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"The first laparoscopy-assisted gastrectomy for gastric cancer was performed in Japan in 1991. In the ensuing 20 years, at first through a process of trial and error, then through the sharing of master surgeons’ accumulated experience, the procedure has been honed and refined to its current high level. From the beginning, it soon became evident that this much less invasive form of gastrectomy, in comparison with traditional open surgery, led to improved quality of life for postsurgical patients, and use of the procedure spread rapidly among gastric surgeons. Early on, however, there were calls for the establishment of standard techniques and procedures to be followed, with a recognized need to improve the level of safety and the quality of lymph node dissection for local control in cancer treatment. Toward that end, the Laparoscopy-Assisted Gastrectomy Club was formed in 1999. In the following year, because both Japan and Korea experience a high rate of gastric cancer, specialists from those two nations came together to form the Japan–Korea Laparoscopic gastrectomy joint seminar, to facilitate and encourage the exchange of vital information. The result has been to achieve an evolving consensus among specialists in the field of endoscopic surgery in Japan and Korea with expertise that can be shared worldwide. A compilation of the current state-of-the-art is now presented in this volume, with accompanying DVD, which will be of great value to all endoscopic surgeons who perform laparoscopic gastrectomy."

"Latar Belakang: Tujuan dari manajemen luka bakar adalah untuk menginiasi penutupan luka dini atau epitelisasi, dan untuk mencegah komplikasi akibat sepsis. Namun, dari praktik harian kami, diagnosis dini, terutama dalam menentukan kedalaman luka bakar pada fase akut, cukup sulit karena proses luka bakar terus berlangsung. Pengukuran objektif merupakan metode tambahan yang baik untuk membantu dokter mengevaluasi kedalaman luka bakar, misalnya pencitraan termal FLIR ONE. Tujuan penelitian ini adalah untuk mengevaluasi validitas FLIR ONE termografi sebagai alat untuk menilai kedalaman luka bakar, dan keandalan evaluasi klinis dan FLIR ONE yang dilakukan oleh ahli konsultan ahli luka bakar bedah plastik dan senior residen bedah plastik. Metode: Studi diagnostik yang dilakukan dari November 2019 - April 2020 di pusat kami. Dengan kriteria inklusi disebutkan kami melakukan pengamatan dua kali berdasarkan evaluasi klinis dan juga alat bantu FLIR ONE termografi pada luka bakar superfisial dan mid-dermal dalam waktu 48 jam pascalukabakar, dan hari 3-5 pascalukabakar, dengan outcome yaitu evaluasi klinis yang dilakukan oleh ahli bedah plastik konsultan luka bakar berpengalaman di hari ke 7. Data dikumpulkan dan menganalisis validitas dan realibilitas. Hasil: 43 sampel yang diambil dari laki-laki 15 (53,6%) dan perempuan 13 (46,4%), usia rata-rata 41,82 ± 13,52 tahun. Sebagian besar sampel adalah dari wajah 14 (32,6%), dan ekstremitas atas 11 (25,6%). Realibitas: ICC adalah T1 0,95 dan T3 0,98, menunjukkan angka baik hingga hari ke 7 hari pascalukabar. Kesenjangan evaluasi klinis antara kedua pengamat (konsultan luka bakar bedah plastic berpengalaman dan residen bedah plastik senior) di T1 adalah 6,9% dan di T3 adalah 9,3%. Tidak ada perbedaan yang signifikan dalam penilaian klinis baik di T1 (p = 0,82) dan T3 (p = 0,51) dan tidak ada perbedaan yang signifikan dalam pengukuran menggunakan alat FLIR ONE antara dua pengamat baik di T1 (p = 0,25) dan T3 (p = 0,91 ). Validitas: AUC dihitung pada T1 adalah 0,72 (95% CI: 0,563 - 0,880) p = 0,014 dengan titik batas T1 pada -0,8 ° C, menunjukkan diskriminasi moderat antara kategori penyembuhan yang re-epitelisasi <= 7 hari dan > 7 hari (sensitivitas 62,5%; spesifisitas 78,9%). Kami menggabungkan evaluasi klinis dan T1 dalam waktu 48 jam setelah luka bakar, penggunaan Flir ONE sebagai alat tambahan meningkatkan sensitivitas menjadi 58,33%, spesifisitas 98% dari evaluasi klinis saja. Probabilitas re-epitelisasi temuan klinis kedalaman luka superfisial dengan nilai T1 > -0,8 C memiliki probabilitas tertinggi (90,94%) untuk re-epitelisasi dalam waktu kurang dari sama dengan 7 hari. Kesimpulan: Penelitian ini menunjukkan validitas dan reliabilitas yang baik dari evaluasi klinis saja dan evaluasi klinis dengan FLIR ONE termografi dalam menilai kedalaman luka bakar. Titik potong kami dalam menentukan kedalaman luka bakar adalah -0,8 ° C, dengan hasil probabilitas yang baik untuk membedakan hasil epitelisasi berulang. Penelitian ini juga memberi tahu kami bahwa program residensi bedah plastik di rumah sakit pendidikan kami telah berhasil membangun kompetensi modul yang baik, dan reisden memiliki paparan yang cukup terhadap kasus luka bakar.

