• Title/Summary/Keyword: Surgical Instruments

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Stapling and Suturing of Blebs and Bullae without Excision in Thoracoscopic Surgery (비디오 흉강경하에서 절제없이 봉합에 의한 기포정복술)

  • 김은규;최형호;양현웅;이삼윤;최종범
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.995-998
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    • 1998
  • Background: Prolonged air leak is a common complication after thoracoscopic bullectomy. Materials and methods: A technique is described to minimize postoperative air leak in thoracoscopic surgery for the treatment of recurrent or persistent spontaneous pneumothorax. Results: A 3.5cm utility incision is made in the anterior axillary line at the level of the third intercostal space, and blebs and bullae are stapled and sutured without excision, using standard surgical instruments and stapler. Conclusions: This technique may be useful to reduce prolonged air leak after removal of the bleb and bullous lesion, and may minimize the delayed recurrence of ipsilateral pneumothorax.

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Early Experiences of Single Incision Laparoscopic Surgery in Pediatrics in a Single Center (단일기관 소아환자에서 단일절개복강경하수술의 초기경험)

  • Song, Ra-Yeong;Jung, Kyuwhan
    • Advances in pediatric surgery
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    • v.19 no.2
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    • pp.90-97
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    • 2013
  • Laparoscopic surgery has become popular in the past few decades, owing to less postoperative pain, fast recovery, and better cosmetic outcomes. The laparoscopic approach has been employed in pediatric surgery for the same reasons. After the first attempts of single incision laparoscopic appendectomy in pediatrics in 1998, single incision laparoscopic surgery (SILS) has recently been proven to be safe and feasible for the pediatric population. However, limitations have been reported for SILS, such as the wide learning curve, compared to standard laparoscopic surgery, and the restricted number of hospitals with surgical training programs including SILS. In this study, we intend to present our initial experiences with SILS in children, and to describe the technique, instruments used, and outcomes. This is a retrospective study of 71 pediatric patients who underwent SILS, at a tertiary medical center, between September, 2012 and August, 2013. Electronic medical records were reviewed for demographics, type of procedure, operation time, use of additional ports, conversion to open surgery, complications and hospital stay. Additional ports were inserted in 4 cases, for the purpose of traction. Postoperative complications were noted in 13 cases, which were mostly related to wound inflammation or formation of granulation tissue. According to our analyses, patients with complications had significantly longer use and more frequent use of pain killers. Notwithstanding the small sample size, many of the procedures performed in pediatric patients seem to be possible with SILS.

The Effect of the Patient's Characteristics on Nursing Outcomes in Gastrointestinal Surgery Patients (간호결과에 대한 환자 특성의 영향 - 위장관계 수술 환자를 중심으로 -)

  • Lee, Byoung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.3
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    • pp.249-259
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    • 2008
  • Purpose: This study was performed to identify the patient characteristics significantly affecting nursing outcomes and their predictability in gastrointestinal surgery patients. Method: The subjects were 149 abdominal surgery patients from 3 general surgical nursing units of 3 general hospitals. Two instruments were used to measure nursing outcomes and acuity of the subjects. The nursing outcomes were measured at post-operation 4 and 7days using review of patients' records, observation of patients, and interviews with patients by a trained nurse. For data analysis, T-test or ANOVA, Pearson Correlation and Stepwise Multiple Regression were done. Result: Age, severity score, diagnosis, cancer or not, operation site were the subjects' characteristics that were significantly related to the nursing outcomes in both post-operation 4 and 7days. Cancer or not, age, diagnosis and severity score were the significant predictors for the scores of nursing outcome in post-operation 4days and the predictability was 34.9%. The predictability of cancer or not was highest, 22.6%. Age, diagnosis and cancer or not were the significant predictors for the scores of nursing outcome in post-operation 7days and the predictability was 27.8%. The predictability of age was highest, 17.3%. Conclusions: The patient characteristics affecting nursing outcomes should be considered when nursing care is planned and provided. Especially, careful attention should be given to the patients with cancer and older age. And, these patient characteristics should be adjusted for correct estimation of the effectiveness of nursing interventions on nursing outcomes.

