• Title/Summary/Keyword: Minimally invasive procedure

검색결과 217건 처리시간 0.021초

디스포저블 관절경 수술기의 개발 (A Development of Disposable Arthroscopic Shaver)

  • 지영준;임찬양;윤재웅
    • 한국정밀공학회지
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    • 제22권10호
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    • pp.218-224
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    • 2005
  • Arthroscopy is a surgical procedure orthopedic surgeons use to visualize, diagnose and treat problems inside a joint. In usual, since the arthroscopic surgery is more accurate and minimally invasive than through 'open' surgery, the surgery of knee, shoulder, and wrist using auto-shaver is increasing in recent. However, repetitive use of arthroscopic-shaver may induce the second infection, hence the disposable arthroscopic-shaver should be developed. In this paper, a unique power transmission mechanism using DC motor, gear trains, and link mechanism is proposed for disposable arthroscopic-shaver and some test results of tissue cutting are introduced.

Infection of Thyroid Cyst Occurring 1 Month after Fine-Needle Aspiration in an Immunocompetent Patient

  • Park, Jung Kyu;Jeon, Eon Ju
    • International journal of thyroidology
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    • 제11권2호
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    • pp.182-188
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    • 2018
  • Fine-needle aspiration (FNA) with ultrasonography is considered a minimally invasive and safe procedure. Complications of it are infrequent and occur immediately or within a few days after FNA. Such complications may occur mainly in patients with underlying problems. We here report a rare case of thyroid cystic nodule infection occurring 1 month after FNA in an immunocompetent patient and serial sonographic findings in this patient. A 33-year-old woman with a cystic nodule including partially isoechoic solid areas on the right thyroid gland complained of difficulty swallowing and painful sensations in the right neck 1 month after FNA. On follow-up examination, the cystic nodule and perithyroidal soft tissue were suspicious of infection. The possibility of infection after FNA should be considered even if the patient is immunocompetent in order to prompt evaluation and immediate management with empirical antibiotic therapy to avoid life-threatening complications.

Corticotomy for orthodontic tooth movement

  • Lee, Won
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제44권6호
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    • pp.251-258
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    • 2018
  • Corticotomy was introduced as a surgical procedure to shorten orthodontic treatment time. Corticotomy removes the cortical bone that strongly resists orthodontic force in the jaw and keeps the marrow bone to maintain blood circulation and continuity of bone tissues to reduce risk of necrosis and facilitate tooth movement. In the 21st century, the concept of regional acceleratory phenomenon was introduced and the development of the skeletal anchorage system using screw and plate enabled application of orthopedic force beyond conventional orthodontic force, so corticotomy has been applied to more cases. Also, various modified methods of minimally invasive techniques have been introduced to reduce the patient's discomfort due to surgical intervention and complications after surgery. We will review the history of corticotomy, its mechanism of action, and various modified procedures and indications.

Levoatrial Cardinal Vein: Occluder Embolization and Complication Management

  • Mercan, Ilker;Akyuz, Muhammet;Guven, Baris;Isik, Onur
    • Journal of Chest Surgery
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    • 제54권3호
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    • pp.214-217
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    • 2021
  • In rare cases, levoatrial cardinal vein may occur as an isolated condition without additional congenital anomalies. Depending on the direction and flow of the shunt, this pathology may produce symptoms; alternatively, it may be asymptomatic, as in the case presented in this study. In asymptomatic cases, complications, such as paradoxical embolism and brain abscess, can arise later. In the 11-year-old patient whose case is presented here, the levoatrial cardinal vein was asymptomatic and incidentally detected. The percutaneous closure method was applied first. However, by 16 hours after the procedure, the occluder device had embolized to the iliac artery. Emergency surgery was performed; first, the occluder device was removed, and levoatrial cardinal vein ligation was then performed via a mini-thoracotomy. The symptoms, diagnosis, and treatment modalities of isolated levoatrial cardinal vein are discussed in the context of this case described herein.

A Hybrid Intervention for Post-infarction Papillary Muscle Rupture with Severe Mitral Regurgitation: A Case Report

  • Nakamae, Kosuke;Oshitomi, Takashi;Uesugi, Hideyuki
    • Journal of Chest Surgery
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    • 제55권3호
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    • pp.239-242
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    • 2022
  • Papillary muscle rupture with severe acute mitral regurgitation is a rare complication of acute myocardial infarction (AMI) that causes pulmonary congestion and cardiogenic shock. Moreover, it has a poor prognosis. Surgical intervention, including revascularization, is indicated; however, surgical mortality remains high. We report the case of an 85-year-old woman with cardiogenic shock from severe acute mitral regurgitation, in whom a hybrid intervention, combining percutaneous coronary intervention with mitral valve replacement via minithoracotomy, was performed after post-infarction papillary muscle rupture. She was discharged in a favorable clinical condition. We describe a novel hybrid intervention for treating a rare complication of AMI, which could minimize surgical invasion in elderly patients, prevent disuse syndrome after the intervention, and improve prognosis. However, mitral valve surgery via minithoracotomy for emergency cases requires technical proficiency, as well as collaboration with other healthcare professionals, and the choice to perform this procedure requires careful consideration.

