• 대한두경부종양학회지
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• 제28권2호
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• pp.114-117
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• 2012

Background and Objectives : To assure the surgical completeness of the gasless endoscopic thyroidectomy via single incision axillary approach using flexible videoscope which provide wide angle and working space, we compared single incision axillary approach and axillo-areolar approach by means of clinical, surgical outcomes. Materials and Methods : From March 2011 to July 2012, 24 patients who had underwent endoscopic thyroidectomy via transaxillary approach were enrolled. Of total, 17 patients underwent single incision axillary approach(group I) and the other 7 underwent axillo-areolar approach(group II). Results : Patient demographics, surgical indications were similar between the two groups. The operating time(group I 144.6min, group II 153.6 min ; p=.29), blood loss(group I : 55.4cc, group II : 35.7cc : p=.64), hospital stay(group I : 4.2days, group II : 4.4 days ; p=.65) were similar in the two groups. Overall, two patients in group I(2/17, 11.8%) experienced postoperative complications, including one hematoma and one seroma. Due to narrow working space, one patient was change to axillo-areolar approach during single incision axillary approach with $30^{\circ}$ rigid endoscope. Conclusion：Single incision axillary approach is safe and effective similar to other endoscopic thyroidectomy methods using flexible videoscope. Different with $30^{\circ}$ rigid endoscope, 10-mm flexible videoscope can put inside the axillary inicision site in different axis with endoscopic instruments. This difference in endoscopic axis help to prevent crash with endoscopic instrument.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권6호
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• pp.373-378
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• 2020

The purpose of this review is to assess the surgical outcomes of two different treatment modalities, endoscopic and open resection, for the management of sinonasal malignancies by comparing the effectiveness of these two methods. A wide search was carried out considering various electronic databases for English language articles from 2013 to 2018 using keywords such as sinonasal malignancies, endoscopic surgery, open resection for sinonasal malignancies, and endoscopic versus open surgery. One thousand articles were identified from the literature for screening. After a thorough systematic assessment and based on the selection criteria, 10 articles with 4,642 patients were included in this quantitative analysis. With a total of 4,642 patients, 1,730 patients were operated on using endoscopic resection and 2,912 patients were operated on using open resection. The endoscopic approach was found to have a shorter hospital stay compared to open surgical resection (P<0.05). The rate of positive margins and the recurrence rate for open surgical resection were both smaller compared to those for endoscopic resection (P>0.05), and the endoscopic approach had smaller complication rates and a higher survival rate compared to open resection (P>0.05). Though endoscopic resection and open surgical resection have comparable postoperative benefits, preoperative evaluation of cases presenting with sinonasal malignancies is necessary for determining the right treatment method to obtain the best possible results postoperatively.

• Clinical Endoscopy
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• 제57권1호
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• pp.82-88
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• 2024

Background/Aims: Guide tube-assisted endoscopy for procedures that require repeated endoscopic access is safer and more effective than conventional endoscopy. However, its effectiveness has not been confirmed in animal studies. We assessed the usefulness of guide tube-assisted endoscopic procedures in an in vivo porcine model. Methods: Five different guide tube-assisted endoscopic procedures were performed by experienced endoscopists on a pig weighing 32 kg. To evaluate the efficacy of these procedures, we compared the endoscopic approach time when a guide tube was used to that when it was not. Additional endoscopic procedures using a guide tube were performed, including multiple foreign body extractions, multiple polypectomies, and multiple submucosal dissections. To evaluate safety, we compared the insertion force into the proximal esophagus between the guide tube and conventional overtube methods. Results: Using the endoscopic approach with a guide tube required a shorter average approach time to reach the three target lesions than when using the endoscopic approach without a guide tube (p<0.001). Compared to the conventional overtube method, the guide tube method produced a lower average resistance during insertion into the upper esophagus (p<0.001). Conclusions: Guide tube-assisted endoscopic procedures are effective and safe for repeated endoscopic access in an in vivo porcine model.

