Surgical technology international
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The first aortic valve homograft was implanted by Sir Donald Ross in 1962. Since then, over 25,000 aortic homografts have been implanted worldwide. Unfortunately, the current cryopreservation method promotes a degenerative process leading to progressive homograft fibrosis and calcification. ⋯ Structural homograft valve deterioration translates predominately into valve insufficiency and less frequently into stenosis. Young recipient age it appears is the major determinant of reoperation. Predictors of early and late mortality are discussed.
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The "sportsman's hernia" commonly presents as a painful groin in those sports that involve kicking and twisting movements while running, particularly in rugby, football, soccer, and ice hockey players. Moreover, sportsman's hernia can be encountered even in normally physically active people. The pain experienced is recognized at the common point of origin of the rectus abdominis muscle and the adductor longus tendon on the pubic bone and the insertion of the inguinal ligament on the pubic bone. ⋯ Our etiopathogenetic theory is based on three factors: (1) the compression of the three nerves of the inguinal region, (2) the imbalance in strength of adductor and abdominal wall muscles caused by the hypertrophy and stiffness of the insertion of rectus muscle and adductor longus muscle, and (3) the partial weakness of the posterior wall. Our surgical procedure includes the release of all three nerves of the region, the correction of the imbalance in strength with the partial tenotomy of the rectus and adductor longus muscles, and the repair of the partial weakness of the posterior wall with a lightweight mesh. This treatment reported excellent results with complete relief of symptoms after resumption of physical activity in all cases.
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Laparoscopic surgery has revolutionized the manner in which many operations are performed today. The volume of tissue to be removed during some operations can be a limiting factor for laparoscopy and is frequently a reason for converting from a minimally invasive laparoscopic surgical approach to the conventional open surgical approach. The introduction of the electronic morcellator has helped facilitate the removal of large specimens via minimally invasive surgery. ⋯ The MOREsolution™ tissue morcellator demonstrated significantly faster tissue morcellation times (544.6 ± 123.0 sec) and produced a higher number of long tissue fragments (7.44 ± 0.683) compared to the Rotocut™ G1 morcellators' time (609.7 ± 153.2 sec) and number of long tissue fragments (6.00 ± 0.638). No significant differences were found between the Gynecare Morcellex® and other morcellators in the total number of fragments obtained nor study participant opinion on the ease of use of the three morcellators. This study demonstrates that the MOREsolution™ morcellator is a faster morcellator and produces larger tissue fragments as compared to the Rotocut™ G1; however, more studies should be performed to confirm these findings in a clinical setting.
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Tourniquets provide a bloodless field in limb operations and their introduction in orthopaedic operative technique has been considered as a landmark. A new tourniquet device, a silicone ring tourniquet (SRT) (HemaClear or S-MART, OHK Medical Devices, Haifa, Israel), was introduced into clinical practice a few years ago. A few clinical studies as well as comparative studies in volunteers have reported its use in a relatively small number of cases. ⋯ It is sterile, and occupies a narrow area of the limb. Its application combines three functions at the same time: exsanguination, tourniquet, and stockinet application. Although it cannot entirely replace the classic pneumatic tourniquet, it is a safe and useful device in orthopaedic operations because of its advantages.
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Review Meta Analysis
Gelatin-thrombin matrix for intraoperative hemostasis in abdomino-pelvic surgery: a systematic review.
Different hemostatic methods are available for mild to moderate intraoperative bleeding during open and laparoscopic abdomino-pelvic surgery, but topical hemostats have gained popularity. We sought to review evidence on the use of a gelatin-thrombin matrix (FloSeal®) in elective abdominal and pelvic surgery. A systematic search of PubMed, EMBASE, and Cochrane databases was conducted. ⋯ Data were not pooled because of the heterogeneity in design. There is insufficient evidence that FloSeal provides better results than conventional hemostasis in abdominal and pelvic surgery, except for open myomectomy. Well-designed randomized trials are needed to evaluate the use of gelatin-thrombin matrix in elective abdomino-pelvic surgery outcomes.