The Development of an Idealized Trocar Layout Decision System for Laparoscopic Surgery for Neurologically Impaired Children Based on Abdominal Working Space Calculations Made Using a 3D Scanner

• Project/Area Number: 16K11350
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Pediatric surgery
• Research Institution: Kagoshima University
• Principal Investigator: YAMADA Koji 鹿児島大学, 附属病院, 特任助教 (80528042)
• Co-Investigator(Kenkyū-buntansha): 家入 里志 鹿児島大学, 医歯学域医学系, 教授 (00363359) ; 山田 和歌 鹿児島大学, 医歯学域附属病院, 特任助教 (20457659) ; 川野 孝文 鹿児島大学, 医歯学総合研究科, 客員研究員 (40457651) ; 加治 建 鹿児島大学, 附属病院, 特任教授 (50315420) ; 植村 宗則 九州大学, 大学病院, 助教 (50636157) ; 中目 和彦 鹿児島大学, 医歯学域附属病院, 講師 (70448570) ; 向井 基 鹿児島大学, 医歯学域医学系, 准教授 (80468024) ; 大西 峻 鹿児島大学, 附属病院, 医員 (10614638)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000); Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2016: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
• Keywords: 3Dスキャナー / 腹腔鏡手術 / シミュレーター / トレーニング / 重症心身障害児 / ３D / 3Ｄ / 3D / 3Dスキャナ

Outline of Final Research Achievements

By integrating 3D data of body surface and abdominal CT image, volume data of abdominal surface was calculated. Then, 3D volume data of the intra-abdominal organ was created, and the shape of the organ under peumoperitoneum was simulated by adding the effect of the organ deformation.We could create the virtual image of laparoscopic surgery.
The dry box which simulated laparoscopic surgery from the virtual image was created, and we could verify the port layout before operation. We can train the operation in the model, and measure the data of trajectory of the forceps during the training, and the data can be used to provide feedback to the trainee and to arrange the menu of training.

Academic Significance and Societal Importance of the Research Achievements

本研究により、特に体幹の変形の強い患者に対するポートレイアウトのシミュレーションを術前に行うことが可能となった。それにより手術時間の短縮が図れ、合併症の発生率の軽減が期待できる。また本技術をシミュレーターを用いた手術トレーニングに応用することで、術者の技能向上や効率的なトレーニングメニューの開発につなげることができるほか、手術時の鉗子軌跡を測定するすることにより、鉗子運動の特性を把握し、術者の不得手な部分をカバーするオーダーメイドな手術トレーニングを行う事ができる。

