Experimental Surgery Laboratory Research Articles

Comparison of salpingectomy and tubal detorsion procedures after experimental ischemia-reperfusion injury in a rat fallopian tube model: biochemical and histopathological evaluation

To compare salpingectomy and detorsion procedures and investigate the biochemical and histopathological changes in the fallopian tubes in the experimentally isolated fallopian tube torsion model in rats. Experimental study. Experimental surgery laboratory in a training and research hospital. Twenty-seven Sprague-Dawley rats in the reproductive period. Group 1, control group (n = 6); group 2, bilateral total salpingectomy group after 4 hours of tubal ischemia (n = 7); group 3: 4 hours of bilateral tubal ischemia plus 1 week of reperfusion (n = 7); and group 4, 4-hour period of bilateral tubal ischemia plus 30 days of reperfusion (n = 7). A 22-gauge catheter was administered before and after surgery using methylene blue through the uterine horn of the rat to evaluate tubal patency. Preoperative and postoperative serum antimüllerian hormone (AMH) levels, histopathological examination of the rat tuba uterine and histopathological damage scores, antioxidant compounds (superoxide dismutase [SOD], catalase, and glutathione peroxidase [GSH-Px]), and oxidative stress end product levels (malondialdehyde [MDA] and 8-hydroxy-2'-deoxyguanosine [8-OHdG]). Although a significant difference was observed in the tissue SOD, GSH-Px, MDA, and 8-OHdG values, no significant difference was observed between the groups in serum samples. The tissue SOD and tissue GSH-Px levels in group 2 significantly decreased, and a significant increase was observed in the tissue MDA and 8-OHdG values in group 2. Among the histopathological parameters, epithelial changes, vascular congestion, and the total fallopian tube mean damage score of 4 showed a significant decrease in group 4. When the methylene blue transitions before and after ischemia-reperfusion injury were compared, the values of the methylene blue transition after ischemia-reperfusion injury in groups 2-4 significantly decreased. When the serum AMH levels were analyzed, the postoperative AMH value in group 2 significantly increased. This study reveals that biochemical and histopathological improvement is observed in the fallopian tube tissues gradually when the detorsion procedure is performed for the necrotized tubal tissue instead of salpingectomy. Although there is restoration of epithelial integrity after reperfusion, tubal passage remains absent. This study was approved by the Local Ethics Committee for Animal Experiments of the Health Sciences University, Istanbul Hamidiye Medicine Faculty (approval number 27.05.2022-9269). The study followed the ethics standards recommended by the Declaration of Helsinki.

Prototype of Low-Cost Microvascular Clips for Laboratory Use

Vascular neurosurgical procedures require temporary or permanent surgical clips to treat cerebral aneurysms, arteriovenous malformations, or bypass surgery. In this scenario, surgical clips should have specific characteristics such as high-quality material, proper design, closing force, and biocompatibility. Due to these characteristics, the price of these clips does not allow their availability at the experimental surgery laboratory worldwide. We describe here the technique for manufacturing handcrafted clips of low cost, using dental stainless steel or titanium wire of 0.18mm, 0.20mm, or 0.22mm in diameter. We must complete six steps to obtain the clip using our hands and small electrician needle nose pliers for wire molding. These clips have a closing force of 30-60 gr/cm2 (depending on the wire diameter). They can be used in the experimental surgery laboratory to clip arteries or veins during vascular microsurgery procedures. Also, they can be used as temporary clips with confidence in low-flow bypass (v.gr. superficial temporal artery to middle cerebral artery or occipital artery to posterior inferior cerebellar artery anastomoses). Making practical low-cost clips for use in laboratory procedures or during low-flow anastomosis as temporary clips is possible. The main advantages are the low cost and the worldwide availability of the basic materials. The main disadvantage is the learning curve to get the ability to master the manufacturing of these clips.

