• 제목/요약/키워드: Minimally invasive procedures

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안전한 매선요법 시술을 위한 멸균, 소독 및 무균법 (Disinfection, Sterilization and Aseptic Technique for Thread Embedding Acupuncture)

  • 윤영희;손재웅;고성규;최인하
    • 한방안이비인후피부과학회지
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    • 제29권1호
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    • pp.103-112
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    • 2016
  • Objective : Thread embedding acupuncture has become popular as a minimally invasive treatment for facial wrinkles and laxity. However, there is little published clinical practice guidelines about disinfection, sterilization and aseptic technique for thread embedding acupuncture. This study is to introducing a specific guidelines about disinfection, sterilization and aseptic technique for thread embedding acupuncture.Method : We reviewed internal regulations and guidelines about hospital infection, and Traditional Korean medicine doctors, nurses, and director of central supply room discussed in depth and established a regulation of disinfection, sterilization and aseptic technique for thread embedding acupuncture.Result : The regulation of disinfection, sterilization and aseptic technique for thread embedding acupuncture consisted of ① management of supplies, ② guidelines of disinfection, sterilization, and reuse, ③ aseptic technique for thread embedding acupuncture.Conclusion : Microbial management is an essential element of medical care and quality. Traditional Korean medicine doctors will care for disinfection, sterilization, and this should not neglect to comply with the procedures and guidelines in the medical field as well as to understand the aseptic techniques.

The Single Incision Laparoscopic Intragastric Wedge Resection of Gastric Submucosal Tumor

  • Na, Jin-Uk;Lee, Sang-Il;Noh, Seung-Moo
    • Journal of Gastric Cancer
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    • 제11권4호
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    • pp.225-229
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    • 2011
  • Purpose: Laparoscopic wedge resection of gastric submucosal tumor may be difficult in case of the endophytic mass or the mass located unreachable area such as cardia, and intragastric approach can be useful. We would present the experiences of the intragastric wedge resection. Materials and Methods: There were 7 patients diagnosed as gastric submucosal tumor and underwent the intragastric wedge resection at Surgery, Chungnam National University Hospital. We reviewed medical record. Results: There were 3 male and 4 female. Mean age was 65 years-old (57~73). Mean body mass index was 26.28 kg/$m^2$ (21.28~35.30). Location of lesions was 4 cardia, 2 fundus and 1 midbody, respectively. Mean operation time was 83.6 minutes (70~105). All patients were healed without any complication. Mean postoperative hospital stay was 5.4 days (4~6). Mean size was 2.7 cm (2.3~3.8). Pathologic finding was 5 gastrointestinal stromal tumor and 2 leiomyoma. Conclusions: The single incision intragastric wedge resection of gastric submucosal tumor is feasible and acceptable, especially in mass of gastric upper part.

소아 비천공 충수염에 대한 복강경 충수절제술 (Laparoscopic Appendectomy in Nonperforated Appendicitis of Children)

  • 김대연;김성철;김인구
    • Advances in pediatric surgery
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    • 제9권1호
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    • pp.41-44
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    • 2003
  • Appendicitis is the most common surgical emergency in childhood. Open appendectomy has been the standard treatment. The minimally invasive techniques have been adopted in children after experiences in various surgical conditions in adults has accumulated. It is debatable whether laparoscopic appendectomy (LA) is superior to open appendectomy (OA) in children. The goal of this study is to review the results of laparoscopy and laparotomy in the nonperforated appendicitis. The records of 22 patients under 15 years of age who were operated upon for nonperforated appendicitis at Asan Medical Center were analyzed between December 2002 and April 2003. Age, type and length of intervention, frequency of analgesic use, complication, length of hospitalization, and cost for each treatment groups (N=11) were compared. Laparoscopy patients were older (13.0 vs. 10.1 years; p > 0.05), and operative time was longer (55.0 vs. 35.0 minutes; p < 0.05). There was no conversion (OA to LA). The median length of hospital stay was significantly shorter in laparoscopy (3.0 vs. 2.0 days; p < 0.05). The median cost for LA was more expensive (W833, 836 vs. W751,398; p < 0.05). Even though there were higher costs and longer operative times with laparoscopic procedures, the shorter hospital stay was an advantage.

