• 제목/요약/키워드: Minimally invasive method

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

  • 공준혁;이응배;조준용;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • 제33권9호
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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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비침습 연속혈당 모니터링 기술동향 (Trends in Non-invasive Continuous Glucose Monitoring Technology)

  • 김종덕;김봉규
    • 전자통신동향분석
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    • 제36권5호
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    • pp.9-20
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    • 2021
  • A technology to replace the traditional blood sampling method for glucose monitoring has been sought for a long time. It is now possible to measure the blood glucose change rate continuously for more than 24 hours using a minimally invasive method that does not involve blood collection. Furthermore, various technology development efforts are being made for innovative diabetes management through intermittent or continuous blood glucose monitoring in a non-invasive manner. In this paper, we present an overview of diabetes and the need for continuous blood glucose measurement techniques., and then introduce various non-invasive blood glucose measurement techniques currently being studied. In addition, through research and analysis of the recent commercialization development status of minimally invasive, non-invasive, and wearable continuous blood glucose measurement technologies, we examine global development trends of future technologies.

검상돌기하절개에 의한 심방중격결손증의 교정 -2례보고- (Subxiphois Approach for The Repair of Atrial Septal Defects -A cases report-)

  • 오상기
    • Journal of Chest Surgery
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    • 제33권2호
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    • pp.183-185
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    • 2000
  • With the marked decrease in operative mortality in simple heart diseases there have been several reports on the minimally invasive and cosmetic techniques including submammary incision right parasternal approach right anterolateral thoracotomy partial sternotomy and subxiphoid approach. We report here subxiphoid approach without sternotomy for the repair of atrial septal defect as the procedure that has less invasive technique and more cosmetic effect.

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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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    • 제41권1호
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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.

Risk Factors for the Severity of Complications in Minimally Invasive Total Gastrectomy for Gastric Cancer: a Retrospective Cohort Study

  • Roh, Chul Kyu;Lee, Soomin;Son, Sang-Yong;Hur, Hoon;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • 제21권4호
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    • pp.352-367
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    • 2021
  • Purpose: Minimally invasive gastrectomy is a promising surgical method with well-known benefits, including reduced postoperative complications. However, for total gastrectomy of gastric cancers, this approach does not significantly reduce the risk of complications. Therefore, we aimed to evaluate the incidence and risk factors for the severity of complications associated with minimally invasive total gastrectomy for gastric cancer. Materials and Methods: The study included 392 consecutive patients with gastric cancer who underwent either laparoscopic or robotic total gastrectomy between 2011 and 2019. Clinicopathological and operative characteristics were assessed to determine the features related to postoperative complications after minimally invasive total gastrectomy. Binomial and multinomial logistic regression models were used to identify the risk factors for overall complications and mild and severe complications, respectively. Results: Of 103 (26.3%) patients experiencing complications, 66 (16.8%) and 37 (9.4%) developed mild and severe complications, respectively. On multivariate multinomial regression analysis, independent predictors of severe complications included obesity (OR, 2.56; 95% CI, 1.02-6.43; P=0.046), advanced stage (OR, 2.90; 95% CI, 1.13-7.43; P=0.026), and more intraoperative bleeding (OR, 1.04; 95% CI, 1.02-1.06; P=0.001). Operation time was the only independent risk factor for mild complications (OR, 1.06; 95% CI, 1.001-1.13; P=0.047). Conclusions: The risk factors for mild and severe complications were associated with surgery, indicating surgical difficulty. Surgeons should be aware of these potential risks that are related to the severity of complications so as to reduce surgery-related complications after minimally invasive total gastrectomy for gastric cancer.

로봇을 이용한 심장수술이 환자의 통증, 수면 및 자가간호수행에 미치는 영향 (Effects of pain, sleep and self-care behavior in patients underwent robotic minimally invasive cardiac surgeries)

