PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “SUTURE TECHNICS”

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.

At least 1,189 records · Page 66Linked to original sources
PubMed1997

Laparoscopic adjustable silicone gastric banding (Lap-Band): how to avoid complications.

BACKGROUND: The laparoscopic application of LAP-BAND is gaining widespread acceptance as a gastric restrictive procedure. At the same time the reported morbidities (i.e., gastric perforation, stomach and/or band slippage) are cause for some concern. METHODS: From September 1993 until May 1997, 260 patients underwent LAP-BAND at the Department of Surgery at the University of Padova, Italy. RESULTS: The mortality rate was zero and the morbidity rate requiring reoperation was 3.4% (stomach slippage, gastric perforation, erosion). In order to avoid complications the key points of the technique are reviewed: (1) reference points for dissection (equator of the balloon, left crus); (2) retrogastric tunnel within the layers of the phrenogastric ligament; (3) embedment of the band; (4) proper outlet calibration; and (5) retention sutures. CONCLUSIONS: Attention to technical details is of paramount importance for a safe, standardized and effective operation.

Adolescent↗
PubMed1993

[Endoscopically controlled optimization of trans-scleral suture fixation of posterior chamber lenses in the ciliary sulcus].

Two technical difficulties have to be overcome in transscleral suture fixation of posterior chamber intraocular lenses (PCL) in the ciliary sulcus: first, exact needle penetration through the sulcus, and second, exact positioning of the PCL haptics in the sulcus. Incongruence of the two may lead to long-term complications by compression or even strangulation of ciliary processes. Intraocular endoscopy was used intraoperatively to visualize the site of needle penetration and the final location of the haptics in patients. It turned out that with our previously described standard techniques the precision was far less than anticipated. Thus, new technical ways had to be sought to improve the precision of positioning. In secondary implantation without perforating keratoplasty we achieved the best results when the needle was passed ab externo before opening the eye and before anterior vitrectomy, taking advantage of a precisely prepared sclerocorneal zone. Passing the needle ab externo in an already hypotonic eyeball gives much less precise results. In combination with perforating keratoplasty with an open-sky approach, needle penetration ab interno is reliable. Correct positioning of the PCL haptics is at least as difficult as correct needle penetration, a fact which up to now has mostly been ignored. In 33 consecutively operated eyes the technique of implantation and PCL design was varied under endoscopical control.(ABSTRACT TRUNCATED AT 250 WORDS)

Combined Modality Therapy↗
PubMed2003

A randomized comparison of a percutaneous suture device versus manual compression for femoral artery hemostasis after PTCA.

BACKGROUND: The prolonged bed rest following femoral sheath removal after PTCA is a source of discomfort for the patient. We designed a randomized study to evaluate the efficacy and safety of an arterial suture device developed to percutaneously close the vascular access site after PTCA, allowing immediate sheath removal and early ambulation, compared to manual compression. METHODS: After successful PTCA, patients were randomized to manual compression or immediate femoral percutaneous closure. Exclusion criteria were arteritis, age > 80 years and > 3 previous femoral punctures on the same side. The two-needle device was used for the 6F sheath removal and the four-needle device for the 8F sheath. Ambulation was allowed 4 hours after the arterial suture. RESULTS: One hundred and sixty-seven patients (59 +/- 10 years, 81% males) were randomized to suture device (n = 91) or to manual compression (n = 76). The two groups were similar in terms of age, sex, size of sheath, number of patients with stent implantation (62 vs 61%), procedural anticoagulation. Procedural duration was 8 +/- 6 minutes with percutaneous suture versus 25 +/- 11 minutes with manual compression (P < 0.0001). Procedural success with percutaneous suture was 93% whereas six technical failures were treated with prolonged manual compression. Nonsurgical hematoma occurred in five patients (5%) with the suture device and in two (3%) with manual compression with no need for blood transfusion (P = NS). Uneventful blood oozing occurred in 11 patients (12%) with percutaneous suture and in only 2 (3%) with manual compression (P < 0.06). The tolerance of the hemostasis procedure and the length of post-procedure hospital stay (40 +/- 32 hours) were similar in the two groups. CONCLUSION: Percutaneous suture of the femoral artery, allows immediate closure of femoral puncture sites after PTCA, without increasing the incidence of vascular complications. The use of this device should allow earlier discharge and subsequent cost savings.

Aged↗
PubMed1979

[Endoscopic control of esophago-gastric sutures after superior polar resection. Advantages of the Lortat-Jacob reconstruction technic].

The results of superior polar resection carried out for benign and malignant lesions of the lower 3rd of the oesophagus and cardias were controlled endoscopically. Cure time, elasticity, suture function and the onset of complications were assessed in relation to the technique employed. It is known that the most important late complications in this surgery are, apart from recurrences, cicatricial stenosis, perianastomotic granulomas and, particularly, serious oesophagitis secondary to reflux. It is concluded that Lortat-Jacob valvular anastomosis gives the best immediate and long-term results because of its good elasticity and anastomosis function; there are almost never any problems connected with the presence of reflux, which is so important and invalidating for patients operated on with other techniques.

