By Ulrich Spandau, Mitrofanis Pavlidis
This ebook presents step by step directions on the way to function with 27G instrumentation in quite a lot of surgical symptoms, together with vitreous floaters, macular holes, dropped nucleus, retinal detachment, diabetic retinopathy, submacular hemorrhage, retinopathy of prematurity and masses trauma. All surgical procedures are approached in cookbook style, with preliminary assurance of the “ingredients” (devices and tools) after which meticulous description of instruction and function with assisting photos, drawings and video clips. additionally, the diversities and merits compared to 23G and 25G vitrectomy are highlighted.
Small-gauge vitrectomy has significantly replaced the ways that vitrectomy is played. 27G vitrectomy is the latest and most enjoyable improvement in small-gauge vitrectomy. The therapeutic time is quicker however the small diameter prolongs the length of surgical procedure. This crisis has been conquer with robust new vitrectomy machines and progressive vitreous cutters with slicing blades making 27G vitrectomy as quickly as 25G. This new gear has accelerated the symptoms for 27G surgical procedures immensely from detachment surgical procedure to retinopathy of prematurity and the arrival of recent tools might make 27G the premiere sooner or later. This publication, written through authors with large event in 27G vitrectomy, will allow surgeons to totally make the most its advantages.
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Additional resources for 27-Gauge Vitrectomy: Minimal Sclerotomies for Maximal Results
43 Silicone oil removal with plastic pipe for 20G–27G (DORC) Fig. 44 Vicryl 8-0 suture for suturing of conjunctiva and sclerotomies 37 38 2 Optimal Visualization, Optimal Instruments and Optimal Technique Fig. 45 Mersilene 5-0 (Ethicon): suturing of a cerclage Fig. 46 Supramid 5-0 (Serag Wiessner): suturing of a silicone sponge (Fig. 34). The backflush handpiece and the backflush cannula are available as one instrument or as two separate instruments (DORC, MedOne). 2 Endodiathermy Probe (Fig. 36) An endodiathermy probe is useful for (1) marking of retinal breaks in detachment surgery and (2) cauterizing bleeding retinal vessels such as those present in diabetic retinopathy.
42 A 27G cannula is attached to the syringe for silicone oil injection. VFI04 Fig. 43 Silicone oil removal with plastic pipe for 20G–27G (DORC) Fig. 44 Vicryl 8-0 suture for suturing of conjunctiva and sclerotomies 37 38 2 Optimal Visualization, Optimal Instruments and Optimal Technique Fig. 45 Mersilene 5-0 (Ethicon): suturing of a cerclage Fig. 46 Supramid 5-0 (Serag Wiessner): suturing of a silicone sponge (Fig. 34). The backflush handpiece and the backflush cannula are available as one instrument or as two separate instruments (DORC, MedOne).
2. 3. 4. 4 Double-Cut Vitreous Cutter 11 Fig. 11 Removal of a vitreous with synchysis scintillans Fig. 12 After removal of the trocars. The sclerotomies are watertight, require no suture and no hypotony is present the day after. This is an excellent feature for long eyes and pediatric eyes 5. Retinal detachment: Tight globe, less leakage resulting in better tamponade 6. Lens exchange: Less hypotony compared with 23G 27G Is Less Useful for the Following Pathologies These indications have a low risk of postoperative hypotony.