• Title/Summary/Keyword: Minimally Invasive Surgery

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Minimally Invasive Cardiac Surgery through A Small Right Parasternal Incision (개실술에서 우측흉골우연소절개법을 이용한 최소침투수술)

  • 공준혁;이응배;조준용;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.723-728
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    • 2000
  • Background: Minimally invasive techniques for open heart surgery are widely accepted in these days. There are minimally invasive approaches by the right or left parasternal incision and another approaches by mini-sternotomy of upper or lower half or sternum. We report the safety and efficacy of minimally invasive technique with right parasternal incision compared with the routine full sternotomy. Material and Method: From April 1997 through February 1999, 20 patients(Group A) underwent minimally invasive cardiac operations. We chose 41 patients(Group B) whose preoperative diagnosis were the same and general conditions were similar and who underwent routine full sternotomy before April 1997. We compared A group and B group in many aspects. We performed routine full median sternotomy in B group but we did a minimally invasive technique through a small right parasternal incision in A group. Result: mean age was 36.1 years in both groups. In disease entities, there were 11 cases of ASD, 9 cases of mitral valve disease in group A, and 16 cases of ASD, 25 cases of mitral valve diseases in group B. In ASD, operation time, cardiopulmonary bypass time of aortic occulusion time were 263 min, 82 min, and 41 min in group A and 180 min, 53 min, and 32 min in group B. In mitral valve disease, operation time, cardiopulmonary bypass time and aortic occlusion time were 267min, 106 min, and 70min in A group and were 207 min, 82 min, and 69 min in group B. There were significant differences in operation time, CPB time, and ACC time between group A and group B. There was a significant difference in the amount of bleeding in postoperative day 1 between group A and group B of mitral diasease. However, there was no significant difference in the amount of bleeding in other comparisons. Mean length of incision was 8.7 cm in group A. There was no significant difference in postoperative complications between A group and B group. There was no mortality in either group. Conclusion: We conclude that this minimally invasive technique with right parasternal incision is cosmetically excellent but it is not effective in reducing operative time and there was no significant difference in recovery time and postoperative complications compared with routine full sternotomy.

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Minimally Invasive Redo Mitral Valve Replacement under Fibrillatory Arrest in a Patient with a Calcified Aorta and Patent Previous Bypass Grafts

  • Kim, Seung Hyun;Kim, Hak Ju;Hwang, Ho Young
    • Journal of Chest Surgery
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    • v.51 no.4
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    • pp.283-285
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    • 2018
  • A 73-year-old woman who underwent combined bioprosthetic mitral valve replacement, tricuspid ring annuloplasty, and coronary artery bypass grafting 12 years previously visited our clinic due to aggravated dyspnea caused by structural valve deterioration of the mitral prosthesis. Because aortic or femoral artery cannulation and cross-clamping would have a high risk of stroke owing to severe calcification of the ascending aorta and ilio-femoral vessels, and because there was a risk of redo sternotomy due to the patent bypass grafts, a comprehensive approach including axillary artery cannulation, a minimally invasive right thoracotomy approach, and a clampless hypothermic fibrillatory arrest technique was used during redo mitral valve replacement.

Minimally Invasive Excision of Epidermal Cysts through a Small Hole Made by a $CO_2$ Laser

  • Song, Seung Wook;Burm, Jin Sik;Yang, Won Yong;Kang, Sang Yoon
    • Archives of Plastic Surgery
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    • v.41 no.1
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    • pp.85-88
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    • 2014
  • To improve the cosmetic results of removing epidermal cysts, minimally invasive methods have been proposed. We proposed a new minimally invasive method that completely removes a cyst through a small hole made by a $CO_2$ laser. Twenty-five patients with epidermal cysts, which were 0.5 to 1.5 cm in diameter, non-inflamed, and freely movable, were treated. All of the patients were satisfied with the cosmetic results. This method is simple and results in minimal scarring and low recurrence rates without complications.

Abstract Minimally Invasive Aort ic Valve Surgery -A Report of Two Cases (최소 침습성 대동맥 판막 수술 -2례 보고-)

  • 백완기;김현태
    • Journal of Chest Surgery
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    • v.30 no.11
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    • pp.1139-1141
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    • 1997
  • Recently, minimally invasive approach via limited incision becomes one of the rapidly developing strategy in cardiac surgery as it gives less surgical trauma and is more satisfactory to the patients in respect to operative scar although the surgical technique is more demanding. Here, we report two cases of aortic valve replacement via limited transsternal incision. The methodology is described with review of the relevant literature.

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Minimally Invasive Reduction and Pin Fixation Treatment for Displaced Intraarticular Calcaneal Fracture (최소 침습적 정복술 및 금속강선 고정술을 이용한 전위된 관절내 종골 골절의 치료)

  • Lee, Jin-Young;Park, In-Heon;Kim, Gab-Lae;Kim, Tae-Hwa;Oh, Bum-Suk
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.66-72
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    • 2010
  • Purpose: To evaluate the clinical efficacy of the minimally invasive posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2006 to October 2008, we studied retrospectively 45 patients, 56 cases who were treated with minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and AOFAS score, circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared Bohler angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 1 was 81, type 2 was 75, type 3 was 69, type 4 was 61. By AOFAS score, Sanders type 1 was 88, type 2 was 82, type 3 was 78, type 4 was 63. And by circle draw test, type 1 was 8.8 cm, type 2 was 8.5 cm, type 3 was 8 cm, type 4 was 6.6 cm. Preoperative Bohler angle and Gissane angle were $7.2^{\circ}$, $98^{\circ}$, and it increased to $21.2^{\circ}$, $116^{\circ}$ after postoperative 1 year. Conclusion: Minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture was considered to be an effective treatment modality.

