Interposition vein grafting in head and neck reconstructive microsurgery.
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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.
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Liquid crystal temperature monitoring for microsurgery.
Postoperative monitoring of free tissue transfers remains a problem for the microsurgeon. Liquid crystal temperature probes (LCT) are used by anesthesiologists to monitor patient core temperature and to indicate changes in temperature trends as an indicator of pending malignant hyperthermia. By placing an LCT monitor on the flap and adjacent tissue at the completion of surgery, temperature differentials can be reliably monitored. If the temperature differential exceeds 2 degrees C, the flap is re-explored. The LCT readout resembles a standard thermometer and can easily be recorded by even inexperienced personnel. LCTs are a convenient, inexpensive, and easy method to monitor both free muscle and free fasciocutaneous flaps.
Body Temperature↗
Use of the vascular punch in microsurgery.
End-to-side microvascular anastomoses continue to present technical difficulties. We have recently modified our technique when performing arteriotomy, utilizing an available vascular punch. Experience to date with this technique has been encouraging in the performance of arteriotomy for end-to-side anastomoses. This technique has been particularly useful in patients with arteriosclerotic vascular disease. There have been no complications related to the technique, and we feel it may provide the best arteriotomy for end-to-side anastomosis.
Adult↗
Automated photography in microsurgery.
An automated method is proposed for photographing a microsurgical field that avoids missed photographs and time-consuming manipulations. The basic principles applied to microscopic photography are briefly reviewed and instructions are provided for standardized, reproducible, high quality photographs. A limitation at present is that auto-focusing cameras have not yet been adapted for use with surgical microscopes. One type of microscope is discussed and details about the only camera system currently suitable for such a microscope are described.
Humans↗
The home microsurgery laboratory.
A home microsurgical laboratory has proven to be a valuable adjunct to clinical microsurgical practice. Microscopes designed for industrial purposes can be modified to substitute effectively for more expensive models used in clinical practice. In this setting, techniques learned in formal training may be perfected, regular practice maintained, and new materials and methods evaluated. Furthermore, the incorporation of a personal computer into the home laboratory allows for acquisition and evaluation of experimental data in a manner previously possible only in larger research centers.
Humans↗
The value of the photoplethysmograph in monitoring skin closure in microsurgery.
Excessive tension during skin closure may impair flow in a free tissue transfer. Objective methods to observe skin perfusion have been developed. One of these, photoplethysmography, is commonly used for postoperative observation of flow in free flaps. This article demonstrates that valuable information can be obtained with photoplethysmography during wound closure also.
Adult↗
Application of microsurgery in plastic and reconstructive surgery.
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Adult↗
Assessment of definitive residual pituitary-adrenal function and of hydrocortisone replacement therapy 10 to 14 days after microsurgery for pituitary adenomas.
Anterior pituitary function was evaluated by a combined stimulation test 10-14 days and again 6-8 months after micro-surgery for pituitary tumors. It was found that definite residual pituitary-adrenal function could accurately be assessed already 10-14 days after operation, as judged by the subsequent testing. By this means, hydrocortisone replacement therapy necessary one year after operation could be predicted.
Adenoma↗
Left ventricular bypass in inbred rats--a new experimental model in microsurgery. Operative technique and hemodynamic evaluation.
The technique of heterotopic thoracic transplantation of cardiac grafts is shown. Postoperative assessment of pump performance shows that the graft was capable of taking over a significant part of the circulatory load.
Animals↗
[Special aspects of histopathologic diagnosis in laser microsurgery of cancers of the upper aerodigestive tract].
Histological examination of CO2 laser-resected specimens reveals a thin layer of carbonisation, beneath which the cellular architecture is preserved, permitting adequate assessment. With early staged laryngeal, oral and pharyngeal carcinomas, it is usually possible to remove the tumour as a single block, and the margins can be studied by parallel histologic sections. Advanced tumours, regardless of their localisation, demand resection in several blocks. Each tissue block is carefully orientated and the deep surface of every specimen is stained. Accurate mapping of every block is essential to enable the surgeon to identify the precise location of each specimen in the patient. The specimens are vertically sectioned after paraffin wax embedding. Grading, depth of invasion, lateral and basal margins are examined. Like in conventional surgery, it is technically impossible to examine all margins of a large specimen. With vertical sections only limited information can be obtained about lateral and basal margins. If deep tumour infiltration reaches cartilage or bony structures, clear microscopic margins are difficult to prove after laser resection. Finally it must be possible for the surgeon to recreate a complete, 3-dimensional mosaic of the entire lesion to achieve accurate pT-staging.
Carcinoma, Squamous Cell↗
[Free microsurgical superior musculocutaneous trapezius flap of the swine: an ideal training model for microvascular reconstructions and in vitro model for experimental microsurgery].
BACKGROUND: Until now there have been no published studies on musculocutaneous porcine free flaps with an uncompromised vascular pedicle, easy surgical access and anatomic orientation allowing unlimited postoperative movement, as German animal research regulations require. RESULTS: The authors present the porcine musculocutaneous superior trapezius flap. It is supplied by the transverse neck artery, a branch of the thyrocervical trunk of the subclavian artery as in human anatomy. CONCLUSION: The advantages of this flap are its easy surgical access, its uncompromised vascular anatomy, and the easy closure of the donor area. The authors demonstrated the uncompromised vascular anatomy in 40 pigs with body weights ranging between 24 and 68 kg. The pigs were able to move normally following surgery.
