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Suture Ligation (suture + ligation)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Surgical Excision of Pedunculated Supernumerary Digits Prevents Traumatic Amputation Neuromas

PEDIATRIC DERMATOLOGY, Issue 2 2003
Geoffrey E. Leber
The first group consisted of three patients who had among them five traumatic amputation neuromas. In each case these lesions resulted from primary suture ligation of accessory digits in infancy. Secondary surgical excision of the vestigial digit with high ligation and retraction of the accompanying nerve tissue was required in all cases. The second group consisted of six patients who had 12 pedunculated supernumerary digits. Primary surgical excision of these digits was performed with high transection and retraction of the accompanying accessory digital nerve. All patients in this group had excellent cosmetic results with no postoperative neuroma formation. Adult family members who had undergone suture ligation of similar supernumerary digits in infancy accompanied seven of the nine patients in this series. On careful examination, each of these family members had signs and symptoms attributable to traumatic amputation neuromas. We feel identification and high transection of the accessory digital nerve is essential in the treatment of pedunculated supernumerary digits. This treatment prevents traumatic amputation neuromas and yields a better cosmetic result than the traditional method of suture ligation in infancy. [source]

Chylous Ascites Requiring Surgical Intervention after Donor Nephrectomy: Case Series and Single Center Experience

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2010
J. Aerts
Chylous ascites as a result of laparoscopic donor nephrectomy (LDN) is a rare complication that carries significant morbidity, including severe protein-calorie malnutrition and an associated immunocompromised state. We report a patient who underwent hand-assisted left LDN and subsequently developed chylous ascites. He failed conservative therapy including low-fat diet with medium-chain triglycerides (LFD/MCT) and oral protein supplementation as well as strict NPO status with intravenous (IV) total parenteral nutrition (TPN) and subcutaneous (SQ) somatostatin analogue administration. Laparoscopic re-exploration and intracorporeal suture ligation and clipping of leaking lymph channels successfully sealed the chyle leak. We review the literature to date including diagnosis, incidence, management options, psychosocial aspects and clinical outcomes of chylous ascites after LDN. [source]

Safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles in vaginal hysterectomy: randomised controlled trial

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 3 2005
M.A. Hefni
Objective To assess the safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles during vaginal hysterectomy in comparison with the conventional method of securing the pedicles by suture ligation. Design Randomised controlled trial. Setting Gynaecology Department, Benenden Hospital, Kent. Population One hundred and sixteen women undergoing vaginal hysterectomy were prospectively randomised to either LigaSure (Group I) or suture ligation (Group II) for securing the pedicles. Methods Data of patients were collected prospectively. Statistical analysis was performed using the Mann,Whitney U test, ,2 and Fisher's exact test as appropriate. Main outcome measures Operating time, operative blood loss and peri-operative complications. Results The operating time was significantly shorter in the LigaSure group compared with the control group (P < 0.04). There was no statistical significant difference between the two groups in operative blood loss (P= 0.433), but peri-operative haemorrhagic complications were less frequent in the LigaSure group (0%vs 6.8%, P= 0.057). Four patients in the control group required either conversion to laparotomy because of bleeding, return to theatre for immediate post-operative haemorrhage or readmission for vault haematoma, whereas none in the LigaSure group had bleeding from unsecured pedicles. Conclusion The LigaSure vessel sealing system is a safe alternative for securing pedicles in vaginal hysterectomy when compared with conventional suture ligation. Larger studies are required to determine its place in gynaecological surgery. [source]

Pancreatic leak after left pancreatectomy is reduced following main pancreatic duct ligation

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2003
M. M. Bilimoria
Background: Although much is known about the long-term outcome of patients undergoing left (distal) pancreatectomy for malignancy, comparatively little is known about the optimal management strategy for the residual transected pancreatic parenchyma and the divided pancreatic duct. Clinicopathological and operative factors that may contribute to postoperative pancreatic leak were evaluated. Methods: A retrospective review of the medical records of 126 patients who underwent left pancreatectomy between June 1990 and December 1999 at the University of Texas M. D. Anderson Cancer Center was performed. Results: Indications for left pancreatectomy included pancreatic neoplasms (n = 42; 33·3 per cent), en bloc resection for management of retroperitoneal sarcoma (n = 21; 16·7 per cent), gastric adenocarcinoma (n = 14; 11·1 per cent), renal cell carcinoma (n = 11; 8·7 per cent) and other tumours or benign conditions (n = 38; 30·2 per cent). Pancreatic parenchymal closure was accomplished by a hand-sewn technique, mechanical stapling, or a combination of the two in 83, 20 and 15 patients respectively. No form of parenchymal closure was used in eight patients. Identification of the pancreatic duct and suture ligation was performed in 73 patients (57·9 per cent). Twenty-five patients (19·8 per cent) developed a pancreatic leak. For subgroups having duct ligation or no duct ligation, pancreatic leak rates were 9·6 per cent (seven of 73 patients) and 34·0 per cent (18 of 53 patients) respectively (P < 0·001). Multivariate analysis including clinicopathological and operative factors indicated that failure to ligate the pancreatic duct was the only feature associated with an increased risk for pancreatic leak (odds ratio 5·0 (95 per cent confidence interval 2·0 to 10·0); P = 0·001). Conclusion: Pancreatic leak remains a common complication after left pancreatectomy. The incidence of leak is reduced significantly when the pancreatic duct is identified and directly ligated during left pancreatectomy. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Identification of post-transplant lymphocele using lymphatic mapping with isosulphane blue

CLINICAL TRANSPLANTATION, Issue 1 2009
A. Cakmak
Abstract:, Lymphocele development after renal transplantation is a well-recognized complication that occurs with the incidence of 0.6,18%. Although the majority of patients are asymptomatic, post-renal transplant lymphocele continues to be a major cause of morbidity if it is left untreated. The standard approach for the treatment of symptomatic lymphoceles is accepted to be laparoscopic or open marsupialization in many centers if simple drainage and conservative measures fail. However, marsupialization is almost impossible under certain circumstances, such as in the case of excessive abdominal adhesions. Hence, direct visualization of the lymphatic leak and suture ligation may become inevitable, which is usually a challenging procedure for the surgeon. Herein we report a case of post-renal transplant lymphocele treated by the direct identification and suture ligation of injured lymphatic vessel using a new method similar to sentinel lymph node detection using the dye isosulphane blue. [source]