Pub Date : 2021-06-15DOI: 10.11648/J.JS.20210904.13
A. Fukui, H. Yamada, T. Yoshii
Background: Synovectomy, arthroplasty, and other surgical procedures are generally used to correct wrist joint destruction in patients with rheumatoid arthritis (RA). Methodology: We unilaterally injected 20 mg of triamcinolone acetonide and 5 mL of 1% lidocaine hydrochloride of RA patients with joints pain who refused surgery. We then evaluated the clinical benefit and safety of intra-articular triamcinolone acetonide by analyzing data on (1) the number of injections with Larsen’s grade and whether a biologic was used or not, (2) decrease in visual analog scale pain, (3) changes in carpal height ratio, radio carpal distance ratio and radial rotation angle in dorso-palmar plain X-ray imaging, and (4) the side effects of triamcinolone acetonide injection into the joints. Results: The mean number of injections per patient was less than 5 times, and sufficiently reduced or eliminated joints pain. X-ray evaluation did not reveal progress of joint destruction due to triamcinolone acetonide. No side effects of injection did not occur. Conclusions: It was found that joint injection of triamcinolone acetonide can reduce joint pain and suppress joint destruction, and it is possible that surgery will not be necessary in the future.
{"title":"Efficacy of Intra-Articular Triamcinolone Acetonide Injections for Wrist Pain in Rheumatoid Arthritis Patients: A Retrospective Study","authors":"A. Fukui, H. Yamada, T. Yoshii","doi":"10.11648/J.JS.20210904.13","DOIUrl":"https://doi.org/10.11648/J.JS.20210904.13","url":null,"abstract":"Background: Synovectomy, arthroplasty, and other surgical procedures are generally used to correct wrist joint destruction in patients with rheumatoid arthritis (RA). Methodology: We unilaterally injected 20 mg of triamcinolone acetonide and 5 mL of 1% lidocaine hydrochloride of RA patients with joints pain who refused surgery. We then evaluated the clinical benefit and safety of intra-articular triamcinolone acetonide by analyzing data on (1) the number of injections with Larsen’s grade and whether a biologic was used or not, (2) decrease in visual analog scale pain, (3) changes in carpal height ratio, radio carpal distance ratio and radial rotation angle in dorso-palmar plain X-ray imaging, and (4) the side effects of triamcinolone acetonide injection into the joints. Results: The mean number of injections per patient was less than 5 times, and sufficiently reduced or eliminated joints pain. X-ray evaluation did not reveal progress of joint destruction due to triamcinolone acetonide. No side effects of injection did not occur. Conclusions: It was found that joint injection of triamcinolone acetonide can reduce joint pain and suppress joint destruction, and it is possible that surgery will not be necessary in the future.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"9 1","pages":"159"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85351263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-15DOI: 10.11648/J.JS.20210904.12
Houssemeddine Kouki, A. Traverso, Thibaut Royon, S. Abou-Khalil
Treatment of distal tibiofibular syndesmosis injuries requires an early and accurate reduction to prevent poor outcomes. Screw fixation technique remains the gold standard for syndesmosis injuries despite the increasing popularity of suture button fixation. We report the cases of three patients with acute distal tibiofibular syndesmosis injuries treated by open reduction and internal fixation using a plate and two screws. The objective of this study was to describe a different syndesmosis fixation technique with a two holes one-third tubular plate and two screws, relate the radiologic findings and analyze the functional outcomes. Clinical and functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale. Reduction of the syndesmosis was assessed radiographically by measuring the tibiofibular clear space, tibiofibular overlap, and the medial clear space at the final follow-up. Compared to preoperative values, postoperative values were improved with this method. Our findings suggest this new technique as a safe and reliable option to consider for the treatment of acute distal tibiofibular syndesmosis injuries. The main advantage is an optimal positioning of the screws on the lateral fibular cortex in the anteroposterior plan with an ideal space between them.
