Surgery
Surgery May Be Considered for Extreme Face Pain
A new guideline developed by the American Academy of Neurology finds surgery may be considered for people who suffer from extreme, electric shock-like pain in their face and do not respond well to drugs. The guideline on treating trigeminal neuralgia is published in the August 20, 2008, online issue of Neurology®, the medical journal of the American Academy of Neurology.
“There are very few drugs with strong evidence of effectiveness in treating trigeminal neuralgia,” said guideline author Gary Gronseth, MD, with the University of Kansas in Kansas City and Fellow of the American Academy of Neurology. “If people fail to respond to these drugs, physicians should not be reluctant to consider referring the patient for surgery. Often surgery is considered a last resort and patients suffer while the well-intentioned physician tries other medications with limited effectiveness.”
Trigeminal neuralgia is a chronic pain condition that causes extreme, stabbing pain throughout the face. The pain normally doesn’t last more than a few seconds or a minute per episode, but the episodes can last for days, weeks, or months and then disappear for months or years. The intense pain can be triggered by shaving, applying makeup, brushing teeth, eating, drinking, talking, or being exposed to the wind. It is more common in women than in men.
Rhinoplasty technique preserves ethnic identity
African Americans who underwent a nose job, also referred to as rhinoplasty, reported a high degree of satisfaction with the results.
Rhinoplasty was conducted using a three-tiered approach that included an adjustment in nasal height and angle with a reshaping of the tip and a reduction in the width of the nose.
Dr. Oleh Slupchynskyj and Marzena Gieniusz analyzed questionnaires completed by 75 African American patients who underwent the procedure at their private practice, the Aesthetic Facial Surgery Center of New York and New Jersey in New York City.
Laparoscopic gastric bypass provides better results
Performing gastric bypass surgery to reduce the weight of morbidly obese patients using a laparoscopic method, rather than the conventional more invasive “open” abdominal method, reduces postoperative complications, the need for a second operation, and shortens hospital stays, new research shows. Nevertheless, laparoscopic gastric bypass is more expensive.
Obesity surgery, also called bariatric surgery, is growing in popularity and more and more of these operations are being done using a laparoscope, note co-authors Dr. Wendy E. Weller, from the University at Albany in New York, and Dr. Carl Rosati, from Albany Medical Center.
This is done by placing one or more small incisions in the abdomen, through which a hollow tube is inserted. This allows very small instruments to be inserted to perform the gastric bypass. The entire procedure is visualized on a screen. In contrast, the more invasive “open” procedure involves making an incision to open the abdomen so the procedure can be performed.
Pioneering heart surgeon DeBakey dies at age 99
Surgeon Michael DeBakey, whose ground-breaking heart transplants and coronary bypass operations made him one of the giants of 20th century medicine, has died at age 99.
The Baylor College of Medicine and Methodist Hospital said DeBakey died on Friday of natural causes. Methodist Hospital in Houston was his primary surgical hospital for many years.
In a career that spanned more than seven decades, DeBakey developed a number of new surgical procedures that now are standard in treating heart ailments and led many to consider him the father of modern cardiovascular surgery.
Neurologic Complications of Heart Surgery Detailed in Comprehensive Review Article
Possible neurologic complications of heart surgery, ranging from headaches to strokes, are detailed in a new report in the online journal MedLink Neurology.
The review article, which compiled results of previously published studies, was written by Dr. Betsy Love and Dr. Jose Biller of Loyola University Chicago’s Stritch School of Medicine and Dr. James Fleck of Indiana University School of Medicine.
In the most comprehensive and up-to-date review of its kind, researchers list possible nervous system complications of bypass surgeries, cardiac catheterizations, valve replacements, heart transplants and surgeries for congenital heart disease.
Minimally Invasive Weight-Loss Surgery Improves Health of Morbidly Obese Teens
Teenagers’ obesity-related medical complications improve just six months after laparoscopic gastric banding surgery, according to outcomes data presented this week. The preliminary results by physician-scientists from Morgan Stanley Children’s Hospital of NewYork-Presbyterian and Columbia University Medical Center were presented on June 17 at The Endocrine Society’s 90th Annual Meeting in San Francisco.
The study reports that the small group of extremely obese teenagers who received the minimally invasive surgery, also called the Lap-Band procedure, as part of a clinical trial lost an average of 20 pounds after six months and had significant improvements in abdominal fat, triglyceride measurements (levels of fat in the blood) and blood sugar levels as measured by hemoglobin A1c—all risk factors for diabetes and heart disease. The patients’ liver function and a measure of immune response also improved, according to the abstract.
“Extremely obese teenagers have obesity-related health problems, particularly diabetes and increased cardiovascular risk. Laparoscopic gastric banding, which has been shown to be a safe and effective way to lose weight, now offers the possibility of reducing obesity’s medical complications,” says lead author Dr. Ilene Fennoy, a pediatric endocrinologist at Morgan Stanley Children’s Hospital of NewYork-Presbyterian and clinical professor of pediatrics at the Columbia University College of Physicians and Surgeons.
