• 제목/요약/키워드: minimal invasive technique

검색결과 57건 처리시간 0.022초

수술 술기: 변경된 비침습적 경피적인 비복근 근막 절제술 (Technique Tip: Percutaneous Gastrocnemius Aponeurosis Recession - A Modified Minimal Invasive Technique)

  • 김태훈;한승환
    • 대한족부족관절학회지
    • /
    • 제15권1호
    • /
    • pp.47-50
    • /
    • 2011
  • Equinus contracture of the gastrocnemius-soleus complex is associated with many foot and ankle diseases. We introduce a new simple technique that can be performed using a minimal incision with simple devices. Briefly, 0.5 cm sized medial and lateral longitudinal skin incisions are made at the level of the distal one third of the calf. The musculotendinous junction of the gastrocnemius is gently transected using an Arachnoid blade. The skin is, then, closed with non-absorbable sutures.

크루존씨 병에서 최소침습 절개법 Le Fort III 절골술을 통한 RED II 골 신연술 후 조기 고정 1례 (A Case Report of RED II Distraction Osteogenesis and Early Rigid Fixation by Minimal Invasive Approach Le Fort III Osteotomy in Crouzon's Disease)

  • 김영석;이지나;박병윤
    • Archives of Plastic Surgery
    • /
    • 제34권1호
    • /
    • pp.123-127
    • /
    • 2007
  • Purpose: Rigid external distraction(RED) is a highly effective technique for correction of maxillary hypoplasia in patients with cleft or syndromic craniosynostosis. Despite many advantages of RED, it also has the problem of relapse as the conventional advancement surgery. Bicoronal approach, that is the common approach to gain access to the craniofacial skeleton, had some morbidity, such as hair loss, sensory loss, wide scar and temporal hollowing. We present our clinical experience of RED distraction with minimal invasive approach and early rigid fixation to overcome these disadvantages. Methods: A 27-year-old female patient with Crouzon's disease underwent Le Fort III osteotomy and RED device application through the minimal invasive direct skin incisions. After the latent period of 5 days, distraction was undertaken until proper convexity and advancement were obtained. During the rigid retention period, inflammation occurred on the right cheek, and proper conservative managements were done including continuous irrigation. To maintain the stability of distraction, early rigid fixation was undertaken on the osteotomy sites through another skin incisions. Preoperative and postoperative orthodontic treatments were performed. Serial photographs and cephalometric radiographs were obtained preoperatively, after distraction and 6 months after distraction. Results: The cephalometric analysis demonstrated postoperatively significant advancement of the maxilla and improvement of facial convexity. After 6-month follow-up period, the maxilla was stable in the sagittal plane and no relapse was found. Facial scars were not noticeable and other deformity and morbidity did not occur. Conclusion: This effective and stable technique will be a good alternative for the patients who need large amount of distraction and for adult patients with severe maxillary hypoplasia or syndromic craniosynostosis.

스폰지 겸자를 이용한 아킬레스건의 최소 절개 봉합술: 술기 보고 (Minimally Invasive Repair Technique of Achilles Tendon Using Sponge Forceps: A Technical Report)

  • 박삼국;박철현
    • 대한족부족관절학회지
    • /
    • 제20권2호
    • /
    • pp.88-91
    • /
    • 2016
  • Various minimally invasive repair techniques have been performed for acute Achilles tendon rupture. Despite this, it is difficult to use these techniques in common practice because of the necessity of special instruments. We propose a novel minimal invasive technique using sponge holding forceps, which are commonly used in the operating room for the acute Achilles tendon rupture.

족근동 접근법을 이용한 관절 내 종골 골절의 치료 (The Sinus Tarsi Approach for the Treatment of Intra-Articular Calcaneal Fractures)

  • ;;;김범수
    • 대한족부족관절학회지
    • /
    • 제17권4호
    • /
    • pp.257-263
    • /
    • 2013
  • Open reduction and internal fixation is currently considered as a gold standard of treatment in most of the intra-articular calcaneal fractures. Among various different approaches, extensile lateral approach is the most popular since it provides good exposure to the subtalar joint. However, wide skin incision followed by extensive soft tissue dissection leading to increased risk of wound breakdown is the most serious drawback. Sinus tarsi approach, a minimal invasive technique to approach the subtalar joint and reduce the intra-articular calcaneal fractures, provides good clinical outcome and less wound complications compared to the extensile lateral approach. This article introduces the surgical technique and review of the literature regarding the sinus tarsi approach.

