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A finales de 2019 se identificó el virus SARS-CoV-2 (por su significado en inglés Severe Acute Respiratory Syndrome Coronavirus 2) como agente etiológico de la COVID-19 (por su significado en inglés coronavirus disease 2019) en la ciudad de Wuhan, China. Debido a su rápida propagación al resto del mundo durante el primer trimestre del año 2020, la Organización Mundial de la Salud (OMS) la declaró pandemia mundial en marzo del mismo año. Por el potencial de contagio de COVID-19 se ha considerado que el entorno clínico en el que se desenvuelve la odontología puede ser de alto riesgo para el paciente, el odontólogo y sus asistentes si no se tienen las medidas de bioseguridad adecuadas. En un principio se vieron suspendidas las consultas regulares; sin embargo, al volver a la actividad laboral se han adaptado protocolos para el control de infecciones como reforzar el uso de barreras de protección y minimizar tratamientos que involucren aerosoles. La caries es uno de los principales motivos de consulta en la odontología pediátrica, por lo que en este escrito se sugieren algunos protocolos basados en la mínima invasión que prescinden de instrumental rotatorio para salvaguardar al paciente en riesgo de contagio, reduciendo el número de visitas y tiempo en consulta e incluso controlando algunos aspectos de salud bucal fuera de consulta clínica por medio de estrategias preventivas que pueden llevarse a cabo desde casa. Esto significa también mantener la tranquilidad por parte de los tutores del paciente ante la pandemia que se vive actualmente (AU)
At the end of 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified as the etiological agent of COVID-19 in the city of Wuhan China. Due to its rapid spread to the rest of the world during the first trimester of 2020, the WHO declared a global pandemic in March of the same year. Due to the contagion potential of COVID-19, it has been considered that the clinical environment in which dentistry operates may be in high risk for the patient if the appropriate biosafety measures are not taken, initially clinical practices were suspended. However, when returning to work, protocols have been adapted to the infection control procedures, reinforced the use of protective barriers, and minimize treatments that involve aerosols. Caries is one of the main reasons for consultation in Pediatric Dentistry, this article suggests some protocols based on minimal invasion that dispense with rotating instruments to safeguard the patient from the risk of contagion, reducing the number of visits and time in consultation and even controlling some aspects of the oral health outside the dental visit through preventive strategies that can be carried out from home. Modifications to Dental Home. This should include maintaining tranquility and calm on the part of the patient's tutors in the face of the pandemic that we are currently experiencing (AU)
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Humans , Child, Preschool , Child , Coronavirus Infections , Dental Care for Children/methods , Aerosols , Pit and Fissure Sealants , Tooth Remineralization , Clinical Protocols , Fluorides, Topical/therapeutic use , Risk Factors , Composite Resins , Infection Control, Dental/methods , Dental Caries/therapy , Dental Plaque/prevention & control , Dental Atraumatic Restorative TreatmentABSTRACT
OBJECTIVE@#To explore the application of digital positioning guide plate in extraction of impacted supernumerary teeth and evaluate its clinical efficacy.@*METHODS@#From March to August, 2019, 30 patients with labial impacted supernumerary teeth treated in the Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University were enrolled in this study. Fifteen of the patients were treated with digital positioning guide plate to remove the impacted supernumerary teeth (test group). According to the CBCT data and the dentition model of the patients, the positioning guide plate was positioned by avoiding the important anatomical structure with the tooth-bone surface as the support to design the soft tissue incision line and bone tissue exposure range. The other 15 patients who were treated without the use of the guide plate for operation served as the control group. The design time, tooth searching time, operation time and complications were compared between the two groups.@*RESULTS@#The positioning guide plate was well attached during the operation and allowed quick location of the supernumerary teeth while helping to expose the supernumerary teeth and avoid the damage of the adjacent important anatomical structures. The pre-operative design time was 50 ± 5 min in the test group and 0 min in the control group. The average time of tooth finding in the test group was 5±2 min, as compared with 10±3 min in the control group (=15.40, < 0.01); the average time of operation was significantly shorter in the test group than in the control group (25±4 min 45±6 min; =35.50, < 0.01). No intraoperative complications occurred in the test group, and slight deviation occurred in one case in the control group.@*CONCLUSIONS@#The application of digital positioning guide plate in extraction of embedded supernumerary teeth can significantly shorten the time of tooth finding, reduce the difficulty of operation, and improve the quality of operation.
