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

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 Orbital Wall Reconstruction with Titanium Mesh: Retrospective Study of 24 Patients

2011 ◽  
Vol 4 (3) ◽  
pp. 151-156 ◽  
Author(s):  
Mario Francisco Gabrielli ◽  
Marcelo Silva Monnazzi ◽  
Luis Augusto Passeri ◽  
Waldner Ricardo Carvalho ◽  
Marisa Gabrielli ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Correction ◽  
Infraorbital Nerve ◽  
Efficacy And Safety ◽  
Titanium Mesh ◽  
Orbital Reconstruction ◽  
Vehicle Accidents ◽  
Orbital Floor Fractures ◽  
Orbital Wall

The aim of this study was to evaluate the efficacy and safety of traumatic orbital defect reconstruction with titanium mesh. A retrospective study was made. Evaluations were made after a minimum postoperative follow-up of 12 months, looking for the main complications. Twenty-four patients were included in this evaluation; 19 were male (79.1%) and 5 (20.8%) were female. The main injury etiology was vehicle accidents (50%) followed by other causes. Fourteen patients (58.3%) presented orbital floor fractures, and 10 had more than one wall fractured (41.6%). Permanent infraorbital nerve hypoesthesia was observed in two patients (8.3%), enophthalmos occurred in five patients (20.8%), and exophthalmos was found in two patients (8.3%). Four patients (16.6%) still presented evidence of residual prolapsed intraorbital content, and one of those needed further surgical correction; sinusitis occurred in one patient (4.1%). Titanium mesh is a reliable option for orbital reconstruction, despite some complications found in this sample.

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.

The first experience of using tissue-engineered constructs for surgical correction of anterior vaginal wall prolapse

2021 ◽  
Vol 20 (1) ◽  
pp. 89-97
Author(s):  
A.I. Ishchenko ◽  
◽  
Yu.N. Tarasenko ◽  
A.A. Ishchenko ◽  
L.S. Aleksandrov ◽  
...  
Keyword(s):  
Valsalva Maneuver ◽  
Vaginal Wall ◽  
Anterior Vaginal Wall ◽  
Early Postoperative Period ◽  
Cellular Component ◽  
Dermal Fibroblasts ◽  
Surgical Correction ◽  
Stage Ii ◽  
Perineal Pain ◽  
Anterior Vaginal Wall Prolapse

Objective. To study the effectiveness and safety of new surgical method for correcting the anterior vaginal wall prolapse using tissue-engineered constructs. Patients and methods. After preliminary experimental work on the creation and evaluation of the biocompatibility of tissueengineered constructs based on non-biodegradable (polypropylene and titanium endoprostheses) mesh implants with an autologous cellular component (rat and human dermal fibroblasts), 4 patients aged 44, 54, 70 and 75 years were examined. Inclusion criteria: anterior vaginal wall prolapse (stage II – III); consent to the installation of tissue-engineered construct. A fourstage surgical program providing for the correction of stage II-III anterior vaginal wall prolapse using tissue-engineered constructs of individual size was used. Results. In the early postoperative period, one patient was diagnosed with a small hematoma of the anterior vaginal wall. During the first month after surgery, one patient complained of gradual perineal pain, another patient – of frequent urination. Subsequently, these symptoms stopped. After 3, 6, 9, 12, 15 months after surgery, during the pelvic examination at rest, the Valsalva maneuver and transperineal ultrasound, no displacement of organs was detected, ultrasound clearly visualized a tissueengineered construct without displacement and deformation. Conclusion. We have developed an original method for correcting the prolapse of the anterior vaginal wall using tissueengineered constructs based on polypropylene and titanium with an autologous cellular component, which helps to optimize the results of surgical treatment, reduce the frequency of disease recurrence and the risk of developing mesh-related complications. Key words: pelvic organ prolapse, tissue-engineered constructs, surgical correction

Laparoscopic bilateral subperitoneal correction of apical prolapse with titanium mesh implants

2021 ◽  
Vol 20 (3) ◽  
pp. 19-27
Author(s):  
A.I. Ishchenko ◽  
◽  
A.A. Ishchenko ◽  
A.A. Kazantsev ◽  
L.S. Aleksandrov ◽  
...  
Keyword(s):  
Vaginal Wall ◽  
Surgical Correction ◽  
Questionnaire Data ◽  
Intraoperative Blood Loss ◽  
Apical Prolapse ◽  
Titanium Mesh ◽  
Early Postoperative Complications ◽  
Pelvic Organs ◽  
Duration Of Surgery

