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‣ T-Shaped Microsuture: A New Suture Technique for Laryngeal Microsurgery

TSUJI, Domingos H.; NITA, Luciana Miwa; HACHIYA, Adriana; IMAMURA, Rui; SENNES, Luiz U.
Fonte: MOSBY-ELSEVIER Publicador: MOSBY-ELSEVIER
Tipo: Artigo de Revista Científica
Português
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To describe a new suture technique for laryngeal microsurgery and to test its applicability in human cadaver larynges. The new technique was experimentally tested in freshly excised human larynges fixed to a larynx holder appropriate for the simulation of laryngeal microsurgery. A mucosal flap was created in the vocal fold for the fabrication of a pocket for subepithelial fat implantation, and the wound edges were then brought together and sutured using the proposed technique. The time necessary for suture was measured with a stopwatch for five successive sutures performed by one of the surgeons. The presence or absence of mucosal rupture was determined for five sutures performed by two surgeons, for a total of 10 sutures. The sutures were performed without the help of an assistant, with no laceration of the mucosa being observed in any of the attempts, and within a relatively short period of time even without previous training. The sutures performed permitted the implanted fat to remain stable under the mucosal flap. Conclusions: the new suture technique is an easy procedure, which can be performed by a single surgeon under microscopic vision, with a low risk of tissue rupture. The technique does not markedly prolong the duration of surgery and a single suture thread can be used for the fabrication of more than one stitch.

‣ Viabilidade anátomo-clínica da utilização dos vasos perfurantes do músculo peitoral maior como pedículo receptor na reconstrução mamária imediata e tardia com microcirurgia; Viability of utilizing the pectoralis major perforator muscular vessels as a recipient pedicle in immediate and late breast reconstruction with microsurgery

Munhoz, Alexandre Mendonça
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 06/12/2006 Português
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Na reconstrução mamária com microcirurgia, a qualidade dos vasos, a proximidade com a região torácica e a anatomia constante são fatores relevantes na escolha do pedículo receptor. Apesar da grande aplicação clínica, os vasos toracodorsais e torácicos internos apresentam restrições como a imprevisibilidade da qualidade nas reconstruções tardias, as alterações do contorno do tórax e a inviabilidade de uma eventual revascularização futura do miocárdio. Com o desenvolvimento dos retalhos vascularizados por vasos perfurantes e o maior treinamento dos cirurgiões, novas alternativas de pedículos foram desenvolvidas. A preservação da cartilagem costal e dos vasos torácicos internos, bem como a maior exposição do campo operatório são mencionados como vantagens do emprego dos vasos perfurantes do músculo peitoral maior como receptor. Apesar da anatomia dos vasos perfurantes ter sido previamente estudada, são imprecisas as informações sobre sua origem e distribuição no tórax. Ademais, são escassos os dados relacionados à sua incidência e utilização nas reconstruções imediatas e tardias. Na presente investigação foram incluídos dois estudos: anatômico e clínico. No estudo anatômico avaliou-se a origem...

‣ Dissecting mitosis with laser microsurgery and RNAi in Drosophila cells

Pereira, António J.; Matos, Irina; Lince-Faria, Mariana; Maiato, Helder
Fonte: Universidade do Porto Publicador: Universidade do Porto
Tipo: Artigo de Revista Científica
Português
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Progress from our present understanding of the mechanisms behind mitosis has been compromised by the fact that model systems that were ideal for molecular and genetic studies (such as yeasts, C. elegans or Drosophila) were not suitable for intracellular micromanipulation. Unfortunately, those systems that were appropriate for micromanipulation (like newt lung cells, PtK1 cells or insect spermatocytes) are not amenable for molecular studies. We believe that we can significantly broaden this scenario by developing high resolution live cell microscopy tools in a system where micromanipulation studies could be combined with modern gene-interference techniques. Here we describe a series of methodologies for the functional dissection of mitosis by the use of simultaneous live cell microscopy and state-of-the-art laser microsurgery, combined with RNA interference (RNAi) in Drosophila cell lines stably expressing fluorescent markers. This technological synergism allows the specific targeting and manipulation of several structural components of the mitotic apparatus in different genetic backgrounds, at the highest spatial and temporal resolution. Finally, we demonstrate the successful adaptation of agar overlay flattening techniques to human HeLa cells and discuss the advantages of its use for laser micromanipulation and molecular studies of mitosis in mammals.

