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Dissection Technique (dissection + technique)
Selected AbstractsDonor Harvesting: A New Approach to Minimize Transection of Hair FolliclesDERMATOLOGIC SURGERY, Issue 4 2000Damkerng Pathomvanich MD Background. There are several methods for harvesting donor hairs, including punch excision, single-bladed knife excision, and multibladed knife excision. All of these procedures are blind and thus result in transection of hair follicles. Transection of hair follicles during harvesting results in fewer follicles being available for transplantation, detrimentally affecting the final cosmetic result. Objective. To explore a new method of donor hair harvesting called "donor dissecting." This new procedure is an open technique because hair follicles are directly visualized during the harvesting process. Methods. The technique of donor dissecting utilizes a #15 scalpel blade to excise the donor hair ellipse from the occiput while maintaining meticulous hemostasis. This enables individual hair follicles to be visualized and protected from transection during the harvesting process. Once the donor ellipse is harvested, it is then further divided into individual mini- and micrografts using direct visualization of individual follicles to again prevent transection. Results. The technique of donor dissecting was utilized in 50 consecutive hair transplant patients. Utilizing this new technique, only 1.9% of hair follicles in the donor ellipse were transected during the harvesting process. The dissection of the donor ellipse 1.2% follicles being transected in the graft cutting process. Combining the donor dissection technique with dissection of the individual grafts, we were able to transect 1.59% of hair follicles harvested for transplantation. Conclusion. The technique of donor dissection minimizes the transection of hair follicles in the donor hair harvesting phase of hair transplantation. This technique is superior to the blind methods of donor harvesting which have been plagued by the problem of hair follicle transection. [source] THE TECHNICAL FUNDAMENTALS OF ENDOSCOPIC MUCOSAL RESECTION IN THE COLON: OUR METHODDIGESTIVE ENDOSCOPY, Issue 2004Yasushi Oda ABSTRACT Endoscopic mucosal resection (EMR) is the technique used to resect flat or depressed tumors or larger tumors such as laterally spreading tumors with marginal normal mucosa. Recently, endoscopic mucosal dissection technique has been rapidly accepted, mainly in early gastric cancer in Japan. We need to have firm knowledge of EMR technique in the colon for recovery as we advance this new technique. We describe our conventional EMR method practically. EMR should be performed to locate the target lesion at down side to perform sure EMR. The ideal shape of upheaval by saline injection is hemisphere. The needle sheath and snare should be taken out a little of the endoscopy to manipulate firmly. Another technique of secure EMR is the snare manipulation. We prefer that the shape of the snare is circular and the snare is hard. It is important while trapping to press the target lesion with both the whole snare circle and the end of the sheath. With these fundamental procedures we could resect the target lesions at will. [source] The use of water-jet dissection in open and laparoscopic liver resectionHPB, Issue 4 2008H. G. RAU Abstract Background. We intend to give an overview of our experiences with the implementation of a new dissection technique in open and laparoscopic surgery. Methods. Our database comprises a total of 950 patients who underwent liver resection. Three hundred and fifty of them were performed exceptionally with the water-jet dissector. Forty-one laparoscopic partial liver resections were accomplished. Results. Using the water-jet dissection technique it was possible to reduce the blood loss, the Pringle- and resection time in comparison to CUSA® and blunt dissection. In the last five years we could reduce the Pringle-rate from 48 to 6% and the last 110 liver resections were performed without any Pringle's manoeuvre. At the same time, the transfusion-rate decreased from 1.86 to 0.46 EC/patient. In oncological resections, the used dissection technique had no influence on long-time survival. Conclusions. The water-jet dissection technique is fast, feasible, oncologically safe and can be used in open and in laparoscopic liver surgery. [source] The use of integra artificial dermis to minimize donor-site morbidity after suprafascial dissection of the radial forearm flapMICROSURGERY, Issue 7 2007Andreas I. Gravvanis M.D., Ph.D. In an effort to minimize the radial forearm flap donor-site morbidity, the flap was elevated using the suprafascial dissection technique, in six patients with various facial defects. The donor site was covered primarily with Integra artificial skin and secondarily with an ultrathin split-thickness skin graft. The mean time to wound healing of the forearm donor site was 24 days. There were no flap