Swennen Gwen R. J., Weinberg Yves, de O. Andriola Fernando
Division of Maxillofacial Surgery, Department of Surgery, AZ Sint-Jan Brugge-Oostende AV, Belgium, Bruges, Belgium
Oral and Maxillofacial Surgery Division of Surgery, Barzilai University Medical Center, Ashkelon, Israel
Step-by-step standardization of minimally invasive (MI) orthognathic surgical techniques increases surgical efficiency and decreases patient morbidity. In this chapter, an innovative systematized “5 step-by-step approach” toward mandible constriction or expansion following a "MI philosophy and mindset” is outlined in detail. General considerations regarding the preparation of the patient, instrumentation table, and operating room toward MI mandible constriction or expansion are well described. Dedicated new developed MI orthognathic surgical instruments allow to optimize the vascular blood supply and decrease of interstitial edema and swelling after mandible constriction or expansion which enhances postoperative fast recovery of the patient. Moreover, the introduction of MI orthognathic surgical codes and MI orthognathic surgical sequences creates a common language among the surgical team (operating surgeon, surgical assistants, and operating nurse) which increases surgical efficiency and additionally decreases patient morbidity. Furthermore, systematization of storage of the MI orthognathic instruments allows to optimize their gathering, cleaning, and sterilization process toward a more time-efficient and cost-effective clinical routine. Every single step of the MI approach toward the mandible constriction or expansion surgical procedure is illustrated in detail by high-quality graphic illustrations and pictures made on synthetic skulls and human cadavers. Finally, the limits of the described MI surgical technique toward maxillary expansion are summarized.
微创正颌外科技术的逐步标准化提高了手术效率,降低了患者的发病率。在本章中,将详细概述一种遵循“微创理念和思维方式”对下颌骨进行缩窄或扩张的创新系统化“五步方法”。文中还详细描述了针对微创下颌骨缩窄或扩张的患者准备、器械台和手术室的一般注意事项。专门新开发的微创正颌外科器械能够优化血管血液供应,减少下颌骨缩窄或扩张后的间质水肿和肿胀,从而促进患者术后快速恢复。此外,引入微创正颌外科编码和微创正颌外科手术顺序,在手术团队(主刀医生、手术助手和手术室护士)之间创造了一种通用语言,提高了手术效率,并进一步降低了患者的发病率。此外,微创正颌器械的存储系统化有助于优化其收集、清洁和消毒过程,实现更高效、更具成本效益的临床常规操作。通过在合成头骨和人体尸体上制作的高质量图形插图和图片,详细展示了微创方法在下颌骨缩窄或扩张手术过程中的每一个步骤。最后,总结了所描述的微创外科技术在上颌骨扩张方面的局限性。