scholarly journals Potentialities of Minimally Invasive Osteosynthesis in Treatment of Malleolus Fractures

2015 ◽  
pp. 54-59
Author(s):  
E. I. Solod ◽  
A. F. Lazarev ◽  
E. G. Ermolaev
Keyword(s):  
Minimally Invasive ◽  
Main Group ◽  
Invasive Technique ◽  
Medial Malleolus ◽  
Joint Function ◽  
Minimally Invasive Osteosynthesis ◽  
Duration Of Hospitalization ◽  
Fracture Nonunion ◽  
Comparative Group ◽  
Medial Malleolus Fracture

Treatment results for 71 patients with malleolus fractures are presented. In 32 patients (comparative group) surgery was performed by AO/ASIF technique after edema resolution. Thirty nine patients from the main group were operated on by our minimally invasive technique using V-shaped pins and threaded pins on the next day after admission independently on the presence of edema in the ankle joint region. All patients were operated on at terms from 1 to 3 weeks after injury. Duration of hospitalization averaged 16 and 10 days, restoration of joint function made up 6 and 2 weeks for the patients from the comparative and main group, respectively. Complications were observed only in patients from the comparative group, i.e. marginal skin necrosis in 8 (25%), inflammatory complications in 5 (15.6%), metal fixator migration in 1 (3.1%) and fracture nonunion in 4 (12.5%) patients. Outcomes were assessed by AOFAS Ankle- Hindfoot Scale. Mean point made up 90.3 in the main group and 88.6 in the comparative jnt. In the experimental part of the study the strength (tensile and shear) of 3 types of osteosynthesis for medial malleolus fracture were compared: with either 2 cannulated screws, V-shaped pin or 2 biodegradable screws of glycolized lactic acid was compared. Although the osteosynthesis of medial malleolus with V-shaped pin was the least strong it met the requirements of internal osteosynthesis.

scholarly journals Potentialities of Minimally Invasive Osteosynthesis in Treatment of Malleolus Fractures

2015 ◽  
Vol 22 (3) ◽  
pp. 54-59
Author(s):  
E. I Solod ◽  
A. F Lazarev ◽  
E. G Ermolaev
Keyword(s):  
Minimally Invasive ◽  
Main Group ◽  
Invasive Technique ◽  
Medial Malleolus ◽  
Joint Function ◽  
Minimally Invasive Osteosynthesis ◽  
Duration Of Hospitalization ◽  
Fracture Nonunion ◽  
Comparative Group ◽  
Medial Malleolus Fracture

Treatment results for 71 patients with malleolus fractures are presented. In 32 patients (comparative group) surgery was performed by AO/ASIF technique after edema resolution. Thirty nine patients from the main group were operated on by our minimally invasive technique using V-shaped pins and threaded pins on the next day after admission independently on the presence of edema in the ankle joint region. All patients were operated on at terms from 1 to 3 weeks after injury. Duration of hospitalization averaged 16 and 10 days, restoration of joint function made up 6 and 2 weeks for the patients from the comparative and main group, respectively. Complications were observed only in patients from the comparative group, i.e. marginal skin necrosis in 8 (25%), inflammatory complications in 5 (15.6%), metal fixator migration in 1 (3.1%) and fracture nonunion in 4 (12.5%) patients. Outcomes were assessed by AOFAS Ankle- Hindfoot Scale. Mean point made up 90.3 in the main group and 88.6 in the comparative jnt. In the experimental part of the study the strength (tensile and shear) of 3 types of osteosynthesis for medial malleolus fracture were compared: with either 2 cannulated screws, V-shaped pin or 2 biodegradable screws of glycolized lactic acid was compared. Although the osteosynthesis of medial malleolus with V-shaped pin was the least strong it met the requirements of internal osteosynthesis.

scholarly journals MINIMALLY INVASIVE AND TRADITIONAL OPERATIVE TECHNIQUES IN SURGICAL TREATMENT OF ACUTE COMPLICATED PANCREATITIS

2019 ◽  
Vol 72 (9) ◽  
pp. 1736-1739
Author(s):  
Victor P. Andriuschenko ◽  
Dmytro V. Andriuschenko ◽  
Oleg T. Girniak
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Main Group ◽  
Subsequent Stage ◽  
Operative Techniques ◽  
Closed Drainage ◽  
Combined Use ◽  
Comparative Group ◽  
Invasive Techniques ◽  
Combined Interventions

