• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.439-447
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• 2018

Background: Since open Wiltse approach allows limited visualization for foraminal stenosis leading to an incomplete decompression, we report the short-term clinical and radiological results of unilateral biportal endoscopic foraminal decompression using $0^{\circ}$ or $30^{\circ}$ endoscopy with better visualization. Methods: We examined 31 patients that underwent surgery for neurological symptoms due to lumbar foraminal stenosis which was refractory to 6 weeks of conservative treatment. All 31 patients underwent unilateral biportal endoscopic far-lateral decompression (UBEFLD). One portal was used for viewing purpose, and the other was for surgical instruments. Unilateral foraminotomy was performed under guidance of $0^{\circ}$ or $30^{\circ}$ endoscopy. Clinical outcomes were analyzed using the modified Macnab criteria, Oswestry disability index, and visual analogue scale. Plain radiographs obtained preoperatively and 1 year postoperatively were compared to analyze the intervertebral angle (IVA), dynamic IVA, percentage of slip, dynamic percentage of slip (gap between the percentage of slip on flexion and extension views), slip angle, disc height index (DHI), and foraminal height index (FHI). Results: The IVA significantly increased from $6.24^{\circ}{\pm}4.27^{\circ}$ to $6.96^{\circ}{\pm}3.58^{\circ}$ at 1 year postoperatively (p = 0.306). The dynamic IVA slightly decreased from $6.27^{\circ}{\pm}3.12^{\circ}$ to $6.04^{\circ}{\pm}2.41^{\circ}$, but the difference was not statistically significant (p = 0.375). The percentage of slip was $3.41%{\pm}5.24%$ preoperatively and $6.01%{\pm}1.43%$ at 1-year follow-up (p = 0.227), showing no significant difference. The preoperative dynamic percentage of slip was $2.90%{\pm}3.37%$; at 1 year postoperatively, it was $3.13%{\pm}4.11%$ (p = 0.720), showing no significant difference. The DHI changed from $34.78%{\pm}9.54%$ preoperatively to $35.05%{\pm}8.83%$ postoperatively, which was not statistically significant (p = 0.837). In addition, the FHI slightly decreased from $55.15%{\pm}9.45%$ preoperatively to $54.56%{\pm}9.86%$ postoperatively, but the results were not statistically significant (p = 0.705). Conclusions: UBEFLD using endoscopy showed a satisfactory clinical outcome after 1-year follow-up and did not induce postoperative segmental spinal instability. It could be a feasible alternative to conventional open decompression or fusion surgery for lumbar foraminal stenosis.

• Archives of Plastic Surgery
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• v.43 no.3
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• pp.229-236
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• 2016

Recently, diagnoses of and operations for medial orbital blowout fracture have increased because of the development of imaging technology. In this article, the authors review the literature, and overview the accumulated knowledge about the orbital anatomy, fracture mechanisms, surgical approaches, reconstruction materials, and surgical methods. In terms of surgical approaches, transcaruncular, transcutaneous, and transnasal endoscopic approaches are discussed. Reconstruction methods including onlay covering, inlay implantation, and repositioning methods are also discussed. Consideration and understanding of these should lead to more optimal outcomes.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup2
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• pp.67-71
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• 2008

The incidence of inflammatory bowel disease (IBD), especially Crohn disease, in children is remarkably increasing in Korea. Therefore, it is necessary for pediatrician to be aware of the initial presentation of Crohn disease and ulcerative colitis. Laboratory tests, radiologic studies, and endoscopic procedures are helpful in differentiating between them. At the time of presentation, most of children with IBD have abdominal pain, diarrhea, hematochezia and/or weight loss. However, atypical presentation of these diseases may contribute to a delay in diagnosis.

• Journal of Gastric Cancer
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• v.4 no.3
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• pp.176-179
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• 2004

Surgical treatment for afferent loop syndrome (ALS) in patients with recurrent gastric cancer is usually not feasible because of the recurrent tumor mass at the anastomosis site and/or extensive carcinomatosis resulting in bowel loop fixation. Furthermore, ALS usually makes oral intake impossible, resulting in a rapid deterioration in general condition. In this situation, gastroscopic stenting at the anastomotic site and/or percutaneous external drainage may be a more feasible alternative for palliation. We herein report a recurrent gastric cancer whose ALS was successfully treated with internal and external drainage procedures.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.320-326
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• 2013

