• Title/Summary/Keyword: 최소침습수술

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Endovascular Treatment for Vascular Injuries of the Extremities (사지 혈관 손상의 인터벤션 치료)

  • Tae Won Choi;Yohan Kwon;Jinoo Kim;Je Hwan Won
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.846-854
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    • 2023
  • Vascular injuries of the extremities are associated with a high mortality rate. Conventionally, open surgery is the treatment of choice for peripheral vascular injuries. However, rapid development of devices and techniques in recent years has significantly increased the utilization and clinical application of endovascular treatment. Endovascular options for peripheral vascular injuries include stent-graft placement and embolization. The surgical approach is difficult in cases of axillo-subclavian or iliac artery injuries, and stent-graft placement is a widely accepted alternative to open surgery. Embolization can be considered for arterial injuries associated with active bleeding, pseudoaneurysms, and arteriovenous fistula and in patients in whom embolization can be safely performed without a risk of ischemic complications in the extremities. Endovascular treatment is a minimally invasive procedure and is useful as a simultaneous diagnostic and therapeutic approach, which serve as advantages of this technique that is widely utilized for vascular injuries of the extremities.

The Comparison of Clinical Study of Off Pump and On Pump CABG (On Pump-CABG와 Off Pump-CABG의 임상적 고찰에 관한 비교연구)

  • 유경종;임상현;송석원;김치영;홍유선;장병철
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.261-266
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    • 2002
  • In an attempt to avoid the adverse effects of the cardiopulmonary bypass, off pump coronary artery bypass grafting(Off pump CABG) that has recently been rediscovered and refined. We compared the preoperative risk factors and in-hospital outcomes of patients done Off pump with those done On pump CABG. Material na Method: One hundred seventy eight patients was underwent CABG between January 2001 and July 2001 12 patients whom underwent associated valvular or left ventricular volume reduction surgery were excluded in this study Data were collected for 52 Off pump CABG and 114 On pump CABG for patient and disease risk factors, extent of coronary disease, and in-hospital outcomes. Result: Off pump CABG and On pump CABG groups did not show any differences in their patient and disease risk factors, and extent of coronary disease. Off pump CABG group had significantly lower mean operation time(234 $\pm$ 37 min vs 290 $\pm$ 48 min, p<0.001), lower mean CK-MB level(10.1 $\pm$ 13.5 IU/L vs 33.1 $\pm$ 18.2 IU/L, p<0.001) and mean ventilation time(14.8 $\pm$ 3.5 hours vs 16.2 $\pm$ 4.9 hours, p=0.048) than On pump CABG groups. On pump CABG group had significantly more distal grafts(3.4 $\pm$ 0.9 vs 2.6 $\pm$ 0.8, p<0.001) than Off pump CABG groups. There were no operative mortality in two groups. Off pump) CABG and On pump CABG groups did not show any differences in their postoperative complications and outcomes including perioperative myocardial infarction, stroke, respiratory failure, renal failure, reoperation, the amount of bleeding, the need of intraaortic balloon pump, the need of inotropics, and the stay of intensive care unit and hospital. Two patients were converted to On pump CABG. Conclusion: This study showed that patients having Off pump CABG are not exposed to a greater risks of adverse outcomes and also provided evidence that patients having Off pump CABG have significantly lower operation time, CK-MB, ventilation time and less distal grafts. Although there may be potential benefits to Off pump CABG, further studies must be directed to determine those patients who would benefit from Off pump CABG.

Clinical Effect of Arthrocentesis for Patients with Disc Displacement without Reduction of Temporomandibular Joint : Report of Cases (측두하악관절의 비정복성 관절원판변위 환자에 대한 관절강 세정술의 임상효과 : 증례보고)

  • Kim, Cheul;Kim, Young-Jun
    • Journal of Oral Medicine and Pain
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    • v.31 no.2
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    • pp.177-183
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    • 2006
  • The management of refractory pain and limitation of mouth opening in the temporomandibular joint (TMJ) is both challenging and controversial. Arthrocentesis is a simple technique and it can be used instead of more invasive surgical procedures for patients who failed to conventional conservative treatments. The patients in this case report had complained persistent severe pain and restricted mandibular movement of TMJ, although they had been treated with conservative therapy, e.g., stabilization splint therapy, behavioral therapy, physical therapy, pharmacological therapy. Therefore we employed arthrocentesis for these patients, and they showed significant reduction of pain and improvement of mandibular movement after repetitive arthrocentesis. We recommend arthrocentesis as an effective, minimally invasive technique for patients with continuing severe pain and restricted mobility in the TMJ that is unresponsive to conservative management.

