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$175.00

 

Surgical Technology International XXIV contains 48 articles with color illustrations.

 

 

San Francisco, March, 2014

ISBN: 1-890131-20-2

 

1 year Institutional Subscription 

both electronic and print versions.

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Surgical Overview

 

Karl Storz
  • Karl Storz Karl Storz

 

 

 

 

 

 

Face Validation of a Portable Ergonomic Laparoscopy Skills Simulator for Single-incision Laparoscopic Surgery Training

Dong J. Xiao, MD, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands, Armagan Albayrak, PhD, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands, Sonja N. Buzink, PhD, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, the Netherlands, Jack J. Jakimowicz, PhD, Internal Auditor, Department of Research and Education, Catharina Hospital Eindhoven, Eindhoven, the Netherlands, Richard H.M. Goossens, PhD, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, the Netherland

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PMID: 24526423

Abstract

In recent years, many efforts have been made to reduce the trauma of surgical access further by the use of single-incision laparoscopic surgery (SILS). The Ergo-Lap (ergonomic laparoscopic) simulator was taken to the 20th International Congress of the European Association for Endoscopic Surgery (EAES) in 2012 in Brussels, Belgium. During the congress, the simulator was assessed by 13 general surgeons with different SILS experience using a standardized questionnaire to determine the usability of the Ergo-Lap simulator training for basic SILS skills. Eleven of the 13 participants rated the simulator as an attractive simulator (attractive here means arousing interest of the trainees). For the aspects of training in an ergonomic way, 12 of 13 participants rated it as good to excellent because the work space and task panel location can be adjusted according to the length of instruments. Also, 92% (12 of 13) thought the Ergo-Lap simulator was useful for practicing basic SPLS skills. And 85% (11 of 13) thought it was very easy to use. For SILS skills training, this inexpensive and portable Ergo-Lap simulator offers a feasible training opportunity to help trainees practice their SILS skills under ergonomic conditions.

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Teleflex
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Laparoscopic Port Closure

Emad Mikhail, MD, Assistant Professor, Division of General Obstetrics and Gynecology, Department of Obstetrics and Gynecology , University of South Florida Morsani College of Medicine, Tampa, Florida, Stuart Hart, MD, FACOG, FACS, Director, Tampa Bay Research and Innovation Center (TBRIC), Director, USF Center for the Advancement of Minimally-Invasive Pelvic Surgery (CAMPS) , Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology , USF Health Center for Advanced Medical Learning and Simulation (CAMLS), University of South Florida Morsani College of Medicine, Tampa, Florida

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PMID: 24700212

Abstract

Formation of a post-operative trocar site hernia (TSH) is a serious complication of laparoscopic surgery with an incidence of 1.5%–1.8%, and may necessitate emergent surgical correction in the case of bowel strangulation. Many contributing factors increase the risk of this complication, and various surgical devices have been developed to help prevent post-operative TSH formation. Bladeless trocars with radially expanding technology have been shown to decrease the incidence of post-operative TSH. Various port site closure devices are also available on the market, which assist in closing the fascia, thus decreasing the risk of this complication. In this article, we will review the use of these devices and their potential to reduce post-operative TSH formation.

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Vesicourethral Anastomosis Using Novel Telesurgical System with Haptic Sensation, the Telelap Alf-X: A Pilot Study
Stefano Gidaro, MD, Assistant Professor, Department of Surgical Science, Università G.D’Annunzio Cheti-Pescara, Chieti-Pescara, Italy, Emanuela Altobelli, MD, Resident, Department of Urology, Campus Biomedico, University of Rome, Rome, Italy, Cristina Falavolti, MD, Resident, Department of Urology, University of Rome, Rome, Italy, Alfredo Maria Bove, MD, Resident, Department of Urology , Campus Biomedico, University of Rome, Rome, Italy, Emilio Morales Ruiz, Eng, Director, ALF-X Robotic Department, Sofar S.p.A., Trezzano Rosa, Italy, Michael Stark, MD, President, New European Surgical Academy , Berlin, Germany, Giuliano Ravasio, VD, Research Fellow, Department of Veterinary Science and Public Health, Milan, Italy, Sara Simona Lazzaretti, VD, PhD, Research Fellow, Department of Veterinary Science and Public Health, Milan, Italy, Buscarini, Maurizio, MD, PhD, Associate Professor, Department of Urology, Campus Biomedico, University of Rome, Rome, Italy

