• The Korean Journal of Pain
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• v.29 no.1
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• pp.57-61
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• 2016

Foraminal or extraforaminal Far Lateral Disc Herniations (FLDH) extending into or beyond the foraminal zone have been recognized as between 7-12% of all lumbosacral disc herniations. Conventional posterior laminectomy may not provide good access to a herniation that lies far lateral to the lateral margin of the pedicle. Use of the endoscopic technique through a percutaneous approach to treat such FLDH patients can decrease the surgical morbidity while achieving better outcomes. We made an effort to utilize the advantages of percutaneous endoscopic lumbar discectomy (PELD) and to determine the appropriate approach for FLDH at the level between the 5th Lumbar and first Sacral vertebrae(L5-S1). The authors present a case of an endoscopically resected lumbar extruded disc of the left extraforaminal zone with superior foraminal migration at the level of L5-S1, which had led to foot drop, while placing the endoscope in the anterior epidural space without facetectomy.

• Journal of Chest Surgery
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• v.51 no.1
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• pp.76-80
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• 2018

Early diagnosis followed by primary repair is the best treatment for spontaneous esophageal perforation. However, the appropriate management of esophageal leakage after surgical repair is still controversial. Recently, the successful adaptation of vacuum-assisted closure therapy, which is well established for the treatment of chronic surface wounds, has been demonstrated for esophageal perforation or leakage. Conservative treatment methods require long-term fasting with total parenteral nutrition or enteral feeding through invasive procedures, such as percutaneous endoscopic gastrostomy or a feeding jejunostomy. We report 2 cases of esophageal leakage after primary repair treated by endoscopic vacuum therapy with continuous enteral feeding using a Sengstaken-Blakemore tube.

• Journal of Gastric Cancer
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• v.14 no.3
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• pp.211-214
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• 2014

We report our experience of a concurrent robot assisted distal gastrectomy and partial nephrectomy for synchronous early gastric cancer and renal cell carcinoma. A 55-year-old female patient was diagnosed with early gastric cancer on screening endoscopy. Abdominal computed tomography showed an incidental right renal cell carcinoma. Robot assisted distal gastrectomy was performed, followed by partial nephrectomy. The final pathological examination showed signet ring cell carcinoma within the lamina propria and renal cell carcinoma with negative resection margins. The patient showed no evidence of recurrence at 6-months. A robot-assisted combined operation could be a treatment option for early stages of synchronous malignancies.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.187-191
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• 2003

The Dieulafoy's lesion is a rare cause of recurrent massive gastrointestinal bleeding in children. The bleeding results from an abnormally large submucosal artery that protrudes through a small mucosal defect. The lesion is commonly found on proximal stomach. Surgical intervention was believed to be the best treatment in the past, but recent advancement in endoscopy has made effective hemostasis possible. We report a case of a 9-year-old boy with underlying mycoplasma pneumonia with effusion who presented with massive upper gastrointestinal bleeding. Bleeding was controlled with endoscopic treatment by epinephrine and ethanol injection and the patient was successfully treated.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.198-203
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• 2008

We report a 10-year-old girl with the blue rubber bleb nevus syndrome (BRBNS) who had chronic severe anemia caused by chronic occult bleeding in the gastrointestinal (GI) tract. The patient was admitted to the hospital frequently for recurrent pallor and fatigue since the age of 7 years. Gastroduodenoscopy and capsule endoscopy revealed multiple venous malformations with blood oozing in the stomach, small bowel and colon. The patient was treated by aggressive surgical resection of the 23 vascular malformations in the GI tract. The patient is well without anemia 15 months post surgery.

• Journal of Yeungnam Medical Science
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• v.30 no.1
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• pp.62-65
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• 2013

Gastric bezoars are concretion of undigested material in the gastrointestinal tract. In the past, gastric bezoars were generally treated with surgical management. Recently, the efficacy of oral intake or endoscopic injection therapy with Coca-Cola has been reported. We report a case of a 47-year-old-man with huge gastric bezoar ($4{\times}2.5$ cm) that was successfully removed by endoscopic fragmentation with Coca-Cola injection. Compared with a single endoscopic fragmentation therapy, the combination therapy with Coca-Cola injection shortened the procedure time and reduced the complication associated with fragmented bezoar.

