scholarly journals C-arm Guided Minimally Invasive Percutaneous Fixation Technique of Mandibular Angle and Ramus Fractures - a Prospective Clinical Study at a Tertiary Care Center of Odisha, India.

2020 ◽  
Vol 2 (2) ◽  
pp. 10-16
Author(s):  
Sourav Kumar Rout ◽  
Subrat Kumar Jena
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Tertiary Care ◽  
Distinct Advantage ◽  
Invasive Technique ◽  
Rigid Fixation ◽  
Mandibular Angle ◽  
Unique Challenge ◽  
Nerve Paralysis ◽  
Intraoral Approach

Background: Rigid internal fixation of displaced mandibular angle and ramus fractures often poses a unique challenge to oral and maxillofacial surgeons. Various methods have been published to provide a safe and secure gateway for these circumstances. Intra-oral approach supplemented by a limited percutaneous method of fixation offers a distinct advantage of rigid fixation, reducing the known morbidity of using the sole internal as well as external techniques. The objective was to describe a minimally invasive technique for the mandibular angle and ramus fractures using the combined intraoral and extra-oral approach.Methods: This study was conducted on ten patients with mandibular angle or ramus fractures. All patients underwent open reduction and internal fixation. The intra-oral incision was used for visualization and reduction of fractures, and supplemental percutaneous stab incision was utilized to create a path for insertion of the handheld battery-operated microdrill shaft and screwdriver to permit screws fixation perpendicular to the plates.Results: This combined technique depicted minimal or no soft tissue infections, wound dehiscence, occlusal disturbances, or seventh cranial nerve paralysis. The mean surgical duration was 41.5 minutes. No patient had an visible scar marks, which would require further intervention.Conclusion: The described minimally invasive combined percutaneous and intraoral approach for mandibular angle, and ramus fracture provides a satisfactory alternative which could be safely applied to provide rigid fixation of these fractures with minimal damage to vital structures.

S123 – New Approaches to Infratemporal Fossa Foreign Body Removal

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P118-P118
Author(s):  
Andrew R Scott ◽  
Thomas B Dodson ◽  
Michael P Platt ◽  
Ralph B Metson
Keyword(s):  
Minimally Invasive ◽  
Head And Neck ◽  
Foreign Bodies ◽  
Infratemporal Fossa ◽  
Tertiary Care ◽  
Care Facility ◽  
Guidance System ◽  
Invasive Technique ◽  
Hypodermic Needle ◽  
Surgical Removal

Objectives 1) To understand indications for removal of foreign bodies (FB) from the head and neck. 2) To be able to describe the use of new surgical technologies for FB removal from the head and neck region. 3) To understand the clinical applications of a novel, minimally-invasive technique for removal of FB from the infratemporal fossa. Methods A retrospective review of 2 cases of infratemporal fossa foreign bodies, which were referred to a tertiary care facility for management utilizing a novel transoral, endoscopic, image-guided approach. Results Both patients presented with pain and trismus following failed attempts to retrieve foreign bodies–1 broken hypodermic needle and 1 torn cottonoid sponge-through open explorations. Use of endoscopic equipment for visualization and image-guidance system for precise localization enabled both objects to be removed through a transoral approach. Surgical removal resulted in improvement in pain and trismus in both patients who were discharged within 24 hours. Conclusions A new approach is now available for the minimally-invasive retrieval of radio-opaque foreign bodies in the infratemporal fossa, which avoids the need for extensive surgical dissection or an external incision.

scholarly journals Transulcal parafascicular minimally invasive approach to deep and subcortical cavernomas: technical note

2016 ◽  
Vol 125 (6) ◽  
pp. 1360-1366 ◽  
Author(s):  
Robert A. Scranton ◽  
Steve H. Fung ◽  
Gavin W. Britz
Keyword(s):  
White Matter ◽  
Minimally Invasive ◽  
Technical Difficulty ◽  
Subcortical White Matter ◽  
Technical Note ◽  
Vascular Lesions ◽  
Invasive Technique ◽  
Minimally Invasive Approach ◽  
Unique Challenge ◽  
Invasive Approach

Cavernomas comprise 8%–15% of intracranial vascular lesions, usually supratentorial in location and superficial. Cavernomas in the thalamus or subcortical white matter represent a unique challenge for surgeons in trying to identify and then use a safe corridor to access and resect the pathology. Previous authors have described specific open microsurgical corridors based on pathology location, often with technical difficulty and morbidity. This series presents 2 cavernomas that were resected using a minimally invasive approach that is less technically demanding and has a good safety profile. The authors report 2 cases of cavernoma: one in the thalamus and brainstem with multiple hemorrhages and the other in eloquent subcortical white matter. These lesions were resected through a transulcal parafascicular approach with a port-based minimally invasive technique. In this series there was complete resection with no neurological complications. The transulcal parafascicular minimally invasive approach relies on image interpretation and trajectory planning, intraoperative navigation, cortical cannulation and subcortical space access, high-quality optics, and resection as key elements to minimize exposure and retraction and maximize tissue preservation. The authors applied this technique to 2 patients with cavernomas in eloquent locations with excellent outcomes.

