SEARCH · PubMed Health
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.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
A method to localize A-V fistulas is described herein, using sterile staples as makers with angiography. This may decrease the operative time spent searching for A-V fistulas and may diminish morbidity and help improve the patency of the graft.
Thirty seven dogs and cats were subjected to lobectomy, partial lobectomy, or pneumonectomy using stapling equipment. The most common indication was neoplasia. No operative, perioperative, or long-term deaths could be attributed to the use of staples: complications were minimal. Staple resection was believed to be safe, fast, and efficient for removal of various segments of canine and feline lung.
Pharyngeal diverticulum (Zenker's diverticulum, hypopharyngeal pouch) is an outpouching of pharyngeal mucosa through a triangular area of weakness between the lower oblique fibres of the inferior constrictor muscle and cricopharyngeus called Killian's dehiscence. Prescribed treatment in large pouches is excision of the diverticulum with or without cricopharyngeal myotomy. Experience of closure of the oesophageal defect with an automatic stapling device is presented in nine cases of pharyngeal diverticula. Previous reports describing this technique have included substantial delays in the resumption of oral intake and prolonged hospitalization. It is shown that these delays are unnecessary.
The use of stapling instruments to perform gastric surgery in small animal patients provides alternative techniques that are often more reliable and are usually performed more quickly than conventional techniques with manual sutures. In addition to reducing anesthetic and operating times, the risk of contamination of the abdominal cavity may be decreased significantly.
The particular advantage of using the intraluminal stapler in Rehbein's operation for Hirschsprung's disease is that we are able to achieve very low and safe anastomoses 2-3 cm above the anal verge. Use of the intraluminal stapler has successfully overcome the difficulties of a very low handsewn anastomoses in children. In this way the aganglionosic segment can be resected completely. In 16 infants we can demonstrate the safety and reliability of colorectal anastomoses using the smallest intraluminal circular stapler, 21 mm in diameter. Endoscopic and manometric investigations demonstrate no stenosis or stricture.
Palliation of symptomatic emphysema may include bullous resection to improve function of the remaining lung. Buttressing staple lines with bovine pericardium partially alleviates postoperative air leak, but can promote inflammation and infection. We report a patient expectorating staples and pericardium 5 years after bilateral apical bullectomy. Previous reporting of this complication in lung volume reduction operation also involved both pericardium and staples, and we propose that an ongoing local inflammatory reaction to these materials may facilitate delayed erosion into airways.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
After anecdotal reports of significant complications with laparoscopic hysterectomy, the Royal Australian College of Obstetricians and Gynaecologists, South Australian branch, instituted the Adelaide laparoscopic hysterectomy audit. All 760 cases performed in the city of Adelaide (population 1 million) from commencement in 1991 to 1994 were analyzed with specific attention to major complications such as hemorrhage, hematoma, laparotomy rates, and urinary tract injuries. Potential bias was carefully avoided by auditing independent of the surgeons involved. Eighty-nine percent of cases were performed with disposable endoscopic surgical staples. Surgical technique was a combined laparoscopic and vaginal approach. Mean operating time was 129 minutes, mean estimated blood loss was 263 ml, and average hospital stay was 4.9 days. Significant hemorrhagic complications occurred in 3% of women. Hematoma formation requiring reintervention was reported at 3.3%, with an overall laparotomy rate of 5.3%. Urinary tract injury overall totaled 2.4%, consisting of bladder laceration 0.9%, ureteric laceration 0.5%, and late diagnosis 1.1%. Hemorrhage, hematoma, and laparotomy rates were higher than published data suggest but compared favorably with appropriate abdominal and vaginal hysterectomy complication series. However, urinary tract injuries were significantly elevated in comparison with published data, raising the questions of learning curve and experience as factors.
Since modern surgical stapling instruments have found a wide range of usefulness in gastrointestinal surgery, we have attempted to establish the feasibility of staple rather than suture closure of the transected pancreas. Distal pancreatic resection has been performed in eight dogs utilizing the Auto Suture Model TA-55 surgical staple instrument for primary closure of the transected margin of the remaining pancreas. Serial serum amylase determinations for each of the animals remained within normal range. Each animal was sacrificed one week after the initial surgery with examination of the remaining pancreas. None of the animals demonstrated any evidence of pancreatic fistula or abscess. Similar technique for distal pancreatic resection has been utilized in 12 patients. Five of the resections were performed for malignancies, four for trauma, and three for benign pancreatic disease. In each case, the residual pancreas was closed with the TA-55 surgical staple instrument. Although two patients died during the postoperative period of causes unrelated to the pancreas, none developed either fistula or other evidence of difficulty in healing of the pancreas. It is our conclusion that staple closure of the transected margin of the pancreas is a reasonable and safe alternative to standard suture closure technique.
