• Proceedings of the Korean Society of Precision Engineering Conference
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• 2003.06a
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• pp.1302-1305
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• 2003

In this paper we analyzed the effect of compliance mismatch with respect to the thickness variation of elastic foundation(fatty tissue) in end-to-end anastomosis. This study considered the preliminary deformed shape induced by suturing in the anastomosis of coronary artery and PTFE with different diameters using simplified suturing model and the fatty tissue surrounding heart and coronary artery for more accurate result using finite element method. Area compliance(C$\sub$A/) was used to analyze the final deformed shape of the anastomotic part with respect to the thickness variation of fatty tissue under mean blood pressure, 100 mmHg(13.3kPa). The results obtained were as follows : 1. When the elastic foundation, assumed to be incompressive material, surrounded the grafts in anastomosis, the compliance mismatch of artery and PTFE was improved by 47∼72%. 2. As the initial diameter ratio(R$\sub$I/) became larger, the higher difference of compliance was induced in spite of elastic foundation surrounding grafts.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.5
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• pp.650-656
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• 2012

This study was to investigate the origin of meridian through the relationship between Five Su Points and arteriovenous anastomosis. We searched traditional studies about origin of merdian and papers on relationship origin of merdian and blood vessels. As bibliographic search results, we got the conclusion that it is funtion of arteriovenous anastomosis and its anatomical position. Next we compared relationship between it and merdian. We found that Jeong-Acupuncture Points of Five-Su Points and Geun-Acupuncture Points of merdian have close relate to anatomical position(similarities). When we compared relationship between arteriovenous anastomosis and hypertension, we found that Biao Acupuncture Points and Geun Acupuncture Points of merdian have close relate to regulation of blood pressure and blood circulation. According to this results, Five Su Points and arteriovenous anastomosis have close relationship in anatomical position and regulatory function of blood pressure.

• Journal of Veterinary Clinics
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• v.21 no.4
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• pp.349-354
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• 2004

The effectiveness of a synthetic solution of sodium carboxymethy1cellulose (SCMC) and dextran in the prevention of adhesion formation following intestinal anastomosis of intestine in dogs was elucidated and compared with Interceed. Following induction of adhesion on jejunum of dogs by resection and intestinal anastomosis, the dogs were infused with a synthetic solution of 1% SCMC and 10% dextran in saline in the abdominal cavity at the dose of 5ml/kg of body weight or treated with Interceed membrane. Fourteen days after operation, all the dogs showed adhesion of anastomotic sites to surrounding tissues. The average score of adhesion was 0.50, 0.60 and 0.80 in the dogs infused with the synthetic solution, Interceed membrane and saline solution, respectively. The synthetic solution showed better result of adhesion prevention than Interceed or saline solution. No significant change of body weight, vital signs, hematological values and side effects after operation was found in each group. Therefore, a synthetic solution which is combined with 1% SCMC and 10% dextran in saline can be effectively used for the prevention of adhesion formation comparable to Interceed membrane following intestinal anastomosis in the dogs.

• Journal of Chest Surgery
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• v.33 no.8
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• pp.676-680
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• 2000

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.61-69
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• 1997

A total of 55 patients underwent surgical managements for postintubation tracheal stenosis from July 1975 through March 1997. All but 8 had received ventilatory assistance. The patients had S cuff lesions, 17 stoma lesions, 7 at both levels, 5 at subglottic lesions. Thirty two patients underwent the sleeve tracheal resection and end-to-end anastomosis. Five patients performed a wedge resection and end-to-end anastomosis. Twenty two patients received the Montgomery T-tube for relief of airway obstruction. Simple excision of granulation tissue was done in 7 patients. Rethi procedures(anterior division of cricoid cartilage, partial wedge resection of lower thyroid cartilage and T-tube molding) were performed in 2 subglottic stenosis patients. And the other subglottic patient was received permanent tracheal fenestration at 1975. The tracheoesophageal fistula patient was done sleeve tracheal resection and end-to-end anastomosis with interrupted double layer closure of esophageal fistula site. Cervical approach was used in 49 cases, cervicomediastinal in 13 cases and median stemotomy In 6 cases. Techniques for obtaining tension-free anastomosis included a cervical neck flexion(15-30$^{\circ}$) in all sleeve resection patients and laryngeal release in one. The length of resection was 1.5 to 5.0 on A total of 41 patients(74.5%) had good(24 patients) or satisfactory(17 patients) results. But in ten cases, the restenosis of anastomosis site which is the most common complication was developed Two of them underwent a second reconstruction and 8 patients required T-tube insertion for airway maintenance. Three patients(5.4%) died. The causes of death were tracheo-innominate artery fistula(2) and sudden obstruction of airway(1).