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Background: The aim of the management of burn wound is to initiate early wound closure or epithelization, and to prevent sepsis complication. However, from our daily practice, early diagnosis especially in determining the depth of burn wound in acute phase, is quiet difficult as burn wound process is running. Objective measurement may be great adjunct methods to to help clinician evaluating burn wound depth, as an example of FLIR ONE thermal imaging. The objective was to evaluate the validity of FLIR ONE thermal imager as an adjunct tool to assess burn wound depth, and reliability of clinical evaluation and FLIR ONE performed by senior resident of plastic surgery and experienced burn consultant plastic surgeon. Methods: This is a diagnostic study conducted from November 2019 – April 2020 in our center. With inclusion criteria mentioned we did observation twice based on clinical visual and also FLIR ONE thermal imaging on superficial and mid dermal burn within 48 hours post burn, and post burn day 3-5, outcome by clinical evalution done by experienced burn consultant plastic surgeon on day 7. Data were collected and analyze validity and realibility. Result: We had 43 samples taken from male 15 (53,6%) and female 13 (46.4%), average age 41.82 ± 13.52 years. As facial 14(32.6%), and upper extremities 11 (25.6%) as most samples use. Reliability: ICCs were T1 0.95 and T3 0.98, indicating excellent reliability up to 7 days after burn. The gap of clinical evaluation between both observers (experienced burn consultant and senior plastic surgery resident) at T1 is 6.9 percent and at T3 is 9.3 percent. There were no significant difference in clinical assessment both in T1 (p=0.82) and T3 (p=0.51) and no significant difference in measurements using FLIR ONE between two observers both in T1 (p=0.25) and T3 (p=0.91). Validity: the area under the curve was calculated at T1 was 0.72 (95% CI: 0.563 – 0.880) p = 0.014 with a cut-off point of T1 at -0.8°C, shows a moderate discrimination between healing categories re-epithelialization <= 7 days and > 7 days (62.5% sensitivity; 78.9% specificity). We combined clinical evaluation and T1 within 48 hours post burn, the use of Flir One as an adjunct tool increased the sensitivity to 58.33%, specificity 98% of clinical evaluation solely. the probability of re-epithelialization of clinical finding of superficial wound depth with T1 value of >-0.8oC had the highest probability (90.94%) to re-epithelialized in less equal to 7 days. Conclusion: This research showed good validity and reliability of clinical evaluation alone and clinical evaluation adjunct with FLIR ONE thermal imaging in assessment of burn wound depth. Our cut off point in determining the burn wound depth was -0.8° C, with good probability result to differentiate re-epithelialization outcome. This research told us that plastic surgery residency program of our teaching hospital had successfully established a good module competency, and resident had enough exposure to the burn cases."

