• 제목/요약/키워드: surgical procedure

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당뇨환자의 불안정 족관절에 있어서의 전방 T자형 금속판을 이용한 족관절 고정술 (Ankle Arthrodesis Using an Anterior T Plate in treating the Charcot joint of Ankle in a diabetic patient - A Case Report -)

  • 황건성;성일훈;조수현
    • 대한족부족관절학회지
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    • 제5권1호
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    • pp.23-27
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    • 2001
  • It has been known that the ankle arthrodesis is a common surgical procedure for treating the ankle arthrosis and deformity that do not respond to the non-operative treatment. To date, various surgical techniques for the ankle arthrodesis have been reported. Clinical and biomechanical trials have shown that the rigid internal fixation leads the increased rate of the union. The ankle arthrodesis may be complicated with the nonunion, delayed union, malunion, and infection. In cases of the Charcot joint of the ankle in diabetic patients, however, arthrodesis could reduce the disadvantage of the nonoperative treatment, such as the loss of the reduction, progressive collapse, multiple ulcerations and infection. The object of this case report is to report our experience of a successful ankle arthrodesis using an anterior T plate in treating the unstable ankle of a diabetic patient, associated with the ankle fracture and the neuropathy. The surgical approach of this technique is simple so that it would allow less soft tissue injury, and this procedure would be regarded as one alternative to provide the rigid internal fixation in the ankle arthrodesis.

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Video-Assisted Thoracic Surgery Lobectomy

  • Kim, Hong Kwan
    • Journal of Chest Surgery
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    • 제54권4호
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    • pp.239-245
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    • 2021
  • Video-assisted thoracoscopic surgery (VATS) has been established as the surgical approach of choice for lobectomy in patients with early-stage non-small cell lung cancer (NSCLC). Patients with clinical stage I NSCLC with no lymph node metastasis are considered candidates for VATS lobectomy. To rule out the presence of metastasis to lymph nodes or distant organs, patients should undergo meticulous clinical staging. Assessing patients' functional status is required to ensure that there are no medical contraindications, such as impaired pulmonary function or cardiac comorbidities. Although various combinations of the number, size, and location of ports are available, finding the best method of port placement for each surgeon is fundamental to maximize the efficiency of the surgical procedure. When conducting VATS lobectomy, it is always necessary to comply with the following oncological principles: (1) the vessels and bronchus of the target lobe should be individually divided, (2) systematic lymph node dissection is mandatory, and (3) touching the lymph node itself and rupturing the capsule of the lymph node should be minimized. Most surgeons conduct the procedure in the following sequence: (1) dissection along the hilar structure, (2) fissure division, (3) perivascular and peribronchial dissection, (4) individual division of the vessels and bronchus, (5) specimen retrieval, and (6) mediastinal lymph node dissection. Surgeons should obtain experience in enhancing the exposure of the dissection target and facilitating dissection. This review article provides the basic principles of the surgical techniques and practical maneuvers for performing VATS lobectomy easily, safely, and efficiently.

Primary versus revision total shoulder arthroplasty: comparing relative value and reimbursement trends

  • Carney, John Joseph;Gerlach, Erik;Plantz, Mark;Swiatek, Peter Raymond;Marx, Jeremy;Saltzman, Matthew;Marra, Guido
    • Clinics in Shoulder and Elbow
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    • 제25권1호
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    • pp.42-48
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    • 2022
  • Background: Total shoulder arthroplasty (TSA) has been demonstrated to be an effective treatment for multiple shoulder pathologies. The purpose of our study was to compare the relative value units (RVUs) per minute of surgical time for primary and revision TSA. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried to identify patients that underwent primary TSA, one-component revision TSA, and two-component revision TSA between January 1, 2015 and December 31, 2017 using current procedure terminology codes. RVUs were divided by mean operative time for each procedure to determine the amount of revenue generated per minute. Rates were compared between the groups using a one-way analysis of variance with post-hoc Tukey test. Statistical significance was set at p<0.05. Results: When dividing compensation by surgical time, we found that two-component revision generated more compensation per minute compared to primary TSA (0.284±0.114 vs. 0.239±0.278 RVU per minute or $10.25±$4.11 vs. $8.64±$10.05 per minute, respectively; p=0.001). Conclusions: The relative value of revision TSA procedures is weighted to account for the increased technical challenges and time associated with these procedures. This study confirms that reimbursement is higher for revision TSA compared to primary TSA.

