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At least 523 records · Page 29Linked to original sources

PubMed2003

[Microsurgery treatment of old Achilles tendon rupture merging with skin defect].

OBJECTIVE: To explore the methods of treatment for old achilles tendon rupture merging with skin defect. METHODS: By following up retrospectively 10 patients from February 1995 to December 2001, we analyzed the operative methods, the points for attention and the results. Gastrocnemius musculocutaneous flaps were used in 3 cases, foot lateral skin flaps in 4 cases, superior medial malleolus skin flaps in 2 cases, and sural neural skin flap in 1 case. The Achilles tendon was sutured directly in 8 patients, with Lindholm's technique in 2 patients. RESULTS: All flaps survived and the wound healed well in 8 cases and reruptured in 2 cases. According to Yin Qing-shui's criteria to test the efficacy, the results were excellent in 5 patients, good in 4 and poor in 1. CONCLUSION: Repairing the old Achilles tendon rupture merging with skin defect by use of microsurgery has good results and plays an important role in reducing joint contracture and stiffness, and in saving the ability to push forward and flex.

Achilles Tendon↗

PubMed1992

[Laser microsurgery of meningioma. An analysis of a consecutive series of 164 cases treated surgically by using different lasers].

Over a six years period, 224 laser procedures were performed in our clinic, of these 164 (72%) involved meningiomas of various intracranial and spinal locations; 82 (50%) tumors were located in the posterior fossa, 36 (32%) were suprasellar or parasellar meningiomas: a carbon dioxide laser was used in 56 cases, a double wave length YAG laser in 101 cases, and recently a simultaneous Nd YAG and CO2 combolaser in 7 cases. Complete tumor removal was accomplished in 83% of cases and overall mortality was 3%. We think that microscope guided laser techniques represents a significant advancement in the ability to remove deep situated meningiomas that might prove difficult to extirpate by conventional microsurgery. The advantages of these methods include: 1. reduced brain retraction; 2. the ability to operate with smaller and different exposures; 3. a reduced amount of mechanical manipulation by vaporizing in first the dural attachment; 4. improved operative precision and 5. decreased intra operative blood loss.

Adult↗

PubMed1992

The role of microsurgery in pediatric craniofacial reconstruction.

Great strides have been made in both microsurgery and craniofacial surgery. Situations arise in which practitioners of both disciplines must work closely together to achieve a satisfactory reconstruction for the patient. This unified approach has set the stage for a new era in the treatment of pediatric craniofacial problems.

Adolescent↗

PubMed1991

[Evaluation of the healing value of Iwonicz mineral water in balneo-climatic therapy of chronic hyperplastic laryngitis with wide pachydermic changes of laryngeal mucous membrane after microsurgery by the Kleinsasser method].

The paper comprises clinical estimation of using Iwonicz mineral water Elin 7 in balneotherapy of chronic hyperplastic laryngitis after its microsurgical therapy by Kleinsasser method. Investigation in the group of 246 people showed that combined treatment, i.e. microsurgery and balneotherapy, is an effective method of healing some hyperplastic inflammatory diseases of mucous membrane of the larynx.

Adult↗

PubMed1976

[Ocular microsurgery. Contemporary ideas].

Microsurgery in ophthalmic practice consists of performing certain operations on the eye with the aid of a powerful binocular telescopic system which gives a greatly magnified view of the ocular structures. The equipment in use has improved progressively since 1953. The classical operations have been improved and new surgical techniques are now possible.

Humans↗

PubMed1992

[Eye controlled microscope used in ophthalmic microsurgery].

This article presents a system of oculomotor control of the microscope used in ophthalmic microsurgery. An eye movement sensor has been integrated within the microscope lens. The information provided by this sensor is used to control the position of the microscope with no alteration of the surgeon's visual functions and no interference with his visual sensori-motor reflexes. Results have been obtained from laboratory experimentations as well as from a series of anterior and posterior segment surgical procedures. They demonstrate the high precision and sensitivity of the gaze control which can be used to compensate for the reduction of the field of vision resulting from the optical magnification of the microscope.

