Luigi Garufi, Alvise Guariento, Francesco Bertelli, Vladimiro Vida
{"title":"3D Reconstruction for a Complex Pediatric Redo Aortic Arch Surgery in a 9-Year-Old Ukrainian Refugee.","authors":"Luigi Garufi, Alvise Guariento, Francesco Bertelli, Vladimiro Vida","doi":"10.52198/23.STI.43.CV1738","DOIUrl":"10.52198/23.STI.43.CV1738","url":null,"abstract":"<p><p>Redo aortic surgery poses significant challenges, particularly in complex scenarios involving congenital heart conditions that have been previously operated on several years prior. The integration of three-dimensional (3D) reconstruction and printing holds immense potential to greatly improve surgical precision, particularly in critical situations.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138462710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Malysz Oyola, John Miller, Colston Edgerton, William Hope
{"title":"Polymer versus Titanium Clips in Laparoscopic Cholecystectomy.","authors":"Anna Malysz Oyola, John Miller, Colston Edgerton, William Hope","doi":"10.52198/23.STI.43.GS1730","DOIUrl":"10.52198/23.STI.43.GS1730","url":null,"abstract":"<p><strong>Background: </strong>Surgical clips are commonly used during laparoscopic cholecystectomy for cystic duct and artery ligation. Titanium and polymer clips are the two most common types used for this indication. Given the cost-saving potential, design advantages, and decreased incidence of complications associated with polymer clips, we sought to study whether there is a clinically significant difference in outcome between polymer and titanium clips in laparoscopic cholecystectomy.</p><p><strong>Methods: </strong>Fifty consecutive cases using polymer clips followed by 50 consecutive cases using metal clips over a 6-month period by residents under the direction of a single surgeon were retrospectively reviewed. The following outcomes were evaluated: incidence of bile leak, postoperative bleeding, need for additional procedures, hospital length of stay, and cost.</p><p><strong>Results: </strong>We found that significantly more misfires occurred with the use of the polymer clips (n=17) than with the titanium clips (n=2, p<.001). Eight cases (16%) required opening of an additional polymer clip cartridge to complete the operation. Despite this additional expense, the total cost as it pertained to clip usage ($30.32 USD) was still lower than that using titanium clips ($139.17 USD). While these numbers were not statistically significant, three cases had bile leaks and required additional procedures, all of which were performed with metal clips. No postoperative bleeds were identified and there was no difference in hospital length of stay; most patients were discharged on the day of the procedure.</p><p><strong>Conclusion: </strong>These findings demonstrate comparable clinical outcomes between laparoscopic cholecystectomies performed with polymer and titanium clips, though polymer clip usage carries a lower cost.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oliver C Sax, Zhongming Chen, Sandeep S Bains, Danielle A Jacobstein, Jeremy A Dubin, Daniel Hameed, Mallory C Moore, Michael A Mont, James Nace, Ronald E Delanois
{"title":"Does Preoperative Statin Exposure Reduce Prosthetic Joint Infections and Revisions Following Total Joint Arthroplasty?","authors":"Oliver C Sax, Zhongming Chen, Sandeep S Bains, Danielle A Jacobstein, Jeremy A Dubin, Daniel Hameed, Mallory C Moore, Michael A Mont, James Nace, Ronald E Delanois","doi":"10.52198/23.STI.43.OS1717","DOIUrl":"10.52198/23.STI.43.OS1717","url":null,"abstract":"<p><strong>Introduction: </strong>The pleiotropic effects of statins extend beyond managing cardiovascular health and are suggested to modulate Staphylococcus aureus biofilm formation with prosthetic joint infection (PJI) reduction. However, a large analysis of statin use prior to total joint arthroplasty (TJA) to determine infection and revision risk is lacking. We specifically evaluated: 90-day to two-year (1) prosthetic joint infection (PJIs); (2) revisions; and (3) respective risk factors.</p><p><strong>Materials and methods: </strong>We queried a national, all-payer database for patients undergoing either TKA or THA between 2010-2020. Chronic statin exposure was defined as >3 prescriptions filled within one-year prior to TJA (statin users). A control cohort of patients undergoing TJA without history of statin use prior was identified (statin naïve). Cohorts were matched 1:1 based on demographics and comorbidities (TKA: n=579,136; THA: n=202,092). Multivariate logistic regression was performed to evaluate risk factors for PJIs and revisions.