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At least 667 records · Page 37Linked to original sources

PubMed1998

Treatment injuries in dentistry--cases from one year in the Swedish Patient Insurance Scheme.

Eight hundred and fifty-one claims submitted to the Swedish Patient Insurance Scheme were studied and analysed. The most frequent claim referred to root fractures of roots with posts, and to root perforations also related to root posts. Other relatively frequent claims referred to pulpal complications in connection with fixed prosthodontics, root perforations related to endodontic treatment, and dysaesthesia. The mean latency time (the time from the actual treatment to the diagnosis of the injury) was for root fractures 10.6 months, and the mean latency time for root perforations that were not directly observed during preparation was 15.9 months. Pulpal complications of teeth treated with crowns or fixed partial dentures had a mean latency time of 7.6 months. Injuries with a low frequency were, for example, fracture of vital abutments for crowns or fixed partial dentures, damage to tissue by electrosurgery or to the floor of the mouth by drilling, or perforations to the antrum. Two cases of particles dropped into the patient's eye were also reported.

Crowns↗

PubMed1984

Bowel preparation and the risk of explosion during colonoscopic polypectomy.

Concentration of oxygen, methane, and hydrogen were measured in intracolonic gas samples aspirated through the colonoscope at the time of colonoscopy from 46 patients. Of the above patients 20 prepared either with mannitol (n = 10) or with castor oil (n = 10) had the instrument passed to the caecum without air insufflation or suction. After mannitol, mean intracolonic hydrogen concentration (4.07%) was significantly higher (p less than 0.001) than after castor oil (0.51%). Mean oxygen and methane concentrations were approximately similar. Potentially explosive concentrations of hydrogen (greater than 4.1%) and or methane (greater than 5%) were present in 6/10 patients given mannitol and 2/10 patients given castor oil. Nevertheless only one patient from each group had coexisting oxygen concentrations of more than 5% producing thus a combustile mixture. Routine colonoscopy (using air insufflation and suction) was performed in 26 patients prepared with mannitol. Mean intracolonic hydrogen and methane was 0.63% and 0.88% respectively. The highest recorded concentration of hydrogen was 2.6%, and of methane 2.1%, while all patients had oxygen concentrations of more than 5%. It is suggested, therefore, that routine insufflation and suction before colonoscopic electrosurgical polypectomy should result in safe levels of these gases. The remote possibility of pockets of undiluted gas in explosive concentration, however, indicates the use of an inert gas such as carbon dioxide if mannitol preparation is used before electrosurgery.

Adult↗

PubMed1991

Current role of catheter ablative procedures in patients with cardiac arrhythmias. A report for health professionals from the Subcommittee on Electrocardiography and Electrophysiology, American Heart Association.

Catheter ablative techniques have assumed an increasingly important role in the treatment of patients with drug-refractory cardiac arrhythmias. Catheter ablation of the AV junction is considered the procedure of choice for management of patients without bypass tracts with drug-resistant supraventricular arrhythmias. Catheter techniques have been used with increasing frequency in attempts to ablate accessory AV tracts. These techniques currently appear to be less effective than surgical techniques but involve less morbidity and expense. In some centers, accessory pathway ablation using catheter techniques is the procedure of first choice in selected patients with drug-refractory tachycardia mediated by an accessory pathway. Catheter ablation of ventricular tachycardia should be reserved for patients with mappable ventricular tachycardia who are not candidates for cardiac electrosurgery or insertion of an automatic defibrillator. The development of more flexible catheters and more manageable energy delivery systems holds promise for more effective catheter techniques.

Arrhythmias, Cardiac↗

PubMed2004

Energy sources in laparoscopy.

