Letteratura scientifica selezionata sul tema "Hemostasis, Surgical – Methods"
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Articoli di riviste sul tema "Hemostasis, Surgical – Methods"
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Rathod, Dr Rohit Narendra. "Hemostasis in the Surgical Field". EAS Journal of Medicine and Surgery 4, n. 10 (16 novembre 2022): 211–14. http://dx.doi.org/10.36349/easjms.2022.v04i10.003.
Testo completoAbstract (sommario):
Hemostatic mechanisms are an integral a part of the human physiology. Traditionally divided into intrinsic and extrinsic arms, the coagulation cascade converges, through the interactions of the many various factors, at a standard element—thrombin. As a consequence, variety of various agents is developed to supplement this common, critical step to assist surgical hemostasis. Intraoperative interventions most ordinarily include sutures and heat-generating cautery devices; however, these methods are sometimes insufficient or inappropriate for a selected procedure or anatomic location, resulting in the event of other adjunctive therapies, including topical hemostats. Topical hemostatic agents generally act as active, passive, and combinations therapies, counting on their individual composition and mode of action. We offer a quick review of the traditional coagulation cascade, including critical points, followed by a discussion of surgical strategies and adjuctive therapies want to achieve surgical hemostasis and concluding with a discussion of topical thrombins.
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Zavhorodnii, S. M., O. V. Kapshytar, O. I. Kotenko, O. O. Kapshytar e M. B. Danyliuk. "The results of endoscopic and surgical methods of hemostasis in persons of elderly and senile age with acute gastrointestinal bleeding caused by an ulcer". Zaporozhye Medical Journal 24, n. 4 (1 agosto 2022): 402–7. http://dx.doi.org/10.14739/2310-1210.2022.4.245872.
Testo completoAbstract (sommario):
The aim of the study. To define the number of acute gastrointestinal bleeding cases due to ulcer and to analyze the results of endoscopic and surgical methods of hemostasis in elderly and senile patients. Materials and methods. In total, 463 patients with acute gastrointestinal bleeding (AGIB) due to ulcer were treated between 2019 and 2020. There were 323 persons over 60 years of age (69.8 %). A risk for bleeding was identify according to the Forrest Classification (2006). Local hemostasis was performed in 68 (21.1 %) patients over 60 years of age. Results. Group A (n = 32; 47.1 %) was represented by patients who underwent endoscopic hemostasis by diathermocoagulation, and local hemostasis was achieved. The indication was the bleeding activity: FIa in 4 (12.5 %) patients, FIb – in 14 (43.8 %), FIIa – in 1 (3.1 %), FIIb – in 6 (18.8 %) and FIIc – in 7 (21.9 %). Successful hemostasis was achieved in 24 (75 %) patients, and they were discharged. Recurrent massive AGIB was observed in 8 (25 %) patients for 2–6 days. We have identified the causes of recurrent bleeding: giant ulcers on the posterior wall of the duodenal bulb, lesser curvature and gastric cardia, active bleeding at the time of hemostasis, prehospital anticoagulants, decompensated concomitant pathology. Emergency laparotomy with variants of surgical hemostasis was performed in 6 (75 %) patients. After the operation, 5 (83.3 %) patients died (hemorrhagic shock – 2, multiple organ failure – 2, pulmonary embolism – 1). Repeated endoscopic hemostasis was performed for 2 (25 %) patients with a fatal outcome in both cases. Group B (n = 36; 52.9 %) was represented by patients with F1a stigma who failed to perform endoscopic hemostasis and underwent surgical hemostasis. 16 (44.4 %) patients died (hemorrhagic shock – 8, multiple organ failure – 5, polymorbid state – 2, pulmonary embolism – 1). Conclusions. Among patients with AGIB due to ulcer, persons over 60 years old accounted for 69.8 %, among whom local hemostasis was performed in 21.1 % with the prevalence of surgical hemostasis over endoscopic one, 52.9 % and 47.1 %, respectively. Surgical hemostasis options were traumatic, more reliable, but resulted in a high mortality rate – 44.4 %. Endoscopic hemostasis was low-traumatic, successful in 75 % of patients, non-effective in the form of massive rebleeding episodes – in 25 %, followed by surgical hemostasis, that led to the high mortality rate – 83.3 %.
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Gerlach, Rüdiger, Gerhard Marquardt, Heimo Wissing, Inge Scharrer, Andreas Raabe e Volker Seifert. "Application of recombinant activated factor VII during surgery for a giant skull base hemangiopericytoma to achieve safe hemostasis". Journal of Neurosurgery 96, n. 5 (maggio 2002): 946–48. http://dx.doi.org/10.3171/jns.2002.96.5.0946.
