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Oper Neurosurg (Hagerstown) 2019 Mar 15. Epub 2019 Mar 15.

Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts.

The literature has long attempted distinct classifications of arteriovenous fistulae and arteriovenous malformations of the spine.1-3 It is worth noting that lesions can become more complex during recurrence and may not adhere to traditional definitions. In these cases, recognizing the principles of pathology and pathophysiology can guide management and treatment. Read More

Ann Burns Fire Disasters 2018 Sep;31(3):233-237

Department of Plastic Surgery and Burns Unit, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal.

Despite the wide and growing use of microsurgery, its application in primary burn reconstruction is not very frequent as it faces a number of additional challenges in this setting. A retrospective analysis of the clinical records of all patients submitted to microvascular free tissue transfer for primary burn reconstruction over an 8-year period (from January 2009 to December 2016) was performed. An evaluation of the indications, timing, principles of flap selection, complications and outcomes of free tissue transfer in primary burn reconstruction was made. Read More

Plast Reconstr Surg 2019 Feb 14. Epub 2019 Feb 14.

Department of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.

The field of facial paralysis requires the reconstructive surgeon to apply a wide spectrum of reconstructive and aesthetic principles utilizing a comprehensive array of surgical tools, including microsurgery, peripheral nerve surgery, and aesthetic facial surgery on the road to optimize patient outcomes. The distinct deficits created by different anatomic levels of facial nerve injury require a fundamental understanding of facial nerve anatomy. Palsy duration, followed by location and mechanism, will determine mimetic muscle salvageability, either via direct repair, grafting, or nerve transfers, while longer palsy durations will necessitate introducing a new neuromuscular unit, whether by muscle transfer or free functional muscle transplant. Read More

Clin Podiatr Med Surg 2019 Apr 12;36(2):323-337. Epub 2018 Dec 12.

Plastic Reconstructive and Orthopaedic Surgery, University of Pennsylvania Health System, Perelman Center for Advanced Medicine, 3400 Civic Center Boulevard, South Pavilion, 1st Floor, Philadelphia, PA 19104, USA.

Soft tissue defects and wound healing complications related to calcaneus fractures may result in significant morbidity. The management of these soft tissue complications requires following reconstructive principles that provide the requisites for preservation of the injured limb and the maximization of function. Soft tissue complications are addressed with methods that commensurate with the degree of injury, ranging from local wound care to free flap reconstruction. Read More

Turk Neurosurg 2018 Jun 13. Epub 2018 Jun 13.

NATIONAL INSTITUTE OF MENTAL HEALTH AND NEUROSCIENCES.

In side to side anastomosis and end to end (one way up) microvascular anastomosis, the back wall of the vessel is sutured first with inverted/buried knots. A common mistake made by surgeons during this step is the formation of a granny knot. In inverted suturing, cut ends of granny knot points inside the vessel lumen and interfere with the suture line. Read More

J Stomatol Oral Maxillofac Surg 2019 Jan 11. Epub 2019 Jan 11.

Hospital Universitari de Girona Doctor Josep Trueta, Spain.

Successful head and neck reconstructive microsurgery requires a multidisciplinary approach involving specialists such as maxillofacial surgeons, plastic surgeons, otolaryngologists, anaesthesiologists, and nurses. It requires strict perioperative management of the patient, with special attention paid to parameters such as blood pressure, ventilation, and bleeding, which can all impact flap perfusion. In high-volume centers, specially-trained microsurgery units are available for optimal control of flap monitoring and management of all aspects of patient care. Read More

Eur J Orthop Surg Traumatol 2019 Feb 8;29(2):271-278. Epub 2019 Jan 8.

Duke Cancer Institute, Duke University, Durham, NC, USA.

Sarcomas are rare mesenchymal bone and soft tissue tumors of the musculoskeletal system. In the past, the primary treatment modality was amputation of the involved limb and the 5-year survival was very low for high-grade tumors. During the last three decades, limb salvage has become the rule rather than the exception and the use of neoadjuvant and adjuvant therapies (radiation and chemotherapy) has dramatically increased disease-free survival. Read More

Zhonghua Shao Shang Za Zhi 2018 Dec;34(12):844-846

Department of Burns and Cutaneous Surgery, Burn Center of PLA, Xijing Hospital, Air Force Medical University, Xi'an 710032, China.

