scholarly journals A Modified Technique of Bipolar Loop Resectoscopic Slicing for Treating Submucous Fibroids With Enucleation Makes the Operation Safer

2021 ◽  
Vol 8 ◽  
Author(s):  
Wenying Zhang ◽  
Jing Liu ◽  
Qiongwei Wu ◽  
Yu Liu ◽  
Chunchun Wang ◽  
...  
Keyword(s):  
Uterine Cavity ◽  
Operation Time ◽  
Complete Removal ◽  
Modified Technique ◽  
Classical Technique ◽  
Submucous Fibroid ◽  
Media Volume

Background: In this study, a modified technique of resectoscopic slicing with a common bipolar loop was introduced, which facilitated the complete removal of the submucous fibroid inside the uterine cavity without any novel equipment.Results: Compared with the classical technique, our modified procedure possessed a shorter operation time (22.9 ± 7.3 vs. 38.9 ± 13.0 min, p < 0.05) and a smaller distending media volume (1,495.6 ± 540.1 vs. 2,393.1 ± 719.4 ml, p < 0.01).Conclusion: As a result, the current study suggested that the enucleation of submucous fibroid under hysteroscopy could be achieved by using only the bipolar loop, which reduced the consumption for novel equipment and enhanced the safety of the technique.

scholarly journals Hysteroscopic evaluation in infertility and abnormal uterine bleeding

2018 ◽  
Vol 7 (2) ◽  
pp. 612
Author(s):  
Navneet Kaur ◽  
Ruby Bhatia ◽  
Paramjit Kaur ◽  
Surinder K. Bhopal
Keyword(s):  
Endometrial Hyperplasia ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Therapeutic Modality ◽  
Secondary Infertility ◽  
Endometrial Polyps ◽  
Submucous Fibroid

Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention.

scholarly journals All-arthroscopic repair of Atzei class II and III triangular fibrocartilage complex tears using the FasT-Fix suture device

2020 ◽  
Author(s):  
Mengchun Tsai ◽  
Yi-Hsuan Lin ◽  
Chih-Hao Chiu ◽  
Chun-Ying Cheng ◽  
Yi-Sheng Chan ◽  
...  
Keyword(s):  
Operation Time ◽  
Class Ii ◽  
Triangular Fibrocartilage Complex ◽  
Arthroscopic Repair ◽  
Class Iii ◽  
Modified Technique ◽  
Repair Procedure ◽  
Triangular Fibrocartilage ◽  
Suture Device

Abstract Background The study is aimed to propose an arthroscopic repair technique using a pre-tied suture device for peripheral TFCC (triangular fibrocartilage complex) tear with proximal component involvement. Methods Through a retrospective review in the medical records of patients who underwent unilateral arthroscopic repair for TFCC Palmer IB lesion between 2017 and 2019, 12 patients were arthroscopically diagnosed as proximal component tear and received more than one year follow-up postoperatively. The arthroscope was introduced from 6R portal to discriminate Atzei class II from III lesions by a “visualization test”, and to supervise the repair procedure using pre-tied FasT-Fix suture device from 3-4 portal. Two poly-ether-ether-ketone (PEEK) blocks were further advanced along the device needle to finally seat outside the ulnar joint capsule, followed by gradually tightening the pre-tied suture loop until the TFCC periphery was securely repositioned and held stably. Results Operation time averaged 87 minutes. Hook test and DRUJ arthroscopy confirmed proximal component tear in all 12 wrists.Four patients were diagnosed to be Atzei class II lesion as full thickness tear of distal component was arthroscopically identified from 6R portal while the other 8 exhibited partial thickness tear and were categorized as class III lesion. Follow-up averaged 15 months with a range of 12 to 24 months. Mayo modified wrist score improved from an average of 61.3 preoperatively to 90.4 at the latest visit. Conclusions A modified technique for diagnosis and all-arthroscopic repair in TFCC Atzei class II and III lesions using a pre-tied suture device is a feasible and safe option with promising results.

