• Title/Summary/Keyword: guided surgery

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Difficult Intubation in Patients Undergone Oromaxillary Surgery: Retrospective Study (전신마취를 시행한 구강외과 환자에서 어려운 기관내삽관: 후향적 연구)

  • Kwon, O-Seon;Kim, Cheul-Hong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.8 no.2
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    • pp.118-121
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    • 2008
  • Background: This retrospective study aims to describe the airway management and to search predictive parameter for difficult intubation in 700 patients undergoing oromaxillary surgery. Methods: The medical records of 700 patients undergone oromaxillary surgery were reviewed for airway management during perioperative period. The cases of difficult intubation were selected and those radiologic findings were reviewed. The mandibular depth (MD), mandibular length (ML), thyromental distance (TMD) were measured. Results: In 41 cases difficult intubation were recorded in anesthetic record. The grade of Cormack and Lehane was III in 36 patients and IV in 5 cases. The MD of difficult intubation cases was $4.2{\pm}3.2\;cm$. The ML of difficult intubation cases was $10.1{\pm}3.8\;cm$. The TMD of difficult intubation cases was $5.9{\pm}4.3\;cm$. Under the fiberoptic guided awake intubation was undertaken in 75 patient. In none of the cases was failed nasotracheal intubation. Conclusions: The patients undergoing oromaxillar surgery have a potentially difficult airway but, if managed properly during perioperative preiod, morbidity and mortality can be reduced or avoided. The radiologic findings were poor predict for difficult intubation. The fiberoptic guided awake intubation is a safe alternative to direct laryngoscopic intubation.

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Musculoskeletal Ultrasound Intervention: Principles & Cautions (초음파를 이용한 침습적 치료: 원칙과 주의점)

  • Oh, Gun-Myung;Lee, Kyung Jae;Min, Byung-Woo;Kim, Dong-Wan
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.1
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    • pp.38-44
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    • 2013
  • The ultrasound can be used primarily to guide exact needle placement for aspirations of fluids, injections of steroid, and biopsies in musculoskeletal field. Recently, ultrasound-guided intervention is widely used because of several advantages such as real-time performance, relatively inexpensiveness, and getting multiple images without additional radiations. However, the modality is operator dependent and requires detailed knowledge of the relevant anatomy and there have been also reported serious complications related to the procedure. So, authors will discuss about the basic techniques, principles and cautions for the use of ultrasound-guided intervention in musculoskeletal field.

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Optical Imaging Technology for Real-time Tumor Monitoring

  • Shin, Yoo-kyoung;Eom, Joo Beom
    • Medical Lasers
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    • v.10 no.3
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    • pp.123-131
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    • 2021
  • Optical imaging modalities with properties of real-time, non-invasive, in vivo, and high resolution for image-guided surgery have been widely studied. In this review, we introduce two optical imaging systems, that could be the core of image-guided surgery and introduce the system configuration, implementation, and operation methods. First, we introduce the optical coherence tomography (OCT) system implemented by our research group. This system is implemented based on a swept-source, and the system has an axial resolution of 11 ㎛ and a lateral resolution of 22 ㎛. Second, we introduce a fluorescence imaging system. The fluorescence imaging system was implemented based on the absorption and fluorescence wavelength of indocyanine green (ICG), with a light-emitting diode (LED) light source. To confirm the performance of the two imaging systems, human malignant melanoma cells were injected into BALB/c nude mice to create a xenograft model and using this, OCT images of cancer and pathological slide images were compared. In addition, in a mouse model, an intravenous injection of indocyanine green was used with a fluorescence imaging system to detect real-time images moving along blood vessels and to detect sentinel lymph nodes, which could be very important for cancer staging. Finally, polarization-sensitive OCT to find the boundaries of cancer in real-time and real-time image-guided surgery using a developed contrast agent and fluorescence imaging system were introduced.

Comparison of the Clinical Outcomes of an Ultrasound-Guided and C-Arm Guided Cervical Nerve Root Block (초음파와 방사선 투시장치를 이용한 경추 신경근 차단술의 임상결과 비교)

