• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.485-497
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• 2017

Surgical treatment of the degenerative disc disease has evolved from traditional open spine surgery to minimally invasive spine surgery including endoscopic spine surgery. Constant improvement in the imaging modality especially with introduction of the magnetic resonance imaging, it is possible to identify culprit degenerated disc segment and again with the discography it is possible to diagnose the pain generator and pathological degenerated disc very precisely and its treatment with minimally invasive approach. With improvements in the optics, high resolution camera, light source, high speed burr, irrigation pump etc, minimally invasive spine surgeries can be performed with various endoscopic techniques for lumbar, cervical and thoracic regions. Advantages of endoscopic spine surgeries are less tissue dissection and muscle trauma, reduced blood loss, less damage to the epidural blood supply and consequent epidural fibrosis and scarring, reduced hospital stay, early functional recovery and improvement in the quality of life & better cosmesis. With precise indication, proper diagnosis and good training, the endoscopic spine surgery can give equally good result as open spine surgery. Initially, endoscopic technique was restricted to the lumbar region but now it also can be used for cervical and thoracic disc herniations. Previously endoscopy was used for disc herniations which were contained without migration but now days it is used for highly up and down migrated disc herniations as well. Use of endoscopic technique in lumbar region was restricted to disc herniations but gradually it is also used for spinal canal stenosis and endoscopic assisted fusion surgeries. Endoscopic spine surgery can play important role in the treatment of adolescent disc herniations especially for the persons who engage in the competitive sports and the athletes where less tissue trauma, cosmesis and early functional recovery is desirable. From simple chemonucleolysis to current day endoscopic procedures the history of minimally invasive spine surgery is interesting. Appropriate indications, clear imaging prior to surgery and preplanning are keys to successful outcome. In this article basic procedures of percutaneous endoscopic lumbar discectomy through transforaminal and interlaminar routes, percutaneous endoscopic cervical discectomy, percutaneous endoscopic posterior cervical foraminotomy and percutaneous endoscopic thoracic discectomy are discussed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제45권5호
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• pp.241-253
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• 2019

This study evaluated and compared the donor site morbidity following minimally invasive and conventional open harvesting of iliac bone for secondary alveolar bone grafting in cleft palate patients. A thorough electronic search of PubMed, Google Scholar, EMBASE, and an institutional library and manual search of various journals was done; Inclusion criteria: 1) full-text articles using a minimally invasive or conventional open harvesting technique for iliac bone for secondary alveolar grafting in cleft palate patients and 2) articles published between January 1, 2001 and June 30, 2017 and Exclusion criteria: 1) articles published in languages other than English, 2) case reports, case series, animal studies, in vitro studies, and letters to the editor, and 3) full-text article unavailable even after writing to the authors. Preliminary screening of 274 studies excluded 223 studies for not meeting the eligibility criteria. Of the remaining 51 studies, 19 were removed for being duplicates. Of the remaining 32 studies, 15 were excluded after reading the abstract. Of the 17 studies that were left, 2 were excluded because they were in a language other than English, and 2 were excluded because the study group did not mention cleft palate patients. Thus, 13 studies providing results for a total of 654 patients were included in this qualitative synthesis. Minimally invasive bone graft harvest techniques are better than the conventional open iliac bone harvest method because they offer shorter operative time, decreased requirement for pain medications, less pain on discharge, and a shorter hospital stay.

• 대한두경부종양학회지
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• 제15권2호
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• pp.194-199
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• 1999

Introduction: Since 1996, Dr. James Norman has successfully performed mimimally invasive radio-guided parathyroidectomy(MIRP) using intraoperative nuclear mapping with $^{99m}Tc$ sestamibi scanning and radioactivity detection probe. Objectives: We aimed to introduce this new surgical technique and evaluate it's efficacy by our own experiences. Method: From May to October 1999, five consecutive patients with primary hyperparathyroidism underwent parathyroidectomy by using modified MIRP technique. $^{99m}Tc$ sestamibi scanning was performed 1.0 or 1.5 hour before operation. After intraoperative localization of the tumor under the guidance of quantitative gamma counting with a NEVIGATOR probe, an unilateral small skin incision(3.0-4.0cm) was placed. Without a skin flap, the strap muscle was directly divided with the use of a Harmonic scalpel. After careful dissection, the parathyroid tumor was removed. Result: In all patients, a single adenoma could be easily detected and removed by this new technique. Mean incision length was 3.2cm(3.0-4.0cm) and operative time ranged from 40 to 110minute. All the patients were discharged within 2 days of surgery without any complication. Conclusion: This new operative technique could become the most minimally invasive alternative to the standard operative procedure for parathyroid adenoma.

• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.597-603
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• 2017

Objective : Several surgical methods have been reported for treatment of ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine. Despite rapid innovation of instruments and techniques for spinal surgery, the postoperative outcomes are not always favorable. This article reports a minimally invasive anterior decompression technique without instrumented fusion, which was modified from the conventional procedure. The authors present 2 cases of huge beak-type OPLL. Patients underwent minimally invasive anterior decompression without fusion. This method created a space on the ventral side of the OPLL without violating global thoracic spinal stability. Via this space, the OPLL and anterior lateral side of the dural sac can be seen and manipulated directly. Then, total removal of the OPLL was accomplished. No orthosis was needed. In this article, we share our key technique and concepts for treatment of huge thoracic OPLL. Methods : Case 1. 51-year-old female was referred to our hospital with right lower limb radiating pain and paresis. Thoracic OPLL at T6-7 had been identified at our hospital, and conservative treatment had been tried without success. Case 2. This 54-year-old female with a 6-month history of progressive gait disturbance and bilateral lower extremity radiating pain (right>left) was admitted to our institute. She also had hypoesthesia in both lower legs. Her symptoms had been gradually progressing. Computed tomography scans showed massive OPLL at the T9-10 level. Magnetic resonance imaging of the thoracolumbar spine demonstrated ventral bony masses with severe anterior compression of the spinal cord at the same level. Results : We used this surgical method in 2 patients with a huge beaked-type OPLL in the thoracic level. Complete removal of the OPLL via anterior decompression without instrumented fusion was accomplished. The 1st case had no intraoperative or postoperative complications, and the 2nd case had 1 intraoperative complication (dural tear) and no postoperative complications. There were no residual symptoms of the lower extremities. Conclusion : This surgical technique allows the surgeon to safely and effectively perform minimally invasive anterior decompression without instrumented fusion via a transthoracic approach for thoracic OPLL. It can be applied at the mid and lower level of the thoracic spine and could become a standard procedure for treatment of huge beak-type thoracic OPLL.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2015년도 제46회 하계학술대회
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• pp.1229-1230
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• 2015