{"title":"Surgical Treatment of Distal Tibiofibular Syndesmosis Injuries Using Open Reduction Internal Fixation by Plate and Screws: A Case Series and Literature Review","authors":"Houssemeddine Kouki, A. Traverso, Thibaut Royon, S. Abou-Khalil","doi":"10.11648/J.JS.20210904.12","DOIUrl":"https://doi.org/10.11648/J.JS.20210904.12","url":null,"abstract":"Treatment of distal tibiofibular syndesmosis injuries requires an early and accurate reduction to prevent poor outcomes. Screw fixation technique remains the gold standard for syndesmosis injuries despite the increasing popularity of suture button fixation. We report the cases of three patients with acute distal tibiofibular syndesmosis injuries treated by open reduction and internal fixation using a plate and two screws. The objective of this study was to describe a different syndesmosis fixation technique with a two holes one-third tubular plate and two screws, relate the radiologic findings and analyze the functional outcomes. Clinical and functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale. Reduction of the syndesmosis was assessed radiographically by measuring the tibiofibular clear space, tibiofibular overlap, and the medial clear space at the final follow-up. Compared to preoperative values, postoperative values were improved with this method. Our findings suggest this new technique as a safe and reliable option to consider for the treatment of acute distal tibiofibular syndesmosis injuries. The main advantage is an optimal positioning of the screws on the lateral fibular cortex in the anteroposterior plan with an ideal space between them.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"215 1","pages":"153"},"PeriodicalIF":0.0,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78125365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-09DOI: 10.11648/J.JS.20210904.11
Gautam Shubhankar, Ashutosh Nagpal, Gautam Anand, D. Sharma
Background: Liver abscess if left untreated can rupture into adjoining pleura, pericardium, peritoneum. Rupture into pericardium, though very rare, is a dreaded complication and worsens the prognosis. Presentation here can be nonspecific. Rupture into pericardium if associated with cardiac tamponade often requires pericardiotomy. Case information: A 16-year boy presented with epigastric pain, fever and recent onset chest discomfort. No signs of cardiac tamponade were seen on clinical examination. Investigations revealed a left lobe liver abscess rupturing into pericardium and asymptomatic pericardial effusion. Serological testing confirmed the etiology to be amebic. The condition was using pigtail catheter drainage in both the pericardial cavity and hepatic abscess. Discussion: Ruptured liver abscess occurs more commonly due to delay in diagnosis. It increases the severity of disease depending upon the site of rupture. Pericardial rupture is the most feared complication out of these. Published literature lacks reports of asymptomatic pericardial rupture of liver abscess, and management options. Available literature reports invariable requirement of surgical drainage for this entity. This report shows that lesser invasive drainage procedures can successfully resolve this dreaded complication. Conclusion: Amoebic liver abscess rupturing into pericardium can be asymptomatic. Successful management with percutaneous drainage and double pigtail catheters offers resolution and avoids morbidity associated with surgical drainage.
