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Dentistry Journal Jun 2024A new access technique was developed to reduce postoperative adverse events after the extraction of impacted maxillary wisdom teeth. Hence, this study aimed to assess...
BACKGROUND
A new access technique was developed to reduce postoperative adverse events after the extraction of impacted maxillary wisdom teeth. Hence, this study aimed to assess the occurrence of adverse events after the extraction of maxillary impacted wisdom teeth using a traditional access (TA) or a new technique (NT).
METHODS
Two different surgical incision designs were used for bilateral wisdom tooth extractions in 30 patients. The traditional incision was performed distal to the second molar in the center of the tuberosity, followed by a buccal releasing incision. After the tooth extraction, the wound was secured by sutures. The new technique consists of an oblique incision from the distal palatal aspect of the tuberosity towards the buccal aspect of the second molar. After the tooth extraction, cyanoacrylate glue was used on the wound.
RESULTS
Lower pain was reported by patients at the site treated with the new technique ( < 0.01). Edema, postsurgical bleeding, and hematoma were similar in both groups. The surgical time was shorter for the new technique ( < 0.01).
CONCLUSIONS
The new technique applied for the extraction of impacted maxillary wisdom teeth reduced postsurgical pain and the duration of surgery.
PubMed: 38920884
DOI: 10.3390/dj12060184 -
Plastic and Reconstructive Surgery.... Jun 2024Preoperative vascular imaging has become standard practice in the planning of microsurgical breast reconstruction. Currently, translating perforator locations from...
Preoperative vascular imaging has become standard practice in the planning of microsurgical breast reconstruction. Currently, translating perforator locations from radiological findings to a patient's abdomen is often not easy or intuitive. Techniques using three-dimensional printing or patient-specific guides have been introduced to superimpose anatomy onto the abdomen for reference. Augmented and mixed reality is currently actively investigated for perforator mapping by superimposing virtual models directly onto the patient. Most techniques have found only limited adoption due to complexity and price. Additionally, a critical step is aligning virtual models to patients. We propose repurposing suture packaging as an image tracking marker. Tracking markers allow quick and easy alignment of virtual models to the individual patient's anatomy. Current techniques are often complicated or expensive and limit intraoperative use of augmented reality models. Suture packs are sterile, readily available, and can be used to align abdominal models on the patients. Using an iPad, the augmented reality models automatically align in the correct position by using a suture pack as a tracking marker. Given the ubiquity of iPads, the combination of these devices with readily available suture packs will predictably lower the barrier to entry and utilization of this technology. Here, our workflow is presented along with its intraoperative utilization. Additionally, we investigated the accuracy of this technology.
PubMed: 38919516
DOI: 10.1097/GOX.0000000000005933 -
Clinical Endoscopy May 2024With the alarmingly increasing prevalence of obesity in the Western world, it has become necessary to provide more acceptable treatment options for patients with... (Review)
Review
With the alarmingly increasing prevalence of obesity in the Western world, it has become necessary to provide more acceptable treatment options for patients with obesity. Minimally invasive endoscopic techniques are continuously evolving. Currently, metabolic and bariatric endoscopies encompass several different techniques that can offer significant weight loss and improvement in comorbidities with a favorable safety profile. Restrictive bariatric procedures include the use of intragastric balloons and gastric remodeling techniques with different suturing devices. Several studies have demonstrated the efficacy and safety of these techniques that are widely used in clinical practice. Small intestine-targeted metabolic endoscopy is an intriguing and rapidly evolving field of research, although it is not widespread in routine practice. These techniques include duodenal-jejunal bypass liners, duodenal mucosal resurfacing, and incisionless anastomoses. The aim of this review article is to provide a detailed update on the currently available bariatric endoscopy techniques in Western countries.
PubMed: 38919056
DOI: 10.5946/ce.2023.253 -
Journal of Medical Case Reports Jun 2024Free gingival graft is commonly used to augment the keratinized mucosa and vestibular depth around dental implants. The proper suturing technique is fundamental to...
