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Intervention: Nanotechnology in Reconstructive Intervention and Surgery
Published in Harry F. Tibbals, Medical Nanotechnology and Nanomedicine, 2017
Laparoscopic surgery is performed by making small incisions and inserting and manipulating surgical instruments through the openings, without the necessity of cutting an incision large enough for the surgeon’s hands or exposing the organs (laparotomy) [60-62]. Endoscopic surgery combines endoscopy with laparoscopic surgery [63]. Historically, laparoscopic surgery originated with fishing for bullets or shrapnel without the aid of imaging or endoscopy. Laparoscopic surgery can be performed today by using x-ray or MRI to guide the surgeon in real time, or by stereotaxy, using images obtained in advance, combined with stereotaxic fixtures to maintain accurate positioning and guidance of the surgical probes.
Simulation of non-Newtonian flow of blood in a modified laparoscopic forceps used in minimally invasive surgery
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Md. Abdul Raheem Junaidi, Harsha Sista, Ram Chandra Murthy Kalluri, Y. V. Daseswara Rao, Alla Gopala Krishna Gokhale
There has been a significant development in the field of surgery over the last few years to facilitate and improve surgeons' performance and patients' safety. Earlier, surgeons used to perform laparotomy procedures by cutting the abdominal cavity wide open, to view the internal organs directly. This often requires a big incision of about 100 mm in length (Buia et al. 2015). Laparoscopic procedure, on the other hand, is a minimally invasive surgery (MIS) used by surgeons to operate upon the abdominal cavity by viewing the internal organs through a monitor. Depending on the type of surgery, up to four small incisions of less than 10 mm are made in the abdomen through which instruments like a laparoscope, dissector forceps, and suction–irrigation (S–I) device are inserted. A laparoscope is a 330 mm long device with a high-resolution camera used for viewing organs in the abdominal cavity. The dissector forceps is used for grasping and dissecting the infected tissue. The S–I process is used to clean and disinfect the abdominal cavity to enable safe and efficient surgical intervention. This is done by sucking out blood and other body fluids and irrigating with a disinfectant such as saline water. S–I instruments must be sterilized properly to avoid the clotting of blood and trapping of tissue inside it. Some advantages of the laparoscopic procedures include minimal scarring, less trauma, less post-operative pain, less chances of infection to patients and surgeons, reduced duration of stay in the hospital, and faster recovery time (Chambers et al. 2011; Li 2011; Santos et al. 2011; Zhu et al. 2017).
Clinical role of fluorescence imaging in colorectal surgery - an updated review
Published in Expert Review of Medical Devices, 2020
Amandeep Ghuman, Sandra Kavalukas, Stephen P. Sharp, Steven D. Wexner
After intravenous injection of ICG, the compound is bound by serum proteins after which it can permeate the endothelial lining and is retained in cancer tissue due to impaired lymphatic drainage from the lesion. This phenomenon has been described as enhanced permeability and retention (EPR) [44]. ICG injection at the time of HIPEC for colorectal surgery has been investigated as a means of identifying metastatic disease or undetected tumor implants. When given for this purpose, a mean time of 50 mins has been reported until detection [45]. Liberale et al. performed intraoperative ICG detection during laparotomy for HIPEC, finding that in 29% of patients, the surgery was modified by the detection of additional peritoneal implants otherwise not found using white light visualization and palpation [46]. Another study found a significant increase in the median Peritoneal Cancer Index (PCI) score, from 7 to 10 after ICG guided imaging [45] The authors reported the sensitivity of detecting implants went from 76.9% with the conventional diagnostic procedures and 96.9% with use of ICG guided imaging. Use of fluorescence imaging with tumor-targeted antibodies like the endoscopic method described above are being investigated with many types of tumors.
Medical textiles
Published in Textile Progress, 2020
In gastrointestinal surgery, a Cochrane Review assessed the best way of closing a laparotomy wound. The review asked the question ‘does the type of suture material, or type of closure prevent complications?’ With regard to sutures, there was no difference at one year or more of follow up of the incidence of incisional hernia between absorbable and non-absorbable sutures. Nor was there any difference in risk of wound infection. However, absorbable sutures did reduce the risk of sinus or fistula tract formation when compared to non-absorbable sutures and the review suggested that absorbable sutures could be used to reduce the risk of chronic drainage from the wound and monofilament sutures considered for abdominal closure to reduce the risk of incisional hernia [323]. For obstetrics, a Cochrane Review assessed the role of absorbable sutures for repair of perineal damage at the time of childbirth. Women stitched with synthetic materials had less pain in the first three days after delivery and required fewer pain-relieving drugs in the 10 days after giving birth compared to those stitched with catgut. However, there was evidence that synthetic sutures were not always readily absorbed and some women required the sutures to be removed [324].