‣ An alternative experimental model for training in microsurgery

Maluf Junior,Ivan; Silva,Alfredo Benjamin Duarte Da; Groth,Anne Karoline; Lopes,Marlon Augusto Camara; Kurogi,Adriana Sayuri; Freitas,Renato Da Silva; Tomasich,Flávio Daniel Saavedra
Fonte: Colégio Brasileiro de Cirurgiões Publicador: Colégio Brasileiro de Cirurgiões
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2014 Português
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OBJECTIVE: to describe a new model of training in microsurgery with pig spleen after splenectomy performed by undergraduate students of the Discipline of Operative Technique of the UFPR Medical School. METHODS: after the completion of splenectomy we performed dissection of the vascular pedicle, distal and proximal to the ligation performed for removal of the spleen. After complete dissection of the splenic artery and vein with microscope, clamps were placed and the vessels were cut. We then made the anastomosis of the vessels with 9.0 nylon. RESULT: the microsurgical training with a well-defined routine, qualified supervision and using low cost experimental materials proved to be effective in the practice of initial microvascular surgery. CONCLUSION: the use of pig spleen, which would be discarded after splenectomy, is an excellent model for microsurgical training, since besides having the consistency and sensitivity of a real model, it saves the sacrifice of a new animal model in the initial learning phase of this technique.

‣ Basic microsurgery training: comments and proposal

Martins,Paulo Ney Aguiar; Montero,Edna Frasson de Souza
Fonte: Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia Publicador: Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2007 Português
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Microsurgical techniques have been applied in many surgical specialties and have also a broad application in surgical research. It demands high technical skills and continued training. The microsurgical training is lengthy, very expensive and demands high commitment. The microsurgical skills should be first mastered in the lab and only then applied in the clinic. Here, we propose a model of a training course in microsurgery. We also suggest that surgical societies involved with microsurgery promote training courses on a regular basis.

‣ Characteristics of polypoid lesions in patients undergoing microsurgery of the larynx

Ido Filho,Jorge Massaaki; Carvalho,Bettina; Mizoguchi,Flavio Massao; Catani,Guilherme Simas do Amaral; Macedo Filho,Evaldo Dacheux de; Malafaia,Osvaldo; Stahlke Jr.,Henrique Jorge
Fonte: Fundação Otorrinolaringologia Publicador: Fundação Otorrinolaringologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2013 Português
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INTRODUCTION: Dysphonia is the main symptom of lesions that affect the vocal tract. Many of those lesions may require surgical treatment. Polyps are one of the most common forms of vocal cord lesions and the most prevalent indication for laryngeal microsurgery. There are different types of polyps, and their different characteristics can indicate different prognosis and treatments. AIM: To conduct a comparative study of polypoid lesions (angiomatous and gelatinous) in patients undergoing laryngeal microsurgery via an electronic protocol. METHOD: We prospectively evaluated 93 patients diagnosed with vocal fold polyps; the polyps were classified as angiomatous or gelatinous. RESULTS: In total, 93 patients undergoing laryngeal microsurgery were diagnosed with vocal fold polyps. Of these, 63 (64.74%) had angiomatous and 30 (32.26%) gelatinous polyps. Most patients with angiomatous polyps were men; their polyps were frequently of medium size, positioned in the middle third of the vocal fold, and accompanied by minimal structural alterations (MSA). In contrast, the majority of patients with gelatinous polyps were women; their polyps were smaller, positioned in the middle and posterior third of the vocal fold, and were not accompanied by MSA. Both types of polyps were more frequently located on the right vocal fold. CONCLUSION: Angiomatous polyps were more frequently encountered than gelatinous polyps. In addition...

