With the expansion of minimally invasive surgery (MIS) applications in surgery, the remote centre of motion (RCM) manipulator requires a more flexible workspace to meet different operation requirements. Thus, the mechanical structure and motion control of the RCM manipulator play important roles.
Methods
A multi-objective genetic algorithm was exploited to maximise the kinematic performance and obtain a compact structure of the RCM manipulator. An inverse kinematic solution method is proposed to meet task accuracy and kinematic singularity avoidance constraints for safety motion control.
Results
Simulation results demonstrate that there are significant improvements in the reachable workspace inside the abdominal cavity, the flexibility of the workspace, kinematic performance, and compactness of the RCM manipulator. Experiments verify the feasibility of the prototype and the validity of the proposed inverse kinematic solution method.
Conclusions
This enhances the adaptability and safety of the RCM manipulator and provides potential prospects for MIS application.
{"title":"Dimensional optimisation and an inverse kinematic solution method of a safety-enhanced remote centre of motion manipulator","authors":"Fang Huang, Hongqiang Sang, Fen Liu, Rui Han","doi":"10.1002/rcs.2579","DOIUrl":"10.1002/rcs.2579","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With the expansion of minimally invasive surgery (MIS) applications in surgery, the remote centre of motion (RCM) manipulator requires a more flexible workspace to meet different operation requirements. Thus, the mechanical structure and motion control of the RCM manipulator play important roles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multi-objective genetic algorithm was exploited to maximise the kinematic performance and obtain a compact structure of the RCM manipulator. An inverse kinematic solution method is proposed to meet task accuracy and kinematic singularity avoidance constraints for safety motion control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Simulation results demonstrate that there are significant improvements in the reachable workspace inside the abdominal cavity, the flexibility of the workspace, kinematic performance, and compactness of the RCM manipulator. Experiments verify the feasibility of the prototype and the validity of the proposed inverse kinematic solution method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This enhances the adaptability and safety of the RCM manipulator and provides potential prospects for MIS application.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41170754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The EDGE SP1000 is a newly developed single-port (SP) robotic surgical system whose clinical evaluation in gynaecology has not yet been addressed.
Methods
This is a single-arm clinical trial evaluating the perioperative outcomes of patients receiving EDGE SP1000 assisted surgeries. Patients with either benign or malignant gynaecological diseases suitable for robotic surgery were included, and their data were prospectively collected.
Results
Eighteen patients were included and 8 of them had malignant conditions. The total operative time was 190.1 ± 83.3 min for benign diseases and 254.4 ± 59.4 min for malignant diseases. The mean estimated blood loss was 25 mL (range, 5–100). No assistant ports or conversions were required. No perioperative complications occurred. Overall satisfaction with the umbilical wounds was expressed at the 1-month follow-up.
Conclusion
EDGE SP1000 SP robotic surgical system is technically feasible and safe in various gynaecological surgeries with good cosmetic effects.
{"title":"Single-port robotic surgery using the EDGE SP1000 surgical system in gynaecology: Initial experience of a single institution","authors":"Yu Chen, Ying Zheng, Ping Wang, Qiao Wang, Fan Yang, Shengtao Zhou","doi":"10.1002/rcs.2578","DOIUrl":"10.1002/rcs.2578","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The EDGE SP1000 is a newly developed single-port (SP) robotic surgical system whose clinical evaluation in gynaecology has not yet been addressed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a single-arm clinical trial evaluating the perioperative outcomes of patients receiving EDGE SP1000 assisted surgeries. Patients with either benign or malignant gynaecological diseases suitable for robotic surgery were included, and their data were prospectively collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighteen patients were included and 8 of them had malignant conditions. The total operative time was 190.1 ± 83.3 min for benign diseases and 254.4 ± 59.4 min for malignant diseases. The mean estimated blood loss was 25 mL (range, 5–100). No assistant ports or conversions were required. No perioperative complications occurred. Overall satisfaction with the umbilical wounds was expressed at the 1-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EDGE SP1000 SP robotic surgical system is technically feasible and safe in various gynaecological surgeries with good cosmetic effects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41142300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Among the novel robotic platforms, the Hugo RAS system is the second most studied platform, next to the da Vinci system, and we aim to address our experiences in radical prostatectomy (RP) with the Hugo RAS system.
