Cos'è un'ernia inguinale? Storia ed attualità della terapia chirurgicaSalvatore Cuccomarino
Cos'è un'ernia inguinale, storia della chirurgia dell'ernia, tecnica di Trabucco, tecnica laparoscopica TAPP
What is an inguinal hernia, history of hernia surgery, Trabucco technique, TAPP technique
Cos'è un'ernia inguinale? Storia ed attualità della terapia chirurgicaSalvatore Cuccomarino
Cos'è un'ernia inguinale, storia della chirurgia dell'ernia, tecnica di Trabucco, tecnica laparoscopica TAPP
What is an inguinal hernia, history of hernia surgery, Trabucco technique, TAPP technique
Osteosintesi percutanea del radio distale: Tecnica di Legnago (2013)Alberto Mantovani
SUMMARY
Purpose: We have developed and used a system of percutaneous fixation of unstable distal radius fractures (DRF)
using 4 Kirschner (K) wires. These wires are passed from the lateral side of the radius and connected among themselves
using a clamp. We call this the “Legnago technique” and the objective of this study is to standardize the
method and make it safe and easily reproducible. Methods: 27 patients aged from 45 to 102, 3 men and 24 women,
were treated using this technique. The indications were strictly limited to type A2 and A3 of the AO classification,
excluding the A3.3. These were usually emergency procedures, performed under local anaesthesia and under
image intensifier control. We recommend a small incision at the entry point of each K wire and blunt dissection up
to the bone in order to avoid impalement of vessels, tendons or nerves.We follow a standard sequence of passing four
K wires, starting with a 2 mm K wire from the radial styloid into the medullary canal of the radius. This is inserted
dorsal to the tendons of the first extensor compartment. The K wire was mounted on a Jacob’s chuck handle and
was pre-bent at its leading end to around 30 degrees. This helps to control the direction of the wire within the bone
and, also, helps in achieving the reduction. The subsequent three wires of diameter 1.8 mm are passed using a motorised
drill from the lateral aspect of the lower end of the radius across the fracture site to engage the opposite cortex.
Finally, each of the wires is bent adequately in a convergent direction along the axis of the wrist on the lateral side
and held together with the help of a clamp. Results: Each patient was evaluated according to MayoWrist Score criteria,
with a follow-up ranging from 4-26 months.We noted 17 excellent results, 7 good and 3 satisfactory. Radiological
consolidation of the fracture was achieved in each patient, at an average delay of 40 days. Union occurred
with no change in the radiological parameters achieved by the operation. The complications included three cases of
superficial infection around the K wires and a partial lesion of the superficial radial nerve. The patients regained
complete autonomy in the use of the affected upper limb for activities of daily living within a week from the operation.
None of the patients underwent supervised physiotherapy. Conclusions: The Legnago technique of percutaneous
fixation of the DRF has proved efficacious in the treatment of unstable extra-articular fractures. The particular
arrangement of insertion of the K-wires and their connection using an external fixator clamp allowed early
active mobilisation of the wrist without plaster support. This concurs with recent experimental demonstrations according
to which the biomechanical stability of the percutaneous fixation of the DRF with externally connected
crossing K wires is superimposable to that obtained by volar locked plates. RivChirMano 2012; 3: 339-349
Osteosintesi percutanea del radio distale: Tecnica di Legnago (2013)Alberto Mantovani
SUMMARY
Purpose: We have developed and used a system of percutaneous fixation of unstable distal radius fractures (DRF)
using 4 Kirschner (K) wires. These wires are passed from the lateral side of the radius and connected among themselves
using a clamp. We call this the “Legnago technique” and the objective of this study is to standardize the
method and make it safe and easily reproducible. Methods: 27 patients aged from 45 to 102, 3 men and 24 women,
were treated using this technique. The indications were strictly limited to type A2 and A3 of the AO classification,
excluding the A3.3. These were usually emergency procedures, performed under local anaesthesia and under
image intensifier control. We recommend a small incision at the entry point of each K wire and blunt dissection up
to the bone in order to avoid impalement of vessels, tendons or nerves.We follow a standard sequence of passing four
K wires, starting with a 2 mm K wire from the radial styloid into the medullary canal of the radius. This is inserted
dorsal to the tendons of the first extensor compartment. The K wire was mounted on a Jacob’s chuck handle and
was pre-bent at its leading end to around 30 degrees. This helps to control the direction of the wire within the bone
and, also, helps in achieving the reduction. The subsequent three wires of diameter 1.8 mm are passed using a motorised
drill from the lateral aspect of the lower end of the radius across the fracture site to engage the opposite cortex.
