Claudia Collà Ruvolo, Margarita Afonina, Eleonora Balestrazzi, Marco Paciotti, Adele Piro, Federico Piramide, Carlo Andrea Bravi, Maria Peraire Lores, Gabriele Sorce, Mario Belmonte, Silvia Rebuffo, Marco Ticonosco, Nicola Frego, Giorgia Gaia, Ruben De Groote, Alexandre Mottrie, Geert De Naeyer
Background
We aimed to compare the outcomes of Robot-assisted sacrocolpopexy (RASC) performed using the novel HUGOTM Robot-Assisted Surgery (RAS) System with the Da Vinci® Xi surgical system.
Methods
Data from 38 women undergoing RASC for a ≥ 2-grade pelvic organ prolapse were collected (2021–2023).
Results
Overall, 23 (60.5%) and 15 (39.5%) procedures were performed using the DaVinci® Xi and the HUGOTM RAS system, respectively. The median total operative time was 123 (IQR:106.5–140.5) minutes for the DaVinci® Xi versus 120 (IQR:120–146) minutes for the HUGOTM RAS cases (p = 0.5). No conversion to open/laparoscopic surgery, perioperative complications, or system failures occurred. No differences were recorded according to day of catheter removal and length of stay.
Conclusions
This study represents the first worldwide comparison of RASC executed using the HUGOTM RAS versus the Da Vinci® Xi System. Our data suggest that RASC might be performed with both robotic platforms with similar perioperative outcomes.
{"title":"A comparative analysis of the HUGOTM robot-assisted surgery system and the Da Vinci® Xi surgical system for robot-assisted sacrocolpopexy for pelvic organ prolapse treatment","authors":"Claudia Collà Ruvolo, Margarita Afonina, Eleonora Balestrazzi, Marco Paciotti, Adele Piro, Federico Piramide, Carlo Andrea Bravi, Maria Peraire Lores, Gabriele Sorce, Mario Belmonte, Silvia Rebuffo, Marco Ticonosco, Nicola Frego, Giorgia Gaia, Ruben De Groote, Alexandre Mottrie, Geert De Naeyer","doi":"10.1002/rcs.2587","DOIUrl":"10.1002/rcs.2587","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to compare the outcomes of Robot-assisted sacrocolpopexy (RASC) performed using the novel HUGO<sup>TM</sup> Robot-Assisted Surgery (RAS) System with the Da Vinci<sup>®</sup> Xi surgical system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 38 women undergoing RASC for <i>a</i> ≥ 2-grade pelvic organ prolapse were collected (2021–2023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 23 (60.5%) and 15 (39.5%) procedures were performed using the DaVinci<sup>®</sup> Xi and the HUGO<sup>TM</sup> RAS system, respectively. The median total operative time was 123 (IQR:106.5–140.5) minutes for the DaVinci<sup>®</sup> Xi versus 120 (IQR:120–146) minutes for the HUGO<sup>TM</sup> RAS cases (<i>p</i> = 0.5). No conversion to open/laparoscopic surgery, perioperative complications, or system failures occurred. No differences were recorded according to day of catheter removal and length of stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study represents the first worldwide comparison of RASC executed using the HUGO<sup>TM</sup> RAS versus the Da Vinci<sup>®</sup> Xi System. Our data suggest that RASC might be performed with both robotic platforms with similar perioperative outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"20 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685949","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 aim of this study was to evaluate the usefulness of Automated Performance Metrics (APMs) in assessing the learning curve.
Methods
A retrospective review of 85 consecutive patients who underwent total robotic colorectal surgery at a single institution between August 2020 and October 2022 was performed. Patient demographics, operation type, and APMs were collected and analysed. Cumulative summation technique (CUSUM) was used to construct learning curves of surgeon console time (SCT), use of the fourth arm, clutch activation, instrument off screen (number and duration), and cut electrocautery activation.
Results
Two phases with 50 and 35 cases were identified from the CUSUM graph for SCT. The SCT was significantly different between the two phases (176 and 251 min, p < 0.002). After adjustment for SCT, the APMs were not significantly different between the two phases.
Conclusions
Most APMs do not offer additional learning curve information when compared with SCT analysis alone.