{"title":"Double Pigtail to Manage Pericardial Rupture of Left Lobe Liver Abscess","authors":"Gautam Shubhankar, Ashutosh Nagpal, Gautam Anand, D. Sharma","doi":"10.11648/J.JS.20210904.11","DOIUrl":"https://doi.org/10.11648/J.JS.20210904.11","url":null,"abstract":"Background: Liver abscess if left untreated can rupture into adjoining pleura, pericardium, peritoneum. Rupture into pericardium, though very rare, is a dreaded complication and worsens the prognosis. Presentation here can be nonspecific. Rupture into pericardium if associated with cardiac tamponade often requires pericardiotomy. Case information: A 16-year boy presented with epigastric pain, fever and recent onset chest discomfort. No signs of cardiac tamponade were seen on clinical examination. Investigations revealed a left lobe liver abscess rupturing into pericardium and asymptomatic pericardial effusion. Serological testing confirmed the etiology to be amebic. The condition was using pigtail catheter drainage in both the pericardial cavity and hepatic abscess. Discussion: Ruptured liver abscess occurs more commonly due to delay in diagnosis. It increases the severity of disease depending upon the site of rupture. Pericardial rupture is the most feared complication out of these. Published literature lacks reports of asymptomatic pericardial rupture of liver abscess, and management options. Available literature reports invariable requirement of surgical drainage for this entity. This report shows that lesser invasive drainage procedures can successfully resolve this dreaded complication. Conclusion: Amoebic liver abscess rupturing into pericardium can be asymptomatic. Successful management with percutaneous drainage and double pigtail catheters offers resolution and avoids morbidity associated with surgical drainage.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"75 1","pages":"149"},"PeriodicalIF":0.0,"publicationDate":"2021-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85028280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-08DOI: 10.11648/J.JS.20210903.12
Ibrahim Cherry, Tammy Sadighi, D. Franck
Introduction: A single effective therapeutic option for ear keloids has yet to be discovered. Many treatments have been studied with variable effectiveness, side effects and complications. Pressure therapy using custom molded clip is a non-invasive treatment with minimal side effects. In the present study, the recurrence rate of a treatment protocol combining excisional surgery and pressure therapy on ear keloids is being studied in a pediatric population. Materials and Methods: The charts of 22 consecutive patients treated between January 2008 and January 2019 were reviewed. All patients were under 18 years of age and clinically diagnosed with, at least, one keloid of the ear. They all underwent complete surgical excision with primary closure followed by early postoperative pressure therapy using custom molded clips. The collected data included patient age at time of diagnosis and surgery, sex, skin type, familial and personal history, etiology and anatomical location of the keloid, and recurrence. Patients or parents were interviewed by phone call and reviewed by an independent examiner to evaluate the current evolution of their scar (s). Results: 22 patients were included in the study, representing a total of 26 keloids of the ear. The male to female ratio was of 3:4. The mean age at diagnosis was 9.7 years old. The mean follow-up time was 5.2 years. Four ears needed a single corticoid injection in addition to the initial protocol. Follow-up observations showed a recurrence rate of 15.4%. Conclusion: Excisional surgery combined with pressure therapy is an effective and well-tolerated treatment for ear keloids in a pediatric population. Although residual symptoms are sometimes observed, it seems to be better tolerated than other, more invasive, therapies.
{"title":"Combination Between Surgical Excision and Pressure Therapy for Ear Keloids in a Pediatric Population: Clinical Results","authors":"Ibrahim Cherry, Tammy Sadighi, D. Franck","doi":"10.11648/J.JS.20210903.12","DOIUrl":"https://doi.org/10.11648/J.JS.20210903.12","url":null,"abstract":"Introduction: A single effective therapeutic option for ear keloids has yet to be discovered. Many treatments have been studied with variable effectiveness, side effects and complications. Pressure therapy using custom molded clip is a non-invasive treatment with minimal side effects. In the present study, the recurrence rate of a treatment protocol combining excisional surgery and pressure therapy on ear keloids is being studied in a pediatric population. Materials and Methods: The charts of 22 consecutive patients treated between January 2008 and January 2019 were reviewed. All patients were under 18 years of age and clinically diagnosed with, at least, one keloid of the ear. They all underwent complete surgical excision with primary closure followed by early postoperative pressure therapy using custom molded clips. The collected data included patient age at time of diagnosis and surgery, sex, skin type, familial and personal history, etiology and anatomical location of the keloid, and recurrence. Patients or parents were interviewed by phone call and reviewed by an independent examiner to evaluate the current evolution of their scar (s). Results: 22 patients were included in the study, representing a total of 26 keloids of the ear. The male to female ratio was of 3:4. The mean age at diagnosis was 9.7 years old. The mean follow-up time was 5.2 years. Four ears needed a single corticoid injection in addition to the initial protocol. Follow-up observations showed a recurrence rate of 15.4%. Conclusion: Excisional surgery combined with pressure therapy is an effective and well-tolerated treatment for ear keloids in a pediatric population. Although residual symptoms are sometimes observed, it seems to be better tolerated than other, more invasive, therapies.