-
Plica Semilunaris Sub-Tenon Approach Retrobulbar Anesthesia for Posterior Segment Surgery
Patel SN,
Langer PD,
Bhagat N
Issue:
Volume 1, Issue 2, June 2013
Pages:
12-13
Received:
14 April 2013
Published:
30 May 2013
Abstract: Purpose: To describe a surgical technique to access the posterior sub-Tenon’s space through a plica semilunaris incision where retrobulbar anesthesia is given in a safe and consistent manner. Methods: A modified technique for retrobulbar anesthesia with fewer complications. Results: This anesthetic approach has been used consistently and effectively in con-trolling intraoperative pain in 581 eyes undergoing both 20-gauge and small gauge pars plana vitrectomy over the last 5 years at our institution. Conclusion: Retrobulbar anesthesia through a plica semilunaris incision using a blunt cannula may have a better safety profile than the intraconal approach using a sharp needle.
Abstract: Purpose: To describe a surgical technique to access the posterior sub-Tenon’s space through a plica semilunaris incision where retrobulbar anesthesia is given in a safe and consistent manner. Methods: A modified technique for retrobulbar anesthesia with fewer complications. Results: This anesthetic approach has been used consistently and effectivel...
Show More
-
Nasopalatine Duct Cyst: Report of 52 Cases in a Retrospective Epidemiological Study
Francesco Cecchetti,
Matacena Giada,
Cicciù Marco,
Francesco Germano,
Claudio Arcuri,
Bramanti Ennio
Issue:
Volume 1, Issue 2, June 2013
Pages:
14-17
Received:
12 May 2013
Published:
10 June 2013
Abstract: Introduction. Nasopalatine duct cysts (NPDCs) are the most common developmental epithelial non-odontogenic cysts of the upper maxilla. Their etiological origin is still uncertain; NPDCs are often asymptomatic and are usually found randomly through local radio-diagnostic investigations carried out for other reasons. Main body. The aim of this investigation is to analyze and discuss the etiology, differential diagnosis, clinic-pathological characteristics of these lesions as well as to report the relative frequency and distribution of nasopalatine duct cysts in general population (NPDCs) with a literature’s review on the topic. The retrospective study was carried out using 52 clinical cases, with histopatological confirmation for NPDC, radiographs and oral photographs. Data included age and gender of the patient, radiographic findings, etiological factors, treatment, and prognosis of NPDC. Few surgical consideration are discussed. The study results report a NPDCs’ incidence of 2.39% and a male predilection with a 2:1.25 ratio. No statistically significant correlation was observed between the size of the lesion and patient’s gender. Lesions were usually asymptomatic (73%). All cysts were located in the anterior maxillary midline region. Panoramic X-rays and computed tomography was used to identify the lesion. Surgical treatment was performed under local anesthesia including the dissection and the removal of the cyst, usually adopting a palatine approach with an enveloping flap from 1.4 to 2.4. Relapse occured in 15.4% of the cases. Conclusions. The etiology of NPDC is unclear and a male predilection was observed. The histological analysis of cystic lesions was fundamental for the final diagnosis. Simple surgical resection was recommended, followed by clinical and radiological control to ensure the correct and complete resolution of the case.
Abstract: Introduction. Nasopalatine duct cysts (NPDCs) are the most common developmental epithelial non-odontogenic cysts of the upper maxilla. Their etiological origin is still uncertain; NPDCs are often asymptomatic and are usually found randomly through local radio-diagnostic investigations carried out for other reasons. Main body. The aim of this invest...
