The MEMS-based micro surgical tools are a kind of new devices applied in the minimally-invasive surgery. This paper introduces their application background and basic technology first, and then lays emphasis on the typical research accomplishments in the world. Finally, the research activities in China and some of the difficulties about the work are discussed.
Biosensing Techniques ; Endoscopes ; Equipment Design ; Microsurgery ; instrumentation ; Minimally Invasive Surgical Procedures ; instrumentation ; Surgical Equipment

Humans ; Laryngeal Diseases ; surgery ; Larynx ; surgery ; Microsurgery ; instrumentation ; Otorhinolaryngologic Surgical Procedures ; instrumentation ; Surgical Instruments

With the development of laryngeal microsurgery, the requirements for the flexibility and convenience of surgical instruments are increasing. The research on related instruments has important value for the clinical application of laryngeal microsurgery. We have redesigned a gun-type tube-guide device of laser fiber by comparing the shortcomings of existing laser fiber introducers. The innovation of this design lies in its rotating nut device with adjustable laser angle and pre-bent tip. The corresponding
Humans ; Larynx/surgery* ; Laser Therapy/instrumentation* ; Lasers ; Microsurgery/instrumentation* ; Surgical Instruments

In this paper we briefly introduce some microdevices which have been developed recently for biomedical applications by micro-fabrication technology. These applications mainly include areas of diagnostics, drug delivery, tissue engineering and minimally-invasive surgery.
Biomedical Engineering ; instrumentation ; methods ; Clinical Laboratory Techniques ; instrumentation ; methods ; Drug Delivery Systems ; instrumentation ; methods ; Equipment Design ; Humans ; Microsurgery ; instrumentation ; Miniaturization ; Tissue Engineering ; instrumentation ; methods

OBJECTIVE: To investigate the surgery management of glottic carcinoma with high-frequency electrotome. METHOD: Twenty cases of patients with glottic carcinoma were treated by cordectomy under micro-laryngoscopy with high-frequency electrotome. RESULT: The 20 patients were followed up from 5 months to 6 years, retained good laryngeal function and structure: 1 case had local recurrences after 6 months, underwent total laryngectomy, and now no recurrence had been found: 19 cases (mild adhesions of vocal cords formed in 2 cases) had no local recurrence nor lymph node metastasis. CONCLUSION It is unnecessary to invest in expensive equipment in the cordectomy under micro-laryngoscopy with high frequency electrotome under general anesthesia and the result is satisfactory.
Aged ; Electrosurgery ; instrumentation ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; surgery ; Laryngectomy ; instrumentation ; methods ; Male ; Microsurgery ; Middle Aged ; Treatment Outcome

The herniated lumbar disc (HLD) in adolescent patients is characterized by typical discogenic pain that originates from a soft herniated disc. It is frequently related to back trauma, and sometimes it is also combined with a degenerative process and a bony spur such as posterior Schmorl's node. Chemonucleolysis is an excellent minimally invasive treatment having these criteria: leg pain rather than back pain, severe limitation on the straight leg raising test (SLRT), and soft disc protrusion on computed tomography (CT). Microsurgical discectomy is useful in the cases of extruded or sequestered HLD and lateral recess stenosis due to bony spur because the nerve root is not decompressed with chymopapain. Spinal fusion, like as PLIF, should be considered in the cases of severe disc degeneration, instability, and stenosis due to posterior central bony spur. In our study, 185 adolescent patients, whose follow-up period was more than 1 year (the range was 1 - 4 years), underwent spinal surgery due to HLD from March, 1998 to December, 2002 at our institute. Among these cases, we performed chemonucleolysis in 65 cases, microsurgical discectomy in 94 cases, and posterior lumbar interbody fusion (PLIF) with cages in 33 cases including 7 reoperation cases. The clinical success rate was 91% for chemonucleolysis, 95% for microsurgical disectomy, and 89% for PLIF with cages, and there were no non- union cases for the PLIF patients with cages. In adolescent HLD, chemonucleolysis was the 1st choice of treatment because the soft adolescent HLD was effectively treated with chemonucleolysis, especially when the patient satisfied the chemonucleolysis indications.
Adolescent ; Adult ; Child ; Diskectomy/instrumentation/*methods ; Follow-Up Studies ; Humans ; *Intervertebral Disk Chemolysis ; Intervertebral Disk Displacement/*surgery/*therapy ; Lumbar Vertebrae/*surgery ; Microsurgery ; Spinal Fusion/instrumentation/*methods ; Treatment Outcome

OBJECTIVETo provide anatomical data for transoral atlantoaxial reduction plate internal fixation.

