Cowanvinding9458

6%) achieving complete relief, 35 (46.7%) partial relief and 11 (14.7%) no relief. The procedure proved equally effective for both episodic and chronic cluster headache. Complications including facial numbness, masseter weakness, facial hypoesthesia and cheek hematoma were observed, but all were mild and disappeared within 6 months. Conclusions CT-guided low-temperature plasma radiofrequency ablation is an effective and safe strategy for refractory cluster headache. For patients who have not responded to conservative treatment, this minimally invasive intervention is a reliable alternative.Introduction The nerve fibers innervating the annulus fibrosus are the major origin of degeneration-associated discogenic pain. selleck kinase inhibitor Coblation is a tissue-dissociating technique in which the nerve fibers in the degenerative disc tissue are ablated. We hypothesized that coblation annuloplasty would be an effective maneuver for cervical discogenic pain without radiculopathy. Aim To observe the therapeutic efficacy of coblation annuloplasty in patients with cervical discogenic pain without radiculopathy. Material and methods Forty patients diagnosed with cervical discogenic pain without radiculopathy were screened for coblation annuloplasty therapy. The patient-rated visual analog scale (VAS) score for pain, significant pain relief rate, and Modified MacNab pain-relieving effect were adopted to evaluate the therapeutic effect within a 1-year follow-up period. Results Thirty-three patients eventually completed the study. The average pain duration was 4.6 ±1.6 years (range 0.5-8 years). The mean VAS pain score decreased from preoperative 6.8 ±0.9 to postoperative 2.5 ±1.3 (p less then 0.01). For all participants, the immediate pain relief rate was 78.7% (26/33), which continued to postoperative 6 months. One year later, 22 (66.6%) subjects reported that their pain was significantly alleviated. According to the Modified MacNab criteria, 63.6-82.1% considered the effect of surgery for their pain therapy as "excellent" during the 1-year follow-up period. No significant complications such as hemorrhage, paresthesia, or infection were observed. Conclusions This study is the first to demonstrate that coblation annuloplasty is an effective intervention providing significant alleviation of neck pain from cervical discogenic injury without radiculopathy.Introduction The effect of tiredness has been proved for the surgeons' musculature performing laparoscopic or robotic procedures (physical stress). Mental stress after robotic surgery has been reported as well. It is still unclear how much the surgical skills are altered and which types of skills are more affected at the final steps of long, complex robotic surgical procedures. Aim To evaluate to what extent the surgeon's skills are influenced by long procedures, using the objective assessment of different surgical skills by a virtual reality robotic simulator. Material and methods Fifteen surgeons were asked to perform a continuous 4 h virtual robotic surgical simulator training session. At the beginning of simulator training and at the end of each of the 4 h of training, three exercises of increasing difficulty were selected to be performed in order to assess the surgeons' skills. Results There were statistically significant differences between the initial and final overall scores for all the three exercises, the final outcomes being inferior. The specific metrics for each exercise slightly improved within 1 h from the beginning and thereafter decreased to a statistically significantly inferior value. Conclusions The specific metrics on the virtual reality robotic surgical simulator were altered after a 4-hour console training period. Further larger and more complex studies are necessary to evaluate the translation from the simulator to real-life robotic surgery.Introduction Roux-en-Y gastric bypass (RYGB) is one of the safe and easily reproducible bariatric procedures. Aim To evaluate the effect of biliopancreatic limb (BPL) and alimentary limb (AL) length on weight loss outcomes after RYGB. Material and methods This retrospective cohort study included 313 morbidly obese patients who underwent primary laparoscopic RYGB 2009-2015. Patients' BPL and AL lengths were categorized into three groups group 1 (BPL 50 cm and AL 150 cm), group 2 (BPL 150 cm and AL 50 cm), and group 3 (BPL 100 cm and AL 100 cm). Data were provided from the Iranian National Obesity Surgery Database. The generalized estimating equations method was used to assess the effect of limbs length on %excess weight loss (%EWL). Results Mean ± standard deviation age and body mass index (BMI) of 252 patients were 38.55 ±10.24 years and 45.8 ±4.77 kg/m2, respectively. Totally, 172 (68.3%, BMI of 46 ±5 kg/m2), 48 (19%, BMI of 45.12 ±4.26 kg/m2), and 32 (12.7%, BMI of 45.43 ±4.23 kg/m2) were in group 1, 2, and 3, respectively (p = 0.44). The results showed that the choice of different limb lengths had no significant effect on %EWL over 12 months follow-up (p = 0.625) adjusted for baseline BMI (p = 0.25). Mean %EWL in the patients with longer BPL and shorter AL was 5.43% (1.91, 8.95) higher in comparison to the patients with shorter BPL and longer AL during 36 months postoperatively adjusted for baseline BMI (p = 0.002). Conclusions During 12 months after RYGB, %EWL was not associated with BPL or AL length. However, during 36 months postoperatively, the patients with longer BPL had a significantly higher %EWL in comparison to the patients with shorter BPL.Aim The aim of the study was to evaluate the incidence and severity of visually induced motion sickness (VIMS) during 3D laparoscopy, in operators without prior experience. Material and methods Design A retrospective comparative study (Canadian Task Force classification II-2). Setting A university hospital. Intervention Gynecologic surgery. Main outcome measure This is a prospective observational study, which enrolled 9 surgeons as participants. None of these surgeons had any prior experience with 3D laparoscopy. Each participant performed 10 consecutive cases of 3D laparoscopy in patients with benign or premalignant gynecological diseases. The primary outcome measure was the incidence and severity of VIMS, which was evaluated using the validated Simulator Sickness Questionnaire. Personal preferences, discomfort, and ease of 3D laparoscopy were also evaluated. Results Sixty-seven percent of surgeons experienced VIMS during their first 3D laparoscopy case. The incidence and severity of VIMS dramatically decreased from the second case onward.