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Wang SH, Hsieh TH, Chao WP, Lo TY, Huang TS, Chen YH. Application and advantages of a joystick-controlled robotic scope holder in transoral endoscopic thyroidectomy vestibular approach: a comparative study. Updates Surg 2024; 76:1425-1434. [PMID: 38468019 DOI: 10.1007/s13304-024-01783-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 02/03/2024] [Indexed: 03/13/2024]
Abstract
Transoral endoscopic thyroidectomy has gained popularity due to its scarless nature, but the use of a handheld endoscope can lead to an unstable visual field. Soloassist II, a robotic scope holder, enables precise control using a joystick, ensuring stable vision. This study aims to evaluate the application and the advantages of Soloassist II in transoral thyroidectomy. Patients who underwent transoral thyroidectomy with Soloassist II or human assistance between June 2019 and May 2021 were reviewed. Patient demographics and surgical outcomes were compared. The ergonomic stress of the assistant in both groups was also measured. A total of 100 consecutive patients were included: 32 were assisted by Soloassist II and 68 by humans. The Soloassist II group demonstrated significantly shorter operation times (median [IQR]) (165 [149,179] vs. 181 [165,204] min, P = 0.004) in unilateral lobectomy and less blood loss (median [IQR]) (2 [2,2] vs. 2 [2,3] ml, P = 0.002) than the human-assisted group. Postoperative course and complication rates were similar. The musculoskeletal pain of the assistant was significantly higher and involved more areas in the human-assisted group. The utilization of Soloassist II in transoral endoscopic thyroidectomy is easy to set up and leads to shorter operation times, reduced blood loss, and decreased musculoskeletal pain compared to human handheld endoscope. These findings support the potential of Soloassist II in improving surgical outcomes and minimizing physical strain during transoral thyroidectomy.
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Affiliation(s)
- Suo-Hsien Wang
- Department of General Surgery, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung, 204, Taiwan
| | - Tsai-Heng Hsieh
- Department of General Surgery, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung, 204, Taiwan
| | - Wu-Po Chao
- Department of General Surgery, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung, 204, Taiwan
| | - Ta-You Lo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Keelung, Taiwan
| | - Ting-Shuo Huang
- Department of General Surgery, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung, 204, Taiwan
| | - Yu-Hsien Chen
- Department of General Surgery, Chang Gung Memorial Hospital, No. 222, Maijin Rd., Anle Dist., Keelung, 204, Taiwan.
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Khorasani M, Abdurahiman N, Padhan J, Zhao H, Al-Ansari A, Becker AT, Navkar N. Preliminary design and evaluation of a generic surgical scope adapter. Int J Med Robot 2023; 19:e2475. [PMID: 36288569 DOI: 10.1002/rcs.2475] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/21/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Robotic scope assistant systems are used to visualise and navigate the operative field during a laparoscopic surgery. The objective of this work is to design a surgical scope adapter that enables control of different scope types (zero-degree, angulated, and articulated), and can be connected to any six degree-of-freedom robotic manipulator for usage as a robotic scope assistant system. METHODS A surgical scope adapter compatible with different camera heads and scope types was designed and prototyped. The technical performance of the scope adapter was evaluated and a user study was conducted to assess the human-in-the-loop control. RESULTS All the subjects were able to navigate the simulated operative field. The scope adapter permits continuous motion to explore the operative field as well as intermittent motion to accurately focus on the targeted anatomical landmarks. CONCLUSION The modular and generic nature of the surgical scope adapter may enable its usage across different minimally invasive surgeries.
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Affiliation(s)
| | | | | | - Haoran Zhao
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas, USA
| | | | - Aaron T Becker
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas, USA
| | - Nikhil Navkar
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
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Hamza H, Baez VM, Al-Ansari A, Becker AT, Navkar NV. User interfaces for actuated scope maneuvering in surgical systems: a scoping review. Surg Endosc 2023:10.1007/s00464-023-09981-0. [DOI: 10.1007/s00464-023-09981-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/25/2023] [Indexed: 03/29/2023]
Abstract
Abstract
Background
A variety of human computer interfaces are used by robotic surgical systems to control and actuate camera scopes during minimally invasive surgery. The purpose of this review is to examine the different user interfaces used in both commercial systems and research prototypes.
