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At least 1,171 records · Page 65Linked to original sources
PubMed1999

Reliability of cranial flap fixation techniques: comparative experimental evaluation of suturing, titanium miniplates, and a new rivet-like titanium clamp (CranioFix): technical note.

OBJECTIVE: To ensure patients' safety, the mechanical strength of cranial flap refixation techniques and implants (sutures, titanium miniplates, and new rivet-like titanium clamps) had to be validated. METHODS: With craniotomied cadaver skulls for each refixation technique, load-bearing tests were performed by applying an external force until an impression depth of the cranial flap of 2 mm was reached and the results were compared. RESULTS: CranioFix (Aesculap AG, Tuttlingen, Germany) and miniplates were revealed to be the strongest fixation devices, although with miniplates, the plastic deformation started from the beginning of load application, whereas CranioFix additionally provided a better spring-elastic reserve and a higher reproducibility of fixation strength not dependent on bone thickness and consistency. Flaps fixed by sutures were dislocated from the start. CONCLUSION: Although CranioFix offers distinct advantages over miniplates, both proved to be definitely superior to suturing, which is still used in many centers. Therefore, whether suturing can still be regarded as a state-of-the-art technique must be reconsidered.

Bone Plates↗
PubMed2002

Modified sleeve anastomosis for reconstruction of the hepatic artery in rat liver transplantation.

End-to-end sleeve anastomosis between a donor common hepatic artery and a recipient proper hepatic artery was proven to be the most physiological and simple method for hepatic rearterialization in rat liver transplantation. Current technical variants of the sleeve technique, however, are hampered by the high rate of bleeding from the anastomotic site. This report deals with a technical modification which inhibits postoperative bleeding efficiently. The procedure consisted of a guiding suture, as previously described in other technical variants, and a modified fixing suture. Instead of using a single stitch to fix the feeding vessel with the receiving vessel, a running suture between the edge of the donor common hepatic artery and the adventitia of the recipient proper hepatic artery was performed to avoid a possible backflow. The patency rate of 91% was as high as reported by others using a sleeve technique, which was also reflected in the histomorphological picture, being indistinguishable from normal liver histology. This technical modification simplified the procedure of reconstructing the hepatic artery and could contribute to a wider use of the arterialized liver transplantation model in rats.

Anastomosis, Surgical↗
PubMed1991

A comparison of suture and tubulization nerve repair techniques in a primate.

This study compared standard methods of nerve repair, epineurial or perineurial sutures with a technique termed fascicular tubulization using a biodegradable polyglycolic acid tube in a nonhuman primate model. Electrophysiologic analysis demonstrated that the percentage of proximal axons that conducted across the repair site did not significantly differ among the three techniques while epineurial suture repairs were associated with significantly longer conduction delays across the repair site compared with the other two techniques. Even though fascicular tubulization using the current polyglycolic acid tube resulted in regeneration equal to the currently perceived best suture repair technique, associated technical problems with the current tube design indicate that this fascicular tubulization technique cannot, at present, be considered as an alternative to present clinically used nerve suture techniques.

Animals↗
PubMed2003

Safety and efficacy of the Perclose suture-mediated closure device following carotid artery stenting under clopidogrel platelet blockade.

The aim of this study was evaluation of a closure device (Perclose, Menlo Park, Calif.) for closure of the femoral artery access site in patients undergoing aggressive anticoagulation and platelet blockade after carotid stenting. Fifty-five patients who received clopidogrel in addition to aspirin and heparin as medication for carotid stenting were included for suture of the femoral access site after using 7- or 8-F guide catheters. The technical success, the time for suture, the clotting parameters, and complications were examined. Follow-up investigations, including ultrasound and clinical examinations, were performed. The groin was checked for possible hematoma, pseudoaneurysm, arteriovenous fistula, and local infection. Technical success was obtained in 51 of 54 patients (94%) after a mean procedure time of 6 min (range 5-10 min). The suture device was not used in one patient (2%) for anatomical reasons and failed to obtain hemostasis in 3 of 54 (6%) patients. In 4 of 54 patients (7%) bleeding was observed at the punctured site 4-6 h after intervention which was treated by a compression bandage. The mean dedicated activated clotting time was 137 s (range 29-287 s) before intervention and 349 s (150-958 s) just before deploying the Perclose device. During follow-up after 2 days (range 2-6 days) and 6 months no further complications of the puncture site were observed except for two large groin hematomas. No major complications occurred. Closure of the femoral access site after carotid stenting using a Perclose closure device is safe and effective even in patients receiving an aggressive anticoagulation and antiplatelet therapy.