Robotically assisted microsurgery or telemicrosurgery is a new technique using robotic telemanipulators. This allows for the addition of optical magnification (which defines conventional microsurgery) to robotic instrument arms to allow the microsurgeon to perform complex microsurgical procedures. There are several possible applications for this platform in various microsurgical disciplines. Since 2009, basic skills training courses have been organized by the Robotic Assisted Microsurgical and Endoscopic Society. These basic courses are performed on training models in five levels of increasing complexity. This paper reviews the current state of the art in robotically asisted microsurgical training.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5589-5594
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• 2015

Cystitis and proctitis are defined as inflammation of bladder and rectum respectively. Haemorrhagic cystitis is the most severe clinical manifestation of radiation and chemical cystitis. Radiation proctitis and cystitis are major complications following radiotherapy. Prevention of radiation-induced haemorrhagic cystitis has been investigated using various oral agents with minimal benefit. Bladder irrigation remains the most frequently adopted modality followed by intra-vesical instillation of alum or formalin. In intractable cases, surgical intervention is required in the form of diversion ureterostomy or cystectomy. Proctitis is more common in even low dose ranges but is self-limiting and improves on treatment interruption. However, treatment of radiation proctitis is broadly non-invasive or invasive. Non-invasive treatment consists of non-steroid anti-inflammatory drugs (NSAIDs), anti-oxidants, sucralfate, short chain fatty acids and hyperbaric oxygen. Invasive treatment consists of ablative procedures like formalin application, endoscopic YAG laser coagulation or argon plasma coagulation and surgery as a last resort.

• Journal of Korean Neurosurgical Society
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• v.60 no.3
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• pp.322-326
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• 2017

Neuroendoscopic surgery is performed because it causes minimal damage to normal structures, carries a lower rate of complications, and achieves excellent outcomes. Surgeons using an endoscope and related instruments can perform complex operations through very small incisions, which is especially useful for minimally invasive procedures for the brain and spine. Neuroendoscopic surgery is now performed in cases of obstructive hydrocephalus, various intraventricular lesions, hypothalamic hamartomas, craniosynostosis, skull base tumors, and spinal lesions. This review discusses the brief history of neuroendoscopy and the current state and future perspectives of endoscopic surgery.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.206-209
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• 1996

Thoracic sympathetic nerve block has a wide range of therapeutic applications which clinicians utilize neurolytics or perform operative sympathectomy. All methods have advantages and disadvantages. We performed "thoracic sympathetic ganglion cauterization" using resectoscope as it is less invasive and more effective than traditional operative methods. Successful procedures were performed involving 2 cases of idiopathic hyperhidrosis and 1 case of sympathetically maintained pain on chest and upper extremity. We experienced failure with one case of idiopathic hyperhidrosis due to severe pleural adhesion. There was also a case of complication of periganglional hemorrhage and parenchymal lung perforation which we successfully treated.

• Advances in pediatric surgery
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• v.2 no.1
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• pp.53-58
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• 1996

Congenital duplication of the gallbladder, including true duplication and septated gallbladder, is an uncommon but potentially complicated malformation. It presents biliary colic associated with acute or chronic cholecystitis. It can be diagnosed preoperatively by various imaging tools such as real-time ultrasonography, biliary scintigraphy, oral cholecystography, or endoscopic retrograde cholangiography. It can be safely managed by either laparoscopic or open procedures. This report describes a 6-year-old girl with true duplication of gallbladder diagnosed preoperatively by real-time ultrasonography and treated by open cholecystectomy.

• Journal of Minimally Invasive Surgery
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• v.21 no.4
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• pp.177-179
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• 2018

A rectocele with a weakened rectovaginal septum can be repaired with various surgical techniques. We performed laparoscopic posterior vaginal wall repair and rectovaginal septal reinforcement without mesh using a modified transperineal approach. A 63-year-old woman with outlet dysfunction constipation complained of lower pelvic pressure and sense of heaviness for 30 years. Initial defecography showed an anterior rectocele with a 45-mm anterior bulge and perineal descent. Laparoscopic procedures included peritoneal and rectovaginal septal dissection directed toward the perineal body, rectovaginal septal suturing, and peritoneal closure. The patient started a soft diet the following day and was discharged on the 5th postoperative day without any complications. The patient had no dyschezia or dyspareunia, and no problem with bowel function; 3-month follow-up defecography showed a decrease in bulging to 18 mm. Laparoscopic posterior vaginal wall and rectovaginal septal repair is safe and feasible for treatment of a rectocele, and enables early recovery.