Le Fort III Distraction Osteogenesis: Early Experience With an Internal Bilevel Midface Distraction System

FACE ◽  
2020 ◽  
pp. 273250162097640
Author(s):  
Colin M. Brady ◽  
Jordan P. Steinberg ◽  
Marisa Parks ◽  
Stacy Mobley ◽  
Joseph K. Williams
Keyword(s):  
Operative Time ◽  
Soft Tissues ◽  
Vertical Component ◽  
Early Experience ◽  
Differential Resistance ◽  
Patient Demographics ◽  
Le Fort Iii ◽  
The Mean ◽  
Mean Time ◽  
Internal Distraction

Internal distraction devices for severe midface hypoplasia are often criticized for their distraction at a single pivot point, resulting in “mid-face tipping,” a phenomenon which is in part related to the differential resistance of the soft tissues at orbital and maxillary levels. To address this deficiency, we present our early experience with an internal bi-level midface distraction system. Four patients underwent midface advancement with an internal bi-level distraction system. The specifics of design, application, distraction, and removal are detailed. Hospital records were reviewed to capture patient demographics, length of stay, OR times, and complications. Relevant cephalometry was performed pre- and post-operatively, and compared. In 2015, 4 patients with severe mid-face hypoplasia were treated with an internal bi-level mid-face distraction system. The mean age was 13.5 ± 1.7 years. The mean operative time was 269.7 ± 67.4 min. The mean LOS was 10 ± 7.4 days. The on-table distraction was 5 mm. Distraction subsequently proceeded at a variable rate of 0.5 to 1.0 mm daily with a maximal distraction of 20 and 30 mm at orbital and maxillary levels, respectively. Mean time to distractor removal was 11.2 ± 1.1 weeks. Device design allowed facile removal through minimally invasive incisions. Cephalometry was seen to progress towards age-matched norms. There were no major complications. Minor complications included breakage of the vertical component of the maxillary arm at the time of device removal in 1 patient. By allowing real-time adjustment at the orbital and maxillary levels to combat differential resistance, early experience with our device maximizes occlusal advancement without overcompensating orbital translation.

Kinh nghiệm qua 126 bệnh nhân phẫu thuật nội soi cắt toàn bộ dạ dày điều trị ung thư dạ dày

2021 ◽  
Author(s):  
Van Huong Nguyen
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Total Gastrectomy ◽  
Operative Time ◽  
Laparoscopic Total Gastrectomy ◽  
Oral Feeding ◽  
Linear Stapler ◽  
The Mean ◽  
End To End ◽  
Mean Time

TÓM TẮT Đặt vấn đề: Báo cáo kinh nghiệm về kỹ thuật phẫu thuật nội soi cắt toàn bộ dạ dày qua 126 bệnh nhân điều trị ung thư dạ dày tại Bệnh viện Hữu nghị Đa khoa Nghệ An. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả hồi cứu, các bệnh nhân được phẫu thuật nội soi cắt toàn bộ dạ từ 2014 đến 05/2021. Kết quả: Có 126 bệnh nhân, tuổi trung bình 60,6 ± 11,1 tuổi. 15,9% ung thư 1/3 trên dạ dày và 81,7% là 1/3 giữa. Ung thư ở giai đoạn I, II, III là 19,0%, 49,2%, 31,7%. 71,4% PTNS hoàn toàn cắt TBDD và nối lưu thông tiêu hóa bằng máy cắt nối thẳng. 3,2% trường hợp có tai biến trong mổ và 2,4% có biến chứng sau mổ, không có trường hợp nào tử vong. Số hạch nạo vét được trung bình 22,06 ± 7,6 hạch, lượng máu mất trung bình là 32,14 ± 10,4 ml, thời gian phẫu thuật trung bình là 210,4 ± 34,3 phút, thời gian nằm viện trung bình là 8,3 ± 2,5 ngày và thời gian sống thêm toàn bộ sau mổ trung bình là 36,9 ± 2,25 tháng. Kết luận: PTNS cắt TBDD là kỹ thuật an toàn và hiệu quả trong điều trị UTDD, nối thực quản hỗng tràng bằng máy cắt nối thẳng không cắt thực quản và hỗng tràng trước là kỹ thuật an toàn, tiết kiệm. Từ khóa: Kỹ thuật phẫu thuật nội soi dạ dày, ung thư dạ dày. ABSTRACT EXPERIENCE IN 126 PATIENTS OF LAPAROSCOPIC TOTAL GASTRECTOMY FOR THE TREATMENT OF GASTRIC CANCER Background: The goal of this study was to report on the experience of laparoscopic total gastrectomy (LTG) in 126 patients with gastric cancer Materials and Methods: Retrospective descriptive study of 126 patients who underwent LTG for gastric cancer between 2014 and May 2021. Results: Mean age 60,6 ± 11,1; gastric cancer at stage I, II, III was 19,0%, 49,2%, 31,7% respectively. 71,4% patients underwent totally LTG and functional end-to-end esophagojejunostomy by linear stapler without previous resection of esophagus and jejunum. 3.2% of cases had complications during surgery and 2,4% of cases had complications after surgery. There was no postoperative deaths. The average number of dredged lymph nodes was 22.06 ± 7.6 lymph nodes. The mean blood loss was 32.14 ± 10.4 ml. The mean operative time was 210.4 ± 34.3 minutes. The mean time for beginning oral feeding was 4.4 ± 1.9 days. The mean hospital stay was 8.3 ± 2.5 days. The mean overall survival was 36.9 ± 2,25 months. Conclusions: LTG is a safe and effective technique for the treatment of gastric cancer. The technique functional end-to-end esophagojejunostomy by linear stapler without previous resection of esophagus and jejunum was safe and saving. Keywords: Technique of laparoscopic gastrectomy, gastric cancer

