Mini Incision Research Articles

Miniopen vs Lateral Approach for Ankle Arthrodesis, Which Approach is Superior in Joint Preparation: A Cadaver Study

Category:Ankle, Ankle Arthritis, Arthroscopy, Basic Sciences/BiologicsIntroduction/Purpose:Ankle arthrodesis is a gold standard for end-stage ankle arthritis after conservative managements fail. It may be done through direct anterior, lateral, arthroscopic or mini open approaches. Joint preparation, apposition of joint surfaces and stable fixation are very important for successful outcomes. Ankle arthrodesis maybe associated with infection, chronic pain and nonunion - of these, nonunion is the most common complication reported. Achieving union is of utmost importance while minimizing complications associated with the procedure.Regardless of approach or fixation method, preparation of articular surface is of paramount importance for successful union and may be limited by the approach used. Our study aims to evaluate the difference between direct lateral and dual mini-open approaches (extended arthroscopic portals) in terms of joint preparation.Methods:We used 10 below knee fresh-frozen cadaver legs for this cadaveric study. Ankle joints of five specimens were prepared through the lateral approach, while the remaining five ankles were prepared using dual mini incisions. After the completion of preparation, all ankles were dissected to open, photographic images of tibial plafond and talar articular were taken. Surface areas of each articular facet and unprepared cartilage of the talus, distal tibia, and distal fibula were measured and analyzed using ImageJ software.Results:Significantly greater amount of total surface area was prepared among specimens using mini-open approach compared to those with trans-fibular approach. The percentage of total articulating surface area prepared (including talus and tibia/fibula), talus, tibia and fibula in trans-fibular approach were 76.9%, 77.7% and 75% respectively. The percentages were 90.9%, 92.9%, and 88.6% in mini-open approach.While the medial gutter was well prepared with mini incision technique (unprepared surface 44 .64% vs 91.08%), lateral gutter was well prepared in trans-fibular technique (88.82vs 82.04 square cm).There is no difference in the amount of unprepared surface of talar dome between the two approaches. When excluding the medial gutter, there was no significant difference between trans-fibular and mini open techniques (83.94 vs 90.85, p=0.1412).Conclusion:Joint preparation using the mini-open approach (extended arthroscopic portal) is equally as efficacious as the transfibular approach for preparation of the tibiotalar joint. When including preparation of the medial gutter, the mini-open approach provides superior joint preparation. This may be advantageous with decreased rate of nonunion and less complications. But many surgeons fuse only tibiotalar surface, considering that, both approaches yield equal amount of joint preparation. But it needs to be confirmed with clinical studies.

Short-term clinical outcomes of arthroscopic fixation of displaced posterior cruciate ligament avulsion fractures with the use of an adjustable loop suspensory device.

To describe the clinical outcomes of arthroscopic fixation of displaced posterior cruciate ligament (PCL) avulsion fractures with/without associated tibia plateau fractures using an adjustable loop suspensory fixation device. Four male patients who have sustained PCL tibia avulsion fractures with/without associated tibia plateau fractures were operated on in a single centre using an arthroscopic adjustable loop suspensory device technique. After arthroscopic evaluation and reduction of the fracture using a probe and PCL drill guide, a proximal medial tibial mini incision was used to drill a bone tunnel through the fracture fragment. An adjustable loop suspensory device was relayed through the bone tunnel via a transtibial manner, and the button device was flipped onto the bony fragment for fixation. The associated tibial plateau fractures were then fixed if present. Knee function at the last follow-up was evaluated by International Knee Documentation Committee (IKDC), Knee Injury And Osteoarthritis Outcome Score (KOOS), Lysholm scores. Range of motion and knee stability were assessed, and fracture union was evaluated by plain radiographs. All patients underwent the operation successfully with no major complications encountered. All were followed up for a minimum of 6 months. There was no instability reported by the patients or found during objective evaluation using posterior drawer test and reverse pivot shift test. All fractures achieved union. Mean post-operative Lysholm score was 91.5 (range 85-95), IKDC score was 85.1 (range 74.7-89.7) and KOOS was 89.3 (range 81.5-94.6). All patients returned to their pre-injury activities of daily living and work. Radiographic evaluation showed union at the fracture site in all four patients at the last follow-up. This arthroscopic procedure is a viable minimally invasive technique that is appropriate in minimally displaced avulsion fractures of the PCL with associated tibia plateau fractures. Case Series, IV.