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Humans , Bone Plates , Bone and Bones , Operative Time , Tooth Extraction , Tooth, Impacted , Tooth, SupernumeraryABSTRACT
Introducción: El uso de postes de fibra de vidrio es el método actual más utilizado para la reconstrucción postendodóncica. Sin embargo, su adhesión sigue siendo impredecible debido al control limitado de su técnica de cementación. Las resinas bulk-fill revelan valores de fuerza flexural similares a la dentina y su empleo en la reconstrucción postendodóncica podría ser una alternativa viable y conservadora. Objetivo: Comparar tres técnicas de reconstrucción postendodóncica al medir su resistencia a fuerzas de desalojo, clasificar el tipo de fractura y falla adhesiva, evaluar su costo y tiempo de trabajo. Material y métodos: Se realizan 18 muestras divididas en tres grupos: grupo 1: poste más cemento de un paso, grupo 2: poste más cemento de tres pasos y grupo 3: reconstrucción postendodóncica con resina bulk-fill. Resultados: En la evaluación de la fuerza al desalojo no se encontró diferencia estadísticamente significativa en los tres grupos. Respecto al comportamiento y falla adhesiva, se encontró una diferencia significativa p < 0.001, favoreciendo a los grupos 2 y 3, por su adhesión en la porción radicular. El tipo de fractura fue restaurable para los tres grupos. Respecto al tiempo y costo, fueron significativamente menores para el grupo 3. Conclusión: En nuestro estudio no existió diferencia significativa en la fuerza al desalojo en los tres grupos; sin embargo, la hubo en el comportamiento, falla adhesiva, costo y tiempo, favoreciendo mayormente al grupo 3. La técnica de reconstrucción con resina puede ser una técnica predecible, suficientemente resistente, conservadora, rápida y de menor costo
Introduction: The use of fiberglass posts is the current method most used for post-endodontic reconstruction. However, its adhesion remains unpredictable due to the limited control of its cementing technique. Bulkfill resins reveal values of flexural strength similar to dentin and their use in post-endodontic reconstruction could be a viable and conservative alternative. Objective: Compare three post-endodontic reconstruction techniques by measuring their resistance to eviction forces, classifying the type of fracture and adhesive failure, evaluating their cost and time of work. Material and methods: 18 samples are divided into 3 groups: group 1: post plus cement of 1 step, group 2: post plus cement of 3 steps and group 3: post-endodontic reconstruction with bulk-fill resin. Results: In the evaluation of the force to the eviction, no statistically significant difference was found in the 3 groups. Regarding the behavior and adhesive failure, a significant difference was found p < 0.001, favoring groups 2 and 3, due to its adhesion in the root portion. The type of fracture was restorable for the 3 groups. Regarding time and cost, they were significantly lower for group 3. Conclusion: In our study there was no significant difference in the force to the eviction in the three groups, however there was in the behavior, adhesive failure, cost and time, favoring mainly the group 3. The technique of reconstruction with resin can be a predictable technique, Sufficiently resistant, conservative, fast and of lower cost (AU)
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Post and Core Technique , Composite Resins , Dental Restoration, Permanent , Dental Bonding , Glass , MexicoABSTRACT
Objective To study the clinical value of minimally invasive surgery Mammotome in diagnosing and treating early breast cancer.Methods The clinical data from 41 cases of breast cancer underwent Mammotome from January 2015 to June 2016,were retrospectively analyzed.Results Patients aged 35~50 years old accounted for the highest proportion in patients with breast cancer underwent mini-mally invasive surgery,and patients aged older than 50 years old of age was on the contrary.The incidence of breast cancer in the upper outer quadrant was significantly higher than the other quadrants.The diame-ter of 83% lesions were no more than 20 mm and 85% of all cases had no axilla lymph node metastasis, which suggested that MMT biopsy had advantage of diagnosing early breast cancer.BI-RADS reported as 4a,but MMT biopsy of malignancy accounted for 71%.All cases had no local recurrence and metastasis in 3-months,6-months and 12-months follow-up.Conclusion Mammotome-biopsy not only removes tumors with minimal invasion,but also is good for early diagnosis and therapy of breast cancer.
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The replantation of amputated finger (or limb) and the reconstruction of the thumb and fingers started in 1960s in China. With the development of microsurgical techniques, both finger replantation and reconstruction achieved worldwide significant success. And now it is not the survival rate but the function of replanted finger that attracted more attention. Moreover, the breakthrough of particular type of digital replantation has broadened its indications. In terms of reconstruction, not only that a great deal of experiences in dealing with different types of thumb defects was accumulated, but also more micro-surgeons focus on minimal invasion and reducing the damage to the donor area.
