• 제목/요약/키워드: robot surgery

검색결과 129건 처리시간 0.026초

Similar Operative Outcomes between the da Vinci Xi® and da Vinci Si® Systems in Robotic Gastrectomy for Gastric Cancer

  • Alhossaini, Rana M.;Altamran, Abdulaziz A.;Choi, Seohee;Roh, Chul-Kyu;Seo, Won Jun;Cho, Minah;Son, Taeil;Kim, Hyung-Il;Hyung, Woo Jin
    • Journal of Gastric Cancer
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    • 제19권2호
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    • pp.165-172
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    • 2019
  • Purpose: The robotic system for surgery was introduced to gastric cancer surgery in the early 2000s to overcome the shortcomings of laparoscopic surgery. The more recently introduced da Vinci $Xi^{(R)}$ system offers benefits allowing four-quadrant access, greater range of motion, and easier docking through an overhead boom rotation with laser targeting. We aimed to identify whether the $Xi^{(R)}$ system provides actual advantages over the $Si^{(R)}$ system in gastrectomy for gastric cancer by comparing the operative outcomes. Materials and Methods: We retrospectively reviewed all patients who underwent robotic gastrectomy as treatment for gastric cancer from March 2016 to March 2017. Patients' demographic data, perioperative information, and operative and pathological outcomes were collected and analyzed. Results: A total of 109 patients were included in the $Xi^{(R)}$ group and 179 in the $Si^{(R)}$ group. Demographic characteristics were similar in both groups. The mean operative time was 229.9 minutes in the $Xi^{(R)}$ group and 223.7 minutes in the $Si^{(R)}$ group. The mean estimated blood loss was 72.7 mL in the $Xi^{(R)}$ group and 62.1 mL in the $Si^{(R)}$ group. No patient in the $Xi^{(R)}$ group was converted to open or laparoscopy, while 3 patients in the $Si^{(R)}$ group were converted, 2 to open surgery and 1 to laparoscopy, this difference was not statistically significant. Bowel function was resumed 3 days after surgery, while soft diet was initiated 4 days after surgery. Conclusions: We found no difference in surgical outcomes after robotic gastrectomy for gastric cancer between the da Vinci $Xi^{(R)}$ and da Vinci $Si^{(R)}$ procedures.

AESOP을 이용한 좌측 최소개흉술하 동맥하형 심실중격 결손증 교정술 - 1예 보고 - (Repair of the Subarterial Type of VSD via a Left Minithoracotomy with using AESOP - A case report -)

  • 문덕환;이재원;조현진;제형곤;정성호;주석중;송현;정철현
    • Journal of Chest Surgery
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    • 제41권5호
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    • pp.630-632
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    • 2008
  • AESOP (Automated Endoscope System for Optimal Positioning)을 이용한 최소 침습적 심장 수술은 고식적인 정중흉골 절개술을 이용한 심장 수술에 비하여 수술 상처가 작고, 수술 후 환자의 회복이 빠르며, 입원 기간을 단축시키는 등의 장점이 알려져 있다. 저자들은 26세 여자 환자에서 좌측 최소 개흉술을 이용한 동맥하형 심실중격 결손증의 교정수술을 성공적으로 시행하였기에 문헌고찰과 함께 보고하는 바이다.

Hybrid Robotic and Laparoscopic Gastrectomy for Gastric Cancer: Comparison with Conventional Laparoscopic Gastrectomy

