Hemostasis, Surgical ; Hepatectomy ; methods ; Humans ; Laparoscopy

Bezoars are persistent concretions of indigestible material that are usually found in the stomach. With the significant development of endoscopic techniques, many authors have reported the removal of bezoars using methods such as endoscopic forceps, snares, electrohydraulic lithotripsy, laser. However, there are no reports of using argon plasma to remove a bezoar in Korea. Argon plasma coagulation is a non-contact electrosurgical technique, which is an inexpensive, easily learned, and effective method in gastrointestinal endoscopy. In addition, this method is associated with a decreased risk of perforation and tissue damage by maintaining a controllable depth of coagulation. We report a 71-year-old man with a 11x11x8 cm sized huge gastric phytobezoar found by endoscopy. The bezoar was broken into pieces using the argon plasma coagulator. Endoscopic forceps and a basket were then used to crush and extract its fragments. The bezoar was removed safely without any complications. We report this case with a review of the relevant literature.
Aged ; Argon Plasma Coagulation ; Argon* ; Bezoars ; Endoscopes* ; Endoscopy ; Endoscopy, Gastrointestinal ; Humans ; Korea ; Lithotripsy, Laser ; Plasma* ; SNARE Proteins ; Stomach ; Surgical Instruments

Dermatologists frequently perform a number of procedures without the aid of an assistant and have sometimes difficulty to obtain hemostasis during the biopsy or other minor surgery. A flat plastic cylinder made of a disposable syringe effectively stops bleeding and procedures are easily carried out with a clean surgical field. It is believed to be inexpensive, durable and easy to be sterilized.
Biopsy ; Hemorrhage ; Hemostasis* ; Plastics* ; Surgical Procedures, Minor ; Syringes*

BACKGROUND AND OBJECTIVES: Nasal packing after nasal surgery is commonly practiced. Merocel(R) is one of the most popular packing material, however it can be associated with significant pain and bleeding on its removal. A prospective study was performed to compare the efficacy and patient tolerance of Merocel(R) and newly designed Latex-covered Merocel(R) (LCM). MATERIALS AND METHOD: Sixty patients underwent septoplasty for septal deviation. Following septoplasty, the patients were randomly allocated into two groups of 30 patients each who underwent insertion of either Merocel(R) or LCM. Patients were asked to record pain levels using a visual analogue scale(VAS) before and after packing removal, and number of analgesic injection were recorded. Resistance and amount of bleeding on packing removal were also recorded. RESULTS: Both nasal packs effectively prevented post-operative bleeding. However the VAS score for nasal pain and numbers of analgesic use before and after packing removal were significantly lower in the LCM group. LCM was removed more smoothly causing significantly less amount of bleeding on removal. CONCLUSION: LCM provides good post-operative hemostasis and its removal is less traumatic and painful for the patients, therefore improving patient's comfort.
Hemorrhage ; Hemostasis ; Humans ; Nasal Surgical Procedures ; Prospective Studies

This article introduces the basic structure, features and the priciples of a portable automatic pneumatic tourniquet and its prospects of applications.
Anastomosis, Surgical ; methods ; Automation ; Bandages ; Extremities ; surgery ; Hemostasis, Surgical ; instrumentation ; Humans ; Intraoperative Care ; Tourniquets

Recently, biomaterials for spacers following sinus surgery have been extensively researched. Such materials may reduce the incidence of early postoperative bleeding and formation of synechiae, and possibly promote mucosal healing. The aims of this study are to review recent advances in absorbent packing materials for the nasal cavity and to differentiate their effects on hemostasis, wound healing and prevention of adhesion.
Biocompatible Materials ; Hemorrhage ; Hemostasis ; Incidence ; Nasal Cavity* ; Nasal Surgical Procedures ; Wound Healing

OBJECTIVETo explore the efficacy of injectable gelatin matrix as a hemostatic agent for treatment of grade III-IV hepatic trauma to a canine model with contrast-enhanced ultrasound (CEUS) guidance.

METHODSTwenty-seven healthy adult dogs underwent celiotomy in induce grade III-IV hepatic trauma in the left lateral lobe of the liver. The dogs were then randomized into 3 groups, namely the treatment group in which the injectable hemostat was percutaneously injected into the injury site under CEUS guidance, and the positive and negative control groups with thrombin solution and normal saline treatment, respectively. Intra-abdominal blood loss within 30 min postoperatively, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) 7 days postoperatively were compared among the groups. Follow-up CEUS was performed in each animal 7 days after the operation.

