• Journal of Chest Surgery
• /
• v.31 no.7
• /
• pp.711-717
• /
• 1998

Background: Although various anastomotic techniques and suture materials have been used in esophageal anastomosis, anastomotic leakage and stenosis are still somewhat frequent and serious complications when compared to other intestinal anastomoses. We have used interrupted single-layer suture technique using monofilament polypropylene suture in various esophageal anastomoses, including repair of the esophageal atresia, since 1990. Methods and method: We retrospectively evaluated the efficacy of this technique on postoperative leakage and stenosis in several esophageal reconstructions. The esophageal reconstructions using this technique were performed in 90 patients at Dong-A University Hospital from April 1990 through December 1996. Results: Anastomotic leakage occurred in 5 patients(5.6%) with one operative death. Stenosis at the anastomotic site occurred in 15 patients(n=86, 17.4%), which was most common in esophagogastrostomy(22%) and least common in esophagocolostomy (5%). This result was comparable to other methods including the autosuture technique. Conclusions: We concluded that this suture technique in esophageal anastomosis can be used with reasonable results in various esophageal reconstructions including correction of the esophageal atresia.

• Journal of the Korean Arthroscopy Society
• /
• v.17 no.1
• /
• pp.95-99
• /
• 2013

We introduce arthroscopic Bankart repair technique using antegrade suture passer that can effectively restore detached anteroinferior capsulolabral complex for shoulder anterior instability. After diagnostic arthroscopy is performed using posterior, anteroinferior and anterosuperior portals, we confirm Bankart lesion and perform debridement and decortications of anteroinferior glenoid edge and neck. Suture anchor is inserted through anteroinferior portal at 2 mm medial side of glenoid edge (4:30 direction). Scorpion$^{TM}$ loaded suture is directly advanced to detached and retracted anteroinferior capsulolabral complex and the suture is passed at 10~15 mm medial side of detached anteroinferior capsulolabral complex (5:30 direction). The suture is retrieved by Scorpion's hook and then is tied using samsung medical center (SMC) sliding knot technique. Then suture anchors are serially inserted (2:30, 3:30) and capsulolabral complex repair is performed using suture hook and suttle-relay technique. This technique that can obtain anatomical restoration of anteroinferior glenohumeral ligament with proper tension is useful technique to reduce postoperative recurrence and makes it possible for less experienced surgeons.

• Journal of Chest Surgery
• /
• v.51 no.6
• /
• pp.423-426
• /
• 2018

This study determined the feasibility of the cuff technique for small-caliber vascular grafts in a rat model. A graft was implanted with the cuff technique or suture technique in a 1-cm segment of the abdominal aorta in 12 rats. The mean aortic clamp time was 29 minutes with the cuff technique and 44 minutes with the suture technique; the cuff technique was significantly shorter. Abdominal angiography at 1 week after implantation showed no significant stenosis in 9 rats, focal stenosis of the mid-portion of the graft in 1 rat with each technique, and total occlusion of the graft in 1 rat with the suture technique. We have successfully used the cuff technique for anastomosis for small-caliber vascular grafts in an animal model.

• The Academic Congress of Korean Shoulder and Elbow Society
• /
• 2001.03a
• /
• pp.24-25
• /
• 2001

• The Academic Congress of Korean Shoulder and Elbow Society
• /
• 2008.03a
• /
• pp.178-178
• /
• 2008

In order to improve static stability and healing of reattached labrum, we combined the advantages of suture bridge and transosseous technique. Using the conventional 3 portal for anterior instability, check stability of bony Bankart and preparation of glenoid bed in 3 way including removal, reshaping or mobilization of bony fragment. Two anchors were inserted to the superior and inferior portion and medial edge of bony Bankart lesion. It usually corresponded to the area of IGHL. Medial mattress sutures were applied around IGHL complex to get enough depth of glenoid coverage using suture hook. Make 3.5mm pushlock anchor hole to the articular edge of glenoid cartilage. Proximal suture bridge was applied at first and then distal suture bridge was inserted to mobilize the labrum in proximal direction. These construction can provide more stable labral repair with wide contact and compression in case of deficient bony stability. It not only avoids technical disadvantage of point contact with anchor fixation, but also decreasing gap formation through cross compression of labrum that couldn't gain even with the transosseous fixation which affords linear compression effect. Additional bony stability could be gained if the the bony fragment was mobilized to the glenoid margin with potential healing bed or reshaped for the good contact with reattached labrum.