scholarly journals Hysteroscopy to identify retained placental tissue and excision in secondary post-partum haemorrhage

2020 ◽  
Vol 9 (5) ◽  
pp. 1847
Author(s):  
Pratibha Devabhaktuni ◽  
Padmaja Allani
Keyword(s):  
Caesarean Delivery ◽  
Postpartum Haemorrhage ◽  
Post Partum ◽  
Uterine Fibroids ◽  
Uterine Cavity ◽  
Placental Tissue ◽  
Complete Removal ◽  
Time Treatment ◽  
Products Of Conception ◽  
Retained Placental Tissue

Background: Most cases of secondary postpartum haemorrhage (PPH) are due to retained placental products (RPP). This study had a crop of five cases of secondary PPH, referral cases, during a period of six months during 2006. Four cases were following a caesarean delivery and in one, sub mucous and intra mural, uterine fibroids, caused retained placental tissue by distortion of the uterine cavity. Objectives of this study were to evaluate the feasibility of hysteroscopy to identify the retained placental products in cases of secondary postpartum haemorrhage. Verification of complete removal of RPP by reinsertion of hysteroscope, after removal of RPP by using a sponge holder, or curette.Methods: Trans vaginal ultrasonography (TVS) identified echogenic retained products of conception in all cases. Surgical profile investigations were done as per protocol. Transfusion of blood products was needed in some. Bettocchi 5 mm continuous flow hysteroscope (Karl Storz) was used. Storz endomat hysteroflator was used for irrigation and aspiration.Results: Hysteroscopic guided excision of the placental tissue was one-time treatment in four of study cases, and one needed a second hysteroscopic excision. Secondary PPH occurred at varying periods after the caesarean delivery, one week in one, two weeks in one case, three weeks in two cases and one woman was admitted with retained placenta, primary PPH continuing to secondary PPH. Hysteroscopy done during the puerperal period, in cases of secondary PPH, had certain challenges to cope with.Conclusions: Hysteroscopic guided excision of the retained placental tissue was successful in all the five cases with secondary postpartum haemorrhage. Hysteroscopy is an excellent procedure in cases of secondary PPH. We request guidelines committees to consider including hysteroscopic guided removal of retained placental products, in the algorithm of management of secondary PPH.

scholarly journals Platelet-rich fibrin (PRF) in implants dentistry in combination with new bone regenerative flapless technique: evolution of the technique and final results

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Antonio Cortese ◽  
Giuseppe Pantaleo ◽  
Massimo Amato ◽  
Candace M. Howard ◽  
Lorenzo Pedicini ◽  
...  
Keyword(s):  
Bone Growth ◽  
Alveolar Bone ◽  
Operation Time ◽  
Control Group ◽  
Height Loss ◽  
Minimal Amount ◽  
Modified Technique ◽  
Inflammatory Reactions ◽  
Platelet Rich Fibrin ◽  
Bone Expansion

AbstractMost common techniques for alveolar bone augmentation are guided bone regeneration (GBR) and autologous bone grafting. GBR studies demonstrated long-term reabsorption using heterologous bone graft. A general consensus has been achieved in implant surgery for a minimal amount of 2 mm of healthy bone around the implant.A current height loss of about 3-4 mm will result in proper deeper implant insertion when alveolar bone expansion is not planned because of the dome shape of the alveolar crest. To manage this situation a split crest technique has been proposed for alveolar bone expansion and the implants’ insertion in one stage surgery. Platelet-rich fibrin (PRF) is a healing biomaterial with a great potential for bone and soft tissue regeneration without inflammatory reactions, and may be used alone or in combination with bone grafts, promoting hemostasis, bone growth, and maturation.AimThe aim of this study was to demonstrate the clinical effectiveness of PRF combined with a new split crest flapless modified technique in 5 patients vs. 5 control patients.Materials and methodsTen patients with horizontal alveolar crests deficiency were treated in this study, divided into 2 groups: Group 1 (test) of 5 patients treated by the flapless split crest new procedure; Group 2 (control) of 5 patients treated by traditional technique with deeper insertion of smaller implants without split crest. The follow-up was performed with x-ray orthopantomography and intraoral radiographs at T0 (before surgery), T1 (operation time), T2 (3 months) and T3 (6 months) post-operation.ResultsAll cases were successful; there were no problems at surgery and post-operative times. All implants succeeded osteointegration and all patients underwent uneventful prosthetic rehabilitation. Mean height bone loss was 1 mm, measured as bone-implant most coronal contact (Δ-BIC), and occurred at immediate T2 post-operative time (3 months). No alveolar bone height loss was detected at implant insertion time, which was instead identified in the control group because of deeper implant insertion.ConclusionThis modified split crest technique combined with PRF appears to be reliable, safe, and to improve the clinical outcome of patients with horizontal alveolar crests deficiency compared to traditional implanting techniques by avoiding alveolar height-loss related to deeper insertion of smaller implants.