</p><p><strong>Results: </strong>Among TKA recipients, statin users had lower incidence of PJIs at one year (0.36 vs. 0.39%) to two years (0.45 vs. 0.49%) compared to the statin naïve (all, p≤0.007). Similarly, statin users had lower incidence of one- to two-year revisions (all, p≤0.048). Among THA recipients, statin users had lower incidence of PJIs at 90 days (0.37 vs. 0.45%) to two years (2% vs. 2.14%) (all, p<0.001). Similar trends were observed for 90-day to two-year revisions (all, p≤0.022). Statin use was independently associated with decreased odds of PJIs and revisions by one year.</p><p><strong>Conclusions: </strong>Statin use is associated with a reduced risk of PJIs and revisions from one to two years following TJA. It may be worthwhile to ensure patients take statin therapy if indicated for previously established cardiovascular guidelines.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41238637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melanie Caba, Laura Scholl, Alexandra Valentino-Pfeil, Emily Hampp, Nipun Sodhi, Jeremy Dubin, Daniel Hameed, Michael A Mont
{"title":"Using Software to Implant Orthopaedic Hardware: Surgeon Intraoperative Confidence Increased with Latest Technological Updates.","authors":"Melanie Caba, Laura Scholl, Alexandra Valentino-Pfeil, Emily Hampp, Nipun Sodhi, Jeremy Dubin, Daniel Hameed, Michael A Mont","doi":"10.52198/23.STI.43.OS1716","DOIUrl":"10.52198/23.STI.43.OS1716","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted total knee arthroplasty (TKA) has been associated with improved accuracy and precision of implant placement, protection of soft tissue, and improved patient-reported postoperative outcomes when compared to manual TKA techniques. Previous studies have highlighted the importance of surgical confidence throughout the learning curve when adopting robotic-assisted platforms. The purpose of this study was to evaluate the confidence and efficiencies of surgeons when utilizing computed tomography (CT)-based robotic TKA technology.</p><p><strong>Materials and methods: </strong>A cross-sectional, questionnaire-based study was conducted with 20 arthroplasty-trained surgeons with prior experience in both manual TKA and robotic-assisted TKA techniques. The surgeons completed an initial learning period, with new software, during various stages of their experience. The new TKA software upgrade builds on the prior software version with new features. A Net Promoter Score (NPS), the measurement of a respondent's likelihood to recommend a product or service to others, was used during the analysis of survey questions. A NPS over 50 indicates a positive score.</p><p><strong>Results: </strong>When compared to manual TKA techniques, 95% of surgeons reported that their overall intraoperative confidence increased with the new software upgrade for CT-based robotic technology and had an average rating of 8.9 out of 10 for their intraoperative confidence with the new software upgrade. Additionally, 100% of surgeons reported that they were more confident when performing intraoperative implant adjustments with the new software upgrade when compared to manual TKA. Surgeons determined that the overall use of the new software upgrade was intuitive (8.4 of 10 average rating) and were satisfied with the overall use of the new software upgrade (9 of 10 average rating). Also, surgeons reported that they would recommend the new software upgrade for CT-based robotic technology to colleagues (NPS of 85), as well as being used as a research tool (NPS of 85) or for a training and education tool in a fellowship program (NPS of 90).</p><p><strong>Conclusion: </strong>As new technology continues to enter the field of orthopedics, it is important to ensure upgrades and advancements continue to serve surgeons and provide efficiencies in the operating room. For established robotic surgeons, the new robotic technology assessed in this study provided increased confidence when compared to manual TKA. Based on these results, the new software upgrade demonstrated value during various stages of a TKA procedure and is highly recommended for use by others in the field of orthopedics.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41146647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giuseppe Nasso, Giuseppe Speziale, Francesco Bartolomucci, Giovani Valenti, Claudio Larosa, Francesco Borrello, Vincenzo Amodeo, Flavio Fiore, Ignazio Condello