Traditional monopolar and bipolar electrosurgery remain very useful in laparoscopic surgery. The need for meticulous hemostasis and the tedium of vessel ligation in advanced cases has propelled the development of new energy source devices that have proved to be remarkably helpful in both laparoscopic and open surgery. Energy sources in the form of argon beam coagulation, ultrasonic coagulation, and bipolar vessel sealing systems have revolutionized laparoscopic surgery. Although each of these energy sources has improved the efficiency and safety of minimally invasive techniques, they can also be associated with distressing complications. This report describes the biophysics of these tools, their spectrum of effectiveness, and methods of application that may improve our ability to perform surgery in a safe and proficient manner.

Argon↗

PubMed2004

Optimal management of facial telangiectasia.

Telangiectasia can be treated with many different modalities. Electrosurgery is effective but dependent on technique. Sclerotherapy can be used on larger blue telangiectasia but may be complicated from inadvertent injection into arterioles. Surgical phlebectomy can be used on reticular veins but is technically difficult. Many different laser wavelengths can be successfully used to minimize and/or eliminate vascular lesions on the face. Each type of laser has advantages unique to its profile of wavelength, pulse duration, spot size and cutaneous cooling. The benefits of using 532-595 nm lasers are the multiple applications of these lasers on treating not only telangiectasia, but also pigmentation and even fine wrinkles. Newer methods of cutaneous cooling and lengthening of pulse duration make these lasers less painful with fewer adverse effects (purpura) than previous lasers. The benefit in using a 1064 nm laser is that its longer wavelength can penetrate more deeply, allowing effective thermosclerosis of vessels up to 3-4 mm in diameter. In addition, the 1064 nm wavelength permits treatment of patients of skin types I-VI with or without a tan, since melanin absorption is minimal.

Electrosurgery↗

PubMed1990

[Treatment and analysis of a clinical case of gingival pigmentation around the restored teeth].

A remarkable gingival pigmentation around the restorated teeth was successfully treated by simple surgical removal; incision & coagulasion of deposits by electrosurgery. Before the treatment, a biopsy from the pigmented gingiva was histopathologically examined, and a lot of small pigment deposits were found in the lamina propria with no inflammation, but not in the epitherium. Elements constructing the deposits were also determined by means of an electron probe X-ray microanalyser. Silver was found to be the principal element of the deposits, but not found at all in the crown metal. These results suggested that the cause of the pigmentation was implantation of metal fragments from metal cores during abutment teeth preparation. Therefore, the surgical removal was performed. Relapses have not occurred for 3 years since the treatment.

Electron Probe Microanalysis↗

PubMed2004

Electrosurgical adenoid ablation.

OBJECTIVE: The technique of adenoidectomy has undergone many refinements over the years with, most recently, the addition of electrosurgery alone as a viable method for removal of adenoid tissue. Several studies have suggested good efficacy with this method. The objective of this study is to examine the effectiveness of adenoidectomy by electrosurgical ablation by the following measures: reduction of the adenoid size, blood loss, and postoperative complications. DESIGN AND METHODS: In this prospective study, we reviewed patients who underwent electrosurgical adenoid ablation for either nasal obstructive symptoms or chronic otitis media with effusion requiring a second or greater set of pressure equalization tubes and adenoidectomy. Preoperative and postoperative videonasopharyngoscopy were performed and evaluated. A grading system for adenoid size for the endoscopic parameters was used. The amount of blood loss and postoperative complications were recorded. RESULTS: On preoperative nasopharyngoscopy, 7 of 23 children had a grade II adenoid size, 15 of 23 had grade III adenoid pads, and 1 of 23 had grade IV adenoid size. Postoperative follow-up at 6 to 8 weeks revealed that 19 of 23 children showed no evidence of adenoid tissue. Three of 23 children had only tiny residual tissue that fell into grade I and one had regrowth of tissue to fit into grade III. Eight patients were seen at 6 months postoperatively, four of whom were followed up to 12 months postoperatively; all showed no evidence of regrowth of adenoid tissue. Average blood loss for the procedure was 2.6 cc. No postoperative complications (postoperative bleed, dehydration requiring hospitalization, infection, velopharyngeal insufficiency) were encountered. CONCLUSIONS: Electrosurgical adenoid ablation is a safe method with minimal intraoperative blood loss and postoperative complications. Follow-up at 6 to 8 weeks and up to 1 year postoperatively suggests that it is an effective method in removing adenoid tissue and alleviating nasal obstruction.

