• Korean Journal of Radiology
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• v.22 no.5
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• pp.706-713
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• 2021

Objective: To evaluate the impact of surgical simulation training using a three-dimensional (3D)-printed model of tetralogy of Fallot (TOF) on surgical skill development. Materials and Methods: A life-size congenital heart disease model was printed using a Stratasys Object500 Connex2 printer from preoperative electrocardiography-gated CT scans of a 6-month-old patient with TOF with complex pulmonary stenosis. Eleven cardiothoracic surgeons independently evaluated the suitability of four 3D-printed models using composite Tango 27, 40, 50, and 60 in terms of palpation, resistance, extensibility, gap, cut-through ability, and reusability of. Among these, Tango 27 was selected as the final model. Six attendees (two junior cardiothoracic surgery residents, two senior residents, and two clinical fellows) independently performed simulation surgeries three times each. Surgical proficiency was evaluated by an experienced cardiothoracic surgeon on a 1-10 scale for each of the 10 surgical procedures. The times required for each surgical procedure were also measured. Results: In the simulation surgeries, six surgeons required a median of 34.4 (range 32.5-43.5) and 21.4 (17.9-192.7) minutes to apply the ventricular septal defect (VSD) and right ventricular outflow tract (RVOT) patches, respectively, on their first simulation surgery. These times had significantly reduced to 17.3 (16.2-29.5) and 13.6 (10.3-30.0) minutes, respectively, in the third simulation surgery (p = 0.03 and p = 0.01, respectively). The decreases in the median patch appliance time among the six surgeons were 16.2 (range 13.6-17.7) and 8.0 (1.8-170.3) minutes for the VSD and RVOT patches, respectively. Summing the scores for the 10 procedures showed that the attendees scored an average of 28.58 ± 7.89 points on the first simulation surgery and improved their average score to 67.33 ± 15.10 on the third simulation surgery (p = 0.008). Conclusion: Inexperienced cardiothoracic surgeons improved their performance in terms of surgical proficiency and operation time during the experience of three simulation surgeries using a 3D-printed TOF model using Tango 27 composite.

• Journal of Korean Foot and Ankle Society
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• v.27 no.3
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• pp.112-116
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• 2023

A 74-year-old female patient, who underwent surgery for a left distal tibiofibular fracture 40 years earlier, visited the hospital with an ankle varus deformity due to malunion. The patient complained of discomfort while walking due to the ankle and hindfoot varus deformity but did not complain of ankle pain. Therefore, correction using supramalleolar osteotomy was planned, and through virtual surgical simulation, it was predicted that a correction angle of 24° and an osteotomy gap open of 12 mm would be necessary. An osteotomy guide and an osteotomy gap block were made using three-dimensional (3D) printing to perform the osteotomy and correct the deformity according to the predicted goal. One year after surgery, it was observed that the ankle varus was corrected according to the surgical simulation, and the patient was able to walk comfortably. Thus, for correction of deformity, virtual surgical simulation and a 3D-printed osteotomy guide can be used to predict the target value for correction. This is useful for increasing the accuracy of correction of the deformity.

• Korean Journal of Adult Nursing
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• v.25 no.5
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• pp.494-503
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• 2013

Purpose: The purpose of this study was to examine the effects of a simulation-based educational program on anxiety and discomfort in patients with early stage of stomach cancer or stomach adenoma undergoing gastroendoscopic surgery. Methods: The study employed a non-equivalence control group and non-synchronized design to prevent diffusion of treatment. Data were collected from 110 patients (experimental group=55, control group=55) admitted to a department of gastroenterology to undergo gastroendoscopic surgery for early stage of stomach cancer or stomach adenoma. The program was conducted as a 30-minute simulation-based education including 12 processes which patients would experience. Outcome variables were state anxiety, objective discomfort, and subjective discomfort. Results: The scores of state anxiety in the experimental group significantly decreased over time compared to those in the control group. The scores of objective and subjective discomfort after surgery in the experimental group were significantly lower than those in the control group. Conclusion: The study findings suggested that the simulation-based educational program making a person feel sense of real experiences could reduce anxiety and discomfort in gastroendoscopic surgery patients.

• Archives of Plastic Surgery
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• v.41 no.3
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• pp.218-224
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• 2014

Plastic surgery training worldwide has seen a thorough restructuring over the past decade, with the introduction of formal training curricula and work-based assessment tools. Part of this process has been the introduction of revalidation and a greater use of simulation in training delivery. Simulation is an increasingly important tool for educators because it provides a way to reduce risks to both trainees and patients, whilst facilitating improved technical proficiency. Current microsurgery training interventions are often predicated on theories of skill acquisition and development that follow a 'practice makes perfect' model. Given the changing landscape of surgical training and advances in educational theories related to skill development, research is needed to assess the potential benefits of alternative models, particularly cross-training, a model now widely used in non-medical areas with significant benefits. Furthermore, with the proliferation of microsurgery training interventions and therefore diversity in length, cost, content and models used, appropriate standardisation will be an important factor to ensure that courses deliver consistent and effective training that achieves appropriate levels of competency. Key research requirements should be gathered and used in directing further research in these areas to achieve on-going improvement of microsurgery training.

