• 한국CDE학회논문집
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• 제17권5호
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• pp.303-311
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• 2012

Laparoscopic surgery is a surgical procedure which uses long laparoscopic instruments through tiny holes in abdomen while watching images from a laparoscopic camera through umbilicus. Laparoscopic surgeries have many advantages rather than open surgeries, however it is hard to learn the surgical skills for laparoscopic surgery. Recently, some virtual simulation systems for laparoscopic surgery are developed to train novice surgeons or resident surgeons. In this study, we introduce the techniques that we developed for laparoscopic surgical training simulator for cholecystectomy (gallbladder removal), which is one of the most frequently performed by laparoscopic surgery. The techniques for cholecystectomy simulation include modeling of human organs (liver, gallbladder, bile ducts, etc.), real-time deformable body calculation, realistic 3D visualization of surgical scene, high-fidelity haptic rendering and haptic device technology, and so on. We propose each simulation technique for the laparoscopic cholecystectomy procedures such as identifying cystic duct and cystic artery to clamp and cut, dissecting connective tissues between the gallbladder and liver. In this paper, we describe the techniques and discuss about the results of the proposed cholecystectomy simulation for laparoscopic surgical training.

• 대한치과의사협회지
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• 제50권11호
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• pp.660-669
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• 2012

We describes the process of 3D virtual treatment planning and of CAD/CAM for surgical splint in orthognathic surgery. The potential benefits and disadvantages of 3D virtual approach and the use of CAD/CAM system for the treatment of the patient with a maxillofacial deformity are discussed. For the more convenient applications,3D software should be improved.

• 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.

• 디지털콘텐츠학회 논문지
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• 제17권4호
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• pp.287-293
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• 2016

시간, 공간, 금전적인 문제 때문에 실습이 쉽지 않은 학문들이 있다. 특히 의료교육은 장소와 시간의 제약이 특히 심하며 cadaver(카드버:인체해부 실습용 시체)를 통해 이루어지기 때문에 어려움이 많다. 그 대안으로 다양한 가상 수술방법이 존재하지만 장비가 고가이거나 구하기 쉽지 않기 때문에 어려운 문제가 발생한다. 이러한 문제점의 해결 방법으로 3D-Virtual Reality(3D가상현실)를 활용하여 실제와 유사한 환경을 제공하고자 한다. 일반적으로 컴퓨터의 Interface(인터페이스)로 키보드와 마우스를 사용하지 않고 Oculus Rift(오큘러스 리프트)와 Leap Motion(립 모션)를 사용함으로써 더욱더 현실감을 느낄 수 있어 실습교육비용을 절감함으로써 실습교육에 대한 효과를 극대화 할 수 있다. 본 논문에서는 두개의 Device(디바이스)인 Oculus Rift(오큘러스 리프트)와 Leap Motion(립 모션)를 이용하여 3D가상 수술 시스템을 구축하고 실습할 수 있는 제안으로 의료교육인 수술교육에 대치하여 효율성을 높이는 방식을 제안하였고, 이는, 다른 Simulation(시뮬레이션)이 활용 가능한 학문분야에 까지 확장할 수 있을 것으로 사려된다.

• 한국컴퓨터정보학회논문지
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• 제28권12호
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• pp.89-96
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• 2023

본 논문에서는 GPU기반으로 옷감을 찢는 데 필요한 동적 재메싱를 실시간으로 처리할 수 있는 방법을 제안한다. 얇은 쉘 재질은 물리 기반 시뮬레이션/애니메이션, 게임, 가상현실 등 다양한 분야에서 활용되고 있다. 옷감을 찢는 것은 기하학과 연결 구조를 동적으로 갱신해야 되기 때문에 그 처리 과정이 복잡하고 계산양이 크다. 특히 인터랙티브 콘텐츠를 다루는 분야에서는 이 과정이 빠르게 수행되어야 한다. 대부분의 방법에서는 실시간을 유지하기 위해 저해상도 시뮬레이션을 통해 재메싱을 수행하거나 이미 분할된 패턴을 그대로 이용하기 때문에 동적 재메싱이라고 보기 어려우며, 찢어진 패턴의 품질이 낮다. 본 논문에서는 GPU에 최적화된 동적 재메싱 알고리즘을 새롭게 제안함으로써 고해상도 옷감 찢어짐을 실시간으로 처리할 수 있게 한다. 본 논문에서 제안하는 방법은 사전에 쪼개진 메쉬 형태가 아닌 동적 재메싱이 가능하기 때문에 가상 수술시뮬레이션이나, 실시간을 요구하는 게임 및 가상환경에서 물리 기반 모델링울 할 때 활용될 수 있다.

