Chu Xiangyang. / Thesis submitted in: December 1999. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 130-148). / Abstracts in English and Chinese. / ABSTRACT --- p.i / ACKNOWLEDGMENTS --- p.v / ABBREVIATION --- p.vi / TABLE OF CONTENT --- p.viii / Chapter 1. --- Introduction / Chapter 1.1 --- General introduction --- p.1 / Chapter 1.2 --- History of laparoscopic surgery --- p.2 / Chapter 1.2.1 --- Diagnostic laparoscopy --- p.3 / Chapter 1.2.2 --- Operative laparoscopy --- p.5 / Chapter 1.2.3 --- Pediatric laparoscopy --- p.6 / Chapter 1.3 --- Pathophysiology of pneumoperitoneum --- p.8 / Chapter 1.3.1 --- Choice of gas for pneumoperitoneum --- p.9 / Chapter 1.3.2 --- C02 absorption and acid-base balance --- p.10 / Chapter 1.3.3 --- Effects of pneumoperitoneum on respiratory system --- p.16 / Chapter 1.3.4 --- Effects of pneumoperitoneum on circulatory system --- p.17 / Chapter 1.3.4.1 --- Due to hypercarbia --- p.18 / Chapter 1.3.4.2 --- Due to increased intraabdominal pressure (IAP) --- p.21 / Chapter 1.4 --- Pathophysiology of peritonitis --- p.26 / Chapter 1.4.1 --- Animal model of peritonitis --- p.26 / Chapter 1.4.2 --- Effects of peritonitis on cardiovascular system --- p.30 / Chapter 1.5 --- The purpose of this study --- p.33 / Chapter 2. --- Materials and Methods / Chapter 2.1 --- Animals and grouping --- p.34 / Chapter 2.2 --- Anaesthesia and procedures --- p.35 / Chapter 2.3 --- Pulmonary monitoring --- p.41 / Chapter 2.4 --- Hemodynamic monitoring --- p.42 / Chapter 2.4.1 --- Arterial catheter --- p.42 / Chapter 2.4.2 --- Pulmonary arterial catheter --- p.43 / Chapter 2.4.3 --- Cardiac output measurement --- p.44 / Chapter 2.5 --- Experimental design --- p.45 / Chapter 2.5.1 --- Operative intervention --- p.47 / Chapter 2.5.2 --- C02 pneumoperitoneum --- p.47 / Chapter 2.5.3 --- Data collection --- p.48 / Chapter 2.6 --- Blood gas analysis --- p.49 / Chapter 2.7 --- Oxygenation analysis --- p.50 / Chapter 2.8 --- Histological study --- p.51 / Chapter 2.9 --- Equations used for calculations --- p.54 / Chapter 2.10 --- Statistical analysis --- p.55 / Chapter 3. --- Results / Chapter 3.1 --- Baseline physiological measurements --- p.56 / Chapter 3.2 --- Acid-base balance measurements --- p.58 / Chapter 3.2.1 --- End tidal C02 tension (PetC02) --- p.58 / Chapter 3.2.2 --- Arterial partial pressure of C02 (PaC02) --- p.60 / Chapter 3.2.3 --- Arterial pH (pHa) --- p.62 / Chapter 3.2.4 --- Arterial bicarbonate (HC03a-) --- p.67 / Chapter 3.2.5 --- Arterial base excess (BEa) --- p.72 / Chapter 3.3 --- Hemodynamic measurements --- p.77 / Chapter 3.3.1 --- Mean arterial pressure (MAP) --- p.77 / Chapter 3.3.2 --- Central venous pressure (CVP) --- p.82 / Chapter 3.3.3 --- Mean pulmonary artery pressure (MPAP) --- p.84 / Chapter 3.3.4 --- Pulmonary artery wedge pressure (PAWP) --- p.86 / Chapter 3.3.5 --- Heart rate (HR) --- p.88 / Chapter 3.3.6 --- Cardiac index (CI) --- p.93 / Chapter 3.3.7 --- Stroke volume index (SVI) --- p.96 / Chapter 3.3.8 --- Systemic vascular resistance index (SVRI) --- p.98 / Chapter 3.3.9 --- Pulmonary vascular resistance index (PVRI) --- p.100 / Chapter 3.4 --- Respiratory and oxygenation measurements --- p.101 / Chapter 3.4.1 --- Peak inspiratory pressure (PIP) --- p.101 / Chapter 3.4.2 --- Arterial oxygen saturation (Sa02) --- p.105 / Chapter 3.4.3 --- Arterial oxygen content (Ca02) --- p.107 / Chapter 3.4.4 --- Oxygen delivery index (D02I) --- p.107 / Chapter 3.4.5 --- Oxygen consumption index (V02I) --- p.107 / Chapter 3.5 --- Pathology --- p.108 / Chapter 4. --- Discussion / Chapter 4.1 --- Effects on C02 homeostasis --- p.112 / Chapter 4.2 --- Effects on hemodynamics --- p.117 / Chapter 4.2 --- Effects on oxygenation --- p.123 / Chapter 4.3 --- Evaluation of the animal model --- p.124 / Chapter 5. --- Conclusion / Chapter 5.1 --- Conclusion --- p.127 / Chapter 5.2 --- Future prospective --- p.129 / BIBLIOGRAPHY --- p.130