Cardia↗
PubMed1997

Improved technique of heterotopic cervical heart transplantation in mice.

BACKGROUND: The method for mouse vascularized heart transplantation have been described using suture and cuff techniques. Technical problems have limited its widespread use. Here, we describe our method of modified cervical heterotopic transplantation with the cuff technique. METHODS: By using a smaller Teflon cuff (external diameter 0.6 mm, internal diameter 0.4 mm) and superfine-tip forceps, it became possible to directly pull the edge of the carotid artery and evert the proximal end of the artery over the cuff. Similarly, the external jugular vein could be easily everted over a 22-gauge cuff with this direct pulling method. RESULTS: By these modifications, the operation time was reduced. It usually takes 20 min for the donor harvest, 15 min for preparation of the cervical vessels, and 15 min for anastomosis. All procedures from the donor harvest through skin closure of the recipient mice can be completed within 1 hr, and ischemic time is within 25-40 min. CONCLUSIONS: This method can be used to investigate cyclophosphamide-induced tolerance and mechanisms of reperfusion injury.

Anastomosis, Surgical↗
PubMed1975

Routine intraoperative angiography. An essential adjunct in vascular surgery.

Intraoperative angiography was performed during a variety of 155 arterial reconstructive procedures including bypass, endarterectomy, embolectomy, thrombectomy, primary reconstruction, and angioplasty. In 27 or 17% of these cases, defects were identified that could be corrected. These included technical errors at the suture line, accumulation of platelet thrombus and atherosclerotic debris, or unrecognized lesions in the runoff. The likelihood of identifying such lesions is greatest in patients undergoing bypass surgery, particularly when the distal anastomosis involves one of the leg arteries. Routine use of intraoperative angiography as an adjunct to vascular surgery is justified and will help to obviate many early graft failures.

Aneurysm↗
PubMed1999

Laparoscopic surgery for genuine stress incontinence.

Laparoscopic Burch colposuspension has rapidly become one of the primary surgical treatment options for genuine stress incontinence. The procedure has been modified by some investigators because of technical difficulty with laparoscopic suturing, but should be identical to the conventional open Burch procedure. This article reviews the indications, operative technique, clinical results, complications and learning curve for laparoscopic retropubic surgical procedures.

Clinical Competence↗
PubMed1977

Surgical repair of gastroesophageal reflux with sliding hiatal hernia.

A controlled prospective study of forty-two patients shows it is feasible to correct gastroesophageal reflux complicating sliding hiatal hernia by modifying Allison's repair, using the technic of vertical mattress sutures and Dacron pledgets to approximate the crura and reattach the esophagus to the narrowed hiatus. There was no operative mortality and minimal morbidity. The follow-up period ranges from six to eighty-two months (mean, 38.5 months). One recurrence was noted clinically and verified by esophagogram, esophagoscopy, and motility studies. The remainder have no symptoms of gastroesophageal reflux, and no recurrence has been seen on repeat esophagograms.

Adult↗
PubMed2006

da Vinci-assisted robotic partial nephrectomy: technique and results at a mean of 15 months of follow-up.

OBJECTIVE: Laparoscopic partial nephrectomy is gaining acceptance as an alternative to open surgery for small renal tumours, although technical difficulty of intracorporeal suturing and concerns over warm ischemia time are limitations. Previous work has demonstrated that suturing with the robotic system is easier compared with laparoscopy. We believe the robot has an application and we report our initial experience in 10 patients undergoing robotic partial nephrectomy. METHODS: Ten patients with small exophytic renal masses underwent intraperitoneal robotic partial nephrectomy. Principles of traditional open surgery were followed and intraoperative ultrasound was used to define resection margins. The renal artery was clamped with laparoscopic bulldog clamps and indigo carmine was administered intravenously to detect entry into collecting system. Suture closure and FLOSEAL were used for hemostasis. Frozen sections were obtained in all patients. RESULTS: Seven men and three women, mean age 59 yr, underwent robotic partial nephrectomy. Mean tumour size was 2 cm. Mean console and warm ischemia time were 158 min and 21 min, respectively. The median hospital stay was 1.5 d. Pathology revealed renal cell carcinoma in eight, oncocytoma in one, and lipoma in one. All resection margins were negative. Follow-up ranged from 6 to 28 mo. CONCLUSIONS: Robotic partial nephrectomy is a viable alternative to open or laparoscopic partial nephrectomy in carefully selected patients with small renal tumours. The advantages of the robotic system must be weighed against its cost. Further studies will determine if reduction in procedure complexity warrants the expense of such technology.

Adult↗
PubMed1984

Evaluation of the use of the argon laser in repairing rat and primate nerves.