Testo completoAbstract (sommario):
✓ The authors report on a 64-year-old woman with a huge recurrent skull base hemangiopericytoma, in whom they encountered severe difficulty in attaining intraoperative hemostasis. Standard surgical hemostatic methods and the administration of fresh-frozen plasma and prothrombin complex concentrates failed to stop diffuse bleeding from an inoperable tumor remnant. At a critical point during the operation, the intravenous administration of recombinant activated factor VII, combined with mechanical compression, finally led to satisfactory hemostasis. The rationale for using recombinant activated factor VII in situations of uncontrolled bleeding during neurosurgical procedures is discussed, along with the literature in which the use of recombinant activated factor VII as a maneuver of last resort is reported for hemostasis in other surgical fields.
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Semichev, Ye V., A. N. Baikov, P. S. Bushlanov e G. Ts Dambayev. "COMPARATIVE ANALISYS OF HEMOSTASIS METHODS IN OPERATIONS ON SPLEEN". Bulletin of Siberian Medicine 14, n. 2 (28 aprile 2015): 91–99. http://dx.doi.org/10.20538/1682-0363-2015-2-91-99.
Testo completoAbstract (sommario):
The paper provides statistics of spleen traumas, anatomy and characters of the organ damage. The most common methods of spleen hemostasis, currently used in surgical clinics of the Russian Federation, are presented. A small historical excursus about existed methods of hemostasis is given in the paper. A comparative analysis of currently used methods, their advantages and disadvantages is carried out. Some possible criteria for an ideal method of spleen hemostasis are listed as well.
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Malkov, I. S., M. N. Nasrullaev, G. R. Zakirova e I. I. Khamzin. "Modern methods of diagnosis and treatment of acute gastrointestinal bleeding of various etiology". Kazan medical journal 97, n. 6 (15 dicembre 2016): 832–37. http://dx.doi.org/10.17750/kmj2016-832.
Testo completoAbstract (sommario):
Aim. Analysis of the treatment results in patients with gastrointestinal bleeding with the use of endoscopic and surgical methods of hemostasis.Methods. Analysis of the treatment results in 421 patients with acute gastrointestinal bleeding from the urgent surgical department of City Clinical Hospital №7 of Kazan was conducted.Results. Endoscopic methods of hemostasis in bleeding from the upper gastrointestinal tract (argon plasma coagulation, combined prolonged infiltration hemostasis with the use of 6% solution of polyglucin with mafusol, irrigation with the solution «Hemolab», ligation of the esophageal veins and Danis stent implantation) were applied to 404 patients. All patients simultaneously received conservative treatment. When using the methods of endoscopic hemostasis mentioned above in patients with bleeding from upper gastrointestinal tract the efficiency was achieved in 87.9% of cases. It was the highest when using combined endoscopic methods. Recurrent acute bleeding was diagnosed in 30 (7.1%) cases. Majority of the patients with recurrent bleeding suffered from gastric ulcer and/or duodenal ulcer (21 patients). In all 30 patients with recurrent bleeding surgical intervention with the author’s technique was performed.Conclusion. The efficacy of endoscopic methods of hemostasis in bleeding from the upper gastrointestinal tract, especially their combined use, was revealed; differentiated approach to the use of endoscopic and surgical techniques of hemostasis depending on the source of bleeding and its intensity is required.
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Tușaliu, Mihai, Raluca Băican, Tatiana Decuseară, C. Ioniţă, Andreea Nicoleta Costache, A. Coman, Loredana Ghiuzan, I. Bulescu e Vlad Andrei Budu. "Methods of hemostasis in endoscopic sinus surgery". ORL.ro 2, n. 1 (9 maggio 2016): 6–8. http://dx.doi.org/10.26416/orl.31.2.2016.127.
Testo completoAbstract (sommario):
Functional endoscopic sinus surgery gained increasing popularity among otolaryngologists in the last decades. During any endoscopic sinonasal surgery the major limiting factors are its complex anatomy and the high vascularity. Often, even a small hemorrage is sufficient to reduce visibility of the operating field. From the surgical perspective, there are novel technologies that reduce bleeding, thus, improving the visualization of the operating field. We present some methods of hemostasis used in endoscopic sinus surgery
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Alfieri, Ottavio. "Evaluation of BioFoam for Anastomotic Bleeding in Cardiovascular Surgery". AORTA 06, n. 02 (aprile 2018): 053–58. http://dx.doi.org/10.1055/s-0039-1678549.
