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Precision Surgery

Orhan Beger, Uğur Dinç, Burhan Beger, Deniz Uzmansel, Zeliha Kurtoğlu
PURPOSE: The main objective of this study is to showcase the growth dynamics of levator scapulae, rhomboid major, and rhomboid minor algebraically, to help plan surgeries on newborns and young infants. METHODS: Twenty-five formalin-fixed fetuses (11 male-14 female) with a mean gestational age of 21.80 ± 2.61 (range 18-27) weeks present in the inventory of Mersin University Faculty of Medicine Anatomy Department were dissected. Surface area of levator scapulae, rhomboid major, and rhomboid minor was calculated using digital image analysis software; width and length parameters were measured using digital calipers...
March 15, 2018: Surgical and Radiologic Anatomy: SRA
Tanchen Ren, Anne Faust, Yolandi van der Merwe, Bo Xiao, Scott Johnson, Apoorva Kandakatla, Vijay S Gorantla, Stephen F Badylak, Kia M Washington, Michael B Steketee
In peripheral nerve (PN) injuries requiring surgical repair, as in PN transection, cellular and ECM remodeling at PN epineurial repair sites is hypothesized to reduce PN functional outcomes by slowing, misdirecting, or preventing axons from regrowing appropriately across the repair site. Herein this study reports on deriving and analyzing fetal porcine urinary bladder extracellular matrix (fUB-ECM) by vacuum assisted decellularization, fabricating fUBM-ECM nerve wraps, and testing fUB-ECM nerve wrap biocompatibility and bioactivity in a trigeminal, infraorbital nerve (ION) branch transection and direct end-to-end repair model in rat...
March 14, 2018: Scientific Reports
B Borghese, P Santulli, L Marcellin, C Chapron
Endometriosis and adenomyosis are histologically defined. The frequency of endometriosis cannot be precisely estimated in the general population. Endometriosis is considered a disease when it causes pain and/or infertility. Endometriosis is a heterogeneous disease with three well-recognized subtypes that are often associated with each other: superficial endometriosis (SUP), ovarian endometrioma (OMA), and deep infiltrating endometriosis (DIE). DIE is frequently multifocal and mainly affects the following structures: the uterosacral ligaments, the posterior vaginal cul-de-sac, the bladder, the ureters, and the digestive tract (rectum, recto-sigmoid junction, appendix)...
March 11, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Piero Perucca, Ingrid E Scheffer, Michelle Kiley
The International League Against Epilepsy has recently published a new classification of epileptic seizures and epilepsies to reflect the major scientific advances in our understanding of the epilepsies since the last formal classification 28 years ago. The classification emphasises the importance of aetiology, which allows the optimisation of management. Antiepileptic drugs (AEDs) are the main approach to epilepsy treatment and achieve seizure freedom in about two-thirds of patients. More than 15 second generation AEDs have been introduced since the 1990s, expanding opportunities to tailor treatment for each patient...
March 19, 2018: Medical Journal of Australia
Émilie Liot, Nicolas Christian Buchs, Jacques Klein, Boris Schiltz, Philippe Morel, Frederic Ris
Patients with rectal cancer have an increased risk of developing sexual disorders. These dysfunctions are caused by the disease itself (negative psychological impact, nerve compression in the pelvis), as well as by the treatments (radiotherapy, chemotherapy and surgery). Most sexual disorders are due to the surgery and can be attributed to injuries of the retroperitoneal nerves. Sexuality assessment of patients before and after treatment, a precise knowledge of the pelvic anatomy by the surgeon, and an appropriate care by specialists (gynaecologists, urologists and sexologists) are essential to reduce the risk of sexual disorders and to minimize their impact on overall quality of life...
March 14, 2018: Revue Médicale Suisse
Carolina Torres, Paul J Grippo
Pancreatic ductal adenocarcinoma (PDAC) is projected to become the second cause of cancer-related deaths by 2020. Although it has traditionally been approached as one disease, accumulated evidences point to the clinical heterogeneity of this disease which translates into disparity in outcomes between patients. Much emphasis has been put into patient classification introducing a platform for more tailored therapies. In the last ten years, there have been important advances in the understanding of the molecular pathogenesis of PDAC, which has culminated with a comprehensive integrated genomic analysis from RNA expression profiles...
March 14, 2018: Annals of Medicine
An Yong-de, Zhu Wen-Jun, Guo Ya-Min, Han Xiu-Min
Echinococcosis is a zoonotic parasitic disease caused by the larvae of Echinococcus granulosus and E. multiltilocularis , which mainly violate the liver. And the surgical treatment is an important method to cure the disease at present. However, there are many surgical methods for the treatment of hepatic echinococcosis, and different surgeries with different indications and risks. With the standard of precision surgery and no tumor surgery, the surgical operation is more precise. The innovation of surgical methods makes the operation of curing complex hepatic echinococcosis become true...
