Robotic systems are increasingly used to enhance clinical outcomes in prostate intervention. To evaluate the clinical value of the proposed portable robot, the robot-assisted and robot-targeted punctures were validated experimentally.
Method
The robot registration utilising the electromagnetic tracker achieves coordinate transformation from the ultrasound (US) image to the robot. Subsequently, Transrectal ultrasound (TRUS)-guided phantom trials were conducted for robot-assisted, free-hand, and robot-targeted punctures.
Results
The accuracy of robot registration was 0.95 mm, and the accuracy of robot-assisted, free-hand, and robot-targeted punctures was 2.38 ± 0.64 mm, 3.11 ± 0.72 mm, and 3.29 ± 0.83 mm sequentially.
Conclusion
The registration method has been successfully applied to robot-targeted puncture. Current results indicate that the accuracy of robot-targeted puncture is slightly inferior to that of manual operations. Moreover, in manual operation, robot-assisted puncture improves the accuracy of free-hand puncture. Accuracy superior to 3.5 mm demonstrates the clinical applicability of both robot-assisted and robot-targeted punctures.
{"title":"Preliminary evaluation for ultrasound-guided targeted prostate biopsy using a portable surgical robot: Ex vivo results","authors":"Wenhe Jiang, Yongzhuo Gao, Mingwei Wen, Zhichao Ye, Huageng Liang, Dongmei Wu, Wei Dong","doi":"10.1002/rcs.2597","DOIUrl":"10.1002/rcs.2597","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic systems are increasingly used to enhance clinical outcomes in prostate intervention. To evaluate the clinical value of the proposed portable robot, the robot-assisted and robot-targeted punctures were validated experimentally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The robot registration utilising the electromagnetic tracker achieves coordinate transformation from the ultrasound (US) image to the robot. Subsequently, Transrectal ultrasound (TRUS)-guided phantom trials were conducted for robot-assisted, free-hand, and robot-targeted punctures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The accuracy of robot registration was 0.95 mm, and the accuracy of robot-assisted, free-hand, and robot-targeted punctures was 2.38 ± 0.64 mm, 3.11 ± 0.72 mm, and 3.29 ± 0.83 mm sequentially.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The registration method has been successfully applied to robot-targeted puncture. Current results indicate that the accuracy of robot-targeted puncture is slightly inferior to that of manual operations. Moreover, in manual operation, robot-assisted puncture improves the accuracy of free-hand puncture. Accuracy superior to 3.5 mm demonstrates the clinical applicability of both robot-assisted and robot-targeted punctures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178234","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}
Gloria Coden, Patrick Greenwell, Ruijia Niu, Christopher Fang, Carl Talmo, Eric L. Smith
Introduction
Little information is known regarding the energy expenditure of the surgeon during total hip arthroplasty (THA). We sought to compare the energy expenditure associated with femoral broaching using two techniques: manual and automated.
Methods
We recorded energy expenditure, minute ventilation, heart rate, and total broaching time of a single surgeon while broaching the femoral canal during direct anterior THA using two different techniques: Manual broaching (n = 26) and automated broaching (n = 20).
Results
Manual broaching required a longer time than automated broaching (6.1 ± 1.1 vs. 3.7 ± 0.9 min; p < 0.001) with an increase in energy expenditure (32.6 ± 7.0 vs. 16.0 ± 7.1 Calories; p < 0.001). Heart rate was higher with manual broaching (99.4 ± 9.8 vs. 90.1 ± 9.8 beats per min; p = 0.003), along with minute ventilation (36.5 ± 7.0 vs. 30.3 ± 5.8 L/min; p = 0.003). There were no intraoperative complications.
Conclusions
Automated femoral broaching during THA can decrease the energy expenditure of broaching by 50% and time of broaching by 40%, when compared to manual technique.
Clinical Trial Registration
This research was not a clinical trial.
