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Journal of Reconstructive Microsurgery Jan 2017Topical vasodilators are frequently used during free tissue transfer to prevent and treat vasospasm and microvascular thrombosis. A variety of agents have been... (Review)
Review
Topical vasodilators are frequently used during free tissue transfer to prevent and treat vasospasm and microvascular thrombosis. A variety of agents have been studied and are available, yet most microsurgeons select an agent based on anecdotal evidence or personal training. Our aim was to review the literature on topical vasodilators so microsurgeons can make more informed decisions about which agent to use. A systemic review of the literature was performed on PubMed, EMBASE, and Google Scholar using keywords "topical vasodilator," "antispasmodic," "vasospasm," "free flaps," and "microsurgery." Studies were included if they provided a comparative quantitative assessment of topical vasodilators and were written in English. In vitro, in vivo and clinical studies were included. A total of 15 studies were identified and included in our analysis. The three most common classes of topical vasodilator include local anesthetics, phosphodiesterase inhibitors, and calcium channel blockers (CCBs). Of the most commonly used topical vasodilators, CCBs (nifedipine and verapamil) were most effective followed by papaverine and lidocaine. The most effective topical vasodilators appear to be CCBs including nifedipine, nicardipine, and verapamil. Evidence suggests that these agents are more effective than papaverine and lidocaine solutions that are commonly used. Future research should directly compare individual CCBs to assess the most effective agent. Studies to date have focused on vessels other than those used by microsurgeons, and therefore further studies specific to these vessels are warranted.
Topics: Administration, Topical; Constriction, Pathologic; Evidence-Based Medicine; Humans; Intraoperative Complications; Microsurgery; Plastic Surgery Procedures; Vasoconstriction; Vasodilator Agents
PubMed: 27636540
DOI: 10.1055/s-0036-1592191 -
Current Opinion in Ophthalmology May 2019This article reviews operative techniques and risks associated with microincision vitrectomy surgery. (Review)
Review
PURPOSE OF REVIEW
This article reviews operative techniques and risks associated with microincision vitrectomy surgery.
RECENT FINDINGS
All three microincision vitrectomy surgery platforms (23, 25, and 27 gauge) are associated with both advantages and disadvantages, combined with similarly low rates of hypotony, endophthalmitis, corneal astigmatism, and postoperative inflammation.
SUMMARY
Hybrid-gauge vitrectomy, utilizing larger gauge MIVS cannulas, preserves surgeon access to benefits of both larger and smaller gauge MIVS platforms without compromising safety, efficacy, or efficiency.
Topics: Humans; Microsurgery; Postoperative Complications; Suture Techniques; Vitrectomy
PubMed: 30883444
DOI: 10.1097/ICU.0000000000000568 -
Zeitschrift Fur Gastroenterologie Aug 2017
Topics: Animals; Endoscopy, Gastrointestinal; Germany; Humans; Microsurgery; Minimally Invasive Surgical Procedures; Research; Robotic Surgical Procedures; Surgical Instruments
PubMed: 28799155
DOI: 10.1055/s-0043-114080 -
Clinical Anatomy (New York, N.Y.) Jul 2024The glossopharyngeal nerve is a complicated and mixed nerve including sensory, motor, parasympathetic, and visceral fibers. It mediates taste, salivation, and... (Review)
Review
The glossopharyngeal nerve is a complicated and mixed nerve including sensory, motor, parasympathetic, and visceral fibers. It mediates taste, salivation, and swallowing. The low cranial nerves, including IXth, Xth, and XIth, are closely related, sharing some nuclei in the brainstem. The glossopharyngeal nerve arises from the spinal trigeminal nucleus and tract, solitary tract and nucleus, nucleus ambiguous, and inferior salivatory nucleus in the brainstem. There are communicating branches forming a neural anastomotic network between low cranial nerves. Comprehensive knowledge of the anatomy of the glossopharyngeal nerve is crucial for performing surgical procedures without significant complications. This review describes the microsurgical anatomy of the glossopharyngeal nerve and illustrates some pictures involving the glossopharyngeal nerve and its connective and neurovascular structures.
Topics: Glossopharyngeal Nerve; Humans; Microsurgery
PubMed: 38380502
DOI: 10.1002/ca.24143 -
Acta Cirurgica Brasileira Sep 2018Technological advances such as optical instruments and surgical tools have enabled the considerable contributions of microsurgery to surgical therapies. Accordingly,...
Technological advances such as optical instruments and surgical tools have enabled the considerable contributions of microsurgery to surgical therapies. Accordingly, surgical therapeutics has provided the latest information across a wide range of medical specialties, including immunology and pharmacology, despite specialization according to organs and organ systems. The International Society for Experimental Microsurgery, an academic organization, has utilized experimental microsurgery technology in the identification of curative concepts for diseases that remain difficult to treat. For this publication to mark the 32nd anniversary of the Brazilian Surgical Society, I introduced the following types of technology related to the further development of microsurgical technological innovations in the future: high-resolution three-dimensional (3D) video and touch-sensitive microsurgery robots.