February 26, 2018: Zhongguo Xue Xi Chong Bing Fang Zhi za Zhi, Chinese Journal of Schistosomiasis Control
P F Alesina, B Meier, J Hinrichs, W Mohmand, M K Walz
PURPOSE: Visualization and precise dissection of the parathyroid glands are a crucial step of thyroidectomy. Moreover, identification of parathyroid adenoma in patients with primary hyperparathyroidism can be challenging due to the possible abnormal location of the enlarged parathyroid. Near-infrared fluorescence (NIR) can be adopted during video-assisted neck surgery in addition to standard endoscopic magnification to enhance the visualization of the parathyroid tissue. METHODS: Between July and August 2017, five patients (one male, four females) underwent video-assisted neck surgery at our hospital...
March 13, 2018: Langenbeck's Archives of Surgery
Philipp Kauffmann, Anna Rau, Wilfried Engelke, Markus Troeltzsch, Phillip Brockmeyer, Lauer-Saridakis Dagmar, Robert Cordesmeyer
PURPOSE: Preoperative planning of the implant position as part of a coordinated prosthetic and surgical concept is becoming increasingly important regarding function and esthetics. The aim of this study was to investigate the transmission accuracy of template fixation during surgery in edentulous arches with hand fixation in comparison to intermediary screw fixation. MATERIALS AND METHODS: Preoperatively, 10 implant positions were planned using computed tomography (CT) with the system med3D for implant placement in four mandible models of the Goettingen study model, using a prosthetic diagnostic template...
March 2018: International Journal of Oral & Maxillofacial Implants
Jan Brandt, Martin Brenner, Hans-Christoph Lauer, Silvia Brandt
PURPOSE: The aim of this in vitro study was to evaluate the accuracy of template-guided implantation planned with implant-planning software (Implant Studio), comparing computer-aided design/computer-assisted manufacture (CAD/CAM)-based measurements with measurements via cone beam computed tomography (CBCT). MATERIALS AND METHODS: Thirty template-guided implantations were planned and performed on acrylic-resin models. The implant positions were detected with an intraoral scanner, evaluated with CAD quality-control software, and compared with the planned positions in the test group...
March 2018: International Journal of Oral & Maxillofacial Implants
Hannes Petersen, Alexandra Gliese, Yannick Stober, Stephanie Maier, Nils-Owe Hansen, Sebastian Kruber, Dennis Eggert, Miklós Tóth, Tobias Gosau, Hartmut Schlüter, Klaus Püschel, Udo Schumacher, Robert John Dwayne Miller, Adrian Münscher, Carsten Dalchow
OBJECTIVE: Using a contact-free laser technique for stapedotomy reduces the risk of mechanical damage of the stapes footplate. However, the risk of inner ear dysfunction due to thermal, acoustic, or direct damage has still not been solved. The objective of this study was to describe the first experiences in footplate perforation in cadaver tissue performed by the novel Picosecond-Infrared-Laser (PIRL), allowing a tissue preserving ablation. PATIENTS AND INTERVENTION: Three human cadaver stapes were perforated using a fiber-coupled PIRL...
April 2018: Otology & Neurotology
Fei Cong, Jia-Wei Wang, Bo Wang, Zhangyan Yang, Jing An, Zhentao Zuo, Zihao Zhang, Yu-Qing Zhang, Yan Zhuo
OBJECTIVES: To image the pedunculopontine tegmental nucleus (PPN), a deep brain stimulation (DBS) target for Parkinson disease, using MRI with validated results. METHODS: This study used the MP2RAGE sequence with high resolution and enhanced grey-white matter contrast on a 7-T ultra-high-field MRI system to image the PPN as well as a diffusion spectrum imaging method on a 3-T MRI system to reconstruct the main fibre systems surrounding the PPN. The coordinates of the rostral and caudal PPN poles of both sides were measured in relation to the third and fourth ventricular landmarks on the 7-T image...
March 12, 2018: European Radiology
Keisuke Sugahara, Yoshiharu Katsumi, Masahide Koyachi, Yu Koyama, Satoru Matsunaga, Kento Odaka, Shinichi Abe, Masayuki Takano, Akira Katakura
Background: Along with the advances in technology of three-dimensional (3D) printer, it became a possible to make more precise patient-specific 3D model in the various fields including oral and maxillofacial surgery. When creating 3D models of the mandible and maxilla, it is easier to make a single unit with a fused temporomandibular joint, though this results in poor operability of the model. However, while models created with a separate mandible and maxilla have operability, it can be difficult to fully restore the position of the condylar after simulation...