Monitoring of mechanical properties of tissues as well as direction/quantities of forces is considered as an essential way for disease diagnosis and haptic feedback systems. There are extensively increasing interests for measuring normal/shear force and touch feelings, especially for surgery systems. Highly sensitive and flexible tactile sensor is needed in palpation for detecting cancer cyst as well as real time pressure monitoring in minimally invasive surgery (MIS). Importantly, MEMS technique with miniaturized fabrication technique is essential for the on-chip integration with biopsy and biomedical grasper. Here, we propose the flexible tactile sensor with high sensitivity based on piezoresistive effect. We analyzed the sensitivity according to the pressure and directions and showed the ability of discrimination of the different materials surfaces, illustrating the feasibility of the flexible tactile sensor for biomedical grasper by mimicking human skin.

• Journal of Chest Surgery
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• 제49권1호
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• pp.70-72
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• 2016

The single-suture neochorda-folding plasty technique is a modification of existing mitral valve repair techniques. In the authors' experience, its simplicity, reliability, and versatility make it a useful technique for mitral valve repair, especially when a minimally invasive approach is used.

• Journal of Chest Surgery
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• 제49권1호
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• pp.1-8
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• 2016

More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950's, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft $f{\ddot{u}}r$ osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has becomeavailable suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2007년도 춘계학술대회A
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• pp.378-383
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• 2007

As the Minimally Invasive Surgery (MIS) is developed, an interventional procedure becomes the major of the spine surgery in the world. Despite of the use of the expensive medical equipments, the success chance of the nucleoplasty is about 30%. The reason is that the shape of the cannular needle is similar to that of the conventional injector and looks like the straight. Because the tip of these straight needles is not able to reach in the vicinity of the disc bulging or the protrusion, which are the cause of the low back pain and because the far indirect plasma discharge results in the decompression, the nucleoplasty has the limit. Many incurable diseases has not been solved due to the unexistence of the advanced technique for the MIS human body cannula device. If 3-D direction controllable cannular catheter (whose direction is accurately controlled after inserting into the bodies to cure the lesion) is developed, it is expected that new devised cannular catheter can cure many incurable diseases simultaneously. Therefore, the aims of this research are to develop the new devised cannular catheter of SMA direction controller for the medical situation, which has been produced through many previous trial-error procedures, and to produce the commercial medical device.

• Journal of Korean Neurosurgical Society
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• 제40권4호
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• pp.296-299
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• 2006

Recently the trend of surgical procedure for treatment of lumbar benign disease is a minimally invasive surgery due to small incision, minimal blood loss, and a short hospital day. By using a microscope or an endoscope, and other surgical equipment, a delicate manipulation in a narrow space became feasible, consequently, to secure a wider view with small incision, appropriate retractors are required. But the various tubular retractor systems are expensive and have some problems. We modified Thoracoport [Auto Suture Co., Norwalk, CT] by making a window at the distal end of trocar and used it as a tubular retractor in surgical procedure for treatment of lumbar benign disease. This modified tubular retractor is docked closely on the curved lamina and provides a wider view. We used it as a tubular retractor also in lumbar bilateral decompression involving a unilateral approach. But this trocar has the limited sizes [diameter and length], and also it is difficult to fix the retractor or change the direction of retractor. And then, we propose a more modified Thoracoport with various sizes and attaching the settling holders to the head of tubular retractor to be able to fix the retractor.

• Journal of Veterinary Science
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• 제23권2호
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• pp.38.1-38.13
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• 2022

Background: Minimally invasive surgery (MIS) technique of sacroiliac luxation in toy breed dogs using cannulated screws has not been described. Objectives: The purpose of this study was to evaluate the effectiveness of pelvic canal recovery, the reproducibility of successful surgery outcomes, and the acceptable difficulty of the procedure in MIS of sacroiliac luxation in toy breed dogs. Methods: MIS using 2.3-mm cannulated screws was demonstrated in 12 toy breed dog cadavers with sacroiliac luxation artificially induced. Pre and postoperative radiographs were used to evaluate the pelvic canal diameter ratio (PCDR), hemipelvic canal width ratio (HCWR), and reduction rate. Dorsoventral angle (DVA) and craniocaudal angle (CCA) of the inserted screw were obtained postoperative computed tomographic scan. Results: The statistically significant difference between the mean pre and postoperative PCDR was found (1.10 ± 0.12 and 1.26 ± 0.11, respectively; p = 0.002), and the mean HCWR close to 1.0 meaning symmetric pelvis also was obtained (0.97 ± 0.07). The mean DVA and CCA were 2.26° ± 1.33° and 2.60° ± 1.86°, respectively. Conclusions: MIS of sacroiliac luxation using 2.3-mm cannulated screws is applicable to toy breed dogs with acceptable difficulty.