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Number of results: 15
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Abstract

The last decades, when robots have appeared in the operating room, showed the possibility of surgery enhancement by improving precision, repeatability, stability and dexterity. However, taking into consideration still existing limitations of robotics in surgery, and treating the robots as medical devices with the highest degree of safety level requirements, one must take a number of complex actions when preparing the experimental clinical application of a new modern robot Robin Heart. Presented paper describes the current state of procedures carried out in the Robin Heart project of surgery robots prepared for clinical application. Based on experiences with the devices existing on the market and, first of all, thanks to knowledge and expertise gained by our team during last 12 years, intensive work are currently done in order to introduce both mechanical and electronic modifications as well as to improve the safety system. As far as human resources are concerned, a professional team able to carry out the robot-supported surgery is prepared based on the created system of technical and functional trainings on simulation stands, which also includes the developed operation planning procedures. The first telemanipulator designed for clinical practice is the Robin Heart Vision – endoscopic system manipulator.

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Authors and Affiliations

Zbigniew Nawrat
Paweł Kostka
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Abstract

Transcatheter valve replacement often saves patients’ lives. The procedure has become relatively safe and very effective, and may soon become common practice.
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Authors and Affiliations

Adam Witkowski
1

  1. National Institute of Cardiology in Warsaw
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Abstract

Introduction: The prolongation of the life of men results in the growing number of people suffering from benign prostatic hyperplasia (BPH). In 2010, BPH concerned more than 200 million men in the whole world, which at that time made up 6% of the population of men at large. Currently, the population of men in the world amounts about three billion six hundred million. The modern surgical treatment of BPH consists of minimally invasive techniques, including laser systems.

Aim: Evaluation of the eff ectiveness of photoselective vaporization of the prostate (PVP) on the basis of subjective parameters assessed by patients using IPSS and QoL questionnaires as well as objective parameters obtained from results of urodynamic tests.

Material and Methods: Between 2012 and 2015, 120 patients with benign prostatic hyperplasia were included in the study and underwent PVP. Finally, 77 patients were included in the study. In all patients, IPSS and QoL sheets were carried out 1, 6 and 12 months, and urodynamic tests 12 months after the surgical treatment.

Results: The statistically signifi cant change in the value of each parameter assessed: decrease in the IPSS, QoL, PVR, Pmax, Pop, the degree of obstruction according to Schäfer and ICS nomogram, and an increase in the values of Qmax and Qave.

Conclusions: Photoselective vaporization of the prostate is an eff ective method of therapy in patients with benign prostatic hyperplasia.

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Authors and Affiliations

Rafał Jedynak
Grzegorz Piotrowicz
Tomasz Syryło
Andrzej Buczyński
Henryk Zieliński
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Abstract

Dr. Artur Binda, a bariatric surgeon from the Orłowski Independent Public Teaching Hospital in Warsaw, discusses bariatric surgery procedures, frequently the only treatment for patients with life-threatening obesity.

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Authors and Affiliations

Artur Binda
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Abstract

One of the most common reasons for horse lameness is subchondral bone cysts (SBCs), which are especially evident in young horse athletes. It is believed that SBC development is strongly associated with an individual’s bone growth and/or bone microstructure impairment. Current methods of SBC treatment include pharmacological treatment or surgical procedures which may allow the bone within the cyst to rebuild and be restored to properly developed bone tissue. Thus, we propose filling the SBCs with a 3D complex of alginate hydrogel and autologous adipose derived mesenchymal stem cells (ASCs). We have observed at the in vitro level, that this hydrogel complex induces osteogenic and chondrogenic differentiation potential through the upregulation of bone morphogenetic protein, osteopontin, collagen type I and aggrecan mRNA levels. Moreover, we detected the creation of a 3D extracellular matrix (EM). To investigate the complex in vivo, we chose 8 horses of varying age suffering from SBC, which resulted in lameness, to undergo experimental surgery. We documented the horses’ clinical appearance, lameness and radiographic appearance, to determine that there was clinical improvement in 87.75% of the patients (n=7, out of 8 horses) 6 months postoperatively and 100% (n=8, out of 8 horses) a year after surgery. These results are promising for the potential of this procedure to become the standard in SBC treatment.
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Authors and Affiliations

P. Golonka
M. Szklarz
M. Kusz
M. Marędziak
J.M. Irwin Houston
K. Marycz
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Abstract

