Gastric ulcer treated using an elastic traction ring combined with clip: A case report

BACKGROUND There is a high annual incidence of acute,nonvariceal upper gastrointestinal bleeding in Chinese adults.Early endoscopic intervention can reduce rates of rebleeding,surgery,and mortality.The metal clip is the most common method for establishing homeostasis;however,it possesses several limitations.In patients with bleeding secondary to large gastric ulcers,the clip will often fail to stop the bleeding.This article highlights the use of an elastic traction ring as a novel hemostatic method for patients with upper gastrointestinal bleeding.CASE SUMMARY An elderly male presented to the emergency room with complaints of hematemesis and melena.Endoscopic examination revealed an ulcer(Forrest IIa)in the lesser curvature of the gastric antrum.Six tissue clips and one elastic traction ring were inserted into the stomach cavity to suture the ulcer.The patient recovered quickly without postoperative gastrointestinal bleeding.Two months later,the patient's ulcer was significantly healed.CONCLUSION To our best knowledge,this is the first report to demonstrate the safety and efficacy of elastic traction rings for upper gastrointestinal bleeding.Elastic traction rings should be considered a routine therapeutic modality for patients with upper gastrointestinal bleeds.

Experimental and finite element analysis studies of a reduction-force reducing traction method for pelvic fracture surgeries

Pelvic fracture is among the most complicated fractures in traumatic orthopedics,with high mortality and morbidity rates.The main difficulty associated with the reduction surgery is significant muscle resistance.It then becomes necessary to decrease the reduction force against this strong muscle resistance,for improving surgical safety.Here,we propose a novel traction method for decreasing the reduction force during pelvic reduction,and investigate the performance of the elastic traction method on decreasing the reduction force using experimental tests and simulation-based analyses.From the experimental results,the reduction force decreased by 59.2%when 10 kg of elastic traction was applied.We also establish a musculoskeletal model of the pelvic fracture reduction,for analyzing the muscle resistance and the optimal traction force applied in reduction surgeries.The elastic traction method can counteract the muscle resistance increase in the non-traction direction owing to its flexibility.We conclude that the optimal traction force applied should be in the 10–15 kg range,and recommend adopting a dynamic traction strategy rather than continuous traction in clinical settings.Elastic traction is very promising for various surgeries that require traction,including pelvic reduction.It significantly reduces force,which can significantly reduce the physical exertion of the operating surgeon,the possibility of additional injuries to the operated patient,and promotes robot-assisted reduction surgeries.