• Title/Summary/Keyword: Surgical Microscope

Search Result 97, Processing Time 0.031 seconds

An Anatomical Variant : Low-Lying Bifurcation of the Common Carotid Artery, and Its Surgical Implications in Anterior Cervical Discectomy

  • Gulsen, Salih;Caner, Hakan;Altinors, Nur
    • Journal of Korean Neurosurgical Society
    • /
    • v.45 no.1
    • /
    • pp.32-34
    • /
    • 2009
  • The common carotid artery generally bifurcates into the internal and external carotid arteries at the level of C3-4. Injury to the common carotid artery during anterior cervical discectomy is a complication that is very much feared but encountered rarely. Knowing the anatomic variations of the common carotid artery and using an operating microscope during the anterior cervical approach for cases with low-lying bifurcation of the common carotid artery would prevent injuries to this artery. We present a 42-year-old female who has successfully undergone anterior cervical discectomy at the level of C5-6 and C6-7. She had a low-lying bifurcation of the common carotid artery.

Transthoracic-Extrapleural Approach for Microsurgical Thoracic Discectomy with Video Assistance - Technical Report of Three Cases - (내시경을 이용한 경흉강 늑막외측 접근 흉추 추간판 절제술 3례 - 수술수기 증례보고 -)

  • Lee, Sang-Ho;Jeon, Sang-Hyeop;Choi, Jong-Yeul;Lee, Ho-Yeon;Jung, Byung-Joo;Lim, Sang-Rak
    • Journal of Korean Neurosurgical Society
    • /
    • v.29 no.12
    • /
    • pp.1677-1681
    • /
    • 2000
  • Microsurgical transthoracic extrapleural approach for thoracic discectomy in three cases were modified and simplified in order to achieve better exposure of ventral extradural space than posterolateral extrapleural(lateral extracavitary) approach and less pulmonary complications than transthoracic transpleural approach. These approaches were optimized by microscope and video-assistance. Surgery was followed by clinical improvement in all patients. The results of treatment seem to support the use of these modified techniques as adequate surgical treatment of thoracic disc herniations without any complications.

  • PDF

Use of elevator instruments when luxating and extracting teeth in dentistry: clinical techniques

  • Mamoun, John
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.43 no.3
    • /
    • pp.204-211
    • /
    • 2017
  • In dentistry, elevator instruments are used to luxate teeth, and this technique imparts forces to tooth particles that sever the periodontal ligament around tooth roots inside the socket and expand alveolar bone around tooth particles. These effects can result in extraction of the tooth particles or facilitate systematic forceps extraction of the tooth particles. This article presents basic oral surgery techniques for applying elevators to luxate teeth. Determination of the optimal luxation technique requires understanding of the functions of the straight elevator and the Cryer elevator, the concept of purchase points, how the design elements of elevator working ends and tips influence the functionality of an elevator, application of forces to tooth particles, sectioning teeth at furcations, and bone removal to facilitate luxation. The effectiveness of tooth particle luxation is influenced by elevator tip shape and size, the magnitude and the vectors of forces applied to the tooth particle by the tip, and sectioning and bone removal within the operating field. Controlled extraction procedures are facilitated by a dental operating microscope or the magnification of binocular surgical loupes telescopes, combined with co-axial illumination.

The surgical retrieval of a broken dental needle: A case report

  • Lee, Jiseon;Park, Min Woo;Kim, Min Keun;Kim, Soung Min;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.15 no.2
    • /
    • pp.97-100
    • /
    • 2015
  • One complication related to local anesthesia in the dental clinic is a broken needle. Although rare, a broken needle may be difficult to retrieve. Dental radiographs and 3D CT have been used in the past to confirm the location of a broken needle. We present the case of a broken needle, which was successfully removed using a careful, microscopic approach.

