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Surgical innovation

Eddie Y Liu, Bo Li, Cindy M L Hutnik
Wet lab and surgical simulation can reduce the learning curve of difficult surgical techniques, accelerate the rate for trainees to achieve surgical competency, and improve patient safety. To provide the most up-to-date information and hands-on experiences with novel ophthalmic surgical techniques and instruments, the Department of Ophthalmology at Western University has created a wet lab-based, multilevel microsurgery skills transfer course through collaboration with various industry partners. Several elements in the course goal and design differentiate this type of surgical course from typical wet labs: the format is multileveled surgical training, with a beginner level targeting undergraduate medical students, an intermediate level for ophthalmology residents, and an advanced level for trained ophthalmologist...
October 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Joel E Abbott, Roger L Sur
The aim of this paper was to evaluate the current technology and designs of flexible ureterorenoscopes. We will review contemporary fiberoptic and digital ureteroscopes, including a discussion on ureteroscope damage and repair, and lastly present the projected future of flexible ureterorenoscopy. Ureterorenoscopy has evolved dramatically over the past several decades, which has led to landscape reshaping of stone disease treatment and upper tract pathology. Advancements in tip control, miniaturization of scopes, introduction of a digital chip on the tip, disposable devices to augment surgery, surgical experience/familiarity and most recently single use scopes are all independent factors that have increased flexible ureterorenoscopy adoption and success...
October 19, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Giovanni Galluccio
Tracheo-oesophageal fistulas represent a major complication of prolonged intubation and may cause death. Surgical repair is a complex procedure that can be challenging in compromised patients. In this study, we describe a simple endoscopic technique that resulted in the effective palliation of symptoms.
2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Nidal Farhan Al Deek, Donald H Lalonde
Fu-Chan Wei is a world-renowned plastic and reconstructive surgeon. He is clearly one of the most influential and innovative surgeons in the history of plastic surgery. The Taiwanese legend is the innovator of the osteoseptocutaneous fibula flap, which revolutionized the reconstruction of composite bone and soft tissue defects in the jaw and extremities. He has pioneered several perforator flaps, including the free style variety. He has taken toe-to-hand microsurgical transplantation to a whole new level. He is not only recognized for his surgical skills and clinical innovations, but also for his vision, leadership, and teaching...
September 2016: Plastic and Reconstructive Surgery. Global Open
Anil Gungor
Pediatric OSAS and craniofacial malformations present challenges that require innovative approaches and comprehensive treatment strategies. Synchronous airway lesions, craniofacial malformations, obstructive anomalies of the tongue base, nasal vault and choanae are commonly addressed by subspecialists from various clinical and surgical academic traditions who practice variable levels of required communication. This is not a mere social requirement but an important requisite for intelligent and effective airway management...
September 28, 2016: American Journal of Otolaryngology
Francesco Carlino, Gian Piero Villani, Andrea Berti, Giuseppe Pantaleo, Antonio Cortese, Pier Paolo Claudio
Aim of this work is to present the evolution of an innovative technique for tooth/implant supported bone distraction, leading to proper oral rehabilitation in patients with atrophic alveolar bone, even when a complete premaxilla expansion is needed, or in patients in whom implants were already present, but inserted in wrong position.Distraction osteogenesis was selected because of its moderate invasiveness, the few surgical steps needed, and the proper cost/benefits balance. This procedure is particularly suited for young patients with remarkable aesthetic demands related to active social and working life, as for elderly patients expecting lower surgical stress and risks...
October 14, 2016: Journal of Craniofacial Surgery
Marko Poglitsch
Primary aldosteronism (PA) is severe form of hypertension characterized by a strongly increased aldosterone secretion mediated by adenomas or other forms of adrenal hyper-activity. Once detected, PA can be usually cured by either surgical intervention or by appropriate pharmacologic treatments. The incidence of PA among hypertensive patients varies strongly between different studies, which is in part caused by the complex state-of-the-art testing procedure that is unfortunately far away from being a versatile PA screening tool...
