0000000000464147
AUTHOR
S. Fazzotta
Nanofibrillar scaffold resists to bile and urine action: experiences in pigs
Biomaterial-based-scaffolds’ functions are to replace anatomical and functional features loss of an injured tissue. They can replace native tissue after their reabsorption. Material and methods. In our experimental procedures we utilized the PHEA-PLA+PCL scaffold in 2 female pigs to assess its resistance to bile and urine. Results. Both pigs survived to surgical procedures. After a month fibres appeared unchanged in term of form and dimension at electronic microscopy. Cells and ECM factors were founded inside the scaffold in a microscopical evaluation. Conclusion. Planar and tubular scaffolds were colonized by cells and extracellular matrix elements. The study conducted on pig suggested tha…
Intraoperative cholangiography during cholecystectomy using a biliary-nose tube: Routinely used in patients with main bile duct stones
Background: Nowadays, the “gold standard” treatment for gallbladder stones is laparoscopic cholecystectomy but the risk of iatrogenic biliary duct injuries is increased compared to “open” surgery. Intraoperative cholangiography (IOC) can be useful to avoid biliary injuries but it can also be a no-safe procedure in center in which it is not routinely performed. Aim and objective: The aim of our study is to trust the efficacy of IOC in a patient with common bile duct (CBD) and gallbladder stones using a biliary-nose tube. Materials and methods: 135 patients with gallbladder and CBD stones were treated with sequential therapy and randomly divided into two groups. Laparoscopic cholecystectomy w…
Current Strategies for Tracheal Replacement: A Review
Airway cancers have been increasing in recent years. Tracheal resection is commonly performed during surgery and is burdened from post-operative complications severely affecting quality of life. Tracheal resection is usually carried out in primary tracheal tumors or other neoplasms of the neck region. Regenerative medicine for tracheal replacement using bio-prosthesis is under current research. In recent years, attempts were made to replace and transplant human cadaver trachea. An effective vascular supply is fundamental for a successful tracheal transplantation. The use of biological scaffolds derived from decellularized tissues has the advantage of a three-dimensional structure based on t…
Use of platelet concentrate gel in second-intention wound healing: a case report.
Abstract Background Wound healing is a complex and dynamic process. Healing of acute and chronic wounds can be impaired by patient factors (that is, comorbidities) and/or wound factors (that is, infection). Regenerative medicine products, such as autologous/homologous platelet-rich plasma gel, may speed up the healing process. Autologous/homologous platelet-rich plasma is an advanced wound therapy used for hard-to-heal acute and chronic wounds. The cytokines and growth factors contained in platelet-rich plasma play a crucial role in the healing process. Case presentation A 61-year-old Caucasian male patient, suffering from mental retardation following meningitis, with a transplanted kidney …
One shoot seldinger central venous catheterization in dialyzed patients
Introduction: Central Venous Catheterization is necessary in uremic patient (before dialysis) and many other conditions. In this study we demonstrated the advantages of ultrasonography to perform the procedure. Materials and methods: 48 uremic patient were submitted to ultrasound-guided central venous catheterization. The procedure was performed following the Seldinger “one shot” technique. Results: The mean operative time was 4 minutes, with a high rate of success (100%) and a low percentage of complications (2%). Conclusion: The ultrasound-guided central venous catheterization is a safe procedure, rapid and easy to perform. The procedure has a low rate of failures and complications and a …
Laparoscopic adrenalectomy: preoperative data, surgical technique and clinical outcomes
Background: laparoscopic adrenalectomy has become the standard treatment for adrenal lesions. The better clinical outcoms of laparoscopic technique are valid for treatment of small benign masses (< 5-6 cm), instead there are still open questions in literature regarding the correct management of larger lesions (> 6 cm) or in case of potentially malignant adrenal tumors. The aim of this study is to evaluate the outcomes of laparoscopic adrenalectomy in a referral surgical department for endocrine surgery. Methods: at the University Hospital Policlinico "P. Giaccone" of Palermo between January 2010 and December 2017 we performed a total of 81 laparoscopic adrenalectomy. We created a retr…
Electrospun PHEA-PLA/PCL Scaffold for Vascular Regeneration: A Preliminary in Vivo Evaluation
Abstract Background There is increasing interest in the development of vessel substitutes, and many studies are currently focusing on the development of biodegradable scaffolds capable of fostering vascular regeneration. We tested a new biocompatible and biodegradable material with mechanical properties similar to those of blood vessels. Methods The material used comprises a mixture of α,β-poly(N-2-hydroxyethyl)- d,l -aspartamide (PHEA) and polylactic acid (PLA), combined with polycaprolactone (PCL) by means of electrospinning technique. Low-molecular-weight heparin was also linked to the copolymer. A tubular PHEA-PLA/PCL sample was used to create an arteriovenous fistula in a pig model wit…
Platelet-rich gel for the adjuvant treatment of wound healing of transposed flap for arteriovenous fistula in systemic scleroderma
LETTER TO EDITOR
Laparoscopic Repair of Boundary Incisional Hernia in a Kidney Transplant Patient: A Safe Tacks-Fibrin Glue Combined Mesh Fixation Technique.
