scholarly journals A New Technique for Surgical Treatment of Vaginal Agenesis Using Combined Abdominal-Perineal Approach

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Mehmet Sinan Beksac ◽  
Mehmet Coskun Salman ◽  
Nasuh Utku Dogan
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Surgical Approach ◽  
Surgical Procedure ◽  
Split Thickness Skin Graft ◽  
Success Rates ◽  
Perineal Approach ◽  
Vaginal Agenesis ◽  
Thickness Skin ◽  
A New Technique

Optimum therapeutic approach in vaginal agenesis has always been an area of extensive controversies. Although surgical management gained priority due to the evolution of techniques, there is currently no consensus in the literature regarding the best type of surgical approach. The most commonly preferred surgical procedure among gynecologists is McIndoe operation which involves the creation of a space between bladder and rectum, insertion of a mold covered with split-thickness skin graft into that neovaginal space, and use of postoperative vaginal dilation to avoid stenosis. However, many modifications have been introduced in time in an attempt to increase the success rates. In this paper, we describe two cases with vaginal agenesis with functioning uterus who were subjected to surgery by combined abdominal-perineal approach. The surgical technique also included the use of a specially designed vaginal mold made up of polymethyl methacrylate and use of Hyalobarrier gel which is an adhesion-preventing agent.

scholarly journals Surgical management of vaginal agenesis using a modified Mc Indoe’s technique: VIMS experience

2017 ◽  
Vol 6 (9) ◽  
pp. 3841
Author(s):  
Chandrashekhar Tharihalli ◽  
Muralikrishna V. ◽  
Shiva Kumar H. C.
Keyword(s):  
Skin Graft ◽  
Split Thickness Skin Graft ◽  
Success Rates ◽  
Vaginal Agenesis ◽  
Vaginal Reconstruction ◽  
Obstetrics And Gynaecology ◽  
Vaginal Length ◽  
Thickness Skin ◽  
Müllerian Agenesis

Background: Mullerian agenesis is a challenge to reconstructive surgeons. In order to create a new vagina that mimic the normal one in size, lining and appearance, multiple techniques have been designed; among these techniques Mc Indoe’s vaginoplasty represents the simplest one with good results. Mc Indoe’s operation which involves the creation of a space between bladder and rectum, insertion of a mould covered with split-thickness skin graft into that neo-vaginal space, and use of postoperative vaginal mould for dilation and to avoid stenosis. However, many modifications have been introduced in time in an attempt to increase the success rates. The purpose of vaginal agencies treatment is to create an adequate passage for penetration during sexual intercourse.Methods: Between Jan 2010 to June 2017, ten patients with vaginal agenesis were admitted to Dept of Obstetrics and Gynaecology, VIMS Ballari for vaginal reconstruction. All cases underwent a modified Mc Indoe’s technique, and follow up was done for one year.Results: All ten cases of vaginal agenesis underwent vaginal reconstruction by modified Mc Indoe's technique. Post-operative vaginal length varied from 5 to 7 cm in patients who used mould regularly. Successful skin graft take was achieved in 6 cases. one case of perforation of rectum and one case of vaginal stricture was noted.Conclusions: To optimize sexual comfort, the clinical management of women with vaginal agenesis must be multidisciplinary and individually tailored. Our findings suggest that the modified Mc Indoe’s technique is a simple, effective procedure for the treatment of vaginal agenesis, but proper mould usage after surgery remains the cornerstone of the treatment.

scholarly journals Harmonic scalpel® hemorrhoidectomy: A painless procedure?

2007 ◽  
Vol 60 (9-10) ◽  
pp. 421-426 ◽  
Author(s):  
Dejan Ivanov ◽  
Sinisa Babovic ◽  
Dora Selesi ◽  
Mirjana Ivanov ◽  
Radovan Cvijanovic
Keyword(s):  
Surgical Treatment ◽  
Postoperative Pain ◽  
Visual Analog Scale ◽  
Surgical Approach ◽  
Surgical Procedure ◽  
Thermal Damage ◽  
Harmonic Scalpel ◽  
Hemorrhoidal Disease ◽  
Disease Stage ◽  
Analog Scale