Topics: Brazil; Humans; Imaging, Three-Dimensional; Microsurgery; Robotic Surgical Procedures; Surgery, Computer-Assisted; Translational Research, Biomedical
PubMed: 30328919
DOI: 10.1590/s0102-865020180090000015 -
Dental Clinics of North America Jan 2017Increased use of the surgical operating microscope in endodontic surgery has elucidated many shortcomings of previous techniques and along with microsurgical instruments... (Review)
Review
Increased use of the surgical operating microscope in endodontic surgery has elucidated many shortcomings of previous techniques and along with microsurgical instruments and new more biologically acceptable root-end filling materials has started the new microsurgical era in surgical endodontics. Endodontic microsurgery is a minimally invasive technique that results in less postoperative pain and edema and faster wound healing. It offers a significantly higher success rate than traditional apical surgery technique. The components, key concepts and procedural steps of endodontic microsurgery as well as the prognosis and predictability of modern root-end procedures are presented in this review.
Topics: Dental Pulp Diseases; Humans; Microsurgery; Oral Surgical Procedures
PubMed: 27912820
DOI: 10.1016/j.cden.2016.08.007 -
Acta Chirurgiae Plasticae 2020Microvascular free flap reconstruction is a routine option for coverage of a variety of tissue defects. Accurate monitoring in the postoperative period is a crucial part... (Review)
Review
Microvascular free flap reconstruction is a routine option for coverage of a variety of tissue defects. Accurate monitoring in the postoperative period is a crucial part of successful flap surgery allowing early detection of vascular compromise and prompt intervention in flap salvaging. Despite that many safety procedures to assess flap viability have been developed, flap failure is consistently seen in 2-5% of free tissue transfers. In addition, great progress is being made in relation to various state-of-the-art technologies for flap monitoring. However, the gold standard still remains clinical monitoring at most institutions even though there is no standardized management protocol. The review should present a prospective optimal monitoring protocol and introduce some of the latest monitoring devices based on the recent literature and personal experience.
Topics: Clinical Protocols; Free Tissue Flaps; Graft Survival; Humans; Microsurgery; Monitoring, Physiologic; Prospective Studies; Plastic Surgery Procedures
PubMed: 32380838
DOI: No ID Found -
Plastic and Reconstructive Surgery Mar 2015Microsurgery practice, including preoperative patient selection, intraoperative technique, and anesthetic considerations, varies from institution to institution and from... (Review)
Review
Microsurgery practice, including preoperative patient selection, intraoperative technique, and anesthetic considerations, varies from institution to institution and from surgeon to surgeon. Many surgeons' practices are driven by "conventional wisdom," which is handed down from mentors to fellows and residents. In this article, the authors explore the oxymoron that there is evidence to support controversy in microsurgery. Indeed, if there was convincing evidence to support varying microsurgery practices, there would be no controversy. The authors conducted a review with a focus on evidence-based medicine to support microsurgery practice.
Topics: Evidence-Based Medicine; Humans; Microsurgery; Patient Selection; Plastic Surgery Procedures
PubMed: 25719724
DOI: 10.1097/PRS.0000000000000971 -
Current Opinion in Otolaryngology &... Apr 2022Exoscopes are external digital devices that provide enhanced and magnified visualization of the surgical field. They usually have dedicated digital controls and a more... (Review)
Review
PURPOSE OF REVIEW
Exoscopes are external digital devices that provide enhanced and magnified visualization of the surgical field. They usually have dedicated digital controls and a more compact mechanical structure than operative microscopes and current robotic surgical systems. This technology has significant potential in otolaryngology - head and neck surgery, especially concerning the field of transoral approaches. We herein analysed the overall technical characteristics of currently available exoscopic systems and contextualized their advantages and drawbacks in the setting of transoral surgery.
RECENT FINDINGS
The actual advantages of exoscopy are still indeterminate, as it has only been applied to limited surgical series. However, its specific properties are herein compared with conventional transoral microsurgery and transoral robotic surgery, discussing the available literature on such a topic, filtered on the basis of the authors' experience and its possible future evolutions. Finally, a summary of current experiences in the field of three-dimensional (3D) transoral exoscopic surgery is presented, highlighting differences compared with standard approaches.
SUMMARY
3D-exoscopic transoral surgery will possibly play an essential role in future management of early laryngeal and oropharyngeal lesions, significantly shifting the paradigms of this type of procedures.
Topics: Humans; Microsurgery; Robotic Surgical Procedures
PubMed: 35131988
DOI: 10.1097/MOO.0000000000000794 -
Fertility and Sterility Apr 2016
Review
Topics: Animals; Fallopian Tube Diseases; Female; Humans; Infertility, Female; Microsurgery; Plastic Surgery Procedures; Reproductive Techniques, Assisted
PubMed: 26773194
DOI: 10.1016/j.fertnstert.2015.12.040