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}
Yulan Wang, Weimin Liu, Peng Yu, Xin Huang, Junjun Pan
Background
Pancreatic diseases such as cancer and pancreatitis pose significant health risks. Early detection requires precise segmentation results. Fully automatic segmentation algorithms cannot integrate clinical expertise and correct output errors, while interactive methods can offer a better chance for higher accuracy and reliability.
Methods
We proposed a new network—RRM-TransUNet for the interactive pancreas segmentation task in CT images aiming to provide more reliable and precise results. The network incorporates Rotary Position Embedding, Root Mean Square Normalisation, and a Mixture of Experts mechanism. An intuitive interface is constructed for user-aided pancreas segmentation.
Results
RRM-TransUNet achieves outstanding performance on multiple datasets, with a Dice Similarity Coefficient (DSC) of 93.82% and an Average Symmetric Surface Distance error (ASSD) of 1.12 mm on MSD, 93.79%/1.15 mm on AMOS, and 93.68%/1.18 mm on AbdomenCT-1K.
Conclusion
Our method outperforms previous methods and provides doctors with an efficient and user-friendly interactive pancreas segmentation experience through the intuitive interface.
{"title":"RRM-TransUNet: Deep-Learning Driven Interactive Model for Precise Pancreas Segmentation in CT Images","authors":"Yulan Wang, Weimin Liu, Peng Yu, Xin Huang, Junjun Pan","doi":"10.1002/rcs.70065","DOIUrl":"https://doi.org/10.1002/rcs.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pancreatic diseases such as cancer and pancreatitis pose significant health risks. Early detection requires precise segmentation results. Fully automatic segmentation algorithms cannot integrate clinical expertise and correct output errors, while interactive methods can offer a better chance for higher accuracy and reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We proposed a new network—RRM-TransUNet for the interactive pancreas segmentation task in CT images aiming to provide more reliable and precise results. The network incorporates Rotary Position Embedding, Root Mean Square Normalisation, and a Mixture of Experts mechanism. An intuitive interface is constructed for user-aided pancreas segmentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RRM-TransUNet achieves outstanding performance on multiple datasets, with a Dice Similarity Coefficient (DSC) of 93.82% and an Average Symmetric Surface Distance error (ASSD) of 1.12 mm on MSD, 93.79%/1.15 mm on AMOS, and 93.68%/1.18 mm on AbdomenCT-1K.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our method outperforms previous methods and provides doctors with an efficient and user-friendly interactive pancreas segmentation experience through the intuitive interface.</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":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818363","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 prostate brachytherapy, oblique-tip needles are frequently used to deliver radioactive seeds to the target area. These needles often experience deflection during insertion, leading to deviations from the planned trajectory and compromising treatment accuracy.
Method
This study did not involve human participants or animals, and therefore, ethics review and approval were not required. The proposed method combines preoperative needle trajectory planning with real-time intraoperative corrections, using an adaptive PID controller enhanced by reinforcement learning to adjust corrective forces during needle insertion.
Results
Experimental results demonstrated that the proposed method reduced the average seed implantation error to 1.92 mm, with a standard error of 0.56 mm. These findings indicate that the method minimises needle deflection and improves precision in seed implantation.
Conclusion
The proposed modular robotic system and puncture control method enhance the precision of seed implantation and show promise for improving treatment outcomes in prostate cancer therapy.
{"title":"Research on Prostate Brachytherapy Robot Design and Puncture Control Strategy","authors":"Xuesong Dai, Yongde Zhang, Yue Sun","doi":"10.1002/rcs.70059","DOIUrl":"https://doi.org/10.1002/rcs.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In prostate brachytherapy, oblique-tip needles are frequently used to deliver radioactive seeds to the target area. These needles often experience deflection during insertion, leading to deviations from the planned trajectory and compromising treatment accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This study did not involve human participants or animals, and therefore, ethics review and approval were not required. The proposed method combines preoperative needle trajectory planning with real-time intraoperative corrections, using an adaptive PID controller enhanced by reinforcement learning to adjust corrective forces during needle insertion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Experimental results demonstrated that the proposed method reduced the average seed implantation error to 1.92 mm, with a standard error of 0.56 mm. These findings indicate that the method minimises needle deflection and improves precision in seed implantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The proposed modular robotic system and puncture control method enhance the precision of seed implantation and show promise for improving treatment outcomes in prostate cancer therapy.</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":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690008","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}
Traditional robot-assisted hysterectomy port placement causes visible scarring. We developed a novel diamond-shaped lower abdominal port placement technique using the Hugo RAS System, designed to minimise scarring while maintaining surgical efficacy through the system's modular design.
Methods
We analysed records of 72 robot-assisted hysterectomies performed between November 2023 and August 2024, including six cases using diamond port placement. We evaluated demographics, operative metrics, complications, and pain scores.
Results
Median operative time was 70 min, with minimal blood loss and no complications. Postoperative pain scores at 24 h (median 2.5) were significantly lower than preoperative expectations (median 7.0, p = 0.00409).
Conclusions
The lower abdominal diamond port placement technique for Hugo RAS System hysterectomy appears safe and effective, potentially improving cosmetic outcomes while maintaining surgical efficiency.