• Journal of International Society for Simulation Surgery
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• v.2 no.2
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• pp.83-86
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• 2015

Recently, computer-assisted surgery is popular for performing well-planned operations. Computer-aided navigation system is helpful in maxillofacial surgery with real time instrument positioning and clear anatomic identification. Generally, segmental mandibulectomy and reconstruction flap surgery have done by extra-oral approach such as, submandibular approach. This case report describes performing intra-oral segmental mandibulectomy and reconstruction with monocortical deep circumflex iliac artery (DCIA) flap and CT guided implant surgery by using computer-aided surgical guide and navigation for managing ameloblastoma in a 31 years old female patient.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2011.06a
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• pp.945-946
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• 2011

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.402-407
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• 2010

Introduction: The planning of implant surgery is an important factor for the implant prosthesis. Stereolithographic (SLA) surgical stents based on a computer simulation are quite helpful for clinicians to perform the surgery as planned. Although many clinical and technical trials have been performed for computed tomography (CT)-guided implant stents to improve the surgical procedures and prosthetic treatment, there are still many problems to solve. We developed a system of a surgical guide based on 3 dimensional (3D) CT for implant therapy and achieved satisfactory results in the terms of planning and operation. Materials and Methods: Fifteen patients were selected and 30 implant fixtures were installed. The preoperative CT data for surgical planning were prepared after obtaining informed consent. Surgical planning was performed using the simulation program, Ondemend3D In2Guide. The stents were fabricated based on the simulation data containing information of the residual bone, the location of the nerve, and the expected design of the prostheses. After surgery with these customized stents, the accuracy and reproducibility of implant surgery were evaluated based on the computer simulation. The data of postoperative CT were used to confirm this system using the image fusion technique and compare the implant fixtures between the planned and implanted. Results: The mean error was 1.18 (${\pm}0.73$) mm at the occlusal center, 1.23 (${\pm}0.67$) mm at the apical center, and the axis error between the two fixtures was $3.25^{\circ}C$ (${\pm}3.00$). These stents showed superior accuracy in maxilla cases. The lateral side error at the apical center was significantly different from the error at the occlusal center but there were no significant differences between the premolars, 1st molars and 2nd molars. Conclusion: SLA surgical stents based on a computer simulation have the satisfactory accuracy and are expected to be useful for accurate planning and surgery if some errors can be improved.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.327-329
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• 2013

As a technically demanding skill, microsurgery is taught in the lab, in the form of a course of variable length (depending on the centre). Microsurgical training courses usually use a mixture of non-living and live animal simulation models. In the literature, a plethora of microsurgical training models have been described, ranging from low to high fidelity models. Given the high costs associated with live animal models, cheaper alternatives are coming into vogue. In this paper we describe the use of the chicken aorta as a simple and cost effective low fidelity microsurgical simulation model for training.

• The Journal of the Korean dental association
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• v.57 no.2
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• pp.100-104
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• 2019

Orthognathic surgery is designed to correct problems of the jaw and face and restore facial harmony. The limitations of orthognathic surgery occur at all steps of the surgical workflow: preoperative planning, simulation, and operation. Many studies have shown the accuracy and advantages of 3 dimensional computer-assisted program for orthognathic surgery. The purpose of this paper is to introduce the accuracy of the maxillary repositioning in patients who underwent orthognathic surgery using a 3 dimensional computer assisted surgery program. The reliability of computer guided orthognathic surgery using splint and surgical guide need to be improved further. The 3 dimensional computer assisted analysis seems to be more precise to interpret than two-dimensional analysis. High-precision planning of orthognathic surgery has predictable results. Three-dimensional computer assisted orthognathic surgery has the following advantages : planned surgical movement is possible, splints guide with CAD/CAM technology; and increase predictable results .Computer assisted simulation surgery ensures accuracy during surgery, thereby facilitating predictable results. It may provide solution that enables surgeon to perform planned surgery more accurately.

• Journal of Korea Multimedia Society
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• v.14 no.9
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• pp.1175-1181
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• 2011

Practice education using virtual medical simulation has been recently introduced to maximize the learning efficiency in clinical environment. Specially, in minimally invasive surgery, the necessity of virtual surgery medical simulation has been substantially increased. Since cauterizing effect occurred frequently in minimally invasive surgery has been represented by simple bleeding, realistic cauterizing effect animation has not been proposed yet. In this paper, we propose realistic real-time cauterizing effect animation. Proposed method changes the individual element of each vertex color of the mesh and uses sigmoid function to impose weights for the smooth color change inside the valid mesh region so that the results of cauterizing effect animation was realistic. In addition, by proposing cauterizing color buffer, overlapped cauterizing effects can be realistically represented. Proposed method greatly improves the sense of the real and absorption in virtual surgery medical simulation so that the education efficiency of doctors and students using medical simulation can be maximized.