• International Journal of Control, Automation, and Systems
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• v.4 no.1
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• pp.30-41
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• 2006

The goal of this work is to develop and test a robot-assisted surgery system for spinal fusion. The system is composed of a robot, a surgical planning system, and a navigation system. It plays the role of assisting surgeons for inserting a pedicle screw in the spinal fusion procedure. Compared to conventional methods for spinal fusion, the proposed surgical procedure ensures minimum invasion and better accuracy by using robot and image information. The robot plays the role of positioning and guiding needles, drills, and other surgical instruments or conducts automatic boring and screwing. Pre-operative CT images intra-operative fluoroscopic images are integrated to provide the surgeon with information for surgical planning. Some experiments employing the developed robotic surgery system are conducted. The experimental results confirm that the system is not only able to guide the surgical tools by accurately pointing and orienting the specified location, but also successfully compensate the movement of the patient due to respiration.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2005.10a
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• pp.144-148
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• 2005

The goal of this work is to develop and test a robot-assisted surgery system for spinal fusion. The system is composed of a robot, a surgical planning system, and a navigation system. It plays the role of assisting surgeons for inserting a pedicle screw in the spinal fusion procedure. Compared to conventional methods fer spinal fusion, the proposed surgical procedure ensures minimum invasion and better accuracy by using robot and image information. The robot plays the role of positioning and guiding needles, drills, and other surgical instruments or conducts automatic boring and screwing. Pre-operative CT images and intra-operative fluoroscopic images are integrated to provide the surgeon with information for surgical planning. Several experiments employing the developed robotic surgery system are conducted. The experimental results confirmed that the system is not only able to guide the surgical tools by accurately pointing and orienting the specified location, but also successfully compensate the movement of the patient due to his/her respiration.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.3
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• pp.282-288
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• 2010

Surgery with the computer navigation system can make it possible to identify important anatomical structures which are difficult to be confirmed with the naked eye in the operation, and has extended their applications in various surgical fields. The head and neck surgery especially requires detailed anatomical knowledges and these knowledges have influences on postoperative functions and esthetics of a patient. In the orthognathic surgery, we should take osteotomies in the precise locations of the jawbones and move segments to the intended positions. There are so many important anatomical structures around the osteotomy-sites in the orthognathic surgery that the prevention of damage to these structures to obtain satisfactory results without any complication. There are vessels of the pterygoid plexus posterior to the pterygoid plate in the maxilla and the mandibular nerve enters the mandibluar foramen in the mandibular ramus. These locations should be confirmed perioperatively to avoid any injury to these structures. The navigation-assisted surgery may be helpful for this purpose. We performed navigational orthognathic surgeries with preoperative CT images and obtained satisfactory results. The osteotomy was performed in the proper location and damaging the surrounding important anatomical structures was avoided by keeping the saw away from them with the real-time navigation. It may be required to develop proper devices and protocols for the navigation-assisted orthognathic surgery.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.1-6
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• 2009

The usefulness and accuracy of computer-assisted surgery have been evaluated clinically in many orthopedic fields, such as, joint replacement arthroplasty, cruciate ligament reconstruction, and pedicle screw placemen. Recently several preliminary reports have been issued on the application of navigation to bone tumor surgery. The main advantage of navigation-assisted bone tumor surgery is that it provides highly accurate three-dimensional radiological information for intraoperative guidance. In particular, distances from tumors to resection margins can be precisely determined using intraoperative three-dimensional images. Accordingly, the technique allows preservation of function to be maximized by minimizing unnecessary resection. However, surgeons should recognize that the accuracies of navigation systems in bone tumor surgery have some hidden pitfalls. Here, based on our clinical results, we describe the surgical techniques used and include some cautionary notes.

