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Minimally Invasive Spleen-Preserving Distal Pancreatectomy in Obese Patients: Factors Related to Clinically Relevant Pancreatic Fistula 肥胖患者微创保脾远端胰腺切除术:与临床相关胰瘘相关的因素
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2025-07-08 DOI: 10.1002/rcs.70091
Fabio Ausania, Filippo Landi, Carolina González-Abós, John B. Martinie, Dionisios Vrochides, Matthew Walsh, Shanaz M. Hossain, Steven White, Viswakumar Prabakaran, Laleh G. Melstrom, Yuman Fong, Giovanni Butturini, Laura Bignotto, Valentina Valle, Yuntao Bing, Dianrong Xiu, Gregorio Di Franco, Francisco Sanchez-Bueno, Nicola de'Angelis, Alexis Laurent, Giuseppe Giuliani, Graziano Pernazza, Alessandro Esposito, Roberto Salvia, Francesca Bazzocchi, Ludovica Esposito, Andrea Pietrabissa, Luigi Pugliese, José Rios, Andrea Coratti, Luca Morelli, Pier C. Giulianotti

Background

Minimally invasive spleen-preserving distal pancreatectomy (MI-SPDP) provides superior outcomes compared with open surgery, with robotic techniques showing better short-term results than laparoscopic techniques, particularly in obese patients. This study aimed to evaluate the impact of the surgical approach on postoperative pancreatic fistula (POPF) incidence in obese patients undergoing MI-SPDP.

Methods

A retrospective analysis of obese patients from 16 international centres compared robotic (R-SPDP) and laparoscopic (L-SPDP) approaches. Perioperative outcomes and factors associated with clinically relevant POPF were analysed using univariate and multivariate methods.

Results

Among 130 patients (57L-SPDP, 73R-SPDP), POPF incidence was significantly lower in the robotic group (15.1% vs. 42.1%; p = 0.001). The Comprehensive Complications Index was also lower (8% vs. 15%; p = 0.002). Laparoscopic approach (OR = 4.0), pancreatic body transection (OR = 2.6), and non-stapler stump closure (OR = 3.2) were independently associated with higher POPF rates.

Discussion

Robotic MI-SPDP reduces POPF in obese patients. Transection at the pancreatic neck and stapler-based closure can improve outcomes.

与开放手术相比,微创保脾远端胰腺切除术(MI-SPDP)提供了更好的结果,机器人技术比腹腔镜技术显示出更好的短期效果,特别是在肥胖患者中。本研究旨在评估手术入路对MI-SPDP肥胖患者术后胰瘘(POPF)发生率的影响。方法回顾性分析来自16个国际中心的肥胖患者,比较机器人(R-SPDP)和腹腔镜(L-SPDP)入路。采用单因素和多因素方法分析围手术期结局和临床相关POPF相关因素。结果在130例患者(57L-SPDP, 73R-SPDP)中,机器人组的POPF发生率显著低于前者(15.1% vs. 42.1%;p = 0.001)。综合并发症指数也较低(8% vs. 15%;p = 0.002)。腹腔镜入路(OR = 4.0)、胰体横断(OR = 2.6)和非吻合器残端闭合(OR = 3.2)与较高的POPF发生率独立相关。机器人MI-SPDP降低肥胖患者的POPF。胰颈横断及吻合器缝合可改善预后。
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引用次数: 0
The Silent Transformation of Stereotactic Brain Biopsies After the Introduction of Robotics 机器人技术引入后立体定向脑活检的无声转变
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2025-07-05 DOI: 10.1002/rcs.70087
Eliane Weinbrenner, Mykola Gorbachuk, Kathrin Machetanz, Florian Grimm, Linda Oberle, Sophie S. Wang, Marcos Tatagiba, Georgios Naros

Background

In frame-based stereotaxy, the design of the frame limits trajectory selection, e.g., to the temporal lobe and posterior fossa. We hypothesise that frame-less neuronavigation and robotic technology might have expanded these stereotactic corridors.