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Image-navigation-assisted positioning and puncturing system is a newly-developed treatment technology in recent years,which carries broad application prospects.It combines image and navigation technology together.Guided by the dynamic real-time imaging the operator can precisely manipulate the surgical instruments to operate on the target lesion,in this way the minimally-invasive interventional therapy can be greatly optimized.The image-guided methods mainly include ultrasound,CT,MR,etc.Based on the principles of different positioning methods,the navigation and positioning technology can be classified into mechanical positioning,optical positioning and electromagnetic positioning.Each image guidance and navigation technology has its own advantages and disadvantages.At present,image-navigation-assisted positioning and puncturing system has already been widely used in various minimally-invasive interventional therapies,such as tumor biopsy,local ablation therapy,radioactive seed implantation,etc.,and satisfactory clinical results have been achieved although in clinical practice they still have some shortcomings.In this paper,the application of this technique in minimally-invasive interventional therapy is briefly reviewed.
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Objective To evaluate the efficacy of percutaneous transforaminal endoscopic discectomy ( PTED) in the treatment of obese patients with lumbar disc herniation (LDH).Methods From February 2015 to January 2017,52 obese patients with lumbar disc herniation who underwent percutaneous endoscopic surgery were included in this study .Comparison of preoperative and postoperative 1 week,3 months, 6 months and 12 months VAS,JOA and modified MacNab criteria were employed to measure the clinical outcome .Complications during and after the operation were recorded to evaluate the safety of surgery .Results All the patients were followed up for 6 to 12 months,average of 8 months.Four patients experienced abnormal sensations in the nerve root exit zone postoperatively ,and disapperaed after 3 days of treatment with dehydratio and administration of hormone .Three cases of recurrence were observed at 3 months,6 months and 7 months postoperatively and were treated by open window discetomy .The postoperative VAS scores were significantly reduced compared to that before the operation , with significant difference(P<0.05).The JOA scores had significantly improved after surgery (P<0.05).In the last follow-up,the clinical effects of modified Macnab criteria were evaluated ,excellent in 16 cases,good in 29,fair in 4 cases,poor in 3 cases,and 86.5％of patients had excellent and good outcomes .Conclusion Percutaneous transforaminal endoscopic discectomy is effective for obese patients with lumbar disc herniation ,which has the advantages of minimally invasive ,less bleeding and quick recovery for the patients .
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Objective To explore the clinical effect of lacrimal endoscope assisted minimally invasive lacrimal duct recanalization combined with silicone tube intubation in the treatment of lacrimal duct obstruction. Methods 3 cases(4 eyes)of the superior canaliculus obstruction,5 cases(6 eyes)of the inferior canaliculus,20 cases (29 eyes) of common canaliculus and 25 cases (36 eyes) of nasolacrimal duct were enrolled. They were randomly divided into two groups:Group A(40 eyes)treated with lacrimal endoscope assisted laser lacrimal forming combined with silicone tube implantation and Group B(36 eyes)with lacrimal endoscope assisted laser lacrimal forming combined with silicone tube implantation. The cases were all followed up for 3-6 months after treatment. Results Except the intraoperative bleeding,there were no significant differences in the incidence of various complications. All the eyes could be recanalized under the aid of lacrimal endoscope. The total effective rates were 87.50% and 91.43% in Group A and B,respectively. The difference was not statistically significant. Conclusion Lacrimal endoscope assisted minimally invasive lacrimal duct recanalization combined with silicone tube intubation is a safe,effective,and minimally invasive method to recanalize the lacrimal obstruction.
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Objective To explore the clinical effect of lacrimal endoscope assisted minimally invasive lacrimal duct recanalization combined with silicone tube intubation in the treatment of lacrimal duct obstruction. Methods 3 cases(4 eyes)of the superior canaliculus obstruction,5 cases(6 eyes)of the inferior canaliculus,20 cases (29 eyes) of common canaliculus and 25 cases (36 eyes) of nasolacrimal duct were enrolled. They were randomly divided into two groups:Group A(40 eyes)treated with lacrimal endoscope assisted laser lacrimal forming combined with silicone tube implantation and Group B(36 eyes)with lacrimal endoscope assisted laser lacrimal forming combined with silicone tube implantation. The cases were all followed up for 3-6 months after treatment. Results Except the intraoperative bleeding,there were no significant differences in the incidence of various complications. All the eyes could be recanalized under the aid of lacrimal endoscope. The total effective rates were 87.50% and 91.43% in Group A and B,respectively. The difference was not statistically significant. Conclusion Lacrimal endoscope assisted minimally invasive lacrimal duct recanalization combined with silicone tube intubation is a safe,effective,and minimally invasive method to recanalize the lacrimal obstruction.
