Introduction: Degenerative disorder involving the acromioclavicular joint (ACJ) is quite common especially in the elderly. One of the surgical modalities of treatment of this disorder is the Mumford Procedure. Arthroscopic approach is preferred due to its reduced morbidity and faster post-operative recovery. One method utilizes the anteromedial and Neviaser portals, which allow direct and better visualization of the ACJ from the subacromial space. However, the dangers that may arise from incision and insertion of instruments through these portals are not fully understood. This cadaveric study was carried out to investigate the dangers that can arise from utilization of these portals and which structures are at risk during this procedure. Materials and Methods: Arthroscopic Mumford procedures were performed on 5 cadaver shoulders by a single surgeon utilizing the anteromedial and Neviaser portals. After marking each portals with methylene blue, dissection of nearby structures were carried out immediately after each procedure was completed. Important structures (subclavian artery as well as brachial plexus and its branches) were identified and the nearest measurements were made from each portal edges to these structures. Results: The anteromedial portal was noted to be closest to the suprascapular nerve (SSN) at 2.91 cm, while the Neviaser portal was noted to be closest also to the SSN at 1.60 cm. The suprascapular nerve was the structure most at risk during the Mumford procedure. The anteromedial portal was noted to be the most risky portal to utilize compared to the Neviaser portal. Conclusion: Extra precaution needs to be given to the anteromedial portal while performing an arthroscopic distal clavicle resection in view of the risk of injuring the suprascapular nerve of the affected limb.
urgical Procedures, Operative ; General Surgery

A case of inguinoscrotal bladder hernia in a 68-year-old man is reported. He was referred from the Department of Internal Medicine to our department because of the presence of occult blood in the urine. On abdominal examination, a goose-egg-sized inguinal hernia was noted extending into the scrotum. Cystography, CT and MRI demonstrated hernia of the bladder into the right side of the scrotum. Although a radical cure operation had been planned, ileocecum excision was enforced, as the symptoms of appendicitis were developed. Postoperatively, the right side of the inguinal swelling disappeared, and the repeated cystgraphy showed the bladder to be in the normal position with a normal contour.
Hernia ; Bladder ; Appendicitis ; Procedures on bladder ; GENERAL OPERATIVE PROCEDURES

The purpose of this article is to describe our initial experience using laparoscopy to perform surgery for endometrial cancer. The patient was 59 years old with 2 para and was diagnosed as having a clinical endometrial adenocarcinoma in FIGO Stage Ia or Ib. Hysterectomy, bilateral salpingo-oophorectomy and lymph node sampling were performed using a laparoscopic procedure. We analyzed the problems and advantages of the procedure in this case.
Patients ; Malignant neoplasm of endometrium ; GENERAL OPERATIVE PROCEDURES ; Laparoscopic ; Procedures

A Statistical observation was made on 284 In-Patients with age distribution and operative procedures in the Department of Urology, Eul Ji General Hospital, during the period from June 1, 1976 to December 31, 1978.
Age Distribution ; Hospitals, General ; Surgical Procedures, Operative ; Urology*

A statistical observation was made on 680 in-patients with age distribution and operative procedures in the Department of Urology, Korea General Hospital, during the period from January 1, 1973 to December 31, 1977.
Age Distribution ; Hospitals, General ; Korea ; Surgical Procedures, Operative ; Urology*

Although a laparotomy itself may be successful, various complaints, whose organic causes are not definite, occasionally arise afterwards. We report two cases of complaints after abdominal operations successfully treated with kososanryo. The chief complaints were anorexia in Case 1, and anxiety in Case 2. We treated the pathological states in these cases as qi stagnation, or qi obstruction in Japanese-oriental medicine sense. The symptoms in these cases improved soon after administration of kososanryo, which is traditionally used for qi stagnation. On closer investigation, we first report that kososanryo is useful for complaints after abdominal operations. Complaints after various operations lower quality of life and, what is even worse, may cause unreliability of medical treatment. The present cases suggest that Japanese-oriental medicine has therapeutic utility in the therapy of complaints after various operations.
seconds ; Complaint, NOS ; Surgical aspects ; Cases ; GENERAL OPERATIVE PROCEDURES