Testo completoAbstract (sommario):
Background Hemostatic agents are increasingly used as an adjunct to standard methods of controlling anastomotic bleeding in surgical procedures. The purpose of this study was to investigate the safety and effectiveness of BioFoam Surgical Matrix used as an adjunct for anastomotic hemostasis following cardiovascular surgery. Methods A prospective, multicenter, single arm study was conducted with 75 subjects treated with BioFoam following a total of 105 elective cardiovascular surgical procedures. Time to hemostasis was recorded following a single application of BioFoam in 74 subjects. Safety evaluations included intraoperative administration of a blood product, requirement for alternative means to achieve hemostasis, and the incidence of reoperation for bleeding. Results Hemostasis within 3 minutes was achieved in 62 (84%) of the 74 subjects and within 10 minutes in 69 (93%) of these subjects. BioFoam was well tolerated. Twelve (16%) of the 75 enrolled subjects each experienced one adverse event, and 13 serious adverse events were reported in 10 (13.3%) of the subjects. None of the adverse events was considered by the Investigators to be related to BioFoam. Blood products were administered to 14 (18.6%) of the 75 subjects, banked autologous blood was given to 5 (6.6%) subjects, and 57 (75.7%) subjects required only a cell saver. Four (5.3%) of the 75 subjects required reoperation for bleeding within 24 hours of surgery. There were no observations of bleeding in any subject at discharge and no reoperation for bleeding following discharge. The mean operation time was 218.2 (±72.2) minutes. Conclusions This study demonstrates the effectiveness of BioFoam Surgical Matrix when used as an adjunct for anastomotic hemostasis following a broad range of cardiovascular surgical procedures. The safety outcomes were within the normal limits for the types of procedures performed.
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de Nucci, Germana, Raffaella Reati, Ilaria Arena, Cristina Bezzio, Massimo Devani, Cristina della Corte, Daniela Morganti et al. "Efficacy of a novel self-assembling peptide hemostatic gel as rescue therapy for refractory acute gastrointestinal bleeding". Endoscopy 52, n. 09 (21 aprile 2020): 773–79. http://dx.doi.org/10.1055/a-1145-3412.
Testo completoAbstract (sommario):
Abstract Background Acute gastrointestinal bleeding (AGIB) results in significant morbidity and mortality. Topical hemostatic products have been developed for endoscopic use to help in the management of difficult bleeding. Our aim was to demonstrate the ease of use, safety, and efficacy of PuraStat, a novel hemostat, to control AGIB. Methods We describe 77 patients (41 men) who were treated for acute upper and lower AGIB in a 2-year period. In 50 patients, bleeding occurred as a complication of a previous endoscopic procedure, predominantly endoscopic mucosal resection (EMR) and endoscopic retrograde cholangiopancreatography (ERCP); however, in the other 27 patients, it derived from peptic ulcers, angiodysplasia, cancers, and surgical anastomoses. Bleeding was spurting in 13 of the 77 patients and oozing in 64. PuraStat was used after the failure of at least two conventional hemostatic methods. Results A mean of 2.6 conventional hemostatic methods had been attempted prior to the application of PuraStat. PuraStat achieved successful hemostasis in 90.9 % of patients. In 41 patients, once hemostasis was obtained with PuraStat, endoscopists further stabilized hemostasis by using at least one additional method. Recurrence of bleeding was observed in eight patients (10.4 %). In 16 patients with intraprocedural bleeding, it was possible to complete the procedures (14 EMR, 2 ERCP) after PuraStat hemostasis. No adverse events related to PuraStat were recorded. Conclusions PuraStat is feasible, safe, and effective in controlling different types of gastrointestinal hemorrhage after failure of conventional hemostatic methods. Its application also does not hinder continuing endotherapy.
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Reuthebuch, Oliver, Lachat, Vogt, Schurr e Turina. "FloSeal®: Ein neuartiges Hämostyptikum in der peripheren Gefäßchirurgie". Vasa 29, n. 3 (1 agosto 2000): 204–6. http://dx.doi.org/10.1024/0301-1526.29.3.204.
