Friday, June 15, 2012

Hypospadias part 2 (pics): orthoplasty :step by step oper series

Hypospadias part 2 (pics only): orthoplasty & ttt options :step by step oper series

pics as post for those who dislike slideshare or have slow net

Orthoplasty steps:

•Dissection of atretic C.S. & under urethral plate
•Shortening of long side (no need for plate transection)
•Lengthening of short side (need plate transection)

•Transection of urethral plate (last resort, with or without lengthening)

shorten longer (dorsal) aspect-
1- Nesbitt

elevate NVB
excising an ellipse or ellipses from the dorsum of the tunica albuginea,
closing the defects in watertight fashion

2- T.A.P. plication (modified Nesbitt)
Elevation of NVB
Ts parallel incisions

3- Baskin suture
Dorsal midline ts sutures
No need to elevate NVB

Lengthening short surface-
1- Heineke-Mikulicz suture
Not effective
Ts incision & close long.

2- Dermal graft
From non-hairy groin



atef soliman said...

thanks go ahead for part 3

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