Pub Date : 2016-11-01DOI: 10.7599/HMR.2016.36.4.205
C. Song, K. Tae
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Recently robotic thyroidectomy has gained its popularity for the treatment of differentiated thyroid cancer and benign thyroid tumors. It has been developed to overcome the drawbacks of conventional open trans-cervical thyroidectomy, which is an apparent neck wound that is visible unless concealed with clothes. Robotic thyroidectomy provides surgeons with three-dimensional magnified view and multiarticulated robotic arms that can stabilize hand tremors. It also has advantages over conventional trans-cervical thyroidectomy that include recovery of voice symptoms and acoustic parameters along with superior cosmetic outcomes. Robotic thyroidectomy results in equivalent surgical outcomes including oncologic safety and complications compared with conventional thyroidectomy. Various approaches including transaxillary, postauricular facelift, and breast-axillary approaches have been developed for robotic thyroidectomy. Recently, the indication of robotic surgery has been extended to neck dissection of the lateral compartment. Herein we summarize the indication, procedures, and efficacy of robotic thyroidectomy, and also introduce our experience with robotic thyroidectomy.
{"title":"Robotic thyroidectomy: Evolution and Outcomes","authors":"C. Song, K. Tae","doi":"10.7599/HMR.2016.36.4.205","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.4.205","url":null,"abstract":"This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Recently robotic thyroidectomy has gained its popularity for the treatment of differentiated thyroid cancer and benign thyroid tumors. It has been developed to overcome the drawbacks of conventional open trans-cervical thyroidectomy, which is an apparent neck wound that is visible unless concealed with clothes. Robotic thyroidectomy provides surgeons with three-dimensional magnified view and multiarticulated robotic arms that can stabilize hand tremors. It also has advantages over conventional trans-cervical thyroidectomy that include recovery of voice symptoms and acoustic parameters along with superior cosmetic outcomes. Robotic thyroidectomy results in equivalent surgical outcomes including oncologic safety and complications compared with conventional thyroidectomy. Various approaches including transaxillary, postauricular facelift, and breast-axillary approaches have been developed for robotic thyroidectomy. Recently, the indication of robotic surgery has been extended to neck dissection of the lateral compartment. Herein we summarize the indication, procedures, and efficacy of robotic thyroidectomy, and also introduce our experience with robotic thyroidectomy.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"07 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126173668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.7599/HMR.2016.36.4.248
B. Yi, Hyun-Soo Yoon
In typical sinus surgery, surgeons use one hand to hold an endoscope and another hand to operate surgical tools. Both are the straight type. Thus, as seen in Fig. 1, there are many blind regions in the sinus area to which any currently existing surgical tools cannot reach and any endoscope cannot visualize. Thus large invasive surgery is inevitable to treat target legions in the blind regions. Current trend in computer-aided surgery is minimally invasive surgery. Using this concept, many surgical robotic systems have been successfully employed in operation room. There are three issues to provide true minimally invasive surgery. i. flexible mechanism that enables surgical endoscope or devices to approach the target legion ii. navigation software with advanced functions To date, research activities in the area of flexible mechanisms have been very active for last 10 years. Burgner-Kahrs et al [1] surveyed most research works related to flexible mechanisms. Among them, Choi et al [2] was the first one who suggested a flexible endoscope. They employed a spring as a backbone of the flexible endoscope. At the distal end of the mechanism, a camera of 3 mm diameter with resolution of 400x400 was installed. This flexible endoscope was able to look inside the maxillary sinus by turning 180 degrees. Its radius of curvature of diameter was designed as 10 mm to fit into the anatomy of the typical maxillary sinus of Korean people. Simaan et al [3] investigated an active compliance control algorithm for sinus surgery. Rather than using any navigation algorithm, their designed flexible mechanism measured the contact force during insertion and was able to comply to the sinus wall not to damage the sinus area. Yoon et al [4] developed a dual robotic system that consists of one flexible endoscope and one flexible Sinus is a cavity within a bone. Most are commonly found in the bones of the face. Specially, paranasal sinuses are air cavities in the cranial bones, especially those near the nose. They include the frontal sinuses, the ethmoid sinuses, the sphenoid sinuses and the maxillary sinuses. There are many types of sinus disease. They are classified as acute (quick onset) and chronic (over a long period of time). Besides, there are several other types of sinus diseases due to fungus and polyps. Sinus tumors also happen although it is relatively uncommon. Navigation software for general sinus surgery has been developed and are being used in the operation room. However, there are still many blind regions in the sinus area by using conventional straight type endoscope and devices. To cope with such a problem, flexible endoscope and devices are being developed along with advanced navigation algorithms. In this review, many research activities associated with computer-aided sinus surgery are discussed.