Introduction: The issue of surgical treatment of acute pancreatitis, in particular the choice of operative technique, is becoming increasingly relevant. The aim: To work out surgical approach in patients with acute complicated pancreatitis (ACP) using minimally invasive and traditional operative techniques. Materials and methods: 170 patients underwent surgery for ACP. The main group (109 subjects) had minimally invasive techniques (MIT) dominated, the comparative group (61 subjects) – traditional operations. Results: MIT performed “as final” in 62 (69%), “stage”– in 16 (18%) and “stabilizing patient condition” – in 12 (13%) of observations. The number of combined interventions predominated in the main group – 26% and 12% (χ2=4.002; р=0.04), traditional in comparative groups – 67% and 17% cases (χ2=40.291; р<0.0001). Primary laparotomy operations were used in 41 (67%) patients from comparative and 19 (17%) patients from the main group (χ2=40.291; р<0.0001). The extent of traditional operations in the main group consisted predominantly of necrosequestrectomy with Beger closed drainage – in 26 (55%) and 15 (31%) observations, respectively (χ2=5.018; р=0.02). Necrosequestrectomy with subsequent stage lavage performed in common purulent-necrotic lesions were comparable in both groups – in 11 (23%) and 13 (26%) observations (χ2=0.0013; р>0.05). Conclusions: The worked out surgical treatment approach in ACP with individual and combined use of MIT and traditional operations resulted in decreased rates of postoperative complications from 13.1% to 8.3% and mortality from 14.8% to 9.2%.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

scholarly journals Endovascular Bariatric Surgery as Novel Minimally Invasive Technique for Weight Management in the Morbidly Obese: Review of the Literature

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2541
Author(s):  
Giuseppe Massimo Sangiorgi ◽  
Alberto Cereda ◽  
Nicola Porchetta ◽  
Daniela Benedetto ◽  
Andrea Matteucci ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Minimally Invasive ◽  
Weight Management ◽  
World Health ◽  
Invasive Technique ◽  
Morbidly Obese ◽  
World Population ◽  
Obese Patients ◽  
The World ◽  
Open Bariatric Surgery

Nowadays, obesity represents one of the most unresolved global pandemics, posing a critical health issue in developed countries. According to the World Health Organization, its prevalence has tripled since 1975, reaching a prevalence of 13% of the world population in 2016. Indeed, as obesity increases worldwide, novel strategies to fight this condition are of the utmost importance to reduce obese-related morbidity and overall mortality related to its complications. Early experimental and initial clinical data have suggested that endovascular bariatric surgery (EBS) may be a promising technique to reduce weight and hormonal imbalance in the obese population. Compared to open bariatric surgery and minimally invasive surgery (MIS), EBS is much less invasive, well tolerated, with a shorter recovery time, and is probably cost-saving. However, there are still several technical aspects to investigate before EBS can be routinely offered to all obese patients. Further prospective studies and eventually a randomized trial comparing open bariatric surgery vs. EBS are needed, powered for clinically relevant outcomes, and with adequate follow-up. Yet, EBS may already appear as an appealing alternative treatment for weight management and cardiovascular prevention in morbidly obese patients at high surgical risk.

scholarly journals The Surgical Outcomes of Unstable Ankle Fractures in Patients Aged >65 Years

2021 ◽  
Vol 12 ◽  
pp. 215145932199776
Author(s):  
Adem Sahin ◽  
Anıl Agar ◽  
Deniz Gulabi ◽  
Cemil Erturk
Keyword(s):  
Surgical Outcomes ◽  
External Rotation ◽  
High Energy ◽  
Ankle Fractures ◽  
Medial Malleolus ◽  
Aofas Score ◽  
Non Union ◽  
The Mean ◽  
Medial Malleolus Fracture ◽  
Mechanism Of Trauma

Aim: To evaluate the surgical outcomes and complications of patients over 65 years of age, with unstable ankle fractures. Material and Method: The study included 111 patients (73F/38 M) operated on between January 2015 and February 2019 and followed up for a mean of 21.2 months (range, 6-62 months).Demographic characteristics, comorbidities, fracture type, and mechanisms of injury were evaluated. Relationships between postoperative complications and comorbidities were examined. In the postoperative functional evaluations, the AOFAS score was used and pre and postoperative mobilization (eg, use of assistive devices) was assessed. Results: The mean age of the patients was 70.5 ± 6.1 years (range, 65-90 years). The mechanism of trauma was low-energy trauma in 90.1% of the fractures and high-energy trauma in 9.9%. The fractures were formed with a SER injury (supination external rotation) in 83.7% of cases and bimalleolar fractures were seen most frequently (85/111, 76%).Complications developed in 16 (14.4%) patients and a second operation was performed in 11 (9.9%) patients with complications. Plate was removed and debridement was performed in 5 of 6 patients due to wound problems. Nonunion was developed in the medial malleolus in 4 patients. Revision surgery was performed because of implant irritation in 2 patients and early fixation loss in the medial malleolus fracture in one patient. Calcaneotibial arthrodesis was performed in 3 patients because of implant failure and ankle luxation associated with non-union. A correlation was determined between ASA score and DM and complications, but not with osteoporosis. The mean follow-up AOFAS score was 86.7 ± 12.5 (range, 36-100).A total of 94 (84.7%) patients could walk without assistance postoperatively and 92 (82.9%) were able to regain the preoperative level of mobilization. Conclusion: Although surgery can be considered an appropriate treatment option for ankle fractures in patients aged >65 years, care must be taken to prevent potential complications and the necessary precautions must be taken against correctable comorbidities.

