The Experts below are selected from a list of 5664 Experts worldwide ranked by ideXlab platform
T Ohtsuka - One of the best experts on this subject based on the ideXlab platform.
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minimal damage during endoscopic latissimus dorsi muscle mobilization with the Harmonic Scalpel
The Annals of Thoracic Surgery, 2000Co-Authors: Hirotaka Inaba, T Ohtsuka, Yukihiro Kaneko, Masahiko Ezure, Keita Tanaka, Katsuhito Ueno, Shinichi TakamotoAbstract:Abstract Background . To reduce wound-related complications, a video-assisted surgical technique has been adopted for the mobilization of the latissimus dorsi muscle. We postulated that thermal damage to the muscle might be minimized by using a Harmonic Scalpel instead of electrocautery during this procedure. Methods . Canine latissimus dorsi muscles were mobilized through a small incision, assisted by a videoscope. In 6 dogs, dissection with electrocautery was used to mobilize the latissimus dorsi muscle. In 6 other dogs, the Harmonic Scalpel was used. We compared operation times, wound infection rates, histologic changes in the muscles, and ease of handling between these groups. Results . The operation time was significantly shorter in the Harmonic Scalpel group than in the electrocautery group (61.5 versus 106.5 minutes, p = 0.00014). The Harmonic Scalpel caused less histologic damage to the mobilized muscles and produced less vision-obscuring smoke. Conclusions . The Harmonic Scalpel shortens the operation, minimizes muscle damage, and facilitates the performance of video-assisted latissimus dorsi muscle mobilization.
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Video-assisted mammary harvest technique with Harmonic Scalpel
Kyobu geka. The Japanese journal of thoracic surgery, 1998Co-Authors: T Ohtsuka, Shinichi Takamoto, Tadasu Kohno, R K WolfAbstract:We have developed a video-assisted mammary harvest technique using the Harmonic Scalpel. The clinical method and results are reported here. Since Nov. 1995, 70 left and 5 right internal mammary arteries (L/RIMAs) were taken down thoracoscopically and utilized for minimally invasive coronary artery bypass grafting. Each of the IMAs was harvested up to the upper margin of the first rib or higher and down to the bifurcation. Coagulation and cutting of the branches were achieved with excellent hemostasis using only the Harmonic Scalpel with a hook dissector. A CO2 insufflation technique with 8-10 mmHg of intrathoracic pressure safely improved visualization of the IMA in each case. The mean operative time was 65 minutes (range 45-95) for the left and 35 minutes (range 25-45) for the right. All the pedicled IMAs but one which was lost due to intimal dissection had satisfactory free flows. Video-assisted mammary harvest can be accomplished with insufflation technique and facilitated by using the Harmonic Scalpel with a hook dissector.
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Thoracoscopic internal mammary artery harvest for MICABG using the Harmonic Scalpel.
The Annals of thoracic surgery, 1997Co-Authors: T Ohtsuka, R K Wolf, L F Hiratzka, P Wurnig, J B FlegeAbstract:Thoracoscopic internal mammary artery (IMA) harvest is technically demanding, particularly on the left side. We have devised a Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH) technique to facilitate this procedure, and describe our clinical experience here. The Harmonic Scalpel functions with ultrasonic energy, producing less smoke and lower heat than regular electrocautery. A total of 27 (22 left and 5 right) pedicles of the IMA in 23 patients were harvested from the upper margin of the first rib or higher to the lower margin of the fifth rib thoracoscopically using the Harmonic Scalpel with a hook blade. In each case, the IMA harvest was completed thoracoscopically with only the Harmonic Scalpel, decreasing instrument transfers. Each vascular branch was coagulated without charring and was transected with excellent hemostasis. Smokeless views were provided. In the first 17 harvests, Doppler studies 3 months after the procedures demonstrated patent IMAs to the coronary circulation. The Harmonic Scalpel facilitates thoracoscopic IMA harvest and is expected to minimize hyperthermic damage of the IMA.
