Minimal incision access for pediatric and adult cochlear implantation

Background Cochlear implant surgery is widely practiced.Minimal incision cochlear implant surgery has been developed with the aims of reducing the impact of surgery on the patient and improving cosmesis while maintaining the low morbidity of conventional wider access approaches.This study aimed to assess the surgical technique and complication rate of minimal incision cochlear implantation （MICI） for children and adults.Methods Data for this study were obtained via a retrospective analysis.Totally 378 patients were included in the study.All patients received minimal incision cochlear implantation,using the skin protector during the process of the operation.The surgical complications of MICI were recorded in a spreadsheet format.The incidence of major and minor complication were analyzed,and appropriate treatment was provided.Results A total of 40 （10.5％） complications were noted in the study.There were 0 life-threatening,9 major,and 31 minor complications.Of the nine major complications,five were device failures,one developed infection and extrusion,and three required receiver-stimulator repositioning.Conclusions MICI is as safe as standard cochlear implantation （SCI） and affords with it other benefits.Eliminating the scalp flap avoids devascularization and minimizes the opportunity of flap infection or necrosis.Complications not related to the flap are similar to SCI.

Comparison of Minimal Skin Incision Technique in Living Kidney Transplantation and Conventional Kidney Transplantation

Background：Recently,the most common incision for kidney transplantation （KT） is an inverted J-shaped incision known as the ＆quot;hockey-stick.＆quot; However,demands for minimally invasive surgery in KT are increasing as in other various fields of surgery.Hence,we evaluated whether there is difference between minimal skin incision technique in kidney transplantation （MIKT） and conventional KT （CKT）.Methods：Between June 2006 and March 2013,a total of 452 living kidney transplant patients were enrolled.The MIKT group included 17 young unmarried women whose body mass index was 〈25 kg/m^2 and had no anatomic variation.The CKT group included 435 patients.The MIKT operation technique restricted to the 10 cm-sized skin incision in the lower right abdomen from laterally below the anterior superior iliac spine to the midline just above the pubis was performed.We compared the baseline clinical characteristics and postoperative results between two groups.For proper comparison,propensity score matching was implemented.Results：There was no difference in graft function,survival,and postoperative complication rate between MIKT and CKT groups （all P 〉 0.05）.The 5-year graft survival was 92.3% and 85.7% in MIKT and CKT groups,respectively （P =0.786）.Conclusions：Our results indicated that MIKT showed more favorable cosmetic results,and there were no statistical differences in various postoperative factors including graft function,survival,and complications compared with CKT.Hence,we suggested that MIKT is an appropriate method for selected patients in living KT.