Anomalous Aortic Origin of the Coronary Arteries – State of the Art Management and Surgical Techniques

2021 ◽  
Vol 24 ◽  
pp. 85-94
Author(s):  
Carlos Bonilla-Ramirez ◽  
Silvana Molossi ◽  
Christopher A. Caldarone ◽  
Ziyad M. Binsalamah
Keyword(s):  
Coronary Arteries ◽  
State Of The Art ◽  
Surgical Techniques

Isolated meniscus injuries in skeletally immature children and adolescents: state of the art

2021 ◽  
pp. jisakos-2020-000496
Author(s):  
Gustavo Vinagre ◽  
Flávio Cruz ◽  
Khalid Alkhelaifi ◽  
Pieter D'Hooghe
Keyword(s):  
Children And Adolescents ◽  
State Of The Art ◽  
Surgical Techniques ◽  
Meniscal Repair ◽  
Management Plan ◽  
Anatomical Location ◽  
Return To Sports ◽  
Meniscal Tears ◽  
Geographical Differences ◽  
Meniscal Healing

The prevalence of isolated meniscal injuries in children and adolescents is low; however, we see an increase mainly due to intensified sports-related activities at an early age. A meniscal repair should be attempted whenever possible as children present with increased meniscal healing potential. The diagnosis and management of meniscal tears involve both patient factors and tear characteristics: size, anatomical location and associated injuries. Special attention should be given to the feature of discoid menisci and related tears as they require a specific management plan. This state-of-the-art review highlights the most recent studies on clinical evaluation, surgical techniques, tips and tricks, pitfalls, outcomes, return-to-sports, geographical differences and future perspectives related to meniscal injuries in children and adolescents.

Meniscal transplantation: state of the art

2017 ◽  
Vol 2 (6) ◽  
pp. 339-349 ◽  
Author(s):  
Pablo E Gelber ◽  
Peter Verdonk ◽  
Alan M Getgood ◽  
Juan C Monllau
Keyword(s):  
State Of The Art ◽  
Surgical Techniques ◽  
Return To Sport ◽  
Reoperation Rate ◽  
Controversial Issues ◽  
Future Perspectives ◽  
Meniscal Allograft Transplantation ◽  
Meniscal Allograft ◽  
Feasible Option ◽  
Chondroprotective Effect

Meniscal resection is the most common surgical procedure in orthopaedics. When a large meniscal loss becomes clinically relevant, meniscal allograft transplantation (MAT) is a feasible option. However, although this technique has evolved since the ‘80s, there are still several controversial issues related to MAT. Most importantly, its chondroprotective effect is still not completely proven. Its relatively high complication and reoperation rate is another reason for this procedure not yet being universally accepted. Despite its controversial chondroprotective effect, nevertheless, MAT has become a successful treatment for pain localised in a previously meniscectomised knee, in terms of pain relief and knee function. We conducted a careful review of the literature, highlighting the most relevant studies in various aspects of this procedure. Precise indications, how it behaves biomechanically, surgical techniques, return to sport and future perspectives are among the most relevant topics that have been included in this state-of-the-art review.

Computed Tomography Imaging of the Coronary Arteries: State of the Art Applications and Recent Patents

2014 ◽  
Vol 4 (1) ◽  
pp. 22-30
Author(s):  
Alon Schaffer ◽  
Ettore Cassetti ◽  
Maria Iovine ◽  
Lucia Barbieri ◽  
Andrea Rognoni ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Arteries ◽  
State Of The Art ◽  
Computed Tomography Imaging ◽  
Tomography Imaging

Treatment of elbow instability: state of the art

2020 ◽  
pp. jisakos-2019-000316
Author(s):  
Alessandro Marinelli ◽  
Benjamin R Graves ◽  
Gregory Ian Bain ◽  
Luigi Pederzini
Keyword(s):  
Soft Tissue ◽  
State Of The Art ◽  
Current Knowledge ◽  
Imaging Techniques ◽  
Surgical Techniques ◽  
Surgical Instruments ◽  
Future Research ◽  
Elbow Instability ◽  
Soft Tissue Healing ◽  
Tissue Healing

The elbow is a congruent joint with a high degree of inherent stability, provided by osseous and soft-tissue constraints; however, when substantial lesions of these stabilising structures happen, instability of the elbow occurs. Significant improvements in surgical elbow instability diagnosis and treatment have been recently introduced both for acute and chronic cases. Specific stress tests, recently introduced in the clinical practice, and different imaging techniques, both static and dynamic, allow assessment of the elbow stabilisers and detection of the instability direction and mechanism even in subtle forms. Many surgical techniques have been standardised and surgical instruments and devices, specifically dedicated to elbow instability treatment, have been developed. Specific rehabilitation protocols have been designed to protect the healing of the elbow stabilisers while minimising elbow stiffness. However, despite the progress, surgical treatments can be challenging even for expert surgeons and the rate of persistent instability, post-traumatic arthritis, stiffness and pain can be still high especially in most demanding cases. The biology of the soft-tissue healing remains one of the most important aspects for future investigation. If future research will help to understand, correct or modulate the biological response of soft-tissue healing, our confidence in elbow instability management and the reproducibility of our treatment will tremendously improve. In this paper, the state of the art of the current knowledge of elbow instability is presented, specifically focusing on modern surgical techniques used to solve instability, with repair or reconstruction of the damaged elbow stabilisers.

