scholarly journals Comparison Effect of Direct Trocar and Veress Needle Entry Techniques on Gut Functions after Laparoscopic Procedures: Randomized Clinical Trial

2016 ◽  
Author(s):  
Taylan Şenol ◽  
Mesut Polat ◽  
Enis Özkaya ◽  
İlhan Şanverdi ◽  
Birsen Konukçu ◽  
...  
Keyword(s):  
Laparoscopic Approach ◽  
The Body ◽  
Veress Needle ◽  
Intraabdominal Pressure ◽  
Intraperitoneal Pressure ◽  
Laparoscopic Entry ◽  
Significant Difference ◽  
Group 2 ◽  
Needle Entry ◽  
Index Comparison

<p><strong>OBJECTIVE:</strong> The aim of this study was to compare the effect of two different laparoscopic entry methods on postoperative gastrointestinal functions.<br /><strong>STUDY DESIGN:</strong> A total of 108 women who underwent gynecological operation via laparoscopic approach with different indications were randomly assigned to 2 groups: In Group 1 pneumoperiteneum was achieved by direct trocar entry (n=72), while in group 2, Veress needle was used.<br /><strong>RESULTS:</strong> Correlation analyses showed a significant association between the technique for abdominal entry and postoperative hemoglobin and hematocrit concentrations, time to maximal intraabdominal pressure and the body mass index. Comparison of groups with different laparoscopic entry techniques showed a significant difference between groups in terms of postoperative hemoglobin and hematocrit concentrations, time to obtain maximal intraabdominal pressure and time to first flatulence (p &lt; 0.05, Table 2). No intra or postoperative complications was observed.<br /><strong>CONCLUSION:</strong> Direct or Veress needle entry methods were both safe to create pneumoperitoneum with similar postoperative gastrointestinal functions except for earlier first flatulence in Veress needle group while direct trocar entry was found to be associated with favorable postoperative blood count and shorter duration to obtain enough intraperitoneal pressure.</p>

scholarly journals COMPARISON OF A NEW VERESS NEEDLE ENTRY METHOD AND CLASSIC VERESS NEEDLE ENTRY METHOD IN GYNECOLOGIC LAPAROSCOPY: A PROSPECTIVE RANDOMIZED STUDY

2018 ◽  
Vol 6 (2) ◽  
pp. 74-79
Author(s):  
Uğurkan Erkayıran ◽  
Bülent Köstü ◽  
Alev Özer
Keyword(s):  
Horizontal Plane ◽  
Randomized Study ◽  
Veress Needle ◽  
Operative Outcomes ◽  
Laparoscopic Entry ◽  
Gynecologic Laparoscopy ◽  
The Mean ◽  
Group 2 ◽  
Needle Entry ◽  
Group 1

Background: To compare cranial 15º angulation of Veres needle to classic Veress needle entry in closed laparoscopic entry in obese patients. Method: Patients with BMI index>30 were divided into two groups. Initial entry into the abdomen in Group 1 (n=29) was performed with the intraumbilical insertion of Veress needle in 90o angle relative to the horizontal plane. In Group 2 (n=31) the Veress needle was placed intraumbilically in a cranial direction, the tip of the needle towards the thoracic cavity, with an angle of 15o to the horizontal plane. Two groups were compared with respect of the operative outcomes. Results: In Group 2, the mean number of Veress needle entries attempt was significantly lower than Group 1 (p=0.01). Time to insertion of the Veress needle was found to be significantly shorter in Group 2 than in Group 1 (p<0.001). While entry failure occurred in 3 patients in Group 1 (10.3%), no failures were monitored in any patients in Group 2 (p= 0.01). Complication rate was significantly lower in Group 2 than in Group 1 (p= 0.03). Conclusion: Placement of Veress needle intraumbilically in a cranial direction at 15°angle to the horizontal plane increases entry success and reduces complications.

scholarly journals Miniplate 1.5 fixation for the repair of mandibular osteotomies in cats

2011 ◽  
Vol 26 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Adelina Maria da Silva ◽  
Wilson Machado de Souza ◽  
Patrícia de Athayde Barnabé ◽  
Marion Burkhardt de Koivisto ◽  
Nair Trevizan Machado de Souza
Keyword(s):  
Radiolucent Line ◽  
The Body ◽  
Bone Union ◽  
Dental Occlusion ◽  
Mandibular Fractures ◽  
Significant Difference ◽  
Osteotomy Line ◽  
Group 2 ◽  
Adult Cats ◽  
Group 1

