Ōsaka, Japan
Ōsaka, Japan

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Asai T.,Kansai Medical University | Kawashima A.,Ishikiri Seiki Hospital
Japanese Journal of Anesthesiology | Year: 2011

Background : The i-gel, which has been introduced into clinical practice in Japan in 2010, has a potential role in maintaining a clear airway during general anesthesia. Methods : We retrospectively studied the efficacy of the i-gel in 120 patients who had undergone elective surgery under general anesthesia. Results : It was always possible to insert the i-gel at the first attempt. However, there was gasleak around the device in 5 patients, and the device was reinserted. It was possible to obtain adequate ventilation via the i-gel in 117 patients (97.5%) within two attempts at insertion. Insertion was judged easy in 106 patients, somewhat difficult in 12 patients, and difficult in 2 patients. The mean minimum airway pressure at which gas leaked around the device was 26.4cmH 2O, with no gasleak at the airway pressure of 30cmH 2O in 66 of 120 patients. In no patients, did any airway complications, such as airway obstruction, occur during positive pressure ventilation, during the return of spontaneous breathing around the end of surgery, and during emergence from anesthesia. After removal of the i-gel, there was no stain of blood on the device. Conclusions : We believe that the i-gel is useful in maintaining a clear airway during general anesthesia.


Yabe T.,Ishikiri Seiki Hospital | Tsuda T.,Ishikiri Seiki Hospital | Hirose S.,Ishikiri Seiki Hospital | Ozawa T.,Osaka City University
Annals of Plastic Surgery | Year: 2015

There have been numerous reports on the use of aponeurotic surgery to correct involutional blepharoptosis. However, it is still difficult to determine optimal eyelid level during operation. Here we present our new method to adjust eyelid level intraoperatively. After the aponeurosis was temporally sutured to the tarsus, while still in the supine position, the patient was asked to look up, and the position of the eyelid margin was confirmed. The margin should be located above the pupil but within the cornea while the patient gazes up. And it is ideal if the eyelid position is located in the upper half of this range. Although 3 of 29 patients were reoperated on in the follow-up period, only 1 patient required readjustment in the perioperative period. Our method is simple, easy and reduces operative time, because it is not necessary to change patient position during the operation. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


Yabe T.,Ishikiri Seiki Hospital | Tsuda T.,Ishikiri Seiki Hospital | Hirose S.,Ishikiri Seiki Hospital | Ozawa T.,Osaka City University
Journal of Craniofacial Surgery | Year: 2012

Nasal fractures are the most common facial fracture in children and adults. Generally, it is believed that reduction of pediatric nasal fracture is more difficult and should be performed earlier compared with that of adult nasal fracture. However, there has been no article to prove this theory. We investigated 423 patients with acute nasal fractures requiring surgery and divided them into the following 2 groups: patients 12 years and younger (pediatric group) and patients 13 years and older (adult group). We then compared these patients in various aspects. There were no significant differences in the cause of fracture or postoperative conditions. Only the type of fracture and the anesthesia were different between these 2 groups. In the pediatric group, the interval between injury and surgery was arbitrarily divided into 2 groups, but there was no significant difference between these groups in the postoperative conditions. Some reports recommended that pediatric nasal fractures should be reduced within 3 to 5 days, but it cannot be proven. In conclusion, it is not necessary to distinguish treatment of pediatric nasal fracture from that of adult nasal fracture. Copyright © 2012 by Mutaz B. Habal, MD.


Yabe T.,Ishikiri Seiki Hospital | Ozawa T.,Osaka City University
Journal of Craniofacial Surgery | Year: 2011

As a postoperative complication in nasoethmoid-orbital fractures, nasal depression often occurs. The cause of this is an overlooked left nasal septum fracture. By reducing and fixing the nasal septum, nasal depression could have been avoided. Kirschner wire is useful for the fixation of the nasal septum, and it is fixed with zygomatic bone or/and frontal process of the maxillary bone. Three cases of nasoethmoid-orbital fractures were treated with this method. Kirschner wire fixation of the nasal septum is a simple and an easy method and can avoid unnecessary bone graft. © 2011 by Mutaz B. Habal, MD.


Yabe T.,Ishikiri Seiki Hospital | Tsuda T.,Ishikiri Seiki Hospital | Hirose S.,Ishikiri Seiki Hospital | Ozawa T.,Osaka City University
Journal of Reconstructive Microsurgery | Year: 2012

In this article, a comparison of replantation using microsurgical replantation (replantation) and the Brent method and its modification (pocket principle) in the treatment of fingertip amputation is reported. As a classification of amputation level, we used Ishikawa's subzone classification of fingertip amputation, and the cases of amputations only in subzone 2 were included in this study. Between these two groups, there was no statistical difference in survival rate, postoperative atrophy, or postoperative range of motion. In terms of sensory recovery, some records were lost and exact study was difficult. But there was no obvious difference between these cases. In our comparison of microsurgical replantation versus the pocket principle in treatment of subzone 2 fingertip amputation, there was no difference in postoperative results. Each method has pros and cons, and the surgeon should choose which technique to use based on his or her understanding of the characteristics of both methods. © 2012 by Thieme Medical Publishers, Inc.


