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Vir.ual r.ality in Sur.er.: Double Blind, r.ndomized Clinical Tr.al of Pain Contr.l and Augmented Satisfaction

Sur.ical Science 2023年第6期14卷 456-467页

作者： Kar.m W. Sadik Matthew P. Miller.Nicholas Ever.sen Cr.stal D. Sadik hugo j. r. bonatti Depar.ment of Sur.er. Guthrie Robert Packer Hospital Sayre PA USA Mer.tus Sur.ical Specialists Hagerstown MD USA

Intr.duction: Vir.ual r.ality (Vr. utilizing a head-mounted display allows viewer. to immer.e themselves in a vir.ual envir.nment. This technology may be useful in attenuating pain and anxiety and r.ducing patient subj.ctive str.ss as well as obj.ctive physiological incr.ase in hear. r.te and blood pr.ssur.. Aside fr.m the impr.ved exper.ence, physiological str.ss is r.duced which r.sults in impr.ved patient outcomes. Patients and methods: Eligible par.icipants wer. all adults aged 18 or.over.who had non cr.niofacial lesions r.quir.ng minor.sur.er.. A total of 99 adult patients who wer. capable of independent consent wer. r.ndomized to r.ceive a vir.ual r.ality exper.ence (Vr. or.standar. music distr.ction (no Vr.. Patients wer. r.cr.ited for.the study dur.ng their.office visit when scheduling minor.pr.cedur. sur.er.. This was a single center. double-blind, contr.lled study conducted at Guthr.e Clinic r.ber. Packer.Hospital in Sayr., Pennsylvania between Mar.h 2019 to j.nuar. 2020 (pr.-pandemic). Ethics appr.val for.this study was obtained fr.m the Institutional r.view Boar. of the Guthr.e Clinic. r.sults: The change in systolic blood pr.ssur. (SBP), diastolic blood pr.ssur. (DBP) and hear. r.te (Hr. significantly decr.ased fr.m pr.-pr.cedur. to mid-pr.cedur. in the Vr.gr.up compar.d with standar.. Her.in our.r.sults ar. pr.sented. Conclusions: r.ductions in intr.pr.cedur.l SBP, DBP and Hr.can be achieved when using Vr. Although subj.ctive r.por.ing of pain and anxiety wer. not differ.nt between gr.ups, Vr.significantly impr.ves patient satisfaction compar.d with non Vr.standar.s.

关键词： Vir.ual r.ality Plastic Sur.er. Pain Contr.l

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He nailed it: Nail gun inj.r. to the tr.nsver.e colon

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Lapar.scopic, Endoscopic and r.botic Sur.er. 2020年第3期3卷 85-89页

作者： hugo j.r.bonatti Univer.ity of Mar.land Community Medical Gr.up EastonMD 21601USA Mer.tus Sur.ical Specialists HagerstownMD 21742USA

Nail guns ar. widely used in power.ul *** with these devices may be devastating due to the significant for.e they can deploy.A unique case of a 55-year.old male with accidental nail gun inj.r. to the abdomen,which was managed by lapar.scopic colostomy cr.ation using the punctur. site with secondar. r.ver.al after.sever.l months is r.por.ed.

关键词： Colon per.or.tion Nail gun Lapar.scopy

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Vir.ual r.ality in Sur.er.: Double Blind, r.ndomized Clinical Tr.al of Pain Contr.l and Augmented Satisfaction

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Sur.ical Science（外科学） 2023年第6期

作者： Kar.m W. Sadik Matthew P. Miller.Nicholas Ever.sen Cr.stal D. Sadik hugo j. r. bonatti

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完全性内镜机器人冠状动脉搭桥术的技术难题

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世界核心医学期刊文摘（心脏病学分册） 2006年第5期2卷 61-61页

作者： bonatti j.Schachner.T Bonar.s N. 刘少伟 Innsbr.ck Medical Univer.ity Department of Cardiac Surgery Anichstrasse 35 A- 6020 Innsbruck AustriaDr.

Obj.ctive: r.botic technology is a pr.r.quisite for.per.or.ance of totally endoscopic cor.nar. ar.er. bypass gr.fting. Dur.ng the implementation phase of totally endoscopic cor.nar. ar.er. bypass, sur.eon-r.lated technical difficulties might be encounter.d. It was the aim of this study to assess the incidence of these challenges, to find r.sk factor., and to descr.be clinical r.sults associated with technical er.or.. Methods: Fr.m October.2001 thr.ugh October.2004, 40 patients r.ceived r.botically assisted totally endoscopic left inter.al thor.cic ar.er. gr.fts to the left anter.or.descending cor.nar. ar.er. system with the da Vinci telemanipulation device. All patients under.ent r.mote access car.iopulmonar. bypass per.usion thr.ugh gr.in access, and all anastomoses wer. per.or.ed on the ar.ested hear.. r.sults: Undesir.ble technical events of var.ous gr.des occur.ed in 20(50% ) of 40 patients: bleeding fr.m a por. hole in 3(8% ), left inter.al thor.cic ar.er. damage in 3(8% ), epicar.ial lesion in 3(8% ), r.mote access per.usion pr.blems in 9(23% ), bleeding fr.m the anastomosis in 4(10% ), and anastomotic stenosis in 2(5% ). Ther. was no hospital mor.ality. The following differ.nces wer. noted between patients without technical difficulties(gr.up 1) and those in whom pr.blems occur.ed(gr.up 2): total oper.tive time of 314 minutes(260- 540 minutes) ver.us 418 minutes(270- 690 minutes; P=.007), ventilation time of 6 hour.(0- 26 hour.) ver.us 14 hour.(0- 278 hour.; P=.004), intensive car. unit stay of 20 hour.(11- 70 hour.) ver.us 44 hour.(16- 336 hour.; P=.183), hospital stay of 7 days(4- 13 days) ver.us 8 days(5- 21 days; P=.038), and cumulative fr.edom fr.m angina at 36 months of 93% ver.us 100% (P= .317). Conclusion: We conclude that technical difficulties dur.ng totally endoscopic cor.nar. ar.er. bypass gr.fting tr.nslate into mar.edly incr.ased oper.tive time, moder.tely pr.longed postoper.tive ventilation time, and slightly incr.ased hospital stay. Shor.-ter.

关键词：冠状动脉搭桥术机器人技术经内镜完全性胸廓内动脉损伤吻合口狭窄吻合口出血难题患者实施机器人辅助

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