{"title":"Cardiopulmonary Bypass Settings for the Prevention of Early Hypotension During CABG.","authors":"Giuseppe Nasso, Giuseppe Speziale, Francesco Bartolomucci, Giovani Valenti, Claudio Larosa, Francesco Borrello, Vincenzo Amodeo, Flavio Fiore, Ignazio Condello","doi":"10.52198/23.STI.43.CV1727","DOIUrl":"10.52198/23.STI.43.CV1727","url":null,"abstract":"<p><strong>Background: </strong>Vasoplegic syndrome is a form of vasodilatory shock that can occur before, during or after cardiopulmonary bypass (CPB). We introduce a strategy to reduce the incidence of early hypotension phenomena during Coronary Artery Bypass Graft (CABG) procedures.</p><p><strong>Materials and methods: </strong>In this prospective cohort study, 100 patients underwent elective CABG with two perioperative CPB settings. The study group (50 patients) was managed with retrograde autologous priming (RAP), 3-minute stepwise for the institution of CPB, and pulsatile flow (PP). The control group (50 patients) was managed without RAP, with the rapid initiation of CPB, and non-pulsatile (NP) flow. The primary endpoints were MAP (mmHg), number of hypotensive phenomena (MAP < 50 mmHg for > 30 sec), the venous return volume on CPB (ml), the cardiac index (L/min/m2), hemoglobin (g/dL), indexed oxygen delivery (DO2i, ml/min/m2), the systemic vascular resistance index (SVRI, dynes s m2/cm5), number of 1-ml boluses of a vasoactive substance (norepinephrine), the positive fluid balance (ml), and the number of red blood cell units for transfusion.</p><p><strong>Results: </strong>During CPB, the mean values in the study and control groups were as follows: MAP, 68± 7 vs 56 ± 7 (p-value, 0.0019); hypotensive phenomena, 3 ± 1 vs 8 ±2 (p-value, 0.019); venous return volume, 840±79 vs 1129 ±123 (p-value, 0.0017); cardiac index, 2.4 ± 0.4 vs 2.7 ±0.2 (p-value, 0.0023); hemoglobin, 9.13 ± 0.29 vs 7.8± 0.23 (p-value, 0.0001); DO2i, 301± 12 vs 276±23 (p-value, 0.0011); SVRI, 1879 ±280 vs 2210 ±140 (p-value, 0.0017); norepinephrine, 1±2 vs 8 ±3 (p-value, 0.0023); positive fluid balance, 750 ±212 vs 1450 ±220 (p-value, 0.005); and total number of red blood cell units for transfusion, 16 ±4.2 vs 27 ± 5.3 (p-value, 0.008).</p><p><strong>Conclusions: </strong>In this prospective cohort study, during CPB, the study group showed a better preservation of MAP, SVRI, and DO2i, and a reduction of vasoconstrictor use in a CPB setting with the RAP technique, 3-minute stepwise for the initiation of CPB and pulsatile pump flow, compared to the control group. Further studies are needed to validate this perioperative approach to CPB.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41238636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Novel Uses of Indocyanine Green in Thoracic Surgery: A Review and Case Series.","authors":"Justin A Olivera, Isaac Faith, Osita Onugha","doi":"10.52198/23.STI.43.CV1706","DOIUrl":"10.52198/23.STI.43.CV1706","url":null,"abstract":"<p><p>Indocyanine green (ICG) is a water-soluble molecule that emits fluorescence in the near-infrared light spectrum. Due to its fluorescence properties, safety profile, and cost-effectiveness, ICG is used in minimally invasive surgery, enabling real-time visualization of structures during the operation. Until recently, its use was mainly limited to robotic surgery, which required specific technological setups to visualize the fluorescence. With recent technological advancements, however, similar capabilities can now be integrated into smaller laparoscopic instruments, broadening the accessibility and usefulness of ICG. In this article, we present various innovative applications of ICG in thoracic surgery, drawing from recent developments in the field and our own experiences. Specifically, we focus on the novel role of ICG in the evaluation of gastric conduit perfusion, lung nodule localization, and thoracic duct ligation.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mark S Granick, Ashley Ignatiuk, James Yang, Vanessa A Ocon, Edward S Lee
