• Title/Summary/Keyword: Surgical reconstruction

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Constrained High Accuracy Stereo Reconstruction Method for Surgical Instruments Positioning

  • Wang, Chenhao;Shen, Yi;Zhang, Wenbin;Liu, Yuncai
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.6 no.10
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    • pp.2679-2691
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    • 2012
  • In this paper, a high accuracy stereo reconstruction method for surgery instruments positioning is proposed. Usually, the problem of surgical instruments reconstruction is considered as a basic task in computer vision to estimate the 3-D position of each marker on a surgery instrument from three pairs of image points. However, the existing methods considered the 3-D reconstruction of the points separately thus ignore the structure information. Meanwhile, the errors from light variation, imaging noise and quantization still affect the reconstruction accuracy. This paper proposes a method which takes the structure information of surgical instruments as constraints, and reconstructs the whole markers on one surgical instrument together. Firstly, we calibrate the instruments before navigation to get the structure parameters. The structure parameters consist of markers' number, distances between each markers and a linearity sign of each instrument. Then, the structure constraints are added to stereo reconstruction. Finally, weighted filter is used to reduce the jitter. Experiments conducted on surgery navigation system showed that our method not only improve accuracy effectively but also reduce the jitter of surgical instrument greatly.

Virtual Surgical Planning System for Mandible Reconstruction (하악골 재건을 위한 가상수술계획 시스템)

  • Kim, Hannah;Kim, Youngjun;Cho, Hyunchul;Shim, Eung June;Lee, Deukhee;Kim, Laehyun;Park, Sehyung;Lee, Jung-Woo
    • Korean Journal of Computational Design and Engineering
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    • v.21 no.2
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    • pp.196-203
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    • 2016
  • In this paper, we propose a virtual surgical planning system specialized to mandible reconstruction surgery. Mandible reconstruction surgery is one of the most difficult surgeries, even for experienced surgeons. Compared to the traditional surgical procedures, virtual surgical planning can reduce the operation time in operating room while expecting better surgical outcome with optimized planning. However, with existing software systems, it requires much time and manual operations in virtual surgical planning. To reduce preparation time and improve accuracy of virtual surgical planning, we have developed optimized functions for virtual surgical simulation of mandible reconstruction with user-friendly interface. We found that the proposed system shortened the preparation time by half compared to the existing system from the experiments. The proposed system supports surgeons to make accurate plan faster and easier. The virtually planned results are used to make surgical cutting guide by 3D printing, and this will enhance surgical performance in operating room.

Arthroscopic Revision ACL Reconstruction (전방십자인대 재재건술)

  • Ahn Jin-Hwan
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.20-27
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    • 2003
  • It is reported that approximately 100,000 anteior cruciate ligament (ACL) reconstructions are performed in the United States each year. Recurrent instability because of graft failure is estimated to occur in from 0.7$\%$ to 8$\%$ of reconstruction. Recently revision ACL reconstruction is likely to become more common as the number of primary reconstructions continues to increase. Arthroscopic revision ACL surgery with adequate graft for failed ACL reconstruction was successful in objectively and subjectively improving stability. However, considering the most common causes of failure after ACL reconstruction were errors in surgical technique, it is important that the primary ACL reconstruction should be performed with correct surgical technique. Therefore author reviewed the causes of failure of reconstruction to prevent the failure of reconstruction and described the surgical technique of revision ACL reconstruction.