  • Ha, Dae Ho;Shim, Dae Moo;Kim, Tae Kyun;Oh, Sung Kyun;Lee, Hyun Jun
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.78-84
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    • 2020
  • Purpose: This paper compares the clinical outcomes of patients who were treated with a cervical nerve block by ultrasound and C-arm and reports the complication. Materials and Methods: A total of 97 patients were treated with an ultrasound-guided nerve root block from May 1, 2015 to February 8, 2018. On the other hand, 94 patients were treated with a C-arm guided nerve root block. The consequences of the cervical pain and the radiating pain before and after the procedures were reviewed using the verbal numeric rating scale (VNRS). In addition, the complications related to the procedures from the daily notes from the chart were inspected. Results: Sixty-six cases out of 97 cases of ultrasound-guided nerve root block were enrolled in the study. The average age of the patients was 57 years, including 41 males and 25 females. Seventy seven out of 94 cases by a C-arm guided root block were included in the study. The average age of the patients was 55 years, including 40 males and 37 females. Before the nerve root block, the mean numeric rating pain scale (NRS) of the cervical pain in ultrasound-guided block decreased from 5.4 points to 2.7 points at three weeks and 1.4 points at six weeks (p=0.0023, p<0.001), and 3.1 points in the C-arm (p<0.001, p<0.001) at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the case of radiating pain, the mean NRS in the ultrasound-guided nerve root block group improved from 6.3 points after the procedure to 2.8 points at three weeks and 1.5 points at six weeks (p<0.001, p<0.001). In the C-arm guided nerve root block group, the NRS improved from 7.4 points after the procedure to 3.3 points at three weeks and 1.9 points at six weeks. In the case of complications, Horner's syndrome and propriospinal myoclonus were observed in one case of C-arm guided block group. Conclusion: The clinical results of the patients who underwent ultrasound-guided cervical nerve root block were not significantly different from those who underwent a C-arm guided cervical nerve root block.

The development of Frameless Image-Guided Surgery system based on magnetic field digitizers (마그네틱 센서를 이용한 영상유도 뇌정위 시스템 개발)

  • Woo, J.H.;Jang, D.P.;Kim, Y.S.;Kim, Sun-I.
    • Proceedings of the KOSOMBE Conference
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    • v.1998 no.11
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    • pp.269-270
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    • 1998
  • Image-guided surgery (IGS) system has become well known in the field of neurosurgery and spine surgery. A patient's anatomy is first registered to preoperatively acquired CT/ MRI data using the point matching algorithm. A magnetic field digitizer was used to measure the physical space data and the system was based on Workstation of Unix system. To evaluate the spatial accuracy of interactive IGS system, the phantom consisting of rods varied height and known location was used. The RMS error value between CT/MR images and real location was 3-4mm. For the more convenience of the surgery, we provide various image display modules.

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Imaging guided adrenalectomy with Indocyanine green fluorescence in a dog with a pheochromocytoma

  • Seung-yeon Yu;Sungin Lee
    • Journal of Veterinary Science
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    • v.25 no.4
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    • pp.53.1-53.6
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    • 2024
  • Importance: This case report presents the successful surgical removal of a pheochromocytoma in a dog using indocyanine green (ICG) fluorescence imaging. Case Presentation: A 10-year-old, 6.87 kg, spayed female poodle was referred for an abdominal mass and eight episodes of vomiting. Computed tomography revealed masses in the spleen and left adrenal gland. Based on the plasma normetanephrine levels, the patient was diagnosed with pheochromocytoma. Subsequently, a total splenectomy and left adrenalectomy were performed. A dose of 5 mg/kg ICG was administered intravenously 24 h prior to surgery. Using ICG allowed visualization of tumor margins, aiding in complete resection and minimizing anesthesia-related risks. Conclusions and Relevance: No evidence of recurrence or metastasis has been observed for 12 months. To our knowledge, this is the first report of the surgical removal of a pheochromocytoma using intraoperative ICG imaging in veterinary medicine. This case highlights the efficacy of ICG fluorescence imaging as a valuable tool for the surgical management of adrenal tumors in veterinary medicine.

Comparison of unprocessed silk cocoon and silk cocoon middle layer membranes for guided bone regeneration

  • Kim, Seong-Gon;Kim, Min-Keun;Kweon, HaeYong;Jo, You-Young;Lee, Kwang-Gill;Lee, Jeong Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.11.1-11.8
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    • 2016
  • Background: Silk cocoon is composed of multiple layers. The natural silk cocoon containing all layers was cut as a rectangular shape as defined as total group. The inner and outermost layers were removed from the total group and the remained mat was defined as the middle group. The objectives of this study was to compare the total group with the middle group as a barrier membrane for the guided bone regeneration. Methods: The effects of these materials on the cellular proliferation and alkaline phosphatase (ALP) expression of MG63 cells were explored. For comparing bone regeneration ability, bilateral bone defects were created in calvarial areas in ten adult New Zealand white rabbits. The defects were covered with silk membranes of the middle group, with silk membrane of the total group used as the control on the contralateral side. The defects were allowed to heal for 4 and 8 weeks. Micro-computerized tomography (${\mu}CT$) and histological examination were performed. Results: The middle group exhibited a higher MTT value 48 and 72 h after treatment compared to the total group. ALP expression was also higher in the middle group. The results of ${\mu}CT$ and histologic examination showed that new bone formation was significantly higher in the middle group compared to the total group 8 weeks postoperatively (P < 0.05). Conclusions: In conclusion, the middle layer of the silk cocoon supports guided bone regeneration better than unprocessed silk cocoon.

