We performed a systematic review of the literature on the surgical treatment of cleft lip, emphasizing the prevalence, complications associated with the treatment and the points of disagreement between authors. We conducted a literature cross-sectional search that analyzed publications in books, articles and on the databases SciELO - Scientific Electronic Library Online, PubMed, of the National Center for Biotechnology Information. We conclude that: 1) the severity of the cleft will indicate the technique presenting more advantages; 2) the different approaches indicate that there is no consensus on the optimal technique; and 3) the surgeon experience contributes to choosing the best option.

The objective of this study is to disclose an experimental model of low cost, which complies with the regulatory norms of animal experiments by using dead animals from other experiments, contributing to the improvement of microsurgery learning. Cadavers of Wistar rats, originated from disposal of other courses, are used. The corpses of thawed mice are used for basic microsurgical training of medical students at the Nove de Julho University, aiming to contribute to the students' training. Their use is justified by the low cost of the material used, many animals being spared during the intermediate phase of skill development for realization of micro-anastomoses. This experimental model is inexpensive and allows the rational use of animals, corroborating with the ethical standards of experimental research and contributing to the education and training of microsurgery.

There was no statistically significant increase in the spleen volume after partial ligation of the portal vein when comparing the calculated volume in the first operation to the volume found at reoperation. There was no difference when comparing the spleen volumes of the animals reoperated after 15 days and the ones reoperated after 30 days.

Background: Adhesions induced by biomaterials experimentally implanted in the abdominal cavity are basically studied by primary repair of different abdominal wall defects or by the correction of incisional hernias previously performed with no precise definition of the most appropriate model. Aim: To describe the adhesions which occur after the development of incisional hernias, before the prosthesis implantation, in an experimental model to study the changes induced by different meshes. Methods: Incisional hernias were performed in 10 rats with hernia orifices of standardized dimensions, obtained by the median incision of the abdominal wall and eversion of the defect edges. Ten days after the procedure adhesions of abdominal structures were found when hernias were repaired with different meshes. Results: The results showed hernia sac well defined in all rats ten days after the initial procedure. Adhesions of the greater omentum occurred in five animals of which two also showed adhesions of small bowel loops besides the omentum, and another two showed liver adhesions as well as the greater omentum, numbers with statistical significance by Student's t test (p<0.05). Conclusion: Although it reproduces the real clinical situation, the choice of experimental model of incisional hernia repair previously induced implies important adhesions, with possible repercussions in the evaluation of the second operation, when different implants of synthetic materials are used.

Introdução: A anastomose arteriovenosa latero-lateral é um procedimento complexo para acadêmicos de medicina, pois requer treinamento repetitivo. Objetivo: Comparar o aprendizado de alunos do quinto e décimo semestres da graduação de medicina, após treinamento de anastomose arteriovenosa latero-lateral, em modelo para treinamento que utiliza línguas bovinas. Materiais e Métodos: Estudo realizado na Universidade Nove de Julho, São Paulo, SP, Brasil, com a participação de 20 graduandos de medicina (dois grupos de dez alunos, de quinto e décimo semestres). No primeiro dia os alunos assistiram aula sobre a técnica da anastomose arteriovenosa latero-lateral e realizaram o procedimento, sendo avaliados dez critérios quanto à realização do procedimento. Os grupos treinaram durante quatro sessões de duas horas e foram novamente submetidos à mesma avaliação. As notas médias foram analisadas pelo teste T de Student. Resultados: O grupo de quinto semestre obteve média de 3 pontos na avaliação 1 e 5 pontos na avaliação 2 (p = 0,08393). O grupo de décimo semestre obteve média de 5 pontos na avaliação 1 e 7 pontos na avaliação 2 (p = 0,08393). Conclusões: Comparando o desempenho dos alunos de quinto e décimo semestre, após treinamento específico da anastomose vascular proposta, houve melhora na nota dos dois grupos, mas não houve significância estatística quando os valores foram comparados.

