• Journal of Chest Surgery
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• 제41권2호
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• pp.264-267
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• 2008

현재 사용되고 있는 수술 로봇 중 가장 진보된 장비인 da Vinci (Intuitive Surgical, Sunnyvale, CA, USA)는 심장 수술분야에서도 그 적응증을 넓혀가고 있다. 저자들은 주로 승모판막의 수술에 이용되었던 da Vinci 시스템을 이용하여 3혈관 질환 환자에서 양측 내흉동맥을 박리하고, 좌 요골동맥을 취득한 후 최소 개흉 다혈관 관상동맥우회술을 섬박동하에 성공적으로 시행하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Gastric Cancer
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• 제18권1호
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• pp.90-98
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• 2018

Purpose: We evaluated the learning curve and short-term surgical outcomes of robot-assisted distal gastrectomy (RADG) performed by a single surgeon experienced in open, but not laparoscopic, gastrectomy. We aimed to verify the feasibility of performing RADG without extensive laparoscopic experience. Materials and Methods: Between July 2012 and December 2016, 60 RADG procedures were performed by a single surgeon using the da $Vinci^{(R)}$ Surgical System (Intuitive Surgical). Patient characteristics, the length of the learning curve, surgical parameters, and short-term postoperative outcomes were analyzed and compared before and after the learning curve had been overcome. Results: The duration of surgery rapidly decreased from the first to the fourth case; after 25 procedures, the duration of surgery was stabilized, suggesting that the learning curve had been overcome. Cases were divided into 2 groups: 25 cases before the learning curve had been overcome (early cases) and 35 later cases. The mean duration of surgery was 420.8 minutes for the initial cases and 281.7 minutes for the later cases (P<0.001). The console time was significantly shorter during the later cases (168.6 minutes) than during the early cases (247.1 minutes) (P<0.001). Although the volume of blood loss during surgery declined over time, there was no significant difference between the early and later cases. No other postoperative outcomes differed between the 2 groups. Pathology reports revealed the presence of mucosal invasion in 58 patients and submucosal invasion in 2 patients. Conclusions: RADG can be performed safely with acceptable surgical outcomes by experts in open gastrectomy.

• Journal of Chest Surgery
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• 제42권3호
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• pp.396-400
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• 2009

다빈치 로봇수술은 현재 다양한 외과영역에서 시행되고 있으나 폐, 식도 외과영역에서는 아직까지 널리 이용되지 않고 있다. 본원에서는 74세 남자환자가 딸꾹질과 연하곤란을 주소로 내원하여 시행한 검사에서 식도암으로 진단되어 da Vinci 로봇을 이용하여 식도절제술을 시행한 후, 복강경으로 위장튜브를 만들어 흉골하 통로를 통해 경부에서 위장-식도 단단 문합을 시행하였다. 환자는 수술 후 특별한 합병증 없이 완쾌 퇴원하였다. 향후 다빈치로봇을 이용한 최소 침습수술이 식도암을 비롯한 폐, 식도외과 영역에의 활용에 있어서 좋은 결과가 기대되므로 보고하는 바이다.

• Journal of Gastric Cancer
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• 제10권2호
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• pp.69-74
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• 2010

Purpose: Laparoscopic gastrectomy has been common treatment modality for gastric cancer. But, most surgeons tend to perform laparoscopy-assisted distal gastrectomy using epigastric incision. Delta-shaped anastomosis is known as intracorporeal gastroduodenostomy, but it is technically difficult and needed many staplers. So we tried to find simple and economical method, here we report on the results of liner-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy. Materials and Methods: We retrospectively reviewed the medical records of 25 patients who underwent totally laparoscopic distal gastrectomy using liner-shaped anastomosis at School of Medicine, Ajou University between January to October 2009. The indication was early gastric cancer as diagnosed by preoperative workup, the anastomoses were performed by using laparoscopic linear stapler. Results: There were 12 female and 13 male patients with a mean age of $55.6{\pm}11.2$. The following procedures were performed 14 laparoscopic gastrectomies, 11 robotic gastrectomies. The mean operation time was $179.5{\pm}27.4$ minutes, the mean anastomotic time was $17.5{\pm}3.4$ minutes. The mean number of stapler cartridges was $5.6{\pm}0.8$. Postoperative complication occurred in one patient, anastomotic stenosis, and the patient required reoperation to gastrojejunostomy. The mean length of postoperative hospital stay was $6.7{\pm}1.0$ days except the complication case, and there was no case of conversion to open procedure and postoperative mortality. Conclusions: Linear-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy is technically simple and feasible method.

