Open Rhinoplasty – Should It Be the Procedure of Choice?

1993 ◽  
Vol 1 (4) ◽  
pp. 166-176
Author(s):  
Bernd R Neu
Keyword(s):  
Surgical Technique ◽  
Open Rhinoplasty ◽  
Open Approach ◽  
Nasal Dorsum ◽  
Endonasal Approach ◽  
External Appearance ◽  
Cartilage Grafts ◽  
Tip Rotation ◽  
Post Traumatic ◽  
New Perspective

BR Neu. Open rhinoplasty – Should it be the procedure of choice? Can J Plast Surg 1994;1(4):166-176. Open rhinoplasty is currently recognized for its usefulness in treating complex nasal deformities. This study examines and supports the routine use of the open approach for all cosmetic nasal operations. Forty consecutive open rhinoplasties were carried out. Included were primary, secondary and post-traumatic deformities. The surgical technique is described and the results are reviewed. Precision is enhanced with the open exposure. Alar cartilages are repositioned and contoured into shape with sutures. Tip rotation and elevation are more easily controlled. Cartilage grafts are used less often and, when required, are accurately sutured into place. A learning period is needed to understand the new perspective of the exposed cartilages and the effect on the external appearance. Asymmetries are easily created, and overcorrections must be avoided. The procedure takes longer. Nasal tip hypoesthesia and edema are more pronounced. The columellar scar is well accepted. The improved results with open rhinoplasty justify it becoming the procedure of choice in the author's practice. Minor modifications of the nasal dorsum or tip are still carried out through the endonasal approach.

Complication Rate after Radical Cystectomy Depends on the Surgical Technique and Patient’s Clinical Status

2021 ◽  
pp. 1-8
Author(s):  
Przemysław Adamczyk ◽  
Paweł Pobłocki ◽  
Mateusz Kadlubowski ◽  
Adam Ostrowski ◽  
Witold Mikołajczak ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Complication Rate ◽  
Tnm Stage ◽  
Complication Rates ◽  
Open Approach ◽  
Invasive Approach ◽  
Asa Score

<b><i>Purpose:</i></b> This study aimed to explore the complication rates of radical cystectomy in patients with muscle-invasive bladder cancer and identify potential risk factors. <b><i>Methods:</i></b> A total of 553 patients were included: 131 were operated on via an open approach (ORC), 242 patients via a laparoscopic method (LRC), and 180 by a robot-assisted procedure (RARC). Patient age, gender, American Society of Anesthesiologists (ASA) score, urinary diversion type, preoperative albumin level, body mass index (BMI), pathological (TNM) stage, and surgical times were collected. The severity of complications was classified according to the Clavien-Dindo scale (Grades 1–5). <b><i>Results:</i></b> The surgical technique was significantly related to the number of complications (<i>p</i> &#x3c; 0.00005). Grade 1 complications were observed most frequently following LRC (52.5%) and RARC (51.1%), whereas mostly Grade 2 complications were detected after ORC (78.6%). Those with less severe complications had significantly higher albumin levels than those with more severe complications (<i>p</i> &#x3c; 0.05). Patients with an elevated BMI had fewer complications if a minimally invasive approach was used rather than ORC. The patient’s general condition (ASA score) did not impact the number of complications, and urinary diversion type did not affect the severity of the complications. Mean surgical time differed according to the urinary diversion type in patients with a similar TNM stage (<i>p</i> &#x3c; 0.005); however, no difference was found in those with more locally advanced disease. Longer operation time and lower protein concentration were associated with higher probability of complication rate, that is, Clavien-Dindo score 3–5. <b><i>Conclusions:</i></b> The risk of complications after RC is not related to the type of urinary diversion, and can be reduced by using a minimally invasive surgical technique, especially in patients with high BMI.

scholarly journals Nasal sill augmentation: an overlooked concept in rhinoplasty—a technical note and review of the literatures

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Gholamhossein Adham ◽  
Seied Omid Keyhan ◽  
Hamid Reza Fallahi ◽  
Heliya Ziaei ◽  
Mohan Thomas
Keyword(s):  
Technical Note ◽  
Open Rhinoplasty ◽  
Open Approach ◽  
Base Approach ◽  
Patient Dissatisfaction ◽  
Novel Technique ◽  
Alar Base ◽  
Defect Area ◽  
Augmentation Procedure ◽  
Made In

