• Title/Summary/Keyword: Surgery training

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A study on the effect of vision therapy after surgery for intermittent exotropia under 12 years of age (12세 미만 간헐성 외사시안의 수술 이후 시각훈련효과에 대한 임상연구)

  • Jang, Woo-Yeong;Lee, Seung-Wook
    • Journal of Korean Clinical Health Science
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    • v.9 no.2
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    • pp.1520-1525
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    • 2021
  • Purpose. This study conducted visual function training for children under 12 years of age who relapsed after surgery for intermittent exotropia. We are trying to find out whether the visual function has been improved by visual function training. Methods. After surgery, the subject with recurrent exotropia was given a prescription for refractive error, followed by visual function training and vision therapy with visual sence using prisms and lenses. Results. The subjects' positive relative convergence improved to 19.69𝚫, corrected visual acuity improved to 0.88, and stereoscopic vision function improved to 53.08 arc second. It was found that the smaller the angle of deviation at the time of recurrence after surgery, the better the vision therapy effect. Conclusions. It can be seen that visual function training is helpful in improving visual function, and the importance of visual function training can be known.

Robotically Assisted Microsurgery: Development of Basic Skills Course

  • Liverneaux, Philippe Andre;Hendriks, Sarah;Selber, Jesse C.;Parekattil, Sijo J.
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.320-326
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    • 2013
  • Robotically assisted microsurgery or telemicrosurgery is a new technique using robotic telemanipulators. This allows for the addition of optical magnification (which defines conventional microsurgery) to robotic instrument arms to allow the microsurgeon to perform complex microsurgical procedures. There are several possible applications for this platform in various microsurgical disciplines. Since 2009, basic skills training courses have been organized by the Robotic Assisted Microsurgical and Endoscopic Society. These basic courses are performed on training models in five levels of increasing complexity. This paper reviews the current state of the art in robotically asisted microsurgical training.

Dye-Perfused Human Placenta for Simulation in a Microsurgery Laboratory for Plastic Surgeons

  • Laura C. Zambrano-Jerez;Karen D. Diaz-Santamaria;Maria A. Rodriguez-Santos;Diego F. Alarcon-Ariza;Genny L. Melendez-Florez;Monica A. Ramirez-Blanco
    • Archives of Plastic Surgery
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    • v.50 no.6
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    • pp.627-634
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    • 2023
  • In recent decades, a number of simulation models for microsurgical training have been published. The human placenta has received extensive validation in microneurosurgery and is a useful instrument to facilitate learning in microvascular repair techniques as an alternative to using live animals. This study uses a straightforward, step-by-step procedure for instructing the creation of simulators with dynamic flow to characterize the placental vascular tree and assess its relevance for plastic surgery departments. Measurements of the placental vasculature and morphological characterization of 18 placentas were made. After the model was used in a basic microsurgery training laboratory session, a survey was given to nine plastic surgery residents, two microsurgeons, and one hand surgeon. In all divisions, venous diameters were larger than arterial diameters, with minimum diameters of 0.8 and 0.6 mm, respectively. The majority of the participants considered that the model faithfully reproduces a real microsurgical scenario; the consistency of the vessels and their dissection are similar in in vivo tissue. Furthermore, all the participants considered that this model could improve their surgical technique and would propose it for microsurgical training. As some of the model's disadvantages, an abundantly thick adventitia, a thin tunica media, and higher adherence to the underlying tissue were identified. The color-perfused placenta is an excellent tool for microsurgical training in plastic surgery. It can faithfully reproduce a microsurgical scenario, offering an abundance of vasculature with varying sizes similar to tissue in vivo, enhancing technical proficiency, and lowering patient error.

The Rat Model in Microsurgery Education: Classical Exercises and New Horizons

  • Shurey, Sandra;Akelina, Yelena;Legagneux, Josette;Malzone, Gerardo;Jiga, Lucian;Ghanem, Ali Mahmoud
    • Archives of Plastic Surgery
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    • v.41 no.3
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    • pp.201-208
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    • 2014
  • Microsurgery is a precise surgical skill that requires an extensive training period and the supervision of expert instructors. The classical training schemes in microsurgery have started with multiday experimental courses on the rat model. These courses have offered a low threat supervised high fidelity laboratory setting in which students can steadily and rapidly progress. This simulated environment allows students to make and recognise mistakes in microsurgery techniques and thus shifts any related risks of the early training period from the operating room to the lab. To achieve a high level of skill acquisition before beginning clinical practice, students are trained on a comprehensive set of exercises the rat model can uniquely provide, with progressive complexity as competency improves. This paper presents the utility of the classical rat model in three of the earliest microsurgery training centres and the new prospects that this versatile and expansive training model offers.