{"title":"Automated performance metrics, learning curve and robotic colorectal surgery","authors":"Shing Wai Wong, Philip Crowe","doi":"10.1002/rcs.2588","DOIUrl":"10.1002/rcs.2588","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this study was to evaluate the usefulness of Automated Performance Metrics (APMs) in assessing the learning curve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of 85 consecutive patients who underwent total robotic colorectal surgery at a single institution between August 2020 and October 2022 was performed. Patient demographics, operation type, and APMs were collected and analysed. Cumulative summation technique (CUSUM) was used to construct learning curves of surgeon console time (SCT), use of the fourth arm, clutch activation, instrument off screen (number and duration), and cut electrocautery activation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two phases with 50 and 35 cases were identified from the CUSUM graph for SCT. The SCT was significantly different between the two phases (176 and 251 min, <i>p</i> < 0.002). After adjustment for SCT, the APMs were not significantly different between the two phases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most APMs do not offer additional learning curve information when compared with SCT analysis alone.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"20 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2588","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685950","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}
Xingyuan Xiao, Yuancheng Zhou, Shuaishuai Chai, Gong Cheng, Bing Li
Background
To describe the surgical technique of robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation to repair unilateral multifocal ureteral strictures in one stage and report 9-month follow-up outcomes.
Method
A longitudinal ventral incision of proximal ureter strictures No. 1 and 2 was performed, and the appendix was detubularised along its antimesenteric border. Then, the appendiceal onlay flap was anastomosed with the spatulated ureter in an onlay fashion. To manage the distal ureteral stricture No. 3, ureteral reimplantation was performed in a tension-free manner.
Results
Voiding cystourethrography and antegrade urography showed urine regurgitation into the ureter without dilation and no obstruction of the reconstructed ureteral segment 7 weeks after surgery. No postoperative complications occurred during the 9-month follow-up.
Conclusions
Robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation appears to be a safe and effective surgical method for repairing the unilateral multifocal ureteral strictures.
{"title":"Robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation for multifocal ureteral strictures: Case report and technical description","authors":"Xingyuan Xiao, Yuancheng Zhou, Shuaishuai Chai, Gong Cheng, Bing Li","doi":"10.1002/rcs.2589","DOIUrl":"10.1002/rcs.2589","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To describe the surgical technique of robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation to repair unilateral multifocal ureteral strictures in one stage and report 9-month follow-up outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A longitudinal ventral incision of proximal ureter strictures No. 1 and 2 was performed, and the appendix was detubularised along its antimesenteric border. Then, the appendiceal onlay flap was anastomosed with the spatulated ureter in an onlay fashion. To manage the distal ureteral stricture No. 3, ureteral reimplantation was performed in a tension-free manner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Voiding cystourethrography and antegrade urography showed urine regurgitation into the ureter without dilation and no obstruction of the reconstructed ureteral segment 7 weeks after surgery. No postoperative complications occurred during the 9-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation appears to be a safe and effective surgical method for repairing the unilateral multifocal ureteral strictures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"20 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241915","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}
Anouk Verhellen, Shirley A. Elprama, Thierry Scheerlinck, Fiene Van Aerschot, Johnny Duerinck, Frederick Van Gestel, Taylor Frantz, Bart Jansen, Jef Vandemeulebroucke, An Jacobs
Background
This study used the Unified Theory of Acceptance and Use of Technology (UTAUT) to investigate the acceptance of HMD-based AR surgical navigation.
Methods
An experiment was conducted in which participants drilled 12 predefined holes using freehand drilling, proprioceptive control, and AR assistance. Technology acceptance was assessed through a survey and non-participant observations.
Results
Participants' intention to use AR correlated (p < 0.05) with social influence (Spearman's rho (rs) = 0.599), perceived performance improvement (rs = 0.592) and attitude towards AR (rs = 0.542).
Conclusions
While most participants acknowledged the potential of AR, they also highlighted persistent barriers to adoption, such as issues related to user-friendliness, time efficiency and device discomfort. To overcome these challenges, future AR surgical navigation systems should focus on enhancing surgical performance while minimising disruptions to workflows and operating times. Engaging orthopaedic surgeons in the development process can facilitate the creation of tailored solutions and accelerate adoption.