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thoracoscopic internal mammary artery harvest for micabg using the Harmonic Scalpel
The Annals of Thoracic Surgery, 1997Co-Authors: T Ohtsuka, R K Wolf, L F Hiratzka, P Wurnig, J B FlegeAbstract:Background. Thoracoscopic internal mammary artery (IMA) harvest is technically demanding, particularly on the left side. We have devised a Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH) technique to facilitate this procedure, and describe our clinical experience here. Methods. The Harmonic Scalpel functions with ultrasonic energy, producing less smoke and lower heat than regular electrocautery. A total of 27 (22 left and 5 right) pedicles of the IMA in 23 patients were harvested from the upper margin of the first rib or higher to the lower margin of the fifth rib thoracoscopically using the Harmonic Scalpel with a hook blade. Results. In each case, the IMA harvest was completed thoracoscopically with only the Harmonic Scalpel, decreasing instrument transfers. Each vascular branch was coagulated without charring and was transected with excellent hemostasis. Smokeless views were provided. In the first 17 harvests, Doppler studies 3 months after the procedures demonstrated patent IMAs to the coronary circulation. Conclusions. The Harmonic Scalpel facilitates thoracoscopic IMA harvest and is expected to minimize hyperthermic damage of the IMA.
J B Flege - One of the best experts on this subject based on the ideXlab platform.
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Thoracoscopic internal mammary artery harvest for MICABG using the Harmonic Scalpel.
The Annals of thoracic surgery, 1997Co-Authors: T Ohtsuka, R K Wolf, L F Hiratzka, P Wurnig, J B FlegeAbstract:Thoracoscopic internal mammary artery (IMA) harvest is technically demanding, particularly on the left side. We have devised a Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH) technique to facilitate this procedure, and describe our clinical experience here. The Harmonic Scalpel functions with ultrasonic energy, producing less smoke and lower heat than regular electrocautery. A total of 27 (22 left and 5 right) pedicles of the IMA in 23 patients were harvested from the upper margin of the first rib or higher to the lower margin of the fifth rib thoracoscopically using the Harmonic Scalpel with a hook blade. In each case, the IMA harvest was completed thoracoscopically with only the Harmonic Scalpel, decreasing instrument transfers. Each vascular branch was coagulated without charring and was transected with excellent hemostasis. Smokeless views were provided. In the first 17 harvests, Doppler studies 3 months after the procedures demonstrated patent IMAs to the coronary circulation. The Harmonic Scalpel facilitates thoracoscopic IMA harvest and is expected to minimize hyperthermic damage of the IMA.
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thoracoscopic internal mammary artery harvest for micabg using the Harmonic Scalpel
The Annals of Thoracic Surgery, 1997Co-Authors: T Ohtsuka, R K Wolf, L F Hiratzka, P Wurnig, J B FlegeAbstract:Background. Thoracoscopic internal mammary artery (IMA) harvest is technically demanding, particularly on the left side. We have devised a Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH) technique to facilitate this procedure, and describe our clinical experience here. Methods. The Harmonic Scalpel functions with ultrasonic energy, producing less smoke and lower heat than regular electrocautery. A total of 27 (22 left and 5 right) pedicles of the IMA in 23 patients were harvested from the upper margin of the first rib or higher to the lower margin of the fifth rib thoracoscopically using the Harmonic Scalpel with a hook blade. Results. In each case, the IMA harvest was completed thoracoscopically with only the Harmonic Scalpel, decreasing instrument transfers. Each vascular branch was coagulated without charring and was transected with excellent hemostasis. Smokeless views were provided. In the first 17 harvests, Doppler studies 3 months after the procedures demonstrated patent IMAs to the coronary circulation. Conclusions. The Harmonic Scalpel facilitates thoracoscopic IMA harvest and is expected to minimize hyperthermic damage of the IMA.
Fiorella Perrino - One of the best experts on this subject based on the ideXlab platform.
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ultracision Harmonic Scalpel in oral and oropharyngeal cancer resection
Journal of Cranio-maxillofacial Surgery, 2014Co-Authors: Giancarlo Tirelli, Giulia Carolina Del Piero, Fiorella PerrinoAbstract:Abstract Objective The aim of this prospective study was to evaluate the benefits and risks when using an Ultracision Harmonic Scalpel in the surgical treatment of oral and oropharyngeal carcinomas. Study design Prospective non-randomized. Setting Clinica Otorinolaringoiatrica, Azienda Ospedaliero-Universitaria. Trieste, Italy. Subjects and methods In this study, conducted from April 2008 to August 2010, 36 consecutive patients underwent resection of oral or oropharyngeal carcinoma and lateral lymphadenectomy using the Ultracision Harmonic Scalpel. Evaluation criteria included length of the surgical procedure, intraoperative blood loss, quantity of neck drainage on the first, second and third postoperative days, postoperative complications, and a subjective assessment of postoperative pain and lymphatic oedema of the neck. Results were compared with previous surgical procedures carried out between May 2006 and March 2008 using cold knife and bipolar haemostasis ( n = 36) when the Harmonic Scalpel was not available. Results In patients treated with the Harmonic Scalpel, operating time was significantly reduced, both for resection of the carcinoma and the lateral lymphadenectomy. Intraoperative blood loss and neck drainage on the first and second postoperative days were significantly less and pain scores were significantly lower than in the cold knife group. No postoperative complications were noted in the Harmonic Scalpel group. The only disadvantage noted in the Harmonic Scalpel group was the high incidence of lymphatic oedema of the neck. Conclusions Use of the Harmonic Scalpel during resection of oral cancer and lateral lymphadenectomy is safe and confers some advantages over conventional methods.
