scholarly journals Transtemporal amygdalohippocampectomy: a novel minimally-invasive technique with optimal clinical results and low cost

2017 ◽  
Vol 75 (11) ◽  
pp. 801-808 ◽  
Author(s):  
Juan Antonio Castro Flores ◽  
Felipe Hada Sanders ◽  
Eberval Gadelha Figueiredo ◽  
Manoel Jacobsen Teixeira
Keyword(s):  
Minimally Invasive ◽  
Low Cost ◽  
Case Series ◽  
Clinical Results ◽  
Invasive Technique ◽  
Mesial Temporal Sclerosis ◽  
Class Iii ◽  
Surgical Time ◽  
Temporal Muscle ◽  
Prospective Case Series

ABSTRACT Mesial temporal sclerosis creates a focal epileptic syndrome that usually requires surgical resection of mesial temporal structures. Objective: To describe a novel operative technique for treatment of temporal lobe epilepsy and its clinical results. Methods: Prospective case-series at a single institution, performed by a single surgeon, from 2006 to 2012. A total of 120 patients were submitted to minimally-invasive keyhole transtemporal amygdalohippocampectomy. Results: Of the patients, 55% were male, and 85% had a right-sided disease. The first 70 surgeries had a mean surgical time of 2.51 hours, and the last 50 surgeries had a mean surgical time of 1.62 hours. There was 3.3% morbidity, and 5% mild temporal muscle atrophy. There was no visual field impairment. On the Engel Outcome Scale at the two-year follow-up, 71% of the patients were Class I, 21% were Class II, and 6% were Class III. Conclusion: This novel technique is feasible and reproducible, with optimal clinical results.

A gaming system with haptic feedback to improve upper extremity function: A prospective case series

2021 ◽  
pp. 1-12
Author(s):  
Hamilton Hernandez ◽  
Isabelle Poitras ◽  
Linda Fay ◽  
Ajmal Khan ◽  
Jean-Sébastien Roy ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Haptic Feedback ◽  
Low Cost ◽  
Case Series ◽  
Performance Measure ◽  
Occupational Performance ◽  
Canadian Occupational Performance Measure ◽  
Prospective Case Series ◽  
Paediatric Rehabilitation ◽  
Therapeutic Settings

BACKGROUND: Video games can be used to motivate repetitive movements in paediatric rehabilitation. Most upper limb videogaming therapies do not however include haptic feedback which can limit their impact. OBJECTIVE: To explore the effectiveness of interactive computer play with haptic feedback for improving arm function in children with cerebral palsy (CP). METHODS: Eleven children with hemiplegic CP attended 12 therapist-guided sessions in which they used a gaming station composed of the Novint Falcon, custom-built handles, physical supports for the child’s arm, games, and an application to manage and calibrate therapeutic settings. Outcome measures included Quality of Upper Extremity Skills Test (QUEST) and Canadian Occupational Performance Measure (COPM). The study protocol is registered on clinicaltrials.gov (NCT04298411). RESULTS: Participants completed a mean of 3858 wrist extensions and 6665 elbow/shoulder movements during the therapist-guided sessions. Clinically important improvements were observed on the dissociated and grasp dimensions on the QUEST and the performance and satisfaction scales of the COPM (all p< 0.05). CONCLUSION: This study suggests that computer play with haptic feedback could be a useful and playful option to help improve the hand/arm capacities of children with CP and warrants further study. The opportunities and challenges of using low-cost, mainstream gaming software and hardware for therapeutic applications are discussed.

scholarly journals Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Motohide Shibayama ◽  
Guang Hua Li ◽  
Li Guo Zhu ◽  
Zenya Ito ◽  
Fujio Ito
Keyword(s):  
Minimally Invasive ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Facet Joint ◽  
Clinical Results ◽  
Invasive Technique ◽  
Clinical Effects ◽  
Lumbar Interbody Fusion ◽  
Disc Space ◽  
Single Level

