• 대한치과의사협회지
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• 제55권8호
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• pp.556-564
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• 2017

Endodontic surgery is a procedure to treat apical periodontitis or abscess in cases that did not heal after nonsurgical treatment or retreatment. This might include situations with persistent intracanal infection after root canal treatment. Other reasons might be found in extraradicular infection, such as bacterial biofilm on the apical root surface or bacteria within the lesion. For many years, the treatment standard was the traditional approach with surgical burs and amalgam for root-end filling. Endodontic microsurgery is the most recent step in the evolution of endodontic surgery, applying not only ultrasonic tip and biocompatible filling materials but also incorporating high-power magnification and illumination. Although many studies have been published that advocate the use of modern technique, the traditional techniques are still widely used in the surgery community. The purpose of this study was to demonstrate the endodontic microsurgery procedure including the root-end preparation and filling with the use of a surgical operating microscope.

• 한국임상수의학회지
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• 제40권5호
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• pp.354-359
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• 2023

This case report describes the clinical presentation and successful surgical repair of a diaphragmatic hernia-related small intestinal strangulation in a neonatal foal. A nine-day-old foal presented with colic signs and respiratory distress. History taking showed that the dam of the foal experienced difficulty during delivery, and the owner assisted in delivery by pulling on the foal. Radiography and ultrasonography confirmed the diaphragmatic rent and the presence of a small intestine within the thoracic cavity. Surgical intervention was required to repair the diaphragmatic defect and address the intestinal strangulation. The diaphragm was reconstructed, and the nonviable incarcerated portion of the small intestine was resected and anastomosed using an end-to-end technique. This unusual case report provides insights into the surgical repair and outcomes of an acquired diaphragmatic hernia in a neonatal foal.

• Clinics in Shoulder and Elbow
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• 제26권4호
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• pp.445-454
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• 2023

The Latarjet procedure is a surgical procedure that can effectively restore glenohumeral stability, especially in patients with anterior shoulder instability and glenoid bone loss. Many studies have shown comparable clinical outcomes between patients undergoing the arthroscopic Latarjet procedure and those undergoing traditional open methods or other glenohumeral joint stabilization procedures. However, the arthroscopic Latarjet procedure is a challenging technique due to the unfamiliar portal placements, proximity of neurovascular structures, and serious postoperative complications. The arthroscopic Latarjet procedure has not yet been widely applied, and a clear understanding of the anatomical structure and the precise methods is required prior to operation performance. Satisfactory clinical outcomes can be achieved by thorough preoperative planning and proper implant fixation methods.

• Hip & pelvis
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• 제34권1호
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• pp.62-67
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• 2022

Posterior wall fractures are the most common type of acetabular fractures. Treatment can be conservative or surgical. Operative treatment is indicated for acetabular fractures that result in hip joint instability and/or incongruity, as well injuries with incarceration of fragments of bone or soft tissue within the hip joint. Surgical treatment can range from open reduction and osteosynthesis to hip arthroplasty. Arthroscopy has recently been used as the main surgical technique or as a reduction aid. In this case a 26-year-old male with a fracture of the posterior wall who underwent a posterior miniinvasive approach, followed by hip arthroscopy. This allowed joint wash, removal of the loose body, confirmation of reduction and absence of intra-articular hardware. Excellent clinical and radiological results were obtained. This case demonstrates the advantage of using hip arthroscopy in assessment of fracture reduction, the absence of intra-articular hardware or fragments, as well as a less invasive approach.

• Journal of Korean Neurosurgical Society
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• 제52권4호
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• pp.306-311
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• 2012

Objective : A superciliary keyhole approach is an attractive, minimally invasive surgical technique, yet the procedure is limited due to a small cranial opening. Nonetheless, an unruptured supraclinoid internal carotid artery (ICA) aneurysm can be an optimal surgical target of a superciliary approach as it is located in the center of the surgical view and field. Therefore, this study evaluated the feasibility and surgical outcomes of a superciliary keyhole approach for unruptured ICA aneurysms. Methods : The authors report on a consecutive series of patients who underwent a superciliary approach for clipping unruptured ICA aneurysms between January 2007 and February 2012. The data were compared with a historical control group who underwent a pterional approach between January 2003 and December 2006. Results : In the superciliary group, a total of 71 aneurysms were successfully clipped without a residual sac in 70 patients with a mean age of 57 years (range, 37-75 years). The maximum diameter of the aneurysms ranged from 4 mm to 14 mm (mean${\pm}$standard deviation, $6.6{\pm}2.3$ mm). No direct mortality or permanent morbidity was related to the surgery. The superciliary approach demonstrated statistically significant advantages over the pterional approach, including a shorter operative duration (mean, 100 min), no intraoperative blood transfusions, and no postoperative epidural hemorrhages. Conclusion : A superciliary keyhole approach provides a sufficient surgical corridor to clip most unruptured supraclinoid ICA aneurysms in a minimally invasive manner.