Purpose: To evaluate the application of the maxillofacial miniplate 1.5 in the repair of unilateral mandibular osteotomies in cats. Methods: Twelve adult cats were divided into two groups. In group 1 (n=6), the osteotomy was performed in the body of the mandible, behind the 1st molar. In group 2 (n=6), the osteotomy was performed between the 4th premolar and 1st molar. The osteotomy was fixed with a titanium miniplate 1.5. Oral alimentation was reinitiated 24 hours after surgery. Cats were euthanized at 12 weeks postoperative. Results: Radiographs taken 1 week after surgery showed a radiolucent line. The osteotomy line was not more visible on the radiographs taken at 12 weeks postoperative. Macroscopic examination confirmed alignment and bone union of operated hemimandibles. Histological examination showed formation of woven bone within the osteotomy line. The percentage of bone tissue at these areas was measured by the histometry. There was no statistically significant difference between the values of group 1(75.07 ± 5.99) and group 2 (74.76 ± 8.54) (Mann-Whitney's test p= 0.469). Conclusion: We concluded that the use of miniplate 1.5 for the fixation of mandibular osteotomy in cats provided the main goals in the treatment of mandibular fractures: bone union, normal dental occlusion and immediate return to oral alimentation.

scholarly journals Comparison of Complications between Direct Trocar Insertion Versus Veress Needle for Creation of Pneumoperitoneum in Patients Undergoing laparoscopic Cholecystectomy: A Randomized Control Trial

2021 ◽  
pp. 294-299
Author(s):  
Kamran Hamid ◽  
Shabbir Ahmad ◽  
Bahzad Akram Khan ◽  
Muhammad Faheem Answer ◽  
Amer Latif ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Needle Insertion ◽  
Veress Needle ◽  
P Value ◽  
Surgical Department ◽  
Trocar Insertion ◽  
Laparoscopic Entry ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Direct Trocar Insertion

Aim: To compare the outcomes in term of complication of Veress Needle Insertion (VNI) to Direct Trocar Insertion (DTI) for creation of pneumoperitoneum in laparoscopic cholecystectomy. Design: Randomized controlled trial Place and Duration of Study: The current analysis was conducted at Khawaja Muhammad Safdar Medical College Surgical Department, Allama Iqbal Memorial Hospital and Govt. Sardar Begum Teaching Hospital, Sialkot from September 27, 2017, to September 26, 2020. Methodology: A total of six hundred and eight (n=608) patients, having age 30 to 75 years planned for laparoscopic cholecystectomy were included in this study. Patients were randomly divided into two groups, Group A (Direct Trocar Insertion), Group B (Veress Needle Insertion). Both groups had age and sex matched males and female. All trocars and veress needle used were disposable, with a safety shield. The primary outcome of our study was to compare the complications to assess the safety levels, while total time taken by the procedure and mean time for laparoscopic entry were the secondary end points. The collected data was analyzed by using software SPSS version 22. Chi-square test was used to check the significance of variance. P-value less than 0.05 remained the statistically significant. Results: The complication rate in VNI group were significantly greater than the DTI group (p < 0.01), the duration of surgery between the two groups was not significantly different (p > 0.05), but we found statistically significant difference in mean laparoscope insertion time (DTI 3.4+ 1.4 versus VNI 4.8+ 0.7 minutes, p < 0.001). Conclusion: From the results of our study, it can be concluded that the direct trocar insertion is a safe alternative to veress needle insertion in laparoscopic cholecystectomy as it is associated with fewer complications.

Abstract WP380: Thyrotoxicosis is Associated With Worse In-Hospital Mortality in Patients With Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Sakiru O Isa ◽  
Olajide Buhari ◽  
Hameem Changezi
Keyword(s):  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Length Of Hospital Stay ◽  
The Body ◽  
Significant Difference ◽  
History Of ◽  
Group 3 ◽  
Group 2 ◽  
Time Of Presentation ◽  
Group 1