• 대한두개안면성형외과학회지
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• 제13권2호
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• pp.99-103
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• 2012

Purpose: Many surgical methods for reconstruction of orbital floor fracture have been reported, which include subciliary approach, transconjunctival approach, transantral and transnasal endoscopic approach, etc. The purpose of this study is to demonstrate a surgical technique and analyze the results of transnasal endoscopic approach with Foley catheter ballooning without implantation of artificial surgical material through subciliary approach. Methods: Between February 2007 and November 2010, 29 orbital floor fracture patients, who had no herniated muscles through bone fragments, were treated through transnasal endoscopic approach with Foley catheter ballooning. Under the endoscopic view, the operator identified the opening of maxillary sinus. After widening of the opening using forceps, the operator reduced the fragmented bone with curved suction tip. Thereafter, 18-Fr Foley catheter was inserted. Four weeks after the operation, the catheter was removed. Results: Preoperatively, 6 patients had diplopias, 4 patients had limitations of extraocular motions and 3 patients had enophthalmos. After removal of the Foley catheter 4 weeks after the operation, 2 patients had diplopias, 1 patient had a limitation of extraocular motion, 1 patient has an enophthalmos and 1 patient had numbness on the cheek. These symptoms were resolved about 6 months after the surgery. Conclusion: The operative technique of Foley catheter ballooning through transnasal endoscopic approach without implantation of the artificial surgical material through subciliary approach can be considered one of the appropriate techniques for orbital floor fracture.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.552-556
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• 2006

Purpose: As the use of computed tomographic scanning spread, the diagnosis of blow-out fractures of the medial orbital wall increased. Conventionally, the surgery of blow-out fractures in medial orbital wall was performed by various approaches with external incision or endoscopic approach. Although the field of orbital surgery has progressed significantly during the last decade, accurate realignment and replacement of component is difficult due to lack of visualization of the fracture site, blind dissection of the orbital wall, and difficulty in insertion of implant. In order to overcome these shortcomings, we explored the use of endoscopic transnasal approach together with subciliary approach. Methods: The entrapped periorbital tissues in the ethmoid sinus were completely reduced endoscopically, and the bone defect of medial orbital wall was reconstructed with $Medpor^{(R)}$ insertion via subciliary approach. This technique was applied to 13 patients who had medial orbital wall fracture. Results: The patients were followed-up for 3 to 24 months with an average of 9 months. The postoperative courses were satisfactory in all cases. Conclusion: The conjunction of endoscopic transnasal and subciliary approach technique seems to produce good results in medial orbital wall fracture.

• 한국산학기술학회논문지
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• 제16권10호
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• pp.6985-6991
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• 2015

서론: 통상적인 갑상선 암 수술시 생기는 목의 전면에 있는 흉터를 피하기 위해 여러 다양한 수술 기법들이 고안되고 있다. 저자들이 고안한 로봇 내시경 갑상선 수술법으로 수술을 시행 받은 256예를 대상으로 기구의 변화와 더불어 로봇 내시경적 수술방법(액와 유륜 접근법과 유일-액와 접근법)에 따라 수술 결과를 비교하여 각 수술 방법의 안정성 및 유용성을 확인하고자 하였다. 대상 및 방법: 2008년 11월부터 2014년 7월까지 로봇 내시경 갑상선 수술을 시행 받은 256명의 환자를 대상으로 하였다. 접근방법에 따라 2008년 11월부터 2010년 7월까지 액와-유륜 접근법(Axillo-Breast approach, AB group)이 128례, 2010년 8월부터 2014년 7월까지 유일-액와 접근법(Only-Axillary approach, OA group)이 128예로 구성되었다. 수집된 자료는 SPSS v.12 를 이용하여 실험군과 대조군의 동질성 검정은 independent t-test, fisher's exact test, $x^2$-test로 양측검정을 실시하였다. 결과: 종양의 특성, 수술범위, 채취된 평균 림프절 개수(AB group 5.1개, OA group 6.1개), 수술 후 주요 합병증(AB group 0.8%, OA group 0.8%)은 양 군간에 차이는 없었다. 유일-액와 접근법의 경우 유륜의 흉터를 피할 수 있었다. 결론: 액와-유륜 접근법과 유일-액와 접근을 통한 로봇 내시경적 갑상선 절제술 모두 안전하고 유용한 수술법이다. 로봇 내시경 갑상선 수술에서 유륜의 흉터를 피하고자 하는 경우, 5 mm Maryland dissector 2개를 이용한 유일-액와 접근을 통한 로봇 내시경 갑상선 절제술을 고려해 볼 수 있을 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제40권2호
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• pp.79-83
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• 2006