Adenoidectomy↗

PubMed2004

Endoscopic electrosurgical management of posterior epistaxis: shifting paradigm.

Recent literature has embraced the use of electrosurgery, sphenopalatine vascular clipping, and endoscopy in posterior epistaxis. With the advent of endoscopy, the surgical treatment of posterior epistaxis has shifted from internal maxillary ligation to endoscopic sphenopalatine artery control. This article introduces an endoscopic electrosurgical approach for patients suffering from idiopathic posterior epistaxis that combines one or more of the following methods: endoscopic selective branch cauterization, endoscopic sphenopalatine artery cautery, and endoscopic posterior nasal cauterization. This approach is currently used in a hospital-based community otolaryngology practice and is presented from a Canadian health care perspective (Quebec). This article presents the experience in a series of 17 patients treated during a 35-month period and prospectively followed and discusses the surgical technique, patients' outcome, and the implications of such a practice.

Adult↗

PubMed2004

Endoscopic electrosurgical adenoidectomy: technique and outcomes.

Recent literature has embraced the use of electrosurgery and endoscopy in adenoidectomy, with several published articles on the subject. The combination of these methods and the routine use of endoscopy have not been reported. This approach provides a direct-targeted route to the nasopharynx, improved visualization, and magnification and offers a bloodless surgical field. It allows improved evaluation of the adenoids with their peritubal extensions, their lateral and central portions, and their extension to the posterior nasal choanae and even in the posterior nasal fossae and evaluation of the posterior of the middle and inferior turbinates. It permits objective documentation of the cause of nasal obstruction with possible use in outcome assessment. It is also an effective teaching method and a motivating approach for the nursing team. Our approach has proved cost and time efficient in our minimally invasive surgical (endoscopic) operating room set-up. This article reflects the experience in a series of 96 consecutive patients performed during a 9-month period and discusses the surgical technique and patients' outcomes. The endoscope and suction cautery were systematically used for all adenoid surgery. Outcomes were evaluated using a telephone survey with a global rating questionnaire.

Adenoidectomy↗

PubMedDate not supplied

Are engineers unsung heroes of medical progress?: the historic bond between physics, engineering, and medicine.

This review traces the heretofore unsung hero role of engineering in the evolution of today's healthcare and the growing bond between physics, engineering, and medicine. It recognizes the debt owed to the various specialties of healthcare engineering, especially the bioengineers who contribute not only to a better understanding of basic physiologic and pathologic processes but also to the development and application of technology and the adaptation of new engineering discoveries to medicine. In the past half-millennium, the fields of physics, engineering, and medicine have made a large number of seminal contributions to each other, resulting in ever-advancing healthcare methodologies, although only a precious few remain identified by the originators' names. In this review, 3 engineers are cited in detail for their milestone contributions to medical progress: Roentgen in radiology, Bovie in electrosurgery, and, more recently, Greatbatch in implantable cardiac pacemakers. Future horizons in medicine appear to be ever more attainable because of the synergism between the physical and biological sciences.

Biomedical Engineering↗

PubMedDate not supplied

Modification of surgery equipment for ovine surgery.

Surgery equipment was modified for ovine surgery. Pre- and postoperative holding pens were designed to meet the specific requirements of sheep. A hydraulic trolley lift was constructed and operating tables fitted with spilltrays. A gag was made to protect Magill tubing and the indifferent electrode was altered for electrosurgery. For fluoroscopy a flexible table was constructed to accommodate sheep.

Animals↗

PubMed1998

Transurethral prostate vaporization using an oval electrode in 82 cases of benign prostatic hyperplasia.

