scholarly journals Shaft-only Phalloplasty: Technical Modifications to Optimize Aesthetics

2021 ◽  
Vol 9 (6) ◽  
pp. e3645
Author(s):  
Blair R. Peters ◽  
Eleanor McCreary ◽  
Carley A. Putnam ◽  
Jens U. Berli
Keyword(s):  
Technical Modifications

scholarly journals Robotic natural-orifice IntraCorporeal anastomosis with Extraction (NICE procedure) for complicated diverticulitis

2021 ◽  
Author(s):  
Eric M. Haas ◽  
Thais Reif de Paula ◽  
Roberto Luna-Saracho ◽  
Melissa Sara Smith ◽  
Jean-Paul J. LeFave
Keyword(s):  
Complicated Diverticulitis ◽  
Intracorporeal Anastomosis ◽  
Natural Orifice ◽  
Abdominal Incision ◽  
Stepwise Approach ◽  
Stapling Device ◽  
Video Recordings ◽  
Conversion Rates ◽  
Technical Modifications ◽  
Instrument Control

Abstract Background Totally intracorporeal surgery for left-sided resection carries numerous potential advantages by avoiding crossing staple lines and eliminating the need for an abdominal incision. For those with complicated diverticulitis, minimally invasive surgery is known to be technically challenging due to inflamed tissue, distorted pelvic anatomy, and obliterated tissue planes, resulting in high conversion rates. We aim to illustrate the stepwise approach and modifications required to successful complete the robotic Natural-orifice IntraCorporeal anastomosis with transrectal specimen Extraction (NICE) procedure in this cohort. Methods Consecutive, elective, unselected patients presenting with complicated diverticulitis defined as fistula, abscess and stricture underwent the NICE procedure over a 24-month period. Demographic and intraoperative data were collected, and video recordings were reviewed and edited on encrypted server. Results A total of 60 patients (50% female) underwent the NICE procedure for complicated diverticulitis with a mean age of 58.9 years and mean BMI of 30.7 kg/m2. The mean operative time was 231.6 min. All cases (100%) were achieved with intracorporeal anastomosis using a circular stapling device. All but one patient (98.3%) had successful transrectal extraction of the specimen. Forty-four (73%) of the specimens required a specimen-thinning maneuver to successfully extract the specimen and there were no conversions. We identified seven key technical modifications and considerations to facilitate successful completion of the procedure which are illustrated, including early release of the disease, mesentery-sparing dissection, dual instrument control of the mesenteric vasculature, release of the rectal reflection, use of NICE back table, specimen-thinning maneuver, and closure of the rectal cuff. Conclusion We present a stepwise approach with key modifications to successfully achieve totally robotic intracorporeal resection for those presenting with complicated diverticulitis. This approach may help overcome the technical challenges and provide a foundation for reproducible results.

Technical Modifications for Laparoscopic Appendectomy and Other Pelvic Procedures Using Microinstruments

2000 ◽  
Vol 10 (4) ◽  
pp. 211-214
Author(s):  
Jorge Cueto ◽  
Martín Salvador Valencia-Reyes ◽  
Jose Antonio Vazquez-Frias ◽  
Pablo Castaneda-Leeder ◽  
Roberto Nevarez-Bernal ◽  
...  
Keyword(s):  
Laparoscopic Appendectomy ◽  
Technical Modifications

scholarly journals Technical modifications in bar removal in the Nuss procedure

2010 ◽  
Vol 37 (3) ◽  
pp. 747-748
Author(s):  
José M. Mier ◽  
Laureano Molins ◽  
Juan J. Flibla
Keyword(s):  
Nuss Procedure ◽  
Technical Modifications

scholarly journals Conjugated and unconjugated bilirubins in bile of humans and rhesus monkeys. Structure of adult human and rhesus-monkey bilirubins compared with dog bilirubins

1977 ◽  
Vol 167 (3) ◽  
pp. 535-548 ◽  
Author(s):  
S G Blumenthal ◽  
D B Taggart ◽  
R Ikeda ◽  
B H Ruebner ◽  
D E Bergstrom
Keyword(s):  
Chemical Composition ◽  
Gall Bladder ◽  
Rhesus Monkey ◽  
Rhesus Monkeys ◽  
Glucuronic Acid ◽  
Unknown Compound ◽  
Adult Human ◽  
Adult Humans ◽  
Technical Modifications ◽  
Working Day

1. Bilirubin-IXalpha, -IXalpha diglucuronide, -IXalpha monoglucuronide, -IXalpha monoglucoside -IXalpha monoxyloside, a bilirubin-IXalpha diconjugate containing glucose and another unknown compound, and bilirubin-IXbeta are present in gall-bladder bile of adult human, rhesus monkey and dog. Dog bile normally also contains other bilirubin-IXalpha diconjugates, i.e. compounds containing two conjugating sugars such as glucuronic acid and glucose, glucuronic acid and xylose and glucose xylose. 2. Azopigments alphaF, alphaO, alpha2, alpha3, betax and delta derived from human and rhesus-monkey bilirubins are identical in their chemical composition with those obtained from the dog. 3. Azopigments alphaF and betax found in diazotized biles of adult humans, rhesus monkeys and dogs are products of unconjugated bilirubin-IXbeta. 4. Technical modifications of previously published procedures [Heirwegh, Fevery, Michiels, Van Hees & Compernolle, (1975) Biochem. J. 145, 185-199] were introduced which make it possible to separate the bilirubins, diazotize the separated bilirubins, extract the azopigments and chromatograph them in one working day (6-8h).