scholarly journals Short Dental Implants: State of the Art and Systematic Review

2021 ◽  
pp. 50-55
Author(s):  
Marcelo Henrique Batista Santos ◽  
Priscilla Janaína de Lima Borelli Bovo ◽  
Henrique Esteves Magalhães ◽  
Luciano Rodrigues Neves ◽  
Elias Naim Kassis
Keyword(s):  
Systematic Review ◽  
Dental Implants ◽  
State Of The Art ◽  
Fibrous Tissue ◽  
Surgical Techniques ◽  
Cochrane Library ◽  
Implant Surface ◽  
Short Implants ◽  
Correct Technique ◽  
Bone Height

Introduction: The success of dental implants is due to their ability to osseointegrate, with direct contact of the implant surface with the bone, without the interposition of fibrous tissue. Because many patients do not receive implant treatments because they do not have adequate or sufficient bone height, the development of shorter implants could meet the needs of these patients. Objective: To carry out a brief systematic review to present the state of the art of using short implants. Methods: The present study followed a concise systematic review model. The search was carried out in the PubMed, Embase, Ovid, Cochrane Library, Web Of Science, and Scopus databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: Short implants are an increasingly common alternative to other surgical techniques in areas where bone availability is reduced. Despite the advantages they offer, a variety of biological repercussions have been described in the literature that can even lead to their loss. Conclusion: The studies analyzed showed that short implants are a reliable, safe, and practical alternative to be used in situations with reduced bone height. They do not present bone loss or resorption over the years, nor the risk of fracture or any damage to patients, as long as they have an adequate design, correct technique, and meticulous planning.

State of the Art in Phalloplasty

2005 ◽  
Vol 22 (3) ◽  
pp. 172-178 ◽  
Author(s):  
Alexander A. Krakovsky
Keyword(s):  
Patient Satisfaction ◽  
Sigmund Freud ◽  
Cosmetic Surgery ◽  
State Of The Art ◽  
Surgical Techniques ◽  
The United States ◽  
Assessment Scale ◽  
Medical Community ◽  
Penis Size ◽  
Image Assessment

Introduction: After Sigmund Freud “opened the bedroom door,” significant shifts in social attitudes, behaviors, and institutional regulations concerning male and female body images and the understanding of human sexuality began to occur. Today, male cosmetic genital enhancement surgery, or phalloplasty, has become the subject of recent surgical achievements that are gaining significant popularity in the United States and abroad. Appropriate methodology and surgical techniques have been developed to fulfill the demand in this field of cosmetic surgery. The objective of this study is to review the state of the art in phalloplasty and provide information about the availability of the techniques to the medical community and the public to inform them of surgical treatments that may improve unsatisfactory sexual performance, relationships, intimacy, and love by increasing the size of a man's penis. Material and Methods: Two surgeons performed phalloplasty on 594 patients at multiple surgical facilities over a 2-year period. Phalloplasty procedures include penile lengthening, penile girth enhancement, dual augmentation (combined lengthening and girth enhancement), penile glanular enhancement, scrotal web resection, and reconstruction. The patients' own satisfaction with the results of their surgeries was analyzed by using the Penis Image Assessment Scale Questionnaire. The assessment was based upon questions related to penis size, satisfaction of sexual experiences, and the psychological perspective of patients regarding their penises before and after phalloplasty. Results: Patient scores on the Penis Image Assessment Scale Questionnaire were higher before surgery (almost twice as high) than they were after surgery, showing an increase in patient satisfaction with penis size and performance after enhancement. Seventeen patients required subsequent surgery to treat local infection. Twenty-nine patients experienced localized swelling 3–7 days after surgery. The results showed enormous patient satisfaction with the cosmetic surgical procedures performed. Discussion: Penis size has always symbolized strength, virility, power, and domination in relationships. Although this subject was taboo some years ago, today many men are interested in learning about how phalloplasty may improve their self-confidence, sexual relationships, and female partners' satisfaction. Consequently, phalloplasty has acquired wide acceptance and tremendous popularity.

scholarly journals State-of-the-art surgery for pancreatic cancer

2021 ◽  
Author(s):  
Anna Nießen ◽  
Thilo Hackert
Keyword(s):  
Pancreatic Cancer ◽  
Pancreatic Surgery ◽  
Best Practice ◽  
New Technologies ◽  
State Of The Art ◽  
Surgical Techniques ◽  
Complication Management ◽  
Oncological Treatment ◽  
Current State ◽  
The Impact

Abstract Background The d evelopment of surgical techniques and specialization and specifically complication management in pancreatic surgery have improved surgical outcomes as well as oncological results in pancreatic surgery in recent decades. Historical morbidity and especially mortality rates of up to 80% have decreased to below 5% today. This review summarizes the current state of the art in pancreatic cancer surgery. Methods The present literature and clinical experience are summarized to give an overview of the present best practice in pancreatic surgery as one of the most advanced surgical disciplines today. Results Based on the available literature, three important aspects contribute to best patient care in pancreatic surgery, namely, surgical progress, interdisciplinary complication management, and multimodal oncological treatment in case of pancreatic cancer. In addition, minimally invasive and robotic procedures are currently fields of development and specific topics of research. Conclusion In experienced hands, pancreatic surgery—despite being one of the most challenging fields of surgery—is a safe domain today. The impact of multimodal, especially adjuvant, therapy for oncological indications is well established and evidence-based. New technologies are evolving and will be evaluated with high-evidence studies in the near future.

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