This article briefly introduces the development history of Department of Burns and Cutaneous Surgery in Xijing Hospital of Air Force Medical University (the former the Fourth Military Medical University) since its establishment more than 60 years ago. The medical staff of the department have been adhering to the treatment concept of the older generation of experts and professors, applying the principles and methods of plastic surgery to the treatment of deep burn wounds. Furthermore, the new techniques in the field of flap surgery, microsurgery, and minimally invasive surgery are applied to repair various complex wounds after burn/trauma and severe scar deformities. Read More

Eur J Orthop Surg Traumatol 2019 Feb 27;29(2):263-269. Epub 2018 Nov 27.

Department of Orthopaedic Surgery, School of Medicine, University of Ioannina, Ioannina, Greece.

The injuries of the peripheral nerves are relatively frequent. Some of them may lead to defects which cannot be repaired with direct end-to-end repair without tension. These injuries may cause function loss to the patient, and they consist a challenge for the treating microsurgeon. Read More

J Surg Oncol 2018 Oct 27;118(5):832-839. Epub 2018 Sep 27.

Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Supermicrosurgery is defined as microsurgery in less than 0.8 mm vessels. It is an evolved form of microsurgery but with the same principle: (1) enhanced working environment including microscopes and finer instruments; (2) detailed preoperative evaluation and planning; (3) supermicrosurgical technique; and (4) postoperative care. Read More

Oper Neurosurg (Hagerstown) 2019 Apr;16(4):E114

Department of Neurosurgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Children with arteriovenous malformations (AVMs) are at cumulative, life-long risk of debilitating and fatal intracranial hemorrhage, especially with syndromes such as hereditary hemorrhagic telangiectasia. Cerebral angiography is the gold standard for diagnosis and allows simultaneous adjunctive embolization limiting radiation and contrast exposure and intraoperative blood loss, important in pediatric patients with low blood volume. Microsurgical resection of low-grade AVMs offers cure with minimal morbidity. Read More

World Neurosurg 2018 Aug 17;116:133-135. Epub 2018 May 17.

Department of Neurological Surgery, The Neurological Institute, University Hospital Case Medical Center, Cleveland, Ohio, USA.

In anterosuperior-projecting anterior communicating artery (ACoA) aneurysms, the aneurysm dome usually adheres to 1 or both proximal A2 segments, which may present technical difficulties. This video demonstrates microsurgical clipping of a ruptured anterosuperior-projecting ACoA aneurysm. A 52-year-old male presented with a Hunt-Hess grade II subarachnoid hemorrhage. Read More

Zhonghua Nan Ke Xue 2017 Aug;23(8):680-686

Department of Urology,Guangzhou General Hospital of Guangzhou Military Region, Guangzhou,Guangdong 510010,China.

Objective: To investigate the feasibility of establishing a model of allograft penile transplantation in adult beagle dogs and explore the conditions for constructing a stable animal model of penis transplant.

Methods: Following the principles of similarity, repeatability, feasibility, applicability, and controllability in the construction of experimental animal models, we compared the major anatomic features of the penis of 20 adult beagle dogs with those of 10 adult men. Using microsurgical techniques, we performed cross-transplantation of the penis in the 20 (10 pairs) beagle dogs and observed the survival rate of the transplanted penises by FK506+MMF+MP immune induction. Read More

World Neurosurg 2018 Jul 17;115:e305-e311. Epub 2018 Apr 17.

Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA. Electronic address:

Background: Animal models are commonly used in training protocols for microsurgical vascular anastomosis. Rat common carotid arteries (CCAs) are frequently used for this purpose. Much attention has been paid to the technical details of various anastomosis configurations using these arteries. Read More

Dermatol Surg 2018 06;44(6):778-784

Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, New York.