Methods

We analysed 376 frame-based, neuronavigated and robotic brain biopsies. We analysed entry (EP) and target (TP) point coordinates, trajectory lengths (TL) and angles (α1,α2), skin-to-skin time (STS), diagnostic yield and morbidity.

Results

Robotics liberated TP and EP selection, enabling trajectories not applicable with the frame. There was an increased application of lateral trajectories (reducing α1) while decreasing TL. There was a significant STS reduction attributable to a modification of the surgical approach (twist drill vs. burr hole).

Conclusions

Robotics modified trajectory selection and the surgical approach. Duration and invasiveness of brain biopsies were decreased without affecting diagnostic yield or morbidity. This may represent a clinical benefit of robotics compared with frame-based and frame-less stereotaxy.

在基于框架的立体定位中,框架的设计限制了轨迹的选择,例如,颞叶和后窝。我们假设,无框架神经导航和机器人技术可能扩大了这些立体定向走廊。方法对376例基于框架、神经导航和机器人的脑活检进行分析。我们分析了入点(EP)和靶点(TP)坐标、轨迹长度(TL)和角度(α1、α2)、皮肤对皮肤时间(STS)、诊断率和发病率。结果机器人解放了TP和EP的选择,使得不适用于框架的轨迹成为可能。在降低TL的同时,增加了侧向轨迹的应用(降低α1)。由于手术入路的改变(麻花钻vs毛刺孔),STS显著降低。结论机器人技术改进了手术入路选择和手术入路。在不影响诊断率和发病率的情况下,脑部活检的时间和侵入性降低。与基于框架和无框架立体定位相比,这可能代表了机器人技术的临床优势。
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引用次数: 0
UK-YOLOv10: Deep Learning-Based Detection of Surgical Instruments 基于深度学习的手术器械检测
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2025-06-27 DOI: 10.1002/rcs.70083
Li Zhang, Guanqun Guo, Wenjie Wang

Background

Accurate detection of surgical instruments is essential for robot-assisted surgery. Existing methods face challenges in both accuracy and real-time performance, limiting their clinical applicability.

Methods

We propose UK-YOLOv10, a novel framework that integrates two innovations: the uni-fusion attention module (UFAM) for enhanced multi-scale feature representation, and the C2fKAN module, which employs KAN convolution to improve classification accuracy and accelerate training.

Results

On the M2CAI16-Tool-Locations dataset, UK-YOLOv10 achieves detection accuracy of 96.7%, an [email protected] of 96.4%, and an [email protected]:0.95 of 0.605, outperforming YOLOv10 by 3%, 2.2% and 3.6%, respectively. Generalisation on COCO2017 resulted in an [email protected]:0.95 of 0.386.

Conclusion

UK-YOLOv10 significantly improves surgical instrument detection and demonstrates strong potential for robot-assisted surgeries.

手术器械的准确检测是机器人辅助手术的关键。现有方法在准确性和实时性方面都面临挑战,限制了其临床适用性。我们提出了一个新的框架UK-YOLOv10,它集成了两个创新:用于增强多尺度特征表示的统一融合注意模块(UFAM)和使用KAN卷积来提高分类精度和加速训练的C2fKAN模块。结果在M2CAI16-Tool-Locations数据集上,UK-YOLOv10的检测准确率为96.7%,[email protected]的检测准确率为96.4%,[email protected]的检测准确率为0.95(0.605),分别优于YOLOv10 3%、2.2%和3.6%。对COCO2017的概括得出[email protected]:0.95(0.386)。结论UK-YOLOv10显著提高了手术器械的检测水平,在机器人辅助手术中具有很强的应用潜力。
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引用次数: 0
Correction to “Robotic Assisted Minimally Invasive Coronary Revascularisation: Midterm Results” 对“机器人辅助微创冠状动脉血管重建术:中期结果”的更正
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2025-06-26 DOI: 10.1002/rcs.70086

Arslanhan, G., Özcan, Z. S., Şenay, Ş., Baştopçu, M., Karaağaç, A., Koçyiğit, M., Değirmencioğlu, A., Alis, D., and Alhan, C. 2025. “Robotic Assisted Minimally Invasive Coronary Revascularisation: Midterm Results.” The International Journal of Medical Robotics and Computer Assisted Surgery, 21(3): e70071. https://doi.org/10.1002/rcs.70071.