Testo completoAbstract (sommario):
Background: Bleeding is a common and often severe side-effect in vascular surgery. The use of glue is widely accepted to achieve a dry surgical field. The application of sealant is limited when the surface is covered with blood. Aim of this study was to evaluate a new sealant (FloSeal®) in patients undergoing vascular surgery. Patients and methods: Between June 1998 and July 1999 a total of 17 patients with peripheral vascular interventions was included in this investigation. Effectiveness was measured by bleeding severity prior and after application, time to hemostasis, amount of fusion matrix necessary for hemostasis, the potential need for additional hemostatic measures, or the need for reoperations to control the bleeding. Results: In 15 out of 17 patients bleeding was controlled with FloSeal® alone, two patients required further surgical or hemostatic treatment. There were no local or systemic complications after use of this product. Conclusion: FloSeal® is an advantageous hemostatic tool.
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Shutov, S. A., K. I. Danishyan, O. V. Shcherbakova, L. A. Gorgidze, P. A. Batrov e O. S. Dimitrieva. "Transperitoneal hernioplasty in a patient with severe hemophilia A on preventive treatment with emicizumab". Pediatric Hematology/Oncology and Immunopathology 20, n. 3 (8 ottobre 2021): 116–24. http://dx.doi.org/10.24287/1726-1708-2021-20-3-116-124.
Testo completoAbstract (sommario):
Performance of surgical interventions in patients with severe hemophilia A on emicizumab requires the development of a protocol for the perioperative period management. Objective. To present the first experience of laparoscopic hernioplasty, hemostatic therapy and laboratory monitoring in a patient with severe hemophilia A on emicizumab. A transperitoneal hernioplasty was performed in a 31-year-old patient with severe hemophilia A on emicizumab. The patient received hemostatic therapy with recombinant FVIII for 5 days. Laboratory parameters (detection of FVIII via chromogenic and clotting methods, thromboelastography, determination of aPTT and FVII inhibitor titer) were monitored for 8 days. For a complete postoperative hemostasis, a significantly smaller amount of FVIII concentrate was required due to the lower frequency of administrations compared to similar surgical interventions in patients with severe hemophilia A who did not receive prophylactic therapy with emicizumab. According to thromboelastrography data, not a single episode of hypercoagulation was recorded. Emicizumab monotherapy can maintain adequate hemostasis during surgical procedures associated with a potentially low risk of perioperative bleeding in patients with hemophilia A. In other situations, the use of standard doses of FVIII concentrate concomitantly with emicizumab makes it possible to control hemostasis during postoperative period without the risk of thrombotic complications. The patient has signed a consent to the use of information, including photos, for research purposes and in publications.
Tesi sul tema "Hemostasis, Surgical – Methods"
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Souza, Maria Claudia de Campos Mello Inglez de. "Desenvolvimento e avaliação de método substitutivo para a prática da hemostasia em cadáveres quimicamente preservados". Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/10/10137/tde-07062013-102925/.
Testo completoAbstract (sommario):
O aprendizado e o ensino da cirurgia veterinária envolvem o desenvolvimento de habilidades que podem ser obtidas em laboratórios, por meio de vários modelos já disponíveis, incluindo o treinamento em cadáveres. Nestes, quando comparados aos procedimentos em animais vivos, duas limitações são notadas e frequentemente mencionadas, e referem-se às alterações de consistência dos tecidos e à ausência de sangramento durante o treinamento cirúrgico. Este trabalho foi focado na superação destas questões, por meio da realização da simulação de circulação sanguínea em cadáveres adequadamente preservados, permitindo aos usuários do sistema a possibilidade de treinamento cirúrgico em um modelo mais próximo do animal vivo, viabilizando também o aprendizado e a prática da hemostasia. Depois de desenvolvido o sistema, o mesmo foi utilizado por estudantes de Medicina Veterinária com distintos níveis de experiência, que avaliaram todo o método por meio de questionário, ressaltando também os pontos positivos e negativos observados. Concluiu-se que é possível realizar a simulação de sangramento em cadáveres quimicamente preservados, e que tal sistema foi bem aceito por quem o utilizou, sendo mais uma alternativa para melhor preparar estudantes para as experiências em animais vivos que necessitem de intervenções cirúrgicas.Veterinary surgery demands skills acquisition and refinement that can be obtained in laboratories using several available models, including training on cadavers. Those, when compared to live animal procedures, two limitations are noted and often mentioned, and are due to tissue consistency alterations and absence of bleeding during surgical training. This work was focused on overcoming these issues, by performing blood flow simulation in properly chemically preserved cadavers, giving users of this system the possibility of surgical training in a model closer to live animal, also enabling learning and practice of hemostasis. After developed the system, it was used by veterinary students with distinct experience levels, evaluating the whole method through a questionnaire, emphasizing positive and negative aspects. It was concluded that bleeding simulation in chemically preserved cadavers is possible, and that such a system was well accepted by those who used it, being an alternative to better prepare students for experiments on live animals that require surgical interventions.
