Chirurgia Bucharest
-
Chirurgia Bucharest · Mar 2009
Case ReportsTraumatic bilateral rupture of the patellar tendon in an apparently healthy patient.
We present a case of a 37 year old male who suffered a fall from approximately 2.5 meters; at the moment of impact he performed a bilateral knee hyperflexion. The presumptive clinical diagnosis was bilateral rupture of patellar tendon. In order to confirm the diagnosis, we performed bilateral anteroposterior and lateral radiographies and bilateral echography of the knee. ⋯ Bilateral rupture of the patellar tendon is rather uncommon and is usually associated with systemic diseases. The case presentation is important because the bilateral patellar tendon rupture due to minimum trauma has no explanation--the patient was young, with no genetic disorders and no systemic diseases. Literature mentions a little over 20 cases of bilateral patellar tendon rupture in individuals with no diseases previous to the injury.
-
Chirurgia Bucharest · Mar 2009
Randomized Controlled Trial Comparative Study[TIVA-TCI (Total IntraVenous Anesthesia-Target Controlled Infusion) versus isoflurane anesthesia for laparoscopic cholecystectomy. Postoperative nausea and vomiting, and patient satisfaction].
Numerous studies have shown that TIVA is followed by a significant reduction in the incidence of PONV in day-case surgery, including laparoscopic cholecystectomy, where the incidence of PONV can reach 70% according to some studies. TCI is the TIVA technique that maintain a constant plasma concentration due to pharmacokynetic models incorporated in TCI device that inject the anesthetic agent. Besides implementing TIVA-TCI in clinical practice in Romania, our study was designed to evaluate the impact of TIVA-TCI on postoperative outcome and our patient satisfaction after laparoscopic cholecystectomy. ⋯ Compared with Isoflurane, TIVA-TCI was followed by significantly lower incidence of PONV and significantly greater patients satisfaction.
-
Chirurgia Bucharest · Mar 2009
First year experience of robotic-assisted laparoscopic surgery with 153 cases in a general surgery department: indications, technique and results.
Robotic surgery was developed in response to the limitations and drawbacks of laparoscopic surgery. Since 1997 when the first robotic procedure was performed various papers pointed the advantages of robotic-assisted laparoscopic surgery, this technique is now a reality and it will probably become the surgery of the future. The aim of this paper is to present our preliminary experience with the three-arms "da Vinci S surgical system", to assess the feasibility of this technique in various abdominal and thoracic procedures and to point out the advantages of the robotic approach for each type of procedure. ⋯ Our preliminary experience suggests that robotic surgery is feasible and worth of clinical application. The best indications for robotic surgery are the procedures that require a small operating field, a fine a precise dissection (suitable for pelvic and gastric lymphadenectomy, nerve sparing in total mesorectal excision) and safe intracorporeal sutures.