Evaluating of the Outcomes of Median Nerve Decompression with a Mini Incision Proximal to the Distal Wrist Crease.

To evaluate the feasibility of the mini-open incision method in patients who underwent median nerve decompression in the carpal tunnel with a mini incision made proximal to the distal wrist crease. A total of 80 patients (84 hands) operated by a single surgeon with a mini incision were included. The patients were evaluated postoperatively for the presence of pillar pain, pain on the incision scar, and scar sensitivity in addition to preoperative findings. The Quick Disabilities of the Arm, Shoulder and Hand (Quick DASH) questionnaire was used for clinical scoring. To evaluate the effectiveness of the method, the findings were recorded at and compared between at 12 and 24 months follow-ups. No complications were observed at the wound site in the early postoperative period. Ten patients reported numbness, 5 experienced weakness, and 4 revealed positive Tinel's sign. Keloid formation without pain and scar sensitivity was detected in 2 patients at 6 months. No patient reported night pain, pain on pillar or incision scar, scar sensitivity, recent sensory loss, and disease recurrence. Numbness was present in 7 patients at 12 months and in 3 at 24 months; 3 and 2 patients reported weakness at 12 and 24 months, respectively. The mean Quick DASH score was 72.7 preoperatively, 10.2 at 12 months, and 9.1 at 24 months. The median nerve decompression in the carpal tunnel may be performed with a mini incision made proximal to the distal wrist crease is effective and safe method, and provides less complications and higher patient comfort.

Comparative Study between Mini Incision Open Appendectomy and Laparoscopic Appendectomy in Terms of Post Operative Pain Length of Hospital Stay and Return to Normal Life

Comparative Study between Mini Incision Open Appendectomy and Laparoscopic Appendectomy in Terms of Post Operative Pain Length of Hospital Stay and Return to Normal Life

Sinus tarsus mini incision approach with percutaneous reduction and fixation for Sanders II、III calcaneal fractures

Objective To explore the methods and clinical effect of the sinus tarsus mini incision approach with percutaneous fixation technique in the treatment of Sanders II, III calcaneus fractures. Methods From January 2015 to May 2016, the clinical data of 64 cases with Sanders II, III calcaneus fractures who were treated by sinus tarsus mini incision approach with percutaneous reduction and fixation were analyzed retrospectively. The average age was 46.64±10.51 years (range, 25-68) and 49 patients were males and 15 patients were females. According to Sander's classification, 39 patients were Sanders II and 25 were Sanders III fracture. Calcaneal varus was corrected and the length, width and height of bone were reduced by sinus tarsus mini incision approach with percutaneous fixation technique. Calcaneal fracture was treated by calcaneal bone plate combined with percutaneous screw fixation. Complications and operation procedure were recorded post-operation. Anteroposterior, lateral and axial views of preoperative and postoperative X-ray and CT scan were taken to assess the classification, restoration and intertion status of fracture. Radiological assessment was performed using Bohler's angle and Gissane's angle. Functional outcome was assessed using the Maryland foot score (MFS). Results All of the sixty-four patients were followed up for 12-18 months (average, 14.80±2.03). After surgery, only 4 cases of superficial necrosis of the incision were found, and the incisions were all healed and no infection occurred after surgery. No tendon tenosynovitis was seen after surgery. There were no fracture displacement, internal fixation failure, and fracture deformity healing cases. The mean time of bone union was 9.44±1.38 weeks (8-12 weeks) without fracture deformity healing case. The mean time of bone union was 9.17±1.16 weeks for the 23 cases with bone graft. For the 41 cases without bone graft, the bone healing average time was 9.91±1.62 weeks, and there is no statistically difference between cases with and without bone graft (t=1.936, P=0.061). Bohler's angle was 6.625°±4.904° (range, -5°-15°) preoperative, and improved to 31.031°±4.660° (range, 24°-40°), which had statistically significant difference (t=-28.863, P=0.000). Gissane's angle was from preoperative 76.094°±12.981° (range, 55°-105°) to 127.328°±6.486° (range, 115°-140°) at the time of the latest follow-up, and the difference had statistically significant (t=-28.246, P=0.000). Maryland Score: excellent 30 cases (22 cases of type II, 8 cases of type III), good 27 cases (15 of type II, 12 of type III), fair 7 cases (2 of type II, 5 of type III). The overall good rate was 89.06% (57/64). Conclusion The tarsal sinus minimally invasive small incision reduction and internal fixation combined with percutaneous reduction and fixation technique in the treatment of calcaneal fractures, exerts the advantages of small trauma, clear surgical exposure for reduction, reliable fixation, and low incision complications, which is applicable to treat the Sanders II, III calcaneal fractures. Key words: Calcaneus; Fractures, bone; Fracture fixation, internal

