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    Wyświetlanie 1-4 z 4
    Tytuł:
    New techniques in ventral hernia surgery – an evolution of minimally-invasivehernia repairs
    Autorzy:
    Mitura, Kryspin
    Powiązania:
    https://bibliotekanauki.pl/articles/1391732.pdf
    Data publikacji:
    2020
    Wydawca:
    Index Copernicus International
    Tematy:
    component separation
    eTEP
    hernia repair
    mesh
    sublay
    surgery
    ventral hernia
    Opis:
    Incisional ventral hernia occurs after almost every fourth laparotomy. Still, both simple suturing of the hernia defect and open mesh repair, lead to a high incidence of infections and recurrences. In recent years, we have observed a further evolution of operational techniques used in order to reduce the number of complications. The search for effective repair methods is currently going in two directions: on the one hand, techniques to reduce tissue tension in the suture line are being developed and disseminated (including modifications to the so-called Ramirez technique); on the other hand, minimally invasive techniques are introduced that allow placement of large synthetic meshes without the need for extensive tissue dissection using open repair. In the first group of presented techniques, emphasis is put on basics and access in the following repair method: original Ramirez technique, modified Ramirez technique, anterior component separation with periumbilical perforator-sparing, endoscopic anterior component separation and transversus abdominis release. In the second part of the manuscript, attention is drawn to the following hernia repair techniques: eTEP, reversed TEP, MILOS/eMILOS, stapler repair, TAPP, TARUP, TESLA, SCOLA, REPA, LIRA, IPOM, IPOM-plus. When choosing the optimal technique for a given patient, the surgeon should first of all be guided by technical feasibility, availability of materials, their own experience, as well as the characteristics of the patient and overall burdens. Nevertheless, surgeons undertaking reconstruction of the abdominal wall in the case of hernias should know different surgical accesses and individual spaces of the abdominal integument, in which a synthetic material may be placed. However, it should be emphasized that poor ergonomics of novel techniques, complex anatomy and complicated dissection of space, as well as the need for laparoscopic suturing in a difficult arrangement of tissue layers and in a narrow space, without a full triangulation of instruments, make these operations a challenge even for a surgeon experienced in minimally invasive surgeries.
    Źródło:
    Polish Journal of Surgery; 2020, 92, 4; 38-46
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    The impact of COVID-19 pandemic on critical care and surgical services availability
    Wpływ pandemii COVID-19 na intensywną terapię i dostępność usług chirurgicznych
    Autorzy:
    Mitura, Kryspin
    Powiązania:
    https://bibliotekanauki.pl/articles/1033281.pdf
    Data publikacji:
    2020
    Wydawca:
    Towarzystwo Pomocy Doraźnej
    Tematy:
    COVID-19
    SARS-CoV-2
    availability
    coronavirus
    deferral
    delay
    surgery
    Opis:
    The spreading of COVID-19 pandemic caused by the SARS-CoV-2 coronavirus affects the entire healthcare system in the world. As one of the side effects of the pandemic, the need for surgery deferral has emerged. The purpose of this analysis is to review current literature discussing the issue of a limited access to critical care and surgical services. Following the outbreak of a pandemic, many national scientific societies, as well as numerous medical specialty associations, have begun working on developing guidelines to deal with these issues to enable access to medical services for the most seriously ill patients affected by COVID-19. Moreover, limited access to intensive care beds, shortages in personal protective equipment chain supply and the risk of an unintended spread of infection among the staff and the patients led to a severe limitation of all elective operations, mostly excluding oncological, ur-gent/emergent and trauma interventions. This period of uncertainty about the risk of virus transmission can last for many months, if not years. Therefore, it is necessary to develop such behavioral patterns that will allow us to work safely without limiting the number of elective operations and maintaining continuous access to critical and surgical care. As elective operations were cancelled in the world to the extent that history did not witnessed so far, there is a simultaneous unintended harmful effect of this phenomenon. The overall survival time of patients may be shortened, their quality of life might be reduced, the risk of complications and the need for critical care in the most severe cases will increase. Currently, it seems of the utmost importance to develop a plan for a safe return to elective surgery. At the same time, international organizations should warrant the development of alternative plans for dealing with similar events in the future.
    Rozprzestrzenianie się pandemii COVID-19 wywołanej przez koronawirusa SARS-CoV-2 wpływa na systemy opieki zdrowotnej na całym świecie. Jako jeden ze skutków ubocznych pandemii pojawiła się potrzeba odroczenia operacji. Cel tej analizy ma na celu przegląd aktualnego piśmiennictwa omawiającego kwestię ograniczonego dostępu do intensywnej terapii i usług chirurgicznych. Po wybuchu pandemii wiele krajowych towarzystw naukowych, a także liczne organizacje medyczne i stowarzyszenia rozpoczęły działania nad opracowaniem wytycznych dotyczących tych problemów, aby umożliwić dostęp do opieki medycznej najciężej chorym pacjentom z COVID-19. Ponadto ograniczony dostęp do stanowisk intensywnej terapii, niedobory łańcucha dostaw środków ochrony osobistej i ryzyko niezamierzonego rozprzestrzeniania się infekcji wśród personelu i pacjentów doprowadziły do poważnego ograniczenia wszystkich operacji planowych, nie licząc onkologicznych, ratujących życie i interwencji urazowych. Ten okres niepewności co do ryzyka przeniesienia wirusa może trwać wiele miesięcy, jeśli nie lat. Dlatego konieczne jest opracowanie takich wzorców zachowań, które pozwolą bezpiecznie pracować bez ograniczania liczby operacji planowych i utrzymać ciągły dostęp do intensywnej terapii oraz opieki chirurgicznej. Zabiegi operacyjne zostały ograniczone na świecie tak, jak jeszcze nigdy w historii, a jednocześnie nie określono jeszcze szkodliwych efektów tego zjawiska. Ogólny czas przeżycia pacjentów może zostać skrócony, ich jakość życia może zostać obniżona, a ryzyko powikłań i potrzeba intensywnej terapii w najcięższych przypadkach wzrośnie. Obecnie wydaje się, że ogromne znaczenie ma opracowanie planu bezpiecznego powrotu do planowej operacji. Jednocześnie organizacje międzynarodowe powinny uzasadnić opracowanie alternatywnych planów radzenia sobie z podobnymi wydarzeniami w przyszłości.
