IMPACTO DA CIRURGIA ROBÓTICA NA RECUPERAÇÃO PEDIÁTRICA

  Robotic surgery has become an essential tool in contemporary surgical practice, offering significant advancements in the precision and effectiveness of procedures, especially in pediatrics. This article reviews the current applications of robotic surgery in pediatric surgery, highlighting its advantages in reducing surgical trauma, faster recovery, and better aesthetic outcomes. Although facing challenges such as high costs and surgeon learning curve, robotic surgery promises to further transform pediatric surgery with the continuous development of more advanced technologies and training techniques.A cirurgia robótica tem se tornado uma ferramenta essencial na prática cirúrgica contemporânea, oferecendo avanços significativos na precisão e eficácia dos procedimentos, especialmente na pediatria. Este artigo revisa as aplicações atuais da cirurgia robótica em cirurgia pediátrica, destacando suas vantagens na redução do trauma cirúrgico, recuperação mais rápida e melhores resultados estéticos. Embora enfrentando desafios como custos elevados e curva de aprendizado dos cirurgiões, a cirurgia robótica promete transformar ainda mais a cirurgia pediátrica com o desenvolvimento contínuo de tecnologias mais avançadas e aprimoramento de técnicas de treinamento

Insatisfação e complicações pós-cirúrgicas caracterizam erro médico?

Nota-se atualmente um crescente número de processos judiciais a médicos, com base em uma suposta quebra de contrato ao direito do consumidor, onde se exige do profissional médico resultados, enquanto este, pelo código de ética médica e bom senso, tem obrigação de meios. O objetivo deste estudo foi discutir os resultados, satisfação e complicações de três das principais cirurgias ortopédicas à nível do joelho (área de atuação dos autores) com o fim de estabelecer diferenças entre erro e insucesso, próprio do ato médico. Concluímos que a imperfeição faz parte da natureza humana e que, por diversos motivos, as cirurgias ortopédicas complicam, falham e pacientes ficam insatisfeitos, independente do grau de recursos que o profissional disponha, o que não caracteriza erro médico.There is currently a growing number of lawsuits against physicians, based on an alleged breach of contract to consumer law, where results are required from the medical professional, while the latter, according to the code of medical ethics and common sense, has an obligation of means. The aim of this study was to discuss the results, satisfaction and complications of three of the main orthopedic surgeries at the level of the knee (the authors' field of work) in order to establish differences between error and failure, which are characteristic of the medical act. We conclude that imperfection is part of human nature and that, for various reasons, orthopedic surgeries complicate, fail and patients are dissatisfied, regardless of the degree of resources available to the professional, which does not characterize medical error

Evaluation of multiple doses of tranexamic acid on blood loss in total knee arthroplasty

Objective: To evaluate the efficacy of multiple doses of tranexamic acid (TXA) in blood loss in patients undergoing total knee arthroplasty (TKA). Methods: Seven patients of both genders over 50 years old undergoingTKA, who received 15 mg/kg intravenous (IV) TXA 30 minutes before the surgical incision and another 3 doses thereafter were included in this report. Blood loss analysis included blood loss at the drain, hemoglobin loss, and estimated blood loss. Statistical analysis was performed. Results: There was a significant hemoglobin drop after 48 hours, compared to preoperative. Mean blood loss assessed by drain was 20.0 ± 25.17 mL after 24 h. Estimated blood loss was higher after 48 hours compared to 24 hours. No complications were reported in this sample, and no patient received transfusions. Conclusion: The use of TXA in multiple doses did not prevent the drop in postoperative hemoglobin levels and did not correlate with increased complications

Patellar Transskeletal Traction for the Treatment of Chronic Patellar Pseudoarthrosis

Patellar fractures, which constitute approximately 1% of bone lesions, may lead to severe impairment of the extensor mechanism. When conservative or surgical treatment fails, the patella may develop pseudoarthrosis. Neglect or delayed treatment of this type of injury may lead to significant diastasis between the patellar fragments. There is no consensus regarding the best treatment for such cases. This study is aimed at describing a rare case of patellar pseudoarthrosis in a patient who underwent two-step surgical treatment comprising transskeletal patellar traction followed by osteosynthesis with a tension band. A 17-year-old male patient presented with a left patellar fracture that resulted from a fall from a standing height 8 years ago. He did not undergo any type of surgical treatment during that time, but the fracture was immobilized for only 2 weeks. The two-step surgical treatment with transskeletal patellar traction and patellar osteosynthesis was performed and provided satisfactory functional clinical results in this patient. This two-step surgical treatment can be performed in cases similar to ours with satisfactory results

Posterior Root Repair of Medial Meniscus Combined With Valgus Opening Wedge Tibial Osteotomy

The medial meniscal root tear, a particular meniscal injury at the level of its posterior bone insertion, leads to a loss of impact absorption and load distribution capacity, similar to total meniscectomy. Therefore, its repair is fundamental for knee joint longevity. This type of injury often occurs in middle-aged patients with lower limbs varus malalignment, which results in mechanical overloading of the medial compartment and induces premature cartilage wear out. The success of meniscal root repair, with meniscal bone reinsertion, depends on the correction and realignment of varus deformities greater than 5° for physiological levels. In this situation, corrective tibial osteotomy combined with meniscal repair is indicated. Our goal is to describe the step-by-step technique of the valgus opening wedge tibial osteotomy combined with the arthroscopic reinsertion of the posterior meniscal root in tibia during the treatment of a patient with varus deformity and medial meniscus root tear