• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.1.1-1.8
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• 2020

Considering psychosocial needs of patients, it is not surprising that surgery-first approach (SFA) is becoming more popular than ever. Although the concept of SFA was introduced a few decades ago, the limitation of analysis method based on two-dimensional images makes surgeons reluctant to choose SFA. Recently, the advancement of three-dimensional technology allows us to perform SFA even without minimal pre-surgical orthodontic treatment, and the prediction of surgical outcome became more accurate, especially in obstructive sleep apnea (OSA) patients to whom the advantages of SFA should be more significant. Here, we describe the current trend of SFA and its implication in OSA patients.

• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.87.1-87.4
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• 2018

Objective: Upper paraaortic lymph node dissection (UPALD) to the infrarenal level is one of the most challenging robotic procedures. Because robotic system has the limitation in robotic arm mobility. This surgical video introduces a novel robotic approach, lower pelvic port placement (LP3), to perform optimally and simultaneously both UPALD and pelvic procedures in gynecologic cancer patients using da Vinci Xi system. Methods: The patient presented with high-grade endometrial cancer. She underwent robotic surgical staging operation. For the setup of the LP3, a line was drown between both anterior superior iliac spines. At 3 cm below this line, another line was drown and four robotic ports were placed on this line. Results: After paraaortic lymph node dissection (PALD) was completed, the boom of robotic system was rotated $180^{\circ}$ to retarget for the pelvic lateral displacement. Robotic ports were placed and docked again. The operation was completed robotically without any complication. Conclusion: The LP3 was feasible for performing simultaneously optimal PALD as well as procedures in pelvic cavity in gynecologic cancer patients. The advantage of LP3 technique is the robotic port placement that affords for multi-quadrant surgery, abdominal and pelvic dissection. The LP3 is facilitated by utilizing advanced technology of Xi system, including the patient clearance function, the rotating boom, and 'port hopping' that allows using every ports for a camera. The LP3 will enable surgeons to extend the surgical indication of robotic surgical system in the gynecologic oncologic field.

• 대한의용생체공학회:의공학회지
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• 제34권3호
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• pp.141-147
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• 2013

Ultrasonic shears is currently in wide use as an energy device for minimal invasive surgery. There is an advantage of minimizing the carbonization behavior of the tissue due to the vibrational energy transfer system of the transducer by applying a piezoelectric ceramic. However, the vibrational energy transfer system has a pitfall in energy consumption. When the movement of the forceps is interrupted by the tissue, the horn which transfers the vibrational energy of the transducer will be affected. A study was performed to recognize different tissues by measuring the impedance of the transducer of the ultrasonic shears in order to find the factor of energy consumption according to the tissue. In the first stage of the study, the voltage and current of the transducer connecting portion were measured, along with the phase changes. Subsequently, in the second stage, the impedance of the transducer was directly measured. In the final stage, using the handpiece, we grasped the tissue and observed the impedance differences appeared in the transducer To verify the proposed tissue distinguishing method, we used the handpiece to apply a force between 5N and 10N to pork while increasing the value of the impedance of the transducer from 400 ${\Omega}$.. It was found that fat and skin tissue, tendon, liver and protein all have different impedance values of 420 ${\Omega}$, 490 ${\Omega}$, 530 ${\Omega}$, and 580 ${\Omega}$, respectively. Thus, the impedance value can be used to distinguish the type of tissues grasped by the forceps. In the future study, this relationship will be used to improve the energy efficiency of ultrasonic shears.

• 제어로봇시스템학회논문지
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• 제20권3호
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• pp.345-355
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• 2014

Since the beginning of the 21st century, emergence of innovative technologies in robotic and telepresence surgery has revolutionized minimally access surgery and continually has advanced them till recent years. One of such surgeries is endoscopic surgery, in which endoscope and endoscopic instruments are inserted into the body through small incision or natural openings, surgical operations being carried out by a laparoscopic procedure. Due to a vast amount of developments in this technology, this review article describes only a technological state-of-the arts and trend of endoscopic robots, being further limited to the aspects of key components, their functional requirements and operational procedure in surgery. In particular, it first describes technological limitations in developments of key components and then focuses on the description of the performance required for their functions, which include position control, tracking, navigation, and manipulation of the flexible endoscope body and its end effector as well, and so on. In spite of these rapid developments in functional components, endoscopic surgical robots should be much smaller, less expensive, easier to operate, and should seamlessly integrate emerging technologies for their intelligent vision and dexterous hands not only from the points of the view of surgical, ergonomic but also from safety. We believe that in these respects a medical robotic technology related to endoscopic surgery continues to be revolutionized in the near future, sufficient enough to replace almost all kinds of current endoscopic surgery. This issue remains to be addressed elsewhere in some other review articles.

• Journal of Information Technology Applications and Management
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• 제27권1호
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• pp.125-145
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• 2020

We explore technology ecosystem of smart surgical medical system by analyzing patent data applied for in Korea and Japan. First, a review of trends of patent application by country/technological domain show that there exist a minority of technology domains focused on R&D, which represent their trends have been increasingly active. Also, while a number of Japanese firms mainly consist of the patent market of Japan, in case of the Korean market, a few universities, SMEs, and foreign firms are found to be the main applicants. As a result of the network analysis with the links as the relations of co-patenting, the relationships, which are active of convergence and knowledge spillover among the heterogeneous technology domains within each market, as well as the technology domains, which are the most active in international cooperation among each homogeneous domain, could get derived and visualized in the ecosystem. In addition, the technology domains in each patent market with leading locations, roles, and influence in the network can also be identified through the centrality analysis. In this study, the analysis for technology competitiveness are carried out focusing on patent activity and patent impact. The results denote that across all domains, the Japanese market may possess higher patent activity and patent impact compared to the Korean market. In consequence, we derive the position map for comparison by country and technology domain from a perspective considering comprehensively the multi-dimensional attributes based on the results of both network analysis and technology competitiveness.

