Frontiers in surgery
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Frontiers in surgery · Jan 2019
Augmented Reality in Orthopedics: Current State and Future Directions.
Augmented reality (AR) comprises special hardware and software, which is used in order to offer computer-processed imaging data to the surgeon in real time, so that real-life objects are combined with computer-generated images. AR technology has recently gained increasing interest in the surgical practice. ⋯ AR has been applied to a wide spectrum of orthopedic procedures, such as tumor resection, fracture fixation, arthroscopy, and component's alignment in total joint arthroplasty. The present study aimed to summarize the current state of the application of AR in orthopedics, in preclinical and clinical level, providing future directions and perspectives concerning potential further benefits from this technology.
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Frontiers in surgery · Jan 2018
Comparing the Efficacy of IV Ibuprofen and Ketorolac in the Management of Postoperative Pain Following Arthroscopic Knee Surgery. A Randomized Double-Blind Active Comparator Pilot Study.
Introduction: Acute postoperative pain following knee arthroscopy is common in orthopedic surgeries. Managing pain postoperatively combines usage of opioids and non-steroidal anti-inflammatory drugs. The aim of this clinical study was to assess the efficacy of two different analgesic treatment regimens: intravenous (IV) ibuprofen and IV ketorolac for the treatment of postoperative pain pertaining to arthroscopic knee surgery. ⋯ Future prospective clinical trials using similar regimens should be conducted in order to gain a better understanding of how to best provide perioperative analgesic regimens. Clinical Trial Registration: www. ClinicalTrials.gov, identifier NCT01650519.
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Frontiers in surgery · Jan 2017
Posterior Tracheopexy for Severe Tracheomalacia Associated with Esophageal Atresia (EA): Primary Treatment at the Time of Initial EA Repair versus Secondary Treatment.
We review outcomes of posterior tracheopexy for tracheomalacia in esophageal atresia (EA) patients, comparing primary treatment at the time of initial EA repair versus secondary treatment. ⋯ Posterior tracheopexy is effective in treating severe tracheomalacia with significant improvements in clinical symptoms and degree of airway collapse on bronchoscopy. With no significant differences in outcomes between primary and secondary treatment, posterior tracheopexy should be selectively considered at the time of initial EA repair.
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Frontiers in surgery · Jan 2017
ReviewImproving Surgical Outcome Using Diffusion Tensor Imaging Techniques in Deep Brain Stimulation.
Recent advances in surgical imaging include the use of diffusion tensor imaging (DTI) in deep brain stimulation (DBS) and provide a detailed view of the white matter tracts and their connections which are not seen with conventional magnetic resonance imaging. Given that the efficacy of DBS depends on the precise and accurate targeting of these circuits, better surgical planning using information obtained from DTI may lead to improved surgical outcome. We aim to review the available literature to evaluate the efficacy of such a strategy. ⋯ The studies reviewed show that the use of DTI for surgical planning is feasible, provide additional information over conventional targeting methods, and can improve surgical outcome. Patients in whom the DBS electrodes were within the DTI targets experienced better outcomes than those in whom the electrodes were not. Many current studies are limited by their small sample size or retrospective nature. The use of DTI in DBS planning appears underutilized and further studies are warranted given that surgical outcome can be optimized using this non-invasive technique.
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Frontiers in surgery · Jan 2017
Case ReportsPerioperative Management of Subarachnoid Hemorrhage in a Patient with Alagille Syndrome and Unrepaired Tetralogy of Fallot: Case Report.
Alagille syndrome (ALGS) is a genetic disorder associated with multisystem dysfunction involving the hepatic, cardiovascular, and neurologic systems. Tetralogy of Fallot (TOF), a congenital cardiac anomaly, is commonly found in these patients. Patients with ALGS may also have an increased risk of cerebrovascular abnormalities and bleeding. ⋯ Surgical treatment included diagnostic cerebral arteriography with coil embolization of a left posterior communicating artery aneurysm, and placement of right external ventricular drain (EVD). The combination of neuroprotective anesthetic techniques, fast emergence from anesthesia, and maintenance of intraoperative hemodynamic stability led to a successful perioperative management. A multidisciplinary approach in specialized centers is essential for the treatment of patients with SAH, especially in patients with ALGS and complex congenital heart disease such as TOF.