‣ The Role of Speech Therapy in Patients Who Underwent Laryngeal Microsurgery due to Phonotraumatic Lesions and Lesions Unrelated to Phonotrauma

Macedo,Claudia de Assis Corrêa de; Macedo,Evaldo Dacheux de; Malafaia,Osvaldo; Catani,Guilherme Simas do Amaral; Ido,Jorge Massaki; Stahlke Jr.,Henrique Jorge
Fonte: Fundação Otorrinolaringologia Publicador: Fundação Otorrinolaringologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2014 Português
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Introduction The role of the speech-language pathology in the multiprofessional team dealing with laryngology and the voice has been recognized for a long time. Scientific studies in this field recommend therapies for laryngeal microsurgeries; few of the studies, however, effectively evaluate the result of postoperative speech therapy. Objective To compare speech therapy evaluation and treatment among patients with phonotraumatic lesions and patients with lesions unrelated to phonotrauma who underwent laryngeal microsurgery. Methods This study was performed at IPO Hospital (Paranaense Institute of Otorhinolaryngology, Curitiba, Paraná, Brazil) between February 2010 and February 2011. Of 254 patients who underwent laryngeal microsurgery, 208 patients were included in the study and divided in two groups: group A with phonotraumatic lesions (n = 131) and group B with lesions unrelated to phonotrauma (n = 77). The number of sessions and the functional result after speech therapy were evaluated. Results The number of postoperative phonotherapy sessions after microsurgery was up to 10 sessions in 89.31% and 87.71% for groups A and B, respectively. Phonotherapy treatment showed a better functional evolution in group A (92.37%). Conclusion A significant difference was observed only in functional evolution...

‣ Towards a Global Understanding and Standardisation of Education and Training in Microsurgery

Leung, Clement Chi Ming; Ghanem, Ali M; Tos, Pierluigi; Ionac, Mihai; Froschauer, Stefan; Myers, Simon R
Fonte: The Korean Society of Plastic and Reconstructive Surgeons Publicador: The Korean Society of Plastic and Reconstructive Surgeons
Tipo: Artigo de Revista Científica
Português
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With an increasing emphasis on microsurgery skill acquisition through simulated training, the need has been identified for standardised training programmes in microsurgery. We have reviewed microsurgery training courses available across the six continents of the World. Data was collected of relevant published output from PubMed, MEDLINE (Ovid), and EMBASE (Ovid) searches, and from information available on the Internet of up to six established microsurgery course from each of the six continents of the World. Fellowships and courses that concentrate on flap harvesting rather than microsurgical techniques were excluded. We identified 27 centres offering 39 courses. Total course length ranged from 20 hours to 1,950 hours. Student-to-teacher ratios ranged from 2:1 to 8:1. Only two-thirds of courses offered in-vivo animal models. Instructions in microvascular end-to-end and end-to-side anastomoses were common, but peripheral nerve repair or free groin flap transfer were not consistently offered. Methods of assessment ranged from no formal assessment, where an instructor monitored and gave instant feedback, through immediate assessment of patency and critique on quality of repair, to delayed re-assessment of patency after a 12 to 24 hours period. Globally...

‣ A Systematic Review of Evidence for Education and Training Interventions in Microsurgery

Ghanem, Ali M; Hachach-Haram, Nadine; Leung, Clement Chi Ming; Myers, Simon Richard
Fonte: The Korean Society of Plastic and Reconstructive Surgeons Publicador: The Korean Society of Plastic and Reconstructive Surgeons
Tipo: Artigo de Revista Científica
Português
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Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices...

‣ Robotically Assisted Microsurgery: Development of Basic Skills Course

Liverneaux, Philippe André; Hendriks, Sarah; Selber, Jesse C; Parekattil, Sijo J
Fonte: The Korean Society of Plastic and Reconstructive Surgeons Publicador: The Korean Society of Plastic and Reconstructive Surgeons
Tipo: Artigo de Revista Científica
Português
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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.

