{"title":"Surgical insights: Assessing acute appendicitis in a fifth-wave COVID-19 cluster—A retrospective cohort analysis","authors":"Ahmed Gawash, David F. Lo MBS","doi":"10.1111/1744-1633.12684","DOIUrl":"https://doi.org/10.1111/1744-1633.12684","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"38"},"PeriodicalIF":0.8,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140544389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical Practice February 2024 CME for Fellows","authors":"","doi":"10.1111/1744-1633.12685","DOIUrl":"https://doi.org/10.1111/1744-1633.12685","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"50-51"},"PeriodicalIF":0.8,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140544388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Surgical Practice November 2023 CME for Fellows","authors":"","doi":"10.1111/1744-1633.12682","DOIUrl":"https://doi.org/10.1111/1744-1633.12682","url":null,"abstract":"","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"48-49"},"PeriodicalIF":0.8,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140544381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca Lau HonsBMSc, Katherine Aw HonsBMSc, Sami Aftab Abdul HonsBSc, Caitlin Anstee BA, Sebastien Gilbert MDCM, Daniel Jones MD, Msc, Andrew J. E. Seely MDCM, PhD, R. Sudhir Sundaresan MD, Patrick J. Villeneuve MDCM, PhD, Donna E. Maziak MDCM, MSc
Objective
To compare the safety and effectiveness of different surgical approaches in thymectomy: robotics, subxiphoid, lateral video-assisted thoracoscopy surgery (LVATS) and open.
Methodology
We retrospectively reviewed 68 cases of thymectomy with a robot-assisted, subxiphoid, LVATS, open sternotomy or thoracotomy approach for thymic lesions or myasthenia gravis between July 2017 and May 2023 at a single centre. Peri-operative outcomes (operating time, estimated blood loss, conversion rates, R0 resection, adverse events and length of stay [LOS]) were collected.
Results
We observed six conversions to open (from five LVATS and one robot assisted). The median estimated blood loss was lower for LVATS (100.00 [50.0–100.0] mL) compared with open thymectomies (200.0 [150.0–400.0]; P < .001). No intra-operative adverse events were reported in the robotics, subxiphoid or LVATS groups. In patients with thymic tumours (n = 34), R0 resection was achieved in 100% (2/2) of robotics, 83% of subxiphoid (5/6), 93% (13/14) of LVATS and 75% (n = 9/12) of open cases. The median LOS was shortest for robot assisted (1.0 [interquartile range (IQR) 1.0–3.0]), then subxiphoid (2.0 [IQR 1.0–3.0]), LVATS (2.0 [IQR 1.0–3.0]) then open (5.0 [IQR 4.0–6.0]; P < .001).
Conclusions
Our results suggest that with a shorter LOS, robotics, subxiphoid and LVATS thymectomies are safe. Larger size studies are required to compare R0 resection rates between these less invasive surgical approaches.
