How to improve tissue handling skills

Author(s):  
Mickey Tivers
Keyword(s):  
1995 ◽  
Vol 12 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Jung I. Park

Abdominoplasty is a relatively major cosmetic procedure with associated complications such as excessive bleeding, hematoma, seroma formation, infection, and pulmonary embolism, etc. Complete hemostasis and gentle tissue handling are of paramount importance to avoid stated complications. The application of laser technology had given us opportunities to achieve these goals by drastically reducing intraoperative and postoperative bleeding, by sealing the lymphatic capillaries and by allowing a gentle tissue dissection. The laser physics, its clinical application, the surgical procedure, and patient photographs are presented. The Nd-YAG contact tip laser allowed us to perform surgery with almost absolute hemostasis. Recovery from surgery has been rapid due to less postoperative pain. The expense of laser use has been reduced significantly by the introduction of a compact model with less wattage for office use.


1999 ◽  
Vol 123 (7) ◽  
pp. 620-621 ◽  
Author(s):  
Michael L. Cibull

Abstract This article reviews the “state of practice” with regard to sentinel lymph node biopsy, a new and evolving technique currently used most commonly for staging of malignant melanoma and adenocarcinoma of the breast. Sentinel lymph node biopsy has the potential to both increase the accuracy of lymph node sampling as a prognostic tool and to decrease the need for unnecessary and morbid extensive lymph node dissection in such patients. The need for close cooperation and planning involving the surgeon and pathologist is stressed, and gross room tissue handling, radiation safety, microscopic examination, and the use of ancillary diagnostic techniques are discussed.


2007 ◽  
Vol 51 (8) ◽  
pp. 1349-1354 ◽  
Author(s):  
William F. Young, Jr. ◽  
Geoffrey B. Thompson

Laparoscopic adrenalectomy is one of the most clinically important advances in the past 2 decades for the treatment of adrenal disorders. When compared to open adrenalectomy, laparoscopic adrenalectomy is equally safe, effective, and curative; it is more successful in shortening hospitalization and convalescence and has less long-term morbidity. The laparoscopic approach to the adrenal is the procedure of choice for the surgical management of cortisol-producing adenomas and for patients with corticotropin (ACTH) dependent Cushing's syndrome for whom surgery failed to remove the source of ACTH. The keys to successful laparoscopic adrenalectomy are appropriate patient selection, knowledge of anatomy, delicate tissue handling, meticulous hemostasis, and experience with the technique of laparoscopic adrenalectomy.


2022 ◽  
Vol 11 ◽  
Author(s):  
Mattia Marinucci ◽  
Caner Ercan ◽  
Stephanie Taha-Mehlitz ◽  
Lana Fourie ◽  
Federica Panebianco ◽  
...  

The use of patient-derived organoids (PDO) as a valuable alternative to in vivo models significantly increased over the last years in cancer research. The ability of PDOs to genetically resemble tumor heterogeneity makes them a powerful tool for personalized drug screening. Despite the extensive optimization of protocols for the generation of PDOs from colorectal tissue, there is still a lack of standardization of tissue handling prior to processing, leading to microbial contamination of the organoid culture. Here, using a cohort of 16 patients diagnosed with colorectal carcinoma (CRC), we aimed to test the efficacy of phosphate-buffered saline (PBS), penicillin/streptomycin (P/S), and Primocin, alone or in combination, in preventing organoid cultures contamination when used in washing steps prior to tissue processing. Each CRC tissue was divided into 5 tissue pieces, and treated with each different washing solution, or none. After the washing steps, all samples were processed for organoid generation following the same standard protocol. We detected contamination in 62.5% of the non-washed samples, while the use of PBS or P/S-containing PBS reduced the contamination rate to 50% and 25%, respectively. Notably, none of the organoid cultures washed with PBS/Primocin-containing solution were contaminated. Interestingly, addition of P/S to the washing solution reduced the percentage of living cells compared to Primocin. Taken together, our results demonstrate that, prior to tissue processing, adding Primocin to the tissue washing solution is able to eliminate the risk of microbial contamination in PDO cultures, and that the use of P/S negatively impacts organoids growth. We believe that our easy-to-apply protocol might help increase the success rate of organoid generation from CRC patients.


2016 ◽  
Vol 18 (3) ◽  
pp. 351 ◽  
Author(s):  
Markus G. Mohaupt ◽  
Spyridon Arampatzis ◽  
Nathan Atkinson ◽  
Dong Yi ◽  
Xin Wu Cui ◽  
...  

The substantial evidence base for interventional ultrasound approaches to renal diagnostic sampling and therapeutic access exists. This review comments on the evidence-based recommendations on ultrasound-guided renal access which have been published recently within the framework of Guidelines on Interventional Ultrasound (InVUS) of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) from a clinical practice point of view. Specific aspects of tissue handling and workup, procedural approach and patient interaction are discussed. Indications, contraindications, risk factors and methods to reduce these risks are considered.