Methods
A comprehensive scoping review of scientific literature was conducted using PubMed and IEEE Xplore databases to identify user interfaces used in commercial products and research prototypes of robotic surgical systems and robotic scope holders. Papers related to actuated scopes with human–computer interfaces were included. Several aspects of user interfaces for scope manipulation in commercial and research systems were reviewed.
Results
Scope assistance was classified into robotic surgical systems (for multiple port, single port, and natural orifice) and robotic scope holders (for rigid, articulated, and flexible endoscopes). Benefits and drawbacks of control by different user interfaces such as foot, hand, voice, head, eye, and tool tracking were outlined. In the review, it was observed that hand control, with its familiarity and intuitiveness, is the most used interface in commercially available systems. Control by foot, head tracking, and tool tracking are increasingly used to address limitations, such as interruptions to surgical workflow, caused by using a hand interface.
Conclusion
Integrating a combination of different user interfaces for scope manipulation may provide maximum benefit for the surgeons. However, smooth transition between interfaces might pose a challenge while combining controls.
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A New Robotic Endoscope Holder for Ear and Sinus Surgery with an Integrated Safety Device. SENSORS 2022; 22:s22145175. [PMID: 35890855 PMCID: PMC9319134 DOI: 10.3390/s22145175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 02/01/2023]
Abstract
In the field of sinus and ear surgery, and more generally in microsurgery, the surgeon is faced with several challenges. The operations are traditionally carried out under binocular loupes, which allows for the surgeon to use both hands for a microinstrument and an aspiration tool. More recently, the development of endoscopic otological surgery allowed for seeing areas that are difficult to access. However, the need to handle the endoscope reduces the surgeon’s ability to use only one instrument at a time. Thus, despite anaesthesia, patient motions during surgery can be very risky and are not that rare. Because the insertion zone in the middle ear or in the sinus cavity is very small, the mobility of the endoscope is limited to a rotation around a virtual point and a translation for the insertion of the camera. A mechanism with remote center motion (RCM) is a good candidate to achieve this movement and allow for the surgeon to access the ear or sinus. Since only the translational motion along the main insertion axis is enabled, the ejection motion along the same axis is safe for the patient. A specific mechanism allows for inserting and ejecting the endoscope. In a sense, the position is controlled, and the velocity is limited. In the opposite sense, the energy stored in the spring allows for very quick ejection if the patient moves. A prototype robot is presented using these new concepts. Commercially available components are used to enable initial tests to be carried out on synthetic bones to validate the mobility of the robot and its safety functions.
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Michel G, Salunkhe DH, Bordure P, Chablat D. Literature Review on Endoscopic Robotic Systems in Ear and Sinus Surgery. J Med Device 2021. [DOI: 10.1115/1.4052516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
In otolaryngologic surgery, endoscopy is increasingly used to provide a better view of hard-to-reach areas and to promote minimally invasive surgery. However, the need to manipulate the endoscope limits the surgeon's ability to operate with only one instrument at a time. Currently, several robotic systems are being developed, demonstrating the value of robotic assistance in microsurgery. The aim of this literature review is to present and classify current robotic systems that are used for otological and endonasal applications. For these solutions, an analysis of the functionalities in relation to the surgeon's needs will be carried out to produce a set of specifications for the creation of new robots.
