Surgery Commons^™

Popliteal Artery Entrapment Syndrome Treated By A Posterior Approach In A 15-Year-Old Athlete, Lili Sadri, Robert L Myers, Casey Paterson, Quyngdiem Lam, Danielle M Pineda

Department of Surgery Faculty Papers

Popliteal artery entrapment syndrome is a rare source of claudication in young people. We present the case of a 15-year-old male athlete who presented with intermittent numbness of his right foot with exertion. Imaging revealed classic compression from a right type III popliteal artery entrapment. The left popliteal artery was chronically occluded with a large collateral vessel. He underwent release of the accessory bands of the gastrocnemius muscle with significant arteriolysis on the right side via a posterior approach. Chronic popliteal artery entrapment can be treated from a posterior approach, resulting in arterial occlusion and will be asymptomatic if well ...

Podium Presentation: Opioid Use Among Total Knee Arthroplasty Patients, Kelsie Welle, Karen Colorafi, Kenn Daratha

Providence Nurse Research Conference (2022 - present)

No abstract provided.

Identifying Skin Integrity Issues In The Post Anesthesia Care Unit: A Qualitative Improvement Project, Lori Patten

Providence Nurse Research Conference (2022 - present)

No abstract provided.

Will Apfel Score Awareness Among Caregivers Improve Postoperative Nausea And Vomiting (Ponv) Incidence And Management In Day Surgery?, Leni Alejo, Cherry De Guia, Cassandra Luck-Bird, Cynthia Rodriguez, Lilibeth Paloso, Gillian Ramirez, Deborah Graham

Providence Nurse Research Conference (2022 - present)

Background: Evidence supports Apfel Simplified Risk Score (SRS) as being effective in predicting postoperative nausea and vomiting (PONV) in patients following general anesthesia. Raising awareness of a person’s risk for PONV allows for prescription of antiemetics based on the Apfel SRS. Clinical Practice Guidelines (CPGs) for the management of PONV highlight first identifying patients’ risk to better manage anesthesia side effects. A team of nurses working in a tertiary hospital in Texas led a project using the Apfel SRS to improve PONV management.

Purpose: To raise awareness of patients' PONV risk perioperatively to improve patient outcomes of PONV events ...

Risk Of Upper Extremity Musculoskeletal Injury In Laparoscopy Training, Theddeus Oh Prasetyono, Christopher R. Andrian, Elisabet La Kinanthi

The New Ropanasuri Journal of Surgery

Introduction. The laparoscopy procedure still has an ergonomic burden that can increase the risk of musculoskeletal injury, especially in the upper extremity. Furthermore, the risk is compounded in laparoscopic training as the trainees have to repeat the same movements many times to achieve competencies. This study revealed the relation between the position and the risk of musculoskeletal injury in laparoscopy training.

Methods. A cross-sectional study on nine subjects was conducted during laparoscopy training. By fixing the table height at 77 cm, we measured the operator height and upper extremity positions to relate them to their VAS and DASH scores.

Results ...

Graduated Compression Stockings For Deep Vein Thrombosis Prevention In Surgical Patients: A Systematic Review, Dedy Pratama, Satria M.H Simatupang

The New Ropanasuri Journal of Surgery

Introduction. Oral anticoagulant therapy is commonly used to prevent deep vein thrombosis (DVT). However, it might increase the risk of intraoperative and postoperative bleeding. Graduated compression stockings (GCS) reduced DVT risk, but there is a lack of supporting evidence. Thus, the study aimed to find the efficacy of GCS compared to the pharmacological method in high-risk surgical patients.

Method. Literature search proceeded in Cochrane, ClinicalKey, and PubMed. Using keywords graduated compression stockings" or "mechanic" or mechanical") and ("pharmacologic" or "oral anticoagulants" or "NOAC") and "comparison" and "prophylaxis" and ("DVT" or "deep vein thrombosis) and ("surgery" or "surgical").

Results. There were ...

