광추적기와 내부 비전센서를 이용한 수술도구의 3차원 자세 및 위치 추적 시스템

조영진(Young Jin Joe),오현민(Hyun Min Oh),김민영(Min Young Kim) 제어로봇시스템학회 2016 제어·로봇·시스템학회 논문지 Vol.22 No.8

When surgical instruments are tracked in an image-guided surgical navigation system, a stereo vision system with high accuracy is generally used, which is called optical tracker. However, this optical tracker has the disadvantage that a line-of-sight between the tracker and surgical instrument must be maintained. Therefore, to complement the disadvantage of optical tracking systems, an internal vision sensor is attached to a surgical instrument in this paper. Monitoring the target marker pattern attached on patient with this vision sensor, this surgical instrument is possible to be tracked even when the line-of-sight of the optical tracker is occluded. To verify the system"s effectiveness, a series of basic experiments is carried out. Lastly, an integration experiment is conducted. The experimental results show that rotational error is bounded to max 1.32° and mean 0.35°, and translation error is in max 1.72mm and mean 0.58mm. Finally, it is confirmed that the proposed tool tracking method using an internal vision sensor is useful and effective to overcome the occlusion problem of the optical tracker.

A Method for Fluoroscopy Based Navigation System to Assist Needle Insertion Concerning Reduced Radiation Exposure for Endoscopic Disc Surgery

Jinkon Park,Hyon Min Yoon,Siyeop Yoon,Malinda Vania,Deukhee Lee 제어로봇시스템학회 2015 제어로봇시스템학회 국제학술대회 논문집 Vol.2015 No.10

Endoscopic disc surgery requires a process of inserting a guide-needle to the target lumbar disc. And the insertion path is manually planned by drawing lines on the patient’s skin while monitoring the fluoroscopic view of the lumbar. Such operative procedure inevitably exposes both surgeon and patient to the fluoroscopic radiation emitted from c-arm for a long time. To reduce the radiation exposure time, this study proposes a computer assisted operative planning method implemented by using computer vision and computer graphics theory. This method calculates the 3-dimensional path line of guide-needle from multiple triangular planes. Triangular planes can be obtained by analyzing 2-dimensional images of patient’s disc in 3 different angles from rotationally movable c-arm. Additionally, a method of guiding robot’s control based on the 3-dimensional needle path was developed by implementing the Hand-eye (end-effector and camera) calibration. Hand-eye calibration method calculates the geometric transformation matrix between the c-arm coordinate system and base of guidance robot coordinate system. The proposed system was then tested for its accuracy.

Trends in the Charges and Utilization of Computer-Assisted Navigation in Cervical and Thoracolumbar Spinal Surgery

Dominy Calista L.,Tang Justin E.,Arvind Varun,Cho Brian H.,Selverian Stephen,Shah Kush C.,Kim Jun S.,Cho Samuel Kang-Wook 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.5

Study Design: Retrospective national database study.Purpose: This study is conducted to assess the trends in the charges and usage of computer-assisted navigation in cervical and thoracolumbar spinal surgery.Overview of Literature: This study is the first of its kind to use a nationwide dataset to analyze trends of computer-assisted navigation in spinal surgery over a recent time period in terms of use in the field as well as the cost of the technology.Methods: Relevant data from the National Readmission Database in 2015–2018 were analyzed, and the computer-assisted procedures of cervical and thoracolumbar spinal surgery were identified using International Classification of Diseases 9th and 10th revision codes. Patient demographics, surgical data, readmissions, and total charges were examined. Comorbidity burden was calculated using the Charlson and Elixhauser comorbidity index. Complication rates were determined on the basis of diagnosis codes.Results: A total of 48,116 cervical cases and 27,093 thoracolumbar cases were identified using computer-assisted navigation. No major differences in sex, age, or comorbidities over time were found. The utilization of computer-assisted navigation for cervical and thoracolumbar spinal fusion cases increased from 2015 to 2018 and normalized to their respective years’ total cases (Pearson correlation coefficient=0.756, <i>p</i> =0.049; Pearson correlation coefficient=0.9895, <i>p</i> =0.010). Total charges for cervical and thoracolumbar cases increased over time (Pearson correlation coefficient=0.758, <i>p</i> =0.242; Pearson correlation coefficient=0.766, <i>p</i> =0.234).Conclusions: The use of computer-assisted navigation in spinal surgery increased significantly from 2015 to 2018. The average cost grossly increased from 2015 to 2018, and it was higher than the average cost of nonnavigated spinal surgery. With the increased utilization and standardization of computer-assisted navigation in spinal surgeries, the cost of care of more patients might potentially increase. As a result, further studies should be conducted to determine whether the use of computer-assisted navigation is efficient in terms of cost and improvement of care.

