• 제목/요약/키워드: Laparoscopy

검색결과 295건 처리시간 0.027초

로봇 수술을 위한 3차원 구조계산의 필요성 조사 (Research of 3D Information processing for Robot Surgery)

  • 정재은;최석윤
    • 대한디지털의료영상학회논문지
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    • 제11권1호
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    • pp.43-50
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    • 2009
  • Geometry calculation Using Abdominal internal organ image from traditional laparoscopy or robotic surgery system we can make depth informations through measured 3D structure informations is very helpful to doctors, depth information is mare useful then others that use traditional laparoscopy or robotic surgery system to many doctors. however, traditional method are incomplete. less experienced doctors make much mare prohability of mistake. Hence, 3D information of organ is very helpful to the less experienced doctors. it will be greate role of reducing medical accidents and surgical time. We can get 3D informations using geometrical calculation method in robotic surgical system. also suggested method is needed in traditional surgical method without the need to create a new system, finally, We can get 3D information from traditional system without any new system, it take advantage in cost and create high efficiency. mare information will provided to many doctors.

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복강경하 질식 자궁적출술 및 제왕절개술 후 발생한 골반외 자궁내막증 2 예 (Two Cases of Extrapelvic endometriosis following Laparoscopy-assisted vaginal hysterectomy and Cesarean section)

  • 배제준;임미선;고민환;이태형;김미진
    • Journal of Yeungnam Medical Science
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    • 제24권1호
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    • pp.91-96
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    • 2007
  • Extrapelvic endometriosis is a rare disease. The majority of extrapelvic endometriosis cases involve scar tissue following obstetric and gynecologic procedures. We have treated two cases of extrapelvic incisional endometriosis. A 39 year old female patient with cyclic vaginal spotting after laparoscopic assisted vaginal hysterectomy due to uterine myoma and a 35 year old female patient with a painful palpable abdominal mass after cesarean section. Both underwent complete excision and were proven to have endometriosis by pathology. Here we report on both cases and review the medical literatures.

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부인과 복강경 수술 후 한의진료 방향에 대한 고찰 (Traditional Korean Medicine(TKM) Management for the Recovery after Laparoscopic Gynecological Surgery)

  • 정재철;최민선;김동일
    • 대한한방부인과학회지
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    • 제21권4호
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    • pp.218-227
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    • 2008
  • Purpose: The purpose of this study is to report the TKM Management for the recovery after laparoscopic gynecological surgery. Methods: The basic informations about laparoscopy and report 3 laparoscopic postoperative patients were managed with TKM. Patients had taken the surgery for the different gynecologic diseases. Results: The 3 patients' symptoms were improved gradually. TKM management is good for the recovery of laparoscopic surgery. And the management need to reflect postoperative complications. the cause and part of operation. and postoperative common symptoms. Conclusion: The TKM managements are effective in the postoperative recovery after laparoscopic gynecological surgery. And more study is needed for developing the model.

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Unpredictable post-laparoscopic bleeding in essential thrombocytosis: a call for additional safety measures

  • Atef M.M. Darwish;Dina A.M. Darwish;Yasser Abdelaal
    • Journal of Medicine and Life Science
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    • 제20권2호
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    • pp.99-102
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    • 2023
  • Patients with essential thrombocythemia (ET) can undergo laparoscopy without international precautions. This case report describes an ET with a mild increase in the platelet count that developed after laparoscopic surgery and prolonged intraperitoneal bleeding. The patient underwent intensive postoperative medical and surgical treatments until cured. Patients with ET should provide informed consent for post-laparoscopic bleeding. Surgeons should perform optimal hemostasis. Further studies are required to provide clear guidelines for both medical and surgical interventions aimed at preventing thrombo-hemorrhagic complications associated with ET. A preoperative study of platelet function and the selection of the best cytotoxic drug for the perioperative period are mandatory.

복강경 보조 유문부보존 위절제술의 초기 경험: 복강경 보조 원위부 위절제술 후 Billroth-I 재건술과의 비교 (The Early Experience with a Laparoscopy-assisted Pylorus-preserving Gastrectomy: A Comparison with a Laparoscopy-assisted Distal Gastrectomy with Billroth-I Reconstruction)

