• Journal of Gastric Cancer
• /
• v.24 no.1
• /
• pp.57-68
• /
• 2024

Reduced-port gastrectomy (RPG) includes all procedures derived from various efforts to minimize surgical invasiveness, with single-incision laparoscopic gastrectomy (SILG) being the ultimate reduced-port technique. However, there are challenges related to its feasibility, oncological validity, training, and education. This review describes the current issues and challenges, as well as the future prospects of RPG for gastric cancer. Gastrectomy, which started as an open surgery, has evolved into a laparoscopic surgery. With the advancements in laparoscopic technology, SILG has been used to minimize surgical scarring. However, owing to the technical difficulties of SILG, cases involving the addition of 1 trocar or needle grasper alongside the multichannel port have also been reported. Additionally, 3-port laparoscopic gastrectomy (3PLG) using only 3 trocars is also being performed. RPG, as a concept, includes a range of approaches such as SILG, 2-port laparoscopic gastrectomy, and 3PLG. These techniques aimed to reduce the number of ports or incisions required for laparoscopic gastrectomy. Despite technical difficulties, RPGs offer numerous advantages, including minimal invasiveness, excellent cosmetic outcomes, and the potential for improved postoperative recovery, such as reduced length of hospital stay and post-operative pain. It could be considered similar to conventional laparoscopic gastrectomy, and may not be oncologically inferior. Ongoing studies, such as the KLASS 12, are required to gain further insights.

• The Journal of the Korean bone and joint tumor society
• /
• v.13 no.2
• /
• pp.75-80
• /
• 2007

Purpose: To investigate the quality of training hospital based treatment, we evaluated the soft tissue sarcoma treatments afforded by general orthopedic surgeon rather than orthopedic oncologist. Materials and Methods: We reviewed the details of 25 patients with pathologically confirmed soft tissue sarcoma who registered in our hospital between July 1997 and 2006 September. We evaluated initial diagnoses, the surgical treatment (including adjuvant therapy) and the follow up method used and related these to the principles of soft tissue sarcoma treatment. Results: The study cohort comprised 16 men and 9 women of mean age of 50.2 years. A diagnostic biopsy was performed in 9(36%) cases before definitive surgical treatment. Wide excision was performed in 13(52%) cases. For the 12 cases in which the grade of sarcoma was estimated, adequate surgical treatment with adjuvant therapy was performed only in 4(33.3%) cases. In addition, an adequate follow up schedule was adopted in only 4(16%) of the 25 study subjects. Conclusion: Unexpectedly, many cases of soft tissue sarcoma were treated inadequately even in a training hospital. An intensive education program on the treatment of soft tissue sarcoma is necessary for all orthopedic surgeons.

• Journal of Korean Academy of Nursing Administration
• /
• v.16 no.2
• /
• pp.152-161
• /
• 2010

Purpose: The aim of this project was to develop a patient safety-focused inservice education program for surgical nurse and to test the effects of this program. Methods: Methodological designs for instruments development, a pretest-posttest and a posttest design were employed. After the education, nurses' satisfaction, confidence, usefulness and application of 137 nurses were evaluated at 15 surgical units of a tertiary teaching hospital in Seoul, Korea. The education contents are 6 skill areas (infusion pump use, suction, chest tube drainage, oxygen administration, nebulizer use, insulin administration) and medication knowledge. Teaching methods were lecture, instructor demonstration, and 1:1 skill test. Descriptive statistics, Wilcoxon test, Spearman's correlation and Stepwise regression were used. Results: Satisfaction scores for skills and medication education were 4.00-4.21 (out of 5), The more performance frequency in 6 skills, the higher score in confidence as well as in usefulness and application, and the higher satisfaction with the program, the higher score in usefulness, application, confidence, and medication knowledge. Medication knowledge improved after the education (Z=-7,757, p<.001). Significant predictors of skill confidence were application of skills in job performance, medication confidence, and career in present unit. Conclusion: The results of this study suggest that systematic and continuous inservice education will improve patient safety by promoting nursing quality.

