Viviana DE Assis, Hasan Alhasan, Emad Mikhail
Preterm birth is the leading cause of perinatal and neonatal morbidity and mortality in the developed world. An important cause of preterm birth is cervical insufficiency, leading to membrane prolapse, premature rupture of membranes, and mid-trimester pregnancy loss. A cerclage can be placed vaginally or abdominally to treat cervical insufficiency. In cases of failed prior transvaginal cerclage (TVC), transabdominal cerclage (TAC) is the alternative. The procedure can be completed via laparoscopy or open approach...
May 30, 2024: Surgical Technology International
Domenico Policicchio, Riccardo Boccaletti, Filippo Veneziani Santonio, Anna Mingozzi, Giosuè Dipellegrini
INTRODUCTION: The introduction of flexible fiber technology in the early 2000s revitalized the interest in the CO2 laser for neurosurgical applications, making it suitable for microsurgical procedures. Despite its widespread use, specific indications for the CO2 laser in neurosurgery remains undefined. This study evaluates the efficacy and limitations of the CO2 laser in brain tumor surgery. MATERIALS AND METHODS: This retrospective observational single-center study analyzed the use of the CO2 laser in intracranial neoplasm surgeries from 2011 to 2021...
May 29, 2024: Surgical Technology International
Xiaoming Guan, Daniel Y Lovell, Robert Zurawin
Laparoscopy has advanced over the last three decades with residency training programs focusing on trans-abdominal laparoscopic techniques whether conventional or robotic. Despite attempts over many years to adopt vaginal surgery as the preferred method of hysterectomy, traditional vaginal surgery has largely fallen out of favor. Vaginal natural orifice transluminal endoscopic surgery (vNOTES) has gained popularity with patients and promises to provide an attractive option, but the surgical skills of many gynecologists have limited its widespread adoption...
May 22, 2024: Surgical Technology International
Patricia R Melvin, Todd Bertrand, David A Crawford, Keith R Berend
INTRODUCTION: Utilization of the direct anterior approach (DAA) for total hip arthroplasty (THA) has been steadily increasing in recent years. While the DAA may offer some benefits compared to other approaches, there are still risks involved including relatively higher rates of periprosthetic femur fractures, especially when combined with cementless femoral stem use. The purpose of this study is to evaluate the early postoperative femoral complications with a short triple-wedge tapered stem used in primary THA via a DAA...
May 9, 2024: Surgical Technology International
George A Skarpas, Konstantinos Maniatis, Nikolaos Barmpounakis, Georgios Kakavas
Injuries of the meniscus often lead to changes in joint biomechanics, which affect the load distribution and contact stresses. The menisci consist of a peripheral vascular region (red zone) and an inner avascular region (white zone). The blood supply plays an important role in the healing of meniscal tears. Surgical treatment of such lesions includes meniscectomy/meniscoplasty and repair, depending on the type of injury, where "meniscoplasty" refers to the treatment modality that occurs under coblation...
May 9, 2024: Surgical Technology International
Rahim Hirani, Abbas Smiley, Rifat Latifi
INTRODUCTION: This study aimed to ascertain the risk factors contributing to in-patient mortality in elderly patients 65 years and older who were admitted emergently, diagnosed with intestinal fistula, and underwent surgery. MATERIALS AND METHODS: Data were extracted from the National Inpatient Sample (NIS) spanning the years 2005-2014. Multivariable logistic regression and a generalized additive model (GAM) were employed to investigate predictors of mortality. Continuous variables are presented as mean values with standard deviations (SD)...
May 9, 2024: Surgical Technology International
Dustin Nowotny, Kristen Reede, Mentor Ahmeti
PURPOSE: Rib fixation procedures are being performed more frequently as they have shown multiple advantages over traditional non-operative management in well-selected patients. We have developed a rib-fixation simulation on cadavers for use by surgical residents in attempt to improve their comfort, knowledge and ability to use this new technology. METHODS: Residents in years 3 through 5 of training attended a rib-fixation simulation course with cadavers. Trauma faculty and representatives of manufacturers of rib-fixation hardware participated...
