• 한국간담췌외과학회지
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• 제27권1호
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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.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2011년도 춘계학술대회 논문집
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• pp.383-384
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• 2011

• 제어로봇시스템학회논문지
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• 제22권8호
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• pp.615-618
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• 2016

This paper proposes a method to estimate vertical interaction force to the end of the surgical instrument by measuring reaction force at the part supporting the trocar. Relation between the force to the trocar and the interaction force is derived using the beam theory. The vertical interaction force is modeled as a function of the reaction force to the trocar and the distance between the drape plate and the trocar. Experimental results show that error is induced by the asymmetric shape of the trocar tip because contact position between the instrument and the trocar tip is changed depending on the direction of the interaction force. The theoretical relation, therefore, is compensated and reduced. Average $L_2$ relative error of the estimated force in the x-direction and the y-direction is 5.81 % and 5.99 %, respectively.

• 한국전기전자재료학회논문지
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• 제25권12호
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• pp.990-995
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• 2012

A piezoelectric ultrasonic bone surgical instrument, usually used to remove the tartar out of teeth or to cut the dentine of the tooth, is a recently popular instrument for dental treatment due to its several merits such as small size, low-electric power and precision control of surgical operation. It has typically two parts of a tip and vibration system which is also composed of head, piezoelectric elements and tail-mass. In order to improve the performance of the instrument, it is important to standardize the size of the vibration system without tip for high performance. In this study, a Finite Element Analysis (FEA) was utilized to optimize the structure of ultrasonic instrument in vibration system. Consequently, this study revealed that influence of several tips on property were minimized and it showed good property at the frequency range of 22~32 kHz.

• 로봇학회논문지
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• 제7권4호
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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.

• 대한의용생체공학회:의공학회지
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• 제44권2호
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• pp.109-117
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• 2023

In this study, the effect of the shape of the specimen and the feedrate of the dental ultrasonic surgical instrument on the cutting force and surface roughness of the specimen is analyzed. Experimental specimens were made of SAWBONES artificial bone materials in square and spherical specimens. In addition, the cutting feedrate of the surgical instrument was controlled through the developed moving system. The cutting force generated when cutting the specimen was measured through a force sensor. After the experiment, the cutting surface of the specimen was observed through a three-dimensional optical microscope and the surface roughness was measured. Through one-way ANOVA, the effect of each specimen shape and feed rate on surface roughness was analyzed. As a result of the experiment, the cutting force increased proportionally in the initial feed rate increase stage, but the increase in cutting force decreased as the feed rate continued to increase. Also, the cutting force showed a difference according to the shape of the specimen. The spherical specimen with a relatively small cutting surface area had less cutting force than the square specimen. However, as a result of one-way ANOVA, it was found that the specimen shape and feed rate did not affect the surface roughness. In future studies, it is expected to be used for comparative analysis of ultrasonic surgical instruments and correlation analysis between cutting factors.

• Archives of Plastic Surgery
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• 제38권4호
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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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권5호
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• pp.251-258
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• 2016

Objectives: The aim of this retrospective study was to investigate factors associated with increased difficulty in the surgical extraction of impacted lower third molars and to improve identification of difficult cases. Materials and Methods: A total of 680 patients who required 762 surgical extractions of impacted lower third molars from 2009 to 2014 were enrolled in the study. Demographic factors, clinical factors, radiographic factors, surgical extraction difficulty, and presumed causes of difficulty were collected. Data were statistically analyzed using IBM SPSS Statistics version 23. Results: Age, sex, depth of impaction, and blurred radiographic image influenced difficulty in surgical extraction. The position of the impacted tooth influenced surgical difficulty, especially when it was accompanied by other factors. Conclusion: It is challenging to design a reliable and practical instrument to predict difficulty in surgical extraction of impacted lower third molars. To identify very difficult cases, root investigation using computed tomography is advised when impacted tooth position suggests difficult extraction.

• 한국정밀공학회지
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• 제21권3호
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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.

• 한국정밀공학회지
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• 제30권4호
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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.