Experiences with a modified preauricular mini incision with subdermally dissection in condylar and subcondylar fractures of the mandible

ObjectiveCondylar and subcondylar fractures (CSFs) are among the most common mandible fractures. If reduction of these fractures is not carried out correctly, serious complications can result, including infection, damage to temporomandibular joint (TMJ) function, malocclusion, nonunion, malunion, and ankylosis of the TMJ. MethodsWe used a preauricular, mini-incision, open technique (PMIOT) for CSF of the mandible. 66 patients (48 males, 18 females), with a total of 72 CSFs of the mandible, were repaired with PMIOT between 2011 and 2016. Average age was 37.8 years (range: 8–78). CSFs were located on the right side, left side, and bilaterally in 21, 27 and six patients, respectively. We used only one mini incision of length 2 cm for non-displaced subcondylar fractures. However, we had to perform a second mini incision for condylar fractures displaced by more than 45°, where subcondylar fractures overlapped, or where there was deep surgical exposure and difficulty with reduction. ResultsNo early complications, such as bleeding, hematoma, seroma, infection, or parotid fistula, were seen in any patients. Temporary facial nerve paresis was reported in three patients, but these recovered spontaneously with conservative treatment within 15 days. Permanent facial nerve paralysis occurred in none of the patients. ConclusionWe believe that PMIOT is an effective, reliable, and feasible method for repair of CSF. It does not need any expensive and sophisticated tools, and has low complication rates. The mini incision used in our technique results in both a hidden scar and protection of essential structures in the region.

Incidental appendectomy during mini incision post-partum sterilization (Chokchai technique): A prospective cross-sectional study.

We aimed to determine the success rate of incidental appendectomy during post-partum sterilization (PPS) using the Chokchai technique and to compare the postoperative morbidity between patients who underwent this procedure with those who underwent simple PPS. Appendectomy during PPS was performed in 141 patients from 1 May 2012 to 30 April 2014. The control group consisted of 182 simple PPS patients. Primary outcomes were the success rate of the procedure and secondary outcomes were postoperative morbidity and complications. The success rate of this procedure was 98.6%. There was no statistically significant difference in intraoperative blood loss, hospital length of stay, or postoperative morbidity. Appendectomy added 7.5 min to the total procedure. Intravenous sedation requirements were 13.7% and 33.3% in the control and study groups, respectively. Pathologic evaluation of resected appendices revealed 15 abnormalities (10.8%), including two cases of periappendicitis (1.4%). When carried out by experienced surgeons and with appropriate anesthesia, incidental appendectomy during PPS is safe. The Chokchai technique (approach through a small periumbilical incision) achieved a high success rate and resulted in minimal scar. Incidental appendectomy not only prevents any future appendicitis but also helps to detect periappendicitis and treat its primary cause. However, this is an option for only selected patients who are clearly informed about the possible risks and benefits of the procedure.

