• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.22-28
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• 2012

Purpose: In accordance to an increased interest in facial appearance and the popularization of computed tomography scanning, the number of diagnosis and treatment of blowout fractures has been increased. The purpose of this article is to review pure blowout fracture surgery through transconjunctival incision focusing on complications and their management. Methods: In this retrospective study, 583 patients, who had been treated for pure blowout fracture through transconjunctival incision from 2000 to 2009, were evaluated. Their hospital records were reviewed according to their sex, age, fracture site, preoperative presentations, time interval between trauma and surgery, and postoperative complications. Results: According to postoperative follow-up results, there were early complications that included wound dehiscence and infection (0.2%), hematoma (insomuch as extraocular movement is limited) (0.7%), lacriminal duct injury (0.5%), and periorbital nerve injury (0.7%). In addition, there were late complications that lasted more than 6 months, that included persistent diplopia (1.7%), extraocular movement limitation (0.9%), enophthalmos (1.0%), periorbital sensation abnormalities (1.0%), and entropion (0.5%). Conclusion: We propose the following guidelines for prevention of postoperative complications: layer by layer closure; bleeding control with the epinephrine gauzes, Tachocomb, and Tisseel; conjunctival incision 2 to 3 mm away from punctum; avoidance of excessive traction; performing surgical decompression and high dose corticosteroid therapy upon confirmation of nerve injury; atraumatic dissection and insertion of Medpor Barrier implant after securing a clear view of posterior ledge; using Medpor block stacking technique and BioSorb FX screw fixation; performing a complete resection of the anterior ethmoidal nerve during medial wall dissection; and making an incision 2 to 3 mm below the tarsal plate.

• Journal of Chest Surgery
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• v.55 no.1
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• pp.44-48
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• 2022

Background: Although classical multi-port video-assisted thoracic surgery has been widely performed, single-incision thoracoscopic surgery (SITS) is a popular surgical technique for the treatment of primary spontaneous pneumothorax (PSP). However, the inconvenient alignment of instruments and the limited field of view occasionally make surgeons convert from SITS to multi-port surgery or extend the incision. This study aimed to present an easy and safe SITS technique for PSP using a spinal needle. Methods: In total, 139 patients underwent SITS between May 2011 and December 2017. We used a spinal needle to hook the bulla or bleb, and wedge resection was performed through a small incision. Patients' medical records were reviewed retrospectively, and a telephone survey was conducted to investigate the recurrence rate. Results: The mean age of the 139 patients was 23.62±9.60 years. The mean operative time was 36.69±14.64 minutes, and multi-port conversion was not performed. The mean postoperative hospital stay was 3.00±0.78 days, and the mean indwelling chest tube duration was 1.97±0.77 days. No complications were observed. In the mean follow-up period of 86.75±23.20 months, recurrence of pneumothorax was found in 3 patients. Conclusion: We suggest that SITS for PSP with the aid of a spinal needle to replace a grasper is a safe and easy technique that only requires a small incision.

• Journal of Gastric Cancer
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• v.17 no.3
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• pp.193-203
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• 2017

The implementation of national cancer screening has increased the detection rates of early gastric cancer (EGC) in Korea. Since the successful introduction of laparoscopic gastrectomy for gastric cancer in the early 1990s, this technique has demonstrated improved short-term outcomes without compromising long-term oncologic results. It is associated with reduced pain, shorter hospitalization, reduced morbidity rates, better cosmetic outcomes, and equivalent mortality rates as those for open surgery. Laparoscopic gastrectomy improves patients' quality of life (QOL) and provides favorable prognosis. Single-incision laparoscopic gastrectomy (SILG) is one extremely minimally invasive method, theoretically offering improved cosmetic results, less postoperative pain, and earlier recovery after surgery than conventional multiport laparoscopic gastrectomy. In this context, SILG is thought to be an optimal method to promote and maximize patients' QOL in the acute postoperative phase. However, the technical difficulties of this procedure have limited its use. Since the first report describing single-incision distal gastrectomy in 2011, only 16 studies to date have evaluated SILG. Most of these studies have focused on the technical feasibility and safety of SILG because its long-term outcomes have not been reported. This article reviews the advantages and limitations of SILG.

