• Title/Summary/Keyword: repair technique

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Next-Generation Frozen Elephant Trunk Technique in the Era of Precision Medicine

  • Suk-Won Song;Ha Lee;Myeong Su Kim;Randolph Hung Leung Wong;Jacky Yan Kit Ho;Wilson Y. Szeto;Heinz Jakob
    • Journal of Chest Surgery
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    • v.57 no.5
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    • pp.419-429
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    • 2024
  • The frozen elephant trunk (FET) technique can be applied to extensive aortic pathology, including lesions in the aortic arch and proximal descending thoracic aorta. FET is useful for tear-oriented surgery in dissections, managing malperfusion syndrome, and promoting positive aortic remodeling. Despite these benefits, complications such as distal stent-induced new entry and spinal cord ischemia can pose serious problems with the FET technique. To prevent these complications, careful sizing and planning of the FET are crucial. Additionally, since the FET technique involves total arch replacement, meticulous surgical skills are essential, particularly for young surgeons. In this article, we propose several techniques to simplify surgical procedures, which may lead to better outcomes for patients with extensive aortic pathology. In the era of precision medicine, the next-generation FET device could facilitate the treatment of complex aortic diseases through a patient-tailored approach.

Convenient Suture Technique for Pediatric Facial Lacerations (소아 안면열상 환자의 치료에 있어서 유용한 봉합술)

  • Kim, Jun-Hyung;Kwon, Soon-Beom;Eo, Su-Rak;Cho, Sang-Hun;Markowitz, Bernard L.
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.496-498
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    • 2010
  • Purpose: Lacerations requiring formal wound closure compose a significant number of all childhood injuries presenting to the emergency department. The problem with conventional suture technique are that suture removal is quite cumbersome, especially in children. Unwanted soft tissue damage can result in the process of suture removal, which calls for sedation, stressful for both medical personnel and child. The purpose of this study is to introduce the convenient suture technique for pediatric facial lacerations. Methods: Children under the age of four, presenting to the emergency department with facial lacerations were enrolled in the study. From March 2008 to June 2009, 63 patients (41 males and 22 females) with an average age of 1.4 years were treated with our convenient suture technique using utilized a loop suspended above a double, flat tie. Clean, tension free wounds were treated with our technique, wounds with significant skin defect and concomitant fractures were excluded. Results: The Patients were followed-up in 1, 3 and 5 days postoperatively. On the third hospital visit, suture removal was done by simply cutting the loop suspended above the wound margin and gently pulling the thread with forceps. There were no significant differences in the rates of infection and dehiscence compared with conventional suture technique. Conclusion: The use of our technique was to be simple with similar operative time compared with conventional suture technique. Removal of suture materials were easy without unwanted injuries to the surrounding tissue which resulted in less discomfort for the patient and greater parental satisfaction, minimized the complications. It can be considered as a viable alternative in the repair of pediatric facial lacerations.

Arch Reconstruction with Autologous Pulmonary Artery Patch in Interrupted Aortic Arch

  • Lee, Won-Young;Park, Jeong-Jun
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.129-132
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    • 2014
  • Various surgical techniques have been developed for the repair of an interrupted aortic arch. However, tension and Gothic arch formation at the anastomotic site have remained major problems for these techniques: Excessive tension causes arch stenosis and left main bronchus compression, and Gothic arch configuration is related to cardiovascular complications. To resolve these problems, we adopted a modified surgical technique of distal aortic arch augmentation using an autologous main pulmonary artery patch. The descending aorta was then anastomosed to the augmented aortic arch in an end-to-side manner. Here, we report two cases of interrupted aortic arch that were repaired using this technique.

Surgical Treatment of Atrioventricular Septal Defect (방실중격 결손증의 외과적 치료)

  • 오태윤
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.41-48
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    • 1990
  • Thirteen patients underwent repair of atrioventricular septal defect [AVSD] from January 1980 to July 1989 at Kyungpook National University Hospital. Two patients had complete AVSD [Rastelli type A] and eleven patients had partial AVSD [ostium primum atrial septal defect and cleft of anterior mitral leaflet]. In all the patients of partial AVSD, atrial septal defect was closed with Dacron patch and the mitral cleft was approximated with interrupted simple sutures. In one patient of complete AVSD, one patch technique was used to close the atrial and ventricular septal defect, and in the other patient of complete AVSD, two patch technique was used. In six patients, there were associated anomalies; four had isolated ostium secundum ASD, two had patent foramen ovale. Postoperative complete A-V block was noted in a patient of partial AVSD, but it was returned to 1st degree A-V block 30 months later and in another case of partial AVSD, severe congestive heart failure [NYHA functional class IV] due to residual mitral insufficiency was developed postoperatively, but this patient was recovered to the state of functional class I after receiving mitral valve replacement. There was one hospital death [8 %] resulting from low cardiac output.

