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The relationship between grip force of surgeons and operation force of two mechanical circular staplers under different grip widths
e100
Scientific Poster Presentations: 2014 Clinical Congress
emergencies carried out at two Community hospitals in the North east of Italy. METHODS: From January 1992 and January 2014 a total of 2205 patients underwent emergency laparoscopy (small bowel obstruction 75; gastro-duodenal ulcer disease 69; biliary disease 504; pelvic disease and NSAP 1504 cases; colonic perforations 32; hernias diseases 21). RESULTS: The conversion rate was 3.1% (69 cases) and was mainly due to the presence of dense intra-abdominal adhesions. Complications ranged as high as 2.4% (53 cases) with a postoperative mortality of 0.3% (7 cases). A definitive diagnosis was accomplished in 96% (2119) of cases, and 97% (2059) such patients were treated successfully by laparoscopy. CONCLUSIONS: We do think that laparoscopy is not an alternative to physical examination/good clinical judgment but it must be considered first as an effective option in patients (both adults and children) in whom conventional non-invasive methods fail, especially with increasing experience and skills of the surgeons, and second as a challenging alternative to open surgery in the management algorithm for abdominal emergencies. The relationship between grip force of surgeons and operation force of two mechanical circular staplers under different grip widths Emiko Kono, Mitsunori MT Tada, Dr, Makiko Kouchi, Yui Endo, Yasuko Tomizawa, MD Osaka Kosei-Nenkin Hospital, Osaka, Japan and Digital Human Research Center, Koto-ku, Japan and Tokyo Women’s Medical University, Shinjuku-ku, Japan INTRODUCTION: Our previous survey demonstrated that surgeons wearing glove size 6.0 and smaller had difficulty in firing a circular stapler. The purpose of this study is to reveal the cause of difficulty by experiments. METHODS: For this purpose, the grip force of 113 (52 males and 61 females) Japanese surgeons was measured under five grip widths. For two types of circular staplers (DST-EEA28 and CDH29), the indentation depth and the reaction force were also measured by a mechanical testing stand with a force gauge at three different points on the lever to obtain the relationship between the grip width and the operation force required to push the lever. These force-width relationships for surgeons and staplers are superimposed to evaluate the difficulty of firing. RESULTS: Optimal grip width was 62.58.5 mm for males and was 55.55.9 mm for females (p<0.001). The maximum grip force was 44.26.1 kg for males and was 29.74.5 kg for females (p<0.001). The superimposed force-width relationships clearly demonstrated that these staplers had similar grip width at firing position, while CDH29 requires relatively higher operation force. Even in the case of DST-EEA28, it was physically impossible for female surgeons with lower grip force to fire the stapler by gripping the proximal end of the grip with one hand.
J Am Coll Surg
CONCLUSIONS: The two staplers had different force-width relationship. It was revealed that firing the stapler by one hand was physically impossible for female surgeons with lower grip force. A prospective randomized-controlled study comparing the Olongapo incision with the Rockey-Davis Incision for open appendectomy Voltaire A Carandang Sr, MD James L Gordon Memorial Hospital, Olongapo City, Philippines INTRODUCTION: The 2004 Cochrane Review - claimed to be the most comprehensive meta-analysis of 54 Randomized-Clinical Trials, failed to establish significant dominance of laparoscopic vs open appendectomy. The open technique therefore, remains the goldstandard for appendectomy to this day. In 2012, the authors spearheaded a pilot study on a novel technique known as the “Olongapo incision” aimed to elucidate the procedure in a descriptive case-series. This study aims to compare the Olongapo incision with the Rockey-Davis incision as to: duration of operation, degree of post-operative pain, length of hospital stay and occurrence of post-operative morbidities. METHODS: Randomization process on 150 patients was carriedout. Patients were grouped into 2 arms: Group A - “Olongapo Incision Group”, Group B - “Rockey-Davis Group”. Selection was based on right lower quadrant pain (<24 hours), 7-10 score on the Alvarado Scoring System regardless of age and BMI. Exclusion criteria were: pain > 24 hours, generalized peritonitis, existence of co-morbidities and pregnancy. RESULTS: The Olongapo Incision (Group A) technique was statistically comparable with the Rockey-Davis (Group B) in terms of duration of operation, length of hospital stay, post-operative complications, pain observations upon discharge and 30 days post-operatively. Post-operative pain was significantly less in Group A. CONCLUSIONS: The Olongapo Incision is superior in terms of the duration of procedure, has less post-operative pain as compared with the Rockey-Davis Incision. The Olongapo Incision is comparable to the Rockey-Davis Incision in terms of recuperation period - reflected by short length of hospital stay. No pain, lots of gain: a method to reduce opioid adverse events in your hospital Jay A Redan, MD, FACS, Sandra Reeder, Tina Wells, RN Florida Hospital Celebration Health, Kissimmee, FL INTRODUCTION: Opioids are commonly used in post-operative pain management. Adverse side-effects of opioids include; respiratory depression, urinary retention, pruritus, vomiting, nausea, constipation, and increased fall risk. Surgical site infiltration with extended release liposomal bupivacaine is effective in reducing pain. The purpose of the present study was to examine the effects of liposomal bupivacaine on postoperative opioid use and related
