Creating the Successful Global Maxillofacial Surgeon: A 35-Year Perspective.
This article provides valuable information on these issues from three oral and maxillofacial surgeons who have been engaged in global oral and maxillofacial surgery outreach programs for decades. PMID: 32620215 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - July 6, 2020 Category: Surgery Authors: Bertz JE, Ghali GE, Williams TP Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Superficial and Deep Facial Anatomy and Its Implications for Rhytidectomy.
This article details the anatomy of the midface and neck that is essential to understanding and performing the face-lift operation. PMID: 32503712 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Sykes JM, Riedler KL, Cotofana S, Palhazi P Tags: Facial Plast Surg Clin North Am Source Type: research

Subunit Approach to Facelifting and Facial Rejuvenation.
This article discusses using the relationships of the facial anatomic subunits to obtain more consistent and natural facial rejuvenation outcomes. PMID: 32503713 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Azizzadeh B, Fitzgerald R, Massry G, Smith E Tags: Facial Plast Surg Clin North Am Source Type: research

Less Invasive Superficial Musculoaponeurotic System Approaches in Rhytidectomy: How, When, and Why.
Abstract As a facial plastic surgeon gains experience, further improvements can be gained with more aggressive surgery, but complications begin to occur when more aggressive measures are undertaken. Therefore, the ideal technique is one that maximizes rejuvenation while minimizing adverse effects. The senior author has found that the aggressive techniques in the region of the neck have improved dramatically the overall initial and long-term results for the neck portion of the rhytidectomy. More aggressive treatment of the midface during the modified deep plane rhytidectomy does not necessarily improve the overall ...
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Starkman SJ, Mangat DS Tags: Facial Plast Surg Clin North Am Source Type: research

Nuances in Superficial Musculoaponeurotic System Rhytidectomy.
This article describes the nuances of SMAS rhytidectomy, the biplanar SMAS imbrication technique, and adjuvant procedures used. This biplanar SMAS technique has been refined over more than 25 years and has proved to be a reliable and safe technique that leads to high patient satisfaction with minimal complications. PMID: 32503715 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Rousso DE, Adams AS Tags: Facial Plast Surg Clin North Am Source Type: research

Extended Superficial Musculoaponeurotic System Flap Rhytidectomy.
This article reviews rhytidectomy approaches and the current methods and practice patterns of the senior author. It includes a discussion of the extended sub-superficial musculoaponeurotic system rhytidectomy technique, which, in the opinion of the senior author, offers the best result with respect to neck rhytids, cervicomental angle and jawline definition, and improvement of jowling. With its ability to be readily coupled with a deep plane dissection, when indicated, this technique becomes indispensable in the facial plastic surgeon's armamentarium. PMID: 32503716 [PubMed - as supplied by publisher] (Source: The Sur...
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Quatela V, Montague A, Manning JP, Antunes M Tags: Facial Plast Surg Clin North Am Source Type: research

From the Deep-Plane Rhytidectomy to the Vertical Platysma Advancement.
This article provides the facial plastic surgeon with anatomic and embryologic evidence supporting use of the deep-plane technique and understanding the evolution of the technique over decades to the vertical platysma advancement for optimal treatment of facial aging. The original description of the deep-plane rhytidectomy described a basic subsuperficial musculoaponeurotic system dissection in the midface. This plane of dissection provides access to deeper anatomic structures. A detailed description of the procedure is provided to allow safe and consistent performance. Insights into anatomic landmarks, technical nuances, ...
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Gordon NA, Tower JI, Paskhover B Tags: Facial Plast Surg Clin North Am Source Type: research

A Novel Volumizing Extended Deep-Plane Facelift: Using Composite Flap Shifts to Volumize the Midface and Jawline.
Abstract Traditional superficial musculoaponeurotic system (SMAS) facelifting surgery uses a laminar surgical dissection. This approach does not treat areas of facial volume loss, and requires additional volume supplementation with fat grafting or fillers. The novel volumizing extended deep-plane facelift uses a composite approach to the facelift flap. By incorporating a platysma myotomy in the extended deep-plane flap, a novel composite transposition flap can be created that revolumizes the posterior jawline, recreating a defined convex jawline of youth. Special attention is paid to the deep anatomy of the face, ...
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Jacono AA Tags: Facial Plast Surg Clin North Am Source Type: research

Incorporating Midline Platysmaplasty with Lateral Superficial Muscular Aponeurotic System Facelifting.
This article reviews platysmal anatomy, indications for platysmaplasty, preoperative patient assessment, surgical technique for midline platysmaplasty, postoperative management, long-term outcomes, and the senior author's experience and philosophy on midline platysmaplasty in the setting of lateral superficial muscular aponeurotic system facelifting. PMID: 32503719 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Gerecci D, Floyd EM, Perkins SW Tags: Facial Plast Surg Clin North Am Source Type: research

Laser-Assisted Facelifting and Energy-Based Rejuvenation Techniques During Rhytidectomy.
Abstract The use of energy-based devices as surgical tools during rhytidectomy was introduced in early 2007 to 2008 and occurred when the first fiber laser was approved for laser lipolysis. It became evident that the fiber laser-assisted rhytidectomy could offer several advantages compared with conventional rhytidectomy. The use of energy devices now includes temperature-controlled radiofrequency and helium plasma devices. Energy devices continue to offer advantages compared with knife and scissor approaches: improved hemostasis; an ability to dissect into areas without full flap elevation; and the shrink-wrap lat...
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Gentile RD Tags: Facial Plast Surg Clin North Am Source Type: research

Incorporating Fat Grafting with Facelift Surgery: When, How, and Where.
Abstract Facial aging is a multifactorial process with many articles over decades supporting various theories of varying causes. It is generally thought that aging occurs as a combination of changes in skin quality, gravitational descent of tissue with interaction of retaining ligaments on the ptotic tissue, and facial volume loss or the appearance of volume loss. The most significant cause of volume loss is skeletal remodeling and bone loss, which manifests as characteristic shadows and hollows on the face in conjunction with soft tissue changes that are yet to be completely elucidated. PMID: 32503721 [PubMe...
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Buckingham ED, Smith SW Tags: Facial Plast Surg Clin North Am Source Type: research

Local Anesthetic Facelift.
Abstract A thorough medical history is critical in patient selection for local anesthesia facelifting. Patients with no prior issues with dental procedures and no history of significant anxiety are better candidates. Simplifying local anesthesia mixtures and using dilute concentrations will minimize dosing errors and decrease risk of local anesthesia toxicity. Oral anxiolytics can be used with caution to minimize patient anxiety. Pulse oximetry, telemetry, and blood pressure monitoring should be performed with any addition of oral or IV sedation/anxiolytic. The short-scar anterior facelift is ideal for local anest...
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: DeJoseph LM, Pou JD Tags: Facial Plast Surg Clin North Am Source Type: research

Approaches to Reducing Risk in Rhytidectomy Surgery.
This article discusses facelift complications, the causes thereof, and how to assess a problem, manage each complication, and comfort a distraught patient. PMID: 32503723 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Truswell WH Tags: Facial Plast Surg Clin North Am Source Type: research

Face-Lift Surgical Techniques.
PMID: 32503724 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Thomas JR Tags: Facial Plast Surg Clin North Am Source Type: research

Face-Lift Surgical Techniques.
PMID: 32503725 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - June 8, 2020 Category: Surgery Authors: Jacono AA Tags: Facial Plast Surg Clin North Am Source Type: research

Cancer Incidence and Trends.
Abstract The incidence of many types of cancer continues to increase, and despite many successes in the realms of screening, prevention, and treatment, cancer remains the second leading cause of death in North America. Cancer types affecting this population have varied over time, with a trend toward more malignancies caused by modifiable risk factors related to a western lifestyle. Despite the increasing incidence of cancer, a combination of population-based screening and improved therapeutics has made the disease more survivable, and created an ever-increasing community of cancer survivors. These cancer survivors...
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Hulvat MC Tags: Surg Clin North Am Source Type: research

Cancer Genetics.
Abstract For most individuals, cancer development is multifactorial; however, up to 10% of all cancers are related to an inherited genetic mutation. As health care shifts to having a greater emphasis on prevention, care providers, including general surgeons, will need to play a role in identifying patients at high risk for cancer development. Genetic testing provides a tool to determine those patients with a genetic mutation and to whom appropriate preventive care and treatment may be offered. It is imperative for general surgeons to understand the role genetics plays in the care of individual patients and their r...
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Van Cott C Tags: Surg Clin North Am Source Type: research