The use of hyperbaric oxygen therapy (HBOT) is an accepted method of supporting wound healing in human medicine. Yet, because of the risk of complications associated with HOBT, a safer modification of the therapy, known as L-HOBT (lower pressure and lower oxygen concen- tration), is increasingly used nowadays. Therefore, due to the lack of literature reports regarding the clinical use of L-HBOT in animals, the authors decided to present the results of L-HBOT supportive treatment of postoperative wounds after hemimastectomy compared to classic treat- ment. The study group included 12 bitches divided into two groups: group A (assisted L-HBOT) and group B (classic treatment). In addition to conventional treatment, the supportive therapy included 1.5 hours of hyperbaric chamber therapy for 5 consecutive days, starting 24 hours after surgery (1500hPa pressure and 26% oxygen concentration in the chamber). The patients were followed and evaluated throughout the course of the treatment by two independent doctors. The results of the treatment revealed no negative clinical impact of L-HOBT supportive therapy on the body of the animals. At the same time, postoperative wounds after L-HOBT healed faster and with fewer postoperative complications compared to the control group. This resulted in a shorter treatment period, terminating with an earlier skin suture removal.

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Authors and Affiliations

W. Łunkiewicz
Z. Kiełbowicz
K. Kalisiak
K. Tuliński
P. Prządka
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Abstract

B a c k g r o u n d: During COVID-19 pandemic, it is necessary to collect and analyze data concerning management of hospitals and wards to work out solutions for potential future crisis. The objective of the study was to investigate how surgical wards in Poland are managing during rapid development of the COVID-19 pandemic.
M e t h o d s: An anonymous, online survey was designed and distributed to surgeons and surgery residents working in surgical departments during pandemic. Responders were divided into two groups: Group 1 (responders working in a “COVID-19-dedicated” hospital) and Group 2 (responders working in other hospitals).
R e s u l t s: Overall, 323 responders were included in the study group, 30.03% of which were female. Medical staff deficits were reported by 21.15% responders from Group 1 and 29.52% responders from Group 2 (p = 0.003). The mean number of elective surgeries performed weekly prior to the pandemic in Group 1 was 40.37 ± 46.31 and during the pandemic was 13.98 ± 37.49 (p <0.001). In Group 2, the mean number of elective surgeries performed weekly before the start of the pandemic was 26.85 ± 23.52 and after the start of the pandemic, it was 7.65 ± 13.49 (p <0.001). There were significantly higher reported levels of preparedness in Group 1 in terms of: theoretical training of the staff, equipping the staff and adapting the operating theater to safely perform procedures on patients with COVID-19. Overall, 62.23% of responders presume being infected with SARS-CoV-2.
C o n c l u s i o n s: SARS-CoV-2 pandemic had a significantly negative impact on surgical wards. Despite the preparations, the number of responders who presume being infected with SARS-CoV-2 during present crisis is high.


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Authors and Affiliations

Tomasz Stefura
1
Justyna Rymarowicz
1
Michał Wysocki
1
Jacek Szeliga
2
Grzegorz Wallner
3
Michał Pędziwiatr
1
Michał Nowakowski
1
Piotr Major
1

  1. 2nd Department of General Surgery, Jagiellonian University Medical College, Kraków, Poland
  2. Department of General, Gastroenterological, and Oncological Surgery, Collegium Medicum Nicolaus Copernicus University, Toruń, Poland
  3. 2nd Department of General, Gastrointestinal and Oncological Surgery of the Alimentary Tract, Medical University of Lublin, Lublin, Poland
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Abstract

Maternal-fetal medicine is a dynamically developing field, which enables not only to diagnose and treat maternal diseases but also condtions of an unoborn child developing in a womb. Fetal therapy is a highly specialized branch of maternal-fetal medicine which offers surgeries before birth. Prenatal intervensions aim to correct or diminish unfavorable effects of a fetal congenital defect. However, the starting point for a succesful intrauterine therapy is always a thorough prenatal diagnosis and an extensive knowledge regarding fetal pathophysiology in each case. Fetal surgery is now an established but still rapidly evolving specialty, born from the rationale that destructive embryologic processes, recognized early in gestation, can be curtailed by prenatal correction. Prenatal surgical techniques have evolved from highly invasive interventions involving hysterotomy to minimally- invasive fetoscopic interventions. However, there is still space for research aiming to find solutions including pharmacological treatment. In this review we aimed to present various conditions in which fetal surgery has been attempted and the present the current status of this specialty.
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Authors and Affiliations

Mirosław Wielgoś
1
Marzena Dębska
1
Michał Lipa
1
Ewelina Litwińska
1
Magdalena Litwińska
1
Natalia Mazanowska
1

  1. Warszawski Uniwersytet Medyczny, I Katedra i Klinika Położnictwa i Ginekologii, Uniwersyteckie Centrum Zdrowia Kobiety i Noworodka WUM, Warszawa
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Abstract

The purpose of this study was to investigate the effect of tramadol (TM) (2 mg/kg) administered intramuscularly (IM) followed by a constant rate infusion (CRI) of TM (2 mg/kg/h) in pigs. Sixteen pigs undergoing experimental surgery were premedicated IM with a combination of alfaxalone (5 mg/kg) and midazolam (0.5 mg/kg). Anaesthesia was induced with propofol (2 mg/kg) intravenously (IV) and maintained with isoflurane. Pigs were randomly assigned to one of the two following groups: Group 1 (n=8): received a loading dose of TM (2 mg/kg) followed by a CRI of TM (2 mg/kg/h); Group 2 (n=8): a loading dose of TM (2 mg/kg) followed by a CRI of lactated Ringer’s solution (2 ml/kg/h). Heart rate (HR), respiratory rate (RR), rectal temperature (RT), haemoglobin oxygen saturation (SpO2), fraction of inspired oxygen (FIO2), end-tidal concentration of isoflurane (FEISO), end-tidal carbon dioxide concentration (FECO2), pH, arterial oxygen partial pressure (PaO2), arterial carbon dioxide partial pressure (PaCO2) and bicarbonate concentration (HCO3-) were recorded immediately after loss of righting reflex (T=0 min) and at 15-min intervals over a period of 60 min. Continuous data were analysed using a repeated-measure analysis of variance (ANOVA) and a p-value <0.05 was considered significant. HR, RR and FEISO were significantly lower (p<0.05) in Group 1 at T30 and T45, which corresponded to the time of the most intense surgical stimulation. The results suggest that the TM infusion minimizes the HR and RR response, slightly reducing isoflurane requirements and determining a superior perioperative analgesia.

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Authors and Affiliations

G. Catone
M. Meligrana
G. Marino
C. Vullo
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Abstract

This article summarizes technical aspects of preparing printable 3D anatomical models created from radiological data (CT, MRI) and discusses their usefulness in surgery of the human skull. Interdisciplinary approach to the capabilities of the 3D printers, and the materials used for manufacturing 3D objects oriented on replicating anatomical structures has created new possibilities for simulating and planning surgical procedures in clinical practice settings.
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Authors and Affiliations

Janusz Skrzat
1

  1. Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
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Abstract

Malignant neoplasms are currently a severe medical challenge and the second leading cause of death worldwide. The modern anesthesia applied may improve the patient outcome. This paper presents a review of anesthesia management related to patients with gynaecologic malignancies. It includes the influence of the type of anesthesia on cancer recurrence, application of regional anesthesia in gynaecologic oncologic surgery, and selected aspects of anesthesia for robotic surgery. We performed a literature search on MEDLINE, EMBASE, Google Scholar, the Cochrane Central Register of Controlled Trials, and Clinical Trials. The database search focused on the topics related to anesthesia in gynecological oncology. The authors also contributed through individual, independent literature searches.
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Authors and Affiliations

Paweł Krawczyk
1
Tomasz Lonc
1
Rafał Świstek
1
Paweł Tyszecki
2
Janusz Andres
1

  1. Department of Anesthesiology and Intensive Care Medicine, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Anesthesiology and Intensive Care Medicine 5th Military Hospital with Polyclinic Kraków, Poland
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Abstract

This contribution points out the most important aspects to consider in the ethical (in) acceptability of aesthetic operations. Starting from the value of the human body seen from a biblical perspective, it introduces the reader to the essential magisterial statements concerning aesthetic surgery, among which the speech of Pope Pius XII occupies a particular position. It also refers to ethical principles, especially the principle of double effect and totality, and outlines the basic argumentative positions of selected bioethics committees. There is also a brief introduction to the positions of several contemporary bioethicists. In conclusion, the author presents his point of view and briefly explains what the patient should take into account and what the aesthetic surgeon should look for to avoid ethically wrong actions
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Authors and Affiliations