BACKGROUND
Free gingival graft is commonly used to augment the keratinized mucosa and vestibular depth around dental implants. The proper suturing technique is fundamental to achieve a successful result following free gingival graft. However, there are limited studies that focus on the details of the suturing methods to optimize graft adaptation. The purpose of this technical note is to describe a new suturing technique for optimal approximation and stabilization of free gingival graft around dental implants.
CASE PRESENTATION
Here, we present a 53-year-old Persian female with peri-implantitis and lack of keratinized mucosa around mandibular implants who was a candidate for free gingival graft. A new suturing technique, double vertical interrupted suture, was conducted in the interimplant areas. In addition, the suspensory cross-mattress sutures were added to ensure the adaptation of the graft over the implants. The proposed suturing technique is useful for soft tissue augmentation around multiple implants with concave or uneven recipient bed.
CONCLUSION
The present article describes a novel suturing technique for good adaptation and fixation of free gingival graft around dental implants.
Topics: Humans; Female; Middle Aged; Gingiva; Suture Techniques; Dental Implants; Peri-Implantitis; Mandible
PubMed: 38918876
DOI: 10.1186/s13256-024-04611-2 -
Scientific Reports Jun 2024Residents learn the vesico-urethral anastomosis (VUA), a key step in robot-assisted radical prostatectomy (RARP), early in their training. VUA assessment and training...
Prediction of Robotic Anastomosis Competency Evaluation (RACE) metrics during vesico-urethral anastomosis using electroencephalography, eye-tracking, and machine learning.
Residents learn the vesico-urethral anastomosis (VUA), a key step in robot-assisted radical prostatectomy (RARP), early in their training. VUA assessment and training significantly impact patient outcomes and have high educational value. This study aimed to develop objective prediction models for the Robotic Anastomosis Competency Evaluation (RACE) metrics using electroencephalogram (EEG) and eye-tracking data. Data were recorded from 23 participants performing robot-assisted VUA (henceforth 'anastomosis') on plastic models and animal tissue using the da Vinci surgical robot. EEG and eye-tracking features were extracted, and participants' anastomosis subtask performance was assessed by three raters using the RACE tool and operative videos. Random forest regression (RFR) and gradient boosting regression (GBR) models were developed to predict RACE scores using extracted features, while linear mixed models (LMM) identified associations between features and RACE scores. Overall performance scores significantly differed among inexperienced, competent, and experienced skill levels (P value < 0.0001). For plastic anastomoses, R values for predicting unseen test scores were: needle positioning (0.79), needle entry (0.74), needle driving and tissue trauma (0.80), suture placement (0.75), and tissue approximation (0.70). For tissue anastomoses, the values were 0.62, 0.76, 0.65, 0.68, and 0.62, respectively. The models could enhance RARP anastomosis training by offering objective performance feedback to trainees.
Topics: Humans; Anastomosis, Surgical; Robotic Surgical Procedures; Machine Learning; Clinical Competence; Electroencephalography; Male; Urethra; Eye-Tracking Technology; Prostatectomy; Urinary Bladder
PubMed: 38918593
DOI: 10.1038/s41598-024-65648-3 -
Endoscopy Dec 2024
Topics: Suture Techniques; Humans
PubMed: 38917981
DOI: 10.1055/a-2337-9471 -
Endoscopy Dec 2024
Topics: Suture Techniques; Humans; Sutures
PubMed: 38917970
DOI: 10.1055/a-2335-6761 -
Cureus May 2024Various benefits of needleless suture loop techniques in anterior cruciate ligament reconstruction graft preparation have been discussed, yet their impact on graft...
INTRODUCTION
Various benefits of needleless suture loop techniques in anterior cruciate ligament reconstruction graft preparation have been discussed, yet their impact on graft diameter remains unexplored. We hypothesized that the suture loop technique would reduce the graft diameter compared to the conventional locking suture technique.
METHODS
Fifty-seven patients whose grafts were made with the Krackow stitch (group K) and 54 patients with the suture loop (group SL) were analyzed retrospectively. (1) The distal (sutured side) diameter of each anteromedial bundle and posterolateral bundle was compared to the proximal (non-sutured side) diameter, and (2) the average of the proximal and distal graft diameters in each group was calculated.