  • Kim, So Jung;Jeon, Chul Hyo;Jung, Yoon Ju;Seo, Ho Seok;Lee, Han Hong;Song, Kyo Young
    • Journal of Gastric Cancer
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    • 제21권3호
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    • pp.308-318
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    • 2021
  • Purpose: The benefits of robotic gastrectomy remain controversial. We designed this study to elucidate the advantages of a hybrid robot and laparoscopic gastrectomy over conventional laparoscopic surgery. Materials and Methods: A total of 176 patients who underwent gastrectomy for gastric cancer were included in this study. We compared 88 patients treated with hybrid robotic and laparoscopic gastrectomy (HRLG) and 88 patients who underwent conventional laparoscopic gastrectomy (CLG). In HRLG, suprapancreatic lymph node (LN) dissection was performed in a robotic setting. Clinicopathological characteristics, operative details, and short-term outcomes were analyzed for the patients. Results: The number of LNs retrieved from the suprapancreatic area was significantly greater in the HRLG group (11.27±5.46 vs. 9.17±5.19, P=0.010). C-reactive protein levels were greater in the CLG group on both postoperative day (POD) 1 (5.11±2.64 vs. 4.29±2.38, P=0.030) and POD 5 (9.86±6.51 vs. 7.75±5.17, P=0.019). In addition, the neutrophil-to-lymphocyte ratio was significantly greater in the CLG group on both POD 1 (7.44±4.72 vs. 6.16±2.91, P=0.031) and POD 5 (4.87±3.75 vs. 3.81±1.87, P=0.020). Pulmonary complications occurred only in the CLG group (4/88 [4.5%] vs. 0/88 [0%], P=0.043). Conclusions: HRLG is superior to CLG in terms of suprapancreatic LN dissection and postoperative inflammatory response.

The Feasibility and Future Prospects of Robot-Assisted Surgery in Gastric Cancer: Consensus Comments from the National Evidence-based Collaborating Agency Round-Table Conference

  • Shin, Eunhee;Choi, Jieun;Seo, Seongwoo;Lee, SeonHeui
    • 보건행정학회지
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    • 제25권2호
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    • pp.67-70
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    • 2015
  • To establish an appropriate policy for robotic surgery in Korea, the National Evidence-based Collaborating Agency (NECA) and the Korean Society of Health Policy and Administration held a round-table conference (RTC) to gather opinions through a comprehensive discussion of scientific information in gastric cancer. The NECA RTC is a public discussion forum wherein experts from diverse fields and members of the lay public conduct in-depth discussions on a selected social issue in the health and medical field. For this study, representatives from the medical field, patient groups, industry, the press, and policy makers participated in a discussion focused on the medical and scientific evidence for the use of robotic surgery in gastric cancer. According to the RTC results, robotic surgery showed more favorable results in safety and efficacy than open surgery and it is similar to laparoscopy. When the cost-effectiveness of robotic surgery and laparoscopy is compared, robotic surgery costs are higher but there was no difference between the two of them in terms of effectiveness (pain, quality of life, complications, etc.). In order to resolve the high cost issue of the robotic surgery, a proper policy should be implemented to facilitate the development of a cost-effective model of the robotic surgery equipment. The higher cost of robotic surgery require more evidence of its safety and efficacy as well as the cost-effectiveness issues of this method. Discussions on the national insurance coverage of robotic surgery seems to be necessary in the near future.

Novel Clean End-to-End Anastomosis Method, Without Opening the Stomach Lumen, in Totally Laparoscopic or Robotic Pylorus-Preserving Gastrectomy