Cosmetic surgery booming in Britain, study finds
Britons might be feeling the pinch of the global credit crunch, but they’re still ready to pay thousands of pounds for cosmetic surgery, a report suggested on Monday.
Britain’s largest cosmetic surgery provider the Harley Medical Group said demand for procedures had grown by 35 percent over the past 10 months.
Abdomnoplasty or “tummy tuck” operations, a procedure costing nearly 5,000 pounds ($9,700), were up 59 percent, while breast augmentation surgery swelled 40 percent, it said.
Heart surgery deaths often preventable
New research indicates that roughly one third of deaths that occur in the hospital after heart bypass surgery are preventable.
The findings also suggest that while overall death rates are convenient measures of hospital quality, they do not correlate with preventable deaths.
In light of these findings, Dr. Veena Guru, from the Institute for Clinical Evaluative Sciences in Toronto, and colleagues conclude that healthcare “providers should conduct detailed adverse event audits to drive meaningful improvements in quality.”
Acupuncture reduces pain after neck surgery
Acupuncture helped alleviate lingering pain and decreased shoulder mobility in people who had surgery for head and neck cancer, U.S. researchers said on Saturday.
The ancient Chinese therapy also resulted in significant improvements in extreme dry mouth or xerostomia, which often occurs in people who have had radiation treatment for head and neck cancer, they said at a meeting of the American Society of Clinical Oncology in Chicago.
Researchers at Memorial Sloan-Kettering Cancer Center in New York studied 70 patients who were at least three months past their surgery and radiation treatments.
Study shows benefit of statins before heart surgery
People given cholesterol-fighting statin drugs before heart surgery are far less likely to die or suffer complications afterwards, German researchers said on Wednesday.
The analysis of more than 31,000 patients provides some of the strongest evidence yet of the benefits of statins before heart surgery but it also found that too few doctors are prescribing them, they said in the European Heart Journal.
“This is the first big summary of all the existing studies about people undergoing cardiac surgery,” said Oliver Liakopoulos, a researcher at the University of Cologne, who led the study.
Leg bypass surgery outcome poor in diabetics
Patients with diabetes fare worse than their non-diabetic counterparts after leg bypass surgery to restore restricted blood flow to the legs due to hardening of the leg arteries, Swedish researchers report.
They found that survival free of amputation after leg bypass surgery for severely reduced blood flow to the legs (i.e., critical limb ischemia) is lower in diabetics than non-diabetics, and death associated with this procedure is also higher among diabetics.
Dr. Jonas Malmstedt of Karolinska University Hospital, Stockholm and colleagues note that patients with critical limb ischemia usually require leg bypass surgery to prevent amputation. They also point out that there is a lack of population-based studies involving diabetics.
Medicare may broaden obesity surgery payment
The U.S. Medicare program may expand reimbursement for bariatric surgery for the obese, in light of a study that found the treatment can help reverse diabetes, the agency said on Monday.
Recent research found the surgery can completely reverse type 2 diabetes, a metabolic condition spurred by weight gain and suffered by millions of Americans.
Medicare, the government health plan for the nation’s 44 million elderly, “will assess the nature of the scientific evidence supporting surgery for the treatment of diabetes,” the agency said on its Web site.
China girl’s legs amputated to free her from rubble
Chinese doctors amputated a teenage girl’s crushed legs on Thursday, the only way they could pull her alive from the wreckage of her school three days after an earthquake flattened swathes of the country’s southwest.
Yang Liu was trapped in what appeared to be a doorway by Monday’s massive 7.9 magnitude quake, near the top of a massive pile of bricks and concrete.
Her position likely saved her life.
Psychologist develops post-operative care for heart patients in Bermuda
31 March 2008: A psychologist at the University of Liverpool is helping to create a potentially life-saving post-operative care service for heart patients in Bermuda.
The service, being developed in conjunction with the Bermuda Heart Foundation, will help support patients who have been fitted with an Implantable Cardioverter Defibrillator (ICD). ICDs are used to treat irregular heart beats, which can lead to heart attacks. If the heart rhythm increases in speed the ICD delivers low-voltage electrical impulses to the heart in an attempt to correct the rhythm.
Health care services in Bermuda are unable to offer the implants so patients are referred to Baltimore and other cities in the US where the ICD can be fitted. Patients returning to Bermuda after surgery have no post-operative care available to support them with any emotional or physical effects.
Men Seeking Vasectomy Reversals Can Expect High Rates of Success
This retrospective study compared postoperative semen analysis parameters and patency rates of vasovasostomy performed in the convoluted versus straight portion of the vas deferens. This study was undertaken to assess whether or not the perceived increased technical difficulty that may be encountered resulted in a change in success rates.
Patient age, partner age, obstructive interval, gross and microscopic appearance of the intraoperative fluid aspirated from the testicular portion of the vas deferens, and postoperative semen analysis results were examined. Patency was defined as any sperm in the postoperative ejaculate and was compared for the 2 groups.
There were no significant differences in the postoperative semen analysis parameters of volume, total count, sperm density, motility or total motile count between the 2 groups. The patency rate was 98.1% and 97.3% for convoluted vasovasostomy and straight vasovasostomy, respectively, and was not statistically different.