Jan Polák
1

  1. Palacký University Olomouc, Czech Republic
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Abstract

Introduction: The main goal of the present umbrella review was to provide the most up-to- date and evidence-based results regarding the various treatment options for tennis elbow (TE), which hopefully will significantly decrease the confusions existing in the literature. Furthermore, our study differs from past analytical studies because, as to the best of the authors’ knowledge, is the first to provide independent (not in comparison to other treatment) statistical results regarding the effectiveness of each TE treatment.
Materials and Methods: Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library, BIOSIS, and EBSCO were searched. The overall search process was conducted in 3 stages.
Results: A total of 40 studies met the inclusion criteria and were included in this study. Out of those 40 meta-analyses, a total of 160 primary studies were screened in order to extract the data and perform a statistical analysis.
Conclusion: The present umbrella review underlines the efficiency of injection therapies, especially autologous blood, and platelet-rich plasma, while simultaneously proving the ineffectiveness of acupunc-ture and shock wave therapy as treatments for TE. Furthermore, the value of other known conservative treatment modalities, such as physical therapy, has been demonstrated.
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Authors and Affiliations

Michał Bonczar
1 2
Patryk Ostrowski
1 2
Dawid Plutecki
2 3
Martyna Dziedzic
1 2
Jakub Florek
4
Weronika Michalik
1
Wojciech Przybycień
1
Paweł Depukat
1
Bartosz Rutowicz
1
Ewa Walocha
1 2
Mateusz Koziej
1 2

  1. Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
  2. Youthoria. Youth Research Organization, Kraków, Poland
  3. Collegium Medicum, Jan Kochanowski University, Kielce, Poland
  4. Department of Orthopaedics and Traumatology, Rydygier Hospital, Brzesko, Poland
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Abstract

Whatever the type of surgery related to inner organs, traditional or robotic, the contact with them during surgery is a key moment for pursuing the intervention. Contacts by means of surgery instruments namely scalpels, staples, clamps, graspers, etc. are decisive moments. False, and erroneous touching and manoeuvring of organs operated on can cause irreversible damage as regard morphological aspects (outer impact) and physiological aspects (inner impact). The topic is a great challenge in the effort to measure and characterize damages. In general, electrical instruments for surgery employ the following technologies: ultrasound, radiofrequency (monopolar, and bipolar), and laser. They all result in thermal damages difficult to evaluate. The article proposes a method for a pre-screening of organ features during robotic surgery sessions by pointing out mechanical and thermal stresses. A dedicated modelling has been developed based on experimental activities during surgery session. The idea is to model tissue behaviour from real images to help surgeons to be aware of handling during surgery. This is the first step for generalization by considering the type of organ. The measurement acquisitions have been performed by means of an advanced external camera located over the surgery quadrant. The modelling and testing have been carried out on kidneys. The modelling, carried out through Comsol Multiphysics, is based on the bioheat approach. A further comparative technique has been implemented. It is based on computer vision for robotics. The findings of human tissue behavior exhibit reliable results.
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Authors and Affiliations

Aimé Lay-Ekuakille
1
Moise Avoci Ugwiri
2
Consolatina Liguori
2
Satya P. Singh
3
Md Zia Uhr Rahman
4
Domenico Veneziano
5

  1. University of Salento, Department of Innovation Engineering, Via Monteroni sn, 73100 Lecce, Italy
  2. University of Salerno, Department of Industrial Engineering, Via Giovanni Paolo II n.132, 84084 Fisciano, Italy
  3. Nanyang Technological University, School of Computer Science and Engineering, 50 Nangyang Ave, Singapore 639798
  4. K L University, Department of Electronics & Communication Engineering, Green Fields, Vaddeswaram, Guntur-522502, India
  5. Asl Reggio Calabria, Hospital “Bianchi-Melacrino-Morelli”, Via Giuseppe Melacrino n.21, 89124 Reggio Calabria, Italy
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Abstract

Coronaviruses present a considerable concern for humans and animals. The current world- wide pandemic of SARS-CoV-2 virus showed many gaps in understanding of coronaviruses spread and transmission. Because of lack of effective vaccine against SARS-CoV-2 the only preventive measures are represented by wearing protective masks and gloves thus limiting potential risk of contact with the airborne virus. Inversely, the limited time of protective function of the masks presents another drawback of their use. Therefore, the application of disinfection agent dispersed on the surface of protective masks may enhance their effectivity and safety of their application. The aim of the study was to examine the virucidal efficacy of low-concentra- ted sodium hypochlorite dispersed using ultrasonic humidifier on the surface of surgery masks. The study was conducted using SARS-CoV-2 surrogate virus, namely porcine epidemic diarrhea virus (PEDV) representing a model with similar biophysical properties and genomic structure to human coronaviruses. Five different concentrations of the disinfectant with different content of sodium hypochlorite were selected for the study. A final concentration of 0.228 g/L sodium hypochlorite effectively inactivated the PED virus and may support the biosafety of masks usage.

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Authors and Affiliations

M. Antas
A. Szczotka-Bochniarz
G. Woźniakowski

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