• Title/Summary/Keyword: surgical

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위 수술 전후의 내시경 시술: 재건법에 따른 접근, 수술의 관점 (Endoscopy after Gastric Surgery: For Each Reconstruction Method, Operator's Point of View)

  • 주일석;조현진;최수인
    • Journal of Digestive Cancer Research
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    • 제11권2호
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    • pp.66-76
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    • 2023
  • Endoscopy is an important noninvasive procedure for patients with gastrointestinal problems. However, surgical techniques are shifting to laparoscopic surgery, and changes in endoscopic findings after laparoscopic surgery differ from those after previous surgical methods. Postoperative endoscopic findings differ from normal anatomical structures, and findings reportedly vary depending on the type of surgical technique. Therefore, we aimed to summarize the surgical and endoscopic findings for each surgical method from the surgeon's point of view. The causes of gastric emptying delay, bleeding, afferent loop syndrome, or anastomosis leakage occurring after gastric cancer surgery can be identified via upper gastrointestinal endoscopy that is relatively less invasive than the surgical method. Regarding postoperative anastomosis leakage, endoscopy can directly evaluate the degree of leakage at the anastomosis site more accurately than computed tomography and enable immediate intervention. As endoscopy is less invasive than the surgical method, patients can be evaluated and treated more safely. However, coordination between the surgeon and the endoscopist is necessary to perform the procedures effectively. Therefore, reviewing the changes in surgical and endoscopic findings is important.

The Impact of Educational Status on the Postoperative Perception of Pain

  • Lanitis, Sophocles;Mimigianni, Christina;Raptis, Demetris;Sourtse, Gionous;Sgourakis, George;Karaliotas, Constantine
    • The Korean Journal of Pain
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    • 제28권4호
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    • pp.265-274
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    • 2015
  • Background: Postoperative (PO) pain interferes with the recovery and mobilization of the surgical patients. The impact of the educational status has not been studied adequately up to now. Methods: This prospective study involved 400 consecutive general surgery patients. Various factors known to be associated with the perception of pain including the educational status were recorded as was the preoperative and postoperative pain and the analgesia requirements for the $1^{st}$ PO week. Based on the educational status, we classified the patients in 3 groups and we compared these groups for the main outcomes: i.e. PO pain and PO analgesia. Results: There were 145 patients of lower education (junior school), 150 patients of high education (high school) and 101 of higher education (university). Patients of lower education were found to experience more pain than patients of higher education in all postoperative days (from the $2^{nd}$ to the $6^{th}$). No difference was identified in the type and quantity of the analgesia used. The subgroup analysis showed that patients with depression and young patients (< 40 years) had the maximum effect. Conclusions: The educational status may be a significant predictor of postoperative pain due to various reasons, including the poor understanding of the preoperative information, the level of anxiety and depression caused by that and the suboptimal request and use of analgesia. Younger patients (< 40), and patients with subclinical depression are mostly affected while there is no impact on patients over 60 years old.

하악골 재건을 위한 가상수술계획 시스템 (Virtual Surgical Planning System for Mandible Reconstruction)

  • 김한나;김영준;조현철;심응준;이득희;김래현;박세형;이정우
    • 한국CDE학회논문집
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    • 제21권2호
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    • pp.196-203
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    • 2016
  • In this paper, we propose a virtual surgical planning system specialized to mandible reconstruction surgery. Mandible reconstruction surgery is one of the most difficult surgeries, even for experienced surgeons. Compared to the traditional surgical procedures, virtual surgical planning can reduce the operation time in operating room while expecting better surgical outcome with optimized planning. However, with existing software systems, it requires much time and manual operations in virtual surgical planning. To reduce preparation time and improve accuracy of virtual surgical planning, we have developed optimized functions for virtual surgical simulation of mandible reconstruction with user-friendly interface. We found that the proposed system shortened the preparation time by half compared to the existing system from the experiments. The proposed system supports surgeons to make accurate plan faster and easier. The virtually planned results are used to make surgical cutting guide by 3D printing, and this will enhance surgical performance in operating room.