Esophagus and Gastrointestinal Junction Tumors.
Abstract Esophageal squamous cell carcinoma and adenocarcinoma account for 95% of all esophageal malignancies. The rates of esophageal adenocarcinoma have increased in Western countries, making it the predominant type of esophageal cancer. Treatment of both types of cancer has transformed to a more minimally invasive approach, with endoscopic methods being used for superficial cancers and more frequent use of video-assisted and laparoscopic modalities for locally advanced tumors. The current National Comprehensive Cancer Network guidelines advocate a trimodal approach to treatment, with neoadjuvant chemoradiation ...
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Kurtom S, Kaplan BJ Tags: Surg Clin North Am Source Type: research

Management of Gastric Adenocarcinoma for General Surgeons.
This article reviews pearls and pitfalls of multidisciplinary management of the gastric adenocarcinoma for best outcomes. PMID: 32402298 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Hoshi H Tags: Surg Clin North Am Source Type: research

Primary Liver Cancers: Intrahepatic Cholangiocarcinoma and Hepatocellular Carcinoma.
This article reviews the essential workup and treatment options necessary for general surgeons as they treat patients with primary liver cancers. PMID: 32402299 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Mejia JC, Pasko J Tags: Surg Clin North Am Source Type: research

Cancers Metastatic to the Liver.
Abstract The liver is a common site of metastatic cancer spread, and metastatic lesions are the most common malignant liver tumors. Diagnosis of liver metastases often is established based on clinical assessment, laboratory tests, and appropriate imaging. Surgical resection is the treatment of choice for resectable colorectal and neuroendocrine liver metastases. Long-term survival outcome data after treatment of hepatic metastases of noncolorectal non-neuroendocrine tumors are less robust. The treatment strategy for patients with liver metastases should be determined case by case in a multidisciplinary setting. ...
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Rashidian N, Alseidi A, Kirks RC Tags: Surg Clin North Am Source Type: research

Pancreas Solid Tumors.
This article reviews the classification, clinical presentation, and workup in differentiating solid tumors of the pancreas and serves as an additional tool for general surgeons faced with such a clinical finding, from a surgical oncology perspective. PMID: 32402301 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Younan G Tags: Surg Clin North Am Source Type: research

Pancreas Cystic Lesions.
This article outlines the principles behind the management of pancreatic cystic lesions. We outline what the general surgeon needs to know in managing and triaging these patients. It is our feeling that the general surgeon is often the first line of evaluation of these complex patients and a working knowledge of the different types of cysts is critical to safe care of the patient. PMID: 32402302 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Osman H, Jeyarajah DR Tags: Surg Clin North Am Source Type: research

Peritoneal Cancers and Hyperthermic Intraperitoneal Chemotherapy.
Abstract Cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy is an aggressive, potentially curative approach used to treat locoregional disease associated with primary and secondary malignancies of the peritoneum. It involves resection of all macroscopic disease larger than 2.5 mm, followed by instillation of hyperthermic chemotherapy directly into the peritoneum for higher drug exposure to microscopic disease. In select patients with primary peritoneal mesothelioma, pseudomyxoma peritonei, colorectal adenocarcinoma, appendiceal adenocarcinoma, or ovarian cancer, with no extra-abdomina...
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Pletcher E, Gleeson E, Labow D Tags: Surg Clin North Am Source Type: research

Management of Rectal Cancer.
This article clarifies and simplifies this common clinical problem from the surgical perspective. Treatment of rectal cancer requires an understanding of presenting stage (early or advanced) and location (high or low) to provide oncologic sound treatment decisions. Surgical treatment requires a minimum of 1 cm distal margin, careful clearance of the mesorectum and radial margin using total mesorectal excision technique, and 12 or more regional lymph nodes harvested and analyzed. Appropriate and effective multimodality treatments exist and must be used based on sound guidelines as outlined. PMID: 32402304 [PubMed ...
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Wilkinson N Tags: Surg Clin North Am Source Type: research

Anal Cancer.
This article discusses the most commonly encountered anal canal tumors, the evaluation of these tumors, and their management. The foundation for successful therapy includes timely diagnosis, accurate staging, and routine surveillance. PMID: 32402305 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Young AN, Jacob E, Willauer P, Smucker L, Monzon R, Oceguera L Tags: Surg Clin North Am Source Type: research

Neuroendocrine Tumors of the Pancreatobiliary and Gastrointestinal Tracts.
This article addresses current guidelines for diagnosis and localization of NETs, including somatostatin receptor PET. Updated treatment and outcomes of NETs by primary tumor site are discussed as well as those metastatic to the liver. PMID: 32402306 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Bonds M, Rocha FG Tags: Surg Clin North Am Source Type: research