引言:关于全髋关节置换术中外科医生能量消耗的信息很少。我们试图比较使用两种技术(手动和自动)与股骨拉削相关的能量消耗。方法:我们记录了一名外科医生在直接前路THA中牵引股管时的能量消耗、分钟通气量、心率和总牵引时间，使用两种不同的技术:手动牵引(n = 26)和自动牵引(n = 20)。结果:手动拉削比自动拉削所需时间更长(6.1±1.1 vs 3.7±0.9 min);结论:与手动技术相比，THA期间自动股骨拉削可以减少50%的拉削能量消耗和40%的拉削时间。临床试验注册:本研究不是临床试验。
{"title":"Energy expenditure of femoral broaching in direct anterior total hip replacements—Comparison between manual and automated techniques","authors":"Gloria Coden, Patrick Greenwell, Ruijia Niu, Christopher Fang, Carl Talmo, Eric L. Smith","doi":"10.1002/rcs.2592","DOIUrl":"10.1002/rcs.2592","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Little information is known regarding the energy expenditure of the surgeon during total hip arthroplasty (THA). We sought to compare the energy expenditure associated with femoral broaching using two techniques: manual and automated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We recorded energy expenditure, minute ventilation, heart rate, and total broaching time of a single surgeon while broaching the femoral canal during direct anterior THA using two different techniques: Manual broaching (<i>n</i> = 26) and automated broaching (<i>n</i> = 20).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Manual broaching required a longer time than automated broaching (6.1 ± 1.1 vs. 3.7 ± 0.9 min; <i>p</i> < 0.001) with an increase in energy expenditure (32.6 ± 7.0 vs. 16.0 ± 7.1 Calories; <i>p</i> < 0.001). Heart rate was higher with manual broaching (99.4 ± 9.8 vs. 90.1 ± 9.8 beats per min; <i>p</i> = 0.003), along with minute ventilation (36.5 ± 7.0 vs. 30.3 ± 5.8 L/min; <i>p</i> = 0.003). There were no intraoperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Automated femoral broaching during THA can decrease the energy expenditure of broaching by 50% and time of broaching by 40%, when compared to manual technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trial Registration</h3>\u0000 \u0000 <p>This research was not a clinical trial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178233","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}
Yibo Tang, Min Chen, Yuan Xing, Yu Wang, Honglei Wang, Yunpeng Ji
Background
A training system that allows the trainee to perform laparoscopic suturing in a realistic environment and measures the force applied to the tissue would be invaluable. This study aims to establish the construct and content validity of the training system we developed for the objective assessment of surgeons' skills.
Methods
Ten novices, 6 residents, and 6 experts performed the suturing and knot-tying task using the training system. Ten force-related parameters were used to analyse the system's construct validity. Experts were invited to evaluate the content validity with questionnaires.
Results
Eight parameters showed significant differences between the three groups. The construct validity results demonstrated that the system could distinguish the tissue handling ability of operators. The experts agreed that the system had excellent content validity with an average score of 4.71/5.
Conclusions
The training system is likely valid for surgical training. It can realistically simulate surgical scenarios and evaluate the tissue handling ability of trainees.
{"title":"Validation of a training system for laparoscopic longitudinal suturing in lesion","authors":"Yibo Tang, Min Chen, Yuan Xing, Yu Wang, Honglei Wang, Yunpeng Ji","doi":"10.1002/rcs.2594","DOIUrl":"10.1002/rcs.2594","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A training system that allows the trainee to perform laparoscopic suturing in a realistic environment and measures the force applied to the tissue would be invaluable. This study aims to establish the construct and content validity of the training system we developed for the objective assessment of surgeons' skills.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten novices, 6 residents, and 6 experts performed the suturing and knot-tying task using the training system. Ten force-related parameters were used to analyse the system's construct validity. Experts were invited to evaluate the content validity with questionnaires.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight parameters showed significant differences between the three groups. The construct validity results demonstrated that the system could distinguish the tissue handling ability of operators. The experts agreed that the system had excellent content validity with an average score of 4.71/5.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The training system is likely valid for surgical training. It can realistically simulate surgical scenarios and evaluate the tissue handling ability of trainees.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523788","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}
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, Valentina Valle, Yuntao Bing, Dianrong Xiu, Gregorio Di Franco, Nicola de' Angelis, Alexis Laurent, Giuseppe Giuliani, Graziano Pernazza, Riccardo Memeo, José Rios, Andrea Coratti, Luca Morelli, Pier C. Giulianotti
Background
Robotic distal pancreatectomy (RDP) is associated with a lower conversion rate and less blood loss than laparoscopic distal pancreatectomy (LDP). LDP has similar oncological outcomes as open surgery in PDAC. The aim of this study was to compare perioperative and oncological outcomes in obese patients with RDP versus LDP for PDAC.
