scholarly journals Biologic Hemostatic Agents in Obstetrics and Gynecology

2021 ◽  
Author(s):  
Michael Patriarco ◽  
Sachin Shenoy ◽  
Nicholas Taylor
Keyword(s):  
Surgical Techniques ◽  
Fibrin Clot ◽  
Coagulation Cascade ◽  
Gynecologic Surgery ◽  
Obstetrics And Gynecology ◽  
Hemostatic Agents ◽  
Fibrin Sealants ◽  
Minimally Invasive Surgical ◽  
Clotting Cascade ◽  
Plug Formation

In Obstetrics and Gynecology, the practice of biologic hemostatic agents in the field are generally used to augment the basic tenets of hemostasis to decrease the morbidity and mortality of such procedures. These hemostatic agents work along with the body’s physiology to rapidly aid in platelet plug formation, activation of the clotting cascade, the creation of fibrin, and to form a stable clot. The four main sub-categories of hemostatic agents include mechanical, biological, flowable, and fibrin sealants. Mechanical agents act as scaffolding for platelet aggregation to form a platelet plug. Biological agents activate clotting factors in the coagulation cascade to aid in hemostasis. Flowable agents combine biologic with mechanical agents to stabilize clot formation while also providing mechanical tamponade. Fibrin sealants combine high levels of fibrin and thrombin that when combined, form a fibrin clot at an accelerated speed. Hemostatic agents in obstetrics are often used in the setting of postpartum hemorrhage, cesarean delivery and postpartum hysterectomy to decrease the rate of morbidity most commonly seen with abnormal placentation and uterine atony. With gynecologic surgery, hemostatic agents are more commonly used then in obstetrics. They aid in hemostasis with common gynecologic procedures including hysterectomies, ovarian cystectomies, myomectomies, endometriosis cases, incontinence procedures and malignant debulking procedures. Also, with the increase in minimally invasive surgical techniques, topical hemostasis can aid in fewer transfusions, improved visualization in the surgical field decreased operative time and reduction in the risk of conversion to laparotomy.

Minimally Invasive Surgical Techniques to Treat Spine Infection S

1996 ◽  
Vol 27 (1) ◽  
pp. 183-199 ◽  
Author(s):  
Larry M. Parker ◽  
Paul C. McAfee ◽  
Ira L. Fedder ◽  
James C. Weis ◽  
W. Peter Geis
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Spine Infection ◽  
Minimally Invasive Surgical

scholarly journals Avascular Spaces of the Female Pelvis—Clinical Applications in Obstetrics and Gynecology

2020 ◽  
Vol 9 (5) ◽  
pp. 1460
Author(s):  
Stoyan Kostov ◽  
Stanislav Slavchev ◽  
Deyan Dzhenkov ◽  
Dimitar Mitev ◽  
Angel Yordanov
Keyword(s):  
Pelvic Surgery ◽  
Gynecologic Surgery ◽  
Obstetrics And Gynecology ◽  
Nerve Sparing ◽  
Clinical Anatomy ◽  
Anatomical Landmarks ◽  
Female Pelvis ◽  
Precise Understanding ◽  
Significant Difference ◽  
Gynecological Diseases

The term “spaces” refers to the areas delimited by at least two independent fasciae and filled with areolar connective tissue. However, there is discrepancy regarding the spaces and their limits between clinical anatomy and gynecologic surgery, as not every avascular space described in literature is delimited by at least two fasciae. Moreover, new spaces and surgical planes have been developed after the adoption of laparoscopy and nerve-sparing gynecological procedures. Avascular spaces are useful anatomical landmarks in retroperitoneal anatomic and pelvic surgery for both malignant and benign conditions. A noteworthy fact is that for various gynecological diseases, there are different approaches to the avascular spaces of the female pelvis. This is a significant difference, which is best demonstrated by dissection of these spaces for gynecological, urogynecological, and oncogynecological operations. Thorough knowledge regarding pelvic anatomy of these spaces is vital to minimize morbidity and mortality. In this article, we defined nine avascular female pelvic spaces—their boundaries, different approaches, attention during dissection, and applications in obstetrics and gynecology. We described the fourth space and separate the paravesical and pararectal space, as nerve-sparing gynecological procedures request a precise understanding of retroperitoneal spaces.

