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Biomedical subjects

S Gentilli

Publications and source records attributed to S Gentilli.

At least 19 recordsLinked to original sources
PubMed2006

[Prototype of a system for electric conduction at contact with laparoscopic tools].

The authors present their prototype of a system for electric conduction at contact with laparoscopic tools, devised, designed and produced by them at the Politecnico di Torino, Department of Mechanical Engineering. The system consists of a two sided plate, one side is a non conducting adhesive surface to stick to the surgical glove and the other side is a subtle flexible shell of a conductor. The Authors used the instrument with surgical tools with a metallic handle, during three cholecystectomies. Nowadays all standard laparoscopic tools have the chance and the need to be electrified. Now the way commonly used to electrify a laparoscopic tool is using a wire plugged to a fixed conducting point of the instrument. This prototype has been devised and produced to avoid some discomforts met during the numerous manoeuvres of connecting and disconnecting the wire at the time of a surgical intervention. This device permits the direct transfer (by contact) of electric energy from the wire to surgical tools. The advantage is to be more rapid in changing surgical tools obtaining, immediately an electrified instrument in your hand.

Cholecystectomy, Laparoscopic↗
PubMed1999

[Cicatricial stenosis of colorectal anastomosis. Transanal treatment with circular stapler].

Anastomotic strictures complicating colorectal anastomoses can be difficult to treat. This condition must not be considered as an uncommon complication. In 20% of patients it may be a serious state that may require a therapy. Two patients treated successfully without complication with the transanal use of an CEEA stapler are presented. The staple cutter is safe and easy to use, and except for a conventional anoscope, no special equipment, including fluoroscope, is needed. On the basis of the successful results obtained, the procedure using staple cutter is recommended for the treatment of anastomotic stricture of the rectum.

Adenocarcinoma↗
PubMed1998

Laparoscopic splenectomy. How to make it easier using an innovative atraumatic suction grasper.

BACKGROUND: With the evolution of laparoscopic surgery comes the need for specific instruments that apply traction to parenchymal tissue, like the spleen, without exposing the organ to the associated high risk of bleeding. To meet this need, we designed and developed a suction-cup grasper that allows easy grasping and manipulation of the spleen. Some of the difficulties usually encountered during laparoscopic splenectomy may be overcome by using this device. MATERIALS: The instrument consists of a cone-shaped, silicone rubber suction cup designed with an antislip internal surface. The cup is connected to a support arm with a flexible distal end that can be rotated. Traction is exerted with a commonly available suction system. The device is inserted through a 12-mm-diameter guide sheath. RESULTS: The two interventions performed with the atraumatic device were completed with laparoscopic technique. No complications arose during or after the operations. The average operating time was 110 min. The patients were discharged after 4 and 5 days postoperative, respectively. CONCLUSIONS: As a device specifically designed for grasping parenchymal organs, the atraumatic suction grasper affords the operator a faster and safer technique in laparoscopic splenectomy.

Equipment Design↗
PubMed1998

Laparoscopic adrenalectomy: advantages of an atraumatic suction grasper.

Laparoscopic adrenalectomy still presents some technical problems. The impossibility of directly grasping the gland is the main difficulty. To overcome this problem, we have begun to use an atraumatic suction grasper. From September 1995 to December 1997, 15 laparoscopic adrenalectomies were performed. Group 1 comprised 8 patients operated on without the atraumatic suction grasper; group 2 consisted of 7 patients who underwent a laparoscopic adrenalectomy with the use of this new device. The surgical technique with the use of an atraumatic suction grasper is described. No significant difference was noted between the two groups except in the operative time, which was reduced in group 2, and in the surgeon's comfort. The reported advantages are a direct grasp of the adrenal gland without the risk of squeezing, rupture, or bleeding; a better exposure of the adrenal vessels; and shorter operating time.

Adrenal Gland Neoplasms↗
PubMed1996

[Gallbladder carcinoma. Our experience].

The authors report their experience of 18 patients with primary cancer of the gallbladder. On 10 patients at stage IV, 9 had a preoperative diagnosis, while at stage 0-1 and 2 the diagnosis was intraoperative or histologic. Every patient had a cholelithiasis at the same time. The authors discuss prophylactic cholecystectomy, even without specific symptoms, and emphasize the need for a better morphological and radiomorphological classification. In the light of the new microinvasive surgical techniques, they briefly discuss laparoscopic cholecystectomy and histologic diagnosis of carcinoma of the gallbladder.

