• Journal of Korean Neurosurgical Society
• /
• 제29권4호
• /
• pp.564-568
• /
• 2000

The authors present a rare case of subependymal giant cell astrocytoma which successfully treated with endoscopic tumor resection. A 15-year-old boy was presented with multiple episode of generalized seizure and intermittent headache for 5 years. The patient had facial adenoma sebaceum, multiple nevi on his back, and mental retardation. Cerebral MRI scans showed a round tumor located at the frontal horn of right ventricle near the foramen monro. The tumor was totally removed with endoscopic procedure and histologically confirmed as a subependymal giant cell astrocytoma. Subependymal giant cell astrocytomas can cause all the clinical problems that are associated with other types of intracranial tumor. However, surgical indication is not well standardized, because of the lack of basic knowledge about the tumor and the likelihood of surgical morbidity. We believe that endoscopic surgery, a minimally invasive technique, can circumvent the surgical disadvantage while achieving the surgical goal.

• Journal of Trauma and Injury
• /
• 제29권3호
• /
• pp.93-97
• /
• 2016

Hepatic duct confluence injury, which is developed by blunt abdominal trauma, is rare. Conventionally, bile duct injury was treated by surgical intervention. In recent decades, however, there had been an increase in radiologic or endoscopic intervention to treat bile duct injury. In a hemodynamically stable patient, endoscopic intervention is considered as the first-line treatment for bile duct injury. A 40 year-old man was transferred to the emergency department of ${\bigcirc}{\bigcirc}$ trauma center after multiple blunt injuries. Contrast-enhanced abdominal computed tomography performed in another hospital showed a liver laceration with active arterial bleeding, fracture of the sacrum and left inferior pubic ramus, and intraperitoneal bladder rupture. The patient presented with hemorrhagic shock because of intra-peritoneal hemorrhage. After resuscitation, angiographic intervention was performed. After angiographic embolization of the liver laceration, emergency laparotomy was performed to repair the bladder injury. However, there was no evidence of bile duct injury on initial laparotomy. On post-trauma day (PTD) 4, the color of intra-abdominal drainage of the patient changed to a greenish hue; bile leakage was revealed on magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP). Bile leakage was detected near the hepatic duct confluence; therefore, a biliary stent was placed into the left hepatic duct. On PTD 37, contrast leakage was still detected but both hepatic ducts were delineated on the second ERCP. Stents were placed into the right and left hepatic ducts. On PTD 71, a third ERCP revealed no contrast leakage; therefore, all stents were removed after 2 weeks (PTD 85). ERCP and biliary stenting could be effective treatment options for hemodynamically stable patients after blunt trauma.

• Journal of Gastric Cancer
• /
• 제15권2호
• /
• pp.139-142
• /
• 2015

Hepatic metastasis of early gastric cancer (EGC) following subtotal gastrectomy with lymphadenectomy is rare. We report the case of a 61-year-old male patient who was diagnosed with EGC that was initially treated using endoscopic submucosal dissection (ESD) and subsequently underwent laparoscopic subtotal gastrectomy. Histopathological examination of the patient's ESD specimen showed a moderately differentiated tubular adenocarcinoma invading the submucosa without lymphatic invasion. The deep margin of the specimen was positive for adenocarcinoma, and he subsequently underwent laparoscopic distal gastrectomy. The patient developed liver metastasis 15 months after the operation and then underwent liver resection. Histology of the resected specimen confirmed the diagnosis of two foci of metastatic adenocarcinoma originating from stomach cancer. Immunohistochemical analysis of the specimen demonstrated overexpression of human epidermal growth factor receptor 2. The patient was treated with trastuzumab in combination with chemotherapy consisting of capecitabine and cisplatin. Twenty-four months after the operation, the patient remained free of recurrence.

• Journal of Trauma and Injury
• /
• 제24권2호
• /
• pp.136-142
• /
• 2011

Purpose: Blunt pancreatic injury has a high mortality rate, especially if adequate management is delayed. Although many guidelines exist for diagnosis and treatment, there is no consensus to date. Therefore, we analyzed the role of endoscopic retrograde cholangiopancreatography (ERCP) as a diagnostic and therapeutic tool for the treatment of traumatic pancreatic injury. Methods: We retrospectively reviewed the electronic medical records (EMR) database at Asan Medical Center (Seoul, South Korea) to identify all patients diagnosed with trauma to the pancreas between June 2003 and December 2010. Clinical and operative findings, CT (computed tomography) images, and ERCP findings were assessed. Results: A total of 40 patients were evaluated in this study. Of these, 14 patients underwent diagnostic ERCP, and 26 did not. Of the 14 patients who underwent diagnostic ERCP, 5 were found to have normal pancreatic ducts, thereby preventing a needless laparotomy in these patients. Of the patients diagnosed with ductal injury, four were treated with endoscopic intervention, and four underwent an exploratory laparotomy. The remaining patient was treated with radiologic intervention (percutaneous drainage) to manage pancreatic pseudocyst formation. Conclusion: Our findings suggest that ERCP is a beneficial diagnostic and therapeutic modality for the treatment of traumatic pancreatic injury.

• Journal of the Korean Arthroscopy Society
• /
• 제11권2호
• /
• pp.134-138
• /
• 2007

Brodie abscess is a localized form of subacute or chronic osteomyelitis which is common in children but may also occur in adulthood. When Brodie abscess is located in the posterior metaphysis of the proximal tibia, open biopsy and curettage have a difficulty in approach to the lesion and can cause neurovascular injury or soft tissue contamination. We report a case wherein a novel surgical technique was used to treat a Brodie abscess in the posterior proximal tibial metaphysis in 48 year-old-male with endoscopic-assisted curettage by commercial anterior cruciate ligament targeting device(Rigid Fix; Mitek, Johnson & Johnson, Norwood, MA). Two portals were created toward the abscess site and, through each portal interchangeably, the granulation tissue and sclerotic bone could be excised. We believe that endoscopic-assisted curettage presents safe technique, decreased morbidity, accurate assessment of the extent of the abscess and possible improvement in long-term outcomes.