Methods
We recorded our first 12 cases of prostate cancer undergoing RP with the Hugo RAS system. The median console time was 145 min and median hospital stay was 7 days. Hedge’ g was applied to search for the cut-off case in four parameters in surgeries.
Results
Pre-console preparation was significantly improved after the first seven cases, and the console time was remarkably shortened after the first two cases. The intraoperative pause for trouble shooting was remarkably shortened after the first three cases.
Conclusions
We found that RP with the Hugo RAS system was feasible, and the learning curve was short as surgeons may benefit from the previous experience with the da Vinci system.
背景 在新型机器人平台中，Hugo RAS 系统是仅次于达芬奇系统的第二大研究平台。 方法 我们记录了首批 12 例使用 Hugo RAS 系统进行前列腺癌根治术的病例。中位控制台时间为 145 分钟，中位住院时间为 7 天。采用 Hedge'g 方法寻找手术中四个参数的临界病例。 结果 前七例手术后，控制台前准备工作明显改善，前两例手术后，控制台时间明显缩短。前三例手术后，术中停顿以排除故障的时间明显缩短。 结论 我们发现使用 Hugo RAS 系统进行 RP 是可行的，而且学习曲线很短，因为外科医生可以从之前使用达芬奇系统的经验中获益。
{"title":"Robot-assisted radical prostatectomy using hugo RAS system: The pioneer experience in Taiwan and Northeast Asia","authors":"Yen-Chuan Ou, Hsien-Che Ou, Yung-Shun Juan, Ragavan Narasimhan, Alex Mottrie, Wei-Chun Weng, Li-Hua Huang, Yi-Sheng Lin, Chao-Yu Hsu, Che-Hsueh Yang, Min-Che Tung","doi":"10.1002/rcs.2577","DOIUrl":"10.1002/rcs.2577","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Among the novel robotic platforms, the Hugo RAS system is the second most studied platform, next to the da Vinci system, and we aim to address our experiences in radical prostatectomy (RP) with the Hugo RAS system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recorded our first 12 cases of prostate cancer undergoing RP with the Hugo RAS system. The median console time was 145 min and median hospital stay was 7 days. Hedge’ g was applied to search for the cut-off case in four parameters in surgeries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pre-console preparation was significantly improved after the first seven cases, and the console time was remarkably shortened after the first two cases. The intraoperative pause for trouble shooting was remarkably shortened after the first three cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We found that RP with the Hugo RAS system was feasible, and the learning curve was short as surgeons may benefit from the previous experience with the da Vinci system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2577","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ulf Bertram, Istvan Köveshazi, Monika Michaelis, Simon Weidert, Tobias Philip Schmidt, Christian Blume, Felix Swamy v. Zastrow, Christian-Andreas Müller, Szilard Szabo
Objective
This study evaluates the precision of a commercially available spine planning software in automatic spine labelling and screw-trajectory proposal.
Methods
The software uses automatic segmentation and registration of the vertebra to generate screw proposals. 877 trajectories were compared. Four neurosurgeons assessed suggested trajectories, performed corrections, and manually planned pedicle screws. Additionally, automatic identification/labelling was evaluated.
Results
Automatic labelling was correct in 89% of the cases. 92.9% of automatically planned trajectories were in accordance with G&R grade A + B. Automatic mode reduced the time spent planning screw trajectories by 7 s per screw to 20 s per vertebra. Manual mode yielded differences in screw-length between surgeons (largest distribution peak: 5 mm), automatic in contrast at 0 mm. The size of suggested pedicle screws was significantly smaller (largest peaks in difference between 0.5 and 3 mm) than the surgeon's choice.
Conclusion
Automatic identification of vertebrae works in most cases and suggested pedicle screw trajectories are acceptable. So far, it does not substitute for an experienced surgeon's assessment.
