检索结果-南通市图书馆

Determining the need for a thoracoscopic approach to treat a giant hiatal hernia when abdominal access is poor

World Journal of Gastrointestinal Surgery 2023年第12期15卷 2739-2746页

作者： Francisco Javier Pérez Lara rogelio zubizarreta jimenez Tatiana Prieto-Puga Arjona Pilar Gutierrez Delgado Juan Manuel Hernández Carmona Jose Manuel Hernández Gonzalez Maria Pitarch Martinez Department of Surgery Hopital de AntequeraAntequera 29200Spain DOXA MicrofluidicsRincon de la Victoria 29730Spain Department of Surgery HRU Carlos HayaUnidad Cirugia Hepatobiliopancreat&TrasplantesMalaga 29200Spain

BACKGROUND Giant hernias present a significant challenge for digestive *** approach taken(laparoscopic vs thoracoscopic)depends largely on the preferences and skills of each surgeon,although in most cases today the laparoscopic approach is *** To determine whether patients presenting inadequate laparoscopic access to the intrathoracic hernial sac obtain poorer postoperative results than those with no such problem,in order to assess the need for a thoracoscopic *** For the retrospective series of patients treated in our hospital for hiatal hernia(n=112),we calculated the laparoscopic field of view and the working area accessible to surgical instruments,by means of preoperative imaging tests,to assess the likely outcome for cases inaccessible to *** Patients with giant hiatal hernias for whom a preoperative calculation suggested that the laparoscopic route would not access all areas of the intrathoracic sac presented higher rates of perioperative complications and recurrence during follow-up than those for whom laparoscopy was *** difference was statistically ***,the insertion of mesh did not improve results for the non-accessible *** For patients with giant hiatal hernias,it is essential to conduct a preoperative evaluation of the angle of vision and the working area for *** parts of the intrathoracic sac are inaccessible laparoscopically,the thoracoscopic approach should be considered.

关键词： Hiatal hernia Abdominal surgery Laparoscopy Thoracoscopy surgery

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Preoperative calculation of angles of vision and working area in laparoscopic surgery to treat a giant hiatal hernia

引用

World Journal of Gastrointestinal Surgery 2021年第12期13卷 1638-1650页

作者： Francisco Javier Perez Lara rogelio zubizarreta jimenez Francisco Javier Moya Donoso Jose Manuel Hernández Gonzalez Tatiana Prieto-Puga Arjona Arturo del Rey Moreno Maria Pitarch Martinez Surgery Service Antequera HospitalRincón de la Victoria 29730MálagaSpain DOXA Microfluidics Rincon de la Victoria 29738MálagaSpain

BACKGROUND Giant hiatal hernias still pose a major challenge to digestive surgeons,and their repair is sometimes a highly complex *** is usually performed by laparoscopy,while the role of the thoracoscopic approach has yet to be clearly *** To preoperatively detect patients with a giant hiatal hernia in whom it would not be safe to perform laparoscopic surgery and who,therefore,would be candidates for a thoracoscopic *** In the present study,using imaging test we preoperatively simulate the field of vision of the camera and the working area(instrumental access)that can be obtained in each patient when the laparoscopic approach is *** From data obtained,we can calculate the access angles that will be obtained in a preoperative computerised axial tomography coronal section,according to the location of the *** also provide the formula for performing the angle calculations If the trocars are placed in loss common situations,thus enabling us to determine the visibility and manoeuvrability for any position of the *** The working area determines the cases in which we can operate safely and those in which certain areas of the hernia cannot be accessed,which is when the thoracoscopic approach would be safer.

关键词： Hiatal hernia Angles Approach Laparoscopy Thoracoscopy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Novel suturing technique,based on physical principles,achieves a breaking point double that obtained by conventional techniques

引用

World Journal of Gastrointestinal Surgery 2021年第9期13卷 1039-1049页

作者： Francisco Javier Pérez Lara rogelio zubizarreta jimenez Francisco Javier Moya Donoso Jose Manuel Hernández Gonzalez Tatiana Prieto-Puga Arjona Ricardo Marín Moya Maria Pitarch Martinez Department of Surgery Hopital de AntequeraMalaga 29200Spain DOXA Malaga 29730Spain

BACKGROUND Sutures have been used to repair wounds since ancient ***,the basic suture technique has not significantly *** Phase I of our project,we proposed a“double diabolo”suture design,using a theoretical physical study to show that this suture receives 50%less tension than conventional sutures,and so a correspondingly greater force must be applied to break *** To determine whether these theoretical levels of resistance were met by the new type of *** An observational study was performed to compare three types of sutures,using a device that exerted force on the suture until the breaking point was *** tension produced by this traction was *** following variables were considered:Tearing stress on entry/exit points,edge separation stress,and suture break *** study sample consisted of 30 sutures with simple interrupted stitches(Group 1),30 with continuous stitches(Group 2),and 30 with the“double diabolo”design(Group 3).RESULTS The mean degree of force required to reach the breaking point for each of these variables(tearing,separation,and final breaking)was highest in Group 3(14.56,18.28,and 21.39 kg),followed by Group 1(7.36,10.38,and 12.81 kg)and Group 2(5.77,7.7,and 8.71 kg).These differences were statistically significant(P<0.001)in all *** The experimental results show that with the“double diabolo”suture,compared with conventional sutures,greater force must be applied to reach the breaking point(almost twice as much as in the simple interrupted suture and more than double that required for the continuous suture).If these results are confirmed in Phase III(the clinical phase)of our study,we believe the double diabolo technique should be adopted as the standard approach,especially when the suture must withstand significant tension(e.g.,laparotomy closure,thoracotomy closure,diaphragm suture,or hernial orifice closure).

关键词： Suture Technique Physical principles Tension

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：