time. The opportunity of treating a pathology like bilateral varicocele by means of laparoscopy, which requires general anaesthesia, needs further confirmation and a larger number of case histories.

scholarly journals Nonmotor-Related Quality of Life in Parkinson’s Patients with Subjective Memory Complaints: Comparison with PDQ-39

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Alexis Lionel Jenny ◽  
Antonia Meyer ◽  
Ivana Handabaka ◽  
Pasquale Calabrese ◽  
Peter Fuhr ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cognitive Decline ◽  
Depression And Anxiety ◽  
Subjective Memory Complaints ◽  
Subjective Memory ◽  
Self Assessment ◽  
Confounding Effect ◽  
Memory Complaints ◽  
Assessment Questionnaire

Background. Parkinson’s disease (PD) is associated with cognitive decline, progressing from subjective memory complaints (SMC) via mild cognitive impairment (MCI) to dementia. SMC are only measurable by an interview and thus rely on individuals reporting a subjectively perceived worsening of cognitive functioning. Cognitive decline is accompanied by a reduction in quality of life (QoL); however, the extent to which SMC manifest a reduction of QoL remains unclear. Objective. To determine the association between SMC and deterioration of QoL in patients suffering from PD. Methods. A total of 46 cognitively unimpaired PD patients (29 men and 17 women) completed PDQ-39, two assessments to measure SMC (Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and a Self-Assessment questionnaire), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Multiple regression modelling was conducted to investigate the confounding effect of depression and anxiety. Results. The PDQ-39 domain cognitions, but not the PDQ-39 sum score, correlated significantly with the SMC Self-Assessment questionnaire (r = 0.57; p<0.001). The conducted regression model indicates a significant confounding effect of depression and anxiety (p<0.001, R2 = 0.55). Conclusion. In our study, SMC is significantly related to a reduction of cognitive QoL. In addition, we observed significant relation to anxiety and depression levels. In contrast to our main hypothesis, we found no association with overall QoL; this lack of association could be due to unstandardized questionnaires and emphasizes the need of validated tools for evaluating SMC.

scholarly journals Laparoscopic Adrenalectomy for Adrenal Tumors

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Sun Chuan-yu ◽  
Ho Yat-faat ◽  
Ding Wei-hong ◽  
Gou Yuan-cheng ◽  
Hu Qing-feng ◽  
...  
Keyword(s):  
Blood Loss ◽  
Laparoscopic Adrenalectomy ◽  
Benign Tumor ◽  
Operating Time ◽  
Adrenal Tumors ◽  
Benign Tumors ◽  
Intraoperative Blood Loss ◽  
First Choice ◽  
Average Operating ◽  
Average Operating Time

Objective. To evaluate the indication and the clinical value of laparoscopic adrenalectomy of different types of adrenal tumor.Methods. From 2009 to 2014, a total of 110 patients were diagnosed with adrenal benign tumor by CT scan and we performed laparoscopic adrenalectomy. The laparoscopic approach has been the procedure of choice for surgery of benign adrenal tumors, and the upper limit of tumor size was thought to be 6 cm.Results. 109 of 110 cases were successful; only one was converted to open surgery due to bleeding. The average operating time and intraoperative blood loss of pheochromocytoma were significantly more than the benign tumors (P<0.05). After 3 months of follow-up, the preoperative symptoms were relieved and there was no recurrence.Conclusions. Laparoscopic adrenalectomy has the advantages of minimal invasion, less blood loss, fewer complications, quicker recovery, and shorter hospital stay. The full preparation before operation can decrease the average operating time and intraoperative blood loss of pheochromocytomas. Laparoscopic adrenalectomy should be considered as the first choice treatment for the resection of adrenal benign tumor.

scholarly journals The Treatment Advantage of Complex Acetabular Fractures by the Pararectus Approach

2021 ◽  
Author(s):  
Guoming Liu ◽  
Jinli Chen ◽  
Chengzhi Liang ◽  
Chengdong Zhang ◽  
Xuwen Li ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Operating Time ◽  
Hip Osteoarthritis ◽  
Anterior Column ◽  
Acetabular Fractures ◽  
Heterotopic Bone ◽  
Heterotopic Bone Formation ◽  
Orthopedic Surgeons ◽  
Pararectus Approach