{"title":"Man versus machine: Automatic pedicle screw planning using registration-based techniques compared with manual screw planning for thoracolumbar fusion surgeries","authors":"Ulf Bertram, Istvan Köveshazi, Monika Michaelis, Simon Weidert, Tobias Philip Schmidt, Christian Blume, Felix Swamy v. Zastrow, Christian-Andreas Müller, Szilard Szabo","doi":"10.1002/rcs.2570","DOIUrl":"10.1002/rcs.2570","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study evaluates the precision of a commercially available spine planning software in automatic spine labelling and screw-trajectory proposal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The software uses automatic segmentation and registration of the vertebra to generate screw proposals. 877 trajectories were compared. Four neurosurgeons assessed suggested trajectories, performed corrections, and manually planned pedicle screws. Additionally, automatic identification/labelling was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Automatic labelling was correct in 89% of the cases. 92.9% of automatically planned trajectories were in accordance with G&R grade A + B. Automatic mode reduced the time spent planning screw trajectories by 7 s per screw to 20 s per vertebra. Manual mode yielded differences in screw-length between surgeons (largest distribution peak: 5 mm), automatic in contrast at 0 mm. The size of suggested pedicle screws was significantly smaller (largest peaks in difference between 0.5 and 3 mm) than the surgeon's choice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Automatic identification of vertebrae works in most cases and suggested pedicle screw trajectories are acceptable. So far, it does not substitute for an experienced surgeon's assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2570","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10553267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dennis King-Hang Yee, Jonathan Patrick Ng, Cyrus Tsun-Kit Lau, Kevin Ki-Wai Ho, Gene Chi-Wai Man, Vikki Wing-Shan Chu, Tsz Lung Choi, Gloria Yan Ting Lam, Michael Tim-Yun Ong, Patrick Shu-Hang Yung
Background
This study investigated the accuracy in achieving proper lower limb alignment and component positions after total knee replacement (TKR) with image-free and image-based robotic-assisted TKR.
Methods
A total of 129 patients (166 knees) suffering from end-stage knee arthritis who underwent TKA operated by robotic-assisted surgery between the years 2018 and mid-2021 were recruited. Radiological outcomes were compared between image-free and image-based robotic-assisted surgical systems.
Results
There were significant differences between the two robotic systems when comparing the mean planned component alignment and the mean measured alignment on radiographs, in which the image-free robotic-assisted system was more varus, whereas the image-based robotic-assisted system was more valgus for both the mean femoral and tibial component coronal alignment (p < 0.001). For tibial component sagittal alignment, the image-based group had a larger deviation from the planned posterior slope (p < 0.001).
Conclusion
Image-free and image-based robotic assisted TKR had differing accuracy in femoral and tibial alignment.
{"title":"Surgical accuracy of image-free versus image-based robotic-assisted total knee arthroplasty","authors":"Dennis King-Hang Yee, Jonathan Patrick Ng, Cyrus Tsun-Kit Lau, Kevin Ki-Wai Ho, Gene Chi-Wai Man, Vikki Wing-Shan Chu, Tsz Lung Choi, Gloria Yan Ting Lam, Michael Tim-Yun Ong, Patrick Shu-Hang Yung","doi":"10.1002/rcs.2574","DOIUrl":"10.1002/rcs.2574","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study investigated the accuracy in achieving proper lower limb alignment and component positions after total knee replacement (TKR) with image-free and image-based robotic-assisted TKR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 129 patients (166 knees) suffering from end-stage knee arthritis who underwent TKA operated by robotic-assisted surgery between the years 2018 and mid-2021 were recruited. Radiological outcomes were compared between image-free and image-based robotic-assisted surgical systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were significant differences between the two robotic systems when comparing the mean planned component alignment and the mean measured alignment on radiographs, in which the image-free robotic-assisted system was more varus, whereas the image-based robotic-assisted system was more valgus for both the mean femoral and tibial component coronal alignment (<i>p</i> < 0.001). For tibial component sagittal alignment, the image-based group had a larger deviation from the planned posterior slope (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Image-free and image-based robotic assisted TKR had differing accuracy in femoral and tibial alignment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2574","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10160271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Barbara Flora, Alba Scerrati, Federica Trovalusci, Silvia Vesco
Background
Autologous bones are traditionally used in surgical reconstruction of skullcap. Since patients’ bones are often unavailable or cause of infections, implantable synthetic materials emerged as promising alternative. These can be shaped by different technologies, while 3D printing offers remarkable chances in terms of flexibility, accuracy, cost-saving and customizability.
