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At least 631 records · Page 35Linked to original sources

PubMed1995

[The role of microsurgery in the reconstruction of loss of substance of soft tissue in the maxillofacial region].

Reconstruction of oncological defects in the maxillofacial region still remains a real surgical challenge due to the complexity and the tridimensional aspect of these defects responsible for heavy functional impairment. Microsurgery allowing the transfer of free flaps gives the surgeon the opportunity to adapt a specific reconstruction to each defect and to reinsert the patient in a quasi normal social life. These reconstruction technics are routinely used in many centers; they must be integrated in our therapeutic arsenal and in the training of the maxillofacial surgeon. Seven years ago, we incorporated microsurgical reconstruction in our therapeutical concepts and today, it seems to us important to share our experience of microsurgical reconstruction in the field of soft tissues defects in the maxillofacial region.

Facial Neoplasms↗

PubMed1995

[Complications of endonasal microsurgery].

Endonasal microsurgery, which has widely proved its efficacy, is not free of complications. They can be due to the technical act itself. In this case they result of surgery mistake and they induce an effraction of the operatory cavity walls. They can also be due to excessive healing of the nasal mucosa. Then they represent the real cause of failure in this type of surgery. The authors present their experience that they compare with similar cases of the literature.

Microsurgery↗

PubMedDate not supplied

Local excision of rectal tumours with transanal endoscopic microsurgery.

Transanal Endoscopic Microsurgery (TEM) is a novel technique, first introduced by Buess and coworkers in 1983 for the treatment of large sessile polyps of the rectum. Due to the excellent results the indication was then extended also for the removal of low risk early adenocarcinomas (pT1, G1-G2). TEM allows, by using an operative proctoscope of an outside diameter of only 4 cm., all the conventional surgical manoeuvers within the rectal lumen, up to 20 cm. from the anal verge. The Authors report a consecutive series of 53 patients submitted to TEM over a 37 month period; apart from 7 patients excluded for different reasons, postoperative diagnosis showed 30 adenocarcinomas (65.2%), 15 adenomas (32.6%) and 1 epidermoidal carcinoma (2.2%). The low recurrence rate observed both for adenomas (0%) and pT1 adenocarcinomas (9%) coupled with the optimum vision allowed by the 6-fold magnified stereoscopic view, make this technique the method of choice for selected patients with these kind of pathologies.

Adenoma↗

PubMed1993

Review: transanal endoscopic microsurgery (TEM).

Transanal endoscopic microsurgery (TEM) is performed with the use of a complex operative system, which allows the application of all surgical techniques for dissection and suturing inside the rectal cavity up to a height of 20 cm from the dentate line. Gas dilation and stereoscopic vision give an optimal overview during the procedure. In sessile adenomas and carcinomas within the region of the extraperitoneal rectum, full thickness excision is the standard procedure. The postoperative course is completely painless in all excisions at some distance from the dentate line. The complication rate is low compared with other procedures and the recurrence rate in sessile adenomas (3.5%) lower than in conventional surgery as a result of the precise dissection which is possible under the magnified stereoscopic vision. In PT1 low risk cancer we found one recurrence in 29 patients.

Adenoma↗

PubMed1994

[Evaluation of application of transparent keratoscope in ocular microsurgery].

The clinical effects of application of a transparent keratoscope in cataract extraction and intraocular lens implantation were reported. The patients were divided into 2 groups: 1 group without and the other group with the application of a transparent keratoscope to control the corneal curvature by regulating the strength of the continuous suture during the microsurgery. The pre-operative and the post-operative corneal curvatures of patients in both groups were measured and the results were compared. The comparison shows that the clinical effect in regard to the corneal curvature is better in the group with the application of a transparent keratoscope. In this group, 63% of the post-operative corneal astigmatism is less than 2D, 91% less than 3D and none more than 4D.

Adolescent↗

PubMedDate not supplied

Transanal endoscopic microsurgery.

Transanal endoscopic microsurgery is a minimally invasive technique for local excision of tumours in the rectum and lower sigmoid colon. It allows precise transanal dissection and suturing, and enables sphincter-preserving local resection to be performed without an abdominal or perineal incision.

