• Title/Summary/Keyword: Surgery techniques

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Usefulness of Oncoplastic Volume Replacement Techniques after Breast Conserving Surgery in Small to Moderate-sized Breasts

  • Yang, Jung Dug;Kim, Min Chul;Lee, Jeong Woo;Cho, Young Kyoo;Choi, Kang Young;Chung, Ho Yun;Cho, Byung Chae;Park, Ho Yong
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.489-496
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    • 2012
  • Background In Korean women, many of whom have small to moderate-sized breasts, it is difficult to cover a partial breast defect using oncoplastic volume displacement techniques after removal of an adequate volume of tissue during oncologic surgery. In such cases, oncoplastic volume replacement techniques are more useful. Methods From January 2007 to December 2011, 104 women underwent a total of 107 breast-conserving surgeries with various kinds of oncoplastic volume replacement techniques. We used latissimus dorsi (LD) myocutaneous flap for cases in which the resection mass was greater than 150 g. In case with a resection mass less than 150 g, we used regional flaps such as a lateral thoracodorsal flap, a thoracoepigastric flap, or perforator flaps such as an intercostal artery perforator (ICAP) flap or a thoracodorsal artery perforator (TDAP) flap. Results The mean age was 46.1 years, and the average follow-up interval was 10.3 months. The patients underwent oncoplastic volume replacement techniques with a lateral thoracodorsal flap (n=9), thoracoepigastric flap (n=7), ICAP flap (n=25), TDAP flap (n=12), and LD flap (n=54). There was one case of congestion in an LD flap, and two cases of fat necrosis in an ICAP flap. Most of the patients were satisfied with the cosmetic results. Conclusions Oncoplastic volume replacement techniques can be reliable and useful for the correction of breast deformity after breast-conserving surgery, especially in patients with small to moderate-sized breasts.

Simple Anastomotic Techniques for Coronary Artery Bypass Surgery in Patients with Small Coronary Arteries or a Marked Size Discrepancy Between the Coronary Artery and Graft

  • Lee, Mi Kyung;Song, Joon Young;Kim, Tae Youn;Kim, Jong Hun;Choi, Jong Bum;Kuh, Ja Hong
    • Journal of Chest Surgery
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    • v.49 no.6
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    • pp.485-488
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    • 2016
  • Different suture techniques have been used for anastomosis in coronary artery bypass graft surgery. Bypass surgery may be difficult for patients who have small coronary arteries or marked size discrepancies between target coronary arteries and grafts. For proximal and distal anastomoses, three continuous stitches are first placed in the heel and toe of the small coronary arteries; for sequential anastomosis, an interrupted eight-stitch technique is used. We applied these anastomotic suture techniques in patients requiring coronary artery bypass graft surgery, achieving an early angiographic patency rate of 100%.

Mandibular Angle Management for Improving the Esthetic Result of Orthognathic Surgery (임상가를 위한 특집 3 - 악교정 수술과 함께하는 mandibular angle management)

  • Han, Se-Jin
    • The Journal of the Korean dental association
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    • v.50 no.11
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    • pp.677-681
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    • 2012
  • Orthognathic surgery(2-jaw or 1-jaw surgery) is very famous one of cosmetic techniques. However, primary purpose of orthognathic surgery is to improve the occlusion of jaw and secondary purpose is to improve the esthetic result. Unfortunately, many patients don't only confuse often primary and secondary purpose of orthognathic surgery but they think the esthetic result is more important than the occlusion. Therefore, oral and maxillofacial surgeon has to fully understand cosmetic needs of patient and reflect that in the treatment plan. Patients with prominent mandibular angle want to have the narrower face of so called 'V-line' shape. Various techniques like the angle shaving, ostectomy of the lateral cortex around the mandibular angle and masseter musclectomy can be used for improving the mandibular angle hypertrophy. These techniques also can be applied in orthognathic surgery at the same time. We operated patients of orthognathic surgery, especially, with wide lower face and post-operative results were satisfactory in all cases. So, we propose mandibular angle management for improving the esthetic result of orthognathic surgery.