• 한국CDE학회논문집
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• 제16권5호
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• pp.315-322
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• 2011

The goal of total knee replacement (TKR) surgery is to replace patient's knee joint with artificial implants in order to restore normal knee joint functions. Since mismatched knee implants often cause a critical balancing problem and short durability, designing a well-fitted implant to a patient's knee joint is essential to improve surgical outcomes. We developed a software system that three-dimensionally (3D) simulates TKR surgery based upon 3D knee models reconstructed from computed tomography (CT) imaging. The main task of the system was to extract precise 3D anatomical parameters of a patient's knee that were directly used to determine a custom fit implant and to virtually perform TKR surgery. The virtual surgery was simulated by amputating a 3D knee model and positioning the determined implant components on the amputated knee. The test result shows that it is applicable to derive surgical parameters, determine individualized implant components, rehearse the whole surgical procedure, and train medical staff or students for actual TKR surgery. The feasibility and verification of the proposed system is described with examples.

• 전자공학회논문지
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• 제53권12호
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• pp.175-179
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• 2016

최근 의료 영상 기술의 발전은 진단, 수술계획, 또는 교육에 도움이 되는 수술 시뮬레이션을 만들어 왔다. 개선된 고화질 영상과 3차원 시각화는 의료 영상 가용성을 향상시키고 수술, 교육 분야에서 더 잘 이용할 수 있게 되었다. 실제 인간의 시각은 입체이다. 따라서, 외과의사의 판단을 통해 2차원 영상을 스테레오로 재구성하여 처리하는 것이 함께 필요하다. 이러한 과정을 줄이기 위해, 3차원 (3D) 이미지가 사용되어 왔다. 3D 영상은 복잡한 상황에서 외과 의사가 매우 짧은 시간에 판단할 수 있도록 3D 시각화를 강화하여 제공한다. 3D 화상 데이터 세트에 기초하여, 가상 내시경 수술 계획, 실시간 상호 작용 가상 의료 시뮬레이션이 가능하게 되었다. 본 논문은 새로운 이미징 기술의 최근 응용 프로그램을 설명하고 이의 기본과 특별히 주목할만한 의료 3D 복원 기술에 관한 것이다. 최근 CT, MR 및 기타 영상 양식의 기술발전은 흥미로운 새로운 솔루션과 어깨 영상의 활용 가능성을 넓혀왔다. 특히, 의료 기기에서 파생 된 3차원 (3D) 이미지는 고급 정보를 제공한다. 이 프레젠테이션은 어깨와 팔꿈치의 수술실습에서 원리, 3D 영상기술의 잠재적 응용가능성, 시뮬레이션, 3D프린팅을 설명한다.

• 대한치과의사협회지
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• 제52권10호
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• pp.596-601
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• 2014

Computer-aided surgery is popular and useful in the field of oral and maxillofacial surgery, because of the possibility of simulation with a high accuracy. In all aspects of surgery, proper planning facilitates more predictable operative results, however before the use of virtual planning, much of this relied on 2-dimensional (2-D) imaging for treatment planning on a 3-dimensional (3-D) object and surgical trial and error. With real-time instrument positioning and clear anatomic identification, a computer-assisted navigation system (CANS) is exceptionally helpful in maxillofacial surgery. These techniques enable performing precise bony ablation and reconstruction, and also decrease surgical time and donor site defect.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제14권4호
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• pp.1738-1756
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• 2020

To improve the accuracy and realism of the virtual surgical simulation system, this paper proposes an optimized mass-spring model with shape restoration ability based on volume conservation to simulate soft tissue deformation. The proposed method constructs a soft tissue surface model that adopts a new flexion spring for resisting bending and incorporates it into the mass-spring model (MSM) to restore the original shape. Then, we employ the particle swarm optimization algorithm to achieve the optimal solution of the model parameters. Besides, the volume conservation constraint is applied to the position-based dynamics (PBD) approach to maintain the volume of the deformable object for constructing the soft tissue volumetric model base on tetrahedrons. Finally, we built a simulation system on the PHANTOM OMNI force tactile interaction device to realize the deformation simulation of the virtual liver. Experimental results show that the proposed model has a good shape restoration ability and incompressibility, which can enhance the deformation accuracy and interactive realism.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.14.1-14.10
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• 2019

Background: Condylar dislocation can arise as a complication in patients who required mandibular and/or condylar reconstruction and were operated on with fibula free flap (FFF) using surgical guides designed using simulation surgery. Surgeons should be aware of the complications in these present cases when planning and performing reconstructions as well as predicting prognoses. Cases presentation: Two cases showed condylar dislocation in mandibular reconstruction using a FFF fixed with a reconstruction plate. Three cases showed condylar dislocation in mandibular reconstruction using a fibula free flap fixed with a mini-plate. Conclusion: Despite the lack of clinical symptoms in these cases following mandibular reconstruction using an FFF, the mandibular condyle was severely displaced away from the glenoid fossa. A surgeon must have sufficient time to consider the use of a long flap with thickness similar to that of the mandible, ways to minimize span and bending, and methods of fixation. The patient, moreover, should be educated on condylar dislocation. Customized CAD/CAM-prototyped temporomandibular condyle-connected plates may be a good alternative even if virtual simulation surgery is to be performed before surgery. These considerations may help reduce the incidence of complications after mandibular reconstruction.