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Medicina (Kaunas, Lithuania) Mar 2023: Endodontic surgery has evolved over the last two decades. The use of state-of-the-art guided endodontic surgical procedures produces a predictable outcome in the... (Review)
Review
: Endodontic surgery has evolved over the last two decades. The use of state-of-the-art guided endodontic surgical procedures produces a predictable outcome in the healing of lesions of endodontic origin. The main objective of this review paper is to define and characterize guided surgical endodontics as well as its benefits and drawbacks by reviewing the most recent relevant scientific literature. : A literature search was conducted using multiple databases comprising of MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were 'guided endodontics', 'surgical endodontics', and 'endodontic microsurgery'. : In total, 1152 articles were obtained from the analysis of the databases. Unrelated articles from the available full text of 388 articles were excluded. A total of 45 studies were finally included in the review. : Surgical-guided endodontics is a relatively new area of study that is still maturing. It has many applications such as root canal access and localization, microsurgical endodontics, endodontic retreatment, and glass fiber post removal. Additionally, it does not matter how experienced the operator is; the procedure can be completed for the patient in less time and provides greater accuracy and safety than conventional endodontics.
Topics: Humans; Root Canal Therapy; Endodontics; Microsurgery
PubMed: 37109636
DOI: 10.3390/medicina59040678 -
Sensors (Basel, Switzerland) Oct 2023Microsurgical techniques have been widely utilized in various surgical specialties, such as ophthalmology, neurosurgery, and otolaryngology, which require intricate and... (Review)
Review
Microsurgical techniques have been widely utilized in various surgical specialties, such as ophthalmology, neurosurgery, and otolaryngology, which require intricate and precise surgical tool manipulation on a small scale. In microsurgery, operations on delicate vessels or tissues require high standards in surgeons' skills. This exceptionally high requirement in skills leads to a steep learning curve and lengthy training before the surgeons can perform microsurgical procedures with quality outcomes. The microsurgery robot (MSR), which can improve surgeons' operation skills through various functions, has received extensive research attention in the past three decades. There have been many review papers summarizing the research on MSR for specific surgical specialties. However, an in-depth review of the relevant technologies used in MSR systems is limited in the literature. This review details the technical challenges in microsurgery, and systematically summarizes the key technologies in MSR with a developmental perspective from the basic structural mechanism design, to the perception and human-machine interaction methods, and further to the ability in achieving a certain level of autonomy. By presenting and comparing the methods and technologies in this cutting-edge research, this paper aims to provide readers with a comprehensive understanding of the current state of MSR research and identify potential directions for future development in MSR.
Topics: Humans; Robotics; Microsurgery; Neurosurgical Procedures; Neurosurgery; Clinical Competence
PubMed: 37896597
DOI: 10.3390/s23208503 -
Chirurgie (Heidelberg, Germany) Apr 2023In recent years surgical robotic systems which were specifically developed for microsurgery have expanded the application of robotic-assisted surgery to plastic... (Review)
Review
In recent years surgical robotic systems which were specifically developed for microsurgery have expanded the application of robotic-assisted surgery to plastic reconstructive surgery. Currently, there are two microsurgical robotic systems available for reconstructive plastic surgery. Both systems feature tremor reduction and motion scaling technologies, which are intended to optimize the surgeon's precision and dexterity. In the Department of Plastic Surgery and Hand Surgery at the University Hospital Zurich, the Symani Surgical System® has already been used for many microsurgical and supermicrosurgical operations, including autologous breast reconstruction, nerve transfer and, in particular, reconstructive lymphatic surgery. Despite special technical challenges, such as a lack of haptic feedback, the advantages outweigh the disadvantages for an appropriately trained and skilled microsurgeon, including smaller surgical access incisions for anatomically deep structures and an improvement in surgical precision.
Topics: Humans; Robotic Surgical Procedures; Surgery, Plastic; Robotics; Plastic Surgery Procedures; Microsurgery
PubMed: 36625922
DOI: 10.1007/s00104-022-01790-w -
Spine Apr 2021Systematic review and meta-analysis. (Comparative Study)
Comparative Study Meta-Analysis
STUDY DESIGN
Systematic review and meta-analysis.
OBJECTIVE
To give a systematic overview of effectiveness of percutaneous transforaminal endoscopic discectomy (PTED) compared with open microdiscectomy (OM) in the treatment of lumbar disk herniation (LDH).
SUMMARY OF BACKGROUND DATA
The current standard procedure for the treatment of sciatica caused by LDH, is OM. PTED is an alternative surgical technique which is thought to be less invasive. It is unclear if PTED has comparable outcomes compared with OM.
METHODS
Multiple online databases were systematically searched up to April 2020 for randomized controlled trials and prospective studies comparing PTED with OM for LDH. Primary outcomes were leg pain and functional status. Pooled effect estimates were calculated for the primary outcomes only and presented as standard mean differences (SMD) with their 95% confidence intervals (CI) at short (1-day postoperative), intermediate (3-6 months), and long-term (12 months).