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Eshkenazy, Rony. ""Perfusão hipotérmica in situ versus exclusão vascular total do fígado para ressecções hepáticas complexas"". Universidade de São Paulo, 2005. http://www.teses.usp.br/teses/disponiveis/5/5154/tde-16022006-215151/.
Testo completoAbstract (sommario):
Os resultados sobre o tempo adequado da exclusão vascular total do fígado(EVTF) para a realização de hepatectomias continuam sendo discutidos. Dados favoráveis têm sido descritos, quando se associa a EVTF com a perfusão de solução hipotérmica, porém a comparação entre estas técnicas ainda não foi descrita. Este estudo tem como objetivo comparar os resultados da ressecção hepática com EVTF, realizada sob hipotermia(solução de preservação hipotérmica in situ), com aqueles obtidos quando se realiza esta ressecção com EVTF com tempo de isquemia menor que 60 minutos, e naqueles com tempo de isquemia maior ou igual a 60 minutos. Para tanto, foram analisados, como parâmetros, a função renal e hepática, morbidade, e mortalidade pós-operatórias nos três grupos mencionados,buscando-se determinar valores preditivos para indicação das técnicas. PACIENTES E MÉTODO. Foram estudados 81 pacientes submetidos à ressecção hepática. Estes pacientes foram divididos em três grupos. Trinta e quatro pacientes com EVTF menor do que 60 minutos (EVTF < 60), 19 pacientes com EVTF maior ou igual a 60 minutos (EVTF ≥ 60), e 28 pacientes nos quais a perfusão hipotérmica in situ (EVTFHIPOT) foi realizada. Os valores das transaminases hepáticas (ASAT e ALAT), Bilirrubinas totais, creatinina, e tempo de protrombina foram registrados. Também foram verificados os índices de morbidade e de mortalidade pós-operatórias nos três grupos. RESULTADOS. O valor máximo no pós-operatório das enzimas hepáticas - ASAT e ALAT foram significativamente menores (p < 0.05) no grupo EVTFHIPOT (535 + 361 U/L e 436 + 427 U/L), quando comparados aos outros grupos - EVTF<60(988 + 798 U/L; 844 + 733 U/L), EVTF>60 (1583 + 984 U/L; 1082 + 842 U/L). No grupo EVTFHIPOT, os valores máximos das bilirrubinas (6,5 + 2,5 mg/dl),creatinina (1,2 + 0,7 mg/dl), e o número de complicações por paciente (1,2 + 1) foram semelhantes aos do grupo EVTF<60 (5,5 + 7,8; 1,3 + 1; e 0,7 + 1 respectivamente), e significativamente menores que os do grupo EVTF > 60(12,8 + 11,8; 2,3 + 2,3, e 2,3 + 1,2). A mortalidade hospitalar foi de 1/34, 2/19 e 2/28 nos grupos EVTF < 60, EVTF > 60, e EVTFHIPOT, respectivamente,sem diferença estatística. CONCLUSÕES. Quando comparadas as técnicas clássicas de exclusão vascular do fígado,de qualquer duração, com aquela na qual se realizou a perfusão hipotérmica do fígado, conclui-se que, nesta última, os pacientes toleraram melhor a isquemia. Deve-se enfatizar que, na EVTF com hipotermia, existe melhor preservação da função hepática, melhor preservação da função renal, e menores índices de morbidade, quando comparada com a EVTF>60 sem hipotermia. Os fatores preditivos de EVTF por mais de 60 minutos auxiliam na adoção da opção pelo resfriamento hepático.OBJECTIVE. To compare the results of liver resection performed under in situ hypothermic perfusion vs standard total vascular exclusion (TVE) of the liver < 60 minutes and ≥ 60 minutes in terms of liver tolerance, liver and renal functions, postoperative morbidity and mortality. SUMMARY BACGROUND DATA. The safe duration of TVE is still debated. Promising results have been reported following TVE associated with hypothermic perfusion of the liver with durations of up to several hours. The two techniques have not been compared so far. PATIENTS AND METHODS.The study population includes 81 consecutive liver resections under TVE < 60 minutes (group TVE < 60 , 34 patients), ≥ 60 minutes (group TVE ≥ 60, 19 patients) and in situ hypothermic perfusion (group TVEHYPOTH , 28 patients). Liver tolerance (peaks of transaminases), liver and kidney function (peak of bilirubin, minimum prothrombin time and peak of creatinine), morbidity and inhospital mortality were compared within the 3 groups. RESULTS. The postoperative peaks of ASAT and ALAT were significantly lower (p < 0.05) in group TVE HYPOTH (535 + 361 U/L and 436 + 427 U/L) compared to the groups TVE<60 (988 + 798 