Technical Development of a New Semispherical Radiofrequency Bipolar Device (RONJA): Ex Vivo and In Vivo Studies

The aim of this study is to inform about the development of a new semispherical surgical instrument for the bipolar multielectrode radiofrequency liver ablation. Present tools are universal; however they have several disadvantages such as ablation of healthy tissue, numerous needle punctures, and, therefore, longer operating procedure. Our newly designed and tested semispherical surgical tool can solve some of these disadvantages. By conducting an in vivo study on a set of 12 pigs, randomly divided into two groups, we have compared efficiency of the newly developed instrument with the commonly used device. Statistical analysis showed that there were no significant differences between the groups. On average, the tested instrument RONJA had shorter ablation time in both liver lobes and reduced the total operating time. The depth of the thermal alteration was on average 4 mm larger using the newly tested instrument. The new radiofrequency method described in this study could be used in open liver surgery for the treatment of small liver malignancies (up to 2 cm) in a single application with the aim of saving healthy liver parenchyma. Further experimental studies are needed to confirm these results before clinical application of the method in the treatment of human liver malignancies

Changes of Vital Parameters after Administration of Butorphanol during Tiletamine-Zolazepam-Ketamine-Xylazine Anaesthesia for Joint Surgery in Miniature Pigs

The study compares the effects of butorphanol in pigs undergoing joint surgery in tiletamine-zolazepam-ketamine-xylazine (TKX) anaesthesia. A total of 12 pigs were divided into 2 groups by 6 animals - BUT (anaesthetized with TKX combination and butorphanol) and CON (control group - anaesthetized with TKX combination only). All pigs were sedated with a mix of tiletamin-zolazepam-ketamin-xylazin, put into total anaesthesia using propofol, and connected to an anaesthesiology unit (O2-Air). For 40 min we logged the heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), haemoglobin saturation by oxygen (SpO2) and end-tidal CO2 concentration (ETCO2) values. Ten minutes after connecting to the devices, the pigs in the BUT group were intravenously administered butorphanol (0.2 mg/kg) in the total volume of 2 ml, or physiological saline in the same volume. The pigs in the BUT group had a lower (p th, 10th and 25th min, and a lower RR in the 10th, 15th and 20th min. MAP, ETCO2 and SpO2 values did not differ substantially. Butorphanol can thus be identified as a suitable analgesic TKX supplement to anaesthesia of miniature pigs with minimum effect on vital functions

A systematic review and meta-analysis of lifestyle and body mass index predictors of successful assisted reproductive technologies

Objective: Lifestyle (smoking, drinking alcohol) and body mass index (BMI) predictors of successful outcomes in assisted reproductive technology (ART) treatments were examined in this meta-analysis. Method: A bibliographic search was undertaken using six databases. The review was informed by PRISMA/MOOSE guidelines. Meta analytic data were analysed using random effects models. Results: We included 77 studies examining effects of BMI, smoking and drinking alcohol. Patients with a BMI25 OR 1.219 (95% CI:1.128–1.319, z 4.971, p<.001; I2 53.779%, p .001). Non-smokers were significantly more likely to achieve a LB or pregnancy than smokers OR 1.457 (95% CI:1.228–1.727, z 4.324, p<.001; I2 51.883; p .001). Meta-regression revealed the number of embryos transferred significantly moderated the effects of smoking on ART outcomes, and there was a trend indicating primary infertility and high BMI were also significant moderators. The evidence for drinking alcohol was inconclusive due to the small number of studies. Conclusions: This meta-analysis confirms that ART treatment success can be predicted with life-style factors. Further, non-smokers’ relative odds of pregnancy/live birth increase as more embryos were transferred but there was a trend that the odds of pregnancy/live birth decrease with primary infertility and high BMI

New semi-spherical radiofrequency energy device for liver resection: an experimental study in pigs

The aim of this experimental study was to verify a new semi-spherical surgical tool for bipolar radiofrequency liver ablation, which can solve some of the disadvantages of the commonly used device, such as the long duration of ablation. A total of 12 pigs which were randomly divided into two groups were used. Each pig underwent resection of the two liver lobes. In group 1, pigs were treated with the commonly used device; in group 2 the newly developed semi-spherical device was used. During surgery and the post-surgical period, many categories were observed and later analyzed. The blood count and biochemistry were monitored on days 0, 14 and 30 from the operation. On day 14 since the liver resection, pigs underwent diagnostic laparoscopy to evaluate their condition focusing on the site of the liver lobe resection. On day 30 after operation, all pigs were euthanized and subjected to histopathological examination. Histopathological evaluation of thermal changes at the resection margin showed strong thermal alteration in both groups. Data between both groups were compared using median test for continuous variables and Fisher’s exact test for categorical variables. Statistical analyses were performed with IBM SPSS software version 18.0. Statistical analysis of collected data did not prove any significant (P < 0.05) differences between the commonly used device and the newly designed surgical tool

Effect of Selected Preoperative Factors on Postoperative Mortality in Dogs with Small Bowel Obstruction

A total of 52 dogs surgically treated for small bowel obstruction were evaluated for selected preoperative clinical and laboratory findings as possible risk factors in regard to postoperative mortality in these patients. Relative risk of postoperative mortality was established for the following preoperative findings and indicators: leukocytosis or leukopaenia, anaemia, hypoalbuminaemia, hypocalaemia, thrombocytopaenia and bacterial peritonitis. Of the selected preoperative factors, connection was demonstrated (p < 0.05) with hypoalbuminaemia, anaemia, thrombocytopaenia and bacterial peritonitis. On the other hand, preoperative findings of hypocalaemia, leukopaenia or leukocytosis were not associated in the monitored group of patients with a higher risk of postoperative patient mortality. In clinical practice, preoperative assessment of the mentioned risk factors connected with a higher postoperative mortality rate could contribute to establishing a more accurate diagnosis in cases of the small bowel obstruction disease in dogs