Materials and methods
Retrospectively, all obese patients who underwent RDP or LDP for PDAC between 2012 and 2022 at 12 international expert centres were included.
Results
out of 372, 81 patients were included. All baseline features were comparable between the two groups. RDP was associated with decreased blood loss (495mlLDP vs. 188mlRDP; p = 0.003), lower conversion rate (13.5%RDP vs. 36.4%LDP; p = 0.019) and lower rate of Clavien-Dindo ≥3 complications (13.5%RDP vs. 36.4%LDP; p = 0.019). Overall and disease-free survival were comparable.
Conclusions
In obese patients with left-sided PDAC, the robotic approach was associated with improved intraoperative outcomes and fewer severe complications.
{"title":"Robotic versus laparoscopic distal pancreatectomy for pancreatic adenocarcinoma in obese patients","authors":"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, Valentina Valle, Yuntao Bing, Dianrong Xiu, Gregorio Di Franco, Nicola de' Angelis, Alexis Laurent, Giuseppe Giuliani, Graziano Pernazza, Riccardo Memeo, José Rios, Andrea Coratti, Luca Morelli, Pier C. Giulianotti","doi":"10.1002/rcs.2596","DOIUrl":"10.1002/rcs.2596","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic distal pancreatectomy (RDP) is associated with a lower conversion rate and less blood loss than laparoscopic distal pancreatectomy (LDP). LDP has similar oncological outcomes as open surgery in PDAC. The aim of this study was to compare perioperative and oncological outcomes in obese patients with RDP versus LDP for PDAC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>Retrospectively, all obese patients who underwent RDP or LDP for PDAC between 2012 and 2022 at 12 international expert centres were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>out of 372, 81 patients were included. All baseline features were comparable between the two groups. RDP was associated with decreased blood loss (495mlLDP vs. 188mlRDP; <i>p</i> = 0.003), lower conversion rate (13.5%RDP vs. 36.4%LDP; <i>p</i> = 0.019) and lower rate of Clavien-Dindo ≥3 complications (13.5%RDP vs. 36.4%LDP; <i>p</i> = 0.019). Overall and disease-free survival were comparable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In obese patients with left-sided PDAC, the robotic approach was associated with improved intraoperative outcomes and fewer severe complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489831","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}
In robot-assisted surgery, automatic segmentation of surgical instrument images is crucial for surgical safety. The proposed method addresses challenges in the craniotomy environment, such as occlusion and illumination, through an efficient surgical instrument segmentation network.
Methods
The network uses YOLOv8 as the target detection framework and integrates a semantic segmentation head to achieve detection and segmentation capabilities. A concatenation of multi-channel feature maps is designed to enhance model generalisation by fusing deep and shallow features. The innovative GBC2f module ensures the lightweight of the network and the ability to capture global information.
Results
Experimental validation of the intracranial glioma surgical instrument dataset shows excellent performance: 94.9% MPA score, 89.9% MIoU value, and 126.6 FPS.
Conclusions
According to the experimental results, the segmentation model proposed in this study has significant advantages over other state-of-the-art models. This provides a valuable reference for the further development of intelligent surgical robots.
{"title":"MFF-Net: Multiscale feature fusion semantic segmentation network for intracranial surgical instruments","authors":"Zhenzhong Liu, Laiwang Zheng, Shubin Yang, Zichen Zhong, Guobin Zhang","doi":"10.1002/rcs.2595","DOIUrl":"10.1002/rcs.2595","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In robot-assisted surgery, automatic segmentation of surgical instrument images is crucial for surgical safety. The proposed method addresses challenges in the craniotomy environment, such as occlusion and illumination, through an efficient surgical instrument segmentation network.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The network uses YOLOv8 as the target detection framework and integrates a semantic segmentation head to achieve detection and segmentation capabilities. A concatenation of multi-channel feature maps is designed to enhance model generalisation by fusing deep and shallow features. The innovative GBC2f module ensures the lightweight of the network and the ability to capture global information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Experimental validation of the intracranial glioma surgical instrument dataset shows excellent performance: 94.9% MPA score, 89.9% MIoU value, and 126.6 FPS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>According to the experimental results, the segmentation model proposed in this study has significant advantages over other state-of-the-art models. This provides a valuable reference for the further development of intelligent surgical robots.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489830","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}
To summarise the application of minimally invasive surgery for female primary pelvic retroperitoneal tumours (PPRTs).