Research Products

• [Journal Article] Effective Treatment of Laparoscopic Lateral Segmentectomy for Intrahepatic Portosystemic Shunt Transection in an Infantile Case (2018)
  • Author(s): Yamada Koji、Kaji Tatsuru、Kawano Takafumi、Moriguchi Tomoe、Sugita Koshiro、Masuya Ryuta、Machigashira Seiro、Onishi Shun、Yamada Waka、Nakame Kazuhiko、Mukai Motoi、Kawano Yoshifumi、Ieiri Satoshi
  • Journal Title: Journal of Laparoendoscopic & Advanced Surgical Techniques & Part B Volume: 28 Issue: 1
  • DOI: 10.1089/vor.2017.0441
• [Journal Article] Trends in Development of Surgical Device for Fetal, Neonatal and Pediatric Surgery (2018)
  • Author(s): Ieiri Satoshi、Murakami Masakazu、Baba Tokuro、Harumatsu Toshio、Yamada Koji
  • Journal Title: Journal of Japan Society of Computer Aided Surgery Volume: 20 Issue: 3 Pages: 154-157
  • DOI: 10.5759/jscas.20.154
  • NAID: 130007892688
  • ISSN: 1344-9486, 1884-5770
• [Journal Article] The effect of intravenous lipid emulsions and mucosal adaptation following massive bowel resection (2018)
  • Author(s): Onishi Shun、Kaji Tatsuru、Machigashira Seiro、Yamada Waka、Masuya Ryuta、Nakame Kazuhiko、Kawano Masato、Yano Keisuke、Yamada Koji、Kawano Takafumi、Mukai Motoi、Yoshioka Takako、Tanimoto Akihide、Ieiri Satoshi
  • Journal Title: Journal of Pediatric Surgery Volume: 53 Issue: 12 Pages: 2444-2448
  • DOI: 10.1016/j.jpedsurg.2018.08.019
  • Peer Reviewed / Open Access
• [Journal Article] Ghrelin Stimulates Intestinal Adaptation Following Massive Small Bowel Resection (2018)
  • Author(s): Onishi S, Kaji T, Yamada W, Nakame K, Machigashira S, Yano K, Kawano M, Harumatsu T,Masuya R, Kawano T, Mukai M, Yoshioka T, Souda M, Hamada T, Tanimoto A, Ieiri S
  • Journal Title: Peptide Volume: 106 Pages: 264-267
  • DOI: 10.1016/j.peptides.2018.06.009
  • Peer Reviewed / Open Access
• [Journal Article] Long-term outcomes of surgery for choledochal cysts: a single-institution study focusing on follow-up and late complications (2018)
  • Author(s): Mukai Motoi、Kaji Tatsuru、Masuya Ryuta、Yamada Koji、Sugita Koshiro、Moriguchi Tomoe、Onishi Shun、Yamada Waka、Kawano Takafumi、Machigashira Seiro、Nakame Kazuhiko、Takamatsu Hideo、Ieiri Satoshi
  • Journal Title: Surgery Today Volume: 48 Issue: 9 Pages: 835-840
  • DOI: 10.1007/s00595-018-1660-9
  • Peer Reviewed / Open Access
• [Journal Article] Predictors of a successful outcome for infants with short bowel syndrome: a 30-year single-institution experience (2017)
  • Author(s): Kaji Tatsuru、Nakame Kazuhiko、Machigashira Seiro、Kawano Takafumi、Masuya Ryuta、Yamada Waka、Yamada Koji、Onishi Shun、Moriguchi Tomoe、Sugita Koshiro、Mukai Motoi、Ieiri Satoshi
  • Journal Title: Surgery Today Volume: 47 Issue: 11 Pages: 1391-1396
  • DOI: 10.1007/s00595-017-1534-6
  • Peer Reviewed / Open Access
• [Journal Article] A comparison of the characteristics and precision of needle driving for right-handed pediatric surgeons between right and left driving using a model of infant laparoscopic diaphragmatic hernia repair (2017)
  • Author(s): Ikee Takamasa、Onishi Shun、Mukai Motoi、Kawano Takafumi、Sugita Koshiro、Moriguchi Tomoe、Yamada Koji、Yamada Waka、Masuya Ryuta、Machigashira Seiro、Nakame Kazuhiko、Kaji Tatsuru、Ieiri Satoshi
  • Journal Title: Pediatric Surgery International Volume: 33 Issue: 10 Pages: 1103-1108
  • DOI: 10.1007/s00383-017-4144-x
  • Peer Reviewed / Open Access
• [Journal Article] Ghrelin Improves Intestinal Mucosal Atrophy During Parenteral Nutrition: An Experimental Study (2016)
  • Author(s): Yamada W, Kaji T, Onishi S, Nakame K, Yamada K, Kawano T, Mukai M, Souda M, Yoshioka T, Tanimoto A, Ieiri S
  • Journal Title: J Pediatr Surg Volume: 51(12) Issue: 12 Pages: 2039-2043
  • DOI: 10.1016/j.jpedsurg.2016.09.035
  • Peer Reviewed / Open Access
• [Journal Article] Long-term outcome of bowel function for 110 consecutive cases of Hirschsprung's disease: Comparison of the abdominal approach with transanal approach over 30 years in a single institution : Is the transanal approach truly beneficial for bowel function? (2016)
  • Author(s): Onishi S, Nakame K, Yamada K, Yamada W, Kawano T, Mukai M, Kaji T, Ieiri S
