• Title/Summary/Keyword: Minimally Invasive

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Minimally Invasive Combined Interlaminar and Paraisthmic Approach for Symptomatic Lumbar Foraminal Stenosis : Surgical Technique and Preliminary Results

  • Kwon, Young-Joon
    • Journal of Korean Neurosurgical Society
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    • v.42 no.1
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    • pp.11-15
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    • 2007
  • Objective : Lumbar foraminal stenosis is an important etiology of lumbar radicular symptomatology and frequent causes of remained symptoms after decompressive surgery. This study was conducted to determine the precise clinical and radiologic diagnosis of lumbar foraminal stenosis, and to demonstrate thorough treatment by decompressive surgery using a minimally invasive technique. Methods : Seven patients with established unilateral lumbar foraminal stenosis according to clinical and radiologic diagnosis were retrospectively studied. All patients underwent combined interlaminar and paraisthmic procedure with partial facetectomy. The outcome of surgery was evaluated and classified into excellent, good, fair and poor. Results : The results were excellent in four patients, good in two, and fair in one during the follow-up. There were no surgery-related complications. Conclusion : Minimally invasive combined interlaminar and paraisthmic approach provides good outcome in carefully selected patients with symptomatic lumbar foraminal stenosis.

Combined Percutaneous Transluminal Coronary Angioplasty and Minimally Invasive Coronary Arterial Bypass Grafting(Hybrid CABG) (경피적 경혈관 관상동맥 중재술과 최소침습성 관상동맥 우회술의 병용요법)

  • 장지민;유원희;김기봉
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1127-1130
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    • 1999
  • Percutaneous coronary intervention including intracoronary stenting is currently an accepted treatment modality in the treatment of coronary artery disease and is widely performed to treat the patient with multivessel disease with decreased morbidities and less cost compared with conventional coronary rtery bypass grafting(CABG), Repeated interventions due to restenosis even after successful angioplasty are the major disadvantage of the angioplsty especially when the lesion is located inthe left anterior descending artery(LAD) Recently CABG through left anterior small thoracotomy using the left internal thoracic artery to revascularize the LAD territory without cardiopulmonary bypass so called Minimally Invasive Direct Coronary Artery Bypass(MIDCAB) was intrduced and performed with comparable early outcomes. In this regard the integrated approach with percutaneous coronary intervention and minimally invasive direct coronary artery bypass surgery so called 'Hybrid CABG' was suggested to be an effective treatment in suitable patients with multivessel coronary artery disease. We report three cases of Hybrid CABG.

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Minimally Invasive Proximal Transverse Metatarsal Osteotomy Followed by Intramedullary Plate Fixation for Hallux Valgus Deformity: A Case Report (무지외반증 교정을 위한 최소침습적 근위 중족골 횡절골술 및 골수강 내 금속판 고정: 증례 보고)

  • Kim, Jong Hun;Suh, Jin Soo;Choi, Jun Young
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.3
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    • pp.141-144
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    • 2021
  • More than 120 surgical methods for the correction of hallux valgus deformities have been reported. For the correction of moderate to severe hallux valgus deformities with aesthetic demands, minimally invasive surgery at the proximal area can be considered. This paper reports a case of moderate hallux valgus deformity treated by a minimally invasive proximal transverse metatarsal osteotomy followed by intramedullary plate fixation.

Ultrasound-Guided Minimally Invasive Procedure Using Thread (실을 이용한 초음파 유도하 최소침습시술)

  • Park, Hae-Yeon;Kim, Jae Min
    • Clinical Pain
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    • v.20 no.2
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    • pp.70-73
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    • 2021
  • A minimally invasive procedure refers to a procedure that minimizes tissue damage due to incision. By limiting the size of the incision, it can be expected to reduce the time taken for wound healing, reduce pain, and reduce the risk of infection. Recently, studies have been attempted to dissect the structures of the neuromusculoskeletal system using ultrasound-guided minimally invasive technique. Among those, dissecting thread may be utilized in several musculoskeletal diseases, including carpal tunnel syndrome, cubital tunnel syndrome, trigger finger, and selective crural fasciectomy. In this brief review, the use of dissecting thread in treating neuromusculoskeletal diseases are described.

Minimally invasive distal biceps tendon repair: a case series

  • Paul Jarrett;Anna-Lisa Baker
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.222-230
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    • 2023
  • Background: Distal biceps tendon repairs are commonly performed using open techniques. A minimally invasive distal biceps tendon repair technique using a speculum and hooded endoscope was developed to improve visualization, reduce soft-tissue dissection, and minimize complications. This paper describes the technique and reports the outcomes of 75 minimally invasive distal biceps tendon repairs. Methods: The operation reports and outcomes of 75 patients who underwent distal biceps tendon repair using this technique between 2011 and 2021 were retrospectively reviewed. Results: Median time to follow-up was 12 months (interquartile range [IQR], 6-56 months). Primary outcomes were function as measured by the Disabilities of Arm, Shoulder and Hand Score (DASH) questionnaire, and rate of complications. Median DASH score was 1.7 of 100 (IQR, 0-6.8). There were 2 of 75 (2.7%) re-ruptures of the distal tendon. There were no cases of vascular injury, proximal radius fracture, or posterior interosseous nerve, median, or ulnar nerve palsy. Conclusions: In this series, minimally invasive distal biceps repair was safe and effective with a low rate of major complications. Recovery of function, as indicated by low DASH scores, was satisfactory, and inconvenience during recovery was minimized. Level of evidence: IV.

