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Biomedical subjects

G Szinicz

Publications and source records attributed to G Szinicz.

At least 19 recordsLinked to original sources
PubMed1998

Laparoscopic appendectomy does not change the incidence of postoperative infectious complications.

BACKGROUND: It is not clear whether the laparoscopic approach does decrease the incidence of postoperative infectious complications after appendectomy. METHODS: One hundred sixty-nine patients were randomized, 87 with laparoscopic (LA) and 82 with open appendectomy (OA). Patients in the OA group had a McBurney incision; LA was performed in the lithotomy position. RESULTS: Acute appendicitis was confirmed in 75% of patients. The appendix was perforated in 5 patients of the LA versus 2 patients of the OA group. No conversion to the open procedure was necessary. The median operating time was 35 minutes in the LA group and 31 minutes in the open group (P = 0.58). The median postoperative hospital stay was shorter after laparoscopic than after open surgery (3 days versus 4 days, P = 0.026), whereas the time required for return to work was not significantly different (14 versus 15 days). There were 5 (6%) patients with superficial wound infection following LA and 6 (7%) after OA (P = 0.67). Intra-abdominal fluid collections were found in 2 (2%) patients following LA and 3 (4%) patients following OA (P = 0.60). In the LA group, 3 patients presented with intra-abdominal hemorrhage and another 3 developed a paralytic ileus that was treated conservatively. CONCLUSIONS: Laparoscopic appendectomy is as safe and as effective as the open procedure; however, it does not decrease the rate of postoperative infectious complications.

Abdominal Abscess↗
PubMed1997

[Role of the pulsatile organ perfusion surgical simulator in surgery education].

The operation simulator with pulsatile organ perfusion ("POP trainer") simulates the blood supply of organs or organ complexes and was developed for the training in both minimally invasive and conventional surgery. With the redesigned new POP-trainer, even complex operations, such as colorectal and antireflux procedures can be practised. Due to perfect quality of simulation, simple handling and economic aspects, the POP trainer serves to intensify the training of surgeons, simultaneously decreasing the number of animal experiments.

Animal Testing Alternatives↗
PubMed1996

[Double balloon catheter for facilitating (laparoscopic) choledochus drainage].

In laparoscopic management of choledocholithiasis the drains available for bile-duct drainage are problematic. Since November 1991 we have given priority to the laparoscopic management of common bile-duct stones (n = 97). In cooperation with industry (W. Rüsch/D-Waiblingen), we have developed a double-balloon catheter for laparoscopic application. In 15 cases we used this double-balloon catheter. There were no complications like dislocation, obstruction or leakage. This new catheter facilitates the procedure of laparoscopic bile-duct exploration in choledocholithiasis. The operating time is reduced and removal of residual concrements is easily possible.

Catheterization↗
PubMed1996

[Laparoscopic therapy of choledocholithiasis].

The introduction of laparoscopic cholecystectomy has led to controversial discussions about the proceeding in case of coincident common bile duct stones. In our unit choledocholithiasis has been treated laparoscopically since November 1991. Basic requirement has been a routine intraoperative cholangiography. 67 patients with common bile duct stones were treated until January 1995. All patients underwent a follow up and the results were compared to other concepts. In 40 cases common bile duct stones were eliminated via cystic duct and in 27 cases by choledochotomy. The choledochus was drained routinely for postoperative x-ray control. In 9 cases we found residual concrements: 7 patients required postoperative endoscopic papillotomy and in 2 cases the calculi where eliminated with a dormia basket introduced via drainage tube. In one case surgical management was changed to laparotomy. Postoperative complications occurred in 8 cases. One patient suffering from bacterial peritonitis underwent laparotomy on the 9th postoperative day; one with bleeding from the cystic artery was treated by relaparoscopy. One patient developed a liver abscess and two patients a bilioma requiring ultrasound guided drainage. A superficial wound infection in one patient and a biliary leakage after removal of the drainage in two patients healed spontaneously. Due to an intact papilla with less stress to the patient, as well as a complication rate comparable with other published therapeutic concepts, this strategy can be recommended as a valuable alternative procedure.

Cholangiography↗
PubMed1996

[Laparoscopic versus conventional appendectomy: a prospective randomized study].

The discussion about laparoscopic appendectomy has increased since the introduction of this method. Randomized comparisons are still feasible, whereas this cannot be stated for other laparoscopic procedures (e.g., laparoscopic cholecystectomy). This randomized controlled trial included 170 patients. Open appendectomy was employed in 83 patients, and 87 were treated laparoscopically. The treatment groups were comparable regarding age, sex, Broca index, ASA classification, preliminary operations, and preoperative leucocytes. No statistically significant differences could be found with respect to surgical and general complications, operating time, consumption of analgesics and antibiotics, and return to work. The analysis revealed a statistically significant shorter hospital stay, a shorter time until return to normal physical activity, and a shorter duration of complaints for the laparoscopic group. We were unable to demonstrate any statistically significant advantage in using the open procedure.

Adolescent↗
PubMed1995

[Educational opportunities in minimally invasive surgery].

Since minimally invasive surgery makes high demands on the skill, concentration and endurance of the surgeon, requisite training in this operating technique is of overriding importance. Basic training on pelvitrainers serves to enable the participant to become acquainted with the instruments and the video technique and to gain experience in handling the camera. A realistic simulation of intraoperative situations is not possible. With pulsatile organ perfusion (POP) nearly all abdominal, thoracic, vascular, urological and gynecological surgical procedures, as well as the encountered complications, can be imitated, widely replacing the need for animal experiments. Complex operations which are bound to anatomical structures, have to be practised on anaesthetized animals, as before.

Animals↗
PubMed1995

[Laparoscopic therapy of choledocholithiasis].

