Robotic assisted surgery (RAS) has seen significant advancement in many surgical specialties, although the application of robotics in plastic and reconstructive surgery remains to be widely established. This systematic review aims to assess the role of RAS in plastic and reconstructive surgery.
Methods
The review protocol was published and registered a priori as CRD42024507420. A comprehensive electronic search for relevant studies was performed in MEDLINE, Embase and Google scholar databases.
Results
Overall, 132 studies were initially identified, of which, 44 studies satisfied the eligibility criteria with a cumulative total of 239 patients. RAS demonstrated a high degree of procedural success and anastomotic patency in microvascular procedures. There was no significant difference in periprocedural adverse events between robotic and manual procedures.
Conclusion
RAS can be feasibly implemented in plastic and reconstructive surgery with a good efficacy and safety profile, particularly for microsurgical anastomosis and trans-oral surgery.
{"title":"The application of robotics in plastic and reconstructive surgery: A systematic review","authors":"Francesca Ruccia, Akash Mavilakandy, Hassan Imtiaz, John Erskine, Yong Yie Liew, Meyada Ali, Ankur Khajuria","doi":"10.1002/rcs.2661","DOIUrl":"10.1002/rcs.2661","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic assisted surgery (RAS) has seen significant advancement in many surgical specialties, although the application of robotics in plastic and reconstructive surgery remains to be widely established. This systematic review aims to assess the role of RAS in plastic and reconstructive surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The review protocol was published and registered a priori as CRD42024507420. A comprehensive electronic search for relevant studies was performed in MEDLINE, Embase and Google scholar databases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 132 studies were initially identified, of which, 44 studies satisfied the eligibility criteria with a cumulative total of 239 patients. RAS demonstrated a high degree of procedural success and anastomotic patency in microvascular procedures. There was no significant difference in periprocedural adverse events between robotic and manual procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RAS can be feasibly implemented in plastic and reconstructive surgery with a good efficacy and safety profile, particularly for microsurgical anastomosis and trans-oral surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2661","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617777","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}
Blood accumulation often occurs during bleeding in surgery. Simulating the blood accumulation in surgical simulation system not only enhances the realism and immersion of surgical training, but also helps researchers better understand the physical properties of blood flow.
Methods
To realistically simulate the blood accumulation during the bleeding, this paper proposes a novel kernel function with non-negative second derivatives to improve the SPH method. Meanwhile, a simple form of boundary force equation is constructed to impose the solid boundary condition.
Results
We simulate the blood accumulation during liver bleeding and vessel bleeding respectively in the surgical simulation system. The simulation results show that there is no occurrence of blood physically penetrating the boundary.
Conclusions
Applying the solid boundary condition to the blood by using the method proposed in this paper is not only convenient but can also eliminate compression instability in the blood accumulation simulation.
{"title":"Simulating blood accumulation with improved smoothed particle hydrodynamics in surgical simulation system","authors":"Pengyu Sun, Peter Xiaoping Liu","doi":"10.1002/rcs.2663","DOIUrl":"10.1002/rcs.2663","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Blood accumulation often occurs during bleeding in surgery. Simulating the blood accumulation in surgical simulation system not only enhances the realism and immersion of surgical training, but also helps researchers better understand the physical properties of blood flow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To realistically simulate the blood accumulation during the bleeding, this paper proposes a novel kernel function with non-negative second derivatives to improve the SPH method. Meanwhile, a simple form of boundary force equation is constructed to impose the solid boundary condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We simulate the blood accumulation during liver bleeding and vessel bleeding respectively in the surgical simulation system. The simulation results show that there is no occurrence of blood physically penetrating the boundary.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Applying the solid boundary condition to the blood by using the method proposed in this paper is not only convenient but can also eliminate compression instability in the blood accumulation simulation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617776","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}
This study aimed to develop a novel deep convolutional neural network called Dual-path Double Attention Transformer (DDA-Transformer) designed to achieve precise and fast knee joint CT image segmentation and to validate it in robotic-assisted total knee arthroplasty (TKA).
Methods
The femoral, tibial, patellar, and fibular segmentation performance and speed were evaluated and the accuracy of component sizing, bone resection and alignment of the robotic-assisted TKA system constructed using this deep learning network was clinically validated.
