Michael Kutka

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BACKGROUND As general surgeons perform a growing number of laparoscopic operations in increasingly specialized environments, the ability to obtain expert advice during procedures becomes more important. Technological advances in video and computer communications are enabling surgeons to procure expertise quickly and efficiently. In this article, we present(More)
BACKGROUND Hypercapnia and local pressure effects unique to CO(2) base minimally invasive surgery alter renal blood flow. We have demonstrated laparoscopic antireflux surgery to have an additional impact upon hemodynamics (decreased cardiac output), potentially extending known effects upon renal blood flow. METHODS We measured renal blood flow with(More)
This is the first multicenter prospective study of outcomes of tibial neurolysis in diabetics with neuropathy and chronic compression of the tibial nerve in the tarsal tunnels. A total of 38 surgeons enrolled 628 patients using the same technique for diagnosis of compression, neurolysis of four medial ankle tunnels, and objective outcomes: ulceration,(More)
Background: Advances in technique and instrumentation have enabled surgeons to perform an increasing number of complicated procedures through laparoscopy. However, these efforts have often been compromised by the exertion of excessive force when anatomical structures are retracted to create a clear view of the anatomy. Here, we present a comparative study(More)
PURPOSE The aim of this study is to elucidate the effects of laparoscopic Nissen fundoplication (LNF) with carbon dioxide (CO(2)) or helium (He) on the cell-mediated immune response in a pediatric animal model compared with open Nissen fundoplication (ONF). METHODS Cell immune response was evaluated in 45 1-week-old Sprague Dawley rats using the delayed(More)
BACKGROUND Laparoscopic Nissen fundoplication (LNF) is gaining popularity. Although the hemodynamic effects of the typical pneumoperitoneum have been studied, the additional consequences of the hiatal dissection necessary for LNF have not. METHODS Seven female pigs were anesthetized, intubated, and ventilated with a volume ventilator and hemodynamic and(More)
Background: As general surgeons perform a growing number of laparoscopic operations in increasingly specialized environments, the ability to obtain expert advice during procedures becomes more important. Technological advances in video and computer communications are enabling surgeons to procure expertise quickly and efficiently. In this article, we present(More)
Background: We designed a prospective controlled animal study to compare the stress response induced after laparoscopic and open cholecystectomy. Methods: Twelve female pigs (20–25 kg body weight) were anesthetized with ketamine, pentobarbital, and fentanyl. The animals were randomized into the following four groups: control (C), pneumoperitoneum with CO2(More)
Predictive ability of a positive Tinel sign over the tibial nerve in the tarsal was evaluated as a prognostic sign in determining sensory outcomes after distal tibial neurolysis in diabetics with chronic nerve compression at this location. Outcomes were evaluated with a visual analog score (VAS) for pain and measurements of the cutaneous pressure(More)
Advances in technique and instrumentation have enabled surgeons to perform a growing array of procedures through laparoscopy. However, these efforts have often been compromised by exerting excessive forces during retraction of the structures necessary for anatomical view. Here, we present a comparative study of human and robotic performance in force(More)