Abstract Background Lumbar interbody fusion is a standard technique for treating degenerative lumbar disorders involving instability. Due to its invasiveness, a minimally invasive technique, extraforaminal lumbar interbody fusion (ELIF), was introduced. On surgically approaching posterolaterally, the posterior muscles and spinal canal are barely invaded. Despite its theoretical advantage, ELIF is technically demanding and has not been popularised. Therefore, we developed a microendoscopy-assisted ELIF (mELIF) technique which was designed to be safe and less invasive. Here, we aimed to report on the surgical technique and clinical results. Methods Using a posterolateral approach similar to that of lateral disc herniation surgery, a tubular retractor, 16 or 18 mm in diameter, was placed at the lateral aspect of the facet joint. The facet joint was partially excised, and the disc space was cleaned. A cage and local bone graft were inserted into the disc space. All disc-related procedures were performed under microendoscopy. The spinal canal was not invaded. Bilateral percutaneous screw-rod constructs were inserted and fixed. Results Fifty-five patients underwent the procedure. The Oswestry Disability Index and visual analogue scale scores greatly improved. Over 90% of the patients obtained excellent or good results based on Macnab’s criteria. There were neither major adverse clinical effects nor the need for additional surgery. Conclusions mELIF is minimally invasive because the spinal canal and posterior muscles are barely invaded. It produces good clinical results with fewer complications. This technique can be applied in most single-level spondylodesis cases, including those involving L5/S1 disorders.

scholarly journals Achilles tendon repair by a minimally invasive technique using Tenolig®

2020 ◽  
Vol 14 (3) ◽  
pp. 269-273
Author(s):  
Vinicius Oliveira ◽  
Sérgio Prata
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Postoperative Infection ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Aofas Score ◽  
Functional Scores

Objective: To assess the degree of postoperative satisfaction of patients with acute Achilles tendon rupture who underwent surgical reconstruction by a minimally invasive technique using Tenolig®. Methods: A retrospective observational study was conducted with 18 patients with acute Achilles tendon rupture diagnosed by a positive Thompson test who underwent surgery. Outcomes were assessed using the American  arthopaedic Foot and Ankle Society (AOFAS) score and the Foot Function Index (FFI). Furthermore, quantitative variables were descriptively treated, and patients’ age was correlated with FII and AOFAS score using Spearman’s correlation coefficient at a significance level of 5%. Results: Patients underwent surgery from one to six days after injury and were discharged one day later. Only one patient had a superficial postoperative infection. Patients’ AOFAS scores ranged from 75 to 100 points, and FFI ranged from 0 to 20%. The patient withsuperficial postoperative infection had an AOFAS score and a FFI of 75 points and 20%, respectively. Conclusion: Percutaneous repair of complete Achilles tendon rupture with Tenolig® resulted in high functional scores and a low rate of complications. Level of Evidence IV; Therapeutic Studies; Case Series.

scholarly journals Results of a novel surgical technique for iridodialysis repair using segments

2021 ◽  
Author(s):  
Ugur Unsal ◽  
Huri Sabur ◽  
Mehmet Soyler
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Clinical Results ◽  
Study Data ◽  
Invasive Technique ◽  
Minimally Invasive Surgical ◽  
Corrected Distance Visual Acuity ◽  
History Of ◽  
Surgical Manipulation

Abstract Purpose: To describe a novel surgical technique for iridodialysis repair using iris retractor segments and report its clinical results.Methods: 53 eyes of 53 patients who underwent surgery for iridodialysis repair were enrolled in this retrospective study. Data recorded from patient files consisted of age, sex, history of trauma, surgical indications and type of surgery, preoperative and postoperative corrected distance visual acuity (CDVA), intraocular pressure (IOP), complications, and follow-up time. The novel, minimally invasive surgical technique was explicitly described in detail.Results: Mean follow-up time was 34.4 (range 12-84) months. The subjects were 29 (54.7%) men and 26 (45.3%) women, and the mean age was 56.6±14.0 years. Iridodialysis repair performed using one segment in 37 (69.8%) eyes, two segments in 15 (28.3%) eyes, and three segments in 1 (1.9%) eye. Pupilloplasty was performed in 17 eyes due to wide pupil diameter. The iridodialysis repair was combined with lens removal in 48 eyes, and anterior vitrectomy was performed in 10 eyes. CDVA significantly improved after surgery (p<0.001). Post-traumatic IOP rise was the most common complication, and six patients needed medical therapy for glaucoma control.Conclusion: Iridodialysis repair using iris retractor segment is a minimally invasive technique and found to be safe and effective, providing less surgical manipulation and surgical time than other techniques.

