scholarly journals Defining the limits of caesarean scar niche repair: new anatomical landmarks

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Tanushree Rao ◽  
Neera Lambert ◽  
Bhaswati Ghosh ◽  
Timothy Chang
Keyword(s):  
Laparoscopic Repair ◽  
Anatomical Landmark ◽  
Anatomical Landmarks ◽  
Video Presentation ◽  
Surgical Method ◽  
Caesarean Scar ◽  
Reproducible Technique ◽  
The Ideal

Abstract Background Caesarean scar niche is increasingly being seen due to the rise in the number of caesarean sections worldwide. Indications and the ideal route for niche repair are still being researched. If the residual myometrium is less than 3 mm thick and potential fertility is needed, laparoscopy is the ideal surgical method for caesarean scar niche repair. The aim of this video presentation is to demonstrate techniques of identifying new anatomical landmarks during laparoscopic uterine niche repair. Results As seen in the video, Caesarean scar niche repair can be done in a step-by-step manner, with lateral bands serving as anatomical landmarks. Conclusions Lateral bands are a consistent anatomical landmark which identify the level and width of the uterine niche and thus simplify the laparoscopic repair making this a reproducible technique.

scholarly journals The medial condylar wall is a reliable landmark to kinematically align the femoral component in medial UKA: an in-silico study

2021 ◽  
Author(s):  
Benjamin Preston ◽  
Simon Harris ◽  
Loic Villet ◽  
Collin Mattathil ◽  
Justin Cobb ◽  
...  
Keyword(s):  
Femoral Component ◽  
Anatomical Landmark ◽  
Axial Plane ◽  
Medial Wall ◽  
Kinematic Alignment ◽  
Anatomical Landmarks ◽  
Medial Condyle ◽  
Axial Alignment ◽  
Cylindrical Axis ◽  
The Ideal

Abstract Purpose Kinematic alignment (KA) aligns the femoral implant perpendicular to the cylindrical axis in the frontal and axial plane. Identification of the kinematic axes when using the mini-invasive sub-quadricipital approach is challenging in unicompartmental knee arthroplasty (UKA). This study aims to assess if the orientation of condylar walls may be suitable for use as an anatomical landmark to kinematically align the femoral component in medial UKA. It was hypothesised that the medial wall of the medial condyle would prove to be a reliable anatomical landmark to set both the frontal and axial alignment of the femoral component in medial UKA. Methods 73 patients undergoing medial UKA had pre-operative CT imaging to generate 3D models. Those with osteophytes that impaired visualisation of the condylar walls were excluded. 28 patients were included in the study. The ideal KA was determined using the cylindrical axis in the frontal and axial plane. Simulations using the medial wall of the medial condyle (MWMC) and the lateral wall of the medial condyle (LWMC) were performed to set the frontal alignment. To set the axial alignment, the MWMC, LWMC, medial wall of the lateral condyle (MWLC), and medial diagonal line (MDL) anatomical landmarks were investigated. Differences between the ideal measured KA values and values obtained using landmarks were investigated. Results Use of the MWMC let to similar frontal alignment compared to the ideal KA (2.9° valgus vs 3.4° valgus, p = 0.371) with 46.4% (13/28) of measurements being $$\le $$ ≤ 1.0° different from the ideal KA and only 1 simulation with greater than 4.0° difference. Use of the MWMC led to very similar axial alignments compared to the ideal KA (0.5° internal vs 0.0°, p = 0.960) with 75.0% (21/28) of measurements being $$\le $$ ≤ 1.0o different from the ideal KA, and a maximum difference of 3.0°. Use of the MWLC and MDL was associated with significant statistical differences when compared to the ideal KA (p < 0.001 for both). Conclusions The native orientation of the medial condylar wall seems to be a reliable anatomical landmark for aligning the femoral component in medial KA UKA in both the axial plane and frontal planes. Other assessed landmarks were shown to not be reliable. Clinical and radiographic assessments of the reliability of using the MWMC to set the frontal and axial orientation of the femoral component when performing a medial KA UKA are needed.

