Rubber Band Application Research Articles

Phallic rubber band application to prevent enuresis unusual cause of urethral stricture in a child: A case report

Phallic rubber band application to prevent enuresis unusual cause of urethral stricture in a child: A case report

Application of rubber band and clip traction for removal of a submucosal fecalith mimicking a submucosal tumor of the appendix under colonoscopy.

Application of rubber band and clip traction for removal of a submucosal fecalith mimicking a submucosal tumor of the appendix under colonoscopy.

Ambulatory management of Hemorrhoids by Rubber Band Ligation

Objective: To evaluate the efficacy of rubber band ligation for the management of internal haemorrhoids. Study design: A prospective randomized study. Place and duration of study: Department of Surgery Lahore General Hospital conducted from April 1999 to June 2002. Subject/Methods: One hundred and eighty patients with II & III degree Hemorrhoids were treated with rubber band application. Results: About 562 band applications in 255 sessions were made. Follow up ranged from 3 to 50 months with a median follow up of 19 months. The common post procedural complaints were anal discomfort (78 patients), proctalgia (24 patients) and soiling (12 patients). The overall success rate of RBL was 91.7%. Conclusion: Ambulatory RBL should be considered as a safe and effective treatment for 2nd and 3rd degree symptomatic haemorrhoids and is associated with low morbidity.

Probability of pregnancy after sterilization: a comparison of hysteroscopic versus laparoscopic sterilization

ObjectiveTo compare the expected probability of pregnancy after hysteroscopic versus laparoscopic sterilization based on available data using decision analysis. Study designWe developed an evidence-based Markov model to estimate the probability of pregnancy over 10 years after three different female sterilization procedures: hysteroscopic, laparoscopic silicone rubber band application and laparoscopic bipolar coagulation. Parameter estimates for procedure success, probability of completing follow-up testing and risk of pregnancy after different sterilization procedures were obtained from published sources. ResultsIn the base case analysis at all points in time after the sterilization procedure, the initial and cumulative risk of pregnancy after sterilization is higher in women opting for hysteroscopic than either laparoscopic band or bipolar sterilization. The expected pregnancy rates per 1000 women at 1 year are 57, 7 and 3 for hysteroscopic sterilization, laparoscopic silicone rubber band application and laparoscopic bipolar coagulation, respectively. At 10 years, the cumulative pregnancy rates per 1000 women are 96, 24 and 30, respectively. Sensitivity analyses suggest that the three procedures would have an equivalent pregnancy risk of approximately 80 per 1000 women at 10 years if the probability of successful laparoscopic (band or bipolar) sterilization drops below 90% and successful coil placement on first hysteroscopic attempt increases to 98% or if the probability of undergoing a hysterosalpingogram increases to 100%. ConclusionBased on available data, the expected population risk of pregnancy is higher after hysteroscopic than laparoscopic sterilization. Consistent with existing contraceptive classification, future characterization of hysteroscopic sterilization should distinguish “perfect” and “typical” use failure rates. ImplicationsPregnancy probability at 1 year and over 10 years is expected to be higher in women having hysteroscopic as compared to laparoscopic sterilization.

Effects of penehyclidine hydrochloride in small intestinal damage caused by limb ischemia-reperfusion

