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At least 721 records · Page 40Linked to original sources
PubMed2000

Vascular complications of native arteriovenous fistulas for hemodialysis: role of microsurgery.

This article describes the treatment of 56 early and late vascular complications of native arteriovenous fistula (AVF) in patients with end-stage renal disease, between January 1987 and January 1999. Twenty-six were arteriovenous aneurysms and 2 pseudoaneurysms; 25 were thromboses. We also observed two cases of periarteritis associated with systemic lupus erythematosus (SLE) and one complex iatrogenic lesion caused by an attempt at percutaneous restoration of potency. We applied microsurgical principles, instruments, and techniques. It was possible to restore a vascular access at the original site, using the same vessels in 45 cases (80.4%). In 10.7% of cases, we were able to rescue the original AVF by microsurgical revision. A new vascular access had to be created proximally in the same limb or in the contralateral forearm in 11 cases of aneurysms (19.6% of the total, 42% of the aneurysms). After a minimum follow-up of 8 months, a total of four patients had to be reoperated for further complications (7.2%). Our data support the idea that microsurgical treatment of vascular complications of native AVF is highly successful compared with results obtained by conventional surgery and, in a defined subgroup of patients, permits salvage of the fistula.

Aged↗
PubMed2001

Computer-guided microsurgery: surgical evaluation of a telerobotic arm.

A new telerobotic arm was evaluated in different microsurgical procedures. The system consisted of a robotic arm bearing a microsurgical forceps controlled by a joystick-like master unit operated by the surgeon's hand. The robotic arm functioned as an operating as well as assisting instrument. Advantages of the system were its precise functioning, which was especially important when tissue or instruments had to be held for a longer period of time, as well as its ability to replace an assisting person to some extent. Deficiencies of the system were its 10-min startup, the spatial conflict with in the operative field, and the poor rotation of the robotic tip. In some procedures, the telerobotic arm could replace the standard microsurgical instrument guided by the surgeon's second hand; in other maneuvers it could function as the surgeon's third hand with precision and void of tremor.

Anastomosis, Surgical↗
PubMed1975

Development of needles and sutures for microsurgery.

At present, the smallest needle commonly available is about 130 mum in diameter in combination with a suture of about 25 mum in diameter. Marked reductions in size, particularly of the needle, are advantageous for microvascular surgery. A needle of about 70 mum in diameter, welded to a suture of about 18 mum diameter, has been developed. In initial tests, it has performed satisfactorily in the repair of the carotid artery of the white rat. It is shown that the basic properties of materials severely limit further reductions in the size of needles and sutures.

Animals↗
PubMed1977

Homozygous mouse embryos produced by microsurgery.

Homozygous mouse blastocysts have been produced following microsurgical removal of one pronucleus from the fertilized egg, diploidization in cytochalasin B, and culture in vitro. This combination of techniques should greatly shorten the time required to obtain homozygous strains of mice.

Animals↗
PubMed1994

Development of rat x mouse hybrid embryos produced by microsurgery.

Experimental production of hybrid embryos between Mus musculus L. and Rattus norvegicus L. was achieved by nuclear transplantation using both ovulated oocytes in metaphase II and pronuclear zygotes. Recipient egg-cells were of mouse origin in all cases. The developmental potential of hybrids was examined in vivo. Nucleo-cytoplasmic hybrids resulting from the introduction of rat metaphase II chromosomes into enucleated mouse oocytes, which were subsequently activated, were regularly blocked at the 1- or 2-cell stage. Nuclear (genetic) hybrids produced by transfer of a rat nucleus (in the form of metaphase II chromosomes or a pronucleus) into a nucleated mouse recipient (oocyte or zygote) were capable of development to the 5- to 8-cell stage. Transplantation of rat cytoplasm alone to intact metaphase II oocytes, followed by oocyte activation, generated cytoplasmic hybrids which developed to the morula stage. In control experiments (nuclear transfer between mouse oocytes or zygotes), a high proportion of embryos formed morulae and blastocysts. These results demonstrate that the rat nucleus is incapable of functioning in mouse cytoplasm, that introduction of the rat genome into intact mouse egg-cells impairs normal development, and that transfer of foreign (rat) cytoplasm into mouse egg-cells affects preimplantation development of manipulated embryos.