Soft Tissue Tumors of the Abdomen and Retroperitoneum.
Abstract Soft tissue tumors of the abdomen and retroperitoneum encompass a wide range of benign and malignant neoplasms. Retroperitoneal sarcomas, the most common, are composed of rare malignancies with numerous histiotypes. Surgery remains the cornerstone of treatment and the only curative option for retroperitoneal sarcomas. With histiotype-dependent local and distant recurrences, it is imperative these cases are discussed in a multidisciplinary tumor board setting at specialized sarcoma centers. This review discusses the current evidence for the management of abdominal and retroperitoneal soft tissue tumors, wi...
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Turgeon MK, Cardona K Tags: Surg Clin North Am Source Type: research

Soft Tissue Tumors of the Extremity.
This article focuses on the optimal workup of soft tissue masses including the indications for ultrasound and MRI, as well as use of preoperative core needle biopsy. Current AJCC staging, surgical principles of soft tissue sarcoma management, and data regarding indications for radiation therapy and chemotherapy are reviewed. As up to 50% of patients with soft tissue sarcoma will develop recurrent disease, surgical management of locally recurrent and distant metastatic disease is discussed. PMID: 32402308 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Roland CL Tags: Surg Clin North Am Source Type: research

Foreword.
PMID: 32402309 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Martin RF Tags: Surg Clin North Am Source Type: research

Surgical Oncology for the General Surgeon.
PMID: 32402310 [PubMed - as supplied by publisher] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - May 14, 2020 Category: Surgery Authors: Wilkinson N, Zuckerman R Tags: Surg Clin North Am Source Type: research

Follicular Unit Transplantation.
This article focuses on follicular unit transplantation and performance of the strip technique. PMID: 32312502 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - April 23, 2020 Category: Surgery Authors: Sand JP Tags: Facial Plast Surg Clin North Am Source Type: research

Follicular Unit Excision: Current Practice and Future Developments.
Abstract Hair transplantation, or hair restoration surgery (HRS) remains the only method to consistently restore hair in those experiencing pattern hair loss as well as hair loss from most other causes. HRS has been significantly improved with the development of follicular unit extraction, later renamed follicular unit excision, or FUE. This allows the surgeon to harvest grafts from the donor area without leaving a scar. FUE can also be used to harvest grafts from other areas of the body. When performed properly using the most technically advanced devices, the transection of the grafts with FUE remains under 4%. ...
Source: The Surgical Clinics of North America - April 23, 2020 Category: Surgery Authors: Epstein GK, Epstein J, Nikolic J Tags: Facial Plast Surg Clin North Am Source Type: research

Hair Transplantation for Scarring Alopecia.
This article addresses the challenges posed by scarring alopecia in hair-loss treatment and the evidence-based practices that exist for hair transplantation in scarring alopecia. PMID: 32312504 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - April 23, 2020 Category: Surgery Authors: Kumar AR, Ishii LE Tags: Facial Plast Surg Clin North Am Source Type: research

Platelet-Rich Plasma for Hair Restoration.
Abstract Platelet-rich plasma (PRP) is a promising treatment for hair restoration in patients with androgenic alopecia. Created from a platelet concentrate from an autologous blood draw, PRP is a safe therapeutic option for patients with hair loss. It is used alone or in conjunction with topical and oral therapies. Most studies of hair restoration with PRP report positive outcomes. Further research to optimize PRP preparation/administration procedures and identify patient populations that benefit most from this treatment are needed, as is long-term follow-up of objective hair loss outcomes. PRP appears to be a saf...
Source: The Surgical Clinics of North America - April 23, 2020 Category: Surgery Authors: Justicz N, Derakhshan A, Chen JX, Lee LN Tags: Facial Plast Surg Clin North Am Source Type: research

Robotic Hair Transplantation.
Abstract Contemporary hair transplant surgery creates natural appearing transplanted hair. The procedure is performed as an outpatient under local anesthesia. Donor harvesting can be performed by either elliptical donor harvesting or follicular unit extraction. An experience surgical team is needed for a high-quality, efficient procedure. Robotic hair transplantation allows precise and efficient removal of follicular units. The robot allows for minimally invasive surgery. Robotic hair transplantation is an important tool for hair transplant surgeons, but does not replace appropriate candidate selection, hairline d...
Source: The Surgical Clinics of North America - April 23, 2020 Category: Surgery Authors: Avram MR, Watkins S Tags: Facial Plast Surg Clin North Am Source Type: research

