• Journal of International Society for Simulation Surgery
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• 제1권1호
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• pp.7-12
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• 2014

Purpose Surgical correction of various occular problems which do not have visual problem in plastic surgical area is to normalize the appearance of the face by restoring the normal position of orbit and eyeball. With development of surgical technique, the orbit can be restored exactly in trauma patient and can be moved totally in hypertelorism, as an example of congenital disease. All these surgeries are based on the hypothesis that the position of oclular glove moves in the plane in a quantitatively predictable reationship to osseous orbit movement. However, no studies have critically evaluated between the change of periorbital soft tissue and the outcome of the surgical correction, because there is no method of objective, quantitave evaluation of the periorbital soft tissue. Method Author suggest the methodology for quantitative assessment of ocular and periocular fat changes using the manipulation of digital images of computed tomographic scan. Results The method was allowed to evaluate inter-dacryon distance, inter-centroid distance, movement of the medial orbital wall, movement of the lateral orbital wall, alteration of thickness of the lateral periorbital fat as indicator of movement of the orbital wall and orbit in the patient with congenital periorbital anomaly and postoperative periorbital surgery. The goal of surgical correction of various occular problems which do not have visual problem in plastic surgical area is to normalize the appearance of the face by restoring the normal position of orbit and eyeball. With development of surgical technique, the orbit can be restored exactly in trauma patient and can be moved totally in hypertelorism, as an example of congenital disease. All these sugeries are based on the hypothesis that the position of oclular glove moves in the plane in a quantitatively predictable relationship to osseous orbit movement. However, no studies have critically evaluated between the change of periorbital soft tissue and the outcome of the surgical correction, because there is no method of objective, quantitave evaluation of the periorbital soft tissue. In this report, author suggest the methodology for quantitative assessment of ocular and periocular fat changes using the manipulation of digital images of computed tomographic scan. Conclusion The method suggested is objective and accurate method in measurement of the orbital contents. It takes time and is not easy to do, however, this kind of measurement for fine structures will be more easily available in near future.

• 한국컴퓨터그래픽스학회논문지
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• 제20권1호
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• pp.1-11
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• 2014

뇌성마비에서 나타나는 하지 변형은 정상 보행 및 자세 유지에 어려움을 준다. 이를 교정하기 위해 임상의는 변형 정도를 측정하여 교정 절골술 계획을 수립하고 계획된 정도만큼 절골술을 시행한다. 그러나 절골술 시행 후 원래 계획보다 더 적거나 더 많이 교정되는 상황이나 의도치 않았던 변형이 발견되는 상황이 종종 발생한다. 이러한 문제 상황들이 발생하는 이유는 절골술 계획수립 시, 기존의 방법이 하지골의 정확한 형태학적 정보를 반영하기 어렵고 하지골을 절골하여 회전 시키는 정도에 따라 최종 결과가 어떻게 나오는지 사전에 예측하는 것이 쉽지 않으며 효과적인 교정 결과를 얻을 수 있는 절골술 방법, 회전각도 등 다양한 입력 조건의 최적 조합을 찾기가 어렵기 때문이다. 본 논문은 이를 해결하기 위해 컴퓨터 그래픽스 분야의 정기구학, 역기구학 및 최적화 기법을 하지 교정 절골술에 적용하여 임상의가 최적의 절골술 계획을 수립할 수 있도록 하는 방법을 제안한다. 하지 골의 3차원 메쉬 모델을 입력으로 받아 이를 분석하여 하지 특징점을 추출하고 임상지표를 자동으로 계산하여 변형 정도를 파악하는 방법, 하지 골을 대상으로 하는 5가지 교정 절골술의 시뮬레이션을 통해 그 결과를 사전에 예측할 수 있는 방법 그리고 비선형 최적화 문제로 변환하여 최적 교정 절골술 계획을 자동으로 수립하는 방법을 제안한다. 이를 통해 하지 골 교정 절골술과 관련된 거의 모든 경우의 수를 사전에 확인해 볼 수 있어서 종래의 방법보다 훨씬 쉽고 효율적으로 절골술을 계획하고 실행할 수 있을 것이다.