• The Journal of Korea Robotics Society
• /
• 제16권2호
• /
• pp.164-171
• /
• 2021

This paper proposes a continuum mechanism for manually controlled endoscopic surgical instruments. The wire-driven mechanism is typically adapted for endoscopic surgical tools because motors cannot be embedded to the joints due to the size limitation. However, the conventional wire-driven mechanism has inherent problems caused by redundancy, such as deflection and low precision. It does not have operating force and manipulability for surgery. Therefore, a method to increase the force of the continuum mechanism using a multi-wire with simple mechanical structure is proposed. Moreover, for intuitive operation, a hand-controller mechanism that can manipulate the length of the wire without complex process is proposed. Finally, we show that the proposed mechanism and methods are applicable to endoscopic surgical tools through simple experiments.

• Journal of Korean Neurosurgical Society
• /
• 제59권6호
• /
• pp.643-646
• /
• 2016

Chordoid glioma of the third ventricle is a rare and challenging tumor to surgery because of its unique anatomical location and its close juxtaposition to the neurovascular structures and hypothalamus. The authors report a case of chordoid glioma of the third ventricle in a 43-year-old woman, who presented with headache and somnolence. The tumor was approached by endoscopic transnasal technique with a favorable result. Histopathologic examination disclosed a neoplastic tissue composed of eosinophilic epithelioid cells, mucinous, periodic acid Schiff-diastase positive, extracellular matrix, and scattered lymphoplasmacytic infiltrates. The best treatment option remains controversial. Customarily, the surgical route to remove chordoid glioma is transcranial; however, the undersurface of the optic chiasm and optic nerves preclude an adequate surgical visualization. In contrast, an expanded endoscopic transnasal approach provides a direct midline corridor to this region without any brain retraction.

• Proceedings of the KOSOMBE Conference
• /
• 대한의용생체공학회 1995년도 춘계학술대회
• /
• pp.164-166
• /
• 1995

The objectives of study are to develop a peripheral device on the endoscopic surgery system. These systems are consist of the following units. They are a color monitor of high resolution, light source, computer system and endoscopic camera with a C-mount head, irrigator, color video printer, Super VHS recorder and a system rack. The color monitor is a NTSC monitor for monitoring the image projected of the surgical section. The lightsource is necessary to irradiate the interior of a body via an optic fiber, The light projector will adapt the brightness in accordance with changing distance from the object. A miniature camera using a color CCD chip and computer system is used to capture and control an image of the surgical section[1]. The video printer is a 300 DPI resolution using thermal sublimation methods, which is developed by Samsung Electronics Co., Ltd. The specification of the endoscopic data management system is consist of storage of a captured image and pathological database of patients [2-4].

• Journal of Korean Neurosurgical Society
• /
• 제55권3호
• /
• pp.173-177
• /
• 2014

Neurocysticercosis is the commonest parasitic disease of the human central nervous system. The incidence of intra ventricular form of neurocysticercosis (NCC) is less common accounting 10-20% that of total central nerve system cysticercosis. Intra ventricular NCC is complicated due, to its high incidence of acute hydrocephalus caused by ball valve mechanism. The only reliable tool for diagnosis of NCC is by neuroimaging with CT or MRI. MRI preferred over CT because of its high specificity and sensitivity. In emergency situations like acute hydrocephalus one can proceed with emergency endoscopic surgery. Through the endoscopic view, intra ventricular NCC (IVNCC) has distinguished morphological features like the full moon sign. This feature not only helps in identification of IVNCC, but also guides in further endoscopic treatment strategy. Authors report two cases of 3rd ventricular NCC with acute hydrocephalus managed with emergency endoscopy. Authors have discussed the clinical features, intra operative endoscopic findings and role of endoscopy in emergency surgery for NCC with acute hydrocephalus.

• Journal of Korean Foot and Ankle Society
• /
• 제15권2호
• /
• pp.92-96
• /
• 2011

Purpose: To compare the result of endoscopic versus open bursectomy in lateral malleolar bursitis, which was not treated conservatively. Materials and Methods: Between January 2008 and October 2009, We divided to two groups, endoscopy (group A) 11 cases, open bursectomy (group B) 11 cases. The average follow up period was 15 months (range, 12 to 18), the mean age was 66 (range, 38 to 79). We compared patients satisfaction, complete healing time, operation time, complications and recurrence. Results: Group A had significant difference in terms of the clinical satisfactions, complete healing time. operation time, complications. Group A showed satisfaction (excellent 9, good 2), mean complete healing time 11.9 (8~14) days, operation time 37 (25~45) minutes, 1 case recur. Group B showed satisfaction (excellent 4, good 3, fair 1, poor 3), complete healing time 32.7 (14~98) days, operation time 22 (18~26) minutes. complication were one case of skin necrosis, one case of wound dehiscence, two cases of superficial peroneal nerve injury, no recurrence. Significant advantages of endoscopic method include lower morbidity and rapid wound healing period (p<0.05). Conclusion: Endoscopic resection of the lateral malleolar bursitis is a promising technique and shows favourable results compared to the open resection. Significant advantages of this method include lower morbidiy and rapid wound healing.