• 한국간담췌외과학회지
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• 제27권2호
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• pp.211-216
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• 2023

It has been shown that external pancreatic ductal stenting (EPDS) can reduce the incidence of clinically relevant postoperative pancreatic fistula. Although studies have described EPDS in open pancreaticoduodenectomy (PD), EPDS in minimally invasive PD has not been reported yet. Thus, the objective of this study was to describe the technique of EPDS in minimally invasive PD. The procedure was performed either laparoscopically or using a robot. Once PD was completed, key steps included triple enterotomy, threading of silk-suture through all enterotomies and exteriorization, completing posterior layer of pancreaticojejunostomy (PJ), railroading stent through preplaced silk-suture, intubation of stent into the pancreatic duct, completion of PJ, followed by hepaticojejunostomy and parietalization of jejunum at the stent exit site. EPDS in PD through a minimally invasive approach can be performed safely in selected cases with either a small-sized pancreatic duct or a soft pancreas.

• 대한관절경학회지
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• 제16권1호
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• pp.92-97
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• 2012

목적: 회전근 개 파열의 봉합 가능성은 수술적 치료의 적응증을 정립하는데 매우 중요하다. 저자는 회전근 개의 봉합 가능성 및 치유에 영향을 주는 요소들과 회전근 개 파열의 수술적 치료의 적응증에 대해서 고찰하였다. 대상 및 방법: 회전근 개 파열의 봉합 가능성은 수술적 봉합 가능성과 술 후 회전근 개 파열의 치유 가능성의 측면에서 고려되어야 한다. 회전근 개 파열의 자연 경과에 대한 이해 역시 수술적 치료를 할 것인지 보존적 치료를 할 것인지를 결정하는데 큰 도움을 준다. 결과: 회전근 개의 치유 가능성을 예측하는 세가지 일반적인 범주가 있는데 첫째로 수술적 요소, 생물학적 요소, 환경적 요소이다. 수술의는 수술적 기법을 스스로 선택함으로써 수술적 요소를 제어할 수 있으며, 생물학적 요소는 나이와 급성 외상의 유무, 만성화 정도, 파열의 정도 등을 고려하여 주의 깊게 수술 적응 대상을 선택함으로써, 환경적 요소는 흡연 및 비스테로이드성 소염진통제(nonsteroidal anti-inflammatory drug, NSAID) 사용을 피함으로써 더 좋은 임상 결과를 기대할 수 있다. 결론: 회전근 개 파열의 자연 경과와 봉합 가능성에 대한 정확한 이해는 회전근 개 파열의 수술적 치료의 적응증을 정립하고 만족스러운 임상결과를 얻는데 큰 도움을 줄 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.4989-4992
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• 2012

Purpose: Guide-wire localization (GWL) has been a standard technique for many years. Excision of nonpalpable malignant breast lesions with clear surgical margins reduces the risk of undergoing re-excision. The objective of the present study was to evaluate the efficacy of GWL biopsy for assessing surgical margins. Methods: This retrospective study concerned 53 patients who underwent GWL biopsy for non-palpable breast lesions and breast carcinoma diagnosed by histological examination. Age of the patients, tumour size, radiographic findings, breast density specifications, specimen volumes, menopausal status and family history of the patients and surgical margin status were recorded. Results: Median age was 53.3 years, median tumour size was 1.5 cm and median specimen volume was $71.5cm^3$. In fifteen patients (28%) DCIS and in 38 patients (72%) invasive ductal carcinoma was diagnosed. There was positive surgical margins in twenty eight (52.8%) patients. The median distance to the nearest surgical margin was 7.2 mm in clear surgical margins. Younger age and denser breast specifications were found as statistically significant factors for surgical margin status. Median age of the patients who had positive margins was 49.4 years where it was 56.9 years in the patients with negative margins (p=0.04). 79% of the patients with positive margins had type 3-4 pattern breast density according to BIRADS classification as compared to 48% in the patients who had negative margins (p=0.03). Some 38 patients who had positive or close surgical margins received re-excision (72%). Conclusion: Positive margin rates may be higher because of inherent biological differences and diffuse growth patterns in younger patients. There are also technical difficulties that are relevant to denser fibroglandular tissue in placing hooked wire. High re-excision rates must be taken into consideration while performing GWL biopsy in non-palpable breast lesions.

