• 제목/요약/키워드: Minimal invasive procedure

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임상가를 위한 특집 3 - Minimally Invasive Approach with Composite Resin

  • 장희선
    • 대한치과의사협회지
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    • 제51권11호
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    • pp.604-609
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    • 2013
  • Crown fractures are relatively common trauma to anterior teeth, and should be restored immediately in most cases. For those who suffer from unfortunate traumatic episode, the best treatment option should be minimally invasive approach. In the presence of fractured tooth fragment, reattachment procedure creates positive emotional response in the patient and simplifies the procedure and maintenance of the patient's original tooth anatomy and occlusion. Without fractured tooth fragment, next conservative option could be direct composite restoration which is based on minimal invasion concept. This article proposes simple and very conservative techniques that anyone can do in daily practice.

체외강력집속초음파치료 (Extracorporeal High Intensity Focused Ultrasound Therapy)

  • 한상석
    • 대한골관절종양학회지
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    • 제11권1호
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    • pp.17-24
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    • 2005
  • 의학의 발달과 더불어 종양에 대한 국소치료는 광범위근치술(extended radical surgery) 로부터 기능보존술(function preserving surgery)로 발달하고 이것은 다시 최소침습술(minimal-invasive surgery)로 발전하여 왔다. 그러나 최근 들어서는 기술의 혁신적인 진보로 비침습적수술법(non-invasive surgery)이 개발되어 감마나이프(gamma knife), 사이버나이프(cyber knife), 및 하이푸나이프(HIFU knife) 등이 출현하게 되었다. 본 논문에서는 이들 중 하이푸나이프를 이용한 체외강력집속초음파치료(extracorporeal high intensity focused ultrasound therapy)에 대하여 발달사, 치료기 구조 및 치료과정, 조직학적 변화와 기전, 임상적용, 장단점 및 전망 등을 살펴보고자 한다.

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High-Intensity Focused Ultrasound: A Satisfactory, Non-invasive Procedure for Crow's Feet Wrinkles

  • Jung, Gyu Sik;Cho, In Kook;Sung, Hyung Min
    • Medical Lasers
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    • 제8권2호
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    • pp.59-63
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    • 2019
  • Background and Objectives High-intensity focused ultrasound (HIFU) has been developed as an effective, non-invasive, skin-tightening method in response to the increasing demand for improvements in skin laxity and tightening with minimal risk and recovery time. This study evaluated the efficacy and safety of HIFU for non-invasive skin tightening of crow's feet wrinkles, with the aim of determining how long the tightening can be maintained. Materials and Methods Between January and March 2019, 21 female patients with crow's feet wrinkles were treated with HIFU. The treatment involved 200 shots, three times every 2 weeks. Three blinded, experienced plastic surgeons and patients evaluated satisfaction at 2 weeks after the first procedure, 2 weeks after the second procedure, 2 weeks after the third procedure, and 6 weeks after the first procedure based on photographs according to the Global Aesthetic Improvement Scale (GAIS). The Friedman test was used to compare data. Results Of the 21 patients treated using HIFU, one was lost to follow-up for nonstudy-related reasons. Therefore, 20 patients were evaluated and ranged in age from 28 to 48 years. Plastic surgeons' GAIS scores were 2.6, 2.3, 1.7, and 1.3 and patients' GAIS scores were 2.6, 2.2, 1.8, and 1.4 at 2 weeks after the first procedure, 2 weeks after the second procedure, 2 weeks after the third procedure, and 6 weeks after the third procedure. No serious adverse effects were observed. Conclusion The aging face with crow's feet wrinkles can be improved by using HIFU, while minimizing epidermal and dermal injury.

A Minimally Invasive lumbar Spine Surgery Technique Using a Modified Thoracoport : Proposal of a New Tubular Retractor

  • Park, Kwang-Woo;Park, Chan-Woo;Park, Jin-Soo;Lee, Sang-Gu
    • Journal of Korean Neurosurgical Society
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    • 제40권4호
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    • pp.296-299
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    • 2006
  • Recently the trend of surgical procedure for treatment of lumbar benign disease is a minimally invasive surgery due to small incision, minimal blood loss, and a short hospital day. By using a microscope or an endoscope, and other surgical equipment, a delicate manipulation in a narrow space became feasible, consequently, to secure a wider view with small incision, appropriate retractors are required. But the various tubular retractor systems are expensive and have some problems. We modified Thoracoport [Auto Suture Co., Norwalk, CT] by making a window at the distal end of trocar and used it as a tubular retractor in surgical procedure for treatment of lumbar benign disease. This modified tubular retractor is docked closely on the curved lamina and provides a wider view. We used it as a tubular retractor also in lumbar bilateral decompression involving a unilateral approach. But this trocar has the limited sizes [diameter and length], and also it is difficult to fix the retractor or change the direction of retractor. And then, we propose a more modified Thoracoport with various sizes and attaching the settling holders to the head of tubular retractor to be able to fix the retractor.

