Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 18.170
Filtrar
1.
Acta Cir Bras ; 35(2): e202000206, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32348403

RESUMEN

Purpose To present new endoscopic robotic devices in the context of minimally invasive procedures with high precision and automation. Methods Review of the literature by December 2018 on robotic endoscopy. Results We present the studies and investments for robotic implementation and flexible endoscopy evolution. We divided them into forceps manipulation platforms, active endoscopy and endoscopic capsule. They try to improve forceps handling and stability and to promote active movement. Conclusion The implementation and propagation of robotic models depend on doing what the endoscopist is unable to. The new devices are moving forward in this direction.


Asunto(s)
Endoscopía/métodos , Procedimientos Quirúrgicos Robotizados/métodos , Animales , Endoscopios/clasificación , Resección Endoscópica de la Mucosa/instrumentación , Resección Endoscópica de la Mucosa/métodos , Diseño de Equipo , Humanos , Procedimientos Quirúrgicos Mínimamente Invasivos/instrumentación , Modelos Animales , Procedimientos Quirúrgicos Robotizados/instrumentación , Cirugía Asistida por Computador/instrumentación , Instrumentos Quirúrgicos
2.
Indian J Dent Res ; 31(1): 4-13, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32246674

RESUMEN

Purpose: The history of dentistry is not short; it started from ancient Egypt to ancient Romans and ancient Greeks. When it comes to extraction, all of them have made their own discoveries and progress. The progress they made also helped dentistry to move ahead in evolution of new extraction technique - the Physics Forceps. We have assessed the viability in using the Physics Forceps for routine dental extraction in our study for a period of 1 year. Materials and Methods: The study was conducted on 241 patients indicated for extraction based on our inclusion criteria using Physics Forceps after obtaining informed consent and University Ethics Committee approval. Tooth fracture, buccal alveolar bone fracture, and soft tissue injury around the tooth to be extracted were studied. Results: In our present study of 241 patients, 57.67% were females and 42.32% were males, out of which 93.77% had no tooth fracture, 3.32% had crown fracture, 1.65% had root fracture, and 1.24% had apex fracture. Further, 85.47% had no buccal alveolar bone fracture and 14.53% had buccal alveolar bone fracture. Using proper technique, 96.26% of patients had no soft tissue damage, and minimal damage was seen in 3.73% of patients. Discussion: Extraction by Physics Forceps is a very good technique of extraction. No or very minimal tooth fracture and soft tissue injury were noted. Though the forceps is costly, it represents a valuable addition to regular armamentarium for a general dentist for routine extraction. Physics Forceps is a dental extractor rather than a forceps.


Asunto(s)
Pico , Fracturas de los Dientes , Animales , Femenino , Humanos , Masculino , Física , Instrumentos Quirúrgicos , Extracción Dental , Alveolo Dental
3.
Medicine (Baltimore) ; 99(10): e19474, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32150110

RESUMEN

The modified Blumgart method for pancreaticojejunostomy has been shown to reduce the rate of postoperative pancreatic fistula (POPF) in open surgery. We describe a modified Blumgart method using LAPRA-TY suture clips to facilitate laparoscopic pancreaticojejunostomy.We prepared a double-armed 4-0 nonabsorbable monofilament, which was ligated using the LAPRA-TY clip at the tail end, 12-cm in length. Next, the U-suture was placed through the pancreatic stump and the seromuscular layer of the jejunum. We performed duct-to-mucosa suturing with a 5-0 absorbable monofilament. After completing the duct-to-mucosa suturing, as a final step we placed the sutures through the seromuscular layer of the jejunum on the ventral side and tightly secured the thread with the LAPRA-TY clips. We performed laparoscopic Blumgart pancreaticojejunostomy during pancreaticoduodenectomy in 39 patients. We compared the surgical outcomes of 19 patients who underwent Blumgart pancreaticojejunostomy using the LAPRA-TY clips (LAPRA-TY group) with 20 patients undergoing surgery not using the LAPRA-TY clips (conventional group).The rate of clinically relevant postoperative pancreatic fistula in the LAPRA-TY group was 21.1%, which did not differ significantly from the rate of the conventional group. However, the mean time of pancreaticojejunostomy in the LAPRA-TY group was 56.2 min (range, 39-79 min), which was significantly shorter than that of the conventional group (69.7 min; range, 53-105 min, P < .001).Although the modified Blumgart pancreaticojejunostomy using LAPRA-TY suture clips did not improve the pancreatic fistula rate, it allowed for shorter operative times. Thus, this procedure lends itself to positive surgical and patient outcomes.


