• Title/Summary/Keyword: Suture technique

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Correction of Cup Ear using the Mattress suture (매트리스봉합을 이용한 수축귀의 교정)

  • Jang, Soo Won;Lee, Jang Hyun;Choi, Seung Suk;Tak, Min Sung
    • Archives of Plastic Surgery
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    • v.36 no.1
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    • pp.118-121
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    • 2009
  • Purpose: Constricted ear, which is named by Tanzer includes lop ear, cup ear, and sort of prominent ear. It has classified three groups by Tanzer, especially grou I and IIA have been corrected by banner flap, Musgrave's technique, tumbling concha - cartilage flap, reversed banner flap and others. However, these techniques were too invasive for correcting mild degree of deformity. Therefore, we corrected the ear with mattress suture which is simple and less invasive. Method: The operations were done against 5 patients from 2005 March to 2008 April. All the cases were unilateral ears with constriction included helix and scaphoid fossa without difference in length between both ears. Though a posterior auricular skin incision, the folded cartilage is exposed and two parallel incisions on superior crus were made. After mattress suturing in cartilage, the superior crus of antihelix was formed and its force enables the folded portion to be in a normal anatomic position. Result: All of 5 patients got satisfactory results. There were no complications like hematoma or skin necrosis, and no recurrence during follow - up period(the average period was 9 months). And we couldn't recognize the difference between height of both auricles. Conclusion: Mattress suture is simple, less invasive, and suitable on correcting mild deformity of constricted ear with better result, so here we suggest the method.

Laparoscopic Reinforcement Suture (LARS) on Staple Line of Duodenal Stump Using Barbed Suture in Laparoscopic Gastrectomy for Gastric Cancer: a Prospective Single Arm Phase II Study

  • Kim, Min Chan;Kim, Sang Yun;Kim, Kwan Woo
    • Journal of Gastric Cancer
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    • v.17 no.4
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    • pp.354-362
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    • 2017
  • Purpose: Laparoscopic gastrectomy is accepted as a standard treatment for patients with early gastric cancer in Korea, Japan, and China. However, duodenal stump leakage remains a fatal complication after gastrectomy. We conducted a prospective phase II study to evaluate the safety of the new technique of laparoscopic reinforcement suture (LARS) on the duodenal stump. Materials and Methods: The estimated number of patients required for this study was 100 for a period of 18 months. Inclusion criteria were histologically proven gastric adenocarcinoma treated with laparoscopic distal or total gastrectomy and Billroth II or Roux-en-Y reconstruction. The primary endpoint was the incidence of duodenal stump leakage within the first 30 postoperative days. The secondary endpoints were early postoperative outcomes until discharge. Results: One hundred patients were enrolled between February 2016 and March 2017. The study groups consisted of 65 male and 35 female patients with a mean age (years) of 62.3. Of these, 63 (63%) patients had comorbidities. The mean number of retrieved lymph nodes was 38. The mean operation time was 145 minutes including 7.8 minutes of mean LARS time. There was no occurrence of duodenal stump leakage. Thirteen complications occurred, with one case of reoperation for splenic artery rupture and one case of mortality. Conclusions: Based on the results of this prospective phase II study, LARS can be safely performed in a short operation period without development of duodenal stump leakage. A future randomized prospective controlled trial is required to confirm the surgical benefit of LARS compared to non-LARS.

A Clinical Study of Patent Ductus Arteriosus (동맥관 개존증의 임상적 고찰)

  • Jo, Jung-Gu;Park, Geon-Ju;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.18 no.4
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    • pp.574-581
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    • 1985
  • Surgical treatment for PDA has been pivotal in historical development of surgery for congenital heart disease. A clinical study on 36 cases of operated PDA were performed during period from Aug. 1981 to Jul. 1985 at the Department of Thoracic & Cardiovascular Surgery in Chonbuk University. The following results are obtained. 1. The 8 males and 28 females ranged in age from 2 yrs, to 24 yrs, [mean 11 yrs.] 2. Chief complaints of the patients were dyspnea on exertion in 61%, palpitation in 39%, frequent URI in 12%, and no subjective symptoms in 11%. 3. On auscultation, continuous machinery murmur heard in 94% and systolic in 14%. 4. Radiologic findings of chest P-A showed increased density of pulmonary vascularity in 94%, cardiomegaly in 69%, and within normal limits in 5% of the patients. 5. EKG findings of the patients revealed LVH in 69%, RVH in 6%, BVH in 6%, and within normal limits in 17%. 6. Of the 36 patients, cardiac catheterization was performed in 34 patients. The results showed mean Qp/Qs = 2.25, mean Pp/Ps=0.42, and mean systolic pulmonary arterial pressure=53mmHg. 7. Surgical methods were as followed: The 32 case of ductal ligation and one case of division & suture technique for PDA through the left posterolateral thoracotomy were done. And 2 cases of ductal ligation one suture closure through the pulmonary artery were performed under the cardiopulmonary bypass. 8. Intraoperative complication was ductal rupture with division 8< suture for PDA and transient hoarseness in 1, recanalization in 1, and urethral stricture in 1 case postoperatively. 9. One patient died due to ductal rupture intraoperatively and operative mortality was 2.8%.