{"title":"Bioabsorbable Temporizing Matrix (BTM): Not Just for Burns.","authors":"Mark S Granick, Ashley Ignatiuk, James Yang, Vanessa A Ocon, Edward S Lee","doi":"10.52198/23.STI.43.WH1700","DOIUrl":"10.52198/23.STI.43.WH1700","url":null,"abstract":"<p><p>A skin substitute developed in Australia 2 decades ago for use in acute burns was recently introduced into the United States for the treatment of open wounds. This product has been shown to be very efficacious for coverage of debrided burn wounds. It consists of an inorganic synthetic woven layer that induces cellular ingrowth and deposition of interstitial tissue. It is covered by an attached silicone layer that seals the wound. The product is placed with the woven side directly on the wound. It is fixed in place and optimally covered by a negative pressure dressing for the first 5-10 days. Due to its synthetic composition, it is highly resistant to infection and can stay on the wound for as long as needed. The authors have used this matrix in a wide variety of complex reconstructions in 27 patients, consisting of 10 females and 17 males. Eleven had traumatic wounds of various etiologies (deep burns, crush injuries, Morell-Lavallee lesion, hand injuries, multiple trauma, open fractures, compartment syndromes and soft tissue avulsions). The following wounds were also treated with BTM: pressure ulcers, axillary hidradenitis, scalp wounds, severe facial acne keloidalis, Fournier's gangrene, a diabetic foot ulcer, a chronic venous ulcer, a cutaneous pyoderma gangrenosum, a radiation ulcer with exposed Achilles tendon, a disfiguring scar from an old Dupytrens excision and a non-healing chemotherapy extravasation ulcer. Hand and leg wounds with exposed tendon achieved coverage without tethering. The scalp wounds developed a neodermis and were skin-grafted. A pyoderma gangrenosum patient with excessive slough and uncontrolled bleeding was temporarily immunosuppressed, aggressively debrided and covered with the matrix. Her bleeding resolved. She developed a neodermis, and had reduced symptoms. The Fournier's patient had immediate skin-grafting of his penis and testicles, but the remaining extensive perineal and upper thigh wounds were treated with the matrix and healed without additional skin grafting. A hand patient with a forearm fasciotomy wound was covered with the matrix. As the swelling resolved the size of the defect decreased to the point that the wound was delaminated. The adjacent skin was elevated and used to cover the open area, achieving full closure. There were no complications attributed to the use of the matrix. Several patients healed secondarily with the silicone sheeting gradually peeling off. Seven patients have received or are awaiting skin grafts to be placed over the neodermis. Although this is an early review of the use of this synthetic matrix in the US, it comes with a positive legacy from Australia. The findings thus far indicate that there is a wide range of applications for this product well beyond burn care. Its safety record, resistance to infection and ease of use facilitate surgery.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41168246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hosam Elghadban, Ahmed Negm, Mohamed Samir, Magdy Basheer, Ibrahim Dawoud, Ashraf Shouma, Elsayed Abdallah, Ahmed Taki-Eldin
{"title":"Staple Line Reinforcement Using SEAMGUARD® versus Suture Over Sewing During Laparoscopic Sleeve Gastrectomy for Super Morbidly Obese Patients: A Prospective Randomized Clinical Trial.","authors":"Hosam Elghadban, Ahmed Negm, Mohamed Samir, Magdy Basheer, Ibrahim Dawoud, Ashraf Shouma, Elsayed Abdallah, Ahmed Taki-Eldin","doi":"10.52198/23.STI.43.GS1704","DOIUrl":"10.52198/23.STI.43.GS1704","url":null,"abstract":"<p><p>Itroduction: Although theoretically a simple procedure, laparoscopic sleeve gastrectomy (LSG) can be followed by life-threatening complications. Early postoperative complications include staple line bleeding and leakage. Staple line reinforcement (SLR) has been used to decrease these complications. There are various methods for reinforcement of staple line such as suture over sewing, placing omental flap, using buttressing material, and spraying fibrin glue along the staple line. However, it is controversial whether SLR reduces the rate of staple line complications or not.</p><p><strong>Materials and methods: </strong>A prospective randomized clinical trial included 200 super morbidly obese patients randomized into two groups: Group 1 with reinforcement of the staple line by SEAMGUARD® (Gore Medical, Newark, Delaware) and Group 2 with reinforcement of the staple line using suture over sewing.