Short-Term Radiographic Outcomes of Calcaneus Fractures Treated With 2-Incision, Minimally Invasive Approach

2019 ◽  
Vol 40 (9) ◽  
pp. 1060-1067
Author(s):  
Snow B. Daws ◽  
Kaitlin Neary ◽  
Gregory Lundeen
Keyword(s):  
Minimally Invasive ◽  
Sensory Nerve ◽  
Case Series ◽  
Fracture Reduction ◽  
Minimally Invasive Approach ◽  
Invasive Treatment ◽  
Level Of Evidence ◽  
Invasive Approach ◽  
Calcaneus Fractures ◽  
Böhler’S Angle

Background: The treatment of displaced, intra-articular calcaneus fractures is controversial. The extensile lateral approach has been historically preferred because it provides excellent exposure and visualization for fracture reduction. However, soft tissue complications with this approach can lead to poor outcomes for patients. Recently, there has been an interest in the minimally invasive treatment of calcaneus fractures. The purpose of the present study was to determine the radiographic reduction of displaced, intra-articular calcaneus fractures and the rate of complications using a 2-incision, minimally invasive approach. Methods: A dual-incision, minimally invasive approach with plate and screw fixation was utilized for the treatment of 32 patients with displaced, intra-articular calcaneus fractures. Preoperative and postoperative calcaneal measurements were taken to assess fracture reduction. Additionally, a retrospective chart review was performed to assess for complications. Results: The mean preoperative Bohler’s angle measurement was 12.9 (range, –5 to 36) degrees and the final postoperative Bohler’s angle was 31.7 (range, 16-40) degrees. One patient (3.1%) had postoperative numbness related to the medial incision in the calcaneal branch sensory nerve distribution. Two patients (6.2%) had a wound infection treated with local wound care and oral antibiotics, while 1 patient (3.1%) had a deep infection that required a secondary surgery for irrigation and debridement. Two patients (6.2%) returned to the operating room for removal of symptomatic hardware. Conclusion: Operative fixation of displaced, intra-articular calcaneus fractures treated with a 2-incision, minimally invasive approach resulted in acceptable fracture reduction with a minimal rate of complications. Level of Evidence: Level IV, retrospective case series.

scholarly journals The Arrowhead Ministernotomy with Rigid Sternal Plate Fixation: A Minimally Invasive Approach for Surgery of the Ascending Aorta and Aortic Root

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Mark J. Russo ◽  
John Gnezda ◽  
Aurelie Merlo ◽  
Elizabeth M. Johnson ◽  
Mohammad Hashmi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Aortic Root ◽  
Plate Fixation ◽  
Aortic Surgery ◽  
Case Series ◽  
Ascending Aorta ◽  
The Body ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Novel Approach

Background. Ministernotomy incisions have been increasingly used in a variety of settings. We describe a novel approach to ministernotomy using arrowhead incision and rigid sternal fixation with a standard sternal plating system.Methods. A small, midline, vertical incision is made from the midportion of the manubrium to a point just above the 4th intercostal mark. The sternum is opened in the shape of an inverted T using two oblique horizontal incisions from the midline to the sternal edges. At the time of chest closure, the three bony segments are aligned and approximated, and titanium plates (Sternalock, Jacksonville, Florida) are used to fix the body of the sternum back together.Results. This case series includes 11 patients who underwent arrowhead ministernotomy with rigid sternal plate fixation for aortic surgery. The procedures performed were axillary cannulation (n=2), aortic root replacement (n=3), valve sparing root replacement (n=3), and replacement of the ascending aorta (n=11) and/or hemiarch (n=2). Thirty-day mortality was 0%; there were no conversions, strokes, or sternal wound infections.Conclusions. Arrowhead ministernotomy with rigid sternal plate fixation is an adequate minimally invasive approach for surgery of the ascending aorta and aortic root.

scholarly journals Minimally invasive treatment of spinal dural arteriovenous fistula with the use of intraoperative indocyanine green angiography