Methods
The clinical data of PPRT in a hospital between January 2017 and August 2022 were retrospectively collected. Surgical outcomes for cystic and solid tumours and two minimally invasive techniques were compared.
Results
99 patients were included. Cystic tumours had fewer intraoperative injuries (4.0% vs. 28.0%, p < 0.001) than solid tumours. Robot-assisted laparoscopy (RALS) seemed to have fewer intraoperative complications (8.3% vs. 35.1%, p = 0.156) than conventional laparoscopy (CLS) in solid tumours. For cystic tumours, RALS included larger tumour sizes and longer operative times (p < 0.05), but intraoperative injury was comparable to CLS. RALS exhibited a higher cost than CLS in all tumours.
Conclusions
Minimally invasive surgery for solid PPRTs tends to be more difficult than for cystic tumours, and RALS has a slight advantage over CLS with respect to short-term PPRT outcomes.
{"title":"The surgical treatment of female primary pelvic retroperitoneal tumours: A retrospective study of 99 patients from a single centre in China","authors":"Xueyan Liu, Mengling Zhao, Hanlin Fu, Lulu Si, Qian Wang, Meng Mao, Ying Zhu, Ruixia Guo","doi":"10.1002/rcs.2591","DOIUrl":"10.1002/rcs.2591","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To summarise the application of minimally invasive surgery for female primary pelvic retroperitoneal tumours (PPRTs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The clinical data of PPRT in a hospital between January 2017 and August 2022 were retrospectively collected. Surgical outcomes for cystic and solid tumours and two minimally invasive techniques were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>99 patients were included. Cystic tumours had fewer intraoperative injuries (4.0% vs. 28.0%, <i>p</i> < 0.001) than solid tumours. Robot-assisted laparoscopy (RALS) seemed to have fewer intraoperative complications (8.3% vs. 35.1%, <i>p</i> = 0.156) than conventional laparoscopy (CLS) in solid tumours. For cystic tumours, RALS included larger tumour sizes and longer operative times (<i>p</i> < 0.05), but intraoperative injury was comparable to CLS. RALS exhibited a higher cost than CLS in all tumours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Minimally invasive surgery for solid PPRTs tends to be more difficult than for cystic tumours, and RALS has a slight advantage over CLS with respect to short-term PPRT outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415850","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}
Ruixuan Li, Ayoob Davoodi, Yuyu Cai, Gianni Borghesan, Nicola Cavalcanti, Christoph J. Laux, Mazda Farshad, Fabio Carrillo, Philipp Fürnstahl, Emmanuel Vander Poorten
Purpose
Spinal instrumentation with pedicle screw placement (PSP) is an important surgical technique for spinal diseases. Accurate screw trajectory is a prerequisite for PSP. Ultrasound (US) imaging with robot-assisted system forms a non-radiative alternative to provide precise screw trajectory. This study reports on the development and assessment of US navigation for this application.
Methods
A robot-assisted US reconstruction was proposed and an automatic CT-to-US registration algorithm was investigated, allowing the registration of screw trajectories. Experiments were conducted on ex-vivo lamb spines to evaluate system performance.
Results
In total, 72 screw trajectories are measured, displaying an average position accuracy of 2.80 ± 1.14 mm and orientation accuracy of 1.38 ± 0.61°.
Conclusion
The experimental results demonstrate the feasibility of proposed US system. This work, although restricted to laboratory settings, encourages further exploration of the potential of this technology in clinical practice.
