Surgical treatment of the consequences of a gunshot wound to the lumbar spine using endoscopic techniques

A clinical case of treatment of a patient with long-term consequences of a gunshot wound to the lumbar spine with a follow-up period of fifteen years is presented. In the last year and a half, the repeatedly recurrent retroperitoneal phlegmon associated with a foreign body of the lumbar spine has prompted a decision on the issue of surgical treatment (removal of a foreign body - a bullet). The location of the foreign body and previous experience with endoscopic foreign body removal played a decisive role in the choice of surgical tactics. Removal of the wounding projectile was performed using a percutaneous transforaminal endoscopic approach. The choice of such an approach was dictated by the peculiarity of the location of the foreign body (coaxial with the endoscopic tube in the foraminal approach), as well as sufficient experience in using the technique of percutaneous endoscopic surgery. At the same time, the conversion plan was worked out in sufficient detail with both posterolateral and anterior open approaches with the involvement of appropriate specialists. So, in case of failure, it was planned to transfer endoscopic access to open, using the already installed working tube of the endoscope as a conductor to a foreign body. In case of inefficiency, for some reason, this version of the operation was planned for the next, third stage: wound suturing, patient turning on the back with a right-hand retroperitoneal approach to the anterior-lateral surface of LI and LII bodies. Fortunately, the purpose of the operation was achieved using the most gentle version of the allowance. The given clinical case testifies that the technique of percutaneous transforaminal endoscopic surgery is not limited in indications to the treatment of degenerative-dystrophic diseases of the spine.

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Full-endoscopic surgery for gunshot penetrating wound of the lumbar spine (literature review and clinical case)

Russian journal of neurosurgery ◽

10.17650/1683-3295-2018-20-2-66-73 ◽

2018 ◽

Vol 20 (2) ◽

pp. 66-73

Author(s):

M. N. Kravtsov ◽

S. A. Landik ◽

A. А. Dubinin ◽

K. S. Azatyan ◽

В. V. Gaidar ◽

...

Keyword(s):

Lumbar Spine ◽

Endoscopic Surgery ◽

Spinal Canal ◽

Gunshot Wound ◽

Clinical Case ◽

Gunshot Wounds ◽

Minimal Invasive ◽

Study Objective ◽

Invasive Approach ◽

Minimal Invasive Approach

The study objectiveis to determine the feasibility and effectiveness evaluation of full-endoscopic surgery in gunshot wound of the lumbar spine.Materials and methods.A clinical case of a 24-year-old male who received a gunshot wound to the lumbar spine is described. The patient underwent a full-endoscopic intervention aimed at extracting a bullet from the spinal canal.Results.Minimal-invasive approach to spinal canal with the possibility to extract a bullet, decompression of nerve roots, defect closure of the dura mater is demonstrated.Conclusion.Good clinical outcome allows to recommend the full-endoscopic surgery with similar gunshot wounds of the lumbar spine at the stage of specialized care.

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A CLINICAL CASE OF REMOVING A RESIDUAL FOREIGN BODY FROM THE LEFT SUPRACLAVICULAR REGION

Inter Collegas ◽

10.35339/ic.4.3.120-122 ◽

2017 ◽

Vol 4 (3) ◽

pp. 120-122

Author(s):

V.V. Boyko ◽

V.V. Makarov ◽

A.L. Sochnieva ◽

V.V. Kritsak

Keyword(s):

