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13 results on '"Russell K. Woo"'

1. The complexities in diagnosing intradiaphragmatic extrapulmonary sequestration: a case report

Author

Anna-Kaelle K. J. Ramos, Tori R. Teramae, Collin G. Z. Liang, Miriam L. Brazer, and Russell K. Woo

Subjects
Pulmonary sequestration, Bronchopulmonary sequestration, Congenital, Lung malformation, Extralobar, Intradiaphragmatic, Pediatrics, RJ1-570, Surgery, RD1-811
Abstract

Abstract Background Extralobar pulmonary sequestration–a congenital lung malformation characterized by nonfunctional lung tissue with its own visceral pleura and without a connection to the normal tracheobronchial tree–is often surgically resected given the potential for infectious complications. We report a case of a child with extralobar pulmonary sequestration in a rare and challenging intradiaphragmatic location, which made preoperative identification and planning difficult. Case presentation A 2-year-old boy presented for follow-up of a large left extralobar pulmonary sequestration initially diagnosed on an antenatal ultrasound. Follow-up imaging, including prenatal MRI and postnatal CT angiography, was inconclusive on the precise location of the extralobar pulmonary sequestration in relation to the diaphragm but did reveal a subdiaphragmatic arterial supply from a branch off the celiac trunk. Planned resection with diagnostic thoracoscopy revealed the mass to seemingly be below the diaphragm; however, subsequent abdominal laparoscopy identified it to be within the diaphragm. Once the supplying vessel off the celiac trunk was controlled and divided, the mass was circumferentially excised from the edges of the diaphragmatic muscle. The remaining diaphragmatic defect was then closed, and the patient did well postoperatively. Conclusions This case demonstrates the difficulty of making a definitive diagnosis of intradiaphragmatic extralobar pulmonary sequestration without operative intervention. CT angiography and identification of the sequestration’s arterial supply may not be conclusive in determining the precise location if in close proximity to the diaphragm.

Published
2023
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2. The Evolving Use of Magnets in Surgery: Biomedical Considerations and a Review of Their Current Applications

Author

William G. Lee, Lauren L. Evans, Sidney M. Johnson, and Russell K. Woo

Subjects
review, surgery, magnet, medical, device, compression, Technology, Biology (General), QH301-705.5
Abstract

The novel use of magnetic force to optimize modern surgical techniques originated in the 1970s. Since then, magnets have been utilized as an adjunct or alternative to a wide array of existing surgical procedures, ranging from gastrointestinal to vascular surgery. As the use of magnets in surgery continues to grow, the body of knowledge on magnetic surgical devices from preclinical development to clinical implementation has expanded significantly; however, the current magnetic surgical devices can be organized based on their core function: serving as a guidance system, creating a new connection, recreating a physiologic function, or utilization of an internal–external paired magnet system. The purpose of this article is to discuss the biomedical considerations during magnetic device development and review the current surgical applications of magnetic devices.

Published
2023
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3. A combined medical/surgical appendicitis pathway decreases pediatric CT utilization, perforation, and negative appendectomy rates

Author

Sidney M. Johnson, Devin P. Puapong, Charles Peebles, Kelli Ishihara, Kenneth Bogenberger, and Russell K. Woo

Subjects
Pediatrics, RJ1-570, Surgery, RD1-811
Abstract

Abstract Background We sought to improve the care of pediatric patients with possible appendicitis by decreasing unnecessary CT scanning. In an early QI initiative, we systematically emphasized the superiority of Ultrasonography (US) over CT, but did not find a decrease in CT utilization in practice. We therefore redoubled our initiative using a multimodal approach. We hypothesized a combined diagnostic and treatment pathway that allowed residual diagnostic uncertainty and used both surgery and antibiotic therapy for appendicitis that would decrease the need for diagnostic CT scanning. Results Prior to implementation of the protocol, 33% of ER patients with appendicitis typical abdominal pain were treated for appendicitis (with surgery); after implementation, the total number treated remained unchanged 32.5% (p = NS), but the appendectomy rate dropped from 33 (204/619) to 23% after implementation of the pathway (96/419, p < 0.0005) with 50 patients treated with antibiotics. There was a reduction in CT scanning (pre 39% vs. 11%, p < 0.0001) while the use of US increased (pre 30% vs. 53%, p < 0.0001). The perforation rate decreased from 12 to 5% (p < 0.002) and negative appendectomy decreased from 13 to 4% (p < 0.0001). Of the 50 patients treated with antibiotics, 10 eventually crossed over to surgery. Conclusion The use of a diagnostic and therapeutic pathway that offers antibiotic therapy for early probable appendicitis decreases the need for diagnostic CT scanning without increasing morbidity in pediatric appendicitis. Adherence to a medical/surgical treatment protocol that reserves surgery for clinically advanced appendicitis results in a reduction in CT scanning, perforation rates, negative appendectomy rates, and overall surgery for appendicitis.