만성 심낭염의 외과적 요법 (Surgical Treatment of Chronic Pericarditis: Case Analysis of 19 Cases)

  • 이동준;최순호
    • Journal of Chest Surgery
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    • 제11권3호
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    • pp.273-280
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    • 1978
  • 19 chronic pericarditis patients reviewed who were treated by surgical intervention in the Department of Thoracic and Cardiovascular Surgery, Chonnam University Hospital during the recent 10 years from January of 1968 to January of 1978. 2. There were 14males and 5 females in this series. Range of age varied from 110 days to 61 years. 2. There were two hospital death, one expired 2 days and another 3 days after the pericardiectomy. In both of them, myocardial damage by disease process seemed to be major contributing factor. 2. Clinical and histological study showed tuberculous origin in 8 cases, nonspecific chronic inflammatory changes in 6 cases and pyogenic infection cases in 5 patients. 2. The postoperative complications were observed in 6 cases, and the most common was cardiac arrhythmia and wound infection. 2. The extent of pericardiectomy should be confined to the left and right ventricles to correct the hemodynamic anomaly in general. The results of this procedure has been satisfactory in 89 percent of the cases. 2. Optimal myocardial function in cases of constritive pericarditis was the key to the successful outcome of this procedure.

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Lumbar Sympathetic Radiofrequency Neurotomy in Plantar Hyperhidrosis

  • Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • 제41권1호
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    • pp.27-29
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    • 2007
  • Objective : Surgical treatment of focal plantar hyperhidrosis is often unsatisfactory compared to palmar hyperhidrosis. The purpose of this study is to evaluate the effect of lumbar sympathetic radiofrequency neurotomy on plantar hyperhidrosis. Methods : From February 2004 to December 2005, 10 patients [mean age 24.3 male 1, female 9] with the clinical diagnosis of plantar hyperhidrosis were treated by bilateral lumbar sympathetic radiofrequency neurotomy of L3 and L4. Patients' symptom relief, satisfactory rate and side effects related to the procedure were analyzed. Results : Radiofrequency neurotomy was effective in the treatment of focal plantar hyperhidrosis showing excellent [more than 75% improved] outcome in 70% of the patients and good [more than 50% improved] in 30%. Complications related to the surgical procedure, such as sensory dysesthesia and compensatory hyperhidrosis were not detected in any case. Conclusion : The use of radiofrequency neurotomy to ablate the lumbar sympathetic ganglion is a safe and effective treatment option for patients with plantar hyperhidrosis.

수술로봇을 이용한 식도절제 및 종격동림프절 박리술 (Robot-Assisted Thoracoscopic Esophagectomy and Lymph Node Dissection)

  • 김대준
    • 대한기관식도과학회지
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    • 제17권2호
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    • pp.89-91
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    • 2011
  • Robotic surgery have been increasingly applied in the past several years to assist in a variety of operations. Some applications, such as in prostatectomy, have been widely adopted and have largely supplanted the alternative minimally invasive or open techniques. However, the use of surgical robots in esophagectomy has not been as common. Although a limited number of case reports demonstrated the feasibility of robotic esophagectomy, no large series of patients has been reported to date. The data on robotic-assisted esophagectomy suggest that the procedure is safe, feasible, and associated with perioperative outcomes similar to open and minimally invasive esophagectomy. Benefits of robotic system could be maximized when we do a extensive total mediastinal lymphadenectomy. For this procedure to gain widespread acceptance, identifiable benefit relative should be demonstrated in near future.