failures, and all flaps healed uneventfully. At the end of the follow-up, all patients showed normal range of motion of the wrist and the fingers, normal power grip, and power pinch. All patients evaluated the esthetic appearance of the forearm donor site as very good. In conclusion, suprafascial dissection of the forearm flap creates a superior graft recipient site, and the use of Integra artificial dermis is a valuable advancement to further minimize the donor-site morbidity, resulting in excellent functional and aesthetic outcomes. © 2007 Wiley-Liss, Inc. Microsurgery, 2007. [source] THYROIDECTOMY IS SAFE AND EFFECTIVE FOR RETROSTERNAL GOITREANZ JOURNAL OF SURGERY, Issue 4 2006Ajay Chauhan Background: Retrosternal goitre was defined as any thyroid enlargement identified below the thoracic inlet at operation, with the patient's neck held in extension. The aim of this study was to determine the characteristics of the patients, the goitres, the surgery and its morbidity (including tracheomalacia, recurrent laryngeal nerve palsy and hypocalcaemia) and the incidence of malignancy in order to establish guidelines for managing patients with a retrosternal goitre. Methods: Data were collected prospectively on all thyroidectomies carried out by a single surgeon over 14 years. Patients underwent appropriate preoperative assessment and thyroidectomy was carried out using a standardized capsular dissection technique. There were 199 cases of retrosternal extension. Results: Retrosternal extension was significantly more common on the left side than on the right side (ratio 3:2, P < 0.05). Most patients (83.4%) had significant symptoms that were relieved by surgery. Of the 199 thyroidectomies, none required a sternal split. The rate of malignancy was low (2.5%). Postoperative morbidity was 30%, the majority being asymptomatic temporary hypocalcaemia. There were no patients with permanent recurrent laryngeal nerve palsies or permanent hypoparathyroidism. There was one case of tracheomalacia. There was no death. Conclusion: Retrosternal goitre is a frequently symptomatic condition, with a low but definite rate of malignancy. Surgery is usually possible through a cervical incision and with an acceptable risk of significant morbidity. Thyroidectomy should be recommended as the treatment of choice. [source] Religious circumcision under local anaesthesia with a new disposable clampBJU INTERNATIONAL, Issue 6 2001R.F. Schmitz Objective To compare the results using a new disposable clamp (the Taraklamp Circumcision Device®, TCD, Taramedic Europe BV, Bilthoven, The Netherlands), used since 1998 in one clinic, and the conventional dissection technique (CDT) in another clinic, for religious circumcision in infants. Subjects and methods The TCD and CDT were compared prospectively; the duration of the procedure, complications and postoperative pain were recorded. The cosmetic result and the degree to which the parents were satisfied were evaluated after 6 weeks. After obtaining informed consent, 275 boys were included in the study (median age 3 years). Results The median operative duration was 8 min less for the TCD (15 vs 7 min; P < 0.001). There was no difference in complication rate (bleeding in one vs two; infection in two vs three) and postoperative pain was comparable in both groups. The cosmetic results were better for the TCD group (P < 0.001). The parents' satisfaction score for the procedure was equal in the groups, at 8, on a scale of 1 (very bad) to 10 (extremely good). Conclusion A religious circumcision outside the hospital with the TCD is quicker and leads to a better cosmetic result than with the CDT, without increasing morbidity. [source] Dissection and cotransplantation of large pieces of RPE and neural retina; effect of protease K on the developmentACTA OPHTHALMOLOGICA, Issue 1 2000Rajesh Kumar Sharma ABSTRACT. Purpose: This study attempts to cotransplant large pieces of the RPE and neural retina in the subretinal space of rabbits by using protease K for dissection of the donor tissue, and to investigate the effect of dissection technique on the development of the grafts. Methods: Eyes from 15-day-old pigmented rabbit embryos were partly digested by protease K to assist dissection of sclera and the choroid from RPE and neural retina. Large pieces of RPE and the neural retina thus obtained were cotransplanted into the eyes of adult albino rabbits who were allowed to survive for up to 63 days. The transplants were examined under light microscope. Results: It was possible to transplant large sheets of RPE and neural retina together. Both the RPE and the neural retina survived after cotransplantation. Retinal pigment epithelium survived in layers, but at places formed clusters. In cotransplants neural retina formed rosettes, developed gliosis, and photoreceptors failed to develop outer segments, possibly due to the action of protease K. Conclusion: Proteases seem to be injurious for the development of the neural retina. [source] | ||||||||||