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Single-port robot-assisted prosthetic breast reconstruction with the da Vinci SP Surgical System: first clinical report

  • Joo, Oh Young;Song, Seung Yong;Park, Hyung Seok;Roh, Tai Suk
    • Archives of Plastic Surgery
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    • v.48 no.2
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    • pp.194-198
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    • 2021
  • Robot-assisted nipple-sparing mastectomy with immediate reconstruction is currently performed in an attempt to seek smaller and indistinct incisions. Robotic surgery system has been evolving under the concept of minimal invasive technique which is a recent trend in surgery. One of the latest version is the da Vinci SP Surgical System (Intuitive Surgical). In this report, we will share our experiences. Two patients underwent robot-assisted nipple-sparing mastectomy, each followed by immediate robot-assisted expander insertion and prepectoral direct-to-implant breast reconstruction, respectively. There was no open conversion or major postoperative complication. One patient experienced mild infection, which was resolved by intravenous antibiotic treatment. Simple docking process, multi-joint instruments, and thirdarm functionality are among the new surgical system's advantages. The present cases suggest that robot-assisted nipple-sparing mastectomy with immediate reconstruction using the da Vinci SP Surgical System is feasible and safe. The promising features and potential application of da Vinci SP in breast reconstruction need further study.

Surgical Treatment of Chronic Lateral Ankle Instability: Repair versus Reconstruction (만성 족관절 외측 불안정성의 수술적 치료: 봉합술과 재건술의 비교)

  • Kim, Keun Soo;Park, Young Uk
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.1
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    • pp.1-5
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    • 2019
  • Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.

Complications of Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술의 합병증)

  • Song Eun-Kyoo;Kim Jong-Seok
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.15-19
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    • 2003
  • Although the number of anterior cruciate ligament reconstruction is increasing, complications after primary ACL reconstruction are more difficult to determine. Intraoperative and postoperative complications can lead to ultimate failure of a primary reconstructive procedure. Therefore, surgical success in ACL reconstruction requires detailed knowledge and technical advancements about ACL reconstruction. Preoperatively surgeon must pay attention to selection of grafts and methods of fixation, and intraoperatively, attention to the harvest of graft, passage of graft, intraarticuar placement of the graft, notchplasty, proper tensioning of the graft, and others. Postoperative complications must be detected early, including infection, abnormal healing responses, arthrofibrosis, graft rejection, and reflex sympathetic dystrophy. Careful patient selection, appropriate surgical timing, careful surgical technique, and supervised preoperative and postoperative rehabilitation can minimize postoperative complications.

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Limberg flap reconstruction for sacrococcygeal pilonidal sinus disease with and without acute abscess: Our experience and a review of the literature

  • Sinnott, Catherine J.;Glickman, Laurence T.
    • Archives of Plastic Surgery
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    • v.46 no.3
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    • pp.235-240
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    • 2019
  • Background The efficacy of Limberg flap reconstruction for pilonidal sinus with acute abscess remains unclear. This study aimed to compare outcomes after Limberg flap reconstruction for pilonidal sinus disease with and without acute abscess. A secondary objective was to perform a review of the literature on the topic. Methods A retrospective chart review was conducted of all patients who underwent excision and Limberg flap reconstruction for pilonidal sinus from 2009 to 2018. Patient demographics, wound characteristics, and complication rates were reviewed and analyzed. Results Group 1 comprised 19 patients who underwent Limberg flap reconstruction for pilonidal sinus disease without acute abscess and group 2 comprised four patients who underwent reconstruction for pilonidal sinus disease with acute abscess. The average defect size after excision was larger in group 2 than group 1 ($107.7{\pm}60.3cm^2$ vs. $61.4{\pm}33.8cm^2$, respectively). There were no recurrences, seromas or cases of flap necrosis postoperatively. There was only one revision surgery needed for evacuation of a postoperative hematoma in group 1. There were comparable rates of partial wound dehiscence treated by local wound care, hematoma, need for revision surgery and minor infection between group 1 and group 2. Conclusions Limberg flap reconstruction for pilonidal sinus in the setting of acute abscess is a viable option with outcomes comparable to that for disease without acute abscess. This practice will avoid the pain and cost associated with a prolonged local wound care regimen involved in drainage of the abscess prior to flap reconstruction.

