소아 신경외과 환자의 임상적 분석 : 1957~1982

왕규창,김현집,조병규,심보성 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.4

The authors analyzed pediatric (under 15-year of age) neurosurgical patients admitted to the Department of Neurosurgery of the Seoul National University Hospital during the 26-year period from 1957 to 1982. The results were as follow : 1) Among the total 13,941 neurosurgical admission cases during this period, pediatric cases were 2,543 (18.2%) in number. 2) The male to female ratio was 2.2:1. 3) The total admission cases consisted of traumatic (56.9%), congenital (9.7%), infectious (7.2%), neoplastic (12.0%), vascular (2.4%), and miscellaneous (11.8%) lesions. The proportion of traumatic lesion has been getting smaller since early 1970's while those of other lesions, especially neoplastic one, larger. 4) Among the 2,543 admissions, 853 cases (33.5%) were operated. The annual operation rate gradually increased since mid-1970's. 5) The total admission and operation mortalities were 6.6% and 7.7%, but those figures of 1980's were 3.1% and 3.4%, respectively.

로봇을 이용한 두개골 드릴링 시스템의 프로토타입 개발

정연찬(YunChan Chung) (사)한국CDE학회 2012 한국CDE학회 논문집 Vol.17 No.3

This paper presents an overview of automated robotic system for skull drilling, which is performed to access for some neurosurgical interventions, such as brain tumor resection. Currently surgeons use automatic-releasing cranial perforators. The drilling procedure must be performed very carefully to avoid penetration of brain nerve structures; however failure cases are reported. The presented prototype system utilizes both preoperative and intraoperative information. Preoperative CT image is used for robot path planning. A NeuroMate robot with a six-DOF force sensor at the end effector is used for intraoperative operation. Intraoperative cutting force from the force sensor is the key information to revise an initial registration and preoperative path plans. Some possibilities are verified by path simulation but cadaver experiments are required for validation of this prototype.

Development of a New Neurosurgical 5-DOF Parallel Robot for Stereotactic DBS Operations

김성목,이병주,정재헌,정주노,김희국 한국정밀공학회 2017 International Journal of Precision Engineering and Vol.18 No.3

In this study, a new 5-degree of freedom parallel-type robot for neurosurgery is developed and investigated for potential application in deep brain surgery (DBS). The neurosurgical robot consists of the base plate, the moving plate, and three limbs (a PPPU type central limb and two SPS type side limbs) connecting the plates. With an intension to use the developed neurosurgical micro robot with a macro scale robot, the position and kinematic analyses of the macro–micro robot are conducted. A structural analysis under the maximum payload condition is also conducted to confirm its structural rigidity. Then, a macro–micro robot simulator that employs the prototype as a micro robot module is developed to test both its motion capability and its potential application as a stereotactic DBS device. Finally, the absolute position accuracy measurement of the developed micro robot module based on its identified kinematic calibration model verified that its accuracy is comparable to those of existing micro robot module candidates.

The experience of surgery and endovascular procedure of cerebrovascular disease in the hybrid operating room; Multi-axis robotic C-arm DSA system

Chang Hyeun Kim,이상원,Young Ha Kim,성순기,손동욱,송근성 대한뇌혈관외과학회 2020 Journal of Cerebrovascular and Endovascular Neuros Vol.22 No.4

Objective: To report on combined surgical and/or endovascular procedures for cerebrovascular disease in a hybrid operating room (OR). Methods: Between October 2016 and June 2020, 1832 neurosurgical procedures were performed in a hybrid OR. Our institution’s hybrid OR consists of a multi-axis robotic C-arm monoplane digital subtraction angiography (DSA) system with an operating table, 3D-rotational DSA, cone-beam computed tomography (dyna CT), and real-time navigation software. Procedures were categorized into six categories according to purpose: (1) simple diagnosis and follow-up, (2) simple endovascular procedure, (3) combination of surgery and endovascular procedures, (4) rescue surgery after endovascular procedures, (5) frameless stereotactic procedure, and (6) other surgeries requiring C-arm. Results: Of 1832 neurosurgical procedures in the hybrid OR, 1430 were simple diagnosis and follow-up cases, 330 simple endovascular procedures, 8 combination of surgery and endovascular procedures, 15 rescue after endovascular procedure, 40 frameless stereotactic procedures, and 9 other surgeries. Eight cases of combination of surgery and endovascular procedures, safely performed without wasting time on patient transfer, were performed in seven bypass end endovascular procedures and one case of bow-hunter syndrome in complex cerebrovascular disease. After embolization, craniotomy (or craniectomy) and intracerebral hemorrhage removal were performed in eight patients in-situ. Of the 40 frameless stereotactic procedure, 37 were extraventricular drainage before/after coil embolization in subarachnoid hemorrhage patients. They all mounted conduits in their planned locations. Conclusions: A hybrid OR for combined endovascular and surgical procedures represents a safe and useful strategy for cerebrovascular disease. In hybrid ORs various neurosurgical procedures can be safely and conveniently performed. Hybrid OR will pioneer a new era in neurosurgical procedures.

수술후 발생한 경막하 긴장성 기두증 : 증례보고

김성호,구환회,김관태,김윤 대한신경외과학회 1985 Journal of Korean neurosurgical society Vol.14 No.2

Tension, pneumocephalus is rare complication in neurosurgical operation, But it should be treated promptly because of sudden neurological deterioration. Computed tomography permitted rapid diagnosis including localization of the air, thus facilitating prompt tratment. A case of subdural tension pneumocephalus after cranial operation under the impression of bifrontal subdural hygroma is presented.

경막하 수낭종에 대한 임상적 고찰

백광흠,오석전,김광명,김남규,정환영 대한신경외과학회 1990 Journal of Korean neurosurgical society Vol.19 No.4

The author analysed 140 cases of subdural hygroma developed after head injury and various neurosurgical operations and was treated at Hanyang university hospital form 1983 to 1989. The results were analysed and summarized as follows. 1) The peak incidence was the age over 50 and under 10. 2) 104 cases (74.4%) were bilateral frontotemporoparietal lesions. 3) Causes were head injury (121 cases), operation for intracranial aneurysms (5 cases), ventriculoperitoneal shunt (5 cases), traumatic intracranial hematoma removal (4 cases), transcallosal tumor removal (2 cases), meningitis (2 cases), external ventricular drainage (1 cases). 4) Change in mental status without focal sign of brain damage was presenting symptom. 5) Operation was underwent if 63 cases and the reaccumulation rate was high (26.8%) after traphination but outcome was favourable. 6) Mortal rate in traumatic subdural hygroma was low (5.8%) because brain CT could detect subdural hygroma easily in early stage.

로봇을 이용한 두개골 천공 시스템의 공구 경로 생성

정연찬(YunChan Chung) (사)한국CDE학회 2013 한국CDE학회 논문집 Vol.18 No.4

This paper presents a tool-path generation methods for an automated robotic system for skull drilling, which is performed to access to some neurosurgical interventions. The path controls of the robotic system are classified as move, probe, cut, and poke motions. The four motions are the basic motion elements of the tool-paths to make a hole on a skull. Probing, rough cutting and fine cutting paths are generated for skull drilling. For the rough cutting path circular paths are projected on the offset surfaces of the outer top and the inner bottom surfaces of the skull. The projected paths become the paths on the top and bottom layers of the rough cutting paths. The two projected paths are blended for the paths on the other layers. Syntax of the motion commands for a file format is also suggested for the tool-paths. Implementation and simulation results show that the possibility of the proposed methods.