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Results 41 through 60 out of 103

in category surgery


41: Seeing the light: Improving the usability of fluorescence-guided surgery by adding an optimized secondary light source

Jonathan T. Elliott, Dennis J. Wirth et al.

359 downloads (posted 12 Mar 2020)

BackgroundTumors that take up and metabolize 5-aminolevulinic acid (5-AlA) emit bright pink fluorescence when illuminated with blue light, aiding surgeons in identifying the margin of resection. The adoption of this method is hindered by the blue light illumination, which is too dim to safely operate under, and therefore, necessitates switching back and forth from white-light mode. This paper examines the addition of an optimized secondary illuminant adapter (SIA) to improve usability of blue-light mode without degrading tumor contrast. MethodsWe used color science methods to evaluate the color of the secondary illuminant and its impact on color rendering index (CRI) as well as the tumor-to-background color contrast (TBCC). A secondary illuminant adapter was built to provide 475-600 nm light the intensity of which can be controlled by the surgeon and was evaluated in two patients. ResultsSecondary illuminant color had opposing effects on color rendering index (CRI) and tumor to background color contrast (TBCC); providing surgeon control of intensity allows this trade-off to be balanced in real-time. Experience in two cases suggests additional visibility adds value. ConclusionThe addition of a secondary illuminant may mitigate surgeon complaints that the operative field is too dark under the blue light illumination required for 5-ALA fluorescence guidance by providing improved CRI without completely sacrificing TBCC.


42: Impacts on Surgery Resident Education at a first wave COVID-19 epicenter

Alexander Ostapenko, Samantha McPeck et al.

352 downloads (posted 18 Aug 2020)

Background: This study aims to identify the effects of the COVID-19 pandemic on surgical resident training and education at Danbury Hospital. Methods: We conducted an observational study at a Western Connecticut hospital heavily affected by the first wave of the COVID-19 pandemic to assess its effects on surgical residents, focusing on surgical education, clinical experience, and operative skills development. Objective data was available through recorded work hours, case logs, and formal didactics. In addition, we creat...


43: Open and laparoscopic surgeries are associated with comparable 90 day morbidities and mortalities following ERAS protocols- A retrospective Study.

BHAVIN VASAVADA, hardik patel

351 downloads (posted 10 Apr 2020)

IntroductionAim of study to evaluate 90 days mortality and morbidity after ERAS protocol and also weather there is any difference in morbidity and mortality between Open and Laparoscopic surgeries. Material and MethodsAll the gastrointestinal surgeries performed between April 2016 to march 2019 in our institution have been analysed for morbidity and mortality after ERAS protocols and data was collected prospectively. ResultsWe performed 245 gastrointestinal and hepato-biliary surgeries between April 2016 to march 2019...


44: Risk Factors for Clinically Relevant Postoperative Pancreatic Fistula (CR-POPF) after Distal Pancreatectomy: A Single Center Experience

Gao Qing Wang, Dipesh K Yadav et al.

350 downloads (posted 08 May 2020)

Clinically relevant postoperative pancreatic fistula (CR-POPF) is the considerable contributor to major complications after pancreatectomy. The purpose of this study was to evaluate the potential risk factor contributing to CR-POPF following distal pancreatectomy (DP) and discussed the risk factors of pancreatic fistula in order to interpret the clinical importance. All the patients who underwent DP in between January 2011 and January 2020 were reviewed retrospectively in accordance with relevant guidelines and regulati...


45: A prospective study to identify rates of SARS-CoV-2 virus in the peritoneum and lower genital tract of patients having surgery

Dominique Jones, David Faluyi et al.

349 downloads (posted 01 Aug 2020)

Introduction The risks to surgeons of carrying out aerosol generating procedures during the COVID pandemic are unknown. To start to define these risks, in a systematic manner, we investigated the presence of SARS-CoV-2 virus in the abdominal fluid and lower genital tract of patients undergoing surgery. Methods We carried out a prospective cross sectional observational study of 113 patients undergoing abdominal surgery or instrumentation of the lower genital tract. We took COVID swabs from the peritoneal cavity and from ...


46: Protocol for Project Recovery: Cardiac Surgery - Leveraging Digital Platform for Efficient Collection of Longitudinal Patient-Reported Outcome Data Towards Improving Postoperative Recovery

Makoto Mori, Cornell Brooks et al.