In Vivo Modeling of Complicated Necrotizing Enterocolitis

Introduction: There is no adequate and easily reproducible model of complicated necrotizing enterocolitis (NEC) that allows to study its etiopathogenesis and test various surgical treatment options in an experiment.Objective: To devise a method for in vivo modeling of complicated NEC using laparoscopy.Materials and methods: Our study was conducted at the premises of the Laboratory of Experimental Surgery and Oncology (Scientific Research Institute of Experimental Medicine, Kursk State Medical University) in compliance with international ethical standards and guidelines for humane animal treatment. Fifteen immature male rabbits underwent laparoscopy under inhalation anesthesia and then subserosal injection of damaging solutions (33% H2O2, 10% CaCl2, 4% KCl, 70% C2H5OH, 10% CH2O) into the intestinal wall. In 24 hours, we performed laparotomy, assessed pathological changes visually, and resected the section of the intestinal tube at the injection site. Then we performed a single­layer end­to­end intestinal anastomosis. Histological samples were made from a biopsy specimen. Morphological assessment of the changes was performed.Results: The most pronounced macro­ and microscopic changes were found in the animals injected with hydrogen peroxide. We assessed changes in the abdominal cavity 24 hours since the start of modeling and observed a pattern of partial intestinal obstruction and serous peritonitis. The morphological pattern was characterized by acute circulatory disorder in the intestinal wall with ulcerative necrotic defects and perforations.Conclusions: Based on morphological manifestations we devised a method for modeling complicated NEC using laparoscopy. It is easily reproducible in an in vivo experiment, close to the clinical situation, and allows to simulate typical morphological changes during severe NEC.

Use of Alginate Polymer Polysaccharide Hemostatic Hydrogel 
 in the Treatment of Simulated Bleeding Stomach Defects

The aim of the study was to develop in vivo technique and study the potential of alginate polymer polysaccharide hemostatic hydrogel application in the treatment of experimental bleeding stomach ulcers.Materials and methods. The in vivo experiment was conducted in the Laboratory of Experimental Surgery, the Research Institute of Experimental Biology and Medicine, N.N. Burdenko Voronezh State Medical University. Twelve healthy laboratory animals (dog) weighed 7-10.5 kg were selected for the study. Each animal was exposed to two bleeding stomach defects: one of which was experimental, and the other was control. Bleeding arrest in the experimental group of animals was carried out by insufflation of powdered alginate polymer polysaccharide hemostatic for a bleeding defect (Patent RF №2762120). Control stomach defects were not subjected to endoscopic treatment. The results of the experimental study were evaluated according to the following parameters: the time of experimental bleeding arrest, the presence of repeated bleeding, the timing and quality of healing simulated defects.Results. Experimental studies have demonstrated that the alginate polymer polysaccharide hemostatic hydrogel applied in the endoscopic treatment of simulated bleeding stomach defects can significantly (P=0.000001) reduce the time of experimental bleeding, from 26.5(25.3-32.0) sec to 6.0(4.0-8.0) sec, and helps to reduce the regeneration time of experimental defects from 14.5(13.5-16.5) days up to 8.0(7.5-8.5) days (P=0.000001), while improving the quality of their healing.Conclusion. Thus, the use of alginate polymer polysaccharide hemostatic hydrogel is an effective method of treating simulated bleeding stomach defects.

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First Femoropopliteal Bypass for a Critical Limb Ischemia

First Femoropopliteal Bypass for a Critical Limb Ischemia

BRAZO ROBÓTICO ARTICULADO PARA ASISTENCIA EN RADIOLOGÍA INTERVENCIONISTA

Objectives: Robotic technology has helped medicine to reduce exposure time and offer greater efficiency and precision in surgical interventions. The goal of using an articulated robotic arm for X-ray (Rx) guided minimally invasive surgery and interventional assistance is to reduce direct and secondary radiation on physicians. The use of a collaborative robotic arm (COBOT) that replaces the operating arm of the surgeon-interventionist physician to avoid exposure to X-rays is described. Methods: The COBOT has a remote-controlled electronic gripper and includes a special needle holder made using 3D printing technology; This holds the interventional instrument, needles, and other surgical elements. The instrument-loaded forceps are oriented and progressed toward intracorporeal therapeutic target points used in interventional radiology and radiation therapy procedures, the COBOT boasts operational precision. Results: Its operation was verified by simulating the interventional action in models in animal tissue, and experimental surgery laboratory. Conclusions: It is concluded that the robot arm can perform assistance functions in radiological and stereotaxic neuroradiological interventionism with a good level of precision, reducing the doctor's exposure to X-rays. Keywords: Robotics, X-Rays, Radiology, Interventional, Robotic Surgical Procedures (Source: MeSH NLM)

