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At least 145 records · Page 8Linked to original sources

PubMed1993

Bacterial endophthalmitis following sutureless cataract surgery.

We examined a patient who developed group G streptococcal endophthalmitis following phacoemulsification with intraocular lens implantation and sutureless wound closure. Pathologic examination of the enucleated globe 1 month after surgery revealed an intense suppurative reaction centered in the anterior chamber and an open surgical wound filled with fibrinopurulent granulation tissue. Inadequate draping, a high number of instruments passing into and out of the eye during surgery, and wound testing for water tightness with viscoelastic substance in the eye were observed on a videotape of the surgery.

Aged↗

PubMed1996

Sutureless pars plana vitrectomy through self-sealing sclerotomies.

A new technique of creating self-sealing pars plana sclerotomies is described. In a series of 50 consecutive vitrectomies, no complication was encountered related to this new technique. All of the 47 primary vitrectomy procedures performed had self-sealing sclerotomies that did not require suturing at the end of surgery. This type of wound construction allows for sutureless closure of sclerotomies with better control of intraoperative ocular pressure.

Eye Diseases↗

PubMed1991

Sutureless vascular anastomosis with biocompatible heat-shrink tubing.

We have tested a new method of vascular repair using biocompatible, low-temperature, heat-shrinkable tubing on canine carotid arteries. All of 16 canine carotid arteries were patent immediately after the anastomosis. None of the anastomoses leaked after the clamps were released. Average time from severing the vessel to releasing the clamps was 12 minutes. At 2 weeks, nine of 12 vessels were patent; the three failures were attributed to infection of a seroma that occurred in all of the dogs' necks. Histologic evaluation of the uninfected cases showed no inflammatory exudate around the prosthesis. Macroscopic and electron microscopic examination confirmed healing of the endothelium across the anastomoses. Sutureless vascular anastomosis with biocompatible heat-shrink tubing is a potential new modality for the acute repair of severed vessels.

Anastomosis, Surgical↗

PubMed1978

Proximal hepatic duct reconstruction. Repair using sutureless mucosal graft hepaticojejunostomy.

Six patients who had hepatic duct lesions, five who had strictures, and one who had a right hepatic duct transection underwent repair by sutureless mucosal graft hepaticojejunostomy. All patients had initial improvement, and five have maintained excellent biliary-intestinal continuity after an average 25-month follow-up. In one patient, recurrent symptoms developed and she died of cholangiocarcinoma. This technique is simple and fulfills the criteria for successful high hepatic duct reconstruction. The promising early results in these patients suggest that this procedure may provide a superior approach to this difficult problem.

Biliary Tract Diseases↗

PubMed2006

Fragmentation hemolytic anemia 8 years after replacement of ascending aorta with a sutureless intraluminal graft.

A 56-year-old man underwent replacement of the ascending aorta with a sutureless intraluminal graft, for a Stanford type A aortic dissection. Eight years after the operation, he developed gross hemoglobinuria, associated with an intravascular hemolytic anemia. Due to numerous schistocytes in the peripheral blood, the hemolysis was attributed to mechanical injury of the red blood cells at the site of the vascular graft. The patient's course was complicated by an infection of the aortic graft, which led to an urgent graft replacement. The hemolytic anemia resolved completely shortly after the reoperation. Physicians should consider this etiology in the differential diagnosis of fragmentation hemolytic anemia.

Aorta, Thoracic↗

PubMed1980

A controlled trial to evaluate and compare a sutureless skin closure technique (Op-Site skin closure) with conventional skin suturing and clipping in abdominal surgery.

Sutureless wound closure employing a new product, Op-Site Skin Closure, was evaluated in comparison with two standard techniques of skin closure, using interrupted nylon sutures and Michel clips. The trial involved 110 patients undergoing elective and emergency abdominal surgery. The results showed that Op-Site Skin Closure was as good as the conventional techniques of skin closure with the advantages that it is easier and quicker to apply, produces a superior cosmetic result and, consequently, has gained excellent patient and nurse acceptance.

