라인 레이저를 이용한 수술기기 삽입 유도 시스템의 제어 방법

박철우(Chul-Woo Park),박일형(Il-Hyung Park),정상현(Sanghyun Joung) 한국정보기술학회 2018 한국정보기술학회논문지 Vol.16 No.5

In orthopedic surgery, the medical staff determines the insertion position and direction of the surgical instrument, depending on the 2D fluoroscopic images taken with the C-arm and the clinical experience. Such a surgical technique is not only difficult to accurately treat, but also causes medical staff to experience radiation exposure problems. In this paper, we propose a system and a control method to indicate insertion position and direction of surgical instruments by attaching two line laser projection devices to C-arm head. In the proposed system, if the insertion position and direction of the surgical instrument are specified, two line lasers are projected on the lesion to guide the insertion position and direction of the surgical instrument. The medical staff can insert the surgical instrument such as the fixing screw in the position and direction guided by the line laser, so that it can be treated more quickly and accurately than the existing surgical method. The surgical instrument insertion guiding system proposed in this paper can reduce the radiation dose of the medical staff and reduce the operation time, which can contribute to the recovery of the patient.

고주파 전기 수술기 개발

송도선(DoSun Song),최현호(Hyen-Ho Choi),정동규(Dong-Gyu Jeong) 한국정보기술학회 2005 Proceedings of KIIT Conference Vol.2005 No.-

오늘날 환자의 수술은 간편하고, 통증이 없이 이루어질 수 있는 방향으로 의약과 의료기가 개발되고 있다. 대표적인 의료기기 중 하나가 전기 수술기라 할 수 있다. 이러한 수술기는 기존의 아날로그 전기 회로를 사용하여 시스템의 부피가 크고 무거운 단점이 있다. 본 연구에서는 대규모 집적도가 가능한 디지털 형 고주파 전기 수술기를 개발하였다. 개발된 고주파 전기 수술기는 부피가 작고 무게가 가벼운 특징을 갖고 있다. 개발된 수술기의 실험결과에서는 5가지의 다른 디지털 파형을 발생시킬 수 있음을 보여주며, 수술의 종류에 따라 특정 고주파 전기 파형이 사용된다. Recently many kinds of medical drugs and instruments have been developed to perform the surgical operation without pain. One of the instruments would be high frequency electro-surgical instrument. Conventional electro-surgical instruments has been producted with analog-typed circuits, and thus they are heavy and bulky. In this paper we shows a high frequency electro-surgical instrument based on digital electronic circuits. The developed instrument has small bulky and light weight. And the experimental results show that the new instrument can generate five kinds of electrical wave. According to the kind of surgical operations, one of the high frequency electrical waves are applied.

Constrained High Accuracy Stereo Reconstruction Method for Surgical Instruments Positioning

( Chenhao Wang ),( Yi Shen ),( Wenbin Zhang ),( Yuncai Liu ) 한국인터넷정보학회 2012 KSII Transactions on Internet and Information Syst Vol.6 No.10

In this paper, a high accuracy stereo reconstruction method for surgery instruments positioning is proposed. Usually, the problem of surgical instruments reconstruction is considered as a basic task in computer vision to estimate the 3-D position of each marker on a surgery instrument from three pairs of image points. However, the existing methods considered the 3-D reconstruction of the points separately thus ignore the structure information. Meanwhile, the errors from light variation, imaging noise and quantization still affect the reconstruction accuracy. This paper proposes a method which takes the structure information of surgical instruments as constraints, and reconstructs the whole markers on one surgical instrument together. Firstly, we calibrate the instruments before navigation to get the structure parameters. The structure parameters consist of markers` number, distances between each markers and a linearity sign of each instrument. Then, the structure constraints are added to stereo reconstruction. Finally, weighted filter is used to reduce the jitter. Experiments conducted on surgery navigation system showed that our method not only improve accuracy effectively but also reduce the jitter of surgical instrument greatly.