Results
Overall, DDA-Transformer outperformed six other networks in terms of the Dice coefficient, intersection over union, average surface distance, and Hausdorff distance. DDA-Transformer exhibited significantly faster segmentation speeds than nnUnet, TransUnet and 3D-Unet (p < 0.01). Furthermore, the robotic-assisted TKA system outperforms the manual group in surgical accuracy.
Conclusions
DDA-Transformer exhibited significantly improved accuracy and robustness in knee joint segmentation, and this convenient and stable knee joint CT image segmentation network significantly improved the accuracy of the TKA procedure.
{"title":"Development and clinical validation of a deep learning-based knee CT image segmentation method for robotic-assisted total knee arthroplasty","authors":"Xingyu Liu, Songlin Li, Xiongfei Zou, Xi Chen, Hongjun Xu, Yang Yu, Zhao Gu, Dong Liu, Runchao Li, Yaojiong Wu, Guangzhi Wang, Hongen Liao, Wenwei Qian, Yiling Zhang","doi":"10.1002/rcs.2664","DOIUrl":"10.1002/rcs.2664","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to develop a novel deep convolutional neural network called Dual-path Double Attention Transformer (DDA-Transformer) designed to achieve precise and fast knee joint CT image segmentation and to validate it in robotic-assisted total knee arthroplasty (TKA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The femoral, tibial, patellar, and fibular segmentation performance and speed were evaluated and the accuracy of component sizing, bone resection and alignment of the robotic-assisted TKA system constructed using this deep learning network was clinically validated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, DDA-Transformer outperformed six other networks in terms of the Dice coefficient, intersection over union, average surface distance, and Hausdorff distance. DDA-Transformer exhibited significantly faster segmentation speeds than nnUnet, TransUnet and 3D-Unet (<i>p</i> < 0.01). Furthermore, the robotic-assisted TKA system outperforms the manual group in surgical accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DDA-Transformer exhibited significantly improved accuracy and robustness in knee joint segmentation, and this convenient and stable knee joint CT image segmentation network significantly improved the accuracy of the TKA procedure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592288","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}
Haiyan Du, Xinran Zhang, Yongde Zhang, Fujun Zhang, Letao Lin, Tao Huang
Background
At present, the number and overall level of ultrasound (US) doctors cannot meet the medical needs, and the medical ultrasound robots will largely solve the shortage of medical resources.
Methods
According to the degree of automation, the handheld, semi-automatic and automatic ultrasound examination robot systems are summarised. Ultrasound scanning path planning and robot control are the keys to ensure that the robot systems can obtain high-quality images. Therefore, the ultrasound scanning path planning and control methods are summarised. The research progress and future trends are discussed.
Results
A variety of ultrasound robot systems have been applied to various medical works. With the continuous improvement of automation, the systems provide high-quality ultrasound images and image guidance for clinicians.
Conclusion
Although the development of medical ultrasound robot still faces challenges, with the continuous progress of robot technology and communication technology, medical ultrasound robot will have great development potential and broad application space.
{"title":"A review of robot-assisted ultrasound examination: Systems and technology","authors":"Haiyan Du, Xinran Zhang, Yongde Zhang, Fujun Zhang, Letao Lin, Tao Huang","doi":"10.1002/rcs.2660","DOIUrl":"10.1002/rcs.2660","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>At present, the number and overall level of ultrasound (US) doctors cannot meet the medical needs, and the medical ultrasound robots will largely solve the shortage of medical resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>According to the degree of automation, the handheld, semi-automatic and automatic ultrasound examination robot systems are summarised. Ultrasound scanning path planning and robot control are the keys to ensure that the robot systems can obtain high-quality images. Therefore, the ultrasound scanning path planning and control methods are summarised. The research progress and future trends are discussed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A variety of ultrasound robot systems have been applied to various medical works. With the continuous improvement of automation, the systems provide high-quality ultrasound images and image guidance for clinicians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although the development of medical ultrasound robot still faces challenges, with the continuous progress of robot technology and communication technology, medical ultrasound robot will have great development potential and broad application space.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560901","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}
Despite partial nephrectomy (PN) renal function preservation benefits, postoperative renal dysfunction may occur. Perirenal fat thickness (PFT) is associated with renal dysfunction such as diabetes; however, its role in renal tumour surgery is unclear. This study investigates the role of PFT in renal function after robot-assisted partial nephrectomy (RAPN).
