Sineprapia, curiosa aportación técnica, del catedrático Sagarra Lascurain 1848-1924) para seccionar los tejidos / Sineprapia, curious technical contribution, of the surgical professor Sagarra Lascurain (1848-1924) to section the injuries

Muchas técnicas se han propuesto con el fin de optimizar la ejecución y desarrollo de los procedimientos en cirugía. Algunas sehan mantenido a lo largo del tiempo y otras han dejado de utilizarse por muy variados motivos. La sinemaprapía fue un procedimiento que, aunque si bien tuvo antecedentes de empleo por algunos autores de forma ocasional, fue el Catedrático de AnatomíaQuirúrgica, Operaciones, Apósitos y Vendajes Vicente Sagarra Lascurain el que la promociono a finales del siglo XIX y principiosdel XX. Quiso destacar en ella su sencillez de uso, eficacia en la diéresis y sobre todo la menor hemorragia que se producía en laherida quirúrgica en su aplicación, que la hacía muy adecuada su empleo en tejidos y órganos muy vascularizados, como eran lasamputaciones de pene y lengua. La técnica se empleo de una forma no muy extendida y con el paso del tiempo quedó olvidada. Eltrabajo trata de recordar desde el punto de vista histórico esta técnica, su empleo, las indicaciones de uso y referencia a sus resultados, profusamente publicados por su promotor. (AU)

Many techniques have been proposed in order to optimize the performance and development of surgical procedures. Some have beenmaintained over time and others have been discontinued for a variety of reasons. Sinemaprasía was a procedure, which althoughit had a history of employment by some authors occasionally, it was the Professor of Surgical Anatomy, Operations, Dressings andBandages, Vicente Sagarra Lascurain who promoted it at the end of the 19th and early 20th centuries. He wanted to highlight in itits simplicity of use, effectiveness in the umlaut and above all the less bleeding that occurred in the surgical wound in its application,which made it very suitable for use in highly vascular tissues and organs, such as penile amputations. and tongue. The techniquewas used in a not very widespread way and with the passage of time it was forgotten. The work tries to remember from the historicalpoint of view this technique, its use, the indications for use and reference to its results, widely published by its promoter. (AU)

Mathieu Jaboulay (1860-1913) and His Innovations in Vascular and General Surgery.

Mathieu Jaboulay (1860-1913) was an inventor in vascular and general surgery. He fabricated many new surgical techniques and instruments such as Jaboulay method for vascular sutures, Jaboulay anastomotic button, and Jaboulay amputation, known also as hemipelvectomy. In addition, he was a pioneer in heterologous transplantation and sympathectomy. He found death suddenly in a terrible train crash. He was a reputable Professor of Surgery at Lyon Faculty of Medicine with prestigious students in vascular surgery.

Pure tissue repairs: a timely and critical revival.

"The majority of hernias can be satisfactorily repaired by using the tissues at hand. The use of mesh prosthesis should be restricted to those few hernias in which tension or lack of good fascial structures prevents a secure primary repair. This group includes large direct inguinal hernias and incisional hernias in which the defect is too large to close primarily without undue tension. Most recurrent hernias, because of this factor are best repaired with mesh prosthesis". These words, penned in 1960 by Francis Usher have reconfirmed what had been a mantra of the Shouldice Hospital (Usher in 81:847-854, 1960). The Shouldice Hospital has specialized in the treatment of abdominal wall hernias since 1945. It has, since its beginning, insisted on the fact that a thorough knowledge of anatomy coupled with large volumes of surgical cases would lead to unparalleled expertise. It was Cicero who taught us that "Practice, not intelligence or dexterity, will win the day"! Since the seminal contribution of Bassini (1844-1924), there have been no less than 80 procedures imitating his inguinal herniorrhaphy and much more since the introduction of mesh and mesh devices (Iason in Hernia. The Blakiston Company, Philadelphia, pp 475-604, 1940). All have failed to some extent and it appears that the common denominator for these failures was the inability to understand the importance of entering the preperitoneal space. Only Shouldice and McVay (Lotheissen, Narath) realized the shortcoming and have continued to thrive as a successful procedure. Entering the preperitoneal space eliminates any temptation to plicate the posterior inguinal wall, a layer normally deficient in direct inguinal hernias, but it also allows the identification of muscle layers rectus, transversus and internal oblique muscles which will go to reconstruct the posterior inguinal wall, without tension as reported by Schumpelick (Junge in 7(1):17-20, 2003).

One of the Earliest Accounts of Head Wounds in Firdaws al-Hikma by al-Tabari from the 9th Century.

