PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Microsurgery”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed1998

Rectal expander-assisted transanal endoscopic microsurgery in rectal tumors.

Rectal expander-assisted transanal endoscopic microsurgery (RE-TEM) was performed for two cases of early rectal cancer and a case of villous tumor under saddle block anesthesia. RE-TEM is the new technique for local excision of rectal tumors with a rectal expander that we developed. The rectal expander expands the rectum after insertion through the anus and provides adequate vision for microsurgery with standard video monitors. Tumors were located 8, 8, and 5 cm from the anal verge, and all of them were excised completely with no difficulty. Minor bleeding was noted in all cases and was controlled by electric coagulation and/or sutures. Average operative time for the three cases was 105 min. We conclude that RE-TEM is useful for rectal tumors and/or early rectal cancer that cannot be removed by endoscopy.

Adenocarcinoma↗
PubMed1998

[Use of the internal mammary artery in reconstructive microsurgery in the thoracic region: anatomical-radiologic study].

In this study, the topographic anatomy and the diameter of the internal mammary (thoracic) vessels was investigated in regard to their potential as a recipient vessel in reconstructive microsurgery in the ventral thoracic region. Particularly for reconstruction of large thoracic wall defects as well as for female breast reconstruction with free tissue transplantation, these vessels seem to be suitable due to their location. We performed an anatomical study on 86 cadavers and a radiological investigation on 50 female patients and volunteers. We found a mean diameter on 50 female patients and volunteers. We found a mean diameter of 1.8 mm of the artery and 2.1 mm of the commitant vein at the level of the fourth rib, one to two centimeters parasternally. We conclude that the internal mammary vessels can serve as recipient vessels in reconstructive microsurgery in the ventral thoracic region at the level of the fourth rib or cranially. Hypothetically, free muscle flaps for the treatment of sternal osteitis, free fasciocutaneous flaps to replace presternal burn scars or appropriate flaps to fill up a funnel chest cavity subcutaneously may be anastomosed to the internal mammary vessels.

Adult↗
PubMed1996

[Transsphenoidal microsurgery for pituitary adenoma: analysis of 3 fatal cases].

To prevent severe postoperative complications and increase the survival rate of patients with pituitary adenoma after transsphenoidal microsurgery, 3 fatal cases were analysed in terms of clinical features and caused of death. They included (1) the too deeply inserted suction apparatus with resultant midbrain damage; (2) bleeding from residual tumor into aphragma sellae and dura mater, entering the subarachnoid, causing spasm of the brain vessels. In order to avoid complication, it is necessary to follow strictly the rules for transsphenoidal microsurgery and improve surgical skills.

Adenoma↗
PubMed1998

[Reconstructive and plastic microsurgery in the treatment of combat trauma to the extremities].

In the department of microsurgery of A.A. Vishnevsky Central Hospital the transplantation and transposition of the at the gunshot injuries of the extremities have begun to execute since 1990. For this time 94 surgical interventions have been conducted at 88 wounded: 57 transplantations and 37 transpositions of the bloody tissues. The transplantation and transposition of the vascularized complexes of tissues with application of microsurgical technique is the effective method of the treatment of the wounded in the extremities. In the conditions of the local armed conflicts it is necessary to provide deployment of the department of microsurgery at stages of the specialized medical care.

Adult↗
PubMed1997

[Functional voice evaluation after Reinke's edema treated with CO2 laser and Kleinsasser's microsurgery].

The authors performed functional evaluation of voice in 124 patients treated with microsurgery due to oedema Reincke in the years 1991-1994. In 90 patients surgery was performed with CO2 laser microsurgery and in 34 patients with microlaryngoscopy according to Kleinsasser. The picture of larynx was registered and evaluated with help of laryngovideostroboscopy. The voice status was evaluated in phoniatric examination, registered on tape and submitted to acoustic analysis. No correlation between method of surgical treatment and quality of voice was observed. However, significantly worse quality of voice was noted in those smoking after surgery.

