• Title/Summary/Keyword: Surgery techniques

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COMPARATIVE STUDY OF SURGICAL TECHNIQUE FOR THE CORRECTION OF THE CONGENITAL CLEFT PALATE IN MONGOLIA

  • Gongorjav, Ayanga;Luvsandorj, Davaanyam;Nyanrag, Purevjav;Garidkhuu, Ariuntuul;Dondog, Agiimaa;Rentsen, Bayasgalan;Jang, Eun-Sik;Kim, Seong-Gon;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.5
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    • pp.381-385
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    • 2009
  • Objective : The objective of this study was to compare the surgical techniques for the correction of congenital cleft palate. Techniques and approaches : Four-hundred-sixity patients operated between 1993 and 2008 were included in this study. The collected data were age, sex, operating time, admission days, and complications. The comparison between techniques were done by independent t-test. Results: The majority (86.9 %) of patients were received the operation later than 1.5 years old. The distribution of each surgical technique was 43.8 % by Bardach palatoplasty, 11.9 % by Furlow palatoplasty, 1.8 % by Veau palatoplasty, and 42.4 % by the new technique developed by us. Postoperative complication such as wound dehiscence, formation of oro-nasal fistulas in the soft and hard palates were shown in 23.0 % of Bardach technique, 44.2 % of Furlow technique, and 37.5 % of Veau technique. However, only 5.4 % of patients were shown complications in our technique (P<0.001). The operation time was recorded 70 minutes under new technique while the others were 110 minutes (P<0.001). The clinical treatment at hospital was required 7.4 days for our technique and 11.3-15.5 days for the other methods. Conclusion : The surgical treatment of congenital cleft palate in Mongolia was conducted later than proper timing for surgery. As the results were indicated, our new technique should be considered for the correction of cleft palate in old aged patients.

Demographic review of aesthetic surgery for patients with facial palsy

  • Min Young Lee;Yun Jung Kim;Young Seok Kim;Tai Suk Roh;In Sik Yun
    • Archives of Craniofacial Surgery
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    • v.25 no.1
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    • pp.22-26
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    • 2024
  • Background: This study analyzed the demographic characteristics of patients with facial palsy who were treated using either dynamic or static procedures. This study aimed to compare the frequency of procedure implementation and age distribution between the two groups. Methods: This study retrospectively analyzed the medical records of patients treated for facial palsy at a single institution from 2014 to 2022. Among cases included in our study, dynamic procedures involved cross-facial nerve graft and latissimus dorsi or gracilis muscle flap transfer. Static procedures included gold weight insertion, canthopexy, browlift, and thread lift/static slings. Results: Among the 31 patients included in our study, eight (25.8%) incorporated dynamic techniques, and the average age of patients was 44.75 years (range, 24-68 years) with a male to female ratio of 1:4. The remaining 23 patients (74.2%) underwent a static procedure, of which the average age was 59.17 years (range, 23-81 years) which was statistically significantly higher than the average age of 44.75 of dynamic patients (p= 0.013). Regarding the timing of treatment after diagnosis, no patient underwent dynamic procedures more than 20 years after initial diagnosis. A greater diversity in the timing of treatment was observed in the static group. All patients who underwent dynamic procedures were treated using static procedures during the study period. Conclusion: Because aesthetics-based static techniques are typically quick outpatient procedures that can be performed under local anesthesia, our study shows that these are often preferred treatments for all age groups, especially for debilitated or older patients. Further research is required to investigate the long-term functional outcomes of these surgical techniques in a wider population of patients.

Biportal Percutaneous Endoscopic Spinal Surgery for Lumbar Spinal Stenosis (요추 척추관 협착증 환자의 양방향 경피적 내시경을 이용한 척추 수술)

  • Kang, Taewook;Lee, Soon Hyuck;Park, Si Young
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.219-226
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    • 2019
  • Lumbar decompressive surgery is a standard surgery for lumbar spinal stenosis. Many surgical techniques have been introduced, ranging from open surgery to percutaneous procedures. Minimally invasive techniques are preferred because of the less postoperative pain and shorter hospital stay. Uniportal percutaneous endoscopic decompression has technical difficulties due to the narrow field. Biportal percutaneous endoscopic decompression is a satisfactory technique that can compensate for the shortcomings and provide sufficient decompression.