BackgroundThe calculation of the volume ratio between the hernia sac and the abdominal cavity of incisional hernias is based on tomographic sections as well as the mathematical formula of the volume of the ellipsoid, which allows determining whether this is a giant hernia or there is a "loss of domain". As the images used are not exact geometric figures, the study of the volume of two solid organs of Wistar rats was performed to validate these calculations.AimTo correlate two methods for determining the volume of the kidney and spleen of rats, comparing a direct method of observation of the volume with the mathematical calculation of this value.MethodsThe volume of left kidney, geometrically more regular, and spleen, with its peculiar shape, of ten animals was established in cubic centimeters after complete immersion in water with the aid of a beaker graduated in millimeters. These values ​​were compared with those obtained by calculating the same volume with a specific mathematical formula: V = 4/3 × π × (r1 x r2 x r3). Data were compared and statistically analyzed by Student's t test. RESULTS: Although the average volume obtained was higher through the direct method (1.13 cm3 for the left kidney and 0.71 cm3 for the spleen) than the values ​​calculated with the mathematical formula (0.81 cm3 and 0.54 cm3), there were no statistically significant differences between the values ​​found for the two organs (p>0.05).ConclusionThere was adequate correlation between the direct calculation of the volume of the kidney and spleen with the result of mathematical calculation of these values ​​in the animals' studies.

BackgroundPartial portal vein ligation causes an increase in portal pressure that remains stable even after the appearance of collateral circulation, with functional adaptation to prolonged decrease in portal blood flow.AimTo assess whether different constriction rates produced by partial ligation of the vein interfere with the results of this experimental model in rats.MethodsThree groups of five rats each were used; in group 1 (sham-operated), dissection and measurement of portal vein diameters were performed. Portal hypertension was induced by partial portal vein ligation, reducing its size to 0.9 mm in the remaining 10 animals, regardless of the initial diameter of the veins. Five animals with portal hypertension (group 2) underwent reoperation after 15 days and the rats in group 3 after 30 days. The calculation of the constriction rate was performed using a specific mathematical formula (1 - π r 2 / π R2) x 100% and the statistical analysis with the Student t test.ResultsThe initial diameter of the animal's portal vein was 2.06 mm, with an average constriction rate of the 55.88%; although the diameter of the veins and the constriction rate in group 2 were lower than in group 3 (2.06 mm - 55,25% and 2.08 mm - 56.51%, respectively), portal hypertension was induced in all rats and no significant macroscopic differences were found between the animals that were reoperated after 15 days and after 30 days respectively, being the shorter period considered enough for the evaluation. Comparing the initial diameter of the vein and the rate of constriction performed in groups 2 and 3, no statistic significance was found (p>0.05).ConclusionPre-hepatic portal hypertension in rat can be induced by the reduction of the portal vein diameter to 0.9 mm, regardless the initial diameter of the vein and the vessel constriction rate.

OBJETIVO: Tentar correlacionar a hérnia de Spiegel com eventuais alterações anatômicas da parede anterolateral do abdome. Abordar as particularidades do estudo anatômico em cadáver, com destaque aos músculos oblíquo interno, transverso abdominal, aponeurose de Spiegel, linha semilunar e ao aparecimento de hérnias de Spiegel. MÉTODO: A parede anterolateral do abdome foi dissecada em 31 cadáveres frescos do Departamento de Patologia da Santa Casa de Misericórdia de São Paulo, sendo realizada nos dois primeiros cadáveres a dissecção unilateral e nos 29 restantes o estudo bilateral da parede abdominal, completando 60 dissecções. Considerando que operamos no Hospital São Luiz Gonzaga, da Irmandade da Santa Casa de Misericórdia de São Paulo, 13 doentes com 14 hérnias de Spiegel, pudemos correlacionar os elementos clínicos aos estudos anatômicos em cadáver. RESULTADOS: Defeitos encontrados nos músculos e aponeuroses: Oblíquo externo: 4/60 (6,6%) - Oblíquo interno: 6/60 (10%) - Transverso abdominal: 14/60 (23,3%). Disposição dos músculos em forma de feixes de fibras: Oblíquo interno: 10/60 (16,6%) - Transverso abdominal: 12/60 (20%). CONCLUSÕES: As variações anatômicas e os defeitos encontrados, durante as dissecções do oblíquo interno e transverso abdominal, não se acompanharam de hérnias de Spiegel no cadáver, já a gordura pré-peritoneal, dissecando as fibras da aponeurose de Spiegel e oblíquo interno, foi encontrada nas operações e nas dissecções, podendo representar uma relação entre os defeitos musculoaponeuróticos da parede anterolateral do abdome e a hérnia de Spiegel.