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"7 1","pages":"103"},"PeriodicalIF":0.0,"publicationDate":"2021-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78757703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-26DOI: 10.11648/J.JS.20210902.14
P. Baumann, Franz Gumpinger
This is the first prospective, single centre study assessing the clinical outcome of a new quick, absorbable, monofilament suture for skin closure in adults after general surgical interventions. In total 50 patients were included in the study to apply Monosyn Quick suture to skin closure. Suture handling was evaluated by the surgeons using a 5-point Likert scale. The Visual-Analogue-Scale (VAS) was used to rate wound healing, pain and satisfaction. Adverse events were reported up to the day of discharge. The new suture material was judged good to excellent regarding its handling properties. Patients stayed in hospital for an average of 5.46 days. Wound healing assessment by the physician was excellent [mean (range) 94.94 (50.00 – 100.00)]. Low pain level was reported by the patients (mean (SD) 23.21±18.96; [range 0.00 – 95.00]) and persisted in mean for 2.56 days [range 0.00 - 7.00 days]. High satisfaction with the skin closure was reported by patients at discharge (mean (SD) 94.25±7.89 [range 70.00 – 100.00]). No wound healing-related adverse events were observed. Our results showed, that the new quick, absorbable, monofilament suture is appropriate for dermal wound approximation in general surgery and represents a good alternative option to other suture materials which are in common use to close the skin.
{"title":"Prospective, Observational Study to Assess a New Quick Absorbable Monofilament Suture for Skin Closure in Adults","authors":"P. Baumann, Franz Gumpinger","doi":"10.11648/J.JS.20210902.14","DOIUrl":"https://doi.org/10.11648/J.JS.20210902.14","url":null,"abstract":"This is the first prospective, single centre study assessing the clinical outcome of a new quick, absorbable, monofilament suture for skin closure in adults after general surgical interventions. In total 50 patients were included in the study to apply Monosyn Quick suture to skin closure. Suture handling was evaluated by the surgeons using a 5-point Likert scale. The Visual-Analogue-Scale (VAS) was used to rate wound healing, pain and satisfaction. Adverse events were reported up to the day of discharge. The new suture material was judged good to excellent regarding its handling properties. Patients stayed in hospital for an average of 5.46 days. Wound healing assessment by the physician was excellent [mean (range) 94.94 (50.00 – 100.00)]. Low pain level was reported by the patients (mean (SD) 23.21±18.96; [range 0.00 – 95.00]) and persisted in mean for 2.56 days [range 0.00 - 7.00 days]. High satisfaction with the skin closure was reported by patients at discharge (mean (SD) 94.25±7.89 [range 70.00 – 100.00]). No wound healing-related adverse events were observed. Our results showed, that the new quick, absorbable, monofilament suture is appropriate for dermal wound approximation in general surgery and represents a good alternative option to other suture materials which are in common use to close the skin.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"45 1","pages":"63"},"PeriodicalIF":0.0,"publicationDate":"2021-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79053057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-12DOI: 10.11648/J.JS.20210902.12
Anna Katrine Nyman Rasmussen, M. Larsen, A. Ainsworth
Background: This study aims to examine if a standardized enhanced recovery program (ERP) could reduce the length of stay (LOS) after minimally invasive esophagectomy (MIO) compared to the earlier applied recovery program without increasing the risk of postoperative complications and readmissions. Methods: Retrospective study of patients with esophageal and gastroesophageal junction cancer who have had an uncomplicated postoperative stay following MIO. Patients had followed two different postoperative recovery programs according to their year of surgery (2016 versus 2018). Results: 48 patients in 2016 and 42 patients in 2018 were included. Patients were comparable on demographic factors. The median LOS was reduced from 9 days in 2016 to 8 days in 2018 (p 0.05) between the two groups in the risk of complications (Clavien-Dindo degree 0-2). Two patients in 2016 (4.2%) and two patients in 2018 (4.8%) were readmitted within 7 days after discharge (not significant). There was no in-hospital mortality or 30-day mortality in either of the two groups. Conclusion: The introduction of an ERP at our institution reduced the median postoperative stay after MIO by one day without increasing the risk of complications and readmittance. Further reduction might be obtained if oral feeding is allowed earlier.
