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Biomedical subjects

J E Losanoff

Publications and source records attributed to J E Losanoff.

At least 19 recordsLinked to original sources

Surgery for deeply located hydatid cysts of the liver: a simple alternative.

Gaining access to deeply located hydatid cysts of the liver using conventional surgical techniques may be accompanied by significant intra- and postoperative complications. In addition, obliteration of the cyst cavity is still a matter of controversy. We developed a novel method for easy access to deep hydatid cysts using a water jet dissector (Parenchimotom 01, TOSA, Pleven, Bulgaria). At pressure of 20 Bar using a 0.2 mm nozzle, a corridor is created through the liver parenchyma overlying the cyst; vessels and biliary duct are thus clearly displayed as linear structures traversing the corridor and are ligated and divided under direct visual control. The fibrous capsule of the cyst is spared by the jet. Following endocystectomy performed in the ordinary manner, the cyst cavity is filled with gelatin sponge; a passive tube drain is placed in contact with the liver incision. In allowing for a selective dissection of the liver parenchyma, the jet makes safe access to deeply located hydatid cysts possible. On the other hand, the gelatin sponge induces good fibroblast response and assists in rapid and effective obliteration of the residual cavity. This novel technique works well in our hands but more extensive studies are necessary before its final acceptance.

Echinococcosis, Hepatic↗

Recurrent idiopathic perforations of the small intestine.

BACKGROUND/AIMS: Idiopathic perforation of the small intestine is extremely rare. The definition depends on the absence of any detectable pathology that could be responsible for the perforation. This study was undertaken to outline the criteria for determination of the condition. METHODS: Case report and review of the literature. RESULTS: A 50-year-old male patient underwent surgery including laparostomy and planned reexplorations for multiple recurrent small intestinal perforations of unknown origin; the patient made an uneventful recovery. Extensive investigations were carried out to search for any pathology that could explain the occurrence of perforations, but yielded no results. CONCLUSIONS: Further studies will possibly give more information concerning idiopathic perforation of the small intestine, provided that judicious criteria for its determination are applied.

Humans↗

Eosinophilic enterocolitis and visceral neuropathy with chronic intestinal pseudo-obstruction.

A patient is described who was found to have both eosinophilic enterocolitis and visceral neuropathy with chronic idiopathic intestinal pseudo-obstruction. The etiology and pathogenesis of this rare combined disorder of the gastrointestinal tract are discussed. Although eosinophilic enterocolitis is amenable to conservative treatment, surgery may be necessary for palliation in selected patients with pseudo-obstruction due to visceral neuropathy.

Adult↗

Reconstructive renal surgery using a water jet.

PURPOSE: We describe the successful application of a water jet to reconstructive renal surgery. MATERIALS AND METHODS: Two consecutive patients underwent reconstructive renal surgery using a waterjet apparatus for a 4.0x6.5 cm. well encapsulated tumor of the lower pole of the left kidney and a 4.5x2.5 cm. staghorn calculus of the left kidney, respectively. The water jet apparatus (Parenchimotom 01) consists of a pressure generating pump and a flexible hose connected to the hand piece, and a nozzle with a pinhole opening of 0.3 mm. RESULTS: Both patients underwent surgery through a left lumbar incision. Partial nephrectomy was performed in 1 patient and anatrophic nephrotomy for stone removal in the other. Dissection time was 25 and 12 minutes, with blood loss of 150 and 100 ml., respectively. No temporary vascular clamping or local hypothermia was necessary. Both patients were discharged home 10 days after surgery and at followup no negative sequelae were attributable to the procedure. CONCLUSIONS: The operative procedures proved easy, fast and effective. No temporary vessel clamping or hypothermia was required. Using a water jet is a novel approach that is helpful in renal surgery.

Equipment Design↗