25-Gauge vitrectomy; Up-to-date Indications and Applications

2021 ◽  
pp. 308-311
Keyword(s):  
Recovery Time ◽  
Wide Spectrum ◽  
Vitreoretinal Surgery ◽  
Postoperative Recovery ◽  
Surgical Skills ◽  
Patient Comfort ◽  
Surgical Time ◽  
Postoperative Inflammation ◽  
25 Gauge Vitrectomy

Reduction of surgical time, increased patient comfort by decreased postoperative inflammation and fast postoperative recovery time are the main benefits of 25-G vitrectomy. Recently, with the advent of new microsurgical instrumentation and the improvement of surgical skills, we can use 25-G vitrectomy in a wide spectrum of vitreoretinal pathology. In this review, we aimed to summarize the surgical advances and evolution of 25-Gauge vitrectomy and discuss its advantages and application in vitreoretinal surgery.

Dyskeratosis congenita and squamous cell carcinoma of the mandibular alveolar ridge

2021 ◽  
Vol 14 (5) ◽  
pp. e242459
Author(s):  
Alfonso Manfuso ◽  
Antonio Maria Risitano ◽  
Chiara Copelli
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Skin Pigmentation ◽  
Dyskeratosis Congenita ◽  
Postoperative Recovery ◽  
Patient Comfort ◽  
Alveolar Ridge ◽  
Therapeutic Decisions ◽  
Disseminated Disease

Dyskeratosis congenita is a rare disease caused by telomerase dysfunction classically characterised by the triad: skin pigmentation, nail dystrophy and mucosal leukoplakia. Few cases are described in literature regarding patients with head and neck squamous cell carcinoma affected by dyskeratosis congenita, and the therapeutic decisions are not yet well defined. A review of the literature of the last 20 years (2001–2021) was performed, and it was analysed the case of a 38-year-old male patient affected by dyskeratosis congenita diagnosed with a squamous cell carcinoma of the inferior alveolar ridge, treated with surgery. The absence of complications and the good postoperative recovery of the patient comfort in saying that resection and reconstructive surgery can be safely performed. The occurrence of disseminated disease 6 months after the treatment warns about the extreme aggressiveness of the pathology, its often systemic nature and the necessity of a multidisciplinary approach as well as further studies.

scholarly journals A Pilot Study Evaluating the Effects of Magtrace® for Sentinel Node Biopsy in Breast Cancer Patients Regarding Care Process Optimization, Reimbursement, Surgical Time, and Patient Comfort Compared With Standard Technetium99

2020 ◽  
Author(s):  
Sina Shams ◽  
Kai Lippold ◽  
Jens Uwe Blohmer ◽  
Robert Röhle ◽  
Friedrich Kühn ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Sentinel Node ◽  
Care Pathway ◽  
Lymph Node Biopsy ◽  
Patient Comfort ◽  
Surgical Time ◽  
Node Biopsy

Abstract Background Sentinel lymph node biopsy after technetium-99 (Tc99) localization is a mainstay of oncologic breast surgery. The timing of Tc99 injection can complicate operating room schedules, which can cause increasing overall costs of care and patient discomfort. Methods This study compared 59 patients who underwent breast cancer surgery including sentinel lymph node biopsy. Based on the surgeon’s choice, 29 patients were treated with Tc99, and 30 patients received the iron-based tracer, Magtrace. The primary outcomes were time spent on the care pathway and operating time from commissioning of the probe to removal of the sentinel node. The secondary outcomes were patient pain levels and reimbursement. Results The mean time spent on the preoperative breast cancer care pathway was significantly shorter for the Magtrace group (5.4 ± 1.3 min) than for the Tc99 group (82 ± 20 min) (p < 0.0001). The median time from probe usage to sentinel node extirpation was slightly but not significantly shorter in the Magtrace group (5 min; interquartile range [IQR], 3–15 min vs 10 min; IQR, 7–15 min; p = 0.151). Reimbursement and pain levels remained unchanged, and the hospital length of stay was similar in the two groups (Magtrace: 5.1 ± 2.3 days vs Tc99: 4.5 ± 3.2 days). Conclusions Magtrace localization shortened the preoperative care pathway and did not affect surgical time or reimbursement. Once established, it could allow for cost reduction and improve patient comfort.

