• 제목/요약/키워드: Minimal invasive surgery

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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.

AESOP 3000을 이용한 흉강경적 대동맥 판막 치환술 (Thoracoscopic Aortic Valve Replacement assisted with AESOP (Automated Endoscope System for Optimal Positioning) 3000)

  • 신홍주;김희중;주석중;송현;정철현;송명근;이재원
    • Journal of Chest Surgery
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    • 제38권7호
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    • pp.507-509
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    • 2005
  • 우측 개흉술을 통한 개심술은 심방중격 결손증, 승모판막 질환에서 이루어질 수 있다. 최근에 본원에서는 AESOP 3000을 이용하여 흉강경적 심방중격 봉합술, 승모판막 성형술, Maze 수술, 최소침습적 관상동맥 우회술 등을 시행하고 있다. 하지만, 흉강경을 이용한 대동맥 판막 치환술에 대해서는 현재 국내 보고가 없는 실정이다. 본원에서는 31세 여자 환자에게서 AESOP 3000을 이용한 흉강경적 대동맥 판막 치환술을 성공적으로 시행하였기에 문헌 고찰과 함께 보고하는 바이다.

One Stage Posterior Minimal Laminectomy and Video-Assisted Thoracoscopic Surgery (VATS) for Removal of Thoracic Dumbbell Tumor

  • Nam, Kyoung Hyup;Ahn, Hyo Yeoung;Cho, Jeong Su;Kim, Yeoung Dae;Choi, Byung Kwan;Han, In Ho
    • Journal of Korean Neurosurgical Society
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    • 제60권2호
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    • pp.257-261
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    • 2017
  • Objective : This study was conducted to assess the surgical results of one-stage posterior minimal laminectomy and video-assisted thoracoscopic surgery (VATS) for the treatment of thoracic dumbbell tumor and to describe its precise technique. In addition, we investigated the technique's usefulness and limitations. Methods : Seven cases of thoracic dumbbell tumor (two men and five women, mean age, 43 years) were analyzed retrospectively. Pathological findings included schwannoma in four patients, neurofibroma in two patients, and hemangioma in one patient. The location of tumors varied from T2/3 to T12/L1. Dumbbell tumors were resected by one-stage operation using posterior laminectomy followed by VATS without instrumentation. Clinical data were reviewed. Results : The mean follow-up period was 25 months (range, 3-58 months), and the operative time ranged from 255 to 385 min (mean, 331 min), with estimated blood loss ranging from 110 to 930 mL (mean, 348 mL). The tumor was completely resected without instrumentation and postoperative instability in all cases. Postoperative complications included atelectasis and facial anhydrosis in one case each. Conclusion : One-stage posterior minimal laminectomy and VATS may be a safe and less invasive technique for removal of thoracic dumbbell tumor without instability. This method has the advantage of early ambulation and rapid recovery because it reduces blood loss and postoperative pain.

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.

Application of Monitored Anesthesia Care Using Dexmedetomidine to Common Oral and Maxillofacial Trauma Cases

  • Lee, Deok-Won;Shin, Min Cheol;Hong, Sung ok
    • Journal of Korean Dental Science
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    • 제10권2호
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    • pp.82-86
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    • 2017
  • Oral and maxillofacial surgery (OMFS) trauma cases are commonly treated under general anesthesia. The purpose of this case report is to introduce an alternative method of anesthesia in patients who refuse general anesthesia. A combination of dexmedetomidine and ketamine for sedation anesthesia in 3 frequent fracture types in the field of OMFS-Le Fort I fracture, mandibular fracture, and alveolar bone fracture-was used. Dexmedetomidine as the single agent has not shown stable success rates for invasive procedures. To overcome some of the pitfalls with dexmedetomidine, combination sedation using ketamine was performed. Visual analogue scale scores were recorded postoperatively. Dexmedetomidine combined with ketamine administration provided safe and effective sedation and anxiolysis for surgical reduction and internal fixation of OMFS fractures. It showed advantages of decreased admission time, reduced expenses, minimal pain, and reduced anesthetic burden for the patient thus ultimately increasing overall satisfaction.