Comparison of Ultrasound Guided Ankle Block versus Anatomical Landmark Guided Ankle Block in Minor Ankle and Foot Surgeries

2021 ◽  
Vol 15 (11) ◽  
pp. 3484-3487
Author(s):  
Muhammad Nawaz Anjum ◽  
Wajeeha Mufti ◽  
Yasser Athar Shah ◽  
Irfan Ali
Keyword(s):  
Success Rate ◽  
Regional Anesthesia ◽  
Lower Limb ◽  
Local Population ◽  
Anatomical Landmark ◽  
Anatomical Landmarks ◽  
Block Group ◽  
Ultrasound Guided ◽  
Anatomic Landmark ◽  
Lower Limb Surgery

Background: Regional anesthesia has increasingly expanded its role in perioperative care of patients undergoing foot and ankle surgery. The use of regional anesthesia has been widely implemented among anesthesiologists and pain providers. Multiple approaches for sephanous nerve blockade have been used including nerve stimulation, anatomical landmarks and ultrasound. It has been observed in previous studies that USG ankle block is more successful as compared to conventional anatomical landmark guided nerve block; so this study was planned to get precise and reliable results regarding both techniques in our local population. Objective: To compare the methods of surgical anesthesia of Ultrasound-guided ankle block versus conventional anatomic landmark-guided techniques in lower limb surgery under regional anesthesia. Materials and methods: This randomized control was carried out at Department of Anesthesia Mayo Hospital Lahore. After meeting the inclusion and exclusion criteria 50 patients (25 in each group ) were enrolled. Patients were randomly divided into two groups using lottery method. Group A patients underwent USG ankle block while group B patients underwent conventional anatomic landmark guided ankle block. Results: Mean age of patients was 46.96±11.578 years; 40(80%) patients were male and 10(20%) patients were females. Successful anesthesia was achieved in 42 (84%) patients; in which in USG block group the successful anesthesia was achieved in 22(88%) patients and in ALG block group successful anesthesia was achieved in 20(80%) patients (p value =0.702) Conclusion : Findings of this study conclude that both techniques have statistically insignificant difference in terms of success rate , however USG ankle block for surgical anesthesia showed higher success rate as compared to anatomic landmark guided technique in lower limb surgery under regional anesthesia. Keywords: Ultrasound-guided Ankle Block, Anatomic Landmark-guided Ankle Block, Lower limb surgery.

A technique for evaluating reconstitution properties of milk powders

1973 ◽  
Vol 40 (2) ◽  
pp. 135-147
Author(s):  
T. C. Wyeth ◽  
G. C. Cheeseman
Keyword(s):  
Quantitative Data ◽  
Milk Powder ◽  
Skim Milk ◽  
The Other ◽  
Reproducible Technique ◽  
Freeze Dried ◽  
The Ideal

SummaryAn accurate and reproducible technique involving a continuous aqueous elution from a bed of dried-milk powder was developed to evaluate reconstitution characteristics. Quantitative data for the determination of reconstitution behaviour were obtained by analysis of the eluate for protein, lactose and Ca constituents. A reconstitution coefficient (P) was derived from the formula (W1+ΣWi)/T, where W1 was the amount reconstituted in the first eluate fraction, ΣWi the total amount reconstituted in 8 fractions, and T the time taken for 1/3 of the constituent to be reconstituted. Values obtained for P were thus related to the reconstitution properties and could be used to grade the powders. A freeze-dried skim-milk gave the ideal reconstitution behaviour with W1 values in the range 42·0–44·2, ΣWi values in the range 93·6–101·3, T values in the range 3·0–3·3 and reconstitution coefficients in the range 41·1–46·3 for the 3 constituents. All the other preparations tested gave lower values for W1 and P, although some gave ΣWi values in the same range, whilst all T values were higher than those for the freeze-dried sample.