• The Korean Journal of Pain
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• v.24 no.2
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• pp.74-80
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• 2011

Background: Lidocaine patch (L5P) has demonstrated short-term efficacy in treating both acute surgical pain and chronic neuropathic pain with tolerable side effects. Percutaneous endoscopic lumbar discectomy (PELD) is the mainstay of minimally invasive spine surgery (MISS). Sufficient analgesia during PELD surgery makes the patient consider it real MISS. This study was performed to evaluate the efficacy and adverse effects of lidocaine patch in patients who underwent PELD under local anesthesia. Methods: L5P (L group) or placebo (P group) was randomly applied on the skin of the back covering the anticipated path of the working channel before 1 hour of surgery in 100 patients who underwent a single level PELD at L4-L5. Efficacy of the lidocaine patch was assessed by patient's numeric rating scale (NRS) of pain at each stage during the surgery and by a 5-scale grading of the satisfaction with the anesthesia of the operator and patients after surgery. Results: Mean NRS scores at the stages of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture were significantly lower in the L group than the P group. Postoperative operator's and patients' satisfaction scores were also significantly higher in L group than in the P group. There were subtle adverse effects in both groups. Conclusions: L5P provided better pain relief during PELD, especially at the stage of needle insertion, skin incision, serial dilation and insertion of working channel, and subcutaneous suture. It also provided higher patient and operator postoperative satisfaction, with only subtle adverse effects.

• Journal of Gastric Cancer
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• v.15 no.2
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• pp.147-150
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• 2015

Gastric volvulus is an uncommon clinical entity. There are three types of gastric volvulus; organoaxial, mesenteroaxial and combined type. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report a successful case of a patient with chronic gastric volvulus with a laparoscopic treatment. A 79-year-old woman came to the emergency department with epigastric pain accompanied by nausea for 2 weeks. Abdominal computed tomography revealed markedly distended stomach with transposition of gastroesophageal Junction and gastric antrum. Barium meal study revealed presence of the antrum was folded over 180 degrees that was located above gastroesophageal junction. We attempted an endoscopic reduction, but it was unsuccessful. The patient got laparoscopic anterior gastropexy. Based on our result, laparoscopic gastropexy can be considered as a good choice of the treatment for gastric volvulus.

• Korean Journal of Digital Imaging in Medicine
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• v.5 no.1
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• pp.26-31
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• 2002

This paper represents the design of 3D endoscopic video system in order to improve visualization and enhance the ability of the surgeon to perform delicate endoscopic surgery. Minimally invasive techniques have set new standards in all surgical may experience less post-operative discomfort, shorter hospitalization, and quicker recuperation. Finally, the aim of the present study was to determine the influence of 2D and 3D video imaging on defined tasks on a laparoscopic trainer.

• Journal of Gastric Cancer
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• v.15 no.1
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• pp.68-73
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• 2015

Gastric cancer that mimics a submucosal tumor is rare. This rarity and the normal mucosa covering the protuberant tumor make it difficult to diagnosis with endoscopy. We report two cases of advanced gastric cancer that mimicked malignant gastrointestinal stromal tumors preoperatively. In both cases, the possibility of cancer was not completely ruled out. In the first case, a large tumor was suspected to be cancerous during surgery. Therefore, total gastrectomy with lymph node dissection was performed. In the second case, the first gross endoscopic finding was of a Borrmann type II advanced gastric cancer-like protruding mass with two ulcerous lesions invading the anterior wall of the body. Therefore, subtotal gastrectomy with lymph node dissection was performed. Consequently, delayed treatment of cancer was avoided in both cases. If differential diagnosis between malignant gastrointestinal stromal tumor and cancer is uncertain, a surgical approach should be carefully considered due to the possible risk of adenocarcinoma.