Hairline-Lowering Surgery.
Abstract As an alternative to hair transplantation for lowering the overly high hairline, hairline-lowering/forehead-reduction surgery has several advantages, including unsurpassed density and immediate results. Appropriate candidates for this surgery must have a stable frontal hairline (thus excluding most men) and a fairly to very mobile scalp that will permit sufficient advancement to warrant this more "invasive" approach. The main objective of this surgery is the lowering of the hairline. The authors' surgical approach, which was developed over the performance of more than 90 of these procedures and ...
Source: The Surgical Clinics of North America - April 23, 2020 Category: Surgery Authors: Epstein J, Epstein GK Tags: Facial Plast Surg Clin North Am Source Type: research

Hair Loss and Hair Restoration in Women.
Abstract Hair restoration in women involves mastering both the medical and the surgical treatment. Preoperatively, women should be thoroughly evaluated for biochemical causes of hair loss along with a complete history and physical examination taken. The physician must recognize the clinical presentation of scarring alopecias and maintain a low threshold for biopsy to rule out this condition. Postoperative hair shock loss is a common feature following hair transplant in women, and the surgeon should understand the preoperative counseling and preventative measures needed, the intraoperative methods to reduce the inc...
Source: The Surgical Clinics of North America - April 23, 2020 Category: Surgery Authors: Lam SM Tags: Facial Plast Surg Clin North Am Source Type: research

Complications with Hair Transplantation.
This article discusses potential complications associated with hair restoration surgery, and the roles of the patient and physician in decreasing the risk of complications. PMID: 32312509 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - April 23, 2020 Category: Surgery Authors: Nadimi S Tags: Facial Plast Surg Clin North Am Source Type: research

Beard Hair Transplantation.
Abstract In the field of hair restoration, there has been a significant increase in demand with patients for facial hair transplantation procedures. Modern techniques in hair transplantation allow for facial hair transplantation and for the attainment of natural-appearing results. Facial hair transplantation is a subspecialty within hair restoration with many gratifying benefits for the patients as well as for the hair restoration surgeon. Adapting these advanced techniques into a hair restoration practice allows a surgeon to offer their patients these procedures and provides an expanded artistic element to a hair...
Source: The Surgical Clinics of North America - April 23, 2020 Category: Surgery Authors: Bared A Tags: Facial Plast Surg Clin North Am Source Type: research

Techniques for Hair Restoration.
PMID: 32312511 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - April 23, 2020 Category: Surgery Authors: Thomas JR Tags: Facial Plast Surg Clin North Am Source Type: research

Hair Transplantation: Advances in Diagnostics, Artistry, and Surgical Techniques.
PMID: 32312512 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - April 23, 2020 Category: Surgery Authors: Ishii LE, Lee LN Tags: Facial Plast Surg Clin North Am Source Type: research

Obturation and Tissue Transfer for Large Craniofacial Defects.
This article discusses various factors taken into consideration when deciding on which reconstructive option is ideal for a given patient and defect. For large craniofacial defects, reconstruction using tissue transfer is considered preferentially over obturation, although in select defects obturation using a traditional tooth- or implant-borne prosthetic obturator can be considered a viable option. PMID: 32247438 [PubMed - in process] (Source: The Surgical Clinics of North America)
Source: The Surgical Clinics of North America - April 7, 2020 Category: Surgery Authors: Schmidt CD, Patel SY, Woerner JE, Ghali GE Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Orthodontic Considerations for Cleft Orthognathic Surgery.
Abstract Preparation and planning for orthognathic surgery in late adolescence depends on the complexity of unresolved problems with which the patient presents. Different strategies are presented to address these unresolved problems in the adult patient with cleft lip and palate. Different surgical and orthodontic treatments are presented to correct the class III malocclusion in patients with cleft lip and palate in ranges that are analogous to the envelope of discrepancy. For complex cases, the principles of achievability, stability, and esthetics should guide the decision-making process for planning the preparat...
Source: The Surgical Clinics of North America - April 7, 2020 Category: Surgery Authors: Yen S, Hammoudeh J, Edwards SP, Urata M Tags: Oral Maxillofac Surg Clin North Am Source Type: research