December 2018: Maxillofacial Plastic and Reconstructive Surgery
Angelo Castello, Laura Olivari, Egesta Lopci
Surgery, radiation therapy and chemotherapy are the oldest modalities for cancer treatment. However, as part of a continuous research in medicine, in order to improve therapeutic precision and biological effectiveness, there is an increasing interest into the use of heavy particle (e.g. protons or heavy ions) in the treatment of solid tumors. However, the restricted availability of the technology has concentrated the expertise in highly specialized centers that take care and treat extreme cases and rare pathologies...
2018: American Journal of Nuclear Medicine and Molecular Imaging
Sibylle C Mellinghoff, Jörg Janne Vehreschild, Blasius J Liss, Oliver A Cornely
BACKGROUND: Surgical site infections (SSIs) are among the most common hospital acquired infections. While the incidence of SSI in certain indicator procedures is the subject of ongoing surveillance efforts in hospitals and health care systems around the world, SSI rates vary markedly within surgical categories and are poorly represented by routinely monitored indicator procedures (eg, mastectomy or hernia surgery). Therefore, relying on indicator procedures to estimate the burden of SSI is imprecise and introduces bias as hospitals may take special precautions to achieve lower SSI rates...
March 12, 2018: JMIR Research Protocols
Andrea Franzini, Federico Legnani, Elena Beretta, Francesco Prada, Francesco DiMeco, Sergio Visintini, Angelo Franzini
BACKGROUND: Laminoplasty and laminectomy are two common surgical procedures utilized in approaching degenerative and neoplastic disease of the spinal canal. Routinely adopted instruments, such as Kerrison rongeur or high-speed drill (HSD), entail some potentially serious complications such as dura injuring and thermal and mechanical damage to neurovascular structures. We have adopted piezoelectric bone surgery, which permits a selective cut of mineralized tissues, to perform posterior procedures on the thoracic spine, where the relationship between bone and the spinal cord are critical...
March 9, 2018: World Neurosurgery
Germán L Farfalli, Jose I Albergo, Nicolas S Piuzzi, Miguel A Ayerza, D Luis Muscolo, Lucas E Ritacco, Luis A Aponte-Tinao
BACKGROUND: The treatment of locally aggressive bone tumors is a balance between achieving local tumor control and surgical morbidity. Wide resection decreases the likelihood of local recurrence, although wide resection may result in more complications than would happen after curettage. Navigation-assisted surgery may allow more precise resection, perhaps making it possible to expand the procedure's indications and decrease the likelihood of recurrence; however, to our knowledge, comparative studies have not been performed...
March 2018: Clinical Orthopaedics and related Research
John A Abraham, Barry Kenneally, Kamil Amer, David S Geller
BACKGROUND: Navigation-assisted resection has been proposed as a useful adjunct to resection of malignant tumors in difficult anatomic sites such as the pelvis and sacrum where it is difficult to achieve tumor-free margins. Most of these studies are case reports or small case series, but these reports have been extremely promising. Very few reports, however, have documented benefits of navigation-assisted resection in series of pelvic and sacral primary tumors. Because this technology may add time and expense to the surgical procedure, it is important to determine whether navigation provides any such benefits or simply adds cost and time to an already complex procedure...
March 2018: Clinical Orthopaedics and related Research
Matthew G Crockett, Marcus J Drake
PURPOSE OF REVIEW: Benign prostatic obstruction (BPO) is a common cause of lower urinary tract symptoms (LUTS) in elderly men. However, such symptoms are often caused by primary detrusor overactivity or underactivity. Surgical management where BPO is absent or merely incidental has a lower chance of success, and exposes the patient to the potential complications of surgery. This review discusses the diagnostic challenges facing this common presentation. RECENT FINDINGS: Most evidence comes from small, historical prospective cohort studies...
March 9, 2018: Current Opinion in Urology
Marina Roizenblatt, Thomas L Edwards, Peter L Gehlbach
Vitreoretinal microsurgery is among the most technically challenging of the minimally invasive surgical techniques. Exceptional precision is required to operate on micron scale targets presented by the retina while also maneuvering in a tightly constrained and fragile workspace. These challenges are compounded by inherent limitations of the unassisted human hand with regard to dexterity, tremor and precision in positioning instruments. The limited human ability to visually resolve targets on the single-digit micron scale is a further limitation...
2018: Robotic Surgery: Research and Reviews
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