scholarly journals Vaginal extirpation of the uterus using implants made of titanium silk to prevent recurrence of the disease

2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Anatoliy I. Ishchenko ◽  
Tat'yana V. Gavrilova ◽  
Anton A. Ishchenko ◽  
Oksana Y. Gorbenko ◽  
Teya A. Dzhibladze ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Uterine Prolapse ◽  
Titanium Implants ◽  
New Method ◽  
Vaginal Examination ◽  
Titanium Mesh ◽  
Surgical Method ◽  
Pelvic Organs ◽  
Reliable Tool

INTRODUCTION: The frequency of post-hysterectomy prolapse of the vaginal dome reaches 43% in patients after surgical treatment for complete uterine prolapse. Goal ― improving the effectiveness of surgical treatment with titanium mesh implants in pre- and postmenopausal patients with complete uterine prolapse. MATERIALS AND METHODS: The study involved 21 patients with complete uterine prolapse who underwent the proposed new method of transvaginal surgical prevention of post-hysterectomy prolapse of the vaginal dome. The result of surgical treatment was evaluated by analyzing the data of vaginal examination and ultrasound. RESULTS: Patients were observed for 2 years ― after 1, 6, 12 and 24 months. Analysis of vaginal examination and ultrasound data showed no displacement of the vaginal dome, pelvic organs and deformation of titanium implants. There were no mesh-associated complications during follow-up. CONCLUSIONS: The use of the developed surgical method for the correction of post-hysterectomy prolapse of the vaginal dome with the use of implants made of titanium silk is a reliable tool that provides anatomical efficiency in pre- and postmenopausal patients.

scholarly journals Surgical correction of prolapse of anterior wall of the vagina and cervix using titanium mesh implants

2020 ◽  
Vol 75 (1) ◽  
pp. 18-26
Author(s):  
Anatoly I. Ishchenko ◽  
Leonid S. Aleksandrov ◽  
Anton A. Ishchenko ◽  
Anton A. Kazantsev ◽  
Irina D. Khokhlova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Titanium Implants ◽  
Surgical Correction ◽  
Valsalva Manoeuvre ◽  
Titanium Mesh ◽  
Group Iii ◽  
Female Patients ◽  
Pelvic Exam ◽  
Group I

Background: Regardless of a variety of surgical techniques and hi-tech materials for pelvic prolapse treatment, there is no decrease in the disease recurrences. Aims: Evaluation of the efficacy of the developed method of surgical correction of IIIV degree colpoptosis anterior combined with IIIII degree C-prolapse with the use of titanium mesh implants in reproductive, pre- and postmenopausal female patients. Methods: Female patients (group I, n = 25) with colpoptosis anterior and cervical prolapse were examined and operated on according to the developed know-how technique with the use of titanium mesh implants. Evaluation of the efficacy of surgical correction of the disease was performed using questioning, pelvic exam with Valsalva manoeuvre, transvaginal and transperineal ultrasound, pelvis MRI. The findings were compared with the result of surgical treatment of 46 (group II) and 32 (group III) female patients operated on without the use of titanium implants. After surgical treatment according to the three-stage surgical program that provides for multifocal fixation of anatomical formations with the use of titanium implants, the case follow-up was performed in 321 months. Results: Questioning the patients in group I demonstrated their satisfaction with the surgical treatment results that positively affected the quality of life, mood, and contributed to an increase in sexual activity and community commitment. Check-up showed that the surgical correction of prolapse was completely preserved in the patients of group I during 1821 months. Pelvic exam at rest and with Valsalva manoeuvre, transvaginal and transperineal ultrasound, pelvis MRI did not reveal any significant extrusion of the pelvic organs or titanium implants. No mesh-associated complications were observed during the follow-up. Recurrence of genital prolapse was diagnosed in 12 (26%) patients of group II, mesh-associated complications were detected in 6 (18.8%) women of group III. Conclusions: The preserving three-stage surgical program, developed by us, contributed to optimize the results of surgical treatment, decrease the rate of the disease recurrence, and reduce the risk of the development of mesh-associated complications.

