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Article: Errors in laparoscopic surgery: what surgeons should know.

Galleano, R / Franceschi, A / Ciciliot, M / Falchero, F / Cuschieri, A

2011 Volume 66, Issue 2, Page(s) 107–117

Abstract: Some two decades after its introduction, minimal access surgery (MAS) is still evolving. Undoubtedly, its significant uptake world wide is due to its clinical benefits to patient outcome. These benefits include reduced traumatic insult, reduction of pain, ...

Abstract	Some two decades after its introduction, minimal access surgery (MAS) is still evolving. Undoubtedly, its significant uptake world wide is due to its clinical benefits to patient outcome. These benefits include reduced traumatic insult, reduction of pain, earlier return to bowel function, decrease disability, shorter hospitalization and better cosmetic results. Nonetheless complications due to the laparoscopic approach are not rare as documented by several studies on task specific or procedure related MAS morbidity. In all these instances, error analysis research has demonstrated that an understanding of the underlying causes of these complications requires a comprehensive approach addressing the entire system related to the procedure for identification and characterization of the errors ultimately responsible for the morbidity. The present review covers definition, taxonomy and incidence of errors in medicine with special reference to MAS. In addition, possible root causes of adverse events in laparoscopy are explored and existing methods to study errors are reviewed. Finally specific areas requiring further human factors research to enhance safety of patients undergoing laparoscopic operations are identified. The hope is that awareness of causes and mechanisms of errors may reduce incidence of errors in clinical practice for the final benefit of the patients.
MeSH term(s)	Humans ; Laparoscopy/standards ; Medical Errors/prevention & control ; Medical Errors/statistics & numerical data ; Terminology as Topic
Language	English
Publishing date	2011-04
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	123603-9
ISSN	1827-1626 ; 0026-4733
ISSN (online)	1827-1626
ISSN	0026-4733
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Conference proceedings ; Online: Analysis of the output of two isotype cell sets compared to a precicion spectroradiometer

Norton, M. / Galleano, R. / Siefer, G. / Steiner, M. / Kenny, R. / Zaaiman, W.

Fraunhofer ISE

2015

Abstract: Isotype cells can be used to obtain coarse measurements of the solar spectrum relevant for multi-junction photovoltaic outdoor performance characterization. However, the present literature lacks detailed comparisons between these sensors and high quality ...

Abstract	Isotype cells can be used to obtain coarse measurements of the solar spectrum relevant for multi-junction photovoltaic outdoor performance characterization. However, the present literature lacks detailed comparisons between these sensors and high quality spectroradiometer systems. A measurement campaign has been performed over several days where the outputs of two different isotype sensor sets are compared against the output of an OL750 spectroradiometer. The current generation of each isotype cell has been calculated using its measured spectral response and the spectrum measured by the OL750. The current generation ratios between the different junctions are then calculated, and compared with the measured isotype outputs. The results show a consistent relationship between both sets of isotype cells and the spectroradiometer, with a standard deviation between values of less than 1%. These results support the use of isotype sensors for obtaining broadband spectral measurements of the solar spectrum
Keywords	Materialien - Solarzellen und Technologie ; III-V und Konzentrator-Photovoltaik ; Hochkonzentrierende Systeme (HCPV) ; cells ; spectroradiometer
Subject code	621
Language	English
Publishing country	de
Document type	Conference proceedings ; Online
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Conference proceedings ; Online: Analysis of the output of two isotype cell sets compared to a precicion spectroradiometer

Norton, M. / Galleano, R. / Siefer, Gerald / Steiner, Marc / Kenny, Robert / Zaaiman, W.

2015

Abstract: Art. 050008, 7 S. ... Isotype cells can be used to obtain coarse measurements of the solar spectrum relevant for multi-junction photovoltaic outdoor performance characterization. However, the present literature lacks detailed comparisons between these ... ...