  • 박수현;장인실
    • 디지털융복합연구
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    • 제17권7호
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    • pp.265-274
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    • 2019
  • 본 연구는 로봇을 이용한 최소침습절개술 접근과 기존의 정중흉골절개술 접근을 이용한 심장판막수술환자를 대상으로 통증, 수면, 자가간호수행을 파악하고 이를 비교분석하기 위한 조사연구이다. 대상자는 서울시 일개 상급종합병원에서 심장수술을 시행한 대상자 중 정중흉골절개술군 64명, 최소침습절개술군 64명을 대상으로 하였다. 자료분석은 SPSS 22.0 프로그램을 이용하여 기술적 통계, ${\chi}^2$ 검증, paired t-test를 시행하였다. 수술 후 2일째, 5일째 모두 통증은 로봇을 이용한 최소침습절개술군이 정중흉골절개술군에 비해 높았다. 통증발생부위는 두 군 모두 수술접근부위로 크게 나타났다. 수면은 수술 후 2일째 정중흉골절개술군에서 높게 나타났으며, 자가간호수행은 최소침습절개술군에서 높게 나타났다. 그러므로 로봇 수술의 재원기간 단축과 빠른 회복 등의 장점에도 불구하고 대상자의 통증관리를 위해 정확한 통증 사정 및 차별화된 프로토콜의 적용이 필요시 된다. 또한 성별, 연령 및 수술방법의 차이를 고려하여 안위를 증진시키기 위한 체계화된 교육 프로그램 중재가 요구되어진다.

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

  • 조성탄;서진수;최준영
    • 대한족부족관절학회지
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    • 제23권3호
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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.

최소 침습적 경피적 나사못 고정 방법을 이용한 전위된 관절내 종골 골절 치료 (Minimally-invasive Percutaneous Screw Fixation of Displaced Intra-articular Calcaneal Fractures)

  • 채수욱;양정환
    • 대한족부족관절학회지
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    • 제14권1호
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    • pp.73-78
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    • 2010
  • Purpose: The purpose of this study is to analyze the clinical and radiological results of minimally invasive percutaneous screw fixation in intra-articular calcaneal fractures and its complications. Materials and Methods: This study is based on 30 intra-articular calcaneal fractures that treated by index operation from June 2005 to November 2006 with at least 6 months follow-up. We assessed the clinical and radiological outcomes and complications. Results: According to Sanders classification, there were 8 in type IIA, 7 in type IIB, 3 in type IIIAB, 6 in type IIIBC, 6 in type IV. And according to Essex-Lopresti classification, there were 9 in the tongue type, 21 in the joint depression type. Average follow-up period was 14.6 months (range: 6-23 months). Average interval between from injury to operation was 2.3 days. Average AOFAS score was 87.7 (range: 52-92). Satisfactory results were obtained in 22 cases (73.3%) by AOFAS score and in 20 cases (66.7%) by VAS score (mean: 3.4). Radiological results improved from 8.7 to 20.3 degrees in the Bohler angle and from 40.2 mm to 52.1 mm in calcaneal height. Postoperative complications were 2 skin and soft tissue problems and 1 sural neuropathy. Conclusion: Minimally invasive percutaneous screw fixation may be useful alternative surgical method in the management of Sanders type II and III calcaneal fractures, which is possible to achieves the anatomical restoration and minimizes postoperative complication in patients with high risks of soft tissue compromise and allows relatively early operation.

Multi-modal treatment strategy for achieving an aesthetic lower face

  • Jeong, Tae Kwang;Chung, Chang Ho;Min, Kyung Hee
    • 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.

최소 침습성 심장수술 -세가지 다른 접근법- (Minimally Invasive Cardiac Surgery - Three different approaches -)

  • 정승혁;양지혁;남혜원;김기봉;안혁
    • Journal of Chest Surgery
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    • 제32권5호
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    • pp.438-441
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    • 1999
  • 배경: 최소 침습성 심장수술은 기존의 정중 흉골절개술보다 우수한 미용효과, 흉곽 개폐에 있어서의 용이함, 작은 외상에 따른 통증, 감염, 출혈 등의 감소, 빠른 회복 및 재원일수의 감소 등이 장점으로 제시되면서 점차 널리 시행되고 있다. 대상 및 방법: 저자들은 1997년 3월부터 12월 까지 36명의 환자를 대상으로 우측 방정중 절개법, 흉골횡 절개법, 최소흉골절개법 등의 3가지 접근방법으로 대동맥 판막 및 승모판 판막질환, 선천성 심기형의 환자 등에 대해 최소 침습성 심장수술을 시행하였다. 결과: 사망례는 없었다. 합병증으로는 술후 부정맥 4례, 출혈로 인한 재수술 1례, 창상 지연유합 1례가 있었다. 사용된 창상의 평균 길이는 9.1$\pm$0.9cm이었고 중환자실 체류기간은 평균 48$\pm$29시간, 술후 재원기간은 평균 10$\pm$7일 이었다. 결론: 술중 제세동, 탈기, 심장감압 등의 과정에 있어서 어려운 점이 있고 아직까지는 선별된 예에 한해 시행되고 있으나 경험의 축적에 따라 점차 그 적용례가 늘어날 것이라 전망된다.

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