• Journal of Yeungnam Medical Science
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• v.21 no.1
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• pp.1-11
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• 2004

Total knee arthroplasty has become a common procedure for treatment of severe osteoarthritis, rheumatoid arthritis and post-traumatic arthritis. In the past, failure of total knee arthroplasty was commonly attributable to aseptic loosening, often associated with component malalignment, soft tissue imbalance. With improved surgical instrumentation and soft tissue balancing techiniques, failure secondary to mechanical loosening has been minimal. But surgeons are still dissatisfied with implant malalignment. Correct tibiofemoral alignment seems to be particularly important since it is generally agreed that axial deviation and imprecise implantation may lead to loosening of the implant component. Navigation systems and robotic techniques could potentially solve problems of imprecision in traditional total knee arthroplasty. It is expected that the success rate and longevity of total knee arthroplasty will be improved during the twenty first century.

• Journal of Gastric Cancer
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• v.16 no.1
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• pp.14-20
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• 2016

Purpose: Early diagnosis of gastric cancer is still the exception in Western countries. In the East, as in Japan and Korea, this disease is an endemic disorder. More conservative surgical procedures are frequently performed in early gastric cancer cases in these countries where sentinel lymph node navigation surgery is becoming a safe option for some patients. This study aims to evaluate preliminary outcomes of patients with early gastric cancer who underwent sentinel node navigation surgeries in Brazil, a country with non-endemic gastric cancer levels. Materials and Methods: From September 2008 to March 2014, 14 out of 205 gastric cancer patients underwent sentinel lymph node navigation surgeries, which were performed using intraoperative, endoscopic, and peritumoral injection of patent blue dye. Results: Antrectomies with Billroth I gastroduodenostomies were performed in seven patients with distal tumors. The other seven patients underwent wedge resections. Sentinel basin resections were performed in four patients, and lymphadenectomies were extended to stations 7, 8, and 9 in the other 10. Two patients received false-negative results from sentinel node biopsies, and one of those patients had micrometastasis. There was one postoperative death from liver failure in a cirrhotic patient. Another cirrhotic patient died after two years without recurrence of gastric cancer, also from liver failure. All other patients were followed-up for 13 to 79 months with no evidence of recurrence. Conclusions: Sentinel lymph node navigation surgery appears to be a safe procedure in a country with non-endemic levels of gastric cancer.

• Journal of Korean Neurosurgical Society
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• v.63 no.2
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• pp.237-247
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• 2020

Objective : Fixation of the C1-2 segment is challenging because of the complex anatomy in the region and the need for a high degree of accuracy to avoid complications. Preoperative 3D-computed tomography (CT) scans can help reduce the risk of complications in the vertebral artery, spinal cord, and nerve roots. However, the patient may be susceptible to injury if the patient's anatomy does not match the preoperative CT scans. The intraoperative 3D image-based navigation systems have reduced complications in instrument-assisted techniques due to greater accuracy. This study aimed to compare the radiologic outcomes of C1-2 fusion surgery between intraoperative CT image-guided operation and fluoroscopy-guided operation. Methods : We retrospectively reviewed the radiologic images of 34 patients who underwent C1-2 fusion spine surgery from January 2009 to November 2018 at our hospital. We assessed 17 cases each of degenerative cervical disease and trauma in a study population of 18 males and 16 females. The mean age was 54.8 years. A total of 139 screws were used and the surgical procedures included 68 screws in the C1 lateral mass, 58 screws in C2 pedicle, nine screws in C2 lamina and C2 pars screws, four lateral mass screws in sub-axial level. Of the 34 patients, 19 patients underwent screw insertion using intraoperative mobile CT. Other patients underwent atlantoaxial fusion with a standard fluoroscopy-guided device. Results : A total of 139 screws were correctly positioned. We analyzed the positions of 135 screws except for the four screws that performed the lateral mass screws in C3 vertebra. Minor screw penetration was observed in seven cases (5.2%), and major pedicle screw penetration was observed in three cases (2.2%). In one case, the malposition of a C2 pedicle screw was confirmed, which was subsequently corrected. There were no complications regarding vertebral artery injury or onset of new neurologic deficits. The screw malposition rate was lower (5.3%) in patients who underwent intraoperative CT-based navigation than that for fluoroscopy-guided cases (10.2%). And we confirmed that the operation time can be significantly reduced by surgery using intraoperative O-arm device. Conclusion : Spinal navigation using intraoperative cone-beam CT scans is reliable for posterior fixation in unstable C1-2 pathologies and can be reduced the operative time.

