Surgical Technique
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2021 ◽  
Vol 47 (6) ◽  
pp. 1219-1227
Daniel Hampl ◽  
Leandro Koifman ◽  
Ricardo de Almeida ◽  
Marcio Ginsberg ◽  
Francisco J. B. Sampaio ◽  

2021 ◽  
Vol 7 (4) ◽  
pp. 1-5
Cristianne Confessor Castilho Lopes ◽  

Obesity is a chronic disease described by the large amount of body fat that leads to an increase in Body Mass Index (BMI). It is subdivided into three levels, being grade I with a BMI between 30 and 34.9 kg/m2, grade II between 35 and 39.9 kg/m2 and grade III or morbid obesity with a BMI above 40 kg/m2. Aiming at reversing the morbid condition caused by the disease, the bariatric surgical technique presents itself as the most effective option to contain grade III obesity, as well as the associated co morbidities. The objective of surgical techniques is to improve the quality of life of the obese, reducing both physical and psychosocial problems. As endocrine disease is related to several co morbidities, such as high blood pressure, sleep apnea and even some types of cancer, it is necessary to carry out an investigation into the surgical technique to be applied as well as its effectiveness during and after the surgical procedure.

2021 ◽  
pp. 019459982110444
Tiffany Peng Hwa ◽  
Garrett Locketz ◽  
Michael J. Ruckenstein

We report our experience using a novel minimally invasive surgical technique for implantation of a fully implantable active bone conduction implant. This was a retrospective review of 16 adults, including 10 women and 6 men. The mean age was 54 years. Hearing loss profiles included 8 with mixed hearing loss, 5 with conductive hearing loss, and 3 with single-sided deafness. Nine patients underwent placement through the standard approach and 7 with the minimally invasive approach. There were no postoperative complications at a mean follow-up of 6.5 months (SD, 4; range, 1.5-12), and all patients received audiologic benefit with objective improvement in sound-field thresholds upon activation. Mean operative time was shorter with the minimally invasive approach (64 vs 41 minutes, P = .01). The fully implantable bone-anchored auditory implant can be effectively placed via a minimally invasive incision, with potential benefits of decreased operative time, low risk for intra- and postoperative complications, and rapid healing.

2021 ◽  
pp. 175319342110512
Derek B. Asserson ◽  
Taylor J. North ◽  
Peter C. Rhee ◽  
Allen T. Bishop ◽  
Jeffrey S. Brault ◽  

A retrospective review of hospital employees at a single employer institution who underwent ultrasound guided thread carpal tunnel release (TCTR) or open carpal tunnel release (OCTR) between January 2018 and August 2020 was performed to ascertain differences in return-to-work status. Patient age, sex, occupation, handedness, severity of carpal tunnel syndrome, prior treatments and surgical outcomes were reviewed. A total of 18 patients underwent TCTR and 17 patients underwent OCTR. The TCTR group averaged 12 days to return to work without restrictions, as opposed to 33 days for the OCTR group. Resolution of symptoms was afforded in all patients without any complications regardless of surgical technique. While both TCTR and OCTR were effective, our data indicates that TCTR resulted in a shorter return to work. Level of evidence: III

