scholarly journals Association between the computed tomography findings and operative time for interval appendectomy in children

2021 ◽  
Vol 18 (2) ◽  
pp. 73
Author(s):  
Takahiro Hosokawa ◽  
Yutaka Tanami ◽  
Yumiko Sato ◽  
Tetsuya Ishimaru ◽  
Hiroshi Kawashima ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Operative Time ◽  
Interval Appendectomy

scholarly journals Significance of prediction of the dorsal landmark using three-dimensional computed tomography during laparoscopic lymph node dissection along the proximal splenic artery in gastric cancer

2020 ◽  
Vol 8 ◽  
pp. 205031212093691
Author(s):  
Taro Ikeda ◽  
Shingo Kanaji ◽  
Gosuke Takiguchi ◽  
Naoki Urakawa ◽  
Hiroshi Hasegawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Splenic Artery ◽  
Operative Time ◽  
Splenic Vein ◽  
Three Dimensional ◽  
Anatomical Landmarks ◽  
Node Dissection ◽  
Preoperative Simulation

Objectives: Dissection of the No. 11p lymph nodes is technically challenging because of variations in anatomical landmarks. This study aimed to determine the accuracy and efficacy of predicting the dorsal landmark of No. 11p lymph node using three-dimensional computed tomography simulation. Methods: Laparoscopic gastrectomy with No. 11p lymph node dissection with preoperative simulation using three-dimensional computed tomography was performed in 24 patients at our institution from October 2016 to May 2018. Initially, preoperative three-dimensional computed tomography findings with operative videos in these 24 patients were compared. The dorsal landmark was defined as an anatomical structure behind the splenic artery on preoperative three-dimensional computed tomography and operative videos. The dorsal landmark of No. 11p lymph node was divided into four types: (1) splenic vein type, (2) splenic vein and pancreas type, (3) pancreas type, and (4) unclear type. Then, to investigate the efficacy of three-dimensional computed tomography, we compared the clinical and pathological features and surgical outcomes of nine patients who underwent preoperative three-dimensional computed tomography simulation (three-dimensional computed tomography group) and 23 patients who did not undergo three-dimensional computed tomography simulation from August 2014 to September 2016 (non-three-dimensional computed tomography group). All procedures were performed by one surgeon certified by the Endoscopic Surgical Skill Qualification System in Japan. Results: The concordance rate between three-dimensional computed tomography and operative videos of the dorsal landmark using three-dimensional computed tomography was 79% (19/24). The operative time of No. 11p lymph node dissection was significantly shorter in the three-dimensional computed tomography group than in the non-three-dimensional computed tomography group (7.7 versus 15.8 min, P = 0.044). Conclusion: The accuracy of predicting the dorsal landmark of No. 11p lymph node using three-dimensional computed tomography was extremely high. Preoperative simulation with three-dimensional computed tomography was useful in shortening the operative time of No. 11p lymph node dissection.

Preoperative Computed Tomography Angiography for ALT Flaps Optimizes Design and Reduces Operative Time

2021 ◽  
Author(s):  
Christopher M. Schneider ◽  
Patrick A. Palines ◽  
Daniel J. Womac ◽  
Charles T. Tuggle ◽  
Hugo St Hilaire ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Operative Time ◽  
Donor Site ◽  
Vascular Anatomy ◽  
Complication Rates ◽  
Anterolateral Thigh ◽  
Extremity Reconstruction ◽  
Alt Flap ◽  
Selection Of

Abstract Background Computed tomography angiography (CTA) has been widely used for perforator mapping in abdominal-based reconstruction, but it is less widespread in the anterolateral thigh (ALT) flap. However, CTA may be quite useful for ALT planning, as this flap has demonstrated substantial variability in intrapatient bilateral vascular anatomy. This study investigated whether standard use of preoperative CTA resulted in selection of the donor extremity with preferential perforator anatomy, and whether this affected operative time and postoperative outcomes. Methods A retrospective review of 105 patients who underwent proposed ALT flap reconstruction was performed. Seventy-nine patients received bilateral lower extremity CTAs, which were evaluated for dominant perforator anatomy (septocutaneous, musculoseptocutaneous, or musculocutaneous). Donor extremity selection was noted, and predicted perforator anatomy was compared with that encountered intraoperatively. Results Among the 73 patients who received bilateral imaging and ultimately received an ALT, congruent findings between imaging and surgical exploration were observed in 51 (69.8%) patients. Thirty (37.9%) patients had asymmetric perforator anatomy between their bilateral extremities on imaging. Among these, the leg with optimal perforator anatomy was selected in 70% of cases. There were no significant reductions among postoperative complication rates, but selection of the donor site with preferential anatomy was associated with a decrease in operative time (p = 0.049) among patients undergoing extremity reconstruction. Conclusion CTA is a useful tool for optimizing donor site selection for ALT flaps and reducing operative time. We believe that standard use of preoperative CTA in ALTs warrants further consideration.