{"title":"Comparing the safety and effectiveness of surgical approaches in thymectomy","authors":"Rebecca Lau HonsBMSc, Katherine Aw HonsBMSc, Sami Aftab Abdul HonsBSc, Caitlin Anstee BA, Sebastien Gilbert MDCM, Daniel Jones MD, Msc, Andrew J. E. Seely MDCM, PhD, R. Sudhir Sundaresan MD, Patrick J. Villeneuve MDCM, PhD, Donna E. Maziak MDCM, MSc","doi":"10.1111/1744-1633.12688","DOIUrl":"10.1111/1744-1633.12688","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the safety and effectiveness of different surgical approaches in thymectomy: robotics, subxiphoid, lateral video-assisted thoracoscopy surgery (LVATS) and open.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>We retrospectively reviewed 68 cases of thymectomy with a robot-assisted, subxiphoid, LVATS, open sternotomy or thoracotomy approach for thymic lesions or myasthenia gravis between July 2017 and May 2023 at a single centre. Peri-operative outcomes (operating time, estimated blood loss, conversion rates, R0 resection, adverse events and length of stay [LOS]) were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed six conversions to open (from five LVATS and one robot assisted). The median estimated blood loss was lower for LVATS (100.00 [50.0–100.0] mL) compared with open thymectomies (200.0 [150.0–400.0]; <i>P</i> < .001). No intra-operative adverse events were reported in the robotics, subxiphoid or LVATS groups. In patients with thymic tumours (<i>n</i> = 34), R0 resection was achieved in 100% (2/2) of robotics, 83% of subxiphoid (5/6), 93% (13/14) of LVATS and 75% (<i>n</i> = 9/12) of open cases. The median LOS was shortest for robot assisted (1.0 [interquartile range (IQR) 1.0–3.0]), then subxiphoid (2.0 [IQR 1.0–3.0]), LVATS (2.0 [IQR 1.0–3.0]) then open (5.0 [IQR 4.0–6.0]; <i>P</i> < .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results suggest that with a shorter LOS, robotics, subxiphoid and LVATS thymectomies are safe. Larger size studies are required to compare R0 resection rates between these less invasive surgical approaches.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"152-158"},"PeriodicalIF":0.3,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1744-1633.12688","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140730570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yue Sun Cheung, Hon Ting Lok, Andrew Kai Yip Fung, Paul Bo San Lai
Objectives
To study the feasibility of using surgical procedure manager (SPM), a digital checklist platform, to standardise surgical steps of open hernia repair and monitor the operative performance.
Methodology
A retrospective study on all open mesh repair of inguinal hernia under local anaesthesia from September 2019 to November 2021 at the Prince of Wales Hospital was performed. The operative outcomes of patients having operations with or without the use of SPM were compared. Procedures using SPM had operation steps shown as a digital checklist inside the theatre. The time used for each surgical step was recorded and analysed. The operative performance of the surgeons was analysed by observing the trend of the mean operation time over time.
Results
A total of 123 patients were recruited, of which 52 were using the SPM. The median age of patients was 75 (range 49–93) years. A decreasing trend in the mean operation time for dissection, mesh placement, wound closure and total operation time was observed in surgeries using SPM. There was no significant difference in the operation time, theatre time, total length of stay, blood loss and readmission rate between the SPM and non-SPM groups. The proportion of basic surgical trainees as coached surgeons in the SPM group was significantly higher (SPM = 52% vs non-SPM = 28%, P = .07).
Conclusions
The use of SPM did not significantly prolong the operation time and produce comparable operative outcomes in open hernia repair. It provided the additional advantage of standardising operation steps and monitoring the performance of surgical trainees during their training.
{"title":"Use of surgical procedure manager to standardise operation steps and monitor surgeon performance in open repair of inguinal hernia","authors":"Yue Sun Cheung, Hon Ting Lok, Andrew Kai Yip Fung, Paul Bo San Lai","doi":"10.1111/1744-1633.12686","DOIUrl":"10.1111/1744-1633.12686","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To study the feasibility of using surgical procedure manager (SPM), a digital checklist platform, to standardise surgical steps of open hernia repair and monitor the operative performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>A retrospective study on all open mesh repair of inguinal hernia under local anaesthesia from September 2019 to November 2021 at the Prince of Wales Hospital was performed. The operative outcomes of patients having operations with or without the use of SPM were compared. Procedures using SPM had operation steps shown as a digital checklist inside the theatre. The time used for each surgical step was recorded and analysed. The operative performance of the surgeons was analysed by observing the trend of the mean operation time over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 123 patients were recruited, of which 52 were using the SPM. The median age of patients was 75 (range 49–93) years. A decreasing trend in the mean operation time for dissection, mesh placement, wound closure and total operation time was observed in surgeries using SPM. There was no significant difference in the operation time, theatre time, total length of stay, blood loss and readmission rate between the SPM and non-SPM groups. The proportion of basic surgical trainees as coached surgeons in the SPM group was significantly higher (SPM = 52% vs non-SPM = 28%, <i>P</i> = .07).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of SPM did not significantly prolong the operation time and produce comparable operative outcomes in open hernia repair. It provided the additional advantage of standardising operation steps and monitoring the performance of surgical trainees during their training.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"139-143"},"PeriodicalIF":0.3,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140744493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetic mastopathy is a rare benign breast condition that mimics breast carcinoma in patients with diabetes. Clinicians must differentiate it from malignant causes because of differences in prognosis and management. This paper presents a case report of an 87-year-old lady with type 2 diabetes and diabetic mastopathy. We also review the literature on the pathogenesis, clinical presentation, diagnostic workup and management of diabetic mastopathy.