Modifield Desarda Repair and Hernioplastia Lichtenstein Repair for Inguinal Hernia

2021 ◽  
Vol 2 (3) ◽  
pp. 01-05
Author(s):  
Pedro Rolando Lòpez Rodrìguez ◽  
Eduardo Garcia Castillo ◽  
Olga Caridad Leòn Gonzàlez ◽  
Jorge Agustin Satorre Rocha ◽  
Luis Marrero Quiala ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Controlled Trial ◽  
Operation Time ◽  
Lichtenstein Repair ◽  
Prospective Randomized Controlled Trial ◽  
The Mean ◽  
Group 2 ◽  
Location Type ◽  
Mean Time

Introduction: The objective of this study is to compare the outcomes of Modified Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 1342 patients having 1394 hernias operated from January 2008 to December 2020. 690 patients were operated using Lichtenstein repair and 652 using Desarda repair. The demographie data (Age,Sex) , hernia type and location , anesthetic , operative time , postoperative pain and complications were analysed. Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 52 minutes in Modified Desarda group and 42 minutes in the Lichtenstein group that is significant (p<0.05). The recurrence was 0.0 % in Modified Desarda group and 0.28 % in Lichtenstein group. But, there were 9 cases of infection to the polypropylene mesh in the Lichtenstein group, 2 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (7,6 %) as compared to Modified Desarda group (3.8 %). The mean time to return to work in the Modified Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. in Modified Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: The modified Desarda repair scores significantly on Lichtenstein repair in most of all aspects, including reexplorations and morbidity. Modified Desarda repair is a better option compared to Lichtenstein repair.

Incisional Hernia Risk after Hand-Assisted Laparoscopic Surgery

2012 ◽  
Vol 78 (8) ◽  
pp. 864-869 ◽  
Author(s):  
William S. Cobb ◽  
Alfredo M. Carbonell ◽  
Garrett M. Snipes ◽  
Brianna Knott ◽  
Viet Le ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Incisional Hernia ◽  
Operative Time ◽  
Group Versus ◽  
True Incidence ◽  
Hernia Formation ◽  
The Mean ◽  
Laparoscopic Techniques ◽  
Mean Time

