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Objectives: The use of gasless laparoscopy with an abdominal wall-lifting device for benign gynecological diseases was compared to conventional laparoscopy with CO2 pneumoperitoneum. Methods: From February 2007 to July 2007, 76 women with uterine and/or adnexal benign diseases and candidates for laparoscopic surgery were recruited in this study. Thirty-two women underwent gasless laparoscopic surgery and 44 women underwent pneumoperitoneum laparoscopic surgery. Results: Diverse pathologies, including adnexal cyst, uterine myoma and ectopic pregnancy, were treated successfully with gasless laparoscopic surgery. Compared with the patients in the pneumoperitoneum group, the similar hospital stay (P=0.353) and intraoperative blood loss (P=0.157) were observed. However, the mean operative time in the gasless group was significantly longer than that in the pneumoperitoneum group (P=0.003). No severe intraoperative or postoperative complications were found in either group, except for one case of laparotomic conversion in the pneumoperitoneum group due to dense pelvic adhesions. The total hospital charges were significantly less in the gasless group than in the pneumoperitoneum group (P=0.001). In 38 cases of ovarian cyst resection, the mean operative time in the gasless group remained longer than that in the pneumoperitoneum group (P=0.017). The total hospital charges were also significantly less in the gasless group than in the pneumoperitoneum group (P<0.001). Conclusion: Our preliminary results demonstrated that the laparoscopic procedure using the gasless technique was a safe, effective method to treat benign gynecological diseases. Moreover, it was easy to master. As a minimally invasive treatment, gasless laparoscopic surgery provides a good choice to patients in the undeveloped regions in China without increasing the patients' and the government's burden significantly.

"The first six volumes of this work recorded the progress of Surgery down to 1913. Then came the Great War . Hence, immediately after the Armistice . I began to assemble a full staff of experts, whose work appears in Volumes VII and VIII."--Preface, v.7, 1921. ; "The five volumes originally contemplated in this System of Surgery were published between 1906 and 1909. Although the time that has elapsed since the publication of even the first volume, seven years, ."--Preface, v. 6, 1913. ; Volume 1 was published in 1906; v.2 in 1907; v.3-4 in 1908; v.5 in 1909; v.6 in 1913; v.7-8 in 1921. ; Vols. 4-5 edited by William Williams Keen and John Chalmers Da Costa. ; Contains bibliographies. ; v. 1. History; surgical physiology; surgical pathology; infections; tumors; wounds.--v. 2 Bones; joints; fractures; dislocations, orthopedics; muscles; lymphatics skin; nerves; spine.--v. 3. Head; neck; thorax; esophagus; abdominal wall; peritoneum; stomach; liver; spleen; pancreas.--v. 4 Intestines; rectum; herina; genito-urinary organs; eye; ear; military, naval, tropical surgery.--v. 5 Vascular; gynecology; anesthesia; X-rays; operative & plastic; infections; leagl pathologic relations; hospital organization.--v. 6 The newest surgery; general index to complete works. vols. I-VI.--v. 7. Supplementary volume. General: military; naval; technic; fractures; spine & peripheral nerves; orthopedic; vascular system.--v. 8. Supplementary volume. Muscles; endocrines; amputations; bones; joints; head; thorax; abdomen genito-urinary radium; X-ray; anesthesia; legal. ; Mode of access: Internet.

Gybalo R. V., Tsema Ie. V., Batiuk A. I. The treatment results of patients with postoperative ventral hernias after multi-stage surgery of open abdominal gunshot wounds (improvement of hernioplasty-technique). Journal of Education, Health and Sport. 2020;10(7):216-223. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.07.024 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.07.024 https://zenodo.org/record/3960500 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 19.06.2020. Revised: 09.07.2020. Accepted: 24.07.2020. The treatment results of patients with postoperative ventral hernias after multi-stage surgery of open abdominal gunshot wounds (improvement of hernioplasty-technique) R. V. Gybalo1, Ie. V. Tsema1,2, A. I. Batiuk1 1National Military Medical Clinical Centre of Ministry of Defense of Ukraine, Kyiv, Ukraine 2Bogomolets National Medical University of Ministry of Health Care of Ukraine, Kyiv, Ukraine Abstract Aim: to compare a new technique of the tension-free abdominal wall repair for postoperative ventral hernia after multi-stage surgery of open abdominal gunshot wounds with the ...