Show More
-
Association of Gastro-Oesophageal Reflux Disease with Oesophageal Stricture: What can be Done to Prevent It
Abdulzahra Hussain,
Tahir Chohan,
Ali Adnan,
Shamsi El-Hasani,
Maxwell Asante
Issue:
Volume 1, Issue 2, June 2013
Pages:
18-21
Received:
6 May 2013
Published:
10 June 2013
Abstract: Objectives: GORD is associated with benign oesophageal stricture. Endoscopic management of which is safe, effective and commonly applied. The aim of this study is to assess the causes of benign oesophageal stricture,the outcome of endoscopic management and to explore the literatures on ways of preventions. Patients and Methods: Data from our endoscopy unit was reviewed using unisoft software. Seventy -one patients who have been diagnosed with oesophageal strictures during March 2006-January 2012,were selected for this study. Twelve oesophageal cancers, 4 patients with achalasia and 6 patients with anastomotic stricture were excluded. The data was collected from case notes of the remaining forty-nine patients. Results: Forty-nine patients were diagnosed with symptomatic benign stricture due to reflux disease and inflammation (47 and 2 patients respectively). The age range was 38-92 (mean 59), 17(34.7%) women and 32(65.3%) men were included. 42(85.71%) patients underwent dilatation, of which 88.7% had 1-4 dilatations (mean of 2 dilatations). The remaining 14.28% (6 patients) had very tight strictures and each had 5-7 dilatations. One (2.04%) patient had anti-reflux surgery. Six (12.24%) patients were treated conservatively using proton pump inhibitors and they didn’t need dilatation. There were 34 patients developed minor morbidities such as chest pain (11%); minor bleeding (15) and nausea (3%),no oesophageal perforation or other major complications were reported. Conclusions: Endoscopic dilatation for benign oesophageal stricture is a safe and an effective procedure. Follow up of younger patients are necessary to achieve satisfactory symptomatic relief and to prevent advanced and severe stricture developing at a later age.
Abstract: Objectives: GORD is associated with benign oesophageal stricture. Endoscopic management of which is safe, effective and commonly applied. The aim of this study is to assess the causes of benign oesophageal stricture,the outcome of endoscopic management and to explore the literatures on ways of preventions. Patients and Methods: Data from our endosc...
Show More
-
Continent Urinary Diversion with Short Appendices in Obese Patients: the Initial Results of a Surgical Option
Marcelo Ferreira Cassini,
Antônio Antunes Rodrigues Júnior,
Carlos Augusto Fernandes Molina,
Adauto José Cologna,
Alessandra Mazzo,
SílvioTucci Júnior
Issue:
Volume 1, Issue 2, June 2013
Pages:
22-27
Received:
15 May 2013
Published:
10 June 2013
Abstract: Introduction: Many patients need to be submitted to a continent urinary derivation surgery. Lost of bladder compliance secundary to neurogenic bladder injuries, severe and untractable urethral stenos is are some of the main indications. We present here the initial results and outcomes of twelve procedures performed using the association between Mitrofanoff’s principle and Monti’s technique as a surgical option for a continenturinarydiversion in patients with short appendices or obese. Materials and Methods: We analyzed data from twelve patients who were submitted to ileocistoplasty and urinary continent derivation by association between Mitrofanoff’s principle and Monti’s technique performed from january2009 to december 2012 in our institution. In all patients the appendices were too short to reach the skin, some of them, because the obesity. Results: Twelve patients were submitted to the Mitrofanoff and Monti techniques association. The most common surgical complications were stoma skin stenosis (02 cases) and urinary leakage through the re-opened bladder neck in 02 patients. Urinary infection (01 sepse) was the main clinical complication. Eleven patients are totally adapted to intermittent clear catheterization through the naveland satisfyed with urinary continence and quality of life.There were no deaths and no urinary or intestinal fistulas secondary to the procedure. Conclusions: The association between Mitrofanoff’s principle and Monti’s technique is safe, feasible and a very useful alternative in urologic cases, (i.e., severe and untractable urethral stenos is and low compliance neurogenic bladder, for example) of continent urinary diversion, when the ileocecal appendix is too short to reach the skin (i.e., obese patients).
Abstract: Introduction: Many patients need to be submitted to a continent urinary derivation surgery. Lost of bladder compliance secundary to neurogenic bladder injuries, severe and untractable urethral stenos is are some of the main indications. We present here the initial results and outcomes of twelve procedures performed using the association between Mit...
Show More
-
Preliminary Analysis of a New Ergonomic System for Surgical Instruments Used in Laparoscopy
Arturo Minor Martínez,
Ricardo Ordorica Flores,
Alfredo Vázquez Huerta,
José Luis Ortiz Simón
Issue:
Volume 1, Issue 2, June 2013
Pages:
28-31
Received:
10 May 2013
Published:
30 June 2013
Abstract: Background. The laparoscopic surgeon requires very fine motor dexterity to perform complex surgical procedures. This skill can be significantly altered by the motor stress of the surgeon, which mainly results from a lack of ergonomics of the instruments. The objective of this article was to analyse a new ergonomic system that can significantly reduce motor stress. Material and Methods. Two expert surgeons tested the new ergonomic system by performing transfer and suture tasks. The results were compared to those obtained from executing the same tasks using commercial laparoscopic instruments, without any pre-selection being established. Electronic switches were placed on the handles of the instruments to register the time of opening and closure, as well as the time taken to complete the tasks. Results. The comparative data indicate that the new ergonomic system substantially reduces the motor stress of the surgeon by reducing the number of manual operations needed to carry out the routine training tasks of transfer and suture. Conclusions. A new ergonomic system has been developed that reduces the number of manual operations required for carrying out the same task using commercial laparoscopic instruments. The execution time and motor stress is substantially decreased with this new design. We have confidence that these results will be extended to surgical procedures.