{"title":"Development and evaluation of robot-assisted ultrasound navigation system for pedicle screw placement: An ex-vivo animal validation","authors":"Ruixuan Li, Ayoob Davoodi, Yuyu Cai, Gianni Borghesan, Nicola Cavalcanti, Christoph J. Laux, Mazda Farshad, Fabio Carrillo, Philipp Fürnstahl, Emmanuel Vander Poorten","doi":"10.1002/rcs.2590","DOIUrl":"10.1002/rcs.2590","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Spinal instrumentation with pedicle screw placement (PSP) is an important surgical technique for spinal diseases. Accurate screw trajectory is a prerequisite for PSP. Ultrasound (US) imaging with robot-assisted system forms a non-radiative alternative to provide precise screw trajectory. This study reports on the development and assessment of US navigation for this application.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A robot-assisted US reconstruction was proposed and an automatic CT-to-US registration algorithm was investigated, allowing the registration of screw trajectories. Experiments were conducted on ex-vivo lamb spines to evaluate system performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 72 screw trajectories are measured, displaying an average position accuracy of 2.80 ± 1.14 mm and orientation accuracy of 1.38 ± 0.61°.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The experimental results demonstrate the feasibility of proposed US system. This work, although restricted to laboratory settings, encourages further exploration of the potential of this technology in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50159508","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}
Claudia Collà Ruvolo, Margarita Afonina, Eleonora Balestrazzi, Marco Paciotti, Adele Piro, Federico Piramide, Carlo Andrea Bravi, Maria Peraire Lores, Gabriele Sorce, Mario Belmonte, Silvia Rebuffo, Marco Ticonosco, Nicola Frego, Giorgia Gaia, Ruben De Groote, Alexandre Mottrie, Geert De Naeyer
Background
We aimed to compare the outcomes of Robot-assisted sacrocolpopexy (RASC) performed using the novel HUGOTM Robot-Assisted Surgery (RAS) System with the Da Vinci® Xi surgical system.
Methods
Data from 38 women undergoing RASC for a ≥ 2-grade pelvic organ prolapse were collected (2021–2023).
Results
Overall, 23 (60.5%) and 15 (39.5%) procedures were performed using the DaVinci® Xi and the HUGOTM RAS system, respectively. The median total operative time was 123 (IQR:106.5–140.5) minutes for the DaVinci® Xi versus 120 (IQR:120–146) minutes for the HUGOTM RAS cases (p = 0.5). No conversion to open/laparoscopic surgery, perioperative complications, or system failures occurred. No differences were recorded according to day of catheter removal and length of stay.
Conclusions
This study represents the first worldwide comparison of RASC executed using the HUGOTM RAS versus the Da Vinci® Xi System. Our data suggest that RASC might be performed with both robotic platforms with similar perioperative outcomes.
{"title":"A comparative analysis of the HUGOTM robot-assisted surgery system and the Da Vinci® Xi surgical system for robot-assisted sacrocolpopexy for pelvic organ prolapse treatment","authors":"Claudia Collà Ruvolo, Margarita Afonina, Eleonora Balestrazzi, Marco Paciotti, Adele Piro, Federico Piramide, Carlo Andrea Bravi, Maria Peraire Lores, Gabriele Sorce, Mario Belmonte, Silvia Rebuffo, Marco Ticonosco, Nicola Frego, Giorgia Gaia, Ruben De Groote, Alexandre Mottrie, Geert De Naeyer","doi":"10.1002/rcs.2587","DOIUrl":"10.1002/rcs.2587","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to compare the outcomes of Robot-assisted sacrocolpopexy (RASC) performed using the novel HUGO<sup>TM</sup> Robot-Assisted Surgery (RAS) System with the Da Vinci<sup>®</sup> Xi surgical system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 38 women undergoing RASC for <i>a</i> ≥ 2-grade pelvic organ prolapse were collected (2021–2023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 23 (60.5%) and 15 (39.5%) procedures were performed using the DaVinci<sup>®</sup> Xi and the HUGO<sup>TM</sup> RAS system, respectively. The median total operative time was 123 (IQR:106.5–140.5) minutes for the DaVinci<sup>®</sup> Xi versus 120 (IQR:120–146) minutes for the HUGO<sup>TM</sup> RAS cases (<i>p</i> = 0.5). No conversion to open/laparoscopic surgery, perioperative complications, or system failures occurred. No differences were recorded according to day of catheter removal and length of stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study represents the first worldwide comparison of RASC executed using the HUGO<sup>TM</sup> RAS versus the Da Vinci<sup>®</sup> Xi System. Our data suggest that RASC might be performed with both robotic platforms with similar perioperative outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this study was to evaluate the usefulness of Automated Performance Metrics (APMs) in assessing the learning curve.
