• The Journal of Korea Robotics Society
• /
• v.14 no.3
• /
• pp.203-210
• /
• 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
• /
• v.16 no.2
• /
• pp.164-171
• /
• 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.

• Proceedings of the Korean Society of Precision Engineering Conference
• /
• 2004.10a
• /
• pp.804-808
• /
• 2004

This paper deals with the designing of instrument for achieving surgical operation in the stomach and gullet using endoscope channel. The method used herein was to provide beads to knot suturing thread automatically. Following design rules were applied : 1) that instrument must be designed to enable surgical operator to stitch successively by only simple handling 2) that instrument must be designed to minimize insertion and extraction of endoscope. The main result from the experiment with animal stomach was that the surgical operation time was reduced and successive suture was available. Considering the requirement of operator‘s highly trained skills and the discomfort of patient in traditional suture process, the proposed design is expected to markedly improve the endoscopic suturing performance.

• Korean Journal of Head & Neck Oncology
• /
• v.28 no.2
• /
• pp.114-117
• /
• 2012

Background and Objectives : To assure the surgical completeness of the gasless endoscopic thyroidectomy via single incision axillary approach using flexible videoscope which provide wide angle and working space, we compared single incision axillary approach and axillo-areolar approach by means of clinical, surgical outcomes. Materials and Methods : From March 2011 to July 2012, 24 patients who had underwent endoscopic thyroidectomy via transaxillary approach were enrolled. Of total, 17 patients underwent single incision axillary approach(group I) and the other 7 underwent axillo-areolar approach(group II). Results : Patient demographics, surgical indications were similar between the two groups. The operating time(group I 144.6min, group II 153.6 min ; p=.29), blood loss(group I : 55.4cc, group II : 35.7cc : p=.64), hospital stay(group I : 4.2days, group II : 4.4 days ; p=.65) were similar in the two groups. Overall, two patients in group I(2/17, 11.8%) experienced postoperative complications, including one hematoma and one seroma. Due to narrow working space, one patient was change to axillo-areolar approach during single incision axillary approach with $30^{\circ}$ rigid endoscope. Conclusion：Single incision axillary approach is safe and effective similar to other endoscopic thyroidectomy methods using flexible videoscope. Different with $30^{\circ}$ rigid endoscope, 10-mm flexible videoscope can put inside the axillary inicision site in different axis with endoscopic instruments. This difference in endoscopic axis help to prevent crash with endoscopic instrument.

• Journal of Chest Surgery
• /
• v.47 no.4
• /
• pp.327-332
• /
• 2014

Single-port video-assisted thoracic surgery (VATS) has slowly established itself as an alternate surgical approach for the treatment of an increasingly wide range of thoracic conditions. The potential benefits of fewer surgical incisions, better cosmesis, and less postoperative pain and paraesthesia have led to the technique's popularity worldwide. The limited single small incision through which the surgeon has to operate poses challenges that are slowly being addressed by improvements in instrument design. Of note, instruments and video-camera systems that are narrower and angulated have made single-port VATS major lung resection easier to perform and learn. In the future, we may see the development of subcostal or embryonic natural orifice translumenal endoscopic surgery access, evolution in anaesthesia strategies, and cross-discipline imaging-assisted lesion localization for single-port VATS procedures.

• Journal of dental hygiene science
• /
• v.14 no.2
• /
• pp.264-268
• /
• 2014

There are a lot of dental emergency situation. Especially on disabled or pediatric patient with negative behavior, accidental aspiration or ingestion of foreign body (ex: dental instrument) is one of the common accidents in dental procedure. Dentists and dental hygienists must have knowledge about the precaution and be ready to deal with foreign body aspiration during dental treatment, especially on the disabled. This is a case of an accident during the dental treatment of 14-year-old female patient with cerebral palsy. During scaling, prolonged retained primary tooth which had resorbed roots was fell into left bronchi. So we tried to remove the crown by endotracheal approach. Most ingested foreign bodies pass through the gastrointestinal tract spontaneously, but some of them need endoscopic or surgical removal. Moreover aspiration into broncho-trachea can be more serious events and must be treated as emergency situation.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.7 no.1
• /
• pp.29-32
• /
• 2011

There are a lot of dental emergency situations and accidental aspiration or ingestion of a dental instrument is one of the common accidents in dental practice especially on disabied or pediatric patient with negative behavior. Most of ingested foreign bodies pass through the gastrointestinal tract spontaneously, but some of them (about 20%) need endoscopic or surgical removal. This is a case of an accident during the treatment of a 18 months male patient with caries of anterior deciduous teeth. During the treatment, the gauze was used by waterproofing instead of a rubber dam. #4 round bur (approximately 2.2cm long) which was put on the tray was cling to the gauze and the bur was fell into the patient's throat. The bur was 2.2cm long and very sharp so it could not be passed spontaneously through the pylorus, so we tried to remove the bur by esophagogastroduodenoscopy. Endoscopic removal of foreign bodies in the upper gastrointestinal tract is an effective and safe procedure.

• Journal of Korean Clinical Nursing Research
• /
• v.18 no.2
• /
• pp.284-295
• /
• 2012

Purpose: This study was done to clarify effects of bispectral index monitoring sedative administration, compared to MOAA/S (Modified Observer's Assessment of Alertness and Sedation), on conscious sedation, physiological stability and recovery time for patients undergoing endoscopic submucosal dissection. Methods: Participants In this study were patients who underwent endoscopic submucosal dissection because of early gastric cancer. Participants were assigned randomly to an experimental group receiving sedatives based on bispectral index monitoring or to a control group with the MOAA/S instrument. Movements, belching, memory, pain, discomfort, physiological stability (MBP, PR, $SpO_2$), and recovery time were measured during the treatment and recovery. Data were analyzed using Spearman partial correlation coefficient analysis, Mixed model and Wilcoxon rank sum test to determine differences in the parameters. Results: There were no statistically significant differences between the two groups for conscious sedation(movement, belching, memory, pain, or discomfort), physiological stability and recovery time. Conclusion: The results of this study indicate that no differences were found between the two types of monitoring. Thus, use of a bispectral index monitor in clinical practice enabling medical staff to readily assess the conscious sedation of for these patients is expected to be increasingly used as an objective assessment tool for conscious sedation for patient safety.