Distal purse-string suture technique for TaTME.
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ABSTRACT:
SUBMITTER: Wu R
PROVIDER: S-EPMC6394705 | biostudies-literature | 2019 Jan
REPOSITORIES: biostudies-literature
Publications
Distal purse-string suture technique for TaTME.
Wu R R Benedict R R Caycedo-Marulanda A A
Techniques in coloproctology 20181222 1
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Project description:AimTo observe the clinical outcomes of 30-gauge (G) needle-guided 10-0 prolene suture purse-string pupilloplasty for atonic pupil management.MethodsEight patients with atonic pupils who underwent suture purse-string pupilloplasty were retrospectively analyzed. Preoperative data and at least 6mo of postoperative data were collected from all the patients.ResultsThe corrected distance visual acuity (CDVA) before and after surgery was 0.58±0.22 and 0.20±0.10 logMAR, respectively (P=0.002). The pre- and postoperative pupil size was 7.38±0.88 and 3.09±0.71 mm (P=0.000), respectively. The corneal endothelial cell count was 2841±176/mm2 before and 2692±143/mm2 after surgery (P=0.000). No intraoperative or postoperative complications were reported. During the follow-up period of at least 6mo, all treated pupils were centered and generally or nearly round. Furthermore, the patients did not exhibit photophobia, glare, or diplopia.ConclusionThis technique is a simple and effective method for pupil reduction.
| S-EPMC11589452 | biostudies-literature
Project description:BackgroundTo investigate the feasibility of purse string suture pancreaticojejunostomy in complete laparoscopic pancreaticoduodenectomy for patients with an undilated pancreatic duct.MethodsWe retrospectively reviewed a database of 113 patients with undilated pancreatic ducts who had undergone laparoscopic pancreaticoduodenectomy (LPD) with purse string suture pancreaticojejunostomy to analyze the perioperative outcomes.ResultsOne hundred thirteen patients underwent successful LPD. The surgery time was 353 ± 41 min, the time required for pancreaticojejunostomy was 27 ± 5 min, and the hospital stay after surgery was 16 ± 8 days. Fifteen patients suffered postoperative complications, including twelve patients with pancreatic fistula, one with bile leakage, one with gastroparesis (complicated with abdominal infection), and one with abdominal bleeding. No perioperative death occurred.ConclusionsPurse string suture pancreaticojejunostomy is safe and feasible for patients with an undilated pancreatic duct.
| S-EPMC9118586 | biostudies-literature
Project description:BackgroundPurse-string suture is a simple technique to reduce wound size and to achieve complete or partial closure of skin defects.ObjectiveTo classify situations in which purse-string sutures can be utilized and to assess the long-term size reduction and cosmetic outcome of the final scar.MethodsPatients (93 from Severance hospital and 12 from Gangnam Severance hospital) in whom purse-string sutures were used between January 2015 and December 2019 were retrospectively reviewed. Wound site, final reconstruction method, repair duration, final wound size, and Vancouver scar scale were assessed.ResultsA total of 105 patients were reviewed. Lesions were located on the trunk (48 [45.7%]), limbs (32 [30.5%]), and face (25 [23.8%]). Mean ratio of wound length/primary defect length was 0.79±0.30. Multilayered purse-string suture showed the shortest duration from excision to final repair (p<0.001) and most effectively minimized the scar size (scar to defect size ratio 0.67±0.23, p=0.002). The average Vancouver scar scale measured at the latest follow-up visit at least 6 months postoperatively was 1.62, and the risk of hypertrophic scarring was 8.6%. There was no significant difference in the Vancouver scar scale and the risk of hypertrophic scarring between the different surgical method groups.ConclusionPurse-string sutures can be utilized in many stages of reconstruction to effectively reduce scar size without compromising the final cosmetic outcome.
| S-EPMC10112374 | biostudies-literature
Project description:ObjectiveThis study aimed to investigate the optimal strategy for myomectomy for removing giant uterine fibroids when necessary in women undergoing cesarean section.MethodsThis study was retrospective in design, and assessed outcomes in 26 patients who underwent myomectomy using a "base purse-string suture" during cesarean section. The operative duration, blood loss, uterine involution, and duration of postpartum lochia were analyzed.ResultsThis suture was associated with a mean operative duration of 11.17 ± 5.36 minutes and the mean estimated blood loss was 11.15 ± 6.05 mL. The mean postpartum duration of lochia was 34.92 ± 7.55 days and there were no cases of postpartum hemorrhage. Uterine size returned to normal within 6 weeks of delivery, without any apparent defects or abnormalities in the uterine wall as shown by an ultrasonic examination.ConclusionThis novel implementation of a base purse-string suture during cesarean myomectomy for removal of giant fibroids is a simple, safe, and effective intervention that should be considered for implementation in appropriate patients.
