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1.
Br J Oral Maxillofac Surg ; 59(1): 16-20, 2021 01.
Article in English | MEDLINE | ID: mdl-32620301

ABSTRACT

While a simple interrupted sutured anastomosis remains the gold standard in microsurgery, the introduction of the microanastomotic coupler device (MACD) has decreased procedure time and thrombosis risk, and improved the patency of venous anastomoses. The aim of this review is to update the evidence-based advantages of the MACD on arteries, based on clinical and experimental data, and to compare them to the hand-sewn approach in free flap transfer. All relevant articles that appeared in the PubMed and Medline/Ovid databases during the past three decades were reviewed. After exclusions, 11 studies were retained and discussed. The MACD had a generally shorter arterial anastomosis time, with improved flap survival and reduced ischaemia compared with the hand-sewn approach. The use of the MACD in arterial anastomosis is an efficient and less time-consuming alternative to the hand-sewn technique, provided that the selection of vessels is appropriate and the vessel diameter is large enough to do the anastomosis.


Subject(s)
Free Tissue Flaps , Plastic Surgery Procedures , Anastomosis, Surgical , Arteries/surgery , Humans , Microsurgery , Retrospective Studies
2.
HNO ; 59(3): 261-5, 2011 Mar.
Article in German | MEDLINE | ID: mdl-21424364

ABSTRACT

Transoral robotic surgery (TORS) can be considered an extension of transoral microscopic laser surgery. The microscope is replaced by an endoscope that provides the surgeon with a three-dimensional view of the surgical field. The surgeon operates from a console that controls the arms of the patient cart. These arms hold miniaturized surgical instruments that are transorally inserted into the patient, enabling tumor resection. Exposure is ensured by various mouth gags. The use of various endoscopes (0°, 30°), a work radius of 540° for instruments, and a zoom function provides significant advantages over the common transoral laser techniques. With this article we report our first experience with this technique and believe that it may provide significant advantages. However, thorough clinical testing in Germany is required before conclusions can be drawn.


Subject(s)
Endoscopes , Oral Surgical Procedures/instrumentation , Robotics/instrumentation , Surgery, Computer-Assisted/instrumentation , Equipment Design , Equipment Failure Analysis , Humans , Pilot Projects
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