OBJECTIVE: To present our initial experience in transurethral vaporization of the prostate (TVP) using an oval electrode for the treatment of benign prostatic hyperplasia (BPH). METHODS: A total of 82 patients underwent TVP procedures with the oval electrode. The newly designed oval-shaped electrode can work with a High Frequency Electrosurgery Unit. Prostate gland tissue was vaporized through an Fr 24 percutaneous nephroscope transurethrally. The operation procedure was similar to transurethral resection of the prostate (TURP) or transurethral laser prostatectomy (TULP). Power setting ranged from 240 W to 320 W. Local vaporization temperature reached 120 degrees C. RESULTS: Urination was recovered in all 82 patients after TVP. Mean post-treatment International Prostate Symptom Score (I-PSS) reduced from 27.10 to 5.05; mean bladder residual urine volume dropped from 147.71 ml to 33.2 ml; and mean urine flow rate (MFR) increased from 4.45 ml/s to 14.57 ml/s (P < 0.01). The initial results of short-term follow-up were excellent. CONCLUSIONS: TVP with the oval electrode is easy to perform and causes less hemorrhage and few complications. It especially benefits elderly and/or critically-ill patients. We believe that TVP with our oval electrode is feasible with low risk.

Aged↗

PubMed2000

MegaDyne Mega 2000 return electrode.

The Mega 2000 return electrode, manufactured by MegaDyne Medical Products, is a reusable, capacitively coupled return electrode used in monopolar electrosurgery. It consists of a large--almost two feet by three feet--sheet of flexible conductive fabric that is enclosed in a nonlatex, urethane insulating material. Unlike conductive return electrodes, which are applied adhesively to the patient, the Mega 2000 does not come into direct contact with the patient. Rather, it is placed on an OR table and covered by a protective sheath and, at most, a cover sheet and draw sheet. The patient lies on top of these sheets. The electrode forms a large capacitor with the patient, capacitively coupling the patient into the electrosurgical circuit. Because it is reusable--only the protective sheath is replaced--the Mega 2000 is touted as being a significantly less expensive alternative to traditional conductive return electrodes. And because it is not affixed to the patient, it offers potential advantages for patients having frail skin or extensive skin and tissue damage that would make the use of adhesive return electrodes difficult or impossible. While some healthcare facilities have considered using this return electrode because of its potential clinical and economic benefits, others have questioned its safety because it differs in design from a traditional return electrode. Therefore, we have examined its safety, efficacy, and cost-effectiveness in this Evaluation. We also offer guidance for facilities trying to decide whether to buy the Mega 2000.

Electrodes↗

PubMed2000

[Study on women with abnormal uterine bleeding treated by hysteroscopic electric resection].

OBJECTIVE: To evaluate the efficacy, prognosis and influences of hysteroscopic electrosurgery in treating abnormal uterine bleeding (AUB). METHODS: Eighty two women with AUB were treated by hysteroscopic electric resection. Among them, 48 cases had submucous myomas, 29 cases endometrial polyps, 4 cases dysfunctional uterine bleeding, and 1 case had submucous myoma and endometrial polyps. RESULTS: The mean time of follow-up was 25.5 months. The effective rate of menstrual flow ameliorated was in 91.5% of the patients. Yet, the percentage of the effective rate was decreased gradually with time. The improved effective rates of dysmenorrhea, midcycle pain, premenstrual symptoms and perimenstrual symptoms were 83.3%, 60.0%, 60.0% and 62.7% respectively. The effective rate of total symptoms improved in endometrial thickness with < or = 5 mm was 91.3%, and that in endometrial thickness with > 5 mm was 63.6%. There is a significant difference between in endometrial thickness with < 5 mm and in endometrial thickness with < 5 mm (P < 0.05). The effective rate of total symptoms improved with drugs suppressing endometrium used in perioperation was 93.8%, and that with no drug used was 72.0%. There is also a significant difference between drug used and no drug used groups (P < 0.05). CONCLUSIONS: Hysteroscopic electric resection in treating AUB improves not only menstrual flow but also perimenstrual symptoms. The effectiveness and prognosis of this operation may be related to endometrial thickness and medical treatment.