Abstract Background: The surgical treatment of complex acetabular fractures is one of the most challenging procedures for orthopedic surgeons. The Pararectus approach, as a reasonable alternative to the existing surgical procedures, was performed for the treatment of complex acetabular fractures involving the anterior column. This study aimed to evaluate outcome using the Pararectus approach for acetabular fractures involving anterior columns. Methods: Thirty-seven with displaced complex acetabular fractures involving anterior columns were treated between July 2016 and October 2019 using the Pararectus approach. The functional outcomes (using the Merle d Aubigné and Postel scoring system, WOMAC and modified Harris scoring), the quality of surgical reduction (using the Matta criteria), and postoperative complications were assessed with about 26 months follow-up.Results: Thirty-seven patients (mean age 53 years, range: 30-71; 28 male) underwent surgery. Mean intraoperative blood loss was 840 ml (rang: 400-2000 ml) and mean operating time was 210 min (rang: 140-500 min). The modified Merle d Aubigné score was excellent and good in 27 cases (73%), fair in 6 cases (16%), and poor in 3 cases (12%). The mean score was 88.5 (range:77-96) for the modified Harris Hip scores, and 22 (range:7-35) for the WOMAC scores after operation. Postoperative functional outcomes were significantly improved compared with preoperative outcomes (P<0.0001). The quality of reduction was anatomical in 21 cases (57%), satisfactory in 9 cases (24%), and unsatisfactory in 7 cases (20%). At follow-up, four patients developed a DVT, and heterotopic bone formation was observed in one patient. The hip osteoarthritis was not observed.Conclusion: The Pararectus approach achieved good functional outcomes and anatomical reduction in the treatment of complex acetabular fractures involving anterior column with minimal access morbidity.

scholarly journals URBAN PUBLIC TRANSPORT: MARGINAL VALUE OF THE CAPACITY FACTOR

2019 ◽  
Vol 16 (3) ◽  
pp. 290-301
Author(s):  
A. I. Fadeev ◽  
Ye. V. Fomin ◽  
S. Alhusseini
Keyword(s):  
Public Transport ◽  
Operating Time ◽  
Capacity Utilization ◽  
Utilization Factor ◽  
Marginal Value ◽  
Passenger Traffic ◽  
Urban Public Transport ◽  
Speed Fluctuation ◽  
Average Operating ◽  
Average Operating Time

Introduction. One of the most important indicators determining the public transport service quality is the capacity utilization factor of transport fleet. This parameter directly effects on the economic efficiency of the transport organization. For the carrier it is desirable from an economic point of view that the value of the capacity utilization factor takes on the greatest value. Passengers, on the contrary, prefer to transfer without overfull capacity of transport vehicles. Moreover, this factor is used in determining travel fares, analyzing the executed movement regarding the availability of reserves in carrying capacity and planning transportation process. The paper discusses the method of marginal value calculation of the transport fleet’s capacity utilization factor of urban public transport based on ensuring standard vehicle's cabin filling limits.Materials and methods. The authors solved the task of determining the filling marginal value for transport fleet while working on regular urban routes by analyzing the dependence of the capacity utilization factor on the passenger traffic parameters, the average operating time of the transport fleet on the route and the speed fluctuation during public transport operation. The authors also proposed the indicator of the transportation speed fluctuation during the operation of urban public transport.Results. The authors found out that the capacity utilization factor of transport fleet substantially depended on the passenger traffic parameters, on the average operating time of the transport fleet and on the speed fluctuation during public transport operation.Discussion and conclusion. The obtained dependences allow us calculating the marginal values of capacity utilization factor with taking into account the parameters of the planned transport process. The standard capacity utilization factor varies within considerable limits from 0.2 to 0.4, depending on the operating conditions.

833 Hyper Acute Dialysis Access Pathway (HADAP) – Undertaking Creation of Arteriovenous Fistulae in The Renal Ward

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Shetty ◽  
P Chowdary ◽  
D Dabare ◽  
C Seet ◽  
R Ahmed ◽  
...  
Keyword(s):  
Operating Time ◽  
Surgical Site Infections ◽  
Primary Patency ◽  
Successful Implementation ◽  
Dialysis Access ◽  
Arteriovenous Fistulae ◽  
Surgical Assistance ◽  
Average Operating ◽  
Average Operating Time ◽  
Duration Of Operation

Abstract Introduction The impetus to apply the “lean method” to creation of arteriovenous fistulae came with the pandemic restricting access to theatres. Here we present HADAP implemented in a dedicated procedure room in the Renal ward. Method Between April and September 2020, 44 patients underwent ward-based arteriovenous fistula operations with no more than 3 people in the room – surgeon, runner and patient. The parameters assessed were duration of operation, complications, patency, patient and surgeon feedback and financial implications. Results The service was predominantly registrar-led who created 91% of the fistulae. 95% operations were completed successfully with a 2-week primary patency of 73% and no surgical site infections. 40% of the procedures were radiocephalic fistulae. 14% procedures required surgical assistance by the runner. The average operating time reduced from 90 minutes for the first 10 cases to 50 minutes for the last 9. A structured questionnaire showed positive feedback from both patients and surgeons (4-5 out of 5). This service has cleared potentially 9 main theatre lists for more complex procedures. Conclusions Our study demonstrates the successful implementation of a novel operating environment allowing expedited care for renal failure patients. It has enhanced our ability to deliver a dialysis access program despite the challenges of COVID.

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