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Biomedical subjects

J F Chambers

Publications and source records attributed to J F Chambers.

8 recordsLinked to original sources
PubMed1993

Laparoscopically assisted vaginal hysterectomy. The initial Nashville, Tennessee, experience.

It is now possible to begin a difficult hysterectomy via laparoscopy with or without adnexal removal and then complete the operation vaginally. We report our successful experience with laparoscopically assisted vaginal hysterectomy in 62 of 68 patients. Techniques used for hemostatic separation of the uterus and adnexal pedicles included an automatic laparoscopic stapling device (49 cases), bipolar coagulation with sharp transection (11) and combined techniques (2). Minor complications occurred in four patients. Six patients had their operations converted from laparoscopy to laparotomy because of significant adhesions (three), large fibroids (two) and poor access due to obesity (one). The use of a stapling device required less anesthesia time (1 hour, 57 minutes, vs. 3 hours, 43 minutes), a smaller blood loss (145 vs. 247 mL) and shorter hospital stays (2.53 vs. 2.75 days) than did laparoscopic bipolar coagulation. However, the average hospital costs were greater for disposable automatic stapling devices and trocars when compared to bipolar coagulation techniques ($9,310 vs. $6,227). Postoperative patient satisfaction with the operation was high (98%), with a high rate of symptom resolution (95%). Laparoscopically assisted vaginal hysterectomy is a safe, effective operation in selected cases and may soon become a common alternative to abdominal hysterectomy in certain cases.

Adult↗
PubMed1991

The use of an automatic stapling device for laparoscopic appendectomy.

Laparoscopic appendectomy, for years performed only occasionally, is becoming more common with the increasing interest by both general surgeons and gynecologists in "minimally invasive surgery." A recently available automatic laparoscopic stapling system (the MULTI-FIRE ENDO GIA 30) claims to make laparoscopic appendectomy technically easier to perform. The technique of laparoscopic appendectomy using this automatic stapling device was evaluated in ten patients and compared with our previous laparoscopic techniques. The MULTI-FIRE ENDO GIA passes through a 12-mm trocar and allows placement of two triple-staggered lines of titanium staples with a simultaneous cut. Using this technique, operating time for laparoscopic appendectomy was reduced from an average of 30 to a minimum of 5 minutes. With this technique, no appendiceal contents leaked intraperitoneally. The larger trocar allowed easier removal of the separated appendix with minimal dissection of the mesoappendix. Indications for appendectomy included endometriosis of the appendix (three), fixation to the right tube or ovary (three), early acute appendicitis (two), and elective removal (two). There were no immediate or late complications. Our preliminary experience with the MULTI-FIRE ENDO GIA 30 stapler suggests that it is a safe, easy, and rapid method of removing the appendix laparoscopically.

Adult↗
PubMed1985

Needs assessment of enteral nutrition support products.

An opinion survey of San Diego hospital health care professionals who use enteral nutrition products for patient care identified cost as an important factor but indicated that quality control, special nutrition features, and wide application of use were even more important product characteristics considered prior to purchase. There was general agreement that customer service, along with volume discounts, was a crucial aspect of successful marketing. The need for local availability of products was also stressed repeatedly. The importance of high-cost product promotions by vendors was downplayed. Health professionals want more nutrition products with specialized compositional profiles (e.g., low or high protein, low sodium, and gluten- and lactose-free), improved flavor, and convenient single-serving packaging.

Attitude of Health Personnel↗
PubMed1980

Prostaglandin E2 vaginal suppositories in pregnancy with an anencephalic fetus.

Three patients with anencephalic fetuses were delivered vaginally following use of prostaglandin E2 (PGE2) vaginal suppositories with minimal side effects and minimal delay until delivery, even though the cervix was unfavorable. One patient had laminaria inserted 12 hours prior to a single PGE2 suppository. The fetuses were stillborn, although all had had fetal heart tones when the first suppository was inserted. The observed uterine tachysystole and hypertonus under these circumstances may be advantageous if they prevent the additional emotional stress involved with the birth of a "live" anencephalic infant.

Abortion, Induced↗