• The Korean Journal of Pain
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• 제27권4호
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• pp.313-320
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• 2014

Dexmedetomidine, an imidazoline compound, is a highly selective ${\alpha}_2$-adrenoceptor agonist with sympatholytic, sedative, amnestic, and analgesic properties. In order to minimize the patients' pain and anxiety during minimally invasive spine surgery (MISS) when compared to conventional surgery under general anesthesia, an adequate conscious sedation (CS) or monitored anesthetic care (MAC) should be provided. Commonly used intravenous sedatives and hypnotics, such as midazolam and propofol, are not suitable for operations in a prone position due to undesired respiratory depression. Dexmedetomidine converges on an endogenous non-rapid eye movement (NREM) sleep-promoting pathway to exert its sedative effects. The great merit of dexmedetomidine for CS or MAC is the ability of the operator to recognize nerve damage during percutaneous endoscopic lumbar discectomy, a representative MISS. However, there are 2 shortcomings for dexmedetomidine in MISS: hypotension/bradycardia and delayed emergence. Its hypotension/bradycardiac effects can be prevented by ketamine intraoperatively. Using atipamezole (an ${\alpha}_2$-adrenoceptor antagonist) might allow doctors to control the rate of recovery from procedural sedation in the future. MAC, with other analgesics such as ketorolac and opioids, creates ideal conditions for MISS. In conclusion, dexmedetomidine provides a favorable surgical condition in patients receiving MISS in a prone position due to its unique properties of conscious sedation followed by unconscious hypnosis with analgesia. However, no respiratory depression occurs based on the dexmedetomidine-related endogenous sleep pathways involves the inhibition of the locus coeruleus in the pons, which facilitates VLPO firing in the anterior hypothalamus.

• Journal of Chest Surgery
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• 제51권2호
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• pp.146-148
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• 2018

Left atrial appendage (LAA) aneurysm is a rare, pathologic condition that may lead to atrial tachyarrhythmia or thromboembolic events. A 49-year-old man presented with aggravated palpitation and dizziness. He suffered from refractory atrial fibrillation despite a previous history of radiofrequency catheter ablation. Echocardiography revealed a 57-mm LAA aneurysm. Surgical ablation was performed through a right mini-thoracotomy, and the LAA aneurysm was obliterated with a 50-mm AtriClip (Atricure Inc., Westchester, OH, USA). However, follow-up computed tomography showed residual communication, so the patient is still taking warfarin. We report that a minimally invasive strategy for treating LAA aneurysm can be considered, but incomplete closure may occur; thus, caution is needed.

• 대한족부족관절학회지
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• 제19권3호
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• pp.77-80
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• 2015

Acute Achilles tendon rupture is a frequent injury during sports and recreational activities. Treatments for Achilles tendon rupture have been controversial in recent decades. Traditionally the surgical treatment had benefit over nonsurgical treatment in terms of low rerupture rate and early functional restoration. Recently, nonsurgical treatment was found to show no statistically significant inferiority in re-rupture rate, functional outcome, and calf strength. Whereas, surgical treatment had some complications including adhesion, nerve injury, and infection. Nonsurgical treatment has been increasing due to functional rehabilitation with early weight bearing and restricted early motion. It focuses more attention on the course of caring for patients with deep discussion. There are open repair and minimally invasive repair in terms of surgical treatment. There are various techniques for minimally invasive repair of Achilles tendon, which has some advantages over the open repair. However, the optimal technique for minimally invasive repair has not been established. The number of suture strands is important regardless of suture technique.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2007년도 춘계학술대회A
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• pp.378-383
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• 2007

As the Minimally Invasive Surgery (MIS) is developed, an interventional procedure becomes the major of the spine surgery in the world. Despite of the use of the expensive medical equipments, the success chance of the nucleoplasty is about 30%. The reason is that the shape of the cannular needle is similar to that of the conventional injector and looks like the straight. Because the tip of these straight needles is not able to reach in the vicinity of the disc bulging or the protrusion, which are the cause of the low back pain and because the far indirect plasma discharge results in the decompression, the nucleoplasty has the limit. Many incurable diseases has not been solved due to the unexistence of the advanced technique for the MIS human body cannula device. If 3-D direction controllable cannular catheter (whose direction is accurately controlled after inserting into the bodies to cure the lesion) is developed, it is expected that new devised cannular catheter can cure many incurable diseases simultaneously. Therefore, the aims of this research are to develop the new devised cannular catheter of SMA direction controller for the medical situation, which has been produced through many previous trial-error procedures, and to produce the commercial medical device.

