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Current and Future of Spinal Robot Surgery
양문술,정진환,김재민,김충현,이성,하윤,김긍년,윤도흠 대한척추신경외과학회 2010 Neurospine Vol.7 No.2
Objective: To review the current applications of robotics in spinal surgery. Methods: We reviewed the literature on robotic surgery identified by searching Pubmed. Articles reporting clinical results of robotic surgeries using the da Vinci surgical system® were analyzed. Descriptions of our trials and comparisons with the conventional techniques were added to the review. Results: Several surgical robots have been developed however, most of the robots are currently unavailable for practical use. Most of publications regarding spinal surgical robots merely suggested its feasibility. The da vinci surgical system® is the popular robotic system designed for use in various surgical fields. However, clinical applications of this innovative instrument in spinal surgery seem to be in the experimental phase. According to our research, the advantages of robotic surgery using the da Vinci surgical system® were maximized in cases of paravertebral or presacral tumors however, its use in other types of spinal surgeries such as the transoral craniovertebral junction approach andanterior lumbar interbody fusion will be feasible in the near future despite the current limitations. Conclusions: Clinical application of robotic surgery in the spinal surgical field is currently confined to the treatment of some specific diseases or procedures however, robotic surgery is expected to play a practical future role as a minimally invasive surgical instrument in spinal surgery.
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침습성 프로락틴 분비 뇌하수체 선종에서 Bromocriptine의 치료효과
양문술,김선호,임승길,이승구,Yang, Moon-Sool,Kim, Sun-Ho,Lim, Seung-Gil,Lee, Seung-Koo 대한신경외과학회 2005 Journal of Korean neurosurgical society Vol.37 No.4
Objective: The prolactinoma is the most common pituitary tumor and sometimes shows severe invasiveness to the adjacent cavernous sinus, especially in the male patient. The dopamine agonist can be used as an alternative treatment modality to surgery. But, the transsphenoidal or transcranial approach for tumor removal has been more preferred treatment option of neurosurgeons in invasive prolactinoma. Especially rapid decompression of mass effect and resolution of the neurologic deficit is demanded. The prospective study is done in order to identify the therapeutic efficacy of bromocriptine as an initial treatment option for the invasive prolactionomas. Methods: Twenty patients with invasive prolactinoma were studied. Preoperative neurological and endocrinological evaluations were done, and size and invasiveness of the tumor was estimated on MRI. Bromocriptine was administrated by increasing dose planning reaching maximum dose at 1 month of treatment, with close neurological and endocrinological monitoring. At 3months after treatment, MRI was taken and decision was made whether to continue bromocriptine or to have surgical intervention. Results: Thirteen patients showed excellent result with only bromocriptine treatment. These patients showed not only marked reduction of tumor volume and prolactin level, but also, improving clinical symptoms and other hormonal deficits. 13patients who had visual field defect and decreased visual acuity had all improved visual symptoms. But, the remaining 4patients required surgical treatment due to insufficient reduction of tumor size inspite of normalized prolactin level within 3months. Remaining 2patients had $20{\sim}30%$ of tumor size reduction, but prolactin level was not normalized. One patient required radiation therapy. Conclusion: Bromociptine can be used as initial treatment for the invasive prolactinomas with careful monitoring of the neurological and endocrinological status. It should be carefully followed up for tumor size reduction within 3 months after initiation of treatment.
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Robot-assisted Resection of Paraspinal Schwannoma
양문술,김긍년,윤도흠,William Pennant,하윤 대한의학회 2011 Journal of Korean medical science Vol.26 No.1
Resection of retroperitoneal tumors is usually perfomed using the anterior retroperitoneal approach. Our report presents an innovative method utilizing a robotic surgical system. A 50-yr-old male patient visited our hospital due to a known paravertebral mass. Magnetic resonance imaging showed a well-encapsulated mass slightly abutting the abdominal aorta and left psoas muscle at the L4-L5 level. The tumor seemed to be originated from the prevertebral sympathetic plexus or lumbosacral trunk and contained traversing vessels around the tumor capsule. A full-time robotic transperitoneal tumor resection was performed. Three trocars were used for the robotic camera and working arms. The da Vinci Surgical System® provided delicate dissection in the small space and the tumor was completely removed without damage to the surrounding organs and great vessels. This case demonstrates the feasibility of robotic resection in retroperitoneal space. Robotic surgery offered less invasiveness in contrast to conventional open surgery.
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뇌전산화단층촬영에서 완전 석회화 종양으로 오인한 두개강내 사종성 수막종 -증례보고-
김현우 ( Hyun Woo Kim ),김충현 ( Choong Hyun Kim ),양문술 ( Mun Sul Yang ),정진환 ( Jin Hwan Cheong ),김재민 ( Jae Min Kim ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2011 대한뇌종양학회지 Vol.10 No.1
Meningioma is one of the most frequently encountered brain tumors and it constitutes 10 to 20% of intracranial tumors of adults. Meningioma may also include focal calcified components. However, there have been few case reports on meningioma with totally calcified components. We report an uncommon case of totally calcified meningioma without any bony involvements. A 49-year-old woman presented to emergency room with head trauma. Brain computed tomography (CT) scans revealed an extra-axial mass which was totally calcified. The mass size was 3.2×2.3×2.6 cm and located in the paramedian convexity of the right parietal region. Brain CT and magnetic resonance (MR) imaging features suggested a well-demarcated round structure with mostly calcified components. She underwent the tumor removal and the final pathology was consistent with the psammomatous meningioma. This case report emphasizes the importance of meticulous observation of preoperative neuroimaging studies and also discusses the pertinent literatures.
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