Application of augmented reality using neuro-navigation system for individualized brain tumor surgery

김형민,이민호,이태규 대한두개저학회 2022 대한두개저학회지 Vol.17 No.2

Background : With the recent development of augmented reality (AR) systems, it has become possible to implement three-dimensional (3D) images directly with a microscope using a navigation system. The authors would like to show how this AR system is used in brain tumor surgery. Materials and Methods : From November 2020 to August 2021, consecutive patients who underwent brain tumor surgery were enrolled in this study. Preoperatively, magnetic resonance imaging (MRI) was obtained using a 3-Tesla scanner. Surrounding significant structures were segmented from MRI. Segmented objects were stored as analyzed images and imported into the navigation system. During the operation, a neuro-navigation system and a microscope were linked and applied. Through the eyepiece of the microscope, segmented objects could be overlaid in AR format on the actual operative field. Results : Thirty-four cases were enrolled in the study. Patients comprised 19 male patients and 15 female patients. The median age was 60 years (range, 36-81 years); 11 cases were meningiomas, 10 cases were metastatic brain tumors, 8 cases were glioblastomas, 2 were hemangioblastomas, and there were 1 ependymoma, 1 giant pituitary adenoma, and 1 primary intracranial lymphoma. All cases were resected gross totally, except two cases (one glioblastoma, and one giant pituitary adenoma). There was no postoperative hemorrhage or infection. Conclusions : Brain tumor surgery using the AR system can increase the convenience of surgery by providing intuitive information to the surgeon. The AR system may become an invaluable tool in delivering safer care to brain tumor patients.

증강현실 수술 내비게이션 시스템을 위한 단일 카메라 깊이 추정 기반 마커리스 정합

최민혁(Min-Hyuk Choi),최시은(Si-Eun Choi),강세룡(Se-Ryong Kang),유지용(Ji-Yong Yoo),양수(Su Yang),김조은(Jo-Eun Kim),허경회(Kyung-Hoe Huh),이삼선(Sam-Sun Lee),허민석(Min-Suk Heo),이원진(Won-Jin Yi) 대한전기학회 2021 전기학회논문지 Vol.70 No.12

In augmented reality(AR) surgical navigation system, the depth estimation using RGBD camera has limitation in obtaining the dense depth necessary to increase the registration accuracy. Recently, deep learning based monocular depth estimation has showed remarkable performance. In this study, we developed a markerless registration method using the monocular depth estimation, and applied it to AR surgical navigation system. The accuracy of our method of monocular depth estimation was 2.47 ± 1.15mm, while that of the method of the RGBD camera was 2.33 ± 1.24mm. There was no significant difference by paired T-test. Furthermore, the monocular depth estimation was able to acquire denser depth than the RGBD camera.

Safe and time-saving treatment method for acute cerebellar infarction: Navigation-guided burr-hole aspiration – 6-years single center experience

Min-Woo Kim,Eunsung Park,Dae-Won Kim,Sung-Don Kang 대한뇌혈관외과학회 2023 Journal of Cerebrovascular and Endovascular Neuros Vol.25 No.4

Objective: While patients with medically intractable acute cerebellar infarction typically undergo suboccipital craniectomy and removal of the infarcted tissue, this procedure is associated with long operating times and postoperative complications. This study aimed to investigate the effectiveness of minimally invasive navigationguided burr hole aspiration surgery for the treatment of acute cerebellar infarction.Methods: Between January 2015 and December 2021, 14 patients with acute cerebellar infarction, who underwent navigation-guided burr hole aspiration surgery, were enrolled in this study.Results: The preoperative mean Glasgow Coma Scale (GCS) score was 12.7, and the postoperative mean GCS score was 14.3. The mean infarction volume was 34.3 cc at admission and 23.5 cc immediately following surgery. Seven days after surgery, the mean infarction volume was 15.6 cc. There were no surgery-related complications during the 6-month follow-up period and no evidence of clinical deterioration. The mean operation time from skin incision to catheter insertion was 28 min, with approximately an additional 13 min for extra-ventricular drainage. The mean Glasgow Outcome Scale score after 6 months was 4.8.Conclusions: Navigation-guided burr hole aspiration surgery is less time-consuming and invasive than conventional craniectomy, and is a safe and effective treatment option for acute cerebellar infarction in selected cases, with no surgery-related complication.

