1
|
Melcher C, Gottschalk O, Mazoochian F, Pieper K, Wegener V, Pellengahr CS, Teske W, Wegener B. A new minimal-invasive approach for total hip replacement in sheep. Technol Health Care 2023; 31:1867-1874. [PMID: 37125586 DOI: 10.3233/thc-220805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Over the last 50 years arthroplasty became the gold-standard treatment for disabling conditions of the coxofemoral joint. Variations of anterior, lateral, and dorsal incision have been applied, but as each approach requires the incision and reflection of various muscles to gain adequate exposure of the joint results are still controversial. OBJECTIVE The purpose of this study was to develop a minimal-invasive, tissue-sparing approach in sheep with reduced risks in animal testing. METHODS 12 mature sheep underwent hip surgery as part of a study to evaluate a hip resurfacing system. In line with the preliminary cadaveric tests a modified, minimal-invasive, musclepreserving surgical approach was sought after. RESULTS We developed a surgical approach to the coxofemoral joint in sheep using only blunt tissue dissection after skin incision without any limitations in joint exposure or increased blood loss/duration of surgery. CONCLUSION Even though limitations occur and femoral orientation in sheep differs from man, joint forces have similar relative directions to the bone with similar bony and vascular anatomy. Therefore, this minimal-invasive muscle preserving approach might be a safe and comparable alternative in still inevitable animal testing.
Collapse
Affiliation(s)
- Carolin Melcher
- Department of Spine Surgery and Scoliosis Center, Schön Klinik Neustadt in Holstein, Neustadt, Germany
- Musculoskeletal University Center, Ludwig Maximilian University of Munich, Munich, Germany
- Department of Spine Surgery and Scoliosis Center, Schön Klinik Neustadt in Holstein, Neustadt, Germany
| | - Oliver Gottschalk
- Department of Foot and Ankle Surgery, Schön Klinik München Harlaching, Munich, Germany
- Department of Spine Surgery and Scoliosis Center, Schön Klinik Neustadt in Holstein, Neustadt, Germany
| | - Farhad Mazoochian
- Department of Foot and Ankle Surgery, Schön Klinik München Harlaching, Munich, Germany
| | - Korbinian Pieper
- Clinic of Veterinary Surgery, Ludwig Maximilian University of Munich, Munich, Germany
| | | | | | | | - Bernd Wegener
- Musculoskeletal University Center, Ludwig Maximilian University of Munich, Munich, Germany
| |
Collapse
|
2
|
Goyal NN. Practice Points from Prof. Lawrence M. Field-Father of Modern Dermatosurgery: Bi-level anesthesia and blunt dissection. J Cutan Aesthet Surg 2021; 14:359-361. [PMID: 34908781 PMCID: PMC8611712 DOI: 10.4103/jcas.jcas_220_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Nilesh N Goyal
- Lilavati Hospital, Bandra West, Mumbai, Maharashtra, India
| |
Collapse
|
3
|
Çağlayan Özcan H, Gurol Uğur M, Sucu S, Balat Ö. Blunt dissection technique with finger and vessel skeletonization in the posterior vesical wall for abnormally invasive placenta previa. J Matern Fetal Neonatal Med 2019; 33:2441-2444. [PMID: 30486701 DOI: 10.1080/14767058.2018.1554043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: This study described a new technique to minimize the bleeding resulted from aberrant engorged vessels and unintended bladder injury in cases with abnormally invaded placenta adjacent to posterior bladder wall at cesarean hysterectomy.Methods: After filling the bladder with 300 ml saline aberrant engorged vessels were identified and skeletonized between lower uterine segment and bladder with blunt dissection by index finger down to the distal end point of cervix.Results: This technique has beneficial effect on preventing bladder injury and reduces bleeding resulting from the aberrant vessels and the communicating vessels that were based around the vesicouterine fold and the cervico-vesical interface (in the lower part of the cervix); respectively.Conclusion: Our procedure may have some benefits including shorter operation time, lower amount of hemorrhage, and less bladder injury where anatomical landmarks are unclear, especially in abnormally invasive placentation adjacent to posterior bladder wall at cesarean hysterectomy.
