• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.371-376
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• 2005

Background: Retrospective study was carried out on patients with primary spontaneous pneumothorax with the aim of determining if conventional thoracoscopic wedge resection is superior to modified transaxillary minithoracotomy with thoracoscopy in the surgical treatment. Material and Method: 160 patients, aged 14 to 35 years with primary spontaneous pneumothorax were involved in this study. Patients were assigned to two groups by surgical technique; Conventional thoracoscopic wedge resection (group A; n=80) and modified transaxillary minithoracotomy with thoracoscopy (group B; n=80). Apical pleural abrasion & talc poudrage were performed in all cases. This study evaluated the following factors: duration of operation, days of analgesics used after operation, number of no air leak on the first postoperative day, duration of indwelling chest tube, hospital stay, postoperative complications, chronic chest pain (during follow-up) and resumption of normal activity. Relapses (ipsilateral recurrence after discharge) during follow-up periods were evaluated. Result: No significant differences were found in any of the factors studied in either group. Conclusion: Conventional thoracoscopic wedge resection and modified transaxillary minithoracotomy with thoracoscopy offer similar results in the surgical treatment of primary spontaneous pneumothorax. The rate of complication is low and the level of pain is acceptable without long-term sequele. Therefore, modified transaxillary minithoracotomy with thoracoscopy method appears as a valuable alternative surgical technique.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.52-54
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• 1998

Recently, several versatile approaches via limited incision have been developed for minimally invasive cardiac surgery. As the incision is limited, it is often dfficult to get a satisfactory operative field, especially for the manipulation of two separate lesions such as simultaneous mitral and aortic valve disease with a single limited incision. Here, we describe a case of successful double valve replacement via ministernotomy, which was followed by two cases of minimally invasive aortic valve replacement via transsternal approach. The operative field was unexceptionally satisfactory and the postoperative patient's acceptance was high. The methodology is described with a review of the relevant literatures.

• Journal of Chest Surgery
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• v.32 no.4
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• pp.373-378
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• 1999

Background: Minimally invasive technique for various cardiac surgeries has become widely accepted since it has been proven to have distinct advantages for the patients. We describe here the results of our experiences of minimal incision in cardiac surgery. Material and Method: From February 1997 to November 1998, we successfully performed 31 cases of minimally invasive cardiac surgery. Male and female ratio was 17:14, and the patients age ranged from 1 to 75 years. A left parasternal incision was used in 9 patients with single vessel coronary heart disease. A direct coronary bypass grafting was done under the condition of the beating heart without cardiopulmonary bypass support(MIDCAB). Among these, one was a case of a reoperation 1 week after the first operation due to a kinked mammary artery graft. A right parasternal incision was used in one case of a redo mitral valve replacement. Mini-sternotomy was used in the remaining 21 patients. The procedures were mitral valve replacement and tricuspid annuloplasty in 6 patients, mitral valve replacement 5, double valve replacement 2, aortic valve replacement 1, removal of left atrial myxoma 1, closure of atrial septal defect 2, repair of ventricular septal defect 2, and primary closure of r ght ventricular stab wound 1. The initial 5 cases underwent a T-shaped mini-sternotomy, however, we adopted an arrow-shaped ministernotomy in the remaining cases because it provided better exposure of the aortic root and stability of the sternum after a sternal wiring. Result: The operation time, the cardiopulmonary bypass time, the aorta cross-clamping time, the mechanical ventilation time, the amount of chest tube drainage until POD#1, the chest tube indwelling time, and the duration of intensive care unit staying were in an acceptable range. There were two surgical mortalities. One was due to a rupture of the aorta cannulation site after double valve replacement on POD#1 in the mini-sternotomy case, and the other was due to a sudden ventricular arrhythmia after MIDCAB on POD#2 in the parasternal incision case. Postoperative complications were observed in 2 cases in which a cerebral embolism developed on POD#2 after a mini-sternotomy in mitral valve replacement and wound hematoma developed after a right parasternal incision in a single coronary bypass grafting. Neither mortality nor complication was directly related to the incision technique itself. Conclusion: Minimally invasive surgery using parasternal or mini-sternotomy incision can be used in cardiac surgeries since it is as safe as the standard full sternotomy incisions.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.258-262
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• 2005

An 18-year old woman had dysphagia and frequent vomiting after meals for 6 years. She lost 15 kg in 6 months recently. After esophageal manometry, she was diagnosed with achalasia. We decided to use laparoscopic surgery because there was no symptomatic improvement after medication. We made small 5 incisions on her abdomen. We performed Heller myotomy and Dor fundoplication. We performed esophagogram one day after the operation. There was no leakage of the contrast media, and it passed well. She started to eat at the 2nd day after the operation and was discharged on the 9th day without other specific problem.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.69-73
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• 2008

Synovial chondromatosis is an uncommon condition, and the involvement of the shoulder joint is rare. A 15 year old female patient presented to author's institution for right shoulder pain. We checked the plain radiographs and MRI. And they showed that a diagnosis of synovial chondromatosis in the shoulder, and they also demonstrated that the disease involved the bicipital tendon sheath as well as glenohumeral joint. We removed all loose bodies with total synovectomy by arthroscopic procedure, and a miniopen procedure for the lesions of biceps tendon sheath. Arthroscopic treatment affords excellent visualization of the shoulder joint with less morbidity. However, with current arthroscopic techniques, it is difficult to manage the synovial chondromatosis of biceps tendon in bicipital groove. The authors suggest that the complete elimination of synovial chondromatosis involving shoulder requires a mini-open procedure for the lesions of biceps tendon sheath in addition to the arthroscopic resection of the affected synovium and loose body removal in the glenohumeral joint.

• Journal of Chest Surgery
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• v.30 no.11
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• pp.1139-1141
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• 1997

Recently, minimally invasive approach via limited incision becomes one of the rapidly developing strategy in cardiac surgery as it gives less surgical trauma and is more satisfactory to the patients in respect to operative scar although the surgical technique is more demanding. Here, we report two cases of aortic valve replacement via limited transsternal incision. The methodology is described with review of the relevant literature.

• Journal of Chest Surgery
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• v.31 no.3
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• pp.308-310
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• 1998

Minimally invasive techniques for various cardiac disease are widely accepted in these days. We report a successful case of reoperative mitral valve replacement approached successfully by a small right parasternal incision.