all surgery stories

Video game technology may help surgeons operate on beating hearts

50443248 — Mon, 09 Jun 2008 14:20:48 -0400

Surgery has been done inside some adults’ hearts while the heart is still beating, avoiding the need to open the chest, stop the heart and put patients on cardiopulmonary bypass. But to perform intricate beating-heart operations in babies with congenital heart disease or do beating-heart complex repairs in adults, surgeons need fast, highly sophisticated real-time imaging that allows them to see depth.

Prayers don't help heart surgery patients

50443248 — Wed, 18 Jul 2007 13:10:41 -0400

Many - if not most - people believe that prayer will help you through a medical crisis such as heart bypass surgery. If a large group of people outside yourself, your family, and your friends add their prayers, that should be even more helpful, or so such reasoning goes.

CT significantly reduces the need for appendectomy

70652986 — Mon, 26 Mar 2007 06:20:19 -0400

For the study, the researchers analyzed 663 patients who were examined on CT for suspected appendicitis. An appendectomy was performed on 268 of the CT-screened patients. Of these 268 patients, only eight had a negative appendectomy.

Breathing easier after spinal cord injuries

50443248 — Tue, 24 Jul 2007 12:21:29 -0400

njuries to the upper spinal cord can take a victim's breath away.
Most people don't know that breathing difficulties are the leading cause of disease and death after such injuries. Indeed, respiratory failure causes more deaths than limb paralysis does, and survivors often become dependent on ventilation machines.

For the first time, Harvard researchers successfully tested an inexpensive, readily available class of drugs that has restored normalcy to rats who suffered the same loss of breath as humans who receive spinal cord injuries in combat, falls, car wrecks, or by gun or knife. These drugs include buspirone, a tranquilizer used to ease anxiety in the elderly and to help people quit smoking.

Ninety percent of U.S. wounded survive

70652986 — Mon, 26 Mar 2007 05:36:53 -0400

For an article in the Dec. 9, 2004 issue of the New England Journal of Medicine, Atul Gawande, an assistant professor at Harvard Medical School and a surgeon at Brigham and Women's Hospital in Boston, gathered data on casualties and talked with surgical teams that served near the front lines in Iraq. He concludes that the "military medical system has made fundamental - and apparently effective - changes in the strategies and systems of battle care, even since the Persian Gulf War." In that 1990-91 conflict, 24 percent of the wounded died, or more than twice the rate in Iraq and Afghanistan since 2001. The reduced death toll has occurred despite the limited number of medical personnel available. Gawande says that the shortage means that the Army keeps "no more than 30 to 50 general surgeons and 10 to 15 orthopedic surgeons in Iraq." This relatively small cadre attends a fighting force growing to 150,000 troops. The surgeons are deployed in small teams of 20 people called Forward Surgical Teams (FST). "Each FST is equipped to move directly behind troops and establish a functioning hospital with four ventilator-equipped beds and two operating tables within a difficult-to-fathom 60 minutes," Gawande explains.

Surgery done on a single cell

70652986 — Mon, 26 Mar 2007 05:33:20 -0400

A superprecise scalpel that can be used to operate on an individual cell is now a reality thanks to experimenters at Harvard University. "Ultrashort laser pulses [up to 1,000 a second] produce a spot as hot as the sun," notes Eric Mazur, Gordon McKay Professor of Applied Physics. "Normally, that kind of heat would vaporize a cell, but it only shines for a millionth of a billionth of a second. The light intensity is very high, but the energy generated in such a short time can be compared to a mosquito bumping into your arm. A cell can easily take that." A laser beam ordinarily travels right through a piece of glass or a transparent cell, but in this application it is focused into a very, very small space within a cell. "It's like lighting a hot spark inside the cell without disturbing the surface membrane, the fragile bag that holds the cell together," Mazur says. An exacting technique like this opens up a plethora of medical possibilities. The Harvard researchers vaporized a single mitochondrion, a minute biological motor that provides power to a cell to carry out its many functions. They cleaved a single nerve in a tiny roundworm, knocking out the creature's sense of smell.

