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PubMed1998

Symphysiotomy.

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Birth Injuries↗
PubMed1982

Transoral hypophysectomy with mandibular symphysiotomy in the dog.

A surgical approach that offered direct visualization and removal of the hypophysis was evaluated in 17 dogs. Ten of the dogs were euthanatized and used to identify reliable landmarks for the drill site in the basisphenoid bone to expose the hypophysis. The intersphenoidal suture was an accurate landmark in that 1 cm caudal to the intersphenoidal suture was determined to be the precise point for the center of the drill hole. The remaining 7 dogs were hypophysectomized, using this approach. The landmarks were accurate, the surgery had a high degree of safety, and all hypophyses were removed.

Animals↗
PubMed1982

Complications of cleft palate repair in large animals.

Seven foals, 2 horses, and 2 calves were presented to the George D. Widener Hospital for Large Animals at New Bolton Center and the Large Animal Clinic at Auburn University for surgical repair of cleft palate. All animals had preexisting pneumonia. Initial repair of cleft palate in 6 foals, 2 horses, and 2 calves was performed via mandibular symphysiotomy. Primary repair of cleft soft palate in a foal was attempted through a pharyngotomy incision after fracture of the basal hyoid bone; however, exposure was inadequate and mandibular symphysiotomy had to be done. Dehiscence of a portion of the cleft palate occurred in all cases (10 of 11) that survived the immediate postoperative period. A 2nd repair was attempted in 3 foals; however, dehiscence of the palate recurred. Osteomyelitis of the mandibular symphysis developed in 6 animals; dehiscence of the lower lip occurred in 3 animals. Serious complications after surgery led to euthanasia or death of 5 animals. Of the 6 surviving animals, 4 did not grow normally. All survivors experienced chronic nasal discharge often contaminated with food material. Although mandibular symphysiotomy provided adequate exposure for surgical repair of cleft palate, serious complications have not been overcome.

Animals↗
PubMed1979

Horseshoe kidney associated with surgery of the abdominal aorta.

Of 53 patients with horseshoe kidney (9 in the present series), 45 underwent operation for an abdominal aortic aneurysm: 40 electively and 5 on an emergency basis. The remaining eight patients underwent revascularization for arteriosclerosis obliterans. Of the 53 patients, 35 (66%) had renal artery anomalies. The anomalous arteries prevented aortic repair in 6 patients (17%), were left undisturbed in 9 (26%), were revascularized in 7 (20%), and were ligated in 13 (37%). Partial nephrectomy was required in 2 of the 13 patients undergoing arterial ligation. Symphysiotomy was performed in 16 (30%) of the 53 patients. The following approach to management of horseshoe kidney associated with disease of the abdominal aorta is suggested. 1. Whenever a horshoe kidney is suspected, excretory urography, aortography, and, if necessary, selective renal arteriography should be obtained preoperatively. 2. Anomalous renal arteries arising from resected segments of the aorta should be revascularized whenever technically possible, usually by reimplantation of the renal artery into the aortic graft. 3. If an anomalous renal artery is ligated, the kidney should be inspected for signs of ischemia, and partial nephrectomy should be performed if ischemia occurs. 4. Symphysiotomy should be avoided. If division is necessary, symphysiectomy is preferable to symphysiotomy. In either circumstance, care need be taken lest there be fusion of the urinary collecting system and the renal parenchyma. In most patients with horseshoe kidney, aortic surgery has been accomplished without complication and with only minor alteration in surgical technique, even when the renal anomaly is first detected at surgical exploration.

Aged↗
PubMed2004

The chain saw--a Scottish invention.

The prototype of the chain saw familiar today in the timber industry was pioneered in the late 18th Century by two Scottish docors, John Aitken and James Jeffray, for symphysiotomy and excision of diseased bone respectively. The chain hand saw, a fine serrated link chain which cut on the concave side, was invented around 1783-1785. It was illustrated in Aitken's Principles of Midwifery or Puerperal Medicine (1785) and used by him in his dissecting room. Jeffray claimed to have conceived the idea of the chain saw independently about that time but it was 1790 before he was able to have it produced. In 1806, Jeffray published Cases of the Excision of Carious Joints by H. Park and P. F. Moreau with Observations by James Jeffray M.D.. In this communication he translated Moreau's paper of 1803. Park andMoreau described successful excision of diseased joints, particularly the knee and elbow. Jeffray explained that the chain saw would allow a smaller wound and protect the adjacent neurovascular bundle. While a heroic concept, symphysiotomy had too many complications for most obstetricians but Jeffray's ideas became accepted, especially after the development of anaesthetics. Mechanised versions of the chain saw were developed but in the later 19th Century, it was superseded in surgey by the Gigli twisted wire saw. For much of the 19th Century, however, the chain saw was a useful surgical instrument.

Amputation, Surgical↗
PubMed1989

Labor outcome of juvenile primiparae in a population with a high incidence of contracted pelvis.

Labor outcome of primiparae less than 17 years was compared with non-juvenile primiparae in a population with a high incidence of contracted pelvis. Juvenile primiparae were referred to hospital on the basis of age, whereas non-juveniles were referred for an obstetric complication. There was no statistical difference in rates of cesarean section, Ventouse, operative delivery, low birth weight, or perinatal mortality between 538 juveniles and 5294 older "high risk" mothers. Symphysiotomy rates were actually higher in the juveniles (12.6% vs. 9.7%, P less than 0.05). These data support the practice of hospital referral for juvenile African women in labor.

Adolescent↗
PubMed1997

Pelvic distraction to improve exposure in radical surgery for pelvic tumours in children.

We describe one patient who had pubic osteotomy and three who had symphysiotomy as an aid to radical tumour resections over the last 7 years. In each it was possible to distract the pelvis so improving access to the tumour. All four patients had pelvic rhabdomyosarcomata, three primarily in the prostate and lower bladder and one was a large tumour filling the pelvis, probably of bladder origin. No immediate or long-term complications of the procedure occurred, and in the two patients who died (2.5 years and 1 year post-surgery) or in the two survivors.

Child, Preschool↗
PubMed1999

Temporomandibular ankylosis in the cat: a review of seven cases.

Ankylosis of the temporomandibular joint (TMJ) in the cat is an unusual complication of traumatic lesions involving articular (true ankylosis) or periarticular structures (false ankylosis). Seven cats with true ankylosis of the TMJ (four cases unilateral and three cases bilateral), of which previous trauma had been documented in five cases, were referred to the authors' clinic between September 1991 and October 1996. Radiographic assessment was performed in all cases, using dorsoventral and oblique projections. Five subjects underwent arthroplastic excision of the TMJ and, in the remaining two cases, stretching of the jaws was performed under general anaesthesia. The surgical outcome was satisfactory in all but one case, where partially decreased joint mobility was observed (follow-up time one to five years), but in the two cases where non-surgical treatment was carried out, recurrence of TMJ ankylosis was observed (follow-up time two to five months). In the authors' experience, surgery represents the treatment of choice for TMJ ankylosis in cats. Additional mandibular symphysiotomy can confirm the radiological findings in unilateral cases.

Animals↗