• 제목/요약/키워드: Minimally invasive

검색결과 734건 처리시간 0.027초

Minimally Invasive Approach for Redo Mitral Valve Replacement: No Aortic Cross-Clamping and No Cardioplegia

  • Kim, Hong Rae;Kim, Gwan Sic;Yoo, Jae Suk;Lee, Jae Won
    • Journal of Chest Surgery
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    • 제48권2호
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    • pp.126-128
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    • 2015
  • A 75-year-old woman who had previously undergone a double valve replacement was admitted to Asan Medical Center because of severe bioprosthetic mitral valve dysfunction and tricuspid regurgitation. Under hypothermic fibrillatory arrest without aortic cross-clamping, minimally invasive mitral and tricuspid valve surgery was performed via a right minithoracotomy.

Refractory Coronary Artery Spasm after Minimally Invasive Direct Coronary Artery Bypass Grafting

  • Ju, Min-Ho;Kim, Joon-Bum;Kim, Hee-Jung;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • 제44권4호
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    • pp.288-291
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    • 2011
  • Postoperative coronary arterial spasm is a rare but potentially fatal complication. A 51-year-old male patient with a history of a reactive ergonovine stress test coronary angiogram developed refractory coronary artery spasm after undergoing minimally invasive direct coronary artery bypass grafting of the left anterior descending coronary artery. The patient was successfully managed with rapid implementation of intra-aortic balloon-pump counter pulsation and extracorporeal membrane oxygenation.

급성 아킬레스건 파열의 최소 침습적 봉합술 (Minimal Invasive Surgery for Acute Achilles Tendon Rupture)

  • 이명진;김민우
    • 대한족부족관절학회지
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    • 제25권2호
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    • pp.76-79
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    • 2021
  • Recently, the incidence of Achilles tendon rupture has been increasing with an increase in the elderly and the sports population. Various kinds of surgical options have been introduced up to now. Among them, the traditional open repair is most commonly used despite the risk of re-rupture or post-operative infections, which in turn can impair the blood flow to the Achilles tendon. Therefore, minimally invasive methods to overcome these complications have been studied with excellent outcomes.

Recent advances in minimally invasive surgery for gynecologic indications

  • Koo, Yu-Jin
    • Journal of Yeungnam Medical Science
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    • 제35권2호
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    • pp.150-155
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    • 2018
  • Recently, an increasing interest in less invasive surgery has led to the advent of laparoendoscopic single-site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES). LESS and NOTES could be technically challenging, but available literature has demonstrated the feasibility and safety of LESS for benign gynecologic diseases. However, the evidence is not strong enough to recommend the use of LESS over that of conventional multiport laparoscopic surgery (MLS). As per the results of the most recently published meta-analysis, the majority of surgical outcomes are equivalent between LESS and MLS, except for the longer operative time in LESS for both adnexal surgery and hysterectomy. Although an increasing number of studies have reported on robotic LESS, NOTES, and LESS for gynecologic malignancy, definite conclusions have not been drawn owing to the lack of sufficient information.

Proximal Anterior-Antrum Posterior (PAAP) Overlapping Anastomosis in Minimally Invasive Pylorus-Preserving Gastrectomy for Early Gastric Cancer Located in the High Body and Posterior Wall of the Stomach

  • Park, Ji-Hyeon;Kong, Seong-Ho;Choi, Jong-Ho;Park, Shin-Hoo;Suh, Yun-Suhk;Park, Do-Joong;Lee, Hyuk-Joon;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • 제20권3호
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    • pp.277-289
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    • 2020
  • Purpose: To evaluate the feasibility and safety of intracorporeal overlapping gastrogastrostomy between the proximal anterior wall and antrum posterior wall (PAAP; PAAP anastomosis) of the stomach in minimally invasive pylorus-preserving gastrectomy (PPG) for early gastric cancer (EGC). Materials and Methods: From December 2016 to December 2019, 17 patients underwent minimally invasive PPG with PAAP anastomosis for EGC in the high body and posterior wall of the stomach. Intraoperative gastroscopy was performed with the rotation maneuver during proximal transection. A longer antral cuff (>4-5 cm) was created for PAAP than for conventional PPG (≤3 cm) at the point where a safe distal margin and good vascular perfusion were secured. Because the posterior wall of the proximal remnant stomach was insufficient for intracorporeal anastomosis, the anterior wall was used to create an overlapping anastomosis with the posterior wall of the remnant antrum. The surgical and oncological outcomes were analyzed, and the stomach volume was measured in patients who completed the 6-month follow-up. The results were compared to those after conventional PPG (n=11 each). Results: PAAP anastomosis was successfully performed in 17 patients. The proximal and distal resection margins were 2.4±1.9 cm and 4.0±2.6 cm, respectively. No postoperative complications were observed during the 1-year follow-up esophagogastroduodenoscopy (n=10). The postoperative remnant stomach (n=11) was significantly larger with PAAP than with conventional PPG (225.6±118.3 vs. 99.1±63.2 mL; P=0.001). The stomach length from the anastomosis to the pylorus was 4.9±2.4 cm after PAAP. Conclusions: PAAP anastomosis is a feasible alternative for intracorporeal anastomosis in minimally invasive PPG for highly posteriorly located EGC.