{"title":"Exploring technology acceptance of head-mounted device-based augmented reality surgical navigation in orthopaedic surgery","authors":"Anouk Verhellen, Shirley A. Elprama, Thierry Scheerlinck, Fiene Van Aerschot, Johnny Duerinck, Frederick Van Gestel, Taylor Frantz, Bart Jansen, Jef Vandemeulebroucke, An Jacobs","doi":"10.1002/rcs.2585","DOIUrl":"10.1002/rcs.2585","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study used the Unified Theory of Acceptance and Use of Technology (UTAUT) to investigate the acceptance of HMD-based AR surgical navigation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An experiment was conducted in which participants drilled 12 predefined holes using freehand drilling, proprioceptive control, and AR assistance. Technology acceptance was assessed through a survey and non-participant observations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants' intention to use AR correlated (<i>p</i> < 0.05) with social influence (Spearman's rho (rs) = 0.599), perceived performance improvement (rs = 0.592) and attitude towards AR (rs = 0.542).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While most participants acknowledged the potential of AR, they also highlighted persistent barriers to adoption, such as issues related to user-friendliness, time efficiency and device discomfort. To overcome these challenges, future AR surgical navigation systems should focus on enhancing surgical performance while minimising disruptions to workflows and operating times. Engaging orthopaedic surgeons in the development process can facilitate the creation of tailored solutions and accelerate adoption.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"20 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223089","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}
Pietro Anoldo, Michele Manigrasso, Anna D’Amore, Mario Musella, Giovanni Domenico De Palma, Marco Milone
Background
This study aimed to assess clinical results in terms of intraoperative outcomes, recovery and recurrence of our robotic technique for the treatment of patients affected by simultaneous inguinal and umbilical hernia, providing technical details to facilitate multiquadrant surgery in robotic hernia repair.
Methods
Data from patients affected by simultaneous primary inguinal and umbilical hernia who underwent robotic repair with our dual docking technique was retrospectively analysed.
Results
Fifteen patients were included. No intraoperative complications occurred. All patients achieved complete mobilisation within 7 h. The mean length of hospital stay was 21.6 h, with five patients discharged on the same day of surgery. There was no major complication and no recurrence within the median follow-up period of 673 days.
Conclusions
This surgical technique shows optimal postoperative outcomes, such as early mobilisation and short length of stay. Our study provides an aid to surgeons performing multiquadrant robotic surgery for the treatment of abdominal hernias.
{"title":"Dual docking technique for robotic repair of simultaneous inguinal and umbilical hernia: A preliminary single center experience","authors":"Pietro Anoldo, Michele Manigrasso, Anna D’Amore, Mario Musella, Giovanni Domenico De Palma, Marco Milone","doi":"10.1002/rcs.2586","DOIUrl":"10.1002/rcs.2586","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to assess clinical results in terms of intraoperative outcomes, recovery and recurrence of our robotic technique for the treatment of patients affected by simultaneous inguinal and umbilical hernia, providing technical details to facilitate multiquadrant surgery in robotic hernia repair.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from patients affected by simultaneous primary inguinal and umbilical hernia who underwent robotic repair with our dual docking technique was retrospectively analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen patients were included. No intraoperative complications occurred. All patients achieved complete mobilisation within 7 h. The mean length of hospital stay was 21.6 h, with five patients discharged on the same day of surgery. There was no major complication and no recurrence within the median follow-up period of 673 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This surgical technique shows optimal postoperative outcomes, such as early mobilisation and short length of stay. Our study provides an aid to surgeons performing multiquadrant robotic surgery for the treatment of abdominal hernias.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"20 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2586","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41223088","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}
Robotic-assisted radical cystectomy (RARC) with neobladder reconstruction has gained popularity in recent years.
Methods
We conducted a retrospective study of 17 consecutive patients who underwent RARC with totally intracorporeal J-pouch neobladder reconstruction without ureteral stent by a single experienced surgeon to evaluate perioperative, oncological and functional outcomes.
Results
The median follow-up duration was 32.8 months (range: 17.4–59.0 months), and the 2-year disease-free survival rate was 88.2%. Five out of 12 patients were totally continent, and none required more than one pad per day. The overall complication rate was 41.2%, and hydronephrosis was the most common adverse event. The renal function remained stable, and no long-term renal function impairment was detected.
Conclusion
Our study suggests that RARC with totally intracorporeal J-pouch neobladder reconstruction without ureteral stent is a safe and feasible option for the treatment of muscle-invasive bladder cancer, with good oncological and functional outcomes.