Surgical Treatment ◽

Foreign Body ◽

Soft Tissue ◽

Clinical Case ◽

Foreign Bodies ◽

Soft Tissues ◽

Life Quality ◽

The Other ◽

Practical Case ◽

The One

Boyko V.V., Makarov V.V., Sochnieva A.L., Kritsak V.V.Residual foreign bodies in soft tissues are one of the main causes of chronical infection lesions and decrease in life quality. Surgical treatment is the most common way to relieve the patient from a foreign body. Often there is a question whether to remove a foreign body? On the one hand, all foreign bodies that are in the human body must be removed. On the other hand, in the absence of symptoms, the risk of surgery performed for the purpose of removal exceeds the risk associated with finding the foreign body. We would like to describe a practical case of removing a foreign body (Kirschner`s wires) from the left supraclavicular region. The young patient lived with a fragment of Kirschner's wire left after the osteosynthesis of the fractured clavicle for 5 years. Surgery to remove the residual foreign body was successful. On the 7th postoperative day the patient was discharged from the hospital under the supervision of surgeons at the place of residence.Key words: foreign body in soft tissue, Kirschner`s wire, surgical treatment. КЛІНІЧНИЙ ВИПАДОК ВИДАЛЕННЯ ЗАЛИШКОВ СТОРОННЬОГО ТІЛА З ЛІВОЇ НАДКЛЮЧИЧНОЇ ОБЛАСТІБойко В.В., Макаров В.В., Сочнева А.Л., Крицак В.В.Залишкові чужорідні тіла м'яких тканин залишаються однією з основних причин виникнення вогнища хронічної інфекції та зниження рівня якості життя. Хірургічне лікування основний спосіб позбавити хворого від наявності чужорідного агента. Часто виникає питання чи видаляти чужорідне тіло. З одного боку, усі сторонні тіла, що знаходяться в тілі людини, підлягають видаленню, з іншого боку при відсутності симптомів ризик операції, проводимої з метою видалення, перевищує ризик, пов'язаний з перебуванням чужорідного тіла. Ми хотіли б поділитися випадком видалення залишкового стороннього тіла (спиці Кіршнера) лівої надключичної ділянки із власної практики. Молода пацієнтка прожила з уламком спиці Кіршнера, залишеної після металлоостеосинтезу поламаної ключиці протягом 5 років. Операція з видалення залишкового стороннього тіла пройшла успішно. На 7 післяопераційну добу пацієнтка була виписана зі стаціонару під спостереження хірурги за місцем проживання.Ключові слова: чужорідне тіло м'яких тканин, спиця Кіршнера, хірургічне лікування. кЛИНИЧЕСКИЙ СЛУЧАЙ УДАЛЕНИЯ ОСТАТКОВ ИНОРОДНОГО ТЕЛА ИЗ ЛЕВОЙ ПОДКЛЮЧИЧНОЙ ОБЛАСТИ Бойко В.В., Макаров В.В., Сочнева А.Л., Крицак В.В.Остаточные инородные тела мягких тканей остаются одной из основных причин возникновения очага хронической инфекции и снижения уровня качества жизни. Хирургическое лечение основной способ избавить больного от наличия чужеродного агента. Часто возникает вопрос удалять ли инородное тело? С одной стороны, все инородные тела, находящиеся в теле человека, подлежат удалению, с другой стороны при отсутствии симптомов риск операции, производимой с целью удаления, превышает риск, связанный с нахождением инородного тела. Мы хотели бы поделится случаем удаления остаточного инородного тела (спицы Киршнера) левой надключичной области из собственной практики. Молодая пациентка прожила с обломком спицы Киршнера, оставленной после металлоостеосинтеза поломанной ключицы в течении 5 лет. Операция по удалению остаточного инородного тела прошла успешно. На 7 послеоперационные сутки пациентка была выписана из стационара под наблюдение хирурги по месту жительства.Ключевые слова: инородное тело мягких тканей, спица Киршнера, оперативное лечение.

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Historical aspects of video endoscopic surgery of the lumbar spine

Hirurgiâ pozvonočnika ◽

10.14531/ss2021.1.70-77 ◽

2021 ◽

Vol 18 (1) ◽

pp. 70-77

Author(s):

M. N. Kravtsov

Keyword(s):

Lumbar Spine ◽

Literature Review ◽

Endoscopic Surgery ◽

English Literature ◽

Surgical Interventions ◽

Historical Aspects ◽

Endoscopic Techniques ◽

History Of

The literature review is devoted to the history of the development of endoscopic surgery of the lumbar spine: from open surgical interventions and puncture procedures – to percutaneous intracanal endoscopic operations, combining interventional and video endoscopic technologies and referred to in the English literature as “full-endoscopy”. The article also touches upon the historical aspects of fibroendoscopic and laparoscopic interventions on the lumbar spine. In conclusion, the principle of classification of endoscopic techniques is proposed.

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Incisive dental implant migration into the nasal septum

BMJ Case Reports ◽

10.1136/bcr-2018-228325 ◽

2019 ◽

Vol 12 (7) ◽

pp. e228325 ◽

Cited By ~ 1

Author(s):

Ana Sousa Menezes ◽

Nuno Daniel Ribeiro Martins da Costa ◽

Filipa Carvalho Moreira ◽

Daniela Ribeiro

Keyword(s):

Emergency Department ◽

Surgical Treatment ◽

Foreign Body ◽

Dental Implant ◽

Nasal Septum ◽

Clinical Case ◽

Cartilage Destruction ◽

Septal Cartilage ◽

Abscess Drainage ◽

Septal Abscess

We report the clinical case of a female patient who presented to our emergency department due to a septal abscess caused by the displacement of a dental implant into the nasal septum. The patient underwent surgical treatment for endoscopic foreign body excision and septal abscess drainage. Despite the presence of septal cartilage destruction, the L-shaped structure was preserved and no reconstruction was required. Postoperative healing was uneventful.