METHODMicrosurgical dissecting was performed on 10 fresh craniocervical specimens layer by layer according to transoral approach. Stratification of posterior pharyngeal wall, course of vertebral artery, adjacent relationships of atlas and axis and correlative anatomical parameters of internal fixation to atlantoaxial joint were observed.

RESULT(1) Posterior pharyngeal wall consisted of 2 layers and 2 interspace: mucosa, anterior fascia of vertebrae, posterior interspace of pharynx and anterior interspace of vertebrae. (2) The range from anterior rim of foramen magnum to C3 could be exposed by this approach. (3) The distance between the vertebral artery at atlas and midline was (25.2 +/- 2.3) mm and that between the vertebral artery at axis and midline was (18.4 +/- 2.6) mm. (4) The width of atlas and that of axis could be exposed respectively to (39.4 +/- 2.2) mm and (39.0 +/- 2.1) mm. The distance (a) between 2 atlas screw inserting points (center of anterior aspect of C-1 lateral mass) was (31.4 +/- 3.3) mm. The vertical distance (b) between the connecting line of 2 atlas screw inserting points and that of 2 axis screw inserting points (at the central part of the vertebrae which was 3 - 4 mm lateral to the midline of C-2 vertebrae) was (18.7 +/- 2.7) mm. The odds of a/b was 1.5 approximately 1.7.

CONCLUSIONSAnterior atlantoaxial plate internal fixation through transoral approach is suitable and feasible. The design of the plate should be based on the above data.

Atlanto-Occipital Joint ; anatomy & histology ; surgery ; Bone Plates ; Cervical Vertebrae ; anatomy & histology ; surgery ; Equipment Design ; Humans ; Microsurgery ; Oropharynx ; anatomy & histology ; Spinal Fusion ; instrumentation ; methods

INTRODUCTIONIn line with the effort to evaluate feasible surgical options for vasectomy reversal and to increase patients' willingness to undergo the procedure, this study reported on a technique for ambulatory mini-incision microsurgical vasovasostomy using a double-ringed clamp (i.e. Moon's clamp). This technique does not require the use of dilators, approximators and other accessory devices.

METHODSAmbulatory mini-incision microsurgical vasovasostomy was conducted on 263 patients who satisfied the surgical eligibility requirements for vasovasostomy and the safety criteria for local anaesthesia. The operation time, details on postoperative recovery and results of the postoperative semen analysis were recorded and retrospectively analysed.

RESULTSThe mean time used to isolate the bilateral vas deferens was 25.5 minutes. All patients were discharged on the day of surgery and all patients returned to their normal activities within 24-48 hours after surgery. No haematoma or infection occurred except in one patient. Postoperative semen analysis showed that the surgery was successful in 182 (96.8%) of the 188 patients who complied with the postoperative patient instructions.

CONCLUSIONAmbulatory mini-incision microsurgical vasectomy reversal using Moon's clamp and under local anaesthesia is a surgically feasible option that offers the advantages of a low-risk operation. It also achieves successful vasovasostomy without other accessory devices and allows patients to return to their daily activities quickly with minimal complications.

Adult ; Anesthesia, Local ; methods ; Equipment Design ; Feasibility Studies ; Follow-Up Studies ; Humans ; Male ; Microsurgery ; methods ; Middle Aged ; Retrospective Studies ; Surgical Instruments ; Suture Techniques ; instrumentation ; Vasovasostomy ; methods

Mineral trioxide aggregate (MTA) is considered at the present time as the gold standard for root-end filling in endodontic surgery. However, this biocompatible material presents several drawbacks such as a long setting time and handling difficulties. The aim of this article is to present a new commercialized calcium silicate-based material named Biodentine with physical improved properties compared to MTA in a clinical application. Two endodontic microsurgeries were performed by using specific armamentarium (microsurgical instrumentation, ultrasonic tips) under high-power magnification with an operatory microscope. Biodentine was used as a root-end filling in order to seal the root canal system. The two cases were considered completely healed at 1 year and were followed for one more year. The 2-year follow-up consolidated the previous observation with absence of clinical symptoms and radiographic evidence of regeneration of the periapical tissues.
Calcium Compounds ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Microsurgery ; instrumentation ; Middle Aged ; Periapical Diseases ; therapy ; Periapical Tissue ; diagnostic imaging ; physiology ; Radiography, Bitewing ; Regeneration ; physiology ; Retrograde Obturation ; methods ; Root Canal Filling Materials ; therapeutic use ; Root Canal Preparation ; instrumentation ; Silicates ; therapeutic use ; Ultrasonic Surgical Procedures ; instrumentation ; Wound Healing ; physiology