Optimizing Treatment of Breast Cancer Related Lymphedema Using Combined DIEP Flap and Lymphedema Surgery

  • Chang, Edward I.
    • Archives of Plastic Surgery
    • /
    • v.49 no.2
    • /
    • pp.150-157
    • /
    • 2022
  • Patients undergoing treatment for breast cancer who undergo an axillary dissection and require adjuvant therapies such as radiation and chemotherapy are at high risk of developing lymphedema of the associated extremity. Historically, patients with lymphedema were treated with ablative procedures aimed simply to remove excess fluid and adiposity; however, the field of lymphatic surgery employing super-microsurgery techniques has witnessed tremendous advances in a relatively short period of time. Advancements in surgical instruments, microscope magnification and optics, imaging technology, and surgeon experience have ushered in a new era of hope to treat patients suffering from breast cancer-related lymphedema (BCRL). Here we aim to present the available options for patients suffering from BCRL, and the pinnacle in reconstruction and restoration for these patients.

Study of a Brain Tumor and Blood Vessel Detection System Using Multiple Fluorescence Imaging by a Surgical Microscope (수술현미경에서의 다중형광영상을 이용한 뇌종양과 혈관영상 검출 시스템 연구)

  • Lee, Hyun Min;Kim, Hong Rae;Yoon, Woong Bae;Kim, Young Jae;Kim, Kwang Gi;Kim, Seok Ki;Yoo, Heon;Lee, Seung Hoon;Shin, Min Sun;Kwon, Ki Chul
    • Korean Journal of Optics and Photonics
    • /
    • v.26 no.1
    • /
    • pp.23-29
    • /
    • 2015
  • In this paper, we propose a microscope system for detecting both a tumor and blood vessels in brain tumor surgery as fluorescence images by using multiple light sources and a beam-splitter module. The proposed method displays fluorescent images of the tumor and blood vessels on the same display device and also provides accurate information about them to the operator. To acquire a fluorescence image, we utilized 5-ALA (5-aminolevulinic acid) for the tumor and ICG (Indocyanine green) for blood vessels, and we used a beam-splitter module combined with a microscope for simultaneous detection of both. The beam-splitter module showed the best performance at 600 nm for 5-ALA and above 800 nm for ICG. The beam-splitter is flexible to enable diverse objective setups and designed to mount a filter easily, so beam-splitter and filter can be changed as needed, and other fluorescent dyes besides 5-ALA and ICG are available. The fluorescent images of the tumor and the blood vessels can be displayed on the same monitor through the beam-splitter module with a CCD camera. For ICG, a CCD that can detect the near-infrared region is needed. This system provides the acquired fluorescent image to an operator in real time, matching it to the original image through a similarity transform.

ULTRASTRUCTURAL STUDY FOR VEIN REGENERATION AFTER MICROVASCULAR ANASTOMOSIS IN RABBIT FEMORAL VEIN (가토 대퇴정맥 미세정맥문합술 후 정맥 문합부 재생에 관한 미세조직학적 연구)