    Źródło:
    Critical Care Innovations; 2020, 3, 2; 43-50
    2545-2533
    Pojawia się w:
    Critical Care Innovations
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Groin Hernia Surgery in Northern Ghana - Humanitarian Mission of Polish Surgeons in Tamale
    Autorzy:
    Mitura, Kryspin
    Kozieł, Sławomir
    Pasierbek, MichaŁ
    Powiązania:
    https://bibliotekanauki.pl/articles/1395201.pdf
    Data publikacji:
    2015-03-01
    Wydawca:
    Index Copernicus International
    Tematy:
    inguinal hernia
    Africa
    Ghana
    humanitarian mission
    surgery
    Opis:
    Availability of surgical care in Africa is severely limited. This is due to the lack of surgeons and a small number of public hospitals. Only 25 out of 100,000 patients with inguinal hernia undergo a surgical treatment. As many as 65% of inguinal hernia repairs are performed urgently because of incarceration. Among patients with incarceration who do not reach the hospital there is recorded as many as 87 deaths per 100 cases. In order to improve the availability of treatment of inguinal hernia in Africa, humanitarian medical missions involving surgeons from Europe are organized. During regular visits to selected centers in Africa, they also carry out intensified treatment of patients and training of the local staff. The aim of the study was to present the experience of Polish surgeons from the humanitarian medical mission in Tamale in northern Ghana undertaken in fall of 2014. Material and methods. Surgical repair was performed in 87 patients (74 men – 85% and 13 women – 15%) between the ages of 26 to 70 years (mean 52.8 years; SD 10.3), who underwent a total of 98 inguinal hernia repairs under local anesthesia. Results. Lichtenstein procedure was performed in 93 and Desarda technique in 5 patients. Patients reported the long-term presence of hernia symptoms - from one to 7 years (mean 3.4 years, SD 1.4). In most patients, hernia occurred more than 3 years earlier (61 patients; 70%). There were no intraoperative complications. All patients were discharged the next day after surgery. There was one wound infection in postoperative period which required mesh explantation. Conclusions. Inguinal hernia commonly found in Ghana is a major issue for the inefficient health care system. Humanitarian medical missions can help to improve the treatment results, as long as they are carried out periodically and allow for training of local personnel. Scarce equipment of medical facilities in Ghana is not a significant difficulty in performing the Lichtenstein repair under the local anesthesia.
    Źródło:
    Polish Journal of Surgery; 2015, 87, 1; 16-21
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Guidelines for the management of surgical departments in non-uniform hospitals during the COVID-19 pandemic
    Autorzy:
    Mitura, Kryspin
    Myśliwiec, Piotr
    Rogula, Wojciech
    Solecki, Michał
    Furtak, Jarosław Piotr
    Kazanowski, Michał
    Kłęk, Stanisław
    Nowakowski, Michał
    Pędziwiatr, Michał
    Zawadzki, Marek
    Wallner, Grzegorz
    Sobocki, Jacek
    Powiązania:
    https://bibliotekanauki.pl/articles/1391784.pdf
    Data publikacji:
    2020
    Wydawca:
    Index Copernicus International
    Tematy:
    COVID-19
    SARS-CoV-2
    pandemic
    epidemic
    surgical care
    personal protective equipment
    FFP3 masks
    surgery
    hospital
    virus
    guidelines
    recommendations
    Opis:
    In the last several weeks we have been witnessing the exponentially progressing pandemic SARS-CoV-2 coronavirus. As the number of people infected with SARS-CoV2 escalates, the problem of surgical management of patients requiring urgent surgery is increasing. Patients infected with SARS-CoV2 virus but with negative test results will appear in general hospitals and may pose a risk to other patients and hospital staff. Health care workers constitutes nearly 17% of infected population in Poland, therefore early identification of infected people becomes a priority to protect human resources and to ensure continuity of the access to a surgical care. Both surgical operations, and endoscopic procedures are considered as interventions with an increased risk of infection. Therefore, determining the algorithm becomes crucial for qualifying patients for surgical treatment, but also to stratify the risk of personnel being infected during surgery and to adequately protect staff. Each hospital should be logistically prepared for the need to perform urgent surgery on a patient with suspected or confirmed infection, including personal protective equipment. Limited availability of the equipment, working under pressure and staff shortages in addition to a highly contagious pathogen necessitate a pragmatic management of human resources in health care. Instant synchronized action is needed, and clear uniform guidelines are essential for the healthcare system to provide citizens with the necessary surgical care while protecting both patients, and staff. This document presents current recommendations regarding surgery during the COVID-19 pandemic in Poland.
    Źródło:
    Polish Journal of Surgery; 2020, 92, 2; 42-53
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
      Wyświetlanie 1-4 z 4

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