{"title":"Diabetic mastopathy: A case report and literature review on a mimic of breast carcinoma in patients with diabetes","authors":"Wai Si Crystal Li MBChB, Shun Yan Chan MBBS","doi":"10.1111/1744-1633.12681","DOIUrl":"10.1111/1744-1633.12681","url":null,"abstract":"<p>Diabetic mastopathy is a rare benign breast condition that mimics breast carcinoma in patients with diabetes. Clinicians must differentiate it from malignant causes because of differences in prognosis and management. This paper presents a case report of an 87-year-old lady with type 2 diabetes and diabetic mastopathy. We also review the literature on the pathogenesis, clinical presentation, diagnostic workup and management of diabetic mastopathy.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 2","pages":"109-111"},"PeriodicalIF":0.3,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140231104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The study aimed to elucidate the clinical efficacy of colonoscopy combined with laparoscopic radical resection for patients with colon cancer.
Methods
Cases with colon cancer were divided into the control group (received laparoscopic radical resection) and the experimental group (received colonoscopy combined with laparoscopic radical resection). Inflammatory cytokines’ levels and immune functions were evaluated before and after the operation. The 36-item Short Form Health Survey (SF-36) was used to evaluate the living quality.
Results
Relative to the control group, individuals in the experimental group had a shorter hospital stay and post-operative anal exhaust, and reduced intraoperative blood loss. Changes in serum interferon-gamma (IFN-γ), interleukin-8 (IL-8) and IL-10 levels were minimal in the experimental group. Serum CD3+%, CD4+% and CD4+/CD8+ values of the two groups were significantly decreased compared with the preoperative values, which increased more significantly in the experimental group relative to the control group. After the operation, individuals in the experimental group presented higher SF-36 scores than those in the experimental group. The experimental group presented a low incidence of post-operative complications.
Conclusions
Colonoscopy combined with laparoscopic radical resection for colon cancer had only a little effect on immune function and inflammatory response. It can shorten the recovery time of patients and reduce post-operative complications, which is worthy of further clinical promotion.
{"title":"Colonoscopy combined with laparoscopy can improve post-operative quality of life in patients with colon cancer","authors":"Suyan Ding, Buluan Zhu, Tiantian Sun, Lili Qu","doi":"10.1111/1744-1633.12680","DOIUrl":"10.1111/1744-1633.12680","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The study aimed to elucidate the clinical efficacy of colonoscopy combined with laparoscopic radical resection for patients with colon cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cases with colon cancer were divided into the control group (received laparoscopic radical resection) and the experimental group (received colonoscopy combined with laparoscopic radical resection). Inflammatory cytokines’ levels and immune functions were evaluated before and after the operation. The 36-item Short Form Health Survey (SF-36) was used to evaluate the living quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Relative to the control group, individuals in the experimental group had a shorter hospital stay and post-operative anal exhaust, and reduced intraoperative blood loss. Changes in serum interferon-gamma (IFN-γ), interleukin-8 (IL-8) and IL-10 levels were minimal in the experimental group. Serum CD3<sup>+</sup>%, CD4<sup>+</sup>% and CD4<sup>+</sup>/CD8<sup>+</sup> values of the two groups were significantly decreased compared with the preoperative values, which increased more significantly in the experimental group relative to the control group. After the operation, individuals in the experimental group presented higher SF-36 scores than those in the experimental group. The experimental group presented a low incidence of post-operative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Colonoscopy combined with laparoscopic radical resection for colon cancer had only a little effect on immune function and inflammatory response. It can shorten the recovery time of patients and reduce post-operative complications, which is worthy of further clinical promotion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"132-138"},"PeriodicalIF":0.3,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140232816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paraganglioma of the thyroid gland is a rare disease entity, with only a handful of cases documented in the literature. We report on a middle-aged man with thyroid paraganglioma that presented as an incidental finding on the computed tomography scan of the thorax. Preoperative fine-needle aspiration cytology (FNAC) was suggestive of a neuroendocrine tumour. Hemithyroidectomy was performed and histological findings were most compatible with paraganglioma arising from the thyroid gland. The diagnosis of primary thyroid paraganglioma is rarely established by FNAC preoperatively due to architectural similarities with other thyroid tumours; the most important clinical technique for differentiating thyroid paraganglioma from other histology is immunohistochemistry. According to the literature, the first-line treatment for primary thyroid paraganglioma is surgical resection. The prognosis following surgical resection is generally good.