Methods
This study aims to evaluate strengths and limitations of the three main strategies that imply additive manufacturing for the implementation of cranial prosthesis: (i) direct printing of PLA (polylactic acid) skullcaps, mould casting of poly(methyl methacrylate) (PMMA) prosthesis using (ii) silicone mould manufactured from a 3D printed master, (iii) 3Dprinted TPU (thermoplastic polyurethane) mould.
Results
All solutions achieved good geometric accuracy and excellent mechanical resistance. Direct printing of the PLA resulted in the fastest strategy, followed by PMMA casting in a silicone mould.
Conclusions
The use of silicone was overall more advantageous, due to lower costs and the possibility of sterilization by using autoclaving.
{"title":"Patient-specific cranioplasty, by direct and indirect additive manufacturing of biopolymers and implantable materials","authors":"Barbara Flora, Alba Scerrati, Federica Trovalusci, Silvia Vesco","doi":"10.1002/rcs.2568","DOIUrl":"10.1002/rcs.2568","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autologous bones are traditionally used in surgical reconstruction of skullcap. Since patients’ bones are often unavailable or cause of infections, implantable synthetic materials emerged as promising alternative. These can be shaped by different technologies, while 3D printing offers remarkable chances in terms of flexibility, accuracy, cost-saving and customizability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study aims to evaluate strengths and limitations of the three main strategies that imply additive manufacturing for the implementation of cranial prosthesis: (i) direct printing of PLA (polylactic acid) skullcaps, mould casting of poly(methyl methacrylate) (PMMA) prosthesis using (ii) silicone mould manufactured from a 3D printed master, (iii) 3Dprinted TPU (thermoplastic polyurethane) mould.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All solutions achieved good geometric accuracy and excellent mechanical resistance. Direct printing of the PLA resulted in the fastest strategy, followed by PMMA casting in a silicone mould.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of silicone was overall more advantageous, due to lower costs and the possibility of sterilization by using autoclaving.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10534799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monserrat Ríos-Hernández, Juan Manuel Jacinto-Villegas, Nabil Zemiti, Adriana Herlinda Vilchis-González, Miguel Angel Padilla-Castañeda, Blaise Debien
Background
Lumbar puncture is an essential medical procedure whose objective is to obtain cerebrospinal fluid. Lumbar puncture is considered a complex procedure, mainly for novice residents who suffer from stress and low confidence, which may result in harm to the patient.
Methods
The LPVirSim, has been developed in four stages: i) requirements analysis through user-centred design; ii) prototyping of the virtual environment and the haptic component; iii) preliminary tests with Ph.D. students and physicians using two haptic devices (Omega.7 and Sigma.7); iv) a user study where physicians evaluated the usability and user experience.
Results
The LPVirSim integrates non-technical skills and the possibility of representing different patients for training. Usability increased from 61.76 to 68.75 in the preliminary tests to 71.43 in the user study.
Conclusions
All the results showed good usability and demonstrated that the simulator arouses interest and realistically represents a Lumbar puncture, through the force and visual feedback.
