• Title/Summary/Keyword: Surgery robot

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Salvage Transoral Robotic Surgery for Recurrent or Residual Head and Neck Squamous Cell Carcinoma: A Single Institution Experience

  • Dabas, Surender;Dewan, Abhinav;Ranjan, Reetesh;Dewan, Ajay Kumar;Shukla, Himanshu;Sinha, Rupal
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7627-7632
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    • 2015
  • Background: The present study was conducted to evaluate the technical feasibility, safety and adequacy of surgical margins with salvage transoral robotic surgery (TORS) for recurrent or residual head and neck squamous cell carcinoma patients. Materials and Methods: Thirty patients who underwent salvage TORS using the 'DaVinci' robot were enrolled in the study and data related to their surgical time, complications and functional outcome were recorded. Results: The feasibility of salvage TORS in our study was observed to be 100%. Positive margins were encountered in only 6.7% of patients. Mean blood loss was 23.3 ml with no patient requiring blood transfusion. Postoperative complications in the form of primary haemorrhage requiring active surgical intervention occurred in 13.3%. Oral feeding could be started as early as the 3rd postoperative day in a few patients, with nasogastric tubes being removed on the 12th postoperative day. Long term gastrostomy tube dependency was seen in 10% cases. Median survival of patients was 19 months. Conclusions: Salvage TORS is a safe, effective and feasible option in the management of treatment failure cases. It offers an alternative surgical approach with unexpected benefits in terms of tracheostomy tube use, Ryle's tube and gastrostomy dependence.

Research on the Development of Artificial Organs based on the Physical Properties of the Human Body (인체의 물리적 성질을 이용한 인공장기 개발 연구)

  • Lee, SeungBock
    • The Journal of the Korea Contents Association
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    • v.22 no.7
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    • pp.670-675
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    • 2022
  • In the era of the 4th industrial revolution, everything is data-centric. The type and amount of data may be central, and new data may be required in special circumstances. As 3D printers are used in various fields, there are fields that are newly challenged. In particular, in the medical field, new attempts that have not been considered before are taking place. This paper is a study to enable research in fields that require physical properties of the human body. In the meantime, research using human organs has mainly used the materials made of silicon. We measure the physical properties of the human body from cadavers, apply these characteristics to develop new materials, and develop artificial organs with 3D printers. Using the artificial organs made in this way, you can practice surgery with a robot that removes kidney stones. In this paper, we would like to introduce a series of research processes to develop advanced materials similar to human organs.

Comparison of the Operative Results of Performing Endoscopic Robot Assisted Minimally Invasive Surgery Versus Conventional Cardiac Surgery (수술용 내시경 로봇(AESOP)을 이용한 최소 침습적 개심술과 동 기간에 시행된 전통적인 개심술의 결과에 대한 비교)

  • Lee, Young-Ook;Cho, Joon-Yong;Lee, Jong-Tae;Kim, Gun-Jik
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.598-604
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    • 2008
  • Background: The improvements in endoscopic equipment and surgical robots has encouraged the performance of minimally invasive cardiac operations. Yet only a few Korean studies have compared this procedure with the sternotomy approach. Material and Method: Between December 2005 and July 2007, 48 patients (group A) underwent minimally invasive cardiac surgery with AESOP through a small right thoracotomy. During the same period, 50 patients (group B) underwent conventional surgery. We compared the operative time, the operative results, the post-operative pain and the recovery of both groups. Result: There was no hospital mortality and there were no significant differences in the incidence of operative complications between the two groups. The operative $(292.7{\pm}61.7\;and\;264.0{\pm}47.9min$, respectively; p=0.01) and CPB times ($128.4{\pm}37.6\;and\;101.7{\pm}32.5min$, respectively; <0.01) were longer for group A, whereas there was no difference between the aortic cross clamp times ($82.1{\pm}35.0\;and\;87.8{\pm}113.5min$, respectively; p=0.74) and ventilator times ($18.0{\pm}18.4\;and\;19.7{\pm}9.7$ hr, respectively; p=0.57) between the groups. The stay on the ICU $(53.2{\pm}40.2\;and\;72.8{\pm}42.1hr$, respectively; p=0.02) and the hospitalization time ($9.7{\pm}7.2\;and\;14.8{\pm}11.9days$, respectively; p=0.01) were shorter for group A. The Patients in group B had more transfusions, but the difference was not significant. For the overall operative intervals, which ranged from one to four weeks, the pair score was significantly lower for the patients of group A than for the patients of group B. In terms of the postoperative activities, which were measured by the Duke Activity Scale questionnaire, the functional status score was clearly higher for group A compared to group B. The analysis showed no difference in the severity of either post-repair of mitral ($0.7{\pm}1.0\;and\;0.9{\pm}0.9$, respectively; p=0.60) and tricuspid regurgitation ($1.0{\pm}0.9\;and\;1.1{\pm}1.0$, respectively; p=0.89). In both groups, there were no valve related complications, except for one patient with paravalvular leakage in each group. Conclusion: These results show that compared with the median sternotomy patients, the patients who underwent minimally invasive surgery enjoyed significant postoperative advantages such as less pain, a more rapid return to full activity, improved cosmetics and a reduced hospital stay. The minimally invasive surgery can be done with similar clinical safety compared to the conventional surgery that's done through a median sternotomy.