{"title":"Standardized Postoperative Recovery Reduces in-Hospital Stay After Minimally Invasive Esophagectomy","authors":"Anna Katrine Nyman Rasmussen, M. Larsen, A. Ainsworth","doi":"10.11648/J.JS.20210902.12","DOIUrl":"https://doi.org/10.11648/J.JS.20210902.12","url":null,"abstract":"Background: This study aims to examine if a standardized enhanced recovery program (ERP) could reduce the length of stay (LOS) after minimally invasive esophagectomy (MIO) compared to the earlier applied recovery program without increasing the risk of postoperative complications and readmissions. Methods: Retrospective study of patients with esophageal and gastroesophageal junction cancer who have had an uncomplicated postoperative stay following MIO. Patients had followed two different postoperative recovery programs according to their year of surgery (2016 versus 2018). Results: 48 patients in 2016 and 42 patients in 2018 were included. Patients were comparable on demographic factors. The median LOS was reduced from 9 days in 2016 to 8 days in 2018 (p 0.05) between the two groups in the risk of complications (Clavien-Dindo degree 0-2). Two patients in 2016 (4.2%) and two patients in 2018 (4.8%) were readmitted within 7 days after discharge (not significant). There was no in-hospital mortality or 30-day mortality in either of the two groups. Conclusion: The introduction of an ERP at our institution reduced the median postoperative stay after MIO by one day without increasing the risk of complications and readmittance. Further reduction might be obtained if oral feeding is allowed earlier.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"65 1","pages":"53"},"PeriodicalIF":0.0,"publicationDate":"2021-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86163084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-27DOI: 10.11648/J.JS.20210901.18
M. Bouziane, Omar Mouni, W. Kaikani, M. Kassimi, R. Rabii, A. Albouzidi
Background: Bladder infiltration by neighbourhood tumors is a common situation and can be found in prostate, colo-rectum and genital tumours in women. The main mechanism is a direct invasion of the bladder by the tumor. Intraluminal bladder metastases from distant primary tumors remain exceptional. Patient: We report the case of a 56-year-old patient without any particular medical history initially admitted for an occlusion caused by a transverse colic tumor. The patient did not have clinically haematuria and the initial scan did not show a location or abnormality in the bladder. Initial surgical exploration did not find peritoneal or bladder abnormalities. The patient's evolution will be marked by the appearance of bladder thickening at a distance from the primary tumor and peritoneal carcinosis. The immunohistochemical study in addition to the anatomopathological examination resulted in positive marking of the chorion tubes by anti CDX2 and anti CK 20 and positive marking of surface vesical epithelium by anti P63, anti GATTA3 and anti CK7 which confirmed the colorectal origin of endo-vesical metastasis. Conclusion: We will try through this case report and a review of literature to shed light on this unusual situation and it is important to keep in mind the possibility of remote metastatic location at the bladder of another primary tumor.