Improving visualization in shoulder arthroscopy

  • Emily R. McDermott;David J. Tennent;Daniel J. Song
    • Clinics in Shoulder and Elbow
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    • 제26권4호
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    • pp.455-461
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    • 2023
  • Arthroscopic shoulder procedures are one of the most common procedures used to restore function through minimally invasive techniques. With the demand for shoulder arthroscopic procedures comes the need for safe, effective, and efficient surgery that maximizes patient outcomes while minimizing complications. Many variables contribute to visualization in shoulder arthroscopy including vascular anatomy, blood pressure control, arthroscopic pump systems, turbulence control, epinephrine, and tranexamic acid. Furthermore, patient positioning can have a dramatic effect on visualization with both the beach chair position and lateral decubitus positioning having various strengths and weaknesses depending on the intended procedure being performed. The purpose of this review is to examine the benefits and complications reported in the literature for improving visualization in shoulder arthroscopy.

Intestinal Perforation Caused by Lumboperitoneal Shunt Insertion Repaired with an Over-the-Scope Clip

  • Naoki Ishizuka;Eiji Komatsu
    • Clinical Endoscopy
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    • 제55권1호
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    • pp.146-149
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    • 2022
  • Lumboperitoneal or ventriculoperitoneal shunt insertion is a standard therapy for hydrocephalus that diverts cerebrospinal fluid from the subarachnoid space into the peritoneal cavity. Gastrointestinal perforations due to this procedure occur rarely; however, accepted treatment strategies have not yet been established. Hence, the most common treatment approaches are open surgery or spontaneous closure without endoscopy. We report the case of a small intestinal perforation in a 73-year-old-woman that occurred after the insertion of a lumboperitoneal shunt. A positive cerebrospinal fluid culture and high cerebrospinal fluid white blood cell count indicated a retrograde bacterial infection, and computed tomography revealed that the peritoneal tip of the shunt catheter was located in the lumen of the gastrointestinal tract. We repaired the perforation endoscopically using an over-the-scope clip, and the patient's recovery was uneventful. Use of an over-the-scope clip could be an effective and minimally invasive treatment for intestinal perforations caused by lumboperitoneal or ventriculoperitoneal shunt insertion.

Endoscopic Ultrasound-Guided Transgastric Puncture and Drainage of an Adrenal Abscess in an Immunosuppressed Patient

  • Carlos Andres Regino;Jean Paul Gomez;Gabriel Mosquera-Klinger
    • Clinical Endoscopy
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    • 제55권2호
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    • pp.302-304
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    • 2022
  • Adrenal gland infection is a clinical entity of great importance, but it is a largely unrecognized pathology. Immunosuppressed individuals are at a higher risk of presentation. Herein, we describe a young female patient, recently diagnosed with HIV, who presented with severe sepsis due to methicillin-resistant Staphylococcus aureus, associated with a left adrenal abscess. She was initially treated with antibiotics; however, due to the persistence of the systemic inflammatory response and bacteremia, endoscopic ultrasound-guided drainage was performed. This procedure was successful in resolving the clinical situation. Endoscopic ultrasound-guided adrenal gland drainage can be a safe, efficacious, and minimally invasive option for managing antibiotic-refractory adrenal abscesses in immunosuppressed patients.

Volumizing Threads (Jamber) in the Midface and Managing Side Effects: Clinical Cases

  • Kyu-Ho Yi;Soo-Yeon Park
    • Archives of Plastic Surgery
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    • 제51권4호
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    • pp.350-355
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    • 2024
  • The clinical application of polydioxanone (PDO) threads, traditionally utilized for tissue lifting, is now being explored for its volumizing effects in midface rejuvenation. The novel approach involves employing PDO volumizing threads to achieve physical augmentation akin to a "solid filler." The study introduces a more convenient insertion method for these threads, prioritizing ease and efficacy. Clinical cases demonstrate the efficacy of volumizing threads in addressing midface concerns, such as nasolabial folds and midcheek grooves. Additionally, the integration of volumizing threads to provide support in sagging areas is examined for achieving natural-looking enhancements. While highlighting positive outcomes, potential side effects like thread protrusion are addressed, along with strategies for their mitigation. Volumizing threads are presented as a suitable procedure for patients wary of traditional fillers or seeking subtle enhancements, with the recommendation of combining them with cog threads for those desiring more pronounced changes in facial contour. In summary, volumizing thread offers a minimally invasive alternative with fewer side effects for midface rejuvenation.

Long-term Surveillance Comparing Satisfaction between the Early Experience of Nuss Procedure vs. Ravitch Procedure

  • Kang, Chang Hyun;Park, Samina;Park, In Kyu;Kim, Young Tae;Kim, Joo Hyun
    • Journal of Chest Surgery
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    • 제45권5호
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    • pp.308-315
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    • 2012
  • Background: Long-term surveillance comparing satisfaction between the early experience of Nuss procedure vs. Ravitch procedure. Materials and Methods: A total of 100 patients that underwent surgical correction of a pectus excavatum between 2001 and 2004 and were followed for ${\geq}2$ years were included. Surveillance on the degree of satisfaction was performed using five-levels of the Likert scale and self-assessment scoring. Results: Nuss or Ravitch surgery was performed in 63 and 37 patients, respectively. The Nuss procedure required a shorter operation time and shorter hospital stay than the Ravitch procedure (p<0.001). The surveillance demonstrated that 17.6% of the Nuss group and 35.7% of the Ravitch group were not satisfied with the outcome of the surgery (p=0.072). The most common causes of dissatisfaction were redepression in the Nuss group (n=5) and incomplete correction in the Ravitch group (n=7). The multivariate analysis showed that reoperation and a high postoperative pectus index were significant risk factors for a low satisfaction score. Conclusion: The Nuss procedure had several advantages over the Ravitch procedure in the immediate postoperative period. However, the long-term satisfaction was determined by a complete correction without recurrence or need for re-intervention rather than by the operation type.