Sphinx Modified Position For Scaphocephalic And Complex Craniofacial Patients. Technical Note

Abstract Background The development of less invasive surgical techniques means that surgical remodelling techniques can be performed at younger ages in more complex situations and at lower cost. Methods Descriptive study Results We describe the technique of positioning and reviews our experience with the partially-modified sphinx position (MSP) in a serie of 234 patients, 96 of these endoscopic procedures (EP). Patient position on the operating table with regard to the treatment area, as well as the position of the treatment area in regard to the floor plane, is paramount for their anaesthetic and surgical management. Conclusions We consider that MSP is safe, facilitates access to the operative field, shortens surgery time, reduces bleeding and offers maximum airway and cranio cervical safety in patients undergoing surgery to correct cranial vault pathologies.

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IMPACT OF LAPAROSCOPIC COLORECTAL SURGERY ON BODY IMAGE

British Journal of Surgery ◽

10.1093/bjs/znab160.023 ◽

2021 ◽

Vol 108 (Supplement_3) ◽

Author(s):

A Fernández Candela ◽

L Sánchez-Guillén ◽

L García Catalá ◽

C Curtis Martínez ◽

M Bosch Ramírez ◽

...

Keyword(s):

Body Image ◽

Colorectal Surgery ◽

Laparoscopic Colorectal Surgery ◽

Wound Complication ◽

Descriptive Study ◽

Surgical Quality ◽

Body Image Scale ◽

Study Results ◽

The Impact ◽

Observational Descriptive Study

Abstract INTRODUCTION The aim of this study is to evaluate the impact of laparoscopic colorectal surgery (LCS) on body image using the validated Body Image Scale (BIS) as a parameter of surgical quality. MATERIAL AND METHODS We conducted an observational descriptive study. Patients who underwent scheduled LCS between June 2015 and December 2019 by a General Hospital Coloproctology Unit were included. RESULTS The sample included 180 patients, 115 men (63.9%) and 65 women (36.1%) with a median age of 67 years. Right hemicolectomies (31.7%) and sigmoidectomies (28.3%) were the main procedures performed. In most patients, a suprapubic (69.4%) or transverse (19.4%) incision was made. 21.9% suffered some type of postoperative complication (13.9% wound complication, 10.6% incisional hernia). The general result of the BIS questionnaire was satisfactory, with a median of 0 in the responses (no alteration of body image). We found that 46.2% of the women had some alteration in body image, compared to 28.7% of the men (p = 0.018) and low and ultra-low anterior resection were the surgeries that obtained worst scores, with 13,5% and 12,5% respectively of patients with a BIS score above 5 (p = 0.044). Patients with a stoma also obtained worst punctuation (25% above 5 vs 6,1%, p = 0.001). No statistically significant differences were found regarding type of incision, presence of complications and anxiety or depression. CONCLUSION Study results show, in general, good post-surgical body image after LCS. However, patients with stoma and women were more dissatisfied. Interestingly, there is no worse body image due to type of incision, so we recommend the least iatrogenic one.

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Skin-, nipple-, and areola-sparing mastectomy

Breast Cancer Online ◽

10.1017/s1470903108007682 ◽

2008 ◽

Vol 11 (12) ◽

Author(s):

E. M. Umoh ◽

N. Arora ◽

R. M. Simmons

Keyword(s):

Breast Cancer ◽

Breast Carcinoma ◽

Clinical Outcome ◽

Surgical Management ◽

Surgical Techniques ◽

Oncologic Outcomes ◽

Cancer Management ◽

Breast Cancer Management ◽

Feasible Option

AbstractSurgical management of breast carcinoma has evolved to include more breast conserving techniques such as skin-, nipple-, and areola-sparing mastectomies, as improved cosmesis becomes an increasing concern. However, the oncologic risk of these procedures must be strongly considered before such techniques can be widely adopted. Here we review available literature on these techniques and their associated clinical outcome. From our own experience, as well as from that reported, we conclude that nipple-, skin-, and areola-sparing mastectomies in carefully selected patients can have safe oncologic outcomes comparable to more traditional surgical techniques and therefore may be a feasible option for breast cancer management.