RESULTSThe mean blood loss was 47.69 ml in the treatment group, significantly less than that in the positive control group (81.77 ml, P/0.01) and negative control group (110.35 ml, P<0.01). The treatment group had also significantly lower ALT and AST levels than the two control groups (ALT: 49.37, 62.81, and 82.83 U/L, respectively, P<0.05; AST: 48.32, 67.16, and 82.54 U/L, respectively, P<0.05). In the treatment group, CEUS did not detect hepatic lesions or ascites as found in the two control groups, and the perfusion of the liver was homogeneous.

CONCLUSIONThe injectable hemostat injected under the guidance of CEUS can effectively control grade III-IV hepatic hemorrhage in the canine model and show strong effects of stopping bleeding and promoting wound healing.

Animals ; Contrast Media ; Dogs ; Gelatin ; administration & dosage ; therapeutic use ; Hemostasis, Surgical ; Liver ; injuries ; Ultrasonography, Interventional

BACKGROUND AND OBJECTIVES: Nasal packing after nasal surgery is commonly practiced for various purposes including hemostasis, stabilization of nasal structure, and synechia prevention. However, the use of nasal packing has led to the development of uncomfortable symptoms such as nasal obstruction. In this study, therefore, we have devised a new method of nasal packing involving the use of an airway tube for reducing nasal obstruction and discomforts in association with post-surgical nasal obstruction. Materials and METHODS: An airway tube was made by cutting the distal end of a 1cc syringe. It was inserted between the nasal septum and the packing material. Nasal cavities of 20 patients (Group 1) who underwent nasal surgery were packed using packing materials and the devised airway tubes following nasal surgery. We evaluated the symptoms of nasal obstruction after the postoperative nasal packing in this study group and compared them with those of the 20 patients (Group 2) who received packing with existing merocel nasal stents and 20 patients (Group 3) who were given packing with only merocel without airway tubes after nasal surgery. RESULT: In this study, nasal obstruction and discomforts in association with post-surgical nasal obstruction were significantly improved among patients given packing material and devised airway tubes (Group 1) comparative to other patient groups. CONCLUSION: Devised airway tube is useful in minimizing the symptoms of nasal obstruction and discomforts as well as in reducing surgical expense.
Formaldehyde ; Hemostasis ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum ; Nasal Surgical Procedures ; Polyvinyl Alcohol ; Stents ; Syringes

OBJECTIVETo discuss the safety and the feasibility of laparoscopic selective portal inflow occlusion.

METHODSFrom January 2005 to February 2006, 7 patients were performed by laparoscopic hepatectomy with selective portal inflow occlusion. The patients included 1 male and 6 females, the mean age was 48.9 years, ranged from 31 to 70 years. Procedure included left lateral segmentectomies (4 patients), left hemihepatectomies (2 patients), and right hemihepatectomies (1 patient). Portal vein, hepatic artery and their branches were exposed by blunt dissection and performed selective portal occlusion with absorbable clips.

RESULTSThere is no conversion, no mortality, and no postoperative complication. Seven selective portal inflow occlusions were performed successfully. The mean operating time was 188.7 min (range 70 min to 300 min), the mean intraoperative blood loss was 625 ml (range 350 ml to 1000 ml), and the mean postoperative hospital stay was 8.4 days.

CONCLUSIONSLaparoscopic selective portal inflow occlusion is a safe and feasible technique.

Adult ; Aged ; Female ; Follow-Up Studies ; Hemostasis, Surgical ; methods ; Hepatectomy ; methods ; Humans ; Laparoscopy ; Male ; Middle Aged

The incidence of vertebral artery (VA) injury (VAI) in posterior approach tumor resection surgery is extremely rare, but it can lead to serious complication. In this case, a 57-year-old man underwent surgery for resection of the tumor involving left epidural space and neural foramen at C2-3 level. Iatrogenic VAI occurred suddenly during tumor resection procedure using pituitary forceps. Immediate local hemostasis and maintaining of perfusion for reducing the risk of posterior circulation ischemia were performed. Intraoperative angiogram of both VA and emergent trapping embolization were done as well. It may reduce the risk of immediate postop complication, and further delayed occurrence. The patient had no complication after VAI by appropriate intraoperative management. Preoperative angiographic work up and preparation of endovascular team cooperation are positively necessary as well as a warning for the VAI during cervical spine surgery.
Epidural Space ; Hemostasis ; Humans ; Incidence ; Ischemia ; Middle Aged ; Neurilemmoma* ; Perfusion ; Spine ; Surgical Instruments ; Vertebral Artery*