THRUST GENERATION AND PROPULSIVE EFFICIENCY OF A BIOMIMETIC FOIL MOVING IN A LOW REYNOLDS NUMBER FLOW (저 레이놀즈 수에서 이동하는 생체모사익의 추력 생성 및 추진효율)

  • An, Sang-Joon;Choi, Jong-Hyeok;Maeng, Joo-Sung;Han, Cheol-Heui
    • Journal of computational fluids engineering
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    • v.15 no.2
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    • pp.41-46
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    • 2010
  • In this paper, the fluid dynamic forces and performances of a moving airfoil in the low Reynolds number flow is addressed. In order to simulate the necessary propulsive force for the moving airfoil in a low Reynolds number flow, a lattice-Boltzmann method is used. The critical Reynolds and Strouhal numbers for the thrust generation are investigated for the four propulsion types. It was found that the Normal P&D type produces the largest thrust with the highest efficiency among the investigated types. The leading edge of the airfoil has an effect of deciding the force production types, whereas the trailing edge of the airfoil plays an important role in augmenting or reducing the instability produced by the leading edge oscillation. It is believed that present results can be used to decide the optimal propulsion types for the given Reynolds number flow.

Morphometric Study on the Arterial Palmar Arch of the Hand (손바닥 동맥활에 관한 형태계측 연구)

  • Park, Bong Kwon;Jang, Soo Won;Choi, Seung Suk;Ahn, Hee Chang
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.691-701
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    • 2009
  • Purpose: Deviations of arterial palmar arches in the hand can be explained on the embryological basis. The purpose of this study was to provide new information about palmar arches through cadaver's dissection. The values of the location and diameter in these vessels were analyzed in order to support anatomical research and clinical correlation in the hand. Methods: The present report is based on an analysis of dissections of fifty - three hands carried out in the laboratory of gross anatomy. A reference line was established on the distal wrist crease to serve as the X coordinate and a perpendicular line drawn through the midpoint between middle and ring fingers, which served as the Y coordinate. The coordinates of the x and y values were measured by a digimatic caliper, and statistically analyzed with Student's t - test. Results: Complete superficial palmar archs were seen in 96.2 % of specimens. In the most common type of males, the superficial arch was formed only by the ulnar artery. In the most common type of females, the superficial arch was formed anastomosis between the radial artery and the ulnar artery. The average length of the superficial and deep palmar arch is $110.3{\pm}33.0mm$ and $67.9{\pm}14.0mm$ respectively. Regarding the superficial palmar arch, ulnar artery starts $-16.1{\pm}5.1mm$ on X - line, and $2.5{\pm}24.5mm$ on Y - line. Radial artery appears on palmar side $7.7{\pm}3.2mm$ on X - line, and $20.9{\pm}10.9mm$ on Y - line. But radial artery starts on $6.3{\pm}3.6mm$ on X - line, and $3.4{\pm}5.1mm$ on Y - line. Digital arteries of superficial palmar arch starts on $6.1{\pm}3.7mm$, $33.9{\pm}8.8mm$ on index finger, $1.8{\pm}3.4mm$, $40.1{\pm}7.3mm$ on middle finger, $-3.2{\pm}4.9mm$, $42.6{\pm}7.0mm$ on ring finger, and $-8.9{\pm}5.1mm$, $42.5{\pm}80mm$ on little finger in respective X and Y coordinates. Radial artery of deep palmar arches measured at the palmar side perforating from the dorsum of hand. It's coordinates were $9.7{\pm}4.8mm$ on X - line, $21.7{\pm}10.2mm$ on Y - line. Ulnar artery was measured at hypothenar area, and it's coordinates were $-20.4{\pm}6.3mm$ on X - line, and $30.6{\pm}7.4mm$ on Y - line. Conclusions: Anatomically superficial palmar arch can be divided into a complete and an incomplete type. Each of them can be subdivided into 4 types. The deep palmar arch is less variable than the superficial palmar arch. We believe these values of the study will be used for the vascular surgery of the hand using the endoscope and robot in the future.

