• Title/Summary/Keyword: surgical instrument

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Laparoscopic Ovariohysterectomy in Female Dogs (복강경을 이용한 암캐의 난소자궁절제술)

  • Kim, Young-Ki;Lee, Scott-S.;Park, Se-Jin;Lee, Seung-Yong;Lee, Hee-Chun;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.149-153
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    • 2011
  • In this report, laparoscopic ovariohysterectomy (LOHE) was performed on two, healthy, intact female dogs. Three ports, umbilical port for placing the laparoscope and the left and right paramedian instrument ports were placed into the abdominal cavity. First, in order to isolate the right ovary, the vascular pedicle was coagulated by activating the universal bipolar forceps. Then, the pedicle and suspensory ligament were transected by the bipolar electrocauterization scissors. In the same manner, the left ovary was isolated. The uterine body and the uterine arteries were coagulated bilaterally and transected just rostral to the cervix. The isolated ovaries and uterus were exteriorized through the left paramedian instrument port, which was extended by approximately 1 cm to allow for tissue removal. The skin and subcutaneous tissue were closed in a routine manner. Surgical times for LOHE in two dogs were 35, 40 min respectively. Total length of abdominal incision was shorter than 3 cm in two dogs. No clinical complications related to the LOHE were observed during 1.5 years after surgery. The LOHE is an alternative surgical technique that deserves further investigation.

Instruments to Assess Physical Impairments in Post-Intensive Care Syndrome: A Systematic Review (집중치료 후 증후군의 신체적 장애 측정도구에 관한 체계적 고찰)

  • Kang, Jiyeon;Lee, Minju;Jeong, Yeon Jin;Kim, Soo Kyung;Cho, Young Shin;Park, Jung Hoon;Lee, Soon;Hong, Ji Won
    • Journal of Korean Critical Care Nursing
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    • v.11 no.1
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    • pp.46-66
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    • 2018
  • Purpose : The purpose of this study was to systematically review the instruments utilized to assess physical impairment in post-intensive care syndrome (PICS) of intensive care unit (ICU) survivors. Method : Online databases searched were MEDLINE, Cochrane, CINAHL, and Embase. Studies that met the following criteria were included: 1) the study population exclusively had experience with ICU admission; 2) the study assessed pulmonary, neuromuscular, and physical functions; and 3) the study was published in English language journals after 2007. Results : A total of 56 instruments (2 pulmonary, 25 neuromuscular, 29 physical function) from 94 studies were reviewed. They were classified into self-report, observation, and measurement according to the type of assessment. No instrument measured all 3 areas of physical impairment. Five instruments were originally developed for the ICU patients. The most frequently applied instruments were the Medical Research Council and the 36-item Short Form Survey (physical component summary), which were used in 23 studies each. Only 13.8% of reviewed studies reported the reliability or validity of the instruments. Conclusion : Our results suggest that the appropriateness of instruments assessing physical impairment in PICS cannot be guaranteed. Despite the multidimensional concept of physical disabilities, most studies measured only one area, and studies that reported psychometric properties were limited. Accordingly, we propose to develop a unique and multifaceted instrument for ICU survivors.

Radiological and Clinical Results of Laminectomy and Posterior Stabilization for Severe Thoracolumbar Burst Fracture : Surgical Technique for One-Stage Operation

  • Kim, Myeong-Soo;Eun, Jong-Pil;Park, Jeong-Soo
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.224-230
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    • 2011
  • Objective : This study aimed to show the possibility of neural canal enlargement and restoration of bony fragments through laminectomy and minimal facetectomy without pediculectomy or an anterior approach, and also to prove the adequacy of posterior stabilization of vertebral deformities after thoracolumbar bursting fracture. Methods : From January 2003 to June 2009, we experienced 45 patients with thoracolumbar burst fractures. All patients enrolled were presented with either a neural canal compromise of more than 40% with a Benzel-Larson Grade of VI, or more than 30% compromise with less than a Benzel-Larson Grade of V. Most important characteristic of our surgical procedure was repositioning retropulsed bone fragments using custom-designed instruments via laminectomy and minimal facetectomy without removing the fractured bone fragments. Beneath the dural sac, these custom-designed instruments could push the retropulsed bone fragments within the neural canal after the decompression and bone fragment repositioning. Results : The mean kyphotic deformities measured preoperatively and at follow-up within 12 months were 17.7 degrees (${\pm}6.4$ degrees) and 9.6 degrees (${\pm}5.2$ degrees), respectively. The mean midsagittal diameter improved from 8.8 mm (${\pm}2.8$ mm) before surgery to 14.2 mm (${\pm}1.6$ mm) at follow-up. The mean traumatic vertebral body height before surgery was 41.3% (${\pm}12.6%$). At follow-up assessment within 12 months, this score showed a statistically significant increase to 68.3% (${\pm}12.8%$). Neurological improvement occurred in all patients. Conclusion : Though controversy exists in the treatment of severe thoracolumbar burst fracture, we achieved effective radiological and clinical results in the cases of burst fractures causing severe canal compromise and spinal deformity by using this novel custom-designed instruments, via posterior approach alone.

