A surgical operation performed on Siamese twins during the tenth century in Byzantium.
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Greece↗
SEARCH · PubMed Health
Results for “Surgical Performance”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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[Relation between the economic efficiency of treating patients with open hand injuries and the method of performing primary surgical treatment of the wound].
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Accidents, Occupational↗
[Surgical operations performed for tubercular changes in the intestines].
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Adult↗
Concordance of surgical clerkship performance and National Board of Medical Examiners Part II subtest scores. A validation model.
This study compares the National Board of Medical Examiners Part II (NBME II) subtest scores of medical students attaining honors in a clinical clerkship to those of students receiving a passing score to determine if the NBME II examinations could be considered independently as valid indicators of clinical achievement. Significant differences were found in five of the eight clinical clerkships; four of the six NBME II subtests were involved. A validation model was derived, and error estimates were obtained by using the NBME II surgery subtest scores and surgery clerkship performance as the criteria. Although the mean scores of students receiving honors in surgery were significantly higher than those not receiving honors (P less than 0.001), there was a considerable false negative error rate of 61%. These data suggest that on an individual basis, a good correlation does not exist between clinical performance in surgery and objective assessment of knowledge as determined by NBME scores.
Certification↗
[Possibility of performing ambulatory surgical treatment of concominant strabismus in adults].
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Adolescent↗
[Mass occurrence of trauma in Rwanda. 247 surgical interventions performed by 2 surgeons during 2 weeks].
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Developing Countries↗
Mechanical performance of disposable surgical needle holders.
The mechanical performance of disposable Webster surgical needle holders supplied by three different surgical instrument companies was determined by recording the forces (clamping moment) applied by the different needle holder jaws to curved surgical needles. This investigation demonstrated that there was a large variability in the mechanical performance of the disposable needle holders supplied by each surgical instrument company. In addition, the mechanical performance of the disposable needle holder of each surgical instrument company was distinctly different.
Disposable Equipment↗
[Preventive surgical scleral buckling of retinal detachment after severe ocular injuries].
We performed surgical scleral buckling with an encircling band to prevent retinal detachment in twenty eyes with severe ocular injury (three contusions, seventeen penetrating eye injuries including twelve eyes with intraocular foreign bodies). All surgical buckling were performed during the two weeks following the injury. The purpose of this surgical procedure is to prevent the traction from contracting vitreous base which it itself secondary to vitreoretinal proliferation; several factors promote this latter outcome: perforating injury, vitreous hemorrhage, intraocular foreign body and the mix of vitreous substance and lens material. This prophylaxis is justified by the high frequency and often bad prognosis of post-traumatic retinal detachment. A mean follow-up of thirteen months showed no contusion associated delayed retinal detachment, with a final visual acuity superior to 7/10: thus, preventive surgical buckling appears efficient; perforating injuries were followed by retinal detachment in three cases; of these, two were reattached, and the final visual acuity depended on associated destructions. With the limitation of a short follow-up, this surgical procedure seems to be able to prevent most of the delayed retinal detachments.
Adolescent↗
Surgical approaches for osteoarthritis.
Patients with osteoarthritis (OA) often benefit from properly performed surgical procedures. However, the scientific database from studies investigating appropriate timing of surgery, patient morbidity, quality of life before and after the intervention, and cost utility of different procedures is insufficient. In order to allow a fair allocation of resources in future health care systems, randomized controlled trials (RCTs) with defined entry criteria, sufficient number of patients, and valid outcome measures should be performed for different surgical approaches. They should especially include control groups with conservative treatment in order to allow an evidence based comparison between different therapeutic approaches. At present, however, optimal management of OA as a dynamic disease process must include a combination of conservative as well as operative treatment modalities. In case of malalignment, instability and intra-articular causes of mechanical dysfunction, correction of these abnormalities and relief of symptoms can be achieved with properly indicated and performed osteotomies. Debridement by arthroscopy and arthotomy probably does not alter the natural history of OA and true clinical outcomes are difficult to determine, but it can provide transient relief of symptoms. Joint replacement has to be considered for refractory pain associated with disability and radiological deterioration. As the pre-operative functional status seems to influence the outcome not only in joint replacement but also in joint-preserving osteotomies, the indication for these procedures might be expanded in the future.
Adolescent↗
Surgical outcome after paediatric cochlear implantation: diminution of complications with the evolution of new surgical techniques.
