Publications
“Scientific research is one of the most exciting and rewarding of occupations.”
A doctor is a scientist as well. Conducting research allows me to get new insights on how the body functions, how certain surgical techniques can be improved, and what the impact is of the surgery on a patient's quality of life. It allows me to continuously improve the care that I can provide to you.
Below you will find an overview of my publications. Some are open access, which means they can be read by anyone (just click on the article to go to the journal website). I provide you with a short summary of each article and give you insights on how my research improves my surgical technique, treatment options, and results.
Feel free to dig in !
Rejuvenating the mons pubis
A monsplasty is a very rewarding procedure that I continuously incorporate in a body contouring procedure, such as an abdominoplasty or tummy tuck. With aging or weight loss, there is often excess skin and/or bulging of the mons. This may not only cause functional issues but may be a psychological and hygienic burden as well. With the team of UZ Brussels, we published a state-of-the-art article in which we discuss an advanced surgical technique to correct a sagging or bulging mons and give the patient a flatter, more aesthetically appealing mons pubis. This study proves that the patients not only liked their abdomen much more after the procedure but that they also had a lot of functional and aesthetic improvements. I actively bring it up during the consultation when the indication is there and patients usually are very grateful for this little “bonus” I add to the procedure.
Click on the image to read the article.
Enhancing safety during liposuction
Performing liposuction is a technically demanding operation. Not only to deliver an optimal surgical outcome, but also to ensure optimal patient safety. One of the key aspects in patient safety, is making sure the fluid balance of the patient stays within the safety limits of the human body. At the start of each liposuction, a fluid is infiltrated in the subcutaneous tissue (the fat-compartment) to limit blood loss during the procedure and to loosen up the fat tissue. I have performed a clinical study to determine the safety limits of the infiltrated volume, to make sure the patient does not receive too much fluid inside the body. Based on clinical data, we have generated a scientific formula that every surgeon can use to calculate the amount of fluids that can be delivered to the patient. This not only helps the surgeon to prepare the surgery in a more optimal way, but it also enhances the patient safety during surgery and patient recovery after surgery.
Click on the image to read the article.
Visualising your anatomy through AR
These 4 articles are all connected to a company I founded in 2018, called Augmented Anatomy. Our core value is to visualise the patient’s individual anatomy through Augmented Reality. By showing the real anatomy through the skin of a patient, we are able to enhance the safety, improve surgical techniques, and provide better treatments for our patients. Our first product is called ARtery 3D, which enables me to visualise your facial anatomy, based on an MRI of your face. When it’s the first time that I would treat you with fillers, I may ask you to plan an MRI first. The MRI will allow me to visualise your arteries under the skin, so that I am sure I avoid an injection into a blood vessel. This will reduce the risk of complications, reduce the pain during treatment and reduce the risk of bruising. We have published both the MRI-technique and the development of ARtery 3D in a number of articles, which are free to read. The article also won the prize for best journal article of 2022.
Click on the image to read the article.
Breast reconstruction with a free flap from the inner thigh
If you are thinking about having a breast reconstruction (after successfully beating breast cancer), we have 2 main surgical options: using breast implants or using your own tissue. You can find more information on this by clicking here. In case that we would use your own tissue, the first choice remains the abdomen. However, the body offers a number of other regions (flaps) that can be harvested to create a beautiful, natural breast. One of those areas in the inner thigh. To improve the pre-operative planning of this kind of surgery, I have conducted a study to accurately detect the perforators (feeding blood vessels) into the flap and I have developed an axis system to mark them precisely on your leg during the pre-operative drawing. I apply a similar planning system for a tissue flap of the abdomen as well. This will help me during surgery to more precisely find the perforator. It makes the surgery quicker and safer, which will ultimately lead to a faster recovery and less downtime for you !
Click on the image to read the article.
How to successfully treat a rare wound infection
Wound infection is one of the potential complications after any kind of surgery. With a good surgical technique and optimal patient hygiene, we can reduce the risk to a minimum. One of the less frequent bacteria causing a surgical site infection is called Mycobacterium Fortuitum, a micro-organism that often breeds in contaminated water sources. Typical symptoms for this kind of infection are: late presentation (often several weeks after the surgery); the development of small liquid collections with a clear, odourless fluid drainage when evacuated; minor wound dehiscences; local irritation or erythema. Usually there is no pus or any form of severe infection. General symptoms, such as fever, are usually absent. I treated one patient with this kind of rare infection at the University Hospital in Brussels during my residency and found it appropriate to conduct some research on the prevalence, diagnosis and treatment of this bacteria. Although I have published this a few years ago, the findings stay relevant and may always be helpful if another patient would develop a similar infection.
