Surgical technology international
-
Controlled Clinical Trial
Does Amicar affect blood loss in patients with adolescent idiopathic scoliosis treated with pedicle screws and Ponte osteotomies?
Amicar may affect estimated blood loss (EBL) and blood transfusion in patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion (PSF) with pedicle screws and Ponte osteotomies. We performed a retrospective analysis of a prospectively collected, single-center database of 33 patients with main thoracic AIS treated with greater than 80% pedicle screws. Patients were divided into two groups based on whether they received Amicar (Yes), or did not receive any antifibrinolytics and Ponte osteotomies (No). ⋯ There were no differences in mean arterial pressure during surgery. There were no complications in either group. Amicar reduces EBL and homologous transfusion requirements in patients with main thoracic AIS undergoing PSF with pedicle screws and Ponte osteotomies.
-
Standardization of the intraoperative neuromonitoring (IONM) technique is an essential aspect of modern monitored thyroid surgery. The standardized technique involves vagal nerve stimulation. VN stimulation is useful for technical problem solving, detecting non-recurrent laryngeal nerve (non-RLN), recognizing any recurrent laryngeal nerve (RLN) lesions, and precisely predicting RLN postoperative function. Herein, we present technical notes for the VN identification to achieve the critical view of safety of the VN stimulation with or without dissection.
-
Standard sutures used in vaginal cuff reapproximation in total laparoscopic hysterectomies and hysterotomy closure in myomectomies require knot placement and tensioning of the suture throughout the closure. This may contribute to wound dehiscence, increased blood loss, and ischemia of tissue surrounding the knots. In 2004, the United States Food and Drug Administration approved the Quill™ bidirectional barbed suture (Angiotech Pharmaceuticals, Inc., Vancouver, BC, Canada)(Fig. 1). ⋯ The barbs minimize tissue recoil and do so with accurate soft tissue approximation, achieving hemostasis without the use of locking and figure eight sutures. Barbed suture allows for a shorter operative time, as there is an ease of suturing without the complication of knot tying. Barbed sutures are essential tools in the modern laparoscopist's toolbox.