• Journal of Chest Surgery
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• 제31권3호
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• pp.308-310
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• 1998

최근 심혈관질환 수술에서 경침습 술기가 다양하게 적용되고 있다. 본 인하대학교 흉부외과에서는 승모판 교련절개술 후 재발한 착증에서 흉골측면 소절개를 이용한 경침습 접근을 통해 판막치환에 성공하였기에 보고하는 바이다.

• 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.

• Archives of Plastic Surgery
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• 제47권3호
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• pp.256-262
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• 2020

Background Most women consider an oval-shaped face to be youthful and beautiful. In recent years, demand has grown for surgical procedures with a shorter downtime and fewer complications. These minimally invasive procedures include botulinum toxin type A (BoNTA) injection, filler injection, suction-assisted liposuction (SAL), laser-assisted lipolysis (LAL), thread lifting, and fat grafting. This study aims to introduce an effective method for creating an aesthetically pleasing lower face using a combination of minimally invasive procedures. Methods From March 2017 to March 2019, 94 patients simultaneously underwent LAL, SAL, and thread lifting. Ancillary procedures such as BoNTA injections, hyaluronic acid filler injections, and removal of the buccal fat pad (BFP) were selectively performed according to the patient's condition. Results Patients rated their postoperative satisfaction as very satisfied, satisfied, dissatisfied, or very dissatisfied. Approximately 83% of all respondents were satisfied with the results, whereas the remaining respondents had complaints regarding the outcomes. The most common reasons for dissatisfaction were a longer-than-expected recovery time and undercorrection, and the most severe complaint was skin depression as a result of overcorrection. Conclusions Our method of simultaneously performing LAL, SAL, and thread lifting, while adding BoNTA, filler injections, and BFP removal as needed, was capable of producing consistent and reliable aesthetic outcomes for the lower face.

• 한국임상수의학회지
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• 제34권3호
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• pp.200-203
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• 2017

The objective of this study was to evaluate the effectiveness of the minimally invasive plate osteosynthesis (MIPO) method for treatment of tibial shaft fractures in dogs by comparing MIPO radiographic and fracture healing time results with those from the popular open reduction and internal fixation (ORIF) technique. In this clinical study at the Royal Animal Medical Center, five consecutive dogs with diagnoses of comminuted tibial shaft fractures were treated with the MIPO surgical approach. For comparison, an additional five breed-, age-, and weight-matched dogs with comminuted tibial shaft fractures were treated with the ORIF technique. Mean healing time was $75.6{\pm}12.5$ days in the MIPO group and $131.8{\pm}18.6$ days in the ORIF group (p < 0.01). The mean surgery time in the MIPO group ($36.4{\pm}3.5$ minutes) was significantly shorter (p < 0.01) than that for the ORIF group ($47.0{\pm}2.2$ minutes). Based on the short surgical and healing times, the MIPO approach is clinically superior to the ORIF approach and should be the preferred approach in tibial fracture cases.

• Journal of Chest Surgery
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• 제31권1호
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• pp.52-54
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• 1998

근래 들어 최소 침습적 심장수술을 위한 여러 가지 다양한 소절개법이 개발되고 있다. 소절개를 통한 심장판막수술이 기존의 정중 흉골절개술에 비해 단일판막수술의 경우, 수술시야의 확보에 있어 그다지 뒤떨어지지 않으나, 다중판막수술과 같이 서로 떨어져 있는 두 병소를 동시에 수술해야 할 경우 단일 소절개로 양쪽 병소를 다 잘 볼 수 있는 만족스러운 수술시야를 얻기란 용이하지 않다. 본 인하병원 흉부외과에서는 최근 횡흉골절개를 통한 최소 침습적 방법으로 대동맥판막치환술을 2례 시행한데 이어, 금번 소흉골절개를 통한 이중판막치환술을 시행한 바, 수술시야는 비교적 만족스러웠으며 수술 후 환자의 호응도도 높았기에 수술방법을 중심으로 문헌고찰과 함께 보고하고자 한다.

• 센서학회지
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• 제26권4호
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• pp.266-273
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• 2017

In this research a medical palpation guidance system for minimally invasive surgery (MIS) is proposed. Palpation is a useful tool for identifying a size and location of a lump during a surgery. However, conventional manual palpation is only available in open surgery, so there has been several researches about palpation assistant or guidance system for MIS. The previously developed systems are based on a pressure based or stiffness based approach. These previous approaches have some limitations in increasing complexity of the systems and lack of geometric information about the lump which is more important information for the lump removal than the stiffness information. We propose a palpation guidance system using a novel approach using contact pressure distribution. Since our approach gives the geometry information of the lump as well as the existence information, the operator can easily notice the currently identified lump region and the optimal position for the next palpation. The experiment results show that our approach can offer the geometry information of the lump correctly.