• Imaging Science in Dentistry
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• 제52권2호
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• pp.225-230
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• 2022

Purpose: This report presents the first known use of a rigid endoscope with augmented reality technology for the removal of an odontogenic cyst that penetrated the maxillary sinus and illustrates its practical use in a patient. Materials and Methods: In the preoperative period, cone-beam computed tomography was performed in a specially designed marker holder frame, and the contours of the cyst and the nearest anatomical formations were segmented in the 3D Slicer program. During the operation, a marker was installed on the patient's head, as well as on the tip of the endoscope, which made it possible to visualize the mass and the movement of the endoscope. The surgical intervention was performed with the support of augmented reality in HoloLens glasses (Microsoft Corporation, Redmond, WA, USA). Results: The use of this technology improved the accuracy of surgical manipulations, reduced operational risks, and shortened the time of surgery and the rehabilitation period. Conclusion: With the help of modern technologies, a navigation system was created that helped to track the position of the endoscope in mixed reality in real time, as well as to fully visualize anatomical formations.

• 대한후두음성언어의학회지
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• 제24권2호
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• pp.83-87
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• 2013

The term "phonosurgery," coined in the early 1960s, refers to surgical procedures that maintain, restore, or enhance the human voice. Phonosurgery includes phonomicrosurgery (endoscopic microsurgery of the vocal folds), laryngoplastic phonosurgery (open-neck surgery that restructures the cartilaginous framework of the larynx and the soft tissues), laryngeal injection (injection of medications as well as synthetic and organic biologic substances), and reinnervation of the larynx. Phonomicrosurgery is a means of maximally preserving the layered microstructure of the vocal fold, that is, the epithelium and lamina propria. The purpose of the surgery is usually to improve the vibratory characteristics of the layered microstructure of the vocal folds. Phonomicrosurgery has developed from convergence of microlaryngoscopic surgical technique theory and the mucosal wave theory of laryngeal sound production. Improvements in technology (i.e., laryngoscopes, handled instruments, and lasers), which in part arise from developments in more frequently performed minimally invasive surgical procedures, will probably facilitate the next generation of procedural innovations. The best methods of optimizing phonosurgical outcomes include making an accurate diagnosis, completing a comprehensive voice evaluation, providing sufficient preoperative therapy, carefully selecting patients to undergo phonomicrosurgical procedures, and requiring sufficient postoperative rest and therapy. Phonomicrosurgery will continue to evolve as a result of the interdependent collaboration of surgeons with voice scientists, speech pathologist, and other voice professionals.

• Industrial Engineering and Management Systems
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• 제8권1호
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• pp.37-46
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• 2009

Patient safety has become a growing concern in health care. The U.S. Institute of Medicine (IOM) report "To Err Is Human: Building a Safer Health System" in 1999 included estimations that medical error is the eighth leading cause of death in the United States and results in up to 100,000 deaths annually. However, many adverse events and errors occur in surgical practice. Within all kinds of surgical adverse events, wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events are the most devastating, unacceptable, and often result in litigation. Much literature claims that systems must be put in place to render it essentially impossible or at least extremely difficult for human error to cause harm to patients. Hence, this research aims to develop a prototype system based on active RFID that detects and prevents errors in the OR. To fully comprehend the operating room (OR) process, multiple rounds of on site discussions were conducted. IDEF0 models were subsequently constructed for identifying the opportunity of improvement and performing before-after analysis. Based on the analysis, the architecture of the proposed RFID-based OR system was developed. An on-site survey conducted subsequently for better understanding the hardware requirement will then be illustrated. Finally, an RFID-enhanced system based on both the proposed architecture and test results was developed for gaining better control and improving the safety level of the surgical operations.

• 대한치과의사협회지
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• 제57권2호
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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 Korean Neurosurgical Society
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• 제64권4호
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• pp.495-504
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• 2021

Three-dimensional printing (3DP) applications possess substantial versatility within surgical applications, such as complex reconstructive surgeries and for the use of surgical resection guides. The capability of constructing an implant from a series of radiographic images to provide personalized anatomical fit is what makes 3D printed implants most appealing to surgeons. Our objective is to describe the process of integration of 3DP implants into the operating room for spinal surgery, summarize the outcomes of using 3DP implants in spinal surgery, and discuss the limitations and safety concerns during pre-operative consideration. 3DP allows for customized, light weight, and geometrically complex functional implants in spinal surgery in cases of decompression, tumor, and fusion. However, there are limitations such as the cost of the technology which is prohibitive to many hospitals. The novelty of this approach implies that the quantity of longitudinal studies is limited and our understanding of how the human body responds long term to these implants is still unclear. Although it has given surgeons the ability to improve outcomes, surgical strategies, and patient recovery, there is a need for prospective studies to follow the safety and efficacy of the usage of 3D printed implants in spine surgery.