Carbon Dioxide↗
PubMed1998

Insertion of microscopic objects through plant cell walls using laser microsurgery

A detailed protocol is presented for precisely inserting microscopic objects into the periplasmic region of plant callus cells using laser microsurgery. Ginkgo biloba and Agrobacterium rhizogenes were used as the model system for developing the optical tweezers and scalpel techniques using a single laser. We achieved better than 95% survival after plasmolyzing G. biloba cells, ablating a 2-4-μm hole through the cell wall using a pulsed UV laser beam, trapping and translating bacteria into the periplasmic region using a pulsed infrared laser beam, and then deplasmolyzing the cells. Insertion of bacteria is also described. A thermal model for temperature changes of trapped bacteria is included. Comparisons with other methods, such as a reverse-pressure gradient technique, are discussed and additional experiments on plants using laser microsurgery are suggested. Copyright 1998 John Wiley & Sons, Inc.

Journal Article↗
PubMed1986

A preoperative classification to predict the intrauterine and ectopic pregnancy rates after distal tubal microsurgery.

A simple preoperative classification is described to predict the intrauterine and ectopic pregnancy rates following distal tubal microsurgery. Laser CO2 microsurgical salpingostomies were performed on 76 patients between January 1979 and January 1984. All of the patients underwent a preoperative assessment, which included hysterosalpingogram and laparoscopy, to formulate a preoperative classification based on a point system. The patients were divided into four groups according to tubal damage, with a subsequent intrauterine pregnancy rate of 58.3% in grade I, 36.6% in grade II, 9.5% in grade III, and 0% in grade IV. The patients were divided into four groups according to adhesions, with a subsequent intrauterine pregnancy rate of 38.8% with no adhesion, 32.0% with mild adhesions, 26.6% with moderate adhesions, and 5.5% with severe adhesions. From these results, a preoperative management is proposed for patients being considered for either distal tubal microsurgery or in vitro fertilization.

Adult↗
PubMed2001

Organ preservation by transoral laser microsurgery in piriform sinus carcinoma.

OBJECTIVE: To determine the effectiveness of organ-preserving CO2 laser microsurgery for the treatment of piriform sinus carcinoma. METHODS: A retrospective review of 129 previously untreated patients undergoing CO2 laser microsurgery for the treatment of squamous cell carcinomas of the piriform sinus from 1981 to December 1996 was undertaken. The intention was complete tumor removal by preserving functionally important structures of the larynx. Distribution of tumors (Union Internationale Contre le Cancer/American Joint Committee on Cancer, 1992) was 24 cases with pT1, 74 with pT2, 17 with pT3, and 14 with pT4 disease. Node status was positive in 68% of patients. Seventy-five percent of patients had stage III or IV disease. Forty-two percent of the patients were treated solely with surgery, and 58% had surgery and postoperative radiotherapy. The median follow-up interval was 44 months. RESULTS: Eighty-seven percent of patients were controlled locally. Neck recurrences occurred in 14.0% of patients, metachronous distant metastases with locoregional control in 6.2%, and second primary tumors in 18.6%. Twenty percent of patients died of TNM-related deaths. The 5-year overall Kaplan-Meier survival rate was 71% for stages I and II and 47% for stages III and IV disease; the 5-year recurrence-free survival rates were 95% and 69%, respectively. CONCLUSION: A comparatively low local recurrence rate, a high recurrence-free survival rate, and the avoidance of laryngectomy favor function-preserving surgery of piriform sinus carcinomas.

Adult↗
PubMed2001

Development of micro-active forceps for future microsurgery.

A new eye microsurgical system is proposed. The final goal of our research project has been not only to improve surgical instruments, but also to establish a total surgical system applicable to today's most difficult microsurgery, within the eye. The new prototype micro-forceps, which have a joint that enlarges the surgical area and a built-in thin optical fibrescope to increase the dexterity of retinal microsurgery, was designed as the first step in a long-term research plan. The micro-active forceps is equipped with a thin optical fibre inside the stem, giving a lateral view of the retina and a drastic improvement in fine operations. Moreover, this new tool, with an active joint and an end-effector, could find application in other microsurgical fields, such as in the brain, ear, nose and throat.

