Discussions on hypospadius repair

2021 ◽  
Vol 3 (2) ◽  
pp. 39-42
Author(s):  
Chanjiv Singh Mehta ◽  
Gursehaj Singh Mehta ◽  
Satinderjit Singh Bajaj ◽  
Amit Kumar
Keyword(s):  
Surgical Techniques ◽  
Island Flap ◽  
Flap Technique ◽  
Tissue Handling ◽  
Teaching Aids ◽  
Ten Commandments ◽  
Single Technique ◽  
General Method

Surgery for Hypospadius is fraught with complications. The very fact that there are more than a hundred techniques described for this problem is evidence enough to confirm that no single technique is the perfect answer to our efforts. The presenting author is a student of Dr.H.S.Asopa and an advocate of the perpucial island flap technique, though not dogmatic in its propagation. He has also had the opportunity to train with Mr. Aviar Bracka and uses different techniques judiciously. This presentation is about the details no author stresses upon for Hypospadius and surgery. Pre and post operative pictures are not the only teaching aids. Ten Commandments for Hypospadius surgeons. These are in themselves self explanatory for the students of Hypospadius as well as the senior specialist. We have been achieving consistant results even though we have not struck to any one technique. We have been using the modified Asopa-I technique (for almost half the cases) and Bracka technique as the two main methods for surgery. This step by step on pitfalls in hypospadius surgery is not to highlight surgical techniques but to discuss about steps which have their own importance to produce acceptable results.In spite of so many methods to perform surgery for patients of hypospadius, some general principles on tissue handling, suture management, prevention of edema, general method of dissection, dressing techniques etc go a long way in giving consistant results whatever the method used for the repair.

scholarly journals Comparative radiographic and resonance frequency analyses of the peri-implant tissue after dental implants placement using flap and flapless techniques: An experimental study on domestic pigs

2013 ◽  
Vol 70 (6) ◽  
pp. 586-594 ◽  
Author(s):  
Zoran Vlahovic ◽  
Branko Mihailovic ◽  
Zoran Lazic ◽  
Mileta Golubovic
Keyword(s):  
Bone Resorption ◽  
Resonance Frequency ◽  
Dental Implants ◽  
Dental Implant ◽  
Surgical Techniques ◽  
Primary Stability ◽  
Implant Stability ◽  
Domestic Pigs ◽  
Flap Technique ◽  
Implant Placement

Background/Aim. Flapless implant surgery has become very important issue during recent years, mostly thanks to computerization of dentistry and software planning of dental implants placements. The aim of this study was to compare flap and flapless surgical techniques for implant placement through radiographic and radiofrequency analyses. Methods. The experiment was made in five domestic pigs. Nine weeks following domestic pigs teeth extraction, implants were placed, on the right side using surgical technique flap, and flapless on the left side. Digital dental Xrays were applied to determine primary dental implant stability quality (ISQ). At certain intervals, not later than three months, the experimental animals were sacrificed, and just before it, control X-rays were applied to measure dental implants stability. Results. Radiographic analysis showed that peri-implant bone resorption in the first 4 weeks following placement implants with flap and flapless surgical techniques was negligible. After the 3 months, mean value of peri-implant bone resorption of the implants placed using flap technique was 1.86 mm, and of those placed using flapless technique was 1.13 mm. In relation to the primary dental implant stability in the first and second week there was an expected decrease in ISQ values, but it was less expressed in the dental implants placed using the flapless technique. In the third week the ISQ values were increased in the dental implants placed by using both techniques, but the increase in flapless implant placement was higher (7.4 ISQ) than in flap implant placement (1.5 ISQ). The upward trend continued in a 4- week period, and after 3 months the dental implant stability values in the implants placed using flap technique were higher than the primary stability for 7.1 ISQ, and in the implants placed using flapless technique were higher comparing to the primary stability for 10.1 ISQ units. Conclusion. Based on the results of radiographic and resonance frequency analyses it can be concluded that the flapless technique in surgical implants placemat, leads to better results.