scholarly journals P.138 Minimally invasive treatment of syringomyelia using tubular retractors

2018 ◽  
Vol 45 (s2) ◽  
pp. S53-S53
Author(s):  
K Yang ◽  
M Sourour ◽  
N Zagzoog ◽  
K Reddy
Keyword(s):  
Minimally Invasive ◽  
Chart Review ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Senior Author ◽  
Invasive Technique ◽  
Single Center ◽  
Invasive Treatment ◽  
Multiple Modalities ◽  
Subarachnoid Spaces

Background: Multiple modalities have been used in the treatment of syringomyelia, including direct drainage, shunting into peritoneal, pleural and subarachnoid spaces. The authors report their experience of surgical treatment of syringomyelia in a minimally invasive fashion. Methods: We conducted a single-center retrospective chart review on our syringomyelia cases treated with minimally invasively using Metrx Quadrant retractor system since January 2011. Lateral fluoroscopy was used to guide the placement of the retractor onto the lamina of the corresponding level. This was followed by laminectomy and a small durotomy. Once the syrinx cavity was identified and the proximal end of the tubing was inserted into the syrinx cavity, the tubing was tunneled into the pleural incision subcutaneously. Insertion of the pleural end of the shunt was performed under the microscope, with removal of a small amount of the rib at its upper edge. Results: 10 procedures were performed in 7 patients by the senior author. Etiologies of syringomyelia included Chiari malformation, trauma, diastematomyelia and kyphoscoliosis. All patients improved neurologically. No patients had immediate postoperative complications. One patient underwent two revisions of syringopleural shunts due to multilobulated nature of syringomyelia. Conclusions: Our case series presents a novel, minimally invasive technique for shunting of syringomyelia with results comparable to open procedures.

scholarly journals Ultrasound-guided removal of soft tissue foreign bodies in companion animals: A case series

2020 ◽  
Vol 65 (No. 2) ◽  
pp. 49-55
Author(s):  
S Manfredi ◽  
G Covi ◽  
M Bonazzi ◽  
G Gnudi ◽  
M Fumeo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Foreign Bodies ◽  
Soft Tissues ◽  
Companion Animals ◽  
Case Series ◽  
Invasive Technique ◽  
Surgical Removal ◽  
Small Animals ◽  
Ultrasound Guided

Foreign bodies (FBs) retained in the subcutaneous tissues are a common reason for medical consultation. In small animals, FBs usually consist of vegetal materials, especially grass awns. Failure to remove the FBs is likely to give rise to acute or late complications. The surgical removal of the FBs can be invasive, costly and technically challenging. Ultrasound has become a mainstay in the detection of FBs and it can be used to guide the extraction of the FBs with a minimally invasive technique. This study describes the detection and extraction of soft-tissue FBs in small animals. One hundred-sixty-two patients, presenting at two veterinary clinics with suspected FBs retained in the soft tissues of various body districts, were considered. Once an ultrasound diagnosis was established, the ultrasound-guided removal of the FB was performed. A high-frequency linear transducer, a skin disinfection, sedation or anaesthesia was used when needed and a scalpel and some Hartmann forceps were also used. One hundred-eighty-two FBs were successfully removed in all the patients. In six cases, the FB was identified during a second ultrasonographic examination, after recurrence of the fistula. No complications were reported after the procedure. The extraction of the FB was performed in an echographic suite in 138 cases and in a surgery room with surgical intervention in 24 cases. In the latter situation, the surgical minimally invasive dissection of tissues under ultrasound guidance was performed before the removal of the FB. In conclusion, the ultrasound-guided removal of the FBs retained in the superficial soft tissue can be considered a good alternative to surgery. However, failure to remove a FB does not preclude the removal by traditional surgery.

