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At least 1,081 records · Page 60Linked to original sources
PubMed1982

[Role of smooth muscle cells in reparative processes in a vascular suture of the rat aorta performed using a microsurgical technic].

The abdominal aorta in 56 white rats has been sutured by means of a microsurgical technique in order to study changes that the smooth muscle cells (SMC) of the vascular wall undergo during the restorative process of its integrity and intima formation. The material for histological investigation is fixed in 10% formalin or in Karnoy fluid and embedded in paraffin. For the electron microscopic investigation the specimens of the aorta are treated in 2% and 5% glutaraldehyde solution and in 1% tetraoxic osmium solution and embedded in epon and araldit mixture. The muscular wall SMC actively participate in the reparative processes when the vascular suture is performed by means of the microsurgical technique. The vascular wall SMC ensure the rat aorta restoration in such a way that already 3 weeks after the operation the cut line can be defined only by the presence of the suture thread and by a slight sheet of the connective tissue. Migration and accumulation of the SMC under the endothelium restored its integrity results in the intima formation. Simultaneously, an intercellular substance is forming, that is directly connected with the SMC development.

Animals↗
PubMed1993

[Surgical technical principles of trans-scleral suture of posterior chamber lenses].

BACKGROUND: Most reports on transscleral suture fixation of posterior chamber lenses (PCL) do not mention the principal difficulty that the surgeon has no valid information which structures were perforated by the needle and where he happened to fix the PCL loops. To know this exactly is a "conditio sine qua non". Without it, no valid evaluation of longterm results of this method will ever be possible. MATERIALS AND METHODS: Thirtythree PCL were fixated by transscleral suturing. The results of the decisive surgical steps were controlled by intraoperative endoscopy. The experiences and insights gained thereby were used to develop step by step optimal surgical procedures for different conditions. The results of the endoscopically controlled group were compared with the results of 128 eyes with transscleral suture fixation of a PCL without endoscopic control between 6/88 and 4/91. RESULTS: On the basis of systematically performed endoscopic controls during surgery we have identified several faults and pitfalls which should be avoided. In consequence we have developed rules and items that should be fulfilled in order to arrive at an anatomically correct position of the PCL: 1. The transscleral suture should only penetrate the sulcus and no adjacent structures of the iris or the ciliary processes. 2. The PCL loops must be primarily directed into the sulcus, 3. PCL design must be adapted to the anatomical needs of the procedure and must provide a safe distance between iris and PCL to avoid iris-shafting. Detailed suggestions are given to fulfil these requirements. The most important point is the two-step implantation of the PCL out of the anterior chamber into the posterior chamber to avoid a steep and disadvantageous implantation angle. Up to date, no cases with chronic intraocular inflammation have occurred in the endoscopically controlled group in contrast to the earlier non-controlled group. CONCLUSIONS: Our results allow--even without endoscopic control--an exact positioning of the PCL hepatics in the sulcus, which is the most important step in the whole procedure. However, for a scientific evaluation of longterm results after transscleral suturing of PCL endoscopic control will further be needed to demonstrate or to rule out any potentially harmful compression of the ciliary body or iris structures and to see whether or not such irregularities will be associated with reduced longterm tolerance.

Endoscopes↗
PubMed2004

A new technical approach for sternal closure with suture anchors (Dogan technique).

OBJECTIVES: Various methods for sternal approximation have been described previously. Some patients undergoing these procedures are at risk for sternal dehiscence and mediastinitis. We used a different method, with a suture anchor system, for median sternotomy closure as an alternate technique in patients with a high risk of postoperative sternal dehiscence and sternal nonunion. MATERIAL AND METHOD: Suture anchor systems have been developed principally for the fixation of tendons or ligaments to the bone. We first used the suture anchor system for median sternotomy closure, although it has been frequently used in various orthopedic surgical procedures. In this report, we describe the use, after fresh cadaveric tests, of an alternative technique in a patient undergoing coronary artery bypass grafting. RESULTS: There were no complications due to the suture anchor device, and successful application was performed for sternotomy fixation after surgical procedure in a patient. The standard techniques have several disadvantages, such as osteomyelitis, chondritis, cutting into the sternum and sternal dehiscence, prolonged hospitalization, and increased mortality and morbidity due to the listed complications, but these devices may protect the wire from cutting into the sternal bone. CONCLUSION: We propose suture anchors for reapproximation of the sternum to decrease the complications related to surgical steel wires. We therefore consider this technique to be easy, safe, and effective in patients with diabetes mellitus or severe osteoporosis considered to have risk for sternal dehiscence postoperatively. Another advantage of this suture system is that the titanium wire makes it more magnetic resonance compatible than systems using surgical steel wire.

Cadaver↗
PubMedDate not supplied

[Round ligament suspension in laparoscopic hepatic surgery: technical advantages].