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Affiliation(s)
- Guillaume Michel
- ENT Department, CHU de Nantes, 1, place A. Ricordeau, Nantes 44093, France
| | - Durgesh Haribhau Salunkhe
- Laboratoire des Sciences du Numérique de Nantes, UMR CNRS 6004, 1 rue de la Noë, Nantes 44321, France
| | - Philippe Bordure
- ENT Department, CHU de Nantes, 1, place A. Ricordeau, Nantes 44093, France
| | - Damien Chablat
- Laboratoire des Sciences du Numérique de Nantes, UMR CNRS 6004, 1 rue de la Noë, Nantes 44321, France
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Campbell RG, Harvey RJ. How close are we to anterior robotic skull base surgery? Curr Opin Otolaryngol Head Neck Surg 2021; 29:44-52. [PMID: 33337610 DOI: 10.1097/moo.0000000000000683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE OF REVIEW The application of robotic surgery to anterior skull base disease has yet to be defined despite the potential for improved tumour resection with less morbidity in this region. Complex anatomy and restricted access have limited the development of robotic anterior skull base surgery. RECENT FINDINGS A limited number of transoral robotic surgical anterior skull base procedures have been undertaken; however, there are significant limitations to the utilization of this technology in the anterior skull base. In this article, the advantages, disadvantages and limitations of robotic anterior skull base surgery are discussed. Currently, the major limitation is the size of the robotic endoscope and of the available instrumentation. Technological advancements that provide promise for the future development of robotic anterior skull base surgery are in development, such as single-port robots, flexible instrument systems and miniaturization and growth of minimally invasive platforms. SUMMARY Although transnasal access to the skull base is not possible with the currently available robotic systems, promising technology does exist and is in development. Robotic anterior skull base surgery promises to provide greater access to skull base disease, improve oncologic results, reduce morbidity and to reduce the ergonomic burden on the surgeon.
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Affiliation(s)
- Raewyn G Campbell
- Faculty of Medicine, Health and Human Sciences, Macquarie University
- Department of Otolaryngology - Head and Neck Surgery, Royal Prince Alfred Hospital
- Rhinology and Skull Base Research Group, St. Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia
| | - Richard J Harvey
- Faculty of Medicine, Health and Human Sciences, Macquarie University
- Rhinology and Skull Base Research Group, St. Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia
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Okuda H, Okamoto J, Takumi Y, Kakehata S, Muragaki Y. The iArmS Robotic Armrest Prolongs Endoscope Lens–Wiping Intervals in Endoscopic Sinus Surgery. Surg Innov 2020; 27:515-522. [DOI: 10.1177/1553350620929864] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. Fouling of the endoscope lens is a major problem in endoscopic sinus surgery (ESS). We examined whether the use of the intelligent arm support system (iArmS), a robotic armrest, could prolong endoscope lens–wiping intervals in ESS and thus allow for continuously clear endoscopic images. Study Design. This study is a prospective, nonrandomized crossover study. Methods. Three surgeons who performed ESS at 2 centers each conducted 3 operations with the iArmS and 3 operations without the iArmS; thus, 18 operations were assessed. To blind the assessments, we performed them prospectively without informing subjects of the endpoints. We recorded the operations and observed the recordings at a later date; endoscope lens–wiping times were noted in seconds to determine the endoscope lens–wiping intervals. Our examination was based on the null hypothesis that endoscope lens–wiping intervals would not differ according to the use or nonuse of the iArmS. Results. The median endoscope lens–wiping intervals with and without using the iArmS were 361 seconds and 135 seconds, respectively. Based on the Wilcoxon rank-sum test, this difference was significant ( P = 0.001); thus, the null hypothesis was rejected. This result indicated that endoscope lens–wiping intervals are greatly prolonged by the use of the iArmS. Conclusion. The iArmS robotic armrest is suitable for ESS, prolongs endoscope lens–wiping intervals, and facilitates obtaining continuous clear endoscopic images.
