• Publication type
• Overall MeSH

BACKGROUND AND AIMS: Gastric restriction techniques have recently emerged as minimally invasive bariatric procedures. Endoscopic sutured gastroplasty (ESG) with the Endomina (Endo Tools Therapeutics, Gosselies, Belgium) triangulation platform proved to be safe and effective for the treatment of class I and II obesity in prospective studies. In this registry, we aimed to further assess on a larger scale the safety and efficacy of the procedure in routine practice with a dedicated device. METHODS: This was a multicenter, observational, prospective post-market study including patients with obesity undergoing Endomina ESG. The primary safety outcome was the occurrence of serious adverse device effects (SADEs) at 12 months. The primary efficacy outcome was the technical success defined by completing the procedure without premature abortion owing to technical issues. The rates of procedure-related adverse events, weight loss outcomes, and quality of life changes were collected. RESULTS: A total of 142 patients underwent ESG in 3 centers from July 2020 to March 2023. Of these, 67 (mean body mass index, 38.5 ± 6.3 kg/m2) reached at least 12 months of follow-up up to October 2022. Technical success was 100%. No SADEs occurred. Seven mild procedure-related adverse events were reported overall. Mean percentage of excess weight loss and total body weight loss at 12 months' follow-up were 48.5% ± 38.6 and 15.3% ± 10.6, respectively (n = 67). Improved quality of life was observed following ESG. CONCLUSIONS: ESG is safe and effective, thus offering a satisfactory therapeutic option for a wide range of obese patients on a large scale.

• MeSH
• Adult MeSH
• Gastroplasty * methods   adverse effects   MeSH
• Gastroscopy methods   MeSH
• Weight Loss MeSH
• Quality of Life MeSH
• Middle Aged MeSH
• Humans MeSH
• Obesity, Morbid surgery   MeSH
• Obesity surgery   complications   MeSH
• Postoperative Complications MeSH
• Product Surveillance, Postmarketing * MeSH
• Prospective Studies MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH

BACKGROUND: Minimally invasive surgery may be further advanced with the novel biofragmentable magnetic anastomosis compression system. Two magnets may be swallowed, or placed by flexible endoscopy, in a side-to-side magnetic jejuno-ileostomy (MagJI) bipartition for weight and type 2 diabetes (T2D) reduction. MagJI markedly reduces the major complications of enterotomy, stapling/suturing, and retained foreign materials. METHODS: This was a prospective first-in-human investigation of feasibility, safety, and preliminary efficacy in adults with body mass index (BMI, kg/m2) ≥ 30.0- ≤ 40.0. After serial introduction via swallowing or endoscopy, linear magnets were laparoscopically guided to the distal ileum and proximal jejunum where they were aligned. Magnets fused over 7-21 days forming jejuno-ileostomy. PRIMARY ENDPOINTS: feasibility and severe adverse event (SAEs) incidence (Clavien-Dindo grade); secondary endpoints: weight, T2D reduction. RESULTS: Between 3-1 - 2024 and 6-30 - 2024, nine patients (mean BMI 37.3 ± 1.1) with T2D (all on T2D medications; mean HbA1C 7.1 ± 0.2%, glucose 144.8 ± 14.3 mg/dL) underwent MagJI. Mean procedure time: both magnets swallowed, 86.7 ± 6.3 min; one magnet swallowed with second delivered endoscopically, 113.3 ± 17.0 min. Ninety-day feasibility confirmed in 100.0%: 0.0% bleeding, leakage, infection, mortality. Most AEs grade I-II; no SAEs. At 6-month radiologic confirmation, all anastomoses were patent. Excess weight loss 17.5 ± 2.8 kg; mean BMI reduction 2.2 ± 0.3, HbA1C 6.1 ± 0.1% (p < 0.01), glucose 115.5 ± 6.5 mg/dL (p = 0.19); 83.0% dropped below 6.5% HbA1C and had markedly reduced anti-T2D medications. CONCLUSIONS: The swallowable, biofragmentable magnetic anastomosis system appeared to be feasible and safe in achieving incisionless, sutureless jejuno-ileostomy. The first-in-human MagJI procedure may offer minimally complicated anastomosis creation and moderate MBS weight loss and T2D reduction.

