• 제목/요약/키워드: surgical incision

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Innovation in the planning of V-Y rotation advancement flaps: A template for flap design

  • Dolen, Utku Can;Kocer, Ugur
    • Archives of Plastic Surgery
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    • 제45권1호
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    • pp.85-88
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    • 2018
  • Local flaps exhibit excellent color matching that no other type of flap can compete with. Moreover, surgery using a local flap is easier and faster than surgery using a distant or free flap. However, local flaps can be much more difficult to design. We designed 2 templates to plan a V-Y rotation advancement flap. The template for a unilateral V-Y rotation advancement flap was used on the face (n=5), anterior tibia (n=1), posterior axilla (n=1), ischium (n=1), and trochanter (n=2). The template for a bilateral flap was used on the sacrum (n=8), arm (n=1), and anterior tibia (n=1). The causes of the defects were meningocele (n=3), a decubitus ulcer (n=5), pilonidal sinus (n=3), and skin tumor excision (n=10). The meningocele patients were younger than 8 days. The mean age of the adult patients was 50.4 years (range, 19-80 years). All the donor areas of the flaps were closed primarily. None of the patients experienced wound dehiscence or partial/total flap necrosis. The templates guided surgeons regarding the length and the placement of the incision for a V-Y rotation advancement flap according to the size of the wound. In addition, they could be used for the training of residents.

Delaire 방법을 이용한 구순열의 교정 (Primary Cleft Lip Repair Using the "Delaire" Technique)

  • 김용하;이현태
    • 대한두개안면성형외과학회지
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    • 제12권2호
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    • pp.75-80
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    • 2011
  • Deformities related with cleft lip are not only limited to the cleft site but also extended to all around the nasolabial region. Facial development is composed of several complex processes as the formation, migration, coalescence and interaction of separate fields. When there is a cleft event, it means there are general problems of those processes. As a result facial elements should have displacement, deformation and functional hypotrophy. These also affect the mucocutaneous structures, which result in the typical deformities of cleft lip. Traditional surgical methods are not sufficient of the correction of functional impairments in the cleft lip. Accordingly, there are relatively high possibilities of occurring secondary deformities. The Delaire's method focuses on repair of functional impairment of the cleft. Consequently, it can maintain the initial good surgical result and avoid the unnecessary incision scar. And this method can minimize secondary nasal deformities which can reduce the risk of additional nasal correction. Therefore authors introduce this advantageous the Delaire technique cheliolplasty which it can be widely used for the cleft lip correction in Korea.

Robotic harvest of a latissimus dorsi flap using a single-port surgical robotic system in breast reconstruction

  • Joo, Oh Young;Song, Seung Yong;Lew, Dae Hyun;Park, Hyung Seok;Lee, Dong Won
    • Archives of Plastic Surgery
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    • 제48권6호
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    • pp.577-582
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    • 2021
  • Robot-assisted surgery is evolving to incorporate a higher number of minimally invasive techniques. There is a growing interest in robotic breast reconstruction that uses autologous tissue. Since a traditional latissimus dorsi (LD) flap leads to a long donor scar, which can be an unpleasant burden to patients, there have been many attempts to decrease the scar length using minimally invasive approaches. This study presents the case of a patient who underwent a robot-assisted nipple-sparing mastectomy followed by immediate breast reconstruction with an LD flap using a single-port robotic surgery system. With the assistance of a single-port robot, a simple docking process using a short and less visible incision is possible. Compared to multiport surgery systems, single-port robots can reduce the possibility of collision between robotic arms and provide a clear view of the medial border of the LD where the curvature of the back restricts the visual field. We recommend the use of single-port robots as a minimally invasive approach for harvesting LD flaps.