• Clinical Endoscopy
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• v.55 no.5
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• pp.615-625
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• 2022

Background/Aims: Mucosal incision-assisted biopsy (MIAB) for tissue acquisition (TA) from subepithelial lesions (SELs) is emerging as an alternative to endoscopic ultrasound (EUS)-guided TA. Only a limited number of studies compared the diagnostic utility of MIAB and EUS for upper gastrointestinal (GI) SELs; therefore, we conducted this systematic review and meta-analysis. Methods: A comprehensive literature search from January 2020 to January 2022 was performed to compare the diagnostic accuracy and safety of MIAB and EUS-guided TA for upper GI SELs. Results: Seven studies were included in this meta-analysis. The pooled technical success rate (risk ratio [RR], 0.96; 95% confidence interval [CI], 0.89-1.04) and procedural time (mean difference=-4.53 seconds; 95% CI, -22.38 to 13.31] were comparable between both the groups. The overall chance of obtaining a positive diagnostic yield was lower with EUS than with MIAB for all lesions (RR, 0.83; 95% CI, 0.71-0.98) but comparable when using a fine-needle biopsy needle (RR, 0.93; 95% CI, 0.83-1.04). The positive diagnostic yield of MIAB was higher for lesions <20 mm (RR, 0.75; 95% CI, 0.63-0.89). Six studies reported no adverse events. Conclusions: MIAB can be considered an effective alternative to EUS-guided TA for upper GI SELs without an increased risk of adverse events.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.214-216
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• 1998

In the treatment of maxillary lesion including a maxillary sinuses, most of oral and maxillofacial surgeons have used the vestibular incision or the Weber-Fergusson incision. However, the vestibular incision has disadvantage which it provides a rather limited exposure and the Weber-Fergusson incision leaves visible scar in the midface. Furthermore, because the scar is confined on unilateral side only, the technique is hesitated to apply especially in children, younger patients and women. Since Casson first introduced midfacial degloving technique, this approach has been used frequently to treat the lesion on nasal cavity, nasopharynx, skull base and paranasal sinuses by ENT surgeons. But, we think this technique can be used usefully in oral and maxillofacial regions. So, we experienced favorable results which it provided a proper exposure, no visible facial scar and it could be used on bilateral midfacial lesions.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.345-348
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• 2008

Purpose: Fracture of the frontal sinus accounts for 5-15% of all facial fractures. Only anterior table fracture occupies one third of the frontal sinus fracture. Conventional coronal approach is the standard treatment, but this method is very aggressive, especially in patient with simple, depressed, anterior frontal sinus wall fracture. We introduce new, simple technique for these patients, using small incision and Dual-top screws. Methods: A 27-year-old male patient was introduced to our department under the impression of fracture of frontal sinus, involving only anterior table. Under general anesthesia, 1.5 cm-sized, small incision was made on the suprabrow area. We reduced fractured fragment with two dual-top screws and 25G wires. Fixation was not necessary Results: The operation took about forty minutes, and the patient discharged 2 days after the operation. Postoperative 2 months follow up CT shows maintenance of reduction site. Gross depression of the forehead and visible scar was not observed. Conclusion: Although the indication of this procedure is limited, less aggressive, simple and very effective to the patient with simple. depressed, anterior frontal sinus fracture.

