Laparoscopic adrenalectomy by the lateral transperitoneal approach in patients with a history of previous abdominal surgery

INTRODUCTION: Even the half of patients undergoing laparoscopic adrenalectomy has history of previous abdominal surgeries. However, it is still uncertain if this fact has an impact on the operation itself as well as the postoperative course. AIM: To analyze the effects of previous abdominal surgery on surgical outcomes in adrenal tumor patients subjected to laparoscopic adrenalectomy. MATERIAL AND METHODS: This study included 268 patients with adrenal gland tumors operated on by means of laparoscopic lateral transperitoneal adrenalectomy: 1) previously subjected to at least one abdominal surgery (group A, n = 101), or 2) with no history of previous abdominal operations (group B, n = 167). RESULTS: Groups A and B did not differ in terms of tumor size (p = 0.132), mean operation time (p = 0.456), mean intraoperative blood loss (p = 0.754), or perioperative complication rate (p = 0.833). Dissection of intraperitoneal adhesions was considered difficult in 32 patients from group A (31.6%) and 8 subjects from group B (4.7%, p < 0.001). Conversion was required in three subjects from group A (2.9%) and 3 patients from group B (1.8%, p = 0.529). CONCLUSIONS: Previous abdominal surgery does not constitute a contraindication to laparoscopic transperitoneal adrenalectomy

Prediction of technical difficulties in laparoscopic splenectomy and analysis of risk factors for postoperative complications in 468 cases

Prediction of intraoperative difficulties may be helpful in planning surgery; however, few studies explored this issue in laparoscopic splenectomy (LS). We performed retrospective analysis of consecutive 468 patients undergoing LS from 1998 to 2017 (295 women; median age 47 years). The patients were divided into difficult LS and control groups. The inclusion criteria for difficult LS were operative time &#8805;mean + 2SD; intraoperative blood loss &#8805;500 mL, intraoperative adverse events (IAE), conversion. Primary outcomes were risk factors for difficult splenectomy and secondary outcomes for perioperative morbidity. Fifty-six patients were included in the difficult LS group (12%). Spleens &#8805;19 cm and higher participation of younger surgeons in consecutive years were predictive for difficult splenectomy. Age &#8805;53 years and diagnosis other than idiopathic thrombocytopenic purpura (ITP) were independent risk factors of spleen &#8805;19 cm. The perioperative morbidity was 8.33%; its OR was increased only by blood loss and IAEs. Only blood loss significantly increased serious morbidity. Male sex, spleens &#8805;19 cm, and IAEs were independent risk factors for intraoperative hemorrhage. Spleen length &#8805;19 cm was a risk factor for difficult LS and intraoperative hemorrhage. Diagnoses other than ITP in patients aged &#8805;53 years with &#8805;19 cm spleens are predictive for intraoperative difficulties and perioperative complications

A Low-Cost pH Sensor Based on RuO2 Resistor Material

Fresh water deficiency caused by climate change calls for employing novel measures to ensure safety of drinking water supply. Wireless sensor networks can be used for monitoring hydrological conditions across wide area, allowing flow forecasting and early detection of pollutants. While there are no fundamental technological obstacles to implementation of large area sensor networks, their feasibility is constrained by unit cost of sensing nodes. This paper describes a low-cost pH sensor, intended for use in fresh water monitoring. The sensor was fabricated in a standard thick film process, and an off-the-shelf resistive paste was used as a sensing material. For the fabrication of sensor, RuO2 resistive paste was screen printed on the alumina substrate with silver conducting layer. Test solutions with pH ranging from 2 to 10 were prepared from HCl or KOH solutions. The potential difference between reference and sensing electrode (electromotive force emf of an electrochemical cell) should be proportional to the pH of a solution according to the Nernst equation. The fabricated sensor exhibits Nernstian response to pH. Influence of storage conditions on sensing performance was also investigated