Inferior Vena Cava Filter In Managing Venous Thromboembolism Associated With Malignancy: A Systematic Review, Patrianef Darwis, Satria M.H Simatupang

The New Ropanasuri Journal of Surgery

Introduction. The risk of venous thromboembolism (VTE) associated with malignancy is 4.1-fold greater than patients without malignancy. Malignancypatientst has a greater risk of bleeding with the commonly used anticoagulant therapy. Inferior Vena Cava Filter (Ihas have been recommended as a controversial alternative. This study aims to find the most robust evidence of the safety, advantage, and clinical outcome of the IVCF for managing VTE associated with malignancy.

Method. Thus, we ran a systematic review found on Cochrane, PubMed, ScienceDirect, and ClinicalKey.

Results. There were ten articles reviewed (1,191 participants). Safety and efficacy, advantage, and complications were discussed regarding ...

Revascularization Techniques For Infra-Popliteal Peripheral Artery Disease In Diabetic Foot: A Literature Review, Raden Suhartono, Ghany H. Wijaya

The New Ropanasuri Journal of Surgery

Foot ulcers are one of the problems that are often encountered in uncontrolled diabetes mellitus. With diabetic peripheral neuropathy, the typical clinical symptoms of PAD (peripheral arterial disease) may be obscured, leading to critical limb ischemia (CLTI). Diabetes may accelerate atherosclerosis that diminishes blood flow in PAD—further, diabetic patients with PAD often enfaces infra-popliteal lesions and require revascularization. However, studies on revascularization techniques in infra-popliteal PAD remain minimal. We reviewed the literature on EBSCO, and PubMed focused on the revascularization techniques in PAD, namely: expanded polytetrafluoroethylene (ePTFE), saphenous vein graft (SVG), atherectomy, surgical revascularization first, revascularization with endovascular bypass ...

Review: Conventional Thrombectomy With Intraoperative Fluoroscopy In Acute Limb Ischemia Rutherford Iib, Heru Angkoso, Dedy Pratama

The New Ropanasuri Journal of Surgery

Introduction. Acute limb ischemia (ALI) is a severe condition affecting the extremities and the patient’s survival that requires immediate treatment. It can be treated with either surgical or endovascular revascularization or both (hybrid procedure). It is crucial to evaluate the defect using intraoperative fluoroscopy or angiography in each case. The review aimed to find out the outcomes of the thrombectomy with intraoperative fluoroscopy for ALI Rutherford IIb.

Method. According to the PRISMA protocol, the literature search proceeded in online databases, i.e., Cochrane, Scopus, PubMed, and EBSCOhost, with no year limitation on the publication. All articles were screened and ...

An Unusual Case Of Perforated Appendicitis In Situs Inversus Totalis In Indonesia, Valencia J. Martin, Imanuel T. Parinding

The New Ropanasuri Journal of Surgery

Situs inversus is a rare congenital anomaly where the internal organs are transposed in a mirror image. It is commonly unrecognized until a patient comes with a complaint, especially in developing countries where people do not have a routine medical checkup. We report a case of a young female with unusual left lower quadrant pain abdominal pain. Perforated appendicitis leading to peritonitis was confirmed using ultrasonography and successfully treated with laparotomy. Appendicitis should be considered a working diagnosis in lower left quadrant abdominal pain

Review: Management Of Complex Anal Fistula, Agi S. Putranto, Winda J. Layardi

The New Ropanasuri Journal of Surgery

Introduction. Complex anal fistula has a high postoperative recurrence rate and incontinence as well. There have been many emerging surgical techniques, but there are no new recommendations for managing complex anal fistula. One of the critical parameters in evaluating surgical technique outcomes is the recurrence rate and incontinence. This study describes postoperative results in recurrence rates and incontinence in various surgical techniques in managing complex anal fistula.

Method. This review commenced with literature searches on online databases, including Cochrane Library, MEDLINE (PubMed), ScienceDirect, and CINAHL (EBSCOhost).

Results. The study enrolled two RCTs, four systematic reviews, 14 retrospective and prospective studies ...

