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Biomedical subjects

S Kathy

Publications and source records attributed to S Kathy.

7 recordsLinked to original sources

[Endoscopic subfascial vein dissection].

Endoscopic subfascial dissection is an effective method for the interruption of incompetent perforating veins. From 15th October to 15th December of 1995 11 patients underwent endoscopic subfascial sectioning. It is the first time to apply this procedure in Hungary. A venous ulcer was found in 5 patients. Endoscopic sectioning supplemented by extensive fasciotomy, without any substantial complication. The method is recommended due to its reduced invasiveness and fair results.

Adult↗

Laparoscopic fenestration of symptomatic solid spleen cyst with harmonic scalpel instrument.

The treatment of two operated solid splenic cysts has been reported by authors. Laparoscopic cyst fenestration has been demonstrated to be a useful alternative method to open surgery. The aim of the authors was to analyse the use of Ultracision Harmonic Scalpel in two spleen preserving procedures. Cysts were located in the superior and the anterior-inferior pole of the spleen. Cyst wall not covered by spleen tissues was removed, drain was left in the abdomen. In the demonstrating spleen cyst operation the advantages of HS instrument was the clean operating field, correct coagulation of cyst wall, short hospital stay. Authors believe that this new technology will make it easier and more desirable for surgeons to fenestrate symptomatic spleen cysts.

Cysts↗

Laparoscopic hiatal reconstruction and use of harmonic scalpel instrument.

The method of laparoscopic repair of hiatal hernia is accepted in surgery. Usually associated with Nissen fundoplication which is the most commonly performed antireflux operation. Within a ten-year period authors have done 90 antireflux operations, 52 was laparoscopic procedures. (30 operations for GERD, 10 for hiatal hernia, 12 for the combination of both.) A patient was submitted to operation with large hiatal hernia. He was treated laparoscopic way with success and good results. The Ultracision Harmonic Scalpel instrument helped their operation in many ways, and provided correct bloodless preparation of cardiac region. The authors demonstrate our procedure and the use of the Harmonic Scalpel. Their patient were completely pleased with the results after discharge, they are still under regular control.

Blood Loss, Surgical↗

Use of harmonic scalpel at laparoscopic cardiomyotomy. A new method.

The laparoscopic cardiomyotomy with anterior fundoplication (Heller-Dor procedure) is accepted for treatment of esophageal achalasia. The crucial point of the procedure is proper myotomy and avoid perforation of the esophagus. Hook cautery is widely accepted to dissect the oesophageal muscle. We'd like to demonstrate our experiences with a new device--Ultrasonically Activated Harmonic Scalpel-, witch was used at our operation for achalasia to make the cardiomyotomy. Between December 1993 and December 1996, 11 patients with esophageal achalasia underwent laparoscopic Heller's operation with Dor's antireflux procedures. In one patient we applied the Ultrasonically Activated Harmonic Scalpel (HS) to make the cardiomyotomy. The use of HS and results were evaluated. Application of the Harmonic Scalpel is effective for cardiomyotomy. It can be used more safe than electrocoagulation, because it cause less thermic lesion. It's easy to use at laparoscopic way. A perforation of the esophagus didn't occur. There was no intra-, or postoperative complications. After the operation the patient is free of complains. After our first operation, we have found, that Ultrasonically Activated Scalpel can be applied with safe and good results for the cardiomyotomy at laparoscopic operations for esophageal achalasia.

Adult↗

Use of harmonic scalpel for division of short gastric vessels at laparoscopic Nissen fundoplication. A new method.

The essential of laparoscopic Nissen fundoplication is creating a loose and tension free wrap requiring mobilisation of the gastric fundus. Division of the short gastric vessels (SGV) is a standard component of that procedure which requires considerable part of the operation time, and despite of a careful dissection sometimes significant blood loss can be occurred. The Ultracision Harmonic Scalpel (HS) makes the process quicker safer and can cause less intraoperative complication. This study compares our original method of vessel control (at 10 cases, Group 1), to the Ultracision Harmonic Scalpel (at 10 cases, Group 2) Times for SGV division, estimated blood loss and intraoperative and postoperative complications were evaluated. In the favour for Group 2 a significant reduction was reached in the time required for division of SGV to mobilize the fundus. As the most common postoperative complication, the dysphagia concerns we found significant difference in the two groups and dysphagia was mild at Group 2. Application of HS provide safer, easier and faster division of SGV resulting significant savings of time and less prone to thermic trauma and recommended at LNF operations to avoid potential intra- and postoperative complications.

Blood Loss, Surgical↗

Results with collagen fleece coated with fibrin glue (TachoComb). A macroscopical and histological experimental study.

Diffuse bleeding from parenchymatous organs at conventional surgery is eliminated with the usual methods coagulation tamponade or styches. We performed experimental series at 9 dogs. After resection of spleen, liver, pancreas and kidney, the bleeding surface was covered by collagen fleece coated with fibrin glue (TachoComb). Postoperatively 7 days, 10 days, 14 days and 28 days we made a relaparotomy. Then the results were analyzed macroscopically and microscopically. In the abdominal cavity neither significant quantity of blood nor greater adhesions were detected. At all cases the fibrin glue was found on place were it was put before. Histologically a perfect wound healing experienced. The fibrin glue (TachoComb) using at diffuse parenchymatous organs' bleeding give a very good results when the wound area is at least 1 cm beyond the immediate wound margin and the fibrin glue is applied onto the wound and pressed on it for 4-5 minutes.

Animals↗

Splenic autotransplantation after abdominal trauma in childhood. Clinical and experimental data.

Splenectomy is known to increase the risk of overwhelming bacterial infection. There is a decrease in immunoglobulin IgM and T-lymphocytes, primary antibody response to antigen challenge is impaired, altered opsonic function an Tuftsin deficiency are noted. Splenic autotransplantation has been suggested as a method of preserving function and this concept is supported by experiments in animals. Prior to operation on humans the technique was thoroughly elaborated and practised in animal experiments (dogs). After splenectomy, 6-8 thin segments (Furka's "spleen chip") are placed in between the plates of the major omentum. Within the period of ten years out of 52 patients 11 children (4 girls, 7 boys) suffered from abdominal trauma underwent total splenectomy, and than autotransplantation in the Kenézy Hospital in Debrecen, Hungary. In several patients the postoperative follow-up radionuclide imaging, IgM, and Tuftsin levels, and the haematological changes (leukocytes, differential blood count, platelet count, iron level in serum) unambiguously confirmed the function of the splenic tissue.

Abdominal Injuries↗