고령의 식도암 환자에서 다빈치 S 로봇을 이용한 식도 절제술 ($DaVinci^{TM}$ S robot-assisted esophagectomy in a 83-year-old patient with esophageal cancer)

  • 함석진;박성용;백효채
    • 대한기관식도과학회지
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    • 제14권2호
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    • pp.53-56
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    • 2008
  • The postoperative respiratory complications such as pneumonia and ARDS, are poor prognostic factors after esophagectomy in patients with esophageal cancer. To avoid these complications, there have been attempts to use minimally invasive approach. Recently introduced daVinciTM S surgical system is used in esophagectomy because of its advantages of minimal invasiveness, clear 3-dimensional imaging and precise handling of robotic arms. We report a 83-year-old esophageal cancer patient who underwent daVinciTMS robot-assisted esophagectomy, laparoscopic stomach mobilization followed by cervical esophagogastrostomy.

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Coil과 Fibrin Glue를 이용한 기관지 내시경하 기관지 늑막강루의 치료- 1예 보고 - (Bronchoscopic Treatment of a Bronchopleural Fistula with using Coils and Fibrin Glue - A case report -)

  • 조성준;류세민
    • Journal of Chest Surgery
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    • 제40권9호
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    • pp.648-650
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    • 2007
  • 기관지늑막강루는 드문 질환이지만, 일단 생기면 높은 이완율과 치명률을 보이며 입원 기간과 비용부담이 초래되는 합병증의 하나이다. 일반적으로 수술적 치료가 우선이지만, 최근 들어 비침습적 방법으로 기관지 내시경을 이용한 치료가 보고되고 있다. 괴사성 폐렴에 합병된 기관지 늑막강루를 코일과 글루를 사용하여 기관지내시경을 이용, 성공적으로 치료하였기에 그 결과를 보고한다.

Well-Differentiated Papillary Mesothelial Tumor: An Unusual Radiologic Presentation: A Case Report

  • Moslem Abdelghafar;Krishna Anand;Antonio Paiva-Correia;Elaine Paula Smith;Francoise Galateau Salle;Vijay Joshi
    • Journal of Chest Surgery
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    • 제56권3호
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    • pp.220-223
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    • 2023
  • Well-differentiated papillary mesothelial tumor (WDPMT) is an uncommon tumor, formerly named well-differentiated papillary mesothelioma in the 2015 World Health Organization classification. It has a characteristic papillary architecture, bland cytologic features, a tendency toward superficial spread without invasion, and a good prognosis due to its clinically indolent behavior with prolonged survival. Rare cases with superficial invasion are termed WDPMT with invasive foci. WDPMT occurs primarily in the peritoneum of reproductive-age women, but also rarely in the pleura. We report a case of a 60-year-old woman who developed WDPMT with minimal invasion in the pleura with atypical radiological features and a family history of mesothelioma and indirect asbestos exposure.

마이크로머시닝 기술의 의학 및 생물학 응용

  • 장준근;김용권
    • 전자공학회지
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    • 제24권10호
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    • pp.63-72
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    • 1997
  • Application of MEMS to biologic system mainly categorized into bio-electronics and micro-medical systems, Bio-electronics concerns on the biocompatible electronic device, in-vivo sensors, the sensors based on biological materials, biological materials for electronics and optics, the concepts and materials Inspired by biology and useful for electronics, the algorithm inspired by biology, artificial sense, and the biologic-inorganic hybrids. Micro-medical systems are utilited into the drug delivery systems, micro patient monitoring systems, micro prosthesis and artificial organs, cardiology related prothesis, analysis systems, and the minimal invasive surgery tools based on the m icrom achining technology.

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New Surgical Approach for Gastric Bezoar: "Hybrid Access Surgery" Combined Intragastric and Single Port Surgery

  • Son, Tae-Il;Inaba, Kazuki;Woo, Yang-Hee;Pak, Kyung-Ho;Hyung, Woo-Jin;Noh, Sung-Hoon
    • Journal of Gastric Cancer
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    • 제11권4호
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    • pp.230-233
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    • 2011
  • Regarding the removal of a gastric bezoar, laparoscopic surgery was performed and it was shown that the laparoscopic approach is safe and feasible. However, the laparoscopic method has the risk of intraabdominal contamination, when the gastric bezoar is retrieved from the gastric lumen in the peritoneal cavity. We developed and applied a new procedure for the removal of the gastric bezoar using one surgical glove and two wound retractors as a fashion of intragastric single port surgery. Herein we present this new minimal invasive procedure, so named "hybrid access surgery" which involves the use of existing devices and overcomes the weakness of laparoscopic removal of the gastric bezoar. Our new procedure, combining the concept of intragastric and single port access, is acceptable and feasible to retrieve the gastric bezoar. In the future, this procedure may be one of the alternative procedures for retrieving gastric bezoar even when it is incarcerated in the pylorus.