Biomedical subjects

S T Ko

Publications and source records attributed to S T Ko.

6 recordsLinked to original sources

PubMed1992

Transanal endoscopic microsurgery.

Transanal endoscopic microsurgery (TEM) has emerged as a minimally invasive means of resecting rectal tumors. Developed in Germany and now being used with increasing frequency in the United States, TEM utilizes a 40-mm operating rectoscope, which is sealed with an airtight facepiece. Carbon dioxide is constantly infused, thereby distending the rectum and maintaining visibility. A variety of instruments, such as tissue graspers, a high-frequency knife, suction, and needle holders, are inserted through the facepiece. Adenomas that are small, large, or even circumferential, as well as selected carcinomas up to 24 cm, can be removed with TEM instrumentation. The optics provide sixfold magnification, and this, combined with the constantly distended operative field, allows for a precise excision of the tumor as well as closure of the wound. For lesions in the mid and upper rectum, TEM is an alternative to a transsacral or transabdominal approach, with subsequently shorter hospital stay and fewer complications.

Adenoma↗

PubMed1992

Assessment of quality of care in laparoscopic cholecystectomy.

With the advent of laparoscopic cholecystectomy, assessment of data and its relationship to quality of care became important. The Mount Sinai Hospital Medical Center conducted a prospective survey in conjunction with the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) National Survey. In this survey, only two surgeons operated as surgeon and co-surgeon with an extremely small rate of complication. A national survey of chairpersons in surgery was designed at Rush Presbyterian St. Luke's Hospital, and 4300 chairpersons were mailed questionnaires to record complications of laparoscopic cholecystectomy. There were 36,232 patients and 3111 surgeons in the survey. The Southern Surgeons Club experience, as reported in New England Journal of Medicine, was reviewed. Because of the complexity of understanding the implications of the survey results, the authors have arrived at a simplified system of evaluating quality of care in laparoscopic cholecystectomy. In this system only three considerations are taken into account: (a) elective conversions to standard operation, (b) forced conversions (due to iatrogenic injuries), and (c) reoperation rate (delayed complication). It is hoped that data collection will be simplified and more meaningful.

Cholecystectomy↗

PubMed1991

Laparoscopic removal of a large colonic lipoma. Report of a case.

A 72-year-old white male was found to have a 6-cm submucosal mass at 35 cm on screening sigmoidoscopy. The lesion had all the characteristics of a submucosal lipoma. Instead of performing a laparotomy with its potential morbidity, the lesion was removed laparoscopically in its entirety without untoward operative sequelae. Laparoscopic techniques have had a profound impact on the treatment of patients with surgical disorders. This new technology can be applied to selected patients with colorectal diseases.

Aged↗

PubMed1991

Review of 300 consecutive laparoscopic cholecystectomies: development, evolution, and results.

The present paper reviews 300 laparoscopic cholecystectomies with intraoperative cholangiograms that were performed by the authors. The development and evolution of this procedure are described along with the results. The guidewire technique used for operative cholangiography and the maneuver applied to control bleeding of the cystic artery are detailed. Five cases were converted to open operations. No serious complications were encountered. One common bile duct injury occurred during endoscopic retrograde cholangiopancreaticography performed on postoperative day 8 for diagnostic purposes.

Adolescent↗

PubMed1976

Chronic anemia, wound healing, and red cell 2,3-diphosphoglycerate.

Relationships between various types of chronic anemia, wound healing, and red cell 2,3-diphosphoglycerate (2,3 DPG) were examined in rabbits. Wound tensile strength and energy absorption were not affected by chronic iron-deficiency anemia, the chronic hemolytic anemia caused by intravenous water infusion nor by chronic hemolytic anemia caused by intravenous water infusion nor by chronic phenylhydrazine-induced anemia. Red cell 2,3 DPG levels were increased in the anemia of iron deficiency and were normal in the rabbits with chronic phenylhydrazine-induced anemia at the time of wound excision but were low following phynylhydrazine injection. The results show that chronic anemia per se does not affect the tensile strength and energy adsorption of wound healing. The findings suggest that the wound healing process may differ in certain types of anemia.

Anemia↗

PubMedDate not supplied

Therapeutic laparoscopic suturing techniques.

With the introduction of the technique of Interventional laparoscopy, a new era of minimally invasive general surgery has begun. The well-established principles of general surgical technique have not been altered by this new technology. As the new laparoscopic technology has become available, intraabdominal laparoscopic suturing and ligating techniques have been developed. The authors have attempted to elucidate the techniques of endoligation, "Endoloop" application, endosuture placement, sling suture placement, and continuous suture placement in laparoscopic surgery.

Humans↗