R. Joseph Fogler

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We evaluated in this prospective study the effectiveness of continuous thoracic epidural anesthesia (TEA) and postoperative analgesia with ropivacaine and compared it with general anesthesia (GA) and opioids for pain relief, side effects, postanesthesia recovery, and hospital discharge after modified radical mastectomy. Sixty ASA physical status II and III(More)
Routine use of the concepts of expeditious hemostasis including the use of packing and temporizing surgical resection without anastomosis followed by delayed reexploration and reconstruction in victims of major pancreaticoduodenal trauma encouraged us to manage other devastating abdominal injuries in a similar fashion. A variety of multiple organ injuries(More)
Leiomyomas represent 2% of gastric tumors. Commonly, gastric leiomyomas are clinically silent. Most often they become clinically apparent due to bleeding from ulceration of the overlying gastric mucosa. Surgical extirpation of the tumor is the standard treatment. Gastric leiomyomectomy was done routinely through open laparotomy until availability of(More)
Several techniques have been described for the trocar placement in laparoscopic-assisted colectomy (LAC). They share the placement of four or five trocars in different areas of the abdomen. A specimen extraction incision in these techniques generally incorporates only one or two trocar sites, and combined length of these incisions approximates the length of(More)
Treatment of colonic injury has progressed since the recognition of the value of colostomy or bowel exteriorization during the second World War. The treatment guidelines take into consideration the time interval between perforation and treatment as well as the nature, the site, and the cause of perforation. Laparoscopic primary repair of relatively small(More)
BACKGROUND Temporization in the management of patients in extremis has gained acceptance in trauma surgery. Resection, without anastomosis, in major visceral injuries followed by delayed reconstruction has been successful. METHODS To evaluate this approach in patients with substantial vascular trauma, we reviewed our experience of five patients with major(More)
Experience and success with packing, resuscitation, and re-exploration for severe traumatic liver injury stimulated application of this concept to more complicated problems. In the case presented, these principles were utilized in managing a combined major hepatic and pancreaticoduodenal disruption. We emphasize stabilization, temporization, and delayed(More)
This paper explores the possibility of separating and classifying remotely-sensed multispectral data from rocks and minerals onto seven geological rock-type groups. These groups are extracted from the general categories of metamorphic, igneous and sedimentary rocks. The study is performed under ideal conditions for which the data is generated according to(More)