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Clinical and Experimental Dental... Aug 2021Abnormalities in the maxillary frenum may lead to esthetic or functional limitations and need to be corrected with a surgical intervention called frenectomy. The aim of... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Abnormalities in the maxillary frenum may lead to esthetic or functional limitations and need to be corrected with a surgical intervention called frenectomy. The aim of the study was to compare frenectomies performed using Er:YAG laser technology with those using a conventional scalpel technique. Comparisons were of patients' experiences, treatment times, bleeding during treatment and wound healing.
MATERIAL AND METHODS
The trial was performed as a prospective, randomized and controlled, single-blind investigation. A total of 40 patients requiring frenectomy were randomly assigned to groups which underwent either conventional or Er:YAG laser treatment. Patients' experiences, treatment time, bleeding and wound healing were evaluated immediately after surgery and 5 days, 12 days and 3 months after surgery.
RESULTS
Significant increase in time spent in surgery and bleeding was seen with conventional scalpel surgery. Directly after surgery the wound area was significantly larger in the laser group but at the 5-day evaluation no difference could be observed between the groups. Finally, patients were satisfied with both methods, giving them the same assessments.
CONCLUSION
In the frenectomy procedure, laser surgery is faster and causes less bleeding and may be advantageous in frenectomies.
Topics: Humans; Labial Frenum; Laser Therapy; Lasers, Solid-State; Prospective Studies; Single-Blind Method
PubMed: 33369213
DOI: 10.1002/cre2.374 -
International Journal of Surgery... 2014The ultrasonic scalpel is a surgical shear that uses high-frequency mechanical energy to enable simultaneous vessel sealing and tissue coagulation at the same time. We... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The ultrasonic scalpel is a surgical shear that uses high-frequency mechanical energy to enable simultaneous vessel sealing and tissue coagulation at the same time. We conducted a prospective study to compare the outcome of total thyroidectomy using the ultrasonic scalpel versus the device Ligasure in terms of safety, operative time, overall drainage volume, complications, hospital stay.
METHODS
Between January 2008 and December 2013,400 patients (260 women, 140 men; mean age 46 years) undergoing thyroidectomy were randomized into two groups: group A, where Ultracision were used, and group B, where the Ligasure device was used.
RESULTS
There was no significant differences between the two groups in terms of age, gender, indication for thyroidectomy, thyroid gland weight and diameter, histopathologic diagnosis, preoperative and postoperative serum calcium levels, postoperative complications and reoperative thyroid surgery, time of operation and amount of drainage.
CONCLUSIONS
The ultrasonic scalpel and the Ligasure ares safe, effective, useful, and time-saving alternative to the traditional suture ligation technique for thyroid surgery. They simplified total thyroidectomy, eliminating the need for clamp-and-tie maneuvers while achieving efficient hemostasis.
Topics: Adolescent; Adult; Aged; Female; Follow-Up Studies; Humans; Length of Stay; Male; Microsurgery; Middle Aged; Operative Time; Postoperative Complications; Prospective Studies; Suture Techniques; Thyroid Diseases; Thyroidectomy; Treatment Outcome; Young Adult
PubMed: 24859410
DOI: 10.1016/j.ijsu.2014.05.011 -
Clinical, Cosmetic and Investigational... 2020Rhinophyma is an advanced stage of rosacea affecting the nasal soft tissues and resulting in disruption of the nasal architecture, airway obstruction, and disfigurement... (Review)
Review
Rhinophyma is an advanced stage of rosacea affecting the nasal soft tissues and resulting in disruption of the nasal architecture, airway obstruction, and disfigurement of the nasal aesthetic units. Rhinophyma presents with hypertrophy of the nasal soft tissues, erythema, telangiectasias, nodules, and lobules with a bulbous appearance. Significant psychosocial morbidity is associated with the disease. Understanding of this disease has improved and multiple treatment options exist. The article is a review of the literature to evaluate the pathophysiology, clinical presentation, and epidemiology of keywords "rhinophyma" and "rosacea" using an OVID Medline and PubMed search along with a systematic review of outcomes pertaining to treatment of rhinophyma with laser therapy, scalpel excision, and the subunit method using an OVID Medline search. The subunit method has the highest complication and revision rates followed by carbon dioxide laser therapy. Outcomes between carbon dioxide laser and scalpel therapy and electrocautery are equivalent. Scalpel excision is a more cost-effective treatment modality with less post-operative complications; however, it risks poor hemostasis intraoperatively. Patient satisfaction is common post-therapy regardless of the treatment method. Over 89% of patients would recommend undergoing treatment for rhinophyma irrespective of treatment type. Treatment options vary, and choice of treatment can be dependent on practitioner and patients' treatment goals.
