우리는 그의 정신적 지원을위한 VR 마법의 비디오 클립 박사 Wael 엘 Gendy, 박사 클레멘스 바그너 감사하고 싶습니다. 저자의 개인 자금.

1. 목적 가상 현실 백내장 수술 시뮬레이터와 인간의 눈이 cystotome를 사용하여 구조 기법 아웃 capsulorhexis 방사형 눈물을 설명합니다. 2. 방법 capsulorhexis이 동공 마진 이외의 주변으로 반경 바꾸다 시작하면 다음 단계는 지체없이 적용되어야합니다. <ol><li> 추가 capsulorhexis 박사의 계획을 중지하고 상황을 재평가. </li><li> 안과 viscosurgical 장치 (OVD)과 앞쪽에 챔버를 입력합니다. 우리는 앞쪽에 챔버가 빠르게 reinflated 수 있도록 OVD 들어있는 주사기로 cystotome를 장착하는 것이 좋습니다. </li><li> capsulorhexis 플랩 그런 다음 렌즈 표면에 펼쳐진 남아 있습니다. </li><li> cystotome 팁는 플랩을 절단하거나 펑쳐링 피하기 위해 수평으로 기울어져 있으며, 눈물의 최첨단 근처의 플랩에 종사하지만 너무 눈물의 지점에 가까이하지 않습니다. </li><li> 부드럽게 눈물의 방향에 눈물 반대의 최첨단 밀어하거나 가져옵니다. </li><li> 최고의 찢어진 가장자리는 &#39;U - 턴&#39;을 할 시작합니다. 원하는 궤도에 끊어지고 가장자리를 반환 때까지 플랩에있는 긴장을 유지합니다. </li></ol> 3. 검색 결과 우리의 기술을 사용하여 외과 수술 도구를 변경하지 않고도 방사상 눈물 아웃에 즉시 응답할 수 있습니다. 이 중요 단계에서 수술 도구를 변경하면 인해 갑자기 유리체에서 앞으로 압력의 결과로 앞쪽에 챔버 shallowing을 추가로 방사상 눈물의 위험을 실행합니다. 우리의 기술은 각막 상처 왜곡 이후 앞쪽에 챔버 붕괴를 줄이는 장점도 있습니다.

<ol>
	<li>Little, B. C., Smith, J. H., Packer, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> J Cataract Refract Surg. 32 (9), 1420-1422 (2006).</li><li>Neuhann, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Theorie+und+Operationstechnik+der+Kapsulorhexis.">Theorie und Operationstechnik der Kapsulorhexis.</a> Klin Monatsbl Augenheilkd. 190, 542-545 (1987).</li><li>Gimbel, H. V., Neuhann, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development,+advantages+and+methods+of+the+continuous+circular+capsulorhexis+technique.">Development, advantages and methods of the continuous circular capsulorhexis technique.</a> J Cataract Refract Surg. 16, 31-37 (1990).</li><li>Gimbel, H. V., Neuhann, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Continuous+curvilinear+capsulorhexis.+(letter).">Continuous curvilinear capsulorhexis. (letter).</a> J Cataract Refract Sur. 17, 110-111 (1991).</li><li>Gimbel, H. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evolving+techniques+of+cataract+surgery:+continuous+curvilinear+capsulorhexis,+down-slope+sculpting,+and+nucleofractis.">Evolving techniques of cataract surgery: continuous curvilinear capsulorhexis, down-slope sculpting, and nucleofractis.</a> Semin Ophthalmol. 7, 193-207 (1992).</li></ol>

관심 없음 충돌 선언하지 않습니다.

EYESI 외과 시뮬레이터 기술을 복잡한 capsulorhexis 찢어 아웃 연습 외과에 대한 현실적인 교육 플랫폼입니다. Capsulorhexis는 phacoemulsification 및 endocapsular intraocular 렌즈 이식 절차의 가장 중요하고 복잡한 부분입니다. 성공적인 백내장 수술은 좋은 capsulorhexis를 달성에 따라 달라집니다. capsulorhexis 동안, 외과 의사들은 눈물 아웃 capsulorhexis 방사형 같은 어려운 상황에 직면 수 있습니다. 외과 의사는 상황?...

