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Biomedical subjects

V Delmas

Publications and source records attributed to V Delmas.

177 records · Page 10Linked to original sources
PubMed1984

Anatomical basis of total prostatocystectomy in man.

In the first part of this paper special emphasis is given to the anatomy of Denonvillier 's fascia which is derived from the prostatic capsule and covers the seminal vesicles, and to the preprostatic veins. In the second part devoted to the surgical technique of total prostatocystectomy the authors propose that the vesicoprostatic unit be freed by dissecting posterior to Denonvillier 's fascia. It is also proposed that the membranous urethra be sectioned prior to performing hemostasis of the preprostatic veins.

Fascia↗
PubMed1984

[Santorini's venous plexus].

This article provides an anatomical study of Santorini's venous plexus based on forty dissections. The authors present a sketch of the plexus and its housing and suggest surgical applications of this anatomic sketch.

Humans↗
PubMed1984

[The medio-femoral approach].

The authors report a series of thirty A. profunda femoris dissections by anterior approach: the medio femoral way, which is enabled to isolate an arterial segment of six centimeters.

Aged↗
PubMed1983

[Approach to the pelvic ureter by disinsertion of a rectus abdominis muscle].

Disinsertion of one rectus abdominis muscle provides excellent exposure of one side of the pelvis. This offers an approach to the pelvic portion of the ureter and if necessary the possibility of an endovesical procedure at the same time. In common with other authors who use the technique, we fell that reinsertion of the muscle is very secure. The advantages and disadvantages of disinsertion of the rectus are exposed and the place of this technique in the approach to the pelvic portion are discussed.

Abdominal Muscles↗
PubMed1983

[Percutaneous nephrostomy under echographic guidance. Apropos of 31 cases].

31 percutaneous nephrostomies (P.C.N.) were realised under a combination of real time ultrasound and fluoroscopic guidance. No failure in placement of the nephrostomy tube was noted. 13 complications were noted in 9 patients: 3 were major, consisted in 1 severe hemorrhage and 2 septicemia and 10 were minor, mainly caused by secondary displacement of the tube. Three indications of P.C.N. are related to upper urinary tract obstruction: 1) Overdistension and fever or pain associated with poor patient's condition. 2) Short-term obstructions. 3) Diagnosis of the nature or location of the obstruction when other techniques don't provide the solution, and/or evaluation of renal function. The drainage of some ureteral fistules represent the fourth indication. P.C.N. allows ureteral antegrad catheterization and its applications. Results are discussed and present or future applications of interventional uro-radiology are related.

Aged↗
PubMed1981

[Towards early functional treatment of urinary incontinence after prostatectomy (author's transl)].

The authors report their striking experience of the effectiveness of early functional treatment of urinary incontinence after prostatectomy. This experience is based upon 50 cases collected over a period of 10 years. Treatment is based upon stimulation of the perineal musculature by faradic current, ano-perineal exercises, and mictional rehabilitation. Results, in 50 cases, showed a marked improvement in 43 (86%), including 15 complete cures (30%). Such a favourable result was obtained with six weeks' treatment. It would appear that the result is all the better when treatment is started earlier, whether in a case of arrhythmic incontinence dominated by urgency, or isolated nocturnal incontinence. The results, once acquired, generally persist. A relapse of incontinence often responds adequately to a new series of sessions of functional treatment. It would appear that the mode of action of this functional therapy is based upon a decrease in bladder instability, and an increase in urethra resistance. The authors show that, with their treatment, improvements and cures in urinary incontinence after prostatectomy occur much earlier with the aid of functional treatment than spontaneously. Thus, treatment is worthwhile undertaking.

Electric Stimulation↗
PubMed1981

[Attempt at defining a pyelocaliceal system. Application to partial nephrectomy].

A comparative study of the pyelo-caliceal segmentation of the kidney and the arterial intra-parenchymal segmentation has been realised from the analysis of 60 plastic molds of the pyelo-caliceal system from which 42 were also molds of the arterial and venous systems (Fig. 8). These molds were obtained through injection with Rhodopas, then corrosion by hydrochloric acid. Their analytical study concludes to the existence of a pyelo-caliceal systematization and particularly of an intra-parenchymal arterial segmentation that corresponds to the pyelo-caliceal arborization.

Aged↗
PubMed1981

[A new technique for extended left nephrectomy (author's transl)].

Description of a technique for extended left nephrectomy, the originality of which lies in the approach to the pedicle via a supra-mesocolic way. Opening of the posterior cavity of the epiploons, upward displacement of the pancreas and downward displacement of the mesocolon give wide exposure of the vessels and sub-pedicular lymph node dissection is possible under good conditions. The spleen is less exposed than in the classical approach. Only experience will make it possible to fix the limitations and role of this technique which the authors have been using for the past two years.

Humans↗
PubMed1980

[Internal thoracic vessels: importance in microsurgery].