임상가를 위한 특집 2 - 폐쇄성 수면 무호흡증의 외과적 치료: 최신 경향 (Surgical Management of Obsructive Slepp Apnea Syndrom: latest tendency)

  • 송승일;이호경
    • 대한치과의사협회지
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    • 제52권10호
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    • pp.602-614
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    • 2014
  • 폐쇄성 수면 무호흡증(OSAS)환자의 외과적 치료(surgical treatment)로는 다양한 방법들이 있고 수술 방법의 선택시 여러 인자들을 고려해서 선택해야 한다. 즉, 수술은 폐쇄성 수면 무호흡증(OSAS)을 조절하는데 있어 보존적 치료 (non-surgical treatment)의 좋은 대체 방안(alternative chance)이 될 수 있기에, 증상(OSAS)의 주관적(subjective), 객관적(objective), 심각성(severity)을 해부학적 이상(anatomic abnormality) 정도와 연관시켜 적절한 수술법(surgical procedure)을 선택해야 한다. 수술 방법은 한가지 방법을 사용(single-level)하는지, 여러 수술 방법을 통합하여 사용(multi-level)하는지에 따라 다양하며, 그 예후도 각각 다르다. 중요한 점은 다단계 폐색(multilevel obstruction)이 있는 경우에는 다단계 치료(multilevel treatment) 방법이 가장 추천된다는 것이며, 이는 단지 증상(OSAS)의 심각성(severity)을 기준으로만 평가해서는 안되며 경도나 중등도(mild to moderate)의 환자에서도 필요시 보존적 치료(non-surgical treatment)를 시행하기 전에 다단계 외과적 치료(multilevel surgical treatment) 방법을 적극적으로 고려해야 한다. 비록 다단계 치료(multilevel treatment)방법은 상대적으로 짧은 임상 기간을 거쳤지만, 앞으로 지속적인 연구 결과(evidence-based data)를 이어간다면, 개개 환자에 맞는 최적의 치료 방법(optimal surgical intervention)을 제시할 수 있을 것이다.

Development of the implant surgical technique and assessment rating system

  • Park, Jung-Chul;Hwang, Ji-Wan;Lee, Jung-Seok;Jung, Ui-Won;Choi, Seong-Ho;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chang-Sung
    • Journal of Periodontal and Implant Science
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    • 제42권1호
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    • pp.25-29
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    • 2012
  • Purpose: There has been no attempt to establish an objective implant surgical evaluation protocol to assess residents' surgical competence and improve their surgical outcomes. The present study presents a newly developed assessment and rating system and simulation model that can assist the teaching staffs to evaluate the surgical events and surgical skills of residents objectively. Methods: Articles published in peer-reviewed English journals were selected using several scientific databases and subsequently reviewed regarding surgical competence and assessment tools. Particularly, medical journals reporting rating and evaluation protocols for various types of medical surgeries were thoroughly analyzed. Based on these studies, an implant surgical technique assessment and rating system (iSTAR) has been developed. Also, a specialized dental typodont was developed for the valid and reliable assessment of surgery. Results: The iSTAR consists of two parts including surgical information and task-specific checklists. Specialized simulation model was subsequently produced and can be used in combination with iSTAR. Conclusions: The assessment and rating system provided may serve as a reference guide for teaching staffs to evaluate the residents' implant surgical techniques.

Reliability of a chairside CAD-CAM surgical guide for dental implant surgery on the anterior maxilla: An in vitro study

  • Phyo Ei Ei Htay;Richard Leesungbok;Suk Won Lee;Yu-Jin Jee;Kyung Lhi Kang;Sung Ok Hong
    • The Journal of Advanced Prosthodontics
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    • 제15권5호
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    • pp.259-270
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    • 2023
  • PURPOSE. This study evaluated the reliability of the chair-side CAD-CAM surgical guide (CSG) in the anterior maxilla by comparing its accuracy with the laboratory 3D-printed surgical guide (3DSG) and manual surgical guide (MSG) concerning different levels of dentists' surgical experience. MATERIALS AND METHODS. Ten surgical guides of each type (MSG, 3DSG, and CSG) were fabricated on a control study model with missing right and left central incisors. Sixty implants were placed in 30 study models by two dentists (one inexperienced and one experienced) using three different types of surgical guides. Horizontal deviations at shoulder and at apex, vertical, and angular deviations were measured after superimposing the planned and placed implant positions in the software. Kruskal-Wallis and Mann-Whitney U tests were used to compare the accuracy of three types of surgical guides in each dentist group and the accuracy of each surgical guide between two dentists (α = .05). RESULTS. There were no significant differences in any deviations between CSG and 3DSG, apart from angular deviation, for both dentists' groups. Moreover, both CSG and 3DSG showed no significant differences in accuracy between the two dentists (P > .05). In contrast, MSG demonstrated significant differences from CSG and 3DSG and a significant difference in accuracy between the two dentists (P < .05). CONCLUSION. CSG provides superior accuracy to MSG in implant placement in the maxillary anterior region and is comparable to 3DSG at different levels of surgical experience, while offering the benefits of shorter manufacturing time and reduced patient visits.