The argon laser coagulates blood selectively, making it an adherent material. Argon laser energy is almost completely absorbed by red blood cells and does not seem to affect white nerve tissue. To demonstrate the technical feasibility of laser repair for severed nerves, we cut the sciatic nerves of rats and the median nerves of nonhuman primates and then repaired them by use of an argon laser beam delivered through a 400 microns optical fiber and handpiece that was developed in our laboratory. Autogenous blood was spread around the group of fascicles at the repair site and was then coagulated with the laser to form a minitubule around each fascicle group. Transmission and scanning electron microscopy showed that the repairs appeared technically superior to control sutured nerves and that the laser apparently had no untoward effects on either the repair site or on the control nerve. The minitubules seemed to channel the axon sprouts into the distal tubules extremely well and to prevent ingrowth of scar tissue at the juncture site.

Animals↗
PubMed2001

An all-arthroscopic soft-tissue balancing technique for lateral patellar instability.

Patellar realignment procedures for lateral patellar instability often involve open approaches to imbricate the medial soft tissues. We present a technique to balance the soft tissues to correct lateral patellar instability that is performed entirely arthroscopically. A retinacular release is performed laterally and the soft tissues are imbricated medially using arthroscopic suture passing and knot tying techniques.

Arthroscopy↗
PubMed2001

Arthroscopic reconstruction for acromioclavicular joint dislocation.

We describe an arthroscopic reconstruction technique for acromioclavicular joint dislocation. Subsequent to Baum's first repair of the coracoclavicular complex in 1886, over 60 operative procedures have been described in the literature. This procedure is the first described arthroscopic approach used in reconstruction for acromioclavicular dislocation. It provides an anatomically correct and structurally sound reconstruction of the coracoclavicular ligament complex. This arthroscopic technique is also a cosmetically pleasing alternative to previously described open procedures for reconstruction of acromioclavicular joint dislocations. As with most arthroscopic procedures, this technique achieves its goals with minimal morbidity and violation of the surrounding soft tissues.

Acromioclavicular Joint↗
PubMed2002

Newly devised anterior portal technique for arthroscopic bankart repair using suture anchors.

Many techniques and instrument systems have been developed for performing arthroscopic Bankart repair using a suture anchor. The suture anchor procedure relies on a secure knot, which does not become entangled in the anterior portal. A newly devised anterior portal technique can solve this problem. We have used this technique for arthroscopic Bankart repair using suture anchor. This technique may be useful for any type of suture materials such as SLAP lesion.

Arthroscopy↗
PubMed1994

Laparoscopic Repair of Perforated Peptic Ulcer.

The recent introduction of laparoscopy into the armamentarium of the general surgeon has revolutionized many aspects of surgical practice. The repair of perforated peptic ulceration is ideally suited to a laparoscopic approach. An accurate diagnosis is obtained, and closure of the perforation with thorough peritoneal toilet safely can be undertaken. The main advantages include the avoidance of a major incision and the reduction of postoperative pain. This may benefit the patient with associated respiratory disease in particular. Although mobilization may be improved, early discharge from the hospital is unlikely because the patient must recover from the peritonitis and associated ileus. The main drawback is a longer operating time caused by technical difficulty with laparoscopic suturing. Many innovative techniques have been described to simplify the procedure. The reported experience with laparoscopic repair of perforated peptic ulcers is encouraging, and randomized trials comparing it with open surgery are eagerly awaited.

Journal Article↗
PubMed2005

How safe are laparoscopic intracorporeal anastomoses?

BACKGROUND: A recent German Multicenter Study comprising 3 070 laparoscopic colorectal resections indicates that complete intracorporeal anastomoses are performed in only 1.8 % cases. The aim of our study was to review and analyse the safety of complete intracorpeal anastomosis. METHODS: In a literature survey we searched for complete intracorporeal anastomosis with different key words. RESULTS: In agreement with the literature, technically demanding hand-sutured anastomoses are no common practice. Intracorporeal anastomosis is usually done using endoscopic linear stapling devices or a conventional circular stapler by performing end-to-end, end-to-side, and side-to-side anastomoses. These techniques are more frequently used in the upper than in the lower gastrointestinal tract. CONCLUSIONS: The data published so far, however, indicates that completely intracorporeal performed anastomoses are safe in the hands of laparoscopically experienced surgeons. This technique implies very low percentages of postoperative stenoses (0-10 %) and, furthermore, very low percentages of postoperative anastomotic leakages (0-8 %).

Anastomosis, Surgical↗
PubMed1993

[Tarsal flap technique. A technically simple procedure for correction of lower lid flaccidity, senile ectropion and ptosis of the lateral canthus].

Lower lid flaccidity, senile extropion and canthal malposition are the principal indications for the tarsal flap technique. This is a technically simple procedure avoiding sutures on the border of the lashes and avoiding the disadvantages of the technique of Kuhnt - Szymanowski, which cause a shortening of palpebral length due to tarsal resection.

Aged↗
PubMed1980

[Possibilities of microsurgery on ophthalmic vessels (author's transl)].

Ciliary arteries, isolated from the eyes of human cadavers, were incised or severed under the microscope in order to test the technical possibilities of placing sutures or creating leak-proof anastomoses in ophthalmic vessels. Commercially available, minute atraumatic needles and 10-0 "Ethilon" or 15-0 Supramid suture material was used. The experiments were successful.

Ciliary Body↗