Abstract Background Incisional hernia in renal transplant patients is a complication that negatively affects the global outcome of transplant and quality of life. The repair of this condition was classically made by open repair with mesh. Increasing evidence suggests that laparoscopic repair could be advocated as the technique of choice in these patients with optimal results. However, the fixation of mesh should be performed by a mixed combination of fibrin sealant (lateral margin of wall defect) and tacks (medial margin). The tacks fixation of the mesh along the lateral margin of the wall defect, close to the graft, is generally difficult for the small size of the remaining aponeurotic pla…
Feeding the brain: the importance of nutrients for brain functions and health
‘We are what we eat’, said the philosopher Feuerbach. In fact, the quality of the food we eat affects our mind as well: the brain, which represents 2% of our body weight, consumes about 20% of the calories we eat each day. Follow a few rules could therefore help to feed properly our brain, so it works to the best of its ability. It is important to know properties of foods especially regarding their aminoacidic composition because aminoacids are components of neurotransmitters, molecules needed for brain transmission and function. It is also possible to choose specific food to prevent or support different diseases that affects nervous system.
Comparison between Rapid Intraoperative and Central Laboratory Parathormone Dosage in 12 Kidney Transplant Candidates
Abstract Background The rapid intraoperative parathormone (PTH) and at central laboratory PTH dosage gives similar results. The central laboratory provides results in longer times and higher costs. Intraoperative measurement can reduce time and costs during parathyroidectomy. Methods Twelve patients undergoing parathyroidectomy for hyperparathyroidism renal transplant candidates were included. Diagnosis was made by laboratory tests (serum calcium, PTH) and imaging techniques (ultrasonography and scintigraphy). All patients presented PTH levels of >400 pg/mL (the limit value to be maintained in list for kidney transplantation) and resistant to medical therapy. For each patient, 2 blood sampl…
Analisi dei fattori di rischio dell'ipoparatiroidismo transitorio e definitivo nei pazienti sottoposti a tiroidectomia
Obiettivi. Con questa revisione della letteratura ci proponiamo di valutare quali sono i fattori che possono essere valutati nei pazienti da sottoporre a tiroidectomia ai fini di una migliore gestione preoperatoria e post-operatoria dell’ipoparatiroidismo transitorio e definitivo. Discussione. L’ipoparatiroidismo transitorio è una complicanza potenzialmente grave che include una vasta gamma di segni e sintomi che permane solo per poche settimane dopo l’intervento chirurgico. L’ipoparatiroidismo definitivo si verifica quando è necessario un trattamento medico per un periodo maggiore di 12 mesi. I fattori di rischio che ne possono influenzare l’insorgenza in seguito ad interventi di tiroidect…
The value of diagnostic ultrasound for detecting occult inguinal hernia in patients with groin pain
Aims: chronic groin pain caused by an occult hernia can be a difficult clinical diagnosis and may require additional investiga- tive modalities. The aim of this study was to demonstrate the accuracy of ultrasound in diagnosing occult hernia in patients with recurrent inguinal pain and a negative clinical examination. Patients and methods: over a period of three years, a total of 76 patients were referred for ultrasound examination with clini- cally suspected occult inguinal hernia. Patients with positive US scans were offered surgery, while those with negative US findings were offered further imaging or other diagnostic tests. The ultrasound examination of the inguinal region was conducted …
Laparotomic vs laparoscopic ovariectomy: comparing the two methods. The ovariectomy in the bitch in laparoscopic era
