Surgical Concepts Research Articles

Intraoperative Holographic Guidance Using Virtual Reality and Mixed Reality Technology During Laparoscopic Colorectal Cancer Surgery.

This study aimed to investigate the feasibility of a mixed reality (MR)-based hologram for intraoperative navigation in colorectal surgery. Virtual reality (VR) and MR technologies can visualize overlapping three-dimensional (3D) hologram images and real space using the wearable HoloLens2 glasses. This study comprised 13 patients with colorectal cancer. Twelve participants had hologram images created from computed tomography (CT) between August and September 2021. One patient who underwent lateral lymph node dissection (LLND) after this period was included. A 3D hologram of the arteries, veins, and tumor was downloaded to HoloLens2 with the Holoeyes MD system and used during surgery. Hologram visibility, surgical outcome, and the NASA Task Load Index (TLX) were examined. A total of 2 ileocecal resections, 6 right hemicolectomies, 1 partial colectomy, 4 LLNDs, and 1 para-aortic lymph node dissection were performed safely while viewing the holograms. The mean operative duration was 421 [290-555] min, blood loss was 5 [5-15] ml, and the postoperative hospital stay was 10 [9-14] days. Regarding the TLX, the mental demand score was 30 [20-40], the physical demand score was 60 [50-67.5], the temporal demand score was 50 [40-62.5], the performance score was 15 [2.5-35], the effort score was 45 [35-62.5], the frustration score was 60 [50-65], and the weighted workload score was 34 [30.17-45.835]. Viewing a hologram in VR/MR can improve the understanding of the anatomy, which cannot be ascertained on a conventional two-dimensional monitor. Holographic guidance is a highly novel surgical concept that can potentially reduce the mental demand on surgeons.

360. DIAGNOSIS OF RECURRENT LARYNGEAL NERVE PARALYSIS BY EVALUATING MOVEMENT OF THE VOCAL CORDS USING ULTRASONOGRAPHY AFTER MINIMALLY INVASIVE ESOPHAGECTOMY

Abstract Development of thoracoscopic surgical skills and concepts in minimally invasive esophagectomy (MIE) and robotic-assisted (MIE) have provided us with a more wider anatomical understanding of lymphadenectomy and the relationship between lymph node dissection and recurrent laryngeal nerve paralysis (RLNP). However, RLNP correlates to postoperative complications even in prognosis. Early warning and novel diagnosis are urgent in the management of esophageal cancer patients. Taking a novel approach to researching the diagnosis of RLNP, we evaluated movement of the vocal cords and arytenoid cartilages using ultrasonography in patients who underwent thoracoscopic esophagectomy after extubating of trachea cannula at department of critical care medicine. Further ultrasonography combined endoscopy evaluation and verification were performed on day 5–7 before hospital discharge. RLNP occurred in 4 of the 20 patients’ cohort (20%). All of 20 patients were finished ultrasonography combined endoscopy evaluation. The diagnostic accuracy of RLNP by ultrasonography compared to endoscopy had a sensitivity of 100.0% (4/4), a specificity of 87.5% (14/16). The positive predictive value was 66.7% (4/6), negative predictive value was 100.0% (14/14), a false positive rate of 33.3% (2/6), and a false negative rate of 0% (0/14). Ultrasonography is a quite non-invasive and effective measure to diagnose and evaluate RLNP after esophagectomy compared to traditional examination of endoscopy. It also has a perspective future in evaluation for the recovery status of RLNP.

Multidisciplinary Treatment Strategies for Wilms Tumor: Recent Advances, Technical Innovations and Future Directions.