"ABSTRAK Nama Isma Tria SavitriProgram Studi Pendidikan Dokter Gigi Spesialis Bedah MulutJudul Keakuratan Model 3 Dimensi Fused Deposition Modeling FDM Dibandingkan CT Scan 3 Dimensi pada Pengukuran Panjang Vertikal Ramus Mandibula Jarak Gonion Menton dan Gonial Angle Latar Belakang Rekonstruksi dan koreksi defek pada regio kraniomaksilofasial membutuhkan perencanaan pra operasi yang sangat matang Hal ini dikarenakan anatomi pada regio ini sangat kompleks melibatkan sistem sistem yang sensitif berdekatan dengan struktur anatomis vital serta mempengaruhi penampilan dan fungsional Dengan perkembangan teknologi di bidang Computed Tomography mampu menciptakan pendekatan perawatan yang baru serta memungkinkan untuk memperoleh model tulang tengkorak 3 Dimensi 3D menggunakan teknik solid free form fabrication SFF Tiap tahapan proses produksi berpotensi untuk terjadi error dan menghasilkan model akhir yang mengalami distorsi Tujuan Penelitian ini dilakukan untuk mengetahui keakuratan dari model 3D FDM dengan cara membandingkan panjang vertikal ramus mandibula jarak Gonion Menton dan gonial angle pada model 3D dengan pengukuran pada CT rekonstruksi 3D Metode Penelitian 8 Sampel data CT scan pasien Bedah Mulut dan Maksilofasial Fakultas Kedokteran Gigi Universitas Indonesia Rumah Sakit Cipto Mangunkusumo Jakarta dibuatkan model 3D menggunakan teknik FDM Kemudian dilakukan pengukuran panjang vertikal ramus mandibula jarak Gonion Menton dan gonial angle terhadap CT rekonstruksi 3D menggunakan piranti lunak OsiriX dan model 3D menggunakan kaliper digital dan goniometri lalu hasil keduanya dibandingkan Hasil Tidak terdapat perbedaan yang bermakna antara pengukuran panjang vertikal ramus mandibula jarak Gonion Menton dan gonial angle pada CT 3D dan model 3D FDM Kesimpulan Model 3D yang menggunakan teknik FDM dinilai akurat sehingga dapat diterima secara klinis Kata kunci Model 3D FDM CT 3D panjang vertikal ramus mandibula jarak Gonion Menton gonial angle.ABSTRACT Name Isma Tria SavitriStudy Program Post Graduate Student of Oral and Maxillofacial SurgeryTitle Accuracy of Three Dimensional Fused Deposition Modeling FDM Models Compared with Three Dimensional CT Scans on Measurement of Mandibular Ramus Vertical Length Gonion Menton Length and Gonial Angle Background Pre surgical treatment planning plays important role in reconstruction and correction of defect in craniomaxillofacial region The advance of solid freeform fabrication techniques has significantly improved the ability to prepare biomodel using computer aided design and data from medical imaging Many factors are implicated in the accuracy of the 3D model Purpose To determine the accuracy of the three dimensional fused deposition modeling FDM models compared with three dimensional CT scans on measurement of mandibular ramus vertical length Gonion Menton length and Gonial angle Research Methods 8 3D Models were produced from 8 CT scan data DICOM file patients of Oral and Maxillofacial Department Fakultas Kedokteran Gigi Universitas Indonesia Rumah Sakit Cipto Mangunkusumo Three measurements were done three times by two examiner Measurement of 3D CT scans were made using OsiriX software while measurement of 3D models were made using digital caliper and goniometry The measurement results were then compared Result There is no significant difference between measurement of mandibular ramus vertical length Gonion Menton length and Gonial angle 3D CT scans and FDM 3D models Conclusion FDM 3D models are considered accurate and is acceptable for clinical applications in dental and craniomaxillofacial surgery."