Review: Partial Splenic Embolization Outcome On Liver Cirrhosis With Esophageal Varices, Raden Suhartono, Muhammad F. A Irsal

The New Ropanasuri Journal of Surgery

Introduction. Liver cirrhosis may be followed by complications such as esophageal varices for 30 days mortality rate up to 15-20%. Partial splenic embolism (PSE) or partial splenic embolization has been developed as a safe and effective alternative therapy for managing bleeding in esophageal varices. This study aims to determine the outcome of PSE in patients with liver cirrhosis with esophageal varices.

Method. In this review, the literature search proceeded on three online databases (Cochrane Library, MEDLINE (PubMed), and ScienceDirect) according to PRISMA protocol. Through selections, six articles were included, and all were the reports.

Results. Of six reports, three were ...

Effect Of Ischemia-Reperfusion Injury And Preconditioning On Lung Parenchyma After Acute Limb Ischemia, David Hutagaol, Dhama S. Susanti, Wuryantoro Soeharto, Muhammad A. Putra, Suprayitno Wardoyo, William Makdinata, Moira Setiawan

The New Ropanasuri Journal of Surgery

Introduction. Acute limb ischemia, a sudden decrease of perfusion to the extremities, can compromise the survival of the limbs. Medical intervention and surgery are often needed to return perfusion. However, reperfusion injury can trigger oxidative stress and inflammatory response, leading to local and remote tissue damage, such as the lungs, which increases morbidity and mortality. This research aims to study the effects of hypothermia and remote ischemic preconditioning (RIPC) on the lung parenchyma after being exposed to reperfusion after acute limb ischemia in rabbits.

Method. Eighteen New Zealand White rabbits were divided into three groups of 6. The femoral artery ...

Mini-Review: Omental Patch Repair Of Giant Perforated Peptic Ulcer, Ridho A. Syaiful, Muhammad F. Agustian

The New Ropanasuri Journal of Surgery

Introduction. A perforated giant peptic ulcer is an emergency that requires surgery. Closure of the perforation with an omental patch has been reported in several cases of perforated giant peptic ulcers. However, there is insufficient evidence regarding the option of preferred treatment. This review to discuss published reports of a perforated giant peptic ulcer closed with an omental patch that focused on the complications

Method. The literature search was conducted through the Cochrane, PubMed, Scopus, and EBSCO data sites. The articles obtained were screened for duplication, title, abstracts, and full-text based on inclusion and exclusion criteria.

Result: Two articles were ...

Serum Cea Level In Predicting Liver Metastases Of Colorectal Cancer Among Young Adult Patients, Ely S.P Sihotang, Agi S. Putranto

The New Ropanasuri Journal of Surgery

Introduction: Incidence and mortality of CRC are currently increasing in those under 50 years. The study aims to determine the predictive value of serum CEA levels as the liver metastases predictor of colorectal cancer (CRC) in young adults.

Methods: A cross-sectional study was conducted using secondary data (patient medical records) from 2015–to 2021. Patients aged <50 years who were diagnosed histopathologically with primary colorectal cancer at dr. Cipto Mangunkusumo General Hospital (CMGH) were recruited. We excluded patients with a history of other malignancies, who had undergone operative management for colorectal cancer, and preexisting liver disease. The outcome of this study is the cut-off of the CEA value obtained by the ROC curve and the sensitivity and specificity of the CEA value in predicting CR liver metastases.

Results: Out of 181 subjects enrolled, a total of 43.6% were female. Fifty-nine subjects (32.6%) had liver metastases. The CEA level of the metastases group was 208.1 (2.1–12503.2) ng/mL; this was much higher than the non-metastases group ...

Fondaparinux As An Alternative Anticoagulant Treatment In Patients With Left Ventricular Assist Devices And Recurrent Gastrointestinal Bleeding: Case Series, Daniela Piani, Andrea Lechiancole, Massimo Maiani, Igor Vendramin, Sandro Sponga, Elisabetta Auci, Ugolino Livi

The VAD Journal

Gastrointestinal bleeding (GIB) can occur in patients after left ventricular assist device (LVAD) implantation. In cases of recurrent GIB, the management of anticoagulation treatment represents a challenging situation in which the risk of bleeding recurrence and the need for long-term anticoagulation must be balanced. This case series describes the successful management of anticoagulation in three patients with recurrent GIB using fondaparinux.