To investigate the protective effect of penehyclidine hydrochloride post-conditioning in the damage to the barrier function of the small intestinal mucosa caused by limb ischemia-reperfusion (LIR) injury. Male Wistar rats were randomly divided into three groups (36 rats each): the sham-operation group (group S), lower limb ischemia-reperfusion group (group LIR), and penehyclidine hydrochloride post-conditioning group (group PHC). Each group was divided into subgroups (n = 6 in each group) according to ischemic-reperfusion time, i.e. immediately 0 h (T₁), 1 h (T₂), 3 h (T₃), 6 h (T₄), 12 h (T₅), and 24 h (T₆). Bilateral hind-limb ischemia was induced by rubber band application proximal to the level of the greater trochanter for 3 h. In group PHC, 0.15 mg/kg of penehyclidine hydrochloride was injected into the tail vein immediately after 3 h of bilateral hind-limb ischemia. The designated rats were sacrificed at different time-points of reperfusion; diamine oxidase (DAO), superoxide dismutase (SOD) activity, myeloperoxidase (MPO) of small intestinal tissue, plasma endotoxin, DAO, tumor necrosis factor-α (TNF-α), and interleukin (IL)-10 in serum were detected in the rats. The pathological changes in the small intestine were observed under light microscope. The levels of MPO, endotoxin, serum DAO, and IL-10 at T₁-T₆, and TNF-α level at T₁-T₄ increased in groups LIR and PHC (P < 0.05) compared with those in group S, but tissue DAO and SOD activity at T₁-T₆ decreased (P < 0.05). In group PHC, the tissue DAO and SOD activity at T₂-T₆, and IL-10 at T₂-T₅ increased to higher levels than those in group LIR (P < 0.05); however, the levels of MPO, endotoxin, and DAO in the blood at T₂-T₆, and TNF-α at T₂ and T₄ decreased (P < 0.05). Penehyclidine hydrochloride post-conditioning may reduce the permeability of the small intestines after LIR. Its protection mechanisms may be related to inhibiting oxygen free radicals and inflammatory cytokines for organ damage.

Band Ligation of the Perforated Gall Bladder During Laparoscopic Cholecystectomy

Perforation of the gall bladder is a frequent complication during laparoscopic cholecystectomy. Grasping the perforated part of the gall bladder, clip application, or endoscopic loop application are possible solutions to prevent spillage. We propose laparoscopic rubber band application to close the perforated part of the gall bladder as an easy and safe method. We performed rubber band application after iatrogenic perforation of the gall bladder during laparoscopic cholecystectomy in 5 patients. Two-millimeter-wide multiple rubber rings, cut from a 14-Fr Foley catheter, are loaded on a grasper. When a perforation occurred during the dissection of the gall bladder, the hole is grasped with this instrument and 1 of the rings is placed on the gall bladder by the aid of a dissector. Thus, the grasper remained available for traction of the Hartmann's pouch during further dissection of the gall bladder. The rubber bands were placed successfully in all cases. Two perforations occurred in 1 case, and 2 bands were placed with ease. Bile leakage or gall stone spillage did not occur. Operation time was not prolonged. Rubber band ligation of perforation of the gall bladder is a simple, safe, inexpensive, and effective method to prevent spillage of the bile or gallstones in laparoscopic surgery.

Pravastatin attenuates tourniquet-induced skeletal muscle ischemia reperfusion injury

Background Revascularization of a limb following prolonged ischemia results in substantial skeletal muscle injury. Statins play a well-understood role in the treatment of hypercholesterolemia but are also known to have anti-inflammatory properties. The purpose of this study was to examine the effects of pravastatin pre-treatment in the setting of skeletal muscle ischemia reperfusion injury (IRI).Methods Adult male Sprague Dawley rats (n = 27) were randomized into 3 groups: control group, I/R group, IR group pre-treated with pravastatin. Bilateral hind-limb ischemia was induced by rubber band application proximal to the level of the greater trochanters for 2.5 h. Treatment groups received normal saline in equal volumes prior to tourniquet release. Following 12 h reperfusion, the tibialis anterior muscle was dissected and muscle function assessed electrophysiologically by electrical field stimulation. The animals were then killed and skeletal muscle harvested for evaluation.Results We found that pre-treatment with pravastatin reduces the tissue oxidative damage and edema associated with skeletal muscle reperfusion injury. Skeletal muscle injury, measured by edema, leucose-questration and electrical properties were significantly lower with pravastatin pre-treatment compared to the non-treated group.Interpretation We feel that pravastatin pre-treatment may be a potential therapeutic intervention for skeletal muscle ischemia reperfusion injury in the clinical setting. ▪

Activated protein C attenuates skeletal muscle ischaemia reperfusion injury.