"ABSTRAKLatar belakang: Beberapa komplikasi sulit yang timbul setelah tindakan sternotomi mediana yang menjadi penyebab utama mortalitas dan morbiditas pasien. Hal ini dapat dicegah dengan aproksimasi sternum yang stabil, Berbagai macam teknik jahitan fiksasi untuk aproksimasi sternum menggunakan wire. Peneliitian ini membandingkan biomekanik teknik jahitan figure of eight trans-sternal dan peristernal. Metode: Penelitian eksperimental pada sternum kambing sebanyak 36 sampel, dilakukan sternotomi mediana, kemudian dilakukan fiksasi sternum menggunakan wire, 18 sampel dilakukan fiksasi jahitan figure of eight peristernal dan 18 sampel trans-sternal. Dinilai dengan uji komparasi tiga dimensi: lateral distraction, transversal shear dan longitudianal shear dengan beban 125N, 150N, 200N, 250N, 300N, 400N. pergeseran diukur dalam mm setiap tingkat pembebanan. Dilakukan analisis statistik dengan uji independent sample t-test. Hasil: Pada uji lateral distraction dan longitudinal shear didapatkan perbedaan bermakna pada pemberian beban ringan 125N, 150N dan 200N, pada beban 300N dan 400N tidak ada perbedaan bermakna. Uji transversal shear tidak ada perbedaan bermakna pada kedua teknik jahitan. Pada hasil uji tarik kedua teknik jahitan mengalami pergeseran lebih dari 2mm pada pembebanan 250 N. Kesimpulan: Stabilitas sternum pada teknik jahitan figure of eight peristernal sama dibanding jahitan figure of eight trans-sternal.

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ABSTRACTBackgrounds There are troublesome complications following median sternotomy which are lead to major causes of morbidity and mortality of patients. This can be prevented by stable sternal approximation, Various suturing fixation method for sternal approximation using wire. To compare the biomechanics of the figure of eight trans sternal and the peristernal suturing method. Methods Experimental study on goat sternum 36 samples, performed sternotomi mediana, then performed sternum fixation using wire, 18 samples performed suturing fixation of figure of eight peristernal and 18 sample trans sternal. Assessed by a three dimensional comparative test lateral distraction, transversal shear and longitanium shear with loads of 125N, 150N, 200N, 250N, 300N, 400N. Shifts are measured in mm at each loading level. Statistical analysis was performed using independent sample t test. Results In lateral distraction and longitudinal shear tests, there were significant differences in the loading of light loads of 125N, 150N and 200N. The transverse shear test no significant difference in the two suturing techniques, In the bending test results both suturing method experience a shift of more than 2mm at 250 N loading. No other significant differrences in clinical outcomes. Conclusions The sternal stability of the peristernal figure of eight method is the same as that of the trans sternal figure of eight."