• 한국정밀공학회지
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• 제21권8호
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• pp.157-163
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• 2004

Scoliosis is a complex musculoskeletal dieses requiring 3-D treatment with surgical instrumentation. To investigate the effects of correction surgery, a finite element model of personalized model of the scoliotic spine that will allow the design of clinical test providing optimal estimation of the post-operation results was developed. Three dimensional skeletal parts, such as vertebrae, clavicle and scapular were modeled as rigid bodies with keeping their morphologies. Kinematical joints and spring elements were adapted to represent the inter-vertebral disc and ligaments respectively. With this model, two types of surgery procedure, distraction procedure with Harrington device and rod derotation procedure with pedicle screw and rod system had been carried out. The obtained simulation results were comparatively corresponding to the post operational outcomes and successfully demonstrated qualitative analysis of surgical effectiveness. From this analysis, it has been found that the preparing of appropriate rod curvature and its insertion was more important than just performing the excessive derotation for scoliosis correction.

• Archives of Plastic Surgery
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• 제44권4호
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• pp.337-339
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• 2017

We present the case of a patient with severe postoperative scarring from surgical treatment for gastroschisis, with the intestine located immediately under the dermal scar. Although many patients are unsatisfied with the results of scar repair treatment, few reports exist regarding severe or difficult cases involving the surgical repair of postoperative scar contracture. We achieved an excellent result via simulation involving graph paper drawings that were generated using computed tomography images as a reference, followed by dermal scar deepithelialization. The strategy described here may be useful for other cases of severe postoperative scar contracture after primary surgery for gastroschisis.

• Journal of International Society for Simulation Surgery
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• 제2권1호
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• pp.10-12
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• 2015

Purpose It has been stated that patient satisfaction is the crucial factor for determining success in plastic surgery. The convergence of medical science and computer vision has made easier to satisfy patients who wants to have plastic surgery. In this paper, we try to apply 3D face modeling in plastic surgical area. Materials and Methods The author introduces a method for accurate 3D face modeling techniques using a statistical model-based 3D face modeling approach in a mirror system. Results We could successfully obtain highly accurate 3D face shape results. Conclusion The method suggested could be used for acquiring 3D face models from 2D face image and the result obtained from this could be effectively used for plastic surgical areas.

• 로봇학회논문지
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• 제7권1호
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• pp.20-28
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• 2012

In spite of the difficulties and uncertain characteristic of cable driven method, surgical robot instrument has adopted it as driving mechanism for various reasons. To overcome the problem of cable system, previous research applied SMCSPO (sliding mode control with sliding perturbation observer) algorithm as robust controller to control the instrument and found that the value of SPO (sliding perturbation observer) followed force disturbance, reaction force loaded on the tip very similarly. Thus, this paper confirms that the perturbation observer is sufficient estimator which finds out the mount of loaded force on the surgical robot instrument. To prove the proposition, simulation using the similar model with an actual instrument and experimental evaluation are performed. The results show that it is possible to substitute SPO for sensors to measure the reaction force. This estimated reaction force will be used to realize haptic function by sending the reaction force to a master device for a surgeon. The results will contribute to create surgical benefit such as shortening the practice time of a surgeon and giving haptic information to surgeon by using it as haptic signal to protect an organ by making force boundary.

• 한국시뮬레이션학회:학술대회논문집
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• 한국시뮬레이션학회 1999년도 춘계학술대회 논문집
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• pp.143-146
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• 1999

수술 시뮬레이션은 의학 교육, 수술 훈련, 수술 계획과 정확한 수술을 위해 그 중요성이 더해지고 있다. 본 논문은 물리적 모델을 기반으로 3차원 객체의 변형을 인터액티브하게 수행할 수 있는 인체 내장 기관에 대한 수술 시뮬레이터의 개발을 목적으로 한다. 물리적 모델은 컴퓨터 애니매이션과 컴퓨터 그래픽 모델에 대한 새로운 시도로써 많이 연구되고 있으며, 본 논문에서는 심장에 대한 3차원 자료를 매스-스프링 모델로 구현 및 변형을 수행하였다. 본 연구의 결과는 일차적으로는 심장 수술 시뮬레이션에 적용 가능하며 나아가 다른 내장 기관의 수술 시뮬레이션 및 non-rigid한 객체에 대한 변형에 적용 가능하다.

