Stenting of Malignant Urinary Tract Obstructions in Humans and Companion Animals

Urine retention secondary to neoplastic obstructions of the upper and lower urinary tracts is a life-threatening condition in both humans and companion animals. Stents can be placed to temporarily or permanently open obstructed urinary tract lumens and are often able to be placed using minimally invasive techniques with guidance via ultrasonography or fluoroscopy. The literature for these techniques is vast for humans and growing for companion animals. The below review provides a discussion of the principles of stenting and types of ureteral and urethral stents, as well as the techniques for placing these stents in humans and companion animals.

TREATMENT OF BRONCHIAL FISTULA ASSOCIATED WITH NON-SPECIFIC CHRONIC PLEURAL EMPYEMA: Review

The treatment of non-specific chronic pleural empyema with bronchial fistulae remains one of the most relevant issues in thoracic surgery. The question about the treatment phasing of bronchial fistulae associated with chronic pleural empyema is yet to be answered. Is it reasonable to seal a bronchial fistula before or after the sanitation and obliteration of the residual pleural cavity? The choice of bronchial fistula sealing technique is also a relevant issue because, in spite of the multitude of techniques, there is still no single doctrine. The terms of traditional and minimally invasive techniques aimed at bronchial fistula sealing and pleural cavity obliteration are not defined, either. This article summarises the opinions of leading authors presented in the literature concerning the solution of this complex, life-threatening problem.

Minimally Invasive Surgery in Emergency Surgery: A WSES Survey

Background: The diffusion of minimally invasive surgery in emergency surgery still represents a developing challenge. Evidence about the use of minimally invasive surgery shows its feasibility and safety, however the diffusion of these techniques is still poor. The aims of the present survey were to explore the diffusion and variations in the use of minimally invasive surgery among surgeons in the emergency setting.Methods: This is a web-based survey administered to all the WSES members investigating the diffusion of minimally invasive surgery in emergency. The survey investigated personal characteristics of participants, hospital characteristics, personal confidence in the use of minimally invasive surgery in emergency, limitations in the use of it and limitations to prosecute minimally invasive surgery in emergency surgery. Characteristics related to the use of minimally invasive surgery were studied with a multivariate ordinal regression.Results: The survey collected a total of 415 answers; 42.2% of participants declared a working experience >15 years and 69.4% of responders worked in tertiary level centre or academic hospital. In primary emergencies only28,7% of participants declared the use of laparoscopy in more than 50% of times. Personal confidence with minimally invasive techniques was the highest for appendectomy and cholecystectomy. At multivariate ordinal regression a longer professional experience, the use of laparoscopy in major elective surgery and bariatric surgery expertise were related to a higher use of laparoscopy in emergency surgery.Conclusions: The survey shows that minimally invasive techniques in emergency surgery are still underutilized. Greater focus should be placed on the development of dedicated training in laparoscopy among emergency surgeons.

Surgical Gynecology

Gynecology is principally an operative specialty and the range of gynecologic procedures managed is constantly expanding due to improved instrumentation and minimally invasive techniques. Covering the entire spectrum of gynecologic surgery through a case-based, digestible format, procedures such as vaginal, transvaginal, hysteroscopic, laparoscopic, robotic, and abdominal procedures are included, as well as common surgical challenges and complications. For each case, a clinical vignette outlines the situation and the clinical context of the patient, followed by a comprehensive discussion of the evidence-based management approach and key teaching points. The decision to operate, contraindications, alternatives to surgery and preoperative counseling is discussed in detail along with the level of care needed for each case. Readers will improve their knowledge base of gynecologic surgery and gain multiple tools to overcome common surgical obstacles.

Periodontally accelerated osteogenic orthodontics- A Literature review

Periodontics and Orthodontics often relates to a symbiotic relationship. Corticotomy was introduced as a surgical procedure to shorten orthodontic treatment time. This procedure involves the removal of cortical bone that strongly resists orthodontic force in the jaw. Though there are numerous studies done in the literature on PAOO, this review mainly focuses on the various comparative studies employed under this procedure. On the other hand, various modifications of this method such as minimally invasive techniques have been introduced to reduce the patient’s discomfort due to surgical intervention and complications after surgery. The present review focuses on the history of corticotomy, its mechanism of action, and various comparative studies done under PAOO.

Minimally Invasive Techniques Used for Caries Management in Dentistry. A Review

Objective: Minimally invasive techniques that use silver compounds and glass ionomer cement are suggested for caries management due to their effectiveness, simplicity, and low cost. The aim of this review is to examine the evidence supporting the use of silver compounds and glass ionomer cement in dentistry. Study design: Literature was searched using PubMed, Elsevier, EBSCO, Google scholar, AAPD and UABC’s database from 1958 to 2018 with the keywords: “Silver nitrate”, “silver diamine fluoride”, and “glass ionomer cement”. The selected studies were then fully read to prove their relevance for this review. Results: The use of glass ionomer cement and silver compounds were shown to be effective in arresting caries. These compounds reduce cariogenic microorganisms. Their chemical properties inhibit bacterial growth while promoting remineralization. They are simpler and less time consuming than conventional restorations. They also cause less discomfort and anxiety to patients. Silver compounds were shown to stain teeth and may burn the cornea if used in high concentration. These disadvantages limit the use of silver compounds to posterior teeth and require caution when handling. Conclusions: Minimally invasive therapies are easy to apply, non-invasive and affordable. Further studies should be done to provide more evidence of these techniques for caries management.