scholarly journals Posterior-only Debridement, Internal Fixation, and Interbody Fusion Using Titanium Mesh in the Surgical Treatment of Thoracolumbar Tuberculosis With Spinal Epidural Abscess: A Minimum 5-year Follow-up

2021 ◽  
Author(s):  
Qile Gao ◽  
Chaofei Han ◽  
Manini Daudi Romani ◽  
Chaofeng Guo ◽  
Mingxing Tang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Interbody Fusion ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Titanium Mesh ◽  
Neurological Score ◽  
The Mean ◽  
Spinal Epidural

Abstract Objective: To investigate the clinical efficacy and feasibility of posterior-only debridement, internal fixation, and interbody fusion using titanium mesh in the surgical treatment of thoracolumbar tuberculosis (TB) with spinal epidural abscess.Methods: From January 2008 to January 2014, a total of 45 patients (27 male and 18 female) were reviewed. The patients were diagnosed with thoracolumbar TB with spinal epidural abscess. The patients underwent posterior-only debridement, internal fixation, and interbody fusion using titanium mesh. Hence, we assessed the intraoperative and postoperative complications, disease recurrences, kyphosis deformity correction, and neurological improvement following the American Spinal Injury Association (ASIA). We used SPSS 22.0 for the statistical analyses. An independent Student’s t-test was used for the analysis of preoperative and postoperative continuous variables. The value of P (P<0.05) was considered statistically significant.Results: The mean age of patients was 37.76 ±10.94 years (17–59 years). The mean follow-up time was 82.76 ±12.56 months (60–128 months). The mean kyphosis Cobb angle preoperative was 29.36 ±13.29° (5–55°) and postoperative was 3.58 ±5.44° (–6–13°), given the value of P (P<0.001). According to the neurological score by the ASIA scale, there were 3 cases of grade B, 11 cases of grade C, 16 cases of grade D, and 15 cases of grade E preoperatively. The neurological score improved by 1~2 grades. All patients achieved pain relief and the VAS score significantly reduced at the last follow-up (P＜0.05). While 1 patient had cerebrospinal fluid leakage, 1 had a neurological complication, 1 had delayed surgical wound healing, and 1 had a disease recurrence. No pseudoarthrosis or implant failure occurred in our patients. All patients achieved solid bone graft fusion.Conclusion: For thoracolumbar TB patients with spinal epidural abscess, posterior-only debridement, internal fixation, and interbody fusion using titanium mesh are safe and effective surgical treatments.*As a note, Qile Gao and Chaofei Han are Co-First authors.

scholarly journals Posterior-only debridement, internal fixation, and interbody fusion using titanium mesh in the surgical treatment of thoracolumbar tuberculosis with spinal epidural abscess: a minimum 5-year follow-up

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Qile Gao ◽  
Chaofei Han ◽  
Manini Daudi Romani ◽  
Chaofeng Guo ◽  
Mingxing Tang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Interbody Fusion ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Titanium Mesh ◽  
Neurological Score ◽  
The Mean ◽  
Spinal Epidural

