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1.
Rev. argent. cir ; 113(1): 117-120, abr. 2021. graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1288181

ABSTRACT

RESUMEN La resección gástrica atípica ha demostrado ser beneficiosa para tumores submucosos. La técnica pre senta mayor riesgo cuando estos se desarrollan próximos a la unión esófago-gástrica (UEG). Para esta limitación se propuso la resección intragástrica mediante una técnica mixta combinando laparoscopia y endoscopia. En nuestro medio no existen publicaciones al respecto. Se trata de una mujer de 42 años, con lesión subepitelial-subcardial de 2 cm, evaluada mediante videoendoscopia alta (VEDA), compa tible con tumor del estroma gastrointestinal (GIST) evaluado mediante ecoendoscopia. La lesión fue resecada mediante abordaje combinado laparoendoscópico. Bajo visión laparoscópica se introdujeron en cavidad abdominal trocares con balón, y bajo visión endoscópica intragástrica se introdujeron estos en el estómago y se fijó la pared gástrica a la pared abdominal insuflando dichos balones. Posterior mente se realizó la resección de la lesión con sutura mecánica. El abordaje combinado es seguro y eficaz, simple en manos entrenadas, pero constituye una opción reproducible en casos seleccionados.


ABSTRACT Atypical gastric resection has proved to be beneficial to treat submucosal tumors. The technique is more difficult when these tumors develop next to the gastroesophageal junction (GEJ). Intragastric resection combining endoscopic and laparoscopic approach was proposed to solve this limitation. There are no publications about this technique in our environment. A 42-year-old female patients with a 2-mm subepithelial tumor below the cardia evaluated by upper gastrointestinal (UGI) videoendoscopy and endoscopic ultrasound suggestive of a gastrointestinal stroma tumor (GIST) underwent resection using the combined laparo-endoscopic approach. Under laparoscopic guidance, balloon-tipped trocars were introduced in the abdominal cavity and then into the stomach using endoscopic view. The balloons were inflated to fix the gastirc wall to the abdominal wall. The lesion was resected using mechanical stapler. The combined approach is safe and efficient, and simple to perform for trained professionals, constituting a reproducible option in selected cases.


Subject(s)
Laparoscopy , Esophagogastric Junction , Neoplasms , Patients , Stomach , Surgical Instruments , Vision, Ocular , Women , Wounds and Injuries , Cardia , Endosonography , Mechanics , Abdominal Cavity , Endoscopy , Environment , Hand , Methods
2.
Arq. bras. oftalmol ; 83(6): 547-551, Nov.-Dec. 2020. graf
Article in English | LILACS | ID: biblio-1153077

ABSTRACT

ABSTRACT This article reports a combined technique of sutureless intrascleral fixated intraocular lens implantation and Descemet membrane endothelial keratoplasty in a patient with anterior pseudophakic bullous keratopathy. Two scleral tunnels were created, corneal incisions were made, and a foldable intraocular lens was cut and removed from the anterior chamber. After performing anterior vitrectomy, a 3-piece foldable intraocular lens was implanted into the anterior chamber. One of the intraocular lens haptics was grasped with a forceps and pulled out from the scleral tunnel. Then, the end of the haptic was cauterized. Similar maneuvers were applied for the other haptic. Next, an 8-mm-diameter donor tissue was prepared, and the recipient endothelial tissue was peeled and removed from the center of the recipient cornea. The prepared donor tissue was injected into the anterior chamber. After proper opening and placement of the donor tissue, an air bubble was injected below the tissue. There were no postoperative complications during the 1-month follow-up.


RESUMO Relato de uma técnica que combina o implante de uma lente intraocular com fixação intraescleral sem sutura e uma ceratoplastia endotelial da membrana de Descemet em paciente com ceratopatia bolhosa pseudofácica anterior. Foram criados dois túneis esclerais. Foram feitas incisões na córnea e a lente intraocular dobrável foi cortada e removida da câmara anterior. Foi então efetuada uma vitrectomia anterior e uma lente intraocular dobrável de 3 peças foi implantada na câmara anterior. Um dos hápticos da lente intraocular foi pinçado com um fórceps e puxado para fora do túnel escleral. A extremidade do háptico foi cauterizada. Manobras semelhantes foram feitas no outro háptico. Foi preparado um tecido de doador com 8 mm de diâmetro e o tecido endotelial da área receptora foi removido do centro da córnea. O tecido preparado do doador foi injetado na câmara anterior. Após abertura e posicionamento adequados do tecido do doador, foi injetada uma bolha de ar abaixo do tecido. Não foi observada nenhuma complicação pós-operatória durante um mês de acompanhamento.