Abstract Background Nasal sill is one of the components of the alar ring, affecting the esthetic outcomes of rhinoplasty; accordingly, we developed a novel technique to adjust defects in this area and compared it with the available techniques. Methods Our technique was based on creating a tunnel access to the nasal sill area through an incision made in the lower third of the columella using the open approach or through a nostril base incision in patients, who underwent alar base reduction, followed by insertion of a cartilaginous graft into the marked defect area. Results A total number of 54 patients with a defect in the nasal sill area were included in this study. Thirty-one patients underwent open rhinoplasty with the sill approach from the lower third of the columella, while 23 patients underwent rhinoplasty with a nostril base approach for nasal sill augmentation procedure. There were no reports of patient dissatisfaction, infection, bleeding, sensory dysfunction, or remaining asymmetry of the sill area. Conclusion Based on the findings of the present study, this technique can be successfully used in reconstructing the nasal sill area with minimal complications and morbidity.

Arthroscopic Reduction and Internal Fixation (ARIF) of a Comminuted Posterior Talar Body Fracture: Surgical Technique and Case Report

2017 ◽  
Vol 10 (5) ◽  
pp. 465-469 ◽  
Author(s):  
Rishin Kadakia ◽  
Jeff Konopka ◽  
Tristan Rodik ◽  
Samra Ahmed ◽  
Sameh A Labib
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Internal Fixation ◽  
Case Reports ◽  
Wound Complications ◽  
Open Approach ◽  
Arthroscopic Reduction ◽  
Body Fracture ◽  
Anatomic Reduction ◽  
Talar Body Fracture

The talus is the second most common fractured tarsal bone. While their incidence may be low, talus fractures are severe injuries that can lead to long-term disability and pain. Displaced talar body fractures are typically treated through an open approach with the aim of obtaining anatomic reduction and stable fixation. There are several case reports in the literature demonstrating successful management of talus fractures arthroscopically. An arthroscopic approach minimizes soft tissue trauma, which can help decrease postoperative wound complications and infections. In this article, the authors describe a surgical technique of an arthroscopic reduction and internal fixation of a comminuted posterior talar body fracture. Compared with an open posterior approach with or without osteotomies, an arthroscopic technique improved visualization and allowed precise reduction and fixation. Levels of Evidence: Level V: Case report

The Modified Open Rhinoplasty

1993 ◽  
Vol 1 (3) ◽  
pp. 131-136
Author(s):  
Laurence T Glickman ◽  
Gene W Lee
Keyword(s):  
Surgical Approach ◽  
Open Rhinoplasty ◽  
Open Approach ◽  
The Past ◽  
External Incision ◽  
Wide Exposure

LT Glickman, GW Lee. The modified open rhinoplasty. Can J Plast Surg 1993;1(3):131-136. Despite considerable attention in the past 10 to 20 years, the open rhinoplasty remains a controversial procedure. Advocates of this technique argue that the exposure and thus the surgical manoeuvres it makes are unequalled. Detractors argue that the transcolumellar scar left by the procedure is unacceptable and is most often unnecessary. This report describes a modification of the open rhinoplasty which has most of the advantages of the open approach, but is performed without the external incision. The procedure, its advantages and drawbacks, and comparisons among the modified open, open and closed rhinoplasty are described. It is concluded that the modified open rhinoplasty is an excellent surgical approach that can be used on most patients and that it provides wide exposure without an external incision.

scholarly journals Imaging appearance on CT post laparoscopic Roux-en-Y gastric bypass using bioabsorbable prosthesis with fibrin glue fixation to prevent a Petersen’s space hernia

2019 ◽  
Vol 5 (3) ◽  
pp. 20180111
Author(s):  
Mark Page ◽  
James Drummond ◽  
Mark Magdy ◽  
John Vedelago ◽  
Vytauras Kuzinkovas
Keyword(s):  
Gastric Bypass ◽  
Small Bowel ◽  
Surgical Technique ◽  
Fibrin Glue ◽  
Subsequent Treatment ◽  
Open Approach ◽  
Internal Hernias ◽  
Haemostatic Agents ◽  
Petersen’S Hernia ◽  
Post Bariatric Surgery

