• Title/Summary/Keyword: Minimally invasive procedure

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Endoscopic Removal of Traumatic Intracerebral Hematoma via Superolateral Keyhole (외상성 뇌실질내 혈종에 대한 상측방 키홀을 통한 내시경적 혈종 제거)

  • Park, Sung-Jin;Ha, Ho-Gyun;Jung, Ho;Lee, Sang-Keol;Park, Moon-Sun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.249-254
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    • 2000
  • Objective : As a minimally invasive strategy, endoscopic technique was introduced for removal of the traumatic intracerebral hematoma. Material and Method : A 54-year-old man with three-day history of seizure and progressive mental deterioration after traffic accident was presented. Computerized Tomography(CT) of the brain showed a huge intracerebral hematoma on the right frontal lobe and ventricle. The operation was performed via right frontal superolateral keyhole with 2cm eyebrow skin incision. Using 0-degree and 30-degree angled lens 4mm rigid endoscopes, nearly all of the hematoma was evacuated under the direct endoscopic visualization and a ventricular catheter was exactly placed into the frontal horn of the right lateral ventricle at the end of procedure. Results : The seizure was discontinued and neurological status had been improved during postoperative periods. Postoperative CT demonstrated that most of the hematoma was removed and the ventricular drainge tube was exactly placed in the right foramen of Monro. Conclusion : With endoscopic technique, the authors successfully evacuated traumatic intracerebral hematoma and exactly placed the ventricular drainage catheter under direct visualization. This technique may be considered as an another option for removal of traumatic intracerebral hematoma.

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Percutaneous Discectomy of Herniated Intervertebral Disc with a Dekompressor(R) (요추 추간판 탈출증에서 Dekompressor(R)를 이용한 경피적 수핵 감압술)

  • Cho, OiGyeong;Kim, Chan;Han, Kyung Ream;Lee, Hyun Ho;Cho, Hye Won
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.192-197
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    • 2005
  • Background: Radicular pain, associated with herniated intervertebral disc, has been treated with either conservative treatments or a traditional surgical discectomy. Several modalities for minimally invasive percutaneous procedures have been developed as alternatives to a surgical discectomy. Percutaneous decompression using a $Dekompressor^{(R)}$ probe has been recently introduced. Herein, we report the outcome of percutaneous decompression with a $Dekompressor^{(R)}$ for the treatment of a herniated intervertebral disc. Methods: Between August 2004 and April 2005, percutaneous decompression was performed using a $Dekompressor^{(R)}$, 1.5-mm percutaneous lumbar discectomy probe in 17 patients with a herniated lumbar intervertebral disc resistant to conservative treatments, with the results reviewed retrospectively. The procedure was performed under fluoroscopic guidance after local anesthesia. Disc access was gained with a posterolateral approach on the symptomatic side and intradiscal placement of the discectomy probe in the herniated disc confirmed from the anteroposterior and lateral views on the fluoroscopy. Results: We obtained satisfactory clinical results in 14 patients with a decrease in the initial Visual analogue scale (VAS) of more than 55% and the elimination or reduction of analgesic medication, with a follow-up of 3 to 11 months. Conclusion: We concluded that a percutaneous discectomy with a $Dekompressor^{(R)}$ probe might be an effective alternative for the treatments of painful disc herniations resistant to conservative managements when performed under proper selection criteria.

A Study on the Intervertebral Disc Temperature Distribution During Electrothermal Therapy (추간판의 전기열치료시 온도분포에 관한 연구)

  • 진의덕;탁계래;구자중;김한성;이성재;이정한
    • Journal of Biomedical Engineering Research
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    • v.24 no.1
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    • pp.23-29
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    • 2003
  • The prevalence of discogenic pain among patients with chronic low back pain is estimated to be about 40%. Lumbar discectomy is being performed as a treatment according to the studies done so far. Recently IDET- Intradiscal electrothermal therapy which is minimally invasive technique is being introduced. This study will investigate important factors of this procedure such as the temperature of heat source, loading times, and the temperature distribution within the intervertebral disc. This study utilized finite element analysis and experiment. It was able to analyze the temperature range of inner intervertebral disc by two mechanisms which are known to alleviate pain clinically. As a result, verification of temperature distribution to 15.6mm($\geq$45$^{\circ}C$) (Mechanism 1-coagulation inner annulus by heat) and 9mm($\geq$6$0^{\circ}C$) (Mechanism 2- contraction inner nucleus by heat) from the heat source was done.