Оценка спаечного процесса после травмы печени в хроническом опыте

Background. The issue of studying the reaction of a macroorganism to use of various local hemostatic agents is relevant. In particular, an important factor for use of a certain hemostatic agent in practical medicine is the low probability of formation of adhesions in the postoperative period after its implantation. Aim. Was to investigate the peculiarities of the course of adhesion process in the abdomen of laboratory animals after liver injury and stoppage of bleeding by local spongy hemostatic agents in an experiment. Materials and Methods. As materials, various samples of spongy hemostatic agents were used: Tachocomb®, Na-CMC + tranexamic acid, Na-CMC. The study was performed on male rabbits of the «Soviet chinchilla» breed (10 in each experimental group) in the operating unit of the laboratory of experimental surgery and oncology of the Research Institute of Experimental Medicine of KSMU. Surgical intervention was performed using a video-surgical complex, a liver wound was formed, and to stop bleeding, the studied samples of hemostatic sponges were used. Before surgery and on the 1st, 3rd, 7th, 15th, 30th day after surgery each animal was made the control dynamic laparoscopy, in which the evidence and spread of peritoneal adhesions were macroscopically evaluated. Results. In the group where Tachocomb® collagenous plate was used for arrest of bleeding, practically no statistically significant differences were found in comparison of the results of control dynamic laparoscopy (CDL) – on the 1st day after injury, there was no active bleeding and adhesions, on the 30th day a decrease in the area of growth of connective tissue structures was noted in the region of injury, and the color of parenchyma was comparable with that of intact areas. The parameters were analyzed both within the group (at different periods of the experiment) and between the experimental groups. Conclusions. In the intra-group comparison, a small number of significant differences were noted which may evidence comparability of the adhesive process at different periods of the experiment in the study groups. In practically of all cases of adhesion, they attached to the anterior abdominal wall at the point of insertion of the cannula for laparoscope (or quite close to it) that may be associated with frequent trauma of the peritoneum in this region provided by the design of the experiment, and in all cases threadlike adhesions were found, the morphological substrate of which was a strand of greater omentum. There were no clinical manifestations of adhesive intestinal obstruction in laboratory animals.

Training of students of higher medical educational institutions in endovideosurgery skills

Aim. Evaluation of basic skills in endovideosurgery of students of higher medical educational institutions (HMEI) before and after taking an elective course Basics of Surgical Technique.
 Materials and Methods. Basic skills in endovideosurgery were investigated in students of the General Medicine Faculty before and after taking an elective course Basics of Surgical Technique organized on the base of the simulation hall of the experimental surgery and oncology laboratory of Research Institute of Experimental Medicine at Kursk State Medical University. The training course included the following exercises on box trainers: Peg Transfer, Pattern Cut, Intracorporal (single interrupted) Suture. After achievement of satisfactory results, final assessment was conducted in the form of examination in practical skills and abilities on laboratory animals biological models (Wetlab). Manipulations conducted by students were assessed using Global Operative Assessment of Laparoscopic Skill (GOALS).
 Results. The average values of the assessed parameters increased: criteria manipulations with tissues from 2.8 to 4.0 points (42.9%), perception of depth from 2.4 to 3.6 points (50%), movement effectiveness by 54.5% (from 2.2 to 3.4 points), bimanual orientation by 60% (from 2.0 to 3.2 points). Criterion independence increased by 66.7% (from 1.8 to 3.0 points).
 Conclusion. After the elective course Basics of Surgical Technique, all average values of the studied parameters increased. The results obtained evidence effectiveness of the methods of training in basics of endovideosurgery within the frames of the elective course, which permits to develop skills in endosurgical technique at the stage of getting higher medical education.

