• Title/Summary/Keyword: 최소침습법

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Minimally Invasive Technique for Thyroidectomy ; A Modification of the Conventional Thyoidectomy Technique (최소침습 갑상선 수술법 :전통적 갑상선 수술법의 변형술식)

  • Park Cheong-Soo;Chung Woung-Youn;Chang Hang-Seok
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.2
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    • pp.177-181
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    • 2000
  • 배경 및 목적: Theodor Kocker에 의해 일반화된 전통적인 갑상선 수술방법은 갑상선 질환의 종류 및 정도, 수술범위와 상관없이 광범위한 수술범위로 인한 조직 손상으로 인해 수술후 환자들의 여러가지 불편감은 물론 경부의 넓은 부위의 통증과 경부 피부부종, 장액종, 혈종 등과 같은 후유증을 동반할 수 있다. 최근 본 저자들은 이같은 전통적 갑상선 수술의 부작용을 최소화하기 위해 작은 피부절개($3{\sim}4.5cm$) 후 피하 피판(subplatysmal skin flap) 없이 직접 갑상선으로 접근하는 새로운 수술기법으로서 최소침습 갑상선 수술기법을 개발하였기에 그 술식을 소개하고 전통적인 갑상선 절제술에 대한 우월성을 확인하고자 본 연구를 시행하였다. 대상 및 방법: 1999년 1월 15일 부터 2000년 1월 14일까지 573예의 갑상선 수술 예 중 최소침습 갑상선절제술이 시행되었던 466예와 1998년 1월 15일부터 1999년 1월 14일까지 전통적 갑상선 수술을 시행한 549예 중 거대 종양(양성>6cm, 악성>5cm), 흉골하 선종, 국소진행암, 재발암, 측경부의 다발성 림프절 전이가 있었던 112예를 제외한 437예의 임상병리적 특성과 피부절개 길이, 수술 시간, 수술중 출혈양, 수술후 진통제 요구빈도 및 재윈기간, 수술 후 합병증 발생빈도를 비교 분석하였다. 결 과: 두 군간의 임상병리적 특성상의 유의한 차이는 없었다. 피부절개 길이($3.7{\pm}0.7cm,\;vs\;9.6{\pm}3.3cm$), 수술 시간($57.6{\pm}11.7$분 vs $85.2{\pm}32.3$분) 수술 중 출혈양($18.4{\pm}15.3ml\;vs\;43.1{\pm}21.8ml$), 수술후 재원기간($1.6{\pm}0.5$일 vs $4.3{\pm}1.6$일), 및 수술후 진통제 요구빈도가 전통적 수술군에 비해 최소침습 수술군에서 통계적으로 유의하게 감소되었으나(p<0.05), 수술후 장액종 및 혈종 형성, 일시적인 음색변화, 일시적인 저칼슘혈증과 같은 합병증의 발생빈도는 각각 4.3%(n=20)와 4.8%(n=21)로 두 군간에 유의한 차이가 없었다. 결 론: 최소침습 갑상선 수술법은 새로운 수술기구의 도입 없이도 갑상선 수술의 충분한 시야를 확보할 수 있고 안전하고 간단하게 시행할 수 있으며, 기존 수술법으로 인한 부작용을 최소화할 수 있어 전통적 인 수술법을 대치할 수 있는 새로운 방법으로 사료된다.

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Minimally Invasive Cardiac Surgery - Three different approaches - (최소 침습성 심장수술 -세가지 다른 접근법-)