OBJECTIVE: Cochlear implantation is a commonly performed surgical procedure with specific aspects in the paediatric population. The surgical outcome associated with this procedure in a paediatric population is analyzed. METHOD: A retrospective study was performed of all children receiving a cochlear implant at The Hospital for Sick Children from 1990 to 1998. During this period, 104 patients received a cochlear implant. RESULTS: The complications encountered were classified as major (4%), minor (3%), and device failure (2%). The surgical techniques developed to decrease complications are discussed. CONCLUSION: Paediatric cochlear implantation is a safe procedure with a low incidence of complications. Nevertheless, the surgeon is now facing new challenges with cochlear implantation performed in patients with an abnormal cochlea, who carry a higher rate of complications, and cochlear reimplantation in case of device failure.
Adolescent↗
The role of mental rotation and memory scanning on the performance of laparoscopic skills: a study on the effect of camera rotational angle.
OBJECTIVE: The rotational angle of the laparoscopic image relative to the true horizon has an unknown influence on performance in laparoscopic procedures. This study evaluates the effect of increasing rotational angle on surgical performance. METHODS: Surgical residents (group 1) (n = 6) and attending surgeons (group 2) (n = 4) were tested on two laparoscopic skills. The tasks consisted of passing a suture through an aperture, and laparoscopic knot tying. These tasks were assessed at 15 degrees intervals between 0 degrees and 90 degrees , on three consecutive repetitions. The participant's performance was evaluated based on the time required to complete the tasks and number of errors incurred. RESULTS: There was an increasing deterioration in suturing performance as the degree of image rotation was increased. Participants showed a statistically significant 20-120% progressive increase in time to completion of the tasks (p = 0.004), with error rates increasing from 10% to 30% (p = 0.04) as the angle increased from 0 degrees to 90 degrees. Knot-tying performance similarly showed a decrease in performance that was evident in the less experienced surgeons (p = 0.02) but with no obvious effect on the advanced laparoscopic surgeons. CONCLUSIONS: When evaluated independently and as a group, both novice and experienced laparoscopic surgeons showed significant prolongation to completion of suturing tasks with increased errors as the rotational angle increased. The knot-tying task shows that experienced surgeons may be able to overcome rotational effects to some extent. This is consistent with results from cognitive neuroscience research evaluating the processing of directional information in spatial motor tasks. It appears that these tasks utilize the time-consuming processes of mental rotation and memory scanning. Optimal performance during laparoscopic procedures requires that the rotation of the camera, and thus the image, be kept to a minimum to maintain a stable horizon. New technology that corrects the rotational angle may benefit the surgeon, decrease operating time, and help to prevent adverse outcomes.
Clinical Competence↗
Augmented reality in surgery.
OBJECTIVE: To evaluate the history and current knowledge of computer-augmented reality in the field of surgery and its potential goals in education, surgeon training, and patient treatment. DATA SOURCES: National Library of Medicine's database and additional library searches. STUDY SELECTION: Only articles suited to surgical sciences with a well-defined aim of study, methodology, and precise description of outcome were included. DATA SYNTHESIS: Augmented reality is an effective tool in executing surgical procedures requiring low-performance surgical dexterity; it remains a science determined mainly by stereotactic registration and ergonomics. Strong evidence was found that it is an effective teaching tool for training residents. Weaker evidence was found to suggest a significant influence on surgical outcome, both morbidity and mortality. No evidence of cost-effectiveness was found. CONCLUSIONS: Augmented reality is a new approach in executing detailed surgical operations. Although its application is in a preliminary stage, further research is needed to evaluate its long-term clinical impact on patients, surgeons, and hospital administrators. Its widespread use and the universal transfer of such technology remains limited until there is a better understanding of registration and ergonomics.
Forecasting↗
The IOLAB, Inc pediatric intraocular lens study. AAPOS Reasearch Committee. American Association for Pediatric Ophthalmology and Strabismus.