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

Shurey, Sandra; Akelina, Yelena; Legagneux, Josette; Malzone, Gerardo; Jiga, Lucian; Ghanem, Ali Mahmoud
Fonte: The Korean Society of Plastic and Reconstructive Surgeons Publicador: The Korean Society of Plastic and Reconstructive Surgeons
Tipo: Artigo de Revista Científica
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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.

‣ Stepwise Training for Reconstructive Microsurgery: The Journey to Becoming a Confident Microsurgeon in Singapore

Ramachandran, Savitha; Ong, Yee-Siang; Chin, Andrew YH; Song, In-Chin; Ogden, Bryan; Tan, Bien-Keem
Fonte: The Korean Society of Plastic and Reconstructive Surgeons Publicador: The Korean Society of Plastic and Reconstructive Surgeons
Tipo: Artigo de Revista Científica
Português
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Microsurgery training in Singapore began in 1980 with the opening of the Experimental Surgical Unit. Since then, the unit has continued to grow and have held microsurgical training courses biannually. The road to becoming a full-fledged reconstructive surgeon requires the mastering of both microvascular as well as flap raising techniques and requires time, patience and good training facilities. In Singapore, over the past 2 decades, we have had the opportunity to develop good training facilities and to refine our surgical education programmes in reconstructive microsurgery. In this article, we share our experience with training in reconstructive microsurgery.

‣ Development of a Five-Day Basic Microsurgery Simulation Training Course: A Cost Analysis

Singh, Masha; Ziolkowski, Natalia; Ramachandran, Savitha; Myers, Simon R; Ghanem, Ali Mahmoud
Fonte: The Korean Society of Plastic and Reconstructive Surgeons Publicador: The Korean Society of Plastic and Reconstructive Surgeons
Tipo: Artigo de Revista Científica
Português
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The widespread use of microsurgery in numerous surgical fields has increased the need for basic microsurgical training outside of the operating room. The traditional start of microsurgical training has been in undertaking a 5-day basic microsurgery course. In an era characterised by financial constraints in academic and healthcare institutions as well as increasing emphasis on patient safety, there has been a shift in microsurgery training to simulation environments. This paper reviews the stepwise framework of microsurgical skill acquisition providing a cost analysis of basic microsurgery courses in order to aid planning and dissemination of microsurgical training worldwide.

‣ Robotic Microsurgery Optimization

Brahmbhatt, Jamin V; Gudeloglu, Ahmet; Liverneaux, Philippe; Parekattil, Sijo J
Fonte: The Korean Society of Plastic and Reconstructive Surgeons Publicador: The Korean Society of Plastic and Reconstructive Surgeons
Tipo: Artigo de Revista Científica
Português
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The increased application of the da Vinci robotic platform (Intuitive Surgical Inc.) for microsurgery has led to the development of new adjunctive surgical instrumentation. In microsurgery, the robotic platform can provide high definition 12×-15× digital magnification, broader range of motion, fine instrument handling with decreased tremor, reduced surgeon fatigue, and improved surgical productivity. This paper presents novel adjunctive tools that provide enhanced optical magnification, micro-Doppler sensing of vessels down to a 1-mm size, vein mapping capabilities, hydro-dissection, micro-ablation technology (with minimal thermal spread-CO2 laser technology), and confocal microscopy to provide imaging at a cellular level. Microsurgical outcomes from the use of these tools in the management of patients with infertility and chronic groin and testicular pain are reviewed. All these instruments have been adapted for the robotic console and enhance the robot-assisted microsurgery experience. As the popularity of robot-assisted microsurgery grows, so will its breadth of instrumentation.

