• Journal of Chest Surgery
• /
• 제56권4호
• /
• pp.229-237
• /
• 2023

Background: We aimed to demonstrate the advances we have achieved in pectus excavatum surgery over the last 10 years, with a particular focus on the refinement of pectus bar stabilization techniques and devices. Methods: In total, 1,526 patients who underwent minimally invasive repair of pectus excavatum surgery from 2013 to 2022 were enrolled and analyzed. We have pursued a new paradigm of crane-powered remodeling of the entire chest wall. The method of bar stabilization has changed from claw fixators to hinge plates and, finally, to bridge plate connections. We also evaluated the effectiveness of the hinge plate (group H) and the bridge plate (group B). Results: The bar displacement rates were 0.1% (n=2) for the claw fixator, 0% for the hinge plate (n=0), and 0% for the bridge plate (n=0). We stopped using the claw fixator in 2022 and the hinge plate in 2019. Since 2022, when we shifted to a multiple-bar technique for all patients, the bridge plate has replaced both the claw fixator and the hinge plate. No bar displacement occurred in either group. Group H had more pleural effusion, wound problems (p<0.05), and longer stays (5.5 vs. 6.2 days, p=0.034) than group B. Conclusion: We have made significant progress in pectus repair surgery over the last decade, particularly in stabilizing the pectus bar and reducing perioperative complications. Our current strategy is the multiple-bar approach with bridge stabilization. Since the bridge-only technique resulted in no bar displacement, we could eliminate the invasive claw fixator or hinge plate.

• Restorative Dentistry and Endodontics
• /
• 제44권4호
• /
• pp.38.1-38.8
• /
• 2019

Navigation of the main root canal and dealing with a dens invaginatus (DI) is a challenging task in clinical practice. Recently, the guided endodontics technique has become an alternative method for accessing root canals, surgical cavities, and calcified root canals without causing iatrogenic damage to tissue. In this case report, the use of the guided endodontics technique for two maxillary lateral incisors with multiple DIs is described. A 16-year-old female patient was referred with the chief complaint of pain and discoloured upper front teeth. Based on clinical and radiographic findings, a diagnosis of pulp necrosis and chronic periapical abscess associated with double DI (Oehler's type II) was established for the upper left lateral maxillary incisor (tooth #22). Root canal treatment and the sealing of double DI with mineral trioxide aggregate was planned for tooth #22. For tooth #12 (Oehler's type II), preventive sealing of the DI was planned. Minimally invasive access to the double DI and the main root canal of tooth #22, and to the DI of tooth #12, was achieved using the guided endodontics technique. This technique can be a valuable tool because it reduces chair-time and, more importantly, the risk of iatrogenic damage to the tooth structure.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권1호
• /
• pp.43-48
• /
• 2010

The mandibular condyle fracture occurs at 15-30% frequency of whole mandibular fracture. The treatment of choice is open reduction or closed reduction. In many cases, closed reduction is preferred for treatment of condylar fracture because it is hard to approach to condyle and there is risk of surgical complications, such as nerve damage in open reduction. Open reduction, however, has some advantages like possibility of anatomical reduction, occlusal stability and rapid functional recovery. Furthermore, it is possible to retain original ramal heights and to decrease deviation during mouth opening. There are many surgical approaches for open reduction of subcondyle fracture. At present, transoral approach using trochar device is tried for effective and minimally invasive method for open reduction of subcondyle fracture. And the authors report the cases of reduction of subcondyle fracture with transoral approach using trochar device.

• 대한기관식도과학회지
• /
• 제16권1호
• /
• pp.27-32
• /
• 2010

Organ preservation surgery and minimally invasive surgery have been developed during the past 20 years with major focus on transoral laser surgery, endoscopic surgery, and robotic surgery. Two major robotic surgeries in head and neck area are transoral robotic surgery (TORS) and robotic thyroidectomy. Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal. hypopharyngeal and laryngeal neoplasm. Advantages of the technique include adequate ability to visualize and manipulate lesions with two hands. TORS can provide magnified three dimensional views and overcome the limitation resulting from the "line of sight" which hinders transoral laser procedure. The swallowing function following transoral robotic surgery show superior and patients were able to retain or rapidly regain swallowing function in the majority of cases. Recently, robotic thyroidectomy has also been developed to overcome the [imitation of endoscopic thyroidectomy. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach using a da Vinci S Surgical Robot is a feasible and cosmetically excellent procedure. It can be a promising alternative to endoscopic thyroidectomy or conventional open thyroidectomy.

• Journal of Chest Surgery
• /
• 제33권1호
• /
• pp.85-87
• /
• 2000

Patent ductus arteriosus(PDA) is a common congenital heart disease encountered in premature neonates infants and children. Patent ductus arteriosus was the first surgically managed congenital heart disease,. Classic surgical interruption of patent ducturs arteriosus was partially replaced by a transcatheter endovascular closure, After a 5-7 mm video-assisted thoracoscopic interruption of the patent ductus arteriosus first applied in 1991, this minimally invasive technique came to be used in many centers, Video-assisted thoracoscopic interruption of the patent ductus arteriosus is feasible in low-weight infants whereas transcatheter endovascular closure of the ductus is usually not possible. We experienced successful outcome for the treatment of patent ductus arteriosus with 2 mm video-assisted thoracoscopic titanium clipping, We believed that this technique is a simple safe and rapid method for closure of the patent arteriosus.