{"title":"First Case Series of Robotic-Assisted Hysterectomy Below the Bikini Line: ‘Diamond’ Port Placement Using the Hugo RAS System","authors":"Ikuko Sakamoto, Yoshihiko Ito, Kosuke Matsuda, Takahiro Nozaki, Keiko Kagami","doi":"10.1002/rcs.70061","DOIUrl":"https://doi.org/10.1002/rcs.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Traditional robot-assisted hysterectomy port placement causes visible scarring. We developed a novel diamond-shaped lower abdominal port placement technique using the Hugo RAS System, designed to minimise scarring while maintaining surgical efficacy through the system's modular design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed records of 72 robot-assisted hysterectomies performed between November 2023 and August 2024, including six cases using diamond port placement. We evaluated demographics, operative metrics, complications, and pain scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median operative time was 70 min, with minimal blood loss and no complications. Postoperative pain scores at 24 h (median 2.5) were significantly lower than preoperative expectations (median 7.0, <i>p</i> = 0.00409).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The lower abdominal diamond port placement technique for Hugo RAS System hysterectomy appears safe and effective, potentially improving cosmetic outcomes while maintaining surgical efficiency.</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":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632990","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}
Compared with traditional open surgery, robotic-assisted minimally invasive surgery lacks force sensing ability.
Methods
A sensorless transparency optimised force safety mechanism is put forward to improve the external force safety of the surgical robot in this paper. An improved fixed-time indirect adaptive fuzzy controller is proposed to approximate the unknown uncertainties in the dynamics of the patient-side manipulator. An online force simulation controller is designed based on the hierarchical force.
Results
Simulations and experiments demonstrate that the designed fixed-time indirect adaptive fuzzy controller exhibits excellent performance in trajectory tracking, fixed-time convergence, fuzzy approximation, and smooth control input. In addition, the online force simulation controller effectively decreases the force in the potentially unsafe area, thereby inhibiting the unsafe force.
Conclusions
This mechanism offers potential applications to improve the safety of external forces for the sensorless surgical robots.
{"title":"Sensorless Transparency Optimised Force Safety Guarantee Mechanism for Robot-Assisted Minimally Invasive Surgery","authors":"Fang Huang, Hongqiang Sang, Fen Liu, Rui Han","doi":"10.1002/rcs.70060","DOIUrl":"https://doi.org/10.1002/rcs.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Compared with traditional open surgery, robotic-assisted minimally invasive surgery lacks force sensing ability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A sensorless transparency optimised force safety mechanism is put forward to improve the external force safety of the surgical robot in this paper. An improved fixed-time indirect adaptive fuzzy controller is proposed to approximate the unknown uncertainties in the dynamics of the patient-side manipulator. An online force simulation controller is designed based on the hierarchical force.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Simulations and experiments demonstrate that the designed fixed-time indirect adaptive fuzzy controller exhibits excellent performance in trajectory tracking, fixed-time convergence, fuzzy approximation, and smooth control input. In addition, the online force simulation controller effectively decreases the force in the potentially unsafe area, thereby inhibiting the unsafe force.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This mechanism offers potential applications to improve the safety of external forces for the sensorless surgical robots.</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":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602474","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}
Robotic systems are increasingly utilised to improve clinical outcomes in prostate interventions.
Methods
We enroled 20 patients to verify the clinical feasibility of transrectal ultrasound (TRUS)-guided robot-assisted prostate biopsy (PBx). For each patient, controlled trials of systematic 12-core PBx were initially conducted manually using a biopsy gun, followed by a 3-core cognitive fusion targeted biopsy performed by the hand-held robot.
Results
The targeting errors for robot-assisted biopsy and freehand biopsy were 3.71 ± 1.41 mm and 3.94 ± 1.49 mm, respectively. Their cancer core rates were 19.1% and 12.6%, and the average duration of each biopsy was 6.94 min and 1.62 min, respectively.
Conclusions
The robot's sampling success rate was lower than that of freehand with a biopsy gun in the clinical trial. However, robot-assisted PBx has shown improved cancer core rate, slightly enhanced surgical accuracy, and the capability to reach clinically significant tumours' 5 mm error range, all demonstrating its clinical value.
{"title":"Safety and Efficacy Clinical Trial of Robot-Assisted Prostate Biopsy Using a Hand-Held Robotic System","authors":"Wenhe Jiang, Yongzhuo Gao, Mingwei Wen, Qiangqiang Huang, Hui Dong, Huageng Liang, Dongmei Wu, Wei Dong","doi":"10.1002/rcs.70062","DOIUrl":"https://doi.org/10.1002/rcs.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic systems are increasingly utilised to improve clinical outcomes in prostate interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enroled 20 patients to verify the clinical feasibility of transrectal ultrasound (TRUS)-guided robot-assisted prostate biopsy (PBx). For each patient, controlled trials of systematic 12-core PBx were initially conducted manually using a biopsy gun, followed by a 3-core cognitive fusion targeted biopsy performed by the hand-held robot.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The targeting errors for robot-assisted biopsy and freehand biopsy were 3.71 ± 1.41 mm and 3.94 ± 1.49 mm, respectively. Their cancer core rates were 19.1% and 12.6%, and the average duration of each biopsy was 6.94 min and 1.62 min, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The robot's sampling success rate was lower than that of freehand with a biopsy gun in the clinical trial. However, robot-assisted PBx has shown improved cancer core rate, slightly enhanced surgical accuracy, and the capability to reach clinically significant tumours' 5 mm error range, all demonstrating its clinical value.</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":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143581824","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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