Animals↗
PubMed1983

Microsurgery of the fallopian tube with the carbon dioxide laser: analysis of 230 cases with a two-year follow-up.

Between September 1979 and December 1982, 230 cases of tubal reconstructive surgery were followed for 2 years. An analysis of these cases showed 75% to have had more than one procedure performed. There were 91 pregnancies in this group. In the bipolar disease population, 36% achieved an intrauterine pregnancy. Tubal reversal procedure resulted in comparable rates when compared to conventional surgery (71%). The ectopic pregnancy rate was 4.4%, and spontaneous abortion rate was 6.6%. The carbon dioxide laser appears to have a place in the armamentarium of the microsurgeon.

Adult↗
PubMed1991

Technique for cellular microsurgery using the 193-nm excimer laser.

A new cell surgery technique has been developed to produce well-defined alterations in cells and tissue without detectable heating and/or other structural damage in the surroundings. The technique involves the use of an argon fluoride excimer laser, in the deep ultraviolet (UV) region of the spectrum at 193 nm, which is guided through a glass pipette filled with a positive air pressure. To demonstrate the method, holes were drilled in the zona pellucida of mouse oocytes. The diameter of the drilled hole was determined by the pipette tip size, and its depth by an energy emitted per pulse and number of pulses. Scanning electron microscopy of the drilled mouse oocytes showed uniform, round, well-circumscribed holes with sharp edges. Oocytes that had their zona pellucida drilled with this new method fertilized in vitro and developed to the blastocyst stage in a rate similar to that of control group. These results demonstrate the nonperturbing nature of this cold laser microsurgical procedure. In addition to the extension of our results for clinical in vitro fertilization purposes, such as enhancement of fertilization and embryo biopsy, there are wide-ranging possible uses of our method in fundamental and applied investigations that require submicron accuracy in cellular alteration.

Animals↗
PubMed1995

Spot size reduction in coupling of laser to micromanipulator in laser microsurgery by fiberoptic link.

BACKGROUND AND OBJECTIVE: In coupling laser with micromanipulator through fiberoptics, the resulting diameter of the spot is limited by the laws of geometrical optics, because of the high numerical aperture (N.A.) of fiberoptic radiation. A new method for the reduction of spot size diameter is suggested. STUDY DESIGN/MATERIALS AND METHODS: The output of a 2 mW He-Ne laser was couped via fiberoptic link, the fiberoptic output light collected by a single lens collimator and directed to the input of the micromanipulator. RESULTS: The spot size can be considerably reduced by the introduction of an aperture which reduces the numerical aperture (N.A.) of the fiberoptic. The resulting reduction in total power has little effect on the power density. CONCLUSION: This approach to the collimator design permits reduction in spot size without any significant changes in power density, thus avoiding damage to the tissue and obtaining optimum performance from the micromanipulator.

Algorithms↗
PubMed2002

Effect of Timolol vs. a postural orthotic on hand tremor during microsurgery.

The efficacy of beta blockers to control hand tremor remains equivocal. This study evaluated the effectiveness of Timolol, as well as a postural orthotic, in reducing movement deviation during a laboratory exercise. Eleven volunteers completed three randomized trials involving administration of Timolol, a placebo, or a postural orthotic. Drug administration was blinded. Each trial consisted of a simulated 2-hr clinical procedure, punctuated by video recordings of the subject's hand motion during a standardized pattern of instrument movement. ECRL EMG activity and digital oxygen perfusion were also measured. Recordings were converted into estimates of linear variance at baseline and 1 and 2 hr. A repeated-measures ANOVA, or the Friedman test, were used to assess significant differences. Movement deviation, EMG activity, and oxygen perfusion were unaffected by the duration of exercise or treatment (P > or = 0.454). We conclude that none of the treatments accorded a significant benefit in allaying hand tremor.

Adrenergic beta-Antagonists↗
PubMed2003

Dextrans in microsurgery: A review.

This articles reviews the use of dextrans in free tissue transfer. Current recommended regimes, indications, and complications are discussed. In conclusion, dextrans cannot be used as a substitute for good surgical technique, and should be utilized cautiously, especially in the elderly.

Adult↗