Asunto(s)
Anastomosis Quirúrgica/instrumentación , Laparoscopía/instrumentación , Fístula Pancreática/cirugía , Pancreatoyeyunostomía/instrumentación , Instrumentos Quirúrgicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pancreaticoduodenectomía , Complicaciones Posoperatorias , Técnicas de Sutura , Resultado del Tratamiento
5.
Zhonghua Wai Ke Za Zhi ; 58(3): 165-169, 2020 Mar 01.
Artículo en Chino | MEDLINE | ID: mdl-32187919

RESUMEN

Image-guided percutaneous placement of breast tissue marker clip (breast marker) is mainly used for precisely marking and localizing breast cancer lesion and metastatic axillary lymph node. Until now, there is no clinical guideline in the field worldwide. This consensus established by Chinese Society of Breast Surgery, Chinese Surgical Society of Chinese Medical Association is based on our clinical practice and literature review, and particularly focuses on indications and contraindications, key placement procedures and evaluation methods, complications prevention and treatment, to provide guidance for the safe and standard clinical applications of breast marker.


Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Mama/diagnóstico por imagen , Marcadores Fiduciales , Ganglios Linfáticos/diagnóstico por imagen , Axila , Consenso , Femenino , Humanos , Instrumentos Quirúrgicos
6.
Artículo en Chino | MEDLINE | ID: mdl-32074752

RESUMEN

Objective: To compare the efficacies of the two techniques of "micro-hemostasis and micro-cutting" with straight bipolar electrocoagulation forceps and traditional clamp-ligation for hemostasia in thyroid surgery. Methods: A total of 228 patients who underwent surgical treatment for thyroid neoplasms in our hospital between January 2015 and December 2018 were retrospectively analyzed, including 50 males and 178 females, aged 23-68 years old. Of those, 150 cases as electric knife group received traditional thyroid surgery between January 2015 and December 2018 and 78 cases as bipolar electrocoagulation group received thyroid surgery by using the technique of bipolar electrocoagulation with meticulous anatomy between January 2018 and December 2018. The total operation time, single operation time, intraoperative hemorrhage, postoperative drainage volume on the first day, postoperative hoarseness and hypocalcemia were compared between the two groups. SPSS 16.0 was used to analyze the data. Results: The total operation time and intraoperative hemorrhage in the bipolar electrocoagulation group were significantly lower than those in the electric knife group ((59.33±18.29)min vs (77.21±25.39)min, (14.83±9.22)ml vs (36.86±11.80)ml, all P<0.01). The single operation time of the bipolar electrocoagulation group was shorter than that of the electric knife group((10.25±6.16) min vs (20.34±7.24)min, (16.25±7.15)min vs (35.68±8.25)min, (12.12±5.25)min vs (20.68±7.26)min, t value was 3.948,16.262,8.238, all P<0.01).There was no significant difference between the two groups in postoperative drainage volume on the first day (P>0.05) and the incidence of postoperative hoarseness (P>0.05), while the incidence of hypocalcemia in the bipolar electrocoagulation group(10.26%) was lower than that in the electric knife group(21.33%,χ(2)=4.353, P<0.05). Conclusions: The fine dissection for thyroid operation can be achieved by using straight bipolar electrocoagulation tweezers. The use of "micro-hemostasis" and "micro-cutting" technique with bipolar electrocoagulation tweezers can greatly reduce intraoperative bleeding, operation time and postoperative complication.