The internal thoracic vessels were studied in seventy adult fresh corpses. The left and right vessels were studied so as to precise symmetry relating to the different characters. After injection of coloured latex, the arteries and veins were skeletonized. The origin, the caliber, the length, the connections with the sternal side, the ending were specified. The origin and the ending of these vessels are variable. A statistical study specifies these measures. In the second intercosal space a great contancy of these vessels was observed which was confirmed by angiography. They are used at this level to revascularize the subcutaneous esophagoplasties. The internal thoracic artery can be skeletonized by a right thoracotomy and allowed to revascularize a free jejunal graft for reconstruction of the upper thoracic esophagus.

Adult↗
PubMed1979

[The dichotomous distribution of the renal calices].

The analysis of the caliceal cavities of 30 pairs of Kidneys shows a dichotomous distribution of two types: cranio-caudal for the major calices, ventro-dorsal for the minor ones. The dichotomous organization does not result from the initial division of the ureteral bud: but it should depend upon the renal arteries growth commanding a new caliceal pattern during the morphogenesis of the Kidney.

Aged↗
PubMedDate not supplied

[Endo-surgical dissection of the upper urinary tract through the retroperitoneal and transperitoneal route: an experimental study with pigs and cadavers].

In order to define the best method for endosurgical dissection of the upper urinary tract, an experimental study comparing the retroperitoneal and transperitoneal approaches was performed. Between September 1991 and February 1992, 15 female pigs and 8 human cadavres underwent endosurgical dissection of the upper urinary tract. The retroperitoneal approach was used in 8 pigs and 5 cadavres. In the lateral supine position, the retroperitoneum was insufflated at the lower pole of the kidney, via a 2 cm cutaneo-muscular incision, followed by a blind dissection with the finger to create a space in the retroperitoneal fat. Four trocars were inserted into the retroperitoneal space allowing dissection of the ureter, kidney and its vascular pedicle. The renal vessels and the ureter were then clipped or stapled with the endo-GIA then sectioned. The operation was successfully performed in all of the pigs with a mean operating time of 2 hours. Complications were limited to two peritoneal effractions. Retroperitoneal endosurgical dissection was much longer and more difficult to perform on the cadavre (mean operating time: 3 hours). Satisfactory retropneumoperitoneum was never able to be obtained due to the large amount of retroperitoneal fat and the proximity of the twelfth rib and posterior iliac crest interfered with the insertion of the trocars and made dissection more difficult. The transperitoneal approach was performed in 7 pigs and three cadavres. In the lateral supine position, after creating pneumoperitoneum using a Veress needle, 4 trocars were inserted into the peritoneal cavity. Toldt's fascia was gripped and incised allowing retraction of the colon towards the midline, thereby exposing the renal region. The ureter and the renal vessels were dissected. The renal artery and vein were then clipped or stapled with the endo-GIA then sectioned, while the ureter was clipped and sectioned. The complications of the transperitoneal route were: an injury to the small intestine during insertion of a trocar and haemorrhage due to accidental section of a lower pole renal artery, which was able to be controlled by application of clips. In the pig, the transperitoneal approach was as simple to perform as the retroperitoneal approach and the mean operating time was the same (two hours).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMedDate not supplied

[Scrotal trauma. Report of 33 cases].

We report a serial case study of 33 patients from May 1980 to November 1990 presenting a scrotal contusion. In 2/3 of cases, the physical examination showed a scrotal oedema or an hematocele. Ultrasonography showed a testicular injury while clinical examination was subnormal in 2 patients. In the other cases, ultrasonography showed an hematocele without asserting in all cases the traumatic rupture of the tunica albuginea. 27 patients have been surgically explored: 14 ruptures of the testicle, 3 intratesticular haematoma, 3 scrotal open traumatic injuries, and 7 extratesticular haematoma. Only 3 orchidectomies were required for the 6 patients who have not been explored surgically, the testis was normal at one month. The follow-up of these young patients is difficult, 11 had been seen again at 1 month. At long term follow-up, three patients had been seen at 1, 3 or 6 years without testicular after-effects.

Adolescent↗
PubMedDate not supplied

[Surgical significance of Denonvillier's aponeurosis].

This article provides a macroscopic and microscopic anatomical study of the structure of Denonvilliers' fascia, and suggests that it is embryologically connected with the anlage of the Wolffian duct, prostate and trigone.

Connective Tissue↗
PubMedDate not supplied

[Urinary infections in pregnant women].

Urinary tract infection is frequent during pregnancy with a high potential risk for mother and child. Based on a review of the literature and a retrospective survey conducted in 20 representative French university hospitals during 1993, the authors propose a practical review designed to standardize the therapeutic approach to this disease. They define a high-risk group which requires systematic screening and close surveillance during pregnancy. They evaluate the need for complementary investigations in relation to the 3 clinical presentations encountered (asymptomatic bacteriuria, cystitis and acute pyelonephritis) taking into account their respective adverse effects. The therapeutic modalities of the three clinical forms are then described, including drainage of the urinary tract.

Acute Disease↗