| S-EPMC7783271 | biostudies-literature
Project description:Abstract Background Purse-string suture in transanal total mesorectal excision is a key procedural step. The aims of this study were to develop an automatic skill assessment system for purse-string suture in transanal total mesorectal excision using deep learning and to evaluate the reliability of the score output from the proposed system. Methods Purse-string suturing extracted from consecutive transanal total mesorectal excision videos was manually scored using a performance rubric scale and computed into a deep learning model as training data. Deep learning-based image regression analysis was performed, and the purse-string suture skill scores predicted by the trained deep learning model (artificial intelligence score) were output as continuous variables. The outcomes of interest were the correlation, assessed using Spearman’s rank correlation coefficient, between the artificial intelligence score and the manual score, purse-string suture time, and surgeon’s experience. Results Forty-five videos obtained from five surgeons were evaluated. The mean(s.d.) total manual score was 9.2(2.7) points, the mean(s.d.) total artificial intelligence score was 10.2(3.9) points, and the mean(s.d.) absolute error between the artificial intelligence and manual scores was 0.42(0.39). Further, the artificial intelligence score significantly correlated with the purse-string suture time (correlation coefficient = −0.728) and surgeon’s experience (P< 0.001). Conclusion An automatic purse-string suture skill assessment system using deep learning-based video analysis was shown to be feasible, and the results indicated that the artificial intelligence score was reliable. This application could be expanded to other endoscopic surgeries and procedures. The aims of this study were to develop an automatic skill assessment system for purse-string suture in transanal total mesorectal excision (TaTME) using artificial intelligence (AI) and to evaluate the reliability of the score output. The score output by AI exhibited statistically significant correlation with the manual score, purse-string suture time, and surgeon’s experience. To the best of our knowledge, this is the first report on automatic skill assessment for purse-string suture in TaTME.
| S-EPMC9991500 | biostudies-literature
Project description:A single-arm, single-center prospective study of a novel double purse-string technique for constructing the colorectal anastomosis in robot-assisted laparoscopic resection of the sigmoid colon for cancer.
| 2326540 | ecrin-mdr-crc
Project description:Distal biceps ruptures are common injuries that lead to significant decrease in elbow supination strength and pain. This Technical Note describes a single-incision distal biceps tendon repair using 2 knotless suture anchors. This technique is easily reproducible, is efficient, and has the unique benefits of decreasing the risk of heterotopic ossification and damage to neurovascular structure while providing similar outcomes to other described fixation techniques.
| S-EPMC10907892 | biostudies-literature
Project description:PurposeThe optimal method for intracorporeal esophagojejunostomy remains unclear because a purse-string suture for fixing the anvil into the esophagus is difficult to perform with a laparoscopic approach. Therefore, this study aimed to evaluate our novel technique to fix the anvil into the esophagus.Materials and methodsThis retrospective study included 202 patients who were treated at our institution with an intracorporeal circular esophagojejunostomy in a laparoscopy-assisted total gastrectomy with a Roux-en-Y reconstruction (166 cases) or a laparoscopy-assisted proximal gastrectomy with jejunal interposition (36 cases). After incising 3/4 of the esophageal wall, a hand-sewn purse-string suture was placed on the esophagus. Next, the anvil head of a circular stapler was introduced into the esophagus. Finally, the circular esophagojejunostomy was performed laparoscopically. The clinical characteristics and surgical outcomes were evaluated and compared with those of other methods.ResultsThe average operation time was 200.3 minutes. The average hand-sewn purse-string suturing time was 6.4 minutes. The overall incidence of postoperative complications (Clavien-Dindo classification grade ≥II) was 26%. The number of patients with an anastomotic leakage and stenosis at the esophagojejunostomy site were 4 (2.0%) and 12 (6.0%), respectively. All patients with stenosis were successfully treated by endoscopic balloon dilatation. There was no mortality. Regarding the materials and devices for anvil fixation, only 1 absorbable thread was needed.ConclusionsOur procedure for hand-sewn purse-string suturing with the double ligation method is simple and safe.
| S-EPMC6769370 | biostudies-literature
Project description: Not available
| S-EPMC11843451 | biostudies-literature
Project description:ObjectiveTo compare the short-term results of classic single-layer uterine closure and double-layer purse-string uterine closure (Turan technique) techniques in cesarean section in terms of the incidence of ischiocele formation.Materials and methodsThis was a prospective randomized controlled trial study. Participants undergoing first-time cesarean delivery were randomized into two groups. Fifty-eight participants were included in the double-layered uterine closure group (study group), while 53 participants were randomized into the classical single-layered uterine closure group (control group). For comparison of isthmocele formation, transvaginal ultrasound examination was planned in all patients 6 weeks after surgery. The operation data,the formation of isthmocele, its dimensions and volume were recorded.ResultsA total of 111 women were included in the study. The incidence of ischiocele at 6 weeks after birth was not significantly different between the groups (p=0.128). Isthmosel was detected in 20.8% of single-layer closures, and this rate was determined as 10.3% in the purse technique. In the Kerr incision made during surgery, the uterine incision size did not differ in either group, but the uterine incision length after suturing was significantly smaller in the purse technique compared with the other group (p<0.001).ConclusionThe incidence of ischiocele formation after cesarean section and the depth of the ischiocele was independent of the uterotomy closure technique.
| S-EPMC10478730 | biostudies-literature