Asunto(s)
Electrocoagulación , Instrumentos Quirúrgicos , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
8.
World Neurosurg ; 136: e578-e585, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31958589

RESUMEN

OBJECTIVE: To determine the rate and anatomical location of dural tears associated with spinal surgery using a percutaneous biportal endoscopic surgery (PBES) technique. We investigated the relationship between dural tears and the type of procedure and type of instrument used. METHODS: We retrospectively analyzed 643 PBES cases by reviewing the medical records, operative records, and operative videos. Incidental durotomy was identified in 29 cases. We analyzed the size and anatomical location of the dural tears, the surgical instrument that caused the tear, and the technique used to seal the tear. RESULTS: The dural tear incidence was 4.5% (29 of 643 cases). Tears in the exiting nerve area (2 cases; 6.9%) had mainly been caused by curettage, tears in the thecal sac area (18 cases; 62.1%) were associated with electric drill and forceps use; and tears in the traversing nerve area were associated with the use of a Kerrison punch (9 cases; 31%). Of the 29 cases of dural tear, 12 were treated with in-hospital monitoring and bed rest, 14 were treated with a fibrin sealant, 2 were treated with a nonpenetrating titanium clip, and 1 was converted to microscopic surgery. One case of postoperative meningocele after conservative treatment required endoscopic revision surgery to close the dural tear. CONCLUSIONS: Most cases of incidental dural tear during PBES were treated with an endoscopic procedure. The incidence of dural tear was no greater than that associated with microscopic surgery. Our management strategy for incidental dural tears during PBES has been shown to be safe and effective.


Asunto(s)
Duramadre/lesiones , Neuroendoscopía/efectos adversos , Columna Vertebral/cirugía , Duramadre/cirugía , Femenino , Adhesivo de Tejido de Fibrina/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Neuroendoscopía/instrumentación , Tempo Operativo , Estudios Retrospectivos , Instrumentos Quirúrgicos , Adhesivos Tisulares/uso terapéutico
9.
World Neurosurg ; 136: e300-e309, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31901493

RESUMEN

OBJECTIVE: Although the risk of aneurysm remnants after microsurgical clipping is generally low, complete aneurysm occlusion is not always guaranteed. We performed a morphometric analysis of intracranial aneurysms to identify predictors for aneurysm remnants and to propose a novel risk score. METHODS: This is a retrospective, single-center analysis of consecutive patients with ruptured and unruptured aneurysms who underwent microsurgical clipping and postoperative digital subtraction angiography between 2010 and 2018. Based on preoperative rotational angiography, distinct morphologic aneurysm characteristics were determined and correlated with postoperative angiographic results. Factors predictive in the univariate and multivariate analyses were determined to establish a risk score for postoperative remnants after aneurysm clipping. RESULTS: Among 140 patients with 166 clipped aneurysms, aneurysm remnants were present in 19.9%. In the multivariate analysis, ruptured aneurysm status (odds ratio [OR], 7.8; 95% confidence interval [CI], 1.7-36; P < 0.01) and increased aspect ratio (OR, 1.9; 95% CI, 1.0-4.0; P = 0.07) were associated with postoperative aneurysm remnants. Anterior communicating artery location (P = 0.02), internal carotid artery location (P = 0.06), increased aneurysm inclination angle (P < 0.01), and irregular aneurysm shape (P = 0.07) were further predictors for aneurysm remnants in the univariate analysis. These factors were weighted and included into a risk sum score for postoperative aneurysm remnants (range, 0-8 points), which performed with good accuracy (area under the curve = 0.807). CONCLUSIONS: After external validation of the proposed risk score, it could help identify cases requiring angiographic control after aneurysm surgery.


Asunto(s)
Aneurisma Intracraneal/patología , Aneurisma Intracraneal/cirugía , Procedimientos Neuroquirúrgicos/métodos , Adolescente , Adulto , Anciano , Aneurisma Roto/patología , Aneurisma Roto/cirugía , Femenino , Humanos , Masculino , Microcirugia/instrumentación , Microcirugia/métodos , Persona de Mediana Edad , Procedimientos Neuroquirúrgicos/instrumentación , Estudios Retrospectivos , Factores de Riesgo , Instrumentos Quirúrgicos , Adulto Joven
10.
World Neurosurg ; 136: e371-e379, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31931237