BACKGROUND: This study was performed to evaluate and determine the validity and benefits of video-assisted thoracic surgical simultaneously stapled pulmonary lobectomy without rib spreading. METHODS: Between September 1992 and August 1995, 100 consecutive video-assisted thoracic surgical simultaneously stapled lobectomies without rib spreading were performed. RESULTS: Forty-five male and 55 female patients had 24 right upper, 8 right middle, 29 right lower, 24 left upper, 15 left lower lobectomies for 66 adenocarcinomas, 20 squamous cell carcinomas, 4 large cell carcinomas, 8 benign lesions, and 2 metastatic lesions. Seventy-six patients had negative nodes. Nine patients had positive nodes. Every bronchoscopy was visually and cytologically negative. Forty-nine cervical mediastinoscopies were negative. Operating time for the series averaged 90.3 minutes. Hospitalization averaged 3.5 days for the entire group, but was 2.6 days for the last 20 patients. Lesions ranged from 1.5 to 8 cm, averaging 3.4 cm. There was no surgical mortality, no hemorrhage, no transfusion, and no urgent conversion to an open procedure. No bronchial fistula, vascular fistula, or bronchovascular fistula has occurred. Complications included 6 air leaks, 2 cerebrovascular accidents, 1 infected chest tube site, 2 cases of pneumonitis, and 1 subcutaneous emphysema. CONCLUSIONS: Video-assisted thoracic surgical simultaneously stapled lobectomy without rib spreading is a safe operation that can be combined with lymph node sampling. At this early stage, therapeutic outcomes (survival) for resected neoplasms appear similar to results obtained from traditional open techniques.
BACKGROUND: The purpose of this study is to confirm the safety and validity of video-assisted thoracic surgical simultaneously stapled subsegmentectomy (simultaneously stapling of all subsegmental bronchi and vessels in their natural construction). METHODS: The clinicopathologic information of the 10 patients who underwent video-assisted thoracic surgical simultaneously stapled subsegmentectomy for primary lung cancer (6) and metastatic lung tumor (4) were reviewed retrospectively. The patient population consisted of 7 men and 3 women with a mean age of 70.2 years. RESULTS: Median operative time was 201 minutes. Average blood loss was 76 ml. Mean duration of thoracic drainage was 3 days. There was no surgical mortality. Recurrence was diagnosed in 2 of 6 lung cancer patients (each of contralateral lung metastasis and brain metastasis), and 1 of 2 died 26 months after the operation. All patients have been followed for a mean period of 30.4 months with no local recurrence. CONCLUSIONS: Video-assisted thoracic surgical simultaneously stapled subsegmentectomy is safe and may be an acceptable alternative to segmentectomy, and wedge resection for strictly selective patients with peripheral lung tumors.
Since their inception, surgical stapling devices have been used almost exclusively in pulmonary and gastrointestinal procedures. We present our experience with surgical staplers in operations for aneurysms of the aorta. Three illustrative case reports are presented that demonstrate the applicability of surgical stapling devices in excluding aortic aneurysms. Seven patients have undergone operation using this technique, all with excellent technical results. We believe that surgical stapling devices represent a safe, easy, and rapid means of excluding aneurysms of the aorta.
Surgical training is an apprenticeship with surgical techniques passed from one physician to another. Often these techniques are based more on surgical dogma than scientific evidence. Despite surgical dogma to the contrary, electrocautery is the preferred technique for wound creation, and peritoneal closure has no significant advantage over nonclosure. No method of handling the subcutaneous tissue is clearly superior; however, suture closure appears to have some advantages in preventing wound disruption. Subcuticular suture closure results in less pain and better patient satisfaction, and it is more cost-effective than surgical staples. These surgical techniques, as well as many others, need to be subjected to rigorous, randomized prospective trials. It is incumbent on each physician to ensure that his or her surgical techniques are evidence based and not simply the result of adherence to surgical dogma.
Explore the source record for details and available documents.
A number of surgical stapling instruments are on the market. The variety of instruments, stapling cartridges, and their potential veterinary uses are discussed. The basic principles of application and operation of these devices are emphasized.
Partial splenectomy was performed in 17 adult dogs by using either surgical stapling instrumentation or conventional suturing techniques. Blood loss was minimal as determined by clinical observation and comparison of packed cell volumes and total protein levels before and after surgery. Surgical stapling instrumentation or suturing techniques may be used safely for partial splenectomy in the dog; however, the stapling technique significantly decreases operative time.
In recent years, the use of surgical staples has become popular in all subspecialties of surgery. The advantages proposed have been a decrease in operative time and morbidity. This paper reviews the University of Miami/Jackson Memorial Medical Center, Division of Gynecologic Oncology experience with the use of surgical staples in gastrointestinal surgery on patients with a diagnosis of a gynecologic malignancy. Between January 1, 1979 and July 1, 1985, a total of 152 procedures were done, 81 by stapler and 71 by suture anastomosis. Ninety-one patients had received previous radiation or chemotherapy. The average age of the patients was 52 years. The results show a decrease in operating time, blood loss, and postoperative hospital stay in those patients where the stapler anastomosis was used. The postoperative morbidity and mortality were not increased. Twenty-seven total pelvic exenterations were performed during the period of study and they were evaluated separately. The hospital stay and blood loss as well as the operative time were significantly less using staplers. This report includes a detailed evaluation of the results. From this study, we concluded that surgical staples are a safe alternative in gastrointestinal surgery in patients with a gynecologic malignancy.