Thickness of Cadaveric Human Lung Tissue.

Background: Choosing the correct surgical staple height is dependent on knowledge of specific tissue thickness and compressibility. The purpose of this study was to measure the thickness of cadaveric human lung tissue.

Materials And Methods: Between December 2012 and February 2013, whole lungs were procured from 12 donors.

A Narrative of Intraoperative Staple Line Leaks and Bleeds During Bariatric Surgery.

The primary objective of this review was to assess the incidence of intraoperative staple line leaks and bleeds during laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). A literature search of MEDLINE®, EMBASE™, and Biosis from January 2010 to November 2014, plus secondary citations extending to 2008, identified 16 relevant articles. For LSG, the incidence of intraoperative leaks and bleeds was as high as 3.

Gastrectomy and D2 Lymphadenectomy for Gastric Cancer: A Meta-Analysis Comparing the Harmonic Scalpel to Conventional Techniques.

The ultrasonic Harmonic scalpel has demonstrated clinical and surgical benefits in dissection and coagulation. To evaluate its use in gastrectomy, we conducted a systematic review and meta-analysis of randomized controlled trials comparing the Harmonic scalpel to conventional techniques in gastrectomy for patients with gastric cancer. International databases were searched without language restrictions for comparisons in open or laparoscopic gastrectomy and lymphadenectomy.

Surgical stapling device-tissue interactions: what surgeons need to know to improve patient outcomes.

The introduction of both new surgical devices and reengineered existing devices leads to modifications in the way traditional tasks are carried out and allows for the development of new surgical techniques. Each new device has benefits and limitations in regards to tissue interactions that, if known, allow for optimal use. However, most surgeons are unaware of these attributes and, therefore, new device introduction creates a "knowledge gap" that is potentially dangerous.

Device-tissue interactions: a collaborative communications system.

Medical devices, including surgical staplers, energy-based devices, and access enabling devices, are used routinely today in the majority of surgical procedures. Although these technically advanced devices have proved to be of immense benefit to both surgeons and patients, their rapid development and continuous improvement have had the unintended consequence of creating a knowledge gap for surgeons due to a lack of adequate training and educational programs. Thus, there is an unmet need in the surgical community to collect existing data on device-tissue interactions and subsequently develop research and educational programs to fill this gap in surgical training.

Costs and clinical outcomes of conventional single port and micro-laparoscopic cholecystectomy.

Background And Objective: This study compares hospital costs and clinical outcomes for conventional laparoscopic, single-port, and mini-laparoscopic cholecystectomy from US hospitals.

Methods: Eligible patients were aged ≥18 years and undergoing laparoscopic cholecystectomy with records in the Premier Hospital Database from 2009 through the second quarter of 2010. Patients were categorized into 3 groups-conventional laparoscopic, single port, or mini-laparoscopic-based on the International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes and hospital charge descriptions for surgical tools used.

Electromagnetic energy sources in surgery.

The biophysics, mechanism of actions, applications, benefits and complications of electromagnetic (EM) energy-based surgical instruments, and their current use are reviewed. Understanding the mechanism of action, tissue effects, and appropriate applications of EM devices is critical to achieving an optimal surgical outcome. Although a more diverse range of EM devices are used in human medicine, current use in veterinary medicine is limited to conventional electrosurgery and CO(2) lasers.

Website navigation and surgical education.

We evaluated the way in which medical students interacted with a surgical education Website. Ten medical students on their paediatric surgery rotation were asked to study online a chapter on intussusception in young children, for a period of 1 h. The computer was connected by video link to a video-recorder that recorded their navigation movements, i.

Effects of pneumoperitoneum on hemodynamic and systemic immunologic responses to peritonitis in pigs.

Background: Experimental evidence supporting the safety of laparoscopic intervention during sepsis is limited. The purpose of this study was to evaluate the effects of pneumoperitoneum on immunologic and hemodynamic responses to peritoneal sepsis.

Materials And Methods: A porcine model of peritonitis was created using an intraperitoneal autologous fecal inoculum.

A canine model of gastroesophageal reflux disease (GERD).

Background: Although a variety of antireflux procedures and medications are used to treat gastroesophageal reflux disease (GERD), reliable large-animal models of GERD that can be used to objectively compare the efficacy of these treatments are lacking.

Methods: Esophageal manometry and 24-h gastroesophageal pH monitoring with event data were performed in 18 mongrel dogs with a cervical esophagopexy. We then calculated a modified DeMeester score: The Duke Canine reflux score (DCR).

Unusual complications following laparoscopic Nissen fundoplication.

Laparoscopic Nissen fundoplication is commonly used to treat medically refractory gastroesophageal reflux disease. The most frequent severe complications following laparoscopic Nissen fundoplication are pneumothorax, gastroesophageal leak, and splenic injury. Prompt recognition and treatment of complications are important in reducing subsequent morbidity and mortality.

Laparoscopy and the internet. A surgeon survey.

Background: The Internet has become an important new tool for the delivery and acquisition of medical information.

Methods: A 13-item questionnaire designed to collect information on the attitudes and practices of surgeons regarding the use of the Internet as a medical resource was posted on the World Wide Web and also sent via e-mail.

Results: Over a 2-month period, 459 surgeons were enrolled in this study.

Intraperitoneal immunity and pneumoperitoneum.

Background: Carbon dioxide (CO(2)) pneumoperitoneum has been implicated as a possible factor in depressed intraperitoneal immunity. Using in vitro functional assays, CO(2) has been shown to decrease the function of peritoneal macrophages harvested from insufflated mice. However, an effective in vivo assessment is lacking.

Laparoscopy and mesothelioma.

Malignant mesothelioma is a well-recognized long-term sequela of chronic asbestos exposure. Asbestos use in the United States began in the 1950s and was widespread until the mid-1970s. Although currently only 2.

Conversion factors for laparoscopic splenectomy for immune thrombocytopenic purpura.

Background: Since 1994, 27 patients at our institution have undergone laparoscopic splenectomy for immune thrombocytopenic purpura (ITP). Laparoscopic splenectomy was completed in 22 of these patients. We sought to identify factors that precluded successful laparoscopic splenectomy in the remaining 5 patients.

Laparoscopic biliary and enteric bypass.

Very few patients with a periampullary neoplasm present with resectable disease. Consequently, various operative and non-operative techniques have been developed to palliate patients with unresectable periampullary disease. Laparoscopic biliary (cholecystojejunostomy) and enteric bypass (gastrojejunostomy) are reasonable options as compared to their open counterparts for operative palliation.

Diagnostic laparoscopy outside of the operating room.

Laparoscopy is increasingly being used as a diagnostic technique to characterize intraperitoneal processes. This technique can be highly informative when applied in settings such as the intensive care unit, the emergency room, the trauma bay, and the office. Diagnostic laparoscopy is an excellent method to evaluate intraperitoneal processes and should be part of the general surgeon's armamentarium of skills.

The laparoscopic management of gastroesophageal reflux disease.

Laparoscopic fundoplication has replaced open fundoplication as the gold standard for the surgical management of patients with GERD. The improvements in technique that have led to the excellent results on long-term follow-up have broadened the indications for surgical involvement along the continuum of severity in GERD. Therefore, the importance of accurate preoperative testing for appropriate patient classification must be emphasized to all who care for these patients.

Small bowel intussusception and laparoscopy.

Adult intussusception is rare and is usually caused by a tumor serving as a lead point. Surgery is necessary to treat obstruction and rule out malignancy. However, if a benign cause (lipoma, fibroma, or Meckel's diverticulum) is suspected preoperatively, a minimally invasive surgical approach should be considered.