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Affiliation(s)
- Hideki Okuda
- Social Solutions Business Development Division, DENSO Corporation, Japan
| | - Jun Okamoto
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, Japan
| | - Yutaka Takumi
- Department of Otorhinolaryngology, Shinshu University School of Medicine, Japan
| | - Seiji Kakehata
- Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Japan
| | - Yoshihiro Muragaki
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women’s Medical University, Japan
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Song C, Ma X, Xia X, Chiu PWY, Chong CCN, Li Z. A robotic flexible endoscope with shared autonomy: a study of mockup cholecystectomy. Surg Endosc 2019; 34:2730-2741. [PMID: 31722046 DOI: 10.1007/s00464-019-07241-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/28/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Endoscope is the eye of surgeon in minimally invasive surgery (MIS). Prevailing handheld endoscopes are manually steered, which can cause endoscope-instrument fencing. Robotic endoscopes can reduce the fatigue but could not reduce collisions. Handheld endoscopes with a flexible bending tip can reduce the shaft pivoting and collisions. However, its steering is challenging. In this paper, we present a robotic flexible endoscope with auto-tracking function and compare it with the conventional rigid endoscopes. METHODS A robotic flexible endoscope (RFE) with shared autonomy is developed. The RFE could either track the instruments automatically or be controlled by a foot pedal. A mockup cholecystectomy was designed to evaluate the performance. Five surgeons were invited to perform the mockup cholecystectomy in an abdominal cavity phantom with a manual rigid endoscope (MRE), a robotic rigid endoscope (RRE), and the RFE. Space occupation, time consumption, and questionnaires based on the NASA task load index were adopted to evaluate the performances and compare the three endoscope systems. An ex vivo experiment was conducted to demonstrate the feasibility of using the RFE in a biological tissue environment. RESULTS All surgeons completed the mockup cholecystectomy with the RFE independently. Failure occurred in the cases involving the RRE and the MRE. Inside the body cavity, the space occupied when using the RFE is 17.28% and 23.95% (p < 0.05) of that when using the MRE and the RRE, respectively. Outside the body cavity, the space occupied when using the RFE is 14.60% and 15.53% (p < 0.05) of that by using MRE and RRE. Time consumed in the operations with MRE, RRE, and RFE are 28.3 s, 93.2 s and 34.8 s, respectively. Questionnaires reveal that the performance of the RFE is the best among the three endoscope systems. CONCLUSIONS The RFE provides a wider field of view (FOV) and occupies less space than rigid endoscopes.
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Affiliation(s)
- Chengzhi Song
- Department of Surgery, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR
| | - Xin Ma
- Chow Yuk Ho Technology Centre for Innovative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR
| | - Xianfeng Xia
- Department of Surgery, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR
| | - Philip Wai Yan Chiu
- Department of Surgery, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR
- Chow Yuk Ho Technology Centre for Innovative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR
| | | | - Zheng Li
- Department of Surgery, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR.
- Chow Yuk Ho Technology Centre for Innovative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR.
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9
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Campbell RG. Robotic surgery of the anterior skull base. Int Forum Allergy Rhinol 2019; 9:1508-1514. [DOI: 10.1002/alr.22435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/24/2019] [Accepted: 08/29/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Raewyn G. Campbell
- Department of Otorhinolaryngology, Head and Neck SurgeryRoyal Prince Alfred Hospital Sydney NSW Australia
- Department of Otorhinolaryngology, Head and Neck SurgeryMacquarie University Hospital Sydney NSW Australia
- Department of Otorhinolaryngology, Head and Neck SurgeryThe Chris O'Brien Lifehouse Sydney NSW Australia
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10
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Zhong F, Li P, Shi J, Wang Z, Wu J, Chan JYK, Leung N, Leung I, Tong MCF, Liu YH. Foot-Controlled Robot-Enabled EnDOscope Manipulator (FREEDOM) for Sinus Surgery: Design, Control, and Evaluation. IEEE Trans Biomed Eng 2019; 67:1530-1541. [PMID: 31494541 DOI: 10.1109/tbme.2019.2939557] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Despite successful clinical applications, teleoperated robotic surgical systems face particular limitations in the functional endoscopic sinus surgery (FESS) in terms of incompatible instrument dimensions and robot set-up. The endoscope remains manually handled by an assistant when the surgeon performs bimanual operations. This paper introduces the development of the Foot-controlled Robot-Enabled EnDOscope Manipulator (FREEDOM) designed for FESS. The system features clinical considerations that inform the design for providing reliable and safe endoscope positioning with minimal obstruction to the routine practice. The robot structure is modular and compact to ensure coaxial instrument manipulation through the nostril for manual procedures. To avoid rigid endoscope motions, a new compliant endoscope holder is proposed that passively limits the lens-tissue contact forces under collisions for patient-side protection. To facilitate hands-free endoscope manipulation that imposes minimal distractions to the surgeon, a foot-wearable interface is further designed to relieve the assistant's workload. The foot control method owns a short learning curve (mean 3.4 mins), and leads the task to be more ergonomic and surgeon-centered. Cadaver and clinical studies were both conducted to evaluate the surgical applicability of the FREEDOM to assist endoscope manipulation in FESS. The system was validated to be safe (IEC-60601-1) and easy for set up (mean 3.6 mins), from which the surgeon could perform various three-handed procedures alone in FESS without disrupting the routine practice.