Significant progress has been made in the management of Wilms tumor (WT) in recent years, mostly as a result of collaborative efforts and the implementation of protocol-driven, multimodal therapy. This article offers a comprehensive overview of current multidisciplinary treatment strategies for WT, whilst also addressing recent technical innovations including nephron-sparing surgery (NSS) and minimally invasive approaches. In addition, surgical concepts for the treatment of metastatic disease, advances in tumor imaging technology and potentially prognostic biomarkers will be discussed. Current evidence suggests that, in experienced hands and selected cases, laparoscopic radical nephrectomy and laparoscopic-assisted partial nephrectomy for WT may offer the same outcome as the traditional open approach. While NSS is the standard procedure for bilateral WT, NSS has evolved as an alternative technique in patients with smaller unilateral WT and in cases with imminent renal failure. Metastatic disease of the lung or liver that is associated with WT is preferably treated with a three-drug chemotherapy and local radiation therapy. However, surgical sampling of lung nodules may be advisable in persistent nodules before whole lung irradiation is commenced. Several tumor markers such as loss of heterozygosity of chromosomes 1p/16q, 11p15 and gain of function at 1q are associated with an increased risk of recurrence or a decreased risk of overall survival in patients with WT. In summary, complete resection with tumor-free margins remains the primary surgical aim in WT, while NSS and minimally invasive approaches are only suitable in a subset of patients with smaller WT and low-risk disease. In the future, advances in tumor imaging technology may assist the surgeon in defining surgical resection margins and additional biomarkers may emerge as targets for development of new diagnostic tests and potential therapies.

The opportunities and challenges of gynecologic cancer in precision medicine

In recent years, the diagnosis and treatment of gynecologic cancer have entered a new era with the development of precision medicine. The diagnosis and treatment modes for ovarian cancer, cervical cancer, and endometrial cancer are constantly adjusted. The application of molecular targeted drugs and the progress of surgical concepts and technology have greatly improved the survival of patients with ovarian cancer. Immunotherapy and targeted therapy have become a new hot spot in the treatment of cervical cancer. More clinical research data have been accumulated on the comparison of laparoscopic and open radical hysterectomy in cervical cancer. The surgical management of endometrial cancer has been improved, and molecular diagnostics are increasingly used to guide the diagnosis and treatment of endometrial cancer. Meanwhile, it's necessary to realize the limitations and challenges of precision medicine in gynecologic cancer.

Simplified anatomical nomenclature of lateral female pelvic spaces

ObjectivesThe surgical management of gynecological malignancies involves the development of spaces and division of structures attaching the genital tract to other pelvic organs and to the pelvic sidewall. Definition, description,...

The Surgical Treatment of Osteoarthritis

Osteoarthritis is a degenerative condition affecting the whole joint with the underlying bone, representing a major source of pain, disability, and socioeconomic cost worldwide. Age is considered the strongest risk factor, albeit abnormal biomechanics, morphology, congenital abnormality, deformity, malalignment, limb-length discrepancy, lifestyle, and injury may further increase the risk of the development and progression of osteoarthritis as well. Pain and loss of function are the main clinical features that lead to treatment. Although early manifestations of osteoarthritis are amenable to lifestyle modification, adequate pain management, and physical therapy, disease advancement frequently requires surgical treatment. The symptomatic progression of osteoarthritis with radiographical confirmation can be addressed either with arthroscopic interventions, (joint) preservation techniques, or bone fusion procedures, whereas (joint) replacement is preferentially reserved for severe and end-stage disease. The surgical treatment aims at alleviating pain and disability while restoring native biomechanics. Miscellaneous surgical techniques for addressing osteoarthritis exist. Advanced computer-integrated surgical concepts allow for patient personalization and optimization of surgical treatment. The scope of this article is to present an overview of the fundamentals of conventional surgical treatment options for osteoarthritis of the human skeleton, with emphasis on arthroscopy, preservation, arthrodesis, and replacement. Contemporary computer-assisted orthopaedic surgery concepts are further elucidated.