• 한방안이비인후피부과학회지
• /
• 제28권1호
• /
• pp.119-133
• /
• 2015

Objective : Thread embedding acupuncture has become popular as a minimally invasive treatment for facial wrinkles and laxity. However, there is little published clinical practice guidelines. This study is to developing a specific procedure of thread embedding acupuncture for facial wrinkles and laxity. Method : We reviewed and summarized 6 studies on thread embedding acupuncture for facial wrinkles and laxity. And, four practitioners who have more than four year of clinical experience and one hundred of cases were participated in developing a thread embedding acupuncture procedure for facial wrinkles and laxity. Result and conclusion : We developed a thread embedding acupuncture procedure for facial wrinkles and laxity which consists of correction of lower jaw, facial laxity, nasolabial fold and eye wrinkles.

• Advances in pediatric surgery
• /
• 제17권1호
• /
• pp.58-64
• /
• 2011

Minimally invasive techniques for pediatric inguinal hernia repair have been evolving in recent years. We applied the laparoscopic method to repair pediatric inguinal hernia using the techniques of sac transection and intra-corporeal ligation. Between November 2008 and August 2010, 67 pediatric patients (47 boys and 20 girls) with inguinal hernias were included in this study. Postoperative activities, pain, and complication were checked prospectively at regular follow-up. One patient presented with clinically bilateral hernia, and three patients had metachronous hernias. Thirty-two cases out of 63 patients with unilateral hernias had a patent processus vaginalis on the contralateral side. Mean operation time was $35{\pm}11.4$ minutes for unilateral hernias and $43{\pm}11$ minutes for bilateral hernias. There were no intra-operative complications. One patient had a small hematoma on the groin postoperatively, which subsided spontaneously in a week. Recurrence and metachronous hernia were not found at follow up. In summary, laparoscopic inguinal repair in children is safe, easy to perform and has an additional advantage of contralateral exploration. Further studies should include long term follow-up.

• Journal of Yeungnam Medical Science
• /
• 제32권1호
• /
• pp.8-12
• /
• 2015

Background: Enlargement of subdural hematomas is relatively rapid in subacute stage of hematoma with clinical deterioration, which eventually necessitates surgery. The purpose of this study is to investigate the feasibility and safety of burr hole drainage using urokinase for management of patients with subacute subdural hematoma (SASDH). Methods: Nine patients with SASDH were treated by burr hole drainage using urokinase. Under local anesthesia a catheter was inserted into the hematoma through a burr hole. Burr hole drainage was followed by hematoma thrombolysis with instillation of urokinase (10,000 units) every 12 hours. Drainage was discontinued when a significant decrease of hematoma was observed on cranial computed tomography. Results: The patients' median age was 70 years (range, 62-87). The median Glasgow Coma Scale score before surgery was 15 (range, 11-15). Drainage was successfully performed in all patients. All patients had Glasgow Outcome Scale scores of 5 at discharge. There was no surgery-related morbidity or mortality. Conclusion: A burr hole drainage using urokinase could be a safe, feasible and effective minimally invasive method with low morbidity in treatment of selected patients with SASDHs.

• Archives of Plastic Surgery
• /
• 제36권4호
• /
• pp.516-518
• /
• 2009

Purpose: To retrieve the retracted flexor tendon, additional incision and wide dissection are conventionally required. We introduce minimal - incision tenorrhaphy using 1 cm - length incision and minimal dissection. Methods: Transverse incision about 1 cm - length is made over the level of retracted tendon. Nelaton's catheter is advanced into tendon sheath from distal primary laceration wound to emerge proximally through the incisional wound. Catheter is sutured to proximal tendon in end - to - end fashion. By gently pulling the catheter, retracted tendon is delivered to distal wound. Tenorrhaphy with core suture and epitendinous suture is then carried out. Results: This retrieving technique provides minimal incision, minimal dissection, minimal bleeding, minimal injury to tendon end, and shorter operation time with preservation of vincula tendinum and pulley system. Conclusion: In case of flexor tendon rupture with retraction, this operative method is believed to allow reliable and effective tenorrhaphy and excellent postoperative outcomes.

• Journal of Chest Surgery
• /
• 제36권4호
• /
• pp.297-299
• /
• 2003

흉강내시경을 이용한 교감신경 절단술은 수장부 다한증뿐만 아니라 액와부 다한증에 대해서도 효과가 좋다고 알려져 있다. 이전에 R2, 3, 4교감신경 절단술의 여러 가지 조합 방법들과 다르게 R4, 5절단 방법 효과를 알아보고자 한다. 액와부 액취증 없이 과다한 땀이 나는 환자들을 대상으로 2002년 2월부터 8월까지 2mm 흉강내시경 이용하여 5예의 흉강경 교감신경절단술 시행하였다. 모든 환자들 수술 결과에 만족하였고 과다한 땀은 더 이상 없었다. 총 5예 중, 3예에서(60%) 보상성 다한증을 경험하였는데, 그중 1예만(20%) 의미 있게(불편한 정도는 아니지만) 보상성 다한증을 허리 및 허벅지에 보였다. 액와부 다한증에 대한 치료로 R4, 5 교감신경절단술은 효과적인 치료 방법으로 생각한다.