Venous Air Embolism during Endoscopic Strip Craniectomy for Repair of Craniosynostosis in Infants

2001 ◽  
Vol 95 (2) ◽  
pp. 340-342 ◽  
Author(s):  
Joseph D. Tobias ◽  
Joel O. Johnson ◽  
David F. Jimenez ◽  
Constance M. Barone ◽  
D. Scott McBride
Keyword(s):  
Surgical Procedures ◽  
Operating Time ◽  
Air Embolism ◽  
Postoperative Recovery ◽  
Surgical Time ◽  
Venous Air Embolism ◽  
Low Incidence ◽  
End Tidal ◽  
Neonates And Infants ◽  
Strip Craniectomy

Background Various studies have reported an incidence of venous air embolism (VAE) as high as 82.6% during surgical procedures for craniosynostosis. There has been an increase in the use of minimally invasive, endoseopie surgical procedures, including applications for endoscopic strip craniectomy. The current study prospectively evaluated the incidence of VAF during endoscopic strip craniectomy. Methods Continuous, intraoperative monitoring for VAE was performed using precordial Doppler monitoring. A recording was made of the Doppler tones and later reviewed to verify its accuracy. Results The cohort for the study included 50 consecutive neonates and infants ranging in age from 3.5 to 36 weeks and ranging in weight from 3 to 9 kg. Surgical time varied from 31 to 95 min for a total of 2,701 mm of operating time, during which precordial Doppler tones were auscultated. In 46 patients, there was no evidence of VAE. In four patients, there was a single episode of VAE. Two of the episodes of VAE were grade I (change in Doppler tones), and two were grade H (change in Doppler tones and decrease in end-tidal carbon dioxide). No grade III (decrease in systolic blood pressure by 20% from baseline) VAF was noted. Conclusion In addition to previously reported benefits of decreased blood loss, decreased surgical time, and improved postoperative recovery time, the authors noted a low incidence of VAF during endoscopic strip craniectomy in neonates and infants.

scholarly journals Comparison of endoscopic-assisted and temporary keratoprosthesis-assisted vitrectomy in combat ocular trauma: experience at a tertiary eye center in Turkey

2018 ◽  
Vol 46 (7) ◽  
pp. 2708-2716 ◽  
Author(s):  
Onder Ayyildiz ◽  
Ali Hakan Durukan
Keyword(s):  
Medical Records ◽  
Ocular Trauma ◽  
Vitreoretinal Surgery ◽  
Common Type ◽  
Improvised Explosive Devices ◽  
Surgical Time ◽  
Temporary Keratoprosthesis ◽  
Improvised Explosive ◽  
Explosive Devices ◽  
Type Of Injury

Objective This study was performed to compare the functional and anatomical results of endoscopic-assisted and temporary keratoprosthesis (TKP)-assisted vitrectomy in patients with combat ocular trauma (COT). Methods The medical records of 14 severely injured eyes of 12 patients who underwent endoscopy or TKP implantation in combination with vitreoretinal surgery from 2007 to 2015 were retrospectively evaluated. The patients’ ocular history and functional and anatomic anterior and posterior segment results were analyzed. Results Eight eyes (57%) underwent TKP-assisted vitrectomy and six eyes (43%) underwent endoscopic vitrectomy. The most common cause of COT was detonation of improvised explosive devices (72%), and the most common type of injury was an intraocular foreign body (50%). The median time from trauma to surgery and the median surgical time were significantly shorter in the endoscopy than TKP group. The postoperative functional and anatomical results were not significantly different between the two groups. Conclusions TKP-assisted vitrectomy should be performed in eyes requiring extensive bimanual surgery. In such cases, a corneal graft must be preserved for the TKP at the end of the surgery. Endoscopy shortens the surgical time and can reduce the complication rate.

scholarly journals Pain and Vomiting after Vitreoretinal Surgery: A Potential Role for Local Anaesthesia

