بایگانی برچسب برای: Surgery

Advanced Colonoscopy and Endoluminal Surgery[taliem.ir]

Advanced Colonoscopy and Endoluminal Surgery

Philipp Bozzini is considered by many the father of endoscopy. Born in Mainz, Germany, in 1773, Bozzini’s goal was to examine the inner cavities of the human body in designing the Lichtleiter, or “light conductor.” He recognized the importance of direct observation in the ability to understand the physiology and function of human organs . With his design, he also foresaw the ability to perform new procedures and to make existing procedures safer by allowing, for instance, the removal of rectal polyps or cervical tumors to be done under direct visualization rather than to depend on luck. The original Lichtleiter consisted of a vase-shaped lantern made of tin and covered with leather . Within this housed the light source, a wax candle, on a spring device designed to keep the flame at a constant height. A concave mirror was placed to project light through an aperture, onto which various tubular specula could be attached. The mirror directed light toward the hollow organ and avoided reflection toward the observer’s eye . On the opposite side was another fenestration onto which an eyepiece was attached for the observer . The tubular specula were made of brass or silver and modifed based of the organ they were meant for: urethra, vagina, rectum, and so on . His conductors were straight to avoid deviating from the straight lines on which light rays travel. In order to observe objects at an angle, for instance behind the nasopharynx, he used a mirror to bend the light. He did note, however, that bending the light compromised the clarity of the image
Acute Care Surgery Around the World.[taliem.ir]

Acute Care Surgery Around the World: Future Perspectives

Increasing specialization and fragmentation of ‘general surgery’ has reduced the role of surgeons to care for patients with acute surgical emergencies. The need for such services, however, has escalated due to the population living to older age with increasingly complex diseases and co-morbidities. Compounding the problem is the mounting number of severely injured patients in the emergency departments which are already filled to capacity by non-emergency patients. Other factors have also contributed to the emergence of the new specialty of ‘acute care surgery’. These include the dissatisfaction of surgeons with trauma as a career in the current era of non-operative management of many traumatic injuries; the loss of traditional general surgery cases to ‘organ-specific practices’ (e.g. colon and rectal surgery, upper GI surgery, endocrines) and highly specialized techniques (minimally invasive surgery, organ transplantation, and robotic surgery). Even nonsurgical specialties, for example interventional radiology and gastrointestinal endoscopy have eroded the modern surgical practice. The time was ripe for the creation of a new specialty, acute care surgery, created and developed by the American Association of Surgery for Trauma (AAST).