Abstract	Art. 050008, 7 S. Isotype cells can be used to obtain coarse measurements of the solar spectrum relevant for multi-junction photovoltaic outdoor performance characterization. However, the present literature lacks detailed comparisons between these sensors and high quality spectroradiometer systems. A measurement campaign has been performed over several days where the outputs of two different isotype sensor sets are compared against the output of an OL750 spectroradiometer. The current generation of each isotype cell has been calculated using its measured spectral response and the spectrum measured by the OL750. The current generation ratios between the different junctions are then calculated, and compared with the measured isotype outputs. The results show a consistent relationship between both sets of isotype cells and the spectroradiometer, with a standard deviation between values of less than 1%. These results support the use of isotype sensors for obtaining broadband spectral measurements of the solar spectrum
Keywords	Materialien - Solarzellen und Technologie ; III-V und Konzentrator-Photovoltaik ; Hochkonzentrierende Systeme (HCPV) ; cells ; spectroradiometer ; 621 ; 697
Subject code	621
Language	English
Publishing country	de
Document type	Conference proceedings ; Online
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Article: New technique for optical control of the first trocar insertion.

Lombezzi, R / Galleano, R / Lucarini, L / Falchero, F

Minerva chirurgica

2002 Volume 57, Issue 4, Page(s) 527–529

Abstract: Background: In laparoscopic surgery serious complications caused by the blind insertion of the first trocar have been reported even after the pneumoperitoneum is established by means of a Veress needle. As a consequence, some techniques to safely insert ...

Abstract	Background: In laparoscopic surgery serious complications caused by the blind insertion of the first trocar have been reported even after the pneumoperitoneum is established by means of a Veress needle. As a consequence, some techniques to safely insert the first port have been developed. Many surgeons advocate a minilaparotomy to position the first port. However, especially in obese patients, the dissection to insert the Hasson's trocar may be difficult and time consuming. As an alternative, optical disposable trocars have been studied and produced to be safely positioned under direct visualization. Methods: A new technique to insert, under adequate optical control, a non disposable standard port is described. Personal experience in 126 consecutive patients is reviewed. Data were recorded prospectically and insertion time was recorded in every case. Results: Medium time of trocar insertion was 55 sec (range 30-160 sec). Identification of distinct layers of the abdominal wall was always possible. There were no complications related to the insertion of the first reusable cannula under visual control. Conclusions: This technique may be considered a safe, simple and cost effective method to insert the first trocar.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Cholecystectomy, Laparoscopic/instrumentation ; Female ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Optics and Photonics ; Postoperative Complications ; Surgical Instruments ; Time Factors
Language	English
Publishing date	2002-08
Publishing country	Italy
Document type	Comparative Study ; Journal Article
ZDB-ID	123603-9
ISSN	1827-1626 ; 0026-4733
ISSN (online)	1827-1626
ISSN	0026-4733
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Article: Laparoscopic-assisted Hartmann's reversal with the Dexterity Pneumo Sleeve.

Lucarini, L / Galleano, R / Lombezzi, R / Ippoliti, M / Ajraldi, G

Diseases of the colon and rectum

2000 Volume 43, Issue 8, Page(s) 1164–1167

Abstract: Several laparoscopic techniques of Hartmann reversal have been published. An alternative laparoscopic-assisted procedure, essentially aseptic, which uses the minilaparotomy for colostomy mobilization to apply the Dexterity Pneumo Sleeve device is ... ...

Abstract	Several laparoscopic techniques of Hartmann reversal have been published. An alternative laparoscopic-assisted procedure, essentially aseptic, which uses the minilaparotomy for colostomy mobilization to apply the Dexterity Pneumo Sleeve device is described. This technique combines the advantages of the minimally-invasive approach with the direct access of the surgeon's hand to the patient's abdomen.
MeSH term(s)	Asepsis ; Colon/surgery ; Colostomy/methods ; Equipment Design ; Humans ; Laparoscopes ; Laparoscopy/methods ; Surgical Wound Infection/prevention & control
Language	English
Publishing date	2000-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1007/bf02236567
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Article: Trattamento laparoscopico in due tempi della diverticolite acuta complicata. Esperienza iniziale.

Galleano, Raffaele / Di Giorgi, Sebastiano / Franceschi, Angelo / Falchero, Filippo

Annali italiani di chirurgia

2007 Volume 78, Issue 1, Page(s) 61–64

Abstract: Today no secure consensus exists about the best treatment of complicated diverticulitis. The classic surgical procedures are associated to a high immediate and delayed morbidity. In the last few years several more conservative techniques have been ... ...