Abstract: Background. The laparoscopic surgeon requires very fine motor dexterity to perform complex surgical procedures. This skill can be significantly altered by the motor stress of the surgeon, which mainly results from a lack of ergonomics of the instruments. The objective of this article was to analyse a new ergonomic system that can significantly redu...
Show More
-
Different Surgical Treatment of Post-Burn Contracture of Foot and Ankle Joint
Issue:
Volume 1, Issue 2, June 2013
Pages:
32-36
Received:
14 May 2013
Published:
30 June 2013
Abstract: The foot and ankle scar post burn contractures are the result of deep partial and full-thickness burns that affect foot motion, impair the lower extremity function and benefit from surgical reconstruction. 76 patients (ages 2-46) with post burn foot and ankle joint contractures were treated at the Inter-regional Burn Center and burn department of RCSUMA Samarkand, Uzbekistan. The operations must be performed within 6-12 months after healing of burn wounds to prevent secondary changes. In the case when contracture is severe, the operation must be performed as soon as possible. The method of operation should be chosen according to both severity and localization of the injury, using local uninjured tissues and soft scars to make trapezoid, Z-form, triangular, free and other grafts placed on the area of the excised scars Results in 71, 05% of all cases the contracture of the foot-ankle joint was completely eliminated and the conditions necessary for the rehabilitation of the injured ankle were ensured. There was improvement after burn treatment or secondary changes due to inflammatory processes and foot inactivity due to its wrong position; in 3,95% there was not improvement. Negative results were due to deep tissue defect, irreversible changes in the bone- joints, late recourse to medical aid, and post operative effect. We did not observe any ulceration of skin grafts.
Abstract: The foot and ankle scar post burn contractures are the result of deep partial and full-thickness burns that affect foot motion, impair the lower extremity function and benefit from surgical reconstruction. 76 patients (ages 2-46) with post burn foot and ankle joint contractures were treated at the Inter-regional Burn Center and burn department of R...
Show More
-
Clinical Outcomes and Costs of Laparoscopic Versus Open Appendectomy for Appendicitis
Chang Sik Shin,
Jae Il Kim,
Young Nam Roh,
Pyong Wha Choi,
Tae Gil Heo,
Je Hoon Park,
Myung Soo Lee
Issue:
Volume 1, Issue 2, June 2013
Pages:
37-42
Received:
22 June 2013
Published:
10 July 2013
Abstract: Purpose: The aim of this study was to compare clinical outcomes between open appendectomy (OA) and laparoscopic appendectomy (LA) for both uncomplicated appendicitis (UA) and complicated appendicitis (CA) and to help to choose the appropriate procedure for its management. Methods: The medical records of patients who underwent OA (OA group) or LA (LA group) for UA or CA between January 1, 2010 and December 31, 2011, were retrospectively reviewed. Results: For UA, time to a soft diet (1.5±0.7 in OA versus 1.4±0.7 days in LA, p=0.0010) and the length of hospital stay (3.9±1.5 in OA versus 3.3±1.4 days in LA, p<0.0001) were significantly shorter in the LA group. The length of hospital stay for CA was significantly shorter in the LA group than in the OA group (7.5±3.8 versus 4.9±2.8 days, p=0.0012). Complication rates were not significantly different between the LA and OA groups for both UA and CA. Conclusions: We conclude that for CA, clinical outcomes were better in the LA than in the OA group. For UA, there were no significant advantages of LA considering expensive hospital costs. The results of this study suggest that LA is the procedure of choice for patients with complicated appendicitis.
Abstract: Purpose: The aim of this study was to compare clinical outcomes between open appendectomy (OA) and laparoscopic appendectomy (LA) for both uncomplicated appendicitis (UA) and complicated appendicitis (CA) and to help to choose the appropriate procedure for its management. Methods: The medical records of patients who underwent OA (OA group) or LA (L...
Show More
