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M Medot

Publications and source records attributed to M Medot.

7 recordsLinked to original sources

Video-microsurgery: a new tool in microsurgery.

Endoscopic surgery is slowly becoming an increasing part of plastic surgical practice. Besides its most obvious advantages, related to small incisions, the endoscope provides excellent magnification of the operative field. We thus decided to investigate the possibility of using the endoscope as an alternative to the operative microscope for performing microsurgical procedures. Before starting a clinical investigation, digital artery, nerve, vein microsutures, and neck dissections were performed in fresh human cadavers. Magnification, working distance, depth of focus, diameter and temperature of the operative field, and resolution were measured using either the operating microscope or the endoscope. Working conditions were compared. The advantages of the endoscope as compared to the microscope were: less bulk, sterility, mobility, versatility and cost-effectiveness. The disadvantages were: short working distance, inferior resolution and two-dimensional images. Overall, the endoscope was found to be an interesting alternative to the operating microscope. We are now using the endoscope routinely in the clinical arena, and we believe that it has a great potential and a promising future as a microsurgical tool.

Endoscopes↗

Effects of capsular contracture on ultrasonic screening for silicone gel breast implant rupture.

Unlike computed tomography and magnetic resonance imaging, ultrasound is an inexpensive test of potential use in detecting silicone gel breast implant (SBI) rupture. However, periprosthetic capsular contracture can make ultrasonic diagnosis of rupture difficult because the contracture-related radial folds inside the SBI can lead to a false-positive diagnosis of rupture. This study was conducted to determine the effects of capsular contracture on the ability of ultrasound to diagnose SBI rupture. Preoperative ultrasonic results of 122 SBIs were compared with surgical findings at the time of implant removal. The sensitivity and negative predictive values of ultrasound were lower in the presence of a contracted capsule (41.2% vs. 68.7%, p = 0.062; and 58.3% vs. 79.6%, p = 0.056 respectively). Ultrasound should be considered reliable in diagnosing SBI rupture only in the absence of a contracted capsule.

Adult↗

Experimental model of pudendal nerve innervation of a skeletal muscle neosphincter for faecal incontinence.

BACKGROUND: Faecal incontinence is difficult to treat. A variety of reconstructive procedures has been described, but none is entirely satisfactory. This study evaluated the feasibility of cross-innervating a skeletal muscle neosphincter with the pudendal nerve in a canine model. METHODS: Thirty dogs were rendered surgically incontinent (the pudendal nerve was cut and the external sphincter was partially excised). A neosphincter was then created using the semitendinosus muscle. In ten dogs pudendal nerve transposition (PNT) to the nerve to the semitendinosus muscle was performed. Ten dogs were given a dynamic neosphincter by inserting a pulse generator at 6 weeks. The remaining ten dogs served as controls with passive semitendinosus wraps. Anal manometry was performed before operation and monthly for 5 months. Muscle biopsies, performed at the initial operation and at 5 months, were stained for slow- and fast-twitch fibres, and were examined histologically. RESULTS: At 1 month, mean sphincter function was 32 per cent of the preoperative value in the control animals, 34 per cent in the PNT group and 27 per cent in the electrostimulation group; all dogs were incontinent. At 5 months the mean recovery of sphincter function was 42 per cent of the preoperative value in controls, 100 per cent in dogs with PNT (P < 0.001) and 63 per cent in dogs having electrostimulation (stimulator on) (P = 0.02). Six dogs with PNT had squeeze pressures equal to or greater than preoperative levels. At 5 months the ratio of slow to fast fibres was significantly greater in all dogs (control P = 0.01, PNT P < 0.005, electrostimulation P < 0.001). CONCLUSION: Use of the pudendal nerve to innervate a canine skeletal muscle anal wrap produced a functional anal sphincter that was superior to electrically stimulated and passive wraps.

Anal Canal↗

[Nose injuries].

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Accidents, Traffic↗

The cutaneous territory of the transverse tensor fascia lata flap: further anatomical considerations.

The cutaneous territory and the anatomical variations of the lateral circumflex femoral artery (LCFA) were studied on 20 fresh cadavers. This territory extends transversally on an average of 20 per 18 cm on the supero-lateral aspect of the thigh. The LCFA divides into three terminal branches as it enters the tensor fascia lata muscle. The posterior transverse branch is constant and makes the transverse tensor fascia lata (TFL) flap highly reliable, as opposed to the classical longitudinal TFL flap. The latter is based on the descending branch of the LCFA which is missing in 5 out of 20 cadavers. The lateral circumflex femoral artery also gives 1 to 2 ascending branches running toward the iliac crest and providing its periosteal blood supply. Based on these branches, it might be possible to raise an osteomyocutaneous flap of tensor fascia lata and iliac crest.

Aged↗

[Mediastinitis: diagnosis, risk factors and treatment].

The authors review the literature concerning post-sternotomy mediastinitis. The incidence, mortality, diagnosis and risk factors are discussed, but above all, the various treatments are reviewed and compared with respect to their advantages and risks, their respective usefulness and results, in order to define a reasonable way of management of this highly pejorative surgical complication. Open technique, closed irrigation and surgical flaps of omentum, pectoralis major and rectus abdominis are successively considered.

Anti-Bacterial Agents↗