2021 ◽  
Mohammad H Abul

Abstract Background Crocodile tear syndrome (CTS) is a condition characterised by excessive tear secretion in response to eating, drinking, or smelling foods. Traditionally, acquired cases are most commonly reported following facial nerve trauma or paralysis, or in slow-growing facial nerve tumours. More recently, it has been reported following vestibular Schwannoma surgery. We report the first case of crocodile tear syndrome following microvascular decompression of the trigeminal nerve. Case presentation A 61-year-old lady presented with excessive lacrimation and clear rhinorrhoea one month post-operatively from a re-do trigeminal microvascular decompression surgery. The patient experienced similar symptoms following her initial surgery two years prior, which had resolved spontaneously. CT and MRI head, and comprehensive clinical examination showed no evidence of CSF rhinorrhoea or cause of her symptoms. An ENT opinion was sought, and the patient was diagnosed with post-operative crocodile tear syndrome.Literature review revealed no reported cases of CTS following microvascular decompression of the trigeminal nerve. Surgical technique and relevant imaging were reviewed for any possible explanation for the condition. Considering the accepted pathogenesis of CTS, we discuss the aetio-pathogenesis for the development of the condition following this procedure. Conclusions We conclude CTS should be considered in patients presenting with rhinorrhoea following microvascular decompression of the trigeminal nerve. In patients presenting with post-operative rhinorrhoea after MVD, after excluding CSF leak, CTS should be considered as a potential differential diagnosis. Treatment for CTS in this context may pose a challenge. The patient has undergone botulinum toxin injection of the lacrimal gland and will need long term follow up. This is the first documented case of CTS post microvascular decompression of the trigeminal nerve.

2021 ◽  
Vol 10 (13) ◽  
pp. e161101320915
Monique Gonçalves da Costa ◽  
Anderson Maikon de Souza Santos ◽  
Mirela Caroline Silva ◽  
Tiburtino José de Lima Neto ◽  
Eduardo Dallazen ◽  

Extraction is one of the most common procedures performed by dental surgeons in their daily clinical practice. Among the trans and postoperative complications associated with this procedure can be mentioned the occurrence of trismus, infections, edema, alveolitis, paresthesia or fractures. The purpose of this study was to report a clinical case of a mandibular fracture associated with first molar extraction, approaching its main risk factors and treatment. Patient JSS, 24 years old, female, was referred to the service of Maxillofacial Surgery due to complications resulted from the extraction of element 36. On physical examination, was observed the presence of fragment mobility, communication of bone tissue with the oral environment and pain complaint was reported by the patient. Computed tomography showed the presence of a fracture in the region of the mandibular body on the left side. The planned surgical proposal was the intraoral debridement of bone fragments, extraoral access in the base of the mandible, fixation of the fracture with plate 2.4 and intraoral and extraoral access suture. During the surgical procedure, it is of great importance that the dental surgeon be aware to the signals emitted by the patient, such as clicks associated with severe pain, profuse bleeding or crackling as these symptoms may be the result of mandibular fracture. When any of these signs are found during the operation, the professional must investigate the occurrence of a possible fracture. It is concluded that in addition to performing a good preoperative evaluation, the dental surgeon must carry out a correct planning of the surgical act based on the basic principles of the surgical technique.

2021 ◽  
Vol 3 (30) ◽  
pp. 21-29
Vijay Vaghela ◽  

This review was undertaken to compare the effects of surgically assisted rapid palatal expansion (SARPE) and mini-screw assisted rapid palatal expansion (MARPE). Discrepancies in the transverse relation between maxillary and mandibular dentition can result in the development of posterior cross bite. For the correction of posterior cross bite, maxillary expansion is frequently undertaken. The conventional approach for maxillary expansion includes expansion screw being anchored to the maxillary teeth and is known and rapid palatal expansion (RPE) appliance. However, RPE can only be applied in growing individuals and is not as effective in late adolescents and adults. In such patients, surgically assisted rapid palatal expansion (SARPE) technique is used to expand the maxillary arch. As this procedure involves surgery, it deters many patients from choosing SARPE as a treatment option. Recently a non-surgical technique of expansion of maxillary arch has been introduced that can be applied to late adolescents and adults using palatal mini-screws. This technique is known as mini-screw assisted rapid palatal expansion (MARPE). In this review, the studies in the current literature regarding the SARPE and MARPE expansion techniques as compared to conventional RPE were included. It was observed that both SARPE and MARPE are effective methods for achieving maxillary expansion. With both techniques being effective, the advantage of MARPE over SARPE is the non-surgical approach which leads to higher patient acceptance and lower rate of complications.