Abstract Objective To investigate the clinical efficacy and feasibility of posterior-only debridement, internal fixation, and interbody fusion using titanium mesh in the surgical treatment of thoracolumbar tuberculosis (TB) with spinal epidural abscess. Methods From January 2008 to January 2014, a total of 45 patients (27 male and 18 female) were reviewed. The patients were diagnosed with thoracolumbar TB with spinal epidural abscess. The patients underwent posterior-only debridement, internal fixation, and interbody fusion using titanium mesh. Hence, we assessed the intraoperative and postoperative complications, disease recurrences, kyphosis deformity correction, and neurological improvement following the American Spinal Injury Association (ASIA). We used SPSS 22.0 for the statistical analyses. An independent Student’s t-test was used for the analysis of preoperative and postoperative continuous variables. The value of P (P < 0.05) was considered statistically significant. Results The mean age of patients was 37.76 ± 10.94 years (17–59 years). The mean follow-up time was 82.76 ± 12.56 months (60–128 months). The mean kyphosis Cobb angle preoperative was 29.36 ± 13.29° (5–55°) and postoperative was 3.58 ± 5.44° (− 6–13°), given the value of P (P < 0.001). According to the neurological score by the ASIA scale, there were 3 cases of grade B, 11 cases of grade C, 16 cases of grade D, and 15 cases of grade E preoperatively. The neurological score improved by 1 ~ 2 grades. All patients achieved pain relief and the VAS score significantly reduced at the last follow-up (P<0.05). While 1 patient had cerebrospinal fluid leakage, 1 had a neurological complication, 1 had delayed surgical wound healing, and 1 had a disease recurrence. No pseudoarthrosis or implant failure occurred in our patients. All patients achieved solid bone graft fusion. Conclusion For thoracolumbar TB patients with spinal epidural abscess, posterior-only debridement, internal fixation, and interbody fusion using titanium mesh are safe and effective surgical treatments.

A new method of organ-preserving surgical correction of cervical elongation using titanium mesh implants. The “Moscow” surgery

2021 ◽  
Vol 20 (4) ◽  
pp. 84-92
Author(s):  
A.I. Ishchenko ◽  
◽  
V.V. Ivanova ◽  
A.A. Ishchenko ◽  
I.D. Khokhlova ◽  
...  
Keyword(s):  
Transvaginal Ultrasound ◽  
Vaginal Wall ◽  
Titanium Implants ◽  
Surgical Correction ◽  
Stage I ◽  
Perineal Pain ◽  
Titanium Mesh ◽  
Cervical Elongation ◽  
Original Technique

Objective. To study the efficacy and safety of the original technique for surgical correction of cervical elongation with vaginal wall prolapse (stage I–II) in patients of reproductive and menopause age. Patients and methods. The study included 17 patients aged 30 to 56 years with cervical elongation and vaginal wall prolapse. All patients underwent the original surgery – cervical amputation along with combined transobturator and sacrospinous TiMeshligature cervical suspension. Results. The patients were observed 1, 6, 12 and 18 months after surgery. Comparison of the patients’ questionnaire data in the pre- and postoperative periods showed an improvement in their quality of life, an increase in their social and sexual activity. During the first month, 10 (58.8%) patients noted intermittent episodes of perineal pain and 3 (17%) – frequent urination. Comprehensive clinical examination after 6, 12, and 18 months revealed complete preservation of surgical correction of prolapse in all patients. Gynecological and rectal examinations, transperineal and transvaginal ultrasound revealed no displacement of pelvic organs and titanium implants. There were no mesh-associated complications during follow-up. Conclusion. The developed original technique for surgical correction of cervical elongation with vaginal wall prolapse (stage I–II) using a combination of titanium mesh implants and non-absorbable ligatures with two-lateral suture anchor was shown to be effective and safe, as evidenced by normalization of the uterus position in the pelvis and absence of pelvic organ displacement and mesh-associated complications during follow-up. Key words: cervical elongation, stage I–II vaginal wall prolapse, titanium mesh implants, mesh-ligature correction of prolapse

Surgical Treatment of Congenital Choanal Atresia

1978 ◽  
Vol 87 (3) ◽  
pp. 346-350 ◽  
Author(s):  
Atle Freng
Keyword(s):  
Surgical Treatment ◽  
Nasal Cavity ◽  
High Frequency ◽  
Choanal Atresia ◽  
Posterior Part ◽  
Scar Tissue ◽  
Postoperative Treatment ◽  
Surgical Method ◽  
Dental Drill

