• 대한기관식도과학회지
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• 제17권1호
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• pp.29-34
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• 2011

Traditionally, the main strategy of treatment of the head and neck cancer was en bloc resection including adjacent normal tissues through wide incision. However, the procedures may leave severe functional deficit such as swallowing difficulty, aspiration, and wide neck scar. Therefore, many attempts have been made up to minimize these morbidities. Of them, the minimal invasive approach such as transoral laser microsurgery (TLM) and transoral robot surgery (TORS) have been spolighted as a sensible strategy for organ preservation of the head and neck cancer patients. Results of TLM are equivalent to those obtained by conventional surgery, with considerably less morbidity, less hospital time and better postoperative function. Oncologic results of TLM are equivalent to conventional surgery. TORS are safe, feasible, and promising but oncologic safety is not yet verified. This article covers to current application of TLM and TORS, their advantages and limitations, and future direction.

• Journal of Chest Surgery
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• 제41권5호
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• pp.568-572
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• 2008

배경: 이미 여러 외과 영역에서 내시경수술이 보편화 되었고, 심장외과 영역에서도 그간 무펌프 관상 동맥우회술이나, 최소절개 또는 변형된 흉골절개 등을 이용한 최소침습수술이 꾸준히 시도되어 왔다. 하지만, 시야확보 및 체외순환을 위한 흉골절개의 필요성 때문에 이러한 변화에 둔감했던 것이 사실이다. 최근 로봇을 이용한 내시경 심장수술이 도입되는 것은 환영할 만한 일이나 고가의 장비가 필요하다는 문제가 있다. 이에 저자는 기존의 흉강경을 이용하여 심방중격결손의 폐쇄를 시행하였다 대상 및 방법: 2006년 5월부터 2008년 2월까지 15명의 환자를 대상으로 흉강경을 이용한 심방중격결손의 페쇄를 시행하였다. 수술 시 평균 연령은 $31{\pm}6$세였고 이들 중 2명을 제외하고는 모두 여자였다. 술전 심초음파상 심방중격결손의 평균 크기는 $24{\pm}5mm$였고, 삼첨판을 통한 압력차는 $30{\pm}5$ mmHg로 측정되었다. 삼첨판 페쇄부전은 3명에서는 경-중도였고 나머지에서는 경도 이하였으며, 1명에서 경-중도의 승모판폐쇄부전이 동반되었다. 수술은 우측 내경정맥과 대퇴동-정맥으로 캐뉼라를 삽관하여 체외순환을 시행하고, 유방하구를 따라 $4{\sim}5cm$의 소절개를 한 뒤 제4늑간을 통한 작업창과 흉강경으로 시야를 확보하며 심내교정을 시행하였다. 심방중격결손의 페쇄는 11명에서는 자가심낭을 이용하였고 4명에서는 일차봉합하였다. 관련 술기로는 3예의 삼첨판 성형술과 1예의 승모판 성형술을 시행하였다. 체외순환시간은 $160{\pm}47$분, 대동맥차단시간은 $70{\pm}26$분이었다. 결과: 술 후 사망 또는 주요합병증은 없었다. 3예에서 수혈이 필요하였고, 흉관제거 후 기흉이 관찰된 1예와 창상치유가 지연되었던 1예, 일시적인 부정맥의 1예 외에 별다른 합병증 없이 술 후 $5.9{\pm}1.8$일째 퇴원하였다. 술 후 시행한 심초음파 상 잔여 단락은 없었으며, 삼첨판폐쇄부전은 전예에서 경도 이하였다. 평균 추적관찰 기간은 $10.7{\pm}6.4$개월이었고 3명의 환자가 마지막 외래 방문 시 우측 가슴이나 대퇴부 안쪽의 감각이상을 호소하였으나 그 외 이상소견은 없었다. 결론: 저자들은 기존의 흉강경 장비를 이용한 심방중격결손의 페쇄로 술 후 만족할만한 임상적, 미용적 결과를 얻을 수 있었다. 그러나, 아직까지 수술시간이 많이 소요되며, 완전히 폐쇄된 공간 안에서의 수술이 아니고 작으나마 개흉이 필요하므로 향후 경험과 장비 면에서 보완이 필요하리라 생각된다.

• 한국CDE학회논문집
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• 제20권3호
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• pp.246-253
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• 2015

In this paper, we propose calibration methods that can be applied to the markerless surgical robotic system for Intracerebral Hematoma (ICH) Surgery. This surgical robotic system does not require additional process of patient imaging but only uses CT images that are initially taken for a diagnosis purpose. Furthermore, the system applies markerless registration method other than using stereotactic frames. Thus, in overall, our system has many advantages when compared to other conventional ICH surgeries in that they are non-invasive, much less exposed to radiation exposure, and most importantly reduces a total operation time. In the paper, we specifically focus on the application of calibration methods and their verification which is one of the most critical factors that determine the accuracy of the system. We implemented three applications of calibration methods between the coordinates of robot's end-effector and the coordinates of 3D facial surface scanner, based on the hand-eye calibration method. Phantom tests were conducted to validate the feasibility and accuracy of our proposed calibration methods and the surgical robotic system.

• 제어로봇시스템학회논문지
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• 제22권8호
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• pp.597-602
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• 2016

In image guided surgery, a patient registration process is a critical process for the successful operation, which is required to use pre-operative images such as CT and MRI during operation. Though several patient registration methods have been studied, we concentrate on one method that utilizes 3D surface measurement data in this paper. First, a hand-held 3D surface measurement device measures the surface of the patient, and secondly this data is matched with CT or MRI data using optimization algorithms. However, generally used ICP algorithm is very slow without a proper initial location and also suffers from local minimum problem. Usually, this problem is solved by manually providing the proper initial location before performing ICP. But, it has a disadvantage that an experience user has to perform the method and also takes a long time. In this paper, we propose a method that can accurately find the proper initial location automatically. The proposed method finds the proper initial location for ICP by converting 3D data to 2D curvature images and performing image matching. Curvature features are robust to the rotation, translation, and even some deformation. Also, the proposed method is faster than traditional methods because it performs 2D image matching instead of 3D point cloud matching.