scholarly journals Endoscopic-Assisted Intraoral Open Reduction Internal Fixation of Mandibular Subcondylar Fractures: Initial Experiences from a Tertiary-Care Maxillofacial Center in India

2018 ◽  
Vol 11 (3) ◽  
pp. 183-191 ◽  
Author(s):  
Venkatesh Anehosur ◽  
Abhijit Joshi ◽  
Saravanan Rajendiran
Keyword(s):  
Facial Nerve ◽  
Learning Curve ◽  
Internal Fixation ◽  
Open Reduction ◽  
Tertiary Care ◽  
Mouth Opening ◽  
Open Reduction Internal Fixation ◽  
Steep Learning Curve ◽  
Intraoral Approach ◽  
Condylar Fractures

Management of condylar fractures is a highly controversial and debatable area. Open reduction and internal fixation (ORIF) using an extraoral approach has certain benefits over the nonsurgical treatment. Risk of damage to the facial nerve and an extraoral scar remains constant deterrents. An endoscopic-assisted ORIF offers an intraoral approach, thus eliminating consequences such as scarring. Though this technique offers unparalleled advantages, it is associated with a steep learning curve. Surgical results improve only with patience and experience. Patients with condylar fractures reported to SDM Craniofacial Unit, Dharwad, India, from 2013 to 2015 are included. Patients were treated with endoscopic-assisted ORIF and were evaluated for functional outcomes that included occlusion, maximal interincisal opening, and deviation of mouth and complications such as facial nerve pareses, postsurgical infection, and morbidity. Fifteen patients included in the study: 4 left sided and 11 right sided fractures. Nine patients had associated other mandibular fracture. Mean age of the patients was 28.2 years. Mean mouth opening at the end of 1 week, 6 weeks, and 6 months was 32.6, 37.8, and 40.5 mm, respectively. Transient facial nerve pareses were noted in one patient, and an extraoral draining sinus was noted in another. Endoscopic-assisted ORIF has a definite scope in management of condylar fractures. Results are more predictable with appropriate case selection due to a steep learning curve and intraoperative technical challenges. An initial experience in ORIF using extraoral approaches would greatly benefit a surgeon in utilizing this novel and alternate tool.

Minimally invasive harvesting fascia lata (FL) in ophthalmic plastic surgery

2021 ◽  
pp. 112067212110481
Author(s):  
Syeed Mehbub Ul Kadir ◽  
Md. Hasanuzzaman ◽  
Yvette Marie Santiago-Gatmaitan ◽  
Vanessa Naseem Mansurali ◽  
Mukti Rani Mitra ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Plastic Surgery ◽  
Tertiary Care ◽  
Fascia Lata ◽  
Invasive Technique ◽  
Congenital Ptosis ◽  
Orbital Implant ◽  
Fascial Sling ◽  
Invasive Method ◽  
Patch Graft

Purpose: To describe a minimally invasive technique of harvesting fascia lata, and also to analyze the clinical uses and the outcome of fascia lata in Ophthalmic Plastic and Reconstructive surgery. Methods: This interventional study was done in three tertiary care eye hospitals in Bangladesh from July 2014 to June 2020. We obtained autologous fascia lata for the correction of congenital ptosis with poor levator function (⩽4 mm), covering the ciliary staphyloma, repair of the extruded implant following anophthalmic socket surgery, and was also used to wrap the orbital implant after enucleation. Preserved FL was used only for children before 6 years of age for the treatment of congenital ptosis. Results: Out of 60 subjects, 38 (63.3%) were male and 22 (36.7%) were female. Autogenous fascia lata was used for frontalis brow suspension (FBS) in 25 (41.67%) patients of congenital ptosis with poor levator function, as patch graft in ciliary staphyloma (11 cases, 18.3%), to wrap orbital implant following enucleation in intraocular malignancies (nine cases, 15%), to repair of implant extrusion following evisceration (five cases, 8.3%), and as fascial sling to correct recurrent paralytic ectropion (one case, 1.67%). Allogeneic or preserved fascia lata was used to correct congenital ptosis in patients less than 6 years of age (nine cases, 15%). Mean follow-up time was 5.32 months. Conclusion: Fascia lata (autogenous and allogeneic preserved) has varied uses in ophthalmic plastic surgery. Harvesting fascia lata (FL) using with minimally invasive method was successful with the least scar on the thigh to correct congenital ptosis, ciliary staphyloma, repair of extruded implant, and in wrapping implant after enucleation to get better cosmesis and motility.

scholarly journals Access to the crista galli and the foramen caecum in nasal dermal sinus cysts - lessons learned in a single tertiary care centre