Risks and complications in rhinoplasty. A comparative study in structural vs preservation rhinoplasty

Introduction. Rhinoseptoplasty is considered the most challenging operation because many techniques have to be taken into consideration to achieve an optimal aesthetic and functional results. Rhinoseptoplasty techniques have been perfected over time, following two main surgical approaches: structural rhinoplasty (resection/ reconstruction) and conservative (preservation rhinoplasty). Methods. The authors present the risks and complications in a comparative study of 100 cases with patients in primary rhinoseptoplasty performed between 2019-2021: 50 cases in Structural Rhinoplasty and 50 cases in Preservation Rhinoplasty. The study presents two surgical concepts of rhinoplasty regarding the main advantages, disadvantages and indications of each type of rhinoseptoplasty surgery. Results and conclusions. Complications post-rhinoseptoplasty can be considered as perioperative, functional, anatomic (aesthetic) and psyhological. In this study 10 cases (10%) of primary rhinoplasty required revision surgery. The most frequent postoperative deformity is the “pollybeak” when a deep naso-frontal angle, cartilaginous hump and reduced tip projection are present preoperatively. The pollybeak was the indication in 4 cases (40%) of all revision rhinoplasties. Other frequent postoperative deformities are: wide nasal tip, retractions of the columella base and irregularities of the nasal dorsum. These deformities are very often combined and caused by a loss of septal support. Septorhinoplasty is a difficult procedure and the surgeon must have accurate anatomical knowledge and rich clinical experience. The risks for rhinoplasty-complications can be reduced with increasing experience. It is very important to make distinction between complication and mistake.

Nasal Spine of the Frontal Bone: A Consistent Landmark for Safe Outside-In Frontal Drill-Out.

Outside-in frontal drill out entails drilling the frontal sinus floor in the midline before identifying and dissecting the frontal recesses. It is a more direct approach, especially in revision surgery or cases with challenging anatomy. The aim of this study was to highlight the anatomical and surgical concepts for easy and safe outside-in frontal drill out by a preclinical anatomic study on cadaveric heads. In addition, to review our experience with this approach over a 5-year period for challenging frontal sinus pathologies. The study included 2 sectors; a preclinical study, in which 5 cadaveric heads were dissected and studied to identify and standardize the anatomical landmarks of this approach. This was followed by a clinical case series which included 22 patients with challenging frontal sinus pathologies that were treated with this proposed approach. We concluded from the anatomic study that the nasal spine of the frontal bone (NSFB) and its anatomical orientation in relation to the nasal branch of the anterior ethmoidal artery (NBAEA) is a consistent landmark that enables the surgeon to identify the correct coronal trajectory of drilling to avoid injury of the cribriform and the skull base. The clinical case series included 22 patients that were successfully treated with the proposed approach. No intraoperative nor postoperative complications were reported in this study. Long-term follow-up showed that the frontal neo-ostium was patent in all cases (n = 22). Outside-in frontal drill-out is a safe and easy approach; especially in challenging frontal sinus pathologies; using the NSFB and its anatomical coronal orientation to the NBAEA as a consistent landmark, anterior to the skull base. This approach offers early, safe, and direct bone removal without the need for initial identification and dissection of the frontal recess.

Influence of different sphincter-preserving surgeries on postoperative defecation function

Advances in surgical techniques and treatment concept have allowed more patients with low rectal cancer to preserve sphincter without sacrificing survival benefit. However, postoperative dysfunctions such as fecal incontinence, frequency, urgency, and clustering often occur in patients with low rectal cancer. The main surgical procedures for low rectal cancer include low anterior rectum resection (LAR), intersphincteric resection (ISR), coloanal anastomosis (Parks) and so on. The incidence of major LARS after LAR is up to 84.6%. The postoperative function of ISR is even worse than LAR. Moreover, the greater the extent of resection ISR surgery, the worse the postoperative function. There are few studies on the function of Parks procedure. Current evidence suggests that the short-term function of Parks procedure is inferior to LAR, but function can gradually recovered over time. Colorectal surgeons have attempted to improve postoperative defecation by modifying bowel reconstructions. Current evidence suggests that J pouch or end-to-side anastomosis during LAR does not reduce the incidence of defecation disorders. Pouch reconstruction during ISR cannot reduce the incidence of severe LARS either. In general, the protection of postoperative defecation function in patients with low rectal cancer still has a long way to go.

