AIM:To explore a simple and low-cost self-made disposable flexible iris retractor and study its clinical efficacy and safety in small pupil phacoemulsification.METHODS:Polyproplyenesutureandscalpacupuncture were used ...AIM:To explore a simple and low-cost self-made disposable flexible iris retractor and study its clinical efficacy and safety in small pupil phacoemulsification.METHODS:Polyproplyenesutureandscalpacupuncture were used to make iris retractor.A prospective study were carried on 50 patients(50 eyes)with a maximally dilated pupil size of 2.5-4.0 mm which underwent phacoemulsification using this self-made iris retractor.Another 50 cases of phacoemulsification with normal pupil size sever as control group.The mean operation time,ultrasound time and ultrasonic power,volume of irrigation fluid were documented intraoperatively.The visual acuity,pupil size and complication were observed on 1d,1wk,1mo and 1y after operation.Corneal endothelial cell was measured at 1mo postoperatively.·RESULT:Pupils could be expanded to approximately4.5-5.5 mm with our self-made iris retractor in operation.No serious postoperative complication was found.Most(88%)of the pupils returned round or oval shape,light reflex restored to varying degrees at the first day after surgery.Best corrected visual acuity stabilized in 37 eyes(74%)at one day,in 43 eyes(86%)at one week,in 44eyes(88%)at one month and 46 eyes(92%)at one year.Compared with the control,more time was needed to complete the operation in the small pupil group.There was no significant difference of the mean ultrasound time,ultrasonic power,volume of irrigation fluid requiredand corneal endothelial cell loss in 1mo follow up between the two groups.CONCLUSION:Our self-made disposable flexible iris retractor could be easy obtained preoperatively or intraoperatively.It performed both safety and efficacy in our clinical trials.This simple self-made device has shown economic and practical values,especially in primary care hospital of the less developed districts.展开更多
Objective: The aim of this study was to improve muscle flaps and to evaluate surgical outcomes with the use of a novel specialized retractor, which is a surgical instrument used to locate and shape a bony seat for min...Objective: The aim of this study was to improve muscle flaps and to evaluate surgical outcomes with the use of a novel specialized retractor, which is a surgical instrument used to locate and shape a bony seat for minimally invasive cochlear implantation.Methods: 50 patients aged 1 e75 years with sensorineural hearing loss who required cochlear implantation were recruited. A small incision(<3 cm) was made, and the novel specialized retractor was used in the study group during cochlear implantation. The incision length, surgical outcomes and operative time were recorded and analyzed.Results: The incision length, total operative time and drilling bony time were shorter in the study group than in the control group(P < 0.05, respectively). All patients recovered well after the surgery without any severe complications.Conclusion: The use of a novel specialized retractor standardized the surgical processes of cochlear implantation. The retractor helped locate and control the size of the bony well during bone drilling. The tool reduced the technical difficulty and improved the efficacy of this minimally invasive operation.展开更多
BACKGROUND Phimosis is one of the most common diseases in children.Early selection of appropriate treatment for phimosis in children is beneficial to the development of their reproductive organs and significantly impr...BACKGROUND Phimosis is one of the most common diseases in children.Early selection of appropriate treatment for phimosis in children is beneficial to the development of their reproductive organs and significantly improves the prognosis of phimosis in children.Although traditional circumcision is the most widely used,it has many disadvantages,including postoperative bleeding and incision infection,pain,obvious scars on the surgical incision,and unsatisfactory appearance.In addition,there is much contro-versy regarding treatment options and timing at home and abroad.Surgical procedures such as circumcision and cerclage for children with excessively long foreskin will greatly affect the normal life of children after the operation.Young children need general anesthesia,but this anesthesia carries a great risk.AIM To design a new children phimosis dilatation retractor for children phimosis.METHODS The children phimosis was dilated with an elastic dilation frame,in order to expand the foreskin mouth and expose the penis head,and after that,the phimosis was cured.RESULTS A new type of phimosis dilatation retractor was designed,which can gently dilate the prepuce at multiple angles and in multiple directions at the same time.It has obtained the national patent for clinical application.CONCLUSION The phimosis dilatation retractor based on the principle of elastically expanding the prepuce can achieve the purpose of expanding the phimosis.The clinical application shows that the effect of the children phimosis retractor is significant,which is worth promoting.展开更多