Hand-assisted laparoscopic surgery (HALS) bridges traditional open surgery and pure laparoscopy. The HALS technique provides the necessary site for organ retrieval, reduces operative time, and realizes the postoperative benefits of laparoscopic techniques. Although the reported rates of incisional hernia should be theoretically low, we sought to determine our incidence of hernia after HALS procedures. A retrospective review of all HALS procedures was performed from July 2006 to June 2011. All patients who developed postoperative incisional hernias at the hand port site were confirmed by imaging or examination findings. Patient factors were reviewed to determine any predictors of hernia formation. Over the 5 years, 405 patients undergoing HALS procedures were evaluated: colectomy (264), nephrectomy (107), splenectomy/pancreatectomy (18), and ostomy reversal (10). The overall incidence of incisional hernia was 10.6 per cent. There were three perioperative wound dehiscences. The mean body mass index was significantly higher in the hernia group versus the no hernia cohort (32.1 vs 29.2 kg/m2; P = 0.001). The hernia group also had a higher incidence of renal disease (18.6 vs 7.2%; P = 0.018). Mean time to hernia formation was 11.4 months (range, 1 to 57 months). Follow-up was greater than 12 months in 188 (46%) of patients, in which the rate of incisional hernia was 17 per cent. The rate of incisional hernia formation after hand-assisted laparoscopic procedures is higher than the reported literature. Because the mean time to hernia development is approximately 1 year, it is important to follow these patients to this end point to determine the true incidence of incisional hernia after hand-assisted laparoscopy.

Percutaneous CT-Guided Cryoablation of the Bilateral Pudendal Nerves for Palliation of Intractable Pain Related to Pelvic Neoplasms

2020 ◽  
Vol 37 (8) ◽  
pp. 619-623 ◽  
Author(s):  
John David Prologo ◽  
Sivasai Manyapu ◽  
Zachary L. Bercu ◽  
Ashmit Mittal ◽  
Jason W. Mitchell
Keyword(s):  
Computed Tomography ◽  
Pelvic Pain ◽  
Pudendal Nerve ◽  
Intractable Pain ◽  
Pelvic Neoplasms ◽  
Ct Guided ◽  
Patient Demographics ◽  
Pain Scores ◽  
The Mean ◽  
Mean Time

Objectives: The purpose of this report is to describe the effect of computed tomography–guided bilateral pudendal nerve cryoablations on pain and time to discharge in the setting of acute hospitalizations secondary to refractory pelvic pain from cancer. Methods: Investigators queried the medical record for patients who underwent pudendal nerve cryoablation using the Category III Current Procedural Technology code assignment 0442T or Category I code 64640 for cases prior to 2015. The resulting list was reviewed, and procedures performed on inpatients for intractable pelvic pain related to neoplasm were selected. The final cohort was then analyzed with regard to patient demographics, procedure details, technical success, safety, pain scores, and time to discharge. Results: Ten patients underwent cryoablation by 3 operators for palliation of painful pelvic neoplasms between June 2014 and January 2019. All probes were satisfactorily positioned and freeze cycles undertaken without difficulty. There were no procedure-related complications or adverse events. The mean difference in pre- and posttreatment worst pain scores was significant (n = 5.20, P = .003). The mean time to discharge following the procedure was 2.3 days. Conclusion: Computed tomography–guided percutaneous cryoablation of the bilateral pudendal nerves may represent a viable option in the setting of acute hospitalization secondary to intractable pain in patients with pelvic neoplasms.

ENDOSCOPIC RESECTION OF THORACIC PARAVERTEBRAL AND DUMBBELL TUMORS

Neurosurgery ◽  
2006 ◽  
Vol 59 (6) ◽  
pp. 1195-1202 ◽  
Author(s):  
Ignacio J. Barrenechea ◽  
Royd Fukumoto ◽  
Jonathan B. Lesser ◽  
Douglas R. Ewing ◽  
Cliff P. Connery ◽  
...  
Keyword(s):  
Granular Cell Tumor ◽  
Operative Time ◽  
Granular Cell ◽  
Posterior Mediastinum ◽  
Thoracoscopic Resection ◽  
Patient Demographics ◽  
Tongue Swelling ◽  
Estimated Blood Loss ◽  
The Mean ◽  
Intraspinal Extension