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Blister like aneurysm: a review about its surgical management / Aneurismas blister-like: uma revisão sobre seu manejo cirúrgico

Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo ◽

10.26432/1809-3019.2019.64.2.131 ◽

2019 ◽

Vol 64 (2) ◽

pp. 131

Author(s):

Rodrigo Salmeron de Toledo Aguiar ◽

Guilherme Brasileiro de Aguiar ◽

Rafael Gomes dos Santos ◽

André Freitas Nunes ◽

Renan Maximilian Lovato ◽

...

Keyword(s):

Surgical Management ◽

Intracranial Aneurysms ◽

Surgical Techniques ◽

Vascular Lesion ◽

High Morbidity ◽

Good Efficiency ◽

Treatment Techniques ◽

Pubmed Database ◽

Surgical Methods ◽

Ruptured Intracranial Aneurysms

ABSTRACT Introduction: Blister aneurysms are of uncertain pathogenesis and are a vascular lesion located in the brain. Overall, they represent 0.3% - 1.0% of all intracranial aneurysms and 0.9% - 6.5% of ruptured intracranial aneurysms. They are associated with high morbidity and mortality. Even with the first description being from 1969, there is still debate in the literature about which type of treatment is the best: surgical or endovascular. In this review, we focus on the surgical management. Method: The authors performed a review of available surgical techniques used for blood blister-like aneurysms treatment. Pubmed database was used as search source introducing blister-like aneurysm and blister aneurysms as keywords. The most relevant articles and those that focused on surgical treatment techniques were selected. Discussion: The most used surgical methods are clipping, trapping, wrapping and bypass. As main features of each technique, we can highlight clipping with good efficiency, when there is good neck exposure; trapping being employed in ruptured aneurysm; wrapping for avulsion and bypass that promotes vascularization to the distal territory of the aneurysm. Conclusion: The endovascular method has shown to be promising and efficient. However, different surgical techniques are still being employed based on their efficiency when facing certain surgical scenarios.Keywords: Neurosurgery, Subarachnoid hemorrhage, Intracranial aneurysm, Endovascular proceduresRESUMOIntrodução: Aneurismas cerebrais blister-like são lesões vasculares de patogenia incerta. De modo geral, representam 0.3%-1.0% de todos aneurismas intracranianos e 0.9% - 6.5% dos aneurismas intracranianos que rompem. Estão associados a alta morbimortalidade. Mesmo com a primeira descrição sendo de 1969, ainda há debate na literatura sobre qual tipo de tratamento é o melhor: cirúrgico ou endovascular. Nessa revisão, focamos no tratamento cirúrgico. Métodos: Os autores realizaram uma revisão das técnicas cirúrgicas utilizadas para tratamento de aneurismas blister-like. A plataforma Pubmed foi utilizada para a pesquisa das palavras chaves “blister-like aneurysm” e “blister aneurysm”. Os artigos de maior relevância e aqueles que enfatizam as técnicas cirúrgicas foram selecionados. Discussão: Os métodos cirúrgicos empregados são clipagem, trapping, wrapping e bypass. Quanto às características de cada método, podemos salientar a eficácia da clipagem, quanto melhor for a exposição do aneurisma; o uso do trapping em situações de rompimento do aneurisma; wrapping para casos em que houve avulsão do aneurisma e by-pass que promove a vascularização distal ao aneurisma. Conclusão: O método endovascular tem se mostrado promissor e efetivo. No entanto, as diferentes técnicas cirúrgicas ainda são empregadas e defendidas devido a sua eficiência frente certos cenários cirúrgicos.Descritores: Neurocirurgia, Hemorragia subaracnóidea, Aneurisma intracraniano, Procedimentos endovasculares

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BMI Specific Complications Following Implant-Based Breast Reconstruction after Mastectomy

Journal of Clinical Medicine ◽

10.3390/jcm10235665 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5665

Author(s):

Helena Sophie Leitner ◽

Reinhard Pauzenberger ◽

Ines Ana Ederer ◽

Christine Radtke ◽

Stefan Hacker

Keyword(s):

