• 제목/요약/키워드: Surgical technique

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Personal technique for definite repair of complete unilateral cleft lip: modified Millard technique

  • Han, Kihwan;Park, Jeongseob;Lee, Seongwon;Jeong, Woonhyeok
    • 대한두개안면성형외과학회지
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    • 제19권1호
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    • pp.3-12
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    • 2018
  • Background: Millard's rotation-advancement repair, which is used by many surgeons, can make a natural philtral column, but most surgeons use a modification of the rotation-advancement flap. The purpose of this article is to introduce a modification utilized by the authors and to provide detailed surgical procedure. Methods: We retrospectively reviewed 82 patients' medical records and presented surgical technique and outcomes. The main features of the authors' strategy are emphasizing horizontal length of the lip, orbicularis oris muscle duplication for improving the definition of the philtral column, overcorrection of domal portion than the non-cleft side in order to compensate for the recurrence during growth. Two judges rated two times the appearance of the patients' nose and lip using Asher-McDade aesthetic index. Intra- and interobserver reliabilities were determined using Cohen's kappa statistics. Results: All patients recovered eventually after surgery; however, two patients have a minor complications (wound infection in one patient, wound disruption due to trauma in the other patient). The improvement of the aesthetic results can be achieved with this modified Millard technique. Total mean scores of the Asher-McDade index was 2.08, fair to good appearance. The intraobserver reliabilities were substantial to almost perfect agreement and the interobserver reliabilities were moderate to almost perfect agreement. Conclusion: We modified Millard method for repair of complete unilateral cleft lip. The surgical outcomes were favorable in long-term follow-up. We hope our technique will serve as a guide for those new to the procedure.

Aortic Valve Replacement Using Continuous Suture Technique in Patients with Aortic Valve Disease

  • Choi, Jong Bum;Kim, Jong Hun;Park, Hyun Kyu;Kim, Kyung Hwa;Kim, Min Ho;Kuh, Ja Hong;Jo, Jung Ku
    • Journal of Chest Surgery
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    • 제46권4호
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    • pp.249-255
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    • 2013
  • Background: The continuous suture (CS) technique has several advantages as a method for simple, fast, and secure aortic valve replacement (AVR). We used a simple CS technique without the use of a pledget for AVR and evaluated the surgical outcomes. Materials and Methods: Between October 2007 and 2012, 123 patients with aortic valve disease underwent AVR alone (n=28) or with other concomitant cardiac procedures (n=95), such as mitral, tricuspid, or aortic surgery. The patients were divided into two groups: the interrupted suture (IS) group (n=47), in which the conventional IS technique was used, and the CS group (n=76), in which the simple CS technique was used. Results: There were two hospital deaths (1.6%), which were not related to the suture technique. There were no significant differences in cardiopulmonary bypass time or aortic cross-clamp time between the two groups for AVR alone or AVR with concomitant cardiac procedures. In the IS group, two patients had prosthetic endocarditis and one patient experienced significant perivalvular leak. These patients underwent reoperations. In the CS group, there were no complications related to the surgery. Postoperatively, the two groups had similar aortic valve gradients. Conclusion: The simple CS method is useful and secure for AVR in patients with aortic valve disease, and it may minimize surgical complications, as neither pledgets nor braided sutures are used.

개에서 경구개열의 외과적 교정례 (Surgical Closure of Cleft Hard Palate in a Dog)

  • 권영삼;장환수;장광호
    • 한국임상수의학회지
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    • 제21권3호
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    • pp.326-328
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    • 2004
  • A 7-month-old, weak female dachshund dog which had signs of cough and sneezing while eating was admitted. This case was diagnosed as cleft hard palate by the physical and blood examination. After aseptic surgical preparation, a surgical method utilizing mucoperiosteal and buccal flap technique, in which accurate apposition and secure closure was very important, was used successfully. The defect of hard palate was healed completely on 10 days after surgery without any other complication.

