• Title/Summary/Keyword: Minimally invasive techniques

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The Pringle maneuver in the modern era: A review of techniques for hepatic inflow occlusion in minimally invasive liver resection

  • Omar A. Mownah;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.131-140
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    • 2023
  • During minimally invasive liver resection (MILR), the Pringle maneuver aims to minimize blood loss and provide a clear operative field, thereby identifying intrahepatic structures and facilitating safe parenchymal transection. Several techniques for using the Pringle maneuver in MILR have been described. This review presents various methods which have been reported in the literature. A systematic literature search used the MEDLINE/PubMed database from its earliest records to August 2022 using appropriate search headings and keywords. The primary outcome was identifying techniques for performing hepatic inflow occlusion during laparoscopic/robotic hepatectomy. Inclusion criteria consisted of publications describing technical steps to obtain hepatic inflow occlusion during minimally invasive hepatectomy. A literature search identified 23 relevant publications, and the full texts were examined. The techniques described in the reports can be broadly categorized into three groups: (1) the Rummel-tourniquet technique, (2) vascular clamp use, and (3) the Huang Loop technique. Various techniques have been used in MILR to achieve inflow confinement successfully. The authors prefer the modified Huang Loop technique because it is inexpensive, reliable, and quick to apply or release. Hepatobiliary surgeons are advised to familiarize themselves with these MILR techniques, which have proven effective and safe inflow occlusion.

Minimally Invasive Repair Technique of Achilles Tendon Using Sponge Forceps: A Technical Report (스폰지 겸자를 이용한 아킬레스건의 최소 절개 봉합술: 술기 보고)

  • Park, Sam Guk;Park, Chul Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.2
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    • pp.88-91
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    • 2016
  • Various minimally invasive repair techniques have been performed for acute Achilles tendon rupture. Despite this, it is difficult to use these techniques in common practice because of the necessity of special instruments. We propose a novel minimal invasive technique using sponge holding forceps, which are commonly used in the operating room for the acute Achilles tendon rupture.

Design of Dexterous Manipulator for MIS (복강경 수술을 위한 지능형 작동기의 제작)

  • Song, Ho-Seok;Chung, Jong-Ha;Lee, Jung-Ju
    • Proceedings of the KSME Conference
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    • 2004.11a
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    • pp.823-828
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    • 2004
  • Minimally Invasive Surgery (MIS) is surgery of the chest, abdomen, spine and pelvis, done with the aid of a viewing scope, and specially designed instruments. Benefits of minimally invasive surgery are less pain, less need for post-surgical pain medication, less scarring and less likelihood for incisional complications. Since the late 1980's, minimally invasive surgery has gained widespread acceptance because of the such advantages. However there are significant disadvantages which have, to date, limited the applications for these promising techniques. The reasons are limited degree-of-freedom, reduced dexterity and the lack of tactile feeling. To overcome such disadvantages many researchers have endeavored to develop robotic systems. Even though some robot aided systems achieved success and commercialized, there still remain many thing to be improved. In this paper, the robotic system which can mimic whole motions of a human arm by adding additional DOF is presented. The suggested design is expected to provide surgeons with improved dexterity during minimally invasive surgery.

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Minimally Invasive Lumbar Spinal Decompression : A Comparative Study Between Bilateral Laminotomy and Unilateral Laminotomy for Bilateral Decompression

  • Kim, Seok-Won;Ju, Chang-Il;Kim, Chong-Gue;Lee, Seung-Myung;Shin, Ho
    • Journal of Korean Neurosurgical Society
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    • v.42 no.3
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    • pp.195-199
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    • 2007
  • Objective : Bilateral laminotomy and unilateral laminotomy for bilateral decompression are becoming the minimally invasive procedures for lumbar spinal stenosis (LSS). With the aim of less invasiveness and better preservation of spinal stability. these techniques have been developed. But there are no large randomized studies to show the surgical results between these two techniques. The objective of this study was to examine the safety and efficacy of these two minimally invasive techniques. Methods : A total of 80 patients were included in this study (Group I : bilateral laminotomy, Group II : Unilateral laminotomy for bilateral decompression). Perioperative parameters and complications were analyzed. Symptoms and scores such as visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, and SF-36 scores of prospectively accrued patients were assessed preoperatively and at 1 month and 12 months after surgery. Paired-t test, two-sample student-t tests, and non parametric tests were used to determine cross-sectional differences between two groups. Results : No major complications such as spinal instability or deaths occurred during follow-up periods. VAS, ODI scores and SF-36 body pain and physical function scores showed statistically significant improvements in both groups (p<0.001). The significant widening of the spinal canal diameter was also noted in both groups. But, in Group II. there were minor postoperative complications such as dural tear (2 cases 5.0%), fracture of ipsilateral inferior facet (1 case 2.5%), and 5 cases of transient leg symptoms of contralateral side. Conclusion : Both bilateral laminotomy and unilateral laminotomy for bilateral decompression allow achievement of adequate and long-lasting operative results in patients with LSS. But postoperative complications are more frequent in Group II (unilateral laminotomy and bilateral decompression). These results indicate that bilateral laminotomy is the preferred minimally invasive technique to treat symptomatic LSS.