Aged↗
PubMedDate not supplied

Technical considerations in knot construction. Part II. Interrupted dermal suture closure.

The purpose of this study was to identify the optimal knot construction for interrupted dermal sutures. A synthetic braided absorbable suture, sizes 3-0 and 5-0, was selected for this evaluation. With reproducible mechanical performance tests, we determined that the construction of secure knots without ears required one additional throw as compared with secure knots with 3-mm ears. The direction of applied tension did not alter knot security, with the exception of granny knots, which required an extra throw when tension was applied parallel to the suture loop. Because interrupted dermal knot construction is accomplished without knot ears and with an applied tension parallel to the wound, one additional throw must be added to the knot to ensure knot security.

Humans↗
PubMed1997

Direct bladder stimulation with suture electrodes promotes voiding in a spinal animal model: a technical report.

To determine the efficacy of a new electrode for direct bladder stimulation, five male cats were instrumented during anesthesia. Multistranded, 316LVM, stainless-steel, wire electrodes were implanted on the bladder wall serosa above the trigone area. The electrodes were made with a needle attached to the end that was cut off after suturing the electrode in place. Additional instrumentation included tubes for pressure recording and filling, and hook electrodes for leg and pelvic floor EMG recording. Bladder filling and stimulation studies were conducted in tethered animals 1 to 2 weeks following recovery. Chronic studies were conducted following recovery in tethered animals. To test these electrodes in a spinal cord injury (SCI) model, a T-1 level complete lesion was performed on the above instrumented animals. Spinal animals had successful direct bladder stimulation that induced active contractions and voiding both before and after SCI, but voiding rates were higher more than 2 weeks after SCI and at larger initial bladder volumes. Optimum stimulation parameters consisted of 40 pulses per second, 300 microseconds to 1 ms pulse duration, a stimulation period of 3 to 4 s, and 10 to 40 mA. Urethral resistance, indicated by a urethral function measure, showed that stimulation had no adverse effect on urethral function, and fluoroscopy showed an open membranous urethra during stimulation and voiding. The cat has a small penile urethra that is the flow rate controlling zone. The suture electrode did not corrode, erode into the bladder, or become dislodged, and appears suitable for chronic implantation.

Animals↗
PubMed2001

Laparoscopic cross-trigonal Cohen ureteroneocystostomy: novel technique.

PURPOSE: We describe a novel technique of laparoscopic transvesical cross-trigonal Cohen anti-reflux ureteroneocystostomy. MATERIALS AND METHODS: A 10, an 11 and a 32-year-old patient with symptomatic unilateral vesicoureteral reflux underwent laparoscopic cross-trigonal ureteral reimplantation. Two 5 mm. balloon tip ports were suprapubically inserted into the bladder. Using a transurethral resectoscope with a Collins knife a 4 to 5 cm. cross-trigonal submucosal trough was created from the refluxing ureteral orifice to the contralateral side of the bladder. The refluxing ureteral orifice and intramural ureter were completely mobilized intravesically, advanced transtrigonally and secured to the detrusor muscle at the apex of the trough with 3 deep interrupted sutures. The elevated mucosal flaps of the trough were suture approximated over the ureter to create a submucosal tunnel. All suturing was performed by freehand laparoscopic technique. RESULTS: Operative time was between 2.5 and 4.5 hours and blood loss was 10 to 50 cc. Adequate submucosal trough creation, ureteral extravesical mobilization and intravesical advancement, and bladder mucosal flap reapproximation were done to create a submucosal tunnel in all cases. Satisfactory transtrigonal anchoring of the neoureteral orifice to the detrusor muscle and mucosa was achieved with 3 stitches. Hospital stay was 2, 2 and 1 days in the 3 cases, and the Foley catheter remained in place for 3, 1 and 1 week, respectively. At 6 months reflux had resolved in 2 patients, while in 1 grade II reflux persisted, which was improved from grade IV preoperatively. All patients have remained infection-free without antibiotics. CONCLUSIONS: Laparoscopic transvesical cross-trigonal antireflux ureteral reimplantation is technically feasible. Intravesical laparoscopic suturing is possible. Potential advantages include a decreased hospital stay, decreased narcotic requirement and better cosmesis. Further experience is necessary to refine the technical nuances and evaluate outcomes compared to the open technique.