scholarly journals Simultaneous right-sided nephrectomy with orthotopic liver and kidney transplantation—An alternative method for patients with autosomal dominant polycystic liver and kidney disease

2021 ◽  
Author(s):  
Philipp Felgendreff ◽  
Hans-Michael Tautenhahn ◽  
Sascha Lux ◽  
Felix Dondorf ◽  
René Aschenbach ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Disease ◽  
Autosomal Dominant ◽  
Graft Function ◽  
Operation Time ◽  
Modified Technique ◽  
Anatomical Structures ◽  
Polycystic Liver ◽  
Transplantation Technique ◽  
Liver And Kidney

Abstract Purpose In patients suffering from autosomal dominant polycystic liver and kidney disease (ADPLKD), combined organ transplantation often poses a technical challenge due to the large volume of both organs. To simplify the transplantation procedure by improving the exposure of anatomical structures, we introduce a novel surgical technique of orthotopic liver and kidney transplantation. Methods The modified simultaneous liver and kidney transplantation technique via a right-sided L-incision included three steps: (1) right-sided nephrectomy in the recipient followed by (2) orthotopic liver transplantation in cava replacement technique and (3) the orthotopic kidney transplantation with arterial reconstruction to the right common iliac artery. Results In total, seven patients with ADPLKD were transplanted by using the modified transplantation technique. The mean operation time was 342.43 min (±68.77). Postoperative patients were treated for 6.28 days (±2.50) in the intensive care unit and were discharged from the surgical ward approximately 28 days (±5.66) after the operation with normal graft function. Complications associated with the use of the modified technique, such as bleeding, anastomotic stenosis, biloma, or urinoma, did not occur. Conclusion Modified simultaneous liver and kidney transplantation is a safe alternative for patients with ADPLKD. By combining right-sided nephrectomy and orthotopic graft transplantation, the approach optimizes the exposure of anatomical structures and simplifies the transplantation procedure. Additionally, the modified transplantation technique does not require a particular organ explantation procedure and can be applied for all liver and kidney grafts.

scholarly journals All-arthroscopic repair of Atzei class II and III triangular fibrocartilage complex tears using the FasT-Fix suture device

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Mengchun Tsai ◽  
Yi-Hsuan Lin ◽  
Chih-Hao Chiu ◽  
Chun-Ying Cheng ◽  
Yi-Sheng Chan ◽  
...  
Keyword(s):  
Operation Time ◽  
Class Ii ◽  
Triangular Fibrocartilage Complex ◽  
Arthroscopic Repair ◽  
Class Iii ◽  
Modified Technique ◽  
Repair Procedure ◽  
Triangular Fibrocartilage ◽  
Suture Device