Postoperative radiotherapy may not be necessary for locally advanced head and neck squamous cell carcinoma: a case-match multicentre study

BackgroundSome head and neck cancer surgeons found that many patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC) without postoperative radiotherapy (PORT) also have a good prognosis. The purpose of this study was to determine the effect of PORT on survival in patients with LA-HNSCC.MethodsA case-match cohort analysis was performed at two institutions on patients with LA-HNSCC. Patients who received surgery alone were case-matched 1: 1 with patients treated by surgery plus PORT based on pT, pN, tumor subsite etc.Results114 patients were matched into 57 pairs, with a median follow-up period of 40.2 months. No difference in overall survival (OS, HR 0.88; 95% CI 0.50–1.58; P = 0.79) or disease-specific survival (DFS, 0.86; 95% CI 0.50–1.50; P = 0.76) was observed with no PORT.ConclusionsPORT isn’t necessary for patients with LA-HNSCC who are treated for the first time as long as the head and neck cancer surgeon adhere to appropriate surgical concepts. The indications of PORT for patients with LA-HNSCC need to be further discussed.

Preoperative leukocytosis is an independent risk factor for morbidity and survival after resection of colorectal liver metastases

Although surgical resection of colorectal liver metastases (CRLM) remains to be the only option for long term survival, traditional surgical concepts have been challenged by the introduction of the liver first approach or neoadjuvant chemotherapy in resectable CRLM and interventional therapies. The aim of this study was to identify prognostic factors for postoperative morbidity and survival and to externally evaluate the recently introduced resection severity index (RSI), in order to optimize patient selection and treatment strategies. This is a retrospective single centre analysis of 213 patients undergoing surgery for CRLM in curative intent between January 2010 and December 2018. Median follow up after liver resection was 28.56 (0.01-111.46) months. Severe postoperative complications (Clavien-Dindo ≥ IIIa) were observed in 46 (21.6%) cases. Preoperative leukocytosis (OR: 3.114, CI-95%: 1.089-8.901; p=0.034) and operation time in minutes (OR: 1.007, CI-95%: 1.002-1.011; p=0.002) were determined as independent risk factors. Overall survival (OS) was 46.68 months with a 5-year survival rate of 40.5%. Independent prognostic factors were preoperative leukocytosis (HR: 2.358, CI-95%: 1.170-4.752; p=0.016), major hepatectomy (HR: 1.741, CI-95%: 1.098-2.759; p=0.018) and low grading of the primary intestinal tumour (HR: 0.392, CI-95%: 0.231-0.667; p < 0.001). The RSI (ASAT (U/l) divided by Quick (%) multiplied by the extent of liver resection in points) was identified as independent risk factor for OS only in patients without neoadjuvant chemotherapy. Detection of leukocytosis in patients prior resection of CRLM was associated with increased postoperative morbidity and decreased OS and could therefore prove valuable for perioperative risk stratification.

A Scientometric Analysis and Visualization Discovery of Enhanced Recovery After Surgery.