Minimally Invasive Surgery for Esophageal Cancer (식도암에 대한 최소 침습수술)

  • Ryu Kyong Min;Jung Yo Chun;Cho Suk Ki;Jin Sung Hoon;Sung Sook Whan;Park Do Joong;Kim Hyung-Ho;Jheon Sanghoon
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.255-259
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    • 2006
  • The operation for esophageal cancer is both complex and challenging, and may be associated with significant morbidity and mortality compared to other oncologic surgeries. Minimally invasive surgeries have been applied on various kinds of surgery to enhance better recovery with minimal surgical complications. But for the esophageal cancer, it has not been actively applied yet. With improvement in instrumentations and increasing experience with endoscopic surgical techniques, minimally invasive surgical approaches to esophageal cancer are being explored to determine feasibility, results and potential advantages. We experienced eight cases of minimally invasive surgery for esophageal cancer and report here focusing on surgical techniques and tips.

An Algorithm for Labia Minora Reduction Based on a Review of Anatomical, Configurational, and Individual Considerations

  • Maurits Lange;J. Joris Hage;Refaat B. Karim;Frederic Amant
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.17-25
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    • 2023
  • A variety of reduction labiaplasty techniques have been introduced to date, but no single technique will offer the optimal solution for every patient. Rather, the technique should be chosen based on anatomical, configurational, and technical considerations, as well as on patients' personal preferences regarded maintenance of the labial rim, maintenance of labial sensitivity, and prevention of iatrogenic thickening of the labium. We reviewed, defined, and assessed labial configurational variety, neurovascular supply, reduction techniques, and patient's preferences as the considerations relevant to the choice of labiaplasty technique. Based on this review, an algorithm was constructed that leads to a choice of reduction technique through five decisions to be made regarding (1) resection or (partial) retention of the labial free rim, (2) the measure of required labial width reduction, (3) labial vascular status, (4) prevention of iatrogenic labial thickening, and (5) preservation of labial sensibility. The choice of techniques includes edge trimming, central spindle form de-epithelialization or full-thickness resection, and three modifications of the wedge resection or de-epithelialization technique. These three modifications comprised a modified anterior resection or de-epithelialization combined with posterior flap transposition, a custom flask resection or de-epithelialization, and a modified posterior wedge resection or de-epithelialization combined with anterior flap transposition. Use of the five decisional steps and the inclusion of modifications of all three conventional reduction techniques offer an improved algorithm for the choice of labioplasty technique.

Replantation of the Amputated Penis using Microsurgery (미세수술에 의한 절단 음경의 재접합)

  • Kang, Yang-Soo;Park, Yong-Nam;Lee, Myung-Ju;Yang, Jeong-Yeol;Rho, Joon;Kim, Chul-Sung
    • Archives of Reconstructive Microsurgery
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    • v.10 no.1
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    • pp.23-27
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    • 2001
  • Penile amputation results primarily from attempts at self-emasculation in the psychotic individual or from felonious assault. Because of the complex nature of patients whom perform self-emasculation and low incidence of felonious assault, large series of these individuals do not exist, and experience with amputation injuries of the genitals is confined to individual case reports. Fortunately, complete amputation of penis is quite rare but potentially devastating occurrence. The repels of the treatment of penile amputation by coporal reapproximation that have been published since 1977 indicate that microreplantation techniques are propably superior to the technically simpler nonmicroscopic coporal reapproximation techniques. As microsurgical techniques have been demonstrated to superior, the preferred method of replantation involves this routine whenever possible. We have experience of a case of successful replantation of completely amputated penis by using microneurovascular repair, with the good result of cosmetic and functional concern. Herein, we report this case with the review of the literatures.

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Common Sites, Etiology, and Solutions of Persistent Septal Deviation in Revision Septoplasty