Dr. Halim Ulugöl who has contributed to the cases and to the article writing process was mistakenly not added to the initial author list. This was corrected and the correct author list is as follows:

Gökhan Arslanhan, Zeynep Sıla Özcan, Şahin Şenay, Murat Baştopçu, Anıl Karaağaç, Muharrem Koçyiğit, Halim Ulugöl, Aleks Değirmencioğlu, Deniz Alis, Cem Alhan

In Table 3, the reoperation for bleeding is given as 1 patient out of 150 patients and its respective ratio was given as 0.006% instead of 0.66%. This was also corrected.

We apologize for this error.

Arslanhan, G., Özcan, Z. S., Şenay, Ş。, batopu, M., Karaağaç, A., Koçyiğit, M., Değirmencioğlu, A., Alis, D., Alhan, C. 2025。机器人辅助微创冠状动脉血管重建术:中期结果。国际医学机器人与计算机辅助外科杂志,21(3):e70071。https://doi.org/10.1002/rcs.70071.Dr。对案件和文章撰写过程做出贡献的哈利姆Ulugöl被错误地排除在最初的作者名单之外。更正后,正确的作者名单如下:Gökhan Arslanhan, Zeynep Sıla Özcan, Şahin Şenay, Murat batopu, Anıl Karaağaç, Muharrem Koçyiğit, Halim Ulugöl, Aleks Değirmencioğlu, Deniz Alis, Cem alhan表3中,150例患者中因出血再手术1例,其相应比例为0.006%,而不是0.66%。这也被纠正了。我们为这个错误道歉。
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引用次数: 0
Robotic Versus Total Laparoscopic Splenectomy With Pericardial Devascularisation for Portal Hypertension: A Retrospective Cohort Study 机器人与全腹腔镜脾切除术合并心包断流术治疗门静脉高压:一项回顾性队列研究
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2025-06-24 DOI: 10.1002/rcs.70085
Zhen Ma, Hongbin Cui, Lei Gaoi, Bin Ma, Puyi He, Yang Yu, Yunpeng Wang, Yanling Ma, Hao Chen

Background

This study compared the feasibility, efficacy, and safety of robotic splenectomy with pericardial devascularisation (TRSPD) versus total laparoscopic splenectomy with pericardial devascularisation (TLSPD) in patients with portal hypertension (PHT) complicated by splenomegaly, hypersplenism, and oesophagogastric varices.

Methods

A retrospective cohort analysis was conducted on 17 patients undergoing minimally invasive splenectomy with pericardial devascularisation between 2022 and 2024. Outcomes included operative metrics, postoperative recovery, and portal hypertension resolution.

Results

TRSPD significantly reduced intraoperative blood loss (175 vs. 436 mL, p = 0.004) despite longer operative duration (400 vs. 256 min, p = 0.001). Zero conversions occurred with TRSPD versus 3 conversions with TLSPD (p = 0.02). Postoperatively, TRSPD accelerated gastrointestinal recovery (2.1 vs. 3.5 days, p = 0.02) and shortened drainage duration (4.0 vs. 6.2 days, p = 0.02). Both techniques normalised haematologic indices, reduced portal vein diameter (p < 0.05), and resolved varices without major complications.

Conclusions

TRSPD demonstrates superior intraoperative safety and faster recovery compared with TLSPD while achieving equivalent therapeutic efficacy for portal hypertension. Robotic approaches may optimise the minimally invasive management of complex portosplenic vascular pathologies.