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Rhinolithiasis: A Rare Clinical Case

10.36811/ojor.2021.110013 ◽

2021 ◽

pp. 23-26

Author(s):

Sylvain Diembi ◽

Harol Boris Otouana ◽

Gerard Chidrel Gouoni ◽

A Tsieri Tsoba ◽

Brice Diabassana ◽

...

Keyword(s):

Foreign Body ◽

Ct Scan ◽

Nasal Cavity ◽

Nasal Obstruction ◽

Endoscopic Surgery ◽

Clinical Case ◽

Current Practice ◽

Rare Condition ◽

Therapeutic Management ◽

Positive Diagnosis

Rhinolithiasis is a rare condition in our current practice. We report the case of a 19 year old woman, presenting with a double symptom marked by rhinorrhea and chronic unilateral nasal obstruction evolving since the age of 7 years, without any known foreign body. Rhinoscopy and nasal endoscopy coupled with CT scan were decisive examinations for the positive diagnosis. The therapeutic management consisted in the extraction of the rhinolithiasis resulting in the vacuity of the nasal cavity. The evolution was favorable with simple postoperative courses. Keywords: Rhinolithiasis; Woman; Rhinoscopy; Endoscopic Surgery

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A CLINICAL CASE OF SURGICAL TREATMENT OF PEPTIC ULCER OF GASTROENTEROANASTOMOSIS

Nauka molodykh (Eruditio Juvenium) ◽

10.23888/hmj202191101-106 ◽

2021 ◽

Vol 9 (1) ◽

pp. 101-106

Author(s):

S.V. Leonchenko ◽

◽

V.N. Petyushkin ◽

A.P. Motin ◽

A.A. Dyomin ◽

...

Keyword(s):

Peptic Ulcer ◽

Surgical Treatment ◽

Clinical Case ◽

Abdominal Cavity ◽

Decisive Role ◽

Pain Syndrome ◽

Gastric Surgery ◽

Early Postoperative Period ◽

Actual Problem ◽

Long Time

In the article a clinical case of surgical treatment of peptic ulcer of gastroenteroanastomosis complicated with perforation and gastrointestinal bleeding, is described. The patient was observed with the diagnosis: cholelithiasis, chronic calculous cholecystitis, for which planned laparoscopic cholecystectomy with draining of the abdominal cavity was performed. According to the discharge record, the operation ran without peculiarities. Later the patient was rehospitalized with complaints of weakness, nausea, vomiting, pain in the upper parts of the abdomen; he was diagnosed with ulcer of gastroenteroanastomosis and continuing bleeding that were indications for the surgical intervention for life-saving indications. From the patient words, a part of the stomach was resected more than 20 years before for gastric ulcer. Until the latest time, the patient felt satisfactory, but within 6 months pain in the abdomen reappeared, however, on examination cholelithiasis was identified, and the pain syndrome was attributed to this pathology. Assumably, after the first operation performed in 1995, a complication developed in the early postoperative period in the form of obstruction of gastroenteroanastomosis (anastomositis?), and additional gastroenteroanastomosis was applied. Conclusion. Peptic ulcer of anastomosis is an actual problem of the gastric surgery which may not only appear long time after the operation, but may give the same complications as «essential» peptic ulcer, and really threaten the life of patients. It should be noted that in some cases the intraoperative picture, experience and sensations of a surgeon play a decisive role in the diagnosis of surgical pathology even if they differ from the data of additional methods of examination.

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Result of Surgical Treatment Congenital Kyphoscoliotic Deformity Lumbar Spine

Research Institute of Traumatology and Orthopedics ◽

10.52889/1684-9280-2020-2-52-34-38 ◽

2020 ◽

Vol 2 (52) ◽

pp. 34-38

Author(s):

Serik Serikov ◽

◽

Seidaly Abdaliуev ◽

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Clinical Case ◽

The Body ◽

Congenital Deformity ◽

Two Stage ◽

Full Correction

The progression of congenital deformity of the spine with lateral and posterolateral hemivertebrae requires early radical surgical treatment with full correction of the deformity and restoration of the anatomical and physiological curves of the spine. The level and length of fixation is selected individually; the duration of fixation depends on the time of fusion formation. A clinical case of a two-stage surgical treatment with dorsal access of a patient with progressive kyphoscoliotic deformity is presented. As a result of the operations, a complete correction of the deformation was achieved while maintaining the correct balance of the body.