"ABSTRAK Latar Belakang: Simple bone cyst (SBC) adalah tumor tulang jinak, berisi cairan.Tujuan utama terapi SBC adalah mendapatkan penyembuhan tulang, mencegahfraktur patologis, dan manajemen gejala khususnya nyeri. Terdapat berbagaimetode pengobatan SBC, namun saat ini masih kontroversial karena angkakesembuhan dan tingkat invasi operasi. Terapi injeksi perkutaneus steroidmerupakan metode operasi dengan tingkat invasi rendah sehingga penyembuhantulang dan luaran fungsional lebih baik. Metode: Total terdapat 10 pasien (6 laki-laki, 4 perempuan, rerata usia13 tahun)SBC yang terbagi dalam dua kelompok. 5 pasien (proksimal femur 3; proksimalhumerus 1; calcaneus 1) dilakukan terapi injeksi perkutaneus steroid dan 5 pasien(proksimal femur 2; proksimal humerus 2, radius 1) terapi kurease denganhidroksiapatit. Injeksi perkutaneus steroid dilakukan sebanyak tiga kali denganinterval waktu tiap satu bulan. Rerata follow up adalah 12-26 bulan. Evaluasipenyembuhan tulang dinilai secara radiologi dengan kriteria Chang dkk. Luaranfungsional dinilai berdasarkan skor MSTS.Hasil: Penyembuhan tulang komplit didapatkan pada kedua kelompok, namunsolid union lebih cepat terjadi pada kelompok terapi injeksi perkutaneus steroid. Luaran fungsional didapatkan nilai yang lebih baik pada kelompok injeksiperkutaneus steroid terutama pada bulan ke-3 (55%) dan ke-6 (84%) pasca operasiberdasarkan skor MSTS dibandingkan terapi kuretase dengan hidroksiapatit(bulan ke-3 47% dan ke-6 69,3%). Simpulan: Terapi injeksi perkutaneus steroid masih tetap menjadi pilihan utamametode terapi SBC dengan solid union lebih cepat, tingkat prosedur operasi invasi rendah, lebih mudah, efektif, dan aman.ABSTRACT Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The maingoals of the therapy are to get the bone healing, prevent pathological fractures, andmanagement of pain symptom. There are various methods of the SBC treatment, howeverstill remains controversial because of their healing rate and invasiveness of surgery.Steroid injection therapy is a surgical procedure with a low level of invasiveness so thatbetter bone healing and functional outcomes.Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were dividedinto two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1)performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2proximal humerus, radius 1) performed curretage with hydroxyapatite therapy.Percutaneous steroid injection was performed three times at intervals of each month. Themean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed byChang criteria and the functional outcome by MSTS score.Results: Complete bone healing was found in both group, but solid union occurred fasterin steroid injection theraphy group. The functional outcomes found better value in thesteroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) thancurettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) postoperation based on MSTS score.Conclusions: Percutaneus steroid injection therapy is still the main choice of SBCtreatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe.;Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The maingoals of the therapy are to get the bone healing, prevent pathological fractures, andmanagement of pain symptom. There are various methods of the SBC treatment, howeverstill remains controversial because of their healing rate and invasiveness of surgery.Steroid injection therapy is a surgical procedure with a low level of invasiveness so thatbetter bone healing and functional outcomes.Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were dividedinto two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1)performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2proximal humerus, radius 1) performed curretage with hydroxyapatite therapy.Percutaneous steroid injection was performed three times at intervals of each month. Themean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed byChang criteria and the functional outcome by MSTS score.Results: Complete bone healing was found in both group, but solid union occurred fasterin steroid injection theraphy group. The functional outcomes found better value in thesteroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) thancurettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) postoperation based on MSTS score.Conclusions: Percutaneus steroid injection therapy is still the main choice of SBCtreatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe.;Background: Simple bone cysts (SBC) are a benign bone tumor, fluid-filled. The maingoals of the therapy are to get the bone healing, prevent pathological fractures, andmanagement of pain symptom. There are various methods of the SBC treatment, howeverstill remains controversial because of their healing rate and invasiveness of surgery.Steroid injection therapy is a surgical procedure with a low level of invasiveness so thatbetter bone healing and functional outcomes.Methods: A total of 10 patients (6 males, 4 females, mean age 13 year) SBC were dividedinto two groups. 5 patients (proximal femur 3; proximal humerus 1; calcaneus 1)performed percutaneous steroid injection therapy and 5 patients (proximal femur 2; 2proximal humerus, radius 1) performed curretage with hydroxyapatite therapy.Percutaneous steroid injection was performed three times at intervals of each month. Themean follow-up of 12-26 months. Evaluation of bone healing radiological asseesed byChang criteria and the functional outcome by MSTS score.Results: Complete bone healing was found in both group, but solid union occurred fasterin steroid injection theraphy group. The functional outcomes found better value in thesteroid injection theraphy group, particulary at 3 months (55%) and 6 months (84%) thancurettage with hydroxyapatite therapy(3 months 47% and 6 months 69,3%) postoperation based on MSTS score.Conclusions: Percutaneus steroid injection therapy is still the main choice of SBCtreatment with faster solid union, a lower level operating procedures invasion, easy, effective, and safe."