Published
2020
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6. The Multisplit Ventilator System: Performance Testing of Respiratory Support Shared by Multiple Patients

Author

Donald J. Gaucher, A. Zachary Trimble, Brennan E. Yamamoto, Ebrahim Seidi, Scott F. Miller, John D. Vossler, Reid C. Mahoney, Ryan L. Bellomy, William R. Heilbron, Sidney M. Johnson, Devin P. Puapong, Hyeong Jun Ahn, and Russell K. Woo

Subjects
Biomedical Engineering, Medicine (miscellaneous)
Abstract

Ventilator sharing has been proposed as a method of increasing ventilator capacity during instances of critical shortage. We sought to assess the ability of a regulated, shared ventilator system, the multisplit ventilator system, to individualize support to multiple simulated patients using one ventilator. We employed simulated patients of varying size, compliance, minute ventilation requirement, and positive end-expiratory pressure (PEEP) requirement. Performance tests were performed to assess the ability of the system, versus control, to achieve individualized respiratory goals to clinically disparate patients sharing a single ventilator following ARDSNet guidelines (Acute Respiratory Distress Syndrome). Resilience tests measured the effects of simulated adverse events occurring to one patient on another patient sharing a single ventilator. The multisplit ventilator system met individual oxygenation and ventilation requirements for multiple simulated patients with a tolerance similar to that of a single ventilator. Abrupt endotracheal tube occlusion or extubation occurring to one patient resulted in modest, clinically tolerable changes in ventilation parameters for the remaining patients. The proof-of-concept ventilator system presented in this paper is a regulated, shared ventilator system capable of individualizing ventilatory support to clinically dissimilar simulated patients. It is resilient to common adverse events and represents a feasible option to ventilate multiple patients during a severe ventilator shortage.

Published
2022
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7. Telehealth Delivery of Outpatient Pediatric Surgical Care in Hawai'i: An Opportunity Analysis

Author

Nicole R, Laferriere, Michele, Saruwatari, Xuan-Lan, Doan, Kelli B, Ishihara, Devin P, Puapong, Sidney M, Johnson, and Russell K, Woo

Subjects
Male, Postoperative Care, Infant, Articles, Ambulatory Care Facilities, Pediatrics, Hawaii, Telemedicine, Child, Preschool, Surgical Procedures, Operative, Humans, Female, Child, health care economics and organizations, Retrospective Studies
Abstract

In the state of Hawai‘i, nearly all pediatric surgical care is delivered on the main island of O‘ahu at the state’s primary tertiary children’s hospital. Outpatient clinic visits require patients and families to travel to O‘ahu. The direct and opportunity costs of this can be significant. The objective of this study was to characterize potential telehealth candidates to estimate the opportunity for telehealth delivery of outpatient pediatric surgical care. A retrospective chart review including all patients transported from neighbor islands for outpatient consultation with a pediatric surgeon on O‘ahu over a 4-year period was performed. Each patient visit was examined to determine if the visit was eligible for telehealth services using stringent criteria. Direct, insurance-based costs of the travel necessary were then determined. Demographic data was used to characterize the patients potentially affected. A total of 1081 neighbor island patients were seen in the pediatric surgery clinic over 4 years. Thirty-one percent of these patients met criteria as candidates for telehealth visits. The majority of patients came from Hawai‘i and Maui. Most patients were identified as Native Hawaiian or Asian. The average cost per trip was $112.53 per person, leading to a potential direct cost savings of $37,697 over 4 years. Over 30% of outpatient pediatric surgical encounters met stringent criteria as candidates for telehealth delivery of care. Given the significant number of patients that met our criteria, we believe there is an opportunity for direct, travel-based cost savings with the implementation of telehealth delivery of outpatient pediatric surgical care in Hawai‘i.