• The Journal of Korean Physical Therapy
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• 제33권5호
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• pp.231-237
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• 2021

Purpose: This study sought to investigate the effects of robot-assisted gait training on balance in total hip arthroplasty (THA) patients after bilateral avascular necrosis (AVN). Methods: This case study in two patients utilized an 'A-B-A' single-subject experimental design that included five days of pre-intervention, followed by five days of intervention, and five days of post-intervention. The intervention involved the use of a standing inclined robot (R-bot) for 15 minutes. The outcome measures were evaluated using the Functional Reaching Test (FRT), Time Up to Go (TUG), and the Modified One Leg Standing Test (OLST). Results: Patient 1 showed improvement based on data gathered from baseline A to intervention period B, with results as follows: FRT improved from 27.7 cm to 41.28 cm, OLST LT from 14.03 seconds to 67.37 seconds, OLST RT from 2.94 seconds to 35.97 seconds, and TUG from 12.96 seconds to 7.82 seconds. Patient 2 also showed improvement from baseline A to intervention period B, with results as follows: FRT improved from 17.18 cm to 24.3 cm, OLST LT from 11.53 seconds to 52.01 seconds, OLST RT from 12.99 seconds to 62.19 seconds, and TUG from 27.31 seconds to 12.99 seconds. Conclusion: Based on the results of this study, robotic rehabilitation during the early stages after surgery is effective for promoting balance in patients who have undergone THA due to bilateral AVN.

• Journal of Chest Surgery
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• 제42권1호
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• pp.28-33
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• 2009

배경: 경도이상의 기능성 삼첨판막 폐쇄부전이 있는 경우 삼첨판 성형술이 널리 시행되고 있으며, 판륜링을 이용한 성형술이 우수한 성적을 나타내고 있다. 우리는 새로운 삼차원적 모양의 삼첨판륜링(Edwards $MC^3$ annuloplasty system [Edward LifeSciences, Irvine, CA])을 이용한 삼첨판 성형술의 조기성적을 보고하고자 한다. 대상 및 방법: 2004년 11월부터 2006년 7월까지 삼첨판륜의 확장 및 경도이상의 삼첨판막 폐쇄부전이 있는 72명의 환자에서 Edwards $MC^3$ annuloplasty ring을 이용한 삼첨판 성형술을 시행하였다. 72명의 환자 중, 68명에서 정중흉골절개술을 하였고 4명에서 로봇팔을 이용한 최소절개 개흉술을 시행하였다. 남녀비는 21 : 51이었고 평균 나이는 $53.9{\pm}12.3$세였다. 수술 전 삼첨판막 폐쇄부전은 평균 $2.2{\pm}1.0$도였으며 평균 NYHA functional class는 $3.1{\pm}0.8$, 평균 좌심실박출계수는 $57.0{\pm}9.9$%였다. 결과: 삼첨판막 폐쇄부전과 NYHA functional class는 각각 $0.4{\pm}0.6$, $2.0{\pm}0.7$으로 의미있게 감소하였고 삼첨판막 협착은 없었다(p<0.001). 병원 사망은 1명이 있었으며 술 후 합병증은 3도 블록이 발생하여 영구적 인공심박동기 삽입을 한 경우가 1명이 있었다. 결론: 3차원적 모양의 삼첨판륜링은 장착하기 용이하며 임상적, 심초음파 검사상 단기성적은 우수한 것으로 판단된다. 그러나 이 판막륜링의 장기 성적에 대하여는 연구 대상환자에 대한 정기적인 추적관찰 및 검사가 필요하고 더 많은 임상 적용 및 경험이 필요할 것으로 판단된다.