Methods
A retrospective review of 85 consecutive patients who underwent total robotic colorectal surgery at a single institution between August 2020 and October 2022 was performed. Patient demographics, operation type, and APMs were collected and analysed. Cumulative summation technique (CUSUM) was used to construct learning curves of surgeon console time (SCT), use of the fourth arm, clutch activation, instrument off screen (number and duration), and cut electrocautery activation.
Results
Two phases with 50 and 35 cases were identified from the CUSUM graph for SCT. The SCT was significantly different between the two phases (176 and 251 min, p < 0.002). After adjustment for SCT, the APMs were not significantly different between the two phases.
Conclusions
Most APMs do not offer additional learning curve information when compared with SCT analysis alone.
{"title":"Automated performance metrics, learning curve and robotic colorectal surgery","authors":"Shing Wai Wong, Philip Crowe","doi":"10.1002/rcs.2588","DOIUrl":"10.1002/rcs.2588","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this study was to evaluate the usefulness of Automated Performance Metrics (APMs) in assessing the learning curve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of 85 consecutive patients who underwent total robotic colorectal surgery at a single institution between August 2020 and October 2022 was performed. Patient demographics, operation type, and APMs were collected and analysed. Cumulative summation technique (CUSUM) was used to construct learning curves of surgeon console time (SCT), use of the fourth arm, clutch activation, instrument off screen (number and duration), and cut electrocautery activation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two phases with 50 and 35 cases were identified from the CUSUM graph for SCT. The SCT was significantly different between the two phases (176 and 251 min, <i>p</i> < 0.002). After adjustment for SCT, the APMs were not significantly different between the two phases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most APMs do not offer additional learning curve information when compared with SCT analysis alone.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/rcs.2588","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xingyuan Xiao, Yuancheng Zhou, Shuaishuai Chai, Gong Cheng, Bing Li
Background
To describe the surgical technique of robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation to repair unilateral multifocal ureteral strictures in one stage and report 9-month follow-up outcomes.
Method
A longitudinal ventral incision of proximal ureter strictures No. 1 and 2 was performed, and the appendix was detubularised along its antimesenteric border. Then, the appendiceal onlay flap was anastomosed with the spatulated ureter in an onlay fashion. To manage the distal ureteral stricture No. 3, ureteral reimplantation was performed in a tension-free manner.
Results
Voiding cystourethrography and antegrade urography showed urine regurgitation into the ureter without dilation and no obstruction of the reconstructed ureteral segment 7 weeks after surgery. No postoperative complications occurred during the 9-month follow-up.
Conclusions
Robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation appears to be a safe and effective surgical method for repairing the unilateral multifocal ureteral strictures.
{"title":"Robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation for multifocal ureteral strictures: Case report and technical description","authors":"Xingyuan Xiao, Yuancheng Zhou, Shuaishuai Chai, Gong Cheng, Bing Li","doi":"10.1002/rcs.2589","DOIUrl":"10.1002/rcs.2589","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To describe the surgical technique of robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation to repair unilateral multifocal ureteral strictures in one stage and report 9-month follow-up outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A longitudinal ventral incision of proximal ureter strictures No. 1 and 2 was performed, and the appendix was detubularised along its antimesenteric border. Then, the appendiceal onlay flap was anastomosed with the spatulated ureter in an onlay fashion. To manage the distal ureteral stricture No. 3, ureteral reimplantation was performed in a tension-free manner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Voiding cystourethrography and antegrade urography showed urine regurgitation into the ureter without dilation and no obstruction of the reconstructed ureteral segment 7 weeks after surgery. No postoperative complications occurred during the 9-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Robotic-assisted appendiceal onlay flap ureteroplasty combined with ureteral reimplantation appears to be a safe and effective surgical method for repairing the unilateral multifocal ureteral strictures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50311,"journal":{"name":"International Journal of Medical Robotics and Computer Assisted Surgery","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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