• Title/Summary/Keyword: Invasive surgery

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Clinical Outcomes of Minimally Invasive Surgical Stabilization of Rib Fractures Using Video-Assisted Thoracoscopic Surgery

  • Chae-Min Bae;Shin-Ah Son;Yong Jik Lee;Sang Cjeol Lee
    • Journal of Chest Surgery
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    • v.56 no.2
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    • pp.120-125
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    • 2023
  • Background: Multiple rib fractures are common in blunt chest trauma. Until recently, most surgical rib fixations for multiple rib fractures were performed via open thoracotomy. However, due to the invasive nature of tissue dissection and the resulting large wound, an alternative endoscopic approach has emerged that minimizes the postoperative complications caused by the manipulation of injured tissue and lung during an open thoracotomy. Methods: Our study concentrated on patients with multiple rib fractures who underwent surgical stabilization of rib fractures (SSRF) between June 2018 and May 2020. We found 27 patients who underwent SSRF using video-assisted thoracoscopic surgery. The study design was a retrospective review of the patients' charts and surgical records. Results: No intraoperative events or procedure-related deaths occurred. Implant-related irritation occurred in 4 patients, and 1 death resulted from concomitant trauma. The average hospital stay was 30.2±20.1 days, and ventilators were used for 12 of the 22 patients admitted to the intensive care unit. None of the patients experienced major pulmonary complications such as pneumonia or acute respiratory distress syndrome. Conclusion: Minimally invasive rib stabilization surgery with the assistance of a thoracoscope is expected to become more widely used in patients with multiple rib fractures. This method will also assist patients in a quick recovery.

Minimally Invasive Reduction and Pin Fixation Treatment for Displaced Intraarticular Calcaneal Fracture (최소 침습적 정복술 및 금속강선 고정술을 이용한 전위된 관절내 종골 골절의 치료)

  • Lee, Jin-Young;Park, In-Heon;Kim, Gab-Lae;Kim, Tae-Hwa;Oh, Bum-Suk
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.66-72
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    • 2010
  • Purpose: To evaluate the clinical efficacy of the minimally invasive posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2006 to October 2008, we studied retrospectively 45 patients, 56 cases who were treated with minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and AOFAS score, circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared Bohler angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 1 was 81, type 2 was 75, type 3 was 69, type 4 was 61. By AOFAS score, Sanders type 1 was 88, type 2 was 82, type 3 was 78, type 4 was 63. And by circle draw test, type 1 was 8.8 cm, type 2 was 8.5 cm, type 3 was 8 cm, type 4 was 6.6 cm. Preoperative Bohler angle and Gissane angle were $7.2^{\circ}$, $98^{\circ}$, and it increased to $21.2^{\circ}$, $116^{\circ}$ after postoperative 1 year. Conclusion: Minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture was considered to be an effective treatment modality.

Minimally Invasive Approach for Reoperative Mitral Valve Replacement (승모판 재수술에서 경침습 술기의 적용)

  • Sun, Kyung;Kim, Jung-Taek;Kim, Kwang-Ho;Kim, Hyun-Tae;Kim, Sei-Ryun;Lee, Choon-Soo;Lee, Woo-Hyoung
    • Journal of Chest Surgery
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    • v.31 no.3
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    • pp.308-310
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    • 1998
  • Minimally invasive techniques for various cardiac disease are widely accepted in these days. We report a successful case of reoperative mitral valve replacement approached successfully by a small right parasternal incision.

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Minimal Invasive Coronary Artery Fistula Ligation

  • Mitropoulos, Fotios A.;Kanakis, Meletios A.;Chatzis, Andrew;Contrafouris, Constantinos;Sofianidou, Ioanna A.;Lioulias, Achilleas G.
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.545-547
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    • 2014
  • A coronary artery fistula was surgically ligated in a 38-year-old woman via a left anterior mini-thoracotomy without the use of cardiopulmonary bypass. In selected cases, this surgical approach can provide an excellent surgical exposure for coronary artery fistula ligation. It also offers an excellent cosmetic result and shorter hospital stay.