Subject(s)
Humans , Female , Aged , Corneal Transplantation , Lenses, Intraocular , Sclera/surgery , Surgical Instruments , Lens Implantation, Intraocular , Descemet Membrane
3.
Rev. medica electron ; 42(3): [16], mayo.-jun. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1341954

ABSTRACT

Se narran los sucesos históricos más relevantes de la práctica de la especialidad de Oftalmología en la provincia de Matanzas y los relacionados con la formación de profesionales a partir de la década del 70 del siglo XX. Al utilizar el método de la narración histórica, se propició la reflexión sobre los propios acontecimientos y su relación con el contexto socio-económico al momento en que estos se produjeron; destacándolos como los antecedes y factores favorecedores del desarrollo de la Oftalmología en Matanzas. Este trabajo se realizó no sólo para narrar de manera cronológica la historia desde los inicios y creciente práctica local de la especialidad, sino también, como a manera de testimonio para las actuales y futuras generaciones, de cómo tributaron los profesionales, las instituciones y los propios eventos, al avance científico y al impacto social de la especialidad en Matanzas. Se concluye, que el comienzo del esplendor de la práctica de la Oftalmología en la provincia de Matanzas, se enmarca a la década del 70 del siglo pasado; y a los inicios del siglo XXI al de mayor desarrollo acumulado. Todo este salto de calidad en el tiempo y en el espacio, ha sido posible, gracias a las políticas de salud y educacionales implementadas por el Ministerio de Salud Pública del país (AU).


The authors recount the most relevant historical facts of the Ophthalmology practice in the province of Matanzas and those related to professionals´ training from the seventies of the XX century. Using the method of historical recount helped the reflection on the proper facts and their relation to the socio-economic context at the moment they took place, highlighting them as antecedents and factor favoring the development of Ophthalmology in Matanzas. The current paper was written not only to recount in a chronological way the history from the beginning and growing local practice of the specialty, but also as a testimony for the current and future generations to know how the professionals, institutions and events contributed to the scientific advance and to the social impact of the specialty in Matanzas. It is concluded that the beginning of the splendor of Ophthalmology practice in the province of Matanzas falls within the decade of the seventies of the past century, and the beginning of the XXI century is the time of the bigger accumulated development. All this quality jump in the time and space has been possible thanks to health and educational politics implemented by the Ministry og Public Health of the country (AU).


Subject(s)
Humans , Ophthalmology/history , Professional Practice , Ophthalmologic Surgical Procedures/history , Surgical Instruments/history , Ophthalmologists/history , History of Medicine , History, 20th Century , Professional Training , Faculty/history
6.
Article in Chinese | WPRIM | ID: wpr-880397

ABSTRACT

With the development of laryngeal microsurgery, the requirements for the flexibility and convenience of surgical instruments are increasing. The research on related instruments has important value for the clinical application of laryngeal microsurgery. We have redesigned a gun-type tube-guide device of laser fiber by comparing the shortcomings of existing laser fiber introducers. The innovation of this design lies in its rotating nut device with adjustable laser angle and pre-bent tip. The corresponding


Subject(s)
Humans , Larynx/surgery , Laser Therapy/instrumentation , Lasers , Microsurgery/instrumentation , Surgical Instruments
7.
Article in Korean | WPRIM | ID: wpr-811310

ABSTRACT

PURPOSE: To compare the visual acuity and retinal thickness in patients with an idiopathic epiretinal membrane (ERM) after vitrectomy and membranectomy using two different methods.METHODS: This retrospective observational study included 77 eyes (32 eyes in the diamond-dusted membrane scraper [DDMS] group, and 45 eyes in the intraocular forceps [IOF] group) of 77 patients with idiopathic ERM who underwent pars plana vitrectomy and membranectomy. The main outcome measures were best-corrected visual acuity (BCVA, logMAR) and mean retinal thickness.RESULTS: In the IOF group, the BCVA at postoperative 1 week was significantly lower than at baseline and had improved at 12 weeks after surgery. In the DDMS group, the BCVA at postoperative 1 week showed no significant difference at baseline and had improved at 4 weeks after surgery. The central macular thickness at postoperative 6 months was significantly lower than at baseline (all, p < 0.001); there was no significant difference between the two groups (p = 0.400). The postoperative macular thickness of the DDMS group was significantly lower than that of the IOF group in the inner inferior and outer inferior areas at postoperative 12 weeks and 4 weeks (p = 0.046 and p = 0.039, respectively). Five eyes of the DDMS group and 15 eyes of the IOF group developed cystoid macular edema, 14 eyes of that improved without treatment.CONCLUSIONS: In patients with ERM, the use of DDMS or IOF for vitrectomy and membranectomy both resulted in improved visual acuity and decreased mean retinal thicknesses.