{"title":"Development of a lumbar puncture virtual simulator for medical students training: A preliminary evaluation","authors":"Monserrat Ríos-Hernández, Juan Manuel Jacinto-Villegas, Nabil Zemiti, Adriana Herlinda Vilchis-González, Miguel Angel Padilla-Castañeda, Blaise Debien","doi":"10.1002/rcs.2572","DOIUrl":"10.1002/rcs.2572","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lumbar puncture is an essential medical procedure whose objective is to obtain cerebrospinal fluid. Lumbar puncture is considered a complex procedure, mainly for novice residents who suffer from stress and low confidence, which may result in harm to the patient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The LPVirSim, has been developed in four stages: i) requirements analysis through user-centred design; ii) prototyping of the virtual environment and the haptic component; iii) preliminary tests with Ph.D. students and physicians using two haptic devices (Omega.7 and Sigma.7); iv) a user study where physicians evaluated the usability and user experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The LPVirSim integrates non-technical skills and the possibility of representing different patients for training. Usability increased from 61.76 to 68.75 in the preliminary tests to 71.43 in the user study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>All the results showed good usability and demonstrated that the simulator arouses interest and realistically represents a Lumbar puncture, through the force and visual feedback.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10516240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robot-assisted surgery can effectively reduce the difficulty and improve the success rate of the surgeries. However, currently available flexible instruments have several limitations, such as large size, few degrees of freedom, and lack of contact force perception.
Methods
This study proposes a master-slave flexible instrument capable of force feedback. The instrument has a maximum outer diameter of 3 mm and an overall length of 1200 mm. With the internal working channel unoccupied, a three-dimensional force sensing unit is designed based on the neural network. The corresponding master-slave control method with proportional force feedback was also designed to effectively control the instrument.
Results
To verify the effectiveness of the system, in vitro and in vivo experiments were conducted. The corresponding tasks were successfully completed.
Conclusions
The animal trial conducted in the digestive tract of a live swine proved that the system has the potential for clinical use.
{"title":"Flexible instrument with contact-aided structure and force feedback for endoscopic surgery","authors":"Chi Zhang, Zhongyuan Ping, Siyang Zuo","doi":"10.1002/rcs.2573","DOIUrl":"10.1002/rcs.2573","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robot-assisted surgery can effectively reduce the difficulty and improve the success rate of the surgeries. However, currently available flexible instruments have several limitations, such as large size, few degrees of freedom, and lack of contact force perception.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study proposes a master-slave flexible instrument capable of force feedback. The instrument has a maximum outer diameter of 3 mm and an overall length of 1200 mm. With the internal working channel unoccupied, a three-dimensional force sensing unit is designed based on the neural network. The corresponding master-slave control method with proportional force feedback was also designed to effectively control the instrument.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>To verify the effectiveness of the system, in vitro and <i>in vivo</i> experiments were conducted. The corresponding tasks were successfully completed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The animal trial conducted in the digestive tract of a live swine proved that the system has the potential for clinical use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10155302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luca Morelli, Gregorio Di Franco, Niccolò Furbetta, Matteo Palmeri, Simone Guadagni, Desirée Gianardi, Cristina Carpenito, Annalisa Comandatore, Elisa Giovannetti, Giulio Di Candio, Alfred Cuschieri
Introduction
Delayed gastric emptying (DGE) is a frequent complication after pancreatoduodenectomy, especially after pylorus preservation (Pp). We evaluated the effect of a fully robotic approach with da Vinci Xi on DGE after PpPD.
Methods
Open and robotic PDs were performed in 353 and 50 cases, respectively, from January 2009 to March 2022. We compared the clinical outcomes and incidence of clinically relevant DGE between robotic PpPD (R-PpPD) and open PpPD after one-to-one case-control matching.
Results
Each group consisted of 30 patients. Clinically relevant DGE was less common after R-PpPD (3/30 [10%] vs. 10/30 cases [33.3%], p = 0.028). The median length of hospital stay (LoS) was significantly lower in the R-PpPD group (10 vs. 15 days, p = 0.013).
Conclusion
The reduced tissue trauma by the minimally invasive robotic approach is associated with a lower incidence of DGE, reducing the LoS and encouraging PpPD performed using the fully robotic approach.
