-
Ear, Nose, & Throat Journal Feb 2021Lasers have been used in otolaryngology for more than 40 years and are widely considered an established way of addressing laryngeal pathology, benign and malignant.... (Review)
Review
Lasers have been used in otolaryngology for more than 40 years and are widely considered an established way of addressing laryngeal pathology, benign and malignant. Carbon dioxide (CO) laser is considered a gold standard, but over the last 2 decades, a new technology has been developed and established in other medical specialties, not so much in Ear Nose and Throat (ENT), the diode laser. It consists of a flexible fiber that passes through a hollow guidance system and is capable of reaching certain angled spots easier than straight beam systems. Portability, lower cost, easier setup, and improved photocoagulation are just some of the many features rendering it an excellent choice for the surgeon and the patient. The few studies published worldwide for the usage and efficacy of this system show no major differences related to the oncologic outcome and survival rate of patients having an early glottic tumor between diode laser microsurgery and CO laser cordectomy. Nevertheless, the advantages offered by fiber-optic laser surgery render it a worthy and perhaps equal alternative for treating this kind of pathology.
Topics: Adult; Aged; Aged, 80 and over; Carbon Dioxide; Female; Glottis; Humans; Laryngeal Neoplasms; Laryngectomy; Laryngoscopy; Lasers, Gas; Lasers, Semiconductor; Male; Microsurgery; Middle Aged; Treatment Outcome
PubMed: 32529850
DOI: 10.1177/0145561320932043 -
Asian Journal of Andrology Jan 2013Microsurgical training is imperative for urologists and clinical andrologists specializing in male infertility. Success in male infertility microsurgery is heavily... (Review)
Review
Microsurgical training is imperative for urologists and clinical andrologists specializing in male infertility. Success in male infertility microsurgery is heavily dependent on the surgeon's microsurgical skills. Laboratory-based practice to enhance microsurgical skills improves the surgeon's confidence, and reduces stress and operating time, benefiting both the patient and the surgeon. This review provides guidelines for setting up a microsurgical laboratory to develop and enhance microsurgical skills using synthetic and animal models. The role of emerging techniques, such as robotic-assisted microsurgery, is also discussed.
Topics: Andrology; Animals; Humans; Infertility, Male; Internship and Residency; Laboratories; Male; Microsurgery; Models, Animal; Rats; Robotics; Surgical Instruments; Suture Techniques; Urology
PubMed: 23160265
DOI: 10.1038/aja.2012.86 -
Acta Otorhinolaryngologica Italica :... Apr 2024In carotid paraganglioma surgery, magnification is crucial to properly evaluate the anatomical relationships between mass, carotid wall, cranial nerves, tumour vascular...
OBJECTIVES
In carotid paraganglioma surgery, magnification is crucial to properly evaluate the anatomical relationships between mass, carotid wall, cranial nerves, tumour vascular supply and fascial envelope. The aims of this study are to describe the microsurgical technique, along with the underlying microsurgical anatomy, and to assess outcomes in terms of disease control, complications and functional results.
METHODS
Twenty-six patients, accounting for 29 carotid paragangliomas, treated with microsurgery by the same senior surgeon over a 35-year period, were included.
RESULTS
No carotid injury requiring repair, nor peri- or post-operative stroke occurred in this series. No surgical injury of the main trunk of VII to XII cranial nerves occurred. Complete excision was obtained in all cases and no recurrence was observed during follow-up.
CONCLUSIONS
The small study size and its retrospective nature suggests caution; however, our results show that microsurgery can allow a safe and precise dissection of the carotids and nerves.
Topics: Humans; Carotid Body Tumor; Microsurgery; Middle Aged; Male; Female; Retrospective Studies; Adult; Aged
PubMed: 38651551
DOI: 10.14639/0392-100X-N2761 -
Journal of Neurosurgical Sciences Mar 2016After the senior author took chairmanship in Helsinki University Hospital in, he led the department into making neurosurgical operations much faster, safer and workflow... (Review)
Review
After the senior author took chairmanship in Helsinki University Hospital in, he led the department into making neurosurgical operations much faster, safer and workflow more efficient, and at the same time maintaining high surgical quality and results. The aim was to describe the philosophies and style of Helsinki Microneurosurgery. The philosophies of Helsinki Neurosurgery are categorized into two concepts: The operation room TEAM concept and the main principle "Simple, clean, fast and respecting the normal anatomy". The way to be efficient is to find good methods based on logic, reason and experience. Specific and systematic procedures before the microneurosurgery followed by high quality skills under the microscope are of utmost importance. Moreover, intraoperatively, neuroanesthesia has to provide good surgical conditions. Today, Helsinki University Central hospital Department of Neurosurgery has an annual workflow 3500 neurosurgical operations. We believe that microneurosurgical treatment remains to be important for years ahead, and neurosurgeons of great hearts, minds and skills are welcomed all over the world.