• MeSH
• Anastomosis, Surgical methods   MeSH
• Diabetes Mellitus, Type 2 * surgery   MeSH
• Adult MeSH
• Weight Loss MeSH
• Ileum * surgery   MeSH
• Body Mass Index MeSH
• Jejunostomy * methods   instrumentation   MeSH
• Jejunum * surgery   MeSH
• Laparoscopy methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetics MeSH
• Magnets * MeSH
• Prospective Studies MeSH
• Feasibility Studies MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Aim: To present on video our current most used technique of robot-assisted resection of renal tumour (RR). Material: We performed 274 RRs between June 2020 and November 2024. Our technique is based on a modification of conventional laparoscopic renal resection, of which we performed 599 between August 2004 and May 2020. RRs currently account for over one third of the surgical procedures for kidney cancer at our institution. Laparoscopic (rarely robotic assisted) nephrectomy is almost as frequent. Open resection accounts for about 17% and open nephrectomy for slightly less. Open resections are mainly indicated for more complex tumours, for tumors with significant \"toxic\" fat capsule, and when combined with other procedures, mostly for intestinal malignancies. RR is routinely performed by two console surgeons, occasionally by two additional ones. Operation technique: General anaesthesia. Optional urinary catheter inserted. Lateral position 60-70°. Upper limbs extended in front, close together. Operative field prepared for eventual lumbotomy. Transperitoneal approach. The capnoperitoneum is created with a Veres needle, CO2 pressure 12 mmHg. Assist port 12 mm slightly lateral to the umbilicus. Four 8-mm robotic ports are inserted pararectally under visual control. Four-arm daVinci Xi robotic system is inserted. Ports craniocaudally: 1. ProGrasp, 2. bipolar grasper (bipolar forceps Maryland or more often fenestrated) or monopolar curved scissors (Hot shears) according to the operated side and the dominant hand of the operator, 3. camera 30°, 4. the second of the mentioned instruments from port 2. The scissors are alternated with a needle driver, usually the Large SutureCut needle driver. In the Toldt line, the peritoneum is opened, the colon is retracted medially, and the Gerota fascia is opened medially from the kidney. The necessary part of the kidney is dissected from the fat capsule for good access to the tumour. The tumour is verified sonographically with a drop-in probe inserted through the assistant port. Scissors can be used to mark the line of resection on the kidney. The ureter is verified and the hilar vessels are released. The artery(s) or necessary branch is bypassed with tubing and clamped with the SCANLAN® robotic endo-bulldog. Only in central tumours is the vein also clamped. Knowledge of the topographic anatomy of the vessels from two-phase CT angiography is very helpful at this stage. The effectiveness of ischemia is verified by Doppler; exceptionally (especially in selective clamping of the artery branches) by NIR imaging with FireFly® with administration of indocyanine green - Verdye® 1.25-2.5 mg. The tumour is resected with cold scissors with a rim of healthy tissue. Suturing of the base is performed with an absorbable self-anchoring barbed suture (V-Loc® 90, size 3-0, 1/2 needle 26 mm). The edges of the kidney are mattress sutured with another suture, tightened with Absolok® AP300 absorbable clips (polydioxanone PDS, size ML) - \"sliding clips\" technique. The second layer of the parenchyma is sewn with simple continuation stitches, mostly without continuous anchoring. For more superficial tumours, a straight suture of the parenchyma is

• MeSH
• Laparoscopy MeSH
• Humans MeSH
• Kidney Neoplasms * surgery   MeSH
• Nephrectomy MeSH
• Robotic Surgical Procedures methods   MeSH
• Check Tag
• Humans MeSH

