• Laparoscopic Repair of a Right Paraduodenal Hernia

      Bittner, James G.; Edwards, Michael A.; Harrison, Steven J.; Li, Kelvin; Karmin, Paul N.; Mellinger, John D.; Department of Surgery; Department of Medical Illustration; Department of Radiology (2009)
      Background and Objectives
    • Laparoscopic right paraduodenal hernia repair

      Bittner, James G.; Department of Surgery (2010)
      Letter To Editor
    • Maxillary growth in patients with complete unilateral cleft lip and palate treated with Nasoalveolar molding

      Manente, M; Levy-Bercowski, D; Abreu, A; Fortson, W; Deleon, E; Yu, J; Looney, S; Department of Orthodontics; Department of Plastic Surgery; Department of Biostatistics and Data Science (Augusta University Libraries, 2019)
      In patients with cleft lip and/or palate (CLP), the nasolabial defect has a significant esthetic impact on the face and may impair psychosocial development. Nasoalveolar molding (NAM) is a pre-surgical orthopedic technique aimed to improve the alveolar and nasolabial morphology of patients with cleft lip and palate. This technique is used to facilitate and improve the future surgical correction in cleft lip and palate patients. Influences such as differences in patient age and gingivoperiosteoplasty procedures are among many that have made it difficult for conclusive results to be found and published on the impact of the NAM technique on maxillary growth in patients with complete unilateral cleft lip and palate (CUCLP).
    • Need for criteria for the diagnosis and severity assessment of acute cholangitis and cholecystitis: Tokyo Guidelines.

      Sekimoto, Miho; Takada, Tadahiro; Kawarada, Yoshifumi; Nimura, Yuji; Yoshida, Masahiro; Mayumi, Toshihiko; Miura, Fumihiko; Wada, Keita; Hirota, Masahiko; Yamashita, Yuichi; et al. (2007-01-25)
      The Tokyo Guidelines formulate clinical guidance for healthcare providers regarding the diagnosis, severity assessment, and treatment of acute cholangitis and acute cholecystitis. The Guidelines were developed through a comprehensive literature search and selection of evidence. Recommendations were based on the strength and quality of evidence. Expert consensus opinion was used to enhance or formulate important areas where data were insufficient. A working group, composed of gastroenterologists and surgeons with expertise in biliary tract surgery, supplemented with physicians in critical care medicine, epidemiology, and laboratory medicine, was selected to formulate draft guidelines. Several other groups (including members of the Japanese Society for Abdominal Emergency Medicine, the Japan Biliary Association, and the Japanese Society of Hepato-Biliary-Pancreatic Surgery) have reviewed and revised the draft guidelines. To build a global consensus on the management of acute biliary infection, an international expert panel, representing experts in this area, was established. Between April 1 and 2, 2006, an International Consensus Meeting on acute biliary infections was held in Tokyo. A consensus was determined based on best available scientific evidence and discussion by the panel of experts. This report describes the highlights of the Tokyo International Consensus Meeting in 2006. Some important areas focused on at the meeting include proposals for internationally accepted diagnostic criteria and severity assessment for both clinical and research purposes.
    • Regarding diagnosis and management of Spigelian hernia.

      Bittner, James G.; Department of Surgery (2009-6-26)
    • Sex cord-gonadal stromal tumor of the rete testis.

      Sajadi, Kamran P.; Dalton, Rory R; Brown, James A.; Department of Surgery; Department of Pathology (2009-01-06)
      A 34-year-old tetraplegic patient with suppurative epididymitis was found on follow-up examination and ultrasonography to have a testicular mass. The radical orchiectomy specimen contained an undifferentiated spindled sex cord-stromal tumor arising in the rete testis. Testicular sex cord-stromal tumors are far less common than germ cell neoplasms and are usually benign. The close relationship between sex cords and ductules of the rete testis during development provides the opportunity for these uncommon tumors to arise anatomically within the rete tesis. This undifferentiated sex cord-stromal tumor, occurring in a previously unreported location, is an example of an unusual lesion mimicking an intratesticular malignant neoplasm.
    • Three-dimensional visualisation and articulating instrumentation: Impact on simulated laparoscopic tasks.

      Bittner, James G.; Hathaway, Christopher A; Brown, James A.; Virtual Education and Surgical Simulation Laboratory (VESSL), Section of Urology, Department of Surgery, Medical College of Georgia; Department of Surgery (2009-6-26)
      Laparoscopy requires the development of technical skills distinct from those used in open procedures. Several factors extending the learning curve of laparoscopy include ergonomic and technical difficulties, such as the fulcrum effect and limited degrees of freedom. This study aimed to establish the impact of four variables on performance of two simulated laparoscopic tasks. METHODS: Six subjects including novice (n=2), intermediate (n=2) and expert surgeons completed two tasks: 1) four running sutures, 2) simple suture followed by surgeon's knot plus four square knots. Task variables were suturing angle (left/right), needle holder type (standard/articulating) and visualisation (2D/3D). Each task with a given set of variables was completed twice in random order. The endpoints included suturing task completion time, average and maximum distance from marks and knot tying task completion time. RESULTS: Suturing task completion time was prolonged by 45-degree right angle suturing, articulating needle holder use and lower skill levels (all P < 0.0001). Accuracy also decreased with articulating needle holder use (both P < 0.0001). 3D vision affected only maximum distance (P=0.0108). For the knot tying task, completion time was greater with 45-degree right angle suturing (P=0.0015), articulating needle holder use (P < 0.0001), 3D vision (P=0.0014) and novice skill level (P=0.0003). Participants felt that 3D visualisation offered subjective advantages during training. CONCLUSIONS: Results suggest construct validity. A 3D personal head display and articulating needle holder do not immediately improve task completion times or accuracy and may increase the training burden of laparoscopic suturing and knot tying.
    • Ureteral Clipping Simplifies Hand-Assisted Laparoscopic Donor Nephrectomy

      Brown, James A.; Sajadi, Kamran P.; Wynn, James J.; Department of Surgery (2010)