2013 ◽  
Vol 35 (v2supplement) ◽  
pp. Video5 ◽  
Author(s):  
Ricardo B. Fontes ◽  
Lee A. Tan ◽  
John E. O'Toole
Keyword(s):  
Minimally Invasive ◽  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Early Mobilization ◽  
Open Approach ◽  
Minimally Invasive Approach ◽  
Invasive Treatment ◽  
Spinal Dural Arteriovenous Fistula ◽  
Invasive Approach

Spinal dural arteriovenous fistula (dAVF) is the most common vascular malformation of the spinal cord. Traditionally it is treated by the standard muscle-splitting midline approach with bilateral laminectomies extending from one level above to one level below the dAVF. We present a minimally invasive approach for ligation of dAVF with concurrent use of intraoperative indocyanine green (ICG) angiography. Minimally invasive watertight dural closure technique is also demonstrated and discussed. The minimally invasive approach with intraoperative ICG results in quicker recovery, early mobilization and shorter hospital stay compared to traditional open approach.The video can be found here: http://youtu.be/mNUeJKLxL3Q.

scholarly journals Minimally invasive approach to extraforaminal disc herniations at the lumbosacral junction using an operating microscope: case series and review of the literature

2008 ◽  
Vol 25 (2) ◽  
pp. E10 ◽  
Author(s):  
Stephen M. Pirris ◽  
Sanjay Dhall ◽  
Praveen V. Mummaneni ◽  
Adam S. Kanter
Keyword(s):  
Minimally Invasive ◽  
Lumbar Disc ◽  
Case Series ◽  
Minimally Invasive Approach ◽  
Tubular Retractor ◽  
Invasive Approach ◽  
Surgical Access ◽  
Small Series ◽  
Disc Herniations ◽  
Anatomical Constraints

Surgical access to extraforaminal lumbar disc herniations is complicated due to the unique anatomical constraints of the region. Minimizing complications during microdiscectomies at the level of L5–S1 in particular remains a challenge. The authors report on a small series of patients and provide a video presentation of a minimally invasive approach to L5–S1 extraforaminal lumbar disc herniations utilizing a tubular retractor with microscopic visualization.

scholarly journals Computed tomography as a method of substantiating a minimally invasive approach in the treatment of esophageal injuries and their complications

2021 ◽  
Vol 25 (2) ◽  
pp. 63-73
Author(s):  
T. G. Barmina ◽  
S. N. Danielyan ◽  
L. S. Kokov ◽  
F. A.-K. Sharifullin ◽  
O. A. Zabavskaya ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Minimally Invasive ◽  
Pleural Empyema ◽  
Complete Information ◽  
Treatment Method ◽  
Thoracic Esophagus ◽  
Minimally Invasive Approach ◽  
Invasive Treatment ◽  
Invasive Approach ◽  
Ct Data

The purpose of the study. To analyze possibilities of computed tomography (CT) for esophageal injuries and their complications as part of a differentiated approach to the choice of a minimally invasive treatment method.Materials and methods. The results of CT scans were analyzed in 25 patients with esophageal injuries of various etiologies who were treated at the N.V. Sklifosovsky Research Institute of SP in the period 2019–2020. CT was performed with oral and intravenous bolus contrast, primarily at admission and in dynamics, a total of 77 studies.Results. In all cases, direct and indirect CT signs of esophageal damage were detected, and the degree of involvement of surrounding organs and tissues in the pathological process was assessed. Based on the data obtained, the following variants of esophageal damage and its complications were identified: intramural esophageal hematoma (2); rupture of the thoracic esophagus without the development of purulent complications (2); rupture of the thoracic esophagus complicated by the development of mediastinitis (4); rupture of the thoracic esophagus with the development of mediastinitis and pleural empyema (13); rupture of the cervical calving of the esophagus, complicated by phlegmon of the neck and descending mediastinitis (4). Different patient management tactics were used for each variant. Thus, the selection and sequence of minimally invasive interventions, such as thoracoscopic sanitation mediastinal and pleural cavity, esophageal stenting, percutaneous endoscopic gastrostomy (CEG) and endoscopic vacuum aspiration system (E-VAS), were carried out taking into account CT data, including observations in dynamics.Conclusion. CT scan for esophageal injuries allows you to get complete information about both the nature of esophageal damage and its complications, to determine their type, localization and volume. CT data allow us to justify a minimally invasive approach in the treatment of esophageal injuries, to determine the order of interventions. CT studies performed in dynamics allow us to evaluate the effectiveness of treatment and to carry out timely correction of tactics.