Direct anterior approach (DAA) for total hip arthroplasty (THA) is a minimally invasive technique. In this approach, two assistants are necessary. We developed a retractor holding device called “Spider arm” to repla...Direct anterior approach (DAA) for total hip arthroplasty (THA) is a minimally invasive technique. In this approach, two assistants are necessary. We developed a retractor holding device called “Spider arm” to replace an assistant in the contra-lateral side. In this study, we investigated the usefulness of Spider arm in THA through direct anterior approach. 20 hips were operated without Spider arm and 21 hips were operated with Spider arm. The surgery time and the blood loss were compared. The cup position and leg length discrepancy were measured on radiography. There was no statistical significance between two groups in all parameters. No clinical complications were reported. With Spider arm, DAA-THA could be performed by two surgeons without deterioration of the surgery time and blood loss. The accuracy of cup position and leg length discrepancy was not affected. Spider arm can contribute to reducing the manpower in DAA-THA.展开更多
In recent years, a variety of minimally invasive lumbar surgery techniques have achieved desirable efficacy, but some dispute remains regarding the advantages over open surgery. This study aimed to compare minimally i...In recent years, a variety of minimally invasive lumbar surgery techniques have achieved desirable efficacy, but some dispute remains regarding the advantages over open surgery. This study aimed to compare minimally invasive lumbar interbody fusion via MAST Quadrant retractor with open surgery in terms of perioperative factors, postoperative back muscle function, and 24-month postoperative follow-up results. Methods From September 2006 to June 2008, patients with single-level degenerative lumbar spine disease who were not responsive to conservative treatment were enrolled in this study. Patients were randomized to undergo either minimally invasive surgery （MIS, transforaminal lumbar interbody fusion via MAST Quadrant retractor, 41 cases） or open surgery （improved transforaminal lumbar interbody fusion, 38 cases）. Results The MIS group had longer intraoperative fluoroscopy time than the open surgery group, and the open surgery group had significantly increased postoperative drainage volume and significantly prolonged postoperative recovery time compared with the MIS group （P 〈0.05 for all）. MRI scanning showed that the T2 relaxation time in the multifidus muscle was significantly shorter in the MIS group than in the open surgery group at 3 months after surgery （P 〈0.01）. Surface electromyography of the sacrospinalis muscle showed that the average discharge amplitude and frequency were significantly higher in the MIS group than in the open surgery group （P 〈0.01）. The Oswestry disability index and visual analog scale scores were better at 3, 6, 12 and 24 months postoperatively than preoperatively in both groups. Both groups of patients met the imaging convergence criteria at the last follow-up. Conclusions MIS can effectively reduce sacrospinalis muscle injury compared with open surgery, which is conducive to early functional recovery. In the short term, MIS is superior to open surgery, but in the long term there is no significant difference between the two procedures.展开更多
This study compares the safety and efficiency of two techniques in microendoscopic discectomy(MED)for lumbar disc herniation.The two techniques are MED with automatic nerve retractor and MED with nerve hook which had ...This study compares the safety and efficiency of two techniques in microendoscopic discectomy(MED)for lumbar disc herniation.The two techniques are MED with automatic nerve retractor and MED with nerve hook which had been widely used for many years.The former involves a newly developed MED device which contains three parts to protect nerve roots during operation.Four hundred and twenty-eight patients underwent MED treatments between October 2010 and September 2015 were recruited and randomized to either intraoperative utilization of automatic nerve retractor(n紏315,group A)or application of nerve hook during surgery(n=113,group B).Operation time and intraoperative bleeding volume were evaluated.Simultaneously,Visual Analogue Scales(VAS)and muscle strength grading were performed preoperatively,and 1,2,3 days,1,2 weeks,3 and 6 months postoperatively.No dramatic difference of pain intensity was observed between the two groups before surgery and 6 months after surgery(P>0.05).The operation time was shorter in group A(30.3061.89 min)than that in group B(59.4163.25 min).Group A(67.83613.14 ml)experienced a significant decrease in the amount of blood loss volume when compared with group B(100.04615.10 ml).There were remarkable differences of VAS score and muscle strength grading after postoperative 1,2,3 days,1,2 weeks and 3 months between both groups(P≤0.05).MED with automatic nerve retractor effectively shortened operation time,decreased the amount of bleeding,down-regulated the incidence of nerve traction injury.展开更多
目的探讨长骨牵开器在弹性髓内钉治疗儿童股骨干骨折中的应用效果。方法采用长骨牵开器辅助复位弹性髓内钉治疗15例儿童股骨干骨折。记录手术情况、骨折愈合情况、关节活动度及并发症发生情况,根据Flynn et al提出的下肢骨折评分标准评...目的探讨长骨牵开器在弹性髓内钉治疗儿童股骨干骨折中的应用效果。方法采用长骨牵开器辅助复位弹性髓内钉治疗15例儿童股骨干骨折。记录手术情况、骨折愈合情况、关节活动度及并发症发生情况,根据Flynn et al提出的下肢骨折评分标准评估疗效。结果手术时间31~65 min,术中出血量5~15 ml,术中透视7~15次,住院时间2~6 d。术中无血管神经以及肌肉牵拉伤,牵拉置入斯氏针处无骨折以及渗出感染。患儿均获得随访,时间5~18个月。骨折均愈合,时间9~18周。末次随访时,患儿均可下地完全负重行走,无跛行,内固定无失效断裂,下地负重后无大腿疼痛、局部压痛以及纵向叩击痛;髋关节屈曲130°~135°,膝关节伸直0°~5°、屈曲120°~140°;根据Flynn et al提出的下肢骨折评分标准评估疗效:优13例,良2例。结论弹性髓内钉治疗儿童股骨干骨折中采用长骨牵开器辅助复位操作简便,复位质量可靠,同时能维持骨折断端复位,方便弹性髓内钉的置入,疗效较好。展开更多
文摘AIM:To explore a simple and low-cost self-made disposable flexible iris retractor and study its clinical efficacy and safety in small pupil phacoemulsification.METHODS:Polyproplyenesutureandscalpacupuncture were used to make iris retractor.A prospective study were carried on 50 patients(50 eyes)with a maximally dilated pupil size of 2.5-4.0 mm which underwent phacoemulsification using this self-made iris retractor.Another 50 cases of phacoemulsification with normal pupil size sever as control group.The mean operation time,ultrasound time and ultrasonic power,volume of irrigation fluid were documented intraoperatively.The visual acuity,pupil size and complication were observed on 1d,1wk,1mo and 1y after operation.Corneal endothelial cell was measured at 1mo postoperatively.·RESULT:Pupils could be expanded to approximately4.5-5.5 mm with our self-made iris retractor in operation.No serious postoperative complication was found.Most(88%)of the pupils returned round or oval shape,light reflex restored to varying degrees at the first day after surgery.Best corrected visual acuity stabilized in 37 eyes(74%)at one day,in 43 eyes(86%)at one week,in 44eyes(88%)at one month and 46 eyes(92%)at one year.Compared with the control,more time was needed to complete the operation in the small pupil group.There was no significant difference of the mean ultrasound time,ultrasonic power,volume of irrigation fluid requiredand corneal endothelial cell loss in 1mo follow up between the two groups.CONCLUSION:Our self-made disposable flexible iris retractor could be easy obtained preoperatively or intraoperatively.It performed both safety and efficacy in our clinical trials.This simple self-made device has shown economic and practical values,especially in primary care hospital of the less developed districts.
基金supported by the Special Funds for National Excellent Doctoral Dissertation of Higher Education from the Ministry of Education (Project Number: 2007B67)the National Major Research Project (2014CB943003)
文摘Objective: The aim of this study was to improve muscle flaps and to evaluate surgical outcomes with the use of a novel specialized retractor, which is a surgical instrument used to locate and shape a bony seat for minimally invasive cochlear implantation.Methods: 50 patients aged 1 e75 years with sensorineural hearing loss who required cochlear implantation were recruited. A small incision(<3 cm) was made, and the novel specialized retractor was used in the study group during cochlear implantation. The incision length, surgical outcomes and operative time were recorded and analyzed.Results: The incision length, total operative time and drilling bony time were shorter in the study group than in the control group(P < 0.05, respectively). All patients recovered well after the surgery without any severe complications.Conclusion: The use of a novel specialized retractor standardized the surgical processes of cochlear implantation. The retractor helped locate and control the size of the bony well during bone drilling. The tool reduced the technical difficulty and improved the efficacy of this minimally invasive operation.
文摘BACKGROUND Phimosis is one of the most common diseases in children.Early selection of appropriate treatment for phimosis in children is beneficial to the development of their reproductive organs and significantly improves the prognosis of phimosis in children.Although traditional circumcision is the most widely used,it has many disadvantages,including postoperative bleeding and incision infection,pain,obvious scars on the surgical incision,and unsatisfactory appearance.In addition,there is much contro-versy regarding treatment options and timing at home and abroad.Surgical procedures such as circumcision and cerclage for children with excessively long foreskin will greatly affect the normal life of children after the operation.Young children need general anesthesia,but this anesthesia carries a great risk.AIM To design a new children phimosis dilatation retractor for children phimosis.METHODS The children phimosis was dilated with an elastic dilation frame,in order to expand the foreskin mouth and expose the penis head,and after that,the phimosis was cured.RESULTS A new type of phimosis dilatation retractor was designed,which can gently dilate the prepuce at multiple angles and in multiple directions at the same time.It has obtained the national patent for clinical application.CONCLUSION The phimosis dilatation retractor based on the principle of elastically expanding the prepuce can achieve the purpose of expanding the phimosis.The clinical application shows that the effect of the children phimosis retractor is significant,which is worth promoting.
