Suction Unit Research Articles

Retroperitoneal Laparoscopic Liposuction for Large Adrenal Myelolipomas: A Report of Nine Cases

Removing relatively large adrenal myelolipomas using retroperitoneal laparoscopy is difficult and carries risk of intraoperative injury to adjacent organs and vessels. We aimed to introduce a new method of retroperitoneal laparoscopic liposuction with suction units for resection of large adrenal myelolipomas. From June 2005 to October 2011, 8 patients (nine lesions, including bilateral lesions in 1 patient) with adrenal myelolipoma more than 8 cm in maximum diameter underwent retroperitoneal laparoscopic liposuction with suction units. Patients included 3 males and 5 females with a mean age of 47 years (range, 35-62 years). Tumor resection was performed after deflation and shrinkage of tumor. The mean maximum diameter was 10.5 cm, ranging from 8 to 14 cm. Five tumors were located on the right side, two were on the left side, and one was bilateral. Adrenal computed tomography was done in each patient preoperatively. Round or oval masses were found in dense fat in the adrenal area, and all cases were diagnosed as adrenal myelolipoma. Five patients had backache or abdominal discomfort; three patients had no symptoms. The mean operation time was 75 minutes, and the mean intraoperative blood loss was 30 mL. The mean postoperative length of stay was 3 days. No significant intraoperative or postoperative complications occurred. The follow-up length ranged from 8 to 77 months. No tumor recurrence was observed. Retroperitoneal laparoscopic liposuction with suction units is safe and effective for resection of relatively large adrenal myelolipomas. Deflation and shrinkage of the tumor make the operation safer and easier without affecting its pathological diagnosis.

Intermittent aspiration of pharyngeal secretion for re-intubation prevention

The inability of extubated patients to clear oropharyngeal secretion increases the risk of re-intubation. To eliminate excessive oropharyngeal secretion, we devised a suctioning method: intermittent aspiration of pharyngeal secretion (IAPS). IAPS is a simple, low-cost technique utilizing an intermittent suction unit and a common suction tube (Figure ​(Figure1),1), which may reduce the risk of re-intubation on extubated patients requiring supraglottic airway management. Figure 1 Intermittent aspiration of pharyngeal secretion. Methods A retrospective study was performed on 24 patients who received IAPS after extubation from June 2009 to May 2011. A suction tube was placed in the pharynx after extubation. The same suction unit used in intermittent subglottic secretion drainage was applied. IAPS is effective for patients with large amounts of oropharyngeal secretion (A), patients with poor laryngopharyngeal function (B), and patients unable to expel viscous sputum (C). Efficacy of IAPS in each of these patient groups was studied.

Simple, Safe, and Successful Evacuation of Severe Organized Clot Retention Using a Catheter Connected With Wall Suction: Suction and Fishing Method

To introduce a novel method to successfully remove organized hematoma. Endoscopic evacuation can be troublesome in some patients with a large amount of blood clots or organized hematoma. We retrospectively reviewed medical records of 15 patients who were treated with a so-called "suction and fishing method" for severe clot retention. A large-bore catheter connected with a wall suction unit was inserted into the bladder through the resectoscope sheath, and subsequently a large volume of urine retention and quite a substantial amount of soft clots were removed (suction step). After awhile, negative pressure could not work when the catheter met large and organized fragments of blood clots. In this situation, large blood clots hanging on the catheter tip were removed by gently removing the catheter (fishing step). In all patients, clot retention was successfully managed with this method. Clot evacuation was performed without anesthesia in 9 patients when electrocauterization was not planned, and opioid analgesics were sufficient for pain control. In the other 6 patients, clot evacuation and fulguration were performed under anesthesia. Median time for clot evacuation was 20 minutes (range 5-55) and median estimated volume of clot evacuated was 200 mL (range 50-600). There was no procedure-related complication such as bladder rupture. The suction and fishing method is a simple, safe, and successful way to evacuate severe organized clot retention. It can resolve intractable clot retention and rapidly relieve related symptoms without anesthesia.