One-Stage repair of hypospadias using the modified prepucial island flap technique: Experience with 200 cases

2016 ◽  
Vol 6 (2) ◽  
pp. 121
Author(s):  
AdityaP Singh ◽  
ArvindK Shukla ◽  
Pramila Sharma ◽  
Ramji Prasad
Keyword(s):  
Island Flap ◽  
Flap Technique ◽  
One Stage

Modified Oblique Triangular Neurovascular Island Flap Technique to Prevent the Development of Hooked Nail Deformity

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Wichit Siritattamrong ◽  
Saichol Wongtrakul ◽  
Samran Pookang ◽  
Wuttipong Siriwittayakorn
Keyword(s):  
Island Flap ◽  
Flap Technique ◽  
Nail Deformity

scholarly journals Tunica vaginalis flap following ‘Tubularised Incised Plate’ urethroplasty to prevent urethrocutaneous fistulaa

2015 ◽  
Vol 48 (02) ◽  
pp. 187-191 ◽  
Author(s):  
Raashid Hamid ◽  
Aejaz A. Baba ◽  
Altaf Shera ◽  
Sarfaraz Ahmad
Keyword(s):  
Wound Infection ◽  
Operative Procedure ◽  
Tunica Vaginalis ◽  
Hospital Policy ◽  
Meatal Stenosis ◽  
Tissue Handling ◽  
Good Cosmetic ◽  
Time Of Presentation ◽  
Single Technique

ABSTRACT Introduction: Surgery for hypospadias has been continuously evolving, implying thereby that no single technique is perfect and suitable for all types of hypospadias. Snodgrass technique is presently the most common surgical procedure performed for hypospadias. Materials and Methods: We analysed the results of tunica vaginalis flap (TVF) as an additional cover to the tubularised incised plate (TIP) repair. Results: A total of 35 patients of hypospadias were repaired using TIP urethroplasty and TVF as a second layer. Mean age at the time of presentation was 6.63 ± 3.4 years. Post-operative complications namely wound infection, flap necrosis, scrotal haematoma, scrotal abscess, urethral fistula, meatal stenosis were recorded and analysed during follow-up period. Need for re-do surgery was considered as failure of the operative procedure. Out of 35 patients, 8 (22.85%) patients had proximal penile hypospadias and 27 (77.14%) patients had distal penile hypospadias. Mean post-operative follow-up was 24.53 months. During the follow-up complications noticed included wound infection (n = 2), urethrocutaneous fistula (n = 1) and meatal stenosis (n = 1). Wound infection was managed with appropriate antibiotics as per hospital policy/culture and sensitivity reports. Meatal stenosis responded to bougie dilatation/calibration during follow-up. Conclusion: To conclude, TVF as an additional cover is associated with an acceptable complication rate and good cosmetic results if performed with meticulous tissue handling.

Urethroplasty for Severe Urethral Strictures, Using the Preputial Island Flap Technique: Revisited

1993 ◽  
Vol 24 (1) ◽  
pp. 77-80 ◽  
Author(s):  
J.D.M. de Vries ◽  
J.J.M.C.H. de la Rosette ◽  
E.J.K.J.E.M. van Grunsven
Keyword(s):  
Island Flap ◽  
Flap Technique ◽  
Urethral Strictures

Ventral preputial onlay island flap and proximal flip-flap technique for the repair of epispadias: A case report

1993 ◽  
Vol 28 (7) ◽  
pp. 945-947
Author(s):  
Ronald S. Sutherland ◽  
Martin A. Koyle ◽  
Ronald R. Pfister
Keyword(s):  
Case Report ◽  
Island Flap ◽  
Flap Technique ◽  
Onlay Island Flap

ONE-STAGE REPAIR OF HYPOSPADIAS BY ISLAND FLAP TECHNIQUE

1961 ◽  
Vol 28 (6) ◽  
pp. 405-411 ◽  
Author(s):  
JOHN D. DESPREZ ◽  
LESTER PERSKY ◽  
CLIFFORD L. KIEHN
Keyword(s):  
Island Flap ◽  
Flap Technique ◽  
One Stage

Omega Flap Technique: Revisiting Conventional Wisdom

Hand ◽  
2021 ◽  
pp. 155894472199078
Author(s):  
G. Balakrishnan ◽  
S. Vijayaragavan ◽  
Somesh Balakrishnan
Keyword(s):  
Medical Care ◽  
Surgical Techniques ◽  
Flap Necrosis ◽  
Secondary Surgery ◽  
Form And Function ◽  
Flap Technique ◽  
Volar Aspect ◽  
Different Types ◽  
Good Technique ◽  
And Function