Oncoplastic Techniques For Treatment of Inferiorly Located Breast Cancer (종양성형적 술식을 이용한 하부 유방에 위치한 유방암 치료)

  • Bae, Sung-Gun;Yang, Jung-Dug;Lee, Sang-Yun;Chung, Ki-Ho;Chung, Ho-Yun;Cho, Byoung-Chae;Park, Ho-Yong
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.680-686
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    • 2008
  • Purpose: Breast conserving surgery(BCS) for breast cancer has a common treatment protocol. Oncoplastic surgery represents a form of BCS which combines both a cosmetic mammoplasty approach and oncologic resection for the treatment of breast cancer. Depending on the tumor site, BCS can make an unsatisfactory cosmetic result, especially in inferiorly placed tumors. This study describes the use of oncoplastic techniques for inferiorly located breast tumors in immediate partial mastectomy reconstruction. Methods: From September of 2006 to February of 2008, these techniques were used in 11 patients at the ${\bigcirc}{\bigcirc}$ hospital. After BCS was preceded, breast reshaping by oncoplastic techniques were selected depending on the location and size of the tumor within the breast as well as the size of breast itself. Oncoplastic techniques after partial mastectomy included 'Wise pattern (inverted T)' reduction mammoplasty, 'vertical pattern' mammoplasty, 'J-pattern' mammoplasty. In order to improve the cosmetic outcome, repositioning of the nipple areola complex(NAC) or reshaping of the contralateral breast may be considered additionally. Results: These techniques have been used in 11 patients. The mean age was 51 and the average follow-up period was 8 months. Eleven of these patients underwent the 'Wise pattern(inverted T)' reduction mammoplasty(n=6), 'vertical pattern' mammoplasty(n=3) and 'J-pattern' mammoplasty(n=2). There was one wound dehiscence during the follow-up periods. This complication was treated by conservative approach. The overall cosmetic result was evaluated in 6 months. The majority of patients were satisfied at the cosmetic result. Conclusion: Oncoplastic techniques in inferiorly located breast tumors could be a reasonable and safe option for breast cancer patients who desire conserving surgery with esthetical breast.

Robot-Assisted Thoracic Surgery in Non-small Cell Lung Cancer

  • Lee, Jun Hee;Hong, Jeong In;Kim, Hyun Koo
    • Journal of Chest Surgery
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    • v.54 no.4
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    • pp.266-278
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    • 2021
  • Lobectomy is the standard treatment for early non-small cell lung cancer. Various surgical techniques for lobectomy have been developed, and minimally invasive thoracic surgery, such as video-assisted thoracic surgery or robot-assisted thoracic surgery, has been considered as an alternative to conventional open thoracotomy. The recently robotic lobectomy technique has developed since the first case series was published in 2002. Several studies have reported that robotic lobectomy has comparable oncologic and perioperative outcomes to those of video-assisted thoracic surgery lobectomy and open lobectomy. However, robotic lobectomy remains a challenge for surgeons because of the steep learning curve, reduced tactile sensation, difficulty in port placement, and challenges in cooperation between the surgeon and assistant. Many studies have reported on robotic lobectomy, but few have presented surgical techniques for robotic lobectomy. In this article, the surgical techniques and optimal performance of robotic lobectomy are described in detail for all 5 types of lobectomy for surgeons beginning with robotic lobectomy.

Judgement in artificial eruption of embedded teeth from an oral surgery perspective: review article

  • Mahardawi, Basel;Kumar, KC;Arunakul, Kanin;Chaiyasamut, Teeranut;Wongsirichat, Natthamet
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.1
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    • pp.12-18
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    • 2020
  • Impacted teeth are a frequent phenomenon encountered by every clinician. The artificial eruption of embedded teeth is the process of directing an impacted tooth into normal occlusion. This procedure is currently attracting attention, with the aim of finding the best technique to use according to each case. This article presents key information regarding impacted incisors, canines, and premolars. In addition, we describe the most common techniques to use for artificial eruption, the open and closed techniques. We review the literature concerning these techniques and outline how clinicians can manage every type of impacted tooth.

Advances in surgical treatment of lymphedema

  • Beederman, Maureen;Chang, David W.
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.670-677
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    • 2021
  • An estimated 250 million people worldwide suffer from lymphedema. In the past, the first-line option for treatment was nonsurgical management, either in the form of compression garments or wrapping, or comprehensive decongestive therapy, with debulking surgery reserved for the more advanced cases. However, with improvements in microsurgical techniques and imaging modalities, surgical intervention is increasingly being utilized. This review highlights recent advancements in the surgical treatment of lymphedema, specifically focusing on improvements in imaging, surgical techniques, and prevention of lymphedema.