Background: Studies show that patients recall less than half of the information given by their physicians. Use of video in medicine increases patient comprehension and satisfaction and decreases anxiety. However, studies have not elaborated on video content. Read More

BMJ Open 2018 03 28;8(3):e019054. Epub 2018 Mar 28.

Department of Hand and Microsurgery, Tampere University Hospital, Tampere, Finland.

Introduction: Dupuytren's contracture (DC) is a chronic fibroproliferative disorder of the palmar fascia which leads to flexion contracture in one or more fingers. There is no definitive cure for DC, and treatment aims at relieving symptoms by releasing the contracture using percutaneous or operative techniques.

Methods And Analysis: We planned a prospective, randomised, controlled, outcome assessor-blinded, three-armed parallel 1:1:1, multicentre trial comparing the effectiveness and cost of (1) collagenase clostridium histolyticum injection followed by limited fasciectomy in non-responsive cases, (2) percutaneous needle fasciotomy followed by limited fasciectomy in non-responsive cases and (3) primary limited fasciectomy during short-term and long-term follow-up for Tubiana I-III stages DC. Read More

World Neurosurg 2018 Jul 21;115:e33-e44. Epub 2018 Mar 21.

Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China. Electronic address:

Background: Endoscopic endonasal clipping of intracranial aneurysms may use microsurgical techniques as an alternative to the transcranial approach. Here we report a series of patients who underwent microsurgical clipping of anterior circulation aneurysms via an endoscopic endonasal approach (EEA).

Methods: This retrospective chart review included all the patients who underwent standard binostril EEA for aneurysm clipping. Read More

J Indian Soc Periodontol 2018 Jan-Feb;22(1):5-11

Department of Prosthodontics, Surendera Dental College and Research Institute, Sriganganagar, Rajasthan, India.

The use of magnification to perform various procedures in medical and dental field, particularly endodontics has long been recognized. Unfortunately, its application in periodontics is not widely popularized. The objective of this article is to emphasize the application of microsurgical principles in various periodontal surgical procedures and to reinforce the incorporation of microscope into periodontal practice. Read More

J Reconstr Microsurg 2018 May 2;34(4):277-292. Epub 2018 Feb 2.

Division of Plastic Surgery, Albany Medical Centre, Albany, New York.

Background:  In 1986, Marko Godina published his seminal work regarding the timing of free-flap reconstruction for traumatic extremity defects. Early reconstruction, compared with delayed and late reconstruction resulted in significant decreases in free-flap failure rate, post-operative infections, hospitalization time, bone healing time, and number of additional anesthesias. The objective of this manuscript was to evaluate whether these principles continue to apply. Read More

J Hand Surg Am 2018 02;43(2):179-181

University of South Dakota Sanford School of Medicine, Vermillion, SD.

Health care in the United States is both expensive and wasteful. The cost of health care in the United States continues to increase every year. Health care spending for 2016 is estimated at $3. Read More

Handchir Mikrochir Plast Chir 2018 04 29;50(2):93-100. Epub 2018 Jan 29.

Universitätsklinikum Erlangen, Plastische und Handchirurgische Klinik.

Background: The advent of Tissue Engineering (TE) in the early 1990ies was fostered by the increasing need for functional tissue and organ replacement. Classical TE was based on the combination of carrier matrices, cells and growth factors to reconstitute lost or damaged tissue and organs. Despite considerable results in vitro and in experimental settings the lack of early vascularization has hampered its translation into daily clinical practice so far. Read More

Dermatol Surg 2018 May;44(5):621-629

Department of Dermatology, St. Louis University School of Medicine, Anheuser Busch Institute, St. Louis, Missouri.

Background: The trilobed flap is a useful repair option for distal nasal defects. In certain cases, however, the placement of its quaternary defect may risk compression of the internal nasal valve or induction of ectropion. In this study, we propose a modified design of the trilobed flap, which uses unequal external interlobe angles. Read More

Indian J Ophthalmol 2018 01;66(1):10-19

Department of Phaco-Refractive, Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India.