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a novel technique of rescuing capsulorhexis radial tear-out using a cystotome

1 부 : 목적 : 백내장 수술 가상 현실 시뮬레이터와 인간의 눈이 cystotome를 사용하여 구조 기법 아웃 capsulorhexis 방사형 눈물을 설명합니다. 2 부 : 방법 : 단계 : capsulorhexis는 동공 마진 이외의 주변으로 반경 바꾸다 시작하면 다음 단계는 지체없이 적용되어야합니다. 2.1) 추가 capsulorhexis 박사의 계획을 중지하고 상황을 재평가. 2.2) 안과 viscosurgical 장치 (OVD)과 앞쪽에 챔버를 입력합니다. 우리는 앞쪽에 챔버가 빠르게 reinflated 수 있도록 OVD 들어있는 주사기로 cystotome를 장착하는 것이 좋습니다. capsulorhexis의 플랩이 후 남아있는 2.3) 렌즈 표면에 펼쳐진 거죠. 2.4) cystotome 끝 절단 또는 플랩을 펑쳐링 피하기 위해 수평으로 기울어져 있으며, 눈물의 최첨단 근처의 플랩에 종사하지만 너무 눈물의 지점에 가까이하지 않습니다. 2.5) 부드럽게 밀어 또는 눈물의 방향에 눈물 반대의 최첨단을 가져옵니다. 2.6) 선도 끊어지고 가장자리는 &#39;U - 턴&#39;을 할 시작합니다. 원하는 궤도에 끊어지고 가장자리를 반환 때까지 플랩에있는 긴장을 유지합니다. 파트 3 : 검색 결과 : 우리의 기술을 사용하여, 외과 수술 도구를 변경하지 않고도 방사상 눈물 아웃에 즉시 응답할 수 있습니다. 이 중요 단계에서 수술 도구를 변경하면 인해 갑자기 유리체에서 앞으로 압력의 결과로 앞쪽에 챔버 shallowing을 추가로 방사상 눈물의 위험을 실행합니다. 우리의 기술은 각막 상처 왜곡 이후 앞쪽에 챔버 붕괴를 줄이는 장점도 있습니다. 4 부 : 토론 EYESI 외과 시뮬레이터 기술을 복잡한 capsulorhexis 찢어 아웃 연습 외과에 대한 현실적인 교육 플랫폼입니다. Capsulorhexis는 phacoemulsification 및 endocapsular intraocular 렌즈 이식 절차의 가장 중요하고 복잡한 부분입니다. 성공적인 백내장 수술은 좋은 capsulorhexis를 달성에 따라 달라집니다. capsulorhexis 동안, 외과 의사들은 눈물 아웃 capsulorhexis 방사형 같은 어려운 상황에 직면 수 있습니다. 외과 의사는 상황이 더 악화하지 않고 신속하게 문제를 해결하기 위해 학습해야합니다. 상황을 구조의 일부 다른 방법은 capsulorhexis의 집게를 사용하여 설명하고 있습니다. 그러나, 우리는 우리의 방법은, 더 빠르고 더 효과적이고 EYESi 수술 시뮬레이터와 인간의 눈에 보여주으로 조작하기가 쉽습니다 믿습니다. 응답 : 응답 목록 및 자금 소스. 우리는 비디오 클립에 대한 박사 Wael 엘 Gendy을 감사드립니다. 공개 : 우리는 공개할 게 없다는 잠재적인 충돌 관심이나 상태를 설명합니다. 참조 : 1. 브라이언 C. 리틀, 제니퍼 H. 스미스, 마크 패커. 32:1420 1422, 이슈 - 9, J 백내장은 Surg 2006 굴절. 2. Neuhann T. Theorie 놀이 Operationstechnik 데르 Kapsulorhexis. 클린 Monatsbl가 Augenheilkd. 1987, 1990 542-545. 3. 김벌 HV, Neuhann T. 개발, 장점과 지속적인 원형 capsulorhexis 기술의 방법. J 백내장은 Surg을 굴절. 1990, 16 : 31-37. 4. 김벌 HV, Neuhann T. 연속 곡선 capsulorhexis. (편지) J 백내장 쉬르을 굴절. 1991, 17 : 110-111.

