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Topic Review
Definitions and the Basics of Knot Tying
Surgical knots are sequences of half-knots (H) or half-hitches (S), defined by their number of throws, by an opposite or similar rotation compared with the previous one, and for half-hitches whether they are sliding (s) or blocking (b). Opposite rotation results in (more secure) symmetric (s) knots, similar rotation in asymmetric (a) knots, and changing the active and passive ends has the same effect as changing the rotation. Loop security is the force to keep tissue together after a first half-knot or sliding half-hitches. With polyfilament sutures, H2, H3, SSs, and SSsSsSs have a loop security of 10, 18, 28, and 48 Newton (N), respectively. With monofilament sutures, they are only 7, 16, 18, and 25 N. For knot security, half hitch sequences such as 2 sliding and 2 blocking half hitches are the future: the risk of destabilisation is less, and for monofilament sutures, they are mandatory.   
  • 3.2K
  • 05 Dec 2023
Topic Review
Breast Implant Illness
Breast implant illness refers to a combination of different symptoms related to breast implant surgery, including fatigue, brain fog, and arthralgias. This malaise occurs after cosmetic and reconstructive breast surgeries, although it has not been proven to be a disease. Complications associated with breast implants include breast pain, capsular contracture, infections, as well as other manifestations specific to breast reconstruction. 
  • 2.4K
  • 26 May 2022
Topic Review
Anal Stenosis
Anal stenosis (AS) is defined as anatomical or functional narrowing of the anal canal, which can result from inflammatory bowel diseases, radiation therapy, congenital malformations, or excisional hemorrhoidectomy. The anatomical AS is related to the increased fibrous scar tissue forming, which disables stretching of the anal canal. The leading cause of the anatomical AS is excisional hemorrhoidectomy that is often the chosen treatment for grade III and IV hemorrhoidal disease.
  • 2.3K
  • 18 Apr 2022
Topic Review
Volumetric Muscle Loss
Volumetric muscle loss (VML) is the massive wasting of skeletal muscle tissue due to traumatic events or surgical ablation. This pathological condition exceeds the physiological healing process carried out by the muscle itself, which owns remarkable capacity to restore damages but only when limited in dimensions. Upon VML occurring, the affected area is severely compromised, heavily influencing the affected person’s quality of life. Overall, this condition is often associated with chronic disability, which makes the return to duty of highly specialized professional figures (e.g., military personnel or athletes) almost impossible. The actual treatment for VML is based on surgical conservative treatment followed by physical exercise; nevertheless, the results, in terms of either lost mass and/or functionality recovery, are still poor. On the other hand, the efforts of the scientific community are focusing on reconstructive therapy aiming at muscular tissue void volume replenishment by exploiting biomimetic matrix or artificial tissue implantation. Reconstructing strategies represent a valid option to build new muscular tissue not only to recover damaged muscles, but also to better socket prosthesis in terms of anchorage surfaces and reinnervation substrates for reconstructed mass. 
  • 2.0K
  • 26 May 2021
Topic Review
Intersphincteric Resection for Low Rectal Cancers
Intersphincteric resection is an anus-preserving technique for low rectal cancers described by Schiessel et al. in 1994 as a combination of two techniques: the intersphincteric rectal excision for inflammatory bowel disease and the coloanal anastomosis for low rectal resections.
  • 1.6K
  • 08 Oct 2021
Topic Review
Rex Shunt
Rex shunt, which was first put in use in 1992, has been considered as an ideal surgical method for the treatment of extra-hepatic portal venous obstruction (EHPVO) due to its reconstruction of the hepatopetal portal blood flow. 
  • 1.4K
  • 29 Mar 2022
Topic Review
Pathophysiology and Clinical Assessment of DFI
In the past 30 years, diabetic foot infections (DFI) have become increasingly prevalent due to the rising incidence of diabetes mellitus (DM). Twenty percent of diabetes-related hospital admissions in the U.S. are from DFI, which is typically introduced by direct inoculation through a traumatic entry site in an insensate foot.
