• Title/Summary/Keyword: surgical blood use

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The Pringle maneuver in the modern era: A review of techniques for hepatic inflow occlusion in minimally invasive liver resection

  • Omar A. Mownah;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.131-140
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    • 2023
  • During minimally invasive liver resection (MILR), the Pringle maneuver aims to minimize blood loss and provide a clear operative field, thereby identifying intrahepatic structures and facilitating safe parenchymal transection. Several techniques for using the Pringle maneuver in MILR have been described. This review presents various methods which have been reported in the literature. A systematic literature search used the MEDLINE/PubMed database from its earliest records to August 2022 using appropriate search headings and keywords. The primary outcome was identifying techniques for performing hepatic inflow occlusion during laparoscopic/robotic hepatectomy. Inclusion criteria consisted of publications describing technical steps to obtain hepatic inflow occlusion during minimally invasive hepatectomy. A literature search identified 23 relevant publications, and the full texts were examined. The techniques described in the reports can be broadly categorized into three groups: (1) the Rummel-tourniquet technique, (2) vascular clamp use, and (3) the Huang Loop technique. Various techniques have been used in MILR to achieve inflow confinement successfully. The authors prefer the modified Huang Loop technique because it is inexpensive, reliable, and quick to apply or release. Hepatobiliary surgeons are advised to familiarize themselves with these MILR techniques, which have proven effective and safe inflow occlusion.

Study on Application of the Colla Corii Asini Blended Prescription from The Dongeuybogam (동의보감(東醫寶鑑)중 아교(阿膠)가 배오(配俉)된 처방(處方)의 활용(活用)에 대한 고찰(考察))

  • Kim, Chae-Hyun;Jeung, Jong-Kil
    • Herbal Formula Science
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    • v.15 no.2
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    • pp.79-87
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    • 2007
  • This study was investigated to make sure the range of the Colla Corii Asini treatment. the nature of disease and the pathology of it in D ongeuyboga. The following conclusion were reached through invetigations on the prescriptions that use the Colla Corii Asini as a ingredient. 1. The Colla Corii Asini was used a internal disease more than a surgical disease in the dongeuybogam. 2. The Colla Corii Asini was used lung and large intestine disease in abundance and especially anhidrosis. cough and dysentery. 3. The Colla Corii Asini was applied much more disease about blood in the dongeuybogam, but some was used almost bleeding disease. one was used blood deficiency. 4. The processed Colla Corii Asini was used more than the Colla Corii Asini in the dongeuybogam, because of convenience of preparation and ease of intestinla drug absorption. 5. The Colla Corii Asini was used more useful dysentery than tranquilizeing mind in cooperation with Rhizoma Coptidis in the dongeuybogam. 6. Instead of the Colla Corii Asini, we can apply the Colla Comus Cervi or they are mutual reinforcement.

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Use Biologic Fibrin Adhesive in Otologic Surgery : Compared with Ammonium Sulfate Fibrin Adhesive and Tisseel$^{(R)}$ (중이수술에 인체에서 추출한 Fibrin 접착제의 이용 : Ammonium Sulfate fibrin 접착제와 Tisseel$^{(R)}$의 비교)

  • Lee, Hyung-Chul;Yang, Mi-Gyeung;Park, Mun-Heum
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.127-135
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    • 1991
  • Successful middle ear surgery requires the availability of al safe, effective bonding material. Side effect caused by synthetic materials have led to the use of biologic adhesive. However, they carry the risk of transmission of infectious diseases if they are prepared from pooled human blood. The adhesive strength of ammonium sulfate fibrin adhesive produce an adhesive strength that is half that of the homologous commercial product. It is, however, good enough for use in several otolaryngological operations, tympanoplasty, facial nerve repair, reconstruction of ossicles, reconstruction of posterior wall of ear canal and obliteration of frontal sinus and mastoid antrum using bone dust.

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Development of Indocyanine Green and 5-Aminolevulinic Acid Detection System for Surgical Microscope (수술현미경용 다중형광 관측 시스템 연구)

  • Kim, Hong Rae;Lee, Hyun Min;Yoon, Woong Bae;Kim, Young Jae;Kim, Seok Ki;Yoo, Heon;Joo, Jae Young;Kim, Kwang Gi;Lee, Seung-Hoon
    • Journal of Biomedical Engineering Research
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    • v.36 no.1
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    • pp.16-21
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    • 2015
  • Indocyanine green(ICG) and 5-aminolevulinic acid(5-ALA) have been widely used to mark blood vessels or tumors. However, fluorescent dye detection systems were designed to use one type of dyes only. In this study, we proposed a detection system capable of detecting Indocyanine green and 5-aminolevulinic acid. Multiple filters and light sources are integrated into a single system. In this study, we performed analysis of fluorescent dyes and configured a detection system. During the analysis, it was found that Indocyanine green and 5-aminolevulinic acid have the maximum intensity at $40{\mu}M$. We designed light source for fluorescent dyes and conducted compatibility test using a commercial surgical microscope. The fluorescent dye detection system was configured based on the experimental results. The developed system successfully detects Indocyanine green and 5-aminolevulinic acid. Therefore, more efficient surgical operations can be achieved using both fluorescent dyes at the same time. We expect that the developed system can increase the survival rate of patients.

