• Title/Summary/Keyword: Operative technique

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Microvascular Anastomosis Using 'Continuous Suture with Interrupted Knot' Technique (연속 봉합 단속 결찰법을 이용한 미세 혈관 문합법)

  • Choi, Moon-Su;Park, Sang-Hoon
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.22-27
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    • 1999
  • While the conventional end-to-end anastomotic technique is accepted as 'the golden standard' for microvascular anastomosis, it is time-consuming and tedious. In an effort to offer faster and safer ways of performing microvascular anastomoses, numerous anastomotic techniques have been proposed, but further refinements in microvascular techniques are still necessary. A 'continuous suture with interrupted knot' technique was devised for faster and safer anastomosis. It has been successfully used in microanastomoses of both artery and vein for free tissue transfer. It is a combination of the interrupted suturing technique and the continuous suturing technique. First, a continuous suture is made with the size of loop decreasing in order, and then the sutures are tied individually from the first loop to the last one as in the conventional interrupted suturing technique. It was applied clinically to fourteen patients over the past ten months and found to be a highly efficient technique that satisfied our needs. This 'continuous suture with interrupted knot' technique has several advantages over other techniques : The operative time is reduced comparing conventional interrupted suture technique. By delaying the tie and with the vessel walls kept separated, the risk of through-stitch can be reduced. Tying all the sutures at one time not only speed up the procedures, but also reduced the surgeon's fatigue. In addition, it has no problem of anastomotic stenosis which is a disadvantage of continuous suture technique. This technique proved to be faster and safer, and has patency equal to that of the conventional end-to-end anastomosis. It is of great help to the surgeon in reducing operative time, especially in clinical situations when many anastomoses are required, or lengthy grafting procedures are undertaken.

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Automated 2D/3D Image Matching Technique with Dual X-ray Images for Estimation of 3D In Vivo Knee Kinematics

  • Kim, Yoon-Hyuk;Phong, Le Dinh;Kim, Kyung-Soo;Kim, Tae-Seong
    • Journal of Biomedical Engineering Research
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    • v.29 no.6
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    • pp.431-435
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    • 2008
  • Quantitative information of a three dimensional(3D) kinematics of joint is very useful in knee joint surgery, understanding how knee kinematics related to joint injury, impairment, surgical treatment, and rehabilitation. In this paper, an automated 2D/3D image matching technique was developed to estimate the 3D in vivo knee kinematics using dual X-ray images. First, a 3D geometric model of the knee was reconstructed from CT scan data. The 3D in vivo position and orientation of femoral and tibial components of the knee joint could be estimated by minimizing the pixel by pixel difference between the projection images from the developed 3D model and the given X-ray images. The accuracy of the developed technique was validated by an experiment with a cubic phantom. The present 2D/3D image matching technique for the estimation of in vivo joint kinematics could be useful for pre-operative planning as well as post-operative evaluation of knee surgery.

The Treatment of the Acromioclavicular Dislocation using the Modified Neviaser Method (변형된 Neviaser 술식을 이용한 견봉쇄골관절 탈구의 치료)

  • Han Su Il;Kim Joon Seok;Lee Young Kuk
    • Clinics in Shoulder and Elbow
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    • v.4 no.1
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    • pp.24-29
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    • 2001
  • Purpose: To describe a technique of the modified Neviaser method and to evaluate the clinical outcome of the technique in the treatment of the complete acromioclavicular joint dislocation, Materials and Method: We evaluated 20 patients who were treated by a modified Neviaser method from June 1996 to January 1999, They were followed up for a minimum of two years. The operative technique includes fixation of the acromioclavicular joint, repair of coracoclavicular ligament and transfer of the anterolateral band of coracoacromial ligament. Results: The 20 patients were evaluated clinically using Kang's criteria. The satisfactory results obtained in 85%. The mean coracoclavicular interval ratio was decreased from 2.22 preoperatively to 1.07 postoperatively. At the time of two year follow-up, the mean ratio was 1.20. There was no definite complication such as re-dislocation of the joint. Conclusion: In above type 3 acromioclavicular dislocation, the modified Neviaser method provided the advantage of strong and stable fixation with a low complication rate. Therefore, it is thought to be one of the useful operative technique.

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One Stage Eepair of Interruption of Aortic Arch with VSD in Neonate (신생아에서 심실중격결손증을 동반한 대동맥궁 결손증의 일단계 완전 교정술 -3례 치험-)

  • 전희재
    • Journal of Chest Surgery
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    • v.28 no.6
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    • pp.610-618
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    • 1995
  • Three neonates with interrupted aortic arch with VSD underwent one stage repair using revised technique of cardiopulmonary bypass with short period of circulatory arrest. A left posterolateral thoracotomy was made to permit mobilization of the descending aorta and placement of polytetrafluoroethylene[PTFE graft for distal aortic perfusion. Then the patient was placed in the supine position and a median sternotomy was performed to permit the proximal dissection, VSD repair, and direct anastomosis between the ascending aorta and descending aorta. This technique has advantages to facilitate direct anastomosis between the ascending aorta and the descending aorta, to lessen circulatory arrest time, and to prevent dangerous laceration and post-operative narrowing of the thin small ascending aorta at cannulation site. There was no operative mortality but postoperative stenosis developed in one case which was relieved with balloon aortoplasty.