scholarly journals Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Motohide Shibayama ◽  
Guang Hua Li ◽  
Li Guo Zhu ◽  
Zenya Ito ◽  
Fujio Ito
Keyword(s):  
Minimally Invasive ◽  
Spinal Canal ◽  
Interbody Fusion ◽  
Facet Joint ◽  
Clinical Results ◽  
Invasive Technique ◽  
Clinical Effects ◽  
Lumbar Interbody Fusion ◽  
Disc Space ◽  
Single Level

Abstract Background Lumbar interbody fusion is a standard technique for treating degenerative lumbar disorders involving instability. Due to its invasiveness, a minimally invasive technique, extraforaminal lumbar interbody fusion (ELIF), was introduced. On surgically approaching posterolaterally, the posterior muscles and spinal canal are barely invaded. Despite its theoretical advantage, ELIF is technically demanding and has not been popularised. Therefore, we developed a microendoscopy-assisted ELIF (mELIF) technique which was designed to be safe and less invasive. Here, we aimed to report on the surgical technique and clinical results. Methods Using a posterolateral approach similar to that of lateral disc herniation surgery, a tubular retractor, 16 or 18 mm in diameter, was placed at the lateral aspect of the facet joint. The facet joint was partially excised, and the disc space was cleaned. A cage and local bone graft were inserted into the disc space. All disc-related procedures were performed under microendoscopy. The spinal canal was not invaded. Bilateral percutaneous screw-rod constructs were inserted and fixed. Results Fifty-five patients underwent the procedure. The Oswestry Disability Index and visual analogue scale scores greatly improved. Over 90% of the patients obtained excellent or good results based on Macnab’s criteria. There were neither major adverse clinical effects nor the need for additional surgery. Conclusions mELIF is minimally invasive because the spinal canal and posterior muscles are barely invaded. It produces good clinical results with fewer complications. This technique can be applied in most single-level spondylodesis cases, including those involving L5/S1 disorders.

The Emerging Role of Robotic Single-site Approach for Myomectomy: A Systematic Review of the Literature

2021 ◽  
pp. 155335062098822
Author(s):  
Eirini Giovannopoulou ◽  
Anastasia Prodromidou ◽  
Nikolaos Blontzos ◽  
Christos Iavazzo
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Complication Rate ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Single Site ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Robotic Myomectomy ◽  
The Mean

Objective. To review the existing studies on single-site robotic myomectomy and test the safety and feasibility of this innovative minimally invasive technique. Data Sources. PubMed, Scopus, Google Scholar (from their inception to October 2019), as well as Clinicaltrials.gov databases up to April 2020. Methods of Study Selection. Clinical trials (prospective or retrospective) that reported the outcomes of single-site robotic myomectomy, with a sample of at least 20 patients were considered eligible for the review. Results. The present review was performed in accordance with the guidelines for Systematic Reviews and Meta-Analyses (PRISMA). Four (4) studies met the inclusion criteria, and a total of 267 patients were included with a mean age from 37.1 to 39.1 years and BMI from 21.6 to 29.4 kg/m2. The mean operative time ranged from 131.4 to 154.2 min, the mean docking time from 5.1 to 5.45 min, and the mean blood loss from 57.9 to 182.62 ml. No intraoperative complications were observed, and a conversion rate of 3.8% was reported by a sole study. The overall postoperative complication rate was estimated at 2.2%, and the mean hospital stay ranged from 0.57 to 4.7 days. No significant differences were detected when single-site robotic myomectomy was compared to the multiport technique concerning operative time, blood loss, and total complication rate. Conclusion. Our findings support the safety of single-site robotic myomectomy and its equivalency with the multiport technique on the most studied outcomes. Further studies are needed to conclude on the optimal minimally invasive technique for myomectomy.

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