Watch this Scientific Journal Video about A Novel Technique of Rescuing Capsulorhexis Radial Tear-out using a Cystotome at JoVE.com

A Novel Technique of Rescuing Capsulorhexis Radial Tear-out using a Cystotome

Capsulorhexis는 phacoemulsification 수술에서 중요한 단계입니다. 외과 의사가 끊어지고 벡터 세력을 제어하여 앞쪽에 렌즈 캡슐에 지속적인 곡선 눈물을 만듭니다. peripherally 확장 눈물은 심각한 합병증이다. 이 동영상은 cystotome를 사용하여 밖으로 capsular 요골 눈물을 구조의 소설 기법을 보여줍니다.

Cystotome를 사용하여 방사형 구조 Capsulorhexis의 소설 기술 테어 아웃

Part 1 : Purpose:   To demonstrate a capsulorhexis radial tear out rescue technique using a cystotome on a virtual reality cataract surgery simulator and ...

a-novel-technique-rescuing-capsulorhexis-radial-tear-out-using

Universidad de Cartagena UDEC

Research

JoVE Journal

Medicine

13.2K 조회수.  Hairmyres Hospital, NHS Lanarkshire. Capsulorhexis는 phacoemulsification 수술에서 중요한 단계입니다. 외과 의사가 끊어지고 벡터 세력을 제어하여 앞쪽에 렌즈 캡슐에 지속적인 곡선 눈물을 만듭니다. peripherally 확장 눈물은 심각한 합병증이다. 이 동영상은 cystotome를 사용하여 밖으로 capsular 요골 눈물을 구조의 소설 기법을 보여줍니다.

비디오: A Novel Technique of Rescuing Capsulorhexis Radial Tear-out using a Cystotome

A Novel Capsulorhexis Technique Using Shearing Forces with Cystotome

Purpose:
To demonstrate a capsulorhexis technique using predominantly shearing forces with a cystotome on a virtual reality simulator and on a human eye.
Method:
Our technique involves creating the initial anterior capsular tear with a cystotome to raise a flap. The flap left unfolded on the lens surface. The cystotome tip is tilted horizontally and is engaged on the flap near the leading edge of the tear. The cystotome is moved in a circular fashion to direct the vector forces. The loose flap is constantly swept towards the centre so that it does not obscure the view on the tearing edge.
Results:
Our technique has the advantage of reducing corneal wound distortion and subsequent anterior chamber collapse. The capsulorhexis flap is moved away from the tear leading edge allowing better visualisation of the direction of tear. This technique offers superior control of the capsulorhexis by allowing the surgeon to change the direction of the tear to achieve the desired capsulorhexis size.
Conclusions:
The EYESI Surgical Simulator is a realistic training platform for surgeons to practice complex capsulorhexis techniques. The shearing forces technique is a suitable alternative and in some cases a far better technique in achieving the desired capsulorhexis.

This video demonstrates a novel capsulorhexis technique in modern cataract surgery. Capsulorhexis is the most difficult and important part of phacoemulsification surgery.

Cystotome와 쉬어링 부대를 사용하여 소설 Capsulorhexis 기법

Purpose:
To demonstrate a capsulorhexis technique using predominantly shearing forces with a cystotome on a virtual reality simulator and on a human eye....

