Search results for "Surgical anatomy"

Anatomy and physiology of cisternostomy

2016

Cisternostomy is defined as opening the basal cisterns to atmospheric pressure. This technique helps to reduce the intracranial pressure in severe head trauma as well as other conditions when the so-called sudden “brain swelling” troubles the surgeon. We elaborated the surgical anatomy of this procedure as well as the proposed physiology of how cisternostomy works. This novel technique may change the current trends in neurosurgery.

Operative Anatomy of the Skull Base: 3D Exploration with a Highly Detailed Interactive Atlas.

2020

Abstract Objective We evaluated the usefulness of a three-dimensional (3D) interactive atlas to illustrate and teach surgical skull base anatomy in a clinical setting. Study Design A highly detailed atlas of the adult human skull base was created from multiple high-resolution magnetic resonance imaging (MRI) and computed tomography (CT) scans of a healthy Caucasian male. It includes the parcellated and labeled bony skull base, intra- and extracranial vasculature, cranial nerves, cerebrum, cerebellum, and brainstem. We are reporting retrospectively on our experiences with employing the atlas for the simulation and teaching of neurosurgical approaches and concepts in a clinical setting. Setti…

Surgical anatomy applied to the international classification of the abdominal wall planes (ICAP) - a video vignette.

2021

Surgical Anatomy of the Rectovaginal Space: Does a Standalone Rectovaginal Septum or Denonvilliers Fascia Exist in Women?

2021

Background Below the anterior peritoneal reflection, the anterior rectal wall and mesorectum are separated from the posterior vaginal wall by a virtual rectovaginal space. In this space, the description of a specific and independent rectovaginal septum as a female counterpart of Denonvilliers fascia has been the subject of debate over the years. Objective The aim of this study is to perform an accurate anatomical study of the rectovaginal area in a cadaveric simulation model of total mesorectal excision to evaluate the possible structures and the dissection planes contained within the rectovaginal space. Design and setting This is a cadaveric study performed at the University of Valencia. P…

The Smith-Robinson Approach to the Subaxial Cervical Spine: A Stepwise Microsurgical Technique Using Volumetric Models From Anatomic Dissections.

2020

BACKGROUND: The Smith-Robinson1 approach (SRA) is the most widely used route to access the anterior cervical spine. Although several authors have described this approach, there is a lack of the stepwise anatomic description of this operative technique. With the advent of new technologies in neuroanatomy education, such as volumetric models (VMs), the understanding of the spatial relation of the different neurovascular structures can be simplified. OBJECTIVE: To describe the anatomy of the SRA through the creation of VMs of anatomic dissections. METHODS: A total of 4 postmortem heads and a cervical replica were used to perform and record the SRA approach to the C4-C5 level. The most relevant…

Microsurgical Anatomy of the Insular Region and Operculoinsular Association Fibers and its Neurosurgical Application

2019

Objective To analyze the three-dimensional relationships of the operculoinsular compartments, using standard hemispheric and white matter fiber dissection and review the anatomy of association fibers related to the operculoinsular compartments of the Sylvian fissure and the main white matter tracts located deep into the insula. The secondary aim of this study was to improve the knowledge on this complex region to safely address tumor, vascular, and epilepsy lesions with an integrated perspective of the topographic and white matter fiber anatomy using 2D and 3D photographs. Methods Six cadaveric hemispheres were dissected. Two were fixed with formalin and the arteries were injected with red …

Laparoscopic Total Mesometrial Resection (L-TMMR)

2017

Abdominal radical hysterectomy and pelvic lymph node dis- section as introduced by Wertheim and Meigs [1–2] first in the beginning of the century is still regarded as “gold stan- dard” in the surgical treatment of the uterine cervix carci- noma, FIGO stages IA2-IB and IIA. The resection of the parametrial and paracervical tissues proposed by the conventional radical hysterectomy is based on a “centrifu- gal diffusion” from the center of the tumor on the direction of the parametrial (dorsal, lateral and ventral) highways. This imply a classic functional and ligament-focused view of the surgical anatomy.

Surgery of the Cranio-Vertebral Junction: Image Guidance, Navigation, and Augmented Reality

2019

Due to the density of essential, small, and mobile structures, mastering the surgical anatomy of the craniovertebral junction may be extremely challenging. Quality and safety of interventions can be improved using navigation. Currently, patient-specific anatomy preparation, surgical planning, intervention, and quality assessment are disconnected actions performed in different conditions and environments and by multiple team members. The whole process needs to be integrated by surgeons performing the intervention. The complexity of the process exposes to errors and degraded precision. It is therefore relevant to develop tools that reduce the need to extrapolate and simplify the information i…

“Near-TME”: proposed standardisation of the technique for proctectomy in male patients with ulcerative colitis

2022

Abstract Background The aim of the present study was to describe in detail an approach to proctectomy in ulcerative colitis (UC), which can be standardized; near-total mesorectal excision (near-TME), to prevent injuries to autonomic pelvic nerves and subsequent sexual dysfunction. Methods We demonstrate the technique ex vivo on a cadaver from a male patient in lithotomy position and on a sagittal section of a male pelvis. We also demonstrate the technique in vivo in two male patients diagnosed with UC, with no history of sexual dysfunction or bowel neoplasia. The study was performed at the Human Embryology and Anatomy Department. University of Valencia, Spain. Results The posterolateral dis…

Simulation of Supralevator Abscesses and Complex Fistulas in Cadavers: Pelvic Dissemination and Drainage Routes

2018

BACKGROUND: Most perianal abscesses have a cryptoglandular origin, following the pathogenesis described by Parks in 1961. Supralevator abscesses have the most uncommon location. Nevertheless, such pathology results in a high morbidity because of their difficult diagnosis and treatment. OBJECTIVE: This study aimed to deepen the knowledge of the pathogenesis and management of supralevator abscesses, as well as the complications derived from incorrect treatment, by using simulation in cadavers. DESIGN: This study is an anatomosurgical description of pelvic and perianal zone and simulation of the different types of supralevator abscesses, their correct drainage routes, and secondary complex fis…