BackgroundEnhanced recovery after surgery (ERAS), a new clinical surgical concept, has been applied in many surgical disciplines with good clinical results for the past 20 years. Bibliometric analysis is an effective method to quantitatively evaluate the academic productivity. This report aimed to perform a scientometric analysis of the ERAS research status and research hotspots.MethodsComprehensive scientific mapping analysis of a wide range of literature metadata using the scientometric tools, including the Bibliometrix R Package, Biblioshiny, and CiteSpace. Data were retrieved from the Web of Science Core Collection database of original articles from 2001 to 2020. Specific indicators and maps were analyzed to show the co-authorship, co-institute, co-country, co-citation, and international cooperation. Automatic literature screening, unsupervised cluster filtering, and topic cluster identification methods were used to display the conceptual framework and thematic evolution.ResultsA total of 1,403 research projects drafted by 6,966 authors and published in 413 sources were found. There was an exponential growth in the number of publications on ERAS. There were 709 collaborations between authors from different countries, and the US, China, and the UK had the greatest number of publications. The WORLD JOURNAL OF SURGERY, located in Bradford’s Law 1, had the highest number of published articles (n = 1,276; total citations = 3,193). CiteSpace network analysis revealed 15 highly correlated cluster ERAS studies, and the earliest study was on colonic surgery, and ERAS was recently applied in cardiac surgery. The etiology of ERAS is constantly evolving, with surgery and length of hospital as the main topics. Meta-analyses and perioperative care have tended to decline.ConclusionThis is the first scientometric analysis of ERAS to provide descriptive quantitative indicators. This can provide a better understanding of how the field has evolved over the past 20 years, help identify research trends, and provide insights and research directions for academic researchers, policymakers, and medical practitioners who want to collaborate in these areas in the future.

Rapid Rehabilitation in Urological Surgery with Psychological and Preoperative Care

Urological surgery patients will be studied to see whether a combination of rapid recovery surgery and psychological nursing might help them recover more quickly. Methods There were 74 patients identified and treated in our urological surgery department between April 2020 to April 2022, and they were separated into two groups: the control group and the observation group, with 37 cases in each. During the preoperative period, the control group received regular nursing care, whereas the observation group was exposed to the quick recovery surgical concept in conjunction with psychological nursing care. In the end, here's what happened: Patients in the observation group spent less time getting out of bed and tiring themselves during the first hour after insertion of the drainage tube than those in the control group (P0.05). A larger percentage of the observation group's nurses were satisfied with their work than the control group's nurses, at 94.59 percent (P0.05), while the observation group's complication rate was lower than the control group's (at 18.91 percent) at 8.11 percent (P0.05). Fast recovery surgery coupled with psychological nursing may help patients recover from surgery, minimize the time it takes for them to get out of bed and indwell the drainage tube, enhance their psychological condition, and lower their risk of problems. As a nursing intervention strategy, it is both effective and practical.

SURG-01. The Tentative Application of En Bloc concept in the Pediatric Brain Tumor: A Retrospective Study of 171 Cases from A Large Pediatric Center in China

BACKGROUND: The less allowable blood loss and tolerance of intraoperative blood loss of children lead to the high rate of massive blood transfusion. The surgical concepts of en bloc resection may contribute to the improvement of brain tumor resection. OBJECTIVE: To investigate the effects of en bloc concept on short outcomes of pediatric brain tumors and factors associated with the application of en bloc concept. METHODS: According to the surgical concept involved, the patients were divided into three subgroups-complete en bloc concept, partial en bloc concept and piecemeal concept. The matching-comparison(en bloc group consisting of the first two subgroups and piecemeal group) was conducted to investigate the effect of the en bloc concept on the short-term outcomes. Then the patient data after January 2018, when the en bloc concept was routinely integrated into brain tumor surgery in our medical center, were reviewed and analyzed to find out the predictors associated with the application of en bloc concept. RESULTS: In the en bloc group, the perioperative outcomes, including hospital stay(p=0.001), PICU stay(p=0.003), total blood loss(p=0.015), transfusion rate(p=0.005) and complication rate(p=0.039), were all significantly improved. The multinomial logistic regression analysis showed that tumor volume, bottom vessel, and imaging features, like encasing nerve or pass-by vessel, finger-like attachment, ratio of “limited line” and ratio of “clear line” remained independent predictors for the application of en bloc concept in our medical center. CONCLUSION: The application of en bloc concept based on the imaging features can improve the short-term outcomes.

Exploring Surgeons', Nurses', and Patients' Information Seeking Behavior on Medical Innovations: The Case of 3D Printed Biodegradable Implants in Breast Reconstruction.