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의학

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms

Less invasive surgical approaches for intracranial aneurysm clipping may reduce length of hospital stay, surgical morbidity, treatment cost, and improve patient outcomes. We present our experience with a minimally invasive pterional approach for anterior circulation aneurysms performed in a major tertiary cerebrovascular center and compare the results with an aged matched dataset from the Nationwide Inpatient Sample (NIS). From August 2008 to December 2012, 22 elective aneurysm clippings on patients &#8804;55 years of age were performed by the same dual fellowship-trained cerebrovascular/endovascular neurosurgeon. One patient (4.5%) experienced transient post-operative complications. 18 of 22 patients returned for follow-up imaging and there were no recurrences through an average duration of 22 months. A search in the NIS database from 2008 to 2010, also for patients aged &#8804;55 years of age, yielded 1,341 hospitalizations for surgical clip ligation of unruptured cerebral aneurysms. Inpatient length of stay and hospital charges at our institution using the minimally invasive thumb-sized pterional technique were nearly half that of NIS (length of stay: 3.2 vs 5.7 days; hospital charges: $52,779 vs. $101,882). The minimally invasive thumb-sized pterional craniotomy allows good exposure of unruptured small and medium-sized supraclinoid anterior circulation aneurysms. Cerebrospinal fluid drainage from key subarachnoid cisterns and constant bimanual microsurgical techniques avoid the need for retractors which can cause contusions, localized venous infarctions, and post-operative cerebral edema at the retractor sites. Utilizing this set of techniques has afforded our patients with a shorter hospital stay at a lower cost compared to the national average.

Minimally invasive thumb-sized pterional craniotomy for aneurysm clipping has afforded our patients with a shorter hospital stay at a lower cost compared to the national average.

최소 침습 엄지 손가락 크기의 Pterional 개두술을 파열 전방 순환 동맥류의 수술 클립 결찰에 대한

Less invasive surgical approaches for intracranial aneurysm clipping may reduce length of hospital stay, surgical morbidity, treatment cost, and improve ...

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

Today&#39;s gold standard in the treatment of infrasaccal primary acquired nasolacrimal duct obstruction (PANDO) is external dacryocystorhinostomy (DCR), a relatively invasive procedure that can be performed after failure of recanalizing treatments. However, with progress in the field of diode laser technology, new approaches have emerged. Laser-assisted transcanalicular DCR with subsequent bicanalicular silicon intubation is a new option showing great promise as a viable minimally invasive procedure. Under permanent endoscopic visual control from the nasal cavity, a diode laser fiber is inserted into the lacrimal sac and laser energy is applied to create a bony ostium between the lacrimal sac and the nasal cavity. Since no skin incision needs to be made, advantages of this method comprise the sparing of the skin as well as the medial palpebral structures and the physiological palpebral-canalicular pump mechanism. The duration of surgery as well as reconvalescence is generally shorter than with external DCR. Complications include silicon tube prolapse, mild swelling and, rarely, canalicular infection and thermal injury. One-year functional success rates, defined as complete resolution of symptoms and ostium patency, are high, yet still range behind those of external DCR. However, secondary external DCR after failure of laser-assisted DCR can be performed without difficulty. Thus, laser-assisted transcanalicular DCR is a valid option that should be considered as a second-step procedure after failure of recanalization procedures and before external DCR.

The goal of this protocol is to present transcanalicular laser-assisted dacryocystorhinostomy as a minimally invasive approach in the treatment of primary acquired nasolacrimal duct obstruction.

기본의 치료에 대 한 Transcanalicular 다이오드 레이저를 이용한 Dacryocystorhinostomy 인수 비누 덕트 방해

Today&#39;s gold standard in the treatment of infrasaccal primary acquired nasolacrimal duct obstruction (PANDO) is external dacryocystorhinostomy (DCR), ...