시행기준 원가계산을 적용한 간호단위 원가 및 수익 인식에 관한 연구: 1개 종합병원 일반외과병동 사례를 중심으로 (An Analysis of Cost and Profit of a Nursing Unit using Performance-Based Costing: Case of a General Surgical Ward in a General Hospital)

  • 임지영
    • 대한간호학회지
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    • 제38권1호
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    • pp.161-171
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    • 2008
  • Purpose: The aim of this study was to analysize net income of a surgical nursing ward in a general hospital. Method: Data collection and analysis was conducted using a performance-based costing and activity-based costing method. Result: Direct nursing activities in the surgical ward were 68, indirect nursing activities were 10. The total cost volume of the surgical ward was calculated at \119,913,334.5. The cost volume of the allocated medical department was \91,588,200.3, and the ward consumed cost was \28,325,134.2. The revenue of the surgical nursing ward was \33,269,925.0. The expense of a surgical nursing ward was \28,325,134.2. Therefore, the net income of a surgical nursing ward was \4,944,790.8. Conclusion: We suggest that to develop a more refined nursing cost calculation model, a standard nursing cost calculation system needs to be developed.

Which factors are associated with difficult surgical extraction of impacted lower third molars?

  • Park, Kyeong-Lok
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제42권5호
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    • pp.251-258
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    • 2016
  • Objectives: The aim of this retrospective study was to investigate factors associated with increased difficulty in the surgical extraction of impacted lower third molars and to improve identification of difficult cases. Materials and Methods: A total of 680 patients who required 762 surgical extractions of impacted lower third molars from 2009 to 2014 were enrolled in the study. Demographic factors, clinical factors, radiographic factors, surgical extraction difficulty, and presumed causes of difficulty were collected. Data were statistically analyzed using IBM SPSS Statistics version 23. Results: Age, sex, depth of impaction, and blurred radiographic image influenced difficulty in surgical extraction. The position of the impacted tooth influenced surgical difficulty, especially when it was accompanied by other factors. Conclusion: It is challenging to design a reliable and practical instrument to predict difficulty in surgical extraction of impacted lower third molars. To identify very difficult cases, root investigation using computed tomography is advised when impacted tooth position suggests difficult extraction.

Master/Slave 복합형 고관절 전치환 수술 로봇의 설계와 제어 (Design and Control of a Master/Slave Combined Surgical Robot for Total Hip Replacement Surgery)

  • 권동수;허관희;정종하;박영배;이정주;원중희;윤용산
    • 제어로봇시스템학회:학술대회논문집
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    • 제어로봇시스템학회 2000년도 제15차 학술회의논문집
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    • pp.540-540
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    • 2000
  • This paper explores design and control methods of a surgical robot for total hip replacement surgery which can be easily maneuvered by a surgeon Like an advanced surgical tool. The 3-DOF in-parallel surgical robot is fixed directly onto patient's femur by the bone clamp during surgery. With the master/slave combined surgical robot, the surgeon can directly control the motion of the surgical robot with surgeon's experience and judgment during operation. For the easiness of operation, the master/slave combined robot is controlled using admittance control paradigm. And for the precise operation, the robot motion is restricted at the surgical boundary using virtual hard wall display.

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Battery type 외과수술용 핸드피스 구동 드라이브 시스템 (Development of Battery Type Powered Handpiece Drive System for Surgical Operation)

  • 하정준;윤용호
    • 전기학회논문지P
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    • 제57권4호
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    • pp.388-394
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    • 2008
  • The purpose of this paper is concerned with a battery type powered handpiece drive system for surgical operation. Battery type powered surgical handpiece is suitable for delicate surgical operating. The conventional air-type handpiece has a mechanical noise, a strong oscillation and a danger of infection. And the conventional contact switching type handpiece has problems that is restricted by surroundings. By reason of this kind, we studied noncontact switching type surgical handpiece to change conventional air type surgical handpiece and contact switching type. Also in this paper we develop the battery type power handpiece drive system for surgical operation using controller IC UC3625 of UNITRODE CO. Finally some experimental and simulation results are provided to demonstrate the validity of the proposed battery type power handpiece drive system.