Cíl: Představit naši současnou techniku mini málně invazivní nefropexe. Řídíme se daty vychá- zejícími z klinických studií nižší kvality doporučujících laparoskopickou techniku sutury ledvinného pouzdra na konvexitě ledviny. Materiál, metody: Indikací k operaci jsou symptomatické pacientky s prokázanou nefroptózou při radiologických vyšetřeních (hlavně IVU). Od 12/2004 do 4/2024 byla provedena nefropexe u 37 žen. U 34 na pravé straně, dvakrát na obou stranách a jednou na levé. Prvních 34 bylo laparoskopických a poslední 3 asistované robotem. Již dříve jsme publikovali laparoskopický postup včetně sledování a hodnocení účinnosti metody. Pravostranná laparoskopická nefropexe byla dvakrát kombinována s resekční pyeloplastikou. Laparoskopická technika: Poloha na boku, ev. močový katétr. Pneumoperitoneum je vytvořeno Veresovou jehlou, tlak CO2 12 mm Hg. Desetimilimetrový port pro kameru přes pupek a další dva pracovní porty (5 a 3 mm). V Toldtově linii se otevírá pobřišnice. Uvolní se laterální část ledviny a přilehlá břišní stěna. Ledvina je fixována k břišnímu transverzálnímu svalu třemi nebo čtyřmi samostatnými otáčkami dlouhodobě vstřebatelným/nevstřebatelným samokotvovacím ostnatým stehem (V-Loc® 180 nebo nevstřebatelný, velikost 2-0, jehla 1/2 26 mm). V prvních 15 případech byly použity tři jednotlivé nevstřebatelné ProlenTM stehy. Peritoneální defekt se uzavře pokračujícím ostnatým vstřebatelným stehem V-Loc® 90. Stehy se zavedou přes trokar 10 mm a extrahují stejným způsobem nebo ihned přes břišní stěnu s předchozím narovnáním jehly. Není použit drén. Pacientka je tři dny v klidu na lůžku. Doporučujeme vyhýbat se skákání, jízdě na koni atd. po dobu dvou měsíců. Roboticky asistovaná technika je podobná: Systém daVinci Xi, tři ramena v poloze V (kamera 30° v pupku), porty 8 mm – nůžky/jehelec, bipolární graper Maryland. Výsledky: Laparoskopická skupina: Průměrný věk 36,9 ± 13,9 (20,0 až 65,1) let. Průměrný BMI 22,3 ± 2,8 (17,3 až 27,9). Průměrná doba operace na jedné straně výkonu 59,2 ± 17,0 (35 až 100), oboustranných výkonů (včetně rotace pacienta) 155 a 150 minut. Všechny výkony byly bez krevních ztrát a předoperačních a pooperačních komplikací. V letech 2022–2024 byly provedeny 3 roboticky asistované nefropexe u žen. Věk 47, 48 a 34 let, BMI 20, 21 a 23, doba operace 32, 31 a 36 min. Závěr: Laparoskopická/roboticky asistovaná transperitoneální nefropexe s fixací konvexity ledviny pokračujícím samokotvícím ostnatým stehem je standardem chirurgické léčby nefroptózy na našem pracovišti. Doporučuje se pečlivá disekce a pečlivé uvolnění břišní stěny umožňující bezpečné sešití bez poškození nervů břišní stěny. Robotická varianta se zdá být jednodušší (zejména šití) a rychlejší. Vzhledem k relativní vzácnosti takové operace budou dlouhodobé výsledky u větší skupiny pacientů dosažitelné pouze v multicentrické studii.