Subject(s)
Epiretinal Membrane , Humans , Macular Edema , Membranes , Observational Study , Outcome Assessment, Health Care , Retinaldehyde , Retrospective Studies , Surgical Instruments , Visual Acuity , Vitrectomy
8.
Article in English | WPRIM | ID: wpr-811124

ABSTRACT

BACKGROUND: Periprosthetic joint infection (PJI) is one of the commonly found catastrophic complications after total knee arthroplasty (TKA). Preoperative antibiotic prophylaxis, proper skin cleansing, shortened operative time, and sterility of surgical field and equipment are essential to minimize the risk of PJI. Although bacterial contamination of electrocautery tips has been reported, contamination of residual product of electrocoagulation, burnt necrotic tissue (BNT), is not well known. Therefore, we aimed to assess the contamination rate of BNT and association between contaminated BNT and PJI, and risk factors.METHODS: BNTs from 183 patients who had undergone unilateral primary TKA at our institution were retrospectively analyzed. In each patient, three to five specimens of BNT were routinely collected in the operative field of primary TKA. Collecting time was defined as the duration from start of using the electrocautery device to the first collection of BNT.RESULTS: Culture was positive in eight of 183 patients (4.4%; contaminated BNT group), and the most commonly isolated organism was coagulase-negative Staphylococcus (62.5%). The average operative time was 103.1 ± 44.2 minutes in the contaminated BNT group and 79.0 ± 16.7 minutes in the non-contaminated BNT group (p = 0.17), and collecting time was 48.0 ± 44.3 minutes and 29.7 ± 17.0 minutes (p = 0.28), respectively. None of the patients with contaminated BNT developed PJI, whereas four patients with culture-negative BNT developed PJI within 2 postoperative years.CONCLUSIONS: BNT in surgical field can become a reservoir of contaminating bacteria. However, contamination of BNT was not associated with PJI. Therefore, routine removal of all BNTs may be unnecessary.


Subject(s)
Antibiotic Prophylaxis , Arthroplasty , Arthroplasty, Replacement, Knee , Bacteria , Electrocoagulation , Humans , Infertility , Joints , Knee , Operative Time , Prosthesis-Related Infections , Retrospective Studies , Risk Factors , Skin , Staphylococcus , Surgical Instruments
9.
ABCD arq. bras. cir. dig ; 33(3): e1542, 2020. graf
Article in English | LILACS | ID: biblio-1152620

ABSTRACT

ABSTRACT Background: Robotic gastrectomy is gaining popularity worldwide. It allows reduced blood loss and lesser pain. However, it widespread use is limited by the extensive learning curve and costs. Aim: To describe our standard technique with reduced use of robotic instruments. Methods: We detail the steps involved in the procedure, including trocar placement, necessary robotic instruments, and meticulous surgical description. Results: After standardizing the procedure, 28 patients were operated with this budget technique. For each procedure material used was: 1 (Xi model) or 2 disposable trocars (Si) and 4 robotic instruments. Stapling and clipping were performed by the assistant through an auxiliary port, limiting the use of robotic instruments and reducing the cost. Conclusion: This standardization helps implementing a robotic program for gastrectomy in the daily practice or in one`s institution.


RESUMO Racional: A gastrectomia robótica está ganhando popularidade no mundo. Ela permite menor perda sanguínea e menos dor. Entretanto, a curva de aprendizado extensa e os custos limitam seu amplo uso. Objetivo: Descrever nossa técnica padrão com uso reduzido de instrumental robótico. Métodos: Detalham-se todos os passos envolvidos no procedimento, incluindo posicionamento de portais, instrumentos robóticos necessários e descrição cirúrgica meticulosa. Resultados: Após a padronização do procedimento, 28 pacientes foram operados com essa técnica. Em cada procedimento foram utilizados: 1 (modelo Xi) ou 2 (Si) trocárteres descartáveis e 4 pinças robóticas. Grampeamentos e colocação de clips ficaram a cargo do auxiliar, reduzindo o número de instrumentos robóticos utilizados, diminuindo assim o custo. Conclusão: Essa padronização ajuda a implementar programa robótico de gastrectomia na prática diária ou em uma instituição.


