• Title/Summary/Keyword: 복강경수술

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Successful Laparoscopic-Assisted Ovariohysterectomy in a Cat with Pyometra (고양이의 자궁축농증에서 복강경을 이용한 난소자궁절제술)

  • Kim, Young-Ki;Lee, Seung-Yong;Park, Se-Jin;Seok, Seong-Hoon;Jin, So-Young;Lee, Hee-Chun;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.408-411
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    • 2012
  • Laparoscopic-assisted ovariohysterectomy was performed in a cat (2.7 kg) with pyometra. A 10-mm operative laparoscope was inserted into the abdomen through an umbilical port. A transabdominal suspension suture was placed to maintain the exposure of the ovarian vascular pedicle. The ovarian vascular pedicle and suspensory ligament were progressively cauterized and transected with 5-mm multifunction bipolar grasping forceps. Both ovaries and the uterus were exteriorized via 5-mm caudal port enlarged to 2 cm. The uterine body and associated arteries were ligated, transfixed, and transected under direct vision. No peri- or post-operative complications were encountered. To the authors' knowledge, this is the first report of the use of laparoscopy for the treatment of pyometra in the cat.

Laparoscopic Salpingectomy for Sterilization in an Asian Black Bear (Ursus thibetanus) (반달가슴곰에서 불임을 위한 복강경 이용 난관 절제술 1례)

  • Yoon, Hun-Young;Chung, Byung-Hyun;Lee, Soo-Han
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.149-151
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    • 2014
  • A 170 kg, 9-year-old, female Asian black bear was presented for sterilization. Physical examination revealed no evidence of any abnormal clinical sign. Laparoscopic salpingectomy was performed for sterilization. A $25^{\circ}$ laparoscope was inserted in the first port, 1-cm caudal to the umbilical scar, to view the abdominal cavity. Two more ports were made 15 cm caudo-lateral to the first port bilaterally. An atraumatic grasper and a vessel-sealing device were inserted in the bilateral ports. The vessel-sealing device was used to seal and cut the fallopian tube and mesosalpinx. There was no sign of hemorrhage on the severed ends of the fallopian tube and mesosalpinx. At 4 weeks, no physical, behavioral, or other assessable impairment was found. This is the first case report in an Asian black bear to describe laparoscopic salpingectomy for sterilization.

Morbidity of Laparoscopic Assisted Gastrectomy for Early Gastric Cancer (조기 위암에서 복강경 보조 하 위 절제술 후 합병증 발생)

  • Choi, Ji-Eun;Jeong, Oh;Yook, Jeong-Hwan;Kim, Kab-Jung;Lim, Jung-Tack;Oh, Sung-Tae;Park, Gun-Choon;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.7 no.3
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    • pp.152-159
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    • 2007
  • Purpose: Recently, the use of laparoscopic assisted gastrectomy for early gastric cancer has been on the increase and the procedure has been quickly adopted by clincians. However, there are few reports regarding the safety and risk of this type of surgery. The aim of this study is to evaluate the morbidity and to verify the safety of laparoscopic assisted gastrectomy for early gastric cancer. Materials and Methods: A total of 376 patients that had undergone laparoscopic assisted gastrectomy for early gastric cancer between April 2004 and December 2006 were reviewed retrospectively. The clinicopathological characteristics, operative complications, and factors related to complications were evaluated. Results: The overall operative morbidity and mortality rates were 10.6% and 0%, intraoperative morbidity was 1.1% (4 of 376 patients) and post operative morbidity was 9.6% (36 of 376 patients). Most complications required no surgery except for an intestinal obstruction in two cases. Multivariate analysis of risk factors related to operative morbidity determined that age was an independent factor associated with morbidity (P=0.021). Conclusion: The complication rate of laparoscopic assisted gastrectomy is low and most complications can be managed by conservative methods rather than with surgery. There were no specific predicting factors for complications except old age. Laparoscopy is a technically feasible and acceptable surgical modality for early gastric cancer.

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The Role of Hepatobiliary Scintiuaphy and Oral Cholecystography in Predicting the Performance of Laparoscopic Cholecystectomy (복강경담낭절제술에서 수술전 간담도신티그라피와 경구담낭조영술의 의의)

