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Biomedical subjects

N Taffinder

Publications and source records attributed to N Taffinder.

7 recordsLinked to original sources
PubMed1997

Cells are present in the smoke created during laparoscopic surgery.

BACKGROUND: The application of laparoscopy for malignancy has been halted in many centres because of a growing number of reports of metastases arising in port sites. The smoke created by coagulation during laparoscopic surgery appears to contain particles visible to the naked eye. This study tested the hypothesis that whole cells can be carried as an aerosol in the pneumoperitoneum during laparoscopy. METHODS: Nine patients undergoing laparoscopic surgery for benign and metastatic disease were studied. Throughout the procedure the gas of the pneumoperitoneum was allowed to escape through a filter. The filters and tubing were washed, and washing solution was centrifuged and stained immunohistochemically to identify the cells. Three of the filters were also examined with an electron microscope. RESULTS: Six of the nine samples contained cells. Clumps of whole cells were identified as mesothelial in origin; the electron micrographs showed many other cells stuck to the filter, which appeared to be blood and mesothelial cells but were not analysed further. CONCLUSION: The presence of whole identifiable cells carried in the pneumoperitoneum raises concerns for operating staff and could be a mechanism for tumour implantation. No malignant cells were found, but ethical considerations prevented intentional coagulation of malignant tissue.

Aerosols↗
PubMed1997

[Laparoscopic surgery. Does smoke transport cells?].

The study was designed to test the hypothesis that whole cells can be carried as an aerosol in the pneumoperitoneum during laparoscopy. Twelve patients undergoing laparoscopic surgery for benign and metastatic disease were included in the study. Throughout the 12 procedures, the smoke and the gas of the pneumoperitoneum was evacuated through 17 filters. Twelve filters and the tubing were washed. The liquid was centrifuged and stained immunocytochemically to identify the cells. Five other filters were also photographed with an electron microscope. On immunocytochemistry, nine of the twelve samples were identified as mesothelial in origin and the electron micrograph show many other cells stuck to the filter which appeared to be blood cells and mesothelial cells. Malignant cells were not conclusively identified, but ethical considerations prevented any intentional coagulation of malignant tissue. The presence of whole identifiable cells in the pneumoperitoneum could partly explain, port site metastasis after laparoscopic surgery for cancer.

Carbon Dioxide↗
PubMed1996

Serious trocar accidents in laparoscopic surgery: a French survey of 103,852 operations.

The incidence of serious trocar accidents was evaluated from a retrospective French study of 103,852 laparoscopic operations involving almost 390,000 trocars. Seven perioperative deaths occurred (mortality 0.07/1,000), arising almost exclusively from vascular injuries. The incidence of vascular injuries was 0.4/1,000. There were injuries to almost all the abdominal organs and most of the abdominal vascular tree. In the absence of any well-defined safety regulations, the technique of open insertion of the first trocar would appear to be the best means of preventing these accidents.

Data Collection↗
PubMed1996

[Can we recognize the pathological character of the appendix during laparoscopy? Prospective study: 81 cases].

In a prospective study of 81 patients, the appendix was photographed during a laparoscopy performed for pain in the right iliac fossa. An appendicectomy was performed in 65 patients, for the remaining 16, another cause for the pain was found and the appendix was left in place. The evaluation of the photographed appendix was formed afterwards by a group of 10 surgeons and compared with the histopathological results. In 20 cases (30%) the appendix was normal. In 7 (10%) minimal mucosal inflammation was found and in 38 (60%) acute appendicitis. All the surgeons correctly recognised acute appendicitis. The accuracy of recognition of a normal appendix was 70% overall, and the maximum risk of leaving an early form of appendicitis to evolve was 14%. We propose not removing an appendix judged to be normal during laparoscopy if no other cause for the pain is found. A short course of antibiotics would cover the low risk of allowing a very early appendicitis to develop.

Acute Disease↗
PubMed1992

Portal vein thrombosis in a complicated case of Crohn's disease.

Portal vein thrombosis is a rare complication of ulcerative colitis and is invariably fatal. This report describes a patient with severe Crohn's disease who underwent elective surgery complicated by an anastomotic disruption with faecal peritonitis. Following emergency laparotomy he developed left hypochondrial pain which was a manifestation of splenomegaly consequent upon portal vein thrombosis. Anticoagulation was successful in preventing further spread of the thrombosis as monitored by colour Doppler ultrasound. Severe active disease, surgery and sepsis have been recognized as predisposing factors for thromboembolic complications in inflammatory bowel disease and this patient was exposed to all three. It is conceivable that portal vein thromboses occur more commonly than suspected and ultrasound scanning could ascertain the prevalence if performed prospectively.

Adult↗