PURPOSE: This report is a summary of the data of the IOLAB, Inc pediatric intraocular lens (IOL) implantation investigation. The goal of this study was to evaluate the safety and efficacy of IOL implantation for the treatment of pediatric aphakia, pending approval by the Food and Drug Administration. METHODS: From May 1981 to July 1994, a total of 1260 pediatric eyes received 171 styles of IOLs implanted by 361 US investigators. Preoperative, operative, and postoperative status reports over the first year were required for each eye entered into the study. Annual visit reports were requested thereafter to determine the long-term effects. The study was terminated in November 1995. All IOLs were obtained from IOLAB, Inc (now Chiron Vision Corp). RESULTS: Reporting compliance was 98.3% for the preoperative and operative reports, 45.1% at 1 year, and 13.8% at 3 years. The subjects' ages ranged from younger than 1 yearto 17 years. Nine subjects (0.7%) were younger than 1 year, with the largest group of 533 subjects (42.3%) aged between 6 and 12 years atthe time of surgery. Cataract types were congenital (45.6%), traumatic (37.1%), secondary (11%), senile (0.95%), and unrecorded (5.4%). The IOL was implanted primarily in 74.8% of cases and secondarily in 21.4% of cases. There was no record in 3.8% of the cases. IOL types included anterior chamber (4.1%), iridocapsular (0.71%), posterior chamber (93.6%), and unrecorded (1.59%). There were 130 adverse reactions that required secondary surgical intervention. The most frequently performed surgical procedures included lens removal without replacement, vitrectomy, lens repositioning, and lens replacement. More than half (52%) of all eyes had a visual acuity of 20/200 or worse before surgery; amblyopia was reported in 21.1% of all participants at baseline. Postoperative visual acuity data were available on 563 eyes at 1 year after surgery. Overall, 52.8% of all eyes attained a visual acuity of 20/40 or better by the 1-year visit, and only 15.5% had visual acuity worse than 20/200. In general, the older patient, traumatic cataract, and secondary cataract categories were overrepresented in the better visual acuity outcome group. CONCLUSION: The IOLAB, Inc pediatric IOL study is the first multiple-practitioner, national study designed to evaluate the safety and efficacy of IOL implantation in children. The study results are compromised by the almost 50% loss of follow-up at the 1-year evaluation. Other variables that most likely influenced outcome results were the methods of cataract extraction, medical management, and IOL design, all of which evolved dramatically over the time course of the study. Despite these issues, pediatric IOL implantation seems to be a reasonable treatment modality for aphakia, on the basis of the available 1-year follow-up data of the remaining 45.1% of eyes in the study.
Adolescent↗
The radial sensory nerve. An anatomic study.
The superficial branch of the radial nerve was dissected using loupe magnification in 20 cadaver forearms. The nerve was found to arise between the tendons of the branchioradialis and extensor carpi radialis longus 8.6 cm proximal to the radial styloid, piercing the forearm fascia 6.0 cm from the radial styloid. An average of 5.8 branches crossed the wrist joint. Innervation to the dorsum of the digits was variable, with 45% of specimens innervating the radial 2 1/2 digits and 30% innervating the radial 3 1/2 digits. Sixteen specimens had branches directly overlying the typical transverse incision for De Quervain's release and 12 specimens had branches directly overlying the 3-4 wrist arthroscopy portal. An appreciation for the location of the superficial radial nerve in the forearm, the variation of its digital innervation, and the proximity of branches to commonly used surgical incisions is important when performing surgical procedures over the dorsum of the hand and wrist.
Humans↗
Does surgical experience influence mastectomy complications?
Mastectomy remains the most commonly performed surgical procedure for breast cancer, and complications such as infection or wound breakdown (which may relate to the experience of the operator) could expensively prolong hospital stay and retard the administration of additional therapy. We examined the complications, hospital stay and cost of therapy of total mastectomy and axillary node clearance in 164 women, comparing these between four grades of surgeon: registrar (67 operations), senior registrar (58), part-time consultant (21) and professor (18). Our policy, for local reasons, was to perform mastectomy whenever possible rather than select lesser surgical or non-surgical management options. There was no significant difference between operators when the percentage of seromas requiring aspiration (9, 3, 5, 6), infection (16, 7, 23, 11), or wound breakdown (7, 3, 5, 6) were compared. Neither the length of hospital stay (9.3 +/- 6.9, 8.2 +/- 4.7, 9 +/- 7.3, 9.2 +/- 11.2 days), nor cost (2005, 1939, 1966, 1927 rands) differed. Surgical experience did not significantly influence mastectomy complications.
Aged↗
Revision of circumcision in children: Report of 56 cases.
BACKGROUND/PURPOSE: Circumcision is the most commonly performed surgical procedure in the United States today. Despite the large number of specialists who perform this procedure, only occasionally are the results unsatisfactory. The purpose of this study is to review the indications for circumcision revision, attempt to identify the specialists who are performing unsatisfactory circumcisions, describe the authors' surgical technique for circumcision revision, and review current coding and billing issues related to this procedure. METHODS: The authors reviewed the charts of 56 consecutive children who underwent circumcision revision over a 4-year period (1995 to 1999). They also reviewed their current coding and billing practices for this procedure. RESULTS: Children undergoing revision of circumcision ranged in age from 6 weeks to 11 years with a mean of 26.7 months. Redundant foreskin was the most common indication for circumcision revision. In 38 patients (68%) the authors were able to identify the specialist who performed the procedure. Pediatricians were most commonly identified (n = 26), followed by residents in training (n = 10) family physician (1), and nurse midwife (1). The authors were unable to identify the type of neonatal circumcision originally performed. Their surgical procedure was the conventional sleeve technique without variation in 55 cases. A gomco clamp was utilized in one patient under local anesthesia and resulted in significant difficulty in the performance of the revision. All patients had a satisfactory cosmetic outcome. There was one complication in a child who required a return to the operating room for postoperative bleeding and hematoma. In review of the authors coding practices they found that there was an appropriate diagnosis code available for redundant foreskin but a specific procedure code was lacking before 2002. The authors also found that midwives perform circumcisions throughout the United States. CONCLUSIONS: Considering the number of neonatal circumcisions performed in the United States, revision of circumcision uncommonly is required. The most common indication for circumcision revision is redundant foreskin. Although pediatricians were most commonly implicated in this study as the source of unsatisfactory circumcisions, that finding probably is more a reflection of local practices and referral patterns. Our recommended surgical procedure, the conventional sleeve technique, is familiar to pediatric surgeons, produces a satisfactory cosmetic result, and is easy to teach to residents and fellows. The authors do not recommend the use of a gomco clamp for circumcision revision. The authors do not feel that a circumcision revision should be delayed expecting that the child will grow into the redundant foreskin. Appropriate diagnosis codes have been available, but a new and more specific procedure code has just been introduced in 2002.
Child↗
Outcomes for surgical management of orchalgia in patients with identifiable intrascrotal lesions.
OBJECTIVE: The outcome of surgery for relief of orchalgia in patients with identifiable intrascrotal pathology is not well defined. We evaluated the success of commonly performed surgical procedure indicated for pain relief in patients with specific intrascrotal lesions. METHODS: Surgical cases performed for relief of painful scrotal pathology were reviewed, including ligation of internal spermatic vein, hydrocelectomy, spermatocelectomy, and orchiopexy for suspected intermittent torsion. Relief of pain as reported to the physician and time for return to full activity were determined. Pain relief was compared to a 50% placebo rate using Fisher's exact test. RESULTS: Eigthy-five of 151 patients (56%) undergoing surgery for pain relief had complete data and adequate follow-up for analysis. Of 40 patients who had ligation of the internal spermatic vein, 30 (75%) were relieved of pain (p = 0.037). All 19 patients with painful hydroceles and 16 of 17 (94%) with spermatoceles were relieved of pain (p < 0.001). Of 9 patients undergoing scrotal orchiopexy for suspected intermittent torsion, 8 (89%) were pain-free (p < 0.001). CONCLUSION: Surgical management of specific intrascrotal lesions is highly effective.
Adult↗
Neurological deficit in injuries of the thoracic and lumbar spine. A consecutive series of 70 patients.
Seventy consecutive patients with injuries of the thoracic and lumbar spine accompanied by neurological deficit were prospectively studied and follow-up. In 40 of these patients with a burst fracture, the degree of involvement of the cross-sectional area of the spinal canal, as revealed on first CT after admission, was not correlated with the type and degree of initial neurological deficit. In patients with injuries of the lumbar spine, neurological deficit may be mild, although the sagittal diameter of the spinal canal may be reduced by as much as 90%. We cannot establish a difference in neurological recovery between those cases who were managed conservatively and those in whom a surgical decompression and stabilization procedure was performed. Surgical stabilizing procedures, however, result in immediate stabilization of the spine, they diminish pain, facilitate nursing care and allow more rapid mobilization and earlier active rehabilitation. If major extraspinal injuries form a relative contra-indication to surgical decompression of the cord and stabilization of the spine injury, the patient can quite well be treated conservatively without endangering neurological recovery.
Follow-Up Studies↗