A new strategy for managing presacral venous hemorrhage：bipolar coagulation hemostasis

Massive presacral venous hemorrhage is dangerous and difficult to manage. Traditional methods for controlling this condition include packing with laparotomy pads, the use of sterile thumbtacks,1 ligation of the internal iliac vessel,2 and selective arterial embolization.3 These methods are generally ineffective. Recently, several other methods for controlling presacral bleeding have been reported, such as occlusion of the wound with rectus muscle fragment welding,4 oppression with sterile normal saline bags,5 balloon tamponade,6 and the use of endoscopic staples.7 However, these measures fail to arrest the bleeding in some patients, resulting in massive hemorrhage and even death.

Adverse events associated with the gold probe and the injection gold probe devices used for endoscopic hemostasis:A MAUDE database analysis

BACKGROUND Gastrointestinal(GI)bleeding accounts for over half a million admissions annually and is the most common GI diagnosis requiring hospitalization in the United States.Bipolar electrocoagulation devices are used for the management of gastrointestinal bleeding.There is no data on device-related adverse events for gold probe(GP)and injection gold probe(IGP).AIM To analyze this using the Food and Drug Administration(FDA’s)Manufacturer and User Facility Device Experience(MAUDE)database from 2013 to 2023.METHODS We examined post-marketing surveillance data on GP and IGP from the FDA MAUDE database to report devicerelated and patient-related adverse events between 2013-2023.The MAUDE database is a publicly available resource providing over 4 million records relating to medical device safety.Statistical analyses were performed using IBM SPSS Statistics V.27.0(IBM Corp.,Armonk,NY,United States).RESULTS Our search elicited 140 reports for GP and 202 reports for IGP,respec-tively,during the study period from January 2013 to August 2023.Malfunctions reportedly occurred in 130 cases for GP,and actual patient injury or event occurred in 10 patients.A total of 149 patients(74%)reported with Injection GP events suffered no significant consequences due to the device failure,but 53 patients(26%)were affected by an event.CONCLUSION GP and IGP are critical in managing gastrointestinal bleeding.This study of the FDA MAUDE database revealed the type,number,and trends of reported device-related adverse events.The endoscopist and support staff must be aware of these device-related events and be equipped to manage them if they occur.

Treatment of symptomatic epilepsy with lesionectomies combined with bipolar coagulation of the surrounding cortex

Objective To observe the clinical effects of lesionectomies combined with bipolar coagulation of the surrounding cortex (BCSC) on symptomatic epilepsy. Methods The effectiveness of lesionectomies combined with BCSC (71 patients) and of lesionectomies alone (78 patients) were compared in follow-up surveys conducted 2-5 years (average of 37 months) post-operation.Results Treatment in the BCSC group was significantly more effective than in the lesionectomy group (P<0.01). Meanwhile, patients in the BCSC group suffered no permanent post-operative complications. Conclusion Lesionectomy combined with BCSC is a new, effective and safe treatment for symptomatic epilepsy.

Clinical uses of ligasure vessel sealing system (LVSS) in surgery

This article provides the efficacy of the new device, Ligasure Vessel Sealing System（LVSS） for achieving hemostasis. LVSS is an alternative to suture ligatures, hemoclips, staplers, for ligating vessels and tissue bundles. This new device seals the vessels up to 7 mm in diameter by denaturing collagen and elastin within vessel wall and surrounding connective tissue.