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Article: Transanal Hemorrhoidal Dearterialization (THD) Anolift-Prospective Assessment of Safety and Efficacy.

Giordano, Pasquale / Schembari, Elena

2021 Volume 8, Page(s) 704164

Abstract: The adjunct of a mucopexy to conventional dearterialization has become a routine part of the transanal hemorrhoidal dearterialization procedure in order to facilitate the management of the prolapsing component and has helped to expand the indications of ... ...

Abstract	The adjunct of a mucopexy to conventional dearterialization has become a routine part of the transanal hemorrhoidal dearterialization procedure in order to facilitate the management of the prolapsing component and has helped to expand the indications of this technique to more advanced stages of hemorrhoidal disease. A simple technical modification of THD with targeted mucopexy (TM), called Anolift, is described. The aim of the study was to evaluate the safety and effectiveness of this technical variation. The procedure consisted of two parts: one aimed at the dearterialization and the other concentrated on the management of the prolapsing component. Once all the arteries were identified and transfixed an Anolift targeted mucopexy was performed using a continuous barbed suture with a synthetic absorbable monofilament (Polydioxanone) 2/0 Filbloc (Assut Europe) stitch mounted on a 4/8 30 mm needle. Severity of hemorrhoidal symptoms was scored from 0 to 20 using a dedicated questionnaire: the Hemorrhoidal Assessment Severity Score (HASS). From May 2018 to November 2020, 60 patients with hemorrhoidal disease (HD) underwent a THD Anolift procedure. Three patients experienced severe post-operative pain and 10 (23%) suffered with difficulty in evacuation. The median follow-up period was 15.5 months (range 2-32 months). The mean HASS changed from 16.43 pre-operatively to 1.95 post-operatively (
Language	English
Publishing date	2021-09-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2021.704164
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Article ; Online: Mesh mediated fascial traction in the management of the open abdomen: A video vignette.

Schembari, Elena / Richardson, Carl / King, Andrew T / Layfield, David M

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2023 Volume 26, Issue 1, Page(s) 207–210

MeSH term(s)	Humans ; Traction ; Surgical Mesh ; Abdomen/surgery ; Fascia ; Negative-Pressure Wound Therapy ; Abdominal Wound Closure Techniques ; Fasciotomy
Language	English
Publishing date	2023-11-29
Publishing country	England
Document type	Video-Audio Media ; Letter
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16816
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Zs.A 5799: Show issues

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Article ; Online: THD Anolift for advanced haemorrhoidal disease: a video vignette.

Giordano, Pasquale / Schembari, Elena / Cocco, Francesca / Gallo, Gaetano

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2022 Volume 24, Issue 8, Page(s) 1018–1019

MeSH term(s)	Anal Canal ; Hemorrhoids/surgery ; Humans ; Rectum
Language	English
Publishing date	2022-04-15
Publishing country	England
Document type	Letter ; Video-Audio Media
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16134
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Article ; Online: The surgical treatment of Morgagni hernias in adults: a systematic review for the standardization of laparoscopic surgical repair.

Schembari, Elena / Reitano, Elisa / Sofia, Maria / Latteri, Saverio / La Greca, Gaetano

Updates in surgery

2023

Abstract: A Morgagni hernia is a congenital diaphragmatic hernia that is rarely diagnosed in adults, and the technique for its repair has not yet been standardized. This review will give an overview of the different laparoscopic methods reported by other authors, ... ...

Abstract	A Morgagni hernia is a congenital diaphragmatic hernia that is rarely diagnosed in adults, and the technique for its repair has not yet been standardized. This review will give an overview of the different laparoscopic methods reported by other authors, highlighting the key points indicating a good repair to help standardize the technique. A systematic review of the available articles on PubMed was conducted according to PRISMA 2020 by two authors independently in May 2022. Only articles written in English were included. A total of 180 case reports of laparoscopic Morgagni's hernia repair procedures were found; direct repair was performed in 59 patients, mesh was used in 119 patients, and mesh was not used in 2 patients. The hernia sac was removed in 71 patients, and the defect was closed before mesh placement in 49 patients. Nonabsorbable, dual or biologic mesh was used. The mean operative time was 92.65 min for direct repair and 84.11 min for mesh repair. One recurrence was reported in the direct repair series. The optimal method of repair has not yet been identified. The laparoscopic approach is associated to fewer complications and facilitates a faster recovery than the open approach. Several manoeuvres have been reported to help surgeons, who are not trained in laparoscopic knotting, perform extracorporeal knotting. Mesh should be placed when tension is too high after a direct repair or when primary closure cannot be achieved.
Language	English
Publishing date	2023-11-04
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-023-01677-3
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Article ; Online: Forty years after the first totally implantable venous access device (TIVAD) implant: the pure surgical cut-down technique only avoids immediate complications that can be fatal.