Study identifies risk factors for retained objects after surgery

70652986 — Mon, 26 Mar 2007 05:28:27 -0400

A study found that errors involving leaving surgical sponges or instruments inside patients are more likely to happen during emergency procedures, or in operations where there is a sudden change in plan. Additionally the research revealed that the higher a patient's weight, the more statistically likely it is that an object will be inadvertently left behind. "Often when you hear about these kinds of cases, people assume it is due to negligence," said Atul Gawande of Brigham and Women's Hospital. "But we found that these errors usually occur despite teams following proper procedures. These errors tend to occur in unpredictable situations, such as emergency operations, that challenge standard protocols." Gawande and his colleagues analyzed malpractice claims filed with one particular insurance company between 1985 and 2001. In all, 54 cases were confirmed to involve retained objects. Sixty-nine percent of the cases involved sponges, and 31 percent involved instruments. These cases were then compared to data from patients undergoing the same operations who did not have this complication. In emergency operations, retained object errors are nine times more likely to happen, the study showed. The findings appeared in the January 16, 2003 edition of the New England Journal of Medicine.

Replacing joints early may be better than waiting for some osteoarthritis sufferers

70652986 — Mon, 26 Mar 2007 05:28:36 -0400

In a study, scientists from Brigham and Women's Hospital (BWH) and Toronto Western Hospital followed the progress of patients who opted to have joint replacement surgery. They found that those patients who had postponed having the surgery the longest -- and therefore were experiencing the most pain and loss of joint function -- also experienced the worst results two years after joint replacement surgery. "Many patients and doctors have traditionally regarded this kind of surgery as a last-resort sort of procedure," said the study's senior author, Jeffrey Katz of BWH. "But we found that patients could have a positive impact on their quality of life by being proactive about the real benefits associated with having this surgery before their conditions completely degenerate." In the study, 222 patients were divided into two groups: those with higher joint function and less pain, and those with more pain, and less joint function. Researchers noticed very little difference between how people felt after six months, compared to how they felt after two years. However, the patients who went into surgery feeling the worst, also felt worse than the healthier group two years after having their hips or knees replaced.

Research finds benefits for adults who have tonsils removed

70652986 — Mon, 26 Mar 2007 05:26:09 -0400

A study followed 83 chronic tonsillitis sufferers over a three-year period. Brigham and Women's Hospital researchers found that removing the tonsils was ultimately more effective than antibiotic treatments because those patients who had their tonsils extracted missed only 0.6 days of work a year on average after their tonsillectomy, versus 9.2 workdays before the surgery. "The myth persists that if you're an adult, you shouldn't have your tonsils removed," said Assistant Professor of Otology and Laryngology Neil Bhattacharyya of BWH. "But for people who get tonsillitis several times a year, the surgery makes sense, medically, financially, and from a quality-of-life perspective." Bhattacharyya's findings also included how long patients remained on antibiotics over the course of a year. Before tonsillectomy, patients spent an average of six and a half weeks a year taking antibiotics, whereas after tonsillectomy the same patients averaged less than a day per year on antibiotics. The study was published in the November 2002 issue of the Annals of Otology, Rhinology and Laryngology.

Robots move into operating room

70652986 — Mon, 26 Mar 2007 05:16:09 -0400

The U.S. Food and Drug Administration has approved robotic devices for use in minimally invasive gallbladder and gastroesophageal reflux disease surgery. But the high-tech helpers haven't made a surgeon's job that much easier -- or quicker. That's because they are not easy to maneuver. It's also hard for the surgeon to see more than a very small area at once. There are potentially great benefits from robotic surgery for a patient, however, including smaller incisions, and therefore, faster recovery times. So two Harvard researchers -- Robert D.

Surgery without scalpels

70652986 — Mon, 26 Mar 2007 05:07:11 -0400

Paul Simmons, a 29-year-old Maine farmer, suffered from a lung tumor. In February 2001, at Harvard-affiliated Brigham and Women's Hospital in Boston, a probe containing a long needle was inserted into his chest and guided to the tumor by a scanning device. As Eric vanSonnenberg and his colleagues did the procedure, they could watch on a screen as the needle approached the lemon-sized tumor in Simmons' right lung. When contact was made, a burst of radio waves produced enough heat to literally "cook" the malignancy. Simmons is impressed with the outcome. "I had an inoperable tumor; surgeons couldn't reach it with their instruments," he says. "In 20 minutes, it was gone. In three days, I was up and out of the hospital."