scholarly journals Relevant Insertion Site Anatomy of the Conventus Distal Radius System

Hand ◽  
2017 ◽  
Vol 13 (3) ◽  
pp. 341-345
Author(s):  
Jacob Duncan ◽  
Marc Trzeciak
Keyword(s):  
Patient Satisfaction ◽  
Minimally Invasive ◽  
Distal Radius ◽  
Kirschner Wire ◽  
Insertion Site ◽  
Minimally Invasive Approach ◽  
Lateral Aspect ◽  
Invasive Approach ◽  
The Mean ◽  
Application Methods

Background: The Conventus Distal Radius System (DRS) is an intramedullary fixation scaffold inserted into the lateral aspect of the distal radius. The purpose of this study was to identify insertion site anatomy to illustrate risks associated with the minimally invasive nature of radial-sided implant application. Methods: Ten cadavers were utilized. Using fluoroscopy, the 1.1-mm Kirschner wire and template was introduced per manufacturer’s guidelines, access guide assembled, and dissection carried out to the superficial radial nerve (SRN) with preservation of the native location. The access guide marked the insertion location for the side-cut drill. This point was measured in relationship to structures nearby, including the SRN, brachioradialis (BR), lateral antebrachial cutaneous nerve (LABCN), and radial styloid (RS). Results: The large guide contacted the SRN in 4 of 10 cadavers and was volar to it in 6 of 10. When volar, the mean distance was 1.7 mm. The tip of the RS to the large access guide averaged 44.5 mm. The small guide contacted the SRN in 2 of 10, was volar to it in 4 of 10, and between the bifurcation in 4 of 10. When volar, the distance averaged 3.25 mm. When bifurcated, the distance from the small guide to both the dorsal and volar branches was 3.5 mm. The distance from the RS to the small guide averaged 37.8 mm. The LABCN was found in the field of dissection in 4 of 10 cadavers. Conclusions: Several structures are at risk during insertion of the Conventus DRS; thus, knowledge of the relevant anatomy of this minimally invasive approach is crucial to optimize outcomes and patient satisfaction, and to avoid nerve injury.

scholarly journals Minimally Invasive Plate Osteosynthesis for a Distal Radius Fracture with Forearm Skin Problem

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Kiyohito Naito ◽  
Yoichi Sugiyama ◽  
Mayuko Kinoshita ◽  
Ahmed Zemirline ◽  
Chihab Taleb ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Distal Radius ◽  
Skin Disorder ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Volar Locking Plate ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Locking Plate Osteosynthesis ◽  
The Right

In this study, we performed osteosynthesis for a distal radius fracture using a minimally invasive approach for a patient with skin disorder of the forearm and obtained favorable results. This case report may provide new findings confirming the usefulness of this surgical approach for distal radius fractures. Blister formation on the right forearm was observed in a 53-year-old female who was diagnosed with a distal fracture of the right radius and underwent splinting in a local hospital, and she was referred to our hospital 2 days after the injury. Minimally invasive locking plate osteosynthesis was performed, and there was no skin lesion at this incision site. Postoperatively, there were no complications in soft tissues and the operative scar was almost unrecognizable. We reported volar locking plate osteosynthesis using the minimally invasive approach in a patient with skin disorder of the forearm. Such patients are rarely encountered. However, this minimally invasive approach is extremely useful for utilizing the advantages of volar locking plate fixation without being affected by the soft tissue environment.

Sutureless Aortic Valve Implantation through an Upper V-Type Ministernotomy: An Innovative Approach in High-Risk Patients

2013 ◽  
Vol 8 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Giovanni Concistrè ◽  
Antonio Miceli ◽  
Francesca Chiaramonti ◽  
Pierandrea Farneti ◽  
Stefano Bevilacqua ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Valve ◽  
Minimally Invasive ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
High Risk Patients ◽  
Risk Patients ◽  
The Mean ◽  
Valve Implantation