Adult↗

PubMedDate not supplied

Laparoscopic intracorporeal bowel resection with ultrasound versus electrosurgical dissection.

BACKGROUND AND OBJECTIVES: We assessed resection time and collateral thermal tissue damage of ultrasonically activated surgery (UAS) and high-frequency blade-enhanced bipolar electrosurgery (BE) in laparoscopic bowel surgery. METHODS: We compared UAS laparoscopic intracorporeal small bowel mesentery re-section with an equivalent procedure performed with BE in a porcine model. Resection was defined as 12 end-arcade arteries supplying the intended bowel segment. Vessels were divided one cm off the bowel wall. Aside from shaft diameter, jaws gaping pattern, and cutting blade length, UAS and BE devices were well matched for handle ergonomics, jaws gaping extent, power setting, type of use, working shaft axial rotation, and length. A pathologist blind to the method used assessed the collateral thermal damage. Resections were allocated to either method by computer-generated block randomization. The study design was sequential triangular with a 5% significance level and 90% power. RESULTS: No significant differences occurred in intraoperative blood pressure and heart rate variations in pigs undergoing UAS or BE. Median operating time (measured after 10, 20, and 30 resections in each study arm) was significantly shorter in UAS than in BS (0.57 vs. 2.01 min P < 0.001). Histology of small bowel wall specimens revealed no collateral thermal damage. CONCLUSIONS: UAS laparoscopic bowel surgery offers reduced resection time as com-pared with its BE counterpart in a porcine model.

Animals↗

PubMed2001

Stationary surgical smoke evacuation systems.

Two types of systems are available for evacuating the surgical smoke created by electrosurgery and laser surgery: portable and stationary surgical smoke evacuation systems. While portable systems dominate the market today, stationary systems are an alternative worth considering--even though they are still in their infancy, with fewer than 90 systems installed to date. Stationary systems represent a major commitment on the part of the healthcare facility. Several system components must be installed as part of the physical plant (for instance, within the walls), making the system a permanent fixture in the surgical suite. Installation of these systems is often carried out during building construction or major renovation--although the systems can be cost-effective even if no renovations are planned. For this Evaluation, we tested three stationary systems. All three are adequate to capture surgical smoke and evacuate it from the operating room. These systems are easy to use, are quietter than their portable counterparts, and require minimal user maintenance. They represent an excellent option for most hospitals actively evacuating surgical smoke. In this article, we discuss the factors to consider when selecting from among these systems. We also offer guidance on choosing between stationary systems and portable ones.

Decision Making, Organizational↗

PubMed2002

Endotracheal tube fire during tracheostomy: a case report.

Electrosurgery in the presence of volatile anesthetic gases has been associated with operating-room fires. We report a case in which an operating-room fire occurred while an intubated patient underwent electrosurgical tracheostomy. The fire in this case was caused by a combination of an oxygen-rich environment, a polyvinyl chloride tube, and heat generated by an electrosurgical unit. We also discuss factors that increase the risk of this type of fire and the management steps that should be undertaken in the event that such a fire occurs, and we briefly review the literature on this subject.

Adult↗

PubMed2003

[Comparative aspects of surgical treatment of hemorrhoid].

Based on experience in treating 64 patients with chronic hemorrhoid a comparative clinical evaluation of efficiency of electrosurgical methods is carried out hemorrhoidectomy. Compared with traditional Milligan-Morgan surgery, electrosurgical method demonstrates the absence of intraoperative blood loss, a reduction in the algetic syndrome after surgery, a decrease in postoperative complications rates by 4.8 times. Physiological and physical activity, stool are also recovered by electrosurgery.

Adult↗