To explore information seeking behavior on medical innovations. While autologous and alloplastic options for breast reconstruction are well established, it is the advent of the combination of 3D printing technology and the biocompatible nature of a highly porous biodegradable implants that offers new treatment options for the future. While this type of prosthesis is not yet clinically available understanding how patients, surgeons, and nurses take up new medical innovations is of critical importance for efficient healthcare provision. Using the largest ever combined sample of breast cancer patients (n = 689), specialist surgeons (n = 53), and breast care nurses (n = 101), we explore participants preference for a new surgical treatment concept rooted in 3D printed and biodegradable implant technologies in the context of breast reconstruction. We find that patients overwhelmingly favor information from a successful patient of the proposed new technology when considering transitioning. Surgeons and nurses instead favor regulatory body advice, peer-reviewed journals, and witnessing the procedure performed (either in person or online). But while 1 in 4 nurses nominated talking to a successful patient as an information source, not a single surgeon chose the same. Our multinomial logit analysis exploring patient preference (controlling for individual differences) showed statistically significant results for both the type of surgical treatment and choice to undergo reconstruction. Women who underwent a type of mastectomy procedure (compared with lumpectomy patients) were more likely to choose a former patient than a surgeon for seeking information relating to a new breast implant technology. Further, women who chose to undergo a reconstruction procedure, compared with those who did not, where more likely to prefer a surgeon for information relating to a new breast implant technology, rather than a successful patient. For medical professionals, we find no statistically significant relationship between medical professionals' preference and their age, nor the number of other medical professionals they work with daily, nor the average number of breast procedures performed in their practice on a weekly basis. As our findings show large variation exists (both within our patient group and compared with medical professionals) in where individuals favor information on new medical innovations, future behavioral research is warranted.

Perioperative anemia and its implications

Preoperative anemia is very common and is related to adverse clinical outcomes, including mortality. The immediate and most widely used treatment for postoperative anemia is blood transfusion. However, also blood transfusion carries some risks. Patient blood management (PBM) is defined as the timely application of evidence-based medical and surgical concepts designed to maintain a patient’s hemoglobin concentration, optimize hemostasis, and minimize blood loss in an effort to improve the outcome. The aim of this narrative review is to describe in detail what is PBM and how it should be part of the Enhanced Recovery After Surgery (ERAS) protocols.

Application of rapid rehabilitation surgical concepts in the care of patients with modified radical breast cancer in the perioperative period.

article: Application of rapid rehabilitation surgical concepts in the care of patients with modified radical breast cancer in the perioperative period - Minerva Surgery 2022 May 16 - Minerva Medica - Journals

Bhagandara: A Review Article on Types of Bhagandara and its Management

Ayurveda is an eternal branch considered as the science of life. Its prime motto is maintaining the health of healthy individual first and then curing the disease, which promotes a disease free, healthy life span. Ayurveda is an abundant ocean full of knowledge consisting of eight superior branches. Amongst them Shalya Tantra is the prime branch rich in surgical concept. History reveals that the period of Acharya Sushrut was the golden era of surgery where various surgical procedures were performed. More over in regards of anorectal and perineal surgery, Acharya has expounded much, with an approach of emphasise both surgical and Para surgical measures.&#x0D; Bhagandara can be screened in ancient Ayurvedic texts and varying systematic, scientific detailed descriptions are found. It is the common ano-rectal disease prevalent in the population worldwide. Because of its tedious nature of healing Bhagandara is considered difficult to be cured also it is found to be one amongst the Ashta Mahagada, where Acharya has explained the limitation of the treatment by considering it as Duschikitsya Vyadhi. Hence this article has emphasized on the available discretion on various types of Bhagandara and its management.

