• 제목/요약/키워드: surgical incision

검색결과 510건 처리시간 0.029초

최소 절개 기법에 의한 아킬레스건 파열의 수술적 봉합술 (Surgical Repair of Achilles Tendon Rupture by Minimal Incision Technique)

  • 정홍근;백호동
    • 대한족부족관절학회지
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    • 제9권2호
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    • pp.173-178
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    • 2005
  • Propose: There have been many debates about the ideal surgical technique for acute Achilles tendon rupture. The purpose of this study is to review and analyze the clinical outcome of the acute Achilles tendon ruptures that had been repaired by indirect suture technique with minimal incision that utilized an instrument called Achillon (Newdeal, France). Materials and Methods: This study is based on the 14 cases (14 patients) of acute Achilles tendon total ruptures that have been repaired by minimal incision technique utilizing Achillon instrument from June 2003 to December 2004. Two cases were reruptured before 8 weeks and repaired again using Krackow suture which left 12 feet for postoperative functional evaluation with at least 6 months of follow-up. Ten cases were men and average age at time of injury was 34.4 (26-49) years. The time from injury to surgery was an average of 4.5 (1-9) days and the postoperative evaluations were done by an Arner-Lindholm scale and AOFAS score. The ability to return to original work and sports activities as well as patient satisfaction were also evaluated. Results: The follow-up period was averaged for 13.2 (6-24) months. Seventy-one percent of cases were ruptured during sports activities. The ruptured level was the average of 5.1 cm (3.2-8 cm) above calcaneal attachment and the skin incision was averaged for 2.7 cm (2.5-3.0 cm) long. At final follow-up, standing on tip-toe was possible in all cases while the heel-floor height on ruptured side was shorter by 0.7 cm (0-2 cm). By Arner-Lindholm evaluation scale, 9 cases were excellent, and 3 cases were good. Overall AOFAS score was an average of 96.1 (94-100), and all patients were satisfied with the result. Patients returned to work at an average of 1.3 months after the surgery and pre-injury sports activities were all possible from at 6 months after operation. Conclusion: Since we have treated acute Achilles tendon ruptures with minimal incision technique utilizing the Achillon and gained encouraging functional results with all patients returning to previous work with high patient satisfaction, this technique could be recommended as one of the ideal surgical options for the Achilles tendon ruptures.

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Comparison of short-term outcomes of open and laparoscopic assisted pancreaticoduodenectomy for periampullary carcinoma: A propensity score-matched analysis

  • Utpal Anand;Rohith Kodali;Kunal Parasar;Basant Narayan Singh;Kislay Kant;Sitaram Yadav;Saad Anwar;Abhishek Arora
    • 한국간담췌외과학회지
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    • 제28권2호
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    • pp.220-228
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    • 2024
  • Backgrounds/Aims: Postoperative pancreatic fistula is the key worry in the ongoing debate about the safety and effectiveness of total laparoscopic pancreaticoduodenectomy (TLPD). Laparoscopic-assisted pancreaticoduodenectomy (LAPD), a hybrid approach combining laparoscopic resection and anastomosis with a small incision, is an alternative to TLPD. This study compares the short-term outcomes and oncological efficacy of LAPD vs. open pancreaticoduodenectomy (OPD). Methods: A retrospective analysis of data of all patients who underwent LAPD or OPD for periampullary carcinoma at a tertiary care center in Northeast India from July 2019 to August 2023 was done. A total of 30 LAPDs and 30 OPDs were compared after 1:1 propensity score matching. Demographic data, intraoperative and postoperative data (30 days), and pathological data were compared. Results: The study included a total of 93 patients, 30 underwent LAPD and 62 underwent OPD. After propensity score matching, the matched cohort included 30 patients in both groups. The LAPD presented several advantages over the OPD group, including a shorter incision length, reduced postoperative pain, earlier initiation of oral feeding, and shorter hospital stays. LAPD was not found to be inferior to OPD in terms of pancreatic fistula incidence (Grade B, 30.0% vs. 33.3%), achieving R0 resection (100% vs. 93.3%), and the number of lymph nodes harvested (12 vs. 14, p = 0.620). No significant differences in blood loss, short-term complications, pathological outcomes, readmissions, and early (30-day) mortality were observed between the two groups. Conclusions: LAPD has comparable safety, technical feasibility, and short-term oncological efficacy.

