• 한국정밀공학회지
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• 제28권9호
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• pp.1048-1053
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• 2011

Recently, robots have been used in surgical area. Robotic surgery in Minimally Invasive Surgery gives many advantages to surgeons and patients both. This study introduce a robotic assistant to improve the safety of telerobotic Minimally Invasive Surgical procedures. The master-slave system is applied to the telerobotic surgical system with the master arm, which control the system, and slave robot which operates the surgery on the patient body. By using a 3-DOF master arm, the surgeon can control the 6-DOF surgical robot under the constraint of fulcrum point. This paper explains the telerobotic surgical system and confirms the system with the precision of the robot control related to the fulcrum point to enhance the safety.

• 대한족부족관절학회지
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• 제24권2호
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• pp.102-106
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• 2020

A postoperative hallux varus deformity is a dreaded complication of hallux valgus surgery. Several surgical options have been introduced to overcome this problem. This paper reports an uncommon case of a 68-year-old female patient who presented with a postoperative hallux varus deformity combined with a rupture of the flexor hallucis longus (FHL) tendon. She was treated successfully by a minimally invasive correctional osteotomy with open tenorrhaphy. With experience in treating this complicated case, it was noted that FHL could be transected during the trans-articular adductor tenotomy. Hence, extra caution is needed when the degree of hallux valgus deformity is excessive. To the best of the author's knowledge, correctional valgization osteotomy for a postoperative hallux varus deformity in a minimally invasive manner has not been reported. This case report is expected to benefit surgeons and their patients with severe hallux valgus deformity.

• 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.

• Journal of Chest Surgery
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• 제33권2호
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• pp.183-185
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• 2000

With the marked decrease in operative mortality in simple heart diseases there have been several reports on the minimally invasive and cosmetic techniques including submammary incision right parasternal approach right anterolateral thoracotomy partial sternotomy and subxiphoid approach. We report here subxiphoid approach without sternotomy for the repair of atrial septal defect as the procedure that has less invasive technique and more cosmetic effect.

• Journal of Korean Neurosurgical Society
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• 제42권3호
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• pp.195-199
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• 2007

Objective : Bilateral laminotomy and unilateral laminotomy for bilateral decompression are becoming the minimally invasive procedures for lumbar spinal stenosis (LSS). With the aim of less invasiveness and better preservation of spinal stability. these techniques have been developed. But there are no large randomized studies to show the surgical results between these two techniques. The objective of this study was to examine the safety and efficacy of these two minimally invasive techniques. Methods : A total of 80 patients were included in this study (Group I : bilateral laminotomy, Group II : Unilateral laminotomy for bilateral decompression). Perioperative parameters and complications were analyzed. Symptoms and scores such as visual analog scale (VAS) scores, Oswestry Disability Index (ODI) scores, and SF-36 scores of prospectively accrued patients were assessed preoperatively and at 1 month and 12 months after surgery. Paired-t test, two-sample student-t tests, and non parametric tests were used to determine cross-sectional differences between two groups. Results : No major complications such as spinal instability or deaths occurred during follow-up periods. VAS, ODI scores and SF-36 body pain and physical function scores showed statistically significant improvements in both groups (p<0.001). The significant widening of the spinal canal diameter was also noted in both groups. But, in Group II. there were minor postoperative complications such as dural tear (2 cases 5.0%), fracture of ipsilateral inferior facet (1 case 2.5%), and 5 cases of transient leg symptoms of contralateral side. Conclusion : Both bilateral laminotomy and unilateral laminotomy for bilateral decompression allow achievement of adequate and long-lasting operative results in patients with LSS. But postoperative complications are more frequent in Group II (unilateral laminotomy and bilateral decompression). These results indicate that bilateral laminotomy is the preferred minimally invasive technique to treat symptomatic LSS.

• Journal of Chest Surgery
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• 제49권2호
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• pp.92-98
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• 2016

Background: We used an Abramson technique for minimally invasive repair of pectus carinatum in patients who preferred surgery to brace therapy, had been unsuccessfully treated via brace therapy, or were unsuitable for brace therapy because of a rigid chest wall. Methods: Between July 2011 and May 2015, 16 patients with pectus carinatum underwent minimally invasive surgery. Results: The mean age of the patients was $24.35{\pm}13.20years$ (range, 14-57 years), and all patients were male. The percentage of excellent aesthetic results, as rated by the patients, was 37.5%, and the percentage of good results was 56.25%. The preoperative and postoperative Haller Index values were $2.01{\pm}0.19$ (range, 1.60-2.31), and $2.22{\pm}0.19$ (range, 1.87-2.50), respectively (p-value=0.01), and the median hospital stay was $7.09{\pm}2.91days$ (range, 5-15 days). Only one patient experienced postoperative complications. Conclusion: Minimally invasive repair is effective for the treatment of pectus carinatum, even in adult patients.

