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PubMed1975

Sutureless epicardial pacemaker lead: a satisfactory preliminary experience.

The first pacemaker systems used the epicardial electrode. The transvenous endocardial electrode rapidly supplanted the epicardial electrode since it could be positioned with less morbidity and mortality and was associated with a lower incidence of wire breakage. The long term complication rate of the transvenous electrode had not been inconsequential. The sutureless epicardial electrode combines the greater reliability of the epicardial lead system with the ease of insertion and low morbidity of the endocardial lead system. We have used this electrode in 33 patients. The electrode was positioned using the subxiphoid approach and local anesthesia in most patients. There have been few complications and none that resulted in long term morbidity. There have been no deaths related either to the operative approach or to the pacing system. There has been no instance of lead failure during the follow-up period.

Aged↗

PubMed1976

Subepicardial infarction, myocardial impression, and ventricular penetration by sutureless electrode and leads.

Postmortem examination two weeks following implantation of a demand pacemaker with sutureless electrodes demonstrated that (1) the loops of intrapericardial electrode leads indented the myocardium and produced a circumscribed area of subepicardial necrosis, and (2) one of the electrode coils protruded into the right ventricular cavity. The use of extrapericardial electrode leads and left ventricular implantation sites should avoid these problems.

Electrodes, Implanted↗

PubMed2003

Radio frequency "sutureless" fistulotomy- a new way of treating fistula in anus.

AIM: To explore the effect of the classical lay open technique or fistulotomy with the radio frequency surgical device in the treatment of fistula in anus. METHODS: In our study, the conventional 'lay open' technique, or 'fistulotomy' was performed by employing the radio frequency surgical device as an alternative to the traditional knife and scissors. In a span of 18 months starting from July 1999 to December 2000, 210 cases with fistula in anus of varied types were operated in our nursing home exclusively applying the radio frequency device. RESULTS: The results of the study were not only encouraging but also were satisfactory. A follow up of the operated patients with radio frequency surgery over a period of 15 months, i.e. from December 2000 to March 2002 was summarized as below: (a) average time taken by the patient to resume routine - 7 days; (b) none of the patient had any interference with the continence; (c) the wounds were found healed within an average time of 47 days; (d) delayed wound healing was noticed only in 7 patients; (e) recurrence/ failure rate was reduced to as low as 1.5 percent. CONCLUSION: This technique has been found superior to the conventional fistulotomy in the sense that the time taken for the whole procedure is reduced to almost half, chances of bleeding are reduced to a minimum and the use of suture material is dispensed with. The procedure can safely be called a "Sutureless fistulotomy".

Adult↗

PubMed1999

[Sutureless compression small intestine anastomoses creation using device with shape memory (experimental study)].

Specially developed device for creation of sutureless compression intestinal anastomoses was applied in 85 mongrel dogs. Function of the device is based on the effect of form memory of the alloy of Titanium nickelid, TH-10. The information about changes of mechanical strength (physical hermetism) of the anastomosis due to strength characteristics of the used construction as well as the study of blood supply in compression anastomosies in postoperative period is presented.

Anastomosis, Surgical↗

PubMed1997

[Phacoemulsification and foldable intraocular lens implantation through a small sutureless incision].

OBJECTIVE: To evaluate the therapeutic effects of phacoemulsification and the foldable intraocular lens implantation. METHODS: The surgery was performed through a 3.2 mm incision on 72 eyes of 65 patients with senile, complicated, congenital and traumatic cataracts. RESULTS: Post-operatively, the visual acuities with spherical correction or without correction were 0.5 or better in 94.4% at one day, and 1.0 or better in 70.8%, 75.8%, and 76.5% at one week, one month and three months respectively. The mean post-operative astigmatism was 0.89 +/- 0.83 D at one week and 0.73 +/- 0.76 D at one month which was respectively less than that in the control group with a 6.5 mm incision (P < 0.001), but no statistical difference between them at three months (P > 0.05). CONCLUSION: The foldable intraocular lens implantation through a small sutureless incision could reduce early post-operative astigmatism and shorten the period of visual rehabilitation.

Adult↗

PubMed1999

Sutureless technique for subacute left ventricular free wall rupture: A case report of an 85-year-old.

This case was an 85-year-old female who developed left ventricular free wall rupture (LVFWR) of the anterior wall 13 days after an acute myocardial infarction. She was further complicated with an ascending aortic aneurysm and severe aortic regurgitation. The wall was repaired using a sutureless technique with an autologous pericardial patch and GRF glue without cardiopulmonary bypass. Although the complication of a left ventricular aneurysm was seen, the postoperative course was uneventful. Nevertheless, she is doing well 9 months after surgery.

Aged↗

PubMed2000

Sutureless laparoscopic extraperitoneal inguinal herniorrhaphy using reusable instruments: two hundred three repairs without recurrence.

Laparoscopic extraperitoneal hernia repair has several distinct advantages over the anterior repair and the laparoscopic transabdominal preperitoneal method. Laparoscopic extraperitoneal hernia repair allows detection and repair of occult contralateral defects with minimal risk of intraabdominal injury or adhesion formation and is associated with less pain and a quicker recovery. However, there are disadvantages. Circumferential mobilization of the spermatic cord and the use of staples to secure the mesh have been associated with injury to the spermatic cord and nerves. The cost of the laparoscopic approach is higher than that of open herniorrhaphy. Additionally, it is more difficult to do because there is a poor understanding of the preperitoneal fascial anatomy. A method of totally extraperitoneal inguinal herniorrhaphy emphasizing anatomic dissection and landmarks is described. The authors use only reusable instruments, no balloon dissector, and no fixation of the mesh. The wide dissection of the myopectineal orifice allows placement of a large mesh and utilizes intraabdominal pressure alone to secure the mesh on the posterior aspect of the abdominal wall, as described by Stoppa et al. (1). Operative costs are minimized. From experience with 203 sutureless extraperitoneal repairs, a low incidence of complications and no recurrences are demonstrated. It is extrapolated that the cost of this laparoscopic repair will approximate more closely that of open anterior herniorrhaphy.

Adult↗

PubMedDate not supplied

Self-sealing sclerotomies for sutureless pars plana vitrectomy.

OBJECTIVE: To determine the efficacy of self-sealing pars plana sclerotomies for vitrectomy and to identify complications associated with this new technique. METHOD: There were 150 self-sealing sclerotomies performed in 50 patients undergoing pars plana vitrectomy between October 1996 and March 1998. RESULTS: Of the 150 sclerotomies, 115 (76.6%) did not require suturing while 35 (23.3%) were closed with one radial 7.0 vicryl suture. The scleral tunnel incisions ensured minimal loss of intraocular fluids during instrument exchange and scleral plugs were not required to avoid ocular hypotony during scleral indentation. Distortion of scleral flap incisions requiring a suture were commonly seen in procedures using multiple instrumentations and extensive explants. CONCLUSIONS: Sutureless sclerotomies are simple to perform, save operative time, and reduce the risk of peroperative hypotony following removal of instruments or the infusion cannula. The technique reduces postoperative inflammation, suture-related problems including astigmatism, and allows more rapid rehabilitation.

Adult↗

PubMed2001

Sutureless skin closure in varicose vein surgery: preliminary results.

OBJECTIVE: To describe the preliminary results of a special method of wound closure in varicose vein surgery using the tissue adhesive butyl-2-cyanoacrylate. METHODS: Eighteen consecutive young women (mean age 23 years) underwent partial stripping of the greater saphenous vein for varicose veins of the lower limbs by an external phleboextractor. Their wounds were closed without sutures by means of the adhesive butyl-2-cyanoacrylate. The cutaneous edges were drawn together by linear traction between forceps and the adhesive was applied and allowed to set. Less than 0.5 ml of adhesive was required to complete the entire procedure. Wounds were evaluated at 7 days for infection, dehiscence, and tissue reactions. At 6 months all wounds were rated for cosmesis using a validated visual analog scale, that is, a 100 mm line with "worst scar" at the right end of the line and "best scar" at the left end. All patients were interviewed about their acceptance of tissue adhesive skin closure. RESULTS: The mean time required to close the epidermis with the adhesive was 117 seconds. All patients were followed up for 6 months. At 7 days no adverse outcomes had occurred. Results of wound evaluation at 6 months by the visual analog scale showed scores of 22.2 +/- 13.8 mm (optimal). The percentage of optimal scores was 94.4%, and only one patient (5.6%) had a suboptimal score. Inquiry into the patient's opinions suggested that this procedure was very acceptable. CONCLUSION: Preliminary results with sutureless skin closure in varicose vein surgery have been very encouraging. This fast and cosmetic method of wound repair can replace the need for skin sutures in varicose vein surgery.

Adult↗

PubMedDate not supplied

High volume sutureless intraocular lens surgery in a rural eye camp in india.

BACKGROUND AND OBJECTIVE: To describe the use of small incision sutureless cataract surgery (SISCS) that permits high-volume, high-quality, and low-cost surgery. PATIENTS AND METHODS: We compared the speed, safety, and visual results of 1190 surgical techniques performed in a public eye camp in India. Intraocular lenses were received by 97% of patients (1154). Surgical techniques used were SISCS, phacoemulsification, and standard extracapsular cataract extraction (ECCE) technique. RESULTS: Postoperatively, 60.0% attained uncorrected vision of 6/24 or better. There was little difference in visual results or complication rates among the three techniques. The most striking finding is the speed of SISCS, which enables experienced surgeons to perform the technique in 3.8 to 4.2 minutes. CONCLUSION: We believe this surgical technique is of major importance especially in developing nations facing enormous surgical volumes and limited resources.

Humans↗

PubMed2002

Improved device for sutureless aortic anastomosis applied in a case of cancer.

To reduce the time needed for clamping or circulatory arrest (or both) during substitution of a prosthesis for the thoracic aorta, we developed an expandable device that can be used with any commercially available prosthetic graft to enable sutureless aortic anastomosis. Improvements upon a previous version of the device include the use of nickel-titanium alloy (Nitinol) instead of stainless steel. This, together with an improved wire-looping design, now enables continuous control of diameter, even when the device is in contact with blood. A further improvement consists of 4 metallic hooks on the outer surface, which enable firm fixation to the aortic stump. In March 2001, a 47-year-old man was admitted to our institution for evaluation of left upper-lobe bronchogenic adenocarcinoma that had infiltrated the distal aortic arch and upper descending aorta. Re-staging of the neoplasm ruled out distant metastasis. We resected the infiltrated aortic wall en bloc with the upper lobe. The expandable device enabled the distal anastomosis of the aortic prosthesis to be performed easily, in less than 3 minutes. The main advantages of this device are an easier, quicker anastomosis and the absolute prevention of suture-line hemorrhage (no suture line). The expandable device overcomes the drawbacks of the intraluminal ringed prosthesis used in the past.

Anastomosis, Surgical↗

PubMed2002

Left ventricular free wall rupture: off-pump sutureless patch and glue technique.

Left ventricular free wall rupture is a well-recognized complication of myocardial infarction and is a frequent cause of death. Immediate surgical repair is the treatment of choice and many different surgical approaches have been reported. We describe an off-pump sutureless technique with the use of a glutaraldehyde-treated bovine pericardial patch and biological glue (N-butyl-2-cyanoacrylate) in a 60-year-old male patient with echocardiographic evidence of cardiac tamponade and a free wall rupture site on the lateral wall. The recovery was uneventful and the patient was discharged from the hospital on the eleventh postoperative day. At 3 months, he remained well and without any symptoms.

Bioprosthesis↗

PubMedDate not supplied

Blepharoptosis repair by modified sutureless Fasanella-Servat Operation (F.S.O)--a large series of 50 cases.

A modified technique of sutureless Fasanella-Servat Operation (F.S.O.) using special curved haemostat for the correction of mild to moderate acquired ptosis with good Levator Palpebrae Superioris (L.P.S.) action (12 m.m.) was performed in a large series of 50 eyes. Excellent correction was achieved in 94.6% eyes with mild ptosis & 61.6% eyes with moderate ptosis. No operative and post operative complications were observed. The technique was found to be very safe, quick and effective.

Aged↗

PubMed1992

[Sutureless bowel anastomosis with a biofragmentable ring in Crohn's disease].

A biofragmentable anastomosis ring has recently been developed and is used in end-to-end intestinal anastomosis. It is composed of 2 circular polyglycolic acid (Dexon) components which are interdigitated to form a sutureless anastomosis. We used it in an ileo-ileal and 2 ileo-colic end-to-end anastomoses in 3 patients with Crohn's disease in the past 6 months. Postoperative recovery of bowel function and oral feeding were comparable to that in patients after conventional anastomoses with sutures or staplers. Experience accumulated in 2 large multicentric comparative studies proved that the ring is a safe, fast and effective method for bowel anastomosis. We found it to be safe even in Crohn's disease.

Anastomosis, Surgical↗

PubMedDate not supplied

Sutureless limited vitrectomy for positive vitreous pressure in cataract surgery.

A sutureless transconjunctival pars plana vitrectomy with the 25-gauge transconjunctival vitrectomy system is used to facilitate phacoemulsification in eyes with positive posterior vitreous pressure and shallow anterior chamber. Peribulbar local anesthesia is administered. In eyes with shallow anterior chamber, if an injection of a viscoelastic substance through anterior chamber paracentesis fails to deepen the anterior chamber, a limited pars plana vitrectomy is performed to remove a small amount of retro-lental vitreous (approximately 0.2 to 0.3 cc) with a 25-gauge high-speed cutter. Phacoemulsification is subsequently performed. The limited pars plana vitrectomy reduces the chances of intraoperative vitreous loss and suprachoroidal hemorrhage. It also increases the anterior chamber depth, facilitates intraoperative steps such as pupil stretching and capsulorhexis, and results in a phacoemulsification procedure that is less complex and safer.

Equipment Design↗

PubMed1990

A flexible sutureless intraluminal graft that becomes rigid after placement in the aorta.

A new sutureless intraluminal graft has been developed with a ring made of a coiled, overlapping, stainless steel spring with ratchets in one overlapping end. This graft is flexible during insertion but becomes rigid after proper intraaortic placement as the spool is dilated and the ratchest lock into position. The new graft was implanted in 10 dogs and was evaluated histologically and angiographically at various intervals. No ring dislodgment, aortic rupture, stenosis, or aneurysmal dilation was observed. The flexible component of this graft allows it to be introduced and secured in place easily and provides a technical advantage compared with the clinically used rigid intraluminal graft.

Animals↗

PubMed1989

Hospital and home care of sutureless percutaneous catheters.

Percutaneous catheter drainage of the biliary tree, kidney pelvis, and abdominal abscess cavities has become increasingly prevalent over the last ten years. These procedures, along with percutaneous gastrostomies, are safer to perform and can be accomplished when the patient is not a candidate for surgical placement. Because patients are usually discharged with the catheter in place, it is necessary to have a simple but effective dressing procedure. Catheters placed through the skin have traditionally been sutured to the skin to prevent displacement. This sutureless method employs a technique that is safely managed, not only by hospital staff but by patients and/or their home care givers as well. The written instruction for this procedure were developed by an ET Nurse in collaboration with the Radiologists who insert the catheters.

Catheters, Indwelling↗

PubMed1989

Sutureless nerve repair at the fascicular level using a nerve coupler.

Peripheral nerves are transected in many traumatic injuries of the extremities. Satisfactory functional regeneration of such nerves often fails to occur after repair with sutures. Possible reasons for these failures include poor alignment of nerves or fascicles, intrusion of scar tissue into the nerve junction, and outgrowth of nerve tissue from the repair site. This animal study describes an experimental method of sutureless, monofascicular peripheral nerve repair using a resorbable nerve coupler in the rat model. The first version of this coupler shows approximately equal performance to suture repair. Histology and electrophysiology assessments after regeneration showed that the polyglycolic acid (PGA) tube repairs were functionally equal to monofascicular suture junctions as well as being quicker and simpler to perform. Modified coupler designs based on this and other work show greater promise. Collateral studies are using similar versions of the nerve coupler as a vehicle for the insertion of chemical and neuro-electronic factors that may enhance nerve regeneration.

Animals↗