Abstract Background The study is aimed to propose an arthroscopic repair technique using a pre-tied suture device for peripheral TFCC (triangular fibrocartilage complex) tear with proximal component involvement. Methods Through a retrospective review in the medical records of patients who underwent unilateral arthroscopic repair for TFCC Palmer IB lesion between 2017 and 2019, 12 patients were arthroscopically diagnosed as proximal component tear and received more than 1 year follow-up postoperatively. The arthroscope was introduced from 6R portal to discriminate Atzei class II from III lesions by a “visualization test” and to supervise the repair procedure using pre-tied FasT-Fix suture device from 3-4 portal. Two poly-ether-ether-ketone (PEEK) blocks were further advanced along the device needle to finally seat outside the ulnar joint capsule, followed by gradually tightening the pre-tied suture loop until the TFCC periphery was securely repositioned and held stably. Results Operation time averaged 87 min. Hook test and DRUJ arthroscopy confirmed proximal component tear in all 12 wrists. Four patients were diagnosed to be Atzei class II lesion as full thickness tear of distal component was arthroscopically identified from 6R portal while the other 8 exhibited partial thickness tear and were categorized as class III lesion. Follow-up averaged 15 months with a range of 12 to 24 months. Mayo modified wrist score improved from an average of 61.3 preoperatively to 90.4 at the latest visit. Conclusions A modified technique for diagnosis and all-arthroscopic repair in TFCC Atzei class II and III lesions using a pre-tied suture device is a feasible and safe option with promising results.

scholarly journals The long-term outcome of the modified external dacryocystorhinostomy

2017 ◽  
Vol 10 (2) ◽  
pp. 56-61
Author(s):  
Vyacheslav V Rakhmanov ◽  
Vitaly V Potemkin ◽  
Elena V Meshveliani ◽  
Alyona A Pirgunova ◽  
Aisa S Alchinova ◽  
...  
Keyword(s):  
Success Rate ◽  
Standard Procedure ◽  
Operation Time ◽  
Modified Technique ◽  
Long Term Outcome ◽  
External Dacryocystorhinostomy ◽  
The Mean ◽  
External Dcr

External dacryocystorhinostomy (DCR) is still the gold standard procedure for treating nasolacrimal duct obstruction or chronic dacryocystitis. Purpose: to evaluate the long-term functional outcome of the modified technique of external dacryocystorhinostomy. Materials. 55 patients (61 eyes) with lacrimal drainage system disorders who underwent the modified technique of external DCR between 2013-2015 were involved in the study. In this modified procedure of external DCR, anastomosis was created by suturing only anterior flaps of the lacrimal sac and nasal mucosa and excision of the posterior flaps. The mean age of the patients was 65.8 ± 12.38 years (range, 27-87 years), including 47 females and 8 males. The mean follow-up time was 19.4 ± 6.9 months (range, 4-33 months). The success rate was recorded during the follow-up period. Cosmetic result of surgery was interpreted by the patients. Results. Criteria for surgical success were defined as no or minimal intermittent epiphora, no reflux on lacrimal irrigation postoperatively and a positive functional dye test. The modified external DCR with only anterior flap anastomosis had a success rate of 93.4%. 4 patients (6.6%) had recurrence of epiphora and not patent lacrimal system to irrigation. In our study, the operation time of DCR varies from 25-40 minutes. After surgery 15 of 55 patients (27.3%) described the incision scar as “invisible” and 3 of 55 patients (5.5%) graded it as very visible, hypertrophic scar. Five of 55 patients (9.1%) were not satisfied with the appearance of the incision. Conclusion. The present study concludes that modified external DCR with anterior flaps anastomosis only is a simple, less time consuming surgical technique that is easy to perform and the outcome is comparable to conventional DCR.

scholarly journals A Modified Technique of Thulium Laser Enucleation for Benign Prostatic Hyperplasia With Non-morcellator Approach

2021 ◽  
Vol 8 ◽  
Author(s):  
Yifeng Jing ◽  
Qian Sun ◽  
Wenhuan Guo ◽  
Dapeng Zhou ◽  
Yiping Zhu ◽  
...  
Keyword(s):  
Specific Antigen ◽  
Urine Volume ◽  
Operation Time ◽  
Bladder Injury ◽  
Thulium Laser ◽  
Modified Technique ◽  
Total Operation Time ◽  
Postvoid Residual Urine ◽  
Laser Enucleation