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Clinical Study of 156 Cases of Secundum Atrial Septal Defect closed by Direct Suture (직접봉합으로 치료한 단독 이차공 심방중격결손증 156례 보고)

  • 송정근
    • Journal of Chest Surgery
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    • v.28 no.4
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    • pp.335-339
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    • 1995
  • Secundum atrial septal defect occupies about 10 to 15% of congenital heart diseases, and the surgical accomplishment is outstanding, so that the operative mortality is getting near to zero percent. But, the methods of correction, direct closure versus patch closure are still controversial and there is no absolute method about it. Some surgeons prefer direct closure technique for its simplicity and lesser thrombogenicity but others, afraid of arrhythmia and suture detachment after closure of large defect, prefer patch closure. Usually most surgeons use direct suture technique in small and moderate sized defects and patch closure in large defects. In our hospital, 156 cases of isolated secundum atrial septal defect were closed directly by double continuous over and over suture using 5-0 polypropylene[prolene , regardless their sizes and the amounts of shunt flow. There were no operative mortality and no serious complications such as heart block, suture detachment and embolism.

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Correction of King-Moe Type V Scoliosis with Optimization Method in a FE Model (King-Moe Type V 형태의 척추측만증 유한 요소 모델에서 최적화 기법을 적용한 교정 방법)

  • 김영은;손창규;박경열;정지호;최형연
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2003.06a
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    • pp.701-704
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    • 2003
  • Scoliosis is a complex musculoskeletal dieses requiring 3-D treatment with surgical instrumentation. Conventional corrective surgery for scoliosis was done based on empirical knowledge without information of the optimum position and operative procedure. Frequently, post operative change of rib hump increase and shoulder level imbalance caused serious problems in the view of cosmetics. To investigate the effect of correction surgery, a reconstructed 3-D finite element model for King-Moe type V was developed. Vertebrae, clavicle and other bony element were represented using rigid bodies. Kinematic joints and nonlinear bar elements used to represent the intervertebral disc and ligaments according to reported experimental data. With this model, optimization technique was also applied in order to define the optimal magnitudes of correction. The optimization procedure corrected the scoliotic deformities by reducing the objective function by more than 94%. with an associated reduction of the scoliotic descriptors mainly on the frontal thoracic curve.

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Deep proximal margin rebuilding with direct esthetic restorations: a systematic review of marginal adaptation and bond strength

  • Hoda S. Ismail;Ashraf I. Ali;Rabab El. Mehesen;Jelena Juloski;Franklin Garcia-Godoy;Salah H. Mahmoud
    • Restorative Dentistry and Endodontics
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    • v.47 no.2
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    • pp.15.1-15.18
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    • 2022
  • This review aimed to characterize the effect of direct restorative material types and adhesive protocols on marginal adaptation and the bond strength of the interface between the material and the proximal dentin/cementum. An electronic search of 3 databases (the National Library of Medicine [MEDLINE/PubMed], Scopus, and ScienceDirect) was conducted. Studies were included if they evaluated marginal adaptation or bond strength tests for proximal restorations under the cementoenamel junction. Only 16 studies met the inclusion criteria and were included in this review. These studies presented a high degree of heterogeneity in terms of the materials used and the methodologies and evaluation criteria of each test; therefore, only a descriptive analysis could be conducted. The included studies were individually evaluated for the risk of bias following predetermined criteria. To summarize the results of the included studies, the type of restorative material affected the test results, whereas the use of different adhesive protocols had an insignificant effect on the results. It could be concluded that various categories of resin-based composites could be a suitable choice for clinicians to elevate proximal dentin/cementum margins, rather than the open sandwich technique with resin-modified glass ionomers. Despite challenges in bonding to proximal dentin/cementum margins, different adhesive protocols provided comparable outcomes.

Operative Treatment of Hallux Valgus (무지 외반증의 수술적 치료)

  • Lee, Jung-Woo;Ahn, Jae Hoon;Kim, Man-Soo;Kim, Seung-Chan
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.2
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    • pp.48-55
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    • 2014
  • Hallux valgus, or a 'bunion', is a deformity characterized by lateral deviation of the big toe. Surgery is indicated when conservative treatments have failed to result in improvement of symptoms. Operative techniques include simple bunionectomy, distal soft tissue procedure, phalangeal osteotomy, metatarsal osteotomy (distal, shaft, or proximal), arthrodesis (metatarsophalangeal or tarsometatarsal), or resection arthroplasty. Good results are expected when the selection of operative technique is based on the correct treatment principle.

Endocrown restorations for extensively damaged posterior teeth: clinical performance of three cases

  • Tzimas, Konstantinos;Tsiafitsa, Maria;Gerasimou, Paris;Tsitrou, Effrosyni
    • Restorative Dentistry and Endodontics
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    • v.43 no.4
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    • pp.38.1-38.9
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    • 2018
  • The restoration of endodontically treated teeth (ETT) with more than one cusp missing and thin remaining walls is challenging for the general practitioner. The use of posts combined with full coverage restorations is a well-established approach, yet not following the minimal invasive principles of adhesive dentistry. Endocrowns are indirect monoblock restorations that use the pulp chamber of the ETT for retention. In this study the fabrication of 4 endocrowns and their clinical performance will be discussed. Two clinical cases include computer-aided design/computer-aided manufacturing manufactured molar endocrowns (one feldspathic ceramic and one hybrid composite-ceramic restoration) and the other two are dental laboratory manufactured resin composite premolar endocrown restorations. The modified United States Public Health Service criteria were used to assess the clinical behavior of the restorations at different follow up periods. Endocrown restorations present a satisfactory clinical alternative, either by the use of resin composite or glass ceramic and hybrid materials. Specific guidelines with minimal alterations should be followed for an endocrown restoration to be successful. Due to limited evidence regarding the long term evaluation of this restorative technique, a careful selection of cases should be applied.