本研究比较了机器人脾切除术合并心包断流术(TRSPD)与全腹腔镜脾切除术合并心包断流术(TLSPD)治疗门脉高压(PHT)合并脾肿大、脾功能亢和食管胃静脉曲张的可行性、有效性和安全性。方法回顾性分析2022 ~ 2024年间行微创脾切除术合并心包断流术的17例患者。结果包括手术指标、术后恢复和门静脉高压缓解。结果尽管手术时间较长(400 vs 256 min, p = 0.001),但TRSPD显著减少术中出血量(175 vs 436 mL, p = 0.004)。TRSPD组为0例,TLSPD组为3例(p = 0.02)。术后TRSPD加速胃肠恢复(2.1 vs. 3.5天,p = 0.02),缩短引流时间(4.0 vs. 6.2天,p = 0.02)。两种技术均使血液学指标正常化,门静脉直径减小(p <;0.05),静脉曲张消退,无重大并发症。结论与TLSPD相比,TRSPD术中安全性更高,恢复速度更快,治疗门静脉高压症的效果相当。机器人入路可以优化复杂门脾血管病变的微创治疗。
{"title":"Robotic Versus Total Laparoscopic Splenectomy With Pericardial Devascularisation for Portal Hypertension: A Retrospective Cohort Study","authors":"Zhen Ma,&nbsp;Hongbin Cui,&nbsp;Lei Gaoi,&nbsp;Bin Ma,&nbsp;Puyi He,&nbsp;Yang Yu,&nbsp;Yunpeng Wang,&nbsp;Yanling Ma,&nbsp;Hao Chen","doi":"10.1002/rcs.70085","DOIUrl":"https://doi.org/10.1002/rcs.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study compared the feasibility, efficacy, and safety of robotic splenectomy with pericardial devascularisation (TRSPD) versus total laparoscopic splenectomy with pericardial devascularisation (TLSPD) in patients with portal hypertension (PHT) complicated by splenomegaly, hypersplenism, and oesophagogastric varices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort analysis was conducted on 17 patients undergoing minimally invasive splenectomy with pericardial devascularisation between 2022 and 2024. Outcomes included operative metrics, postoperative recovery, and portal hypertension resolution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TRSPD significantly reduced intraoperative blood loss (175 vs. 436 mL, <i>p</i> = 0.004) despite longer operative duration (400 vs. 256 min, <i>p</i> = 0.001). Zero conversions occurred with TRSPD versus 3 conversions with TLSPD (<i>p</i> = 0.02). Postoperatively, TRSPD accelerated gastrointestinal recovery (2.1 vs. 3.5 days, <i>p</i> = 0.02) and shortened drainage duration (4.0 vs. 6.2 days, <i>p</i> = 0.02). Both techniques normalised haematologic indices, reduced portal vein diameter (<i>p</i> &lt; 0.05), and resolved varices without major complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TRSPD demonstrates superior intraoperative safety and faster recovery compared with TLSPD while achieving equivalent therapeutic efficacy for portal hypertension. Robotic approaches may optimise the minimally invasive management of complex portosplenic vascular pathologies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473109","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}
引用次数: 0
Clinical and Economic Assessment of Robot-Assisted Radical Prostatectomy With the Hinotori Surgical System: Insights From a Japanese Single-Centre Study 机器人辅助根治性前列腺切除术与Hinotori手术系统的临床和经济评估:来自日本单中心研究的见解
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2025-06-21 DOI: 10.1002/rcs.70084
Kotaro Obayashi, Jun Akatsuka, Takuya Nishino, Mami Takadate, Hiroya Hasegawa, Hikaru Mikami, Hayato Takeda, Yuki Endo, Yuka Toyama, Takeshi Yamada, Yoichiro Yamamoto, Go Kimura, Yukihiro Kondo

Background

We investigated the clinical and economic outcomes of robot-assisted radical prostatectomy (RARP) using the hinotori surgical system (H-RARP).

Methods

The analysis was conducted on 76 and 68 patients who underwent RARP using the da Vinci surgical system (D-RARP) and H-RARP, respectively. Safety, oncological, and functional outcomes were compared between H-RARP and D-RARP. Risk factors influencing medical costs in RARP were identified via linear regression analysis.

Results

Except for longer operative time in H-RARP, clinical outcomes were comparable. The median medical costs per case were $12,426.8 for D-RARP and $12,548.9 for H-RARP. Operative time (coefficient: 0.0002, p < 0.001), pathological T stage (coefficient: 0.023, p = 0.030), and postoperative hospital stay (coefficient: 0.028, p < 0.001) were significant factors affecting medical costs; in contrast, the type of robot-assisted surgical system was not a significant factor.