3차원 수술 항법 장치를 위한 정밀 얼굴 정합

김현준,강승우,박태용,이정진 한국차세대컴퓨팅학회 2020 한국차세대컴퓨팅학회 논문지 Vol.16 No.1

본 논문에서는 실용성 높은 3차원 수술 항법 장치를 위한 정밀 얼굴 정합방법을 제안한다. 첫 번째, 환자의 CT 영 상에서 눈과 코를 포함하는 ROI영역에 표면 추출을 하여 점군을 획득하고, 수술 전 환자로부터 CT 영상에서 획득 한 점군과 비슷한 모양으로 프로브를 움직여 점군을 획득한다. 획득한 두 점군 각각 데이터의 특징을 이용하여 눈, 코, 이마 등과 같은 해부학적 특징점을 찾는다. 두 번째, 찾은 특징점을 데이터의 특징을 이용하여 서로 매칭하여 초기정합을 수행한다. 세 번째, CPD 알고리즘을 사용하여 2차 정합을 수행한다. 마지막으로 파웰 방법을 이용하여 CPRE가 최소가 되는 위치로 정밀 정합한다. 실험 결과, 제안 방법은 실용성이 높은 피부 데이터만 이용 시 기존 방법보다 정확도가 높고 오차수치는 1.07mm로 나타났다. In this paper, we propose accurate face registration for practical 3D surgical navigation system. First, we performed Surface Extraction of the patient's CT image by masking the ROI area which includes eyes and nose to obtain a point set. The other point set is acquired by moving probe on the patient face before surgery. This point set also includes eyes and nose. Anatomical features such as eyes, nose, and forehead are extracted from each of the two point sets. Second, initial registration is performed by matching the found feature points using data structures. Third, two point sets are aligned using the CPD algorithm. Finally, we fit the two point set using Powell's method by minimizing CPRE. According to the results of accuracies using only skin data, our method had 1.07mm error which is more accurate than the previous method.

Advancements and Challenges in Robot-Assisted Bone Processing in Neurosurgical Procedures

Yoshihiro Kitahama,Hiroo Shizuka,Yuto Nakano,Yukoh Ohara,Jun Muto,Shuntaro Tsuchida,Daisuke Motoyama,Hideaki Miyake,Katsuhiko Sakai 대한척추신경외과학회 2024 Neurospine Vol.21 No.1

Objective: Practical applications of nerve decompression using neurosurgical robots remain unexplored. Our ongoing research and development initiatives, utilizing industrial robots, aim to establish a secure and efficient neurosurgical robotic system. The principal objective of this study was to automate bone grinding, which is a pivotal component of neurosurgical procedures. Methods: To achieve this goal, we integrated an endoscope system into a manipulator and conducted precision bone machining using a neurosurgical drill, recording the grinding resistance values across 3 axes. Our study encompassed 2 core tasks: linear grinding, such as laminectomy, and cylindrical grinding, such as foraminotomy, with each task yielding unique measurement data. Results: In linear grinding, we observed a proportional increase in grinding resistance values in the machining direction with acceleration. This observation suggests that 3-axis resistance measurements are a valuable tool for gauging and predicting deep cortical penetration. However, problems occurred in cylindrical grinding, and a significant error of 10% was detected. The analysis revealed that multiple factors, including the tool tip efficiency, machining speed, teaching methods, and deflection in the robot arm and jig joints, contributed to this error. Conclusion: We successfully measured the resistance exerted on the tool tip during bone machining with a robotic arm across 3 axes. The resistance ranged from 3 to 8 Nm, with the measurement conducted at a processing speed approximately twice that of manual surgery performed by a surgeon. During the simulation of foraminotomy under endoscopic grinding conditions, we encountered a -10% error margin.

영상유도수술을 위한 광학추적 센서 및 관성항법 센서 네트웍의 칼만필터 기반 자세정보 융합

오현민,김민영,Oh, Hyun Min,Kim, Min Young 대한전기학회 2017 전기학회논문지 Vol.66 No.1

Tracking system is essential for Image Guided Surgery(IGS). Optical Tracking System(OTS) is widely used to IGS for its high accuracy and easy usage. However, OTS doesn't work when occlusion of marker occurs. In this paper sensor data fusion with OTS and Inertial Navigation System(INS) is proposed to solve this problem. The proposed system improves the accuracy of tracking system by eliminating gaussian error of the sensor and supplements the disadvantages of OTS and IMU through sensor fusion based on Kalman filter. Also, sensor calibration method that improves the accuracy is introduced. The performed experiment verifies the effectualness of the proposed algorithm.

A preliminary study on surgical navigation for epiduroscopic laser neural decompression

Jeon, Sangseo,Lee, Gun Woo,Jeon, Young Dae,Park, Il-Hyung,Hong, Jaesung,Kim, Jae-Do Professional Engineering Publishing Ltd. 2015 Proceedings of the Institution of Mechanical Engin Vol. No.

<P>Epiduroscopic laser neural decompression is an emerging therapeutic modality to treat lumbar spine pathologies including chronic low back pain, spinal stenosis, and disk herniation via catheter insertion followed by laser ablation of the lesion. Despite the efficacy of epiduroscopic laser neural decompression, excessive radiation doses due to fluoroscopy during epiduroscopic laser neural decompression have limited its widespread application. To address the issue, we propose a surgical navigation system to assist in epiduroscopic laser neural decompression procedures using radiation-free image guidance. An electromagnetic tracking system was used as the basic modality to track the internal location of the surgical instrument with respect to the patient body. Patient-to-image registration was carried out using the point-based registration method to determine the transformation between the coordinate system of the patient and that of the medical images. We applied the proposed system in epiduroscopic laser neural decompression procedures to assess its effectiveness, and the outcomes confirmed its clinical feasibility. To the best of our knowledge, this is a report on the first surgical navigation applied for epiduroscopic laser neural decompression procedure.</P>