To our knowledge, these are the first reported cases of recurrent GIB in which a single dose of subcutaneous fondaparinux was used instead of oral anticoagulation. None of the patients presented with signs of pump thrombosis or arterial embolism ...

Initial Single Surgeon Evaluation Comparing A Prospective, Multicenter Initial Evaluation Of The C-Arm Fluoroscopy With The Cirq Robotic Assistance Device For Instrumentation Of The Thoracolumbar Spine, Jennifer Adams, Sohum Desai

MEDI 9331 Scholarly Activities Clinical Years

Objective: To compare our experience with pedicle screw insertion of the thoracolumbar spine utilizing the Cirq robot assistance device compared with traditional paradigm using fluoroscopy.

Methods: We prospectively collected data of patients undergoing pedicle screw instrumentation in the thoracolumbar spine performed by a single surgeon at three different centers. One center took delivery of the Cirq robotic assistance device. Remaining two centers used C-arm fluoroscopy. Demographic information, diagnosis, total OR time, intraoperative complications, unexpected return to the operating room, and hospital readmissions within ninety days was compared between the two cohorts.

Results: A total of 66 screws were placed during ...

Predictive Factors For Length Of Hospital Stay In Pediatric Dog Bite Patients, Dominic Alessio-Bilowus, Nishant Kumar, Elika Ridelman Ph.D, Christina Shanti Md

Medical Student Research Symposium

Title: Predictive Factors for Length of Hospital Stay in Pediatric Dog Bite Patients

Authors: Alessio-Bilowus D¹, Kumar N², Ridelman E¹, Shanti C^2
1Wayne State University, Detroit, MI; ²Children’s Hospital of Michigan, Detroit, MI

Introduction: Dog bite injuries are a source of significant morbidity in the United States, with children being at increased risk compared to adults, yet there is a lack of published data on factors affecting hospital length of stay (LOS) in pediatric patients.

Methods: A full-text retrospective chart review was conducted of all patients presenting to our urban, academic pediatric surgery ...

False-Positive Serum Igm/Igg To Sars-Cov-2 In A Rare Pulmonary Neuroendocrine Carcinoma With Ocular Metastasis: A Case Report, Irandi P. Pratomo, Gatut Priyonugroho, Aris Ramdhani, Dian Zamroni, Thariqah Salamah, Yayi D.B Susanto, Ramdinal A. Zairinal, Annisa N. Witjaksono, Dita Aditianingsih, Jamal Zaini

The New Ropanasuri Journal of Surgery

The Coronavirus disease 2019 (COVID-19) pandemic impacts pulmonary cancer management since it shares similar clinical features and creates fear among patients to visit hospitals due to possible in-hospital disease transmission. We report a patient who presented with a rare case of a pulmonary neuroendocrine tumor with an ocular involvement, which, unfortunately, experienced a delay in diagnostics. The first hospitalization was due to superior vena cava syndrome, pleural and pericardial effusions, and swollen left eye. The patient was diagnosed with pulmonary cancer, released after the symptoms were relieved, and expected to visit a referral hospital for further diagnostics and treatments. The ...

Gibbon Surgical Review, Volume 5, Issue 1, 2022

Gibbon Surgical Review

In this Issue:

A History of ECMO and its Use During the COVID-19 Pandemic, 6

The First Pig-to-Human Heart Xenotransplantation, 8

Residency Interviewing in the Zoom Era, 9

An Interview with Dr. Andrew Newman, 10

Lung Transplantation for Patients with Severe COVID-19 Pulmonary Disease, 12

Risk Factors for Five-year Mortality after Carotid Endarterectomy, 14

An Interview with Dr. Scott Cowan,16

General Surgery 101: The J-Pouch, 18

The Business of Surgery: Recognizing Barriers to Gender Equity, 20