Improving accuracy and reducing radiation exposure in minimally invasive lumbar interbody fusion

2010 ◽  
Vol 12 (5) ◽  
pp. 533-539 ◽  
Author(s):  
Martin James Wood ◽  
Richard John Mannion
Keyword(s):  
Minimally Invasive ◽  
Radiation Exposure ◽  
Interbody Fusion ◽  
Case Series ◽  
Guidance System ◽  
Screw Placement ◽  
Invasive Technique ◽  
Computer Assisted ◽  
Lumbar Interbody Fusion ◽  
Screw Misplacement

Object The authors assessed the accuracy of placement of lumbar transpedicular screws by using a computer-assisted, imaged-guided, minimally invasive technique with continuous electromyography (EMG) monitoring. Methods This was a consecutive case series with prospective assessment of procedural accuracy. Forty-seven consecutive patients underwent minimally invasive lumbar interbody fusion and placement of pedicle screws (PSs). A computer-assisted image guidance system involving CT-based images was used to guide screw placement, while EMG continuously monitored the lumbar nerve roots at the operated levels with a 5-mA stimulus applied through the pedicle access needle. All patients underwent CT scanning to determine accuracy of PS placement. All episodes of adjusted screw trajectory based on positive EMG responses were recorded. Pedicle screw misplacement was defined as breach of the pedicle cortex by the screw of more than 2 mm. Results Two hundred twelve PSs were inserted in 47 patients. The screw misplacement rate was 4.7%. One patient experienced new postoperative radiculopathy resulting from a sacral screw that was too long, with lumbosacral trunk impingement. The trajectory of the pedicle access needle was altered intraoperatively on 20 occasions (9.4% of the PSs) based on positive EMG responses, suggesting that nerve root impingement may have resulted from these screws had the EMG monitoring not been used. Conclusions The combination of computer-assisted navigation combined with continuous EMG monitoring during pedicle cannulation results in a low rate of PS misplacement, with avoidance of screw positions that might cause neural injury. Furthermore, this technique allows reduction of the radiation exposure for the surgical team without compromising the accuracy of screw placement.

scholarly journals Description of a minimally invasive technique with a modified instrument for the osteosynthesis of proximal femoral fractures using the standard DHS and case series

2020 ◽  
Vol 47 ◽  
Author(s):  
RICARDO RAMON CAMACHO IRIGOYEN ◽  
RAFAEL DE LUCA DE-LUCENA ◽  
JEAN KLAY SANTOS MACHADO ◽  
GABRIEL SEVERO DA-SILVA ◽  
CARLOS ROBERTO SCHWARTSMANN ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Techniques ◽  
Case Series ◽  
Femoral Fractures ◽  
Soft Tissue Injuries ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Trochanteric Fractures ◽  
Clinical Complications ◽  
Minimally Invasive Surgical

ABSTRACT Introduction: the number of hip fractures is estimated to increase from 1.66 million in 1990 to 6.26 million by 2050. Internal fixation is the most common surgical treatment for intertrochanteric fractures. Objectives: the objective of the present research is to describe a minimally invasive technique with a modified instrument for the treatment of stable proximal femoral trochanteric fractures using the standard DHS, classified as Tronzo types 1 and 2 (AO 31A1.2), and presenting a case series. Methods: a case was selected to present the technique. Patients operated by this technique undergo a clinical evaluation and preoperative preparation as routine. The criteria for inclusion in the study were the presence of stable fracture of the proximal femur verified by two hip specialist orthopedists, and operated by the minimally invasive technique with a modified instrument using a standard DHS. Exclusion criteria were cases of patients operated for unstable fractures, and the use of other surgical techniques. A case series of 98 patients was performed and discussed. Results: minimally invasive technique with a modified instrument using the standard DHS device can reduce bleeding, it decreases soft tissue injuries, surgical time, and hospital stay, as any other MIPO procedures. Ninety-eight patients underwent the operation (Tronzo types I and II), 59 female and 39 male, ages from 50 to 85 years old. Immediate post-operative complications were shortening of the lower limb, loss of fracture reduction, and death by clinical complications. Conclusion: the present study describes a minimally invasive surgical technique using a modified instrument to perform proximal femoral osteosynthesis for stable trochanteric fractures, using the standard DHS.

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