Subject(s)
Humans , Stomach Neoplasms/surgery , Surgical Instruments , Robotic Surgical Procedures/standards , Gastrectomy/standards , Reference Standards , Laparoscopy
10.
Article in Spanish | LILACS, BINACIS | ID: biblio-1146278

ABSTRACT

La artroscopía de rodilla es un procedimiento quirúrgico frecuente con baja incidencia de complicaciones. La rotura de instrumental y retención intraarticular del mismo son sumamente infrecuentes. Presentamos un caso de rotura por fatiga de una cánula de irrigación y retención intraarticular de parte de la misma en una paciente intervenida quirúrgicamente por una artroscopía de rodilla. En la bibliografía encontramos un solo caso similar. El fragmento presentaba bordes netos que impresionaban fatiga en zona de soldadura de fábrica. Es probable que la falla haya ocurrido durante una maniobra que se realiza "a ciegas" al final del procedimiento. Consideramos fundamental ser meticulosos en la supervisión del instrumental tanto antes como al final del procedimiento quirúrgico. En caso de encontrarnos con esta complicación, resolverla utilizando todas las herramientas al alcance. Nivel de evidencia: IV. Tipo de estudio: Reporte de caso


Subject(s)
Arthroscopy/adverse effects , Rupture , Surgical Instruments/adverse effects , Intraoperative Complications , Knee Joint/surgery
11.
Rev. Col. Bras. Cir ; 47: e20202435, 2020. tab, graf
Article in English | LILACS | ID: biblio-1136608

ABSTRACT

ABSTRACT Objective: Since its first report, video-assisted thoracic surgery (VATS) lung lobectomy was carried out with the use of conventional surgical instruments, used in laparoscopy and open thoracotomy. These instruments are expensive, not standardized and there are a variety of models and manufacturers. The aim of this study was to determine the impact of the use of these instruments on the experimental pulmonary lobectomy. Methods: We used a modified surgical simulator that uses a porcine heart-lung block filled with tomato sauce, and tested specific (Group 1) and regular (Group 2) instruments. Each group includes 15 experiments. Results: The median total time, excluding the time spent to correct the lesions, was 45.08 and 45.81 minutes, respectively in Group 1 and Group 2. There was no statistical difference between the total times (p=0.58). The only statistically different was seen for partial times regarding the elapsed time to cut and suture of lung fissures (p=0.03 and 0.04, respectively). There were more direct lesions and indirect leaks in Group 2, but without statistical significance (p=1.000 and p=0.203, respectively). The mean time spent for the diagnosis and correction of these events was 1.77 minutes with a standard deviation of 1.18 for Group 1 and 2.72 ± 1.11 minutes for Group 2 (p=0.044). Conclusion: The use of minimally invasive instruments is not associated with time improvement spent with experimental video-assisted lung lobectomy and does not lead to a faster or safer surgery. The use of VATS instruments makes correction of adverse events faster when they occur.


RESUMO Objetivo: desde os primeiros registros, a lobectomia pulmonar por cirurgia torácica videoassistida (CTVA) foi feita usando instrumentos convencionais e de laparoscopia. Recentemente instrumentais específicos para CTVA surgiram. Esses instrumentais têm custo elevado, não são padronizados existindo uma variedade de modelos e fabricantes. Buscou-se determinar o impacto do uso desses instrumentais na realização da lobectomia pulmonar superior esquerda experimental. Métodos: foi usado simulador modificado com bloco de coração-pulmões preenchidos com molho de tomate para testar o uso de instrumental dedicado de CTVA e de cirurgia convencional (Grupo 1 e Grupo 2, respectivamente). Cada grupo inclui 15 experimentos. Resultados: a mediana do tempo total, excluído o tempo para corrigir vazamentos, foi de 45,8 e 45,81 minutos, respectivamente para o Grupo 1 e Grupo 2. Não houve diferença estatisticamente significante entre os tempos totais (p=0,58). Os únicos tempos parciais estatisticamente diferentes foram os para cortar e suturar a fissura pulmonar (p=0,03 e 0,04, respectivamente). Ocorreram mais lesões diretas e vazamentos indiretos no Grupo 2, mas sem significância estatística (p=1,000 e 0,203, respectivamente). A média de tempo gasto para diagnosticar e corrigir os eventos de lesão e vazamento foi de 1,77 minutos com desvio padrão de 1,18 para o Grupo 1 e 2,72±1,11 minutos para o Grupo 2 (p=0,044). Conclusão: o uso de instrumentos para CTVA não torna a cirurgia mais rápida, nem mais segura. O uso de instrumentos de CTVA permitiu uma correção mais rápida dos eventos adversos ocorridos.


