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At least 253 records · Page 14Linked to original sources

PubMedDate not supplied

[Microsurgery of the appendix testis (experimental research)].

Based on their own experience with 83 reconstructive microsurgeries performed for epididymis obstruction the authors concluded that a simple incorporation of microsurgical techniques into the surgery of excretory infertility failed to substantially improve the results of the treatment. Supposing a well-managed clinical study to be the main tool to provide better results and the data of animal studies to be inapplicable for the diseases of the human reproductive system, the authors suggested that the aforementioned study in the clinical settings should conform to the two major requirements: an uniform pattern of the techniques employed and an exacting control over anastomosis application. As a method of choice, end-to-side vasoepididymostomy was offered. A training model for gaining the mastery of epididymis microsurgery techniques was developed as well. The reliability of the method was proved by experiments on 20 rabbits. 17 animals gave offsprings. The system of epididymal ducts studied in health opened the possibility of a well-founded division of epididymis into zones of surgical importance.

Adult↗

PubMedDate not supplied

[Methods of capsular and intracapsular microsurgery, intracapsular implantation and sutureless fixation of artificial lenses].

The author recommends mastering the methods of capsular and intracapsular microsurgery for cataracts on cadaver eyes. He advises to remove the cornea and the iris to have a better view of the technique. As the physician masters the technique, he screens the lens sac equatorial area by keeping the iris and later the cornea (to make the conditions as close to clinical surgery as possible) and then removes the iris and the cornea for controlling the quality of the capsular pocket preparation. Artificial lenses similar in shape to B. N. Alexeev's design may be implanted in the prepared lens sac; then the anterior capsule of the lower capsular pocket in the central area is removed. The training may be completed by removal of the anterior capsule alone, i.e. by extracapsular extraction. The described methodology helps more rapidly master the techniques of capsular and intracapsular microsurgery and intracapsular implantation of artificial lenses and thus promotes a wide practical employment of these microsurgical techniques.

Humans↗

PubMedDate not supplied

[Computed tomography in the Multidisciplinary Science and Technology Complex "Eye Microsurgery"].

The paper is devoted to analysis of the results of CT in 1000 patients examined in the Multibranch Research and Technology Complex "Eye Microsurgery". The specific feature of CT in this institution is that 52% of all investigations of ophthalmological patients fall to the share of eyeball abnormality and 40%--to a study of the other parts of the organ of vision. CT indications are extended for low tension glaucoma, complicated high myopia, and for monitoring the position of microsurgical implants. The use of CT in such a highly specialized medical institution as the MRTC "Eye Microsurgery" is considered indispensable.

Eye Diseases↗

PubMed1987

[Use of microsurgery in the treatment of ischemic heart disease].

Coronary artery bypass operations with the use of microsurgery were performed in 60 patients with diffuse forms and distal levels of coronary artery lesions. In 55 patients aortocoronary bypass operations, and in 5 patients mammary-coronary bypass operations were performed (total of 213 distal anastomoses). During the operation and in immediate postoperative period 3 patients (5%) died, 3 patients developed the intraoperational myocardial infarction. Microsurgery has good prospects in operations of coronary arteries.

Adult↗

PubMed1978

Microsurgery of the peripheral nerve: a physiological approach.

Results with peripheral nerve injuries, which today still fall short of our goals, should intensify our efforts in this specialized field of microsurgery. We are living in an exciting era of functional reconstitution. Long gone are the times when a pink replanted digit or a successful free flap comprised the end-point of our surgical efforts. The direction from now on is toward achieving functional restoration by utilizing basic principles while armed with the unlimited potentials of reconstructive microsurgery. To this end we need the assistance and cooperation of other sciences since the enigma of the peripheral nerve can be deciphered only by a multidisciplinary approach.

Electrophysiology↗

PubMedDate not supplied

[The current role of microsurgery and in vitro fertilization in the treatment of tubal infertility].

Tubal sterility is an important cause of sterility in the couple. Its treatment has been revolutionised, firstly by the progress in microsurgery and, more recently, by the current progress in in vitro fertilisation. Consequently, the gynecologist must have a very good knowledge of sterility in the couple and of tubal pathology. The authors report the results of 400 microsurgical operations performed in the Maternity department of the Port-Royal hospital and compare these results with those of in vitro fertilisation. In the light of these results, they then attempt to define the therapeutic indications which depend on a very precise investigation of the condition of the tubes. Microsurgery and in vitro fertilisation constitute complementary approaches in cases which are difficult to evaluate.