To present our contemporary technique of minimally invasive nephropexy. We follow data based on clinical studies of lower quality recommending the laparoscopic technique of suturing of a renal capsule at the convexity of kidney. Material, methods: Indications for surgery are symptomatic patients with proven nephroptosis on radiological examinations (mainly IVU). From 12/2004 until 4/2024, nephropexy was performed on 37 women. In 34 on the right side, two times on both sides and once on the left. The first 34 were laparoscopic and the last 3 robot-assisted. We have previously published the laparoscopic procedure, including monitoring and evaluating the effectiveness of the method. The right side laparoscopic nephropexy was twice combined with dismembered pyeloplasty. The laparoscopic technique: Flank position, eventually urinary catheter. Pneumoperitoneum is created with a Veres needle, the pressure of CO2 12 mm Hg. Ten mm port for the camera through the umbilicus and further two working ports (5 and 3 mm). The peritoneum is opened in Toldt's line. The lateral part of the kidney and the adjacent abdominal wall are cleaned. The kidney is fixed to the abdominal transversal muscle with three or four separate revolutions with long--term absorbable/non-absorbable self-anchoring barbed stitch (V-Loc® 180 or Non-absorbable, size 2-0, needle 1/2 26 mm). In the first 15 cases, three non-absorbable stitches ProlenTM were used. The peritoneal defect is closed with a running barbed absorbable suture V-Loc® 90. The stitches are introduced through the trocar 10 mm and extracted in the same way or immediately through the abdominal wall with the previous straightening of the needle. No drain is placed. The patient is on bed rest for three days. We recommend avoiding jumping, horse-riding etc. for two months. The robot-assisted technique is similar: System daVinci Xi, three arms in V position (camera 30° in umbilicus), ports 8 mm - scissors/needle driver, bipolar grasper Maryland. Results: Laparoscopic group: Mean age 36.9 ± 13.9 (20.0 to 65.1) years. Mean BMI 22.3 ± 2.8 (17.3 to 27.9). The mean time of operation on one side procedure 59.2 ± 17.0 (35 to 100), bilateral procedures (including rotation of patient) 155 and 150 minutes. All procedures were without blood loss and peroperative and postoperative complications. In 2022-4, 3 robot-assisted nephropexis in women were performed. Age 47, 48 and 34 years, BMI 20, 21, and 23, time of surgery 32, 31, and 36 min. Conclusion: Laparoscopic /robot-assisted transperitoneal nephropexy with fixation of convexity of the kidney with running self-anchoring barbed stitch is the standard of surgical treatment of nephroptosis at our department. Meticulous dissection and careful liberation of the abdominal wall enabling safe suturing without damage to nerves of the abdominal wall is recommended. The robotic variant seems to be easier (especially suturing) and faster. Due to relatively rarity of such surgery, long term results in a bigger group of patients will be only achievable in a multicentre trial.

• Keywords
• nefropexe, Nefroptóza,
• MeSH
• Kidney * surgery   pathology   MeSH
• Humans MeSH
• Robotic Surgical Procedures * methods   MeSH
• Suture Techniques MeSH
• Urologic Surgical Procedures methods   MeSH
• Check Tag
• Humans MeSH

Úvod a cíl: Rychlá maxilární expanze (RME) je léčebná metoda sloužící k rozšíření horního zubního oblouku a horní čelisti v oblasti patrového švu. Méně diskutovaným efektem tohoto terapeutického postupu jsou změny v dolní čelisti a v oblasti temporomandibulárního kloubu (TMK). Cílem tohoto přehledu je shrnout současné poznatky o změnách na dolním zubním oblouku, dolní čelisti a v oblasti TMK u pacientů s jednostranným zkříženým skusem (UPCB) po léčbě pomocí RME, které byly publikovány ve 49 vybraných odborných článcích. Metodika: V databázích PubMed/Medline, Scopus a Embase bylo provedeno vyhledávání a průzkum literatury na základě použití klíčových slov „RME“, „jednostranný zkřížený skus“, „mandibula“, „TMK“, „dentální, dentoalveolární a skeletální změny“ a „rostoucí pacient“. Kritériem výběru byly průřezové studie, prospektivní a retrospektivní klinické studie, randomizované kontrolované studie a systematické přehledy publikované v anglickém jazyce v letech 1999 až 2023. Výsledky: Kritéria pro zařazení splňovalo 49 publikací, z nichž deset bylo systematickým přehledem. Největší statisticky prokazatelné změny na mandibule u pacientů s UPCB na straně zkříženého skusu jsou v délce mandibuly, celkové výšce ramus mandibulae, ve výšce kondylů a v jejich pozici ve fossa glenoidalis. Byly použity různé vyšetřovací metody. Při analýze modelů se větší část studií ztotožnila s výsledky, které poukazují na obecné tendence rozšiřování dolní čelisti v mezimolárové vzdálenosti. Závěr: Většina dostupných studií se zabývá asymetrickým růstem obličejového skeletu. Souvislost mezi jednostranným zkříženým skusem a asymetrií skeletu není dosud dostatečně popsána. V literatuře existuje na téma změn na skeletu mandibuly po RME malé množství kvalitních studií se statisticky a klinicky významnými výsledky. Jsou zapotřebí další výzkumy s větší velikostí vzorku, přesně definovanými diagnostickými kritérii, přísnými vědeckými metodikami a dlouhodobou kontrolou.

