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PubMed2001

Closed anterior scoring for prominent-ear correction revisited.

The closed-anterior-scoring technique has been used over the past 3 years to correct 56 prominent ears in 32 patients at the West Midlands Regional Plastic Surgery Unit at Wordsley Hospital. A review was carried out to assess the result of this surgical procedure. We briefly discuss the historical development of other surgical techniques for prominent-ear correction, and describe in detail the operative technique for this procedure, which includes closed scoring and suturing of the cartilage. We used this technique to treat 24 patients with bilateral prominent ears and eight patients with unilateral prominent ears. The series comprised 20 females and 12 males, 26 children and six adults. The age range was from 4 to 24 years old. There were two complications (an upper-pole recurrence and protrusion of a buried prolene suture). Patients were followed up for between 6 months and 3 years (mean: 1.5 years). This procedure is quick and technically easy to learn, with no anterior scars or posterior cartilage overlap. Minimal dissection is involved, leading to a low rate of complications. The learning curve is rapid; this paper represents the experience of a specialist trainee (SST) after he was taught the technique by the senior author.

Adolescent↗
PubMed1997

Video-assisted coronary bypass grafting on the beating heart.

BACKGROUND: Concepts to make coronary artery bypass operations less invasive include minimization of access incisions, elimination of cardiopulmonary bypass, and no manipulation of the aorta. A spectrum of minimally invasive coronary bypass procedures now exist that eliminate the median sternotomy (port-access approach), cardiopulmonary bypass ("off-pump bypass"), or both (minimally invasive direct coronary artery bypass procedure). Although all have advantages in decreasing the morbidity of myocardial revascularization, significant limitations exist including surgeon experience, access, exposure, visualization, hemodynamic support, and technique of anastomosis. METHODS: In an attempt to extend the applicability of the current minimally invasive techniques, efforts are being made both to extend the indications for the procedure as well as to modify the technical aspects. Our current experimental protocol involves a ports-only approach with three-dimensional video imaging, percutaneous Hemopump circulatory support, Octopus coronary immobilization, and an endoscopically sutured coronary anastomosis. RESULTS: In a series of animal studies we have been able to successfully accomplish a totally endoscopic coronary artery bypass procedure on a beating heart without cardiopulmonary bypass. CONCLUSIONS: Although endoscopic coronary artery bypass without cardiopulmonary bypass is possible, many technical challenges remain. Three-dimensional video imaging, wall motion immobilization and presentation, and an axial-flow device can facilitate the procedure. Future enabling technology including motion robotics and nonvisual imaging systems may ultimately further minimize the invasiveness of surgical myocardial revascularization.

Coronary Artery Bypass↗
PubMed1997

Surgical maxillary expansion: a new minimally invasive technique.

This paper describes the author's surgical maxillary expansion technique using a 2 mm osteotome. The use of this osteotome avoids the classical mucoperiosteal incision, thus a less traumatic and invasive procedure is performed. From 1992 to 1995, 24 surgical osteotomy cases were performed using this minimally invasive technique. Successful maxillary expansion was obtained in 23 cases. If the minimally invasive technique is unsuccessful, it can be converted into a traditional technique procedure during surgery, thus neither an anatomical nor a technical compromise will be required. Both the past and present literature concerning various theories as to which suture line is primarily involved in producing resistance against maxillary expansion is reviewed. From his personal experience, the author has seen that the maxillary midline suture does not play a primary role in permitting maxillary expansion but instead he found the zygomatic-maxillary and pterygoid-palatine sutures to be of primary importance.

Adolescent↗
PubMed1987

Ear replantation.

The authors' tactical and technical contribution to this type of microsurgical replantation can be summarized in three main points: (1) direct sutures to the superficial temporal vessels, when these are undamaged, which simplifies the operation and makes it safer; (2) use of Kunlin's technique to make up for the great difference in diameter between the arterial vessels; and (3) deepithelialization of the posterior auricular skin to allow for creation of venous drainage channels during the first postoperative days and the enlargement of the area of contact with the recipient bed, which also helps to better immobilize the amputated part.

Accidents, Traffic↗
PubMed1991

Wound Complications Following Vertical Banded Gastroplasty: report of experience and review of the literature.

This prospective study was undertaken to evaluate wound management and outcome in 76 morbidly obese patients undergoing vertical banded gastroplasty through a detailed protocol to determine the nature and incidence of wound complications and to evaluate these results relative to the surgical literature. Early wound complications can be infrequent. Late wound failures often occur in patients not experiencing early wound complications. Mechanical factors, such as size-related tension across the incision, undoubtedly play a major role in late wound failure. A long suture length to wound length ratio mitigates mechanical factors involved in late wound failure. With attention to technical factors and detail, wound complications can be minimized, though not eliminated.