  • Won, Kyoung-Sook;Moon, Dae-Hyuk;Yang, Seoung-Oh;Han, Dong-Bok;Park, Cheol-Min;Lee, Moon-Gyu;Lee, Hee-Kyung;Park, Kwang-Min;Lee, Sung-Gyu;Ryu, Jin-Sook
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.1
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    • pp.102-107
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    • 1997
  • Laparoscopic cholecystectorny can be performed safely in most patients with symptomatic cholelithiasis. Preoperative evaluation should assess the potential problems that affect the performance of laparoscopic cholecystectomy. Hepatobiliary scintigraphy or oral cholecystography can assess the gallbladder function and nonvisualization of gallbladder usually indicates acute or severe chronic cholecystitis. The purpose of this study was to evaluate the role of preoperative hepatobiliary scintigraphy or oral cholecystography in predicting the performance of laparoscopic cholecystectorny. The study group consists of 176 patients who underwent both hepatobiliary scintigraphy with Tc-99m DISIDA and oral cholecystography within one month before laparoscopic cholecystectomy. Nonvisualization of gallbladder was defined as persistent nonvisualization of gallbladder until 4 hours on hepatobiliary scintigraphy or 12 hours on oral cholecystography. Among 176 patients, gallbladder was not visualized in 38 patients on hepatobiliary scintigraphy and 41 patients on oral cholecystography. Concordance rate between hepatobiliary scintigraphy and oral cholecystography was 89.2%. The conversion rate to open cholocystectomy was significantly higher in patients with nonvisualization of gallbladder than in patients with gallbladder visualization(15.8% vs 2.9% on hepatobiliary scintigraphy, 12.2% vs 3.7% on oral cholecystography p<0.01 and p<0.05 respectively). The operative complication rate was also significantly higher in patients with nonvisualization of gallbladder (13.2% vs 2.9% on hepatobiliary scintigraphy, 14.6% vs 2.2% on oral cholecystography p<0.01 and p<0.001, respectively). Similarly, operation time was significantly prolonged in patients with nonvisualization of gallbladder ($88.8{\pm}41.9min$ vs $62.5{\pm}23.6min$ on hepatobiliary scintigraphy : p<0.001, $89.4{\pm}41.3$ min vs $61.8{\pm}22.8$ min on oral cholecystography : p<0.001). It is concluded that nonvisualization of gallbladder on hepatobiliary scintigraphy or oral cholecystography is a valuable preoperative clinical risk factor in predicting increased conversion rate to open cholecystectomy, increased operative complication and prolonged operation time.

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Laparoscopy-assisted Total Gastrectomy with Pancreas-preserving Splenectomy for Early Gastric Cancer: A Case Report (조기위암에서 복강경보조 위전절제술 및 췌장보존식 비전절제술 1예)

  • Park, Jong-Min;Kim, Do-Yoon;Lee, Jae-Man;Leem, Chai-Sun;Jin, Sung-Ho;Cho, Yong-Kwan;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.7 no.2
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    • pp.97-101
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    • 2007
  • We report our experience with a case of performing laparoscopy-assisted total gastrectomy along with pancreas-preserving splenectomy for treating early gastric cancer. laparoscopy-assisted total gastrectomy was planned for a 62-year-old male patient with a double early gastric cancer located in the upper and lower third of the stomach. Five trocars were placed and we used a harmonic scalpel to dissect the greater curvature. Enlarged splenic hilar lymph node was encountered and they were proved to be metastasis by frozen section biopsy. We then performed total gastrectomy with pancreas-preserving splenectomy for the purpose of completely dissecting the lymph nodes along the splenic artery and splenic hilum. We created a 4 cm sized longitudinal mini-laparotomy below the xiphoid process to remove the specimen, and anastomosis was done via the Roux-en-Y method. The patient was discharged on the 9th postoperative days after an uneventful recovery. Our experience shows that laparoscopy-assisted total gastrectomy with pancreas-preserving splenectomy is a relatively safe procedure for treating upper third early gastric cancer with metastatic splenic hilar lymph nodes.

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Comparison of $LigaSure^{TM}$ and Bipolar Vessel Sealing System for Laparoscopic Ovariectomy in Cats (복강경을 이용한 고양이의 난소 절제술에서 지혈기구인 $LigaSure^{TM}$와 양극 전기 응고 장치(bipolar)의 비교)

  • Jin, So-Young;Lee, Seung-Yong;Park, Se-Jin;Kim, Young-Ki;Seok, Seong-Hoon;Hwang, Jae-Min;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.477-482
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    • 2014
  • The aim of this study was to investigate and compare technique, surgical time, and complications of laparoscopic ovariectomy using $LigaSure^{TM}$ and bipolar vessel sealing system in cats. Laparoscopic ovariectomy was performed under general anesthesia on 10 healthy female cats admitted for elective ovariectomy. Surgery was performed through three midline portals. Each ovary was randomly-assigned to removal by use of either $LigaSure^{TM}$ or bipolar vessel sealing system. Duration of predetermined surgery intervals and complications were compared. Bipolar OVE ($2:16{\pm}1:14$ minutes) took significantly longer surgical time compared to the $LigaSure^{TM}$ OVE ($1:24{\pm}0:59$ minutes, P = 0.021). The ovarian pedicle fat and obesity did not influence surgery duration. Intraoperative hemorrhage occurred with bipolar OVE in three cats, but had no significant influence on surgical time. The results suggest that both $LigaSure^{TM}$ and bipolar devices appear to be effective, but $LigaSure^{TM}$ can be used as a stand-alone device that decreases surgical time and complication compared with bipolar vessel sealing system.

