Endoscopic Sural Nerve Removal in Obstetric Brachial Plexopathy Using Basic Endoscopy Instruments: Technical Note
Abstract Introduction The sural nerve (SN) is commonly used for grafting following resection of a neuroma-in-continuity in neonatal brachial plexus lesions (NBPL). The main drawbacks of the current open techniques are large scars and contractures in the late postoperative stage, which m...
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| Format: | Article |
| Language: | English |
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Thieme Revinter Publicações Ltda.
2017-06-01
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| Series: | Brazilian Neurosurgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1603966 |
| _version_ | 1818721355117363200 |
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| author | José Augusto Malheiros Sérgio Augusto Vieira Cançado João Tiago Alves Belo Luiz Alberto Otoni Garcia Marcelo Magaldi de Oliveira Martjin J. A. Malessy |
| author_facet | José Augusto Malheiros Sérgio Augusto Vieira Cançado João Tiago Alves Belo Luiz Alberto Otoni Garcia Marcelo Magaldi de Oliveira Martjin J. A. Malessy |
| author_sort | José Augusto Malheiros |
| collection | DOAJ |
| description | Abstract
Introduction The sural nerve (SN) is commonly used for grafting following resection of a neuroma-in-continuity in neonatal brachial plexus lesions (NBPL). The main drawbacks of the current open techniques are large scars and contractures in the late postoperative stage, which may, in severe cases, cause equinovarus contractures.
Objective To describe the feasibility and the technical aspects of endoscopic SN harvesting with the use of basic endoscopy instruments and small incisions.
Methods Prospective observational study of NBPL subjected to endoscopic nerve harvesting between February of 2012 and February of 2014 in a consecutive series. Patients were operated at the Felício Rocho Hospital (Hospital Felício Rocho) and the Clinical Hospital, Federal University of Minas Gerais (Hospital das Clínicas UFMG), Belo Horizonte/MG, in Brazil. The study outcomes assessed were: scar size, presence or absence of contractures in the calf, bleeding volume (measured by the number of gauzes used) and number of incisions. Only patients with a follow-up longer than 6 months were included.
Results Seven patients were selected and twelve endoscopic nerves were endoscopically harvested. The average surgery time was 45 minutes. Nine SNs were harvested through two incisions, and three nerves through three incisions. The estimated bleeding was less than 5ml and there were no complications or contractures during the follow-up period of 6 months to 4 years.
Conclusion Sural nerve harvesting in children with NBPL is feasible and it offers the advantage of needing only two or three small incisions using basic endoscopy instruments. |
| first_indexed | 2024-12-17T20:37:25Z |
| format | Article |
| id | doaj.art-e4f96772719442309f52b7f876f27b32 |
| institution | Directory Open Access Journal |
| issn | 0103-5355 2359-5922 |
| language | English |
| last_indexed | 2024-12-17T20:37:25Z |
| publishDate | 2017-06-01 |
| publisher | Thieme Revinter Publicações Ltda. |
| record_format | Article |
| series | Brazilian Neurosurgery |
| spelling | doaj.art-e4f96772719442309f52b7f876f27b322022-12-21T21:33:25ZengThieme Revinter Publicações Ltda.Brazilian Neurosurgery0103-53552359-59222017-06-01360207507910.1055/s-0037-1603966Endoscopic Sural Nerve Removal in Obstetric Brachial Plexopathy Using Basic Endoscopy Instruments: Technical NoteJosé Augusto Malheiros0Sérgio Augusto Vieira Cançado1João Tiago Alves Belo2Luiz Alberto Otoni Garcia3Marcelo Magaldi de Oliveira4Martjin J. A. Malessy5Neurological and Neurosurgery Clinic, Hospital Felício Rocho - Fundação Felice Rosso, Belo Horizonte, MG, BrazilNeurological and Neurosurgery Clinic, Hospital Felício Rocho - Fundação Felice Rosso, Belo Horizonte, MG, BrazilNeurological and Neurosurgery Clinic, Hospital Felício Rocho - Fundação Felice Rosso, Belo Horizonte, MG, BrazilNeurological and Neurosurgery Clinic, Hospital Felício Rocho - Fundação Felice Rosso, Belo Horizonte, MG, BrazilNeurosurgery Department, Hospital das Clínicas, Universidade Federal de Minas Gerais (HC-UFMG), Belo Horizonte, MG, BrazilDepartment of Neurosurgery, Leids Universitair Medisch Centrum, Leiden, NetherlandsAbstract Introduction The sural nerve (SN) is commonly used for grafting following resection of a neuroma-in-continuity in neonatal brachial plexus lesions (NBPL). The main drawbacks of the current open techniques are large scars and contractures in the late postoperative stage, which may, in severe cases, cause equinovarus contractures. Objective To describe the feasibility and the technical aspects of endoscopic SN harvesting with the use of basic endoscopy instruments and small incisions. Methods Prospective observational study of NBPL subjected to endoscopic nerve harvesting between February of 2012 and February of 2014 in a consecutive series. Patients were operated at the Felício Rocho Hospital (Hospital Felício Rocho) and the Clinical Hospital, Federal University of Minas Gerais (Hospital das Clínicas UFMG), Belo Horizonte/MG, in Brazil. The study outcomes assessed were: scar size, presence or absence of contractures in the calf, bleeding volume (measured by the number of gauzes used) and number of incisions. Only patients with a follow-up longer than 6 months were included. Results Seven patients were selected and twelve endoscopic nerves were endoscopically harvested. The average surgery time was 45 minutes. Nine SNs were harvested through two incisions, and three nerves through three incisions. The estimated bleeding was less than 5ml and there were no complications or contractures during the follow-up period of 6 months to 4 years. Conclusion Sural nerve harvesting in children with NBPL is feasible and it offers the advantage of needing only two or three small incisions using basic endoscopy instruments.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1603966sural nerveendoscopybrachial plexus |
| spellingShingle | José Augusto Malheiros Sérgio Augusto Vieira Cançado João Tiago Alves Belo Luiz Alberto Otoni Garcia Marcelo Magaldi de Oliveira Martjin J. A. Malessy Endoscopic Sural Nerve Removal in Obstetric Brachial Plexopathy Using Basic Endoscopy Instruments: Technical Note Brazilian Neurosurgery sural nerve endoscopy brachial plexus |
| title | Endoscopic Sural Nerve Removal in Obstetric Brachial Plexopathy Using Basic Endoscopy Instruments: Technical Note |
| title_full | Endoscopic Sural Nerve Removal in Obstetric Brachial Plexopathy Using Basic Endoscopy Instruments: Technical Note |
| title_fullStr | Endoscopic Sural Nerve Removal in Obstetric Brachial Plexopathy Using Basic Endoscopy Instruments: Technical Note |
| title_full_unstemmed | Endoscopic Sural Nerve Removal in Obstetric Brachial Plexopathy Using Basic Endoscopy Instruments: Technical Note |
| title_short | Endoscopic Sural Nerve Removal in Obstetric Brachial Plexopathy Using Basic Endoscopy Instruments: Technical Note |
| title_sort | endoscopic sural nerve removal in obstetric brachial plexopathy using basic endoscopy instruments technical note |
| topic | sural nerve endoscopy brachial plexus |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1603966 |
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