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Care of the Obese Trauma Patient
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
The operating table load is not normally a problem since most modern tables can take up to 320 kg. However, side supports and leg gutters are required to ensure the patient does not move during tilting. Obesity means that any surgery is technically more demanding, the procedure may take longer, and blood loss may be greater.
Microsurgery and Orthopedic Animal Models
Published in Yuehuei H. An, Richard J. Friedman, Animal Models in Orthopaedic Research, 2020
A normal operating room for animal surgery should be equipped with an operating microscope. A steady and adjustable operating table is ideal. The housing facility needs to be equipped with intensive monitoring devices such as a skin thermometer and a Doppler vessel blood flow monitor. A qualified full-time technical assistant is necessary to achieve optimal postoperative care and monitoring of the animals.
Other Support Surfaces
Published in J G Webster, Prevention of Pressure Sores, 2019
In order to accommodate the optimal surgical access and to obtain proper physical support, the operating table is adjusted to various surgical positions. The specific weight-bearing regions are at risk of pressure sore formation. In fact, the standard operating table that is constructed with a 25–50 mm foam mattress offers little protection to anesthetized patients.
The upside-down anatomy: perspectives from cranial neurosurgery
Published in British Journal of Neurosurgery, 2022
Samer S. Hoz, Fatimah Oday Ahmed, Zahraa F. Al-Sharshahi, Baha’eddin A. Muhsen, Mohammed A. Al-Dhahir
The majority of cranial approaches entail positioning the patient supine, lateral, or prone with the surgeon at the top of the operating table in such a way that the surgical field is turned upside-down compared to the studied anatomical orientation.3 For example, when studying the anatomy of the central skull base and trigeminal ganglion, all orientations are defined in relation to the classic anatomical position (Figure 1(A)). However, when viewed from the perspective of the sub-temporal approach, the anatomy would be upside down with slight obliquity (Figure 1(B)). Another example is the use of the prototypical, pterional approach; Figure 2(A) shows how to study the anatomy of the region around the optic chiasm using the upside-down anatomy concept while Figure 2(B) shows a real-life operative view of similar neurovascular and cortical relationships.
Surgery in antiquity: the origin of the Trendelenburg position revisited
Published in Acta Chirurgica Belgica, 2021
Marios Papadakis, Constantinos Trompoukis
Friedrich Trendelenburg began experimenting with the Raised Pelvic Position in the 1880s to facilitate pelvic access in patients suffering from vesicovaginal fistulas, not reachable through the conventional vaginal route. The position allows the surgeon to operate in a standing position, without bending over the surgical field. Originally it was achieved by letting the patient’s legs rest on the assistant’s shoulders. Later, the assistant was replaced by a special operating table. Trendelenburg expanded the use of the position also in gynecological procedures. However, it was his student Willy Meyer who introduced the term Raised Pelvic Position into the medical terminology in 1885. The eponym (Trendelenburg position) was created three years later by the Dutch gynecologist Maurice Arthur Mendes de Leon, while in 1890, Trendelenburg published his experience with the application of the position in vesicovaginal fistulas and other gynecological operations [9].
Current utilization and future directions of robotic-assisted endovascular surgery
Published in Expert Review of Medical Devices, 2020
Peter Legeza, Gavin W. Britz, Thomas Loh, Alan Lumsden
Currently, the CorPath 200 and GRX systems are the only commercially available endovascular robotic devices. However, the first robot, designed for mainly peripheral endovascular interventions, was the Magellan Robotic Catheter System (Hansen Medical, Mountain View, California). The main components of the Magellan robot are a remote wire and a remote catheter manipulator. Two robotic steerable catheter systems are available. A low profile 6 Fr system with two bending sections for navigation in smaller arteries. The other system consists of a 6-F inner leader catheter with the capability of a 180-degree multidirectional articulation, and a 9-F outer sheath with an additional 90-degree multidirectional articulation. The articulation is achieved by remotely controllable pull wires, integrated into the devices [47]. The patient-side robotic manipulator allows the advancement, retraction, rotation, and bend of the catheter system. This manipulator is mounted on the operating table. The robotic workstation is placed outside the radiation source. It consists of the robotic console and monitors, displaying the fluoroscopic images and the real-time catheter orientation. Target vessels can be reached with the robot, but the therapeutic devices have to be delivered manually, supported by the stability of the robotic catheters (Table 1).