Biomedical subjects
Publications and source records attributed to L A McCain.
Endoscopy is a surgical technique involving the use of an endoscope, an instrument with a tiny camera inserted through very small incisions designed to project images of the body's internal structures onto a video monitor. In aesthetic surgery, endoscopic technology is a solution to the scarring problems that have long frustrated patients and surgeons alike.
There has been an explosive interest in endoscopic techniques by plastic surgeons over the past two years. Procedures such as facial rejuvenation, breast augmentation and abdominoplasty are being performed with endoscopic assistance. Endoscopic operations require a complex setup with components such as video camera, light sources, cables and hard instruments. The Hopkins Rod Lens system consists of optical fibers for illumination, an objective lens, an image retrieval system, a series of rods and lenses, and an eyepiece for image collection. Good illumination of the body cavity is essential for endoscopic procedures. Placement of the video camera on the eyepiece of the endoscope gives a clear, brightly illuminated large image on the monitor. The video monitor provides the surgical team with the endoscopic image. It is important to become familiar with the equipment before actually doing cases. Several options exist for staff education. In the operating room the endoscopic cart needs to be positioned to allow a clear unrestricted view of the video monitor by the surgeon and the operating team. Fogging of the endoscope may be prevented during induction by using FREDD (a fog reduction/elimination device) or a warm bath. The camera needs to be white balanced. During the procedure, the nurse monitors the level of dissection and assesses for clogging of the suction.
Although plastic surgeons had been slow to incorporate endoscopic techniques into their surgical armamentarium, there has been considerable interest in this field during the last 2 years. The aim of endoscopic brow lifting has been to achieve elevation of the brow through small scalp incisions without the associated nerve damage of the open approach and to accurately address excision of the muscles responsible for frowning. Endoscopic neck lift is a more recently pioneered technique which, although still in developmental stages, appears to provide good results. The technique involves undermining the skin of the neck extending from the chain to the jawline around the ear. Endoscopic facelifting is still very much in the experimental stages. Endoscopic techniques reduce the need for an incision in front of the ears. Using the endoscope, it has become a simple matter to perform a transaxillary breast augmentation using very small axillary incisions and precise placement of the implants. This results in excellent symmetry postoperatively and easy scar concealment. Abdominoplasty is another example of a procedure usually associated with a long incision and some degree of postoperative pain and immobility. Endoscopic abdominoplasty has been devised to provide not only contouring of abdominal fat through liposuction, but correction of the weakened abdominal muscle through a small incision placed just above the suprapubic hairline.
Autoimmune disorders lead to a sequence of tissue reactions and damage that may produce diffuse, systemic signs and symptoms. Litigants in many breast implants trials have claimed their autoimmune disorders (rheumatoid arthritis, scleroderma, and SLE) were from a causal relationship with mammary implants. Science suggests environmental factors, such as vinyl chloride, and hereditary factors may account for some of the prevalence of these disorders, however the exact cause remains a mystery and brings into question the claims being brought by litigants regarding implants.
The permanent loss of a breast from cancer brings forth a range of emotional and behavioral reactions. As more and more women opt for immediate breast reconstruction, plastic surgical nurses need to recognize the acute stress reactions these patients are experiencing. Not only should the disease itself be treated, but the individual suffering from the disease. This article provides an overview of women's psychological responses and adjustments to the breast cancer diagnosis that plastic surgical nurses need to consider.