Journal Article↗
PubMed1993

Unrecognized injuries in patients referred for emergency microsurgery.

Replantation of amputated parts and emergency microvascular repair of injured extremities are the two most common applications of clinical microsurgery. A major complication of emergency referral of such cases is the existence of the other injuries unrecognized at the time of initial evaluation. We have reviewed this complication within a series of emergency microsurgical cases referred to this unit. Several reports examining this problem of missed injuries exist in the general trauma literature. To our knowledge this study is the first to look at this important problem in the context of acutely injured patients referred for emergency microsurgery. A retrospective analysis of patients referred to Davies Medical Center over a 7-year period was performed. Nine of 1100 patients (0.8%) transferred to our unit for microsurgical evaluation and treatment had unrecognized coexisting injuries that put those patients at high risk for injury-specific morbidity and demanded immediate changes in the original care planned at the time of referral. Brief case histories of these patients are outlined. We review the trauma literature of such injuries. A concise protocol elucidating the guidelines and pitfalls of emergency microsurgical referral is offered.

Adolescent↗
PubMed2005

A prospective analysis of extended endoscopic mucosal resection for large rectal villous adenomas: an alternative technique to transanal endoscopic microsurgery.

INTRODUCTION: Endoscopic mucosal resection is a safe resection tool for selected flat, sessile and lateral spreading tumours of the colon. Transanal microsurgical resection of select rectal neoplastic lesions is another accepted modality. Recent data suggests transanal microsurgery may have high complication rates. We conducted a prospective clinicopathological evaluation of an extended endoscopic mucosal resection technique for highly selected lesions of the rectum and assessed outcome data over a maximal 24-month period. PATIENTS AND METHODS: Eighty-three patients with known rectal neoplastic lesions underwent chromoscopic colonoscopy and on-table staging using a high-frequency (12.5 MHz) mini-probe EUS by a single endoscopist. Patients with T2 or node positive disease were referred for surgery. Following extended endoscopic mucosal resection patients were followed-up at 3, 6, 12 and 24 months post 'index' resection with chromoscopic endoscopy and EUS. Procedural complications, recurrence rates and outcome data were collected. RESULTS: Sixty-two patients fulfilled inclusion criteria. Median procedure time was 48 mins (range 32-126). Lateral spreading tumours (median diameter 30 mm; range 18-42 mm) and sessile lesions (median diameter 38 mm; range 25-86 mm) accounted for 19% and 81% of lesions, respectively. Ninety-seven percent of patients undergoing EMR were discharged within 6-h of procedure. Thirty-day re-admission and death rate was 0%. Bleeding complications occurred in 5/62 (8%) of patients with all achieving complete haemostasis using endo clips. None required transfusion. There were no procedural related complications or perforations. Overall 'cure' rate at a median follow-up of 16 months was 98%. CONCLUSIONS: Extended endoscopic mucosal resection for rectal neoplastic lesions can achieve superior results to those of per-anal excision and trans-anal microsurgery with regard to complications and recurrence rates. Extended endoscopic mucosal resection may be an alternative therapeutic modality in selected patients.

Adenoma, Villous↗
PubMed1986

Photodocumentation of laser microsurgery: preoperative, intraoperative, and postoperative techniques for still and video photographs.

