• Title/Summary/Keyword: Surgical Instruments

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Constrained High Accuracy Stereo Reconstruction Method for Surgical Instruments Positioning

  • Wang, Chenhao;Shen, Yi;Zhang, Wenbin;Liu, Yuncai
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.6 no.10
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    • pp.2679-2691
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    • 2012
  • 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.

Computer Integrated Surgical Robot System for Spinal Fusion

  • Kim Sungmin;Chung Goo Bong;Oh Se Min;Yi Byung-Ju;Kim Whee Kuk;Park Jong Il;Kim Young Soo
    • Journal of Biomedical Engineering Research
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    • v.26 no.5
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    • pp.265-270
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    • 2005
  • A new Computer Integrated Surgical Robot system is composed of a surgical robot, a surgical planning system, and an optical tracking system. The system plays roles of an assisting surgeon and taking the place of surgeons for inserting a pedicle screw in spinal fusion. Compared to pure surgical navigation systems as well as conventional methods for spinal fusion, it is able to achieve better accuracy through compensating for the portending movement of the surgical target area. Furthermore, the robot can position and guide needles, drills, and other surgical instruments or conducts drilling/screwing directly. Preoperatively, the desired entry point, orientation, and depth of surgical tools for pedicle screw insertion are determined by the surgical planning system based on CT/MR images. Intra-operatively, position information on surgical instruments and targeted surgical areas is obtained from the navigation system. Two exemplary experiments employing the developed image-guided surgical robot system are conducted.

Development of Air-powered Handpiece for Surgical Operation (외과 수술용 Air-Powered Handpiece 개발)

  • 윤길상;이영훈;허영무;서태일;최길운
    • Journal of the Korean Society for Precision Engineering
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    • v.21 no.3
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    • pp.188-193
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    • 2004
  • The purpose of this paper is concerned with a development of an air-powered handpiece for surgical operation. The handpiece is the tool of surgical instruments and it can be used to interchange multiple attachments for drilling, pinning, sawing, driving screws and reaming. Most of domestic medical instruments bring in overseas and the air-powered handpiece imported from foreign countries at 100% too. Therefore we develop new air powered handpiece. we research in 2D and 3D modeling, design of air line, analyze structure. The air-powered handpiece composes of body, power supply air-line, elements for mechanical power transmission, attachment, and surgical tools. The handpiece is developed by several processes that 3D design, machining, heat treatment and coating. The developed handpiece is experimented to confirm check the efficiency.

Possibility of Local Recurrence Caused by Surgical Instruments in the Mouse Skin Cancer Model (백서 모델에서 수술 기구를 통한 피부악성종양의 국소 재발 가능성)

  • Kim, Gook-Jin;Lee, Hyoung-Suk;Kim, Nam-Gyun;Lee, Kyung-Suk;Kim, Jun-Sik;Park, Sang-Woo
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.339-344
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    • 2011
  • 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 DMBA-TPA 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.

Augmented Reality-based Surgical Nursing Practice Application Development and Evaluation (증강현실 기반의 수술간호 실습교육 애플리케이션 개발 및 평가)

  • Ko, Jung-Yon;Jung, Ae-Ri
    • Journal of Convergence for Information Technology
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    • v.11 no.2
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    • pp.47-56
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    • 2021
  • The purpose of this research was to develop an augmented reality-based surgical nursing practice education application. The research proceeded in ADDIE order of analysis, design, development, implementation, and evaluation stages. In the analysis phase, we analyzed the surgical nursing learning needs of the expert group and nursing student group. As a result of the analysis, the demand for surgical instruments was generally high. We selected 51 surgical instruments of the 7 categories most frequently used in the operating room based on the needs, and produced them as AR Book. The augmented reality application was created based on the Unity 3D engine, and the application was built with Android OS so that the target person could use it. Expert assessment of application for augmented reality-based surgical nursing practice education application showed 73.4±4.3 out of 80. This study is significant in the part that first developed a new method of learning tools for surgical instruments. We determined that an augmented reality-based application has reality, portability, accessibility and simplicity.

Instruments to Assess Physical Impairments in Post-Intensive Care Syndrome: A Systematic Review (집중치료 후 증후군의 신체적 장애 측정도구에 관한 체계적 고찰)

  • Kang, Jiyeon;Lee, Minju;Jeong, Yeon Jin;Kim, Soo Kyung;Cho, Young Shin;Park, Jung Hoon;Lee, Soon;Hong, Ji Won
    • Journal of Korean Critical Care Nursing
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    • v.11 no.1
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    • pp.46-66
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    • 2018
  • Purpose : The purpose of this study was to systematically review the instruments utilized to assess physical impairment in post-intensive care syndrome (PICS) of intensive care unit (ICU) survivors. Method : Online databases searched were MEDLINE, Cochrane, CINAHL, and Embase. Studies that met the following criteria were included: 1) the study population exclusively had experience with ICU admission; 2) the study assessed pulmonary, neuromuscular, and physical functions; and 3) the study was published in English language journals after 2007. Results : A total of 56 instruments (2 pulmonary, 25 neuromuscular, 29 physical function) from 94 studies were reviewed. They were classified into self-report, observation, and measurement according to the type of assessment. No instrument measured all 3 areas of physical impairment. Five instruments were originally developed for the ICU patients. The most frequently applied instruments were the Medical Research Council and the 36-item Short Form Survey (physical component summary), which were used in 23 studies each. Only 13.8% of reviewed studies reported the reliability or validity of the instruments. Conclusion : Our results suggest that the appropriateness of instruments assessing physical impairment in PICS cannot be guaranteed. Despite the multidimensional concept of physical disabilities, most studies measured only one area, and studies that reported psychometric properties were limited. Accordingly, we propose to develop a unique and multifaceted instrument for ICU survivors.