Journal Article↗
PubMed2026

Applications of artificial intelligence in robot-assisted surgery: a systematic review.

To characterize applications of artificial intelligence (AI) in robot-assisted surgery, summarize technical and clinical performance, and assess the quality of the available evidence. PubMed, Web of Science Core Collection, and Scopus were searched for English-language journal articles published from 1 January 2020 through 31 October 2025. Randomized, observational, model-development, validation, and feasibility studies evaluating AI in robot-assisted surgery or closely related image-guided minimally invasive workflows were eligible. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Owing to heterogeneity in surgical procedures, AI tasks, analytical units, validation strategies, and outcomes, findings were synthesized descriptively without statistical pooling. The review was registered in the International Prospective Register of Systematic Reviews (CRD420251175699). Seventeen studies were included: seven clinical prediction or decision-support studies, eight intraoperative recognition, segmentation, or image-guided studies, and two training or workflow studies. Five prediction studies reported area-under-the-curve values of 0.74-0.95. Technical studies reported F1 or Dice scores of 0.525-0.995 and task-specific accuracies of 0.840-0.998. Two randomized studies suggested benefits for personalized suturing feedback and automated camera control, but neither established improved patient outcomes. Only one study had low overall risk of bias; the remaining studies were at high or unclear risk or raised some concerns. AI applications in robot-assisted surgery show promise for prediction, intraoperative perception, training, and workflow support. Evidence primarily demonstrates technical feasibility rather than established clinical effectiveness. Independent multicenter validation and prospective evaluation of patient, educational, and workflow outcomes are required before widespread implementation.

Robotic Surgical Procedures↗
PubMed1984

[Craniostenosis in Algeria. Surgical indications and results of a personal technic].

This paper is based on a predominant type of craniosynostosis seen in Maghreb, the oxycephaly (82,5% of all craniosynostosis in our series). The authors describe a surgical technic which is based on King's free flaps method, used by Acquaviva and Berrada, and Powiertowski's total craniectomy. With this technic, they perform craniectomy of the vertical part of the frontal bone, extended to temporal bone and 2-3 cm behind lambdoid suture. Two small flaps of parietal and temporal bones are left in place sparing temporal muscle insertion. The authors give results of 200 cases treated in the Neuro-Surgical Hospital Ali Ait-Idir Algiers, which consist in encephalic reexpansion and physiological redistribution of the cranial diameters. The authors emphasize a stabilisation is not a recovery from the functional signs, with normalisation in 3/4 of cases of the E.E.G. patterns. The visual acuity is stabilised. In conclusion, the authors estimate this technic has a place among the others procedures in the management of the craniosynostosis.

Algeria↗
PubMed2005

The HAGL lesion: an arthroscopic technique for repair of humeral avulsion of the glenohumeral ligaments.

Glenoid avulsion of the capsulolabral complex and associated capsular laxity are well-described results of traumatic anterior dislocation. A less common consequence of traumatic anterior instability is the humeral avulsion of the glenohumeral ligaments (HAGL) lesion. An understanding of the arthroscopic pathoanatomy of the HAGL lesion will assist the surgeon in recognizing this uncommon entity. We describe a suture anchor technique for arthroscopic repair of HAGL lesions that anatomically reapproximates the torn edge of the glenohumeral ligament complex to its humeral head insertion. The technique is technically straightforward and does not require special equipment beyond that typical for arthroscopic labral repairs.

Arthroscopy↗
PubMed1979

Preventing disruption of abdominal wounds.

The use of silver wire retention sutures requires added operating room time and expense, and it incurs the potential hazards of caught viscera, the possibility of more adhesions, leakage of intraperitoneal fluid through the exit wound, mild infection of exit wounds, and, on removal of the sutures, pain despite sedation, cutting of viscera, and a residual cross-hatched scar. Nevertheless, we believe that use of the technic is amply justified by the prevention of abdominal wound disruption, ease in visualization of the wound, ease in providing equal distribution of wound tension and periodic adjustment of it, and in reapproximation of superficial tissues in the event of wound breakdown, as well as in the elimination of need for any external supportive device. The existence of a voluminous literature on the placing, making, and closing of abdominal incisions suggests that no single ideal method exists. Major disruption of abdominal wounds continues to be a serious problem, despite the infrequency of its occurrence. The use of through-and-through semirigid silver wire retention sutures with adjustable tension as a complement to the routine layered closure can prevent disruption of abdominal wounds while causing only minor complications.

Abdominal Injuries↗