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RISS 인기검색어
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- 저자 : 박치우(Chi-Woo Park) (검색결과 3 건)
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개 모델에서 시행한 복강경보조 자연개구부 내시경 맹장절제술
김영일(Young-Ill Kim),박치우(Chi-Woo Park),정성목(Seong-Mok Jeong),이상일(Sang-Il Lee),김진수(Jin-Soo Kim),김지연(Ji-Yeon Kim) 대한외과학회 2010 Annals of Surgical Treatment and Research(ASRT) Vol.79 No.5
Purpose: Natural orifice transluminal endoscopic surgery (NOTES) is a new operation technique that utilizes natural orifices of the patient’s body with the intention to puncture hollow viscera in order to insert an endoscope into a peritoneal cavity for incisionless surgery. The aim of this study was to evaluate the safety and feasibility of endoscopic cecectomy through the rectum in one dog and the vagina in another dog. Methods: This study was performed in two beagle dogs for rectal and vaginal approaches. A five-milimeter trocar was inserted into the abdominal cavity by the Hasson method and intra-abdominal pressure was maintained at 5 ㎜Hg with CO₂. After pneumoperitoneum was accomplished, the rectum or vagina was incised with a needle knife and a one-channel gastric endoscope was inserted into the abdominal cavity. Counter-traction was performed using a laparoscopic grasper introduced via the 5 ㎜ trocar in the umbilicus. The cecum was dissected from the base by using a needle knife with the aid of laparoscopic counter-traction. The resected cecum was retrieved through the anus or vagina without pouch bag. The incised rectum was closed by using 90-degree endoclips whereas the incised vagina was not repaired. Results: Cecectomies were successfully performed with both transrectal and transvaginal routes. Both cases had no complication and recovered from surgery uneventfully. Conclusion: Endoscopic cecectomy with hybrid NOTES are feasible and safe. With the improvement of surgical experiences and further instrumental development, NOTES can be one option for human intestinal surgery.
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이한준 ( Han Jun Lee ),박치우 ( Chi Woo Park ) 대한슬관절학회 2011 대한슬관절학회지 Vol.23 No.2
The purpose of postoperative rehabilitation after anterior cruciate ligament (ACL) reconstruction is to restore the knee joint function by recovering the joint stability and preventing postoperative complications, such as stiffness and patello-femoral problem. Many accelerated rehabilitation programs have been introduced in order to restore the knee joint function, and performed pre-and post-operatively. Pre-operative rehabilitation programs consistof preparing the operation mentally and physically, especially the patient education is the most important point of this step. Post-operative rehabilitations and methods of the ligament reconstruction should be explained and expectation of the patients also should be fully understood by the surgeon. The main purpose of rehabilitation is to acquire contentable range of motion by regulating painand swelling of the knee joint, and to prevent atrophy of quadriceps muscles. The fundamental concepts of the post-operative rehabilitation are early knee joint extension, early weight bearing and early recover of quadriceps muscle power of the knee joint. Passive knee extension should be achieved completely within 1 week post-operatively to prevent contracture of the posterior capsule and scaring of the femoral condylar notch, but if not attained at least 2 weeks, that could bring a poor outcomes. Partial weight bearing should be started immediately if not painful, and full weight bearing could be allowed after 4 weeks. Quadriceps muscle exercise including isometric contracture should begin to start at the first day after surgery because restoration of quadriceps muscle power is important for return to activity of daily living. Electrical muscle stimulation and biofeedback would be helpful to recover quadriceps muscle power by decreasing pain and swelling of the joint effectively. Two weeks after surgery, patients could begin closed kinetic chain exercise, after that, patients could exercise the quadriceps muscle more effectively adding open kinetic chain exercise. Recently, trainings for proprioception and neuromuscular control have been emphasized in orderto improve dynamic stability of the knee joint. Nowadays, variable post-operative rehabilitation programs are introduced for regain the knee joint function, and can be differed by types of graft, concomitant injuries, and especially methods of surgery, so should be performed individually, not by standardized program.
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