Wenda Xu, Zhihang Tan, Zexin Cao, Haofei Ma, Gongcheng Wang, Han Wang, Weidong Wang, Zhijiang Du
Background
Emerging imitation learning (IL) approaches have provided innovative solutions for completing surgical robotic suturing autonomously, significantly aiding surgeons in their manipulations.
Methods
We introduce Diffusion Policy for Autonomous Suturing (DP4AuSu), a novel framework that leverages diffusion policy (DP) and dynamic time wrapping-based locally weighted regression to achieve autonomous robotic suturing.
Results
In simulation, DP4AuSu achieved a 94% success rate for insertion subtasks over 50 trials. In a real-world setting, it achieves 85% success rate over 20 trials for suturing manipulations in 390.55–41.59s faster than conventional diffusion policy.
Conclusions
Our novel framework can capture the multimodality in demonstrations and successfully learn the suturing policy and reduce the suturing time. To the best of our knowledge, this work represents the first application of diffusion policy for robotic suturing. We hope this research paves the way for the automation of more complex surgical tasks.
新兴的模仿学习（IL）方法为自主完成手术机器人缝合提供了创新的解决方案，极大地帮助了外科医生的操作。方法引入自主缝合的扩散策略（Diffusion Policy for Autonomous suture, DP4AuSu），这是一个利用扩散策略（Diffusion Policy， DP）和基于动态时间包裹的局部加权回归来实现机器人自主缝合的新框架。结果在仿真中，DP4AuSu在50次试验中插入子任务的成功率达到94%。在现实环境中，与传统的扩散策略相比，它在390.55 - 41.59秒内完成了20次缝合操作，成功率达到85%。结论该框架能有效地捕捉多模态，有效地学习缝合策略，缩短缝合时间。据我们所知，这项工作代表了扩散策略在机器人缝合中的首次应用。我们希望这项研究能为更复杂的手术任务的自动化铺平道路。
{"title":"DP4AuSu: Autonomous Surgical Framework for Suturing Manipulation Using Diffusion Policy With Dynamic Time Wrapping-Based Locally Weighted Regression","authors":"Wenda Xu, Zhihang Tan, Zexin Cao, Haofei Ma, Gongcheng Wang, Han Wang, Weidong Wang, Zhijiang Du","doi":"10.1002/rcs.70072","DOIUrl":"https://doi.org/10.1002/rcs.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Emerging imitation learning (IL) approaches have provided innovative solutions for completing surgical robotic suturing autonomously, significantly aiding surgeons in their manipulations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We introduce Diffusion Policy for Autonomous Suturing (DP4AuSu), a novel framework that leverages diffusion policy (DP) and dynamic time wrapping-based locally weighted regression to achieve autonomous robotic suturing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In simulation, DP4AuSu achieved a 94% success rate for insertion subtasks over 50 trials. In a real-world setting, it achieves 85% success rate over 20 trials for suturing manipulations in 390.55–41.59s faster than conventional diffusion policy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our novel framework can capture the multimodality in demonstrations and successfully learn the suturing policy and reduce the suturing time. To the best of our knowledge, this work represents the first application of diffusion policy for robotic suturing. We hope this research paves the way for the automation of more complex surgical tasks.</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":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085186","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}
Current instruments used in tight spaces face challenges. Additionally, accessing the endoscopic sinus pathway is complex due to its curved and narrow nature, requiring intricate manual manoeuvres. Therefore, there is a demand for the development of a flexible instrument.
Methods
In this study, a rigid-flex coupling flexible manipulator was designed specifically for endoscopic sinus surgery. The investigation includes various theoretical analyses such as clinical requirements, stiffness, kinematics, statics and master–slave control strategy.
Results
The manipulator is fabricated and its properties is evaluated. The experimental results demonstrate that the proposed theoretical model accurately describes the motion of the manipulator. Furthermore, the feasibility of the manipulator was verified using both 3D-printed sinus models and human head models.