Methods
Pre-operative factors for postoperative renal dysfunction were analysed in 156 patients undergoing RAPN with ≥1-year follow-up. PFT measured using computed tomography categorised patients with PFT >21.0 mm (median) as high-PFT.
Results
Tumour size, total R.E.N.A.L. nephrometry score and its N component, renal calyx opening, achievement of trifecta, and PFT were risk factors for renal dysfunction 1 year postoperatively. Age ≥75 years (p = 0.024), total RNS ≥7 (p = 0.036), and PFT >21.0 mm (p = 0.002) significantly correlated with postoperative renal dysfunction.
Conclusions
CT-measured PFT is a valuable predictor of postoperative renal dysfunction.
{"title":"Effects of perirenal fat thickness on postoperative renal dysfunction in patients who underwent robot-assisted partial nephrectomy for renal tumours","authors":"Ryoma Nishikawa, Shuichi Morizane, Atsushi Yamamoto, Hiroshi Yamane, Ryutaro Shimizu, Yusuke Kimura, Noriya Yamaguchi, Katsuya Hikita, Masashi Honda, Atsushi Takenaka","doi":"10.1002/rcs.2662","DOIUrl":"10.1002/rcs.2662","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite partial nephrectomy (PN) renal function preservation benefits, postoperative renal dysfunction may occur. Perirenal fat thickness (PFT) is associated with renal dysfunction such as diabetes; however, its role in renal tumour surgery is unclear. This study investigates the role of PFT in renal function after robot-assisted partial nephrectomy (RAPN).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pre-operative factors for postoperative renal dysfunction were analysed in 156 patients undergoing RAPN with ≥1-year follow-up. PFT measured using computed tomography categorised patients with PFT >21.0 mm (median) as high-PFT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tumour size, total R.E.N.A.L. nephrometry score and its N component, renal calyx opening, achievement of trifecta, and PFT were risk factors for renal dysfunction 1 year postoperatively. Age ≥75 years (<i>p</i> = 0.024), total RNS ≥7 (<i>p</i> = 0.036), and PFT >21.0 mm (<i>p</i> = 0.002) significantly correlated with postoperative renal dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CT-measured PFT is a valuable predictor of postoperative renal dysfunction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545669","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}
Minimally invasive percutaneous plate osteosynthesis for humeral shaft fractures (HSFs) has limitations due to malreduction and radiation exposure. To address these limitations, we integrated robotics and 3D printing by incorporating plates as reduction templates.
Method
The innovative technology facilitated closed reduction of HSFs in the operating theatre using 18 models with cortical marking holes. The dataset of the precontoured plate was imported into 3D planning software for virtual fixation and screw path planning. The models were divided into half to simulate transverse fractures. During the operation, the software generated drilling trajectories for robot navigation, and precise plate installation achieved automatic fracture reduction.
Results
The evaluation results of reduction accuracy revealed variations in length, apposition, alignment, and rotation that meet the criteria for anatomic reduction. High interoperator reliabilities were observed for all parameters.
Conclusions
The proposed technology achieved anatomic reduction in simulated bones.