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Perceived Powerlessness in Hospitalized Elderly Patients (내·외과 병동에 입원한 노인들의 무력감 지각정도에 관한 연구)

  • Choi, Soo-Jeong
    • Korean Journal of Adult Nursing
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    • v.13 no.4
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    • pp.601-609
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    • 2001
  • Purpose: The purpose of this study was to identify the degree of perceived powerlessness in hospitalized elderly patients of the medical and surgical unit. Method: The instrument for this study was the Powerlessness Behavioral Assessment Tool(Miller, 1983). The reliability of the instruments was .85. The data was analyzed by descriptive statistics, t-test, and ANOVA. Results: The results were as follows ; 1. The mean score of powerlessness was $35.02(SD={\pm}9.24)$ in a range of 19 to 64, and the mean of powerlessness was total 1.84. Among 4 subscales, the highest score was in the area of verbal response (M=1.98), and the lowest score for powerlessness was in the area of daily activities(M=1.74). In all items, 'verbal expression of fatalism' showed the highest score(M=2.78), and 'verbal expressions of giving up' showed the lowest score(M=1.38). 2. There were significant differences in the level of powerlessness according to hospitalization experience(t=-3.03, p=0.006), medical treatment experience(t=.291, p=.004). Especially, there was significant difference according to the hospitalization experience of the hospital in all sub- scales. Conclusion: Based on these conclusions, nursing education for patient's diseases and treatment can be used for proper nursing intervention in reducing the level of powerlessness of hospitalized elderly.

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A Study On Shape Design of Implant Systems For Bone Fracture Operations By Using Finite Element Method (유한요소법을 이용한 골절치료용 임플란트 시스템 형상설계에 관한 연구)

  • Cho, Ji-Hyun;Seo, Keum-Hee;Seo, Tae-il
    • Journal of the Korean Society of Manufacturing Technology Engineers
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    • v.21 no.3
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    • pp.425-432
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    • 2012
  • This paper investigates shape design processes of two implant systems for bone fracture treatment ; Bone plate and Interlocking nail system. These systems can directly fix fractured human bones by surgical operations. The bone plates consist of various shaped plates and implant screws for fixation of fractured human bones with various manual instruments allowing to handle them. The material corresponds to titanium alloy Ti6Al4V because it is harmless material for human body as well as significantly rigid. This system has to be suitably rigid as well as manually bended in orthopedic surgery operations. The Interlocking nail system is a kind of nail implanted inside fractured human bones. The shapes of these systems have to be suitably designed in order to endure various loads as well as avoid any damages. If various shaped prototypes would be fabricated and tested to design the optimal shapes, optimal shapes could be obtained but very long time and expensive costs must be required. In this paper finite element method was applied into these systems. Under various boundary conditions a series of structural analysis was conducted by using ANSYS. Finally important shape factors could be determined on the basis of the analysis results.

Exophthalmometric values using White-light Scanning Interferometer (백색광 간섭계를 이용한 안구돌출값 측정)

  • Chang, Jung-Soo;Kim, Young-kil
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2017.05a
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    • pp.175-178
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    • 2017
  • The relative position of the eyeballs in the orbit can be a criterion for estimating multiple pathological conditions. Especially, it is useful to diagnose orbital fracture, thyroid eye disease, orbital tumor, and to evaluate the result of drug and surgical treatment. The Hertel and the Naugle exophthalmometer, which are typical measuring instruments used mainly to measure the protrusion of the eye, are inevitably error by the measurer. In this paper, we propose a method to increase the accuracy and repeatability of the measurement of eyeball exophthalmometric values by using a white light interferometer.