Background: Until recently, most enucleation techniques of the prostate were performed with the application of morcellator. We introduce a modified enucleation technique of thulium laser with non-morcellator approach, which is about incising and vaporizing remaining prostate tissue instead of a morcellator.Methods: A retrospective evaluation of 223 patients undergoing ThuLEP from January 2014 to December 2015 was performed in our institution. One hundred five of the patients used morcellator while the other 118 used non-morcellator approach. All patients were assessed with the International Prostate Symptom Score (IPSS), quality of life (Qol), ultrasonography, serum prostate-specific antigen (PSA), maximal urine flow rate (Qmax), and postvoid residual urine volume (PVR). We reassessed these parameters at 1-, 3-, 6-, and 12-months after operation. Operative time, perioperative, and postoperative complications were also recorded.Results: Significant improvement was noted in the IPSS, QoL, Qmax, and PVR in both groups at the 12-month follow-up, and assessment showed no differences in these parameters between the two groups. Comparisons of the total operation time and enucleation time demonstrated no significant differences between the two groups. Our non-morcellator approach needed more time to incise and vaporize the enucleated tissue compared to morcellation when the prostate volume was about 40–80 ml (p < 0.05), while it showed a significant lower rate of superficial bladder injury than using morcellator (p < 0.05). There were no significant differences in other complications between the two groups (p > 0.05).Conclusions: Our modified technique is a safe and effective procedure for the treatment of BPH avoiding the potential complications caused by morcellator.

scholarly journals Mini-Review of the New Therapeutic Possibilities in Asherman Syndrome—Where Are We after One Hundred and Twenty-Six Years?

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 706 ◽  
Author(s):  
Bogdan Doroftei ◽  
Ana-Maria Dabuleanu ◽  
Ovidiu-Dumitru Ilie ◽  
Radu Maftei ◽  
Emil Anton ◽  
...  
Keyword(s):  
Adhesion Formation ◽  
Uterine Cavity ◽  
Complete Removal ◽  
Cervical Canal ◽  
Reproductive Outcomes ◽  
Efficient Tool ◽  
Non Invasive ◽  
Intrauterine Adhesion ◽  
New Directions ◽  
Therapeutic Possibilities

Asherman syndrome is a multifaceted condition describing the partial or complete removal of the uterine cavity and/or cervical canal. It is a highly debatable topic because of its pronounced influence on both reproductive outcomes and gynaecologic symptoms. The latest reports demonstrated that trauma to the endometrium is the main cause of intrauterine adhesion formation. Left untreated, such adhesions gradually lead to a range of repercussions ranging from mild to severe. Considering the lack of non-invasive approaches, the advent of hysteroscopy has revolutionized the entire field, being otherwise considered the most efficient tool offering new directions and amplifying the chances of treating the Asherman syndrome.

scholarly journals Surgical treatment of synovial osteochondromatosis of the hip using a modified-Hardinge approach with a Z-shaped capsular incision

2015 ◽  
Vol 7 (4) ◽  
Author(s):  
Yu Takeda ◽  
Shigeo Fukunishi ◽  
Shoji Nishio ◽  
Yuki Fujihara ◽  
Tomokazu Fukui ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Great Trochanter ◽  
Rare Condition ◽  
Complete Removal ◽  
Modified Technique ◽  
Non Union ◽  
Synovial Osteochondromatosis ◽  
Surgical Dislocation ◽  
Capsular Incision

Synovial osteochondromatosis of the hip is a rare condition, and the surgical treatment approach for this condition requires complete removal of loose bodies combined with synovectomy. While these, procedures are generally accepted as the optimal treatment method, this is still controversial topic. Recent studies have reported that open surgical procedures remain acceptable for synovial osteochondromatosis of the hip. These procedures include the dislocation of the femoral head, and complications such as femoral head necrosis and bursitis or great trochanter non-union due to trochanteric osteotomy have been reported. The present study reports a modified technique for surgical dislocation through a Z-shaped capsular incision without trochanteric flip osteotomy for the treatment of synovial osteochondromatosis of the hip.

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