Use of the Carbon Dioxide Laser for Acoustic Tumor Surgery

Neurosurgery ◽  
1983 ◽  
Vol 12 (3) ◽  
pp. 286-290 ◽  
Author(s):  
John H. Robertson ◽  
Craig W. Clark ◽  
James T. Robertson ◽  
Gale L. Gardner ◽  
Coyle M. Shea
Keyword(s):  
Carbon Dioxide ◽  
Surgical Technique ◽  
Carbon Dioxide Laser ◽  
Tumor Surgery ◽  
Operating Microscope ◽  
Intracranial Surgery ◽  
Technical Modifications ◽  
Acoustic Tumor ◽  
Neurological Surgery ◽  
And Control

Abstract The carbon dioxide laser has been used clinically in both otorhinolaryngology and neurological surgery for approximately 10 years. Only recently, however, have technical modifications allowed its use with the operating microscope, providing the increased precision and control necessary for intracranial surgery. This paper reports the authors' experience with the carbon dioxide laser in the removal of acoustic tumors, details the surgical technique involved, and describes the advantages that may accompany the use of the laser in the removal of these difficult lesions.

scholarly journals Spade-Shaped Anastomosis after Laparoscopic Proximal Gastrectomy Using Double Suture Anchoring between the Posterior Wall of the Esophagus and the Anterior Wall of the Stomach (SPADE Operation): A Case Series

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 379
Author(s):  
Sin Hye Park ◽  
Harbi Khalayleh ◽  
Sung Gon Kim ◽  
Sang Soo Eom ◽  
Fahed Merei ◽  
...  
Keyword(s):  
Los Angeles ◽  
Anastomotic Stricture ◽  
Bile Reflux ◽  
Proximal Gastrectomy ◽  
Case Series ◽  
Posterior Wall ◽  
Anterior Wall ◽  
Reflux Symptoms ◽  
Laparoscopic Proximal Gastrectomy ◽  
Technical Modifications

We introduced SPADE operation, a novel anastomotic method after laparoscopic proximal gastrectomy (PG). Technical modifications were performed and settled. This report aimed to demonstrate the short-term clinical outcomes after settlement. Data from 34 consecutive patients who underwent laparoscopic PG with SPADE between June 2017 and March 2020 were retrospectively reviewed. Reflux was evaluated based on the patients’ symptoms and follow-up endoscopy using Los Angeles (LA) classification and RGB Classification (Residue, Gastritis, Bile). Other complications were classified using the Clavien–Dindo method. The incidence of reflux esophagitis was 2.9% (1/34). Bile reflux was observed in six patients (17.6%), and residual food was observed in 16 patients (47.1%) in the endoscopy. Twenty-eight patients had no reflux symptoms (82.4%), while five patients (14.7%) and one patient (2.9%) had mild and moderate reflux symptoms, respectively. The rates of anastomotic stricture and ileus were 14.7% (5/34) and 11.8% (4/34), respectively. No anastomotic leakage was observed. The incidence of major complications (Clavien-Dindo grade III or higher) was 14.7%. The SPADE operation following laparoscopic PG is effective in reducing gastroesophageal reflux. Its clinical usefulness should be validated using prospective clinical trials.

scholarly journals In search of sports biomechanics’ holy grail: Can athlete-specific optimum sports techniques be identified?

2019 ◽  
Author(s):  
Paul Stephen Glazier ◽  
Sina Mehdizadeh
Keyword(s):  
Dynamical Systems ◽  
Holy Grail ◽  
Optimum Technique ◽  
Dynamic Landscape ◽  
Extended Practice ◽  
Technical Modifications ◽  
Sports Skills ◽  
The Mathematical Model ◽  
Near Future ◽  
Sports Biomechanics

The development of methods that can identify athlete-specific optimum sports techniques—arguably the holy grail of sports biomechanics—is one of the greatest challenges for researchers in the field. This ‘perspectives article’ critically examines, from a dynamical systems theoretical standpoint, the claim that athlete-specific optimum sports techniques can be identified through biomechanical optimisation modelling. To identify athlete-specific optimum sports techniques, dynamical systems theory suggests that a representative set of organismic constraints, along with their non-linear characteristics, needs to be identified and incorporated into the mathematical model of the athlete. However, whether the athlete will be able to adopt, and reliably reproduce, his/her predicted optimum technique will largely be dependent on his/her intrinsic dynamics. If the attractor valley corresponding to the existing technique is deep, or if the attractor valleys corresponding to the existing technique and the predicted optimum technique are in different topographical regions of the dynamic landscape, technical modifications may be challenging or impossible to reliably implement even after extended practice. The attractor layout defining the intrinsic dynamics of the athlete, therefore, needs to be determined to establish the likelihood of the predicted optimum technique being reliably attainable by the athlete. Given the limited set of organismic constraints typically used in mathematical models of athletes, combined with the methodological challenges associated with mapping the attractor layout of an athlete, it seems unlikely that athlete-specific optimum sports techniques will be identifiable through biomechanical optimisation modelling for the majority of sports skills in the near future.

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