RESULTS
We identified 2276 citations, of which eventually 14 studies were included. There was substantial heterogeneity in effects on leg pain at short term. There is moderate quality evidence suggesting no difference in leg pain at intermediate (SMD 0.05, 95% CI -0.10-0.21) and long-term follow-up (SMD 0.11, 95% CI -0.30-0.53). Only one study measured functional status at short-term and reported no differences. There is moderate quality evidence suggesting no difference in functional status at intermediate (SMD -0.09, 95% CI -0.24-0.07) and long-term (SMD -0.11, 95% CI -0.45-0.24).
CONCLUSION
There is moderate quality evidence suggesting no difference in leg pain or functional status at intermediate and long-term follow-up between PTED and OM in the treatment of LDH. High quality, robust studies reporting on clinical outcomes and cost-effectiveness on the long term are lacking.Level of Evidence: 2.
Topics: Cost-Benefit Analysis; Diskectomy, Percutaneous; Endoscopy; Humans; Intervertebral Disc Degeneration; Intervertebral Disc Displacement; Lumbar Vertebrae; Microsurgery; Pain Measurement; Prospective Studies; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 33290374
DOI: 10.1097/BRS.0000000000003843 -
Clinics in Plastic Surgery Jul 2019Mutilating injuries include a wide and heterogeneous spectrum of clinical presentations, each being unique in terms of pattern of tissue damage, patient characteristics,... (Review)
Review
Mutilating injuries include a wide and heterogeneous spectrum of clinical presentations, each being unique in terms of pattern of tissue damage, patient characteristics, and functional requirements. Understanding the principles of reconstruction of bone and soft tissues, a wide repertoire of surgical techniques, and the ability to plan the reconstructive journey leading to a functional hand are crucial. Management of these injuries involves several on-the-spot decisions by the surgeon. This article aims to equip the surgeon with the key principles and the bits of knowledge that are essential for effective planning and execution when dealing with such injuries.
Topics: Amputation, Traumatic; Hand Injuries; Humans; Microsurgery; Orthopedic Procedures; Peripheral Nerve Injuries; Plastic Surgery Procedures; Skin Transplantation; Soft Tissue Injuries; Tendon Transfer
PubMed: 31103080
DOI: 10.1016/j.cps.2019.02.009 -
International Journal of Computer... Nov 2017Origami-based biomedical device design is an emerging technology due to its ability to be deployed from a minimal foldable pattern to a larger volume. This paper aims to... (Review)
Review
PURPOSE
Origami-based biomedical device design is an emerging technology due to its ability to be deployed from a minimal foldable pattern to a larger volume. This paper aims to review state-of-the-art origami structures applied in the medical device field.
METHODS
Publications and reports of origami structure related to medical device design from the past 10 years are reviewed and categorized according to engineering specifications, including the application field, fabrication material, size/volume, deployment method, manufacturability, and advantages.
RESULTS
This paper presents an overview of the biomedical applications of devices based on origami structures, including disposable sterilization covers, cardiac catheterization, stent grafts, encapsulation and microsurgery, gastrointestinal microsurgery, laparoscopic surgical grippers, microgrippers, microfluidic devices, and drug delivery. Challenges in terms of materials and fabrication, assembly, modeling and computation design, and clinical adoptability are discussed at the end of this paper to provide guidance for future origami-based design in the medical device field.
CONCLUSION
Concepts from origami can be used to design and develop novel medical devices. Origami-based medical device design is currently progressing, with researchers improving design methods, materials, fabrication techniques, and folding efficiency.
Topics: Biocompatible Materials; Cardiac Catheterization; Equipment Design; Humans; Laparoscopy; Microsurgery; Surgical Equipment
PubMed: 28260164
DOI: 10.1007/s11548-017-1545-1 -
European Journal of Physical and... Dec 2014Various lumbar exercise programs are prescribed for rehabilitation purposes following microdiscectomy applied for the treatment of lumbar disk herniation. The literature... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Various lumbar exercise programs are prescribed for rehabilitation purposes following microdiscectomy applied for the treatment of lumbar disk herniation. The literature contains several studies on this subject. However, there are no studies investigating the effects of supervised dynamic lumbar stabilization exercises on fear and fear/regression attitudes of patients and on their return to work.
AIM
This study investigates the effects of supervised dynamic lumbar stabilization exercises during postoperative rehabilitation on spinal mobility, pain, functional status, return to work, quality of life, and fear/regression attitude of patients who underwent lumbar microdiscectomy for the first time.
SETTING
The study was conducted at physical therapy and rehabilitation clinics.
STUDY DESIGN
A randomized clinical trial comparing exercise programs after lumbar microdiscectomy.
PATIENTS SAMPLE
Forty-four lumbar microdiscectomy patients were randomized into two groups.
