14 research outputs found
Laparoscopic treatment of a De Garengeot hernia. Case report and review of literature
No full textDe Garengeot hernia is defined as femoral hernia containing appendix. It’s an extremely rare occurrence occurring in 0.5% to 3% of femoral hernia cases, with a female: male ratio is 6: 1. We report the case of a 71 years old female patient, who presented an incarcerated right femoral hernia. We performed an explorative laparoscopy with the visualisation of the appendix. The appendix was normal. An intraabdominal reduction of the appendix and the treatment of the hernia by TAPP technique was performed. De Garengeot hernia can be can be a unusal discovery during surgery. The differential diagnostic is with Amyand hernia, which is an incarceration of the appendix in an inguinal hernia. Due to the low occurence of this pathology the explorative laparoscopy may be a valid technique for diagnostic and treatment. In case of acute appendicitis, the use of the mesh is not formally recommended. The laparoscopic treatment of De Garengeot’s hernia is feasible even in emergency setting. If the appendix is inflammatory the appendectomy is mandatory
Bariatric Artery Embolization for Obese Patients. An Up-to-Date Review
No full textOverweight and obesity are one of public health’s major problems in the world. Conservative treatment with exercise, diet and pharmacotherapy is often ineffective, especially in the long term. Bariatric surgery is the gold standard method for a sustained long-term weight loss. Recently the endovascular technique of bariatric artery embolization (BAE) has been studied as an obesity and overweight treatment, with promising results. The goal of this article is to analyze the rationale behind BAE and to provide an up-to-date analysis of its strengths and limitation in comparison with bariatric surgery as a treatment for obesity.SCOPUS: ar.jinfo:eu-repo/semantics/publishe
Numerical Model of an Injection-Locked Wideband Frequency Modulator for Polar Transmitters
No full textWe present a numerical model of a wideband injection-locked frequency modulator used in a polar transmitter for 3G cellular radio application. At the heart of the system is a self-injection-locked oscillator with a programmable linear tuning range of up to 200 MHz at 4-GHz oscillation frequency. The oscillator is injection locked to a time-delayed version of its resonating voltage, and its frequency is modulated by manipulating the phase and amplitude of the injected current. The model is used to study the feasibility of the proposed system by analyzing the impact of various impairments in the auxiliary injection loop on the system performance. The model is written in MATLAB/SIMULINK, and the simulation output is analyzed by a vector signal analyzer in terms of 3GPP specifications. Based on the simulation results, key specifications for individual blocks in the system are determined. The key benefits of the presented modeling methodology are simplicity, efficiency, and portability.Electronic
The Utilisation of Digital Applications for Measuring Patient Outcomes Following Bariatric Surgery: a Systematic Review and Meta-analysis of Comparative Studies
No full textIn the context of escalating obesity rates, bariatric surgery holds a crucial role in managing severely obese patients. With a demonstrated effectiveness in weight loss and with the advent of ambulatory surgery, bariatric surgery allows for a streamlined care pathway, ideally suited for postoperative surveillance using digital health applications. The aim of this systematic review and meta-analysis is to evaluate the effect of eHealth-delivered health services or support for adults undergoing bariatric surgery. Five studies, encompassing 2210 patients, were analysed. The intervention group showed a 10% increase in total weight reduction and a 22% reduction in excess weight loss. ED visitation rates also trended towards reduction. Despite the absence of clear statistical superiority for DHA, the findings suggest potential benefits of DHA in postoperative monitoring. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature
Efficiency Optimization of Double-sided LCC Matching Network for Electric Vehicle Inductive Power Transfer System
No full textThis thesis presents an efficiency optimization of double-sided inductor-capacitor-capacitor
(LCC) matching network for inductive power transfer (IPT) systems. Compensation factors
of the primary and secondary LCC circuit are defined and optimized, both analytically
and numerically. Through this investigation, the secondary compensation factor, krx, highly
influences the copper loss of the wireless coupler, while the primary compensation factor, ktx,
affects the switching loss and conduction loss of the input inverter. With a proper selection of
these compensation factors, it is possible to achieve a high and sustained efficiency over a wide
range of load and misalignment. For the analysis-based optimization, the matching networks
are assumed to be lossless in order to simplify the process of the analytical derivation. The
established formulae presented in this thesis is compact and convenient to use.