Eye Movements↗

PubMedDate not supplied

[Clinical experience in using a metallic suture in eye microsurgery].

The use of a metallic suture in eye microsurgery is described in the paper. The metallic suture made from a 0.05-0.05 mm vanadic stainless steel wire (corresponding to 8:0) was applied in 1202 cataract extractions, penetrating injuries, antiglaucomatous surgeries and in removal of pterygium at the medical-and-sanitary facility of steel works in the town of Bokaro (India). The observation period ranged, on the average, from 3 months to 3 years. There were no complications during the procedure of applying the suture. However, it caused a minor response in the ocular tissues during the early postoperative period. Small bullae were observed in the corneal surface near the suture in 7 cases (0.58%), which disappeared spontaneously in 3-4 days. Irritations inflicted by the suture ends were registered in 2.58% of cases (31 patients). The mean postoperative astigmatism was, 3 months after surgery, 1.65 diopters. The sutures were removed in 132 cases (10.98%), including in 16 patients with irritation, and in 116 patients for the purpose of correcting a high astigmatism. The share of patients with a visual acuity of 0.5 and higher was, in one week, 43.59% and went up, one month later, to 78.20%. The suture was well tolerated by patients, it was quickly covered by the corneal epithelium, there was no rejection and it can be easily manufactured. The suture is sterilized by routine techniques without need for any extra treatment before use; it is a reactive, biologically inactive, efficient, convenient and causes minimal operative and postoperative complications.

Adolescent↗

PubMed2003

[Surgical approach to the sphenoid sinus in microsurgery of hypophyseal tumors].

Currently there are three major surgical approaches into the sphenoid sinus during transsphenoidal microsurgery. The first approach is the sublabial incision with submucous resection along the nasal septum. It is particularly advantageous in patients with small nasal apertures, in pediatric patients, and for large tumors extending into the cavernous sinuses or into the clivus. The second approach, the transnasal submucous tunnel, is presently the most frequent technique used, although it provides the narrowest operation field. The third technique is the direct transnasal approach. This method is less destructive to structures in the nasal cavity and less time-consuming. In the period of 20 months the authors performed 81 transsphenoidal microsurgical operations in 44 women and 37 men. Visual field defect was the most frequent indication for surgery in 42 cases, followed by hormonal abnormality in 24 patients. The sublabial approach was used in 69 cases, the technique of transnasal submucous tunnel in 10 patients, and the direct transnasal approach in 2 cases. The authors encountered no short-term or long-term complications related to various surgical approaches to the sphenoid sinus.

Female↗

PubMed1992

[Fetal microsurgery. The past and present of a frontier of surgery].

The concept that the fetus may be a patient is very recent. Modern ultrasonography can detect fetal abnormalities early in utero, and lead to prenatal correction of such malformations. At present three anatomic defects can benefit from fetal surgery: diaphragmatic hernia, urethral obstructions and obstructive hydrocephalus. The feasibility of fetal surgery has been proved both experimentally and clinically. Microsurgery can be of great help in this type of surgery. At this stage, fetal surgery should be pursued only in very qualified centers.

Animals↗

PubMed1992

A new endoscope for ophthalmic microsurgery.

We present an endoscope designed for ophthalmic microsurgery. The handpiece contains a charge-coupled device, a solid-state imager (250,000 pixels), and a probe (either 0.89 or 1.5 mm in diameter), including the light guide. The light source is a halogen lamp. The clear views the instrument provides of the ciliary sulcus and ciliary body behind the iris make it useful in secondary posterior chamber intraocular lens implantation using the ciliary sulcus suturing technique, and in endolaser photocoagulation of the ciliary body in end-stage glaucoma. It also is useful in performing vitrectomy in cases in which visualization is difficult because of corneal opacification or fluid-gas exchange.

Cataract Extraction↗

PubMed1992

[Transanal endoscopic microsurgery: technique and clinical results].

