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Biomedical subjects

W Vaneerdeweg

Publications and source records attributed to W Vaneerdeweg.

At least 19 recordsLinked to original sources
PubMed2003

A performance study comparing manual and robotically assisted laparoscopic surgery using the da Vinci system.

BACKGROUND: The objective of this study was to compare the efficacy of the da Vinci robotic system using both the three-dimensional view (3D) and two-dimensional (2D) view options with traditional manually assisted laparoscopic techniques in performing standardized exercises. METHODS: To evaluate surgical efficiency in the use of robotically assisted and manual laparoscopic surgery for standardized exercises six, last-year medical students without any surgical experience were selected. The exercises consisted of placing rings over receptacles, grasping a free hanging suture and cutting three pieces of it, running a suture, and performing a surgical knot. Each student performed the exercise twice. The median times needed for completion of the exercises and the median number of errors in performing the tasks were noted. RESULTS: The unexperienced students performed the standardized tasks significantly quicker and with fewer errors when assisted by the da Vinci robot in the 3D optical display mode, as compared with traditional manually assisted laparoscopic surgery. Even when the 2D mode was selected, a significant advantage favoring the da Vinci robotic system was seen both in time and efficacy for most exercises. When the 3D and 2D modes were compared, time differences in favor of the 3D mode remained, but a significant difference in efficacy favoring the 3D mode was seen only in one exercise (exercise 2: suture cutting). CONCLUSIONS: The da Vinci robotic system permits standardized minimal invasive surgical exercises to be performed quicker and more efficiently than traditional minimally invasive techniques. Therefore, with the aid of this robotic system, difficult laparoscopic interventions may become easier to perform, and indications for minimal invasive surgery may be expanded.

Data Display↗
PubMed2003

Unusual complications of preperitoneal mesh implantation in the treatment of inguinal hernia.

More and more prosthetic materials are being used in the treatment of inguinal hernia. This report deals with some unusual but devastating complications, occurring after preperitoneal mesh implantation. A 56-year old male patient underwent a Stoppa-repair for a bilateral inguinal hernia. Two years postoperatively, a localized abdominal wall abscess was treated with antibiotics and drainage. A barium enema and a CT-scan of the abdomen were performed to rule out an enteric fistula; the CT-scan unexpectedly revealed a tumoral mass involving the sigmoid colon, and an explorative laparotomy was done. Peroperatively, part of the mesh was found to penetrate the bowel wall and a sigmoidectomy with removal of the mesh was performed. Two years later, ingrowth of the urinary bladder by the remains of the mesh was the unfortunate peroperative finding when the patient was operated on for an inflammatory mass, involving the bladder wall. The patient needed two more interventions for persisting wound fistulas. All the remains of the mesh have been removed and all fistulas have been widely excised. Nowadays, the patient is recovering well with complete healing of all wounds. Although infection of prostheses used in the treatment of hernias has been described, late and serious complications related to mesh implantation, such as perforation of the colon and the bladder, have seldom been reported.

Biocompatible Materials↗
PubMed2001

Pancreatocolonic fistula due to severe acute pancreatitis: imaging findings.

Colonic involvement is an uncommon but potentially lethal complication of severe acute pancreatitis. The spectrum of colonic complications includes localized ileus with "pseudo-obstruction", obstruction, necrosis, hemorrhage, fistula, and ischemic colitis. We report on a patient who developed pancreatocolonic fistulization in the course of protracted severe acute pancreatitis. Emphasis is made on the computed tomographic and water soluble contrast enema findings.

Acute Disease↗
PubMed2000

Effect of gentamicin-containing sponges on the healing of colonic anastomoses in a rat model of peritonitis.

OBJECTIVE: To study the influence of gentamicin-containing sponges on the healing of colonic anastomoses in a rat model of peritonitis. DESIGN: Controlled laboratory study. SETTING: University hospital, Belgium. MATERIALS: 40 male Wistar rats. INTERVENTIONS: Peritonitis was caused by implantation of a gelatin capsule containing faeces and barium sulphate. The rats then had a colonic anastomosis. They were divided into 4 groups (n = 10 in each). The control group (no additional treatment); a second group in which a plain collagen sponge was wrapped around the anastomosis; a third group in which a gentamicin-containing collagen sponge was wrapped around the anastomosis; the last group in which the animals were given an intramuscular dose of gentamicin. MAIN OUTCOME MEASURES: Operative mortality, weight loss and anastomotic bursting pressure four days after the anastomosis. RESULTS: Seven rats died before necropsy but none in the last group. Peritonitis developed in all rats Weight loss was significantly higher in the plain collagen group. Bursting pressures were similar in the control and two gentamicin groups. In the plain collagen group all the anastomoses but one had broken down. CONCLUSION: There was no difference in bursting pressure between rats treated with gentamicin sponges or systemically, and controls. Healing was severely compromised when a plain collagen sponge was used.