  • 1.3K
  • 28 Dec 2021
Topic Review
A Smarter Health through Internet of Surgical Things
To systematically study the technological advances in a particular sector, attributed to the utilization of the Internet, the term “Internet of Things” (IoT) was introduced. The present systematic review, aims to present and analyze the modern applications of the IoT within the surgical world. While not strictly defined, IoT describes a network of Internet-based connected things equipped with (embedded) sensing and actuating devices, with data production, processing, and consumption abilities. The utilization of the Internet and IoT in medical practice can take many shapes and forms. Ranging from the awe-inspiring telesurgical procedures to complex AI machine learning applications that aid in medical decision making , to a simple email containing a preoperative CT scan, the Internet of Surgical Things (IoST) is here to stay. 
  • 1.3K
  • 04 Jul 2022
Topic Review
Lemongrass Essential Oil
Cymbopogon spp. are fast-growing C4 perennial sedges from the grass family Poaceae and are primarily cultivated for their essential oils. The genus lemongrass comprises about 180 species, such as Cymbopogon citratus, Cymbopogon flexuosus, Cymbopogon winterianus, Cymbopogon martinii, Cymbopogon nardus, and Cymbopogon refractus. Lemongrass (Cymbopogonspp.) oil is a cocktail of various terpenes and terpenoids, out of which the major components belong to cyclic and acyclic monoterpenes. The monoterpenes are derived from geranyl diphosphate (GPP).
  • 1.2K
  • 29 Mar 2022
Topic Review
Classification and Diagnosis of Acute Pancreatitis
The pancreas is a glandular organ that is responsible for the proper functioning of the digestive and endocrine systems, and therefore, it affects the condition of the entire body. Consequently, it is important to effectively diagnose and treat diseases of this organ. According to clinicians, pancreatitis—a common disease affecting the pancreas—is one of the most complicated and demanding diseases of the abdomen. The classification of pancreatitis is based on clinical, morphologic, and histologic criteria. Medical doctors distinguish, inter alia, acute pancreatitis (AP), the most common causes of which are gallstone migration and alcohol abuse.
  • 1.2K
  • 30 Aug 2022
Topic Review
Azoospermia
Azoospermia (a-, without + –zoo– » Greek zôion, animal + –spermia– » Greek sperma, sperm/seed) is defined by the absence of sperm in the ejaculate.
  • 1.2K
  • 04 Aug 2021
Topic Review
Differential Diagnosis of Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is the most common median nerve compression neuropathy. Its symptoms and clinical presentation are well known. However, symptoms at median nerve distribution can also be caused by a proximal problem. Pronator syndrome (PS) and anterior interosseous nerve syndrome (AINS) with their typical characteristics have been thought to explain proximal median nerve problems.
  • 1.1K
  • 27 Jul 2022
Topic Review
Complete Mesogastric Excisions Involving Anatomical and Embryological Factors
Surgeries for gastrointestinal tract malignancies are based on the paradigm that we should remove the tumour together with its lymphatic drainage in one block. This concept was initially proposed in rectal surgery and called a total mesorectal excision.
  • 1.1K
  • 03 Dec 2021
Topic Review
Vascularization of the Thyroid Gland
The thyroid gland is a richly vascularized endocrine gland. It is an uneven organ located in a median position in the antero-lower region of the neck, between the fifth cervical vertebra and the first thoracic vertebra.
  • 1.1K
  • 29 Jan 2022
Topic Review
Segmentectomy for Lung Cancer
A lung segmentectomy, a type of sublobar resection, preserves more pulmonary function than is lobectomy. The use of minimally invasive lung segmentectomy for early-stage lung cancer has been increasing. This procedure is associated with technical challenges because (1) it requires a thorough understanding of the complex segmental anatomy that frequently accompanies anomalies, and (2) it is difficult to confirm the location of small tumors during minimally invasive surgery, which makes it difficult to obtain adequate surgical margins. 
