• Title/Summary/Keyword: surgical

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Surgical Experience of Double Outlet Right Ventricle with Right Ventricular Outflow Obstruction (폐혈류유출로협착을 동반한 양대혈관 우심기시증의 수술치험)

  • 김삼현
    • Journal of Chest Surgery
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    • v.21 no.2
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    • pp.326-333
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    • 1988
  • The results of surgical experience of double outlet right ventricle with pulmonic stenosis in 14 patients are reported. Among the 14 patients, 8 underwent the intraventricular tunnel repair with the result of 3 hospital deaths, 5 had Fontan type operations due to the various anatomic reasons and resulted in one hospital death, and the remaining one patient had palliative pulmonary valvotomy. Besides the problems related to the effective relief of the pulmonic stenosis, double outlet right ventricle with pulmonic stenosis may present a surgical challenge because severe associated anomalies which definitely complicate their repair are not uncommon. We describe the anatomic details of our 14 cases of DORV with PS and the surgical results. The results having been unsatisfactory, more meticulous diagnostic studies for the detailed intracardiac morphologies and the strict indication for their repair with the refinement of surgical technique seem necessary for the better surgical results.

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Development of Air-powered Handpiece for Surgical Operation (외과 수술용 Air-Powered Handpiece 개발)

  • 윤길상;이영훈;허영무;서태일;최길운
    • Journal of the Korean Society for Precision Engineering
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    • v.21 no.3
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    • pp.188-193
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    • 2004
  • The purpose of this paper is concerned with a development of an air-powered handpiece for surgical operation. The handpiece is the tool of surgical instruments and it can be used to interchange multiple attachments for drilling, pinning, sawing, driving screws and reaming. Most of domestic medical instruments bring in overseas and the air-powered handpiece imported from foreign countries at 100% too. Therefore we develop new air powered handpiece. we research in 2D and 3D modeling, design of air line, analyze structure. The air-powered handpiece composes of body, power supply air-line, elements for mechanical power transmission, attachment, and surgical tools. The handpiece is developed by several processes that 3D design, machining, heat treatment and coating. The developed handpiece is experimented to confirm check the efficiency.

History of Esophagogastric Junction Cancer Treatment and Current Surgical Management in Western Countries

  • Berlth, Felix;Hoelscher, Arnulf Heinrich
    • Journal of Gastric Cancer
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    • v.19 no.2
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    • pp.139-147
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    • 2019
  • The incidence of esophagogastric junction (EGJ) cancer has been significantly increasing in Western countries. Appropriate planning for surgical therapy requires a reliable classification of EGJ cancers with respect to their exact location. Clinically, the most accepted classification of EGJ cancers is "adenocarcinoma of the EGJ" (AEG or "Siewert"), which divides tumor center localization into AEG type I (distal esophagus), AEG type II ("true junction"), and AEG type III (subcardial stomach). Treatment strategies in western countries routinely employ perioperative chemotherapy or neoadjuvant chemoradiation for cases of locally advanced cancers. The standard surgical treatment strategies are esophagectomy for AEG type I and gastrectomy for AEG type III cancers. For "true junctional cancers," i.e., AEG type II, whether the extension of resection in the oral or aboral direction represents the most effective surgical therapy remains debatable. This article reviews the history of surgical EGJ cancer treatment and current surgical strategies from a Western perspective.

Two-jaw surgery by use of Surgical Jaw Relator (Surgical Jaw Relator를 이용한 양악 수술 치험례)

  • Yang, Sang-Duck
    • The korean journal of orthodontics
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    • v.35 no.3 s.110
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    • pp.238-249
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    • 2005
  • The contemporary two-jaw surgical approach usually involves a Le Fort osteotomy of the maxilla and a ramal osteotomy of the mandible with 3-dimensional repositioning of the jaws as well as the occlusal planes. After making the surgical treatment plan. the surgical movements are duplicated in the model surgery. During this procedure, reference poings and lines are drawn on the base of the models over the dental arch and sawcuts are mads according to these marked osteotomy lines. This technique, however, has been found to be inexact. especially when the laws are moved in several dimensions simultaneously. To overcome this. different methods have been developed for an accurate repositioning of the jaws as planned. A new appliance. Surgical Jaw Relater, has been devised by th8 author for the simple 3-dimensional relocation of the upper and lower models, resulting in the easy construction of the splints such as centric relation splint, intermediate and final splint. This article describes an introduction and a clinical application of this appliance. Through the application of this system to the orthognathic cases including two-law surgery. it is proved that the row device is very clinically useful.