  • Journal Title: J Pediatr Surg Volume: 51(12) Issue: 12 Pages: 2010-2014
  • DOI: 10.1016/j.jpedsurg.2016.09.029
  • Peer Reviewed / Open Access
• [Journal Article] Changing Profile of Safe Techniques for Insertion a Central Venous Catheter in Pediatric Patients - Improvement in Outcomes with the Experience of 500 Insertions in a Single Institution (2016)
  • Author(s): Kaji T, Kawano T, Yamada W, Yamada K, Onishi S, Nakame K, Mukai M, Ieiri S, Takamatsu H
  • Journal Title: J Pediatr Surg Volume: 51 Issue: 12 Pages: 2044-2047
  • DOI: 10.1016/j.jpedsurg.2016.09.037
  • Peer Reviewed / Open Access
• [Journal Article] Efficacy of Ethanol locks to reduce the incidence of catheter-related bloodstream infections for home parenteral nutrition pediatric patients. Comparison of therapeutic treatment with prophylactic treatment- (2016)
  • Author(s): Kawano T, Kaji T, Ohnishi S, Yamada K, Yamada W, Nakame K, Mukai M, Ieiri S
  • Journal Title: Pediatric Surgery International Volume: 32(9) Issue: 9 Pages: 863-867
  • DOI: 10.1007/s00383-016-3933-y
  • Peer Reviewed / Open Access
• [Journal Article] The administration of ghrelin improved hepatocellular injury following parenteral feeding in a rat model of short bowel syndrome. (2016)
  • Author(s): Onishi S, Kaji T, Yamada Y, Moriguchi T, Sugita K, Yamada K, Kawano T, Nakame K, Mukai M, Yamada S, Yoshioka T, Tanimoto A, Ieiri S
  • Journal Title: Pediatr Surg Int Volume: 32(12) Issue: 12 Pages: 1165-1171
  • DOI: 10.1007/s00383-016-3975-1
  • Peer Reviewed / Open Access
• [Presentation] The development of an idealized trodar layout decision system for laparoscopic surgery (2018)
  • Author(s): Yamada K , Kawamura K, Uemura M, Yano K, Kawano M, Onishi S, Yamada W, Masuya R, Kawano T, Machigashira S, Nakame K, Mukai M, Kaji T, Ieiri S
  • Organizer: 27th annual congress for endosurgery in children,
  • Int'l Joint Research
• [Presentation] 当施設における心疾患合併新生児外科症例の検討-院内完結型治療開始以降の分析- (2018)
  • Author(s): 山田耕嗣、川野正人、矢野圭輔、大西峻、山田和歌、桝屋隆太、川野孝文、町頭成郎、中目和彦、向井 基、加治 建、井本 浩、家入里志
  • Organizer: 第55回日本小児外科学会学術集会
• [Presentation] 高度映像機器(8K&3D)の導入による細径胆管に対する腹腔鏡下胆管空腸吻合術の工夫 (2018)
  • Author(s): 山田耕嗣、村上雅一、矢野圭輔、馬場徳朗、大西峻、春松敏夫、山田和歌、桝屋隆太、川野孝文、町頭成郎、中目和彦、向井 基、加治 建、家入里志
  • Organizer: 第38回日本小児内視鏡外科・手術手技研究会
• [Presentation] 広域医療圏をカバーする小児外科専門施設における外傷症例の検討 (2018)
  • Author(s): 山田耕嗣、村上雅一、矢野圭輔、馬場徳朗、大西峻、春松敏夫、山田和歌、桝屋隆太、川野孝文、町頭成郎、中目和彦、向井 基、加治 建、家入里志
  • Organizer: 第32回日本小児救急医学会学術集会
• [Presentation] 胆道拡張症に対する腹腔鏡手術導入の治療成績 (2018)
  • Author(s): 山田耕嗣、村上雅一、矢野圭輔、馬場徳朗、大西峻、春松敏夫、山田和歌、桝屋隆太、川野孝文、町頭成郎、中目和彦、向井 基、加治 建、家入里志
  • Organizer: 第55回九州小児外科学会
• [Presentation] 高度映像機器導入による腹腔鏡下胆管空腸吻合術の工夫 (2018)
  • Author(s): 山田耕嗣、村上雅一、矢野圭輔、馬場徳朗、大西峻、春松敏夫、山田和歌、桝屋隆太、川野孝文、町頭成郎、中目和彦、向井 基、加治 建、家入里志
  • Organizer: 第20回南九州内視鏡外科研究会
• [Presentation] 1歳未満根治術ヒルシュスプルング病の長期排便機能 Open Soave-Denda vs Lap-TAEPT (2018)
  • Author(s): 山田耕嗣、村上雅一、矢野圭輔、馬場徳朗、大西峻、春松敏夫、山田和歌、桝屋隆太、川野孝文、町頭成郎、中目和彦、向井 基、加治 建、家入里志
  • Organizer: 第31回日本内視鏡外科学会総会
• [Presentation] SUCCESSFUL TREATMENT OF LAPAROSCOPIC LATERAL SEGMENTECTOMY FOR INTRA-HEPATIC PORT-SYSTEMIC SHUNT TRANSECTION IN AN INFANTILE CASE (2017)
  • Author(s): Koji Yamada,Takafumi Kawano, Tomoe Moriguchi, Koushiro Sugita,Ryuta Masuya, Seirou Machigashira, Shun Onishi, Waka Yamada, Kazuhiko Nakame, Motoi Mukai, Tatsuru Kaji,,Satoshi Ieiri,
  • Organizer: IPEG’s 26th Annual Congress for Endosurgery in Children （IPEG）
• [Presentation] 生涯一例の稀少疾患に挑む―我より古を作す小児内視鏡外科手術― 鹿児島大学学術研究院医歯学域医学系小児外科学分野 (2016)
  • Author(s): 山田耕嗣
  • Organizer: 第29回日本内視鏡外科学会総会
  • Place of Presentation: パシフィコ横浜（神奈川県・横浜市）
  • Year and Date: 2016-12-08
• [Presentation] 両端針による連続縫合を用いた 肝管空腸吻合術 (2016)
  • Author(s): 山田耕嗣
  • Organizer: 第36回日本小児内視鏡外科・手術手技研究会
  • Place of Presentation: ソニックシティ（埼玉県・さいたま市）
  • Year and Date: 2016-10-27
• [Presentation] 総排泄腔残症術後で成人期に到達した４症例の検討 (2016)
  • Author(s): 山田耕嗣
  • Organizer: 第27回日本小児外科QOL研究会
  • Place of Presentation: 川崎医科大学（岡山県・倉敷市）
  • Year and Date: 2016-10-15
• [Presentation] 当科における肝損傷のまとめ (2016)
  • Author(s): 山田耕嗣
  • Organizer: 第53回日本小児外科学会学術集会（JSPS2016）
  • Place of Presentation: ヒルトン福岡シーホーク（福岡県・福岡市）
  • Year and Date: 2016-05-24