{"title":"Delayed gastric emptying after pylorus-preserving pancreatoduodenectomy: Comparison between traditional open surgery and full-robotic approach with da Vinci Xi","authors":"Luca Morelli, Gregorio Di Franco, Niccolò Furbetta, Matteo Palmeri, Simone Guadagni, Desirée Gianardi, Cristina Carpenito, Annalisa Comandatore, Elisa Giovannetti, Giulio Di Candio, Alfred Cuschieri","doi":"10.1002/rcs.2571","DOIUrl":"10.1002/rcs.2571","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Delayed gastric emptying (DGE) is a frequent complication after pancreatoduodenectomy, especially after pylorus preservation (Pp). We evaluated the effect of a fully robotic approach with da Vinci Xi on DGE after PpPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Open and robotic PDs were performed in 353 and 50 cases, respectively, from January 2009 to March 2022. We compared the clinical outcomes and incidence of clinically relevant DGE between robotic PpPD (R-PpPD) and open PpPD after one-to-one case-control matching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Each group consisted of 30 patients. Clinically relevant DGE was less common after R-PpPD (3/30 [10%] vs. 10/30 cases [33.3%], <i>p</i> = 0.028). The median length of hospital stay (LoS) was significantly lower in the R-PpPD group (10 vs. 15 days, <i>p</i> = 0.013).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The reduced tissue trauma by the minimally invasive robotic approach is associated with a lower incidence of DGE, reducing the LoS and encouraging PpPD performed using the fully robotic approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10120303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Piermarco Papini, Andrea De Palma, Michael Ginesini, Leonardo Rossi, Lorenzo Fregoli, Rossella Elisei, Antonio Matrone, Riccardo Morganti, Carlo Enrico Ambrosini, Gabriele Materazzi
Background
The use of robot-assisted transaxillary thyroidectomy (RATT) has rapidly spread in the last 2 decades, although it is mostly limited to Asian countries.
Method
We retrospectively enroled all patients with histologic diagnoses of thyroid cancer who underwent RATT at the University Hospital of Pisa from May 2012 to September 2020.
Results
The study included 242 patients; 128 (47%) underwent total thyroidectomy and 114 (53%) underwent thyroid lobectomy, among which 28 patients (24.6%) required completion thyroidectomy. Radioactive iodine ablation therapy was required in 90 patients (37%). The complication rate was 5.3%. After a median follow-up of 38 months, an excellent response to therapy was achieved in 107 patients (74%), whereas the response was indeterminate in 12 (8%) and incomplete in 16 (11%). No local or distant relapses or increases in thyroglobulin or antibody levels were documented.
Conclusions
In experienced hands, RATT represents a valid option for the treatment of thyroid cancer in selected cases.
{"title":"Robot-assisted transaxillary surgery for thyroid cancer: Oncologic and surgical outcomes in long term follow-up","authors":"Piermarco Papini, Andrea De Palma, Michael Ginesini, Leonardo Rossi, Lorenzo Fregoli, Rossella Elisei, Antonio Matrone, Riccardo Morganti, Carlo Enrico Ambrosini, Gabriele Materazzi","doi":"10.1002/rcs.2563","DOIUrl":"10.1002/rcs.2563","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The use of robot-assisted transaxillary thyroidectomy (RATT) has rapidly spread in the last 2 decades, although it is mostly limited to Asian countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We retrospectively enroled all patients with histologic diagnoses of thyroid cancer who underwent RATT at the University Hospital of Pisa from May 2012 to September 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 242 patients; 128 (47%) underwent total thyroidectomy and 114 (53%) underwent thyroid lobectomy, among which 28 patients (24.6%) required completion thyroidectomy. Radioactive iodine ablation therapy was required in 90 patients (37%). The complication rate was 5.3%. After a median follow-up of 38 months, an excellent response to therapy was achieved in 107 patients (74%), whereas the response was indeterminate in 12 (8%) and incomplete in 16 (11%). No local or distant relapses or increases in thyroglobulin or antibody levels were documented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In experienced hands, RATT represents a valid option for the treatment of thyroid cancer in selected cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2563","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10548131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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