Development of a novel deployable arm for natural orifice transluminal endoscopic surgery(NOTES)

xlomafota13 shared this article with you from Inoreader Development of a novel deployable arm for natural orifice transluminal endoscopic surgery(NOTES) Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract: Background NOTES is aided by the instrument channel of an endoscope. Limited by the diameter of the endoscope, the construction of the operation triangle is affected. This paper presents a deployable arm that can increase the distance between the arms. Methods The manipulation arm is composed of a continuum arm and a deployable arm. The deployable arm can be locked by a stay cable and a mechanical structure. The angle between the end‐effectors and the common workspace of the two manipulation arms are comprehensively analyzed. Through experiments, the design parameters are validated and justified. Results The experiment shows that the deployment arm can maintain the deformation within 3.5 mm under a 300 g load, and the angle between the two end‐effectors can be maintained within the range of [88o ,110o]. Conclusions The novel deployment arms enlarge the angle between the end effectors, which significantly improves the flexibility of the arms. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Fluorescence‐guided D3 lymphadenectomy in robotic right colectomy with complete mesocolic excision

xlomafota13 shared this article with you from Inoreader Fluorescence‐guided D3 lymphadenectomy in robotic right colectomy with complete mesocolic excision Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background In robotic right hemicolectomy for cancer, appropriate lymphadenectomy is essential. Visualization of draining lymph nodes and blood flow with near‐infrared (NIR) fluorescence DaVinci® imaging system is a recent development. We present the technique of robotic right colectomy with complete mesocolic excision (CME) and D3 lymphadenectomy using Indocyanine Green (ICG) endoscopic submucosal injection to intraoperatively identify tumour lymphatic basin. Methods The day before surgery, in patients scheduled for robotic right colectomy an endoscopic submucosal injection of 3 mg of ICG solution around the tumor is realized. Robotic right hemicolectomy is performed with suprapubic trocars layout and "bottom to up dissection", realizing a CME with central vessel ligation and D3 lymphadenectomy. Site of primary tumor and lymphatic basin are visible with the FireflyTM camera modality. Results From July 2016 to July 2020, 85 patients received a robotic right colectomy with CME and D3 lymphadenectomy. In 50 patients, ICG submucosal injection was performed: visualisation of the site of primary tumour and of LN in the D3 area was possible in all cases; in 17/50 patients (34%), LN out from anatomical lymphatic basin were identified. No side effects were observed. Conclusions In this series, submucosal ICG injection showed to be feasible and safe. The accuracy in identification of D3 lymphatic basin was high, thus permitting an image‐guided radical lymphadenectomy. Fluorescent technology represents an interesting innovation to ameliorate surgery of colon cancer. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Master manipulator optimisation for robot assisted minimally invasive surgery

xlomafota13 shared this article with you from Inoreader Master manipulator optimisation for robot assisted minimally invasive surgery Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background In robot‐assisted minimally invasive surgery, the surgeon controls a robot by operating a pair of master manipulators. Thus, the performance of a master manipulator directly affects the work of the surgeon physiologically and psychologically. Aims In order to improve the operability and quality of operation, a structure optimisation method of master manipulator is proposed. Materials & Methods The optimisation index of workspace and dexterity of main manipulator based on ergonomics and kinematics is established, and the reasonable weight coefficient of optimisation index is determined by using combination weighting method. Results Experiments verified that the proposed optimisation method ensures a large workspace and good kinematic performance for the master manipulator. Conclusion This improves the comfort of the surgeon and can effectively avoid the problem of cutting off master–slave communication to adjust the position of the master manipulator owing to the small workspace. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Urological and sexual function after robotic and laparoscopic surgery for rectal cancer: A systematic review, meta‐analysis and meta‐regression

xlomafota13 shared this article with you from Inoreader Urological and sexual function after robotic and laparoscopic surgery for rectal cancer: A systematic review, meta‐analysis and meta‐regression Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background This systematic review sought to compare the urogenital functions after laparoscopic (LAP) and robotic (ROB) surgery for rectal cancer. Methods This study conformed to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Results Twenty‐six studies (n = 2709 for ROB, n = 2720 for LAP) were included. There was a lower risk of 30‐day urinary retention in the ROB group (risk ratios 0.78, 95% confidence interval [CI] 0.61–0.99), but the long‐term risk was comparable (p = 0.460). Meta‐regression showed a small, positive relationship between age and risk of 30‐day urinary retention in both the ROB (p = 0.034) and LAP groups (p = 0.004). The International Prostate Symptom Score was better in the ROB group at 3 months (mean difference [MD] −1.58, 95% CI −3.10 to −0.05). The International Index of Erectile Function score was better in the ROB group at 6 months (MD 4.06, 95% CI 2.38 – 5.74). Conclusion While robotics may improve urogenital function after rectal surgery, the quality of evidence is low based on the Grading of Recommendations, Assessment, Development and Evaluation approach. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acceptance of patients towards task‐autonomous robotic cochlear implantation: An exploratory study