Surgical Anatomy of Lateral Extracavitary Approach to the Thoracolumar Spine - Cadaveric Study - (흉요추부 외측 강외 접근법(Lateral Extracavitary Approach)의 수술해부학적 구조 - 사체해부실험 -)

  • Kim, Sang-Don;Suh, Jung-Keun;Ha, Sung-Kon;Kim, Joo-Han;Cho, Tae-Hyung;Park, Jung-Yul;Kim, Hyun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1187-1192
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    • 2001
  • Objective : The lateral extracavitary approach(LECA) to the thoracolumbar spine is known as one of procedure which allows not only direct vision of pathologic lesion, but also ventral decompression, and dorsal fixation of the spine through the same incision. However, some drawbacks of LECA, including the technically- demanding, time-consuming, unfamiliar surgical anatomy and excessive blood loss, make surgeons to hesitate to use this approach. This study is to provide the surgical anatomy of LECA using cadavers, for detailed informations when LECA is considered for the surgery. Methods : We performed the 10 cadaveric studies, 7 male and 3 female, and careful dissection was carried out on right side of thoracolumbar region, except one for thoracic region. The photographs with micro-lens were taken to depict the close-up findings and for demonstrating detailed anatomy. Results : The photographs and hand-drawings demonstrated the relationships among the musculature, segmental vessels and nerve roots seen during each dissection plane. The lateral branches of dorsal rami of spinal nerve and the transverse process were confirmed to be the most important landmark of this approach. Conclusion : We concluded that detailed anatomical findings for LECA through this step-by-step dissection would be useful during operative intervention to reduce the intraoperative complications in LECA.

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보철 수복시 치간 유두에 대한 고려 사항

  • Lee, Sung-Bok;Lee, Seung-Gyu
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.10 no.1
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    • pp.30-45
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    • 2001
  • In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

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CLINICAL USE OF CORTICOTOMIES IN ADULT ORTHODONTICS (성인 교정치료를 위한 피질골절단술(Corticotomy)의 임상 적용)

  • Lee, Baek-Soo;Hwang, Hye-Wook;Chung, Kyu-Rhim
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.21 no.3
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    • pp.303-311
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    • 1999
  • In adult patients, the corrections of their malocclusion may be more difficult and require longer treatment time due to thicker layer of cortical bone and reduced blood supply. Recently, various methods such as surgery, implant for anchorage and corticotomy have been tried to overcome these problems. Corticotomy is a surgical technique in which a fissure is made through the cortical bone that surrounds a tooth so that the tooth is embedded within a block of bone that is connected to adjacent blocks through only the medullary bone. Technique of corticotomy has been widely used for correction of maxillary transverse deficiency, but hasn't actively in other fields of orthodontics. We applied corticotomies in many types of orthodontic treatment and had satisfactory results. We suggested clinical application of corticotomy in adult orthodontics to reduce treatment period and to achieve better stability after orthodontic treatment.

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Use of Buccal pad on the Immediate Implant Placement in the Maxillary Posterior Area: Report of two Cases (상악 구치부에서 즉시 임플란트 식립시 협지방대의 이용)

  • Jeong, Jong-Cheol;Jeon, Chang-Hun;Choe, Se-Hun;Song, Min-Seok;Kim, Seong-Beom;Seo, Ji-Hun;Kim, Se-Ung
    • The Journal of the Korean dental association
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    • v.41 no.8 s.411
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    • pp.566-571
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    • 2003
  • Now a days, immediate implant placement: is becoming one of the popular method. But for the success of this method in implant surgery, initial stability and establishment of sufficient blood supply to the implant placement: areas are very important. Buccal Fat Pad(BFP) has favorable characteristics for the reconstruction of maxillary hard &soft tissue defects. So it has been used for reconstruction of posterior maxillary area or closure of oro-antral area. Using BFP, we could get primary tissue closure without extensive releasing incision during implant surgery and adequate attached gingival after healing of the surgical area. So We report clinical usefulness of BFG during immediate important placement in the posterior maxillary area

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Treatment of osteomyelitis in the rear area of the lingula of the mandible using sagittal split ramus osteotomy: a case report

  • Jung, Tae-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.4
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    • pp.203-207
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    • 2015
  • Osteomyelitis is classified into three groups according to its origin: osteomyelitis that originates from the blood supply, osteomyelitis related to bone disease or vascular disease, and osteomyelitis related to a local infection of dental or non-dental origin. The present case involved osteomyelitis related to a local infection of dental origin and was located in the rear area of the lingula of the mandible. We decided to use sagittal split ramus osteotomy to access the osteomyelitis area. Under general anesthesia, we successfully performed surgical sequestrectomy and curettage via sagittal split ramus osteotomy.

Clinical Application of SPECT and PET in CerebroVascular Disease (뇌혈관질환에서 SPECT와 PET의 임상적 응용)

  • Ra, Young-Shin
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.1
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    • pp.1-12
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    • 2003
  • Single photon emission computed tomography(SPECT) and positron emission tomography(PET) are modern imaging techniques that allow for both qualitative and quantitative assessment of hemodynamic changes in cerebrovascular diseases. SPECT has been becoming an indispensable method to investigate regional cerebral blood flow because equipment and isotope are easily available in most general hospitals. Acetazolamide stress SPECT has also been proved to be useful to evaluate the cerebrovascular reserve of occlusive cerebrovascular diseases and to select surgical candidate. PET has gained wide spread clinical use in the evaluation of the hemodynamic and metabolic consequences of extracranial or intracranial arterial obstructive disease despite its complexity and limited availability. PET has been established as an invaluable tool in the pathophysilogy investigation of acute ischemic stroke. The potentials, limitations, and clinical applications of SPECT and PET in various cerebrovascular diseases will be discussed in this article with reviews of literatures.