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PMID: 24706079

Abstract

Vesicourethral anastomosis is a necessary part of radical prostatectomy and presents technical challenges when performed endoscopically. This study demonstrates the feasibility of the van Velthoven anastomosis method in swine model using a novel telesurgical system with haptic sensation: the Telelap Alf-X. Twenty vesicourethral anastomoses were performed using the system in female swine with two working ports and a camera. With two 2.0 Vicryl, a single knot vesicourethral anastomosis was performed as described by van Velthoven with Telelap Alf-X. The time of each operation was recorded, water tightness and tension were examined at the end of the procedure by irrigation through a 12 Fr catheter. The 1:1 haptic sensation, improved ergonomy, the open architecture of the robotic system, and articulated handles contributed to the easiness of performance and short learning curve, as the time of the procedure decreased by 50% after the first 5 cases. All the anastomoses were functional and proved to be successful and watertight. No leakage occurred. The novel features of the Telelap Alf-X contribute to its ease of use and make the telesurgical performance of vesicourethral anastomosis similar to open surgery, without the disadvantages of the latter.

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Evidence of the Effect of Immunonutrition on the Prevention of Surgical Site Infection

Jaime Ruiz-Tovar, MD, PhD, Department of Surgery , General University Hospital Elche, Alicante, Spain, José Gregorio Ruiz García, MD, Department of Surgery, National Obesity Center, Mexico City, Mexico

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PMID: 24526428

Abstract

Surgical candidates are often immunosuppressed patients. Immunodeficiency associated with malnutrition are risk factors for developing postoperative SSI. The term “immunonutrition” refers to the addition of omega-3 fatty acids, glutamine and arginine to liquid nutritional supplements. Diverse studies have shown a reduction in septic complications after perioperative use of immunonutrition, but these results could not be confirmed by other authors. In this issue, we will review the actual evidence about the effect of immunonutrition on the prevention of SSI.

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Biomechanical Features of  Bidirectional-barbed Suture: A Randomized Laboratory Analysis
Maria Antonietta Castaldi, MD, Research Fellow, Department of the Woman, the Child, and General and Specialized Surgery, Second University of Naples, Naples, Italy, This author contributed equally to the article., Luigi Cobellis, MD, PhD, Professor of Obstetrics and Gynecology, Department of the Woman, the Child, and General and Specialized Surgery, Second University of Naples, Naples, Italy, This author contributed equally to the article., Fernando Fraternali, MD, PhD, Professor of Civil Engineering, Department of Civil Engineering, Laboratory of Biomechanics, University of Salerno, Salerno, Italy, Mario Ardovino, MD, Consultant Gynecologist, Department of the Woman, the Child, and General and Specialized Surgery, Second University of Naples, Naples, Italy, Italo Ardovino, MD, Chief of Department, Department of the Woman and the Child, Operative Unit of Obstetrics and Gynaecology, A.O.R.N. S.G. Moscati, Avellino, Italy, Nicola Colacurci, MD, PhD, Professor of Obstetrics and Gynecology, Department of the Woman, the Child, and General and Specialized Surgery, Second University of Naples, Naples, Italy

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PMID: 24700213

Abstract

The aim of the current prospective study was to evaluate the biomechanical stability of barbed suture vs. conventional suture. Biomechanical stability of a 14x14-cm PDO/polydioxanone, with a half circle and 36-mm needle, bidirectional barbed 0-Quill suture (Angiotech, Vancouver, British Columbia, Canada) vs. 1-Poliglecaprone 25 (Monocryl, Ethicon, Inc, Somerville, NJ) suture was evaluated on biological specimens. The 1-Monocryl suture was chosen because it is widely used by gynecological surgeons in the repair either of the vaginal cuff or the uterine wall defects. Forty specimens of aponeurotic muscle, obtained from abdominal wall of a lamb, were prepared, and randomly assigned to 1 of 2 repair groups: Group A (n = 20) classic repair with 1-Monocryl suture; Group B (n = 20) 0-Quill barbed suture. Each specimen was transected at the midpoint and then repaired. Biomechanical stability of the repaired specimen was verified on a CMT6000 electromechanical universal testing machine (SANS, MTS SYSTEMS, China Co., Ltd., Shenzhen, China), with a 1kN cell. Biomechanical tests showed that maximum force was similar for 1-Monocryl and 0-Quill respectively (p = non-significant). This randomized laboratory study shows that biomechanical stability of the sutures is comparable.

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