xlomafota13 shared this article with you from Inoreader Acceptance of patients towards task‐autonomous robotic cochlear implantation: An exploratory study Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Recently, task‐autonomous image‐guided robotic cochlear implantation has been successfully completed in patients. However, no data exist on patients' perspective of this new technology. The aim of this study was to evaluate the acceptance of patients towards task‐autonomous robotic cochlear implantation (TARCI). Methods We prospectively surveyed 63 subjects (51 patients and 12 parents of infants) scheduled for manual cochlear implantation. We collected sociodemographic and clinico‐pathological characteristics and their attitude towards TARCI for themselves or their child using a questionnaire. Differences between variables were analysed using one‐way analysis of variance and Spearman's rho was used to test for correlation. Results Seventy‐three percent of patients and 84% of parents expressed a high acceptance towards TARCI for themselves, or their child, respectively. Interestingly, patients with a negative attitude towards TARCI were significantly younger. Conclusion The attitude of patients and parents likely does not represent a barrier towards application of this new technology. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

End‐user evaluation of software‐generated intervention planning environment for transrectal magnetic resonance‐guided prostate biopsies

xlomafota13 shared this article with you from Inoreader End‐user evaluation of software‐generated intervention planning environment for transrectal magnetic resonance‐guided prostate biopsies Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background This study presents user evaluation studies to assess the effect of information rendered by an interventional planning software on the operator's ability to plan transrectal magnetic resonance (MR)‐guided prostate biopsies using actuated robotic manipulators. Methods An intervention planning software was developed based on the clinical workflow followed for MR‐guided transrectal prostate biopsies. The software was designed to interface with a generic virtual manipulator and simulate an intervention environment using 2D and 3D scenes. User studies were conducted with urologists using the developed software to plan virtual biopsies. Results User studies demonstrated that urologists with prior experience in using 3D software completed the planning less time. 3D scenes were required to control all degrees‐of‐freedom of the manipulator, while 2D scenes were sufficient for planar motion of the manipulator. Conclusions The study provides insights on using 2D versus 3D environment from a urologist's perspective for different operational modes of MR‐guided prostate biopsy systems. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

easyEndo robotic endoscopy system: Development and usability test in a randomized controlled trial with novices and physicians

xlomafota13 shared this article with you from Inoreader easyEndo robotic endoscopy system: Development and usability test in a randomized controlled trial with novices and physicians Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Some difficulties are common when using endoscopes. Steering is not intuitive, the endoscope weight is a physical burden to physicians and communication problems often occur between operators. Method To overcome these, we developed a robotic endoscopy system and conducted a usability test to compare conventional and robotic manipulation. Nine novices and eighteen physicians participated with the physicians being divided into intermediate and expert groups. The participants performed endoscope insertion into a simulator (physicians) or lesion marking on a testbed (novices) and simulate biopsies. Result Novices completed the tasks faster and with a lower workload when using robotic manipulation, whereas the experts showed the opposite trend. Still, the intermediates showed no significant difference as trials proceeded. Nevertheless, the learning curve analysis showed that the learning rate in all groups is greater for robotic manipulation (21.02% on average) than for conventional manipulation (13.75%) and predicted that physicians can reach manual performance. Conclusion The proposed robotic endoscopy system may allow solo‐manipulation using one controller and may be more intuitive and convenient to use than conventional manipulation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A deep learning network‐assisted bladder tumour recognition under cystoscopy based on Caffe deep learning framework and EasyDL platform

xlomafota13 shared this article with you from Inoreader A deep learning network‐assisted bladder tumour recognition under cystoscopy based on Caffe deep learning framework and EasyDL platform Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Cystoscopy plays an important role in the diagnosis of bladder tumours. As a typical representative of the deep learning algorithm, the convolutional neural network has shown great advantages in the field of image recognition and segmentation. Methods One thousand two photographs of normal bladder tissue and 734 photos of bladder tumours under cystoscopy were taken from 175 patients. Caffe deep learning framework and EasyDL platform were used to structure and train the model. The trained model from the EasyDL platform was deployed on a mobile phone. Results The accuracy rate of the neural network to recognise the bladder cancer based on Caffe framework was 82.9%, and the data on the EasyDL platform were 96.9%. The model from EasyDL platform could discern bladder cancer accurately on the phone and website. Conclusion The deep learning network could recognise the bladder cancer accurately. Deploying that model on the mobile phone was useful for clinical use. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Robotic enucleation for oesophageal benign and borderline tumours: Less is more?