• Journal of Advanced Navigation Technology
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• v.15 no.6
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• pp.1111-1117
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• 2011

We was designed the portable LED light which can shadowless shooting and developed using a high-power LED that medical attention as a new lighting components for structural confirmation of oral dental area, medical and surgical lesions in the local area. LED which applied to the development, was used the 3-color LEDs for possible of implement a variety of colors and adjusted the light intensity. It is being magnified of delicacy expressiveness and three-dimensional for tone of the subject-specific. It has been developed a highly efficient light module that LED is used to consider the electrical characteristics and optical properties. SMPS has We was designed the portable LED light which can shadowless shooting and developed using a high-power LED that medical attention as a new lighting components for structural confirmation of oral dental area, medical and surgical lesions in the local area. LED which applied to the development, was used the 3-color LEDs for possible of implement a variety of colors and adjusted the light intensity. It is being magnified of delicacy expressiveness and three-dimensional for tone of the subject-specific. It has been developed a highly efficient light module that LED is used to consider the electrical characteristics and optical properties. SMPS has produced for use in mobile that can be driven at low voltage. In addition, it was also possible to implement a variety of colors from monochromatic Light to polychromatic light using by PWM control method and were available 32,768.

• Archives of Craniofacial Surgery
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• v.17 no.3
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• pp.146-153
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• 2016

Background: Restoring the orbital cavity in large blow out fractures is a challenge for surgeons due to the anatomical complexity. This study evaluated the clinical outcomes and orbital volume after orbital wall fracture repair using a rapid prototyping (RP) technique and intraoperative navigation system. Methods: This prospective study was conducted on the medical records and radiology records of 12 patients who had undergone a unilateral blow out fracture reconstruction using a RP technique and an intraoperative navigation system from November 2014 to March 2015. The surgical results were assessed by an ophthalmic examination and a comparison of the preoperative and postoperative orbital volume ratio (OVR) values. Results: All patients had a successful treatment outcome without complications. Volumetric analysis revealed a significant decrease in the mean OVR from $1.0952{\pm}0.0662$ (ranging from 0.9917 to 1.2509) preoperatively to $0.9942{\pm}0.0427$ (ranging from 0.9394 to 1.0680) postoperatively. Conclusion: The application of a RP technique for the repair of orbital wall fractures is a useful tool that may help improve the clinical outcomes by understanding the individual anatomy, determining the operability, and restoring the orbital cavity volume through optimal implant positioning along with an intraoperative navigation system.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.478-489
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• 2018

Total knee arthroplasty has become a standard procedure for advanced knee arthritis to relieve pain and improve function. Computer-assisted navigation systems have been used in total knee arthroplasty to improve the mechanical axis of the limb as well as the alignment and position of the components. A computer-assisted navigation system has the advantage of real-time feedback during surgery, such as mediolateral balance in extension and flexion gap, alignment of the lower limb, and components. On the other hand, the computer-assisted navigation system requires an additional stab wound for tracker fixation, which can increase the likelihood of superficial wound infection and stress fractures and increase the operation time and cost of surgery. The clinical efficacy of computer-assisted navigation in total knee arthroplasty is also controversial. Compared to the conventional technique, computer navigation improves the accuracy of the postoperative mechanical axis within outliers of $3^{\circ}$ varus or $3^{\circ}$ valgus. This paper reviews the surgical technique, pitfalls, clinical and radiological outcomes, useful clinical cases, and future perspectives in computer-assisted navigation total knee arthroplasty.