Objective Aortic valve replacement in minimally invasive approach has shown to improve clinical outcomes even with a prolonged cardiopulmonary bypass and aortic cross-clamp (ACC) time. Sutureless aortic valve implantation may ideally shorten operative time. We describe our initial experience with the sutureless 3f Enable (Medtronic, Inc, ATS Medical, Minneapolis, MN USA) aortic bioprosthesis implanted in minimally invasive approach in high-risk patients. Methods Between May 2010 and May 2011, thirteen patients with severe aortic stenosis underwent aortic valve replacement with the 3f Enable bioprosthesis through an upper V-type ministernotomy interrupted at the second intercostal space. The mean ± SD age was 77 ± 3.9 years (range, 72–83 years), 10 patients were women, and the mean ± SD logistic EuroSCORE was 15% ± 13.5%. Echocardiography was performed preoperatively, at postoperative day 1, at discharge, and at follow-up. Clinical data, adverse events, and patient outcomes were recorded retrospectively. The median follow-up time was 4 months (interquartile range, 2–10 months). Results Most of the implanted valves were 21 mm in diameter (19–25 mm). The CPB and ACC times were 100.2 ± 25.3 and 66.4 ± 18.6 minutes. At short-term follow-up, the mean ± SD pressure gradient was 14 ± 4.9 mm Hg; one patient showed trivial paravalvular leakage. No patients died during hospital stay or at follow-up. Conclusions The 3f Enable sutureless bioprosthesis implanted in minimally invasive approach through an upper V-type ministernotomy is a feasible, safe, and reproducible procedure. Hemodynamic and clinical data are promising. This innovative approach might be considered as an alternative in high-risk patients. Reduction of CPB and ACC time is possible with increasing of experience and sutureless evolution of actual technology.

Minimally Invasive Lateral Retropleural Thoracolumbar Approach: Cadaveric Feasibility Study and Report of 4 Clinical Cases

2011 ◽  
Vol 68 (suppl_1) ◽  
pp. ons32-ons39 ◽  
Author(s):  
Juan S. Uribe ◽  
Elias Dakwar ◽  
Rafael F. Cardona ◽  
Fernando L. Vale
Keyword(s):  
Minimally Invasive ◽  
Thoracolumbar Spine ◽  
Early Experience ◽  
Complication Rates ◽  
Minimally Invasive Approach ◽  
Lateral Aspect ◽  
Invasive Approach ◽  
Vertebral Bodies ◽  
Clinical Cases

Abstract BACKGROUND: Traditional anterior and posterior approaches to the thoracolumbar spine are associated with significant morbidity. In an effort to eliminate these drawbacks, minimally invasive retropleural approaches have been developed. OBJECTIVE: To demonstrate the feasibility and clinical experience of a minimally invasive lateral retropleural approach to the thoracolumbar spine. METHODS: Seven cadaveric dissections were performed in 7 fresh specimens to determine the feasibility of the technique. In each specimen, the lateral aspect of the vertebral body was accessed retropleurally, and a corpectomy was performed. Intraprocedural fluoroscopy and postoperative computed tomography were used to assess the extent of decompression. As an adjunct, 3 clinical cases of thoracic fractures and 1 neurofibroma were treated with this minimally invasive approach. Operative results, complications, and early outcomes were assessed. RESULTS: In the cadaveric study, adequate exposure was obtained to perform a lateral corpectomy and to allow interbody grafting between the adjacent vertebral bodies. The procedures were successfully performed in the 4 clinical cases without conversion to conventional approaches. A pleural tear was noted in the first clinical case, and a chest tube was placed without any long-term sequelae. CONCLUSION: Our early experience suggests that the minimally invasive lateral retropleural approach allows adequate vertebrectomy and canal decompression without the tissue disruption associated with posterolateral approaches. This approach may improve the complication rates that accompany open or endoscopic approaches for thoracolumbar corpectomies.

scholarly journals Minimally Invasive Approach With Pronator Quadratus Preservation for Distal Radius Fracture

Hand ◽  
2016 ◽  
Vol 11 (1_suppl) ◽  
pp. 43S-43S ◽  
Author(s):  
Gustavo Gomez Rodriguez ◽  
Hugo Sarmiento ◽  
Gabriel Clembosky
Keyword(s):  
Minimally Invasive ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Radius Fracture ◽  
Minimally Invasive Approach ◽  
Pronator Quadratus ◽  
Invasive Approach

scholarly journals Fractura de radio distal: abordaje mininvasivo con preservación del pronador cuadrado. [Distal radius fracture: minimally invasive approach with pronator quadrates preservation.]