전방십자인대 재재건술 (Arthroscopic Revision ACL Reconstruction)

  • 안진환
    • 대한정형외과스포츠의학회지
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    • 제2권1호
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    • pp.20-27
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    • 2003
  • 전방십자인대재건술의빈도가증가함에따라실패율도증가되고있다. 전방십자인대재건술의실패원인중수술수기의잘못이가장흔한원인으로보고되고있다. 이에그실패의원인과재재건술의수기의문제점에대하여알아보고자한다.

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상완골 근위부 골절에 시행한 긴장 대 봉합을 동반한 관혈적 골수강내 고정술 (Open Intramedullary Nail with Tension Band Sutures on Proximal Humeral Fracture)

  • 박진영;안진우;이성철
    • Clinics in Shoulder and Elbow
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    • 제6권2호
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    • pp.149-160
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    • 2003
  • Purpose: to determine the results after open intramedullary nailing and tension band suture technique in proximal humerus fracture for improving the stability and decreasing the complications. Materials and Method: Authors reviewed 27 patients treated by open intramedullary nailing and tension band suture technique. Mean follow-up period was 39 months (24-59months). Surgical neck fracture were 6 cases, surgical neck fracture with shaft fracture were 3 cases, three part fracture with greater tuberosity fracture were 17 cases, four part fracture was 1 case and fracture and dislocation were 2 cases Results: We got the bony union in 26 cases. Average pain scale was 1 point (0-6), Neer score was 86 point(45-99) and ASES score was 85 point(40-100). We separate all cases in two groups based on age (65 years), L-spine t-score (-2.5) and Neer classification (2 and 3 part). There is no significance in pain scale, Neer score and ASES score between each group. Conclusion: As a method of surgical treatment on severe proximal humeral fractures, we recommend intramedullary nailing and tension band suture technique and it may have particular advantages in early exercise and satisfactory functional outcome.

Posterior Cervical Fixation with a Nitinol Shape Memory Loop for Primary Surgical Stabilization of Atlantoaxial Instability : A Preliminary Report

  • Kim, Duk-Gyu;Eun, Jong-Pil;Park, Jung-Soo
    • Journal of Korean Neurosurgical Society
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    • 제52권1호
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    • pp.21-26
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    • 2012
  • Objective : To evaluate a new posterior atlantoaxial fixation technique using a nitinol shape memory loop as a simple method that avoids the risk of vertebral artery or nerve injury. Methods : We retrospectively evaluated 14 patients with atlantoaxial instability who had undergone posterior C1-2 fusion using a nitinol shape memory loop. The success of fusion was determined clinically and radiologically. We reviewed patients' neurologic outcomes, neck disability index (NDI), solid bone fusion on cervical spine films, changes in posterior atlantodental interval (PADI), and surgical complications. Results : Solid bone fusion was documented radiologically in all cases, and PADI increased after surgery (p<0.05). All patients remained neurologically intact and showed improvement in NDI score (p<0.05). There were no surgical complications such as neural tissue or vertebral artery injury or instrument failure in the follow-up period. Conclusion : Posterior C1-2 fixation with a nitinol shape memory loop is a simple, less technically demanding method compared to the conventional technique and may avoid the instrument-related complications of posterior C1-2 screw and rod fixation. We introduce this technique as one of the treatment options for atlantoaxial instability.

Photosensor를 이용한 재활 치료형을 위한 $CO_2$ laser 의 출력변동율 안정을 위한 실시간 제어특성 연구 (Real time control special quality research for $CO_2$ laser's output change rate stability for accumulation style surgical operation rehabilitation of ventriculus that use Photosensor)

  • 김휘영
    • 대한전자공학회:학술대회논문집
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    • 대한전자공학회 2006년도 하계종합학술대회
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    • pp.1015-1016
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    • 2006
  • The important parameters deciding the fluctuation of Accumulation style surgical operation of ventriculus laser beam are smoothing capacitor, frequency and he characteristics of laser resonator. In this thesis, we control the fluctuation of medical $CO_2C$ laser in realtime by changing Duty-Ratio of IGBT and switching frequency with fixed the smoothing capacitor to improve the fluctuation of laser beam. We detect the light on laser resonator using a CdS photo sensor to improve ripple factor of laser beam and feedback fluctuated signals refined by a band pass filter into the control circuit to stabilize fluctuation actively. There is much to be desired in the realtime controlling technique of the light on Accumulation style surgical operation of ventriculus laser discharge tube in electrical signal. We propose switching control technique with microprocessor and photo sensing technique by controlling switch devices optimum operation and feedback signals detected by a photo sensor into the laser power supply in order to improve ripple factor of the $CO_2$ laser beam.