— In a follow-up, 2 to 27 years postoperatively, of 43 patients with unilateral choanal atresia a high frequency of relapses was observed. In 47% of the cases, preoperative symptoms had reappeared, and in 84% scar tissue had reduced the choanal opening to less than half of normal size. In most of the patients a transpalatinal approach was used, either ad modum Ruddy, Wilson or Owens. In order to improve the results, the surgical method and the postoperative treatment were changed in a new series of 15 patients with unilateral atresia. These patients, 6 to 26 years of age, were operated on by a transpalatinal approach during two months in the autumn of 1974. After removal of the atresia, the posterior part of the nasal cavity was modeled, with a dental drill, to increasing diameter towards epipharynx. To keep the opening patent a PVC tube was left in the choana for six weeks postoperatively. The results were encouraging. Two and a half years after the operation there were no relapses.

scholarly journals An effective method of surgical treatment of refractory glaucoma patients using Ex-PRESSTM filtering device

2013 ◽  
Vol 6 (1) ◽  
pp. 3-8 ◽  
Author(s):  
Sergey Yuryevich Astakhov ◽  
Ahmed Alievich Harsha
Keyword(s):  
Data Analysis ◽  
Surgical Treatment ◽  
Surgical Procedure ◽  
New Method ◽  
Refractory Glaucoma ◽  
Low Level ◽  
Device Implantation ◽  
Operative Complications

Based on data obtained from examination and subsequent follow-up of 47 patients (50 eyes) with refractory glaucoma, an efficacy estimation of a new method of the Ex-PRESSTM filtering device implantation was performed. The data analysis showed that the proposed surgical procedure has a low level of intra- and post-operative complications, is characterized by technical ease, and provides a long term stabilization of the glaucomatous process. Therefore it is possible to draw a conclusion that the Ex-PRESSTM filtering device implantation is an effective method for the treatment of refractory glaucoma.

scholarly journals The efficacy of allograft bone using titanium mesh in the posterior-only surgical treatment of thoracic and thoracolumbar spinal tuberculosis

2020 ◽  
Author(s):  
Bingjin Wang ◽  
Wenbin Hua ◽  
Wencan Ke ◽  
Yukun Zhang ◽  
Xianlin Zeng ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Spinal Injury ◽  
Spinal Tuberculosis ◽  
Allograft Bone ◽  
Titanium Mesh ◽  
Analog Scale ◽  
Bony Fusion ◽  
The Mean ◽  
Thoracolumbar Spinal Tuberculosis

Abstract Background: The bony fusion of allograft bone using titanium mesh in the posterior-only surgical treatment of thoracic and thoracolumbar spinal tuberculosis has not been explained in detail. We aimed to analyze the efficacy of bony fusion of allograft bone using titanium mesh in the posterior-only surgical treatment of thoracic and thoracolumbar spinal tuberculosis.Methods: We treated 32 thoracic or thoracolumbar tuberculosis patients by one-stage posterior debridement, allograft bone graft using titanium mesh, posterior instrumentation, and fusion from May 2011 to September 2015. The American Spinal Injury Association neurological classification, visual analog scale, and Oswestry disability index scores were analyzed preoperatively, postoperatively, and at final follow-up. The Cobb angles were recorded to evaluate the kyphosis correction and the loss of correction. The bony fusion was evaluated by X-ray and computed tomography images, and the bony fusion classifications were recorded.Results: All patients had pain relief. The erythrocyte sedimentation rate, C-response protein, and hepatorenal function were normal at final follow-up. The American Spinal Injury Association neurological classification, visual analog scale, and Oswestry disability index scores were improved in all the patients. All patients achieved bone fusion. Twenty-eight patients achieved complete fusion (Grade I), whereas only four patients achieved partial fusion (Grade II). The preoperative Cobb angle was 33.6±9.3°. The Cobb angle was reduced to 10.6±2.6° postoperatively and was found to be 11.4±3.1° at the final follow-up. The mean angle correction was 23.0±8.9°, and the correction rate was 66.2±12.2%. The mean angle lost was 0.8±0.9°, and the lost rate was 5.8±5.4% at the final follow-up.Conclusions: Allograft bone using titanium mesh in the posterior-only surgical treatment is effective for patients with thoracic and thoracolumbar spinal tuberculosis. It can correct kyphosis, and most patients can achieve complete bony fusion.

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