• Title/Summary/Keyword: 최소 침습적

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Multi-vessel Small Thoracotomy (MVST) CABG with Robot-assisted Bilateral ITA Harvesting - A case report - (수술 로봇을 이용한 양측 내흉동맥 채취 후 시행한 최소 침습적 다혈관 관상동맥 우회술 - 1예 보고 -)

  • Chung, Jin-Woo;Lee, Jae-Won;Je, Hyoung-Gon
    • Journal of Chest Surgery
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    • v.41 no.2
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    • pp.264-267
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    • 2008
  • The da Vinci telemanipulator system (Intuitive Surgical, Sunnyvale, CA USA) is the most advanced robotic surgical system and has been increasingly used for cardiac surgical procedures. We report out first clinical experience of use of the da Vinci telemanipulator system for endoscopic harvesting of the bilateral thoracic artery andmulti-vessel small thoracotomy off pump CABG for 3-vessel disease. The da Vinci telemanipulator system has been previously utilized primarily for mitral valve surgery.

A Comparison between Minimally Invasive Percutaneous Plate Osteosynthesis and Plate Fixation in the Treatment of Clavicle Midshaft Fracture (쇄골 간부 골절의 최소 침습적 경피적 금속판 고정술과 관혈적 수술 비교)

  • Yoo, Seong-Ho;Kang, Suk-Woong;Kim, Bu-Hwan;Song, Moo-Ho;Kim, Yeong-Joon;Park, Gyu-Taek;Kwack, Chang-Hun
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.1-6
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    • 2017
  • Purpose: To retrospectively compare minimally invasive percutaneous plate osteosynthesis (MIPPO) with open plate fixation for the treatment of clavicle midshaft fracture. Materials and Methods: Between November 2011 to May 2014, 40 cases that were followed for more than 1 year-among all cases of MIPPO and open plate fixation-were analyzed. The study population was divided into two groups: group A included 20 cases of MIPPO and group B included 20 open plate fixation cases. The comparative analysis between the two groups was based on the operative time, bone union, functional evaluation (American Shoulder and Elbow Society score), incision length, pain relief (visual analogue scale, VAS), and complication. Results: The bone union was successful for all the cases, and the functional evaluation scores of the shoulder joint were satisfactory for both groups (p>0.05). The operative time was 47.5 minutes and 58.7 minutes for group A and B, respectively (p<0.05). The incision length for group A was 6.2 cm and that for group B was 10.7 cm with statistical significance (p<0.05). Pain relief (VAS) after surgery for group A showed a quick recuperation in the early stages. For complications, there were 2 cases of dysesthesia and 1 case of malunion due to metal fixation failure in group A. There were 6 cases of dysesthesia and 2 cases of cosmetic problem due to hypertrophic scar in group B. Conclusion: Surgical results of clavicle shaft fracture were satisfactory for both groups, but group A had advantages of shorter operative time, minimal incision length, and better pain relief in the early stages compared with group B. However, we need further evaluations with long-term follow-up results and complications, such as malunion and exposure on radiation.

Anatomic Concerns about Hip Arthroscopy (고관절 관절경을 위한 해부학적 관점)

  • Kim, S.J.;Oh, Kwang-Jun
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.79-87
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    • 2010
  • 고관절경을 시행하는 집도의사는 관절경을 통해 관찰되는 정상 고관절의 해부학적 구조물에 대한 정확한 지식과 삽입구 위치에 대한 숙지를 통해 환자의 증상과 비정상 관절경 소견을 임상적으로 연관 시키는 것이 중요하며, 적절한 환자의 선택과 고관절경의 술기에 대한 항상성을 유지할 수 있어야 최소 침습적인 술기의 장점을 가지고 있는 고관절경의 만족할 만한 치료 결과를 기대할 수 있다.

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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.

Minimally Invasive Surgery for Esophageal Cancer (식도암에 대한 최소 침습수술)

  • Ryu Kyong Min;Jung Yo Chun;Cho Suk Ki;Jin Sung Hoon;Sung Sook Whan;Park Do Joong;Kim Hyung-Ho;Jheon Sanghoon
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.255-259
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    • 2006
  • The operation for esophageal cancer is both complex and challenging, and may be associated with significant morbidity and mortality compared to other oncologic surgeries. Minimally invasive surgeries have been applied on various kinds of surgery to enhance better recovery with minimal surgical complications. But for the esophageal cancer, it has not been actively applied yet. With improvement in instrumentations and increasing experience with endoscopic surgical techniques, minimally invasive surgical approaches to esophageal cancer are being explored to determine feasibility, results and potential advantages. We experienced eight cases of minimally invasive surgery for esophageal cancer and report here focusing on surgical techniques and tips.

Cauterizing Effect Animation for Virtual Surgery Medical Simulation (가상 수술 의료 시뮬레이션을 위한 소작 효과 애니메이션 기법)

  • Lee, Jeong-Jin;Lee, Ho;Kye, Hee-Won
    • Journal of Korea Multimedia Society
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    • v.14 no.9
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    • pp.1175-1181
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    • 2011
  • Practice education using virtual medical simulation has been recently introduced to maximize the learning efficiency in clinical environment. Specially, in minimally invasive surgery, the necessity of virtual surgery medical simulation has been substantially increased. Since cauterizing effect occurred frequently in minimally invasive surgery has been represented by simple bleeding, realistic cauterizing effect animation has not been proposed yet. In this paper, we propose realistic real-time cauterizing effect animation. Proposed method changes the individual element of each vertex color of the mesh and uses sigmoid function to impose weights for the smooth color change inside the valid mesh region so that the results of cauterizing effect animation was realistic. In addition, by proposing cauterizing color buffer, overlapped cauterizing effects can be realistically represented. Proposed method greatly improves the sense of the real and absorption in virtual surgery medical simulation so that the education efficiency of doctors and students using medical simulation can be maximized.