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Spinal Cord Stimulation for Refractory Angina Pectoris - A Case Report -

  • Lee, Seong-Heon;Jeong, Hye-Jin;Jeong, Sin-Ho;Lee, Hyung-Gon;Choi, Jeong-Il;Yoon, Myung-Ha;Kim, Woong-Mo
    • The Korean Journal of Pain
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    • 제25권2호
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    • pp.121-125
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    • 2012
  • Refractory angina pectoris is defined as angina refractory to optimal medical treatment and standard coronary revascularization procedures. Despite recent therapeutic advances, patients with refractory angina pectoris are not adequately treated. Spinal cord stimulation is a minimally invasive and reversible technique which utilizes electrical neuromodulation by means of an electrode implanted in the epidural space. It has been reported to be an effective and safe treatment for refractory angina pectoris. We report a case of spinal cord stimulation which has effectively relieved chest pain due to coronary artery disease in a 40-year-old man. This is the first report of spinal cord stimulation for treatment of refractory angina pectoris in South Korea.

아킬레스 건병증의 수술 전략 (Surgical Strategies for Achilles Tendinopathy)

  • 박현우
    • 대한족부족관절학회지
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    • 제25권2호
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    • pp.95-99
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    • 2021
  • The surgical treatment of Achilles tendinopathy can be considered after the failure of conservative treatment, and the surgical methods may be divided into two groups; treatments for insertional and non-insertional tendinopathy. In the case of insertional tendinopathy, debridement including tendon and calcification of the diseased lesion, reattachment of the tendon, and calcaneal ostectomy of the Haglund lesion are the primary treatments. If reattachment is not possible, reconstruction should be performed by other methods such as tendon transfer. As a result of surgery for insertional tendinopathy, there is an improvement in the pain and function after surgery, but there are some patients whose pain does not completely disappear. Some residual pain may persist; therefore, the overall success rate of the surgery can be expected to be 80% to 90%. For the patients of non-insertional tendinopathy, conservative treatment through eccentric exercise is the primary treatment, and most of them have reported good results. In case of failure after various conservative treatments, debridement of the diseased lesion and repair of the remaining tendon would be the primary surgical treatments. If the remaining tendon is not sufficient, reconstruction such as tendon transfer should be considered.

Epilepsy Surgery in 2019 : A Time to Change

  • Phi, Ji Hoon;Cho, Byung-Kyu
    • Journal of Korean Neurosurgical Society
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    • 제62권3호
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    • pp.361-365
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    • 2019
  • Epilepsy has been known to humankind since antiquity. The surgical treatment of epilepsy began in the early days of neurosurgery and has developed greatly. Many surgical procedures have stood the test of time. However, clinicians treating epilepsy patients are now witnessing a huge tide of change. In 2017, the classification system for seizure and epilepsy types was revised nearly 36 years after the previous scheme was released. The actual difference between these systems may not be large, but there have been many conceptual changes, and clinicians must bid farewell to old terminology. Paradigms in drug discovery are changing, and novel anti-seizure drugs have been introduced for clinical use. In particular, drugs that target genetic changes harbor greater therapeutic potential than previous screening-based compounds. The concept of focal epilepsy has been challenged, and now epilepsy is regarded as a network disorder. With this novel concept, stereotactic electroencephalography (SEEG) is becoming increasingly popular for the evaluation of dysfunctioning neuronal networks. Minimally invasive ablative therapies using SEEG electrodes and neuromodulatory therapies such as deep brain stimulation and vagus nerve stimulation are widely applied to remedy dysfunctional epilepsy networks. The use of responsive neurostimulation is currently off-label in children with intractable epilepsy.

만성 족관절 외측 불안정성의 수술적 치료: 봉합술과 재건술의 비교 (Surgical Treatment of Chronic Lateral Ankle Instability: Repair versus Reconstruction)

  • 김근수;박영욱
    • 대한족부족관절학회지
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    • 제23권1호
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    • pp.1-5
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    • 2019
  • Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.

Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma

  • Park, Joo Hyun;Ahn, Jungmin;Moon, Il Joon
    • Clinical and Experimental Otorhinolaryngology
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    • 제11권4호
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    • pp.233-241
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    • 2018
  • Objectives. As endoscopic instrumentation, techniques and knowledges have significantly improved recently, endoscopic ear surgery has become increasingly popular. Transcanal endoscopic ear surgery (TEES) can provide better visualization of hidden areas in the middle ear cavity during congenital cholesteatoma removal. We aimed to describe outcomes for TEES for congenital cholesteatoma in a pediatric population. Methods. Twenty-five children (age, 17 months to 9 years) with congenital cholesteatoma confined to the middle ear underwent TEES by an experienced surgeon; 13 children had been classified as Potsic stage I, seven as stage II, and five as stage III. The mean follow-up period was 24 months. Recurrence of congenital cholesteatoma and surgical complication was observed. Results. Congenital cholesteatoma can be removed successfully via transcanal endoscopic approach in all patients, and no surgical complications occurred; only one patient with a stage II cholesteatoma showed recurrence during the follow-up visit, and the patient underwent revision surgery. The other patients underwent one-stage operations and showed no cholesteatoma recurrence at their last visits. Two patients underwent second-stage ossicular reconstruction. Conclusion. Although the follow-up period and number of patients were limited, pediatric congenital cholesteatoma limited to the middle ear cavity could be safely and effectively removed using TEES.

Wear of contemporary dental composite resin restorations: a literature review

  • Dimitrios Dionysopoulos;Olga Gerasimidou
    • Restorative Dentistry and Endodontics
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    • 제46권2호
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    • pp.18.1-18.13
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    • 2021
  • Composite resins are the most commonly used dental restorative materials after minimally invasive dental procedures, and they offer an aesthetically pleasing appearance. An ideal composite restorative material should have wear properties similar to those of tooth tissues. Wear refers to the damaging, gradual loss or deformation of a material at solid surfaces. Depending on the mechanism of action, wear can be categorized as abrasive, adhesive, fatigue, or corrosive. Currently used composite resins cover a wide range of materials with diverse properties, offering dental clinicians multiple choices for anterior and posterior teeth. In order to improve the mechanical properties and the resistance to wear of composite materials, many types of monomers, silane coupling agents, and reinforcing fillers have been developed. Since resistance to wear is an important factor in determining the clinical success of composite resins, the purpose of this literature review was to define what constitutes wear. The discussion focuses on factors that contribute to the extent of wear as well as to the prevention of wear. Finally, the behavior of various types of existing composite materials such as nanohybrid, flowable, and computer-assisted design/computer-assisted manufacturing materials, was investigated, along with the factors that may cause or contribute to their wear.

Artificial Intelligence in Surgery and Its Potential for Gastric Cancer

  • Takahiro Kinoshita;Masaru Komatsu
    • Journal of Gastric Cancer
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    • 제23권3호
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    • pp.400-409
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    • 2023
  • Artificial intelligence (AI) has made significant progress in recent years, and many medical fields are attempting to introduce AI technology into clinical practice. Currently, much research is being conducted to evaluate that AI can be incorporated into surgical procedures to make them safer and more efficient, subsequently to obtain better outcomes for patients. In this paper, we review basic AI research regarding surgery and discuss the potential for implementing AI technology in gastric cancer surgery. At present, research and development is focused on AI technologies that assist the surgeon's understandings and judgment during surgery, such as anatomical navigation. AI systems are also being developed to recognize in which the surgical phase is ongoing. Such a surgical phase recognition systems is considered for effective storage of surgical videos and education, in the future, for use in systems to objectively evaluate the skill of surgeons. At this time, it is not considered practical to let AI make intraoperative decisions or move forceps automatically from an ethical standpoint, too. At present, AI research on surgery has various limitations, and it is desirable to develop practical systems that will truly benefit clinical practice in the future.