PubMed: 32848439
DOI: 10.2147/CCID.S201290 -
Translational Andrology and Urology Aug 2017According to data from the National Study of Family Growth, vasectomy is utilized by 6-13% of American couples for their form of contraception. Physician surveys have... (Review)
Review
According to data from the National Study of Family Growth, vasectomy is utilized by 6-13% of American couples for their form of contraception. Physician surveys have shown that over 500,000 men undergo vasectomies per year, and more than 75% of vasectomies are performed by urologists. This chapter provides a brief history of vasectomy, as well as recommendations for preoperative counseling, an overview of the modified no-scalpel vasectomy technique, and a brief description of the complications of vasectomy.
PubMed: 28904903
DOI: 10.21037/tau.2017.07.08 -
Biomedicines Nov 2022The plasma scalpel is an application of gas discharges in electrosurgery. This paper introduces the device structure and physicochemical parameters of the two types of... (Review)
Review
The plasma scalpel is an application of gas discharges in electrosurgery. This paper introduces the device structure and physicochemical parameters of the two types of plasma scalpels, namely, a single-electrode Ar discharge device (argon plasma coagulation) and a two-electrode discharge device in normal saline. The diagnostic methods, including the voltage and current characteristics, optical emission spectroscopy, electron spin resonance, and high-speed imaging, are introduced to determine the critical process parameters, such as the plasma power, the gas temperature, the electron density, and the density of active species, and study the ignition dynamics of the plasma discharges in water. The efficacy of the plasma scalpel is mainly based on the physical effects of the electric current and electric field, in addition to the chemical effects of high-density energetic electrons and reactive species. These two effects can be adjusted separately to increase the treatment efficacy of the plasma scalpel. Specific guidance on further improvements of the plasma scalpel devices is also provided.
PubMed: 36428535
DOI: 10.3390/biomedicines10112967 -
Il Giornale Di Chirurgia 2018The Harmonic scalpel ("Focus" and the new version "Focus+") is one of the first devices for surgical simultaneous cutting and tissue coagulation which allows to obtain... (Comparative Study)
Comparative Study Randomized Controlled Trial
INTRODUCTION
The Harmonic scalpel ("Focus" and the new version "Focus+") is one of the first devices for surgical simultaneous cutting and tissue coagulation which allows to obtain dissection and hemostasis by direct application of ultrasound and allows minimally invasive surgical procedures with minimal lateral thermal spread and, thus, minimal adjacent tissue destruction. The aim of the study is to complete the previous study that we made in 2014, based on the TT performed between January 2008 and December 2013, with new data about TT performed in our Surgical Division between January 2014 and December 2016 and compare the outcome using the Ultrasonic scalpel versus the device Ligasure in term of safety, operative time, overall drainage volume, complications, hospital stay.
PATIENTS AND METHODS
250 patients were randomized into two groups: Group A where Ultracision were used and Group B where the Ligasure device was used.
RESULTS
The results of the group A and of the Group B 2014-2016 have been compared with the results of the previous study and we found that they are similar, but asymptomatic hypocalcaemia increased in the patients of the new study.
CONCLUSIONS
We found that the use of Ultrasonic scalpel and Ligasure is effective both in the hemostasis of all vessels and in dissection of tissues and confirm the results of our first study without significant difference in the rate of post-operative morbidity with these two different energy based devices used.
Topics: Adolescent; Adult; Aged; Dissection; Female; Hemostasis, Surgical; Humans; Hypocalcemia; Length of Stay; Male; Middle Aged; Operative Time; Postoperative Complications; Prospective Studies; Radiofrequency Ablation; Thyroidectomy; Ultrasonic Surgical Procedures; Vocal Cord Paralysis; Young Adult
PubMed: 29549681
DOI: 10.11138/gchir/2018.39.1.045 -
Indian Journal of Thoracic and... Apr 2019
PubMed: 33060995
DOI: 10.1007/s12055-018-0747-7 -
JB & JS Open Access 2020The impact of left-handedness on orthopaedic surgeons and trainees has not been well described. We investigated the prevalence and perceived impact of left-handedness... (Review)
Review
BACKGROUND
The impact of left-handedness on orthopaedic surgeons and trainees has not been well described. We investigated the prevalence and perceived impact of left-handedness among orthopaedic surgeons and trainees.
METHODS
We distributed a survey regarding handedness to active members of the American Orthopaedic Association and the Council of Orthopaedic Residency Directors affiliates, including department chairs, program directors, and residency and fellowship program coordinators. Program coordinators were asked to distribute the survey to their current residents and fellows.