Conclusions

H-RARP offers clinical outcomes comparable to those of D-RARP while maintaining equivalent medical costs.

我们研究了使用hinotori手术系统(H-RARP)的机器人辅助根治性前列腺切除术(RARP)的临床和经济效果。方法对76例和68例采用达芬奇手术系统(D-RARP)行RARP的患者进行分析。比较了H-RARP和D-RARP的安全性、肿瘤学和功能结果。通过线性回归分析确定影响RARP医疗费用的危险因素。结果除H-RARP手术时间较长外,两组临床结果具有可比性。每例D-RARP患者的平均医疗费用为12426.8美元,H-RARP患者的平均医疗费用为12548.9美元。操作时间(系数:0.0002,p <;0.001)、病理T分期(系数:0.023,p = 0.030)、术后住院时间(系数:0.028,p <;0.001)是影响医疗费用的显著因素;相比之下,机器人辅助手术系统的类型并不是一个重要因素。结论H-RARP的临床效果与D-RARP相当,同时保持相同的医疗费用。
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引用次数: 0
Paediatric Robotic Transperitoneal Heminephroureterectomy in Complete Duplicated Systems: Early and Long-Term Outcomes 儿童机器人经腹膜肾输尿管切除术在完全重复系统:早期和长期的结果
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2025-06-20 DOI: 10.1002/rcs.70082
Donatella Di Fabrizio, Thomas P. Cundy, Azad S. Najmaldin

Background

We present outcomes for paediatric robotic heminephroureterectomy from a prospective single-surgeon series.

Methods

Children who underwent this operation between July 2007 and March 2017 were reviewed from a prospective database.

Results

There were 32 heminephroureterectomy (28 upper, 4 lower) for ureterocele (13), reflux (7), ectopic ureter (11), ureteric atresia (1). Co-morbidities (urological anomalies, recurrent infection, previous abdominal scarring) were common. Concomitant non-robotic procedures took place in 50%. Mean console time was 101 ± 30.2 min, hospital stay 29.5 ± 10.3 h. There were no conversions, intraoperative complications, and no remnant moiety function loss. Excision of diseased moiety calyces was complete in 30 (94%), incomplete in 2 (6%) who subsequently developed asymptomatic small marginal cysts. Eleven (34%) had total-ureterectomy, the remaining 21 (66%) were left with a ureteric stump. Postoperatively 3 (9%) females with residual stump (2 ureterocele, 1 bladder neck ectopia) and other urological anomalies underwent surgery (stump excision + reimplant refluxing remnant moiety ureter) for recurrent infection.

Conclusion

In children, heminephroureterectomy is well suited to a robotic approach with favourable outcomes in our experience.

背景:我们介绍了一项前瞻性单外科医生系列的儿童机器人半肾输尿管切除术的结果。方法从前瞻性数据库中回顾2007年7月至2017年3月期间接受该手术的儿童。结果输尿管囊肿(13例)、反流(7例)、输尿管异位(11例)、输尿管闭锁(1例)行输尿管半切32例(上输尿管28例,下输尿管4例)。合并症(泌尿系统异常,复发性感染,既往腹部瘢痕)是常见的。50%的患者进行了非机器人手术。平均控制台时间为101±30.2 min,住院时间为29.5±10.3 h。无转归,术中并发症,无残余部分功能丧失。30例(94%)完全切除病变部分肾盏,2例(6%)不完全切除,随后发展为无症状的小边缘囊肿。11例(34%)行全输尿管切除术,其余21例(66%)留下输尿管残端。术后3例(9%)女性残端(2例输尿管膨出,1例膀胱颈异位)及其他泌尿系统异常因复发感染而行手术(残端切除+再植入返流残段输尿管)。结论根据我们的经验,儿童半肾输尿管切除术非常适合机器人入路,效果良好。
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引用次数: 0
Robotic Submesocolic Left Adrenalectomy: The Evolution of Delbet Approach 机器人结肠膜下左肾上腺切除术:Delbet入路的演变
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2025-06-17 DOI: 10.1002/rcs.70080
Monica Ortenzi, Andrea Santini, Andrea Balla, Diletta Corallino, Giovanni Lezoche, Mario Guerrieri, Danila Azzolina

Introduction

The left adrenal gland is prone to being approached with several access points. This study presents a series of robotic submesocolic left adrenalectomies.

