Epidural Neuroplasty
After applying local anesthetic, live medical imaging device (C-arm) is used to identify the legion. Microcatheter (syringe 2mm in diameter) is inserted through the coccyx, and special preparation (local anesthetic, enzyme preparation, steroids, and hypertonic saline solution) is administered directly to the lesion. This rinses away inflammatory substances from the legion, dissolves scar tissues and adhered tissues, and reduces swelling of herniated discs and nerves, to promote healing of the disc. All while widening the spinal canal for uninterrupted passage of the nerves.

Collagen injection therapy
Instead of blocking and/or numbing pain for our patients, injecting ‘fibroblast collagen’ is similar to the already existing collagen in human bodies. The injection can promote disc regeneration and growth. This injection therapy not only removes spinal pain but also improves muscle strength.

Endoscopic discectomy
Minimal incision around 0.6cm is made on the skin. Damaged discs are removed selectively by endoscopic surgical tools. This minimally invasive method involves no bleeding or cutting of the bone, resulting in short recovery time. High-magnification lenses in the endoscope provide a large surgical field of view, allowing fine capillaries to be identified and avoided if needed, for safer and more accurate treatment. The procedure can be performed with local anesthesia and is safe for the elderly or diabetic patients with compromised immune functions, for whom general anesthesia may be dangerous.

Endoscopic Fusion
External filum terminale cutting addresses degenerative, not congenital symptoms, caused by the filum terminale of the peripheral spinal nerves pulling on the entire spine. The procedure is performed to treat syringomyelia, fibromyalgia, and restless legs syndrome, which occur more frequently in adults.

Microsurgery
This surgical method requires minimal cuts in the spine, preserving as much normal tissue as possible while treating disc herniation or stenosis. A microscope enters a tiny incision to magnify the lesion several tens of times. The procedure is low risk of damaging normal nerves, muscle, blood vessels, and cartilaginous plates in the vertebrae, providing high success rates with minimal risk.

Filum Terminale
This surgical procedure corrects meningocele in patients suffering from Arnold-Chiari Malformation. Cutting the filum terminale removes the root cause of tightness in the filum terminale of the peripheral spinal nerves. The method is performed through a perforation of the sacrum. At Gang nam St.Peter’s Hospital, external and internal filum terminale cutting procedures are performed according to individual patient’s conditions.

• Internal filum terminale
  This procedure address congenital conditions where the filum terminale of the peripheral spinal nerves, which naturally degenerate with the passage of time in normal cases, continue to pull on the nerves. Internal filum terminale cutting usually treats Arnold-Chiari Malformations which are most commonly found in children.
• External filum terminale
  External filum terminale cutting addresses degenerative, not congenital symptoms, caused by the filum terminale of the peripheral spinal nerves pulling on the entire spine. The procedure is performed to treat syringomyelia, fibromyalgia, and restless legs syndrome, which occur more frequently in adults.

Lateral Lumbar Interbody Fusion (LLIF)
In the past, LLIF procedure was performed through anterior or posterior access. Today, improvements in understanding anatomical structures have allowed for artificial bone to be inserted in a bloodless procedure involving a minimal incision of about 2cm. Lateral access to the surgical site with minimal incision of skin and muscle tissue means fast post-op recovery periods, minimal damage, and aftereffects. The procedure can be performed safely on elderly patients as well.

Artificial Disc Replacement
In the past, lumbar fusion procedures were the norm. The purpose of these procedures was to prevent deformation or instability of the spine. However, these procedures limited freedom of movement in bending the neck or spine forward or backward. Artificial disc replacement was developed to address these disadvantages. Artificial disc replacement is a procedure where a severely damaged intervertebral disc is completely removed and replaced with an insertion of an artificial disc. This effective procedure immediately alleviates pain and minimizes degeneration of adjacent vertebrae while allowing for natural movement on par with a natural disc.