Collapse
Affiliation(s)
- Hüseyin Çağlayan Özcan
- Department of Obstetrics and Gynecology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Mete Gurol Uğur
- Department of Obstetrics and Gynecology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Seyhun Sucu
- Department of Obstetrics and Gynecology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Özcan Balat
- Department of Obstetrics and Gynecology, School of Medicine, Gaziantep University, Gaziantep, Turkey
| |
Collapse
|
4
|
Sarubbo S, De Benedictis A, Merler S, Mandonnet E, Barbareschi M, Dallabona M, Chioffi F, Duffau H. Structural and functional integration between dorsal and ventral language streams as revealed by blunt dissection and direct electrical stimulation. Hum Brain Mapp 2018; 37:3858-3872. [PMID: 27258125 DOI: 10.1002/hbm.23281] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 05/07/2016] [Accepted: 05/24/2016] [Indexed: 01/24/2023] Open
Abstract
The most accepted framework of language processing includes a dorsal phonological and a ventral semantic pathway, connecting a wide network of distributed cortical hubs. However, the cortico-subcortical connectivity and the reciprocal anatomical relationships of this dual-stream system are not completely clarified. We performed an original blunt microdissection of 10 hemispheres with the exposition of locoregional short fibers and six long-range fascicles involved in language elaboration. Special attention was addressed to the analysis of termination sites and anatomical relationships between long- and short-range fascicles. We correlated these anatomical findings with a topographical analysis of 93 functional responses located at the terminal sites of the language bundles, collected by direct electrical stimulation in 108 right-handers. The locations of phonological and semantic paraphasias, verbal apraxia, speech arrest, pure anomia, and alexia were statistically analyzed, and the respective barycenters were computed in the MNI space. We found that terminations of main language bundles and functional responses have a wider distribution in respect to the classical definition of language territories. Our analysis showed that dorsal and ventral streams have a similar anatomical layer organization. These pathways are parallel and relatively segregated over their subcortical course while their terminal fibers are strictly overlapped at the cortical level. Finally, the anatomical features of the U-fibers suggested a role of locoregional integration between the phonological, semantic, and executive subnetworks of language, in particular within the inferoventral frontal lobe and the temporoparietal junction, which revealed to be the main criss-cross regions between the dorsal and ventral pathways. Hum Brain Mapp 37:3858-3872, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Silvio Sarubbo
- Division of Neurosurgery, Department of Neurosciences, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy. .,Structural and Functional Connectivity Lab, Division of Neurosurgery, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy.
| | - Alessandro De Benedictis
- Department of Neuroscience and Neurorehabilitation, Neurosurgery Unit, Bambino Gesù Children's Hospital - IRCCS, 4 Piazza Sant'Onofrio, Roma, 00165, Italy
| | - Stefano Merler
- Bruno Kessler Foundation (FBK), 18 via Sommarive, Trento, 38123, Italy
| | - Emmanuel Mandonnet
- Department of Neurosurgery, Lariboisiere Hospital, 2 Rue Ambroise Pare, Paris, 75010, France
| | - Mattia Barbareschi
- Department of Histopathology, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy
| | - Monica Dallabona
- Division of Neurosurgery, Department of Neurosciences, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy
| | - Franco Chioffi
- Division of Neurosurgery, Department of Neurosciences, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy.,Structural and Functional Connectivity Lab, Division of Neurosurgery, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy
| | - Hugues Duffau
- Department of Neurosurgery, Hôpital Gui De Chauliac, Montpellier University Medical Center, 80 Av Augustin Fliche, Montpellier, 34295, France.,Institute for Neuroscience of Montpellier, INSERM U1051, Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors," Saint Eloi Hospital, Montpellier, France
| |
Collapse
|
5
|
Abstract
RATIONALE Surgical removal of a sebaceous cyst is usually accomplished through an external incision, which inevitably results in a scar. Herein, we described an intraoral approach for excising sebaceous cysts located in the lip or cheek near lip commissure, to avoid a skin scar. PATIENT CONCERNS Removal of the cyst but without leaving a scar on the face. DIAGNOSES Six patients were diagnosed with a subcutaneous cyst located in the lip or cheek near lip commissure. INTERVENTIONS We implemented an intraoral approach to excise the cyst, wherein an intraoral incision was made and blunt dissection was performed through the buccinator muscle or orbicularis oris muscle until the cyst wall was seen. The cyst was then dissected from the surrounding subcutaneous tissue by careful blunt dissection with a hemostat and completely removed through the intraoral incision. OUTCOMES All patients had complete recovery, with no recurrence or complaints for at least 6 months after the surgery. LESSONS A sebaceous cyst located in the lip or cheek near lip commissure can be excised by an intraoral approach through the mouth, which avoids a visible scar on the skin.
