• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.6
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• pp.521-526
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• 2016

This paper suggests a new design that makes use of rotary inertia that can allow autonomous movement of an autonomous colonoscope robot in the colon of a patient as a locomotive mechanism. As commercial colonoscopy causes a lengthy time of pain and discomfort to the patients when colonoscopy patients are reluctant to receive surgery, there is a tendency to avoid the test in the early diagnosis of colorectal cancer. To solve this problem, research has been conducted on the next generation of robotic colonoscopes that can reduce the discomfort and pain by moving autonomously within the colon of the patients. In the driving mechanism utilizing the rotational inertia, a flywheel is driven by a motor to store energy and produce rotational inertia. By the energy stored and released by the flywheel, the stick phenomenon that occurs when the robot is running in the intestine can be overcome effectively. To do this, a controller that can control the velocity of the flywheel and is robust to high frequency noise was designed and implemented. The driving mechanism using the rotational inertia presented here showed that the structure is also effective and the experiment can be run easily compared to another mechanism.

• Journal of Digital Convergence
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• v.19 no.6
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• pp.393-398
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• 2021

As society becomes more complex and advanced, the risk of accidents is inevitably increased, and this is an opportunity to increase the occurrence of not only congenital disabilities but also acquired disabilities. In this situation, the use of rehabilitation robots, a complex of advanced technologies, is expected to increase steadily in the future. So the authors would take a look the technological trends and future development prospects of domestic and foreign rehabilitation robots. Until now, disability assistive robot technology has been mainly developed in the field of supporting disability with walking disabilities or work limitations rather than cognitive disabilities. However, another issue of population aging is that cognitive impairment has the potential to increase, so development of a disability assistance robot that secures user safety must be actively promoted. It is thought that empirical results should be derived and converged

• Journal of Gastric Cancer
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• v.16 no.2
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• pp.63-71
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• 2016

Pylorus-preserving gastrectomy (PPG) is a function-preserving surgery for the treatment of early gastric cancer (EGC), aiming to decrease the complication rate and improve postoperative quality of life. According to the Japanese gastric cancer treatment guidelines, PPG can be performed for cT1N0M0 gastric cancer located in the middle-third of the stomach, at least 4.0 cm away from the pylorus. Although the length of the antral cuff gradually increased, from 1.5 cm during the initial use of the procedure to 3.0 cm currently, its optimal length still remains unclear. Standard procedures for the preservation of pyloric function, infra-pyloric vessels, and hepatic branch of the vagus nerve, make PPG technically more difficult and raise concerns about incomplete lymph node dissection. The short- and long-term oncological and survival outcomes of PPG were comparable to those for distal gastrectomy, but with several advantages such as a lower incidence of dumping syndrome, bile reflux, and gallstone formation, and improved nutritional status. Gastric stasis, a typical complication of PPG, can be effectively treated by balloon dilatation and stent insertion. Robot-assisted pylorus-preserving gastrectomy is feasible for EGC in the middle-third of the stomach in terms of the short-term clinical outcome. However, any benefits over laparoscopy-assisted PPG (LAPPG) from the patient's perspective have not yet been proven. An ongoing Korean multicenter randomized controlled trial (KLASS-04), which compares LAPPG and laparoscopy-assisted distal gastrectomy for EGC in the middle-third of the stomach, may provide more clear evidence about the advantages and oncologic safety of PPG.

• Journal of Chest Surgery
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• v.56 no.5
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• pp.336-345
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• 2023

Background: The objective of this study was to demonstrate the safety, efficacy, and feasibility of intraoperative monitoring of the recurrent laryngeal nerves during thoracoscopic and robotic 3-field esophagectomy. Methods: This retrospective analysis details our initial experience using intraoperative nerve monitoring (IONM) during minimally invasive 3-field esophagectomy. Data were obtained from a prospectively maintained database and electronic medical records. The study included all patients who underwent minimally invasive (video-assisted thoracic surgery/robotic) transthoracic esophagectomy with neck anastomosis. The patients were divided into those who underwent IONM during the study period and a historical cohort who underwent 3-field esophagectomy without IONM at the same institution. Appropriate statistical tests were used to compare the 2 groups. Results: Twenty-four patients underwent nerve monitoring during minimally invasive 3-field esophagectomy. Of these, 15 patients underwent thoraco-laparoscopic operation, while 9 received a robot-assisted procedure. In the immediate postoperative period, 8 of 24 patients (33.3%) experienced vocal cord paralysis. Relative to a historical cohort from the same institution, who were treated with surgery without nerve monitoring in the preceding 5 years, a 26% reduction was observed in the nerve paralysis rate (p=0.08). On follow-up, 6 of the 8 patients with vocal cord paralysis reported a return to normal vocal function. Additionally, patients who underwent IONM exhibited a higher nodal yield and a decreased frequency of tracheostomy and bronchoscopy. Conclusion: The use of IONM during minimally invasive 3-field esophagectomy is safe and feasible. This technique has the potential to decrease the incidence of recurrent nerve palsy and increase nodal yield.

• The Journal of Korea Robotics Society
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• v.9 no.1
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• pp.48-56
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• 2014

In robotic surgery, a surgeon checks only a surgical site of patient in the progress of surgery by vision and sound information. In order to solve this limited information, the haptic function is necessary. And haptic surgical robot is also necessary to design a haptic master device. The master device for laparoscope operation with cable-conduit was developed in previous research to give haptic function. It suggested a possibility of developing a master device by using the cable-conduit. However, it is very inconvenient to use. Therefore, this paper suggests a new mechanism design structure to solve the problems of the previous work by new forming a new master device. And it has proved that it's usability is better than previous one. Furthermore it has also experimented and analyzed that a backlash of new master device is compensated by smooth backlash inverse algorithm.

