• Title/Summary/Keyword: Minimally invasive operation

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Comparison of Perioperative and Oncologic Outcomes with Laparotomy, and Laparoscopic or Robotic Surgery for Women with Endometrial Cancer

  • Manchana, Tarinee;Puangsricharoen, Pimpitcha;Sirisabya, Nakarin;Worasethsin, Pongkasem;Vasuratna, Apichai;Termrungruanglert, Wichai;Tresukosol, Damrong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5483-5488
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    • 2015
  • Purpose: To compare perioperative outcomes and oncologic outcomes in endometrial cancer patients treated with laparotomy, and laparoscopic or robotic surgery. Materials and Methods: Endometrial cancer patients who underwent primary surgery from January 2011 to December 2014 were retrospectively reviewed. Perioperative outcomes, including estimated blood loss (EBL), operation time, number of lymph nodes retrieved, and intra and postoperative complications, were reviewed. Recovery time, disease free survival (DFS) and overall survival (OS) were compared. Results: Of the total of 218 patients, 143 underwent laparotomy, 47 laparoscopy, and 28 robotic surgery. The laparotomy group had the highest EBL (300, 200, 200 ml, p<0.05) while the robotic group had the longest operative time (302 min) as compared with laparoscopy (180 min) and laparotomy (125 min) (p<0.05). Intra and postoperative complications were not different with any of the surgical approaches. No significant difference in number of lymph nodes retrieved was identified. The longest hospital stay was reported in the laparotomy group (four days) but there was no difference between the laparoscopy (three days) and robotic (three days) groups. Recovery was significantly faster in robotic group than laparotomy group (14 and 28 days, p =0.003). No significant difference in DFS and OS at 21 months of median follow up time was observed among the three groups. Conclusions: Minimally invasive surgery has more favorable outcomes, including lower blood loss, shorter hospital stay, and faster recovery time than laparotomy. It also has equivalent perioperative complications and short term oncologic outcomes. MIS is feasible as an alternative option to surgery of endometrial cancer.

A Study on Safety and Performance Evaluation of Micro - surgical Robots Based on Open Robot Platform (개방형 로봇 플랫폼 기반 미세수술로봇의 안전성 및 성능평가에 관한 연구)

  • Park, Junhyun;Ho, YeJi;Lee, Duck Hee;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.40 no.5
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    • pp.206-214
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    • 2019
  • Surgical methods and associated precision systems have been developed, but surgical procedures that require precise location and fine manipulation of the lesion remain a limitation. The combination of precision robot manipulation technology and 3D medical image navigation technology overcomes the limitations of minimally invasive surgery (MIS) and enables a more stable and successful operation. Surgical robots are surgical robots such as da Vince, and surgical robots using industrial robotic arms. There are various developments and researches of medical robots. In recent medical robot development, a new type of surgical robot based on an industrial robot arm capable of easily replacing the end effector according to the user's needs is being actively developed at home and abroad. Therefore, in this study, we developed safety and performance evaluation guideline for micro - surgical robots based on open robot platform using general purpose robot arm to help quality control of the medical device.

Minimally Invasive Surgery without Decompression for Hepatocellular Carcinoma Spinal Metastasis with Epidural Spinal Cord Compression Grade 2