Introduction: Hyperthyroidism increases the basal metabolic rate and affects most systems in the body. Patients with hyperthyroidism have been shown to have a higher incidence of ischemic stroke. There is a paucity of information regarding its effects on the short-term outcomes of patients admitted with ischemic stroke. Hypothesis: Hyperthyroidism is associated with worse in-hospital outcomes in patients admitted for ischemic stroke. Methods: We queried the National Inpatient Sample to identify adult patients(aged 18 and above) admitted for ischemic stroke between January 2011 and December 2014. We compared those with a history of hyperthyroidism (group 1) and thyrotoxicosis on admission (group 2) with the rest of the patients (group 3). The main outcome was in-hospital mortality. Secondary outcomes included the length of hospital stay and cost of hospitalization. We used the logistic regression model and adjusted for baseline characteristics and co-morbidities. Results: There were 643,786 patients in the study, 0.44% had a history of hyperthyroidism, and 0.01% had thyrotoxicosis at the time of presentation. The odd of mortality in group 1 compared to group 3 was 0.89, 95% CI 0.75-1.05, p=0.16 while in group 2 compared to group 3, it was 2.42, 95% CI 1.29-4.52, p<0.006. The mean length of stay was also longer in group 2 with a mean difference of 8.06, 95% CI 4.74 - 11.39, p<0.0001. Conclusion: From the study, there was no significant difference in in-hospital mortality between patients with previously diagnosed hyperthyroidism and those without diagnosed hyperthyroidism. Patients who had thyrotoxicosis on admission, on the other hand, had worse outcomes compared to patients without thyrotoxicosis.

scholarly journals Miniplate fixation for the repair of segmental mandibular defects filled with autogenous bone in cats

2011 ◽  
Vol 26 (3) ◽  
pp. 174-180 ◽  
Author(s):  
Adelina Maria da Silva ◽  
Wilson Machado de Souza ◽  
Marion Burkhardt de Koivisto ◽  
Patrícia de Athayde Barnabé ◽  
Nair Trevizan Machado de Souza
Keyword(s):  
The Body ◽  
Bone Union ◽  
Dental Occlusion ◽  
Autogenous Bone ◽  
Iliac Crest Bone Graft ◽  
Mandibular Fractures ◽  
Segmental Defect ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

PURPOSE: To evaluate the use of maxillofacial miniplate 1.5 in the repair of segmental mandibular defects filled with autogenous bone in cats. METHODS: Twelve adult cats were divided into two groups. A segmental defect of 4mm was created in one of the hemimandibles and filled with autogenous iliac crest bone graft. The operated hemimandible was fixed with a 1.5mm titanium miniplate. In group 1 (n=6), the defect was performed in the body of the mandible, behind the 1st molar. In group 2 (n=6), the defect was performed between the 4nd premolar and 1st molar, with extraction of the 1st molar. Oral alimentation was reinitiated 24 hours after surgery. Cats were euthanized at 20 weeks postoperative. RESULTS: Incorporation of the graft was suggested by the radiographs taken 20 weeks after surgery. Macroscopic examination confirmed alignment and bone union of operated hemimandibles. Histological examination showed formation of woven bone in rostral and caudal mandible/graft interfaces. The percentage of bone tissue at these areas was measured by the histometry. There was no statistically significant difference between the values of group 1(64.48 ± 4.51) and group 2 (71.69 ± 14.47) (Mann-Whitney's test p= 0.294). CONCLUSION: The use of miniplate 1.5 for the fixation of mandibular defects filled with autogenous bone in cats provided the main goals in the treatment of mandibular fractures: bone union, normal dental occlusion and immediate return to oral alimentation.

scholarly journals Dentinal Microcrack Formation after Root Canal Instrumentation by XP-Endo Shaper and ProTaper Universal: A Microcomputed Tomography Evaluation

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Sarah M. Alkahtany ◽  
Ebtissam M. Al-Madi
Keyword(s):  
The Body ◽  
Micro Ct ◽  
Cross Sectional ◽  
Significance Level ◽  
Root Canals ◽  
Type Iv ◽  
Significant Difference ◽  
Before And After ◽  
Microcrack Formation ◽  
Group 2

