Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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The relevance of subcutaneous transposition of the ulnar nerve in the therapy of cubital tunnel syndrome is still under debate. The aim of this study was to compare the results after decompression to additional transposition in cases of intraoperative luxation. ⋯ Nerve transposition revealed no benefits in the treatment of cubital tunnel syndrome when performed in cases of intraoperative nerve luxation.
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Thyroid surgery is one of the newest fields for application of video-assisted surgery. The majority of approaches must choose between optimizing cosmetic results by hiding scars in the chest and axillary region while maximizing tissue dissection and post-operative pain versus having a visible cervical scar with minimal tissue dissection. In an effort to minimize surgical trauma and to achieve an optimal cosmetic result we investigated the transoral approach to the thyroid. ⋯ Our results demonstrate the feasibility and safety of a transoral access for thyroidectomy. In comparison to other minimally invasive thyroidectomy access procedures, the transoral approach is minimally invasive and at the same time cosmetically optimal.
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Every medical intervention constitutes a physical injury and therefore requires the consent of the patient to avoid liability. In order that the patient can effectively consent to the intervention by ensuring autonomy of decision, the patient must be fully informed of the risks involved in medical interventions. ⋯ In these instances individual factors, such as the personal background of the patient, play a role. Documentation of the clarification serves as proof that it has been carried out and to what extent.
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The Aachen model is a practical mode in teaching and advanced training, which is closely geared to the areas of academic acquisition and training. During medical education optional student courses with constitutive curricula offer practical points of contact to the surgical department at all times. Besides improvement of manual training the aims are enhancing interests and acquisition of talents. ⋯ Next to the formal guidelines of the curriculum, education logbook and progression conversations, quality, transparency and reliability are particularly emphasized. An evaluation of both the reforms and the surgical trainers is still to be made. In addition procurement of an affirmative occupational image is essential.
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In recent years minimally invasive surgical techniques in children have made substantial progress. The feasibility and safety of a wide spectrum of laparoscopic and thoracoscopic procedures have been confirmed in numerous studies. ⋯ The present article reviews information on established as well as feasible but not yet established surgical procedures. The discussion of potential hemodynamic, respiratory and organ perfusion effects of the CO(2) pneumoperitoneum and the notation of special logistic aspects should support the reader in the process of decision-making to schedule infants and children for minimally invasive surgery.