Materials and Methods

Intraoperative and post-operative outcomes of robotic (RB) and laparoscopic (LP) submesocolic (SM) access to the adrenal gland were compared. Subsequently, these were compared to left adrenalectomy performed using the anterior approach (AT).

Results

Operative time was statistically longer in the LP group (p < 0.001). There was no statistical difference for postoperative complications. After the propensity matching, there was a correlation between the BMI and the onset of post-operative complications (OR = 1.01). The operative time was significantly longer in the AT group both overall (p = 0.023) and within the LP procedures (p < 0.001), but not in the RB procedures (p = 0.386). Length of stay was shorter in the SM group (p = 0.024).

Conclusions

The RB SM approach to the left adrenal gland is a safe and feasible.

左肾上腺容易通过几个接入点进入。本研究提出了一系列的机器人结肠膜下左肾上腺切除术。材料与方法比较机器人(RB)和腹腔镜(LP)结肠膜下(SM)进入肾上腺的术中、术后结果。随后,将这些与采用前路(AT)进行的左肾上腺切除术进行比较。结果LP组手术时间更长,差异有统计学意义(p <;0.001)。两组术后并发症发生率无统计学差异。倾向匹配后,BMI与术后并发症发生率存在相关性(OR = 1.01)。AT组总的手术时间(p = 0.023)和LP组的手术时间(p <;0.001),但在RB过程中没有(p = 0.386)。SM组患者住院时间较短(p = 0.024)。结论RB - SM入路是一种安全可行的左肾上腺入路。
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引用次数: 0
A Miniature Flexible Scanning Device for Gastrointestinal Endomicroscopy 一种用于胃肠道内镜检查的微型柔性扫描装置
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2025-06-14 DOI: 10.1002/rcs.70081
Xingfeng Xu, Jianshuo Liu, Siyang Zuo

Background

Probe-based confocal laser endomicroscopy (pCLE) offers real-time optical biopsy of the gastrointestinal mucosa, promising early detection of gastrointestinal cancer. However, its limited field-of-view necessitates a flexible device for expansive scanning and mosaicking of cancerous regions.

Methods

This work presents a novel 4 degree-of-freedom flexible scanning device with a 3 mm outer diameter and a 2.2 mm working channel. The positioning accuracy of the scanning mechanism was recorded as 3.94° in yaw, 4.23° in pitch, 0.17 mm in linear, and 0.69 mm in rotational motions.

Results

Ex vivo tissue scanning achieved an area of 11.4 mm2. In vivo animal experimental results revealed the device's capacity to scan and mosaic an area of 5.05 mm2.

Conclusions

This design is compatible with endomicroscopic probes and optimises the endoscope deployment. Comprehensive mechanical evaluations and scanning experiments demonstrated the device's clinical potential in gastrointestinal cancer diagnosis.

基于探针的共聚焦激光内镜(pCLE)提供了实时的胃肠道粘膜光学活检,有望早期发现胃肠道肿瘤。然而,其有限的视野需要一个灵活的设备,以扩大扫描和镶嵌癌区域。方法设计了一种外径为3mm、工作通道为2.2 mm的4自由度柔性扫描装置。扫描机构的定位精度为横摆3.94°,俯仰4.23°,直线0.17 mm,旋转0.69 mm。结果离体组织扫描面积为11.4 mm2。体内动物实验结果显示,该设备的扫描和镶嵌面积为5.05平方毫米。结论该设计与内镜探头兼容,优化了内镜部署。综合力学评估和扫描实验证明了该装置在胃肠道癌症诊断中的临床潜力。
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引用次数: 0
Dimensional Synthesis of 6-DOF Parallel Robot for Intra-Operative Radiation Therapy 术中放射治疗六自由度并联机器人的尺寸综合
IF 2.3 3区 医学 Q2 SURGERY Pub Date : 2025-06-04 DOI: 10.1002/rcs.70076
Baoying Peng, Yushuo Zhu, Chuanmeng Niu

Background

In order to meet the kinematic requirements of large range of motion, payload, and stiffness of Intra-Operative Radiation Therapy robots, a 6-degree-of-freedom (DOF) parallel platform (Stewart-Gough mechanism) is introduced and a dimensional synthesis study is carried out.