{"title":"Paraganglioma of the thyroid gland: A case report and literature review","authors":"Yeuk-Nam Lee, Yi-Po Tsang, Ka-Wan Karen Yuen, Chi-Yee Choi","doi":"10.1111/1744-1633.12678","DOIUrl":"10.1111/1744-1633.12678","url":null,"abstract":"<p>Paraganglioma of the thyroid gland is a rare disease entity, with only a handful of cases documented in the literature. We report on a middle-aged man with thyroid paraganglioma that presented as an incidental finding on the computed tomography scan of the thorax. Preoperative fine-needle aspiration cytology (FNAC) was suggestive of a neuroendocrine tumour. Hemithyroidectomy was performed and histological findings were most compatible with paraganglioma arising from the thyroid gland. The diagnosis of primary thyroid paraganglioma is rarely established by FNAC preoperatively due to architectural similarities with other thyroid tumours; the most important clinical technique for differentiating thyroid paraganglioma from other histology is immunohistochemistry. According to the literature, the first-line treatment for primary thyroid paraganglioma is surgical resection. The prognosis following surgical resection is generally good.</p>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"39-42"},"PeriodicalIF":0.8,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140250948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmed Mostafa Maghraby Mohamed MD, Mansour Mohammed Kabbash MD, Abdullah Abd El-Rasoul Al-Noby Al-Bokhary MBBCH, Yasser Mohammed Seddeik Rayan MD
Objective
The objective of this study was to compare, evaluate and manage abdominal trauma using two distinct surgical techniques: laparoscopy and laparotomy. The aim was to assess the effectiveness and safety of laparoscopic procedures compared with laparotomy for treating penetrating or blunt abdominal trauma.
Methodology
In this prospective comparative study, we recruited 60 patients clinically diagnosed with abdominal trauma. The research was conducted at the Emergency Unit of the Department of General Surgery, Faculty of Medicine, Aswan University Hospital. All participants provided signed informed consent before their inclusion in the study.
Results
There was a significant statistical difference between the two groups in terms of the operation duration, length of stay in the intensive care unit post-operatively, occurrence of gas passage and duration of hospitalisation.
Conclusions
Laparoscopic surgical procedures present a viable and practical alternative to laparotomy in appropriate cases for patients. The decision to choose laparoscopy as a surgical approach should depend on the surgeon's proficiency and the availability of required resources.
{"title":"Laparoscopy versus laparotomy in the management of abdominal trauma","authors":"Ahmed Mostafa Maghraby Mohamed MD, Mansour Mohammed Kabbash MD, Abdullah Abd El-Rasoul Al-Noby Al-Bokhary MBBCH, Yasser Mohammed Seddeik Rayan MD","doi":"10.1111/1744-1633.12679","DOIUrl":"https://doi.org/10.1111/1744-1633.12679","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to compare, evaluate and manage abdominal trauma using two distinct surgical techniques: laparoscopy and laparotomy. The aim was to assess the effectiveness and safety of laparoscopic procedures compared with laparotomy for treating penetrating or blunt abdominal trauma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>In this prospective comparative study, we recruited 60 patients clinically diagnosed with abdominal trauma. The research was conducted at the Emergency Unit of the Department of General Surgery, Faculty of Medicine, Aswan University Hospital. All participants provided signed informed consent before their inclusion in the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a significant statistical difference between the two groups in terms of the operation duration, length of stay in the intensive care unit post-operatively, occurrence of gas passage and duration of hospitalisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Laparoscopic surgical procedures present a viable and practical alternative to laparotomy in appropriate cases for patients. The decision to choose laparoscopy as a surgical approach should depend on the surgeon's proficiency and the availability of required resources.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 3","pages":"122-128"},"PeriodicalIF":0.3,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142231063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pietro Susini MD, Mirco Pozzi MD, Davide Di Seclì MD, Giuseppe Nisi MD, Roberto Cuomo MD, Luca Grimaldi MD
Objective
Included foreign bodies of a metallic nature are commonly found. They are often small, asymptomatic, with few or non-visible scars or even clinically invisible. Sometimes the patient does not remember their existence. The condition is benign and does not require special attention, unless a magnetic resonance imaging scan is necessary. Indeed, magnetic field interactions could pose significant risks, and the procedure is typically contraindicated unless the ferromagnetic foreign body (FFB) has been previously removed. For such purposes, the magnet that is commonly used in breast and plastic surgery units for breast expanders port injection site identification could represent a time-saving and cost-effective solution.
Methodology
This paper presents an alternative technique based on off-label application of the breast expander magnet to localize FFBs.
Results
Between April 2023 and June 2023, the breast expander magnet allowed successful pre-operative localisation and intra-operative guidance for removal of FFBs in four clinical cases. The post-operative ultrasound confirmed the absence of metal residues after the procedure in all cases.
Conclusion
Off-label application of the breast expander magnet allows for FFB pre-operative localisation and safe intra-operative surgical guidance, thus representing a promising off-label application of the device. After surgical removal of FFBs, the magnetic resonance imaging is allowed without any risk.
{"title":"Off-label application of the breast expander magnet: An alternative approach to enable localisation and removal of ferromagnetic subcutaneous foreign bodies","authors":"Pietro Susini MD, Mirco Pozzi MD, Davide Di Seclì MD, Giuseppe Nisi MD, Roberto Cuomo MD, Luca Grimaldi MD","doi":"10.1111/1744-1633.12677","DOIUrl":"10.1111/1744-1633.12677","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Included foreign bodies of a metallic nature are commonly found. They are often small, asymptomatic, with few or non-visible scars or even clinically invisible. Sometimes the patient does not remember their existence. The condition is benign and does not require special attention, unless a magnetic resonance imaging scan is necessary. Indeed, magnetic field interactions could pose significant risks, and the procedure is typically contraindicated unless the ferromagnetic foreign body (FFB) has been previously removed. For such purposes, the magnet that is commonly used in breast and plastic surgery units for breast expanders port injection site identification could represent a time-saving and cost-effective solution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This paper presents an alternative technique based on off-label application of the breast expander magnet to localize FFBs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between April 2023 and June 2023, the breast expander magnet allowed successful pre-operative localisation and intra-operative guidance for removal of FFBs in four clinical cases. The post-operative ultrasound confirmed the absence of metal residues after the procedure in all cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Off-label application of the breast expander magnet allows for FFB pre-operative localisation and safe intra-operative surgical guidance, thus representing a promising off-label application of the device. After surgical removal of FFBs, the magnetic resonance imaging is allowed without any risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51190,"journal":{"name":"Surgical Practice","volume":"28 1","pages":"32-37"},"PeriodicalIF":0.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140092662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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