123 research outputs found
sj-docx-1-ehi-10.1177_11786302231195794 – Supplemental material for The Influence of Socio-Economic and Psychological Factors on the Composition of Household Solid Waste in Farahzad Neighborhood, Tehran, Iran
No full textSupplemental material, sj-docx-1-ehi-10.1177_11786302231195794 for The Influence of Socio-Economic and Psychological Factors on the Composition of Household Solid Waste in Farahzad Neighborhood, Tehran, Iran by Shaghayegh Gharagozloo and Mahdi Jalili Ghazizade in Environmental Health Insights</p
Erratum to ‘Effects of rumen undegradable protein source on feed intake and milk yield of Holstein dairy cows’
No full textThe article ‘Effects of rumen undegradable protein source on feed intake and milk yield of Holstein dairy cows’ (SAJAS volume 53, issue 5, DOI: 10.4314/sajas.v53i5.15) was initially published with an incorrect author list.
The correct author list is as follows:M. Savari, M.S.S. Firouzabadi, F. Mohammadi, R. Abigaba, A.R. Rayshan, A. Gharagozloo, F. Abdollahzadeh, & E. Ghasem
Robotic Laparoscopic Transhiatal Anatomic Repair of Hiatal Hernias
No full textAlthough laparoscopic Nissen fundoplication is the most common procedure for hiatal hernia (HH) repair, HH recurrence because of the breakdown of the hiatoplasty and intrathoracic migration of the wrap has been reported as a common mechanism of failure after primary repair. Left transthoracic anatomic and physiologic repair (AFR) of HH is associated with lower incidence of leak and reoperation, but has greater morbidity (1–5). Adopting the transthoracic approach to a robotic laparoscopic platform may represent the ideal approach to the repair of HH (6–8).
The accompanying video details a retrospective review performed on patients who had robotic AFR (RAFR) of large HH. All patients received the previously validated gastroesophageal reflux disease-health-related quality of life (GERD-HRQL) questionnaire preoperatively and postoperatively. Objectively, symptoms were graded using the Visick scale Recurrence was defined as greater than 2 cm or 10% of the stomach above the diaphragm detected by either CT, esophagogram, or endoscopy. The preoperative data was then compared to the results at two years.
The results showed that of the 396 patients who underwent RAPR, the median GERD-HRQL score was 42 (range 38–45) preoperatively and 6 (range 0–14) at two years (p
The conclusion was made that RAFR of HH is associated with excellent symptom relief and low recurrence rate. RAFR should be considered when deciding which operation to perform in patients with large paraesophageal hiatal hernias.
References
1. Luketich, J.D., Nason, K.S., Christie, N.A., Pennathur, A., Jobe, B.A., Landreneau, R.J., et al . (2010) Outcomes after a Decade of Laparoscopic Giant Paraesophageal Hernia Repair. The Journal of Thoracic and Cardiovascular Surgery , 139, 395-404. https://doi.org/10.1016/j.jtcvs.2009.10.005
2. Rathore, M.A. andrabi, S.I.H., Bhatti, M.I., Najfi, S.M.H. and McMurray, A. (2011) Metaanalysis of Recurrence after Laparoscopic Repair of Paraesophageal Hernia. JSLS, 11, 456-460.
3. Laan, D.V., Agzarian, J., Harmsen, W.S., Shen, K.R., Blackmon, S.H., Nichols, F.C., Cassivi, S.D., Wigle, D.A. and Allen, M.S. (2018) A Comparison between Belsey Mark IV and Laparoscopic Nissen Fundoplication in Patients with Large Paraesophageal Hernia. The Journal of Thoracic and Cardiovascular Surgery, 156, 418-428. https://doi.org/10.1016/j.jtcvs.2017.11.092
4. Carrott, P.W., Hong, J., Kuppusamy, M., Koehler, R.P. and Low, D.E. (2012) Clinical Ramifications of Giant Paraesophageal Hernias Are Underappreciated Making the Case for Routine Surgical Repair. The Annals of Thoracic Surgery, 94, 421. https://doi.org/10.1016/j.athoracsur.2012.04.058
5. Morrow, E.H., Chen, J., Patel, R., Bellows, B., Nirula, R., Glasgow, R. and Nelson, R.E. (2018) Watchful Waiting versus Elective Repair for Asymptomatic and Minimally Symptomatic Paraesophageal Hernias: A Cost-Effectiveness Analysis. The American Journal of Surgery, 216, 760-763. https://doi.org/10.1016/j.amjsurg.2018.07.037
6. Gharagozloo, F., Meyer, M. and Poston, R. (2022) Cardiovascular Complications of Large Hiatal Hernias: Expanding the Indications for Robotic Surgical Anatomic and Physiologic Repair: A Review. World Journal of Cardiovascular Surgery, 12, 39-69. https://doi.org/10.4236/wjcs.2022.123005