Osteoplasty in Acute Vertebral Burst Fractures

  • Park, Sang-Kyu;Bak, Koang-Hum;Cheong, Jin-Hwan;Kim, Jae-Min;Kim, Choong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.90-94
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    • 2006
  • Objective : Acute vertebral burst fractures warrant extensive fixation and fusion on the spine. Osteoplasty [vertebroplasty with high density resin without vertebral expansion] has been used to treat osteoporotic vertebral compression fractures. We report our experiences with osteoplasty in acute vertebral burst fractures. Methods : Twenty-eight cases of acute vertebral burst fracture were operated with osteoplasty. Eighteen patients had osteoporosis concurrently. Preoperative MRI was performed in all cases to find fracture level and to evaluate the severity of injury. Preoperative CT revealed burst fracture in the series. The patients with severe ligament injury or spinal canal compromise were excluded from indication. Osteoplasty was performed under local anesthesia and high density polymethylmethacrylate[PMMA] was injected carefully avoiding cement leakage into spinal canal. The procedure was performed unilaterally in 21 cases and bilaterally in 7 cases. The patients were allowed to ambulate right after surgery. Most patients discharged within 5 days and followed up at least 6 months. Results : There were 12 men and 16 women with average age of 45.3[28-82]. Five patients had 2 level fractures and 2 patients had 3 level fractures. The average injection volume was 5.6cc per level Average VAS [Visual Analogue Scale] improved 26mm after surgery. The immediate postoperative X-ray showed 2 cases of filler spillage into spinal canal and 4 cases of leakage into the retroperitoneal space. One patient with intraspinal leakage was underwent the laminectomy to remove the resin. Conclusion : Osteoplasty is a safe and new treatment option in the burst fractures. Osteoplasty with minimally invasive technique reduced the hospital stay and recovery time in vertebral fracture patients.

Removal of Submandibular Stones via Intraoral approach (구강내 접근을 이용한 악하선 타석의 제거)

  • Lee, Sung-Bu;Lee, Jong-Cheol;Choi, Seung-Ho;Kim, Sang-Yoon;Nam, Soon-Yuhl
    • Korean Journal of Bronchoesophagology
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    • v.14 no.1
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    • pp.23-28
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    • 2008
  • Background and Objectives : Traditionally, the excision of submandibular gland (SMG) has been commonly used for treatment of calculi in the proximal duct or gland parenchyma. Over the last 10 years several new minimally invasive techniques including lithotripsy, sialendoscope were introduced in the treatment of sialolithiasis. But these have some limitation on large, infected calculi. The aim of this study is to assess the intraoral treatment of submadibular stones. Subjects and Method : The records of one hundred and seventy-three patients who underwent intraoral removal of submadibular sialolithiasis between June 1, 1989 and July 31, 2006 were retrospectively reviewed. Results : Stone location was distal to the edge of the mylohyoid muscle in 127 patients and proximal to gland in 48 patients (mean size of sialoliths, 7.1mm [range 3.0-25mm]). The complete removal of stones was observed in 170 (97.1%) patients regardless of size and location. Recurrence of lithiasis was found in 8 patients (then treated with intraoral removal in 5 patientsand resection of SMG (submandibular glands) in 3 patients). Acalculous sialadenitis in 9 patients (5.1%) and cyst formation in 2 patients (1.1%) was found. But no evidence of postoperative complications including hemorrhage, fistula, damage to lingual nerve were found. Conclusion : The intraoral removal of submandibular stone is useful in preservation of submandiblar function and effective in palpable stones regardless of location, size.

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The combined use of computer-guided, minimally invasive, flapless corticotomy and clear aligners as a novel approach to moderate crowding: A case report

  • Cassetta, Michele;Altieri, Federica;Pandolfi, Stefano;Giansanti, Matteo
    • The korean journal of orthodontics
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    • v.47 no.2
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    • pp.130-141
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    • 2017
  • The aim of this case report was to describe an innovative orthodontic treatment method that combined surgical and orthodontic techniques. The novel method was used to achieve a positive result in a case of moderate crowding by employing a computer-guided piezocision procedure followed by the use of clear aligners. A 23-year-old woman had a malocclusion with moderate crowding. Her periodontal indices, oral health-related quality of life (OHRQoL), and treatment time were evaluated. The treatment included interproximal corticotomy cuts extending through the entire thickness of the cortical layer, without a full-thickness flap reflection. This was achieved with a three-dimensionally printed surgical guide using computer-aided design and computer-aided manufacturing. Orthodontic force was applied to the teeth immediately after surgery by using clear appliances for better control of tooth movement. The total treatment time was 8 months. The periodontal indices improved after crowding correction, but the oral health impact profile showed a slight deterioration of OHRQoL during the 3 days following surgery. At the 2-year retention follow-up, the stability of treatment was excellent. The reduction in surgical time and patient discomfort, increased periodontal safety and patient acceptability, and accurate control of orthodontic movement without the risk of losing anchorage may encourage the use of this combined technique in appropriate cases.