Transabdominal suspension sutures are generally described in different laparoscopic surgical techniques. During the different phases of the surgical procedure, this solution permits the surgeon to achieve better exposure of the "target organ" or adequate stabilisation of it without adding more ports and instruments. In a limited working space, the use of many instruments may interfere with the surgeon's movements. In the present paper, we present the use of suspension sutures of the round ligament in different hepatic surgical techniques performed laparoscopically in our department of surgery, analysing the technical advantages.

Adult↗
PubMed1999

[Continuous loop suture in a longitudinal arteriotomy].

The author describes a technical 8-shaped variation of continuous suture of longitudinal arteriotomy. He describes the technical details of implementation of the suture which by crossing of the thread between the margins of the arteriotomy prevents overlapping of the margins and thus narrowing the arterial lumen. Practical aspects of the use of the suture are described, incl. evaluation of conditions and local findings where this continuous suture can, due to its functional effect, replace autovenous or prosthetic plastic surgery of the artery.

Arteries↗
PubMed1978

Evaluation of through-and-through corneal sutures.

Sutures placed at the level of Descemet's membrane were compared with sutures placed through and through the full corneal thickness in 42 rabbit corneas using cataract and corneal wounds. The rabbits were killed, and sutures were removed at various postoperative periods up to four weeks. Evaluation of the wounds demonstrated that although the through-and-through technique provided good wound closure in the immediate postoperative period, the technique produced more damage to Descemet's membrane and to the endothelial cells, both at the time of suturing and at the time of suture removal, and tended to produce greater retrocorneal membrane formation. In addition, the through-and-through suturing technique was technically more difficult. In this study performed in rabbits, the one advantage of the through-and-through suture, ie, immediate posterior wound closure, was outweighed by its many disadvantages.

Animals↗
PubMed1996

Laparoscopic transgastric suturing for bleeding peptic ulcers.

BACKGROUND: Peptic ulcers are a frequent cause of upper G.I. bleeding. Since endoscopic methods may be unsuccessful, we have studied the feasibility of a new laparoscopic approach on a porcine model to control the bleeding of these ulcers with transgastric suturing. METHODS: After approval of the Animal Ethics Committee, 20 pigs (20 kg) were anticoagulated with intravenous sodium heparin (400 U/kg), and anesthetized. A nasogastric tube was inserted and a 15 mmHg pneumoperitoneum was created. Two 10-mm trocars and one 5-mm trocar were inserted through the abdominal cavity for laparoscopic guidance of three 7-mm endoluminal trocars inside the stomach through the anterior wall. Two posterior gastric ulcers were mechanically made on each pig by a "lift and cut technique." Ulcers were observed for at least 1 min for evidence of continued bleeding. First, bleeding ulcers were treated with sclerosing agents (epinephrine and ethanolmine oleate 5%); following sclerotherapy, ulcers were sutured intraluminaly with 2-0 silk, with intracorporeal knots. RESULTS: Ulcers created extended into the vascular submucosa and averaged 7 mm in diameter. Bleeding rate was variable, but significant (2 cm3/min) in 40%. It was technically possible to suture these ulcers in 80%. Bleeding was controlled in 95% of cases with sclerotherapy and intraluminal sutures. One perforation of the posterior gastric wall occurred and four endoluminal trocars had to be reinserted after dislodgement. CONCLUSIONS: It is possible to technically control bleeding ulcers in most cases with a laparoscopic transgastric technique using sclerosing agent and intraluminal sutures. This approach is promising for future human application; also, the intragastric suturing skills developed may be useful for other surgical interventions.

Animals↗
PubMed1997

The torque and tilt gamble.

PURPOSE: To analyze possible suture configurations at the haptics of posterior chamber intraocular lenses (IOLs) and estimate the resulting tilt. SETTING: King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia. METHODS: Using a plastic cylinder with two pairs of holes drilled on opposite sides and an IOL with eyelets in the haptics, we determined possible suture configurations and analyzed them for net torque on the IOL haptics that would result in tilting of the optic. RESULTS: We identified 64 combinations of regular and countless combinations of irregular suture configurations. Among the 16 most likely combinations, only 4 were torque-free (or torque neutral), 2 caused maximum tilt, and 10 induced some tilting. Theoretically, torque could be eliminated by radial suture placement, but this is anatomically undesirable, and by positioning the eyelet perpendicular to the haptic, but this is technically difficult. Longer suture bites tended to lessen the torsion on the haptic but increased the risk of the suture looping around the free end of the haptic. CONCLUSION: Surgeons using scleral fixation of a posterior chamber IOL should be aware of the possibility of inducing tilt and should aim for symmetrical suture configurations at the two haptics.

Foreign-Body Migration↗