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At least 793 records · Page 44Linked to original sources
PubMed1984

PO2 and pH measurements within the rabbit oviduct following tubal microsurgery: reanastomosis of previously dissected tubes.

Adhesions of the fallopian tube might be a source of generalized infertility. In order to improve the mechanical and functional properties of the oviduct, microsurgical replacement of the affected tubular segments have been applied, however, with contradictory results. In order to improve the situation and gain further information about this problem, catheter microelectrodes for Po2 and pH measurements within the lumen of the fallopian tube have been developed. The validity of the measurements was tested in a series of rabbits (Dutch belt strain, n = 19, 3.5-4.5 kg bw) which have been laparatomized under pentobarbital anesthesia during the oestrus phase. From one side of the oviduct 1 cm was resected and the free ends reanastomosed while the other side served as a control. Six to eight weeks later Po2 and pH values within the oviduct were measured. After another 4-5 weeks ovulation had been induced and artificial insemination performed. 64 hours later the rabbits were sacrificed. The oviducts were isolated and the corpora lutea as well as the ova were collected and examined histologically. The mean Po2 of the oviduct was 53 (+/- 16) mm Hg (mean +/- SD) for the control side and 56 (+/- 13) mm Hg (mean +/- SD) within the anastomosed tubes. The range of values was the same in both groups (n = 8) 34-75 mm Hg. A T-test comparison of the means of the two groups gave p-values which were not significant (p greater than 0.1). Po2 fluctuations with small-fast amplitudes (1 mm Hg) and additional slow-large oscillations (about 20 mm Hg) have been observed similar to the Po2 waves described for muscle and brain. The mean pH value of the oviduct a showed slight, statistically significant pH differences (7.75 reanastomosed side, 7.94 control side) whereby the degree of adhesions was correlated with luminal pH value. In three rabbits the relationship between corpora lutea and fertilized ova was 1:6, 2:9, 3:6 for the reanastomosed side while the control side showed balanced quotients of 4:4, 4:4, 6:6. In two rabbits unfertilized ova have been observed within the reanastomosed tubes where the typical outside layer of mucoproteids was absent while the control side was normal. Nevertheless, within both oviducts a continuous layer of epithelial cells has been observed even after reanastomosis.

Animals↗
PubMed1994

New kinds of microneuroprotectors for microsurgery and endoscopy of cerebellopontine angle neurovascular decompression.

New microsurgical devices for neurovascular decompression--microneuroprotectors (MNP)--are described. Four constructive kinds of MNP have been developed according to topographic peculiarities of pathological neurovascular contacts. The hydrodynamic and biological testing of MNP has been concluded. The methods of microsurgical and endoscopic techniques of MNP insertion on the cranial nerves or posterior fossa vessels are reported.

Animals↗
PubMed1991

Microsurgery of intrinsic midbrain lesions.

The advanced tools of neuro-imaging provide sufficient details for an appropriate open microsurgical approach to those lesions, which are well circumscribed even as intrinsic lesions of the midbrain. 30 reported cases with only 3 postoperative death related to surgery but otherwise no morbidity except in one case, demonstrate the safety of modern microsurgical techniques, provided the case has been well selected for surgery and the appropriate approach is chosen well. A clear histological diagnosis also is the foundation for the additional methods of postoperative treatment.

Adolescent↗
PubMed1983

Contact glasses for use with high power lasers. Two new contact glasses for microsurgery at the iris, in the pupillary and the retropupillary space.

Two new contact glasses, one for irradiation of the iris and the other for irradiation of pathological structures within the pupillary and retropupillary regions are described. First order geometric considerations using the Young-Weierstrass imaging theorem indicate nearly aberration-free, stigmatic focussing, even for large numerical apertures. For surgical tasks utilizing high-power lasers, excellent focussing of strongly convergent ray-bundles which lead to small focus diameter and large diameters while passing through the pre-focal optical media are seen to be essential. Thus the efficiency of the laser-surgical treatment, its reliability, as well as security and harmlessness within the pre-focal media are increased.

Humans↗
PubMed1986

Laser microsurgery: a review of 105 intracranial tumors.