RESUMEN

BACKGROUND: This study aimed to compare the functional outcome at discharge for unruptured cerebral aneurysms (UCAs) between surgical clipping and endovascular coiling in total, nonelderly (<65 years), and elderly (≥65 years) patients by nonbiased analysis based on a national database in Japan. METHODS: A total of 15,671 patients with UCA were registered in the Diagnosis Procedure Combination, the nationwide database, from 2010 to 2015 in Japan. The outcome of the Barthel Index (BI) at discharge was investigated, and propensity score-matched analysis was conducted in total, nonelderly, and elderly patient groups. RESULTS: Propensity score-matched analysis found no significant difference for in-hospital mortality between the 2 treatment methods in the total and both age-groups. The rate of morbidity of BI <90 at discharge was higher after surgical clipping than after endovascular coiling in the total (4.9% vs. 3.9%; P = 0.040; risk difference, -1.0%; 95% confidence interval, -3.6 to 2.3%) and the elderly age-group (8.1% vs. 5.0%; P < 0.001; risk difference, -3.1%; -4.8% to 1.5%), however, no significant association between the 2 treatment methods (2.4% vs. 2.6%; P = 0.67; risk difference, 0.22%; -0.79 to 1.22%) was found in the nonelderly group. CONCLUSIONS: In elderly patients with UCA, a better outcome at discharge after endovascular coiling was found. However, no significantly different functional outcome at discharge between surgical clipping and endovascular coiling for UCA in nonelderly patients was confirmed by propensity score-matched analysis from a nationwide database in Japan.


Asunto(s)
Aneurisma Intracraneal/cirugía , Procedimientos Neuroquirúrgicos/instrumentación , Procedimientos Neuroquirúrgicos/métodos , Anciano , Prótesis Vascular , Bases de Datos Factuales , Procedimientos Endovasculares/instrumentación , Procedimientos Endovasculares/mortalidad , Femenino , Humanos , Aneurisma Intracraneal/mortalidad , Japón , Masculino , Persona de Mediana Edad , Puntaje de Propensión , Instrumentos Quirúrgicos , Resultado del Tratamiento
11.
Anticancer Res ; 40(1): 401-404, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892593

RESUMEN

BACKGROUND/AIM: Bile leakage after liver surgery is still a problem to be solved. Here, we introduce a simple new technique, the Clip on Staple method, a preventive measure for bile leakage after anatomical liver resection using a stapling device. PATIENTS AND METHODS: Before liver parenchymal transection, the roots of Glissonean pedicles for target segments were dissected and divided using the Endo-GIA™ Tri-Staple™ Curved Tip. After the parenchymal transection was completed, the full length of the stapled stump was reinforced by multiple clips. The DS Titanium Ligation Clip was used as the clipping device. RESULTS: Twenty patients underwent this technique during anatomical liver resections with stapling devices. No patient developed postoperative bile leakage of any grade. There was no reoperation or readmission within 90 days. CONCLUSION: The Clip on Staple method is simple and offers a preventive effect for postoperative bile leakage after anatomical liver resection using stapling devices.


Asunto(s)
Bilis/metabolismo , Hígado/cirugía , Instrumentos Quirúrgicos , Grapado Quirúrgico , Anciano , Anciano de 80 o más Años , Hepatectomía , Humanos , Procesamiento de Imagen Asistido por Computador , Persona de Mediana Edad , Resultado del Tratamiento
12.
World Neurosurg ; 133: 283-290, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31505282

RESUMEN

BACKGROUND: Traditional manual retraction to access deep-seated brain lesions has been associated with complications related to vascular compromise of cerebral tissue. Various techniques have been developed over time to minimize injury, such as self-sustaining retractors, neuronavigation, and endoscopic approaches. Recently, tubular retractors, such as the ViewSite Brain Access System (VBAS), have been developed to reduce mechanical damage from retraction by dispersing the force of the retractor radially over the parenchyma. Therefore, we sought to review the current literature to accurately assess the indications, benefits, and complications associated with use of VBAS retractors. METHODS: A literature search for English articles published between 2005 and 2019 was performed using the MEDLINE database archive with the search terminology "Vycor OR ViewSite OR Brain-Access-System NOT glass." The VBAS website was also examined. Only articles detailing neurosurgical procedures using the VBAS tubular retractor system alone, or in combination with other retractors, were included. Postoperative morbidity and mortality were analyzed to estimate complications linked to using the retractor. RESULTS: Twelve publications (106 patients) met the inclusion criteria. The VBAS retractor was used for tumor resections, hematoma evacuations, cyst removal, foreign body extractions, and lesion resection in toxoplasmosis and multiple sclerosis. These cases were subdivided into groups based on lesion location, size, and resection volume for further analysis. Gross total resection was achieved in 63% of tumor excisions, and subtotal resection was achieved in 37%. Hematoma evacuation was successful in all cases. There were 3 short-term postoperative complications linked to the retractor, with an overall complication rate of 2.8%. CONCLUSIONS: This report is the first formal assessment of the VBAS, highlighting technical considerations of the retractor from the surgeon's perspective, patient outcomes, and complications. The retractor is a safe and efficacious tubular retraction system that can be used for tumor biopsy and resection, colloid cyst removal, hematoma evacuation, and removal of foreign bodies. However, further randomized controlled trials are indicated to accurately assess complication rates and outcomes.


