Implementation Strategies and Ergonomic Factors in Robot-assisted Microsurgery.

Robot-assisted surgery represents a significant innovation in reconstructive microsurgery, providing enhanced precision and reduced surgeon fatigue. This study examines the integration of robotic assistance in a series of 85 consecutive robot-assisted microsurgical (RAMS) operations. It aims to evaluate changes in the integration of RAMS during the implementation phase in a single institution.

Robot-assisted microsurgery: a single-center experience of 100 cases.

The adoption of robot-assisted microsurgery (RAMS) is a cutting-edge advancement in the realm of microsurgery. The Symani Surgical System is CE approved and has recently gained FDA approval. It provides tremor elimination, motion scaling and improved ergonomics.

Hands-On Robotic Microsurgery: Robotic-Assisted Free Flap Reconstruction of the Upper Extremity.

: Robot-assisted microsurgery (RAMS) has been introduced into the field of plastic surgery in recent years. It potentially offers enhanced precision and control compared to traditional methods, which is crucial for complex microvascular tasks in free flap reconstructions. We aim to analyze our experiences with robotic-assisted microsurgery in the field of upper extremity free flap reconstruction.

Ergonomic Considerations in Robotic-assisted Microsurgery.

Objective: Microsurgery necessitates precision and skill, with conventional methods often leading to surgeon discomfort due to prolonged static postures. The introduction of robot-assisted microsurgery using the Symani surgical system and a three-dimensional exoscope aims to enhance surgical precision while mitigating these ergonomic issues.

Methods: This prospective, single-center clinical study involved 50 preclinical training sessions and 87 robot-assisted microsurgical procedures at the authors' institution, covering a wide array of interventions from free flap reconstructions to nerve and lymphatic surgeries.

[Free medial sural artery perforator flap for reconstruction of hand defects].

Objective: Defect reconstruction of the hand by means of the free medial sural artery perforator (MSAP) flap.

Indications: Reconstruction of full-thickness defects on the hand with a thin non-bulky flap in cases of exposure of functional structures or in combination with simultaneous osteosynthetic procedures.

Contraindications: Prior surgery at the donor site or progressive peripheral artery occlusive disease.

A single-center retrospective comparison of muscle versus cutaneous free flaps for posterior elbow defect reconstruction.

Introduction: Comparative data on free flap outcomes for elbow defect reconstruction are still lacking. This study aimed to compare complication rates of free muscle flaps (MFs) versus cutaneous flaps (CFs) for posterior elbow reconstruction.

Methods: In a single-center retrospective analysis, patients who underwent posterior elbow reconstruction with free MFs and CFs from 2000 to 2021 were analyzed.

The free vastus lateralis-And conjoined vastus lateralis anterolateral thigh/tensor fascia lata flap for oncological chest wall reconstruction.

Introduction: A reconstructive option for extensive chest wall reconstruction is the free myocutaneous vastus lateralis muscle (VL) flap which can be performed in isolation or in conjunction with a fasciocutaneus anterolateral thigh (cVLALT) and/or myofasciocutaneous tensor fascia lata flap (cVLTFL). We aimed to directly compare the outcomes of these reconstructive options.

Methods: Patients who underwent oncological chest wall reconstruction with a free VL, cVLALT, or cVLTFL flap between February 2010 and 2022 were included in this retrospective study.

[Modern concepts of interdisciplinary extremity reconstruction in open fractures].

The orthoplastic approach involves the collaboration of orthopedic/trauma surgeons, vascular surgeons and reconstructive microsurgeons. In cases of complex limb fractures, the aims are to optimize blood flow, restore bone stability, reconstruct soft tissue defects, and enhance function and sensitivity. The early administration of antibiotics and a timely, high-quality debridement after initial interdisciplinary assessment are carried out.

The Application of a Synthetic Biodegradable Temporizing Matrix in Extensive Burn Injury: A Unicenter Experience of 175 Cases.

: Addressing extensive and deep burn wounds poses considerable challenges for both patients and surgeons. The NovoSorb Biodegradable Temporizing Matrix (BTM) emerged as a novel dermal substitute and has been subjected to evaluation in large burn wound cases, with a specific focus on identifying risk factors associated with suboptimal take rates. : All patients with burn wounds greater than 10% body surface that underwent BTM treatment between March 2020 and November 2023 were eligible for inclusion.

Negative pressure wound therapy in burns: a prospective, randomized-controlled trial.

Background: Negative-pressure-wound-therapy (NPWT) has become a widely used tool for the coverage and active treatment of complex wounds, including burns. This study aimed to evaluate the effectiveness of NPWT in acute burns of upper and lower extremities and to compare results to the standard-of-care (SOC) at our institution.

Methods: Patients that were admitted to our institution between May 2019 and November 2021 with burns on extremities between 0.

Free Flap Reconstruction of Sternal Defects after Cardiac Surgery: An Algorithmic Approach for Dealing with Sparse Recipient Vessels.

Background: Sparsity of recipient vessels poses a challenge for microsurgical free flap reconstruction of sternal defects following deep sternal wound infection after cardiac surgery.

Methods: From January 2013, a standardized algorithm for dealing with sparse recipient vessels was strictly followed. In this retrospective study including 75 patients, we compared operative details, surgical complications, and reconstructive outcomes of patients treated according to this algorithm (group A: January 2013-May 2021; n = 46) with a historical control group (group B: January 2000-December 2012, n = 29).

NovoSorb® Biodegradable Temporising Matrix (BTM): What we learned from the first 300 consecutive cases.

Introduction: Extensive full-thickness soft-tissue defects remain a challenge in reconstructive surgery. NovoSorb® Biodegradable Temporising Matrix (BTM) represents a novel dermal substitute and was evaluated in wounds deriving from different aetiologies and to highlight risk factors for poor take rates.

Methods: All patients treated with BTM at our department between March 2020 and October 2022 were included.

[Robot-assisted Microsurgery in Lower Extremity Reconstruction].

Background: In recent years, various robotic systems specifically designed for microsurgical tasks have been developed and approved. There is not much evidence for these systems to date. In our study, we examined the use of robot-assisted microsurgery in the reconstruction of the lower extremity.

Using a Microsurgical Robotic Platform for In-flap Anastomosis in Autologous Bipedicular Breast Reconstruction.

Autologous microsurgical breast reconstruction has become a standard of care. As techniques become more individualized and aim for less-invasive approaches, vessels ever smaller in diameter are considered for flap anastomosis. Robot-assisted surgery has great potential to reduce tremor and enhance precise motion.

[Interdisciplinary defect reconstruction of upper aerodigestive fistulas-case series and treatment algorithm].

Background: Persistent complex defects and dysfunctions of the upper aerodigestive tract after tumor surgery represent a major challenge. The aim of this study was to evaluate the effectiveness of an interdisciplinary approach using the free anterolateral thigh flap (ALT) as a reconstruction option in the upper aerodigestive tract.

Materials And Methods: The retrospective study identified 5 patients with complex defects after laryngectomy/pharyngolaryngectomy (LE/PLE) and multiple revision surgeries between 2017 and 2023.

Reconstruction of Hand and Foot Defects with Free Serratus Carpaccio Flap and Free Serratus Fascia Flap: A Comparative Retrospective Study of Surgical Outcomes.

Background: Defects of the hand and foot often require an individualized reconstructive approach, due to their unique functional and aesthetic characteristics. Transferred tissues should be thin, pliable, and durable, with free fascial flaps meeting these requirements. This study aimed to evaluate the serratus fascia flap and the serratus carpaccio flap, which is a modification of the fascia flap, by including a thin muscle layer, with the goal of enhancing flap resilience and lowering morbidity rates.

[The conjoined latissimus dorsi and parascapular free flap for reconstruction of extensive soft tissue defects].

Objective: Durable and resilient soft tissue reconstruction of vast defects of the extremities or the torso.

Indications: Reconstruction of disproportionately large defects, particularly in cases of simultaneous bone and joint reconstruction.

Contraindications: History of surgery or irradiation of upper back and axilla, impossibility of surgery under lateral positioning; relative contraindications in wheelchair users, hemiplegics, or amputees.

Scalp Reconstruction Using the Latissimus Dorsi Free Flap: A 12-Year Experience.

Background: Complex scalp defects are regularly reconstructed using microvascular tissue transfer. The latissimus dorsi free flap is one of the workhorse flaps used in scalp reconstruction. These cases necessitate, particularly in the elderly, a close cooperation between plastic surgeons and neurosurgeons.

A Retrospective Matched-Pair Analysis of Long-term Outcomes after Successful Lower Extremity Free Flap Salvage.

Background:  Pedicle occlusion with total free flap loss after microvascular lower extremity reconstruction is a considerably rare yet devastating complication. Fortunately, in the majority of cases, emergency salvage takebacks of compromised free flaps are initiated in a timely manner. In this report, we present our analysis of long-term outcomes following transient vascular compromise mitigated through successful free flap salvage in the lower extremity.

Hopeless Neuroma-The Neurotized Free Flap Tissue Augmentation as Salvage Therapy-A Concept and Clinical Demonstration.

Therapy-resistant neuroma pain is a devastating condition for patients and surgeons. Although various methods are described to surgically deal with neuromas, some discontinuity and stump neuroma therapies have anatomical limitations. It is widely known that a neurotizable target for axon ingrowth is beneficial for dealing with neuromas.

Effective or Harmful-Evaluation of Locally Applied Antibiotics on Adipose Tissue during Lipofilling to the Breast-An In Vitro Study.

Lipofilling is a frequently used and safe procedure for breast reconstruction. One of the most feared complications is soft tissue infection following lipofilling. Because of this, some surgeons propose the practice of rinsing fat grafts with antibiotics.

Microsurgical Strategies after Free Flap Failure in Soft Tissue Reconstruction of the Lower Extremity: A 17-Year Single-Center Experience.

There is no clear consensus on the optimal surgical strategy for providing safe coverage in salvage free flap surgery after total free flap failure. A retrospective study was conducted to evaluate patients with total failure of the primary free flap in lower extremity reconstruction between 2000 and 2017. In a cohort of 1.