scholarly journals PRIMARY ABANDON-OF-THE-SAC (PAS) TECHNIQUE: PRELIMINARY RESULTS OF A NOVEL MINIMALLY INVASIVE APPROACH FOR INGUINOSCROTAL HERNIA REPAIR

2020 ◽  
Vol 33 (2) ◽  
Author(s):  
Alexander Charles MORRELL ◽  
Andre Luiz Gioia MORRELL ◽  
Flavio MALCHER ◽  
Allan Gioia MORRELL ◽  
Alexander Charles MORRELL-JUNIOR
Keyword(s):  
Minimally Invasive ◽  
Average Length ◽  
Intraoperative Complications ◽  
Case Series ◽  
Surgical Site Infections ◽  
Postoperative Outcomes ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Preliminary Results ◽  
Average Length Of Stay

ABSTRACT Background: Laparoscopic best approach of repairing inguinoscrotal hernias are still debatable. Incorrect handling of the distal sac can possibly result in damage to cord structures and negative postoperative outcomes as ischemic orquitis or inguinal neuralgia. Aim: To describe a new technique for a minimally invasive approach to inguinoscrotal hernias and to analyze the preliminary results of patients undergoing the procedure. Methods: A review of a prospectively maintained database was conducted in patients who underwent minimally invasive repair using the “primary abandon-of-the-sac” (PAS) technique for inguinoscrotal hernias. Patient´s demographics, as well as intraoperative variables and postoperative outcomes were also analyzed. Results: Twenty-six male were submitted to this modified procedure. Mean age of the case series was 53.8 years (range 34-77) and body mass index was 26.8 kg/m2 (range 20.8-34.2). There were no intraoperative complications or conversion. Average length of stay was one day. No surgical site infections, pseudo hydrocele or neuralgia were reported after the procedure and two patients presented seroma. No inguinal hernia recurrence was verified during the mean 21.4 months of follow up. Conclusion: The described technique is safe, feasible and reproducible, with good postoperative results.

scholarly journals Guidelines of the Italian Society of Videosurgery in Infancy (SIVI) for the minimally invasive treatment of fetal and neonatal ovarian cysts

2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Salvatore Fabio Chiarenza ◽  
Maria Luisa Conighi ◽  
Andrea Conforti ◽  
Cosimo Bleve ◽  
Ciro Esposito ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Prenatal Screening ◽  
Minimally Invasive Treatment ◽  
Ovarian Cysts ◽  
Minimally Invasive Approach ◽  
Invasive Treatment ◽  
Invasive Approach ◽  
Technological Improvement ◽  
Treatment Uncertainties ◽  
Screening Ultrasound

In the last three decades, fetal ovarian cysts were diagnosed more frequently, due to technological improvement and the increasing use of prenatal screening ultrasound. Nonetheless, treatment uncertainties are still present, either prenatally or postnatally. Recently, significant innovations on diagnosis and treatment have been proposed and a more conservative, minimally invasive approach may be offered to the Pediatrician or the Surgeon who face with this condition during prenatal or neonatal age. (...)

scholarly journals Pinhole surgical technique – A novel minimally invasive approach for treatment of multiple gingival recession defects: A case series

