Articles: surgery.
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While inadvertent perioperative hypothermia has received serious attention in many surgical specialties, few discussions of hypothermia have been published in the plastic surgery literature. This article reviews the physiology of thermoregulation, describes how both general and regional anesthesia alter the normal thermoregulatory mechanisms, indicates risk factors particularly associated with hypothermia, and discusses the most effective current methods for maintaining normothermia. Hypothermia is typically defined as a core body temperature of /=36.5 degrees C is maintained. ⋯ None of these measures can be adequately employed unless a patient's core body temperature is monitored throughout the perioperative period. Prevention of perioperative hypothermia is neither difficult nor expensive. Proper preventive measures can reduce the risk of complications and adverse outcomes, and eliminate hours of needless pain and misery for our patients.
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Robotic mitral valve repair using the da Vinci telemanupilation system has become the standard of care at many centres worldwide. We perform the first robotic MV repair in the United States in the year 2000. This article reviews our 6 year experience and current technique of robotic MV repair as well as future trends in the field. ⋯ Robotic MV repair operations are safe with excellent early results. Follow-up studies are needed to determine repair longevity. We must continue to improve the current technology in order to develop the next generation of tools that will facilitate robotic MV repairs.
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Cardiac surgery, traditionally conducted via median sternotomy, has been recently forwarded by progressively advanced technology facilitating sternal-sparing minimally invasive, access to the heart. Robotic systems, comprised of miniaturized surgical instruments mounted on long thin shafts with multiple degrees of range of motion coupled with a dual camera endoscope providing true three-dimentional high-magnification visualization have greatly propelled this field. ⋯ As minimally invasive and robotic surgical technology advances, so proceeds the spectrum of potential applications for robotic cardiac surgery.
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AJNR Am J Neuroradiol · Sep 2006
Case ReportsPercutaneous radio-frequency mandibular nerve rhizotomy guided by CT fluoroscopy.
We describe a new method for radio-frequency mandibular nerve rhizotomy under CT fluoroscopy. A patient with cancer had severe intractable and drug-resistant pain in his left mandibular region. ⋯ The needle was advanced to the mandibular nerve just caudal to the foramen ovale under real-time CT fluoroscopy, avoiding the cancer region. Pain scores of the patient were reduced after the nerve rhizotomy, without any complications.
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A VIRTUAL REALITY system has been devised to superimpose a computer-generated rendering of a volumetric target to be surgically approached or resected on a real-time video image of the surgical field. A stereotactic frame is used to register the image from the video camera with the image of the target volume for accurate localization. The volumetric target is obtained from preoperative imaging studies and can be modified to adjust the intended line of resection or to avoid eloquent vascular or neural tissue. ⋯ To date, 74 intracranial tumor resections have been performed under video virtual reality guidance. Postoperative scanning corresponds in every case with preoperative planning. This system is also designed to be adapted to frameless guidance, which can be further enhanced by the incorporation of an audible tone to signal the relationship of the tip of the resection instrument to the line of resection.