FUNCTIONAL OUTCOME OF DISTAL FEMORAL FRACTURES AND THEIR MANAGEMENT

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Raman Shrivastava ◽  
Namita Shrivastava
Keyword(s):  
Functional Outcome ◽  
Surgical Techniques ◽  
Femoral Fractures ◽  
Railway Track ◽  
Distal Femoral Fractures ◽  
Minimally Invasive Surgical ◽  
Fall From Height ◽  
Classification Management ◽  
A Prospective Study ◽  
Jawaharlal Nehru

Background: Fractures of distal end of femur are complex injuries which are difficult to manage. These fractures often are unstable and comminuted. Despite advances in surgical techniques and improvement in implants, treatment of distal femoral fractures remains a challenge in many situations. This study was done to analyse the functional outcome and this management of distal femoral fractures. Material & Methods: This study has been done between August 2008 to March 2010 on patients coming to Orthopaedics Department at Jawaharlal Nehru Hospital and Research Center, Bhilai. It is a prospective study which includes 25 patients with 10 Type A, 7 Type B and 8 Type C fractures of distal femur after fulfilling the inclusion and exclusion criteria. Results: Mean age of 47.08 years with sex incidence of 3.17:1(M:F). Mode of injury was RTA in 16, simple fall in 6, fall from height in 2 and railway track accident in 1 patient. There were 5-A1, 1-A2, 4-A3, 3-B1, 1-B2, 3-B3, 1-C1, 4-C2 and 3-C3 fractures. Results were found to be excellent in 17, good in 1, moderate in 3 and poor in 4 patients. Conclusion: We conclude that minimally invasive surgical techniques and with the availability of locking type of plates distal femoral fractures can now be dealt with more precessions and more satisfactory results can be produced. Keywords: Distal fractures, Muller Classification, Management, Femoral fractures

scholarly journals Surgical techniques: past, present and future

2012 ◽  
Vol 2 (1) ◽  
pp. 9 ◽  
Author(s):  
Karim Qayumi
Keyword(s):  
Middle Ages ◽  
Technological Progress ◽  
Surgical Techniques ◽  
Neolithic Period ◽  
Minimally Invasive Surgical ◽  
Surgical Methods ◽  
Modern Hospital ◽  
The 19Th Century ◽  
Further Development ◽  
Shed Light

The aim of this paper is to provide an analytical survey of the information available on the development of past and present surgical techniques, and to make projections for the future. For the purposes of this paper, the <em>Past</em> starts in the Neolithic period and ends in the 1800s. In this context, I have divided the <em>Past</em> into <em>Prehistoric</em>, <em>Ancient</em> and <em>Middle Ages</em>, and this period ends in the second half of the 19th century when the major obstacles to the further development of surgery, such as overcoming pain and infection, were removed. We will discuss the development of surgical techniques, and the obstacles and opportunities prevalent in these periods. In the context of this paper, the <em>Present</em> begins in 1867, when Louis Pasteur discovered microorganisms, and ends in the present day. There have been many important changes in the development of surgical techniques during this period, such as the transfer of surgery from the unsterile operating room to the modern hospital operating theater, the development of advanced and specialized surgical practices, such as transplants and laparoscopy, and minimally invasive surgical methods, robotic and Natural Orifice Transluminal Endoscopic Surgery. It is very difficult to foresee how surgical techniques will develop in the <em>Future</em> because of the unpredictable nature of technological progress. Therefore, in this paper, the forecast for the <em>Future</em> is limited to the next 50- 100 years and is a realistic calculation based on already existing technologies. In this context, the <em>Future</em> is divided into the development of surgical techniques that will develop in the <em>near</em> and <em>distant</em> future. It is anticipated that this overview will shed light on the historical perspective of surgical techniques and stimulate interest in their further development.

Multiple Myeloma: Most Common End-Organ Damage and Management

2007 ◽  
Vol 5 (2) ◽  
pp. 170-178 ◽  
Author(s):  
Mohamad A. Hussein
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Percutaneous Vertebroplasty ◽  
Surgical Techniques ◽  
Organ Damage ◽  
Early Mortality ◽  
Adjunctive Treatment ◽  
Plasma Cell Dyscrasia ◽  
End Organ Damage ◽  
Minimally Invasive Surgical

End-organ damage is the factor that differentiates plasma cell dyscrasia requiring therapy (active multiple myeloma [MM]) from disease that does not require therapy (monoclonal gammopathy of undetermined significance and smoldering [asymptomatic] MM). Progressive skeletal destruction is the hallmark of MM and responsible for principle morbidity in the disease. The spine is the most afflicted skeletal organ, and vertebral fractures have significantly contributed to its poor prognosis. Early mortality in MM is usually attributed to the combined effects of active disease and comorbid factors. Infection and renal failure are the main direct causes of early mortality. Using bisphosphonates to manage skeletal events mainly by preventing or slowing the destructive process has become an important adjunctive treatment in MM. Advances in minimally invasive surgical techniques, such as percutaneous vertebroplasty and kyphoplasty, offer these patients less-invasive options for treating vertebral collapse and restoring function. The aggressive management of other complications of the disease through more effective and less toxic therapy that targets the primary disease, in addition to supportive care, is resulting in patients experiencing less morbidity and probably lower mortality. This article reviews recent advances in the understanding of bone disease in MM, the role of bisphosphonates in preventing skeletal events, and available data on percutaneous vertebroplasty and kyphoplasty, and discusses the management of infection and renal failure, which seem to be responsible for high initial mortality and thereby compromise the current advances in therapy.

Sign in / Sign up

Export Citation Format

Share Document