In order to take into account the conduction loss of the input inverter and rectifier, and the
losses on components of matching networks, a Genetic Algorithm (GA) - based optimization
is implemented. The primary and secondary compensation factor are the variables needed
to be solved by the GA optimization. The fitness function is the total loss of the circuit, and
the GA optimization will search for a pair of variables, ktx and krx, to minimize the fitness
function, while satisfies a constraint, which is the output power. It will be shown later that
the results of the GA optimization agree excellently with the ones from the analysis-based
optimization. Therefore, both methods presented can be utilized in practice, providing
a convenient tool for designers who deals with the LCC-LCC matching network in IPT
applications. In addition, a sensitivity analysis study is presented in this thesis in order to
investigate the impact of components’ tolerance on the winding-to-winding efficiency and
input power factor.
In order to demonstrate the feasibility and validity of the proposed method, a scaled-down
prototype of an IPT system has been implemented with the operating frequency of 85kHz,
transfer gap of 170mm and misalignment of up to 100mm. Experimental results show a good
agreement with the theoretical analysis. The peak efficiency of the proposed system is 91.6%
under the perfect alignment or at the coupling coefficient of 0.172. The efficiency still remains
at 86.37% even under 100mm misalignment with the coupling coefficient of 0.123. The
optimization method presented in this thesis is for the double-sided LCC topology, however,
the author believes the optimization methodology can be applied for other topologies of
matching networks in IPT systems
Case report: Sclerosed hemangioma of the liver: A diagnostic challenge
No full textHemangiomas are the most common noncystic benign hepatic tumors and are usually incidentally discovered during routine radiological examinations. The diagnosis of hepatic hemangiomas with a typical presentation is generally easy with plain and cross-sectional imaging; however, it can be complicated when hemangiomas undergo histological changes such as fibrosis. Sclerosed hepatic hemangioma (SHH) is the extreme presentation of this fibrotic process. These atypical lesions can be misdiagnosed as primary hepatic malignancies or metastasis. Their diagnosis is established by histological examination. We report the case of a patient with an SHH, which was misdiagnosed as an intrahepatic cholangiocarcinoma. This article's aim is to draw attention to this infrequent pathology and underline the features of this benign tumor that could suggest its diagnosis prior to surgery to avoid unnecessary hepatic resections
Side-to-side magnet anastomosis system duodeno-ileostomy with sleeve gastrectomy: early multi-center results
No full textIntroduction: Gastrointestinal anastomoses with classical sutures and/or metal staples have resulted in significant bleeding and leak rates. This multi-site study evaluated the feasibility, safety, and preliminary effectiveness of a novel linear magnetic compression anastomosis device, the Magnet System (MS), to form a side-to-side duodeno-ileostomy (DI) diversion for weight loss and type 2 diabetes (T2D) resolution. Methods: In patients with class II and III obesity (body mass index [BMI, kg/m2] ≥ 35.0– ≤ 50.0 with/without T2D [HbA1C > 6.5%]), two linear MS magnets were delivered endoscopically to the duodenum and ileum with laparoscopic assistance and aligned, initiating DI; sleeve gastrectomy (SG) was added. There were no bowel incisions or retained sutures/staples. Fused magnets were expelled naturally. Adverse events (AEs) were graded by Clavien-Dindo Classification (CDC). Results: Between November 22, 2021 and July 18, 2022, 24 patients (83.3% female, mean ± SEM weight 121.9 ± 3.3 kg, BMI 44.4 ± 0.8) in three centers underwent magnetic DI. Magnets were expelled at a median 48.5 days. Respective mean BMI, total weight loss, and excess weight loss at 6 months (n = 24): 32.0 ± 0.8, 28.1 ± 1.0%, and 66.2 ± 3.4%; at 12 months (n = 5), 29.3 ± 1.5, 34.0 ± 1.4%, and 80.2 ± 6.6%. Group mean respective mean HbA1C and glucose levels dropped to 1.1 ± 0.4% and 24.8 ± 6.6 mg/dL (6 months); 2.0 ± 1.1% and 53.8 ± 6.3 mg/dL (12 months). There were 0 device-related AEs, 3 procedure-related serious AEs. No anastomotic bleeding, leakage, stricture, or mortality. Conclusion: In a multi-center study, side-to-side Magnet System duodeno-ileostomy with SG in adults with class III obesity appeared feasible, safe, and effective for weight loss and T2D resolution in the short term.SCOPUS: ar.jinfo:eu-repo/semantics/publishe
The Utilisation of Digital Applications for Measuring Patient Outcomes Following Bariatric Surgery: a Systematic Review and Meta-analysis of Comparative Studies.