• Clinics in Shoulder and Elbow
• /
• v.11 no.2
• /
• pp.82-89
• /
• 2008

Ideal rotator cuff repair is to maintain high fixation strength and minimize gap formation for optimizing the environment of biologic healing of tendon to bone. Among the current repair techniques, the suture bridge technique is superior to single- or double-row repair in ultimate load to failure, gap formation, restoring anatomical footprint and achieving pressurized contact area. The suture bridge technique also minimizes gap formation and has rotational and torsional resistances allowing early rehabilitation. However, despite superior biomechanical characteristics of the suture bridge technique, there is no evidence that these mechanical advantages result in better clinical outcomes. Furthermore, there is no difference in failure rates between the double-row repair and suture bridge techniques. An appropriate repair technique should be determined based on tear size and pattern and tendon quality.

• Journal of Korean Foot and Ankle Society
• /
• v.20 no.2
• /
• pp.73-77
• /
• 2016

Purpose: The purpose of this study was to evaluate the clinical outcome of a modified Kidner procedure using a suture bridge technique in symptomatic type II accessory navicular. Materials and Methods: Between January 2013 and December 2014, a total of 35 cases with symptomatic type II accessory navicular were treated with a modified Kidner procedure using the suture bridge technique. The patients were evaluated preoperatively, 3 months after surgery, and at the latest follow-up (at least six months postoperatively) clinically via the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, visual analogue scale (VAS), and the self-subjective satisfaction score. Results: The mean AOFAS midfoot score demonstrated significant improvement from a mean of 45.3 preoperatively to a mean of 89.2 at 3 months after surgery. At the latest follow-up, the mean AOFAS midfoot score was 92.6 (p<0.001). The mean VAS also improved significantly, decreasing from 6.7 out of 10 preoperatively to 1.8 at 3 months after surgery. At the latest follow-up, the VAS was 1.2 (p<0.001). The mean time of a single-limb heel raise was 4.6 months postoperatively and the self-subjective satisfaction score was 1.4 out of 4 at the latest follow-up. Conclusion: The short-term surgical results of the modified Kidner procedure with a suture bridge technique for symptomatic type II accessory navicular were good to excellent in terms of pain, functional and clinical assessments. In conclusion, the modified Kidner procedure with the suture bridge technique is a reasonable treatment option for symptomatic type II accessory navicular.

• Clinics in Shoulder and Elbow
• /
• v.18 no.4
• /
• pp.197-205
• /
• 2015

Background: The purpose of this study was to evaluate the postoperative magnetic resonance imaging (MRI) results of minimal-tying (one medial-row tie among 4 medial-row sutures) on the medial-row in double-row suture-bridge configuration ($2{\times}2$ anchor with $4{\times}4$ suture stands). Methods: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using $2{\times}2$ anchor double-row configuration. The mean age was 61.3 years (range, 31-81 years). Two double-loaded suture anchors were used for medial-row. Four medial-row stitches were made with only one medial-row knot-tying (the most anterior suture). Lateral-row was secured using the conventional suture-bridge anchor technique; all 4 strands were used for each anchor. Repair integrity was evaluated with MRI at mean 6.2 months postoperatively. Retear and the pattern of retear, change of fatty infiltration, and muscle atrophy of supraspinatus were evaluated using pre- and postoperative MRI. Results: Repaired tendon integrity was 38 for type I, 30 for type II, 6 for type III, 4 for type IV, and 1 for type V, according to Sugaya classification. Considering type IV/V as retear, the rate was 6.3% (5 out of 79 patients). Medial cuff failure was observed in 4 patients. Fatty atrophy of supraspinatus was significantly improved postoperatively according to Goutallier grading (p=0.01). The level of muscle atrophy of supraspinatus was not changed significantly after surgery. Conclusions: Minimal tying technique with suture configuration of four-by-four strand double-row suture-bridge yielded a lower retear rate (6.3%) in medium to large rotator cuff tears.