  • Chung, Sung-Hyuk;Yang, Ji-Hyuk;Nam, Hye-Won;Kim, Ki-Bong;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.438-441
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    • 1999
  • Background: Minimally invasive cardiac surgery has emerged as a new approach to the conventional median sternotomy. The suggested advantages of the minimally invasive technique includes improved cosmesis, simplicity of opening and closing the chest, less postoperative pain, less risk of infection and bleeding, early rehabilitation, and reduced length of hospital stay. Material and Method: Between March 1997 and December 1997, we performed 36 cases of minimally invasive cardiac surgery via three different approaches ; right paramedian, transverse sternotomy and mini-sternotomy with upper sternal split. Result: There was no operative mortality. Postoperative complications were atrial fibrillation in 4 patients, bleeding that required reoperation in 1 patient, and delayed wound closure in 1 patient who underwent 3rd redo operation. Average length of skin incision was 9.1${\pm}$0.9 cm. Average duration of stay in the intensive care unit was 48${\pm}$29 hours and the patients were discharged 10${\pm}$7 days after the operation. Conclusion: In spite of the difficulties in defibrillation, deairing, and cardiac decompensation, minimally invasive approaches will be applied increasingly because of the suggested advantages.

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Clinical performance of esthetic ceramic partial-coverage restorations with supra-gingival margin using minimally invasive tooth preparation method according to the concept of adhesive dentistry (접착치의학 개념에 따른 최소 침습적 치아 삭제법을 적용한 심미적인 치은 연상 변연 도재 부분피개관 수복 증례)

  • Hong, Myung-Sik;Choi, Yu-Sung;Lee, Jong-Hyuk;Ha, Seung-Ryong
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.319-332
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    • 2021
  • With the rapid development of aesthetic ceramic materials and resin adhesives, the transition from metal ceramic crown to all-ceramic restoration is being actively carried out. When making porcelain restorations, the advantages can be maximized only when appropriate forms and techniques are used. Recently, an esthetic partial-coverage restoration method with supra-gingival margins was introduced by applying a minimally invasive tooth removal method that preserves enamel as much as possible and enhances adhesion efficiency. Through this, various advantages such as minimization of tooth structure removal and ease of excess cement removal can be obtained. In addition, since this manufacturing method does not require cord packing, it is possible to save time for impression taking and reduce patient discomfort. Furthermore, the margins can be clearly obtained without the intervention of gingival fluid or blood, making it possible to manufacture more accurate restorations. In the following cases of patients with partial tooth defects, esthetic ceramic partial-coverage restorations with supra-gingival margin was applied using minimally invasive tooth preparation method according to the concept of adhesive dentistry. Therefore, unnecessary tooth abutment preparation was prevented and residual tooth structure could be preserved as much as possible. After delivery of the ceramic partial-coverage restorations, favorable outcome was obtained.

Use of Minimally Invasive Plate Osteosynthesis for Tibial Diaphyseal Fracture in Three Dogs (경골 골간 골절에서의 최소 침습적 금속판 고정술의 이용 3례)

  • Heo, Su-Young;Lee, Ki-Chang;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.29 no.4
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    • pp.339-343
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    • 2012
  • Three dogs were presented with diaphyseal fracture of the tibia following separate motor vehicle accidents. On physical and orthopedic examinations, the dogs were noted to have soft-tissue swelling and a closed fracture in these tibia sites. Radiographs revealed a simple, short oblique fracture (case 1), a comminuted, spiral fracture (case 2), and a simple, spiral fracture (case 3) in tibia. Minimally invasive percutaneous plate osteosynthesis (MIPO) using a veterinary cuttable plate or locking plate was applied for the treatment of these fractures. The surgery was successful, and the fractures healed without any complications by 7 weeks (case 1), 10 weeks (case 2) and 8 weeks (case 3) after surgery. Our patients showed fast bone healing times and early weight-bearing during the treatment of their tibia fractures. Therefore, MIPO was a useful procedure for diaphyseal fracture of the tibia in veterinary orthopedics.

Minimally Invasive Arthroscopic-Assisted Reduction with TightRope® for Coxofemoral Luxation in a Korean Water Deer (Hydropotes inermis argyopus) (고라니에서 최소침습적 관절경과 TightRope®의 이용한 엉덩관절탈구 교정 증례)

  • Heo, Su-Young;Seol, Jae-won;Park, Ji-young;Jeong, Seong-mok;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.32 no.6
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    • pp.540-543
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    • 2015
  • A Korean water deer was rescued with non-weight-bearing lameness of the right hind limb. Clinical and radiographic examination revealed a craniodorsal coxofemoral luxation. The cause of the right coxofemoral luxation (CL) was unknown. We performed minimally invasive arthroscopic-assisted reduction with toggle pin fixation (mini TightRope$^{(R)}$). Craniodorsal CL in the water deer was reduced and stabilized successfully. At 60 days after admission, the water deer was successfully released back into the wild. This minimally invasive surgical technique can be used to correct coxofemoral luxation in wild animals.