Gastropleural Fistula: A Rare Complication of Ewing Sarcoma

  • Bozkurt, Mehmet Abdussamet;Kones, Osman;Basoglu, Irfan;Alis, Halil
    • Journal of Chest Surgery
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    • v.46 no.4
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    • pp.293-294
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    • 2013
  • Gastropleural fistula (GPF) is a rare condition that can occur as a consequence of prior pulmonary surgery, trauma, or malignancy. Conservative management usually fails, and gastrectomy and even thoracotomy is often required, especially in debilitated patients. We present a patient with GPF who had a history of Ewing's sarcoma. Diagnosis of GPF was confirmed by upper gastrointestinal system endoscopy and radiographic contrast examination, and the patient underwent a laparoscopic wedge resection of the fistula. To our knowledge, this is the first report of a GPF, in the formation of which recurrence of Ewing's sarcoma had played a role and in the treatment of which wedge resection of the fistula was performed. Laparoscopic treatment of GPF may be associated with less morbidity and should be considered as the initial procedure of choice.

Quality of Life in Older Adults with Cochlear Implantation: Can It Be Equal to That of Healthy Older Adults?

  • Tokat, Taskin;Muderris, Togay;Bozkurt, Ergul Basaran;Ergun, Ugurtan;Aysel, Abdulhalim;Catli, Tolgahan
    • Korean Journal of Audiology
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    • v.25 no.3
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    • pp.138-145
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    • 2021
  • Background and Objectives: This study aimed to evaluate the audiologic results after cochlear implantation (CI) in older patients and the degree of improvement in their quality of life (QoL). Subjects and Methods: Patients over 65 years old who underwent CI at implant center in Bozyaka Training and Research Hospital were included in this study (n=54; 34 males and 20 females). The control group was patient over 65 years old with normal hearing (n=54; 34 males and 20 females). We administered three questionnaires [World Health Organization Quality of Life-BREF (WHOQOL-BREF), World Health Organization Quality of Life-OLD (WHOQOL-OLD)], and Geriatric Depression Scale (GDS) to evaluate the QoL, CIrelated effects on activities of daily life, and social activities in all the subjects. Moreover, correlations between speech recognition and the QoL scores were evaluated. The duration of implant use and comorbidities were also examined as potential factors affecting QoL. Results: The patients had remarkable improvements (the mean score of postoperative speech perception 75.7%) in speech perception after CI. The scores for the WHOQOL-OLD and WHOQOL-BREF questionnaire responses were similar in both the study and control groups, except those for a two subdomains (social relations and social participation). The patients with longer-term CI had higher scores than those with short-term CI use. In general, the changes in GDS scores were not significant (p<0.05). Conclusions: The treatment of hearing loss with CI conferred significant improvement in patient's QoL (p<0.01). The evaluation of QoL can provide multidimensional insights into a geriatric patient's progress and, therefore, should be considered by audiologists.

Quality of Life in Older Adults with Cochlear Implantation: Can It Be Equal to That of Healthy Older Adults?