• Archives of Plastic Surgery
• /
• v.37 no.5
• /
• pp.650-658
• /
• 2010

Purpose: In the case of repair for far distal parts of FDP (Flexor digitorum profundus) division, the method of either pull-out suture or fixation of tendon to the distal phalanx is preferred. In this paper, the results of a modified loop suture technique used for the complete division of FDP from both zone 1a and distal parts of zone 1b in Moiemen classification are presented. Methods: From July 2006 to July 2009, the modified loop suture technique was used for the 10 cases of FDP in complete division from zone 1a and distal parts of zone 1b, especially where insertion sites were less than 1 cm apart from a tendon of a stump. In a suture technique, a loop is applied to each distal and proximal parts of tendon respectively. Core suture of 2-strand and epitendinous suture are done with PDS 4-0. Out of 10 patients, the study was done on 6 patients who were available for the followup. The average age of the patients was 49.1 years (in the range from 26 to 67). 5 males and 1 female patients were involved in this study. There were 3 cases with zone 1a and distal parts of zone 1b. The average distance to the distal tendon end was 0.6 cm. There were 5 cases underwent microsurgical repair where both artery and nerve divided. One case of only tendon displacement was presented. The dorsal protective splint was kept for 5 weeks on average. The results of the following tests were measured: active & passive range of motion, grip strength test, key pinch and pulp pinch test. Results: The follow-up period on average was 11 months, in the range from 2 to 20 months. There was no case of re-rupture, but tenolysis was performed in 1 cases. In all 6 cases, the average active range of motion of distal interphalangeal joint was 50.8 degree. The grip strength (ipsilateral/contralateral) was measured as 88.7% and the pulp pinch test was 79.2% as those of contralateral side. Flexion contracture was presented in 2 cases (15 degree on average) and there was no quadrigia effect found. Conclusion: Despite short length of tendon from the insertion site in FDS rupture in zone 1a and distal parts of zone 1b, sufficient functional recovery could be expected with the tendon to tendon repair using the modified loop suture technique.

• Journal of Minimally Invasive Surgery
• /
• v.21 no.4
• /
• pp.160-167
• /
• 2018

Purpose: The aim of our study was to present an abdominal wall closure technique using barbed suture $V-Loc^{TM}$ 90 after single incision laparoscopic appendectomy (SILA) and to compare perioperative outcomes with conventional layer by layer abdominal wall closure after SILA. Methods: From March 2014 to July 2016, a retrospective case-control study was conducted for a total of 269 consecutive patients who underwent SILA. According to abdominal wall closure methods, 129 patients were classified into the V-Loc closure group and 140 patients were assigned into the conventional layer by layer closure group. In the V-Loc group, abdominal wall closure was performed from the fascia to the skin with a single thread of unidirectional absorbable barbed suture $V-Loc^{TM}$ 90 2-0 using continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time ($40.0{\pm}15.4min$ vs. $44.9{\pm}16.3min$, p=0.013) and abdominal wall cusing continuous running suture and reverse overlapping reinforced running technique. Subcutaneous closure and subcuticular suture were performed with the remaining portion of V-Loc. Results: The V-Loc closure group showed shorter total operation time losure time ($5.5{\pm}0.9min$ vs. $6.5{\pm}0.8min$, p<0.001). Postoperative incision length was significantly shorter in the V-Loc closure group ($1.1{\pm}0.3cm$ vs. $1.8{\pm}0.4cm$, p<0.001). Postoperative wound pain, time to resume diet, postoperative hospital stay, complications including surgical site infection, or mean patient satisfaction score at one month after hospital discharge was not significantly different between the two groups. Conclusion: In conclusion, unidirectional knotless barbed suture is a safe alternative method for abdominal wall closure after SILA. It can save time while providing comparable cosmesis.