• Journal of Korean Critical Care Nursing
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• v.15 no.3
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• pp.75-87
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• 2022

Purpose : This retrospective investigation study aimed to determine the predictive validity of superficial surgical site infection assessment tools by measuring the risk score at the surgical site. Methods : This study included patients hospitalized to the general surgery department of a Hospital from January 2021 to December 31, 2021. The inclusion criteria were age ≥19 years, general abdominal surgery under general anesthesia, and hospital stay longer than 2 days. Patients who had undergone transplantation were excluded. Results : Tool validity results showed that tools including surgical time and operative procedure were more accurate than previously developed tools, with a sensitivity of 71.1%, specificity of 71.4%, positive prediction of 12.3%, negative prediction of 97.8%, and area under the curve of 0.743 (95% confidence interval, 0.678~0.745). The tool's cut-off score was 15, and the risks of infection was increased by 6.14 times at or above this cut-off point. Preoperative hair removal period, surgical wound classification, surgery time, body temperature on the second day after surgery, drainage tube type, and suture type affected the risk of infection at the surgical site. Conclusion : The incidence of healthcare-associated infections has been declining in the past decade; however, surgical site infections still account for a considerable proportion. Therefore, early identification of high-risk groups for surgical site infection is crucial for reducing the incidence of surgical site infection using appropriate management.

• 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.

• Archives of Plastic Surgery
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• v.41 no.3
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• pp.225-230
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• 2014

The increased application of the da Vinci robotic platform (Intuitive Surgical Inc.) for microsurgery has led to the development of new adjunctive surgical instrumentation. In microsurgery, the robotic platform can provide high definition $12{\times}-15{\times}$ digital magnification, broader range of motion, fine instrument handling with decreased tremor, reduced surgeon fatigue, and improved surgical productivity. This paper presents novel adjunctive tools that provide enhanced optical magnification, micro-Doppler sensing of vessels down to a 1-mm size, vein mapping capabilities, hydro-dissection, micro-ablation technology (with minimal thermal spread-$CO_2$ laser technology), and confocal microscopy to provide imaging at a cellular level. Microsurgical outcomes from the use of these tools in the management of patients with infertility and chronic groin and testicular pain are reviewed. All these instruments have been adapted for the robotic console and enhance the robot-assisted microsurgery experience. As the popularity of robot-assisted microsurgery grows, so will its breadth of instrumentation.

• 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.

• 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.

• KIPS Transactions on Software and Data Engineering
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• v.12 no.6
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• pp.275-284
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• 2023

Virtual reality simulations are used for education and training in various fields, and are especially widely used in the medical field recently. The education/training simulator consists of tactile/force feedback generation and image/sound output hardware that provides a sense similar to a doctor's treatment of a real patient using real surgical tools, and software that produces realistic images and tactile feedback. Existing simulators are complicated and expensive because they have to use various types of hardware to simulate various surgical instruments used during surgery. In this paper, we propose a dental surgical simulation system using a force feedback device and a morphable haptic controller. Haptic hardware determines whether the surgical tool collides with the surgical site and provides a sense of resistance and vibration. In particular, haptic controllers that can be deformed, such as length changes and bending, can express various senses felt depending on the shape of various surgical tools. When the user manipulates the haptic feedback device, events such as movement of the haptic feedback device or button clicks are delivered to the simulation system, resulting in interaction between dental surgical tools and oral internal models, and thus haptic feedback is delivered to the haptic feedback device. Using these basic techniques, we provide a realistic training experience of impacted wisdom tooth extraction surgery, a representative dental surgery technique, in a virtual environment represented by sophisticated three-dimensional models.

• Journal of Gastric Cancer
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• v.18 no.4
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• pp.313-327
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• 2018

The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea, and physicians, including surgeons, have been focusing on its treatment. Indeed, in Korea, medical treatment using a proton pump inhibitor is the mainstream treatment for GERD, while awareness of surgical treatment is limited. Accordingly, to promote the understanding of surgical treatment for GERD, the Korean Anti-Reflux Surgery Study Group published the Evidence-Based Practice Guideline for the Surgical Treatment of GERD. The guideline consists of 2 sections: fundamental information such as the definition, symptoms, and diagnostic tools of GERD and a recommendation statement about its surgical treatment. The recommendations presented 5 debates regarding fundoplication: 1) comparison of the effectiveness of medical and surgical treatments, 2) effectiveness of surgical treatment in cases of refractory GERD, 3) effectiveness of surgical treatment of extraesophageal symptoms, 4) comparison of effectiveness between total and partial fundoplication, and 5) effectiveness of fundoplication in cases of hiatal hernia. The present guideline is the first to demonstrate the efficacy of the surgical treatment GERD in Korea.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.10.1-10.5
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• 2017

Background: Because of changing surgical procedures in the fields of oral and maxillofacial surgery, new methods for surgical education are needed and could include recent advances in digital technology. Many doctors have attempted to use digital technology as educational tools for surgical training, and movies have played an important role in these attempts. We have been using a 3D full high-definition (full-HD) camcorder to record movies of intraoral surgeries. Method: The subjects were medical students and doctors receiving surgical training who did not have actual surgical experience (n = 67). Participants watched an 8-min, 2D movie of orthognathic surgery and subsequently watched the 3D version. After watching the 3D movie, participants were asked to complete a questionnaire. Result: A lot of participants (84%) felt a 3D movie excellent or good and answered that the advantages of a 3D movie were their appearance of solidity or realism. Almost all participants (99%) answered that 3D movies were quite useful or useful for medical practice. Conclusions: Three-dimensional full-HD movies have the potential to improve the quality of medical education and clinical practice in oral and maxillofacial surgery.

• Journal of Periodontal and Implant Science
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• v.42 no.1
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• pp.25-29
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• 2012

Purpose: There has been no attempt to establish an objective implant surgical evaluation protocol to assess residents' surgical competence and improve their surgical outcomes. The present study presents a newly developed assessment and rating system and simulation model that can assist the teaching staffs to evaluate the surgical events and surgical skills of residents objectively. Methods: Articles published in peer-reviewed English journals were selected using several scientific databases and subsequently reviewed regarding surgical competence and assessment tools. Particularly, medical journals reporting rating and evaluation protocols for various types of medical surgeries were thoroughly analyzed. Based on these studies, an implant surgical technique assessment and rating system (iSTAR) has been developed. Also, a specialized dental typodont was developed for the valid and reliable assessment of surgery. Results: The iSTAR consists of two parts including surgical information and task-specific checklists. Specialized simulation model was subsequently produced and can be used in combination with iSTAR. Conclusions: The assessment and rating system provided may serve as a reference guide for teaching staffs to evaluate the residents' implant surgical techniques.