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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Do barbed sutures with different surface textures have different effects on adhesion formation and histological features? An experimental blinded study in an animal model(WROCLAW MEDICAL UNIV, 2019-01-01) Karacan, Tolga; Ozyurek, Eser; Turkgeldi, Lale Susan; Kiyak, Huseyin; Pesen, Simge; Yasti, Merve; Usta, TanerBackground. The obstetrics and gynecology literature has expanded in recent years to include clinical trials assessing the use of barbed sutures. The difficulty of intracorporeal suturing continues to be a barrier to a wider use of laparoscopy. Although the use of barbed sutures has been shown to ease the process of laparoscopic suturing considerably, concerns have been raised regarding a potentially increased risk of adhesions or inflammation as a result of their use. Objectives. The aim of this study was to determine whether differences in surface textures, resulting from the variations in the geometric configurations of barbs, lead to differences in intra-abdominal adhesion formation. Material and methods. A total of 27 non-pregnant female Wistar Hannover rats, weighing 200-250 g, with intact uteri were used as an adhesion formation model. The rats were randomly assigned to 3 groups: barbed suture group 1, barbed suture group 2 and control group ( no intracorporeal suture). A 2-centimeter vertical incision was performed on the anti-mesosalpingeal side of one of the uterine horns. The incision on the uterine horn was reapproximated with a running suture, entailing 3 needle punctures and left untied at one end. Six weeks after the operation, intra-abdominal adhesion formations were investigated both clinically and histopathologically. Results. Clinical adhesion scores and histopathological parameters in both the barbed suture groups were statistically significantly higher than in the control group (p < 0.05). There was no significant difference between the barbed suture groups regarding the adhesion scores. Conclusions. The 2 types of barbed sutures with different surface textures, used for myometrial closure, form a similar profile with respect to postoperative adhesion formation.Item Is there any difference between the distances created by towel clamp lifting and towel clamp plus manual lifting of the anterior abdominal wall for direct trocar entry in laparoscopic gynecologic surgery? A prospective interventional study(GALENOS YAYINCILIK, 2017-01-01) Usta, Taner A.; Karacan, Tolga; Kovalak, Evrim Ebru; Hanli, Ulviye; Naki, M. MuratObjective: Most surgeons prefer to perform anterior abdominal wall lifting during abdominal entry to avoid damage to intestines or main vessels. Anterior abdominal wall lifting is assumed to prevent vital organ injuries by creating an adequate distance prior to entry into the peritoneal cavity. In this study, we compared the distance created for trocar entry into the peritoneal cavity with towel clamp lifting and towel clamp plus manual elevation of the anterior abdominal wall. Material and Methods: Forty patients who underwent various laparoscopic procedures were enrolled. The study was performed in two steps: first the anterior abdominal wall was lifted using towel clamps (TC group), next the anterior abdominal wall was lifted via maximal manual elevation from the lower abdomen in addition to towel clamps (TCM group). The insertion distance of a plastic ruler into the abdomen was measured from the parietal peritoneum to the intra-abdominal structure in both groups. Results: There was a statistically significant difference between the two groups (TC group 3.9 +/- 1.5 cm vs. TCM group 4.5 +/- 1.5 cm, p<0.001). Correlation analysis of the relationship of distance with BMI in the study groups revealed a strong negative linear correlation {[}TC group vs. body mass index (BMI)