• Proceedings of the Korean Society of Precision Engineering Conference
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• 2009.06a
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• pp.965-966
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• 2009

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.2
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• pp.266-269
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• 2024

Choledochal cyst is a condition involving an abnormal dilation of the bile ducts, which can lead to various symptoms and comorbidities, including cancer. The treatment of choice for choledochal cyst is surgical correction including choledochal cyst excision and Roux-en-y hepaticoenterostomy. Minimal invasive methods like laparoscopic methods or robotic methods are used for surgical correction of choledochal cysts; however, it is still controversial which method is superior. A Korean company, LIVESMED, developed Artisential^®, a laparoscopic surgical instrument that can overcome the drawbacks of laparoscopic methods. This article presents a case of the first Artisential^®-performed surgical excision of a choledochal cyst and hepaticojejunostomy.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2010.11a
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• pp.779-780
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• 2010

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.1
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• pp.95-101
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• 2023

Rapid adoption of a robotic approach as a minimally invasive surgery tool has enabled surgeons to perform more complex hepatobiliary surgeries than conventional laparoscopic surgery. Although various types of liver resections have been performed robotically, parenchymal transection is challenging as commonly used instruments (Cavitron Ultrasonic Surgical Aspirator [CUSA] and Harmonic) lack articulation. Further, CUSA also requires a patient-side assistant surgeon with hepatobiliary laparoscopic skills. We present a case report of total robotic right hepatectomy for multifocal hepatocellular carcinoma in a 70-year-old male using 'Vessel Sealer' for parenchymal transection. Total operative time was 520 minutes with a blood loss of ~400 mL. There was no technical difficulty or instrument failure encountered during surgery. The patient was discharged on postoperative day five without any significant complications such as bile leak. Thus, Vessel Sealer, a fully articulating instrument intended to seal vessels and tissues up to 7 mm, can be a promising tool for parenchymal transection in a robotic surgery.

• Journal of Institute of Control, Robotics and Systems
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• v.20 no.8
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• pp.801-806
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• 2014

LAS (Laparoscopy Assisted Surgery) has been substituted alternatively for traditional open surgery. However, when using a commercialized robot assisted laparoscopic such as Da Vinci, surgeons have encountered some problems due to having to depend only on information by visual feedback. To solve this problem, a haptic function is required. In order to realize the haptic teleoperation system, a force feedback and bilateral control system are needed. Previous research showed that the perturbation value estimated by a SPO (Sliding Perturbation Observer) followed a reaction force that loaded on the surgical robot instrument. Thus, in this paper, the force feedback problem of surgical robots is solved through the reaction force estimation method. This paper then introduces the possibility of the haptic function realization of a laparoscopic surgery robot using a bilateral control system. For bilateral control, the master uses an impedance control and the slave uses a SMC (Sliding Mode Control). The experiment results show that a torque and force sensorless teleoperation system can be implemented using a bilateral control structure.

• Journal of Veterinary Clinics
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• v.28 no.1
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• pp.149-153
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• 2011

In this report, laparoscopic ovariohysterectomy (LOHE) was performed on two, healthy, intact female dogs. Three ports, umbilical port for placing the laparoscope and the left and right paramedian instrument ports were placed into the abdominal cavity. First, in order to isolate the right ovary, the vascular pedicle was coagulated by activating the universal bipolar forceps. Then, the pedicle and suspensory ligament were transected by the bipolar electrocauterization scissors. In the same manner, the left ovary was isolated. The uterine body and the uterine arteries were coagulated bilaterally and transected just rostral to the cervix. The isolated ovaries and uterus were exteriorized through the left paramedian instrument port, which was extended by approximately 1 cm to allow for tissue removal. The skin and subcutaneous tissue were closed in a routine manner. Surgical times for LOHE in two dogs were 35, 40 min respectively. Total length of abdominal incision was shorter than 3 cm in two dogs. No clinical complications related to the LOHE were observed during 1.5 years after surgery. The LOHE is an alternative surgical technique that deserves further investigation.