  • Jung, Jong-myung;Chung, Chun Kee;Kim, Chi Heon;Yang, Seung Heon
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.467-475
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    • 2019
  • Objective : There is a lack of knowledge regarding whether decompression is necessary in treating patients with epidural spinal cord compression (ESCC) grade 2. The purpose of this study was to compare the outcomes of minimally invasive surgery (MIS) without decompression and conventional open surgery (palliative laminectomy) for patients with hepatocellular carcinoma (HCC) spinal metastasis of ESCC grade 2. Methods : Patients with HCC spinal metastasis requiring surgery were retrospectively reviewed. Patients with ESCC grade 2, medically intractable mechanical back pain, a Nurick grade better than 3, 3-6 months of life expectancy, Tomita score ${\geq}5$, and Spinal Instability Neoplastic Score ${\geq}7$ were included. Patients with neurological deficits, other systemic illnesses and less than 1 month of life expectancy were excluded. Thirty patients were included in the study, including 17 in the open surgery group (until 2008) and 13 in the MIS group (since 2009). Results : The MIS group had a significantly shorter operative time ($94.2{\pm}48.2minutes$ vs. $162.9{\pm}52.3minutes$, p=0.001), less blood loss ($140.0{\pm}182.9mL$ vs. $1534.4{\pm}1484.2mL$, p=0.002), and less post-operative intensive care unit transfer (one patient vs. eight patients, p=0.042) than the open surgery group. The visual analogue scale for back pain at 3 months post-operation was significantly improved in the MIS group than in the open surgery group ($3.0{\pm}1.2$ vs. $4.3{\pm}1.2$, p=0.042). The MIS group had longer ambulation time ($183{\pm}33days$ vs. $166{\pm}36days$) and survival time ($216{\pm}38days$ vs. $204{\pm}43days$) than the open surgery group without significant difference (p=0.814 and 0.959, respectively). Conclusion : MIS without decompression would be a good choice for patients with HCC spinal metastasis of ESCC grade 2, especially those with limited prognosis, mechanical instability and no neurologic deficit.

The Successful Application of Nuss Procedures with Modified Operative Technique (수술적 기법의 보완을 통한 성공적인 너스 술식의 적용(단일 기관 135명의 경험))

  • Kim Do-Mun;Shim Young-Mog;Kim Kwhan-Mien;Choi Yong-Soo;Kim Jhin-Gook
    • Journal of Chest Surgery
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    • v.39 no.10 s.267
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    • pp.765-769
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    • 2006
  • Background: Nuss procedure is a minimally invasive technique for correcting the pectus excavatum. But there are some limitations of correcting the complex anomaly or grown-up patients. Material and Method: we retrospectively reviewed 135 consecutive patients who underwent repair of pectus excavatum by the Nuss procedure and its modifications between November 1999 and December 2004. We analyzed the computed tomography, age on operation, operative technique, and complications. Result: We operated 135 patients of pectus excavatum during 62 months. Total number of operations about Nuss procedure is 216, including bar removal procedure of 64 cases, redo Nuss procedures of 47 cases. We modified the point of bar insertion to the hinge point, made a shoulder in the bar to prevent a displacement. And then we changed the fixation material from Vicryl to steel wire. If the patients are old, we retract the sternum during bar rotation and fixation. Until 2002, the number of redo Nuss operations were 17, complications were 23. but, after modifications, the number of redo Nuss operation were 0, complications were 2. Conclusion: This result indicates that our modifications of Nuss operation is effective, and could decrease the number of redo Nuss operation and complications.

Bilateral Video-Assisted Thoracoscopic Surgery Resection for Multiple Mediastinal Myelolipoma: Report of a Case

  • Nakagawa, Masatoshi;Kohno, Tadasu;Mun, Mingyon;Yoshiya, Tomoharu
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.189-192
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    • 2014
  • Myelolipoma in the mediastinum is an extremely rare entity. In this report, we present the case of a 79-year-old asymptomatic man who had three bilateral paravertebral mediastinal tumors. The three tumors were resected simultaneously using bilateral three-port video-assisted thoracoscopic surgery (VATS). There has been no evidence of recurrence within four years after the operation. Multiple bilateral mediastinal myelolipomas are extremely rare. There are no reports in the English literature of multiple bilateral thoracic myelolipomas that were resected simultaneously using bilateral VATS. We also present characteristic features of myelolipomas, which are helpful for diagnosis.

Acute Spinal Epidural Hematoma Following Unilateral Laminectomy for Bilateral Decompression

  • Lee, Dong-Yeob;Lee, Sang-Ho;Jang, Jee-Soo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.1
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    • pp.35-37
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    • 2006
  • We present a case of acute spinal epidural hematoma[EDH] following unilateral laminectomy for bilateral decompression[ULBD]. A 45-year-old male presented with severe multi-level spinal stenosis underwent ULBD on the left side at the L2-3 and L3-4 level. Five hours after operation, paraparesis developed along with severe bilateral buttock pain. The CT scan showed an acute spinal EDH at the L2-3 level. The acute spinal EDH was successfully decompressed after emergency decompressive surgery with performing an additional laminectomy on the contralateral side at the L2-3 level. Although ULBD is an effective minimally invasive surgical technique for treating spinal stenosis, the possibility of acute spinal EDH should be kept in mind, as happened in our case.

