• Title/Summary/Keyword: 계획수술

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Improvement of a Planning Technique Based on Heuristic Target Shaping for Stereotactic Radiosurgery (방사선 수술시 경험적 표적 근사화에 근거한 최적화 방법 개선)

  • Oh Seungjong;Choi Kyoung-Sik;Song Ju-Young;Suh Tae-Suk
    • Progress in Medical Physics
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    • v.16 no.4
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    • pp.176-182
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    • 2005
  • Stereotactic radiosurgery (SRS) is a technique to deliver a high dose to a target region and a low dose to a critical organ through only one or a few irradiation. The SRS must be planned exactly. Currently the surgery plan is peformed by trial and error method. There are many questions about the reliability and reproducibility of the plan result. This study Improve each step of the Oh's method based on heuristic target shaping to obtain the better result. The target was reconstructed using cylinders with same height and the neighbored cylinders were combined according to the difference of each center and diameter. Then, spheres were packed within each cylinders by the packing rules. Two virtual targets were used to compare this method with Oh's method. As a result, the numbers of isocenter were successfully reduced - more than $35\%$ and $26\%$ - without serious differences of proscription isodose to tumour volume ratio (PITV) and maximum dose to proscription dose ratio (MDPD). This technique using cylinder piling and sphere packing will be a helpful tool to planner in stereotactic radiosurgery.

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Traumatic Brachial Plexus Injury: Preoperative Evaluation and Treatment Principles (상완 신경총 손상에서의 수술 전 평가와 치료 계획)

  • Yoo, Jae-Sung;Park, Sung-Bae;Kim, Jong-Phil
    • Archives of Hand and Microsurgery
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    • v.22 no.3
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    • pp.137-146
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    • 2017
  • Brachial plexus injury is regarded as one of the most devastating injuries of the upper extremity. Accurate diagnosis is important to obtain the successful results. Basic preoperative evaluation includes simple radiography, cervical myelography. Magnetic resonance imaging, angiography, electrophysiologic studies and intraoperative studies. Furthermore, proper timing of surgery, surgical indication, plan and sufficient understanding of patients about the prognosis are the key for the satisfactory outcomes. This article provides an overview of the evaluation, diagnosis, intraoperative monitoring, and proper surgical planning for the treatment of posttraumatic brachial plexus injuries.

Risk Factors of Morbidity and Mortality after Coronary Artery Bypass Grafting (관상동맥우회로 이식술 후 이환과 사망의 위험요인)

  • 박창률;이응배;전상훈;장봉현;이종태;김규태
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1159-1164
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    • 1998
  • Background: Although operative outcome is progressing due to the development of operative techniques and myocardial protection, some patients face an increased morbidity and mortality. Therefore, it has become increasingly important to predict the operative morbidity and mortality. Material and Method: This retrospective study reports the results of risk factor analysis of morbidity and mortality of 137 consecutive patients who were underwent coronary artery bypass graft surgery(CABG). Preoperative variables were age, sex, preoperative myocardial infarction, operative priority, left ventricular ejection fraction, obesity and triple vessel disease. Postoperative morbidities were arrhythmia, wound infection, cerebral infarction, prolonged postoperative hospitalization, pneumonia, acute renal failure, prolonged use of ventilator and operative death. Result: The mean age of total patients was 56.7 years, from 27 to 74. The overall mortality was 6.6%(9 of 137) with the mortality of 3.9%(5 of 128) for elective operation, and 44.4%(4 of 9) for emergent or urgent cases. The morbidity of patients over 65 years was stastistically higher than that of under 65 years. Sex distribution showed no difference in morbidity, however operative mortality rate was slightly higher in women (5/41, 12.19%) than in men(4/96, 4.17%). Morbidity of emergent or urgent operation was 100%, much higher than that of the elective operation. Mortality of the patients whose left ventricular ejection fraction was under 50% was higher than that of those over 50%. Conclusion: We concluded that the risk factors of morbidity after CABG were old age above 65 years and emergent or urgent operation, and that risk factors of mortality were low left venticular ejection fraction under 50% and emergent or urgent operation.

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The comparison of treatment planning between stereotactic radiosurgery planning systems (정위방사선수술 치료계획시스템간의 치료계획비교)

  • 김기환;조문준;김재성;김준상;신교철;김진기;오영기;정동혁;김정기
    • Progress in Medical Physics
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    • v.12 no.2
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    • pp.171-175
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    • 2001
  • We analyze the relation of dose volume histogram, conformity index and homogeneity index based on RTOG9005 for treatment planning result between framed based stereotactic radiosurgery(SRS) system and frameless SRS/T system to verify the difference of two systems in the intracranial target. There is same treatment planning result by two treatment planning systems.

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Mass-Spring based Deformable Modelling for Surgical Simulation (수술 시뮬레이션을 위한 매스-스프링 기반 변형 모델링)

  • 남상아
    • Proceedings of the Korea Society for Simulation Conference
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    • 1999.04a
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    • pp.143-146
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    • 1999
  • 수술 시뮬레이션은 의학 교육, 수술 훈련, 수술 계획과 정확한 수술을 위해 그 중요성이 더해지고 있다. 본 논문은 물리적 모델을 기반으로 3차원 객체의 변형을 인터액티브하게 수행할 수 있는 인체 내장 기관에 대한 수술 시뮬레이터의 개발을 목적으로 한다. 물리적 모델은 컴퓨터 애니매이션과 컴퓨터 그래픽 모델에 대한 새로운 시도로써 많이 연구되고 있으며, 본 논문에서는 심장에 대한 3차원 자료를 매스-스프링 모델로 구현 및 변형을 수행하였다. 본 연구의 결과는 일차적으로는 심장 수술 시뮬레이션에 적용 가능하며 나아가 다른 내장 기관의 수술 시뮬레이션 및 non-rigid한 객체에 대한 변형에 적용 가능하다.