7. Gharagozloo, F., Meyer, M. (2022) Robotic Laparoscopic Transdiaphragmatic Repair of Large Hiatal Hernias. World Journal of Cardiovascular Surgery, 12, 85-104. https://doi.org/10.4236/wjcs.2022.124007
8. Gharagozloo F. et.al. Robotic Repair of Giant Hiatal Hernias. Chapter in Gharagozloo F, Patel V, Giulianotti P, Poston R, Gruessner R, Meyers M: (eds.) Robotic Surgery. Second Edition, Springer, 2021.</p
Robotic Selective Dorsal Sympathectomy for Hyperhidrosis
No full textPresently, hyperhidrosis is the most important established indication for thoracic sympathectomy. Historically, surgical sympathectomy for hyperhidrosis has been associated with three areas of controversy: the surgical approach; the technique of sympathectomy; and the extent of sympathectomy. Many surgical approaches have been described: the posterior thoracic approach; cervical supraclavicular approach; transthoracic approach; transaxillary approach; thoracoscopic approach; and robotic thoracoscopic approach. The most common approach to sympathectomy has been ganglionectomy. However, ganglionectomy has been associated with high rates of compensatory hyperhidrosis (1–3). Selective dorsal sympathectomy represents a more directed approach to sympathetic denervation of the upper extremity (2).
In this procedure, the sympathetic trunk and ganglia are left intact and only the preganglionic and postganglionic nerves as well as the communicating rami for intercostal nerves two, three, and four are divided. One study reported a success rate of up to percent and a compensatory hyperhidrosis rate of 2.5 percent after performing selective sympathectomy (4,5). Recently, another study reported a series of patients who underwent robotic simultaneous bilateral selective dorsal sympathectomy using a surgical robot (6,7). In addition, another study has shown a 98 percent relief of hyperhidrosis and only a 2 percent rate of compensatory hyperhidrosis following robotic staged bilateral selective dorsal sympathectomy (8). This video illustrates the technique of robotic selective dorsal thoracic sympathectomy.
References
1. Cerfolio RJ, De Campos JR, Bryant AS, Connery CP, Miller DL, et al. The Society of Thoracic Surgeons expert consensus for the surgical treatment of hyperhidrosis. Ann Thorac Surg 2011;91:1642-8.
2. Baumgartner FJ, Toh Y. Severe hyperhydrosis: clinical features and current thoracoscopic surgical management. Ann Thorac Surg 2003;76:1878-83.
3. Schmidt J, Bechara FG, Altmeyer P, Zirngibl H. Endoscopic thoracic sympathectomy for severe hyperhydrosis: impact of restrictive denervation on compensatory hyperhydrosis. Ann Thorac Surg 2006;81:1048-55.
4. Friedel G, Linder A, Toomes H. Sympathectomy and agronomy. In: Mannke K, Rosin RD, editors. Minimal access thoracic surgery. London: Chapman Hall; 1998. pp. 67-83.
5. Friedel G, Linder A, Toomes H. Selective video-assisted thoracoscopic sympathectomy. Thorac Cardiovasc Surg 1993;41:245-8.
6. Coveliers H, Meyer M, Gharagozloo F, Wisselink W, Rauwerda J, et al. Robotic Selective Postganglionic Thoracic Sympathectomy for the treatment of hyperhidrosis. Ann Thorac Surg 2013;95:269-74.
7. Coveliers H, Meyer M, Gharagozloo F, Wisselink W. Selective Sympathectomy for hyperhidrosis: technique of robotic transthoracic selective postganglionic sympathectomy. Eur J Cardiovasc Surg 2013;43:428-30.
8. Gharagozloo F. Robotic Selective Thoracic sympathectomy for hyperhidrosis. Mini-invasive Surg 2020, 4:14-29</p
Institutional economics in robotic colorectal surgery
No full textIn this chapter, the different steps of setting up a robotic colorectal surgical program are analysed from both financial and clinical standpoints.
Robotic surgery represents a further step forward in the evolution of minimally invasive surgery and is one of the major advances and innovations in the surgical field of the last decades. Nevertheless, higher costs and a still lacking evident clinical proof of superiority, when compared to conventional laparoscopic surgery, have limited its widespread acceptance.
It is of paramount importance to define an institutional business plan when starting a robotic surgery program and many factors should be taken into account in order to reduce institutional financial burden and optimize clinical outcomes. Surgical volume and multidisciplinary use are fundamental to reduce per-case share of capital investment and avoid underutilization of the platform. An adequate structured training program is fundamental to ensure optimization of clinical outcomes since the beginning of surgical activity.
