Prolonged soft tissue compression results in discomfort and pain secondary to local ischemia in normal individuals. During surgery, patients are immobile and unable to perceive the discomfort of prolonged pressure, and the anesthetized patient lacks a protective mechanism to prevent pressure sores. Many intrinsic and extrinsic factors are associated with pressure sore development; however, the intensity and duration of pressure are critical components in the etiology of pressure sores. We conclude that interface pressure on a patient lying on an operating table during a long operation is a primary factor of postoperative occipital pressure sores.
Deception ; Humans ; Ischemia ; Operating Tables ; Pressure Ulcer*

This study aimed to assess a new flexible, single-arm robotic surgical system to retroauricular thyroidectomy. Three fresh cadavers were used. Technical elements of the system and the whole surgical procedures were described in detail. This single-port flexible system could be used to successfully perform retroauricular thyroidectomy. The ideal angle to dock the patient-side cart was at a 90-degree angle to the operating table. When the cannula tip was placed 10–15 cm away from the skin incision, positioning and full movement of all four instruments without collisions were possible. Flexible three instruments and a stereoscope made the robotic dissection more efficient, safe and time-saving. We report the first preclinical evaluation of an innovative, flexible, single-arm robotic surgical system for retroauricular thyroidectomy.
Cadaver ; Catheters ; Operating Tables ; Skin ; Thyroidectomy*

PURPOSE: The aim of this study was to investigate the relationship between eversion or reduction of patella and the heights of the extension or flexion gaps. MATERIALS AND METHODS: Measurements of the heights of the extension and flexion gaps were obtained during 32 primary posterior-stabilized total knee arthroplasties in 25 osteoarthritic patients. A tensor device was introduced after femoral and tibial bony resections while putting the knees flat on the operating table to measure the extension gaps in the medial and lateral compartments, respectively. The knee was flexed 95 degrees, and the tensor was introduced to measure the flexion gaps in the same manner. A calibrated torque wrench permitted the application of the force of about 113.4N.cm both in extension and in flexion in right knee, and of about 152.4N.cm both in extension and in flexion in left knee. RESULTS: The average height of the extension gap with everted patella was 20.9+/-2.6mm medially and 23.6+/-2.5 mm laterally, respectively. The average height of the extension gap with reduced patella was 21.0+/-2.6mm medially and 23.7+/-2.4mm laterally, respectively. The average height of the flexion gap with everted patella was 20.7+/-2.5mm medially and 23.2+/-2.8mm laterally, respectively. The average height of the flexion gap with reduced patella was 22.1+/-2.3mm medially and 24.2+/-2.8mm laterally, respectively. After reducing the patella, the flexion gap height increased an average 1.4+/-1.1(range: 0~4)mm and 1.0+/-1.2(range: -1~3)mm in the medial and lateral compartments, respectively. CONCLUSION: The height of flexion gap would be increased by reducing the patella from everted position in posterior- stabilized total knee arthroplasty for the patient with good preoperative flexion. The flexion gap must be observed not with everted patella but with reduced patella to determine whether it appears symmetric and balanced.
Arthroplasty* ; Humans ; Knee* ; Operating Tables ; Patella ; Torque

Surgical treatment, especially the early synovectomy is now closed-up in the field of orthopedic fields for last several years. Authors had experienced in 30 operations for advanced rheumatoid arthritis. A suruey is carried out with analysis of operation result (Excellent 4 cases, Good 13 cases, Fair 7 cases and Poor 6 cases) in regard to pre-operative contracture of joint. X-ray findings and findings on operating table. Operative finding namely the extent of tissue involvement of the joint is found to be closely related with the final results Some details and important points of treatment are emphasized with reference reviews.
Arthritis, Rheumatoid ; Contracture ; Joints ; Operating Tables ; Orthopedics

Piriformis fossa is chosen for the entry point of the intramedullary nail insertion for the broken femoral shaft. To evaluate the correct entry point selection, the use of the usual operation table and short skin incision, we tried the percutaneous interlocking intramedullary nailing with retrograde guide wire insertion technique. The guide wire is inserted through the short skin incision on the anterior thigh and comes out through piriformis fossa easily. Through over the guide wire the femoral nail was inserted with only short skin incision. And the trick makes no difference except the convenience compared with the antegrade guide wire insertion technique. It is considered as a useful tip of the intramedullary nailing of the femoral shaft fracture.
Femur ; Fracture Fixation, Intramedullary* ; Operating Tables ; Skin ; Thigh