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Blood Blister-Like Aneurysm with Rupture Point Close to Origin of Anterior Choroidal Artery

  • Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.500-503
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    • 2014
  • If a ruptured blood blister-like aneurysm (BBA) arises from the lateral or superolateral wall of the internal carotid artery (ICA) at the level of the anterior choroidal artery (AChA), its proximity to the origin of the AChA presents a serious surgical challenge to preserve the patency of the AChA. Two such rare cases are presented, along with successful surgical techniques, including the application of a C-shaped aneurysm clip parallel to the ICA and a microsuture technique to repair the arterial defect. The patency of the AChA and ICA was successfully preserved without recurrence or rebleeding of the BBA during a 1-year follow-up after the operation.

Repair of Inferior Sternal Cleft Using Bilateral Sternal Bar Turnover Flaps in a Patient with Pentalogy of Cantrell

  • Chia, Hui-Ling;Yeow, Vincent Kok-Leng
    • Archives of Plastic Surgery
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    • v.41 no.1
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    • pp.77-80
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    • 2014
  • We report a case of sternal reconstruction using bilateral sternal bar turnover flaps in a 4-year-old boy with an inferior sternal cleft, as part of Cantrell's pentad. When the patient was 10 months old, he underwent sternal reconstruction using a resorbable poly-L-lactic-polyglycolic acid plate in the first stage when there was insufficient autogenous tissue to provide a reliable reconstruction. Bilateral sternal bar turnover was performed in the second stage at 4 years of age. This operative technique is described in this report. This novel technique provides a robust, dynamic, and reliable reconstruction for inferior sternal defects.

A Structural Planning Technique to Improve Structural Efficiency of Deteriorated Apartment Houses (노후 공동주택의 구조성능 개선을 위한 구조계획기법 제안)

  • 박경현;문선미;이성복;윤영호;양지수
    • Proceedings of the Korea Concrete Institute Conference
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    • 2000.10b
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    • pp.1079-1084
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    • 2000
  • The apartment houses which were constructed in a large quantity are currently being deteriorated and the reuse of them is directly related to the economic and environmental problem of the nation. Therefore, this research approaches to structural planning other than to the materials and/or the repair for the reuse of these deteriorated buildings. The research suggests the structural planning technique which includes the idea for the reinforcement of the structure in a part to improve the structural efficiency by investigating the current condition which includes the structural type of the buildings, examining the plan for the improvement of the structural efficiency, establishing the model of the space reorganization associated to the capability changes for the scale, the use, and the facilities, and checking of the structural efficiency through the structural analysis for the building structure suggested to be replaced.

Effect of Indentation Residual Stresses on the Fatigue Crack Initiation Life (피로균열 발생수명에 대한 압입 잔류응력의 영향)

  • 이환우;강태일
    • Journal of the Korean Society for Precision Engineering
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    • v.21 no.5
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    • pp.158-165
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    • 2004
  • Up to now, many crack repair techniques have been developed for inhibiting crack growth in structural components. However, the simplest way for inhibiting crack growth is to apply a indentation at the crack tip or at some distance ahead of the expected crack growth path so as to produce residual compressive stresses that can reduce the effective stresses around the crack tip. In spite of its importance to the aerospace industry, little attention has been devoted to evaluation of the indentation residual stress effect on the fatigue crack initiation life quantitatively. Therefore, in the present work, the magnitude and distribution of the indentation residual stresses were investigated in order to estimate the beneficial effect on fatigue crack initiation by using finite element method. Furthermore, to examine the validity of finite element analysis results, residual stress distribution in the indented specimen was measured by using X-ray diffraction technique, and fatigue crack behavior at fastener hole in aluminum alloy 7075-T6 before and after indentation processes was investigated.

Arthroscopic Procedure in the Treatment of Chronic Lateral Ankle Instability (만성 발목 불안정증의 치료에서 관절경 수술)

  • Lee, Ho Jin;Jeong, Bi O
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.25-31
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    • 2021
  • The open Broström procedure is considered the surgery of choice for treating chronic lateral ankle instability. The role of arthroscopy has gained popularity in the surgical treatment of chronic lateral ankle instability, partly for the ability to manage the intra-articular pathology combined with ankle instability. Arthroscopic techniques can be divided broadly into the arthroscopic-assisted Broström technique and arthroscopic all-inside ligament repair. The clinical results of these arthroscopic techniques are similar to open procedures. The arthroscopic technique may be an excellent alternative to the open Broström procedure in treating chronic lateral ankle instability when applying the appropriate indications.

Spare parts neoumbilicoplasty

  • Tobler, William D. Jr;Nicholas, Kelly N.;Cruz, Carolyn De La
    • Archives of Plastic Surgery
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    • v.46 no.4
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    • pp.371-374
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    • 2019
  • Umbilical preservation can be challenging, particularly in complex cases involving simultaneous ventral hernia repair and abdominoplasty. Although the umbilicus serves no functional purpose, removal of the umbilicus can draw unwanted attention to the abdominal area and can cause emotional distress to patients. There are several well documented options for umbilical reconstruction. We present a new umbilical reconstruction technique relevant for such cases. This neoumbilicoplasty allows for preservation of the original umbilicus with relocation and reconstruction using local flaps. The technique is relatively simple and the time needed is minimal. The result is a natural, well positioned umbilicus using the principles of spare part surgery.