• Archives of Plastic Surgery
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• 제46권1호
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• pp.79-83
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• 2019

Robotic surgery facilitates surgical procedures by employing flexible arms with multiple degrees of freedom and providing high-quality 3-dimensional imaging. Robot-assisted nipple-sparing mastectomy with immediate reconstruction is currently performed to avoid breast scars. Four patients with invasive ductal carcinoma underwent robot-assisted nipple-sparing mastectomy and immediate robot-assisted expander insertion. Through a 6-cm incision along the anterior axillary line, sentinel lymph node biopsy and nipple-sparing mastectomy were performed by oncologic surgeons. The pectoralis major muscle was elevated, an acellular dermal matrix (ADM) sling was created with robotic assistance, and an expander was inserted into the subpectoral, sub-ADM pocket. No patients had major complications such as hematoma, seroma, infection, capsular contracture, or nipple-areolar necrosis. The mean operation time for expander insertion was 1 hour and 20 minutes, and it became shorter with more experience. The first patient completed 2-stage prosthetic reconstruction and was highly satisfied with the unnoticeable scar and symmetric reconstruction. We describe several cases of immediate robot-assisted prosthetic breast reconstruction. This procedure is a feasible surgical option for patients who want to conceal surgical scars.

• 대한의용생체공학회:의공학회지
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• 제40권5호
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• pp.206-214
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• 2019

Surgical methods and associated precision systems have been developed, but surgical procedures that require precise location and fine manipulation of the lesion remain a limitation. The combination of precision robot manipulation technology and 3D medical image navigation technology overcomes the limitations of minimally invasive surgery (MIS) and enables a more stable and successful operation. Surgical robots are surgical robots such as da Vince, and surgical robots using industrial robotic arms. There are various developments and researches of medical robots. In recent medical robot development, a new type of surgical robot based on an industrial robot arm capable of easily replacing the end effector according to the user's needs is being actively developed at home and abroad. Therefore, in this study, we developed safety and performance evaluation guideline for micro - surgical robots based on open robot platform using general purpose robot arm to help quality control of the medical device.

• Journal of Chest Surgery
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• 제46권2호
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• pp.93-97
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• 2013

Background: Minimally invasive cardiac surgery has emerged as an alternative to conventional open surgery. This report reviews our experience with atrial septal defect using the da VinciTM surgical robot system. Materials and Methods: This retrospective study included 50 consecutive patients who underwent atrial septal defect repair using the da VinciTM surgical robot system between October 2007 and May 2011. Among these, 13 patients (26%) were approached through a totally endoscopic approach and the others by mini-thoracotomy. Nineteen patients had concomitant procedures including tricuspid annuloplasty (n=10), mitral valvuloplasty (n=9), and maze procedure (n=4). The mean follow-up duration was $16.9{\pm}10.4$ months. Results: No remnant interatrial shunt was detected by intraoperative or postoperative echocardiography. The atrial septal defects were mainly repaired by Gore-Tex patch closure (80%). There was no operative mortality or serious surgical complications. The aortic cross clamping time and cardiopulmonary bypass time were $74.1{\pm}32.2$ and $157.6{\pm}49.7$ minutes, respectively. The postoperative hospital stay was $5.5{\pm}3.3$ days. Conclusion: The atrial septal defect repair with concomitant procedures like mitral valve repair or tricuspid valve repair using the da VinciTM system is a feasible method. In addition, in selected patients, complete port access can be helpful for better cosmetic results and less musculoskeletal injury.

• 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.

• 대한정형외과학회지
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• 제53권6호
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• pp.459-465
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• 2018

정형외과 수술의 임상적 결과에 영향을 미치는 요소는 여러 가지가 있지만 수술적 수기가 가장 중요한 요인이며 로봇공학은 술기를 보다 정확하고 일관되게 수행하기 위해 도입되었다. 정형외과 영역에서는 20년 전부터 로봇수술을 사용하였으나 실용성 문제와 합병증의 발생으로 일부 로봇은 도태되었으며 단점을 개선한 로봇이 소개되고 있다. 대부분의 로봇수술은 인공관절수술 분야에서 시행되었고 치환물의 정렬과 위치 선정에서 우수한 것으로 보고되고 있다. 그러나 임상적 결과의 우수성, 실용성, 가성비 등의 측면에서 제한점이 있고 일부 로봇수술에서는 합병증 발생 빈도가 높다는 보고가 있었다. 초기 로봇수술은 수술자의 개입 없이 계획된 수술이 진행되는 능동형 로봇수술이 주를 이루었으나 최근에는 수술과정에서 실시간 피드백을 통해 술자가 술 전 계획을 변경할 수 있고, 햅틱 경계 내에서 제한된 골절제를 함으로써 주요 혈관, 신경, 인대 등의 손상을 최소화할 수 있는 반능동형 로봇수술이 소개되고 있다.