Z Lengthening of Achilles Tendon through Three Longitudinal Mini Incisions

Category: Ankle Introduction/Purpose: Achilles tendon lengthening is considered an integral step in management of major foot and ankle deformities. Many procedures were described. Selective gastrocnemius recession is sometimes useful but is insufficient in severe equinus deformities in which the Achilles tendon itself needs to be lengthened. Z lengthening is sufficient to correct severe equinus deformities but is associated with marked scarring and tension on the wound after correction of the deformity. Percutaneous triple hemisection is an alternative but has the disadvantages of uncontrolled lengthening and risk of rupture in correcting severe deformities. In this study, a new technique of Z lengthening through three small longitudinal incisions to avoid the disadvantages of open Z lengthening and percutaneous triple hemisection was evaluated. Methods: Three longitudinal incisions of 1 to 1.5 cm were done, one over the most distal portion of the Achilles tendon and the second and third incisions over the midportion and the upper end of the tendon. Through the distal incision, the distal part of the tendon was split into two equal halves and the medial half was detached from the calcaneus and sutured. The suture was then passed using an artery forceps to the middle and then the superior incision with gentle pulling to complete the splitting of the two halves. Then, the lateral half was detached from the tendon proximally. Then, the equinus was corrected and the two halves were sutured together through the middle incision with removal of excess tendon. Longitudinal incisions were preferred to avoid fish mouth opening with deformity correction and to leave a chance to convert to open lengthening should posterior capsular release found necessary. Results: Ten patients with severe fixed equinus deformity alone or as an element of more complex foot deformities with clinically and radiologically reasonable ankle joints that can be preserved were included in the study. Three patients had poliomyelitis, two had Charcot-Marie Tooth syndrome, two had cerebral palsy, two had idiopathic equinocavus deformity and one had posttraumatic deformity. The average age was 24 years (range: 14-36). The follow up was at least six months. Equinus deformity was successfully corrected in all patients and the Achilles lengthening procedure was successful in all cases without need to convert to the classic open technique. No wound healing problems were encountered and the extensive scarring associated with open Z lengthening of the Achilles tendon was not encountered. Conclusion: Z lengthening of the Achilles tendon using three mini incisions can be a good option to treat severe equinus deformities with avoiding the complications of open Z lengthening and the percutaneous triple hemisection. It has however a limitation when posterior ankle capsular release is needed, but in such cases, the incisions can be connected converting the procedure to an open Z lengthening. Further studies are needed with larger number of cases and with comparison to other methods of Achilles lengthening.

A Retrospective Analysis of Surgical Femoral Artery Closure Techniques: Conventional versus Purse Suture Technique

Different techniques have been reported for the exploration and repair of femoral artery (FA) in patients who undergo minimally invasive cardiac surgery (MICS) and endovascular aortic surgery. We used a modified approach alternative to the conventional technique (group CT) since May 2013, which specifies a shorter groin incision and diamond-shaped hemostatic purse sutures for arteriotomy closure without the requirement of cross-clamping (group PT [purse suture technique]) and evaluated early outcomes and the complication profiles of the 2 techniques for femoral access. In our clinic, between May 2011 and December 2015, 503 FA cannulations were performed on 345 patients who underwent MICS (n=109, mean age 64.1±17.6 years, female/male ratio 71/38), endovascular abdominal aneurysm repair (n=158, mean age 71.3±10.2 years, female/male ratio 63/95), thoracal endovascular aneurysm repair (n=50, mean age 65.0±15.3 years, female/male ratio 15/35), and transaortic valve implantation (n=28, mean age 80.8±5.9 years, female/male ratio 13/15). A total of 295 FAs were exposed via mini incision and were repaired with the PT. We compared the duration of femoral closure (FC), wound infection, and vascular complications including bleeding hematoma, thromboembolic and ischemic events, pseudoaneurysm, seroma, surgical reintervention rates, delayed hospital stay for groin complications, and existence of postoperative local luminal narrowing (LLN) at the intervention site over 25% for both groups. FC time (CT 14.9±3.16min, PT 6.5±1.12min, P<0.0001), bleeding hematoma frequency (CT 6.2%, PT 1.7%, P=0.01), and prolonged hospital stay for groin complications (CT 14.9%, PT 3.4%, P<0.0001) were significantly lower in the PT group. Rate of technical success (CT 80.3%, PT 87.4%, P=0.03) and event-free patient (CT 66.1%, PT 77.5%, P=0.03) were significantly better in the PT group. There were no differences between groups in terms of ischemic events, wound infection rates, development of pseudoaneurysm and seroma, surgical reintervention rates, and LLN of FA over 25% at 6-month duplex evaluation. The comparison of the 2 approaches revealed the advantages of the PT in terms of bleeding hematoma and shortening in FC time and the length of hospital stay. We suggest performing a smaller skin incision for FA access and utilizing purse sutures, which allows completing the procedure without cross-clamping, thus providing a favorable approach and excellent comfort for the surgeon.

Mini incision appendectomy: an analysis of 70 cases

Background: Appendicitis is a common surgical emergency world over, requiring surgical intervention immediately or as elective procedure to avoid complications. Various methods of appendisectomy are in practice, which includes conventional and laparoscopic appendectomy. One other method of appendectomy called mini appendisectomy is performed in selected patients. This study analyses the advantage, feasibility and utility of using mini incision Appendectomy for patients with appendicitis at Saveetha Medical College and Hospital, a teaching tertiary care hospital, Chennai, India.Methods: A total number of 70 cases diagnosed with appendicitis underwent this technique of mini incision appendisectomy mostly under spinal anesthesia. The study period was from 2013 to 2016, for 4 years duration. Patients detailed history, physical examination, operative details, post-operative complications, length of hospital stay, pain scores, analgesic requirements and patient satisfaction scores were collected.Results: Mini-incision appendectomy was performed in 70 patients with 2 cases (2.8%) which required an extension of the incision to 3.5 cm. Wound infection occurred in 2 patients which was treated conservatively. The average operating time was 25 minutes (20-45 minutes). No post-operative mortality. Patients had minimal post-operative pain.Conclusions: Hence mini incision appendectomy is a safe and advantageous technique in performing appendectomy in all hospitals.

A randomised controlled trial of mini incision or conventional incision for saphenous vein harvesting in patients undergoing myocardial revascularization.

ObjectiveCompare the evolution regarding the complications concerning two types of incision (conventional × mini-incision), for saphenectomy in patients that go under myocardial revascularization or otherwise known as coronary artery bypass surgery.MethodsIn January 2012 to August 2013, 66 patients were prospectively selected for coronary artery bypass with cardiopulmonary bypass surgery. These were divided into two groups: Conventional and Mini-Incision, with 33 patients in each group chosen in a random fashion and with knowledge of which technique to be used being presented only at the start of the surgery. In the conventional group, the patients received an incision to the lower member of 7–10 cm. The patients in the Mini-Incision group received an incision to the lower member of 3–4 cm, both performed without the use of any special material.ResultsThe groups were similar in terms of clinical data and in the preoperative period. Males made up a greater part of the group with 63.7% and 81.9% in groups C and M, respectively. Among the complications analysed, edema (p = 0.011), hematoma (p = 0.020), dehiscence (p = 0.012) and infection (p = 0.012), were significantly greater in group C when compared to group M. When the matter comes to the variable in relation to the risk of Surgical Site Infections (SSI), no difference was found between the groups.ConclusionCoronary artery bypass surgery with mini-incision for saphenectomy, demonstrated a lower rate for preoperative complications when compared to saphenectomy under conventional incision procedures.