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Robotic Surgery in the Orthopedic Field (정형외과 영역에서 로봇수술)

  • Lee, Woo-Suk;Jung, Woo-Suk
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.459-465
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    • 2018
  • Of the many factors that affect the clinical outcomes of orthopedic surgery, the surgical procedure is the most important. Robotics have been developed to perform the surgical procedures more accurately and consistently. Robotic surgical procedures in the orthopedic field were developed 20 years ago. Some designs of surgical robots have disappeared due to practical problems and complications, and an another design of surgical robots is emerging. To date, the use of robot surgery in arthroplasty is still controversial in terms of the clinical outcomes, practicality, and cost-effectiveness, even though it has been reported to be effective in the alignment and positioning of components in the field of artificial joints. Early robotic surgery was based mainly on active robot surgery according to the scheduled operation without the intervention of the operator. Recently the semi-active system of robotic surgery has been introduced. In a semi-active system, the robot constrains the surgeon to a haptic boundary defined by the computer based on the 3-dimensional imaging preoperative plan, and the operator can change the preoperative plan through real-time feedback during operation.

A study on the postoperative stability of occlusal plane in Class III orthognathic surgery patients (제 III급 부정교합자의 양악수술후 교합평면의 안정성에 관한 연구)

  • Lee, Yoon-Jeong;Sohn, Byung-Wha
    • The korean journal of orthodontics
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    • v.30 no.5 s.82
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    • pp.643-655
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    • 2000
  • In Patients with severe skeletal discrepancy, surgical orthodontic treatment must be accompanied, and recently two jaw surgery has become a common procedure, resulting in improved esthetics and function. Choosing the position of the occlusal plane in this two jaw surgery is an important factor in postoperative stability Therefore this must be taken into consideration during the diagnosis and treatment plan. In this study, among patients with skeletal Class III occlusion, 25 patients(8 male, 17 female, average age $23.2{\pm}3.17$) who have undergone two jaw surgery, setting the ideal occlusal plane according to Delaire's architectural and structural cranial analysis. In comparing preoperative($T_1$). postoperative($T_2$, average of 15.4 days), and long-term postoperative($T_3$, average of 32.6 months) lateral cephalometric radiography, the following conclusions have been made. 1. There were no significant changes of the occlusal plane angle after the two jaw surgery, and there were no significant differences between the surgical technique(SSRO and IVRO). 2. The postoperative changes of the occlusal Plane had no relationship with the amount of jaw movement, amount of posterior impaction, nor the time relapse after surgery. 3. After two jaw surgery, in the SSRO group there was significant forward movement of the mandible, and in the IVRO group the lower incisors extruded as the mandible moved backward and downward which makes the genial angle and the mandibular plane angle significantly increased

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QA of a stereotactic radiosurgery system for clinical application (정위방사선수술 시스템의 임상 적용을 위한 QA)

  • 조병철;오도훈;배훈식
    • Progress in Medical Physics
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    • v.10 no.2
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    • pp.89-94
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    • 1999
  • We developed a sterotactic radiosurgery system which is comprised of 1) collimators with small circular aperture, 2) an angiographic target localizer, 3) a target localizer used for alignment of planned target position with isocenter of treatment machine, and 4) a treatment planning system named LinaPel. In this study, we performed a series of treatment simulations to specify and analyze geometrical errors contained our in-house radiosurgery system. As results, 1) using Geometrical Phantom(Radionics,USA), the accuracy of target localization by LinaPel was determined as Avg. =(equation omitted) the accuracy of mechanical isocenter was found out to be 0.6 $\pm$ 0.2 mm, 3) the positional difference of target localization which determined by CT and angiography was 0.8 mm, and their size difference was 1.5 mm, and 4) the positional error during whole treatment was found out to be 0.9 $\pm$ 0.3 mm. With these results, we concluded that our in-house radiosurgery system can be used clinically. However, these range of accuracies need periodical quality assurance strongly.

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Customized Model Manufacturing for Patients with Pelvic Fracture using FDM 3D Printer (FDM 방식의 3D 프린터를 이용한 골반 골절 환자의 맞춤형 모델제작)

  • Oh, Wang-Kyun
    • The Journal of the Korea Contents Association
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    • v.14 no.11
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    • pp.370-377
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    • 2014
  • At present trend 3D Printing technology has been using more efficiently than conventional subtractive manufacturing method in various medical fields, in particular this technology superior in saving production time, cost and process than conventional. Especially in orthopedics, an attractive attention has been paid by adopting this technology because of improving operation, operation accuracy, and reducing the patient's pain. Though 3D printing technology has enormous applications still in some hospitals have not been using due to having the problem of technical utilization of hardware, software & chiefly financial availability and etc. In order to solve these problems by reducing the cost and time, we have used CT images in pre-operative planning by directly making the pelvic fracture model with open source DICOM viewer and STL file conversion program, assembly 3D printer of FDM wire additive manufacturing. After having the customized bone model of six patients who underwent unstable pelvic fracture surgery, we have operated our system in orthopedic section of University Hospital through the clinician. Later, we have received better reviews and comments on utilization availability, results, and precision and now our system considered to be useful in surgical planning.