Surgical Technique thor the Removal of Deep Vein Thrombi of the Lower Extremities (하지 심부정맥 혈전의 외과적 제거)

  • 이상호;최준영;김성호;김병균;장인석;이정은;옥창대;김종우;나재범
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.402-406
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    • 2002
  • The conventional surgery method of thrombectomy of venous thrombi from the deep veins of the lower extremity was the use of Forgarty balloon catheter. The catheter is inconvenient due to the presence of the balloon and prohibiting venous valves within the venous trees. With the use of a stone-forceps(Fig. 1), thrombi within iliofemoral vein could be easily removed without the obstacle of the valves because the instrument keeps valves open. This instrument is also useful in monitoring the back-flow from the iliac vein. Thrombi within the veins below the level of inguinal incision are removed successfully only by effective manual compression of the calf and thigh muscles. 1 recommend operating on the iliac vein first rather than the lower venous tree.

Comparative study of wound healing in porcine urinary bladder with CO2 laser and scalpel incisions (CO2 Laser와 Scalpel을 이용한 절개 시 돼지 방광에서의 창상치유 평가)

  • Lee, Jae-Yeon;Jeong, Seong-Mok;Cho, Sung-Whan;Park, Chang-Sik;Kim, Myung-Cheol
    • Korean Journal of Veterinary Research
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    • v.50 no.3
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    • pp.247-251
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    • 2010
  • This study compared the instrument performance and tissue healing of a steel scalpel with a $CO_2$ laser in an animal urinary bladder surgery model. Landrace and Yorkshire mixed breed pigs were used. Two symmetrical incisions were made in urinary bladder of each pig. One incision was made on the left side of ventral aspect on urinary bladder using a steel scalpel, while the other incision was performed on the right side using a $CO_2$ laser with an 8W output power. Each instrument was evaluated clinically for speed, ease of incision, and extent of bleeding. At 7 and 21 days after initial wounding, each wound was taken for histological observations. The scalpel was an easier instrument to use in the confines of the urinary bladder tissue, compared with the laser. However, there was no significant difference between the two groups. The amount of bleeding was less in the laser group but the time of the incisions was shorter with the scalpel. Scalpel incisions showed complete restoration of the epithelium and muscularis. On the other hand, the laser incisions showed incomplete restoration of the epithelium and muscularis. However, most of wound healing in the laser incisions was accomplished according to the time lapse. Although the scalpel produced less damage to the urinary bladder tissue and was easier to handle than the $CO_2$ laser, it did not provide hemostasis that was helpful for use on highly vascular tissue. The $CO_2$ laser provided good hemostasis, but delayed wound healing. In conclusion, the $CO_2$ laser provided better hemostasis and better surgical field than the scalpel. The $CO_2$ laser was used effectively in urinary bladder incision.

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

  • Jung, Hong-Geun;Paik, Ho-Dong
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.2
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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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Laparoscope Manipulator Control for Minimally Invasive Surgery (최소침습수술을 위한 복강경 매니퓰레이터 제어)