OBJECTIVE: To present the first Arabic text on suturing scalp wounds. METHODS: A related section entitled "On the wounds in the head" from the book Firdaws al-Hikma (Paradise of the Wisdom) written by al-Tabari in the 9th century was identified and analyzed. This work was one of the earliest medical compendiums in the Islamic world during the medieval period. A printed copy of Firdaws al-Hikma edited by Muhammad Zubayr al-Siddiqi was examined, and findings were compared with relevant knowledge in the literature. RESULTS: A notable part of this text is based on appropriate closure of scalp wounds using sutures. Before this work, only the well-known Indian medical book Susruta-Samhita had mentioned closure of scalp wounds using sutures. In his work, al-Tabari recommended using materials made of silk or linen for suturing. He additionally proposed some recipes that have a coating feature that prevents bleeding from the wound after it was closed properly. He also dealt with persistent swelling and provided formulas for solving the problem with special compositions. CONCLUSIONS: Firdaws al-Hikma is a noteworthy work in the history of medicine, and it includes a unique chapter on head wounds. To the best of our knowledge, this is the first mention of suturing scalp cuts in Arabic literature and the second reference in medical literature after the Indian work Susruta-Samhita.

Suture of a stab wound of the heart.

Over many centuries, from the early writings of Galen, 'the father of Medicine', wounds of the heart were considered fatal and outside the remit of surgery. With the advent of anaesthesia, (ether was introduced by William Morton in 1846) and of antiseptic surgery, (Joseph Lister's first publication was in 1867), there was an explosion in the surgery of the abdominal cavity, the chest, the skull and the limbs, yet the heart was considered by the surgical fraternity to be the 'no-go' area of the body. Theodor Billroth, Professor of Surgery in Vienna and himself a pioneer of modern surgery, (he performed the first successful partial gastrectomy for carcinoma of the stomach in 1881), wrote "the surgeon who would attempt to suture a wound of the heart should lose the respect of his colleagues". In London, Stephen Paget, in 1896, wrote: "No new method and no new discovery can overcome the natural difficulties that attend a wound of the heart. It is true that suture has been vaguely proposed as a possible procedure and has been done in animals but I cannot find that it has ever been attempted in practice". (In fact, the heart is an amazingly tough and efficient pump that goes on working, year after year, without ever stopping for a service!).

Instrumento de grapado quirúrgico vascular para realizar una sutura mecánica entre un vaso sanguíneo y una prótesis sintética / Vascular surgery stapling tool for making a mechanical suture between a blood vessel and a synthetic implant

OBJETIVO: Realización y desarrollo de un modelo de sutura vascular mecánica entre un vaso y una prótesis sintética. MATERIAL Y MÉTODOS: Para la realización del prototipo actual se diseñó un modelo experimental matemático que fue aplicado en un programa de diseño informático. Se utilizó como base un modelo similar descrito previamente por el autor y recogido en un documento de literatura científica protegido con el n.° 03/2008/258 en el registro de la propiedad intelectual con el título de «Sistema o dispositivo de soporte y sutura vascular mecánica», lo que permitió la descripción detallada de las diferentes partes y sus medidas específicas con el objetivo de obtener un sistema de sutura vascular mecánica cuyo mecanismo de funcionamiento fuese más efectivo. RESULTADOS: El sistema de sutura mecánica vascular que se describe es efectivo y seguro: demuestra la posibilidad de fabricación de un dispositivo de sutura circular con un diámetro superior a 16 mm. La máquina grapadora presenta una zona proximal de donde salen 3 filas de grapas a través de unas minirranuras. La suelta de las grapas se hace con un sistema de émbolo semejante a los aparatos de sutura mecánica intestinal. La prótesis se aloja en el interior del vástago, que es semihueco, que permite después de la sutura la retirada de la grapadora. CONCLUSIONES: Este prototipo permite realizar la sutura mecánica entre un vaso y una prótesis de forma mecánica ya sea por vía abierta o laparoscópica, facilitando y acortando este tiempo quirúrgico, que hasta la actualidad era uno de los inconvenientes mayores para el avance de la cirugía vascular laparoscópica

PURPOSE: Implementation and development of an experimental model of mechanical vascular suture between a vessel and a synthetic implant. MATERIAL AND METHOD: To use this experimental device, a mathematical model was designed and applied on design computer software. A similar model previously described by the author and included in a scientific document (No. 03/2008/258 copyright) was used as the basis. This method presented the detailed description of the different parts, and specific measurements of this mechanical tool in order to obtain an accurate mechanical system. RESULTS: The vascular stapling system described is effective and safe, demonstrating the possibility of performing a circular suture with a diameter greater than 16 mm. The stapling device has a proximal area from where 3 rows of staples that pass through mini-slots. The staples are released using a system similar to the mechanical intestinal suture. The prosthesis is fixed within a stem that is semi-hollow allowing the suture after removal of the stapler. CONCLUSIONS: The device describe here allows a mechanical suture between a vessel and a synthetic prosthesis, assisting and shortening the surgical time, which until now was one of the biggest drawbacks to the advancement of laparoscopic vascular surgery

Hermenegildo Arruga (1886-1972): a versatile ophthalmologist who simplified cerclage to retinal surgery.