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Tension-free repair for inguinal hernias has been led into China since 1997 and being promoted quick development of hernia and abdominal wall surgery in China,meanwhile,there are still many problems in the recurrence,chronic pain and patch infection due to irregular operations.In order to solve these problems and improve the diagnosis,treatment and research levels of hernia and abdominal wall surgery,surgeons must pay attention to the basic and clinical technologies,quality control and so on.The studies on etiology of hernia will bring innovative therapy,registration system will contribute to summarize the clinical experiences,and establishment and implementation of quality control of hernia could ensure the effects of diagnosis and treatment.However,there is still a controversy about whether laparoscopic technology on inguinal hernias is minimally invasive surgery or not,though it is safe and effective.
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Objective:To evaluate the clinical effects of short fiber ribbon combined with resin bonding technology for the treatment of food impaction between posterior teeth. Methods:98 cases of vertical food impaction between posterior teeth( total of 135 vertical food impaction units) were included. 73 units were treated by short quartz fiber ribbon combined with resin bonding technology( SQFRB) and 63 by resin bonding(RB). 12, 24 and 36 months after restoration, clinical effects were evaluated referring to the Modified United States Public Health Service (USPHS) Criteria, data were statistically analyzed. Results:12, 24 and 36 months after treatment the cure rate of SQFRB was 97. 3%, 97. 3% and 95. 9%, inefficacy rate was 0, 0 and 0;the cure rate of RB was 85. 5%, 82. 2% and 82. 2%, the inefficacy rate was 4. 8%, 11. 3% and 12. 9%, respectively(between groups, P<0. 05). Conclusion:Minimally inva-sive restorations using short fiber ribbon combined with resin bonding technology is effective in the treatment of vertical food impaction between posterior teeth.
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<p><b>OBJECTIVE</b>To investigate the clinical effects of located needle knife in the treatment of trigger finger.</p><p><b>METHODS</b>The clinical data of 133 patients(145 fingers) with trigger finger underwent treatment with located needle knife from September 2010 to March 2014 were retrospectively analyzed. There were 37 males(40 fingers) and 96 females (105 fingers), aged from 18 to 71 years old with a mean of 51.8 years. Course of disease was from 1 to 19 months with an average of 8.2 months. Affected fingers included 82 thumbs, 12 index fingers, 11 middle fingers, 36 ring fingers, and 4 little fingers. According to the standard of Quinnell grade, 42 fingers were grade III, 92 fingers were grade IV, and 11 fingers were grade V. Firstly the double pipe gab was put into the distal edge of hypertrophic tendon sheath, then small knife needle was used to release the sheath proximally along the tendon line direction. The informations of wound healing and nerve injury, postoperative finger function, finger pain at 6 months were observed.</p><p><b>RESULTS</b>The operation time was from 8 to 25 min with an average of 9.8 min. All the patients were followed up from 6 to 26 months with an average of 12.5 months. No complications such as the wound inflammation and seepage, vascular or nerve injuries were found. According to the standard of Quinnell grade, 123 fingers got excellent results, 15 good, 7 poor.</p><p><b>CONCLUSIONS</b>It's a good choice to treat trigger finger with located needle knife in advantage of minimal invasion, simple safe operation, and it should be promoted in clinic.</p>
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Objective To study the feasibility,safety,indications and possible advantages of minimally invasive surgery over traditional open surgery in treating pancreatic body or tail lesions.Methods From December 2009 to December 2014,the clinical data of 71 patients with lesions in pancreatic body or tail who underwent minimally invasive distal pancreatectomy (MIDP) or open distal pancreatectomy (ODP) at the General Surgery of Huadong Hospital were retrospectively analyzed.There were 22 patients in the MIDP group and 49 patients in the ODP group.The operations in 15 patients in the MIDP group were performed by the Da Vinci robot-assisted surgical system and 7 patients by laparoscopic distal pancreatectomy.Results The MIDP group had a shorter time to pass first flatus [(MIDP (2.5 ± 1.0) d vs ODP (3.5 ±1.0)d,P ＜ 0.05],and shorter postoperative hospital stay [(MIDP (15.2 ± 7.9) d vs ODP (23.4 ±21.2) d,P ＜ 0.05] than the ODP group.There were no significant differences on total pancreatic fistula rate [MIDP 45.5％ (10/22) vs ODP 55.1％ (27/49),P ＞ 0.05] and symptomatic postoperative pancreatic fistula rate [MIDP 18.2％ (4/22) vs ODP 18.4％ (9/49),P ＞ 0.05] between the two groups.The MIDP group had a significant longer operative time [MIDP (246.3 ±75.3)min vs ODP (168.1 ±33.7)min,P＜0.05] than the ODP group.Conclusions Minimally invasive surgery is safe and feasible in treatment of lesions in pancreatic body or tail with less trauma and faster recovery.The application of robotic surgery has expanded the treatment options for lesions in pancreatic body or tail.