No full textpeer reviewedIn the context of escalating obesity rates, bariatric surgery holds a crucial role in managing severely obese patients. With a demonstrated effectiveness in weight loss and with the advent of ambulatory surgery, bariatric surgery allows for a streamlined care pathway, ideally suited for postoperative surveillance using digital health applications. The aim of this systematic review and meta-analysis is to evaluate the effect of eHealth-delivered health services or support for adults undergoing bariatric surgery. Five studies, encompassing 2210 patients, were analysed. The intervention group showed a 10% increase in total weight reduction and a 22% reduction in excess weight loss. ED visitation rates also trended towards reduction. Despite the absence of clear statistical superiority for DHA, the findings suggest potential benefits of DHA in postoperative monitoring
Robotic median arcuate ligament release: a video vignette
No full textMedian arcuate ligament syndrome (MALS) poses a rare challenge in diagnosis and management. We present a case of MALS in a 50-year-old male with recurrent epigastric pain, vomiting, and diarrhea. Diagnostic imaging revealed celiac artery stenosis and gastroduodenal artery collateral dilatation. Robotic-assisted median arcuate ligament release successfully alleviated symptoms. Utilizing the da Vinci X system (Intuitive Surgical, Inc.), the procedure involved meticulous dissection of the celiac artery and surrounding tissue. Postoperative duplex ultrasound confirmed improved arterial flow. Literature underscores the diagnostic hurdles of MALS and the advantages of minimally invasive approaches over conventional open surgery. The robotic approach may help smoothen the learning curve associated with this procedure, by providing improved operative flexibility. Patient outcomes are excellent, with long-term symptom relief in most cases
Feasibility and satisfaction with remote digital postoperative follow-up using a three-tiered alert system after bariatric surgery.
No full textpeer reviewed[en] INTRODUCTION: With the global prevalence of obesity steadily increasing, bariatric surgery has gained significance in managing this health challenge. Fast-track healthcare pathways have shown promise in improving outcomes and patient satisfaction for bariatric surgery. In this study, we aimed to evaluate the safety and feasibility of responsive remote digital postoperative follow-up using a smartphone application.
MATERIALS AND METHODS: Consecutive patients undergoing bariatric surgery at CHU Saint-Pierre University Hospital between September 2022 and October 2023 were prospectively enrolled. Patients were instructed to download and install the application on their smartphones, which prompted them with predetermined daily questions. Depending on their responses, alerts could be generated for review by medical staff A three-tiered alert system (orange, red, red+) was implemented to signify increasing significance. Comparisons between categorical variables were conducted using Fisher's exact test, while comparisons between continuous variables were assessed using the one-way Analysis of Variance (ANOVA) test for normally distributed data and the Mann-Whitney U test for non-normally distributed data.
RESULTS: During the study period, a total of 1119 alerts were recorded from 104 patients, with 39.3% occurring within the first seven postoperative days. Patient alert profiles were significantly associated with postoperative outcomes, with worsening outcomes observed from basic orange alerts to red+ alerts. Patients with red+ alerts had nearly a threefold increase in postoperative morbidity rates, emergency department visits, and readmissions. No significant differences in weight loss outcomes were observed. Patient response adherence was 67.5%, while the overall satisfaction with the use of the application was 94%.
CONCLUSION: Remote follow-up via a mobile application holds promise for enhancing the management of bariatric surgery patients, complementing traditional practices. The implementation of a three-tiered alert system may help identify patients at risk of serious complications, potentially reducing unnecessary emergency department and hospital resource utilization
