PURPOSE: Increased robotic surgery is attended by increased reports of complications, largely due to limited operative view and lack of tactile sense. These kinds of obstacles, which seldom occur in open surgery, are challenging for beginner surgeons. To enhance robotic surgery safety, we created an augmented reality (AR) model of the organs around the thyroid glands, and tested the AR model applicability in robotic thyroidectomy. METHODS: We created AR images of the thyroid gland, common carotid arteries, trachea, and esophagus using preoperative CT images of a thyroid carcinoma patient. For a preliminary test, we overlaid the AR images on a 3-dimensional printed model at five different angles and evaluated its accuracy using Dice similarity coefficient. We then overlaid the AR images on the real-time operative images during robotic thyroidectomy. RESULTS: The Dice similarity coefficients ranged from 0.984 to 0.9908, and the mean of the five different angles was 0.987. During the entire process of robotic thyroidectomy, the AR images were successfully overlaid on the real-time operative images using manual registration. CONCLUSION: We successfully demonstrated the use of AR on the operative field during robotic thyroidectomy. Although there are currently limitations, the use of AR in robotic surgery will become more practical as the technology advances and may contribute to the enhancement of surgical safety.
Carotid Artery, Common ; Esophagus ; Humans ; Robotic Surgical Procedures ; Surgeons ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Trachea

PURPOSE: The purpose of this study was to evaluate the bone regeneration of novel biodegradable amorphous calcium phosphate. MATERIALS AND METHOD: An 8-mm, calvarial, critical-size osteotomy defect was created in each of 20 male Sprague-Dawley rats(weight 250~300g). The animals were divided into two groups of 10 animals each and allowed to heal for 2 weeks(10 rats) or 8 weeks(10 rats). The first group was the control group and the other group was the experimental group which received the novel biodegradable calcium phosphate. RESULTS: The healing of the calvarium in the control group was uneventful. The histologic results showed little bone formation in the control group. The experimental group which received the novel biodegradable calcium phosphate showed a normal wound healing. There were a lot of new bone formation around the biomaterial in 2 weeks. The bone formation increased in 8 weeks when compared to 2 weeks and there was a significant bone increase as well(P<0.01).The novel biodegradable calcium phosphate showed statistical significance when compared to the control group (P<0.05). The novel biodegradable calcium phosphate in 8 weeks showed a significant increase in bone formation when compared to 2 weeks (40.4+/-1.6)(%). The biodegradable calcium phosphate which is made from mixing calcium phosphate glass(CPG), NaCO and NaOH solution, is biocompatible, osteoconductive and has a high potency of bone formation. CONCLUSION: We can conclude that the novel biodegradable calcium phosphate can be used as an efficient bone graft material for its biodegradability and osteoconductivity.
Animals ; Bone Regeneration* ; Calcium* ; Humans ; Male ; Osteogenesis ; Osteotomy ; Rats* ; Rats, Sprague-Dawley ; Skull ; Transplants ; Wound Healing