背景：微创经皮钢板骨合成术治疗肱骨轴骨折（HSFs）有其局限性，原因是钢板还原不良和辐射暴露。为了解决这些局限性，我们整合了机器人技术和 3D 打印技术，将钢板作为还原模板：方法：这项创新技术利用 18 个带有皮质标记孔的模型，在手术室内完成了 HSF 的闭合复位。预轮廓钢板的数据集被导入三维规划软件，用于虚拟固定和螺钉路径规划。模型被分成两半，以模拟横向骨折。在操作过程中，软件为机器人导航生成钻孔轨迹，钢板的精确安装实现了骨折的自动复位：结果：骨折复位精确度的评估结果显示，长度、位置、对齐和旋转的变化符合解剖复位的标准。所有参数的操作员间可靠性都很高：结论：所提出的技术实现了模拟骨骼的解剖复位。
{"title":"Combining robotics and 3D printing facilitates closed reduction of humeral shaft fractures using a minimally invasive plate as a reduction template: A proof-of-concept study","authors":"Dapeng Liu, Jinghao Liang, Hongju Yang","doi":"10.1002/rcs.2656","DOIUrl":"10.1002/rcs.2656","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Minimally invasive percutaneous plate osteosynthesis for humeral shaft fractures (HSFs) has limitations due to malreduction and radiation exposure. To address these limitations, we integrated robotics and 3D printing by incorporating plates as reduction templates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The innovative technology facilitated closed reduction of HSFs in the operating theatre using 18 models with cortical marking holes. The dataset of the precontoured plate was imported into 3D planning software for virtual fixation and screw path planning. The models were divided into half to simulate transverse fractures. During the operation, the software generated drilling trajectories for robot navigation, and precise plate installation achieved automatic fracture reduction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The evaluation results of reduction accuracy revealed variations in length, apposition, alignment, and rotation that meet the criteria for anatomic reduction. High interoperator reliabilities were observed for all parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The proposed technology achieved anatomic reduction in simulated bones.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545668","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}
Gaoyang Cao, Yaoyao Zhao, Xinjie Zhang, Da Man, Fei Wang, Xianlei Cai
Background
Robotic-assisted surgery (RAS) is increasingly used for treating low rectal cancer. Its comparative effectiveness against laparoscopic surgery (LAS) in enhancing long-term anal function remains uncertain.
Methods
A meta-analysis was conducted to compare long-term anal function outcomes between patients undergoing RAS and LAS. Meta-regression and sensitivity analyses were performed to assess available evidence. Studies published up to September 2023 in English or Chinese were included.
Results
Seven studies were identified. RAS patients exhibited lower low anterior resection syndrome (LARS) scores (standardised mean difference [SMD] = −1.39; 95% confidence interval [CI]: −2.64 to −0.15) and Wexner scores (SMD = −0.74; 95% CI: −1.20 to −0.27) compared with LAS patients. However, RAS did not significantly reduce major LARS risk (odds ratio = 0.85; 95% CI: 0.68–1.04).
Conclusions
RAS slightly improved postoperative anal function compared with LAS. Further studies with large samples are warranted to confirm or update our findings.
背景：机器人辅助手术（RAS）越来越多地用于治疗低位直肠癌。在提高长期肛门功能方面，机器人辅助手术与腹腔镜手术（LAS）的比较效果仍不确定：方法：我们进行了一项荟萃分析，比较了接受 RAS 和 LAS 手术的患者的长期肛门功能结果。为评估现有证据，进行了元回归和敏感性分析。纳入了截至 2023 年 9 月发表的英文或中文研究：结果：共发现七项研究。与LAS患者相比，RAS患者的低前切除综合征（LARS）评分（标准化平均差[SMD] = -1.39; 95%置信区间[CI]：-2.64至-0.15）和Wexner评分（SMD = -0.74; 95%置信区间[CI]：-1.20至-0.27）较低。然而，RAS并没有明显降低重大LARS风险（几率比=0.85；95% CI：0.68-1.04）：结论：与 LAS 相比，RAS 稍微改善了术后肛门功能。结论：与 LAS 相比，RAS 稍微改善了术后肛门功能。我们需要进一步开展大样本研究，以证实或更新我们的发现。
{"title":"Comparing the long-term follow-up anal function between robot-assisted and laparoscopic surgery for low rectal cancer: A meta-analysis and systematic review","authors":"Gaoyang Cao, Yaoyao Zhao, Xinjie Zhang, Da Man, Fei Wang, Xianlei Cai","doi":"10.1002/rcs.2659","DOIUrl":"10.1002/rcs.2659","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic-assisted surgery (RAS) is increasingly used for treating low rectal cancer. Its comparative effectiveness against laparoscopic surgery (LAS) in enhancing long-term anal function remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A meta-analysis was conducted to compare long-term anal function outcomes between patients undergoing RAS and LAS. Meta-regression and sensitivity analyses were performed to assess available evidence. Studies published up to September 2023 in English or Chinese were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven studies were identified. RAS patients exhibited lower low anterior resection syndrome (LARS) scores (standardised mean difference [SMD] = −1.39; 95% confidence interval [CI]: −2.64 to −0.15) and Wexner scores (SMD = −0.74; 95% CI: −1.20 to −0.27) compared with LAS patients. However, RAS did not significantly reduce major LARS risk (odds ratio = 0.85; 95% CI: 0.68–1.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RAS slightly improved postoperative anal function compared with LAS. Further studies with large samples are warranted to confirm or update our findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499860","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}
Erkin Gezgin, Alp E. Yaşar, Tuğrul Uslu, Mertcan Koçak, Didem Güzin, Seda Özbek, Gökmen A. Türkmen, Goncagül Karayaman, Rahime Alsanğur, Barış Bıdıklı, Fatih C. Can, Levent Çetin
Background
The method of stem cell transfer to narrow cochlear canals in vivo to generate hair cells is still an unclear operation. Thus, the development of any possible method that will ensure the usage of medical microrobots in small cochlear workspaces is a challenging procedure.