September 2016: Journal of Hypertension
Anita Mohandas, Chris Summa, W Bradley Worthington, Jason Lerner, Kevin T Foley, Robert J Bohinski, Gregory B Lanford, Carol Holden, Richard N W Wohns
STUDY DESIGN: Delphi Panel expert panel consensus and narrative literature review OBJECTIVE.: To obtain expert consensus on best practices for patient selection and perioperative decision making for outpatient anterior cervical surgery (anterior cervical disc fusion (ACDF) and cervical total disc replacement (CTDR)). SUMMARY OF BACKGROUND DATA: Spine surgery in ambulatory settings is becoming a preferred option for both patients and providers. The transition from traditional inpatient environments has been enabled by innovation in anesthesia protocols and surgical technique, as well as favorable economics...
October 6, 2016: Spine
Baldwin Yeung, Philip Chiu, Anthony Teoh, Linfu Zheng, Shannon Chan, Kelvin Lam, Raymond Tang, Enders K W Ng
Background and study aims: Submucosal tunnelling endoscopic resection (STER) is a novel endoscopic technique to remove submucosal tumour (SMT). We propose a novel, low cost simulator for training of techniques for STER. Patients and methods: The model consisted of an ex-planted porcine oesophagus, stomach and duodenum with marbles embedded surgically in the submucosal plane. Two expert endoscopists with experience in submucosal tunnelling and 5 board-certified endoscopists with no experience in submucosal tunnelling were recruited...
October 2016: Endoscopy International Open
Frank-Martin Haecker, Sergio Sesia
BACKGROUND: For specific therapy to correct pectus excavatum (PE), conservative treatment with the vacuum bell (VB) was introduced more than 10 years ago in addition to surgical repair. Preliminary results using the VB were encouraging. We report on our 13-year experience with the VB treatment including the intraoperative use during the Nuss procedure and present some technical innovations. METHODS: A VB with a patient-activated hand pump is used to create a vacuum at the anterior chest wall...
September 2016: Annals of Cardiothoracic Surgery
Thomas H Hartranft, Kurt Yandle, Tim Graham, Charles Holden, Lowell W Chambers
OBJECTIVE: This study was conducted to assess the effectiveness of a newly implemented electronic web-based review system created at our institution for evaluating resident performance relative to established milestones. DESIGN: Retrospective review of data collected from a survey of general surgery faculty and residents. SETTING: Tertiary care teaching hospital system and independent academic medical center. PARTICIPANTS: A total of 12 general surgery faculty and 17 general surgery residents participated in this study...
October 13, 2016: Journal of Surgical Education
S M Johnson, G M Garnett, R K Woo
Maintenance of central venous access in patients with chronic medical conditions such as short bowel syndrome demands forethought and ingenuity. We describe an innovative technique for re-utilizing central venous access sites in patients who have chronic central venous access needs. Records of patients undergoing this technique were reviewed between August 2012 and December 2015. The technique involves "cutting-down" to the sterile fibrous tunnel that naturally forms around tunneled catheters. The fibrous sheath is then isolated and controlled much as would be done for a venous "cut-down...
October 14, 2016: Pediatric Surgery International
Russell S Frautschi, Brianna Halasa, Susan Orra, Karolina Mlynek, Charles P Steiner, Francis A Papay
The sphenopalatine ganglion is an extracranial neural structure within the pterygopalatine fossa. Modulation of this region via implantation of a neuromodulatory device presents a novel therapy for the treatment of facial and head pain. Yet sex, race, and genetic factors contribute to morphological variations between individuals. This study defines the standards and variations of the bony landmarks surrounding the pterygopalatine fossa. One hundred dry skulls were analyzed from the Hamann-Todd osteological collection...
October 2016: Journal of Craniofacial Surgery
Ricardo Zorron, Alcides Branco, Jose Sampaio, Claudia Bothe, Tido Junghans, Gyurdzhan Rasim, Johann Pratschke, Safak Guel-Klein
BACKGROUND: The anatomical and physiological changes after Roux-en-Y gastric bypass for morbid obesity can lead to severe hyperinsulinemic hypoglycemia with neuroglycopenia in a small percentage of patients. The exact physiologic mechanism is not completely understood. Surgical reversal to the original anatomy and distal or total pancreatectomy are current therapeutic options to reverse the hypoglycemic effect, with substantial associated morbidity. Our group reports a pilot clinical series of a novel surgical technique using one-anastomosis jejunal interposition with gastric remnant resection (Branco-Zorron Switch)...