RESULTS
Of 510 survey respondents, 78 (15%) were identified as left hand dominant (LHD). Regarding scalpel/cautery use, 64% of LHD respondents reported using their left hand primarily and 10% reported using their right hand primarily; 26% of LHD respondents described themselves as ambidextrous in scalpel/cautery use, compared with 4.7% of right hand dominant (RHD) respondents (p < 0.001). Regarding suturing, 53% of LHD respondents reported using their left hand primarily and 38% reported using their right hand primarily; 9.0% of LHD respondents described themselves as ambidextrous when suturing, compared with 1.9% of RHD respondents (p = 0.012). Only 5.1% of LHD respondents reported having received laterality-specific psychomotor training, whereas 17% perceived a need for such training during residency; RHD respondents reported similar rates. Ambidexterity in scalpel/cautery use or suturing among LHD respondents was not associated with the perception that their left-handedness was advantageous. LHD attending surgeons were more likely than LHD trainees to perceive their handedness as advantageous (p = 0.007).
CONCLUSIONS
Fifteen percent of orthopaedic surgeons and trainees who responded to our survey were LHD. LHD respondents reported significantly higher rates of ambidexterity in both scalpel/cautery use and suturing compared with RHD respondents. Ambidexterity was not associated with a self-perception that left-handedness was advantageous. LHD-attending surgeons were significantly more likely than LHD residents/fellows to perceive their left-handedness as advantageous. There may be benefits to pairing LHD residents with LHD faculty surgeons early in their training to provide mentorship and insight regarding performing surgical procedures left handed.
LEVEL OF EVIDENCE
Level IV.
PubMed: 32832824
DOI: 10.2106/JBJS.OA.20.00019 -
European Review For Medical and... Nov 2014Surgical knife has been extensively used in surgery for a number of years and is the most widely used surgical instrument in the world at present. Manual removal of the...
Surgical knife has been extensively used in surgery for a number of years and is the most widely used surgical instrument in the world at present. Manual removal of the blade can be difficult, particularly when the scalpel is wet. Percutaneous injuries during changing the scalpel blade may lead to serious and potentially fatal infections from blood borne pathogens such as hepatitis B virus (HBV), hepatitis C (HCV), or human immunodeficiency virus (HIV) and others including cytomegalovirus, herpes simplex virus and parvovirus B19. In addition to the risk of illness and death after an exposure, psychological trauma and long-term disability are of great concern. Many devices have been developed in an effort to facilitate the removal of the blade from the scalpel, and to render the removal procedure less dangerous. But there is no device to both remove and install the blade at the same time. In particular, the present invention relates to a scalpel blade changer that enables a blade to be removed from a scalpel and retained in the remover and at the same time to install the blade on to the scalpel handle.
Topics: Equipment Design; HIV Infections; Humans; Parvoviridae Infections; Protective Devices; Surgical Instruments; Virus Diseases
PubMed: 25491617
DOI: No ID Found -
World Journal of Pediatric Surgery 2022The purpose of the study is to compare the labial frenectomy between the laser surgery (erbium yttrium aluminum garnet and neodymium-doped yttrium aluminum garnet...
AIM
The purpose of the study is to compare the labial frenectomy between the laser surgery (erbium yttrium aluminum garnet and neodymium-doped yttrium aluminum garnet (Er:YAG and Nd:YAG)) and the scalpel method.
METHODS
The trial was a randomized controlled test. Thirty four patients aged from 5 to 10 years requiring the frenectomy were included in this study. Patients were randomly divided into two groups: group A: Er:YAG and Nd:YAG laser group and group B: scalpel group. In addition, this comparison considered the following factors: surgical time and Visual Analog Scale (VAS) pain score, which includes intraoperative pain, postoperative pain and complications, such as speaking and chewing, for 1 day and 7 days following labial frenectomy. After 3 months, we recorded the healing outcome by photos.
RESULTS
There was a statistically significant difference in mean surgical time between laser surgery (mean=224±59 s) and scalpel surgery (mean=740±168 s). According to VAS scores of the intraoperative period (3 hours after the operation and 1st postoperative day of pain), chewing and speaking were statistically higher in group B than those in group A; but in the 7th postoperative day of pain, there was no significant difference in speaking and chewing. After 1 month, all of the patient results were recorded, including the healing of wound and scar. Except for one patient in group B who had a scar, all patients achieved good results.
CONCLUSION
Based on the results of this study, it can be concluded that Nd:YAG laser is an efficient and more comfortable alternative to the scalpel for a frenectomy in upper lip frenulum.
PubMed: 36474628
DOI: 10.1136/wjps-2021-000363