뒤꿈치 족저부에 발생한 무균 농양(1예 보고) (Sterile Abscess at the Heel Pad (A Case Report))

  • 김갑래;신성일;김태화;박현진
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.236-239
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    • 2009
  • Heel abscesses present as heel pain that progressively worsens, with associated tenderness and fullness a the heel pad. To our knowledge, there are fews reports in the literature describing a spontaneous heel pad abscess. A 48-years old woman presented spontaneously with pain, erythema, edema and increased warmth to this right foot. She has no underlying disease and steroid injection history. A radiologic examination was suggestive of an abscess. Follow incision and drainage, cultures that were taken during the surgical procedure did not produce any organism. The patient was discharged home and recovered from the abscess without recurrence or further surgical intervention.

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누두흉의 외과적 치료 -Metal bar를 이용한 수술치험 7예- (Operative treatment of pectus excavatum -7 cases used retrosternal metal bar-)

  • 이정철
    • Journal of Chest Surgery
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    • 제19권3호
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    • pp.391-398
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    • 1986
  • From Jan. 1983 to Dec. 1985, seven cases of pectus excavatum, six were male and one female, were underwent an operation at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University Hospital. The ages of patients ranged from 6 to 27 years. They all had symptoms of feeling inferiority about chest deformity. The concavity on the funnel chest varied in its extent, and the severity, which was measured by water volume filled into it, varied from 59.5cc/m2 to 129.9cc/m2. All but one patients were approached through a bilateral transverse submammary incision and one approached through a vertical midline incision. Successful surgical correction required resection of all deformed costal cartilages with transverse anterior osteotomy and internal fixation using retrosternal metal bar. No serious complication have followed the use of this technique, but minor complications such as serous accumulation, pneumothorax and strut migration have been experienced. All patients were satisfactory about the surgical results.

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최소 침습성 대동맥 판막 수술 -2례 보고- (Abstract Minimally Invasive Aort ic Valve Surgery -A Report of Two Cases)

  • 백완기;김현태
    • Journal of Chest Surgery
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    • 제30권11호
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    • pp.1139-1141
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    • 1997
  • 최근 개발된 소절개를 통한 소위 최소 침습적 심장수술은 기존의 정중 흉골절개술을 통한 심장수술에 비해 수술의 난이도가 높음에도 불구하고 환자에게 가해지는 수술에 의한 손상을 최소화할 뿐 아니라 술 후 수술 반흔의 측면에서도 환자의 만족도를 높일 수 있다는 장점들로 인하여 빠르게 확산되는 추세에 있다. 본 인하병원 흉부외과에서는 흉골의 횡절개를 통한 최소 침습적 방법으로 대동맥 판막치 환술을 2례 시행하였기에 문헌고찰과 함께 보고하고자 한다.

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A Case Report of Prolonged Hemorrhage Following Traditional Phlebotomy (Fasd)

  • Sajjad Sadeghi
    • 대한약침학회지
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    • 제27권1호
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    • pp.47-52
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    • 2024
  • Phlebotomy, a therapeutic method of bloodletting typically performed using a needle, has a traditional technique known as "Fasd." In this method, blood is extracted by creating a longitudinal incision on a vein (3-5 mm) with a surgical scalpel blade, usually blade No. 11. Due to the incision in the vessel wall, establishing hemostasis is more challenging compared to conventional methods. Hemostasis is usually achieved within minutes after Fasd. We present a case highlighting an uncommon yet significant complication of traditional phlebotomy. A 55-year-old man with no prior medical conditions underwent traditional phlebotomy at an academic traditional medicine clinic. Senior MD-PhD students in Iranian Traditional Medicine, under professor supervision, performed Fasd. A sterile scalpel blade No. 11 was used to create a longitudinal incision of approximately 4 mm on the patient's median basilic vein in the right hand. After removing 400 cc of blood, a pressure dressing was applied to the incision site. Despite attempts such as hand elevation, ice pack application, prolonged direct pressure, and tight elastic bandaging, bleeding from the incision persisted. After an hour of supportive therapy, hemostasis was eventually achieved within a few minutes using burnt cotton dressing (a traditional method for blood hemostasis). Following intravenous hydration, the patient was discharged in stable condition and reported no issues during the one-month follow-up. The traditional phlebotomy (Fasd) carries the risk of serious complications, including uncontrolled and prolonged bleeding. Further research on the efficacy and safety of burnt cotton dressing for controlling hemostasis is recommended.