Introduction of Intracapsular Rotary-cut Procedures (IRCP): A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation

Uterine fibroids are common benign tumors in the female reproductive system. A hysterectomy is the most effective treatment for symptomatic fibroids. For patients desiring pregnancy, laparoscopic intracapsular myomectomy (LM) is an alternative surgery option. Although LM is widely accepted to treat fibroids, it is technically demanding with risk of excessive bleeding and difficult suturing, especially in cases with large fibroids or tumors in unusual locations. Therefore, we developed an intracapsular rotary-cut procedure (IRCP) as a modification of laparoscopic intracapsular myomectomy, with the intention to minimize risks of LM and help uterine healing. A summary of the improvements to the IRCP is described: 1) making an incision at the site of the fibroid with a length of one-third to one-half of the fibroid&#39;s diameter at a depth reaching the fibroid&#39;s surface; 2) holding the fibroid stably and making rotary cuts on the fibroid at a depth of 0.5&#8211;1 cm within its pseudo-capsule while pulling it outward slightly, making sure not to cut off any pieces of the fibroid; and 3) repeating the cutting-and-pulling until the longest dimension of the fibroid is outside the incision. The multiple cuts are to minimize the diameter and extend the length of the fibroid. When the multiple cuts cause half of the fibroid body to &#34;shrink&#34;, the fibroid is squeezed out by contraction of the surrounding myometrium. Evaluation of the outcomes of IRCP showed that the time of enucleation and suturing, intraoperative bleeding, and decline of hemoglobin were significantly lower in the IRCP group than the LM group. As for reproductive outcomes, the full-term live birth rate of the IRCP group was significantly higher than that of LM group. However, there was no difference in delivery modes between the two groups. In conclusion, IRCP significantly benefits fertility preservation by minimizing damage to the uterus, protecting myofibers of the pseudo-capsule, and resulting in a shallower residual cavity, which eases stitching and causes less bleeding. It is worthwhile to adopt IRCP in younger patients who desire preservation of their fertility.

Introduction of Intracapsular Rotary-cut Procedures IRCP: A Modified Hysteromyomectomy Procedures Facilitating Fertility Preservation

Here, we present a protocol for performing an intracapsular rotary-cut procedure (IRCP), a modified laparoscopic intracapsular myomectomy that promotes fertility preservation.

Intracapsular 로타리 컷 절차 (IRCP)의 도입: A 다 산 보존을 촉진 하는 Hysteromyomectomy 프로시저 수정

Uterine fibroids are common benign tumors in the female reproductive system. A hysterectomy is the most effective treatment for symptomatic fibroids. For ...

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique

Autologous arteriovenous fistula (AVF) is the primary and best option to obtain vascular access for hemodialysis treatment; other options are arteriovenous graft (AVG) and central venous catheterization (CVC). The implementation of radio-cephalic autologous arteriovenous fistula (RC-AVF) in the forearm was preferred among patients with superior vascular conditions. However, there is a high rate of early fistula failure. The chosen surgical method is understood to have an effect on the maturation of the fistula. New surgical procedures such as radial artery deviation and reimplantation (RADAR) have been significantly improved for juxta-anastomotic stenosis. Nevertheless, new problems such as stenosis of arteries and narrowing of surgical indication were also found. In this report, we presented a modified no-touch technique (MNTT) to create an RC-AVF, in which the venous and arterial wall avoid devascularization and the radial artery does not sever.

We present a modified no-touch technique (MNTT) to create a radio-cephalic arteriovenous fistula (RC-AVF) in which the venous and arterial wall avoid devascularization and the radial artery does not sever.

수정된 노터치 기술로 팔뚝에 무선 세팔릭 동맥 누공 만들기

Autologous arteriovenous fistula (AVF) is the primary and best option to obtain vascular access for hemodialysis treatment; other options are ...

백내장 수술에서 IOL 회전을 통한 후낭 혼탁 예방(Preventing Posterior Capsular Oppacification Through IOL rotation in Cataract Surgery)

Rotating the Intraocular Lens to Prevent Posterior Capsular Opacification in Cataract Surgeries