Abdomen↗

PubMed1989

Sutureless large bowel anastomosis: European experience with the biofragmentable anastomosis ring.

Sutureless colonic anastomosis using a biofragmentable anastomosis ring (BAR) has been evaluated in a prospective randomized comparison with sutures and staples for elective colorectal surgery. One hundred and one patients underwent BAR anastomosis, 85 a sutured anastomosis, and 16 a stapled anastomosis. There were two anastomotic leaks in the patients undergoing BAR anastomosis, seven in patients having a sutured anastomosis, and one in a patient who had a stapled anastomosis. Wound infection occurred in ten BAR patients, ten sutured patients and no stapled patient. There was no statistically significant difference in these or in other postoperative complications between the groups. The BAR was easy to use and is a safe alternative to sutures and staples for large bowel anastomosis.

Adolescent↗

PubMed1991

Sutureless intestinal anastomoses.

Sutureless intestinal anastomoses can be achieved either by compression, where two inverted rings of bowel are compressed by a hollow circular device that subsequently sloughs away and is passed anally, or by the use of tissue glues or laser welding. Compression devices used clinically with success are the Valtrac biofragmentable anastomotic ring, the polypropylene rings described by Rosati and the AKA guns. Glued anastomoses have only been used in animals and seem to be unsafe. However, laser-welded intestinal anastomoses appear highly promising in experimental studies and further development of this technique is warranted.

Adhesives↗

PubMed2004

Early ostial saphenous vein graft stenosis associated with the use of Symmetry sutureless aortic proximal anastomosis device: successful percutaneous revascularization.

A recent advance in technology permits the creation of sutureless proximal aortic anastomosis during coronary artery bypass graft surgery. This new tool has significant potential benefit by minimizing aortic manipulation with subsequent reduction in neuroembolization. Implantation of a nitinol-based proximal aortic connector (Symmetry) has a potential to elicit intimal hyperplastic reaction analogous to restenosis after coronary stent placement. We report cases of early vein graft stenosis in association with the use of the Symmetry device. Three patients suffered from severe ostial stenosis within 6 months of bypass surgery with symptomatic presentation. Of these three patients, two underwent successful percutaneous revascularization. Fluoroscopic star-shaped appearance of the metallic Symmetry allows device recognition during angiography. We review current data regarding graft patency with the use of Symmetry device and discuss technical issues to address specific problems during percutaneous revascularization.

Anastomosis, Surgical↗

PubMed1989

The first sutureless, laser-welded, end-to-end bowel anastomosis.

The use of laser energy to weld together tissue offers great promise in the expanding field of laser surgery. The published results of laser welding intestinal tissue have, to date, been limited to the successful laser closures of small enterotomies. This is the first report of using laser energy alone to create an end-to-end small bowel anastomosis. A biocompatible, water-soluble, intraluminal stent was employed during the laser welding of this sutureless, stapleless ileal anastomosis in a rabbit model. Excellent recovery and healing were observed. The rapidity, ease, and potential for full precision automation of laser welding mandates further research.

Anastomosis, Surgical↗

PubMed1990

Sutureless end-to-end bowel anastomosis using Nd:YAG and water-soluble intraluminal stent.

Sutureless end-to-end intestinal anastomoses were successfully constructed in 20 rabbits. A water-soluble intraluminal stent was used to approximate the tissue edges, and the anastomotic seam was lased with 1.06 microns neodymium:YAG (Nd:YAG) laser energy supplied through a hand-held 600-microns gas-cooled noncontact optical fiber. A continuous 5-watt wave of power was applied over periods ranging from 46 to 92 seconds to produce the tissue blanching and shrinkage that indicated a satisfactory tissue weld. Integrity, degree of tissue reaction, and bursting pressures of the anastomoses were compared to those of anastomoses constructed using standard sutured techniques. The results of the two methods were equivalent at 1 to 3 days, but the laser-fused enteric anastomoses showed less inflammatory reaction and greater bursting pressures at 7 and 14 days. Application of a variety of proteinaceous solutions including extracellular matrix materials and epidermal growth factors prior to lasing failed to augment wound healing. We conclude that lasers show promise as reconstructive, in addition to ablative, surgical instruments.