• Journal of Chest Surgery
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• 제56권5호
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• pp.336-345
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• 2023

Background: The objective of this study was to demonstrate the safety, efficacy, and feasibility of intraoperative monitoring of the recurrent laryngeal nerves during thoracoscopic and robotic 3-field esophagectomy. Methods: This retrospective analysis details our initial experience using intraoperative nerve monitoring (IONM) during minimally invasive 3-field esophagectomy. Data were obtained from a prospectively maintained database and electronic medical records. The study included all patients who underwent minimally invasive (video-assisted thoracic surgery/robotic) transthoracic esophagectomy with neck anastomosis. The patients were divided into those who underwent IONM during the study period and a historical cohort who underwent 3-field esophagectomy without IONM at the same institution. Appropriate statistical tests were used to compare the 2 groups. Results: Twenty-four patients underwent nerve monitoring during minimally invasive 3-field esophagectomy. Of these, 15 patients underwent thoraco-laparoscopic operation, while 9 received a robot-assisted procedure. In the immediate postoperative period, 8 of 24 patients (33.3%) experienced vocal cord paralysis. Relative to a historical cohort from the same institution, who were treated with surgery without nerve monitoring in the preceding 5 years, a 26% reduction was observed in the nerve paralysis rate (p=0.08). On follow-up, 6 of the 8 patients with vocal cord paralysis reported a return to normal vocal function. Additionally, patients who underwent IONM exhibited a higher nodal yield and a decreased frequency of tracheostomy and bronchoscopy. Conclusion: The use of IONM during minimally invasive 3-field esophagectomy is safe and feasible. This technique has the potential to decrease the incidence of recurrent nerve palsy and increase nodal yield.

• 대한소아치과학회지
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• 제31권1호
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• pp.34-40
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• 2004

상악 전치의 맹출장애는 임상적으로 비교적 흔한 치열발육 이상으로 환자측에서 인지하기 쉬우며 심미적, 사회 심리적으로 중요한 문제가 될 수 있다. 맹출장애의 치료방법으로는 주기적 관찰, 공간 확보, 치은 절제술을 포함한 단순 노출, 교정적 견인, 외과적 노출과 교정적 견인의 병행, 발거 후 자가치아이식 등 여러 방법이 있다. 이 중 적절한 치료방법을 선택하기 위해서는 우선 환자의 내과적, 치과적 병력을 고려해야 하고 치아의 위치, 상태, 치근 형성정토 및 만곡여부, 맹출을 위한 공간 확보 여부, 주위 치조골 및 치주조직의 상태, 견인 방법, 이동에 소요되는 기간 등을 고려해야 한다. 저자는 상악 전치부의 맹출장애를 보이는 두 증례를 치험한 바, 첫 번째 증례는 상악 우측 중절치의 이소맹출과 우측 견치의 맹출지연을 주소로 내원한 환자로서, 견치를 노출시킨 후 견인을 시행하였으며 현재 우측 중절치를 배열중이다. 두 번째 증례는 상악 좌측 중절치의 맹출지연을 주소로 내원한 환자로서, 상악 좌측 중절치를 발거 한 후 자가치아이식을 시행하였다. 위 증례를 통해서 치아의 맹출력을 기대할 수 없거나 맹출방향이 비정상적인 경우에는 외과적 노출과 견인을 동반한 방법을 우선 적용할 수 있으나, 치아의 위치 이상이 심각하거나 치근의 위치가 과도하게 이탈된 경우에는 자가치아이식을 포함한 외과적 술식이 맹출유도에 도움이 된다는 사실을 확인하였다.