수면무호흡 환자에서의 외측 인두성형술 후 발생한 피하기종 (A Rare Case of Subcutaneous Emphysema following Lateral Pharyngoplasty for Obstructive Sleep Apnea)

  • 차동철;이영우;조형주
    • Journal of Rhinology
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    • 제25권2호
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    • pp.99-102
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    • 2018
  • Lateral pharyngoplasty is a surgical option for treatment of obstructive sleep apnea (OSA). Here, we present a case involving a 40-year-old healthy man who underwent surgery, including lateral pharyngoplasty and robotic tongue base resection, for OSA. There were no intraoperative or immediate postoperative complications. However, on postoperative day 3, the patient presented with swelling in the temporal and buccal areas and was diagnosed with subcutaneous emphysema, later confirmed by computed tomography. The patient was carefully monitored under conservative care and discharged without complications. Although subcutaneous emphysema following tonsillectomy is a rare complication and usually resolves with conservative management, in certain cases, it might require surgical intervention. Lateral pharyngoplasty involves tonsillectomy and additional incision along the tonsillar fossa, which makes it susceptible to pharyngeal wall defects and, consequently, subcutaneous emphysema. Additionally, lateral pharyngoplasty and robotic tongue base resection cause pain and might thus contribute to the increase in intrapharyngeal pressure, which might aggravate subcutaneous emphysema. Lateral pharyngoplasty should be performed with meticulous dissection of the superior pharyngeal constrictor muscle. Healthcare providers should be aware of these complications and, upon suspicion of the same, place the patient under close observation to prevent life-threatening situations.

전두-안와 구역에 발생한 섬유성 이형성증의 근치적 절제술 및 자가두개골 이식을 이용한 재건을 통한 치료: 증례보고 (Treatment of Fibrous Dysplasia of the Fronto-Orbital Area with Radical Resection and Autogenous Reconstruction Using Split Calvarial Bone Graft: A Case Report)

  • 최지안;곽정하;윤청민
    • 대한두경부종양학회지
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    • 제37권1호
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    • pp.57-61
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    • 2021
  • Fibrous dysplasia is a bone condition characterized by the replacement of normal bone tissue and the medullary cavity by abnormal fibrous tissues. Craniofacial fibrous dysplasia causes facial asymmetry compromising the aesthetics as well as vision and hearing. A 21-year-old male visited the clinic due to vertical orbital dystopia and exophthalmos that had developed over the previous 2 months. The patient was diagnosed with a fibrous dysplasia of the frontal, ethmoid bones and superior orbital wall. By a bicoronal incision on the scalp, the radical resection of the lesions was done. After harvesting the remaining frontal bone, we did the autogenous reconstruction using split calvarial bone graft. Postoperatively, the vertical orbital dystopia and exophthalmos significantly improved. The patient is satisfied with the surgical outcomes and has not reported any recurrence.

Current Diagnostic Methods for Periprosthetic Joint Infection

  • Lee, Jiyoung;Park, Heechul;Bae, Jinyoung;Hyun, Hyanglan;Kim, Sunghyun
    • 대한의생명과학회지
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    • 제28권1호
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    • pp.1-8
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    • 2022
  • Total joint arthroplasty is a successful joint replacement treatment that improves joint function and overall quality of life and provides pain relief. However, the prevalence of periprosthetic joint infection (PJI) has become prevalent with the rise in the incidence of arthroplasty surgery. PJI occurs rarely following arthroplasty however presents with serious complications, including high morbidity. The identification of causative microorganisms is essential for the treatment of PJI. Managing PJI requires complex treatment strategies, including long-term antibacterial treatment, and significant medical costs can be incurred. The American Academy of Orthopedic Surgeons, the Centers for Disease Control and Prevention, and Surgical Care Improvement Project guidelines recommend that prophylactic antibiotics such as first-generation cephalosporins be infused completely 1 hour before surgical incision. However, these preventative antibiotics are very limited, therefore risk factors must be identified to diagnosis and treat patients effectively. Moreover, determining antimicrobial susceptibility during artificial joint surgery and choosing the most appropriate treatment strategy following an accurate diagnosis of microbial infections are essential. In the present review, we describe the management, including the etiology, diagnosis, and classification of PJI, and approaches to its diagnosis using the available novel molecular diagnostic methods.