Small incision lenticule extraction (SMILE), a variant of refractive lenticule extraction technology is becoming increasingly popular, as a flapless and minimally invasive form of laser vision correction (LVC) for the treatment of myopia and myopic astigmatism. This review aims at summarizing the principles, surgical technique, and clinical outcomes in terms of visual and refractive results, safety, efficacy, postoperative dry eye, aberrations, and biomechanics of SMILE and its comparison with other conventional techniques of LVC, such as laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). Recent advancements in the laser frequency and energy delivery patterns, instrumentation, and surgical techniques have shown significant improvement in the visual recovery and outcomes after SMILE, compared to the initial results published by Sekundo and Shah et al. Read More

J Cerebrovasc Endovasc Neurosurg 2017 Jun 30;19(2):101-105. Epub 2017 Jun 30.

Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA.

Large lobar intracerebral hemorrhages (ICHs) can cause rapid neurological deterioration, and affected patients have low rates of survival and functional independence. Currently, the role of surgical intervention in the management patients with lobar ICHs is controversial. Minimally invasive technologies have been developed which may potentially decrease the operative morbidity of ICH surgery. Read More

J Reconstr Microsurg 2018 Oct 9;34(8):563-571. Epub 2017 Nov 9.

Division of Plastic Surgery, Department of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.

Background:  February of 2016 marked 30 years since the passing of Marko Godina, a pioneer and prodigy in the field of reconstructive microsurgery. Most noteworthy among his many contributions was his method of radical debridement of contaminated compound fractures followed by early free tissue transfer for wound closure. In the last three decades, the landscape of reconstructive surgery has undergone significant transformation owing to advances in reconstructive techniques and wound care technology, as well as new data. Read More

J Reconstr Microsurg 2018 Feb 27;34(2):145-150. Epub 2017 Oct 27.

Department of Plastic and Reconstructive Surgery, St. John's Hospital, Livingston, Howden, United Kingdom of Great Britain and Northern Ireland.

Background:  Microsurgery fellowships have become an integral part of every plastic surgery training program. While each subspecialty differs in terms of reconstructive requirements, the basic tenets and skill sets remain the same. We explore the possibility of designing a clinical curriculum for microsurgery that can provide residents and fellows with a more foundational and structured approach to microsurgical training. Read More

J Laparoendosc Adv Surg Tech A 2018 Feb 24;28(2):186-188. Epub 2017 Oct 24.

1 Department of General Surgery, Rambam Health Care Campus , Haifa, Israel .

Background: Distal rectal cancer resection is an ongoing challenge for the colorectal surgeon. In recent years new technical approaches, especially with implementation of transanal platforms were developed to help in the visualization and resection of these tumors. Nevertheless, the use of these platforms is demanding with significant complications during the onset phase. Read More

Plast Reconstr Surg Glob Open 2017 Jul 24;5(7):e1409. Epub 2017 Jul 24.

The Royal London Hospital, Barts Health NHS Trust, Academic Plastic Surgery Group, Queen Mary University of London, London, United Kingdom; Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

Microsurgery simulation courses increasingly use assessment methodologies to evaluate the quality of microvascular anastomosis and to provide constructive feedback in competency-based training. Assessment tools evaluating the "journey" of skill acquisition in anastomosis have evolved, including global rating scores, hand motion analysis, and evaluation of the final outcome, that is, "end-product" assessment. Anastomotic patency is the gold standard end-product in clinical microvascular surgery, and in vivo end-to-side anastomosis, which can be confirmed using the Acland-test. Read More

Asia Pac J Ophthalmol (Phila) 2017 Sep-Oct;6(5):456-464. Epub 2017 Jul 31.

Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.

Our purpose is to present a broad review about the principles, early history, evolution, applications, and complications of femtosecond lasers used in refractive and nonrefractive corneal surgical procedures. Femtosecond laser technology added not only safety, precision, and reproducibility to established corneal surgical procedures such as laser in situ keratomileusis (LASIK) and astigmatic keratotomy, but it also introduced new promising concepts such as the intrastromal lenticule procedures with refractive lenticule extraction (ReLEx). Over time, the refinements in laser optics and the overall design of femtosecond laser platforms led to it becoming an essential tool for corneal surgeons. Read More

Eur Surg Res 2017 26;58(5-6):246-262. Epub 2017 Jul 26.

Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.

Background: Expectations towards surgeons in modern surgical practice are extremely high with minimal complication rates and maximal patient safety as paramount objectives. Both of these aims are highly dependent on individual technical skills that require sustained, focused, and efficient training outside the clinical environment. At the same time, there is an increasing moral and ethical pressure to reduce the use of animals in research and training, which has fundamentally changed the practice of microsurgical training and research. Read More

J Plast Reconstr Aesthet Surg 2017 Sep 9;70(9):1155-1170. Epub 2017 Jun 9.

Reconstructive Surgery & Regenerative Medicine Group, Institute of Life Science, Swansea University Medical School, Swansea, UK; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK. Electronic address:

Despite the increasing laboratory research in the growing field of 3D bioprinting, there are few reports of successful translation into surgical practice. This review outlines the principles of 3D bioprinting including software and hardware processes, biocompatible technological platforms and suitable bioinks. The advantages of 3D bioprinting over traditional tissue engineering techniques in assembling cells, biomaterials and biomolecules in a spatially controlled manner to reproduce native tissue macro-, micro- and nanoarchitectures are discussed, together with an overview of current progress in bioprinting tissue types relevant for plastic and reconstructive surgery. Read More

Arch Plast Surg 2017 Jul 15;44(4):293-300. Epub 2017 Jul 15.

Academic Plastic Surgery, The Royal London Hospital, Barts Health NHS Trust, Queen Mary University of London, London, UK.

Background: Simulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here. Read More

J Neurosci Methods 2017 Aug 17;287:58-67. Epub 2017 Jun 17.

Department of Microsurgery and Orthopedic Trauma, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, PR China; Center for Peripheral Nerve Tissue Engineering and Technology Research, Guangdong, Guangzhou 510080, PR China. Electronic address:

Background: The precise annotation and accurate identification of the topography of fascicles to the end organs are prerequisites for studying human peripheral nerves.

New Method: In this study, we present a feasible imaging method that acquires 3D high-resolution (HR) topography of peripheral nerve fascicles using an iodine and freeze-drying (IFD) micro-computed tomography (microCT) method to greatly increase the contrast of fascicle images.

Results: The enhanced microCT imaging method can facilitate the reconstruction of high-contrast HR fascicle images, fascicle segmentation and extraction, feature analysis, and the tracing of fascicle topography to end organs, which define fascicle functions. Read More

World Neurosurg 2017 Sep 9;105:534-542. Epub 2017 Jun 9.

Department of Neurosurgery, Helsinki University Hospital, Helsinki, Finland.

Objective: The supracerebellar infratentorial (SCIT) paramedian approach in sitting position represents one of the most used surgical routes for dealing with pineal region lesions. The purpose of this study is to determine the cornerstones to perform this approach in a simple, safe, and effective way, so that it could be easily reproduced in other neurosurgical centers, particularly in those with modest resources.

Methods: We reviewed and analyzed the surgical videos of 24 pineal region lesions that were operated on through an SCIT approach between June 2012 and October 2015. Read More

Ophthalmologe 2017 Jul;114(7):661-665

Klinik für Augenheilkunde, Goethe-Universität Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.

Objective And Principles: In LASIK, after cutting a lamellating stromal corneal incision (flap) with a microkeratome or a femtosecond laser, the underlying tissue is treated with an excimer laser for refractive correction. The objective is to achieve independency from spectacles and contact lenses due to correction of ametropia.

Indications: Surgery is indicated when the patient wishes to achieve independency from spectacles and contact lenses. Read More

Orthop Surg 2017 Feb;9(1):3-12

The treatment of adult osteonecrosis of the femoral head (ONFH), with 8.12 million patients in China, remains a challenge to surgeons. To standardize and improve the efficacy of the treatment of ONFH, Chinese specialists updated the experts' suggestions in March 2015, and an experts' consensus was given to provide a current basis for the diagnosis, treatment and evaluation of ONFH. Read More

Dermatol Surg 2017 Apr;43(4):507-511

*Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia;†Department of Dermatology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Background: The adoption of recently created protocols introduces Mohs laboratories to the principles of immunohistochemistry (IHC) performance validation and clinical laboratory regulations that are unique to these evolving technologies.