349 downloads (posted 16 Jan 2020)

IntroductionImproving postoperative patient recovery after cardiac surgery is a priority, but our current understanding of individual variations in recovery and factors associated with poor recovery is limited. We are using a health-information exchange platform to collect patient-reported outcome measures (PROMs) and wearable device data to phenotype recovery patterns in the 30-day period after cardiac surgery hospital discharge, to identify factors associated with these phenotypes and to investigate phenotype associat...


47: A new ischemic grading system to aid combat extremity vascular injury decision making

Amila S. Ratnayake, Viktor A Reva et al.

346 downloads (posted 07 Aug 2020)

Abstract Introduction In resource limited combat settings with frequent encounters of mass casualty incidents, the decision to attempt limb salvage versus primary amputation is refined over time based on experience. This experience can be augmented by grading systems and algorithms to assist in clinical decisions. Few investigators have attempted to explicitly grade limb ischemia according to clinical criteria and study the impact of limb ischemia on clinical outcome. We suggest a new ischemia grading system based on th...


48: Extrafascial transfissural approach with finger fracture technique approach for liver resection.Old is still gold?

BHAVIN VASAVADA, hardik patel

345 downloads (posted 10 Apr 2020)

Background: Background: We evaluated our protocol of extrafascial transfissural approach for liver resection with intrafascial approach that we use in case of donor hepatectomy. Material and Method: We use extrafascial transfissural approach with finger fracture technique for liver resections and inftrafascial approach with clamp crush technique in case of donor hepatectomy. Major hepatectomy defined as resection of 2 or more adjacent segments.We compared these two techniques with regard to blood loss, operative time, m...


49: Use of the Spatial Access Ratio to Measure Geospatial Access to Emergency Surgical Services in California

Marta L. McCrum, Neng Wan et al.

341 downloads (posted 29 May 2020)

Background: Emergency general surgery (EGS) diseases carry a substantial public health burden, accounting for over 3 million admissions annually. Due to their time-sensitive nature, ensuring adequate access to EGS services is critical for reducing patient morbidity and mortality. Travel-time alone, without consideration of resource supply and demand, may be insufficient to determine a regional health care system's ability to provide timely access to EGS care. Spatial Access Ratio (SPAR) incorporates travel-time, as well...


50: Fully Automated Delineation of the Optic Radiation for Surgical Planning using Clinically Accessible Sequences

Lee B. Reid, Eloy Martínez-Heras et al.

339 downloads (posted 18 Jul 2020)

Quadrantanopia caused by inadvertent severing of Meyer's Loop of the optic radiation is a well-recognised complication of temporal lobectomy for conditions such as epilepsy. Dissection studies indicate that the anterior extent of Meyer's Loop varies considerably between individuals. Quantifying this for individual patients is thus an important step to improve the safety profile of temporal lobectomies. Previous attempts to delineate Meyer's Loop using diffusion MRI tractography have had difficulty estimating its full an...


51: COVID-19: how the pandemic impacted the emergency department and urgent surgical activity in a medium-size Italian hospital.

Enrico Pinotti, Francesca Carissimi et al.

338 downloads (posted 20 Nov 2020)

BackgroundsCOVID-19 has grown rapidly in Lombardy, particularly in the province of Bergamo. To deal with the pressure the pandemic has exerted on the Italian health system; many hospitals have had to reorganize their medical and surgical activities. The aim of this study was to evaluate how the pandemic influenced the emergency department and urgent surgical activity in a medium-size hospital in the province of Bergamo. MethodsIn this retrospective observational study, we analyzed the number of admissions to the medica...



David Mansouri, Stephen T McSorley et al.

338 downloads (posted 17 Aug 2020)

Introduction Around 40% of patients who attend for colonoscopy following a positive stool screening test have adenomatous polyps. Identifying which patients have a higher propensity for malignant transformation is currently poorly understood. The aim of the present study was to assess whether the type and intensity of inflammatory infiltrate differs between high-grade (HGD) and low-grade dysplastic (LGD) screen detected adenomas. Methods A representative sample of 207 polyps from 134 individuals were included from a dat...


53: Protection of health care workers from exhaled air of patients operated under local, regional, spinal or epidural anaesthesia during COVID 19 pandemic

Kuldeep Atodaria, Mayank Singh et al.

336 downloads (posted 02 Dec 2020)

The SARS-CoV-2 (COVID-19) pandemic mandates the use of N-95/FFP-2 masks for healthcare workers, especially in operation room (OR) for surgical or aerosol producing pro-cedures. During pandemic, surgical interventions such as limb trauma, limb amputations, and limb malignancies continued to flow into the hospitals and are normally performed un-der local, regional or spinal anaesthesia. N-95/FFP-2 masks normally do not prevent escape of exhaled air to surrounding and to avoid the escape of exhaled unfiltered air, sealing ...


