-
Article type: Cover
2009 Volume 18 Issue 12 Pages
Cover10-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Cover
2009 Volume 18 Issue 12 Pages
Cover11-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
867-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
867-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
868-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Koji Iihara, Shinji Nagahiro
Article type: Article
2009 Volume 18 Issue 12 Pages
869-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Yoshihiro Kimata, Kenjiro Hasegawa, Sunao Morisada
Article type: Article
2009 Volume 18 Issue 12 Pages
870-874
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
The technique called "Ultramicrosurgery", "Supermicrosurgery" is defined as microsurgical anastomosis of vessels with a diameter less than 0.5mm. This surgical method increases the chances for achieving finger tip replantation, a free perforator flap reconstruction that reduces the flap donor site morbidity, and lymphaticovenous shunting to treat the lymphoedema. In this report, we introduce the various ultramicrosurgery techniques and representative cases and its application.
View full abstract
-
Akira Dezawa, Tamiyo Kon
Article type: Article
2009 Volume 18 Issue 12 Pages
875-881
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
"Primum nil nocere" (minimally invasive procedure) has been the perennial pursuit for surgeons since the time of Hippocrates. However, due to recent advances in optical technology and the development of related devices, remarkable progress has been made in lumbar discectomy using minimally invasive surgery. By minimizing not only the skin incision but also approach related morbidity, nerve root damage can be reduced to a minimum. And one day surgery (outpatient surgery, same day surgery, ambulatory surgery) hastens the patients' return to normal life. In the U.S., outpatient surgery has grown in popularity since Medicare's introduction of the prospective payment system for in-hospital treatment in 1983. As for lumbar disc surgery, a surgical technique which is equally applicable to disc herniation at a high location or a traverse section has been developed. This procedure is conducted under either local or general anaesthesia and is designed to take pressure off of the nerve root by directly excising the disc that is pushing against the nerve root. The surgery can be done on an outpatient basis or with one overnight stay in the hospital, and most patients can be released from the hospital within 24 hours. This technique is called Percutaneous Endoscopic Lumbar Discectomy (PELD) and the disc can be dissected from the lateral intervertebral foramen or between the interlaminar window of the vertebrae. PELD originated from the Percutaneous Nucleotomy procedure devised by Hijikata et al. in 1975 and the introduction of endoscopic techniques has enabled a direct approach for lumbar disc herniation, located further posteriorly than the nucleus pulposus. It is not an exaggeration to say that this technique was created in Japan. Minimal damage to the posterior longitudinal ligament and bones reduces postsurgical instability. The procedure is also advantageous in preventing lumbar facet syndrome and vertebral canal stenosis. The patients' satisfaction rate is high in terms of postoperative recovery and reducing the usage of NSAIDs, and compared to microscopic discectomy and the MED technique, PELD can be considered as a less invasive surgical technique for lumbar disc herniation. This technique makes the most of the space within the intervertebral foramen where, as Kambin claimed, a safe approach to the lesion is possible. And, as we make the skin incision more medially than reported before in order to approach the intervertebral foramen at a steep angle, the occurrence of an exiting nerve lesion at a superior location has also decreased. This surgical method would be a promising alternative to the MED technique as well as to microscope-assisted technique.
View full abstract
-
Hitoshi Ogino
Article type: Article
2009 Volume 18 Issue 12 Pages
882-888
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
We review the characteristics of various graft materials such as biologic and synthetic conduits for vascular reconstruction for dilated or steno-occlusive vascular disease in the field of cardiovascular surgery. In addition, a variety of reconstruction techniques are described. Aortic surgeries requiring cerebrospinal protection related to the field of neurosurgery including aortic arch repair and thoracoabdominal aortic replacement are also referred.
View full abstract
-
Mitsuhiro Okano
Article type: Article
2009 Volume 18 Issue 12 Pages
889-896
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
Since the introduction of endoscopy into the ENT field in the late 1970s, both the diagnosis and treatment of ENT diseases have improved dramatically. Paranasal sinus are narrow confines, and sometime show anatomic variations. Thus endoscopic sinus surgery (ESS) with advanced development of operation-assisted instruments including powered instrumentation and valuable image guidance system contributes to the outcomes in treatment of chronic rhinosinusitis. Furthermore, the technical, surgical options offered by the endoscope go far beyond the management of chronic rhinosinusitis. They include cystic diseases, traumas including cerebrospinal fluid fistulas, and tumors.