Laparoscopic Nissen Fundoplication and Collis Gastroplasty (복강경을 이용한 니센 위저추벽성형술 및 콜리스 위성형술)

  • Song Sang-Yun;Park Jeong-Min;Jung In-Suk;Anh Byung-Hee;Na Kook-Ju
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.733-738
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    • 2006
  • The prevalence of gastroesophageal reflux disease has been increased recently in Korea. The use of minimally invasive laparoscopic and thoracoscopic surgery has become popular in the operation of esophageal disease such as esophageal cancer or gastroesophageal reflux disorder. We experienced three cases of laparoscopic Nissen fun-doplications and one case of laparoscopic Collis gastroplasty, and we will describe the technical aspect of these surgeries.

Treatment of Transverse Patella Fracture with Minimally Invasive Load-Sharing Patellar Tendon Suture and Cannulated Screws (최소 침습 기법 슬개건 부하 분산 봉합술과 유관 나사못을 이용한 슬개골 횡골절의 치료)

  • Lee, Beom-Seok;Park, Byeong-Mun;Yang, Bong-Seok;Kim, Kyu-Wan
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.540-545
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    • 2021
  • A transverse fracture is the most common type of displaced patella fracture requiring surgery. These fractures are commonly fixed with parallel Kirschner wires or screws that cross the fracture line, often with an additional tension band. Nevertheless, conventional fixation methods of patella fractures have prevalent complications caused by the protrusion of wires or pins. These complications necessitate additional surgery for hardware removal, increase medical cost, and can limit the function of the knee joint. This paper reports cases treated with a minimally invasive load-sharing percutaneous suture of the patella tendon. The procedure provides reliable fixation for transverse patella fractures, minimizes soft tissue injuries, preserves blood flow, and reduces postoperative pain. In addition, the procedure also reduces the irritation and pain caused by the internal fixture, thereby reducing the risk of restricted knee joint movement.

Treatment of Simple Bone Cyst in Calcaneus with Endoscopic Curettage and Autologous Bone Graft - Case Report - (종골에 발생한 단순 골낭종의 내시경적 소파술 및 골 이식술 - 증례 보고 -)

  • Jung, Gu-Hee;Kim, Jae-Do;Kim, Ji-Youn
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.182-186
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    • 2008
  • Simple bone cysts are common, benign bone tumor and for the treatment, curettage with bone grafting, resection and intralesional steroid or autogenic bone marrow injections were usually performed. Simple bone cysts of the calcaneus are relatively uncommon and curettage with autologous bone grafting were proposed for management rather than intralesional steroid injections. We would like to report 9 year-old male with calcaneal simple bone cyst treated satisfactorily by minimally invasive endoscopic curettage and autologous bone grafting with review of the relevant literature.

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Biportal Percutaneous Endoscopic Spinal Surgery for Lumbar Spinal Stenosis (요추 척추관 협착증 환자의 양방향 경피적 내시경을 이용한 척추 수술)

  • Kang, Taewook;Lee, Soon Hyuck;Park, Si Young
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.219-226
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    • 2019
  • Lumbar decompressive surgery is a standard surgery for lumbar spinal stenosis. Many surgical techniques have been introduced, ranging from open surgery to percutaneous procedures. Minimally invasive techniques are preferred because of the less postoperative pain and shorter hospital stay. Uniportal percutaneous endoscopic decompression has technical difficulties due to the narrow field. Biportal percutaneous endoscopic decompression is a satisfactory technique that can compensate for the shortcomings and provide sufficient decompression.