{"title":"Review of Computer-Aided Sinus Surgery","authors":"B. Yi, Hyun-Soo Yoon","doi":"10.7599/HMR.2016.36.4.248","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.4.248","url":null,"abstract":"In typical sinus surgery, surgeons use one hand to hold an endoscope and another hand to operate surgical tools. Both are the straight type. Thus, as seen in Fig. 1, there are many blind regions in the sinus area to which any currently existing surgical tools cannot reach and any endoscope cannot visualize. Thus large invasive surgery is inevitable to treat target legions in the blind regions. Current trend in computer-aided surgery is minimally invasive surgery. Using this concept, many surgical robotic systems have been successfully employed in operation room. There are three issues to provide true minimally invasive surgery. i. flexible mechanism that enables surgical endoscope or devices to approach the target legion ii. navigation software with advanced functions To date, research activities in the area of flexible mechanisms have been very active for last 10 years. Burgner-Kahrs et al [1] surveyed most research works related to flexible mechanisms. Among them, Choi et al [2] was the first one who suggested a flexible endoscope. They employed a spring as a backbone of the flexible endoscope. At the distal end of the mechanism, a camera of 3 mm diameter with resolution of 400x400 was installed. This flexible endoscope was able to look inside the maxillary sinus by turning 180 degrees. Its radius of curvature of diameter was designed as 10 mm to fit into the anatomy of the typical maxillary sinus of Korean people. Simaan et al [3] investigated an active compliance control algorithm for sinus surgery. Rather than using any navigation algorithm, their designed flexible mechanism measured the contact force during insertion and was able to comply to the sinus wall not to damage the sinus area. Yoon et al [4] developed a dual robotic system that consists of one flexible endoscope and one flexible Sinus is a cavity within a bone. Most are commonly found in the bones of the face. Specially, paranasal sinuses are air cavities in the cranial bones, especially those near the nose. They include the frontal sinuses, the ethmoid sinuses, the sphenoid sinuses and the maxillary sinuses. There are many types of sinus disease. They are classified as acute (quick onset) and chronic (over a long period of time). Besides, there are several other types of sinus diseases due to fungus and polyps. Sinus tumors also happen although it is relatively uncommon. Navigation software for general sinus surgery has been developed and are being used in the operation room. However, there are still many blind regions in the sinus area by using conventional straight type endoscope and devices. To cope with such a problem, flexible endoscope and devices are being developed along with advanced navigation algorithms. In this review, many research activities associated with computer-aided sinus surgery are discussed.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130455967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.7599/HMR.2016.36.4.211
Young Soo Kim
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. An important trend of surgical procedure is minimally invasive surgery (MIS). Neurosurgery is an important part of the surgical field that may lead in trends. The MIS provides surgeons use of a variety of techniques to operate with less injury to the body than with open surgery. In general, it is safer than open surgery and allows patients to recover faster and heal with less pain and scarring. There are various techniques and medical devices for improving the MIS. Recently, robotic surgery was introduced to MIS. Advanced robotic systems give doctors greater control and vision during surgery, allowing them to perform safe, less invasive, and precise surgical procedures. On the one hand, several robotic systems have been developed for use in neurosurgery. Some of those neurosurgical robots have been commercialized and used in clinical practice while others have not been used because of safety and ethical issues. This paper provides a brief review on robotic systems for neurosurgery, primarily focusing on commercially available systems.