Posterior capsule opacification (PCO) is a common postoperative complication of extracapsular cataract surgery, which is caused by the proliferation and migration of lens epithelial cells and can affect long-term visual outcomes significantly. The most effective treatment for PCO is neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy; however, this treatment is associated with posterior segment complication and can break the stability of capsular bag, affecting the position and function of trifocal or toric intraocular lenses (IOLs). Advances in surgical procedures, IOL design, and pharmacy have reduced the rate of PCO in recent years, concentrating on the inhibition of proliferative lens epithelial cells (LECs). This protocol aimed to clear LECs more thoroughly during phacoemulsification and IOL implantation. The first several steps, including clear corneal incision, continuous circular capsulorhexis, hydrodissection, hydrodelineation, and phacoemulsification, were completed as conventional procedures. After placing the IOL into the capsular bag, rotation of the IOL by at least 360&#176; was performed using an irrigation/aspiration tip or a hook, with slight stress on the posterior capsule. Some residuals occurred in the originally transparent capsular bag after rotation of the IOLs. Then, these materials and the viscoelastic were cleared completely using an irrigation/aspiration system. A clear posterior capsule was observed after the surgery in patients undergoing this method. This method of rotating IOLs is a simple, effective, and safe way to prevent PCO by clearing residual LECs and can be carried out without extra tools or skills.

저자 스포트라이트: 백내장 수술의 시각적 결과 향상: IOL 회전을 통한 후낭 혼탁을 방지하기 위한 새로운 기법 

The present protocol describes removing residual epithelial cells by rotating the intraocular lens in extracapsular cataract surgery without extra tools for preventing posterior capsular opacification.

백내장 수술에서 후방 수정체 예화를 방지하기 위해 인공 수정체 회전

Posterior capsule opacification (PCO) is a common postoperative complication of extracapsular cataract surgery, which is caused by the proliferation and ...

PCL 낭종 절제술을 위한 관절경 이중 후방 접근법

Arthroscopic Excision of Posterior Cruciate Ligament Cysts Using a Double Posteromedial Approach

Cruciate ligament cysts of the knee are a rare condition. Posterior cruciate ligament cysts of the knee are less common than anterior cruciate ligament cysts. In patients with asymptomatic isolated cruciate ligament cysts of the knee, conservative treatment is recommended. Symptomatic cruciate ligament cysts of the knee are mostly manifested as knee hyperflexion pain, straightening pain, knee discomfort after standing for a long time or walking for a long time, etc., which seriously affects the quality of life, surgical treatment can be performed. The surgical treatments can be divided into ultrasound-guided cyst puncture and fluid extraction procedure and arthroscopic cystectomy. Cysts are mostly lobulated with a multi-layer cyst wall, cyst fluid extraction does not remove the cyst wall completely but simply extracts cyst fluid, leading to a high recurrence rate. Arthroscopic surgery can completely remove the cyst wall with little trauma, a low recurrence rate, and fast postoperative recovery, so arthroscopic resection is the most common and preferred method of treatment. Since posterior cruciate ligament cysts mostly occur posterior to the ligament, we remove the cyst wall by adding a double posteromedial approach to the knee joint, and the cyst wall is removed under direct vision, which is simple to operate, the cyst wall is completely cleared, the trauma is small, the postoperative recovery is fast, and there is no recurrence. Here, 8 posterior cruciate ligament cysts were removed with complete postoperative symptom relief, no surgical complications, and no recurrence at 1-year follow-up.

저자 스포트라이트: 후방 십자인대 낭종 치료를 위한 이중 후방 접근법

We present a surgical approach to treat posterior cruciate ligament cysts by an arthroscopic double posteromedial approach.

Double posteromedial Approach를 사용한 후방 십자인대 낭종의 관절경 절제

Cruciate ligament cysts of the knee are a rare condition. Posterior cruciate ligament cysts of the knee are less common than anterior cruciate ligament ...

Cystotome를 사용하여 방사형 구조 Capsulorhexis의 소설 기술 테어 아웃

요약

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백내장 수술에서 후방 수정체 예화를 방지하기 위해 인공 수정체 회전

백내장 수술에서 후방 수정체 예화를 방지하기 위해 인공 수정체 회전

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Double posteromedial Approach를 사용한 후방 십자인대 낭종의 관절경 절제