May 9, 2024: Surgical Technology International
Mallory M Przybylski, Daniel T Hall, Laura H Ikuma
The primary objectives of any high-volume surgery department should be patient safety, block time utilization and operating room efficiency. Reducing preparation time in the OR prior to actual surgery can improve operating room efficiency and utilization, but only if patient safety can be maintained. With this goal, this study evaluated a novel skin preparation technique using a device named ULTRAPREP™, a sterile, medical-grade plastic bag that is applied to the upper or lower extremity in the pre-operative holding area which allows for skin disinfection outside the OR (referred to as "disinfection bag")...
April 18, 2024: Surgical Technology International
Alice Moynihan, Patrick Boland, Ronan A Cahill
Transanal minimally invasive surgery (TAMIS) is an effective procedure that plays an important role in the care of patients with significant rectal neoplasia and polyps including early-stage cancers. However, it is perhaps underutilised and under threat from both advanced flexible endoscopic procedures and proceduralists (who often act as gatekeepers for referral to colorectal surgeons), as well as from robotic surgery proponents. TAMIS advocates can learn and adopt practice insights from both these fields and incorporate available technological innovations building on the huge accomplishments already delivered in this area...
April 16, 2024: Surgical Technology International
Daniel Hameed, Jeremy A Dubin, Ignacio Pasqualini, Viktor Krebs, Nicolas S Piuzzi, Michael A Mont
Revision total hip arthroplasty (THA) presents a formidable challenge when addressing extensive acetabular defects, particularly in severe cases classified under Paprosky types 3A and 3B and American Academy of Orthopaedic Surgeons types 3 and 4. Traditional methods often fall short, prompting the potential use of custom triflange acetabular components or patient-specific acetabular implants (PSAIs). These implants are specifically designed to conform to an individual's anatomy, aiming to enhance defect reconstruction and pelvic stabilization...
April 8, 2024: Surgical Technology International
Joshua P Rainey, Jeremy M Gililland, Kevin Marchand, Kelly Taylor, Michael A Mont, Robert C Marchand
BACKGROUND: Shorter, metaphyseal-filling collared stems have become popular with the direct anterior approach (DAA), based on their ease of broaching and insertion through less invasive surgical exposures. To aid with the DAA, robotic-assisted technology provides three-dimensional computed tomography (CT) preoperative planning and intraoperative guidance to accurately assess stem version. With other femoral stems, this has been shown to provide more accurate implant planning and improved patient outcomes...
April 4, 2024: Surgical Technology International
Allegra L Fierro, Carolyn Foley, Tomer Lagziel, John C Lantis
Autologous blood-derived therapies have emerged as a unique and promising treatment option for chronic wounds. From whole blood clots to spun-down clot constituents, these therapies are highly versatile and tend to have a lower cost profile, allow for point-of-service preparation, and inherently carry minimal to no risk of rejection or allergic reaction when compared to many alternative cellular and matrix-like products. Subsequently, a diversity of processing systems, devices, and kits have surfaced on the market for preparing autologous blood-derived products (ABDPs) and many have demonstrated preclinical and clinical efficacy in facilitating chronic wound healing...
March 29, 2024: Surgical Technology International
Sean B Sequeira, Matthew F Myntti, Jeanne Lee, Michael A Mont
Periprosthetic joint infection (PJI) is a serious postoperative complication in joint arthroplasty procedures that carries substantial morbidity and mortality associated with it. Several strategies have been developed both in the preoperative, perioperative, and postoperative periods to both combat and prevent the development of this devastating complication. Intraoperative irrigation is an important modality used during arthroplasty procedures prior to the implantation of final components that seeks to eradicate any biofilm formation...
March 28, 2024: Surgical Technology International
Arthur Evensen, Jodi Walters, James Dancho, Valarie Samoy, David Jolley
Synthetic extracellular matrices are artificial polymers that are elongated and deposited as a matrix of nanofibers which mimic the native extracellular matrix. RenovoDerm® Anthem™ Wound Matrix (Columbus, Ohio) is comprised of polyglycolic acid and poly (L-lactide-co-caprolactone) which degrade by hydrolysis into a-hydroxy and fatty acids, lowering the pH and promoting regenerative cellular activity including angiogenesis. Amniotic allografts contain growth factors, cytokines, amino acids, extracellular matrix proteins, and hyaluronic acid which are recognized as intrinsic to the wound healing process...
