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Published in Charles E. Carraher, Carraher's Polymer Chemistry, 2017
Isotactic polypropylene is employed as a suture material. It is extruded as a monofilament. Tissue reaction is minimal and, in vivo, it offers outstanding stability, making it a good candidate when permanent support is needed. It resists repeated bending over a long time period, retains good strength, offers minimal rejection, and good controlled elongation, making it a suture of choice for cardiovascular and cuticular applications. It also offers minimal resistance or drag as it is moved through tissues, creating a minimal of tear and tissue dragging. It provides good knot security. It is also used in plastic reconstruction, gynecology and obstetrics, orthopedics, and general surgery.
Observing and Assessing Surgical Teams: The Observational Teamwork Assessment for Surgery© (OTAS)©
Published in Rhona Flin, Lucy Mitchell, Safer Surgery, 2009
Shabnam Undre, Nick Sevdalis, Charles Vincent
The study also aimed to compare general surgery with urology elective procedures. As in the previous study, care was taken to inform staff about the study and to reassure them that data would be used for research purposes only.
Innovative Photodynamic Therapy at the National Cancer Institute: Intraoperative, Intracavitary Treatment
Published in Barbara W. Henderson, Thomas J. Dougherty, Photodynamic Therapy, 2020
Harvey I. Pass, Thomas F. DeLaney
After the previously described in vitro, small- and large-animal experiments were completed, a Phase I study evaluating the technical capability to deliver PDT to the peritoneal cavity, at the time of laparotomy with maximal cytoreductive surgery, was performed. The chief purpose of this program was to assess the maximum tolerated dose of PDT that could be safely employed, in the hopes of future designs for a Phase II efficacy trial. Eligible patients included those with intraperitoneal tumor that had recurred after conventional treatment with surgery, chemotherapy, or radiation therapy, or a combination thereof. Eligibility requirements included disease confined to the abdomen, ability to tolerate general surgery and anesthesia, no medical contraindications to receiving hematoporphyrin derivative sensitizer (porphyria, cirrhosis, or major liver dysfunction), and a preoperative evaluation that indicated the tumor could be resected to less than 5-mm thickness. Laparotomy is performed under filtered, operating room lights, with resection of all tumor possible to leave residual disease of less than 5-mm thickness. For several patients, this has necessitated bowel resection with reanastamosis. The 630-nm light was delivered to the peritoneal surface using one or two sterile 600-μm optical fibers, with a 1.0 to 1.5- cm cylindrical light-diffusing tip, within a sterile endotracheal tube (Shiley, size 8, low-pressure cuff, outer diameter 10.9 mm, Shiley, Inc., Irvine, California) [12]. The sterile optical fiber is coupled to a transmission fiber from the dye laser. The optical fiber is secured within the endotracheal tube by specially machined O-rings (Frank Harrington, NCI). The distal beveled end of the endotracheal tube is cut perpendicularly and capped so that a dilute lipid solution can be instilled within the endotracheal tube for light need dispersion. The end of the endotracheal tube is capped so that the lipid solution will not leak out. The cuff of the endotracheal tube is inflated with the dilute lipid solution, and this then functions like a bulb illuminator. The sterile optical fiber-endotracheal tube system permits high-power light delivery while protecting intra-abdominal organs from physical and thermal injury from the tip of the optical fibers. Total power delivery with one or two lasers has ranged from 1.1 to 7 W.
Spatial access to Emergency General Surgery (EGS) services and EGS bypass behaviours in California
Published in Annals of GIS, 2023
Jiuying Han, Neng Wan, Simon C. Brewer, Marta McCrum
Emergency General Surgery (EGS) represents a heterogeneous group of surgical conditions that require ‘emergent surgical evaluation (operative or non-operative) for diseases within the realm of general surgery as defined by the American Board of Surgery’ (Shafi et al. 2013). This includes conditions such as appendicitis, diverticulitis and bowel obstruction. There are nearly 3 million patients in the United States admitted with an EGS condition annually, exceeding other public health problems, such as newly diagnosed cancers or new onset diabetes (Becher et al. 2018). Moreover, EGS represents a high-risk patient population with up to eight times higher mortality compared to patients who undergo similar elective operations (Scott et al. 2018). The high burden of disease and mortality rate suggests an urgent need for improving EGS health care services.
Development of AR training systems for Humanitude dementia care
Published in Advanced Robotics, 2022
Ryo Kurazume, Tomoki Hiramatsu, Masaya Kamei, Daiji Inoue, Akihiro Kawamura, Shoko Miyauchi, Qi An
To date, various training systems for care and rehabilitation techniques using robot technology have been proposed [11–17]. In addition, AR or VR technologies have also been used for medical, nursing, and care training. An early survey regarding the use of VR in healthcare education and training was presented in [18]. A recent survey of VR-based nursing education can be found in [19]. In medical training, surgical training simulators using VR systems have been widely adopted [20]. For example, the NeuroTouch VR neurosurgery simulator [21] provides haptic feedback with visual information and enables simulation of tumor-debulking tasks. Several VR simulators have been developed for the education of laparoscopic and endoscopic surgery. LapSim (Surgical Science) [22], MIST (Mentice) [23], LAP Menter (Simbionix) [24], CAE LapVR (CAE Healthcare) [25], and LAP-X (MEDICAL-X) [26] are commercial VR simulators. In particular, the LAP Mentor includes over 65 cases in the fields of general surgery, gynecology, urology, and bariatric surgery.
The role of robotic technology in minimally invasive surgery for mitral valve disease
Published in Expert Review of Medical Devices, 2021
Johannes Bonatti, Bob Kiaii, Cem Alhan, Stepan Cerny, Gianluca Torregrossa, Gianluigi Bisleri, Caroline Komlo, T. Sloane Guy
As a new generation of cardiac surgeons which is open to digital and robotic technology is being trained and as robotic surgeons are moving up into leadership ranks it can be expected that robotic mitral valve surgery will become routine and an integral part of OR schedules at an increasing number of heart surgery units. There is already a trend visible that major cardiothoracic surgery societies like the STS, the AATS, and ISMICS are fully embracing robotic techniques. The AATS and STS are offering official fellowships, the STS conducts courses on robotic heart surgery, and ISMICS which has promoted robotics for years has released an official statement to support robotic cardiothoracic surgery [63]. Official robotic surgery task forces were implemented by the latter two societies. If this trend holds other large scientific associations will integrate the topic of robotics and issue official training certificates for heart surgeons. As simulation is an indispensable component of training refined simulation modules will have to be developed. Virtual whole procedure modules do already exist for urology, gynecology, general surgery, and thoracic surgery. One important next step for cardiac surgery during the next five years is therefore to offer such tools in order to dampen learning curves in robotic mitral valve surgery.