Introduction, aim: Rapid Maxillary Expansion (RME) is a treatment method used to expand the maxillary arch and maxillary palatal suture. A less discussed effect of this therapeutic procedure are changes in the mandible and temporomandibular joint (TMJ) region. The aim of this review is to summarize the current published findings of changes in the mandible and TMJ region in patients with unilateral posterior crossbite (UPCB) after treatment with RME. Methods: PubMed/Medline, Scopus, and Embase databases were used for literature search and screening employing the keywords "RME", "unilateral crossbite", "mandible", "TMJ", "dental, dentoalveolar and skeletal changes" and "growing patient". The selected articles were cross-sectional studies, prospective and retrospective clinical trials, randomized controlled trials, and systematic reviews published in English between 1999 and 2023. Results: Forty nine publications met the inclusion criteria, of which 10 were systematic reviews. The largest statistically demonstrable changes in the mandibles of patients with UPCB on the crossbite side were in mandibular length, total height of the ramus mandibulae, condyle height, and condyle position in the fossa glenoidalis using different examination methods. In the analysis of the plaster casts, the majority of the studies agreed with the results of the general tendency of the mandibular expansion in the intermolar distance. Conclusion: Most of the available studies deal with asymmetric skeletal growth. The relationship between unilateral crossbite and skeletal asymmetry is not yet sufficiently described. There is a small number of good quality studies in the literature on the topic of mandibular skeletal changes after RME with statistically and clinically significant results. Further studies with larger sample sizes, well-defined diagnostic criteria, rigorous scientific methodologies and long-term follow-up are needed.

• MeSH
• Facial Asymmetry pathology   therapy   MeSH
• Cephalometry methods   MeSH
• Humans MeSH
• Malocclusion diagnostic imaging   pathology   therapy   MeSH
• Mandible * anatomy & histology   diagnostic imaging   pathology   MeSH
• Cone-Beam Computed Tomography MeSH
• Radiography, Panoramic MeSH
• Radiography, Dental MeSH
• Palatal Expansion Technique * classification   methods   MeSH
• Temporomandibular Joint pathology   MeSH
• Imaging, Three-Dimensional MeSH
• Dental Arch diagnostic imaging   pathology   MeSH
• Dental Casting Technique MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Systematic Review MeSH