{"title":"Roles of Stereotactic Surgical Robot Systems in Neurosurgery","authors":"Young Soo Kim","doi":"10.7599/HMR.2016.36.4.211","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.4.211","url":null,"abstract":"This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. An important trend of surgical procedure is minimally invasive surgery (MIS). Neurosurgery is an important part of the surgical field that may lead in trends. The MIS provides surgeons use of a variety of techniques to operate with less injury to the body than with open surgery. In general, it is safer than open surgery and allows patients to recover faster and heal with less pain and scarring. There are various techniques and medical devices for improving the MIS. Recently, robotic surgery was introduced to MIS. Advanced robotic systems give doctors greater control and vision during surgery, allowing them to perform safe, less invasive, and precise surgical procedures. On the one hand, several robotic systems have been developed for use in neurosurgery. Some of those neurosurgical robots have been commercialized and used in clinical practice while others have not been used because of safety and ethical issues. This paper provides a brief review on robotic systems for neurosurgery, primarily focusing on commercially available systems.","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114560512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.7599/HMR.2016.36.4.215
Woo-Jung Lee
{"title":"Ten-year Experience of the da Vinci Robotic Surgery At Severance Yonsei University Hospital in Korea","authors":"Woo-Jung Lee","doi":"10.7599/HMR.2016.36.4.215","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.4.215","url":null,"abstract":"","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114809873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.7599/HMR.2016.36.4.262
J. Yang, H. Park, J. Byun, Sung Hwan Kim, Sung Ho Moon, Jong Duk Kim, Dea-Yeon Kim
Multi-drug resistant tuberculosis (MDR-TB) is a major health problem that threatens the success of tuberculosis (TB) control programs worldwide [1, 2]. The World Health Organization (WHO) launched the global surveillance project for anti-TB drug resistance in 1994 [1]. An estimated 3.3% (2.2-4.4%) of new cases and 20% (14-27%) of repeat TB cases were caused by MDR-TB in 2014, consistent with recent years [1]. In 2014, an estimated 480,000 people worldwide developed MDR-TB, and 190,000 people died as a result [1]. MDR-TB is caused by strains of Mycobacterium tuberculosis that are resistant to both isoniazid (INH) and rifampicin (RFP), the two most potent TB drugs. In 1965, the incidence of TB in South Korea was 668 cases per 100,000 [3]. Since the implementation of standardized therapeutic approaches in the 1980s, the prevalence of TB and Hanyang Med Rev 2016;36:262-268 https://doi.org/10.7599/hmr.2016.36.4.262 pISSN 1738-429X eISSN 2234-4446 Jun Ho Yang, M.D, Hyun Oh Park, M.D, Joung Hun Byun, M.D, Sung Hwan Kim, M.D, Sung Ho Moon, M.D, Jong Duk Kim, M.D and Dea Yeon Kim, M.D
耐多药结核病(MDR-TB)是威胁全球结核病(TB)控制规划成功的主要健康问题[1,2]。世界卫生组织(WHO)于1994年启动了全球抗结核耐药性监测项目[1]。2014年估计有3.3%(2.2-4.4%)的新发结核病例和20%(14-27%)的重复结核病例由耐多药结核引起，与近年来的情况一致[1]。2014年，全世界估计有48万人患上耐多药结核病，19万人因此死亡[1]。耐多药结核病是由对异烟肼(INH)和利福平(RFP)都具有耐药性的结核分枝杆菌菌株引起的，这是两种最有效的结核病药物。1965年，韩国结核病发病率为每10万人668例[3]。自20世纪80年代实施标准化治疗方法以来，结核病的患病率和汉阳医学Rev 2016;36:262-268 https://doi.org/10.7599/hmr.2016.36.4.262 pISSN 1738-429X eISSN 2234-4446 Jun Ho Yang, M.D, Hyun Oh Park, M.D, jung Hun byd, Sung Hwan Kim, M.D, Sung Ho Moon, M.D, Jong Duk Kim, M.D和Dea Yeon Kim, M.D
{"title":"Risk Factors for poor Outcomes in Patients with Multi-Drug Resistant Tuberculosis in south korea","authors":"J. Yang, H. Park, J. Byun, Sung Hwan Kim, Sung Ho Moon, Jong Duk Kim, Dea-Yeon Kim","doi":"10.7599/HMR.2016.36.4.262","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.4.262","url":null,"abstract":"Multi-drug resistant tuberculosis (MDR-TB) is a major health problem that threatens the success of tuberculosis (TB) control programs worldwide [1, 2]. The World Health Organization (WHO) launched the global surveillance project for anti-TB drug resistance in 1994 [1]. An estimated 3.3% (2.2-4.4%) of new cases and 20% (14-27%) of repeat TB cases were caused by MDR-TB in 2014, consistent with recent years [1]. In 2014, an estimated 480,000 people worldwide developed MDR-TB, and 190,000 people died as a result [1]. MDR-TB is caused by strains of Mycobacterium tuberculosis that are resistant to both isoniazid (INH) and rifampicin (RFP), the two most potent TB drugs. In 1965, the incidence of TB in South Korea was 668 cases per 100,000 [3]. Since the implementation of standardized therapeutic approaches in the 1980s, the prevalence of TB and Hanyang Med Rev 2016;36:262-268 https://doi.org/10.7599/hmr.2016.36.4.262 pISSN 1738-429X eISSN 2234-4446 Jun Ho Yang, M.D, Hyun Oh Park, M.D, Joung Hun Byun, M.D, Sung Hwan Kim, M.D, Sung Ho Moon, M.D, Jong Duk Kim, M.D and Dea Yeon Kim, M.D","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126387454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.7599/HMR.2016.36.4.254
Sung Mok Kim, W. Kim