Adult↗
PubMed2005

[Evaluation of short-time resorption surgical sutures in tubal anastomoses with use of microsurgical techniques. An experimental study].

In the paper there have been evaluated synthetic absorbable surgical sutures--Coated VICRYL, of short time of their resorption in an organism. The valuation concened their usefulness to carrying out the operations of oviducts with use of microsurgical technique. It consisted in determination of biocompatibility degree of analyzed sutures within tubal tissues and also their technical utility to this kind of procedures. The valuation of the surgical sutures was performed on the ground of experimental studies with use of laboratory animals--New Zealand white female rabbits, in which "end-to-end" microsurgical tubal anastomoses were made, with use of analyzed sutures. In further stage, pathomorphological investigations of the animals were performed (in various time after the operation), during which there were conducted microscopic observations of histologic slides derived from tubal anastomoses regions. The purpose of the work was trying to appoint the most adequate suture material for carrying out the operations of oviducts with use of microsurgical technique. It was also an assistance for an operator to take a decission of choice of the proper surgical sutures for surgical treatment of female mechanical infertility and other kind of microsurgical operations which are performed in gynaecology. Generally good technical utility in microsurgical practice of surgical sutures Coated VICRYL--absorbable of short period of their resorption in tissues was stated. They cause the formation of only single peritoneal adhesions, mainly in the regions of tubal anastomoses previously made and produce relatively small tubal tissue reaction, which testifies to high biocompatibility of the sutures, as the implantation material. The analyzed surgical sutures characterize themselves of very good usefulness to microsurgical operations of oviducts.

Absorbable Implants↗
PubMed2005

[Evaluation of long-time resorption surgical sutures in tubal anastomoses with use of microsurgical techniques. An experimental study].

In the paper there have been evaluated synthetic absorbable surgical sutures--MAXON, of long time of their resorption in an organism. The valuation concerned their usefulness to carrying out the operations of oviducts with use of microsurgical technique. It consisted in determination of biocompatibility degree of analyzed sutures within tubal tissues and also their technical utility to this kind of procedures. The valuation of the surgical sutures was performed on the ground of experimental studies with use of laboratory animals--New Zealand white female rabbits, in which "end to end" microsurgical tubal anastomoses were made, with use of analyzed sutures. In further stage, pathomorphological investigations of the animals were performed (in various time after the operation), during which there were conducted microscopic observations of histologic slides derived from tubal anastomoses regions. The purpose of the work was trying to appoint the most adequate suture material for carrying out the operations of oviducts with use of microsurgical technique. It was also an assistance for an operator to take a decission of choice of the proper surgical sutures for surgical treatment of female mechanical infertility and other kind of microsurgical operations which are performed in gynaecology. Generally good technical utility in microsurgical practice of surgical sutures MAXON--absorbable of long period of their resorption in tissues was stated. They cause the formation of only single peritoneal adhesions, mainly in the regions of tubal anastomoses previously made and produce relatively small tubal tissue reaction, which testifies to high biocompatibility of the sutures, as the implantation material. The analyzed surgical sutures characterize themselves of very good usefulness to microsurgical operations of oviducts and they seem to be the most adventageous for performing this type of operations. They give a greater certainty of formation of durable accretion of tubal wall in the place of created anastomosis, with simultaneous complete elimination of the implantation material from the organism.