Scientific Poster Presentations: 2014 Clinical Congress
emergencies carried out at two Community hospitals in the North east of Italy. METHODS: From January 1992 and January 2014 a total of 2205 patients underwent emergency laparoscopy (small bowel obstruction 75; gastro-duodenal ulcer disease 69; biliary disease 504; pelvic disease and NSAP 1504 cases; colonic perforations 32; hernias diseases 21). RESULTS: The conversion rate was 3.1% (69 cases) and was mainly due to the presence of dense intra-abdominal adhesions. Complications ranged as high as 2.4% (53 cases) with a postoperative mortality of 0.3% (7 cases). A definitive diagnosis was accomplished in 96% (2119) of cases, and 97% (2059) such patients were treated successfully by laparoscopy. CONCLUSIONS: We do think that laparoscopy is not an alternative to physical examination/good clinical judgment but it must be considered first as an effective option in patients (both adults and children) in whom conventional non-invasive methods fail, especially with increasing experience and skills of the surgeons, and second as a challenging alternative to open surgery in the management algorithm for abdominal emergencies. The relationship between grip force of surgeons and operation force of two mechanical circular staplers under different grip widths Emiko Kono, Mitsunori MT Tada, Dr, Makiko Kouchi, Yui Endo, Yasuko Tomizawa, MD Osaka Kosei-Nenkin Hospital, Osaka, Japan and Digital Human Research Center, Koto-ku, Japan and Tokyo Women’s Medical University, Shinjuku-ku, Japan INTRODUCTION: Our previous survey demonstrated that surgeons wearing glove size 6.0 and smaller had difficulty in firing a circular stapler. The purpose of this study is to reveal the cause of difficulty by experiments. METHODS: For this purpose, the grip force of 113 (52 males and 61 females) Japanese surgeons was measured under five grip widths. For two types of circular staplers (DST-EEA28 and CDH29), the indentation depth and the reaction force were also measured by a mechanical testing stand with a force gauge at three different points on the lever to obtain the relationship between the grip width and the operation force required to push the lever. These force-width relationships for surgeons and staplers are superimposed to evaluate the difficulty of firing. RESULTS: Optimal grip width was 62.58.5 mm for males and was 55.55.9 mm for females (p<0.001). The maximum grip force was 44.26.1 kg for males and was 29.74.5 kg for females (p<0.001). The superimposed force-width relationships clearly demonstrated that these staplers had similar grip width at firing position, while CDH29 requires relatively higher operation force. Even in the case of DST-EEA28, it was physically impossible for female surgeons with lower grip force to fire the stapler by gripping the proximal end of the grip with one hand.
J Am Coll Surg
CONCLUSIONS: The two staplers had different force-width relationship. It was revealed that firing the stapler by one hand was physically impossible for female surgeons with lower grip force. A prospective randomized-controlled study comparing the Olongapo incision with the Rockey-Davis Incision for open appendectomy Voltaire A Carandang Sr, MD James L Gordon Memorial Hospital, Olongapo City, Philippines INTRODUCTION: The 2004 Cochrane Review - claimed to be the most comprehensive meta-analysis of 54 Randomized-Clinical Trials, failed to establish significant dominance of laparoscopic vs open appendectomy. The open technique therefore, remains the goldstandard for appendectomy to this day. In 2012, the authors spearheaded a pilot study on a novel technique known as the “Olongapo incision” aimed to elucidate the procedure in a descriptive case-series. This study aims to compare the Olongapo incision with the Rockey-Davis incision as to: duration of operation, degree of post-operative pain, length of hospital stay and occurrence of post-operative morbidities. METHODS: Randomization process on 150 patients was carriedout. Patients were grouped into 2 arms: Group A - “Olongapo Incision Group”, Group B - “Rockey-Davis Group”. Selection was based on right lower quadrant pain (<24 hours), 7-10 score on the Alvarado Scoring System regardless of age and BMI. Exclusion criteria were: pain > 24 hours, generalized peritonitis, existence of co-morbidities and pregnancy. RESULTS: The Olongapo Incision (Group A) technique was statistically comparable with the Rockey-Davis (Group B) in terms of duration of operation, length of hospital stay, post-operative complications, pain observations upon discharge and 30 days post-operatively. Post-operative pain was significantly less in Group A. CONCLUSIONS: The Olongapo Incision is superior in terms of the duration of procedure, has less post-operative pain as compared with the Rockey-Davis Incision. The Olongapo Incision is comparable to the Rockey-Davis Incision in terms of recuperation period - reflected by short length of hospital stay. No pain, lots of gain: a method to reduce opioid adverse events in your hospital Jay A Redan, MD, FACS, Sandra Reeder, Tina Wells, RN Florida Hospital Celebration Health, Kissimmee, FL INTRODUCTION: Opioids are commonly used in post-operative pain management. Adverse side-effects of opioids include; respiratory depression, urinary retention, pruritus, vomiting, nausea, constipation, and increased fall risk. Surgical site infiltration with extended release liposomal bupivacaine is effective in reducing pain. The purpose of the present study was to examine the effects of liposomal bupivacaine on postoperative opioid use and related