Robotic versus Laparoscopic Gastrectomy for Gastric Carcinoma: a Meta-Analysis of Efficacy and Safety

  • Hu, Li-Dong;Li, Xiao-Fei;Wang, Xiu-Yue;Guo, Tian-Kang
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4327-4333
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    • 2016
  • Purpose: To systematically review efficacyand safety of robotic gastrectomy (RG) compared with conventional laparoscopic gastrectomy (LG) for gastric carcinoma. Materials and Methods: A systematic literature search was carried out using PubMed, Cochrane Library, CBM, CNKI, WanFang, VIP and other sources like relevant references to obtain comparative studies assessing the effectiveness and safety between RG and LG published between 2013 and 2016. Then the literature was screened and the data were extracted by 2 independent reviewers. The quality of the literature was assessed, and the data analyzed using Stata/SE 14 software. Fixed effects or random effects models wereapplied according to heterogeneity. Results: A total of 12 non-randomized observational clinical studies involving 3,580 patients were included, of which 1,096 had undergone RG and 2,484 had received LG. The results of the meta-analysis showed in terms of effectiveness, RG was associated with less blood loss, less time to first flatus and greater number of harvested lymph nodes, but there were no significant differences in proximal and distal resection margins, compared with LG. In terms of efficiency, RG was associated with shorter hospital stay, but longer operative time. In terms of safety, there were no statistically significant differences in complications, mortality and conversions between RG and LG. Conclusions: RG can achieve comparable or better short-term and radical effects than LG, with respect to effectiveness, efficiency and safety in treatment of gastric carcinoma. Future studies involving RG should focus on decreasing operative time and reducing cost. Moreover, there is a need for randomized controlled trials comparing the two techniques with long-term follow-up.

Smart Glasses Cannula Guide System Development for Interventional Cardiology Procedures (중재적 심장 질환 시술을 위한 스마트 글래스 삽입관 가이드 시스템 개발)

  • Jang, Ik Gyu;Heo, Yeong Jun;Jeon, Geum Sang;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.41 no.5
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    • pp.173-178
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    • 2020
  • Remote control intervention surgery robotic system improves treatment effect on cardiovascular patients and reduces X-ray exposure. However, at the time of the first procedure, CT (computerized tomography) and other ultrasound diagnostic equipment should be used because the operator must insert the cannula directly into the patient's leg. Improvements to this have been un-met-needs of hospitals. In this paper, we developed a system that can insert the cannula intuitively and quickly by displaying blood vessels at a glance through the system using smart wearable glasses. The core development method is as follows. In order to project augmented reality onto the surgical image, CT scan angiography image is extracted and processed. In the process, three CT-Markers are used to create a coordinate system of blood vessel images. Additionally, a reference marker is photographed on a single camera to obtain a camera coordinate system. Since the CT marker and the reference marker are in the same position, 3D registration is performed. In the text, a detailed explanation will be given.

Healthcare Robots in the New Normal era; Outlook for the Post-Corona era (뉴노멀 시대의 의료 로봇; Post-Corona 시대를 위한 전망)

  • Moon, Jeong Eun;Cho, Yong Jin
    • Journal of Digital Convergence
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    • v.19 no.2
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    • pp.509-514
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    • 2021
  • The pandemic of COVID-19 is driving the demand for non-face-to-face diagnosis, observation, and treatment in the healthcare environment, which has led to increased interest in helathcare robots. The authors intend to predict the direction in which the quarantine healthcare robots should be utilized in the post-corona era through analysis of national agency reports, on-offline press reports, and domestic and foreign robot company press releases. The COVID-19 pandemic has raised interest in medical robots. And there is a need to apply healthcare robots that can perform tasks such as disinfection, logistics transfer, screening tests, monitoring of patients, remote medical treatment support for isolated patients, and video calls with family members. Therefore, it is considered that future correct development and application of healthcare robots and empirical research to verify them should be continued based on sufficient consideration for various problems associated with the practical application of robots.

Relationship of Hospital Ownership and Profitability with Prices of Non-Covered Services (병원의 설립형태 및 수익성과 비급여 서비스 가격의 연관성)

  • Do Hee Kim;Tae Hyun Kim
    • Korea Journal of Hospital Management
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    • v.28 no.1
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    • pp.37-51
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    • 2023
  • Purposes: There exist many non-covered services that the National Health Insurance does not cover, and thus, their prices are set by individual health care providers. However, little study has been done to investigate how hospitals set prices for those services. The purpose of this study is to examine the relationship between ownership, profitability, and prices of those services for a sample of general hospitals. Methodology/Approach: Data regarding the prices of major non-covered services (e.g., upper-level hospital room fees, MRI, Da 7inci robot surgery, and LASIK) were obtained from the Health Insurance Review and Assessment Service and the financial information, as well as other characteristics, were derived from the financial reports from the Korea Health Industry Development Institute. Descriptive statistics, t-tests, and multiple linear regression analyses were used to test the relationship between the independent variables and the dependent variables. Findings: Hospitals owned by private universities appeared to have higher prices for non-covered services while regional public hospitals tend to have lower prices. Profitability, measured by operating margin, was not significantly related to the prices. Hospitals that charge higher prices were more likely to be located in the capital area (Seoul, Incheon, and Gyeonggi), and to employ larger number of personnel. Practical Implications: Public hospitals tend to charge lower prices for non-covered services. Relative market power appears to be related to pricing. Further research is needed to investigate whether such a relationship varies over time and its effects on the quality and access.

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