Collapse
|
6
|
De Benedictis A, Petit L, Descoteaux M, Marras CE, Barbareschi M, Corsini F, Dallabona M, Chioffi F, Sarubbo S. New insights in the homotopic and heterotopic connectivity of the frontal portion of the human corpus callosum revealed by microdissection and diffusion tractography. Hum Brain Mapp 2016; 37:4718-4735. [PMID: 27500966 DOI: 10.1002/hbm.23339] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 06/12/2016] [Accepted: 07/26/2016] [Indexed: 12/16/2022] Open
Abstract
Extensive studies revealed that the human corpus callosum (CC) plays a crucial role in providing large-scale bi-hemispheric integration of sensory, motor and cognitive processing, especially within the frontal lobe. However, the literature lacks of conclusive data regarding the structural macroscopic connectivity of the frontal CC. In this study, a novel microdissection approach was adopted, to expose the frontal fibers of CC from the dorsum to the lateral cortex in eight hemispheres and in one entire brain. Post-mortem results were then combined with data from advanced constrained spherical deconvolution in 130 healthy subjects. We demonstrated as the frontal CC provides dense inter-hemispheric connections. In particular, we found three types of fronto-callosal fibers, having a dorso-ventral organization. First, the dorso-medial CC fibers subserve homotopic connections between the homologous medial cortices of the superior frontal gyrus. Second, the ventro-lateral CC fibers subserve homotopic connections between lateral frontal cortices, including both the middle frontal gyrus and the inferior frontal gyrus, as well as heterotopic connections between the medial and lateral frontal cortices. Third, the ventro-striatal CC fibers connect the medial and lateral frontal cortices with the contralateral putamen and caudate nucleus. We also highlighted an intricate crossing of CC fibers with the main association pathways terminating in the lateral regions of the frontal lobes. This combined approach of ex vivo microdissection and in vivo diffusion tractography allowed demonstrating a previously unappreciated three-dimensional architecture of the anterior frontal CC, thus clarifying the functional role of the CC in mediating the inter-hemispheric connectivity. Hum Brain Mapp 37:4718-4735, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Alessandro De Benedictis
- Department of Neuroscience and Neurorehabilitation, Neurosurgery Unit, Bambino Gesù Children's Hospital - IRCCS, 4 Piazza Sant'Onofrio, Roma, 00165, Italy
| | - Laurent Petit
- Groupe D'Imagerie Neurofonctionnelle, Institut Des Maladies Neurodégénératives - UMR 5293, CNRS, CEA University of Bordeaux, Bordeaux, France
| | - Maxime Descoteaux
- Sherbrooke Connectivity Imaging Lab, University of Sherbrooke, Sherbrooke, Québec, Canada
| | - Carlo Efisio Marras
- Department of Neuroscience and Neurorehabilitation, Neurosurgery Unit, Bambino Gesù Children's Hospital - IRCCS, 4 Piazza Sant'Onofrio, Roma, 00165, Italy
| | - Mattia Barbareschi
- Department of Histopathology, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy
| | - Francesco Corsini
- Department of Neurosciences, Division of Neurosurgery, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy.,Structural and Functional Connectivity Lab, Division of Neurosurgery, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy
| | - Monica Dallabona
- Department of Neurosciences, Division of Neurosurgery, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy.,Structural and Functional Connectivity Lab, Division of Neurosurgery, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy
| | - Franco Chioffi
- Department of Neurosciences, Division of Neurosurgery, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy.,Structural and Functional Connectivity Lab, Division of Neurosurgery, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy
| | - Silvio Sarubbo
- Department of Neurosciences, Division of Neurosurgery, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy.,Structural and Functional Connectivity Lab, Division of Neurosurgery, "S. Chiara" Hospital, Trento APSS - 9 Largo Medaglie D'Oro, Trento, 38122, Italy
| |
Collapse
|