Superciliary Keyhole Approach for Unruptured Anterior Circulation Aneurysms : Surgical Technique, Indications, and Contraindications

  • Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.56 no.5
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    • pp.371-374
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    • 2014
  • Neurosurgeons have been trying to reduce surgical invasiveness by applying minimally invasive keyhole approaches. Therefore, this paper clarifies the detailed surgical technique, its limitations, proper indications, and contraindications for a superciliary keyhole approach as a minimally invasive modification of a pterional approach. Successful superciliary keyhole surgery for unruptured aneurysms requires an understanding of the limitations and the use of special surgical techniques. Essentially, this means the effective selection of surgical indications, usage of the appropriate surgical instruments with a tubular shaft, and refined surgical techniques, including straightforward access to the aneurysm, clean surgical dissection, and the application of clips with an appropriate configuration. A superciliary keyhole approach allows unruptured anterior circulation aneurysms to be clipped safely, rapidly, and less invasively on the basis of appropriate surgical indications.

Radiological and Clinical Results of Laminectomy and Posterior Stabilization for Severe Thoracolumbar Burst Fracture : Surgical Technique for One-Stage Operation

  • Kim, Myeong-Soo;Eun, Jong-Pil;Park, Jeong-Soo
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.224-230
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    • 2011
  • Objective : This study aimed to show the possibility of neural canal enlargement and restoration of bony fragments through laminectomy and minimal facetectomy without pediculectomy or an anterior approach, and also to prove the adequacy of posterior stabilization of vertebral deformities after thoracolumbar bursting fracture. Methods : From January 2003 to June 2009, we experienced 45 patients with thoracolumbar burst fractures. All patients enrolled were presented with either a neural canal compromise of more than 40% with a Benzel-Larson Grade of VI, or more than 30% compromise with less than a Benzel-Larson Grade of V. Most important characteristic of our surgical procedure was repositioning retropulsed bone fragments using custom-designed instruments via laminectomy and minimal facetectomy without removing the fractured bone fragments. Beneath the dural sac, these custom-designed instruments could push the retropulsed bone fragments within the neural canal after the decompression and bone fragment repositioning. Results : The mean kyphotic deformities measured preoperatively and at follow-up within 12 months were 17.7 degrees (${\pm}6.4$ degrees) and 9.6 degrees (${\pm}5.2$ degrees), respectively. The mean midsagittal diameter improved from 8.8 mm (${\pm}2.8$ mm) before surgery to 14.2 mm (${\pm}1.6$ mm) at follow-up. The mean traumatic vertebral body height before surgery was 41.3% (${\pm}12.6%$). At follow-up assessment within 12 months, this score showed a statistically significant increase to 68.3% (${\pm}12.8%$). Neurological improvement occurred in all patients. Conclusion : Though controversy exists in the treatment of severe thoracolumbar burst fracture, we achieved effective radiological and clinical results in the cases of burst fractures causing severe canal compromise and spinal deformity by using this novel custom-designed instruments, via posterior approach alone.

Fifty Years of Innovation in Plastic Surgery

  • Kwasnicki, Richard M;Hughes-Hallett, Archie;Marcus, Hani J;Yang, Guang-Zhong;Darzi, Ara;Hettiaratchy, Shehan
    • Archives of Plastic Surgery
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    • v.43 no.2
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    • pp.145-152
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    • 2016
  • Background Innovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years. Methods Patents and publications related to plastic surgery (1960 to 2010) were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored. Results Between 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued. Conclusions The application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active.

Biportal Endoscopic Spinal Surgery for Lumbar Intervertebral Disc Herniation (두 개의 입구를 통한 내시경 척추 수술: 요추부 추간판 탈출증에의 적용)

  • Lee, Ho-Jin;Choi, Dae-Jung;Park, Eugene J.
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.211-218
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    • 2019
  • Herniation of the intervertebral disc is a medical disease manifesting as a bulging out of the nucleus pulposus or annulus fibrosis beyond the normal position. Most lumbar disc herniation cases have a favorable natural course. On the other hand, surgical intervention is reserved for patients with severe neurological symptoms or signs, progressive neurological symptoms, cauda equina syndrome, and those who are non-responsive to conservative treatment. Numerous surgical methods have been introduced, ranging from conventional open, microscope assisted, tubular retractor assisted, and endoscopic surgery. Among them, microscopic discectomy is currently the standard method. Biportal endoscopic spinal surgery (BESS) has several merits over other surgical techniques, including separate and free handling of endoscopy and surgical instruments, wide view of the surgical field with small skin incisions, absence of the procedure of removing fog from the endoscope, and lower infection rate by continuous saline irrigation. In addition, existing arthroscopic instruments for the extremities and conventional spinal instruments can be used for this technique and surgery for recurred disc herniation is applicable because delicate surgical procedures are performed under a brightness of 2,700 to 6,700 lux and a magnification of 28 to 35 times. Therefore, due to such advantages, BESS is a novel technique for the surgical treatment of lumbar disc herniation.