1.THUNDERBEAT IN USE THYROID SURGERY
Tumur-Ochir Ch ; Shim Woo Jeong ; Munkhbat D ; Baasanjav D ; Bayarkhuu A ; Enkhbat G ; Erdene-Bolor B ; Naranbat L
Journal of Surgery 2016;19(1):64-69
Introduction: Last Decades, Date by date
medical developments providing friendly,
high-efficiency treatment equipment and
services in developed countries are working
toward an advanced, as our country medical
services are trying to that country’s technology
has been introduced. In our country every
day there is only surgical care necessary to
endocrine gland disorders, including most
common thyroid surgery. It is open and
robotic assistant endoscopic surgery in the
world. But robotic assistant endoscopic
surgery is too expensive and impossible in
our country. Thus we chose Thunderbeat
for open thyroid surgery in especially huge
enlarged goiter and vascularized goiter to try
prevent bleeding, recurrent laryngeal nerve
palsy and post operation hematoma and
other complications
Thunderbeat is new generation instrument
combines an advanced bipolar clamp to the
existing ultrasonic cutter.
Materials and Methods: M 51-years-oldwoman
was admitted to Mongol Hyundae
hospital because of front of neck pain, multi
nodular goiter, tachycardia, sweaty and not
controlling emotion.
Anamnesis: She diagnosed to
Thyrotoxicosis in 2005 and she took
medicine last ten years but not controlling
that poisoning. Status locals: Huge enlarged
goiter in front of her neck
Treatment plan:
1. Preoperative Preparation
2. Operation: Open total thyroidectomy
3. Medicine
4. Wound dressing
5. Observation
We did operation after day of admission
day, Patient is placed in a Semi erect position
with a folded sheet underneath the shoulders
so that the head is sharply angulated backward
on the multifunctional surgical table under
general anesthesia. We used thunderbeat
from muscular to all procedures, dissection
both thyroid gland and isthmus after Kocher
skin incision and sub skin tissue dissected.
There is no complication while procedure
and post operation days
Result: Nodular hyperplasia of thyroid
gland with focci of micro adenomatous
change
Conclusion: Thunderbeat in use open
thyroid surgery first outcomes blood loss
than 30ml, no injury of recurrent laryngeal
nerve and no penetration ligament of Berry
while procedure, second outcomes no
hematoma, painless, wound healing process
faster and short time hospitalization.
2. THUNDERBEAT IN USE THYROID SURGERY
Tumur-Ochir CH ; Shim Woo Jeong ; Munkhbat D ; Baasanjav D ; Bayarkhuu A ; Enkhbat G ; Erdene-Bolor B ; Naranbat L
Journal of Surgery 2016;19(1):64-69
Introduction: Last Decades, Date by datemedical developments providing friendly,high-efficiency treatment equipment andservices in developed countries are workingtoward an advanced, as our country medicalservices are trying to that country’s technologyhas been introduced. In our country everyday there is only surgical care necessary toendocrine gland disorders, including mostcommon thyroid surgery. It is open androbotic assistant endoscopic surgery in theworld. But robotic assistant endoscopicsurgery is too expensive and impossible inour country. Thus we chose Thunderbeatfor open thyroid surgery in especially hugeenlarged goiter and vascularized goiter to tryprevent bleeding, recurrent laryngeal nervepalsy and post operation hematoma andother complicationsThunderbeat is new generation instrumentcombines an advanced bipolar clamp to theexisting ultrasonic cutter.Materials and Methods: M 51-years-oldwomanwas admitted to Mongol Hyundaehospital because of front of neck pain, multinodular goiter, tachycardia, sweaty and notcontrolling emotion.Anamnesis: She diagnosed toThyrotoxicosis in 2005 and she tookmedicine last ten years but not controllingthat poisoning. Status locals: Huge enlargedgoiter in front of her neckTreatment plan:1. Preoperative Preparation2. Operation: Open total thyroidectomy3. Medicine4. Wound dressing5. ObservationWe did operation after day of admissionday, Patient is placed in a Semi erect positionwith a folded sheet underneath the shouldersso that the head is sharply angulated backwardon the multifunctional surgical table undergeneral anesthesia. We used thunderbeatfrom muscular to all procedures, dissectionboth thyroid gland and isthmus after Kocherskin incision and sub skin tissue dissected.There is no complication while procedureand post operation daysResult: Nodular hyperplasia of thyroidgland with focci of micro adenomatouschangeConclusion: Thunderbeat in use openthyroid surgery first outcomes blood lossthan 30ml, no injury of recurrent laryngealnerve and no penetration ligament of Berrywhile procedure, second outcomes nohematoma, painless, wound healing processfaster and short time hospitalization.