Weiping Yang - One of the best experts on this subject based on the ideXlab platform.
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Harmonic Scalpel versus electrocautery dissection in modified radical mastectomy for breast cancer a meta analysis
PLOS ONE, 2015Co-Authors: Jinbo Huang, Yinghua Yu, Qinguo Mo, Weiping YangAbstract:Background Despite the common use of conventional electrocautery in modified radical mastectomy for breast cancer, the Harmonic Scalpel is recently emerging as a dominant surgical instrument for dissection and haemostasis, which is thought to reduce the morbidity, such as seroma and blood loss. But the results of published trials are inconsistent. So we made the meta-analysis to assess the intraoperative and postoperative endpoints among women undergoing modified radical mastectomy with Harmonic Scalpel or electrocautery. Methods A comprehensive literature search of case-control studies from PubMed, MEDLINE, EMBASE and Cochrane Library databases involving modified radical mastectomy with Harmonic Scalpel or electrocautery was performed. We carried out a meta-analysis of primary endpoints including postoperative drainage, seroma development, intraoperative blood loss and secondly endpoints including operative time and wound complications. We used odds ratios (ORs) with 95% confidence intervals (CIs) to evaluate the effect size for categorical outcomes and standardised mean differences (SMDs) for continuous outcomes. Results A total of 11 studies with 702 patients were included for this meta-analysis. There was significant difference in total postoperative drainage (SMD: -0.74 [95%CI: -1.31, -0.16]; P< 0.01), seroma development[OR: 0.49 (0.34, 0.70); P < 0.01], intraoperative blood loss(SMD: -1.14 [95%CI: -1.81,-0.47]; P < 0.01) and wound complications [OR: 0.38 (0.24, 0.59); P < 0.01] between Harmonic Scalpel dissection and standard electrocautery in modified radical mastectomy for breast cancer. No difference was found as for operative time between Harmonic Scalpel dissection and standard electrocautery (SMD: 0.04 [95%CI: -0.41, 0.50]; P = 0.85). Conclusion Compared to standard electrocautery, Harmonic Scalpel dissection presents significant advantages in decreasing postoperative drainage, seroma development, intraoperative blood loss and wound complications in modified radical mastectomy for breast cancer, without increasing operative time. Harmonic Scalpel can be recommended as a preferential surgical instrument in modified radical mastectomy.
Terry L Donat - One of the best experts on this subject based on the ideXlab platform.
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a comparison of tonsillectomy with the Harmonic Scalpel versus electrocautery
Otolaryngology-Head and Neck Surgery, 2002Co-Authors: Stuart A Morgenstein, Kurt H Jacobs, Peter A Brusca, Angelo R Consiglio, Joseph Donzelli, James A Jakubiec, Terry L DonatAbstract:Abstract Objective: We sought to test whether the use of the Harmonic Scalpel would cause less pain and more rapid recovery in tonsillectomy patients versus the use of electrocautery. Design and Setting: In a private practice community hospital, we conducted a prospective nonrandomized comparison of 156 pediatric tonsillectomy cases. Local anesthetic infiltrations and steroids were used at the discretion of the surgeon. Outcome variables consisted primarily of immediate- and mid-term pain, pain medications required, time to eating, morbidities and charges. Results: There were no differences between the groups on an intention-to-treat basis except for costs, which were higher in the Harmonic Scalpel group. When rescue use of electrocautery was required to control bleeding in the in the Harmonic Scalpel patients, more pain and longer times to taking food were noted. Conclusions: Used with discretion the Harmonic Scalpel is equivalent to electrocautery for tonsillectomy. Significance: The Harmonic Scalpel does not provide a major benefit over more conventional methods of tonsillectomy. (Otolaryngol Head Neck Surg 2002;127:333-8.)