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Kawashima K, Kanno T, Tadano K. Robots in laparoscopic surgery: current and future status. BMC Biomed Eng 2019; 1:12. [PMID: 32903302 PMCID: PMC7422514 DOI: 10.1186/s42490-019-0012-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/25/2019] [Indexed: 02/07/2023] Open
Abstract
In this paper, we focus on robots used for laparoscopic surgery, which is one of the most active areas for research and development of surgical robots. We introduce research and development of laparoscope-holder robots, master-slave robots and hand-held robotic forceps. Then, we discuss future directions for surgical robots. For robot hardware, snake like flexible mechanisms for single-port access surgery (SPA) and NOTES (Natural Orifice Transluminal Endoscopic Surgery) and applications of soft robotics are actively used. On the software side, research such as automation of surgical procedures using machine learning is one of the hot topics.
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12
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Park JO, Kim MR, Park YJ, Kim MS, Sun DI. Transoral endoscopic thyroid surgery using robotic scope holder: Our initial experiences. J Minim Access Surg 2019; 16:235-238. [PMID: 31031326 PMCID: PMC7440021 DOI: 10.4103/jmas.jmas_12_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background : Transoral thyroid surgery represented by the da Vinci system is attracted attention and performed by several institutions. However, the current available da Vinci system still has some limitations to be improved for transoral thyroid surgery including high cost of equipment and expendables, larger diameter scope and instruments and no tactile sensation. It triggered us interest in more easily available robotic scope holder. Soloassist II (AktorMed GmbH, Barbing, Germany) is an active endoscope holder system which is controlled by a joystick. It has total six joints: three joints which are controlled by computer, one is controlled by manual and two act as a gimbal joint following the movement of the main body. Materials and Methods We tried transoral endoscopic thyroidectomy using Soloassist II (AktorMed GmbH, Barbing, Germany) in December 2017 in our hospital. Results We successfully performed four thyroid lobectomies in four patients with Soloassist II. We refined and described surgical procedures in each step using video clips. It provided an excellent vibration-free stable surgical view which enabled fatigue-free work, without shaking or tilting the horizon. The surgeon could perform transoral endoscopic thyroid surgery with only one assistant surgeon. Docking and preparation time for Soloassist was within 10 min in all four patients. The setup and dismantling could be performed parallel to the usual workflow. No complication was reported by any patient. Conclusions : The robotic scope holder (Soloassist II) seems to be safe and feasible equipment for performing transoral endoscopic thyroid surgery. Several possible advantages could be expected with this robotic scope holder.
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Affiliation(s)
- Jun-Ook Park
- Department of Otolaryngology Head and Neck Surgery, College of Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Mi Ra Kim
- Department of Otolaryngology Head and Neck Surgery, College of Medicine, Haeundae Paik Hospital, Inje University of Korea, Busan, South Korea
| | - Yeong Jun Park
- Department of Otolaryngology Head and Neck Surgery, College of Medicine, Haeundae Paik Hospital, Inje University of Korea, Busan, South Korea
| | - Min-Sik Kim
- Department of Otolaryngology Head and Neck Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Dong-Il Sun
- Department of Otolaryngology Head and Neck Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
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Hachem RA, Rangarajan S, Beer-Furlan A, Prevedello D, Ozer E, Carrau RL. The Role of Robotic Surgery in Sinonasal and Ventral Skull Base Malignancy. Otolaryngol Clin North Am 2017; 50:385-395. [PMID: 28314404 DOI: 10.1016/j.otc.2016.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Over the past decade, robotic surgery has gained wide popularity, making a significant impact on multiple surgical specialties. In the head and neck arena, transoral robotic surgery has proven to be safe and associated with acceptable oncological and superior functional outcomes for surgery of the oropharynx, hypopharynx, supraglottis, and glottis; thus, changing the paradigm for the management of tumors in these anatomic locations. Robotic surgery of the ventral skull base is at an early stage of development. In this article reviews the literature discussing the role of robotic surgery in managing sinonasal and ventral skull base malignant lesions.