54: Titanium Fasteners In Endoscopic Mitral Valve Surgery

Rafik Margaryan, Giacomo Bianchi et al.

330 downloads (posted 05 Jun 2020)

Objective We sought to review our experience of new titanium knot fastener devices. We hypothesized that it might reduce the cardiop-polmonary bypass time, aortic cross-clamping time and intervention time. Materials We reviewed our electronic records in order identify the patients who underwent mitral valve (MV) repair and replacement in totally endoscopic setup. Surgical approach was trough limited right periareolar or inframmamary thoracotomy with mainly femoro-femoral arterio-venous cannulation. A part of patients un...


55: An effect of the COVID-19 pandemic: significantly more complicated appendicitis due to delayed presentation of patients!

Marie Burgard, Floryn Cherbanyk et al.

325 downloads (posted 25 Jan 2021)

AIMS OF THE STUDY: The novel coronavirus pandemic has affected emergency department consultations for surgical pathologies. The aim of our study was to compare the number of acute appendicitis cases and the proportion of complicated appendicitis before and during the COVID 19 pandemic. METHODS: We retrospectively analyzed all data collected from a multicenter database of patients presenting to the emergency department for acute appendicitis during the COVID-19 pandemic from March 12 to June 6, 2020, and compared these d...


56: Safety and efficacy of three-cavity clearance in the management of cryptoglandular perianal abscess: A multicentre randomized controlled study

xinyi zhang, Chen cheng et al.

322 downloads (posted 15 Apr 2020)

OBJECTIVE: To evaluate the safety and efficacy of three-cavity clearance in the management of cryptoglandular perianal abscess. METHOD: This was a multicentre randomized controlled study. The study was designed and approved by the ethics committee of the Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine. The study was registered in the Chinese Clinical Trial Register centre (ChiCTR1800016958).Patients with cryptoglandular perianal abscess in 5 Hospitals from Sept.2018 to Sept. 2019 were in...


57: Surgical activity in England and Wales during the COVID-19 pandemic: a nationwide observational cohort study

T. D. Dobbs, J A G Gibson et al.

320 downloads (posted 01 Mar 2021)

ObjectivesTo report the volume of surgical activity and the number of cancelled surgical procedures during the COVID-19 pandemic. Design and settingAnalysis of electronic health record data from the National Health Service (NHS) in England and Wales. MethodsWe used hospital episode statistics for all adult patients undergoing surgery between 1st January 2020 and 31st December 2020. We identified surgical procedures using a previously published list of procedure codes. Procedures were stratified by urgency of surgery a...


58: The Role of Social Media in Disseminating Plastic Surgery Research: The Relationship between Citations, Altmetrics and Article Characteristics

Michael C Grant, Ryckie G Wade et al.

318 downloads (posted 01 Sep 2020)

Background: Social media (SoMe) enables publishers and authors to disseminate content immediately and directly to interested end-users, on a global scale. Alternative metrics (altmetrics) are non-traditional bibliometrics which describe the exposure and impact of an article on freely available platforms such as Twitter, Facebook, Wikipedia and the news. Altmetrics are strongly associated with ultimate citation counts in various medical disciplines, except plastic surgery which represents the rational for this study. Met...


59: The impact of patient body mass index on surgeon posture during simulated laparoscopy

Ryan Sers, Massimiliano Zecca et al.

314 downloads (posted 27 Nov 2020)

Laparoscopy is a cornerstone of modern surgical care. Despite clear advantages for the patients, it has been associated with inducing upper body musculoskeletal disorders amongst surgeons due to the propensity of non-neutral postures. Furthermore, there is a perception that patients with obesity exacerbate these factors. Therefore, novice, intermediate and expert surgeon upper body posture was objectively quantified using inertial measurement units and the LUBA ergonomic framework was used to assess the subsequent postu...


60: Impact of bariatric surgery on multiple health outcomes:a protocol for umbrella review of systematic review and meta-analysis.

Min Seo Kim, Jong Yeob Kim et al.

312 downloads (posted 25 Aug 2020)

The number of bariatric surgery rises as the prevalence of obesity and metabolic comorbidities consistently increases[1]. Although bariatric surgery was originally developed for glycemic control and weight reduction, increasing evidence suggested extra-metabolic health outcomes are followed by bariatric surgery; incidences on diverse types of cancer[2], perinatal outcomes[3], sexual function[4], and even degree of physical activity[5] are known to be altered after bariatric surgery. We aim to conduct umbrella review for...