Subject(s)
Humans , Pneumonectomy/instrumentation , Surgical Instruments , Thoracotomy/instrumentation , Thoracic Surgery, Video-Assisted/instrumentation , Pneumonectomy/methods , Thoracotomy/methods , Thoracic Surgery, Video-Assisted/methods , Simulation Training/methods
12.
Rev. Col. Bras. Cir ; 47: e20202558, 2020. graf
Article in Portuguese | LILACS | ID: biblio-1136582

ABSTRACT

RESUMO A infecção pelo coronavírus determinante da doença COVID-19, também conhecida como SARS-COV2 foi classificada nos últimos meses como pandemia. Essa é potencialmente fatal, representando enorme problema de saúde mundial. A disseminação, após provável origem zoonótica na cidade de Wuhan, China, resultou em colapso do sistema de saúde de diversos países, alguns com enorme impacto social e número grande de mortes descritas na Itália e Espanha. Medidas extremas intra e extra-hospitalares têm sido implementadas a fim de conter a transmissão e disseminação da COVID-19. No âmbito cirúrgico, enorme quantidade de procedimentos considerados não essenciais ou eletivos foram prorrogados ou suspensos até resolução da pandemia. No entanto, cirurgias de urgência e oncológicas não permitem que o paciente espere. Nesta publicação, sugerimos e ensinamos adaptação a ser feita com materiais de uso corriqueiro em laparoscopias para evitar a contaminação ou a disseminação entre as equipes assistenciais e os pacientes.


ABSTRACT The coronavirus infection, also known as SARS-COV2, has proven to be potentially fatal, representing a major global health problem. Its spread after its origin in the city of Wuhan, China has resulted in a pandemic with the collapse of the health system in several countries, some with enormous social impact and expressive number of deaths as seen in Italy and Spain. Extreme intra and extra-hospital measures have been implemented to decrease the transmission and dissemination of the COVID-19. Regarding the surgical practice, a huge number of procedures considered non-essential or elective were cancelled and postponed until the pandemic is resolved. However, urgent and oncological procedures have been carried out. In this publication, we highlight and teach adaptations to be made with commonly used materials in laparoscopy to help prevent the spread and contamination of the healthcare team assisting surgical patients.


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Surgical Procedures, Operative/standards , Laparoscopy/methods , Coronavirus Infections/prevention & control , Aerosols/adverse effects , Pandemics/prevention & control , Robotic Surgical Procedures/methods , Operating Rooms/methods , Pneumoperitoneum, Artificial/standards , Protective Devices/standards , Surgical Instruments/standards , Punctures/methods , Disease Transmission, Infectious/prevention & control , Betacoronavirus , SARS-CoV-2 , COVID-19 , Intraoperative Period
13.
Prensa méd. argent ; 105(11): 775-782, dic2019. graf
Article in English | LILACS, BINACIS | ID: biblio-1049768

ABSTRACT

Antecedentes: En la cirugía video-laparoscópica, aparecieron nuevas complicaciones, donde se incluyen las relacionadas con las eventraciones de los orificios de los trocares (EOT). Objetivos: Observar la aparición de hernias a través de los orificios de los trocares en la cirugía video laparoscópica. Diseño: Prospectivo, protocolizado y cooperativo Lugar de aplicación: Servicio de Guardia del HNC. Clínica Privada Caraffa. Servicio de Cirugía General "Pablo Luis Mirizzi". HNC Material y Método: Entre diciembre de 2005 y diciembre del 2018 hemos intervenido quirúrgicamente 81 pacientes con EOT. 49 eran del sexo femenino y los 32 restantes del masculino con un promedio de 49, 05 de edad (rango: 25-85 años). En un primer grupo (no complicados), 62 de 73 pacientes presentaban tumor y dolor en la región umbilical y peri umbilical y los otros 11 con dolor y tumor en región epigástrica. Los 8 pacientes restantes que conforman el grupo II (complicados), ingresaron por un cuadro abdominal oclusivo. Resultados: En los pacientes no complicados, se decidió la reparación de la eventración mediante la utilización de una malla de polipropileno. Asimismo, en dos complicados se utilizó este procedimiento. Por otro lado, en el grupo complicado, una paciente presentaba una peritonitis fecal, donde se realizó una diversión de los cabos. En otro paciente, se realizó una resección intestinal. En los otros cuatro restantes, solamente se comprobó una necrosis de epiplón, el cual fue resecado. Conclusiones: A través de los años, con el incremento de los procedimientos laparoscópicos, ha comenzado a observarse un llamativo número de EOT.