View full abstract
-
Hideaki Nukui
Article type: Article
2009 Volume 18 Issue 12 Pages
897-898
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Osamu Okuda, Hideki Bandai, Suguru Nagaoka, Yukou Ohara, Yasuomi Nonak ...
Article type: Article
2009 Volume 18 Issue 12 Pages
899-906
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
Unilateral microscopic fenestration is a less invasive surgical technique as it preserves the contralateral paraspinal muscles as well as posterior components such as inter- and supra-spinous ligaments. The authors studied a consecutive series of patients aged 65 and over with lumbar canal stenosis (dividing into two groups, the early-staged elderly of age 65〜74 and latter-staged elderly of age 75 and over), in whom unilateral microscopic fenestration surgery was performed. From June 2003 to February 2008, 65 consecutive patients with a mean age of 73.2 years were operated upon using this technique and followed-up for a mean period of 20.7 months. Overall improvements were achieved in 89.2% of intermittent claudication, in 57.6% of radiculopathic symptom and in 69.0% of lumbago. While the latter-staged elderly have more co-existing illness, they showed outcomes as favorable as the early-staged elderly in terms of the results, post-operative compilations and hospital days. Thus, less invasive surgery can be successfully performed also in elderly patients of age 75 and over with acceptable morbidity rates.
View full abstract
-
Akira Tsunoda, Shinsuke Ohno, Chikashi Maruki
Article type: Article
2009 Volume 18 Issue 12 Pages
907-913
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
We reported 13 patients suffering idiopathic normal pressure hydrocephalus (iNPH) treated by a hybrid shunt system, which consists of pressure programmable and gravity assisted devices. All patients showed some clinical improvement. Three of them underwent re-programming of their shunt opening pressure. Post-operative intraventricular pressure was regulated within physiological range regardless of posture. It was suggested that, compared with an ordinary pressure programmable system, our hybrid system seldom required reprogramming of the shunt opening pressure. The hybrid shunt system is a promising device for iNPH which requires delicate control of intraventricular pressure after shunt placement.
View full abstract
-
Yoichi Miura, Fujimaro Ishida, Shinichi Shimosaka, Masashi Fujimoto, N ...
Article type: Article
2009 Volume 18 Issue 12 Pages
914-920
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
Background and Purpose: The aim of this study was to determine the feasibility and usefulness of Gadolinium-enhanced three dimensional magnetic resonance angiography (GE MR angiography) performed at 1.5T for the follow-up of coil-treated intracranial aneurysms, compared with 3D time-of-flight (TOF) MR angiography. Materials and Methods: In a prospective study, 4 patients with 4 intracranial aneurysms treated with coils underwent GE MR angiography and 3D TOF MR angiography at 1.5T on the same day at a mean follow-up of 6 months (range, 3-11 months) after coil placement. Results: Visualization of the surrounding vessel systems after coil placement was better with GE MR angiography than with 3D TOF MR angiography. In Case 3, GE MR angiography was useful to evaluate the residual neck and recanalization after treating the intracranial aneurysms which, were demonstrated with 3D digital subtraction angiography (DSA). Conclusion: GE MR angiography is feasible and useful in the follow-up of patients with intracranial aneurysms treated with coil placement.
View full abstract
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
921-925
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
939-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
940-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
940-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
940-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
941-942
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
943-946
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
947-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Appendix
2009 Volume 18 Issue 12 Pages
947-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Index
2009 Volume 18 Issue 12 Pages
948-952
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Index
2009 Volume 18 Issue 12 Pages
953-956
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Index
2009 Volume 18 Issue 12 Pages
957-959
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS
-
Article type: Cover
2009 Volume 18 Issue 12 Pages
Cover12-
Published: December 20, 2009
Released on J-STAGE: June 02, 2017
JOURNAL
FREE ACCESS