Published
2020

8. Magnetic Compression Stricturoplasty For Treatment of Refractory Esophageal Strictures in Children: Technique and Lessons Learned

Author

Devin P. Puapong, Russell K. Woo, Scott F. Miller, Christopher Marc Wong, Zachary Trimble, Shannon M. Koehler, and Sidney M. Johnson

Subjects
Reoperation, medicine.medical_specialty, 03 medical and health sciences, 0302 clinical medicine, Refractory, Pediatric surgery, medicine, Humans, Interventional endoscopy, Esophageal Atresia, business.industry, Anastomosis, Surgical, Infant, equipment and supplies, medicine.disease, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Atresia, Esophageal stricture, Esophageal Stenosis, Magnets, Esophageal surgery, Stents, 030211 gastroenterology & hepatology, business, Complication, human activities
Abstract

Introduction. Esophageal stricture is the most common complication following repair of esophageal atresia (EA). In general, these strictures are successfully managed using endoscopic techniques including bougie and balloon dilation, stenting, and chemotherapeutic agent application. If these techniques are unsuccessful, patients require segmental esophageal resection and reanastomosis or esophageal replacement. Magnetic compression anastomosis has been described in children. Herein we report our experience with magnetic compression stricturoplasty to treat refractory strictures after EA repair. Methods. We reviewed our experience using magnets to treat refractory strictures in 2 patients. Both patients failed multiple standard interventions. Because of near complete esophageal obstruction, both patients were candidates for esophageal replacement or segmental resection/anastamosis. In both patients, we applied neodymium-iron-boron magnets using fluoroscopic and endoscopic guidance. Results. The magnets were successfully positioned in both cases. Magnets were left in place for 7 and 10 days allowing for gradual compression stricturoplasty/anastamosis. Upon removal of the magnets, recanalization was visualized endoscopically and self-expanding stents were placed. There were no leaks or significant early complications. By 31 months post–magnetic stricturoplasty, both patients achieved durable esophageal patency without dysphagia. Conclusion. Magnetic stricturoplasty was successful at establishing early patency of the esophagus in 2 patients with recalcitrant EA strictures. Fundamental knowledge of magnetism was critical in configuring magnet arrays for surgery. In both cases, early follow-up is promising. Further follow-up will define the long-term success of this technique.

Published
2017
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9. Lost in translation: Informed consent in the medical mission setting

Author

Ana Mezynski, Russell K. Woo, George P. Yang, Raja R. Narayan, Arden M. Morris, and Lindsay A. Sceats

Subjects
Adult, Male, Risk, medicine.medical_specialty, Medical missions, Hernia, Inguinal, computer.software_genre, Informed consent, medicine, Humans, Informed Consent, Descriptive statistics, Adult patients, business.industry, Communication, Medical Missions, Middle Aged, Translating, Guatemala, humanities, Comprehension, Family medicine, Inguinal herniorrhaphy, Mental Recall, Surgery, Female, Thematic analysis, business, computer, Interpreter
Abstract

Background Informed consent is a fundamental tenet of ethical care, but even under favorable conditions, patient comprehension of consent conversations may be limited. Little is known about providing informed consent in more uncertain situations such as medical missions. We sought to examine the informed consent process in the medical mission setting. Methods We studied informed consent for adult patients undergoing inguinal herniorrhaphy during a medical mission to Guatemala using a convergent mixed-methods design. We audiotaped informed consents during preoperative visits and immediately conducted separate surveys to elicit comprehension of risks. Informed consent conversations and survey responses were translated and transcribed. We used descriptive statistics to examine informed consent content, including information provided by surgeon, the translation of information, and patient comprehension, and used thematic analysis to examine the consent process. Results Thirteen adult patients (median age 53 years, 69% male) participated. Surgeons conveyed 4 standard risks in 10 out of 13 encounters (77%); all 4 risks were translated to patients in 10 out of 13 encounters (77%). No patient could recall all 4 risks. Qualitative themes regarding the informed consent process included limited physician language skills, verbal domination by physicians and interpreters, and mistranslation of risks. Patients relied on faith and prior or vicarious experiences to qualify surgical risks instead of consent conversations. Many patients restated surgical instructions when asked about risks. Conclusion Despite physicians’ attempts to provide informed consent, medical mission patients did not comprehend surgical risks. Our data reveal a critical need to develop more effective methods for communicating surgical risks during medical missions.

Published
2018

10. Contributors

Author

Mark C. Adams, Obinna O. Adibe, Jeremy Adler, N. Scott Adzick, Craig T. Albanese, Walter S. Andrews, Harry Applebaum, Marjorie J. Arca, Daniel C. Aronson, Richard G. Azizkhan, Robert Baird, Sean Barnett, Douglas C. Barnhart, Katherine A. Barsness, Robert H. Bartlett, Laurence S. Baskin, Spencer W. Beasley, Michael L. Bentz, Deborah F. Billmire, Scott C. Boulanger, Mary L. Brandt, John W. Brock, Rebeccah L. Brown, Imad F. Btaiche, Ronald W. Busuttil, Anthony A. Caldamone, Donna A. Caniano, Michael G. Caty, Christophe Chardot, Dai H. Chung, Robert E. Cilley, Nadja C. Colon, Paul M. Columbani, Arnold G. Coran, Robin T. Cotton, Robert A. Cowles, Charles S. Cox, Melvin S. Dassinger, Andrew M. Davidoff, Richard S. Davidson, Paolo De Coppi, Bryan J. Dicken, William Didelot, John W. DiFiore, Patrick A. Dillon, Peter W. Dillon, Patricia K. Donahoe, Gina P. Duchossois, James C.Y. Dunn, Sanjeev Dutta, Simon Eaton, Peter F. Ehrlich, Martin R. Eichelberger, Lisa M. Elden, Jonathan L. Eliason, Sherif Emil, Mauricio A. Escobar, Richard A. Falcone, Mary E. Fallat, Diana L. Farmer, Douglas G. Farmer, Albert Faro, Michael J. Fisher, Steven J. Fishman, Tamara N. Fitzgerald, Alan W. Flake, Robert P. Foglia, Henri R. Ford, Andrew Franklin, Jason S. Frischer, Stephanie M.P. Fuller, Sanjiv K. Gandhi, Victor F. Garcia, John M. Gatti, Michael W.L. Gauderer, James D. Geiger, Keith E. Georgeson, Cynthia A. Gingalewski, Kenneth I. Glassberg, Philip L. Glick, Kelly D. Gonzales, Tracy C. Grikscheit, Jay L. Grosfeld, Travis W. Groth, Angelika C. Gruessner, Rainer W.G. Gruessner, Ivan M. Gutierrez, Philip C. Guzzetta, Jason J. Hall, Thomas E. Hamilton, Carroll M. Harmon, Michael R. Harrison, Andrea Hayes-Jordan, Stephen R. Hays, John H. Healey, W. Hardy Hendren, Bernhard J. Hering, David N. Herndon, Shinjiro Hirose, Jennifer C. Hirsch, Ronald B. Hirschl, David M. Hoganson, George W. Holcomb, Michael E. Höllwarth, B. David Horn, Charles B. Huddleston, Raymond J. Hutchinson, John M. Hutson, Grace Hyun, Thomas H. Inge, Tom Jaksic, Andrew Jea, Martin Kaefer, Kuang Horng Kang, Christopher J. Karsanac, Kosmas Kayes, Robert E. Kelly, Edward M. Kiely, Michael D. Klein, Matthew J. Krasin, Thomas M. Krummel, Ann M. Kulungowski, Jean-Martin Laberge, Ira S. Landsman, Jacob C. Langer, Michael P. La Quaglia, Marc R. Laufer, Hanmin Lee, Joseph L. Lelli, Marc A. Levitt, James Y. Liau, Craig Lillehei, Harry Lindahl, Gigi Y. Liu, H. Peter Lorenz, Thomas G. Luerssen, Jeffrey R. Lukish, Dennis P. Lund, John C. Magee, Eugene D. McGahren, Eamon J. McLaughlin, Leslie T. McQuiston, Rebecka L. Meyers, Alastair J.W. Millar, Eugene Minevich, Edward P. Miranda, Michael E. Mitchell, Kevin P. Mollen, R. Lawrence Moss, Pierre Mouriquand, Noriko Murase, J. Patrick Murphy, Joseph T. Murphy, Michael L. Nance, Saminathan S. Nathan, Kurt D. Newman, Alp Numanoglu, Benedict C. Nwomeh, Richard G. Ohye, Keith T. Oldham, James A. O'Neill, Mikko P. Pakarinen, Nicoleta Panait, Richard H. Pearl, Alberto Peña, Rafael V. Pieretti, Agostino Pierro, Hannah G. Piper, William P. Potsic, Howard I. Pryor, Pramod S. Puligandla, Prem Puri, Faisal G. Qureshi, Frederick J. Rescorla, Yann Révillon, Jorge Reyes, Marleta Reynolds, Audrey C. Rhee, Barrie S. Rich, Richard R. Ricketts, Richard C. Rink, Risto J. Rintala, Albert P. Rocchini, David A. Rodeberg, A. Michael Sadove, Bob H. Saggi, L.R. Scherer, Daniel B. Schmid, Stefan Scholz, Marshall Z. Schwartz, Robert C. Shamberger, Nina L. Shapiro, Curtis A. Sheldon, Stephen J. Shochat, Douglas Sidell, Michael A. Skinner, Jodi L. Smith, Samuel D. Smith, Charles L. Snyder, Allison L. Speer, Lewis Spitz, Thomas L. Spray, James C. Stanley, Thomas E. Starzl, Wolfgang Stehr, Charles J.H. Stolar, Phillip B. Storm, Steven Stylianos, Ramnath Subramaniam, Riccardo Superina, David E.R. Sutherland, Leslie N. Sutton, Roman Sydorak, Karl G. Sylvester, Daniel H. Teitelbaum, Joseph J. Tepas, John C. Thomas, Dana Mara Thompson, Juan A. Tovar, Jeffrey S. Upperman, Joseph P. Vacanti, John A. van Aalst, Dennis W. Vane, Daniel Von Allmen, Kelly Walkovich, Danielle S. Walsh, Brad W. Warner, Thomas R. Weber, Christopher B. Weldon, David E. Wesson, Ralph F. Wetmore, J. Paul Willging, Jay M. Wilson, Lynn L. Woo, Russell K. Woo, Elizabeth B. Yerkes, Moritz M. Ziegler, and Arthur Zimmermann

Published
2012
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12. Contributors

Author

Mark C. Adams, N. Scott Adzick, Craig T. Albanese, Fred Alexander, R. Peter Altman, Richard J. Andrassy, Walter S. Andrews, Harry Applebaum, Marjorie J. Arca, Robert M. Arensman, James B. Atkinson, Richard G. Azizkhan, Anwar Baban, Douglas C. Barnhart, Robert H. Bartlett, Laurence S. Baskin, Spencer W. Beasley, Michael L. Bentz, Victor E. Boston, Scott C. Boulanger, Edward L. Bove, Mary L. Brandt, John W. Brock, Rebeccah L. Brown, Marybeth Browne, Terry L. Buchmiller, Ronald W. Busuttil, Michelle S. Caird, Anthony A. Caldamone, Darrell A. Campbell, Donna A. Caniano, Michael G. Caty, Dai H. Chung, Robert E. Cilley, Paul M. Colombani, Joel D. Cooper, Arnold G. Coran, Robin T. Cotton, Michael C. Dalsing, Alan Daneman, Andrew M. Davidoff, Richard S. Davidson, Romano T. DeMarco, Daniel A. DeUgarte, Eric Devaney, William Didelot, John W. DiFiore, Patrick A. Dillon, Peter W. Dillon, Patricia K. Donahoe, James C.Y. Dunn, Simon Eaton, Martin R. Eichelberger, Sigmund H. Ein, Carolyn Ells, Barry L. Eppley, Mary E. Fallat, Diana L. Farmer, Douglas G. Farmer, Steven J. Fishman, Alan W. Flake, Robert P. Foglia, Eric W. Fonkalsrud, Henri R. Ford, Stephanie M.P. Fuller, Victor F. Garcia, John M. Gatti, Michael W.L. Gauderer, James D. Geiger, Keith E. Georgeson, Cynthia A. Gingalewski, Kenneth I. Glassberg, Philip L. Glick, Sherilyn A. Gordon, Tracy C. Grikscheit, Jay L. Grosfeld, Angelika C. Gruessner, Rainer W.G. Gruessner, Philip C. Guzzetta, Carroll M. Harmon, Michael R. Harrison, Andrea A. Hayes-Jordan, Stephen R. Hays, John H. Healey, W. Hardy Hendren, Bernhard J. Hering, David N. Herndon, Ronald B. Hirschl, George W. Holcomb, Charles B. Huddleston, Raymond J. Hutchinson, John M. Hutson, Thomas Inge, Vincenzo Jasonni, Nishwan Jibri, Byron D. Joyner, Martin Kaefer, Henry K. Kawamoto, Robert M. Kay, Kosmas Kayes, Mark L. Kayton, Robert E. Kelly, Stephen S. Kim, Michael D. Klein, Giannoula Klement, Matthew J. Krasin, Thomas M. Krummel, Jean-Martin Laberge, Ira S. Landsman, Michael P. La Quaglia, Stanley T. Lau, Steven L. Lee, Joseph L. Lelli, Marc A. Levitt, Harry Lindahl, Thom E. Lobe, Randall T. Loder, Thomas G. Luerssen, Jeffrey R. Lukish, Dennis P. Lund, Mary Beth Madonna, John C. Magee, Giuseppe Martucciello, Stephen J. Mathes, Eugene D. McGahren, Leslie T. McQuiston, Peter Metcalfe, Alastair J.W. Millar, Eugene Minevich, Edward P. Miranda, Michael E. Mitchell, Takeshi Miyano, Delora Mount, Pierre Mouriquand, Noriko Murase, J. Patrick Murphy, Saminathan S. Nathan, Kurt D. Newman, Alp Numanoglu, Donald Nuss, Richard Ohye, Keith T. Oldham, James A. O'Neill, Evelyn Ong, William L. Oppenheim, H. Biemann Othersen, Mikki Pakarinen, Keshav Pandurangi, Richard H. Pearl, Alberto Peña, Rafael V. Pieretti, Agostino Pierro, William P. Potsic, Pramod S. Puligandla, Devin P. Puapong, Prem Puri, Judson G. Randolph, Frederick J. Rescorla, Jorge Reyes, Richard R. Ricketts, Richard C. Rink, Risto J. Rintala, Albert P. Rocchini, Heinz Rode, Bradley M. Rodgers, A. Michael Sadove, Bob H. Saggi, Arthur P. Sanford, L.R. Scherer, Jay J. Schnitzer, Marshall Z. Schwartz, Robert C. Shamberger, Nina L. Shapiro, Curtis A. Sheldon, Stephen J. Shochat, Michael A. Skinner, C.D. Smith, Jodi L. Smith, Samuel D. Smith, Charles L. Snyder, Lewis Spitz, Thomas L. Spray, Thomas E. Starzl, Charles J.H. Stolar, Phillip B. Storm, Steven Stylianos, Wendy T. Su, Riccardo Superina, David E.R. Sutherland, Leslie N. Sutton, Edward P. Tagge, Daniel H. Teitelbaum, Claire L. Templeman, Gonca Topuzlu Tekant, Joseph J. Tepas, Patrick B. Thomas, Dana Mara Thompson, Juan A. Tovar, Jeffrey S. Upperman, Joseph P. Vacanti, Dennis W. Vane, Mirjana Vustar, Brad W. Warner, Thomas R. Weber, David E. Wesson, Karen W. West, Ralph F. Wetmore, Eugene Wiener, Jay M. Wilson, Russell K. Woo, Hsi-Yang Wu, Elizabeth Yerkes, Daniel G. Young, and Moritz M. Ziegler

Published
2006
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