CT-guided Percutaneous Thermoablation for the Treatment of Osteoid Osteoma (경피적 고주파 열 치료를 이용한 유골 골종의 치료)

  • Sung, Ki-Sun;Seo, Jai-Gon;Ha, Hae-Chan
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.88-95
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    • 2004
  • Purpose: Current treatment for osteoid osteomas is usually surgical excision of the nidus. Various minimal invasive techniques have been reported to overcome the invasiveness of the surgical excision. We treated 22 patients with osteoid osteoma by percutaneous thermoablation of the nidus under computed-tomography guidance. Materials and Methods: Twenty two consecutive patients underwent CT-guided percutaneous radio-frequency thermoablation between April 1999 and May 2004. The mean age was 26.5(7~55) years. In three cases, the diagnosis was confirmed pathologically before the prodedure while the others clinically and radiologically. Computed tomography (CT)-guided percutaneous RF ablation was performed with general or spinal anesthesia. With an RF electrode, the lesion was heated to 80 or 90 degrees C for 6(3~8) minutes. Clinical success was assessed at a mean of 30(4~62) months after the procedure at out patient clinic or by telephone interview. Results: The procedure was technically successful in all cases except a complication. Patients were discharged on 1.9 days after the procedure and resumed normal activities immediately. All patients but three (86%) remained pain free during follow-up (range 4~62 months). A second thermoablation treatment relieved the recurrent symptoms in 2 patients and the remained had persistent pain without a second prodedure. Conclusion: Percutaneous thermoablation appears to be safe and effective for osteoid osteomas, and is a minimally invasive procedure alternative to surgical resection.

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Hybrid Natural Orifice Transluminal Endoscopic Cholecystectomy in Dogs: Transgastric, Transcolonic and Transvaginal Approaches (개에서 자연개구부를 통한 하이브리드 내시경적 담낭절제술: 경위장관, 경결장 및 경질 접근법)

  • Kim, Soo-Hyun;Jeong, Seong-Mok;Shin, Sa-Kyeng;Kim, Seong-Su;Shin, Beom-Jun;Lee, Jae-Yeon;Park, Ji-Yeong;Kim, Myung-Cheol;Kim, Young-Il;Lee, Sang-Il;Kim, Ji-Yeon
    • Journal of Veterinary Clinics
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    • v.28 no.5
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    • pp.497-505
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    • 2011
  • Natural orifice transluminal endoscopic surgery is a newly emerging technique recently, with its many potential advantages in clinical practice. Cholecystectomy by Hybrid NOTES in this work, performed with single working channel endoscope in conjunction with a laparoscopic grasping forceps in dogs, is a "bridge" between laparoscopic procedure and pure NOTES. Three different approaches for cholecystectomy were carried out; transgastric, transcolonic and transvaginal. In all three approaches, abdominal opening was made by a 5 mm trocar, followed by making pneumoperitoneum of 4 mmHg with $CO_2$ insufflator. Transgastric cholecystectomy, single working channel endoscope was advanced to the peritoneal cavity through gastric incision in antral region made by endoscopic needle knife. Endoscope was retroflexed to visualize the gall bladder. Transcolonic access, incision for endoscopic entry was done at right ventral wall of descending colon, 15 cm inside from the anus. Incision in transvaginal access was made at right-ventral region, just caudal to the caudal tubercle. With the simple traction by the laparoscopic grasping forceps, good visualization of surgical field was obtained in all three groups. Cystic duct and artery were ligated with endoclips; for complete gall bladder dissection from liver, L-knife was used. Closure of incision sites were done in transgastric and transcolonic cholecystectomy by endoclips, not in transvaginal approach.

Endoscopic Resection of Early Gastric Cancer in Korea: Recent Results and Future Directions (조기위암 내시경절제술-최근 국내 성적과 발전방향)

  • Lee, Jun-Haeng
    • Journal of Gastric Cancer
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    • v.9 no.2
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    • pp.39-45
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    • 2009
  • Endoscopic resection has been established as one of the treatment options for selected cases of early gastric cancer in Korea. Yet the indications, best treatment methods, management of complications and follow-up methods after the procedure are still uncertain. Some large-scale multicenter studies have recently been reported in Korea. In this review, I will provide an overview of the recent published articles and future directions for endoscopic resection of early gastric cancer.

