29 research outputs found
The relevance of reducing Veress needle overshooting
No full textSafe insertion of the Veress needle during laparoscopy relies on the surgeons’ technical skills in order to stop needle insertion just in time to prevent overshooting in the underlying organs. To reduce this risk, a wide variety of Veress needle systems were developed with safety mechanisms that limit the insertion speed, insertion depth or decouple the driving force generated by the surgeon’s hand on the needle. The aim of this study is to evaluate current surgeons’ perceptions related to the use of Veress needles and to investigate the relevance of preventing overshooting of Veress needles among members of the European Association of Endoscopic Surgery (EAES). An online survey was distributed by the EAES Executive Office to all active members. The survey consisted of demographic data and 14 questions regarding the use of the Veress needle, the training conducted prior to usage, and the need for any improvement. A total of 365 members residing in 58 different countries responded the survey. Of the responding surgeons, 36% prefer the open method for patients with normal body mass index (BMI), and 22% for patients with high BMI. Of the surgeons using Veress needle, 68% indicated that the reduction of overshoot is beneficial in normal BMI patients, whereas 78% indicated that this is beneficial in high BMI patients. On average, the members using the Veress needle had used it for 1448 (SD 3031) times and felt comfortable on using it after 22,9 (SD 78,9) times. The average years of experience was 17,6 (SD 11,1) and the surgeons think that a maximum overshoot of 9.4 (SD 5.5) mm is acceptable before they can safely use the Veress needle. This survey indicates that despite the risks, Veress needles are still being used by the majority of the laparoscopic surgeons who responded. In addition, the surgeons responded that they were interested in using a Veress needle with an extra safety mechanism if it limits the risk of overshooting into the underlying structures.Medical Instruments & Bio-Inspired TechnologyBiomechanical Engineerin
EXTERNALITIES OF GLOBALIZATION
No full textThis paper is an integral part of the former studies of the author. (VERESS, 1999; 2000; 2001). The conclusions of the papers referred to above may be considered as the inputs of the present study. From among them the most important ones concern globalization’s becoming a totality and the new duties of economic policy
Pre-clinical evaluation of the new veress needle+ mechanism on thiel-embalmed bodies: a controlled crossover study – Experimental
No full textBackground: Veress needles (VN) are commonly used in establishing pneumoperitoneum in laparoscopic surgery. Previously, a VN with a new safety mechanism ‘VeressPLUS’ needle (VN+) was developed to reduce the amount of overshoot.Methods: Eighteen participants (novices, intermediates, and experts) performed in total of 248 insertions in a systematic way on Thiel-embalmed bodies with wide and small bore versions of the conventional VN (VNc) and the VN+. Insertion depth was measured by recording the graduations on the needle under direct laparoscopic vision.Results: Participants graded the bodies and the procedures as lifelike. Overall, a significant reduction (P<0.001) in average insertion depth was found for the VN+ compared to the VNc of 26.0 SD16 mm versus 46.2 SD15 mm. The insertion depth difference in the novice group was higher compared to the intermediates and experts (P<0.001). The average insertion depth for both needle types was less (P<0.001) for female participants compared to male.Conclusion: This study indicated that the VN+ significantly reduced the insertion depth in all tested conditions. Whether the difference between female and male performance can be linked to differences in muscle control or arm mass should be further investigated. Useful technical information was gathered from this study to further improve the VN+.<br/
A novel Veress needle mechanism that reduces overshooting after puncturing the abdominal wall
No full textBackground: Complications that occur in laparoscopic surgery are often associated with the initial entry into the peritoneal cavity. The literature reported incidences of Veress needle (VN) injuries of e.g. 0.31% and 0.23%. In a 2010 national survey of laparoscopic entry techniques in the Canadian General Surgical practice, 57.3% of respondents had either experienced or witnessed a serious laparoscopic entry complication like bowel perforation and vascular injury. As those complications are potentially life threatening and should be avoided at all costs, improving safety of this initial action is paramount. Methods: Based on a bare minimum design approach with focus on function expansion of existing components, a new Safety mechanism was developed for the VN that decreases the risks of VN overshooting. The mechanism works by preventing the puncturing acceleration of the tip of the VN by decoupling the surgeon’s hand from the VN immediately after entering the abdomen. Results: Based on a set of requirements, a first prototype of the VN+ with force decoupling safety mechanism is presented and evaluated on an ex vivo porcine abdominal wall tissue model in a custom setup. The experiments conducted by two novices and one experienced surgeon indicated a significant difference between the attempts with a standard, conventional working VN (41.4 mm [37.5–45 mm]) and VN+ with decoupling mechanism (20.8 mm [17.5–22.5 mm]) of p < 0.001. Conclusion: A new decoupling safety mechanism was integrated successfully in a standard VN resulting in a VN+. The results from the pilot study indicate that this new VN+ reduces overshooting with a minimum of 50% in a standardised ex vivo setting on fresh porcine abdominal wall specimens.</p