Electrocoagulation↗

PubMed1994

Indications and technique for TEM (transanal endoscopic microsurgery).

Transanal Endoscopic Microsurgery (TEM) was introduced into clinical practice by the Buess group in 1983. Since then vast experience has been gained in removing tumours of the rectum by the operative rectoscope. Though the indication in benign lesions for TEM as a local resection therapy is undisputed, the indication for resection of T1 or advanced carcinomas has to be evaluated. By using a 40 mm operating rectoscope sealed with a gastight working insert to prevent pressure loss after creation of a pneumorectum and a stereoscopic optic with sixfold magnification, exact visualisation of a rectal tumour can be achieved. The insertion of endoscopic surgical instruments like the high frequency knife, forceps, scissors, and suction device allows precise excision of the lesion as well as suture closure of the wound. Recently a bipolar multifunctional combination instrument has been developed for more precise dissection, less blood loss and shorter operation times.

Anal Canal↗

PubMed1994

[Elbow support for endolaryngeal microsurgery].

The authors present elbow support for endolaryngeal microsurgery. Which prevents fatigue of the surgeons arms during operation. The advantages of this device are that it provides precision and shorten time of operation.

Elbow↗

PubMed1994

Management of large malignant rectal polyps with transanal endoscopic microsurgery. Is there anything better for the patient?

The authors report their experience with transanal endoscopic microsurgery (TEM), a technique that allows all the standard surgical manoeuvres such as tissue excision, suction, control of bleeding and suturing in the entire length of the rectal cavity. Main indications for TEM are the removal of large sessile polyps and early rectal cancers' (T1, G1-G2). Out of 50 patients submitted to TEM the authors consider in this study 24 cases with a preoperative diagnosis of benign large sessile polyps. The procedures included: 14 (58.3%) total wall excision, four (16.6%) total wall excision with perirectal fat, three (12.5%) mucosectomy, one mucosectomy + total wall excision, one partial wall excision + total wall excision, and the remaining case was converted to laparotomy due to a large intraperitoneal perforation. There was no operative mortality and an 8.3% rate of major complications. With a median follow up of 19 months there was no evidence of local or distant recurrence. The authors compare their results with those of alternative endoscopic and surgical techniques and highlight the advantages of TEM in the management of large and giant rectal polyps.

Adenocarcinoma↗

PubMedDate not supplied

[Contact laser microsurgery in laryngeal neoplasms].

Basing on the results obtained in 129 patients with benign and 135 ones with malignant laryngeal tumors the author provides theoretical and practical grounds for introduction of high-energy YAG laser under contact regimen in endolaryngeal microsurgery of relevant tumors. Advantages of the method, indications and contraindications to its application are considered in detail.

Adolescent↗

PubMed1994

[Pathogenesis of rhinosinusitis and endonasal microsurgery].

The functional microsurgery of the nose has been carried out with help of microscope since 1958 by H. Heermann. The authors described the importance of mucociliary system and lateral nasal wall for pathogenesis and diagnosis of recurring and chronic rhinosinusitis. By the means of nasal endoscopy and polytomography the infection foci can be exactly localised. The list of indications corresponds to our actual concept.

Endoscopy↗

PubMed1993

[Treatment outcome of surgery for oviductal infertility using microsurgery techniques on material of the I department and clinic of the Gynecology Academy of Medicine in Wrocław].

Since September 1988 to October 1992 in the I Department and Clinic of Gynaecology Medical Academy of Wrocław 40 women were operated on infertility due to oviductal factor. This kind of infertility has been previously diagnosed by hysterosalpingography examination and then verified in 22 cases (55%) by laparoscopy combined with chromotubation. The operations were carried out with use of microsurgical technique and instruments. At the same time the prophylaxis of postoperative intraperitoneal adhesions was applied. Seven pregnancies were obtained, that makes 17.5% of success. It is an outcome comparable with results presented by many other world centres of gynaecological microsurgery.

