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Patricia L Turner

Publications and source records attributed to Patricia L Turner.

6 recordsLinked to original sources
PubMed2006

Classification of hiatal hernias using dynamic three-dimensional reconstruction.

Hiatal hernias and paraesophageal hernias are common clinical entities and have a well-known classification system. Multiple modalities have been used to illustrate these hernias, most relying on artists' renderings or two-dimensional radiographic studies. However, surgeons would benefit from a comprehensive graphic representation of hiatal hernias based on current imaging technologies. We have applied polygonal mesh surface modeling techniques to render dynamic three-dimensional computed tomography-based models of the four recognized types of hiatal hernias. The resulting images allow nearly real-time navigation in an intuitive and clinically relevant fashion. This model should clarify and eventually advance the existing classification by applying modern and sophisticated image processing to established concepts.

Hernia, Hiatal↗
PubMed2006

Laparoscopic distal pancreatectomy with splenic preservation for serous cystadenoma: a case report and literature review.

A minimally invasive approach can be beneficial in a spleen-preserving distal pancreatectomy. This article reports a 71-year-old woman who presented to her internist with hypertension and persistent hypokalemia. A computed tomography scan to rule out a functional adrenal mass incidentally revealed a 4 cm x 3 cm x 2 cm serous cystadenoma of the distal pancreas and normal adrenal glands. The patient was referred to the general surgery service for resection of the distal pancreatic lesion. A laparoscopic spleen-preserving distal pancreatectomy was performed. The lesion was completely excised, and the pathology revealed serous cystadenoma with focal fibrosis and atrophic acini. The postoperative advantages of this approach were the early return of bowel function, minimal narcotic requirements, and early resumption of normal activities. This case illustrates the advantages of minimally invasive surgery in the performance of a spleen-preserving distal pancreatectomy.

Aged↗
PubMed2006

Endoscopic placement of radiopaque markers for focused evaluation of intestinal motility.

Using traditional techniques in novel ways often can improve management of common surgical problems. Additionally, established products may find new utility when deployed in a slightly different fashion to enhance patient care in a clinically relevant way. This article describes endoscopic placement of radiopaque markers into the proximal small intestine as a means to evaluate motility in a focused fashion. A method to delineate the location of dysmotility in a patient with several potential sites is described. This technique is safe, feasible, reasonably inexpensive, and is easily performed by a skilled endoscopist. Moreover, this technique has the added benefit of providing functional data in a timely fashion.

Capsules↗
PubMed2002

Gender verification of female Olympic athletes.

Gender verification of female athletes has long been criticized by geneticists, endocrinologists, and others in the medical community. Problems include invalid screening tests, failure to understand the problems of intersex, the discriminatory singling out of women based only on laboratory results, and the stigmatization and emotional trauma experienced by individuals screened positive. Genuine sex-impostors have not been uncovered by laboratory-based genetic testing; however, gender verification procedures have resulted in substantial harm to a number of women athletes born with relatively rare genetic abnormalities. Individuals with sex-related genetic abnormalities raised as females have no unfair physical advantage and should not be excluded or stigmatized, including those with 5-alpha-steroid-reductase deficiency, partial or complete androgen insensitivity, and chromosomal mosaicism. In 1990, the International Amateur Athletics Federation (IAAF) called for ending genetic screening of female athletes and in 1992 adopted an approach designed to prevent only male impostors from competing. The IAAF recommended that the "medical delegate" have the ultimate authority in all medical matters, including the authority to arrange for the determination of the gender of the competitor if that approach is judged necessary. The new policy advocated by the IAAF, and conditionally adopted by the International Olympic Committee, protects the rights and privacy of athletes while safeguarding fairness of competition, and the American Medical Association recommends that it become the permanent approach.

Disorders of Sex Development↗
PubMedDate not supplied

Laparoscopic "Dome-down" cholecystectomy with the LCS-5 Harmonic scalpel.

OBJECTIVE: Misidentification of ductal anatomy and electrocautery injuries are complications associated with laparoscopic cholecystectomy (LC). Dome-down LC creates a 360-degree view of the gallbladder-cystic duct junction, reducing the risk for anatomy misidentification. In addition, ultrasonic instrumentation eliminates the risk for electrocautery injuries. This study assessed the feasibility and safety of dome-down LC combined with ultrasound technology. METHODS: Patients with noncancerous gallbladder disease were enrolled consecutively. Gallbladders were classified by clarity (Class I to IV) of anatomy and pathology (acute, chronic, or acalculous). The gallbladder was dissected from the gallbladder bed using a dome-down technique, and the cystic artery was coagulated and transected with the LCS-5 Harmonic scalpel (Ethicon Endo-Surgery Inc., Cincinnati, Ohio). The cystic duct was ligated with 2-polydioxanone Endoloops size 2-0 and sharply divided, leaving one Endoloop on the cystic duct stump. RESULTS: LC was successfully completed in 105 patients (mean age, 44 years; range, 18 to 91 years) in whom the anatomy was classified as Class I in 30 (29%) patients, Class II in 42 (38%), Class III in 25 (24%), and Class IV in 8 (8%). Gallbladder dissection time ranged from 8 to 42 minutes (mean, 18 min). The operating room time ranged from 32 to 128 minutes (mean, 55 min). Two gallbladder perforations occurred, but no complications were associated with the extrahepatic biliary tree, viscera, or major blood vessels. Elective conversion occurred in 8 (7.6%) patients due to poor visualization of anatomy because of inflammation and adhesions. Patient blood loss was minimal in all cases. No postoperative complications were observed after a 6-month follow-up. CONCLUSION: Dome-down laparoscopic cholecystectomy with the LCS-5 Harmonic scalpel decreases the potential for misidentification of ductal anatomy, has minimal complications, and eliminates electrocautery risks. Conversion is related to poor visualization of anatomy due to inflammation and adhesions.

Adolescent↗