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Williams' syndrome을 동반한 선천성 대동맥 판상협착 -치험 1례- (Congenital Supravalvular Aortic Stenosis Associated with Williams'Syndrome -One Case Report-)

  • 박진석
    • Journal of Chest Surgery
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    • 제28권4호
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    • pp.391-394
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    • 1995
  • We expericenced one case of surgical treatment of congenital supravalvular aortic stenosis associated with Willjams` syndrome using Dory procedure. A 22 years-old male patient was admitted to the cardiology department due to dyspnea,easy fatigue,dizziness. On physical examination,systolic murmur was audibled at fight second parasternal intercostal space and his general appearance was elfin face and mental retardation was noted. Cardiac catheterization was revealed as a supravalvular aortic stenosis and pressure gradient was 45mmHg between the left ventricle and the aorta. Successful surgical treatment was accomplished with Inverted Y procedu~:e using Dacron patch[Doty procedure . Postoperative course was uneventful and he was discharged in good condition.

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매복치 자가이식술의 적응증과 치험례 (Autogenous Transplantation of Impacted teeth : Indication and Case Report)

  • 유형석;김태균
    • 대한치과의사협회지
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    • 제38권1호통권368호
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    • pp.22-29
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    • 2000
  • The purpose of this paper is to discuss the indication. treatment procedure. prognosos and complication of autogenous transplantation in treating impacted teeth of orthodontic patient. Autogenous transplantation is indicated, in cases of rejecting orthodontic treatment due to the visible orthodontic appliance, the relatively long treatment time, unfavorable tooth position for orthodontic repositioning, unrestorable advanced detal caries. advanced periodontitis and ankylosed tooth. Most process related to the decision of the prognosis is dependent on the careful surgical technique. In comparison to other orthodontic and surgical procedure, the application of the autotransplantation is limited, although its success rate is markedly increased today. Therefore we must we must pay attention to the treatment planning and cooperation with other specialties is needed.

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개에서 외부고정법을 이용한 양측성 하악골절의 치유 일례 (A Case of External Skeletal Fixation for Treatment of Bilateral Mandibular Fracture in a Dog)

  • 구자민;김현희;박대식;장홍희;이효종;이후장;송해룡;이용훈;정종태
    • 한국임상수의학회지
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    • 제20권1호
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    • pp.134-137
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    • 2003
  • A 5-year-old, male mixed breed dog was presented to Gyeongsang National University Animal Hospital for bilateral mandibular open fracture by bite. The dog had loss of the teeth and injury of the oral mucosa. Radio-graphic and blood examinations were conducted. Fracture lines were observed between first premolar and second premolar, but temporomandibular luxation was not observed on radiographs. In serum analysis, elevated levels of CPK and LDH were found. The dog was anesthetized and prepared for aseptic surgery. Acrylic external skeletal fixator with Kirschiner wire was applied. Pin loosening and malalignment of the right fracture line was observed at 7 weeks after surgery. We applied Kirschner-Ehmer fixator and half pins during the second surgical procedure. At 4 weeks after a second surgical procedure, the fixator and pins were removed from mandible. The fractures were healed with no complications.

동통성 부 주상골 (Painful Accessory Navicular)

  • 정홍근;박종태
    • 대한족부족관절학회지
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    • 제16권3호
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    • pp.162-168
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    • 2012
  • Accessory navicular is a congenital anomaly of the tuberosity of the navicular from a secondary ossification center. The accessory navicular is occasionally the source of pain and local tenderness over the medial side of midfoot. If conservative treatment fails for the painful accessory navicular, surgical treatment is required. There are several surgical option for accessory navicular, which vary from simple excision, percutaneous drilling, modified Kidner procedure and osteosynthesis of the accessory ossicle to the navicular body. In addition, symptomatic flatfoot deformity should be addressed concomitantly.