In elderly and senile patients, extracardiac surgery frequently leads to cardiovascular complications. For their prevention, it is necessary to early detect patients with a potentially poor postoperative period. Routine preoperative examination is of limited prognostic value and instrumental techniques are inaccessible. Objective: to reveal the predictors of cardiac complications of abdominal and small pelvic surgery in elderly and senile patients. Subjects and methods. The study covered 82 patients (63 men and 19 women) aged over 60 years who had undergone at least one-hour open operations on the abdomen and small pelvis at the A. A. Vishnevsky Central Military Hospital Three in 2008—2011. In addition to routine procedures, the preoperative examination comprised the calculation of the Lee, Goldman, and Detsky scores and, in 35 patients, determination of NT-proBNP concentrations. Results. The logistic regression method applying the values routinely measured prior to surgery was used to make a cardiac complication-predicting model that included the Detsky index and blood glucose levels. Its dividing capacity proved to be satisfactory – AUC 0.75. Inclusion of echocardiographic data in the model failed to substantially improve its prognostic capacity. The cardiomarker NT-proBNP was the most effective predictor of postoperative complications. As its value became higher, there was an increase in the frequency of cardiac complications (p<0.001); AUC was 0.96. Conclusion. NT-proBNP is a highly effective predictor of postoperative complications in elderly and senile patients and may be included into preoperative screening. Key words: elderly and senile age, abdominal surgery, heart failure, surgery risk assessment, natriuretic peptides, Lee index, Goldman index, Detsky index, NT-proBNP. ; У больных пожилого и старческого возраста внесердечные операции часто приводят к осложнениям со стороны сердечно-сосудистой системы. Для их предупреждения необходимо заблаговременно выявлять больных с потенциально неблагополучным течением послеоперационного периода. Рутинное предоперационное обследование имеет ограниченную прогностическую ценность, а инструментальные методы малодоступны. Цель исследования — выявить предикторы кардиальных осложнений операций на органах брюшной полости и малого таза у больных пожилого и старческого возраста. Материал и методы. В исследование были включены 82 больных (63 мужчины, 19 женщин) старше 60 лет, которым в 2008—2011 гг. в ЦВКГ №3 им. А. А. Вишневского были выполнены открытые операции на органах брюшной полости и малого таза продолжительностью не менее 1 часа. Предоперационное обследование, помимо рутинных методик, включало расчет оценки по шкалам Lee, Goldman, Detsky и у 35-и больных — определение концентрации NT-proBNP. Результаты. Методом логистической регрессии из показателей, рутинно измеряемых перед операцией, была составлена модель для прогнозирования кардиальных осложнений, включающая индекс Detsky и уровень глюкозы крови. Её разграничительная способность оказалась удовлетворительной — AUC 0,75. Включение в модель данных эхокардиографии не позволило существенно улучшить ее прогностическую способность. Наиболее эффективным предиктором послеоперационных осложнений оказался кардиомаркер NT-proBNP. По мере увеличения его значения отмечалось повышение частоты кардиальных осложений (р<0,001), AUC составила 0,96. Заключение. NT-proBNP является высокоэффективным предиктором послеоперационных осложнений у больных пожилого и старческого возраста и может быть включен в скрининговое предоперационное обследование. Ключевые слова: пожилой и старческий возраст, абдоминальные операции, сердечная недостаточность, оценка риска операций, натрий-уретические пептиды, индекс Lee, индекс Goldman, индекс Detsky, NT-proBNP.

