Application of Pulsating Vacuum Cleaning Technology to Medical Devices Cleaning

This study aims to solve existing problems in cleaning medical devices, such as the cumbersome loading of minimally invasive surgical instruments, the incomplete cleaning of instruments with complex structures, and the low cleaning efficiency of ordinary instruments. A pulsating vacuum cleaning machine was combined with ultrasonic cleaning and boiling cleaning technology to clean various complex medical devices through a pressure pulsating process (i.e., repetitive pump-out and pumpin until the cleaning results meet the cleaning standards for medical devices). The cleaning results of spay washing, ultrasound cleaning and pulsating vacuum cleaning were compared among four groups of medical devices, including silica gel hoses, chamber instruments, whole box of minimally invasive instruments and surgical instruments. The amount of protein residues was tested using the spectrophotometric method. The testing results revealed that the loading capacity of a pulsating vacuum cleaning machine is 3–4 times as much as that of an ordinary spray cleaning machine, without manual placement and connection operation required, which reduced the workload of pretreatment. The protein residue after cleaning meets the requirements of the YY/T0734 standard for the cleaning effect of medical devices. Pulsating vacuum cleaning technology has an overall better loading capacity, when compared to spay washing and ultrasound cleaning, and this can make up for the shortcomings of commonly used cleaning machines, such as the low cleaning efficiency and unsatisfactory cleaning results of medical devices with complex structures.

The Layer 7 Cortical Interface: A Scalable and Minimally Invasive Brain-Computer Interface Platform

Progress toward the development of brain-computer interfaces has signaled the potential to restore, replace, or augment lost or impaired neurological function in a variety of disease states. Existing brain-computer interfaces rely on invasive surgical procedures or brain-penetrating electrodes, which limit addressable applications of the technology and the number of eligible patients. Here we describe a novel approach to constructing a neural interface, comprising conformable thin-film electrode arrays and a minimally invasive surgical delivery system that together facilitate communication with large portions of the cortical surface in bidirectional fashion (enabling both recording and stimulation). We demonstrate the safety and feasibility of rapidly delivering reversible implants containing over 2,000 microelectrodes to multiple functional regions in both hemispheres of the Gottingen minipig brain simultaneously, without requiring a craniotomy, at an effective insertion rate faster than 40 ms per channel, without damaging the cortical surface. We further demonstrate the performance of this system for high-density neural recording, focal cortical stimulation, and accurate neural decoding. Such a system promises to accelerate efforts to better decode and encode neural signals, and to expand the patient population that could benefit from neural interface technology.

Radiation methods of visualization in diagnostics and assessment of the severity of acute pancreatitis (review of literature)

In patients with acute pancreatitis (AP), diagnostic imaging is very important for determining disease etiology and its primary diagnosis in unclear clinical situations. This review presents literature data about the methodology, indications and timing of various imaging methods in the diagnosis and treatment of AP. The detailed information about modern tomography capabilities in stratification of AP severity and morphological assessment of its local complications is presented. Currently, beam imaging methods are crucial in planning of draining minimally invasive surgical interventions for AP and subsequent assessment of their effectiveness, which makes the radiologist a permanent and key member of a multidisciplinary team of specialists, contributing to the optimization of the immediate and long-term results of treatment of this complex pathology.

Contemporary Fertility-Sparing Management Options of Early Stage Endometrioid Endometrial Cancer in Young Nulliparous Patients

Incidence of endometrial cancer (EC) has been increasing in recent years, especially in high-income countries. The disease commonly affects peri- and postmenopausal women; however, about 5% of women are diagnosed with EC in their reproductive age. Due to both the increasing incidence of EC among reproductive age women and trends to delayed childbearing, fertility-sparing treatment for young patients with EC has become extremely important for researchers and practitioners. Because the classic treatment with total hysterectomy and bilateral saplingo-oophorectomy is not an appropriate approach for young women demanding fertility preservation, several fertility-sparing options have been developed and summarized in this review. Utilization of different medications and their combination (progestagens, gonadotropin releasing hormones analogues, and metformin in different formulations) are tested and found as efficient for fertility-sparing treatment. New minimally invasive surgical techniques, combined with progestagens, are also confirmed as valuable. There are many novel conservative and surgical treatment approaches under investigation. Assuming that molecular biomarkers can be both diagnostic and prognostic to assist in prediction of response to a certain therapy, prognostic risk groups’ stratification along with specific biomarkers’ identification will ensure low recurrence and decrease mortality rates in young women with EC.

The Role of Soft Robotic Micromachines in the Future of Medical Devices and Personalized Medicine

Developments in medical device design result in advances in wearable technologies, minimally invasive surgical techniques, and patient-specific approaches to medicine. In this review, we analyze the trajectory of biomedical and engineering approaches to soft robotics for healthcare applications. We review current literature across spatial scales and biocompatibility, focusing on engineering done at the biotic-abiotic interface. From traditional techniques for robot design to advances in tunable material chemistry, we look broadly at the field for opportunities to advance healthcare solutions in the future. We present an extracellular matrix-based robotic actuator and propose how biomaterials and proteins may influence the future of medical device design.