Fallopian Tube Diseases↗

PubMed1993

Echocolonoscopy--an indispensable procedure before and after transanal endoscopic microsurgery.

As a refinement of the widely practised intraluminal sonography, echocolonoscopy represents a breakthrough in preoperative staging and post-operative follow-up of rectal tumor patients. Enabling colonoscopy and intraluminal sonography to be performed in one session, optical control with the Olympus echocolonoscope also prevents inaccurate endosonographic diagnosis caused by tangential cuts or mistaken interpretation of faeces adhering to the mucosa. In the era of transanal endoscopic microsurgery, echocolonoscopy acquires enhanced importance as a pre- and post-operative tool.

Anal Canal↗

PubMed1994

Principles of microsurgery.

Microsurgical techniques have been used to perform a variety of urologic procedures. Basic microsurgical principles are discussed in this article and information is presented regarding instrumentation techniques and the operation of microscopes and microsurgical instruments. Many useful hints to increase the ease of performing microsurgery are discussed and clearly defined.

Equipment Design↗

PubMed1994

[Endonasal microsurgery by Heermann++. Part II].

Endonasal sinus surgery in the case of inflammatory disease is of increasing importance. The maxillary, ethmoid, sphenoid and frontal sinus operations as well as the septumplasty are performed microsurgically. There are only few indications, when the intranasal procedure cannot be applied. We prefer all intranasal operations with the patient placed in semi-Fowler's position with hypotensive anaesthesia. Out of a total of 310 cases in which endonasal microsurgery was performed, 251 were submitted to a retrospective study 12-36 months after the operation. In our study there was an operative success rate of 92.8%. No complications such as: CSF leakage, persisting postoperative visual or ocular disturbance or vascular complications were observed. Compared with transfacial or external sinus surgery, the advantage of the transantral microsurgical technique are better functional results, fewer complications an a reduced duration of hospitalization.

Anesthesia↗

PubMed1993

[Usefulness of a gel with a new composition for gonioscopy and laser microsurgery].

A newly composed gel was examined with a view of determining its usefulness for gonioscopy and laser microsurgery. It was found, that it did not exert any adverse effect on ocular tissue, it displayed perfect transparency and proper consistency facilitating manual operation. Experimental procedures confirmed its clinical usefulness.

Gels↗

PubMedDate not supplied

[A set of instruments for microsurgery of bile ducts].

A set of instruments for bile duct microsurgery is convenient to work in surgical institutions, which are specially and widely engaged in surgical interventions into the bile duct and vessels. It is is quite essential for reconstructive reoperations on the bile and pancreatic ducts.

Bile Ducts↗

PubMed1994

[Therapy of hypopharyngeal cancer. Part III: The concept of minimally invasive therapy of cancers of the upper aerodigestive tract with special reference to hypopharyngeal cancer and trans-oral laser microsurgery].

The concept of minimally invasive therapy in the treatment of tumors of the upper aerodigestive tract is described with special respect to hypopharyngeal carcinomas and transoral laser microsurgery. Differences to conventional surgical treatment regarding operative strategy and technique and resulting advantages are shown. The individual "customized" tailored surgery corresponding to the extent of tumor generally allows maximum preservation of the affected organ and function, even in rather extended tumors. Preconditions for this method are the transoral approach and the possibility of intraoperative evaluation of the true extent of tumor by using the surgical microscope. Incisions through larger tumors enable identification of basal margins and possible infiltration of surrounding structures. The possibility for verifying histologically the margins of resection of the primary tumor is discussed as well as the technical, oncological and functional limits of transoral surgery. The advantage of this method of treatment involves leaving open intra- and postoperatively all diagnostic and therapeutic (surgical) options: i.e., endoscopic re-resections, conventional partial or radical resection and postoperative radiotherapy with or without chemotherapy. The treatment of cervical lymph nodes is usually performed as a selective uni- or bilateral neck dissection (levels II-IV) include functional procedures N0 to N2. The indications for possible adjuvant therapy (radio- and/or chemotherapy) depend on pT- and pN-staging. The prerequisites for successful treatment and our current therapeutic guidelines are described.

Humans↗