Thopaz Portable Suction Systems in Thoracic Surgery: An end user assessment and feedback in a tertiary unit

BackgroundThoracic surgical patients have chest drains inserted to enable re-expansion of lungs, to clear contents from the pleural cavity which sometimes require negative suction. Suction impedes mobility, may have variable suction delivery and increases risk of infection. Assessment of air-leak in conventional drains is not scientific and is subjective. Thopaz chest drain system is a portable suction unit which allows mobilization of the patient, with scientific digital flow recordings and an in built alarm system.MethodsWe evaluated the utility, staff and patient feedback of this device in a pilot evaluation in a regional thoracic unit in a structured format over a period of two months. Staff responses were graded on a scale of 1 to 6 [1 Excellent to 6 Poor].Results120 patients who underwent elective bullectomy/pleurectomy, VATS lung biopsies, VATS metastectomy and lung resections were evaluated. The staff feedback forms were positive. The staff liked the system as it was more scientific and accurately recordable. It made nursing and physiotherapy easier as they could mobilise patients early. The patients liked the compact design, weightlessness and the silence. It enabled mobilisation of the patients and scientific removal of chest drain.ConclusionsThopaz digital suction units were found to be user friendly and were liked by the staff and patients. The staff feedback stated the devices to be objective and scientific in making decisions about removal and enabled mobilisation.

Quantification of aerodynamically induced noise and vibration-induced noise in a suction unit

Noise, generated by a centrifugal blower, can be divided according to its origin, into aerodynamically induced noise and vibration-induced noise. The contribution of the individual noise source to the total emitted noise is hard to determine, but it is crucial for the design of noise reduction measures. In order to reduce the noise of the centrifugal blower in a broad range of operating conditions, an identification of noise sources needs to be performed. An analysis of the most important noise origin in a centrifugal blower presented in this article was performed by measurements of the transfer function between noise and vibration, under different types of excitation. From the analyses one can conclude that the dominant noise source of a centrifugal blower can be attributed to the aerodynamically generated noise which exceeds the vibration-induced noise for more than 10 dB in a broad frequency range.

Low risk of contamination with human papilloma virus during treatment of condylomata acuminata with multilayer argon plasma coagulation and CO2 laser ablation

Multilayer argon plasma coagulation (APC) is a new effective method for the treatment of genital warts. We assessed the generation of aerosols containing human papilloma virus (HPV) DNA during treatment of genital warts with multilayer APC and with CO₂ laser ablation. Surveillance petri dishes, swabs from the glasses and nasolabial folds of the operating physician, and swabs taken from the suction units used during CO₂ laser ablation were tested by HPV PCR. HPV DNA corresponding to patient derived HPV types of genital warts was not found in any of the petri dishes and swabs obtained during APC treatment. HPV DNA was detected in none of the petri dishes obtained during CO₂ laser treatment, but in suction filters. In conclusion, both CO₂ laser ablation with plume suction and APC treatment seem to have a low risk of HPV contamination of the operation room.

Hand-held device for smoke extraction

Electrocautery produces smoke which potentially causes harm to theatre personnel as well as obscuring the surgical view. Few surgeons use smoke extraction units due to lack of availability, expense and the cumbersome nature of purpose-made, hand-held pieces.1 Our team passes the tip of the hand-held diathermy through a 53 cm 12-F suction catheter with a mully tip (Unomedical Pty Ltd, PO Box 405, NSW 2103 Australia; Fig. 1). This is secured with adhesive strips and connected to Flexi-Rib suction tubing (Pennine Healthcare Ltd, Derby, UK) to create an effective and ergonomically acceptable handheld smoke evacuator for less than one pound. The tubing is attached to a filtered smoke evacuator suction unit. Figure 1 Diathermy needle with smoke extractor.

Unrecognised Suction Failure Causing Tension Pneumothorax

We present the case of a patient who developed a bronchopleural fistula, which was treated with the use of a chest drain with application of suction. The patient significantly deteriorated clinically and developed a tension pneumothorax. After some delay, the wall suction unit was found to be blocked, thereby creating a closed system and causing a pneumothorax under tension. We discuss the safe application of suction to chest drains with particular reference to the use of the three-bottle system.