최소 침습적 외측 요추간 유합술: 적응증, 결과, 합병증 (Minimally Invasive Lateral Lumbar Interbody Fusion: Indications, Outcomes and Complications)

  • 소재완;이재철
    • 대한정형외과학회지
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    • 제54권3호
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    • pp.203-210
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    • 2019
  • 최소 침습적 외측 요추체간 유합술의 최신 지견에 대하여 알아보고자 하였다. 아직 도입된 지 얼마 되지 않았으나 근래에 각광받고 있는 최소 침습적 외측 요추체간 유합술에 대한 적응증 및 임상 결과와 유합률, 그리고 합병증에 대하여 문헌 고찰을 하였다. 외측 요추간 유합술의 적응증은 퇴행성 요추부 질환에서 고식적인 전방, 후방 추체간 유합술의 적응증과 거의 유사하다. 특히 척추관 협착증 및 퇴행성 척추 전방 전위증, 퇴행성 척추 변형, 퇴행성 추간판 질환, 인접 분절 퇴행성 질환에서 최소 침습적 수술로서 효과적이다. 또한 고식적 요추부 유합술과 비교하여 임상적 결과 및 유합률이 대등한 것으로 보고되고 있다. 하지만 수술 접근 및 과정에서 발생하는 수술 후 고관절 굴곡근 약화 및 신경 손상, 혈관 손상, 장기 손상, 케이지 침강, 위탈장 등의 비특이적 합병증들이 보고되고 있다. 외측 추체간 유합술은 고식적인 전방 또는 후방 추체간 유합술의 장점을 취합하고 단점을 보완한 수술이며 그 임상 결과나 유합률에도 큰 차이가 없어 퇴행성 요추부 질환의 치료에 최소 침습 수술로서 유용한 치료법이다. 하지만 수술 과정에서 발생하는 비특이적 합병증들을 개선해야 하는 것이 향후 과제이다.

Ultrasound-Guided Radiofrequency Ablation in Tertiary Hyperparathyroidism: A Prospective Study

  • Erya Deng;Tingting Jiang;Huihui Chai;Ning Weng;Hongfeng He;Zhengxian Zhang;Chengzhong Peng;Wenwen Yue;Huixiong Xu
    • Korean Journal of Radiology
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    • 제25권3호
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    • pp.289-300
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    • 2024
  • Objective: To prospectively evaluate the outcomes of ultrasound (US)-guided radiofrequency ablation (RFA) in tertiary hyperparathyroidism (THPT). Materials and Methods: Patients with THPT underwent RFA between September 2017 and January 2022. Laboratory parameters, including serum intact parathyroid hormone (iPTH) levels, were monitored for 48 months after RFA and compared with the levels at baseline. Complications related to RFA and changes in hyperparathyroidism-related clinical symptoms were recorded before and after RFA. Results: A total of 42 patients with THPT were recruited for this study. Ultimately, 36 patients with renal failure and 2 patients who underwent successful renal transplantation (male:female, 17:21; median age, 54.5 years) were enrolled. The follow-up time was 21.5 ± 19.0 months in the 36 patients with renal failure. In these 36 patients, iPTH levels were significantly decreased to 261.1 pg/mL at 48 months compared with the baseline value of 1284.9 pg/mL (P = 0.012). Persistent hyperparathyroidism, defined as iPTH levels maintained at > 585.0 pg/mL for 6 months after treatment, occurred in 4.0% of patients (1/25). Recurrent hyperparathyroidism, defined as iPTH levels > 585.0 pg/mL after 6 months, were 4.0% (1/25) and 0.0% (0/9) at 6 months and 4 years after treatment, respectively. In two patients with THPT after successful renal transplantation, iPTH decreased from the baseline value of 242.5 and 115.9 pg/mL to 171.0 and 62.0 pg/mL at 6 months after treatment. All complications resolved within 6 months of ablation without medical intervention, except in 10.5% (4/38) patients with permanent hypocalcemia. The overall symptom recovery rate was 58.8% (10/17). The severity scores for bone pain, arthralgia, and itchy skin associated with hyperparathyroidism improved after treatment (P < 0.05). Conclusion: US-guided RFA is an effective and safe alternative to surgery in the treatment of patients with TPTH and improves hyperparathyroidism-related clinical symptoms.