Adult↗

PubMed1981

Deliberate hypotension for middle ear microsurgery.

By means of groups of one hundred patients undergoing middle ear microsurgery, we compared two hypotensive anesthesia techniques combining halothane, a non-depolarising myorelaxant and a beta adrenoreceptor blocking agent. Practolol, a beta 1 receptor blocker was administered to the patients of group A while those of group B received labetalol, a more recently introduced alpha and beta receptor blocker. The duration of microsurgery for each type of pathology was identical in both groups but the operation conditions (mostly the amount of bleeding) were better in group B (statistically significant). Moreover, the mean delivered halothane concentration could be reduced by 20% (from 0.85% to 0.68%). Thirty patients undergoing tympanoplasty were followed up for several months to determine the the importance of peroperative conditions in relation to the functional result of these operations. Excessive bleeding hinders the surgeon and the positioning of the implant and also, as confirmed by this study, makes the success of the tympanoplasty uncertain. Two factors likely to predispose the patient to bleeding (and able to be brought under control preoperatively) have been highlighted: these are overweight (obese status about 80 kg) and a systolic arterial blood pressure at rest above 140 torr. The various agents which were used and the reasons for their choice are discussed.

Adrenergic beta-Antagonists↗

PubMed1984

[Tubal sterility: fertilization in vitro or microsurgery].

In this review paper the respective places of microsurgery and in vitro fertilization in the treatment of tubal infertility are evaluated. The best and current results of the two methods are compared and their future is considered. Most of the indications for microsurgery remain, while some (e.g. poor prognosis salpingostomy, repeated tuboplasty, tubal transplantation) require discussion and new ones are appearing. The advent of in vitro fertilization has introduced some technical changes in surgery of the ovaries and surrounding tissues and has given rise to new techniques. It has also modified the initial investigations in infertile women and the use of pre-operative and second-look laparoscopy. It has exerted little influence on microsurgeons specialized in problems of reproduction but has obliged their teams to be reorganized on a multidisciplinary basis in order to cope with new techniques.

Fallopian Tube Diseases↗

PubMed1984

Current status of orthopaedic microsurgery in Japan. Personal experience and review of the literature.

Among the Japanese contributions in reconstructive microsurgery, transplantation of composite tissues and replantation of amputated extremities are the most representative. With the standardization of the techniques of microsurgery and replantation, these operations have become relatively common. By July 1981, 3126 replantations had been performed in 78 hospitals with an 80%-90% success rate. Recently, surgeons have focused on the recovery of function. A recent analysis of the author's series of replantations through the end of 1980, using a scoring system of function evaluation criteria, showed that results in 72% of the 181 patients involving 259 upper extremity replants were excellent or good.

Adolescent↗

PubMedDate not supplied

Emergency versus elective microsurgery.

During a 30-months period, a total of 148 microsurgical gynecological operations were performed in our department. We divided these operations into two groups: Emergency microsurgical operations, where microsurgical technique is used in urgent cases for preservation of fertility potential, and elective microsurgical operations, performed for restoration of fertility. We compared the two groups with regard to their inherent characteristics and differences in therapeutic and prognostic approach towards them. The results of our comparison show, that these two groups having in common only the microsurgical approach, are different from each other in the following points: The average age of the emergency microsurgery group was younger since it contained also prefertility cases; the timing of operations in the elective group was always in the proliferative phase of the menstrual cycle; antibiotics were given pre-, intra and postoperatively only in the elective group; corticosteroids were given intra- and postoperatively only in the elective group; the average number of different operative procedures performed during one operation was higher in the restorative group; desire for pregnancy was always present in the restorative and inconstantly in the preservative group; results of the operations regarding intrauterine pregnancy can be evaluated only for the elective, and not for the emergency group. Psychological evaluation of cases can be performed in the elective and not in the emergency group. Because of these differences, a division of microsurgical operations into elective and emergency microsurgery seems justified and valuable to us.

Adolescent↗

PubMedDate not supplied

In vitro fertilization and microsurgery.

The places microsurgery and in vitro fertilization (IVF) hold, respectively, in the treatment of tubal infertility are evaluated. "Optimal" and "acceptable" results of the two techniques are compared, and future results are talked about. Most of the indications for microsurgery are still valid, some are debatable (salpingostomies with bad prognosis, repeated surgery, tubal transplant, etc.), and some new ones emerge. Technically speaking, IVF introduces some changes in surgery of the ovary and surrounding tissues and gives rise to new techniques. Diagnostic and therapeutic management is changed insofar as initial assessment, preoperative coelioscopy and, above all, postoperative monitoring are concerned. The microsurgeon, who is to remain a reproduction specialist, undergoes few personal changes, but his team must be organized on a multi-field basis in order to cope with the new techniques.

