Implication des différents gènes de développement dans la formation de la face et ses anomalies

Depuis maintenant 150 ans, la génétique et sa compréhension, a permis la découverte de nombreux gènes et leurs implications au niveau des grands syndromes. Depuis la mise en évidence du complexe HOM chez la drozophile et du complexe HOX chez l'homme, les gènes programmateurs du développement ne cessent de faire l'objet de nouvelles découvertes. Les généticiens ont de grands espoirs quant à la révolution thérapeutique qui découlerait de ces découvertes. En effet, isoler un gène, le décrypter ou encore analyser les conséquences de sa mutation sont aujourd'hui, choses courantes. Au niveau de la sphère oro-faciale, de nombreux gènes ont été mis en évidence quant à leur role dans la spécification du système nerveux, dans l'ontogénèse ou encore l'apparition de fentes faciales. Ce travail vise à synthétiser les connaissances actuelles concernant la formation de la face et l'implication de ces différents gènes au niveau des malformations de la face et du couLILLE2-UFR Odontologie (593502202) / SudocLILLE2-BU Santé-Recherche (593502101) / SudocSudocFranceF

Single-access laparoscopic adjustable gastric band removal: Technique and initial experience

Background: Single-access laparoscopy (SAL) has gained significant interest in recent years. Potential benefits, beyond cosmetic outcomes, could be reduction of abdominal trauma, decreased risk of incisional hernia and diminished postoperative pain. Technique and initial experience in patients submitted to laparoscopic adjustable gastric band removal (LAGBR) through SAL is reported here. Methods: Between December 2009 and March 2012, 14 patients (9 females, 5 males) underwent LAGBR through SAL. Indications for operation were band intolerance (11), pouch dilatation (2) and insufficient weight loss (1). The mean age was 40.3 ± 9.1 years (range 26-57), and the mean interval time between LAGB placement and removal was 94.7 ± 41.9 months (range 37-157). The mean weight and the mean body mass index at the time of LAGBR were 89.3 ± 17.6 kg (range 65-119) and 30.6 ± 4.5 kg/m2 (range 25.3-36.7), respectively. Technically, the previous port site scar was used as the single-access site to the abdominal cavity. An 11-mm reusable trocar was adopted for a 10-mm regular scope, besides curved reusable instruments. Results: No patients required conversion to open surgery and none necessitated additional trocars. The mean laparoscopic time was 24.6 ± 7.9 min (range 13-37), and the mean final scar length was 3.6 ± 0.3 cm (range 3-4). Two patients experienced early postoperative complications. The mean hospital stay was 1.3 ± 1.1 days (range 1-5). The mean follow-up time was of 18 ± 9.8 months (range 3-30), and there were no late complications. Conclusions: LAGBR can be safely performed through SAL. Thanks to this technique, the laparoscopic working triangulation is established as well as the ergonomic positions of the surgeon. Due the use of only reusable material, the cost of this SAL remains similar to multiport laparoscopy. © 2012 Springer Science+Business Media New York.SCOPUS: ar.jinfo:eu-repo/semantics/publishe