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Mean Procedure Time (mean + procedure_time)
Selected AbstractsImproved Localization of Right-Sided Accessory Pathways with Microcatheter-Assisted Right Coronary Artery Mapping in ChildrenJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 11 2004MAULLY J. SHAH M.B.B.S. Introduction: Radiofrequency ablation of some right-sided accessory pathways continues to be challenging. The purpose of this study was to evaluate the efficacy of introducing a multielectrode microcatheter in the right coronary artery to localize accessory pathways when conventional mapping was unsuccessful. Methods and Results: A retrospective study was conducted of all right-sided accessory pathway radiofrequency ablation procedures in which a multielectrode microcatheter as a reference in the right coronary artery was used to assist mapping. Between January 1998 and January 2002, 10 patients (5 males) underwent mapping of 11 accessory pathways with this technique at mean age of 12.3 ± 3.8 years. Five patients had Ebstein's anomaly of the tricuspid valve. Accessory pathways were identified in the following locations: right anterior 3, right anterolateral 2, right lateral 1, right posterolateral 2, and right posterior 3. Mean procedure time was 285 ± 70.3 minutes, and fluoroscopy time was 68.7 ± 21 minutes. Average mapping duration prior to microcatheter insertion in the right coronary artery was 136 ± 40 minutes. After microcatheter placement in the right coronary artery, the time to successful ablation of accessory pathways was 38 ± 11 minutes. All 11 (100%) accessory pathways were successfully ablated. Conclusion: Mapping in the right coronary artery with a microcatheter is an effective method to improve localization and successful ablation of difficult right-sided accessory pathways. [source] Comparison of the use of electrothermal bipolar vessel sealer with harmonic scalpel in total laparoscopic hysterectomyJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2007Fazli Demirturk Abstract Aim:, The aim of the present study was to compare the use of electrothermal bipolar vessel sealer (EBVS) with harmonic scalpel (HS) during total laparoscopic hysterectomy with respect to operation time, estimated blood loss and related complications. Methods:, A retrospective study was conducted in the university hospital. Forty patients who underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy were enrolled. Nineteen hysterectomies were performed with HS and in 21 patients the same surgeons used EBVS. Data about the characteristics of the patients, operation time, estimated blood loss, uterine weights, related complications and length of hospital stay were registered and compared. Results:, Mean procedure time and estimated blood loss were significantly less in the EBVS arm (59.57 ± 3.71 vs 90.95 ± 5.73 min, P < 0.001; 87.76 ± 25.48 vs 152.63 ± 60.90 mL; P < 0.001, respectively). The change in hemoglobin and hematocrit values was found to be more significant in the HS group. Conclusion:, EBVS was found to be less time-consuming and caused less bleeding when compared with HS. [source] Linear Ablation with Duty-Cycled Radiofrequency Energy at the Cavotricuspid IsthmusPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 4 2010STEFANIE BOLL Background: Multielectrode catheters using duty-cycled radiofrequency (RF) have been developed to treat atrial fibrillation (AF). Many of these patients also have atrial flutter. Therefore, a linear multielectrode has been developed using the same RF energy. Objective: The concept and acute results of linear ablation using duty-cycled RF were tested in the cavotricuspid isthmus (CTI). Methods: The CTI was targeted in 75 patients, in 68 (90%) among them as an adjunct to AF ablation with the same technology. A linear electrode catheter with a 4-mm tip and five 2-mm ring electrodes was connected to a generator titrating duty-cycled RF at 20,45 W up to a target temperature of 70°C in 1:1 unipolar/bipolar mode. Results: During a mean procedure time of 20 ± 12 minutes, complete CTI block was achieved by 4 ± 3 applications of duty-cycled RF in 69 (92%) patients. No more than three RF applications were necessary in 60% of patients. During the initial learning curve, standard RF had to be used in five (7%) patients. Complete block was not achieved in one patient with frequent episodes of AF. Char was observed in five (7%) patients with poor electrode cooling; consequently, the temperature ramp-up was slowed and manually turned off in the event of low-power delivery. Two groin hematomas occurred; otherwise, no clinical complications were observed. Conclusion: Multielectrode catheters delivering duty-cycled RF can effectively ablate the CTI with few RF applications with promising acute results. Further modifications are necessary to improve catheter steering and prevent char formation. (PACE 2010; 444,450) [source] Robot-assisted laparoscopic adrenalectomy: preliminary UK resultsBJU INTERNATIONAL, Issue 3 2004S. Undre Authors from London describe the early results from the UK in the use of robot-assisted laparoscopic adrenalectomy. In a small group of patients they found that patients could be treated early, with early discharge from hospital. The use of retrograde balloon dilatation of PUJ obstruction is revisited by authors from Plymouth, who review their 10 years of experience with this technique. They found that the procedure gave good symptomatic relief in 76% of their patients, but found no relationship between symptom relief and renographic improvement. In a few patients with a long-term follow-up there was symptomatic improvement and good maintenance of split renal function. OBJECTIVE To describe the results of our first two cases of laparoscopic adrenalectomy using the da VinciTM surgical system (Intuitive Surgical, Inc., Mountain View, CA, USA). PATIENTS AND METHODS Amongst 75 robot-assisted procedures performed at our institution, two patients underwent robot-assisted laparoscopic adrenalectomy. The set-up time, procedure time, hospital stay, complications and outcomes were recorded. RESULTS Both operations were completed successfully using the robot; the mean (range) set-up time was 31 (25,37) min and mean procedure time 118.5 (107,130) min. One patient had a postoperative pulmonary embolus and was discharged 5 days after surgery; the second patient was discharged after 3 days. There were no intraoperative complications; both patients were well at the 1-year follow-up CONCLUSIONS Robot-assisted laparoscopic adrenalectomy is technically feasible and can be conducted efficiently and safely with the da Vinci surgical system. [source] | ||||||||||