  • 박종익;진성호;방호윤;채기봉;백남선;문난모;이종인
    • Journal of Gastric Cancer
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    • 제8권1호
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    • pp.20-26
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    • 2008
  • 목적: 유문부보존 위절제술(pylorus-preserving gastrectomy, PPG)은 유문륜을 보존하여 잔위의 배출기능을 보존하고 담즙 역류를 방지할 수 있는 기능 보존 수술법으로 조기위암 치료에 적용되고 있다. 저자들은 복강경 보조 유문부보존 위절제술(laparoscopy-assisted pylorus-preserving gastrectomy, LAPPG)의 초기 경험을 LADG 후 Billroth-I 재건술과 비교 분석하였다. 대상 및 방법: 2006년 11월부터 2007년 9월까지 원자력병원 외과에서 복강경 보조 위절제술을 시행 받은 39명의 조기위암 환자 중 LAPPG (n=9)와 LADG 후 Billroth-I 재건술(n=18)을 시행 받은 27명의 환자를 대상으로 하였고, 양 군간의 임상병리학적 변수를 비교하였다. 저자들은 LAPPG 시행 중 유문하동맥, 우위동맥, 미주신경 간지, 유문지 및 복강지를 보존하였으며, 림프절 절제술은 우위동맥 림프절(No. 5)을 제외한 D1+$\beta$술식을 시행하였고, 유문륜 상방 $3{\sim}4\;cm$에서 원위부 위절제를 시행하였다. 결과: LAPPG을 시행 받은 환자 9명의 평균 연령은 $59.9{\pm}9.4$세였으며 남녀 성비는 1.3 : 1.0 (남자 5명, 여자 4명)이었고, LADG 후 Billroth-I 재건술을 시행 받은 환자 18명의 평균 연령은 $64.1{\pm}10.0$세였으며 남녀 성비는 2.6 : 1.0 (남자 13명, 여자 5명)이었다. LAPPG 군과 LADG 후 Biliroth-I 재건술을 시행받은 군에서 절제된 림프절의 개수는 각각 $28.3{\pm}11.9$$28.1{\pm}8.9$개, 수술 시간은 각각 $269.0{\pm}34.4$분, $236.3{\pm}39.6$분, 술 중 출혈량은 각각 $191.1{\pm}85.7\;ml$, $218.3{\pm}156.6\;ml$, 술 후 첫 가스 배출은 각각 $3.6{\pm}0.9$일, $3.5{\pm}0.8$일에 있었고 술 후 첫 유동식은 각각 $5.1{\pm}0.9$일, $5.1{\pm}1.7$일에 섭취하였고 술 후 재원 기간은 각각 $10.1{\pm}4.0$일, $9.2{\pm}3.0$일로 모두 통계학적으로 유의한 차이가 없었다(P>0.05). 술 후 합병증은 LAPPG 군에서 위저류증 1예와 창상 장액종 1예가 발생하였고, LADG 후 Biliroth-I 재건술을 시행 받은 군에서는 좌외측간엽경색 1예가 발생하였다. 결론: 조기위암의 치료에 있어서 LAPPG는 기능 보존 수술 법으로 적용 가능하며, 적절한 적응증을 사용하면 임상종양학적 측면에서도 LADG 후 Billroth-I 재건술과 동등한 결과를 보일 것으로 기대된다.

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Comparison of Short-Term Postoperative Outcomes in Totally Laparoscopic Distal Gastrectomy Versus Laparoscopy-Assisted Distal Gastrectomy

  • Han, Gru;Park, Ji Yeon;Kim, Yong Jin
    • Journal of Gastric Cancer
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    • 제14권2호
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    • pp.105-110
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    • 2014
  • Purpose: The advantages of totally laparoscopic surgery in early gastric cancer (EGC) are unproven, and some concerns remain regarding the oncologic safety and technical difficulty. This study aimed to evaluate the technical feasibility and clinical benefits of totally laparoscopic distal gastrectomy (TLDG) for the treatment of gastric cancer compared with laparoscopy-assisted distal gastrectomy (LADG). Materials and Methods: A retrospective review of 211 patients who underwent either TLDG (n=134; 63.5%) or LADG (n=77; 36.5%) for EGC between April 2005 and October 2013 was performed. Clinicopathologic features and surgical outcomes were analyzed and compared between the groups. Results: The operative time in the TLDG group was significantly shorter than that in the LADG group (193 [range, 160~230] vs. 215 minutes [range, 170~255]) (P=0.021). The amount of blood loss during TLDG was estimated at 200 ml (range, 100~350 ml), which was significantly less than that during LADG, which was estimated at 400 ml (range, 400~700 ml) (P<0.001). The hospital stay in the TLDG group was shorter than that in the LADG group (7 vs. 8 days, P<0.001). One patient from each group underwent laparotomic conversion. Two patients in the TLDG group required reoperation: one for hemostasis after intraabdominal bleeding and 1 for repair of wound dehiscence at the umbilical port site. Conclusions: TLDG for distal EGC is a technically feasible and safe procedure when performed by a surgeon with sufficient experience in laparoscopic gastrectomy and might provide the benefits of reduced operating time and intraoperative blood lossand shorter convalescence compared with LADG.