Conclusions
Based on our findings, the proposed flexible manipulator successfully meets the basic requirements of endoscopic sinus surgery.
{"title":"Design of a Rigid-Flex Coupling Flexible Manipulator for Endoscopic Sinus Surgery","authors":"Hongyu Cheng, Zheng Liu, Shuang Wang, Le Xie","doi":"10.1002/rcs.70075","DOIUrl":"https://doi.org/10.1002/rcs.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Current instruments used in tight spaces face challenges. Additionally, accessing the endoscopic sinus pathway is complex due to its curved and narrow nature, requiring intricate manual manoeuvres. Therefore, there is a demand for the development of a flexible instrument.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, a rigid-flex coupling flexible manipulator was designed specifically for endoscopic sinus surgery. The investigation includes various theoretical analyses such as clinical requirements, stiffness, kinematics, statics and master–slave control strategy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The manipulator is fabricated and its properties is evaluated. The experimental results demonstrate that the proposed theoretical model accurately describes the motion of the manipulator. Furthermore, the feasibility of the manipulator was verified using both 3D-printed sinus models and human head models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Based on our findings, the proposed flexible manipulator successfully meets the basic requirements of endoscopic sinus surgery.</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":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074584","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 objective of this study was to assess the perioperative outcomes of robot-assisted radical cystectomy (RARC) with intracorporeal ileal conduit (ICIC) using the hinotori surgical robot system.
Methods
This retrospective study included 20 consecutive patients with bladder cancer who underwent RARC with ICIC using hinotori from October 2023 to July 2024. Major perioperative outcomes were comprehensively analysed.
Results
The median operative time, time using the robotic system, bowel reconstruction and urinary diversion time, and estimated blood loss were 435.0, 330.0, 122.5 min, and 175.0 mL, respectively. No marked intraoperative complications were observed. Perioperative, 30-day, and 90-day complications occurred at rates of 25%, 10%, and 0%, respectively. The learning curve tended to decrease in a case volume-dependent manner.
Conclusions
RARC using hinotori was successfully completed, and favourable perioperative outcomes were achieved without severe complications. This suggests that RARC using hinotori provides a potentially comparable alternative to conventional surgical systems.
{"title":"Robot-Assisted Radical Cystectomy With Intracorporeal Ileal Conduit Using the Hinotori Surgical Robot System: A Single Surgeon's Initial Experience of 20 Cases","authors":"Hiromitsu Watanabe, Yuto Matsushita, Keita Tamura, Daisuke Motoyama, Atsushi Otsuka, Hideaki Miyake","doi":"10.1002/rcs.70074","DOIUrl":"https://doi.org/10.1002/rcs.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The objective of this study was to assess the perioperative outcomes of robot-assisted radical cystectomy (RARC) with intracorporeal ileal conduit (ICIC) using the hinotori surgical robot system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 20 consecutive patients with bladder cancer who underwent RARC with ICIC using hinotori from October 2023 to July 2024. Major perioperative outcomes were comprehensively analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median operative time, time using the robotic system, bowel reconstruction and urinary diversion time, and estimated blood loss were 435.0, 330.0, 122.5 min, and 175.0 mL, respectively. No marked intraoperative complications were observed. Perioperative, 30-day, and 90-day complications occurred at rates of 25%, 10%, and 0%, respectively. The learning curve tended to decrease in a case volume-dependent manner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RARC using hinotori was successfully completed, and favourable perioperative outcomes were achieved without severe complications. This suggests that RARC using hinotori provides a potentially comparable alternative to conventional surgical systems.</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":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144074585","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}
Xinyi Yu, Yinkai Chen, Baiming Shi, Hao Zhuo, Libo Zhou, Yuye Ma, Yan Wei, Linlin Ou
Background
In endoscopic surgery, surgeons collaborate with assistants to manipulate the endoscope and instruments, making it impossible to perform the surgery independently.