• Archives of Plastic Surgery
• /
• v.41 no.4
• /
• pp.403-406
• /
• 2014

Background Perforations in the nasal septum (NSP) give rise not only to disintegration of the septum anatomy but also impairment in normal nasal physiology. The successes of these surgical techniques are usually equated to anatomical closure of the perforation. The goal of this study is to evaluate the subjective and objective results of our surgical technique for septal perforation surgery. Methods All NSPs in the six patients were closed by inferior turbinate flap. The Nasal Obstruction Symptom Evaluation (NOSE) instrument was used to evaluate the preoperative and postoperative subjective sensation of nasal obstruction. Measurement of preoperative and postoperative nasal airway resistance was performed using active anterior rhinomanometry which is an objective test. Wilcoxson signed rank test and Spearman correlation test were used to analyze correlation between NOSE scores and rhinomanometric measurements. Results The full closure of the septal perforations was noted in 100% of patients. The total NOSE score was 14 preoperatively and one postoperatively. The improvement in NOSE scores was statistically significant ($P{\leq}0.002$). The mean preoperative total resistance (ResT150) value was $0.13Pa/cm^3s^{-1}$, which is below the normal range ($0.16-0.31Pa/cm^3s^{-1}$), while the mean postoperative ResT150 value was $0.27Pa/cm^3s^{-1}$. The correlation between the improvement in NOSE scores and improvements in ResT150 values was statistically significant. Conclusions Surgical approaches should aim to solve both the anatomical and physiological problems of NSP. The application of subjective and objective tests in the postoperative period will help surgeons assess the applied techniques.

• Journal of the Korea Convergence Society
• /
• v.9 no.2
• /
• pp.119-124
• /
• 2018

The augmented reality(AR) technology enables to acquire various image information at the same time by combining virtual image information with the user's viewpoint. These AR technologies have been used to visualize patients' organs and tissues during surgery and diagnosis in the fields of Image-Guide Operation, Surgical Training, and Image Diagnosis by medical convergence, and provides the most effective surgical methods. In this paper, we study the technical features and application methods of each element technology for medical fusion of AR technology. In the AR technology for medical convergence, display, marker recognition and image synthesis interface technology is essential for efficient medical image. Such AR technology is considered to be a way to drastically improve current medical technology in the fields of image guide surgery, surgical education, and imaging diagnosis.

• Journal of Korean Neurosurgical Society
• /
• v.55 no.4
• /
• pp.195-199
• /
• 2014

Objective : Age is a strong predictor of mortality in traumatic brain injuries. A surgical decision making is difficult especially for the elderly patients with severe head injuries. We studied so-called 'withholding a life-saving surgery' over a two year period at a university hospital. Methods : We collected data from 227 elderly patients. In 35 patients with Glasgow Coma Score 3--8, 28 patients had lesions that required operation. A life-saving surgery was withheld in 15 patients either by doctors and/or the families (Group A). Surgery was performed in 13 patients (Group B). We retrospectively examined the medical records and radiological findings of these 28 patients. We calculated the predicted probability of 6 month mortality (IPM) and 6 month unfavorable outcome (IPU) to compare the result of decision by the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) calculator. Results : Types of the mass lesion did not affect on the surgical decision making. None of the motor score 1 underwent surgery, while all patients with reactive pupils underwent surgery. Causes of injury or episodes of hypoxia/hypotension might have affected on the decision making, however, their role was not distinct. All patients in the group A died. In the group B, the outcome was unfavorable in 11 of 13 patients. Patients with high IPM or IPU were more common in group A than group B. Wrong decisions brought futile cares. Conclusion : Ethical training and developing decision-making skills are necessary including shared decision making.

• Journal of Gastric Cancer
• /
• v.8 no.4
• /
• pp.244-249
• /
• 2008

Konkuk University Hospital (KUH), which opened in September 2005, is currently categorized as a secondary hospital. Early on after its establishment, the surgical residents and nurses were relatively inexperienced in the treatment of stomach cancer. Therefore, the quality of surgery for stomach cancer at KUH may be different from that of the existing large-scale tertiary hospitals. The purpose of this study is first to investigate the clinicopathological characteristics of the gastric cancer patients at the KUH, and second to compare our morbidity & mortality rates with those of previous studies, and we also analyzed the risk factors of morbidity at the early stage of a training hospital. Materials and Methods: This study retrospectively collected the clinicopathological characteristics and the post-operative morbidity rates and mortality rates with using the electronic medical records of all the patients who went under a gastric cancer operation at KUH from September 2005 to April 2008. Results: The total number of gastric cancer patients who underwent operation was 201. The morbidity rate and death rate at KUH were 10.4% and 0.5%, respectively. The morbidity has increased with an older age. The other variables had no influence on morbidity. Conclusion: The morbidity rate, death rate and the clinicopathological characteristics of gastric cancer patients at KUH were similar to those of the previous reports. We found that age is the main factor affecting the morbidity rate after stomach cancer surgery. For further surgical qualification of stomach cancer surgery at KUH, it is necessary to collect the survival data of patients who undergo stomach cancer surgery.