{"title":"Oncological and functional outcome of robotic-assisted radical cystectomy with total intracorporeal stentless J-pouch neobladder reconstruction","authors":"Hao Xiang Chen, Chi-Ping Huang","doi":"10.1002/rcs.2583","DOIUrl":"10.1002/rcs.2583","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic-assisted radical cystectomy (RARC) with neobladder reconstruction has gained popularity in recent years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective study of 17 consecutive patients who underwent RARC with totally intracorporeal J-pouch neobladder reconstruction without ureteral stent by a single experienced surgeon to evaluate perioperative, oncological and functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median follow-up duration was 32.8 months (range: 17.4–59.0 months), and the 2-year disease-free survival rate was 88.2%. Five out of 12 patients were totally continent, and none required more than one pad per day. The overall complication rate was 41.2%, and hydronephrosis was the most common adverse event. The renal function remained stable, and no long-term renal function impairment was detected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study suggests that RARC with totally intracorporeal J-pouch neobladder reconstruction without ureteral stent is a safe and feasible option for the treatment of muscle-invasive bladder cancer, with good oncological and functional outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"20 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41175433","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}
Xiaoqiang Shi, Hainan Guo, Chao Zhu, Guanglin Qiu, Ting Liang, Jie Lian, Yanfei Ma, Shufeng Wang, Xuqi Li
Objective
To evaluate the feasibility and application value of mixed reality technology (MR) in Primary retroperitoneal tumour (PRT) surgery.
Methods
From 276 patients who underwent PRT resection at the First Affiliated Hospital of Xi'an Jiaotong University, we screened 46 patients who underwent MR-assisted retroperitoneal tumour resection and 46 patients who underwent tumour resection without MR assistance. The intraoperative and postoperative recovery of the patients in both groups were compared, and the reliability and validity of the application of MR were further examined using the Likert scale.
Results
There was a significant difference in the mean intraoperative bleeding volume between the two groups, but it was reduced in the MR group. The results of the Likert scale showed higher scores in the MR group than non-MR group.
Conclusions
MR can be used to assist PRT resection and has great potential to improve the rate of complete retroperitoneal tumour resection.
{"title":"Mixed reality in primary retroperitoneal tumour surgery: Evaluation of preoperative and intraoperative application value","authors":"Xiaoqiang Shi, Hainan Guo, Chao Zhu, Guanglin Qiu, Ting Liang, Jie Lian, Yanfei Ma, Shufeng Wang, Xuqi Li","doi":"10.1002/rcs.2584","DOIUrl":"10.1002/rcs.2584","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the feasibility and application value of mixed reality technology (MR) in Primary retroperitoneal tumour (PRT) surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From 276 patients who underwent PRT resection at the First Affiliated Hospital of Xi'an Jiaotong University, we screened 46 patients who underwent MR-assisted retroperitoneal tumour resection and 46 patients who underwent tumour resection without MR assistance. The intraoperative and postoperative recovery of the patients in both groups were compared, and the reliability and validity of the application of MR were further examined using the Likert scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a significant difference in the mean intraoperative bleeding volume between the two groups, but it was reduced in the MR group. The results of the Likert scale showed higher scores in the MR group than non-MR group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MR can be used to assist PRT resection and has great potential to improve the rate of complete retroperitoneal tumour resection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"20 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41170755","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}
Davor Stamenovic, P. Schiller, I. Karampinis, C. Galata, E. D. Roessner
Background
Uniportal robotic-assisted thoracic surgery (uRATS) has emerged as a promising technique with potential advantages over multiportal approaches. This study aims to evaluate our initial outcomes of uRATS.
Material and Methods
Five patients underwent anatomic lung resections with systematic nodal dissection through a uniportal robotic approach by one surgeon. The results were compared to the results of the first five uniportal video-assisted thoracic surgery (uVATS) anatomical resections performed by the same surgeon.
Results
No adverse events occurred during the uRATS-procedures. Comparable surgical outcomes were observed between uRATS and uVATS, including hospital stays, complication rates, and blood loss. The average procedural time was slightly but non-significantly longer in the uRATS-group. Average pain-scores were lower in the uRATS group. One patient in each group experienced major postoperative complications, with one case of in-hospital mortality in the uRATS-group.
Conclusion
The outcomes of uRATS/uVATS were comparable, highlighting the potential and the feasibility of this technique. Prospective studies comparing the learning curves, complication rate and hospital-stay are required in order to justify the superiority of robotics over uVATS.