Methods
We propose an endoscopic assistive robot based on motion capture control, enabling surgeons to control the endoscope with one hand. The system uses cameras at the master end to capture real-time motion information from the marker accessory, determining the surgeon's intent. It then controls the robot at the slave end to simulate surgical delivery actions, enabling precise endoscopic positioning through master-slave mapping. The omnidirectional wheel design addresses coupling issues of traditional friction wheels, significantly improving control accuracy.
Results
Testing demonstrated a maximum delivery error of 3.99% and 45.77% improvement in rotational precision. The system received positive feedback in both simulated and animal trials.
Conclusions
The system empowers surgeons to perform endoscopic procedures independently, establishing a foundation for advancing diagnosis and treatment of gastric diseases.
{"title":"Design and Evaluation of an Omnidirectional Wheel-Driven Endoscope-Assisted Robotic System Based on Motion Capture Control","authors":"Xinyi Yu, Yinkai Chen, Baiming Shi, Hao Zhuo, Libo Zhou, Yuye Ma, Yan Wei, Linlin Ou","doi":"10.1002/rcs.70070","DOIUrl":"https://doi.org/10.1002/rcs.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In endoscopic surgery, surgeons collaborate with assistants to manipulate the endoscope and instruments, making it impossible to perform the surgery independently.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We propose an endoscopic assistive robot based on motion capture control, enabling surgeons to control the endoscope with one hand. The system uses cameras at the master end to capture real-time motion information from the marker accessory, determining the surgeon's intent. It then controls the robot at the slave end to simulate surgical delivery actions, enabling precise endoscopic positioning through master-slave mapping. The omnidirectional wheel design addresses coupling issues of traditional friction wheels, significantly improving control accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Testing demonstrated a maximum delivery error of 3.99% and 45.77% improvement in rotational precision. The system received positive feedback in both simulated and animal trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The system empowers surgeons to perform endoscopic procedures independently, establishing a foundation for advancing diagnosis and treatment of gastric diseases.</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":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143944607","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}
Ali A. Nazari, Jeremy Catania, Soroush Sadeghian, Amir Jalali, Houman Masnavi, Farrokh Janabi-Sharifi, Kourosh Zareinia
Background
Over the past 2 decades, telerobotic systems with robot-mediated, minimally invasive techniques, have mitigated radiation exposure for medical staff and extended medical services to remote areas. To enhance these services, master-follower telerobotic systems should offer transparency, enabling surgeons and clinicians to feel force interactions similar to those the follower device experiences with patients' bodies.
Methods
We present a three-degree-of-freedom master-follower teleoperated system for robotic catheterisation. The follower device uses a grip-insert-release mechanism to prevent catheter buckling and torsion, mimicking real-world manual intervention. Performance is evaluated through open-loop path tracking on circular, infinity-like and spiral paths.
Results
Path tracking errors, mean Euclidean error (MEE) and mean absolute error (MAE), range from 0.64 to 1.53 cm (MEE) and 0.81–1.92 cm (MAE) for different paths.
Conclusion
While the system meets precision and accuracy targets with an open-loop controller, closed-loop control is needed to address catheter hysteresis, dead zones and nonlinearities.
{"title":"A Master-Follower Teleoperation System for Robotic Catheterisation: Design, Characterisation and Tracking Control","authors":"Ali A. Nazari, Jeremy Catania, Soroush Sadeghian, Amir Jalali, Houman Masnavi, Farrokh Janabi-Sharifi, Kourosh Zareinia","doi":"10.1002/rcs.70073","DOIUrl":"https://doi.org/10.1002/rcs.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Over the past 2 decades, telerobotic systems with robot-mediated, minimally invasive techniques, have mitigated radiation exposure for medical staff and extended medical services to remote areas. To enhance these services, master-follower telerobotic systems should offer transparency, enabling surgeons and clinicians to feel force interactions similar to those the follower device experiences with patients' bodies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We present a three-degree-of-freedom master-follower teleoperated system for robotic catheterisation. The follower device uses a grip-insert-release mechanism to prevent catheter buckling and torsion, mimicking real-world manual intervention. Performance is evaluated through open-loop path tracking on circular, infinity-like and spiral paths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Path tracking errors, mean Euclidean error (MEE) and mean absolute error (MAE), range from 0.64 to 1.53 cm (MEE) and 0.81–1.92 cm (MAE) for different paths.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While the system meets precision and accuracy targets with an open-loop controller, closed-loop control is needed to address catheter hysteresis, dead zones and nonlinearities.</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":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914530","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}
Gökhan Arslanhan, Zeynep Sıla Özcan, Şahin Şenay, Murat Baştopçu, Anıl Karaağaç, Muharrem Koçyiğit, Aleks Değirmencioğlu, Deniz Alis, Cem Alhan
Background
Robotic assistance has many advantages in minimally invasive coronary bypass surgery, such as the harvest of a longer portion of the LIMA in addition to the avoidance of sternotomy, thus offering a less invasive approach for multivessel revascularisation. We present the midterm clinical outcomes of robotic-assisted minimally invasive coronary bypass (RA-CABG) cases at our centre.
