• Title/Summary/Keyword: Minimal incision

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Minimal invasive horizontal ridge augmentation using subperiosteal tunneling technique

  • Kim, Hyun-Suk;Kim, Young-Kyun;Yun, Pil-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.41.1-41.6
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    • 2016
  • Background: The goal of this study was to retrospectively evaluate the prognosis of minimal invasive horizontal ridge augmentation (MIHRA) technique using small incision and subperiosteal tunneling technique. Methods: This study targeted 25 partially edentulous patients (10 males and 15 females, mean age $48.8{\pm19.7years$) who needed bone graft for installation of the implants due to alveolar bone deficiency. The patients took the radiographic exam, panoramic and periapical view at first visit, and had implant fixture installation surgery. All patients received immediate or delayed implant surgery with bone graft using U-shaped incision and tunneling technique. After an average of 2.8 months, the prosthesis was connected and functioned. The clinical prognosis was recorded by observation of the peri-implant tissue at every visit. A year after restoration, the crestal bone loss around the implant was measured by taking the follow-up radiographs. One patient took 3D-CT before bone graft, after bone graft, and 2 years after restoration to compare and analyze change of alveolar bone width. Results: This study included 25 patients and 39 implants. Thirty eight implants (97.4 %) survived. As for postoperative complications, five patients showed minor infection symptoms, like swelling and tenderness after bone graft. The other one had buccal fenestration, and secondary bone graft was done by the same technique. No complications related with bone graft were found except in these patients. The mean crestal bone loss around the implants was 0.03 mm 1 year after restoration, and this was an adequate clinical prognosis. A patient took 3D-CT after bone graft, and the width of alveolar bone increased 4.32 mm added to 4.6 mm of former alveolar bone width. Two years after bone graft, the width of alveolar bone was 8.13 mm, and this suggested that the resorption rate of bone graft material was 18.29 % during 2 years. Conclusions: The bone graft material retained within a pouch formed using U-shaped incision and tunneling technique resulted with a few complications, and the prognosis of the implants placed above the alveolar bone was adequate.

Simultaneous Periareolar Augmentation Mastopexy: Dual Plane Versus Subfascial Plane (동시 유륜절개 유방하수교정술 및 확대술: 이중평면 대 근막밑평면)

  • Sim, Hyung Bo;Yoon, Sang Yub
    • Archives of Plastic Surgery
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    • v.34 no.1
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    • pp.105-110
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    • 2007
  • Purpose: The major drawback of submuscular augmentation of the ptotic breast is a "double-bubble" deformity. If a traditional mastopexy is added to correct the ptosis, there would be additional scars. This article describes simultaneous periareolar mastopexy with dual plane or subfascial breast augmentations. Methods: A series of 81 patients with grade I or II ptosis underwent the procedure from 1999 to 2005. Out of these, dual plane augmentation was done in 71 cases and subfascial plane in 10. After periareolar skin excision, an incision is made perpendicularly down to the fascia of pectoralis. At the lower pole, all breast implants are inserted into the subfascial plane. In case of upper pole thickness of above 20 mm, we inserted the implant into the subfascial plane, whereas below 20 mm, we inserted that into the submuscular plane. Results: No major complications were noted and patients' satisfactory score was high. This technique avoids the "double-bubble" deformity and leaves a minimal periareolar scar. Conclusion: Simultaneous periareolar mastopexy/breast augmentation is useful for correction of the ptotic breast, increasing the volume of breast and providing the natural breast shape with minimal scars. We consider that subfascial plane augmentation with periareolar mastopexy to be an alternative for cases with breast upper pole thickness of at least above 20 mm.