Microforaminotomy
This high-precision endoscopic spinal procedure is performed by a handful of surgeons in Korea. Microsurgery leaves an incision scar of around 3 cm. Palliative endoscopic surgery requires the use of 2 to 3 endoscopes at once. Microforaminotomy involves a single 0.5 to 1 cm fine incision followed by the insertion of a single endoscope containing a special camera and surgical equipment. The endoscope selectively removes damaged discs, muscles, ligaments, and bones.

Adult Stem Cell Therapy
Stem cells are called 'stem’ cells as they are the stems from which all types of cells are created. They have the ability to differentiate into any type of tissue found in the human body. St.Peter’s Hospital Gangnam offers adult stem cell therapies to repair damaged cartilage, regenerate damaged discs, and stop disc degeneration. These methods help to address the root cause of symptoms of pain.

Cartilage Injection
To promote cartilage regeneration in damaged joints, injection therapy which contains a hyaluronic acid solution that contains the components of human cartilage and synovial fluid is introduced. Osteoarthritic patients are unable to naturally produce hyaluronic acid from their joints. Overtime, the amount of hyaluronic acid will decrease in their joints. This in turn causes reduced cartilage and synovial fluid elasticity, compromising the patient’s ability to protect their joints against external impact and aggravating the pain. Hyaluronic acid with high molecular weight is injected into the joints. This aids recovery to normal synovial fluid viscosity and elasticity. The joint will be able to move more smoothly, any impact on the joint will be better absorbed, joint functions will recover and pain will be reduced.

Extracorporeal Shockwave Therapy (ESWT)
This non-invasive therapy delivers 1,000 to 1,500 shockwaves to pain-causing legions, restoring blood flow in affected areas while stimulating the tissues and bone which reduce pain and restore function of the impacted area. The procedure usually takes around 30 minutes with no inpatient hospitalization. Patients can resume their normal day-to-day activities immediately. In most cases, the procedure is administered two to three times at 1-week intervals, depending on the patient’s condition. Patients are advised to avoid applying excessive force for 4 to 6 weeks following the procedure as they wait for the treatment to produce its effects.

Endoscopic Joint Surgery
Endoscopic joint surgery is a common procedure for arthritis, usually performed on knees and/or shoulders. A thin and long pencil-like apparatus around 5mm called an Arthroscope is inserted into the affected joint through a small incision in the skin. The arthroscope contains a small TV camera linked to a monitor, and the video feed from the camera is used to diagnose lesions and administer surgical treatment. The arthroscope is a long tube equipped with special lenses allowing for the structures inside a joint to be viewed from the outside. Also incorporated within the arthroscope are devices for illum inating and washing out the joint with water. The thickest arthroscope is 7.5mm across, meaning that the inside of a joint can be observed through an incision seldom exceeding 1cm. While the number of incisions depends on the procedure and the area of the joint the procedure is being performed on, on average 3 arthroscopes are used for viewing and irrigation. Technology such as the tiny surgical apparatuses have come a long way, endoscopic procedures have now replaced conventional knee joint surgeries. Currently, endoscopic procedures are used on joint cartilage surgery, synovial membrane surgery, fractured joint surgery and more. Arthroscopes were difficult to use when it first was invented, as the surgeon needed to look inside the tube with their bare eyes. The arthroscopes of the present produce a live video feed that can be viewed through a TV monitor. Photos and videos can be captured for data keeping. Endoscopic joint surgery can be performed with local or general anesthesia.

• Cartilage Stem Cell Therapy
  Small incision of the skin allows enough space to transfer Adult stem cells onto the damaged cartilage area to induce self-regeneration of the cartilage.
  Until recently, artificial joint replacement was the only viable surgical treatment for patients with advanced degenerative arthritis.