1995 ◽  
Vol 23 (4) ◽  
pp. 444-448 ◽  
Author(s):  
N. Williams ◽  
A. Strunin ◽  
W. Heriot
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Potential Role ◽  
Neuromuscular Block ◽  
Operating Time ◽  
Vitreoretinal Surgery ◽  
Patient Comfort ◽  
Anaesthetic Technique ◽  
Control Group ◽  
Postoperative Vomiting

Periconal local anaesthesia with subtenon supplementation was used to provide anaesthesia for 94 patients having vitreoretinal surgery. Of these, 44 patients also received general anaesthesia with neuromuscular block. None of these patients received opioid or antiemetic before or during surgery. In comparison with a retrospective control group, patients who had received local anaesthesia as part of their anaesthetic technique were less likely to be given a parenteral opioid (P< 0.001) or to vomit (P<0.001) within six hours of the completion of surgery. They also experienced significantly fewer bradycardic episodes during surgery (P=0 001). For patients having general anaesthesia, administration of an intraoperative antiemetic reduced the incidence of vomiting within six hours of the completion of surgery (P=0.008). For patients who did not receive local anaesthetic, shorter operating time was a factor associated with both reduced postoperative vomiting (P=0.0015) and administration of parenteral opioid (P=0.0014). It is suggested that the use of local anaesthesia as part of the anaesthetic technique for vitreoretinal surgery is associated with improved patient comfort.

Effects of atipamezole dosage and timing of administration on recovery time and quality in cats following injectable anaesthesia incorporating ketamine

2019 ◽  
Vol 22 (6) ◽  
pp. 589-597 ◽  
Author(s):  
Natalie Bruniges ◽  
David Yates
Keyword(s):  
Recovery Time ◽  
Statistical Significance ◽  
Quality Score ◽  
Healthy Male ◽  
Dose Ratio ◽  
Surgical Time ◽  
Preparation Time ◽  
Treatment Groups ◽  
Recorded Data ◽  
Age Range

Objectives The aim of this study was to establish the optimum dosage and timing of administration of atipamezole in cats undergoing general anaesthesia incorporating ketamine to provide the shortest recovery possible without unacceptably compromising recovery quality. Methods In total, 128 healthy male cats (age range 2–108 months, weight range 0.56–5.22 kg) admitted for castration were randomly allocated to groups of 32. Anaesthesia was induced with 60 mg/m2 ketamine, 180 µg/m2 buprenorphine, 3 mg/m2 midazolam and 600 µg/m2 medetomidine intramuscularly (IM). Cats received 600 µg/m2 (groups 1ATI20 and 1ATI40) or 1.5 mg/m2 (groups 2.5ATI20 and 2.5ATI40) atipamezole IM either 20 (groups 1ATI20 and 2.5ATI20) or 40 mins (groups 1ATI40 and 2.5ATI40) after the ‘quad’. Preparation time, surgical time, auricular temperature, times to sternal recumbency and first standing, and recovery quality score were recorded. Data were analysed using ANOVA, Kruskal–Wallis, Mann–Whitney U-tests and χ2 tests. Statistical significance was deemed to be P ⩽0.05. Results Groups did not differ significantly in preparation or surgical time. Auricular temperature decreased significantly over time ( P <0.01) but did not differ between atipamezole treatment groups. Time to sternal recumbency in group 2.5ATI20 (52.9 ± 22.3 mins) was faster than group 1ATI20 (65.7 ± 24.7 mins) ( P ⩽0.05), but there were no significant differences between other groups. Time to first standing and recovery quality scores did not differ significantly between groups. Minimal adverse effects were seen. Conclusions and relevance Atipamezole administration after 20 mins did not reduce recovery time but neither was recovery quality adversely affected compared with when it was administered after 40 mins, following datasheet recommendations with concurrent ketamine administration. The results of this study also suggest that an atipamezole:medetomidine dose ratio of 2.5:1 is more effective than 1:1 in reducing recovery time, regardless of timing of administration, although this only reached statistical significance for time to sternal recumbency when atipamezole was administered after 20 mins.

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