Analysis According to Characteristics of 18 Cases of Brachial Plexus Tumors : A Review of Surgical Treatment Experience

  • Jung, In-Ho;Yoon, Kyeong-Wook;Kim, Young-Jin;Lee, Sang Koo
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.625-632
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    • 2018
  • Objective : Because the anatomical structure of the brachial plexus is very complex, surgical treatment of tumors in this region is challenging. Therefore, a lot of clinical and surgical experience is required for successful treatment; however, many neurosurgeons have difficulty accumulating this experience owing to the rarity of brachial plexus tumors. The purpose of this report is to share our surgical experience with brachial plexus tumor with other neurosurgeons. Methods : The records of 18 consecutive patients with brachial plexus tumors who underwent surgical treatment between January 2010 and December 2017 in a single institution were retrospectively reviewed. The surgical approach was determined according to the tumor location and size, and intraoperative neurophysiological monitoring (IONM) was used in most of cases to prevent iatrogenic nerve injury during surgery. In addition, to evaluate the differences in tumor characteristics according to pathologic diagnosis, the tumors were divided twice into two groups, based on two separate classifications, and statistical analysis was performed. Results : The 18 brachial plexus tumors comprised 15 (83.3%) benign peripheral nerve sheath tumors including schwannoma and neurofibroma, one (5.6%) malignant peripheral nerve sheath tumor, one (5.6%) benign tumor of non-neural sheath origin (neurogenic cyst), and one (5.6%) metastatic tumor (papillary carcinoma). The authors analyzed relationship between tumor size/location and tumor characteristic parameters such as age, size, right-left, and pathology. There were no statistically significant differences except a tendency of bigger tumor size in young age. Conclusion : For a successful surgical outcome, an appropriate surgical approach is essential, and the appropriate surgical approach is determined by the location and size of the tumor. Furthermore, applying IONM may prevent postoperative complications and it is favorable option for brachial plexus tumors surgery.

Total joint reconstruction using computer-assisted surgery with stock prostheses for a patient with bilateral TMJ ankylosis

  • Rhee, Seung-Hyun;Baek, Seung-Hak;Park, Sang-Hun;Kim, Jong-Cheol;Jeong, Chun-Gi;Choi, Jin-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.41.1-41.6
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    • 2019
  • Backgrounds: The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses. Case presentation: A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication. Conclusion: For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

Applicability of Radioguided Occult Lesion Localization for Non-Palpable Benign Breast Lesions, Comparison with Wire Localization, a Clinical Trial

  • Alikhassi, Afsaneh;Saeed, Farzanefar;Abbasi, Mehrshad;Omranipour, Ramesh;Mahmoodzadeh, Habibollah;Najafi, Massoome;Gity, Masoumeh;Kheradmand, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3185-3190
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    • 2016
  • Background: This study was designed to compare radioguided versus routine wire localization of nonpalpable non-malignant breast lesions in terms of efficacy for complete excision, ease of use, time saving, and cosmetic outcome. Materials and Methods: Patients with non-palpable breast masses and non-malignant core biopsy results who were candidates for complete surgical lumpectomy were enrolled and randomly assigned to radioguided or wire localization groups. Radiologic, surgical, and pathologic data were collected and analyzed to determine the difficulty and duration of each procedure, ease of use, accuracy, and cosmetic outcomes. Results: This prospective randomized study included 60 patients, randomly divided into wire guided localization (WGL) or radioguided occult lesion localization (ROLL) groups. The mean duration of localization under ultrasound guidance was shorter in the ROLL group (14.4 min) than in the WGL group (16.5 min) (p<0.001). The ROLL method was significantly easier for radiologists (p=0.0001). The mean duration of the surgical procedure was 22.6 min (${\pm}10.3min$) for ROLL and 23.6 min (${\pm}9.6min$) for WGL (p=0.6), a non-significant difference. Radiography of the surgical specimens showed 100% lesion excision with clear margins, as proved by pathologic examination, with both techniques. The surgical specimens were slightly heavier in the ROLL group, but the difference was not significant (p=0.06). Conclusions: The ROLL technique provides effective, fast, and simple localization and excision of non-palpable non-malignant breast lesions.