Current Issues in Reduced-Port Gastrectomy: A Comprehensive Review

  • Jong Won Kim
    • Journal of Gastric Cancer
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    • 제24권1호
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    • pp.57-68
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    • 2024
  • Reduced-port gastrectomy (RPG) includes all procedures derived from various efforts to minimize surgical invasiveness, with single-incision laparoscopic gastrectomy (SILG) being the ultimate reduced-port technique. However, there are challenges related to its feasibility, oncological validity, training, and education. This review describes the current issues and challenges, as well as the future prospects of RPG for gastric cancer. Gastrectomy, which started as an open surgery, has evolved into a laparoscopic surgery. With the advancements in laparoscopic technology, SILG has been used to minimize surgical scarring. However, owing to the technical difficulties of SILG, cases involving the addition of 1 trocar or needle grasper alongside the multichannel port have also been reported. Additionally, 3-port laparoscopic gastrectomy (3PLG) using only 3 trocars is also being performed. RPG, as a concept, includes a range of approaches such as SILG, 2-port laparoscopic gastrectomy, and 3PLG. These techniques aimed to reduce the number of ports or incisions required for laparoscopic gastrectomy. Despite technical difficulties, RPGs offer numerous advantages, including minimal invasiveness, excellent cosmetic outcomes, and the potential for improved postoperative recovery, such as reduced length of hospital stay and post-operative pain. It could be considered similar to conventional laparoscopic gastrectomy, and may not be oncologically inferior. Ongoing studies, such as the KLASS 12, are required to gain further insights.

Achalasia 의 수술요법 -13례 보고- (Surgical Treatment of Achalasia : A report of 13 cases)

  • 조대윤;양기민;노준량
    • Journal of Chest Surgery
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    • 제13권4호
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    • pp.470-474
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    • 1980
  • Achalasia is a neurogenic esophageal disorder, characterized by incomplete relaxation of the gastroesophageal sphincter in response to deglutition and absence of peristalsis from the body of the esophaugs. Because there is no known method by which esophageal peristalsis can be restored, therapy is directed toward the relief of dital esophageal obstruction. During the period of June 1965 to September 1980, 13 cases of achalasia were operated at the Department of Thoracic SUrgery, Seoul Natonal University Hospital. 1. Among 13 cases, 5 were male and 8 were female. 2. Esophagomyotomy was performed in 12 cases, and 1 case was treated with transverse suture of lower esophagus after longitudinal incision. 3. There was no operative mortality, but 2 cases subsequently underwent esophagogastrostomy after esophagomyotomy. 4. One of 13 cases was combined with mongolism.

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협골복합골절 환자에서 신경감압술에 의한 하안와 신경 착감각증의 치험예 (Treatment of infraorbital paresthesia by external decompression in zygomatic complex fractures;Report of 4 cases)

  • 김일규;이성준
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제11권1호
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    • pp.276-282
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    • 1989
  • This is a report of 4 case of external decompression about infraorbital paresthesia with transconjuctival incision in zygomatic complex fratures. The results are as follows. 1. Decompression for infraorbital nerve injury is indicated if paresthesia exists 5-7 days, although the patients have nondisplaced fractures of zygomatic complex. 2. Satisfactory results are expected within 1-2 weeks after surgical operation in early decompression of infraorbital nerve. 3. Paresthesia of the infraorbital nerve following fracture of the zygomatic complex may be persistent complication. 4. Scar tissues on the face are avoided with transconjuctival approach.

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안와하 골절부의 외과적 접근 방법에 관한 임상적 비교연구 (Clinical comparison of surgical approach for orbital fracture.)

  • 이상철;김현철
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제11권1호
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    • pp.261-266
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    • 1989
  • This study was undertaken to compare those 4 most commonly used incisions for exposure of fractures of the infraorbital rim and the orbital floor. The patient's age ranged from 19 to 67 years, the majority being in the 2nd decade. There were 17males and 1 female. Three orbital rim, 5 lower eyelid, 7 subciliary and 3 combined conjunctival-lateral canthotomy incisions were reviewed. Following points were the summury of author's experience. 1. The average scar following any of four incisions is barely noticeable. 2. Adequate fracture exposure was achieved with lower eyelid, orbital rim, subciliary and combined conjunctival-lateral canthotomy incisions. 3. One transient ectropion following subciliary incision occurred in 29-years old man with prolonged postoperative eyelid edema.

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