Orthodontic and Surgical Principles for Distraction Osteogenesis in Children with Pierre-Robin Sequence.
Abstract Patients with Pierre-Robin sequence recalcitrant to nonsurgical intervention have historically required tracheostomy. Mandibular distraction provides a predictable alternative to tracheostomy. Orthodontic perioperative interventions should be considered, including overcorrection, placement of temporary anchorage devices, elastics, and molding the regenerate. Mandibular distraction can be technically difficult and may cause complications. Performed correctly, mandibular distraction provides patients with a better quality of life than tracheostomy. PMID: 32247440 [PubMed - in process] (Source: The Surg...
Source: The Surgical Clinics of North America - April 7, 2020 Category: Surgery Authors: Yen S, Gaal A, Smith KS Tags: Oral Maxillofac Surg Clin North Am Source Type: research

History of Computer-Assisted Surgery.
Abstract Robotic surgery is growing rapidly, with more than 5000 units in operation worldwide. The most widely used robotic surgery system originated from the concept of telepresence, which led to government-sponsored research and development. The resulting work was taken over by private industry, which led to Food and Drug Administration clearance of the first systems in 2000 to 2001. Robotic surgery offers significant advantages over open surgery; its most important feature is the introduction of a computer into the operating room, with the resulting potential for data collection and analysis that will shape sur...
Source: The Surgical Clinics of North America - March 16, 2020 Category: Surgery Authors: Ranev D, Teixeira J Tags: Surg Clin North Am Source Type: research

Robotic Cardiac Surgery.
Abstract Robotic minimally invasive direct coronary artery bypass is the most common robotic coronary procedure performed worldwide. It can be used to treat isolated left anterior descending (LAD) stenosis or can be coupled with percutaneous coronary intervention to diseased non-LAD targets in patients with multivessel disease. Virtually all types of mitral valve repair can be performed using the robot; valve replacement can also be undertaken. The robot can be used to repair atrial septal defects and resect cardiac myxoma. Increased cost of the robotic procedure may be offset by fewer perioperative complications,...
Source: The Surgical Clinics of North America - March 16, 2020 Category: Surgery Authors: Hemli JM, Patel NC Tags: Surg Clin North Am Source Type: research

Robotic Thoracic Surgery.
Abstract Minimally invasive surgery for diseases of the chest offsets the morbidity of painful thoracic incisions while allowing for meticulous dissection of major anatomic structures. This benefit translates to improved outcomes and recovery following the surgical management of benign and malignant esophageal pathologic condition, mediastinal tumors, and lung resections. This anatomic region is particularly amenable to a robotic approach given the fixed space and need for complex intracorporeal dissection. As robotic platforms continue to evolve, more complex thoracic surgical interventions will be facilitated, t...
Source: The Surgical Clinics of North America - March 16, 2020 Category: Surgery Authors: Schwartz G, Sancheti M, Blasberg J Tags: Surg Clin North Am Source Type: research

Robotic Foregut Surgery.
Abstract Robotic-assisted surgery for benign esophageal disease is described for treatment of achalasia, gastroesophageal reflux, paraesophageal hernias, epiphrenic diverticula, and benign esophageal masses. Robotic Heller myotomy has operative times, relief of dysphagia, and conversion rates comparable to laparoscopic approach, with lower incidence of intraoperative esophageal perforation. The use of robotic platform for primary antireflux surgery is under evaluation, due to prolonged operative time and increased operative costs, with no differences in postoperative outcomes or hospital stay. Studies have shown b...
Source: The Surgical Clinics of North America - March 16, 2020 Category: Surgery Authors: Damani T, Ballantyne G Tags: Surg Clin North Am Source Type: research

Robotic Liver Resection.
Abstract Robotic surgery has rapidly evolved. It is particularly attractive as an alternative minimally invasive approach in liver surgery because of improvements in visualization and articulated instruments. Limitations include increased operative times and lack of tactile feedback, but these have not been shown in studies. Considerations unique to robotic surgery, including safety protocols, must be put in place and be reviewed at the beginning of every procedure to ensure safety in the event of an emergent conversion. Despite the lack of early adoption by many hepatobiliary surgeons, robotic liver surgery conti...
Source: The Surgical Clinics of North America - March 16, 2020 Category: Surgery Authors: Lafaro KJ, Stewart C, Fong A, Fong Y Tags: Surg Clin North Am Source Type: research