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Operative Field (operative + field)
Selected AbstractsDuraprep and the risk of fire during tracheostomyHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2006Stephen M. Weber MD Abstract Background. DuraPrep is a widely used, alcohol-based surgical prep solution. The risk of surgical fire associated with incomplete drying of this agent in the context of electrosurgical procedures has been described previously. To date, there have been no reports of fire during tracheostomy associated with a flammable prep agent before entering the airway. We describe an operating room fire occurring during awake tracheostomy associated with the use of DuraPrep. Methods. A 62-year-old man with copious body hair underwent tracheostomy in the operating room. The neck was prepared with DuraPrep surgical solution, and after at least 3 minutes, the operative field was draped. Activation of electrocautery ignited a fire, and the patient was burned on his neck and shoulders. Results. The fire was extinguished, and the patient recovered from both the tracheostomy and the burns. Conclusion. This case illustrates that DuraPrep should be avoided in the hirsute patient, because body hair interferes with drying of this solution and increases the risk of fire. © 2006 Wiley Periodicals, Inc. Head Neck, 2006 [source] Restoration of Extensive Erosion Areas Using an Indirect Composite TechniqueJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 1 2000JAMES S. KNIGHT DDS ABSTRACT Cervical erosion defects, particularly those of extensive size that are located in an area where control of the operative field is difficult, can present a significant restorative challenge. This article describes an indirect restorative technique to solve this problem. Following tooth preparation, an indirect restoration is luted to the tooth and the margins are finished and polished. Using an indirect technique minimizes operative field isolation time and the total chairside time required to restore the tooth. Clinical cases are presented to illustrate this technique. CLINICAL SIGNIFICANCE An indirect composite restoration provides a useful treatment option when restoring extensive erosion defects in areas of difficult access. [source] Indigenous and austere technique of self-retaining abdominal retraction for facilitating surgical exposureJOURNAL OF SURGICAL ONCOLOGY, Issue 5 2006Sajid S. Qureshi MS Abstract Adequate exposure is of paramount importance in major abdominal surgeries. This is achieved by appropriately placed incision, proper position of the patients, and judicious use of retractors. A third assistant is usually required for retaining the retractors. Self-retaining retractors have also been utilized for assisting in adequate exposure of the operative field. However, these retractors are complex and unwieldy, causing hindrance in the movement of the surgeon. We describe a technique of self-retaining abdominal retraction that is simple and also obviates the need for an additional assistant. J. Surg. Oncol. 2006;93:420,421. © 2006 Wiley-Liss, Inc. [source] Transoral Robotic Surgery: Supraglottic Laryngectomy in a Canine Model,THE LARYNGOSCOPE, Issue 7 2005Gregory S. Weinstein MD Abstract Objectives/Hypothesis: To develop a technique for computer enhanced robotic transoral supraglottic partial laryngectomy in the canine model. Study Design: Surgical procedure on the larynx in a canine model with a commercially available surgical robot. Methods: With use of the da Vinci Surgical Robot (Intuitive Surgical, Inc., Sunnyvale, CA), the supraglottic partial laryngectomy was performed on a mongrel dog that had been orotracheally intubated using general anesthesia. The videoscope and the 8 mm end-effectors of the robotic system were introduced through three ports, transorally. The surgical procedure was performed remotely from the robotic system console. The procedure was documented with still and video photography. Results: Supraglottic partial laryngectomy was successfully performed using the da Vinci Surgical Robot, with 8 mm instrumentation. The robotic system allowed for celerity and accuracy secondary to findings specific to the surgical approach, including excellent hemostasis, superb visualization of the operative field with expeditious identification of laryngeal submucosal soft tissue and skeletal landmarks, and multiplanar transection of tissues. In addition, the use of the robotic system also was found to have technical advantages inherent in robotic surgery, including the use of "wristed" instrumentation, tremor abolition, motion scaling, and three-dimensional vision. Conclusions: The da Vinci Surgical Robot allowed for successful robotic transoral supraglottic partial laryngectomy in the canine model. [source] Magnification devices for endodontic therapyAUSTRALIAN DENTAL JOURNAL, Issue 4 2009M Del Fabbro Background:, After the introduction of microsurgical principles in endodontics, involving new techniques for root canal treatment, there has been a continuous search for enhancing the visualization of the surgical field. It would be interesting to know if the technical advantages for the operator brought in by magnification devices like surgical microscope, endoscope and magnifying loupes, are also associated with advantages for the patient, in terms of improvement of clinical and radiographic outcomes. Objectives:, The purpose of this systematic review was to evaluate and compare the effects of endodontic treatment performed with the aid of magnification devices versus endodontic treatment without magnification devices. We also aimed at comparing