Anterior Choroidal Artery Aneurysm Surgery : Ischemic Complications and Clinical Outcomes Revisited

  • Lee, Young-Sup;Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.86-92
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    • 2013
  • Objective : Surgical results for anterior choroidal artery (AChA) aneurysms have previously been reported as unsatisfactory due to inadvertent occlusion of the AChA, while the low incidence of AChA aneurysms hampers the accumulation of surgical experience. The authors reviewed their related surgical experience to document the ischemic complications and surgical outcomes. Methods : Identification of the AChA at its origin by rigorous visual scrutiny, careful microdissection, and meticulous clip placement to avoid the AChA origin are all crucial surgical maneuvers. A retrospective review of a surgical series of 62 consecutive cases of an AChA aneurysm between 2004 and 2012 was performed. Results : All patients, except for five (8.1%) with a small residual neck, showed complete aneurysm obliteration in postoperative angiographic evaluations. There was no incidence of procedure-related permanent AChA syndrome or oculomotor nerve palsy, while three (4.8%) patients suffered from transient AChA syndrome. The clinical outcomes [the 3-month modified Rankin Scale (mRS)] of the patients were related to their preoperative World Federation of Neurologic Surgeons (WFNS) grade. As regards the 3-month mRS, significant differences were found between patients with an unruptured aneurysm (WFNS grade 0; n=20), good-grade subarachnoid hemorrhage (WFNS grade 1-3; n=30), and poor-grade subarachnoid hemorrhage (WFNS grade 4-5; n=4). Conclusion : In surgical treatment of AChA aneurysms, a risk of AChA insufficiency can be minimized by taking every precaution to preserve the AChA patency and intraoperative monitoring. In addition, the surgical outcome is primarily determined by the preoperative clinical state.

Comparison of Hospital Charges and Patient's Satisfaction between Ambulatory Surgical Procedures and Inpatient Surgery in Vitrectomy and Tonsillectomy Patients (수정체적출술과 편도절제술에 대한 통원수술과 입원수술의 진료비 및 만족도 비교)

  • Seo, Jae-Myung;Yu, Seung-Hum
    • Korea Journal of Hospital Management
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    • v.4 no.2
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    • pp.41-59
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    • 1999
  • Objectives: This study was done to compare patient satisfaction and hospital charges of surgery performed in an outpatient basis(ambulatory surgical procedures). Methods : This retrospective study was performed in 20(vitrectomy 11, tonsillectomy 9) randomly selected ambulatory surgical procedures patients and 50(vitrectomy 26, tonsillectomy 24) inpatients who. received the same procedure at a general hospital in Seoul since January 1, 1998 to October 31, 1998. The operative procedures were vitrectomy and tonsilletomy which could be performed on a ambulatory surgical procedures basis or on an inpatient basis. Results: The results of this study shows that the patients thought the expenses and the surgical operative time was an important factor in a ambulatory surgical procedures but there were no differences in the patient satisfaction by the method of surgery. The charges of vitrectomy and tonsilletomy were reduced up to 495,000 won and 380,000 won from l,589,000 won 842,000 won inpatient surgery respectively. Conclusions: This study focused only on the charges of the surgical procedures and did not include the cost of patient helper, the lost salary due to missing days of work to care for a member of the family, transportation costs, and other indirect costs. Therefore, if those fees were included, ambulatory surgical procedures would be more economical. Therefore, by giving incentives at the fee schedule, the government health policies it would reduce the total hospital charges.

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