Objective: To review Food and Drug Administration (FDA) IHC reagent classifications, IHC validation protocols, and quality assurance (QA) procedures and documentation needed in conjunction with IHC test guidelines.

Methods: A focused review of IHC reagent classifications and guidelines in clinical testing laboratories was conducted using PubMed and FDA source documents. Read More

Clin Plast Surg 2017 Apr 6;44(2):299-311. Epub 2017 Feb 6.

Division of Plastic and Reconstructive Surgery, Mayo Clinic, 200 First Street, Rochester, MN 55905, USA. Electronic address:

Reconstruction of soft tissue defects following tumor ablation procedures in the trunk and extremities can challenge the microsurgeon. The goal is not just to provide adequate soft tissue coverage but also to restore form and function and minimize donor site morbidity. Although the principles of the reconstructive ladder still apply in the trunk and extremities, free tissue transfer is used in many cases to optimally restore form and function. Read More

Otolaryngol Clin North Am 2017 Apr;50(2):365-383

Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 North Medical Drive East, Salt Lake City, UT 84132, USA. Electronic address:

Cavernous sinus (CS) involvement by sinonasal and ventral skull base malignancies is infrequently encountered in neurosurgical practice. Despite advancements in skull base microneurosurgery and endoscopic techniques, detailed knowledge and experience of the surgical management of these lesions are limited. This article elaborates on surgical strategies and approaches for CS involvement of malignant ventral skull base tumors. Read More

Front Surg 2017 23;4. Epub 2017 Feb 23.

Reconstructive Surgery and Regenerative Medicine Research Group (ReconRegen), Institute of Life Science, Swansea University Medical School, Swansea, UK; The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK.

Recent advances in microsurgery, imaging, and transplantation have led to significant refinements in autologous reconstructive options; however, the morbidity of donor sites remains. This would be eliminated by successful clinical translation of tissue-engineered solutions into surgical practice. Plastic surgeons are uniquely placed to be intrinsically involved in the research and development of laboratory engineered tissues and their subsequent use. Read More

Facial Plast Surg 2017 Feb 22;33(1):27-33. Epub 2017 Feb 22.

Department of Otolaryngology, University of Kansas Medical Center, Kansas City, Kansas.

Facial plastic surgeons use a variety of reconstruction techniques to overcome challenges in restoring the function, structural integrity, and intricate nasal contour in nasal reconstruction. Local cutaneous flaps provide excellent skin texture, thickness, and color match in nasal reconstruction. They offer an excellent cosmetic appearance for small- to medium-sized defects and are preferentially utilized when feasible. Read More

Oral Maxillofac Surg Clin North Am 2017 Feb;29(1):63-73

Department of Oral and Maxillofacial Surgery, The University of Texas School of Dentistry, 7500 Cambridge Street, Suite 6510, Houston, TX 77054, USA.

The complex shapes of skeletal components of the craniofacial region combined with the prominence of the face and paucity of overlying soft tissue create significant challenges for the reconstructive surgeon. The in vivo bioreactor strategy is a promising alternative to microvascular surgical techniques that combines tissue engineering principles with microvascular reconstructive techniques to create patient-specific, prevascularized bone flaps for reconstruction of complex maxillofacial defects. This article discusses the use of traditional vascularized bone flaps; preclinical studies using the in vivo bioreactor approach; case reports that have attempted this novel technique; and future challenges and considerations in the development of patient-specific, prevascularized bone flaps for maxillofacial reconstruction. Read More

World Neurosurg 2017 Jan 21;97:565-570. Epub 2016 Oct 21.

Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland; Neurosurgical Unit, EsSalud La Libertad, Trujillo, Peru.

Background: Treatment of multiple intracranial aneurysms is particularly demanding and even more so in a developing country where access to specialized centers may be prevented by different factors.