Absorbable Implants↗
PubMed1983

Evaluation of the patency rate of fibrous microvascular polyurethane prostheses after implantation in the rat aorta.

Two types of fibrous polyurethane prostheses with different compliances were implanted into the rat aorta with interrupted sutures and a running suture line. Excluding two technical failures, one unexplained death, and three infected prostheses, both groups (n = 21) showed a patency rate of 100%, up to 6 months after implantation. Rapid reendothelialisation occurred, and a stable neo-intima was formed. Compliance of the prostheses, as well as the suture technique used, has proven to be an unimportant factor in the rat aorta model, probably due to the low magnitude of the pulsations of the rat aorta. The experience of the surgeon with microsurgical techniques seems to be an underestimated factor in determining patency rates of microvascular prostheses.

Animals↗
PubMed2000

A novel approach to laryngeal suspension after partial laryngectomy.

OBJECTIVES: Supraglottic laryngectomy is a well-established surgical therapy for selected carcinomas of the larynx and hypopharynx. Most compromised by this procedure and its variations is the laryngeal mechanism that protects the lower respiratory tract from aspiration. Laryngeal suspension serves to compensate for the loss of the resected laryngeal elevator muscles by pulling the larynx upward and forward beneath the tongue base. In this study we describe a method of laryngeal suspension in supraglottic laryngectomy using a cartilage-anchored suture carrier device. STUDY DESIGN: Report of this novel approach to laryngeal suspension using seven suture anchors in two patients undergoing supraglottic laryngectomy. METHODS: Seven Mitek Micro anchors (Mitek, Westwood, MA) were used to perform laryngeal suspension in two patients undergoing supraglottic laryngectomy. Our technique is compared with traditional methods. Operative data as well as postoperative functional results are reviewed. RESULTS: Laryngeal suspension using suture anchors was successful, with failure of only one anchor. Oral alimentation was quickly reestablished in both patients. There were no perioperative or postoperative complications. CONCLUSIONS: We describe a novel approach to laryngeal suspension that overcomes some of the technical challenges inherent in traditional suturing techniques. This novel approach is technically easier and more efficient than traditional methods and accomplishes distribution of stress forces on the thyroid cartilage remnant.

Carcinoma, Squamous Cell↗
PubMed2004

Comparison of surgical procedures for vascular and airway anastomoses that utilize a modified non-suture external cuff technique for experimental lung transplantation in rats.

BACKGROUND: Lung transplantation in rats is technically difficult and results may vary. The non-suture cuff technique (non-suture [NS]), which involves using a cuff for anastomoses of vessels and airways, is commonly utilized to perform transplant procedures. However, the standard bronchial cuff may occlude the lumen, resulting in diminished graft survival. In contrast, the non-suture cuff technique for vascular anastomoses with bronchial suturing (bronchial suture [BS]), although more technically difficult, is known to have prolonged bronchial patency. We developed a "modified" NS technique that uses a larger and longer cuff for anastomoses and compared the efficacy of this procedure to the BS technique for lung transplantation. METHODS: The BS procedure was performed in 146 transplant procedures. The modified NS procedure, which uses a larger cuff than the standard NS procedure, was performed in 113 procedures. RESULTS: Although total ischemic times were comparable, the total operation time in the NS group was significantly shorter than in the BS group (p < 0.0001). Bronchial leakage occurred in 9.6% of BS group patients and 0% of NS group patients. Survival rates were comparable between groups. Although the BS technique is widely acknowledged to provide prolonged patency of bronchial anastomosis, graft survival in the NS group was observed up 17 months post-transplant. CONCLUSIONS: These data show that the NS technique, which is less technically difficult, results in shorter operative times compared with the BS procedure, and results in durable anastomoses of lung grafts.

Anastomosis, Surgical↗