Intraoperative Simulation: Team Training for Resuscitation While Using Intraoperative Computed Tomography: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Jacob L Goldberg ◽  
Maria Bustillo ◽  
Jaroslav K Usenko ◽  
Philip Kuo ◽  
Sertac Kirnaz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Operative Time ◽  
Human Subjects ◽  
Positive Outcome ◽  
Spontaneous Circulation ◽  
Neurological Sequelae ◽  
Intraoperative Computed Tomography ◽  
Head Fixation ◽  
Emergency Personnel ◽  
Team Functioning

Abstract Spine surgeons increasingly use intraoperative computed tomography (iCT) to facilitate surgery. iCT has several advantages, including the ability to decrease radiation exposure, improve surgical accuracy, and decrease operative time.1-3 However, the large footprint of the equipment can impede fast patient access in the event of an emergency resuscitation. This challenge is compounded when the patient is prone with rigid head fixation. To achieve fast, high-quality resuscitation, a large team must overcome numerous challenges. Cohesive team functioning under these circumstances requires planning, practice, and refinement.4  As a result of our simulation sessions, we have made several changes to the setup of our iCT cases. The following equipment is now routinely used: extralong tubing between the anesthesia circuit and patient, portable vital monitor, additional intravenous access is obtained, and extension tubing is used with all lines. We have created educational diagrams to streamline 2 challenging processes: optimal bed placement (for supination) and removal of equipment from the operating room (OR) to accommodate an influx of emergency personnel and equipment.  Since the implementation of this protocol, 1 prone posterior cervical patient had intraoperative cardiac arrest. The protocol was followed. Return of spontaneous circulation was achieved within 5 min. The patient was discharged from the hospital with no neurological sequelae. During debriefing, stakeholders uniformly credited the simulated practice with this positive outcome.  Emergency planning is a multifaceted process that continually evolves. With a steady flux of personnel and equipment, ongoing practice is essential to ensure readiness. Here, we share the key elements of our twice-yearly simulation.  This simulation was performed on a training mannequin. This study did not involve human subjects. Any depictions of care rendered to nonidentifiable patients were standard (nonexperimental).

scholarly journals Laparoscopic repair of a giant hiatal hernia after minimally invasive oesophagectomy

2020 ◽  
Vol 102 (6) ◽  
pp. e130-e132
Author(s):  
F Marchesi ◽  
G Dalmonte ◽  
A Morini ◽  
A Annicchiarico
Keyword(s):  
Computed Tomography ◽  
Minimally Invasive ◽  
Hiatus Hernia ◽  
Mesh Repair ◽  
Operative Time ◽  
Laparoscopic Approach ◽  
Oral Intake ◽  
Giant Hiatal Hernia ◽  
One Year ◽  
Minimally Invasive Oesophagectomy

Minimally invasive oesophagectomy has become popular, but studies showed a higher rate of postoperative hiatus hernia compared with open oesophagectomy. Our video presents the laparoscopic biosynthetic mesh repair of a symptomatic giant hiatus hernia in a 71-year-old man who had undergone minimally invasive oesophagectomy one year earlier for distal adenocarcinoma of the oesophagus. The operative time was 120 minutes. The patient started oral intake on postoperative day one and was discharged on postoperative day three. Postoperative computed tomography at six months showed no signs of recurrence. In the setting of a symptomatic hiatus hernia post-minimally invasive oesophagectomy, we suggest an initial laparoscopic approach, because of its countless advantages.