Asunto(s)
Neoplasias Encefálicas/cirugía , Microcirugia/instrumentación , Procedimientos Neuroquirúrgicos/instrumentación , Instrumentos Quirúrgicos , Humanos
13.
Int J Oral Maxillofac Surg ; 49(1): 99-106, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31230766

RESUMEN

This randomized controlled trial (RCT) (ClinicalTrials.gov ID: NCT03001791) compared excisional biopsies of fibrous hyperplasia performed using a CO2 laser (140Hz, 400µs, 33mJ), Er:YAG laser (35Hz, 297µs, 200mJ, air-water cooling), or scalpel (15c blade). Clinical parameters recorded were duration of the intervention, intraoperative bleeding, need for electrocauterization and/or suturing, postoperative side effects, complications, pain, and intake of analgesics. Histopathological linear measurements of the thermal damage zone were performed on the laser biopsies. Results showed that the duration of the intervention was significantly shorter for both lasers compared to the scalpel (P<0.001). Intraoperative bleeding occurred less frequently with the CO2 laser (P<0.001). Additional electrocautery was used in 92% of Er:YAG laser interventions (P<0.001). Postsurgical complications, pain, and the intake of analgesics did not differ between the groups. The measured thermal damage zones differed significantly between the CO2 laser (median of 72.6µm) and Er:YAG laser (30.9µm) (P<0.001). This RCT showed that CO2 laser, Er:YAG laser, and scalpel are all adequate for excisional biopsies of small lesions in the oral mucosa. While patient postoperative morbidity is similar, the ideal instrument can be selected according to the surgical advantages preferred for the individual situation.


Asunto(s)
Terapia por Láser , Láseres de Gas , Láseres de Estado Sólido , Biopsia , Dióxido de Carbono , Humanos , Instrumentos Quirúrgicos
14.
World Neurosurg ; 133: e327-e341, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31520760

RESUMEN

BACKGROUND: Medical implications of 3-dimensional (3D) printing technology have evolved and are increasingly used. Surgical spine oncology involves at times complex resection using various surgical approaches and unique spinal reconstruction. As high general complication rates, including hardware failure, are reported, careful preoperative planning and optimized fixation techniques should be performed. 3D printing technology allows the improvement of preoperative planning, practice and exploration of various surgical approaches, and designing customized surgical tools and patient specific implants. OBJECTIVE: To investigate the use of 3D printing technology in complex spine surgeries. METHODS: Between 2015 and 2018, all complex spine oncological cases were evaluated and assessed for the possible benefit of use of 3D printing technology. Following high-quality imaging, a computerized integrated 3D model was created. Based on the planned procedure considering the various surgical steps, a customized 3D model was planned and printed, and in select cases a 3D custom-made implant was designed and printed in various sizes with matching trials. RESULTS: A total of 7 cases were selected for the use of a 3D printing technology. For all, a custom-made model was created. In 3 of these cases, a customized 3D-printed implant was used. Special customized intraoperative instruments were made for 2 cases, and a simulated surgical approach was performed in 5 cases. In 2 cases, pre-bent rods were made based on the model created and were used in surgery later on. CONCLUSIONS: For complex spine oncology cases, the use of 3D printing allowed better preoperative planning, simplified the operative procedure, and enabled improved reconstruction.