There is a growing interest in telecare, particularly in the kind of "invisible work" involved in teleconsultations (Oudshoorn, 2011). One dimension of this work is the "sensory work" in support of clinical examination at a distance (Lupton & Maslen, 2017). More research is needed to understand how such sensory work is done in and as multimodal interaction (Mondada, 2019). Recent work has shown the extent to which such sensory work could be re-mediated, despite challenges due to the technology, in particular the asymmetry of sensory access (Seuren et al., 2020; Stommel, Van Goor, & Stommel, 2020). In earlier research, we found that showings occurred less frequently in post-surgery consultations conducted through video rather than face-to-face (Stommel et al., 2020). Moreover, in spite of the apparent relevance of visual access, it seemed as if showings were even being evaded. In this article, we use a conversation analytical perspective to examine one case of emergent showing sequences in a video-mediated post-surgery consultation, in order to track its sequential organisation, which develops towards an eventually inadequate showing. The case comes from a set of post-surgery consultations with patients who had undergone tumour resection (abdominal surgery) two weeks earlier. We first present a case from an in-person consultation, in which a showing sequence is inserted smoothly and closed with mutual assessments. Next, we focus on the VMC-showing, which is also inserted in the context of a patient question concerning the surgery scars. We analyse the context leading up to the showing, the showing itself and the abandonment of the showing sequence. We found that, first, the showing is not initiated at the earliest sequential opportunity, but is requested with an orientation to potential barriers. Second, screen-based evidential boundaries emerge, as the surgeon has no visual access to what is shown, in response to which the surgeon employs remedial action. Third, the surgeon moves out of the showing to an instructed touch-sequence – in other words, displays of visual appreciation are neither produced nor pursued. Upon the surgeon's closing formulation that it was "difficult to assess in this manner", the contextual factor of visibility is eventually explicitly claimed to be "ineffective" for medical assessment. These findings might explain the scarcity of showing sequences in our data. More generally, they raise questions about (the limits of) sensory work in video consultations.

A case is presented where a patient referred to the General Surgery Service from the Luanda Main Military Hospital, Angola, has suffered a great loss of abdominal wall, fibrinopurulent peritonitis and severe sepsis due to firearm abdominal wound, and had improved its general condition in spite of divergent criteria about its state. ; Se presenta un paciente atendido en el Servicio de Cirugía General del Hospital Militar Principal de Luanda, Angola, con gran pérdida de la pared abdominal, peritonitis fibrino-purulenta y sepsis grave debido a una herida abdominal (ocasionada por un arma de fuego) que evoluciona favorablemente, a pesar de criterios diferentes ante su grave estado.

AbstractVentriculoperitoneal shunt (VPS) is a well-known procedure in the neurosurgical field. However, it has high complication and reoperation rates. Abdominal pseudocyst (APC) formation is a rare complication of VPS with reports in the literature varying from 4 to 10%. In this article, we report a simple and effective technique, with no additional cost, to avoid APC formation by making small multiple slits along the length of the peritoneal catheter.

This study sought to evaluate injury causes and patient outcomes in young children with abdominal injuries. Cases of blunt abdominal injury (N = 927) to children ages 0 to 4 years were extracted from the National Pediatric Trauma Registry®. Measures included hospital utilization (days hospitalized, intensive care unit use, and surgery) and patient outcome (in-hospital fatality, discharge to rehabilitation facility, home rehabilitation, and home nursing). The three most common mechanisms of abdominal injury were motor vehicles (61.27%), child abuse (15.75%), and falls (13.59%). Hospital utilization was higher in patients with multisystem injuries. Patient outcomes were more severe in abused children or those with concomitant central nervous system (CNS) injury; these were the only variables independently associated with increased mortality in this sample. Pediatric abdominal trauma leads to intense use of hospital resources and a high risk of in-hospital mortality. Child abuse, compared to falls, is independently associated with a 6-fold increase in in-hospital mortality.

From the pioneering Danville surgeon Ephraim McDowell, the first doctor to successfully perform abdominal surgery, and Luke Blackburn, dubbed the "Hero of Hickman" and elected governor in 1879 after his efforts to combat yellow fever, to contemporary Kentucky doctors performing groundbreaking reconstructive surgery and artificial heart implants, Healing Kentucky tells the story of the two-hundred-year struggle to provide good health care to all Kentuckians. Nancy Disher Baird describes Lexington schoolteacher Linda Neville's mission to treat the eye disease trachoma in rural Kentucky, Louise C