• Journal of Chest Surgery
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• 제53권4호
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• pp.152-159
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• 2020

Minimally invasive esophagectomy (MIE) was first introduced in the 1990s. Currently, it is a widely accepted surgical approach for the treatment of esophageal cancer, as it is an oncologically sound procedure; its advantages when compared to open procedures, including reduction in postoperative complications, reduction in the length of hospital stay, and improvement in quality of life, are well documented. However, debates are still ongoing about the safety and efficacy of MIE. The present review focuses on some of the current issues related to conventional MIE and robot-assisted MIE based on evidence from the current literature.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.373-377
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• 2022

Currently, robot-assisted latissimus dorsi muscle flap (RLDF) surgery is used in treating patients with Poland syndrome and for breast reconstruction. However, conventional RLDF surgery has several inherent issues. We resolved the existing problems of the conventional system by introducing the da Vinci single-port system in patients with Poland syndrome. Overall, three patients underwent RLDF surgery using the da Vinci single-port system with gas insufflation. In the female patient, after performing RLDF with silicone implant, augmentation mammoplasty was also performed on the contralateral side. Both surgeries were performed as single-port robotic-assisted surgery through the transaxillary approach. The mean operating time was 449 (335-480) minutes; 8.67 (4-14) minutes were required for docking and 59 (52-67) minutes for robotic dissection and LD harvesting. No patients had perioperative complication and postoperative problems related to gas inflation. The single-port robot-assisted surgical system overcomes the drawbacks of previous robotic surgery in patients with Poland syndrome, significantly shortens the procedure time of robotic surgery, has superior cosmetic outcomes in a surgical scar, and improves the operator's convenience. Furthermore, concurrent application to another surgery demonstrates the possibility in the broad application of the robotic single-port surgical system.

• Journal of Chest Surgery
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• 제54권4호
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• pp.319-324
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• 2021

Robotic thymectomy has been adopted recently and has been shown to be safe and feasible in treating thymic tumors and myasthenia gravis. The surgical indications of robotic technology are expanding, with advantages including an excellent surgical view and sophisticated manipulation. Herein, we describe technical aspects, considerations, and outcomes of robotic thymectomy.

• Journal of Chest Surgery
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• 제55권1호
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• pp.55-60
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• 2022

Background: Robot-assisted repair of atrial septal defect (ASD) can be performed under either beating-heart or non-beating-heart conditions. However, the risk of cerebral air embolism (i.e., stroke) is a concern in the beating-heart approach. This study aimed to compare the outcomes of beating- and non-beating-heart approaches in robot-assisted ASD repair. Methods: From 2010 to 2019, a total of 45 patients (mean age, 43.4±14.6 years; range, 19-79 years) underwent ASD repair using the da Vinci robotic surgical system. Twenty-seven of these cases were performed on a beating heart (beating-heart group, n=27) and the other cases were performed on an arrested or fibrillating heart (non-beating-heart group, n=18). Cardiopulmonary bypass (CPB) was achieved via cannulation of the femoral vessels and the right internal jugular vein in all patients. Results: Complete ASD closure was verified using intraoperative transesophageal echocardiography in all patients. Conversion to open surgery was not performed in any cases, and there were no major complications. All patients recovered from anesthesia without any immediate postoperative neurologic symptoms. In a subgroup analysis of isolated ASD patch repair (beating-heart group: n=22 vs. non-beating-heart group: n=5), the operation time and CPB time were shorter in the beating-heart group (234±38 vs. 253±29 minutes, p=0.133 and 113±28 vs. 143±29 minutes, p=0.034, respectively). Conclusion: Robot-assisted ASD repair can be safely performed with the beating-heart approach. No additional risk in terms of cerebral embolism was found in the beating-heart group.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2004년도 학술대회 논문집 정보 및 제어부문
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• pp.456-458
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• 2004

Recent medical robot systems perform surgery operations, by following the preplanned trajectory and surgical procedures. Depending on the complexity of surgery operations, they are operated in manual, semi-automatic or full automatic mode. To improve the performance of those medical robot systems, development of the simulator and more advanced auto-illumination system, in which intensity of light, direction and focal point can be controlled automatically according to the varied environments during surgical operations. are required. Therefore, in this paper, the simulator for SPINEBOT system which is a computer-intergrated robotic surgery system are developed. And further, an auto-illumination system which will be integrated to the SPINEBOT system is investigated and its preliminary design is described.