Correction: Success of the Orbicularis Oculi Myocutaneous Vertical V-Y Advancement Flap for Upper Eyelid Reconstruction

Sir: The advantages of autogenous bone graft over manufactured bone materials have been well described. Bone removal can be performed by burr, chisel, bone curette, trephine, and bone filter.1 Bone filters have been developed for collecting autogenous bone debris for the purpose of grafting procedures in craniofacial surgery. Morbidity associated with different graft-harvesting techniques has increased the need to find alternative sites. When small amounts of bone graft are needed, bone particles collected by bone filters can be considered an alternative way of obtaining a bone graft.2 The major advantage is the lack of donor-site morbidity. To harvest the maximum amount of dust, a new technique was conceived and used. A small canister with two outlets in the lid is placed between the suction unit and the metallic tip at the end. A copious amount of irrigation is used with a bulb syringe and a craniotome to avoid damage caused by the heat generated. The bone dust is sucked continuously with the suction tip and collected in the small canister. The bone dust settles at the bottom of the container and the irrigation saline is drained. Excess fluid is further drained from the collected dust using dust collector mesh, and the resulting paste is used to fill the bony irregularities (Fig. 1).Fig. 1.: Canister with inlet and outlet in the lid and mesh bone dust collector.The dust has been used to fill full-thickness defects in the skull with good results, and it has been used as a paste to fill irregularities in reconstructions.3 The bone dust has usually been collected using a flat-bladed Ashe periosteal elevator, but this is time consuming, and inevitably some bone dust is lost. A simple teaspoon has also been used for the same purpose. A simple curved frame bone dust collector mesh was used for many years to collect the graft while using a craniotome. The curved frame was designed to fit any area of skull, and thus little dust was lost.4 It is important that a copious amount of irrigation is maintained constantly and the craniotome is run at a moderate speed. In this way, the drilling temperature is kept below 47ºC.5 This is done to avoid damage to the bone regeneration cells. This technique allows us to collect large amounts of bone dust in more efficient manner. This is a very safe and efficient method of obtaining good material with which to fill bony irregularities or defects without spending extra time and effort during surgery. There is no donor-site morbidity or extra anesthesia time and no extra cost to the patient. Gopal Malhotra, M.S., M.Ch., F.R.C.S. Arunesh Gupta, M.S., M.Ch. Ian T. Jackson, F.R.C.S., F.R.A.C.S., D.Sc. Department of Craniofacial Surgery Institute of Craniofacial Surgery Providence Hospital Southfield, Mich.

SOLAR ENERGY UTILIZATION IN WATER DISTILLATION

The aim of this study is to design and evaluate some different units of solar stills constructed as follow a: (control unit, preheating unit, air blower unit and air suction unit). Some different parameters, which affect on the productivity of solar still units, were studied as brine depth, slope angle of glass cover, feed water and cover material. The results show that the highest productivity was with preheating unit (6030cm3/m2.day) with brine depth 2cm, cover slope angle 20°, and feed water time every two hours.

A Novel Laparoscopic Suction Device for Applying Precise Aspiration During Laparoscopic Surgery: Sponge-Tip Suction Tube

Aspiration of the intra-abdominal fluid and debris is usually needed during different stages of the operation. This is necessary to protect the intra-abdominal space from contamination and/or to remove blood or tissue fluids occurring during the operation. It is also essential for obtaining a clean surgical area. Aspiration of the intra-abdominal fluid is relatively more difficult in laparoscopic surgery because of the suctioning of the omentum and intestine with the aspirator. In this paper, we report on a new suction device (sponge tip suction tube; STST), which allows the surgeon easier suctioning of intra-abdominal fluid. STST has an additional sponge tip and air channel, which prevents the device from suctioning intra-abdominal organs, such as the intestine and omentum. We tested the efficacy of STST in a simulated intra-abdominal space, such as a large transparent plastic bag with fresh sheep intestine-omentum and with 2000 cc of physiologic saline solution and 14 mm Hg of air pressure. Whereas the suctioning of all the fluid was difficult and time consuming when the conventional suction unit was used, all of the saline solution was easily and quickly suctioned when STST was used. In conclusion, STST provides a safe, fast, and complete fluid extraction.