Objective. To study the efficacy and to assess the safety of the use of titanium ribbon-like implants for surgical correction of various forms of apical prolapse. Patients and methods. 23 patients with apical prolapse (stage III–IV) aged 29 to 74 years were examined. Surgical correction of various forms of apical prolapse was performed using titanium ribbon-like mesh implants, which are more inert to the surrounding tissues than polypropylene scaffold systems. Dynamic outpatient observation of the patients was carried out after 3, 6, 12, 15 months after surgery. Results. The duration of surgery varied from 55 to 80 minutes, on average 74 ± 11.5 minutes. Intraoperative blood loss ranged from 50 to 150 mL (100 ± 35.7 mL). Of the early postoperative complications, only hematomas in the projection of the posterior vaginal wall of small sizes (up to 10 ml) – 2 (8.7%) were noted. Comparison of the questionnaire data from patients in the preand postoperative period showed an improvement in the quality of life of patients, an increase in their social and sexual activity. There was no significant displacement of the pelvic organs, and there were no mesh-associated complications. Conclusion. Laparoscopic bilateral subperitoneal hystero-, cervico-, colposuspension to the aponeurosis using titanium mesh ribbon-like implants improves the efficiency of surgical treatment of various forms and severity of apical prolapse. Key words: apical prolapse, hysterosuspension, titanium mesh implants

506: A Risk-Adjusted Follow-up for Patients with Stage I and II Renal Cell Carcinoma

2007 ◽  
Vol 177 (4S) ◽  
pp. 169-169
Author(s):  
Quoc-Dien Trinh ◽  
Pierre I. Karakiewicz ◽  
Thierry Lebeau ◽  
Dan Lewinshtein ◽  
Elie Antebi ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Stage I

scholarly journals Single tooth restoration in the maxillary esthetic zone using a one-piece ceramic implant with 1 year of follow-up: case series

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Miren Vilor-Fernández ◽  
Ana-María García-De-La-Fuente ◽  
Xabier Marichalar-Mendia ◽  
Ruth Estefanía-Fresco ◽  
Luis-Antonio Aguirre-Zorzano
Keyword(s):  
Case Series ◽  
Biological Properties ◽  
Titanium Implants ◽  
Plaque Index ◽  
Marginal Bone Loss ◽  
Bleeding On Probing ◽  
Probing Depth ◽  
Zirconia Implants ◽  
Ceramic Implant

Abstract Background Oral implants have helped clinicians to improve the quality of life for many patients. The material of choice for dental implants currently remains titanium type IV, whose mechanical and biological properties have been proven throughout the history of implantology. Yet, this material is not exempt from complications. For these reasons, ceramic alternatives to titanium have emerged. Thus, the purpose of this study is to evaluate peri-implant hard and soft tissue stability with the use of a one-piece ceramic implant (Straumann® PURE Ceramic Implant) during 1 year of follow-up. Study design One-piece all-ceramic zirconia (ZrO2) implants were placed to replace single missing teeth in the esthetic zone. Six to 8 weeks after the procedure, the definitive prosthesis was fabricated. At the time of prosthesis, placement (T0) photographs and periapical radiographs were taken, and the following clinical parameters were recorded: probing depth (PD), plaque index (PI), bleeding on probing (BOP), suppuration on probing (SOP), distance from gingival margin to incisal edge (GM-IE), and Jemt papilla index (JPI). Follow-up appointments were scheduled at 4 (T4), 8 (T8), and 12 (T12) months, when the same parameters were recorded. In addition, plaque control was reinforced and prophylaxis was carried out. In this last appointment, a final periapical radiograph was taken to assess marginal bone loss. Results A total of 32 zirconia implants were placed in 28 patients (16 women and 12 men, aged between 34 and 67 years). The survival and success rate were 96.9%. The increase in probing depth from baseline to 12 months was 0.78 mm. Assessments of plaque index and bleeding on probing showed a slight increase throughout the study. Conclusions The results obtained with the Straumann® PURE Ceramic implants show them to exhibit very good clinical behavior. The survival rate of the implants of our pilot study was 96.9%. For these reasons, we can say that zirconia implants could be an alternative to titanium implants in the esthetic zone.

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