Methods
The current study tries to introduce a macro-micro manipulator system composed of a 6-DoF industrial serial manipulator as a macro manipulator and a proposed 5-DoF parallel manipulator with dual end effectors as a micro manipulator carrying permanent magnets for tetherless microrobot actuation inside the cochlea.
Results
Throughout the study, structural synthesis and kinematic analysis of the proposed micro manipulator were introduced. A prototype of the manipulator was manufactured and its hardware verification procedures were carried out using motion capture cameras and surgical navigation registration methodologies.
Conclusions
Following motion training, the assembled macro-micro manipulator was successfully utilised to actuate a microrobot placed inside a manufactured cochlea mockup model.
{"title":"On the design of a macro-micro parallel manipulator for cochlear microrobot operations","authors":"Erkin Gezgin, Alp E. Yaşar, Tuğrul Uslu, Mertcan Koçak, Didem Güzin, Seda Özbek, Gökmen A. Türkmen, Goncagül Karayaman, Rahime Alsanğur, Barış Bıdıklı, Fatih C. Can, Levent Çetin","doi":"10.1002/rcs.2654","DOIUrl":"10.1002/rcs.2654","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The method of stem cell transfer to narrow cochlear canals in vivo to generate hair cells is still an unclear operation. Thus, the development of any possible method that will ensure the usage of medical microrobots in small cochlear workspaces is a challenging procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The current study tries to introduce a macro-micro manipulator system composed of a 6-DoF industrial serial manipulator as a macro manipulator and a proposed 5-DoF parallel manipulator with dual end effectors as a micro manipulator carrying permanent magnets for tetherless microrobot actuation inside the cochlea.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Throughout the study, structural synthesis and kinematic analysis of the proposed micro manipulator were introduced. A prototype of the manipulator was manufactured and its hardware verification procedures were carried out using motion capture cameras and surgical navigation registration methodologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Following motion training, the assembled macro-micro manipulator was successfully utilised to actuate a microrobot placed inside a manufactured cochlea mockup model.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2654","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473364","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}
Seungmin Kim, Donghyun Shin, Changhyeon Lee, Daehee Yu, Jongho Cho, Hyunhee Bang, Hyunjoo Lee, Donghyun Kim, Ilhyung Park, Jaesung Hong, Sanghyun Joung
Background
Traditional open surgery for bone tumours sometimes has as a consequence an excessive removal of healthy bone tissue because of the limitations of rigid surgical instruments, increasing infection risk and recovery time.
Methods
We propose a remote robot with a 4.5-mm diameter bendable end-effector, offering four degrees of freedom for accessing the inside of the bone and performing tumour debridement. The preclinical studies evaluated the effectiveness, clinical scenario, and usability across 12 total surgeries–six phantom surgeries and six bovine bone surgeries. Evaluation criteria included skin incision size, bone window size, surgical time, removal rate, and conversion to open surgery.
Results
Preclinical studies demonstrated that the robotic approach requires significantly smaller incision size and procedure times than traditional open curettage.
