Technical Modifications to Prevent Massive Hemothorax Following Sternal Plating

2015 ◽  
Vol 30 (9) ◽  
pp. 691-693
Author(s):  
John A. Cece ◽  
Michael R. Rose ◽  
Lisa F. Schneider
Keyword(s):  
Sternal Plating ◽  
Technical Modifications ◽  
Massive Hemothorax

scholarly journals Robotic natural-orifice IntraCorporeal anastomosis with Extraction (NICE procedure) for complicated diverticulitis

2021 ◽  
Author(s):  
Eric M. Haas ◽  
Thais Reif de Paula ◽  
Roberto Luna-Saracho ◽  
Melissa Sara Smith ◽  
Jean-Paul J. LeFave
Keyword(s):  
Complicated Diverticulitis ◽  
Intracorporeal Anastomosis ◽  
Natural Orifice ◽  
Abdominal Incision ◽  
Stepwise Approach ◽  
Stapling Device ◽  
Video Recordings ◽  
Conversion Rates ◽  
Technical Modifications ◽  
Instrument Control

Abstract Background Totally intracorporeal surgery for left-sided resection carries numerous potential advantages by avoiding crossing staple lines and eliminating the need for an abdominal incision. For those with complicated diverticulitis, minimally invasive surgery is known to be technically challenging due to inflamed tissue, distorted pelvic anatomy, and obliterated tissue planes, resulting in high conversion rates. We aim to illustrate the stepwise approach and modifications required to successful complete the robotic Natural-orifice IntraCorporeal anastomosis with transrectal specimen Extraction (NICE) procedure in this cohort. Methods Consecutive, elective, unselected patients presenting with complicated diverticulitis defined as fistula, abscess and stricture underwent the NICE procedure over a 24-month period. Demographic and intraoperative data were collected, and video recordings were reviewed and edited on encrypted server. Results A total of 60 patients (50% female) underwent the NICE procedure for complicated diverticulitis with a mean age of 58.9 years and mean BMI of 30.7 kg/m2. The mean operative time was 231.6 min. All cases (100%) were achieved with intracorporeal anastomosis using a circular stapling device. All but one patient (98.3%) had successful transrectal extraction of the specimen. Forty-four (73%) of the specimens required a specimen-thinning maneuver to successfully extract the specimen and there were no conversions. We identified seven key technical modifications and considerations to facilitate successful completion of the procedure which are illustrated, including early release of the disease, mesentery-sparing dissection, dual instrument control of the mesenteric vasculature, release of the rectal reflection, use of NICE back table, specimen-thinning maneuver, and closure of the rectal cuff. Conclusion We present a stepwise approach with key modifications to successfully achieve totally robotic intracorporeal resection for those presenting with complicated diverticulitis. This approach may help overcome the technical challenges and provide a foundation for reproducible results.

Technical Modifications for Laparoscopic Appendectomy and Other Pelvic Procedures Using Microinstruments

2000 ◽  
Vol 10 (4) ◽  
pp. 211-214
Author(s):  
Jorge Cueto ◽  
Martín Salvador Valencia-Reyes ◽  
Jose Antonio Vazquez-Frias ◽  
Pablo Castaneda-Leeder ◽  
Roberto Nevarez-Bernal ◽  
...  
Keyword(s):  
Laparoscopic Appendectomy ◽  
Technical Modifications

scholarly journals Technical modifications in bar removal in the Nuss procedure

2010 ◽  
Vol 37 (3) ◽  
pp. 747-748
Author(s):  
José M. Mier ◽  
Laureano Molins ◽  
Juan J. Flibla
Keyword(s):  
Nuss Procedure ◽  
Technical Modifications

scholarly journals Conjugated and unconjugated bilirubins in bile of humans and rhesus monkeys. Structure of adult human and rhesus-monkey bilirubins compared with dog bilirubins

1977 ◽  
Vol 167 (3) ◽  
pp. 535-548 ◽  
Author(s):  
S G Blumenthal ◽  
D B Taggart ◽  
R Ikeda ◽  
B H Ruebner ◽  
D E Bergstrom
Keyword(s):  
Chemical Composition ◽  
Gall Bladder ◽  
Rhesus Monkey ◽  
Rhesus Monkeys ◽  
Glucuronic Acid ◽  
Unknown Compound ◽  
Adult Human ◽  
Adult Humans ◽  
Technical Modifications ◽  
Working Day

1. Bilirubin-IXalpha, -IXalpha diglucuronide, -IXalpha monoglucuronide, -IXalpha monoglucoside -IXalpha monoxyloside, a bilirubin-IXalpha diconjugate containing glucose and another unknown compound, and bilirubin-IXbeta are present in gall-bladder bile of adult human, rhesus monkey and dog. Dog bile normally also contains other bilirubin-IXalpha diconjugates, i.e. compounds containing two conjugating sugars such as glucuronic acid and glucose, glucuronic acid and xylose and glucose xylose. 2. Azopigments alphaF, alphaO, alpha2, alpha3, betax and delta derived from human and rhesus-monkey bilirubins are identical in their chemical composition with those obtained from the dog. 3. Azopigments alphaF and betax found in diazotized biles of adult humans, rhesus monkeys and dogs are products of unconjugated bilirubin-IXbeta. 4. Technical modifications of previously published procedures [Heirwegh, Fevery, Michiels, Van Hees & Compernolle, (1975) Biochem. J. 145, 185-199] were introduced which make it possible to separate the bilirubins, diazotize the separated bilirubins, extract the azopigments and chromatograph them in one working day (6-8h).

Thoracic Spine Fracture: An Unusual Case of Bilateral Massive Hemothorax

2010 ◽  
Vol 68 (6) ◽  
pp. 1511 ◽  
Author(s):  
Ming-Shian Lu ◽  
Yen-Yao Li ◽  
Yao-Kuang Huang ◽  
Chiung-Lung Kao
Keyword(s):  
Thoracic Spine ◽  
Unusual Case ◽  
Spine Fracture ◽  
Massive Hemothorax ◽  
Thoracic Spine Fracture
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