‣ Transanal endoscopic microsurgery: a systematic review

Middleton, P.; Sutherland, L.; Maddern, G.
Fonte: Lippincott Williams & Wilkins Publicador: Lippincott Williams & Wilkins
Tipo: Artigo de Revista Científica
Publicado em //2005 Português
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PURPOSE: The aim of this study was to systematically review the evidence relating to the safety and efficacy of transanal endoscopic microsurgery, a relatively new technique used to locally excise rectal tumors, compared with existing techniques such as anterior resections and abdominoperineal resections or local excisions. METHODS: We conducted a systematic review of comparative studies and case series of transanal endoscopic microsurgery from 1980 to August 2002. RESULTS: Three comparative studies (including one randomized, controlled trial) and 55 case series were included. The first area of study was the safety and efficacy of adenomas. In the randomized, controlled trial, no difference could be detected in the rate of early complications between transanal endoscopic microsurgery (10.3 percent) and direct local excision (17 percent) (relative risk, 0.61; 95 percent confidence interval, 0.29–1.29). Transanal endoscopic microsurgery resulted in less local recurrence (6/98; 6 percent) than direct local excision (20/90; 22 percent) (relative risk, 0.28; 95 percent confidence interval, 0.12–0.66). The 6 percent rate of local recurrence for transanal endoscopic microsurgery in this trial is consistent with the rates found in case series of transanal endoscopic microsurgery (median...

‣ Verlaufsbeobachtung nach lokaler Exzision von Rektumadenomen und Rektumkarzinomen durch Transanale Endoskopische Mikrochirurgie; Prospective study after local excision of rectum adenomas and rectum carcinomas with Transanal Endoscopic Microsurgery

Amann, Michael Georg
Fonte: Universidade de Tubinga Publicador: Universidade de Tubinga
Tipo: Dissertação
Português
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In dem Zeitraum von Februar 1998 bis März 2006 wurden insgesamt 279 Patienten mittels Transanaler Endoskopischer Mikrochirurgie (TEM) aufgrund von Rektumneoplasien an der Olympiapark-Klinik München und der Helios-Klinik Müllheim operiert. Bei den hier dargestellten Ergebnissen handelt es sich um eine prospektive Beobachtung mit dem Ziel, die bisher gültigen Indikationen für die lokale Exzision mittels TEM zu prüfen und die Chancen der Ausdehnung der Indikationen zu untersuchen. Die Patienten wurden aufgrund ihrer Diagnose und der angewandten Therapie in sechs Gruppen eingeteilt. Zu diesen Gruppen zählen Patienten mit sonstigen Diagnosen (n=46), Patienten mit Adenomen (n=103), Patienten mit T1 low-risk Karzinomen (n=44), Patienten mit neoadjuvanter Radiochemotherapie (n=26), Patienten mit adjuvanter Radiochemotherapie (n=32) und Karzinom-Patienten mit palliativer Behandlung ohne Radiochemotherapie (n=28). Die Ergebnisse der Studie bestätigen, dass die lokale Exzision mittels TEM bei Rektumadenomen und T1 low-risk Karzinomen ein geeignetes Verfahren ist. Die Rezidivraten bei den Adenom-Patienten liegt bei 2,9% (durchschnittlicher Beobachtungszeitraum 21,8 Monate), die Rate der Therapieversager bei den T1 low-risk Karzinomen beträgt 2...

‣ Head positioning for anterior circulation aneurysms microsurgery

Chaddad-Neto,Feres; Doria-Netto,Hugo Leonardo; Campos-Filho,José Maria de; Ribas,Eduardo Santamaria Carvalhal; Ribas,Guilherme Carvalhal; Oliveira,Evandro de
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/11/2014 Português
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Objective To study the ideal patient's head positioning for the anterior circulation aneurysms microsurgery. Method We divided the study in two parts. Firstly, 10 fresh cadaveric heads were positioned and dissected in order to ideally expose the anterior circulation aneurysm sites. Afterwards, 110 patients were submitted to anterior circulation aneurysms microsurgery. During the surgery, the patient's head was positioned accordingly to the aneurysm location and the results from the cadaveric study. The effectiveness of the position was noted. Results We could determine mainly two patterns for head positioning for the anterior circulation aneurysms. Conclusion The best surgical exposure is related to specific head positions. The proper angle of microscopic view may minimize neurovascular injury and brain retraction.