Repair of Unilateral Cleft Lip and Nose: Mulliken's Modification of Rotation Advancement (편측 구순열비의 교정술: Rotation Advancement 원칙에 근거한 Mulliken의 방법)

  • Jung, Young-Soo;Lee, Gyu-Tae;Jung, Hwi-Dong;Mulliken, John B.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.2
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    • pp.133-139
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    • 2012
  • This is a review regarding Mulliken's Modification using the Millard rotation-advancement principle for the repair of unilateral complete cleft lip and nasal deformity. All patients underwent prior labionasal adhesion and dentofacial orthopedics with a pin-retained (Latham) appliance used for infants with a cleft of the lip and palate. Technical variations concerning the operation are described. A high rotation and releasing incision in the columella lengthens the medial labial element and produces a symmetric prolabium with minimal transgression of the upper philtral column through the advancement flap. The orbicularis oris muscle is everted, from caudad to cephalad, to form the philtral ridge. A minor variation of unilimb Z-plasty is used to level the cleft side of Cupid's bow handle, and cutaneous closure proceeds superiorly from this junction. The dislocated alar cartilage is visualized though a nostril rim incision and suspended to the ipsilateral upper lateral cartilage. Symmetry of the alar base is addressed in three dimensions, including maneuvers to position the deviated anterior-caudal septum, configure the sill, and efface the lateral vestibular web. The authors believe the technical refinements described herein contribute favorably to the outcome of repair regarding unilateral cleft lip and nasal distortion.

First Experience of Cardiac Surgery using da $Vinci^{TM}$ Surgical System in Korea (da $Vinci^{TM}$ 수술로봇을 이용한 심장수술 - 첫 번째 치험 보고)

  • Park, Seong-Yong;Lee, Sak;Joo, Hyun-Chul;Yang, Hong-Suk;Park, Young-Hwan;Park, Har-Ki
    • Journal of Chest Surgery
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    • v.40 no.2 s.271
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    • pp.128-131
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    • 2007
  • da $Vinci^{TM}$ Surgical System is an advanced mode of minimal invasive surgery, using 3-dimensional imaging system and robotic arms which can mimic the dexterity of the human hand. Thus, various operations can be performed with minimal incision and limited surgical field and the merits of minimal invasive surgery can be maximized by using it. We report our first experience of robotic open heart surgery using the da $Vinci^{TM}$ Surgical System for repairing atrial septal defect.

Atypically Large Calcific Tendinitis of the Shoulder: A Case Report

  • Kim, Jin Wan;Moon, Kyu Pill;Kim, Kyung Taek;Hwang, Youn Soo;Park, Won Seok
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.241-244
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    • 2016
  • Calcific tendinitis of the shoulder joint is common disease causing acute pain, mainly involving the supraspinatus or infraspinatus muscle, and less frequently the teres minor or subscapularis muscle. This study reports on the satisfactory arthroscopic removal of calcium deposits as well as infraspinatus and supraspinatus muscle repair without relapse via minimal incision using suture anchors. This was a case of atypically extensive calcific tendinitis involving the infraspinatus muscle, with a bursal side partial rupture of the supraspinatus muscle in a 61-year-old female whose chief complaint was chronic pain of the right shoulder exacerbated by limited movement.

Graft Length of the Bone-patellar Tendon-bone for Reconstruction of ACL (골-슬개건-골을 이용한 전방십자인대 재건술에서 이식물의 길이)

  • Kim, Jung-Man
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.55-62
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    • 1997
  • Various surgical techniques has been advocated for reconstruction of anterior cruciate ligament using the bone-patella tendon-bone graft. Recently endoscopic technique provides good clinical results, with minimal skin incision, accurate positioning of the graft to the femoral tunnel, and decreasing wear rate of the graft. But the graft-tunnel mismatch remains problematic in endoscopic technique. The purpose of this paper is to described causes of the graft-tunnel mismatch and to provide important steps to prevent or minimize the graft-runnel mismatch following anterior cruciate ligament while using the endoscopic technique. Our guideline for prevention of the graft-tunnel mismatch are as follows: (1) The tunnel should he positioned closely to isometric point as much as possible. (2) Anterior placement of the tunnel should be avoided. (3) The change of graft length should be within 2mm between flexion and extension position.