Artificial Joint Replacement Surgery
This procedure replaces damaged cartilage, which causes pain, with ergonomically shaped artificial cartilage. The process can be likened to grinding away dental caries and inlaying with gold. The advantage of artificial joint replacement surgery is that most patients experience no pain after the recovery period. Some patients complain of stinging or numbness in the joint following surgery. This is normal and occurs as the human body accepts the artificial joint. Reducing these symptoms requires consistent exercise, taking hospital-prescribed medicine for up to 3 months following the procedure, and frequent follow-ups. Patients having undergone knee joint replacement are urged to practice knee exercises to strengthen leg muscles. They are cautioned to avoid falling down to avoid damaging their artificial knee joint. If a patient does fall, they should visit a nearby hospital to have their knee checked. Intense exercise, walking for extended periods of time, and other strenuous activities that may strain the knees, should be avoided whenever possible. Artificial joints are made of metal and may trigger metal detectors during airport security screening or MRIs. Make sure to inform security staff of your artificial knee if any alarms are triggered, and also inform your dentist that you have undergone artificial joint replacement surgery.

Coronary Artery Bypass Surgery
In cases involving severe stenosis, a coronary artery bypass procedure is the preferred alternative over stent insertion. As the name suggests, the bypass path is created around a blocked or narrowed portion of the coronary artery. Healthy sections of the artery are taken from the chest or legs to create the bypass. Unlike interventional procedures like stent insertion, coronary bypass surgery is performed under general anesthesia.

Uterine Myoma Embolization
This procedure against uterine myoma selectively blocks off the uterine arteries on both sides of a myoma, inducing ischemia to reduce the size of the myoma.

Laparoscopic Surgery
An incision of 15~20 mm is made inside the belly button to insert the laparoscope and 2 surgical arms to remove the myomas.

Endocervical Surgery
A special scope equipped with special tools is inserted through the vagina. The myomas are removed with the scope offering a live view inside the uterus.

Hysterectomy
This surgical procedure removes the uterus altogether and involves prolonged hospitalization and long recovery times.

TOT therapy for incontinence
Transobturator tape or TOT therapy is a method of treatment where spinal anesthesia is administered and an ergonomically designed mesh tape for incontinence treatment is used to secure the urethra in its normal position and provide support under abdominal pressure due to sudden coughing or sneezing.

Extracorporeal Shock Wave Lithotripsy (ESWL)
A method of treatment that uses a series of shockwaves to dissolve urinary stones

URS (ureteroscopy)
A flexible Olympus 4K ureteroscope is inserted through the urethra and bladder into the ureter to find, dissolve, and extract urinary stones.

Percutaneous Nephrolithotomy (PNL)
A method of treatment where an endoscope is inserted into the kidney through an incision in the back to separate and remove renal stones

Transoral endoscopic thyroid surgery
NOTES (Natural Orifice Transluminal Endoscopic Surgery) is a scarless surgical procedure where endoscopes are inserted into 3 small incisions in the mucosa between the lower lip and gums to remove cancer.

Fine incisions of around 1 cm in the oral mucosa leaves no scarring after the procedure.

Less pain, as the procedure does not involve skin incision

Incisions heal with proper brushing and mouthwash use, without the need for disinfecting (dressing).

Less risk of post-surgical adhesion.

Easy neck movement after the procedure.

RFA radiofrequency ablation therapy
Radiofrequency ablation therapy is a method where a fine (1mm-thick) probe is inserted using real-time ultrasound into nodules to directly deliver high-frequency heat at 100,000 to 500,000hz and cause necrosis. Radiofrequency waves are sent out from the probe into the surrounding tissue, which causes the nearby cells to die. As these cells die, the immune system removes them, which causes an internal reaction and generally results in shrinkage of the nodule.

Mammotome
The mammotome is a vacuum-like apparatus with a special 0.5cm needle which is inserted into the breast. Breast tissues are pulled toward the needle, and any breast tumors are removed. Mammotomes can be used not only for removal of benign breast nodules, but also for breast cancer biopsies.

• Patients requiring mammotome procedures

Microvascular Decompression (MVD)
Microvascular Decompression is a surgery to relieve abnormal compression of a cranial nerve such as hemifacial spasms. This neurosurgical procedure targets the root cause of facial twitching, and has been in widespread use to treat facial twitching and facial paralysis for over 30 years.