among them the different magnification devices used in endodontics (microscope, endoscope, magnifying loupes). Search strategy:, The Cochrane Oral Health Group Trials Register, CENTRAL, MEDLINE and EMBASE were searched with appropriate search strategies. Handsearching included nine dental journals. The bibliographies of relevant clinical trials and relevant articles were checked for identifying studies outside the handsearched journals. Seven manufacturers of instruments in the field of endodontics and/or endodontic surgery, as well as the authors of the identified randomized controlled trials (RCTs) were contacted in order to identify unpublished or ongoing RCTs. There were no language restrictions. The last electronic search was conducted on 2nd April 2009, and the last handsearching was undertaken on 31st January 2009. Selection criteria:, All randomized and quasi-randomized trials comparing endodontic therapy performed with or without using one or more types of magnification device, as well as randomized and quasi-randomized trials comparing two or more magnification devices used as an adjunct to endodontic therapy were considered. Data collection and analysis:, Screening of studies and data extraction were conducted independently and in duplicate. The Cochrane Collaboration statistical guidelines were to be followed for data synthesis. Main results:, No trial could be included in the present review. All of the prospective trials that were identified, all dealing with endodontic surgery, had to be excluded for various reasons. Only one RCT was identified comparing three magnificators (magnifying loupes, surgical microscope, endoscope) in endodontic surgery. No RCT was found that compared the outcome of endodontic therapy using or without using a given magnification device. Authors' conclusions:, No objective conclusion can be drawn from the results of this review as no article was identified in the current literature that satisfied the criteria for inclusion. It is unknown if and how the type of magnification device affects the treatment outcome, considering the high number of factors that may have a significant impact on the success of endodontic surgical procedure. This should be investigated by further long-term RCTs with large sample size. Technical advantages of magnificators have been widely reported in low evidence level studies, but they should be systematically addressed to know if there can be the clinical indication for using a given magnification device for specific clinical situations, such as for molar teeth, or if they can all be used interchangeably. Well-designed RCTs should also be performed to determine the true difference in terms of treatment success rates between using or not using a magnification device in both conventional and surgical endodontic treatment, if any exist. Plain language summary:, Magnification devices for endodontic therapy. There are no data to draw a sound conclusion on the effect of adopting either a microscope, an endoscope, or magnifying loupes for better visualization in endodontic therapy, in terms of clinical outcomes. Though the use of magnification devices has often been associated with technical advantages for the operator and with an improved management of the root canal due to a better visualization of the operative field, it still has to be demonstrated that their use may lead to an improved treatment success rate. More long-term well-designed randomized trials with a large sample size are urgently needed to address the issues of the present review. [source] Testicular-sparing microsurgery for suspected testicular massesBJU INTERNATIONAL, Issue 1 2005Giovanni Maria Colpi OBJECTIVE To describe a microsurgical technique for removing suspected testicular masses with sparing of the testicular parenchyma, and to describe case studies. PATIENTS AND METHODS Six men were referred with testicular lesions (3,6 mm) detected on ultrasonography (US); in one, the lesion was palpable. US showed hypoechoic lesions and in two cases were mixed hypoechoic and anechoic. In these men, the testicular lesion was identified by US before surgery, giving three-dimensional coordinates to facilitate intraoperative recognition. A traditional inguinal incision was used and the funiculus clamped subinguinally without opening the canal. The testicle was isolated after sectioning the gubernaculum testis. In a separate operative field, an equatorial incision of the albuginea was made in a plane orthogonal to the major axis of the testicle, sparing the subtunical vasa. The parenchymal lobuli were dislodged and the seminiferous tubules dissociated, the nodule identified and completely removed, together with ,,1 mm of surrounding healthy tissue. This technique can also be used for microsurgical testicular sperm extraction (MicroTESE), to retrieve sperm in infertile men. RESULTS In two infertile men MicroTESE was also performed. Histology revealed one case each of seminoma, Leydig-cell tumour, Leydig cell hyperplasia, atrophy, normality in the incidental forms, and complicated cysts of the albuginea. In the follow-up for infertility reasons, no scarring was observable on the tunica albuginea in the men who had conservative therapy. One year later the patient with seminoma was free of disease. CONCLUSIONS The increasingly frequent detection of benign testicular lesions, particularly in infertile men, calls for a surgical approach that must be as conservative as possible for the testicular parenchyma. We think that microsurgery should be the first-line technique in small suspected testicular lesions in infertile men. [source] | ||||||||||