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DeBakey type I acute aortic dissection with circular separation of the intima of the brachiocephalic trunk

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2021-180-4-78-81 ◽

2021 ◽

Vol 180 (4) ◽

pp. 78-81

Author(s):

S. Yu. Boldyrev ◽

V. N. Suslova ◽

V. A. Pekhterev ◽

K. O. Barbukhatti ◽

V. A. Porkhanov

Keyword(s):

Surgical Treatment ◽

Aortic Dissection ◽

Clinical Case ◽

Acute Aortic Dissection ◽

Complete Separation ◽

Type I ◽

Brachiocephalic Trunk ◽

Surgical Tactics ◽

Ischemic Attack ◽

Brachiocephalic Arteries

Surgical treatment of DeBakey type I acute aortic dissection is still accompanied by a relatively high mortality rate and complications. Organ malperfusion makes a serious contribution to the structure of mortality in the surgical treatment of patients with acute aortic dissection. At the same time, the spread of dissection to the brachiocephalic arteries is observed in 15–40 % of cases. Some of these patients suffer a transient ischemic attack or stroke in the preoperative period, which significantly aggravates the patient’s condition. We present a clinical case of successful surgical treatment of a patient with DeBakey type I acute aortic dissection, in whom intraoperatively a circular separation of intima from the mouth of the brachiocephalic trunk with its invagination into the lumen of the aortic arch was detected. The patient underwent supracoronary prosthetics of the ascending aorta with incomplete prosthetics of the entire arch and prosthetics of the brachiocephalic trunk. This clinical case demonstrates a variant of the natural course of DeBakey type I acute aortic dissection with a complete separation of intima, which requires active surgical tactics. Currently, due to the lack of sufficient clinical experience in the treatment of patients with such a diagnosis, the question of choosing the optimal surgical tactics remains open.

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A clinical case of surgical correction of post-traumatic aphakia

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2021-3-191-194 ◽

2021 ◽

pp. 191-194

Author(s):

K.S. Khusanbaev ◽

◽

A.F. Yusupov ◽

A.A. Abdushukurova ◽

T.F. Sultonmurodov ◽

...

Keyword(s):

Surgical Treatment ◽

Foreign Body ◽

Clinical Case ◽

Posterior Chamber ◽

Combined Method ◽

Clinical Observations ◽

Corneal Scar ◽

Post Traumatic ◽

The Stability ◽

Iol Fixation

Purpose. To present a clinical case of surgical treatment of post-traumatic aphakia by the method of corneoscleral IOL fixation using the combined method of Kanabrava and Kozhukhov. Material and methods. In March 2021, patient A., born in 1992, turned to the RSSPCEM. diagnosed with OS Condition after a penetrating injury to the eye. Corneal scar. Post-traumatic aphakia. Foreign body (non-metallic) driven into the retina. A decision was made on OS surgical treatment of aphakia by the method of transscleral IOL fixation as the most gentle method, taking into account the paracentral scar of the cornea. And do not remove the foreign body, but additionally restrict it with laser coagulates. Results. On the 14th day after the operation, visual acuity OS 0.7, IOP 18. The eye is calm, there is a scar on the cornea in the paraoptic zone, transparent in the rest of the zone, the anterior chamber is deep, the iris is subatrophic, the pupil is 3 mm, deformed, the IOL is in the posterior chamber, centered. The fundus of the eye: the optic disc is pale pink, the boundaries are clear, the reflex is blurred in the macular zone, the foreign body is limited by pigmented laser coagulates. The standard postoperative drop regimen is recommended. Conclusions. 1. Corneoscleral fixation of the IOL according to the combined method of Canabrava and Kojuhov in the aphakic eye in complicated cases allows to achieve good refractive results with the developed technique of execution. 2. Preliminary laser limitation of an encapsulated non-metallic foreign body gives confidence in the stability of the retina in the intra- and postoperative period. 3. Further clinical observations are required using the above-described surgical technique for correcting aphakia Key words: сorneoscleral fixation, aphakia, Canabrava, Kojuhov.

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