External pancreatic ductal stenting in minimally invasive pancreatoduodenectomy: How to do it?

  • Ram Prakash Gurram;Harilal S L;Senthil Gnanasekaran;Satyaprakash Ray Choudhury;Biju Pottakkat;Kalayarasan Raja
    • 한국간담췌외과학회지
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    • 제27권2호
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    • pp.211-216
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    • 2023
  • It has been shown that external pancreatic ductal stenting (EPDS) can reduce the incidence of clinically relevant postoperative pancreatic fistula. Although studies have described EPDS in open pancreaticoduodenectomy (PD), EPDS in minimally invasive PD has not been reported yet. Thus, the objective of this study was to describe the technique of EPDS in minimally invasive PD. The procedure was performed either laparoscopically or using a robot. Once PD was completed, key steps included triple enterotomy, threading of silk-suture through all enterotomies and exteriorization, completing posterior layer of pancreaticojejunostomy (PJ), railroading stent through preplaced silk-suture, intubation of stent into the pancreatic duct, completion of PJ, followed by hepaticojejunostomy and parietalization of jejunum at the stent exit site. EPDS in PD through a minimally invasive approach can be performed safely in selected cases with either a small-sized pancreatic duct or a soft pancreas.

임상가를 위한 특집2 - Current concepts of Laser dentistry (Current concepts of Laser dentistry)

  • 은희종
    • 대한치과의사협회지
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    • 제49권11호
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    • pp.670-678
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    • 2011
  • Various sorts of dental devices for the dental treatment have been introduced and adopted during past several years. Dental Laser, among all devices, seems to be possible for applying to over the whole treatments and widely employed. Furthermore, this article is to introduce that Dental Laser is intended to care patients secured with the effectual treatment against Conventional procedures based upon its studies. The advantages of Dental Laser treatment-along with LLLT (Low Level Laser Therapy) effect, biostimulation effect, and minimal invasive technique - make the patients reduce their fear of the operation, lighten the inconvenience of post operation, and shorten the treatment period. In particular, it is worth considering that the use of laser-assisted therapies is associated with a marked reduction in the use of analgesics and anti-inflammatory medications compared with conventional procedures. This article is to state advantages and differences of Dental Laser treatment compared with Conventional procedures, and to emphasize to become well-acquainted with the precautions for safety and effective Dental Laser treatment. In case of operating Dental Laser with lack of the instructions, it will cause the unpredicted fatal results; therefore this treatment requires special care in its operation. Henceforward, it is anticipated that infinite treatment protocols will be introduced by applying Dental Laser, and this is to address the utilization of Dental Laser.

Unruptured Supraclinoid Internal Carotid Artery Aneurysm Surgery : Superciliary Keyhole Approach versus Pterional Approach

  • Shin, Donguk;Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.306-311
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    • 2012
  • Objective : A superciliary keyhole approach is an attractive, minimally invasive surgical technique, yet the procedure is limited due to a small cranial opening. Nonetheless, an unruptured supraclinoid internal carotid artery (ICA) aneurysm can be an optimal surgical target of a superciliary approach as it is located in the center of the surgical view and field. Therefore, this study evaluated the feasibility and surgical outcomes of a superciliary keyhole approach for unruptured ICA aneurysms. Methods : The authors report on a consecutive series of patients who underwent a superciliary approach for clipping unruptured ICA aneurysms between January 2007 and February 2012. The data were compared with a historical control group who underwent a pterional approach between January 2003 and December 2006. Results : In the superciliary group, a total of 71 aneurysms were successfully clipped without a residual sac in 70 patients with a mean age of 57 years (range, 37-75 years). The maximum diameter of the aneurysms ranged from 4 mm to 14 mm (mean${\pm}$standard deviation, $6.6{\pm}2.3$ mm). No direct mortality or permanent morbidity was related to the surgery. The superciliary approach demonstrated statistically significant advantages over the pterional approach, including a shorter operative duration (mean, 100 min), no intraoperative blood transfusions, and no postoperative epidural hemorrhages. Conclusion : A superciliary keyhole approach provides a sufficient surgical corridor to clip most unruptured supraclinoid ICA aneurysms in a minimally invasive manner.