</p><p><strong>Results: </strong>The mean operative time was significantly shorter in Group 1 than Group 2 (62.6 ± 14.5 vs. 84.7 ±15.8 min, p=0.02). Intraoperative blood loss was significantly lower in Group 1 than Group 2 (17.1± 19.1 vs. 56.8 ± 27.9ml, p=0.00). Staple line hematomas were significantly higher in Group 2. There was no difference in postoperative bleeding between the two groups. No leak was reported in both groups. The cost was higher in Group 1.</p><p><strong>Conclusion: </strong>Reinforcing the staple line in laparoscopic sleeve gastrectomy using suturing is equal to SEAMGUARD® in all aspects except shorter operative time and lower intraoperative blood loss with SEAMGUARD®.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Odds of Mortality in Geriatric Patients with Appendicitis is 22 Times Higher than that in Non-Geriatrics: An Analysis of 336,880 Patients from NIS Database.","authors":"Rahim Hirani, Abbas Smiley, Rifat Latifi","doi":"10.52198/23.STI.43.GS1671","DOIUrl":"10.52198/23.STI.43.GS1671","url":null,"abstract":"<p><strong>Results: </strong>A total of 336,880 patients were included in the cohort. Mean age was 37.7 and 73.8 years in adult and elderly patients, respectively. 97.3% of adults and 94.2% of elderly patients underwent an operation. The mortality rate in the elderly patients (1.04%, n=402/38,509) was 22 times higher (p<0.0001) than that in adult patients (0.047%, n=144/301,408). Mean (SD) hospital length of stay (HLOS) was 2.6 (2.9) days in adults and 4.9 (5.2) days in elderly patients (p<0.0001). Ninety-nine percent of adult and elderly patients were discharged within 11 and 20 days after emergent hospitalization, respectively. In the final regression model, every one year older in age increased the odds of mortality by 5% (OR=1.05, 95%CI: 1.04-1.06, p<0.001), and for every one day longer, HLOS increased the odds of mortality by 1% (OR=1.01, 95%CI: 1.001-1.02, p<0.001). The multivariable logistic regression model was built on 82,006 patients whose HLOS was ≥4 days, the odds ratio for HLOS was 1.05 (95%CI: 1.04-1.06). This means that for every additional day in hospital after day 4, the odds of mortality increase by 5%.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138446264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roberto Gazzeri, Susanna Tribuzi, Matteo Luigi Giuseppe Leoni, Fabrizio Micheli, Felice Occhigrossi
{"title":"Evaluation of Lumbar Adhesiolysis Using a Radiofrequency Catheter During Epiduroscopy in the Treatment of Failed Back Surgery Syndrome (FBSS).","authors":"Roberto Gazzeri, Susanna Tribuzi, Matteo Luigi Giuseppe Leoni, Fabrizio Micheli, Felice Occhigrossi","doi":"10.52198/23.STI.43.NS1714","DOIUrl":"10.52198/23.STI.43.NS1714","url":null,"abstract":"<p><p>Failed back surgery syndrome (FBSS) is a complication of spinal surgery that results in severe and disabling back/leg pain. Epiduroscopy is a percutaneous minimally invasive surgical technique used in the treatment of lumbar radicular pain that enables both direct visualization of epidural adhesions in patients with FBSS and the mechanical release of fibrotic scars in the epidural space. Although the use of a balloon catheter during epiduroscopy can usually remove adhesions between the dura and the vertebrae, in the thickest areas of fibrosis, the use of a catheter with a molecular quantum resonance radiofrequency generator may resect hard epidural fibrotic obstructions. The aim of this study was to evaluate the efficacy and safety of this radiofrequency catheter in the treatment of severe epidural fibrotic scars. Ninety-three patients with FBSS were enrolled in this study. In 49 cases, a thick area of fibrosis was visualized during epiduroscopy and the use of a balloon catheter could not remove the fibrotic scars. In all of these cases, we used a molecular quantum resonance radiofrequency catheter to remove dense fibrotic areas. Intraoperatively during epiduroscopy, we could directly visualize lysis of the fibrotic scars. Immediately after the procedure and at 1-month and 6-month follow-up, the patients reported significant pain reduction. Pain reduction and patient satisfaction were also reported at 12 months in all but 5 cases. This study found a clinically relevant reduction of pain at 1 and 6 months after epiduroscopy in patients with FBSS. The use of a radiofrequency catheter is safe and effective in resection of hard and thick epidural scars.</p>","PeriodicalId":22194,"journal":{"name":"Surgical technology international","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136399340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}