체외강력집속초음파치료 (Extracorporeal High Intensity Focused Ultrasound Therapy)

  • 한상석
    • 대한골관절종양학회지
    • /
    • 제11권1호
    • /
    • pp.17-24
    • /
    • 2005
  • 의학의 발달과 더불어 종양에 대한 국소치료는 광범위근치술(extended radical surgery) 로부터 기능보존술(function preserving surgery)로 발달하고 이것은 다시 최소침습술(minimal-invasive surgery)로 발전하여 왔다. 그러나 최근 들어서는 기술의 혁신적인 진보로 비침습적수술법(non-invasive surgery)이 개발되어 감마나이프(gamma knife), 사이버나이프(cyber knife), 및 하이푸나이프(HIFU knife) 등이 출현하게 되었다. 본 논문에서는 이들 중 하이푸나이프를 이용한 체외강력집속초음파치료(extracorporeal high intensity focused ultrasound therapy)에 대하여 발달사, 치료기 구조 및 치료과정, 조직학적 변화와 기전, 임상적용, 장단점 및 전망 등을 살펴보고자 한다.

  • PDF

임상가를 위한 특집2 - Current concepts of Laser dentistry (Current concepts of Laser dentistry)

  • 은희종
    • 대한치과의사협회지
    • /
    • 제49권11호
    • /
    • pp.670-678
    • /
    • 2011
  • Various sorts of dental devices for the dental treatment have been introduced and adopted during past several years. Dental Laser, among all devices, seems to be possible for applying to over the whole treatments and widely employed. Furthermore, this article is to introduce that Dental Laser is intended to care patients secured with the effectual treatment against Conventional procedures based upon its studies. The advantages of Dental Laser treatment-along with LLLT (Low Level Laser Therapy) effect, biostimulation effect, and minimal invasive technique - make the patients reduce their fear of the operation, lighten the inconvenience of post operation, and shorten the treatment period. In particular, it is worth considering that the use of laser-assisted therapies is associated with a marked reduction in the use of analgesics and anti-inflammatory medications compared with conventional procedures. This article is to state advantages and differences of Dental Laser treatment compared with Conventional procedures, and to emphasize to become well-acquainted with the precautions for safety and effective Dental Laser treatment. In case of operating Dental Laser with lack of the instructions, it will cause the unpredicted fatal results; therefore this treatment requires special care in its operation. Henceforward, it is anticipated that infinite treatment protocols will be introduced by applying Dental Laser, and this is to address the utilization of Dental Laser.

굴곡건 손상에서 최소절개 건 봉합술 (Minimal-incision tenorrhaphy in flexor tendon injury)

  • 장주윤;오상아;강동희;이치호
    • Archives of Plastic Surgery
    • /
    • 제36권4호
    • /
    • pp.516-518
    • /
    • 2009
  • Purpose: To retrieve the retracted flexor tendon, additional incision and wide dissection are conventionally required. We introduce minimal - incision tenorrhaphy using 1 cm - length incision and minimal dissection. Methods: Transverse incision about 1 cm - length is made over the level of retracted tendon. Nelaton's catheter is advanced into tendon sheath from distal primary laceration wound to emerge proximally through the incisional wound. Catheter is sutured to proximal tendon in end - to - end fashion. By gently pulling the catheter, retracted tendon is delivered to distal wound. Tenorrhaphy with core suture and epitendinous suture is then carried out. Results: This retrieving technique provides minimal incision, minimal dissection, minimal bleeding, minimal injury to tendon end, and shorter operation time with preservation of vincula tendinum and pulley system. Conclusion: In case of flexor tendon rupture with retraction, this operative method is believed to allow reliable and effective tenorrhaphy and excellent postoperative outcomes.

External pancreatic ductal stenting in minimally invasive pancreatoduodenectomy: How to do it?

  • Ram Prakash Gurram;Harilal S L;Senthil Gnanasekaran;Satyaprakash Ray Choudhury;Biju Pottakkat;Kalayarasan Raja
    • 한국간담췌외과학회지
    • /
    • 제27권2호
    • /
    • pp.211-216
    • /
    • 2023
  • It has been shown that external pancreatic ductal stenting (EPDS) can reduce the incidence of clinically relevant postoperative pancreatic fistula. Although studies have described EPDS in open pancreaticoduodenectomy (PD), EPDS in minimally invasive PD has not been reported yet. Thus, the objective of this study was to describe the technique of EPDS in minimally invasive PD. The procedure was performed either laparoscopically or using a robot. Once PD was completed, key steps included triple enterotomy, threading of silk-suture through all enterotomies and exteriorization, completing posterior layer of pancreaticojejunostomy (PJ), railroading stent through preplaced silk-suture, intubation of stent into the pancreatic duct, completion of PJ, followed by hepaticojejunostomy and parietalization of jejunum at the stent exit site. EPDS in PD through a minimally invasive approach can be performed safely in selected cases with either a small-sized pancreatic duct or a soft pancreas.