IOIO (Infraorbital-Intraoral) 절개선을 이용한 상악골 절제술 (HEMIMAXILLECTOMY VIA INFRAORBITAL INTRAORAL-INCISION)

  • 김인수;강석훈;이현상;진우정
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제20권2호
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    • pp.91-96
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    • 1998
  • Surgical resection of tumors in the maxillofacial region sometimes results in extended defects of soft and hard tissue that frequently causes aesthetic, functional and especially mental damages. It is essential for patients with such facial defects to reduce the scar and maxillofacial asymmetry. To attain esthetic facial appearance after hemimaxillectomy, we devise a new design, so called 'IOIO Incision' (InfraOrbital-IntraOral incision). The new approach is established on infraorbital region to expose maxillofacial skeleton in aspect of face. And the other incision is designed on intraoral region. The IOIO incision provide excellent aesthetic result after hemimaxillectomy, because of reduced minimal facial scar contraction. Maxillofacial surgeons are used to designing Weber-Fergusson incision in resection of maxillofacial tumors, but disadvantages of the incision were large scar and asymmetry of face. To improve theses problem, we attempted IOIO Incision.. For correct osteotomy of posterolateral wall of maxillary sinus, 1. Fenestra formation on zygomatic body for easily access of reciprocating saw to posterolateral wall of maxillary sinus. 2. To achieve better visual field in posterolateral aspect of maxilla, fat tissue is removed from infratemporal fossa. This new, versatile procedure can be used for benign and malignant lesions of the maxillary area. We introduce cases with review of literatures.

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이하선 적출에서의 변형적 안면 거상 절개법 (Modified facelift incision in parotidectomy)

  • 김민식;선동일;노우영;조승호
    • 대한기관식도과학회지
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    • 제5권2호
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    • pp.138-142
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    • 1999
  • Background and objectives : During the last century, various incisions for parotidectomy has introduced and among them, the modified Blair incision has been the one most commonly used. The modified facelift incision, in another hand, has only been introduced and applied recently for better aesthetic results, but also has been criticized for its potentially limited anterior exposure. The purpose of this study is to compare the modified facelift incision with the modified Blair incision in its indications, results and complications. Materials and methods : All parotidectomies done at Kang-nam St. Mary's Hospital for benign parotid masses from Jan. 1995 to Aug. 1998 were reviewed. They were then divided into 2 groups according to their surgical approach, and the parameters included age, gender, complications length of follow-ups, the aesthetic results and the pt's satisfaction. Results : There were no significant differences in the incidence of complications in both groups and the aesthetic results and patient's satisfaction were greater in the modified facelift group. Conclusion : The modified facelift incision provides improved aesthetic results in patients with benign parotid masses without the disadvantage of limited exposure and complications.

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A Minimally Invasive lumbar Spine Surgery Technique Using a Modified Thoracoport : Proposal of a New Tubular Retractor

  • Park, Kwang-Woo;Park, Chan-Woo;Park, Jin-Soo;Lee, Sang-Gu
    • 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.

Correction of Minor-Form and Microform Cleft Lip Using Modified Muscle Overlapping with a Minimal Skin Incision

  • Kim, Min Chul;Choi, Dong Hun;Bae, Sung Gun;Cho, Byung Chae
    • Archives of Plastic Surgery
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    • 제44권3호
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    • pp.210-216
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    • 2017
  • Background In treating minor-form or microform cleft lip, obtaining an optimal result is a challenge because of the visible scarring caused by traditional surgery. We present a refined method using muscle overlapping with a minimal skin incision in patients younger than 3 years, a group characterized by thin muscle. Methods The surgical technique involves restoration of the notched vermillion using Z-plasty, formation of the philtral column using overlapping of an orbicularis oris muscle flap through an intraoral incision, and correction of the cleft lip nasal deformity using a reverse-U incision and V-Y plasty. A single radiologist evaluated ultrasonographic images of the upper lip. Results Sixty patients were treated between September 2008 and June 2014. The age at the time of operation ranged from 6 to 36 months (mean, 26 months). The follow-up period ranged from 8 to 38 months (mean, 20 months) in minor-form cases and from 14 to 64 months (mean, 37 months) in microform cases. A notched cupid's bow was corrected in 10 minor-form cases and 50 microform cases. Ultrasonographic images were obtained from 3 patients with minor-form cleft lip and 9 patients with microform cleft lip 12 months after surgery. The average muscle thickness was 4.5 mm on the affected side and 4.1 mm on the unaffected side. Conclusions The advantages of the proposed procedure include the creation of an anatomically natural philtrum with minimal scarring. This method also preserves the continuity and function of the muscle and provides sufficient augmentation of the philtral column and nostril sill.