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Affiliation(s)
- Ralph Abi Hachem
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Starling Loving Hall - Room B221, 320 West 10th Avenue, Columbus, OH 43210, USA
| | - Sanjeet Rangarajan
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Starling Loving Hall - Room B221, 320 West 10th Avenue, Columbus, OH 43210, USA
| | - Andre Beer-Furlan
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Doan Hall 410 West 10th Avenue, Room N1011-A, Columbus, OH 43210, USA
| | - Daniel Prevedello
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Starling Loving Hall - Room B221, 320 West 10th Avenue, Columbus, OH 43210, USA; Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Doan Hall 410 West 10th Avenue, Room N1011-A, Columbus, OH 43210, USA
| | - Enver Ozer
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Starling Loving Hall - Room B221, 320 West 10th Avenue, Columbus, OH 43210, USA
| | - Ricardo L Carrau
- Department of Otolaryngology - Head and Neck Surgery, The Ohio State University Wexner Medical Center, Starling Loving Hall - Room B221, 320 West 10th Avenue, Columbus, OH 43210, USA; Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Doan Hall 410 West 10th Avenue, Room N1011-A, Columbus, OH 43210, USA.
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Rangarajan S, Hachem RA, Ozer E, Beer-Furlan A, Prevedello D, Carrau RL. Robotics in Sinus and Skull Base Surgery. Otolaryngol Clin North Am 2017; 50:633-641. [PMID: 28347482 DOI: 10.1016/j.otc.2017.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Transoral robotic surgery (TORS) has been proven to be safe and to yield acceptable oncological and functional outcomes for surgery of the oropharynx, hypopharynx, supraglottis, and glottis. TORS has been successful at reducing morbidity, improving quality of life, and providing access to areas that previously required mandibulotomy or other more radical approaches in the past. This has changed the paradigm of management of tumors in these anatomic locations. In this article, the authors review the recent literature discussing the role of robotic surgery in managing sinonasal and skull base pathology and discuss its current advantages and limitations.
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Affiliation(s)
- Sanjeet Rangarajan
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Ralph Abi Hachem
- Division of Head and Neck Surgery & Communication Sciences, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Enver Ozer
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Starling Loving Hall, Room B221, 320 West 10th Avenue, Columbus, OH 43210, USA
| | - Andre Beer-Furlan
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
| | - Daniel Prevedello
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Doan Hall 410 West 10th Avenue, Room N1011-A, Columbus, OH 43210, USA
| | - Ricardo L Carrau
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Starling Loving Hall, Room B221, 320 West 10th Avenue, Columbus, OH 43210, USA.
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15
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Lee DY, Baek SK, Jung KY. Solo-Surgeon Retroauricular Approach Endoscopic Thyroidectomy. J Laparoendosc Adv Surg Tech A 2016; 27:63-66. [PMID: 27139938 DOI: 10.1089/lap.2016.0140] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the feasibility and efficacy of solo-surgeon retroauricular thyroidectomy. MATERIALS AND METHODS For solo-surgery, we used an Endoeye Flex Laparo-Thoraco Videoscope (Olympus America, Inc.). A Vitom Karl Storz holding system (Karl Storz GmbH & Co.) composed of several bars connected by a ball-joint system was used for fixation of endoscope. A snake retractor and a brain-spoon retractor were used on the sternocleidomastoid. RESULTS Endoscopic thyroidectomy using the solo-surgeon technique was performed in 10 patients having papillary thyroid carcinoma. The mean patient age was 36.0 ± 11.1 years, and all patients were female. There were no postoperative complications such as vocal cord paralysis and hematoma. When compared with the operating times and volume of drainage of a control group of 100 patients who underwent surgery through the conventional retroauricular approach between May 2013 and December 2015, the operating times and volume of drainage were not significantly different (P = .781 and .541, respectively). CONCLUSION Solo-surgeon retroauricular thyroidectomy is safe and feasible when performed by a surgeon competent in endoscopic thyroidectomy.
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Affiliation(s)
- Doh Young Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Anam Hospital , Seoul, South Korea
| | - Seung-Kuk Baek
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Anam Hospital , Seoul, South Korea
| | - Kwang-Yoon Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Anam Hospital , Seoul, South Korea
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