• 대한의용생체공학회:의공학회지
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• 제40권5호
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• pp.206-214
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• 2019

Surgical methods and associated precision systems have been developed, but surgical procedures that require precise location and fine manipulation of the lesion remain a limitation. The combination of precision robot manipulation technology and 3D medical image navigation technology overcomes the limitations of minimally invasive surgery (MIS) and enables a more stable and successful operation. Surgical robots are surgical robots such as da Vince, and surgical robots using industrial robotic arms. There are various developments and researches of medical robots. In recent medical robot development, a new type of surgical robot based on an industrial robot arm capable of easily replacing the end effector according to the user's needs is being actively developed at home and abroad. Therefore, in this study, we developed safety and performance evaluation guideline for micro - surgical robots based on open robot platform using general purpose robot arm to help quality control of the medical device.

• 한국전산유체공학회지
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• 제15권2호
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• pp.41-46
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• 2010

In this paper, the fluid dynamic forces and performances of a moving airfoil in the low Reynolds number flow is addressed. In order to simulate the necessary propulsive force for the moving airfoil in a low Reynolds number flow, a lattice-Boltzmann method is used. The critical Reynolds and Strouhal numbers for the thrust generation are investigated for the four propulsion types. It was found that the Normal P&D type produces the largest thrust with the highest efficiency among the investigated types. The leading edge of the airfoil has an effect of deciding the force production types, whereas the trailing edge of the airfoil plays an important role in augmenting or reducing the instability produced by the leading edge oscillation. It is believed that present results can be used to decide the optimal propulsion types for the given Reynolds number flow.

• 전기학회논문지
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• 제57권3호
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• pp.518-526
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• 2008

The fuzzy self-tuning PID controller is a PID controller with a fuzzy logic mechanism for tuning its gains on-line. In this structure, the proportional, integral and derivative gains are tuned on-line with respect to the change of the output of system under control. This paper deals with two types of fuzzy self-tuning PID controllers, rule-based fuzzy PID controller and learning fuzzy PID controller. As a medical application of fuzzy PID controller, the proposed controllers were implemented and evaluated in a laparoscopic surgery robot system. The proposed fuzzy PID structures maintain similar performance as conventional PID controller, and enhance the position tracking performance over wide range of varying input. For precise approximation, the fuzzy PID controller was realized using the linear reasoning method, a type of product-sum-gravity method. The proposed controllers were compared with conventional PID controller without fuzzy gain tuning and was proved to have better performance in the experiment.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2006년도 추계학술대회 논문집 전기기기 및 에너지변환시스템부문
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• pp.218-221
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• 2006

This paper reports on a Realtime OS based motor control system for laparoscopic surgery robot which enables telesurgery and overcomes shortcomings with conventional laparoscopic surgery. The system has a conventional master-slave robot configuration and the control system consists of joint controllers, host controllers, and power units. The robot features (1) a compact slave robot with 5 DOF (Degree Of Freedom) expanding the workspace of each tool and increasing the number of tools operating simultaneously, and (2) direct 1:1 correspondence in the joint of master and slave robot that simplifies control algorithm and enhances reliability. Each master, slave and GUI (Graphical User Interface) host has a dedicated RTOS (RealTime OS), RTLinux-Pro (FSMLabs Inc., U.S.A.) Each master and slave controller set pair has a dedicated CAN (Controller Area Network) channel for control and monitoring signal communication. Total 4 pairs of the master/slave manipulators as current are monitored by one host controller for operation monitoring and higher level motion control. The system showed acceptable performance in both position control precision and master-slave motion synchronization and is now under further development for better safety and control fidelity for clinically applicable prototype.

• 대한기관식도과학회지
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• 제16권1호
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• pp.27-32
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• 2010

Organ preservation surgery and minimally invasive surgery have been developed during the past 20 years with major focus on transoral laser surgery, endoscopic surgery, and robotic surgery. Two major robotic surgeries in head and neck area are transoral robotic surgery (TORS) and robotic thyroidectomy. Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal. hypopharyngeal and laryngeal neoplasm. Advantages of the technique include adequate ability to visualize and manipulate lesions with two hands. TORS can provide magnified three dimensional views and overcome the limitation resulting from the "line of sight" which hinders transoral laser procedure. The swallowing function following transoral robotic surgery show superior and patients were able to retain or rapidly regain swallowing function in the majority of cases. Recently, robotic thyroidectomy has also been developed to overcome the [imitation of endoscopic thyroidectomy. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach using a da Vinci S Surgical Robot is a feasible and cosmetically excellent procedure. It can be a promising alternative to endoscopic thyroidectomy or conventional open thyroidectomy.

• Advances in pediatric surgery
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• 제17권1호
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• pp.72-80
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• 2011

Although laparoscopic surgery for hepatobiliary disease in children is possible, it is technically challenging. In an attempt to overcome these difficulties, the da Vinci Robotic Surgical System$^{(R)}$ was used to facilitate the minimally invasive treatment of choledochal Cyst in six children. In early consecutive three cases, we experienced three complications; a case of laparotomy conversion, a case of late stenosis of the hepaticojejunostomy, and a case of leakage from a hepaticojejunostomy. However, in the last three cases the complete resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy were performed using the robotic surgical system without complication. We think robot-assisted choledochal cyst resection in children appears safe and feasible, and may increase the variety of complex procedures in pediatric surgical fields.