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Minimally Invasive Surgery with Tenorrhaphy for Postoperative Hallux Varus Deformity Combined with Flexor Hallucis Longus Rupture after Hallux Valgus Correction: A Case Report (무지외반증 교정술 이후 합병된 무지내반증과 병발한 장무지굴건 파열에 대한 최소침습적 수술 및 건 봉합술: 증례 보고)

  • Nam, Bum Joon;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.2
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    • pp.102-106
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    • 2020
  • A postoperative hallux varus deformity is a dreaded complication of hallux valgus surgery. Several surgical options have been introduced to overcome this problem. This paper reports an uncommon case of a 68-year-old female patient who presented with a postoperative hallux varus deformity combined with a rupture of the flexor hallucis longus (FHL) tendon. She was treated successfully by a minimally invasive correctional osteotomy with open tenorrhaphy. With experience in treating this complicated case, it was noted that FHL could be transected during the trans-articular adductor tenotomy. Hence, extra caution is needed when the degree of hallux valgus deformity is excessive. To the best of the author's knowledge, correctional valgization osteotomy for a postoperative hallux varus deformity in a minimally invasive manner has not been reported. This case report is expected to benefit surgeons and their patients with severe hallux valgus deformity.

Minimally Invasive Surgery for Hallux Valgus Deformity Using Intramedullary Low Profile Plate Fixation: A Case Report (소형 금속판의 골수강 내 고정을 통한 최소 침습적 무지 외반증 교정 수술: 증례 보고)

  • Cho, Sung Tan;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.3
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    • pp.135-138
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    • 2019
  • According to a recent systemic review, hallux valgus deformity has a prevalence rate of about 23% among adults aged 18 to 65 years. To date, more than 100 operative methods have been reported for the correction of hallux valgus deformity. For young female with mild to moderate hallux valgus deformity, minimally invasive surgery can be considered for aesthetic demands. Here, we report a case of a young female patient with mild hallux valgus deformity treated by minimally invasive surgery using intramedullary low profile plate fixation. This can be the favorable method for secure fixation of the osteotomy site and prevention of medial skin irritation symptoms derived from a sharp osteotomy margin.

Development of Immersive Augmented Reality interface for Minimally Invasive Surgery (증강현실 기반의 최소침습수술용 인터페이스의 개발)

  • Moon, Jin-Ki;Park, Shin-Suk;Kim, Eugene;Kim, Jin-Wook
    • The Journal of Korea Robotics Society
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    • v.3 no.1
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    • pp.58-67
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    • 2008
  • This study developed a novel augmented reality interface for minimally invasive surgery. The augmented reality technique can alleviate the sensory feedback problem inherent to laparoscopic surgery. An augmented reality system merges real laparoscope image and reconstructed 3D patient model based on diagnostic medical image such as CT, MRI data. By using reconstructed 3D patient model, AR interface could express structure of patient body that is invisible outside visual field of laparoscope. Therefore, an augmented reality system improved sight information of limited laparoscope. In our augmented reality system, the laparoscopic view is located at the center of a wide-angle concave screen and reconstructed 3D patient model is displayed outside the laparoscope. By using a joystick, the laparoscopic view and the reconstructed 3D patient model view are changed concurrently. With our augmented reality system, the surgeon can see the peritoneal cavity from a wide angle of view, without having to move the laparoscope. Since the concave screen serves immersive environments, the surgeon can feel as if she is in the patient body. For these reasons, a surgeon can recognize easily depth information about inner parts of patient and position information of surgical instruments without laparoscope motion. It is possible for surgeon to manipulate surgical instruments more exact and fast. Therefore immersive augmented reality interface for minimally invasive surgery will reduce bodily, environmental load of a surgeon and increase efficiency of MIS.

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A Medical Palpation Guidance System for Minimally Invasive Surgery using Contact Pressure Distribution (접촉 압력 분포를 이용한 최소 침습 수술을 위한 의료 촉진 가이던스 시스템)

  • Kim, Hyoungkyun;Chung, Wan Kyun
    • Journal of Sensor Science and Technology
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    • v.26 no.4
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    • pp.266-273
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    • 2017
  • In this research a medical palpation guidance system for minimally invasive surgery (MIS) is proposed. Palpation is a useful tool for identifying a size and location of a lump during a surgery. However, conventional manual palpation is only available in open surgery, so there has been several researches about palpation assistant or guidance system for MIS. The previously developed systems are based on a pressure based or stiffness based approach. These previous approaches have some limitations in increasing complexity of the systems and lack of geometric information about the lump which is more important information for the lump removal than the stiffness information. We propose a palpation guidance system using a novel approach using contact pressure distribution. Since our approach gives the geometry information of the lump as well as the existence information, the operator can easily notice the currently identified lump region and the optimal position for the next palpation. The experiment results show that our approach can offer the geometry information of the lump correctly.