Moreover, evaluation of the overall institutional financial burden should consider the potential for cost savings related to robotic surgery, such as reduction in complications and length of stay. A traditional direct costs’ assessment should shift toward a “total-episode” costs’ evaluation
The use of the robot for abdominal oncologic procedures
No full textThe need for improved patient outcomes has been a driving force for novel innovations in the field of abdominal surgical oncology. Specifically, minimally invasive techniques in that field have shown evolving role in defining standards of care, to overcome the limitations of conventional laparoscopic approach as well as to improve the patient outcomes from an oncological as well as quality-of-life points of view. Robotic surgery has developed during the last decades as a more technologically advanced minimally invasive approach, and it is increasingly being adopted for increasingly complex oncologic operations. Robotically assisted technology offers potential advantages that include improved magnified three-dimensional vision, wristed instruments improving surgeon ambidexterity, and tremor filtration facilitating surgical precision. These technological advantages may allow the abdominal oncology surgeon to perform increasingly radical oncologic operations in complex patients. Published outcomes from robotic gastrointestinal surgery highlighted safety, feasibility, and preserved oncologic outcomes. On the other side of the matter, however, robotic approach is affected by some limitations, such as high costs, absence of tactile feedback, and the need for dedicated training. In this chapter, the role of robotic surgery in the management of digestive system cancers is described, with an emphasis on comparison with laparotomy and conventional laparoscopy
An Overview of Concept Hyponymy in Persian: From Cognitive Perspective
No full textIn this paper the author is concerned with the role of cognitive and mental abilities of humans in the formation of hyponymy sense relation at the level of words of Persian language, additionally the importance of the role of developed image schemas in accordance with hyponymy, and also the function of some cognitive and analytical factors in the formation of these image schemas such as construal, consists of perspective (focus point and reference point), profile and scanning are so important to the author. The starting point is the study of the way of the formation of developed image schemas related to hyponymy sense relation. The author's fundamental claim is that the mentioned cognitive and analytical factors have a significant role in the formation of three developed image schemas related to hyponymy, and the mentioned schemas are given different names and they are shown through various figures as well. Next the theory of layered schemas (LST) is provided by analyzing some Persian simple structures including hyponymy. Moreover, we move towards a cognitive inter-lexical semantics in this paper by applying the proposed theory of the author (LST) on Persian linguistic data. For this purpose one example of Persian including hyponymy is analyzed on the basis of (LST). As the last step, the different stages of the formation of hyponymy sense relation between the words of Persian are shown through some cognitive figures to add a kind of consistency and support to the author's proposed program in this paper.Keywords: hyponymy; developed image schemas; cognitive inter-lexical semantics; layered schemas theoryDOI: 10.3329/dujl.v2i4.6897Dhaka University Journal of Linguistics Vol.2(4) August 2009 pp.1-18</jats:p
Technique of robotic lobectomy III: control of major vascular injury, the 5 “P”’s
No full textRobotic Lobectomy has been evolving over the past decade and has been shown to be an oncologically efficacious procedure. Although robotic lobectomy is performed more frequently in centers around the world, it accounts for a small percentage of all lobectomies. One of the major causes of reluctance to adopt robotic lobectomy and segmentectomy procedures by surgeons is the fear of bleeding complications, as well as the lack of a standardized reproducible approach to these potentially catastrophic events. This paper outlines a proven strategy for control of bleeding complications during robotic lobectomy and segmentectomy procedures: the 5 “P”’s of Prevention, Preparedness, Poise, Pressure, and Proximal Control
Development of parameters of GMAW-P for the wire and arc additive manufacturing (WAAM) of aluminum alloys
No full textWire and arc additive manufacturing (WAAM) process is a group of additive manufacturing (AM) techniques that use an electric arc as a heat source and a metal wire as a feedstock for the fabrication of 3D metallic components in a layer-based manufacturing process. The production of aluminum alloys components through the WAAM process is more challenging than other alloys due to the higher gas pore number and coarse dendritic structure during the WAAM process. In this study, a system consisting of a synergic pulsed GMAW source and a robotic arm was employed to conduct the GMAW-based WAAM process. The studied alloy is an Al-Si alloy originating from the ER4143 filler metal deposition for the manufacture of layered walls as component samples made by WAAM. The welding parameters were studied by using Design of Experiments (DOE), and then to build the specimens, the DOE results were used to adjust the welding parameters. The samples were investigated by metallography, microhardness, and tensile strength tests. Finally, the influence of welding parameters and the heat input on the metallurgical and mechanical properties of the aluminum walls were discussed
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