Aim. To evaluate dentinal microcrack formation on root canals instrumented, continuously in the body temperature, with XP-endo shaper (XPES) and ProTaper Universal (PTU), by means of microcomputed tomographic (micro-CT) analysis. Methodology. Nineteen mesial roots with two separate canals (Vertucci Type IV) of extracted mandibular molars were used in this study. The root canals (N = 38) were divided into 2 groups. Group 1 (n = 19): all MB canals were instrumented with XPES. Group 2 (n = 19): all ML canals were instrumented with PTU. All roots were scanned with micro-CT before and after instrumentation. Two precalibrated examiners evaluated the cross-sectional images of each sample with DataViewer program. The dentinal microcracks (complete and incomplete) were counted in each third of the root for the preinstrumentation and the postinstrumentation images. Wilcoxin signed-rank and Mann–Whitney U tests were used for statistical analysis at a significance level of P<0.05. Results. The number of microcracks increased significantly (P<0.05) after instrumentation with XPES in the middle and cervical thirds. The number of microcracks increased significantly (P<0.05) after instrumentation with PTU in the cervical third only. There was no significant difference between the groups in the cervical and apical thirds. In the middle third, the XPES induced more incomplete microcracks than PTU (P<0.05). Conclusion. Within the limitations of this study, there was no significant difference in the dentinal microcrack formation between XPES and PTU in the apical and cervical thirds of the root. However, XPES instrumentation induced more incomplete microcracks than PTU in the middle third of human roots.

scholarly journals A novel Veress needle mechanism that reduces overshooting after puncturing the abdominal wall

2021 ◽  
Author(s):  
Roelf R. Postema ◽  
David Cefai ◽  
Bart van Straten ◽  
Rein Miedema ◽  
Latifa Lesmana Hardjo ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Ex Vivo ◽  
Bowel Perforation ◽  
Veress Needle ◽  
Safety Mechanism ◽  
Laparoscopic Entry ◽  
Significant Difference ◽  
Life Threatening ◽  
Decoupling Mechanism ◽  
Initial Action

Abstract Background Complications that occur in laparoscopic surgery are often associated with the initial entry into the peritoneal cavity. The literature reported incidences of Veress needle (VN) injuries of e.g. 0.31% and 0.23%. In a 2010 national survey of laparoscopic entry techniques in the Canadian General Surgical practice, 57.3% of respondents had either experienced or witnessed a serious laparoscopic entry complication like bowel perforation and vascular injury. As those complications are potentially life threatening and should be avoided at all costs, improving safety of this initial action is paramount. Methods Based on a bare minimum design approach with focus on function expansion of existing components, a new Safety mechanism was developed for the VN that decreases the risks of VN overshooting. The mechanism works by preventing the puncturing acceleration of the tip of the VN by decoupling the surgeon’s hand from the VN immediately after entering the abdomen. Results Based on a set of requirements, a first prototype of the VN+ with force decoupling safety mechanism is presented and evaluated on an ex vivo porcine abdominal wall tissue model in a custom setup. The experiments conducted by two novices and one experienced surgeon indicated a significant difference between the attempts with a standard, conventional working VN (41.4 mm [37.5–45 mm]) and VN+ with decoupling mechanism (20.8 mm [17.5–22.5 mm]) of p < 0.001. Conclusion A new decoupling safety mechanism was integrated successfully in a standard VN resulting in a VN+ . The results from the pilot study indicate that this new VN+ reduces overshooting with a minimum of 50% in a standardised ex vivo setting on fresh porcine abdominal wall specimens.

scholarly journals Impact of Anti-Toxoplasma gondii and adipose hormones with Insulin Resistant on obese aborted women

2020 ◽  
Vol 10 (01) ◽  
pp. 114-118
Author(s):  
Abeer J. Hassan ◽  
Nazar Sh. Mohammed ◽  
Muhannad Shweash ◽  
Hatem M. Hadeed
Keyword(s):  
Toxoplasma Gondii ◽  
Fasting Blood Glucose ◽  
Resistance Index ◽  
The Body ◽  
Control Group ◽  
Obese Women ◽  
Significant Difference ◽  
Patient Groups ◽  
Group 2 ◽  
Group 1

This study was carried out at Baghdad hospital in, for the period from November 2018 to July 2019. The study included (151) aborted obese women whose ages ranged between (18–41) years with positive Toxoplasma gondii infection. They were divided into two groups according to the body mass index (BMI) value: Group 1: consisted of 61 women with BMI less than 30, Group 2: consisted of (90) women with BMI greater than 30. The control group included (52) healthy volunteer women aged 19–41 years with negative Toxoplasma for comparison of the results. The case and controls were matched for age and gender. Serum samples were tested for fasting blood sugar, insulin, IgG, and IgM of Toxoplasma, Leptin, and Adiponectin as well as insulin resistance index. The results showed that the age factor was not significant between group 1 and group 2 when compared with the healthy group, and there was no significant change between group 2 comparing to group1. In this study, the result of BMI showed substantial increase in group 1, while highly marked increase in group 2 when both groups were compared with the control group. Finally, the levels of Toxoplasma IgG and IgM antibodies showed a highly significant increase in the two patient groups in comparison with the control group. An increase in mean value of leptin concentration was noticeable in group 1 and group 2 with a highly significant difference when compared with the control group. No significant difference was found in the levels of fasting blood glucose in Group 1 and Group 2 compared to the control group. Also, a significant difference in HOMA-IR and QUICK- IR was observed in the patient groups once associated control group. Data revealed a considerable difference with the glucose/insulin ratio in group 1, but a highly significant was noticed in group 2 when compared with the control group. HOMA-AD results showed a significant difference in Group 1 and a highly significant decrease in Group 2.