The Pringle maneuver in the modern era: A review of techniques for hepatic inflow occlusion in minimally invasive liver resection

  • Omar A. Mownah;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.131-140
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    • 2023
  • During minimally invasive liver resection (MILR), the Pringle maneuver aims to minimize blood loss and provide a clear operative field, thereby identifying intrahepatic structures and facilitating safe parenchymal transection. Several techniques for using the Pringle maneuver in MILR have been described. This review presents various methods which have been reported in the literature. A systematic literature search used the MEDLINE/PubMed database from its earliest records to August 2022 using appropriate search headings and keywords. The primary outcome was identifying techniques for performing hepatic inflow occlusion during laparoscopic/robotic hepatectomy. Inclusion criteria consisted of publications describing technical steps to obtain hepatic inflow occlusion during minimally invasive hepatectomy. A literature search identified 23 relevant publications, and the full texts were examined. The techniques described in the reports can be broadly categorized into three groups: (1) the Rummel-tourniquet technique, (2) vascular clamp use, and (3) the Huang Loop technique. Various techniques have been used in MILR to achieve inflow confinement successfully. The authors prefer the modified Huang Loop technique because it is inexpensive, reliable, and quick to apply or release. Hepatobiliary surgeons are advised to familiarize themselves with these MILR techniques, which have proven effective and safe inflow occlusion.

Minimally Invasive Approaches Versus Conventional Sternotomy for Aortic Valve Replacement: A Propensity Score Matching Study

  • Bang, Ji-Hyun;Kim, Jong-Wook;Lee, Jae-Won;Kim, Joon-Bum;Jung, Sung-Ho;Choo, Suk-Jung;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.45 no.2
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    • pp.80-84
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    • 2012
  • Background: The aim of this study is to evaluate our institutional results of the aortic valve replacement through minimally invasive approaches compared with conventional sternotomy. Materials and Methods: From August 1997 to July 2010, 838 patients underwent primary isolated aortic valve replacement. Of them, 73 patients underwent surgery through minimally invasive approaches (MIAS group) whereas 765 patients underwent surgery through the conventional sternotomy (CONV group). Clinical outcomes were compared using a propensity score matching design. Results: Propensity score matching yielded 73 pairs of patients in which there were no significant differences in baseline profiles between the two groups. Patients in the MIAS group had longer aortic cross clamp than those in the CONV group ($74.9{\pm}27.9$ vs.. $66.2{\pm}27.3$, p=0.058). In the MIAS group, conversion to full sternotomy was needed in 2 patients (2.7%). There were no significant differences in the rates of low cardiac output syndrome (4 vs. 8, p=0.37), reoperation due to bleeding (7 vs. 6, p=0.77), wound infection (2 vs. 4, p=0.68), or requirements for dialysis (2 vs. 1, p=0.55) between the two groups. Postoperative pain was significantly less in the MIAS group than the conventional group (pain score, $3.79{\pm}1.67$ vs. $4.32{\pm}1.56$; p=0.04). Conclusion: Both minimally invasive approaches and conventional sternotomy had comparable early clinical outcomes in patients undergoing primary isolated aortic valve replacement. Minimally invasive approaches significantly decrease postoperative pain.

Minimally Invasive Simultaneous Treatment for Congenital Cystic Adenomatoid Malformation associated with Pectus Excavatum - A case report - (누두흉과 선천성 낭종성 선종양 기형의 최소 침습적인 동시수술 -1예 보고-)

  • Cho, Deog-Gon;Jo, Min-Seop;Kim, Kyung-Soo;Wang, Young-Pil;Cho, Kyu-Do
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.171-175
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    • 2006
  • Minimally invasive thoracic surgery has been one of the most important surgical advances recently. Congenital cystic adenomatoid malformation of the lung is a relatively rare anomaly and is clearly associated with various congenital anomalies such as pectus excavatum, cardiac and pulmonary vascular lesions. We have experienced a case that was treated with minimal invasive methods for congenital cystic adenomatoid malformation involving in the right lower lobe and pectus excavatum in a 5-year-old boy. We simultaneously performed thoracoscopic right lower lobectomy and Nuss procedure of pectus excavatum using a substernal steel bar. Therefore, a minimally invasive surgical treatment for this diseases is feasible and cosmetically excellent.

Minimally Invasive Surgery for Hallux Valgus Deformity Using Intramedullary Low Profile Plate Fixation: A Case Report (소형 금속판의 골수강 내 고정을 통한 최소 침습적 무지 외반증 교정 수술: 증례 보고)

  • Cho, Sung Tan;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.3
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    • pp.135-138
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    • 2019
  • According to a recent systemic review, hallux valgus deformity has a prevalence rate of about 23% among adults aged 18 to 65 years. To date, more than 100 operative methods have been reported for the correction of hallux valgus deformity. For young female with mild to moderate hallux valgus deformity, minimally invasive surgery can be considered for aesthetic demands. Here, we report a case of a young female patient with mild hallux valgus deformity treated by minimally invasive surgery using intramedullary low profile plate fixation. This can be the favorable method for secure fixation of the osteotomy site and prevention of medial skin irritation symptoms derived from a sharp osteotomy margin.