• 제어로봇시스템학회논문지
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• 제17권7호
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• pp.685-696
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• 2011

An efficient laparoscope manipulator robot was designed to automatically control the position of laparoscope via a passive joint on end-effector position. The end position of the manipulator is controlled to have corresponding velocity defined in the global coordinate space using laparoscopic visual information. Desired spatial position of laparoscope was derived from detected positions of surgical instrument tips, then the clinical viewing plane was moved by visual servoing task. The laparoscope manipulator is advantageous for automatically maintaining clinically important views in the laparoscopic image without any additional operator. A laparoscope is mounted to a holder which is linked to four degree of freedom manipulator via universal joint-type passive rings connection. No change in the design of laparoscope or manipulator is necessary for its application to surgery assistant robot system. Expanded working space and surgical efficiency were accomplished by implementing slant linking structure between laparoscope and manipulator. To ensure reliable positioning accuracy and controllability, the motion of laparoscope in an abdominal space through trocar was inspected using geometrical analysis. A designed laparoscope manipulating robot system can be easily set up and controlled in an operation room since it has a few subsidiary devices such as a laparoscope light source regulator, a control PC, and a power supply.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.2027-2029
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• 2015

Background: Laparoscope-assisted gastrectomy in treating patients with gastric cancers developed with a background of highly invasive traditional surgery and is being increasingly performed in the Asian Pacific area. This study systemically investigated the technique and clinical results for comparison with traditional radical subtotal gastrectomy for gastric cancers. Methods: Clinical studies evaluating the effectiveness and side effects of laparoscope-assisted gastrectomy in treating patients with gastric cancers were identified using a predefined search strategy. Summary rates of effectiveness and side effects of laparoscope-assisted gastrectomy were calculated. Results: Thirteen clinical studies which including 1,412 patients with gastric cancer treated by laparoscope-assisted gastrectomy were considered eligible for inclusion. Systemic analysis showed that, for all patients, the pooled resection rate was 100%. Major adverse effects were anastomotic stenosis, abdominal abscess, abdominal bleeding, postoperative ileus. Treatment related death occurred in 0. 71% (10/1412). Conclusion: This systemic analysis suggests that laparoscope-assisted gastrectomy in treating patients with gastric cancers is associated with good curative rate and acceptable complications.

• 로봇학회논문지
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• 제3권1호
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• pp.58-67
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• 2008

This study developed a novel augmented reality interface for minimally invasive surgery. The augmented reality technique can alleviate the sensory feedback problem inherent to laparoscopic surgery. An augmented reality system merges real laparoscope image and reconstructed 3D patient model based on diagnostic medical image such as CT, MRI data. By using reconstructed 3D patient model, AR interface could express structure of patient body that is invisible outside visual field of laparoscope. Therefore, an augmented reality system improved sight information of limited laparoscope. In our augmented reality system, the laparoscopic view is located at the center of a wide-angle concave screen and reconstructed 3D patient model is displayed outside the laparoscope. By using a joystick, the laparoscopic view and the reconstructed 3D patient model view are changed concurrently. With our augmented reality system, the surgeon can see the peritoneal cavity from a wide angle of view, without having to move the laparoscope. Since the concave screen serves immersive environments, the surgeon can feel as if she is in the patient body. For these reasons, a surgeon can recognize easily depth information about inner parts of patient and position information of surgical instruments without laparoscope motion. It is possible for surgeon to manipulate surgical instruments more exact and fast. Therefore immersive augmented reality interface for minimally invasive surgery will reduce bodily, environmental load of a surgeon and increase efficiency of MIS.

• 한국정밀공학회지
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• 제21권11호
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• pp.83-90
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• 2004

In this paper we present a new real-time visual servoing unit for laparoscopic surgery This unit can automatically control laparoscope manipulator through visual tracking of laparoscopic surgical tool. For the tracking, we present two-stage adaptive CONDENSATION(conditional density propagation) algorithm to extract the accurate position of the surgical tool tip from a surgical image sequence in real-time. This algorithm can be adaptable to abrupt change of laparoscope illumination. For the control, we present virtual damper system to control a laparoscope manipulator safely and stably. This system causes the laparoscope to move under constraint of the virtual dampers which are linked to the four sides of image. The visual servoing unit operates the manipulator in real-time with locating the surgical tool in the center of image. The experimental results show that the proposed visual tracking algorithm is highly robust and the controlled manipulator can present stable view with safe.

• The Korean Journal of Pain
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• 제11권1호
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• pp.124-126
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• 1998

As laparoscopic surgery becomes more popular, various complications following the laparoscope are also increasing. Nerve injury following the laparoscope is an infrequent but serious complication for both the doctor and patient. A 30-year old female patient suffered severe burning pain of the left buttock, inguinal area, external genitalia and inner side of vagina following laparoscopic surgery for ovarian mass. We successfully treated this patient with ilioinguinal, iliohypogastric nerve block in combination with epidural blocks.