A new system has been developed for transanal endoscopic microsurgery (TEM), which allows all the conventional surgical techniques within the rectal cavity. The main indication is the removal of sessile adenomas. "Early rectal carcinomas" are also suitable for local excision. We perform local excision of advanced cancer only in cases where a contraindication exists to perform radical surgery or when the patients is unwilling to undergo demolitive surgery. The system has been employed at our Surgical Department on 206 patients in 223 cases. In 192 cases (87.7%) only one local excision was carried out due to sufficient excision as confirmed by histology (including patients with early "low risk" cancer). the postoperative course of 208 cases (93.3%) was free from any complications. The recurrence rate of adenomas amounted to 5.2%. This technique is particularly applicable for elderly, high risk patients and those with broad based adenomas so that anterior resection, abdominoperineal resection or other invasive operations can be avoided.

Adenoma↗

PubMed2003

[Free autodermoplasty in restorative microsurgery].

Use of the method of free autodermoplasty in the donor and recipient areas of free microsurgical revascularized autotransplants was analyzed in 172 patients. In the donor area the free autoderma was used for complete and partial closure of the wound defects appearing after taking large skin autotransplants of complex composition without tension. In the recipient area the free autoderma was used for the complete covering of microsurgical autotransplants, their partial covering and partial closure of the recipient area itself along the margin of the transplanted revascularized microsurgical autotransplant. The results obtained concerning its grafting (82.6%) suggest that free autodermoplasty is a highly actual method in the restorative microsurgery.

Adolescent↗

PubMed2004

[Ten years' experience with transanal endoscopic microsurgery].

The authors summarize ten years if their experience with the method of trans-anal endoscopic microsurgery (TEM). It has been used to treat 247 patients so far. The aim of the paper is to inform about the problems of solving the lesions of rectum employing the TEM method, a comparison with the application of other methods in this localization and the evaluation of this method after 10 years of practice.

Endoscopy, Gastrointestinal↗

PubMed1992

[The status of replantation centers and services in the area served by the German Professional Society of Microsurgery of Peripheral Nerves and Blood Vessels (Commission for Replantation)].

This survey concerns the years 1989 and 1990. While the number of institutions performing replantations remained constant in Austria and Switzerland, there has been a noticeable trend in Germany from around-the-clock replantation centers to simple replantation services, offering emergency microsurgery by arrangement only. The total number of replantations performed decreased from 975 replanted parts (903 microreplantations and 72 macroreplantations) in 1989 to 875 in 1990, with a micro-/macroreplantation ratio of 12.8:1. Based on the results of questionaire received from 34 university and city hospitals in Austria, Switzerland and former West Germany, an analysis of clinical organization and management of replantation services is presented.

Amputation, Traumatic↗

PubMed2004

Injury of the lacrimal component of the nervus intermedius function after radiosurgery versus microsurgery.