Úvod: Metod provedení uretrovezikální anastomózy při roboticky asistované radikální prostatektomii je celá řada, přičemž neexistují data z prospektivních randomizovaných studií preferovat jednu konkrétní techniku. Cílem videa je prezentovat techniku užívanou na pracovišti hlavního autora práce. Popis metodiky: V Trendelenburgově poloze je provedena trans- či extraperitoneální antegrádní radikální prostatektomie robotickým systémem DaVinci Xi s optikou 30° – prostata je oddělena od hrdla močového měchýře a dorzálně od nervově cévních svazků. Operaci na videu provádí pravák. Video začíná přerušením Santorinského plexu a uretry v jejích 5/6 obvodu nůžkami, vlevo dorzálně je uretra ponechána, aby nedošlo k její retrakci kaudálně do pánevního dna. Krvácející Santorinský plexus je obšit pokračovacím samokotvícím stehem Stratafix® Monocryl 3-0 a vlákno pro další použití ponecháno v dutině břišní fixované jehlou k přední stěně břišní. Na neretrahovanou uretru je na č. 5 naložen druhý identický steh. Pomocí stříhacího jehelce (Larger SutureCut needle driver) je dopřerušena uretra. Následuje uretrovezikální anastomóza bez podpůrné rekonstrukce m. levator ani. Jsou provedeny tři otáčky bez napětí na č. 5–8 a teprve poté je steh postupně dotažen. Je dokončena anastomóza na č. 8–12, ventrálně je k uretře do stehu zavzat i pahýl Santorinského plexu. Anastomóza je došita zbytkem prvního stehu od č. 5 směrem ventrálním až na č. 12. Jehly obou stehů jsou odstřiženy a oba konce samokotvících stehů ještě svázány. Komentář k technice: Metodika je používána přes 10 let u více než 2 000 případů s uspokojivými funkčními výsledky, v kvalitní studii však výsledky zpracované nejsou. Zadní rekonstrukci rutinně neprovádíme, je to dáno i historicky, kdy ani u otevřených výkonů jsme to neprováděli a neměli jsme častější komplikace stran kontinence moči. Zadní podpůrnou rekonstrukci provádíme pouze zcela výjimečně, kdy je po odstranění prostaty velký distanční defekt a v tomto případě je naším záměrem redukce napětí následně prováděné anastomózy. Vlastní přerušení uretry u apexu prostaty provádíme se snahou o maximální zachování puboprostatických ligament, hlavně jejich distálních vláken, které jdou i do venkovního svazku. Následným zavzetím této oblasti do sutury provádíme určitou rekonstrukci závěsného aparátu do hrdla močového měchýře a nedochází k poklesu této oblasti. Tuto přední–horní rekonstrukci pokládáme za fyziologičtější, než provádět rutinně zadní podpůrnou rekonstrukci. Naše funkční výsledky, včetně ekonomických aspektů nás nenutí měnit naši strategii používanou již více jak 10 let. Závěr: Video prezentuje jednu z možných variant uretrovezikální anastomózy při roboticky asistované radikální prostatektomii.

Introduction: There are many methods of performing a urethrovesical anastomosis during robot assisted radical prostatectomy, while there are no data from prospective randomized studies to prefer one specific technique. The aim of this video is to present the technique used at the workplace of the main author of this work. Methodology description: A trans- or extraperitoneal antegrade radical prostatectomy is performed in the Trendelenburg position with the DaVinci Xi robotic system - the prostate is separated from the bladder neck and dorsally from the neurovascular bundles. The operation in the video is performed by a right-handed surgeon. The video begins by cutting the Santorini plexus and the urethra in its 5/6 circumference with scissors, the urethra is left dorsally to prevent its retraction caudally into the pelvic floor. The bleeding Santorini plexus is sutured with a Stratafix® Monocryl 3-0 continuation self-anchoring suture, and the thread is left in the abdominal cavity fixed with a needle to the anterior abdominal wall for further use. A second identical suture is placed on the non-retracted urethra at no. 5. Using a cutting needle (Larger SutureCut needle driver) the urethra is interrupted. This is followed by a urethrovesical anastomosis without supporting reconstruction of the levator ani muscle. Three thread turns are made without tension on No. 5-8 and only then the stitch is gradually tightened. The anastomosis at No. 8-12 is completed, and the stump of the Santorini plexus is sutured ventral to the urethra. The anastomosis is closed with the remainder of the first suture from No. 5 in the ventral direction to No. 12. The needles of both sutures are cut and both ends of the self-anchoring sutures are still tied. Comment on the technique: The methodology has been used for over 10 years in more than 2,000 cases with satisfactory functional results, but the results have not been analysed in a high quality study. We do not routinely perform posterior reconstruction, this is also a given historically, when we did not perform it even in open procedures and we did not have more frequent complications of urinary continence. We perform posterior supportive reconstruction only very exceptionally when there is a large spacer defect after removal of the prostate, and in this case our intention is to reduce the tension of the subsequent anastomosis. We perform the actual interruption of the urethra at the apex of the prostate with an effort to preserve the puboprostatic ligaments as much as possible, especially their distal fibres, which also go into the external bundle. By subsequently taking this area into a suture, we carry out a certain reconstruction of the suspension apparatus in the neck of the bladder and there is no decrease in this area. We consider this front-upper reconstruction to be more physiological than performing a routine posterior support reconstruction. Our functional results, including economic aspects, have not forced us to change our strategy for more than 10 years. Conclusion: The video presents one of the possible variants of urethrovesical anastomosis during robotic-assisted radical prostatectomy.

