• Archives of Plastic Surgery
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• v.41 no.3
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• pp.225-230
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• 2014

The increased application of the da Vinci robotic platform (Intuitive Surgical Inc.) for microsurgery has led to the development of new adjunctive surgical instrumentation. In microsurgery, the robotic platform can provide high definition $12{\times}-15{\times}$ digital magnification, broader range of motion, fine instrument handling with decreased tremor, reduced surgeon fatigue, and improved surgical productivity. This paper presents novel adjunctive tools that provide enhanced optical magnification, micro-Doppler sensing of vessels down to a 1-mm size, vein mapping capabilities, hydro-dissection, micro-ablation technology (with minimal thermal spread-$CO_2$ laser technology), and confocal microscopy to provide imaging at a cellular level. Microsurgical outcomes from the use of these tools in the management of patients with infertility and chronic groin and testicular pain are reviewed. All these instruments have been adapted for the robotic console and enhance the robot-assisted microsurgery experience. As the popularity of robot-assisted microsurgery grows, so will its breadth of instrumentation.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.81-85
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• 1997

This article describes a modified arthroscopic technique of anterior cruciate ligament (ACL) reconstruction using quadrupled hamstring tendon graft. The autogenous semitendinosus and gracilis grafts are harvested without detachment of the tibial insertion. To obtain longer graft, the accessory tibial insertions of the hamstring tendons are dissected. The EndoButton(Acupex Microsurgical, Andover, MA) is used for femoral fixation and two spiked staples are used for tibial fixation in a belt buckle fashion. Then the residual anterior laxity is restored by additional absorbable interference screw fixations. In this technique. more viable graft is obtained and firmer distal fixation is achieved by preservation of the tibial insertion of hamstring tendons.

• Journal of Korean Neurosurgical Society
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• v.51 no.4
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• pp.230-232
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• 2012

A 31-year-old man presented with acute onset of paraplegia. The patient's history was significant for thyroid carcinoma that had been treated 2 years earlier by thyroidectomy. A magnetic resonance imaging scan showed an enhancing intramedullary lesion at T7-8. Patient underwent surgical treatment and a tumor with hematoma was resected via posterior midline myelotomy. Postoperatively, the patient's motor weakness was improved to grade 3. The lesion showed typical histologic features consistent with papillary thyroid carcinoma. Early diagnosis and microsurgical resection can result in improvement in neurological deficits and quality of life of patients with an ISCM.

• Journal of Korean Neurosurgical Society
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• v.59 no.4
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• pp.410-413
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• 2016

Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.232-234
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• 1996

For surgical Treatment of spastic deformities of the foot, selective peripheral neurotomies were introduced. These neurotomies utilize microsurgical techniques and intraoperative electrical stimulation for better identification of the function of the fascicles constituting the nerve. Selectivity is required to supress the excess of spasticity without excessive weakening of motor strength and without producing exaggerated amyotrophy. To achieve this goal, minimum one fourth of the motor fibers must be preserved. Neurotomies may be indicated when spasticity is localized to muscle or muscle groups supplied by a single or a few peripheral nerves that are easily accessible. To help the surgeon decide if neurotomy is appropriate, temporary local anesthetic block of the nerve with bupivacaine can be useful. Such a test can determine if articular limitations result from spasticity, musculotendinous contractures, or articular ankyloses because only spasticity is decreased by the test. In additon, these tests give the patient a chance to appreciate what to expect from the operation.

• Archives of Reconstructive Microsurgery
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• v.11 no.2
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• pp.167-172
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• 2002

The only treatment method for crushed soft tissue injuries in the proximal leg involving the knee joint is the microsurgical free flap transplantation, especially latissimus dorsi myocutaneous free flap is useful to cover the extensive soft tissue defects, therefore prevents iatrogenic below knee amputation and facilitates early wound healing, early ambulation and shortens hospital stay. Authors have treated the open amputation with crushed soft tissue and bone injuries in the proximal leg, and the repeated abrasion and infectious wound with traumatic neuroma in the below knee with myocutaneous free flap and succeeded to wear below knee amputation prosthesis and return to normal activities of the daily living in the relatively shorter period than usual.

• Archives of Craniofacial Surgery
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• v.17 no.2
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• pp.45-50
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• 2016

Extensive surgical resection of the aerodigestive track can result in a large and complex defect of the oropharynx, which represents a significant reconstructive challenge for the plastic surgery. Development of microsurgical techniques has allowed for free flap reconstruction of oropharyngeal defects, with superior outcomes as well as decreases in postoperative complications. The reconstructive goals for oral and oropharyngeal defects are to restore the anatomy, to maintain continuity of the intraoral surface and oropharynx, to protect vital structures such as carotid arteries, to cover exposed portions of internal organs in preparation for adjuvant radiation, and to preserve complex functions of the oral cavity and oropharynx. Oral and oropharyngeal cancers should be treated with consideration of functional recovery. Multidisciplinary treatment strategies are necessary for maximizing disease control and preserving the natural form and function of the oropharynx.

• Journal of International Society for Simulation Surgery
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• v.3 no.1
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• pp.12-15
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• 2016

Functional and esthetic reconstruction after segmental mandibulectomy is one of the most challenging surgeries in microsurgical reconstruction field. Simulation surgery before free flap reconstruction has been performed for efficient surgery and successful results. Fibula free flap is the flap of the choice for reconstruction of the segmental mandibular defect. Straight nature of the fibula bone requires multiple segmentations to fit into mandible. 3D rapid prototype (RP) model gives a lot of information for mandibular reconstruction. The purpose of this study was to report mandibular reconstruction with free fibular flap using simulation surgery. A total of 30 consecutive patients were included for functional and esthetic evaluation. Among 30 patients, two flaps showed necrosis after radiotherapy. The other flaps were all survived and showed successful reconstruction in both function and esthetics.

• 대한생식의학회:학술대회논문집
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• 1999.11a
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• pp.52-52
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• 1999

• Journal of Veterinary Clinics
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• v.37 no.4
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• pp.213-216
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• 2020

Two cats were presented to the Dana Animal Hospital Eye Center and were diagnosed with corneal sequestrum through full ophthalmic examination. After lamellar keratectomy using a reusable corneal trephine blade and a crescent microsurgical knife, porcine urinary bladder submucosa extracellular matrix (UBM, ACeLL Vet^® corneal disc) was applied to the corneal defects. In both cases, no corneal sequestrum recurrences were observed until 119 days and 253 days after the surgery, respectively. Porcine UBM could be recommended as a surgical scaffold for treatment of corneal sequestrum in cats.