Toro, Adriana / Schembari, Elena / Fontana, Emanuele Gaspare / Di Saverio, Salomone / Di Carlo, Isidoro

Langenbeck's archives of surgery

2021 Volume 406, Issue 6, Page(s) 1739–1749

Abstract: Aim: Even though TIVADs have been implanted for a long time, immediate complications are still occurring. The aim of this work was to review different techniques of placing TIVAD implants to evaluate the aetiology of immediate complications.: Methods!# ...

Abstract	Aim: Even though TIVADs have been implanted for a long time, immediate complications are still occurring. The aim of this work was to review different techniques of placing TIVAD implants to evaluate the aetiology of immediate complications. Methods: A systematic literature review was performed using the PubMed, Cochrane and Google Scholar databases in accordance with the PRISMA guidelines. The patient numbers, number of implanted devices, specialists involved, implant techniques, implant sites and immediate complication onsets were studied. Results: Of the 1256 manuscripts reviewed, 36 were eligible for inclusion in the study, for a total of 17,388 patients with equivalent TIVAD implantation. A total of 2745 patients (15.8%) were treated with a surgical technique and 14,643 patients (84.2%) were treated with a percutaneous technique. Of the 2745 devices (15.8%) implanted by a surgical technique, 1721 devices (62.7%) were placed in the cephalic vein (CFV). Of the 14,643 implants (84.2%) placed with a percutaneous technique, 5784 devices (39.5%) were placed in the internal jugular vein (IJV), and 5321 devices (36.3%) were placed in the subclavian vein (SCV). The number of immediate complications in patients undergoing surgical techniques was 32 (1.2%) HMMs. In patients treated with a percutaneous technique, the number of total complications were 333 (2.8%): 71 PNX (0.5%), 2 HMT (0.01%), 175 accidental artery punctures AAP (1.2%) and 85 HMM (0.6%). No mortality was reported with either technique. Conclusion: The percutaneous approach is currently the most commonly used technique to implant a TIVAD, but despite specialist's best efforts, immediate complications are still occurring. Surgical cut-down, 40 years after the first implant, is still the only technique that can avoid all of the immediate complications that can be fatal.
MeSH term(s)	Catheterization, Central Venous/adverse effects ; Catheters, Indwelling/adverse effects ; Humans ; Jugular Veins ; Subclavian Vein
Language	English
Publishing date	2021-06-09
Publishing country	Germany
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-021-02225-6
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Article: Traumatic limb wounds management: Efficacy of silver and hyaluronic acid-containing dressings.

Schembari, Elena / Latteri, Saverio / Reitano, Elisa / Russello, Domenico / La Greca, Gaetano

Journal of tissue viability

2021 Volume 30, Issue 4, Page(s) 594–598

Abstract: Traumatic limb wound management represents a common and challenging health problem. Conservative treatment can be a good option when surgery fails or surgical reconstruction is planned. Wound healing is a complex process that involves several factors and ...

Abstract	Traumatic limb wound management represents a common and challenging health problem. Conservative treatment can be a good option when surgery fails or surgical reconstruction is planned. Wound healing is a complex process that involves several factors and can be delayed if wound details are not noticed. So, expert healthcare professionals should take care of these delicate patients to obtain satisfactory outcomes in terms of cosmesis and functionality of the residual scar. Thanks to the description of three patients with traumatic limb injuries, this article emphasizes the importance of respecting what we call the three golden rules of wound management: correct cleaning of the wound, its accurate inspection and choose the appropriate dressing according to the wound aspect.
MeSH term(s)	Bandages ; Extremities ; Humans ; Hyaluronic Acid/therapeutic use ; Silver ; Wound Healing
Chemical Substances	Silver (3M4G523W1G) ; Hyaluronic Acid (9004-61-9)
Language	English
Publishing date	2021-08-03
Publishing country	England
Document type	Journal Article
ZDB-ID	1282604-2
ISSN	0965-206X
ISSN	0965-206X
DOI	10.1016/j.jtv.2021.07.008
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Article ; Online: Which is Better for Patients with Breast Cancer: Totally Implanted Vascular Access Devices (TIVAD) or Peripherally Inserted Central Catheter (PICC)?

Toro, Adriana / Schembari, Elena / Mattone, Edoardo / Di Carlo, Isidoro

World journal of surgery

2019 Volume 44, Issue 3, Page(s) 1004–1005

MeSH term(s)	Catheterization, Peripheral ; Humans ; Rare Diseases ; Vascular Access Devices
Language	English
Publishing date	2019-09-20
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-019-05196-4
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Article ; Online: Hydatid Cyst of the Liver: A Challenge that can be Amplified Shifting from Open to Laparoscopic Surgery.