BACKGROUND: The aim of the present work is to evaluate the effectiveness of the use of ultrasound scalpel during laparoscopic ovariectomy in the bitch. METHODS: Two groups of 10 subjects each, of different races and ages, were compared. In the first group, ovariectomy was performed laparoscopically, using harmonic scalpel to remove ovary. In the second group surgery was performed by means of classical laparotomy. RESULTS: Pre-operative time was similar in both groups. Total operative time, from incision to skin suture, showed significant difference between the two groups, being laparoscopy faster than laparotomy. Partial operative time for bilateral oophorectomy resulted lower using open te…
VITOM® 3D in Arterio-Venous Fistulas: Single Centre Preliminary Surgical Experience
Background: Arteriovenous fistula (AVF) is the vascular access of choice for hemodialysis patients. A correct microsurgical vascular anastomoses is essential to the optimal care of patients. Loupes can help surgeons perform such procedures, but often cause neck or back pain and fatigue. Aim: This study aimed to evaluate whether a video telescopic operating microscope (VITOM®; Karl Storz Endoscopy GmbH, Tuttlingen, Germany) could be used as a substitute for loupes to create microsurgical vascular anastomoses. Methods: We evaluated microsurgical anastomoses with VITOM® in 10 patients (6 male, 4 female) from January 2019 to December 2019. The created anastomoses were 7 side-to-side, 2 side-to-…
Electrospun Polyhydroxyethyl-Aspartamide-Polylactic Acid Scaffold for Biliary Duct Repair: A Preliminary In Vivo Evaluation
Abstract Tissue engineering has emerged as a new approach with the potential to overcome the limitations of traditional therapies. The objective of this study was to test whether our polymeric scaffold is able to resist the corrosive action of bile and to support a cell's infiltration and neoangiogenesis with the aim of using it as a biodegradable tissue substitute for serious bile duct injuries. In particular, a resorbable electrospun polyhydroxyethyl-aspartamide–polylactic acid (90 mol% PHEA, 10 mol% PLA)/polycaprolactone (50:50 w/w) plate scaffold was implanted into rabbit gallbladder to assess the in vivo effects of the lytic action of the bile on the scaffold structure and then as a tu…
OneShot-M: A New Device for Close Laparoscopy Pneumoperitoneum
Introduction. The induction of pneumoperitoneum is the first and most critical phase of laparoscopy, due to the significant risk of serious vascular and visceral complications. The closed technique for the creation of pneumoperitoneum could lead to several surgical complications. The present study aimed to overcome the complications associated with the insertion of Veress needle, improving its use, and facilitating the rapid creation of pneumoperitoneum. Methods. Thirty large white female pigs were enrolled in our study. A common plunger was modified in order to allow the passage of a 15-cm long Veress needle. This method was applied to 26 laparoscopic procedures (26 pigs) of several speci…
SCAFFOLD SINTETICO DI PHEA-PLA-PCL BIOCOMPATIBILE E BIOFUNZIONALE. STUDI PRELIMINARI SU MODELLO ANIMALE. NUOVE PROSPETTIVE NELLA CHIRURGIA RIGENERATIVA DELLE VIE BILIARI
Introduzione: L’ingegneria tissutale ha sviluppato polimeri sintetici biocompatibili e biofunzionali, capaci di fornire una struttura tridimensionale che supporti la crescita di nuovo tessuto autologo, mediante la migrazione di cellule del ricevente. Obiettivo del nostro studio è stato valutare la resistenza di uno scaffold di PHEA-PLA-PCL ai succhi biliari di un modello animale, per determinarne l’applicabilità nella chirurgia rigenerativa delle vie biliari (VB). Metodologia: Abbiamo utilizzato 10 conigli New Zealand (n=10 )di 1,5 kg di peso. Si è proceduto all’impianto di un innesto di circa 1,5 cm2 di scaffold polimerico, costituito da polimeri di PHEA-PLA-PCL, all’interno di una colecis…
VITOM® 3D system in surgeon microsurgical vascular training: our model and experience.
LETTER TO EDITOR