Acute appendicitis has been known as a disease entity for well over a century but a confident diagnosis before surgery in all patients suspected of the condition is still not possible. Timely diagnosis is essential to minimise morbidity due to possible perforation of the inflamed organ in the event treatment is delayed; so much so that surgeons often preferred to operate at the slightest suspicion of the diagnosis in the past. This resulted in the removal of many normal appendixes. When the diagnosis of appendicitis is clear from the history and clinical examination, then no further investigation is necessary and prompt surgical treatment is appropriate. Where there is doubt about the diagnosis however it is advisable to resort to imaging studies such as abdominal ultrasound or computed tomography to clear such suspicions before subjecting the patient to an appendicectomy. These studies would also help avoid delays in surgery in deserving patients.
Diagnostic ; Appendicitis ; Acute ; Surgical aspects ; GENERAL OPERATIVE PROCEDURES

A keratoacanthoma is a rapidly growing cutaneous tumor that spontaneously involutes in most instances. A giant keratoacanthoma is a rare variant and are characterized by lesions larger than 20 mm in diameter. We report a 56-year-old man with a rapidly growing tumor of the right cheek, which was diagnosed as keratoacanthoma. The mass was excised completely under general anesthesia, followed by Limberg flap for reconstruction. Intraoperative frozen section histology suggested the lesion to be a well-differentiated squamous cell carcinoma, whereas final histopathology was consistent with keratoacanthoma. We herein report the first case of a giant keratoacanthoma treated with surgical excision in Korea and discuss the clinical and histopathological features of keratoacanthoma, with a review of the literature.
Anesthesia, General ; Carcinoma, Squamous Cell ; Cheek ; Frozen Sections ; Humans ; Keratoacanthoma* ; Korea ; Middle Aged ; Surgical Procedures, Operative

Uterine leiomyoma is a common benign tumor. This report concerns a rare case of laparoscopic resection of a unilateral, ovarian leiomyoma requiring seven hours of surgery. A 66-year-old woman (para 2) was referred to Kochi Health Sciences Center because of a pelvic tumor. Transvaginal ultrasonographic examination revealed a pelvic tumor suspected of being a uterine leiomyoma in the cul-de-sac. Total laparoscopic hysterectomy and bilateral salpingo-oophorectomy was performed. A morcellator was used to reduce the volume of the leiomyoma. The uterus and right adnexa were removed via the vagina. When the left ovarian leiomyoma was diminished, it was also removed via the vagina.
Fibroid Tumor ; Excision ; Large ; GENERAL OPERATIVE PROCEDURES ; Neoplasm of uncertain or unknown behavior of ovary

Temperature changes during general anesthesia were studied in relation to age, the duration and type of operative procedure(gastrectomy versus tympanoplasty) and the type of anesthetic(halothane versus conflurane) in 41 patients undergoing surgery in our centrally air-conditioned operating room. Body temperatures were recorded every 15 minutes after intubation by measuring the esophageal temperature in adults and the nasopharyngeal temperature in children. A comparison of temperature changes between adults and children showed a significant temperature decreases in adults during general anesthesia(-0.6 degrees C, p<0.001), while the temperatures of children remained stable. Comparisons of gastrectomy versus tympanoplasty groups indicated the operative site had little effect on the patient's body temperature. Patients who underwent a gastrectomy showed an average fall in esophageal temperature of 0.8 degrees C, where as there was an average temperature decline of 0.5 degrees C in tympanoplasty. Body temperature decrease was dependent on the duration of the operative procedure. The longer the procedure, the greater change in temperature. There was no significant difference between the effects of the volatile anesthetic agents on patient's body temperatures.
Adult ; Anesthesia, General* ; Anesthetics ; Body Temperature ; Child ; Gastrectomy ; Humans ; Intubation ; Operating Rooms ; Surgical Procedures, Operative ; Tympanoplasty