Minimal invasive horizontal ridge augmentation using subperiosteal tunneling technique

  • Kim, Hyun-Suk;Kim, Young-Kyun;Yun, Pil-Young
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제38권
    • /
    • pp.41.1-41.6
    • /
    • 2016
  • Background: The goal of this study was to retrospectively evaluate the prognosis of minimal invasive horizontal ridge augmentation (MIHRA) technique using small incision and subperiosteal tunneling technique. Methods: This study targeted 25 partially edentulous patients (10 males and 15 females, mean age $48.8{\pm19.7years$) who needed bone graft for installation of the implants due to alveolar bone deficiency. The patients took the radiographic exam, panoramic and periapical view at first visit, and had implant fixture installation surgery. All patients received immediate or delayed implant surgery with bone graft using U-shaped incision and tunneling technique. After an average of 2.8 months, the prosthesis was connected and functioned. The clinical prognosis was recorded by observation of the peri-implant tissue at every visit. A year after restoration, the crestal bone loss around the implant was measured by taking the follow-up radiographs. One patient took 3D-CT before bone graft, after bone graft, and 2 years after restoration to compare and analyze change of alveolar bone width. Results: This study included 25 patients and 39 implants. Thirty eight implants (97.4 %) survived. As for postoperative complications, five patients showed minor infection symptoms, like swelling and tenderness after bone graft. The other one had buccal fenestration, and secondary bone graft was done by the same technique. No complications related with bone graft were found except in these patients. The mean crestal bone loss around the implants was 0.03 mm 1 year after restoration, and this was an adequate clinical prognosis. A patient took 3D-CT after bone graft, and the width of alveolar bone increased 4.32 mm added to 4.6 mm of former alveolar bone width. Two years after bone graft, the width of alveolar bone was 8.13 mm, and this suggested that the resorption rate of bone graft material was 18.29 % during 2 years. Conclusions: The bone graft material retained within a pouch formed using U-shaped incision and tunneling technique resulted with a few complications, and the prognosis of the implants placed above the alveolar bone was adequate.

Minimally Invasive Muscle Sparing Transmuscular Microdiscectomy : Technique and Comparison with Conventional Subperiosteal Microdiscectomy during the Early Postoperative Period

  • Park, Beom-Seok;Kwon, Young-Joon;Won, Yu-Sam;Shin, Hyun-Chul
    • Journal of Korean Neurosurgical Society
    • /
    • 제48권3호
    • /
    • pp.225-229
    • /
    • 2010
  • Objective : The authors introduce a minimally invasive muscle sparing transmuscular microdiscectomy (MSTM) to treat herniated lumbar disc disease. Its results are compared with conventional subperiosteal microdiscectomy (CSM) to validate the effectiveness. Methods : Muscle sparing transmuscular microdiscectomy, which involves muscle dissection approach using the natural fat cleavage plane between the multifidus to expose the interlaminar space, was performed in 23 patients to treat a single level unilateral lumbar radiculopathy. The creatine phosphokinase (CPK)-MM serum levels were measured on admission and at 1, 3, and 5 days postoperatively. Postoperative pain was evaluated using a 10-point visual analogue scale (VAS) and recorded on admission and at 1, 3, and 5 days postoperatively. The results were compared to those from the conventional subperiosteal microdiscectomy (43 patients). Results : The CPK-MM levels were significantly lower in the serum of the MSTM group compared to the CSM group on postoperative days three and five (p = 0.03 and p = 0.02, respectively). The clinical scales for back pain using VAS were significantly lower in the MSTM group than in the CSM group on postoperative days three (p = 0.04). The mean VAS scores for leg pain in both groups showed no significant differences during the early postoperative period. Conclusion : Muscle sparing transmuscular microdiscectomy is a minimally invasive surgical option to treat lumbar radiculopathy due to herniated disc. The approach affected minimal injury to posterior lumbar supporting structures with alleviated postoperative back pain.