Accuracy of talonavicular injection using ultrasound versus anatomical landmark: a cadaver study

2020 ◽  
Vol 61 (10) ◽  
pp. 1359-1364
Author(s):  
Aaradhana J Jha ◽  
Gean C Viner ◽  
Haley McKissack ◽  
Matthew Anderson ◽  
John Prather ◽  
...  
Keyword(s):  
Ultrasound Guidance ◽  
Joint Space ◽  
Anatomical Landmark ◽  
Neutral Position ◽  
Anatomical Landmarks ◽  
Talonavicular Joint ◽  
Ultrasound Guided ◽  
Needle Size ◽  
Complex Anatomy ◽  
Landmark Technique

Background Intra-articular injections have diagnostic and therapeutic roles in foot and ankle pathologies due to complex anatomy, small size, diverse bones, and joints with proximity in this region. Conventionally, these injections are carried out using anatomical landmark technique and/or fluoroscopic guidance. The small joint space and needle size make the injection challenging. Fluoroscopy is not readily available in the clinical setting; ultrasound-guidance for injections is therefore increasingly being used. We compared the accuracy of intra-articular talonavicular injections using the anatomical landmark technique versus the ultrasound-guided method. Purpose To determine whether ultrasound guidance yields superior results in intra-articular injections of the talonavicular joint compared to injections using palpatory method guided by anatomical landmarks. Material and Methods The feet of 10 cadaveric specimens were held in neutral position by an assistant while a fellowship-trained foot-ankle orthopedic surgeon injected 2 cc of radiopaque dye using anatomical landmarks and palpation method in five specimens and under ultrasound guidance in the remaining five. The needles were left in situ in all specimens and their placement was confirmed fluoroscopically. Results In all five specimens injected under ultrasound guidance, the needle was found to be in the joint, whereas all five injected by palpation only were out of the joint, with one in the naviculo-cuneiform joint, showing ultrasound guidance to significantly increase the accuracy of intra-articular injections in the talonavicular joint than palpatory method alone. Conclusion Ultrasound-guided injections not only confirm correct needle placement, but also delineate any tendon and/or joint pathology simultaneously.

Laparoscopic Repair of Caesarean Scar Defects Using Capio ® Suture Capturing Device

2013 ◽  
Vol 20 (6) ◽  
pp. S102
Author(s):  
D. Meulenbroeks ◽  
N.P.M. Kuijsters ◽  
M.S.Q. Kortenhorst ◽  
B.C. Schoot
Keyword(s):  
Laparoscopic Repair ◽  
Caesarean Scar

scholarly journals Three-Dimensional Radiographic Evaluation of the Malar Bone Engagement Available for Ideal Zygomatic Implant Placement

2020 ◽  
Vol 3 (3) ◽  
pp. 52 ◽  
Author(s):  
Gerardo Pellegrino ◽  
Francesco Grande ◽  
Agnese Ferri ◽  
Paolo Pisi ◽  
Maria Giovanna Gandolfi ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Ct Scans ◽  
Radiographic Evaluation ◽  
Anatomical Landmarks ◽  
Malar Bone ◽  
Implant Placement ◽  
Zygomatic Implants ◽  
Edentulous Patients ◽  
Zygomatic Implant ◽  
The Ideal

Zygomatic implant rehabilitation is a challenging procedure that requires an accurate prosthetic and implant plan. The aim of this study was to evaluate the malar bone available for three-dimensional zygomatic implant placement on the possible trajectories exhibiting optimal occlusal emergence. After a preliminary analysis on 30 computed tomography (CT) scans of dentate patients to identify the ideal implant emergencies, we used 80 CT scans of edentulous patients to create two sagittal planes representing the possible trajectories of the anterior and posterior zygomatic implants. These planes were rotated clockwise on the ideal emergence points and three different hypothetical implant trajectories per zygoma were drawn for each slice. Then, the engageable malar bone and intra- and extra-sinus paths were measured. It was possible to identify the ideal implant emergences via anatomical landmarks with a high predictability. Significant differences were evident between males and females, between implants featuring anterior and those featuring posterior emergences, and between the different trajectories. The use of internal trajectories provided better bone engagement but required a higher intra-sinus path. A significant association was found between higher intra-sinus paths and lower crestal bone heights.