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El biomodelo porcino en la investigación médica traslacional: del biomodelo al humano en trasplante pulmonar

Introduction: Human and porcine anatomy are comparable. In consequence, the porcine biomodel has the potential to be implemented in the training of surgical professionals in areas such as solid organ transplantation. Objectives: We described the procedures and findings obtained in the experiments of translational respiratory medicine with the porcine biomodel, within an experimentation animal laboratory, and we present a comparative review between human and porcine lung. Materials and methods: The experiment was done in nine pigs of hybrid race within a laboratory of experimental surgery. The anatomy and histology of the respiratory tract were studied with fibrobronchoscopy, bronchial biopsy and bronchoalveolar lavage. The bronchoalveolar lavage was studied with liquid-based cytology and assessed with Papanicolau and hematoxylin-eosin staining. Molecular pathology techniques such as immunohistochemistry, flow cytometry, and electronic microscopy were implemented. The pigs were subjected to left pneumonectomy with posterior implantation of the graft into another experimental pig. Results: Histopathologic and molecular studies evidenced predominance of alveolar macrophages (98%) and T-lymphocytes (2%) in the porcine bronchoalveolar lavage. Studies on the porcine lung parenchyma revealed hyperplasic lymphoid tissue associated with the bronchial walls. Electronic microscopy evidenced the presence of T-lymphocytes within the epithelium and the cilia diameter was similar to the human. Conclusions: The porcine biomodel is a viable tool in translational research applied to the understanding of the respiratory system anatomy and the training in lung transplantation. The implementation of this experimental model has the potential to strength the groups who plan to implement an institutional program of lung transplantation in humans.

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Phylogeny and History of the Lost SIV from Crab-Eating Macaques: SIVmfa.

In the 20th century, thirteen distinct human immunodeficiency viruses emerged following independent cross-species transmission events involving simian immunodeficiency viruses (SIV) from African primates. In the late 1900s, pathogenic SIV strains also emerged in the United Sates among captive Asian macaque species following their unintentional infection with SIV from African sooty mangabeys (SIVsmm). Since their discovery in the 1980s, SIVs from rhesus macaques (SIVmac) and pig-tailed macaques (SIVmne) have become invaluable models for studying HIV pathogenesis, vaccine design and the emergence of viruses. SIV isolates from captive crab-eating macaques (SIVmfa) were initially described but lost prior to any detailed molecular and genetic characterization. In order to infer the origins of the lost SIVmfa lineage, we located archived material and colony records, recovered its genomic sequence by PCR, and assessed its phylogenetic relationship to other SIV strains. We conclude that SIVmfa is the product of two cross-species transmission events. The first was the established transmission of SIVsmm to rhesus macaques, which occurred at the California National Primate Research Center in the late 1960s and the virus later emerged as SIVmac. In a second event, SIVmac was transmitted to crab-eating macaques, likely at the Laboratory for Experimental Medicine and Surgery in Primates in the early 1970s, and it was later spread to the New England Primate Research Center colony in 1973 and eventually isolated in 1986. Our analysis suggests that SIVmac had already emerged by the early 1970s and had begun to diverge into distinct lineages. Furthermore, our findings suggest that pathogenic SIV strains may have been more widely distributed than previously appreciated, raising the possibility that additional isolates may await discovery.

The effects of colloids or crystalloids on acute respiratory distress syndrome in swine (<em>Sus scrofa</em>) models with severe sepsis: analysis on extravascular lung water, IL-8, and VCAM-1

Background: Acute respiratory distress syndrome (ARDS) is a fatal complication of severe sepsis. Due to its higher molecular weight, the use of colloids in fluid resuscitation may be associated with fewer cases of ARDS compared to crystalloids. Extravascular lung water (EVLW) elevation and levels of interleukin-8 (IL-8) and vascular cell adhesion molecule-1 (VCAM-1) have been studied as indicators playing a role in the pathogenesis of ARDS. The aim of the study was to determine the effects of colloid or crystalloid on the incidence of ARDS, elevation of EVLW, and levels of IL-8 and VCAM-1, in swine models with severe sepsis.Methods: This was a randomized trial conducted at the Laboratory of Experimental Surgery, School of Veterinary Medicine, IPB, using 22 healthy swine models with a body weight of 8 to 12 kg. Subjects were randomly allocated to receive either colloid or crystalloid fluid resuscitation. After administration of endotoxin, clinical signs of ARDS, EVLW, IL-8, and VCAM-1 were monitored during sepsis, severe sepsis, and one- and three hours after fluid resuscitation. Analysis of data using the Wilcoxon test , Kolmogorov-Smirnov test, Mann-Whitney test, unpaired t test.Results: Mild ARDS was more prevalent in the colloid group, while moderate ARDS was more frequent in the crystalloid group. EVLW elevation was lower in the colloid compared to the crystalloid group. There was no significant difference in IL-8 and VCAM-1 levels between the two groups.Conclusion: The use of colloids in fluid resuscitation does not decrease the probability of ARDS events compared to crystalloids. Compared to crystalloids, colloids are associated with a lower increase in EVLWI, but not with IL-8 or VCAM-1 levels.

