Minimally Invasive Approach to Eliminate Pyogenic Granuloma: A Case Report

Pyogenic granuloma is one of the inflammatory hyperplasia seen in the oral cavity. The term is a misnomer because it is not related to infection and arises in response to various stimuli such as low-grade local irritation, traumatic injury, or hormonal factors. It is most commonly seen in females in their second decade of life due to vascular effects of hormones. Although excisional surgery is the treatment of choice for it, this paper presents the safest and most minimally invasive procedure for the regression of pyogenic granuloma.

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Minimally invasive procedure for type II canal defect caesarean scar pregnancy with cardiac activity and high hCG titres at 8+2 weeks of gestation

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2014-0049 ◽

2015 ◽

Vol 4 (2) ◽

Author(s):

Elif Gul Yapar Eyi

Keyword(s):

Minimally Invasive ◽

Cardiac Activity ◽

Invasive Procedure ◽

Severe Bleeding ◽

Type Ii ◽

Minimally Invasive Procedure ◽

Invasive Approach ◽

Crown Rump Length ◽

Caesarean Scar ◽

Caesarean Scar Pregnancy

AbstractType II caesarean scar pregnancy (CSP) not only poses important maternal hazards, such as severe bleeding, uterine rupture, disseminated intravascular coagulation and maternal death due to its abnormal location and invasive characteristics, but its surgical management may lead to operative complications and even loss of fertility. The sonographic and Doppler findings of a “canal defect CSP” that has previously been hypothesised, but not illustrated, are presented here. A minimally invasive approach was performed in the presence of a 38.3 mm gestational sac (GS) with a crown rump length of 11.3 mm embryo (8+2 weeks of gestation) and cardiac activity with high (118,839.2 mIU/mL) human chorionic gonadotropin (hCG) levels. A transabdominal intragestational sac injection of potassium chloride to stop cardiac activity, and consecutively, methotrexate (MTX) was given before systemic MTX therapy. Embryonic cardiac activity stopped. Systemic methotrexate was repeated 8 days after the procedure. While vaginal bleeding ceased in 3 weeks with gradual shrinkage of the GS, hCG fell to non-pregnant levels within 112 days (16 weeks); complete resolution of the ectopic mass required 8 months. This is the first report presenting the success of a minimally invasive procedure at a hCG level of 118,839.2 mIU/mL with embryonic cardiac activity in type II CSP.

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Minimally invasive pancreatic resection in the light of evidence − state of the art

10.33699/pis.2021.100.5.213-217 ◽

2021 ◽

Vol 100 (5) ◽

Keyword(s):

Minimally Invasive ◽

Surgical Site Infections ◽

Long Term Results ◽

Sufficient Evidence ◽

Perioperative Outcomes ◽

Benign Tumors ◽

Low Grade ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Oncological Results

The trend of minimally invasive surgery expands even into the most technically demanding areas, including HPB surgery. Faster recovery and elimination of surgical site infections achieved with a minimally invasive approach provides, in addition to a better quality of life, the possibility of starting adjuvant treatment earlier. However, evidence of non-inferiority of short-term and oncological results compared to open surgery is required. In minimally invasive distal pancreatectomy, there is sufficient evidence to suggest that it as the method of choice for benign tumors and low-grade malignancies. For pancreatic cancer, the long-term results so far appear to be equivalent, although this still needs to be confirmed by ongoing randomized controlled trials (RCT). Enucleation of accessible lesions is also a suitable procedure for the minimally invasive approach. In contrast, in pancreaticoduodenectomy, available evidence does not demonstrate a clear benefit of the minimally invasive approach. Safety concerns still remain, and not even formal training has been successful in eliminating the consequences of the long learning curve for perioperative outcomes. Robotic approach appears to be more promising than laparoscopy for pancreaticoduodenectomy.

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Modifying Gummy Smile: A Minimally Invasive Approach

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1625 ◽

2014 ◽

Vol 15 (6) ◽

pp. 821-826 ◽

Cited By ~ 7

Author(s):

Walid Ahmed Abdullah ◽

Hesham S Khalil ◽

Maryam M Alhindi ◽

Hamdy Marzook

Keyword(s):

Patient Satisfaction ◽

Minimally Invasive ◽

Invasive Procedure ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Lower Position ◽