  • Rho, Hong-Seop;Kim, Chul-Hwan;Kim, Kyung-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.33 no.4
    • /
    • pp.340-349
    • /
    • 2007
  • Free flap transplantation with microvascular anastomosis has been successfully performed by development of surgical technique, materials and postoperative monitoring equipments of flap. But success rate of microvascular anastomosis is influenced by various factors, and failure rate is about 5-10%. The most influential factor for success rate is surgical technique and other factors that influence failure of microvascular anastomosis are ischemic time of free flap, thrombus formation of anastomosis region and vascular spasm. In this study, vascular patency and thrombus formation in experimental micro-venous anastomosis, and endothelial repair were observed with histologic analysis, scanning electron microscopy, transmission electron microscopic examination. The results were obtained as follows: 1. In vascular patency test in 30 minute and 7 days after micro-venous anastomosis with heparin irrigation, all of 12 anastomosis site were good vascular patency. 2. In thrombus formation in 2 weeks group(Experimental I), 2 site of 6 cases were observed thrombus, and in 4 weeks group(Experimental II), 1 site of 6 cases were observed thrombus. 3. In histologic examination, normal vein(Control Group) showed continued internal elastic lamina, well formed thick smooth muscle layer and connective tissue. The group of 2 weeks after microvenous anastomosis(Experimental I) showd locally recovered internal lamina, discontinued internal lamina, disorganized smooth muscle cells and granulation tissue around suture silk. In the group of 4 weeks after micro-venous anastomosis(Experimental II), anastomosis site showed almostly continued internal lamina, disorganized smooth muscle cells and cicartrized tissue around suture silk. 4. In scanning electron microscope examination in 2 weeks(Experimental I) after micro-venous anastomosis, mesh fibrin formation showed near to endothelial cells, and in 4 weeks after micro-venous anastomosis(EXperimental II), numerous blood cells and fibrin mesh formation was seen associated with irregular endothelial cell arrangement. 5. In transmission electron microscope examination in 2 weeks after micro-venous anastomosis(Experimental I), irregular arrangement of smooth muscle cells was seen adjacent to collagenized tissue around suture silk. In 4 weeks after micro-venous anastomosis(Experimental II), denuded venous wall composed of relatively well arranged smooth muscle cells was covered by endothelial cells, but fibroblast cells and foreign body giant cells near to suture silk was remained. From the results obtained in this study, results of good vascular patiency and anti-thrombotic effect of heparin were obtained as a local irrigation solution, and repair of venous endothelial cell was observed in 2 weeks after micro-venous anastomosis.

EFFECT OF ARTERIAL REPAIR AND PATENCY AFTER MICROVASCULAR ANASTOMOSIS WITH TOPICAL IRRIGATION OF VARIOUS ANTI-THROMBUS DRUGS (수종의 항혈전제의 국소 세척이 미세혈관문합의 동맥 치유 및 개존에 미치는 영향)

  • Choi, Yong-Chul;Kim, Kyung-Wook;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • v.32 no.2
    • /
    • pp.117-128
    • /
    • 2006
  • Free flap transplantation with microvascular anastomosis has been successfully performed by development of surgical technique, materials and postoperative monitoring equipments of flap. But success rate of microvascular anastomosis is influenced by various factors, and failure rate is about 5-10%. The most influential factor for success rate is surgical technique and other factors that influence failure of microvascular anastomosis are ischemic time of free flap, thrombus formation of anastomosis region and vascular spasm. Many studies has been published in microvascular anastomosis with histologic effect for irrigating solution. But local irrigation solution has been used clinically in microvascular anastomosis, the comparison with each solution, microhistological study for endothelial cell repair and vascular patency has not been reported. The heparin which is anti-thrombotic agent, and urokinase which is fibrinolytic agent are used for this study. Vascular patency and thrombus formation in experimental micro-arterial anastomosis, and endothelial repair were observed with histologic analysis, scanning electron microscopy, transmission electron microscopic examination. The results were obtained as follows: 1. In vascular patency test in 30 minute and 7 days after micro-arterial anastomosis, equal effects of good vascular patency were obtained in group of local irrigation with heparin and urokinase. 2. In thrombus formation in 7 days after micro-arterial anastomosis, equal effects of minimal thrombus formation were obtained in group of local irrigation with heparin and urokinase. 3. In toluidin blue staining in 7 days after micro-arterial anastomosis, local destruction of endothelial cell and inner elastic lamina were seen and endothelial repair was not seen. 4. In scanning electron microscope examination in 7 days after micro-arterial anastomosis, endothelial cell was not seen in peripheral to suture materials, thrombus associated fibrin network was observed. 5. In transmission electron microscope examination in 7 days after micro-arterial anastomosis, inflammatory cell was seen within smooth muscle cells in site of endothelial cell destruction, smooth muscle cell around suture material were arranged irregularly, some collagenous change were seen. From the results obtained in this study, same results of good vascular patency and anti-thrombotic effect of heparin and urokinase were obtained as a local irrigation solution, and repair of endothelial cell was not seen in 7 days after micro-arterial anastomosis.

