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Biomedical subjects

M Henri

Publications and source records attributed to M Henri.

5 recordsLinked to original sources
PubMed2006

[Chronic instability in the ankle area].

For ankle sprains, the initial radiological work-up must include weight-bearing AP and lateral stress views of the sprained and healthy ankle. Films are taken in auto-varus. Other explorations included arthroMRI, arthroscanner or MRI which can be indicated preoperatively to confirm suspected cartilage injury or an associated ligament tear. These techniques should be employed when pertinent information can be expected according to the clinical situation and the operator's experience. In the emergency setting, ultrasonography can provide a simple low-cost confirmation of joint hematoma which is more precise than x-rays with a positive predictive value of nearly 100%. The objective and subjective clinical outcome after surgical anatomic repair or ligamentoplasty are quite similar. The two principal differences relate to persistent subjective instability and post-operative surgical complications. Thus there are advantages and disadvantages for each option advantage for anatomical repair because of the low rate of surgical complications and advantage for ligament repairs which stabilize the subtalar joint with a low rate of residual instability.

Ankle↗
PubMed2002

[Image fusion, virtual reality, robotics and navigation. Effects on surgical practice].

In the new minimally invasive surgical era, virtual reality, robotics, and image merging have become topics on their own, offering the potential to revolutionize current surgical treatment and assessment. Improved patient care in the digital age seems to be the primary impetus for continued efforts in the field of telesurgery. The progress in endoscopic surgery with regard to telesurgery is manifested by digitization of the pre-, intra-, and postoperative interaction with the patients' surgical disease via computer system integration: so-called Computer Assisted Surgery (CAS). The preoperative assessment can be improved by 3D organ reconstruction, as in virtual colonoscopy or cholangiography, and by planning and practicing surgery using virtual or simulated organs. When integrating all of the data recorded during this preoperative stage, an enhanced reality can be made possible to improve intra-operative patient interactions. CAS allows for increased three-dimensional accuracy, improved precision and the reproducibility of procedures. The ability to store the actions of the surgeon as digitized information also allows for universal, rapid distribution: i.e., the surgeon's activity can be transmitted to the other side of the operating room or to a remote site via high-speed communications links, as was recently demonstrated by our own team during the Lindbergh operation. Furthermore, the surgeon will be able to share his expertise and skill through teleconsultation and telemanipulation, bringing the patient closer to the expert surgical team through electronic means and opening the way to advanced and continuous surgical learning. Finally, for postoperative interaction, virtual reality and simulation can provide us with 4 dimensional images, time being the fourth dimension. This should allow physicians to have a better idea of the disease process in evolution, and treatment modifications based on this view can be anticipated. We are presently determining the accuracy and efficacy of 4 dimensional imaging compared to conventional evaluations.

Computer Systems↗
PubMed1991

Peripheral laser angioplasty with sapphire tip.

UNLABELLED: To improve the result of peripheral laser recanalization (less perforation with wider tunnels of vaporization), we used the technique of sapphire laser angioplasty. A Nd:YAG laser with continuous emission was connected to a catheter with a 600 mum fiber and a sapphire probe to its extremity (1.8-3 mm in diameter). Treatment was performed on 127 patients with severe stenosis or occlusion of peripheral arteries (iliac, femoral, or popliteal arteries). Recanalization was obtained in 102 cases (80%) and was further embellished by balloon dilatation. The rate of success decreased proportionally with the length of occlusions (93% for 3 cm, 33% for 15 cm and more). Most failures were due to wall perforation or wall entry of the probe; passage of the sapphire tip was rarely blocked by the occlusion. At follow-up, 26.4% of arteries were reoccluded after 2 months. IN CONCLUSION: laser angioplasty with a sapphire tip can totally recanalize occluded arteries with low rate of failure and complications.

Adult↗
PubMedDate not supplied

Laparoscopic surgery for cancer: are we ready?

Following feasibility studies more and more large prospective reports even randomised trials document the treatment of digestive cancer using a laparoscopic approach. While the spectre of port-site recurrences, once so alarming has faded, it has become a challenge for laparoscopic surgeons to provide long-term follow-up. There is good class II and III evidence that staging laparoscopy (SL) has a value for oesophageal, gastric, pancreatic and hepatobiliary cancer as well as for intra-abdominal lymphomas since it adds to primary staging and often alters the clinical stage of the disease and hence the management of the individual patient. For minimally invasive oesophagectomy and gastric cancer surgery several series have demonstrated shorter perioperative morbidity and hospital stay however at present most studies report smaller numbers of selected patients and long term follow up is rare. The laparoscopic resection of pancreatic malignancies is not reported to be feasible, safe or potentially beneficial for the patient while the curative resection of suspected early gallbladder cancer is a poor indication. Nevertheless laparoscopy is documented to be safe and applicable for small malignant liver lesions and the Lacy trial was significantly in favour of laparoscopy-assisted colectomy, predominantly for stage III disease. Bearing in mind that in many fields of digestive cancer surgery, laparoscopy should still be conducted as part of a trial, it is safe to say that "we are ready" for this revolution to arise.

Abdominal Neoplasms↗