• 대한치과교정학회지
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• 제50권5호
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• pp.293-303
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• 2020

Objective: To investigate the three-dimensional (3D) surgical accuracy between virtually planned and actual surgical movements (SM) of the maxilla in two-jaw orthognathic surgery. Methods: The sample consisted of 15 skeletal Class III patients who underwent two-jaw orthognathic surgery performed by a single surgeon using a virtual surgical simulation (VSS) software. The 3D cone-beam computed tomography (CBCT) images were obtained before (T0) and after surgery (T1). After merging the dental cast image onto the T0 CBCT image, VSS was performed. SM were classified into midline correction (anterior and posterior), advancement, setback, anterior elongation, and impaction (total and posterior). The landmarks were the midpoint between the central incisors, the mesiobuccal cusp tip (MBCT) of both first molars, and the midpoint of the two MBCTs. The amount and direction of SM by VSS and actual surgery were measured using 3D coordinates of the landmarks. Discrepancies less than 1 mm between VSS and T1 landmarks indicated a precise outcome. The surgical achievement percentage (SAP, [amount of movement in actual surgery/amount of movement in VSS] × 100) (%) and precision percentage (PP, [number of patients with precise outcome/number of total patients] × 100) (%) were compared among SM types using Fisher's exact and Kruskal-Wallis tests. Results: Overall mean discrepancy between VSS and actual surgery, SAP, and PP were 0.13 mm, 89.9%, and 68.3%, respectively. There was no significant difference in the SAP and PP values among the seven SM types (all p > 0.05). Conclusions: VSS could be considered as an effective tool for increasing surgical accuracy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권2호
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• pp.158-166
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• 2009

The application of CT with basis on 3 dimensional-reconstruction is getting more widely practiced. With the data obtained from cone-beam computed tomography(CBCT), not only the diagnosis of the patient with skeletal abnormality but also the virtual simulation of the orthognathic surgery were performed and its application would be popular in orthodontic field. We reported a case, a 19-year old man who was diagnosed mandibular prognathism and required orthognatic surgery. In this case, the virtual orthognathic surgery was simulated and surgical wafer was fabricated by using CBCT data. That wafer was applied the actual orthognathic surgery. After preoperative orthodontic treatment, we prepared surgery as follows. : (l)Acquisition of 3D image data, (2)Reconstruction of 3-dimensional virtual model, (3)Virtual model surgery, (4)Extraction of stere-olithographic image, (5)Check-up for occlusal interference, (6)Fabrication of surgical stent by stereolithography. Bilateral sagittal split ramus osteotomy was operated and used stereolithographic surgical stent. 1 month later, we superimposed CBCT datas of virtual surgery and that of actual surgery, and then compared the result. CT data's application for othognathic surgery yielded satisfactory outcomes.

• Journal of International Society for Simulation Surgery
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• 제4권1호
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• pp.9-12
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• 2017

Purpose Surgery for separating craniopagus twins involves many critical issues owing to complex anatomical features. We demonstrate a 3D printed model and virtual reality (VR) technologies that could provide valuable benefits for surgical planning and simulation, which would improve the visualization and perception during craniopagus surgery. Material & Methods We printed a 3D model extracted from CT images of craniopagus patients using segmentation software developed in-house. Then, we imported the 3D model to create the VR environment using 3D simulation software (Unity, Unity Technologies, CA). We utilized the HTC Vive (HTC & Valve Corp) head-mount-display for the VR simulation. Results We obtained the 3D printed model of craniopagus patients and imported the model to a VR environment. Manipulating the model in VR was possible, and the 3D model in the VR environment enhanced the application of user-friendly 3D modeling in surgery for craniopagus twins. Conclusion The use of the 3D printed model and VR has helped understand complicated anatomical structures of craniopagus patients and has made communicating with other medical surgeons in the field much easier. Further, interacting with the 3D model is possible in VR, which enhances the understanding of the craniopagus surgery as well as the success rate of separation surgery while providing useful information on diagnosing and surgery planning.