{"title":"Endovesical Metastasis of a Colic Adenocarcinoma: A Case Report","authors":"M. Bouziane, Omar Mouni, W. Kaikani, M. Kassimi, R. Rabii, A. Albouzidi","doi":"10.11648/J.JS.20210901.18","DOIUrl":"https://doi.org/10.11648/J.JS.20210901.18","url":null,"abstract":"Background: Bladder infiltration by neighbourhood tumors is a common situation and can be found in prostate, colo-rectum and genital tumours in women. The main mechanism is a direct invasion of the bladder by the tumor. Intraluminal bladder metastases from distant primary tumors remain exceptional. Patient: We report the case of a 56-year-old patient without any particular medical history initially admitted for an occlusion caused by a transverse colic tumor. The patient did not have clinically haematuria and the initial scan did not show a location or abnormality in the bladder. Initial surgical exploration did not find peritoneal or bladder abnormalities. The patient's evolution will be marked by the appearance of bladder thickening at a distance from the primary tumor and peritoneal carcinosis. The immunohistochemical study in addition to the anatomopathological examination resulted in positive marking of the chorion tubes by anti CDX2 and anti CK 20 and positive marking of surface vesical epithelium by anti P63, anti GATTA3 and anti CK7 which confirmed the colorectal origin of endo-vesical metastasis. Conclusion: We will try through this case report and a review of literature to shed light on this unusual situation and it is important to keep in mind the possibility of remote metastatic location at the bladder of another primary tumor.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"5 1","pages":"45"},"PeriodicalIF":0.0,"publicationDate":"2021-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79975583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-09DOI: 10.11648/J.JS.20210901.16
Paul Richard Borgmeier, Crystal D. Ricketts, J. Clymer, G. Gangoli, G. Tommaselli
Background: Monopolar electrosurgery, one of the most widely used techniques in surgery, requires two electrodes: a working electrode and a return electrode. Commonly, adhesive or “sticky” pads that attach directly to the patient are used as return electrodes. Acting as electrolytic conductors, adhesive pads are highly effective, but require some effort to apply and remove, and if improperly placed or partially detached may lead to high electrical current density and the potential for pad site burns. Alternatively, a capacitive return electrode, such as the Mega Soft pad, may be used that works on the same principle as a two-plate capacitor. Objective: This article details the technology underlying capacitive electrodes, reviews the scientific literature to-date, and provides recommendations on how to best use the Mega Soft pad. Results: No direct contact is required between the pad and patient, and the return electrode is designed so that current density is limited regardless of pad placement, reducing the risk of pad site burn. Although the technology is now mature, having been in the field for over 20 years, best practices for optimal performance from capacitive return electrodes are still not widespread, and misunderstandings persist regarding use of capacitive electrodes with contact monitoring systems and implantable electronic devices. Conclusion: With proper training, capacitive return electrodes may be substituted for conventional adhesive pads with the benefits of easier application and reduced risk of pad site burns.
{"title":"A Review of Capacitive Return Electrodes in Electrosurgery","authors":"Paul Richard Borgmeier, Crystal D. Ricketts, J. Clymer, G. Gangoli, G. Tommaselli","doi":"10.11648/J.JS.20210901.16","DOIUrl":"https://doi.org/10.11648/J.JS.20210901.16","url":null,"abstract":"Background: Monopolar electrosurgery, one of the most widely used techniques in surgery, requires two electrodes: a working electrode and a return electrode. Commonly, adhesive or “sticky” pads that attach directly to the patient are used as return electrodes. Acting as electrolytic conductors, adhesive pads are highly effective, but require some effort to apply and remove, and if improperly placed or partially detached may lead to high electrical current density and the potential for pad site burns. Alternatively, a capacitive return electrode, such as the Mega Soft pad, may be used that works on the same principle as a two-plate capacitor. Objective: This article details the technology underlying capacitive electrodes, reviews the scientific literature to-date, and provides recommendations on how to best use the Mega Soft pad. Results: No direct contact is required between the pad and patient, and the return electrode is designed so that current density is limited regardless of pad placement, reducing the risk of pad site burn. Although the technology is now mature, having been in the field for over 20 years, best practices for optimal performance from capacitive return electrodes are still not widespread, and misunderstandings persist regarding use of capacitive electrodes with contact monitoring systems and implantable electronic devices. Conclusion: With proper training, capacitive return electrodes may be substituted for conventional adhesive pads with the benefits of easier application and reduced risk of pad site burns.