Modified surgical reconstruction technique for a rare isolated congenital sternal cleft: In a six -year-old child

A complete sternal cleft is a very rare congenital anomaly causing severe respiratory compromise. Surgical reconstruction options are limited, particularly in low birth weight newborns. Herein, we report a case of low birth weight premature newborn with a complete sternal cleft and its surgical treatment.

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Variation in surgical methods used for total laryngectomy in Australia

The Journal of Laryngology & Otology ◽

10.1017/s0022215108002119 ◽

2008 ◽

Vol 122 (7) ◽

pp. 728-732 ◽

Cited By ~ 12

Author(s):

J Maclean ◽

S Cotton ◽

A Perry

Keyword(s):

Head And Neck ◽

Total Laryngectomy ◽

Scientific Evidence ◽

Surgical Techniques ◽

Surgical Reconstruction ◽

Reconstruction Technique ◽

Surgical Closure ◽

Surgical Methods ◽

Suturing Techniques ◽

Pharyngeal Reconstruction

AbstractDeglutition disorders (dysphagia) are common following total laryngectomy. As the aetiology of the disorder is poorly understood, its incidence is probably under-estimated. Dysphagia may result from many factors, including the type of laryngectomy surgery employed and the use of adjuvant treatments (e.g. radiotherapy and chemotherapy). Dysphagia may also be compounded by other co-morbid factors, such as ageing and depression.Aim:To investigate the methods of surgical closure used by Australian ENT and head and neck surgeons after undertaking total laryngectomy surgery.Method:In order to audit surgical variation, 56 short questionnaires were sent to all Australian ENT and head and neck surgeons who were registered members of the Australia and New Zealand Head and Neck Society. Twenty-eight questionnaires (50 per cent) were completed and returned.Results:Respondents reported using a variety of different reconstructive methods after total laryngectomy surgery. Specifically, there were differences in the type and levels of pharyngeal closure employed and the suturing techniques used.Conclusion:Currently, there is no scientific evidence to direct surgeons to the optimal pharyngeal reconstruction technique(s) ensuring for good swallowing results post-laryngectomy. An analysis of the effect of surgical reconstruction technique on laryngectomees' post-operative swallowing ability is needed, in order to provide evidence to determine optimal surgical techniques.

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Mechanics of the Anterior Cruciate Ligament and Its Contribution to Knee Kinematics

Applied Mechanics Reviews ◽

10.1115/1.3120793 ◽

1990 ◽

Vol 43 (5S) ◽

pp. S142-S149 ◽

Cited By ~ 1

Author(s):

S. L.-Y. Woo ◽

J. S. Wayne

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Knee Kinematics ◽

Biological Tissues ◽

Surgical Reconstruction ◽

Reconstruction Technique ◽

Knee Stability ◽

Knee Motion ◽

Anterior Cruciate ◽

Active Patients

The anterior cruciate ligament (ACL), as one of the major stabilizers of knee motion, is anatomically complex. Its inability to heal when torn often requires surgical reconstruction using biological tissues or artificial ligament replacements to achieve knee stability and appropriate kinematics for young and active patients. Yet, there is much debate as to which graft and reconstruction technique best emulate the natural ligament. To increase our knowledge of the function of the ACL in the knee joint, it is crucial to understand the tensile properties of the ligament as well as the its role in maintaining knee kinematics. This information should aid in the selection, design, and evaluation of ligament replacements and reconstruction techniques.

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A Biomechanical Study of Two Distinct Methods of Anterior Cruciate Ligament Rupture, and a Novel Surgical Reconstruction Technique, in a Small Animal Model of Posttraumatic Osteoarthritis

The Journal of Knee Surgery ◽

10.1055/s-0037-1600088 ◽

2017 ◽

Vol 31 (01) ◽

pp. 043-049 ◽

Cited By ~ 3

Author(s):

Austin Ramme ◽

Matin Lendhey ◽

Eric Strauss ◽

Oran Kennedy

Keyword(s):