Abstract OBJECTIVE Neurogenic paravertebral tumors are uncommon neoplasms arising from neurogenic elements within the thorax. These tumors may be dumbbell shaped, extending into the spinal canal or exclusively paraspinal. Generally encapsulated, they are located in the posterior mediastinum. In this report, we present our experience in the thoracoscopic resection of these tumors, including surgical technique and potential pitfalls. METHODS A retrospective review of patients undergoing endoscopic surgery for paravertebral tumors was undertaken. Patient demographics, charts, operative reports, and pre- and postoperative images were reviewed. RESULTS Between 1997 and 2004, 13 patients were treated thoracoscopically for paravertebral tumors in our departments. Our population consisted of four men and nine women. The median age was 44.9 years (range, 29–66 yr). Eight patients presented with pain, dyspnea, cough, and weakness. Five patients had tumors found incidentally. Sizes of the tumors varied from 3 to 9 cm. Final pathology included four neurofibromas, eight schwannomas, and one unclassified granular cell tumor. Gross total resection was achieved endoscopically in all cases. Three patients required a hemilaminectomy for resection of the intraspinal dumbbell component of the tumor during the same operation. The mean operative time was 229.5 minutes. The mean estimated blood loss was 371.1 ml. Postoperative morbidities included one each of tongue swelling, ulnar neuropathy, and intercostal hyperesthesia. The mean hospital stay was 2.8 days. CONCLUSION Paravertebral tumors in the posterior mediastinum are amenable to endoscopic removal, even in hard to reach locations. Tumors with intraspinal extension can be removed concurrently by performing a hemilaminectomy, followed by thoracoscopy, without the need for a thoracotomy.

scholarly journals Ultrasonography-Guided Percutaneous Nephrolithotomy for the Treatment of Urolithiasis in Patients with Scoliosis

2012 ◽  
Vol 97 (2) ◽  
pp. 182-188 ◽  
Author(s):  
Hongyan Li ◽  
Zhuo Zhang ◽  
Hai Li ◽  
Yuanyuan Xing ◽  
Gang Zhang ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Single Session ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
The Mean ◽  
Ultrasonographic Guidance ◽  
Mean Time ◽  
Treatment Of Urolithiasis

Abstract We examined the surgical outcomes of minimally invasive percutaneous nephrolithotomy (MPCNL) in scoliotic patients with complicating urolithiasis. Two patients with scoliosis were hospitalized for MPNCL due to upper tract urolithiasis. Calyx puncture was performed in the prone position under ultrasonographic guidance. The renal access route was established using a set of 8F to 16F dilators, and a transpyelic ballistic lithotriptor was used to fragment the calculi. The stone burdens in the 2 patients were 410 mm2 and 500 mm2. The entire operative time was 40 to 70 minutes, and the mean time of establishing percutaneous access was 20 minutes. The calculi were completely removed by single-session pneumatic lithotripsy. The 2 patients recovered from MPCNL uneventfully, and the follow-up radiologic examinations identified no stone residual or recurrence. MPCNL is a minimally invasive modality that is effective and safe for the treatment of urolithiasis in patients with scoliosis.

scholarly journals Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy in children: a single-institution prospective cohort study

2019 ◽  
Vol 6 (8) ◽  
pp. 2860
Author(s):  
Nguyen Thanh Xuan ◽  
Ho Huu Thien ◽  
Phan Hai Thanh ◽  
Pham Anh Vu ◽  
Nguyen Huu Son ◽  
...  
Keyword(s):  
Choledochal Cyst ◽  
Operative Time ◽  
Bile Leakage ◽  
Short Term ◽  
Cyst Excision ◽  
Drain Removal ◽  
Laparoscopic Excision ◽  
The Mean ◽  
Mean Time ◽  
Time To Drain

Background: Laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy is gaining popularity as a treatment for choledochal cyst in children. The aim of this study is to determine the feasible and safe of the laparoscopic excision with Roux-en-Y hepaticojejunostomy, and evaluate the short-term outcomes after treatment for children with choledochal cyst.Methods: A prospectively of 51 consecutive pediatric patients undergoing laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy performed by one surgeon cysts at Hue Central Hospital from June 2012 to December 2017 was studied.Results: The mean operative time was 214.7±67.95 minutes (range, 100~360 minutes), including the time for intraoperative cholangiography. There were two children requiring blood transfusion. Time to first flatus was 40.35±28.55 hours in average. The mean time to drain removal was 2.89±1.02 days. Mean postoperative hospital stay was 9.31±3.43 days. 6 out of 51 cases having early complications, including 2 cases of pancreatitis and 4 cases of bile leakage. Most of cases (90.5%) were classified as good after 10 days to 3 months of follow-up.Conclusions: Laparoscopic choledochal cyst excision and Roux-en-Y hepaticojejunostomy was feasible and safe in children. The short-term outcomes were good in most cases. 