Reduced use of computed tomography in patients treated with interval appendectomy after implementing a protocol from a prospective, randomized trial

2013 ◽  
Vol 29 (12) ◽  
pp. 1293-1296 ◽  
Author(s):  
E. Marty Knott ◽  
Priscilla Thomas ◽  
Nicole E. Sharp ◽  
Alessandra C. Gasior ◽  
Shawn D. St. Peter
Keyword(s):  
Computed Tomography ◽  
Randomized Trial ◽  
Prospective Randomized Trial ◽  
Interval Appendectomy

scholarly journals Inter-ischial spine distance is a simple index of narrow pelvis that may predict difficulty during laparoscopic low anterior resection: a retrospective study

2021 ◽  
Author(s):  
Nobuki Ichikawa ◽  
Shigenori Homma ◽  
Tadashi Yoshida ◽  
Ken Imaizumi ◽  
Yoichi Miyaoka ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Rectal Cancer ◽  
Blood Loss ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Operative Time ◽  
Ischial Spine ◽  
Laparoscopic Low Anterior Resection ◽  
The Mean ◽  
Narrow Pelvis

Abstract Background A narrow pelvis makes laparoscopic rectal resection difficult. This study aimed to evaluate whether a simple measurement on computed tomography can predict procedural difficulty. Methods A total of 62 patients with low rectal cancer underwent conventional laparoscopic low anterior resection. The inter-ischial spine (IS) distance (i.e., distance between the ischial spines) was measured on an axial computed tomography slice. Operative time, blood loss, and time from insertion of linear staplers to completion of clamping on the distal end of the rectum (clamp time) were compared. Results Overall, 42 men and 20 women with low rectal cancer were assessed. The mean tumor size was 34.5 mm. Total or tumor-specific mesorectal excisions were performed in all cases; high ligation and resection of the inferior mesenteric arteries were carried out in 92% of patients. The mean operative time, and blood loss were 206 min, and 15 mL respectively. Four patients (6.5%) experienced postoperative complications, including two anastomotic leaks (3.2%). The mean IS distance was 93.3 mm. With simple linear regression, shorter IS distance correlated with longer operative time (R2 = 0.08, P = 0.030) and clamp time (R2 = 0.07, P = 0.046). Using an receiver operating characteristic curve, a narrow pelvis was defined as IS distance < 94.7 mm. Multivariate regression analysis revealed that IS distance < 94.7 mm (odds ratio, 3.51; P = 0.04) was independently associated with a longer clamp time. Conclusions The IS distance is a simple and useful measurement for predicting the difficulty of laparoscopic low anterior resection.

scholarly journals Increasing stone complexity does not affect fluoroscopy time in percutaneous nephrolithotomy

2019 ◽  
Vol 11 ◽  
pp. 175628721984021
Author(s):  
Annah Vollstedt ◽  
Johann Ingimarsson ◽  
Lawrence Dagrosa ◽  
Vernon Pais
Keyword(s):  
Computed Tomography ◽  
Percutaneous Nephrolithotomy ◽  
Radiation Dosimetry ◽  
Operative Time ◽  
Fluoroscopy Time ◽  
Intraoperative Radiation ◽  
Intraoperative Fluoroscopy ◽  
Multivariable Regression ◽  
Dosimetry Data ◽  
Operating Room Staff

Background: The aim of this work was to assess whether stone complexity with the Guy’s stone score (GSS) is associated with increased intraoperative fluoroscopy time. Methods: We retrospectively reviewed records of 261 consecutive patients undergoing percutaneous nephrolithotomy between 2007 and 2015. Of these, 203 had both preoperative computed tomography for accurate staging and full intraoperative fluoroscopy and radiation dosimetry data were available. Stone complexity was assessed using GSS. A correlation between fluoroscopy time (FT) and GSS was assessed in a univariate and multivariate fashion, including parameters such as age, sex, body mass index (BMI), and number of accesses. Results: The overall mean FT was 3.69 min [standard deviation (SD) 2.77]. The overall mean Guy’s score was 2.5 (SD 1). There was a statistically significant correlation between operative time and FT ( r = 0.34, p < 0.0001). There was a trend towards increasing operative time with increasing GSS ( r = 0.12, p = 0.08), but there was no statistically significant correlation. There was no correlation between FT and GSS ( r = 0.04, p = 0.55). On multivariable regression, accounting for sex, BMI, age, and singular versus multiple accesses, there was no significant correlation between stone complexity and FT ( p = 0.893). Conclusions: In the setting of conscious efforts to reduce intraoperative radiation exposure, increasing stone complexity, as classified by GSS, did not correlate with FT on univariate or multivariate analysis. Thus, treatment of more complex stones may be undertaken without concern that there is an inevitable need for significantly increased fluoroscopy exposure to the patient or operating room staff.

Sign in / Sign up

Export Citation Format

Share Document