By Ulrich Spandau, Mitrofanis Pavlidis
This publication presents step by step directions on tips 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 type, with preliminary assurance of the “ingredients” (devices and tools) after which meticulous description of guidance and function with helping photos, drawings and movies. furthermore, the diversities and merits compared to 23G and 25G vitrectomy are highlighted.
Small-gauge vitrectomy has substantially replaced the ways that vitrectomy is played. 27G vitrectomy is the latest and most fun improvement in small-gauge vitrectomy. The therapeutic time is quicker however the small diameter prolongs the period of surgical procedure. This problem has been conquer with robust new vitrectomy machines and innovative vitreous cutters with slicing blades making 27G vitrectomy as quickly as 25G. This new gear has extended the indicators for 27G surgical procedures immensely from detachment surgical procedure to retinopathy of prematurity and the arrival of recent tools may possibly make 27G the greatest sooner or later. This booklet, written by way of authors with large event in 27G vitrectomy, will permit surgeons to completely take advantage of its advantages.
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Additional info for 27-Gauge Vitrectomy: Minimal Sclerotomies for Maximal Results
Double-Cut Vitreous Cutter ................................................................................................ 3 The New TDC Cutter Is Much Faster Than the Regular Cutter 4 6 6 7 7 7 7 Trocar Against No Trocar The most essential development of small-gauge vitrectomy was the introduction of a trocar which rests inside the sclera. Instruments are much easier introduced, the trocar protects the sclera against injury through the instruments and a trocar is easier to find than a usual sclerotomy.
41 A 10 ml silicone oil syringe which is filled with silicone oil. DORC Fig. 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 blunt tip (b) may be used for delamination of a membrane or opening of the posterior hyaloid or ILM a b Fig. 27 The package of the retrobulbar cannula (Atkinson), Beaver Visitec a b Fig. 28 (a) 27G disposable intravitreal forceps. DORC. (b) Eckhardt endgripping forceps. Indication: removal of membranes and ILM. 5 27G Standard Instruments Eckardt 33 Tano asymmetrical Fig. 29 Eckardt and Tano forceps (Synergetics forceps, 27G) Fig. 30 Power endgripping forceps. Indication: removal of PVR membranes.
27-Gauge Vitrectomy: Minimal Sclerotomies for Maximal Results by Ulrich Spandau, Mitrofanis Pavlidis