‣ Microsurgery Training for the Twenty-First Century

Myers, Simon Richard; Froschauer, Stefan; Akelina, Yelena; Tos, Pierluigi; Kim, Jeong Tae; Ghanem, Ali M
Fonte: The Korean Society of Plastic and Reconstructive Surgeons Publicador: The Korean Society of Plastic and Reconstructive Surgeons
Tipo: Artigo de Revista Científica
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Current educational interventions and training courses in microsurgery are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess current training tools in microsurgery education and devise alternative methods that would enhance training. Simulation is an increasingly important tool for educators because, whilst facilitating improved technical proficiency, it provides a way to reduce risks to both trainees and patients. The International Microsurgery Simulation Society has been founded in 2012 in order to consolidate the global effort in promoting excellence in microsurgical training. The society's aim to achieve standarisation of microsurgical training worldwide could be realised through the development of evidence based educational interventions and sharing best practices.

‣ Produção de gêmeos monozigóticos bovinos mediante microcirurgia embrionária; Produzione di gemelli monozigoti bovini mediante microchirurgia embrionale; Protection of bovine monozygotic twin by means of embryo microsurgery

Monaci, Maurizio; Vuono, Laudinor de; Chicchini, Umberto
Fonte: Universidade de São Paulo. Faculdade de Medicina Veterinária e Zootecnia Publicador: Universidade de São Paulo. Faculdade de Medicina Veterinária e Zootecnia
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; Formato: application/pdf
Publicado em 01/01/1990 Português
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Após a microcirurgia dos embriões bovinos para a obtenção de gêmeos monozigóticos, passa-se ao exame dos resultados obtidos com o transplante dos mesmos nas receptoras, tendo sido este efetuado imediatamente após a duplicação, ou após o seu desenvolvimento "in vitro" por 36 horas, obtendo uma taxa de gravidez de 42% e de 72% respectivamente.; Gli autori dopo aver preso in considerazione la microchirurgia degli embrioni bovini per ottenere gemelli monozigoti, passano all'esame dei risultati conseguiti con il trapianto di essi nelle riceventi. Tale trapianto veniva effettuato sia immediatamente dopo la duplicazione (Tr. I), sia dopo il loro sviluppo in vitro per 36 ore (Tr. II) ottenendo un tasso di gravidanza dei 40% e dei 72% rispettivamente.; The authors describe the procedures concerning bovine embryo microsurgery to produce identical twin and then they examine the results obtained by the transfer in the recipients. The transplantation was carried out immediately after the micromanipulation, also after 36 h in culture. The pregnancy rate was 40% and 72% respectively.

‣ Local excision of early rectal cancer: is transanal endoscopic microsurgery an alternative to radical surgery?

Palma,P.; Horisberger,K.; Joos,A.; Rothenhoefer,S.; Willeke,F.; Post,S.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/03/2009 Português
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Objective: transanal endoscopic microsurgery (TEM) allows locally complete excision of rectal neoplasms and provides an alternative to conventional surgery for benign tumours. However, its role in the curative treatment of invasive carcinoma is controversial. This paper examines the results of TEM compared with radical surgery (RS) for T1 rectal cancer. Methods: 51 patients with T1 rectal tumours treated by RS, or local excision by means of TEM were included. The following parameters were evaluated: operating time, blood loss, hospital stay and complications, as well as local recurrence rate and survival. Results: 17 patients were treated by RS and 34 by TEM. Operative time, blood loss, and duration of hospitalization were significantly lower in the TEM group compared with the RS group. In the RS group there were 4 patients with complications which required an operative revision (23.5%), compared to 1 reintervention (2.9%) in the TEM group. Local recurrence was 5.88% (n = 2) in the TEM group compared with none after RS (p = 0.547). The overall survival and disease-free survival showed not significant statistical differences between both groups (p = 0.59; p = 1.000, resp.). Conclusions: although local recurrence was only observed after local excision...