Effects of pain, sleep and self-care behavior in patients underwent robotic minimally invasive cardiac surgeries (로봇을 이용한 심장수술이 환자의 통증, 수면 및 자가간호수행에 미치는 영향)

  • Park, Soohyun;Jang, Insil
    • Journal of Digital Convergence
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    • v.17 no.7
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    • pp.265-274
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    • 2019
  • The purpose of this study was to know the difference in pain, sleep, self-care behavior in patients performed by sternotomy and robotic minimally invasive cardiac surgeries. The participants were 64 patients with sternotomy and 64 patients with minimal thoracotomy in heart valve surgeries at a tertiary hospital in Seoul. Data were analyzed using descriptive statistics, ${\chi}^2$ test, paired t-test. with SPSS/WIN(22.0). The participants with minimally invasive thoracotomy felt severe pain than the patients with thoracotomy at post operation day 2 & 5. The severe pain site were the surgical site in both groups. The participants with sternotomy had better sleep than minimally invasive thoracotomy patients. Self-care behavior was higher in the minimally invasive thoracotomy group. Therefore, despite the many advantages of robotic surgery such as rapid recovery and shortening of length of stay in hospital, accurate pain assessment and application of differentiated protocols are needed for the management of pain in the patients with robotic minimally invasive cardiac surgeries. In addition, a structured education program intervention is needed to improve comfort by considering gender, age, and method of operation.

Real-time Bleeding Animation for Virtual Surgery Medical Simulation (가상 수술 의료 시뮬레이션을 위한 실시간 출혈 애니메이션 기법)

  • Lee, Jeong-Jin;Seo, Che-Hwan;Lee, Ho;Kye, Hee-Won;Lee, Min-Sun
    • Journal of Korea Multimedia Society
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    • v.15 no.5
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    • pp.664-671
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    • 2012
  • Recently, practice education using virtual medical simulation has been applied to real clinical environment by enhancing the learning efficiency. Specially, in minimally invasive surgery, the necessity of virtual surgery medical simulation has been increased. Realistic bleeding animation, which represents bleeding special effects frequently occurred in virtual medical simulation environment, has not been proposed yet. In this paper, we propose realistic real-time bleeding animation. For bleeding simulation, proposed method calculates main and effective bleeding regions along the main bleeding direction vector to represent naturalistic bleeding effect. In addition, for bleeding rendering, proposed method uses sigmoid function to impose weights of vertex opacities for the smooth opacity change so that the results of bleeding animation is realistic. Proposed method improves the sense of the real and absorption in virtual surgery medical simulation so that the education efficiency of doctors and students using medical simulation can be enhanced.

Treatment of Distal Tibial Spiral Fractures Combined with Posterior Malleolar Fractures (후과 골절이 동반된 경골 원위부 나선상 골절의 치료)

  • Kim, Young Sung;Lee, Ho Min;Kim, Jong Pil;Chung, Phil Hyun;Park, Soon Young
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.317-325
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    • 2021
  • Purpose: This study compared the functional and radiologic outcomes of intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) for tibia fractures in distal tibial spiral fractures combined with posterior malleolar fractures, as well as the functional and radiologic outcomes with and without fixation for posterior malleolar fractures. Materials and Methods: From January 2010 to December 2018 the radiological and clinical outcomes of 30 skeletally mature patients with tibial spiral fractures (AO Foundation/Orthopaedic Trauma Association classification 42-A1, B1, C1) combined with posterior malleolar fractures were analyzed. Sixteen patients were treated with IMN, and 14 patients were treated with MIPO. Depending on the surgical methods, the radiologic and clinical outcomes were compared by evaluating the bone union time, postoperative alignment, postoperative displacement of the posterior malleolar fragment, and American Orthopaedic Foot and Ankle Society (AOFAS) score. Moreover, the functional and clinical outcomes with and without fixation for posterior malleolar fractures were compared. Results: The mean bone union time was 21.8 weeks in the IMN group and 23.1 weeks in the MIPO group (p=0.500). At the final follow up, the mean alignment was coronal angulation of 1.8°, sagittal angulation of 1.6° in the IMN group and coronal angulation of 1.2° and sagittal angulation of 1.7° in the MIPO group (conoral angulation: p=0.131, sagittal angulation: p=0.850). The postoperative and final radiologic evaluation showed no displacement of the posterior malleolar fragment and excellent joint congruity in all cases. At the final follow-up, the mean AOFAS score was 88.0 on average in the IMN group and 87.6 on average in the MIPO group (p=0.905). The ankle range of motion and AOFAS score were similar in the fixation group and no fixation group for posterior malleolar fractures. Conclusion: Both IMN and MIPO for tibial spiral fractures combined with posterior malleolar fractures result in satisfactory radiological and clinical outcomes.