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Objective To evaluate the clinical application and therapeutic effect of interventional embolization in treating renal pseudoaneurysms. Methods The clinical data of 11 patients with renal pseudoaneurysm, who had received interventional embolization management at authors’ hospital, were retrospectively analyzed. The embolic agents used in the embolization procedure included conventional steel coil, gelatin sponge particles, PVA, etc. All the patients were followed up for 6-24 months. Results Single renal pseudoaneurysm was found in all the 11 patients. Clinically, symptom of bleeding was seen in 3 cases. The renal pseudoaneurysm was located at the upper (n=1), middle (n=4) and lower (n=5) renal artery of the kidney, and in one case the renal pseudoaneurysm was situated at the accessory renal artery. In performing renal artery embolization, pure PVA was used in one case, spring steel coil in one case, PVA together with spring steel coil in one case, and gelatin sponge combined with spring coil in 8 cases. After the embolization, the pseudoaneurysm was no more visualized, the contrast extravasation disappeared, and the parent artery was manifested as a residual root. During the operation the patients had no obvious discomfort. Within one week after embolization therapy, 2 patients developed hemorrhage, and their hemoglobin, white blood cell count and hematocrit were significantly increased. During the follow-up period, all patients showed no recurrence signs, and routine urine tests were normal. Conclusion For the treatment of renal pseudoaneurysms, interventional embolization is minimally-invasive, safe and reliable; this technique can maximally protect the normal kidney tissue, quickly control the bleeding and effectively save the life of patient. Therefore, it is worth promoting this treatment in clinical practice.
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Objective To explore clinical efficacy of percutaneous tiansforaminal endoscopic discectomy on postoperative complications of patients with the protrusion of lumbar intervertebral disc.Methods Sixty cases of lumbar protrusion of the intervertebral disc were selected as our subjects from Nov.2012 to Nov.2013 who were hospitalized in the Seven People's Hospital of Zibo.Of which,30 cases were preformed lumbar protrusion of the intervertebral disc through transforaminal endoscopic treatment.Another 30 case were with small incision fenestration laminectomy discectomy.The information of hospitalized periods,bleeding volume,operation incision length and periods within the bed were collected.Visual analogue scale (VAS) was performed at postoperative 24,48 h.The Oswestry disability index (ODI) was applied to evaluated the daily life ability assessment of patients before surgery,1 month and 6 months after surgery.Results The incision length,intraoperative bleeding volume,postoperative bed and hospitalization periods in patients with transforaminal endoscopic treatment were ((0.7 ± 0.2) cm,(11.6 ± 2.2) ml,(27.5 ± 8.2) d,(3.3 ± 1.1) d respectively,less than that in patients with small incision fenestration laminectomy discectomy ((4.9 ± 0.2) cm,(102.9 ±16.3) ml,(94.1 ±19.7) d,(8.3 ±2.1) d).The differences were significant (t =81.332,30.403,17.095 and 11.552;P＜0.05).VAS in patients with transforaminal endoscopic treatment and in patients with small incision fenestration laminectomy discectomy were (3.7 ± 1.2) and (6.8 ± 1.9),(2.1 ± 1.1) and (5.3 ±1.6),(1.4 ±0.9) and (4.4 ± 1.5) respectively,and the differences were significant(t =7.555,9.026,9.393 ; P ＜ 0.05).The ODI in patients with transforaminal endoscopic treatment at 1 and 6 months after surgery were 12.1 ± 4.7 and 18.6 ± 3.6,higher than that in patients with small incision fenestration laminectomy discectomy(5.4 ± 2.3,13.2 ± 2.7),and the differences were significant (t =6.013,12.045 ; P ＜ 0.05).Conclusion Lumbar percutaneous transforaminal endoscopic discectomy is with obvious superiority than the method of small incision fenestration laminectomy discectomy in terms of the operation incision,intraoperative bleeding volume,postoperative bed and hospitalization time.Meanwhile,it shows the less damage to the spinal stability structure,and quick recovery.