Surgical Methods ◽

Levator Labii Superioris ◽

Gummy Smile

ABSTRACT Aim Excessive gingival display is a problem that can be managed by variety of procedures. These procedures include non-surgical and surgical methods. The underlying cause of gummy smile can affect the type of procedure to be selected. Most patients prefer minimally invasive procedures with outstanding results. The authors describe a minimally invasive lip repositioning technique for management of gummy smile. Materials and methods Twelve patients (10 females, 2 males) with gingival display of 4 mm or more were operated under local anesthesia using a modified lip repositioning technique. Patients were followed up for 1, 3, 6 and 12 months and gingival display was measured at each follow up visit. The gingival mucosa was dissected and levator labii superioris and depressor septi muscles were freed and repositioned in a lower position. The levator labii superioris muscles were pulled in a lower position using circumdental sutures for 10 days. Both surgeon's and patient's satisfaction of surgical outcome was recorded at each follow-up visit. Results At early stage of follow-up the main complaints of patients were the feeling of tension in the upper lip and circum oral area, mild pain which was managed with analgesics. One month postoperatively, the gingival display in all patients was recorded to be between 2 and 4 mm with a mean of (2.6 mm). Patient satisfaction records after 1 month showed that 10 patients were satisfied with the results. Three months postoperatively, the gingival display in all patients was recorded and found to be between 2 and 5 mm with a mean of 3 mm. Patient satisfaction records showed that 8 patients were satisfied with the results as they gave scores between. Surgeon's satisfaction at three months follow up showed that the surgeons were satisfied in 8 patients. The same results were found in the 6 and 12 months follow-up periods without any changes. Complete relapse was recorded only in one case at the third postoperative month. Conclusion This study showed that the proposed lip repositioning technique is an acceptable minimally invasive procedure in managing gummy smile. Clinical significance A non-invasive procedure to avoid other complicated surgical procedures. How to cite this article Abdullah WA, Khalil HS, Alhindi MM, Marzook H. Modifying Gummy Smile: A Minimally Invasive Approach. J Contemp Dent Pract 2014;15(6):821-826.

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Direct Pars Defect Tubular Decompression and TLIF for the Treatment of Low-Grade Adult Isthmic Spondylolisthesis: Surgical Challenges and Nuances of a Muscle-Sparing Minimally Invasive Approach

Minimally Invasive Surgery ◽

10.1155/2020/5346805 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Fabio Roberti ◽

Katie Arsenault

Keyword(s):

Minimally Invasive ◽

Interbody Fusion ◽

Transforaminal Lumbar Interbody Fusion ◽

Low Grade ◽

Lumbar Interbody Fusion ◽

Isthmic Spondylolisthesis ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Muscle Sparing

We present an illustrative report on the use of a minimally invasive, muscle-sparing, direct pars defect decompression with transforaminal lumbar interbody fusion (TLIF) and instrumentation for the treatment of low-grade adult isthmic spondylolysis with spondylolisthesis and discuss the surgical challenges and nuances associated with the technique.

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Circumferential minimally invasive approach for low-grade isthmic spondylolisthesis: A clinical and radiological study of 43 patients

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2018.02.004 ◽

2018 ◽

Vol 104 (5) ◽

pp. 575-579 ◽

Cited By ~ 1

Author(s):

K. Farah ◽

T. Graillon ◽

P. Rakotozanany ◽

S. Pesenti ◽

B. Blondel ◽

...

Keyword(s):

Minimally Invasive ◽

Low Grade ◽

Isthmic Spondylolisthesis ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Radiological Study

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Transapical Off-Pump Neochord Implantation in Case of Severe Mitral Regurgitation

Acta Chirurgica Latviensis ◽

10.1515/chilat-2017-0007 ◽

2016 ◽

Vol 16 (2) ◽

pp. 28-30

Author(s):

Uldis Strazdins ◽

Gvido Janis Bergs ◽

Martins Kalejs ◽

Indra Vilumsone

Keyword(s):

Mitral Valve ◽

Mitral Regurgitation ◽

Minimally Invasive ◽

Invasive Procedure ◽

Valve Repair ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Off Pump ◽

Significant Clinical Improvement ◽

Artificial Chordae

SummaryMitral regurgitation is common valvular heart disease and a major cause of congestive heart failure and death. It is most often associated with degenerative changes in mitral valve which leads to valve prolapse. Transapical off-pump mitral valve repair is a new minimally invasive procedure to treat mitral regurgitation. Here we report 64-year old female who suffered from grade III mitral regurgitation due to ruptured chorda and posterior leaflet P2/P3 segment prolapse. During surgery 4 artificial chordae were implanted and postoperative echocardiography results showed minimal residual grade I mitral regurgitation, therefore significant clinical improvement can be achieved with minimally invasive approach.

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Clinical Nature and Treatment with Sclerotherapy of Pyogenic Granuloma: A Case Series

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/43567.14047 ◽

2020 ◽

Author(s):

Jigna S Shah ◽

Anand Patel ◽

Nutan Lunagariya

Keyword(s):

Laser Therapy ◽

Traumatic Injury ◽

Case Series ◽

Surgical Excision ◽

Pyogenic Granuloma ◽

Low Grade ◽

Treatment Protocols ◽

Carbon Dioxide Co2 ◽

Almost All ◽

Excisional Surgery

Pyogenic granuloma is a misnomer, as in reality it arises in response to various irritating factors such as low-grade local irritation or hormonal factors, traumatic injury as well as presented as inflammatory hyperplasia that is not related to infection. Oral pyogenic granuloma is a lobulated or smooth exophytic lesion with pedunculated or sometimes sessile base, haemorrhagic in tendency. Although excisional surgery is the treatment of choice for it, some other treatment protocols such as laser therapy, sclerotherapy with 3% polidocanol, cryotherapy and steroid therapy have also been proposed. Here, Authors present a case series of gingival as well as extra gingival pyogenic granulomas which were diagnosed and treated by various therapies i.e., surgical excision, Carbon Dioxide (CO2) laser therapy and sclerotherapy. Regression period of lesion with different therapies was evaluated in detail. Maximum patients were female in the age group of 26-50 years in present case series. Almost all cases of pyogenic granuloma had typical clinical characteristic without bony alteration. Amongst all therapies sclerotherapy had the biggest advantage of less regression period for any case of pyogenic granuloma i.e., 7-8 days only.

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