ABSTRACT
Objective: Wisdom teeth were the most common teeth affected among the rest of the teeth, these teeth need accurate evaluation and diagnosis, surgical removal of impacted wisdom needs time for incision, bone removal and suture, so the use of any instrument helps to reduce this time is essential. The objectives of this study were to estimate the time needed for the suture of oral flaps post-surgical removal of the lower wisdom teeth by using Negus knot pusher and compare it with the time used for stitching in conventional manual holding single stitching. Material and Methods: Data had been collected from thirty patients through history, clinical examination and radiographic assessment, followed by classical surgical removal performed on the same principles for all patients, at the suture level patients divided arbitrarily into two groups, control group 15 patients and 15 patients Negus pusher group, using Negus knot pusher, which is usually used to hold the stitch and stop bleeding post tonsillectomy operations by ligation, time elapsed for suturing with knot tying is calculated for both groups. Results: Among the 30 patients incorporated in the clinical study, control group mean was (1 minutes and 11 seconds and 70 milliseconds) while for the pusher group was (1 minutes and 32 seconds and 57 milliseconds), the comparison by means of T-test was not significant with the (0.424) value. Conclusion: the Negus pusher instrument can be used for the knotting stiches post wisdom teeth removal as an auxiliary tool and the time can be shortened by the use of a modified handling technique and more satisfaction for patients. (AU)
Objetivo: Os terceiros molares são os dentes mais afetados entre o resto dos dentes e necessitam de avaliação e diagnóstico precisos. A exodontia desses elementos impactados requer tempo para incisão, remoção óssea e sutura, portanto, é essencial o uso de instrumentos que ajudem a reduzir o tempo de procedimento. Os objetivos do presente estudo foram estimar o tempo necessário para a sutura de retalhos orais após a exodontia de terceiros molares inferiores utilizando o instrumental Empurrador de nó Negus (Negus Knot pusher) e compará-lo com o tempo necessário para a realização de sutura única convencional. Material e Métodos: Os dados foram coletados de 30 pacientes através da história, exame clínico e avaliação radiográfica, seguidos pela remoção cirúrgica clássica realizada através do mesmo princípio para todos os pacientes. Considerando o nível da sutura, os pacientes foram divididos arbitrariamente em dois grupos, grupo controle (n=15) e grupo Empurrador de nó Negus (n=15), o qual é geralmente utilizado para segurar o ponto e estancar o sangramento após cirurgia de tonsilectomia por ligadura. O tempo decorrido para sutura foi calculado para ambos os grupos. Resultados: Entre os 30 pacientes incluídos no estudo, a média do grupo controle foi de 1 minuto e 11 segundos e 70 milissegundos, enquanto para o grupo Empurrador de nó Negus foi de 1 minuto e 32 segundos e 57 milissegundos. A comparação intergrupo por meio do teste T não foi estatisticamente significativa (p=0,424). Conclusão: O instrumental Empurrador de nó Negus pode ser usado para sutura após a extração de terceiros molares como ferramenta auxiliar e o tempo pode ser reduzido pelo uso de uma técnica de manuseio modificada. Ademais, pode estar associado a maior satisfação dos pacientes. (AU)
Subject(s)
Humans , Surgery, Oral , Sutures , Molar, ThirdABSTRACT
The Yoon Soon (YS) knot is a laparoscopic extracorporeal slip knot that is easy to learn and apply. Our new technique, which uses the trocar as a knot pusher, is simpler, faster, and has more tension than conventional knot methods. The YS knot will help surgeons save operative time and perform tension-controlled knot-tying during laparoscopic surgery.
Subject(s)
Laparoscopy , Operative Time , Surgical InstrumentsABSTRACT
PURPOSE: Extracorporeal ligation using knot pusher enables one to tie surgical knots easily. However, commercialized knot pusher can not prevent the leakage of gas along the working port during procedure. So, we made knot pusher by ourselves which has a thick diameter enough to prevent leakage of CO2 gas and evaluated the usefulness of self-made knot pusher. MATERIALS AND METHODS: Between May 1995 and May 1996, 28 women with anatomic SUI underwent laparoscopic BNS at our department. Of the total, 10 patients underwent laparoscopic BNS using commercialized knot pusher with a diameter of 3 mm (thin knot pusher group); whereas 18 underwent operation using self-made knot pusher with a diameter of 5 mm (thick knot pusher group). Laparoscopic BNS was done by extraperitoneal approach in all cases. RESULTS: Patient`s characteristics of the 2 groups were similar. 25 of patients were exhibited grade 1 or 2 of incontinence at physical examinations, 10 in thin knot pusher group and 15 of 18 patients in thick knot pusher group. Urethral hypermobility (mean 52 degree) were observed in all cases by the Q-tip test. VLPP was far above 60 cmH2O at 150 ml filling in all cases. Mean operation time was 185 min in thin knot pusher group and 95min in thick knot pusher group. Post operative blood transfusion was needed in 2 cases (1 case for each group). Urethral catheter were removed 25 hours after the operations and return to normal voiding were possible in 27-29 hours without intergroup difference. Mean duration of hospital stay was 3 days in both group. Amount of residual urine at discharge was less than 100 cc in 28 cases (9 in thin knot pusher group and 19 in thick knot pusher group). Complication included 1 case recurrent urinary incontinence in thin knot pusher group, 1 case of voiding difficulty for each group (which were improved by medication and dean intermittent catheterization), 2 cases of frequency for each group (improved by medication), and 1 case of bleeding in thin knot pusher group(managed by laparoscopic coagulation and hematoma removal). 27 patients were completely dry at followup of 2-12 months following surgery. Only one patient with thin knot pusher group are still wet. CONCLUSIONS: It was evident from this study that tying of knot using knot pusher thick enough to seal the lumen of working port prevented leakage of gas and therefore, shortened the total operation time.