Super-selective prostatic arteries embolization in patients with benign prostate hyperplasia: prevention and treatment of complications

Introduction. Super-selective prostatic arteries embolization (PAE) is a modern minimally invasive surgical method for the treatment of benign prostatic hyperplasia (BPH). PAE is included in the Russian clinical guidelines for the BPH treatment and approved for use in the United States and European countries.Purpose of the study. To analyze the most common PAE-associated complications and to develop preventive arrangements.Materials and methods. During the period from 2013 to 2020, PAE as the main method of BPH treatment was used in 168 patients with an average age of 69.3 ± 8.1 (53-82) years. All patients underwent two-day antibiotic prophylaxis before the operation and lasted 7-10 days. For catheterization of the prostatic arteries, 2.0-2.8 Fr microcatheters and 4-5 Fr microconductors were used. For embolization, hydrogel microspheres with a diameter of 100-300 µm and 300-500 µm were used, as well as poly polyvinyl alcohol (PVA) microparticles with a diameter of 100-500 µm.Results. Bilateral PAE was successfully performed in 146 cases; unilateral PAE was performed in 22 patients due to anatomical features. Seventeen (10.1%) PAE from the orifice, super-selective PAE was performed in 67 (39.9%) cases, the PErFecTED embolization was performed in 84 (50.0%) patients. The most common complication was acute urinary retention (AUR) in 28 (16.6%) patients: trocar cystostomy was required in 11 (6.5%) patients, AUR was resolved using conservative therapy in 17 (10.2%) patients. In 23 (14.2%) cases, complications associated with unintentional embolization of the anastomoses of the prostate arteries were identified: rectal pain and/or the appearance of blood in the stool in 19 (11.3%) patients, the appearance of trophic ulcers on the glans penis in 5 (2.8%) patients. In addition, several adverse events that were not complications were noted: postembolization syndrome in 50 (29.7%) patients, and worsening of LUTS in 41 (24.4%) patients. Seven (4.1%) patients had acute epididymitis; 4 (2.4%) patients had a hematoma at the puncture site.Conclusion. PAE can cause a limited number of complications. It is necessary to unify the system for reporting PAE complications. Antibiotic prophylaxis is recommended. The use of visualization and X-ray navigation methods make it possible to make the PAE safer. The PErFecTED technique in combination with small particle sizes increases the risk of complications. The surgeon's experience and proficiency in special surgical techniques are essential. The transradial approach is promising, but further observation and an increase in patient samples are required. The question of choosing the optimal embolization drug continues to be relevant.

Case Series: Video-Assisted Minimally Invasive Cardiac Surgery During Pregnancy

Surgical intervention is expected to improve maternal outcomes in pregnant patients with heart disease once the conservative treatment fails. For pregnant patients with heart disease, the risk of cardiac surgery under cardiopulmonary bypass (CPB) must be balanced due to the high fetal loss. The video-assisted minimally invasive cardiac surgery (MICS) has been progressively applied and shows advantages in non-pregnant patients over the years. We present five cases of pregnant women who underwent a video-assisted minimally invasive surgical approach for cardiac surgery and the management strategies. In conclusion, the video-assisted MICS is feasible and safe to pregnant patients, with good maternal and fetal outcomes under the multidisciplinary assessment and management.

Comparative Assessment of Original vs. Standard Surgery Techniques in Treatment for Purulent Pyelonephritis

Background. Modern minimally invasive surgical techniques reduce traumatism of operative interventions and aggressive anaesthesia, which accordingly shortens the patient’s hospital stay and rehabilitation period.Aim. An improvement of surgical outcomes in patients with purulent pyelonephritis via introduction of laparoscopic techniques.Materials and methods. Th e study included 80 purulent pyelonephritis patients operated at the Territorial Clinical Hospital during 2006—2018. Th e patients were divided between two cohorts. Cohort 1 included 40 (50 %) patients operated with standard techniques (ST), cohort 2 — 40 (50 %) patients having surgery by an original minimally invasive technique (OT). Kidney decapsulation was found to outcome in parenchymal decompression and blood circulation restore in cortical layer. Intraarterial infusion of alprostadil prevents further spread of purulent-destructive processes in kidney.Results and discussion. In patients with the minimally invasive technique, postoperative period proceeded at no complications. On day 1, the patients reported reduced pain syndrome in the surgical area. Contrasted renal MSCT before and aft er surgery showed the recovery of renal blood flow and significant diminishing of destruction foci in short term. Nephrectomy was not performed as no-indication.Conclusion. The treatment outcomes in 40 patients having the new surgical technique demonstrate its efficacy and applicability in clinical practice.