October 13, 2016: Obesity Surgery
Yung-An Tsou, Yi-Wen Liu, Wen-Dien Chang, Wei-Chen Chen, Hsiang-Chun Ke, Wen-Yang Lin, Hsing-Rong Yang, Dung-Yun Shie, Ming-Hsui Tsai
Objective. Autologous fat injection laryngoplasty is ineffective for some patients with iatrogenic vocal fold paralysis, and additional laryngeal framework surgery is often required. An acoustically measurable outcome predictor for lipoinjection laryngoplasty would assist phonosurgeons in formulating treatment strategies. Methods. Seventeen thyroid surgery patients with unilateral vocal fold paralysis participated in this study. All subjects underwent lipoinjection laryngoplasty to treat postsurgery vocal hoarseness...
2016: BioMed Research International
Francesco Giannini, Andrea Aurelio, Alaide Chieffo
Refractory angina is a chronic condition characterized by the presence of disabling symptoms due to severe obstructive coronary artery disease not improved by either optimal medical therapy and/or percutaneous or surgical revascularization. Mortality rates associated with this condition are quite low in clinically stable patients on optimal medical therapy. However, rehospitalization rates are high. In this subgroup of patients there is thus a clinical need for new therapies targeting an improvement of symptoms but taking into account the potential impact in terms of healthcare and costs...
October 2016: Giornale Italiano di Cardiologia
Ka Hei Chan, Rahul Krishnan, Michael Alexander, Jonathan Rt Lakey
The islets of Langerhans are endocrine tissue clusters that secrete hormones that regulate the body's glucose, carbohydrate and fat metabolism, the most important of which is insulin, a hormone secreted by β cells within the islets. In certain instances, a person's own immune system attacks and destroys them leading to the development of Type 1 diabetes (T1D), a lifelong condition that needs daily insulin administration to maintain health and prolong survival. Islet transplantation is a surgical procedure that has demonstrated the ability to normalize blood sugar levels for up to a few years, but the need for chronic immunosuppression relegates it to a last resort that is often only used sparingly, and in seriously-ill patients...
October 10, 2016: Cell Transplantation
Yaoping Shi, Jianfeng Wang, Zhibin Bai, Yonggang Li, Longhua Qiu, Bo Zhai, Feng Zhang, Xiaoming Yang
Despite recent advances in surgical technique and treatment strategies for esophageal cancer (EC), to effectively manage the advanced (metastatic or disseminated) and recurrent EC still remain a great challenge. The aim of this study was to determine the feasibility of using intra-esophagus radiofrequency hyperthermia to enhance local HSV-TK/ganciclovir-mediated suicide gene therapy of an innovative animal models with orthotopic esophageal squamous cancers. Human esophageal squamous cancer (ESCa) cells were labeled with lentivirus/luciferase...
2016: American Journal of Cancer Research
Petra E Dijkman, Emanuela S Fioretta, Laura Frese, Francesco S Pasqualini, Simon P Hoerstrup
The incidence of severe valvular dysfunctions (e.g., stenosis and insufficiency) is increasing, leading to over 300,000 valves implanted worldwide yearly. Clinically used heart valve replacements lack the capacity to grow, inherently requiring repetitive and high-risk surgical interventions during childhood. The aim of this review is to present how different tissue engineering strategies can overcome these limitations, providing innovative valve replacements that proved to be able to integrate and remodel in pre-clinical experiments and to have promising results in clinical studies...
July 2016: Transfusion Medicine and Hemotherapy
Jacques Balayla
The uterine transplant is an innovative surgical procedure whereby a healthy uterus is transplanted into a woman with uterine factor infertility (UFI) for the purpose of procreation. Twelve uterine transplants have been attempted in the world in the last two decades, and five have led to viable births. While uterine transplantation is still in its experimental stages, it remains unclear whether Canadian centres plan to attempt the procedure in the near future. Herein, I raise several observations that are specific to the Canadian setting and apply the Montreal Criteria for the Ethical Feasibility of Uterine Transplantation to determine whether there is fertile ground for a uterine transplantation program to be adopted in Canada...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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