Postoperative Complications ◽

Breast Reconstruction ◽

Positive Impact ◽

Surgical Techniques ◽

Study Cohort ◽

Complication Rates ◽

Impaired Wound Healing ◽

Reconstruction Methods ◽

Study Results ◽

The Impact

Background: Breast reconstruction has a positive impact on body image and quality of life for women after experiencing the physically and psychologically demanding process of mastectomy. Previous studies have presented body mass index (BMI) as a predictor for postoperative complications after breast reconstruction, however, study results vary. This retrospective study aimed to investigate the impact of patients’ BMI on postoperative complications following implant-based breast reconstruction. Methods: All implant-based breast reconstructions performed at the Department of Plastic, Reconstructive and Aesthetic Surgery at the Medical University of Vienna from January 2001 to March 2018 were evaluated. A total of 196 reconstructed breasts among 134 patients met eligibility criteria. Demographic data, surgical techniques, as well as major and minor complications within a one-year follow-up period were analyzed. Results: Patients’ BMI did not show a significant impact on complication rates. The overall incidence of postoperative complications was 30.5% (40/131) of which 17.6% required reoperation. Impaired wound healing (18.3%), seroma (6.1%), hematoma (4.6%), capsular contraction (4.6%) and infection (3.8%) were the most common complications. Conclusion: In our study cohort, BMI was not associated with a significantly higher risk of complications. However, postoperative complications significantly increased with a longer operative time and resulted in an extended length of hospital stay.

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Surgical Techniques for Dealing with Intraluminal Thrombus of Great Vessels in Advanced Differentiated Thyroid Carcinoma

World Journal of Endocrine Surgery ◽

10.5005/jp-journals-10002-1224 ◽

2017 ◽

Vol 9 (3) ◽

pp. 115-117

Author(s):

Pooja Ramakant ◽

Mallika Dhanda ◽

Akshay Anand ◽

Devenraj Vijayant ◽

Abhinav A Sonkar ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Surgical Management ◽

Tumor Thrombus ◽

Vena Cava ◽

Surgical Techniques ◽

Differentiated Thyroid Carcinoma ◽

Fogarty Catheter ◽

Intraluminal Thrombus ◽

Great Vessels ◽

Venous Tumor Thrombus

ABSTRACT Aim We aim to define and refine the surgical technique for dealing with intraluminal thrombus of great vessels in advanced differentiated thyroid carcinoma (DTC) to reduce the morbidity. Background Venous tumor thrombus from DTC is a rare occurrence with sequelae that cause increased morbidity and early mortality. Management of such patients poses a challenge to surgeons. Materials and methods We define the surgical planning and road map for surgical management of advanced DTC with tumor thrombus involving the internal jugular vein (IJV) and superior vena cava (SVC) by sacrificing one IJV and retrieving the thrombus from the SVC by Fogarty catheter. This technique has minimal morbidity with good outcome. Conclusion By appropriate planning and meticulous surgical techniques, we can aggressively manage patients of advanced DTC with venous tumor thrombus and reduce the morbidity. Clinical significance By surgical techniques leading to complete surgical resections and saving native vital structures, we can aim for successful aggressive surgical management of advanced DTC with venous tumor thrombus. How to cite this article Dhanda M, Anand A, Vijayant D, Sonkar AA, Singh KR, Ramakant P, Mishra A. Surgical Techniques for Dealing with Intraluminal Thrombus of Great Vessels in Advanced Differentiated Thyroid Carcinoma. World J Endoc Surg 2017;9(3):115-117.

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Advantages of CO2 laser use in surgical management of otosclerosis

Vojnosanitetski pregled ◽

10.2298/vsp0303273m ◽

2003 ◽

Vol 60 (3) ◽

pp. 273-278 ◽

Cited By ~ 8

Author(s):

Svjetlana Matkovic ◽

Boris Kitanoski ◽

Zivorad Malicevic

Keyword(s):