In the period November 1991 to October 1993 altogether 418 patients underwent laparoscopic cholecystectomy in our unit. Routine intraoperative cholangiography, a prerequisite for diagnosing choledocholithiasis, was successful in 99.3% of cases. 38 patients were found to have common bile duct calculi and their management and follow up are reported in this study. In 36 cases stones were successfully eliminated by means of the laparoscopic procedure, via the cystic duct in 22 cases and by choledochotomy in 14 cases. One patient required postoperative endoscopic papillotomy, and in the remaining case surgical management was changed to classical laparotomy and open choledochotomy. Postoperative complications occurred in five cases. One patient suffering from bacterial peritonitis underwent laparotomy on the 9th postoperative day, another with postoperative bleeding from the cystic artery was relaparoscopied on the same day as the minimal invasive procedure. One patient developed a liver abscess three weeks after operation, requiring drainage with the aid of ultrasound. A superficial wound infection in one patient and biliary leakage after removal of the T-tube in another patient both healed spontaneously. Our results are similar to those obtained with other therapeutic concepts. Because the papilla of Vater remains intract in minimal invasive surgery, which causes relatively little stress to the patient, as well as considering the economic advantages of a single-step procedure, this management strategy can be recommended as a valuable alternative procedure.

Cholecystectomy, Laparoscopic↗
PubMed1995

[Laparoscopy-assisted colon surgery--overview and personal experiences with 64 patients].

The number of laparoscopic or laparoscopic-assisted operations in abdominal surgery constantly increases. 64 patients between February 1992 and November 1993 underwent a laparoscopic assisted colorectal procedure. In 5 cases laparotomy was necessary. There were only 4 complications: one subileus treated conservatively and one peritoneal abscess was drained successfully under sonographic guidance; furthermore there were a postoperative pneumonia and a prolapse of the greater omentum in the area pierced by a 10 mm-trocar. The oncologic criteria for the resection of malignant tumours can be fulfilled in laparoscopic surgery. Our first experiences indicate that the advantages for the patient in laparoscopic procedures of the colon/rectum are the same as have been reported in laparoscopic cholecystectomy.

Aged↗
PubMed1993

Simulated operations by pulsatile organ-perfusion in minimally invasive surgery.

The rapid amplification of indications and areas of application of laparoscopic or thoracoscopic techniques leads to increasing problems and needs in surgical training. Pulsatile perfusion of organs (POP) and organ groups in laparoscopic training devices (pelvitrainers) aids in creating optimum conditions for the simulation of difficult intraoperative situations and complications. Simple applicability, low cost, and the possibility of a noticeable reduction of the currently required animal experiments render POP an ideal training method for minimally invasive surgery.

Animals↗
PubMed1992

Thoracoscopic resection of a pericardial cyst.

The development of new instruments that can be applied endoscopically opens up new possibilities for minimally invasive thoracic surgery. The surgical technique is exemplified by a thoracoscopic resection of a pericardial cyst. The benefits for the patient are impressive: minimization of surgical trauma and postoperative pain, a short convalescence, and an optimal cosmetic outcome.

Adult↗
PubMed1989

"Reversible gastric banding" in surgical treatment of morbid obesity--results of animal experiments.

The basic principle of "reversible gastric banding" as a new surgical approach to morbid obesity treatment is the creation of a small fundus reservoir using a silicone cuff which is coiled around the stomach close to the cardia. The extent of obstruction corresponds to the amount of liquid in the cuff which can be varied by puncture of a valve implanted in the subcutis. The reversibility of gastric obstruction is the great advantage of this method as compared to vertical banded gastroplasty or gastric bypass. We studied this method in animal experiments using seven "Göttinger Minipigs". In two animals the objectives of the study were reached, the observed complications, mostly caused by the nature of the test animal, are analyzed and discussed. To our knowledge, this is the first report in the literature on animal experiments in bariatric surgery.

Animals↗
PubMed1980

A new implantable sphincter prosthesis for artificial anus.

A new totally implantable hydraulic sphincter prosthesis which differs from other systems by a very simple function is presented. The construction and the performance are described and the results of animal experiments are reported. The clinical application of this device in 3 female and 4 male patients has been successful. Indications and contraindications are discussed.

Aged↗
PubMed1979

Sclerosing angioma of the lung. Case report and electron microscope investigation.

Electron microscopy of a sclerosing angioma of the lung, a coincidental finding in the upper lobe of a 32-year-old woman. The rare, benign tumor, whose vascular proliferation by light microscopy is reminiscent of an angioma, exhibits a clear epithelial structure by electron microscopy. The tumor may develop out of immature pneumocytes. The paper discusses histogenesis and problems of differential diagnosis (potential confusion with carcinomas).

Adult↗
PubMed1977

[Contribution to biliobronchial fistula (author's transl)].

A case report has been made on a bronchobiliary fistula which was caused from an unspecific liver abscess. The causal therapy was the drainage of the liver abscess. The fistula then healed spontaneously. A primary thoracic sanitation of the fistula is in such cases not indicated.

Biliary Fistula↗
PubMed1977

[Functional examination findings after parietal pleurectomy in patients with recurrent of spontaneous pneumothorax (author's transl)].

Eight patients with recurrent of spontaneous pneumothorax were re-examined sixteen months or more after a total parietal pleurectomy had been carried out. This re-examination included: 1. Detailed case history with emphasis on physical performance; 2. clinical findings; 3. Thorax x-ray at two planes; 4. Lungscintigraphy; 5. Spirometry. Following parietal pleurectomy, none of the patients exhibited any functional disturbance worthy of mention. This operative technique, perhaps modified as a partial parietal pleurectomy, can be recommended at this time as the method of choice for treating recurrent spontaneous pneumothorax.

Adult↗