Intraoperative Cooperation Research Articles

Strategies of improving nursing cooperation in surgery of intracranial aneurysms

Objective To discuss the strategies of improving nursing cooperation in surgery of intracranial aneurysms.Methods From Dec 2009,a training program toward nursing cooperation,focusing on emergency handling and detail management in surgery of intracranial aneurysms were carried out in our operation room.The data of a group of 60 patients who was operated after the program was studied and a group of 60 patients who were operated before the program served as control group.The quality of nursing including preoperative preparation,intraoperative cooperation,postoperative nursing defect were evaluated respectively.Results Nursing quality incarnated by satisfaction of preoperative preparation,safe management were better than those of control group.The difference was statistically significant ( P ＜ 0.05 ).Conclusions New nursing modality focusing on emergency handling and detail management for surgery of intracranial aneurysms in operating room is significantly valuable for improvement of nursing quality in operation room. Key words: Aneurysm; Intracranial; Operation room; Nursing management

Intraoperative nursing cooperation for robotic-assisted laparoscopic precise liver resection

Objective To investigate intraoperative nursing cooperation for robotic-assisted laparoscopic precise liver resection. Methods Between April and July 2009, 13 consecutive patients underwent roboticassisted laparoscopic anatomic hepatectomy for benign and malignant hepatic diseases. The clinical data of preoperative preparation, intraoperative cooperation and management of emergency were analyzed retrospectively and summarized gradually. Results All 13 robotic-assisted laparoscopic precise liver resections were performed successfully in the manner of pure laparoscopic resection. The nursing protocol was formulated to improve the preoperative preparation, intraoperative cooperation, management of emergency and postoperative summary. The nursing outcome was satisfactory due to effective nursing strategy. Conclusions Robotic surgery has been expanded into multi-disciplinary field, therefore preparation, communication, discreet placement and protection are important guarantees in its development. Key words: Robot; Intraoperative care; Precise liver resection

The phenomenology research of perioperative therapeutic communication for rectal cancer patients

Objective To explore the clinical practice and patient experience of perioperative therapeutic communication in rectal cancer patients, in order to provide theoretical basis for the further clinical application of therapeutic communication. Methods To adopt phenomenology method of qualitative research, collecting data by the direct participation, observation, half structural formula thorough interview and other methods. To establish coding and refine theme. Results Four themes of the rectal cancer patients experience of perioperative therapeutic communication were generalized: emotional adaptation, actively coping with surgery, intraoperative cooperation, postoperative rehabilitation and self-care. Conclusions Application of therapeutic communication system can effectively interfere with patients cognitive behavior, improve communication ability of nurses and extended the nursing service connotation. Key words: Therapeutic communication; Rectal cancer; Perioperation; Phenomenology research

Unilateral Congenital Blepharoptosis Repair by Anterior Levator Advancement and Resection: An Educational Review

Simple congenital blepharoptosis is caused by levator muscle dysgenesis and commonly presents unilaterally. A complete preoperative evaluation, including ophthalmic, neurologic, and levator function examinations, is essential for ensuring proper diagnosis and selecting the correct procedure. Correction is frequently delayed until the anatomical structures of the eye are fully developed and the child can cooperate with the preoperative examination between the ages of 3 and 5 years, except in cases of visual disturbances. After the preoperative evaluation, the proper treatment can be selected from commonly described procedures, including levator advancement, tarsomyectomy, and frontalis suspension. The authors provide a description of the pediatric levator advancement procedure and demonstrate the procedure with supplemental video content. Levator advancement provides appropriate correction for moderate blepharoptosis repair in pediatric patients with fair to good levator function. Levator advancement in children presents unique challenges because of difficulty performing the preoperative examination and the inability of the patient to provide intraoperative cooperation for proper lid placement because of general anesthesia.

Nursing cooperation of implantation of modified capsular tension ring and foldable posterior chamber intraocular lens combined with phacoemusification in treatment of Marfan syndrome accompahied with lens subluxation

Objective To explore the nursing care of patients with Marfan syndrome accompanied with lens subluxation, and the clinical efficacy of phacoemusification combined with the implantation of modified capsular tension ring and foldable posterior chamber intraocular lens. Methods 11 patients (11 eyes) were performed the surgery. Uncorrected visual acuity preoperatively was (0.13±0.09). Best corrected visual acuity preoperatively was (0.20±0.17). Preoperative preparation, intraoperative observation and postoperative guidance were executed. The prognosis of these patients were observed. Results The operations were performed successfully. No intraoperative complications were founded. Mean uncorrected visual acuity at 2 year postoperatively was (0.60±0.28), and mean best corrected visual acuity was (0.70±0.28). Conclusions Careful preparation before surgery, close cooperation during surgery and the correct management after surgery were the important measures for the success of surgery. Key words: Phacoemusification; Lens subluxation; Capsular tension ring; Intraoperative cooperation; Nursing

Nursing strategy of bypass and revascularization technique in the treatment of intracranial complex aneurysms