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One-half Sternal Turnover; New Operative Approach for Asymmetrical Funnel Chest (절반 흉골반전법;비대칭 누두흉에 대한 새로운 수술기법의 제안)

  • 이승열
    • Journal of Chest Surgery
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    • v.26 no.12
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    • pp.969-971
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    • 1993
  • The sternal turnover has a limited use in an asymmetrical funnel chest. However we tried `One-half sternal turnover` as a new operative approach for an asymmetrical funnel chest. Through the bilateral submammary skin incision, median sternotomy was made from xiphoid process to midsternum and extended horizontally. The segment of ribs were cut at the angle of depression. The en-bloc resected chest wall segment contained one-half sternum as well as a part of ribs and left half of rectus muscle. After turning over the en-bloc segment, reapproximation with wiring was done. Sternotomy wound was closed in layer after placing of substernal drainage tube. Postoperatively, the chest wall was stable and the recovery course was uneventful except left-sided minimal pneumothorax which was cured spontaneaously. The patient was discharged on postoperative 14th day.

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Complications of Donor Site in Latissimus Dorsi Muscle Flap (광배근 피판의 공여부에 대한 문제점의 분석)

  • Chung, Duke-Whan;Han, Chung-Soo;Cho, Chang-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.8 no.2
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    • pp.149-153
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    • 1999
  • Purpose : To investigate the complication of donor site in latissimus dorsi muscle flap. Materials and Methods : From April 1983 to March 1999, forty patients with latissimus dorsi muscle flap for reconstruction of extremity and with a follow-up period of more than 12 months were included. We analysed the complication, shoulder function, degree of shoulder muscle weakness, skin scar width after operation. Results After 1 year, skin scar widening in 12 cases(30%), limitation of shoulder motion in 9 cases(12.5%), muscle weakness in 14 cases(17.5%) were found. Conclusion. The rate of complication at donor site after latissimus dorsi flap operation is around 10%. To minimize the complication, avoiding axillary skin incision, minimal invasive harvesting by endoscopy, meticulous suturing of subcutaneous layer are needed.

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Oblique transnasal wiring canthopexy via Y-V epicanthoplasty for telecanthus correction in a patient with Waardenburg syndrome

  • Choi, Bong Gyu;Kim, Yong-Ha
    • Archives of Craniofacial Surgery
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    • v.20 no.5
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    • pp.329-331
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    • 2019
  • Telecanthus is a common symptom accompanied by Waardenburg syndrome, a rare genetic disorder. The optimal surgery for telecanthus correction is still debated. A 28-year-old patient with Waardenburg syndrome underwent transnasal wiring canthopexy using a Y-V epicanthoplasty for telecanthus correction. A Mini-Monoka stent was used to prevent damage to the lacrimal apparatus. The intercanthal distance decreased from 50 mm to 43.2 mm. The easily designed Y-V epicanthoplasty incision provides sufficient operative field for oblique transnasal wiring, which is effective in properly positioning the medial canthal tendon. It has minimal scarring resulting in satisfactory cosmetic outcomes.

Arthroscopic supraspinatus advancement for retracted rotator cuff tears: a technical note

  • Chris Hyunchul Jo;Pei Wei Wang
    • Clinics in Shoulder and Elbow
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    • v.25 no.4
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    • pp.328-333
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    • 2022
  • Irreparable rotator cuffs with retracted torn ends remain a significant challenge for most shoulder surgeons. Since repairs are preferable to reconstruction or replacement whenever possible, studies for anatomical reductions with minimal tension and secure fixation are important. In this study, the authors introduce an arthroscopic supraspinatus advancement (ASSA) procedure for retracted rotator cuff tears that could not be adequately reduced to the original footprint. Using modified long, narrow, curved Cobb elevators, procedures can be performed through lateral portals without any additional skin incision. Following meticulous stepwise three-compartment elevation procedures based on the supraspinatus insertion anatomy, the supraspinatus muscle could be safely elevated from the fossa and sufficiently advanced laterally. The authors suggest that ASSA could be a useful procedure for management of challenging retracted rotator cuff tears by maximizing lateral excursions that could convert irreparable tears to reparable tears in select patients.