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위 수술 전후의 내시경 시술: 재건법에 따른 접근, 수술의 관점 (Endoscopy after Gastric Surgery: For Each Reconstruction Method, Operator's Point of View)

  • 주일석;조현진;최수인
    • Journal of Digestive Cancer Research
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    • 제11권2호
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    • pp.66-76
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    • 2023
  • Endoscopy is an important noninvasive procedure for patients with gastrointestinal problems. However, surgical techniques are shifting to laparoscopic surgery, and changes in endoscopic findings after laparoscopic surgery differ from those after previous surgical methods. Postoperative endoscopic findings differ from normal anatomical structures, and findings reportedly vary depending on the type of surgical technique. Therefore, we aimed to summarize the surgical and endoscopic findings for each surgical method from the surgeon's point of view. The causes of gastric emptying delay, bleeding, afferent loop syndrome, or anastomosis leakage occurring after gastric cancer surgery can be identified via upper gastrointestinal endoscopy that is relatively less invasive than the surgical method. Regarding postoperative anastomosis leakage, endoscopy can directly evaluate the degree of leakage at the anastomosis site more accurately than computed tomography and enable immediate intervention. As endoscopy is less invasive than the surgical method, patients can be evaluated and treated more safely. However, coordination between the surgeon and the endoscopist is necessary to perform the procedures effectively. Therefore, reviewing the changes in surgical and endoscopic findings is important.

내시경을 이용한 안면골 골절 수술 (ENDOSCOPE-ASSISTED REPAIR OF FACIAL BONE FRACTURES)

  • 조영철;성일용;변기정
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제29권2호
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    • pp.174-181
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    • 2007
  • Today, endoscopic procedures are common in diagnostic and other surgical procedures, with endoscopically enhanced and magnified images permitting surgical access through minimal incisions. This has expanded the treatment options for many difficult anatomic sites, and the endoscope facilitated safe anatomic reduction and fixation. The use of the endoscope may reduce the disadvantages of open fracture repair and should be considered for broad application in the treatment of displaced facial bone fractures. Optical endoscopic magnification minimizes the disadvantages associated with open surgical repair, including the risk of facial nerve injury and external facial scarring, and no postoperative complications have been attributable to the endoscopic approach. This technique was used in 14 patients treated at Ulsan University Hospital, Korea, from September 2004 to August 2006, including six mandibular subcondyle fractures, five blowout fractures and three zygomaticomaxillary complex (ZMC) fractures. Careful preoperative evaluation and proper surgical technique were essential to achieve optimal results in the selected patients.

급성 아킬레스건 파열의 치료 (Treatment of Acute Achilles Tendon Rupture)

  • 이태훈;김학준;전영식
    • 대한족부족관절학회지
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    • 제19권3호
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    • pp.77-80
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    • 2015
  • Acute Achilles tendon rupture is a frequent injury during sports and recreational activities. Treatments for Achilles tendon rupture have been controversial in recent decades. Traditionally the surgical treatment had benefit over nonsurgical treatment in terms of low rerupture rate and early functional restoration. Recently, nonsurgical treatment was found to show no statistically significant inferiority in re-rupture rate, functional outcome, and calf strength. Whereas, surgical treatment had some complications including adhesion, nerve injury, and infection. Nonsurgical treatment has been increasing due to functional rehabilitation with early weight bearing and restricted early motion. It focuses more attention on the course of caring for patients with deep discussion. There are open repair and minimally invasive repair in terms of surgical treatment. There are various techniques for minimally invasive repair of Achilles tendon, which has some advantages over the open repair. However, the optimal technique for minimally invasive repair has not been established. The number of suture strands is important regardless of suture technique.