Cruciate Ligament ◽

Small Animal ◽

Acl Rupture ◽

Surgical Reconstruction ◽

Reconstruction Technique ◽

Joint Mechanics ◽

Small Animal Model ◽

Anterior Cruciate ◽

Tail Tendon ◽

Knee Joint Mechanics

AbstractSmall animal models are critical for studies of sports-related knee injury and disease such as posttraumatic osteoarthritis (PTOA) following anterior cruciate ligament (ACL) rupture. In such models, ACL damage can be achieved by surgical transection or, using a more recent innovation, by noninvasive biomechanical means. Whether these approaches differentially alter normal mechanics is unknown. Furthermore, while surgical reconstruction of ruptured ACL can greatly improve joint stability, its effect on PTOA development is also unclear. Our primary purpose was to characterize rodent knee joint mechanics in two models of ACL rupture using a novel quantitative laxity mechanical test. Our secondary aim was to characterize a new reconstruction technique using autograft tail tendon, and to assess its effect on joint mechanics. Our hypothesis was that surgical ACL transection would have a greater effect on joint mechanics. A total of 24 rat knee specimens underwent surgical or biomechanical ACL rupture and were stabilized using a new reconstruction technique using autograft tail tendon. Joint mechanics were assessed three times; preinjury, postinjury, and again after reconstruction, using quantitative joint laxity testing. Primary test readouts were maximum anteroposterior (AP) laxity, loading curve slope, and energy absorption. Student's t-tests were performed to identify intragroup differences. All surgical transections were completed successfully; maximum load in the biomechanical model was 67 ± 7.7 N, with a coefficient of variation of 11.43%. Surgical transection caused increased AP laxity, while biomechanical injury nonsignificantly increased this parameter. In both cases, these changes recovered to baseline by reconstruction. Loading curve slope was reduced in both models and was also returned to baseline by repair. Energy absorption followed the same pattern except it remained significantly different from baseline postreconstruction in the surgical group. This study supports our hypothesis knee joint mechanics is differentially affected by injury mechanism in a small animal model. We also report a novel reconstruction technique in this model, using autograft tail tendon.

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Impact of Multilayer Vascularized Reconstruction after Skull Base Endoscopic Endonasal Approaches

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0039-1677705 ◽

2019 ◽

Vol 81 (02) ◽

pp. 128-135 ◽

Cited By ~ 1

Author(s):

Juan Antonio Simal-Julián ◽

Pablo Miranda-Lloret ◽

Laila Pérez de San Román Mena ◽

Pablo Sanromán-Álvarez ◽

Alfonso García-Piñero ◽

...

Keyword(s):

Skull Base ◽

Scientific Evidence ◽

Surgical Reconstruction ◽

Csf Leak ◽

Outcome Variable ◽

Reconstruction Technique ◽

Endoscopic Endonasal ◽

Postoperative Leak ◽

Skull Base Defects ◽

Reconstructive Techniques

Abstract Background The use of vascularized flap to reconstruct the skull base defects has dramatically changed the postoperative cerebrospinal fluid (CSF) leak rates allowing the expansion of endoscopic skull base procedures. At present, there is insufficient scientific evidence to permit identification of the optimal reconstruction technique after the endoscopic endonasal approach (EEA). Objective The main purpose of this article is to establish the risk factors for failure in the reconstruction after EEA and whether the use of a surgical reconstruction protocol can improve the surgical results. Material and Methods A retrospective cohort study was conducted in our institution, selecting patients that underwent EEA with intraoperative CSF leak. Two reconstructive protocols were defined based on different reconstructive techniques; both were vascularized but one monolayer and the other multilayer. A multivariate analysis was performed with outcome variable presentation of postoperative leak. Results One hundred one patients were included in the study. Patients reconstructed with protocol 1, with the diagnosis different to the pituitary adenoma and older than 45 years old had higher risk of presenting postoperative leak, and with statistically significant differences when we adjusted for the remaining variables. Conclusion The vascularized reconstructions after endoscopic endonasal skull base approaches have demonstrated to be able to obtain a low rate of postoperative CSF leak. The multilayer vascularized technique may provide a more evolved technique, even reducing the postoperative leak rates comparing with the monolayer vascularized one. The reconstructive protocol employed in each case, as well as age and histological diagnosis, is independent risk factor for presenting postoperative leak.

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An improvised surgical reconstruction technique for repair of traumatic multi- fragmented fracture of first tracheal ring

MOJ Clinical & Medical Case Reports ◽

10.15406/mojcr.2018.08.00243 ◽

2018 ◽

Vol 8 (2) ◽

Author(s):

Ikram ul haq Chaudhry

Keyword(s):

Tracheal Ring ◽

Surgical Reconstruction ◽

Reconstruction Technique

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Reliable reconstruction of the complex high-location bile duct injury: a novel hepaticojejunostomy

BMC Surgery ◽

10.1186/s12893-019-0642-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Yuxin Zhang ◽

Jianping Zhao ◽

Songshan Chai ◽

Zhanguo Zhang ◽

Lei Zhang ◽

...