Identification of noise sources in centrifugal blower with acoustic camera

A centrifugal blower represents the main noise source in a vacuum cleaner. Noise emitted by the centrifugal blower working as a suction unit has aerodynamic, mechanical, and electromagnetic noise origins. Noise emitted by a suction unit consists of airborne and structure‐borne noise. The contribution of the individual noise source to the total noise level depends on the geometry of the suction unit, rotational speed and on the operating conditions. Operating conditions of a suction unit depend on the amount of dust particles in the dust bag and are constantly changing during operation until a zero flow rate is reached. In order to reduce noise of suction unit at broad range of operating conditions, an identification of noise sources needs to be performed. Identification of most important noise sources on the centrifugal blower was performed with an acoustic camera at the design and off‐design operation conditions. From the analyses we can conclude that the rotational noise usually prevails at the design point of operation, and that the nonrotational noise prevails at off‐design operation. The main source of noise within a suction unit can be attributed to the aerodynamically generated noise, at the design as well as at off‐design operation.

Noise Generation by Vacuum Cleaner Suction Units

Among all household appliances, the vacuum cleaner is the most powerful source of noise. The built-in suction unit, consisting of an electric motor and a centrifugal blower, represents the main source of noise; this is partially aerodynamic, mechanical and electromagnetic in origin. The contribution of the particular origin of noise generation to the total noise level depends on the geometry of the suction unit and operating conditions. The aerodynamically generated noise within the blower mostly prevails in the total emitted noise at design and off-design operations, and is especially distinct at partial flow rates when rotating stall and surge appear. The vaned diffuser built into the blower has an important effect on the emitted noise, so on the airborne as well as on the structure-borne noise and their spectra. Detailed analyses of measurement results have shown that the built-in vaned diffuser has numerous disadvantages, including: increase in the tonal and turbulent noise, increase in production costs and reduction of the flow rate, therefore, it could be omitted or replaced by a vaneless one. In this paper, an overview of the effects of the vaned diffuser on the aerodynamic, mechanical and electromagnetic noise origins at different operating conditions is given.

Risk Management in Acute Care Hospital Physical Therapy Departments

[Purpose] A purpose of this study is investigation of risk management organization of a physical therapy section of an acute care hospital. [Subjects] One hundred sixty-nine facilities were selected from among those hospitals registered with the welfare health medical information network (9,019 facilities). [Methods] The study method was a questionnaire survey by mail. The numbers of returned questionnaires was 112, a response rate of 66.3%. [Results] Hospitals sizes ranged from 200~1,500 beds, and the average number of physical therapists was 10.5. The main equipment provided in the physical therapy departments were electrocardiogram monitors, transdermal oxygen saturation level measuring instruments, oxygen tanks, and suction units. In 37.5% of hospitals, nurses did not work in the physical therapy department. [Conclusion] In the near future, physical therapists should be allowed to perform suction technique. Safety in physical therapy was provision of the equipment and the tool of the risk management. The complete procedures are necessary in the case of emergencies.

B21 真空吸引装置によるAl合金の流動評価実験(OS1 機械要素の強さと性能向上VI)

B21 真空吸引装置によるAl合金の流動評価実験(OS1 機械要素の強さと性能向上VI)

Lymphorrhea responds to negative pressure wound therapy

Lymphoceles and lymph fistulas are common complications of femoral exposure for vascular procedures. Three patients who required readmission after their vascular interventions were treated with negative pressure wound therapy. Once adequate control of the drainage was obtained, the patients were discharged home with a portable suction unit. The mean time to stop lymph leak was 14 days, and the mean length of hospital stay was 7.3 days. This method of management offers early control of fluid drainage, rapid control of the wound, earlier closure, and the potential for reduced length of stay. Patient acceptance and convenience may be enhanced by outpatient management and return to work in appropriately motivated individuals.