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A CASE PEPORT OF A DERMOID CYST IN THE FLOOR OF THE MOUTH (설하부에 발생한 류피양종의 치험보고)

  • Pyun, Yong-Sung
    • The Journal of the Korean dental association
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    • v.9 no.10
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    • pp.607-609
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    • 1971
  • The author has diagnosed and treated the dermold cyst patient in the 41 years old korean man. The dermold cyst in the floor of the mouth had various sign and symptom such as elevated tongue, disturbance of speech and swallowing, and etc. The cyst wall of dermoid cyst was enucleated by using of direct enucleation of cyst wall and primary suture technique. The mass of the enucleated dermoid cyst was 5×5.5×6 Cm.in size.

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Reduction Aortoplasty with Suture Plication Technique for Dilatation of the Ascending Aorta associated with Aortic Valve Disease (대동맥판막 질환과 동반된 상행대동맥 확장에 대한 봉합봉축법에 의한 대동맥 축소성형술)

  • Na Chan-Young;Oh Sam-Sae;Lee Chang-Ha;Whang Seong Wook;Lee Cheol;Lim Hong Gook;Kim Jae Hyun;Seo Hong Ju;Kim Gun Gyk;Baek Man-Jong
    • Journal of Chest Surgery
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    • v.38 no.3 s.248
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    • pp.221-228
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    • 2005
  • Reduction aortoplasty has been advocated for dilatation of the ascending aorta associated with aortic valve disease in older, high-risk patients. We report our results with modification of reduction aortoplasty and aortic valve replacement. Material and Method: Between July 2001 and December 2002, 14 consecutive patients who underwent modification of reduction aortoplasty, suture plication technique without excision of the dilated aortic wall, were reviewed. The mean age was 63.7$\pm$6.7 (50 to 75) years. Ten patients had congenital bicuspid aortic valve, Twelve patients had severe aortic valve stenosis and 6 had regurgitation of grade III$\~$IV. The diameter of the ascending aorta was measured before and immediately after surgery and 6 and 12 months postoperatively using echocardiography or computed tomography. Follow-up was complete in an average of 14.7$\~$5.4 (7 to 24) months. Result: There were no early postoperative deaths and no bleeding complications. Reduction aortoplasty with suture plication technique decreased the diameter of ascending aorta from 49.4$\pm$3.5 mm preoperatively to 33.2$\pm$3.4 mm postoperatively (p <0.001). During follow-up, there were no late deaths and no aneurysm recurrence on the ascending aorta. Conclusion: Suture plication technique of reduction aortoplasty without excision of the dilated aortic wall offers good early and short-term results in older, high-risk patients with dilatation of the ascending aorta associated with aortic valve disease. Surgical long-term results of our technique should be evaluated in further studies.

Outcome of Arthroscopic Suture Bridge Technique for Rotator Cuff Tear: Short Term Clinical Outcome In Full-thickness Tear With Fatty Degeneration Less Than Moderate Degree (회전근 개 파열에 대한 관절경적 교량형 봉합술의 결과: 지방 변성이 중등도 이하인 전층 파열에 대한 단기 추시 임상적 결과)

  • Cheon, Sang-Jin;Hur, Joon-Oh;Suh, Jeung-Tak;Yoo, Chong-Il
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.180-188
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    • 2009
  • Purpose: We evaluate the short-term clinical outcome of arthroscopic rotator cuff tendon repair with suture-bridge technique in patients with full thickness rotator cuff tear. Materials and Methods: 29 (male:17, female:12) consecutive shoulders treated with this index procedure and early rehabilitation were enrolled. Mean age was 56.4 years (range, 34~73 years) and mean follow-up period was 13 months (range, 12-15 months). Clinical outcomes were evaluated by using the University of California Los Angeles (UCLA) score, the Korean Shoulder Scoring System (KSS) and Visual Analogue Scale (VAS). Postoperative cuff integrity was evaluated through magnetic resonance imaging (MRI) and categorized by Sugaya classification. Results: Postoperative UCLA scores improved from 16.4 to 31.6 (p< 0.05) and KSS scores showed 88 at 6 months and 92 at last follow up. Preoperative VAS score was 8.6, which was decreased to 2.1 at 3 months and 1.4 at 6 months postoperatively. 28 patients (96.5%) had increase in range of motion. The follow up MRI was taken in 15 shoulders and the cuff integrity was type I in 6 cases, type II in 7, type III in 1 and type V in 1 by Sugaya classification. Conclusion: Arthroscopic suture-bridge technique resulted in good or excellent clinical outcome in 96.5% of the cases, so we think this technique is one of the reliable procedure for full-thicknes rotator cuff tear.