Background: in surgery video-laparoscopic, appeared new complications, including those related to the port site incisional hernia (PIH). Objectives: Observe the emergence of hernias through the holes of trocars in the video laparoscopic surgery. Design: Prospective, cooperative and protocoled. Place of application: Emergency Room of the HNC. Private Clinic Caraffa. General Surgery Service. "Pablo Luis Mirizzi". HNC. Methods: Between December 2005 and December of 2018 we have intervened surgically 81 patients with PIH. 49 were female and the 32 remaining of the male with an average of 49.05 of age (range: 25-85 years). In the first group (No complicated), 62 of 73 patients showed tumour and pain in the umbilical region and perumbilical and the other 11 with pain and tumour in epigastric region. The 8 remaining patients comprising Group II (Complicated), were by an occlusive abdominal picture. Results: In uncomplicated patients (Group I), it was decided to repair of PIH using a polypropylene mesh. In addition, this procedure was used in two complicated. On the other hand, the complicated group (Group II), a patient presented a faecal peritonitis, which was a fun of los capes. In another patient, was a bowel Resection. The other four remaining, only found a necrosis of omentum, which was resected. Conclusions: Through the years, with the increase in laparoscopic procedures, it has begun to observe a striking number of PIH.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Surgical Instruments , Surgical Mesh , Case-Control Studies , Laparoscopy , Video-Assisted Surgery , Hernia, Abdominal/complications
14.
Rev. bras. cir. plást ; 34(3): 384-390, jul.-sep. 2019. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1047160

ABSTRACT

Introdução: O tratamento de grandes e médias feridas é um desafio para os cirurgiões quando precisam fechálas e, normalmente, são utilizadas técnicas cirúrgicas de enxertias ou retalhos, que podem deixar sequelas e até mesmo mutilações. Ao longo do tempo desenvolveu-se a técnica de "sutura elástica" que promove a cicatrização em curto espaço de tempo com sequelas menores, entretanto o procedimento tem sido realizado com material improvisado. Objetivo: Desenvolver um fio de sutura elástico cirúrgico que possa ser esterilizado e confeccionado nos moldes dos produtos médicos cirúrgicos. Métodos: Revisão das patentes existentes por meio da busca de anterioridade e comparação com o dispositivo do estudo. Pesquisa de materiais com as características necessárias como elasticidade e tensão. Teste destas características em laboratórios especializados. Resultados: O produto desenvolvido é um fio elástico com duplo agulhamento para suturas, com matéria prima de silicone que apresenta elasticidade e resistência a tensão. Conclusão: O fio de sutura elástico, com duplo agulhamento, para feridas de médio e grande porte foi desenvolvido.


Introduction: Closing large and medium wounds is challenging for surgeons and often leads to the use of graft or flap surgical techniques. These procedures can leave sequelae and even mutilations. An "elastic suture" technique was developed to promote wound healing in a short time span with minor sequelae; however, improvised materials have been used in this procedure. Objective: To develop a surgical elastic suture thread that can be manufactured and sterilized following the standards of surgical medical products. Methods: We conducted a patent search, compared the findings with the study device, and researched materials with necessary characteristics such as elasticity and tension. Testing these characteristics in specialized laboratories. Results: The developed device is a double-needled elastic suture made of silicone that presents tensile strength. Conclusion: Here, we developed a double-needled elastic suture for medium and large wounds.