  • Takashi Mitsui;Kazuyuki Saito;Yuhei Hakozaki;Yoshiyuki Miwa;Takuji Noro;Emiko Takeshita;Taizen Urahashi;Yasuyuki Seto;Takashi Okuyama;Hideyuki Yoshitomi
    • Journal of Gastric Cancer
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    • 제23권4호
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    • pp.523-534
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    • 2023
  • Purpose: Intra-abdominal infection is a common postoperative complication of laparoscopic pylorus-preserving gastrectomies (PPGs). Many studies have reported that intra-abdominal infectious complications after gastrectomy adversely affect patient survival outcomes. To prevent gastric fluid leakage into the abdominal cavity, we developed a novel anastomosis method in which the stomach lumen is not opened (termed the non-opened clean end-to-end anastomosis method [NoCEAM]) and evaluated its feasibility. Materials and Methods: Subsequent to lymphadenectomy, the oral and anal resection lines were sutured using an intraoperative endoscope. After closing the stomach circumferentially with clips, the specimen was rolled outward like a "donut." We resected the specimen circumferentially using a linear stapler, and anastomosis was completed simultaneously. We examined the feasibility of this procedure ex vivo, using three porcine stomachs, and in vivo, using one pig. Subsequently, we applied the procedure to 13 consecutive patients with middle-third early gastric cancer utilizing laparotomic, laparoscopic, and robotic PPG. Results: NoCEAM was completed in all porcine models and human cases. In the human cases, the mean operation time (±standard deviation) was 279±51 minutes, and mean blood loss volume was 22±45 mL. The mean number of linear staples used was 5.06±0.76. None of the patients had complications, and all were discharged on the eighth postoperative. The serum total protein, serum albumin, and hemoglobin levels did not change significantly after surgery. Conclusions: NoCEAM is feasible and safe for performing totally laparoscopic or robotic PPG. It may reduce postoperative complications, such as intra-abdominal infections.

범용 로봇팔과 모듈러 햅틱 컨트롤러를 사용한 수술 로봇 시스템 개발 (Development of a Robotic Surgery System using General Purpose Robotic Arm and Modular Haptic Controller)

  • 이재봉;진상록;이승준
    • 로봇학회논문지
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    • 제15권2호
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    • pp.131-138
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    • 2020
  • This paper proposes a low-cost robotic surgery system composed of a general purpose robotic arm, an interface for daVinci surgical robot tools and a modular haptic controller utilizing smart actuators. The 7 degree of freedom (DOF) haptic controller is suspended in the air using the gravity compensation, and the 3D position and orientation of the controller endpoint is calculated from the joint readings and the forward kinematics of the haptic controller. Then the joint angles for a general purpose robotic arm is calculated using the analytic inverse kinematics so that that the tooltip reaches the target position through a small incision. Finally, the surgical tool wrist joints angles are calculated to make the tooltip correctly face the desired orientation. The suggested system is implemented and validated using the physical UR5e robotic arm.

ER유체를 이용한 수술용 원격 제어 시스템의 힘 반사 제어부에 관한 연구 (A Study on Force Reflection Controller of Tele-Surgery Control System using ERF)

  • 신진오;이은준;박명관
    • 한국정밀공학회:학술대회논문집
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    • 한국정밀공학회 2000년도 추계학술대회 논문집
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    • pp.132-135
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    • 2000
  • The development of a robot system being able to work instead of human in the hazardous environment have been conducted for many year. In this study, the new design of controllers for the Master-Slave system is discussed. The Master-Slave system, force, velocity and torque signals are communicated between a master and a slave system. the conventional requires the enhancement of characteristics of tactility for minute force, precision signals and mechanical abrasion of loader. It is possible b controlling the viscosity of ERF(Electro-rheological fluid) since it varies with the electric field. Design of controller as well comparison between numerical simulation and experiments as will be presented. Futhermore, current methodology is also applicable to design of tele-surgery

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Computed tomography-guided 3D printed patient-specific regional anesthesia

  • Jundt, Jonathon S.;Chow, Christopher C.;Couey, Marcus
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제20권5호
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    • pp.325-329
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    • 2020
  • Classic anesthetic techniques for the inferior alveolar nerve, lingual nerve, and long buccal nerve blockade are achieved by estimating the intended location for anesthetic deposition based on palpation, inspection, and subsequent correlation for oral anatomical structures. The present article utilizes computed tomography (CT) data to 3D print a guide for repeatable and accurate deposition of a local anesthetic at the ideal location. This technical report aims to anatomically define the ideal location for local anesthetic deposition. This process has the potential to reduce patient discomfort, risk of nerve damage, and failed mandibular anesthesia, as well as to reduce the total anesthetic dose. Lastly, as robotic-based interventions improve, this provides the initial framework for robot-guided regional anesthesia administration in the oral cavity.