• The Journal of Korea Robotics Society
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• v.7 no.4
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• pp.267-275
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• 2012

When using commercialized robot assisted laparoscopic, surgeon has met some problems to depend only on image of the surgical field. To solve it, there were various researches. The previous study showed that it is possible to estimate the operation force on the commercialized instrument inside patient without sensors. To apply the estimated force to a haptic master console for the laparoscopy surgical robot system, the light haptic master console should be designed. This paper suggests the design of lighter master console handle to reduce a weight of the console whose structure can match with the joint and DOF of an instrument. A cable-conduit mechanism is designed to make light structure to perform a delicate manipulation. The cable-conduit mechanism removes the weight and inertia of link caused by haptic actuator and encoder which is separated from handle link of a manipulator.

• Journal of the Korean Society for Precision Engineering
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• v.30 no.4
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• pp.434-441
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• 2013

Bending motion has been used in the surgical instruments with bending structures and tendon mechanisms. A simplified bending angle amplification ratio between the proximal and distal bending joint was derived in this article. The bending structure of disk and rib in the proximal joint was analyzed based on finite element method with an emphasis on the circumferential uniformity of bending stiffness. Regarding the distal joint, optimal design and sensitivity analysis was done with four design variables of outer and inner diameter, rib height and rib width while maximizing the deformation under the stress distribution below the yield stress. Outer diameter and rib width are most critical to maximum deformation as the outer diameter and inner diameters are so to maximum equivalent stress.

• Journal of Institute of Control, Robotics and Systems
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• v.17 no.7
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• pp.685-696
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• 2011

An efficient laparoscope manipulator robot was designed to automatically control the position of laparoscope via a passive joint on end-effector position. The end position of the manipulator is controlled to have corresponding velocity defined in the global coordinate space using laparoscopic visual information. Desired spatial position of laparoscope was derived from detected positions of surgical instrument tips, then the clinical viewing plane was moved by visual servoing task. The laparoscope manipulator is advantageous for automatically maintaining clinically important views in the laparoscopic image without any additional operator. A laparoscope is mounted to a holder which is linked to four degree of freedom manipulator via universal joint-type passive rings connection. No change in the design of laparoscope or manipulator is necessary for its application to surgery assistant robot system. Expanded working space and surgical efficiency were accomplished by implementing slant linking structure between laparoscope and manipulator. To ensure reliable positioning accuracy and controllability, the motion of laparoscope in an abdominal space through trocar was inspected using geometrical analysis. A designed laparoscope manipulating robot system can be easily set up and controlled in an operation room since it has a few subsidiary devices such as a laparoscope light source regulator, a control PC, and a power supply.

• Journal of Veterinary Clinics
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• v.33 no.4
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• pp.214-217
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• 2016

A 10-year-old, 24.1 kg, intact female Siberian husky dog (case 1) and 11-year-old, 5.0 kg, intact male Shihtzu dog (case 2) presented with chief complaints of polydipsia, anorexia, vomiting and exercise intolerance (case 1) and stranguria (case 2). Splenic nodule (case 1) and mass (case 2) were identified in these patients through ultrasonographic examination. Laparoscopic splenectomy was conducted for the histopathologic evaluation. In addition, laparoscopic ovariohysterectomy, liver biopsy (case 1) and castration (case 2) were performed for treatment or diagnosis of primary symptoms. Under general anesthesia, 5 mm three-portal access laparoscopic splenectomy was performed using the Sonicision$^{TM}$ equipment. The dogs were rotated onto right lateral recumbency. The spleen was elevated using a fan or goldfinger retractor, which revealed the ventral aspect of the spleen. Resection of vessels was started at the caudal aspect of the spleen using the Sonicision$^{TM}$. The excised spleen was removed from the abdominal cavity using a 12 mm endo-bag via the enlarged instrument portal. There were no post-operative complications in either patient. Histopathologic diagnoses were splenic lymphoid hyperplasia (case 1) and splenic nodular hyperplasia (case 2). Based on our experience, laparoscopic splenectomy is sufficient to replace traditional splenectomy in small animal surgery. The use of the Sonicision$^{TM}$ could be a novel surgical technique for three-portal laparoscopic splenectomy, regardless of patient size.