Comparison between Use of PSA Kinetics and Bone Marrow Micrometastasis to Define Local or Systemic Relapse in Men with Biochemical Failure after Radical Prostatectomy for Prostate Cancer

  • Murray, Nigel P;Reyes, Eduardo;Fuentealba, Cynthia;Orellana, Nelson;Jacob, Omar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8387-8390
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    • 2016
  • Background: Treatment of biochemical failure after radical prostatectomy for prostate cancer is largely empirically based. The use of PSA kinetics has been used as a guide to determine local or systemic treatment of biochemical failure. We here compared PSA kinetics with detection of bone marrow micrometastasis as methods to determine local or systemic relapse. Materials and Methods: A transversal study was conducted of men with biochemical failure, defined as a serum PSA >0.2ng/ml after radical prostatectomy. Consecutive patients having undergone radical prostatectomy and with biochemical failure were enrolled and clinical and pathological details were recorded. Bone marrow biopsies were obtained from the iliac crest and touch prints made, micrometastasis (mM) being detected using anti-PSA. The clinical parameters of total serum PSA, PSA velocity, PSA doubling time and time to biochemical failure, age, Gleason score and pathological stage were registered. Results: A total of 147 men, mean age $71.6{\pm}8.2years$, with a median time to biochemical failure of 5.5 years (IQR 1.0-6.3 years) participated in the study. Bone marrow samples were positive for micrometastasis in 98/147 (67%) of patients at the time of biochemical failure. The results of bone marrow micrometastasis detected by immunocytochemistry were not concordant with local relapse as defined by PSA velocity, time to biochemical failure or Gleason score. In men with a PSA doubling time of < six months or a total serum PSA of >2,5ng/ml at the time of biochemical failure the detection of bone marrow micrometastasis was significantly higher. Conclusions: The detection of bone marrow micrometastasis could be useful in defining systemic relapse, this minimally invasive procedure warranting further studies with a larger group of patients.

Iatrogenic Intradural Lumbosacral Cyst Following Epiduroscopy

  • Ryu, Kyeong-Sik;Rathi, Nitesh Kumar;Kim, Geol;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.52 no.5
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    • pp.491-494
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    • 2012
  • We report a rare complication of iatrogenic spinal intradural following minimally invasive extradural endoscopic procedues in the lumbo-sacral spines. To our knowledge, intradural cyst following epiduroscopy has not been reported in the literature. A 65-year-old woman with back pain related with previous lumbar disc surgery underwent endoscopic epidural neuroplasty and nerve block, but her back pain much aggravated after this procedure. Postoperative magnetic resonance imaging revealed a large intradural cyst from S1-2 to L2-3 displacing the nerve roots anteriorly. On T1 and T2-weighted image, the signal within the cyst had the same intensity as cerebrospinal fluid. The patient underwent partial laminectomy of L5 and intradural exploration, and fenestration of the cystic wall was accomplished. During operation, the communication between the cyst and subarachnoid space was not identified, and the content of the cyst was the same as that of cerebrospinal fluid. Postoperatively, the pain attenuated immediately. Incidental durotomy which occurred during advancing the endoscope through epidural space may be the cause of formation of the intradural cyst. Intrdural cyst should be considered, if a patient complains of new symptoms such as aggravation of back pain after epiduroscopy. Surgical treatment, simple fenestration of the cyst may lead to improved outcome. All the procedures using epiduroscopy should be performed with caution.

Mediastinoscopic Resection of A Paratracheal Bronchogenic Cyst - A case report - (종격동경을 이용한 기관주위의 기관지성 낭종의 완전절제술 - 1예 보고 -)

  • Cho, Deog Gon;Kang, Chul Ung;Cho, Kue Do;Jo, Min Seop;Jo, Keon Hyon
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.120-123
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    • 2010
  • Bronchogenic cysts (BCs) are relatively common congenital anomalies in the mediastinum. Most of the patients with BC can be managed both safely and effectively by minimally invasive methods. Selected patients with a BC in a favorable location can have the cyst partially or completely excised by mediastinoscopic techniques. Herein we report on a case of a left lower paratracheal bronchogenic cyst that was completely resected by a video-assisted mediastinoscopic technique, and we discuss the technical aspects of this procedure.

Treatment and retention of relapsed anterior open-bite with low tongue posture and tongue-tie: A 10-year follow-up

  • Seo, Yu-Jin;Kim, Su-Jung;Munkhshur, Janchivdorj;Chung, Kyu-Rhim;Ngan, Peter;Kim, Seong-Hun
    • The korean journal of orthodontics
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    • v.44 no.4
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    • pp.203-216
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    • 2014
  • The purpose of the current report is to present 6-year long-term stability and 10-year follow-up data for an adult patient who was treated with a tongue elevator for relapsed anterior open-bite. The 19-year-old male patient presented with the chief complaint of difficulty in chewing his food. Collectively, clinical and radiographic examinations revealed an anterior open-bite, low tongue posture, and tongue-tie. The patient opted for orthodontic treatment alone, without any surgical procedure. A lingual frenectomy was recommended to avoid the risk of relapse, but the patient declined because he was not experiencing tongue discomfort. Initial treatment of the anterior open-bite with molar intrusion and tongue exercises was successful, but relapse occurred during the retention period. A tongue elevator was used for retreatment, because the approach was minimally invasive and suited the patient's requirements regarding discomfort, cost, and time. The appliance changed the tongue posture and generated an altered tongue force, which ultimately resulted in intrusive dentoalveolar effects, and a subsequent counterclockwise rotation of the mandible. The results showed long-term stability and were maintained for six years through continual use of the tongue elevator. The results of this case indicated that a tongue elevator could be used not only as an alternative treatment for open-bite, but also as an active retainer.