Early experiences with robot-assisted prosthetic breast reconstruction

  • Ahn, Sung Jae;Song, Seung Yong;Park, Hyung Seok;Park, Se Ho;Lew, Dae Hyun;Roh, Tai Suk;Lee, Dong Won
    • Archives of Plastic Surgery
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    • v.46 no.1
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    • pp.79-83
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    • 2019
  • Robotic surgery facilitates surgical procedures by employing flexible arms with multiple degrees of freedom and providing high-quality 3-dimensional imaging. Robot-assisted nipple-sparing mastectomy with immediate reconstruction is currently performed to avoid breast scars. Four patients with invasive ductal carcinoma underwent robot-assisted nipple-sparing mastectomy and immediate robot-assisted expander insertion. Through a 6-cm incision along the anterior axillary line, sentinel lymph node biopsy and nipple-sparing mastectomy were performed by oncologic surgeons. The pectoralis major muscle was elevated, an acellular dermal matrix (ADM) sling was created with robotic assistance, and an expander was inserted into the subpectoral, sub-ADM pocket. No patients had major complications such as hematoma, seroma, infection, capsular contracture, or nipple-areolar necrosis. The mean operation time for expander insertion was 1 hour and 20 minutes, and it became shorter with more experience. The first patient completed 2-stage prosthetic reconstruction and was highly satisfied with the unnoticeable scar and symmetric reconstruction. We describe several cases of immediate robot-assisted prosthetic breast reconstruction. This procedure is a feasible surgical option for patients who want to conceal surgical scars.

Surgical Excision and Reconstruction in Oral Cavity Cancer (구강암의 수술적 접근과 재건)

  • Soon-Hyun Ahn
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.1
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    • pp.11-14
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    • 2023
  • The primary treatment of oral cavity cancer is still surgery. By discussing the surgical treatment of oral cavity cancer, the basic concept of head and neck surgery could be thoroughly reviewed. The oral cavity is defined as the hard palate and the anterior 2/3 of the tongue. With appropriate reconstruction, most defects can be repaired without a significant change in quality of life, unlike in the oropharynx or hypopharynx, where aspiration problems frequently occur. The selection of a surgical approach that can provide an appropriate field of view to obtain a resection margin of 5 mm or more has become the core of head and neck surgery. The role of prophylactic neck dissection is also well established in oral cavity cancer patients. Mandibulotomy for access to the oral cavity or mandibulectomy due to cancer invasion requires bony surgical techniques, and reconstruction also requires bone tissue reconstruction techniques as well as soft tissue. Therefore, oral cancer surgery is the most important primary area where all techniques of head and neck surgery are mobilized.

Reconstruction of a Complex Scalp Defect after the Failure of Free Flaps: Changing Plans and Strategy

  • Kim, Youn Hwan;Kim, Gyeong Hoe;Kim, Sang Wha
    • Archives of Craniofacial Surgery
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    • v.18 no.2
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    • pp.112-116
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    • 2017
  • The ideal scalp reconstruction involves closure of the defect with similar hair-bearing local tissue in a single step. Various reconstructions can be used including primary closure, secondary healing, skin grafts, local flaps, and microvascular tissue transfer. A 53-year-old female patient suffered glioblastoma, which had recurred for the second time. The neuro-surgeons performed radial debridement and an additional resection of the tumor, followed by reconstruction using a serratus anterior muscle flap with a split-thickness skin graft. Unfortunately, the flap became completely useless and a bilateral rotation flap was used to cover the defect. Two month later, seroma with infection was found due to recurrence of the tumor. Additional surgery was performed using multiple perforator based island flap. The patient was discharged two weeks after surgery without any complications, but two months later, the patient died. Radical surgical resection of tumor is the most important curative option, followed by functional and aesthetic reconstruction. We describe a patient with a highly malignant tumor that required multiple resections and subsequent reconstruction. Repeated recurrences of the tumor led to the failure of reconstruction and our strategy inevitably changed, from reconstruction to palliative treatment involving fast and stable wound closure for the patient's comfort.