Early ligation of the pulmonary vein can reduce the dissemination of shed tumor cells during thoracoscopic lobectomy

ObjectiveThe sequence of vessel ligation in lobectomy can significantly affect the hematogenous spread of circulating tumor cells (CTCs). Vein-first ligation substantially reduces CTC dissemination and achieves favorable survival compared with artery-first ligation. In this study, we further explored whether the timing of pulmonary vein (PV) ligation determined according to the early and late PV ligation technique is associated with CTC dissemination. MethodsA total of 44 patients who underwent uniform 2-port video-assisted thoracoscopic surgery lobectomy were enrolled; the subjects were divided into the early ligation group (n = 18) and late ligation group (n = 26) according to whether PV ligation was prioritized during surgery. PV blood was obtained before PV ligation and after lobe resection. CTCs were detected using telomerase reverse transcriptase-based CTC detection and validated using FlowSight and fluorescence in situ hybridization. ResultsThe median postoperative PV CTC (Post-PVCTC) count was 9 (interquartile range [IQR], 6-18), which was higher than the median preoperative PV CTC (Pre-PVCTC) count of 1 (IQR, 0-3; P < .001). Clinicopathologic correlation analysis showed that the Pre-PVCTC count correlated positively with TNM stage (P = .002) and lymph node metastasis (P = .002) and that the Post-PVCTC count correlated positively with tumor density (P = .043) and vessel/lymphatic invasion (P < .030). Interestingly, although no statistical difference in the median Pre-PVCTC count was observed, the median Post-PVCTC count in the early ligation group was 16 (IQR, 9.5-36.75), whereas that in the late ligation group it was 8 (IQR, 4.75-12.25), showing a significant difference (P = .004). ConclusionsWe provide the first evidence to show that early PV ligation can prevent PVCTCs from spreading into the circulation, offering an innovative surgical concept for the principle sequence of pulmonary vessel management.

Evaluation of Immediate Functional Loading with Single Piece Implants

Introduction: In recent years, implantology has increasingly advocated the concept of immediate loading, even with single implants. It is defined as the placement of a prosthetic restoration within 48-72 hours after implant placement. Among the other advantages of immediate loading like overall treatment reduction in timing, with function, cosmetic and psychological benefits for the patient. This case described a new surgical concept and a technique to fabricate screw-retained provisional crowns for immediate loading of free-standing single tooth implants. Hence the aim of this study is to evaluate immediate functional loading with single piece implants Materials and Methods: For rehabilitation with basal implants in sites after immediate extraction, a 2-mm twist drill, the first cortex (alveolar) was drilled and then drilling was continued till the basal cortex (nasal floor/sinus floor/lingual cortex/pterygoid bone), which was perceived as a dip. For rehabilitation with compressive screw implants in healed edentulous sites, the compression screw implants in the upper and lower jaw were inserted with the primary aim of achieving stability through compression of trabecular bone along the vertical (endosseous) axis of the implant. Frequency tables and chi square tests were used to analyze the data. Results: There were 30 patients with 76 implants present and assessed for this study. The mean age of the participants was 47.43±16.93. In the study participants, 30% of the participants had hypertension, 20% had diabetes mellitus and 20% had smoking habit. BCS and Compressive type of implants were both used in the study. In 51.32% sites, BCS implants were used and 48.68% sites Compressive type implants were used depending on the clinical situation. For the success of the implant, many criteria was assessed such as Implant stability quotient, mid-buccal gingival level and inter proximal gingival papilla, absence of complications (pain, discomfort, infection, bone loss and mobility). Results showed that there was a significant association found between diabetes mellitus with mobility, bone loss and discomfort. Contrastingly there was no association between smoking habit and any of the complications affecting the success of the implant. This showed that systemic disease plays a major role in the success of the implants. Conclusion: The high cumulative implant survival rate for the devices and the technology of the Strategic Implant® indicates (within the limitations of this study) that the immediate functional loading concept with cortically anchored implants or implants providing corticalization of spongious bone for the rehabilitation of partially edentulous segments and for single-tooth replacement in maxilla and mandible can be a viable concept even in cases where extractions of teeth were done simultaneously. Keywords: Single implants, immediate loading, Compressive implants, implants, BCS implants.