Anastomosis, Surgical↗

PubMedDate not supplied

The utilization of a biological adhesive for wound treatment: comparison of suture, self-sealing sutureless and cyanoacrylate closure in the tensile strength test.

UNLABELLED: We produced a measurement apparatus for testing the tensile strength of wounds during cataract surgery, and tested the tensile strength of treated wounds including wounds sutured with various methods, non-sutured and wounds treated with various bio-tissue adhesives. METHODS: In cataract surgery on white rabbits eyes, a corneoscleral incision 5 mm in length was made 2.5 mm from the limbus corneae, and entry into the anterior chamber was obtained 0.5 mm to the clear cornea. After treatment for closure, the corneoscleral piece was subjected to the tensile strength test. RESULTS: The tensile strengths just after surgery were (1) 0 gf/mm2 after self-sealing sutureless closure; (2) 114 gf/mm2 after vertical suture closure (one stitch with 10-0 nylon); (3) 125 gf/mm2 after horizontal suture closure (one stitch with 10-0 nylon); (4) 143 gf/mm2 after infinity suture closure (with 10-0 nylon); (5) 112 gf/mm2 after fibrin glue (Beriplast P) application (instilled on the surface of scleral incision); (6) 121 gf/mm2 after fibrin glue application (glued on corneoscleral wound); (7) 131 gf/mm2 after cyanoacrylate closure (instilled on the surface of scleral incision); (8) 139 gf/mm2 after cyanoacrylate closure (glued on corneoscleral wound). The respective strengths at four days after surgery were: (1) 86; (2) 131; (3) 137; (4) 175; (5) 109; (6) 43; (7) 138; and (8) 108 gf/mm2. At 28 days after surgery, the respective strengths were (1) 164; (2) 167; (3) 184; (4) 209; (5) 322; (6) 195; (7) 251; and (8) 175 gf/mm2. CONCLUSION: The use of fibrin glue in treatment of a wound in cataract surgery is beneficial in assisting this treatment.

Animals↗

PubMed1992

First experimental sutureless end-to-end laser anastomosis of the large bowel. Short-term results.

Completely sutureless end-to-end large bowel anastomoses were successfully created in New Zealand white rabbits (n = 26) by using a low-energy (0.4-W wave of power) Nd:YAG laser to produce welded anastomoses. In this study, the short-term integrity, degree of narrowing, macroscopic appearance, and microscopic findings were compared with those of the conventional interrupted one-layer anastomosis (n = 24) at zero, one, four, and seven days after surgery. Two rabbits in the laser group died from leakage. All remaining animals had an uneventful postoperative course. The bursting pressures in the laser group at zero, one, and four days were lower than those in the control group. The narrowing index of the laser anastomosis was higher than that of the suture anastomosis at four and seven days. However, the laser anastomoses showed fewer adhesions, no instances of bowel obstruction, and histologic healing with less fibrosis. The technique of laser anastomosis presents a promising alternative to suturing in reconstitution of the large bowel.

Anastomosis, Surgical↗

PubMed1990

Anastomotic compression button: a new mechanical device for sutureless bowel anastomosis.

The anastomotic compression button is a new mechanical device that uses three interlocking polypropylene buttons to produce a sutureless bowel anastomosis. The device is unique in that it allows application of the buttons via a device similar to the popular intraluminal stapler, but it leaves no staples or foreign body of any kind in the bowel wall. The authors compared the 25-mm anastomotic compression button with the 25-mm intraluminal stapler in the colon of dogs. After 28 days, the mucosal blood flow, burst pressure, and anastomotic indices were found to be identical between the anastomotic compression button and the stapler. The anastomotic compression button was easier to use, and microscopic examination showed less ulceration, fibrosis, and inflammation, and better re-epithelialization at the anastomotic compression button site. The anastomotic compression button appears to have the potential to be a superior method compared with stapled anastomoses in the colon.