Introduction: Hydatid disease is a disease that has been known since antiquity and was described by Hippocrates with the particular term Liver filled with water followed by famous Arabian physician Al-rhazes who wrote on hydatid cyst of liver about 1000 years ago. Hydatid disease commonly known as Cystic Echinococcosis (CE) is a parasitic infestation caused by flatworm Echinococcus granulosus. Hydatid disease is characterized by cystic lesions occurring in different parts of body most commonly liver (65%), lungs (15%). Unusual sites of involvement include muscles (5%), bones (5%),kidney (3%), spleen (2%), diaphragm (1%), ovary (0.2%).The peritoneal cavity, thyroid, breast, gall bladder, omentum are rarely involved. Methods: Our study was a prospective observational study conducted in Postgraduate Department of General Surgery, Government Medical College, Srinagar, J&K for a period of 2 years. This study included 30 patients after fulfilment of inclusion and exclusion criteria. Ethical clearance was obtained from institutional Ethical Committee. Results: In this study 30 cases of hydatid disease were studied, the most common age group involved in this disease was 21-30 years. . Most of our patients were females 18 cases (60%) and males 12 cases (40%). Male: Female ratio of our study is 1:1.5. Majority of patients presented with abdominal pain 24 cases (80%) followed by vomiting in 5 cases (16.7%), palpable mass was found in 1 case (3.3%) and Jaundice in 1 case (3.3%). Laparoscopic hydatid cystectomy for hydatid liver was done in 10 cases (33.3%). Open hydatid cystectomy was done in 17 cases (56.7%). Conclusion: Hydatid disease can occur in any age group but is seen most commonly in middle age , females, patients belonging to low socioeconomic status and involved in farming. Low socioeconomic status, agricultural activities and association with dogs or cattle were risk factors for the disease. Absence of history of contact with cattle or dogs doesnt rule out the possibility of disease.

WOS: 000442113000012 ; PubMed: 28196654 ; Adrenal hemorrhage following blunt abdominal trauma is extremely rare. Most of the lesions are unilateral and right sided. Although often asymptomatic, life-threatening adrenal insufficiency may develop in the bilateral adrenal gland hemorrhage. Isolated adrenal injuries are very rare. They are often associated with other organ injuries. The mortality rates of patients range from 7% to 32%. In this report, we present the computed tomography and magnetic resonance imaging findings of unilateral adrenal hemorrhages in two patients with a history of fall from a height. (c) 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V.

Gastrointestinal Stromal Tumour involving rectum and anal canal is an extremely rare entity. This is a case report of a 47 years lady presented with fresh rectal bleed associated with rectal pain and foul smelling rectal mucus discharge. On rectal examination, she had a firm mass palpable about 1.5 cm from anal verge. Considering the size of the tumour and its close proximity with cervix and involvement of levator muscles, extralevator abdominal perineal excision of rectum was undertaken with good recovery after surgery. It was followed by imatinib therapy.

This project by the ICVR (International Consortium of Vascular Registries), a collaboration of 11 vascular surgical quality registries, was designed to evaluate international variation in the contemporary management of abdominal aortic aneurysm (AAA) with relation to recommended treatment guidelines from the Society for Vascular Surgery and the European Society for Vascular Surgery. ; Registry data for open and endovascular AAA repair (EVAR) during 2010 to 2013 were collected from 11 countries. Variations in patient selection and treatment were compared across countries and across centers within countries. ; Among 51 153 patients, 86% were treated for intact AAA (iAAA) and 14% for ruptured AAA. Women constituted 18% of the entire cohort (range, 12% in Switzerland-21% in the United States; P<0.01). Intact AAAs were repaired at diameters smaller than recommended by guidelines in 31% of men (<5.5 cm; range, 6% in Iceland-41% in Germany; P<0.01) and 12% of women with iAAA (<5 cm; range, 0% in Iceland-16% in the United States; P<0.01). Overall, use of EVAR for iAAA varied from 28% in Hungary to 79% in the United States (P<0.01) and for ruptured AAA from 5% in Denmark to 52% in the United States (P<0.01). In addition to the between-country variations, significant variations were present between centers in each country in terms of EVAR use and rate of small AAA repair. Countries that more frequently treated small AAAs tended to use EVAR more frequently (trend: correlation coefficient, 0.51; P=0.14). Octogenarians made up 23% of all patients, ranging from 12% in Hungary to 29% in Australia (P<0.01). In countries with a fee-for-service reimbursement system (Australia, Germany, Switzerland, and the United States), the proportions of small AAA (33%) and octogenarians undergoing iAAA repair (25%) were higher compared with countries with a population-based reimbursement model (small AAA repair, 16%; octogenarians, 18%; P<0.01). In general, center-level variation within countries in the management ...

Medical induction is an alternative to dilatation and evacuation (D and E) in second trimester abortion, though it has higher risk of minor complications compared to D and E. Combination of mifepristone and misoprostol is commonly used for the medical abortion. A 32 years G3P2L2 with previous two cesarean delivery was referred to our center at sixteen weeks of gestation for termination of her pregnancy. After 63 doses of misoprostol, she had to undergo unintended major intra-abdominal surgery for partial uterine rupture. Keywords: Dilatation and evacuation; medical induction; second trimester abortion; uterine rupture.