10.15417/355 ◽  
2015 ◽  
Vol 80 (3) ◽  
pp. 150
Author(s):  
Gabriel Clembosky ◽  
Gustavo Luis Gómez Rodríguez ◽  
Juan Martín Perrone ◽  
Diego José Gómez
Keyword(s):  
Minimally Invasive ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Radius Fracture ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Sobre Todo

<p><strong>Objetivo: </strong>Describir y analizar una técnica de osteosíntesis palmar de radio distal con preservación del pronador cuadrado.</p><p><strong>Materiales y Métodos: </strong>Se revisaron, en forma retrospectiva, 24 pacientes operados con esta técnica (16 mujeres y 8 hombres; edad promedio 65 años). Doce fracturas eran de tipo A; 7, de tipo B y 5, de tipo C. La técnica quirúrgica consiste en practicar una incisión cutánea de 25 mm y profundizar hasta observar el pronador cuadrado. Sin seccionarlo, se realiza una disección de su borde distal, a fin de introducir la placa bloqueada volar por debajo del músculo. Se colocan los tornillos distales bajo visión directa y los tornillos proximales, en forma percutánea. La evaluación posoperatoria se llevó a cabo mediante análisis clínico-funcional y radiográfico.<strong></strong></p><p><strong>Resultados: </strong>En el último control, todos los pacientes presentaban signos clínicos y radiográficos de consolidación ósea. El puntaje en la escala DASH fue, en promedio, de 4,8. Se observó una inclinación palmar posoperatoria de la superficie articular del radio de 14,3º promedio y una inclinación radial de 26,3º promedio. No se detectaron complicaciones relacionadas con la fractura, el implante o la herida quirúrgica en ninguno de los controles posoperatorios.</p><p><strong>Conclusiones: </strong>Sin bien no existe bibliografía que demuestre que la técnica mininvasiva sea superior, sostenemos que el hecho de obtener resultados similares con ambos abordajes (mininvasivo y convencional) justifica llevar a cabo esta técnica con preservación del pronador cuadrado, sobre todo en los pacientes preocupados por el aspecto cosmético de la cicatriz.</p>

scholarly journals Modifying Gummy Smile: A Minimally Invasive Approach

2014 ◽  
Vol 15 (6) ◽  
pp. 821-826 ◽  
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.

scholarly journals Frozen Tissue Examination: Is It really no Longer of Use in Parathyroid Surgery? Single-center Retrospective Study on 97 Patients treated by minimally Invasive Approach

2017 ◽  
Vol 9 (2) ◽  
pp. 55-60
Author(s):  
Thomas Furderer, ◽  
Nicolas Bouviez, ◽  
Brice Paquette, ◽  
Gerard Landecy, ◽  
Bruno Heyd ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Minimally Invasive ◽  
Preoperative Imaging ◽  
Parathyroid Surgery ◽  
Single Center ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Surgical Specimen ◽  
Frozen Tissue ◽  
The Mean