Impact of Non-rib-Spreading, 3D Fully Endoscopic, Mini Incision Technique for Mitral Valve Repair on Quality of Life and Postoperative Pain - A Matched-pair Analysis of 200 Patients

Impact of Non-rib-Spreading, 3D Fully Endoscopic, Mini Incision Technique for Mitral Valve Repair on Quality of Life and Postoperative Pain - A Matched-pair Analysis of 200 Patients

Lateral approach to Thyroid: A Good Technique for Reoperative Thyroid Surgeryat

ABSTRACT Introduction Thyroidectomy is the commonest endocrine surgical procedure undertaken throughout the world. Redo thyroidectomies are challenging procedures with a higher morbidity rate. Lateral approach to thyroid (LATT) is a good alternative to the standard midline exploration. The key to the technique is the development of the natural tissue plane between the strap muscle and the ipsilateral sternocleidomastoid muscle to explore the thyroid bed. A study was carried out to assess the efficacy, safety, and complication of LATT. Materials and methods Data on patients undergoing LATT in professorial surgical unit, Ragama from 2008 to 2015, were collected prospectively and analyzed. All procedures were done by a single surgeon. Results A total of 36 LATTs were done. Data from 32 people were collected, as 4 patients lost follow-up; 29 (90.6%) were females and 3 (9.4%) were males. Their age ranges between 28 and 61 (median 43.37). Three (9.4%) LATTs for parathyroid explorations and out of it one (3.1%) for redo parathyroid explorations were done. Nine (28.1%) cases were redo thyroidectomies and 18 (56.2%) were done with mini incision with lateral approach. Hemithyroidectomies were performed on 28 (87.5%) patients. Bilateral explorations were done on three (9.4%) patients and four (12.5%) lateral approaches were done for completion thyroidectomies for follicular malignant lesions. Transient clinical hypocalcemia was noticed in four (12.5%) patients and one (3.1%) developed hoarseness of voice, which was temporary; and none of them had complications like hematoma and postsurgical stridor. Conclusion Lateral approach to thyroid is a safe alternative to the standard approach for reexplorative thyroid surgery. How to cite this article Dissanayake DDMC, Fernando RF, Dissanayake IJ. Lateral approach to Thyroid: A Good Technique for Reoperative Thyroid Surgery. World J Endoc Surg 2016;8(2):141-142.

Peer review report 2 on “A randomised controlled trial of mini incision or conventional incision for saphenous vein harvesting in patients undergoing myocardial revascularization.”

Peer review report 2 on “A randomised controlled trial of mini incision or conventional incision for saphenous vein harvesting in patients undergoing myocardial revascularization.”

Peer review report 2 on “A randomised controlled trial of mini incision or conventional incision for saphenous vein harvesting in patients undergoing myocardial revascularization”

Peer review report 2 on “A randomised controlled trial of mini incision or conventional incision for saphenous vein harvesting in patients undergoing myocardial revascularization”

The Buried Bumper Syndrome: External Bumper Extraction after Radial Mini Incisions and Replacement through an Adjacent Tract.

Although considered as a safe method to provide long-term nutritional support, percutaneous endoscopic gastrostomy (PEG) may be complicated by a buried bumper syndrome (BBS), a life-threatening condition. Removal of the PEG tube with its buried bumper and reinsertion of a new PEG tube is often necessary. Since its description in 1988, less than 50 cases of BBS managed by external extraction of the buried bumper have been reported. We report a case of buried bumper that was removed by external traction without the need for endoscopic or laparoscopic treatment but with the need of two radial millimeter skin incisions after abdominal CT study and finally immediate PEG replacement but through an adjacent site.

Double mini incision in the treatment of carpal tunnel syndrome

Purpose Patients who undergo an open carpal tunnel surgery frequently complain of a postoperative tender scar as a result of the long incision and of excessive scar formation. Instead, in this study, a double mini skin incision, each 1-cm long, was used in the surgical treatment of the carpal tunnel syndrome (CTS) by using classic instruments with no need for an endoscope. The transverse carpal ligament was easily sectioned. Patients and methods The study population consisted of 40 patients treated in El-Kasr El-Eini Hospital, with CTS and a mean age of 47 years (range: 28–65 years). The average follow-up duration was 12 months (range: 10–15 months). Inclusion criteria included patients with classic CTS without underlying autoimmune disease or traumatic injury. Recurrent cases were excluded in this study. Results Surgical results were evaluated using the Boston Carpal Tunnel questionnaire. Postoperatively, only one patient complained of residual mild pain and one patient complained of residual weak handgrip. Conclusion Double mini incision in the treatment of CTS showed satisfactory pain relief, nontender scar with good functional outcome, and satisfactory healing of wounds.