Trends in Non-invasive Continuous Glucose Monitoring Technology (비침습 연속혈당 모니터링 기술동향)

  • Kim, J.;Kim, B.K.
    • Electronics and Telecommunications Trends
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    • v.36 no.5
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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.

Minimally invasive distal biceps tendon repair: a case series

  • Paul Jarrett;Anna-Lisa Baker
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.222-230
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    • 2023
  • Background: Distal biceps tendon repairs are commonly performed using open techniques. A minimally invasive distal biceps tendon repair technique using a speculum and hooded endoscope was developed to improve visualization, reduce soft-tissue dissection, and minimize complications. This paper describes the technique and reports the outcomes of 75 minimally invasive distal biceps tendon repairs. Methods: The operation reports and outcomes of 75 patients who underwent distal biceps tendon repair using this technique between 2011 and 2021 were retrospectively reviewed. Results: Median time to follow-up was 12 months (interquartile range [IQR], 6-56 months). Primary outcomes were function as measured by the Disabilities of Arm, Shoulder and Hand Score (DASH) questionnaire, and rate of complications. Median DASH score was 1.7 of 100 (IQR, 0-6.8). There were 2 of 75 (2.7%) re-ruptures of the distal tendon. There were no cases of vascular injury, proximal radius fracture, or posterior interosseous nerve, median, or ulnar nerve palsy. Conclusions: In this series, minimally invasive distal biceps repair was safe and effective with a low rate of major complications. Recovery of function, as indicated by low DASH scores, was satisfactory, and inconvenience during recovery was minimized. Level of evidence: IV.

Superciliary Keyhole Approach for Unruptured Anterior Circulation Aneurysms : Surgical Technique, Indications, and Contraindications

  • Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.56 no.5
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    • pp.371-374
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    • 2014
  • Neurosurgeons have been trying to reduce surgical invasiveness by applying minimally invasive keyhole approaches. Therefore, this paper clarifies the detailed surgical technique, its limitations, proper indications, and contraindications for a superciliary keyhole approach as a minimally invasive modification of a pterional approach. Successful superciliary keyhole surgery for unruptured aneurysms requires an understanding of the limitations and the use of special surgical techniques. Essentially, this means the effective selection of surgical indications, usage of the appropriate surgical instruments with a tubular shaft, and refined surgical techniques, including straightforward access to the aneurysm, clean surgical dissection, and the application of clips with an appropriate configuration. A superciliary keyhole approach allows unruptured anterior circulation aneurysms to be clipped safely, rapidly, and less invasively on the basis of appropriate surgical indications.

Function-Preserving Surgery in Gastric Cancer

  • Bueno, Jan Andrew D.;Park, Young-Suk;Ahn, Sang-Hoon;Park, Do Joong;Kim, Hyung-Ho
    • Journal of Minimally Invasive Surgery
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    • v.21 no.4
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    • pp.141-147
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    • 2018
  • The rising incidence of early gastric cancer has enabled the development of function-preserving gastrectomy with the focus on post gastrectomy quality of life and adherence to sound oncologic principles. It is concurrent with the growing popularity of minimally invasive surgery; and both are commonly used together. The different kinds of function-preserving gastrectomy included in this review are: pylorus-preserving and proximal gastrectomy, vagus nerve preservation, sentinel node navigation, and various endoscopic & minimally-invasive techniques. In this article the indications, techniques, oncologic safety, functional benefit, and outcomes of each kind of function-preserving gastrectomy are discussed.

Minimally invasive techniques as adjuncts in low- versus high-lying retained rectal foreign bodies of autoerotic nature in young men: a tailored management algorithm with two contrasting case reports from India

  • Shubham Kumar Gupta;Vivek Kumar Katiyar;Sumit Sharma;Shashi Prakash Mishra;Satyanam Kumar Bhartiya
    • Journal of Trauma and Injury
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    • v.37 no.3
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    • pp.238-242
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    • 2024
  • Retained rectal foreign bodies (RFBs) of an autoerotic nature represent an emerging and rare surgical emergency, posing a sensitive challenge for surgeons. RFBs exhibit a wide range of presentations and require varied management approaches, with the choice of treatment modality differing from case to case. Recently, minimally invasive techniques have been employed for the retrieval of RFBs. In 2021, the World Society of Emergency Surgery and the American Association for the Surgery of Trauma released guidelines on anorectal emergencies, highlighting the usefulness of these techniques as adjunctive tools for both diagnosis and ruling out associated complications. In this report, we describe two noteworthy cases of men who presented to the trauma emergency department with foreign bodies lodged in their rectums. We also highlight the potential role of minimally invasive techniques within a "step-up" approach for the management of retained RFBs.

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

  • 오상기
    • Journal of Chest Surgery
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    • v.33 no.2
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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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