• The Journal of Korea Robotics Society
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• v.14 no.3
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• pp.203-210
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• 2019

This paper proposes a hand-controller mechanism for manually controlled endoscopic surgical instruments. A wire-driven mechanism is typically adapted for endoscopic surgical tools because motors cannot be embedded to the joints due to the size limitation. The wire-driven mechanism requires length control of wires that are pulled and released according to the desired joint angle. It is difficult for the operator to control individual wire lengths intuitively. The hand-controller mechanism should be able to control the wires easily without complex processes. For this purpose, we propose a mechanism that can control the wire lengths with a simple mechanical structure and its optimal design method using genetic algorithm. We show the simulation and experimental results to confirm the proposed mechanism and design methods are useful for the manually controlled endoscopic surgical instrument.

• The Journal of Korea Robotics Society
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• v.16 no.2
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• pp.164-171
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• 2021

This paper proposes a continuum mechanism for manually controlled endoscopic surgical instruments. The wire-driven mechanism is typically adapted for endoscopic surgical tools because motors cannot be embedded to the joints due to the size limitation. However, the conventional wire-driven mechanism has inherent problems caused by redundancy, such as deflection and low precision. It does not have operating force and manipulability for surgery. Therefore, a method to increase the force of the continuum mechanism using a multi-wire with simple mechanical structure is proposed. Moreover, for intuitive operation, a hand-controller mechanism that can manipulate the length of the wire without complex process is proposed. Finally, we show that the proposed mechanism and methods are applicable to endoscopic surgical tools through simple experiments.

• Journal of Chest Surgery
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• v.45 no.4
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• pp.260-262
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• 2012

Postpneumonectomy empyema is a life-threatening complication, which is often related with a bronchopleural fistula. After surgical repair of fistula, sterilization of infected pleural cavity is important and usually carried out by long-term cyclic irrigation. We report a case in which vacuum-assisted closure device was successfully applied to sterilize the pleural cavity and obliterate bronchopleural fistula.

• Archives of Plastic Surgery
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• v.47 no.1
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• pp.20-25
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• 2020

Background Ultrasonic dissection devices cause less thermal damage to the surrounding tissue than monopolar electrosurgical devices. We compared the effects of using an ultrasonic dissection device or an electrocautery device during prosthetic breast reconstruction on seroma development and short-term postoperative complications. Methods We retrospectively reviewed the medical records of patients who underwent implant-based reconstruction following mastectomy between March 2017 and September 2018. Mastectomy was performed by general surgeons and reconstruction by plastic surgeons. From March 2017 to January 2018, a monopolar electrosurgical device was used, and an ultrasonic dissection device was used thereafter. The other surgical methods were the same in both groups. Results The incidence of seroma was lower in the ultrasonic dissection device group than in the electrocautery group (11 [17.2%] vs. 18 [31.0%]; P=0.090). The duration of surgery, total drainage volume, duration of drainage, overall complication rate, surgical site infection rate, and flap necrosis rate were comparable between the groups. Multivariate analysis revealed that the risk of seroma development was significantly lower in the ultrasonic dissection device group than in the electrocautery group (odds ratio for electrocautery, 3.252; 95% confidence interval, 1.242-8.516; P=0.016). Conclusions The findings of this study suggest that the incidence of seroma can be reduced slightly by using an ultrasonic dissection device for prosthesis-based breast reconstruction. However, further randomized controlled studies are required to verify our results and to assess the cost-effectiveness of this technique.

• The Journal of the Korean dental association
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• v.51 no.12
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• pp.650-657
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• 2013

The aim of this study was to achieve healing of Peri-implantitis defects and hard tissue augmentation using a bovine-derived bone mineral on the defect site. Two patients were treated with the surgical approach. With a full muco-periosteal flap elevation, the implant surfaces were exposed and granulation tissue removed around the implant and between the threads. Each surface of the contaminated implant was prepared with the air-abrasive device(PerioFlow$^{(R)}$) for decontamination. Bovine-derived bone mineral(Bio-Oss collagen$^{(R)}$) was then used to fill the defects and muco-periosteal flaps sutured to achieve transmucosal healing. Radiographs and clinical photographs were taken before and after 6 months of healing and an estimate of bone fill was assessed. Within the limits of the present case report, a surgical approach in treatment of peri-implantitis defects using a collagen form of bovine bone mineral was visited. Although limited, the two cases showed the stability and biocompatibility of a bovine-derived bone mineral and effectiveness of air-abrasive device(PerioFlow$^{(R)}$) as a decontamination method.

