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Yunus Yavuz

Publications and source records attributed to Yunus Yavuz.

4 recordsLinked to original sources

Are cold light sources really cold?

BACKGROUND: A fiber optic light source is the central part of endoscopic surgery. However, the light generation process causes heat transmission from a source to tip of a scope. In this study, we measured the amount of heating and pathologic effects of direct contact with the tip of scopes on the small bowel in an experimental set-up. MATERIALS AND METHODS: Temperature measurements were performed at the tip of 4 different scopes (Aesculap, Olympus, Karl Storz, and Richard Wolf), which were connected to either of 3 different xenon light sources (Olympus, Richard Wolf, Karl Storz). Temperatures at the outlet of light sources and the tip of fiber optic cables were measured as well. Tissue samples from the small bowel of a pig were obtained after exposing them to direct contact with the tip of the scopes or the fiber optic cable. RESULTS: The temperature measurements at the tip of the scopes varied between 60 degrees C and 100 degrees C (Celsius). The temperatures showed a wide variation according to the type of light source and fiber optic cable the scopes were connected to. The average temperature at the outlet of the light sources and the tip of fiber optic cables was 750 degrees C and 250 degrees C, respectively. The microscopic scores of the small bowel injury induced by exposition to the heat at the tip of the scopes were significantly high after 5 seconds of contact. Direct contact of the tip of the fiber optic cable caused total carbonization in the wall of the small bowel. CONCLUSION: Direct contact of the tip of the scope with small bowel may cause functional and cytologic injury even after short durations of exposure. Therefore, we do not recommend direct contact of scopes with the intra-abdominal organs to avoid heat injuries. In addition, this study also emphasizes the variation in heat generation at the tip of the scopes when used with a mismatching light source and fiber optic cable.

Animals↗

Clinical evaluation of a new ultrasonic Doppler instrument (SonoDoppler) for the detection of blood flow during laparoscopic procedures.

Complications may be avoided by exactly clarifying the structures in the operative field during laparoscopic surgery. We aimed to study the efficiency of a new ultrasonic Doppler device, SonoDoppler, which offers an easy and efficient way of mapping the anatomy. The design of the study was prospective, open observational and carried out on a sample of 51 patients who were operated on in four hospitals. The surgeons were asked to identify a common hepatic artery, cystic artery and portal vein during a laparoscopic cholecystectomy, and corresponding structures during other laparoscopic procedures using the SonoDoppler, instrument. Total operation time (skin-to-skin) and duration of the SonoDoppler, use were measured. The main outcome measures were gain of additional safety and clinical value. A number of evaluations concerning the ergonomics, functionality and interactions with other instruments were also carried out. The SonoDoppler, instrument has the potential to help to assess and clarify the anatomy during laparoscopic procedures. Its use can be advocated not only for inexperienced surgeons, to help them map the vessels during surgery, but also for experienced surgeons during complicated cases and advanced procedures.

Journal Article↗

An experimental operating room project for advanced laparoscopic surgery.

With the challenges that the health sector now faces in accordance with readjustments and demands for increased efficiency, resource utilization, and innovation, we have initiated a project to develop the future operating room for advanced laparoscopic surgery. New hospitals are being built that contain numerous operating room theaters. To share experiences and avoid repeating the same mistakes as others, we find it suitable to build an "experimental" operating room theater where we can try out and study new equipment, logistics, and communications, and operating forms and new technology that both benefit the establishment of our hospital, as well as the establishment of other hospitals and their laparoscopic operating rooms nationally and internationally. The main goals in the project are, through research and development, to reveal information and develop technology and methods to establish more efficient and prospective patient treatment that is focused on quality. The project is deeply rooted in the established research environment in Trondheim, Norway. We will develop new integrated solutions in the laparoscopic operating unit to create a possibility to rapidly implement the results in the form of practical improvements, increased quality, and renovation in patient treatment. The goal is also that this will result in the establishment of new industry nationally.

Hospital Design and Construction↗

Laparoscopic bowel resection: a comparison of three ultrasonically activated devices.

BACKGROUND AND OBJECTIVES: To compare resection time and collateral thermal damage of 3 currently available ultrasonically activated devices in laparoscopic small bowel surgery. METHODS: AutoSonix, SonoSurg, and UltraCision were compared in laparoscopic small bowel mesentery resection in a porcine model. A resection was defined as 12 endarcade arteries supplying the intended bowel segment. Vssels were divided 1 cm off the bowel wall. AutoSonix, SonoSurg, and UltraCision were comparable for blade length and type, cutting mechanism, handle ergonomics, and vibration amplitude, but not well matched for vibration frequency (55.5;23.5;55.5 kHz), working shaft diameter (5;11;10 mm) and length (29;33;34 cm), respectively. A sample size of 114 was calculated to detect a 25% difference with 90% power at a 5% significance level. Resections were allocated to devices by block randomization. Analysis of variance and pairwise Scheffe tests were used for multiple comparisons, and a Kaplan-Meier plot was drawn to confirm differences in resection time with each device. A pathologist blind to the devices evaluated bowel wall biopsies for thermal damage. RESULTS: Procedures as allocated comprised 114 resections (38 with each device). UltraCision median resection time of 5160 (range 2340-7860) seconds was significantly longer (P=0.0001). The difference in resection time between AutoSonix (median 3420, range 1860-8760 s) and SonoSurg (median 3660, range 1800-6900 s) did not reach statistical significance. A microscopy revealed no thermal damage. CONCLUSIONS: Laparoscopic resection time for porcine bowel mesentery was shorter with AutoSonix or SonoSurg than with UltraCision, and no thermal damage to the bowel wall was found.

Animals↗