Alimentary Tract Duplication in Pediatric Patients: Its Distinct Clinical Features and Managements

  • Kim, Soo-Hong;Cho, Yong-Hoon;Kim, Hae-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권5호
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    • pp.423-429
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    • 2020
  • Purpose: Alimentary tract duplication (ATD) is a rare congenital condition that may occur throughout the intestinal tract. Clinical symptoms are generally related to the involved site, size of duplication, or associated ectopic mucosa. This study aimed to identify clinical implications by anatomical locations and age group and then suggest a relevant management according to its distinct features. Methods: We retrospectively reviewed the clinical data of pediatric patients who received a surgical management due to ATD. Furthermore, data including patients' demographics, anatomical distribution of the duplication, clinical features according to anatomical variants, and outcomes were compared. Results: A total of 25 patients were included in this study. ATD developed most commonly in the midgut, especially at the ileocecal region. The most common clinical presentation was abdominal pain, a sign resulting from intestinal obstruction, gastrointestinal bleeding, and intussusception. The non-communicating cystic type was the most common pathological feature in all age groups. Clinically, prenatal detection was relatively low; however, it usually manifested before the infantile period. A laparoscopic procedure was performed in most cases (18/25, 72.0%), significantly in the midgut lesion (p=0.012). Conclusion: ATD occurs most commonly at the ileocecal region, and a symptomatic one may usually be detected before the early childhood period. Surgical management should be considered whether symptom or not regarding its symptomatic progression, and a minimal invasive procedure is the preferred method, especially for the midgut lesion.

Endoscopic Spinal Surgery for Herniated Lumbar Discs

  • Shim, Young-Bo;Lee, Nok-Young;Huh, Seung-Ho;Ha, Sang-Soo;Yoon, Kang-Joan
    • Journal of Korean Neurosurgical Society
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    • 제41권4호
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    • pp.241-245
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    • 2007
  • Objective : So called "minimally invasive procedures" have evolved from chemonucleolysis, automated percutaneous discectomy, arthroscopic microdiscectomy that are mainly working within the confines of intradiscal space to transforaminal endoscopic technique to remove herniated epidural disc materials directly. The purpose of this study is to assess the result of endoscopic spinal surgery and favorable indication in the thoracolumbar spine. Methods : The records of 71 patients, 73 endoscopic procedures, were retrospectively analysed. Yeung Endoscopic Spine Surgery system with 7 mm working sleeve and $25^{\circ}$ viewing angle was used. The mean follow up period was 6 months [range, 3-9]. Results : Operated levels were from T12-L1 disc down to L5-L6 of S1 disc. Of 71 cases, 2 patients underwent transforaminal endoscopic surgery twice due to recurrence after initial operation. MacNab's criteria was used to assess the outcome. Favorable outcome, excellent of good, was seen in 78% [57 procedures] of the patients. Among 11 fair outcomes, only 1 procedure was followed by secondary open procedure, laminectomy with discectomy. Two of 5 poor outcomes were operated again by same procedure which resulted in fair outcomes. One patient with aggravated cauda equina syndrome remained poor and a lumbar fusion procedure was performed in other patient with poor outcome. There were 2 postoperative discitis that were treated with conservative care in one and anterior lumbar interbody fusion in the other. Conclusion : Evolving technology of mechanical, visual instrument enables minimal invasive procedure possible and effective. The transforaminal endoscopic spinal surgery can reach as high as T12-L1 disc level. The rate of favorable outcome is mid-range among reported endoscopic lumbar surgery series. Authors believe that the outcome will be better as cases accumulate and will be able to reach the fate of standard open microsurgery.

Thoracoscopic Resection of the First Rib for Thoracic Outlet Syndrome: A Case Report

  • Kang, Jae Gul;Chon, Soon-Ho;Yie, Kilsoo;Lee, Min Koo;Kwon, Oh Sang;Lee, Song Hyun;Chon, June Raphael
    • Journal of Trauma and Injury
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    • 제30권2호
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    • pp.63-65
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    • 2017
  • Standard open procedures for resection of the first rib in thoracic outlet syndrome can prove to be quite difficult with extensive incisions. A minimal invasive procedure can also be painstaking, but provides an attractive alternative to the more radical open procedures. We report the details of the technique with direct video footage of the procedure performed in a 41-year-old man with thoracic outlet syndrome done entirely by thoracoscopic methods.