백서 모델에서 수술 기구를 통한 피부악성종양의 국소 재발 가능성

김국진,이형석,김남균,이경석,김준식,박상우 대한성형외과학회 2011 Archives of Plastic Surgery Vol.38 No.4

Purpose: The goal of cancer surgery is complete removal of cancer tissue and prevention of recurrence. Surgeons can change the surgical instruments after total resection of the cancer mass. The purpose of this procedure is to prevent dissemination of the cancer cells attached to the surgical instruments. Authors hypothesize the possibility of local recurrence caused by the cancer cells attached to the surgical instruments in the skin cancer cases. Methods: Skin cancers were induced by using DMBATPA two-stage carcinogenesis model in 10 of Balb/c mice. In 2-weeks, skin cancer was developed in all 10 mice. cancer cell attached surgical instruments were made by pinching the removed cancer tissue using Adson tissue forcep 10, 20, 30 times each. To count number of cancer cells in each forcep with different number of pinching was done, the forceps were washed in 30 mL of the normal saline and Cytospin preparation was done. To make recurrence models from cancer cell attached surgical instrument, three incisions were made in normal skin of each mouse, and local seeding was done by pinching subcutaneous tissue in 10, 20, 30 times each by using Adson teeth forceps mentioned above as cancer cell attached surgical instrument. Results: All skin cancers were squamous cell carcinoma. Local recurrences were developed in 7 mice (3 in 10 times forceping site, 2 in 20 times forceping and 3 in 30 times forceping). In the cytospin test, the mean number of squamous cells in 100 microscope was 28.6 in 10 times, 47.2 in 20 times, 93.6 in 30 times, respectively. P value was 0.002 in Wilcoxon-Sign test. Conclusion: The number of cell count was significantly increased as number of pinching was increased. And these cells are able to induce local recurrence by local seeding. Considering this result, authors are able to confirm that the minimal handling in cancer surgery is important factor to prevent local recurrence.

Initial Experience with Laparoendoscopic Single-Site Surgery by Use of a Homemade Transumbilical Port in Urology

이석영,김용태,박해영,이춘용,박성열 대한비뇨의학회 2010 Investigative and Clinical Urology Vol.51 No.9

Purpose: We present our initial experience with laparoendoscopic single-site surgery (LESS) by a single surgeon in the urologic field. Materials and Methods: From May 2009 to April 2010, 30 consecutive patients underwent LESS including seven cases of nephrectomy, five cases of nephroureterectomy with bladder cuff excision, four cases of ureterolithotomy, eight cases of marsupialization, and six cases of varicocelectomy. We performed a retrospective analysis of the medical records of the above patients. The single port was made with a surgical glove and an AlexisⓇ wound retractor (Applied Medical, Rancho Santa Margarita, CA, USA). The wound retractor was put into the peritoneal space through an umbilical incision, and a laparoscopic triangle was secured by crossing both instruments. All operations were performed by the transperitoneal approach. Results: Mean patient age was 54.8 years. Mean operative time was 171.2±109.1 minutes. Mean estimated blood loss was 265.0±395.5 ml. Mean incision length was 3.2±1.4 cm. Mean length of hospitalization was 5.2±2.9 days. There was one laparoscopic conversion and two open conversions. There were two cases of transient ileus that improved with conservative treatment. Mean visual analogue pain scales on the operative day and first postoperative day were 6.3/10 and 3.1/10, respectively. Conclusions: In our experience, LESS for urologic surgery is feasible, safe, and clinically applicable. We consider the homemade single-port device to be a relatively cost-effective and convenient device. If surgical instruments for LESS and appropriate ports specified for LESS are developed, LESS would be a surgical treatment technique that could be used as an alternative to the conventional types of laparoscopic surgery. Purpose: We present our initial experience with laparoendoscopic single-site surgery (LESS) by a single surgeon in the urologic field. Materials and Methods: From May 2009 to April 2010, 30 consecutive patients underwent LESS including seven cases of nephrectomy, five cases of nephroureterectomy with bladder cuff excision, four cases of ureterolithotomy, eight cases of marsupialization, and six cases of varicocelectomy. We performed a retrospective analysis of the medical records of the above patients. The single port was made with a surgical glove and an AlexisⓇ wound retractor (Applied Medical, Rancho Santa Margarita, CA, USA). The wound retractor was put into the peritoneal space through an umbilical incision, and a laparoscopic triangle was secured by crossing both instruments. All operations were performed by the transperitoneal approach. Results: Mean patient age was 54.8 years. Mean operative time was 171.2±109.1 minutes. Mean estimated blood loss was 265.0±395.5 ml. Mean incision length was 3.2±1.4 cm. Mean length of hospitalization was 5.2±2.9 days. There was one laparoscopic conversion and two open conversions. There were two cases of transient ileus that improved with conservative treatment. Mean visual analogue pain scales on the operative day and first postoperative day were 6.3/10 and 3.1/10, respectively. Conclusions: In our experience, LESS for urologic surgery is feasible, safe, and clinically applicable. We consider the homemade single-port device to be a relatively cost-effective and convenient device. If surgical instruments for LESS and appropriate ports specified for LESS are developed, LESS would be a surgical treatment technique that could be used as an alternative to the conventional types of laparoscopic surgery.