Conclusion
This study validated the performance of the proposed system by assessing its preclinical effectiveness and optimising surgical methods using human phantom and bovine bone tumour models.
{"title":"Clinical efficacy and performance evaluation of a bendable remote robot system for a bone tumour surgery: A pilot animal study","authors":"Seungmin Kim, Donghyun Shin, Changhyeon Lee, Daehee Yu, Jongho Cho, Hyunhee Bang, Hyunjoo Lee, Donghyun Kim, Ilhyung Park, Jaesung Hong, Sanghyun Joung","doi":"10.1002/rcs.2653","DOIUrl":"10.1002/rcs.2653","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Traditional open surgery for bone tumours sometimes has as a consequence an excessive removal of healthy bone tissue because of the limitations of rigid surgical instruments, increasing infection risk and recovery time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We propose a remote robot with a 4.5-mm diameter bendable end-effector, offering four degrees of freedom for accessing the inside of the bone and performing tumour debridement. The preclinical studies evaluated the effectiveness, clinical scenario, and usability across 12 total surgeries–six phantom surgeries and six bovine bone surgeries. Evaluation criteria included skin incision size, bone window size, surgical time, removal rate, and conversion to open surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preclinical studies demonstrated that the robotic approach requires significantly smaller incision size and procedure times than traditional open curettage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study validated the performance of the proposed system by assessing its preclinical effectiveness and optimising surgical methods using human phantom and bovine bone tumour models.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461222","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}
Ashley Ying-Ying Wong, Michael Tim-Yun Ong, Tsz Lung Choi, Gloria Yan-Ting Lam, Xin He, Mingqian Yu, Ben Chi-Yin Choi, Daniel T. P. Fong, Patrick Shu-Hang Yung
Background
Up to 20% of patients remain unsatisfied after total knee arthroplasty (TKA), prompting the development of new implants. Bi-Cruciate Retaining (BCR) TKA preserves both the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), with the ACL beneficial for its proprioceptive qualities. The Bi-Cruciate Stabilised (BCS) TKA substitutes the ACL and PCL with a unique dual cam-post mechanism. Robotics improve accuracy and facilitate technically demanding TKA.
Methods
This was a retrospective case-control study recruited from two centres. Measured outcomes included kinematic analysis, proprioception, and functional outcomes.
Results
There was a significantly larger maximum flexion angle and range of flexion to extension in sit-to-stand and stairs in BCR when compared to BCS. Further analysis revealed more similarities between BCR and normal native knees. Proprioception and functional scores did not have any statistical difference.
Conclusion
BCR TKA demonstrated better knee flexion in weight-bearing active range of motion and showed similarities with normal knee kinematics.
{"title":"Comparison of the in vivo kinematics between robotic-assisted Bi-cruciate retaining and Bi-cruciate stabilised total knee arthroplasty","authors":"Ashley Ying-Ying Wong, Michael Tim-Yun Ong, Tsz Lung Choi, Gloria Yan-Ting Lam, Xin He, Mingqian Yu, Ben Chi-Yin Choi, Daniel T. P. Fong, Patrick Shu-Hang Yung","doi":"10.1002/rcs.2655","DOIUrl":"https://doi.org/10.1002/rcs.2655","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Up to 20% of patients remain unsatisfied after total knee arthroplasty (TKA), prompting the development of new implants. Bi-Cruciate Retaining (BCR) TKA preserves both the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), with the ACL beneficial for its proprioceptive qualities. The Bi-Cruciate Stabilised (BCS) TKA substitutes the ACL and PCL with a unique dual cam-post mechanism. Robotics improve accuracy and facilitate technically demanding TKA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective case-control study recruited from two centres. Measured outcomes included kinematic analysis, proprioception, and functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a significantly larger maximum flexion angle and range of flexion to extension in sit-to-stand and stairs in BCR when compared to BCS. Further analysis revealed more similarities between BCR and normal native knees. Proprioception and functional scores did not have any statistical difference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BCR TKA demonstrated better knee flexion in weight-bearing active range of motion and showed similarities with normal knee kinematics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2655","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441345","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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