Outcome and Cost Effectiveness of Ultrasonographically Guided Surgical Clip Placement for Tumor Localization in Patients undergoing Neo-adjuvant Chemotherapy for Breast Cancer

  • Masroor, Imrana;Zeeshan, Sana;Afzal, Shaista;Sufian, Saira Naz;Ali, Madeeha;Khan, Shaista;Ahmad, Khabir
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8339-8343
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    • 2016
  • Background: To determine the outcome and cost saving by placing ultrasound guided surgical clips for tumor localization in patients undergoing neo-adjuvant chemotherapy for breast cancer. Materials and Methods: This retrospective cross sectional analytical study was conducted at the Department of Diagnostic Radiology, Aga Khan University Hospital, Karachi, Pakistan from January to December 2014. A sample of 25 women fulfilling our selection criteria was taken. All patients came to our department for ultrasound guided core biopsy of suspicious breast lesions and clip placement in the index lesion prior to neo-adjuvant chemotherapy. All the selected patients had biopsy proven breast cancer. Results: The mean age was $45{\pm}11.6years$. There were no complications seen after clip placement in terms of clip migration or hemorrhage. The cost of commercially available markers was approximately PKR 9,000 (US$ 90) and that of the surgical clip was PKR 900 (US$ 9). The cost of surgical clips in 25 patients was PKR 22,500 (US$ 225), when compared to the commercially available markers which may have incurred a cost of PKR 225,000 (US$ 2,250). The total cost saving for 25 patients was PKR 202,500 (US$ 2, 025), making it PKR 8100 (US$ 81) per patient. Conclusions: The results of our study show that ultrasound guided surgical clip placement in index lesions prior to neo-adjuvant therapy is a safe and cost effective method to identify tumor bed and response to treatment for further management.

AN EXPERIMENTAL STUDY OF GUIDED BONE REGENERATION OF BONE DEFECTS IN RABBIT USING RUBBER DAM (가토에서 러버댐을 이용한 골결손부의 골조직 유도 재생술에 관한 실험적 연구)

  • Jang, Chang-Dug;Whang, Hie-Seong;Shin, Sang-Hun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.2
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    • pp.110-119
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    • 1999
  • The principle of guided tissue regeneration (GTR), as applied to bone healing, is based on the prevention of connective tissue from entering the bony defect during the healing phase. This allows the slower bone producing cells to migrate into and reproduce bone within the defect. The principle of guided tissue regeneration has demonstrated a level of success in regenerating bone defect. Several types of membrane barrier, each one with distinct properties, have been utilized to apply this principle in bone regeneration. The purpose of this study is to introduce and discuss the attributes of rubber dam as a barrier membrane and evaluate whether improved bone regeneration can be achieved by GTR using rubber dam. In the 15 New Zealand white rabbits, full-thickness bone defects on three sites of each rabbit calvaria were made. Non membrane group served as a control and experimental group 1 was covered with rubber dam and group 2 covered with Gore-Tex$^{TM}$ membrane. Macroscopic, radiographic, microscopic examinations were made serially on 1, 2, 3, 6, 12 weeks after operation. The results were as follows: 1. Macroscopically, the control site was collapsed and filled with connective tissue throughout the experimental period. But the defects of experimental groups 1 and 2 were filled with bone-like mass and showed the hard consistency on palpation. 2. Radiographically, the early new bone formation appeared similarly from the host bone in groups 1 and 2. 3. Microscopically, there were much connective tissue at the central part of control site but the defect of group 1 and 2 was filled with the mature bony trabeculae on the 12th week. This results suggest that rubber dam can be effectively used as a barrier membrane for guided bone regeneration.

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Comparison of ultrasonography guided serratus anterior plane block and thoracic paravertebral block in video-assisted thoracoscopic surgery: a prospective randomized double-blind study

  • Baytar, Merve Sena;Yilmaz, Canan;Karasu, Derya;Baytar, Cagdas
    • The Korean Journal of Pain
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    • v.34 no.2
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    • pp.234-240
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    • 2021
  • Background: Various truncal block techniques with ultrasonography (USG) are becoming widespread to reduce postoperative pain and opioid requirements in video-assisted thoracoscopic surgery (VATS). The primary aim of our study was to determine whether the USG-guided serratus anterior plane block (SAPB) is as effective as the thoracic paravertebral block (TPVB) in VATS. Our secondary aim was to evaluate patient and surgeon satisfaction, block application time, first analgesic time, and length of hospital stay. Methods: Patients in Group SAPB received 0.4 mL/kg bupivacaine with a USG-guided SAPB, and patients in Group TPVB received 0.4 mL/kg bupivacaine with a USG-guided TPVB. We recorded the pain scores, the timing of the first analgesic requirement, the amount of tramadol consumption, and postoperative complications for 24 hours. We also recorded the block application time and length of hospital stay. Results: A total of 62 patients, with 31 in each group (Group SAPB and Group TPVB) completed the study. Between the two groups, there were no significant differences in rest and dynamic pain visual analog scale scores at 0, 1, 6, 12, and 24 hours after surgery. The total consumption of tramadol was significantly lower in the TPVB group (P = 0.026). The block application time was significantly shorter in Group SAPB (P < 0.001). Conclusions: An SAPB that is applied safely and rapidly as a part of multimodal analgesia in patients who undergo VATS is not inferior to the TPVB and can be an alternative to it.