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"1 1","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83607478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-02DOI: 10.11648/J.JS.20210901.15
Camara Fode Lansana, Balde Abdoulaye Korse, C. Naby, Baldé Habiboulaye, Diakité Saikou Yaya, Balde Oumar Taibata, T. Ibrahima, Balde Thierno Mamadou, Diallo Amadou Dioulde, Camara Alpha Kabine, Doumbouya Bourlaye, T. Aboubacar, D. Taran, Diallo Biro
The aim of this is to make our contribution to the study of Gastrointestinal trichobezoard Introduction: The digestive bezoar is a conglomerate of indigestible substances trapped in the gastrointestinal tract. Aim: The aim was to report an exceptional case of a gastrointestinal trichobezoard revealed by acute intestinal obstruction by ileo-ileal intussusception and to discuss it with data from the literature. Methodology This was a 7-year-old girl who was referred to us from the Nutritional Institute at Donka National Hospital. She presented paroxysmal abdominal pain, vomiting, anorexia and physical asthenia without notion of gas stoppage, evolving for four months. On examination, the patient was in poor general condition with sunken eyeballs. The abdomen was the site of an epigastric mass, mobile and painful. The digital rectal examination noted an emptiness of the rectal bulb. The biological assessment revealed hyperleukocytosis (11.8giga/l); normochromium-normocytic anemia (10g/l). Abdominal ultrasound showed prominent images of distended loops, with material stasis, forming a mass syndrome consistent with a reducible and unstable invagination coil. The diagnosis of acute intussusception was ultrasound. Surgery confirmed intussusception, which was secondary to the entrapment of a trichobezoar in the gastrointestinal lumen. Intestinal disinvagination and extraction of trichobezoar by gastrotomy was the indication. Results the operative consequences were simple. Conclusion: Trichobezoar is a rare condition and the preoperative diagnosis difficult when the notion of trichophagia has not been mentioned. Its treatment is surgical, its prevention requires regular monitoring and psychiatric care.
{"title":"Gastrointestinal Trichobezoard Revealed by Intussusception at the University Hospital of Conakry","authors":"Camara Fode Lansana, Balde Abdoulaye Korse, C. Naby, Baldé Habiboulaye, Diakité Saikou Yaya, Balde Oumar Taibata, T. Ibrahima, Balde Thierno Mamadou, Diallo Amadou Dioulde, Camara Alpha Kabine, Doumbouya Bourlaye, T. Aboubacar, D. Taran, Diallo Biro","doi":"10.11648/J.JS.20210901.15","DOIUrl":"https://doi.org/10.11648/J.JS.20210901.15","url":null,"abstract":"The aim of this is to make our contribution to the study of Gastrointestinal trichobezoard Introduction: The digestive bezoar is a conglomerate of indigestible substances trapped in the gastrointestinal tract. Aim: The aim was to report an exceptional case of a gastrointestinal trichobezoard revealed by acute intestinal obstruction by ileo-ileal intussusception and to discuss it with data from the literature. Methodology This was a 7-year-old girl who was referred to us from the Nutritional Institute at Donka National Hospital. She presented paroxysmal abdominal pain, vomiting, anorexia and physical asthenia without notion of gas stoppage, evolving for four months. On examination, the patient was in poor general condition with sunken eyeballs. The abdomen was the site of an epigastric mass, mobile and painful. The digital rectal examination noted an emptiness of the rectal bulb. The biological assessment revealed hyperleukocytosis (11.8giga/l); normochromium-normocytic anemia (10g/l). Abdominal ultrasound showed prominent images of distended loops, with material stasis, forming a mass syndrome consistent with a reducible and unstable invagination coil. The diagnosis of acute intussusception was ultrasound. Surgery confirmed intussusception, which was secondary to the entrapment of a trichobezoar in the gastrointestinal lumen. Intestinal disinvagination and extraction of trichobezoar by gastrotomy was the indication. Results the operative consequences were simple. Conclusion: Trichobezoar is a rare condition and the preoperative diagnosis difficult when the notion of trichophagia has not been mentioned. Its treatment is surgical, its prevention requires regular monitoring and psychiatric care.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"9 1","pages":"27"},"PeriodicalIF":0.0,"publicationDate":"2021-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85414941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-30DOI: 10.11648/J.JS.20210901.14