U/L; 844 + 733 U/L) and TVE≥60 (1583 + 984 U/L; 1082 + 842 U/L). In the group TVE HYPOTH , the peaks of bilirubin (6,5 + 2,5 mg/dl), creatinine (1,2 + 0,7 mg/dl), and the number of complications per patient (1,2 + 1) were comparable to those of the group TVE<60 (5,5 + 7,8; 1,3 + 1; e 0,7 + 1 respectively) and significantly lower to those of the group TVE≥60 (12,8 + 11,8; 2,3 + 2,3, e 2,3 + 1,2). In hospital mortality rates were 1/34, 2/19 and 2/28 for the groups TVE < 60 , TVE ≥ 60 , and TVEHYPOTH respectively and were comparable. On multivariate analysis, the size of the tumor, portal vein embolization and a planned vascular reconstruction werem significantly predictive of TVE ≥ 60 minutes. CONCLUSIONS. Compared to standard TVE of any duration, hypothermic perfusion of the liver is associated with a better tolerance to ischemia. In addition, compared to TVE ≥ 60 minutes, it is associated with better postoperative liver and renal functions, and a lower morbidity. Predictive factors for TVE ≥ 60 minutes may help to indicate hypothermic perfusion of the liver.
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Daniel, Steven A. School of Medicine UNSW. "Pre-coagulation of solid organs". 2007. http://handle.unsw.edu.au/1959.4/40723.
Testo completoAbstract (sommario):
Coagulation has and continues to be one of the most important elements in medicine. Issues from a lack of hemostasis range from poorer clinical outcomes to sudden death. The evolution of treatments for hemostasis have evolved from the use of Tamponade with direct pressure and bandages, the use of materials such as cobwebs and dust, the use of heat with hot oil or heated irons, to the use of suture, glues, plasmas, staplers, and electricity. This evolution has continued to bring about the prophylactic use of technology in an effort to prevent blood loss. This change from reactive treatments to proactive continue to be on a localized or superficial basis. One of the largest opportunities to proactively reduce blood loss in surgical patients is during the resection of solid organs such as the liver, kidney, and spleen. Few options have existed to help improve hemostasis short of the complete occlusion of blood supplying the tissue such as in the Pringle Maneuver. Recent studies have begun to show that practices such as this may have a significant detrimental effect on morbidity. It has been found that by applying radio frequency electrical energy in a particular way that large amounts of tissue can be pre-coagulated prior to resection. A series of animal and human clinical work has been completed to help evolve and confirm the method and the device that was created and refined during this effort. During the course of this work fifty-three patients were treated at four institutions on three continents. Average blood loss for liver resections performed with this pre-coagulation technique using the developed device in a multicenter control trail was 3.35 ml/cm2 as compared to 6.09 ml/cm2 (p < 0.05) for resections performed using standard surgical techniques alone. Additionally, the transection time necessary was also reduced from mean value of 27 minutes (2 -- 219 minutes) to 35 minutes (5 -- 65 minutes). Patients treated included those suffering from liver cirrhosis, fatty liver disease, and post chemotherapy fibrosis. From this work the use of pre-coagulation with methods and device developed was shown to be safe and effective for reducing the amount of blood loss and transection time during liver resections.
Libri sul tema "Hemostasis, Surgical – Methods"
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Carlo, Isidoro Di. Open, Laparoscopic and Robotic Hepatic Transection: Tools and Methods. Springer, 2012.
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Carlo, Isidoro Di. Open, Laparoscopic and Robotic Hepatic Transection: Tools and Methods. Springer London, Limited, 2012.
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Carlo, Isidoro Di. Open, Laparoscopic and Robotic Hepatic Transection: Tools and Methods. Springer Milan, 2016.
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(Editor), Nadey S. Hakim, e Ruben Canelo (Editor), a cura di. Haemostasis in Surgery. Imperial College Press, 2007.