Objective To explore the nursing strategies of bypass and revascularization in the treatment of complex intracranial aneurysms. Methods Sixteen patients with complex intracranial aneurysms underwent bypass, reconstruction operation, or an aneurysm trapping followed by saphenous vein procedures. Sufficient preoperative preparation and intraoperative proficient cooperation and effective management are helpful to cope with emergent situation. Results Sixteen aneurysms were trapped followed by saphenous vein high-flow bypass.All the patients had good outcome by using effective nursing strategies. Conclusions Bypass and revascularization operation which has a relative long operative duration demand high nursing quality including basic cooperation skill, sufficient preoperative preparation, and rapid and effective dealing with emergent situation, leading to satisfactory intraoperative nursing effect. Key words: Complex intracranial aneurysm; Bypass; Revascularization; Operative nursing

Nursing cooperation for laparoscopic ovarian cystectomy

Objective To discuss the nursing cooperation for laparoscopic ovarian cystectomy. Methods There were totally 121 patients received laparoscopic ovarian cystectomy. Pre - operative visit, mental nursing, intraoperative cooperation and equipment management were strictly carried out Results Except 4 patients turned to receive open -operation, laparoscopic ovarian cystectomy was successfully accomplished in 117 patients, with little bleeding, short operative time, quick recovery and no complication. Conclusions Sufficient pre - operative preparation, satisfactory posture, consummate intraoperative cooperation and rational management of the laparos-copy are the guarantee for laparoscopic ovarian cystectomy. Key words: Ovarian cyst; Laparoscopy; Nursing cooperation

Intraoperative Bypass Graft Angiography: Cooperation between Cardiologist and Surgeons in the Operation Room for Optimal Postoperative Results - Is this the Way for the Future?

To confirm the quality of total arterial CABG carried out using the left internal thoracic artery (LITA) and a radial artery (RA) T-graft and distal anastomoses immediately in the OR, we developed a new technique using intraoperative graft angiography. A 5-Fr sheath is inserted in the proximal radial artery stump, through which a catheter for LITA angiography is later introduced. From July 2004 to March 2005, 23 patients underwent total arterial CABG with the T-graft and intraoperative graft angiography. On-pump CABG was performed in 22 patients and off-pump CABG in 1 patient. Mean procedure time for the angiography was 13.7 +/- 7.3 minutes, and mean fluoroscopy time was 6.2 +/- 4.6 minutes. In two patients, the RA-marginal artery side-to-side anastomosis was stenosed and had to be revised as demonstrated by graft angiography. In one patient, the RA was kinked and in another, there was a kinking of the LITA. In both cases, kinking was corrected. The remaining anastomoses were seen to have unobstructed flow with no evidence of stenosis. Intraoperative graft angiography can be performed in patients undergoing total arterial CABG. This concept of intraoperative cooperation between an interventional cardiologist and surgeons could significantly improve the operative outcome in CABG surgery.

Awake craniotomy

Anaesthetic techniques for awake craniotomy have been evolving over many years and include local anaesthesia and sedation or true asleep–awake–asleep techniques using general anaesthesia with intra-operative wake-up. The key advantage of awake techniques is the ability to assess the patient's neurological status during surgery, although this benefit has to be balanced against the loss of control of ventilation and assurance of immobility. However, the use of short-acting anaesthetic agents provide good operating conditions for the neurosurgeon whilst ensuring intraoperative cooperation from a comfortable patient. It is well tolerated by patients and minor procedures can be performed as a day case or with one overnight stay. The neuroanaesthetist plays a key role in the perioperative management of this challenging procedure.

Lorazepam (Ativan) and Fentanyl (Sublimaze) for Outpatient Office Plastic Surgical Anesthesia

Lorazepam (Ativan) and Fentanyl (Sublimaze) given in small doses during surgery not only achieve excellent intraoperative sedation and patient cooperation, but also significantly reduce recall and recognition of events during the surgery for as long as 3 hours after the surgery. Included is a series of 814 patients in whom this protocol was used between 1981 and 1984 with a 94 percent patient postoperative follow-up. With this protocol there have been no known complications, and patient reactions have been unanimously favorable.

Lorazepam (Ativan) and Fentanyl (Sublimaze) For Outpatient Office Plastic Surgical Anesthesia

Lorazepam (Ativan) and Fentanyl (Sublimaze) given in small doses during surgery not only achieve excellent intraoperative sedation and patient cooperation, but also significantly reduce recall and recognition of events during the surgery for as long as 3 hours after the surgery. Included is a series of 814 patients in whom this protocol was used between 1981 and 1984 with a 94 percent patient postoperative follow-up. With this protocol there have been no known complications, and patient reactions have been unanimously favorable.

Lorazepam (Ativan) and fentanyl (Sublimaze) for outpatient office plastic surgical anesthesia.

Lorazepam (Ativan) and Fentanyl (Sublimaze) given in small doses during surgery not only achieve excellent intraoperative sedation and patient cooperation, but also significantly reduce recall and recognition of events during the surgery for as long as 3 hours after the surgery. Included is a series of 814 patients in whom this protocol was used between 1981 and 1984 with a 94 percent patient postoperative follow-up. With this protocol there have been no known complications, and patient reactions have been unanimously favorable.