Wakil Ahmed, Zinat Rehana Shipu, Md. Fazlul Haque Qasem, Md. Abu Awal Shameem, S. Ullah
Introduction: Tuberculosis of the knee joint is not very much common. It is the third highest affected site after spine and hip in osteoarticular tuberculosis. Diagnosis of TB knee is difficult because the clinical features are not typical. Ligaments reconstruction, meniscus surgery and many other procedures can successfully be done by arthroscopy in knee joint. Aim of the study: The aim of this study was to evaluate the incidence, clinical and laboratory findings and assess the treatment outcome of post arthroscopy MTB infections of the knee joint. Methods: This cross-sectional study was conducted in Ibn Sina Knee Centre, Dhaka and Northern International Medical College Hospital, Dhaka, Bangladesh during the period from February 2015 to January 2020. Purposive sampling technique used in the selection of the study patients. Somehow we selected 7 patients for the study with unusual presentations of night cries after arthroscopic procedures. Statistical data were analysed by MS-Excel 2016. Result: We describe 7 cases of isolated MTB infection after arthroscopic procedures in immuno-competent patients as study people for our inquiry. Almost all the study patients 6 (85.71%) treated by anti- TB drugs and 1 (14.29%) treated with MDR-TB drug. Almost all patients 6 (85.71%) had gain excellent results and 1 (14.29%) had good results. So we found a satisfactory result in the post arthroscopy tuberculosis of the knee joint with this treatment. Conclusion: We found Mycobacterium Tuberculosis (MTB) infection as a complication after arthroscopic procedures like anterior cruciate ligament (ACL) reconstruction and or meniscus surgery of the knee joint.
{"title":"Post-arthroscopy Tuberculosis of the Knee Joint: An Analysis of Incidence, Presentation, Diagnosis and Treatment Outcome","authors":"Wakil Ahmed, Zinat Rehana Shipu, Md. Fazlul Haque Qasem, Md. Abu Awal Shameem, S. Ullah","doi":"10.11648/J.JS.20210901.14","DOIUrl":"https://doi.org/10.11648/J.JS.20210901.14","url":null,"abstract":"Introduction: Tuberculosis of the knee joint is not very much common. It is the third highest affected site after spine and hip in osteoarticular tuberculosis. Diagnosis of TB knee is difficult because the clinical features are not typical. Ligaments reconstruction, meniscus surgery and many other procedures can successfully be done by arthroscopy in knee joint. Aim of the study: The aim of this study was to evaluate the incidence, clinical and laboratory findings and assess the treatment outcome of post arthroscopy MTB infections of the knee joint. Methods: This cross-sectional study was conducted in Ibn Sina Knee Centre, Dhaka and Northern International Medical College Hospital, Dhaka, Bangladesh during the period from February 2015 to January 2020. Purposive sampling technique used in the selection of the study patients. Somehow we selected 7 patients for the study with unusual presentations of night cries after arthroscopic procedures. Statistical data were analysed by MS-Excel 2016. Result: We describe 7 cases of isolated MTB infection after arthroscopic procedures in immuno-competent patients as study people for our inquiry. Almost all the study patients 6 (85.71%) treated by anti- TB drugs and 1 (14.29%) treated with MDR-TB drug. Almost all patients 6 (85.71%) had gain excellent results and 1 (14.29%) had good results. So we found a satisfactory result in the post arthroscopy tuberculosis of the knee joint with this treatment. Conclusion: We found Mycobacterium Tuberculosis (MTB) infection as a complication after arthroscopic procedures like anterior cruciate ligament (ACL) reconstruction and or meniscus surgery of the knee joint.","PeriodicalId":101237,"journal":{"name":"The Journal of Surgery","volume":"3 11 1","pages":"22"},"PeriodicalIF":0.0,"publicationDate":"2021-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74907268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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