Animals↗
[Long-term results of congenital glaucoma microsurgery--retrospective study].
Medium and long term results of trabeculotomy and goniotomy operations for primary congenital glaucomas treated in Lausanne between 1965 and 1990 were studied retrospectively. Parameters evaluated were intraocular pressure (IOP) and final visual acuity (VA). Data on IOP were available for 38 eyes. 66% underwent trabeculotomy and/or goniotomy (first group) the others needed further surgical or medical treatment (second group). IOP was equal or inferior to 19 mmHg in 88% of the first group and 62% of the second group at the end of the study (mean follow-up 13.1 years). Data on VA were available for 32 eyes. In the first group, 65% showed a VA of more than 0.5 compared to 33% for the second group. Therefore, we can consider trabeculotomy and goniotomy as early operations as advisable in first intention treatment of primary congenital glaucoma.
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[Microsurgery of retinal detachment using biological implant material].
In addition to conventional synthetic materials (silicone sponges), dura is ideal for indentation and closure of retinal tears in detachment cases. It is histocompatible, easy to work with, and can be shaped to fit the tear or hole exactly. The authors tested the use of dura in 76 consecutive cases, which were followed up. The anatomic and functional results were similar to those obtained with classical indentation procedures. There were no infections or extrusions of the dura, and in particular no signs of scleral necrosis, which is sometimes seen in cases treated with silicone implants.
Biocompatible Materials↗
[The 0-degree ophthalmologic-assistant microscope of the Zeiss Co., an important advance in microsurgery].
Description of a newly developed 0 degree stereo coworker microscope manufactured by the Zeiss company; it gives the coworker a stereoptic view of the surgical field, with coaxial illumination.
Eye Diseases↗
Anterior cervical epidural abscess treated by endoscopy-assisted minimally invasive microsurgery via posterior approach.
This is a report of clinical manifestation, physical findings, neurophysiological data, magnetic resonance imaging, and results after surgery in a 71-years-old man with cervical abscess. Magnetic resonance imaging after two weeks of empiric antibiotic therapy demonstrated the persistence of an anterior cervical epidural collection and signs of spondylodiscitis at the C5-C6 and C6-C7 levels. Surgery was performed by posterior endoscopy assisted key-hole approach at the C2-C3 level to drain the abscess and to decompress the spinal cord. Postoperative specific medical treatment was then administered. A successful outcome, at 24 months follow-up, was achieved by surgery with complete clinical recovery, resolution of the abscess and healing of the spondylodiscitis. After unsuccessful blind medical therapy the minimally invasive microsurgical technique allowed us to keep the surgical injury of the healthy tissue to a minimum while producing the maximum therapeutic effect.
Abscess↗
Microsurgery of pineal region lesions in children.
Sixteen patients of the pediatric age group (mean age 6.9 years) harboring a tumorous, cystic or vascular mass lesion of the pineal region were evaluated for clinical, neuroradiological and microsurgical aspects. The heterogenous histological pattern of the lesions reflected various clinical signs and neuroradiological features. Computer assisted tomography and magnetic resonance imaging were the main neurodiagnostic tools, although angiography was an important complementary investigation in selected cases. Microsurgical approach and removal of the tumorous and cystic processes proved to be the rational treatment. Additional treatment such as chemotherapy or radiotherapy was performed in malignant processes upon a precise histological evaluation of the tumor specimen.
Adolescent↗
Stereotactic guided microsurgery of cerebral lesions.
A total of 33 patients presenting with various cerebral lesions were operated on with stereotactic guided craniotomy. In all cases the lesion could be totally removed and only one patient suffered from a recurrent metastasis. The survival time of patients with malignant brain tumors was in the range of the generally reported data. All the six patients with malignant gliomas developed a recurrence, four of them have since died. Three of the four patients with brain metastases died from systemic progression of their disease, and one patient died from a recurrence of a centrally located metastasis. A new neurological deficit occurred in only two patients. Despite the often deep or central localization of the lesions, major complications were rare. Stereotactic guidance and preoperative selection of the entry point allow a safer surgical procedure, a larger indication for open surgery in cases considered as not removable, and reduce surgical morbidity.
Adult↗
[Microsurgery of spinal angioblastoma].
The treatment results of ten patients with spinal hemangioblastoma including clinical, radiological and surgical considerations are reported. Magnetic resonance imaging (MRI) is considered to be the radiological method of choice. With its superior imaging qualities MRI was able to clearly demonstrate the exact anatomical location of the tumor nidus as well as the extent and location of the accompanying space-occupying intramedullary cysts. The tumors could be completely removed in all ten patients using microsurgical techniques. The additional application of the CO2-laser has added significantly to the atraumatic and total tumor extirpation. In none of the patients postoperative worsening occurred. In two patients with long lasting symptoms the pre- and postoperative neurological status was unchanged. Minor sensory sequelae persisted in another two patients. In 6 patients the preoperative neurological deficits including significant motor and sensory disturbances resolved completely. It is concluded that microsurgical removal guided by MRI imaging and aided by the application of laser energy is the method of choice in the treatment of spinal hemangioblastomas.
Adolescent↗