Topics: Humans; Microsurgery; Neurosurgical Procedures
PubMed: 26606431
DOI: No ID Found -
Annals of the Royal College of Surgeons... May 2022
Topics: Anastomosis, Surgical; Humans; Microsurgery
PubMed: 34730402
DOI: 10.1308/rcsann.2021.0214 -
Annals of the Royal College of Surgeons... Oct 2011
Topics: Gloves, Surgical; Microsurgery; Teaching Materials
PubMed: 22004649
DOI: 10.1308/rcsann.2011.93.7.557a -
World Neurosurgery Oct 2020
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Eye Protective Devices; Humans; Microsurgery; Neuroendoscopes; Neurosurgical Procedures; Pandemics; Personal Protective Equipment; Pneumonia, Viral; SARS-CoV-2; Surveys and Questionnaires
PubMed: 32413563
DOI: 10.1016/j.wneu.2020.04.251 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Apr 2023The continuous open-loop technique accelerates anastomosis and eliminates the risk of inadvertently catching the back wall, which is the primary cause of technical...
BACKGROUND
The continuous open-loop technique accelerates anastomosis and eliminates the risk of inadvertently catching the back wall, which is the primary cause of technical failure when using interrupted sutures in microsurgical anastomosis. Combined with airborne suture tying, the total anastomosis time is significantly reduced. We conducted an experimental and clinical study to compare this combination to the conventional technique.
METHODS
Experimentally, anastomoses were performed on the femoral arteries (0.60 mm) of rats in two groups. The control group used simple interrupted suturing with conventional tying, while the experimental group employed open-loop suturing with air-borne tying. We recorded the total time taken for anastomosis completion and patency rates. Clinically, we retrospectively analyzed replantation and free flap transfer cases using the open-loop suture and airborne tying technique for arterial and venous microvascular anastomoses, assessing total anastomosis time and patency rates.
RESULTS
Experimentally, a total of 40 anastomoses were performed in two groups. The control group required 779.65 seconds, and the experimental group needed 527.4 seconds for anastomosis completion; this difference was statistically significant (p<0.001). Immediate and long-term patency rates were similar (p=0.5483). Clinically, 18 replantations were performed on 16 patients, and 17 free flap transfers were performed on 15 patients, totaling 104 anastomoses. The anastomosis success rate was 94.2% (33 of 35) for free flap transfers and 95.1% (39 of 41) for replantation cases.
CONCLUSION
The open-loop suture technique with airborne knot tying allows surgeons to complete microvascular anastomoses safely and in less time with minimal assistance when compared to the simple interrupted suture technique.
Topics: Rats; Animals; Retrospective Studies; Anastomosis, Surgical; Arteries; Suture Techniques; Microsurgery; Sutures
PubMed: 36995208
DOI: 10.14744/tjtes.2023.79702 -
CNS Oncology 2015Pituitary adenomas are among the most common central nervous system tumors. They represent a diverse group of neoplasms that may or may not secrete hormones based on... (Review)
Review
Pituitary adenomas are among the most common central nervous system tumors. They represent a diverse group of neoplasms that may or may not secrete hormones based on their cell of origin. Epidemiologic studies have documented the incidence of pituitary adenomas within the general population to be as high as 16.7%. A growing body of work has helped to elucidate the pathogenesis of these tumors. Each subtype has been shown to demonstrate unique cellular changes potentially leading to tumorigenesis. Surgical advancements over several decades have included microsurgery and the employment of the endoscope for surgical resection. These advancements increase the likelihood of gross-total resection and have resulted in decreased patient morbidity.
Topics: Adenoma; History, 19th Century; Humans; Microsurgery; Neurosurgical Procedures; Pituitary Neoplasms
PubMed: 26497533
DOI: 10.2217/cns.15.21 -
European Journal of Trauma and... Jun 2017Microsurgery courses, taught external to surgical training programs, are essential for acquiring the high level of technical skill required for clinical proficiency.
INTRODUCTION
Microsurgery courses, taught external to surgical training programs, are essential for acquiring the high level of technical skill required for clinical proficiency.
METHODS
The Frankfurt microsurgery course is a 5-day, intensive course that teaches arterial and venous anastomosis using end-to-end, end-to-side, one-way-up, continuous-suture, and vessel graft techniques. During the course, the instructor records the level of skill (in-course data) achieved by each trainee by assessing anastomosis completion and patency. Demographic information is also collected. Post-course trainees are invited to complete an online survey (post-course data) to get their opinions of the courses' effectiveness.
RESULTS
The in-course "skill achievement" and post-course "course effectiveness" data are presented below. In-course data: 94.8 and 59.9% of participants completed patent end-to-end arterial and venous anastomoses, respectively, while 85.4% performed a patent end-to-side anastomosis. 96.1 and 57.1% of participants who attempted arterial and venous anastomoses using the one-way-up technique were successful, as were 90.9% of those attempting continuous-suture technique. Patent venous grafts were performed by 54.7% of participants.
POST-COURSE DATA
All respondents indicated significant improvement of their microsurgical skills after taking the course. 66.7% of respondents considered the full-time presence of the instructor to be the most valuable aspect of the course. All respondents would highly recommend the course to colleagues.
CONCLUSION
The microcourse significantly increased trainees' clinical microsurgery skills, confidence, and the number of clinical cases they perform. Of all the anastomosis techniques taught, venous anastomosis and grafting were the most difficult to learn. The presence of a full-time experienced instructor was most important.
Topics: Adult; Aged; Anastomosis, Surgical; Clinical Competence; Curriculum; Female; Germany; Humans; Male; Microsurgery; Middle Aged; Program Evaluation; Suture Techniques; Vascular Surgical Procedures
PubMed: 28161793
DOI: 10.1007/s00068-016-0759-1