ABSTRACT Introduction Surgery, by minimally invasive approach, has become the gold standard in the treatment of primary hyperparathyroidism. However, the preoperative and intraoperative examinations to be performed are still subject to debate. The frozen tissue examination of the parathyroidectomy specimen is often criticized, as it is deemed difficult and noninformative in case of multiglandular disease. The primary objective was to study the result of the frozen tissue examination and its benefit in the operative strategy in minimally invasive surgery. Materials and methods This is a single-centre retrospective descriptive study on patients who underwent surgery for primary hyperparathyroidism between January 2011 and September 2013 at Besançon Centre Hospitalier Régional Universitaire (CHRU) [Regional University Hospital Center]. Inclusion criteria consisted of: At least one contributory preoperative imaging test, a focused approach, and an intraoperative frozen tissue examination with microscopic analysis of the surgical specimen. Results A total of 157 patients were treated for hyperparathyroidism and 97 were enrolled in the study. The mean age was 62.3 ± 13.7 years, mean serum calcium was 2.81 ± 0.24 mmol/L and the mean parathyroid hormone (PTH) level was 175 ± 120 pg/mL. Around 53 patients (54.6%) had concordant scintigraphic and ultrasound examinations while 20 patients (20.6%) had an isolated contributory scintigraphic examination, 21 patients (21.6%) had an isolated contributory cervical ultrasound and 3 patients had discordant examinations. The sensitivity of the preoperative imaging in case of concordance was 84.9% for the location of the diseased gland, and 92.4% for its lateralization. The sensitivity to ultrasound alone and scintigraphy alone was 61.9% and 65% respectively. Nearly 23 false positive imaging results were found in which 11 were corrected during surgery by the surgeon based on the macroscopic appearance. The frozen tissue examination of the surgical specimen changed the surgical strategy in 12 cases (12.4%): Six results of normal parathyroid gland (50%), four results of thyroid tissue (33.3%), and two cases of hyperplastic gland (16.7%). The results of the frozen tissue examination thus led to 12 exploratory cervicotomies, which revealed three ipsilateral adenomas (25%), six contralateral adenomas, and one adenoma included in the thyroid lobe, and enabled the surgeon to perform two subtotal parathyroidectomies for parathyroid hyperplasia. The mean duration of the frozen tissue examination was 24.2 ± 8.6 minutes and the cure rate is 100% for the population treated by minimally invasive approach. Conclusion In our experience, the frozen tissue examination enabled the surgeon to intraoperatively correct 12 erroneous imaging diagnoses, including two cases of parathyroid hyperplasia and thus to continue the exploration of other glands and immediately carry out the appropriate treatment. This is an interesting technique, but it is conditioned by the pathologist’s expertise. How to cite this article Furderer T, Bouviez N, Paquette B, Landecy G, Heyd B, Vienney G, Lakkis Z, Tauziede M. Frozen Tissue Examination: Is It really no Longer of Use in Parathyroid Surgery? Single-center Retrospective Study on 97 Patients treated by minimally Invasive Approach. World J Endoc Surg 2017;9(2):55-60.

Magnetic resonance imaging localization with cod liver oil capsules for the minimally invasive approach to small intradural extramedullary tumors of the thoracolumbar spine

2014 ◽  
Vol 21 (6) ◽  
pp. 882-885 ◽  
Author(s):  
Mazda K. Turel ◽  
Vedantam Rajshekhar
Keyword(s):  
Minimally Invasive ◽  
Operating Time ◽  
Thoracolumbar Spine ◽  
Cost Effective ◽  
Cod Liver Oil ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Accurate Localization ◽  
Intradural Extramedullary ◽  
The Mean

Object Accurate intraoperative localization of small intradural extramedullary thoracolumbar (T-1 to L-3 level) spinal cord tumors is vital when minimally invasive techniques, such as hemilaminectomy, are used to excise these lesions. In this study, the authors describe a simple and effective method of preoperative MRI localization of small intradural extramedullary tumors using cod liver oil capsules. Methods Thirty-five patients with intradural tumors underwent preoperative MRI localization the evening prior to surgery. Patients were positioned prone in the MRI gantry, mimicking the intraoperative position. Nine capsules were placed in 3 rows to cover the lesion. This localization was used to guide the level for a minimally invasive approach using a hemilaminectomy to excise these tumors. Results The mean patient age was 51.5 ± 14.3 years, and the mean body mass index was 24.1 ± 3.5 kg/m2. Twenty-two tumors involved the thoracic spine, and 13 involved the upper lumbar spine from L-1 to L-3. The mean tumor size was 2.2 ± 1.0 cm. Localization was accurate in 34 patients (97.1%). Conclusions Accurate localization with the described method is quick, safe, cost-effective, and noninvasive with no exposure to radiation. It also reduces operating time by eliminating the need for intraoperative fluoroscopy.

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