Adenocarcinoma↗
PubMed1995

[Parapapillary leiomyoma of the second duodenal portion: anatomo-clinical considerations].

The authors describe a rare case of leiomyoma situated in the second duodenal portion near the Vater papillary diagnosed for over eight years. The preoperative investigation isn't able to explain certainly the characteristics and the anatomo-topographic relations of the lesion besides the anatomo-pathologic dates have left a border of uncertainty about the benignity of the lesion. These considerations, as agreed with the greater part of authors, show the necessity of early surgical treatment.

Duodenal Neoplasms↗
PubMed1995

Surgery of the incidentally discovered mass of the adrenal gland (incidentaloma).

The authors present their experience about surgery in adrenal gland incidentaloma, during a period of 12 years (1982-1993), at the VI Division of General Surgery, University of Turin. In 17 patients, of 70 who underwent adrenalectomy, the adrenal neoplasm was located thanks to a diagnostic investigation (ECI or CT) executed for other reasons. In ten cases was diagnosed adenoma, in five cases carcinoma, in two cases cysts. In the diagnostic approach to adrenal incidentaloma we did not search for possible hormonal activity, since the patients had been previously selected from specialized endocrinological centres. At present, biological markers not being certain or absolute radiological significance so as to detect benignant from malignant forms. In accordance with international Literature the size of the neoplasm is the discriminant element for adrenalectomy. We have removed the incidentaloma in all cases, be it clinically or subclinically functional and the silent forms > 4 cm as we have observed a statistically significant difference (p < 0.0002) between the benign and malignant lesions, particularly those measuring more than 4 cm in diameter. We suggest a screening with CT scan every three months in lesions < 4 cm, silent and those > 4 cm in patients over sixty years with a morphological aspect of the bening form.

Adenoma↗
PubMed1994

[Retroperitoneal paragangliomas. Considerations on a internephro-caval case].

A case of paraganglioma situated between right renal vein, right renal artery and inferior vena cava is here with described. The report constitutes the rise to frame with precision the tumor according with WHO classification. Moreover criteria are to be discussed for nature and seat diagnosis, as well for the choice of the best way of access.

Female↗
PubMed1993

[Proctological surgery in the day-hospital regimen].

567 haemorrohoidectomies 83 of which total haemorrhoidectomies for piles with surgical indications, were performed with recourse to day-hospital admission. The authors examine the results of this experience and advise this therapy and this type of admission for pathologies with different cost/benefit ratio.

Ambulatory Surgical Procedures↗
PubMed1993

[Foreign body decubitus: unusual cause of acute appendicitis].

The authors describe the origin and the physiopathological events in acute appendicitis. They show an uncommon case of acute appendicitis. The aetiology was an opaque radiation foreign body causing a subacute abdominal disease. At operation the authors discovered the above body free in the abdominal cavity; the appendix was not in ischemic phase but completely cut off bycecal plant. They suppose aetiology to be of a decubitus origin.

Acute Disease↗
PubMed1993

Ileo-colon-rectoplasty. An experimental morpho-functional study on the pig.

A small bowel loop was interposed, isoperistaltically or pouch-shaped between colon and rectum, (ileo-colon-rectoplasty) in 8 pigs to clarify whether the small intestine can push the semi-solid and septic content of the colon, and whether the function and morphology of the loop are modified with respect to the original. A radiographic and histologic study was performed 6 months after the operation. The structural modifications of the interposed small bowel consist of disappearance of folds, villous atrophy, superficial appearance of the glandular crypts, and, only in the isoperistaltic loop, hypertrophy of the muscular layers. Any modification in the morphologic aspect of the pouch has not been observed, as shown by the radiographic barium enema. Therefore the mucosa of the grafted ileum suffered an architectural change caused from the contact with the fecal material. The lack of structural modifications of the muscular layers and the dimensions of the above colon of the interposed ileal pouch represents an indirect proof of the correct function of reservoir ejection. The experimental results obtained confirm the applicability of this technique in the reconstruction of transit after wide resection of the left colon and rectum, for technical reasons, in man.

Animals↗
PubMed1993

[Intra-operative irrigation during colonic resection and anastomosis in colonic obstruction].