{"title":"Uniportal robotic assisted surgery for anatomical lung resection—First German experience","authors":"Davor Stamenovic, P. Schiller, I. Karampinis, C. Galata, E. D. Roessner","doi":"10.1002/rcs.2580","DOIUrl":"10.1002/rcs.2580","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Uniportal robotic-assisted thoracic surgery (uRATS) has emerged as a promising technique with potential advantages over multiportal approaches. This study aims to evaluate our initial outcomes of uRATS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>Five patients underwent anatomic lung resections with systematic nodal dissection through a uniportal robotic approach by one surgeon. The results were compared to the results of the first five uniportal video-assisted thoracic surgery (uVATS) anatomical resections performed by the same surgeon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No adverse events occurred during the uRATS-procedures. Comparable surgical outcomes were observed between uRATS and uVATS, including hospital stays, complication rates, and blood loss. The average procedural time was slightly but non-significantly longer in the uRATS-group. Average pain-scores were lower in the uRATS group. One patient in each group experienced major postoperative complications, with one case of in-hospital mortality in the uRATS-group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The outcomes of uRATS/uVATS were comparable, highlighting the potential and the feasibility of this technique. Prospective studies comparing the learning curves, complication rate and hospital-stay are required in order to justify the superiority of robotics over uVATS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"20 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2580","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41107874","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}
Christian B. Ong, Graham B. J. Buchan, Alexander J. Acuña, Christian J. Hecht, Yasuhiro Homma, Roshan P. Shah, Atul F. Kamath
Background
The purpose of this study was to assess the cost-effectiveness of a novel, fluoroscopy-based robotic-assisted total hip arthroplasty (RA-THA) system compared to a manual unassisted technique (mTHA) up to 5 years post-operatively.
Methods
A Markov model was constructed to compare the cost-effectiveness of RA-THA and mTHA. Cost-effectiveness was defined as an Incremental Cost-Effectiveness Ratio (ICER) <$50 000 or $100 000 per Quality Adjusted Life Year (QALY).
Results
RA-THA patients experienced lower costs compared to mTHA patients at 1 year ($20 865.12 ± 9897.52 vs. $21 660.86 ± 9909.15; p < 0.001) and 5 years ($23 124.57 ± 10 045.48 vs. $25 756.42 ± 10 091.84; p < 0.001) post-operatively. RA-THA patients also accrued more QALYs (1-year: 0.901 ± 0.117 vs. 0.888 ± 0.114; p < 0.001; 5-years: 4.455 ± 0.563 vs. 4.384 ± 0.537 p < 0.001). Overall, RA-THA was cost-effective (1-year ICER: $−61 210.77; 5-year ICER: $−37 068.31).
Conclusions
The novel, fluoroscopy-based RA-THA system demonstrated cost-effectiveness when compared to manual unassisted THA.
{"title":"Cost-effectiveness of a novel, fluoroscopy-based robotic-assisted total hip arthroplasty system: A Markov analysis","authors":"Christian B. Ong, Graham B. J. Buchan, Alexander J. Acuña, Christian J. Hecht, Yasuhiro Homma, Roshan P. Shah, Atul F. Kamath","doi":"10.1002/rcs.2582","DOIUrl":"10.1002/rcs.2582","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The purpose of this study was to assess the cost-effectiveness of a novel, fluoroscopy-based robotic-assisted total hip arthroplasty (RA-THA) system compared to a manual unassisted technique (mTHA) up to 5 years post-operatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Markov model was constructed to compare the cost-effectiveness of RA-THA and mTHA. Cost-effectiveness was defined as an Incremental Cost-Effectiveness Ratio (ICER) <$50 000 or $100 000 per Quality Adjusted Life Year (QALY).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RA-THA patients experienced lower costs compared to mTHA patients at 1 year ($20 865.12 ± 9897.52 vs. $21 660.86 ± 9909.15; <i>p</i> < 0.001) and 5 years ($23 124.57 ± 10 045.48 vs. $25 756.42 ± 10 091.84; <i>p</i> < 0.001) post-operatively. RA-THA patients also accrued more QALYs (1-year: 0.901 ± 0.117 vs. 0.888 ± 0.114; <i>p</i> < 0.001; 5-years: 4.455 ± 0.563 vs. 4.384 ± 0.537 <i>p</i> < 0.001). Overall, RA-THA was cost-effective (1-year ICER: $−61 210.77; 5-year ICER: $−37 068.31).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The novel, fluoroscopy-based RA-THA system demonstrated cost-effectiveness when compared to manual unassisted THA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"20 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165096","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}
Meltem Kurt Pehlivanoğlu, Eren Cem Ay, Ayşe Gül Eker, Nur Banu Albayrak, Nevcihan Duru, Ahmet Serdar Mutluer, Tolga Turan Dündar, İhsan Doğan