Methods
One hundred and fifty consecutive patients who underwent RA-CABG with preoperative computed tomography angiography guidance were studied. Robotic LIMA harvesting was performed. The main outcome measure of the study was the midterm survival and incidence of major adverse cardiovascular events (MACE) up to 5 years.
Results
The median follow-up was 19.8 months. In the Kaplan–Meier survival analysis, 1-year survival was 99.1% and 5-year survival was 97.5%. 1-year freedom from MACE was 97.3% and 5-year freedom from MACE was 95%.
Conclusions
Robotic-assisted minimally invasive coronary bypass surgery has safe midterm outcomes and can be performed with excellent results.
{"title":"Robotic Assisted Minimally Invasive Coronary Revascularisation: Midterm Results","authors":"Gökhan Arslanhan, Zeynep Sıla Özcan, Şahin Şenay, Murat Baştopçu, Anıl Karaağaç, Muharrem Koçyiğit, Aleks Değirmencioğlu, Deniz Alis, Cem Alhan","doi":"10.1002/rcs.70071","DOIUrl":"https://doi.org/10.1002/rcs.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic assistance has many advantages in minimally invasive coronary bypass surgery, such as the harvest of a longer portion of the LIMA in addition to the avoidance of sternotomy, thus offering a less invasive approach for multivessel revascularisation. We present the midterm clinical outcomes of robotic-assisted minimally invasive coronary bypass (RA-CABG) cases at our centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred and fifty consecutive patients who underwent RA-CABG with preoperative computed tomography angiography guidance were studied. Robotic LIMA harvesting was performed. The main outcome measure of the study was the midterm survival and incidence of major adverse cardiovascular events (MACE) up to 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median follow-up was 19.8 months. In the Kaplan–Meier survival analysis, 1-year survival was 99.1% and 5-year survival was 97.5%. 1-year freedom from MACE was 97.3% and 5-year freedom from MACE was 95%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Robotic-assisted minimally invasive coronary bypass surgery has safe midterm outcomes and can be performed with excellent results.</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":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904973","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 systems enhance physicians' capabilities by replicating hand movements in real-time, ensuring precise control and a quick return to conventional procedures if patient safety is compromised. Physicians performing robot-assisted procedures bear ultimate responsibility, sharing potential liability with manufacturers for malfunctions.
Methods
This study, conducted by a transdisciplinary team of interventional radiologists and a legal expert, evaluates the integration of robotic systems in interventional radiology through a comprehensive literature review, addressing potential legal contingencies.
Results
This paper aims to define liability in this context and examines how workflows and doctor-patient relationships might be reshaped: patients must be informed about treatment options, including details about robot-assisted procedures and associated risks.
Conclusions
These systems could significantly impact interventional radiology practice. A dedicated informed consent process is necessary to ensure clear communication and protect the decision-making process and patient-centred care; thereby, an informed consent is proposed to comprehensively address these needs.