PubMed | Ishikiri Seiki Hospital and Osaka City University
Type: Journal Article | Journal: Asian journal of endoscopic surgery | Year: 2017

Laparoscopic hepatectomy is difficult because surgeons must perform the transection using many (four and more) energy devices and without direct manual maneuvers. Here we introduce hepatic transection by the classical method with a few (two or three) energy devices.We performed laparoscopic hepatectomy for 40 patients with hepatic tumor and liver dysfunction. For parenchymal transection, we used bipolar radiofrequency coagulation forceps connected to a voltage-controlled electrosurgical generator and ultrasonic dissector. The demarcation of the liver surface was made by an ultrasonic dissector. Along the demarcation line, the blades of a BiClamp were opened slightly and inserted into the hepatic parenchyma. We clamped slowly, softly, and gradually, and a small amount of hepatic parenchyma was consequently coagulated and fractured. After the crush, the small vessels and intrahepatic bile duct that were sealed were left as atrophic strings, and the strings were divided by an ultrasonic dissector. Large vessels and Glissons sheaths were left because of the small clamp. Large Glissons sheaths and hepatic veins were ligated with a titanium clip or autosutures, and cut without bile leakage or bleeding. The mean operation time of the procedure was 196.9min, mean blood loss was 69.9mL, and mean postoperative hospitalization was 9.5days. No blood transfusions were needed. Two cases had perioperative complications-one involving right shoulder pain and the other involving ascites due to liver dysfunction-but there were no serious postoperative complications.The present results appear to demonstrate that this simple and safe method helps decrease intraoperative bleeding and shorten hospital stay.


Yamamoto T.,Ishikiri Seiki Hospital
Osaka city medical journal | Year: 2012

A 69-year-old Japanese woman underwent a curative operation for rectal cancer (T2, N0, M0, Dukes B, R0, and stage IIA of American Joint Committee on Cancer) 3 years ago. On subsequent routine follow-up, a right-side thyroid nodule and a regional lymph node of up to 1.5 cm in diameter was palpated. FDG-PET demonstrated high FDG accumulation in the right lobe of the thyroid gland, neck lymph nodes, and sacral periosteum. We diagnosed a local recurrence of rectal cancer and a primary thyroid cancer. We chose radiotherapy for the periosteal recurrence, and then right hemithyroidectomy with regional lymph node dissection for the thyroid tumor was performed. Pathological examination demonstrated mucinous carcinoma, the same as the previous surgical specimen from the rectum. She had been treated with postoperative chemotherapy and had been alive and well for 26 months with lung metastases. Although thyroid gland metastasis from colorectal cancer is rarely reported, physicians should consider the possibility of thyroid gland metastasis when performing routine follow-up examinations for recurrence of colorectal cancer.


Yabe T.,Ishikiri Seiki Hospital | Tsuda T.,Ishikiri Seiki Hospital | Hirose S.,Ishikiri Seiki Hospital | Ozawa T.,Kyoto University | Kawai K.,Ishikiri Seiki Hospital
Journal of Craniofacial Surgery | Year: 2014

Temporomandibular joint dislocation is not frequently encountered, but it is often difficult to reduce the dislocation with conventional methods described in textbooks. The key points to success of reduction depend on the patient's position, route of approach, and timing of reducing each side. We apply a manipulation technique for disk displacement to the reduction that corresponds to these key points. Using our method, temporomandibular joint dislocation can be easily reduced, without using sedative or analgesics. This method is simple, convenient, and worth trying in place of the conventional method. © 2014 Mutaz B. Habal.


Yabe T.,Ishikiri Seiki Hospital | Takahashi M.,Ishikiri Seiki Hospital
Journal of Plastic, Reconstructive and Aesthetic Surgery | Year: 2010

Background: There are various methods for surgical treatment of ingrown toenails. The aim of surgery is to remove the partial germinal matrix completely, but with minimal invasiveness. In previously reported methods, the surgical procedures have been invasive, and it is uncertain whether the partial germinal matrix is completely removed. Objective: A new, less-invasive surgical approach - partial germinal matrix excision using operative microscope - is reported. Methods: Seventy-seven lesions of 56 ingrown toenails in 46 patients were treated with this method. Under an operative microscope, the germinal matrix was excised completely, but with minimal invasiveness. Result: No cases of recurrence or spicule formation occurred, and the time required for wound healing was about 2 weeks. Conclusion: This method is less-invasive compared with traditional methods and is effective for the treatment of ingrown toenails. This method could be an alternative treatment technique. © 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons.


Yabe T.,Ishikiri Seiki Hospital
Japanese Journal of Plastic Surgery | Year: 2014

The pocket principle is a method used to restore finger length after fingertip amputation. Good results were expected for fingertip amputations performed at subzone I or II according to Ishikawa classification of the amputation level. An abdominal subdermal or palmar subcutaneous pocket was used as the donor site, and there was no obvious difference between the two sites in terms of fingertip survival. For amputations performed at the abovementioned levels, the optimal pocketing period ranged from 10 to 14 days, and it took approximately 3 weeks for the graft to be epithelized by second intention. The extent of damage to. and volume of, the amputated fingertip; the pocketing period; the depth of de-epithelization; and the patient's age were all found to affect fingertip survival. Clinicians should be prudent about employing this method for subzone III or IV fingertip amputations because it can produce inconsistent results in such cases.

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