The purpose of this study is to compare short-term surgical outcomes of robotic and abdominal myomectomy and to analyze the factors affecting the total operative time, estimated blood loss and length of hospital stay from a retrospective study of a consecutive case series of 122 pa-tients with symptomatic leiomyomata. Wilcoxon, t tests, multiple linear and logistic regressions analyses were performed. Patients in abdominal group had larger number of leiomyomata, larger tumor size and BMI. The operative time was longer in robotic group and was affected by the size and number of tumors, parity and interaction between parity and BMI. Estimated blood loss was lower in robotic group and was affected by the size and number of tumors .The pre-dicted odds of staying one day or less in the hospital for robotic group was 193.5 times the odds for abdominal group and was affected by the size and number of tumors.

Diss. (sammanfattning) Uppsala : Univ., 2003. / Härtill 5 uppsatser.

Background: The liver biopsy technique in dogs that consistently provides samples adequate for accurate histopathologic interpretation and the variability of histopathology among lobes is unknown. Hypothesis:  Liver biopsy specimens obtained via punch, cup biopsy, and 14 gauge needle biopsy would result in similar histopathologic diagnoses to those found on deeply sectioned samples of liver obtained at necropsy and that discordant results would not differ between lobes.   Animals:  Seventy dogs undergoing necropsy. Methods: Liver specimens were obtained from the left lateral liver lobe with an 8 mm punch, a cup, and a 14 gauge needle. Two larger tissue samples were then collected near the center of the left lateral lobe and used as a histologic standard for comparison.  Samples were also obtained from all remaining lobes. Histopathologic features and numbers of portal triads in each sample were compared. Results: The mean number of portal triads were 2.9 in needle biopsies, 3.4 in cup biopsies, 12 in punch biopsies, and 30.7 in the necropsy samples. Sixty-six percent of needle biopsies,  60% of laparoscopic cup samples, and 69% of punch samples were in agreement with the necropsy samples, differences that were not significantly different. The corresponding kappa coefficient were 0.59 for needle biopsies, 0.52 for cup biopsies, and 0.62 for punch biopsies.  Discordant results did not differ between the liver lobes. Conclusions and Clinical Relevance:  A single biopsy using any of the tested techniques is insufficient for reliable diagnosis of liver disease in the dog.  Multiple biopsies from 2 lobes is recommended. / Master of Science