Keyword(s):

Bile Duct ◽

Bile Duct Injury ◽

Biliary Fistula ◽

Surgical Reconstruction ◽

Reconstruction Technique ◽

The Novel ◽

Repair Operation ◽

The Mean ◽

Convenient Technique

Abstract Background This study aimed to propose a novel surgical reconstruction technique for complex high-location bile duct injury (CHBDI). Methods There were eight patients with CHBDI underwent the novel hepaticojejunostomy between Feb 2015 and Feb 2017. Seven patients underwent a primary operation and found CHBDI postoperatively in the inferior hospitals referred to our center. And four of them had received hepaticojejunostomy, but the results were not satisfying. One patient (No.8) with radiographically diagnosed hilar cholangiocarcinoma came to our center for surgical treatment and underwent the novel hepaticojejunostomy technique because CHBDI was found in operation. Perioperative and follow-up data of these patients were retrospectively reviewed. Results The mean age was 47.6 ± 10.7 years, and there was four female. The mean range of time between the injury and the repair operation in our center was 6.3 ± 4.8 months. All repair operations using the novel hepaticojejunostomy technique in our center were successfully performed. No postoperative complications, including biliary fistula, restenosis, peritonitis, and postoperative cholangitis was observed. Besides, no evidence of biliary stenosis or biliary complications happened during the follow-up (median 28 months). Conclusions The novel hepaticojejunostomy is a reliable and convenient technique for surgical repair of multiple biliary ductal openings like CHBDI.

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Ozaki Procedure for the treatment of Aortic Valve Endocarditis : A Life-saving Alternative

10.22541/au.161262378.88489267/v1 ◽

2021 ◽

Author(s):

Harun Arbatli ◽

Ali Kubilay Korkut ◽

Okan Coskun ◽

Cem Alhan

Keyword(s):

Aortic Valve ◽

Aortic Regurgitation ◽

Surgical Reconstruction ◽

Reconstruction Technique ◽

Pathologic Finding ◽

Mortality And Morbidity ◽

Severe Aortic Regurgitation ◽

First Choice ◽

Magnetic Resonance Imaging Mri ◽

The Right

Infective endocarditis (IE) still has a high risk of mortality and morbidity, despite of developments in medical treatment. Intracranial hemorrhage is one of serious complication, which has poor outcome. We present a 30-year-old male with diagnosis of IE. He had severe aortic regurgitation and oscillating vegetations on both side of the aortic valve. Although there was no neurological symptom in preoperative period, cranial magnetic resonance imaging (MRI) revealed millimetric size ischemic lesions at the right cerebral hemisphere. We performed Ozaki procedure. However, cerebral hemorrhage occurred on the first postoperative day. Computerized tomography (CT) revealed hematoma in parietal and occipital lobes. He was treated with conservative anti-edema therapy and discharged from the hospital on the 25th day with minor visual defect of his eye. Echocardiography control revealed mild aortic regurgitation without any other pathologic finding after 18 months. Aortic neocuspidization by using using of glutaraldehyde treated autologous pericardium decreases the risk of fibrosis and calcification, and thrombosis events. Possibility of suspending the anticoagulant and antiplatelet regimen is a significant advantage in this type of repair. Ozaki procedure might be the first-choice surgical reconstruction technique in anatomically suitable IE cases.

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Strictures and fistulas of the anterior urethra

Urologia Journal ◽

10.1177/039156039706400405 ◽

1997 ◽

Vol 64 (4) ◽

pp. 400-404

Author(s):

S. Ranno ◽

R. Leonardi ◽

G. Stracuzzi ◽

G. Minaldi ◽

P. Miria

Keyword(s):

Gold Standard ◽

Surgical Reconstruction ◽

Reconstruction Technique ◽

Free Graft ◽

Spongy Tissue ◽

Anterior Portion ◽

The Past ◽

Urethral Strictures ◽

Free Grafts ◽

Urethral Surgery

– The first documents of urethral surgery for urethral strictures date back to the 4th century BC. In the past, endoscopic surgery was the best solution for most urologists. Nowadays, literature shows that the approach to urethral strictures depends on the degree of involvement of the spongy body. The choice of surgical reconstruction technique depends on the anatomical differences in the anterior portion of the urethra, which is divided anatomically into navicular, penile and bulbar. The gold standard for urethroplasty of the navicular urethra is the free graft which can take root due to the presence of glandular tissue. Techniques using a preputial pedunculated graft are good for penile urethra, while a free graft of preputial origin, that has first been perforated and then tubularised, is suggested for very long strictures (> 5 cm). Epidermal or mucosal free grafts can be used for bulbous urethral strictures, due to the presence of thick spongy tissue. The urethra should be completely substituted with a neo-urethra formed by preputial pedunculated and tubularised graft only for wide strictures with associated fibrosis of the spongy portion. Recurrent strictures can be treated twice with surgery.

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