Subject(s)
Humans , History, 21st Century , Surgery, Plastic , Surgical Instruments , Sutures/standards , Wound Healing , Suture Techniques/instrumentation , Wound Closure Techniques , Surgery, Plastic/instrumentation , Surgery, Plastic/methods , Surgical Instruments/standards , Sutures , Wound Healing/ethics , Wounds and Injuries , Wound Closure Techniques/instrumentation
15.
Rev. SOBECC ; 24(2): 107-114, abr-.jun.2019.
Article in Portuguese | LILACS, BDENF | ID: biblio-1006177

ABSTRACT

Objetivo: Descrever as etapas de desenvolvimento e avaliação da estrutura informatizada para processamento de bandejas cirúrgicas na área de preparo do centro de material e esterilização. Método: Trata-se de um projeto de desenvolvimento de produção tecnológica embasada na teoria de "ciclo de vida do sistema". Resultados: A estrutura foi criada utilizando formulários e planilhas do Google Apps. Os formulários foram desenvolvidos com base na coleta de informações das referências gravadas nos instrumentais, consulta ao nome correto nos catálogos dos fabricantes e registros fotográficos de detalhes das peças. Foi realizada a avaliação pelos colaboradores, e foram feitas as alterações sugeridas pelos mesmos. Os formulários permitiram identificar o nome do instrumental e a referência do fabricante e acessar as fotos dos materiais, o que passou a gerar planilhas que permitiram a rastreabilidade e o gerenciamento dos materiais cirúrgicos. Conclusão: A informatização do preparo das bandejas de cirurgia minimamente invasiva contribuiu para o preparo de maneira fácil, intuitiva e de forma rastreável. A tecnologia pode otimizar o tempo de assistência do enfermeiro do centro de material e esterilização com as questões relacionadas ao planejamento das ações gerenciais e à rastreabilidade dos processos.


Objective: To describe the stages of development and evaluation of the computerized structure for the processing of surgical trays processing at the preparation room of the central sterile services department (CSSD). Method: This is a technological production development project based on the "system life cycle" theory. Results: The structure was created using Google Apps forms and spreadsheets. The forms were developed based on the collection of information from references recorded in the surgical instruments, and checking of correct names in manufacturers' catalogs and photographic records of details of the parts. The evaluation was performed by the employees, and changes suggested by them were applied. The forms allowed to identify the name each surgical instrument and the manufacturer's reference, and to access the photos of materials, which was input to spreadsheets that allowed the keeping track of and managing surgical instruments. Conclusion: The computerization of the process of preparation of minimally invasive surgery trays made it easier, more intuitive and traceable. Technology can optimize the nursing care time at the CSSD in what concerns the planning of actions and the keeping track of procedures


Objetivo: Describir las etapas de desarrollo y evaluación de la estructura informatizada para el procesamiento de bandejas quirúrgicas en el área de preparación del centro de material y esterilización. Método: Se trata de un proyecto de desarrollo de producción tecnológica basada en la teoría de "ciclo de vida del sistema". Resultados: La estructura se creó utilizando formularios y hojas de cálculo de Google Apps. Los formularios fueron desarrollados en base a la recolección de informaciones de las referencias grabadas en los instrumentos, consulta al nombre correcto en los catálogos de los fabricantes y registros fotográficos de detalles de las piezas. Se realizó la evaluación por los colaboradores, y se efectuaron las alteraciones sugeridas por los colaboradores. Los formularios permitieron identificar el nombre del instrumental y la referencia del fabricante y acceder a las fotos de los materiales, lo que pasó a generar hojas que permitieron la trazabilidad y la gestión de los materiales quirúrgicos. Conclusión: La informatización de la preparación de las bandejas de cirugía mínimamente invasiva contribuyó a la preparación de manera fácil, intuitiva y de forma rastreable. La tecnología puede optimizar el tiempo de asistencia del enfermero del centro de material y esterilización con las cuestiones relacionadas con la planificación de las acciones gerenciales y la trazabilidad de los procesos


Subject(s)
Humans , Information Systems , Ambulatory Surgical Procedures , Surgical Instruments , Sterilization
16.
Article in Chinese | WPRIM | ID: wpr-772492

ABSTRACT

Laparoscopic surgery based on magnetic anchor technique has great potential for further minimally invasive surgery and good surgical field exposure, in which the internal grasper is the key factor. In this paper, an internal grasper based on magnetic anchor laparoscopic surgery is designed, which consists of three parts:target magnet, connection module and tissue forceps. The magnetic shield shell is used to wrap the magnetic core in the target magnet, which not only can increase the magnetic force in the working area, but also reduce the magnetic interference between the instruments, and the connecting module can flexibly adjust the length of the internal grasper. The special structure of tissue gripper can effectively reduce deputy injury and facilitate the replacement of clamp position. It has many advantages, such as ingenious design, easy processing, simple operation and wide range of application, which greatly increased its clinical application value.