• Archives of Plastic Surgery
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• v.46 no.1
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• pp.46-56
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• 2019

Background When performing lymphovenous anastomosis, it is sometimes difficult to find venules in the proximity of an ideal lymphatic vessel that have a similar diameter to that of the lymphatic vessel. In this situation, larger venules can be used. Methods The authors evaluated the efficacy of and patient satisfaction with lymphovenous bypass with sleeve-in anastomosis. Between January 2014 and December 2016, we performed this procedure in 18 patients (eight upper extremities and 10 lower extremities) with secondary lymphedema. Lymphovenous bypass with sleeve-in anastomosis was performed under microscopy after injecting indocyanine green dye. The circumferential diameter was measured before lymphovenous bypass and at 1, 2, and 6 months after the procedure. An outcomes survey that included patients' qualitative satisfaction with lymphovenous bypass was conducted at 6 months postoperatively. Results Almost all patients showed quantitative improvements after surgery. The circumferential reduction rate in patients with stage II lymphedema of both the upper and lower extremities was significantly greater than in their counterparts with stage III/IV lymphedema. The circumferential reduction rate was lower in lower-extremity patients than in upper-extremity patients. Conclusions Lymphovenous bypass surgery with sleeve-in anastomosis in lymphedema patients is beneficial, and appears to be effective, when adequately-sized venules cannot be found in the proximity of an ideal lymphatic vessel.

• Journal of Gastric Cancer
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• v.12 no.3
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• pp.133-139
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• 2012

Laparoscopic gastrectomy has become widely used as a minimally invasive technique for the treatment of gastric cancer. When it was first introduced, most surgeons preferred a laparoscopic-assisted approach with a minilaparotomy rather than a totally laparoscopic procedure because of the technical challenges of achieving an intracorporeal anastomosis. Recently, with improved skills and instruments, several surgeons have reported the safety and feasibility of a totally laparoscopic gastrectomy with intracorporeal anastomosis. This review describes the recent technical advances in intracorporeal anastomoses using circular and linear staplers that allow for totally laparoscopic distal, total, and proximal gastrectomies. Data that demonstrate advantages in early surgical outcomes of a total laparoscopic method compared to laparoscopic-assisted operations are also discussed.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.635-641
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• 1987

Recently, direct atriopulmonary anastomosis was performed in 2 patients without using pericardium or prosthetic material. Case 1 A 13-year-old male patient whose diagnosis was tricuspid atresia [type lb] received direct atriopulmonary anastomosis successfully with good clinical and hemodynamic results. Nine months after operation, he has an increased exercise tolerance. Case 2 A 4-year-old female patient whose diagnosis was DORV with pulmonary atresia in A-V discordance had a formidable surgical challenge. A large-diameter direct atriopulmonary anastomosis was performed after the closure of the right atrioventricular valve. Her postoperative course has been even in 20th postoperative day.

• Journal of Biomedical Engineering Research
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• v.13 no.4
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• pp.313-322
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• 1992

A finite analytic(FA) numerical study was performed to determin'e flow dynamics in the vicinity of an end-to-end anastomosis. Experimental data of instantaneous lumen cross-section were used to simulate steady flow through an end-to-end anastomosis In order to solve the governing axisymmetric Wavier-Stokes equations. Wall shear stresses increased proximal to the anastomosis In flow from the Penrose tubing to the PTFE graft. In flow the PTFE graft to the Penrose tubing, low wall shear stresses were observed distal to the anastomosis. The present study suggests a correlation betweerl regions of low wall shear stress and the do velopment of pnastomotic neointimal fibrous hyperplasia(ANFH ) in end-to-end anastomoses.

• Journal of Korean Neurosurgical Society
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• v.58 no.5
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• pp.467-470
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• 2015

A 74-year-old patient was diagnosed with a subarachnoid hemorrhage suspected from a dissecting aneurysm located at the lateral medullary segment of the posterior inferior cerebellar artery (PICA). Because perforators to the medulla arose both proximal and distal to the dissecting segment, revascularization for distal flow was essential. However, several previously reported methods for anastomosis, such as an occipital artery-PICA bypass or resection with PICA end-to-end anastomosis could not be used. Ultimately, we performed an in situ side-to-side anastomosis of the proximal loop of the PICA with distal caudal loops within a single artery, as a "closing omega," followed by trapping of the dissected segment. The aneurysm was obliterated successfully, with intact patency of the revascularized PICA.