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Roque, Pifarré, a cura di. Anticoagulation, hemostasis, and blood preservation in cardiovascular surgery. Philadelphia: Hanley & Belfus, 1993.
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Open Laparoscopic and Robotic Hepatic Transection. Springer, 2012.
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Feil, Wolfgang M. D., Michel, M.D., Ph.D. Degueldre, Dietrich M. D. Lohlein, Bernhard M. D. Dallemagne, Minna, M.D., Ph.D. Kauko e Bruno M. D. Walther. Ultrasonic Energy For Cutting, Coagulating, And Dissecting. Thieme Medical Publishers, 2004.
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Guerron, A. Daniel, John H. Rodriguez e Matthew Kroh. Endoscopic Management of Complications. A cura di Tomasz Rogula, Philip Schauer e Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0026.
Testo completoAbstract (sommario):
Bariatric surgery has been proven to be safe and durable for treatment of obesity and obesity-related diseases. Although complication rates continue to decrease, complications occur and may impart significant morbidity. Treatment of complications often includes combinations of medical therapies and surgical or endoscopic interventions. Endoscopic techniques to treat complications of bariatric surgery have evolved, with improved tools and devices, as well as increased experience and expertise. Methods of dilation, hemostasis, suturing, clip placement, stenting, and feeding tube placement have given practitioners less-invasive ways to treat complications and also to provide durable enteral access. In patients with high reoperative complexity, endoscopic access may circumvent the abnormal pathology, with a less-invasive route. This chapter focuses on endoluminal management of common complications of bariatric surgery, including techniques employed and outcomes.
Capitoli di libri sul tema "Hemostasis, Surgical – Methods"
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Choudhury, Dhiraj. "Methods of Hemostasis in Surgery". In General Surgical Operations, 9. Jaypee Brothers Medical Publishers (P) Ltd., 2017. http://dx.doi.org/10.5005/jp/books/12957_4.
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Choudhury, Dhiraj. "Methods of Hemostasis in Surgery". In General Surgical Operations, 9. Jaypee Brothers Medical Publishers (P) Ltd., 2008. http://dx.doi.org/10.5005/jp/books/10324_4.
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Z. Safeer, Laraib, Saira Agarwala, Andrew C. Krakowski e Ryan P. Johnson. "The Role of Biosurgical Agents in Dermatologic Surgery". In Contemporary Applications of Biologic Hemostatic Agents across Surgical Specialties - Volume 2 [Working Title]. IntechOpen, 2021. http://dx.doi.org/10.5772/intechopen.96081.
Testo completoAbstract (sommario):
Performed in an outpatient, office-based setting, dermatologic surgery reduces healthcare costs of hospitalization while maintaining low rates of surgical complications such as infection, dehiscence, and hematoma formation. However, the potential for complications requiring hospitalization or IV antibiotic therapy still exists and varies depending on patient risk factors, such as the use of antiplatelet and anticoagulant medications. Furthermore, measured outcomes in dermatologic surgery expand beyond surgical wound complications to include optimization of wound healing and reduction of scar formation, especially in cosmetically sensitive areas of the body. Biosurgical agents are increasingly being used in surgical fields to achieve hemostasis and to optimize wound healing. This chapter reviews the typical methods to achieve hemostasis in dermatologic surgery and examines the current and future role of biosurgical agents in procedural dermatology.
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Henderson, Reney A. "Hemostasis, Thrombosis, Transfusion, and Blood Conservation". In Vascular Anesthesia Procedures, 23–40. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197506073.003.0003.
Testo completoAbstract (sommario):
In vascular surgical procedures, there is a balance of anticoagulation and coagulation that must take place for a successful surgery. This chapter reviews goals in coagulation and hemostasis in vascular surgery. For vascular surgery, patients must be anticoagulated to inhibit occlusion and thrombosis of vasculature. Once the procedure is completed, anticoagulation must be reversed to obtain hemostasis. The method to regain hemostasis varies and can be by the administration of reversal agents, hemostatic agents, or allogenic blood products. This process can sometimes be simplified by using thromboelastography as a guide for treatment. This chapter also touches on blood conservation (cell salvaging techniques) and the use of alternative blood products.
Atti di convegni sul tema "Hemostasis, Surgical – Methods"
1
Yang, Che-Hao, Maher Amer, Wei Li e Roland K. Chen. "A New Concept of Electrosurgical Tissue Joining Process Using Sequential Compression for Minimal Thermal Damage". In ASME 2019 14th International Manufacturing Science and Engineering Conference. American Society of Mechanical Engineers, 2019. http://dx.doi.org/10.1115/msec2019-2946.