scholarly journals Veress needle versus direct trocar entry for laparoscopy: a retrospective study

2018 ◽  
Vol 8 (1) ◽  
pp. 127 ◽  
Author(s):  
Sushma Sinha ◽  
Surya Malik
Keyword(s):  
Retrospective Study ◽  
Veress Needle ◽  
Obstetrics And Gynecology ◽  
P Value ◽  
Surgical Interventions ◽  
Traditional Technique ◽  
Number Of Patients ◽  
Group 2 ◽  
Needle Entry ◽  
Group 1

Background: The aim of this paper is to compare the outcomes of veress needle entry versus direct trocar for laparoscopy in terms of the duration of the procedure, ease of performance and the complications encountered during each technique.Methods: The present study was conducted on a retrospective basis from April ‘2008 to September 2017, in the dept of Obstetrics and Gynecology, in a 100 bedded hospital, ABGH hospital. All the cases who underwent laparoscopic ligation procedure during this time were taken into account. From 2008 to 2012 traditional technique of veress needle entry was used for access(group -1) but it had been switched over to direct trocar since 2013(group -2) These two groups were compared in terms of the demographic profile, duration of procedure, previous h/o surgical interventions ,ease of performance and various complications encountered during the procedure.Results: The total number of patients who underwent ligation during this period were 1912, which were divided into two groups ,till 2012(veress needle entry group,group-1) 754 patients(39.44%),and after 2012 (direct trocar,group -2) 1158 patients(60.56%).Duration of procedure was 4.5±1.2 min in group 1 which was significantly higher than group 2,2.2±0.8 min(p-value <0.001).Amount of gas required was greater in group 1, 4.9±1.3 lts as compared to group 2,2.4±0.5lts.Conclusions: Direct trocar entry is a reliable alternative to traditional technique for pneumoperitoneum establishment and should be regarded as a part of the surgical armamentarium of a trained laparoscopic surgeon.

The effects of high and low doses of folic acid on oxidation of protein levels during pregnancy: a randomized double-blind clinical trial

2017 ◽  
Vol 33 (3) ◽  
Author(s):  
Javad Shiralizadeh ◽  
Haleh Barmaki ◽  
Sanya Haiaty ◽  
Yousef Faridvand ◽  
Mostafa Mostafazadeh ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
The Body ◽  
Biological Molecules ◽  
High Dose ◽  
Double Blind ◽  
Independent Manner ◽  
Protein Levels ◽  
Significant Difference ◽  
Group 2

AbstractObjectiveOxidants include important active molecules which are created in the body and attack biological molecules especially lipids, carbohydrates, nucleic acids and proteins, and cause oxidation and various diseases in the body. Antioxidants existing in the body help to avoid the incidence of these injuries. Pregnant women are among those where oxidation of biological molecules may do irreparable damage to them and their embryos. So, the purpose of this study was to review the effect of folic acid with both high (5 mg/day) and low (0.5 mg/day) doses on the changes of oxidative protein in reducing plasma homocystein concentration during pregnancy.Materials and methodsForty-five pregnant women participated in this study. They were divided into two groups: group 1 included 23 women who received 5 mg/day folic acid and group 2 included 23 women who took 0.5 mg/day folic acid before pregnancy till the 36th week pregnancy. We measured the biochemical variables in the serum of pregnant women at the beginning and at the end of the study.ResultsFolic acid reduced plasma homocytein in both low and high dose groups (p = 0.035, p = 0.012, respectively). Also, the results showed that folic acid prescription led to reduce plasma level of carbonyl groups in both low and high dose groups (p = 0.01, p = 0.03, respectively). Furthermore, the results showed that there is no significant difference between two groups and folic acid affects both groups equally.ConclusionIt is possible that folic acid administration can reduce plasma homocysteine and carbonyl levels during pregnancy in dose independent manner

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