Surgical Repair of Achilles Tendon Rupture by Minimal Incision Technique (최소 절개 기법에 의한 아킬레스건 파열의 수술적 봉합술)

  • Jung, Hong-Geun;Paik, Ho-Dong
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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    • pp.173-178
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    • 2005
  • Propose: There have been many debates about the ideal surgical technique for acute Achilles tendon rupture. The purpose of this study is to review and analyze the clinical outcome of the acute Achilles tendon ruptures that had been repaired by indirect suture technique with minimal incision that utilized an instrument called Achillon (Newdeal, France). Materials and Methods: This study is based on the 14 cases (14 patients) of acute Achilles tendon total ruptures that have been repaired by minimal incision technique utilizing Achillon instrument from June 2003 to December 2004. Two cases were reruptured before 8 weeks and repaired again using Krackow suture which left 12 feet for postoperative functional evaluation with at least 6 months of follow-up. Ten cases were men and average age at time of injury was 34.4 (26-49) years. The time from injury to surgery was an average of 4.5 (1-9) days and the postoperative evaluations were done by an Arner-Lindholm scale and AOFAS score. The ability to return to original work and sports activities as well as patient satisfaction were also evaluated. Results: The follow-up period was averaged for 13.2 (6-24) months. Seventy-one percent of cases were ruptured during sports activities. The ruptured level was the average of 5.1 cm (3.2-8 cm) above calcaneal attachment and the skin incision was averaged for 2.7 cm (2.5-3.0 cm) long. At final follow-up, standing on tip-toe was possible in all cases while the heel-floor height on ruptured side was shorter by 0.7 cm (0-2 cm). By Arner-Lindholm evaluation scale, 9 cases were excellent, and 3 cases were good. Overall AOFAS score was an average of 96.1 (94-100), and all patients were satisfied with the result. Patients returned to work at an average of 1.3 months after the surgery and pre-injury sports activities were all possible from at 6 months after operation. Conclusion: Since we have treated acute Achilles tendon ruptures with minimal incision technique utilizing the Achillon and gained encouraging functional results with all patients returning to previous work with high patient satisfaction, this technique could be recommended as one of the ideal surgical options for the Achilles tendon ruptures.

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Arthroscopic Full-Thickness Rotator Cuff Repair in Elderly Patients (고령 환자의 관절경적 회전근 개 봉합술의 결과)

  • Cheon, Sang Jin;Lee, Dong Ho;Park, Yong Geon;Son, Seung Min
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.38-45
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    • 2020
  • Purpose: To examine the clinical and structural outcomes of an at least two-year follow-up of arthroscopic full-thickness rotator cuff repairs with a single-row or suture-bridge technique in patients more than 65 years of age. Materials and Methods: Patients diagnosed with a full-thickness rotator cuff tear who were more than 65 years of age, underwent arthroscopic rotator cuff repair after at least six months of conservative treatment, agreed to take a follow-up magnetic resonance imaging (MRI) six months postoperatively, and visited outpatient for at least two years were enrolled in this study. Clinical evaluations were done using The University of California Los Angeles score, Constant Shoulder Score, and visual analogue scale evaluated two years after the surgery. The structural integrity was analyzed using follow-up MRI. During surgery, a suture-bridge technique was used if the rotator cuff tendon could cover half of the footprint under constant tension. Otherwise, single-row repair was performed. Results: The samples were 158 cases, consisting of 93 single-repairs and 65 suture-bridge repairs. A preoperative comparison of the age distribution, fatty degeneration of supraspinatus and infraspinatus muscle, medial retraction of torn cuff tendon, and tear size between the two groups were not significant. The clinical scores were improved significantly in all cases. The distribution of the structural integrity by Sugaya classification were 49 cases in type 1 (31.0%), 62 cases in type 2 (39.2%), 30 cases in type 3 (19.0%), 11 cases in type 4 (7.0%), and six cases in type 5 (3.8%). The re-tear rate of the single-row group was 9.7% (nine out of 93 cases) and 12.3% (eight out of 65 cases) for the suture-bridge group. Conclusion: Satisfactory clinical and radiological outcomes were achieved after arthroscopic full-thickness rotator cuff repair in patients more than 65 years of age. Both single-row and suture-bridge techniques would be beneficial for the elderly.

Periareolar Augmentation Mastopexy with Interlocking Gore-Tex Suture, Retrospective Review of 50 Consecutive Patients

  • Franco, Johnny;Kelly, Emma;Kelly, Michael
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.728-733
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    • 2014
  • Background Periareolar Augmentation Mastopexy is one of the most challenging operations in plastic surgery. Problems with scar quality, areolar widening, and distortion are frequent problems that interfere with a predictable result. Methods A retrospective review was performed on fifty consecutive patients who underwent a periareolar augmentation mastopexy with the interlocking approach. Of the 50 patients, 30 had both preoperative and postoperative photographs and were the basis of the study. Results The age of the patients ranged from 19 to 56 years with the average age being 39 years. The postoperative follow-up averaged 9.5 months and the implants averaged 316 mL. There were no deaths, pulmonary embolism, deep vein thrombosis, or infected implants. Four patients had complications following surgery for an overall complication rate of 13%. Two patients developed an infected Gore-Tex suture. Two of these complications were treated with revision surgery. Five patients required reoperation for an overall reoperative rate of 16% (one patient was converted to a full mastopexy). Conclusions As a result of this retrospective study, we have found the interlocking approach to periareolar augmentation/mastopexy to be a safe and reliable operation.