  • Tokat, Taskin;Muderris, Togay;Bozkurt, Ergul Basaran;Ergun, Ugurtan;Aysel, Abdulhalim;Catli, Tolgahan
    • Journal of Audiology & Otology
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    • v.25 no.3
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    • pp.138-145
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    • 2021
  • Background and Objectives: This study aimed to evaluate the audiologic results after cochlear implantation (CI) in older patients and the degree of improvement in their quality of life (QoL). Subjects and Methods: Patients over 65 years old who underwent CI at implant center in Bozyaka Training and Research Hospital were included in this study (n=54; 34 males and 20 females). The control group was patient over 65 years old with normal hearing (n=54; 34 males and 20 females). We administered three questionnaires [World Health Organization Quality of Life-BREF (WHOQOL-BREF), World Health Organization Quality of Life-OLD (WHOQOL-OLD)], and Geriatric Depression Scale (GDS) to evaluate the QoL, CIrelated effects on activities of daily life, and social activities in all the subjects. Moreover, correlations between speech recognition and the QoL scores were evaluated. The duration of implant use and comorbidities were also examined as potential factors affecting QoL. Results: The patients had remarkable improvements (the mean score of postoperative speech perception 75.7%) in speech perception after CI. The scores for the WHOQOL-OLD and WHOQOL-BREF questionnaire responses were similar in both the study and control groups, except those for a two subdomains (social relations and social participation). The patients with longer-term CI had higher scores than those with short-term CI use. In general, the changes in GDS scores were not significant (p<0.05). Conclusions: The treatment of hearing loss with CI conferred significant improvement in patient's QoL (p<0.01). The evaluation of QoL can provide multidimensional insights into a geriatric patient's progress and, therefore, should be considered by audiologists.

A Tie-Over Dressing Using a Silicone Tube to Graft Deep Wounds

  • Bektas, Cem Inan;Kankaya, Yuksel;Ozer, Kadri;Baris, Ruser;Aslan, Ozlem Colak;Kocer, Ugur
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.711-714
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    • 2013
  • Background The most common cause of skin graft failure is the collection of blood or serous fluid underneath the graft. In our study, we describe the use of silicone tube for tie-over dressing to secure the skin graft margins with the aim of decreasing loss of the skin graft, particularly in grafting of deep wounds. Methods Between March 2008 and July 2011, we used this technique in 17 patients with skin defects with depths ranging from 3.5 to 8 mm (mean, 5.5 mm). First, the skin graft was sutured with 3/0 silk suture material from its corners. Then, a silicone round drain tube was sutured with 3/0 absorbable polyglactin 910 over the margins of the graft. Finally, long silk threads were tied over the bolus dressing, and the tie-over dressing was completed in the usual fashion. Results The mean follow-up was 7 months (range, 2-10 months) in the outpatient clinic. Graft loss on the graft margins due to hematoma or seroma was not developed. The results of adhesion between the graft and wound bed peripherally was excellent. Conclusions In our study, we suggest that use of a silicone tube for additional pressure on the edges of skin grafts in case of reconstruction of deep skin defects.

Antithrombotic effect of epigallocatechin gallate on the patency of arterial microvascular anastomoses

  • Igde, Murat;Ozturk, Mehmet Onur;Yasar, Burak;Bulam, Mehmet Hakan;Ergani, Hasan Murat;Unlu, Ramazan Erkin
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.214-220
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    • 2019
  • Background Microvascular anastomosis patency is adversely affected by local and systemic factors. Impaired intimal recovery and endothelial mechanisms promoting thrombus formation at the anastomotic site are common etiological factors of reduced anastomosis patency. Epigallocatechin gallate (EGCG) is a catechin derivative belonging to the flavonoid subgroup and is present in green tea (Camellia sinensis). This study investigated the effects of EGCG on the structure of vessel tips used in microvascular anastomoses and evaluated its effects on thrombus formation at an anastomotic site. Methods Thirty-six adult male Wistar albino rats were used in the study. The right femoral artery was cut and reanastomosed. The rats were divided into two groups (18 per group) and were systemically administered either EGCG or saline. Each group were then subdivided into three groups, each with six rats. Axial histological sections were taken from segments 1 cm proximal and 1 cm distal to the microvascular anastomosis site on days 5, 10, and 14. Results Thrombus formation was significantly different between the EGCG and control groups on day 5 (P=0.015) but not on days 10 or 14. The mean luminal diameter was significantly greater in the EGCG group on days 5 (P=0.002), 10 (P=0.026), and 14 (P=0.002). Intimal thickening was significantly higher on days 5 (P=0.041) and 10 (P=0.02). Conclusions EGCG showed vasodilatory effects and led to reduced early thrombus formation after microvascular repair. Similar studies on venous anastomoses and random or axial pedunculated skin flaps would also contribute valuable findings relevant to this topic.