Aims: Pharmacological modulation of skeletal muscle reperfusion injury after an ischaemic insult may improve limb salvage rates and prevent the associated systemic sequelae. Activated Protein C (APC) is an endogenous anti-coagulant with anti-inflammatory properties that has been extensively studied in the setting of sepsis. The purpose of our study was to evaluate the effects of APC on skeletal muscle ischaemia reperfusion injury. Methods: Adult male Sprague Dawley rats (n = 24) were randomised into three groups: control group, I/R group treated with normal saline and I/R group treated with APC. Bilateral hind-limb ischaemia was induced by rubber band application proximal to the level of the greater trochanters for two hours. Treatment groups received either normal saline or APC prior to tourniquet release. Following twelve hours reperfusion, the tibialis anterior was dissected and muscle function assessed electrophysiologically by electrical field stimulation. The animals were then sacrificed and skeletal muscle harvested for evaluation. Skeletal muscle injury was assessed based on myeloperoxidase content as a measure of neutrophil infiltration and wet to dry ratio as a measure of oedema formation. Histological analysis was also performed on the muscle. Results: APC significantly attenuated skeletal muscle reperfusion injury as shown by reduced myeloperoxidase content, wet to dry ratio and electrical properties of skeletal muscle (Table). TABLE—ABSTRACT 28Skel muscle wet:dry ratioSkel muscle MPO (U/g)Max twitch contraction (N/g)Tetanic contraction at 50 HZ (N/g)Control group3.17 ± 0.100.74 ± 0.032.45 ± 0.264.21 ± 0.26I/R saline3.40 ± 0.140.95 ± 0.131.52 ± 0.202.88 ± 0.53APC3.21 ± 0.110.82 ± 0.071.86 ± 0.183.52 ± 0.36P valueP < 0.03P < 0.02P < 0.01P < 0.01 These findings were supported by our histological findings. Statistical significance was determined using variance analysis. Conclusion: Activated Protein C may have a protective role in the setting of skeletal muscle ischaemia reperfusion injury.

Pregnancy after tubal sterilization with silicone rubber band and spring clip application

Objective: To determine risk factors for pregnancy after tubal sterilization with silicone rubber bands or spring clips. Methods: A total of 3329 women sterilized using silicone rubber bands and 1595 women sterilized using spring clips were followed for up to 14 years as part of a prospective cohort study conducted in medical centers in nine US cities. We assessed the risk of pregnancy by cumulative life-table probabilities and proportional hazards analysis. Results: The risk of pregnancy for women who had silicone rubber band application differed by location of band application and study site. The 10-year cumulative probabilities of pregnancy varied from a low of 0.0 per 1000 procedures at one study site to a high of 42.5 per 1000 procedures in the four combined sites in which fewer than 100 procedures per site were performed. The risk of pregnancy for women who had spring clip application varied by location of clip application, study site, race or ethnicity, tubal disease, and history of abdominal or pelvic surgery. The probabilities across study sites ranged from 7.1 per 1000 procedures at 10 years to 78.0 per 1000 procedures at 5 years (follow-up was limited to 5 years at that site). Conclusion: The 10-year cumulative probability of pregnancy after silicone rubber band and spring clip application is low but varies substantially by both clinical and demographic characteristics.

The Risk of Hysterectomy Quadruples After Women Undergo Sterilization

This article summarizes findings from a case-control study of the risk of hysterectomy among women who have undergone sterilization in the US. Data were obtained on 7174 women who underwent tubal sterilization during 1978-86 in participating medical centers in Baltimore Chapel Hill Honolulu Houston Memphis Sacramento St. Louis and San Francisco. The comparison group included 544 women whose husbands had a vasectomy during 1985-87. Data was collected at the time of the procedures and annually for the first 5 years after the procedure. Sterilized women were more likely to be younger than 35 years less likely to be married and to be White. Nonsterilized women were more likely to have a history of endometriosis and heavy menstrual bleeding but less likely to have pelvic inflammatory disease. Findings indicate that over the 5-year period sterilized women were 4.6 times more likely to have a hysterectomy regardless of age or the type of sterilization procedure. Risk was lowest (2.9) among women who had been sterilized with a silicone rubber band application. Risk was highest (13.2) among women who had interval partial salpingectomy (removal of a tube). Risk was 5-8 times more likely among women who had bipolar or unipolar coagulation clip application or postpartum partial salpingectomy. Among married women with controls for age at sterilization and history of endometriosis or pelvic inflammatory disease sterilized women had a similar risk of hysterectomy. For women aged under 34 years the risk was 2.6-13.3 times greater; for those older than 35 years the risk was 2.9-18.0 times greater.