2013 ◽  
Vol 51 (1) ◽  
pp. 47-53
Author(s):  
D. Vital ◽  
N. Krayenbuhl ◽  
O. Bozinov ◽  
D. Holzmann
Keyword(s):  
Minimally Invasive ◽  
Tertiary Care ◽  
Nasal Bone ◽  
Surgical Techniques ◽  
Lessons Learned ◽  
Invasive Technique ◽  
Dermal Sinus ◽  
Open Rhinoplasty ◽  
Minimally Invasive Approach ◽  
Invasive Approach

Objective: Several surgical techniques have been suggested for the treatment of nasal dermal sinus cysts (NDSC). We have used several different techniques and have developed a minimally invasive approach. The aim of this study is to describe the evolution to this approach and compare the results with those achieved with our experience of more traditional techniques. Methodology/principal: A retrospective data collection of patients with NDSC presenting to our clinic between 1998 and 2012 was performed. We initially performed external approaches as outlined elsewhere. With an increasing number of young children requiring surgery, the technique was modified to a less invasive form. This new approach starts with mobilisation of the pit via a tiny skin incision. An open rhinoplasty approach is used to follow the fistula on the nasal bone. Once the fistula passes underneath the nasal bone, an endoscopic endonasal approach is used. Following the fistula cranially, the area of the foramen caecum can be identified. Results: Twelve out of 15 patients (80%) were treated surgically. The transfacial, coronal subcranial and minimally invasive approach was used in 3 (25%), 4 (33%) and 5 patients (42%), respectively. Radical resection was achieved in all patients. Cosmetic problems were present in all patients undergoing a transfacial and in half of the patients after the coronal subcranial approach. Patients treated by the minimally invasive technique remained without sequelae. Conclusion: The minimally invasive approach enables a perfect exposure of the fistula up to the crista galli and provides less morbidity and better cosmetic results than the transfacial and subcranial approach.

scholarly journals New biological method of internal fixation of the femur

2005 ◽  
Vol 52 (2) ◽  
pp. 113-116 ◽  
Author(s):  
Milorad Mitkovic ◽  
Marko Bumbasirevic ◽  
Z. Golubovic ◽  
D. Mladenovic ◽  
Sasa Milenkovic ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Bone Healing ◽  
Callus Formation ◽  
Invasive Technique ◽  
Fracture Treatment ◽  
Biological Method ◽  
Unsuccessful Treatment ◽  
Periosteal Callus

One of the main goals in fracture treatment is preservation of both intramedular and periosteal vascularisation. The aim of this paper is to show a new method of internal fixation which accomplishes these goals. The paper presents the results of clinical application of Mitkovic Internal Fixator, new self-dynamisable device, which provides fixation of the femur using minimally invasive technique. This device has been investigated experimentally on 60 animals. It has been applied to 267 patients. Here is presented a series of 92 fixations of femoral diaphyses after fresh fractures and after unsuccessful treatment using other methods. Follow-up was 3.1 years (2 to 7 years). Bone healing was achieved in all patients within 3.5 months (2.7-9 months) with big amount of periosteal callus formation. There were no complications in all patients seen. It can be concluded that this method and device meet biological and biomechanical requirements for safe fracture treatment.

scholarly journals Minimally invasive esophagectomy for carcinoma esophagus- outcome of surgical management: a single centre experience

2018 ◽  
Vol 5 (4) ◽  
pp. 1469
Author(s):  
C. K. Jakhmola ◽  
Vikram Trehan ◽  
S. Santosh Kumar
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedure ◽  
Minimally Invasive Esophagectomy ◽  
Tertiary Care ◽  
Laparoscopic Approach ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Chyle Leak ◽  
Invasive Esophagectomy ◽  
Esophageal Malignancy

Background: Minimally invasive esophagectomy (MIE) has shown an increasing trend, especially in the last decade, in the management of esophageal malignancy. The aim of the present study was to present a cohort of patients who underwent MIE between June 2008 to June 2016 at a single tertiary care centre.Methods: A total of 103 esophagectomies were performed for esophageal malignancy which included 69 patients by minimally invasive technique. The procedure was performed by thoracoscopic mobilization of esophagus initially followed by reconstruction part done by either by minilaparotomy or by laparoscopic approach i.e. total thoracolaparoscopic esophagectomy (TLE).Results: The MIE was successfully completed in 65 (94.2%) patients. Operative time ranged from 275 to 420 min (average 356 min). The number of dissected lymph nodes were 5–15 (9 on average). The postoperative period was uneventful - without any complications in 36 (52.17%) patients. The most common postoperative complications were respiratory complications which were observed in 22 (31.88%) patients. Other complications included post-operative bowel obstruction (1 patient), anastomotic leak (4 patients), and necrosis of the gastroplasty (1 patient). One patient had chyle leak while cardiac complication was seen in three cases. The overall morbidity of patients underwent MIE was 47.8%. Thirty-day mortality was 5.79%.Conclusions: Esophagectomy performed by minimally invasive technique is a widely accepted surgical procedure for patients with middle and lower esophageal malignancy. The biggest benefit of MIE is avoidance of thoracotomy / laparotomy associated pain with resultant decrease in morbidity. The success of MIE requires a dedicated surgical team well trained in both MIE as well as in open surgical procedure.

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