Toro, Adriana / Schembari, Elena / Mattone, Edoardo / Di Carlo, Isidoro

World journal of surgery

2018 Volume 42, Issue 9, Page(s) 3054–3055

MeSH term(s)	Echinococcosis/surgery ; Echinococcosis, Hepatic/surgery ; Humans ; Laparoscopy ; Liver
Language	English
Publishing date	2018
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-018-4484-2
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Article ; Online: Subtotal cholecystectomy for difficult acute cholecystitis: how to finalize safely by laparoscopy-a systematic review.

Toro, Adriana / Teodoro, Michele / Khan, Mansoor / Schembari, Elena / Di Saverio, Salomone / Catena, Fausto / Di Carlo, Isidoro

World journal of emergency surgery : WJES

2021 Volume 16, Issue 1, Page(s) 45

Abstract: Background: Aim of this study was to clarify the best laparoscopic subtotal cholecystectomy (LSTC) technique for finalizing a difficult cholecystectomy.: Patients and methods: A review was performed (1987-2021) searching "difficulty cholecystectomy" ... ...

Abstract	Background: Aim of this study was to clarify the best laparoscopic subtotal cholecystectomy (LSTC) technique for finalizing a difficult cholecystectomy. Patients and methods: A review was performed (1987-2021) searching "difficulty cholecystectomy" AND/OR "subtotal cholecystectomy". The LSTC techniques considered were as follows: type A, leaving posterior wall attached to the liver and the remainder of the gallbladder stump open; type B, like type A but with the stump closed; type C, resection of both the anterior and posterior gallbladder walls and the stump closed; type D, like type C but with the stump open. Morbidity (including mortality) was analysed with Dindo-Clavien classification. Results: Nineteen articles were included. Of the 13,340 patients screened, 678 (8.2%) had cholecystectomy finalized by LSTC: 346 patients (51.0%) had type A LSTC, 134 patients (19.8%) had type B LSTC, 198 patients (29.2%) had type C LSTC, and 198 patients (0%) had type D LSTC. Bile leakage was found in 83 patients (12.2%), and recorded in 58 patients (69.9%) treated by type A. Twenty-three patients (3.4%) developed a subhepatic collection, 19 of whom (82.6%) were treated by type A. Other complications were reported in 72 patients (10.6%). The Dindo-Clavien classification was four for grade I, 27 for grade II, 126 for grade IIIa, 18 for grade IIIb, zero for grade IV and three for grade V. Conclusion: In the case of LSTC, closure of the gallbladder stump represents the best method to avoid complications. Careful exploration of the gallbladder stump is mandatory, washing the abdominal cavity and leaving drainage.
MeSH term(s)	Cholecystectomy/methods ; Cholecystectomy, Laparoscopic ; Cholecystitis, Acute/surgery ; Humans
Language	English
Publishing date	2021-09-08
Publishing country	England
Document type	Journal Article ; Systematic Review
ISSN	1749-7922
ISSN (online)	1749-7922
DOI	10.1186/s13017-021-00392-x
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Article ; Online: Learning curve for laparoscopic cholecystectomy has not been defined: A systematic review.

Reitano, Elisa / de'Angelis, Nicola / Schembari, Elena / Carrà, Maria Clotilde / Francone, Elisa / Gentilli, Sergio / La Greca, Gaetano

ANZ journal of surgery

2021 Volume 91, Issue 9, Page(s) E554–E560

Abstract: Background: Laparoscopic cholecystectomy is one of the most performed surgeries worldwide but its learning curve is still unclear.: Methods: A systematic review was conducted according to the 2009 Preferred Reporting Items for Systematic Reviews and ... ...

Abstract	Background: Laparoscopic cholecystectomy is one of the most performed surgeries worldwide but its learning curve is still unclear. Methods: A systematic review was conducted according to the 2009 Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Two independent reviewers searched the literature in a systematic manner through online databases, including Medline, Scopus, Embase, and Google Scholar. Human studies investigating the learning curve of laparoscopic cholecystectomy were included. The Newcastle-Ottawa scale for cohort studies and the GRADE scale were used for the quality assessment of the selected articles. Results: Nine cohort studies published between 1991 and 2020 were included. All studies showed a great heterogeneity among the considered variables. Seven articles (77.7%) assessed intraoperative variables only, without considering patient's characteristics, operator's experience, and grade of gallbladder inflammation. Only five articles (55%) provided a precise cut-off value to see proficiency in the learning curve, ranging from 13 to 200 laparoscopic cholecystectomies. Conclusions: The lack of clear guidelines when evaluating the learning curve in surgery, probably contributed to the divergent data and heterogeneous results among the studies. The development of guidelines for the investigation and reporting of a surgical learning curve would be helpful to obtain more objective and reliable data especially for common operation such as laparoscopic cholecystectomy.
MeSH term(s)	Cholecystectomy, Laparoscopic ; Humans ; Learning Curve
Language	English
Publishing date	2021-06-28
Publishing country	Australia
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.17021
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