Biomedical subjects

James Ellsmere

Publications and source records attributed to James Ellsmere.

3 recordsLinked to original sources

PubMed2006

Endoluminal instrumentation is changing gastrointestinal surgery.

Advances in endoluminal instrumentation and technology are enabling endoscopists to perform increasingly sophisticated procedures. Indications for these procedures are likely to expand as outcomes studies show they are efficacious and cost-effective. This article highlights several recent advances in endoluminal suturing, dissecting, and ligating and discusses the impact of these advances on the practice of gastrointestinal surgery. Endoluminal suturing offers select patients with gastroesophageal reflux disease a safe and effective alternative to laparoscopic surgery. Devices designed for endoluminal hemostasis and endoscopic mucosal resection can be used effectively for a broader range of applications and are already being used to perform transluminal surgery in animal models; human trials are forthcoming. Gastrointestinal surgeons should support efforts to critically evaluate endoluminal techniques because they have an opportunity to improve care. Surgical residents planning careers in gastrointestinal surgery need to understand endoscopic techniques and consider their training opportunities.

Dissection↗

PubMed2004

A new visualization technique for laparoscopic ultrasonography.

BACKGROUND: Using laparoscopic ultrasonography (LUS) is challenging for both novice and experienced ultrasonographers. The major difficulty surgeons experience is understanding the orientation of the ultrasonography image. The purpose of this study was to assess whether providing surgeons with orientation information improves their ability to interpret LUS images. METHODS: We performed a LUS examination on a 25-kg pig and simultaneously digitized video from the laparoscopic camera, the LUS, and a novel orientation system. From the video recordings, 12 different clips of intra-abdominal anatomy were prepared. Twenty surgeons (18 staff, 2 fellows) volunteered to participate in an experimental crossover study. Test subjects reviewed the LUS clips along with the laparoscopic video images and the orientation display. Controls reviewed the LUS clips with only the laparoscopic video images. Diagnostic accuracy was compared by using the odds ratio. RESULTS: For all vessels, the orientation display improved the odds ratio for correctly identifying structures from 3.7 to 8.9 (P=.02). For arteries, the orientation display improved the odds ratio from 2.4 to 9.6 (P=.01). For veins, the orientation display improved the odds ratio from 4.4 to 13.6 (P=.04). CONCLUSIONS: Providing orientation information significantly improves a surgeon's ability to interpret LUS images.

Animals↗

PubMedDate not supplied

Intussusception after Roux-en-Y gastric bypass for morbid obesity: case report and literature review of rare complication.

Obstruction of the small intestine is a recognized complication after Roux-en-Y gastric bypass surgery for morbid obesity. Reported causes after bariatric surgery include volvulus, adhesion, internal hernia, hemorrhagic bezoar, incarcerated ventral hernia, and intussusception. Intussusception after Roux-en-Y gastric bypass for morbid obesity is rare. The etiology remains largely obscure. A delay in the diagnosis and management may result in catastrophic outcomes. Management should include the early involvement of a bariatric surgeon. We describe the clinical and radiologic presentation of a case of jejunojejunal intussusception 4 years after open Roux-en-Y gastric bypass.

Adult↗