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Objective To investigate and confirm the value of minimal invasion of separation between specific subcutancous layers of rats.Methods Thirty-two male SD rats were randomized into four groups,group 1:normal incision plus separation beneath superficial fascia; group 2:normal incision plus subdermal separation; group 3:normal incision plus extended separation beneath superficial fascia ; group 4:extended incision plus separation beneath superficial fascia.Blood sampling was taken preopeatively,2 h,12 h,24 h and 48 h postoperatively.The increase of serum IL-6 and neutrophil elastase levels were compared between different groups.Results Compared with each other,the increase of serum IL-6 and NE levels in group 1 vs 3 and group 2 vs 4 was not different significantly (P value was 0.074,0.096 and 0.747,0.897,respectively).However,the increase of serum levels in group 1 vs 2,1 vs 4,3 vs 2 and 3 vs 4 was different significantly (P ＜ 0.01).Conclusion Operation of separating beneath superficial fascia plus small skin incision in rats conduces to relatively minimal invasion.
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10.3969/j.issn.2095-4344.2013.26.014
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Objective To summarize the main points of nursing the patients during small incision minimally invasive cardiac surgery.Methods Two hundred and seventy-one patients underwent small incision minimally invasive cardiac surgery during April 2010 and December 2010.The cooperative nursing was performed.Results The patients went well with the operations,with the average extracorporeal circulation time of(117.3±47.1)min and aorta blocking time of(82.6±32.1) min.All of the patients were discharged,without postoperative complications.(6.8±2.6)d.Perioperative and after discharge with no deaths.Postoperative recovery and no postoperative complications,were recovered and discharged without any complications.The postoperative hospital length of stay was(6.8±2.6)d.Conclusions The minimally invasive cardiac surgery is effective and safe.The preoperative health education and intraoperative nursing cooperation are critical for the operative success.
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Minimally invasive surgery is associated with a faster postoperative recovery because of reduced postoperative pain and improved respiratory function, especially in elderly patients. We began using a minimally invasive approach (small parasternal incision) for isolated aortic valve replacement (MICS AVR) from January 2011. Between January 2011 and February 2012, 32 patients underwent MICS AVR surgery. The mean age was 73 years (range 57-85 years) ; 69% were women. MICS AVR was performed through a skin incision of 6.5±0.5 cm along the third intercostal space. Cardiopulmonary bypass was established through the right femoral artery and vein. The patients were cooled to 28°C, the aorta was crossclamped with a flex clamp, and antegrade cardioplegic solution was given into the aortic root or selectively into the coronary ostia. The aortic valve procedure was performed in a standard fashion. If the distance to the aortic valve was too far, we used surgical instruments for minimally invasive surgery. Conversion to a conventional approach was not necessary in any patient. Mean overall operative time was 250±49 min, cardiopulmonary bypass 140±34 min, and crossclamp time 99±22 min. Mean ICU stay was 1.2±0.5 days and length of hospital stay was 10.3±2.2 days. There was no re-operation for bleeding or surgical site infection. MICS AVR was safe and feasible with excellent outcome. The advantages of this procedure include reduced bed rest, decreased postoperative pain, avoidance of deep sternal wound infection, and cosmetically attractive results. We now use the minimally invasive approach whenever possible. We report an early outcome, experience, strategy, and surgical technique.
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The concept of minimally invasive surgery is adopted in the diagnosis and treatment of biliary diseases,while during the process,the biological function of the sphincter of Oddi is ignored,and blind expansion of indications of endoscopic sphincterotomy (EST) severely affected the function of the sphincter of Oddi.In this condition,protection of the sphincter of Oddi should be attached great importance.Proper selection of diagnosis method,strictly control of the indications of EST,timely repair the injured sphincter of Oddi are important for a better prognosis of patients with biliary diseases with preservation of the function of the sphincter of Oddi.