Title translation	Two-stage laparoscopic management of complicated acute diverticulitis. Initial experience.
Abstract	Today no secure consensus exists about the best treatment of complicated diverticulitis. The classic surgical procedures are associated to a high immediate and delayed morbidity. In the last few years several more conservative techniques have been suggested to allow a later elective resection. Laparoscopic exploration, peritoneal lavage, and drain of the abdominal cavity followed by an elective sigmoid laparoscopic resection is a new minimal invasive approach. This approach has been applied in our unit to treat four patients. All patients had an acute abdomen due to complicated diverticulitis and one patient had evidence of free air at the abdomen x-ray. At emergent operation pus was cleaned, a peritoneal lavage was carried out, a drain was placed near the colonic lesion and another one in the pelvis. Patients fully recovered without complication and 2 to 28 weeks after first operation an elective laparoscopic resection of descending and sigmoid colon with a Knight-Griffen colorectal anastomosis was performed. Neither residual abscess nor dense adhesions were found at the second operations. There were no complications and median hospital stay after the second operation was 10 days (range, 8-13 days). Laparoscopic treatment of generalized peritonitis due to perforated diverticulitis is an attractive alternative to the traditional management of this disease. Our initial results are comparable to that published in the literature. This approach can be safe and effective in selected cases of complicated acute diverticulitis.
MeSH term(s)	Acute Disease ; Aged ; Diverticulitis, Colonic/complications ; Diverticulitis, Colonic/surgery ; Drainage ; Female ; Humans ; Intestinal Perforation/complications ; Intestinal Perforation/surgery ; Laparoscopy/methods ; Male ; Middle Aged ; Peritoneal Lavage ; Peritonitis/etiology ; Peritonitis/surgery ; Treatment Outcome
Language	Italian
Publishing date	2007-01
Publishing country	Italy
Document type	English Abstract ; Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article: Can armrests improve comfort and task performance in laparoscopic surgery?

Galleano, Raffaele / Carter, Fiona / Brown, Stuart / Frank, Timothy / Cuschieri, Alfred

Annals of surgery

2006 Volume 243, Issue 3, Page(s) 329–333

Abstract: Objective: The study sought to determine whether the support provided by armrests influenced task quality, task efficiency, and surgeon comfort during laparoscopic surgery.: Summary background data: Complex laparoscopic surgery requires precise ... ...

Abstract	Objective: The study sought to determine whether the support provided by armrests influenced task quality, task efficiency, and surgeon comfort during laparoscopic surgery. Summary background data: Complex laparoscopic surgery requires precise movements, and usually long execution times and an uncomfortable stance. Discomfort in the shoulders, back, and neck is an established complaint among laparoscopic surgeons and is related to the unnatural postures adopted during laparoscopic interventions. Discomfort, and the associated fatigue, is a contributory factor in the execution of errors. Methods: Nineteen subjects completed a bimanual simulated laparoscopic task both with and without the aid of bilateral armrests. The task was completed in both an ideal unstressed posture and an uncomfortable, stressed elevated posture that more closely represents real laparoscopic operating conditions. Task duration was prolonged sufficiently to precipitate muscular fatigue. The participants also completed a visual analogue scale instrument on level of discomfort symptoms experienced in every part of the upper limbs and vertebral spine. Execution errors (task quality) and completion times (task efficiency) were recorded automatically by the laparoscopic simulator. Results: Error rates and discomfort measures were significantly improved when the armrests were used, but there was no significant change in task completion time. Conclusions: The use of armrests in simulated laparoscopic surgery brings measurable comfort and task performance benefits, which could transfer to actual surgical procedures.
MeSH term(s)	Adult ; Arm ; Computer Simulation ; Equipment Design ; Ergonomics/instrumentation ; Female ; Humans ; Laparoscopy/methods ; Male ; Muscle Fatigue
Language	English
Publishing date	2006-03
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/01.sla.0000201481.08336.dc
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Article: Screening study of abdominal aortic aneurysm in a general population: lipid parameters.