The relative importance or utility of the carbon dioxide laser within the total context of multimodality therapy and in comparison to conventional surgical techniques is unknown. Over a 36 month period, 421 operations for tumors of the brain and spinal cord were performed in our clinic. Of these, 111 (26%) were carried out with the aid of the laser. After excluding stereotactic and transsphenoidal operations, a comparison was made between 105 laser and 216 non-laser craniotomies. With the exception of pituitary tumors, the most frequent diagnoses in both the laser and non-laser cases were the same: malignant astrocytoma (48.6 vs 33.9%), meningioma (11.4 vs 14.2%) and low grade astrocytoma (8.6 vs 8.7%). The number of reoperations in the laser group (60.1%) was higher than in the non-laser group (32.7%; p less than 0.000001) and the mean operating time (299 minutes vs 237 minutes; p less than 0.00001) was longer, but there was no significant mean difference in mortality, CNS morbidity, mean blood loss (638 ml vs 671 ml) or mean length of stay (23 vs 25 days). For the subgroup of 134 cases of malignant astrocytoma, 82% of laser procedures were reoperations versus 50% for non-laser cases (p less than 0.0002) and the mean operating time was slightly longer (p less than 0.02). The length of stay for laser cases tended to be less (21 vs 27 days; p less than 0.04), but there was again no difference in blood loss (457 ml vs 522 ml), CNS morbidity (7.8 vs 4.8%) or mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Astrocytoma↗
PubMed1995

Transanal endoscopic microsurgery in large, sessile adenomas of the rectum. A 10-year experience.

The clinical and long-term results of 286 cases encountered from 1983 to 1993 in our Department of Surgery regarding the local excision of large, sessile rectal adenomas (> 2 cm2) by the endoscopic surgical method and the influence of this selected series of adenomas on age, sex, size, grade of dysplasia, and architecture are subjects of this study. Histologically proven rectal carcinomas as well as non-neoplastic polyps were excluded from this trial. Early postoperative complications amounted to 3.4%. The 1-year and 5-year recurrence rates +/- SE of adenomas were 1.2 +/- 0.7% and 7.0 +/- 1.9%, respectively. Remarkably, there was no significant relationship between the histological type of the adenoma and the grade of dysplasia nor between the size and grade of dysplasia. However, there was a significant relationship between the size and histological type of the adenoma (P < 0.01). With the endoscopic minimal-invasive system, we are able to achieve a superior rate of recurrence compared to any other local treatment as well as a more favorable operative result compared to extensive surgical procedures.

Adenoma↗
PubMed1981

Vascular microsurgery in orthopaedics.

Three applications of free vascularised bone grafts are described. Free fibular grafts have been performed in 19 cases of avascular necrosis of the femoral head. The grafts are placed along the anterior femoral neck and into the femoral head with a microvascular anastomosis between the nutrient vessels of the fibula and the anterior circumflex pedicle of the hip. The operative technique is described but the post-operative follow-up is still too short to draw any definite conclusions. This operation has been performed in young patients in whom the only alternative would be a total hip replacement. Free vascularised transfers of iliac crest bone are described for bone defects such as infected non-unions of the tibia with soft tissue and bony loss. Free vascularised fibula grafts have also been employed with cancellous grafting for cystic defects such as fibrous dysplasia and large bone cysts. The use of free vascularised fibula grafts is also described in four cases of congenital pseuodarthrosis of the tibia.

Child↗
PubMedDate not supplied

History of replantation: from miracle to microsurgery.

Severed body parts, from fingers to extremities, are now being routinely reattached at medical centers around the world. The dream of replantation traces its rich history from miracles and legends to early laboratory experiments and clinical attempts, culminating in today's commonplace procedure.

History, 16th Century↗
PubMed1986

Anatomy of the veins of the dorsum pedis with regard to their suitability as vascular grafts in reconstructive microsurgery.