Testo completoAbstract (sommario):
Abstract Minimally invasive surgery is a popular surgical method which allows surgeons to be able to employ small incisions to perform surgical procedures. Electrosurgical tissue joining is one method used in minimally invasive surgery to achieve hemostasis. The two major issues need to be concerned are the quality of the tissue joint and the potential thermal damage to the surrounding tissues. In this study, a new sequential compression concept was introduced. This concept uses a pair of smaller electrodes to sequentially compress and join multiple locations across the tissue to form a joint. Due to the smaller area of the electrode surface, a higher compression level can be achieved with a smaller compressive force. In this study, different joining times including 1.5, 1.6, 1.7, 1.9, 2.1 seconds with a 98% compression ratio were used to join porcine arterial tissue. In each test, three locations were sequentially compressed and joined. The resulting tensile strength, specific strength, energy consumption, and thermal dose from the sequential compression method were compared with those resulting from the nonsequential single compression method. For the 1.9-second joining time, the specific strength is 2.5 times higher than the highest specific strength achieved by the single joining method, meaning that only 40% of energy is needed to achieve an equivalent joint strength. A finite element model was built to estimate the temperature and thermal dose during the sequential joining process and also confirmed that the resulting thermal dose is much lower than the single joining method. The results validated that the sequential compression concept has the potential to minimize the thermal damage during the tissue joining process.
2
Yang, Che-Hao, Samantha Kaonis, Roland K. Chen e Wei Li. "Measurement of Tissue Thermal Conductivity With Variable Thermal Dose During an Electrosurgical Joining Process". In ASME 2017 12th International Manufacturing Science and Engineering Conference collocated with the JSME/ASME 2017 6th International Conference on Materials and Processing. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/msec2017-2944.
Testo completoAbstract (sommario):
Electrosurgical vessel joining is commonly performed in surgical procedures to maintain hemostasis. This process requires elevated temperature to denature the tissue and while compression is applied, the tissue can be joined together. The elevated temperature can cause thermal damages to the surrounding tissues. In order to minimize these damages, it is critical to understand how the tissue properties change and how that affects the thermal spread. This study used porcine aorta arterial tissue to investigate tissue thermal conductivity with variable thermal dose. Seven joining times (0, 0.5, 1, 1.5, 2, 4, and 6 seconds) were used to create different amounts of thermal dose. A hybrid method that uses both experimental measurement and inverse heat transfer analysis was conducted to determine the thermal conductivity of thin tissue samples. In general, the tissue thermal conductivity decreases when thermal dose increases. Accordingly, 36% decrease in tissue thermal conductivity was found when the thermal dose reaches the threshold for second-degree burn (with 2-second joining time). When thermal dose is beyond the threshold of third-degree burn, the tissue thermal conductivity does not decrease significantly. A regression model was also developed and can be used to predict tissue thermal conductivity based on the thermal dose.
3
Yang, Che-Hao, Roland K. Chen, Scott Phillips, Josh Ramsay e Wei Li. "Experimental Study on the Electrosurgical Tissue Joining Process With Process Parameter Monitoring for Quality Control". In ASME 2018 13th International Manufacturing Science and Engineering Conference. American Society of Mechanical Engineers, 2018. http://dx.doi.org/10.1115/msec2018-6637.
Testo completoAbstract (sommario):
Electrosurgical tissue joining is an effective way to create hemostasis, especially in surgical procedures performed in the minimally-invasive manner. The quality of tissue joints and potential thermal damage to the surroundings are the two main concerns when using electrosurgical tissue joining tools. A more robust method for quality control is still needed. In this study, we developed an experimental setup to join tissues and performed tensile tests to evaluate the quality of the tissue joint, while also monitoring the process parameters including voltage, current, impedance, temperature and thermal dose. Three joining times (4, 6, and 8 seconds) and three compression levels (80%, 90%, and 95%) were used to join porcine arterial tissues. It was found that 95% compression can form a strong joint with a shorter joining time and less energy, but the joint strength decreases when the joining time is extended to 8 seconds. A lower compression level can still form a quality joint but requires longer joining time and energy which could lead to more thermal damages. A new index, specific strength (mmHg/J), which is defined as the ratio between tensile strength and the consumed energy, is proposed. Specific strength offers a new way to estimate the required joining time to achieve sufficient joining strength while minimizing the energy consumption to reduce thermal damages.