Endoscopic lumbar discectomy, cost effective operative procedure at tertiary care centre

Study design: Retrospective study Background: Endoscopic lumbar discectomy using endoscopic tubular retractor system(METRx-MD) are considered popular minimally invasive surgery (MIS) methods for the treatment of lumbar disc herniation. Our main aim is to apread the benefits related endoscopic technique for lumbar disc herniation at tertiary care centre through which we can reduce the huge patient’s workload and patients are also getting best treatment for their respective disease through minimal invasive surgery. Objective: To evaluate the effectiveness of Endoscopic Lumbar Discectomy as cost effective procedure at tertiary care center where there is huge patient’s workload. Methods: It is a retrospective study of 40 patients were operated during the period between August-2013 to August-2015,at B.J Medical college, civil hospital, ahmedabad out of which 29 were males and 11 females between age group of 17 and 72 years and compared with the standard results of open mini incision discectomy. Inclusion criteria: Single level lumbar disc herniation, Unilateral or bilateral radiculopathy. Exclusion criteria: Multiple level disc bulge, Presence of spinal instability, Presence of gross spinal deformity Results: · In our study out of 40 patients, 29(72.5%) were males and 11(27.5%) were females. · 22 (55%) patients had L4-L5 level disc herniation while 18 (45%) patients had L5-S1 level disc herniation. · Out of 40 patients, only 3 patients presented with complications. · Complications observed in our study were dural tear, infection and recurrence of radiculopathy. · Immediate post-op improvement of VAS, oswestry and SF-12 score was noted in all patients. Conclusion and Summary: Endoscopic Discectomy is a minimally invasive spine surgery which has better outcome (as compared with standard mini incision discectomy) in terms of: · Better Pain Relief · �

超微小切口治疗小儿腹股沟斜疝

目的：评价超微创小切口治疗小儿腹股沟斜疝的临床效果。方法：采用腹股沟区微创小切口治疗小儿腹股沟斜疝197例，年龄7个月~3岁，平均2.6岁。结果：手术过程均顺利，手术时间9~25 min，平均19 min，术后2~3 d出院，197例中无1例复发，无切口感染、精索扭转及睾丸萎缩等并发症，切口隐蔽、瘢痕较小，美容效果好。结论：该术式有很多的优点：操作简单，切口超小，无瘢痕，产生的疼痛轻，造成的损伤小，患者的恢复很快，手术的时间和住院的时间都很短，花费的费用比较低，该手术疗效可靠，而且很安全，手术治疗后很少出现并发症，该病的复发率低等，在临床上很值得进行推广运用。 Objective: To evaluate the clinical effect of minimally invasive incision in the treatment of inguinal hernia in children. Methods: The inguinal region of minimally invasive treatment for pediatric in-guinal hernia in 197 cases, aged from 7 months - 3 years (average: 2.6 years old). Results: The surgery was successful; the operation time was 9 - 25 minutes (average: 19 minutes); patents dis-charge 2 - 3 days after surgery without recurrence in 197 cases, without incision infection, without testicular torsion and atrophy of testis, with concealed incision and small scar; so it has good cos-metic effect. Conclusion: This method has many advantages. The operation is simple with ultra mini incision and without scar; the pain is light; the damage is small, and patients recover quickly; the operation time and hospitalization time are very short; the cost is relatively low. The surgical curative effect is reliable and safe, with few complications after surgical treatment; the recurrence rate is low, and is worthy of promotion in clinical application.

Peer review report 3 on “A randomised controlled trial of mini incision or conventional incision for saphenous vein harvesting in patients undergoing myocardial revascularization”

Peer review report 3 on “A randomised controlled trial of mini incision or conventional incision for saphenous vein harvesting in patients undergoing myocardial revascularization”