The faecal loading associated with colonic obstruction is a fundamental deterrent to constructing a primary distal colonic anastomosis. The authors describe their preliminary experience of intraoperative colonic irrigation in the management of left sided large bowel emergencies. Five patients were operated using this technique (4 cancer obstruction and one sigma volvulus). They show good results performing primary anastomosis after emergency distal resection combined with complete colonic cleansing.

Aged↗
PubMed1991

Modifications of the trophism of intestinal mucosa after intestinal and bilio-pancreatic diversion in the rat.

Morphofunctional alterations to the intestinal mucosa are influenced by three main factors: food, bilio-pancreatic secretions, intestinal hormones. In order to assess the importance of each one, histological and histochemical tests were performed on different segments of intestine taken from rats which were sacrificed one month after the following procedure: gastrojejunal anastomosis on a Roux loop (Model I); same procedure plus biliopancreatic bypass into the jejunum (Model II). When compared to the controls, Model I duodenum samples revealed hypertrophy of the entire wall with "bundles" of villi, while Model II samples showed a clear hypotrophy and reduction in the number of duodenal villi. To such modifications of the duodenum correspond longer, thinner villi in the other bowel segments, particularly in the jejunum and distal ileum. These results suggest that the predominant trophic effect derives from contact with biliopancreatic secretions at a proximal level. The modifications of the duodenal mucosa appear to regulate the trophism of the distal segments probably by the secretion of distant acting enterohormones.

Adaptation, Physiological↗
PubMed1989

[Pseudotumor of the supraclavicular fossa].

The authors focus on a physiopathologic manifestation, most often misdiagnosed, which present as a "lipomatous-like mass in the supraclavicular fossa". This is generally at the origin of sophisticated radiologic tests and, not infrequently of useless biopsies. The paper analyzes the different reasons leading, alone or in combination, to the phenomenon by which the mediastinal fat is pushed toward regions where no limits anatomic structures exist, such as the supraclavicular fossa. Knowledge of the above causes, together with a careful physical examination plus a standard postero-anterior-X-ray can easily lead to a correct diagnosis of "pseudotumor of the supraclavicular fossa", avoiding costly and needless diagnostic and therapeutic interventions.

Adipose Tissue↗
PubMedDate not supplied

Myoelectric activity of an ileal isoperistaltic or antiperistaltic loop interposed between colon and rectum: an experimental study in pigs.

The myoelectric activity of 25-30 cm ileal loops interposed isoperistaltically or antiperistaltically between colon and rectum was investigated 1-3 and 20-22 weeks after surgery, in growing pigs chronically fitted with intraparietal electrodes on the loop and the ileum. The fundamental motor profile of the small intestine consisting of migrating myoelectric complexes (MMC) was present on both loops; the MMCs were propagated on the antiperistaltic loop in the original anatomical direction. There was no coordination between the occurrence of phase 3 on the loop and the ileum. Some minor differences concerning the duration, the frequency and the velocity of propagation of phase 3 were observed between the loops and the ileum. Moreover propagated clusters of spike bursts and propagated long duration spike bursts appeared on the isoperistaltic and antiperistaltic loop, respectively, but not on the ileum. No prominent differences in the motor profiles of the loops have been observed between 1-3 and 20-22 weeks after surgery. It is concluded that despite the presence of semisolid contents with an abundant microflora the fundamental intestinal motor profile persists in ileal loops interposed between colon and rectum.

Animals↗
PubMedDate not supplied

[Combined dissector for laparoscopic esophageal myotomy: introduction of a prototype of dedicated instrumentation].

The authors' aim in this article is to present the use of a combined dissector, devised, designed and patented by themselves, for laparoscopic oesophageal myomectomy in achalasic patients. The prototype was produced by Karl Storz Endoskope. This tool has a stem measuring 10 mm in diameter, with an operative push rod consisting of two upward bent jaws and an electrode that can emerge from the jaws as required by the surgeon. The authors used the dissector in two patients with a surgical achalasic mega-oesophagus. The two jaws can dissect and then divide the oesophageal muscular layer from the submucosal layer, whereas the electrode can cut the muscular fibres. The use of the combined dissector allows the surgeon to perform oesophageal myomectomy easily, with efficacy and safety, using only the right hand. The instrument requires a number of minor changes which are currently being planned.

Equipment Design↗