Management of the paralyzed face using temporalis tendon transfer via intraoral and transcutaneous approach Temporalis tendon transfer

  • Choi, Ji Yun;Kim, Hyo Joon;Moon, Seong Yong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.24.1-24.6
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    • 2018
  • Temporalis tendon transfer is a technique for dynamic facial reanimation. Since its inception, nearly 80 years ago, it has undergone a wealth of innovation to produce the modern operation. Temporalis tendon transfer is a relatively minimally invasive technique for the dynamic reanimation of the paralyzed face. This technique can produce significant and appropriate movement of the lateral oral commissure, more closely mimicking the normal side. The aim of this article is to review the technique of temporalis tendon transfer involving transferring of the coronoid process of the mandible with the insertion of the temporalis tendon via intra-oral and transcutaneous approach.

Ankle Arthrodesis (족관절 유합술)

  • Lee, Jun Young;Park, Sang-Ha
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.147-152
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    • 2014
  • Ankle arthrodesis has been used as standard treatment of ankle arthritis unresponsive to conservative treatment. Transfibular approach was used for ankles with severe deformities and minimally invasive arthroscopic ankle arthrodesis was used for patients with mild deformities. Anterior approach may be used when lateral approach couldn't be performed. Tibiotalocalcaneal arthrodesis is standard treatment for coexisting ankle and subtalar arthritis, and modified Blair arthrodesis can be used if the talus body resection is necessary in severe talar necrosis. In serious infection of ankle arthritis, arthrodesis can be performed as staged operation. In cases with low bone density and severe deformities, Charcot arthropathy should be considered.

Videothoracoscopic Repair of Diaphragmatic Eventration -A Case Report- (흉강경을 이용한 횡격막 거상증 치험 1례)

  • Jeong, Yoon-Seop;Youm, Wook
    • Journal of Chest Surgery
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    • v.32 no.3
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    • pp.330-332
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    • 1999
  • A 40-year-old woman underwent plication by video-assisted thoracoscopy for left diaphragmatic eventration. Normalization in the position of the left diaphragm and a marked improvement in the left lung expansion were identified on the chest X-ray. This technique offers the patients many advantages of the minimally invasive operation.

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Supraorbital Endoscopic Evacuation for Traumatic Intracerebral Hematomas in the Frontal Lobe

  • Oh, Hyuk-Jin;Hwang, Sun-Chul
    • Journal of Korean Neurosurgical Society
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    • v.65 no.6
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    • pp.846-852
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    • 2022
  • Objective : Traumatic intracranial hematomas have been rarely evacuated by endoscopic surgery. The frontal lobe is the usual location for the traumatic intracerebral hematoma (TICH). Endoscopic evacuation for the frontal TICHs via an eyebrow incision is to be presented as minimally invasive surgery. Methods : Thirteen patients with frontal TICHs were managed with endoscopic hematoma evacuation via eyebrow incision. After making the incision in the lateral eyebrow, a small frontal craniotomy was made, and the hematoma was evacuated under direct visualization of a rigid endoscope. No catheter was placed. Orbital rim resection, hematoma evacuation rate, surgical complications, and outcome at discharge were analyzed. Results : Men were 11 and the mean age was 54 years old (range, 27-86). Orbitotomy was performed in four patients, and no effect on the hematoma evacuation rate was observed. More than 80% of the hematoma volume was successfully removed in 10 cases. Hematoma configuration was not related to the hematoma evacuation rate. None of the patients underwent revision operation or decompressive craniectomy. Conclusion : Endoscopic evacuation of the TICHs with the supraorbital approach may be a good method to evacuate the hematoma located in the frontal base.