• 제목/요약/키워드: 최소침습

검색결과 217건 처리시간 0.037초

갑상선 전절제술 과거력이 있는 부갑상선 선종 환자에서 수술 중 초음파 검사를 이용한 최소침습 부갑상선 절제술 1예 (Minimally Invasive Parathyroidectomy using Intraoperative Ultrasonography in Parathyroid Adenoma Patients with a History of Total Thyroidectomy)

  • 남윤빈;정현택;이상목;김지훈
    • 대한두경부종양학회지
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    • 제39권2호
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    • pp.27-30
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    • 2023
  • A 65-year-old patient who underwent total thyroidectomy 10 years ago was suspected of having a parathyroid adenoma, and minimally invasive parathyroidectomy was planned. Preoperative ultrasonography(USG) and 99mTc MIBI scan indicated a left lower parathyroid lesion. In the first operation, intraoperative parathyroid hormone monitoring (IOPTH) was not possible due to hospital circumstances. Although no adenomatous lesion was found in the expected surgical field, surgery was completed after removing lesions around the left lower parathyroid gland. However, post-surgery, parathyroid hormone did not decrease at all, so a second operation was performed with IOPTH preparation. In the second operation, intraoperative ultrasonography was performed, and a suspected adenoma lesion was removed from the left upper lesion. He has been under follow-up for 3 years without complications. Surgeon-peformed intraoperative USG and preoperative scintigraphy had advantages in determining the localization of parathyroid lesion even withiout IOPTH.

의료용 햅틱 마스터의 동적 모델링과 힘 반향 제어 (Dynamic Modeling and Repulsive Force Control of Medical Hpatic Master)

  • 오종석;최승복
    • 한국소음진동공학회논문집
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    • 제22권3호
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    • pp.284-290
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    • 2012
  • In this research, a new type of haptic master device using electrorheological(ER) fluid for minimally invasive surgery(MIS) is devised and control performance of the proposed haptic master is evaluated. The proposed haptic master consists of ER bi-directional clutch/brake for 2 DOF rotational motion(X, Y) using gimbal structure and ER brake on the gripper for 1 DOF rotational motion (Z). Using Bingham characteristic of ER fluid and geometrical constraints, principal design variables of the haptic master are determined. Then, the generation of torque of the proposed master is experimentally evaluated as a function of applied field of voltage. A sliding mode controller which is robust to uncertainties is then designed and empirically realized. It has been demonstrated via experiment that the proposed haptic master associated with the controller can be effectively applied to MIS in real field conditions.

복강경 수술을 위한 지능형 작동기의 제작 (Design of Dexterous Manipulator for MIS)

  • 송호석;정종하;이정주
    • 대한기계학회:학술대회논문집
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    • 대한기계학회 2004년도 추계학술대회
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    • pp.823-828
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    • 2004
  • Minimally Invasive Surgery (MIS) is surgery of the chest, abdomen, spine and pelvis, done with the aid of a viewing scope, and specially designed instruments. Benefits of minimally invasive surgery are less pain, less need for post-surgical pain medication, less scarring and less likelihood for incisional complications. Since the late 1980's, minimally invasive surgery has gained widespread acceptance because of the such advantages. However there are significant disadvantages which have, to date, limited the applications for these promising techniques. The reasons are limited degree-of-freedom, reduced dexterity and the lack of tactile feeling. To overcome such disadvantages many researchers have endeavored to develop robotic systems. Even though some robot aided systems achieved success and commercialized, there still remain many thing to be improved. In this paper, the robotic system which can mimic whole motions of a human arm by adding additional DOF is presented. The suggested design is expected to provide surgeons with improved dexterity during minimally invasive surgery.

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우심실 보조장치 하의 심장박동 상태에서 시행한 관상동맥 우회수술 -2례 보고- (Right Heart Support in OPCAB -2 cases Report-)

  • 조석기;김기봉
    • Journal of Chest Surgery
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    • 제33권11호
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    • pp.906-909
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    • 2000
  • 심폐바이패스를 사용하지 않고 심장박동 상태에서 시행하는 관상동맥 우회수술은 심 비대와 좌심실 기능저하가 동반된 협증심 환자에서는 심장 뒤쪽에 위치한 관상동맥에 대한 접근이 어렵고 수술 중 혈역학적으로 불안정하여 시행하기에 어려운 경우가 많다. 우심실 보조장치 하의 심장박동 상태에서 시행하는 관상동맥 우회수술은 대동맥의 삽관을 피하고, 심폐바이패스의 합병증을 줄일 수 있으며, 심장 뒤쪽에 위치한 혈관의 문합시에도 안정된 혈역학적 상태를 유지 할 수 있어 고위험군 환자에게 도움을 줄 수 있다. 좌심실 기능저하와 심 비대가 동반된 환자에서 우심실 보조장치 하의 심장박동 상태에서 시행한 관상동맥 우회수술을 2례 시행하여 좋은 결과를 얻어 보고하고자 한다.