文摘Direct anterior approach (DAA) for total hip arthroplasty (THA) is a minimally invasive technique. In this approach, two assistants are necessary. We developed a retractor holding device called “Spider arm” to replace an assistant in the contra-lateral side. In this study, we investigated the usefulness of Spider arm in THA through direct anterior approach. 20 hips were operated without Spider arm and 21 hips were operated with Spider arm. The surgery time and the blood loss were compared. The cup position and leg length discrepancy were measured on radiography. There was no statistical significance between two groups in all parameters. No clinical complications were reported. With Spider arm, DAA-THA could be performed by two surgeons without deterioration of the surgery time and blood loss. The accuracy of cup position and leg length discrepancy was not affected. Spider arm can contribute to reducing the manpower in DAA-THA.
文摘In recent years, a variety of minimally invasive lumbar surgery techniques have achieved desirable efficacy, but some dispute remains regarding the advantages over open surgery. This study aimed to compare minimally invasive lumbar interbody fusion via MAST Quadrant retractor with open surgery in terms of perioperative factors, postoperative back muscle function, and 24-month postoperative follow-up results. Methods From September 2006 to June 2008, patients with single-level degenerative lumbar spine disease who were not responsive to conservative treatment were enrolled in this study. Patients were randomized to undergo either minimally invasive surgery （MIS, transforaminal lumbar interbody fusion via MAST Quadrant retractor, 41 cases） or open surgery （improved transforaminal lumbar interbody fusion, 38 cases）. Results The MIS group had longer intraoperative fluoroscopy time than the open surgery group, and the open surgery group had significantly increased postoperative drainage volume and significantly prolonged postoperative recovery time compared with the MIS group （P 〈0.05 for all）. MRI scanning showed that the T2 relaxation time in the multifidus muscle was significantly shorter in the MIS group than in the open surgery group at 3 months after surgery （P 〈0.01）. Surface electromyography of the sacrospinalis muscle showed that the average discharge amplitude and frequency were significantly higher in the MIS group than in the open surgery group （P 〈0.01）. The Oswestry disability index and visual analog scale scores were better at 3, 6, 12 and 24 months postoperatively than preoperatively in both groups. Both groups of patients met the imaging convergence criteria at the last follow-up. Conclusions MIS can effectively reduce sacrospinalis muscle injury compared with open surgery, which is conducive to early functional recovery. In the short term, MIS is superior to open surgery, but in the long term there is no significant difference between the two procedures.
基金This work was in part supported by National Natural Science Foundation of China,No.81260287by Regional Natural Science Foundation of Inner Mongolia of China,No.2014MS0855.
文摘This study compares the safety and efficiency of two techniques in microendoscopic discectomy(MED)for lumbar disc herniation.The two techniques are MED with automatic nerve retractor and MED with nerve hook which had been widely used for many years.The former involves a newly developed MED device which contains three parts to protect nerve roots during operation.Four hundred and twenty-eight patients underwent MED treatments between October 2010 and September 2015 were recruited and randomized to either intraoperative utilization of automatic nerve retractor(n紏315,group A)or application of nerve hook during surgery(n=113,group B).Operation time and intraoperative bleeding volume were evaluated.Simultaneously,Visual Analogue Scales(VAS)and muscle strength grading were performed preoperatively,and 1,2,3 days,1,2 weeks,3 and 6 months postoperatively.No dramatic difference of pain intensity was observed between the two groups before surgery and 6 months after surgery(P>0.05).The operation time was shorter in group A(30.3061.89 min)than that in group B(59.4163.25 min).Group A(67.83613.14 ml)experienced a significant decrease in the amount of blood loss volume when compared with group B(100.04615.10 ml).There were remarkable differences of VAS score and muscle strength grading after postoperative 1,2,3 days,1,2 weeks and 3 months between both groups(P≤0.05).MED with automatic nerve retractor effectively shortened operation time,decreased the amount of bleeding,down-regulated the incidence of nerve traction injury.
文摘目的探讨长骨牵开器在弹性髓内钉治疗儿童股骨干骨折中的应用效果。方法采用长骨牵开器辅助复位弹性髓内钉治疗15例儿童股骨干骨折。记录手术情况、骨折愈合情况、关节活动度及并发症发生情况,根据Flynn et al提出的下肢骨折评分标准评估疗效。结果手术时间31~65 min,术中出血量5~15 ml,术中透视7~15次,住院时间2~6 d。术中无血管神经以及肌肉牵拉伤,牵拉置入斯氏针处无骨折以及渗出感染。患儿均获得随访,时间5~18个月。骨折均愈合,时间9~18周。末次随访时,患儿均可下地完全负重行走,无跛行,内固定无失效断裂,下地负重后无大腿疼痛、局部压痛以及纵向叩击痛;髋关节屈曲130°~135°,膝关节伸直0°~5°、屈曲120°~140°;根据Flynn et al提出的下肢骨折评分标准评估疗效:优13例,良2例。结论弹性髓内钉治疗儿童股骨干骨折中采用长骨牵开器辅助复位操作简便,复位质量可靠,同时能维持骨折断端复位,方便弹性髓内钉的置入,疗效较好。