Anastomosis, Surgical↗
PubMed2000

Intragastric erosion of laparoscopic adjustable silicone gastric band.

Intragastric erosion of the adjustable silicone gastric band (ASGB) is a rare but severe complication of gastric banding, often leading to reoperation. We describe our experience with 4 cases referred to us. The best timing of removal and the choice of another bariatric procedure is still controversial. We advise to wait until migration of the band into the lumen is complete. With removal of the ASGB if another weight reduction procedure is advisable, conversion to a biliopancreatic diversion is possible.

Adult↗
PubMed2000

Gastric emptying rate measurement after vertical banded gastroplasty.

BACKGROUND: In vertical banded gastroplasty (VBG), a small proximal gastric pouch is created, which is believed to fill rapidly and to empty slowly. METHODS: In 13 patients who underwent VBG, gastric emptying rate was measured. A radiolabelled solid test meal was used before and 2 weeks after operation. From a region of interest above the whole stomach, the proximal pouch and the distal stomach, half emptying time as well as retention percentage were derived. RESULTS: All patients experienced early satiety and gastric fullness after ingestion of a small test meal. The proximal pouch emptied rapidly. The evacuation of the test meal from the whole gastric region as well as the distal stomach were not altered significantly by the operation. CONCLUSION: VBG is a safe operation which reduced weight significantly. Early satiety, however, induced by this technique, cannot be explained alone by slow emptying of the proximal pouch. The nature of the outlet of the pouch as well as the behavior of its wall must be considered.

Adult↗
PubMed1999

Intestinal stenosis from mesenteric injury after blunt abdominal trauma.

We report a case in which blunt abdominal trauma resulted in injury to the mesentery with subsequent ischemic stricture of the adjacent small bowel. We present CT images at the time of trauma and 5 weeks later when clinical signs of intestinal obstruction occurred. We include images of enteroclysis and angiography of this uncommon sequela of blunt abdominal trauma. At surgery, a stenotic small bowel loop was found adjacent to a healed defect in the mesentery. Histological examination of the resected segment showed mucosal and submucosal ischemia with mucosal ulceration, mural inflammation, and fibrosis. Posttraumatic intestinal stenosis subsequent to a mesenteric tear should be included in the differential diagnosis in a patient with a history of blunt abdominal trauma and signs of intestinal obstruction.

Abdominal Injuries↗
PubMed1999

Intussusception in infants: an emergency in diagnosis and treatment.

Intussusception is an important cause of intestinal obstruction and bowel necrosis in infants under 2 years. Most frequently the ileocaecal junction is involved. Various aetiologic factors, such as Meckel's diverticulum and lymphoid hyperplasia have been identified. Hydrostatic reduction of the intussusception should be attempted, but delay in diagnosis frequently leads to surgical intervention, because of failing reduction. We report a case of a 4-month-old boy whose ileocaecal junction was intussuscepted into the rectum, and therefore could be palpated by rectal examination. Unsuccessful hydrostatic reduction and bowel necrosis because of delay in diagnosis, made surgical intervention necessary. A terminal ileostomy was performed. A second case report considers a 10-month-old boy whose ileocaecal junction was intussuscepted into the colon sigmoideum. Because there was no delay in diagnosis, this intussusception could be reduced hydrostatically. The procedure however was difficult because of a dolichosigmoideum. Recent literature is also reviewed.

Abdomen, Acute↗
PubMed1999

Radiographic manifestations of intestinal obstruction in the newborn.

Intestinal obstruction in the newborn infant may be due to a variety of conditions, including atresia and stenosis, annular pancreas, malrotation, duplication cyst, meconium ileus, meconium plug syndrome and neonatal small left colon syndrome, and Hirschsprung's disease. Neonates with unrecognised intestinal obstruction deteriorate rapidly, show an increase of associated morbidity and appropriate surgical treatment becomes more hazardous. Early diagnosis depends largely on the prompt detection of obstructive manifestations by the clinician and the subsequent accurate interpretation of radiographic findings by the radiologist. Plain film of the abdomen is often helpful in determining the level of obstruction and usually dictates, together with clinical symptoms, the choice of the contrast study firstly to perform. In this article we will review the clinical and radiological signs of different pathological conditions causing intestinal obstruction in the newborn.

Colon↗
PubMed1998

Diagnosis and nonsurgical management of bile leak complicated by biloma after blunt liver injury: report of two cases.

We report on two patients with biliary tract injury and associated biloma following blunt abdominal trauma. Both patients underwent emergency surgery because of hemodynamic instability and bloody peritoneal aspiration. Computed tomography in the postoperative days showed severe hepatic parenchymal injury and the presence of hypodense collections with intraparenchymal and subcapsular extension, suggestive for biloma, but otherwise failed to demonstrate the exact location of the bile duct injury. One of them underwent temporary percutaneous drainage. Bile duct injury was well demonstrated on endoscopic retrograde cholangiography (ERCP) and treated by endobiliary stent placement. This report advocates the use of ERCP and endobiliary stenting in the management of biliary injury resulting from liver trauma.

Abdominal Injuries↗
PubMed1998

Comparison between plain and gentamicin containing collagen sponges in infected peritoneal cavity in rats.

OBJECTIVE: To study the usefulness of gentamicin-containing sponges in the infected peritoneal cavity in rats. DESIGN: Controlled study. MATERIAL: 83 Male Wistar rats, 36 of which were treated by plain sponge, 36 by gentamicin-impregnated sponge, and 11 acted as controls. INTERVENTIONS: A standard model of intraperitoneal infection was developed by making a 1 cm long incision in the caecum. MAIN OUTCOME MEASURES: Postoperative mortality, macroscopic and microscopic features of infection, and bacterial concentrations in the abdomen on days 3, 6, and 9. RESULTS: In the respective groups 2, 3 and 2 animals died during operation and 4/34 (11%), 3/33 (9%); and 0/9 died before day 3. There were appreciable reductions in the number of animals with features of infection after 3 days but these were not significant at 6 or 9 days. CONCLUSION: Gentamicin-containing collagen sponges placed on a septic focus in the abdomen reduce local infection for at least 3 days.

Animals↗
PubMed1997

A patient with congenital short small bowel associated with malrotation.

A case of congenital short small bowel associated with malrotation and malabsorption in a baby girl is presented. Clinical manifestations developed in the first days after birth and consisted of diarrhea, vomiting and poor weight increase. Congenital short small bowel was suspected on radiological examination, which showed an associated malrotation. The diagnosis was confirmed by exploratory laparotomy. The length of the small intestine was only 50 cm. The intensive work of maintaining nutrition and controlling infection is described.

Body Weight↗
PubMed1997

Shock bowel following massive pulmonary embolism.

Wide-spread abnormalities of the small bowel on CT scan after massive pulmonary embolism and acute hemodynamic collapse are described. These small bowel abnormalities are secondary to hypotension with prolonged hypoperfusion. They consist of diffuse thickening of the small-bowel wall, fluid-filled, dilated loops and increased contrast enhancement of the small-bowel wall (shock bowel). These abnormalities are reversible and should be distinguished from acute vascular occlusion.

Adult↗
PubMed1995

Laparoscopic resection of an adenoma of the urachus in combination with a laparoscopic cholecystectomy.

In a 40-year-old male patient with symptomatic cholecystolithiasis, ultrasound examination disclosed a large cystic mass on the dome of the bladder. Laparoscopic resection of this mass was carried out in combination with a laparoscopic cholecystectomy. Histology disclosed an urachal adenoma. Postoperative recovery was uneventful. We conclude that urachal adenomas can be managed safely by laparoscopic means.

Adenoma↗
PubMed1995

Mucosal proctectomy and colo-anal anastomosis as treatment of rectal atresia.

Rectal atresia is a rare condition in which the anus and sphincter muscles are normally developed. Therefore it seems logical to preserve those structures unaltered during surgical therapy. Mucosal proctectomy and colo-anal anastomosis is a safe, technically well known technique that achieves this goal.

Anal Canal↗
PubMed1995

Pneumatosis cystoides intestinalis. Conservative approach in non surgical pneumoperitoneum: a case report and literature review.

An observation on Pneumatosis Cystoides Intestinalis (PCI) in a 66-year-old man is reported. His general condition allowed a thorough clinical and laboratory investigation which resulted in the diagnosis of the disease and the avoidance of an unnecessary laparotomy. PCI is a relatively rare condition characterized by multiple intramural pockets of gas involving any portion of the gastro intestinal tract. Various theories reflect either a mechanical or a bacterial etiology. Most of the patients are asymptomatic although some experience gastrointestinal complaints. The majority of patients require no treatment.

Aged↗