The objective of this study was to compare the effects of postoperative pain following ovariohysterectomy via harmonic scalpel assisted laparoscopy (HALO) and traditional ovariohysterectomy (OVH) in dogs. The study was designed as a randomized, blinded, prospective study. Sixteen, purpose-bred, intact female, Beagle dogs were used to complete the study. Dogs were placed into two groups. Group 1 included (8 dogs) that underwent ovariohysterectomy via HALO. Group 2 included (8 dogs) that underwent ovariohysterectomy via traditional OVH. Physiologic data, abdominal nociceptive threshold scores, and University of Melbourne pain scores (UMPS) were recorded at 2, 6, 12, 24, 48, and 72 hours following surgery. Blood samples for plasma cortisol, glucose, and creatine phosphokinase (CPK) were taken at the time of the incision and 2, 6, 12, 24, 48, and 72 hours following surgery. No significant surgical complications were encountered in either group. The HALO mean surgical time was significantly longer (55.7 minutes) than the traditional OVH (31.7 minutes). No significant differences were observed between the two groups for the pain measures of heart rate, respiratory rate, temperature, CPK, and glucose. The OVH group had significantly higher mean plasma cortisol levels at hour 2 following surgery than the HALO group (P=0.0001). The mean UMPS were significantly higher in the OVH group than the HALO group at all postoperative times (P=0.0001). Mean nociceptive threshold measurements revealed significantly higher tolerated palpation pressures in the HALO than the OVH group at all postoperative times, except hour 72 (P=0.0002). Dogs in this study appeared to be less painful with HALO procedures versus traditional OVH. The harmonic scalpel coagulated ovarian and uterine vessels completely with minimal collateral damage to surrounding tissues. The clinical relevance of this study demonstrates that harmonic scalpel-assisted laparoscopic ovariohysterectomy is a safe alternative to traditional OVH and offers a minimally invasive and less painful method of surgery. / Master of Science

by Enders Kwok Wai Ng. / Thesis (M.D.)--Chinese University of Hong Kong, [1999]. / Includes bibliographical references (p. 178-203). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web.

Laparoscopic surgery provides major benefits to patients in terms of decreased pain and post-operative hospital stays, but also increases their risks of intra-operative injuries because of the reduction in feedback in the tactile and visual channels compared to open surgery. Although the limitations of laparoscopy have been studied, the specific role of force feedback in laparoscopic surgery performance is not well understood. The purpose of this thesis is to determine the effect of force feedback on the ability to accurately discriminate tissue compliance by comparing subjective tissue softness assessment, force output, and subjective force assessment, in conventional and laparoscopic setups. The experimental trials involved eleven participants providing evaluations for a range of compliant samples, and analyzed their force output as well as their subjective evaluation of force output. The results of this investigation show that the accuracy of compliance discrimination is worse when using indirect probing compared to direct probing, and that the force used in direct probing is lower than the indirect scenario. Further, the subjective assessment of force output in direct probing is not significantly different compared to indirect probing. Further research involving more replication, expert of laparoscopy, and a focus on grip force are recommended to better understand our awareness of the subjective force output.

Laparoscopic surgery provides major benefits to patients in terms of decreased pain and post-operative hospital stays, but also increases their risks of intra-operative injuries because of the reduction in feedback in the tactile and visual channels compared to open surgery. Although the limitations of laparoscopy have been studied, the specific role of force feedback in laparoscopic surgery performance is not well understood. The purpose of this thesis is to determine the effect of force feedback on the ability to accurately discriminate tissue compliance by comparing subjective tissue softness assessment, force output, and subjective force assessment, in conventional and laparoscopic setups. The experimental trials involved eleven participants providing evaluations for a range of compliant samples, and analyzed their force output as well as their subjective evaluation of force output. The results of this investigation show that the accuracy of compliance discrimination is worse when using indirect probing compared to direct probing, and that the force used in direct probing is lower than the indirect scenario. Further, the subjective assessment of force output in direct probing is not significantly different compared to indirect probing. Further research involving more replication, expert of laparoscopy, and a focus on grip force are recommended to better understand our awareness of the subjective force output.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.