• Keywords
• uretrovesical anastomosis,
• MeSH
• Video Recording MeSH
• Humans MeSH
• Prostatectomy methods   MeSH
• Robotic Surgical Procedures classification   methods   MeSH
• Transurethral Resection of Prostate * methods   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

PRCIS: Deep sclerectomy (DS) with fibrin adhesive can constitute a safe alternative to the classic procedure using sutures, providing nonallergenic, nontoxic, and secure adhesion with no sign of aqueous humor outflow obstruction postoperatively. OBJECTIVE: To evaluate short and medium-term postoperative results of DS with a fibrin sealant. PATIENTS AND METHODS: This prospective, noncomparative, interventional case series involves 12 eyes of 12 patients with uncontrolled open angle glaucoma who underwent DS with Esnoper (Clip or V2000) implant between February 2021 and March 2022. A novel method of wound closure (sclera, Tenon fascia, and conjunctiva) employing fibrin glue was used instead of classic sutures. Surgical outcomes assessed include: intraocular pressure and glaucoma therapy reduction, best-corrected visual acuity changes, and number of complications registered peri and postoperatively. All measurements were performed preoperatively, as well as at 1 day, at 1 and 2 weeks, and at 1, 2, 3, 6, 9, and 12 months after surgery. RESULTS: The mean intraocular pressure decreased from 24.0 ± 9.1 mm Hg to 13.8 ± 6.3 mm Hg at 1 year postoperatively ( P < 0.001). Kaplan-Meier survival analysis revealed complete and qualified success rates of 83.3% and 91.7%. The mean glaucoma therapy decreased from 3.2 ± 1.1 to 0.8 ± 1.3 drugs 12 months after surgery ( P < 0.001). Nd:YAG goniopunture was performed in 2 eyes at 1 and 12 months postoperatively. No significant best-corrected visual acuity changes were registered. Perioperatively, we noted a trabeculo-descemet microperforation in 1 eye, transient hypotony in 5 eyes, and mild hyphema in 2 eyes. CONCLUSIONS: Fibrin adhesive provided an effective closure in sutureless DS in the patients included in our study. This modification of classical DS may simplify the surgical technique, ensure secure wound adaptation, optimize healing, and lower the risk of inflammation and fibrosis postoperatively.