Asunto(s)
Imagen por Resonancia Magnética , Modelos Anatómicos , Impresión Tridimensional , Prótesis e Implantes , Procedimientos Quirúrgicos Reconstructivos/métodos , Neoplasias de la Columna Vertebral/cirugía , Cirugía Asistida por Computador/métodos , Tomografía Computarizada por Rayos X , Adolescente , Adulto , Trasplante Óseo , Carcinoma Ductal de Mama/diagnóstico por imagen , Carcinoma Ductal de Mama/secundario , Carcinoma Ductal de Mama/cirugía , Carcinoma de Células Renales/diagnóstico por imagen , Carcinoma de Células Renales/secundario , Carcinoma de Células Renales/cirugía , Condrosarcoma/diagnóstico por imagen , Condrosarcoma/patología , Condrosarcoma/cirugía , Diseño de Equipo , Femenino , Tumores de Células Gigantes/diagnóstico por imagen , Tumores de Células Gigantes/patología , Tumores de Células Gigantes/cirugía , Hemangioma/diagnóstico por imagen , Hemangioma/patología , Hemangioma/cirugía , Humanos , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/patología , Vértebras Lumbares/cirugía , Masculino , Persona de Mediana Edad , Osteoma Osteoide/diagnóstico por imagen , Osteoma Osteoide/patología , Osteoma Osteoide/cirugía , Procedimientos Quirúrgicos Reconstructivos/instrumentación , Sarcoma de Ewing/diagnóstico por imagen , Sarcoma de Ewing/secundario , Sarcoma de Ewing/cirugía , Neoplasias de la Columna Vertebral/diagnóstico por imagen , Neoplasias de la Columna Vertebral/patología , Neoplasias de la Columna Vertebral/secundario , Cirugía Asistida por Computador/instrumentación , Instrumentos Quirúrgicos , Vértebras Torácicas/diagnóstico por imagen , Vértebras Torácicas/patología , Vértebras Torácicas/cirugía , Adulto Joven
15.
Yonsei Med J ; 61(1): 94-99, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31887805

RESUMEN

Developing new surgical instruments is challenging. While making surgical instruments could be a good field of application for 3D printers, attempts to do so have proven limited. We designed a new endoscope-assisted spine surgery system, and using a 3D printer, attempted to create a complex surgical instrument and to evaluate the feasibility thereof. Developing the new surgical instruments using a 3D printer consisted of two parts: one part was the creation of a prototype instrument, and the other was the production of a patient model. We designed a new endoscope-assisted spine surgery system with a cannula for the endoscope and working instruments and extra cannula that could be easily added. Using custom-made patient-specific 3D models, we conducted discectomies for paramedian and foraminal discs with both the newly designed spine surgery system and conventional tubular surgery. The new spine surgery system had an extra portal that can be well bonded in by a magnetic connector and greatly expanded the range of access for instruments without unnecessary bone destruction. In foraminal discectomy, the newly designed spine surgery system showed less facet resection, compared to conventional surgery. We were able to develop and demonstrate the usefulness of a new endoscope-assisted spine surgery system relying on 3D printing technology. Using the extra portal, the usability of endoscope-assisted surgery could be greatly increased. We suggest that 3D printing technology can be very useful for the realization and evaluation of complex surgical instrument systems.


Asunto(s)
Endoscopios , Impresión Tridimensional/instrumentación , Columna Vertebral/cirugía , Instrumentos Quirúrgicos , Discectomía , Humanos
16.
Gastrointest Endosc Clin N Am ; 30(1): 1-11, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31739956

RESUMEN

The over-the-scope clip is a novel endoscopic tool developed for tissue compression in the gastrointestinal tract. It has already revolutionized the management of acute perforations and leaks. In the past decade, it has also increasingly been used for treatment of severe and/or refractory gastrointestinal hemorrhage. Available studies report high rates of primary hemostasis and rebleeding. This article provides an overview on available literature, potential indications, and technical aspects of hemostasis with over-the-scope clip.