scholarly journals Extra-articular Portion of the Sacroiliac Joint—Between the Sacral and Pelvic Tuberosities: An Anatomical Guide for the S2-Alar-Iliac Screw Trajectory

2020 ◽  
pp. 219256822090303
Author(s):  
Yasunori Tatara ◽  
Takanori Niimura ◽  
Tatsuhiro Sekiya ◽  
Hisanori Mihara
Keyword(s):  
Sacroiliac Joint ◽  
Screw Placement ◽  
Anatomical Landmarks ◽  
Related Complication ◽  
Screw Insertion ◽  
Iliac Screw ◽  
The Individual ◽  
The Right ◽  
Navigation Software ◽  
The Ideal

Study Design: A novel technique for S2-alar-iliac (S2AI) screw placement was analyzed. Objectives: Accurate confirmation of the S2AI screw trajectory with free-hand techniques is not simple, although some anatomical landmarks have been reported. To overcome the drawback, we aimed to introduce our technique for S2AI screw placement assisted with a guidewire using a new anatomical landmark. Methods: A total of 104 S2AI screws of 52 patients who underwent S2AI screw placement were investigated. Navigation software was used to simulate S2AI screw placement preoperatively. Screw placement was performed with the nonfluoroscopic free-hand technique. In this technique, a guidewire is inserted into the ilium from the extra-articular portion of the sacroiliac joint just lateral to the ideal screw entry point toward the tip of the greater trochanter and guides the screw trajectory. If the direction of the guidewire is satisfactory, all procedures of screw insertion are performed accordingly. The screw accuracy was assessed with computed tomography. Results: The modal size of the screw was 9.5 mm × 90 mm. The average horizontal angle was 42.0° (SD = 5.1°) on the right and 40.7° (SD = 4.7°) on the left. Of the 104 screws, 4 screws (3.9%) breached dorsally. No screw-related complication was observed. Conclusions: Because the guidewire can be inserted at an angle according to the individual morphology of the sacroiliac joint, it will be a reliable guide for the screw trajectory. This technique with a guidewire would help improve the accuracy of S2AI screw placement.

Precision of Landmark Positioning on Digitized Models from Patients with Cleft Lip and Palate

2006 ◽  
Vol 43 (2) ◽  
pp. 168-173 ◽  
Author(s):  
Jakob Brief ◽  
Jan H. Behle ◽  
Angelika Stellzig-Eisenhauer ◽  
Stefan Hassfeld
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Laser Scanner ◽  
Plaster Cast ◽  
Anatomical Landmarks ◽  
Positioning Error ◽  
The University ◽  
Plaster Models ◽  
The Ideal

Objective To quantify the precision of landmark positioning on digitized casts of patients with unilateral cleft lip and palate. Patients Forty plaster models of newborns up to 8 months of age were selected from the archive of the Department of Orthodontics of the University of Heidelberg. Material and Method The plaster-cast models were digitized with a Micromeasure 70 three-dimensional laser scanner (Micromeasure, Bischoffen, Germany). The laser scanner used in this study operates with a precision of 0.15 mm on the x- and y-axes and 0.06 mm on the z-axis. In the intraobserver study, a single observer placed anatomical landmarks in four rounds, with at least 4 weeks between each round. In the interobserver study, four different observers each placed the same landmarks once. For the two different studies, an ideal location for each landmark was calculated by averaging the landmark positions of the four rounds or observers. The distance between each of the four landmark positions and the ideal landmark was measured. Results A 95% confidence interval for the landmark positioning error was calculated. For the intraobserver investigation, this error was 0.34 to 1.30 mm, and for the interobserver investigation it was 0.7 to 2.00 mm. Conclusion Because both investigations displayed comparable error intervals, it was concluded that different observers could perform landmark positioning for the same studies.