The Efficacy of Preincisional Surgical Site Infiltration of Ketorolac & Bupivacain in Minimally Invasive Thyroid Surgery: A Double Blind Study (최소침습 갑상선절제술에서 피부절개전 Ketororac과 Bupivacaine 국소주사에 의한 진통효과)

  • Chung Woung-Youn;Kim Tae-Jin;Lee Hae-Kyung;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.2
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    • pp.182-186
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    • 2000
  • The reduction of the postoperative wound pain has been a concern in recent surgery, especially in various types of minimally-invasive surgeries. This study was performed to evaluate the postoperative analgesic effect of the preincisional local anesthesia with the mixture of ketorolac(Tarasyn) and bupivacaine to the surgical site in minimally-invasive thyroid surgeries. Of 491 patients who were scheduled for minimally-invasive thyroid surgeries between October 1999 and July 2000, 244 were randomly assigned to receive a mixture of ketorolac tromethamine 15mg(0.5ml) and 0.25% bupivacaine 3ml via surgical site infiltration 3 minutes prior to the skin incision. The outcomes of these patients were compared to those of the 247 controls. Total number of patients in need of post-operative analgesic requirements(n=39, 16.0%), total dose of postoperative analgesics used($19.6{\pm}8.4mg$ of ketorolac) and Visual Analogue Pain Score(VAS, $2.6{\pm}1.2$) of the preincisional local anesthesia group were significantly lower than those of the control group(p<0.05). The mean postoperative hospital stay was $1.6{\pm}0.4$ days for the preincisional local anesthesia group versus $1.9{\pm}0.7$ days for the control group. The preincisional local infiltration of ketorolac and bupivacaine in the minimally invasive thyroidectomies reduces postoperative wound pain thus would be more beneficial to the patients.

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Minimally Invasive Treatment for Sacroiliac Dislocation in Dogs

  • Kim, Young-ung;Cho, Hyoung-sun;Kim, Sun-young;Lee, Ki-chang;Kim, Nam-soo;Kim, Min-su
    • Journal of Veterinary Clinics
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    • v.34 no.5
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    • pp.370-373
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    • 2017
  • Sacroiliac dislocation is the separation of the iliac wing from the pelvic bone and needs to be repaired by surgery. Corrective surgical methods include open reduction and minimally invasive techniques. In the present study, we used a minimally invasive surgical technique in seven dogs with sacroiliac dislocation. Five cases had unilateral sacroiliac joint luxation and two cases had bilateral sacroiliac joint luxation; all were referred to hospital after being hit by an automobile. All cases were treated with a fluoroscope-assisted, minimally invasive technique. Patients were evaluated by measuring surgery time, postoperative ambulatory time, and calculating pelvic canal diameter ratios. Surgery time was measured from initial incision to completion of skin closure. Mean surgery time was 30.6 minutes in unilateral sacroiliac joint luxation and 68 minutes in bilateral sacroiliac joint luxation. Mean preoperative pelvic canal diameter ratio was 1.22 (${\pm}0.27$), immediate postoperative pelvic canal diameter ratio was 1.26 (${\pm}0.10$), and at 2 weeks after surgery, the pelvic canal diameter ratio was 1.37 (${\pm}0.22$). All cases were ambulatory within 1 week and mean postoperative ambulatory time was 5 days. Based on the results, the use of a minimally invasive technique for correction of sacroiliac dislocation can decrease surgical time, lessen operative and postoperative burdens on patients, and provide owners with a good prognosis.

Timed barium esophagography to predict recurrent achalasia after peroral endoscopic myotomy: a retrospective study in Thailand