Asunto(s)
Endoscopía Gastrointestinal/instrumentación , Hemorragia Gastrointestinal/cirugía , Hemostasis Endoscópica/instrumentación , Instrumentos Quirúrgicos , Endoscopía Gastrointestinal/métodos , Diseño de Equipo , Hemostasis Endoscópica/métodos , Humanos
17.
Gastrointest Endosc Clin N Am ; 30(1): 13-23, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31739960

RESUMEN

Endoscopic treatment of lower gastrointestinal bleeding can be challenging. This article reports on the use of the endoscopic clipping over the scope technique to treat acute severe lower gastrointestinal bleeding. In particular, it describes the approaches and outcomes of using the technique for acute severe bleeding in the colon and the anal transition zone. The following synopsis is the one that you supplied, but lightly copyedited. Please confirm OK. Please note that the synopsis will appear in PubMed: Endoscopic treatment of lower gastrointestinal bleeding can be challenging. This article reports on the use of the endoscopic clipping over the scope technique to treat acute severe lower gastrointestinal bleeding. In particular, it describes the approaches and outcomes of using the technique for acute severe bleeding in the colon and the anal transition zone.


Asunto(s)
Enfermedades del Ano/cirugía , Enfermedades del Colon/cirugía , Endoscopía Gastrointestinal/instrumentación , Hemorragia Gastrointestinal/cirugía , Hemostasis Endoscópica/instrumentación , Instrumentos Quirúrgicos , Enfermedad Aguda , Canal Anal/cirugía , Colon/cirugía , Endoscopía Gastrointestinal/métodos , Diseño de Equipo , Hemostasis Endoscópica/métodos , Humanos , Ligadura/instrumentación , Ligadura/métodos , Resultado del Tratamiento
18.
Gastrointest Endosc Clin N Am ; 30(1): 25-39, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31739966

RESUMEN

In gastrointestinal perforation or fistula, endoscopic closure techniques could be used as alternatives to surgery. Early endoscopic recognition and treatment of gastrointestinal perforation is the most important factor determining procedural success and clinical outcomes. The over-the-scope clip with full-thickness grasping capability provides greater technical and clinical success rates compared with the through-the-scope clips. Although the technical success rate of chronic fistula closure is comparable to perforation closure, it has a significantly lower clinical success owing to its less healthy tissue edge of the fistula. The over-the-scope clip system should be considered before surgery for the closure of perforation and fistula.


Asunto(s)
Endoscopía Gastrointestinal/instrumentación , Fístula Intestinal/cirugía , Perforación Intestinal/cirugía , Instrumentos Quirúrgicos , Endoscopía Gastrointestinal/métodos , Diseño de Equipo , Humanos , Resultado del Tratamiento
19.
Gastrointest Endosc Clin N Am ; 30(1): 75-89, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31739968

RESUMEN

The over-the-scope clip is safe and efficacious and has become the preferred device of choice for the treatment of complex gastrointestinal bleeding, perforation, and gastrointestinal leaks. With its widespread adoption in clinical practice, information on complications associated with over-the-scope clip use is emerging. Nonetheless, the overall complication rate is still very low. Most of the reported complications have been related to the technique rather than the actual device and could likely be prevented with proper technique. In this article, the authors summarize the complications associated with over-the-scope clip use and provide guidance on safety measure to mitigate them.


Asunto(s)
Endoscopía Gastrointestinal/instrumentación , Complicaciones Posoperatorias/prevención & control , Instrumentos Quirúrgicos/efectos adversos , Diseño de Equipo , Hemorragia Gastrointestinal/cirugía , Humanos , Perforación Intestinal/cirugía , Complicaciones Posoperatorias/etiología , Resultado del Tratamiento
20.
Gastrointest Endosc Clin N Am ; 30(1): 99-106, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31739970

RESUMEN

Training practicing physicians to adopt new technology may be difficult because most endoscopy training is given during fellowship training. As such, the adoption of new technology in gastroenterology is typically slow. We designed our course to train our cohort of practicing physicians using flipped learning, a pedagogical approach in which instructional cognitive content is delivered to the individual instead of the group, usually through online platforms and outside of the classroom. We describe our methods and results of the training courses on the techniques of clipping over the scope for gastrointestinal bleeding and endoscopic balloon dilation.


Asunto(s)
Educación Médica Continua/métodos , Endoscopía Gastrointestinal/educación , Gastroenterología/educación , Instrumentos Quirúrgicos , Enseñanza , Endoscopía Gastrointestinal/instrumentación , Diseño de Equipo , Humanos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA