Endoscopic Midforehead Techniques: Improved Outcomes with Decreased Operative Time and Cost

2008 ◽  
pp. 224-227
Author(s):  
Asa D. Morton
Keyword(s):  
Operative Time ◽  
Improved Outcomes

Open Colectomies of Shorter Operative Time Do Not Result in Improved Outcomes Compared With Prolonged Laparoscopic Operations

2017 ◽  
Vol 27 (5) ◽  
pp. 361-365 ◽  
Author(s):  
Sara L. Zettervall ◽  
Ivy N. Haskins ◽  
Sarah E. Deery ◽  
Richard L. Amdur ◽  
Paul P. Lin ◽  
...  
Keyword(s):  
Operative Time ◽  
Improved Outcomes

scholarly journals Operative Approaches to Ankle and Hindfoot Arthroscopy

2020 ◽  
Vol 5 (1) ◽  
pp. 247301141989496
Author(s):  
Dominic S. Carreira ◽  
Steven R. Garden ◽  
Thomas Ueland
Keyword(s):  
Operative Time ◽  
Improve Patient Safety ◽  
Arthroscopic Surgery ◽  
Complication Rates ◽  
Level Of Evidence ◽  
Improved Outcomes ◽  
Ankle Surgery ◽  
Lower Complication ◽  
Improve Patient

The role of arthroscopy in the management of ankle and hindfoot pathology management has increased greatly in recent years with the potential for lower complication rates, faster recovery, improved access, and improved outcomes when compared to open techniques. Procedural variations exist as techniques aim to optimize lesion access, decrease operative time, and improve patient safety. Our goal is to summarize the described approaches and patient positionings common in minimally invasive arthroscopic surgery for anterior, lateral, and posterior ankle pathologies. A survey of pathology organized by arthroscopic approach and a review of recent advances in concomitant lesion management may be useful when planning arthroscopic foot and ankle surgery. Level of Evidence: Level V, expert opinion.

scholarly journals Plastic Surgery Techniques for the Improvement of Outcomes of Complex Obstetric Fistula Repairs

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Rachel Pope ◽  
Mary Stokes ◽  
Chisomo Chalamanda ◽  
Jeffrey Wilkinson
Keyword(s):  
Operative Time ◽  
Obstetric Fistula ◽  
Muscle Flap ◽  
Gracilis Muscle ◽  
Tissue Loss ◽  
Type Iii ◽  
Improved Outcomes ◽  
Estimated Blood Loss ◽  
Average Operative Time ◽  
Type 3

Background: As part of a larger study on the outcomes of obstetric fistula surgery, a review on patient outcomes when using gracilis muscle and/or Singapore flaps was conducted. Methods: The database queried includes over 1700 patients. Fifty-five cases were identified having had either a gracilis muscle and or a Singapore flap as part of the repair. Results: Twenty-one patients had a Singapore flap only. Median age was 26 years (19-55), four had one prior repair and two had two prior repair attempts. Nine cases were Goh type 3 and nine were Goh type 4 indicating urethral involvement. 71% (n=15) were >3 centimeters in diameter. Median estimated blood loss (ebl) was 200 ml and average OR time was 2.5 hours. Median catheter duration 17 days (13-25). 81% (n=17) were dye test negative, with an average pad weight of 19.2 grams. 19 patients had a gracilis muscle flap alone with median age of 43 (23-70). Four had one previous repair, one had four previous repairs. Nine were Goh type 3 and eight were Goh type 4. 70% (n=12) had a fistula >3 cm in diameter and 88% (n=15) had type iii considerations (previous repair attempt, circumferential, or severe scarring). Median ebl was 250 ml and average operative time was two hours and 30 minutes. Median catheter duration was 17 days (14-31). 82% (n=14) had negative dye tests, with average pad weight of 19 grams. 16 patients had both a Singapore and a gracilis. Median age was 31 (15-70), nine were Goh type 3, seven were Goh type 4. 87.5% (n=14) had a fistula that was more than 3 cm in diameter and 87.5% (n=14) were type iii. Median ebl was 300 ml (250-1000 ml), and average operative time was 3 hours and 45 minutes. 81% (n=13) had a negative dye test, with two patients going home positive and returning negative over the course of four months. Average pad weight was 18.9 grams. Conclusion: For large fistulas with a significant amount of vaginal tissue loss, the Singapore flap is a potential option for improved outcomes. For recurrent cases and those with poor quality tissue, the gracilis muscle may lead to overall improved outcomes. Overall, these techniques are useful for complex obstetric fistula cases where outcomes are generally less favorable. Further prospective studies are needed.

scholarly journals Plastic Surgery Techniques for the Improvement of Outcomes of Complex Obstetric Fistula Repairs

2018 ◽  
Vol 13 (2) ◽  
pp. 41-43
Author(s):  
Rachel Pope ◽  
Mary Stokes ◽  
Roger H. Brown ◽  
Chisomo Chalamanda ◽  
Larry H. Hollier ◽  
...  
Keyword(s):  
Operative Time ◽  
Obstetric Fistula ◽  
Muscle Flap ◽  
Gracilis Muscle ◽  
Tissue Loss ◽  
Type Iii ◽  
Improved Outcomes ◽  
Estimated Blood Loss ◽  
Average Operative Time ◽  
Type 3

Aims: As part of a larger study on the outcomes of obstetric fistula surgery, a review on patient outcomes when using gracilis muscle and/or Singapore flaps was conducted. Methods: The database queried includes over 1700 patients. Fifty-six cases were identified having had either a gracilis muscle and or a Singapore flap as part of the repair. Results: Twenty-one patients had a Singapore flap only. Median age was 26 years (19-55), four had one prior repair and two had two prior repair attempts. Nine cases were Goh type 3 and nine were Goh type 4 indicating urethral involvement. 71% (n=15) were >3 centimeters in diameter. Median estimated blood loss (ebl) was 200 ml and average OR time was 2.5 hours. Median catheter duration 17 days (13-25). 81% (n=17) were dye test negative, with an average pad weight of 19.2 grams. 19 patients had a gracilis muscle flap alone with median age of 43 (23-70). Four had one previous repair, one had four previous repairs. Nine were Goh type 3 and eight were Goh type 4. 70% (n=12) had a fistula >3 cm in diameter and 88% (n=15) had type iii considerations (previous repair attempt, circumferential, or severe scarring). Median ebl was 250 ml and average operative time was two hours and 30 minutes. Median catheter duration was 17 days (14-31). 82% (n=14) had negative dye tests, with average pad weight of 19 grams. 16 patients had both a Singapore and a gracilis. Median age was 31 (15-70), nine were Goh type 3, seven were Goh type 4. 87.5% (n=14) had a fistula that was more than 3 cm in diameter and 87.5% (n=14) were type iii. Median ebl was 300 ml (250-1000 ml), and average operative time was 3 hours and 45 minutes. 81% (n=13) had a negative dye test, with two patients going home positive and returning negative over the course of four months. Average pad weight was 18.9 grams.  Conclusions: For large fistulas with a significant amount of vaginal tissue loss, the Singapore flap is a potential option for improved outcomes. For recurrent cases and those with poor quality tissue, the gracilis muscle may lead to overall improved outcomes. Overall, these techniques are useful for complex obstetric fistula cases where outcomes are generally less favorable. Further prospective studies are needed.

scholarly journals A Feasibility Study into the Use of Three-Dimensional Printer Modelling in Acetabular Fracture Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
A. W. Yu ◽  
J. M. Duncan ◽  
J. S. Daurka ◽  
A. Lewis ◽  
J. Cobb
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Operative Procedure ◽  
Three Dimensional ◽  
Acetabular Fractures ◽  
Improved Outcomes ◽  
Operative Planning ◽  
Tissue Trauma ◽  
3D Anatomy ◽  
Fracture Surgery

There are a number of challenges associated with the operative treatment of acetabular fractures. The approach used is often extensive, while operative time and perioperative blood loss can also be significant. With the proliferation of 3D printer technology, we present a fast and economical way to aid the operative planning of complex fractures. We used augmented stereoscopic 3D CT reconstructions to allow for an appreciation of the normal 3D anatomy of the pelvis on the fractured side and to use the models for subsequent intraoperative contouring of pelvic reconstruction plates. This leads to a reduction in the associated soft tissue trauma, reduced intraoperative time and blood loss, minimal handling of the plate, and reduced fluoroscopic screening times. We feel that the use of this technology to customize implants, plates, and the operative procedure to a patient’s unique anatomy can only lead to improved outcomes.

Family Support in Early Hearing Detection and Intervention (EHDI) Systems

2012 ◽  
Vol 22 (1) ◽  
pp. 11-21
Author(s):  
Patti Martin ◽  
Nannette Nicholson ◽  
Charia Hall
Keyword(s):  
Family Support ◽  
Hard Of Hearing ◽  
Critical Role ◽  
Annual Conference ◽  
Federal Law ◽  
Think Tank ◽  
Learning Collaborative ◽  
Technological Advances ◽  
Improved Outcomes ◽  
Program Components

Family support has evolved from a buzzword of the 1990s to a concept founded in theory, mandated by federal law, valued across disciplines, and espoused by both parents and professionals. This emphasis on family-centered practices for families of young children with disabilities, coupled with federal policy initiatives and technological advances, served as the impetus for the development of Early Hearing Detection and Intervention (EHDI) programs (Nicholson & Martin, in press). White, Forsman, Eichwald, and Muñoz (2010) provide an excellent review of the evolution of EHDI systems, which include family support as one of their 9 components. The National Center for Hearing Assessment and Management (NCHAM), the Maternal and Child Health Bureau, and the Center for Disease Control Centers cosponsored the first National EHDI Conference. This conference brought stakeholders including parents, practitioners, and researchers from diverse backgrounds together to form a learning collaborative (Forsman, 2002). Attendees represented a variety of state, national, and/or federal agencies and organizations. This forum focused effort on the development of EHDI programs infused with translating research into practices and policy. When NCHAM, recognizing the critical role of family support in the improvement of outcomes for both children and families, created a think tank to investigate the concept of a conference centered on support for families of children who are deaf or hard of hearing in 2005, the “Investing in Family Support” (IFSC) conference was born. This conference was specifically designed to facilitate and enhance EHDI efforts within the family support arena. From this venue, a model of family support was conceptualized and has served as the cornerstone of the IFSC annual conference since 2006. Designed to be a functional framework, the IFSC model delineates where and how families find support. In this article, we will promote and encourage continued efforts towards defining operational measures and program components to ultimately quantify success as it relates to improved outcomes for these children and their families. The authors view this opportunity to revisit the theoretical underpinnings of family support, the emerging research in this area, and the basics of the IFSC Model of Family Support as a call to action. We challenge professionals who work with children identified as deaf or hard of hearing to move family support from conceptualization to practices that are grounded in evidence and ever mindful of the unique and dynamic nature of individual families.

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