Subject(s)
Equipment Design , Laparoscopy , Magnetics , Magnets , Surgical Instruments
17.
Article in Chinese | WPRIM | ID: wpr-772484

ABSTRACT

This article first introduces the regulation requirements for sterilization material in the registration evaluation of sterile medical devices. Secondly, the article chooses the suture passer set kit with multiple sterilization methods as an example product for technical evaluation. The article hopes to provide a reference for the applicant who prepare the registration material and the technical evaluators how to make the evaluation for the medical device registration.


Subject(s)
Sterilization , Surgical Instruments
18.
Article in English | WPRIM | ID: wpr-786620

ABSTRACT

A subepithelial tumor-like esophageal carcinoma is rare. We report a case of an esophageal squamous cell carcinoma with lymph node metastasis presenting as a small subepithelial tumor. A 68-year-old man presented to our hospital complaining of hoarseness since last three months. Endoscopic examination revealed a 1 cm hard and fixed subepithelial tumor with surface erosion in the lower esophagus. A biopsy specimen was obtained using conventional forceps, and histopathological evaluation revealed few atypical squamous epithelial cells. Subsequent EUS demonstrated a homogeneous hypoechoic lesion in the deep mucosal layer. A CT scan of the chest showed a 3 cm mass in the right upper paratracheal area. EUS-guided fine needle biopsy of the lesion led to the diagnosis of squamous cell carcinoma with lymph node metastasis.


Subject(s)
Aged , Biopsy , Biopsy, Fine-Needle , Carcinoma, Squamous Cell , Diagnosis , Endosonography , Epithelial Cells , Esophageal Neoplasms , Esophagus , Hoarseness , Humans , Lymph Nodes , Neoplasm Metastasis , Surgical Instruments , Thorax , Tomography, X-Ray Computed
19.
Article in Korean | WPRIM | ID: wpr-786349

ABSTRACT

The accurate diagnosis of pancreatic cystic lesions (PCLs) is important because they determine the strategy of treatment or follow-up. Endoscopic ultrasound (EUS) has been widely used in diagnosis and treatment of PCLs. EUS can be used to obtain additional information in the case of an indeterminate cyst on computed tomography or magnetic resonance imaging, or in case of showing a worrisome feature. Contrast-enhanced EUS showed highly accurate for differential diagnosing of non-neoplastic cysts from neoplastic cyst, and it also useful for distinguishing mural nodules from mucin. EUS-guided fine needle aspiration can be used to analyze cytology, chemistry, and molecular markers in cystic fluid if there is insufficient evidence for the diagnosis by non-invasive modalities. Needle-based confocal laser endomicroscopy allows real time diagnosis of PCLs with good accuracy during EUS-guided fine needle aspiration by subcellular level imaging. Through-the-needle cystoscopy or through-the-needle forceps biopsy are also attempted in these days but the evidence for its effectiveness is insufficient. EUS-guided ablation procedures are emerging as a minimally invasive therapeutic methods for unmet needs in dichotomous treatment policy for PCLs. Large long-term follow-up observational studies have been reported on the feasibility and efficacy of EUS-guided ablation for PCLs with ethanol or in combination with chemoagent. Further study for the actual treatment effects or real clinical benefit would be needed. The use of EUS in the diagnosis and treatment of PCLs is expected to make much progress in the future.


Subject(s)
Biopsy , Biopsy, Fine-Needle , Chemistry , Cystoscopy , Diagnosis , Endosonography , Ethanol , Follow-Up Studies , Magnetic Resonance Imaging , Mucins , Pancreatic Cyst , Surgical Instruments , Ultrasonography
20.
Article in English | WPRIM | ID: wpr-786155

ABSTRACT

Maxillary sinus floor augmentation (MSFA) is an essential procedure for implant installation in the posterior maxillary area with vertical alveolar bone deficiency. For the past several decades, MSFA has been refined in terms of surgical methods along with technical progress, accumulation of clinical studies, and development of graft materials and surgical instruments. Although some complications in MSFA are inevitable in clinical situations, management of those complications in MSFA has been well established thanks to many clinicians and researchers. Nevertheless, some rare complications may arise and can result in fatal results. Therefore, clinicians should be well aware of such rare situations and complications associated with MSFA. In this review, the authors present several rare complications regarding MSFA, along with corresponding management strategies through a thorough review of the literature.


Subject(s)
Maxillary Sinus , Sinus Floor Augmentation , Surgical Instruments , Transplants
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