• Journal of Chest Surgery
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• 제52권6호
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• pp.385-391
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• 2019

Background: Preoperative autologous blood donation (PABD) is a conservation strategy for reducing allogenic blood transfusion (ABT) during minimally invasive cardiac surgery (MICS). We aimed to evaluate the effects of PABD on the frequency of ABT and clinical outcomes in patients undergoing MICS. Methods: We enrolled 113 patients (47.8±13.1 years, 50 men) undergoing MICS without preoperative anemia (hemoglobin >11 g/dL) between 2014 and 2017. Of these patients, 69 (the PABD group) donated autologous blood preoperatively and were compared to the non-PABD group (n=44). We analyzed the frequency of perioperative ABT and clinical outcomes. Results: Baseline characteristics did not significantly differ between groups, although preoperative hemoglobin levels were lower in the PABD group. All operations were performed using a minimally invasive approach. Patients' surgical profiles were similar. There were no cases of mortality or significant differences in early postoperative outcomes. During the early postoperative period, hemoglobin levels were higher in the PABD group. No significant difference was found in the frequency of ABT. Conclusion: Although the PABD group had higher postoperative hemoglobin levels, there was no clear clinical benefit in the early postoperative period, despite a great deal of effort and additional cost. Additional PABD in the setting of strict policies for blood conservation was ineffective in reducing ABT for young and relatively healthy patients who underwent MICS.

• 대한족부족관절학회지
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• 제14권1호
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• pp.66-72
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• 2010

Purpose: To evaluate the clinical efficacy of the minimally invasive posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2006 to October 2008, we studied retrospectively 45 patients, 56 cases who were treated with minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and AOFAS score, circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared Bohler angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 1 was 81, type 2 was 75, type 3 was 69, type 4 was 61. By AOFAS score, Sanders type 1 was 88, type 2 was 82, type 3 was 78, type 4 was 63. And by circle draw test, type 1 was 8.8 cm, type 2 was 8.5 cm, type 3 was 8 cm, type 4 was 6.6 cm. Preoperative Bohler angle and Gissane angle were $7.2^{\circ}$, $98^{\circ}$, and it increased to $21.2^{\circ}$, $116^{\circ}$ after postoperative 1 year. Conclusion: Minimally invasive reduction and pin fixation treatment for displaced intraarticular calcaneal fracture was considered to be an effective treatment modality.

• Clinics in Shoulder and Elbow
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• 제18권2호
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• pp.75-79
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• 2015

Background: This retrospective comparative study aims to evaluate the surgical outcomes and complications of two surgical methods for simple fractures of the humeral shaft; minimally invasive anterior plating and open reduction combined with internal fixation. Methods: A total of 26 patients with humeral shaft simple fractures, who had surgery between June 2009 and September 2013 and were followed-up at least 12 months, were included in our analysis. They were divided into two groups; group 1 comprised of 12 patients who underwent minimally invasive anterior plating and group 2 comprised of 14 patients who underwent an open reduction and internal fixation. The clinical outcomes, radiological results, and complications were compared and analyzed. Results: We found that bone union was achieved in all patients, and the mean union periods were $20.7{\pm}3.34$ and $20.3{\pm}3.91$ weeks for groups 1 and 2, respectively. In most patients, we found that shoulder and elbow functions were recovered. At 12 months post-operation, we found that the Korean Shoulder Scoring system, the University of California at Los Angeles score and Mayo elbow performance score were $91.4{\pm}7.97$, $33.4{\pm}1.15$, and $90.8{\pm}2.23$ for group 1, and $95.2{\pm}1.53$, $33.3{\pm}1.43$, and $90.17{\pm}1.85$ for group 2. In terms of complications, we found that 2 patients had radial nerve palsy after open reduction and internal fixation, but all cases spontaneously resolved within 6 months. Complications such as infection and loss of fixation were not reported. Conclusions: Both minimally invasive anterior plating and open reduction with internal fixation produced satisfactory outcomes in the treatment of simple fractures of the humeral shaft.

• Journal of Chest Surgery
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• 제39권3호
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• pp.255-259
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• 2006

식도암의 수술은 일반적으로 개흉술과 개복술이 동시에 시행되며 경우에 따라 경부절개까지 추가되므로 다른 수술에 비해 이환율과 사망률이 상대적으로 높다. 수술에 따른 합병증을 최소화하고 빠른 회복을 유도하기 위하여 최근에는 양성 질환뿐만 아니라 악성 종양의 수술에도 저 침습적인 방법이 많이 시행되고 있으나, 식도암에는 적극적으로 적용되고 있지는 않으며 아직 국내보고도 없다. 최근 저자들은 8예의 식도암 환자에게 저 침습 수술을 적용하였기에 수술 기법을 중심으로 보고하는 바이다.