Anastomosis, Surgical↗

PubMed1987

Initial clinical experience with a biofragmentable ring for sutureless bowel anastomosis.

Twenty-seven patients have had bowel anastomoses with a biofragmentable ring for sutureless bowel anastomosis. There were no complications associated with the anastomotic technique. One patient developed an ischemic stricture on the proximal side of the anastomosis due to compromised circulation. There was no leakage. Technical factors regarding the BAR anastomosis are described. A properly placed purse-string suture is of primary importance. Advantages appear to be a more rapid and easy anastomosis with better healing.

Aged↗

PubMed1998

Sutureless "button and hole" splenopexy.

A new technique for fixation of a mobile spleen is described. It offers the advantages of a minimally risky procedure that very effectively keeps a mobile spleen in its bed without foreign materials and is feasible even when the gastrosplenic ligament is absent and the splenic vessels are uncovered. Our "button and hole" sutureless splenopexy was performed in six patients from 1979 to 1995. Three had a gastric volvulus (GV) and an extremely mobile spleen; one of these also had a diaphragmatic eventration. Another three had torsion of the spleen; in one it occurred 9 months after repair of a diaphragmatic hernia. We achieved good results with splenopexy as the sole operation in two cases where a wandering spleen produced a GV.

Child↗

PubMed2006

Postoperative retinal break after 25-gauge transconjunctival sutureless vitrectomy: report of four cases.

BACKGROUND: A 25-gauge transconjunctival sutureless vitrectomy (TSV) has been reported effective. However, complications such as postoperative retinal detachment have been reported. In this study, we report four cases of retinal breaks found after 25-gauge TSV. In this study, we investigated factors contributing to occurrence of postoperative complications. METHODS: Seventy-five patients (75 eyes) underwent 25-gauge TSV surgery at Kanazawa University hospital between April 2004 and September 2005. Postoperative follow-up monitoring was done for at least 3 months. The surgical charts were reviewed. RESULTS: Retinal breaks not accompanied by retinal detachment were noted postoperatively in four patients. All four of these patients had preoperative idiopathic macular holes. In all cases, there was no vitreous traction around the retinal break and photo coagulation was performed. One eye with age-related macular degeneration developed intraoperative rhegmatogenous retinal detachment. No other complications were observed during the intraoperative and postoperative periods. CONCLUSION: Upon performing 25-gauge TSV for macular hole repair, care should be taken to detect retinal breaks and retinal detachment intraoperatively and postoperatively.

Conjunctiva↗

PubMed2000

Octyl 2-cyanoacrylate in sutureless surgery of extraocular muscles: an experimental study in the rabbit model.

BACKGROUND: Sutureless surgery for strabismus eliminates the risk of perforating the ocular bulb in patients with extremely thin sclerae. Thus far, however, the results obtained with tissue adhesives such as the cyanoacrylates instead of sutures have been less than satisfactory. METHODS: A new adhesive, octyl 2-cyanoacrylate, was tested in 36 rabbit eyes in which the superior rectus was recessed 5 mm. In 36 other eyes the same operation was performed using 5/0 Vicryl sutures. Animals were killed 1, 3, 5, 15, 30 and 45 days after surgery. One eye from each animal was used for histopathological examination of the reinserted muscle and sclera, while the other was used in a tensiometric test to measure how many grams of weight were needed to detach the muscle from its new insertion site. RESULTS: The tensile strength of the bond achieved with the cyanoacrylate adhesive was 94+/-12 g 1 day after surgery (vs 238+/-19 g in the suture group) and 520+/-24 g after 45 days (vs 576+/-27 g with sutures). No cases of slippage, muscle detachment, or local tissue reactions were observed in either group. There were no differences in histological findings between the eyes of the two groups. CONCLUSIONS: Although further study will be necessary before this technique can be used in humans, our findings indicate that octyl 2-cyanoacrylate is superior to the cyanoacrylate adhesives used in the past in terms of adhesion and holding power; given its favorable toxicity profile, this product may offer interesting applications in the future.

Animals↗