Click on the image to read the article.
Vacuum-Assisted Closure
During my residency at the department of Cardiac Surgery, we had to treat patients from time to time with an infection of the sternum after undergoing cardiac surgery. One of the newest development in the last decennium is the use of a VAC-system or Vacuum-Assisted Closure. Any form of severe wound dehiscence (not only at the sternum) may benefit from this kind of treatment. During VAC-treatment, we treat the wound with a sponge on which a negative pressure is applied. The continuous negative pressure eliminates bacteria, improves the blood flow of the wound bed and ultimately result in a faster wound healing. The “Two Bridges Technique” is a special construction we have developed specifically for cardiac patients, but the VAC-therapy in general comes in handy in case we have complex defects that require thorough debridement and cleaning. I have treated already several patients at the University Hospital with this device, which truly makes a huge difference in patient and surgical outcome.
Click on the image to read the article.
Fat injections after breast cancer surgery
This is the first article I ever published and it involves research that I have conducted with my colleagues on the oncological risk of fat transfer to the breast after surgical treatment for breast cancer. If you had breast cancer for which only a part of the breast was removed, you likely had additional radiotherapy to treat the breast and further reduce the risk of cancer relapse. Although this is a very effective treatment, which avoids a complete mastectomy, the women often complain of a tissue defect and scar retraction at the site of operation. This is not only aesthetically unpleasant, but may cause discomfort and pain. Injecting a bit of your own fat (that we harvest through liposuction) is an elegant solution that can improve the breast volume and shape, and treat the scar retraction and discomfort at the same time. The main concern of this treatment has always been the potential increased risk of cancer relapse, as the transferred fat contains stem cells (cells that are in a very early development stage) that may become cancer cells once they are transferred into the breast. Through this extensive literature search we were able to investigate the risk. Fortunately, we could not find any proof of increased risk of cancer relapse after lipofilling of the breast. I am therefor still very much convinced of the benefits of this kind of operation and the improvements in the quality of life it can give to my patients. So if you would find yourself in a situation where you underwent breast-sparing surgery, do know that I can offer some very elegant solutions to restore the harmony of your breasts.
Read more about partial breast reconstruction and total breast reconstruction.
Click on the image to read the article.
Other publications
Below are a few more articles I co-authored throughout the years. They help to continuously develop and nurture the scientific mind.
Mespreuve M, Bosmans F, Waked K, Vanhoenacker FM. Hand and Wrist: A Kaleidoscopic View of Accessory Ossicles,Variants, Coalitions, and Others. Semin Musculoskelet Radiol 2019;23:1–12. DOI: 10.1055/s-0039-1693974.
Waked K. Hamdi M. Reply to the Editor: Robotic-assisted DIEP flap harvest: A feasibility study on cadaveric model. J Plast Reconstr Aesthet Surg. 2018 Aug;71(8):1216-1230. DOI: 10.1016/j.bjps.2018.05.006.
Waked K, Zeltzer A. Reply to the Editor: The pedicled internal pudendal artery perforator (PIPAP) flap for ischial pressure sore reconstruction: Technique and long-term outcome of a cohort study. J Plast Reconstr Aesthet Surg. 2018 Jun 28. DOI: 10.1016/j.bjps.2018.06.007.
Waked K, Schepens M. State-of the-art review on the renal and visceral protection during open thoracoabdominal aortic aneurysm repair. Journal of Visualized Surgery. 2018;4:31. DOI: 10.21037/jovs.2018.01.12
Peters B, Waked K, Vanhoenacker FM, Ceulemans J, Mespreuve M. Internal herniation with bowel ischemia after Roux-en-Y gastric bypass surgery. Eurorad. 2016 Nov: online: http://www.eurorad.org/case.php?id=14127. DOI: 10.1594/ EURORAD/CASE.14127
Mespreuve M, Waked K,Verstraete, K. Imaging Findings at the Quadrangular Joint in Carpal Boss. Journal of the Belgian Society of Radiology. 2017;101(1), p.21. DOI: 10.5334/jbr-btr.1257
Mespreuve M, Waked K,Verstraete K. Secondary Abutment Syndromes of the Wrist in Trauma: A Pictorial Essay. Journal of the Belgian Society of Radiology. 2017. 102(1), p.54. DOI: 10.5334/jbsr.1558
Mespreuve M, De Smet L, De Cuyper K, Waked K, Vanhoenacker F. MRI diagnosis of carpal boss and comparison with radiography. Acta Radiologica 2017 jan;284185116685925. DOI: 10.1177/0284185116685925