Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 6 de 6
Filtrar
1.
Chirurg ; 68(5): 531-5, 1997 May.
Artículo en Alemán | MEDLINE | ID: mdl-9303845

RESUMEN

Translaryngeal tracheostomy is a new type of minimally invasive technique for bedside tracheostomy in intensive care patients. After percutaneous puncture of the trachea below the first tracheal ring, a conic tracheal cannula is fixed to an orally forwarded guide wire. The cannula is then pulled through in orthograde fashion set up, rotated and pushed forward caudally. Among the first 25 translaryngeal tracheostomies in 24 patients, only two complications appeared: one misplacement of the cannula and one infection of the stoma. During a median apnoea time of about 80 s an average PaCO2 increase of 8.0 +/- 6.8 mm Hg was documented; hypoxias could not be seen. Translaryngeal tracheostomy seems to be an appropriate alternative to established tracheostomy methods.


Asunto(s)
Laringoscopios , Traqueostomía/instrumentación , Anciano , Cuidados Críticos , Diseño de Equipo , Femenino , Humanos , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos/instrumentación , Oximetría , Complicaciones Posoperatorias/etiología
2.
Aktuelle Traumatol ; 22(3): 102-3, 1992 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-1353288

RESUMEN

Embolism of hepatic tissue to the lung in coincidence with severe injury to the liver is a rare complication. We report on a case of a 22-year old motor-cyclist who was involved in a traffic accident and incured a blunt abdominal trauma. The autopsy revealed a crushed right hepatic lobe. Careful microscopically investigations of the lungs showed multiple small emboli composed primarily of hepatic tissue in pulmonary arterial branches.


Asunto(s)
Hígado , Traumatismo Múltiple/cirugía , Complicaciones Posoperatorias/patología , Embolia Pulmonar/patología , Adulto , Hepatectomía , Humanos , Hígado/lesiones , Masculino , Traumatismo Múltiple/patología , Arteria Pulmonar/patología
3.
Gastrointest Endosc ; 44(3): 262-7, 1996 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-8885344

RESUMEN

BACKGROUND: Restricted depth perception in laparoscopy with two-dimensional imaging has been reported to be a major disadvantage of minimally invasive procedures. Three-dimensional imaging units have been available for almost 2 years and are slowly being integrated into endoscopic surgery. So far, potential advantages or disadvantages have not yet been studied prospectively. METHODS: We evaluated the effects of three-dimensional imaging on surgical performance and its influence on surgeons at different experience levels in a prospective randomized trial. Twenty participants without laparoscopic experience (novices), 20 with less than 50 laparoscopic procedures (beginners), and 20 with more than 50 laparoscopic procedures (advanced surgeons) took part in two different tests (tube test and loop test) on a pelvitrainer. In random order, each test was conducted using a three-dimensional imaging unit under two-dimensional and three-dimensional conditions. During each test, the time was measured and the mistakes counted. The difference of time and number of mistakes for two-dimensional and three-dimensional conditions were calculated for each participant. RESULTS: Speed (p < 0.0001) and accuracy (p < 0.0001) were significantly better under three-dimensional conditions irrespective of the randomized sequence of each individual test. Speed was also influenced by individual experience (p > 0.02). Performance time decreased by 24.4% +/- 2.8% (m +/- SD), and the number of mistakes decreased by 52.5% +/- 27.9% (m +/- SD), as compared with the two-dimensional mode, with no significant influence of individual experience. CONCLUSIONS: Three-dimensional imaging significantly improves performance (speed and accuracy) regardless of previous laparoscopic experience. Thus, three-dimensional imaging may further improve the safety aspect of minimally invasive surgery.


Asunto(s)
Diagnóstico por Imagen/métodos , Laparoscopía/métodos , Análisis de Varianza , Competencia Clínica , Humanos , Laparoscopía/normas , Estudios Prospectivos
4.
Cardiovasc Intervent Radiol ; 22(6): 528-30, 1999.
Artículo en Inglés | MEDLINE | ID: mdl-10556418

RESUMEN

CT fluoroscopy (CTF) facilitates guidance of percutaneous biopsies and other interventional procedures. We wished to demonstrate the usefulness of CTF for the puncture of an unenhanced isodense liver lesion during continuous injection of intravenous contrast medium. We performed CTF-guided puncture of a 2-cm lesion in the liver of a patient suffering from lung cancer. CTF enables puncture of liver foci even if they are unenhanced and isodense with the surrounding parenchyma.


Asunto(s)
Hígado/patología , Punciones , Tomografía Computarizada por Rayos X , Medios de Contraste/administración & dosificación , Fluoroscopía , Humanos , Inyecciones Intravenosas , Hígado/diagnóstico por imagen , Persona de Mediana Edad
5.
World J Surg ; 25(6): 728-34, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11376407

RESUMEN

Posterior retroperitoneoscopic adrenalectomy is one of the new endoscopic methods in endocrine surgery. In a prospective clinical study 142 posterior retroperitoneoscopic adrenalectomies (72 right, 70 left) were performed in 130 patients (52 males, 78 females, age 49.1 +/- 14.9 years). Indications were primary adrenal tumors (unilateral, n = 118; bilateral, n = 2), adrenal metastases (n = 2), and bilateral ACTH-dependent hyperplasias (n = 10). Tumor size ranged from 0.5 to 7.0 cm (mean 2.7 +/- 1.4 cm). Partial adrenalectomies were performed in 39 patients. Conversion to open posterior adrenalectomy was necessary in five patients and seven procedures (5%). Intraoperative and postoperative complications were minor and occurred in 5% and 13%, respectively. Mortality was zero. Operating time was 101 +/- 39 minutes (range 35-285 minutes) and depended on tumor type (pheochromocytoma versus others; p < 0.01), tumor size (< 3 vs. > or = 3 cm; p < 0.05), gender (p < 0.05), and extent of resection (partial versus complete, p < 0.05. Twenty-three adrenalectomies (17%) were performed within 1 hour or less. Blood loss was 54 +/- 72 ml. Consumption of analgesics was low (mean 6 mg piritramide postoperatively). Median duration of hospitalization was 3 days. Posterior retroperitoneoscopic adrenalectomy is a safe method that has become a standard procedure in endocrine surgery.


Asunto(s)
Adenoma/cirugía , Neoplasias de las Glándulas Suprarrenales/cirugía , Adrenalectomía/métodos , Laparoscopía , Feocromocitoma/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad
6.
Surg Endosc ; 13(7): 728-9; author reply 30-1, 1999 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-10384087
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA