The Experts below are selected from a list of 96 Experts worldwide ranked by ideXlab platform
Michel Levardo - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic appendectomy using a Clip Applier
Surgical Endoscopy and Other Interventional Techniques, 1991Co-Authors: Ernard G Cristalli, Vince Izard, Denis Jacob, Michel LevardoAbstract:The diagnostic worth and therapeutic value of laparoscopic surgery are known for ovarian cysts and ectopic pregnancies. Diagnosis of appendicitis is difficult, and laparoscopy is useful in these cases. The present study was done to assess the feasibility, efficacy, and advantages of a new laparoscopic appendectomy technique. Between August 1,1989, and July 31,1990, patients exhibiting right pelvic pain associated with fever were divided into three groups according to the pre-operative diagnosis: appendicitis, pelvic inflammatory disease (PID), and diagnostic doubt between appendicitis and PID. An intra-peritoneal appendectomy was performed if the diagnosis was not PID. Via three suprasymphyseal trocars, the appendix was exposed and the mesoappendix was coagulated. The appendix stump was closed using a Clip Applier (Ethnor T1300). In all, 20 patients underwent laparoscopic appendectomies. The mean duration of the procedure was 36.5 min; in no case was laparotomy necessary. There were no post-operative complications, and digestive transit returned on the 2nd day post-surgery. Both patients and nurses appreciated the technique. The subjects experienced comfortable post-operative periods and gained aesthetic advantages. The operative procedure could be completed on each attempt. We conclude that this technique is sure, quick, and easily reproducible in young patients presenting with right pelvic pain associated with fever.
David G Penningto - One of the best experts on this subject based on the ideXlab platform.
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use of the vascular closure staple Clip Applier for microvascular anastomosis in free flap surgery
Plastic and Reconstructive Surgery, 2000Co-Authors: C Cope, Kenneth K Lee, H S Ste, David G PenningtoAbstract:We report our initial experience using the vascular closure staple Clip Applier (a nonpenetrating titanium Clip applied in an interrupted, everting fashion) for microvascular anastomosis in free-flap surgery. In total, 153 anastomoses were performed in 87 free flaps (174 potential anastomoses) using the vascular closure stapler between October of 1997 and June of 1999. In 66 flaps, both the arterial and venous anastomosis were performed with the Clip Applier, whereas in 21 flaps only the venous anastomosis was performed using the Clips. A total of 146 anastomoses were performed in an end-to-end fashion, and seven were performed end-to-side. Of the 87 flaps there were 53 TRAM flaps, seven bilateral TRAM, five latissimus dorsi, four gastrocnemius, three rectus abdominis, two radial forearm fibula, and four Rubens fat-pad flaps. Seventy flaps were used for breast reconstruction, seven flaps for lower limb reconstruction, four flaps for head and neck reconstruction, and six flaps for chest wall/trunk reconstruction. There were no postoperative anastomotic complications of bleeding, thrombosis, or need for revision (100 percent patency rate), with a significantly reduced time for completion of anastomoses. The Clip Applier is a safe, reliable method for performing microvascular anastomoses, allowing reduced operating time and possible cost savings in free-flap surgery.
Yang Yue - One of the best experts on this subject based on the ideXlab platform.
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Mediastinal micro-vessels Clipping during lymph node dissection may contribute to reduce postoperative pleural drainage
'AME Publishing Company', 2016Co-Authors: Ya Shi, Wang Xing, Lv Chao, Pha Kevi, Wang Yuzhao, Wang Jia, Yang YueAbstract:Background: Postoperative pleural drainage markedly influences the length of postoperative stay and financial costs of medical care. The aim of this study is to retrospectively investigate potentially predisposing factors related to pleural drainage after curative thoracic surgery and to explore the impact of mediastinal micro-vessels Clipping on pleural drainage control after lymph node dissection. Methods: From February 2012 to November 2013, 322 consecutive cases of operable non-small cell lung cancers (NSCLC) undergoing lobectomy and mediastinal lymph node dissection with or without application of Clipping were collected. Total and daily postoperative pleural drainage were recorded. Propensity score matching (1:2) was applied to balance variables potentially impacting pleural drainage between group Clip and group control. Analyses were performed to compare drainage volume, duration of chest tube and postoperative hospital stay between the two groups. Variables linked with pleural drainage in whole cohort were assessed using multivariable logistic regression analysis. Results: Propensity score matching resulted in 197 patients (matched cohort). Baseline patient characteristics were matched between two groups. Group Clip showed less cumulative drainage volume (P=0.020), shorter duration of chest tube (P=0.031) and postoperative hospital stay (P=0.022) compared with group control. Risk factors significantly associated with high-output drainage in multivariable logistic regression analysis were being male, age >60 years, bilobectomy/sleeve lobectomy, pleural adhesion, the application of Clip Applier, duration of operation ≥220 minutes and chylothorax (P
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Mediastinal micro-vessels Clipping during lymph node dissection may contribute to reduce postoperative pleural drainage
JOURNAL OF THORACIC DISEASE, 2016Co-Authors: Ya Shi, Wang Xing, Lv Chao, Pha Kevi, Wang Yuzhao, Wang Jia, Yang YueAbstract:Background: Postoperative pleural drainage markedly influences the length of postoperative stay and financial costs of medical care. The aim of this study is to retrospectively investigate potentially predisposing factors related to pleural drainage after curative thoracic surgery and to explore the impact of mediastinal micro-vessels Clipping on pleural drainage control after lymph node dissection. Methods: From February 2012 to November 2013, 322 consecutive cases of operable non-small cell lung cancers (NSCLC) undergoing lobectomy and mediastinal lymph node dissection with or without application of Clipping were collected. Total and daily postoperative pleural drainage were recorded. Propensity score matching (1: 2) was applied to balance variables potentially impacting pleural drainage between group Clip and group control. Analyses were performed to compare drainage volume, duration of chest tube and postoperative hospital stay between the two groups. Variables linked with pleural drainage in whole cohort were assessed using multivariable logistic regression analysis. Results: Propensity score matching resulted in 197 patients (matched cohort). Baseline patient characteristics were matched between two groups. Group Clip showed less cumulative drainage volume (P=0.020), shorter duration of chest tube (P=0.031) and postoperative hospital stay (P=0.022) compared with group control. Risk factors significantly associated with high-output drainage in multivariable logistic regression analysis were being male, age >60 years, bilobectomy/sleeve lobectomy, pleural adhesion, the application of Clip Applier, duration of operation >= 220 minutes and chylothorax (P<0.05). Conclusions: This study suggests that mediastinal micro-vessels Clipping during lymph node dissection may reduce postoperative pleural drainage and thus shorten hospital stay.Beijing Municipal Science & Technology Commission [Z161100000516063]; Beijing Municipal Administration of Hospitals Clinical medicine Development [ZYLX201509]; Capital R&T Resources Platform [Z141100003414015]SCI(E)PubMedARTICLEnanwu@bjmu.edu.cn3415-421
Ernard G Cristalli - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic appendectomy using a Clip Applier
Surgical Endoscopy and Other Interventional Techniques, 1991Co-Authors: Ernard G Cristalli, Vince Izard, Denis Jacob, Michel LevardoAbstract:The diagnostic worth and therapeutic value of laparoscopic surgery are known for ovarian cysts and ectopic pregnancies. Diagnosis of appendicitis is difficult, and laparoscopy is useful in these cases. The present study was done to assess the feasibility, efficacy, and advantages of a new laparoscopic appendectomy technique. Between August 1,1989, and July 31,1990, patients exhibiting right pelvic pain associated with fever were divided into three groups according to the pre-operative diagnosis: appendicitis, pelvic inflammatory disease (PID), and diagnostic doubt between appendicitis and PID. An intra-peritoneal appendectomy was performed if the diagnosis was not PID. Via three suprasymphyseal trocars, the appendix was exposed and the mesoappendix was coagulated. The appendix stump was closed using a Clip Applier (Ethnor T1300). In all, 20 patients underwent laparoscopic appendectomies. The mean duration of the procedure was 36.5 min; in no case was laparotomy necessary. There were no post-operative complications, and digestive transit returned on the 2nd day post-surgery. Both patients and nurses appreciated the technique. The subjects experienced comfortable post-operative periods and gained aesthetic advantages. The operative procedure could be completed on each attempt. We conclude that this technique is sure, quick, and easily reproducible in young patients presenting with right pelvic pain associated with fever.
C Cope - One of the best experts on this subject based on the ideXlab platform.
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use of the vascular closure staple Clip Applier for microvascular anastomosis in free flap surgery
Plastic and Reconstructive Surgery, 2000Co-Authors: C Cope, Kenneth K Lee, H S Ste, David G PenningtoAbstract:We report our initial experience using the vascular closure staple Clip Applier (a nonpenetrating titanium Clip applied in an interrupted, everting fashion) for microvascular anastomosis in free-flap surgery. In total, 153 anastomoses were performed in 87 free flaps (174 potential anastomoses) using the vascular closure stapler between October of 1997 and June of 1999. In 66 flaps, both the arterial and venous anastomosis were performed with the Clip Applier, whereas in 21 flaps only the venous anastomosis was performed using the Clips. A total of 146 anastomoses were performed in an end-to-end fashion, and seven were performed end-to-side. Of the 87 flaps there were 53 TRAM flaps, seven bilateral TRAM, five latissimus dorsi, four gastrocnemius, three rectus abdominis, two radial forearm fibula, and four Rubens fat-pad flaps. Seventy flaps were used for breast reconstruction, seven flaps for lower limb reconstruction, four flaps for head and neck reconstruction, and six flaps for chest wall/trunk reconstruction. There were no postoperative anastomotic complications of bleeding, thrombosis, or need for revision (100 percent patency rate), with a significantly reduced time for completion of anastomoses. The Clip Applier is a safe, reliable method for performing microvascular anastomoses, allowing reduced operating time and possible cost savings in free-flap surgery.