Author Topic: Minimally invasive procedure?  (Read 4786 times)

Autumn12

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Minimally invasive procedure?
« on: August 23, 2014, 08:46:47 PM »
Has anyone either had or heard of a minimally invasive jaw surgery procedure? I think a surgeon at Stanford and a few at Mass General are performing these procedures but I don't live close enough to go for consult, so I don't know exactly what is involved. I'd like to get enough information to decide if I should drive up to see a surgeon.

molestrip

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Re: Minimally invasive procedure?
« Reply #1 on: August 26, 2014, 10:13:17 PM »
I saw this video. I think the minimally invasive part of the talk applies only to children. Distraction osteogenesis sounded appealing at first but there's a lot of problems with it. There haven't been many cases done on the jaws and that's a big problem for someone with only one life. It's harder to use here because movements are in three dimensions. Complications seem to be greater and I don't think it's really any less invasive. Avoiding hardware is a win to me but not most people. Newer graft materials have eliminated the advantage to the union. I would think it would be easier on the nerves but much harder on other soft tissue. Infection risk looks like a nightmare. I think it's mostly being tested in cases where the tried and true plates aren't possible. That is, very large movements. Still, it's a good suggestion and I think I'll make an appointment with MGH next time I'm in the area (Oct) and keep you posted if you like.

I'm also very interested in this topic though. I've taken interest recently in Dr Hernandez Alfaro. I've been asking around but no one seems to know about him or his procedures. He claims to be able to do a minimally invasive surgery, with only a 2.8cm incision on the upper jaw. From the video the lower incisions look pretty small too. This is a HUGE win that's actually less invasive, if the risk of mistakes doesn't change. I'm thinking of doing a virtual consult with him to learn more about it. He doesn't mention it but I suspect nerve function is much better preserved.

PloskoPlus

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Re: Minimally invasive procedure?
« Reply #2 on: August 27, 2014, 12:02:50 AM »
Distraction osteogenesis is only good for linear movements.

Alue

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Re: Minimally invasive procedure?
« Reply #3 on: August 27, 2014, 12:28:33 AM »
Distraction osteogenesis is only good for linear movements.

Can it work for bi-max advancement or is it just lower?  I remember reading about it a year ago, but haven't really kept up. 

PloskoPlus

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Re: Minimally invasive procedure?
« Reply #4 on: August 27, 2014, 01:06:52 AM »
Can it work for bi-max advancement or is it just lower?  I remember reading about it a year ago, but haven't really kept up.

Profilo has a video on YouTube of a young guy who had 15mm of maxillary advancement. 

Mark32

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Re: Minimally invasive procedure?
« Reply #5 on: August 29, 2014, 04:53:56 PM »
When they do a procedure like this is there a big chance of relapse? As there are no plates or screws couldn't the new bone formed be broken down by the pressure from the soft tissue? Or maybe I've got this wrong and the plates and screws used in other surgeries don't make that much difference.

PloskoPlus

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Re: Minimally invasive procedure?
« Reply #6 on: August 29, 2014, 11:07:47 PM »
When they do a procedure like this is there a big chance of relapse? As there are no plates or screws couldn't the new bone formed be broken down by the pressure from the soft tissue? Or maybe I've got this wrong and the plates and screws used in other surgeries don't make that much difference.

People use osteogenesis to lengthen their legs, so I don't think it's an issue.  Afaik, new bone is stronger than normal bone.

Mark32

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Re: Minimally invasive procedure?
« Reply #7 on: August 30, 2014, 07:31:56 AM »
I never thought of the leg thing and there'd be way more pressure on the bones in your legs.

Could they use this technique to first advance an under grown maxilla and then switch back to more invasive surgery to reposition it vertically? Or angle it and stuff? Or would it be less hassle to do it all in one go using traditional methods?

Autumn12

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Re: Minimally invasive procedure?
« Reply #8 on: August 30, 2014, 12:47:12 PM »
I think I'll make an appointment with MGH next time I'm in the area (Oct) and keep you posted if you like.

Please let me know and keep my updated on anything you find out about minimally invasive procedures.

Thank you

Mark32

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Re: Minimally invasive procedure?
« Reply #9 on: August 30, 2014, 03:06:23 PM »
has anyone ever undergone the more invasive le fort 1 or bsso surgeries with only local anaesthetic? is that possible?

molestrip

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Re: Minimally invasive procedure?
« Reply #10 on: August 30, 2014, 04:48:25 PM »
Dr Alfaro claims he can do it with only local in some cases. I'd settle for keeping most of my soft tissue intact.

The DO devices move in 3 dimensions I think, unlike those used elsewhere. Plates are only needed for the first month or two while the bone heals and aren't needed after that.

PloskoPlus

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Re: Minimally invasive procedure?
« Reply #11 on: August 30, 2014, 06:51:32 PM »
I never thought of the leg thing and there'd be way more pressure on the bones in your legs.

Could they use this technique to first advance an under grown maxilla and then switch back to more invasive surgery to reposition it vertically? Or angle it and stuff? Or would it be less hassle to do it all in one go using traditional methods?

I think the Ben profilo video is just that kind of case.  But in any case, osteogenesis is done only when massive advancement is required.  Otherwise it's too much of hassle as you basically need 2 pperations.