Methods

The kinematic and static stiffness models of the 6-DOF parallel robot for Intra-Operative Radiation Therapy are derived around a virtual isocentric control point. Under the premise of ensuring the positional accuracy, the optimal dimensions of the initial rod length, the radius of the fixed base and movable platform, and the circumferential angle of the 6-DOF parallel platform are obtained by using the multi-objective optimization method combining the non-dominated sorting genetic algorithm and the global 4criterion with the working space, stiffness, and load as the optimization objectives.

Results

A full-size prototype was built, and experiments on payload, range of motion, modality, and harmonic response were carried out.

Conclusions

The results show that the theoretical stiffness model has high accuracy, and the dimensional synthesised 6-DOF parallel platform can meet the clinical requirements of Intra-Operative Radiation Therapy in terms of workspace, stiffness and payload, as well as position accuracy.

Trial Registration

The equipment in this study has not yet obtained a medical device registration certificate, and the 6-DOF parallel robot for Intra-Operative Radiation Therapy experiments were conducted using a self-developed model, which has not yet been subjected to clinical trials.

为了满足术中放疗机器人大运动范围、大载荷、大刚度的运动学要求,引入了一种6自由度并联平台(Stewart-Gough机构),并进行了尺寸综合研究。方法以虚拟等心控制点为中心,建立六自由度放射治疗并联机器人的运动学和静刚度模型。在保证定位精度的前提下,以工作空间、刚度和载荷为优化目标,采用非支配排序遗传算法和全局4准则相结合的多目标优化方法,得到了初始杆长、固定底座和活动平台半径、六自由度并联平台周向角的最优尺寸。结果建立了全尺寸样机,进行了载荷、运动范围、模态和谐波响应实验。结论理论刚度模型精度较高,尺寸合成的6-DOF并联平台在工作空间、刚度、载荷、位置精度等方面均能满足术中放射治疗的临床要求。本研究设备尚未取得医疗器械注册证,术中放射治疗实验用6自由度并联机器人采用自行研制的模型,尚未进行临床试验。
{"title":"Dimensional Synthesis of 6-DOF Parallel Robot for Intra-Operative Radiation Therapy","authors":"Baoying Peng,&nbsp;Yushuo Zhu,&nbsp;Chuanmeng Niu","doi":"10.1002/rcs.70076","DOIUrl":"https://doi.org/10.1002/rcs.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In order to meet the kinematic requirements of large range of motion, payload, and stiffness of Intra-Operative Radiation Therapy robots, a 6-degree-of-freedom (DOF) parallel platform (Stewart-Gough mechanism) is introduced and a dimensional synthesis study is carried out.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The kinematic and static stiffness models of the 6-DOF parallel robot for Intra-Operative Radiation Therapy are derived around a virtual isocentric control point. Under the premise of ensuring the positional accuracy, the optimal dimensions of the initial rod length, the radius of the fixed base and movable platform, and the circumferential angle of the 6-DOF parallel platform are obtained by using the multi-objective optimization method combining the non-dominated sorting genetic algorithm and the global 4criterion with the working space, stiffness, and load as the optimization objectives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A full-size prototype was built, and experiments on payload, range of motion, modality, and harmonic response were carried out.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results show that the theoretical stiffness model has high accuracy, and the dimensional synthesised 6-DOF parallel platform can meet the clinical requirements of Intra-Operative Radiation Therapy in terms of workspace, stiffness and payload, as well as position accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The equipment in this study has not yet obtained a medical device registration certificate, and the 6-DOF parallel robot for Intra-Operative Radiation Therapy experiments were conducted using a self-developed model, which has not yet been subjected to clinical trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206937","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}
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International Journal of Medical Robotics and Computer Assisted Surgery
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