Simulation of drug release and mobility in healthy and osteoporotic bone

Simulation of drug release and mobility in healthy and osteoporotic bone

Surgical simulator for temporal bone dissection training

AbstractTemporal bone dissection plays an important role in the training of surgeons; however, they are difficult to obtain. AimTo develop a synthetic replica of the temporal bone for dissection training. Study DesignExperimental. Materials and MethodsAn acrylic synthetic resin replica was obtained from a human temporal bone. For the evaluation of the method, we selected five ear surgeons to dissect the model in a laboratory of experimental surgery. A questionnaire was filled, assessing external appearance, the simulation of procedures (placement of ventilation tube, mastoidectomy, decompression of the facial nerve and translabyrinthine access to the internal auditory canal) and their final conclusion. ResultsThe evaluation indicated satisfaction in using the model (80%), being more evident concerning the dissection of the mastoid segment of the facial nerve and translabyrinthine access to the internal auditory canal. The placement of a ventilation tube was reasonable for 60% and satisfactory for 40% of them. Mastoidectomy was satisfactory for 60% and fully satisfactory for 40%. ConclusionDissection in this simulator does not replace otologic training in cadaveric temporal bones. However, given the increasing difficulty in obtaining the latter, the development of new teaching tools should be encouraged to continuously improve surgeons.

Corrigendum to “Anabolic androgenic steroids reverse the beneficial effect of exercise on tendon biomechanics: An experimental study” [Foot Ankle Surg 20 (2014) 94–99

Serafim Tsitsilonis MD, MSc, PhD*, Panayiotis E. Chatzistergos PhD, Athanasios S. Mitousoudis PhD, Stavros K. Kourkoulis PhD, Ioannis S. Vlachos MSc, George Agrogiannis MD, Konstantinos Fasseas PhD, Despina N. Perrea PhD, Aristides B. Zoubos MD, PhD a Laboratory for Experimental Surgery and Surgical Research ‘‘N.S. Christeas’’, Athens Medical School, Agiou Thoma str. 15B, 11527 Athens, Greece Charite – University Medicine Berlin, Center for Musculoskeletal Surgery, Augustenburger Platz 1, 13353 Berlin, Germany Berlin-Brandenburg Center for Regenerative Therapies, Charite – University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany Unit of Biomechanics, Department of Mechanics, School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Zografou Campus, 15773 Athens, Greece e 1st Department of Pathology, University of Athens, Athens Medical School, Athens, Greece f Laboratory of Electron Microscopy, Faculty of Agricultural Biotechnology, Department of Plant Biology, Agricultural University of Athens, Iera Odos 75, 11855 Athens, Greece Department of Orthopaedic Surgery, University of Athens, Athens Medical School, ‘‘Attikon’’ University Hospital, Rimini str. 1, 12462 Athens, Greece

Prof. Ioan Jianu: founding member of SICOT.

At the beginning of the twentieth century, Romania witnessed the rise of some brilliant doctors. One of them was Prof. Ioan Jianu, also known in the scientific world as Jean Jiano, whose career was dedicated to medicine and training young generations of doctors. He was one of the founding members of SICOT, at the first meeting held in 1929 at the Hotel de Crillon in Paris, representing Romania. He was a main figure in Romanian surgery, pioneering in the fields of traumatology, reconstructive and plastic surgery and also showing interest in replantation surgery. He also founded the first laboratory of experimental surgery in Romania and two professional associations.