xlomafota13 shared this article with you from Inoreader Robotic enucleation for oesophageal benign and borderline tumours: Less is more? Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Oesophageal benign to borderline tumours are rare entities, and their optimal treatment strategy remains controversial. Surgical robotic enucleation is an option to optimize their management. Methods We prospectively collected data on seven consecutive oesophageal benign to borderline tumours operated robotically over a 4‐year period. Patient baseline characteristics, perioperative outcomes and medium‐term follow‐ups were reviewed and analysed retrospectively. Results Two patients underwent a robotic oesophagectomy and five underwent a simple enucleation. These last were the objective of the final analysis. Median operative time was 150 min. Neither deaths nor postoperative complications occurred. Median oral feeding started on postoperative day 3.5. The median postoperative stay was 5 days. Final histopathology confirmed two gastrointestinal stromal tumours, two leiomyomas and one simple cyst. Conclusions Robotic enucleation of oesophageal benign to borderline tumours is a feasible procedure in a dedicated oesophageal unit, with optimal perioperative outcomes in a small series of cases with limited follow‐up. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Eye Explorer: A robotic endoscope holder for eye surgery

xlomafota13 shared this article with you from Inoreader Eye Explorer: A robotic endoscope holder for eye surgery Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Holding endoscopes by hand when performing eye surgery reduces the dexterity of the surgeon. Methods A robotic endoscope holder called "Eye Explorer" is proposed to hold the endoscope and free the surgeon's hand. Results This device satisfies the engineering and clinical requirements of eye surgery. The force for manual operation is less than 0.5 N. The observable ranges inside the patient's eye considering horizontal and vertical perspectives are 118° and 97°, and the motion of the holder does not interfere with the surgeon's hand and other surgical devices. The self‐weight compensation can prevent the endoscope from falling when extra supporting force is released. When comparing the external force exerted on the eye by the Eye Explorer with that in case of manual operation, a decrease of more than 15% can be observed. Moreover, the consumption time of endoscope view adjustment using the Eye Explorer and manual operation does not significantly differ. Conclusion The Eye Explorer allows dual‐hand operation, facilitating a successful endoscopic eye surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

First in‐human experience with a novel robotic platform and Magnetic Surgery System

xlomafota13 shared this article with you from Inoreader First in‐human experience with a novel robotic platform and Magnetic Surgery System Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Magnetic technologies have been introduced to reduce invasiveness of surgical procedures. This study was aimed to analyse the performance of a novel combined magnetic‐robotic controller as an enhanced accessory to the Magnetic Surgical System in laparoscopic cholecystectomy (LC). Methods This was a prospective study of 10 consecutive patients undergoing LC with this novel surgical system. Results Ten patients were included, nine were female. The mean age was 30.3 ± 9 years. All patients had chronic cholecystitis. Procedures were completed successfully. The median operative time was 50 ± 11 min. The system performed effectively in all cases with no need of additional interventions. There were no device‐related complications or side effects. All patients were discharged the same day. Recovery was uneventful during follow‐up. Conclusions This study demonstrates the first in‐human successful performance of surgeries utilizing a novel combination of magnetic and robotic technologies in one integrated system. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ivor‐Lewis oesophagectomy: A standardized operative technique in 11 steps

xlomafota13 shared this article with you from Inoreader Ivor‐Lewis oesophagectomy: A standardized operative technique in 11 steps Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Synopsis Standardization of robotic oesophagectomy can benefit both patients and surgeons by decreasing complications, shortening the learning curve and improving surgical training. Background Thoraco‐abdominal oesophagectomy with lymphadenectomy is the cornerstone of curative therapy for oesophageal carcinoma. To reduce post‐operative morbidity, minimally invasive technology has become increasingly established. Conventional thoraco‐laparoscopic procedures, however, are limited by their technical feasibility. These limitations can be overcome using robot‐assisted technology. Methods Robotic Ivor‐Lewis oesophageal resection has gradually been implemented in our clinic from 2013. We have performed over 250 robot‐assisted minimally invasive oesophagectomies and more than 2000 robotic procedures overall. This experience allowed us to establish a standardized operative technique. Results We identified 11 operative steps as key elements for oesophageal resection, which should help implementation of this technique and allow surgeons to approach this complex procedure with greater confidence. Conclusion Standardization is fundamental to the establishment of a new surgical technique and is a key element in the learning curve of Ivor‐Lewis oesophageal resection. Standardization can lead to better reproducibility of results, and thus to improved quality. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.