• Journal of Yeungnam Medical Science
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• v.40 no.3
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• pp.252-258
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• 2023

Background: The purpose of this study was to investigate whether postoperative cystography findings can predict early and longterm recovery from incontinence after radical prostatectomy (RP), compared with the other cystography parameters. Methods: I retrospectively reviewed 118 patients who underwent robot-assisted RP (RARP) for localized prostate cancer at single institution between January 2016 and April 2021. One hundred and seven patients were included in the study. Postoperative cystography was routinely performed 7 days after surgery. The bladder neck to pubic symphysis ratio, vesicourethral angle, and bladder neck anteroposterior length (BNAP) ratio (the bladder neck-posterior margin distances divided by the anteroposterior lengths) were evaluated. Continence was defined as cessation of pad use. The association between these variables and urinary incontinence was also analyzed. Results: The urinary incontinence recovery rates 1, 3, 6, and 12 months after RARP were 43.92%, 66.35%, 87.85%, and 97.19%, respectively. Multivariate logistic regression analysis demonstrated that a lower BNAP ratio and wider vesicourethral angle were significantly associated with continence restoration at 1, 3, and 6 months after surgery. In addition, in terms of days of pad usage, lower BNAP ratio, wider vesicourethral angle, and bladder neck preservation were significantly associated with recovery from urinary incontinence within 12 months as assessed by Cox proportional hazard analysis. Conclusion: This study demonstrated that vesicourethral angle and BNAP ratio were independent predictors of early recovery from post-prostatectomy incontinence. I suggest that both the sagittal and coronal views of postoperative cystography help anticipate early continence restoration after RARP.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.2
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• pp.211-216
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• 2023

It has been shown that external pancreatic ductal stenting (EPDS) can reduce the incidence of clinically relevant postoperative pancreatic fistula. Although studies have described EPDS in open pancreaticoduodenectomy (PD), EPDS in minimally invasive PD has not been reported yet. Thus, the objective of this study was to describe the technique of EPDS in minimally invasive PD. The procedure was performed either laparoscopically or using a robot. Once PD was completed, key steps included triple enterotomy, threading of silk-suture through all enterotomies and exteriorization, completing posterior layer of pancreaticojejunostomy (PJ), railroading stent through preplaced silk-suture, intubation of stent into the pancreatic duct, completion of PJ, followed by hepaticojejunostomy and parietalization of jejunum at the stent exit site. EPDS in PD through a minimally invasive approach can be performed safely in selected cases with either a small-sized pancreatic duct or a soft pancreas.

• Journal of Yeungnam Medical Science
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• v.41 no.1
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• pp.48-52
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• 2024

While simultaneous bilateral partial nephrectomy with a conventional multiport robot has been consistently reported since the 2010s, the introduction of the DaVinci SP system (Intuitive Surgical, Sunnyvale, CA, USA) could provide a novel way to perform surgery on bilateral kidneys while innovatively reducing the number of incisions. In our first report worldwide, the patient with bilateral small renal mass (2.0 cm for the left and 1.5 cm for the right side) and preoperative normal renal function was placed in the lateral decubitus position on an inverted bed. After tilting the bed to be as horizontal as possible, a 4-cm incision was made in the lower part of the umbilicus for the floating trocar technique. The partial nephrectomy was performed reliably as with the conventional transperitoneal approach, and then the patient could be repositioned to the contralateral side for the same procedure, maintaining all trocars. Total operation time (skin to skin), total console time, and the left- and right-side warm ischemic times were 260, 164, 27, and 23 minutes, respectively, without applying the early declamping technique. The estimated blood loss was 200 mL. The serum creatinine right after the operation, on the first day, 3 days, and 90 days after surgery were 0.92, 0.77, 0.79, and 0.81 mg/dL, respectively. For 90 days after the procedure, no complications or radiologic recurrence were observed. Further clinical studies will reveal the advantages of using the DaVinci SP device for this procedure over traditional multiport surgery, maximizing the benefit of a single port-based approach.

• The Journal of Korea Robotics Society
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• v.19 no.1
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• pp.39-44
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• 2024

This study introduces a novel method for predicting the shape of soft catheter robots embedded with electromagnets. As an advancement in the realm of soft robotics, these catheter robots are crafted from flexible and pliable materials, ensuring enhanced safety and adaptability during interactions with human tissues. Given the pivotal role of catheters in minimally invasive surgeries (MIS), our design stands out by facilitating active control over the orientation and intensity of the inbuilt electromagnets. This ensures precise targeting and manipulation of the catheter segments. The research encompasses a comprehensive breakdown of the magnetic modeling, tracking algorithms, experimental layout, and analytical techniques. Both simulation and experimental results validate the efficacy of our method, underscoring its potential to augment accuracy in MIS and revolutionize healthcare-oriented soft robotics.

• Journal of Digital Convergence
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• v.19 no.2
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• pp.523-529
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• 2021

Medical service robots are variously defined and classified by researchers and related government departments, but surgical robots and rehabilitation robots are commonly included in medical service robots, and except for these, the robots are classified as other medical service robots. In this study, domestic and foreign development trends and use cases were considered, focusing on logistics, guidance, and drug processing robots among other medical service robots. Logistics and guidance robots were developed quite a lot in Korea and completed a pilot project, or are being commercialized in hospitals, and exported. However, although the drug prcocessing robots was developed in Korea, the robot being use in the hospital was an imported. In order to expand and activate the robot market, systematic follow-up studies such as demand prediction studies are needed.