• Journal of Korean Neurosurgical Society
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• v.59 no.2
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• pp.91-97
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• 2016

Objective : To investigate the biomechanical effects of a newly proposed Interspinous Process Compressor (IPC) and compare with pedicle screw fixation at surgical and adjacent levels of lumbar spine. Methods : A three dimensional finite element model of intact lumbar spine was constructed and two spinal fusion models using pedicle screw fixation system and a new type of interspinous devices, IPC, were developed. The biomechanical effects such as range of motion (ROM) and facet contact force were analyzed at surgical level (L3/4) and adjacent levels (L2/3, L4/5). In addition, the stress in adjacent intervertebral discs (D2, D4) was investigated. Results : The entire results show biomechanical parameters such as ROM, facet contact force, and stress in adjacent intervertebral discs were similar between PLIF and IPC models in all motions based on the assumption that the implants were perfectly fused with the spine. Conclusion : The newly proposed fusion device, IPC, had similar fusion effect at surgical level, and biomechanical effects at adjacent levels were also similar with those of pedicle screw fixation system. However, for clinical applications, real fusion effect between spinous process and hooks, duration of fusion, and influence on spinous process need to be investigated through clinical study.

• The Journal of the Korean dental association
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• v.49 no.8
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• pp.443-450
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• 2011

The leading paradigm of dentistry had been focused on the rehabilitation treatment that identifies active caries, manages them surgically, and restores their original functions. However, changes in the external environment including the current disease prevalence require dentistry to have a paradigm shift. The new paradigm suggests the detection of caries in their earlier stages over the visual diagnosis of cavities, and the reversal of the incipient caries by non-surgical approach. For this to be achieved, a high-technology detection device recognizing changes in the earlier stages which can not he visually observed is needed. Development of early caries detection device has recently become a major issue in preventive dentistry on account of this need, and QLF(Quantitified Light induced Fluorescence) conspicuously stands out among the newly released devices. In this study, the fundamental concept of QLF(Quantitified Light induced Fluorescence) and the possible clinical applications of the earlier intraoral camera model as well as the recently designed digital camera model will be discussed.

• Journal of the Korean Society for Precision Engineering
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• v.21 no.8
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• pp.157-163
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• 2004

Scoliosis is a complex musculoskeletal dieses requiring 3-D treatment with surgical instrumentation. To investigate the effects of correction surgery, a finite element model of personalized model of the scoliotic spine that will allow the design of clinical test providing optimal estimation of the post-operation results was developed. Three dimensional skeletal parts, such as vertebrae, clavicle and scapular were modeled as rigid bodies with keeping their morphologies. Kinematical joints and spring elements were adapted to represent the inter-vertebral disc and ligaments respectively. With this model, two types of surgery procedure, distraction procedure with Harrington device and rod derotation procedure with pedicle screw and rod system had been carried out. The obtained simulation results were comparatively corresponding to the post operational outcomes and successfully demonstrated qualitative analysis of surgical effectiveness. From this analysis, it has been found that the preparing of appropriate rod curvature and its insertion was more important than just performing the excessive derotation for scoliosis correction.

• Proceedings of the KSME Conference
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• 2004.11a
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• pp.714-719
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• 2004

This paper presents two numerical algorithms for registration of cross-sectional medical images such as CT (Computerized Tomography) or MRI (Magnetic Resonance Imaging) by using geometrical information from helix or line fiducials. The registration algorithms are designed to be used for a surgical robot working inside cavities of human body. A cylindrical device with a combination of line and helix fiducials were also devised and is supposed to be attached to the end-effector of surgical robot. The algorithms and the fiducial pattern were tested in various computer-simulated situations, and the results indicate excellent overall registration accuracy.

• Proceedings of the Korean Vacuum Society Conference
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• 2011.08a
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• pp.318-318
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• 2011

Electrosurgery has been widely used in surgical procedures for many years. The surgical procedure using radiofrequency power generated occasionally sparks causing electrical stimulations. According to a paper of commercialized APC (Argon Plasma Coagulation) in the gastrointestinal endoscopy, Patients treated by APC had experienced pain and neuromuscular stimulation. This study aimed to investigate the electrosurgery sparks. In this experiment, current threshold of electrosurgery using rf was investigated. Sparks analogous to surgical situation was generated and measured the I-V figure. Asymmetric current, observed by other researchers, was also measured. This could be explained by difference between positive phase and negative phase. Furthermore, a method was developed to remove asymmetric current and to make safer device for surgical field.