Attempts to locate veins suitable as micro-surgical vascular grafts were carried out in 16 preparations of the subcutaneous venous network of the dorsum pedis. For this reason the length, diameter, valve distances and frequency of longitudinal veins were especially examined. Four types of veins were defined as being suitable for transplantation and it was established that they are situated in the medial half of the dorsum pedis in the so-called microsurgical area in all cases. Collecting and conducting veins can be distinguished by means of the location of the valves, which are generally bicuspidal. In most cases, the level of the opening spaces of both the segment and the opening valves lies parallel to the surface of the skin.

Humans↗
PubMed1979

[A new laryngoscope for endolaryngeal microsurgery. A contribution to injector respiration (author's transl)].

A new laryngoscope was constructed in order to improve visualization of the larynx and to adjust the instrument to individual situation. The Kleinsasser laryngoscope was divided into two parts. The width between these two halfs can be changed by screws. Because the laryngoscope is open laterally there is more space for the operator and shorter instruments can be used.

Laryngoscopes↗
PubMed1991

Fibrin tissue adhesive sealant for the prevention of CSF leakage following transsphenoidal microsurgery.

Fibrin glue (Beriplast, Behring or Tissucol, Immuno) was used for 126 sublabial transseptal transsphenoidal operations in 119 patients from April 1981 to March 1987 in a variety of sellar pathologies together with septal bone and spongycel to seal the sellar floor and the anterior wall of the sphenoid sinus. The incidence of postoperative rhinorrhea was 1.6%. A review of the literature revealed an incidence of 1.5%-9.6% with the use of autologous tissue for sellar packing such as fat or muscle; fibrin glue combined with autologous grafts led to postoperative rhinorrhea in 1%-4.4%. The present results support the view that sellar and sphenoidal sealing with fibrin glue instead of muscle or fat tissue does not raise the incidence of postoperative rhinorrhea.

Adenoma↗
PubMed1994

Tectal plate gliomas. Part I: Microsurgery of the tectal plate gliomas.

A series of 12 patients with tectal plate gliomas, is presented treated by direct surgery. Mean age was 19 years. All patients presented with signs of raised intracranial pressure and supratentorial hydrocephalus on CT scan. Diplopia was the most common local sign. CT scan and MR imaging showed 4 intrinsic, 6 exophytic, and 2 ventrally infiltrating tectal tumours. The histological diagnosis was low-grade astrocytoma in 7, high-grade astrocytoma in 2, oligodendroglioma in one, oligo-astrocytoma in one, and ependymoma in one case. The suboccipital supra- and transtentorial approach was used in every cases. Tumour resection was generous at the level of the superior colliculi, but on the contrary, resection was limited at the level of inferior colliculi due to the auditory risk. Tumour removal was total (macroscopically) in 9 cases and partial in 3 cases. There were 4 surgical complications and one death related to surgery. Parinaud's syndrome was the most-common postoperative sequelae. Auditory hallucinations and the acoustic neglect syndrome were seen once. In three cases additional radiotherapy and chemotherapy were given once with severe sequelae. The treatment of tectal plate gliomas is controversial. The role of different therapeutic options remains open. We consider the tectal plate as a relatively safer territory for surgery than the ventral part of the midbrain. The brain stem auditory evoked potentials (BAEPs) and middle latency potentials (MLPs) monitoring can help to determine the appropriate limit of surgery.

Adolescent↗
PubMed1989

Aesthetic aspects in reconstructive microsurgery.

The reconstruction of a part of the body that has lost or inhibited function has been the most important aspect of reconstructive surgery in the past. Because of the existence of better techniques and the patient's wish for social reintegration, the plastic surgeon today is forced to consider the aesthetic results of his work more than in the past. Sometimes microsurgical procedures in reconstructive surgery are the only chance for the patient to be healed or palliated. Experience with more than 350 free tissue transfers gave us the opportunity to estimate the value of a donor flap with respect to the requirements of the receiving site. To satisfy the high aesthetic demands in these cases, it was necessary for the right place and shape the flap to fit as closely as possible, even if further corrections were necessary to achieve a satisfactory result. The transfer of latissimus dorsi and radial forearm flaps to the face and lower leg is discussed in cases of tumorous diseases and severe injuries of young and old patients.

Adolescent↗