March 22, 2024: Surgical Technology International
Carla R Edgley, Jorge G Zarate Rodriguez, Chet W Hammill
BACKGROUND: Pancreatoduodenectomy is a highly complex surgical procedure associated with high postoperative morbidity and mortality. Treatment of postoperative pain is crucial to preventing chronic pain and further complications. Opioids are the leading treatment modality for acute postoperative pain for all surgical procedures in the US, contributing to the opioid epidemic, a crisis causing death and lifelong impairment in many patients. Multimodal analgesia techniques, such as the transversus abdominis plane (TAP) block, are suggested to reduce perioperative opioid usage...
March 22, 2024: Surgical Technology International
Prachi Rojatkar, Anil K Nalagatla, Crystal D Ricketts, Jeffrey W Clymer, Emily Yosh
Surgical stapling has evolved significantly over time, with the primary goal of improving patient outcomes. This study describes the technological advancements in surgical stapling from the perspective of staple and cartridge design, assessing the impact of staple design when it changes from the traditional B form (also known as 2D staple form) to a three-dimensional form (known as 3D staple form). The change in configuration helps compress a larger surface area of the tissue. The 3D configuration is designed to optimize compression not only underneath each staple but also across staples and multiple staple lines, including both stapled and unstapled regions of the tissue...
March 19, 2024: Surgical Technology International
Adam Truong, Jino Chough, Karen N Zaghiyan, Phillip R Fleshner
INTRODUCTION: Interest in microscopic margin positivity during surgical resection of medical-refractory Crohn's disease has been renewed with multiple recent studies showing an association between microscopic margin positivity with disease recurrence. Our aim was to determine risk factors for microscopic margin disease positivity following ileocolic resection (ICR). MATERIALS AND METHODS: A prospectively-maintained database of patients with Crohn's disease undergoing ICR at a tertiary-referral center was queried...
March 12, 2024: Surgical Technology International
Daniel Hameed, Jeremy Dubin, Zhongming Chen, Nipun Sodhi, Michael A Mont, Steven F Harwin
INTRODUCTION: While dual mobility systems in total hip replacements have demonstrated reduced dislocation and revision occurrences, concerns persist about the potential elevation of metal ions in the bloodstream, leading to negative tissue reactions. Notably, there's a scarcity of research spanning over five years post-surgery that examines cobalt and chromium levels after such implants. This study aimed to delve into these metal ion concentrations after a five-year period, building on previous metal-ion findings...
March 7, 2024: Surgical Technology International
Nathalie Willems, Kevin B Marchand, Christina Esposito, Daniele De Massari, Daniel Hameed, Gavin Clark, Robert Marchand, Michael A Mont, Michael Dunbar
INTRODUCTION: Classical neutral mechanical alignment in total knee arthroplasty (TKA) has been a standard paradigm, while more recently, other alignment schemas, such as kinematic, individualized, and functional, have been explored. This study aimed to investigate the effect of three-dimensional (3D) computed tomography (CT)-based surgical robotics inputs on a classically trained surgeon's TKA component positions and alignment targets over time. MATERIALS AND METHODS: Data from 1,394 consecutive robotically-assisted TKAs by a single surgeon from 2016 to 2020 were analyzed...
March 7, 2024: Surgical Technology International
Daniel Hameed, Brittany Oster, Bryan D Springer, Arthur L Malkani, Michael A Mont
Revision total hip arthroplasty (THA) is a procedure with many challenges, especially when patients exhibit femoral bone defects. The causes of these defects vary, ranging from removal of prior implants to aseptic loosening. As surgeons navigate these challenges, a reliable surgical system is important. One modular fluted tapered system provides surgeons with tools to address complex hip revision cases. Introduced in 2003, this system has been utilized in over 180,000 procedures, demonstrating its reliability and effectiveness...
March 1, 2024: Surgical Technology International
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