RESUMO
High rates of recurrence in hiatus hernia and antireflux surgery led to the introduction of different methods for diaphragm closure. Prosthetic diaphragm closure with meshes remains a controversial issue in the literature. Available data show lower recurrence rates after prosthetic diaphragm closure; however, there is no clear standard for the indications and technique. Despite the availability of a few prospective randomized trials, a clear recommendation regarding this issue cannot currently be given.
Assuntos
Fundoplicatura/métodos , Refluxo Gastroesofágico/cirurgia , Hérnia Hiatal/cirurgia , Próteses e Implantes , Telas Cirúrgicas , Esfíncter Esofágico Inferior/cirurgia , Humanos , Laparoscopia/métodos , Complicações Pós-Operatórias/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Recidiva , Prevenção SecundáriaRESUMO
Nasal septal perforations, particularly those that are large and irregular in shape, often present as challenging surgical dilemmas. New technology has allowed us to develop techniques using computed tomography imaging and 3-dimensional (3D) printers to design custom polymeric silicone septal buttons. These buttons offer patients an option that avoids a surgical intervention when standard buttons do not fit well or are not tolerated. Preliminary data suggest that buttons designed by 3D printer technology provide more comfort than standard commercially available or hand-carved buttons with equivalent reduction of symptoms.