  • Jin, Hong Ryul;Kim, Dae Woo;Jung, Hahn Jin
    • Clinical and Experimental Otorhinolaryngology
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    • v.11 no.4
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    • pp.288-292
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    • 2018
  • Objectives. To investigate the common causes of persistent septal deviation in revision septoplasty and to report the surgical techniques and results to correct them. Methods. A total of 100 consecutive patients (86 males) who had revision septoplasty due to persistent septal deviation from 2008 and 2014 were included in the study. Their mean age was 35.6 years and the mean follow-up duration was 9.1 months. Presenting symptoms, sites of persistent septal deviation, techniques used to correct the deviation, and surgical results were reviewed. Results. The mean interval between primary and revision surgery was 6.2 years. Forty-eight patients received revision septoplasty and 52 received revision septoplasty combined with rhinoplasty. Nasal obstruction was the most presenting symptom in almost all patients. The most common site of persistent septal deviation was middle septum (58%) followed by caudal septum (31%). Correcting techniques included further chondrotomy and excision of deviated portion in 76% and caudal batten graft in 39%. Rhinoscopic and endoscopic exams showed straight septum in 97% and 92 patients had subjective symptom improvement postoperatively. Conclusion. Middle septum and caudal septum were common sites of persistent deviation. Proper chondrotomy with excision of deviated middle septum and correction of the caudal deviation with batten graft are key maneuvers to treat persistent deviation.

Open rhinoplasty in secondary cleft nose deformity with suture techniques

  • Lee, Chong Kun;Min, Byung Duk
    • Archives of Craniofacial Surgery
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    • v.23 no.5
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    • pp.211-219
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    • 2022
  • Background: Correction of secondary cleft nose deformity is one of the most important portions in the management of cleft lip patients. Various techniques have been introduced to achieve adequate shape, balance, and symmetry of anatomical landmarks. None of these methods can claim to universally solve all aspects of the problems encountered in secondary cleft deformity surgery. Some authors overlook the aspect of functional rehabilitation with regard to nasal respiratory pathway problems, which is present in over 90% of the patients. This study aimed to evaluate the aesthetic and functional improvements of the authors' non-destructive technique. Methods: With over 15 years of experience, open rhinoplasty was performed, which included total remodeling of the deformed lower lateral cartilage using several suture fixation techniques without any graft or implantation with septo-turbinoplasty. A total of 150 questionnaires were sent by e-mail, but 55 completed questionnaires were returned. Surgical outcomes were evaluated using questionnaire responses, and outcomes were divided into five categories each for esthetic and functional analyses. Results: The satisfaction rate ranged from 75 % to 98%, which means "more or less," "very much," and "absolutely yes" in the esthetic and functional viewpoints. Conclusion: The results of this study strongly recommend performing the suture fixation technique and functional rehabilitation simultaneously for cleft lip/nose correction.

Comparison of Primary Stability of Different Femoral Fixation Techniques in Anterior Cruciate Ligament Reconstruction (전 십자 인대 재건술에서 대퇴골측 고정 방법의 초기 안정성의 비교)

  • Song, Eun-Kyoo;Lee, Keun-Bae;Lee, Moon
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.85-92
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    • 1998
  • Various methods for fixation of graft have been widely used for reconstruction of anterior cruciate ligament. However, the biomechanical strength of each fixation techniques are not fully understood. The purpose of this study is to compare the pull out strength of different fixation techniques which is probably the most important factor for the success at the initial stage of healing. Biomechanical test was carried out to measure and compare the pull out tensile strength of five different fixation techniques in 35 pig(Yorkshire) knees. ANOVA and Duncan multiple comparison test was applied for statistical analysis. In the two fixation techniques with bone patellar tendon bone graft, the mean maximum tensile strength was $1333.4{\pm}148.5N$ with titanium interference screw, while it was $1310.1{\pm}168.9N$ with biodegradable interference screw. The failure mode were pulled out of bone plugs from the femoral tunnel in majority cases. In the fixations with hamstring tendon, the mean maximum tensile strength were $1405.9{\pm}135.1N$ with SemiFix screw, $820.3{\pm}104.5N$ with biodegradable interference screw, and $682.1{\pm}54.2N$ with Endobutton. The mode of failure was variable in each technique. The tendon was pulled out from the tunnel in biodegradable interference screw fixation, the screw was bent in the SemiFix system, and the polyester tape were ruptured or the buttons were pulled into tunnel in Endobutton fixation. The mean maximum tensile strength of two interference screws with bone patellar tendon bone was statistically comparable to that of SemiFix with hamstring tendon. However biodegradable interference screw and Endobutton with hamstring tendon showed weaker maximum tensile strength than above three fixation techniques (P<0.05).

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The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review

  • Bemelman, Michael;van Baal, Mark;Yuan, Jian Zhang;Leenen, Luke
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.1-8
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    • 2016
  • More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950's, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft $f{\ddot{u}}r$ osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has becomeavailable suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.