Noise generation by vacuum cleaner suction units: Part I. Noise generating mechanisms – An overview

Among all household appliances, the vacuum cleaner is the most powerful source of noise. The built-in suction unit, consisting of an electric motor and a centrifugal blower, represents the main source of noise; this is partially aerodynamic, mechanical and electromagnetic in origin. The contribution of the particular origin of noise generation to the total noise level depends on the geometry of the suction unit and operating conditions. The operating point of a suction unit built into a vacuum cleaner depends on the amount of dust particles in the dust bag and is constantly changing during operation until it reaches a zero flow rate. There are differences in noise generation at different operating conditions as well as between the suction units having a blower without and with a vaned diffuser. In this part of the paper, an overview of aerodynamic, mechanical and electromagnetic noise origins at different operating conditions is given.

Noise generation by vacuum cleaner suction units. Part III. Contribution of structure-borne noise to total sound pressure level

Noise emitted by a vacuum cleaner suction unit consists of airborne and structure-borne noise. The airborne noise is generated mainly by the turbo blower and the structure-borne noise is generated mainly by the driving electric motor. The structure-borne noise depends on the suction unit design and on operating conditions, and is especially distinct at partial flow rates when rotating stall and surge appear. Among geometrical parameters, the stator of the blower and the electric motor, or metal shield if any, have the greatest effect on the structure-borne noise. Therefore, in this part of the paper, the effects of vibrations of the electric motor structure on the noise characteristics have been measured and analysed at the design and off-design operation. The contribution of structure-borne sound to the total sound pressure level becomes relatively less important at higher flow rates and with a vaned diffuser built-in the blower.

Noise generation by vacuum cleaner suction units: Part II. Effect of vaned diffuser on noise characteristics

Noise emitted by a vacuum cleaner suction unit has aerodynamic, mechanical and electromagnetic noise origins. The aerodynamically generated noise within the blower mostly prevails in the total emitted noise at design and off-design operations. The vaned diffuser built into the blower has an important effect on the aerodynamically generated noise and its spectra. Therefore, in this part of the paper, the effects of the vaned diffuser on the performance and noise characteristics have been measured and analysed at the design and off-design operation. Analysis of measurement results have shown that the built-in vaned diffuser has numerous disadvantages, including: increase in the rotational noise, increase in the non-rotational turbulent noise, especially at off-design operation, increase in production costs and reduction of the flow rate. Therefore, and due to variable operating conditions of the suction units built into a vacuum cleaner, it could be omitted or replaced by a vaneless one.

Wall or machine suction rectal biopsy for Hirschsprung’s disease: a simple modified technique can improve the adequacy of biopsy

Suction rectal biopsy (SRB) may not include sufficient submucosa for histological diagnosis of Hirschsprung's disease (HD) and a repeat biopsy is required. Substitution of the conventional syringe for sustained suction from a machine or wall suction unit could provide a more consistently adequate tissue biopsy. This study was conducted to compare the adequacy of SRB specimens using a conventional method of syringe suction (SSRB) with those taken by wall or machine suction (WSRB). Hospital records of patients who had a SRB between 2002 and 2004 were studied retrospectively. The biopsy was considered inadequate if there was insufficient submucosa and a repeat specimen was requested. SSRB were taken using the conventional SSRB technique. WSRB were taken with the same Noblett forceps but with suction from wall suction or from a portable suction machine. Ninety-five infants had 103 SRB, 24 had WSRB and all (100%) were adequate for histopathological diagnosis or exclusion of HD. Seventy nine conventional SSRB were undertaken in 71 infants of which 64 (81.02%) were adequate. The difference in adequacy between WSRB and SSRB was statistically significant (P = 0.02). There were no instances of haemorrhage or bowel perforation in either subgroup. WSRB with the Noblett biopsy forceps is more likely to produce an adequate specimen and to reduce the incidence of repeat biopsies.