Author(s):  
Simon Fisher

Understanding that children are not small adults, and that they come in different sizes and stages of development, is fundamental to paediatric surgery. Knowledge of a child’s weight is crucial when considering fluid and medication administration. Moreover, babies have immature physiology and less functional reserve compared to older children. Understanding basic embryology will unravel some of the mysteries of developmental pathology encoun­tered by the paediatric surgeon, such as oesophageal atresia, malrotation of the gut, annular pancreas, and maldescent of the testis. The paediatric surgeon deals with some of the same surgical condi­tions that affect adults, but even management of a common condition such as inguinal hernia, has different therapeutic implications in children and adults. Paediatric surgery demands gentle tissue handling and deli­cate technique. Good communication skills are a prerequisite for dealing with the distraught or ill child and anxious parents, and the surgeon often retains a clinical interest in his or her patient, well into young adulthood. This chapter will test your knowledge of principles of surgical manage­ment of sick children and your understanding of presentations of some of the more commonplace conditions encountered by surgeons in this demanding, yet rewarding, discipline.


2019 ◽  
Vol 03 (04) ◽  
pp. 186-190
Author(s):  
Eric M. Cohen ◽  
Jacob M. Babu ◽  
Scott Ritterman ◽  
John Tuttle ◽  
Daniel Eisenson ◽  
...  

AbstractPrevious studies have demonstrated varying rates of heterotopic ossification (HO) after total hip arthroplasty (THA) depending on which anatomical approach is utilized. The direct anterior approach (DAA) is considered to be a muscle-sparing approach to the hip, which may lead to decreased rates of HO formation. This study evaluated the incidence of HO formation after DAA THA. The current work is a retrospective review of patients who underwent DAA THA. Six-month postoperative radiographs were evaluated and HO grade was classified using the Brooker classification system. Baseline characteristic differences between the Brooker classification groups were analyzed, specifically looking at: age, sex, type of deep venous thrombosis prophylaxis utilized, and preoperative Bombelli arthritis type. The overall incidence of HO in this DAA group was 179/485 patients (36.9%). There were 14 patients (2.9%) with Brooker Type 3 HO and 1 patient (0.21%) with Brooker Type 4 HO. No surgical excision of HO was performed. Patients were significantly more likely to develop HO if they had Bombelli hypertrophic arthritis (p < 0.00003). Preoperative radiographic imaging suggesting Bombelli hypertrophic arthritis is predictive of HO formation, warranting consideration for HO prophylactic treatment. The radiographic incidence of HO in DAA THA was 36.9%, which is within the previously reported range of HO seen for lateral and posterior approaches to the hip. HO after total hip arthroplasty is likely due to soft tissue handling, hemostasis, and patient factors, rather than type of surgical approach.


2018 ◽  
Vol 40 (1) ◽  
pp. 113-119 ◽  
Author(s):  
Troy S. Watson ◽  
Jordan Panicco ◽  
Amit Parekh

The “anchovy” interpositional arthroplasty technique can be used as a salvage option for failed hallux rigidus procedures. The operative technique utilized by the senior author is described. Careful soft-tissue handling, meticulous joint space and graft preparation, and interposition graft stabilization using a bone tunnel and suture anchors are unique aspects of this technique, which in the authors’ experience have contributed to improved outcomes. Current literature regarding indications and outcomes is limited and controversial. The proposed benefits of soft-tissue interposition arthroplasty of the hallux metatarsophalangeal joint for patients with prior failed implant arthroplasty are improved pain scores and preservation of range of motion. Level of Evidence: Level V, technique guide.


2019 ◽  
Vol 6 ◽  
pp. 237428951984835 ◽  
Author(s):  
MacLean P. Nasrallah ◽  
Zev A. Binder ◽  
Derek A. Oldridge ◽  
Jianhua Zhao ◽  
David B. Lieberman ◽  
...  

Molecular profiling of glioblastoma has revealed complex cytogenetic, epigenetic, and molecular abnormalities that are necessary for diagnosis, prognosis, and treatment. Our neuro-oncology group has developed a data-driven, institutional consensus guideline for efficient and optimal workup of glioblastomas based on our routine performance of molecular testing. We describe our institution’s testing algorithm, assay development, and genetic findings in glioblastoma, to illustrate current practices and challenges in neuropathology related to molecular and genetic testing. We have found that coordination of test requisition, tissue handling, and incorporation of results into the final pathologic diagnosis by the neuropathologist improve patient care. Here, we present analysis of O6-methylguanine-DNA-methyltransferase promoter methylation and next-generation sequencing results of 189 patients, obtained utilizing our internal processes led by the neuropathology team. Our institutional pathway for neuropathologist-driven molecular testing has streamlined the management of glioblastoma samples for efficient return of results for incorporation of genomic data into the pathological diagnosis and optimal patient care.


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