Risk for Malignant and Borderline Ovarian Neoplasms Following Basic Preoperative Evaluation by Ultrasonography, Ca125 Level and Age

  • Karadag, Burak;Kocak, M.;Kayikcioglu, F.;Ercan, F.;Dilbaz, B.;Kose, M.F.;Haberal, A.
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권19호
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    • pp.8489-8493
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    • 2014
  • Objective: To verify the basic preoperative evaluation in the discrimination between benign and malignant adnexal masses in our clinical practice. Materials and Methods: Data were collected on the records of 636 women with adnexal masses who had undergone surgery either by open or endoscopic approaches. Those with obvious signs of malignancy, any history of cancer, emergency surgeries without basic evaluation were excluded. The preoperative features by age, ultrasound and serum Ca125 level were compared with final histopathological diagnosis at the four departments of the institution. These are the general gynecology (Group 1: exploratory laparotomy), the gynecologic endoscopy (Group 2: laparoscopy and adnexectomy), the gynecological oncology (Group 3: staging laparotomy) and the gynecologic endocrinology and infertility (Group 4: laparoscopy and cystectomy). Results: There were simple and complex cyst rates of 22.3% and 77.2%, respectively. There were 86.3% benign, 4.1% (n:20) borderline ovarian tumor (BOT) and 6.4% (n:48) malignant lesions. There were 3 BOT and 9 ovarian cancers in Group 1 and one BOT and two ovarian cancer in the Group 2. During the surgery, 15 BOT (75%) and 37 ovarian cancer (77%) were detected in the Group 3, only one BOT was encountered in the Group 4. The risk of rate of unsuspected borderline or focally invasive ovarian cancer significantly increased by age, size, complex morphology and Ca125 (95% CI, OR=2.72, OR=6.60, OR=6.66 and OR=4.69, respectively). Conclusions: Basic preoperative evaluation by comprehensive ultrasound imaging combined with age and Ca125 level has proved highly accurate for prediction of unexpected malignancies. Neither novel markers nor new imaging techniques provide better information that allow clinicians to assess the feasibility of the planned surgery; consequently, the risk of inadvertent cyst rupture during laparoscopy may be significantly decreased in selected cases.

Laparotomy versus Laparoscopic Placement of Distal, Catheter in Ventriculoperitoneal Shunt Procedure

  • Park, Young-Seop;Park, In-Sung;Park, Kyung-Bum;Lee, Chul-Hee;Hwang, Soo-Hyun;Han, Jong-Woo
    • Journal of Korean Neurosurgical Society
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    • 제48권4호
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    • pp.325-329
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    • 2010
  • Objective : Traditionally, peritoneal catheter is inserted with midline laparotomy incision in ventriculoperitoneal (V-P) shunt procedures. Complications of V-P shunt is not uncommon and have been reported to occur in 5-37% of cases. The aim of this study is to compare the clinical outcomes and the operation time between laparotomy and laparoscopic groups. Methods : A total of 155 V-P shunt procedures were performed to treat hydrocephalic patients of various origins in our institute between June 2006 to January 2010; 95 of which were laparoscopically guided and 65 were not. We reviewed the operation time, surgery-related complications, and intraoperative and postoperative problems. Results : In the laparoscopy group, the mean duration of the procedure (52 minutes) was significantly shorter (p < 0.001) than the laparotomy group (109 minutes). There were two cases of malfunctions and one incidence of diaphragm injury in the laparotomy group. In contrast, there were neither malfunction nor any internal organ injuries in the laparoscopy group (p = 0.034). There were total of two cases of infections from both groups (p = 0.7). Conclusion : Laparoscopically guided insertions of distal shunt catheter is considered a fast and safe method in contrast to the laparotomy technique. This method allows the exact localization of the peritoneal catheter and a confirmation of its patency.

Synchronous Adenocarcinoma and Gastrointestinal Stromal Tumor of the Stomach Treated by a Combination of Laparoscopy-assisted Distal Gastrectomy and Wedge Resection

  • Jeong, Sang-Ho;Lee, Young-Joon;Park, Soon-Tae;Choi, Sang-Kyung;Hong, Soon-Chan;Jung, Eun-Jung;Ju, Young-Tae;Jeong, Chi-Young;Ha, Woo-Song
    • Journal of Gastric Cancer
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    • 제11권1호
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    • pp.55-58
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    • 2011
  • The simultaneous occurrence of a gastrointestinal stromal tumor (GIST) and a gastric adenocarcinoma is uncommon, and has rarely been reported in the literature. The present report describes the case of a 74-year-old male patient who initially presented with an adenocarcinoma that had invaded the antral mucosa. Computed tomography then revealed the presence of a suspected GIST, in the form of a $2{\times}2$ cm mass at the hilum of the spleen. In view of the advanced age of the patient, a surgical approach that would minimize risk and maximize quality of life was preferred. The patient therefore underwent simultaneous laparoscopy-assisted distal gastrectomy for the adenocarcinoma and wedge resection for the GIST. This approach was only chosen after confirming that it would be possible to preserve three or more of the short gastric arteries that supply the area below the wedge resection site. This may be considered a feasible apapproach to the management of the simultaneous occurrence of a mid-to-low gastric body adenocarcinoma and a high gastric body GIST.