Various surgical techniques have been described for the release of syndactylized fingers. In our experience, the omega flap technique, which includes a dorsal truncated flap and an anchor incision on the volar side, stands out as a good technique to release syndactyly. Incidentally, in symbrachydactyly also, the fused digits can be released using this technique. Despite this, we could find no reference in the recent years. We would like to stress the ease and importance of this technique, hoping many practicing hand surgeons will benefit from this. Our purpose was to revisit this technique and expose it to the younger generation of hand surgeons. We have operated on 20 cases of syndactyly of different types—simple, compound, and complex—and 5 cases of symbrachydactyly. In all cases, the omega flap on the dorsum and anchor incision on the volar aspect of the finger forming 2 lateral palmar flaps were used. The release of syndactyly was satisfactory in all patients. There was no flap necrosis. None of these cases have required secondary surgery because the primary releases were adequate. Release of syndactyly had been a problem for centuries. Awareness of the disability was insufficient in earlier days; currently, they seek early medical care. The release should be complete. These children must be able to achieve the form and function of the hand, and additionally precision to work. We believe that the use of omega flap and anchor flap is a good procedure for syndactyly release.

scholarly journals A novel modification of Bardach’s two-flap palatoplasty for the repair of a difficult cleft palate

2021 ◽  
Vol 48 (1) ◽  
pp. 75-79
Author(s):  
Mohd Altaf Mir ◽  
Nishank Manohar ◽  
Debarati Chattopadhyay ◽  
Sameer S Mahakalkar
Keyword(s):  
Cleft Palate ◽  
Soft Palate ◽  
Surgical Techniques ◽  
Fistula Formation ◽  
Tension Free ◽  
Flap Technique ◽  
Oronasal Fistula ◽  
Free Closure ◽  
Microvascular Tissue Transfer ◽  
Difficult Cases

Bardach described a closure of the cleft utilizing the arch of the palate, which provides the length needed for closure and is most effective only in narrow clefts. Herein, we describe a case where we utilized Bardach’s two-flap technique with a vital and easy modification, done to allow closure of a wide cleft palate and to prevent oronasal fistula formation at the junction of the hard and soft palate, which are otherwise difficult to manage with conventional flaps. The closed palate showed healthy healing, palatal lengthening, and no oronasal regurgitation. We advise using this modification to achieve the goals of palatal repair in difficult cases where tension-free closure would otherwise be achieved with more complex flap surgical techniques, such as free microvascular tissue transfer.

Meta Analysis Study of Complications Following Repair of Mid Penile Hypospadius using Different Surgical Techniques

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Aly Hassan ◽  
Assist. Prof. Dr. Nada Abdel Sattar Mahmoud ◽  
Amira Hussein Sabry ◽  
Dina Samir Shalaby Nashed
Keyword(s):  
Observational Studies ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Wound Dehiscence ◽  
International Committee ◽  
Island Flap ◽  
Congenital Defects ◽  
Penile Curvature ◽  
Meatal Stenosis ◽  
Onlay Island Flap

Abstract Background Hypospadias is one of the most common congenital defects affecting the external male genitalia. The incidence is 1 in 250 male newborns, although its incidence seems to be increasing. Hypospadias is defined as an insufficient development of the urethral fold and the ventral foreskin, with or without penile curvature. The urethral opening is located more proximally anywhere between the tip of the penis and the perineum. Aim of the Work The aim of this study is to determine the best surgical technique with the least complications for repair of mid-penile hypospadias. Materials and Methods This systematic review and meta-analysis was performed in accordance to the recommendations of the Meta-analysis of Observational Studies in Epidemiology (MOOSE) statement. MOOSE is a reporting checklist for Authors, Editors, and Reviewers of Meta-analysis of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists. Results Fistula is less common after Preputial island flap technique. Fistula is more common with Modified koyanagi technique. Meatal stenosis is less common after Mathieu and Preputial island flap techniques. Meatal stenosis is more common after TIP technique. Wound Dehiscence is not common after lateral based flap and modified koyanagi and Onlay island flap techniques. Neourethral Stricture is not common after lateral based flap and Mathieu and Onlay island flap techniques. Conclusion The Mathieu and Preputial island flap techniques for mid-penile hypospadias reconstruction are associated with a significantly lower risk for postoperative urethral stricture and may be the preferred method for hypospadias. However, the clinical implications of the results can be discussed because the risk of stricture in all procedures was low. The implications for research are obvious because there had been no studies that provided firm guidelines on the best method for the operative intervention for hypospadias. Further trials are still needed to confirm our findings.

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