<div> <section> <h3> Background</h3> <p>Despite using a variety of path-finding algorithms that use tracts, the most significant advancement in this study is considering the values of all brain areas by doing atlas-based segmentation for a more precise search. Our motivation comes from the literature’s shortcomings in designing and implementing path-planning methods. Since planning paths with curvatures is a complex problem that requires considering many surgical and physiological constraints, most path-planning strategies focus on straight paths. There is also a lack of studies that focus on the complete structure of the brain with the tracks, veins, and segmented areas. Instrument dependence is another inadequacy of the methods proposed in the literature.</p> </section> <section> <h3> Aims</h3> <p>The aim of this study is to design a new surgical path planning framework that helps to plan the surgical path independently of the instrument, considers the entire structure of the brain, and allows curvilinear surgical paths. Thus, neurosurgeons can generate patient-specific possible optimal surgical pathways before the neurosurgical procedure.</p> </section> <section> <h3> Materials & Methods</h3> <p>The proposed framework includes different path-finding algorithms (Dijkstra, A*, and their aggressive variants) that find optimal paths by taking the risk scores (surgeons assessed all the segmented regions, considering the extent of damage. In this evaluation, scores ranged from “0 to 10,” with the most critical areas receiving a score of “10,” while the least possible affected areas were assigned a score of "0") for sensitive brain areas into consideration. For the tract image processing the framework includes fractional anisotropy (FA), relative anisotropy (RA), spherical measure (SM), and linear measure (LM) methods.</p> </section> <section> <h3> Results</h3> <p>This is the first paper to handle tracts and atlas-based segmentation of the human brain altogether under a framework for surgical path planning. The framework has a dynamic structure that gives the flexibility to add different path-finding algorithms and generate different widths of surgical pathways. Moreover, surgeons can update the score table to guarantee minimally invasive surgery. The output file format of all the extracted surgical paths is NRRD, so it can be easily visualised, analysed, or processed over the third part software tools.</p> </section> <section> <h3> Discussion</h3>
{"title":"A new surgical path planning framework for neurosurgery","authors":"Meltem Kurt Pehlivanoğlu, Eren Cem Ay, Ayşe Gül Eker, Nur Banu Albayrak, Nevcihan Duru, Ahmet Serdar Mutluer, Tolga Turan Dündar, İhsan Doğan","doi":"10.1002/rcs.2576","DOIUrl":"10.1002/rcs.2576","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite using a variety of path-finding algorithms that use tracts, the most significant advancement in this study is considering the values of all brain areas by doing atlas-based segmentation for a more precise search. Our motivation comes from the literature’s shortcomings in designing and implementing path-planning methods. Since planning paths with curvatures is a complex problem that requires considering many surgical and physiological constraints, most path-planning strategies focus on straight paths. There is also a lack of studies that focus on the complete structure of the brain with the tracks, veins, and segmented areas. Instrument dependence is another inadequacy of the methods proposed in the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this study is to design a new surgical path planning framework that helps to plan the surgical path independently of the instrument, considers the entire structure of the brain, and allows curvilinear surgical paths. Thus, neurosurgeons can generate patient-specific possible optimal surgical pathways before the neurosurgical procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials & Methods</h3>\u0000 \u0000 <p>The proposed framework includes different path-finding algorithms (Dijkstra, A*, and their aggressive variants) that find optimal paths by taking the risk scores (surgeons assessed all the segmented regions, considering the extent of damage. In this evaluation, scores ranged from “0 to 10,” with the most critical areas receiving a score of “10,” while the least possible affected areas were assigned a score of \"0\") for sensitive brain areas into consideration. For the tract image processing the framework includes fractional anisotropy (FA), relative anisotropy (RA), spherical measure (SM), and linear measure (LM) methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This is the first paper to handle tracts and atlas-based segmentation of the human brain altogether under a framework for surgical path planning. The framework has a dynamic structure that gives the flexibility to add different path-finding algorithms and generate different widths of surgical pathways. Moreover, surgeons can update the score table to guarantee minimally invasive surgery. The output file format of all the extracted surgical paths is NRRD, so it can be easily visualised, analysed, or processed over the third part software tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 ","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"20 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2576","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41158912","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号