Although low-level studies have demonstrated the effectiveness of nerve hydrodissection
, no high-level studies have been reported .
For example, endoscopic techniques for perforator ligation or endovascular therapies have become very prevalent and also sub- cutaneous infiltration of tumescent anesthesia with hydrodissection
, and a powered phlebectomy cath- eter to extract multiple branch varices through lim- ited incisions have been developed.
(2) The use of hydrodissection
to separate the posterior surface of the prostate from the anterior rectal wall in salvage ablation procedures has greatly reduced the risk of rectal injury.
To safely and efficiently develop a paraurethral passage, I perform a hydrodissection
and hemostatic injection at the level of the midurethra using a control top 10-cc syringe with a 22-gauge needle.
By means of a hydrodissection
, done with a Verres needle and using about 60-70 mL of physiologic serum, we create a subplatysmal space, subsequently enlarged in both sides by a specific vascular tunnellizator.
If there was less than 1 cm of subcutaneous tissue overlying the lesion, hydrodissection
and/or warm compresses were used to avoid skin injury.
The injections were applied after the confirmation of location by hydrodissection
developed anterior to erector spinae muscle with 1-2 mL of local anaesthetic solution (Figure 1).
Local anesthesia consisting of xylocaine 1% with epinephrine was utilized in order to achieve hemostatic control and hydrodissection
. The alar cartilage was dissected in its integrity, both internally and externally, with careful attention not to violate the vestibular mucosa.
After the area to be intervened was disinfected, the local anesthetic was administered using a 21-gauge, 100-mm needle (Quincke SonoPlex Pajunk, Geisingen, Germany) with the in-plane technique between the middle layer of the thoracolumbar fascia and QL muscle at the posterior edge of the quadratus lumborum muscle for posterior QLB, and between the aponeurosis at the lateral edge of the QL muscle and TF after the place was confirmed with the hydrodissection
for lateral QLB (the target point was the junction between fascia and QL muscle) (8,10) (Figures 2,3).
Micro-incisional techniques maintains a stable chamber, construction of a round and centred continuous curvilinear capsulorehxis (CCC), effective cortical cleaving hydrodissection
, efficient aspiration of lens material, safe cortical clean-up, careful introduction of the IOL and at the end a seidel negative incision closure15,20,21.
must be done gentlely and sufficiently to ensure that the crystal nucleus may be adequately rotated.