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Purpose Bariatric surgery is on the rise worldwide. With the desired weight loss after bariatric surgery, patients frequently develop massive skin flaps resulting in the need of abdominoplasty. In these patients, this surgical tec...
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Purpose Bariatric surgery is on the rise worldwide. With the desired weight loss after bariatric surgery, patients frequently develop massive skin flaps resulting in the need of abdominoplasty. In these patients, this surgical technique is frequently associated with perioperative complications. Strategies to minimize complications are sought after. The objective of our study was to compare two different dissection techniques and their impact on postoperative outcome.Methods We included 66 patients in our study who underwent abdominoplasty after massive weight loss following bariatric surgery. In group 1, abdominoplasty was performed using the conventional technique of diathermia (n = 20). In group 2, abdominoplasty was performed using LigaSure Impact? (n = 46). The duration of the surgical procedure and perioperative complications were recorded as primary endpoints. Secondary endpoints were length of hospital stay and assessment of additional risk factors.Results Baseline characteristics were comparable between groups. The duration of surgery was significantly shorter in group 2. Postoperative complications were significantly less frequent in group 2 (p = 0.0035). Additional risk factors, e.g., smoking and diabetes mellitus, were not associated with increased rates of perioperative complications.Conclusions The choice of technical device for dissection in abdominoplasty alone will not guarantee minimized complication rates. Yet, the utilization of LigaSure Impact? in refined surgical techniques may facilitate reduced rates of complications, especially wound infections, and a shortened duration of surgery.
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We investigated whether the elevated muscle temperature induced by the first bout influenced V?O 2 the response during a second-bout of heavy exercise. The control conditions were two consecutive 6-min leg cycling bouts (work rate...
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We investigated whether the elevated muscle temperature induced by the first bout influenced V?O 2 the response during a second-bout of heavy exercise. The control conditions were two consecutive 6-min leg cycling bouts (work rate: δ50% between LT and V?O 2 max) separated by a 6-min baseline at 20 W (L1-ex to L2-ex). In the experimental conditions prior to the main bout (H2-ex), the diathermic warming to the front thigh was substituted for the first-bout. The V?O 2 response for the second bout was significantly accelerated compared with the first bout (mean ± SD of the τ by monoexponential fitting: L1-ex: 53.8 ± 11.6, L2-ex: 38.7 ± 7.9 s, P < 0.05). The diathermic warm-up, however, could not accelerate response for subsequent supra-LT leg exercise (τ for H2-ex: 52.3 ± 7.7 s). It was concluded that the facilitation of V?O 2 response during supra-LT exercise after prior heavy exercise does not seem to be caused by increased muscle temperature per se and its related factors.
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Objective: The objective of the study was to determine the incidence and amount of gas embolism during hysteroscopic surgery using either monopolar or bipolar diathermia and to investigate the relationship between the severity of ...
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Objective: The objective of the study was to determine the incidence and amount of gas embolism during hysteroscopic surgery using either monopolar or bipolar diathermia and to investigate the relationship between the severity of gas embolism and the amount of intravasation of distension fluid. Study Design: This was a randomized, observer-blinded trial. Fifty patients, scheduled for hysteroscopic surgery, were assigned to either monopolar or bipolar diathermia. Transesophageal echocardiography was used to detect and classify gas embolism (grade 0-IV). Intravasation of distension fluid was measured. Results: Venous gas embolism was observed in all but 1 patient. A higher incidence of more extensive (grade IV) was seen during bipolar diathermia (42% vs 13%; P =.031). Paradoxical embolism was observed in 2 patients. When intravasation exceeded 1000 mL, significantly more grade IV venous gas embolism was seen (P =.049). Conclusion: During hysteroscopic surgery, gas embolism was equally observed irrespective of the type of diathermia. However, more extensive embolism was observed when intravasation of distension fluid exceeded 1 L. These results question the acceptance of up to 2500 mL intravasation of distension fluid if bipolar diathermia is used.
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