scholarly journals Laparoscopic cholecystectomy in Jordan

2001 ◽  
Vol 7 (4-5) ◽  
pp. 838-840
Author(s):  
A. Al Raymoony
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Return To Work ◽  
Hospital Stay ◽  
Operative Time ◽  
Safe Procedure ◽  
Short Hospital Stay ◽  
Early Return ◽  
The Mean ◽  
Mean Time

This study was conducted on 100 patients with symptomatic gallbladder stones, aged 22-81 years with a mean of 51.5 years, who underwent cholecystectomy in Zarqa city, Jordan between July 1998 and July 1999. The success rate was 87% and the procedure was completed using the conventional method in 13 patients. The mean operative time was 60 minutes, complication rate was 5% and there were no deaths. The mean hospital stay was 1 day and mean time to return to work was 10 days. This study showed that laparoscopic cholecystectomy is a safe procedure with reasonable operative time, less postoperative pain, a short hospital stay, early return to work, and a low morbidity and mortality rate.

Creation of the Miami Pouch During Laparoscopic-Assisted Pelvic Exenteration: The Initial Experience

2009 ◽  
Vol 19 (3) ◽  
pp. 466-470 ◽  
Author(s):  
Gwénaël Ferron ◽  
Timothy Yong Kuei Lim ◽  
Christophe Pomel ◽  
Michel Soulie ◽  
Denis Querleu
Keyword(s):  
Operative Time ◽  
Pelvic Exenteration ◽  
Iliac Fossa ◽  
Initial Experience ◽  
Pelvic Malignancies ◽  
The Mean ◽  
Continent Diversion ◽  
Laparoscopic Assisted ◽  
Mean Time

Purpose:To describe the initial experience of laparoscopic hand-assisted Miami pouch in a group of patients undergoing pelvic exenterations for pelvic malignancies.Materials and Methods:Thirteen female patients underwent laparoscopic-assisted pelvic exenteration in our center between September 2000 and November 2007. Six of them had the Miami pouch created for urinary diversion. The continent diversion was created extracorporeally through a right iliac fossa minilaparotomy.Results:The mean total operative time for the laparoscopic-assisted exenteration and reconstruction was 382 minutes (range, 270-480 minutes), but specifically for the Miami pouch, it took a mean time of 106 minutes (range, 90-130 minutes). Four patients (66.7%) had postoperative urinary tract infection that resolved with antibiotics. One patient had a ureteral stenosis requiring stenting and one had a Miami pouch cutaneous fistula that required a fistulectomy. The mean follow-up was 23 months (range, 9-48 months). All patients were continent and were able to self-catheterize approximately 3 to 6 times/d.Conclusions:It is technically feasible to incorporate the creation of the Miami continent urinary pouch through a minilaparotomy during laparoscopic pelvic exenteration without compromising the benefits of laparoscopic surgery.

scholarly journals EXPERIENCE OF 424 ROBOT-ASSISTED OPERATIONS IN ST-PETERSBURG: RADICAL PROSTATECTOMY, PARTIAL AND RADICAL NEPHRECTOMY

2016 ◽  
Vol 175 (5) ◽  
pp. 74-77 ◽  
Author(s):  
S. Kh. Al’-Shukri ◽  
M. S. Mosoyan ◽  
D. Yu. Semenov ◽  
D. M. Il’In
Keyword(s):  
Survival Rate ◽  
Radical Prostatectomy ◽  
Radical Nephrectomy ◽  
Operative Time ◽  
Da Vinci ◽  
Robot Assisted ◽  
Cancer Specific Survival ◽  
Robotic Radical Prostatectomy ◽  
The Mean ◽  
Mean Time

The article presents the results of 257 robot-assisted radical prostatectomies, 135 partial nephrectomies and 32 radical nephrectomies at the period from 2010 to 2016. The operations were performed on robotic complex da Vinci S. The mean operative time was 170±50 min, 158,4±72,2 min and 143,3±67,3 min, the mean blood loss was 130±35 ml, 213,0±102,2 ml and 141,4±49,0 ml for robotic radical prostatectomy, partial and radical nephrectomy, respectively. The mean time of warm ischemia consisted of 13,1±2,7 min. Five-year cancer-specific survival rate was 100%, 100% and 98%. The overall survival rate was 97,5%, 87% and 92% for robotic radical prostatectomy, partial and radical nephrectomy, respectively.

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