  • 1.0K
  • 22 Jul 2021
Topic Review
Oxygen, pH, Lactate, and Metabolism for Wound Treatment
Over time, we have come to recognize a very complex network of physiological changes enabling wound healing. An immunological process allows the body to distinguish damaged cells and begin a cleaning mechanism by separating damaged proteins and cells with matrix metalloproteinases, a complement reaction, and free radicals. A wide variety of cell functions help to rebuild new tissue, dependent on energy provision and oxygen supply. Topically applied lactate can improve this.
  • 1.0K
  • 12 Nov 2021
Topic Review
Transarterial Chemoembolization for Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. It is principally associated with liver cirrhosis and chronic liver disease. The major risk factors for the development of HCC include viral infections (HBV, HCV), alcoholic liver disease (ALD,) and non-alcoholic fatty liver disease (NAFLD). The optimal treatment choice is dictated by multiple variables such as tumor burden, liver function, and patient’s health status. Surgical resection, transplantation, ablation, transarterial chemoembolization (TACE), and systemic therapy are potentially useful treatment strategies. TACE is considered the first-line treatment for patients with intermediate stage HCC. 
  • 976
  • 24 Mar 2022
Topic Review
Extensive Limb Lengthening
Limb lengthening for achondroplasia is controversial. Modern techniques of limb lengthening, using distraction osteogenesis, have been able to add significant length to the lower and upper limbs of children and adults with achondroplasia and hypochondroplasia. The long-term results of these treatments have remained unknown.
  • 968
  • 16 Jul 2021
Topic Review
Popliteal Bypass Surgery
Popliteal bypass surgery, more specifically known as femoral popliteal bypass surgery (FPB) or more generally as lower extremity bypass surgery, is a surgical procedure used to treat diseased leg arteries above or below the knee. It is used as a medical intervention to salvage limbs that are at risk of amputation and to improve walking ability in people with severe intermittent claudication (leg muscle pain) and ischemic rest pain. Popliteal bypass surgery is a common type of peripheral bypass surgery which carries blood from the femoral artery of the thigh to the end of the popliteal artery behind the knee. The femoral artery runs along the thigh and extends to become the popliteal artery which runs posteriorly to the knee joint and femur. Smaller arteries carry blood supply from the popliteal artery to the calf and into the foot. Blockages caused by plaque build-up or atherosclerosis in any of these arteries can reduce leg blood circulation, causing leg pain that may interfere with daily life. Standard Popliteal bypass surgery involves the bypass of the popliteal artery. During surgery, incisions are made depending on the location of the blockage. Usually, a healthy vein is located and sewn above and below the blockage to bypass the narrowed or blocked femoral artery. This allows the blood to be redirected to flow through the new healthy vessel around the blockage. In some cases, synthetic graft materials (such as polytetrafluoroethylene) are used instead of a vein graft.
  • 898
  • 04 Nov 2022
Topic Review
Mirizzi Syndrome
Mirizzi syndrome is a rare condition caused by the compression of the common hepatic duct due to stones located in the cystic duct or the neck of the gallbladder, which causes obstruction of the extrahepatic biliary tract, what is most commonly presented as jaundice and upper abdominal pain. Mirizzi syndrome occurs approximately in 0.05-4% of patients undergiong cholecystectomy. Prolonged inflammation caused by the stones impacted in the cystic duct or the neck of the gallbladder may lead to advanced stages of Mirizzi syndrome and the formation of a cholecystocholedochal fistula or even a cholecystoenteric fistula. Diagnosis is made upon the symptoms, laboratory results and imaging techniques such as ultrasonography, computed tomography, magnetic resonance imaging or endoscopic retrograde choleangiopancreatography (ERCP), which is considered as the golden standard. However, the preoperative diagnosis is difficult and a large part of all cases is diagnosed intraoperatively. Management of Mirizzi syndrome is mostly surgical, but early stages of the syndrome can be treated with the use of ERCP.  
  • 897
  • 17 Sep 2021
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