• Title/Summary/Keyword: 수술 수기

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Arthroscopic Rotator Cuff Repair: Single Row Technique (관절경적 회전근 개 봉합술: 일열 봉합 수기)

  • Park, Hyung-Bin
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.155-159
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    • 2007
  • Arthroscopic single-row rotator cuff repair is a well established surgical technique for the treatment of rotator cuff tears. However, the problem of postoperative retear remains a concern. Various avenues are being explored to address this problem. Some studies have suggested that restoring the anatomical footprint may improve the healing and initial strength of the repaired rotator cuff tendon. The double-row technique was introduced as a method of reconstructing the anatomical footprint. According to biomechanical studies on cadavers, this technique improved mechanical strength and reduced gap formation. However, the biological properties of reattached tendon such as tension, and vascularity have not been proved yet. Furthermore, the apparent mechanical superiority of the double-row over the single-row construction has not resulted in better functional outcomes. Therefore, the less complicated and less costly single-row technique is still the recommended treatment for rotator cuff repairs.

Mitral Valve Reconstruction in Mitral Insufficiency : Intermediate-Term Results (승모판 폐쇄부전증에서 승모판 재건술의 중기평가)

  • 김석기;김경화;김공수;조중구;신동근
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.705-711
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    • 2002
  • The advantages of mitral valve reconstruction have been well established and so mitral valve reconstruction is now considered as the procedure of choice to correct mitral valve disease. This is the report of intermediate-term results of 38 cases that performed mitral valve reconstruction for valve insufficiency(the total number of mitral valve reconstruction were 49 cases, but 11 cases that performed mitral valve replacement due to incomplete reconstruction were excluded). Material and Method : From March 1991 to March 2001, 38 patients underwent mitral valve repair due to mitral valve regurgitation with or without stenosis. Mean age was 47.6$\pm$14.7 years(range 15 to 70 years) : 11 were men and 27 were women. The causes of mitral valve regurgitation were degenerative in 14, rheumatic in 21, infective in 2 and the other was congenital. Result : According to the Carpentier's pathologic classification of mitral valve regurgitation, 3 were type 1 , 16 were type II and 19 were type III. Surgical procedures were annuloplasty 15, commissurotomy 19, leaflet resection and annular plication 9, chordae shortening 11, chordae transfer 5, new chordae formation 2, papillary muscle splitting 2 and vegetectomy 2. These procedures were combined in most patients. There were 2 early death and the causes of death were respiratory failure, renal failure and sepsis. There was no late death. Valve replacement was done in 6 patients after repair due to valve insufficiency or stenosis 3 weeks, 1, 3, 51, 69, 84months later respectively. These patients have been followed up from 1 to 116 months(mean 43.0 months). The mean functional class(NYHA) was 2.36 pre-operatively and improved to 1.70. Conclusion : In most cases of mitral valve regurgitation, mitral valve reconstruction when technically feasible is effective operation that can achieve stable functional results and low surgical and late mortality.

CLINICAL STUDY ON TRANSSEPTAL TRANSSPHENOIDAL APPROACH TO PITUITARY GLAND (경비중격 경접형동 뇌하수체 수술에 관한 임상적 고찰 -수술적인 접근 방법에 관하여-)

  • 민양기;정하원;오승하;정종우
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.39-39
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    • 1991
  • 뇌하수체 종양에 대한 경비중격 경접형동 수술은 1907년 Schloffer가 비절개수술에 의한 방법을 보고한 이래 1914년 Cushing이 sublabial approach를 정립하였으나, 이후 약 반세기 동안 경비중격 경접형동 수술이 개두술에 비해 종양의 재발율이 높다는 이유로 기피되어왔다. 1968년에 이르러 Cottle의 maxilla-premaxilla approach로 비중격에 대한 수기가 축적되고 수술현미경의 발달로 미세수술이 도입되면서 경비중격 경접형동수술이 다시 각광을 받게 되었다. 이후 sublabial approach, alotomy approach, columellar approach, external rhinoplasty approach 등이 개발되어 보고되었으며 접형동의 함기화가 불완전한conchal 형이나 터어키안 상측부로의 종양의 확장이 심한 예를 제외하고는 모두 이 방법으로 수술을 시행하는 것이 보편화되어 있으며 문헌고찰에 의하면 개두술시의 술후 사망율이 17%인데 비해 경비중격 경접형동술의 경우 1.8%라고 보고되고 있다. 서울대학교병원 이비인후과에서는 sublabial approach로 터어키안까지 종양을 노출시킨 후 신경외과의와 공동으로 뇌하수체 종양을 치료한 예를1977년부터 1988년까지 135례를 보고한 바 있다. 최근에는 sublabial approach의 단점을 보완하면서 외비의 해부학적인 구조에 익숙해질 수 있는external rhinoplasty approach를 이용하여 경비중격 경접형동 수술을 시행하고 있으며 1977년부터의 치험례를 임상분석하여 특히 external rhinoplasty approach의 수술성적을 보고하는 바이다.

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Phonosurgical Vocal Fold Injection (성대주입에 의한 성대수술 -수술수기 및 주입물질을 중심으로-)

  • 최홍식;김성수
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.12 no.1
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    • pp.5-10
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    • 2001
  • Glottal incompetence is one of the causative condition of hoarseness. There have been various methods to improve the glottal conditions. Vocal fold augmentation by injection under direct visual control is a quick and simple operation. Various vocal fold augmentation procedures have developed in recent years. Phonosurgical vocal fold injection can be classified as superficial or deep, by the location of the injection. The choice of material fir vocal fold injection is critical and should be determined by the injection location, technique, and the pathologic condition. There are multiple approaches or methods for vocal f31d injection ; the most widely used are presented in detail in this article.

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Surgical Technique thor the Removal of Deep Vein Thrombi of the Lower Extremities (하지 심부정맥 혈전의 외과적 제거)

  • 이상호;최준영;김성호;김병균;장인석;이정은;옥창대;김종우;나재범
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.402-406
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    • 2002
  • The conventional surgery method of thrombectomy of venous thrombi from the deep veins of the lower extremity was the use of Forgarty balloon catheter. The catheter is inconvenient due to the presence of the balloon and prohibiting venous valves within the venous trees. With the use of a stone-forceps(Fig. 1), thrombi within iliofemoral vein could be easily removed without the obstacle of the valves because the instrument keeps valves open. This instrument is also useful in monitoring the back-flow from the iliac vein. Thrombi within the veins below the level of inguinal incision are removed successfully only by effective manual compression of the calf and thigh muscles. 1 recommend operating on the iliac vein first rather than the lower venous tree.

Hand-assisted Laparoscopic Abdominal Aortic Aneurysm Repair Through a 6 cm Incision (6 cm 절개선을 통한 수기 보조 복강경 복부 대동맥류의 수술)

  • Choi, Hyung-Yoon;Song, Suk-Won;Yi, Gi-Jong
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.645-648
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    • 2009
  • We performed hand-assisted laparoscopic surgery for a 67-year-old male with a 5.6 cm sized abdominal aortic aneurysm. To the best of our knowledge, this is the first report in Korea. After an initial hand dissection of the abdominal aorta under laparoscopy, we performed proximal anastomosis and distal abdominal. aorta suture ligation through a 6 cm abdominal incision. Distal anastomosis was done at the bilateral common femoral arteries. He resumed his oral intake 6 hours after the surgery and discharged at the $4^{th}$ postoperative day.