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Development of Digital Endoscopic Data Management System (디지탈 내시경 데이터 management system의 개발)

  • Song, C.G.;Lee, S.M.;Lee, Y.M.;Kim, W.K.
    • Proceedings of the KOSOMBE Conference
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    • v.1996 no.11
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    • pp.304-306
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    • 1996
  • Endoscopy has become a crucial diagnostic and theraputic procedure in clinical areas. Over the past three years, we have developed a computerized system to record and store clinical data pertaining to endoscopic surgery of laparascopic cholesystectomy, peviscopic endometriosis, and surgical arthroscopy. In this study, we are developed computer system, which is composed of frame grabber, sound board, VCR control board, LAN card and EDMS(endoscopic data management software). Also, computer system has controled over peripheral instruments as a color video printer, video cassette recorder, and endoscopic input/output signals(image and doctor's speech). Also, we are developed one body system of camels control unit including an endoscopic miniature camera and light source. Our system offer unsurpassed image quality in terms of resolution and color fidelity. Digital endoscopic data management system is based on open architecture and a set of widely available industry standards, namely: windows 3.1 as a operating system, TCP/IP as a network protocol and a time sequence based database that handles both an image and drctor's speech synchronized with endoscopic image.

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History and Instrumental Development of Laryngeal Micro-Surgery (후두미세수술의 역사와 기구의 발전)

  • Woo, Joo-Hyun;Kim, Dong-Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.2
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    • pp.97-100
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    • 2010
  • After introduction of operating microscopes and laser devices in the 1960's, monumental innovation for had been achieved in laryngeal microscopic surgery. The development of high-tech operating devices made the laryngeal surgery less invasive and more precise. There were long histories until developing of the modem instruments and surgical techniques. The simple oral mirror introduced by Bozzoni in 1807 is the beginning of laryngoscope. In 1859 Green carried out the laryngeal operation under direct view of larynx. The appearance of local topical anesthesia on throat had contributed to laryngeal surgery coming into wide use. Killian and Jackson made much contribution to developing the design of laryngoscope. After that, modem laryngeal surgery have been developed with development of the stabilizing holder of laryngoscope and optical devices. We propose carefully the direction of the development of the laryngeal surgery by historical consideration of laryngeal surgery and instrumental development.

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Vertebral Artery Injury during Anterior Cervical Spine Surgery : Report of Two Cases (전방경추수술중 추골동맥 손상 : 2예 보고)

  • Lee, Dong Girl;Rhim, Seung Chul;Roh, Sung Woo;Im, Su Bin;Kwon, Yang;Kwun, Byung Duk
    • Journal of Korean Neurosurgical Society
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    • v.30 no.2
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    • pp.231-238
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    • 2001
  • Vertebral artery injury is a rare complication of anterior cervical approach. We report two patients who suffered injury to vertebral artery during anterior cervical spine surgery. The mechanism of injury, their operative management, and the subsequent outcome were assessed and relevant literatures reviewed. The awareness of the possibility of vertebral artery injury is most important to prevent and it's occurrence is best avoided by a thorough understanding of the anatomical relationships of the artery, the spinal canal, and the vertebral body and careful use of surgical instruments.

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Types and Causes of Non-Value-Added Activities in Nursing Practice in Korea (비부가가치 간호활동(Non-Value-Added Nursing Activity) 유형과 발생원인 분석)

  • Choi, Joo Soon;Yang, Young Hee;Baek, Hye Soon
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.3
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    • pp.363-374
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    • 2011
  • Purpose: The purpose of this study was to identify the types and causes of non-value-added (NVA) activities in nursing practice, and to determine the frequency of each NVA type and causes of NVA in clinical area. Methods: This study was conducted using Delphi technique. First, in order to identify NVA and their causes, 24 nurses with 7 years or more of clinical experience were recruited from medical/surgical units in six general hospitals in Korea. Then the NVA types and causes were tested using a larger sample of 130 nurses with more than 3 years of clinical experience at two general hospitals in Korea. Results: NVA was categorized into 6 different types, which are repeating, duplicating, waiting, reverse-proxy working, reworking, and searching. The most prevalent NVAs were repeating and duplicating works. Reworking and searching were less frequent types than others. The causes of NVA were classified into personnel-related, supporting departments, records, regulations, information, materials or instruments, and others. Among them, personnel-related and supporting departments were reported with the highest scores. Conclusion: NVA leads to waste cost and time. These results demonstrated the situations and causes of NVA occurred in nursing practice. Further studies on the typology and moderation of NVA activities are warranted to improve the efficiency and quality of nursing care in day-to-day practice.