scholarly journals Anatomical considerations on the place and formation of the renal veins

2013 ◽  
Vol 19 (4) ◽  
pp. 180-185
Author(s):  
S. Popescu ◽  
A. Olgun ◽  
P. Bordei ◽  
D.M. Iliescu
Keyword(s):  
Renal Vein ◽  
Left Renal Vein ◽  
Anatomical Landmark ◽  
Anatomical Landmarks ◽  
Renal Veins ◽  
Renal Sinus ◽  
Vein Formation ◽  
The Right ◽  
Plastic Injection ◽  
Venous Vasculature

Abstract Our study on the venous vasculature of the kidney (the location and the formation of the renal veins) was performed on a total of 148 cases, using as working methods the dissection, the injection of contrast medium followed by radiography and the plastic injection followed by corrosion. Not all anatomical landmarks could be studied in all cases, each anatomical landmark being assessed on a number of different cases. The left renal vein formation was studied on 124 cases and we have found that the left renal vein may appear inside the renal sinus (intrarenal or intrasinusal) in 13.71 % of cases; in 17.74 % of the cases the confluence of the tributaries of the renal was at the medial border of the kidney, so juxtarenal and the most common form was the extrarenal vein (68.55 % of cases). The level of appearance of the right renal vein was studied on 122 cases, describing the following patterns: intrasinusal in 19.67 % of cases, juxtarenal in 27.87 % of cases and extrarenal in 52.46 % of cases. The formation of renal veins was studied on a number of 114 cases, finding the following variations: in 56.14 % of the cases the renal vein formed from two venous trunks, in 38.60 % of cases from three venous trunks and in 5.26 % of cases from four venous trunks; we did not found cases of renal vein formed from more than 4 tributaries.

scholarly journals Laparoscopic repair of the uterine scar defect – successful treatment of secondary infertility: a case report and literature review

2017 ◽  
Vol 23 (4) ◽  
pp. 227-321 ◽  
Author(s):  
Greta Bakavičiūtė ◽  
Sabina Špiliauskaitė ◽  
Audronė Meškauskienė ◽  
Diana Ramašauskaitė
Keyword(s):  
Caesarean Section ◽  
Laparoscopic Repair ◽  
Clinical Symptoms ◽  
Previous History ◽  
Diagnostic Methods ◽  
Secondary Infertility ◽  
Caesarean Scar ◽  
Treatment Techniques ◽  
History Of ◽  
Uterine Scar

Background. The aim of this paper is to present a clinical case of laparoscopic repair of a uterine scar defect, to assess the effectiveness of treatment reviewing the latest literature sources, and to provide recommendations of uterine scar defect management. Materials and methods. We report the  case of a  33-year-old woman with an insufficient uterine scar and one-year history of secondary infertility. Following this, she underwent corrective laparoscopic repair, successfully got pregnant two months later and carried pregnancy to full term. We discuss the prevalence of caesarean scar defects, their clinical symptoms, diagnostic methods, various treatment techniques, and their outcomes. Results and conclusion. Caesarean scar defects, insufficient uterine scars, isthmocele or scar dehiscence following a caesarean section involve myometrial discontinuity at the site of a scar previous caesarean section. These anatomical defects associated with prolonged menstrual bleeding, chronic pelvic pain, dysmenorrhea, dyspareunia and secondary infertility. Laparoscopic repair of the uterine scar defect is an effective method of treatment of secondary infertility. Patients with a previous history of caesarean section who present complaints of secondary infertility, need a detailed evaluation of the uterine scar before planning future pregnancies.

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