Combined Modality Therapy↗

PubMed1981

Closed microsurgery in the management of intraocular foreign bodies.

The instrumentation and techniques of closed intraocular microsurgery offer a valuable approach to the management of selected intraocular foreign bodies. These methods facilitate the removal of retained material and the surgical repair of intraocular damage resulting from penetration. Although guidelines have been proposed, the precise indications and appropriate timing of surgery have not been established. We present the results of closed microsurgery in a consecutive series of patients with posterior segment intraocular foreign bodies or their sequelae. Factors which appear to limit visual recovery are discussed in relation to the timing of surgery.

Adolescent↗

PubMed1978

[Instruments in microsurgery (author's transl)].

Instruments are at the basis of microsurgery. An operating microscope is the main element and the most important and expensive thing to buy. Yet it is possible to begin with a simple microscope as the ZEISS OMPI 1, or its copy by BAG. Five or six intruments are necessary except irrigation set up, clamps, bipolar coagulation. Suture material will be selected for each times. Microsurgery demands an important training before applying it in the operating room. A good operating position will also be required in order to perform efficiently.

Humans↗

PubMed1981

[Experimental and clinical use of microsurgery in urology].

Application of microsurgery in experimental and clinical urology is reviewed. A summary of the literature and own preliminary results are presented, especially the model of kidney transplantation in the rat and the treatment of male infertility due to obstructive azoospermia. The extended use of microsurgery in urology is possible and necessary.

Animals↗

PubMed1981

[Microsurgery: indications and organization].

Microsurgery is an important, but purely technical advancement. It would be a serious error for medicine and patient care to accept the concept of a "microsurgeon" rather than recognizing the necessity for surgical specialists working in many anatomical regions to learn microsurgery techniques as related to comprehensive care of their area. In hand surgery it is already clear that the duration of procedures and the exhaustion associated especially with reattachment surgery demands care by a team rather than by a single individual. Decision making and over all responsibility for performance of that team must, however, rest clearly with a primary surgeon. The institution of an emergency service for microsurgical cases represents a heavy burden to the infrastructure of a hospital. Therefore it seems reasonable to institute in each country an appropriate number of replantation centers to which the cases can be referred. The indications for reattachment surgery must be carefully evaluated and well balanced against traditional possibilities of treatment. The dramatic achievements of reattachment surgery and composite tissue transfers are illustrated by a few examples.

Adult↗

PubMed1981

[Microsurgery: organization and indication in the Federal Republic of Germany].

Since 1960's the new technique of microsurgery of the nerves was introduced in Germany at Departments of Plastic Surgery, Handsurgery and Neurosurgery. Since 1974 the technique of microvascular surgery was used in different places. In March 1975 the first free flap transfer was performed at our clinic in Munich. In the same year 24 h reimplantation services were established in Hamburg and Munich. In connection with training of other colleagues and information of the population we could perform up to 31 march 1980 703 replantations at the hand with a survival rate of 78.5%. Through education by annual instructional courses and fellowships at our clinic further replantation services were established in Germany. A general request showed that up to the middle of 1979 2742 micro- and 381 macro-replantations were performed in Germany. The places where replantations are done should be classified in 1. replantation centres (at present 9 in FRG), 2. replantation services (at present 4 in FRG), 3. places with microvascular experiences (at further 4 places in FRG). The training program for a member of a replantation team should include: 1. general surgery, traumatology, 2. plastic surgery, 3. hand surgery, 4. microsurgery. Beside the replantation also the clinical application of free tissue transplantation is increasingly used at our clinic and other places in Germany.

Adult↗

PubMed1981

[Organization and activities of microsurgery in Belgium].

Answering the question of indications and organisation in microsurgery in Belgium, a report is given of the microsurgical activities around the country. The benefit of the multicentered activity is stated and the necessity of a more pronounced organisation for emergency microsurgery is stressed.

Belgium↗

PubMed1980

Gynaecological microsurgery in perspective.

The application of microsurgery in gynaecology is discussed. The necessity for a proper training programme and correct selection of patients is stressed. A classification pertaining to surgical procedures is necessary to compare the results of such surgery. The limitations of microsurgery in dealing with adhesions is considered, as well as the markedly improved results in tubal anastomosis, and the possibility of substitution of oviducts is considered.

Animals↗