Methods: Single-stage surgical treatment of 7 cerebral aneurysms was performed in a 58-year-old woman from the northern Peruvian Andes.

Results: All 7 aneurysms were successfully and safely clipped through 2 lateral supraorbital craniotomies. Read More

Facial Plast Surg Clin North Am 2016 Nov;24(4):593-603

Oxford University School of Medicine, Oxford, UK.

Orbito-malar reconstruction after oncological resection represents one of the most challenging facial reconstructive procedures. Until the last few decades, rehabilitation was typically prosthesis based with a limited role for surgery. The advent of microsurgical techniques allowed large-volume tissue reconstitution from a distant donor site, revolutionizing the potential approaches to these defects. Read More

Hand Clin 2016 11;32(4):549-554

Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, 199 Tun-Hwa North Road, Taipei 10591, Taiwan. Electronic address:

The metacarpal-like and metacarpal hand injuries are devastating conditions that render the hand nonfunctional. Although the metacarpal hand is well-studied, the metacarpal-like hand is never addressed. The authors, using the same principles as in the classification and treatment of metacarpal hand, propose an easy to follow treatment algorithm for metacarpal-like hand injury to guide the reconstructive surgeon. Read More

Fertil Steril 2016 Oct;106(5):1025-1031

Department of Obstetrics and Gynecology, Catholic University Leuven, University Hospital, Gasthuisberg, Leuven, Belgium.

"Microsurgery" is a set of principles developed to improve fertility surgery outcomes. These principles were developed progressively based on common sense and available evidence, under control of clinical feedback obtained with the use of second-look laparoscopy. Fertility outcome was the end point; significant improvement in fertility rates validated the concept clinically. Read More

Fertil Steril 2016 Oct 24;106(5):991-993. Epub 2016 Aug 24.

Department of Obstetrics and Gynecology, University of British Columbia, Women's Hospital, Vancouver, British Columbia, Canada.

The health care and the emotional cost of postoperative adhesions that frequently cause chronic pain, infertility, bowel obstruction, and repeat surgery are well known. Our understanding of the pathophysiology of adhesion formation and of its prevention has evolved from good surgical practice based on microsurgical principles, barriers to keep denuded areas separated to the prevention of mesothelial cell damage and of acute inflammation in the entire peritoneal cavity. Oxidative stress, in the surgical lesions and in the peritoneal cavity has an important role in adhesion formation by slowing down repair. Read More

J Hand Surg Asian Pac Vol 2016 02;21(1):13-7

1 Hand and Reconstructive Microsurgery Unit, S. Pio X Clinic, Milan, Italy.

With the amazing increasing in number of participants, rock climbing has become a popular sport in the last decade. A growing number of participants, with different skill level, inevitably leads to an increased number of injuries related to this practice. The kind of lesions that can be observed in rock-climbers is very specific and often involves the hand. Read More

Minim Invasive Ther Allied Technol 2016 Oct 23;25(5):234-40. Epub 2016 Jun 23.

a Gastrointestinal Surgery Department, Hospital Clínic de Barcelona , Barcelona , Spain ;

Minimally invasive techniques (MIS) have been evolving quickly in colorectal surgery during the last two decades. Transanal total mesorectal excision (taTME) was developed as a combination of skills acquired from different MIS approaches such as Transanal Endoscopic Microsurgery (TEM), Transanal Minimally Invasive Surgery (TAMIS) and Natural Orifices Transluminal Endoscopic Surgery (NOTES). TaTME allows for a better visualization of surgical planes of dissection and achievement of rectal resection following oncologic principles. Read More

Rep Pract Oncol Radiother 2016 Jul-Aug;21(4):395-8. Epub 2015 Dec 7.

Otolaryngology, Neurosciences Department, University Hospital, Padua, via N. Giustiniani 2, 35128 Padova, Italy.

Aim: Surgery for acoustic neuroma has developed over the years with a gradual improvement in outcome. The goal of surgery should be cure of the disease and a low morbidity, preserving facial nerve function - and hearing, too, whenever feasible (i.e. Read More