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  • 1
    Electronic Resource
    Electronic Resource
    Laparoskopische Antirefluxverfahren (1998)
    Springer
    Der Chirurg 69 (1998), S. 148-157 
    Details
    ISSN: 1433-0385
    Keywords: Key words: Gastroesophageal reflux disease ; Antireflux procedures ; Methods ; Techniques. ; Schlüsselwörter: Gastrooesophageale Refluxkrankheit ; Antirefluxoperation ; Methoden ; Techniken.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung. Endoskopische Antirefluxchirurgie ersetzt zunehmend die traditionellen Operationsverfahren in der Behandlung der therapierefraktären gastrooesophagealen Refluxkrankheit. Diese laparoskopischen Verfahren sind jedoch technisch sehr anspruchsvoll. Komplikationen können aber durch eine sorgfältige Auswahl der Patienten sowie durch die geeignete chirurgische Technik minimiert werden. In jüngster Zeit wurden zahlreiche Nachuntersuchungen mit guten Langzeitergebnissen und geringen Nebenwirkungen publiziert.
    Notes: Summary. Laparoscopic antireflux surgery is rapidly replacing traditional operations for the treatment of medically refractory gastroesophageal reflux disease. These procedures are technically demanding. Troublesome side effects can be minimized by carefully selecting patients and using a meticulous and appropriate technique. Extensive follow-up data are now emerging and indicate that these procedures can offer long-term control of symptoms with few permanent side effects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001040050389
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  • 2
    Electronic Resource
    Electronic Resource
    Observations of Atmospheric Turbulence with a Radio Telescope at 5 GHz (1970)
    [s.l.] : Nature Publishing Group
    Nature 225 (1970), S. 614-617 
    Details
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Variations of the radio refractive index of the atmosphere are important to radio astronomers and in satellite communications. This article describes the situation at 5 GHz, based on work with the one-mile telescope at ...
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1038/225614a0
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  • 3
    Electronic Resource
    Electronic Resource
    Mechanisms and avoidance of esophageal perforation by anesthesia personnel during laparoscopic foregut surgery (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 979-982 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Esophageal perforation — Anesthesia personnel — Laparoscopic foregut surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: This study retrospectively assesses the mechanisms of 13 esophageal or gastric injuries resulting from dilator or nasogastric tube placement during laparoscopic foregut surgery and is intended to assist in determining methods of prevention. Methods: Information regarding esophageal or gastric injury during laparoscopic foregut surgery was obtained from six experienced laparoscopic surgeons. The specific mechanisms of injury were determined by discussion with the operating surgeon and review of the operative reports. Results: Eleven cases of esophageal or gastric perforation occurred during bougie insertion and two perforations occurred secondary to nasogastric tube placement during Nissen fundoplication or Heller myotomy. Five perforations required conversion to open operation for repair including two delayed thoracotomies. The 13 injuries occurred during the performance of 1,620 laparoscopic foregut operations for an overall incidence of 0.8%. Conclusion: Foregut injury resulting from esophagogastric intubation during laparoscopic surgery is more common than expected. Risk factors include esophageal anatomy, intrinsic pathologic changes of the esophagus, and inexperience. Prevention must focus on close communication between the surgeon and anethesiologist and safe techniques of dilator insertion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900218
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  • 4
    Electronic Resource
    Electronic Resource
    A new form of access for endo-organ surgery (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 738-741 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Endo-organ — Percutaneous endoscopic gastrostomy — Gastric surgery — Intraluminal surgery — Operative port
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Intraluminal gastric surgery provides a new treatment option for various disease processes. This study assesses the safety of a new large-diameter percutaneous endoscopic gastrostomy (PEG) for intraluminal surgery. Methods: Investigators at six institutions were asked to complete a standard questionnaire to assess the difficulties associated with the assembly and introduction of the PEG, plus intraoperative and postoperative problems related to placement of the device. Results: In terms of assembly; 1.9% of respondents reported difficulty obtaining complete vacuum of the balloon tip, and 3.8% had difficulty fitting the graduated dilator to the balloon-tipped cannula. Difficulties associated with introduction of the PEG included disengagement of the dilator from the balloon-tipped cannula (0%), extraction of the dilator-port assembly (0%), difficult PEG pullout (1.9%), abdominal wall bleeding (0%), and difficult PEG dilator separation (7.5%). Intraoperatively, 7.5% of respondents reported inadequate skin bolster fitting, 1.9% had CO2 leakage into the peritoneal cavity, 0% had inadvertent PEG extraction, and 0% reported injury to the esophagus, colon, or small intestine. Postoperatively, there was a 9.4% rate of wound infection, a 1.9% rate of gastrocutaneous fistula, and a 1.9% rate of esophageal, colon, or small intestine injury. Conclusions: The large-diameter PEG is safe and effective for endo-organ surgery. Additional preventive measures for PEG site infection should be investigated.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649901089
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  • 5
    Electronic Resource
    Electronic Resource
    Persistent dysphagia after laparoscopic vagotomy (2000)
    Springer
    Surgical endoscopy and other interventional techniques 14 (2000), S. 330-335 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Dysphagia — Fundoplication — Laparoscopy — Peptic ulcer — Vagotomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Laparoscopic vagotomy represents a new and less invasive treatment for peptic ulcer disease, but the problem of postvagotomy dysphagia has not been solved. The aim of this study was to determine the etiologic factors related to long-term laparoscopic postvagotomy dysphagia. Methods: Two female and 11 male patients with a mean age of 48.5 years who underwent laparoscopic vagotomy were investigated retrospectively. Preoperative diagnosis included duodenal ulcer resistant to medical treatment, gastric hypersecretion, gastric outlet obstruction, cholelithiasis, and gastroesophageal reflux disease (GERD). Ten patients underwent laparoscopic highly selective vagotomy, and three patients had laparoscopic truncal vagotomy with gastrojejunostomy or pyloroplasty. Nine of these patients had a Nissen fundoplication in conjunction with the vagotomy. Results: The median long-term follow-up period was 47 months. Two patients complained of severe dysphagia, one of moderate dysphagia, and two of mild dysphagia. Neither type of vagotomy nor an additional fundoplication was correlated with the severity of postoperative long-term dysphagia. Severity of postoperative dysphagia was associated with severity of preoperative dysphagia (r= 0.752, p= 0.003) but not with heartburn (r= 0.358, p= 0.531) or regurgitation (r= 0.024, p= 0.938). The cause of preoperative dysphagia varied; however, all of these patients had GERD and consequent esophageal lesions. Conclusion: Preexisting dysphagia appears to play an integral role in persistent postoperative dysphagia. Care must be taken to construct a loose fundoplication in patients with dysphagia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004640020060
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  • 6
    Electronic Resource
    Electronic Resource
    Thoracoscopic esophageal myotomy — a surgical technique for achalasia diffuse esophageal spasm and “nutcracker esophagus” (1994)
    Springer
    Surgical endoscopy and other interventional techniques 8 (1994), S. 921-926 
    Details
    ISSN: 1432-2218
    Keywords: Achalasia ; Diffuse esophageal spasm ; Fundoplication ; Hiatal closure ; Myotomy ; Nutcracker esophagus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thoracoscopic myotomy has been performed for diffuse esophageal spasm “nutcracker esophagus” and achalasia. Technical considerations for thoracoscopic long myotomy such as trocar placement, length of myotomy, extent of myotomy distal to the gastroesophageal junction, hiatal closure, fundoplication and degree of esophageal mobilization are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00843474
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  • 7
    Electronic Resource
    Electronic Resource