Simoni, G / Gianotti, A / Ardia, A / Baiardi, A / Galleano, R / Civalleri, D

Cardiovascular surgery (London, England)

1996 Volume 4, Issue 4, Page(s) 445–448

Abstract: The level of blood lipids and apolipoproteins in subjects being screened for abdominal aortic aneurysms have been investigated. As part of an ultrasound screening programme in a population of 65- to 75-year-olds, blood samples were collected from 1460 of ...

Abstract	The level of blood lipids and apolipoproteins in subjects being screened for abdominal aortic aneurysms have been investigated. As part of an ultrasound screening programme in a population of 65- to 75-year-olds, blood samples were collected from 1460 of 1504 subjects with a normal aorta (97.1%) and 69 of 70 patients with an abdominal aortic aneurysm > 29 mm (99%). Samples were also taken from 22 of 27 patients (81%) with an ectatic aorta (26-29 mm). Total cholesterol, HDL-cholesterol, LDL-cholesterol, Apo-AI and Apo-B levels were significantly higher in women than in men (P < 0.01). Levels of HDL-cholesterol and Apo-AI were significantly lower in patients with an abdominal aortic aneurysm than in normal subjects (P < 0.001). The mean(s.d.) body mass index was 25.1(3.9) in women and 25.5(3.2) in men with aneurysms and not significantly greater than that of normal subjects (25.2(3.61) and 25.2(3.38) respectively).
MeSH term(s)	Aged ; Aortic Aneurysm, Abdominal/blood ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/prevention & control ; Apolipoprotein A-I/blood ; Apolipoproteins/blood ; Apolipoproteins B/blood ; Body Mass Index ; Cholesterol/blood ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Female ; Humans ; Lipids/blood ; Male ; Mass Screening ; Risk Factors ; Sex Factors ; Ultrasonography
Chemical Substances	Apolipoprotein A-I ; Apolipoproteins ; Apolipoproteins B ; Cholesterol, HDL ; Cholesterol, LDL ; Lipids ; Cholesterol (97C5T2UQ7J)
Language	English
Publishing date	1996-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1160223-5
ISSN	0967-2109
ISSN	0967-2109
DOI	10.1016/0967-2109(95)00140-9
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Article: Il fumo come fattore di rischio nelle arteriopatie.

Simoni, G / Baiardi, A / Galleano, R / Bonalumi, U / Mondini, G / Bachi, V

Minerva cardioangiologica

1994 Volume 42, Issue 5, Page(s) 245–248

Abstract: Tobacco use represents the most powerful chemical addiction, which has been defined as "the inability to discontinue smoking" and it is one of the main cardiovascular risk factors. It produces alterations in platelet activity, blood viscosity and ... ...

Title translation	Smoking as a risk factor in arteriopathies.
Abstract	Tobacco use represents the most powerful chemical addiction, which has been defined as "the inability to discontinue smoking" and it is one of the main cardiovascular risk factors. It produces alterations in platelet activity, blood viscosity and vascular wall and clinical signs related to the different vascular districts. The probability of carotid lesions increases up to 32% for 10 years/smoking and the progression of the disease is proportional to tobacco consumption; on the contrary smoking cessation may be helpful. Furthermore the risk of PAOD increases 2 to 9-fold, irrespective the number of cigarettes and these modify significantly the long-term patency of the femoro-distal reconstructions (57% vs 78% at 2 years). Very impressive indeed the data concerning major amputations (21% vs 2%) and the mortality rate for cardiovascular diseases (83% vs 33%) between smokers and non-smokers. For the abdominal aortic aneurysm too smoking represents the main independent risk factor and the mortality rate rises 6 to 25-fold compared to the normal population. The conclusions are obvious and can be shortly summarized in the following sentence: "Stop smoking and keep walking".
MeSH term(s)	Adult ; Aged ; Amputation ; Aortic Aneurysm, Abdominal/etiology ; Aortic Aneurysm, Abdominal/mortality ; Aortic Aneurysm, Abdominal/prevention & control ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/mortality ; Cardiovascular Diseases/prevention & control ; Coronary Disease/etiology ; Coronary Disease/mortality ; Coronary Disease/prevention & control ; Exercise ; Female ; Humans ; Leg/blood supply ; Leg/surgery ; Male ; Middle Aged ; Risk Factors ; Smoking/adverse effects ; Smoking Cessation ; Thrombophlebitis/etiology ; Thrombophlebitis/prevention & control ; Thrombophlebitis/surgery
Language	Italian
Publishing date	1994-05
Publishing country	Italy
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	123583-7
ISSN	1827-1618 ; 0026-4725
ISSN (online)	1827-1618
ISSN	0026-4725
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Article ; Online: Anastomosis configuration and technique following ileocaecal resection for Crohn's disease: a multicentre study.