RATIONALE: Due to the synergetic role of the facial nerve and the nervus intermedius in the mechanical protection of the eye, vestibular schwannomas (VS) and/or their treatment are dangerous for the visual function. Our goal was to evaluate and compare the impact of the tumor itself, and the microsurgery (MS) or radiosurgery (RS). MATERIAL AND METHOD: A functional questionnaire evaluating among other items the patient's complaints related to the eye was addressed to a series of 100 patients, 3 years after GKS of a previously unresected unilateral VS. Answers were compared with those of a group of 100 patients operated microsurgically. A Shirmer test was additionally performed before radiosurgery, and more than 2 years after radiosurgery in 46 patients. RESULTS: The risk of dry eye and burning eye was much higher in patients operated by MS compared to patients operated by GKS due to the high incidence of facial palsy in the former (57/99) and the its absence in the later (0/80). In the population operated microsurgically, the presence of a permanent facial palsy (57 patients among 99 responding to the questionnaire) was, of course, associated with a high rate of complaints about burning eye (n=18) and crying eye (n=23). Among patients from the two arms with no facial palsy, a dry eye was reported by 8/64 after GKS and 7/42 after MS (NS) and a burning eye by 9/64 after GKS and 9/42 after MS (NS). Thus patients with no clinical signs of impairement of the VII motor nerve accounted for 14% of the cases signs indicating injury of the intermedius nerve with the same probability whatever the kind of surgery. When no permanent facial palsy was observed a crocodile tear syndrome was more frequently observed after MS (4/42 versus 1/64, p=0.07). This suggests an early lesion of the VII motor and intermedius, and a subsequent abnormal regrowth. The only patient reporting a crocodile tear syndrome after GKS turned out to have presented transiently a discret deficit of orbicular muscle signaling transient partial facial nerve injury. In absence of facial palsy, a "crying eye" was reported more frequently after MS (16/42 versus 9/64, p=0.01), leading us to suspect frequent infraclinical VII nerve injury in patients with no obvious facial palsy operated by MS. Patients tested with Shirmer test, before and more than 2 Years after, were improved in 28.3%, stable in 56.5%, and worse in 15.2%. CONCLUSIONS: This study is the first demonstrating that radiosurgery can induce nervus intermedius injury in a small percentage of cases (14%). These patients had been treated 11 years ago with what we can consider as "archeoGKS technology" compared to today's refinements. The impact of modern GKS on the nervus intermedius is currently under evaluation in our group. However, symptoms related to the eye either due to the injury of the nervus intermedius or of the VII motor or both are much more frequent after MS than after RS.

Adolescent↗

PubMed1992

Microsurgery and its clinical impact.

Microsurgery is a technique of magnifying the visual horizon of the surgeon to enable him to see better, dissect better and perform micro-manipulation. This is to help the surgeon to perform very precise surgery that was not possible in the past. The greatest impact has been in our ability to suture small vessels and to allow us to shift tissues readily from one part of the body to another. It can be considered as a form of "spare part surgery" by using biological tissue consisting of toe, digits, bone, cartilage, skin muscle, intestine and other organs for reconstruction. The techniques are now widely accepted as important techniques in reconstructive surgery. The increasing application of these techniques are now being seen more and more in limb preservation surgery for trauma, tumour resection, congenital abnormality and organ transplant. The potential wide application of the technique in hetero transplant, especially in foetal surgery and foetal tissue transplant is now limited only by immunological rejection.

Fetal Tissue Transplantation↗

PubMedDate not supplied

My association with progress of Italian experimental microsurgery.

The Author reports in this article, of historical and scientific meaning, the long collaboration with Italian researchers who, starting from the beloved and unforgettable Prof G. Mazzoni (1967), allowed to maintain stable and lasting with time up to today a precious bridge of cultural and scientific exchanges aimed at the development of experimental and clinical Microsurgery in Italy and in the World.

Animals↗

PubMed2005

Transanal endoscopic microsurgery for rectal cancer.

BACKGROUND: Transanal endoscopic microsurgery has recently gained acceptance as an alternative minimally invasive surgical technique for the curative management of large rectal adenomas and selected early rectal carcinomas. OBJECTIVES: To analyze our 8 year experience using TEM for the management of rectal cancer. METHODS: Local resection by TEM was performed in patients with benign tumors and early rectal cancer. In addition, selected patients with T2 and T3 rectal cancers who were either medically unfit or unwilling to undergo radical surgery were also treated with this modality. Radical surgery was offered to all patients with incomplete tumor excision by TEM. RESULTS: Overall, 116 TEM operations for rectal tumors were carried out between 1995 and 2003, including 74 patients with rectal adenomas and 42 patients with rectal carcinomas. In 25 patients, TEM successfully removed all T1 tumors with clear tumor margins. Fourteen patients had T2 cancer and 3 of them (21%) required additional radical surgery due to incomplete excision. Local recurrence was observed in one patient with T2 cancer. There was no mortality. Major surgery or radiotherapy-related complications requiring additional surgical intervention was needed in five patients with T2 cancer. CONCLUSIONS: Local excision by TEM is a safe surgical procedure and should be offered to highly selected patients with early rectal cancer.

Adenoma↗