    The use of ultrasound to differentiate rectus sheath hematoma from other acute abdominal disorders (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 1129-1134 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Rectus sheath hematoma — Acute abdomen — Ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Rectus sheath hematoma (RSH) is a rare entity that can mimic an acute abdomen. Therefore, we designed a study to analyze the etiology, frequency, diagnosis using ultrasound, and treatment of RSH. Methods: A total of 1,257 patients admitted for abdominal ultrasound for acute abdominal pain or unclear acute abdominal disorders were evaluated. Results: In 23 (1.8%) patients, an RSH was diagnosed; three of them were not diagnosed preoperatively by ultrasound. Of 13 men and 10 women (mean age, 57 ± 23 years), 13 developed RSH after local trauma, three after severe coughing, two after defecation, and five spontaneously. Fifteen had nonsurgical therapy, and eight underwent surgery. The use of anticoagulants was accompanied by a larger diameter of the RSH (p 〈 .012), and surgical therapy was more frequently required in these patients. In the surgically treated group, more intraabdominal free fluid could be detected by ultrasound (p 〈 .0005), patients required less analgesics (p 〈 .001), and the mean hospital stay was shorter (p 〈 .001). Conclusions: RSH is a rare condition that is usually associated with abdominal trauma and/or anticoagulation therapy. Ultrasound is a good screening technique. Nonsurgical therapy is appropriate but leads to a greater need for analgesics. Surgery should be restricted to cases with a large hematoma or free intraabdominal rupture.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649901188
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  • 8
    Electronic Resource
    Electronic Resource
    1995 SAGES Postgraduate Course. II (1995)
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 1306-1334 
    Details
    ISSN: 1432-2218
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00190167
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  • 9
    Electronic Resource
    Electronic Resource
    An intraluminal surgical approach to the management of gastric bezoars (1995)
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 831-834 
    Details
    ISSN: 1432-2218
    Keywords: Trichobezoar ; Gastrostomy ; Laparoscope instrument ; Foam-rubber stent
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Trichobezoars are difficult to remove endoscopically, often cause nausea and vomiting, and can result in small-bowel obstruction. A patient with a trichobezoar presented to our clinic with symptoms of partial small-bowel obstruction. Multiple attempts at flexible endoscopic removal were unsuccessful. Two large-diameter percutaneous gastrostomies with an inflatable balloon and distal foam-rubber stent to assure intragastric positioning were introduced under general anesthesia. Visualization was provided by a 0° panavision laparoscope placed through one of the gastrostomies. The bezoar was removed through the second gastrostomy using standard laparoscopic instruments. The patient made an uneventful recovery. This is the first reported case of percutaneous removal of a trichobezoar. We conclude large-diameter gastrostomies may serve as a port of access for numerous other intraluminal procedures.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00190094
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  • 10
    Electronic Resource
    Electronic Resource
    Gastric mucosal lesions induced by hemorrhagic shock in baboons (1988)
    Springer
    Digestive diseases and sciences 33 (1988), S. 857-864 
    Details
    ISSN: 1573-2568
    Keywords: free radicals ; gastric mucosa ; ischemia ; microscopy ; scanning electron microscopy ; glutathione
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In this study we sought to define the role of oxygen-derived free radicals during ischemia and reperfusion in the production of acute damage to the gastric mucosa of baboons. The protective effect of the xanthine oxidase inhibitor, allopurinol, the superoxide scavenger, superoxide dismutase (SOD), and a long-acting SOD-albumin was determined. Mucosal damage was evaluated using light and scanning electron microscopy. Evidence for oxidative insult to the gastric mucosa was sought by measuring tissue concentrations of reduced (GSH) and oxidized (GSSG) glutathione. Gastric mucosal blood flow was estimated using the microsphere technique. A similar pattern of tissue damage was found at the end of ischemia in all three groups. Thirty minutes after reperfusion, severe mucosal damage (grade 3) increased only in the untreated control. In the two treated groups, grade 3 damage remained unchanged during reperfusion and a decrease in the percentage of moderate damage (grade 2) was seen. Both GSH and GSSG tissue concentrations were lower in the untreated controls as compared to the scavenger-treated groups, making it questionable whether GSH/GSSG tissue levels adequately reflect oxidative stress. We conclude that in our ischemiareperfusion model the generation of oxygen-derived free radicals produces mucosal damage and prevents the restitution of moderate mucosal damage during reperfusion. In ischemia, factors other than free radicals seem to be responsible for mucosal damage. The protective effect of allopurinol and SOD was not mediated by changes in gastric mucosal blood flow.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01550976
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