BACKGROUND: C-arm fluoroscope has been widely used to promote more effective pain management; however, unwanted radiation exposure for operators is inevitable. We prospectively investigated the differences in radiation exposure related to collimation in Medial Branch Block (MBB). METHODS: This study was a randomized controlled trial of 62 MBBs at L3, 4 and 5. After the patient was laid in the prone position on the operating table, MBB was conducted and only AP projections of the fluoroscope were used. Based on a concealed random number table, MBB was performed with (collimation group) and without (control group) collimation. The data on the patient's age, height, gender, laterality (right/left), radiation absorbed dose (RAD), exposure time, distance from the center of the field to the operator, and effective dose (ED) at the side of the table and at the operator's chest were collected. The brightness of the fluoroscopic image was evaluated with histogram in Photoshop. RESULTS: There were no significant differences in age, height, weight, male to female ratio, laterality, time, distance and brightness of fluoroscopic image. The area of the fluoroscopic image with collimation was 67% of the conventional image. The RAD (29.9 +/- 13.0, P = 0.001) and the ED at the left chest of the operators (0.53 +/- 0.71, P = 0.042) and beside the table (5.69 +/- 4.6, P = 0.025) in collimation group were lower than that of the control group (44.6 +/- 19.0, 0.97 +/- 0.92, and 9.53 +/- 8.16), resepectively. CONCLUSIONS: Collimation reduced radiation exposure and maintained the image quality. Therefore, the proper use of collimation will be beneficial to both patients and operators.
Female ; Humans ; Male ; Operating Tables ; Prone Position ; Prospective Studies ; Thorax

We have treated thirteen complex plateau fractures involving both condyles with one of the following conditions with the use of the combined anterior and posterior approaches in a modified supine position. Associated PCL avulsion fracture, displacement of major fracture plane dominantly at the back, large coronal fracture fragment involving medial or lateral condyles. A patient is placed on an operation table in supine position with a bump under the contralateral buttock. The well leg is placed in a lithotomy position and the injured leg is placed over a sterilized Mayo stand separately. For the posterior approach the table was tilt toward the injured side with the hip abducted and rotated externally. With a modified patient's positioning we were able to use combined anterior and posterior approaches simultaneously for the management of certain complex plateau fractures without changing the draping.
Buttocks ; Hip ; Humans ; Leg ; Operating Tables ; Patient Positioning* ; Supine Position

BACKGROUND: The Modified Mallampati classification is a simple, easily reproducible, widely used test, which is performed with the patient in a sitting position with the tongue protruded and without phonation. It is more convenient when an assessment of modified Mallampati classification is performed while the patient is in a supine position on the operating table. The purposes of this study are to compare the correlation between the modified Mallampati classification in the supine and sitting positions, and the laryngoscopic grades of Cormack and Lehane. METHODS: The data were collected from a total of 224 (98 male) patients older than 18 years of age undergoing elective surgery. The assessment of the modified Mallampati classification was performed two times to the same patient; once while the patient was in a sitting position, and the 2nd time in a supine position on the operating table. Assessment of the modified Mallampati classification in a supine position was performed in the absence of tongue protrusion and the presence of performed phonation. RESULTS: There were significant correlations between assessments of the modified Mallampati classifications (sitting position and supine position) and the laryngoscopic grades of Cormack and Lehane. CONCLUSIONS: Assessment of the Mallampati classification in the supine position had a significant correlation with laryngoscopic grades. We suggest that assessment of Mallampati classification in the supine position can be used as one of the predicting factors for difficult intubation.
Classification* ; Humans ; Intubation ; Operating Tables ; Phonation ; Supine Position* ; Tongue

BACKGROUND: Many factors determine the distribution of local anesthestics in the subaracnoid space. Especially, patient's height is considered an important determinant of the dose of spinal anesthesia. However, the relationship between height and the level of analgesia has not been clearly documented. We studied the correlation between vertebral lengths measured from C7 to the level of the iliac crest (C7-IC), to the sacral hiatus (C7-SH) and to the coccyx (C7-CX) and the level of analgesia injected a fixed amount of local anesthetic in spinal anesthesia. METHODS: Fifty six healthy patients who consented to spinal anesthesia for elective operation were studied. All patient were administered 0.5% hyperbaric bupivacaine 11 mg in the lateral decubitus position on a horizontal operation table. Immediately after drug injection, the patients were turned to the supine horizontal position. For the first 30 minutes, we measured the level of analgesia to pinprick every two minutes. RESULTS: The average of maximum cephalad spread of analgesia was T7.0 1.6. There were weak correlations between patient's height or C7-IC and the level of analgesia. However a significant correlation existed between vertebral length measured from C7 to SH and the level of analgesia. CONCLUSIONS: It is concluded that vertebral length (C7-SH) provides a more meaningful approach to dose selection than height.
Analgesia ; Anesthesia, Spinal* ; Bupivacaine* ; Coccyx ; Humans ; Operating Tables

Gas tamponade is sometimes necessary after vitrectomy. Accurate measurement of intraocular pressure(IOP) in gas-filled eye is important, but is hard to get in operating table, because of lack of a good measuring device. Schiotz tonometry is the only possible method, but it usually gives a lower value than real, because gas-filled eye has a greater compressibility. But if the Schiotz tonometry can give a consistant value in relation to the real value, one can assume a true IOP by simply converting the value, and it will help the vitrectomy surgeon. Vitrectomy with or without lensectomy were done in 7 pigmented rabbits, and fluidair exchange were done at the end of the surgery. Intraocular pressure was monitored by an air infusion system, and true IOP was measured by a transducer from the anterior chamber. Schiotz tonometry was done ar each 5mmHg IOP level, and the values were compared. Schiotz tonometry always gave a lower pressure, and the discrepancy seemed to be greater in aphakic eye, and when the heavier plunger weight were used. Conversion equation was suggested, and their reliability was discussed.
Anterior Chamber ; Intraocular Pressure* ; Manometry ; Operating Tables ; Rabbits ; Transducers ; Vitrectomy*