Effect of Nd:YAG laser irradiation on adherence of retrograde filling materials: evaluation by micro-computed tomography

  • Kim, Minyoung;Kim, Hyeon-cheol;Kwak, Sang Won;Yoon, Tai Cheol;Kim, Euiseong
    • The Journal of the Korean dental association
    • /
    • v.54 no.11
    • /
    • pp.865-873
    • /
    • 2016
  • Background/Purpose: The purpose of this study was to evaluate the effect of Nd:YAG irradiation on adherence of retrograde filling materials (mineral trioxide aggregate [MTA] and Super-EBA) by micro-computed tomography (CT) measurement and to observe the dentinal surface after irradiation by scanning electron microscopy (SEM). Materials and methods: Forty retrofilling models using extracted human teeth were divided into four groups according to the material and method used: ProRoot MTA (MTA group), Super-EBA (EBA group), MTA with Nd:YAG laser irradiation (LMTA group), and Super-EBA with Nd:YAG laser irradiation (LEBA group). All specimens were stored in 100% humidity for 24 hours until micro-CT was performed. The gap volume of the tooth/material interface was measured using the CTAn program. In six samples, the laser-irradiated dentin surface was observed using SEM. Results: The mean percent difference in gap volume was not statistically significant between the Nd:YAG laser-irradiated groups and non-irradiated in both materials(P > 0.05). The gap volume in the MTA group was significantly lower than that in the EBA group (P < 0.05). Examination of the non-irradiated specimens by SEM showed patent dentinal tubules. In contrast, alterations in the texture of the dentin surface and obliteration of the dentinal tubules were evident in the Nd:YAG laser-irradiated specimens. Conclusion: In this study, changes in the dentinal surface after Nd:YAG irradiation did not affect adherence between the apical filling material and the dentin wall.

  • PDF

EXPERIMENTAL STUDY ON THE ANTERIORLY DISPLACED TEMPOROMANDIBULAR JOINT MENISCUS IN RABBIT (실험적으로 전방이동시킨 가토의 악관절원판에 관한 연구)

  • Choi, Nack-Jun;Chang, Young-Il
    • The korean journal of orthodontics
    • /
    • v.21 no.1 s.33
    • /
    • pp.53-76
    • /
    • 1991
  • The study was designed to analyse the reorganization of the rabbit TMJ meniscus which was anteriorly displaced by surgery. The author compared the anteriorly displaced groups with control group. After surgical opening of the left rabbit TMJ space, cut the posterior attachment of the meniscus, and pushed it under the undercut area of the condyle head. Experimental groups were sacrificed by 1, 2, 4, 8 weeks after surgery. The samples were analysed with light microscope under T-B stain and electron microscope. The results were as follows: 1) The rabbit TMJ meniscus consisted of thick anterior and posterior band running different way, and comparative thin intermediate band runining antero-posteriorly. 2) Round oval shape chondrocyte-like cells were imbeded between the collagen fiber bundles and composed of proteoglycan granules, that showed metachromasia with toluidine blue, around the cell matrix. 3) Type II collagen fiber bundles in experimental group occured degenerative changes in organic patterns at 8 weeks, but those of type I collagen fiber bundles sustained longer, 4) The typical fibrocartilage of the rabbit TMJ meniscus was changed into fibrotic mode in process of time and showed the degenerative changes, which contained hyperplasia, calcification, resorption and hyalinization in the connective tissue. 5) The hyperplastic change of the synovial membrane in 4 week group and transitional change from fibrocyte to chondrocyte in cell type in 8 week group were observed. 6) The diameters of collagen fibers were diminished with the degenerative changes, the shape of the fibers became wavier and more nonorganic in running pattern and fiber bundle spaces widened.

  • PDF