"Latar Belakang: Laparoskopi nefrektomi merupakan teknik pembedahan pilihan untuk pasien donor ginjal di RSCM karena memiliki beberapa keunggulan dibandingkan laparotomi. Pembedahan akan mengaktivasi respon stress yang mempengaruhi perubahan hemodinamik intraoperatif. Kombinasi anestesi regional epidural dengan anestesi umum dapat mengurangi respon stress intraoperatif. Teknik yang digunakan adalah epidural. Blok Quadratus Lumborum (QL) merupakan blok interfasia efektif sebagai analgesia pasca bedah abdomen. Penelitian ini bertujuan untuk menilai respon stress hemodinamik intraoperatif antara blok QL dan epidural pada pasien laparoskopi nefrektomi. Parameter yang dinilai adalah tekanan arteri rata-rata (MAP), laju nadi, indeks kardiak (CI), dan gula darah. Kebutuhan fentanyl intraoperatif juga turut dinilai. Metode: Penelitian ini adalah uji klinis acak tidak tersamar terhadap pasien donor ginjal yang menjalani laparoskopi nefrektomi di RSCM selama bulan Juni hingga September 2018. Dilakukan randomisasi sebanyak 36 subjek menjadi 2 kelompok. Setelah induksi, kelompok epidural diberikan epidural kontinyu bupivacain 0.25% sebanyak 6 ml/jam dan pada kelompok QL diberikan 20 ml bupivacain 0.25% secara bilateral. Variabel MAP, laju nadi, CI, gula darah dan kebutuhan fentanyl intraoperatif dicatat. Analisis data dilakukan melalui uji bivariat t-test tidak berpasangan, Mann-Whitney serta uji multivariat general linear model. Hasil: Perubahan MAP pada kelompok QL lebih baik secara signifikan dibandingkan dengan epidural. Tidak terdapat perbedaan yang bermakna pada variabel laju nadi, CI, gula darah dan kebutuhan fentanyl intraoperatif. Kesimpulan: Blok QL tidak lebih baik dari epidural dalam menurunkan respon stress intraoperatif pada laparoskopi nefrektomi. Akan tetapi perubahan MAP pada blok QL lebih stabil.

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Background: Laparoscopic nephrectomy is a surgical technique preferred for renal donor in RSCM because of its advantages over laparotomy. Surgery activated stress responses thus affected intraoperative hemodynamics. Regional epidural anesthesia often combined with general anesthesia to reduce stress responses. Quadratus Lumborum (QL) block is an interfacial block and effective as abdominal surgery analgesia. This study was aimed to assess intraoperative hemodynamic stress response between QL and epidural block in laparoscopic nephrectomy patients. Mean arterial pressure (MAP), pulse rate, cardiac index (CI), and blood sugar was collected. Intraoperative fentanyl consumption also noted.

Methods: This was a randomized clinical trial of renal donor patients who underwent laparoscopic nephrectomy at RSCM during June to September 2018. A total of 36 subjects were randomized into 2 groups. After induction of general anesthesia, the epidural group received continuous epidural infusion of 0.25% 6 ml / hour of bupivacaine and QL group received 20 ml of 0.25% bupivacaine. MAP variables, pulse rate, CI, blood sugar and intraoperative fentanyl consumption were recorded in both groups. Data was analyzed with bivariate paired t-test, Mann-Whitney and multivariate general linear model test.

Results: MAP changes in QL group is significantly better than epidural group. There was no difference in heart rate, CI, blood glucose and fentanyl consumption intraoperative between two groups.

Conclusion : QL block compared to epidural did not have better result in reducing intraoperative stress response. However, MAP changes in QL group have better stability than epidural group."