3.RECURRENCE RATE WITH USE OF INTRAOPERATIVE MITOMYCIN C AND CONJUNCTIVAL AUTOGRAFT FOLLOWING PTERYGIUM EXCISION
Gantsooj N ; Undarmaa T ; Tuvshintugs B ; Tumur G ; Bolortungalag P ; Sainbileg D ; Enkhzul D ; Tumurbaatar B ; Burenjargal P ; Enkh-Oyun Ts
Innovation 2018;12(3):28-30
BACKGROUND: Pterygium is a fibrovascular wing shaped encroachment of conjunctiva
onto the cornea. Although the pathogenesis remains obscure, the ultraviolet radiations
(UVR), especially UVR-A and UVR-B (290-400 nm), are considered the most dangerous in
developing pterygium among other environmental factors (hot, dry, windy, dusty and
smoky environments and hereditary factors. The main histopathological change in primary
pterygium is elastotic degeneration of conjunctival collagen. Patient complaints include
foreign body feeling and visual loss due to corneal astigmatism or growth over the pupil and
cosmetic problems. Anti-inflammatory drugs and lubricants have an important role minimizing
the patient’s discomfort, but they do not cure the disease. After surgical removal there are
still many recurrences regardless of the method used. Autologous conjunctival grafting seems
to be the best method, given both the low recurrence rate and high safety. As described first
by Kenyon et al. in 1985, a conjunctival autograft reported a recurrence rate of 5.3% with
infrequent and relatively minor complications. The primary disadvantage of this technique
is the prolonged operative time required when compared to the bare sclera technique.
These disadvantages are outweighed by the lack of sight-threatening complications and the
relatively low recurrence rate, which made this procedure gain popularity in many centers.
The application of intraoperative 0.02% mitomycin C for the 5 minutes is efficient in reducing
the recurrence rate to a minimum.
METHODS: This retrospective case series, single center study was conducted on 239
patients, who underwent pterygium excision from Jan 2017 to Dec 2017 at the Department
of Ophthalmology of the First Central Hospital. All patients had a detailed ophthalmic
examination before the surgical intervention. Data were collected through a prepared
questionnaire. Postoperative follow-up examination sheets were evaluated. Data
for recurrence rate of pterygium excision were collected and analyzed by using SPSS version 17..
RESULTS: Among the 239 patients, who underwent an operation, 37.2% (n=89) were male and
62.8% (n=150) were female. Participants’ age ranged from 29 -70 years with mean age of 49.5
years old.
There is no statistical significance between the stages of the disease and its post-operative
outcome in the patients, who underwent pterygium excision surgery in 2017. Postoperative
pterygium recurrence was in 9 patients (3.8%); 5 (55.5%) out of all 9 patients with recurred
pterygium had underwent pterygium excision without conjunctival autograft.
MMC was not used intraoperatively for all 9 (3.8%) patients with recurrence post pterygium
excision.
CONCLUSION: The relationship between pterygium stage and its post-operative recurrence
was not statistically significant (P=0.683).
The recurrence rate after pterygium excision with conjunctival autograft was low (P≤0.001)
which showed significant statistically.
There was no recurrence after pterygium excision with MMC (P≤0.001).
The results of studies from Canada, Hong-Kong, India, Philippines and Iran were similar to our
outcome.