Imaging post bariatric surgery is becoming more common over the past decade due to increasing incidence of obesity in the population and subsequent treatment. In recent years, the use of topical haemostatic agents and bioabsorbable prostheses has increased leading to higher likelihood of encountering these agents on post-operative imaging. Imaging in the post-operative period is occasionally performed to assess for complications such as obstruction, leak and abscess formation. Familiarity with these agents is crucial in preventing incorrect diagnosis. Laparoscopic Roux-en-Y gastric bypass (RYGB) is favoured over the open approach as it is safer and more effective, with a mortality rate of 0.5% and morbidity around 7–14 %. The main cause of late post-RYGB complications is the development of internal hernias such as a Petersen’s hernia. During the procedure, a space between the alimentary loop of the small bowel and the transverse mesocolon is created and is called the Petersen’s defect. Subsequently, a part of the small bowel can herniate through this orifice. As this operation is becoming more common, the incidence of internal herniation has been increasing. This case report describes a new bariatric surgical technique and the associated post-operative radiological appearances on CT. The surgical technique has been pioneered in Sydney, Australia and involves a laparoscopic RYGB using bioabsorbable prosthesis with fibrin glue fixation to prevent a Petersen’s space hernia.

The Endoscopic Endonasal Approach to the Meckel's Cave Tumors: Surgical Technique and Indications

2014 ◽  
Vol 82 (6) ◽  
pp. S155-S161 ◽  
Author(s):  
Emmanuel Jouanneau ◽  
Emile Simon ◽  
Timothée Jacquesson ◽  
Marc Sindou ◽  
Stéphane Tringali ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Meckel’S Cave ◽  
Endoscopic Endonasal ◽  
Meckel's Cave

Minimally Invasive Plate Osteosynthesis for Periprosthetic and Interprosthetic Fractures Associated with Knee Arthroplasty: Surgical Technique and Review of Current Literature

2019 ◽  
Vol 32 (05) ◽  
pp. 392-402 ◽  
Author(s):  
Amrut Borade ◽  
Daniela Sanchez ◽  
Harish Kempegowda ◽  
Hemil Maniar ◽  
Rodrigo Pesantez ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Plate Osteosynthesis ◽  
Periprosthetic Fractures ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Open Approach ◽  
Biological Fixation ◽  
Case Examples ◽  
Implant Selection ◽  
Total Knee

AbstractWith the increasing number of total knee arthroplasties (TKAs) being performed, the incidence of periprosthetic fractures adjacent to a TKA is rising. Minimally invasive plate osteosynthesis (MIPO) has proven to be successful for the biological fixation of many fractures. Advances in surgical instrumentation and techniques made MIPO possible for more complex fractures. Periprosthetic fractures are always complicated by problems of soft tissue incisions, scarring, and, of course, the arthroplasty components. MIPO techniques may be particularly suited to these injuries and may make the surgical repair of these fractures safer and more reliable. In this review, case examples are used to define the indications, preoperative planning, implant selection, complications, limitations, and challenges of MIPO for the treatment of periprosthetic fractures about the knee. When considering MIPO for any fracture, we recommend prioritizing an acceptable reduction with biological fixation and resorting to mini-open or open approach when necessary to achieve it. Awareness of the learning curve of the surgical technique, advances in implant designs, the tips and tricks involved, and the limitations of the MIPO is of paramount importance from the orthopaedic surgeon's perspective.

A Novel Approach to Managing a Strangulated De Garengeot’s Hernia

2020 ◽  
pp. 000313482094355
Author(s):  
Francis J. Simpson ◽  
Katherine Fay ◽  
Vivian Wang ◽  
David Elwood
Keyword(s):  
Surgical Technique ◽  
Significant Variation ◽  
Case Reports ◽  
Relevant Literature ◽  
Vermiform Appendix ◽  
Open Approach ◽  
Hernia Defect ◽  
Elderly Female ◽  
Novel Approach ◽  
De Garengeot’S Hernia

De Garengeot’s hernia, the presence of an incarcerated vermiform appendix within a femoral hernia, is a rare general surgery emergency that predominantly affects elderly female patients. Due to its rarity, there is significant variation in surgical technique; however, most case reports favor an open approach. Here we present a case of a De Garengeot’s hernia with a unique hybrid open and laparoscopic repair, utilizing the hernia defect as a port site. We will also review the relevant literature.

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