Since the surgical treatment of hemorrhoidal disease has been characterized by intense postoperative pain, recent studies have tried to modify the standard Milligan-Morgans technique. The up-to-date literature, in the experience of authors, has confirmed that the new method of Harmonic Scalpel? hemorrhoidectomy reduces postoperative pain. The aim of our study was to statistically evaluate, based on our experience, the efficacy of this surgical approach in terms of reducing postoperative pain and establishing a stable hemostasis. Seventy-seven (77) patients suffering from hemorrhoid disease, stage III and IV, underwent surgery in our clinic during the last five years. The postoperative pain was determined using the visual analog scale on the 1st, 2nd and 7th postoperative days. Patients were divided into two groups in regard to the surgical procedure applied. The data were statistically processed using the Statistica 7.0 software. We concluded that Harmonic Scalpel? hemorrhoidectomy, due to less thermal damage, statistically significantly reduced postoperative pain with better hemostasis, compared with Milligan-Morgan's method of treating hemorrhoidal disease. .

scholarly journals Novel Surgical Treatment for Refractory Heel Ulcers in Werner’s Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Keisuke Oe ◽  
Masahiko Miwa ◽  
Yoshitada Sakai ◽  
Masahiro Kurosaka
Keyword(s):  
Surgical Treatment ◽  
Skin Graft ◽  
Donor Site ◽  
Skin Grafting ◽  
Split Thickness Skin Graft ◽  
Leg Ulcers ◽  
Werner’S Syndrome ◽  
Werner's Syndrome ◽  
Thickness Skin ◽  
Chronic Leg Ulcers

Patients with Werner’s syndrome frequently develop chronic leg ulcers that heal poorly. We present a patient who suffered from this rare syndrome and developed typical heel ulcers. Treatment of the ulcer is challenging, as flap options are limited over the lower third of the leg and skin grafting is not easy as there is a lack of healthy granulations. We successfully treated the ulcer with osteomyelitis by drilling the bone and applying an ultrathin split thickness skin graft with the thigh skin as the donor site.

scholarly journals Surgical Removal of Submacular Perfluorocarbon Liquid Using a 41-Gauge Extendible Subretinal Injection Needle

2019 ◽  
Author(s):  
Khalil Ghasemi Falavarjani ◽  
Pasha Anvari
Keyword(s):  
Retinal Detachment ◽  
Surgical Technique ◽  
Surgical Approach ◽  
Surgical Procedure ◽  
Subretinal Space ◽  
Surgical Removal ◽  
Perfluorocarbon Liquid ◽  
Injection Needle ◽  
Subretinal Injection

Submacular perfluorocarbon liquid (PFCL) retention is a well-known complication of vitreoretinal surgeries; however, the optimal surgical technique for the removal of subfoveal PFCL is yet to be determined. We describe a novel surgical technique for the removal of retained submacular PFCL by performing a retinotomy adjacent to the inferotemporal arcade using a 41-gauge extendible subretinal injection needle and inducing a therapeutic retinal detachment. Through the same retinotomy, the bent 41-gauge needle was advanced into the subretinal space to reach the PFCL bubble. Subsequently, active aspiration of PFCL was performed. The surgical procedure was successfully performed in two patients. This technique appears to be an effective surgical approach for removing retained submacular PFCL bubble.

scholarly journals Management of adult concealed penis using a meshed, split-thickness skin graft

2016 ◽  
Vol 10 (11-12) ◽  
pp. 407 ◽  
Author(s):  
Aaron Boonjindasup ◽  
Michael Pinsky ◽  
Carrie Stewart ◽  
Landon Trost ◽  
Abigail Chaffin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Skin Grafting ◽  
Split Thickness Skin Graft ◽  
Recent Experience ◽  
Viable Option ◽  
Cosmetic Results ◽  
Thickness Skin ◽  
Concealed Penis ◽  
Split Thickness Skin Grafting ◽  
Good Cosmetic

Introduction: Concealed penis (CP) is a rare problem faced by urologists and plastic surgeons. CP occurs secondary to trauma, obesity, or infection. Surgical treatment is individualized and based on patient and provider variables. We aim to review our recent experience using meshed split-thickness skin grafting (STSG) for CP management.Methods: A retrospective review was performed on patients who underwent STSG for CP at our institution. Records were reviewed for demographic, operative, and postoperative variables. Preoperative and postoperative photos were obtained to monitor cosmetic results.Results: Eleven patients underwent CP release with meshed STSG placement. All cases showed improved functional phallic length and good cosmetic results, regardless of etiology.Conclusions: STSG is a viable option for penile coverage for management of this difficult-to-treat CP population. This primary or salvage modality offers excellent cosmetic results and may be used following prior reconstructive attempts.

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