2020 ◽  
Vol 11 (1) ◽  
pp. 97
Author(s):  
Geetika Kumar ◽  
ManviChandra Agarwal ◽  
RG Shiva Manjunath ◽  
SS Sai Karthikeyan ◽  
ShivaShankar Gummaluri
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Case Series ◽  
Gingival Recession ◽  
Minimally Invasive Approach ◽  
Invasive Approach

scholarly journals Minimally Invasive Technique for the Reconstruction of the Medial Posteral Corner of the Knee associated to Anterior Cruciate Ligament. Functional Outcomes. Case Series

2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0018
Author(s):  
Daniel Sini ◽  
Andres M. Jalil ◽  
Cristian A. Ferreyra ◽  
Mauricio Balla ◽  
Pablo S. Mancini ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Soft Tissues ◽  
Cruciate Ligament ◽  
Case Series ◽  
Anatomical Reconstruction ◽  
Collateral Ligament ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Acute Injuries ◽  
Anterior Cruciate

The medial collateral ligament (MCL) and the anterior cruciate ligament (ACL) are the most commonly damaged ligaments of the knee. These are common injuries in young people and athletes. Joint laxity may contribute to long-term cartilage degeneration in the medial compartment and give functional limitations as a result of severe lesions of ACL and MCL treated conservatively. In severe acute injuries and chronic symptomatic instabilities should be indicated surgical treatment. The anatomical technique of medial reconstruction of the knee returns stability and allows a distribution of the normal load in patients with severe or chronic acute injuries. Anatomical reconstructions require large incisions and dissections of soft tissues, favoring the risk of contracture in flexion or extension. The technique we used in our series consists of a modification of Laprade’s anatomical technique through a non-anatomical triangular medial reconstruction of the knee, using a minimally invasive approach. Objectives: Show our technique in combined injuries of medial collateral ligament and ACL. Methods: Observational study, case series, retrospective. Population of five patients (N: 5) adults of both sexes, older than 18 years, with a diagnosis of combined lesion of MCL grade II - III with clinical and subjective instability and complete rupture of ACL that have been treated surgically with an anatomical reconstruction using arthroscopic approach of the ACL and a triangular reconstruction with the modified anatomical technique of LaPrade through a minimally invasive approach by the Orthopedics and Traumatology Service of the Reina Fabiola University Clinic. A descriptive statistical analysis of the data was performed. Results: A total of five patients with an average age of 27 ± 10.89 years were included. Of the total 4 (80%) correspond to the male sex. 100% of the cases presented a grade III lesion of the MCL. Patients were followed for an average of 16 ± 9.28 months. The ROM achieved by the patients was of full extension (0°) in 100% of them and flexion in average of 130° ± 14,14. All the cases presented exceeded 100° of flexion. Pain (EVA) 0.45 / 10. The maneuvers of the internal yawn and Lachman were negative in the whole series. According to Lysholm’s functional score, there was an improvement on average of 50.40 ± 6.23 points between the preoperative evaluation, which was initially poor (40.40 ± 9.91) and the post-operative excellent (90.80 ± 4.97). All the cases in the series presented a response to treatment greater than 84 points according to the Lysholm score, with an average good to excellent result in the total. Conclusion: Although there are anatomical techniques validated for the reconstruction of the MCL, the vast majority of them involves an extensive approach with the consequent damage of soft tissues derived from it. The current trend consists of a less aggressive treatment of LCM with an associated reconstruction of the ACL. The fact of performing an anatomical reconstruction with good initial and stable fixation, minimizing soft tissue damage, aims at early rehabilitation, decreasing the chances of rigidity. We did not observe any significant limitation in the ROM, nor post-surgical rigidity in our series of patients. All of them presented a good to excellent Lysholm score and no complications were observed. This type of construct is less invasive and more practical to perform, since it uses a fixation device less than the anatomical technique of LaPrade, which reduces the cost of surgery and decreases less the bone stock, on the other hand the surgical time is not prolonged. Other advantages are that it consists of a short construct with low risk of voltage loss, with a favorable isometry and that is fast, easy to perform and reproducible.

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