OUTCOME MEASURES
Each group was assessed in terms of low back pain, leg pain, spinal mobility, Oswestry Disability Index (ODI), and Nottingham Health Profile (NHP), at the postoperative first, second, and sixth months. Fear/regression beliefs and level of pain were evaluated through the Fear Avoidance Belief Questionnaire (FABQ).
METHODS
Forty-four patients were randomly divided into two equal groups of 22 subjects, respectively, as a study group with Dynamic Lumbar Stabilization (DLS) exercises and home exercises, and a control group with only home exercises for a period of four weeks.
RESULTS
Leg pain decreased more in the study group compared with the control group (P=0.004). Spinal mobility scores demonstrated greater increases in the study group (P<0.001). Statistically greater reductions were observed in the study group regarding ODI and FABQ scores (P<0.017).
CONCLUSION
DLS exercises may be recommended to patients following spinal surgery due to their benefits in reducing pain, increasing spinal mobility, and ensuring faster return to work periods.
Topics: Adult; Analysis of Variance; Diskectomy; Exercise Therapy; Fear; Female; Humans; Intervertebral Disc Displacement; Low Back Pain; Lumbar Vertebrae; Male; Microsurgery; Prospective Studies; Quality of Life; Return to Work; Time Factors
PubMed: 25201615
DOI: No ID Found -
Gaceta Medica de Mexico 2017To establish the frequency and results in patients carriers with multiple aneurysms (MA) treated by microsurgery and/or neurological endovascular therapy (NET) in the...
OBJECTIVE
To establish the frequency and results in patients carriers with multiple aneurysms (MA) treated by microsurgery and/or neurological endovascular therapy (NET) in the Hospital of Specialties on The National Medical Center La Raza.
METHOD
It is an ambispective, descriptive and longitudinal study that includes patients carriers of MA treated in the National Medical Center La Raza from March the 1 of 2009 to April the 30 of 2014.
RESULTS
62 patients carriers of 151 aneurysms were treated. According to the type of treatment, 30 patients (49%) were included in the surgical group (GQ), 25 (40%) in the endovascular group (GE) and 7 (11%) in the combinated group (GC). The number of aneurysms was distributed this way: 69 (46%) in the GQ, 61 (40%) in the GE and 21 (14%) in the GC. At GQ, it was not possible to exclude all their aneurysms on 21% of the patients, while it was feasible in only 27%. In all GE patients (40%) the exclusion of all aneurysms was achieved. The GC, meaning surgical cases that were not completed by NET, formed 11% of the cases. At GQ there was a rate of 6% of complications, meanwhile at GE it was 0.5%.
Topics: Aneurysm, Ruptured; Embolization, Therapeutic; Endovascular Procedures; Female; Hospitals, Special; Humans; Intracranial Aneurysm; Longitudinal Studies; Male; Microsurgery; Prospective Studies; Retrospective Studies; Sex Distribution; Stents; Treatment Outcome
PubMed: 29414955
DOI: 10.24875/GMM.17000398 -
Ugeskrift For Laeger Jun 2016The most common indication for free flap surgery is breast reconstruction. Deep inferior epigastric perforator flaps are safe, quick and provide excellent cosmetic... (Review)
Review
The most common indication for free flap surgery is breast reconstruction. Deep inferior epigastric perforator flaps are safe, quick and provide excellent cosmetic results. The reconstruction in head and neck cancer patients is more complex. The aims are preservation of function and appearance. Free flaps are important in traumatology and the timing of intervention can make the difference between amputation and extremity conserving treatment. Due to the improvement in surgical technique failure rates as low as 2% can be seen. Post-operative monitoring is well-established in all microsurgical centres.
Topics: Free Tissue Flaps; Head and Neck Neoplasms; Humans; Mammaplasty; Microsurgery; Monitoring, Physiologic; Postoperative Care; Plastic Surgery Procedures; Skin Transplantation; Wounds and Injuries
PubMed: 27292576
DOI: No ID Found -
Asia-Pacific Journal of Ophthalmology... 2017Our purpose is to present a broad review about the principles, early history, evolution, applications, and complications of femtosecond lasers used in refractive and... (Review)
Review
Our purpose is to present a broad review about the principles, early history, evolution, applications, and complications of femtosecond lasers used in refractive and nonrefractive corneal surgical procedures. Femtosecond laser technology added not only safety, precision, and reproducibility to established corneal surgical procedures such as laser in situ keratomileusis (LASIK) and astigmatic keratotomy, but it also introduced new promising concepts such as the intrastromal lenticule procedures with refractive lenticule extraction (ReLEx). Over time, the refinements in laser optics and the overall design of femtosecond laser platforms led to it becoming an essential tool for corneal surgeons. In conclusion, femtosecond laser is a heavily utilized tool in refractive and nonrefractive corneal surgical procedures, and further technological advances are likely to expand its applications.
Topics: Corneal Diseases; Corneal Surgery, Laser; Humans; Lasers, Excimer; Microsurgery; Refractive Surgical Procedures; Surgical Flaps
PubMed: 28780779
DOI: 10.22608/APO.2017163