• 제어로봇시스템학회:학술대회논문집
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• 제어로봇시스템학회 2003년도 ICCAS
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• pp.2648-2653
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• 2003

This paper describes the development of a 3-DOF laparoscopic assistant robot system with motor-controlled bending and zooming mechanisms using the voice command motion control and auto-tracking control. The system is designed with two major criteria: safety and adaptability. To satisfy the safety criteria we designed the robot with optimized range of motion. For adaptability, the robot is designed with compact size to minimize interference with the staffs in the operating room. The required external motions were replaced by the bending mechanism within the abdomen using flexible laparoscope. The zooming of the robot is achieved through in and out motion at the port where the laparoscope is inserted. The robot is attachable to the bedside using a conventional laparoscope holder with multiple DOF joints and is compact enough for hand-carry. The voice-controlled command input and auto-tracking control is expected to enhance the overall performance of the system while reducing the control load imposed on the surgeon during a laparoscopic surgery. The proposed system is expected to have sufficient safety features and an easy-to-use interface to enhance the overall performance of current laparoscopy.

• 기본간호학회지
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• 제22권4호
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• pp.379-386
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• 2015

Purpose: The trend of body temperature change during laparoscopic surgery and the most adequate site for monitoring temperature measurements have not been investigated thoroughly. In this study body temperature change during laparoscopic surgery was measured and measurements of the tympanic, esophageal, and nasopharyngeal core temperatures in surgical patients with total intravenous anesthesia were compared. Methods: From February to October 2013, 28 laparoscopic surgical patients were recruited from a tertiary hospital in Seoul. The patients' core temperature was measured 12 times at ten minute intervals from ten minutes after the beginning of endotracheal intubation. Results: Repeated measure of core temperatures indicated a significant difference according to body part (p=.033), time of measure (p<.001) and the reciprocal interaction between body part and time of measure (p<.027). The core temperatures were highest at tympany location, lowest at nasopharynx. The amount of temperature change was least for the esophagus ($36.10{\sim}36.33^{\circ}C$), followed by nasopharynx and tympany. Conclusion: The esophageal core temperature showed the highest stability followed by nasopharyngeal and tympanic temperature. Therefore, close observations are required between 10~20minutes after the beginning of the operation.

• 대한기계학회논문집A
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• 제35권8호
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• pp.883-888
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• 2011

복강경을 이용한 수술법은 입원 기간 단축 및 상처의 감소라는 장점이 있지만 수술 도구 끝단의 움직임의 제한으로 인한 수술 난이도의 증가라는 단점이 있다. 이를 숙련시키기 위해 동물을 이용하여 대체수술을 하거나, Surgery training tool set을 이용하여 조작 기술 습득을 위한 훈련을 하고 있다. 하지만 이 방법들은 사람에게서 느껴지는 촉감을 그대로 재현하지 못한다. 따라서 본 논문은 4-자유도계의 복강경 수술 의료 훈련 시뮬레이터를 통해 원활한 햅틱 피드백을 제공하였다. 햅틱 장비의 기본 요구조건인 무중력, 무마찰 상태를 만족시키기 위해 장비의 중력 및 마찰력을 측정하였다. 이를 위해 의료 시뮬레이터의 모델링을 하여 시술기에 작용하는 중력과 마찰력을 측정하고 이를 선형화 시킨후 이를 토대로 보상기를 모델링하고 이를 검증하였다.

• Journal of Gastric Cancer
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• 제15권2호
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• pp.127-131
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• 2015

The surgical indications for the treatment of gastroesophageal reflux disease (GERD) in patients with esophageal motility disorders have been debated. We report a case of antireflux surgery performed in a patient with absent esophageal motility as categorized by the Chicago classification (2011). A 54-year-old man underwent laparoscopic Toupet fundoplication due to apparent GERD and desire to discontinue all medications. After surgery, his subjective symptoms improved. Furthermore, objective findings including manometry and 24-hour pH-metry also improved. In our experience, antireflux surgery can improve GERD symptoms patients, even with absent esophageal motility.

• Advances in pediatric surgery
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• 제4권2호
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• pp.172-175
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• 1998

With the recent advances in instruments and techniques, laparoscopic procedure have extended to neonates with congenital anomalies. The author reports a 6-day-old boy with Hirschsprung's disease, treated successfully by the laparoscopic endorectall pull-through procedure. The technique and its potential role in the treatment of Hirschsprung's disease are described. One camera port and three working ports were used for access to the peritoneal cavity. The descending and sigmoid colon were mobilized laparoscopically. The submucosal dissection was done transanally. The colon was then pulled down in continuity, divided above the transition zone, and secured to the anal mucosa about 10 mm above the pectinate line. Author concluded that endorectal pull-through can be performed safety with the laparoscope.