Hearing Loss ◽

Surgical Management ◽

Co2 Laser ◽

Functional Results ◽

Bony Labyrinth ◽

Study Results ◽

Classical Technique ◽

Prospective Comparative Study ◽

The Difference ◽

Determination Of Parameters

Background. Otosclerosis is a progressive osteo-destructive disorder of the bony labyrinth in which the fixation of the stapes causes the hearing loss. The aim of this study was the postoperative determination of parameters of the effect of surgical intervention on hearing and the incidence of complications and, on the basis of the differences in the examined parameters of the study, the estimation of the eficacy of the two mentioned surgical thechniques in the treatment of otosclerosis. Methods. In our research 40 patients with conductive hearing loss caused by otosclerosis underwent surgery with CO2 laser. Functional results were compared postoperatively with the results of 40 patients operated by the classical technique without the use of CO2 laser. The research was accomplished as a prospective comparative study. Results. The air-bone interval (gap) as the difference between the rim of air and bone conductivity for separate frequencies did not significantly differ between the control and the experimental group. Both methods were effective in closing the air-bone gap with the rates of closure to within 10 dB in 82.6% and 75.3% for the laser and drill, respectively. The incidence of tinnitus was significantly lower in patients who underwent surgery with CO2 laser. The frequency of intraoperative and postoperative complications was significantly lower in the laser group. Differences were statistically significant for all parameters (p<0.05). Conclusion. On the basis of the degree of postoperative hearing improvement, tinnitus and the incidence of complications it can be concluded that the use of CO2 laser during inverse stapedoplasty represents an effective and safe method, justifying the promotion of its use in the surgical management of otosclerosis.

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The Impact of Coal and Biomass Co-Firing on the Economy of Power Plant Carbon Capture

Advances in Sciences and Engineering ◽

10.32732/ase.2020.12.2.67 ◽

2020 ◽

Vol 12 (2) ◽

pp. 67-77

Author(s):

Quan Zhuang ◽

Philip Geddis ◽

Bruce Clements

Keyword(s):

Economic Evaluation ◽

Power Plant ◽

Incremental Cost ◽

Co2 Capture ◽

Electricity Generation ◽

Carbon Capture ◽

Lower Cost ◽

Study Results ◽

And Performance ◽

The Impact

A detailed economic evaluation was carried out to determine the impact of biomass and coal co-firing on power plant carbon capture by methods of plants equipment designing factors and performance, and the sum up of the associated breakdowns of CAPEX and OPEX. Based on the assumptions of the CO2 neutrality of biomass and likely governmental incentives to reduce CO2 emissions, the study results show that biomass and coal co-firing would result in both lower cost of carbon avoided (carbon capture) and lower incremental cost of electricity generation when MEA solvent carbon capture is applied. Two scenarios for co-firing with carbon capture, 30% biomass blending and 90% or 60% CO2 capture from stack, indicate different preference depending on lower or higher incentives.

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Retrosigmoid transmeatal and suprajugular approach for cerebellopontine angle meningioma: operative video

Neurosurgical FOCUS ◽

10.3171/2017.10.focusvid.17290 ◽

2017 ◽

Vol 43 (videosuppl2) ◽

pp. V3 ◽

Cited By ~ 3

Author(s):

Ken Matsushima ◽

Michihiro Kohno

Keyword(s):

Vagus Nerve ◽

Temporal Bone ◽

Surgical Management ◽

Cerebellopontine Angle ◽

Jugular Foramen ◽

Bone Drilling ◽

Operative Field ◽

Nerve Monitoring ◽

Brainstem Surgery ◽

Neurovascular Structures

Surgical management of cerebellopontine angle meningiomas is challenging due to the intricate neurovascular structures within the limited operative field and the compression of eloquent structures including the brainstem. Surgery on tumors extending into the temporal bone is especially difficult and demands complicated approaches. However, modifications to the retrosigmoid approach utilizing intradural temporal bone drilling enable access to such tumoral extensions without any additional invasive approaches. This video demonstrates the case of a cerebellopontine angle meningioma extending into the internal acoustic meatus and jugular foramen that was surgically treated through the retrosigmoid transmeatal and suprajugular approaches under continuous vagus nerve monitoring.The video can be found here: https://youtu.be/aUD1vr6TbOc.

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Macular Hole in Myopic Eyes: A Narrative Review of the Current Surgical Techniques

Journal of Ophthalmology ◽

10.1155/2019/3230695 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Chiara De Giacinto ◽

Marco R. Pastore ◽

Gabriella Cirigliano ◽

Daniele Tognetto

Keyword(s):

Macular Hole ◽

Surgical Management ◽

Surgical Intervention ◽

Current Knowledge ◽

Surgical Techniques ◽

Retinal Disease ◽

Narrative Review ◽

Vitreomacular Interface ◽

Tractional Forces

Macular hole (MH) in myopic eyes is a disease arising from complex tractional forces exerted by vitreomacular interface, epiretinal tissue, and progressive scleral ectasia of the posterior ocular globe wall. This retinal disease requires vitreoretinal treatment for its repair, and the surgical intervention remains a challenge also for experienced surgeons. The aim of this review is to describe the current knowledge regarding the pathogenesis of MH in myopic eyes and to detail novel surgical techniques and technological advancements in its surgical management.

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