Finally, each of the wires is bent adequately in a convergent direction along the axis of the wrist on the lateral side
and held together with the help of a clamp. Results: Each patient was evaluated according to MayoWrist Score criteria,
with a follow-up ranging from 4-26 months.We noted 17 excellent results, 7 good and 3 satisfactory. Radiological
consolidation of the fracture was achieved in each patient, at an average delay of 40 days. Union occurred
with no change in the radiological parameters achieved by the operation. The complications included three cases of
superficial infection around the K wires and a partial lesion of the superficial radial nerve. The patients regained
complete autonomy in the use of the affected upper limb for activities of daily living within a week from the operation.
None of the patients underwent supervised physiotherapy. Conclusions: The Legnago technique of percutaneous
fixation of the DRF has proved efficacious in the treatment of unstable extra-articular fractures. The particular
arrangement of insertion of the K-wires and their connection using an external fixator clamp allowed early
active mobilisation of the wrist without plaster support. This concurs with recent experimental demonstrations according
to which the biomechanical stability of the percutaneous fixation of the DRF with externally connected
crossing K wires is superimposable to that obtained by volar locked plates. RivChirMano 2012; 3: 339-349
L’invenzione riguarda una tecnica originale per migliorare la qualità delle immagini che si acquisiscono durante un trattamento di adroterapia oncologica e che si basa su un nuovo metodo di sincronizzazione indiretta del sistema di acquisizione con l’acceleratore del fascio di ioni.
Disuria dopo la rimozione del catetere vescicale, come gestirla con il bladde...Carlo Brachelente
sintesi delle raccomandazioni per l'impiego del bladder scanner per gestire la disuria dopo la rimozione del catetere vescicale. Contributo bubblicato sul sito nursetimes.org il 3 giugno 2017
7. il 30% delle donne sottoposte a chirurgia fasciale và incontro a recidiva , che costringe al reintervento, entro 4 anni
8.
9. progressi di biotecnologia e di materiali protesici che promuovono la crescita di tessuto connettivo di supporto chirurgia protesica miniinvasiva Nuova concezione chirurgica nei difetti del pavimento pelvico
10. IVS Intra Vaginal Slingplasty Pelvic Floor Center, Montecchio Emilia
15. Surgical technique: the Perigee device Insertion of the Perigee upper needles Insertion of the Perigee lower needles Final position of the Perigee mesh
17. International Consultation for incontinence Committee for pelvic organ prolapse review Non vi sono dati sufficienti per poter tirare conclusioni definitive sul ruolo dei materiali protesici in chirurgia ricostruttiva pelvica ICI Parigi 2008
18.
19. compartimento anteriore Maher C; Baessler K. Int Urogyn J 2006 uso delle reti compartimento posteriore meno convincente più convincente riparazione fasciale tasso di successo: 80-85%
This illustration in the dorsal lithotomy position demonstrates a total implant in its final position. Anteriorly, the mesh is placed in the vesicovaginal space, with the superficial and deep straps traversing through the obturator foramen. Posteriorly, the mesh is in the rectovaginal space, overlying the rectal muscularis and the straps traversing the sacrospinous ligaments. The mesh is placed from the middle third of the vagina to both sidewalls, and then, back to the uterosacral ligaments at the level of the ischial spines. Now that you have seen the total implant in its final position, let me explain the steps of how to get it there. In order to get an implant into position, a thorough vaginal dissection needs to be made and paths for the straps need to be made. First I am going to describe the anterior path for placing the superficial and deep straps and then I will describe the posterior path. During an anterior, posterior, or total repair using the GYNECARE PROLIFT * Pelvic Floor Repair System, t he patient should be placed in the lithotomy position with her buttocks slightly overlapping the table and her thighs flexed at approximately 90 degrees in relation to the plane of the table. If the surgeon is performing an anterior or total repair, he/she can determine the limits of the obturator foramen by placing the index finger in the vagina and palpating with the thumb externally where the obturator membrane comes into contact with the bony boundaries. Note: Retrospective data analysis suggests that the rate of mesh exposure may be higher when performing the TVM procedure with concurrent hysterectomy.
About the design features of Pinnacel Blue mid line
Blunt dissection medial to ischial spine will identify and expose sacrospinous ligament; Proximal portion of arcus tendineous fascia pelvis (ATFP) will be identified anterolaterally. Ensure that the SSL is clear of any fibrous or fatty tissue.
Place apical sacrospinous Capio arm (leaving the Capio medial to the suture. This is done with the operator ipsilateral index finger). Make sure you are over the ligament and clear of any fibrous tissue over the ischial spine.
Identifying where Apogee is placed in relation to Elevate and as well as the pudendal verve