최소침습술을 위한 의료용 인스트루먼트의 동작 성능 향상

박현준(Hyeonjun Park),원종석(Jongseok Won),박재흥(Jaeheung Park) 제어로봇시스템학회 2013 제어·로봇·시스템학회 논문지 Vol.19 No.12

This paper presents feedforward controllers to improve the control performance of the motion and grasping force of a surgical instrument used in an MIS (Minimally Invasive Surgery) robot. The surgical instrument has a long distance between the drive motors and its active joints. Therefore, the gripper on the instrument is controlled by a cable drive mechanism, which generates a coupled motion between the wrist joint and the grip direction. In order to solve the problem, this paper analyzes the pulley composition of the surgical instrument and proposes feedforward controllers to eliminate the coupled motion. Furthermore, feedforward controllers to regulate the grasping force are proposed to deal with another coupling problem between the grasping force of the instrument and the motion of the instrument joints. The experimental results demonstrate the improved control performance of the motion and grasping force of the instrument.

GradeⅠ요추부 척추 전방 전위증의 치료 : 감압성 후궁절제술과 고정기구 삽입술의 비교

정승영,김국기,임영진,김태성,임언,이봉암,Chung, Seung Young,Kim, Gook Ki,Lim, Young Jin,Kim, Tae Sung,Leem, Won,Rhee, Bong Arm 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.2

Objective : Controversy exists which surgical treatment better in lumbar grade I spondylolisthesis, decompressive laminectomy with or without lumbar instrumentation. Methods : Out of Sixty-four patients with lumbar spondylolisthesis underwent surgery, 18 patients operated with decompressive laminectomy alone and 44 patients with decompession and lumbar instrument, during recent 5-years between January, 1994 and December, 1998. The author studied a long term follow-up in the above two groups to analyzing the overall clinical outcomes in each group and to determining the incidence of pos-toperative radiologic instability. Results : 1) Overall postoperative symptoms improvement were not so different in both groups. 2) Postoperative progressive subluxation is more common after decompressive laminectomy without instrumentation than with instrumentation group. 3) Overall clinical outcomes were slightly better in decompressive laminectomy without instrumentation than with instrumentation group but there was no significant difference. 4) Postoperative radiologic changes did not seem to influence the patient-reported clinical outcomes. 5) Postoperative complications is more common in decompressive laminectomy with instrumentation group than without instrumentation group. Conclusion : In the surgical management of grade I spondylolisthesis, the efficiency and superiority of surgical treatments requires the cost effectiveness and risk/benefit analysis of decompressive laminectomy with or without instrumentation. Therefore, Further detailed studies of long term follow up in a large number of patients in each group are needed for choice of best treatment.

Measuring Method for the Torque Control of Instrument in Surgical Robot

Chi Yen Kim,Min Choel Lee 제어로봇시스템학회 2009 제어로봇시스템학회 국제학술대회 논문집 Vol.2009 No.8

The surgical robot instruments conduct an operation in the body on behalf of the surgeon’s hands. However working inside a body prohibits attaching electronic sensors in addition to space restriction. Therefore, all commercial surgical robots are only operated in position control mode because there is no way to measure the working force at instrument. The position control mode of the robot system has some problem in grasping. To build a force controllable surgical robot instrument system, this paper proposes torque measuring mechanism indirectly using reaction force. The proposed mechanism estimates the grasping force from measuring reaction force against the driving motor by using a load-cell. The motor is mounted on movable platform which push on load cell according to the tension arisen by reaction force.

Friction-Model-Based Estimation of Interaction Force of a Surgical Robot

Subon Kim,Doo Yong Lee 제어로봇시스템학회 2015 제어로봇시스템학회 국제학술대회 논문집 Vol.2015 No.10

This paper reports a method to estimate the interaction forces between the surgical robot instrument and the organ tissues. A previous estimation method uses the kinematical relationship of the surgical robot instrument to estimate the interaction force at the distant tip. It is experimentally found that there is non-ignorable estimation error due to some torque loss and the friction forces inside the instrument attributes to the torque loss. In this paper, a friction model is developed to more accurately estimate the interaction force considering the structure of the instrument. The friction model also reflects the effects of the tendon-driven mechanism inside the instrument on the estimation error. Experimental result shows that the estimation error can be reduced approximately 80% in single degree of freedom free motion compared to when the friction force model was not used.

CT Findings of Foreign Body Reaction to a Retained Endoloop Ligature Plastic Tube Mimicking Acute Appendicitis: A Case Report

안재홍,강채훈,최수정,박만수,정승문,류대식,신동락 대한영상의학회 2016 Korean Journal of Radiology Vol.17 No.4

Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.