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Hand Clinics May 2024Microsurgery is undoubtedly the pinnacle of hand surgery. Significant advancement in recent years has stretched the indications for toe-to-hand transfer in both acquired... (Review)
Review
Microsurgery is undoubtedly the pinnacle of hand surgery. Significant advancement in recent years has stretched the indications for toe-to-hand transfer in both acquired and congenital hand defects to restore function, esthetics, and motion, with minimal morbidity to the donor site. There is no one fixed microsurgical transfer technique but a surgeon's versatility and innovation in using what one could spare because each case is unique. Esthetic refinements and reducing donor site morbidities have taken a front seat in recent years. We present a few cases to put forward the senior author's preferred techniques with this objective in mind.
Topics: Humans; Child; Thumb; Toes; Amputation, Traumatic; Hand; Microsurgery
PubMed: 38553095
DOI: 10.1016/j.hcl.2023.10.004 -
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 -
Medicina (Kaunas, Lithuania) Jun 2023The field of reconstructive microsurgery has witnessed considerable advancements over the years, driven by improvements in technology, imaging, surgical instruments,... (Review)
Review
The field of reconstructive microsurgery has witnessed considerable advancements over the years, driven by improvements in technology, imaging, surgical instruments, increased understanding of perforator anatomy, and experience with microsurgery. However, within the subset of microvascular head and neck reconstruction, novel strategies are needed to improve and optimize both patient aesthetics and post-operative function. Given the disfiguring defects that are encountered following trauma or oncologic resections, the reconstructive microsurgeon must always aim to innovate new approaches, reject historic premises, and challenge established paradigms to further achieve improvement in both aesthetic and functional outcomes. The authors aim to provide an up-to-date review of innovations in head and neck reconstruction for oncologic defects.
Topics: Humans; Plastic Surgery Procedures; Head and Neck Neoplasms; Neck; Microsurgery; Esthetics; Head
PubMed: 37512006
DOI: 10.3390/medicina59071194 -
Clinics in Plastic Surgery Jul 2024Acute burn reconstruction involves intricate strategies such as skin grafting and innovative technologies, addressing challenges in coverage and minimizing donor site... (Review)
Review
Acute burn reconstruction involves intricate strategies such as skin grafting and innovative technologies, addressing challenges in coverage and minimizing donor site morbidity. Despite being rarely used, flap reconstruction becomes necessary when critical structures are exposed, offering robust coverage and reducing complications. However, free flaps in acute burns face challenges, including a higher failure rate attributed to hyperinflammatory states and hypercoagulability. Surgical optimization strategies involve careful timing, patient preparation, and meticulous postoperative care. In delayed burn reconstruction, free flaps proved effective in functional and aesthetic restoration, with low flap loss rates and minimal contracture recurrence. Prefabricated and prelaminated flaps emerged as a solution for complex cases, ensuring the best functional and aesthetic possible outcomes in challenging facial burn reconstructions.
Topics: Humans; Burns; Microsurgery; Plastic Surgery Procedures; Free Tissue Flaps; Skin Transplantation
PubMed: 38789149
DOI: 10.1016/j.cps.2024.02.005 -
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 -
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 -
Journal of Reconstructive Microsurgery Nov 2019Patient safety is defined as freedom from accidental or preventable harm produced by medical care. The identification of patient- and procedure-related risk factors... (Review)
Review
Patient safety is defined as freedom from accidental or preventable harm produced by medical care. The identification of patient- and procedure-related risk factors enables the surgical team to carry out prophylactic measures to reduce the rate of complications and adverse events.The purpose of this review is to identify the characteristics of patients, practitioners, and microvascular surgical procedures that place patients at risk for preventable harm, and to discuss evidence-based prevention practices that can potentially help to generate a culture of patient safety.
Topics: Humans; Microsurgery; Patient Safety; Surgery, Plastic; Vascular Surgical Procedures
PubMed: 31327160
DOI: 10.1055/s-0039-1693142 -
Annals of Plastic Surgery Sep 2019
Topics: Humans; Microsurgery; Models, Educational; Plastic Surgery Procedures
PubMed: 31008791
DOI: 10.1097/SAP.0000000000001825 -
Journal of the Chinese Medical... Jan 2024Lymphedema is a progressive disease with no known cure. Characterized by the accumulation of lymphatic fluid and subsequent swelling in the affected limbs, it often... (Review)
Review
Lymphedema is a progressive disease with no known cure. Characterized by the accumulation of lymphatic fluid and subsequent swelling in the affected limbs, it often poses significant challenges to those living with it. Although various conservative treatments have been used to manage lymphedema, such as compression therapy and physical rehabilitation, surgical interventions have emerged as promising avenues for more substantial relief. Lymphovenous shunts have been described since the 1960s and have garnered much attention in the recent two decades due to technological advances in optics, imaging, and surgical instruments. This review article explores the use of different lymphovenous shunts such as lymphatic implantation, lymph node-to-vein anastomoses (LNVAs), dermal-adipose lymphatic flap venous wrapping (DALF-VW), and supermicrosurgical lymphovenous anastomoses (LVAs) as treatment modalities for lymphedema. We will discuss the underlying principles, indications, techniques, and potential benefits. By examining the current state of knowledge and ongoing research in the field, we aim to provide insights into the role of lymphovenous shunts in the comprehensive management of lymphedema and shed light on the prospects for this treatment option.
Topics: Humans; Lymphedema; Lymphatic Vessels; Lymph Nodes; Veins; Microsurgery
PubMed: 37962114
DOI: 10.1097/JCMA.0000000000001016 -
Microsurgery May 2021
Microsurgery training during COVID-19 pandemic: Practical recommendations from the International Society for Experimental Microsurgery and International Microsurgery Simulation Society.
Topics: Animals; COVID-19; Humans; Microsurgery; Pandemics; Simulation Training
PubMed: 33606305
DOI: 10.1002/micr.30725