Transgastric Endoscopic Cholecystectomy in a Dog : Natural Orifice Transluminal Endoscopic Surgery (개에서 내시경을 이용한 경위장관 담낭절제술 1예 : 자연개구부 내시경수술)

  • Jeong, Seong-Mok;Kim, Young-Ill;Lee, Jae-Yeon;Jee, Hyun-Chul;Park, Ji-Young;Park, Jong-Heon;Kim, Ji-Yeon;Lee, Sang-Il;Kim, Myung-Cheol;Shin, Sang-Tae;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.315-319
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    • 2007
  • Transgastric endoscopic cholecystectomy was successfully accomplished in a 1-year-old, 15 kg, female, mongrel dog. Single-working channel flexible gastric endoscope was used with the aid of one abdominal laparoscopic port. Gastrotomy was performed using endoscopic needle knife at the ventral antral region. Through the gastric incision endoscope was advanced and retroflexed for the visualization of gallbladder. For the better exposure of surgical field, gentle traction was applied at the fundus of the gallbladder using laparoscopic grasping forceps. Cystic duct and artery was ligated using endoclips. After transecting the duct and artery, gallbladder was dissected using endoscopic coagulating grasping forceps and needle knife. Resected gallbladder was retrieved through the mouth and gastric incision site was sutured using endoclips. There was no evidence of bile leakage or stomach leakage on postoperative day (POD) 3. On POD 16, gastric endoscopy and laparoscopy was performed. Gastric endoscopy revealed complete adhesion of incision site. The content of the peritoneum appeared healthy, with no sign of infection, bile staining, or organ injury. The omentum was adhered over resected gallbladder fossa and the serosal surface of gastrotomy site. This is the first report of NOTES cholecystectomy in the dog and provides new concept of cholecystectomy of the dog.

Diagnostic Laparoscopic Biopsy in Dogs and Cats (개와 고양이에서 복강경을 이용한 생검 증례)

  • Park, Se-Jin;Lee, Seung-Yong;Jin, So-Young;Kim, Min-Hyang;Seok, Seong-Hoon;Kim, Young-Ki;Lee, Hee-Chun;Jung, Dong-In;Hong, Il-Hwa;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.21-24
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    • 2016
  • Four dogs and two cats received laparoscopic or laparoscopic-assisted biopsy of abdominal organs for definite diagnosis of illness. Patients were presented with a chief complaint of acute or chronic vomiting excluding case 5 (seizure). Two patients needed the liver biopsy (case 1 and 5), and others did stomach and small intestine biopsy excluding case 2 (small intestine biopsy only). Surgical procedure was performed with modified standard methods. All patients recovered uneventfully and did not require any hospitalization without complications. Laparoscopic and laparoscopic-assisted biopsy could offer benefits of reduced incision length and rapid postoperative recovery.

The Effects of Semi-Fowler's Position on Post-Operative Recovery in Recovery Room for Patients with Laparoscopic Abdominal Surgery (복강경 수술 후의 반좌위가 수술직후 회복정도에 미치는 영향)

  • Kim, Kyung Ah;Kim, Yeong Kyeong
    • Korean Journal of Adult Nursing
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    • v.16 no.4
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    • pp.566-574
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    • 2004
  • Purpose: To find the effects of semi-Fowler's position on the post-operative recovery for patients with laparoscopic abdominal surgery in recovery room. Method: The research was performed by nonequivalent control group non-synchronized quasi-experimental design. The subjects are forty patients who had laparoscopic abdominal surgery in a hospital from Aug. thru Nov. of 2003. Post-recovery scores and $O_2$saturation degree were measured. The experimental group was place in semi fowler's position while the control group was placed in supine position. The homogeneity between the control group and experimental group was analyzed using the Chi-square, and the hypothesis were tested using t-test. Result: 1. The patients in the experimental group placed in semi fowler's position showed significant higher post-recovery scores than those in the control group who were in a supine position. 2. The patients in the experimental group who were in semi Fowler's position showed no significant higher $O_2$ saturation degree than those in the control group who were in supine position. Conclusion: Based on the results described above, it is considered that the semi-Fowler's position might be effective in enhancing the post-operative recovery score of the patients with laparoscopic abdominal surgery in recovery room.

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