Minimum invasive surgery (MIS) has been a key issue in medical surgery since it could not only minimize the operation scars (or other aftermath) but also significantly reduce the recovery time of the patients after the surgery. In fact, robotic technology has shown its effectiveness in many medical surgery areas such as neurologic surgery, orthopedic surgery, percutaneous surgery, radiosurgery, laparoscopic surgery, etc. [1-12]. More effort have been devoted to further extend its potential to other medical areas. In particular, very high precision and safety are extremely important in neurosurgery since the fine and accurate operations either inside the brain or close to neural cords should be conducted. Slight mistakes or errors during the surgery could result in serious and unrecoverable damage to the patients. Thus, as efforts to reduce or to replace the role and the burden of the surgeons in neurosurgical operations such as spinal fusions, stereotactic operations, etc., many different types of advanced neurosurgical robot systems have been introduced [1-12]. Among those neurosurgical operations, the robotic system conducting stereotactic neurosurgical interventions such as Deep Brain Stimulation (DBS) will be mainly discussed in this paper. In DBS operation, a multi-contact electrode is inserted into the designated location of the brain where it provides high frequency electrical current pulses to a subthaelamic necleus. The operation is known to be very effective in the treatment for epilepsy, Alzheimer’s and other diseases but requires extremely high precision and demands carefulness. So far, many different forms of commercialized traditional stereotactic devices have been introduced. The joint structure of the most conventional stereotactic devices are either the PPPRR type or the PPRPR type where P and R denotes the prismatic joint and the revolute joint, respectively. The needle type inserting device or the micro-drive unit attached to Corresponding Author: Wheekuk Kim Affiliation: Department of Control and Instrumentation Engineering, Korea University at Sejong 2511 Sejong-ro, Sejong, Korea Tel: +82-44-860-1443 Email: wheekuk@korea.ac.kr
{"title":"On the structure of the macro-micro neurosurgical robots in stereotactic surgery","authors":"Sung Mok Kim, W. Kim","doi":"10.7599/HMR.2016.36.4.254","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.4.254","url":null,"abstract":"Minimum invasive surgery (MIS) has been a key issue in medical surgery since it could not only minimize the operation scars (or other aftermath) but also significantly reduce the recovery time of the patients after the surgery. In fact, robotic technology has shown its effectiveness in many medical surgery areas such as neurologic surgery, orthopedic surgery, percutaneous surgery, radiosurgery, laparoscopic surgery, etc. [1-12]. More effort have been devoted to further extend its potential to other medical areas. In particular, very high precision and safety are extremely important in neurosurgery since the fine and accurate operations either inside the brain or close to neural cords should be conducted. Slight mistakes or errors during the surgery could result in serious and unrecoverable damage to the patients. Thus, as efforts to reduce or to replace the role and the burden of the surgeons in neurosurgical operations such as spinal fusions, stereotactic operations, etc., many different types of advanced neurosurgical robot systems have been introduced [1-12]. Among those neurosurgical operations, the robotic system conducting stereotactic neurosurgical interventions such as Deep Brain Stimulation (DBS) will be mainly discussed in this paper. In DBS operation, a multi-contact electrode is inserted into the designated location of the brain where it provides high frequency electrical current pulses to a subthaelamic necleus. The operation is known to be very effective in the treatment for epilepsy, Alzheimer’s and other diseases but requires extremely high precision and demands carefulness. So far, many different forms of commercialized traditional stereotactic devices have been introduced. The joint structure of the most conventional stereotactic devices are either the PPPRR type or the PPRPR type where P and R denotes the prismatic joint and the revolute joint, respectively. The needle type inserting device or the micro-drive unit attached to Corresponding Author: Wheekuk Kim Affiliation: Department of Control and Instrumentation Engineering, Korea University at Sejong 2511 Sejong-ro, Sejong, Korea Tel: +82-44-860-1443 Email: wheekuk@korea.ac.kr","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116796776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.7599/HMR.2016.36.4.203
B. Yi
{"title":"Review of Computer-Aided Surgery","authors":"B. Yi","doi":"10.7599/HMR.2016.36.4.203","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.4.203","url":null,"abstract":"","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122065067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.7599/HMR.2016.36.4.242
Hogun Ha, Jaesung Hong