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전기유변 유체를 이용한 햅틱 마스터와 가상의 최소침습수술 환경과의 연동제어 (Force-feedback Control of an Electrorheological Haptic Device in MIS Virtual Environment)

  • 강필순;한영민;최승복
    • 한국소음진동공학회논문집
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    • 제16권12호
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    • pp.1286-1293
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    • 2006
  • This paper presents force-feedback control performance of a haptic device in virtual environment of minimally invasive surgery(MIS). As a first step, based on an electrorheological (ER) fluid and spherical geometry, a new type of master device is developed and integrated with a virtual environment of MIS such as a surgical tool and human organ. The virtual object is then mathematically formulated by adopting the shape retaining chain linked(S-chain) model. After evaluating reflection force, computational time, and compatibility with real time control, the virtual environment of MIS is formulated by interactivity with the ER haptic device in real space. Tracking control performances for virtual force trajectory are presented in time domain.

상부 종격동 및 식도의 최소 침습적 수술 (Minimally Invasive Surgery in Esophagus and Upper Mediastinum)

  • 강창현
    • 대한기관식도과학회지
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    • 제16권1호
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    • pp.11-15
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    • 2010
  • Minimally invasive surgery (MIS) has several advantages over conventional open surgery. Less pain, less morbidity, early recovery and better cosmetic outcomes are well-known benefits of MIS. However, indications of MIS are highly dependent on the experience of surgeon and the disease status, In the benign diseases with less surgical complexity, MIS can be performed relatively and safely. However. in advanced malignant diseases which require more complex surgical manipulation, the of patients and the principles of oncologic surgery should be considered before the selection of surgical methods, MIS would be performed more and more with aid or technologic advancement. However, long-term result with equivalent oncologic outcomes to open surgery is necessary to be one of standard surgical treatments in thoracic surgery.

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물리 엔진을 이용한 수술 로봇의 동작 범위 분석 시스템 개발 (Development of the Workspace-Analysis System of Invasive Robot using Physics Engine)

  • 김도윤;박현근;서재용;조영호
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2008년도 제39회 하계학술대회
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    • pp.1797-1798
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    • 2008
  • 환자의 환부를 최소한으로 절개하여 시술하는 최소 침습 수술 수술은 많은 장점을 가지고 있어 그 활용도가 점차 확대되고 있다. 하지만 조작하는 조직으로부터 눈과 손이 분리되어 있기 때문에 많은 문제점들이 발생한다. 그 중 하나는 수술 영역과 시각 영역이 분리되어 발생하는데, 최적의 위치조정을 위한 자동 복강경 수술 로봇 팔 시스템 도입으로 이러한 문제를 해결하고 있다. 본 연구에서는 복강경 수술 로봇 팔을 설계하는데 있어 동작 범위를 빠르게 시각화하여 설계 단계에서 다양한 파리미터를 적용하여 보다 효율적인 복강경 수술 로봇 팔의 설계 방법을 제시한다. 제안된 물리 엔진을 이용한 동작 범위 분석 방법은 역기구학을 계산할 필요가 없으며, 설계가 바뀌어도 추가로 산출해야 하는 수식 없이 바로 수정된 기구학만으로 동작 범위 분석이 가능하다.

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최소 침습 수술을 위한 유연한 촉각 센서 (Flexible tactile sensor for minimally invasive surgery)

  • 이준우;유용경;한성일;김천중;이정훈
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2015년도 제46회 하계학술대회
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    • pp.1229-1230
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    • 2015
  • Monitoring of mechanical properties of tissues as well as direction/quantities of forces is considered as an essential way for disease diagnosis and haptic feedback systems. There are extensively increasing interests for measuring normal/shear force and touch feelings, especially for surgery systems. Highly sensitive and flexible tactile sensor is needed in palpation for detecting cancer cyst as well as real time pressure monitoring in minimally invasive surgery (MIS). Importantly, MEMS technique with miniaturized fabrication technique is essential for the on-chip integration with biopsy and biomedical grasper. Here, we propose the flexible tactile sensor with high sensitivity based on piezoresistive effect. We analyzed the sensitivity according to the pressure and directions and showed the ability of discrimination of the different materials surfaces, illustrating the feasibility of the flexible tactile sensor for biomedical grasper by mimicking human skin.

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GRIN 렌즈로 구성된 주사방식의 내시현미경 대물렌즈의 설계 (Design of an Endoscopic Microscope Objective Composed of GRIN(Gradient-Index) Lens with Scanning Devices)

  • 김경정;임천석
    • 한국광학회지
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    • 제20권6호
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    • pp.311-318
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    • 2009
  • 본 논문에서는, 2가지 종류의 광학보정소자에 의해 고차의 구면수차와 상면만곡이 보정된, 서브마이크론 (1.0 ${\mu}m$이하)의 광학 분해능을 갖는 매력적인 실시간 in-vivo 내시현미경을 소개한다. 덧붙여 소개된 내시현미경은 대물렌즈부의 직경이 1 mm인 GRIN (Gradient Index) 렌즈로 구성되어 있기 때문에 최소 침습적인 장점도 갖고 있다.

최소침습수복의 전통과 전망 (Perspectives on minimally invasive restoration)

  • 이양진
    • 대한치과의사협회지
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    • 제49권2호
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    • pp.85-94
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    • 2011
  • In the filed of Dentistry, minimally invasive treatment modalities are new trend for conservation of natural teeth. Of them, laminate veneer and resin bonded fixed partial denture belong to restoration procedures. In this review, survival rates of each modalities and cause of unserviceability are analyzed, and criteria for success are presented. To get successful results of minimally invasive restoration, plenty of enamel layer, thin and strong materials, and high bonding strength are essential under cyclically loaded wet oral condition. Newly tried design of minimally invasive technique nowadays have to be evaluated only on the basis of requirement for long-term success.