• Archives of Plastic Surgery
• /
• v.37 no.4
• /
• pp.391-395
• /
• 2010

Purpose: Given that the critical nature of the microvascular anastomosis to what is often a long and difficult reconstructive operation, trainees need to have a high level of microsurgical competence before being allowed to perform microsurgery on patients. Some artificial substitutes and dead or live animal models have been used to improve manual dexterity under the operating microscope. Yet, most surgeons are not equipped with such models, so search for easy available and appropriate microsurgical practice model have been an issue. Umbilical artery, placental vessels and gastroepiploic arteries have been previously suggested as a microsurgical training model, which involves other surgical departments. The purpose of this article is to introduce that saphenous vein specimen obtained from varicose vein surgery is useful and has many advantages as training model for the practice of microvascular anastomosis. Methods: The conventional technique using perforation/inversion method with a metallic stripper is widely performed for varicose vein patients. The stripper is inserted through disconnected safeno-femoral junction and retrieved at the knee or the medial side of ankle. The length of saphenous vein specimens removed is about that of one's leg and inversed from inside out. Obtained saphenous vein specimens are re-inversed and cleansed with normal saline, to be readily available for microsurgical practice. Preserved in a squeezed wet saline gauze and refrigerated, frozen or glycerated specimens were investigated into their comparative quality for microsurgical practice. Results: Varicose vein surgery remains one of the common operations performed in the field of plastic surgery. Convenient informed consent regarding the vessel donation can be easily signed. The diameter of the obtained saphenous vein is as variable as 1.5 to 6 mm, which is already stripped, and is in sufficient length corresponding to that of patient's leg. Vessels specimens were available for microsurgical practice within 1 week period when preserved with squeezed wet saline gauze, and the preservation period could be extended monthly by freezing it. Conclusion: Saphenous vein obtained from varicose vein patients provide with variable size of vessel lumen with sufficient length. The practice can be cost effective and does not require microsurgical laboratory. Additionally there is no need of involving other surgical departments in acquiring vessel specimens. Furthermore, simple preservation method of refrigerating for a week or freezing with squeezed wet saline gauze for a month period, allow the saphenous vein obtained after varicose vein surgery as an excellent model for the microsurgical practice.

• Journal of Korea Multimedia Society
• /
• v.23 no.3
• /
• pp.468-475
• /
• 2020

In this paper, we proposed a three-dimensional visualization system for medical images in augmented reality based on deep learning. In the proposed system, the artificial neural network model performed fully automatic segmentation of the region of lung and pulmonary nodule from chest CT images. After applying the three-dimensional volume rendering method to the segmented images, it was visualized in augmented reality devices. As a result of the experiment, when nodules were present in the region of lung, it could be easily distinguished with the naked eye. Also, the location and shape of the lesions were intuitively confirmed. The evaluation was accomplished by comparing automated segmentation results of the test dataset to the manual segmented image. Through the evaluation of the segmentation model, we obtained the region of lung DSC (Dice Similarity Coefficient) of 98.77%, precision of 98.45%, recall of 99.10%. And the region of pulmonary nodule DSC of 91.88%, precision of 93.05%, recall of 90.94%. If this proposed system will be applied in medical fields such as medical practice and medical education, it is expected that it can contribute to custom organ modeling, lesion analysis, and surgical education and training of patients.

• Journal of Veterinary Clinics
• /
• v.31 no.4
• /
• pp.278-281
• /
• 2014

The object of this study was to determine rate of ability restoration after arthroscopic surgeries in Thoroughbred racehorses. The racehorses that under arthroscopic surgery due to be injured his limbs were studied during exercise or training at Busan Race Park from 2005 to 2010. Rate of arthroscopic surgical treatments was 1.4% (63/4642). The results of arthroscopic surgery for the removal of osteochondral fragments from 70 limbs in 63 horses are reported. Number of patients under arthroscopic surgery were 63 and 58 horses were recovered from the surgeries and 5 horses were in training or resting at the time of publication. Only 52 of 58 horses had previous race experiences before the surgeries. Success horses of returned to the same level of performance were 31 horses (59.6%) and failed horses were 21 horses (40.4%). Average resting periods in success and failed horses were 7 months and 8.8 months, respectively. Resting periods in success horses were shorter than failed horses.