{"title":"Augmented Reality in Medicine","authors":"Hogun Ha, Jaesung Hong","doi":"10.7599/HMR.2016.36.4.242","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.4.242","url":null,"abstract":"","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129015610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-11-01DOI: 10.7599/HMR.2016.36.4.230
N. Matsumoto
The use of computers and robots in the medical field is no longer a research interest but already a part of clinical routine. In otolaryngology/ head and neck surgery, imageguided surgery (IGS) and robotic surgery are becoming more common. IGS provides the computerized real-time feedback to the surgeon about the location and orientation of the surgical devices along with the anatomical information of surrounding structures. The IGS foresees the hidden anatomical structures before they are exposed. IGS is now widely used in endoscopic sinus surgery where the effectiveness of surgical navigation has been reported [1]. The robotic surgery enhances the fine movement of the surgeon’s hands to achieve the surgical goal with minimal damage to surrounding structures. The Da Vinci series (Intuitive Surgical Inc, USA), the only surgical robots currently available, are employed in laryngeal and pharyngeal surgery through the patient’s mouth, which is now termed the transoral robotic surgery (TORS), with promising clinical outcomes [2]. On the other hand, IGS or robots in the otological field are much less popular and most of the otological procedures are exclusively performed manually, which have basically remained unchanged for decades. The otologists’ concern about IGS and robots has been the balance between the required accuracy and the additional invasiveness. Many otologists demand the registration error of no more than 0.5 mm in otological procedures. This requirement almost reaches the inherent limit of accuracy defined by the physical resolution of the CT dataset, i.e. the pixel size, which is typically 0.2-0.5 mm. To achieve this high degree of accuracy, invasive procedures have often been justified, such as invasive fiducial marking, head clamping, or additional radioexposure by intraoperative CT scanning. This invasiveness, however, has restricted the use of IGS to unusually difficult cases that we rarely encounter. Otological cases that justify the robotic surgery with its underlying invasiveness are even rarer. Thus, Corresponding Author: Nozomu Matsumoto, M.D., Ph.D 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan Tel: +81-92-642-5668 Fax: +81-92-642-5685 E-mail: matunozo@med.kyushu-u.ac.jp
{"title":"Role of computers and robots in future otological surgery","authors":"N. Matsumoto","doi":"10.7599/HMR.2016.36.4.230","DOIUrl":"https://doi.org/10.7599/HMR.2016.36.4.230","url":null,"abstract":"The use of computers and robots in the medical field is no longer a research interest but already a part of clinical routine. In otolaryngology/ head and neck surgery, imageguided surgery (IGS) and robotic surgery are becoming more common. IGS provides the computerized real-time feedback to the surgeon about the location and orientation of the surgical devices along with the anatomical information of surrounding structures. The IGS foresees the hidden anatomical structures before they are exposed. IGS is now widely used in endoscopic sinus surgery where the effectiveness of surgical navigation has been reported [1]. The robotic surgery enhances the fine movement of the surgeon’s hands to achieve the surgical goal with minimal damage to surrounding structures. The Da Vinci series (Intuitive Surgical Inc, USA), the only surgical robots currently available, are employed in laryngeal and pharyngeal surgery through the patient’s mouth, which is now termed the transoral robotic surgery (TORS), with promising clinical outcomes [2]. On the other hand, IGS or robots in the otological field are much less popular and most of the otological procedures are exclusively performed manually, which have basically remained unchanged for decades. The otologists’ concern about IGS and robots has been the balance between the required accuracy and the additional invasiveness. Many otologists demand the registration error of no more than 0.5 mm in otological procedures. This requirement almost reaches the inherent limit of accuracy defined by the physical resolution of the CT dataset, i.e. the pixel size, which is typically 0.2-0.5 mm. To achieve this high degree of accuracy, invasive procedures have often been justified, such as invasive fiducial marking, head clamping, or additional radioexposure by intraoperative CT scanning. This invasiveness, however, has restricted the use of IGS to unusually difficult cases that we rarely encounter. Otological cases that justify the robotic surgery with its underlying invasiveness are even rarer. Thus, Corresponding Author: Nozomu Matsumoto, M.D., Ph.D 3-1-1 Maidashi Higashi-ku, Fukuoka 812-8582, Japan Tel: +81-92-642-5668 Fax: +81-92-642-5685 E-mail: matunozo@med.kyushu-u.ac.jp","PeriodicalId":345710,"journal":{"name":"Hanyang Medical Reviews","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125385854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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