Objective : The purpose of this study was to describe a surgical technique of axillary approach of percutaneous endoscopic interlaminar discectomy for L5-S1 disc herniation and its preliminary results. Methods : From July 2002 to September 2003, 101 patients with lumbar radiculopathy due to L5-S1 disc herniation, who were treated by percutaneous interlaminar endoscopic discectomy, were retrospectively reviewed. There were 57 males and 44 females with a mean age of 44.8 years [range, 18 to 62 years]. The surgery consisted of needle insertion into the epidural space via the interlaminar space, sequential dilatation, and endoscopic discectomy through the axillary area of the S1 root. Results : The mean follow-up period was 14.5 months and the average surgical time was 41 min. According to the modified Macnab criteria, 44 patients [43.6%] had excellent outcomes, 49 [48.5%] had good results and only 8 [78%] had fair or poor outcomes. Four patients had a revision microdiscectomy due to incomplete removal of disc fragment. There were no major complications related to this surgical approach. Conclusion : Axillary approach of percutaneous endoscopic interlaminar discectomy is safe and effective procedure for the treatment of L5-Sl disc herniation. It combines the advantages of MED and conventional percutaneous endoscopic discectomy.

• Journal of Gastric Cancer
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• 제13권4호
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• pp.199-206
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• 2013

Since the first transgastric natural orifice transluminal endoscopic surgery was described, various applications and modified procedures have been investigated. Transgastric natural orifice transluminal endoscopic surgery for periotoneoscopy, cholecystectomy, and appendectomy all seem viable in humans, but additional studies are required to demonstrate their benefits and roles in clinical practice. The submucosal tunneling method enhances the safety of peritoneal access and gastric closure and minimizes the risk of intraperitoneal leakage of gastric air and juice. Submucosal tunneling involves submucosal tumor resection and peroral endoscopic myotomy. Peroral endoscopic myotomy is a safe and effective treatment option for achalasia, and the most promising natural orifice transluminal endoscopic surgery procedure. Endoscopic full-thickness resection is a rapidly developing natural orifice transluminal endoscopic surgery procedure for the upper gastrointestinal tract and can be performed with a hybrid natural orifice transluminal endoscopic surgery technique (combining a laparoscopic approach) to overcome some limitations of pure natural orifice transluminal endoscopic surgery. Studies to identify the most appropriate role of endoscopic full-thickness resection are anticipated. In this article, I review the procedures of natural orifice transluminal endoscopic surgery associated with the upper gastrointestinal tract.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권1호
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• pp.105-109
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• 2020

The incidence of acute pancreatitis (AP) has increased in the pediatric population over the past few decades and it stands to follow that the complications of severe AP, including symptomatic pancreatic fluid collections (PFCs) will increase as well. In adults, the therapeutic options for this situation have undergone a dramatic evolution from mainly surgical approaches to less invasive endoscopic approaches, mainly endoscopic ultrasound-guided transmural drainage (EUS-TD) followed be direct endoscopic necrosectomy if needed. This has proven safe and effective in adults; however, this approach has not been well studied or reported in pediatric populations. Here we demonstrate that EUS-TD seems to offer a safe, efficacious and minimally invasive approach to the management of large PFCs in pediatric patients by reviewing two representative cases at our institution.

• 대한두개안면성형외과학회지
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• 제21권6호
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• pp.345-350
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• 2020

Background: This study evaluated the efficacy of the endoscopic medial orbital wall repair by comparing it with the conventional transcaruncular method. This surgical approach differs from the established endoscopic technique in that we push the mesh inside the orbit rather than placing it over the defect. Methods: We retrospectively reviewed 40 patients with isolated medial orbital blowout fractures who underwent medial orbital wall reconstruction. Twenty-six patients underwent endoscopic repair, and 14 patients underwent external repair. All patients had preoperative computed tomography scans taken to determine the defect size. Pre- and postoperative exophthalmometry, operation time, the existence of diplopia, and pain were evaluated and compared between the two methods. We present a case showing our procedure. Results: The operation time was significantly shorter in the endoscopic group (44.7 minutes vs. 73.9 minutes, p= 0.035). The preoperative defect size, enophthalmos correction rate, and pain did not significantly differ between the two groups. All patients with preoperative diplopia, eyeball movement limitation, or enophthalmos had their symptoms resolved, except for one patient who had preexisting strabismus. Conclusion: This study demonstrates that endoscopic medial orbital wall repair is not inferior to the transcaruncular method. The endoscopic approach seems to reduce the operation time, probably because the dissection process is shorter, and no wound repair is needed. Compared to the previous endoscopic method, our method is not complicated, and is more physiological. Larger scale studies should be performed for validation.