• Journal of Oral Medicine and Pain
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• v.22 no.1
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• pp.125-135
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• 1997

The Author examined the clinical and histological changes on the dorsal tongue mucosa of the adult rats after lasing by pulsed Nd:YAG laser and incising with scalpel. The dorsal tongue was lased through 320$\mu\textrm{m}$optic fiber moving 2.5mm/second to make linear incision 5mm. The five conditions of lasing were three application with 1.0W, 1.75W, 3.0W and 3.0W under saline cooling, and single application with 3.0W at 20Hz. With scalpel, linear incisions through the surface epithelium were performed to 5mm in length. After observing the clinical changes of the incised wounds, the animals were sacrified and the tissues were excised to make the tissue specimens. The stained microscopic tissue slide were observed histologically under the microscope. The following results were obtained : 1. While incision with scalpel causes severe bleeding, lasing does not cause bleeding. 2. In three applications with 1.75W and 20Hz, tissue ablation was limited to areas contacted with optic fiber. 3. In three applications with 3.0W and 20Hz, deep incised wound, extensive destruction of the adjacent epithelium and charring were observed. 4. In three applications with 3.0W and 20Hz under saline cooling, tissue ablation was limite to the superficial mucosa and charring was not observed. 5. In single application with 3.0W and 20Hz, the shape of the incised wound was similar to that of the scalpel incision.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.4
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• pp.372-379
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• 2023

Backgrounds/Aims: While single-incision laparoscopic cholecystectomy (SILC) has advantages in cosmesis and postoperative pain, its utilization has been limited. This study raises the possibility of expanding its indication to acute cholecystitis with the novel method of solo surgery under retrospective analysis. Methods: We compared the outcomes of SILC (n = 58) to those of three-incision laparoscopic cholecystectomy (TILC; n = 117) for acute cholecystitis, being performed from March 2014 to December 2015. Results: Intraoperative results, including the operation time, did not differ significantly, except for drain catheter insertion (p = 0.004). Each group had 1 case of open conversion due to common bile duct injury. There was no significant difference in the length of hospital stay. Either group by itself was not a risk factor for complications, but in preoperative drainage for intraoperative perforation, 3 factors of intraoperative perforation, biliary complication, and history of upper abdominal operation for additional port, only American Society of Anesthesiology (ASA) scores for postoperative complication of Clavien-Dindo grades III and IV were significant risk factors. Conclusions: Our study findings showed comparative outcomes between both groups, providing evidence for the safety and feasibility of SILC for acute cholecystitis.

• Journal of Trauma and Injury
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• v.34 no.1
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• pp.75-78
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• 2021

A Morel-Lavallée lesion is a post-traumatic closed degloving soft tissue injury after blunt trauma. Infection and skin necrosis frequently occur if it is not treated properly in the early stages. However, there is no clearly established treatment algorithm. In the acute stage, it is mainly treated with aspiration, simple compression, and incisional drainage. In the chronic stage, sclerotherapy is usually performed. If skin necrosis develops, the necrotic tissue is resected and a skin graft is needed. We describe a case of acute Morel-Lavallée lesion in the buttock region that was treated with limited incisional drainage and negative-pressure wound therapy, and also present a review of the literature.

• Journal of Korean Neurosurgical Society
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• v.40 no.4
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• pp.296-299
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• 2006

Recently the trend of surgical procedure for treatment of lumbar benign disease is a minimally invasive surgery due to small incision, minimal blood loss, and a short hospital day. By using a microscope or an endoscope, and other surgical equipment, a delicate manipulation in a narrow space became feasible, consequently, to secure a wider view with small incision, appropriate retractors are required. But the various tubular retractor systems are expensive and have some problems. We modified Thoracoport [Auto Suture Co., Norwalk, CT] by making a window at the distal end of trocar and used it as a tubular retractor in surgical procedure for treatment of lumbar benign disease. This modified tubular retractor is docked closely on the curved lamina and provides a wider view. We used it as a tubular retractor also in lumbar bilateral decompression involving a unilateral approach. But this trocar has the limited sizes [diameter and length], and also it is difficult to fix the retractor or change the direction of retractor. And then, we propose a more modified Thoracoport with various sizes and attaching the settling holders to the head of tubular retractor to be able to fix the retractor.