• MeSH
• Sutureless Surgical Procedures * methods   MeSH
• Glaucoma Drainage Implants MeSH
• Fibrin Tissue Adhesive * therapeutic use   MeSH
• Glaucoma, Open-Angle * surgery   physiopathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Intraocular Pressure * physiology   MeSH
• Prospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Sclera * surgery   MeSH
• Sclerostomy * methods   MeSH
• Tissue Adhesives * therapeutic use   MeSH
• Tonometry, Ocular MeSH
• Treatment Outcome MeSH
• Visual Acuity * physiology   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Úvod: Práca sa zaoberá manažmentom pacienta s rázštepom pery a podnebia od prenatálneho po pooperačné obdobie na pracovisku ORL oddelenia Detskej fakultnej nemocnice Košice. Pojednávame o racionálnom plánovaní jednotlivých chirurgických výkonov s ohľadom na anestéziologické zázemie. Metodika: V práci sú retrospektívne zhodnotené štatistické údaje súboru 70 pacientov operovaných pre rázštep pery a 74 pacientov pre rázštep podnebia v období rokov 2015–2021. Sledovanými parametrami bol počet pacientov v jednotlivých skupinách, vek v čase operácie, pomer pohlaví, výskyt patológie vzhľadom na stranu postihnutia a typ operačného výkonu. Výsledky sú porovnané s údajmi z literatúry. Výsledky: Pre jednostranný rázštep pery bolo operovaných 54 pacientov, pre obojstranný rázštep 16 pacientov. V tomto súbore pacientov sme pozorovali najčastejšie ľavostranný rázštep pery a podnebia – 38 pacientov. Autori preferujú včasnú intervenciu v prípade rázštepu pery, pričom pri jednostrannom rázštepe využívajú techniku podľa Millarda najmä pre jej univerzálnosť. Pri obojstrannom rázštepe uprednostňujú techniku podľa Blacka. Do mesiaca je operovaných 55 % pacientov pre jednostranný aj obojstranný rázštep pery. Pacienti s rázštepom podnebia sú operovaní v 78 % do roka dvojlalokovou plastikou podľa Bardacha, najčastejšie v období 7.–9. mesiaca. Záver: Pacienti s rázštepom pery a podnebia zvyčajne počas života podstúpia viacero chirurgických výkonov, a preto je dôležité racionálne plánovanie a redukovať počet celkových anestézií spájaním výkonov. Pre zabezpečenie komplexnej starostlivosti o pacientov s rázštepom pery a podnebia je nutná medziodborová spolupráca.

Introduction: The paper deals with the management of patients with cleft lip and patients with cleft lip and palate since prenatal to postoperative period at ENT department of the Children‘s University Hospital in Košice. We discuss reasonable planning of surgical procedures with respect to anaesthetic care. Methods: We retrospectively analysed the clinical data of 144 patients. We performed a primary lip suture in a group of 70 patients and 74 patients underwent palatoplasty since 2015 to 2021. We evaluated a number of patients in different groups, age of patients in a time of surgery, gender ratio, occurrence of pathology and a type of surgery method. We compare our results with literature. Results: A group of 54 patients had primary lip suture for unilateral cleft lip and 16 patients for bilateral cleft lip. We noticed left cleft lip and palate as the most often pathology – 38 patients. The authors prefer early intervention in the case of cleft lip, while in the case of unilateral cleft lip they use the technique according to Millard mainly because of its universality. In the case of a bilateral cleft, they prefer the technique according to Black. Within a month, 55% of patients are operated on for unilateral and bilateral cleft lip. 78% of patients with cleft palate are operated on within a year with two-lobe plastic surgery according to Bardach, most often in the period 7–9 month. Conclusion: Patients with cleft lip and cleft lip and palate usually undergo multiple surgeries during their lifetime. Reasonable planning and reduction the number of general anaesthesia by combining procedures is important. Multidisciplinary collaboration is necessary to ensure comprehensive care.

• MeSH
• Infant MeSH
• Humans MeSH
• Disease Management MeSH
• Infant, Newborn MeSH
• Palate abnormalities   surgery   pathology   MeSH
• Lip abnormalities   surgery   pathology   MeSH
• Retrospective Studies MeSH
• Cleft Palate surgery   pathology   MeSH
• Cleft Lip * surgery   pathology   MeSH
• Congenital Abnormalities surgery   classification   MeSH
• Plastic Surgery Procedures methods   MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Infant, Newborn MeSH

• MeSH
• Amputation, Surgical classification   MeSH
• Surgical Wound classification   MeSH
• Surgical Flaps classification   MeSH
• Surgical Procedures, Operative * classification   methods   MeSH
• Drainage classification   methods   instrumentation   MeSH
• Injections classification   instrumentation   adverse effects   MeSH
• Urinary Catheterization nursing   instrumentation   MeSH
• Blood Loss, Surgical nursing   MeSH
• Humans MeSH
• Punctures classification   methods   instrumentation   MeSH
• Suture Techniques classification   MeSH
• Transplantation classification   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH