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An Under-Drape Ventilator for Cataract Surgery*
443
NOTES, CASES, INSTRUMENTS A distinct advantage in Lachesine is that it is dispensed in powder form. Thus a fresh solution of this surface-active agent may be
prepared in as small a quantity as deemed desirable. 37 South 20th Street (3).
REFERENCES
1. 2. 3. 4.
Feldman, J. B.: Arch. Ophth., 41:1,1949. Ing, H. R.: Brit. J. Ophth., 30:247,1946; Brit. M. Bull., 2:91,1948. Riddell, W. J. B.: Brit. J. Ophth., 30:1,1946. Mann, I.: Brit. J. Ophth., 30:8,1946.
AN UNDER-DRAPE VENTILATOR FOR CATARACT SURGERY* H. FARQUHARSON,
Wipe coil soldeped to frame
M.D.
San Francisco, California One prominent complaint of patients hav ing cataract extraction under local anesthesia has been the feeling of suffocation and heat as they breathe under the drapes. This has contributed a good deal to restlessness and consequent straining and even squeezing of the eyeball by the patient during surgery. To eliminate this hazard, and to add to the comfort of the patient under local anesthesia for intraocular surgery, it was felt that some attempt should be made to provide a cooler, more comfortable atmosphere beneath the drapes without encroaching on the surgeon's field. To accomplish this a suction tubing is placed over the patient's lower jaw, in close proximity to the mouth, to suck away the warm air that accumu lates beneath the drapes (figs. 1 and 2). V&ittl&tor The response by patients has been remarkable, particularly so in the case of those who have had ♦From the Departments of Anesthesiology and Ophthalmology of the University of California Hospital.
Fig. 2 (Farquharson). Showing re lation of suction tubing and frame to patient's face beneath the drapes.
Suction tubing
T
Metal pod beneath patients shoulders
Fig. 1 (Farquharson). Suction tubing supported by frame. the second eye operated upon using this apparatus, after having had the first eye done some months prior to the use of suction. No 5ms// eye in position
sfieet
Large spiii
sheet
444
NOTES, CASES, INSTRUMENTS
longer is there the feeling of suffocation due to the hot humid atmosphere beneath the drapes. These patients now are quieter, more relaxed, and comfortable. The results are, of course, of the utmost importance to the ophthalmic surgeon in intraocular surgery. The apparatus adds to the comfort of any patient who is undergoing surgery un der local anesthesia, necessitating the use of drapes over the face. The apparatus is easy and inexpensive and can be made by any machine shop. The coil through which the tubing passes has an ad justable point so that the apparatus can be adjusted to fit any patient. The open end of the suction tubing should be used, as the addition of any sort of nozzle or tip which narrows the orifice, produces a noise which may be annoying to both patient and surgeon.
surgery about the eyelids. Tantalum foil was folded into four or six thicknesses and su tures were found to pass easily through either thickness when the foil was held with a forceps (fig. 1). It was found not to buckle when the sutures were tied and there was no tissue reaction.
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TANTALUM F O I L PEGS* EARL MAXWELL, COL., (MC)
U.S.A.F.
San Francisco, California About two years ago, after observing how little tissue reaction there was to tantalum, it was decided to try it as pegs in plastic
Fig. 2 (Maxwell). Tantalum pegs used in tarsorrhaphy. Since the initial trial, it has been used ex tensively and found to be more satisfactory than any other substance in tarsorrhaphy (fig. 2), Blaskovicz's ptosis operation, lid repair, reconstruction of the orbit, and other plastic procedures requiring tension sutures to be tied over pegs. It has several advantages —among them: it is nonirritating, secretions do not adhere to the material, it is easily handled, and may be quickly trimmed to any desired size or shape.
ONE-SIDED E P I P H O R A * SAM ENGEL,
M.D.
San Francisco, California Fig. 1 (Maxwell). The suture is being passed through the tantalum peg. * From the Letterman General Hospital.
Not so rarely a patient is seen who com plains of one-sided epiphora. After exclu* From the Department of Ophthalmology, Stan ford University Medical School.