END OF THE ECONOMIC POLICY. THE CASE OF HUNGARY
No full textThe paper discusses the political and economic background of the Hungarian
economic policy in the age of globalization. The author calls the attention
to the minimum conditions of the sovereign national economic policy. In his
opinion, since the second half of 2001 the Hungarian economic policy has
been unable to meet the enlisted minimum conditions
Once again about the London Entombment
No full textHistorical sources, such as the account books of Renaissance bankers offer valuable information about relationship between artists and commissioners. Yet, it is not easy to use such sources in identifying works of art and to integrate them into the catalogue of an important artist such as Michelangelo Buonarroti. Visual evidences and stylistic parallels are indispensable for art historians who endeavor to attribute new works to Michelangelo. After-life or influence of a work (the number of surviving copies and interpretations) can also be indicative, moreover there are iconological aspects (such as the relationship between mother
and son in case of Pietàs) which can also be conclusive. This study proposes to reconsider a hypothesis aroused by earlier scholarship regarding the authorship of the Entombment in London, the National Gallery attributed to Michelangelo. According to some scholars, the author of this painting can probably be found among Florentine mannerists who became
under Michelangelo’s influence during work in the Sagrestia Nuova (1520’s)
Szerződő felek a szindikátusi szerződésben
No full textA magyar jogtudományi szakirodalomban vitatott kérdés, hogy kik lehetnek szerződő felek
a szindikátusi szerződésben. Az alapvető álláspont az, hogy csak a társaság tagjai vehetnek részt
benne. A szerző viszont e megközelítést vitatja, és érveket sorakoztat fel amellett, hogy a szindikátusi szerződés meghatározása és egyéb szerződésektől való elhatárolása nem a szerződő felek
révén megoldandó kérdés. A tanulmány álláspontja szerint nemcsak a tagok jelenhetnek meg
félként a szindikátusi szerződésben, hanem a tagok mellett olyan harmadik személyek is, mint
a társaság vezető tisztségviselői, egyes hitelezői vagy akár maga a társaság is.
It is a controversial issue in the Hungarian legal science who can be a party to the shareholders’
agreement (syndicate contract). The primary point is that only the shareholders or members of
a company can participate in the syndicate contract. However, the author disputes this approach
and puts forward arguments that the definition of the syndicate contract and its delimitation from
other contracts are not solved through the sphere of contracting parties. According to the analysis,
not only the company members can appear as a contracting party in the syndicate agreement, but
also third parties: as directors, some of the creditors or even the company itself
Szerződő felek a szindikátusi szerződésben = Contracting Parties in the Shareholders’ Agreement
No full textIt is a controversial issue in the Hungarian legal science who can be a party to the shareholders’ agreement (syndicate contract). The primary point is that only the shareholders or members of a company can participate in the syndicate contract. However, the author disputes this approach and puts forward arguments that the definition of the syndicate contract and its delimitation from other contracts are not solved through the sphere of contracting parties. According to the analysis, not only the company members can appear as a contracting party in the syndicate agreement, but also third parties: as directors, some of the creditors or even the company itself.A magyar jogtudományi szakirodalomban vitatott kérdés, hogy kik lehetnek szerződő felek a szindikátusi szerződésben. Az alapvető álláspont az, hogy csak a társaság tagjai vehetnek részt benne. A szerző viszont e megközelítést vitatja, és érveket sorakoztat fel amellett, hogy a szindikátusi szerződés meghatározása és egyéb szerződésektől való elhatárolása nem a szerződő felek révén megoldandó kérdés. A tanulmány álláspontja szerint nemcsak a tagok jelenhetnek meg félként a szindikátusi szerződésben, hanem a tagok mellett olyan harmadik személyek is, mint a társaság vezető tisztségviselői, egyes hitelezői vagy akár maga a társaság is
Resveratrol Inhibits Aggregation of Platelets from High-risk Cardiac Patients with Aspirin Resistance
No full text