The Effect of Less Invasive Methods with VATS in the Management of Descending Necrotizing Mediastinitis (하행성 괴사성 종격동염의 치료에서의 비디오 흉강경을 이용한 저침습적 방법의 효용성)

  • 민호기;심영목;김진국
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.630-633
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    • 2002
  • Although the incidence of descending necrotizing mediastinitis(DNM) is low, this is a serious disease because it"s mortality have been reported to be as high as 40∼50%. Currently, many authors have emphasized aggressive surgical approaches rather than medical treatment alone. We report good results in 2 DNM patients treated by less invasive approach with video-assisted thoracoscopic surgery, Less invasive methods with video-assisted thoracoscopic surgery can reduce hospital stay and morbidity if effective drainage can be achieved in selected DNM patients.

Mitral Valve Replacement by Minimally Invasive Right Parasternal Incision -A Case Report (우측 흉골외측 절개를 이용한 승모판막 치환술 -1례보고-)

  • 김학제;조원민
    • Journal of Chest Surgery
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    • v.30 no.10
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    • pp.1015-1018
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    • 1997
  • Median sternotomy incision is world-widely used for open heart surgery, especially in valvular heart disease. But recently, minimally invasive approach by the right parasternal incision for valvular heart disease was introduced with the many merits by small incision. We experienced 1 case of mitral valve repalcement by right parasternal incision and extended transseptal approach. This technique has no specific compli ations or problems compared with the median sternotomy and was proven by the excellent exposure. Cosmetically, the patient was satisfied with the incision.

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Current Issues in Minimally Invasive Esophagectomy

  • Na, Kwon Joong;Kang, Chang Hyun
    • Journal of Chest Surgery
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    • v.53 no.4
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    • pp.152-159
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    • 2020
  • Minimally invasive esophagectomy (MIE) was first introduced in the 1990s. Currently, it is a widely accepted surgical approach for the treatment of esophageal cancer, as it is an oncologically sound procedure; its advantages when compared to open procedures, including reduction in postoperative complications, reduction in the length of hospital stay, and improvement in quality of life, are well documented. However, debates are still ongoing about the safety and efficacy of MIE. The present review focuses on some of the current issues related to conventional MIE and robot-assisted MIE based on evidence from the current literature.

The Pringle maneuver in the modern era: A review of techniques for hepatic inflow occlusion in minimally invasive liver resection

  • Omar A. Mownah;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.131-140
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    • 2023
  • During minimally invasive liver resection (MILR), the Pringle maneuver aims to minimize blood loss and provide a clear operative field, thereby identifying intrahepatic structures and facilitating safe parenchymal transection. Several techniques for using the Pringle maneuver in MILR have been described. This review presents various methods which have been reported in the literature. A systematic literature search used the MEDLINE/PubMed database from its earliest records to August 2022 using appropriate search headings and keywords. The primary outcome was identifying techniques for performing hepatic inflow occlusion during laparoscopic/robotic hepatectomy. Inclusion criteria consisted of publications describing technical steps to obtain hepatic inflow occlusion during minimally invasive hepatectomy. A literature search identified 23 relevant publications, and the full texts were examined. The techniques described in the reports can be broadly categorized into three groups: (1) the Rummel-tourniquet technique, (2) vascular clamp use, and (3) the Huang Loop technique. Various techniques have been used in MILR to achieve inflow confinement successfully. The authors prefer the modified Huang Loop technique because it is inexpensive, reliable, and quick to apply or release. Hepatobiliary surgeons are advised to familiarize themselves with these MILR techniques, which have proven effective and safe inflow occlusion.

The Treatment of Left Atrial Appendage Aneurysm by a Minimally Invasive Approach

  • Kim, Young Woong;Kim, Ho Jin;Ju, Min Ho;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.51 no.2
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    • pp.146-148
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    • 2018
  • Left atrial appendage (LAA) aneurysm is a rare, pathologic condition that may lead to atrial tachyarrhythmia or thromboembolic events. A 49-year-old man presented with aggravated palpitation and dizziness. He suffered from refractory atrial fibrillation despite a previous history of radiofrequency catheter ablation. Echocardiography revealed a 57-mm LAA aneurysm. Surgical ablation was performed through a right mini-thoracotomy, and the LAA aneurysm was obliterated with a 50-mm AtriClip (Atricure Inc., Westchester, OH, USA). However, follow-up computed tomography showed residual communication, so the patient is still taking warfarin. We report that a minimally invasive strategy for treating LAA aneurysm can be considered, but incomplete closure may occur; thus, caution is needed.