Hermenegildo Arruga Liró (1886-1972) was a versatile Spanish ophthalmologist who specialized in retinal surgery. He designed numerous surgical instruments and introduced significant improvements in ophthalmic surgical techniques. Thus, he was among the first ophthalmologists to advocate the intracapsular cataract extraction. Furthermore, he refined several surgical procedures such as dacryocystorhinostomy, corneal transplantation, evisceroenucleation and pterygium excision. Arruga perfected Gonin's operation and contributed significantly for retinal detachment surgery to be put in place. Later, he adopted the injection of air at the end of surgery. In the 1950s, Arruga simplified the technique of equatorial cerclage using a suture to encircle the equator of the eye.

The past and present of liver suture.

Since the first attempts at resecting parts of diseased livers in the late nineteenth century, hemorrhage has been the main obstacle for surgeons. One of the first hemostasis techniques in liver resection was liver suture. The idea of suturing the liver in order to perform resection was proposed by a team of Russian and Polish surgeons from Kharkiv University in today's Ukraine. The liver suture became widely popular and has been used in various forms throughout the surgical world. Further into the twentieth century, it has lost much of its popularity; however, over more than 100 years of existence it has seen several peaks in interest. Currently, it is still being used by some liver surgeons as it is one of the cheapest ways of obtaining a bloodless liver parenchyma transection.

History of carotid surgery: from ancient greeks to the modern era.

A relationship between decreased carotid arterial flow and apoplectic manifestations was already suspected by the ancient Greeks. Early attempts at carotid surgery, however, were limited to emergency arterial ligation in patients with neck trauma. Attempts to suture arterial stumps together to restore blood flow paved the way for Carrel's revolutionary idea of reconstructing the resected or injured arterial segment with an interposition vein graft. DeBakey and Eastcott were the first to perform carotid endarterectomy in North America and the United Kingdom, respectively. In 1959, DeBakey proposed a cooperative study to assess the effectiveness of carotid endarterectomy in the treatment and prevention of ischemic cerebrovascular disease. The study was officially designated the Joint Study of Extracranial Arterial Occlusion and represented the first trial in the United States in which large numbers of patients were randomly allocated to surgical or nonsurgical therapy.

The history of barbed sutures.

Ligatures have been used for millennia to close wounds. Sterilization and synthetic polymers that degrade in a commensurate fashion with wound healing have been the most significant improvements in these age-old devices. However, the constricting loop of a traditional suture and subsequent ischemia ("approximate, don't strangulate") still account for the most common cause of wound dehiscence-necrosis. Inspired by the quill of the North American porcupine, I envisioned a bidirectional array of barbs that could secure tissue without relying on constricting loops. One set of barbs could anchor the other. In this article, I document the development process of these barbed sutures from concept to patent to manufacture and US Food and Drug Administration approval. Knotless, strong, and easy to place, barbed sutures could foreseeably supplant conventional sutures, particularly as endoscopic procedures become more common. They also offer the intriguing potential to suspend ptotic tissues without surgical intervention.

Barbed sutures in breast reconstruction.

Postoperative closure techniques in breast reconstruction have remained largely unchanged over the past 75 years, despite recent use of adhesives and subcuticular staples and the advent of self-anchoring barbed sutures. In this article, the author discusses the applications for barbed sutures in breast reconstruction and describes specific techniques. Innovations in barbed suture material are also described, and the author's personal experiences are presented in comparison with traditional suturing techniques.

New and emerging uses of barbed suture technology in plastic surgery.

Barbed sutures first received US Food and Drug Administration approval for soft tissue approximation in 2005 and early adopters readily embraced this device to develop new techniques. It has become apparent that the advantages are more than just "skin deep." Superficial and deep fascia, cartilage, tendon, joint capsule, and fibrous periprosthetic capsules can also be manipulated. Barbed sutures have revolutionized our approach to facial rejuvenation and body contouring by enhancing our ability to quilt and powerfully lift tissue. The elimination of surgical drains and shorter surgical times has made this a true boon for plastic surgeons as well as many other surgical specialists. This article summarizes some of the current and evolving applications of this exciting new tool.

Breve historia de las suturas mecánicas en la cirugía mundial y argentina / Brief history of mechanical sutures in global surgery and Argentina

Las suturas mecánicas son instrumentos que se utilizan en cirugía para permitir secciones de tejidos de manera rápida y segura. Su invención co- rresponde a los húngaros Victor Fischer y Hümer Hültl. En este artículo se describe su evolución a lo largo de la historia de la cirugía y se detalla su incursión en la cirugía argentina.

Breve historia de las suturas mecánicas en la cirugía mundial y argentina / Brief history of mechanical sutures in global surgery and Argentina

Las suturas mecánicas son instrumentos que se utilizan en cirugía para permitir secciones de tejidos de manera rápida y segura. Su invención co- rresponde a los húngaros Victor Fischer y H³mer H³ltl. En este artículo se describe su evolución a lo largo de la historia de la cirugía y se detalla su incursión en la cirugía argentina.(AU)