Analysis of Cleft Lip Nose Deformities Correction in Adults: Detailed Techniques and Comprehensive Review (성인에서의 구순비변형 교정술에 사용된 상세술기의 분석)

  • Choi, Chi-Won;Kang, Kyung-Dong;Kim, Kyoung-Hoon;Bae, Yong-Chan
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.755-760
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    • 2011
  • Purpose: Correction of cleft lip nose deformity (CLND) in adulthood is different from one in childhood. Usually correction of CLND is final surgery for adult patient who has cleft lip, so many things have to be considered for correction. Of course, it is different from common rhinoplasty, either. The adult patients can be corrected by complete rhinoplasty with various techniques. To recognize how rhinoplasty techniques was used for correction of CLND, authors analyzed detailed techniques which were selected in the adult patients for 10 years and reviewed comprehensive operation. Methods: A retrospective review was conducted involving 64 patients with CLND who underwent surgery and aged after 14 years at operation between 2001 and 2010. Detailed techniques were investigated by medical record review and classified according to incision, septoplasty, osteotomies, correction of vault, tip plasty and etc. Results: Except one, all patients were performed open rhinoplasty. 49 patients were performed septoplasty. 33 patients were performed complete rhinoplasty with osteotomies. Hump nose correction was performed for 10 patients. Dorsal augmentation was performed for 8 patients. And all patients were performed tip plasty. Tip plasty using suture technique was performed for 58 patients and graft was performed for 48 patients. Conclusion: Correction of CLND in adult is one of the most challenging and varied operation of plastic surgery. In this study, the majority of patients were performed complicated and delicated procedures. It seems to be because patient's demand level has been elevated and rhinoplasty procedures have been advanced. This study may help to planning of CLND correction.

The Pringle maneuver in the modern era: A review of techniques for hepatic inflow occlusion in minimally invasive liver resection

  • Omar A. Mownah;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.131-140
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    • 2023
  • During minimally invasive liver resection (MILR), the Pringle maneuver aims to minimize blood loss and provide a clear operative field, thereby identifying intrahepatic structures and facilitating safe parenchymal transection. Several techniques for using the Pringle maneuver in MILR have been described. This review presents various methods which have been reported in the literature. A systematic literature search used the MEDLINE/PubMed database from its earliest records to August 2022 using appropriate search headings and keywords. The primary outcome was identifying techniques for performing hepatic inflow occlusion during laparoscopic/robotic hepatectomy. Inclusion criteria consisted of publications describing technical steps to obtain hepatic inflow occlusion during minimally invasive hepatectomy. A literature search identified 23 relevant publications, and the full texts were examined. The techniques described in the reports can be broadly categorized into three groups: (1) the Rummel-tourniquet technique, (2) vascular clamp use, and (3) the Huang Loop technique. Various techniques have been used in MILR to achieve inflow confinement successfully. The authors prefer the modified Huang Loop technique because it is inexpensive, reliable, and quick to apply or release. Hepatobiliary surgeons are advised to familiarize themselves with these MILR techniques, which have proven effective and safe inflow occlusion.

Closure of oroantral fistula: a review of local flap techniques

  • Kwon, Min-Soo;Lee, Baek-Soo;Choi, Byung-Joon;Lee, Jung-Woo;Ohe, Joo-Young;Jung, Jun-Ho;Hwang, Bo-Yeon;Kwon, Yong-Dae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.1
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    • pp.58-65
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    • 2020
  • Oroantral fistula (OAF), also termed oroantral communication, is an abnormal condition in which there is a communicating tract between the maxillary sinus and the oral cavity. The most common causes of this pathological communication are known to be dental implant surgery and extraction of posterior maxillary teeth. The purpose of this article is to describe OAF; introduce the approach algorithm for the treatment of OAF; and review the fundamental surgical techniques for fistula closure with their advantages and disadvantages. The author included a thorough review of the previous studies acquired from the PubMed database. Based on this review, this article presents cases of OAF patients treated with buccal flap, buccal fat pad (BFP), and palatal rotational flap techniques.