RESULTS
In group K, 78.9% of anteromedial bundles and 40.3% of posterolateral bundles exhibited a larger distal diameter than the proximal, while in group SL, 42.6% of anteromedial bundles and 3.7% of posterolateral bundles showed a larger distal diameter. In both bundles, there were significantly fewer grafts with larger distal diameters in group SL (p < 0.001). The mean distal diameter of anteromedial bundles was smaller in group SL (6.33 ± 0.43 mm vs. 6.07 ± 0.43 mm, p < 0.005). Consequently, the distal cross-sectional area of anteromedial bundles in group SL was 8% smaller than that in group K.
CONCLUSION
The use of the suture loop technique resulted in a significantly smaller distal diameter of the anteromedial bundle. This reduces the size of the tibial tunnel and may contribute to a reduction in potential damage to adjacent structures.
PubMed: 38916006
DOI: 10.7759/cureus.61054 -
Journal of Surgical Case Reports Jun 2024Minimally invasive cardiac surgery off-pump coronary artery bypass (MICSOPCAB) has become increasingly prevalent, with devices like the heart positioner aiding in...
Minimally invasive cardiac surgery off-pump coronary artery bypass (MICSOPCAB) has become increasingly prevalent, with devices like the heart positioner aiding in surgical precision. However, rare complications such as epicardial hematoma can occur. Here, we present a case of a 75-year-old man undergoing MICSOPCAB who developed an epicardial hematoma due to the heart positioner. The hematoma was successfully repaired intraoperatively with direct suturing and large felts. Postoperative recovery was uneventful, highlighting the importance of vigilant monitoring and prompt management of such complications. This case underscores the need for careful attention during the use of cardiac positioners to minimize adverse events and ensure favorable patient outcomes.
PubMed: 38915341
DOI: 10.1093/jscr/rjae417 -
BMC Pregnancy and Childbirth Jun 2024Perineal lacerations are a very common complication of post-partum. Usually, the repair of 1st and 2nd-grade lacerations is performed after the administration of local... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
BACKGROUND
Perineal lacerations are a very common complication of post-partum. Usually, the repair of 1st and 2nd-grade lacerations is performed after the administration of local anesthesia. Despite the great relevance of the problem, there are only a few studies about the best choice of local anesthetic to use during suturing. We performed a randomised controlled trial to evaluate the efficacy and safety of the use of a local anesthetic spray during the suturing of perineal lacerations in the post-partum.
METHODS
We compared the spray with the standard technique, which involves the infiltration of lacerated tissues, using the NRS scale. 136 eligible women who had given birth at University Hospital of Udine were enrolled and randomly assigned to receive nebulization of Lidocaine hydrochloride 10% spray (experimental group) or subcutaneous/submucosal infiltration of mepivacaine hydrochloride (control group) during suturing of perineal laceration.
RESULTS
The lacerations included 84 1st-grade perineal traumas (61.7%) and 52 2nd-grade perineal traumas (38.2%). All the procedures were successfully completed without severe complications or serious adverse reactions. There were no statistically significant differences between the two groups in terms of blood losses or total procedure time. Moreover, there were no statistically significant differences in terms of NRS to none of the intervals considered. Regarding the application of the spray in the B group, in 36 cases (52.9%) it was necessary to improve the number of puffs previously supposed to be sufficient (5 puffs). Just in 3 cases, an additional injection was necessary (4.4%).
CONCLUSIONS
Our study demonstrates that lidocaine spray alone can be used as a first line of local anesthetic during the closure of I-II-grade perineal lacerations, as it has comparable efficacy to mepivacaine infiltration.
TRIAL REGISTRATION
The trial was recorded on https://clinicaltrials.gov . Identification number: NCT05201313. First registration date: 21/01/2022. Unique Protocol ID: 0042698/P/GEN/ARCS.
Topics: Humans; Female; Perineum; Lidocaine; Lacerations; Anesthetics, Local; Adult; Mepivacaine; Suture Techniques; Pregnancy; Treatment Outcome
PubMed: 38914976
DOI: 10.1186/s12884-024-06640-7