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Sherief Azzab ◽  
Ahmed Samy ◽  
Hamdy Singab ◽  
Mohamed EL Ghanam ◽  
Ahmed Tarek

Abstract Background The optimal timing, surgical technique and the influence of Down syndrome on outcome of surgical repair of Complete Atrio-Ventricular Canal Defect (CAVC) remains uncertain. We reviewed our experience in repair of CAVC to identify the influence of these factors on operative outcome. Methods A prospective study included 70 patients who underwent repair of CAVC at Ain Shams university hospitals, academy of cardiothoracic surgery during the period from July 2016 to October 2019. Age at surgery (less than 6 months old versus later), surgical technique used [(modified single patch versus double patch technique), (use of posterior annuloplasty for repair of left AV valve or not)] and association of Down syndrome were evaluated for their impact on the outcome of surgical repair using multivariate analysis. Patients were followed up for 6 months; primary end point was mortality and secondary end point was reappearance of LAVV regurgitation. Results No significant difference between patients operated on, at the first 6 months of age versus later, regarding mortality or LAVV regurgitation. Down patients showed significant difference in the occurrence of postoperative compared to non-Down patients (LAVVR grade 2 + = 8.9% vs 24%, P value =0.005) respectively. Surgical repair by Modified single patch technique showed significant reduction in cross clamp time (mean = 47.6 ± 9.227 min vs 73.55 ± 21.087 min, P value 0.00), shorter bypass time (mean = 71.13 ± 13.507 min vs 99.19 ± 27.092 min, P value =0.00) and shorter duration of ICU stay (mean =3.2 ± 1.657 days vs 5.3 ± 2.761 days, P value=0.01) as compared to double patch technique. Posterior annuloplasty used for repair of LAVV compared to closure of cleft only resulted in significant reduction in the occurrence of post-operative valve regurgitation during the early period (LAVVR 2+ 43% vs 7%, P value=0.03) and at 6 months of follow up. (LAVVR 2+ 35.4% vs 0%, P value=0.01) respectively. Conclusion early intervention, in the first 6 months in patients with CAVC by surgical repair gives comparable acceptable results to later repair, Down syndrome was not found to be a risk factor for early intervention. Modified single patch and double patch techniques for repair, can be used both with comparable results even in large VSD component (8mm and larger), finally, repair of common AV valve by cleft closure with posterior LAV annulplasty showed better results with significant decrease in postoperative LAV regurgitation and early mortality in comparison to closure of cleft only.

Hernia ◽  
2021 ◽  
N. Christou ◽  
F. Ris ◽  
D. Naumann ◽  
J. Robert-Yap ◽  
M. Mathonnet ◽  

Abstract Introduction Surgical site infections (SSIs) following groin hernia repair (GHR) are getting rarer in high income countries despite a wider use of meshes. Among the risk factors for SSIs, those related to the mesh and the surgical technique have rarely been described. Methods A registry-based multicenter study using prospectively collected data, including SSIs and their potential risk factors, was conducted in the French Hernia-Club. Results Between 2012 and 2019, 21,976 consecutive unselected adult patients aged 64.8  ±  15.4 years old (88.9% male) underwent GHR (83.5% unilateral). Fifty four percent were laparoscopic; 97.6% used mesh. The overall incidence of SSI was 0.26%. The incidence of SSI was respectively, 0.24% and 0.19% (p  =  0.420) in open vs laparoscopic repairs; 0.19% and 0.25% (p  =  0.638) for polyester vs polypropylene mesh; In adjusted multivariate analysis focusing on macroporous meshes (which were the most implanted meshes: 23,148 out of 24,099), there were no differences in terms of SSIs’ rates regarding the technique: open versus laparoscopy (p  =  0.762) nor the type of mesh used: polypropylene versus polyester (p  =  0.557). Conclusion The rate of SSI following GHR was low in this large registry study. Mesh type and surgical technique did not affect SSIs rates. Caution is advised when interpreting these data due to this very low rate of SSI and the potential for a type II error.

Raghbir S. Khakha ◽  
Hamid Rahmatullah Bin Abd Razak ◽  
Kristian Kley ◽  
Ronald van Heerwaarden ◽  
Adrian J. Wilson

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