  • Tharathorn Suwatthanarak;Chainarong Phalanusitthepa;Chatbadin Thongchuam;Thawatchai Akaraviputh;Vitoon Chinswangwatanakul;Thikhamporn Tawantanakorn;Somchai Leelakusolvong;Monthira Maneerattanaporn;Piyaporn Apisarnthanarak;Jitladda Wasinrat
    • Clinical Endoscopy
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    • v.57 no.5
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    • pp.610-619
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    • 2024
  • Background/Aims: Achalasia is a rare esophageal motility disease, for which peroral endoscopic myotomy (POEM) has emerged as a promising treatment option; however, recurrence remains a challenge. Timed barium esophagography (TBE) is a useful diagnostic tool and potential outcome predictor of achalasia. This study aimed to determine predictive tools for recurrence after POEM. Methods: This retrospective study enrolled achalasia patients who underwent POEM between January 2015 and December 2021. Patients were categorized into two groups using the 1-month post-POEM Eckardt scores and TBE: the discordant group (Eckardt score improved >50%, TBE decreased <50%) and the concordant group (both Eckardt score and TBE improved >50%). Recurrence was defined as a reincrease in the Eckardt score to more than three during follow-up. Results: Complete medical records were available in 30 patients who underwent POEM. Seventeen patients (56.7%) were classified into the discordant group, while 13 patients (43.3%) were in the concordant group. The overall recurrence rate was 11.9% at 1-year, increasing to 23.8% during the extended follow-up. The discordant group had a 6.87 fold higher recurrence rate than the concordant group (52.9% vs. 7.7%, p=0.017). Conclusions: These results strongly suggest that combining the Eckardt score with TBE can effectively predict recurrent achalasia after POEM. Patients in the discordant group had an elevated risk.

Lobaplatin-TACE Combined with Radioactive 125I Seed Implantation for Treatment of Primary Hepatocellular Carcinoma

  • Peng, Sheng;Yang, Qiu-Xia;Zhang, Tao;Lu, Ming-Jian;Yang, Guang;Liu, Zhen-Yin;Zhang, Rong;Zhang, Fu-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5155-5160
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    • 2014
  • Aim: To investigate the efficacy and safety of lobaplatin-transcatheter arterial chemoembolization (TACE) combined with radioactive $^{125}I$ seed implantation in treatment of primary hepatocellular carcinoma (HCC). Methods: 75 patients with primary HCC were enrolled in the study, among them 43 receiving lobaplatin-TACE (TACE group) and 32 lobaplatin-TACE combined with $^{125}I$ seed implantation (TACE+$^{125}I$ group). After treatment, the local remission rates and postoperative complications of two groups were compared using the Pearson Chi-square test. Overall survival in the two groups was calculated using Kaplan-Meier survival curves and the differences were tested using Log-rank test. Results: There were 7 cases of complete response (CR), 13 of partial response (PR), 6 of stable disease (SD) and 17 of progressive disease (PD) in the TACE group, with 13 cases of CR, 9 of PR, 5 of SD and 5 of PD in the TACE+$^{125}I$ group. The disease control rates of TACE and TACE+$^{125}I$ group were 60.5% (26/43) and 84.4% (27/32), respectively, with a significant difference between them (P < 0.05). The survival rates at 6, 12 and 18 months in the TACE group were 100.0%, 81.8% and 50.0%, respectively, and those in TACE+$^{125}I$ group were 100.0%, 93.8% and 65.6%. The mean survival times in the TACE and TACE+$^{125}I$ groups were 19.5 and 22.9 months, respectively. There was a significant difference in the overall survival rate between two groups (P < 0.05). No serious complications were encountered in either group. Conclusion: Lobaplatin-TACE combined with $^{125}I$ seed implantation is favorable and safe for treatment of primary HCC.

Minimally Invasive Cardiac Surgery through A Small Right Parasternal Incision (개실술에서 우측흉골우연소절개법을 이용한 최소침투수술)

  • 공준혁;이응배;조준용;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.723-728
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    • 2000
  • Background: Minimally invasive techniques for open heart surgery are widely accepted in these days. There are minimally invasive approaches by the right or left parasternal incision and another approaches by mini-sternotomy of upper or lower half or sternum. We report the safety and efficacy of minimally invasive technique with right parasternal incision compared with the routine full sternotomy. Material and Method: From April 1997 through February 1999, 20 patients(Group A) underwent minimally invasive cardiac operations. We chose 41 patients(Group B) whose preoperative diagnosis were the same and general conditions were similar and who underwent routine full sternotomy before April 1997. We compared A group and B group in many aspects. We performed routine full median sternotomy in B group but we did a minimally invasive technique through a small right parasternal incision in A group. Result: mean age was 36.1 years in both groups. In disease entities, there were 11 cases of ASD, 9 cases of mitral valve disease in group A, and 16 cases of ASD, 25 cases of mitral valve diseases in group B. In ASD, operation time, cardiopulmonary bypass time of aortic occulusion time were 263 min, 82 min, and 41 min in group A and 180 min, 53 min, and 32 min in group B. In mitral valve disease, operation time, cardiopulmonary bypass time and aortic occlusion time were 267min, 106 min, and 70min in A group and were 207 min, 82 min, and 69 min in group B. There were significant differences in operation time, CPB time, and ACC time between group A and group B. There was a significant difference in the amount of bleeding in postoperative day 1 between group A and group B of mitral diasease. However, there was no significant difference in the amount of bleeding in other comparisons. Mean length of incision was 8.7 cm in group A. There was no significant difference in postoperative complications between A group and B group. There was no mortality in either group. Conclusion: We conclude that this minimally invasive technique with right parasternal incision is cosmetically excellent but it is not effective in reducing operative time and there was no significant difference in recovery time and postoperative complications compared with routine full sternotomy.

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