{"title":"Legal Implication in Utilizing Automated Robots: A Written Informed Consent Form Proposal","authors":"Maria Teresa Contaldo, Sonia Triggiani, Giacomo Vignati, Daniele Bracchi, Gianpaolo Carrafiello","doi":"10.1002/rcs.70064","DOIUrl":"https://doi.org/10.1002/rcs.70064","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic systems enhance physicians' capabilities by replicating hand movements in real-time, ensuring precise control and a quick return to conventional procedures if patient safety is compromised. Physicians performing robot-assisted procedures bear ultimate responsibility, sharing potential liability with manufacturers for malfunctions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study, conducted by a transdisciplinary team of interventional radiologists and a legal expert, evaluates the integration of robotic systems in interventional radiology through a comprehensive literature review, addressing potential legal contingencies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This paper aims to define liability in this context and examines how workflows and doctor-patient relationships might be reshaped: patients must be informed about treatment options, including details about robot-assisted procedures and associated risks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These systems could significantly impact interventional radiology practice. A dedicated informed consent process is necessary to ensure clear communication and protect the decision-making process and patient-centred care; thereby, an informed consent is proposed to comprehensively address these needs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.70064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856902","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}
Taylor McClennen, Brian Carvalho, Mohamed Yousef, David C. Ayers
Background
Robotic-assisted total knee arthroplasty (rTKA) offers a new method of surgical management for advanced arthritis of the knee. The objective of this review was to evaluate the current literature evidence comparing rTKA to conventional methods (cTKA) across multiple outcome measures.
Methods
PubMed was used to perform a review of articles that discussed outcomes of primary rTKA. Forty-four articles were selected.
Results
rTKA improves surgical precision and accuracy compared with cTKA, potentially leading to better functional outcomes and fewer complications. rTKA has longer intraoperative times and higher initial costs but leads to shorter hospital stays, lower readmission rates, reduced long-term costs and less revisions. Patient-reported outcomes for rTKA indicate less postoperative pain, reduced opioid use, and improved function.
Conclusions
rTKA may provide improved outcomes compared with cTKA. More robust clinical evidence from US-based multicenter prospective propensity matched trials is needed to fully delineate the long-term benefits and limitations of rTKA.
{"title":"Evaluating Robotic-Assisted Total Knee Arthroplasty Compared to Conventional Methods: A Systematic Review of the Literature in the United States","authors":"Taylor McClennen, Brian Carvalho, Mohamed Yousef, David C. Ayers","doi":"10.1002/rcs.70067","DOIUrl":"https://doi.org/10.1002/rcs.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic-assisted total knee arthroplasty (rTKA) offers a new method of surgical management for advanced arthritis of the knee. The objective of this review was to evaluate the current literature evidence comparing rTKA to conventional methods (cTKA) across multiple outcome measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed was used to perform a review of articles that discussed outcomes of primary rTKA. Forty-four articles were selected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>rTKA improves surgical precision and accuracy compared with cTKA, potentially leading to better functional outcomes and fewer complications. rTKA has longer intraoperative times and higher initial costs but leads to shorter hospital stays, lower readmission rates, reduced long-term costs and less revisions. Patient-reported outcomes for rTKA indicate less postoperative pain, reduced opioid use, and improved function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>rTKA may provide improved outcomes compared with cTKA. More robust clinical evidence from US-based multicenter prospective propensity matched trials is needed to fully delineate the long-term benefits and limitations of rTKA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143850988","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}
Chongan Zhang, Xiaoyue Liu, Zuoming Fu, Guoqing Ding, Liping Qin, Peng Wang, Hong Zhang, Xuesong Ye
Background
Robot and navigation systems can relieve surgeon's difficulties in delicate and safe operation in tortuous lumens in traditional intraluminal procedures (IP). This paper aims to review the three key components of these systems: registration, path planning and shape reconstruction and highlight their limitations and future perspectives.
Methods
An electronic search for relevant studies was performed in Web of Science and Google scholar databases until 2024.
