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New Surgical Procedure (new + surgical_procedure)
Selected AbstractsSurgical Treatment of Ingrown Toenail without MatricectomyDERMATOLOGIC SURGERY, Issue 1 2008BERNARD NOËL MD BACKGROUND Partial excision of the nail matrix (matricectomy) is generally considered necessary in the surgical treatment of ingrown toenail. Recurrences may occur, however, and poor cosmetic results are frequently observed. OBJECTIVE The objective is to present a new surgical procedure for ingrown toenail with complete preservation of the nail matrix. METHODS Twenty-three patients with ingrown toenail were included in this study. The surgical excision was performed 1 week after the completion of treatment of the initial infection. A large volume of soft tissue surrounding the nail plate was removed under local anesthesia. No matrix excision was performed. RESULTS Short-term results were excellent. No recurrences or severe complications were observed during the minimum 12-months follow-up period. Cosmetic results were remarkable. CONCLUSIONS Ingrown toenail results from the compression of the lateral nail folds on the nail plate. This study shows that ingrown toenail can be surgically treated without matricectomy. A large volume of soft tissue surrounding the nail plate should be removed to decompress the nail and reduce inflammation. Cosmetic results are excellent and superior to the classical Emmert plasty. Postoperative nail dystrophies and spicule formation are not observed. The main advantage of this surgical approach is the complete preservation of the anatomy and function of the nail to improve both therapeutic and cosmetic results. [source] A concept for the clinical implementation of sentinel lymph node biopsy in patients with breast carcinoma with special regard to quality assurance,CANCER, Issue 3 2005Thorsten Kuehn M.D. Abstract The development of standardized and reproducible clinical pathways is an important precondition for quality assurance in medicine, especially if a new method has not yet been ultimately validated. Sentinel lymph node biopsy (SLNB) is a widely accepted new surgical procedure in the treatment of early breast carcinoma. However, numerous steps of the method and details of the technique are not standardized and, thus, hamper quality assurance for SLNB. The German Society of Senology appointed an interdisciplinary consensus committee to work out guidelines for the standardized performance and quality-assured implementation of SLNB on a nationwide, homogeneous standard. The committee consisted of surgeons, gynecologists, radiooncologists, nuclear physicians, oncologists, and pathologists. Relevant questions related to patient selection, lymphatic mapping, surgery, histopathologic work-up, further local and systemic treatment decisions, patient information, training, and follow-up were evaluated with respect to clinical evidence, objectivity, and reproducibility. Clinical pathways were developed on the basis of this analysis. Requirements to the performing institutions and surgeons were defined. Cancer 2005. © 2004 American Cancer Society. [source] Applying circular posterior-hinged craniotomy to malignant cerebral edemasCLINICAL ANATOMY, Issue 3 2002H. Traxler Abstract Malignant brain edemas are often fatal, regardless of whether they are treated conservatively with sedation, blood pressure management, mannitol-therapy, hyperventilation and hypothermia, or non-conservatively with routine trepanation. Unfortunately, temporal trepanation may result in significant brain damage through herniation of the cerebrum at the edges of the trepanation openings. In one case of a 26-year-old male with severe head injury, a circular posterior-hinged craniotomy (CPHC) was performed after an ineffective unitemporal trepanation for evacuation of an acute subdural hematoma. This ultimately successful operation prompted experimental and morphologic investigations on a new surgical procedure for lowering intracranial pressure (ICP). In 12 of 15 human cadavers, an experimentally ICP was lowered by a CPHC with between 9,21 mm of frontal elevation of the calvaria. Using computer simulation, the frontal elevations of the calvaria were "virtually" performed on 3D reconstructions from CT scans of skulls, and the intracranial volume gained was measured with a computer software program. The volume increase of the cranial cavity showed a relatively constant relation to the cranial capacity and was increased by 6.0% (±0.4%) or 78 cm3 with a 10 mm elevation and by 12.4% (±0.7%) or 160 cm3 with a 20 mm elevation. There were no significant differences with skulls of different ages or ethnic origin; however, a significant effect of gender (F = 7.074; P , 0.013) on the gained volume in percent of the cranial capacity for the 20 mm elevation was observed. This difference can be explained by the inverse relationship between volume increase and cranial capacity (r = ,0.507; P , 0.004). Clin. Anat. Month:173,181, 2002. © 2002 Wiley-Liss, Inc. [source] 3D ultrasound in robotic surgery: performance evaluation with stereo displays,THE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 3 2006Paul M. Novotny Abstract Background The recent advent of real-time 3D ultrasound (3DUS) imaging enables a variety of new surgical procedures. These procedures are hampered by the difficulty of manipulating tissue guided by the distorted, low-resolution 3DUS images. To lessen the effects of these limitations, we investigated stereo displays and surgical robots for 3DUS-guided procedures. Methods By integrating real-time stereo rendering of 3DUS with the binocular display of a surgical robot, we compared stereo-displayed 3DUS with normally displayed 3DUS. To test the efficacy of stereo-displayed 3DUS, eight surgeons and eight non-surgeons performed in vitro tasks with the surgical robot. Results Error rates dropped by 50% with a stereo display. In addition, subjects completed tasks faster with the stereo-displayed 3DUS as compared to normal-displayed 3DUS. A 28% decrease in task time was seen across all subjects. Conclusions The results highlight the importance of using a stereo display. By reducing errors and increasing speed, it is an important enhancement to 3DUS-guided robotics procedures. Copyright © 2006 John Wiley & Sons, Ltd. [source] | ||||||||||