NOTES, CASES, INSTRUMENTS A distinct advantage in Lachesine is that it is dispensed in powder form. Thus a fresh solution of this surface-active agent may be
prepared in as small a quantity as deemed desirable. 37 South 20th Street (3).
REFERENCES
1. 2. 3. 4.
Feldman, J. B.: Arch. Ophth., 41:1,1949. Ing, H. R.: Brit. J. Ophth., 30:247,1946; Brit. M. Bull., 2:91,1948. Riddell, W. J. B.: Brit. J. Ophth., 30:1,1946. Mann, I.: Brit. J. Ophth., 30:8,1946.
AN UNDER-DRAPE VENTILATOR FOR CATARACT SURGERY* H. FARQUHARSON,
Wipe coil soldeped to frame
M.D.
San Francisco, California One prominent complaint of patients hav ing cataract extraction under local anesthesia has been the feeling of suffocation and heat as they breathe under the drapes. This has contributed a good deal to restlessness and consequent straining and even squeezing of the eyeball by the patient during surgery. To eliminate this hazard, and to add to the comfort of the patient under local anesthesia for intraocular surgery, it was felt that some attempt should be made to provide a cooler, more comfortable atmosphere beneath the drapes without encroaching on the surgeon's field. To accomplish this a suction tubing is placed over the patient's lower jaw, in close proximity to the mouth, to suck away the warm air that accumu lates beneath the drapes (figs. 1 and 2). V&ittl&tor The response by patients has been remarkable, particularly so in the case of those who have had ♦From the Departments of Anesthesiology and Ophthalmology of the University of California Hospital.
Fig. 2 (Farquharson). Showing re lation of suction tubing and frame to patient's face beneath the drapes.
Suction tubing
T
Metal pod beneath patients shoulders
Fig. 1 (Farquharson). Suction tubing supported by frame. the second eye operated upon using this apparatus, after having had the first eye done some months prior to the use of suction. No 5ms// eye in position
sfieet
Large spiii
sheet
444
NOTES, CASES, INSTRUMENTS
longer is there the feeling of suffocation due to the hot humid atmosphere beneath the drapes. These patients now are quieter, more relaxed, and comfortable. The results are, of course, of the utmost importance to the ophthalmic surgeon in intraocular surgery. The apparatus adds to the comfort of any patient who is undergoing surgery un der local anesthesia, necessitating the use of drapes over the face. The apparatus is easy and inexpensive and can be made by any machine shop. The coil through which the tubing passes has an ad justable point so that the apparatus can be adjusted to fit any patient. The open end of the suction tubing should be used, as the addition of any sort of nozzle or tip which narrows the orifice, produces a noise which may be annoying to both patient and surgeon.
surgery about the eyelids. Tantalum foil was folded into four or six thicknesses and su tures were found to pass easily through either thickness when the foil was held with a forceps (fig. 1). It was found not to buckle when the sutures were tied and there was no tissue reaction.
* .">• -
<**HT
"*j5sr>
TANTALUM F O I L PEGS* EARL MAXWELL, COL., (MC)
U.S.A.F.
San Francisco, California About two years ago, after observing how little tissue reaction there was to tantalum, it was decided to try it as pegs in plastic
Fig. 2 (Maxwell). Tantalum pegs used in tarsorrhaphy. Since the initial trial, it has been used ex tensively and found to be more satisfactory than any other substance in tarsorrhaphy (fig. 2), Blaskovicz's ptosis operation, lid repair, reconstruction of the orbit, and other plastic procedures requiring tension sutures to be tied over pegs. It has several advantages —among them: it is nonirritating, secretions do not adhere to the material, it is easily handled, and may be quickly trimmed to any desired size or shape.
ONE-SIDED E P I P H O R A * SAM ENGEL,
M.D.
San Francisco, California Fig. 1 (Maxwell). The suture is being passed through the tantalum peg. * From the Letterman General Hospital.
Not so rarely a patient is seen who com plains of one-sided epiphora. After exclu* From the Department of Ophthalmology, Stan ford University Medical School.