Results
As for 2D–3D registration in IP, we focused on analysing feature extraction. For path planning, this paper proposed a new classification method and focused on selection of planning space and the establishment of path cost. Regarding shape reconstruction, the pros and cons of existing methods are analysed and methods based on fibre optic sensors and electromagnetic (EM) tracking are focused on.
Conclusion
These three technologies in IP have made great progress, but there are still challenges that require further research.
机器人和导航系统可以减轻传统腔内手术中外科医生在弯曲腔内进行精细和安全操作的困难。本文旨在回顾这些系统的三个关键组成部分：配准、路径规划和形状重建，并强调它们的局限性和未来的展望。方法电子检索Web of Science和谷歌学者数据库至2024年的相关研究。结果对于IP的2D-3D配准，我们重点分析了特征提取。对于路径规划，本文提出了一种新的分类方法，重点关注规划空间的选择和路径成本的建立。在形状重建方面，分析了现有方法的优缺点，重点介绍了基于光纤传感器和电磁跟踪的形状重建方法。这三种技术在IP领域取得了很大的进步，但仍存在需要进一步研究的挑战。
{"title":"Registration, Path Planning and Shape Reconstruction for Soft Tools in Robot-Assisted Intraluminal Procedures: A Review","authors":"Chongan Zhang, Xiaoyue Liu, Zuoming Fu, Guoqing Ding, Liping Qin, Peng Wang, Hong Zhang, Xuesong Ye","doi":"10.1002/rcs.70066","DOIUrl":"https://doi.org/10.1002/rcs.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robot and navigation systems can relieve surgeon's difficulties in delicate and safe operation in tortuous lumens in traditional intraluminal procedures (IP). This paper aims to review the three key components of these systems: registration, path planning and shape reconstruction and highlight their limitations and future perspectives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An electronic search for relevant studies was performed in Web of Science and Google scholar databases until 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>As for 2D–3D registration in IP, we focused on analysing feature extraction. For path planning, this paper proposed a new classification method and focused on selection of planning space and the establishment of path cost. Regarding shape reconstruction, the pros and cons of existing methods are analysed and methods based on fibre optic sensors and electromagnetic (EM) tracking are focused on.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These three technologies in IP have made great progress, but there are still challenges that require further research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836398","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}
Due to the joint characteristics and friction, continuum surgical instruments based on hinge joints suffer from issues such as slack and hysteresis, which affect the control precision.
Methods
This study introduces cam-based surgical instruments. The variation in cable length during hinge joint rotation was analysed, prompting a redesign of the cam's outer contour. An experimental platform was built to compare the precision of the traditional circular wheel and the cam mechanism. A prototype of surgical instrument with the proposed design was constructed, which was also put into precision testing.
Results
According to the experimental results, the backlash of the cam mechanism was 82% lower than that of the circular wheel. The backlash of our surgical instrument was reduced by 60% at a 20-degree rotation.
Conclusions
This study shows great potential for improving the control precision of continuum surgical instruments with multiple pairs of hinge joints.
{"title":"Development of a Cam-Based Minimally Invasive Surgical Instrument With Reduced Backlash","authors":"Jinhua Li, Yue Yu, Yuteng Bai, Chengcheng Cai, Xinquan Hao, Jianchang Zhao","doi":"10.1002/rcs.70063","DOIUrl":"https://doi.org/10.1002/rcs.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Due to the joint characteristics and friction, continuum surgical instruments based on hinge joints suffer from issues such as slack and hysteresis, which affect the control precision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study introduces cam-based surgical instruments. The variation in cable length during hinge joint rotation was analysed, prompting a redesign of the cam's outer contour. An experimental platform was built to compare the precision of the traditional circular wheel and the cam mechanism. A prototype of surgical instrument with the proposed design was constructed, which was also put into precision testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>According to the experimental results, the backlash of the cam mechanism was 82% lower than that of the circular wheel. The backlash of our surgical instrument was reduced by 60% at a 20-degree rotation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study shows great potential for improving the control precision of continuum surgical instruments with multiple pairs of hinge joints.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":"21 2","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824728","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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