Photodocumentation of preoperative, intraoperative, and postoperative findings serves to enhance and complement the study of normal and pathologic anatomy and physiology. Such documentation is invaluable for the teaching of medical students, physicians in the same or in other specialties, and allied health personnel. A surgeon may review and refine surgical technique, and colleagues around the world may study the situation from the same vantage point after surgery has been completed. Referring physicians may be kept graphically informed of the findings and progress of their patients. With the development of such modern technologies as laser microsurgery, an objective means of assessing ablation of disease and healing of surgical wounds is now available, and many of the extravagant claims of "no bleeding, and no edema during or after surgery" may be confirmed or refuted. I shall describe techniques for endoscopic examination and photodocumentation of the ears, anterior and posterior nares, nasopharynx, hypopharynx, and larynx in the preoperative, intraoperative, and postoperative patient. Techniques for obtaining high-quality color transparencies and color and sound videotapes will be presented. Equipment is simple and relatively inexpensive, and no special knowledge of photography is required. Examples of benign and malignant disease of the ears, nose, nasopharynx, and larynx will be shown before, during, and at regular intervals after microsurgery with the CO2 laser.

Endoscopy↗
PubMed1993

[Stereotactically-guided microsurgery in cerebral processes].

Stereotaxy-guided microsurgery offers significant advantages in the treatment of deep-seated cerebral lesions, or in lesions that cannot reliably be localized because of their small size or lack of evident landmarks. We report our experience with 16 stereotaxy-guided microsurgical procedures performed with the Leksell or the Lerch stereotactic system. Small superficial lesions were operated on in 6 patients and deep-seated subcortical lesions in 10 patients. The lesion size ranged from 10 to 50 mm and the depth of the lesions varied between 5 and 65 mm. A trans-sulcus approach was chosen in patients with cavernomas and a transcortical or transtumoral one in patients presenting with cerebral tumors. In no patient was a new postoperative neurologic deficit found, i.e. 12 patients had neither a pre- nor a postoperative deficit. 2 patients (with central lesions) of 4 presenting with preoperative deficits showed an impressive recovery, while in the other 2 patients with lesions in the dominant temporal lobe the neurologic deficit remained unchanged. Stereotaxy-guided microsurgery allows safe resection of small or deep-seated cerebral lesions without postoperative morbidity in our series.

Adult↗
PubMed1996

Microsurgery in a rat lung transplant model: analysis of benefit.

With the use of microsurgery, we have developed a method of measuring hemodynamic parameters in a rat not possible with previous technology. Three groups of rats were studied: a chemically induced pulmonary hypertensive group (PH); a chemically induced pulmonary hypertensive group treated with single lung transplantation (LT); and an untreated, control group (C). Cardiac output, heart rate, and pulmonary vascular resistance were then calculated in each group from data obtained by 1 mm high fidelity micromanometers and an ultrasonic flow probe. The results show that the data collected from the rodent model are reproducible within each group, and data quality is comparable to large animal models. With this new method, data can be collected in a small animal model at a fraction of the time and cost of large animal studies. Additionally, the complications of graft rejection in large animal studies are eliminated in an isogenic rodent model.

Animals↗
PubMed1998

Artery grafts in microsurgery.

Artery grafts appear to have no significant advantages over vein grafts in experimental models. Research in preservation of artery grafts continues, and holds possibilities of creating stored grafts that can be used clinically. Clinical use of artery grafts in microsurgery is limited to anecdotal use of arteries harvested from damaged body parts in emergencies and use of branched grafts from the subscapular system in elective arterial reconstruction. These clinical uses have never been analyzed, and their reliability and advantages remain undefined.

Animals↗
PubMed2000

Value in microsurgery of the ultrapulse carbon dioxide laser for rapid skin deepithelialization.

Although laser technology continues to evolve, its role in microsurgery is limited to minor adjunctive applications including skin deepithelialization. In the past, continuous-wave carbon dioxide (CO(2)) lasers were the best for performing skin deepithelialization. The newer ultrapulse CO(2) lasers also show promise in this regard. They have become readily available and are very popular for aesthetic skin resurfacing. Their use for skin deepithelialization is an essential part of microsurgical procedures for free flap contouring, flap onlay at the recipient site, and revision of skin grafted free flap donor sites. Complications are essentially nonexistent and competency in using this modality is straightforward for any microsurgeon.

Carbon Dioxide↗