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Permanent Implantation (permanent + implantation)
Selected AbstractsLaser Polishing in Medical EngineeringLASER TECHNIK JOURNAL, Issue 2 2010Laser Polishing of Components for Left Ventricular Assist Devices Cardiac surgery has made significant progress during the last 50 years. nowadays, almost every congenital or contracted dysfunction of the heart can be treated clinically or at least the etiopathology can be alleviated. During these years, implantable Left Ventricular Assist Devices (LVADs) have proven to be an effective and reliable medical product. In particular, the survival rate of patients with cardiac insufficiency has risen due to these devices. This type of heart-assist device is implanted either to bridge the time until cardiac transplantation or recovery has occurred, or for permanent implantation in the patient's body. Berlin Heart GmbH produces the clinically tested axial pump system INCOR® (Figure 1, above). The INCOR heart-as-sisting pump is a powerful implantable LVAD which has been used in more than 500 clinical applications. The main function of the axial pump is to unload the patient's heart by transporting blood from the left ventricle to the aorta. In order to assure high reliability of the pump's operation, the components used for blood transport have to be highly bio- and hemocompatible. [source] Sacral nerve stimulation for faecal incontinence in the UK,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2004M. E. D. Jarrett Background: Sacral nerve stimulation (SNS) is an effective therapy for faecal incontinence. Published studies derive largely from single centres and there is a need to determine the broader applicability of this procedure. Methods: Prospective data were collected for all patients undergoing SNS in the UK. Records were reviewed to determine the outcome of treatment. Results: In three UK centres 59 patients underwent peripheral nerve evaluation, with 46 (78 per cent) proceeding to permanent implantation. Of these 46 patients (40 women) all but two had improved continence at a median of 12 (range 1,72) months. Faecal incontinence improved from a median (range) of 7·5 (1,78) to 1 (0,39) episodes per week (P < 0·001). Urgency improved in all but five of 39 patients in whom ability to defer defaecation was determined, improving from a median of 1 (range 0,5) to 10 (range from 1 to more than 15) min (P < 0·001). Maximum anal squeeze pressure and sensory function to rectal distension changed significantly. Significant improvement occurred in general health (P = 0·024), mental health (P = 0·008), emotional role (P = 0·034), social function (P = 0·013) and vitality (P = 0·009) subscales of the Short Form 36 health survey questionnaire. There were no major complications. One implant was removed. Conclusion: SNS is a safe and effective treatment, in the medium to long term, for faecal incontinence when conservative treatment has failed. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Sacral nerve modulation and other treatments in patients with faecal incontinence after unsuccessful pelvic floor rehabilitation: a prospective studyCOLORECTAL DISEASE, Issue 4 2010S. M. Koch Abstract Objectives Sacral nerve modulation (SNM) is a minimally invasive technique for the treatment of faecal incontinence. This study investigates the results of SNM after negative outcome of a standardized pelvic floor rehabilitation (PFR) programme for the treatment of faecal incontinence. Method, A prospective cohort study was performed between December 2001 and August 2007. Consecutive patients who visited the outpatient department for faecal incontinence were included in a multicentre study and treated with standardized PFR. Those with an unsuccessful result who were eligible for SNM were included in the present study. Failures at test stimulation or SNM received another treatment. Clinical outcome, Vaizey scores and Hirschsprung's disease/anorectal malformation quality-of-life (EQ-5D and HAQL) were assessed during follow-up in patients with SNM and in patients with other treatments (OT). Adverse events (AE) were documented. Results, Thirty-five patients (mean age 59.7 years; 31 females) were included. Twenty-one had a successful test stimulation and 19 patients proceeded to a SNM implant. Incontinence episodes per week decreased significantly from 11.1 ± 11.7 to 1.9 ± 2.6 during test stimulation (P < 0.0001) and SNM over 24.1 months follow-up. The overall success rate was 49% (17/35). The patients with unsuccessful test stimulation or SNM received OT. The Vaizey score improved in both SNM (18.2 ± 3.5 vs 13.7 ± 4.8; P = 0.004) and other treatment (18.2 ± 3.5 vs 13.9 ± 6.9; P = 0.019). The HAQL scale improved significantly during SNM in all subscales (P < 0.005), but not in the other treatment group. Eight AE occurred during test stimulation (23%) and six AE after permanent implantation (26%). Conclusion, Sacral nerve modulation improves disease specific quality of life significantly compared with other treatment. [source] Sacral neuromodulation in patients with faecal incontinence: results of the first 100 permanent implantationsCOLORECTAL DISEASE, Issue 8 2007J. Melenhorst Abstract Objective, Faecal incontinence (FI) is a socially devastating problem. Sacral nerve modulation (SNM) has proven its place in the treatment of patients with FI. In this study, the first 100 definitive SNM implants in a single centre have been evaluated prospectively. Method, Patients treated between March 2000 and May 2005 were included. Faecal incontinence was defined as at least one episode of involuntary faecal loss per week confirmed by a 3-week bowel habit diary. Patients were eligible for implantation of a permanent SNM when showing at least a 50% reduction in incontinence episodes or days during ambulatory test stimulation. Preoperative workup consisted of an X-defaecography, pudendal nerve terminal motor latency measurement, endo-anal ultrasound and anal manometry. The follow-up visits for the permanent implanted patients were scheduled at 1, 3, 6 and 12 months and annually thereafter. The bowel habit diary and anal manometry were repeated postoperatively during the follow-up visits. Results, A total of 134 patients were included and received a subchronic test stimulation. One hundred patients (74.6%) had a positive test stimulation and received a definitive SNM implantation. The permanent implantation group consisted of 89 women and 11 men. The mean age was 55 years (range 26,75). The mean follow-up was 25.5 months (range 2.5,63.2). The mean number of incontinence episodes decreased significantly during the test stimulation (baseline, 31.3; test, 4.4; P < 0.0001) and at follow-up (36 months postoperatively, 4.8; P < 0.0001). There was no significant change in the mean anal resting pressure. The squeeze pressures were significantly higher at 6 months (109.8 mmHg; P = 0.03), 12 months (114.1 mmHg; P = 0.02) and 24 months postoperatively (113.5 mmHg; P = 0.007). The first sensation, urge and maximum tolerable volume did not change significantly. Twenty-one patients were considered late failures and received further treatment. Conclusion, Sacral neuromodulation is an effective treatment for FI. The medium-term results were satisfying. [source] |