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At least 325 records · Page 18Linked to original sources
PubMed2006

Suture anchors and tacks for shoulder surgery, part II: the prevention and treatment of complications.

The use of suture anchors and tacks around the shoulder requires a thorough knowledge of the proper use of the devices and how to insert them. Although typically not technically demanding, suture anchors and tacks can present unique and frustrating challenges to the patient and the surgeon. These challenges can occur whether the procedure is performed via an open or arthroscopic approach, but knowledge of the potential challenges may optimize the surgical result and prevent complications. Complications can be categorized as technique-related or device-related issues (mechanical or biologic failure). Technique-related complications include problems with the delivery systems, anchor malpositioning, and suture management issues, such as knots not sliding. Device-related complications include implant fracture, migration secondary to poor fixation, synovitis from implant degradation, and osteolysis. This review describes the prevention of these and other complications, addresses the indications or need for intervention, and suggests potential solutions when intervention is indicated.

Humans↗
PubMed2002

Use of a Caspari suture punch to repair a radial tear of the lateral meniscus.

SUMMARY: Radial meniscal injuries in young patients are challenging problems. A technique not previously described in the literature is presented for radial meniscal repair. A Caspari suture punch is used to repair the inner leaf of the radial tear followed by standard inside-out augmentation with zone-specific cannulas and No. 2.0 PDS suture. This technical note describes the technique and its result in a case report.

Adult↗
PubMed2001

Robot-assisted microsurgery: a feasibility study in the rat.

OBJECTIVE: Telerobotic surgery is a novel technology that can improve a surgeon's manual dexterity as well as the results achieved with microsurgical procedures. METHODS: A prototype Robot-Assisted MicroSurgery (RAMS) microdexterity enhancement system developed by the Jet Propulsion Laboratory and MicroDexterity Systems, Inc., was tested in 10 rats. Carotid arteriotomies were created and closed using either the RAMS system or conventional microsurgical techniques. The time required, the technical quality (vessel patency and suture line integrity), the error rate, and subjective difficulty were compared. RESULTS: All procedures were successfully completed using the RAMS system to manipulate the vessel but not to hold the needle or place the sutures. The precision, technical quality, and error rate of telerobotic surgery were similar to those of conventional techniques. However, the use of the RAMS system was associated with a twofold increase in the length of the procedure. CONCLUSION: Surgery using a microdexterity enhancement system, or RAMS prototype, is feasible. With further development, such as a stereotelevisualization and haptic feedback system, this system could be used for telerobotic surgery in neurosurgical practice.

Animals↗
PubMed1993

[Precision suture techniques in operations on the large intestine].

Experiments were conducted on 24 dogs to elaborate two variants of precision (microsurgical) double-row suture in operations on the large intestine. The suggested variants of the suture were successfully applied in operations on the large intestine in 48 patients. The first variant of a double-row sero-serous and musculo-intramucous suture is technically simpler and preferable in formation of end to side, side to side ileotransfercal anastomoses, and endo-to end anastomoses of the large intestine. The variant of sero-serous and musculo-intramucous suture with double stitching of the submucous coat on each side of the created anastomosis is preferable in complicated restorative-re constructive interventions. Both variants (the second to a greater measure) ensure sufficient strength and air-tightness of the formed anastomoses, exact approximation of the layers of the edges of the intestine, and quicker healing of the intestinal wound by first intention. The suggested sutures make it possible to decline the formation of preventive relieving colostomas and transanal draining of large intestinal anastomoses.

Adenocarcinoma↗
PubMed1996

Fronto-orbito zygomatic approach: a technical modification.

The fronto-orbito zygomatic approach is part of the surgical armamentarium of modern skull base surgery. As described in the literature, it requires costly technological tools such as powerful drills and saws, to be performed. In the present communication we describe a technical modification that allows the zygoma to be elevated "en bloc" together with the fronto-orbital bone flap by means of appropriate use of the Gigli's saw. Using this technique, adequate replacement of the craniotomy flap requires only two silk sutures. This technical modification, which was already successfully used in over 20 cases, would also allow this useful approach to be performed in those neurosurgical environments where modern costly technology for cranial base surgery is not available.

Journal Article↗
PubMed2002

Repair of a tear at the base of a blister-like aneurysm with suturing and an encircling clip: technical note.

OBJECTIVE: An aneurysm can produce large defects in the parent vessel if the aneurysm tears at the neck of the vessel. The authors present a technique to repair a tear at the base of a blister-like aneurysm encountered during microsurgical clipping of an anterior wall aneurysm of the internal carotid artery. METHODS: The repair technique involved suturing and covering the aneurysm with an encircling aneurysm clip. A large tear had destroyed the vessel's tubular structure, and repair was not sufficient using an encircling clip alone. Two microsuture stitches were placed on the tear, so that a split artery re-formed a tubular structure. The lesion was then covered with Surgicel (Ethicon, Inc., Somerville, NJ) and fibrin glue. When the Surgicel and fibrin glue were applied, the temporary clip on the distal internal carotid artery was removed for a moment, allowing retrograde blood flow to provide the counterforce necessary to maintain the vessel's tubular structure. An encircling clip was then applied to cover the entire circumference of the lesion. RESULTS: This method required only a short occlusion time for arterial repair, thus helping avoid ischemic complications. The patient awoke with transient hemiparesis, but recovery was prompt. CONCLUSION: This technique is useful for repairing an aneurysmal tear at its base, especially if the tear is large.

Aneurysm, Ruptured↗
PubMed1987

[Controlled study comparing mechanical and manual esophago-jejunostomy following gastrectomy].

40 patients with gastric malignancies were entered into a prospective randomised study of mechanical stapling (EEA) vs. manual single layer suturing of the esophago-jejunostomy following total gastrectomy. The groups were well matched with respect to clinical features, medical risk factors and tumor stage. Following manual technique, no anastomotic leak was observed. In the group with automatic mechanical suturing one technical failure and one insufficiency was seen. This difference, however, is not statistically significant. One patient died (cardiac infarction). The analysis of operating time, morbidity and hospital stay showed no significant differences. These results indicate that by use of a precise standardized conventional suture technique the same security performing an esophago-jejunostomy can be achieved as with mechanical staplers.

Adenocarcinoma↗