Celentano, Valerio / Pellino, Gianluca / Spinelli, Antonino / Selvaggi, Francesco / Rottoli, Matteo / Poggioli, Gilberto / Sica, Giuseppe / Giglio, Mariano Cesare / Campanelli, Michela / Coco, Claudio / Rizzo, Gianluca / Sionne, Francesco / Colombo, Francesco / Sampietro, Gianluca / Lamperti, Giulia / Foschi, Diego / Ficari, Ferdinando / Vacca, Ludovica / Cricchio, Marta /

Giudici, Francesco / Selvaggi, Lucio / Sciaudone, Guido / Peltrini, Roberto / Manfreda, Andrea / Bucci, Luigi / Galleano, Raffaele / Ghazouani, Omar / Zorcolo, Luigi / Deidda, Simona / Restivo, Angelo / Braini, Andrea / Di Candido, Francesca / Sacchi, Matteo / Carvello, Michele / Martorana, Stefania / Bordignon, Giovanni / Angriman, Imerio / Variola, Angela / Di Ruscio, Mirko / Barugola, Giuliano / Geccherle, Andrea / Tropeano, Francesca Paola / Luglio, Gaetano / Tanzanu, Marta / Sasia, Diego / Migliore, Marco / Giuffrida, Maria Carmela / Marrano, Enrico / Moretto, Gianluigi / Impellizzeri, Harmony / Gallo, Gaetano / Vescio, Giuseppina / Sammarco, Giuseppe / Terrosu, Giovanni / Calini, Giacomo / Bondurri, Andrea / Maffioli, Anna / Zaffaroni, Gloria / Resegotti, Andrea / Mistrangelo, Massimiliano / Allaix, Marco Ettore / Botti, Fiorenzo / Prati, Matteo / Boni, Luigi / Perotti, Serena / Mineccia, Michela / Giuliani, Antonio / Romano, Lucia / Graziano, Giorgio Maria Paolo / Pugliese, Luigi / Pietrabissa, Andrea / Delaini, GianGaetano

Updates in surgery

2021 Volume 73, Issue 1, Page(s) 149–156

Abstract: A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study ...

Abstract	A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30 days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. 427 patients were included. The side to side anastomosis was the chosen configuration in 380 patients (89%). The stapled anastomotic (n = 286; 67%), techniques were preferred to hand-sewn (n = 141; 33%). Postoperative morbidity was 20.3% and anastomotic leak 3.7%. Anastomotic leak was independent of the type of anastomosis performed, while was associated with an ASA grade ≥ 3, presence of perianal disease and ileocolonic localization of disease. Four predictors of LOS were identified after multivariate analysis. The laparoscopic approach was the only associated with a reduced LOS (p = 0.017), while age, ASA grade ≥ 3 or administration of preoperative TPN were associated with increased LOS. The side to side was the most commonly used anastomotic configuration for ileocolic reconstruction following primary CD resection. There was no difference in postoperative morbidity according to anastomotic technique and configuration. Anastomotic leak was associated with ASA grade ≥ 3, a penetrating phenotype of disease and ileo-colonic distribution of CD.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical/adverse effects ; Anastomosis, Surgical/methods ; Anastomotic Leak/epidemiology ; Anastomotic Leak/etiology ; Cecum/surgery ; Crohn Disease/surgery ; Digestive System Surgical Procedures/adverse effects ; Digestive System Surgical Procedures/methods ; Elective Surgical Procedures/methods ; Female ; Humans ; Ileum/surgery ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Length of Stay/statistics & numerical data ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Reconstructive Surgical Procedures/methods ; Retrospective Studies ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2021-01-06
Publishing country	Italy
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-020-00918-z
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