  • Kim, Soo-Hyun;Kim, Kwang-Gi;Jo, Yung-Ho
    • Journal of Institute of Control, Robotics and Systems
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    • v.17 no.7
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    • pp.685-696
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    • 2011
  • An efficient laparoscope manipulator robot was designed to automatically control the position of laparoscope via a passive joint on end-effector position. The end position of the manipulator is controlled to have corresponding velocity defined in the global coordinate space using laparoscopic visual information. Desired spatial position of laparoscope was derived from detected positions of surgical instrument tips, then the clinical viewing plane was moved by visual servoing task. The laparoscope manipulator is advantageous for automatically maintaining clinically important views in the laparoscopic image without any additional operator. A laparoscope is mounted to a holder which is linked to four degree of freedom manipulator via universal joint-type passive rings connection. No change in the design of laparoscope or manipulator is necessary for its application to surgery assistant robot system. Expanded working space and surgical efficiency were accomplished by implementing slant linking structure between laparoscope and manipulator. To ensure reliable positioning accuracy and controllability, the motion of laparoscope in an abdominal space through trocar was inspected using geometrical analysis. A designed laparoscope manipulating robot system can be easily set up and controlled in an operation room since it has a few subsidiary devices such as a laparoscope light source regulator, a control PC, and a power supply.

Analysis of Nursing Interventions Performed by Chosunjok Nurses in Yanbian Using NIC (연변조선족 간호사가 수행하는 간호중재 분석)

  • ;;;;Li, Chun-Yu;Kim, Kyung-Yun;Huang, Zhen-Yu;Yuk, Moon-Ae
    • Journal of Korean Academy of Nursing
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    • v.31 no.5
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    • pp.793-806
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    • 2001
  • To identify nursing interventions performed by Chosunjok nurses in Yanbian using NIC. Methods: The sample consisted of 36 nurses working in 2 hospitals. The Nursing Interventions Use Questionnaire developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean using the method of back-translation. Results: Twenty-eight interventions were performed at least daily. Interventions in the Physiological: Basic domain were most frequently used at least daily. The most frequently used interventions was Positioning, followed by the interventions Pressure Ulcer Prevention, Intravenous (IV) Therapy, Hypothermia Treatment and Intravenous (IV) Insertion. The least frequently used interventions was Electronic Fetal Monitoring: Antepartum. Nurses working in special medical care units performed interventions most often, while nurses working in general surgical units performed them least. Nurses working in general medical, special medical and other care units performed interventions in the Physiological domain more often than the nurses working in general surgical units. Conclusion: Chosunjok nurses in Yanbian performed physiological interventions frequently. Further studies will be needed to compare interventions performed by nurses in two countries.

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Diagnosing Micro Foreign Bodies with the Microscope

  • Kwon, Chan;Rhee, Seung Chul;Bahk, Su Jin;Cho, Sang Hun;Eo, Su Rak
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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    • pp.93-96
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    • 2014
  • The microscope is a surgical instrument with wide use in plastic surgeries more often than other departments due to the high rate of microscopic surgeries. Unfortunately, because the microscope is used mainly for digital replantations and free flaps, the utilization rate is low compared to the price and usability of the microscope itself. From September 2013 to March 2014, a foreign body which was untraceable with radiology in a patient who desired surgical exploration (one case), and a foreign body which was detected but was smaller than 3 mm (two cases) were removed using the microscope. All foreign bodies, which were fish bone, thin metals, or wooden objects, matching the history of the patients, were completely removed without damage. There were no complications and patient satisfaction was high through follow-up. We have described the microscope as the last and optimal examination tool in removal of micro foreign bodies. A simple change of thought, so that the microscope can be used as a second diagnostic tool will decrease complications by foreign bodies.

Research Literature for Periodical Consideration about Dochim (도침술의 시대적 고찰을 위한 문헌조사연구)

  • Son, Young Hun;Yoon, Sang Hun;Yuk, Dong Il;Sung, In Su;Kim, Min Jung;Hong, Kwon Eui
    • Journal of Acupuncture Research
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    • v.30 no.4
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    • pp.175-180
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    • 2013
  • Objectives : Dochim have been recorded in korean medical classics as a diversified instrument for acupuncture to treat patients with various symptoms. Recently, there is a lot of Korean Medicine Doctors are increasingly using Dochim. For this reason this study surveyed the changing of Dochim's conformation and application through the literature. Methods : We investigated conventional paper and literature about Dochim, according to the flow of the time. Results : Despite changes in the times Dochim was used continuously as a surgical procedure. Recently, as the development of the concept of sterilization utilizing the frequency is increasing. Conclusions : Dochim is worth as the surgical procedure and continuously clinical utilization are needed in the future.